English
Tuffier reports a case in which he found a bean-sized chondroma growing on the external surface of one of the corpora cavernosa, near the middle of the organ and which he removed by operation). If the penis is repeatedly engorged by the ^suka\ tlie vesicles that are developed like neoplasm, are called 'grathita’ {soft vegetations of succulent warts of the mucous membranes and muco-cutaneous junctions, especially found in the coronal sulcus and near frenum). Darkish vegetation that develops like the seed of 'Eugenre jamhiC 'is called ^humbltika DISEASES 395 (corneous vegetations, consisting of brown or dirty-brown, sessile, roundfed growths, quite Arm in structure, growing in the penis, scrotum, crural fields and anus in the male, on the labia raajora, perineum and anus in woman). Ophthalmia ( alaj'i ) is similar to that of gonorrhea ( prameha ; it is probable that by alaji is here either meant the gonorrheal con¬ junctivitis of the eye, or syphilitic gumma of the conjuctiva or sclera or parenchymatous keratitis). If through derangement of ‘vayu' the penis is pressed and beaten (lacking the power of erection and is pendulous ) and on it appears vesicles with edema, it is called ’‘mrdita^ {syphilitic edema of the penis ). The vesicles that develop, in masturbation, are called sammiiiha ( herpes progenitalis which is very pruritic appears about the glans and the foreskin, accompanied with a little moisture. When the parts are inspected in the early stages, small pin-head vesicles will be seen at the edge of the foreskin, in the neighborhood of the corona or near the meatus. When the vesicles have broken, they leave superficial erosions surround¬ ed by minute circular or crescentric areola). Numerous elongated growths appear, breaking 396 ANCIENT HINDU MEDICINE in the middle, causing pain, and horripilation^ and are called‘auoswirtH/Aa’ ( hor71s of penis, which- are usually dark-brown or green in color, in texture resembling the nails, but rough on the surface, arising from the coronal sulcus, especi¬ ally near the frenura, and may attain a length of three inches. They possibly are papilloma¬ tous growths, and avhen protected from the air, remain moist, soft and pinkish, and Avhen exposed become dry, hard and dark brownish in color. On removal, usuallv a ivart is found at their bases, and they are found in persons of careless habits and advanced life). Due to the ( corruption of ) 'blood and the sore that develops in the shape of the petal of lotus, surrounded by pustules, is called 'pushai'ikd' {chanc 7 'oid: it is very hard sometimes to^ distinguish from syphilitic initial lesion-chancre and the pyogenic ulcer-chancroid. Chancroid is contagious, its secretions being always- auto- inoculable, but it is essentially a local lesion, in contradistinction to chancre which is an expres¬ sion of syphilitic constitutional affection. Chan¬ croid is due to Ducrey’s streptobacillus and does not usually appear single, is not sharply circum¬ scribed and. is not indurated like the syphilitic sore.. The ulcer is surrounded by minute pustules DISEASES 397 on the ragged edge, which is slightly inflamed, and from wliich if pressed, appears a thin brownish pus, for the streptobacillus is pyogenic, while the spii-ochete pallida is not. Differential diagnosis is very important before treatment is given, for if the chancroid is treated with mer¬ cury or iodoform ointment, it may seriously complicate the case, while with thorough cleans¬ ing and antisepsis, it can be easily cured ). If due to the lesion of 'suka\ the ( corrupt ) blood causes anesthesia, it is called ‘sparsa hani’ {syphilitic anesthesia of the penis and impotence). Due to the indigestion, caused by 'suka' ( taken internally as an aphrodisiac ), Hhe blood and pillal become deranged, and the growths that appear thereby like Phaseolus mungo and Phaseolus radiatum are called ^uttania' ( milia, resembling millet seeds, usually benign giowtlis, are not infrequently found in the cutaneous investment of the penis ). If due to the (corruption of) ‘vdyu and blood’, the penis is covered with perforating tissues like a sieve, it is called ‘mta-pouaku’ ( tuberculosis of penis occurs in two forms. The majority of cases are examples of chronic tuberculous ulcera¬ tion of the skin or the mucous membrane, the ulcers having the same irregular worm-eaten 398 ANCIENT HINDU MEDICINE shape, blue undermined edges and slowly slough¬ ing or granulating cases. The other form which is rarer, appears to begin in the depth of the erectile tissue, producing a necrotic jnass,. closely resembling the tuberculous sequestra seen in a spongy bone. The latter form is perhaps indicated by ‘mta-ponaka’). If due to ‘pitta and blood', the skin of the penis ulcerates, with burning and fever, it is