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Ashtanga Hridayam Nidanasthanam Chapter 13:  Panduroga Shopha Visarpa Nidanam Adhyaya (Prognosis of Anemia, Dropsy and Herpes)


The thirteenth chapter of Nidanasthanam of Ashtanga Hridayam is known as as Udara Nidanam Adhyayah. This chapter offers with the reason of ‘anemia, dropsy and herpes’.

The subjects coated on this chapter embody –

–       Vataja, Pittaja, Panduroga Nidana, Samprapti – causes and pathogenesis of anemia
–       Kaphaja, Sannipataja and Mrit Bhakshanaja Pandu
–       Kamala – Jaundice
–       Shopha Nidana – analysis and pathogenesis of swelling / edema / dropsy / anasarca
–       Shopha Bheda – sorts of swelling
–       Purvarupa – premonitory signs of Shopha,
–       Rupa – scientific options of Vataja, Pittaja, Kaphaja, Dwidoshaja, Tridoshaja, Abhighataja, Vishaja Shopha
–       Sadhyasadhyata – prognosis of Shopha
–       Visarpa – Herpes – its causes, adhishtana i.e. locations of manifestation, pathogenesis, causes,
–       Medical options of Doshaja Visarpa
–       Agni Visarpa, Granthi Visarpa, Kardama Visarpa, Sannipata Visarpa, Kshataja Visarpa
–       Sadhyasadhyata – prognosis of Herpes

Pledge by the writer(s)

अथात: पाण्डुरोगशोफविसर्पनिदानं व्याख्यास्याम ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having provided prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘analysis of enlargement of anemia, dropsy and herpes’. Thus say (pledge) atreya and different sages.

Panduroga Nidana, Samprapti: Causes and pathogenesis of anemia

पित्तप्रधानः कुपित यथोत्त्कैः कोपनैर्मळाः ।
तत्रानिखेन बलिना क्षित्तं हदि स्थितम् ॥१॥
धमनीर्दश सम्प्रश्य ज्याप्रुवत्सकलां तनुम् ।
श्र्लेष्मत्वग्रक्त्तमांसानि प्रदूष्यान्तरमाश्रितम् ॥२॥
त्वख्यांसयोस्तत्कुरुते त्वचि चर्णानू पृग्विधान् ।
पाण्डुहारिद्रहरितान् पाण्डुत्वं तेषु चाधिकम् ॥३॥
यतोऽतः पाण्डुरित्युक्त्तः स रोगः
Doshas amongst which pitta is predominate, get aggravated by indulgence of their respective causative components; pitta that’s current within the coronary heart is pressured into the ten Dhamanis -arteries and veins, connected to the guts, by the highly effective Vata Dosha and made to unfold all through the physique; pitta then vitiates the kapha, the pores and skin, blood, and muscle mass, by residing inside them and produce within the pores and skin and muscle mass completely different sorts of colours equivalent to pandu – yellowish-white, Harida -turmeric, deep-yellow and Harita -green; Pandu-yellowish- white being extra widespread amongst these, such a illness known as as Pandu roga itself.

Pandu Rupa (Medical options)

तेन गौरवम् ।
धातूनां स्याच्च शैथिल्यमोजसश्च गुणक्षयः ॥ ४ ॥
ततोऽल्परक्तमेदस्को निःसारः स्याच्छ्लथेन्द्रियः ।
मृद्यमानैरिवाङ्गैर्ना द्रवता हृदयेन च ॥ ५ ॥
शूनाक्षिकूटः सदनः कोपनः ष्ठीवनोऽल्पवाक् ।
अन्नद्विट् शिशिरद्वेषी शीर्णरोमा हतानलः ॥ ६ ॥
सन्नसक्थो ज्वरी श्वासी कर्णक्ष्वेडी भ्रमी श्रमी ।
स पञ्चधा पृथग्दोषैः समस्तैर्मृत्तिकादनात् ॥ ७ ॥
By this, the tissues turn into heavy fragile, free, the qualities of ojas turn into diminished, hen the individual turns into poor in blood and fats tissues, the individual loses excellence well being of the tissues; the physique and sense organs turns into flabby (flaccid) has a sense of the physique being squeezed, coronary heart charge will increase, swelling of the attention sockets- space surrounding the eyes, debility, anger, expectoration of sputum and diminution in speech seem; the individual hates meals and chilly issues, falling of physique hairs, lack of digestive exercise, weak point of the thighs, fever, dyspnea, fixed noise within the ears, dizziness and exertion. Pandu is 5 varieties; from every dosha individually, from all of them collectively and from consuming of mud.

