षोडशोऽध्यायः । अथातो मुखरोगाणां निदानं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ।। १ ।।
Now we shall discourse on the Nidana of Mukharoga (diseases. which affect the cavity of the mouth in general). 1
मुखरोगा: पञ्चषष्टिः सप्त स्वायतनेषु । तत्रायतनानि – ओष्ठौ, ।। २ ।।
दन्तमूलानि, दन्ताः, जिह्वा, तालु, कण्ठः, सर्वाणि चेति तत्राष्टावोष्ठयोः, पञ्चदश दन्तमूलेषु, अष्टौ दन्तेषु, पञ्च जिह्वायाम्, नव तालूनि, सप्तदश कण्ठे, त्रयः सर्वेष्वायतनेषु || ३ ||
General Classifications : Sixty five different forms of mouth disease are known in practice. They are found to attack seven different localities viz. the lips, the gums of the teeth, tongue, palate, throat and the entire cavity; of these eight are located to the lips; fifteen, to the roots of the teeth; eight to the teeth; five to the tongue; nine to the palate; seventeen to the throat; and three to the entire oral cavity. 2-3
वातपित्तश्लेष्मसन्निपातरक्तमांसमेदोऽभिघात – तत्रौष्ठप्रकोपा निमित्ताः।। ४।॥
Diseases of the lips: The eight forms which affect the lips, are either Vataja, Pittaja, Kaphaja, Sannipatika, Raktaja, Mansaja, Medaja or Abhighataja (Traumatic). 4
1. According to others sixty-seven-but Dalhana does not support this.
कर्कशौ परुषौ स्तब्धै कृष्णौ तीव्ररुगन्वितौ । दाल्येते परिपाटयेते ह्योष्ठौ मारुतकोपतः ॥ ५ ॥
आचितौ पिडकाभिस्तु सर्षपाकृतिभिर्भृशम् । सदाहपाकसंस्त्रावौ नीलौ पीतौ च पित्ततः ॥ ६ ॥
सवर्णाभिस्तु चीयेते पिडकाभिरवेदनौ । ।।७।। कण्डूमन्तौ कफाच्छूनौ पिच्छिलौ शीतलौ गुरू । ॥ ७ ॥
सकृत् कृष्णौ सकृत् पीतौ सकृच्छ्वेतौ तथैव च । सन्निपातेन विज्ञेयावनेकपिडकाचितौ ।। ८ ।।
The Vataja Type: The lips become dry, rough, numbed, black, extremely painful and the affected part seems as if it were smashed and pulled out or cracked by the action of the aggravated Vayu. In the Pittaja type the lips become blue or yellow-coloured and studded with (a large number of small) mustard-seed-like eruptions, which suppurate and exude a purulent discharge attended with a burning sensation (in the locality). In the Kaphaja type — the affected lips are covered with small eruptions, which are of the same colour as the surrounding part, and become slimy, heavy or thick, cold and swollen. Pain is absent in this type and the patient feels an irresistible inclination to scratch the parts. In the Sannipataja type — the lips change colour, becoming black, yellow, or ash-coloured (white) at intervals and are found to be studded with various sorts of eruptions. 5-8
खर्जूरफलवर्णाभिः पिडकाभि: समाचितौ । रक्तोपसृष्टौ रुधिरं स्त्रवतः शोणितप्रभौ ।। ९ ।।
मांसदुष्टौ गुरू स्थूलौ मांसपिण्डवदुद्गतौ । जन्तवश्चात्र मूर्च्छन्ति सक्कस्योभयतो मुखात् ।। १० ।।
मेदसा घृतमण्डाभौ कण्डूमन्तौ स्थिरौ मृदू । अच्छस्फटिकसङ्काशमास्त्रावं स्त्रवतो गुरू ॥ ११ ॥
क्षतजाभौ विदीर्येते पाटयेते चाभिघाततः । ग्रथितौ च समाख्यातावोष्ठौ कण्डूसमन्वितौ ।। १२ ।।
