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

An ulcer emitting a sweet smell like that of wine, or fragrant aloe wood (Aguru), clarified-butter, Jati flower, Champaka, sandal, lotus or any celestial flower (Divyagandha), should be regarded as the precursor of death. Similarly, a smell like the one which characterises a dog, horse, mole, crow or a bug, or like the one emitted by dry, putrid meat, or resembling the smell of earth or slime, should be likewise deemed unfavourable or fatal in an ulcer.

A physician should give up a case where an ulcer, though it has assumed a blackish, saffron or Kankustha colour (a sort of mountain earth) through the action of the aggravated Pittam, is divested of the burning, sucking and drawing pain, which is peculiar to that morbiferous diathesis. Similarly, an ulcer, which, though brought about through the action of the deranged Kapham, has become cold, hard and whitish as natural in one of the Kaphaja type, should be given up as soon as it is marked by a burning pain. Likewise an ulcer, due to the action of the deranged V^iyu, and characterised by a blackish hue and a thin secretion, and which is found to invade the vital principles of the body, should be abandoned by a physician, whenever found to be entirely devoid of pain.

An ulcer, which makes a gurgling or groaning sound, or one which is characterised by an extreme burning sensation, oris confined to the skin and the flesh,

Chap. XXVIII. ] SUTRASTHA'NAM. 269

and is marked by the emission of wind with a loud report, is sure to have a fatal termination. Likewise, one, which is characterised by extreme pain, though not otherwise seated about any of the vital parts of the body, or which is cold on the surface, though attended with an extremely burning sensation in its inside and vice versa, should be deemed the precursor of death. Similarly, an ulcer should be regarded as fatal, that is shaped like the barb of a spear, or a Kunta (a kind of barbed dart or spear), or like a banner, chariot, horse, or an elephant, or like a cow, an ox, a temple, or a palace.

A wise physician, witli any regard to his own reputation, should abandon a patient laid up with an ulcer which appears to have been dusted over with a sort of pulverised crust, or who has been suffering from one accompanied by loss of flesh and strength, cough, difficult respiration and aversion to food. An ulcer, which occurring at any of the vital parts of the body secretes a copious quantity of pus and blood, and refuses to be healed even after a course of proper and persistent medical treatment, is sure to have a fatal termination.

Thus ends the twenty-eighth Chapter of the SutrasthSnam in the Sushruta SamhitS, which deals with the favourable and unfavourable prognosis of ulcers.

CHAPTER XXIX.

Now we shall discourse on the Chapter, which treats of favourable or unfavourable prognosis in diseases, as known from messengers, omens and dreams etc. (Viparitarviparita-Duta-ShakunaSvapna- Nidarshaniya-madhyaryam).

IVIctrical Texts:— The favourable or unfavourable termination of a disease may be predicted from the appearance, speech, dress and demeanour of the messenger sent to call in a physician, or from the nature of the asterism and the lunar phase marking the time of his arrival, or from the direction of the wind (Anila) blowing at the time, or from the nature of omens (Shakuna) seen by him on the road, or from the posture, temperament or speech of the physician himself.

A messenger belonging to the same caste as the patient* should be regarded as an auspicious omen, whereas one from a different caste would indicate a fatal or an unfavourable termination of the disease,

A eunuch, a husband of many wives, a messenger where a member of the same community would fall ill ; a householder, in the case of a patient of the same social order ; a BrShmana, in the case of a BrShmana patient, and so on ; while an infringement of the rule would be looked upon as an evil omen.

* A P^shanda messenger should be despatched to call in a physician

Chap. XXIX. ] StJTRAStHANAM. ^fl

sent on a different errand and incidentally calling at a physician's house, or one who has quarrelled on the road, or messengers who come riding on camels, donkeys or in carts, or on foot in one unbroken line, should be looked upon as inauspicious messengers.