English
For both these functions a liquid medium is necessary in which the nutritive substances can be in a soluble state, so that by osmotic pressure, it can per¬ colate through the capillary wall and enter into interstitial space, from which the cells extract their food needs by endosmosis, and by exosmo¬ sis, throw out the metabolic waste products formed in the organic synthesis into the lymph, stream. If any of the waste products be allowed to accumulate, the organism would die out of auto-intoxication. So nutrition comprises various functions. (1) Transmission and transformation of food in the alimentary canal by the digestive enzymes, from insoluble into soluble products so that they become dialyzable: starches are saccharified, albumines are peptonised and fats are partly emulsified 116 ANCIENT HINDU MEDICINE and partly split up into fatty acids and glycerine. ,(2) Absorption of the digested soluble nutrients. (3) Detoxication, synthesis and fixation of the nutrients in the liver, especially the glucose, which is converted into glycogen. (4) Trans¬ portation of the nutrients with the blood-circula¬ tion to every tissue of the body for the food- supply of the cells, the extraction of the food- material from the plasma by the cells, and ejec¬ tion into it of the waste-production of catabolism. (5) Regi’essive metamorphosis and reduction of harmful disassimilative products into harmless substances, chiefly in the liver as the conversion of the nitrogenous end-products into urea, (6) Elimination of the metabolic wastes through the kidneys, lungs and the skin. It has been esti¬ mated that an adult voids daily 250 grams of iarbon and 18 grams of nitrogen. This must be replaced to preserve the equilibrium between the cncome and the expenditure of the bodily energy,, or it will slowly starve to death. Death takes place through starvation, when the body has lost nearly 45 per - cent of its weight. When food is withdrawn," the orga- inism performs its multifarious functional activi¬ ties, as the pulsation of the heart,' ■ metabolism,, respiration, maintenance of the body tempera- PATHOLOGY 117 ture, muscular contraction and excretion of waste products, by consumption of the body fat and protein, sacrificing the less useful to the more useful in the economy. Death is postpon¬ ed if plenty of water is taken, for it maintains the integrity of the circulatory system and aids in the transportation of the metabolic wastes for expulsion from the body. Without suffici¬ ent consumption of w'^ater, the increased viscosity of blood and the retention of the toxic excretory substances hasten death. However, death through absolute starvation is very rare. But death through malnutrition—insufficiency or bad quality of food, especially during famine—is very common, indirectly or directly. Malnutrition weakens the vital resisting power of the organ¬ ism and clears the way for the invasion of epidemics, which is usually the case, or death is slowly preceded by gradual emaciation, anemia, dropsy, cardiac and cerebral disturbances, especi¬ ally delirium. If the aliments are too abundant or of bad quality, the undigested food falls an easy prey to microbes that swarm in the alimentary canal, provoking fermentation and putrefaction, thus causing dyspepsia, lientery auto-intox icationn dlatation and catarrh of the digestive tube. In 118 ANCIENT HINDU MEDICINE the cliildren, it is manifest by gradual emaciation, nervous irritability and erethema of the buttocks, vulva and thighs. But even if it be digested and absorbed, overnutrition is liable, with excess of carbohydrate consumption to engender glycosuria, if it be coupled with hepatic and pancreatic in¬ sufficiency, with excess of protein consumption into peptonuria and albuminuria with heptal insufficiency under certain pathological condi¬ tions. The evil effects of over-nutrition did not escape Charaka. Bor he says : ’Tf any one accustomed to day-sleep and the comforts of bed ( i. e. does not take sufficient exercise ) indulge in excess of oily, sweet and slimy, substances, new rice, new wine, meat, fisb, milk, butter, and cakes, he becomes subject to many diseases. If he does not reduce ( the excessive consumption) of restorative dishes, he will suffer from diabetes ( piximeha = glycosuria and albuminuria), cutaneous irritation ( kaitdu), pain {gouty), eczema ( kotha ), jaundice, fever, leprosy, alimentary diseases, strangury ( mutra- krchchhi'a ), loss of appetite, lassitude ( tan- dra,), impotence, emaciation, lethargy, heaviness of the body, burdening the circulatory system with Avaste products, dullness of sense-impressions, mental cloudiness, drowsiness ( pramllaka ), PATHOLOaT 11^ edema ( sotha ), and other diseases.” Charaka L 23. 