The Raktaja type : (Produced by the vitiated condition of the blood) the affected lips look as red as blood and profusely bleed and crops of date coloured (chocolate-coloued) eruptions appear on thier surface. In the Mansaja type (due to the vitiated condition of the local flesh), the lips become heavy, thick and gathered up in the form of a lump of flesh. The angles of the mouth become infested with parasites which germinate and spread themselves in the affected parts. In the Medaja (fat-origined) type the lips become numbed, soft, heavy and marked by an itching sensation. The skin of the inflamed surface becomes glossy and looks like the surface layer of clarified butter exuding a thin crystal-like ( transparent ) watery discharge. In the Abhighataja (Traumatic) type, the lips become knotty and marked by an itching sensation and seem as if pierced into or cut open with an axe and (become cracked and fissured. 9-12
दन्तमूलगतास्तु-शीतादो, दन्तपुप्पुटको, दन्तवेष्टकः, शौषिरो, महाशौषिरः, परिदर, उपकुशो, दन्तवैदर्भो, वर्द्धनोऽधिमांसो, नाड्यः पञ्चेति ।। १३ ।।
Disease of the roots of the teeth: Diseases which are located to the roots of the teeth, are known as Sitada, Danta-pupputaka, Dantavestaka, Sausira, Maha-Sausira, paridara, Upakusa, Danta-vaidarbha, Vardhana, Adhimansa and the five sorts of the Nadi (sinus). 13
शोणितं दन्तवेष्टेभ्यो यस्याकस्मात् प्रवर्त्तते । दुर्गन्धीनि सकृष्णानि प्रक्लेदीनि मृदूनि च।।१४।।
दन्तमांसानि शीर्यन्ते पचन्ति च परस्परम्। शीतादो नाम स व्याधिः कफशोणितसम्भवः ।। १५ ।।
दन्तयोस्त्रिषु वा यस्य श्वयथुः सरुजो महान् । दन्तपुप्पुटको ज्ञेयः कफरक्तनिमित्तजः ।। १६ ।।
स्त्रवन्ति पूयरुधिरं चला दन्ता भवन्ति च। दन्तवेष्टः स विज्ञेयो दुष्टशोणितसम्भवः ।। १७ ।।
श्वयथुर्दन्तमूलेषु रुजावान् कफरक्तजः। लालास्त्रावी स विज्ञेयः कण्डूमान् शौषिरो गदः ॥ १८ ॥
दन्ताश्चलन्ति वेष्टेभ्यस्तालु चाप्यवदीर्यते । दन्तमांसानि पच्यन्ते मुखञ्च परिपीड्यते ।
यस्मिन् स सर्वजो व्याधिर्महाशौषिरसंज्ञकः ।। १९ ।।
Sitada (Scurvy) : The gums of the teeth suddenly bleed and become foul smelling black, and slimy. They become soft and gradually slough off. The disease has its origin in the deranged condition of the local blood and Kapha. Danta-pupputaka (gum boil) : The disease in which the roots of two or three teeth at a time is marked by a violent swelling and pain is called Danta-pupputaka. The disease is due to the vitiated condition of the blood and Kapha. Danta-vestaka : The teeth become loose and mobile in the gums, which exude a discharge of blood and pus, this disease is due to the vitiated blood of the locality. Sausira: The disease in which an itching painful swelling appears at the root of the gums attended with copious flow of saliva is called Sausira (Alveolar abscess). It is caused by the deranged blood and Kapha of the locality Maha-Sausira: The disease in which the teeth become loose, and mobile from the gums, the palate is cracked and fissured, the gums are suppurated and whole-mouth cavity becomes painful is called Mahasausira, this condition is the outcome of the concerted action of the deranged Dosas of the body. 14-19
दन्तामांसानि शीर्यन्ते यस्मिन् ष्ठीवति चाप्यसक् । पित्तासृक्कफजो व्याधिज्ञेयः परिदरो हि सः ।। २० ।।
वेष्टेषु दाहः पाकश्च तेभ्यो दन्ताश्चलन्ति च । आघट्टिताः प्रस्त्रवन्ति शोणितं मन्दवेदनाः ।। २१ ।।
आध्मायन्ते स्रुते रक्ते मुखं पूति च जायते । यस्मिन्नुपकुशः स स्यात् पित्तरक्तकृतो गदः ।। २२ ।।
Paridara : The disease in which the gums become decayed and blood comes on spitting is called Paridara (bleeding gums). The disease has its origin in the deranged condition of the blood, Kapha and Pitta. Upakusa: The disease in which the gums become marked by a burning sensation and suppuration and the teeth become loose and shaky (in their gums ) in consequence and bleed at the least shaking, is called Upakusa. There is a slight pain, and the entire cavity of the mouth becomes swollen and emits a fetid smell; this disease is due to the vitiated condition of the blood and Pitta. 20-22
