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Kiyanta Shiraseeya Adhyaya (view source)

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{{#seo:

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|title=Kiyanta Shiraseeya Adhyaya

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|titlemode=append

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|keywords=Shiroroga (diseases of head), hridaya roga(diseases of heart), imbalances in dosha, dhatu-kshaya, mala-kshaya, pidaka, madhumeha, dosha-gati, sannipata, samsarga, ojokshaya, ojas, signs of depletion of dosha, dhatu and mala, disorders of oja, movement of dosha

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|description=Sutra Sthana Chapter 17. Diseases of three vital organs including Head and other conditions

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}}

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<big>'''Sutra Sthana Chapter 17. Diseases of three vital organs including Head and other conditions'''</big>

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===Sanskrit Text, Transliteration and English Translation===

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अथातः कियन्तःशिरसीयमध्यायं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

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Athātaḥ kiyantaḥśirasīyamadhyāyaṁ vyākhyāsyāmaḥ||1||

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iti ha smAha bhagavAnAtreyaH||2||

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</div></div>

Now we shall expound the chapter on 'How many diseases are of the head?’ Thus said Lord Atreya. [1-2]

==== Questions by Agnivesha ====

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कियन्तः शिरसि प्रोक्ता रोगा हृदि च देहिनाम्|

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क्षयाः कति समाख्याताः पिडकाः कति चानघ!|

गतिः कतिविधा चोक्ता दोषाणां दोषसूदन!||४||

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kiyantaḥ śirasi prōktā rōgā hr̥di ca dēhinām|

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kShayAH kati samAkhyAtAH piDakAH kati cAnagha!|

gatiH katividhA coktA doShANAM doShasUdana!||4||

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</div></div>

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(Agnivesha asked the questions) “Oh God! How many are the diseases of head and heart of human beings? How many are the disorders caused by the varied combinations of discordant ''vata'' and other ''doshas''? How many are the disorders caused by ''kshaya''? How many are the papules (''pidika'')? O Holy One and Dispeller of ''Dosha''! How many types of ''gati'' of ''dosha'' are there? [3-4]

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==== Explanation by Atreya ====

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हुताशवेशस्य वचस्तच्छ्रुत्वा गुरुरब्रवीत्|

पृष्टवानसि यत् सौम्य! तन्मे शृणु सविस्तरम्||५||

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hutāśavēśasya vacastacchrutvā gururabravīt|

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hutAshaveshasya vacastacchrutvA [1] gururabravIt|

pRuShTavAnasi yat saumya! tanme shRuNu savistaram||5||

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</div></div>

On hearing the above questions of Agnivesha, Guru Atreya said “O gentle one! Hear me for the detailed description” [5]

==== Number of diseases ====

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दृष्टाः पञ्च शिरोरोगाः पञ्चैव हृदयामयाः|

व्याधीनां ह्यधिका षष्टिर्दोषमानविकल्पजा||६||

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dr̥ṣṭāḥ pañca śirōrōgāḥ pañcaiva hr̥dayāmayāḥ|

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dRuShTAH pa~jca shirorogAH pa~jcaiva hRudayAmayAH|

vyAdhInAM hyadhikA ShaShTirdoShamAnavikalpajA||6||

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</div></div>

“There are five ''shiroroga'' (diseases of head) and five ''hridroga'' (diseases of heart). On the basis of permutations and combinations of ''dosha'', there are sixty-two disorders” [6]

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दशाष्टौ च क्षयाः सप्त पिडका माधुमेहिकाः|

दोषाणां त्रिविधा चोक्ता गतिर्विस्तरतः शृणु||७||

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daśāṣṭau ca kṣayāḥ sapta piḍakā mādhumēhikāḥ|

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dashAShTau ca kShayAH sapta piDakA mAdhumehikAH|

doShANAM trividhA coktA gatirvistarataH [2] shRuNu||7||

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</div></div>

“There are eighteen varieties of ''kshaya'', seven varieties of ''pidika'' (pustule/carbuncles) caused due to ''madhumeha'' and three courses (''gati'') of ''dosha''. These are being described in detail henceforth” [7]

==== Causes of diseases of head ====

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सन्धारणाद्दिवास्वप्नाद्रात्रौ जागरणान्मदात्|

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वातादयः प्रकुप्यन्ति शिरस्यस्रं च दुष्यति|

ततः शिरसि जायन्ते रोगा विविधलक्षणाः||११||

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sandhāraṇāddivāsvapnādrātrau jāgaraṇānmadāt|

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vAtAdayaH prakupyanti shirasyasraM ca duShyati|

tataH shirasi jAyante rogA vividhalakShaNAH||11||

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</div></div>

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Suppression of natural urges, day-sleep, insomnia, intoxication, talking too loudly, exposure to frost, exposure to wind from the front, excessive sex, inhalation of unwholesome (or toxic) smell, exposure to dust, smoke, cold and sun, over eating of heavy, sour and green food, use of very cold water, trauma to the head, formation of products of improper digestion and metabolism in the body (i.e., ama), excessive weeping or suppression of tears, cloudy weather, irritation of mind/anxiety (manastapa), and anomalous climate/season are the general causative factors of shiroroga. The above factors provoke or vitiate vata, affecting rakta (blood circulation) in the head leading to shiroroga with various symptoms [8-11]

</div>

==== Importance of the Head ====

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प्राणाः प्राणभृतां यत्र श्रिताः सर्वेन्द्रियाणि च|

यदुत्तमाङ्गमाङ्गानां शिरस्तदभिधीयते||१२||

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prāṇāḥ prāṇabhr̥tāṁ yatra śritāḥ sarvēndriyāṇi ca|

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prANAH prANabhRutAM yatra shritAH sarvendriyANi ca|

yaduttamA~ggamA~ggAnAM shirastadabhidhIyate||12||

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</div></div>

''Shira'' (head) is foremost among all organs as it is the region of the body where the vital centres and all the senses (''indriya'') of a living-being are located It is vital (''uttama'') amongst all the other organs of the body [12]

==== Diseases of the Head ====

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अर्धावभेदको वा स्यात् सर्वं वा रुज्यते शिरः|

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अर्दितं शिरसः कम्पो गलमन्याहनुग्रहः|

विविधाश्चापरे रोगा वातादिक्रिमिसम्भवाः||१४||

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ardhāvabhēdakō vā syāt sarvaṁ vā rujyatē śiraḥ|

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arditaM shirasaH kampo galamanyAhanugrahaH|

vividhAshcApare rogA vAtAdikrimisambhavAH||14||

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</div></div>

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Hemicrania (''ardhavabhedaka''), headache (''sarvam va rujyate shiraḥ'') (i.e., that which may involve whole of head), coryza (''pratishyaya''), disorders of mouth, nose, eyes, and ears (''mukhanasakshikarṇaroga''), giddiness/vertigo (''shirobhramaḥ''), facial paralysis (''ardita''), tremors of the head (''shirasaḥ kampa''), stiffness of the neck, nape and jaw (''galamanyāhanugrahah'') and other such diseases of the head are caused by ''dosha'' and micro-organisms/worms (''krimi''). [13-14]

</div>

==== Types of Diseases of Head ====

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पृथग्दिष्टास्तु ये पञ्च सङ्ग्रहे परमर्षिभिः|

शिरोगदांस्ताञ्छृणु मे यथास्वैर्हेतुलक्षणैः||१५||

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pr̥thagdiṣṭāstu yē pañca saṅgrahē paramarṣibhiḥ|

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pRuthagdiShTAstu ye pa~jca sa~ggrahe paramarShibhiH|

shirogadAMstA~jchRuNu me yathAsvairhetulakShaNaiH||15||

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</div></div>

As mentioned in [[Ashtodariya Adhyaya]], there are five types of ''shiroroga'' that are described here with their etiological factors , signs and symptoms [15]

==== ''Vata''-dominant diseases of the Head ====

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उच्चैर्भाष्यातिभाष्याभ्यां तीक्ष्णपानात् प्रजागरात्|

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शिरोगताः सिरा वृद्धो वायुराविश्य कुप्यति|

ततः शूलं महत्तस्य वातात् समुपजायते||१८||

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uccairbhāṣyātibhāṣyābhyāṁ tīkṣṇapānāt prajāgarāt|

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shirogatAH [2] sirA vRuddho vAyurAvishya kupyati|

tataH shUlaM mahattasya vAtAt samupajAyate||18||

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</div></div>

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Indulgence in loud speech, excessive talk, strong drinks, awaking till late night, exposure to cold wind, excessive sexual act, suppression of natural physical urges, fasting, trauma, excessive/strong ''vamana'' or ''virechana'', excessive weeping, grief, fear, terror, excessive-load carrying, way-faring, severe emaciation leads to provocation of ''vata'' which by affecting the vessels of the head gets further provoked and produces severe pain in head [16-18]

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==== Symptoms of ''vataja shiroroga'' ====

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निस्तुद्येते भृशं शङ्कौ घाटा सम्भिद्यते तथा|

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स्फुरत्यति सिराजालं स्तभ्यते च शिरोधरा|

स्निग्धोष्णमुपशेते च शिरोरोगेऽनिलात्मके||२१||

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nistudyētē bhr̥śaṁ śaṅkau ghāṭā sambhidyatē tathā|