Purvarupa (Premonitory signs)

प्राग्रूपमस्य हृदयस्पन्दनं रूक्षता त्वचि ।
अरुचिः पीतमूत्रत्वं स्वेदाभावोऽल्पवह्निता ॥ ८ ॥
Its premonitory signs arethrobbing pulsating ache within the coronary heart – palpitation, dryness of pores and skin, lack of style/ appetitive, yellow coloured urine, absence of sweating, poor digestion power

Vataja Panduroga

सादः श्रमोऽनिलात्तत्र गात्ररुक्तोदकम्पनम् ।
कृष्णरूक्षारुणसिरानखविण्मूत्रनेत्रता ॥ ९ ॥
शोफानाहास्यवैरस्यविट्शोषाः पार्श्वमूर्धरुक् ।
In Pandu attributable to vata, there’s weak point and tiredness, bodyache, pricking ache, tremors blackish, dry, reddish discoloration of the veins, nails, faeces, urine and eyes; swelling, flatulence, unhealthy style within the month-astringent style, dryness of the feces and ache within the flanks and head.

Pittaja Panduroga

पित्ताद्धरितपीताभसिरादित्वं ज्वरस्तमः ॥ १० ॥
तृट्स्वेदमूर्छाशीतेच्छा दौर्गन्ध्यं कटुवक्त्रता ।
वर्चोभेदोऽम्लको दाहः
In Pandu by pitta, there’s inexperienced, yellowish discoloration of veins and so forth., fever, unconsciousness, thirst, perspiration, fainting, need for chilly issues, unhealthy smell-of the physique, mouth and so forth. pungent style, free bowels, sourness, acidity and burning sensation.

Kaphaja Panduroga

कफाच्छुक्लसिरादिता ॥ ११ ॥
तन्द्रा लवणवक्त्रत्वं रोमहर्षः स्वरक्षयः ।
कासश्छर्दिश्च
In that attributable to Kapha, there’s white coloration of the veins and so forth. stupor, saline style within the mouth, horripilation, lack of voice, cough and vomiting.

Sannipataja Panduroga

निचयान्मिश्रलिङ्गोऽतिदुःसहः ॥ १२ ॥
In that attributable to the mix of all of the doshas, there’s combined of signs and the illness is tough to bear.

Mrit Bhakshanaja Panduroga

मृत्कषायानिलं पित्तमूषरा मधुरा कफम् ।
दूषयित्वा रसादींश्च रौक्ष्याद्भुक्तं विरूक्ष्य च ॥ १३ ॥
स्रोतांस्यपक्वैवापूर्य कुर्याद्रुद्ध्वा च पूर्ववत् ।
पाण्डुरोगं ततः शूननाभिपादास्यमेहनः ॥ १४ ॥
पुरीषं कृमिमन्मुञ्चेद्भिन्नं सासृक्कफं नरः ।
In individuals who eat mud- habitually for a very long time, astringent mud aggravates vata, alkaline mud aggravates pitta and candy mud aggravates kapha, mud vitiates rasa and different tissues by its dryness and produces dryness within the meals with out present process digestion itself, the mud fills and blocks the channels of the tissues and produces panduroga as earlier than. The individual develops swelling of the umbilicus, ft, face and genitals, expels feces containing worms, feces is damaged, not nicely fashioned, combined with blood and kapha.