घृष्टेषु दन्तमूलेषु संरम्भो जायते महान् । भवन्ति च चला दन्ताः स वैदर्भोऽभिघातजः ॥ २३ ॥
मारुतेनाधिको दन्तो जायते तीव्र वेदनः । वर्धनः स मतो व्याधिर्जाते रुक् च प्रशाम्यति ॥ २४ ॥
हानव्ये पश्चिमे दन्ते महाञ्छोथो महारुजः । लालास्त्रावी कफकृतो विज्ञेयः सोऽधिमांसकः ।। २५ ।।
दन्तमूलगता नाड्यः पञ्च ज्ञेया यथेरिताः ।। २६ ।।
Danta-Vaidarbha : The disease which is due to the friction of the gums marked by the appearance of a violent swelling about the portion (so rubbed and in which) the teeth become loose and can be moved about, is called Danta-vaidarbha which is due to an extraneous cause such as a blow etc. Vardhana : the disease which is marked by the advent of an additional tooth (the last molar) due to the action of the deranged Vayu with a specific excruciasting pain of its own, is called Vardhana or eruption of the Wisdom tooth. The pain subsides with the cutting of the tooth. Adhimansa: the disease in which a violent and extremely painful large swelling appears about the root of the tooth, and is situated in the farthest end of the cavity of the cheek-bone accompanied by a copious flow of saliva is called Adhimansa or Epulis. It is due to the deranged Kapha. The five sorts of Nadi (sinus ) which affect the roots of the teeth ( are either Vataja, Pittaja, Kaphaja, Sannipataja or Abhighataja), their symptoms being respectively identical with those of the types of Nadi-vrana. 23-26
दन्तगतास्तु- दालन:, क्रिमिदन्तको, दन्तहर्षो, भञ्जनकः, दन्तशर्करा, कपालिका, श्यावदन्तको, हनुमोक्षश्चेति ।। २७ ।।
Diseases to the teeth proper : Diseases which are restricted to the teeth proper are named as, Dalana, Krimi-dantaka, Danta harsa, Bhanjanaka, Danta Sarkara, Kapalika, Syava-dantaka and Hanumoksa. 25
दाल्यन्ते बहुधा दन्ता यस्मिंस्तीव्ररुगन्विताः । दालन: स इति ज्ञेयः सदागतिनिमित्तजः ।। २८ ।।
कृष्णश्छिद्री चल: स्रावी ससंरम्भो महारुजः । अनिमित्तरुजो वाताद् विज्ञेयः क्रिमिदन्तकः ।। २९ ।।
दशना: शीतमुष्णञ्च सहन्ते स्पर्शनं न च। यस्य तं दन्तहर्षन्तु व्याधिं विद्यात् समीरणात् ॥ ३० ॥
वक्त्रं वक्रं भवेद् यस्मिन् दन्तभङ्गश्च तीव्ररुक् । कफवातकृतो व्याधिः स भञ्जनकसंज्ञितः ॥ ३१ ॥
शर्करेव स्थिरीभूतो मलो दन्तेषु यस्य वै। सा दन्तानां गुणघ्नी तु विज्ञेया दन्तशर्करा ॥ ३२ ॥
दलन्ति दन्तवल्कानि यदा शर्करया सह। ज्ञेया कपालिका सैव दशनानां विनाशिनी ।। ३३ ।।
योऽसृङ् मिश्रेण पित्तेन दग्धो दन्तस्त्वशेषतः । श्यावतां नीलतां वाऽपि गतः स श्यावदन्तकः ।। ३४ ।।
वातेन तैस्तैर्भावैस्तु हनुसन्धिर्विसंहतः । हनुमोक्ष इति ज्ञेयो व्याधिरर्दितलक्षणः ।। ३५ ।।
Dalana: The disease in which the teeth seem as if being cleft as under with a violent pain is called Dalana or toothache, the origin of which is ascribed to the action of the aggravated state of the bodily Vayu, Krimi-dantaka: The disease in which the teeth are eaten into by worms, is called Krimi-dantaka (caries) The teeth become loose and perforated by black holes accompanied by a copious flow of saliva. The appearance of an extremely diffused swelling (about the roots of decayed teeth) with a sudden aggravaton of the accompanying pain without any apparent cause is also one