अथातो पाण्डुरोगशोफविसर्पनिदानं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ।
We shall now expound the chapter-Panduroga, sopha, visarpa nidanam-diagnosis of anaemia, dropsy and herpes; thus said Atreya and other great sages.
Panduroga nidana – samprapti – causes and pathogenesis of anaemia
पित्तप्रधानाः कुपिता यथोक्तैः कोपनैर्मला: । तत्रानिलेन बलिना क्षिप्तं पित्तं हृदि स्थितम् ॥ १ ॥
धमनीर्दश सम्प्राप्य व्याप्नुवत्सकलां तनुम् । श्लेष्मत्वग्रक्तमांसानि प्रदूष्यान्तरमाश्रितम् ॥ २ ॥
त्वड्मांसयोस्तत्कुरुते त्वचि वर्णान् पृथग्विधान् । पाण्डुहारिद्रहरितान् पाण्डुत्वं तेषु चाधिकम् ॥ ३ ॥ यतोऽतः पाण्डुरित्युक्तः स रोगः
Dosas among which pitta is predominant, get aggravated by indulgence in their respective causative factors; pitta that is present in the heart is forced into the ten dhamanis (arteries and veins, attached to the heart ) by the powerful anila (vata) and made to spread throughout the body; it (pitta) then vitiates the slesman (kapha), the skin, blood, and muscles, by residing within them and produce in the skin and muscles different kinds of colours such as pandu (yellowish-white), haridra (termuric, deep-yellow) and harita (green); pandu ( yellowish-white) being more (common) among these, the disease is called as Pandu roga itself. 1-4a.
Panduroga Rupa – clinical features of Anaemia
धातूनां स्याच्च शैथिल्यमोजसश्च तेन गौरवम् । गुणक्षयः ॥ ४॥
ततोऽल्परक्तमेदस्को निःसार: स्याच्छ्लथेन्द्रियः । मृद्यमानैरिवाङ्गैर्ना द्रवता हृदयेन च॥५॥
शूनाक्षिकूट: सदनः कोपनः ष्ठीवनोऽल्पवाक् । अन्नद्विट् शिशिरद्वेषी शीर्णरोमा हतानलः ॥ ६ ॥
सन्नसक्थो ज्वरी श्वासी कर्णक्ष्वेडी भ्रमी श्रमी । समस्तैर्मृत्तिकादनात् ॥ ७ ॥ स पञ्चधा पृथग्दोषैः
By this, the tissues, become heavy ( inactive) and loose, the properties of ojas become diminished, then the person becomes poor, in blood and fat (quantity and qualities) and of excellence health (of the tissues); the body becomes flabby and has a feeling of being squeezed, heart rate increases, swelling of the eye sockets (area surrounding the eyes), debility, anger, expectoration of sputum and diminution in speech appear; the person has hatredness towards food and cold things, falling of hairs, loss of digestive activity, weakness of the thighs, fever, dyspnoea, constant noise in the ears, dizziness and exertion.
It is of five kinds; from each dosa seperately, from all of them together and from eating of mud. 4b-7.
Purvarupa – premonitory symptoms
प्राग्रूपमस्य हृदयस्पन्दनं रूक्षता त्वचि । अरुचिः पीतमूत्रत्वं स्वेदाभावोऽल्पवह्निता ॥ ८ ॥
Its premonitory symptoms are throbbings of the heart (palpitation) dryness of the skin, loss of taste / appetite, yellow coloured urine, absence of sweating, poor digestive activity, weakness and exertion. 8.
Vataja panduroga
सादः श्रमो अनिलात्तत्र गात्ररुक्तोदकम्पनम् । कृष्णरूक्षारुणसिरानखविण्मूत्रनेत्रता शोफानाहास्यवैरस्यविशोषाः पार्श्वमूर्धरुक् । ॥९॥
In that caused by vata, there is bodyaches, piercing pain and tremors, blackish-red, lustreless discolouration of the veins, nails, faeces, urine and eyes; swelling, flatulence, bad taste in the mouth (astringment taste) dryness of the faeces 9-10a. and pain in the flanks and head.
