English
(5) The animal pyogenic- parasites are the amcebas of dysentery which not only pi’ovoke ulcerations of the intestinal mucous membrane, but also abscesses in the liver, and the syphilitic spirocheta which may cause gumma and its ulceration. Gangrene is the morbid process charcterized by the mortification {necrobi~ osis) and the putrefaction of the tissues. The microbes causing gangrene act upon the altered tissues by interrupted circulation, by humoral changes or by the interference of the arterial circulation, especially in the extremities exactly as they would act upon the tissues of the cadavers. But between gangrene and the cadaveric putre¬ faction, thei’e is this difference, that in the gangrene, the affected parts are still the seat of certain biotic reactions, as all the cells are not equally attacked by the bacteria and quite a few survive ; and moreover, there is partial influx of serum, lymph, venous blood and blood pigments and the bacteria attacking the exudate produce new fermentations therein. “The ingestion of heavy, unsuitable, dry, rotten, or disharmonious combinations of foods. DISEASES 343 venery, excessive exertion (fatigue), retention of the feces and the urine, and inflammatory beverage provoke bulbous abscess like an ant¬ hill, either by particular lesion or by their combined effects. In the anus, neck of the- bladder, abdomen, axilla and the groin ( bubo-Sin inflammatory swelling of the lymphatic gland, usually leading to suppuration), kidneys (vrkka), spleen, liver and the lung abscesses are formed with the symptoms of superficial abscesses furuncles or boils Y’ Susruta II. 9.13-14”®. “In abortion or injurious delivery, a woman suffers with fever ‘hyperjemia’ from dangerous blood-abscess {ralda-vidradhi = septico-pyemia : if the entire organism is invaded by bacteria which are usually introduced through the septic handling of the genital puerperal wounds, it is 150 . 3^ JJTwit su ANCIENT HINDU MEDICINE called septicemia ; but if the purulent foci are developed as the abscesses in the liver, kidney, lungs, heart etc. which are known, as meta¬ static abscesses, it is called pyemia. In the transitory stage of both these morbid processes, it is often called septico-pyemia. However septicemia and pyemia are both usually attended by fever, diarrhoea and other symptoms of malaise according to the virulence of the infec¬ tion and the bodily reaction)”, Susruta II. 9. “If any one neglects a suppurated abscess, it burrows through to an interior organ, and as it proceeds like a tube, it is called ‘nadl-vrana’ (fistula)'abscess),*’ Susruta II. 10.9^'*. 151 . 152 . snir' I ^ TRU 5 gift ii ^ DISEASES 345 “When a rounded and knotted swelling is developed by the corruption of the *vata, flesh, blood, serous fiuid and the fat\ it is called ‘granthV ipyst). In the ^'cata-granthi (aneurism), pains are felt with the sensation that the cyst is being elongated by a gravitating force (expulsive pain), that it is being torn (terebrant p.), that it is being penetrated by needles (boring p.), as if dashed out ( tensive p.), as if being lancinated (lancinating p. ) or lacerated (lacerating pain ); it is dark and shaped like the bladder, and if it bursts, pure blood comes out of it ( aneurism is a blood-containing cyst formed by circumscribed enlargement of an artery, through which the blood circulates. Such cysts are distinguished by their expansive pulsation with eacli systole of the heart, by a thrill to be felt on pulpation and by a ^hridV heard on auscultation. As they increase in size, they produce absorption of adjacent structures and give rise to distressing pain by their pressure on nerves, and their final tendency is to burst, and if a large artery is the seat of the cyst, to cause death ). In *pitla-granthi’ ( hemangioma ), there is hyperemia, and the pain seems to be like that ■of the application of caustics and cautery : the 346 ANCIE^^X HINDU MEDICINE cyst is of reddish or dark-yellowish color, and if it hursts, rery hot blood comes out ( hemangioma is a blood swelling or cyst due to the dilatation of the blood vessels ). The 'Kapha granthis’ (tubercles) ace cold, pale, slightly painful and are hard like stone, and take a long time for their growth (suppuration) when they burst, a thick whitish pus comes out of them ) ; tubercles are ealled cold abscesses or they ai’ouse no local or general reaction. Tubercles appear under three different aspects; gray granulation, Laenneck’s tubercle and caseous mass. Gray granulation is a small, hard and non-nuclear nodule, surrounded by a reddish vascular zone and their dimensions vary from 0.5 millimeter to 2 or 3 millimeters. Laenneck’s tubercle is more voluminous ; it is a round, gray or yellow mass, having the volume