of its specific features. Dantaharsa: The disease in which the teeth cannot bear the heat, cold or touch is called Danta-harsa. It is due to the deranged condition of Vayu. Bhainjanaka: The disease in which the face is distorted, the teeth are broken and the accompanying pain is severe, is called Bhanjanaka (degeneration of the teeth). The disease is due to the deranged condition of the Vayu and Kapha. Sarkara: The disease, in which tartar, formed on the teeth and hardened (by the action of the deranged Vayu), lie in a crystallised form at the roots of the teeth, is called Danta – Sarkara (Tartar ). Such deposits tend to destroy the healthy growth and functions of the teeth. Kapalika: The disease in which the preceding crystallised deposits get cemented together and afterwards separate from the teeth taking away a part of their coating (enamel) is called Kapalika (calcareous deposit) which naturally makes an erosion into and destroys the teeth Syava-dantaka : The disease, in which the teeth variously scorched by the action of the deranged Pitta and blood assumes a blackish or blue colour, is named as Syava-dantaka (black teeth). Hanu-moksa: The disease in which the Vayu aggravated (by such causes, as by loud talking, chewing of hard substances. or immoderate yawning) produces the dislocation of the jawbones is called Hanu-moksa. It is identical with Arddita as regards its symptoms. 28-35
जिह्वागतास्तु कण्टकास्त्रिविधास्त्रिभिर्दोषैरलास उपजिह्निका चेति ।। ३६ ।।
Diseases of the tongue: The five kinds of diseases which affect the organ of taste are the three sorts of Kantakas due to the three deranged Dosas (Vataja, Pittaja and Kaphaja), Alasa and Upajihvika. 36
जिह्वाऽनिलेन स्फुटिता प्रसुप्ता भवेच्च शाकच्छदनप्रकाशा ।
पित्तेन पीता परिदह्यते च चिता सरक्तैरपि कण्टकैश्च । कफेन गुर्वी बहुला चिता च मांसोद्गमै: शाल्मलिकण्टकाभैः ॥ ३७ ।।
जिह्वातले यः श्वयथुः प्रगाढः सोऽलाससंज्ञ कफरक्तमूर्त्तिः । जिह्वां स तु स्तम्भयति प्रवृद्धो मूले तु जिह्वा भृशमेति पाकम् ||३८ ।।
जिह्वाग्ररूपः श्वयथुर्हि जिह्वामुन्नम्य जातः कफरक्तयोनिः । प्रसेककण्डूपरिदाहयुक्ता प्रकथ्यतेसाऽवुपजिह्विकेति ।। ३९ ।।
The three Kantakas : In the Vataja Kantaka type the tongue becomes cracked, loses the sense of taste and becomes rough like a teak leaf (giving the organ a warty appearance). In the Pittaja Kantaka form the tongue is coloured yellow and studded over with furred blood-coloured papillae with the burning sensation (of the Pitta in them). In the Kaphaja Kantaka type the tongue becomes heavy, thick and grown over with vegetation of slender fleshy warts in the shape of Salmali thorns. Alasa: The severe inflammatory swelling about the under surface of the tongue is called Alasa, which if allowed to grow on unchecked gives rise to numbness and immobility of the organ and tends to a process of rapid suppuration at its base. The disease is caused by the deranged blood and Kapha. The Upa-jihvika: The disease in whicch a (cystic) swelling shaped like the tip of the tongue appears about the under-surface of that organ by raising it a little is called Upajihvika (Ranula). The accompanying symptoms are salivation, burning and itching sensation in the affected organ; these are due to the deranged Kapha and blood (of the locality ). 37-39
