Chapter CLXXXI - The Nidanam of poisons

Now, Hear me, O Sushruta, discourse on the Nidanam of poisoning. Poisons may be divided into two classes such as Vegetable and animal. Poisons obtained from bulbs of plants etc., may be called vegetable poisons, while those dropped down from the fangs of venomous snakes, etc, are called animal poisons.

Somnolence, drowsiness, lassitude with a burning sensation, horripilation, swelling (œdema) and dysentery are the symptoms, which mark the action of vegetable poisons in general, while fever, tooth-edge, hic-cough, pain in the throat, vomiting of frothy mucous, dyspnœa, epileptic fits and a marked repugnance for all kinds of food are the symptoms, which generally walk in the trail of animal poisons. Delirium, unconsciousness and a thrashing or bruised pain in the limbs are the general features, which mark the action of poisons obtained from the roots of poisonous plants or trees. Yawning, shivering, and dyspnœa are the symptoms which result from the ingestion of leaves of poisonous trees (lit, leaf-poisons). Dryness of the mouth with a burning sensation in the body and a distaste for food are the symptoms which result from the ingestion of a fruit-poison. Vomiting, tympanites and epileptic fits are the features which mark the action of a flower-poison. Roughness of the body, head-ache and salivation with a bad smell in the mouth are the symptoms which mark the action of a bark-poison or of a sap-poison. The use of milky exudations of poisonous trees develops such symptoms as a feeling of heaviness in the limbs, emission of frothy mucous from the mouth and violent purgings. Cardiac difficulties, epileptic fits, and a burning sensation about the palate are the symptoms, which are exhibited in cases of poisoning with any metallic poison.

These nine kinds of poison, anywise imbibed by a person, may ultimately prove fatal, if not instantaneously so. A wound from a poisoned weapon is marked by bleeding. It suppurates on the very day it is inflicted and shows signs of putrefaction, the black putrid flesh sloughing off day by day. The patient suffers from thirst, fever, and an intolerable burning sensation in the body until titanus is developed. All these symptoms may be exhibited in connection with any other kind of poisoned wounds. Yellow or black-coloured stool and vomiting of frothy mucous are the specific features of cases of poison-imbibing.

Venomous serpents are divided into three different groups such as, the Bhogis (Hooded ones), Mandalis (spotted with ring-like marks on their bodies) and Rajilas (marked with stripes). Of these, the Bhogis possess a temperament of dominant Vayu, the Mandalis possess a temperament of dominant Pittam, and the Rajilas possess a temperament of dominant Kaphah. From these species of snakes many have originated by hybridisation, and their offspring possess temperaments blended of the specific traits of their parents. A bite by a snake of the Bhogi species imparts a black tint to the skin of the bitten part and the specific symptoms of the deranged Vayu begin to manifest themselves in succession. A bite by a snake of the Mandali species gives a yellow tint to the space about the punctures made by its fangs, which becomes soft and marked by a burning sensation in its inside, and other specific symptoms of the deranged Pittam are found to supervene. Likewise, a bite by a snake of the Rajila species imparts a greyish tint to the seat of the wound, which becomes hard, glossy and slimy, the blood discharged from the punctures being found to be exceedingly thick. Symptoms peculiar to the deranged Kaphah are moreover exhibited in cases of bites by Rajila snakes.

A bite by a snake at the root of an Ashvaththa tree, or in a temple, or at a cremation ground, or near an ant-hill, or at the crossing of two roads, or at evening, or under the influence of the asterisms, Bharani, Ardra, Ashlesha, Magha and Mula invariably proves fatal. Poisons of hooded serpents (Darbikaras) instantaneously prove fatal. Heat enhances the virulence of all kinds of poison. Poisons prove instantaneously fatal in infants, old men, pregnant women, lepers, and hungry or weak persons, as well as in those suffering from any kind of urinary disease or ulcer-cachexia. Persons bitten by snakes in whose body an incision fails to draw any blood (is not followed by bleeding), or strokes of lashes do not leave any marks on the skin, or in whom sprays of cold water do not produce any horripilation, should be abandoned as already in the clutches of death. A snake-bitten person whose face is distorted, nose is sunk down, neck is bent and jaws are locked up, and whose hairs may be easily pulled up, and in whom the punctured wounds of the bite assume a red or blackish hue, should be already counted with the dead. Emissions of ropy mucous from the mouth, and hæmorrhage from the upward or downward apertures of the body point to an unfavourable prognosis in a case of snake-bite. Similarly, four fang-marks on the seat of the bite, as well as loss of voice, inability to walk, or loss of the power of locomotion, blackness of complexion and bending of the nose are symptoms, which portend impending evil in cases of snake-bite.

