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कृत्योत्कृत्यस्तथा [१] दुष्टोऽदुष्टो मर्मस्थितो न च |  

कृत्योत्कृत्यस्तथा [१] दुष्टोऽदुष्टो मर्मस्थितो न च |  

संवृतो दारुणः स्रावी सविषो विषमस्थितः ||२०||  

संवृतो दारुणः स्रावी सविषो विषमस्थितः ||२०||  

उत्सङ्ग्युत्सन्न एषां च व्रणान् विद्याद्विपर्ययात् |  

उत्सङ्ग्युत्सन्न एषां च व्रणान् विद्याद्विपर्ययात् |  

इति नानात्वभेदेन निरुक्ता [२] विंशतिर्व्रणाः ||२१||  

इति नानात्वभेदेन निरुक्ता [२] विंशतिर्व्रणाः ||२१||

kr̥tyōtkr̥tyastathā [1] duṣṭō'duṣṭō marmasthitō na ca|  

kr̥tyōtkr̥tyastathā [1] duṣṭō'duṣṭō marmasthitō na ca|  

saṁvr̥tō dāruṇaḥ srāvī saviṣō viṣamasthitaḥ||20||  

saṁvr̥tō dāruṇaḥ srāvī saviṣō viṣamasthitaḥ||20||  

utsaṅgyutsanna ēṣāṁ ca vraṇān vidyādviparyayāt|  

utsaṅgyutsanna ēṣāṁ ca vraṇān vidyādviparyayāt|  

iti nānātvabhēdēna niruktā [2] viṁśatirvraṇāḥ||21||  

iti nānātvabhēdēna niruktā [2] viṁśatirvraṇāḥ||21||  

kRutyotkRutyastathA [1] duShTo~aduShTo marmasthito na ca |  

kRutyotkRutyastathA [1] duShTo~aduShTo marmasthito na ca |  

saMvRuto dAruNaH srAvI saviSho viShamasthitaH ||20||  

saMvRuto dAruNaH srAvI saviSho viShamasthitaH ||20||  

utsa~ggyutsanna eShAM ca vraNAn vidyAdviparyayAt |  

utsa~ggyutsanna eShAM ca vraNAn vidyAdviparyayAt |  

iti nAnAtvabhedena niruktA [2] viMshatirvraNAH ||21||

iti nAnAtvabhedena niruktA [2] viMshatirvraNAH ||21||

Curable (can be treated with surgical intervention), incurable; infected, non-infected; situated in vital parts, not situated in vital parts; closed, open; hard, soft; discharging, non-discharging; poisonous, non-poisonous; unevenly located, evenly located; pouchy, non-pouchy; elevated, depressed – these are the twenty types of ulcers according to various distinguishing features.(20-21)

 

Three fold examination:

Curable (can be treated with surgical intervention), incurable; infected, non-infected; situated in vital parts, not situated in vital parts; closed, open; hard, soft; discharging, non-discharging; poisonous, non-poisonous; unevenly located, evenly located; pouched, unpouched; elevated, depressed – these are the twenty types of ulcers according to various distinguishing features.[20-21]

 

==== Three fold examination ====

 

दर्शनप्रश्नसंस्पर्शैः परीक्षा त्रिविधा स्मृता |  

दर्शनप्रश्नसंस्पर्शैः परीक्षा त्रिविधा स्मृता |  

वयोवर्णशरीराणामिन्द्रियाणां च दर्शनात् ||२२||  

वयोवर्णशरीराणामिन्द्रियाणां च दर्शनात् ||२२||  

हेत्वर्तिसात्म्याग्निबलं परीक्ष्यं वचनाद्बुधैः |  

हेत्वर्तिसात्म्याग्निबलं परीक्ष्यं वचनाद्बुधैः |  

स्पर्शान्मार्दवशैत्ये च परीक्ष्ये सविपर्यये ||२३||  

स्पर्शान्मार्दवशैत्ये च परीक्ष्ये सविपर्यये ||२३||  

darśanapraśnasaṁsparśaiḥ parīkṣā trividhā smr̥tā|  

darśanapraśnasaṁsparśaiḥ parīkṣā trividhā smr̥tā|  

vayōvarṇaśarīrāṇāmindriyāṇāṁ ca darśanāt||22||  

vayōvarṇaśarīrāṇāmindriyāṇāṁ ca darśanāt||22||  

hētvartisātmyāgnibalaṁ parīkṣyaṁ vacanādbudhaiḥ|  

hētvartisātmyāgnibalaṁ parīkṣyaṁ vacanādbudhaiḥ|  

sparśānmārdavaśaityē ca parīkṣyē saviparyayē||23||  

sparśānmārdavaśaityē ca parīkṣyē saviparyayē||23||  

darshanaprashnasaMsparshaiH parIkShA trividhA smRutA |  

darshanaprashnasaMsparshaiH parIkShA trividhA smRutA |  

vayovarNasharIrANAmindriyANAM ca darshanAt ||22||  

vayovarNasharIrANAmindriyANAM ca darshanAt ||22||  

hetvartisAtmyAgnibalaM parIkShyaM vacanAdbudhaiH |  

hetvartisAtmyAgnibalaM parIkShyaM vacanAdbudhaiH |  

sparshAnmArdavashaitye ca parIkShye saviparyaye ||23||

sparshAnmArdavashaitye ca parIkShye saviparyaye ||23||

Examination of ulcer can be performed by three methods e.g. by inspection, interrogation and palpation.  

