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

According to Dallana it is due to the action of Vayu and blood.

96 THE SUSIIRUTA SAMHITA. [Chap. XIV.

an excruciating pain in the ulcerated region of the organ is called SonitaLrvudam. The vegetation of a fleshy tumour on the penis (incidental to a blow on the organ to alleviate the pain of inserting the hairs of the Suka insect into its body), is called Mainsairvudam. A suppuration as well as sloughing of the penis attended with different kinds of pain which severally mark the deranged Vayu, Pittam and Kapham is called MatnsapSLka. This type is caused by the concerted action of the deranged Vayu, Pittam and Kapham. 15-18.

The specific symptoms of a Tridoshaja Vidradhi as described before (Chap.ix.) mark the one which affects the penis (owing to an injudicious application of the highly poisonous irritant Suka to the organs) The disease is called Vidradhi. A process of general suppuration and sloughing of the organ marks the type which is produced by the application of a black Suka or one of a variegated coloured insect of the same species. The type is called Tilakailaka, and should be regarded as Tridoshaja one. 19-21.

Prognosis: — Of the above enumerated malignant diseases of the penis, those known as Mansarvuda, Mansapaka, Vidradhi and Tilakalak shoulda be deemed as incurable. 22.

Thus ends the fourteenth Chapter of the Nidana Sthanam in the Sus'ruta Samhita which treats of Nidanam of different types of S'ukadohsa.

CHAPTER XV.

Now we shall discourse on the Nidanam of Bhag"- na.m (fractures and dislocations etc. of bones), i

Various kinds of fracture may be caused from a variety of causes, such as by a fall, pressure, blow, violent jerking or by the bites of ferocious beasts etc. These cases may be grouped under the two main subdivisions such as Sandhi-Muktam (dislocation) and KsLnda-Bhagnam (fracture of a kanda). 2.

Cases of Sandhi-muktam (dislocation) maybe divided into six different types, such as the UtplisJitam, Vis'- lishtam, Vivartitam, AdhaJi-Kshiptam, Ati-ksJiiptam and Tiryak-kshiptam. 3

General features of a dislocation :—

Incapability of extension, flexion, movement, circumduction and rotation (immobility, considered in respect of the natural movements of the joint), of the dislocated limb, which becomes extremely painful and cannot bear the least touch. These are said to be the general symptoms of a dislocation. 4.

Diagnostic symptoms of a dislocation : — In case of a friction of a joint by two articular extremeties (Utplishtam) a swelling is found to appear on either side of the articulation attended with a variety of pain at night. A little swelling accompanied by a constant pain and disordered function of the dislocated joint, marks the case of simple-looseness (Vislishtam) of the articulation ; while pain and unevenness of the joint owing to the displacement of the connected bones distinguish a case of Vivartitam (lateral displacement). An excruciating pain, and looseness of the dislocated

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bone arc the symptoms which characterise a case in which a dislodged bone is seen to drop or hang down from its joint (Adhah-kshiptam). In a case of abnormal projection (Ati-kshiptam\ the dislocated bone is removed away from its joint which becomes extremely painful. A case of oblique dislocation (Tiryak-kshiptam) is marked by the projection or displacement of the bone on one side accompanied by a sort of intolerable pain. 5.

Different kinds of Kanda Bhagnam : — Now we shall describe the Kdnda-Bhagnam (fracture etc.)- Fractures may be divided into twelve different kinds which are known as, Karkatakam, As'vakarnam.Churnitam,Pichchitam,Asthi-chchalitam, Kdndabhagnam, Majjagatam, Atipdtitam, Vakram, Chchinnam, Pdtitam and Sphutitam. 6.

General symptoms of Kanda-bhagnam : — A violent swelling (about the seat of fracture) with throbbings or pulsations, abnormality in the position (of the fractured limb), which cannot bear the least touch, crepitus under pressure, a looseness or dropping of the limb, the presence of a variety of pain and a sense of discomfort in all positions are the indications which generally mark all kinds of fracture (Kanda-bhagnam). 7. Diagnostic symptoms :— The case where a fractured bone, pressed or bent down at its tvvo articular extremities, bulges out at the middle so as to resemble the shape of a knot (Granthi), is called Karkatam. The case where the fractured bone projects upward like the ear of a horse is called As'vakarnam. The fractured bone is found to be shattered into fragments in a case of the Chumitam or comminuted kind which can be detected both by palpation and crepitation. A smashed condition of the fractured bone marks a

Chap, XV.] NIDANA STHANAM. 99