1-5*®. II. Mechanical Pathogenesis. Mechanical (Jidhihhaiitika) agents can be the means of causing bodily suffering and death in various ways under different circumstances. If a man falls from a tree, the in jury would depend on the pressure of contact, based on force ( weight, height of the position and the gravitation of the earth, as well as the nature of the ground). Even one can suffer fatal injury, especially to the ner¬ vous system, by the rapid vibration of air, as near the passage of a high-speed projectile, of which there have been numerous victims in the recent war and it is known as ‘shell-shocks’. Whatever may be the injury, it is due to the conflict of power and resistance. When one falls from a tree, he is the body in motion : when a sword or a bullet strikes him, he is the resistance. The injury on the wound depends on their mutualrelation. One might strike another with a sword, lacking force without causing more than a bruise, but the same 55. : 120 ANCIENT HINDU MEDICINE sword can cut him in twain, if struck with vigor. The nature of a wound depends on the instrument and the force with which it is struck. With sharp- pointed intruments as the needle, pin, cannula of hypodermic syringe, sting of certain insects and scorpions, any wound is called the ‘puncture' and puncture is usually harmless. Even the heart can be punctured without any serious consequen¬ ce Neither is the puncture of the nerve serious, unless the vital centres are penetrated which might cause sudden death. A bruise in the soft parts without a break in the skin is called ‘con¬ tused tooimd' which heals very quickly. A clean cut with a sharp instrument is called the ‘'incised wound' and though there is profuse bleeding as long as the incised parts are not tightened togeth¬ er, it heals rapidly usually without infection. Lacerated wounds are those which are inflicted with a blunt instrument or by biting of animals. They generally take a longer time to heal, as it is very hard to keep the torn out tissues in aseptic condition. The seriousness of a gun-shot wound depends on three factors, namely, the point of entrance, the tract and the point of exit. When the bullet has lodged in the tissues of the body, the tract is known as ‘blind'. The wound at the point of entrance is always smaller, due to the PATHOLOGY 121 \ contractibility of tbe tissue than the aperture of the exit, as it is more subjected to pressure and distension and is consequently more or less lace¬ rated whether the tract of the bullet is direct or tortuous. When a bullet lacks a great velocity, it slunts by, if it meets a bone and becomes tor¬ tuous, but if it be driven with a great force, it might drill clear through a bone or cause a frac¬ ture and impart to the fragments sufficient mo¬ mentum to act as glancing missiles and aggravate the lesion. The wounds caused by explosives are more serious, as aside from the mechanical effect, the tremendous sudden increase of press¬ ure and temperature, as well as the liberation of toxic gases cause a very severe nerve shock. In any gun-shot or explosive wound, it is the nerve- shock, that is the serious matter. Otherwise in a simple wound not affecting any vital part in the economy, if there is no introduction of any septic matter, and bleeding can be arrested and suppuration prevented, there need not be any fatal consequence. The physical (kala-vala) agents are many as heat, cold,* air-pressure, sudden seasonal changes, dazzling light, the sun (sun-stoke), sound and electricity. It seems that the human organism can stand cold much easier than heat. Of course 122 ANCIENT HINDU MEDICINE M'itli the rising temperature, metabolism is^ slovA'ed up and the consequence is less oxidation,, which means in other words, less production of heat. And there is vaso-dilatation, and the blood rusliing to the periphery loses part of its heat by radiation in the surrounding atmosphere, and with the evaporation of perspiration, there is not only further loss of heat, but also a noticeably cooling sensation. However, when the evaporation from the skin is not rapid as in humid heat, it is more unpleasant. The dog or the cat whose body is covered Avith hairy coating and can not perspire freely, put out their tongue, execute rapid respiratory movements and thus facilitate evaporation through their gustatory organ. But when due to excessive consumption of alcohol, the vaso-motor mechanism does not react, or due to burn, perspiration is interfered with, or in the close overheated chamber near a furnace or boiler, prostration comes with high feA'er, rapid pulse, stertorous respiration, hot and dry skin and delirium. Perhaps this symptoms-complex is due to the chemical change in the nerves, brought about by excessive heat and hot to the coagulation of myosin as it was supposed before.