त्रयोदशोऽध्यायः । अथातः क्षुद्ररोगाणां निदानं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ।। १ ।।
Now we shall discourse on the Nidana of Ksudraroga (diseases which are known by the general name of minor ailments). 1
समासेन चतुश्चत्वरिंशत् क्षुद्ररोगा भवन्ति । तद्यथा- अजगलिल्का, यवप्रख्याउन्धालजी, विवृता, कच्छपिका, वल्मीकमिन्द्रवद्धा, पनसिका, पाषाणगर्दभो, जालगर्दभः, कक्षा, विस्फोटकोऽग्निरोहिणी, चिप्पं कुनखोऽनुशयी, विदारिका, शर्करार्बुदं, पामा, विचर्चिका, रकसा, पाददारिका, कदरमलसेन्द्रलुप्तौ, दारुणकोऽरुषिका, पलितं, मसूरिका, यौवनपिडका, पद्मिनीकण्टको, जतुमणिर्मशकश्चर्मकीलस्तिलकालकः, न्यच्छं, व्यङ्गं, परिवर्त्तिकाठवपाटिका, निरुद्धप्रकशो, निरुद्धगुदोऽहिपूतनं, वृषणकच्छूर्गुदभ्रंशश्चेति ।। २ ।।
These diseases are generally divided into forty-four distinct varieties or types such as : Ajagallika, Yavaprakhya, Andhalaji, Vivrta, Kacchapika, Valmika, Indravrddha, Panasika, Pasanagardabha, Jala-gardabha, Kaksa, Visphotaka, Agni-rohini, Cippa, Kunakha, Anusayi, Vidarika, Sarkara- Arbuda, Pama, Vicarcika, Rakasa, Padadarika, Kadara, Alasa, Indralupta, Darunaka, Arurnsika, Palita, Masurika, Yauvana-pidaka, Padmini-kantaka, Jatumani, Masaka, Carmakila, Tilakalaka, Nyacchya, Vyanga, Parivartika, Avapatika, Niruddha-Prakasa, Sanniruddha-guda, Ahiputana, Vrsanakacchu, and Guda-bhransa¹. 2
स्निग्धा सवर्णा ग्रथिता नीरुजा मुद्गसन्निभा । कफवातोत्थिता ज्ञेया बालानामजगल्लिका ।। ३ ।।
यवाकारा सुकठिना ग्रथिता मांससंश्रिता । पिडका श्लेष्मवाताभ्यां यवप्रख्येति सोच्यते ।। ४ ।।
घनामवक्त्रां पिडकामुन्नतां परिमण्डलाम् । अन्धालजीमल्पपूयां तां विद्यात् कफवातजाम् ॥ ५॥
विवृतास्यां महादाहां पक्वोदुम्बरसन्निभाम् । विवृतामिति तां विद्यात् पित्तोत्थां परिमण्डलाम् ।। ६ ।।
Metrical Texts: The species of pimples or eruptions which are shaped like the Mudga pulse and are glossy, knotty and painless is called Ajagallika. They are of the same colour (as the surrounding skin) and their origin is usually ascribed to the action of the deranged Kapha and Vayu. The disease is common in infants.2 Yavaprakhya : The eruptions which are shaped like the barley-corns, extremely hard, thick at the middle, knotty and affect (lit.–confined to) the flesh are called Yavaprakhya. They are due to the action of the deranged Vayu and Kapha. Andhalaji: The dense, raised, slender-topped eruptions which appear in circular patches without opening and exude a slight pus are called Andhalaji. They are due to the action of the deranged Vayu and Kapha, Vivrta : Pustules or eruptions, which are coloured like a ripe fig. fruit and are flat-topped and appear in circular patches with an intolerable burning sensation, are called Vivrta. They are due to the action of the deranged Pitta. 3-6
ग्रन्थयः पञ्च वा षड् वा दारुणाः कच्छपोन्नताः । कफानिलाभ्यामुद्भूतां विद्यात् तां कच्छपीमिति ।। ७ ।।
पाणिपादतले सन्धौ ग्रीवायामूर्ध्व ग्रीवायामूर्ध्व जत्रुणि शनैः समुपचीयते ।। ८ ।।
कण्डूमद्भिर्व्रणैर्वृतः । ग्रन्थिर्वल्मीकवद् यस्तु तोदक्लेदपरीदाह व्याधिर्वल्मीक इत्येष कफपित्ता निलोद्भवः ।। ९ ।।
1. Brahinadeva comprising, Garddavika, Irvelika, Gandhapidika and Tilakalaka in the list reads it as consisting of thirty-four different species. Jejjata does not hold the four forms of disease commencing with Garddavika, etc. as included within the list. Gayadasa, finding them included in all the recensions reads Garddabhika, etc. as included within the list of Ksudra Roga and Pama etc. as included within the list of Ksudra Kustha.
