The first chapter of Nidanasthana of Sushruta Samhita is called as Vata Vyadhi Nidanam Adhyaya. This chapter offers with Illnesses of the Nervous System.
अथातो वातव्यधिनिदानं व्याख्यास्यामः ॥१॥
यथोवाच भगवान धन्वन्तरिः॥२॥
Now, we are going to expound the prognosis of Vata Vyadhi (ailments brought on by aggravated Vata, Vis-à-vis ailments of nervous system); as revealed by the venerable Dhanvantari.
धन्वन्तरिं धर्मभृतां वरिष्ठममृतोद्भवम ॥
चरनावुपसंगृह्य सुश्रुतः परिपृच्छति ॥३॥
वायोः प्रकृतिभूतस्य व्यापन्नस्य च कोपनैः ॥
स्थानं कर्म च रोगांश्च वद मे वदतां वर ॥४॥
Sushruta bowed all the way down to the toes of Grasp Dhanvantari who was identified to be the chief amongst those that adopted and maintained Dharma – righteous way of life or ethical code of dwelling and who was born with Amrta – nectar. After providing his respects to his grasp, he requested – ‘Sir, you being the perfect among the many expounders, please let me know in regards to the seats and features of Vata, each – in its regular and irregular states. Additionally enumerate the causes for its abnormality and ailments produced by it’.
Nature and qualities of Vata
तस्य तद्वचनं श्रुत्वा प्राब्रवीद्भिषजां वरः ॥
स्वयंभूरेष भगवान् वायुरित्यभिशब्दितः ॥५॥
स्वातन्त्र्यान्निभावाच्च सर्वगत्वात्तथैव च ॥
सर्वेषामेव सर्वात्मा सर्वलोकनमस्कृतः ॥६॥
स्थित्युत्पत्तिविनाशेषु भूतानामेष कारणम ॥
अव्यक्तो व्यक्तकर्मा च रूक्षः शीतो लघुः खरः ॥७॥
तिर्यग्गो द्विगुणश्चैव रजोबहुल एव च ॥
अचिन्त्यवीर्यो दोषाणां नेता रोगसमूहराट् ॥८॥
आशुकारी मुहुश्चारी पक्वाधानगुदालयः ॥
After having heard the phrases of request from Sushruta, the perfect doctor, revered Lord Dhanvantari started explaining thus –
‘Bhagavan (God) Vayu is Swayambhu – is a self-born divinity. This vayu is unbiased and eternal. It’s an all-pervading and practical entity in all dwelling and nonliving issues. Vayu is extremely revered and worshiped by the whole world and all of the world. Vayu is the trigger for upkeep, start and dying of all dwelling beings. Regardless of it being invisible, vayu is knowable via its actions. It’s dry, chilly, mild, tough and strikes in all of the instructions. Vayu has two qualities i.e. sabda – sound and Sparsha – contact. Being predominant in Rajo Guna, Vayu is extremely highly effective. It’s the chief of doshas and likewise spreads them. Vayu can also be the king of teams of ailments. It’s fast performing, strikes continuously and primarily dwells in Pakvadana – massive gut and Guda – rectum.
Capabilities of Anila (Vata)
देहे विचरतस्तस्य लक्षणानि निबोध मे ॥९॥
दोषधात्वग्रिसमतां संप्राप्तिं विषयेषु च ।
क्रियाणामानुलोम्यं च करोंत्यकुपितोऽनिलः ॥
Now hearken to the features of Vata.
It pervades the whole physique.
In a state of its stability and when not aggravated, this Vayu renders the beneath talked about useful features –
- Maintains normalcy of doshas, dhatus and agni
- Helps the sense organs to understand their respective sense objects
- Initiates the features of the physique, thoughts and speech
Pancha Vata-five divisions of vata
यथाऽग्रिः पञ्चधा भिन्नो नामस्थानक्रियामयैः ॥
भिन्नोऽनिलस्तस्था ह्येको नामस्थानक्रियामयैः ॥११॥
Identical to the agni i.e. pitta is of 5 varieties in respect of its names, seats, features and ailments that it causes, Vata too, regardless of being just one, is split into 5 sorts in respect of its names, seats, features and the ailments it produces.
5 sorts of Vata
Prana Vata
यो वायुर्वक्रसंचारी स प्राणो नाम देहधृक॥
सोऽन्नं प्रवेशयत्यन्तः प्राणांश्चाप्यवलम्बते ॥१३॥
प्रायशः कुरुते दृष्टो हिक्काश्वासादिकान् गदान् ॥
Prana is that type of vayu which strikes within the mouth.
This vayu
- helps the physique
- helps in transferring the ingested meals contained in the alimentary tract
- maintains and helps the Prana – life, and its features
When the identical Prana Vata will get aggravated, it usually causes ailments like hiccups, dyspnea and so on.
Udana Vata
उदानो नाम यस्तूर्ध्वमुपैति पवनोत्तमः ॥१४॥
तेन भाषितगीतादिविशेषोऽभिप्रवर्तते॥
ऊर्ध्वजत्रुगतान् रोगान् करोति च विशेषतः ॥१५॥
Udana is that vayu which strikes in an upward path.
