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

Pain and its character :- Now we shall describe all the different kinds of pain, which are experienced in the several types of Vrana (ulcers) described before.

Vartaja pain : — Pains of pricking, piercing, thrashing, cutting, expanding, gnawing, churning, shooting, tingling, burning, breaking, bursting, pinching, uprooting, uplifting, quivering, aching of different types, shifting, stuffing, benumbing, indurating, contracting, and pains of a spasmodic character are usually felt in ulcers. A pain, which comes on or vanishes without any apparent cause, or is varied and shifting 28

2i8 'I'HE SUSHKUTA SAMHITA. f Chap. XXII.

in its character, should be ascribed to the effects of the deranged Vayu.

Pittaja pain : — A sensation of burning is felt in the ulcer accompanied by a sort of sucking pain. A feeling of inhaling heat or vapour, and a burning sensation running through the whole body, should be looked upon as the resultant of the deranged Pittam. At the same time the body seems as if it had been strewn over with bits of glowing charcoal. The heat or (the temperature of the affected locality) shows a steady rise, and a pain like the one incidental to the application of alkaline water (caustic solution is experienced in the ulcer.

Raktaja pain : — The pain and other specific features of an ulcer due to the vitiated condition of the blood are identical with those developed by one of the Pittaja type.

Kaphaja pain : — An ulcer, characterised by numbness, heaviness, coldness, itching and a slight pain in the affected part, and which seems as if it has been plastered over with a paste, and which proves insensible to touch, should be ascribed to the action of the deranged Kapham.

Sannipai:ika pain -.—The symptoms, described under the head of each of the preceding humoural types of ulcer, simultaneously exhibitp. 219 themselves in the one brought about by the concerted action of all the deranged ^ humours 1 Sannipatikam).

Colours of Vranas : — Now we shall decribe the colours assumed by the several types of ulcers. An ulcer, due to the action of the deranged \'ayu, is rough and black, red, or ash- coloured, or is of the colour of a bone, or a pigeon. An ulcer, caused by the action of the deranged blood or Pittam, is coloured either blue, yellow, greenish-brown, black, reddish-tawny or flame-coloured. An ulcer due to the action of the deranged Kapham is white, grey and gloss)'. An ulcer, due to the combined action of the three deranged bodily humours, may assume any colour peculiar to them.

Authoritative verses on the subject : — Not only in the cases of Vrana, but in all (inflammatory) swellings of whatsoever type, the physician should carefully observe the nature of the local pain, and the colour of the epidermis.

Thus ends the t\vcnl_\--second Chaplcr of the SulraslliAnam in llic SushruUi Sanihila which Heats of secretion from different types of ulcers.

CHAPTER XXIII.

Now we shall discuss the chapter which deals with the Prognosis of an ulcer (Kritya'krityaVidhi-madhya'yam).

A boil or an ulcer appearing in a patient who is young, muscular (in frame\ strong, or is possessed of an indomitable courage and fortitude, proves readily amenable to healing measures and applications ; how much more so when one appears in a patient in whom all these four conditions simultaneously obtain.

An ulcer in a young patient is speedily healed owing to the fresh and vigorous vitalizing principles of the body ; whereas the one, which appears in a person of strong and muscular build, finds a speedy and successful termination owing to the inability of the incising instrument to cut deep into the hard and tough muscles of the affected part and to reach down, or in any way destro}" the underl3nng veins and nerves, etc. A strong and vigorous patient can easily endure a considerable amount of burning pain, etc. and does not feel distressed b)' a strict regimen of diet. A man of stupendous endurance and fortitude can sustain the fatigue and worry of even the most painful surgical operation. Accordingly, a boil or an ulcer, appearing in a patient of the above said description, is easily and speedil)' healed ;

p. 221

whereas the one, which affects either an old, emaciated, or timid person or one of small strength and endurance, takes time to heal.

Boils or ulcers, which appear in the regions of the buttocks (Sphik), or about the anus, and the organs of of generation, or on the back, forehead, cheek, or lips, or in the region of the external ears, or on the testes or the abdomen, or in the cavity of the mouth, or about the nape of the neck, or above the clavicles, can be easily healed. Those, that are seated in the eyes, or in the gums, the nostrils or the exterior angle of the e3^e, or in the cavity of the ears, abdomen or the umbilicus, or about any suture of the body, hips, ribs, arm-pits, chest, breasts, sides, or the joints, as well as those, that secrete frothy blood or pus with a gurgling sound, or contain any foreign matter embedded in their inside, are healed only with the greatest difihcult3\