2. They afflict certain infants. –Dalana
Kacchapika : A group of five or six hard, elevated, nodular eruptions (Granthis), arranged in the shape of a tortoise (which may appear on the surface of any part of the body), are called Kacchapika. They are due to the action of the deranged Kapha and Vayu. Valmika : The knotty undurated eruptions (Granthis) which gradually appear on the soles, palms, joints, neck and on the regions above clavicles and resemble an ant-hill in shape, slowly gaining in size are called Valmika. Ulcers attended with pricking pain, burning, itching sensations and exuding mucopurulent discharges appear around the aforesaid eruptions (Granthis). The disease is due to the action of the deranged Kapha, Pitta and Vayu. 7-9
पद्मपुष्करवन्मध्ये पिडकाभिः समाचिताम् । इन्द्रवृद्वान्तु तां विद्यात् वातपित्तोत्थितां भिषक् ।। १० ।।
कर्णोपरिसमन्ताद् वा पृष्ठे वा पिडकोग्ररुक् । शालूकवत् पनसिकां तां विद्यात् श्लेष्मवातजाम् ।। ११ ।।
हनुसन्धौ समुद्भूतं शोफमल्परुजं स्थिरम् । पाषाणगर्दभं विद्याद् बलासपवनात्मकम् ।। १२ । ।
: ( Indravrddha : Pimples or eruptions (Pidaka) arising (on the surface of the body), arranged in the same circular array as marks the distribution of the seed (sacks) in a lotus flower are called Indravrddha by the physicians. The disease is caused by the action of the deranged Vayu and Pitta. Panasika Eruptions (Pidaka) of a sort of extremely painful pustules all over the back or the ears which resemble the Kumuda bulb in shape, are called Panasika. They are due to the action of the deranged Kapha and Vayu. Pasana-Gardabha : A slightly painful and non-shifting hard swelling, which appears on the joint of the jawbones, (Hanu-sandhi is called Pasana-Gardabha. The disease is the effect of the deranged Kapha and Vayu. 10-12
विसर्पवत् सर्पति यो दाहज्वरकरस्तनुः। अपाकःश्वयथुः पित्तात् स ज्ञेयो जालगर्दभः ॥ १३ ॥
(पिडिकामुत्तमाङ्गस्थां वृत्तामुग्ररुजाज्वराम् । सर्वात्मकां सर्वलां जानीयादिरिवेल्लिकाम् ) ।। १४ ।।
बाहुपाश्र्वसकक्षासु कृष्णस्फोटां सवेदनाम् । पित्तप्रकोपात् संभूतां कक्षामिति विनिर्दिशेत् ।। १५ ।।
(एकामेवंविधां दृष्ट्वा पिटिकां स्फोटसन्निभाम् । त्वग्गतां पित्तकोपेन गन्धनामां प्रचक्षते) ।। १६ ।।
अग्निदग्धनिभाः स्फोटा: सज्वराः रक्तपित्ततः । क्वचित् सर्वत्र वा देहे स्मृता विस्फोटका इति ।। १७ ।।
Jala-Gardabha: A thin and superficial swelling, which like erysipelas is of a shifting or progressive character and is further attended with fever and a burning sensation and which is but rarely found to suppurate, is called Jala-Gardabha. The disease results from the deranged Pitta. Pimples produced in the head and which are rounded, associated with severe pain and fever origined by all the dossas having symptoms of all dosas should be known as Irivellika. The disease characterised by the eruptions of black and painful vesicles (Sphota) on the back, sides, and on the region about the armpits, is called Kaksa. The disease is likewise attributed to the action of the aggravated Pitta only one pimple resembling vericles located in the skin origined by aggravated Pitta is termed as Gandhanama. Visphotaka The disease in which eruptions of burnlike vesicles (Sphota) crop up on the whole surface of the body, or on that of any particular locality, attended with fever, is called Visphotaka. The disease is the effect of vitiated blood and Pitta. 13-17