Udana Vayu helps in attaining the actions of singing, talking and such others. When the identical Udana Vayu will get aggravated, it produces ailments of the organs above the shoulders.
Samana Vata
आमपक्वाशयचरः समानो वह्निसङ्गतः ॥
सोऽत्रं पचति तज्जांश्च विशेषान्विविनक्ति हि ॥१६॥
गुल्माग्रिसादातीसारप्रभृतीन कुरुते गदान् ॥
Samana is that Vayu which strikes within the amasaya – abdomen and small gut and Pakvasaya – colon (massive gut)
This Samana Vayu after getting related to Agni – the digestive hearth, cooks (digests) the meals correctly and separates the essence and waste merchandise from the digested meals.
The identical Samana Vayu, when aggravated, causes ailments like belly tumors, weak point of digestion, diarrhea and so on.
Vyana Vata
कृत्स्नदेहचरो व्यानो रससंवहनोद्येतः ॥१७॥
स्वेदासृकस्त्रावणश्चापि पञ्चाधा चेष्टयत्यपि ॥
कुद्धश्च कुरुते रोगान् प्रायशःसर्वदेहगान् ॥१८॥
Vyana is Vayu which travels all around the physique.
This Vyana Vayu –
- circulates the rasa
- eliminates sweat and
- helps correct circulation of blood,
- performs 5 sorts of motion – enlargement, contraction, upward, downwards and sideward actions
The identical Vyana Vata, when aggravated, usually produces ailments affecting the entire physique.
Apana Vata
पक्वाधानालयोऽपानः काले कर्षति काले कर्षति चाप्यधः ॥
समीरणः शकृन्मुत्रं शुक्रगर्भार्तवानि च ॥।१९॥
कुद्धश्च कुरुते रोगान् घोरान् बस्तिगुदाश्रयान् ॥
Apana is that Vayu which resides in Pakvadana – massive gut.
Apana Vayu eliminates –
flatus,
feces,
urine,
semen,
fetus and
menstrual fluid
The identical Apana Vayu when aggravated offers rise to dreadful ailments of urinary bladder and rectum.
शुक्रदोषप्रमेहस्तु व्यानापानप्रकोपजाः ॥२०॥
युगपत् कुपिताश्चापि देहं भिन्द्युरसंशयम्॥
When Vyana Vayu and Apana Vayu are concurrently aggravated, ailments of semen and diabetes are prompted. When all forms of Vata get aggravated concurrently, they are going to undoubtedly destroy the entire physique.
Asayagata vata vikara: Abnormalities within the viscera brought on by Vata
अत ऊर्ध्वं प्रवक्ष्यामि नानास्थानान्तराश्रितः ||२१||
बहुशः कुपितो वायुर्विकारान् कुरुते हि यान् |
वायुरामाशये क्रुद्धश्छर्द्यादीन् कुरुते गदान् ||२२||
मोहं मूर्च्छां पिपासां च हृद्ग्रहं पार्श्ववेदनाम् |
पक्वाशयस्थोऽन्त्रकूजं शूलं [२] नाभौ करोति च ||२३||
कृच्छ्रमूत्रपुरीषत्वमानाहं त्रिकवेदनाम् |
श्रोत्रादिष्विन्द्रियवधं कुर्यात् क्रुद्धः समीरणः ||२४||
After this, the abnormalities produced by aggravated vata somewhere else of the physique shall be described.
Ashaya during which aggravated vata is seated Signs
Amashaya Gata Vata – Vata aggravated in abdomen (and small intestines) Illnesses like vomiting and so on.
