English
In '‘pitta-vrddhV ( epididymo-orchitis ), the treatment of aneurism is beneficial; if it suppurates, incise it and disinfect it with (antisep; tic ) ointment ( hsaudra-sarpi ~ honied fat ) and then apply vulnerary oil and mucilaginous paste. In 'rahta-vvddhi’ (hematocele), apply leeches for withdrawal of blood, or give as a sedative (diuretic) honey and sugar ; in suppurative or non suppurative form, hematocele should be attended to. In '’slesma-wddhV (hydroseheocele or vaginal hydrocele), apply emplasterum of calorific substances as (cow) dung and urine, drink the infusion of Circuma aromatica (or pinus longi- folia) mixed with urine ; except compression, all other treatments of ‘Mesma-yranthV are beneficial. If it suppurates, incise it, and as a Tulnerary of the wound, the restorative oil 26 386 ANCIENT HINDU MEDICINE concocted with Tritico estivo, Semicarpo anacardia, Alangio hexapetalo and Echite scholari, should be applied. In 'medovrddhV (elephantiasis), use an emplasterum of a gum-resinous substance as^ myrrha or any other sedative, warmed with cow’s urine to soften the scrotum, and when it is done, it should be bandaged (as antisepsis). Then with encouraging words to the patient, it should be incised with a leaf-shaped instrument, sparing the testes and the raphe, and all the fats removed (Eilaria bancrofti and the larva which block the lymph-channels and cause the inflammation of the scrotal tissue), then green vitriol ( = sulphate of iron ) and rock salt (as disinfectant) should be applied and the wound sutured properly. As vulnerary, oil cooked Avith arsenic disulphide, arsenic sulphide, sodium chloride and semicarpus anacarda is to be applied. In '‘mutra-m'ddhV (mdnary extravasation or vaginal hydrocele ), fomentation should be applied to the scrotum (to make it tense ) and then have it bandaged ( as antisepsis). By the raphe downward, an instrument like the sharp point of a grain ( trocar ) should be intro¬ duced, and thereby a double-barrelled cannula DISEASES 387 ( through the one cannula air is passed to cause pressure so that through the other the fluid content may be completely drained off), the urine ( fluid ) is evacuated. Then the cannula is to be withdrawn and ligature applied. If the wound remains clean (non-suppurated or granu¬ lated ), the vulnei’ary is to be applied. (The only difference’in the modern method of tapping in hydrocele, is that after the fluid is evacuated, the cannula is not withdrawn usually, but a syringe which fits it. is filled with half a drachm of a solution of ten parts of carbolic acid to one of glycerine, and is injected into the cavity. This causes but slight pain. However the sac refills partially due to the inflammatory reaction caused by the carbolic acid, but the inflammatory exudate is gradually reabsorbed after the inflam¬ matory process giving rise to it has subsided. However, tapping is but a palliative measure. It has to be done once or twice a year. But perhaps because it causes so little inconvenience and discomfort, it is preferred to operation by excision of a portion of the sac especially in old hydroceles with thickened walls due to sclerous and calcerous changes in the subserous tissues, Avhich gives a more satisfactory result. However, w'hether in tapping or in operation, care has to 388 ANCIENT HINDU MEDICINE be taken to avoid wounding the testes or scrotal vessels). Susruta IV. 19. 3-8* 166. II tvr'53r?i cici: vrvrarat ii -o fqTi3jrai^i'i65[5iT f^; i ’^T I finrjr^jtT n K^jirar fW^^fira^i Pm?iP!aii ^ II n ff^ Jra^ci I nS ^ cs. f%^: n II < ^ I qf ?T Cj[ I qi^ ¥t%R^qi II -srSlm^ u *. "q II '5> ^g wqf ^ I " 'O DISEASES 389 “Carriage of a heavy burden, wrestling with a strong man, fall from a tree—all these strains increase ‘vayti’ wliich enlarges the viscera and which in its downward course makes a tumor- like formation in the groin ( inguinal hernia ). If it be not attended to, it descends to the scrotum ( osceocele ) and causes the inflammation of the testes. This causes the distension of the scrotum like that of the bladder, and if it be pi’essed, gas ascends with noise, but descends again when left. This is called ‘antra-vrddhi’ (inguinal hernia). It is an incui'able disease. ^‘Susrtita II, 12, 6'®’. “The hernia that has reached the groin, to 3^?3t l^cW‘i% 3 T, t 167. 31i* fq33 3W 3“3133 f55I33T313Pfl 331 f^3I 3f3fel3I% 3 3iI3n3i^ 331^3 irfTO ’y3i^'i3lMK3)T31il 3refft3I33: 3^31 siltst vrafh 335333^f%33’.5'^3‘i3, f33 3f3, 3T33ff^fl3Tl[f3SH33h II < 1^33’f%3T, f33I3WW. I 390 ANCIENT HINDU MEDICINE obstruct its passage, should be cauterized by a semilunar-shaped cautery. Stbsriitajy. 