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sphuratyati sirAjAlaM stabhyate ca shirodharA|

snigdhoShNamupashete ca shiroroge~anilAtmake||21||

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</div></div>

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Intense pain in both the temples, splitting sensation in the nape, excessive heat and pain in forehead and between the eyebrows region, severe cutting pain and dissonances in ear, feeling as if the eyes are being gouged out, dizziness, sense of separateness in all the joints, excessive throbs in blood vasculature, stiffness of neck are the symptoms of vataja shiroroga. Use of hot and unctuous things provides relief in ''vata'' type of headache [19-21]

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==== ''Pitta''-dominant diseases of the Head ====

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कट्वम्ललवणक्षारमद्यक्रोधातपानलैः|

पित्तं शिरसि सन्दुष्टं शिरोरोगाय कल्पते||२२||

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kaṭvamlalavaṇakṣāramadyakrōdhātapānalaiḥ|

pittaṁ śirasi sanduṣṭaṁ śirōrōgāya kalpatē||22||

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kaTvamlalavaNakShAramadyakrodhAtapAnalaiH|

pittaM shirasi sanduShTaM shirorogAya kalpate||22||

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</div></div>

Excessive use of pungent, sour, salty and alkali substances and wine, exposure to sun (or heat) and anger leads to provocation of ''pitta'', which by lodging in the head produces ''paittika shiroroga'' [22]

==== Symptoms of ''pittaja shiroroga'' ====

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दह्यते रुज्यते तेन शिरः शीतं सुषूयते |

दह्येते चक्षुषी तृष्णा भ्रमः स्वेदश्च जायते||२३||

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dahyatē rujyatē tēna śiraḥ śītaṁ suṣūyatē |

dahyētē cakṣuṣī tr̥ṣṇā bhramaḥ svēdaśca jāyatē||23||

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dahyate rujyate tena shiraH shItaM suShUyate [1] |

dahyete cakShuShI tRuShNA bhramaH svedashca jAyate||23||

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</div></div>

Burning sensation and pain in the head, desire for cold things, burning sensation in the eyes, thirst, giddiness and perspiration are the symptoms of ''pittaja'' ''shiroroga'' [23]

==== ''Kapha''-dominant diseases of head ====

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आस्यासुखैः स्वप्नसुखैर्गुरुस्निग्धातिभोजनैः|

श्लेष्मा शिरसि सन्दुष्टः शिरोरोगाय कल्पते||२४||

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āsyāsukhaiḥ svapnasukhairgurusnigdhātibhōjanaiḥ|

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AsyAsukhaiH svapnasukhairgurusnigdhAtibhojanaiH|

shleShmA shirasi sanduShTaH shirorogAya kalpate||24||

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</div></div>

Due to sedentary life-style, excessive sleep, indulgence in intake of heavy and unctuous meals or excessive food intake, ''kapha'' gets provoked in the head and produces ''kaphaja shiroroga'' [24]

==== Symptoms of ''kaphaja shiroroga'' ====

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शिरो मन्दरुजं तेन सुप्तं स्तिमितभारिकम्|

भवत्युत्पद्यते तन्द्रा तथाऽऽलस्यमरोचकः||२५||

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śirō mandarujaṁ tēna suptaṁ stimitabhārikam|

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shiro mandarujaM tena suptaM stimitabhArikam|

bhavatyutpadyate tandrA tathA~a~alasyamarocakaH||25||

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</div></div>

Dull headache, numbness, stiffness and heaviness in head, drowsiness, laziness and anorexia are the symptoms of ''kaphaja shiroroga'' [25]

==== Three ''dosha''-dominant disease of head ====

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वाताच्छूलं भ्रमः कम्पः पिताद्दाहो मदस्तृषा|

कफाद्गुरुत्वं तन्द्रा च शिरोरोगे त्रिदोषजे||२६||

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vātācchūlaṁ bhramaḥ kampaḥ pitāddāhō madastr̥ṣā|

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vAtAcchUlaM bhramaH kampaH pitAddAho madastRuShA|

kaphAdgurutvaM tandrA ca shiroroge tridoShaje||26||

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</div></div>

In ''tridoshaja shiroroga'' aching pain, giddiness and tremors occur due to ''vata'', burning sensation, intoxication and thirst occur due to ''pitta'', and heaviness and drowsiness occur due to ''kapha'' [26]

==== Etiological factors and pathogenesis of ''krimija shiroroga'' (disease of head due to parasites/micro-organisms) ====

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तिलक्षीरगुडाजीर्णपूतिसङ्कीर्णभोजनात्|

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ततः शिरसि सङ्क्लेदात् क्रिमयः पापकर्मणः|

जनयन्ति शिरोरोगं जाता बीभत्सलक्षणम्||२८||

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tilakṣīraguḍājīrṇapūtisaṅkīrṇabhōjanāt|

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tataH shirasi sa~gkledAt krimayaH pApakarmaNaH|

janayanti shirorogaM jAtA bIbhatsalakShaNam||28||

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</div></div>

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When a person with provoked ''dosha'' indulges in excessive intake of sesame, milk, molasses,takes meals even when previous meal has not properly digested, eats putrefied or promiscuous food, and/or takes incompatible diet - it causes pathological discharges of ''rakta, kapha'' and ''māmsa'', wherein parasites are produced, leading to ''krimija shiroroga'' with dreadful symptoms [27-28]

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==== Symptoms of ''krimaja shiroroga'' ====

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व्यधच्छेदरुजाकण्डूशोफदौर्गत्यदुःखितम् |

क्रिमिरोगातुरं विद्यात् क्रिमीणां दर्शनेन च||२९||

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vyadhacchēdarujākaṇḍūśōphadaurgatyaduḥkhitam |

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vyadhacchedarujAkaNDUshophadaurgatyaduHkhitam [1] |

krimirogAturaM vidyAt krimINAM darshanena [2] ca||29||

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</div></div>

The patient of ''krimija shiroroga'' suffers from piercing, cutting or aching pains in the head with itching, swelling and foul smelling and detectable parasites [29]

==== Etiological factors and pathogenesis of ''vata''-dominant disease of heart (''vataja hridroga'') ====

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शोकोपवासव्यायामरूक्षशुष्काल्पभोजनैः |

वायुराविश्य हृदयं जनयत्युत्तमां रुजम्||३०||

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śōkōpavāsavyāyāmarūkṣaśuṣkālpabhōjanaiḥ |

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shokopavAsavyAyAmarUkShashuShkAlpabhojanaiH [1] |

vAyurAvishya hRudayaM janayatyuttamAM rujam||30||

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</div></div>

Grief, fasting, over-exercise, intake of rough (non oily or ununctuous) or dry food articles, or food items of low nutritional value are the key etiological factors of ''vatika hridroga''. Provoked ''vata'' , due to these causes, produces severe chest pain by affecting the heart [30]

==== Symptoms of ''vatika hridroga'' ====

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वेपथुर्वेष्टनं स्तम्भः प्रमोहः शून्यता दरः |

हृदि वातातुरे रूपं जीर्णे चात्यर्थवेदना||३१||

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vēpathurvēṣṭanaṁ stambhaḥ pramōhaḥ śūnyatā daraḥ |

hr̥di vātāturē rūpaṁ jīrṇē cātyarthavēdanā||31||

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vepathurveShTanaM stambhaH pramohaH shUnyatA daraH [2] |

hRudi vAtAture rUpaM jIrNe cAtyarthavedanA||31||

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</div></div>

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The symptoms of ''vataja hridroga'' are extra systole/ fibrillation, cardiac cramps, pauses in cardiac beats, stupor, sensation of emptiness in the cardiac region, and murmur (''dara''). The patient suffers from severe chest pain at the time of completion of digestion of the meal [31]

</div>

==== Etiological factors and pathogenesis of ''pitta''-dominant heart diseases (pittaja hridroga) ====

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उष्णाम्ललवणक्षारकटुकाजीर्णभोजनैः|

मद्यक्रोधातपैश्चाशु हृदि पित्तं प्रकुप्यति||३२||

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uṣṇāmlalavaṇakṣārakaṭukājīrṇabhōjanaiḥ|

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uShNAmlalavaNakShArakaTukAjIrNabhojanaiH|

madyakrodhAtapaishcAshu hRudi pittM prakupyati||32||

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</div></div>

Excessive intake of hot, sour, pungent, salty and alkaline food articles, alcohol, exposure to sun, and anger are the etiological factors of ''paittika hridroga'' [32]

==== Symptoms of ''pittaja hridroga'' ====

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हृद्दाहस्तिक्तता वक्रे तिक्ताम्लोद्गिरणं क्लमः|

तृष्णा मूर्च्छा भ्रमः स्वेदः पित्तहृद्रोगलक्षणम्||३३||

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hr̥ddāhastiktatā vakrē tiktāmlōdgiraṇaṁ klamaḥ|

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hRuddAhastiktatA vakre tiktAmlodgiraNaM klamaH|

tRuShNA mUrcchA bhramaH svedaH pittahRudrogalakShaNam||33||

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</div></div>

Burning sensation in the precordial region, bitter taste in mouth, sour eructation, exhaustion, thirst, fainting, giddiness and perspiration are the symptoms of ''pittaja hridroga'' [33]

==== Etiological factors and pathogenesis of ''kapha''-dominant heart diseases (''kaphaja hridroga'') ====

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अत्यादानं गुरुस्निग्धमचिन्तनमचेष्टनम्|