Delusion
Fainting
Thirst
Extreme catching / gripping ache within the area of coronary heart
Ache in flanks
Pakvashaya Gata Vata – Aggravated vata seated in massive gut or aggravation of vata in massive gut Gurgling noise within the stomach
Ache across the navel area
Problem in voiding urine and feces
Flatulence
Low again / sacral ache
Shrotradishu Gata Vata – Aggravated vata localized in ears and so on. (sense organs) Lack of sensory notion of the associated indriya / indriyas whereby vata will get aggravated
Dhatugata Vata Vikara: Abnormalities of vata within the tissues
वैवर्ण्यं स्फुरणं रौक्ष्यं सुप्तिं चुमुचुमायनम् |
त्वक्स्थो निस्तोदनं कुर्यात् त्वग्भेदं परिपोटनम् ||२५||
व्रणांश्च रक्तगो, ग्रन्थीन् सशूलान् मांससंश्रितः |
तथा मेदःश्रितः कुर्याद्ग्रन्थीन्मन्दरुजोऽव्रणान् ||२६||
कुर्यात् सिरागतः शूलं सिराकुञ्चनपूरणम् |
स्नायुप्राप्तः स्तम्भकम्पौ शूलमाक्षेपणं तथा ||२७||
हन्ति सन्धिगतः सन्धीन् शूलशोफौ करोति च |
अस्थिशोषं प्रभेदं च कुर्याच्छूलं च तच्छ्रितः ||२८||
तथा मज्जगते रुक् च न कदाचित् प्रशाम्यति |
अप्रवृत्तिः प्रवृत्तिर्वा विकृता शुक्रगेऽनिले ||२९||
Tissues and constructions during which aggravated vata is localized Signs
Tvakstha Vata – Aggravated vata residing in pores and skin (rasa dhatu) Look of irregular colours within the pores and skin
Throbbing sensation
Roughness
Lack of sensation / lack of consciousness
Tingling sensation
Steady pricking ache
Cracks / fissures within the pores and skin, all around the physique
Peeling off of the pores and skin
Raktagata Vata – aggravated vata localized within the blood Ulcers are fashioned
Mamsagata Vata – aggravated vata localized in muscle mass Painful cystic swellings / tumors
Medogata Vata – aggravated vata localized in fats Cystic swellings / tumors which have delicate ache and are non-ulcerating
Siragata Vata – aggravated vata localized in veins (blood vessels) Ache
Contraction of veins / blood vessels
Fullness of veins / blood vessels
Snayugata Vata – aggravated vata localized in ligaments Stiffness
Tremors
Ache
Convulsions
Sandhigata Vata – aggravated vata localized in bony joints Destroys the actions of the joints
Ache in joints
Swelling in joints
Asthigata Vata – aggravated vata localized within the bones Dryness of the bones
Fractures
Ache within the bones
Majjagata Vata – aggravated vata localized in bone marrow Dryness
Ache which doesn’t subside in any respect
Shukragata Vata – aggravated vata localized in semen tissue Extreme elimination or improper elimination of semen
Motion of irregular vata within the physique
हस्तपादशिरोधातूंस्तथा संचरति क्रमात् ॥
व्याप्रुयाद्वाऽखिलं देहं वायुःसर्वगतो नृणाम् ॥३०॥
स्तम्भनाक्षेपणस्वापशोफशूलानि सर्वगः ॥
Sarvagata Vata
The aggravated vata successively impacts the fingers, toes, head and tissues one after the opposite. It additionally impacts the whole physique when all of the tissues of the physique are invaded by the aggravated vata.
The aggravated vata transferring and pervading the whole physique produces the beneath talked about signs –
lack of actions
convulsions
lack of sensation
swelling and
ache
Affiliation of vata with different doshas and its localization in varied organs
स्थानेषूक्तेषु संमिश्रः संमिश्राः कुरुते रुजः ॥३१॥
कुर्यादवयवप्राप्तो मारुतस्त्वमित्न् गदान् ॥
When related to different doshas i.e. pitta and kapha, the aggravated vata offers rise to blended sorts of pains and signs within the locations of the physique talked about above.
The aggravated vata produces innumerable ailments when localized in varied organs.
Avarana Vata: Vata coated / obstructed by different Doshas
दाहसंतापमूर्च्छाः स्युर्वायौ पित्तसमन्विते ॥३२॥
शैत्यशोफगुरुत्वानि तस्मिन्नेव कफावृते ॥
सूचीभिरिव निस्तोदः स्पर्शद्वेषः प्रसुप्तता॥३३॥
शेषाः पित्ताविकाराः स्युर्मारुते शोणितान्विते ॥
प्राणे पित्तावृते छर्दिर्दाहश्चैवोपजायते ॥३४॥
दौर्बल्यंसदनं तन्द्रा वैवर्न्यं च कफावृते ॥
उदाने पित्तसंयुक्ते मूर्च्छदाहभ्रमक्लमाः ॥३५॥
अस्वेदहर्षौ मन्दोऽग्रिः शीतस्तम्भौ कफावृते॥३६॥
कफाधिकं च विण्मूत्रं रोमहर्षः कफवृते ॥
अपाने पित्तसंयिक्ते दाहौष्णये स्यादसृग्दरः ॥३७॥
अधःकायगुरुत्वं च तस्मिन्नेव कफावृते॥
व्याने पित्तावृते दाहो गात्रविक्षेपणं क्लमः ॥३८॥
गुरुणि सर्वगात्राणि स्तम्भनं चास्थिपर्वणाम् ॥
लिङ्गं कफावृते व्याने चेष्टास्तम्भस्तथैव च ।३९॥
Vata enveloped / blended with pitta offers rise to –
burning sensation,
improve of physique temperature
fainting
Vata enveloped by Kapha produces the beneath talked about signs –
coldness
swelling
heaviness
Vata enveloped by Rakta – blood will trigger –
ache as if pricked by needles
aversion to the touch
numbness – lack of sensation
different signs of pitta aggravation
Prana Vata enveloped by pitta causes –
vomiting
burning sensation
Prana Vata enveloped by kapha causes –
weak point
fatigue
drowsiness / stupor
discoloration
Udana Vata enveloped by Pitta causes –
fainting
burning sensation
giddiness
exhaustion
Udana Vata enveloped by Kapha causes –
absence of sweating
horripilations
weak digestion
coldness
stiffness / lack of motion
Samana Vata enveloped by Pitta causes –
sweating
burning sensation
elevated warmth
fainting
Samana Vata enveloped by Kapha causes –
improve of kapha
extreme formation of feces and urine
horripilation
Apana Vata enveloped by Pitta produces –
burning sensation
extreme warmth
menorrhagia
Apana Vata enveloped by Kapha causes –
heaviness within the decrease portion of the physique
Vyana Vata enveloped by pitta causes –
burning sensation
irregular actions of the physique elements
exhaustion
Vyana Vata coated by Kapha causes –
heaviness of the physique
stiffness of the bony joints – primarily interphalangeal joints and
lack of actions or stiffness of limbs and different elements of the physique
Notes: – Avarana means enveloping or masking. Functionally it means hindering or obstruction of actions or features of vata. Vata will be enveloped by different doshas i.e. pitta or kapha or by dhatus or by its personal subtypes. As a rule, it is just vata or subtype of vata that’s enveloped. The obstructed vata known as avruta. That which envelopes vata or subtype of vata and hampers its features and actions known as avaraka. The mechanism during which an Avaraka envelopes Avruta and interferes with its features known as Avarana. The signs of Avaraka are usually extra highly effective.