Pittaja Pandu
पित्ताद्धरितपीताभसिरादित्वं तृद्स्वेदमूर्च्छाशीतेच्छा दौर्गन्ध्यं कटुवक्त्रता | वर्चोभेदोऽम्लको दाहः ज्वरस्तमः ॥ १० ॥
In that caused by pitta there is green and/or yellowish colour in the veins etc., fever, unconsciousness, thirst, perspiration fainting, desire for cold things, bad smell (of the body, mouth etc.) bitter taste, loose bowels, sourness ( acidity) and burning sensation. 10-11a.
Kaphaja Pandu
कफाच्छुक्लसिरादिता ॥ ११ ॥
तन्द्रा लवणवक्त्रत्वं रोमहर्षः स्वरक्षयः ।
कासश्च्छर्दिश्च
In that caused by kapha, there is white colour of the veins etc., stupor, salt taste in the mouth, horripilations, loss of voice, cough and vomitting. 11b-12a.
Sannipataja Pandu
निचयान्मिश्रलिङ्गोऽतिदुःसहः ॥ १२ ॥
In that caused by the combination of all the dosas, there is mixture of symptoms and the disease is difficult to bear.
Mrit bhaksanaja Pandu
मृत्कषायाऽनिलं पित्तमूषरा मधुरा कफम् । दूषयित्वा रसादींश्च रौक्ष्याद्भुक्तं विरूक्ष्य च ॥ १३ ॥
स्त्रोतांस्यपक्कैवापूर्य कुर्याद्रुद्धवा च पूर्ववत् । पाण्डुरोगं ततः शूननाभिपादास्यमेहनः ॥ १४ ॥ ॥
पुरीषं कृमिमन्मुञ्चेद्भिन्नं सासृक्कफं नरः ।
In persons who eat mud (habitually for a long time) astringent mud aggravates vata, alkalline mud aggravates pitta and sweet mud aggravates kapha, it (mud) vitiates rasa and other tissues by its dryness and produces dryness in the channels (of the tissues) and without undergoing digestion it fills and blocks them and produces panduroga as before. The person develops swelling of the umbilicus, feet, face and genitals, expels faeces containing warms, broken (not well formed) mixed with blood and kapha (mucus). 13-15a.
Kamala roga – jaundice
॥ १६॥ यः पाण्डुरोगी सेवेत पित्तलं तस्य कामलाम् ॥ १५ ॥
कोष्ठशाखाश्रयां पित्तं दग्ध्वाऽसृड्मांसमावहेत् । हारिद्रनेत्रमूत्रत्वडूनखवकाशकृत्तया दाहाविपाकतृष्णावान् भेकाभो दुर्बलेन्द्रियः । भवेत्पित्तोल्वणस्यासौ पाण्डुरोगादृतेऽपि च ॥ १७ ॥
उपेक्षया च शोफाढ्या सा कृच्छ्रा कुम्भकामला। हरितश्यावपीतत्वं पाण्डुरोगे यदा भवेत् ॥ १८ ॥
वातपित्ताद्भ्रमस्तृष्णा स्त्रीष्वहर्षो मृदुर्ज्वरः । तन्द्राबलानलभ्रंशो लोढरं तं हलीमकम् ॥ १९ ॥ अलसं चेति शंसन्ति
That patient of pandu roga (anaemia) who indulges in things which cause increae of pitta, the pitta gets increased, burns up the blood and muscles and produces Kamala roga, localised in the alimentary tract and the tissues, by producing deep yellow colouration of the eyes, urine, skin, nails, mouth and faeces; feeling of burning sensation, indigestion, thirst, resembling a frog (greenish brown in the colour of the skin) and weakness of the sense organs.
It (kamala) happens even without panduroga (anaemia) in person who have aggravation of pitta; neglecting it, leads to Kumbha kamala having profound swelling which is difficult to cure. When in a patient of panduroga (anaemia) green, bluish-yellow discolouration appears along with dizziness, thirst, lack of desire in women (sex), mild fever, stupor, weakness of the body and of digestion due to increase of vata and pitta-then the disease is named as Lodhara or Halimaka or Alasa. 15b-20a.
इति पाण्डुरोगनिदानम् ।
Thus ends the diagnosis of pandu roga (anaemia).
