विंशोऽध्यायः अथातः कर्णगतरोगविज्ञानीयमध्यायं व्याख्यास्यामः । धन्वन्तरिः ॥ १ ॥ यथोवाच भगवान्
Now we shall discourse on the chapter which treats of the causes and symptoms of the diseases peculiar to the ear-the organ of hearing (Karna-gata-Roga-Vijnaniya). 1
कर्णशूलं प्रणादश्च बाधिर्यं क्ष्वेड एव च । कर्णस्रावः कर्णकण्डूः कर्णगूथस्तथैव च ॥ २ ॥ कृमिकर्णप्रतीनाहौ विद्रधिर्द्विविधस्तथा । कर्णपाकः पूतिकर्णस्तथैवार्शश्चतुर्विधम् ॥ ३ ॥ तथार्बुदं सप्तविधं शोफश्चापि चतुर्विधः । एते कर्णगता रोगा अष्टाविंशतिरीरिताः ॥ ४ ॥
Classification – Twenty-eight different forms of ear-diseases are noticed in practice, viz., Karna-sula (Ear-ache), Pranada (ringing or noise in the ear), Badhirya ( deafness ), Ksveda, Karna-Srava (discharge of pus, etc., from the ear), Karna Kandu ( itching in the ear), Karna-gutha, Krmi-karna (vermin-infested ears), Pratinaha, the two kinds of Vidradhi (local abscess ), Karna-paka (suppuration of ear), Puti-karna (fetor in the ear), four kinds of Arsas (Cysts or polypuses in the ear), seven kinds of Arbuda (tumour) and four kinds of Sopha (swelling). 2-4.
Symptoms of Karna-Sula and Pranada
समीरणः श्रोतगतोऽन्यथाचरः समन्ततः शूलमतीव कर्णयोः । करोति दोषैश्च यथास्वमावृतः स कर्णशूलः कथितो दुराचरः ॥ ५ ॥
यदा तु नाडीषु विमार्गमागतः स एव शब्दाभिवहासु तिष्ठति । श्रृणोति शब्दान् विविधांस्तदा नरः प्रणादमेनं कथयन्ति चामयम् ॥ ६ ॥
Symptoms of Karna-Sula and Pranada -The violent aching pain in the region of the ear and inside the tympanum caused by the deranged local Vayu, aggravated and obstructed by the other deranged Dosas in the locality is called the Karna-sula (ear-ache). Ringing and various other sounds in the ear are heard when the deranged Vayu of the locality gets into the wrong way and remains there stuffed in the sound-carrying channels of the organ. This disease is called the Pranada. 5-6.
Symptoms of Badhirya and Ksveda
स एव शब्दानुवहा यदा सिराः कफानुयातो व्यनुसृत्य तिष्ठति । तदा नरस्याप्रतिकारसेविनो भवेत् तु बाधिर्यमसंशयं खलु ॥ ७ ॥ श्रमात् क्षयाद्र्क्षकषायभोजनात् समीरण: शब्दपथे व्यवस्थितः । विरिक्तशीर्षस्य च शीतसेविनः करोति हि क्ष्वेडमतीव कर्णयोः ॥ ८ ॥
Symptoms of Badhirya and Ksveda — Badhirya (deafness) results from the continuance in the sound-carrying channels of the deranged local Vayu in combination with the deranged local Kapha in those localities without anyway being remedied or subdued. An attack of Karna-ksveda (expresing a peculiar sound in the ear) may be attributed to such causes, as the use of any cold thing or exposure to cold after being treated with a head-purging remedy ( errhines), or to the continuance of the deranged local Vayu in the sound-passage, aggravated by excessive labour, by any wasting process in the system or by taking articles of astringent taste or of parching (Ruksa) property. 7-8.
Symptoms of Karna Srava and Karna Kandu
शिरोऽभिघातादथवा निमज्जतो जले प्रपाकादथवाऽपि विद्रधेः । त्रवेत् तु पूयं श्रवणोऽनिलावृतः स कर्णसंस्त्राव इति प्रकीर्तितः ॥ ९ ॥ कफेन कण्डूः प्रचितेन कर्णयोभृशं भवेत् स्त्रोतसि कर्णसंज्ञिते ॥ १० ॥
1. The difference in the “Karna-nada” and “Ksveda” is that in the former the sound in the ear is produced by the deranged Vayu alone and is of various kinds where as, in the latter it is of a special kind, viz., that of a wind-pipe – the exciting cause being the deranged local Pitta, Kapha and blood — Videha.
