अथातो वातव्याधिनिदानं व्याख्यास्यामः ।
इति ह स्माहुरात्रेयादयो महर्षयः ।
We shall now expund Vatavyadhi nidanam-diagnosis of diseases caused by vata (nervous disorders); thus said Atreya and other great sages.
सर्वार्थानर्थकरणे विश्वस्यास्यैककारणम् ।
अदुष्टदुष्टः पवनः, शरीरस्य विशेषतः
For all the good and bad of the world, pavana (vata) the unvitiated (normal) and the vitiated (abnormal) respectively, is the only cause; especially so in the ( human) body.
स विश्वकर्मा विश्वात्मा विश्वरूपः प्रजापतिः । स्त्रष्टा धाता विभुर्विष्णुः संहर्ता मृत्युरन्तकः ॥ २॥
॥ १ ॥ तददुष्टौ प्रयत्नेन यतितव्यमतः सदा ।
He (vata ) is the doer of all actions, the soul of all (things), possessor of all forms, cheif of all living beings, the creator, supporter and controller of all; is omniscient, destroyer, lord of death and death itself. Hence, all our efforts should be made to maintain it normally always. 2-3a.
तस्योक्तं दोषविज्ञाने कर्म प्राकृतवैकृतम् ॥ ३॥
समासाद्व्यासतो दोषभेदीये नाम धाम च । प्रत्येकं पञ्चधा चारो व्यापारश्च इह वैकृतम् ॥ ४॥
तस्योच्यते विभागेन सनिदानं सलक्षणम् । [ असङ्ख्यमपि सङ्ख्याय यदशीत्या पुरेरितम् ।]
Its functions, when it is normal and abnormal were described in dosa vijnana ( chapter 11 of sutrasthana) in detail, including the names and seats of its five divisions seperately, along with the nature of movement and functions of each. Now its abnormalities will be described along with their causes and specific features (though these are innumerable only eighty (which are common) have been enumerated previously). 3b-5a.
धातुक्षयकरैर्वायुः चरन् स्रोतःसु रिक्तेषु भृशं तान्येव पूरयन् । तेभ्योऽन्दोषपूर्णेभ्यः प्राप्य वाऽऽवरणं बली ॥ ६ ॥
Vayu (vata) gets aggravated (increased) from: over indulgence in things (foods, activities etc.) causing depletion (or loss) of tissues. Bali (vata) then fills up the empty channels (because of tissues depletion) and moves greatly (more than the normal) inside them or by getting enveloped by the other dosas which have filled up the channels. 5b-6.
Notes: Aggravation of vata occurs in two ways viz-a. Occupying the empty channels caused by tissue depletion and producing increased functioning in the channels so occupied and by getting enveloped/surrounded/hindered/by the other dosas which have accumilated in the channels and producing decreased or loss of functioning of the channels and producing decreased or loss of functioning of the channel so affected. In the first kind, vata is the only dosa producing the effect, hence not very powerful; while in the second kind vata is associated with any one or more of the other dosas, hence not very powerful.
Vruddha vata karma – functions of aggravated vata
तत्र पक्वाशये क्रुद्धः शूलानाहान्त्रकूजनम् ।
मलरोधाश्मवर्मार्शस्त्रिकपृष्ठकटीग्रहम् करोत्यधरकाये च तांस्तान् कृच्छ्रानुपद्रवान् । ॥७॥
Vata aggravated (and localised) in the pakvasaya (large intestines) gives rise to colic, flatulence, gurglings in the intestine, obstruction to movement of faeces, urinary calculi, enlargement of the scrotum (hernia), piles, catching pain in the upper part of the back, back and waist and other difficult diseases concerned with the lower parts of the body. 7-8a.
आमाशये तृड्वमथुश्वासकासविसूचिकाः ॥ ८॥ कण्ठोपरोधमुद्गारान् व्याधीनूर्ध्वं च नाभितः ।
Aggravated (and localised) in the amasaya (stomach and small intestine) it produces thirst, vomitting, dyspnoea, cough, indigestion associated with simultaneous vomitting and diarrhoea, obstruction of the throat, more of belchings and diseases in body parts above the umbilicus. 8b-9a.
