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of the hot season : it may be also induced by sun or heat stroke accompanied by enervation, dizziness, cramp, disturbed vision, dry skin, rectal and vesical irritability ; in exposure to 234 ANCIENT HINDU MEDICINE cold and dampness, the surface of the body is suddenly chilled with the lowering of the surface temperature, which causes the contraction of the cutaneous blood-vessels, leading to congestion of the internal organs, chiefly the intestine and viscera, and reflexly irritating the motor and secretory nervous mechanism—thus leading to evacuations ; in sudden change of climate, diarrhoea may be, also, induced as hill or spruce d. ), excessive use of lavage ( mechanical d. ), obstructive (due to carcinoma, tumor, calculi, fecal impaction or obstruction of the passage with the tapeworms as tenia solium Avhich is intro¬ duced with incompletely cooked pork and might grow from 6 to 12 feet, tenia saginata, from incom¬ pletely cooked beef varying in size from 10 to 26 feet, tenia lata from half-cooked fish varying in size from 5 to 25 feet, and tenia nana (dwarf tape) from one-fifth to one and one-fourth inches in length ; diarrhoea is provoked by them either because the formed feces can not pass through the obstructed passage and only watery liquid can ooze through, or due to irritation from the mucosa caused by them ), and by ‘krimis’ [worms uncinariasis or hookworm, ascaris lumbricoides or round worms, oxyuris vermicularis or thread¬ worm, tricuris trichiura or whipworm, trematodes DISEASES 235 or flukeworms and strongyloides intestinalis ; microbes : entamebazer rhizapodes in amebic dysentery, flagellates ormastigophores in flagel¬ late dysentery, ciliates ( balandium coli, infuso¬ ria ) in ciliar dysentery, bacillus dysen terise in bacillary dysentery, spirillum cholera asiatica in cholera, bacillus typhosus in typhoid fevers, gonococcus among the pedestrians with extensive lesion of the anal mucosa, plasmodium in bilious remittent fever ] these causes produce dirrhoea.” Susruta VI. 40. 2*“^. “Slow-moving (fyva = ascai’is). agile (vijava = flagellates), creeping (A:ip^a. = trematodes or flukeworm), stealing uncinariasis or hookworm), knotted-feet (gandu-pada = tenia), thread-like = oxyuris vermieularis or thread-worm)and two mouthed(rft•^w^/t/^ =trichu- ris trichiura or whipworm) are the 'krimV (para¬ sites) of the feces ; they are whitish and minute ; they move in the lower intestine and cause (bor- 107. i sRnfin’uf I ^ <U!i iR gxiici^, a 236 ANCIENT HINDU MEDICINB ing pain ; and among them there are some that have flagella puchoua as in flagellates) and they are hroad. Tliese fecal ^TzriniV (worms and other microbic parasites) bring about colics, dyspepsia, jaundice, intestinal obstruction, weakness, over¬ flowing of the watery discharges, heart lesion and non-formation of the feces.” Susruta VI. 54. 4'®*. “The prodromes of diarrhoea are boring pains in the heart, umbilicus, coccygeal region, abdomen and the groin, lassitude of the body, flatulence, constipation, tympanites and indiges¬ tion.” Suiruta VI. 40. 4’®*, “Abdominal pains, oliguria, sounds in the alimentary canal, prolapsus ani, lassitude of the =5’crT: 1HRi grfRi ^ i 5^*“ : T% II : II ^^cTSff'rectl, 8 I 109. wivrqr!r.5K®f^ai?-5irai^i?rf^i^w: i '3ii'}iRH2tn%qT^ na ?VcW‘f%crt, '3T|<C|n|, o t DISEASISS 2m "roin, thigh and the knee and the evacuation, of mucus-covered frothy) dark-brownish^ hardened scybla in small quantities with gas— these are the symptoms of nervous ( dysenteric) diarrhoea. "Dark-yellowish (in biliary obstruction), greenish (due to the presence of unchanged bili- verdin in the discharges as in acute enteritis), or reddish (tarry stools may be due to cancer or idcer of the intestine or dysentery), unformed, serous (like the juice of pressed meat), foul-smell¬ ing and steamy discharges rush forth in bilious diarrhoea (cholera asiatica) ; in this disease the patient becomes exhausted and becomes over¬ powered by polydipsia, vertigo and hyperemia of the internal organs. ' “ Whitish (rice-AVater, or containing undigested fat) and pasty stool appears noiselessly, mixed with mucus in phlegmatic diarrhoea; in this disease the patient suffers from collapse, somno¬ lence, lassitude and repeated evacuations ; and the patient becomes irritable and there is horripi¬ lation (contraction of the peripheral vessels). ‘‘In the typhoid,fevers, the above mentioned symptoms appear, but the color of the evacuation is varied and the patient suffers from polydipsia; . it is very, hard to cure and the prognosis is especi- 238 ANCIENT HINDU MEDICINE ally unfavorable for tbe infants and for tbe aged.” Suiruta VI. 40. 