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

* Women are generally proof against this disease owing to their delicate constitution and to their being subjected to the monthly discharge of vitiated blood and at the same time to their undergoing no physical exercise, and hence there is little chance of the bodily Pittam being deranged and bringing on this disease.

Chap. XIII.] NIDANA STHANAM. 9I

studded over with thorny papilla of the skin resembling the thorns on the stem of the lotus marked by itching are called Padmini-kantaka. The disease is due to the deranged condition of the Vayu and Kapham. Yatumani (mole) : — The reddish, glossy, circular, and painless, congenital marks CSahajam) or moles on the body not more elevated (than the surrounding skin) are called Yatumani. The disease is due to the deranged condition of the blood and Fittam. 26—33.

IVIasaka (Lichen) : -The hard, painless, black and elevated eruptions on the body (skin) resembling the Masha pulse in shape, caused by the aggravated condition of the bodily Vayu are called Mas'aka Tilakalaka: — The black painless spots on the skin about the size of a sesamum seed and level with the skin are called Tilakalaka. This disease is caused through the aggravated condition of the Vayu, Fittam ana Kapham .-f Nyachcham : — The congenital, painless, circular, white or brown (Sydva) patches on the skin, which arc found to be restricted to a small or comparatively diffused area of the skin, are called Nyachcham. Charmakila (hypertrophy of the skin) : — The causes and symptoms of the disease known as Charmakila have been already described (under the head of the Ars'a-Nidanam). Vyang'a : — The Vdyu being aggravated through wrath and overfatiguing physical exercise, and surcharged with Fittam, and suddenly appearing on the face of a person, causes thin, circular, painless and brown-coloured patches or stains. They are known by the name of Vyanga * 34-38.

* According to certain authorities it is due to the absorption of blood by Vayu and Pitlam.

+ According to others the spot goes by the name of iV//j/iaw, if it is black-coloured and appears anywhere other than on the face.

p. 92

The Parivartika :— The vital Vayu (Vydna) aggravated by such causes as excessive massage (masturbation), pressure, or local trauma, attacks the integuments of the penis (prepuce) which being thus affected by the deranged Vayu forms into a knot-like structure and hangs down from the glans penis. The disease known as Parivartika or Phymosis is due to the action of the deranged Vayu aggravated by any extraneous factor. It is marked by pain and burning sensation; and sometimes suppurates. When the knotty growth becomes hard and is accompanied by itching, then it is caused by the aggravated Kapham. 39.

Avapatika : — When the integuments of the prepuce is abnormally and forcibly turned back by such causes as coition under excitement, with a girl (before menstruation and before the rupture of the h}'men and consequently with a narrow external orifice of the vagina) or masturbation or pressure or a blow on the penis, or a voluntary retention of a flow of semen or forcible opening of the prepuce, the disease is called Avapatika or paraphymosis. Niruddha-prakas'a : — The prepuce affected by the deranged Vayu entirely covers up the glans penis and thus obstructs and covers up the orifice of the urethra. In cases of partial obstruction a thin jet of urine is emitted with a slight pain. In cases of complete closing the emission of urine is stopped without causing any crack or fissure in the glans penis in consequence. The disease is called Xiruddha-prakas'a which is due to the deranged Vayu and is marked by pain (in the glans pcnis\ 39-41.

Niruddhaguda :— The Vayu (Apana) obstructed by the repression of a natural urging towards defecation stuffs the rectum, thus producing constriction of its passage and consequent difficulty of defecaChap. XIII.] NIDAKA STHANAM. 93