 

Age, complexion and colour, body parts and sense organs are examined by inspection. Etiology, nature of pain, suitability and power of digestion should be known by patient’s statement. By palpation softness and coldness are known with their contraries. (22-23)

Examination of ulcer can be performed by three methods e.g. by inspection, interrogation and palpation.

Twelve types of ulcers:

Age, complexion and color, body parts and sense organs are examined by inspection. Etiology, nature of pain, suitability and power of digestion should be known by patient’s statement. By palpation softness and coldness are known with their contraries. [22-23]

 

==== Twelve types of ulcers ====

 

श्वेतोऽवसन्नवर्त्माऽतिस्थूलवर्त्माऽतिपिञ्जरः [१] |  

श्वेतोऽवसन्नवर्त्माऽतिस्थूलवर्त्माऽतिपिञ्जरः [१] |  

नीलःश्यावोऽतिपिडको रक्तः कृष्णोऽतिपूतिकः ||२४||  

नीलःश्यावोऽतिपिडको रक्तः कृष्णोऽतिपूतिकः ||२४||  

रोप्यः कुम्भीमुखश्चेति प्रदुष्टा द्वादश व्रणाः |  

रोप्यः कुम्भीमुखश्चेति प्रदुष्टा द्वादश व्रणाः |  

चतुर्विंशतिरुद्दिष्टा [२] दोषाः कल्पान्तरेण वै ||२५||  

चतुर्विंशतिरुद्दिष्टा [२] दोषाः कल्पान्तरेण वै ||२५||  

śvētō'vasannavartmā'tisthūlavartmā'tipiñjaraḥ [1] |  

śvētō'vasannavartmā'tisthūlavartmā'tipiñjaraḥ [1] |  

nīlaḥśyāvō'tipiḍakō raktaḥ kr̥ṣṇō'tipūtikaḥ||24||  

nīlaḥśyāvō'tipiḍakō raktaḥ kr̥ṣṇō'tipūtikaḥ||24||  

rōpyaḥ kumbhīmukhaścēti praduṣṭā dvādaśa vraṇāḥ|  

rōpyaḥ kumbhīmukhaścēti praduṣṭā dvādaśa vraṇāḥ|  

caturviṁśatiruddiṣṭā [2] dōṣāḥ kalpāntarēṇa vai||25||  

caturviṁśatiruddiṣṭā [2] dōṣāḥ kalpāntarēṇa vai||25||  

shveto~avasannavartmA~atisthUlavartmA~atipi~jjaraH [1] |  

shveto~avasannavartmA~atisthUlavartmA~atipi~jjaraH [1] |  

nIlaHshyAvo~atipiDako raktaH kRuShNo~atipUtikaH ||24||  

nIlaHshyAvo~atipiDako raktaH kRuShNo~atipUtikaH ||24||  

ropyaH kumbhImukhashceti praduShTA dvAdasha vraNAH |  

ropyaH kumbhImukhashceti praduShTA dvAdasha vraNAH |  

caturviMshatiruddiShTA [2] doShAH kalpAntareNa vai ||25||

caturviMshatiruddiShTA [2] doShAH kalpAntareNa vai ||25||

White, with depressed margins, very thick margins, much greyish (pinjara), blue, blackish, surrounded with numerous boils, red, black, very foetid odour, non- healing nature and bottle-necked (narrow opening) these are twelve types of defective (dushta)  ulcers.(24-25)

 

Sites of vitiation:

White, with depressed margins, very thick margins, much greyish (''pinjara''), blue, blackish, surrounded with numerous boils, red, black, very fetid odor, non- healing nature and bottle-necked (narrow opening) these are twelve types of defective (''dushta'')  ulcers.[24-25]

 

==== Sites of vitiation ====

 

त्वक्सिरामांसमेदोऽस्थिस्नायुमर्मान्तराश्रयाः |  

त्वक्सिरामांसमेदोऽस्थिस्नायुमर्मान्तराश्रयाः |  

व्रणस्थानानि निर्दिष्टान्यष्टावेतानि सङ्ग्रहे ||२६||  

व्रणस्थानानि निर्दिष्टान्यष्टावेतानि सङ्ग्रहे ||२६||