Sopha nidana – diagnosis of swelling/oedama/dropsy/ anasarea
तेषां पूर्वमुपद्रवाः । शोफप्रधानाः कथिताः स एवातो निगद्यते ॥ २० ॥
Since sopha (swelling, oedema, dropsy) was enumerated as the chief complication/secondary diseases of them (different kinds of panduroga ) hence it is described herein. 20b.
Sopha samprapti – pathogenesis of oedema
अथ शोफनिदानम् । पित्तरक्तकफान्वायुर्दुष्टो दुष्टान् बहिः सिराः । नीत्वा रुद्धगतिस्तैर्हि कुर्यात्त्वङ्मांससंश्रयम् ॥ २१ ॥ उत्सेधं संहतं शोकं तमाहुर्निचयादतः । सर्वं
Vayu (vata) getting vitiated (increased) brings the viti ated pitta rakta (blood) and kapha, into the external channels and getting obstructed by them, produces swelling localised in the skin and muscles called utsedha, samhata and sopha. 21-22a.
Notes : The term ‘Sopha’ in this chapter stands for non-inflamatory swelling known as dropsy or anasarca.
हेतुविशेषैस्तु रूपमेदान्नवात्मकम् ॥ २२ ॥ दोषैः पृथग्द्वयैः सर्वैरभिघाताद्विषादपि ।
Based on different causes and symptoms, it is of nine kinds-from each dosa seperately, from the combination of two dosas, from the combination of all of them, from trauma/injury and from poison. 22b-23a.
द्विधा वा निजमागन्तुं सर्वाङ्गैकाङ्गजं च तम् ॥ २३ ॥ पृथून्नतग्रथितताविशेषैश्च त्रिधा विदुः ।
Again, it is of two kinds; nija (organic) and agantu (traumatic); sarvanga (of all the parts of the body) and ekanga (of any one part); it is known to be of three kinds viz-prthu (hard and wide), unnata (raised/elevated) and grathita (knotted/glandular). 23b-24a.
Sopha nidana – causes of swelling
सामान्यहेतुः शोफानां दोषजानां विशेषतः ॥ २४ ॥
व्याधिकर्मोपवासादिक्षीणस्य भजतो द्रुतम् । गुर्वम्लस्निग्धशीतलम् ॥ २५ ॥
अतिमात्रमथान्यस्य लवणक्षारतीक्ष्णोष्णशाकाम्बु स्वप्नजागरम् ।
मृद्ग्राम्यमांसवल्लूरमजीर्णश्रममैथुनम् पदातेर्मार्गगमनं यानेन क्षोभिणाऽपि वा।
श्वासकासातिसारार्शोजठरप्रदरज्वराः विषूच्यलसकच्छर्दिगर्भवीसर्पपाण्डवः अन्ये च मिथ्योपक्रान्तास्तैर्दोषा वक्षसि स्थिताः ॥ २८ ॥
ऊर्ध्वं शोफमधो बस्तौ मध्ये कुर्वन्ति मध्यगाः । ॥ २६ ॥ ॥२७॥
सर्वाङ्गाः सर्वगतं प्रत्यङ्गेषु प्रत्यङ्गेषु तदाश्रयाः ॥ २९ ॥
General causes of sopha (swelling ) are those which increase the dosas; some other special causes are; persons who are debilitated by diseases, therapies, fasting etc. suddenly indulging in large quantity of food and improper way; foods which are heavy ( not easily digestable ) , unctuous (fatty), cold, salty, alkaline, penetrating, heat producing and leafy vegetables; drinking more water, excess of spleeping or of keeping awake, eating mud, meat of domestic animals, dry meat and uncooked things; exertion and copulation, walking long distance with army colomn; or streneous riding on animals or vehicles; effect of diseases such as dyspnoea, cough, diarrhoea, piles, enlargement of the abdomen, menorrhgia, fever, visuci (simultaneously diarrhoea and vomitting due to severe indigestion), alasa (long stasis of undigested food in the stomach), vomitting, pregnancy, visarpa (herpes), pandu (anaemia) and such others which are improperly treated.
