अथातो वातव्याधिनिदानं व्याख्यास्यामः । इति ह स्माहुरोत्रेयादयो महर्षयः ॥१॥
We will now expound Vatavyadhi nidanam (diagnosis of nervous disorders), thus said Atreya and other great sages. (1)
सर्वार्थानर्थकरणे विश्वस्यास्यैककारणम् । अदुष्टदुष्टः पवनः शरीरस्य विशेषतः ॥२॥
स विश्वकर्मा विश्वात्मा विश्वरूपः प्रजापतिः । स्रष्टा धाता विभुर्विष्णुः संहर्ता मृत्युरन्तकः ॥३॥
तददुष्टौ प्रयत्नेन यतितव्यमतः सदा । तस्योक्तं दोषविज्ञाने कर्म प्राकृतवैकृतम् ॥४॥
समासाद्व्यासतो दोषभेदीये नाम धाम च । प्रत्येकं पञ्चधा चारो व्यापारश्चेह वैकृतम् ॥ ५ ॥
तस्योच्यते विभागेन सनिदानं सलक्षणम् । असङ्ख्यमपि सङ्ख्यायै यदशीत्या पुरेरितम् ॥ ६ ॥
Pavana (vata) is the one (chief) cause of all the good and bad of this world in its normal and abnormal states respectively; specially so, of the human body, it is Visvakarma, Visvatma, Visvarupa, Prajapati, Srasta, Dhata, Vibhu, Visnu, Samharta, Mrtyu and Antaka. Hence all-out efforts should be made to maintain it normally always.
Its normal and abrnormal functions were described in brief in doshavijnana (chapter 19 of sutrasthana) and in detail with its names and places along with its five divisions, movements and functions in doshabhediaya (chapter 20 of sutrasthana).
Now, its abnormalities along with their classifications, causes and symptoms are described here. Though innumerable, eighty numbers of these, were described earlier. ( vide chapter 20 of sutrasthana).
धातुक्षयकरैर्वायुः कुप्यत्यतिनिषेवितैः ।
चरन् स्रोतःसु रिक्तेषु भृशं तान्येव पूरयन् ॥७॥ तेभ्योऽन्यदोषपूर्णेभ्यः प्राप्य वावरणं बली ।
Vayu (vata) undergoes aggravation (increase) by over-indulgence of factors which cause dhatuksya (depletion, loss or decrease of tissues) moving inside the srotas (channels, passages, ducts, cell pores etc) which have become empty (by dhatu ksaya), it fills them up by itself greatly or getting avarana (covering, obstruction, hinderance) by other doshas accumilated in those srotas (channels, pores etc) the mighty (powerful strong ) vata gets aggravated (increased). (2-8a)
तत्र पक्काशये क्रुद्धः शूलानाहान्त्रकूजनम् ॥८॥
मलरोधाश्मवर्ष्मार्शस्त्रिकपृष्ठकटीग्रहम् । करोत्यधरकाये च तांस्तान् कृच्छ्रानुपद्रवान् ॥९॥
Aggravated in the pakvasaya (large intestine) it produces colic, distention of abdomen, gurgling in the intestines, constipation, formation of urinary stones, enlargement of the scrotum, piles, catching pain and loss of movement of the coccygeal region, back and waist and many such complications (secondary diseases) concerned with lower parts of the body. (8b-9)
आमाशये तृड्वमथुश्वासकासविषूचिकाः। कण्ठोपरोधमुद्गारान् व्याधीनूर्ध्वं च नाभितः ॥१०॥
Aggravated in the amasaya (stomach and small intestines) it produces thirst, vomiting, dyspnoea, cough, visucika (vomiting and diarrhoea together ), obstruction of the throat, too many blechings and other diseases concerned with parts above the umbilicus. (10)
श्रोत्रादिष्विन्द्रियवधं त्वचि स्फुटनरूक्षते । रक्ते तीव्रां रुजां स्वापं तापं रागं विवर्णताम् ॥ ११ ॥
अरुंष्यन्नस्य विष्टम्भमरुचिं कृशतां भ्रमम् । मांसमेदोगतो ग्रन्थींस्तोदाढ्यान् कर्कशान् भ्रमम् ॥१२॥
गुर्वङ्गं चातिरुक् स्तब्धं मुष्टिदण्डहतोपमम् । अस्थिस्थः सक्थिसन्ध्यस्थिशूलं तीव्रं बलक्षयम् ॥१३॥