Symptoms of Karna-Srava and Karna-Kandu— Any discharge or secretion of pus from the ear caused by the deranged bodily Vayu stuffing the ear-cavity, owing to a blow on the head or a long immersion in water or a spontaneous suppuration (and bursting) of an abscess in the inner ear, is called Karna-srava. The excessive itching sensation in the ear due to the aggravation of the local Kapha is called Karnakandu. 9-10.
Symptoms of Karna gutha and Karna Pratinaha
विशोषिते श्लेष्मणि पित्ततेजसा नृणां भवेत् स्रोतसि कर्णगूथकः ॥ ११॥
स कर्णगूथो द्रवतां यदा गतो विलायितो घ्राणमुखं प्रपद्यते । तदा स कर्णप्रतिनाहसंज्ञितो भवेद् विकारः शिरसोऽभितापनः ॥ १२॥
Symptoms of Karna-gutha and Karna Prati-naha – Any mucous accumulation in the ear dried and hardened by the heat of the local Pitta is called Karna-gutha; when the dried accumulation of the ear in cases of Karna-gutha become liquefied, (and comes out through ) the cavity of the nose¹ and produces head-disease² it is called Karna Prati-naha. 11-12.
Symptoms of Krmi Karna and Karna Vidradhi
स यदा तु मूर्च्छन्त्यथवाऽपि जन्तवः सृजन्त्यपत्यान्यथवाऽपि मक्षिकाः । तदञ्जनत्वाच्छ्रवणो निरुच्यते भिषग्भिराद्यैः कृमिकर्णकस्तु सः ॥ १३ ॥ क्षताभिघातप्रभवस्तु विद्रधिर्भवेत् तथा दोषकृतोऽपरः पुनः । रक्तपीतारुणमस्त्रमास्त्रवेत्प्र तोदधूमायनदाहचोषवान् ॥ १४ ॥
Symptoms of Krmi-Karna and Karna – Vidradhi – Germination of vermins or of other local parasites in the cavities of the ear completely impairs the faculty of hearing and is called Krmi-karna from the existence of worms in the ear. Any abscess caused by any local ulcer or by a blow, as well as any idiopathic abscess in the cavity of the ear is known as Karna-vidradhi. It is marked by a choked and burning sensation, and piercing and sucking pain, and it secretes red, yellow or reddish bloody discharges. 13-14.
1. Some explain “घ्राणमुखं” to mean the cavity of the nose and of the mouth. 2. In place of “शिरसीऽभितापनः” (producer of head-disease) Madhava in his Nidana reads “शिग्सीऽर्धभेदकृत्” i.e, producer of the head disease known as Ardha-vedhaka (see chapter XXV).
Symptoms of Karna-paka and Puti Karna
भवेत् प्रपाकः खलु पित्तकोपतो विकोथविक्लेदकरश्च कर्णयोः ॥ १५ ॥ स्थिते कफे स्त्रोतसि पित्ततेजसा विलाय्यमाने भृशसम्प्रतापवान् । अवेदनो वाऽप्यथवा सवेदनो घनं स्त्रवेन् पूति स पूतिकर्णकः ॥ १६ ॥ प्रदिष्टलिङ्गान्यशसि तत्त्वतस्तथैव शोफार्बुदलिङ्गमीरितम् । मया पुरस्तात् प्रसमीक्ष्य योजयेदिहैव तानि प्रयतो भिषग्वरः ॥ १७॥
Symptoms of Karna-paka and Puti Karna, etc. – A process of suppuration setting in (in any of these boils) in the ear through the aggravated condition of the deranged Pitta is marked by a blocked and putrid condition of the passage of the ear. The disease is called Karnapaka (suppuration of the ear). A discharge of condensed and fetid pus whether accompanied or not with pain is set up by the local mucus accumulation in the passage of the ear having been liquefied by the heat of the aggravatted Pitta. This disease is called Puti-karna (pus in the ear). The disease is called Puti-karna (pus in the ear). The symptoms of swelling (Sopha), tumours (Arbuda) and Polypoid growths (Arsas) 1 in general as have been described before should be carefully understood by an experinced physician the symptoms of these diseases in the region of the ear. 15-17.
इति सश्रुत संहितायामुत्तरतन्त्रे कर्णगतरोगविज्ञानीयव्याख्यानाम विंशोऽध्यायः ॥ २० ॥
Thus ends the twentieth chapter of the Uttara-Tantra in the Susruta Samhita which deals with the causes and symptoms of the diseases peculiar to the ear.
1. See chapter VI, XVIII and XXIII, Chikitsa-Sthana.
