चतुर्दशोऽध्यायः । अथातः शूकदोषनिदानं व्याख्यास्यामः । यथोवाच भगवान् धन्वन्तरिः ।। १ ।।
Now we shall discourse on the Nidana of the disease known as Sukradosa. 1
लिङ्गवृद्धिमिच्छतामक्रमप्रवृत्तानां शूकदोषनिमित्ता दश चाष्टौ च व्याध्यो जायन्ते । तद्यथा-सर्षपिका, अष्ठीलिका, ग्रथितं, कुभ्भीका, अलजी, मृदितं, सम्मूढपिडका, अवमन्थ, पुष्करिका, स्पर्शहानिः, उत्तमा, शतपोनकः, त्वक्पाकः, शोणितार्बुदं, मांसार्बुदः मांसपाकः, विद्रधिः, तिलकालकश्चेति ॥ २ ॥
Any of the eighteen different types of the disease may affect the genital (penis) of a man who foolishly resorts to the practice of getting it abnormally elongated and swollen by plastering it with Suka (a kind of irritating water insect) and not in the usual officinal way.
Classification : Diseases, which result from such malpractices, are known as–Sarsapika, Asthilika, Grathita, Kumbhika, Alaji, Mrdita, Sammudha-pidaka, Avamantha, Puskarika, Sparsahani, Uttama, Sataponaka Tvakapaka, Sonitarbuda, Mansarbuda, Mansapaka. Vidradhi and Tilakalaka. 2
गौरसर्षपतुल्या तु पिडकाकफरक्ताभ्यां ज्ञेया शूकदुर्भग्नहेतुका । सर्षपिका बुधैः ॥ ३ ॥
कठिना प्रकोपतः । शूकैस्तु विषसंभुग्नैः पिडकाऽष्ठीलिका भवेत् ।। ४ ।।
शूकैर्यत् पूरितं शश्वद् ग्रथितं तत् कफोत्थितम् ।। ५ ।।
कुम्भीका रक्तपित्तोत्था जाम्बवास्थिनिभाऽशुभा ।। ६ ।। विषमैरन्तैर्मारुतस्य
Metrical Texts : The tiny herpetic eruptions (Pidaka) which resemble the seeds of white mustard in shape and size, (and are found to crop up on the male organ of generation) on account of a deranged condition of the blood and Kapha, as the result of an injudicious application of Suka plasters are called Sarsapika by the wise. Eruptions of hard stone-like pimples, (Pidaka) irregular at their sides or edges and which are caused by the aggravation of the local Vayu by the use of a plaster of the poisonous Suka, are called Asthilika. The knotty Granthis (nodules) on the penis owing to its being frequently stuffed with the bristles of a Suka insect are called Grathita. This type is caused by the deranged action of the Kapha. A black wart resembling the stone or seed of a jambolin fruit in shape is called Kumbhika. This type is due to the deranged condition of the blood and Pitta. 3-6
अलजीलक्षणैर्युक्तामलर्जी च वितर्कयेत् ।। ७ ।।
मृदितं पीडितं यत् तु संरब्धं वायुकोपतः ।। ८ ।।
पाणिभ्यां भृशसंमूढे संमूडपिडका भवेत् ।। ९ ।।
दीर्घा बढ्यश्च पिडका दीर्यन्ते मध्यतस्तु याः । सोऽवमन्थः कफासृग्भ्यां वेदनारोमहर्षकृत् ।। १० ।।
An Alji (incidental to an injudicious application of Suka on the penis) exhibits symptoms, which are identical with those manifested by a case of Alaji in Prameha (Ch. vi). A wart (papilloma) attended with swelling of the part and caused by the aggravated Vayu on the hard and inflamed penis causing pressure (on the urethra) is called Mrdita. The pustule or eruption appearing on the penis on account of its being extremely pressed by the hand (for the insertion of the hairs of the Suka) in its dorsum is called Sammudha-pidaka. (It is the outcome of the aggravated Vayu¹). A large number of elongated pustules on the penis (incidental to an application of Suka to the part) which burst at the middle, causing pain and shivering, is called Avamantha (epithelioma). 7-10