called ‘tmk~paka' ( erysipelas or cantharidal ulceration, due to its excessive and concentrated application ). The dark, blood-tumor covered with very pruritic vesicles, is called sonitarcvuda’ {angioma : though angima is more frequent than other benign tumors, it does not attack the penis so commonly as the female organs of generation. Angioma is generally seen in children, forming a superficial flat tumor, giving rarely any symptoms, unless a considerable part of the organ is involved and in that case troublesome priapism has been observed. Due to the lesion of the tissues, develops a neoplasm, called ‘marasarcuda’ ( epUhelioma or cancer of the p>enis : cancer almost invariably originates on tlie prepuce, glansor both combined and is a disease of advanced life. The most DISEASES 399 common mode of origin of epithelioma of the penis is in warty growths, which may promptly or after the lapse of months or years, degenerate into a malignant type. The etiology of the disease is obscure. Beside the unknown factor— tissue susceptibility, chronic irritation caused by phimosis, balanitis, venereal ulcer, especially a chronic ulcer of syphilitic origin seems to be the chief cause of cancer of the penis. It may be grafted from the cancer of the uterus where it is commoner than in man. during coitus. If the diagnosis is correct, amputation or extirpation according to the severity of the lesion, is the only safe remedy. For in many cases, destruction of tissue is marked as well as growth, and the malignant growth consists of an ulcer which may be very deep in the center with greatly thickened and indurated borders, the induration preceding the spread of the ulcer on all sides, and often the urethra is perforated so that the urine can only pass through the soft sloughing tissues, thus producing extensive ulceration ). When ulceration takes place ( of tlie ej)ithe- lioma), it is called malignant '^mamsa-'paka*' ( ulceration of the cancer ). All the symptoms of complicated tumor, 400 ANCIENT HINDU MEDICINE mentioned before ( Smntfa II. 9 ) are the same in the case of tlie ^vidradhi'' ( sarcoma of the penis, like the sarcoma of the other parts of the body, may he found at any time of life from ehiklliood to old age, and is chiefly found in the tissues of the corpora cavernosa, running a rapid and insidious course, forming a tumor witliout any painful sensation, hut enlarging and distorting the penis. If the tumor is extirpated, there is always great danger of the return of the morbid process ). If the poisonous black or multicolored '‘mho’ is used, then the tissues ulcerate with dark pigmentation and fall off ; tliis disease originates from the ( corruption ) of the three humors and is called 'tila-halaka' {gangrene : Gangrene of the 2 )enis is observed in young, but more commonly in elderly, subjects. In some cases balanitis, phimosis, paraphimosis, chancre, or chancroid has been the starting j)oint. Cases have been reported in which gangrene of the penis was said to be due to ingestion of ergot and cautharides). (Of these diseases)^ epithelioma {nuwisarcvuda), ulceration of the cancer ( mcimsa-pdlca ), sarcoma * R. W. Taylor : Genito-urinary atid Venereal Diseases, p. 270. DISEASES 401 { vidradhi ) and gangrene ( tilakdlaka ) of the penis are incurable.” Susrtita II. 14. 3-32 ‘‘Masturbation, manipulation or traumatism of the penis causes the derangement of the ‘vdgu’, which corrupts the ( mucous membrane of) prepuce and causes intumescence, of the glans ; it is called ‘pari-vartika’ ( balanitis ) and being of ‘vayu’ and infectious origin, it is 171 g i fcTfwr ii 'o qffejfi fqqiT’Ptfqqrlqu: i ftw'gw : ftfqrTfifiiqrr a fqitqn w ^ Jja. g mgqflqci; ii c uqg ii e qwrg ql?qii t qrqrc’TKit ii fqrmtfticTO’w m ftfqiTf'qcn i ”3 ?it ^ni u sJiPurf’ n Kar qu t m g gr t^fuTiJiT ii i ^ g g 5B?efici: i qicralPiiu^ sicnri^qr: ii la ^6 402 ANCIENT HINDU MEDICINE painful, causes burning and occasionally suppurates. If it originates from *sle^na\ it is hard and pruritic ( papilloma or any other vegetation.” Susrnfa II. 13. 39^'^. fwnr oisji^T ’3'II in. qiffi 3 5?' 11 U TireTi% 1 UI3Ic{ cf' HtqTqi5g ^^qgicl’ ftfW^II ^i'urf’a fqaraqqr ^ifq ^rmiPu ^ i trrraqifi^ fqxqtqcT: ii qfraifq ^iftt 3,ai5f ti%q; || ^raqrag^tqiq n' fqgm ii qq qRTi^? q? qiqqiqrq q: i ^ fe'tqpq q ^ \lf€51^qTT: II fsTuq^tsm, K ^ 172 . qi^qrailq qqqitqfVtqmcc. i qqi q^qqTI II qqi qraiq’sq^g qfeiqsrat i q^vqqqq qitJjq qpqqq’H ii q^q; r.qre-q qr^i^ a^lq afqcr i qf rasiq qf qfefqqn^ ii ; qifqqt q %q gqjqq feiqr ii v3 DISEASES 403 Balanitis is the inflammation of the mucous membrane of the glans, or of the prepuce (posthitis), or to both conditions combined. The two surfiicgs are generally attacked simultane¬ ously, except in chronic processes which are limited to small areas.