अथातः सन्धिसितासितरोगविज्ञानीयं व्याख्यास्यामः । स्माहुरात्रेयादयो महर्षयः । इति ह
We shall now expound the chapter Sandhi-sita-asita roga vijnaniya-knowledge of diseases of the fornices, sclera and cornea; thus said Atreya and other great sages.
Sandhigata roga – diseases of the fornices
Jalasrava
वायुः क्रुद्धः सिराः प्राय्य जलाभं जलवाहिनीः । अश्रु स्त्रावयते वर्त्मशुक्लसन्धेः तेन नेत्रं सरुग्रागशोफं स्यात्स कनीनकात् जलास्त्रवः ।
Vayu (vata) undergoing increase, getting localised in the channels of water (tears) causes excess flow of tears from the joints of the lids and the white portion ( sclera), through the kaninaka ( inner canthus ). By this the eye develops pain; redness, and swelling. This diseases is called jalasrava. 1-2a.
Kaphasrava
कफात् कफात्रवे श्वेतं पिच्छिलं बहलं स्रवेत् ॥ २ ॥
From (increase of) kapha arises Kapasrava, the exuding fluid will be white, slimy and thick. 2b.
Upanaha
कफेन शोफस्तीक्ष्णाग्रः क्षारबुद्बुदकोपमः । पृथुमूलबलः स्निग्धः सवर्गो मृदुपिच्छिलः ॥ ३ ॥ महानपाकः कण्डूमानुपनाहः स नीरुजः।
From kapha, arises a big swelling with a pointed tip, resembling the bubbles of ksara ( alkali) with thick base, strong, smooth, of the same colour ( as of the base) soft and slimy, big in size non-suppurating and having itching but no pain. This is Upanaha. 3-4a.
Raktasrava
रक्ताद् रक्तात्रवे ताम्रं बहूष्णं चाश्रु संस्त्रवेत् ॥ ४ ॥
From the blood arises Raktasrava, in which the exudation is coppery red, copious, with warm tears. 4b.
Parvani
वर्त्मसन्ध्याश्रया शुक्ले पिटिका दाहशूलिनी । ताम्रा मुद्गोपमा भिन्ना रक्तं स्त्रवति पर्वणी ॥ ५ ॥
Pitaka (eruptions) appearing in the joints between the eyelid and sclera having burning sensation and pain, coppery red, of the size of a green gram exuding blood when brust; this diseases is known as parvani. 5.
Puyasrava
पूयास्त्रावे मलाः सात्रा वर्त्मसन्धेः कनीनकात् । स्त्रावयन्ति मुहुः पूयं सास्त्रं त्वङ्मांसपाकतः ॥ ६ ॥
In puyasrava, the malas (dosas) associated with blood, discharge pus mixed with blood, often from the joints of the lids through the inner canthus, as a result of suppuration/ ulceration of the skin and muscles. 6.
Puyalasa
पूयालसो व्रणः सूक्ष्मः शोफसंरम्भपूर्वकः । कनीनसन्धावाघ्मायी पूयास्त्रावी सवेदनः ॥७॥
Puyalasa is small ulcer, preceded with swelling and samrambha (pain, redness, etc.) causing swelling of the inner canthus, discharge of pus and pain. 7.
Alaji
कनीनस्यान्तरलजी शोफो रुक्तोददाहवान् ।
Alaji is a swelling inside the inner canthus, having pain, pricking and burning sensation.
Krmi granthi
अपाङ्गे वा कनीने वा कण्डूषापक्ष्मपोटवान् ॥ ८ ॥ पूयास्त्रावी कृमिग्रन्थिर्ग्रन्थिः कृमियुतोऽर्तिमान् ।
A tumour developing either at the outer canthus or inner canthus, accompanied with itching, local burning sensation, falling of eyelashes, discharge of pus, having worms (bacteria, etc. ) inside and painful. This diseases is called as Krmigranthi. 8b-9a.
उपनाहकृमिग्रन्थिपूयालसकपर्वणीः
शस्त्रेण साधयेत्पञ्च सालजीनास्त्रवांस्त्यजेत् ।
Upanaha, krmigranthi, puyalasaka, parvani and alaji— these five are to be treated surgicalfy, the (four) asrava should be refused treatment. 9b-10a.