Kamala Roga: Jaundice

यः पाण्डुरोगी सेवेत पित्तलं तस्य कामलाम् ॥ १५ ॥
कोष्ठशाखाश्रयां पित्तं दग्ध्वासृङ्मांसमावहेत् ।
हारिद्रनेत्रमूत्रत्वङ्नखवक्त्रशकृत्तया ॥ १६ ॥
दाहाविपाकतृष्णावान् भेकाभो दुर्बलेन्द्रियः ।
भवेत्पित्तोल्बणस्यासौ पाण्डुरोगादृतेऽपि च ॥ १७ ॥
उपेक्षया च शोफाढ्या सा कृच्छ्रा कुम्भकामला ।
हरितश्यावपीतत्वं पाण्डुरोगे यदा भवेत् ॥ १८ ॥
वातपित्ताद्भ्रमस्तृष्णा स्त्रीष्वहर्षो मृदुर्ज्वरः ।
तन्द्रा बलानलभ्रंशो लोढरं तं हलीमकम् ॥ १९ ॥
अलसं चेति शंसन्ति
That affected person of pandu- anemia who indulges in Pitta rising weight loss program and actions, the pitta will get elevated, burns up the blood and muscle mass and produces Kamala roga, localized within the alimentary tract and the tissues, by producing deep yellow coloration of the eyes, urine, pores and skin, nails, mouth and feces; burning sensation, indigestion, extreme thirst, greenish brown coloration of the pores and skin resembling a frog, and weak point of the sense organs. Kamala can occur even with out panduroga – anemia in individuals who’ve aggravation of pitta; neglecting Kamala can result in Kumbha Kamala, having profound swelling which is tough to treatment. When in a affected person of panduroga- anaemia, there happens inexperienced, brown and yellowish discoloration, dizziness, extreme thirst, lack of need in women- intercourse, delicate fever, stupor, weak point of the physique and of digestion on account of enhance of vata and pitta then the illness is known as as Lodhara or Halimaka or Alasa.

Problems of Shopha

तेषां पूर्वमुपद्रवाः ।
शोफप्रधानाः कथिताः स एवातो निगद्यते ॥ २० ॥
Of all of the problems of Pandu diseae, Shopha – irritation is the chief complication. Therefore, Shopha is defined in additional verses. Thus ends the analysis of Pandu – Anemia, preliminary levels of liver ailments.

Shopha Samprapti: Pathogenesis of edema

पित्तरक्तकफान्वायुर्दुष्टो दुष्टान् बहिःसिराः ।
नीत्वा रुद्धगतिस्तैर्हि कुर्यात् त्वङ्मांससंश्रयम् ॥ २१ ॥
उत्सेधं संहतं शोफं तमाहुर्निचयादतः ।
सर्वं
Vata getting vitiated, brings the vitiated pitta rakta- blood and kapha, out into the exterior channels results in obstruction, causes swelling localized within the pores and skin and muscle mass, this situation known as as shopha. All shophas are attributable to vitiation of all three doshas.

Shopha Bheda: Sorts of swelling

हेतुविशेषैस्तु रूपभेदान्नवात्मकम् ॥ २२ ॥
दोषैः पृथग्द्वयैः सर्वैरभिघाताद्विषादपि ।
Based mostly on completely different causes and signs, Shopha is of 9 varieties from every dosha individually, from the mix of two doshas, from the mix of all three Doshas, on account of damage, from poison.

Shopha Bheda: 2 and three sorts of swelling

द्विधा वा निजमागन्तुं सर्वाङ्गैकाङ्गजं च तम् ॥ २३ ॥
पृथून्नतग्रथितताविशेषैश्च त्रिधा विदुः ।
Once more Shopha is 2 varieties; Nija -organic and Agantu -traumatic sarvanga- Shopha afflicting all components of the physique and Ekanga- Shopha afflicting just one half; it’s identified to be of three kinds-viz – prthu – broad, unnata – raised and grathita – knotted/ glandular.

