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Trishothiya Adhyaya (view source)

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{{#seo:

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|title=Trishothiya Adhyaya

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|titlemode=append

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|keywords=Swellings, endogenous causes, exogenous causes, shotha, nija-agantuja, generalized edema, localized edema

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|description=Sutra Sthana Chapter 18.Three Types of Swellings and other conditions

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}}

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<big>'''Sutra Sthana Chapter 18.Three Types of Swellings and other conditions '''</big>

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=== Sanskrit text, Transliteration and English Translation ===

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अथातस्त्रिशोथीयमध्यायं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

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athātastriśōthīyamadhyāyaṁ vyākhyāsyāmaḥ||1||

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iti ha smAha bhagavAnAtreyaH||2||

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</div></div>

Now we will expound the chapter on three types of ''shotha'' i.e. swellings. Thus, said Lord Atreya. [1-2]

==== Three types of ''shotha'' ====

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त्रयः शोथा भवन्ति वातपित्तश्लेष्मनिमित्ताः, ते पुनर्द्विविधा निजागन्तुभेदेन||३||

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trayaḥ śōthā bhavanti vātapittaślēṣmanimittāḥ, tē punardvividhā nijāgantubhēdēna||3||

trayaH shothA bhavanti vAtapittashleShmanimittAH, te punardvividhA nijAgantubhedena||3||

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</div></div>

There are three types of ''shothas'' (swelling) i.e. ''vataja, pittaja'' and ''kaphaja''. Further, they can be classified into two i.e. ''nija'' (endogenous) and ''agantuja'' (exogenous). [3]

==== Causes of exogenous swelling ====

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तत्रागन्तवश्छेदनभेदनक्षणनभञ्जनपिच्छनोत्पेषण प्रहारवधबन्धनवेष्टनव्यधन पीडनादिभिर्वाभल्लातकपुष्पफलरसात्मगुप्ताशूकक्रिमिशूकाहितपत्रलतागुल्मसंस्पर्शनैर्वा स्वेदनपरिसर्पणावमूत्रणैर्वा विषिणांसविषप्राणिदंष्ट्रादन्तविषाणनखनिपातैर्वा सागरविषवातहिमदहनसंस्पर्शनैर्वा शोथाः समुपजायन्ते||४||

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tatrāgantavaśchēdanabhēdanakṣaṇanabhañjanapicchanōtpēṣaṇa prahāravadhabandhanavēṣṭanavyadhana

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tatrAgantavashchedanabhedanakShaNanabha~jjanapicchanotpeShaNa prahAravadhabandhanaveShTanavyadhana pIDanAdibhirvAbhallAtakapuShpaphala rasAtmaguptAshUkakrimishUkAhitapatralatAgulmasaMsparshanairvA svedanaparisarpaNAvamUtraNairvAviShiNAM saviShaprANidaMShTrAdantaviShANanakhanipAtairvA sAgaraviShavAtahimadahanasaMsparshanairvA shothAH samupajAyante||4||

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</div></div>

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Causes of ''agantuja shotha'' (exogenous swelling): Common etiological factors of ''agantuja shotha'' include ''chhedana'' (excision), ''bhedana'' (incision), ''kshanana'' (churning of bones), ''bhanjana'' (breaking), ''pichhana'' (excess squeezing), ''utprashana'' (grinding), ''prahaara'' (hitting), ''vadha'' (stroking), ''bandhana'' (binding), ''veshtana'' (twisting), ''vyadhana'' (piercing), ''peedana'' (pressing) etc. In addition to these traumas some other factors such as coming in contact with the juice of flowers or fruits of some plants such as ''bhallātaka'' (Semicarpus anacardium), ''atmagupta'' (Mucuna pruriens) or getting bitten or stung by certain insects or touching irritant leaves, climbers, shrubs, sweat or urine of poisonous animals or even coming in physical contact with them, or getting injured by their teeth, horns and nails, or exposure to marine or poisonous air, or exposure to excess cold or burns may also result in ''agantuja shotha''. [4]

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==== Diagnosis and treatment of exogenous swelling ====

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ते पुनर्यथास्वं हेतुव्यञ्जनैरादावुपलभ्यन्ते निजव्यञ्जनैकदेशविपरीतैः;बन्धमन्त्रागदप्रलेपप्रतापनिर्वापणादिभिश्चोपक्रमैरुपक्रम्यमाणाः प्रशान्तिमापद्यन्ते||५||

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tē punaryathāsvaṁ hētuvyañjanairādāvupalabhyantē nijavyañjanaikadēśaviparītaiḥ;bandhamantrāgadapralēpapratāpanirvāpaṇādibhiścōpakramairupakramyamāṇāḥpraśāntimāpadyantē||5||

te punaryathAsvaM hetuvya~jjanairAdAvupalabhyante nijavya~jjanaikadeshaviparItaiH;bandhamantrAgadapralepapratApanirvApaNAdibhishcopakramairupakramyamANAH prashAntimApadyante||5||