Vatarakta Vyadhi: Gout
प्रायशः सुकुमाराणां मिथ्याऽऽहारविहारिणम् ॥
रोगाध्वप्रमदामद्यव्यायामैश्चातिपिडनात् ॥४०॥
ऋतुदात्म्यविपर्यासात्स्नेहादीनां च विभ्रमात् ॥
अव्यवाये तथा स्थूले वातरक्तं प्रकुप्यति॥४१॥
हस्त्यश्वोष्ट्रैर्गच्छतोऽन्यैश्च वायुः कोपं यातः कारणैः सेवितैः स्वैः ॥
तीक्ष्णोष्णाम्लक्षारशाकादिभोज्यैः संतापाद्यैर्भूयसा सेवितैश्च ॥४२॥
क्षिप्रं रक्तं दुष्टिमायति तच्च वायोर्मार्गं संरुणद्धचाशु यातः ॥।
कुद्धोऽत्यर्थं मार्गरोधात् स वायुरत्युद्रिकं दूषयेद्रक्तमाशु ॥४३॥
तत् संपृक्तं वायुना दूषितेन तत्प्राबल्यादुच्यते वातरक्तम् ॥
तद्वत् पित्तं दूषितेनासृजाऽऽक्तं श्लेष्मा दुष्टो दूषितेनासृजाऽऽक्तः ॥४४॥
Etiological elements of Vatarakta – Usually, Vatarakta arises within the beneath talked about individuals / in beneath talked about situations –
in these of tender structure (physique)
in those that excessively bask in unhealthy meals and actions
in these severely exhausted because of the results of long-standing ailments
in those that are accustomed to lengthy distance strolling and sexual indulgence
in those that drink wine or different alcoholic drinks in extra
in those that excessively bask in bodily actions
in those that bask in meals and actions that are reverse to the character of the seasons and accustomed ones (meals and actions)
those that have been administered with improper oleation and different therapies
in those that abstain from copulation and
in those that are overweight
Pathogenesis of Vatarakta –
Vayu will get excessively aggravated because of the beneath talked about causes –
often and excessively using on elephant, horse, camel and so on. for lengthy durations of time and such different causes
extreme indulgence in greens / meals having penetrating high quality, scorching efficiency, bitter and alkaline style
exhaustion by warmth and so on.
The vata thus aggravated shortly causes vitiation of rakta. This rakta in flip obstructs the trail of vata. The vata present process nice aggravation on account of its path being obstructed by blood, causes nice vitiation of the blood. On this illness, the vitiated rakta is mixed with drastically aggravated vata whereby vata could be very predominant. Subsequently, this illness known as Vatarakta.
Equally, when aggravated pitta combines with vitiated blood will probably be referred to as pittarakta. Additionally, the aggravated kapha mixed with vitiated blood will trigger a situation known as kapharakta.