निद्रासुखं चाभ्यधिकं कफहृद्रोगकारणम्||३४||

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atyādānaṁ gurusnigdhamacintanamacēṣṭanam|

nidrāsukhaṁ cābhyadhikaṁ kaphahr̥drōgakāraṇam||34||

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atyAdAnaM gurusnigdhamacintanamaceShTanam|

nidrAsukhaM cAbhyadhikaM kaphahRudrogakAraNam||34||

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</div></div>

Over-eating, intake of heavy and fatty food substances, worry-free and sedentary lifestyle, excessive sleep are the etiological factors of ''kaphaja hridroga'' [34]

==== Symptoms of ''kaphaja hridroga'' ====

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हृदयं कफहृद्रोगे सुप्तं स्तिमितभारिकम्|

तन्द्रारुचिपरीतस्य भवत्यश्मावृतं यथा||३५||

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hr̥dayaṁ kaphahr̥drōgē suptaṁ stimitabhārikam|

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hRudayaM kaphahRudroge suptaM stimitabhArikam|

tandrAruciparItasya bhavatyashmAvRutaM yathA||35||

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</div></div>

Numbness, stiffness and heaviness in the precordial area, a stony sensation in the heart region, drowsiness and anorexia are the symptoms of ''kaphaja hridroga'' [35]

==== Etiological factors and pathogenesis of three ''dosha''-dominant heart diseases (''tridoshaja hridroga'') ====

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हेतुलक्षणसंसर्गादुच्यते सान्निपातिकः|

(हृद्रोगः कष्टदः कष्टसाध्य उक्तो महर्षिभिः)

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hētulakṣaṇasaṁsargāducyatē sānnipātikaḥ|

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hetulakShaNasaMsargAducyate sAnnipAtikaH|

(hRudrogaH kaShTadaH kaShTasAdhya ukto maharShibhiH)

+

</div></div>

In ''tridoshaja hridroga'', the etiological factors and symptoms of all the three ''doshika'' types of ''hridroga'' are present. (''tridoshaja hridroga'' is considered most troublesome disease by great sages)[35½]

==== Etiological factors and pathogenesis of ''krimija hridroga'' ====

+

त्रिदोषजे तु हृद्रोगे यो दुरात्मा निषेवते||३६||

Line 466: Line 557:

सङ्क्लेदात् क्रिमयश्चास्य भवन्त्युपहतात्मनः|

मर्मैकदेशे ते जाताः सर्पन्तो भक्षयन्ति च||३८||

+

tridōṣajē tu hr̥drōgē yō durātmā niṣēvatē||36||

Line 482: Line 574:

sa~gkledAt krimayashcAsya bhavantyupahatAtmanaH|

marmaikadeshe te jAtAH sarpanto bhakShayanti ca||38||

+

</div></div>

+

An unfortunate person already suffering from ''tridoshaja hridroga'', if further indulges in excessive intake of sesame, milk, and molasses, then he develops thrombosis (''granthi'') in the ''rasavaha srotas'' of the heart, leading to softening of the affected area and making it vulnerable to worm infestations. This infestation then spreads and consumes (''bhakṣyanti'') the heart tissues. It is ''krimija hridroga'' [36-38]

</div>

==== Symptoms of ''krimija hridroga'' ====

+

तुद्यमानं स हृदयं सूचीभिरिव मन्यते|

Line 492: Line 587:

हृद्रोगं क्रिमिजं त्वेतैर्लिङ्गैर्बुद्ध्वा सुदारुणम्|

त्वरेत जेतुं तं विद्वान् विकारं शीघ्रकारिणम्||४०||

+

tudyamānaṁ sa hr̥dayaṁ sūcībhiriva manyatē|

Line 504: Line 600:

hRudrogaM krimijaM tvetairli~ggairbuddhvA sudAruNam|

tvareta jetuM taM vidvAn vikAraM shIghrakAriNam||40||

+

</div></div>

+

The patient of ''krimija hridroga'' feels severe pain in the precordial region and complains of itching, as if the heart is being pricked and pierced with needles or cut open by weapons. ''Krimija hridroga'' is a very grave heart condition and may lead to immediate death. Therefore it should be promptly diagnosed and managed [39-40]

Line 510: Line 608:

===== (I). Thirteen types of ''sannipata'' =====

+

द्व्युल्बणैकोल्बणैः षट् स्युर्हीनमध्याधिकैश्च षट्|

समैश्चैको विकारास्ते सन्निपातास्त्रयोदश||४१||

+

dvyulbaṇaikōlbaṇaiḥ ṣaṭ syurhīnamadhyādhikaiśca ṣaṭ|

Line 519: Line 619:

dvyulbaNaikolbaNaiH ShaT syurhInamadhyAdhikaishca ShaT|

samaishcaiko vikArAste sannipAtAstrayodasha||41||

+

</div></div>

+

There are 13 conditions of ''sannipata'' of ''dosha'' (combination of all three ''dosha''), out of these, three conditions are with a dominance of two ''doshas'' (other one ''dosha'' comparatively less increased), three conditions are with dominance of only one ''dosha'' (others two ''dosha'' comparatively less increased), six conditions with diminished, moderate and dominant ''doshas'', and one condition with equal aggravation of all three ''doshas'' [41]

</div>

===== (II). Nine types of ''samsarga'' =====

+

संसर्गे नव षट् तेभ्य एकवृद्ध्या समैस्त्रयः|

पृथक् त्रयश्च तैर्वृद्धैर्व्याधयः पञ्चविंशतिः||४२||

+

saṁsargē nava ṣaṭ tēbhya ēkavr̥ddhyā samaistrayaḥ|

Line 532: Line 636:

saMsarge nava ShaT tebhya [1] ekavRuddhyA samaistrayaH|

pRuthak trayashca tairvRuddhairvyAdhayaH pa~jcaviMshatiH||42||

−

''

+

</div></div>

−

Samsarga'' means a combination of two provoked ''dosha'' and there are nine such combinations or ''samsargas''. Of these, six ''samsargas'' have one ''dosha'' more provoked than the other. In the remaining three cases, both ''dosha'' are equally increased [42]

+

''Samsarga'' means a combination of two provoked ''dosha'' and there are nine such combinations or ''samsargas''. Of these, six ''samsargas'' have one ''dosha'' more provoked than the other. In the remaining three cases, both ''dosha'' are equally increased [42]

===== (III). Twenty-five conditions of ''kshina dosha'' =====

+

यथा वृद्धैस्तथा क्षीणैर्दोषेः स्युः पञ्चविंशतिः|

+

yathā vr̥ddhaistathā kṣīṇairdōṣēḥ syuḥ pañcaviṁśatiḥ|

yathA vRuddhaistathA kShINairdoSheH syuH pa~jcaviMshatiH|

+

</div></div>

Similar to the combinations of increased ''dosha'' mentioned above, there are 25 conditions of ''kshina'' (decreased) ''dosha'' [42½]

===== (IV). Twelve ''sannipata'' of normal, increased and decreased ''dosha'' =====

+

वृद्धिक्षयकृतश्चान्यो विकल्प उपदेक्ष्यते||४३||

Line 551: Line 660:

वृद्धिरेकस्य समता चैकस्यैकस्य सङ्क्षयः|

द्वन्द्ववृद्धिः क्षयश्चैकस्यैकवृद्धिर्द्वयोः क्षयः ||४४||

+

vr̥ddhikṣayakr̥taścānyō vikalpa upadēkṣyatē||43||

Line 561: Line 671:

vRuddhirekasya samatA caikasyaikasya sa~gkShayaH|

dvandvavRuddhiH kShayashcaikasyaikavRuddhirdvayoH kShayaH [2] ||44||

+

</div></div>

+

There is another form of ''sannipata'' where the ''doshas'' are present in normal, decreased or increased combinations, and such cases are of 12 types there. Out of these, six conditions are where one ''dosha'' is increased, the second is normal and the third is decreased. In three types of combinations, two ''dosha'' are increased and the third decreased. Finally, there are three types of combinations where one ''dosha'' is increased and the other two are decreased. [43-44]

Line 567: Line 679:

===== 1. Normal ''pitta'', decreased ''kapha'' and increased ''vata sannipata'' =====

+

प्रकृतिस्थं यदा पित्तं मारुतः श्लेष्मणः क्षये|

Line 573: Line 686:

तदा भेदश्च दाहश्च तत्र तत्रानवस्थितः|

गात्रदेशे भवत्यस्य श्रमो दौर्बल्यमेव च||४६||

+

prakr̥tisthaṁ yadā pittaṁ mārutaḥ ślēṣmaṇaḥ kṣayē|

Line 585: Line 699:

tadA bhedashca dAhashca tatra tatrAnavasthitaH|

gAtradeshe bhavatyasya shramo daurbalyameva ca||46||

+

</div></div>

In a condition where ''kapha'' is decreased, ''vata'' that takes out normal ''pitta'' from its site and spreads it within the body. Wherever this ''pitta'' is placed, there is intermittent breaking pain and burning sensation as well as fatigue and weakness [46]

===== 2.Normal ''kapha'', increased ''vata'' and decreased ''pitta sannipata'' =====

+

प्रकृतिस्थं कफं वायुः क्षीणे पित्ते यदा बली|

कर्षेत् कुर्यात्तदा शूलं सशैत्यस्तम्भगौरवम्||४७||

+

prakr̥tisthaṁ kaphaṁ vāyuḥ kṣīṇē pittē yadā balī|

Line 598: Line 715:

prakRutisthaM [1] kaphaM vAyuH kShINe pitte yadA balI|

karShet kuryAttadA shUlaM sashaityastambhagauravam||47||

+

</div></div>

In a condition of decreased ''pitta'', the increased ''vata'' that takes out normal ''kapha'' from its site and spreads it within the body. Wherever this ''kapha'' is placed, there is coliky pain, coldness, stiffness and heaviness [47]

