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

and of the same colour (white). There is but slight pain and the patient feels an irresistible inclination to scratch the part. It is slow in its progress and suppuration is rare and tardy. A sweet taste is felt in the mouth and the throat and the palate seem as if smeared with a sort of sticky mucous. i<S-2o.

Symptoms of the IVIedaJa Type:—

The swelling is glossy, soft (heavy — D.R) and palecoloured. It emits a fetid smell and is characterised by excessive itching and an absence of pain. It is short at its root and hangs down from the neck in the shape of a pumpkin (Aldvu), gradually gaining its full rotundity at the top. The size of the goitre is proportionate to the growth or loss of flesh of the body. The face of the patient looks as if it has been anointed with oil and a peculiar rumbling sound is constantly heard in the throat. 21.

Prognosis : - A case of goitre attended vvith difficult respiration, a softening of the whole bod}-, weakness, a nonrelish for food, loss of voice as well as the one which is more than of a year's standing should be abandoned by the physician as incurable, 22.

IVIetrical Text : — A pendent swelling whether large or small and occurring about the region of the throat and resembling the scrotum in shape is called a Gala-Ganda. 23.

Thus ends the eleventh Chapter of the Nidana Sthanam in the Snsruta Samhita which treats of the Nidanam of Granlhi, Scrofula, etc.

CHAPTER XII

Now we shall discourse on the Nidanamof Vriddhi (hydrocele, hernia, scrotal tumours etc), Upadatisa. (disease of the genital organ, and ^Ifpada velephantiasis). i .

Classes : -There are seven different types of Vriddhi such as the Vataja, Pittaja, Kaphaja, Raktaja, Medaja, Mutraja and the Antra-vriddhi. Of these both the Mutraja-vriddhi (h\-drocele or extra vagation of the urine), and Antra-vriddhi types, though owing their origin to the deranged condition of the bodily Vayu, have been so named after the organic matters or anatomical parts (urine, iliac colon etc.) involved in them. 2.

Definition and Premonitory symptoms : — Any of the deranged Doshas (Vayu, Pittam. etc i lying in the nether regions of the body may resort to the spermatic cords (Dhamani) and give rise to a swelling and inflammation of Phalacosha (scrotal sac) which is called Vriddhi (scrotal tumour etc.). A pain in the bladder, scrotum, penis and the waist (Kati) incarceration of the Vayu and the swelling of the scrotum, are the premonitory symptoms of the disease. 3 — 4.

The Dosha-origined Types :— The type

in which the scrotum becomes distended with Vayu like an inflated air-drum, marked by roughness of (its surface) and the presence of a varied sort of Vataja pain (in its interior) without any apparent cause is called Vataja Vriddhi. The swollen scrotum, of the Pittaja Vriddhi, assumes the colour of a ripe

8o THE SUSHRUTA SAMHITA. [Ch*p. XII.

Audumvara fruit and is attended with fever, a burning sensation and heat in the affected part. It is of a marked rapid growth and speedy suppuration (of the scrotum). The swollen organ in the Kaphaja Vriddhi becomes hard and cold to the touch accompanied bylittle pain, and itching (in the affected part'. In the Raktaja type the swollen scrotum is covered over with black vesicles, all other symptoms of the type being identical with those of the Pittaja one. In the Medaja type the swollen scrotum looks like a ripe Tdla fruit and becomes soft, glossy and slightly painful. The patient feels a constant inclination to scratch the part. The Mutr.iji- vriddhi (hydrocele) owes its origin to a habit of voluntary retention of urine, its characteristic symptoms being softness and fluctuation on the surface of the swollen scrotum like a skin-bladder filled with water, painful urination, pain in the testes and swelling of the scrotum. 5.

Antra-vriddhi (Inguinal hernia):— The local Vayu enraged and unusually aggravated by lifting a great load, wrestling with a .stronger person, violent physical strain or a fall from a tree and such like physical labour doubles up a part of the small intestine and presses it down into the inguinal regions lying there strangulated in the form of a knot (Granthi) which is known as Antra-vriddhi (inguinal hernia). The part not properly attended to at the outset descends into the scrotum which becomes ultimately elongated and intensely swollen and looks like an inflated air-bladder. It (hernia) ascends upwards under pressure, making a peculiar sound, (gurgling) ; while let free it comes down and again gives rise to the swelling of the scrotum. This disease is called Antra-vriddhi and is incurable. 6.

Chap. XII.] NIDANA STHANAM. Si