षष्ठोऽध्यायः अथातः सर्वगतरोगविज्ञानीयमध्यायं व्याख्यास्यामः, यथोवाच धन्वन्तरिः॥१॥ भगवान्
Now we shall discourse on the chapter which deals with the symptoms and pathology of the diseases affecting the eye as a whole. (Sarva-gata-Rogavijnaniya). 1
Eye Diseases Names and causes
स्यन्दास्तु चत्वार इहोपदिष्टास्तावन्त एवेह तथाऽधिमन्थाः । शोफान्वितोऽशोफयुतश्च पाकावित्येवमेते दश सम्प्रदिष्टाः ॥ २ ॥
हताधिमन्थोऽनिलपर्ययश्च शुष्काक्षिपाकोऽन्यत एव वातः । दृष्टिस्तथाऽम्लाध्युषिता सिराणामुत्पातहर्षावपि सर्वभागाः ॥ ३ ॥
प्रायेण सर्वे नयनामयास्तु भवन्त्यभिष्यन्दनिमित्तमूलाः । तस्मादभिष्यन्दमुदीर्यमाणमुपाचरेदाशु हिताय धीमान् ॥ ४ ॥
Names and causes – The four types of Abhisyanda (Ophthalmatis), the four types of Adhimantha, the two forms of Aksipaka (Suppuration of the eye) attended with without swelling, these then, as well as Hatadhimantha, Anila-paryaya, Susaksipaka, Anyatovata, Amladhyusita, Drsti, Sirotpata and sira- Harsa are the names of the (seventeen kinds of) diseases which affect the eye as a whole. Nearly all these forms of eye-diseases may result from the Abhisyanda (Ophthalmitis). Hence a wise physician shall try speedily to remedy a case of Abhisyanda (Ophthalmitis) as soon as it is found out. 2-4.
Symptoms of Abhisyanda
निस्तोदनं स्तम्भनरोमहर्ष-सङ्घर्षपारुष्यशिरोऽभितापाः । विशुष्कभावः शिशिराश्रुता च वाताभिपन्ने नयने भवन्ति ॥ ५ ॥
दाहप्रपाकौ शिशिराभिनन्दा धूमायनं वाष्पसमुच्छ्रयश्च । उष्णाश्रुता पीतकनेत्रता च पित्ताभिपन्ने नयने भवन्ति ॥ ६ ॥
उष्णाभिनन्दा गुरुताsक्षिशोफः कण्डूपदेहौ सितताऽतिशैत्यम् । स्रावो मुहुः पिच्छिल एव चापि कफाभिपन्ने नयने भवन्ति ॥ ७ ॥
ताम्राश्रुता लोहितनेत्रता च राज्यः समन्तादतिलोहिताश्च । पित्तस्य लिङ्गानि च यानि तानि रक्ताभिपन्ने नयने भवन्ति ॥ ८ ॥
Specific Symptoms of Abhisyanda- The symptoms which mark a case of Abhisyanda due to the action of the deranged Vayu are pricking pain (in the eyes), numbness, horripilation and irritation in the eyes, roughness and parchedness of the organ, cold lachrymations and headache. A case of Pittaja-Abhisyanda exhibits the following features, viz., burning and inflammatory suppuration of the eyes, longing for coldness (in the eyes ), excessive hot lachrymations, cloudy vision and yellowness of the eye. In the Kaphaja type of the disease, the affected organ longs for the contact of warm articles and is attended with a heaviness, itching sensation, swelling, excessive whiteness and a constant deposit and discharge of slimy mucus. The special type of this disease which has its origin in the vitiated condition of the blood, i.e. the Raktaja type is marked by redness of the eyes, flow of copper-coloured tears, as well as the symptoms of the Pittaja type of the disease and the presence of deep red stripes all along. 5-8.
Causes of Adhimantha
वृद्धैरेतैरभिष्यन्दैर्नराणामक्रियावताम् तावन्तस्त्वधिमन्थाः स्युर्नयने तीव्रवेदनाः ॥ ९ ॥
उत्पाट्यत इवात्यर्थं नेत्रं निर्मथ्यते तथा । शिरसोऽर्धन्तु तं विद्यादधिमन्थं स्वलक्षणैः ॥ १० ॥
Causes of Adhimantha – All the (four) forms of chronic Abhisyanda, if not properly attended to and remedied at the outset, may run into as many cases of Adhimantha which is attended (invariably) with an excruciating pain in the eye, which seems as if being torn out, the pain extending to upward and crushing, as it wears, the half region of the head. The characteristic symptoms of the Dosas involved in each case are also seen to supervene. 9-10.