मज्जस्थोऽस्थिषु सौषिर्यमस्वप्नं सन्ततं रुजम् । शुक्रस्य शीघ्रमुत्सर्ग सङ्गं विकृतिमेव वा ॥१४॥
तद्वद्गर्भस्य शुक्रस्थ: सिरास्वाध्मानरिक्तते । तत्स्थ: स्नावस्थितः कुर्यात् गृध्रस्यायामकुब्जताः ॥१५॥
वातपूर्णदृतिस्पर्शं शोफं सन्धिगतोऽनिलः । प्रसारणाकुञ्चनयोः प्रवृत्तिं च सवेदनाम् ॥१६॥
सर्वाङ्गसंश्रयस्तोदभेदस्फुरणभञ्जनम् । स्तम्भनाक्षेपणस्वापसन्ध्याकुञ्चनकम्पनम् ॥ १७॥
Aggravated in the sense organs like the ear, it causes loss of sensory functions; in the skin, cracks and roughness; in the blood it causes severe pain, loss of tactile sensation, increase of temperature, red colouration or discolouration, ulceration, stasis of food inside for long period, anorexia, emaciation and giddiness.
In the muscles and fat it produces tumors which are very painful, hard and rough, giddiness, feeling of heaviness of body, severe pain, stiffness and feeling as though beaten by fist or baton.
In the bones it causes severe pain in the thighs, joints and bones and loss of strength. In the marrow, it causes hallowness ( cavitation) of bones, loss of sleep and intermittant pain.
In the semen, it causes premature ejaculation, non-elemination or other abnormalities, so also abnormalities of the embryo.
In the siras (veins and other vessels) it causes either their dilatation or emptiness.
In the snayus (tendons and nerves), it cause grdhrasi (sciatica) ayama (tetanus) and kubjata (kyphosis, hunch-back).
In the joints it makes them swollen, resembling a bag filled with air for touch, and painful in extending and contracting.
Localised all over the body it produces pains such as pricking, cutting, throbbing and breaking, stiffness ( loss of movement), convulsion, loss of tactile sensation, contractions of the joints and tremors. (11-17)
Aksepaka – convulsions
यदा तु धमनीः सर्वाः क्रुद्धोऽभ्येति मुहुर्मुहुः । तदाङ्गमाक्षिपत्येष व्याधिराक्षेपकः स्मृतः ॥१८॥
When it (vata) getting aggravated (increased) invades all the dhamanis (arteries), produces convulsions of the body often, this disease its known as aksepaka. (18)
Apatanaka – Tetanus
अधःप्रतिहतो वायुर्व्रजन्नूर्ध्वं हृदाश्रिताः । नाडीः प्रविश्य हृदयं शिरः शङ्खौ च पीडयन् ॥ १९ ॥
आक्षिपेत् परितो गात्रं धनुर्वच्चास्य नामयेत् । कृछ्रादुच्छ्वसित्ति स्तब्धस्त्रस्तमीलितदृक् ततः ॥२०॥
कपोत् इव कूजेच्च निस्संज्ञः सोऽपतन्त्रकः ॥२१॥
स एव चापतानाख्यो मुक्ते तु मरुता हृदि । अश्नुवीत मुहुः स्वास्थ्यं मुहुरस्वास्थ्यमावृते ॥२२॥
गर्भापातसमुत्पन्नः शोणितातिस्त्रवोत्थितः । अभिघातसमुत्थश्च दुश्चिकित्स्यतो हि सः ॥ २३ ॥
Vata getting obstructed in its downward path, takes an upward path, enters into the nadis (vessels) situated in the hridaya (heart) makes the body bent like a bow, accompanied with catching pain in the head and temples, convulsions of the body, the patient breathes with difficulty, his eyes are motionless, drooping and closed; produces sound (from his throat) like a peigon and is unconscious. This disease is Apatantraka, also known as Apatanaka. When the heart gets freed of vata, the patient gets health (relief from convulsions) for some time and gets back into ill-health (fits or convulsion) when it (vata) fills (invades) the hridaya (heart) again.