कक्षाभागेषु ये स्फोटा जायन्ते मांसदारुणाः । अन्तर्दाहज्वरकरा दीप्तपावकसन्निभाः ।।१८।।
सप्ताहाद् वा दशाहाद् वा पक्षाद् वा घ्नन्ति मानवम् । तामग्निरोहिणीं विद्यादसाध्यां सन्निपाततः ।। १९ ।।
Agni – Rohini 2 : Vesicles (Sphota) having the appearance of burns and cropping up about the waist (Kaksa) by bursting the local flesh, and which is attended with fever and a sensation as if a blazing fire is burning in the inside (of the affected part ), are called AgniRohini. The disease is caused by the concerted action of the three
1. The circular raised spots studded with vesicles are called Gardabha. They are reddish and painful and produced by the action of Vayu and Pitta. Gayadasa reads it so.
2. Dalhana quotes from another Tantra that the morbific principles in men. aggravated through the action of the enraged and augmented Pitta and blood, give rise to vesicles (blisters) like red-hot charcoal by breaking open the flesh at the waist, attended with extreme pain, high fever and an insufferable burning deranged Dosas (Vayu, Pitta and Kapha). It is incurable and ends in the death of the patient either on the seventh¹, tenth or fifteenth day (of its first appearance). 18-19
नखमांसमधिष्ठाय पित्तं वातश्च वेदनाम् । करोति दाहपाकौ च तं व्याधिं चिप्पमादिशेत् । सदेव क्षतरोगाख्यं तथोपनखमित्यपि ।। २० ।।
अभिघातात् प्रदुष्टो यो नखो रूक्षोऽसितः खरः | भवेत् तं कुनखं विद्यात् कुलीनमिति संज्ञितम् ।। २१ । ।
गम्भीरामल्पसंरम्भां सवर्णामुपरिस्थिताम् । कफादन्तःप्रपाकां तां विद्यादनुशयीं भिषक् ॥ २२ ॥
विदारीकन्दवद् वृत्तां कक्षावङ्क्षणसन्धिषु । रक्तां विदारिकां विद्यात् सर्वजां सर्वलक्षणाम् ।। २३ ।।
Cippa: The deranged Vayu and Pitta vitiating the flesh of the finger-nails, give rise to a disease which is characterised by pain, burning and suppuration. The disease called Cippa, is also denominated as Upanakha and Ksataroga. Kunakha: The nails of fingers becoming rough, dry, black, and injured through the action of the Dosas enraged through the effect of a blow, are called Kunakha (bad nails). It is also called Kulina Anuayi : A small swelling (on the surface of the body) which is of the same colour (as the surrounding skin), but is deepseated, and suppurates in its deeper strata, is called Anusayi by the physicians. The disease is the effect of the deranged Kapha. Vidarika : A round reddish swelling rising either on the axiliary or inguinal regions in the shape of a gourd (Vidarikanda) is known as Vidarika. The disease is due to the concerted action of the deranged Vayu, Pitta and Kapha and is characterised by symptoms similar to each of them. 20-23
sensation which, if not properly remedied, bring on death within a fortnight, or ten days of their first appearance. These (vesicles) are called Vahni-Rohini. And again from another work he cites that a case of Vahni-Rohini due to the action of the deranged Kapha proves fatal within a fortnight, that due to the deranged Pitta, within ten days, and that due to the deranged Vayu, within a week.