श्रोत्रादिष्विन्द्रियवधं
In the ear and other sense organs, it causes loss (or diminition) of their sensory function. 9b.
त्वचि स्फुटनरूक्षते॥९॥
रक्ते तीव्रा रुजः स्वापं तापं रागं विवर्णताम् । अरूंष्यन्नस्य विष्टम्भमरुचिं कृशतां भ्रमम् ॥ १० ॥
मांसमेदोगतो ग्रन्थींस्तोदाढ्यान् कर्कशान् श्रमम् । गुर्वङ्गं चातिरुक्स्तब्धं मुष्टिदण्डहतोपमम् ॥ ११ ॥
अस्थिस्थः सक्थिसन्ध्यस्थिशूलं तीव्रं बलक्षयम्। मज्जस्थोऽस्थिषु सौषिर्यमस्वप्नं सन्ततां रुजम् ॥ १२ ॥
शुक्रस्य शीघ्रमुत्सर्गं सङ्गं विकृतिमेव वा । तद्वद्गर्भस्य शुक्रस्थ: सिरास्वाध्मानरिक्तते ॥ १३ ॥
तत्स्थ: स्नाय्वस्थितः कुर्याद्गृध्रस्यायामकुब्जताः। वातपूर्णहतिस्पर्शं शोफं सन्धिगतोऽनिलः ॥ १४ ॥
प्रसारणाकुञ्चनयोः प्रवृत्तिं च सवेदनाम् सर्वाङ्गसंश्रयस्तोदभेदस्फुरणभञ्जनम् । ॥१५॥
स्तम्भनाक्षेपणस्वापसन्ध्याकुञ्चनकम्पनम्.
In the skin, it causes cracks and dryness;
in the blood it gives rise to severe pain, loss of tactile sensation, increase of temperature, redness, discolouration, ulceration, stasis of undigested food in the alimentary tract for long period, loss of taste/appetite, emaciation and dizziness.
In the muscles and fat, it produces tumors with severe pain and hardness, exertion, heavyness of the body, severe pain, rigidity and feeling as though being beaten with the fist or baton.
In the bones it causes pain in the thighs, joints and bones, and profound loss of strength. In the marrow it produces hallowness of the bones, loss of sleep and constant pain.
In the semen it causes premature ejaculation, obstruction (non ejaculation) or abnormal ejaculation, so also of the foetus (premature, obstructed or abnormal delivery of the foetus).
In the veins (and arteries) it causes either their fullness or emptyness.
In the tendons it causes diseases like grdhrasi (sciatica), ayama (tetanus) and kubjata (kyphosis).
Localised in the bony joints anila (vata) produces swelling resembling and inflated leather bag for touch, pain at the commencement of extending and flexing movements.
Localised all over the body it produces pain such as pricking, splitting, throbbing, cutting etc. stiffness ( limitation or absence of movements), convulsions, loss of tactile sensation, contractions of the joints and tremors. 9b-16a.
Aksepaka – convulsions
यदा तु धमनीः सर्वाः कुद्धोऽभ्येति मुहुर्मुहुः ॥ १६ ॥
तदाऽङ्गमाक्षिपत्येष व्याधिराक्षेपकः स्मृतः ।
When the aggravated vata invades all the dhamanis (arteries) or nerves to be more appropriate then it produces constrictions/contractions of the body ( especially of the extremities) again and again. This disease is known as Aksepaka (convulsions). 16b-17a.