Shopha Nidana: Causes of swelling

सामान्यहेतुः शोफानां दोषजानां विशेषतः ॥ २४ ॥
व्याधिकर्मोपवासादिक्षीणस्य भजतो द्रुतम् ।
अतिमात्रमथान्यस्य गुर्वम्लस्निग्धशीतलम् ॥ २५ ॥
लवणक्षारतीक्ष्णोष्णशाकाम्बु स्वप्नजागरम् ।
मृद्ग्राम्यमांसवल्लूरमजीर्णश्रममैथुनम् ॥ २६ ॥
पदातेर्मार्गगमनं यानेन क्षोभिणापि वा ।
श्वासकासातिसारार्शोजठरप्रदरज्वराः ॥ २७ ॥
विषूच्यलसकच्छर्दिगर्भविसर्पपाण्डवः ।
अन्ये च मिथ्योपक्रान्तास्तैर्दोषा वक्षसि स्थिताः ॥ २८ ॥
ऊर्ध्वं शोफमधो वस्तौ मध्ये कुर्वन्ति मध्यगाः ।
सर्वाङ्गगाः सर्वगतं प्रत्यङ्गेषु तदाश्रयाः ॥ २९ ॥
Common causes of Shopha – swelling, particularly these attributable to the doshas are –
these which happen in individuals who’re debilitated by ailments, aggressive therapies, fasting and so forth. out of the blue indulging in giant amount of meals and improper manner; meals that are heavy, bitter, unctuous -fatty, chilly, salty, alkaline, penetrating, warmth producing and leafy greens; ingesting extra water, extra of sleeping or of retaining awake, consuming mud, meat of home animals, dry meat and raw dishes; indigestion, exertion and extreme copulation, strolling lengthy distances, or strenuous using on animals or automobiles; impact of ailments equivalent to dyspnea, cough diarrhea, piles, enlargement of the stomach, menorrhagia, fever,  concurrently diarrhea and vomiting on account of extreme indigestion, lengthy stasis of undigested meals within the abdomen, vomiting, being pregnant, herpes, Anemia, pandu -and such others ailments are improperly handled; Doshas localized within the chest produce swelling within the higher components of the physique; Doshas localized within the area of the urinary bladder produce swelling within the decrease components of the physique, doshas positioned within the center components of the physique produce swelling within the center components; Doshas, localized everywhere in the physique, produce swelling of the entire physique and localized in anyone half, Doshas trigger swelling of that half solely.

Purvarupa: Premonitory signs

तत्पूर्वरूपं दवथुः सिरायामोऽङ्गगौरवम् ।
Its premonitory signs are – feeling of burning sensation in locations like eyes and so forth. dilatation of the veins on the web site of swelling, and feeling of heaviness of the affected physique half.

Rupa: Medical options

Vataja Shopha

वाताच्छोफश्चलो रूक्षः खररोमारुणासितः ॥ ३० ॥
सङ्कोचस्पन्दहर्षार्तितोदभेदप्रसुप्तिमान् ।
क्षिप्रोत्थानशमः शीघ्रमुन्नमेत् पीडितस्तनुः ॥ ३१ ॥
स्निग्धोष्णमर्दनैः शाम्येद्रात्रावल्पो दिवा महान् ।
त्वक्च सर्षपलिप्तेव तस्मिंश्चिमिचिमायते ॥ ३२ ॥
In Shopha attributable to vata, the swelling is moveable, dry, with tough hair, crimson or black in coloration, related to pains equivalent to constricting, pulsating, tingling, pricking, puncturing, and chopping sort of ache, or having no sensation in any respect; swelling will increase and subsides shortly, swelling shortly spreads and afflicts different components of the physique, subsides by therapeutic massage with unctuous and sizzling supplies; signs are delicate at nights and extreme throughout day time; there’s delicate tingling- burning sensation on the pores and skin, as if pores and skin is coated with mustard seed paste.

