An English Translation of the Sushruta Samhita (Bhishagratna ed.)

* Brahmadeva comprising Garddavika^ Irvellika, Gandhapidikd and Tilakdlaka in the list reads it as consisting of thirty-four different species. Jejjata does not hold the four forms of disease commencing with Gardda- vika, etc, as inchided within the list. Gaydd^sa, finding them included in all the recensions reads Garddabhikd, etc. as included within -the list of Kshudra Roga, and Pama etc. as included within the list of Kshudra Kushtham.

t They afflict certain infants— Dallana.

86 THE SUSHRUTA SAMHITA. CCh»p. XIII.

which are shaped like the barley-corns, extremely hard, thick at the middle, knotty and affect (lit— confined to) the flesh are called Yavaprakshya. They are due to the action of the deranged Vayu and Kapham. Andhail ji : — The dense, raised, slender-topped eruptions which appear in circular patches and exude a slight pus are called Andhdlaji. They are due to the action of the deranged Vdyu and Kapham. VivritSfc: — Pustules or eruptions, which are coloured like a ripe fig. fruit and are flat-topped and appear in circular patches with an intolerable burning sensation, are called Vivrita They are due to the action of the deranged Pittam. 3 - 6.

Kachchapika :— A group of five or six hard,
elevated, nodular eruptions (Granthis), arranged in the
shape of a tortoise (which may appear on the sur-
face of any part of the body), are called Kachchapikd.
They are due to the action of the deranged Kapham
and V4yu. Valmika : —The knotty undurated erup-
tions (Granthis) which gradually appear on the soles,
palms, joints, neck and on the regions above clavicles
and resemble an ant-hill in shape, slowly gaining in size
are called Valmika Ulcers attended with pricking
pain, burning, itching sensations and exuding mucopu-
rulent discharges appear around the aforesaid eruptions
(Granthis). The disease is due to the action of the
deranged Kapham, Pittam and Viyu. 7 — 8.

Indravriddhst : -Pimples or eruptions ^Pidakd) arising (on the surface of the body), arranged in the same circular array as marks the distribution of the seed (sacks) in a lotus flower are called Indravriddha' by the physicians. The disease is caused by the action of the deranged Vdyu and Pittam. Pauasika : — Eruptions (Pidakd) of a sort of extremely painful pustules all over the back or the ears which resemble the

Chap. XIII.] NIDANA STHANAM. 87

Kumuda bulb in shape, are called Panasikat. They are due to the action of the deranged Kapham and Wkyu. i: a^sha^na-Garddabha :— A slightly painful and non-shifting hard swelling, which appears on the joint of the jawbones, (Hanu-sandhi, is called Pashdna- Garddabha. The disease is the effect of the deranged Kapham and Vdyu. Jaila-Garddabha : — A thin and superficial swelling, which like erysipelas is of a shifting or progressive character and is further attended with fever and a burning sensation and which is but rarely found to suppurate, is called Jdla-Garddabha* The disease results from the deranged Pittam. Kakshai • — The disease characterised by the eruptions of black and painful vesicles i^ShphotaJ on the back, sides, and on the region about the arm-pits, is called Kaksha. The disease is likewise attributed to the action of the aggravated Pittam, Vishphotaka — The disease in which eruptions of burnlike vesicles (Shphota) crop up on the whole surface of the body, or on that of any particular locality, attended with fever, is called Vish- photaka. The disease is the effect of vitiated blood and Pittam. 9 — 14.

Agni-Rohinif ;— Vesicles (Shphota) having the appearance of burns and cropping up about the waist

* The circular raised spots studded with vesicles are called Gardda- bhil. They are reddish and painful and produced by the action of Vayu and Pittam. Gayadasa reads it so.

t Dallana quotes from another Tantram that the morbific principles in men, aggravated through the action of the enraged and augmented Pittam and blood, give rise to vesicles (blisters) like red-hot charcoal by breaking open the flesh at the waist, attended with txtreme pain, high fever and an insufferable: burning sensation which,if not properly remedied, bring on dtath wiihin a fortnight, or ten days of their first appearance. These (vesicles) are called Vahni- Rohini. And again from another work he cites that a case of Vahm-Rohini due to the aciipn of the deranged

88 THE SUSHRUTA SAMHITA. [Chap. XIII.

(Kakshd) by bursting the local flesh, and which
is attended with fever and a sensation as if a blazing
fire is burning in the inside (of the affected part), are
called Agni-Rohini. The disease is caused by the
concerted action of the three deranged Doshas (Vayu,
Pittam and Kapham). It is incurable and ends in the
death of the patient either on the seventh*, tenth or
fifteenth day (of its first appearance). 15.

Chippam : — The deranged Vdyu and Pittam vitiating the flesh of the finger-nails, give rise to a disease which is characterised by pain, burning and suppuration. The disease called Chippam, is also denominated Upanakha and Kshataroga. Kuna- kham : — The nails of fingers becoming rough, dry, black, and injured through the action of the Doshas enraged through the effect of a blow, are called Kunakha (bad nails). It is also called Kulinam. Anusayi : — A small swelling (on the surface of the body) which is of the same colour (as the surrounding skin), but is deep-seated, and suppurates in its deeper strata, is called Anusayi by the physicians. The disease is the effect of the deranged Kapham. Vida(rika( :— A round reddish swelling rising either on the auxiliary or inguinal regions in the shape of a gourd ( Viddrikandd) is known as Viddrika. The disease is due to the concerted action of the deranged Vayu, Pittam and Kapham and is characterised by symptoms peculiar to each of them. 16—19,

Kapham proves fatal within » fortnight, that due to the deranged Pittam, within ten days, and that due to the deranged Vayu, within a week.

