Now we shall describe all the different kinds of pain, which are experienced in the several types of Vrana (ulcers) described before.
Pains of pricking, piercing, thrashing, cutting, expanding, gnawing, churning, shooting, tingling, burning, breaking, bursting, pinching, uprooting, uplifting, quivering, aching of different types, shifting, stuffing, benumbing, indurating, contracting, and pains of a spasmodic character are usually felt in ulcers. A pain, which comes on or vanishes without any apparent cause, or is varied and shifting 28 in its character, should be ascribed to the effects of the deranged Vayu.
A sensation of burning is felt in the ulcer accompanied by a sort of sucking pain. A feeling of inhaling heat or vapour, and a burning sensation running through the whole body, should be looked upon as the resultant of the deranged Pittam. At the same time the body seems as if it had been strewn over with bits of glowing charcoal. The heat or (the temperature of the affected locality) shows a steady rise, and a pain like the one incidental to the application of alkaline water (caustic solution is experienced in the ulcer.
The pain and other specific features of an ulcer due to the vitiated condition of the blood are identical with those developed by one of the Pittaja type.
An ulcer, characterised by numbness, heaviness, coldness, itching and a slight pain in the affected part, and which seems as if it has been plastered over with a paste, and which proves insensible to touch, should be ascribed to the action of the deranged Kapham.
The symptoms, described under the head of each of the preceding humoural types of ulcer, simultaneously exhibit themselves in the one brought about by the concerted action of all the deranged humours (Sannipatikam).
Now we shall de-cribe the colours assumed by the several types of ulcers. An ulcer, due to the action of the deranged Vayu, is rough and black, red, or ash-coloured, or is of the colour of a bone, or a pigeon. An ulcer, caused by the action of the deranged blood or Pittam, is coloured either blue, yellow, greenish-brown, black, reddish-tawny or flame-coloured. An ulcer due to the action of the deranged Kapham is white, grey and glossy. An ulcer, due to the combined action of the three deranged bodily humours, may assume any colour peculiar to them.
Not only in the cases of Vrana, but in all (inflammatory) swellings of whatsoever type, the physician should carefully observe the nature of the local pain, and the colour of the epidermis.