===== 3. Normal ''vata'', decreased ''kapha'', and increased ''pitta sannipata'' =====

+

यदाऽनिलं प्रकृतिगं पित्तं कफपरिक्षये|

संरुणद्धि तदा दाहः शूलं चास्योपजायते||४८||

+

yadā'nilaṁ prakr̥tigaṁ pittaṁ kaphaparikṣayē|

Line 611: Line 731:

yadA~anilaM [2] prakRutigaM pittaM kaphaparikShaye|

saMruNaddhi tadA dAhaH shUlaM cAsyopajAyate||48||

+

</div></div>

In a condition of grossly decreased ''kapha'', when increased ''pitta'' obstructs the pathway of normal ''vata'', causing burning sensation and coliky pain (''shula'') [48]

===== 4. Normal ''kapha'', decreased ''vata'', and increased ''pitta sannipata'' =====

+

श्लेष्माणं हि समं पित्तं यदा वातपरिक्षये|

सन्निरुन्ध्यात्तदा कुर्यात् सतन्द्रागौरवं ज्वरम्||४९||

+

ślēṣmāṇaṁ hi samaṁ pittaṁ yadā vātaparikṣayē|

Line 624: Line 747:

shleShmANaM [3] hi samaM pittaM yadA vAtaparikShaye|

sannirundhyAttadA kuryAt satandrAgauravaM jvaram||49||

+

</div></div>

In case of a grossly decreased ''vata'', increased ''pitta'' obstructs the normal ''kapha'', causing fever accompanied with a feeling of heaviness and drowsiness [49]

===== 5. Normal ''vata'', decreased ''pitta'', and increased ''kapha sannipata'' =====

+

प्रवृद्धो हि यदा श्लेष्मा पित्ते क्षीणे समीरणम्|

रुन्ध्यात्तदा प्रकुर्वीत शीतकं गौरवं रुजम् ||५०||

+

pravr̥ddhō hi yadā ślēṣmā pittē kṣīṇē samīraṇam|

Line 637: Line 763:

pravRuddho hi yadA shleShmA pitte kShINe samIraNam|

rundhyAttadA prakurvIta shItakaM gauravaM rujam [4] ||50||

+

</div></div>

In the case of decreased ''pitta'', if increased ''kapha'' obstructs the normal ''vata'' leading to a sensation of cold, heaviness and pain [50]

===== 6. Increased ''kapha'', normal ''pitta'', and decreased ''vata sannipata'' =====

+

समीरणे परिक्षीणे कफः पित्तं समत्वगम्|

Line 647: Line 775:

निद्रां तन्द्रां प्रलापं च हृद्रोगं गात्रगौरवम्|

नखादीनां च पीतत्वं ष्ठीवनं कफपित्तयोः||५२||

+

samīraṇē parikṣīṇē kaphaḥ pittaṁ samatvagam|

Line 659: Line 788:

nidrAM tandrAM pralApaM ca hRudrogaM gAtragauravam|

nakhAdInAM ca pItatvaM ShThIvanaM kaphapittayoH||52||

+

</div></div>

+

In case of decreased ''vata'', if increased ''kapha'' obstructs the normal ''pitta'' then it causes slow digestion,stiffness of head, excessive sleep, drowsiness, delirium, cardiac diseases, heaviness in the body, yellowness in nails etc and excess discharge of ''kapha-pitta''[51-52]

</div>

===== 7. Decreased ''vata'',increased ''kapha'', and ''pitta sannipata'' =====

+

हीनवातस्य तु श्लेष्मा पित्तेन सहितश्चरन्|

Line 669: Line 801:

हृल्लासमास्यस्रवणं पाण्डुतां दूयनं मदम्|

विरेकस्य च वैषम्यं वैषम्यमनलस्य च||५४||

+

hīnavātasya tu ślēṣmā pittēna sahitaścaran|

Line 681: Line 814:

hRullAsamAsyasravaNaM pANDutAM dUyanaM madam|

virekasya ca vaiShamyaM vaiShamyamanalasya ca||54||

+

</div></div>

In case of decreased ''vata'' when increased ''kapha, pitta'' spreads in the body causing anorexia, indigestion, asthenia, heaviness, nausea, salivation, anaemia, fumes sensation of mouth, throat and palate (''dūyana''), intoxication and irregularity of bowels and digestion [53-54]

===== 8. Decreased ''pitta'', increased ''kapha'', and ''vata sannipata'' =====

+

हीनपित्तस्य तु श्लेष्मा मारुतेनोपसंहितः|

Line 691: Line 826:

गौरवं मृदुतामग्नेर्भक्ताश्रद्धां प्रवेपनम्|

नखादीनां च शुक्लत्वं गात्रपारुष्यमेव च||५६||

+

hīnapittasya tu ślēṣmā mārutēnōpasaṁhitaḥ|

Line 703: Line 839:

gauravaM mRudutAmagnerbhaktAshraddhAM pravepanam|

nakhAdInAM ca shuklatvaM gAtrapAruShyameva ca||56||

+

</div></div>

In case of decreased ''pitta'', the increased ''kapha'' and ''vata'' combine together , causing stiffness, coldness, unstable pricking pain, heaviness, diminution of digestion, disinclination for food, tremors, pallor of nails etc., and roughness of the body parts [53-56]

===== 9. Decreased ''kapha'', increased ''vata'' and ''pitta sannipata'' =====

−

+

+

मारुतस्तु कफे हीने पित्तं च कुपितं द्वयम्|

करोति यानि लिङ्गानि शृणु तानि समासतः||५७||

Line 713: Line 851:

भ्रममुद्वेष्टनं तोदं दाहं स्फुटनवेपने|

अङ्गमर्दं परीशोषं दूयनं धूपनं तथा||५८||

+

mārutastu kaphē hīnē pittaṁ ca kupitaṁ dvayam|

Line 725: Line 864:

bhramamudveShTanaM todaM dAhaM sphuTanavepane|

a~ggamardaM parIshoShM dUyanaM dhUpanaM tathA||58||

+

</div></div>

In case of decreased ''kapha'' and an increased ''vata'' and ''pitta'' combine together, causing giddiness, cramps, pricking pain, burning sensation, disruption, tremors, body-ache, dehydration, burning of mouth, throat and palate and smoke from mouth [57-58]

===== 10. Decreased ''vata'' and ''pitta'' and increased ''kapha sannipata'' =====

+

वातपित्तक्षये श्लेष्मा स्रोतांस्यपिदधद्भृशम्|

चेष्टाप्रणाशं मूर्च्छां च वाक्सङ्गं च करोति हि||५९||

+

vātapittakṣayē ślēṣmā srōtāṁsyapidadhadbhr̥śam|

Line 738: Line 880:

vAtapittakShaye shleShmA srotAMsyapidadhadbhRusham|

ceShTApraNAshaM mUrcchAM ca vAksa~ggaM ca karoti hi||59||

+

</div></div>

In case of decreased vata and pitta and an increased kapha, obstruction of srotas causes complete loss of movement, loss of speech and fainting (59).

===== 11. Decreased ''vata'' and ''kapha'' and increased ''pitta sannipata'' =====

+

वातश्लेष्मक्षये पित्तं देहौजः स्रंसयच्चरेत्|

ग्लानिमिन्द्रियदौर्बल्यं तृष्णां मूर्च्छां क्रियाक्षयम्||६०||

+

vātaślēṣmakṣayē pittaṁ dēhaujaḥ sraṁsayaccarēt|

Line 751: Line 896:

vAtashleShmakShaye pittaM dehaujaH sraMsayaccaret|

glAnimindriyadaurbalyaM tRuShNAM mUrcchAM kriyAkShayam||60||

+

</div></div>

In case of decreased ''vata'' and ''kapha'' with an increased ''pitta'', by affecting the ''ojas'' causes malaise (''glani''), asthenia of senses, thirst, fainting and decreased physiological functions (60).

