An English Translation of the Sushruta Samhita, Vol. II — trans. Kaviraj Kunja Lal Bhishagratna (1911)

appearing laterally or across the region of the abdomen (Jathara) and obstructing the passage of stool, urine and flatus (Vata) is called a Pratyashthila. 75 — y^.

Thus ends the fir=t Chapter of the Niciana Slhanam in the Sujhruta Samhita, which treats of the Nidanam of the diseases of the nervous system.

('llAPTiHJ II.

Now wc sliall discourse on the Nidanam of Ars'aS (Hiemorrhoids'. i.

ll.einorrhoids may be divided into six classes vi:: : — (i) Vdtnjii (due to the action of the deranged Vayu\ (ii) Pittiijn (flue to the action of deranged Pittam), (iii) Kaphaja (due to the action of deranged Kapham), (iv) Raktaja (due to the action of the vitiated blood), (v) Sannipdtaja (due to the concerted action of the deranged Vayu, I'ittani and Kai)hami and (vi) Sahaja (congenital).

Pathology : —The deranged Vayu, Pittam, etc. enraged by their specific aggravating causes, or by such acts or conduct as partaking of food composed cjf incompatible substances, eating before the previous meal has been digested, inordinate sexual intercourse, sitting on the haunches, excessive riding, and the voluntary suppression of any natural urging of the body, cither severally or in combination of two or three Doshas, or vitiating the blood of a person, who observes no moderation in food and drink &c., become dislodged from their natural seats in the body [according to the law of Prasaranam (expansion and change of place by a deranged organic principle)] and arc carried down through the large intestine (Pradhana Dhamani) into the descending colon and getting lodged therein, give rise to growths of polypi or fleshy condylomata, which are known as piles. These growths chiefly appear in persons suffering from impaired digestion (Agni), and gain in size through friction with the wearing apparel, weeds, wood, lumps of clay or stone, or by contact with cold water. 3.

The lower end of the large intestine, which passes into the flexure of the rectum and measures four and

Chap. II ] NIDAXA STHANAM. I9

a half fingers in length, is called the Gudam (lit — the channel of fecal matterj, the interior of which is provided with three spiral grooves. Each of these grooves or ring-like muscles lie a finger and a half apart, and arc respectively known as Pravahini, Visarjani and Samvarani, or the grooves of out-flow, defecation and closure of the anus (sphincter ani), covering a space of four fingers and having lateral!)- an elevation of one finger's width. 4

IVIetrlcal Texts :— These grooves arc like the involuted indentures of a conch shell, situated one above the other, coloured like the palate of an elephant. A part of the channel, half a finger's width in length as it is usuall)- measured from the outer hair\- orifice of the rectum, is called the anus (Gudoushtha). 5 — 6.

The first of the aforesaid grooves or rings lies about a finger's ^^■^dth apart from the orifice of the anus.

Premonitory Symptoms:— A non-relish

for food, a tardy and difficult digestion of food (brought into the stomach), acid eructations, a sense of weakness in the thighs, a rumbling .sound in the intestines, emaciation of the body, frequent eructations, .swellings around the eyes, a croaking sound in the intestines, cutting pain in the rectum (Guda), apparent indications of an attack of phthisis, jaundice, dy.sentery, cough, dy.spnoea, vertigo, somnolence, excessive sleep, weakness of the organs (Indriya), are indications which predict the advent of this disease, and which become more marked M ith its progress. 7.

The Vataja Type :— riles, due to the action of the aggravated Vayu, are non-exuding, rose-coloured, and uneven in their surface. They resemble the Kadamba flowers in structure and are either tubular or sharppointed like a needle, sometimes assuming the shape of

20 THE SUSIIRUTA SAMIIITA. [Chap. II.