This Quotation from the writings of one of the founders of ancient Hindu or Ayurvedic medicine, is evidence that Suśruta was aware of the diagnostic significance of odors in many diseases.
For most contemporary physicians an awareness of the importance of the sense of smell in clinical medicine was rekindled largely by the discovery of phenylketonuria by Følling ill 1934.2 He, as has almost every other student of this disease, called attention to a distinctive odor of patients with PKU.
With the burgeoning of our knowledge of inborn errors of metabolism during the last decade, we are now aware of at least five additional conditions in which the patient's odor is unusual; these conditions include disorders of amino acid as well as fatty acid metabolism.
ODORS IN CLINICAL MEDICINE
The quality or character of odors described ill clinical medicine for the same disease varies from author to author. Although an odor may be defined as a volatile emanation that is perceived by the sense of smell, the precise description of a particular odor is extremely difficult. This may be because most of us, unlike almost all other mammals, pay little attention to the odors around us. It is not that we are anosmic but rather that our faculty for discniminating smell in clinical practice has atrophied from disuse.
Sources of Patients' Odors
Odors arise chiefly from the secreta and excreta of the body: sweat, sebum from the skin; secreta from the nose, mouth, throat, bronchi, and lungs; urine, stool and vaginal discharges; wound suppuration; and from necrotic tissue.