Apatantraka – tetanus
अध: प्रतिहतो वायुर्व्रजन्नूर्ध्वं हृदाश्रिताः ॥ १७॥
नाडीः प्रविश्य हृदयं शिरः शङ्खौ च पीडयन् । आक्षिपेत्परितो गात्रं धनुर्वच्चास्य नामयेत् ॥ १८ ॥
कृच्छ्रादुच्छसिति स्तब्धस्त्रस्तमीलितदृक्ततः । कपोत इव कूजेच्च निःसंज्ञः सोऽपतन्त्रकः ॥ १९ ॥
स एव चापतानाख्यो मुक्ते तु मरुता हृदि । अश्नुवीत मुहुः स्वास्थ्यं मुहुरस्वास्थ्यामावृत्ते ॥ २० ॥
Aggravated vata getting obstructed in its downward movement, starts moving upwards, enters into the channels connected to the hrdaya (heart) or brain to be more appropriate) and produces pain in the head and the two temples, constricts the body and bends it like a bow; the patient breaths with difficulty, his eyes are static ( motionless ) drooping down and closed (lids half open ) , makes sound like a peigon, and is unconcious. This disease is Apatantraka, it is known as apatanaka also. When the heart (brain) becomes free from maruta (vata) the person obtains health ( releif from convulsions) momentarily and the ill-health (appearance of convulsions ) again when enveloped / filled with (by vata). 17b-20.
गर्भपातसमुत्पन्नः शोणितातिस्त्रवोत्थितः ।
अभिघातसमुत्थश्च दुश्चिकित्स्यतमो हि सः ॥ २१ ॥
It (apatantraka) caused by abortion, heavy bleeding and trauma (injury to vital organs ) is most difficult to treat. 21.
Antrayama – emprosthotonos
मन्ये संस्तभ्य वातोऽन्तरायच्छन् धमनीर्यदा | व्याप्नोति सकलं देहं जत्रुरायम्यते तदा ॥ २२ ॥
अन्तर्धनुरिवाङ्गं च वेगैः स्तम्भं च नेत्रयोः । करोति जृम्भां दशनं दशनानां कफोद्वमम् ॥ २३ ॥
पार्श्वयोर्वेदनां वाक्यहनुपृष्ठशिरोग्रहम् । अन्तरायाम इत्येष
When vata getting inside the manya dhamanis (arteries / nerves present in the sides of the neck) cause their stiffness and then spreads to all the parts of the body, constricts the shoulders, then makes the body bent inwards like a bow; produces of bouts of convulsions, loss of movements of the eyes, more of yawnings, grinding of the teeth (rigidity of the jaws or lock jaw) vomitting of kapha ( mucus), pain in the flanks, catching (inability ) of speech, catching pain ( loss of movement) of the lower jaw, back and head. This is Antarayama (inward bending ). 22-24b.
Bahirayama – opisthotonos
बाह्यायामश्च तद्विधः ॥ २४ ॥
देहस्य बहिरायामात् पृष्ठतो नीयते शिरः | उरश्रोत्क्षिप्यते तत्र कन्धरा चावमृद्यते ।। २५ ।।
दन्तेष्वास्ये च वैवर्ण्य प्रस्वेदः स्त्रस्तगात्रता । बाह्यायामं धनुष्कम्भं ब्रुवते वेगिनं च तम् ॥ २६ ॥
Similarly so is Bahirayama-outward bending-when the body is bent with head reachig the back, the chest protruding out, the neck extending backward, there is discolouration of the teeth and mouth, profuse sweating, debility of the body.
This is spoken of as Bahyayama, dhanuskambha sthambha) and veginam (episodic). (dhanu24b-26.
Vranayama
व्रणं मर्माश्रितं प्राप्य समीरणसमीरणात् । व्यायच्छन्ति तनुं दोषाः सर्वामापादमस्तकम् ॥ २७ ॥
तृष्यतः पाण्डुगात्रस्य व्रणायामः स वर्जितः ।
The dosas getting localised in wounds situated on vital spots (or organs) get aggravated by samirana (vata) and then spread all over the body from the feet to the head and produce vranayama (convulsions due to traumatic wounds or heamorrhage) associated with thirst and yellowish white colour of the body; this disease should be rejected. 27-28a.