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</div></div>

Exogenous swellings can be primarily identified by characteristic signs of injury and localization. After some time, they become similar to endogenous swellings (due to vitiation of ''dosha''). They are treated by bandage, ''mantra'' (holy chants), antidotes, local application of medicines, fomentation, cooling measures etc. [5]

==== General causes of endogenous swellings ====

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निजाः पुनः स्नेहस्वेदवमनविरेचनास्थापनानुवासनशिरोविरेचनानामयथावत्प्रयोगान्मिथ्यासंसर्जनाद्वाछर्द्यलसकविसूचिकाश्वासकासातिसारशोषपाण्डुरोगोदरज्वरप्रदरभगन्दरार्शोविकारातिकर्शनैर्वा कुष्ठकण्डूपिडकादिभिर्वाछर्दिक्षवथूद्गारशुक्रवातमूत्रपुरीषवेगधारणैर्वा कर्मरोगोपवासाध्वकर्शितस्य वासहसाऽतिगुर्वम्ललवणपिष्टान्नफलशाकरागदधिहरितकमद्यमन्दकविरूढनवशूकशमीधान्यानूपौदक-पिशितोपयोगान्मृत्पङ्कलोष्टभक्षणाल्लवणातिभक्षणाद्गर्भसम्पीडनादामगर्भप्रपतनात् प्रजातानां चमिथ्योपचारादुदीर्णदोषत्वाच्च शोफाः प्रादुर्भवन्ति; इत्युक्तः सामान्यो हेतुः||६||

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nijāḥ punaḥ snēhasvēdavamanavirēcanāsthāpanānuvāsanaśirōvirēcanānāmayathāvatprayōgānmithyāsaṁsarjanādvāchardyalasakavisūcikāśvāsakāsātisāraśōṣapāṇḍurōgōdarajvarapr<br>adarabhagandarārśōvikārātikarśanairvā

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nijAH punaH snehasvedavamanavirecanAsthApanAnuvAsanashirovirecanAnAmayathAvatprayogAnmithyAsaMsarjanAdvAchardyalasakavisUcikAshvAsakAsAtisArashoShapANDurogo<br>darajvarapradarabhagandarArshovikArAtikarshanairvA kuShThakaNDUpiDakAdibhirvAchardikShavathUdgArashukravAtamUtrapurIShavegadhAraNairvA karmarogopavAsAdhvakarshitasya vAsahasA~atigurvamlalavaNapiShTAnnaphalashAkarAgadadhiharitakamadyamandakavirUDhanavashUkashamIdhAnyAnUpaudaka-pishitopayogAnmRutpa~gkaloShTabhakShaNAllavaNAtibhakShaNAdgarbhasampIDanAdAmagarbhaprapatanAt prajAtAnAM ca mithyopacArAdudIrNadoShatvAccashophAH prAdurbhavanti; ityuktaH sAmAnyo hetuH||6||

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</div></div>

''Nija shotha'' i.e. endogenous swelling could be caused due to any of the following factors:

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===== Swelling due to ''vata'' dominance =====

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अयं त्वत्र विशेषः- शीतरूक्षलघुविशदश्रमोपवासातिकर्शनक्षपणादिभिर्वायुः [१] प्रकुपितस्त्वङ्मांसशोणितादीन्यभिभूय शोफंजनयति; स क्षिप्रोत्थानप्रशमो भवति, तथा श्यामारुणवर्णः प्रकृतिवर्णो वा, चलः स्पन्दनः खरपरुषभिन्नत्वग्रोमा छिद्यत इवभिद्यत इव पीड्यत इव सूचीभिरिव तुद्यते पिपीलिकाभिरिव संसृप्यते सर्षपकल्कावलिप्त इव चिमिचिमायते सङ्कुच्यतआयम्यत इवेति वातशोथः (१);

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ayaṁ tvatra viśēṣaḥ- śītarūkṣalaghuviśadaśramōpavāsātikarśanakṣapaṇādibhirvāyuḥ [1]prakupitastvaṅmāṁsaśōṇitādīnyabhibhūya śōphaṁ janayati; sa kṣiprōtthānapraśamō bhavati, tathāśyāmāruṇavarṇaḥ prakr̥tivarṇō vā, calaḥ spandanaḥ kharaparuṣabhinnatvagrōmā chidyata iva bhidyata ivapīḍyata iva sūcībhiriva tudyatē pipīlikābhiriva saṁsr̥pyatē sarṣapakalkāvalipta iva cimicimāyatē saṅkucyataāyamyata ivēti vātaśōthaḥ (1);

ayaM tvatra visheShaH- shItarUkShalaghuvishadashramopavAsAtikarshanakShapaNAdibhirvAyuH [1] prakupitastva~gmAMsashoNitAdInyabhibhUya shophaMjanayati; sa kShiprotthAnaprashamo bhavati, tathA shyAmAruNavarNaH prakRutivarNo vA, calaH spandanaH kharaparuShabhinnatvagromA chidyata iva bhidyata ivapIDyata iva sUcIbhiriva tudyate pipIlikAbhiriva saMsRupyate sarShapakalkAvalipta iva cimicimAyate sa~gkucyata Ayamyata iveti vAtashothaH (1);

