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

As five mixed colours such as grey, brown, Kapila (bluish yellow), Kapota (blackish grey), Mechaka (light-green) may be produced by combination of the five primary colours in definite proportions (such as white, green, black, yellow and red), so a diversity of causes, through the relative preponderance of the particular kinds of food, and of the deranged Doshas, root principles (Dhatu) and excretions of the body (Mala), may be attributed to the origin of Prameha. 35.

IVIemorial verses :— All types of Prameha, not properly treated and attended to at the outset, may ultimately develop into those of Madhumeha types, which are incurable. 36

For English equivalents of the different types of Prameha compare : — Cystitis (Acute Infective) — Frequent, painful micturition, small quantity of urine voided with pain and urgency. Urine — slightly acid or alkaline in reaction, cloudy, containing blood corpuscles. Cystitis (Chronic Infective) — Great and frequent pain, in the lumbar region, rigor. Urine — thick, offensive and alkaline, containing ropy mucous and blood. Cystitis (NonInfective) — Symptoms like those of acute inflammatory type. Urineacid and cloudy with mucous. Blood is generally present in considerable quantity. Neuralgia of the bladder, compare Albuminuria, Albumosuria, Hoemoglobinuria, Hcematuria, Peptonuria, Pyuria, Spermatorrhoea and Diabetes, Proteuria and Polyuria.

Thus ends the sixth Chapter of the Nidana Sthanam in the Sushruta Samhita, which treats of the Nidanam of Prameha.

CHAPTER YII.

Now wc shall discourse on the Nidanam of Udara

(dropsy with an abnormal condition of the abdomen), i.

IVIctrical Text : — The royal sage Dhanvantari, the foremost of all pious men who equalled in splendour and glory the lord of the celestials, thus blissfully discoursed on the Nidanam of Udara to Sus'ruta, the son of the holy Vis'vamitra, who devoutly approached him for that purpose. 2.

Classification : — This disease may be divided into eight different types, of which four are produced by the several actions of the three deranged Doshas of the body and their concerted action as well. Of the remaining types, two being known as Plihodara (including Yakritodara), and Vaddha-Gudodara (tympanites due to the constriction of the anus), the seventh Agantuka (traumatic or of extraneous origin), and the eighth Dakodara (Ascites proper). 3.

Predisposing Causes :— The deranged

Doshas of a person of extremely impaired digestion, addicted to the habit of taking unwholesome food, or of eating dry, putrid food, or of violating the rules of conduct to be observed in connection with oleaginous measures etc.,* are aggravated and find lodgment in the abdomen. Thus appearing in the shape of an abdomi-

, nal tumour (Gulma), they give rise to this dreadful disease, attended with all its characteristic symptoms. The lymph chyle formed out of the assimilated food gets vitiated,

•and, impelled by the aggravated Vayu, it percolates

* These include purgative, emitic, A'stha'panam and Anuva'sanatu mesisures.

Chtp. VII.] NIDANA STHANAM. 5'r:

through the peritoneum in the same manner as a quantity of oil or clarified butter kept in a new earthen pot willtransude through the pores of its sides. It thus gradually distends the skin (Tvak) of the abdomen. The process becomes general all through the abdominal region and" the disease (Udara) is produced in consequence. 4—5.

Premonitory sypmtoms :— The precursory

S}'mptoms of the disease are loss of strength, complexion and appetite, emaciation of the muscles of the abdomen, appearance of veins on its surface, acid reaction of food closely following upon its digestion (Vidaha\ pain in the bladder, and swelling of the lower extremities. The patient cannot ascertain whether his meal has been digested or not. 6.

The Vataja, Pittaja, and Kaphaja

Types : — -A case of Udara in which the abdomen enlarges on its sides and posterior part, and is overspread with nets of black veins should be ascribed to the action of the deranged Vayu. A pain (Sula), suppression of the stool and urine (Anaha) and a cutting and piercinopain and flatulent rumbling in the intestines are the symptoms which likewise characterise this Va'taja form of Udara. A sucking pain in the abdomen, thirst, fever with a burning sensation, yellow colour of the swollen skin of the abdomen, on the surface of which yellow veins appear, yellow colour of the eyes, nails, face, stool and urine and the rapid increase of the dropsical swelling, are the characteristics of the Pittaja Udara. In a case of Kaphaja type the dropsical swelling is cold to the touch and becomes overspread with white-coloured veins. The abdomen seems heavy , hard, glossy and is extremely distended. The swelling slowly increases, -and the fingernails and face of the patient become white, and he complains of a general lassitude, y—.g. \

52 THE SUSHRUTA SAMlliTA. IChap. VII.