Pittaja Shopha

पीतरक्तासिताभासः पित्तादाताम्ररोमकृत् ।
शीघ्रानुसारप्रशमो मध्ये प्राग्जायते तनुः ॥ ३३ ॥
सतृड्दाहज्वरस्वेददवक्लेदमदभ्रमः ।
शीताभिलाषी विड्भेदी गन्धी स्पर्शासहो मृदुः ॥ ३४ ॥
In Shopha attributable to pitta, the swelling is yellow, reddish- black in coloration, hair turns coppery purple; swelling will increase and subsides shortly, seems first within the center components of the physique; is accompanied with thirst, burning sensation, fever, perspiration, raised warmth, elevated moisture element within the physique, intoxication and dizziness; the individual needs chilly issues, has diarrhea, the swelling is foul smelling, illiberal to the touch and comfortable.

Kaphaja Shopha

कण्डूमान् पाण्डुरोमत्वक्कठिनः शीतलो गुरुः ।
स्निग्धः श्लक्ष्णः स्थिरः स्त्यानो निद्राछर्द्यग्निसादकृत् ॥ ३५ ॥
आक्रान्तो नोन्नमेत्कृच्छ्रशमजन्मा निशाबलः ।
स्रवेन्नासृक् चिरात्पिच्छां कुशशस्त्रादिविक्षतः ॥ ३६ ॥
स्पर्शोष्णकाङ्क्षी च कफात्
In Shopha attributable to kapha, the swelling has itching, pale, white discoloration of hair and pores and skin; is difficult, chilly, heavy, unctuous, easy, static and thick, accompanied with extreme sleep, vomiting, causes weak point of digestion; upon urgent it, a pit is fashioned, which doesn’t even out simply, swelling pacifies and kinds with problem, and is predominantly current at night time, when pricked with grass or knife, doesn’t discharge blood; regularly discharges slimy fluid, the affected person of Kaphaja Shotha needs touching and heat.

Dwidoshaja and Tridoshaja Shopha

यथास्वं द्वन्द्वजास्त्रयः ।
सङ्कराद्धेतुलिङ्गानां निचयान्निचयात्मकः ॥ ३७ ॥
Equally, the Shopha attributable to two doshas could have their very own set of causes and signs, and that attributable to all of the doshas could have their respective signs showing concurrently.

Abhighataja shopha: Traumatic swelling

अभिघातेन शस्त्रादिच्छेदभेदक्षतादिभिः ।
हिमानिलोदध्यनिलैर्भल्लातकपिकच्छुजैः ॥ ३८ ॥
रसैः शूकैश्च संस्पर्शाच्छ्वयथुः स्याद्विसर्पवान् ।
भृशोष्मा लोहिताभासः प्रायशः पित्तलक्षणः ॥ ३९ ॥
Abhighataja swelling is that, attributable to chopping, splitting, hitting and so forth, by sharp and other forms of weapons; by publicity to snow, chilly breeze, sea breeze, publicity to juice of bhallataka- marking nut and bristles / hairs of kapikacchu and so forth. swelling spreads from place to position, may be very sizzling to the touch, resembles purple blood coloration and often has signs of pitta.

Vishaja Shopha: Swelling attributable to poison

विषजः सविषप्राणिपरिसर्पणमूत्रणात् ।
दंष्ट्रादन्तनखापातादविषप्राणिनामपि ॥ ४० ॥
विण्मूत्रशुक्रोपहतमलवद्वस्त्रसङ्करात् ।
विषवृक्षानिलस्पर्शाद्गरयोगावचूर्णनात् ॥ ४१ ॥
मृदुश्चलोऽवलम्बी च शीघ्रो दाहरुजाकरः ।
Vishaja shopha – swelling attributable to poison is produced by publicity to crawling (direct physique contact) or urine of toxic animals / bugs, injuring by tusks, tooth or claws by toxic animals and even by the contact of excreta, urine or semen; or material contaminated by these of even non- toxic animals; contact of poisons timber, fuel, smoke, toxic fumes, and rubbing / dusting of synthetic poisons and so forth. such a swelling is comfortable, movable, drooping down, fast to manifest and causes burning sensation and ache.