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</div></div>

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''Vata'' gets vitiated due to excess intake of ''sheeta'' (cold things), ''ruksha'' (rough or low calorie), ''laghu'' (very light), ''vishada'' (non-slimy substance) diets, ''shrama'' (excessive exertion), ''upavasa'' (excessive fasting), ''ati-karshan'' (emaciation), and ''kshapana'' (wasting). This vitiated ''vata'' gets into and stays within ''twak'' (skin), ''mamsa'' (muscle tissue), along with ''rakta'' (blood) and produces ''shotha'', i.e., swelling. This swelling increases as well as subsides quickly, black or reddish in color, fleeting, pulsating, with coarse skin, rough and broken hair. The person feels different types of pain sensation like ''chhidyati'' (excision), ''bhidyati'' (incision), ''suchibhiriva'' (piercing by needles/pricking), crawling of ants, irritation (as if pasted with mustard) and a feeling of contraction or expansion. These are some of the traits of swelling caused by ''vata''. [1]

</div>

===== Swelling due to ''pitta'' dominance =====

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उष्णतीक्ष्णकटुकक्षारलवणाम्लाजीर्णभोजनैरग्न्यातपप्रतापैश्च पित्तं प्रकुपितं त्वङ्मांसशोणितान्यभिभूय शोथं जनयति; सक्षिप्रोत्थानप्रशमो भवति, कृष्णपीतनीलताम्रावभास उष्णो मृदुः कपिलताम्ररोमा उष्यते दूयते धूप्यते ऊष्मायते स्विद्यतेक्लिद्यते न च स्पर्शमुष्णं च सुषूयत इति पित्तशोथः (२);

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uṣṇatīkṣṇakaṭukakṣāralavaṇāmlājīrṇabhōjanairagnyātapapratāpaiśca pittaṁ prakupitaṁtvaṅmāṁsaśōṇitānyabhibhūya śōthaṁ janayati; sa kṣiprōtthānapraśamō bhavati,kr̥ṣṇapītanīlatāmrāvabhāsa uṣṇō mr̥duḥ kapilatāmrarōmā uṣyatē dūyatē dhūpyatē ūṣmāyatē svidyatēklidyatē na ca sparśamuṣṇaṁ ca suṣūyata iti pittaśōthaḥ (2);

uShNatIkShNakaTukakShAralavaNAmlAjIrNabhojanairagnyAtapapratApaishca pittaM prakupitaM tva~gmAMsashoNitAnyabhibhUya shothaM janayati; sakShiprotthAnaprashamo bhavati, kRuShNapItanIlatAmrAvabhAsa uShNo mRuduH kapilatAmraromA [2] uShyate dUyate dhUpyate UShmAyate svidyate klidyate na casparshamuShNaM ca suShUyata [3] iti pittashothaH (2);

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</div></div>

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''Pitta'' is vitiated due to excessive intake of hot, irritant, pungent, alkaline, salt, sour food, taking food when ailing from indigestion, or due to excessive exposure to heat and sunlight. This gets into the skin, muscle tissue, or blood and produces swelling. It also increases and subsides quickly. The affected part becomes blackish, yellow, bluish, copper-tinged, hot, or soft with brown and coppery hair. It gives a burning sensation of various forms and could be hot, sweaty, and moist. The affected region could be tender to touch and very sensitive to heat. These are the traits of swelling due to ''pitta dosha''. [2]

</div>

===== Swelling due to ''kapha'' dominance =====

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गुरुमधुरशीतस्निग्धैरतिस्वप्नाव्यायामादिभिश्च श्लेष्मा प्रकुपितस्त्वङ्मांसशोणितादीन्यभिभूय शोथं जनयति; सकृच्छ्रोत्थानप्रशमो भवति, पाण्डुश्वेतावभासो गुरुः स्निग्धः श्लक्ष्णः स्थिरः स्त्यानः शुक्लाग्ररोमा स्पर्शोष्णसहश्चेतिश्लेष्मशोथः (३);

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gurumadhuraśītasnigdhairatisvapnāvyāyāmādibhiśca ślēṣmā prakupitastvaṅmāṁsaśōṇitādīnyabhibhūyaśōthaṁ janayati; sa kr̥cchrōtthānapraśamō bhavati, pāṇḍuśvētāvabhāsō guruḥ snigdhaḥ ślakṣṇaḥ sthiraḥstyānaḥ śuklāgrarōmā sparśōṣṇasahaścēti ślēṣmaśōthaḥ (3);

gurumadhurashItasnigdhairatisvapnAvyAyAmAdibhishca shleShmA prakupitastva~gmAMsashoNitAdInyabhibhUya shothaM janayati; sa kRucchrotthAnaprashamobhavati, pANDushvetAvabhAso guruH snigdhaH shlakShNaH sthiraH styAnaH shuklAgraromA sparshoShNasahashceti shleShmashothaH (3);

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</div></div>

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''Kapha'' is vitiated due to excessive use of heavy to digest, sweet, cold and unctuous food, excessive sleep, sedentary life, etc. Vitiated ''kapha'' inhabits the skin, muscle tissues, and blood, causing swelling. A ''kapha''-induced swelling grows slowly and subsides with difficulty. Affected part becomes pale, whitish, heavy, unctuous, smooth, stable, thick, with white hair, tolerant of touch and heat This is the swelling caused due to ''kapha''.

