Changes

Kiyanta Shiraseeya Adhyaya (view source)

Revision as of 04:37, 12 December 2017

888 bytes added , 04:37, 12 December 2017

→‎Sanskrit Text, Transliteration and English Translation

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kShayAH kati samAkhyAtAH piDakAH kati cAnagha!|

gatiH katividhA coktA doShANAM doShasUdana!||4||

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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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==== Answers by Atreya ====

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vAtAdayaH prakupyanti shirasyasraM ca duShyati|

tataH shirasi jAyante rogA vividhalakShaNAH||11||

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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]

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

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arditaM shirasaH kampo galamanyAhanugrahaH|

vividhAshcApare rogA vAtAdikrimisambhavAH||14||

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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]

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

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shirogatAH [2] sirA vRuddho vAyurAvishya kupyati|

tataH shUlaM mahattasya vAtAt samupajAyate||18||

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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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निस्तुद्येते भृशं शङ्कौ घाटा सम्भिद्यते तथा|

सभ्रूमध्यं ललाटं च तपतीवातिवेदनम्||१९||

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sphuratyati sirAjAlaM stabhyate ca shirodharA|

snigdhoShNamupashete ca shiroroge~anilAtmake||21||

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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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tataH shirasi sa~gkledAt krimayaH pApakarmaNaH|

janayanti shirorogaM jAtA bIbhatsalakShaNam||28||

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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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vepathurveShTanaM stambhaH pramohaH shUnyatA daraH [2] |

hRudi vAtAture rUpaM jIrNe cAtyarthavedanA||31||

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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]

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

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sa~gkledAt krimayashcAsya bhavantyupahatAtmanaH|

marmaikadeshe te jAtAH sarpanto bhakShayanti ca||38||

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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]

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

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hRudrogaM krimijaM tvetairli~ggairbuddhvA sudAruNam|

tvareta jetuM taM vidvAn vikAraM shIghrakAriNam||40||

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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]

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==== Sixty two permutations and combinations of ''samsarga'' and ''tridosha'' ====

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dvyulbaNaikolbaNaiH ShaT syurhInamadhyAdhikaishca ShaT|

samaishcaiko vikArAste sannipAtAstrayodasha||41||

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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]

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

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vRuddhirekasya samatA caikasyaikasya sa~gkShayaH|

dvandvavRuddhiH kShayashcaikasyaikavRuddhirdvayoH kShayaH [2] ||44||

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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]

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==== Twelve types of irregular (''vishama'') ''sannipata'' (combination of dosha) ====

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nidrAM tandrAM pralApaM ca hRudrogaM gAtragauravam|

nakhAdInAM ca pItatvaM ShThIvanaM kaphapittayoH||52||

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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]

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

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kaphashoNitashukrANAM malAnAM cAtivartanam|

kAlo bhUtopaghAtashca j~jAtavyAH kShayahetavaH||77||

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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]

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

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tairAvRutagatirvAyuroja [1] AdAya gacchati|

yadA bastiM tadA kRucchro madhumehaH pravartate||80||

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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]

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

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sharAvikA kacchapikA jAlinI sarShapI tathA|

alajI vinatAkhyA ca vidradhI ceti saptamI||83||

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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]

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

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hRudaye klomni yakRuti plIhni kukShau ca vRukkayoH|

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

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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.

The ''dosha'' provoked by the above mentioned factors, when it enters the flesh and blood of the internal organs of the body, gives rise to deep-rooted nodule-like swellings with severe pain. It is a severe condition that occurs in the heart, pharynx (''kloma''), liver, spleen, stomach, kidney, navel, groin and bladder [91-94]

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

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jRumbhotkleshArucistambhashItakaiH shlaiShmikIM viduH|

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

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

#''Vātaja vidradhi'': A ''vata'' type of an abscess is marked by a sensation of piercing or cutting pain. It can spread all over the body and exhibits various other symptoms such as giddiness, distension of abdomen, gurgling sound and throbbing.

#''Pittaja vidradhi'': Thirst, burning pain, stupefaction, intoxication and fever are the symptoms of ''pittaja vidradhi''.

#''Kaphaja vidradhi'': Yawning, retching, anorexia, rigidity and chills are the symptoms of ''kapha'' type of ''vidradhi'' [96-97]

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

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

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#Symptoms of ''vidradhi'' in the heart: Cardiac flutter, dyspnoea, stupefaction, cough and breathlessness are the symptoms of abscess in the heart.

#Symptoms of ''vidradhi'' in the ''kloma'': thirst, dryness of mouth and sore throat are the symptoms of abscess in the ''kloma''.

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#Symptoms of ''vidradhi'' in the groin: Weakness of the thigh is the symptom of abscess in groin.

#Symptoms of ''vidradhi'' in the urinary bladder: Painful micturition and defecation and putrid urine and faeces are the symptoms of abscess in the urinary bladder [101]

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==== Route of discharge ====

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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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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.

Therefore immediately on appearance of the internal abscess, it should be managed promptly with effective measures that can act quickly, else it may harm just like an injury caused by a weapon, bite by a snake and burning by lightening or fire. These abscesses may be managed by oleation and purgation therapies as well as all the measures of ''gulma'' [103]

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==== ''Pidika'' can occur without prameha ====

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trividhA cAparA koShThashAkhAmarmAsthisandhiShu|

ityuktA vidhibhedena doShANAM trividhA gatiH||113||

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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]

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

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gatiH kAlakRutA caiShA cayAdyA punarucyate|115|

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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]

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

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sarvA hi ceShTA vAtena sa prANaH prANInAM smRutaH|

tenaiva rogA jAyante tena caivoparudhyate||118||

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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.

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''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]

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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]

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

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