Sadhyasadhyata: Prognosis

नवोऽनुपद्रवः शोफः साध्योऽसाध्यः पुरेरितः ॥ ४२ ॥
Swelling which is of latest onset and never having problems is curable, these described beforehand will not be curable. Thus ends the analysis of oedema/ dropsy

अथ विसर्पनिदानम् ।
Thus ends Visarpa Nidanam.

Nidana: Prognosis of herpes

स्यात् विसर्पो अभिघात अन्तैर्दोषै: दूष्यैश्च शोफवत् ।
Visarpa – Herpes, spreading pores and skin illness is analogous in respect of doshas, Dushyas and sorts with shopha. Sorts of visarpa is just like sorts of Shopha, which ends with Abhighataja selection – prompted on account of trauma.

Notes:
Like shopha-oedema visarpa is attributable to every Dosha, individually, by the mix of any two or all three and by trauma – damage; the pathogenesis of each are additionally similar.

Adhishtana: Place of manifestation of herpes

त्र्यधिष्ठानं च तं प्राहुर्बाह्यान्तरुभयाश्रयात् ॥ ४३ ॥
यथोत्तरं च दुःसाध्या: |
Its place of manifestation is claimed to be three – exterior, inside and each; these are tough to treatment of their succeeding order.

Samprapthi: Pathogenesis

तत्र दोषा यथायथम् ।
प्रकोपणैः प्रकुपिता विशेषेण विदाहिभिः ॥ ४४ ॥
देहे शीघ्रं विसर्पन्ति तेऽन्तरन्तःस्थिता बहिः ।
बहिःस्था द्वितये द्विस्था
The doshas getting aggravated by their respective causes, particularly so, by meals which trigger burning sensation, doshas unfold shortly within the physique, these localized inside unfold to all the interior components; these localized outdoors unfold to all of the exterior components, and people localized in each to all of the components, each inside and exterior.

Nidana: Causes

विद्यात् तत्रान्तराश्रयम् ॥ ४५ ॥
मर्मोपतापात् सम्मोहादयनानां विघट्टनात् ।
तृष्णातियोगाद्वेगानां विषमं च प्रवर्तनात् ॥ ४६ ॥
आशु चाग्निबलभ्रंशादतो बाह्यं विपर्ययात् ।
The interior sort of Visarpa is to be understood as arising from ailments of important organs equivalent to coronary heart, head, urinary bladder and so forth. lack of consciousness, extreme damage to the sense organs, on account of profound thirst, improper elimination of pure urges of the physique; fast destruction of digestion power, the exterior sort of Visarpa arises from causes reverse of the above.

Rupa: Medical options

तत्र वातात्परीसर्पो वातज्वरसमव्यथः ॥ ४७ ॥
शोफस्फुरणनिस्तोदभेदायामार्तिहर्षवान् ।
पित्ताद्द्रुतगतिः पित्तज्वरलिङ्गोऽतिलोहितः ॥ ४८ ॥
कफात्कण्डूयुतः स्निग्धः कफज्वरसमानरुक् ।
स्वदोषलिङ्गैश्चीयन्ते सर्वे स्फोटैरुपेक्षिताः ॥ ४९ ॥
ते पक्वभिन्नाः स्वं स्वं च बिभ्रति व्रणलक्षणम् ।
Within the herpes attributable to vata, the signs are just like these of Vatajvara (vide chapter2 verses 10-17) as well as there’s swelling; throbbing, intermittent, piercing sorts of pains, dilating, chopping and tingling sorts of ache on account of Vata Dosha. In Visarpa attributable to pitta, the spreading is fast, has signs just like these of pitta Jwara (verses 18-20 of chapter of chapter 2) and Visarpa may be very purple. In that attributable to kapha, there’s itching, unctuous- greasy and has signs just like these of kaphajvara (verses 21-22 of chapter2). When uncared for, every type develops eruption- blebs, vesicles having signs of the respective dosha. These eruptions burst after ripening- suppuration, resulting in ulcers having their very own respective signs.