</div>

===== Different types due to involvement of more than one ''dosha'' =====

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यथास्वकारणाकृतिसंसर्गाद्द्विदोषजास्त्रयः शोथा भवन्ति; यथास्वकारणाकृतिसन्निपातात् सान्निपातिक एकः; एवं [४]सप्तविधो भेदः||७||

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yathāsvakāraṇākr̥tisaṁsargāddvidōṣajāstrayaḥ śōthā bhavanti; yathāsvakāraṇākr̥tisannipātāt sānnipātikaēkaḥ; ēvaṁ [4] saptavidhō bhēdaḥ||7||

yathAsvakAraNAkRutisaMsargAddvidoShajAstrayaH shothA bhavanti; yathAsvakAraNAkRutisannipAtAt sAnnipAtika ekaH; evaM saptavidho bhedaH||7||

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</div></div>

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Through the combination of the causes and symptoms of two ''doshas'' (''dwidoshaja''), three types of swelling occur. Similarly, a ''sannipatika shotha'' is caused by the combination of respective causes and symptoms of all three ''doshas''. Thus swelling is of seven types. [7]

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==== Various types of ''shotha'' and cardinal sign ====

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प्रकृतिभिस्ताभिस्ताभिर्भिद्यमानो द्विविधस्त्रिविधश्चतुर्विधः सप्तविधोऽष्टविधश्च शोथ उपलभ्यते, पुनश्चैक एवोत्सेधसामान्यात्||८||

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prakr̥tibhistābhistābhirbhidyamānō dvividhastrividhaścaturvidhaḥ saptavidhō'ṣṭavidhaśca śōthaupalabhyatē, punaścaika ēvōtsēdhasāmānyāt||8||

prakRutibhistAbhistAbhirbhidyamAno [5] dvividhastrividhashcaturvidhaH saptavidho~aShTavidhashca shotha upalabhyate, punashcaika [6] evotsedhasAmAnyAt||8||

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</div></div>

On the basis of causative factors and classifications from different views, swelling may be of two, three, four, seven or eight types Again, there is only one type with common sign of ‘swelling’. [8]

==== Brief description of specific features ====

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भवन्ति चात्र-

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निदानाकृतिसंसर्गाच्छ्वयथुः स्याद्द्विदोषजः|

सर्वाकृतिः सन्निपाताच्छोथो व्यामिश्रहेतुजः||१५||

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bhavanti cātra-

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nidAnAkRutisaMsargAcchvayathuH syAddvidoShajaH|

sarvAkRutiH sannipAtAcchotho vyAmishrahetujaH||15||

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</div></div>

===== Specific features of ''vataja, pittaja'' and ''kaphaja'' swellings =====

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==== Prognosis ====

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यस्तु पादाभिनिर्वृत्तः शोथः सर्वाङ्गगो भवेत्|

जन्तोः स च सुकष्टः स्यात् प्रसृतः स्त्रीमुखाच्च यः||१६||

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यश्चापि गुह्यप्रभवः स्त्रिया वा पुरुषस्य वा|

स च कष्टतमो ज्ञेयो यस्य च स्युरुपद्रवाः||१७||

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yastu pādābhinirvr̥ttaḥ śōthaḥ sarvāṅgagō bhavēt|

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yashcApi guhyaprabhavaH striyA vA puruShasya vA|

sa ca kaShTatamo j~jeyo yasya ca syurupadravAH||17||

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</div></div>

A swelling that starts from the feet and spreads all over the body and which starts from the face in women can only be cured with difficulty. In men or women, swellings that emanate from the genitalia, as well as all complicated variants of edema are mostly difficult to cure. [16-17]

==== Complications of ''shotha'' ====

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छर्दिः श्वासोऽरुचिस्तृष्णा ज्वरोऽतीसार एव च|

सप्तकोऽयं सदौर्बल्यः शोफोपद्रवसङ्ग्रहः||१८||

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chardiḥ śvāsō'rucistr̥ṣṇā jvarō'tīsāra ēva ca|

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chardiH shvAso~arucistRuShNA jvaro~atIsAra eva ca|

saptako~ayaM sadaurbalyaH shophopadravasa~ggrahaH||18||

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</div></div>

Vomiting, breathlessness, anorexia, excessive thirst, pyrexia, diarrhea and weakness - these are seven complications of ''shotha''. [18]

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==== Different types of swelling at specific sites ====

===== ''Upajivhika'' =====

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यस्य श्लेष्मा प्रकुपितो जिह्वामूलेऽवतिष्ठते|