गते वेगे भवेत्स्वास्थ्यं सर्वेष्वाक्षेपकेषु च ॥ २८ ॥
In all types of aksepaka (convulsions) the person obtains health (temporary well being) after the bouts (episodes) pass off.
Notes Aksepaka is convulsions, in general, due to any cause, Apatantraka or apatanaka is Dhanusthambha (tetanus), antarayama and bahirayama are its two kinds of manifestation. Abortion (including miscarriage and abnormalities of delevary), profuse haemorrhage and trauma (injury due to any cause) are some of the common causes, in addition to foods and activities which aggravate vata.
Hanusramsa
जिह्वातिलेखनाच्छुष्कभक्षणादभिघाततः कुपितो हनुमूलस्थ: स्रंसयित्वाऽनिलो हनू ॥ २९ ॥
करोति विवृतास्यत्वमथवा संवृतास्यताम् । हनुस्रंसः स तेन स्यात्कृच्छ्राच्चर्वणभाषणम् ॥ ३० ॥
By too much of scraping of the tongue, eating dry foods, and by trauma (injury), anila (vata) localised at the lower jaw gets aggravated and causes displacement of the lower jaw leading to the mouth being either kept open or closed, associated with difficulty for masticating and speaking; this dis29-30. ease is Hanusramsa.
Jihvasthambha
वाग्वाहिनीसिरासंस्थो जिह्वां स्तम्भयतेऽनिलः ।
जिह्वास्तम्भः स तेनान्नपानवाक्येष्वनीशता ॥ ३१ ॥
When anila ( vata ) gets localised in the veins in (near 1the) vocal cords then it produces loss of movement of the tongue leading to inability to swallow foods, water and to speak; this disease is Jihvasthambha. 31.
Ardita
शिरसा भारहरणादतिहास्यप्रभाषणात् । खरकार्मुककर्षणात् ॥ ३२ ॥
उत्रासवक्त्रक्षवथोः विषमादुपधानाच्च कठिनानां च चर्वणात् । वायुर्विवृद्धस्तैस्तैश्च वातलैरूर्ध्वमास्थितः ॥ ३३ ।।
वक्रीकरोति वक्त्रार्धमुक्तं हसितमीक्षितम् । ततोऽस्य कम्पते मूर्द्धा वाक्सङ्गः स्तब्धनेत्रता ॥ ३४ ।।
दन्तचालः स्वरभ्रंशः श्रुतिहानिः क्षवग्रहः । गन्धाज्ञानं स्मृतेर्मोहस्त्रासः सुप्तस्य जायते ॥ ३५ ॥
निष्ठीव: पार्श्वतो यायादेकस्याक्ष्णो निमीलनम् । जत्रोरूर्ध्वं रुजा तीव्रा शरीरार्धेऽधरेऽपि वा ॥ ३६ ॥ केचिदेकायाममथापरे । तमाहुरर्दितं
Carrying heavy load on the head, over indulgence in laughing, speaking exertion of the face (by acts such as mimicing, others, making faeces, histronic feats etc.), sneezing, bending very hard bows ( iron bars, springs etc. in the present day), use of irregular ( uneven, hard) pillow while sleeping, chewing (biting ) very hard materials and others (food and activities ) cause aggravation of vata, which gets localised in the upper parts of the body and produces irregularities of half of the face; found specially during laughing and seeing, then his head begins to shake, there appears obstruction of speech, loss of movements of the eyes, tremors, shaking of the teeth, hoarseness of voice, deafness, obstruction of sneezing, loss of sense of smell, loss of memory, delusion, exhaustion during sleep, the spittle comes out from the sides of the mouth, one eye is closed, severe pain in the parts above the shoulders, half of the body or lower parts of the body. This disease is called as Ardita by some and as Ekayama by some others. 32-37a.
