An English Translation of the Sushruta Samhita, Vol. I: Sutrasthanam — trans. Kaviraj Kunja Lal Bhishagratna (1907)
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The translator’s English as printed (Kunja Lal Bhishagratna). The original-language text is not held; names are romanised as the translator printed them.
A swelling, due to the action of the deranged Pittam, assumes a yellowish hue. It is soft and fluctuates under pressure, and is marl^ed by an accumulation of blood in its body. It swiftly shifts from one part of the body to another, accompanied by a burning, sucking pain. A swelling, brought ^bout through the deranged condition of the Kapham, assumes a grey or whitish colour. The skin becomes glossy and cold, and the swelling very slowl)'- changes its original site, if it shifts at all, accompanied b}- pain and itching. A swelling engendered through the concerted action of the three bodily humours successively manifests the symptoms and assumes the colours respectively peculiar to each of them. The symptoms which mark a swelling due to the action of the vitiated blood are identical with those which are exhibited in a swelling of the Pittaja type with the exception of the blackness of the part (and an increase of heat). A swelling due to an external blow traumatic) manifests symptoms peculiar to'the Pittaja and blood-origined types.
A swelling, which does not 3'ield to internal and external remedies on account of an excessive accumula tion of the deranged local humours, or through +' insufficient or contrary effects of the remedial ame shows sign of suppuration. i can
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Chap. XVII.] SUTRASTHANAM. 157
Now hear me describe the symptoms, which respectively mark an unsuppurated, suppurating or suppurated swelhng. The un suppurated or immature stage continues as long as the skin of the swelling retains its natural hue, marked by a little pain and heat in its inside, and coldness, hardness and a slight elevation of its surface.
The suppurating stage gives rise to a sensation of pricking pain in the affected locality. The swelhng seems as if it is being pricked with needles, or bitten or wandered over by a host of ants, or cut with a knife, or pierced with a spear, or thrashed with a club, or pressed with the hand, or scraped round with fingers, or burnt with a fire or an alkali. The patient complains of a sort of sucking, burning pain in the swelling of a fixed or shifting character. The patient, as if stung by a scorpion, does not find comfort in any place or position. The hue of the local skin is changed and the swelling goes on increasing like an inflated leather bag ; and fever, thirst, a burning sensation and aversion to food etc. gradually supervene.
The suppurated stage is marked by an amelioration of the local pain and a yellowishness of the skin over the swelling, which cracks and seems too big, thus giving pu§ to folds in the integument. The swelling exhibits the uation under pressure and shows perceptible signs large cdinution. Moreover, it yields to pressure and
1^8 THE SUSHRUTA SAMHITA. [ Chap. XVII, reaches its former height when the pressure is removed. The pus or the suppurated matter changes its place, or shifts from one part of the sweUing to another under pressure hke water in a bloated leather bag. The distressing symptoms gradually subside ; the patient again evinces a desire for food, and feels a constant inclination for scratching the affected part which is characterised by a sort of aching pain. Sometimes, as in cases of traumatic swelling or in those brought about by a deranged condition of the Kapham, the suppurating process is restricted to the deeper tissues of the affected part and hence fail to exhibit its characteristic symptoms — a fact which often misleads a physician (surgeon) as regards the true state (lit : — whether suppurated or not) of the accompan3'ing swelling. But the knowledge that a process of suppuration, occurring in the deeper tissues of an affected part, is accompanied by alleviation of the pain and swelling which becomes as compact as a stone and cold to the touch, and the local skin resuming its natural colour, would unquestionably ward off all apprehensions for error of judgment.
Authoritative verses on the subject :— A physician (surgeon) who is fully conversant with the symptoms which are respectively exhibited by (an inflammatory) swelling in its unsuppurated, supT purating and suppurated stages, is alone worthy of the epithet ; the rest are but impostors. Since there canp. 159 be no pain without the intervention of the deranged V^yu ; and no suppuration can set in without the action of the deranged Pittam ; nor pus, without the action of the deranged Kapham ; it is evident that a suppurated swelling is marked b}^ the combined and simultaneous action of the three deranged humours of the body.
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