Dosas localised in the chest produce swelling in the upper parts of the body; localised in the region of the urinary bladder, produce swelling in the lower parts; localised in the middle parts produce swelling in the middle parts; localised all over the body they produce swelling of the whole body and localised in any one part they cause swelling of that part only.
Purvarupa – premonitory symptoms of swelling
तत्पूर्वरूपं दवथुः सिरायामोऽङ्गगौरवम् ।
Its premonitory symptoms are-feeling of burning sensation in the eyes etc., dilatation of the veins (at the site of swelling) and feeling of heavyness (of the body or part of it).
Rupa-clinical features
Vataja sopha
वाताच्छोफश्चलो रूक्षः खररोमाऽरुणासितः ॥ ३० ॥
सङ्कोचस्पन्दहर्षार्तितोदभेदप्रसुप्तिमान् । शीघ्रमुन्नमेत्पीडितस्तनुः ॥ ३१ ॥
क्षिप्रोत्थानशमः स्निग्धोष्णमर्दनैः शाम्येद्रात्रावल्पो दिवा महान् । त्वक् च सर्षपलिप्तेव तस्मिश्चिमिचिमायते ॥ ३२ ॥
In that caused by vata the swelling in moveable, dry, with rough hair, crimson or black in colour, associated with pains such as constricting, pulsating, tingling, pricking, puncturing, and cutting or having no sensation at all; swelling increasing and subsidding quickly, soon spreads to other parts elevating them (by swelling); subsides by massage with fatty and hot materials; is mild at nights and severe during day; there is mild tingling (burning sensation) as though the skin is coated with paste of sarsapa (mustard seed). 30b-32.
Pittaja sotha
पीतरक्तासिताभासः पित्तादाताम्ररोमकृत्। शीघ्रानुसारप्रशमो मध्ये प्राग्जायते तनुः ॥ ३३ ॥
सतृड्दाहज्वरस्वेददवक्लेदमदभ्रमः शीताभिलाषी विड्भेदी गन्धी स्पर्शासहो मृदुः ॥ ३४ ॥
In that caused by pitta, the swelling is yellow reddish white in colour, with copper red hair swelling increasing and subsidding quickly, appears first in the middle parts of the body; is accompanied with thirst, burning sensation, fever, perspiration, toxicity, and dizziness, the person desires cold things, has diarrhoea, the swelling is foul smelling, intolerant to touch and soft. 33-34.
Kaphaja sotha
कण्डूमान् पाण्डुरोमत्वक्कठिन: शीतलो गुरुः । स्निग्धः श्लक्ष्णः स्थिरः स्त्यानो निद्राच्छर्द्यग्निसादकृत् ॥ ३५ ॥
आक्रान्तो नोन्नमेत्कृच्छ्रशमजन्मा निशाबलः । स्त्रवेन्नासृक् चिरात्पिच्छां कुशशस्त्रादिविक्षतः ॥ ३६ ॥ स्पर्शोष्णकाङ्क्षी च कफात्
In that caused by kapha, the swelling has itching, yellowish white hair and skin; is hard, cold, heavy, unctuous, smooth, static and thick, accompanied with more of sleep, vomitting, causes weakness of digestion; the pit formed when pressed does not get filled up, appears and disappears with grass or knife, it ( swelling ) does not bleed but exudes slimy fluid after a long time, desires touching and warmth. 35-37a.
यथास्वं द्वन्द्वजास्त्रयः ।
सङ्कराद्धेतुलिङ्गानाम् निश्चयान्निचयात्मकः ॥ ३७॥
Similarly, the three caused by two dosas and that by all the dosas will have their respective symptoms appearing simultaneously. 37b.
Abhighataja sotha – traumatic oedema
अभिघातेन शस्त्रादिच्छेदभेदक्षतादिभिः । हिमानिलोदध्यनिलर्भल्लातकपिकच्छुजैः ॥ ३८ ॥ रसैः शूकैश्च संस्पर्शाच्छ्यथ: स्याद्विसर्पवान् । भृशोष्मा लोहिताभासः प्रायशः पित्तलक्षणः ॥ ३९ ॥
Abhighataja (traumatic ) is that caused by cutting, splitting, hitting etc. by sharp and other kinds of weapons; by snow, cold breeze, sea breeze, touch by the juice of bhallataka (marking nut) hairs of kapikacchu and sharp spikes (of grains etc.). Swelling spreads from place to place, is very hot to touch, resembles blood in colour and usually having symptoms of pitta. 38-39.
