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

sound, or which simultaneously secretes pus and blood through both the channels, should be regarded as belonging to the incurable class. An ulcer in an emaciated patient, which is situated either on the head or in the throat, and which is narrow-mouthed and is tra\ersed by a network of capillaries, and studded with fleshy or papillomatous eruptions, should be regarded as incurable. A distinctly audible sound or report is heard in these ulcers which are found to be charged with wind.

An ulcer in an emaciated patient, which secretes blood and pus, and is attended with indigestion, cough, painful respiration and non-relish for food, as well as a case of fractured skull, attended with cough, dyspnoea, secretion of brain-matter, and symptoms peculiar to the concerted action of the three deranged humours of the body, should be given up as past all remedy.

Authoritative verses on the subject : — A traumatic ulcer, which exudes a secretion of fat, marrow or brain- matter, may prove amenable to medical treatment, whereas a humoural ulcer under the circumstance will prove incurable. •

An ulcer appearing at an}' part of the body other than a vital one (Marma), and which is found to invade its successive elements though without affecting any vein, bone, joint, etc. should be regarded as incurable.

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Just as a tree, that has grown old and that has spread its roots deep into the soil, can not be uprooted, so a disease can not be eradicated that has gained in strength and maturity with the process of time, and that has gradually invaded the different essential principles of the body. A disease, which, having been neglected at the outset, has run on to one of a lingering or persistent type by invading the successive elements of the bod}', and has thereby gained in strength and intensity, baffles medicines, (of tested and marked eflicac)^, just as malignant astral combinations tend to nullify potent incantations.

Symptoms of cleansed Fiealthy

ulcers : — An ulcer, not belonging to any of the above said types, may prove easily amenable to the curative efficacies of medicines. In other words, an ulcer of recent origin is easily uprooted like a tender sapling of recent gi^owth. An ulcer, which is unaffected by any of the three deranged bodily humours, and which assumes a dark brown hue along its edges, and is characterised by the absence of any pain, pustular eruptions or secretions, and which is of an even or of an equal elevation throughout its length, should be regarded as cleansed (asepsised or healthy), and divested of all morbid matter or principle (Shuddha-Vrana).

Symptoms of Healing Ulcers:— An

ulcer, which is dove-coloured (yellowish dusky), and isp. 227 not lardaceous at its base, and is further characterised by the absence of any muco-piirulent secretion along its margin, and which has become hard and surrounded b}' shreds of dead skin, and presents symptoms of healthy granulation, should be looked upon as in course of healing.

Symptoms of Healed Ulcers:— An ulcer, with its edges firmly adhered and characterised by the absence of any pain and swelling and not appearing knotty or glandular to the touch and that has left a cicatrix of the same hue with the surrounding skin, should be considered as perfectly healed.

Causes, such as mental excitements, as excessive grief and ecstacies of joy, anger or fright, as well as an external blow, or excessive physical exercise, or an abnormal excitation of any of the deranged humours, or an impaired digestion, may tend to reopen an ulcer recently adhered and healed. Accordingly such acts and conditions should be avoided by an ulcer-patient.

Thus ends the twenty-third Chapter of the Sutrasth^nam in the Sushruta Samhita, which treats of the prognosis of ulcers.

C H A P i E R XXIV.

Now we shall discourse on the Chapter^ which deals with the classification of diseases according to their specific nature (Vya'dhi-Samudcihcshiyamadhya'yam).

Diseases may be grouped under two broad subdivisions, such as Surgical, and Medical, that is those that yield to the administration of purgatives, emetics, oils, diaphoretics, and unguents.

The use or administration of medicated oils and unguents, etc., is not prohibited in a surgical disease, while a case, which is exclusively medicinal in its character, does not admit of the adoption of any surgical remedy. Onl}^ a general outline of the nature and S3miptoms of all diseases will be found to have been briefly laid down in the present work. This work includes within its scope subject matters which have been fully dealt with in other books (having only a general bearing upon all the several branches of the science of medicine).