===== 12. Decreased ''pitta'' and ''kapha'' and increased ''vata sannipata'' =====

+

पित्तश्लेष्मक्षये वायुर्मर्माण्यतिनिपीडयन्|

प्रणाशयति सञ्ज्ञां च वेपयत्यथवा नरम्||६१||

+

pittaślēṣmakṣayē vāyurmarmāṇyatinipīḍayan|

Line 764: Line 912:

pittashleShmakShaye vAyurmarmANyatinipIDayan|

praNAshayati sa~jj~jAM ca vepayatyathavA [6] naram||61||

+

</div></div>

In case of decreased ''pitta'' and ''kapha'', an increased ''vata'' causes compression of the vital centres, adversely impacts consciousness, or leads to severe tremors throughout the whole body [61]

==== General principle of symptoms of increased and decreased ''dosha'' ====

+

दोषाः प्रवृद्धाः स्वं लिङ्गं दर्शयन्ति यथाबलम्|

क्षीणा जहति लिङ्गं स्वं, समाः स्वं कर्म कुवेते||६२||

+

dōṣāḥ pravr̥ddhāḥ svaṁ liṅgaṁ darśayanti yathābalam|

Line 777: Line 928:

doShAH pravRuddhAH svaM li~ggaM darshayanti yathAbalam|

kShINA jahati li~ggaM svaM, samAH svaM karma kuvete||62||

+

</div></div>

An increase in ''dosha'' causes a consequent provocation, to the same extent as the increase, of a symptom of a disease. On the other hand a decrease of ''dosha'' leads to decreased or reduced functions. In normal conditions, ''doshas'' are in an equilibrium [62]

==== Types of ''kshaya'' (decrease) ====

+

वातादीनां रसादीनां मलानामोजसस्तथा|

क्षयास्तत्रानिलादीनामुक्तं सङ्क्षीणलक्षणम् ||६३||

+

vātādīnāṁ rasādīnāṁ malānāmōjasastathā|

Line 790: Line 944:

vAtAdInAM rasAdInAM malAnAmojasastathA|

kShayAstatrAnilAdInAmuktaM sa~gkShINalakShaNam [1] ||63||

+

</div></div>

Now the symptoms of decrease of ''doshas, dhatus, mala,'' (i.e., excreta such as urine, feces,and excreta of nose, ears, eyes and mouth, as well as body hair) and ''ojas'' will be described. The symptoms of decreased ''doshas'' have already been described. [63]

==== Decrease of ''rasa'' ====

+

घट्टते सहते शब्दं नोच्चैर्द्रवति शूल्यते|

हृदयं ताम्यति स्वल्पचेष्टस्यापि रसक्षये||६४||

+

ghaṭṭatē sahatē śabdaṁ nōccairdravati śūlyatē|

Line 803: Line 960:

ghaTTate sahate shabdaM noccairdravati [2] shUlyate|

hRudayaM tAmyati svalpaceShTasyApi rasakShaye||64||

+

</div></div>

Symptoms of diminution of ''rasa'' include restlessness (or feeling as if the heart is being churned), intolerance to loud sounds, acceleration of flow (tachycardia), pain and distress even with the slightest exertion [64]

==== Decrease of rakta ====

+

परुषा स्फुटिता म्लाना त्वग्रूक्षा रक्तसङ्क्षये|

+

paruṣā sphuṭitā mlānā tvagrūkṣā raktasaṅkṣayē|

paruShA sphuTitA mlAnA tvagrUkShA raktasa~gkShaye|

+

</div></div>

Symptoms of decrease of ''rakta'' include roughness, cracks, withering and dryness of skin.[65]

==== Decrease of ''māmsa'' ====

+

मांसक्षये विशेषेण स्फिग्ग्रीवोदरशुष्कता||६५||

+

māṁsakṣayē viśēṣēṇa sphiggrīvōdaraśuṣkatā||65||

mAMsakShaye visheSheNa sphiggrIvodarashuShkatA||65||

+

</div></div>

Symptoms of decrease in ''mamsa'' include thinning specially of hips, neck and belly [65]

==== Decrease of ''medas'' ====

+

सन्धीनां स्फुटनं ग्लानिरक्ष्णोरायास एव च|

लक्षणं मेदसि क्षीणे तनुत्वं चोदरस्य च||६६||

+

sandhīnāṁ sphuṭanaṁ glānirakṣṇōrāyāsa ēva ca|

Line 836: Line 1,002:

sandhInAM sphuTanaM glAnirakShNorAyAsa eva ca|

lakShaNaM medasi kShINe tanutvaM [3] codarasya ca||66||

+

</div></div>

Symptoms of decrease of ''medas'' include cracking of the joints, lassitude of eyes, exhaustion and thinning of the abdomen [66]

==== Decrease of ''asthi'' ====

+

केशलोमनखश्मश्रुद्विजप्रपतनं श्रमः|

ज्ञेयमस्थिक्षये लिङ्गं सन्धिशैथिल्यमेव च||६७||

+

kēśalōmanakhaśmaśrudvijaprapatanaṁ śramaḥ|

Line 849: Line 1,018:

keshalomanakhashmashrudvijaprapatanaM shramaH|

j~jeyamasthikShaye li~ggaM sandhishaithilyameva ca||67||

+

</div></div>

Symptoms of decrease of ''asthi'' are loss of scalp and body-hair, beard, nails and teeth, fatigue and loose joints [67]

==== Decrease of ''majja'' ====

+

शीर्यन्त इव चास्थीनि दुर्बलानि लघूनि च|

प्रततं वातरोगीणि क्षीणे मज्जनि देहिनाम्||६८||

+

śīryanta iva cāsthīni durbalāni laghūni ca|

Line 862: Line 1,034:

shIryanta iva cAsthIni durbalAni laghUni ca|

pratataM [4] vAtarogINi kShINe majjani dehinAm||68||

+

</div></div>

Symptoms of decrease of ''majja'' are atrophy of bone tissues, weakness and lightness of bones and the patients suffers frequently from ''vata'' disorders [68]

==== Decrease of ''shukra'' ====

+

दौर्बल्यं मुखशोषश्च पाण्डुत्वं सदनं श्रमः|

क्लैब्यं शुक्राविसर्गश्च क्षीणशुक्रस्य लक्षणम्||६९||

+

daurbalyaṁ mukhaśōṣaśca pāṇḍutvaṁ sadanaṁ śramaḥ|

Line 875: Line 1,050:

daurbalyaM mukhashoShashca pANDutvaM sadanaM shramaH|

klaibyaM shukrAvisargashca kShINashukrasya lakShaNam||69||

+

</div></div>

Symptoms of decrease in''shukra'' include debility, dryness of mouth, pallor, asthenia, fatigue, impotency and absence of ejaculation [69]

==== Decrease in ''purisha'' ====

+

क्षीणे शकृति चान्त्राणि पीडयन्निव मारुतः|

रूक्षस्योन्नमयन् कुक्षिं तिर्यगूर्ध्वं च गच्छति||७०||

+

kṣīṇē śakr̥ti cāntrāṇi pīḍayanniva mārutaḥ|

Line 888: Line 1,066:

kShINe shakRuti cAntrANi pIDayanniva mArutaH|

rUkShasyonnamayan kukShiM tiryagUrdhvaM ca gacchati||70||

+

</div></div>

In decrease of ''purisha'', provoked ''vata'' causes painful peristalsis in the intestine which spreads upwards and oblique, causing distension of belly and dryness [70]

==== Decrease of ''mutra'' ====

+

मूत्रक्षये मूत्रकृच्छ्रं मूत्रवैवर्ण्यमेव च|

पिपासा बाधते चास्य मुखं च परिशुष्यति||७१||

+

mūtrakṣayē mūtrakr̥cchraṁ mūtravaivarṇyamēva ca|

Line 901: Line 1,082:

mUtrakShaye mUtrakRucchraM mUtravaivarNyameva ca|

pipAsA bAdhate cAsya mukhaM ca parishuShyati||71||

+

</div></div>

Symptoms of decrease of ''mutra'' include dysuria, discoloration of urine, excessive thirst and dryness of mouth [71]

==== Decrease of ''malayana'' ====

+

मलायनानि चान्यानि शून्यानि च लघूनि च|

विशुष्काणि च लक्ष्यन्ते यथास्वं मलसङ्क्षये||७२||

−

+

+

malāyanāni cānyāni śūnyāni ca laghūni ca|

viśuṣkāṇi ca lakṣyantē yathāsvaṁ malasaṅkṣayē||72||

Line 914: Line 1,098:

malAyanAni cAnyAni shUnyAni ca laghUni ca|

vishuShkANi ca lakShyante yathAsvaM malasa~gkShaye||72||

+

</div></div>

There are five other minor ''mala'' (associated with minor orifices) viz. ''mala'' of nose, ears, eyes, mouth and skin. Their deficiencies lead to feeling of emptiness, lightness and dryness of the respective receptacle of that ''mala'' [72]

==== Decrease of ''ojas'' ====

+

बिभेति दुर्बलोऽभीक्ष्णं ध्यायति व्यथितेन्द्रियः|

दुश्छायो दुर्मना रूक्षः क्षामश्चैवौजसः क्षये||७३||

+

bibhēti durbalō'bhīkṣṇaṁ dhyāyati vyathitēndriyaḥ|

Line 927: Line 1,114:

bibheti durbalo~abhIkShNaM dhyAyati vyathitendriyaH|

dushchAyo durmanA rUkShaH kShAmashcaivaujasaH kShaye||73||

+

</div></div>

The symptoms of decrease of ''ojas'' include timidity, debility, constant worry, discomfort of the senses, loss of lustre, neurasthenia, dryness and emaciation [73]

==== Description of ''ojas'' ====

+

हृदि तिष्ठति यच्छुद्धं रक्तमीषत्सपीतकम्|

ओजः शरीरे सङ्ख्यातं तन्नाशान्ना विनश्यति||७४||

+

hr̥di tiṣṭhati yacchuddhaṁ raktamīṣatsapītakam|

Line 940: Line 1,130:

hRudi tiShThati yacchuddhaM raktamIShatsapItakam|

ojaH sharIre sa~gkhyAtaM tannAshAnnA vinashyati||74||

+

</div></div>

The clear and slightly red-yellowish substance situated in the heart is known as ''ojas''. Its destruction leads to death [74]

+

प्रथमं जायते ह्योजः शरीरेऽस्मिञ्छरीरिणाम्|

Line 948: Line 1,140:

(भ्रमरैः फलपुष्पेभ्यो यथा सम्भ्रियते मधु|

तद्वदोजः स्वकर्मभ्यो गुणैः सम्भ्रियते नृणाम्||१||)

