An English Translation of the Sushruta Samhita, Vol. I: Sutrasthanam — trans. Kaviraj Kunja Lal Bhishagratna (1907)

The deranged humours, checked or subdued in their accumulating stage, fail to exhibit any further or subsequent development, but, if left unremedied, they gain in strength and intensity in the course of their further development. The humours, deranged either singly, or in couples, or in a triple combination as regards one or two of their virtues, push on, follow and blend with humours similarly deranged as regards their qualities and combinative numbers.

The medical treatment in a case, where two or all (three) of the deranged humours are involved, consists in conquering the strongest one in the combination, but so as not to enrage or aggravate the minor or the weaker humours in the group and specially so in a case of Sannipata."

* THl- cuniliinaiinii nfany iwnot ihc IkkIIIv liuiiKiuis wiih the viiiaied hlond niav liki'wisf Uc iiiicrpiL-tL-d in signify a SAnnip^tika (tiihuninuial) conil.iTiaticin.

p. 211

A concourse of deranged humours, affecting and appearing in a particular part of the body, is called a boil or an ulcer (Vrana) which "is derived from the root "Vri" to cover and is so called from the fact of its covering a particular part of the body or from its leaving a cicatrix which remains the whole life-time of the patient.

Thus ends ihe l\vcnl\-Hisl chapter uf the Sulraslh^nam in the Sushnila Samhili which treats of investigation into the nature ol the humours giving rise to an ulcer.

CHAPTER XXII.

Now we shall discuss the chapter, which treats of secretions from boils or ulcers of different types. (Vranasra'va-Vijna'niayamadhya'yam).

A boil or an ulcer has its seat generally in one of the eight following components or principles of the body such as, the bone, the skin, the flesh, the veins, the ligaments, the joints, the viscera and the Marmas (vital parts of the body). A boil or an ulcer of any type may crop up or appear in any one of the above mentioned localities.

A boil or an ulcer, which is confined onl)' to the skin, readily yields to medical treatment, while the remaining types, as well as those, which spontaneoush' suppurate and bursty are hard to cure. A boil or an ulcer usually assumes a shape which is either diffused^ rectangular, spheroidal or triangular ; while those, which are irregular or indefinite in shape, (or have forms other than the preceding ones , should be looked upon as belonging to types which can be cured only with the utmost difficulty. Any Vrana (burst or incised abscess) in a patient, who observes a strict regimen, and who, from the outset, is placed under the medical treatment of an experienced physician (surgeon), will be speedily healed ; while an ulcer, affecting a person ofp. 213 irregular habits and treated by a quack or an ignorant physician, will dcNelop into one of a malignant type, which can be healed only with the greatest difficulty, on account of it becoming aggravated b}' the deranged bodily humours involved therein.

Symptoms of Dushta-Vranas :— Malignant ulcers (Dushta Vranas) are known by the following indications : — They are either too narrow or too widemouthed. They feel either extremely hard or soft to the touch and present either a raised elevated or a depressed aspect. They are of either a black or red, yellow or white colour, and are characterised by extremes of temperature. Exhibiting strange and unusual features, they are checkered with networks of veins, hgaments, etc., and are filled with putrid and sloughing flesh and fetid pus. Indefinite and irregular in shape, they are found to exude a sort of dirty, fetid pus, which runs into fissures and cavities, following an oblique or upward course. They have a cadaverous look and smell and are characterised by extreme pain and burning sensation, attended with swelling, redness, itching and suppuration. Pustules crop up round these ulcers, which largely secrete vitiated blood, and linger unhealed for an inordinate length of time.

These ulcers may be divided into six classes [according as, they are severally caused by the deranged bodily humours fVayu, Pittam and Kapham), or are

214 ^^^ SUSHRUTA SAMHITA. [ Chap. XXli.

due to their concerted action '^Sannip^ta), or to the effects of a blow (traumatic) or to vitiated blood.], and should be medically treated according to the nature of their respective exciting factors.