Chapter CXC - The Nidanam of Sarira Vranas (idiopathic ulcers)

Dhanvantari said:—Now hear me, O Sushruta, discourse on the Nidanam of Sharira Vranas. (Idiopathic ulcers). Vranas may be divided into two classes such as the Sharira and Aguntaka (traumatic) ones. Ulcers originating through the agency of the aggravated morbific principles of the body, are called Sharira (Idiopathic) ulcers, while those that are due to the effects of blows with sharp-edged weapons are called Agantukas.

Ulcers due to the action of the deranged and aggravated Vayu is marked by an aching, throbbing pain and a scanty discharge. It becomes hard and assumes a twany brown colour. Pittaja ulcers are marked by a fetid smell and a discharge of fetid pus and give rise to thirst, and fever with a burning sensation in the body and an excited state of mind like that of intoxication. Kaphaja ulcers are characterised by a numbed pain and a greyish colour, They secrete a copious quantity of slimy discharge and are very slow to suppurate, a sensation of heaviness about their locations being also One of their specific traits. Ulcers, which have their origin in the vitiated blood, are marked by a copious bleeding, while those, which are engendered through the concerted action of the three Doshas, or which appear on any of the Marma Sthanas of the body and are marked by an intolerable burning sensation within, although they are felt cold on the surface, or which are attended with cough, emaciation, prostration of the bodily strength and a distaste for food with a copious fetid discharge from their inside, should be regarded as incurable. Ulcers, which do not show any sign of healing inspite of the applications of proper remedial agents and measures, should be pronounced as incurable.