द्वाविंशोऽध्यायः अथातो नासागतरोगविज्ञानीयमध्यायं व्याख्यास्यामः, भगवान् धन्वन्तरिः ॥ १ ॥ यथोवाच
Now we shall discourse on the chapter which deals with the causes and symptoms of diseases of the nose (Nasa gata-roga Vijnaniya).1
Nomenclature and Classification of Diseases of Nose
अपीनसः पूतिनस्यं नासापाकस्तथैव च । तथा शोणितपित्तञ्च पूयशोणितमेव च ॥ २ ॥ क्षवथुभ्रंशथुर्दीप्तो परित्रवः । नासानाहः नासाशोषेण सहिता दशैकाश्चेरिता गदाः ॥ ३ ॥ चत्वार्यशसि चत्वारः शोफा: सप्तार्बुदानि च। प्रतिश्यायाश्च ये पञ्च वक्ष्यन्ते सचिकित्सिताः । एकत्रिंशन्मितास्ते तु नासारोगाः प्रकीर्तिताः ॥ ४ ॥
Nomenclature and Classification- Diseases which specifically found to affect the organ of smell may be classified Thirty-one different groups, viz.,— Apinasa, Puti-nasya, Nasa-Sonita-pitta, Puya-sonita, Ksavathu, Bhramsathu, Dipta, NasanahaPari-srava, Nasa-sosa, the four kinds of Arsas (polypoids), the kinds of swelling, the seven types of tumours and the five types Prati-syaya which will be described hereafter with the specific treatment each. Thus the diseases of the nose are said to be thirty-one in 2-4.
Symptoms of Apinasa and Puti nasya
आनह्यते यस्य विधूप्यते च प्रक्लिद्यते शुष्यति चापि नासा । न वेत्ति यो गन्धरसांश्च जन्तुर्जुष्टं व्यवस्येत् तमपीनसेन । तञ्चानिलश्लेष्मभवं विकारं ब्रूयात् प्रतिश्यायसमानलिङ्गम् ॥ ५ ॥ दोषैर्विदग्धैर्गलतालुमूले संवासितो यस्य समीरणस्तु । निरेति पूतिर्मुखनासिकाभ्यां तं पूतिनासं प्रवदन्ति रोगम् ॥ ६ ॥
Symptoms of Apinasa and Puti-nasya- Chokedness and burning sensation in the nostrils attended with dryness and deposit of filthy slimy mucus in their passages, thereby deadening the faculty of smell and taste for the time being, are the specific indications of Apinasa (obstructions in the nostrils) which are identical with the symptoms (of the same type) of Pratisyaya ( catarrh ). It is due to the concerted action of the deranged Vayu and Kapha. The disease in which the fetid breath is emitted through the mouth and the mostrils owing to the presence of the deranged Vayu mixed up with the other Dosas, (Pitta, Kapha and blood) in the throat and about the root of the palate is called Puti-nasya. 5-6.
Symptoms of Nasa paka, Rakta Pitta and Puya rakta
घ्राणाश्रितं पित्तमरूंषि कुर्याद् यस्मिन् विकारे बलवांश्च पाकः । नासिकापाकमिति व्यवस्येत् विक्लेदकोथावपि यत्र दृष्टौ ॥ ७॥ चतुर्विधं द्विप्रभवं द्विमार्गं वक्ष्यामि भूयः खलु रक्तपित्तम् ॥ ८ ॥ दोषैर्विदग्धैरथवाऽपि जन्तोर्ललाटदेशेऽभिहतस्य तैस्तु । नासा त्रवेत् पूयमसृग्विमिश्रं तत् पूयरक्तं प्रवदन्ति रोगम् ॥ ९॥
Symptoms of Nasa-paka, Rakta Pitta and Puya-rakta- A purulent inflammation and the presence of pimples (Arunsi) in the nostrils owing to the vitiated condition of the local Pitta attended with sliminess and foetid odour is called Nasapaka. The four kinds of RaktaPitta (haemorrhages) with the two different origins and two different courses will be dealt with again later on. The diseases in which bloody or blood-streaked pus is discharged through the nostrils either as the effect of a blow on the region of the fore-head or through the highly heated condition of the local blood, Pitta and Kapha is called Puyarakta (bloody pus). 7-9.
1. The four kinds are due to vitiated Vayu, Pitta, and Kapha as well as their concerted action. The two origins are (a) the spleen and the liver, or (b) the amasaya (stomach) and the Pakvasaya (intestines). The two courses are (a) the upper and the lower orifice, or (b) the mouth and the nostrils. ( 2 )
Symptoms of Ksavathu
घ्राणाश्रिते मर्मणि सम्प्रदुष्टे यस्यानिलो नासिकया निरेति । कफानुयातो बहुशः सशब्दस्तं रोगमाहुः क्षवथुं विधिज्ञाः ॥ १० ॥ तीक्ष्णोपयोगादतिजिघ्रतो वा भावान् कटूनर्कनिरीक्षणाद् वा । सूत्रादिभिर्वा तरुणास्थिमर्मण्युद्घाटिते यः क्षवथुर्निरेति ॥ ११ ॥
Symptoms of Ksavathu — The disease in which the Vayu charged with Kapha repeatedly gushes out of the enostrils accompanied by loud reports or sounds, owing to the fact of the nasa Marma being anywise affected, is called Ksavathu (sneezing).’ A trickling sensation in the gristle of the nose owing to the insertion of a thread, etc., into the nostrils, or to the action of any strong (Tiksna) articles of fare, or of any pungent, smell, or of looking to the sun causes sneezing. 10-11.