Agni Visarpa Rupa

वातपित्ताज्ज्वरच्छर्दिमूर्छातीसारतृड्भ्रमैः ॥ ५० ॥
अस्थिभेदाग्निसदनतमकारोचकैर्युतः ।
करोति सर्वमङ्गं च दीप्ताङ्गारावकीर्णवत् ॥ ५१ ॥
यं यं देशं विसर्पश्च विसर्पति भवेत्स सः ।
शान्ताङ्गारासितो नीलो रक्तो वाशु च चीयते ॥ ५२ ॥
अग्निदग्ध इव स्फोटैः शीघ्रगत्वाद्द्रुतं च सः ।
मर्मानुसारी वीसर्पः स्याद्वातोऽतिबलस्ततः ॥ ५३ ॥
व्यथेताङ्गं हरेत्सञ्ज्ञां निद्रां च श्वासमीरयेत् ।
हिध्मां च स गतोऽवस्थामीदृशीं लभते न ना ॥ ५४ ॥
क्वचिच्छर्मारतिग्रस्तो भूमिशय्यासनादिषु ।
चेष्टमानस्ततः क्लिष्टो मनोदेहश्रमोद्भवाम् ॥ ५५ ॥
दुष्प्रबोधोऽश्नुते निद्रां सोऽग्निविसर्प उच्यते ।
Visarpa arising from the mix of vata and pitta, accompanied with fever, vomiting, fainting, diarrhea, thirst, dizziness, splitting ache within the bones, weak digestion, blindness, and lack of style/urge for food; makes your complete physique as if crammed with burning coal; all of the components to which the herpes spreads, turns into black like coal which has been extinguished; blue or purple in coloration; grows shortly. Blister eruptions develop in these components resembling as if burnt by fireplace and spreads shortly because of the highly effective affect of Vata Dosha. This visarpa invades important organs, causes extreme ache in these components, results in lack of consciousness and sleep, produces dyspnoea and hiccup; having reached this stage, the individual doesn’t discover even little consolation by mendacity on the bottom or on the cot or by sitting; the affected person makes tough painful actions consistently, on account of exertion of the thoughts and physique; attains sleep from which he may be aroused with nice problem – just like demise. This illness is called Agni visarpa

Granthi Visarpa

कफेन रुद्धः पवनो भित्त्वा तं बहुधा कफम् ॥ ५६ ॥
रक्तं वा वृद्धरक्तस्य त्वक्सिरास्नावमांसगम् ।
दूषयित्वा च दीर्घाणुवृत्तस्थूलखरात्मनाम् ॥ ५७ ॥
ग्रन्थीनां कुरुते मालां रक्तानां तीव्ररुग्ज्वराम् ।
श्वासकासातिसारास्यशोषहिध्मावमिभ्रमैः ॥ ५८ ॥
मोहवैवर्ण्यमूर्छाङ्गभङ्गाग्निसदनैर्युताम् ।
इत्ययं ग्रन्थिवीसर्पः कफमारुतकोपजः ॥ ५९ ॥
Vata getting obstructed by Kapha, breaks the kapha into many components or vitiates the blood within the pores and skin, veins, tendons and muscle mass in these having excessively aggravated blood tissue, produces a series of tumors of blood, that are both lengthy, small, spherical, thick or tough; related to extreme ache , fever, dyspnoea, cough diarrhea, dryness of the Mouth, hiccup, vomiting, dizziness, delusion, discoloration, fainting, chopping ache within the physique and weak digestion; this illness is Granthi visarpa attributable to aggravation of kapha and vata.