Vishaja – oedema due to poisons
विषजः सविषप्राणिपरिसर्पणमूत्रणात् । दंष्ट्रादन्तनखापातादविषप्राणिनामपि विण्मूत्रशुक्रोपहतमलवद्वत्रसङ्करात् विषवृक्षानिलस्पर्शाद्गरयोगावचूर्णनात् मृदुश्चलोऽवलम्बी च शीघ्रो दाहरुजाकरः । ॥ ४० ॥ । ॥ ४१ ॥
Visaja (caused by poison) is that produced by crawling or urinating over the body, injuring by tusks, teeth or claws by poisonous animals or even by the contact of excerta, urine or semen; or of cloth contaminated by these of even non poisonous animals; touch of poisonous trees, wind ( gas, smoke, fumes of poisonous nature) and rubbing of artificial poisions etc. Such a swelling is soft, movable, drooping down, quick to manifest and causing burning sensation and pain.
Sadhyasadhyata – prognosis of swelling
नवोऽनुपद्रवः शोफः साध्योऽसाध्यः पुरेरितः ॥ ४२ ॥ इति शोफनिदानम् ।
Swelling which is of recent onset and not having complications/secondary diseases; is curable; those described previ ously (in chapter 5 of sarirasthana) are incurable. 42b.
Thus ends the diagnosis of oedema/dropsy.
अथ विसर्पनिदानम् ।
Visarpa nidana – diagnosis of herpes zoster
स्याद्विसर्पोऽभिघातान्तैर्दोषैर्दूष्यैश्च शोफवत् ।
Visarpa is similar in respect of dosas, dusyas and kinds with sopha, till that kind ending with the traumatic. 43a.
Notes : Like sopha (oedema ) visarpa is caused by each dosa seperately, by the combination of any two, by the combination of all three, and by trauma (injury ) ; the pathogenesis of both are also the same.
Adhisthana – place of manifestation
त्र्यधिष्ठानं च तं प्राहुर्बाह्यान्तरुभयाश्रयात् ॥ ४३ ॥ यथोत्तरं च दुःसाध्याः
Its place of manifestation is said to be three-external, internal and both; these are difficult to cure in their succeding order. 43b-44a.
Samprapti – pathogenesis of herpes
तत्र दोषा यथायथम्। प्रकोपणैः प्रकुपिता विशेषेण विदाहिभिः ॥ ४४ ॥
देहे शीघ्रं विसर्पन्ति तेऽन्तरन्तः स्थिता बहिः । बहिःस्था द्वितये द्विस्था:
The dosas getting aggravated by their respective causes, especially so, by foods which cause burning sensation, spread quickly to all the internal parts; those localised out spread to all the external parts, and those localised in both to all the parts, both internal and external. 44b-45a.
Nidana – causes of visarpa
मर्मोपतापात्सम्मोहादयनानां
विद्यात्तत्रान्तराश्रयम् ॥ ४५ ॥ विघट्टनात् ।
तृष्णातियोगाद्वेगानां विषमं च प्रवर्तनात् ॥ ४६॥ आशु चाग्निबलभ्रंशादतो बाह्यं विपर्ययात् ।
The internal kind is to be understood as arising from diseases of vital organs ( such as heart, head, urinary bladder etc.), loss of consciousness, severe injury to the sense organs, profound thirst, improper way of initating the urges of the body and sudden loss of digestive capacity and the strength of the body; the external kind arises from causes opposite of the above. 45b-47a.
