अथातो ग्रन्थ्यर्बुदश्लीपदापचीनाडींविज्ञानीयं व्याख्यास्यामः । इति स्माहुरात्रेयादयो ह. महर्षयः ।
We shall now expound the chapter Granthi-arbudaslipada apaci-nadi vijnaniya-knowledge of tumours, cancer, filariasis, scrofula and sinus ulcer; thus said Atreya and other great sages.
Granthi – benign tumour
कफप्रधानाः कुर्वन्ति मेदोमांसास्त्रगा मलाः । वृत्तोन्नतं यं श्वयथुं स ग्रन्थिग्रंथनात्स्मृतः ॥ १ ॥ दोषास्त्रमांसमेदोस्थिसिराव्रणभवा नव ।
Malas (dosas) of which kapha is the predominant one, invading the fat, muscle and blood produce a round, raised swelling (new growth) known as Granthi because of its knotty (lumpy) nature. It is nine kinds viz. arising from each dosa from mamsa ( muscle tissue ), medas ( fat tissue ), asthi (bone tissue), sira ( vein) and from vrana ( ulcer.) 1-2a.
ते तत्र वातादायामतोदमेदान्वितोऽसितः ॥ २॥
स्थानात्स्थानान्तरगतिरकस्माद्धानिवृद्धिमान् मृदुर्बस्तिरिवानद्धो विभिन्नोऽच्छं स्रवत्यसृक् ॥ ३॥
That arising from vata, is broad, has pricking and cutting types of pain, black in colour, shifts from place to place, undergoes increases or decrease in size without any reason, soft, bulged like a leather bag and exudes clear thin blood when pricked. 2b-3.
पित्तात्सदाहः पीताभो रक्तो वा, पच्यते भिन्नोऽस्त्रमुष्णं स्त्रवति द्रुतम् ।
That arising from pitta, has burning sensation, yellow or red colour, ripens ( suppurates quickly; exudes warm blood when pricked. 4a.
श्लेष्मणा नीरुजो घनः ॥ ४ ॥ शीत: सवर्णः कण्डूमान्, पक्कः पूयं स्त्रवेद्धनम् ।
That arising from kapha, is painless, hard, cold, of the same colour of the skin, has itching; when ripens exudes thick pus. 4b-5a.
Rakta granthi
दोषैर्दुष्टेऽसृजि ग्रन्थिर्भवेन्मूर्च्छत्सु जन्तुषु ॥ ५॥ सिरामांसं च संश्रित्य सस्वापः पित्तलक्षणः ।
When the dosas get aggravated in the blood a granthi (tumour) develops containing worms which invade the veins and muscles, is accompainied with loss of tactile sensation and presence of symptoms of (aggravation of ) pitta. 5b-6a.
Mamsa granthi
मांसलैर्दुषितं मांसमाहारैर्ग्रन्थिमावहेत् ॥ ६ ॥ स्निग्धं महान्तं कठिनं सिरानद्धं कफाकृतिम् ।
Mamsa (muscle tissue) getting vitiated by indulgence in bad kind of meat as food leads to formation of granthi which is unctuous, large in size, hard, studded with veins and having symptoms of aggravation of kapha. 6b-7a.
Medo granthi
प्रवृद्धं मेदुरैर्मेदो नीतं मांसेऽथवा त्वचि ॥ ७ ॥
वायुना कुरुते ग्रन्थिं भृशं स्निग्धं मृदुं चलम् । श्लेष्मतुल्याकृतिं देहक्षयवृद्धिक्षयोदयम् ॥ ८ ॥
स विभिन्नो घनं मेदस्ताम्रासितसितं स्त्रवेत् ।
Medas (fat tissue) getting increased by indulgence in food containing too much of fat, brought to the muscle or skin by vayu (vata) gives rise to granthi which is very unctuous, soft, movable, having symptoms of aggravation of slesma (kapha), increasing and decreasing in size with the increase or decrease of the body, exudes coppery, black, or white fatty fluid when pricked. ‘7b-9a.
Asthi granthi
अस्थिभङ्गाभिघाताभ्यामुन्नतावनतं तु यत् ॥ ९ ॥ सोऽस्थिग्रन्थिः
Asthi granthi develops as a result of fracture, injuries causing upward displacement (growth) of bones etc. 9b.
