An inflammatory swelling of the genital, whether ulcerated or not is called Upadansa *. The disease owes its origin to the action of the local Doshas, aggravated by promiscuous and excessive sexual intercourse, or by entire abstinence in sexual matter; or by visiting a woman, who had observed a vow of lifelong continence or one who has not long known a man, or one in her menses or one with an extremely narrow or spacious vulva, or with rough or harsh or large pubic hairs; or by going unto a woman whose partturient canal is studded with hairs along its entire length; or by visiting a woman not amorously disposed towards the visitor and vice versa; or by knowing a woman who washes her private parts with foul water or neglects the cleanliness of those parts, or suffers from any of the vaginal diseases, or one whose vagina is naturally foul; or by going unto a woman in any of the natural fissures of her body other than the organ of copulation (Vi-yoni); or by pricking the genital with finger nails, or biting it with the teeth, or through poisonous contact, or through practice of getting the (penis abnormally elongated by pricking the) bristles of a water parasite (Suka) into its body; or by practising masturbation, or any unnatural offence with female quadrupeds; or by washing the genitals with filthy or poisonous water; or through neglect to wash the parts after coition, or voluntary suppression of a natural flow of semen or urine or through any hurt or pressure on the organ etc. The inflammation of the genital thus engendered is called Upadans'a. The disease admits of being divided into five distinct types, such as, the Vŕtaja, Pittaja, Kaphaja, Tridoshaja and the Raktaja. 7 - 8.
* Upadans'a is not syphilis whole to whole. Certain types of Upadans'a such as the Raktaja and Sannipátika types which entail the destruction of the organs concerned exhibit certain symptoms which are common to syphilis as well. The secondary eruptions and tertiary symptoms of syphilis are not mentioned by the A'yurvedic Rishis who used to treat it only with vegetable medicines and this fact intimates the probability that the secondary and tertiary symptoms of syphilis might not arise by their efficient and able treatment from the very beginning, preventing the absorption of the poison into the system. The practice of ablution, so common among the Hindus, might be taken into consideration as one of the important preventive factors. Maharshi Charaka has comprised it within the chapter on Senile Impotency'. - Ed.
The roughness of the genitals, the bursting or cracking of the integuments of the penis and prepuce etc., numbness and swelling of the affected part which is perceived rough to the touch and the presence of a varied sort of pain peculiar to the deranged Vŕyu are the characteristic indications of the Vátaja type. In the Pittaja type fever sets in (from the very beginning), the penis becomes swollen and assumes the colour of a ripe Indian fig (reddish-yellow), attended with a sort of intolerable burning sensation The process of suppuration is rapid and a variety of pain peculiar to the deranged Pittam, (distinguishes it from the other forms of the disease). The penis becomes swollen, hard and glossy in the Kaphaja type marked by itching and a variety of pain characteristic of the deranged Kapham. In the blood-origined type (Raktaja) the organ bleeds heavily and is covered with the eruptions of large black vesicles. Fever, thirst, (Sosha), burning sensations and other characteristic symptoms of the deranged Pittam are also present. Palliation is all that can be occasionally effected in these cases. Symptoms specifically betraying to each of the Vátaja, Pittaja and Kaphaja types concurrently manifest themselves in the Sánnipátika type of Upadansa. The organ cracks, the ulcers or cancers become infested with parasites and death comes in to put a stop to the suffering of its wretched victim. 9 - 13.