Susruta Samhita - Mandhata Global

CHAPTER IV.
Now \vc shall discourse on the Nidanam of Bhag"-
a.ncla.ra.m t,
fistula in ano and fistular ulcers), i.
The deranged Vayu, Pittam, Kaphah and Sannipatah
(a simultaneous derangement of the three bodily Doshas)
and extraneous causes (such as a blow etc.) give rise
to the types of Bhagandaram known as Sataponaka,
Ushtragriva, Parisravi, Samvukavarta and Unmargi.
The disease is so named from the fact that it bursts
the rectum, the perineum, the bladder and the place
adjoning to them (thus setting up a mutual communica-
tion between them). The pustules, which appear in this
regions are called as Pidakas in their unsuppuratcd
stage, while they are called Bhagandaram when they are
in a stage of suppuration. A pain about the sacral
bone and an itching about the anus, accompanied by a
swelling and burning sensation, arc the premonitor)-
s\-mptoms of this disease. 2.
The ^ataponakah Type :—The Vayu,
excited, condensed, and rendered motionless b)' a course
of unwholesome food, gives rise to a pustule within
one or two fingers' length from the rectum (anal
region, — Guda), by vitiating the flesh (areolar tissue)
and blood (of the locality). It assumes a vermilion
colour and is characterised b\' a variety of pricking,
piercing pain. If neglected at the outset, the pustule runs
into suppuration. Owing to its vicinity to the bladder,
the abscess or the suppurated pustule exudes a kind of
slimy secretion and becomes covered with hundreds
of small sieve-like holes, through which a constant frothy
discharge is secreted in large quantities. The ulcer, thus
formed, seems as if it is being thrashed with a rod, pierced