Ulcers may be grouped under two heads according as they are Idiopathic or Traumatic in their origin. The first group includes within its boundary all ulcers that are caused through the vitiated condition of the blood or the several deranged conditions of the Váyu, Pitta and Kapha, or are due to their concerted action (Sannipáta), while the second group embraces those which are caused by the bites of men, beasts, birds, ferocious animals, reptiles or lizards, or by a fall, pressure and blow, or by fire, alkali, poison, or irritant drugs, or through injuries inflicted by pointed wood, skeletal bones * horns, discus, arrows, axes, tridents, or Kuntas (a kind of shovel) or such other weapons. Although both these classes of ulcers possess many features in common, they have been grouped under two distinct heads on account of the diversity of their origin, the difference in remedial measures to be adopted in their treatment, and the variation in their strength and tenacity. Hence the chapter is called Dvivraniya. 2.
* Fragments of broken pottery. - Dallana.
In all cases of traumatic ulcers, cooling measures should be at once resorted to, just after (the fall or blow or stroke), for the cooling of the expanding (radiating) heat of the incidenta ulcer, in the manner laid down in respect of (the pacification of enraged) Pitta, and a compound of honey and clarified butter should be applied on the wounded locality for the adhesion (Sandhána) of the lacerated parts, [and for the pacification, i.e., restoration to normal state, of the local blood and Váyu aggravated through an obstruction of their passage]. Hence arises the necessity of making the two-fold classification of ulcers. After that (a week) a traumatic ulcer should be treated as an idiopathic one (to all intents and purposes) inasmuch as it is found to be associated with deranged Váyu, Pitta or Kapha Hence at that stage the medical treatment of both the forms of ulcer is (practically) the same. 3.
In short, ulcers are further subdivided (particularly) into fifteen groups, according to the presence of the morbific diathesis (deranged Váyu, Pitta Kapha and blood therein), either severally or in combinations as described (before) in the Chapter on Vrana-Pras'na (Sutra Sthánam. Ch. XXI). Several authorities, by adding the simple uncomplicated ulcers (un-associated with any of the morbific principles of the deranged Váyu, Pitta, etc.) to the list, hold the number of types to be sixteen. (Practically they are innumerable, according to the combinations made of the deranged Váyu, etc. and the different Dhátus of the system). 4.
Symptoms of ulcer may be divided into two kinds viz., General and Specific. Pain is the general characteristic (of all forms of ulcer), while the symptoms, which are exhibited in each case according to the virtue of the deranged Váyu, Pitta, etc. involved therein, are called the Specific ones. A Vrana is so named from its etymology (the term being derived from the root Vrana - to break) and signifies a cracked or broken condition of the skin and flesh of the afflicted part) of the body. 5.