Kardama Visarpa

कफपित्ताज्ज्वरः स्तम्भो निद्रातन्द्राशिरोरुजः ।
अङ्गावसादविक्षेपप्रलापारोचकभ्रमाः ॥ ६० ॥
मूर्छाग्निहानिर्भेदोऽस्थ्नां पिपासेन्द्रियगौरवम् ।
आमोपवेशनं लेपः स्रोतसां स च सर्पति ॥ ६१ ॥
प्रायेणामाशये गृह्णन्नेकदेशं न चातिरुक् ।
पिटिकैरवकीर्णोऽतिपीतलोहितपाण्डुरैः ॥ ६२ ॥
मेचकाभोऽसितः स्निग्धो मलिनः शोफवान् गुरुः ।
गम्भीरपाकः प्राज्योष्मा स्पृष्टः क्लिन्नोऽवदीर्यते ॥ ६३ ॥
पङ्कवच्छीर्णमांसश्च स्पष्टस्नायुसिरागणः ।
शवगन्धिश्च वीसर्पं कर्दमाख्यमुशन्ति तम् ॥ ६४ ॥
Brought on by the aggravation of Kapha and pitta, accompanied with fever, stiffness of the physique, sleep, stupor, headache, debility of the physique, tremors, irrelevant speech, lack of urge for food or style; dizziness, fainting, lack of digestive capability, spitting ache within the bones, extreme thirst, feeling or heaviness of sense organs, elimination of feces containing Ama – Mucus coating of the channels – of rasa by Ama (undigested meals metabolites). It typically begins by afflicting one area on the web site of Amasaya – abdomen after which spreads to different components, it’s studded with eruption which aren’t very painful, its coloration varies from deep yellow, purple, yellowish white, with color resembling eye of peacock’s tain, deep blue or black; it’s greasy, soiled, swollen and heavy; undergoes ulceration from deep inside; with elevated warmth the muscle mass of the affected half turn into very moist, fall of like slush when touched, exposing the beneath bundles of tendons and veins emitting cadaveric scent – these being the indicators of gangrene; that is known as as Kardama Visarpa.

Sannipataja Visarpa

सर्वजो लक्षणैः सर्वैः सर्वधात्वतिसर्पणः ।
That attributable to all of the doshas presents with signs of all of the doshas concurrently and spreads drastically to all of the tissues.

Kshataja Visarpa

बाह्यहेतोः क्षतात्क्रुद्धः सरक्तं पित्तमीरयन् ॥ ६५ ॥
विसर्पं मारुतः कुर्यात् कुलत्थसदृशैश्चितम् ।
स्फोटैः शोफज्वररुजादाहाढ्यं श्यावलोहितम् ॥ ६६ ॥
Vata aggravated by trauma on account of exterior causes, aggravates blood and pitta and causes visarpa, studded with boils resembling kulattha- horse gram related to extreme swelling, fever, ache and burning sensation, its coloration being blackish-red.

Sadhya asadhyata (Prognosis)

पृथग्दोषैस्त्रयः साध्या द्वन्द्वजाश्चानुपद्रवाः ।
असाध्यौ क्षतसर्वोत्थौ सर्वे चाक्रान्तमर्मकाः |
शीर्णस्नायुसिरामांसाः प्रक्लिन्नाः शवगन्धयः ॥ ६७ ॥
These attributable to every dosha individually, and people by any two doshas however devoid of any problems, are curable. These attributable to trauma, or by all of the three doshas, these that are invading all important organs/marmas, which have prompted lack of tendons, veins and muscle mass, that are extremely moist and emitting cadaveric scent are incurable.

Notes: As can gathered from the above descriptions, Visarpa – Herpes, spreading pores and skin illness is an infectious illness spreads from place shortly, involving the blood, pores and skin, muscle mass and tendons, having painful eruptions on the pores and skin, lead on to suppuration tumors, gangrene and multation of the physique. It has been recognized with a number of ailments like erysipelas, cellulites, herpes zoster, gangrene, eczema, some sorts of dermatitis, most cancers of the pores and skin, plague and so forth. by trendy students.

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहिताया तृतीये निदानस्थानेपाण्डुरोगशोफविसर्पनिदानं नाम त्रयोदशोऽध्याय: ।। १३॥
Thus ends the chapter Panduroga-shopha-visarpa Nidana the thirteenth in Nidanasthana of Astangahrdaya Samhita composed by Srimad Vagbhata, son of Vaidyapati Simhagupta.



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