Indian Medicine (Medicin), translated by C. G. Kashikar c13.13

Language: English

c13.13.1

§ 68. Leprosy and allied Skin-diseases :— By kuṣṭha, a very dangerous skin-disease causing the most wretched deformation— the so-called black leprosy is in general to be understood. According to the Smṛtis, sinners of the highest grade are punished with kuṣṭha in their future birth¹; therefore, the kuṣṭhin is incapable of inheriting² unless he has practised penance in order to remove the sin³. In the medical literature, however, kuṣṭha appears mostly to have a wider meaning. In the Bower MS, Hoernle has always translated it as "skin-disease". The following are mentioned as causes : food and drink that are injurious or mutually unsuitable (e.g. milk with fish)⁴, suppression of vomiting and of natural excretions in general, physical exercise or excessive heat after a rich meal, a cold bath after experiencing heat, fatigue or anxious excitation, sexual intercourse while having indigestion, mischief against a Brāhman or a spiritual teacher and others, also sins made in an earlier birth. The following are the preliminary signs : the skin appears glittering and rough, there is excessive perspiration or no perspiration, decolourization, heat and itching of the skin, numbness of certain parts of body, exceedingly strong painfulness of wounds or abscesses, quick aggravation and slow cure of the same and of a rough place remaining after the cure, dark colour of blood, goose-skin, red eruption, pain, weakness etc.

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Usually 18 forms of kuṣṭha are distinguished, and are divided into 7 major and 11 minor forms; in particulars, however, the enumerations differ. According to Mādhava the following are the major forms : 1. kāpāla — with black or reddish, dry and rough spots like potsherd (kapāla), acute pain, very dangerous. 2. audumbara — the spots or boils are like a fig (udumbara) are accompanied by pain, heat, redness and itching, the hair on the body become brown. 3. maṇḍala — the spots are white or red, hard, wet, glittering, circular, coherent, scarcely curable. 4. *ṛkṣajihva*— the spots are rough, red on the edges, dark in the middle, painful, formed like the tongue of a bear (*Ṛkṣajihva*). 5. *puṇḍarīka*— the spots are bright red on the edges red in the middle, elevated, like a red lotus-flower. 6. *sidhma*— the spots are white or coppercoloured, small, giving dust if rubbed, appear mostly on the chest and resemble the blossom of gourd. According to Dutt, Pytiriasis, a kind of Herpes with dustlike scales is meant. 7. *Kākaṇa*— resembles in colour the seed of *Kākaṇantikā* (*Abrus precatorius* that is black in the middle, red at the edges), suppurates and aches violently. This form is incurable. While these seven major forms can at least be related for the most part to real leprosy, the eleven minor ones are apparently related to the most varied other skin-diseases. 8a. *ekakuṣṭha*— the skin is sweatless, the spots are big and appear like scales. 8b.

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*carman*— the skin is felt rough like that of an elephant. The former disease is Ichthyosis according to Dutt, the latter Hypertrophy of the skin. 9. *kiṭibha*— dark coloured scars, felt rough and hard, Keloid according to Dutt, that exists in compact rolls arising mostly from the thickening of the skin. 10. *vaipādikā*— violently painful cracks of hands and feet, Psoriasis on foot according to Dutt. 11. *alasaka*— the skin is covered with itching red snobs, a kind Herpes. 12. *Dadrumaṇḍala*— itching, red, elevated spots. According to Dutt ringworm is hereby meant, but this has nothing to do with a disease of the head-skin. 13. *carmadala*—the skin is red, painful, itching and suppurated vesicles are formed that are sensitive to touch. Impetigo. 14. *pāmā*—tiny but numerous vesicles accompanied by discharge, itch and burns. Eczema or wet tetter. 15. *Kacchu*— similar painful scraping with violently burning pustules on the hands and buttocks. 16. *visphoṭa*— dark-red swellings with thinner skin. Boils. 17. *Śatāru*— red or darkcoloured numerous abscesses with heat and pain. Furuncle. 18. *vicarcikā*— itching, dark, severely wet spots or boils. Psoriasis (according to Dutt) or wet tetter. Further divisions depend upon the place of the disease in one of the seven elements of the body; the forms staying in the skin, blood or flesh are only curable.

c13.13.4

In fat particularly there is lameness of hands, inability to walk, decay of limbs, spreading of wounds from one part of body to the other. In marrow and bones there is prolapsis or decay of nose, redness of eyes, maggots are formed in the wounds, the voice is choked. If present in the *śukradhātu* of the father and in the menstrual blood of the mother, the leprosy is transferred to both the offsprings.