आशु सञ्जनयेच्छोथं जायतेऽस्योपजिह्विका||१९||

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yasya ślēṣmā prakupitō jihvāmūlē'vatiṣṭhatē|

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yasya shleShmA prakupito jihvAmUle~avatiShThate|

Ashu sa~jjanayecchothaM [1] jAyate~asyopajihvikA||19||

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</div></div>

When the vitiated ''kapha'' emanates or begins from the root of the tongue and causes swelling suddenly, is called ''upajivhika'' (ranula or hypertrophied solitary lingual papilla). [19]

===== ''Galashundika'' =====

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यस्य श्लेष्मा प्रकुपितः काकले व्यवतिष्ठते|

आशु सञ्जनयेच्छोफं करोति गलशुण्डिकाम्||२०||

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yasya ślēṣmā prakupitaḥ kākalē vyavatiṣṭhatē|

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yasya shleShmA prakupitaH kAkale vyavatiShThate|

Ashu sa~jjanayecchophaM [2] karoti galashuNDikAm||20||

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</div></div>

The vitiated ''kapha'' inhabits at uvula and produces swelling suddenly, that is called ''Galashundika''(uvulitis). [20]

===== ''Galaganda'' =====

−

+

+

यस्य श्लेष्मा प्रकुपितो गलबाह्येऽवतिष्ठते|

शनैः सञ्जनयेच्छोफं गलगण्डोऽस्य जायते||२१||

+

yasya ślēṣmā prakupitō galabāhyē'vatiṣṭhatē|

Line 303: Line 362:

yasya shleShmA prakupito galabAhye~avatiShThate|

shanaiH sa~jjanayecchophaM [3] galagaNDo~asya jAyate||21||

+

</div></div>

A swelling that is caused when a vitiated ''kapha'' affects the throat from the outside, and gradually produces swelling , is called ''galaganda'' (goitre). [21]

===== ''Galagraha'' =====

+

यस्य श्लेष्मा प्रकुपितस्तिष्ठत्यन्तर्गले स्थिरः|

आशु सञ्जनयेच्छोफं जायतेऽस्य गलग्रहः||२२||

+

yasya ślēṣmā prakupitastiṣṭhatyantargalē sthiraḥ|

Line 316: Line 378:

yasya shleShmA prakupitastiShThatyantargale sthiraH|

Ashu sa~jjanayecchophaM [4] jAyate~asya galagrahaH||22||

+

</div></div>

When the vitiated ''kapha'', firmly located inside the throat causes swelling suddenly, it causes ''galagraha'' (pharyingitis). [22]

===== ''Visarpa'' =====

+

यस्य पित्तं प्रकुपितं सरक्तं त्वचि सर्पति|

शोफं सरागं जनयेद्विसर्पस्तस्य जायते||२३||

−

+

+

yasya pittaṁ prakupitaṁ saraktaṁ tvaci sarpati|

śōphaṁ sarāgaṁ janayēdvisarpastasya jāyatē||23||

Line 329: Line 394:

yasya pittaM prakupitaM saraktaM tvaci sarpati|

shophaM sarAgaM janayedvisarpastasya [5] jAyate||23||

+

</div></div>

When a vitiated ''pitta'' (with ''rakta'', or blood) spreads through the skin, it causes swelling with redness.Such a swelling is called ''visarpa'' i.e. erysipelas. [23]

===== ''Pidika'' =====

+

यस्य पित्तं प्रकुपितं त्वचि रक्तेऽवतिष्ठते|

शोथं सरागं जनयेत् पिडका तस्य जायते||२४||

+

yasya pittaṁ prakupitaṁ tvaci raktē'vatiṣṭhatē|

Line 342: Line 410:

yasya pittaM prakupitaM tvaci rakte~avatiShThate|

shothaM sarAgaM janayet [6] piDakA tasya jAyate||24||

+

</div></div>

When the vitiated ''pitta'' is located within the skin and ''rakta'', swelling and redness appears causing ''pidika'' i.e. boils or pustules. [24]

===== ''Tilaka-pipplava-vyanga-neelika'' =====

+

यस्य प्रकुपितं पित्तं शोणितं प्राप्य शुष्यति|

तिलका पिप्लवो व्यङ्गा नीलिका तस्य जायते||२५||

+

yasya prakupitaṁ pittaṁ śōṇitaṁ prāpya śuṣyati|

Line 355: Line 426:

yasya prakupitaM pittaM shoNitaM prApya shuShyati|

tilakA piplavo vya~ggA nIlikA tasya jAyate||25||

−

+

</div></div>

+

When the vitiated ''pitta'' goes into ''rakta'' and gets absorbed in it (i.e., within the blood), it causes ''tilaka'' (moles), ''piplu'' (port-wine marks), ''vyanga'' (blemish/spots), or ''nilika'' (blue-black moles). [25]

