The deranged and aggravated Doshas, (Váyu, Pittam and Kapham) having recourse to, and affecting the Tvaka (Skin), flesh and blood, speedily give rise to a sort of shifting, elevated swelling (Sotha) marked by the characteristic symptoms of any of them involved in the case. This swelling tends to extend all over the body. The disease is called Visarpa from the fact of its extending or swiftly shifting character (Skr. srip - to go, to extend). 2.
The swelling (Sotha) is soft and rough and assumes a black colour attended with an aching pain in the limbs and a cutting or piercing pain (in the affected locality). It is further marked by (all the usual) symptoms of the Vátika fever. A case of this type in which uneven flame coloured vesicles or bulbs appear on the affected part through the extreme vitiation (of the Váyu and Pittam) should be given up as incurable. 3.
The Pittaja Visarpa (erysipelas) rapidly extends (over the body, attended with severe fever, a burning sensation, suppuration and cracking (of the skin . A large number of vesicles appears on the spot which assume a blood-red colour. A case of this type, characterised by the destruction of the local flesh and veins owing to the excessively aggravated condition of the deranged Doshas (Kaphha and Pittam) and a collyrium-like black colour (of the swelling), should be regarded as incurable. The Kaphaja Visarpa extends slowly and the process of suppuration is tardy. The affected part becomes white, glossy and swollen, and is marked by a slight pain and excessive itching. 4-5.
The Visarpa of the Tridoshaja type is deep-seated and the affected part assumes all colours and is attended with all sort-of pain which are peculiar to the three aforesaid types The local flesh and veins are destroyed in the suppurating stage of this disease and hence, it should be looked upon as incurable 6.
The Pittam of a person with a temperament marked by the extreme aggravation of all the three Doshas, in conjunction with the blood, resorts to a wound * in his body and immediately gives rise to Erysipelas (Sopha - lit rash) which assumes a reddish-brown colour, with high fever with a burning sensation, and suppuration in its train, and it is found to be covered with black vesicles to the size of Kulattha pulse. 7.
Prognosis: - The Vátaja, Pittaja and Kaphaja Visarpas are curable; the Sánnipátika and Khataja ones being incurable. The symptoms, which indicate an unfavourable prognosis in a case of Vátaja or Pittaja Erysipelas have been described before Those, which attack the vital parts (Marmas) of the body, can be cured only with the greatest difficulty. † 8.
* Or through the extreme augmentation of all the three doshas in the ulcer (Sadyah kshata-Vrana) according to others.
† Golden coloured (yellow) Erysipelas due to the action of the (deranged) Pittam is incurable (Pittálmá Kánchana-vapuscha ia ha na sydhyet.). - D. R.