1. The patient dies on the seventh day in a case of disease marked by the dominant Vayu, on the tenth day in a case marked by the dominant Pitta and on the fifteenth day in a case of dominant deranged Kapha.
प्राप्य मांससिरास्नायुः श्लेष्मा मेदस्तथाऽनिलः । ग्रन्थि कुर्वन्ति भिन्नोऽसौ मधुसर्पिर्वसानिभम् ॥ २४ ॥
स्त्रवत्यास्त्रावमत्यर्थं तत्र वृद्धिं गतोऽनिलः । मांस विशोष्य ग्रथितां शर्करां जनयेत् पुनः ॥ २५ ॥
दुर्गन्धं क्लिन्नमत्यर्थं नानावर्णं ततः सिराः । स्त्रवन्ति सहसा रक्तं तद् विद्याच्छर्करार्बुदम् ॥ २६ ॥
पामाविचय कुष्ठेषु रकसा च प्रकीर्तिता ॥ २७ ॥
Sarkararbuda : The deranged Vayu and Kapha having recourse to and affecting the flesh, veins (Sira), ligaments (Snaya) and fat give rise to a sort of cyst (Granthi) which when it bursts exudes a copious secretion in its nature somewhat like honey, clarified butter or Vasa. The aforesaid Vayu, when aggravated through excessive secretion, dries and gathers the flesh up again in the shape of (a large number of) gravel-like concretions (Sarkara) known accordingly as Sarkarabuda. A fetid secretion of varied colour is secreted from the veins (Sira) in these Granthis which are sometimes found to bleed suddenly. The three varieties of the skin disease called Pama (Eczema), Vicarcika (Psoriasis) and Rakasa have already been discussed under the head of Kustha (Chapter. V) 24-27
परिक्रमणशीलस्य वायुरत्यर्थरूक्षयोः । पादयोः कुरुते दारीं सरुजां तलसंश्रिताम् ॥ २८ ॥
शर्करोन्मथिते पादे क्षते वा कण्टकादिभिः । मेदोरक्तानुगैश्चैव दोषैर्वा जायते नृणाम् ।। २९ ।।
ग्रन्थिर्निम्नमध्योन्नतोऽपि वा । सकीलकठिनो कोलमात्रः सरुक् स्रावी जायते कदरस्तु सः ॥ ३० ॥
क्लिन्नाङ्गल्यन्तरौ पादौ कण्डूदाहरुगन्वितौ । दुष्टकर्दमसंस्पर्शादलसं तं विनिर्दिशेत् ।। ३१ ।।
Padadarika: The soles and feet of a person of extremely pedestrian habits become dry (and lose their natural serous moisture). The local Vayu thus aggravated gives rise to peculiar painful cracks (Dari in the affected parts) which are called Padadarika. Kadara: The knotty (Granthi), a painful, hard growth raised at the middle or sunk at the sides, which exudes a secretion and resembles an Indian plum (Kola–in shape), and appearing at the soles (palms according to- Bhoja) of a person as an outcome of the vitiated condition of the local blood and fat produced by the deranged Dosas incidental to the pricking of a thorn etc. or of gravel is called a Kadara (corns). Alasa : An affection, caused by contact of poisonous mire and appearing between the toes, which is characterised by pains, burning, itching and exudation, is called Alasa. 28-31
रोमकूपानुगं पित्तं वातेन सह मूर्च्छितम् । प्रच्यावयति रोमाणि ततः श्लेष्मा सशोणितः ॥ ३२ ॥
रुणद्धि रोमकूपांस्तु ततोऽन्येषामसम्भवः । तदिन्द्रलुप्तं खालित्यं रुज्येति च विभाव्यते ।। ३३ ।।
Indralupta : The dranged Vayu and Pitta having recourse to the roots of the hairs bring about their gradual falling off, while the deranged blood and Kapha of the locality fill up those pores or holes, thus barring their fresh growth and recrudescence. The disease is called Indralupta,’ Rujya or Khalitya (Alopecia). 32-33
