The Nádi-Vrana

The pus of an abscess or swelling burrows into the affected part if a person neglects it in its fully suppurated stage, dubious of its being so conditioned, or not, or even neglects to open a fully suppurated abscess. An abscess or swelling is called a Gati Vrana owing to an excessive infiltration of pus, and it is also called a Nádi-vrana owing to the presence of a large number of recesses or cavities in its inside There arc five different types of Nádi-vrana (sinuses)such as the Vátaja, Pittaja Kaphaja, Tridoshaja and Salyaja. 9 - 10.

The Vataja, Kaphaja And Pittaja Types

The Vátaja Sinus is rough and short-mouthed, characterised by an aching pain (in its inside) It exudes a sort of froth)* secretion which becomes greater at night and is attended with an aching pain. Thirst, lassitude, heat and a piercing pain(in the affected locality) arc the usual accompaniments of the Pittaja types. Fever is present from the beginning and the Sinus exudes a large quantity of hot and yellow coloured secretion which is more by day than by night. The Kaphaja Sinus becomes hard and is characterised by itching and a slight pain (numbed?). It is found to secrete a copious quantity of thick, shin)-, white-coloured pus which becomes greater at night. 11-13.

Dvandaja And Tridoshaja Types

A case of Nádi-Vrana involving the concerted action of any two of the deranged Doshas (Váyu, Pittam and Kapham) and exhibiting symptoms peculiar to both, is called a Dvandaja * one. There are three * GáyaJása dues not read the symptoms of Dvi-doshaja (i.e., due to two morbific principles) types of sinus a given in the text which he has rejected as spurious types of this class of disease, (such as the Váta-pittaja. Váta-kaphaja and Pitta-kapJiaja) A case of Nádi-vrana, exhibiting symptoms of the three aforesaid types, and attended with fever and a burning sensation, difficult breathing, dryness of the mouth and syncope, is called Tridoshaja. An attack of this type should be regarded as dreadful and fatal, casting around the gloom of death. 14-15.

The Salyaja Nádi-Vrana

A foreign matter (such as dirt, bone, splinter etc.), lodged within the body and invisible to the eye, tends to burst open the skin, etc. of the locality along its channel of insertion and gives rise to a type of Sinus. It is characterised by a constant pain, and suddenly and rapidly exudes a sort of hot, blood-tinged, agitated, frothy secretion. This type is called Salyaja. 16.

The Stana-Roga

These may be divided into as many types as the aforesaid Nádi-Vrana and are caused by the same exciting factors as the last named malady. The milk-carrying ducts remain closed in the breast of a nullipera thus barring the possibility of the descent of the Doshas through them and of an attack of any disease at that part of the body. On the contrary, such ducts in the breast of a primipara open and expand of their own accord, thus making the advent of diseases possible that are peculiar to the mamma. 17-19

The Breast-Milk

The sweet essence of the Rasa (lymph chyle) drawn from the digested food courses through the whole body and is ultimately concentrated in the breast of a mother or a woman (big with child) which is called milk. 20.

Its Character

The breast milk, like semen, lies hidden and invisible in the organism, though permeating it in a subtle or essential form. The characteristic features of the breast-milk bear analogy to those of semen. The breast milk is secreted, and flows out at the touch, sight or thought of the child in the same manner as the semen is dislodged and emitted at the sight, touch or recollection etc. of a beloved woman. As the strong and unclouded affections of a man are the cause of the emission of semen, so the fondest love of a mother for her children brings about the secretion of her breast-milk Both semen and breast-milk are the product of the essence of digested food, this essence being converted into milk in women. 21 - 22.

Its Abnormal And Normal Traits

The milk of a mother vitiated by the deranged Váyu of her system has an astringent taste and floats on water The milk of a mother vitiated by the deranged Pittam has an acid and pungent taste and becomes marked with a yellow hue * if left to float on water. The milk of a mother vitiated by the deranged Kapham is thick and slimy and sinks in water. The milk of a mother vitiated by the conceited and simultaneous derangement of the three Doshas of the body is marked by the combination of all the preceding symptoms. An external blow or hurt too (Abhigháta) sometimes produces vitiation of the mother's milk. 23.

The milk (of a mothen, which instantly mixes with water., tastes sweet and retains its natural greyish tint, should be regarded as pure. 24.

The bodily Doshas having recourse to the breasts of a woman whether filled with milk or not and vitiating' the local flesh and blood give rise to mammary diseases, (Stana-roga). All the types of abscess (Vidradhi) excepting the one called the Raktaja out of the six types described before are found to attack the mamma, and their symptoms should be understood as identical with those of external abscesses. 25.

* The particle "Cha" in the text indicates that the colour may turn blue or pink in some cases.

Thus ends the tenth Chapter of the Nidánam Sthánam in the Sus'ruta Samhitá which treats of the œtiology and symptoms of Erysipelas, Sinus and mammary abscesses.