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फेनपूयानिलवहः शल्यवान् ऊर्ध्वनिर्वमी । भगन्दरोऽन्तर्वदनस्तथा कट्यस्थिसंश्रितः ॥ १६ ॥
Ulcers that discharge froth, pus, and air/gas (phena-pūya-anila-vahaḥ), those containing a foreign body (śalyavān), those that project upward / are extremely elevated (ūrdhva-nirvamī), or rectal fistula (bhagandaraḥ) with an internal opening (antar-vadanaḥ) that extends into/involves the pelvic bone (kaṭi-asthi-saṃśritaḥ);
english translation
कुष्ठिनां विषजुष्टानां शोषिणां मधुमेहिनां । व्रणाः कृच्छ्रेण सिध्यन्ति येषां च स्युर्व्रणे व्रणाः ॥ १७ ॥
as well as ulcers occurring in patients suffering from skin diseases (kuṣṭhināṃ), affected by poison (viṣa-juṣṭānāṃ), tuberculosis/wasting (śoṣiṇāṃ), and diabetes mellitus (madhumehināṃ), or those in whom new ulcers develop over existing ulcers (yeṣāṃ ca syur vraṇe vraṇāḥ)—all these get cured with great difficulty (kṛcchreṇa sidhyanti).
english translation
नैव सिध्यन्ति वीसर्पज्वरातीसारकासिनाम् । पिपासूनामनिद्राणां श्वासिनामविपाकिनाम् ॥ १८ ॥
Ulcer in patients of herpes, fever, diarrhoea, cough, severe thirst, who do not sleep at all, who are suffering from dyspnea and indigestion,
english translation
भिन्ने शिरःकपाले वा मस्तुलुङ्गस्य दर्शने । स्नायुक्लेदात्सिराछेदाद्गाम्भीर्यात्कृमिभक्षणात् ॥ १९ ॥
in whom the skull is fractured or the brain is visible do not get cured. Due to exudation/sloughing of tendons (snāyu-kledāt), cutting of veins (sirā-chedāt), excessive depth (gāmbhīryāt), infestation/devouring by maggots/worms (kṛmi-bhakṣaṇāt),
english translation
अस्थिभेदात्सशल्यत्वात्सविषत्वादतर्कितात् । मिथ्याबन्धादतिस्नेहाद्रौक्ष्याद्रोमादिघट्टनात् ॥ २० ॥
fracture of bones (asthi-bhedāt), presence of a foreign body (sa-śalyatvāt), presence of poison (sa-viṣatvāt), unexpected/unforeseen complications (atarkitāt), improper bandaging (mithyā-bandhāt), excessive unctuousness (ati-snehāt), excessive dryness (raukṣyāt), or friction caused by body hair and foreign particles (romādi-ghaṭṭanāt);
english translation