Sita/suklagata roga – diseases of the sclera
पित्तं कुर्यात्सिते बिन्दूनसितश्यावपीतकान् ॥ १०॥
मलाक्तदर्शतुल्यं वा सर्वं शुक्लं सदाहरुक् । रोगोऽयं शुक्तिकासंज्ञः सशकृद्भेदतृड्ज्वरः ॥ ११॥
Pitta increased produces in the sclera, small dots ( spots) of black blue or yellow colour; the entier sclera appearing like a mirror covered by dirt and has burning sensation and pain. This disease known as Suktika, is accompanied with diarrhoea, thirst and fever. 10b-11.
Suklarma
कफाच्छुक्ले समं श्वेतं चिरवृद्ध्यधिमांसकम् । शुक्लार्म
From kapha, there develops on the sclera, an extra growth of muscle which is even, white and growing very slow, this is Suklarma. 12a.
Balasa grathita
॥९॥ शोफस्त्वरुजः सवर्णो बहलोऽमृदुः ॥ १२ ॥
गुरुः स्निग्धोऽम्बुबिन्द्वाभो बलासग्रथितं स्मृतम् ।
A swelling which is painless, of the same colour (of the sclera) thick, not soft, heavy, greasy, resembling a water buble—is known as Balasa grathita. 12b-13a.
Pistaka
बिन्दुभिः पिष्टधवलैरुत्सन्नैः पिष्टकं बदेत् ॥ १३ ॥ Presence of pasty white, raised dots on the sclera is called as Pistaka. 13b.
Sirotpata
रक्तराजीततं शुक्लमुष्यते यत्सवेदनम् । अशोफाश्रूपदेहं च सिरोत्पातः स शोणितात् ॥ १४ ॥
The sclera is full of red lines, has burning sensation, pain with slight or no swelling, tears and thickening. This disease is Sirotpata and is caused by blood (vitiated). 14.
Siraharsa
उपेक्षितः सिरोत्पातो राजीस्ता एव वर्धयन् । कुर्यात्सास्त्रं सिराहर्षं तेनाक्ष्युद्वीक्षणाक्षमम् ॥ १५ ॥
Sirotpata when neglected leads on to Siraharsa with increase of red line and discharge of blood (from them); by that the eye becomes unable to see. 15.
Sirajala
सिराजाले सिराजालं बृहद्रक्तं घनोन्नतम् ।
Sirajala is appearance of a hard and elevated net work of veins exuding blood. 16a.
Sonitarma
शोणितार्म समं श्लक्ष्णं पद्माभमधिमांसकम् ॥ १६ ॥ Sonitarma is an extra growth of muscle which is even, smooth and resembling a lotus flower (in colour). 16b.
Arjuna
नीरुक्श्लक्ष्णोऽर्जुनं बिन्दुः शशलोहितलोहितः ।
Arjuna is a dot which is painless, smooth and of the colour of the blood of the rabbit. 17a.
Prastaryarma
मृद्वाशुवृद्ध्यरुड्मांसं प्रस्तारि श्यावलोहितम् ॥ १७ ॥ प्रस्तार्यर्म मलैः सास्त्रैः
A soft, quick developing, painless, growth of muscle spread sidewards, bluish-red in colour is known as Prastharyarma. and is caused by all the dosas together with blood.
Snavarma
स्नावार्म स्त्रावसन्निभम् ।
Snavarma resembles a tendon.
Adhimamsarma
शुष्कासृपिण्डवच्छ्यावं यन्मांसं बहलं पृथु ॥ १८ ॥ अधिमांसा तद्
The muscle ( of the sclera ) becoming thick and hard, blue in colour like the clump of dried blood-this is known as Adhimasarma. 18b-19a.
Siraja pitika
दाहघर्षवत्यः सिरावृताः ।
कृष्णासन्नाः सिरासंज्ञाः पिटिकाः सर्षपोपमाः ॥ १९ ॥
Eruptions resembling mustard, sorrounded by veins, having burning sensation and causing friction appearing near the cornea is known as Siraja pitaka. 19b.
शुक्तिर्षसिरोत्पातपिष्टकग्रथितार्जुनम् साधयेदौषधैः षटं शेषं शस्त्रेण सप्तकम् ॥ २० ॥
नवोत्थं तदपि द्रव्यैः अर्मोक्तं यच्च पञ्चधा ।
तच्छेद्यमसितप्राप्तं चर्मोद्दालवदुच्छ्रायि दृष्टिप्राप्तं च वर्जयेत् ।
Suktika, harsa ( siraharsa ), sirotpata, pistaka, balasagrathita and arjuna-theses six should be treated with medicines; the remaining seven by surgery; among these, those which are of recent origin may be treated with drugs, the five kinds of arma should be excised but not those which have reached the cornea, which are surrounded by muscles, tendons and veins, which are bulging out like a leather bottle and which have reached the dristi (vision- pupil and hindering it) should be rejected. 20-22a.