तालुगतास्तु-गलशुण्डिका, तुण्डिकेरी, अघुषः, मांसकच्छपः, अर्बुदं, मांससङ्घातः, तालुपुप्पुटः, तालुशोषः, तालुपाक इति ।। ४० ।।
Disease of the palate : Diseases which are common to the part of the palate are named as Gala-sundika, Tundikeri, Adhrusa, Mainsakaccchapa, Arbuda, Mansa-sanghata, Talu-pupputa, Talu-sosa and Talu-paka. 40
श्लेष्मासृग्भ्यां तालुमूलात् प्रवृद्धो दीर्घः शोफो ध्मातबस्तिप्रकाशः ।
तृष्णाकासश्वासकृत् संप्रदिष्टो व्याधिर्वैद्यैः कण्ठशुण्डीति नाम्ना ।। ४१ ।।
शोफ: स्थूलस्तोददाहप्रपाकी प्रागुक्ताभ्यां तुण्डिकेरी मता तु ।
शोफः स्तब्धो लोहितस्तालुदेशे रक्ताज्ज्ञेयः सोऽध्रुषो रुग्ज्वराढ्यः ।। ४२ ।।
कूर्म्मोत्सन्नोवेदनोऽशीघ्रजन्माऽरक्तो ज्ञेयः कच्छपः श्लेष्मणा स्यात् ।
पद्माकारं तालुमध्ये तु शोफं विद्याद्रक्तादर्बुदं प्रोक्तलिङ्गम् ।। ४३ ।।
दुष्टं मांसं श्लेष्मणा नीरुजञ्च ताल्दन्तःस्थं मांससङ्घातमाहुः |
नीरुक् स्थायी कोलमात्रः कफात् स्यान्मेदोयुक्तात् पुप्पुटस्तालुदेशे ।। ४४ ।।
शोषोऽत्यर्थं दीर्यते चापि तालुः श्वासो वातात् तालुशोषः सपित्तात् । पित्तं कुर्यात् पाकमत्यर्थघोरं तालुन्येनं तालुपाकं वदन्ति ।। ४५ ।।
Gala-sundika : The diffused and elongated swelling, caused by the deranged blood and Kapha, which first appears about the root of the palate and goes on extending till it looks like an inflated skinbladder is called Gala-sundika (tonsilitis) by physicians. Thirst, cough, difficult breathing are the indications of the disease. Tundikeri : A thick swelling resembling the fruit of the Tundikeri plant in shape and appearing about the root of the palate attended with a burning, piercing or pricking pain and suppuration is called Tundikeri (abscess of the tonsil). Adhrusa : A red, numbed swelling appearing about the same region, as the effect of the vitiated blood of the locality, attended with severe fever and pain, is known by the name of Adhrusha. Mainsakacchapa: A brownish and slightly painful swelling somewhat shaped like the back of a tortoise (and appearing about the region of thesoft palate) is called Mansa-kacchapa. The disease is slow in its growth or development and is due to the deranged Kapha. Arbuda: A swelling shaped like the petal of the lotus lily and appearing in the region of the soft palate as an outcome of the aggravated condition of the local blood is called Arbuda. The swelling is identical with the Raktabuda as described before. Mansa-Sanghata: A vegetation of morbid flesh at the edge or extremity of the soft palate through the action of the deranged Kapha is called Mansa-Sanghata. It is painless. Talupupputa: A painless permanent swelling like the shape of the Kola fruit (plum) caused by the deranged fat and Kapha at the region of the soft palate is called Talu-pupputa. Talu-sosa: The disease of the soft palate in which there is excessive dryness with dyspnoea and a severe piercing pain in the affected part is called Talu-sosa, which has its origin in the aggravated condition of the bodily Vayu acting in concert with the deranged Pitta. Talu-paka The disease in which the deranged Pitta sets up a very severe suppurative process in the soft palate is called Talu-paka. 41-45
कण्ठगतास्तु रोहिण्यः पञ्च, कण्ठशालूकमधिजिह्वो वलयो बलास एकवृन्दो वृन्दः शतघ्नी गिलायुर्गलविद्रधिर्गलौघः स्वरघ्नो मांसतानो विदारी चेति ।। ४६ ।।
