Susruta Samhita - Mandhata Global

Chap. I.] NIDANA STHANAM. II
the regions of the fingers, insteps, abdomen, chest, heart
and throat, forcibly draws in the local ligaments (Snayu),
the body becomes contracted and bent forward, bringing
about a curvature of the inner trunk. The disease
in this form is called Antarayama Dhanushtambha.
The movements of the eyes become impossible, which
become fixed in their sockets ; the jaw-bones become
paralysed, the sides are broken, and the patient ejects
(at intervals quantities of) slimy mucous (Kapham).
These are the features which mark the first type
(Antarayama Dhanushtambha). On the contrary, when
the same enraged Vayu, centred or lodged in ligaments
which traverse the posterior side of the body, attracts
them violently, the body is naturally bent backward.
The patient experiences a sort of breaking pain at
the chest, waist and thighs, (which are ultimately
broken). The disease is called Vahirayama, and should
be looked upon as beyond the pale of all medicinal
treatment. 47— 50.
Four types of Akshepaka are usually recognised
in practice such as, the (i) one incidental to the
concerted action of the enraged bodily Vayu and
Kapham (2), the one brought about through the union
of the enraged Vayu with the deranged Pittam, (3),
the one due to the single action of the agitated Vayu
(4) and the one due to any external injury or blow
( Abhighataja).* An attack of Apatankah due to excessive
haemorrhage, or following closely upon an abortion or
miscarriage at pregnancy (difficult labour), or which is
incidental to an external blow or injury (traumatic),
should be regarded as incurable, 51— 52.
* Brahma Deva designated the four types of the disease, as Apatanakah,
Samsrishta Akshepakab, simple Akshepakah and the Abhighataja
(traumatic).