Chapter CLXXXII - The Nidanam of Shlipadam (Elephantiasis)

Now hear me, O Sushruta, discourse on the Nidanam of Shlipadam (Elephantiasis).

A swelling attended with fever, which first occurs in either of the inguinal regions and ultimately extends to the legs, is called Shlipadam (Elephantiasis). Similar swellings may occur of the ears, hands, nose, lips and genitals. In the Vataja form of Shlipadam (Elephantiasis) the skin of the swelling becomes rough and assumes a black colour. The skin of the affected part breaks, and a diverse kind of pain is felt in the affected regions without any apparent exciting cause. In the Pittaja form of Elephantiasis the swelling becomes soft, attended with a burning sensation in its inside, and the skin of the swelling assumes a yellowish colour. In the Kaphaja form of Elephantiasis the swelling becomes cold, compact, and white, glossy or grey. A case of Elephantiasis, which is of more than a year’s growth, and is grown over with nodular excrescences in the manner of an anthill, should be given up as incurable. All these three forms of Elephantiasis should be understood as marked by a predominant action of the deranged Kaphah, inasmuch as heaviness, and swelling can not originate through the agency of any other morbific principle than the deranged Kaphah.

Now I shall discourse on the Nidanam of Vriddhi-Roga (Hernia, Hematocele). The enraged and aggravated downcoursing Vayu, by descending from the inguinal regions into the scrotum and pressing upon the chords of the testes, gives rise to enlargement of the scrotum, attended with fever, and an aching pain, etc., Vriddhi-Rogas may be divided into seven types according as the different deranged morbific principles attack the blood, fat, urine, or the colon. Of these Mutraja Vriddhi (Hydrocele) and Antra-Vriddhi (Hernia) are brought about through the aggravation of the deranged Vayu, though they are classed as two different diseases according to the difference of their regions of locations. In the Vataja form of Vriddhi-Roga the tumour looks like a full bloated air-bladder and a variety of nervous pain is felt in its inside. In the Pittaja form of Vriddhi Roga the (scrotal tumour) assumes the colour of a ripe Audanavara fruit, and is marked by heat and a burning sensation. In the Kaphaja form of Vriddhi-Roga the tumour is felt hard and becomes cold, glossy, white or grey-coloured and slightly painful. In the Raktaja form of Vriddhi Roga (Hematocele), black belbous eruptions appear on the skin of the tumour and symptoms peculiar to the Pittaja form are likewise found to supervene. In the form of Vriddhi Roga, which has its origin in the diseased condition of the bodily fat, symptoms peculiar to the Kaphaja type are exhibited and the tumour looks big and brown like a ripe Tala fruit.