Signs of Vatarakta brought on by affiliation of vata with varied aggravated doshas
स्पर्शोद्विग्रौ तोदभेप्रशोषस्वापोपेतौ वातरक्तेन पादौ ॥
पित्तासृग्भ्यामुग्रदाहौ भवेतामत्यर्थोष्णौ रक्तशोफौ मृदू च ॥४५॥
कण्डूमन्तौ श्वेतशीतौ सशोफौ पीनस्तब्धौ श्लेष्मदुष्टे तु रक्ते॥
सर्वैर्दुष्टे शोणिते चापि दोषाः स्वं स्वं रूपं पादयोर्दर्शयन्ति ॥४६॥
Beneath talked about are the signs of Vatarakta brought on by predominance of aggravated Vata and Rakta –
- intolerance in direction of contact within the toes
- pricking and slicing forms of ache
- extreme dryness
- lack of sensation
Beneath talked about are the signs of Vatarakta brought on by predominance of aggravated Pitta and Rakta –
- extreme burning sensation
- extreme warmth
- redness
- swelling
- softness of the swelling
Beneath talked about are the signs of Vararakta brought on by predominance of aggravated Kapha and Rakta –
- itching
- whitish discoloration
- feeling of coldness on contact
- swelling bulged up
- immobility of toes
Beneath talked about are the signs of Vatarakta brought on by predominance of all doshas (aggravated) related to aggravated rakta (blood) –
signs of respective doshas concerned within the pathogenesis are manifested within the legs Purvarupa:
Premonitory signs
प्राग्रूपे शिथिलौ स्विन्नौ शीतलौ सविपर्ययौ |
वैवर्ण्यतोदसुप्तत्वगुरुत्वौषसमन्वितौ ।।४७ ।।
Beneath talked about signs will be seen within the toes throughout the premonitory stage of Vatarakta –
- looseness or weak point of the toes
- sweating
- chilly or scorching on contact
- discolored
- pricking sensation / ache
- lack of sensation
- heaviness and
- burning sensation
Unfold of the illness
पादयोर्मूलमास्थाय कदाचिद्धस्तयोरपि ।।
आखोर्विषमिव क्रुद्धं तद्देहमनुसर्पति ।।४८ ।।
Vatarakta stays rooted within the toes and typically even within the fingers. When it will get elevated, the illness spreads all around the physique. The unfold of the illness to all elements of the physique has been in comparison with the unfold of rat poison, which additionally spreads in fast time.
Prognosis of Vatarakta
आजानुस्फुटितं यच्च प्रभिन्नं प्रत्रुतं च यत् ।।
उपद्रवैश्च यज्जुष्टं प्राणमांसक्षयादिभिः ।।४९ ।।
शोणितं तदसाध्यं स्याद्याप्यं संवत्सरोत्थितम् ।।
The prognosis is dangerous and vatarakta is incurable in presence of the beneath talked about indicators and signs –
- cracks and fissures unfold out from toes to the knee joints
- pores and skin is damaged
- exudation of fluids
- presence of issues like lack of prana – the very important life vitality or power and muscle mass and so on.
Then again, vatarakta which persists for greater than a 12 months is taken into account to be manageable however can’t be utterly cured (i.e. it persists to remain).
Akshepaka: Convulsions
यदा तु धमनीः सर्वाः कुपितोऽभ्येति मारुतः ||५०||
तदाक्षिपत्याशु मुहुर्मुहुर्देहं मुहुश्चरः |
मुहुर्मुहुस्तदाक्षेपादाक्षेपक इति स्मृतः ||५१||
The aggravated vata invades all of the dhamanis i.e. nerves of the physique. Doing so, the aggravated vata would shortly trigger vigorous actions of the physique. These actions happen repeatedly. This illness known as as Akshepaka as a result of the vigorous actions of the physique elements happen repeatedly.
Apatanaka
सोऽपतानकसंज्ञो यः पातयत्यन्तगऽन्तरा ।।
कफान्वितो भृशं वायुस्तास्वेव यदि तिष्ठति ।।५२ ।।
स दण्डवत् स्तम्भयति कृच्छ्रो दण्डापतानकः ।।
हनुग्रहस्तदाऽत्यर्थ सोऽन्नं कृच्छ्रान्निषेवते ।।५३ ।।
धनुस्तुल्यं नमेद्यस्तु स धनुःस्तम्भसंज्ञकः ।।
अङ्गुलीगुल्फजठरहद्वक्षोगलसंश्रितः ।।५४ ।।
स्नायुप्रतानमनिलो यदाऽऽक्षिपति वेगवान् ।।
विष्टब्धाक्षः स्तब्धहनुर्भग्नपार्श्वः कर्फ वमन् ।।५५ ।।
अभ्यन्तरं धनुरिव यदा नमति मानवः ।।
तदाऽस्याभ्यन्तरायामं कुरुते मारुतो बली ।।५६ ।।
बाह्यस्नायुप्रतानस्थो बाह्यायामं करोति च ।।
तमसाध्यं बुधाः प्राहुर्वक्षःकट्यूरुभञ्जनम् ।।५७ ।।
कफपित्तान्वितो वायुर्वायुरेव च केवलः ।।
कुर्यादाक्षेपकं त्वन्यं चतुर्थमभिघातजम् ।।५८ ।।
Apatanaka – The situation of Akshepaka during which the particular person falls on the bottom in between the bouts of convulsions is called Apatanaka.
Dandapatanaka – Vatawould get drastically aggravated and on discovering the affiliation with kapha would reside in the identical dhamanis talked about above. Following this, the vata in affiliation with kapha would make the physique stiff, like a log of wooden. This illness known as Dandapatanaka, which is alleged to be troublesome to remedy.
Hanugraha – A situation brought on by vata during which the particular person eats the meals with nice problem known as Hanugraha, which suggests rigidity or stiffness of the decrease jaw (lock-jaw).
Dhanustambha – Dhanustambha is a situation during which the physique is bent like a bow. This bending of the physique is brought on by Aksepaka.
