तृतीयोऽध्यायः अथातो वर्त्मगतरोगविज्ञानीयमध्यायं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the chapter which deals with the pathology of diseases peculiar to the region of the eye-lids (Vartmagata Roga Vijnaniya). 1
पृथग्दोषाः समस्ताश्च यदा वर्त्मव्यपाश्रयाः |
सिरा व्याप्यावतिष्ठन्ते वर्त्मस्वधिकमूर्च्छिताः ॥ २ ॥ विवर्ध्य मांसं रक्तञ्च तदा वर्त्मव्यपाश्रयान् । विकारान् जनयन्त्याशु नामतस्तान् निबोधत ॥ ३ ॥ उत्सङ्गिन्यथ कुम्भीका पोथक्यो वर्त्मशर्करा | तथाऽर्शोवर्त्म शुष्कार्शस्तथैवाञ्जननामिका ॥४॥ बहलं वर्त्म यच्चापि व्याधिर्वर्त्मावबन्धकः । क्लिष्टकर्दमवर्त्माख्यौ श्याववर्त्म तथैव च ॥ ५ ॥ प्रक्लिन्नमपरिक्लिन्नं वर्त्म वातहतन्तु यत् । अर्बुदं निमिषश्चापि शोणितार्शश्च यत् स्मृतम् ॥ ६॥ लगणो बिशनामा च पक्ष्मकोपस्तथैव च । एकविंशतिरित्येते विकारा वर्त्मसंश्रयाः ॥ ७ ॥
Causes and Names – The dosas of the body jointly or seperately expanding through the nerves and veins, (Sira) of the eyelids (Vartma) bringing about an augmentation of the quantity of the blood and the growth of the flesh in the localities (accumalation of blood towards the formation of fleshy growth in the affected parts) gives rise to a host of local diseases which are known as Utsangini, kumbhika, Pothaki, Vartma-Sarkara, Arso-vastma, Susskarsas, Anjana, Bahala-vartma, Vartmavabandha, Klista-vartma, Kardama-vartma, syava-vartma, Parklinna-vartma, Vatahata-vartma, Arbuda, Nimisa, Sonitarsas, Lagana, Visa-vartma and Paksma-kopa these twenty-one diseases are restricted to the eye-lids (vartma). 2-7.
नामभिस्ते समुद्दिष्टा लक्षणैस्तान् प्रचक्ष्महे । अभ्यन्तरमुखी बाह्योत्सङ्गेऽधो वर्त्मनश्च या । विज्ञेयोत्सङ्गिनी नाम तद्रूपपिडकान्विता ॥ ८ ॥ कुम्भीकबीजप्रतिमाः पिडका: यास्तु वर्त्मजाः । आध्मायन्ते तु भिन्ना याः कुम्भीकपिडकास्तु ताः ॥ ९ ॥
The Specific symptoms of the diseases of the eye-lids The names of these have been enumerated; now hear me describing their specific symptoms. A (rolled up and indented) boil or eruption (Pidaka) appearing along the lower eye-lid on its exterior side with its mouth or head directed inward is called Utsamgini. A number of boils or pustules (Pidaka) to the size of a Kumbhika seed appearing on the joint of the eye-lids and the eye-lashes and becoming inflamed after being burst is called Kumbhika.’ 8-9.
स्त्राविण्यः कण्डुराः गुर्व्या रक्तसर्षपसन्निभाः । पिडकाश्च रुजावत्यः पोथक्य इति संज्ञिताः ॥ १० ॥
पिडकाभिः सुसूक्ष्माभिर्घनाभिरभिसंवृता । पिडका या खरा स्थूला या ज्ञेया वर्त्मशर्करा ॥ ११ ॥
A number of red and heavy (hard) boils or pustules (Pidaka ) resembling red mustard seeds attended with pain, itching and exudation is called Pothaki. A rough and large pustule (Pidaka) surrounded by other very small and thick erythematous pustules (covering the entire length of the eye-lid) is called Vartma-sarkara. 10-11.
एर्वारुबीजप्रतिमाः पिडका मन्दवेदनाः । सूक्ष्मा: खराश्च वर्त्मस्थास्तदर्शोवर्त्म कीर्त्यते ॥ १२ ॥ दीर्घोऽङ्कुरः खरः स्तब्धो दारुणो वर्त्मसम्भवः । व्याधिरेष समाख्यातः शुष्कर्श इति संज्ञितः ॥ १३ ॥
1. This disease ( Kumbhika) is due to the concerted action of the three Dosas.
Vegetations of small (D. R. soft) and rough papilae (Pidakas) on the eye-lid resembling Ervaruka seeds and attended with very little pain are called Arso-vartma. Long, rough, hard and numbed papilae (Arnkura) on the eye-lid’ are called suskarsas. 12-13.
दाहतोदवती ताम्रा पिडका वर्त्मसम्भवा । मृद्वी मन्दरुजा सूक्ष्मा ज्ञेया साऽञ्जननामिका ॥ १४ ॥
वर्मोपचीयते यस्य पिडकाभिः समन्ततः । सवर्णाभिः समाभिश्च विद्याद् बहलवर्त्म तत् ॥ १५ ॥
A small, soft, copper-coloured pustule (Pidaka) appearing on the eye-lid and attended with burning, pricking sensation and a slight pain is called an Anjana Vegetations of pustules (Pidaka) of equal size (D. R. — attended with hardness) occurring all along the eye-lid and resembling it (or each other) in colour are called Bahala-vartma. 1415.