19.10'' “. Hernia is the protrusion of the abdominal viscera through weak spots in tlie abdominal wall, which develop either due to congenital delicieney of muscular or tendonous development or due to their degenerative changes. It is met with in two extremes of life. In infancy when the inguinal rings are as yet imperfectly formed, uncontrolled crying, coughing or any other form of severe strain may subject the tissues to give way. In old age tissues begin to degenerate, while the weight of the viscera is heavier, and under severe straining as in asthmatic paroxysm, the weak spots in the parietes are easily apt to yield. “If the prepuce has been forcibly drawn back ( over the glans, and its return ia prevented by the arrest of the narrow opening behind the corona), during coitus with narrow vagina, mastur¬ bation, accident, play or detumescence, it is called 'avapatika' ( paraphimosis ; if this condition is left unrelieved, the circulation in the parts beyond may be interfered with sufficiently to 168. . 33 qr nf i DISEASES 391 make them swell, as to render retraction very •difficult even when the preputual orifice is not very tight ). In ‘niruddha-prakam^ {phimosis) the prepuce adhei’es to the glans penis, and therefore also contracts the meatus. But if it be not complete, the urine flows drop by drop with pain, ballooning the prepuce but without rupturing the glans penis. ( The best remedy of phimosis is circum¬ cision with lateral incision as the dilatation of the preputial opening by any method is only a half measure, involving as much pain as cutting or operating. Phimosis should be corrected as early as possible, as the abdominal pressure exerted in the straining to evacuate the urine and in the crying which often accompanies the effort in such children, is sufficient to prevent the firm closure of the natural hernial openings and to cause yielding of those which have already closed. Another consequence of the mechanical obstruction is the obstacle which it offers to cleanliness, resulting in a balano-posthitis induced by the retention of the smegma which consists of the secretion of the glands of the lining membrane of the prepuce together with the dead epithelial cells from those surfaces, the decomposition of which is hastened by the 392 ANCIENT HINDU MEDICINE admixture of urine. This inflammation reacta- on the nervous system and causes its irritability which is expressed in the peevishness of the child, and urinary disturbances such as frequent micturition, involuntary micturition especially at night, and spasmodic and painful micturition. The acrid and irritable decomposition product also provokes priapism in children and for the relief of this they learn and gradually habituate themselves to the pernicious piactice of mastur¬ bation. In the adult tlie sexual erethism causes self-abuse, veuery, spermatorrhea, premature ejaculation, backache and tlieir various reactions. Circumcision is a great hygienic measure, especi¬ ally in a tropical country). Susnita II. 13. 40-41* 169. 'six: i cif ii a® fern II at DISEASES 39S “Application of ‘suka' for the enlargement of the penis, causes eighteen kinds of diseases. Siw'uta II, Id. 2*"'*. Tradition.ally *mka' is taken as a pruritic water insect and used externally as an aphro¬ disiac. As *saka’ is used in the plural, it is possible that it includes some species of the insects, belonging to the ‘Coleoptera’ order as ‘Lytta or Cantharus covniea’ (blue blistering fly of Bengal) or ‘Lytta nepalensis’ ( Nepal blistering fly, a black species having filiform attenoe and elytra broadened toward the apex ), having its active irritating principle ‘cantharidin^ and which is used as an aphrodisiac. When dried powder or its active principle is applied to the skin, it causes burning sensation and hyperemia, to which in thecour-se of a few hours, succeeds the formation of vesicles. If the appli¬ cation is continued, it forms a blister, and if it goes on like that for a long time, sloughing and ulcerating result. If it is applied to the penis, it causes a voluminous swelling and engorgement of corpus cavernosum, and violent erection. 170 . ^ ^ I AXCIEKT HINDU MEDICINE “Due to the undue application of ‘sTiJca\ vesicl¬ es develop like the mustard seed, and are called *sarsapika’ {canthai'idal vesicles'). Due to the application of poisonous ^siika\ a stone-hard unsyininetrical tumor develops Avhicli is called *astlillika\ osteoma or chondroma of the penis : ossification and calcification of the penis have been reported in many cases. The parts involved are the sheaths of the corpora cavernosa and the septum pectiniform. Ossifica¬ tion Avhich is partial takes place usually in the plates very insiduously and without pain, and the patient first becomes aware of its existence by the impediment it offers to coitus or the curvature which it causes to the organ.