The diseases of the throat and larynx: The diseases common to the throat and the larynx are seventeen in number and are known as the five types of Rohini, Kantha-Saluka, Adhijihva, Valaya, Balasa, Eka-vynda, Vxnda, Sataghni Gilayu, Gala-vidradhi, Galaugha, Svaraghna, Manisatana, and Vidari. 46
गलेऽनिलः पित्तकफौ च मूर्च्छितौ पृथक् समस्ताश्च तथैव शोणितम् ।
प्रदूष्य मांसं गलरोधिनोऽङ्कुरान् सृजन्ति यान् साऽसुहरा तु रोहिणी ।। ४७ ।।
General features of Rohinis : The aggravated Vayu, Pitta, Kapha, either seperately or in combination or blood may affect the mucous of the throat and give rise to vegetations of fleshy papillae, which gradually obstruct the passage of the throat and bring on death. The disease is called Rohint (Diphtheria). 47
जिह्वां समन्ताद् भृशवेदना ये मांसाङ्कराः कण्ठनिरोधिनः स्युः । तां रोहिणीं वातकृतां वदन्ति वातात्मकोपद्रवगाढयुक्ताम् ।। ४८ ॥ क्षिप्रोद्गमा क्षिप्रविदाहपाका तीव्रज्वरा पित्तनिमित्ततः स्यात् । स्रोतोनिरोधिन्यपि मन्दपाका गुर्वी स्थिरा सा कफसम्भवा वै ।। ४९ ।।
The Vataja Rohini : A vegetation of extremely painful fleshy Ankuras (nodules), crops up all over the tongue which tend to obstruct the passage of the throat and are usually accompanied by other distressing symptoms characteristic of the deranged Vayu. PittajaRohini The Ankuras (nodules) in this present type are marked by speedy growth and suppuration, and are accompanied by a burning sensation and high fever Kaphaja Rohini: The Ankuras (nodules) become heavy, hard and characterised by slow suppuration gradually obstructing the passage of the throat. 48-49
गम्भीरपाका प्रतिवारवीर्या त्रिदोषलिङ्गा त्रयसम्भवा स्यात् । स्फोटाचिता पित्तसमानलिङ्गाऽसाध्या प्रदिष्टा रुधिरात्मिकेयम् ।। ५० ।।
The Sannipatika Type: Suppuration takes place in the deeper strata of the membrane accompanied by all the dangerous symptoms similar to the three Dosas. It is rarely amenable to treatment. Raktaja Type: Symptoms characteristic of the Pittaja type of the disease are present and the fleshy outgrowth formed in the throat, is found to be covered with small vesicles. This type is incurable. 50 कोलास्थिमात्रः कफसम्भवो यो ग्रन्थिर्गले कण्टकशूकभूतः । खरः स्थिरः शस्त्रनिपातसाध्यस्तं कण्ठशालूकमिति ब्रुवन्ति
।। ५१ ।। जिह्वाग्ररूपः श्वयथुः कफात् तु जिह्वाप्रबन्धोपरि रक्तमिश्रात् ।
ज्ञेयोऽधिजिह्वः खलु रोग एष विवर्जयेदागतपाकमेनम् ।। ५२ ।।
बलास एवायतमुन्नतञ्च शोकं करोत्यन्नगतिं निवार्य । तं सर्वथैवाप्रतिवारवीर्यं विवर्ज्जनीयं वलयं वदन्ति |॥ ५३॥ ।।
गले तु शोकं कुरुतः प्रवृद्धौ श्लेष्मानिलौ श्वासरुजोपपन्नम्। मर्मच्छिदं दुस्तरमेतदाहुर्बलाससंज्ञं निपुणा विकारम् ॥ ५४॥
Kantha-Saluka : The disease in which a hard rough nodular growth (Granthi) in the shape of a plum-stone crops up in the throat, which seems as if it has been stuffed with the bristle of a Suka insect or been pricked by thorns is called Kantha-Saluka. The disease is due to the action of the deranged Kapha. It is amenable to surgical treatmen only. Adhijihva: A small swelling like the tip of the tongue caused by the deranged blood and Kapha over the root of the tongue is called Adhijihva, which should be given up as soon as suppuration sets in. Valaya A circular or ring-shaped raised swelling due to deranged Kapha obstructing or closing up the upper end of the oesophagus (structure of oesophagues) is called Valaya. It cannot be cured and hence should be given up.