of a pea, a hazelnut or a walnut. The caseous masses are greenish-yellow deposits and look like Roque¬ fort cheese. The tubercular abscess may also arise from the breaking down of a tubercular lymphatic vessel ). The 'Meda-granthV (lipoma) is bright, volumi¬ nous, slightly painful, but pruritic; it grows with the adiposity of the body, and declines with its decrease : if it bursts, fat like that of the- DISEASES 347 kernel of the sesame or like clarified butter comes out ( lipoma is a tumor of the fatty tissue, and grows in the subcutaneous tissues, especi-’ ally in parts subjected to pressure—the shoul¬ ders and the buttocks, the abdominal wall and the breast, though it may be present in tissues containing very little fat as the dura matter, submucous tissue of the intestine, as a single or multiple flattened, rounded or pendiculated growth. When large it is always lobulated. The yellowish tissue of the lobules is usually softer and more plastic than the ordinary fatty tissne ). The *§ir a-granfhi* (cirsoid aneurism) is developed by the derangement of ^vayu’ in a weak person* through wrestling which causes arterial disten¬ sion, distortion or contortion and elevates them ( the arteries) like lotus stems, and makes of them roundish tumors ; if these tumors are pain¬ ful and temporary, they can be cured witli difficulty, but if they are painless, permanent,, voluminous or developed in the vital organs, they are incurable ( cirsoid aneurism is a tumor¬ like collection of dilated and elongated arteries. In the majority of cases, aneurisms are due to weakening of the arterial walls by arteriosclero¬ sis. If the latter is diffuse, the dilatation 548 ANCIENT HINDU MEDICINE is generally fusiform and irregular ; if circum¬ scribed, the yielding is succular. Of the causes of the sclerotic changes, syphilis is the most important in producing aneurism. Prolonged high arterial tension as in laborious muscular work, cardiac hypertrophy, a great and sudden strain as in heavy lifting, violent coughing or -straining may initiate the dilatation if, the coats are weakened by previous disease ). At the maxillary, clavicular, axillary.humero- ulnar (and radial, i. e. elbow), scapulo-clavi- cular ( back-neck ), and hyoid-thyroid-cartila- ginous ( front neck ) joints, due to the accumu- tion of fat, a solid and rounded tumor ( exosto- ■SIS or osteoma ) or causes slightly painful fatty and serous inflammation ; if the tumor resembles the stone of myrobalan or the fish-roe, or any such similar substance and has the color of the skin, it is called ‘apacM (exostosis ) because of its swelling. Exostosis is pruritic and slightly painful ; some of them (exostosises) exudate when torn ( or incised ). It lasts for a long time, its nodules being destroyed and renewed. ' This disease . develops from ‘fat and kapha’ and is vei-y hard to cure ( osteomas and osteomatoid conditions, in which there is loca¬ lized or general overgrowth of the bone, are of DISEASES 34 & common occurrence. Both groups are found chiefly at the point of junction of a bone and its cartilage, fascim, periosteum, tendons and the ligaments, in the pia matter and the dura matter in the choroid and sclerotic coats of the eye at the apex of the lungs, in the sldn and the mucous membrane, and sometimes even in the penis and in muscular tissues. They are usually divided into two groups, the exostosis, or those growing fi’om the surface of the bone, and enostoses or those growing within the bone.. And again they may be divided according to their structure, into eburnated exostosis intense¬ ly hard like that of tlie cement of the tooth and spongy or cauliflower exostosis ). Due to some lesion, the tissues become affect¬ ed, and a rounded, solid neoplasm slightly painful, voluminous, and deep-seated but with slender base, grows without suppuration ; it is called aromida ( tumor, neoplasm or cancer). Due to contraction of the blood-vessels and the blood, owing to a papilliferous, slightly ulcerative and exudative meat-ball {neoplasm) is ferm which, grows rapidly ane causes inces¬ sant bleeding. Thisiscalled‘raA:^-are5;i<d’ {papil¬ loma). Due to the complications ( sequels) arising from the loss of blood, the papilloma 350 ANCIENT HINDU MEDICINB victim becomes anemic. It is an incurable disease ('papilloma is any abnormal excrescence having a villous structure, but more properly a tumor of the skin or of the mucous membrane, either sessile or pedunculated, consisting of hypertrophied or new-formed papillm, covered by an envelope of the epithelial cells separately on each papillte, so as to produce a villous or filiform appearance. Papilloma is usually benign but if neglected, it may form the starting point or be converted into benignant ^epithelioma'.