The hard, painless, black and elevated eruptions on the body (skin) resembling the Másha pulse in shape, caused by the aggravated condition of the bodily Váyu are called Mas'aka Tilakalaka: - The black painless spots on the skin about the size of a sesamum seed and level with the skin are called Tilakálaka. This disease is caused through the aggravated condition of the Váyu, Pittam ana Kapham.† Nyachcham: - The congenital, painless, circular, white or brown (Syáva) patches on the skin, which are found to be restricted to a small or comparatively diffused area of the skin, are called Nyachcham. Charmakila (hypertrophy of the skin): - The causes and symptoms of the disease known as Charmakila have been already described (under the head of the Arsa-Nidŕnam). Vyanga: - The Váyu being aggravated through wrath and over-fatiguing physical exercise, and surcharged with Pittam, and suddenly appearing on the face of a person, causes thin, circular, painless and brown-coloured patches or stains. They are known by the name of Vyanga * 34-38.
* According to certain authorities it is due to the absorption of blood by Váyu and Pittam.
+ According to others the spot goes by the name of Nilikam, if it is black-coloured and appears anywhere other than on the face.
The vital Váyu (Vyána) aggravated by such causes as excessive massage (masturbation), pressure, or local trauma, attacks the integuments of the penis (prepuce) which being thus affected by the deranged Váyu forms into a knot-like structure and hangs down from the glans penis. The disease known as Parivartiká or Phymosis is due to the action of the deranged Váyu aggravated by any extraneous factor. It is marked by pain and burning sensation; and sometimes suppurates. When the knotty growth becomes hard and is accompanied by itching, then it is caused by the aggravated Kapham. 39.
Avapátiká: - When the integuments of the prepuce is abnormally and forcibly turned back by such causes as coition under excitement, with a girl (before menstruation and before the rupture of the hymen and consequently with a narrow external orifice of the vagina) or masturbation or pressure or a blow on the penis, or a voluntary retention of a flow of semen or forcible opening of the prepuce, the disease is called Avapátiká or paraphymosis. Niruddha-prakása: - The prepuce affected by the deranged Váyu entirely covers up the glans penis and thus obstructs and covers up the orifice of the urethra. In cases of partial obstruction a thin jet of urine is emitted with a slight pain. In cases of complete closing the emission of urine is stopped without causing any crack or fissure in the glans penis in consequence. The disease is called Niruddha-prakása which is due to the deranged Váyu and is marked by pain (in the glans penis). 39-41.
The Váyu(Apana)obstructed by the repression of a natural urging towards defecation stuffs the rectum, thus producing constriction of its passage and consequent difficulty of defecation. This dreadful disease is known as Niruddha-gudam (stricture of the rectum) which is extremely difficult to cure. Ahiputana: - A sort of itch-like eruptions appearing about the anus of a child owing to a deposit of urine, perspiration, feces etc consequent on the neglect in cleansing that part. The eruptions which are the effects of the deranged blood and Kapham soon assume an Eczematous character and exude a purulent discharge on account of constant scratching. The Eczema (Vrana) soon spreads, and coalesces and proves very obstinate in the end. The disease is called Ahiputana. Vrishana-kachchu: - When the filthy matter, deposited in the scrotal integuments of a person who is negligent in washing the parts or in the habit of taking daily ablutions, is moistend by the local perspiration, it gives rise to an itching sensation in the skin of the scrotum, which is speedily turned into running Eczema by constant scratching of the parts. The disease is called Vrishana-kachchu and is due to the aggravated condition of the Kapham and blood. Guda-Bhransa: - A prolapse or falling out of the anus (due to the Váyu) in a weak and lean patient through straining, urging or flow of stool as in dysentery is called Guda-Bhrans'a or prolapsus ani. 42 - 45.
Thus ends the thirteenth Chapter of the Nidána Sthánam in the Sus'ruta Samhitá which treats of the Nidánam of minor ailments.