Ulcers (vraṇa) according to Caraka

Innate or Nija type of ulcer can be caused by the vitiation of dosas of the body. The Exogenous or Āgantu type of ulcer is caused by external factors like injuries, contact with poison etc.

Ulcers are of twenty varieties which are as follows: Ulcer are of twenty varieties—

1. Kṛtya,
2. Akṛtya,
3. Duṣṭa,
4. Aduṣṭa,
5. Marmasthita,
6. Amarmasthita,
7. Saṃvṛta,
8. Vivṛta,
9. Dāruṇa,
10. Adāruṇa,
11. Srāvin,
12. Asrāvin,
13. Saviṣa,
14. Aviṣa,
15. Viṣamasthita,
16. Samasthita,
17. Utsaṅgin,
18. Anutsaṅgin,
19. Utsanna,
20. Anutsanna.

Methods of examination of the ulcer is to be carried out in three different ways: these are inspection, interrogation and palpation.

Twelve characteristic features of non-healing ulcers are as follows:

1. Śvetatva,
2. Avasanna-vartmatva,
3. Atisthūla-vartmatva,
4. Atipiñjaratva,
5. Nīlatva,
6. Śyāvatva,
7. Atipiḍakatva,
8. Raktakṛṣṇatva,
9. Raktakṛṣṇatva,
10. Atipūtitva,
11. Ropyatva,
12. Kumbhīmukhatva.

Eight types of location are as follows:

1. Tvagāśraya,
2. Sirāśraya,
3. Māṃsāśraya,
4. Medas-āśraya,
5. Asthyāśraya,
6. Snāyu-āśraya,
7. Marman-āśraya,
8. Antarāśraya or Koṣṭhāśraya.

Twenty-four types of defects are as follows:

1. Snāyu-kleda,
2. Sirā-kleda,
3. Gāmbhīrya,
4. Kṛmi-bhakṣaṇa,
5. Asthibheda,
6. Saśalyatva,
7. Saviṣatva,
8. Sarpaṇatva,
9. Nakha-kāṣṭha-prabheda,
10. Carmaatighaṭṭana,
11. Loma-atighaṭṭana,
12. Mithyā-bandha,
13. Atisneha,
14. Ati-bhaiṣajya-karṣaṇa,
15. Ajīrṇa,
16. Atibhukta,
17. Viruddha-bhojana,
18. Asātmya-bhojana,
19. Śoka,
20. krodha,
21. Divā-svapna,
22. Vyāyāma,
23. Maithuna,
24. Niṣkriyatva.

Sixteen complications of ulcer are as follows:

1. Visarpa,
2. Pakṣāghāta,
3. Sirāstambha,
4. Apartānaka,
5. Moha,
6. Unmāda,
7. Vraṇaruk,
8. Jvara,
9. Tṛṣṇā,
10. Hanugraha,
11. Kāsa,
12. Chardi,
13. Atisāra,
14. Hikkā,
15. Śvāsa,
16. Vepathu.

Thirty-six types of therapy can be used. These are as follows:

1. Śophaghna,
2. Śastrakarman,
3. Avapīḍana,
4. Nirvāpaṇa,
5. Sandhāna,
6. Svedana,
7. Śamana,
8. Eṣaṇa,
9. Śodhana-kaṣāya,
10. Śodhana-pralepa,
11. Ropaṇa-kaṣāya,
12. Ropaṇa-pralepa,
13. Śodhana-tailaghṛta,
14. Ropaṇa-tailaghṛta,
15. Patra,
16. Chādana,
17. Bandhana,
18. Bhojya,
19. Utsādana,
20. Avasādana,
21. Dāha,
22. Kāṭhinyakara-dhūpana,
23. Mārdavakara-dhūpana,
24. Kāṭhinyakara-ālepana,
25. Mārdavakara-ālepana,
26. Avacūrṇana,
27. Ropaṇa,
28. Varṇya,
29. Loma-rohaṇa.

Six types of surgical procedures were followed. These are as follows:

1. incision,
2. puncturing,
3. excision,
4. scooping,
5. scarification or
6. rubbing, suturing.