5-8*^®. "If in cholera asiatica {visucMka) and tym- phenites (alasaha), the teeth (the gum), lips and nails become cyanotic, there is a comatose state, active vomiting, orbits of the eyes are sunk in the sockets, the voice becomes weak and the 110 . f<ffirFf wtfi m j?}: I BP?’ ^^ u fpsrg^t sFtT? s^rn; i is^Pt’ ?rait'?BTwi: H5 S' I DISEASES 239 joints become relaxed, then the prognosis is very unfavorable.” BrnrutaYl. 56. 8“' . “In acute diarrhoea, if the feces is formed or shows symptoms of being formed, and the vitali¬ ty of the patient is not very low, there has not been much emaciation of flesh nor blood much thinned, appetite and digestion have returned, then the patient can be cured with difficulty. But if the patient has the following symptoms, notwithstanding the above-mentioned presenta¬ tions, he is to be regarded as incui’able. Incur¬ able symptoms are being mentioned : if the stool has the color of concoction (dark-brownish), redd¬ ish, like that of the spleen and fat ; or is (in con¬ sistency ) like water in which meat has been washed, curdled milk (semi-fluid), clarified but¬ ter, bone-marrow, oil, butter, milk, condensed milk, or deep bluish (with the development of indican in pronounced putrefaction), reddish, blackish (in bilious remittent or black- water fever ), or transparent like water or the brownish-black color of the banana flowering- stem (clay or chocolate color stool appears in 111. v: i 240 ANCIENT HINDU MEDICINE absence in urdbiliti, that is in the deficiency of the biliary secretion in the intestine ), very fatty, pale-greenish or dark-greenish (due to unchanged biliverdin ), or multi-coloredor is turbid, lubricous or mixed with thread-like substance ( oxyuris vermiculaHs or thread¬ worms), mucus or like the ocellate spots on the tail-feather of a peacock (flakes); the odor is like that of a decomposed corpse (cadaverous), putrid, pyogenous or like raw fish (fishy) ; if the feces attracts quickly the flies, or various viscid sub¬ stances are observed in it (the stool may contain undigested food, blood, mucus, pus, membranes,, fat ; calculi from the gall-bladder, intestines, sto¬ mach, salivary glands ; intestinal parasites, exfo¬ liated polypi and nerotic sloughs), or the discharge contains very little feces (a normal stool should have hard but flexible consistency, golden-brown¬ ish in color, cylindrical in form, nearly an inch in diameter, three to four inches in length ; but if it is of small calibre, it is indicative of prolapr sus ani or an annular stricture of the rectum ribbon-shaped or flattened stool of stricture or cancer of the rectum ; roundish masses of hard¬ ened feces (scybala) may shoot out in dysentery or is indicative of the gastric ulcer, gastric dila¬ tation, cancer of the rectum or chronic coiistipa- DISEASES 241 tion) or is free from it (serous) and the patient suffers from polydipsia, hyperemia of the intern¬ al colics or its insensibility to pain ; if there is anal fistula or ulceration, or hemorrhage of the pile or the pile does not go back to its own place, sti'icture of the anus, emaciation of the body, thinning of the blood (anemia due to the reduction of the red corpuscles), pain in the lumbar region, anorexia, morbid delirium and ooraa, or the diarrhoea suddenly ceases, that patient is to be regarded as incurable.” Charaica VI. 19. 11““. "In the first stage sf diarrhoea, fasting is bene¬ ficial. After fasting, for relief from diarrhoea barley water should be given with (astringent) concoction ( paohana ). If patient still suffers ctrsswTgT fq^JTrr i ^5^- 16 213 ANCIENT HINDU MEDICINE from colics and flatulence, give him an emetic i with piper longum (which is carminative) and I ' rock salt, dissolved in water. After vomiting j light food can be given, ^barley water and piper | longum. But if this does not relieve diarrhoea then everv morning a concoction of turmerics {curcuma longum) or sweet flag {aconm ealamum) should be given to drink.” Susmta VI. 40.16^*^. “In morbid diarrhoea (dysentery) and stran¬ gury, a (rectal) enema (as^i=clyster) of con¬ coction of liquorice root (glgcgm'hiza glabra^ and blue lotus ( nyphaea cacriilea) mixed with milk, clarified butter and honey (for irrigation) should be given ; hemorrhagia proctica, aesus and fever are also relieved by this enema; If there is bloody stool an oily enema of soothing ' and honeyed herbs should be given daily either- 113. <53 I fet; x ggj % i ifeilg ^ ftt<f nTct: g gpR: iu< g^gg'fetTi H !■ DISKASBS at day or at niglit. An oily enema relieves the nervous irritation wliere it is administered ;and if the nerves are subdued, tiie dysentery is also cured.” VI. 40 . 90 ”*. > I llectal irrigation with sootliing oil or steri¬ lizing medical solution or their combined jemul- sion is certainly one of the best means known to combat pernicious, ulcerated and resistant diarrhoea and is very effectively utilized in ;ad- A'anced modern treatment.