Garudapurana 1.160

The glorious Garuḍa Mahāpurāṇa [Chapter] 160. / Dhanvantari said: / Listen, O Suśruta, I shall explain the diagnosis of abscess (vidradhi) and phantom tumor (gulma). / Due to foods that are stale, excessively hot, dry, unctuous-free, and burning,

due to crooked postures in bed and bodily movements, and through various vitiations of the blood, / the skin, muscle, fat, and bone having become vitiated, lodging in the abdomen,

a swelling which is external or internal, accompanied by great colic and severe pain, / and which is round or elongated—that disease is remembered as vidradhi (abscess).

Arising severally or combined from the humors, and from discharged blood, / severe, knotty, and without discharge, it develops in various limbs.

Internally it is severe, deep-seated, and causing gulma to increase; / it discharges like an anthill, and loss of digestive fire also arises.

In the navel, urinary bladder, liver, spleen, kloman, heart, abdomen, and groin, / and in the heart when trembling, there is very sharp pain in each respective spot.

[The vāta-type is] dusky-red, with elevated tips, unevenly situated during suppuration, / causing loss of consciousness, dizziness, abdominal distension, oozing, spreading, and sound.

From pitta it is red, coppery, or dark, with thirst, delusion, fever, and burning; / it rises quickly and ripens rapidly. From kapha it is pale, accompanied by itching,

with distress, coldness, stiffness, yawning, anorexia, and heaviness; / it rises slowly and ripens slowly. The one born of all three humors combines [these signs].

According to bodily power, there is looseness of the bowels; the external and internal characteristics [are as follows]: / covered with black pustules, dark, with intense burning, pain, and fever,

having the signs of pitta, [occurring] externally through blood; in women it is similarly internal. / The cause of disease is also from traumatic injury by weapons and the like, through blood.

Arising from a wound, impelled by wind, that blood, exciting pitta, / produces an abscess having the signs of pitta and blood, with many complications.

Through that, the distinction of complications is recorded according to the distinction of seats: / when it is in the navel, indeed distension occurs; when in the bladder, dysuria arises;

there is obstruction of breathing; in the spleen, extreme thirst; / in the kloman, obstruction of the throat occurs; in the heart, pain throughout all the limbs;

stupefaction, bronchial asthma, cough, and a pounding in the heart; / in the abdomen and flanks, a development of humoral derangement within the belly;

and likewise in the hip-joint, groin, waist, back, / and flanks, there is pain; and in the anus, obstruction of downward wind.

One should indicate their raw, suppurating, and burnt conditions like a swelling; / those facing upwards from the navel, when ripe, discharge [above], others discharge from the rectum.

One should know that in an abscess arising in the rectum or breast, there is humors and moisture; / the one born of all three humors causes distortion of its seat.

When ripe, indeed, lodged in the navel or bladder, it bursts internally or externally; / the internal suppuration of an advanced [abscess] torments a weakened person with complications.

An abscess may occur there in sinful women of bad conduct; / when a fetus dies within the womb, a dense swelling may arise.

When arising in the breast, pain is the sign of an external abscess; / because of the subtleness of blood vessels in young maidens, it does not occur in an unmarried girl.

The aggravated wind whose course is blocked, acting at the root of the penis, / reaching from the testicles and groin to the vessels that carry to the scrotum,

afflicts them and produces an enlargement (vṛddhi) of the vessels in the scrotum; / the humor resides there in the adipose tissues; that disease of swelling (vṛddhi) is sevenfold:

in the urine and wind of both, externally or internally; / full of wind, rough to the touch, and dry, and from wind it produces a burning sensation;

from pitta it resembles a ripe udumbara fruit, having burning, heat, and suppuration; / from kapha it is sharp, heavy, unctuous, itchy, hard, and has slight pain.

From blood it is black, covered with blisters, a lump, with signs of scrotal enlargement; / enlargement of the fat is like kapha, soft and resembling a palmyra fruit.

In a person accustomed to suppressing urine, the urine-born [enlargement] occurs moving there; / without greed, possessing full firmness, soft and shifting, it undergoes agitation;

there is dysuria and below, folds in the scrotum. / By foods that aggravate wind, by baths in cold water,

and by the suppression of feces and urine, by improper bodily movements, / in an emaciated person whose vital energy is disturbed by these agitating causes,

the wind, having become abnormal, carries that blood downward; / lodged at that moment in the groin, it then forms a swelling resembling a tumor (granthi).

In one who neglects it, an increase of gulma, tympanites, colic, and diverse diseases occur; / when firmly pressed, it moves inward with a sound, and causing distension, it goes up again to the head.