Apatanaka caused by abortion (or miscarriage), too much of bleeding or injury are very difficult to treat, (19-23)
Dhanuskampa – tetanus
मन्ये संस्तभ्य वातोऽन्तरायच्छन् धमनीर्यदा । व्याप्नोति सकलं देहं जत्रुरायम्यते तदा ॥ २४ ॥
अन्तर्धनुरिवाङ्गं च वेगैः स्तम्भं च नेत्रयोः । करोति जृम्भां दशनं दशनानां कफोद्वमम् ॥ २५ ॥
पार्श्वयोर्वेदनां वाक्यहनुपृष्ठशिरोग्रहत् । अन्तरायाम इत्येष बाह्यायामश्च तद्विधः ॥२६॥
देहस्यबहिरायामात् पृष्ठतो ह्रियते शिरः । उरश्चोत्क्षिप्यते तत्र कन्धरा चावमृद्यते ॥ २७ ॥
दन्तेऽष्वास्ये च वैवर्ण्यं प्रस्वेदः स्तब्धगात्रता । बाह्यायामं धनुष्कम्पं ब्रुवते वेगिनं च तम् ॥ २८ ॥
When the aggravated vata producing stiffness of the nape of the neck and later begins to travel through all the internal dhamanis, then it causes bending of the neck and the body inwards like a bow, in bouts (periods of convulsions) accompanied with fixed eyes, yawning (mouth kept open) biting of the teeth, vomiting of kapha (mucus or froth), pain in the flanks, catching of speech (inability to speak), lower jaw, back and head. This is known as Antarayama. Similarly is the Bahyayama, with the bending of the body outwards, the head and chest bent backwards along with the neck, discolouration of the teeth and mouth, profuse perspiration and stiffness of the body. This convulsive diseases is called Bahyayama or Dhanuskampa (24-28)
व्रणं मर्माश्रितं प्राप्य समीरणसमीरणात् । व्यायच्छन्ति तनुं दोषाः सर्वामापादमस्तकम् ॥२९॥
तृष्यतः पाण्हुगात्रस्य व्रणायामः स वर्जितः । गते वेगे भवेत् स्वास्थ्यं सर्वेष्वाक्षेपकेषु तु ॥३०॥
The doshas present in the wound (or ulcers) situated over vital organs (or places ) cause aggravation of vata, which in turn, occupies the whole body from the foot to the head, giving rise to thirst, yelowish-white discolouration (and convulsions). This disease is known as Vrannayama and is to be rejected.
In all aksepaka (convulsions) disease such as Apatantraka, Apatanaka, Antarayama, Bahyayama and Vranayama), the patient gets periods of health (relief of symptoms) when the bouts pass off. (29-30)
Hanusramsa – trismus, lock jaw
जिह्वातिलेखनाच्छुष्कभक्षणादभिघाततः । कुपितो हनुमूलस्थ: स्रंसयित्वाऽनिलो हनू ॥ ३१ ॥
करोति विवृतास्यत्वमथवां संवृतास्यताम् । हनुस्रंसः स तेन स्यात् कृच्छ्राच्चर्वणभाषणम् ॥३२॥ .