Symptoms of Vataja Adhimantha
नेत्रमुत्पाट्यत इव मथ्यतेऽरणिवच्च यत् । सङ्घर्षतोदनिर्भेद-मांससंरब्धमाविलम् ॥ ११ ॥
कुञ्चनास्फोटनाध्मान-वेपथुव्यथनैर्युतम् । शिरसोऽर्धञ्च येन स्यादधिमन्थः स मारुतात् ॥ १२ ॥
Symptoms of Vataja Adhimantha- In the Vataja type of Adhimantha the eye becomes cloudy and seems as if being torn out and churned as with an Arani (fire-producing wooden stick) attended with an irritating, piercing and cutting pain, as well as with a swelling of the local flesh, and a half of the head (on the side of the affected eye) is affected with a twisting and cracking sensation as well as with local swelling, shivering and pain. 11-12.
Symptoms of Pittaja Adhimantha
रक्तराजिचितं स्त्रावि वह्निनेवावदह्यते । यकृत्पिण्डोपमं दाहि क्षारेणाक्तमिव क्षतम् ॥ १३॥
प्रपक्वोच्छूनवर्त्मान्तं सस्वेदं पीतदर्शनम् । मूर्च्छाशिरोदाहयुतं पित्तेनाक्ष्यधिमन्थितम् ॥ १४॥
Symptoms of Pittaja Adhimantha- The symptoms which mark the Pittaja type of Adhimantha are the blood-streaked eye attended with secretion and a sensation there in of being burnt with fire, as well as swelling, perspiration and suppuration in the affected organs, yellowish vision, fainting fits and a burning sensation in the head. The eyes in this case become liver-coloured and seem as if ulcerated or rubbed with an alkali. 13-14.
Symptoms of Kaphaja Adhimantha
शोफवन्नातिसंरब्धं स्त्रावकण्डूसमन्वितम् । शैत्यगौरवपैच्छिल्य दूषिकाहर्षणान्वितम् ॥ १५ ॥
रूपं पश्यति दुःखेन पांशुपूर्णमिवाविलम् । नासाध्मानशिरोदुःख – युतं श्लेष्माधिमन्थितम् ॥ १६ ॥
Symptoms of Kaphaja Adhimantha – In the Kaphaja type of Adhimantha the eye is swollen with a slight congestion (inflammation). Discharges with a sensation of itching, coldness and heaviness in the localities set in, and there is horripilation. The eye becomes slimy with deposit of mucous matter. The sight becomes cloudy as if filled with dust, the nostrils are dilated and there is headache. 15-16.
Symptoms of Raktaja Adhimantha
बन्धुजीवप्रतीकाशं ताम्यति स्पर्शनाक्षमम् । रक्तास्त्रावं सनिस्तोदं पश्यत्यग्निनिभा दिशः ॥ १७ ॥
रक्तमग्नारिष्टवच्च कृष्णभागश्च लक्ष्यते । यद्दीप्तं रक्तपर्यन्तं तद्रक्तेनाधिमन्थितम् ॥ १८ ॥
Symptoms of Raktaja Adhimantha – A pricking pain and a blood-streaked secretion from the affected organ which looks (bright red) like a Bandhujiva flower, are the symptoms which mark the type of Raktaja Adhimantha (due to the vitiated blood). The eye becomes painful and incapable of bearing the least touch or contact, and the object of vision seem as if enveloped in flames. The extremities of the eye become red and the whole region of the cornea (black coat of the eye) looks like an Arista fruit submergd in blood. 17-18.
हन्याद् दृष्टिं सप्तरात्रात् कफोत्थोऽधीमन्थोऽसृक्सम्भवः पञ्चरात्रात् ।
षड्रात्राद् वा मारुतोत्थो निहन्यान्मिथ्याचारात् पैत्तिकः सद्य एव ॥ १९ ॥
The prognosis – A course of injudicious diet, conduct or medical treatment may usher in the blindness of vision after seven days from an attack of the Kaphaja type of Adhimantha (Ophthalmia) and in five days from that of the blood-origined (Raktaja) type, in six days in a case of the Vataja Adhimantha and instantaneously within three days of the attack) in the Pittaja type of (i.e. Adhimantha). 19.