दारुणा कण्डुरा रूक्षा केशभूमिः प्रपाट्यते । कफवातप्रकोपेण विद्याद् दारुणकन्तु तम् ॥ ३४ ॥
अरूषि बहुवक्त्राणि बहुक्लेदीनि मूर्धनि । कफासृक्क्रिमिकोपेन नृणां विद्यादरुषिकाम् ।। ३५ ।।
Darunaka: The disease in which the hairy parts of the body (roots of hairs) become hard, dry and characterised by an itching sensation is called Darunaka. The disease is due to the action of the deranged Kapha and Vayu. Arunsika : Ulcers (Arunsi ) attended with mucopurulent discharges and furnished with a number of mouths or outlets and appearing on the scalps of men as the result of the tion of local parasites and of the deranged blood and Kapha (of the locality) are called Arunsika. 34-35
क्रोधशोकश्रमकृतः शरीरोष्मा शिरोगतः । पित्तञ्च केशान् पचति पलितं तेन जायते ।। ३६ ।।
दाहज्वररुजावन्तस्ताम्राः स्फोटा: सपीतकाः । गात्रेषु वदने चान्तर्विज्ञेयास्ता मसूरिकाः ॥ ३७॥
1. Women are generally proof against this disease owing to their delicate constitution and to their being subjected to the monthly discharge of vitiated blood and at the same time to their undergoing no physical exercise, and hence there is little chance of the bodily Pitta being deranged and bringing on this disease.
Palita: The heat and Pitta of the body having recourse to the region of the head owing to overwork, fatigue, and excessive grief or anger, tend to make the hair prematurely grey, and such silvering of the hair (before the natural period of senile decay ) is called Palita. Masorika (variola): The yellow or copper-coloured pustules or eruptions attended with pain, fever and burning and appearing all over the body, on (the skin of) the face and inside the cavity of the mouth are cailed Masurika. 36-37
शाल्मलीकण्टकप्रख्याः कफमारुतशोणितैः । जायन्ते पिडका यूनां वक्त्रे या मुखदूषिकाः ।।३८ ।।
कण्टकैराचितं वृत्तं कण्डूमत् पाण्डुमण्डलम् । पद्मिनीकण्टकप्रख्यैस्तदाख्यं कफवातजम् ।। ३९ ।।
नीरुजं सममुत्सन्नं मण्डलं कफरक्तजम् । सहजं रक्तमीषच्च श्लक्ष्णं जतुमणिं विदुः ॥ ४० ॥
Yauvana-pidaka–(Mukhadusika) : The pimpies like the thorns of a Salmali tree, which are found on the face of young men through the deranged condition of the blood, Vayu and Kapha, are called Yauvana-pidaka or piimples of youth. Padmini-Kantaka : The circular. greyish patches or rash-like eruptions studded over with thorny papilla of the skin resembling the thorns on the stem of the lotus marked by itching are called Padmini-kantaka. The disease is due to the deranged condition of the Vayu and Kapha Jatumani (mole) : The reddish, glossy, circular, and painless, congenital marks (Sahaja) or moles on the body not more elevated (than the surrounding skin) are called Jatumani. The disease is due to the deranged condition of the blood and Kapha. 38-40
स्थिरञ्चैव यस्य गात्रेषु दृश्यते । कृष्णमुत्सन्नमनिलान्मषकं दिशेत् ।। ४१ ।।
कृष्णनि तिलमात्राणि नीरुजानि समानि च । वातपित्तकफोद्रेकात् तान विद्यात् तिलकालकान् ॥ ४२ ॥
अवेदनं माषवत्म ण्डलं महदल्पं वा श्यावं वा यदि वा सितम् । सहजं नीरुजं गात्रे न्यच्छमित्यभिधीयते ।। ४३ ।।
