the palms of the hands and the region of the anus, and in which the local hairs assume a red colour should be regarded as incurable. A case of Kilasham, which is the outcome of a burn (cicatrix) should be likewise considered as incurable. 12.
A preponderance of the deranged Vayu in a case of Kushtham (leprosy) is indicated by a contraction of the skin, local anaesthesia, a copious flow of perspiration, swelling, and piercing or cutting pain in the affected part, together with a deformity of the limbs and hoarseness. Similarly, an excess of the deranged Pittam in a case of Kushtham, should be presumed from the suppuration of the affected part, from the breaking of the local skin, from the falling off of the fingers, from the sinking of the nose and ears, from the redness of the eyes and from the germination of parasites in the incidental ulcer. An excessive action of the deranged Kapham, in a case of Kushtham, gives rise to itching, discolouring and swelling of the affected part which becomes heavy and exudes the characteristic secretion. The types, Pundarika and Kakanam, which are due to the germinal defect of the patient, are incurable, inasmuch as they involve (according to Dallana) the concerted action of the three simultaneously deranged Doshas from the very outset. 13.
Memorial verses:-As a tree, full grown in the course of time, has driven its roots, which derive their nourishment from the rain water, deeper and deeper into the successive strata of the soil, so this disease (Kushtham), first affecting and confining itself to the upper layers of the skin, will invade the deeper tissues and organs etc. of the patient, if unchecked until almost all the fundamental principles or elements Dhatus are attacked by its virus in the course of time. 14.