−

+

+

prathamaṁ jāyatē hyōjaḥ śarīrē'smiñcharīriṇām|

sarpirvarṇaṁ madhurasaṁ lājagandhi prajāyatē||75||

Line 960: Line 1,153:

(bhramaraiH phalapuShpebhyo yathA sambhriyate madhu|

tadvadojaH svakarmabhyo guNaiH sambhriyate nRuNAm||1||)

+

</div></div>

''Ojas'' is the very first substance created in the body of all living beings. Its color resembles that of ghee, tastes like honey and smells like roasted paddy [75]

Line 966: Line 1,160:

==== General etiological factors of ''ojas kshaya'' (i.e., depletion of ''ojas'') ====

+

व्यायामोऽनशनं चिन्ता रूक्षाल्पप्रमिताशनम्|

Line 972: Line 1,167:

कफशोणितशुक्राणां मलानां चातिवर्तनम्|

कालो भूतोपघातश्च ज्ञातव्याः क्षयहेतवः||७७||

+

vyāyāmō'naśanaṁ cintā rūkṣālpapramitāśanam|

Line 984: Line 1,180:

kaphashoNitashukrANAM malAnAM cAtivartanam|

kAlo bhUtopaghAtashca j~jAtavyAH kShayahetavaH||77||

+

</div></div>

+

Excessive exercising, fasting, worrying, fear, grief, taking dry, scanty and limited meals, dry beverages, exposure to wind and sun, insomnia, excessive excretion of mucus, blood, semen and excretions, adverse season or old age, major mental illness (''Bhuta-Upaghāta'') are the general causative factors for ''kshaya'' (depletion) of ''ojas'' [76-77]

</div>

==== Etiological factors and pathogenesis of ''avrita madhumeha'' (diabetes due to obstructive pathogenesis) ====

+

गुरुस्निग्धाम्ललवणान्यतिमात्रं समश्नताम्|

Line 997: Line 1,196:

तैरावृतगतिर्वायुरोज आदाय गच्छति|

यदा बस्तिं तदा कृच्छ्रो मधुमेहः प्रवर्तते||८०||

+

gurusnigdhāmlalavaṇānyatimātraṁ samaśnatām|

Line 1,015: Line 1,215:

tairAvRutagatirvAyuroja [1] AdAya gacchati|

yadA bastiM tadA kRucchro madhumehaH pravartate||80||

+

</div></div>

+

Excessive taking of heavy, unctuous, sour, and salty articles, eating of newly harvested cereals and newly prepared wines/drinks, excessive sleep, sedentary habits, avoidance of exercise or thinking/worry and not doing ''śhodhana'' (purification) lead to excessive increase in ''kapha, pitta, meda'' and ''mamsa''. These obstruct the pathways of ''vata'' leading to ''aavrita vata'' condition. Thus, provoked ''vata'' takes out ''ojas'' from its sites and brings it to ''basti'' causing ''madhumeha'' which is difficult to treat [78-80]

</div>

==== Symptoms of ''avrita madhumeha'' ====

+

स मारुतस्य पित्तस्य कफस्य च मुहुर्मुहुः|

दर्शयत्याकृतिं गत्वा क्षयमाप्यायते पुनः||८१||

+

sa mārutasya pittasya kaphasya ca muhurmuhuḥ|

Line 1,028: Line 1,232:

sa mArutasya pittasya kaphasya ca muhurmuhuH|

darshayatyAkRutiM gatvA kShayamApyAyate punaH||81||

+

</div></div>

In this condition of ''madhumeha'', the symptoms of ''vata, pitta'' and ''kapha'' are frequently manifested. The symptoms subside for some time, but again reappear later [81]

==== ''Sapta pidika'' (seven papules/pustules/carbuncles) ====

+

उपेक्षयाऽस्य जायन्ते पिडकाः सप्त दारुणाः|

Line 1,038: Line 1,244:

शराविका कच्छपिका जालिनी सर्षपी तथा|

अलजी विनताख्या च विद्रधी चेति सप्तमी||८३||

+

upēkṣayā'sya jāyantē piḍakāḥ sapta dāruṇāḥ|

Line 1,050: Line 1,257:

sharAvikA kacchapikA jAlinI sarShapI tathA|

alajI vinatAkhyA ca vidradhI ceti saptamI||83||

+

</div></div>

+

If the diabetic condition is neglected, seven types of ''pidika'' (pustules) are produced. These ''pidika'' occur in fleshy spaces, vital parts (''marma'') and joints. The names of these seven ''pidikā'' are ''sharavika, kacchapika, jalini, sarshapi, alaji, vinata'' and ''vidhradi'' [82-83]

</div>

===== 1. ''Sharavika'' =====

+

अन्तोन्नता मध्यनिम्ना श्यावा क्लेदरुगन्विता|

शराविका स्यात् पिडका शरावाकृतिसंस्थिता||८४||

+

antōnnatā madhyanimnā śyāvā klēdaruganvitā|

Line 1,063: Line 1,274:

antonnatA madhyanimnA shyAvA kledaruganvitA|

sharAvikA syAt piDakA sharAvAkRutisaMsthitA||84||

+

</div></div>

The edges of ''sharavika pidika'' are raised and middle part is depressed, and its colour is dusky-red. It is accompanied by slough (''kleda'') and pain. As its shape is like that of an earthen saucer (''sharavika''), hence its name [84]

===== 2. ''Kacchapika'' =====

+

अवगाढार्तिनिस्तोदा महावास्तुपरिग्रहा|

श्लक्ष्णा कच्छपपृष्ठाभा पिडका कच्छपी मता||८५||

+

avagāḍhārtinistōdā mahāvāstuparigrahā|

Line 1,076: Line 1,290:

avagADhArtinistodA mahAvAstuparigrahA|

shlakShNA kacchapapRuShThAbhA piDakA kacchapI matA||85||

+

</div></div>

''Kacchapika'' (carbuncle) is deeply and extensively infiltrated, with distress and pricking pain. It has a smooth surface like that of tortoise (''Kacchapa''), therefore, its name [85]

===== 3. ''Jalini'' =====

+

स्तब्धा सिराजालवती स्निग्धास्रावा महाशया|

रुजानिस्तोदबहुला सूक्ष्मच्छिद्रा च जालिनी||८६||

+

stabdhā sirājālavatī snigdhāsrāvā mahāśayā|

Line 1,089: Line 1,306:

stabdhA sirAjAlavatI snigdhAsrAvA mahAshayA|

rujAnistodabahulA sUkShmacchidrA ca jAlinI||86||

+

</div></div>

''Jalini pidika'' is extensive, hard, covered with a network of vessels with unctous discharge, having severe pricking type pain and having minute openings on the surface. It is called ''jalini'' because it resembles a net or a web [86]

===== 4. ''Sarshapi'' =====

+

पिडका नातिमहती क्षिप्रपाका महारुजा|

सर्षपी सर्षपाभाभिः पिडकाभिश्चिता भवेत्||८७||

+

piḍakā nātimahatī kṣiprapākā mahārujā|

Line 1,102: Line 1,322:

piDakA nAtimahatI kShiprapAkA mahArujA|

sarShapI sarShapAbhAbhiH piDakAbhishcitA bhavet||87||

+

</div></div>

''Sarshapi pidika'' is not very big but very painful and suppurates quickly and is surrounded by mustard seed-like boils [87]

===== 5. ''Alaji'' =====

+

दहति त्वचमुत्थाने तृष्णामोहज्वरप्रदा|

विसर्पत्यनिशं दुःखाद्दहत्यग्निरिवालजी||८८||

+

dahati tvacamutthānē tr̥ṣṇāmōhajvarapradā|

Line 1,115: Line 1,338:

dahati tvacamutthAne tRuShNAmohajvarapradA|

visarpatyanishaM duHkhAddahatyagnirivAlajI||88||

+

</div></div>

''Alaji pidika'' commences with a burning sensation in the skin accompanied by fever and thirst. It steadily spreads all over the body and causes severe distress with a fire-like burning sensation [88]

===== 6. ''Vinata'' =====

+

अवगाढरुजाक्लेदा पृष्ठे वाऽप्युदरेऽपि वा|

महती विनता नीला पिडका विनता मता||८९||

+

avagāḍharujāklēdā pr̥ṣṭhē vā'pyudarē'pi vā|

Line 1,128: Line 1,354:

avagADharujAkledA pRuShThe vA~apyudare~api vA|

mahatI vinatA nIlA piDakA vinatA matA||89||

+

</div></div>

''Vinatā pidika'' is extremely painful form of pustule. It is soft, situated either on back or abdomen, very extensive and depressed in the middle and bluish in colour. It is known as ''vinata'' because it is depressed or deep [89]

===== 7. ''Vidradhi''-(1) ''bahya vidradhi'' =====

+

विद्रधिं द्विविधामाहुर्बाह्यामाभ्यन्तरीं तथा|

बाह्या त्वक्स्नायुमांसोत्था कण्डराभा महारुजा||९०||

+

vidradhiṁ dvividhāmāhurbāhyāmābhyantarīṁ tathā|

Line 1,141: Line 1,370:

vidradhiM dvividhAmAhurbAhyAmAbhyantarIM tathA|

bAhyA tvaksnAyumAMsotthA kaNDarAbhA mahArujA||90||

+

</div></div>

''Vidradhi'' (abscess) is of two types viz. external and internal. External abscess occurs on skin and flesh. It looks like tendon and can cause severe pain [90]

==== Etiology and pathogenesis of internal abscess ====

+

शीतकान्नविदाह्युष्णरूक्षशुष्कातिभोजनात्|

Line 1,157: Line 1,388:

हृदये क्लोम्नि यकृति प्लीह्नि कुक्षौ च वृक्कयोः|

नाभ्यां वङ्क्षणयोर्वाऽपि बस्तौ वा तीव्रवेदनः||९४||

+

śītakānnavidāhyuṣṇarūkṣaśuṣkātibhōjanāt|

Line 1,184: Line 1,416:

hRudaye klomni yakRuti plIhni kukShau ca vRukkayoH|

nAbhyAM va~gkShaNayorvA~api bastau vA tIvravedanaH||94||

+

</div></div>

+

Excessive use of cold/stale, irritant, hot, un-unctuous and dry food articles, diet with incompatible or unwholesome articles, indigestion, spoiled foods, irregular eating, imbibing spoiled and excessive wines, suppression of natural urges, fatigue, exercise in distorted postures, excessive sleep, carrying heavy loads, excessive wayfaring and excessive sex-activity are the etiological factors of internal abscess.

