and is marked by the emission of wind with a loud report, is sure to have a fatal termination. Likewise, one, which is characterised by extreme pain, though not otherwise seated about any of the vital parts of the body, or which is cold on the surface, though attended with an extremely burning sensation in its inside and vice versa, should be deemed the precursor of death. Similarly, an ulcer should be regarded as fatal, that is shaped like the barb of a spear, or a Kunta (a kind of barbed dart or spear), or like a banner, chariot, horse, or an elephant, or like a cow, an ox, a temple, or a palace.
A wise physician, with any regard to his own reputation, should abandon a patient laid up with an ulcer which appears to have been dusted over with a sort of pulverised crust, or who has been suffering from one accompanied by loss of flesh and strength, cough, difficult respiration and aversion to food. An ulcer, which occurring at any of the vital parts of the body secretes a copious quantity of pus and blood, and refuses to be healed even after a course of proper and persistent medical treatment, is sure to have a fatal termination.
Thus ends the twenty-eighth Chapter of the Sutrasthanam in the Sushruta Samhita, which deals with the favourable and unfavourable prognosis of ulcers.