1. According to certain authorities it is due to the absorption of blood by Vayu and Pitta.
समुत्थाननिदानाभ्यां चर्मकीलं प्रकीर्त्तितम् ॥ ४४ ।। क्रोधायासप्रकुपितो वायुः पित्तेन संयुतः ।
सहसा मुखमागम्य मण्डलं विसृजेत् ततः । नीरुजं तनुकं श्यावं मुखे व्यङ्गं तमादिशेत् ॥ ४५ ॥
Masaka (Lichen) : The hard, painless, black and elevated eruptions on the body (skin) resembling the Masa pulse in shape, caused by the aggravated condition of the bodily Vayu are called Masaka. Tilakalaka: The black painless spots on the skin about the size of a sesamum seed and level with the skin are called Tilakalaka. This disease is caused due to drying up of the Vayu, Pitta and Kapha.¹ Nyaccha : The congenital, painless, circular, white or brown (Syava) patches on the skin, which are found to be restricted to a small or comparatively diffused area of the skin, are called Nyaccha. Carmakila (hypertrophy of the skin): The causes and symptoms of the disease known as Carmakila have been already described (under the head of the Arsa-Nidana). Vyanga: The Vayu being aggravated through wrath and over-fatiguing physical exercise, and surcharged with Pitta, and suddenly appearing on the face of a person, causes thin, circular, painless and brown-coloured patches or stains. They are known by the name of Vyanga. 41-45
मर्दनात् पीडनाच्चापि तथैवात्यभिघाततः । मेढ्रचर्म यदा वायुर्भजते सर्वतश्चरः ॥ ४६॥
तदा वातोपसृष्टन्तु चर्म प्रतिनिवर्त्तते । मणेरधस्तात् कोशश्च ग्रन्थिरूपेण लम्बते ॥ ४७ ॥
सवेदन: सदाहश्च पाकञ्च व्रजति क्वचित् । मारुतागन्तुसम्भूतां विद्यात् तां परिवर्तिकाम् ॥
सकण्डू: कठिना चैव सैव श्लेष्मसमुत्थिता ।। ४८ ।।
The Parivartika: The vital Vayu (Vyana) aggravated by such causes as excessive massage (masturbation), pressure, or local trauma, attacks the integuments of the penis (prepuce) which being thus affected by the deranged Vayu forms into a knot-like structure and hangs down from the glans penis. The disease known as Parivartika
1. According to others the spo goes by the name of Nilika, if it is black-coloured and appears anywhere other than on the face. or Phymosis is due to the action of the deranged Vayu aggravated by any extraneous factor. It is marked by pain and burning sensation; and sometimes suppurates. When the knotty growth becomes hard and is accompanied by itching, then it is caused by the aggravated Kapha. 46-48
अल्पीयः खां यदा हर्षाद् बालां गच्छेत् स्त्रियं नरः । हस्ताभिघातादथवा चर्मण्युद्वर्त्तिते बलात् ।। ४९ ।।
मर्दनात् पीडनाद् वाऽपि शुक्रवेगविघाततः । यस्यावपाटचते चर्म तां विद्यादवपाटिकाम् ।। ५० ।। वातोपसृष्टमेवन्तु चर्म संश्रयते मणिम्।
मणिश्चर्मोपनद्वस्तु मूत्रस्त्रोतो रुणद्वि च ।। ५१ ।।
निरुद्धप्रकशेतस्मिन्मू त्रं प्रवर्त्तते प्रवर्त्तते जन्तोर्मणिर्न मन्दधारमवेदनम् । विदीर्यते ।। ५२ ।।
निरुद्धप्रकश विद्याद् दुरुढाञ्चावपाटिकाम् ॥ ५३॥ ।।