Abhyantarayama – It’s a situation brought on by vata which has received localized within the community of ligaments of the toes, ankle, stomach, coronary heart, chest and throat, producing highly effective actions. Herein, the aggravated vata bends the physique of the particular person inwards, like a bow and therefore known as Abhyantarayama. Beneath talked about are the signs of this situation –
- highly effective actions of the physique elements
- convulsions happen in bouts
- bulging of eyes
- rigidity
- lack of motion of the decrease jaw
- curvature (fracture or distortion) of the flanks
- vomiting of kapha
Bahyayama – Bahyayama is a situation prompted when aggravated Vata will get localized within the exterior community of snayu (ligaments, nerves) and bends the physique outwards. Smart folks contemplate this situation as incurable when it’s related to distortion of chest, waist and thighs.
Vāta produces aksepaka – convulsions all by itself or when related to both kapha or pitta. The fourth type of aksepaka is produced by trauma.
Prognosis of Apatanaka
गर्भपातनिमित्तश्च शोणितातित्रवाच्च यः ।।
अभिघातनिमित्तश्च न सिध्यत्यपतानकः ।।५९ ।।
Apatānaka doesn’t get cured when –
- it’s brought on by abortion,
- it’s prompted on account of extreme hemorrhage and
- it’s prompted on account of trauma
Paksāghāta: Hemiplegia
अधोगमाः सतिर्यग्गा धमनीरूर्ध्वदेहगाः |
यदा प्रकुपितोऽत्यर्थं मातरिश्वा प्रपद्यते ||६०||
तदाऽन्यतरपक्षस्य सन्धिबन्धान् विमोक्षयन् ।।
हन्ति पक्षं तमाहुर्हि पक्षाघातं भिषग्वराः ।।६१ ।।
यस्य कृत्स्नं शरीरार्धमकर्मण्यमचेतनम् ।।
ततः पतत्यसून् वाऽपि त्यजत्यनिलपीडितः ।।६२ ।।
शुद्धवातहतं पक्षं कृच्छ्रसाध्यतमं विदुः ।।
साध्यमन्येन संसृष्टमसाध्यं क्षयहेतुकम् ।।६३ ।।
Pathogenesis –
Severely aggravated vata
↓
Invades the dhamanis (nerves, ligaments) positioned within the downward, sideward and upward instructions / elements of the physique
↓
And causes loosening of the bindings of the joints and
↓
Destroys one half of the physique
↓
This situation known as as Pakshaghata by the perfect physicians
Signs –
- half of the bothered physique turns into incapable of any work or exercise i.e. there shall be no actions or actions within the bothered a part of the physique
- the particular person turns into unconscious (alt – lack of sensation to the touch on the affected facet) or
- the particular person might even die
If the destruction of half of the physique is brought on by vata alone, it can develop into very troublesome to remedy. Then again, if vata is related to different doshas i.e. pitta or kapha, the illness turns into curable. The illness turns into incurable when it causes lower or lack of tissues.
Apatantraka: Tetanus
वायुरूर्ध्वं व्रजेत् स्थानात् कुपितो हृदयं शिरः |
शङ्खौ च पीडयत्यङ्गान्याक्षिपेन्नमयेच्च सः ||६४||
निमीलिताक्षो निश्चेष्टः स्तब्धाक्षो वाऽपि कूजति |
निरुच्छ्वासोऽथवा कृच्छ्रादुच्छ्वस्यान्नष्टचेतनः ||६५||
स्वस्थः स्याद्धृदये मुक्ते ह्यावृते तु प्रमुह्यति |
कफान्वितेन वातेन ज्ञेय एषोऽपतन्त्रकः ||६६||
Pathogenesis –
The aggravated vata strikes upwards from its place (regular seat)
↓
and invades the areas of coronary heart, head and temples and
↓
produces ache, convulsions and bending of the physique
↓
this illness is produced by vata in affiliation with kapha
↓
and known as as Apatantraka
Signs of Apatantraka –
- pains
- convulsions
- bending of physique
- eyes are closed, inactive and there may be lack of actions of the eyes
- moaning i.e. delicate sounds of struggling is heard as coming from the throat
- no respiration or respiration with problem
The particular person turns into regular and wholesome when his coronary heart turns into free and turns into unconscious when his coronary heart will get enveloped.
Mañyā sthambha: Stiff neck / wry neck
मन्यास्तम्भं प्रकुरुते स एव श्लेष्मणाऽऽवृतः ।।६७ ।।
Causes –
- extreme sleeping throughout day time
- improper means of sitting or standing (improper posture)
- extreme gazing upwards
Pathogenesis – As a result of above stated causes, vata will get aggravated and enveloped by kapha, producing Manyastambha.