Sira granthi
पदातेस्तु सहसाऽम्भोवगाहनात् । व्यायामाद्वा प्रतान्तस्य सिराजालं सशोणितम् ॥ १० ॥
वायुः सम्पीड्य सङ्कोच्य वक्रीकृत्य विशोष्य च । निःष्फुरं नीरुजं ग्रन्थिं कुरुते स सिराह्वयः ॥ ११ ॥
Foot soldiers entering into water suddenly or by fatigue after exertion, vayu (vata) getting aggravated along with sonita (blood) invades the network of veins causing pain, constriction, distortion, drying up and gives rise to the formation of granthi which is non-pulsating and painless. This is known as siragranthi. 10-11.
Vrana granthi
अरूढे रूढमात्रे वा व्रणे सर्वरसाशिनः । सार्द्रे वा बन्धरहिते गात्रेऽश्माभिहतेऽथवा ॥ १२ ॥
वातोऽस्त्रमस्त्रुतं दुष्टं संशोष्य ग्रथितं व्रणम् । कुर्यात्सदाहः कण्डूमान् व्रणग्रन्थिरयं स्मृतः ॥ १३ ॥
If the patient indulges in food of all tastes without any control when the ulcer has not healed or healed just then, or if it (ulcer) is not bandaged, when still moist, or the body is hit by stones, etc. then vata dries up the vitiated blood which has not gone out, causes a granthi, in the ulcer associated with burning sensation and itching. This is known as vrana granthi. 12-13.
साध्या दोषास्त्रमेदोजाः, न तु स्थूलखराश्चलाः । मर्मकण्ठोदरस्थाश्च
Those granthi (benign tumour) arising from the dosas, rakta and medas are sadhya (curable ) ; those which are big, hard and movable, those located on vital spots, throat and abdomen are not curable. 14a.
Arbuda – malignant tumour/cancer
महत्तु ग्रन्थितोऽर्बुदम् ॥ १४ ॥ तल्लक्षणं च मेदोन्तः षोढा दोषादिभिस्तु तत् । प्रायो मेदः कफाढ्यत्वात्स्थिरत्वाच्च न पच्यते ॥ १५ ॥
Large granthis are called as Arbuda (malignant tumours); they are of six kinds, caused by the dosas etc. Because of predominance of medas (fat) and kapha generally and due to deep rootedness they do not ripen (suppurate). 14b-15.
Sonitarbuda
सिरास्थं शोणितं दोषः सङ्गोच्यान्तः प्रपीड्य च । पाचयेत् तदानद्धं सास्त्रावं मांसपिण्डितम् ॥ १६ ॥
मांसाङ्कुरैश्चितं याति वृद्धिं चाशु स्रवेत्ततः । अजस्त्रं दुष्टरुधिरं भूरि तच्छोणितार्बुदम् ॥ १७ ॥
Dosas getting aggravated vitiate the blood present inside the veins, causing contractions, pain and ripening, produce a growth of ( tumour) muscle, studded with sprouts of muscle, bleeding constantly; the tumour develops fast and discharges vitiated blood in large quantities. This is sonitarbuda.
तेष्वसृङ्मांसजे वर्ज्य, चत्वार्यन्यानि साधयेत् ।
Among these (arbudas) those arising from blood (sonitarbuda) and muscle tissue (mamsarbuda) should be refused, the remaining four should be treated. 18a. Slipada-(filariasis)
प्रस्थिता वक्षणोर्वादिमधःकायं कफोल्बणाः ॥ १८
दोषा मांसास्त्रगाः पादौ कालेनाश्रित्य कुर्वते । शनैः शनैर्घनं शोफं श्लीपदं तत्प्रचक्षते ॥ १९ ॥
Dosas with the predominance of kapha getting aggravated invade the mamsa (muscle ) and asrk (blood) commencing first in the groin and gradually descend to the feet, making it swollen slowly and steadily, this disease is called as (filariasis). 18b-19.
Shpada
परिपोटयुतं कृष्णमनिमित्तरुजं खरम् । रूक्षं च वातात् पित्तात्तु पीतं दाहज्वरान्वितम् ॥ २० ॥
कफागुरु स्निग्धमरुक् चितं मांसाङ्कुरैबृहत् ।
In that caused by vata the leg is having small cracks in the skin, black in colour, pain develops without any reason and (skin) is dry; in that by pitta, it is yellow, accompainied with burning sensation and fever; in that caused by kapha the leg is heavy, unctuous, painless and studded with big sprouts of muscles fibers. 20-21a.
तत्त्यजेद्वत्सरातीतं सुमहत् सुपरिस्स्रुति ॥ २१ ॥
That which is more than one year old, very big and exuding heavily should be rejected. 21b.