Avapatika: When the integuments of the prepuce is abnormally and forcibly turned back by such causes as coition under excitement, with a girl (before menstruation and before the rupture of the hymen and consequently with a narrow external orifice of the vagina) or masturbation or pressure or a blow on the penis, or a voluntary retention of a flow of semen or forcible opening of the prepuce, the disease is called Avapatika or paraphymosis. Niruddha-prakasa : The prepuce affected by the deranged Vayu entirely covers up the glans penis and thus obstructs and covers up the orifice of the urethra. In cases of partial obstruction a thin jet of urine is emitted with a slight pain. In cases of complete closing the emission of urine is stopped without causing any crack or fissure in the glans penis in consequence. The disease is called Niruddha-prakasa which is due to the deranged Vayu and is marked by pain (in the glans penis). 49-53
वेगसन्धारणाद् वायुर्विहतो गुदमाश्रितः । निरुणद्वि महत् स्रोतः सूक्ष्मद्वारं करोति च।।५४।।
मार्गस्य सौक्ष्म्यात कृच्छ्रेण पुरीषं तस्य गच्छति । सन्निरुद्धगुदं व्याधिमेनं विद्यात् सुदुस्तरम् ।। ५५ ।।
शकृन्मूत्रसमायुक्तेऽधौतेऽपाने शिशोर्भवेत् । स्विन्नस्यास्नाप्यमानस्य कण्डूं रक्तकफोद्भवा ।। ५६ ।।
कण्डूयनात् ततः क्षिप्रं स्फोट: स्त्रावश्च जायते । एकीभूतं व्रणैर्घोरं तं विद्यादहिपूतनम् ॥ ५७ ॥
Niruddhaguha : The Vayu (Apana) obstructed by the repression of a natural urging towards defecation stuffs the rectum, thus producing constriction of its passage and consequent difficulty of defecation. This dreadful disease is known as Niruddha-guda (stricture of the rectum) which is extremely difficult to cure. Ahiputana : A sort of itchlike eruptions appearing about the anus of a child owing to a deposit of urine, perspiration, feces etc. consequent on the neglect in cleansing that part. The eruptions which are the effects of the deranged blood and Kapha soon assume an Eczematous character and exude
a purulent discharge on account of constant scratching. The Eczema (Vrana) soon spreads, and coalesces and proves very obstinate in the end. The disease is called Ahiputana. 54-57
स्नानोत्सादनहीनस्य मलो वृषणसंश्रितः । प्रक्लिद्यते यदा स्वेदात् स कण्डूं जनयेत् सदा ॥ ५८ ॥
तत्र कण्डूयनात् क्षिप्रं स्फोटः स्त्रावश्च जायते । प्राहुर्वृषणकच्छू तां श्लेष्मरक्त प्रकोपजाम् ।। ५९ ।।
प्रवाहणातिसाराभ्यां निर्गच्छति गुदं बहिः । रुक्षदुर्बलदेहस्य गुदभ्रंशं तमादिशेत् ।। ६० ।।
Vrisana-kaccha : When the filthy matter, deposited in the scrotal integuments of a person who is negligent in washing the parts or in the habit of taking daily ablutions, is moistend by the local perspiration, it gives rise to an itching sensation in the skin of the scrotum, which is speedily turned into running Eczema by onstant scratching of the parts. The disease is called Vrisana-kacchu and is due to the aggravated condition of the Kapha and blood/ Guda-Bharansa : A prolapse or falling out of the anus (due to the Vayu) in a weak and lean patient through straining, urging or flow of stool as in dysentery is called Guda-Bhransa or prolapsus ani. 58-60
इति सुश्रुतसंहितायां निदानस्थाने क्षुद्ररोगनिदानं नाम त्रयोदशोध्यायः ।। १३ ।।
Thus ends the thirteenth Chapter of the Nidana Sthana in the Susruta Samhita which treats of the Nidana of minor ailments.