This enlargement from blood is incurable, having the same appearance as that from wind, / with dry, blackish-red veins, like a lattice covered with cobwebs.

Wind, having reached accumulation either separately or combined with the humors, is eightfold; / and through disorder of the menstrual blood, an eighth occurs in women.

Emaciated by fever, fainting, diarrhea, and treatments such as vomiting, / one who is strong [yet] suffers from cold, is hungry,

and drinks food and beverages, practices fasting, swimming, and the like, / or is distressed by loss of consciousness, provoking [the wind],

or resorts to desiccation without practicing oleation and fomentation, / or undergoes purifications or lacks proper purification, or indulges in trembling movements—

his humors, with an excess of wind, either separately / or all accompanied by blood, flowing through the bodily channels because of the wind,

the wind, blocking the upward and downward pathways, indeed causes colic, / which is felt by touch, originating from gulma, hot, and having the form of a lump.

From emaciation, or from suppression of phlegm and feces, or from obstruction of the channels, / wind, finding a seat in the abdomen, becomes hardened through dryness;

independent when vitiated in its own seat, and dependent when in the seat of another. / Then phlegm, resembling a lump and mixed with waste matter,

situated in the bladder, navel, heart, or flanks, is called an abdominal tumor (*gulma*). / In that born of wind, there is headache, colic, fever, enlargement of the spleen, and rumbling in the bowels;

piercing as if by a needle, prolapse of feces, urine passing with difficulty, / swelling in the limbs, face, and feet, and likewise dullness of the digestive fire;

roughness and blackness of the skin and other parts, and, owing to the mobility of the wind, / an unfixed location, producing diverse pains;

the abdominal tumor throbs as if covered with ants and is thrust about. / From bile, there is burning, sourness [in the mouth], fainting, diarrhea, sweating, thirst, and fever;

yellowness in all the limbs, the appearance of swelling around the tumor; / phlegm is depleted or flares up, and it burns its own site, as it were.

From phlegm, there is numbness, loss of appetite, prostration, fever in the head, / catarrh, lethargy, nausea, and whiteness or blackness of the skin and other parts;

the abdominal tumor is deep, hard, and heavy, like a child in the womb; / remaining in their own locations and not wandering, these are fatal precisely for that reason.

Abdominal tumors generally arise from pairs [of humors], caused by mixed sexual intercourse; / that born of all [three humors] has severe pain and burning, suppurates quickly, and is dense and elevated.

That one is incurable. A blood-tumor (*raktagulma*), however, arises only in a woman / who is afflicted with colic during her menstrual period, or who is an ascetic, or who suffers from vaginal diseases;

or if the woman indulges in wind-generating things, the wind, provoked in her, / obstructs the menstrual flow that is situated month by month in the womb;

it produces it in the pelvis and exhibits the signs of pregnancy in her womb: / nausea, pregnancy cravings, appearance of breast milk, and capricious desires.

Gradually, through association with wind, bile causes an accumulation of blood / in the genital tract, [producing] for her the symptoms born of wind- and bile-induced tumors;

and acute colic in the uterus seated in the blood, / vaginal discharge, foul smell, and repeated weeping and pain.

Sometimes the abdominal tumor is like a fetus; all of them arise from sexual intercourse. / It undergoes suppuration after a long time and does not grow. An abscess (*vidradhi*), on the other hand,

suppurates exceedingly quickly, as it is seated in vitiated blood; / therefore, because it burns quickly, it is called an abscess (*vidradhi*).

When an abdominal tumor has an internal seat, there is burning in the bladder, spleen pain, / loss of digestive fire, complexion, and strength, or the suppression of natural urges.

In the opposite case, in the external trunk and limbs, there is not much pain; / or there is discoloration, or a cough, and a marked external elevation.

Violent distension in the belly accompanied by rumbling and intense pain, / caused by obstruction of upward and downward wind, they call intestinal obstruction (*ānāha*).

A hard lump resembling a kernel is called *aṣṭhīlā* when elevated; / endowed with all the symptoms and possessing its shape, it is called *pratyaṣṭhīlā*.

Arising in the colon, wind likewise [acts] from its seat of severe pain. / Excessive eructation, constipation, inability to feel satiated, rumbling of the bowels,

distension with rumbling, and impaired digestion are the signs of an impending abdominal tumor.

Thus ends the one hundred and sixtieth chapter, titled “Diagnosis of Abscess and Abdominal Tumor,” in the Ācārakāṇḍa of the first section of the first part of the glorious Garuḍa Mahāpurāṇa.