An animal or a vegetable poison, made to part with any of the ten specific qualities of instantaneous expansiveness etc., or weakened by time, or through the exposure to air and light, or through contact with any neutralising vegetable agent, is called a Dushi Visha. A slow (dushi) poison, by reason of its weakened potency, lies over-powered by the mucous secretion, which its presence in the organism engenders, and fails to exercise any fatal effect, but long continues uneliminated in the system. The presence of such a poison in the organism is indicated by loose stools, sallowness of complexion, a fetid smell in the body and a distaste in the mouth, with thirst, vertigo, epileptic fits, vomiting, indistinctness of speech, mental and bodily inertia, and a host of other distempers owing to the impairment of the normal physiological functions of the body. The presence of a slow poison in the stomach gives rise to diseases, which are due to the action of the deranged Vayu and Kaphah.

Continuing in the intestines, it brings on disorders which originate from the deranged action of the bodily Vayu and Pittam, falling off of the hair being one of its specific traits. Lodged in the lympchyle (Rasa) it produces indigestion, fever, nausea, jaundice, diseases of the heart, an aching pain in the limbs, a feeling of heaviness of the body and a distaste for food. Located in the blood (affecting the vascular system) it engenders cutaneous affections, erysipelas, pustular eruptions, specks and tans on the face, alopecia, abscesses, hæmorrhoids, tumours, menorrhagia, hæmorrhage, and splenic enlargement. Affecting the flesh it begets scrofula, scurvy, Osthapaka, ranula, tonsilitis, tumours, hæmorrhoids, etc. Deranging the fat it brings on glandular enlargements, tumours, Ostha-prokopa, diabetes and abnormal perspiration. Attacking the bones it produces such diseases as bad nails, Adhidanta, bone-ache, Adhyasthi, etc. Lodged in the marrow it begets darkness of vision, vertigo, epileptic fits, heaviness of the joints and opthalmia, etc. Lodged in the semen (affecting reproductive apparatus) it brings on impotency, seminal concretions in the urethra and spermatorrhoea, etc.

Increased sleep, heaviness of the limbs, yawns, looseness of the joints, horripilation and an aching pain in the body mark the premonitory stage of the aggravation of a slow poison in the system. A feeling of mandagore after eating, indigestion, with a distaste for food, appearance of circular rashes on the skin, or urticaria, loss of flesh, œdematous swelling of the extremities, epileptic fits, vomiting, dysentery, thirst, dyspnœa, fever, and dropsical swelling of the abdomen are the symptoms, which mark the stage when the effects of a slow poison becomes fully patent after the necessary period of incubation. One kind of slow-poison produces insanity, another brings on tympanites, a third begets seminal disorders (losses), a fourth engenders indistinctness of speech, a fifth brings on cutaneous affections, a sixth brings on carbuncles and erysipelas, and so on. A residence in a swampy, or in a marshy country, cloudy days, ingestion of preparations of barley corn, and day-sleep are the factors, which tend to rouse up the latent action of a slow poison. Cases of slow-poisoning of recent origin and occurring in ungreedy and judicious persons are curable, such cases of nearly a year’s standing can only be suppressed, while those occurring in persons of immoderate habits are incurable.

Wicked women, with a view to enthrall their lovers or husbands, mix the dirty rubbings of their bodies, or catamenial blood, or such like poisonous organic refuges with their food and drink, or men’s enemies administer some sorts of slow poison through these vehicles put of a spirit of retaliation with the effect that the lovers or enemies to whom they are administered become afflicted with jaundice, emaciation, impaired digestion, dropsical swelling of the extremities, tympanites, ascites, diarrhœa, pthisis, consumption, fever or intestinal glands.