Balasa: The disease in whcih the unusually aggravated Vayu and Kapha give rise to a swelling in the throat, which is extremely painful and causes a difficulty of respiration, ultimately producing symptoms of complete asphyxia is called Balasa by learned physicians and is very difficult to cure. 51-54
वृत्तोन्नतो यः श्वयथुः सदाहः कण्ड्वन्वितोपाक्यमृदुर्गुरुश्च । नाम्नैकवृन्दः परिकल्पितोऽसौ समुन्नतं वृत्तममन्ददाहं तञ्चापि पित्तक्षतजप्रकोपाद् विद्यात् सतोदं पवनात्मकन्तु ।। ५६ ॥ व्याधिर्बलासक्षतजप्रसूतः ।। ५५ ॥ तीव्रज्वरं वृन्दमुदाहरन्ति ।
Eka-vrnda and Vrnda’ : The disease in which a circular, raised, heavy and slightly soft swelling appears in the throat attended with itching, a slightly burning sensation and non suppurating is called Ekavrnda. The disease is due to the effect of vitiated blood and Kapha. The disease in which a round elevated swelling attended with high fever and a slightly burning sensation is formed in the throat through the aggravated condition of the blood and Pitta is called Vrnda. A piercing pain in the swelling points to its Vataja origin. 55-56
वतिर्घना कण्ठनिरोधिनी या चिताऽतिमात्रं पिशितप्ररोहैः । नानारुजोच्छ्रायकरी त्रिदोषाज् ज्ञेया शतघ्नीव शतध्न्यसाध्या ।। ५७ ।।
Sataghni: The disease in which, through the concerted action of the deranged Vayu, Pitta and Kapha, a hard throat obstructing Varti (jagged membrane) edged like a Sataghni¹ and densely beset with fleshy excrescences is formed along the inner lining of that pipe is denominated as Sataghni. Various kinds of pains, (characteristics of each of the deranged Vayu, Pitta and Kapha) are present in this type which should be necessarily considered as irremediable. 57 ग्रन्थिर्गले त्वामलकास्थिमात्रः स्थिरोऽल्परुक्स्यात् कफरक्तमूर्तिः ।
संलक्ष्यते सक्तमिवाशनञ्च स शस्त्रसाध्यस्तु गिलायुसंज्ञः ।। ५८ ।।
Gilayu : Thedisease in which the aggraavated Kapha and blood
1. The diseases of the throat are 17 in number. Taking Vrnda as a separate disease they amount to 18; but Vrnda, affecting similar place and being similar in appearance with but a slight distinction of symptoms, is only a particular state of Eka-vynda, and not a separate disease give rise to a hard and slightly painful glandular swelling in the throat to the size of the stone of the Amalaka fruit is called Gilayu. A sensation as if a morsel or bolus of food is stuck in the throat is experienced and which is curable by surgery only. 58
सर्वं गलं व्याप्य समुत्थितो यः शोफो रुजो यत्र च सन्ति सर्वा: । स सर्वदोषो गलविद्रधिस्तु तस्यैव तुल्यः खलु सर्वजस्य || ५९ ।।
शोफो महानन्नजलावरोधी तीव्रज्वरो वातगतेर्निहन्ता । कफेन जातो रुधिरान्वितेन गले गलौघः परिकीर्त्यतेऽसौ ।। ६० ।।
योतिप्रताम्यन् श्वसिति प्रसक्तं भिन्नस्वरः शुष्कविमुक्तकण्ठः । कफोपदिग्धेष्वनिलायनेषु ज्ञेयः स रोग: श्वसनात् स्वरघ्नः ।। ६१।। •