===== ''Shankhaka'' =====

+

यस्य पित्तं प्रकुपितं शङ्खयोरवतिष्ठते|

श्वयथुः शङ्खको नाम दारुणस्तस्य जायते||२६||

+

yasya pittaṁ prakupitaṁ śaṅkhayōravatiṣṭhatē|

Line 368: Line 442:

yasya pittaM prakupitaM sha~gkhayoravatiShThate|

shvayathuH sha~gkhako nAma dAruNastasya jAyate||26||

+

</div></div>

When a vitiated ''pitta'' inhabits the temporal regions of the head, severe and fatal swellings known as ''shankhaka'' (saggital sinus thrombosis/ intracranial growth/ temporal arteritis) are caused. [26]

===== ''Karnamulika shotha'' (swelling at base of ears) =====

+

यस्य पित्तं प्रकुपितं कर्णमूलेऽवतिष्ठते|

ज्वरान्ते दुर्जयोऽन्ताय शोथस्तस्योपजायते||२७||

+

yasya pittaṁ prakupitaṁ karṇamūlē'vatiṣṭhatē|

Line 381: Line 458:

yasya pittaM prakupitaM karNamUle~avatiShThate|

jvarAnte durjayo~antAya shothastasyopajAyate||27||

+

</div></div>

When the vitiated ''pitta'' is located at the base of ears, a severe, incurable and fatal swelling arises at the terminal stage of the fever. [27]

===== ''Pliha'' (splenomegaly) =====

−

+

+

वातः प्लीहानमुद्धूय कुपितो यस्य तिष्ठति|

शनैः परितुदन् पार्श्वं प्लीहा तस्याभिवर्धते||२८||

+

vātaḥ plīhānamuddhūya kupitō yasya tiṣṭhati|

Line 394: Line 474:

vAtaH plIhAnamuddhUya kupito yasya tiShThati|

shanaiH paritudan [7] pArshvaM plIhA tasyAbhivardhate||28||

+

</div></div>

When the vitiated ''vata'' inhabits and elevates the spleen, it causes a gradual prickly pain in the sides, causing ''pliha vriddhi'' i.e. splenomegaly. [28]

===== ''Gulma'' (abdominal lumps) =====

+

यस्य वायुः प्रकुपितो गुल्मस्थानेऽवतिष्ठते|

शोफं सशूलं जनयन् गुल्मस्तस्योपजायते||२९||

+

yasya vāyuḥ prakupitō gulmasthānē'vatiṣṭhatē|

Line 407: Line 490:

yasya vAyuH prakupito gulmasthAne~avatiShThate|

shophaM sashUlaM janayan gulmastasyopajAyate||29||

+

</div></div>

When the vitiated ''vata'' inhabits in the abdominal region causing swelling and pain, it causes ''gulma''. [29]

===== ''Vriddhi'' (scrotum enlargement) =====

+

यस्य वायुः प्रकुपितः शोफशूलकरश्चरन्|

वङ्क्षणाद्वृषणौ याति वृद्धिस्तस्योपजायते||३०||

+

yasya vāyuḥ prakupitaḥ śōphaśūlakaraścaran|

Line 420: Line 506:

yasya vAyuH prakupitaH shophashUlakarashcaran|

va~gkShaNAdvRuShaNau yAti vRuddhistasyopajAyate||30||

+

</div></div>

When the vitiated ''vata'' moves from the groins to testicles causing swelling and pain, it causes ''vriddhi'' i.e. testicular swellings. [30]

===== Udara (abdominal diseases) =====

−

+

+

यस्य वातः प्रकुपितस्त्वङ्मांसान्तरमाश्रितः|

शोथं सञ्जनयेत् कुक्षावुदरं तस्य जायते||३१||

+

yasya vātaḥ prakupitastvaṅmāṁsāntaramāśritaḥ|

Line 433: Line 522:

yasya vAtaH prakupitastva~gmAMsAntaramAshritaH|

shothaM sa~jjanayet kukShAvudaraM tasya jAyate||31||

+

</div></div>

When the vitiated ''vata'' located between the skin and muscles produces swelling in the abdomen, it is known as ''udara roga'' i.e. diseases of abdominal cavity. [31]

===== ''Anaha'' (obstruction in abdomen) =====

+

यस्य वातः प्रकुपितः कुक्षिमाश्रित्य तिष्ठति|

नाधो व्रजति नाप्यूर्ध्वमानाहस्तस्य जायते||३२||

+

yasya vātaḥ prakupitaḥ kukṣimāśritya tiṣṭhati|

Line 446: Line 538:

yasya vAtaH prakupitaH kukShimAshritya tiShThati|

nAdho vrajati nApyUrdhvamAnAhastasya jAyate||32||

+

</div></div>

When the vitiated ''vata'' is stuck in the belly and moves neither upwards nor downwards (neither passed through flatus nor through belching), it causes ''anaha'' (obstruction in abdomen). [32]

