162 - Diseases

Dhanvantari said: 

1. O Sushruta, I shall tell you the pathology of Pandu (Chlorosis and Jaundice) and that of Shotha (Oedema and Anasarcha). All the morbid humours with Pitta as their leader become aggravated due to various exciting factors mentioned before. 

2. The more powerful of the doshas lead them on and toss them about all over the body. Finally, when they come to rest they permeate all the ten Dhamanis (Nerves). 

3. The kapha, skin, blood and the flesh are defiled. Different colours are given to the skin. 

4. Among the colours the colour of yellow-like turmeric is predominant. Hence the ailment is called Pandu. A sort of heaviness of the body is caused by Vayu. 

5. In the Amaja type (where much matter is present) the main constituents, Dhatus of the body, lose their consistency and become lighter. The patient becomes deficient in blood (Anaemic). The quantity of fat is diminished. The bones are not substantial. The sense organs do not function properly. 

6. The limbs get thinner and thinner; clammy sweats exude in the cardiac region. Pain in the eyes, rigidity in the face and salivation are observed. 

7. The patient does not feel much thirst. He abhors chillness. With his dishevelled hair fluttering in the air, he patiently suffers from fever of equal intensity. He coughs, has pain in the ears and has vertigo. 

8-10. The ailment is of five types, four of them being caused by the doshas severally and in combination and the fifth by eating earth. The premonitory signs are perspiration in the region of the heart, dryness of the skin, nonrelish for food, scanty yellow urine and absence of perspiration. The Vayu causes a stupor, excruciating pain, wetness all over the body, a sort of black or vermillion colour and dryness in the veins, nails, eyes, faeces and urine, intumescence dryness of mouth and nostrils, scantum of faeces and numbness in the sides. 

11. The Pitta causes greenish or yellow colour in the vein, etc., fever, vanish of vision of light (darkness), thirst, emaciation of the body, swooning, foul smell, fondness for cold things and bitter taste in the mouth. 

12. The Kapha causes diarrhoea, acid erectations, burning sensation, clamminess of the cardiac region, lethargy, saline taste in the mouth, horripilation and aphonia. 

13. Cough and Vomiting the symptoms of a combination are very unbearable. The mucous expectorated is either bitter or sweet due to the prevalent Vayu or Pitta. 

14. The defiled kapha vitiates the fat and other vital constituents of the body and generating a condition of parchedness causes even haemorrhage. As said before, it may obstruct the various ducts and vessels of the body resulting in general debility. 

15. In Jaundice the navel, feet, face and the penis become thinner and thinner; the faeces are infested with germs. loose and mixed with blood and mucous matter. 

16. A patient affected by jaundice continuing to eat pitta-generating foodstuffs is afflicted by Kamala (chlorois). The pitta, coming of its seat in the abdominal cavity scorches up the blood and the flesh. 

17. The colour of the urine, faeces, eyes, mouth and the face become yellow; the patient feels a burning sensation; indigestion sets in and the patient lies like a bloated toad weak in all his limbs and organs of sense. 

18. The unabsorbed pitta of a jaundice patient gives rise to a kind of swelling and when these swellings are neglected, the dreadful ailment of Kumbha Kamala sets in. 

19. The unassimilated Pitta produces greenness of complexion. The Vayu and Pitta in combination produce vertigo, thirst, desire for the company of women and slight rise in temperature. 

20. Moreover, there may be somnolence and impaired digestion. Sages call it Halimaka. A great lassitude is also observed. All these are the premonitory symptoms of this disease. 

21-22. Shotha (oedema) has already been mentioned as a grave ailment. Hence, it is being explained. The defiled Vayu takes the contaminated blood, pitta and kapha to the external vessels and gets obstructed in its path generating a raised and compact swelling in the local flesh and skin. This is called Shotha. 

23-24. This ailment is divided into nine according to the causes--the three doshas separately, in combination of twos, all combined, due to attack and due to poison. It is divided into three in accordance with their shapes (1) large, (2) raised and pointed, (3) knotty. They may be congenital or acquired. If they spread all over the body they are necessarily generated by over lustfulness. 

25. A common cause for all types of Shothas is the deranged morbid humour. They are found in persons emaciated due to sickness, overwork, fasting, etc, rapidly growing. 

26. In the case of others the intake of foodstuffs in large quantities especially such as are heavy, too cold, saline, acid or alkaline, green vegetables and water or excessive sleep or wakefulness may cause Shotha. 

27-28. The voluntary suppression of natural urges, eating dried flesh, indigestion, exhaustion, sexual intercourse, travelling by foot or in a jolting vehicle-all these aggravate these diseases: --dyspnea, cough, dysentery, piles, ascites, leucorrhoea, fever, tympanites, flatulence, vomiting, hiccough, erysipelas and jaundice. 

29. The morbid humours lodged in the upper, middle or lower parts of the body generate Shotha (oedematous swelling) in their seat or in the urinary bladder. 

30. Its premonitory symptoms are burning pain in the nerves and heaviness of limbs. In the Vataja type of swellings, they are found to be shifting in their character, rough, blackish or reddish in colour and have rough hair round their base. 

31. The patient complains of breaking pain in the temples, bladder, entrails, etc. Due to the pain, he is unable to sleep. The swelling grows rapidly and the whole body is painful. 

32. The swelling is small during nights and grows large during the day. It is glossy. By pressure it may subside. If mustard is applied over the swelling a tingling sensation is experienced. 

33. The pittaja type of swelling is black, red or yellow in colour; it produces Shosha (emaciation); it does not subside quickly. Before the advent and in the middle, it gives a burning sensation all over the body. 

34. Fever with thirst, burning sensation and perspiration, vertigo, pain, stupor, yearning for things, loose motion, foul smell and softness to the touch are characteristic symptoms. 

35. In the kaphaja type the swelling gives an itching sensation, has yellow and gray hairs, is hard-skinned, cold, firm, glossy, smooth and painful; it produces sleep, vomiting, sensation and indigestion. 

36-37. A blow, a cut from any weapon or any hard thing, exposure to chill winds or sea breezes or the juice of Bhallataka¹ or Kapikacchu² fruits may produce a swelling with erysipelas. It is marked by extreme heat and exhibits symptoms common to Pittaja type. It is red in colour.

1. Somecarpus anacardium.

2. Perhaps the same as Svayamgupta-Mucuna pruriens.

38. Swelling due to poison is caused by poisonous in sects and reptiles when they pass over the body or urinate there. Even when non-poisonous insects and animals bite or scratch swelling may occur. 

39-40. When one comes into contact with a cloth contaminated by faeces, urine, or semen or when one comes into contact with breeze coming from poisonous trees or when one grinds a poisonous medicine, a swelling may occur that is soft shifting, hanging loose and extremely painful and burning. A fresh swelling without disorders can be cured but not a chronic one.