Siragraha
रक्तमाश्रित्य पवनः कुर्यान्मूर्द्धधरा: सिराः ॥ ३७ ॥ रूक्षाः सवेदना: कृष्णाः सोऽसाध्यः स्यात्सिराग्रहः ।
Pavana (vata) invading/vitiating the blood and getting localised in the veins of the head, makes them rough (hard), painful and black. This is Siragraha, which is incurable. 37b-38a.
Paksavadha
गृहीत्वाऽर्धं तनोर्वायुः सिराः स्नायुर्विशोष्य च ॥ ३८ ॥
पक्षमन्यतरं हन्ति सन्धिबन्धान् विमोक्षयन् । कृत्स्त्रोऽर्धकायस्तस्य स्यादकर्मण्यो विचेतनः ॥ ३९ ॥
एकाङ्गरोगं तं केचिदन्ये पक्षवधं विदुः । सर्वाङ्गरोगं तद्वच्च सर्वकायाश्रितेऽनिले ॥ ४० ॥
शुद्धवातहतः पक्षः कृच्छ्रसाध्यतमो मतः । कृच्छ्रस्त्वन्येन संसृष्टो विवर्ज्य: क्षयहेतुकः ॥ ४१ ॥
Vayu (vata) seizing half of the body, causes dryness of the veins and tendons, destroys ( makes inactive) half of the body ( either left or right) by loosening the joints. By this, half of the body becomes incapable of any functions and insensible (loss of sense of touch). This is called by some as Ekangaroga and by others as Paksavadha.
Likewise, it is sarvangaroga when the entire body is invaded by anila (vata).
Paksavadha caused by vata alone (without the association of pitta or kapha) is most difficult to cure, difficult when associated with others (dosas), that produced because of depletion (or loss of tissues ) is rejectable (incurable). 38b-41.
Dandaka
आमबद्धायनः कुर्यात्संस्तभ्याङ्गं कफान्वितः । असाध्यं हतसर्वेहं दण्डवद्दण्डकं मरुत् ॥ ४२ ॥
Marut (vata) followed by kapha invades all the channels of the body which are filled with ama (undigested food materials) and makes the body stiff like a staff ( log of wood ) with loss of all activities (functions movements); this disease known as Dandaka is incurable. 42.
Apabahuka
अंसमूलस्थितो वायुः सिराः सङ्कोच्य तत्रगाः । बाहुप्रस्पन्दितहरं जनयत्यवबाहुकम् ॥ ४३ ॥
Vayu (vata) located at the root of the shoulders constricts the veins there, produces Apabahuka which causes loss of movement of the arm. 43.
Visvachi
तलं प्रत्यङ्गुलीनां या कण्डरा बाहुपृष्ठतः । बाहुचेष्टापहरणी विश्वाची नाम सा स्मृता ॥ ४४ ॥
The disease which causes constriction of the tendons of the palms and fingers, over the back of the arm leading to loss of function of the arm is known by the name Visvaci. 44.
Khanja-pangu
वायुः कट्यां स्थितः सक्नः कण्डरामाक्षिपेद्यदा । तदा खञ्जो भवेज्जन्तुः पङ्गः सक्योर्द्वयोरपि ॥ ४५ ॥
Vayu localised in the thighs, causes constriction of the tendons there in and gives rise to Khanja (lameness) when one leg is affected and to Pangu (lameness) when both the egs are affected. 45.
Kalavakhanja
कम्पते गमनारम्भे खञ्जन्निव च याति यः । कलायखचं तं विद्यान्मुक्तसन्धिप्रबन्धनम् ॥ ४६ ॥
The legs tremble at the commencement of walking, the patient walks by limping and the bindings of the joints are loosened-this condition is to be known as Kalayakhanja. 46.