Once on a time king Vishvamitra went to the hermitage of the holy Vashishta and attempted to forcibly drag away his cow (Kama dhenu). The beads of perspiration, which the wrath of that insulted sage engendered on his forehead, dropped on the bundles of cut grass (Lunas) stacked near at hand, and, behold, they were transformed into hosts of venomous spiders, called Lutas. Lutas (spiders) are so called from the fact of their originating from the drops of wrathful perspiration of the holy Vashistha which fell upon the bundles of cut grass (Luna’s). There are sixteen different species of spiders, of which the bites by Sauvarnikas etc., prove fatal, while those by Trimandalas etc., obstinately resist the action of curative agents. Sloughing and putrefaction of and bleeding from, the seat of the bite, fever with a burning sensation in the bowels, appearance of large circular rashes and pustular eruptions on the skin, and red or brown-coloured, soft, extensive, and shifting swellings on the limbs form the general features of bites by venomous spiders. Bites by venomous spiders of Trimandala or allied species give a twany brown colour to seats of the bite. The wounds become covered with net works of false membranes and evince a tendency of shifting upward, attended with fever, swelling and discharge. The poison of a spider of any of these species undergoes a long incubation after which its action becomes patent in the organism. A bite by a venomous spider of any of the eight species, such as Sauvranikas (Sauvarnikas?) etc., is marked by a swelling about the seat of the bite and the appearance of white, black, red or yellow pustular eruptions on the skin. Fever, dyspnœa, and hiccough with symptoms of cephalagia are also present and the patient succumbs to the virulence of the poison.

A bite by a poisonous rat is marked by bleeding from the seat of the bite, appearance of grey-coloured rashes on the skin, fever with a distaste for food, horripilation and a burning sensation in the body. A bite by a rat, which is fatally poisonous, gives rise to epileptic fits, a rat-like swelling about the seat of the bite, discolouring of skin, deafness, fever, salivation, vomiting of red blood, heaviness in the head and exudation of slimy fluid from the wound. A bite by a lizard (Krikalasa), is marked by unconsciousness, loose motions of the bowels, and a varied colour of the skin of the seat of the bite. The poison of a centipede first produces an intolerable burning, breaking pain, and courses upward in the organism after which it returns to the seat of the bite and continues therein. A bite by a centipede at the tip of the tongue or nose, or at the region of the heart, happening to develop such symptoms as painful sloughing of the parts, should be regarded as presaging a near death. A bite by a venomous insect of the Kanabha species gives rise to erysipelatous eruptions, œdematous swellings, colic, fever, vomiting and sloughing of the seat of the bite. A bite by a poisonous cricket (Uchchitinga) is followed by horripilation and numbness of the genitals of its victim. An indescribable pain is felt in the body, which seems cold, as if packed in a wet sheet. Venomous frogs are usually found to bite with a single fang, swelling of, and pustular eruptions about, the seat of the bite, thirst, vomiting and somnolence being its specific characteristics. A bite by a venomous fish, is characterised by pain, swelling and a burning sensation. A bite by poisonous leeches develops fever, epileptic fits, swelling and an itching sensation. A bite by a domestic lizard develops perspiration, burning, swelling and a pricking pain. A bite by a venomous mountain-mosquito proves fatal as a Luta-bite of the incurable type. A bite by a fly of the Sthagika species proves instantaneously fatal, the wound being characterised by a constant discharge. Pustular eruptions appear on the skin, and fever, convulsion and a burning sensation in the body supervene. A bite or a scratch by a tiger or an ourang-outang gives rise to inflammation and suppuration in the wound. A bite by a rabid dog or a jackal develops tetanus, fever, etc,. Subsidence of the deranged and aggravated morbific principles of the body, restoration of the fundamental principles of the body to their normal condition with a desire for food, emission of stool and urine, normal functions of the organs, a healthy colour of the complexion, and a cheerful frame of mind of the patient are the symptoms from which a physician should infer the full elimination of a poison from his system.