===== Tumors =====

+

रोगाश्चोत्सेधसामान्यदधिमांसार्बुदादयः|

विशिष्टा नामरूपाभ्यां निर्देश्याः शोथसङ्ग्रहे||३३||

+

rōgāścōtsēdhasāmānyadadhimāṁsārbudādayaḥ|

Line 459: Line 554:

rogAshcotsedhasAmAnyadadhimAMsArbudAdayaH|

vishiShTA nAmarUpAbhyAM nirdeshyAH shothasa~ggrahe||33||

+

</div></div>

Various diseases with names and features such as ''adhimamsa'' (fleshy growth or extra growth of muscles), and ''arbuda'' (tumors) are included in the family of shotha due to the common appearance of swelling. [33]

===== ''Rohini'' (diphtheria) =====

+

वातपित्तकफा यस्य युगपत् कुपितास्त्रयः|

Line 472: Line 569:

त्रिरात्रं परमं तस्य जन्तोर्भवति जीवितम्|

कुशलेन त्वनुक्रान्तः क्षिप्रं सम्पद्यते सुखी||३६||

+

vātapittakaphā yasya yugapat kupitāstrayaḥ|

Line 490: Line 588:

trirAtraM paramaM tasya jantorbhavati jIvitam|

kushalena tvanukrAntaH [8] kShipraM sampadyate sukhI||36||

+

</div></div>

+

When all the three ''doshas'' get aggravated simultaneously and inhabit the base of the tongue, they cause severe burning sensation, acute/intense swelling and various types of pain. This fatal disease is known as ''rohini'' (diphtheria). If afflicted with this ailment and left untreated, the patient could die in three days. But if treated by an expert physician quickly, one can recover almost immediately. [34-36]

Line 495: Line 595:

==== Prognosis of diseases ====

−

+

+

सन्ति ह्येवंविधा रोगाः साध्या दारुणसम्मताः|

ये हन्युरनुपक्रान्ता मिथ्याचारेण वा पुनः||३७||

Line 510: Line 611:

साध्याश्चैवाप्यसाध्याश्च व्याधयो द्विविधाः स्मृताः|

मृदुदारुणभेदेन ते भवन्ति चतुर्विधाः||४१||

+

santi hyēvaṁvidhā rōgāḥ sādhyā dāruṇasammatāḥ|

Line 540: Line 642:

sAdhyAshcaivApyasAdhyAshca vyAdhayo dvividhAH smRutAH|

mRududAruNabhedena te bhavanti caturvidhAH||41||

+

</div></div>

+

There are certain curable diseases that become fatal if improperly managed or not given adequate treatment. There are other curable diseases that are mild and get alleviated certainly with or without effort. There are incurable diseases, considered “palliable”, in which appropriate treatment enables the patient to move along. And finally, there are other incurable diseases that do not respond to any treatment. At times, ignorant physicians treat these enthusiastically. However, the wise should not treat them. Thus, diseases are primarily of two types: curable and incurable, and depending upon their severity and responsiveness to drugs, are further categorized into two sub-categories within each of these types. [37-41]

Line 545: Line 649:

==== Criteria for classification of diseases ====

−

+

+

त एवापरिसङ्ख्येया भिद्यमाना भवन्ति हि|

रुजावर्णसमुत्थानस्थानसंस्थाननामभिः ||४२||

Line 551: Line 656:

व्यवस्थाकरणं तेषां यथास्थूलेषु सङ्ग्रहः|

तथा प्रकृतिसामान्यं विकारेषूपदिश्यते||४३||

+

ta ēvāparisaṅkhyēyā bhidyamānā bhavanti hi|

Line 563: Line 669:

vyavasthAkaraNaM [13] teShAM yathAsthUleShu sa~ggrahaH|

tathA prakRutisAmAnyaM vikAreShUpadishyate||43||

+

</div></div>

There are several diseases classified on the basis of type of pain, appearance (color), etiology, site, symptoms and name. Their systematic classification has been attempted in the form of some gross disease families or classes. However, in other cases general principle may be followed. [42]

==== Identification of new diseases ====

+

विकारनामाकुशलो न जिह्रीयात् कदाचन|

Line 579: Line 687:

यो ह्येतत्त्रितयं ज्ञात्वा कर्माण्यारभते भिषक्|

ज्ञानपूर्वं यथान्यायं स कर्मसु न मुह्यति||४७||

+

vikāranāmākuśalō na jihrīyāt kadācana|

Line 603: Line 712:

yo hyetattritayaM j~jAtvA karmANyArabhate bhiShak|

j~jAnapUrvaM yathAnyAyaM [15] sa karmasu na muhyati||47||

+

</div></div>

One should not be ashamed of one’s inability to name a disease, since all disorders cannot be given standard names. There are innumerable diseases because the same vitiated ''dosha'' causes various disorders according to variations in etiology and location. Hence one should initiate any treatment after acquiring complete knowledge of the nature of the disease as well as its pathogenesis, location and etiological factors. The one who initiates the treatment after knowing all these things, rationally and according to prescribed procedure, does not get confused in actions. [44-47]