Urusthambha
शीतोष्णद्रवसंशुष्कगुरुस्त्रिग्धैर्निषेवितैः । जीर्णाजीर्णे तथाऽऽयाससङ्क्षोभस्वप्नजागरैः ॥ ४७ ॥
संयुतौ सश्लेष्ममेदः अभिभूयेतरं दोषमुरू सक्थ्यस्थीनि प्रपूर्यान्तः श्लेष्मणा स्तिमितेन तत् ।
तदा स्तभ्नाति तेनोरू स्तब्धौ शीतावचेतनौ ॥ ४९ ।।
परकीयाविव स्यातामतिभृशव्यथौ । गुरू ध्यानाङ्गमर्दस्तैमित्यतन्द्राच्छर्द्यरुचिज्वरैः पवनमाममत्यर्थसञ्चितम् । चेत्प्रतिपद्यते ॥ ४८
।। ५०॥ पादसदनकृच्छ्रोद्धरणसुप्तिभिः । तमूरुस्तम्भमित्याहुराढ्यवातमथापरे ॥५१॥
Over indulgence in foods which are cold, hot, liquid, dry, heavy (not easy for digestion), fatty, either cooked or uncooked; exertion, debility, sleep or avoidance of sleep, etc. bring about aggravation of vata associated with slesma ( kapha), medas ( fat tissue) and ama (undigested food metabolities) which accumulate in the thighs, fill up the interior of the thigh bone with kapha, making the thigh stiff and inactive; it becomes cold, senseless as though it belongs to another person, heavy and with severe pain; the patient is greatly worried, has bodyaches, inactive, stupor, vomitting, loss of appetite/taste, fever, weakness of the feet, difficulty in lifting and loss of tactile sensation, This disease is designated as Urusthambha by some and as Adhyavata by some others. 47-51.
Krostuka sirsaka
वातशोणितजः शोफो जानुमध्ये महारुजः । ज्ञेयः क्रोष्टकशीर्षश्च स्थूलः क्रोष्टकशीर्षवत् ॥ ५२ ॥
A swelling in the middle of the knee arising from (aggravated) vata and sonita (blood), highly painful, thick (big) resembling the head of a jackle is to be known as Krostukasirsa. 52.
Vatakantaka
रुक् पादे विषमन्यस्ते श्रमाद्वा जायते यदा । वातेन गुल्फमाश्रित्य तमाहुर्वातकण्टकम् ॥ ५३॥
Vata getting localised in the ankle joint either by placing the foot improperly (while walking) or by over exertion to the feet) produces pain in the ankles. This is called as Vatakantaka. 53.
Grdhrasi
पाष्णि प्रत्यङ्गुलीनां या कण्डरा मारुतार्दिता ।
सक्थ्युत्क्षेपं निगृह्णाति गृध्रसीं तां प्रचक्षते ॥ ५४॥
Tendons of the feet getting vitiated by maruta (vata) cause pain moving towrds the ankles or the toes and make the lifting of the thigth up very difficult; this is called as Grdhrasi. 54.
Khalli
विश्वाची गृध्रसी चोक्ता खल्ली तीव्ररुजान्विते ।
Visvaci and grdhrasi when accompanied with severe pain are called as Khalli. 55a.
Padaharsa
हृष्येते चरणौ यस्य भवेतां च प्रसुप्तवत् ॥ ५५ ॥ पादहर्षः स विज्ञेयः कफमारुतकोपजः ।
The feet having tingling (pins and needles) sensation and seem to be sleeping (with loss of tactile sensation) is to be understood as padaharsa arising from aggravation of kapha and maruta (vata). 55b-56a.
Padadaha
पादयोः कुरुते दाहं पित्तासृक्सहितोऽनिलः ॥ ५६॥
विशेषतश्चङ्क्रमिते पाददाहं तमादिशेत् ।। ५६ ।। Anila (vata) associated with pitta and asrk (blood) produces burning sensation in the feet (soles) in persons who walk more. This is known as padadaha. 56-56.
इति श्री वैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां तृतीये निदानस्थाने वातव्याधिनिदानं नाम पञ्चदशोऽध्यायः ॥ १५ ॥
Thus ends the chapter Vatavyadhi nidana-the fifteenth in of Astangahrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
