An English Translation of the Sushruta Samhita, Vol. II — trans. Kaviraj Kunja Lal Bhishagratna (1911)
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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.
Prognosis : — An abscess appearing on any vital part (Marma) of the organism, whether large or small in size, suppurated or unsuppurated, should be deemed' as extremely hard to cure. Discharge from an abscess formed in the region of the organism above the umbilicus and (spontaneously bursting), will flow out through the mouth whereas similar secretions from down the umbilical region of (the abdomen), naturally find an outlet through the fissure of the anus. The case •in which the secretions (pus etc.) find a downward channel and outlet may end in recovery of the patient, whereas the one in which the secretions take an upward course invariably proves fatal. An incision made by surgeon from the outside into an internal abscess, other than the one situated on the heart, or on the bladder or on the umbilicus may occasionally, prove successful, but the one, seated on any of the preceding vulnerable visceras (heart, bladder etc.) of the body and surgically opened invariably ends in death. 18-19.
A woman, who has miscarried or has been even safely delivered of a child at term, may be afflicted with a dreadful abscess in the event of her taking injudicious and unhwholcsome food after parturition. The abscess in such a case, which is attended with extreme
Chap. IX.] NIDANA STHANAM. 65
hyper-pyrexia (Da hajvara) should be considered as having had its origin to the vitiated blood (Raktaja Vidradhi) accumulated in the organism. The abscess, which appears in the Kukshi (in the iliac region) of a safely delivered woman owing to the presence of the unexpelled blood-clots in those regions after childbirth, should be also diagnosed as a case of Raktaja abscess. The unexpelled blood is called Makkalla. Such an abscess, if not absorbed in the course of a week, is sure to suppurate. 20 - 21.
Differentiating diag^nosis of Gulma and Vidradhi* :— Now I shall discuss the features which distinguish a Gulma (internal tumour; from a Vidradhi (internal abscess). It may be asked, how is it that Gulma, (internal tumour) though caused by, and involving the co-operation of the same deranged Doshas as an internal abscess, does nut suppurate, while the latter (Vidradhi) does run to suppuration ? 22— 23. The answer is that a Gulma (^internal tumour', though caused by the same deranged Doshas as a Vidradhi (internal abscess), does not resort to any deranged organic matter, such as flesh, blood, etc., while, on the contrary, in a case of Vidradhi, the diseased flesh and blood of a locality are in themselves transformed into an abscess. An internal tumour (Gulma) is like a water bubble floating and moving about within a cavity ee THE SUSHRUTA SAMHITA. [Chap. IX.
* A Gulma according !o Sus'nm does not supjniraU', bnl ihc term "Api" (also) contemplates instances in which a Guln.a may suppurate as in the case where it has got its basis in the dernnged flesh etc. of the locality. Charaka asserts that retarded digestion of the ingested food followed by digestionnry acid reaction, colic pain, insomnia with !tver and a non-relish for food and a sense of oppression, etc. are the symptoms which indicate that suppuration has set in a Gulmn, and he advises that it (Gulma) should be treated with poultices, etc.
of the body etc. without any fixed root of its own. Hence, it is that a Gulma (internal tumour) does not suppurate at all. Suppuration sets in in an abscess only because it largely contains flesh and blood unlike a Gulma (internal tumour) which is not formed of any such organic matter, and depends only on the aggravated Doshas giving birth to it. Hence, a Gulma does not suppurate at all. 24.
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