Line 1,190: Line 1,424:

</div>

==== Etymology of ''vidradhi'' ====

+

दुष्टरक्तातिमात्रत्वात् स वै शीघ्रं विदह्यते|

ततः शीघ्रविदाहित्वाद्विद्रधीत्यभिधीयते||९५||

−

+

+

duṣṭaraktātimātratvāt sa vai śīghraṁ vidahyatē|

tataḥ śīghravidāhitvādvidradhītyabhidhīyatē||95||

Line 1,199: Line 1,435:

duShTaraktAtimAtratvAt sa vai shIghraM vidahyate|

tataH shIghravidAhitvAdvidradhItyabhidhIyate||95||

+

</div></div>

Excessively provoked ''rakta'' causes quick softening and formation of pus. Owing to its quickly suppurating (''vidahi'') characteristic, it is called ''vidradhi'' [95]

==== Three types of ''vidradhi'' ====

+

व्यधच्छेदभ्रमानाहशब्दस्फुरणसर्पणैः|

Line 1,209: Line 1,447:

जृम्भोत्क्लेशारुचिस्तम्भशीतकैः श्लैष्मिकीं विदुः|

सर्वासु च महच्छूलं विद्रधीषूपजायते||९७||

+

vyadhacchēdabhramānāhaśabdasphuraṇasarpaṇaiḥ|

Line 1,221: Line 1,460:

jRumbhotkleshArucistambhashItakaiH shlaiShmikIM viduH|

sarvAsu ca [2] mahacchUlaM vidradhIShUpajAyate||97||

+

</div></div>

+

All types of abscesses are very painful. Besides pain, the following symptoms may occur depending upon the ''dosha''.

Line 1,228: Line 1,469:

</div>

==== Symptoms of ripened abscess ====

+

शस्त्रास्त्रैर्भिद्यत इव चोल्मुकैरिव दह्यते|

विद्रधी व्यम्लता याता वृश्चिकैरिव दश्यते||९८||

+

+

śastrāstrairbhidyata iva cōlmukairiva dahyatē|

vidradhī vyamlatā yātā vr̥ścikairiva daśyatē||98||

+

shastrAstrairbhidyata [3] iva colmukairiva dahyate|

vidradhI vyamlatA yAtA vRushcikairiva dashyate||98||

+

</div></div>

On ripening of the abscess, the patient feels pain as if cut by a weapon or as if burnt by coal or as if stung by a scorpion [98]

==== Pus discharge according to type of abscess ====

+

तनु रूक्षारुणं श्यावं फेनिलं वातविद्रधी|

Line 1,245: Line 1,492:

श्लैष्मिकी स्रवति श्वेतं पिच्छिलं बहलं बहु|

लक्षणं सर्वमेवैतद्भजते सान्निपातिकी||१००||

+

tanu rūkṣāruṇaṁ śyāvaṁ phēnilaṁ vātavidradhī|

Line 1,257: Line 1,505:

shlaiShmikI sravati shvetaM picchilaM bahalaM bahu|

lakShaNaM sarvamevaitadbhajate sAnnipAtikI||100||

+

</div></div>

*In ''vata'' type of abscess, the discharge is thin, ununctuous, dusky-red and frothy.

Line 1,264: Line 1,513:

==== Symptoms of ''vidradhi'' according to organ involved ====

+

अथासां विद्रधीनां साध्यासाध्यत्वविशेषज्ञानार्थं स्थानकृतं लिङ्गविशेषमुपदेक्ष्यामः-तत्र प्रधानमर्मजायां विद्रध्यांहृद्धट्टनतमकप्रमोहकासश्वासाः, क्लोमजायां पिपासामुखशोषगलग्रहाः, यकृज्जायां श्वासः, प्लीहजायामुच्छ्वासोपरोधः,कुक्षिजायां कुक्षिपार्श्वान्तरांसशूलं, वृक्कजायां पृष्ठकटिग्रहः, नाभिजायां हिक्का, वङ्क्षणजायां सक्थिसादः, बस्तिजायांकृच्छ्रपूतिमूत्रवर्चसत्वं चेति||१०१||

+

athāsāṁ vidradhīnāṁ sādhyāsādhyatvaviśēṣajñānārthaṁ sthānakr̥taṁ liṅgaviśēṣamupadēkṣyāmaḥ- tatrapradhānamarmajāyāṁ vidradhyāṁ hr̥ddhaṭṭanatamakapramōhakāsaśvāsāḥ, klōmajāyāṁpipāsāmukhaśōṣagalagrahāḥ, yakr̥jjāyāṁ śvāsaḥ, plīhajāyāmucchvāsōparōdhaḥ, kukṣijāyāṁkukṣipārśvāntarāṁsaśūlaṁ, vr̥kkajāyāṁ pr̥ṣṭhakaṭigrahaḥ, nābhijāyāṁ hikkā, vaṅkṣaṇajāyāṁsakthisādaḥ, bastijāyāṁ kr̥cchrapūtimūtravarcasatvaṁ cēti||101||

athAsAM vidradhInAM sAdhyAsAdhyatvavisheShaj~jAnArthaM sthAnakRutaM li~ggavisheShamupadekShyAmaH- tatra pradhAnamarmajAyAM vidradhyAMhRuddhaTTanatamakapramohakAsashvAsAH, klomajAyAM pipAsAmukhashoShagalagrahAH, yakRujjAyAM shvAsaH, plIhajAyAmucchvAsoparodhaH, kukShijAyAMkukShipArshvAntarAMsashUlaM, vRukkajAyAM pRuShThakaTigrahaH, nAbhijAyAM hikkA, va~gkShaNajAyAM sakthisAdaH, bastijAyAMkRucchrapUtimUtravarcasatvaM [1] ceti||101||

+

</div></div>

Now the curability-incurability, and the symptoms of abscesses in specific bodily organs are described as follows:

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</div>

==== Route of discharge ====

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पक्वप्रभिन्नासूर्ध्वजासु मुखात् स्रावः स्रवति, अधोजासु गुदात्, उभयतस्तु नाभिजासु||१०२||

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pakvaprabhinnāsūrdhvajāsu mukhāt srāvaḥ sravati, adhōjāsu gudāt, ubhayatastu nābhijāsu||102||

pakvaprabhinnAsUrdhvajAsu mukhAt srAvaH sravati, adhojAsu gudAt, ubhayatastu nAbhijAsu||102||

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</div></div>

Suppurated internal abscesses burst and the pus is discharged. The discharge of the abscesses situated in the organs above the navel comes out from mouth, of situated below the umbilicus comes out from anus and of around the navel may come from either of the routes [102]

==== Prognosis of abscesses ====

+

आसां हृन्नाभिबस्तिजाः परिपक्वाः सान्निपातिकी च मरणाय; शेषाः पुनः कुशलमाशुप्रतिकारिणंचिकित्सकमासाद्योपशाम्यन्ति|

तस्मादचिरोत्थितां विद्रधीं शस्त्रसर्पविद्युदग्नितुल्यां स्नेहविरेचनैराश्वेवोपक्रमेत् सर्वशो गुल्मवच्चेति||१०३||

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āsāṁ hr̥nnābhibastijāḥ paripakvāḥ sānnipātikī ca maraṇāya; śēṣāḥ punaḥ kuśalamāśupratikāriṇaṁcikitsakamāsādyōpaśāmyanti|

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AsAM hRunnAbhibastijAH paripakvAH sAnnipAtikI ca maraNAya; sheShAH punaH kushalamAshupratikAriNaM cikitsakamAsAdyopashAmyanti|

tasmAdacirotthitAM vidradhIM shastrasarpavidyudagnitulyAM snehavirecanairAshvevopakramet sarvasho gulmavacceti||103||

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</div></div>

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The abscesses occurring in the heart, umbilicus and urinary bladder as well as of ''sannipātika'' type, if suppurated, have bad prognosis and may lead to death. Remaining types of abscess ,if treated immediately by an expert physician, are curable.