==== Discussion on ''dosha'' ====

+

नित्याः प्राणभृतां देहे वातपित्तकफास्त्रयः|

विकृताः प्रकृतिस्था वा तान् बुभुत्सेत पण्डितः||४८||

+

nityāḥ prāṇabhr̥tāṁ dēhē vātapittakaphāstrayaḥ|

Line 616: Line 728:

nityAH prANabhRutAM dehe vAtapittakaphAstrayaH|

vikRutAH prakRutisthA vA tAn bubhutseta paNDitaH||48||

+

</div></div>

''Vata, pitta'' and ''kapha'' - these three ''doshas'' are always present in the body of all living beings. The learned should know about their normal or abnormal states. [48]

===== Functions of normal ''vata dosha'' =====

−

+

+

उत्साहोच्छ्वासनिः श्वासचेष्टा धातुगतिः समा|

समो मोक्षो गतिमतां वायोः कर्माविकारजम्||४९||

+

utsāhōcchvāsaniḥ śvāsacēṣṭā dhātugatiḥ samā|

Line 629: Line 744:

utsAhocchvAsaniH shvAsaceShTA dhAtugatiH samA|

samo mokSho gatimatAM vAyoH karmAvikArajam||49||

+

</div></div>

Enthusiasm, inspiration, expiration, movements, normal processing of dhatu (body tissues), and normal elimination of excreta are the normal functions of ''vayu'' (''vata)''. [49]

===== Functions of normal ''pitta dosha'' =====

−

+

+

दर्शनं पक्तिरूष्मा च क्षुत्तृष्णा देहमार्दवम्|

प्रभा प्रसादो मेधा च पित्तकर्माविकारजम्||५०||

+

darśanaṁ paktirūṣmā ca kṣuttr̥ṣṇā dēhamārdavam|

Line 642: Line 760:

darshanaM paktirUShmA ca kShuttRuShNA dehamArdavam|

prabhA prasAdo medhA ca pittakarmAvikArajam||50||

+

</div></div>

Vision, digestion, (production of) heat, hunger, thirst, softness in body, luster, serenity and intelligence are the normal functions of ''pitta''. [50]

===== Functions of normal ''kapha dosha'' =====

−

+

+

स्नेहो बन्धः स्थिरत्वं च गौरवं वृषता बलम्|

क्षमा धृतिरलोभश्च कफकर्माविकारजम्||५१||

+

snēhō bandhaḥ sthiratvaṁ ca gauravaṁ vr̥ṣatā balam|

Line 655: Line 776:

sneho bandhaH sthiratvaM ca gauravaM vRuShatA balam|

kShamA dhRutiralobhashca kaphakarmAvikArajam||51||

+

</div></div>

Unctuousness, binding, firmness/stability, heaviness, virility, strength, forbearance, restraint and absence of greed are the properties of ''kapha''. [51]

===== Diagnosis of abnormal state of ''dosha'' =====

+

वाते पित्ते कफे चैव क्षीणे लक्षणमुच्यते|

कर्मणः प्राकृताद्धानिर्वृद्धिर्वाऽपि विरोधिनाम्||५२||

+

vātē pittē kaphē caiva kṣīṇē lakṣaṇamucyatē|

Line 668: Line 792:

vAte pitte kaphe caiva kShINe lakShaNamucyate|

karmaNaH prAkRutAddhAnirvRuddhirvA~api virodhinAm||52||

+

</div></div>

Any decrease in ''vata, pitta'' and ''kapha'' is thus indicated by a decrease in their natural functions or increase in functions of opposite ''dosha''. (this is indicated by the properties associated with any of these ''doshas'', for example, reduced unctuousness indicates a decrease in ''kapha'', etc). [52]

+

दोषप्रकृतिवैशेष्यं नियतं वृद्धिलक्षणम्|

दोषाणां प्रकृतिर्हानिर्वृद्धिश्चैवं परीक्ष्यते||५३||

+

dōṣaprakr̥tivaiśēṣyaṁ niyataṁ vr̥ddhilakṣaṇam|

Line 679: Line 806:

doShaprakRutivaisheShyaM niyataM vRuddhilakShaNam|

doShANAM prakRutirhAnirvRuddhishcaivaM parIkShyate||53||

+

</div></div>

Conversely, any aggravation in ''dosha'' is indicated by an increase in their normal functions. Thus normalcy, decrease and aggravation of ''dosha'' are examined. [53]

==== Summary ====

+

तत्र श्लोकाः-

Line 691: Line 820:

वीतमोहरजोदोषलोभमानमदस्पृहः|

व्याख्यातवांस्त्रिशोथीये रोगाध्याये पुनर्वसुः||५६||

+

tatra ślōkāḥ-

Line 707: Line 837:

vItamoharajodoShalobhamAnamadaspRuhaH|

vyAkhyAtavAMstrishothIye rogAdhyAye punarvasuH||56||

+

</div></div>

Types, causes, symptoms and prognoses of swelling, of various diseases, types of diseases, definitions of the three doshas, normal functions and symptoms of decrease and aggravation of doshas - all these have been explained in this chapter on three types of swellings by Punarvasu , who is free from tamas and rajas qualities, doshas, greed, conceit, pride and ambition.[54-56]

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