Rupa – clinical features
तत्र वातात्परीसर्पो शोफस्फुरणनिस्तोदभेदायामार्तिहर्षवान् वातज्वरसमव्यथः ॥ ४७ ॥
पित्ताद् द्रुतगतिः पित्तज्वरलिङ्गोऽतिलोहितः ॥ ४८ ॥
कफात्कण्डूयुतः स्निग्धः कफज्वरसमानरुक् । स्वदोषलिङ्गैश्चीयन्ते सर्वे स्फोटैरुपेक्षिताः ॥ ४९ ॥
ते पक्वभिन्नाः स्वं स्वं च विभ्रति व्रणलक्षणम्।
In that caused by vata, the symptoms are similar to those of vatajvara (vide chapter 2 verses 10-17) in addition there is swelling; throbbing, intermittant, piercing, dilating, cutting and tingling types of pain. In that caused by pitta, the spreading is quick, has symptoms similar to those of pitta jvara (verses 18-20 of chapter 2 ) and swelling is very red. In that caused by kapha, it is itching, unctuous (greasy) and has symptoms similar to those of kaphajvara ( verses 21-22 of chapter 2).
When neglected, each kind develops eruptions (blebs, vesicles) having symptoms of the respective dosa. These eruptions burst after ripening (suppuration) leading to ulcers having their own respective symptoms. 47b-50a.
Agni visarpa
वातपित्ताज्ज्वरच्छर्दिमूर्च्छातीसारतृड्भ्रमैः अस्थिभेदाग्निसदनतमकारोचकैर्युतः करोति सर्वमङ्गं च दीप्ताङ्गारावकीर्णवत् ॥ ५१ ॥
यं यं देशं विसर्पश्च विसर्पति भवेत्स सः । शान्ताङ्गारासितो नीलो रक्तो वाऽऽशु च चीयते ॥ ५२ ॥
अग्निदग्ध इव स्फोटैः शीघ्रत्वाद् द्रुतं च सः । मर्मानुसारी वीसर्पः स्याद्वातोऽतबलस्तितः ॥ ५३ ।।
व्यथेताङ्गं हरेत्संज्ञां निद्रां च श्वासमीरयेत् । हिमां च स गतोऽस्थामीद्दशीं लभते न ना ॥ ५४॥
क्वचिच्छर्मारतिग्रस्तो भूमिशय्यासनादिषु । ॥ ५० ॥
चेष्टमानस्ततः क्लिष्टो मनोदेहश्रमोद्भवाम् ॥ ५५ ॥
दुष्प्रबोधोऽश्नुते निद्रां सोऽग्निवीसर्प उच्यते ।
Visarpa arising from the combination of vata and pitta, is accompanied with fever, vomitting, fainting, diarrhoea, thirst, dizziness, splitting pain in the bones, weak digestion, blindness, and loss of taste / appetite; makes the body as though filled with burning coal; all the parts to which it spreads become black like coal which has been extinguished; blue or red in colour; eruptions ( belbs) develop in those parts resembling as though burnt by fire and spread quickly since vata is very powerful, this visarpa invades vital organs, causes severe pain in those parts, leads to loss of consciouness and sleep, produces dyspnoea and hiccup; having reached this stage the person does not find even little comfort by lying on the ground or on the cot or by sitting; makes difficult movements constantly arising from the exertion of the mind and body; attains sleep from which he can be aroused with great difficulty ( similar to death). This disease is known as Agni visarpa. 50b-56a.
Granthi visarpa
कफेन रुद्धः पवनो भित्वा तं बहुधा कफम् ॥ ५६ ॥
रक्तं वा वृद्धरक्तस्य त्वक्सिरास्त्रायुमांसगम् । दूषयित्वा च दीर्घाणुवृत्तस्थूलखरात्मनाम् ॥ ५७ ॥
ग्रन्थीनां कुरुते मालां रक्तानां तीव्ररुग्ज्वराम् |
कफपित्ताज्वरः स्तम्भो निद्रातन्द्राशिरोरुजः । अङ्गावसादविक्षेपप्रलापारोचकभ्रमाः ॥६०॥
मूर्च्छाग्निहानिर्भेदोऽस्थनां पिपासेन्द्रियगौरवम् । आमोपवेशनं लेपः स्त्रोतसां स च सर्पति ॥ ६१ ॥
प्रायेणामाशये गृह्णन्नेकदेशं न न चातिरुक् । पिटकैरवकीर्णोऽतिपीतलोहितपाण्डुरैः मेचकाभोऽसितः स्निग्धो मलिनः शोफवान् गुरुः ।
गम्भीरपाकः प्राज्योष्मा स्पृष्टः क्लिन्नोऽवदीर्यते ॥ ६३ ॥
पङ्कवच्छीर्णमांसश्च स्पष्टस्नायुसिरागणः । ॥६२॥
शवगन्धिश्च वीसर्पं कर्दमाख्यमुशन्ति तम्॥६४॥