पाणिनासौष्ठकर्णेषु वदन्त्येके तु पादवत् । श्लीपदं जायते तच्च देशेऽनूपे भृशं भृशम् ॥ २२ ॥ Slipada, affects the hands, nose, lips, and ears also like the feet, some ( authorities) say so; and it is especially common in extremely marshy regions. 22.
Gandamala – apaci – scrofula
मेदास्था: कण्ठमन्याक्षकक्षावड्ङ्क्षणगा मलाः । सवर्णान् कठिनान् स्निग्धान् वार्ताकामलकाकृतीन् ॥ २३ ॥ अवगाढान् बहून् गण्डांश्चिरपाकांश्च कुर्वते । पच्यन्तेऽल्परुजस्तेऽन्ये स्रवन्त्यन्येऽतिकण्डुराः॥ २४ ॥ दीर्घकालानुबन्धिनः । क्षयवृद्धिभाक् ॥ २५ ॥ नश्यन्त्यन्ये भवन्त्यन्ये गण्डमालाऽपची चेयं दूर्वेव Dosas aggravated invading the medas (fat) present in the throat, neck, region of collar bone, axilla and the groin, give rise to growth of hard, unctuous, deep rooted, multiple, ganda (small tumours of the same colour as of the skin resembling a vartaka and amalaka (in size), ripening (suppurating) after a long time. Some undergo ripening causing mild pain, and some others are exuding fluid causing severe itching some disappear and some appear afresh, the disease persists for long. This is known as Gandamala or Apaci and undergoes in crease or decrease like the durva grass (disappears in unsuitable climate and reapears in suitable climate). 23-25.
तां त्यजेत्सज्वरच्छर्दिपार्श्वरुक्कासपीनसाम् ।
That associated with fever, vomiting, pain in the flanks, cough and nasal catarrah, should be refused treatment. 26a.
Nadi vrana – sinus ulcer
अमेदात्पक्कशोफस्य व्रणे चापथ्यसेविनः ॥ २६ ॥
अनुप्रविश्य मांसादीन् दूरं पूयोऽभिघावति । गतिः सा दूरगमनान्नाडी नाडीव संस्स्रुतेः ॥ २७ ॥
नाड्येकाऽनृजुरन्येषां सैवानेकगतिर्गतिः।
Not cutting the ripened abscess (and draining out the pus) and the person indulging in unsuitable foods etc. the pus retained inside the ulcer entering into the muscles etc. produces channels (sinus) inside them for long distances. Only one channel which is straight is called as Nadi (sinus) while more than one channel which are not straight (curved) is called as Gati-technically. 26b-28a.
It (nadivrana) is of five kinds, fron. tach dosa seperately, from the combination of all of them and fifth from the foreign body. 28b.
पृथगेकस्थैः शल्यहेतुश्च पञ्चमी ॥ २८ ॥
वातात् सरुक्सूक्ष्ममुखी विवर्णा फेनिलोद्वमा । स्त्रवत्यभ्यधिकं रात्रौ
That caused by vata has pain, small opening, discoloured, exudes forth, more at nights. 29a.
पित्तात्तृड्ज्वरदाहकृत् ॥ २९ ॥
चाति निषिञ्चति । पीतोष्णपूतिपूयस्स्रुद्दिवा
That caused by pitta has thirst, fever burning sensation, exudes yellow, warm, foul smelling pus, more during day.
घनपिच्छिलसंत्रावा कण्डूला कठिना कफात् ॥ ३० ॥ निशि चाभ्यधिकक्लेदा
That caused by kapha – has thick, slimy exudation, severe itching, hardness, exudation more at night. 30b.
सर्वैः सर्वाकृतिं त्यजेत् ।
In that caused by all the dosas, all the symptoms will be present, this should be rejected. 31a.
अन्तः स्थितं शल्यमनाहृतं तु करोति नाडीं वहते च साऽस्य |
फेनानुविद्धं तनुमल्पमुष्णं सास्त्रं च पूयं सरुजं च नित्यम् ॥ ३१ ॥
The foreign body remaining inside the body if not removed leads to nadi (sinus ulcer ) ; it exudes thin, warm, frothy blood and pus every day. 31.
इति श्रीवैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे
उत्तरस्थाने ग्रन्थ्यर्बुदश्लीपदापचीनाडीविज्ञानीयं नामैकोनत्रिंशोऽध्यायः ॥ २९ ॥
Thus end the chapter-Granthi-arbuda-slipada-apacinadi vijnaniya-the twentyninth in of Astangahrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
