Susruta Samhita - Mandhata Global

92 THE SUSHRUTA SAMHITA. [Chap. XIII.
The Parivartika :—The vital Vayu (Vydna)
aggravated by such causes as excessive massage (mastur-
bation), pressure, or local trauma, attacks the integuments
of the penis (prepuce) which being thus affected by
the deranged Vayu forms into a knot-like structure and
hangs down from the glans penis. The disease known
as Parivartika or Phymosis is due to the action of the
deranged Vayu aggravated by any extraneous factor.
It is marked by pain and burning sensation; and some-
times suppurates. When the knotty growth becomes
hard and is accompanied by itching, then it is caused by
the aggravated Kapham. 39.
Avapatika : —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 h}'men 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 Avapatika
or paraphymosis. Niruddha-prakas'a :—The prepuce
affected by the deranged Vayu 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 Xiruddha-prakas'a
which is due to the deranged Vayu and is marked by
pain (in the glans pcnis\ 39-41.
Niruddhaguda :— The Vayu (Apana) obstruct-
ed by the repression of a natural urging towards de-
fecation stuffs the rectum, thus producing constriction
of its passage and consequent difficulty of defeca-