A History of Indian Medical Literature v1.c24.208

v1.c24.208

The subjects dealt with are: the aetiology, pathogenesis and general characteristics of bhagandara;767 this disorder is usually preceded by a boil (piṭikā) and is located in corrupted blood and muscular tissue; bhagandara consists of an external or internal, discharging sore (vraṇa) in the vicinity of the bladder and (other parts of) the urinary tract (28.1–4a);768 when left untreated, it tears the region of the genitals (bhaga), bladder and anus,769 giving rise to numerous subtle openings which emit flatus, urine, faeces, or semen (28.4–5ab);770 eight types occur: arising from a single doṣa, two doṣas, the three doṣas, and from an external cause (āgantu) (28.5cd);771 the disorder is called piṭikā when unripe, but bhagandara after reaching the ripe stage (28.6ab);772 the general characteristics of a piṭikā that may develop into bhagandara (28.6cd–7ab); the characteristics of a piṭikā due to vāta (28.7cd–8a),773 pitta (28.8),774 kapha (28. 9ab),775 vāta and pitta (28.9cd), kapha and vāta (28.10ab), and all the doṣas (28.10cd– 11ab);776 neglect leads to maturation, thus producing a sore (28.11cd);777 the characteristics of this sore when it is brought about by vāta; this type is called śataponaka (28.11d–13a);778 the characteristics of uṣṭragrīva, due to pitta (28.13b),779 parisrāvin, due to kapha (28.13cd),780 parikṣepin, due to vāta and pitta (28.14), ṛju, due to vāta and kapha (28.15ab); the pathogenesis and symptomatology of arśobhagandara, due to kapha and pitta (28.15cd–17ab); the characteristics of śambukāvarta, due to all the doṣas (28.17cd–18ab);781 the origin, pathogenesis and symptomatology of the type called unmārgin 782 or kṣataja 783 (28.18cd–20); the signs characteristic of these types are like those of a vraṇa (28.21ab); six types are difficult to cure; those arising from all the doṣas and from a wound (kṣataja) should be given up (28.21cd);784 the same applies to the bhagandara that has reached the fold (valī) called pravāhiṇī, or the sevanī (raphe) (28. 22ab); first of all, a physician should treat a piṭikā as well as he can, in order to prevent maturation (28.22cd–23ab); when, nevertheless, maturation has developed, the bhagandara should be examined like a haemorrhoid, in order to determine whether it is an external (arvācīna) or internal (parācīna) one;785 both kinds require surgical treatment, followed by application of a caustic or cauterization;786 a caustic ought to be chosen when the fistula is of the uṣṭrakandhara (= uṣṭragrīva) type (28.23cd–26ab);787 the surgical treatment of śataponaka (28.26cd–27ab);788 a parikṣepin fistula is to be treated in the same way, and, also, with the kṣārasūtra described in the chapter on nāḍī789 (28. 27cd); the treatment of an arśobhagandara (28.28–29);790 surgical treatment of a fistula with many openings requires that the physician selects one of the four possible types of incision;791 the description of these incisions, called gotīrtha, sarvatobhadra, dalalāṅgala or ardhalāṅgala, and lāṅgala (28.30–32a);792 indications for cauterization (28. 32b–d);793 the koṣṭha of the patient should be purified from time to time (28.33ab); two external preparations (28.33cd–34);794 more recipes (28.35–42);795 the specific treatment of bhagandara has thus been described; all the measures useful in cases of vraṇa should also be taken into consideration (28.43);796 things to be avoided for a year or longer after the healing of a bhagandara (28.44).797