मांसस्नावसिरावृतम् ॥ २१ ॥
Asita /krsnagata roga ( diseases of the cornea)
Ksata sukra
पित्तं कृष्णेऽथवा दृष्टौ शुक्रं तोदाश्रुरागवत् ॥ २२ ॥
छित्त्वा त्वचं जनयति तेन स्यात्कृष्णमण्डलम् । पक्वजम्बूनिभं किञ्चिन्निम्नं च क्षतशुक्रकम् ॥ २३ ॥
तत्कृच्छ्रसाध्यं, याप्यं तु द्वितीयपटलव्यधात् । तत्र तोदादिबाहुल्यं सूचीविद्धाभकृष्णता ॥ २४ ॥ तृतीयपटलच्छेदादसाध्यं निचितं व्रणैः ।
Pitta invading the krsna ( cornea ) or the drsti ( pupil ) produces a tear by breaking the skin (conjunctive), by this the cornea appears like a ripe jambu fruit (bluish black) in colour and slightly depressed, this is difficult to cure; when it breaks the second layer, it causes great increase of pain etc. resembles the black hole made by the needle and the disease becomes controllable but persisting for a long time; when the third layer is broken it given rise to many wounds/ ulcers and becomes incurable. 22b-25a.
Suddha sukra
शङ्खशुक्लं कफात्साध्यं नातिरुक् शुद्धशुक्रकम् ॥ २५ ॥
From kapha is produced Suddha sukra, in which the cornea has white colour like that of a conch shell and without much pain; this is curable. 25b.
Ajaka
आताम्रपिच्छिलास्त्रस्त्रदाताम्रपिटिकाऽतिरुक् अजाविट्सदृशोच्छ्रायकार्ष्या वर्ज्याऽसृजाऽजका ॥ २६ ॥
Pitaka (eruptions) which are coppery red in colour, slimy, exuding blood which is coppery red, very painful, resembling the excreta of the goat in size and black colour. This disease-Ajaka-caused by (vitiated) blood is to be rejected. 26.
Sirasukra
सिराशुक्रं मलैः सास्त्रैस्तज्जुष्टं कृष्णमण्डलम् । सतोददाहताम्राभिः सिराभिरवतन्यते ॥ २७ ॥
अनिमित्तोष्णशीताच्छघनास्रस्रुच्च तत्त्यजेत् ।
Sirasukra is caused by all the mala (dosa) associated with blood; vitiated by these, the cornea becomes filled with veins, which produce pricking pain, burning sensation and coppery colour; blood which is sometime hot and sometime cold, clear and thick exudes out without any cause. This should be rejected. 27-28a.
Pakataya
दोषैः सास्त्रैः सकृत्कृष्णं नीयते शुक्लरूपताम् ॥ २८ ॥
धवलाभ्रोपलिप्ताभं निष्पावार्धदलाकृति । अतितौव्ररुजारागदाहश्वयथुपीडितम् तच्छुक्रं ॥ २९ ॥ पाकात्ययेन वर्जयेत्तीव्रवेदनम् ।
All the dosas together with blood, make the cornea to assume the features of the sclera, all of sudden; it appears as though covered with white cloud, has the shape of a cotylidon of a nispava, associated with severe pain, redness, burning sensation and swelling, troubling the patient due to over ripening. This Pakatyaya having very severe pain should be rejected. 28b-30a.
यस्य वा लिङ्गनाशोऽन्तः श्यावं यद्वा सलोहितम् ॥ ३० ॥
अत्युत्सेधावगाढं वा साश्रु नाडीव्रणावृतम् । पुराणं विषमं मध्ये विच्छिन्नं यच्च शुक्रकम् ॥ ३१ ॥
That (cornea ) which has caused loss of vision, that which is blue, that which is slightly red, that which is greatly elevated, or greatly depressed, with copious tears flowing out, surrounded by sinus ulcers, which is chronic, uneven, torn in the centre and that having dots / spots-should be rejected. 30b-31.
पञ्चेत्युक्ता गदाः कृष्णे साध्यासाध्यविभागतः ॥ ३१ ॥
Thus were described the five diseases of the krsna (black portion/cornea), classified into curable and incurable. 31½.
इति श्रीवैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने
सन्धिसितासितरोगविज्ञानीयो नाम दशमोऽध्यायः ॥ १० ॥
Thus ends the chapter-Sandhisitasita roga vijnaniya— the tenth in Uttarasthana of Astanga hrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