Gala-vidradhi : The disease in which an extensive swelling occurs along the whole inner lining of the throat, owing to the concerted action of the deranged Vayu, Pitta and Kapha is called Galavidradhi which exhibits all the features present in a Vidradhi of the Sannipatika type. Galaugha : The disease in which a large swelling occurs in the throat so as to completely obstruct the passae of any solid or liquid food and also that of Udana-vayu (choking the pharynx, larynx and the mouth of the esophagus), attended with a high fever is called Galaugha, the origin of which should be ascribed to the action of the deranged blood and Kapha. Svaraghna : The disease in which the patient faints owing to the choking of the larynx by the deranged Kapha which is marked by stertorous breathing, hoarseness, dryness and paralysed condition of the throat is called Svaraghna which has its origin in the deranged Vayu. 59-61
प्रतानवान् यः श्वयथुः सुकष्टो गलोपरोधं कुरुते क्रमेण । स मांसतानः कथितोऽवलम्बी प्राणप्रणुत् सर्वकृतो विकारः ।। ६२ ।।
Manstana: The disease in which a pendent, spreading and extremely painful swelling appears in the throat which gradually obstructs the pipe is called Mansatana. It invariably proves fatal and is caused by the deranged Vayu, Pitta and Kapha. 62
सरक्तमन्तर्गले पूतिविशीर्णमांसम् । पित्तेन विद्याद् वदने विदारीं पावें विशेषात् स तु येन शेते ।। ६३ ।।
सदाहतोदं श्वयथु
Vidari: The disease in which a copper-coloured swelling occurs in the throat, marked by a pricking and burning sensation, and the flesh of the throat gets putrefied and sloughs off (and emits a fetid smell) is called Vidari. The disease is of a Pittaja origin and is found to attack that side of the throat on which the patient is in the habit of lying. 63
वातपित्तकफशोणितनिमित्ताः ।। ६४ ।। सर्वसरास्तु
The disease in the entire cavity : Cases which are found to invade the entire cavity of the mouth (without being restricted to any particular part thereof) may be either due to Vata, Pitta, Kapha or Rakta and are known by the general name Sarva-Sara. 64
स्फोटैः सतोदैर्वदनं समन्ताद् यस्याचितं सर्वसरः स वातात् । रक्तैः सदाह्रैस्तनुभिः सपीतैर्यस्याचितं चापि स पित्तकोपात् ।। ६५ ।।
कण्डूयुतैरल्परुजैः सवर्णैर्यस्याचितञ्चापि स वै कफेन । रक्तेन पित्तोदित एक एव कैश्चित् प्रदिष्टो मुखापाकसंज्ञः ।। ६६ ।
In the Vataja type the cavity of the mouth is studded with vesicles attended with a pricking sensation in their inside. In the Pittaja type a large number of small yellow or red-coloured vesicles attended with a burning sensation crops up on the entire (mucous membrane lining the cavity of the mouth. In the Kaphaja variety a similar crop of slightly painful, itching vesicles of the same colour as the skin ( is found on the entire inner surface of the mouth). The bloodorigined Raktaja type is nothing but a modification of the Pittaja one ( giving rise to similar symptoms ) ; it is also called Mukha-paka by others. 65-66
इति सुश्रुतसंहितायां निदानस्थाने मुखरोगनिदानं नाम षोडशोऽध्यायः । । १६ ।।
Thus ends the sixteenth Chapter of the Nidana-Sthana in the Ssruta Samhita which treats of the Nidana of the diseases of the mouth.
निदानस्थानं समाप्तम् ॥ २॥
Here ends the Nidana Sthana.
