Chapter XXXIII - Fatal Signs of Diseases

Now we shall discourse on the Chapter, which treats of incurable diseases (Avaraniya-adhyaya).

Metrical texts:—

Hear me describe, Oh child, the diseases which being attended with many a distressing and supervenient symptom, and being treated without rejuvenating and restorative medicines, speedily assume incurable character. The following eight diseases, viz:—Maha-Vata-vyadhi (paralysis or diseases affecting the nervous system in general), Prameha (morbid discharges from the urethra), Kushtha, Arsha (piles), Vagandara (fistula in ano), Ashmari (stone in the bladder), Mudha-garbha (false presentations) and the eight kinds of Udari (abdominal dropsy) are, by their very nature, extremely hard to cure. A physician with any regard to professional success should abandon a patient laid up with any of the preceding diseases, marked by complications such as, emaciation of the body, loss of strength, dyspnea, palpitation, wasting, vomiting, dysentery and hic-cough, fever and swoon. A case of Vatavyadhi developing symptoms, such as edematous swelling, complete anesthesia of the affected part, breaking and palsy (shaking) of the affected limbs, distention of the abdomen, with aching and colic pain, usually ends in death.

A case of Prameha, attended with indications as are to be found under the head of that disease, as well as an increased secretion of urine charged with semen, albumen, etc. and eruptions of specific abcesses (known as Sharavika etc.) is sure to have a fatal termination.

A case of Kushtha (leprosy) characterised by spontaneous bursting of the affected parts, hoarse voice, and blood-shot eyes, and not proving itself amenable to the five-fold appliances of emetics, purgatives, etc. (Panca-Karma), usually ends in death. A case of piles attended with thirst, aversion to food, colic pain, excessive hemorrhage, anasarca (Shopha) of the locality, and dysentery is soon relieved by death.

A patient suffering from an attack of fistula in ano, characterised by an emission of flatus (Vayu), urine, fecal matter, worms and semen through the ulcerated locality, should be given up as lost. A patient suffering from the presence of stone, gravel, or urinary concretions (Sharkara) in the bladder and attended with edema of the scrotum and the umbilicus, retention of urine, and colic pain in that organ, is soon relieved of his pain by death.

In a case of false presentation (Mudhagarva) an extreme constriction of the mouth of the uterus (os uteri), development of the peculiar pain of childbirth, which is known as Makkalla, tonic rigidity of the vagina, and situation of the placenta (Apara) at a wrong place (false pregnancy; and other symptoms (convulsions, cough, dyspnea, vertigo etc.) described in the Chapter on the Etiology of that disease, forebode the death of the parturient woman.

A patient suffering from abdominal dropsy (ascites) marked by pain at the sides, aversion to food, ede-matous swelling of the limbs, dysentery and fresh accumulation of water even after he had been tapped, or evacuated with the exhibition of purgatives, should be given up as incurable. A case of fever in which the patient becomes restless and tosses about in the bed in an unconscious state, and lies extremely prostrate, or is incapable of sitting or of holding himself up in any other position and is besides afflicted with rigor though complaining of a burning sensation within, is sure to end in death.

Similarly, a fever patient developing such symptoms as, the appearance of goose flesh on the skin, an aching gathered-up pain in the cardiac region, blood-shot or congested eyes, and breathing through the mouth should be deemed as already at the threshold of death. Similarly, a case of fever, attended with hic-cough, dyspnea, thirst, fits of unconsciousness or fainting, and rolling of the eye-balls, proves fatal in a weak and emaciated patient, who is found to breathe hurriedly through the mouth.

A case of fever proves fatal in a patient, found to be restless or to lie inert in an unconscious (subcomatose) state with dull, clouded, or tearful eyes, or prostrate, somnolent and extremely emaciated. A fever patient and especially an old one extremely enfeebled and emaciated, readily succumbs to an attack of dysentery in which laboured respiration, colic and thirst supervene.

An attack of Phthisis (Yakshma) leads its victim to death in whom glossiness of the e)^res, aversion to food, expiratory (subclavicle) dyspnea, difficult and up-drawn breathing (Urdha-Shvasa), and painful and and excessive micturition (diarrhea according to others), manifest themselves. A patient suffering from an attack of Gulma (abdominal gland), and on the verge of death, exhibits such symptoms as laboured and painful respiration, colic pain, unquenchable thirst, aversion to food, loss of consciousness, anemia, and the sudden obliteration of the Granthi (tumorous or glandular formation).

A person laid up with an attack of Vidradhi (abscess) and exhibiting such fatal symptoms as distension of the abdomen, retention of urine, vomiting, hiccough, thirst, pain of a varied character (such as aching, excruciating, etc.) and dyspnea, should be regarded as to have approached the goal of his life. A patient suffering from an attack of jaundice or chlorosis marked by yellowness of the teeth, nails, and of the conjunctive, and seeing everything yellow, is not expected to long survive the occurrence of the attack.

A person laid up with an attack of Hemoptysis, largely vomiting blood, and viewing everything red or blood-coloured with his blood-shot eyes, should be regarded as about to depart this life. A. person, insane, extremely enfeebled and emaciated, and sitting up sleepless in the night, or with eyes constantly lifted upward or cast down, would be soon relieved of his earthly suffering. A case of Apasmara (epilepsy) proves fatal in a person, who is extremely emaciated, and whose eye-brows are constantly moving and whose eyes seem fixed in an unnatural (oblique) stare.

 

Thus ends the the thirty-third Chapter of the Sutrasthana in the Sushruta Samhita which treats of incurable diseases.