* The patient dies on the seventh day in a case of disease marked by the dominant Vayu, on the tenth day in a case marked by the dominant Pittam and on the fifteenth day in a case of dominant deranged Kapham.

Chap. XIII.] NIDANA STHANAM. 89

^arkararbudam :— The deranged Vayu and Kapham having recourse to and affecting the flesh, veins (S'ira), ligaments (Snayu) and fat give rise to a sort of cyst (Granthi) which when it bursts exudes a copious secretion in its nature somewhat like honey, clarified butter or Vasa. The aforesaid V^yu, when aggravated through excessive secretion, dries and gathers the flesh up again in the shape of (a large number of) gravel-like concretions (Sarkara) known accordingly as Sarkardrbu- dam. A fetid secretion of varied colour is secreted from the veins (Sira) in these Granthis which are sometimes found to bleed suddenly. The three varieties of the skin disease called Psbinat (Eczema), Vicharchikai (Psoriasis) and Rakasat have already been discussed under the head of Kushtham (Chapter. V.). 20-21.

Padadarika :— The soles and feet of a person
of extremely pedestrian habits become dry (and lose
their natural serous moisture). The local Vayu thus
aggravated gives rise to peculiar painful cracks
(Dari in the affected parts) which are called Pada-
darika. Kadara : — The knotty (Granthi), a painful,
hard growth raised at the middle or sunk at the sides,
which exudes a secretion and resembles an Indian
plum (Kola— in shape), and appearing at the soles
(palms according to — Bhoja) of a person as an outcome
of the vitiated condition of the local blood and fat
produced by the deranged Doshas incidental to the
pricking of a thorn etc. or of gravel is called a Kadara
(corns). Alasa : — An affection, caused by contact of
poisonous mire and appearing between the toes, which
is characterised by pains, burningj« itching and exuda-
tion, is called Alasa. 22 — 25.

Indralupta:--The deranged Vayu and Pittam having recourse to the roots of the hairs bring about their

^O THE SUSHRUtA SAMHITA. [Chap. XIll.

gradual falling off, while the deranged blood and Kapham of the locality fill up those pores or holes, thus barring their fresh growth and recrudescence. The disease is called Indralupta,* Rujya or Khailitya (Alo- pecia). Dairunaka: — The disease in which the hairy parts of the body (roots of hairs) become hard, dry and characterised by an itching sensation is called Daru- naka. The disease is due to the action of the deranged Kapham and Vdyu. Arunshikat : — Ulcers (A runshi) at- tended with mucopurulent discharges and furnished with a number of mouths or outlets and appearing on the scalps of men as the result of the action of local parasites and of the deranged blood and Kapham (of the locality) are called Arunshika. Palitam : — The heat and Pittam of the body having recourse to the region of the head owing to overwork, fatigue, and ex- cessive grief or anger, tend to make the hair prema- turely grey, and such silvering of the hair (before the natural period of senile decay) is called Palitam. Masuriksi (variola) : — The yellow or copper-coloured pustules or eruptions attended with pain, fever and burn- ing and appearing all over the body, on (the skin of) the face and inside the cavity of the mouth, are called Masurikd. Yauvana-pidakat— (Mukhadushikai) :~The pimples like the thorns of a Salmali tree, which arefound on the face of young men through the deranged condition of the blood, Vdyu and Kapham, are called Yauvana- pidaki or pimples of youth. Padmini-Kantaka : — The circular, greyish patches or rash-like eruptions

* 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 Vdyu and Kapham. Yatu-
mani (mole) : — The reddish, glossy, circular, and pain-
less, congenital marks (Sahajam) 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 Pittam. 26—33.

IVIasaka (Lichen) : —The hard, painless,
black and elevated eruptions on the body (skin) re-
sembling the Mdsha 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, Pittam and Kapham .f Nyachcham: — The
congenital, painless, circular, white or brown (Sydva)
patches on the skin, which are 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). Vyanga : —
The Vayu being aggravated through wrath and over-
fatiguing physical exercise, and surcharged with Pittam,
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 Pittam.

+ According to others the spot goes by the name of Nilikam^ if it is black-coloured and appears anywhere other than on the face*

92 THE SUSHRUTA SAMHITA. [Chap. XIII.

The Parivartika :— The vital Vayu (Vydna)
aggravated by such causes as excessive massage (mastur-
bation), 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 some-
times 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 hymen and
consequently with a narrow external orifice of the vagina)
or masturbation or pressure or a blow on the penis,
or a voluntary retention o{ a flow of semen or forcible
opening of the prepuce, the disease is called Avapdtikd
or paraphymosis. Niruddha-prakatsa :— -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 Niruddha-prakds a
which is due to the deranged Vayu and is marked by
pain (in the glans penis\ 39-41.

Niruddhaguda :-The Vayu (Apana) obstruct-
ed by the repression of a natural urging towards de-
fecation stuffs the rectum, thus producing constriction
of its passage and consequent difficulty of defeca-