Signs – rigidity or loss or motion of the neck and shoulders
Ardita: Facial paralysis
गर्भिणीसूतिकाबालवृद्धक्षीणेष्वसृक्क्षये ।
उच्चैया॑हरतोऽत्यर्थं खादतः कठिनानि वा ।।
हसतो जृम्भतो भाराद्विषमाच्छयनादपि ।।६८ ।।
शिरोनासौष्ठचिबुकललाटेक्षणसन्धिगः ।।
अर्दयित्वाऽनिलो वक्त्रमर्दितं जनयत्यतः ।।६९ ।।
वक्रीभवति वक्त्रार्धं ग्रीवा चाप्यपवर्तते ।।
शिरश्चलति वाक्सङ्गो नेत्रादीनां च वैकृतम् ।।७० ।।
ग्रीवाचिबुकदन्तानां तस्मिन् पार्श्वे तु वेदना ।।
यस्याग्रजो रोमहर्षी वेपथुनॆत्रमाविलम् ।।७१ ।।
वायुरूर्ध्वं त्वचि स्वापस्तोदो मन्याहनुग्रहः ।।
तमर्दितमिति प्राहुाधिं व्याधिविशारदाः ।।७२ ।।
क्षीणस्यानिमिषाक्षस्य प्रसक्तं सक्तभाषिणः ।।
न सिध्यत्यर्दितं बाढं त्रिवर्षं वेपनस्य च ।।७३ ।।
Causative elements – Beneath talked about are the etiological elements of ardita –
- lack of blood within the pregnant ladies, girl after supply, kids, previous individuals, the debilitated individuals and others
- shouting loudly,
- consuming onerous meals or issues,
- laughing out loudly,
- yawning excessively,
- carrying heavy weights on the top,
- adopting improper postures in sleeping and so on,
Pathogenesis – In these individuals Vata will get (aggravated and) localized in locations akin to the top, nostril, lips, chin, brow and eyes, produces ache in these and offers rise to Ardita.
Signs – On this, - half the face turns into distorted (irregular) so additionally the neck;
- there may be shaking of the top,
- obstruction to talking, problems of the attention and so on,
- ache within the neck, chin and enamel of that facet
Premonitory signs – embrace – - horripilations,
- tremors,
- dirtiness of the eyes / tear crammed within the eyes,
- vayu transferring in upward instructions (and inflicting belching and so on situations)
- numbness of the pores and skin,
- pricking ache,
- stiffness / rigidity of nape of the neck / shoulders and decrease jaw
This illness known as Ardita, by specialists of ailments.
Ardita is incurable –
- in weak individuals
- in those that don’t wink their eyes
- in these whose speech is consistently obstructed
- when it persists for greater than three years
- when it’s related to shaking of head
Gridhrasi: Sciatica
पार्ष्णिप्रत्यङ्गुलीनां तु कण्डरा याऽनिलार्दिता |
सक्थ्नः क्षेपं निगृह्णीयाद्गृध्रसीति हि सा स्मृता ||७४||
Gridhrasi is a situation brought on by the aggravated vata invading the kandaras i.e. ligaments and tendons of the ankles and toes, thereby producing kshepa i.e. ache and lack of ability to increase within the thighs.
Viśāvacī: Monoplegia of arms
तलप्रत्यङ्गुलीनां तु कण्डरा बाहुपृष्ठतः ।।
बाह्वोः कर्मक्षयकरी विश्वाचीति हि सा स्मृता ।।७५ ।।
Visvachi is a illness prompted when aggravated vata invades the kandara i.e. ligaments or tendons of the again of the arms and likewise extends as much as and affecting the palm and fingers, thereby producing lack of features (actions) of the arms.
Kroșțuka śīrşa , Swelling of the knee joints
वातशोणितजः शोफो जानुमध्ये महारुजः ।।
शिरः क्रोष्टकपूर्वं तु स्थूलः क्रोष्टकमूर्धवत् ।।७६ ।।
Krostuka Sirsaka is a illness presenting with a swelling which resembles the top of krostuka i.e. jackal in form. It’s prompted when vata related to rakta i.e. blood produces swelling on the center of the knee joint, accompanied by extreme ache.
Khañja – Pañgu- Lameness
वायुः कट्यां स्थितः सक्थ्नः कण्डरामाक्षिपेद्यदा |
खञ्जस्तदा भवेज्जन्तुः, पङ्गुः सक्थ्नोर्द्वयोर्वधात् ||७७||
Khanja is a illness during which the particular person has problem in strolling. It’s prompted when the aggravated vata will get localized within the waist of the particular person and constricts the ligaments of the thighs. On this situation, just one leg is destroyed. The identical situation known as Pangu when each legs are destroyed, being bothered by vata.
Kalāya khañja: Lathyrism
प्रक्रामन् वेपते यस्तु खञ्जन्निव च गच्छति |
कलायखञ्जं तं विद्यान्मुक्तसन्धिप्रबन्धनम् ||७८||
A illness in which there’s shaking of the legs on the graduation of strolling itself and the particular person strolling like a person lame by one leg and the binding of the joints develop into weak is called Kalaya Khanja.
Vata kantaka: Sprain of the ankle
न्यस्ते तु विषमं पादे रुजः कुर्यात् समीरणः ।।
वातकण्टक इत्येष विज्ञेयः खुडुकाश्रितः ।।७९ ।।
Vata localized within the ankle will get aggravated and produces ache in those that preserve their toes irregularly on the bottom. This situation known as Vatakantaka.