By scraping the tongue too much, eating dry (of hard) foods and injury, anila (vata) located at the root of the jaw getting aggravated causes drooping down of the lower jaw making the mouth kept open always or keeps it tightly closed, creating difficulty to chewing and speaking. This is known as Hanusramsa. (31-32)
वाग्वाहिनीसिरासंस्तो जिह्वां स्तम्भयते ऽनिलः । जिह्वास्तम्भः स तेनान्नपानवाक्येष्वनीशता ॥३३॥
Jihvasthambha – paralysis of the tongue
Anila (vata) residing in the channels of speech (getting aggravated) causes loss of movements of the tongue, creating inability to chewing, drinking and talking. This is Jihvasthambha. ( 33 )
Ardita – facial paralysis
शिरसा भारभरणादतिहास्यप्रभाषणात् । उत्त्रासवक्रक्षवथुखरकार्मुककर्षणात् ॥३४॥
विषमादुपधानाच्च कठिनानां च चर्वणात् । वायुर्विवृद्धस्तैस्तैश्च वातलैरूर्ध्वमास्थितः ॥३५॥
वक्रीकरोति वक्त्रार्धमुक्तं हसितमीक्षितम् । ततोऽस्य कम्पते मूर्धा वाक्सङ्गः स्तब्धत्रता ॥३६॥
दन्तचालः स्वरभ्रंशः श्रुतिहानिः क्षवग्रहः । गन्धाज्ञानं स्मृतेर्मोषस्त्रासः सुप्तस्य जायते ॥३७॥
निष्ठीव: पार्श्वतो यायादेकस्याक्ष्णोर्निमीलनम्। जत्रोरूर्ध्वं रुजास्तीव्राः शरीरार्धेऽधरेऽपिवा ॥ ३८ ॥ तमाहुरर्दितं केचिदेकायाममथापरे ।
Carrying heavy loads on the head, too much of laughing and talking, sneezing, keeping the head in irregular positions, bending a very hard bow, using an uneven pillow, chewing very hard materials and such others activities cause aggravatio of vata located in the upper part (head) getting increased produces irregularity of half of the face and also of laughing and seeing (mouth and eyes), then the patient develops tremors of the head, hinderance to speech, fixed eyes, shaking of the teeth, loss of voice, deafness, absence of sneezing, loss of sense of smell, confusion of memory, fatigue even with sleep, the spittle comes out from a side (of the mouth), closure of one eye, severe pain over the shoulders, half of the oody the lower parts. This (disease) is named as Ardita by some and as Ekayama by some others. ( 34-382 )
रक्तमाश्रित्य पवनः कुर्यान्मूर्धधराः सिराः ॥३९॥
रूक्षाः सवेदनाः कृष्णाः सोऽसाध्यः स्यात् सिराग्रहः ।
Vata invading the rakta (blood) produces dryness, (roughness) pain, black discolouration in the siras ( veins) of the head. This is known as Siragraha. (39)
Paksavadha – hemiplegia
गृहीत्वार्धं तनोर्वायुः सिराः स्नायूर्विशोष्य च ॥४०॥
पक्षमन्यतरं हन्ति सन्धिबन्धान् विमोक्षयन् । कृत्स्नोऽर्धकायस्तस्य स्यादकर्मण्यो विचेतनः ॥४१॥
एकाङ्गरोगं तं केचिदन्ये पक्षवधं विदुः । सर्वांङ्गरोगं तद्वच्च सर्वकायाश्रितेऽनिले ॥४२॥
शुद्धवातहतः पक्षः कृच्छ्रसाध्यतमो मतः । कृच्छ्रस्त्वन्येन संसृष्टो विवर्ज्य: क्षतहेतुकः ॥४३॥
Vata invading half of the body and causing dryness of the siras (veins) and snayus (tendons) and looseness of the joints, kills ( makes inactive) any one half of the body; by this the entire half of the body becomes functionless and senseless. This is called by some as Ekangaroga and by others as Paksavadha.
Similarly is Sarvangaroga, caused when vata invades the whole body. Paksavadha caused by vata alone very difficult to cure, caused by vata associated with others (doshas) is difficult and that which causes emaciation is to be rejected. (40-43)
आमबद्धायनः कुर्यात् संस्तभ्याङ्गं कफान्वितः । असाध्यं हतसर्वेहं दण्डवद्दण्डकं मरुत् ॥४४॥
Vata associating with kapha and invading the channels obstructed by ama produces stiffness and loss of movements of all the parts of the body and makes it resemble a log of wood, This is known as Danndaka. (44)
अंसमूलस्थितो वायुः सिराः सङ्कोच्य तत्रगाः । बाहुप्रस्पन्दितहरं जनयत्यपबाहुकम् ॥ ४५ ॥
Vata located at the base of the shoulders, by constricting the siras (veins) therein, produces Apabahuka, characterised by loss of sensation of the arms. ( 44 )
