A boil or an ulcer appearing in a patient who is young, muscular (in frame), strong, or is possessed of an indomitable courage and fortitude, proves readily amenable to healing measures and applications; how much more so when one appears in a patient in whom all these four conditions simultaneously obtain.
An ulcer in a young patient is speedily healed owing to the fresh and vigorous vitalizing principles of the body; whereas the one, which appears in a person of strong and muscular build, finds a speedy and successful termination owing to the inability of the incising instrument to cut deep into the hard and tough muscles of the affected part and to reach down, or in any way destroy the underlying veins and nerves, etc. A strong and vigorous patient can easily endure a considerable amount of burning pain, etc. and does not feel distressed by a strict regimen of diet. A man of stupendous endurance and fortitude can sustain the fatigue and worry of even the most painful surgical operation. Accordingly, a boil or an ulcer, appearing in a patient of the above said description, is easily and speedily healed; whereas the one, which affects either an old, emaciated, or timid person or one of small strength and endurance, takes time to heal.
Boils or ulcers, which appear in the regions of the buttocks (Sphik), or about the anus, and the organs of of generation, or on the back, forehead, cheek, or lips, or in the region of the external ears, or on the testes or the abdomen, or in the cavity of the mouth, or about the nape of the neck, or above the clavicles, can be easily healed. Those, that are seated in the eyes, or in the gums, the nostrils or the exterior angle of the eye, or in the cavity of the ears, abdomen or the umbilicus, or about any suture of the body, hips, ribs, arm-pits, chest, breasts, sides, or the joints, as well as those, that secrete frothy blood or pus with a gurgling sound, or contain any foreign matter embedded in their inside, are healed only with the greatest difficulty.
Similarly, an abscess or an ulcer appearing in the nether region of the body and pointing upward, or the one appearing on the extremity of scalp (Romanta) or about the end of a finger-nail, or in any of the vulnerable parts of the body, as well as the one affecting either of the thigh bones (femurs), should be looked upon as equally hard to cure. Likewise an abscess or an ulcer affecting a bone of the pelvis (Shronikanda-Acetabulum), as well as a fistula in ano opening inward should be regarded as hard to cure.
An ulcer (Vrana) appearing in a leper (Kushthi) or in a person suffering from diabetes Madhu-meha), or from Shosha (lit: pulmonary-consumption) or from the effects of poison, as well as the one appearing in a pre-existing ulcer, should be looked upon as curable only with the greatest difficulty.
An ulcer incidental to, and affecting the seat of any of the following diseases, viz. Avapathika ( paraphimosis , or Niruddha-Prakash (phimosis), or Sanniruddha-guda (constriction of the anus), or Jathara (abdominal-dropsy), or Granthi (glandular inflammation), and characterised by the germination of parasites in its interior, as well as the one appearing in the cavity of the abdomen, or affecting the mucous linings of the intestines, or brought about by the corrosive secretions of a nasal catarrh (Pratishyaya), and infested with parasites, should be considered as only admitting of a palliative treatment. Similarly palliation is the only remedy in the case of an ulcer which appears in a patient suffering from any morbid secretion from the urethra (Prameha) or from any form of cutaneous affections, marked by worms in its inside.
Likewise a case of gravel Sharkara , or urinary calculi Shikata) in which the urine is found to be charged with concretions, or leaves a deposit of sandy sediment, can not be radically cured by medicine alone. A case of Vata-kundalika, Asthila, Upakusha, Kantha-saluka, Danta-sharkara, Danta-veshta, Visarpa, Asthi-kshata, Uru-kshata, or Vrana-Granthi, may not perfectly yield to medicine alone. In an inflammation of the gums resulting from the use of poisonous twigs as brushes for teeth (Nishkoshana) a temporary amelioration is all that can be expected from a good and efficient treatment.
In a patient neglecting a disease at its preliminary stage, (or otherwise not observing a strict regimen) even a curable malady may speedily develop into one which admits only of palliative measures, while a disease of the last named type is soon transformed into an incurable one. An incurable disease under the circumstances speedily finds a fatal termination. A patient laid up with a disease, which only admits of a palliative treatment, lives so long as the course of the medical treatment is continued, and will die almost simultaneously with its discontinuance. Just as a prop or a pillar can prevent the collapse of a tumbling edifice, so palliative measures, judiciously applied by a skilful physician, may keep off the inevitable in a disease which knows no radical cure.