Caused by the aggravation of kapha and pitta, accompanied with fever, stiffness of the body, sleep, stupor, headache, debility of the body, tremors, irrelevent speech, loss of appetite or taste; dizziness, fainting, loss of digestive capacity, splitting pain in the bones, severe thirst, feeling of heavyness of the motor organs, elimination of feaces containing ama (mucus etc.), coating of the channels (of rasa-plasma ) by ama (undigested food metobolites). It generally starts at the site of amasaya ( stomach) and then spreads to other parts, it is studded with eruptions which are not very painful, its colour varies from deep yellow, red, yellowish white, resem
श्वासकासातिसारास्यशोषहिध्मावमिभ्रमैः मोहवैवर्ण्यमूर्च्छाङ्गभङ्गाग्निसदनैर्युताम् ॥ ५८ ॥
इत्ययं ग्रन्थिवीसर्पः कफमारुतकोपजः ॥ ५९॥
Pavana (vata) getting obstructed by kapha, breaks it into many parts, or vitiating the blood present in the skin, veins, tendons and muscles in persons who have aggravation of blood, produces a chain of tumors of blood, which are either long, small, round, thick or rough; associated with severe pain, fever, dyspnoea, cough, diarrhoea, dryness of the mouth, hiccup, vomitting, dizziness, delusion, discolouration, fainting, cutting pain in the body and weak digestion; this disease is Granthi visarpa caused by aggravation of kapha and vata. 56b-59.
Kardama visarpa
bling that of peacocks feather (deep blue) or black; it is greasy, dirty, swollen and heavy; undergoes ulceration from deep inside; with increased heat the muscles of the affected part becoming very moist, fall of like slush when touched, exposing the bundles of tendons and veins and emitting cadaveric smell (these being the signs of gangrene); this is called as Kardama visarpa. 60-64.
Sannipataja
सर्वजो लक्षणैः सर्वैः सर्वधात्वतिसर्पणः ।
That caused by all the dosas presents with symptoms of all the dosas simultaneously and spreads greatly to all the tissues. 65a.
Ksataja
बाह्यहेतोः क्षतात्क्रुद्धः सरक्तं पित्तमीरयन् ॥ ६५ ॥
विसर्प मारुतः कुर्यात् कुलत्थसदृशैश्चितम् । स्फोटै: शोफज्वररुजादाहाढ्यं श्यावलोहितम् ॥ ६६ ॥
Maruta (vata) aggravated by trauma due to external causes aggravated blood and pitta and produces visarpa, studed with boils (belbs) resembling kulattha (horse gram), associated with severe swelling, fever, pain and burning sensation, its colour being blackish-red. 65b-66.
Sadhyasadhyata – prognosis of herpes
पृथग्दोषैस्त्रयः साध्या द्वन्द्वजाश्चानुपद्रवाः 1 असाध्यौ क्षतसर्वोत्थौ सर्वे चाक्रान्तमर्मकाः ॥ ६७ ॥ इति विसर्पनिदानम् ।
Those caused by each dosa seperately and those by any two dosas but not having any complications are curable. Those caused by trauma, or by all the dosas, those which are invading vital organs/spots, which have caused loss of tendons, veins and muscles, which are highly moist and emitting cadaveric smell are incurable. 67-67/2.
Notes: As can be gathered from the above descriptions, Visarpa is an infectious disease which spreads from place to place quickly, involving the blood, skin, muscles and tendons, having painful eruptions on the skin, lead on to suppurating tumors, gangrence and mutilation of the body. It has been identified with several diseases like eryseplas, cellulits, herpes zooster, gangrene, eczema, some kinds of dermatitts, cancer of the skin, plague etc. by modern scholars.
इति श्री वैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां तृतीये निदानस्थाने पाण्डुरोगशोफविसर्पनिदानं नाम त्रयोदशोऽध्यायः ॥ १३ ॥
Thus ends the chapter Panduroga-sopha-visarpa nidana the thirteenth in of Astangahrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