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</div>

==== Possibility of ''Pidika'' without prameha ====

−

+

+

भवन्ति चात्र-

विना प्रमेहमप्येता जायन्ते दुष्टमेदसः|

तावच्चैता न लक्ष्यन्ते यावद्वास्तुपरिग्रहः||१०४||

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bhavanti cātra-

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vinA pramehamapyetA jAyante duShTamedasaH|

tAvaccaitA na lakShyante yAvadvAstuparigrahaH||104||

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</div></div>

Here are verses again-

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==== Prognosis of ''pidika'' ====

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शराविका कच्छपिका जालिनी चेति दुःसहाः|

जायन्ते ता ह्यतिबलाः प्रभूतश्लेष्ममेदसः||१०५||

−

+

+

śarāvikā kacchapikā jālinī cēti duḥsahāḥ|

jāyantē tā hyatibalāḥ prabhūtaślēṣmamēdasaḥ||105||

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sharAvikA kacchapikA jAlinI ceti duHsahAH|

jAyante tA hyatibalAH prabhUtashleShmamedasaH||105||

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</div></div>

''Sharavika, kacchapika'' and ''jalini'' types of ''pidika'' are formed due to excessive ''kapha'' and ''medas'', and therefore can become very severe and cause unbearable pain [105]

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सर्षपी चालजी चैव विनता विद्रधी च याः|

साध्यः पित्तोल्बणास्तास्तु सम्भवन्त्यल्पमेदसः||१०६||

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sarṣapī cālajī caiva vinatā vidradhī ca yāḥ|

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sarShapI cAlajI caiva vinatA vidradhI ca yAH|

sAdhyaH pittolbaNAstAstu sambhavantyalpamedasaH||106||

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</div></div>

''Sarshapi, alaji , vinata'' and ''vidradhi'' occur due to dominance of ''pitta'' in a person having low ''medas'' and are curable [106]

==== Bad prognostic ''pidika'' ====

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मर्मस्वंसे गुदे पाण्योः स्तने सन्धिषु पादयोः|

जायन्ते यस्य पिडिकाः स प्रमेही न जीवति||१०७||

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+

marmasvaṁsē gudē pāṇyōḥ stanē sandhiṣu pādayōḥ|

jāyantē yasya piḍikāḥ sa pramēhī na jīvati||107||

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marmasvaMse gude pANyoH stane sandhiShu pAdayoH|

jAyante yasya piDikAH sa pramehI na jIvati||107||

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</div></div>

A diabetic person does not survive if he gets ''pidika'' in vital-parts, shoulder, anus, hands, breast, joints, and feet [107]

==== Miscellanous ''pidika'' ====

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तथाऽन्याः पिडकाः सन्ति रक्तपीतासितारुणाः|

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मृद्व्यश्च कठिनाश्चान्याः स्थूलाः सूक्ष्मास्तथाऽपराः|

मन्दवेगा महावेगाः स्वल्पशूला महारुजः||१०९||

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tathā'nyāḥ piḍakāḥ santi raktapītāsitāruṇāḥ|

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mRudvyashca kaThinAshcAnyAH sthUlAH sUkShmAstathA~aparAH|

mandavegA mahAvegAH svalpashUlA mahArujaH||109||

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</div></div>

There are some other types of papules or pustules (''pidika'') with the following characteristics:

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'''Associated pain''': Some pustules are slightly painful while others are very painful. [108-109]

+

ता बुद्ध्वा मारुतादीनां यथास्वैर्हेतुलक्षणैः|

ब्रूयादुपचरेच्चाशु प्रागुपद्रवदर्शनात्||११०||

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tā buddhvā mārutādīnāṁ yathāsvairhētulakṣaṇaiḥ|

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tA buddhvA mArutAdInAM yathAsvairhetulakShaNaiH|

brUyAdupacareccAshu prAgupadravadarshanAt||110||

+

</div></div>

The wise physician should diagnose the above pustules on the basis of the causative factors and characteristics of involved ''dosha'' and treat these appropriately (and quickly) before these advance into complications [110]

==== Complications of pustules (''pidika'') ====

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तृट्श्वासमांससङ्कोथमोहहिक्कामदज्वराः|

वीसर्पमर्मसंरोधाः पिडकानामुपद्रवाः||१११||

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+

tr̥ṭśvāsamāṁsasaṅkōthamōhahikkāmadajvarāḥ|

vīsarpamarmasaṁrōdhāḥ piḍakānāmupadravāḥ||111||

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tRuTshvAsamAMsasa~gkothamohahikkAmadajvarAH|

vIsarpamarmasaMrodhAH piDakAnAmupadravAH||111||

+

</div></div>

Thirst, dyspnoea, sloughing of flesh, stupor, hiccup, toxaemia, fever, spreading inflammatory swelling and obstruction in function of the vital organs are the complications of pustules [111]

==== States (''gati'') of ''dosha'' ====

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क्षयः स्थानं च वृद्धिश्च दोषाणां त्रिविधा गतिः|

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त्रिविधा चापरा कोष्ठशाखामर्मास्थिसन्धिषु|

इत्युक्ता विधिभेदेन दोषाणां त्रिविधा गतिः||११३||

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kṣayaḥ sthānaṁ ca vr̥ddhiśca dōṣāṇāṁ trividhā gatiḥ|

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trividhA cAparA koShThashAkhAmarmAsthisandhiShu|

ityuktA vidhibhedena doShANAM trividhA gatiH||113||

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</div></div>

+

Decrease, normalcy and increase are the three states of ''doshas''. Other three courses of ''doshas'' are upward, downward and oblique/transverse movement. Yet another set of three states of ''dosha'' are by their movement to ''koshtha'' (thoraco-abdominal cavity), ''shakha'' (''tvak'' and ''dhatus'' except ''rasa'') and vital-organs, bones and joints. Thus are described various states of ''doshas'' [112-113]

</div>

==== Seasonal course of ''doshas'' ====

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चयप्रकोपप्रशमाः पित्तादीनां यथाक्रमम्|

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गतिः कालकृता चैषा चयाद्या पुनरुच्यते|११५|

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cayaprakōpapraśamāḥ pittādīnāṁ yathākramam|

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gatiH kAlakRutA caiShA cayAdyA punarucyate|115|

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</div></div>

+

Accumulation, provocation and pacification of ''pitta, vata'' and ''kapha'' respectively occur individually and sequentially in the six seasons beginning with the rainy season (e.g., ''pitta'' accumulation in rainy season, etc). These courses (of accumulation, provocation and/or pacification) of ''dosha'' are known as seasonal courses of ''doshas''.[114]

</div>

==== Physiological and pathological course of ''dosha'' ====

+

गतिश्च द्विविधा दृष्टा प्राकृती वैकृती च या||११५||

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सर्वा हि चेष्टा वातेन स प्राणः प्राणीनां स्मृतः|

तेनैव रोगा जायन्ते तेन चैवोपरुध्यते||११८||

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gatiśca dvividhā dr̥ṣṭā prākr̥tī vaikr̥tī ca yā||115||

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sarvA hi ceShTA vAtena sa prANaH prANInAM smRutaH|

tenaiva rogA jAyante tena caivoparudhyate||118||

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</div></div>

+

Another set of courses of ''dosha'' are physiological and pathological. Normally, heat generated by ''pitta'' digests the food but when the same ''pitta'' is in a provoked state, it causes various disorders. Similarly, normal ''kapha'' contributes to body-strength but when vitiated, it becomes waste material (''mala''). Normal ''kapha'' is also responsible for ''ojas'', however on provocation, it could cause various ailments in the body.

</div>

''Vāta'' is responsible for all types of movements in living beings and represents life of living-beings, but vitiated ''vata'' causes many diseases and is even responsible for causing death [115-118]

+

नित्यं सन्निहितामित्रं समीक्ष्यात्मानमात्मवान्|

नित्यं युक्तः परिचरेदिच्छन्नायुरनित्वरम्||११९||

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nityaṁ sannihitāmitraṁ samīkṣyātmānamātmavān|

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nityaM sannihitAmitraM samIkShyAtmAnamAtmavAn|

nityaM yuktaH paricaredicchannAyuranitvaram||119||

+

</div></div>

A person desiring to live the full span of life should remain self controlled and live with great caution assuming that he is constantly surrounded by the foes to his health [119]

==== Summary ====

+

तत्र श्लोकौ-

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कियन्तःशिरसीयेऽस्मिन्नध्याये तत्त्वदर्शिना|

ज्ञानार्थं भिषजां चैव प्रजानां च हितैषिणा||१२१||

+

tatra ślōkau-

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kiyantaHshirasIye~asminnadhyAye tattvadarshinA|

j~jAnArthaM bhiShajAM caiva prajAnAM ca hitaiShiNA||121||

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</div></div>

Here are two recapitulate verses:

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The diagnosis of diseases of the head, diseases of the heart, diseases caused by minute pathological conditions of the ''doshas'', conditions caused by decreased ''doshas'', inflammatory swellings and various courses of ''doshas'' have been described in this chapter entitled 'how many are the diseases of the head', by the well-wisher of mankind, the great sage Atreya, for the enlightenment of the physicians [120-121]

</div>

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+

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते श्लोकस्थाने कियन्तःशिरसीयो नाम सप्तदशोऽध्यायः||१७||

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Ityagniveśakr̥te Tantre Carakapratisamskr̥te ślokasthāne kiyantaḥśirasīyo Nāma saptadaśoadhyāyaḥ ||17||

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</div></div>

Thus seventeenth chapter of [[Sutra Sthana]] compiled by Agnivesha and revised by Charak entitled [[Kiyanta Shiraseeya Adhyaya]] is completed (17).

Agnivesha

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