तलं प्रत्यङ्गुलीनां या कण्डरा बाहुपृष्ठतः । बाहुचेष्टापहरणी विश्वाची नाम सा स्मृता ॥४६॥
The kandaras (big tendons) situated at the back of the arm and connected with the palm and fingers, getting invaded cause loss of movements of the arm, this is by name Visvaci. (46)
वायुःकट्यां स्थितः सक्थ्नः कण्डरामाक्षिपेद्यदा। तदा खञ्जो भवेज्जन्तुः पङ्गुः सक्श्नोर्द्वयोरपि ॥४७॥
When vata localised in the waist, invades the big tendons of the legs, then the person becomes a Khanja (lame by one leg) and Phangu when both the legs are affected (lame by both legs). (47)
कम्पते गमनारम्भे खञ्जन्निव च याति यः । कलायखचं तं विद्यान्मुक्तसन्धिप्रबन्धनम् ॥४८॥
The person shivers (shakes) at the commencement of walking and walks like a lame, with looseness of all the bindings of the joints, is to be understood as Kalayakhanja ( lathyrism ) ( 48 )
Urusthambha
शीतोष्णद्रवसंशुष्कगुरुस्निग्धैर्निषेवितैः । जीर्णाजीर्णे तथायाससङ्क्षोभस्वप्नजागरैः ॥४९॥
सश्लेष्ममेदः पवनमाममत्यर्थसञ्चितम् । अभिभूयेतरं दोषमुरू चेत् प्रतिपद्यते ॥५०॥
सक्थ्यस्थिना प्रपूर्यान्तः श्लेष्मणा स्तिमितेन तत् । तदा स्तनाति तेनोरू स्तब्धौ शीतावचेतनौ ॥५१॥
परकीयाविव गुरू स्यातामतिभृशव्यथौ । ध्यानाङ्गमर्दस्तैमित्यतन्द्राच्छर्द्यरुचिज्वरैः ॥५२॥
संयुतः पादसदनकृच्छ्रोद्धरणसुप्तिभिः । तमूरुस्तम्भमित्याहुराढ्यवातमथापरे ॥५३॥
Indulgence in foods which are cold, hot (heat producing), liquid, dry (moistureless), heavy (hard to digest), fatty, mixing cooked and uncooked, associating with slesama (kapha), excess of exertion, shock (mental), sleep or wakefulness, medas (fat), and the other dosha (pitta) brings the accumilated ama into the thighs, fills the interior of the bones with solidified kapha; then the thighs become motionless, stiff, cold and senseless, feels as though it belongs to others, is heavy and very painful, accompanied with worry, bdoyache, loss of activity, stupor, vomiting, anorexia, fever, along with weakness of the legs, difficulty for lifting, and loss of sense of touch. This disease is called by some as Urusthambha and by others as adhyavata. (49-53)
वातशोणितजः शोफो जानुमध्ये महारुजः । ज्ञेयः क्रोष्टुकशीर्षस्तु स्थूलः क्रोष्टुकशीर्षवत् ॥५४॥
A swelling caused by vata and sonita (blood) in the middle of the leg ( knee joint) resembling the head of a jackal, big and highly painful is known as Krostukasirsa. (54)
रुक् पादे विषमन्यस्ते श्रमाद्वा जायते यदा । वातेन गुल्फमाश्रित्य तमाहुर्वातकण्टकम् ॥५५॥
Vata getting localised in the ankles due to improper placing of the feet or by exertion, causes pain (in the ankles and feet). This is called as Vatakantaka. (55)
पार्ष्णिं प्रत्यङ्गुलीनां या कण्डरा मारुतार्दिता । सक्थ्युत्क्षेपं निगृह्णाति गृध्रसीं तां प्रचक्षते ॥५६॥
The heels or the big tendons of the toes being invaded by maruta (vata) cause inability for lifting (rising) of the leg. This is spoken as Grdhrasi. (56) विश्वाची गृध्रसी चोक्ता रखल्ली तीव्ररुजान्विता ।
Both Visvaci and Grdhrasi, when associated with severe pain become known as Khalli. (57a)
हृष्येते चरणौ यस्य भवेतां च प्रसुप्तवत् ॥५७॥
पादहर्षः स विज्ञेयः कफमारुतकोपजः ॥५८ ॥
Both the legs have pleasurable sensaion (feeling of pins and needles) and or seem. to be asleep (without tactile a sensation) and the disease is known as Padaharsa and is caused by aggravation of kapha and vata together. (57b-58)
पादयोः कुरुते दाहं पित्तासृकसहितोऽनिलः ।
विशेषतश्चङ्क्रमिते पाददाहं तमादिशेत् ॥ ५९॥
Vata in association with pitta and rakta (blood), produces burning sensation in the legs (soles) specially in those who walk too much., is known as Padadaha. (59)
॥ इति पञ्चदशोऽध्यायः ॥
Thus ends the Fifteenth chapter.