Symptoms of Bhramsathu and Dipta
प्रभ्रश्यते नासिकयैव यश्च सान्द्रो विदग्धो लवणः कफस्तु । प्राक् सञ्चितो मूर्धनि पित्ततप्तस्तं भ्रंशथुं व्याधिमुदाहरन्ति ॥ १२ ॥ घ्राणे भृशं दाहसमन्विते तु विनिःसरेद्धूम इवेह वायुः । नासा प्रदीप्तेव च यस्य जन्तोर्व्याधिन्तु तं दीप्तमुदाहरन्ति ॥ १३ ॥
Symptoms of Bhramsathu and Dipta – The disease in which the deranged undigested thickened and saline Kapha previously accumulated in the region of the head is dissolved or disintegrated and dislodged from its seat through the heat of Pitta and is expelled (sneezed off) through the nostrils is called Bhramsathu. The affection in which the Vayu in the shape of warm vapour-like breaths, comes out of the nostrils accompanied by an excessive burning sensation in the locality is called Dipta. 12-13.
Symptoms of Nasa-Pratinaha, Nasa parisrava and Nasaparisosa
कफावृतो वायुरुदानसंज्ञो यदा स्वमार्गे विगुणः स्थितः स्यात् । घ्राणं वृणोतीव तदा स रोगो नासाप्रतीनाह इति प्रदिष्टः ॥ १४॥ अजस्त्रमच्छं सलिलप्रकाशं यस्याविवर्णं स्त्रवतीह नासा । रात्रौ विशेषेण हि तं विकारं नासापरिस्त्रावमिति व्यवस्येत् ॥ १५ ॥ घ्राणाश्रिते श्लेष्मणि मारुतेन पित्तेन गाढं परिशोषिते च । समुच्छ्वसित्यूर्ध्वमधश्च कृच्छ्राद् यस्तस्य नासापरिशोष उक्तः ॥ १६ ॥
1. The sneezing is here said to be of two kinds (i) Dosaja and (ii) traumatic Here the former is Dosaja, while the latter is of traumatic origin.
Symptoms of Nasa-Pratinaha, Nasa-parisrava and Nasaparisosa – The condition under which the up-coursing Udana Vayu of the region of the head is deranged in its passage by a surcharge of Kapha, seems to stuff the passages of the nostrils, and is called Nasa Pratinaha. The disease in which there is constant, transparent, slightly discoloured water like secretion (of Kapha) through the nostrils, more particularly at night, called Nasa-Parisrava (Fluent coryza). Difficulty of respiration (inhaling and exhaling) caused by the drying up and consequent thickening of the Kapha (mucus) accumulating in the passages of the nostrils, through the action of the deranged Vayu and Pitta, is called Nasa Parisosa (parchedness of the nostrils). 14-16.
Local Arsas (polypoids) as well as local Sopha (four each)
दोषैस्त्रिभिस्तैः पृथगेकशश्च ब्रूयात् तथाऽर्शासि तथैव शोफान् ॥ १७ ॥
शालाक्यसिद्धान्तमवेक्ष्य वापि सर्वात्मकं सप्तममर्बुदन्तु ॥ १८ ॥
रोगः प्रतिश्याय इह प्रदिष्टः स वक्ष्यते पञ्चविधः पुरस्तात् ॥ १९ ॥
नासास्त्रोतोगता रोगास्त्रिंशदेकश्च कीर्तिताः । स्त्रोतः पथे यद् विपुलं कोशवच्चार्बु दं भवेत् ॥ २० ॥
शोफाश्च शोफविज्ञाना नासास्त्रोतोव्यवस्थिताः । निदानेऽशसि निर्दिष्टान्येवं तानि विभावयेत् ॥ २१ ॥
Local Arsas (polypoids) as well as local Sopha (four each) are due to the action of the three deranged Dosas of the locality jointly and separately. The different kinds of Arbuda (nasal tumour) as mentioned in the Salakya-Tantra, with the one of Sannipatika origin are seven in all. The five types of Pratisyaya (catarrh) mentioned here will be dealt with in chapter XXIV. Remarks made in the chapter on the causes and symptoms of swellings in general (Sopha-Vijnana), as well as those of Arsas (haemorrhoid growths) in the Nidana-sthana should be understood to apply to those diseases affecting the locality of the nose as well. 17-21.
इति सश्रुत-संहितायामुत्तरतन्त्रे नासागतरोगविज्ञानीयव्याख्यानाम द्वाविंशोऽध्यायः ॥ २२ ॥
Thus ends the twenty-second chapter in the Uttara-Tantra of the Susruta Samhita which deals with the causes and symptoms of the diseases of the nose.