Pādadāha: Burning toes
पादयोः कुरुते दाहं पित्तासृक्सहितोऽनिलः ।।
विशेषतश्चङ्क्रमणात् पाददाहं तमादिशेत् ।।८० ।।
Vata getting aggravated together with pitta and rakta i.e. blood causes burning sensation of the toes in those that stroll an excessive amount of. This situation known as as padadaha.
Padaharsa: Delicate toes
हृष्यतश्चरणौ यस्य भवतश्च प्रसुप्तवत् ।।
पादहर्षः स विज्ञेयः कफवातप्रकोपजः ।।८१ ।।
The illness brought on by aggravation of kapha and vata presenting with horripilations (pins and needles) and absence of tactile sensation (numbness) within the toes known as as Padaharsa.
Apabāhuka: Losing / emaciation of arms
अंसदेशस्थितो वायुः शोषयित्वांऽसबन्धनम् ।।
सिराश्चाकुञ्य तत्रस्थो जनयत्यवबाहुकम् ।।८२ ।।
Apabahuka is a situation which afflicts the shoulders, prompted when vata localized within the area of the shoulder will get aggravated and dries up the bindings i.e. ligaments of the shoulders and constricts the siras – veins positioned therein.
Badhirya: Deafness
यदा शब्दवहं स्रोतो वायुरावृत्य तिष्ठति ।।
शुद्धः श्लेष्मान्वितो वाऽपि बाधिर्यं तेन जायते ।।८३ ।।
Badhirya means deafness. It’s prompted when the aggravated vata both alone or in affiliation with kapha will get localized within the channels of sound i.e. contained in the ears and damages them.
Karnasula: Earache
हनुशङ्खशिरोग्रीवं यस्य भिन्दन्निवानिलः ।।
कर्णयोः कुरुते शूलं कर्णशूलं तदुच्यते ।।८४ ।।
Karna sula means ache within the ears. That is prompted when the aggravated vata will get localized within the decrease jaw, temples, head and neck and offers rise to splitting or bursting ache within the ears.
Muka – minmina – gadgada- Dumbness – nasal – voice – and stammering
आवृत्य सकफो वायुर्धमनी : शब्दवाहिनीः ।।
नरान् करोत्यक्रियकान्मूकमिन्मिणगद्गदान् ।।८५ ।।
The particular person both turns into muka – dumb or minmina – of nasal discuss or gadgada – stammering when the channels of sound (voice) are coated and blocked by vata aggravated together with kapha.
Tuni-pratituni: Bladder pains
अधो या वेदना याति वर्चोमूत्राशयोत्थिता |
भिन्दतीव गुदोपस्थं सा तूनीत्यभिधीयते ।।८६ ।।
गुदोपस्थोत्थिता सैव प्रतिलोमविसर्पिणी ।।
वेगैः पक्वाशयं याति प्रतितूनीति सा स्मृता ।।८७ ।।
Tuni is a situation brought on by aggravated vata getting localized within the seats of feces i.e. rectum and of urine i.e. urinary bladder, giving rise to slicing ache within the rectum and penis which strikes downwards.
Pratituni is the same type of ache, as in Tuni, which strikes upwards and reaches pakvashhaya i.e. massive intestines, in bouts.
Ādhmāna – pratyādhmāna: Flatulence
साटोपमत्युग्ररुजमाध्मातमुदरं भृशम् ।।
आध्मानमिति जानीयाद्धोरं वातनिरोधजम् ।।८८ ।।
विमुक्तपार्श्वहृदयं तदेवामाशयोत्थितम् ।।
प्रत्याध्मानं विजानीयात् कफव्याकुलितानिलम् ।।८९ ।
Adhmana is a situation which is marked by nice distension of the stomach related to motion of sound and extreme ache. This situation is brought on by recurring suppression of fart (flatus) and is alleged to be dreadful.
The identical adhmana commencing within the amasaya – abdomen, sparing the flanks and coronary heart (area of coronary heart) is called Pratyadhmana. This situation is brought on by vata related to kapha.
Asthila-pratyasthila: Enlarged prostate
अष्ठीलावद्घनं ग्रन्थिमूर्ध्वमायतमुन्नतम् |
वाताष्ठीलां विजानीयाद्बहिर्मार्गावरोधिनीम् [१] ||९०||
एनामेव रुजायुक्तां वातविण्मूत्ररोधिनीम् |
प्रत्यष्ठीलामिति वदेज्जठरे तिर्यगुत्थिताम् ||९१||
A tumor produced by aggravated vata which has the beneath talked about options known as as Asthila –
- onerous like asthila – iron anvil
- elevated upwards and
- obstructing the anal orifice
The identical asthila known as pratyasthila when it’s accompanied with ache, located barely obliquely contained in the stomach and obstructing the passages of fart, feces and urine.
इति श्रीसुश्रुतसंहितायां निदानस्थाने वातव्याधिनिदानं नाम प्रथमोऽध्यायः ।।१ ।।
Thus ends the primary chapter by title Vātavyādhi nidānam , in Nidāna
sthāna of Suśruta samhita .