Now we shall describe the types of diseases which are usually held as incurable. An ulcer (Vrana) cropping up like a fleshy tumour, painful and containing pus in its inside, and which is characterised by a copious secretion, with its edges raised like those of the genital of a mare, should be understood as belonging to the incurable type. A condylomatous (papillomatous ) ulcer which is soft and raised like the horn of a cow, or the one which is moderately raised or elevated at its base, and secretes an exudation of vitiated blood, or a thin slimy secretion, should be likewise regarded as incurable. An ulcer with an embossed or heaved up centre, and one dipped or fissured at its extremity should be regarded as past all remedy. An ulcer covered over with shreds of ligaments, and looking as if studded with loose shreds of hemp, should be given up as incurable. Similarly, an ulcer due to the deranged condition of any of the fundamental humours, and secreting an exudation composed of coagulated blood, fat, marrow and brain-matter should be deemed incurable.
Likewise, an ulcer, in a weak and emaciated person, which is located within the cavity of the abdomen, (Koshtha) and which assumes either a black or yellowish colour, and exudes a secretion composed of urine, pus, blood and fecal matter, which finds its outlet both through the upward and downward fissures of the body (the mouth and the anus,) making a rumbling, gurgling sound, or which simultaneously secretes pus and blood through both the channels, should be regarded as belonging to the incurable class. An ulcer in an emaciated patient, which is situated either on the head or in the throat, and which is narrow-mouthed and is traversed by a network of capillaries, and studded with fleshy or papillomatous eruptions, should be regarded as incurable. A distinctly audible sound or report is heard in these ulcers which are found to be charged with wind.
An ulcer in an emaciated patient, which secretes blood and pus, and is attended with indigestion, cough, painful respiration and non-relish for food, as well as a case of fractured skull, attended with cough, dyspnoea, secretion of brain-matter, and symptoms peculiar to the concerted action of the three deranged humours of the body, should be given up as past all remedy.
A traumatic ulcer, which exudes a secretion of fat, marrow or brain-matter, may prove amenable to medical treatment, whereas a humoural ulcer under the circumstance will prove incurable.
An ulcer appearing at any part of the body other than a vital one (Marma), and which is found to invade its successive elements though without affecting any vein, bone, joint, etc. should be regarded as incurable.
Just as a tree, that has grown old and that has spread its roots deep into the soil, can not be uprooted, so a disease can not be eradicated that has gained in strength and maturity with the process of time, and that has gradually invaded the different essential principles of the body. A disease, which, having been neglected at the outset, has run on to one of a lingering or persistent type by invading the successive elements of the body, and has thereby gained in strength and intensity, baffles medicines, (of tested and marked efficacy), just as malignant astral combinations tend to nullify potent incantations.