कण्डूमताऽल्पतोदेन वर्त्मशोफेन यो नरः । न समं छादयेदक्षि भवेद् बन्धः स वर्त्मनः ॥ १६ ॥
मृद्वल्पवेदनं ताम्रं यद् वर्त्म सममेव च । अकस्माच्च भवेद रक्तं क्लिष्टवर्त्म तदादिशेत् ॥ १७ ॥
Such swelling of the eye-lid attended with an itching sensation and a slight pain as impedes or interferes with its being evenly opened is called Vartma-bandh. A mild and copper-coloured inflammatory swelling of both the eye-lids simultaneously attended with a slight pain and changing suddenly into redness (D. R.-suddenly discharging blood therefrom ) is called Klista-vartma. 16-17.
क्लिष्टं पुनः पित्तयुतं विदहेच्छोणितं यदा | तदा क्लिन्नत्वमापन्नमुच्यते वर्त्मकर्दमः ॥ १८ ॥
यद् वर्त्म बाह्यतोऽन्तश्च श्यावं शूनं सवेदनम् । दाहकण्डूपरिक्लेदि श्याववर्त्मेति तन्मतम् ॥ १९ ॥ deranged
A case of Klista-vartma in which the Pitta has and affected the blood and much dirty matter (mucus) is discharged as a consequence is called a case of Vartma-kardama. A dark brown colour of the eye-lids both internally and externally marked by a swelling (D. R.- pain) and attended with a discharge of pus and with buring and itching sensations is called syava-vartma. 18-19.
1. According to Madhava, the papila in such cases occur in the inner side of the eyelid.
अरुजं बाह्यतः शूनमन्तः क्लिन्नं स्रवत्यपि | कण्डूनिस्तोदभूयिष्ठ क्लिन्नवर्त्म तदुच्यते ॥ २० ॥
यस्य धौतानि धौतानि सम्बध्यन्ते पुनः पुनः । वर्त्मान्यपरिपक्वानि विद्यादक्लिन्नवर्त्म तत् ॥ २१ ॥
An external swelling of the eye-lid with a deposit of mucous matter in its inner surface accompanied with a little pain as well as a discharge, itching and pricking sensation, is called a Praklinna-Vartma. A sticking to gether of the eye-lids even in the absence of any suppuration and in spite of the eyes being constantly washed (with water)¹ is called Praklinna-vartma. 20-21.
विमुक्तसन्धि निश्चेष्टं वर्त्म यस्य न मील्यते । एतद् वातहतं विद्यात् सरुजं यदि वाऽरुजम् ॥ २२ ॥
वर्त्मान्तरस्थं विषमं ग्रन्थिभूतमवेदनम् । विज्ञेयमर्बुदं पुंसां सरक्तमविलम्बितम् ॥ २३ ॥
The drooping down (lit-inactivity) of the eye-lids, whether attended with any pain or not, (so as to obstruct the opening of the eyelashes) where the eyelids seem to be out of joint is called Vatahatavartma. A red and knotty swelling (Granthi) of an uneven size or shape, growing, hastily on the interior side of the eye-lid and attended with a little pain is called an Arbuda or tumour. 22-23.
निमेषिणी: सिरा वायुः प्रविष्टो वर्त्मसंश्रयाः । चालयेदक्षिवर्त्मानि निमेषः स गदो मतः ॥ २४ ॥ छिन्नाश्छिन्ना विर्वधन्ते वर्त्मस्था मृदवोऽ ऽङ्कुराः । दाहकण्डूरुजोपेतास्तेऽर्श: शोणितसम्भवाः ॥ २५ ॥
1. A different reading reads ‘whether washed or not.’ This however, not a good reading.
Constant wrinkling of the eye-lids owing to the incarceration of the (deranged) Vayu within the nerves or veins (Sira) controlling their wrinklings (closing and opening) are known as Nimesa. Soft and fleshy growths (Amkura) on the eye-lid which reappear even after being removed with a knife, and are attended with pain, itching and burning sensation are called Sonitarsas and should be ascribed to be vitiated condition of the blood. 24-25.
अपाकः कठिनः स्थूलो ग्रन्थिवर्त्मभवोऽरुजः । सकण्डूः पिच्छिलः कोलप्रमाणो लगणस्तु सः ॥ २६ ॥
शूनं यद् वर्त्म बहुभिः सूक्ष्मैश्छिद्रैः समन्वितम् । बिसमन्तर्जलमिव बिसवर्त्मेति तन्मतम् ॥ २७ ॥
A thick, slimy, hard and painless nodular swelling ( Granthi) on the eye-lid resembling a Kola fruit in size and marked by an itching sensation and absence of suppuration is called Lagana.¹ An inflammatory swelling of eye-lid dotted with minute punctures like the pores in the stem of a water-soaked lotus plant is called Visa-vartma. 26-27.
पक्ष्माशयगता दोषास्तीक्ष्णाग्राणि खराणि च । निर्वर्तयन्ति पक्ष्माणि तैर्घुष्टञ्चाक्षि दूयते ॥ २८ ॥
उद्धृतैरुद्धृतैः शान्तिः पक्ष्मभिश्चोपजायते । वातातपानलद्वेषी पक्ष्मकोपः स उच्यते ॥ २९ ॥
An accumulation of the deranged Dosas about the eye-lashes makes them rough and sharp-pointed, which gives pain to the eye and gives relief when drawn off. The disease is known as Paksma-kopa in which the eye cannot bear the least wind or heat or the glare of fire. 28-29.
इति सुश्रुत संहितायामुत्तरतन्त्रे वर्त्मगतरोगविज्ञानीयो नाम तृतीयोऽध्यायः ॥ ३ ॥
Thus ends the third chapter of the Uttara-Tantra in the Susruta Samhita which deals with the pathology of the diseases of the eye-lids.