1. According to Dalhana it is due to the action of Vayu and blood.
पित्तशेणितसम्भूता पिडका पिडकाचिता । पद्मपुष्करसंस्थाना ज्ञेया पुष्करिकेति सा ।। ११ ।।
जनयेत् स्पर्शहानिन्तु शोणितं शूकदूषितम् ।। १२ । ।
मुद्गमाषोपमा रक्ता पिडका रक्तपित्तजा उत्तमैषा तु विज्ञेया शूकाजीर्णनिमित्तजा ।। १३ ।।
छिद्रैरणुमुखैर्वस्तु चितं मेढूं समन्ततः । वातशोणितजो व्याधिर्विज्ञेयः शतपोनकः ।। १४ ।।
पित्तरक्तकृतो ज्ञेयस्त्वक्पाको ज्वरदाहवान् ।। १५ ।।
The Puskarika type of the disease is marked by the erruptions of small pimples around the principal one. The type has its origin in the deranged condition of the blood and Pitta and is so called from the part of the excrescenses being arranged in rings or circles like the petals of a lotus flower in shape. A complete anesthesia (of the affected organ) owing to the vitiated blood by the injudicious application of a Suka is called Sparsa-hani. Pidakas appearing on the penis like mudga and masa are red caused due to the vitiation of the local blood and Pitta by such constant applications are called Uttama. That disease in whcih there are multiple tiny openings around the penis is due to vitiation of Vata and sonita is known as sataponka. There is fever with a burning sensation in the affected organ. The disease is due to the vitiated condition of the blood and Pitta is known as Tvakapaka. 11-15
कृष्णैः स्फोटैः सरक्ताभि: पिडकाभिश्च पीडितम् । यस्य वास्तु रुजश्चोग्रा ज्ञेयं तच्छोणितार्बुदम् ।। १६ ।।
मांसदोषेण जानीयादर्बुदं मांससम्भवम् ।। १७ ।।
शीर्यन्ते यस्य मांसानि यस्य सर्वाश्च वेदना: । विद्यात् तं मांसपाकन्तु सर्व्वदोषकृतं भिषक् ॥ १८ ॥
The type of the disease in which the penis is marked by the eruption of black vesicles and is covered over with a large number of red pimples or pustules with an excruciating pain in the ulcerated region of the organ is called Sonitarbuda. The vegetation of a fleshy tumour on the penis (incidental to a blow on the organ to alleviate the pain of inserting the hairs of the Suka insect into its body), is called Mansarbuda. A suppuration as well as sloughing of the penis attended with different kinds of severe pain is called Mansa-paka. This type is caused by the concerted action of the deranged Vayu, Pitta and Kapha. 16-18
विद्रधिं सन्निपातेन यथोक्तमभिनिर्दिशेत् ।। १९ । ।
कृष्णानि चित्राण्यथवा शूकानि सविषाणि च । पातितानि पचन्त्याशु मेढूं निरवशेषतः ।। २० ।।
कालानि भूत्वा मांसानिशीर्यन्ते यस्य देहिनः । सन्निपातसमुत्थानं तं विद्यात् तिलकालकम् ।। २१ । ।
The specific symptoms of a Tridosaja Vidradhi as described before (Chap. ix ) mark the one which affects the penis (owing to an unjudicious application of the highly poisonous irritant Suka to the organ). The disease is called Vidradhi. A process of general suppuration and sloughing of the organ marks the type which is produced by the application of a black Suka or by varied coloured insect of the same species. The type is called Tilakalaka, and should be regarded as Tridosaja one. 19-21
तत्र मांसार्बुदं यच्च मांसपाकश्च यः स्मृतः । विद्रधिश्च न सिध्यन्ति ये च स्युस्तिलकालकाः ॥ २२ ॥
Prognosis: Of the above enumerated malignant diseases of the penis, those known as Mamsarbuda, Mansapaka, Vidradhi and Tilakalak should be deemed as incurable. 22
इति सुश्रुतसंहितायां निदानस्थाने शूकदोषनिदानं नाम चतुर्दशोऽध्यायः ।। १४ । ।
Thus ends the fourteenth Chapter of the Nidana Sthang in the Susruta amhita which treats of Nidana of different types of Sukradosa.