Symptoms of Sa-sopha and A-sopha Aksi-paka
कण्डूपदेहाश्रुयुतः पक्कोदुम्बरसन्निभः । दाहसंहर्षताम्रत्व-शोफनिस्तोदगौरवैः ॥ २० ॥
जुष्टो मुहुः स्त्रवेद् वास्त्रमुष्णशीताम्बु पिच्छिलम् । संरम्भी पच्यते यश्च नेत्रपाकः स शोफजः ॥ २१ ॥
शोफहीनानि लिङ्गानि नेत्रपाके त्वशोफजे ॥ २२ ॥
Symptoms of Sa-sopha and A-sopha Aksi-paka – A case of Sa-sopha-netra-paka exhibits the following symptoms, viz., itching sensation, deposit of mucous matter (in the eye), lachrymation and a redness of the eye like the colour of a ripe Udumbara fruit. There is a burning sensaiton in the eye-ball which becomes copper-coloured, heavy, and attended with a pricking pain and horripilation. The eye becomes swollen and constantly secretes either cold or hot slimy discharges, and ultimately suppurates. All these symptoms except swelling mark the (non-swollen) A-sopha-Netra-paka type of the disease. 20-22.
उपेक्षणादक्षियदाऽधिमन्थो वातात्मकः सादयति प्रसह्य । रुजाभिरुग्राभिरसाध्य एष हताधिमन्थः खलु नाम रोगः ॥ २३ ॥
अन्तःसिराणां श्वसनः स्थितो दृष्टिं प्रतिक्षिपन् । हताधिमन्थं जनयेत् तमसाध्यं विदुर्बुधाः ॥ २४ ॥
पक्ष्मद्वयाक्षिभ्रुवमाश्रितस्तु यत्रानिलः सञ्चरति प्रदुष्टः । पर्य्यायशश्चापि रुजः करोति तं वातपर्यायमुदाहरन्ति ॥ २५ ॥
When the curative measures in eye disease of Adhimantha is neglacted the deranged Vayu getting incarcerated in the optic nerve (Sira) impairs the faculty of sight, and gives rise to an incurable disease which is called Hatadhimantha (blinding Ophthalmia). A shifting pain experienced sometimes in the region of the eye-lashes¹ or of the eye-brows and sometimes in the region of the eye, owing to the coursing of deranged and incarcerated Vayu in those localities, is called Vata – Paryaya. 23-25.
यत् कूणितं दारुणरूक्षवर्त्म विलोकने चाविलदर्शनं यत् । सुदारुणं यत् प्रतिबोधने च शुष्काक्षिपाकोपहतं तदक्षि ॥ २६ ॥
यस्यावटूकर्णशिरोहनुस्थो मन्यागतो वाऽप्यनिलोऽन्यतो वा । कुर्याद्रुजोऽति ध्रुवि लोचने वा तमन्यतोवातमुदाहरन्ति ॥ २७ ॥
The disease in which the eye-lids become dry and hard and remain always closed, the vision becomes cloudy and hazy, and it becomes very painful to open the eye-lids, is called the Suskaksi-paka.2 The excessive pain in the eye or in the eye-brows due to the action of the deranged Vayu incarcerated in the region of the head, the ears, the cheek-bones, the back of the neck (Avatu), the Manya (a particular nerve on either side of the neck ), or in any other ( adjacent ) place is called the Anyato-vata. 26-27.
अम्लेन भुक्तेन विदाहिना च सञ्छाद्यते सर्वत एव नेत्रम् | शोफान्वितं लोहितकैः सनीलैरेतादृगम्लाध्युषितं वदन्ति ॥ २८ ॥
1. Madhava in the Nidana does not mention the eye lashes. 2. Madhava in Nidana reads “दन्दह्यते” which means that a hightly burning sensation is produced the affected eye. in place “विलोकने” a word which seems redundant.
अवेदना वाऽपि सवेदना वा यस्याक्षिराज्यो हि भवन्ति ताम्राः । मुहुर्विरज्यन्ति च ताः समन्ताद् व्याधिः सिरोत्पात इति प्रदिष्टः ॥ २९ ॥
The swelling of the eye attended with a bluish red tint all about, owing to the partakings of meals composed of an unduly large proportion of acid articles, of such food as is followed by a digestionary acid reaction, is called the Amladhyusita – Drsti. The disease in which the veins all over the eye become copper-coloured and are frequently discoloured, whether attended with pain or not, is called the Sirotpata. 28-29.
मोहात् सिरोत्पात उपेक्षितस्तु जायेत रोगस्तु सिराप्रहर्षः । ताम्राच्छमस्त्रं स्रवति प्रगाढं तथा न शक्नोत्यभिवीक्षितुञ्च ॥ ३० ॥
A case of Sirotpata, if not attended to and remedied in time through ignorance, gives rise to transparent and copper-coloured discharges in copious quantities from the eyes and produce a complete blindness of vision. This is known as the Sira harsa. 30.
इति सुश्रुत संहितायामुत्तरतन्त्रे सर्वगतरोगविज्ञनीयो नाम षष्ठोऽध्यायः ॥ ६॥ –
Thus ends the sixth chapter of the Uttara-Tantra in the Susruta Samhita which treats of the diseases affecting the eye as a whole.
