167 - Diseases

Dhanvantari said:

1-2. O Sushruta, I shall tell you about the pathology of Vatarakta. Incompatible articles of fare, injudicious eating, anger, sleeping during the day, keeping awake at night, etc. cause the derangement of Vayu and blood, generally in persons of easy-going temperament and delicate body and those who are extremely obese and indulge in injudicious eating and conduct. 

3. When the blood in the body is contaminated by a blow or due to the impurities injected by cool things or Vayu generating stuffs the aggravated Vayu proceeds along a deviating path. 

4. When obstructed by the blood of such a nature the Vayu of the first variety (Prana) vitiates the same blood and then produces foul wind through the anus or coos like a cuckoo and generates Vatarakta. 

5. When piles grow due to the vitiated blood the Vayu courses through the body and generates vomiting and other symptoms slowly. 

6-7. An affection like Kushtha or Arbuda (carbuncle, swelling) shall then rise. There may be itching sensation, throbbing, excruciating pain, breaking pain, heaviness and insensibility in knees, calves, thighs, hips, shoulders, hands, feet and the joints of limbs: The symptoms occur and vanish, recur again sometimes. 

8. Sometimes it starts from the root of the feet and sometimes from the hands and getting aggravated courses through the whole body like the poison of a mouse. 

9. The Vayu (and the vitiated blood) located in the skin and the flesh rises up and after some time becomes grave and acute and attacks all the fundamental constituents of the body (Dhatus).

10. The Vayu located at the bones and marrow produces intumescence, knotty eruptions and suppurations. The Vayu located in the narrow-constricted places like hips produces copper coloured or tawny or red colour in the skin.

11. Sometimes the Vayu courses in the body as if piercing everything within. Sometimes it courses like a whirlwind in circuits and makes the body lame or limping. 

12. When Vayu is prevalent the pricking pain, throbbing and breaking pain is very much. The swelling is hard and rough and black in colour or tawny. Sometimes it increases. Sometimes it subsides. 

13. Constriction of the nerves and junctions of the fingers, gripping pain tn the limbs, excruciating pain; abhorrence of chillness, non-contiguity; rigidity, shivering and insensibility (in limbs). 

14. The Vayu located with blood produces tumour giving great pain and a piercing achu. It is copper coloured. It gives a very peculiar irritating sensation. Whether glossy or rough it never subsides. It is as it were like a bowl full of mucous substance. 

15. When Pitta too is aggravated the following symptoms are observed: A burning sensation, swooning, perspiration, epileptic fits, inebriety, thirst, not yielding to the touch, painful discharge, drying up, suppuration and excessive heat.

16. When Kapha is aggravated the following symptoms are observed: -rigidity, heaviness, insensibility, glossiness, (numbness), chillness, itchness and slight pain: When two or more doshas combine the symptoms of either occur. 

17. Ailments caused by a single morbid principle can be cured; those caused by two doshas can be alleviated by medication though not cured completely A Rakta pitta caused by three doshas is terrible and should be avoided. 

18. The Vayu located in the extremities and joints attacks the blood and both permeating each other generate excruciating pain and take away the life.

19-20. Vayu is of five types. Prana (one of them) is hard rough. Hence, when it gets aggravated by injudicious conduct (of the patient), fasting, excessive eating, hurt from a blow, suppression or rapid egress of the natural urges, it produces affliction to the eyes, etc, and chatarrh, burning sensation, thirst, cough, dyspnea etc. follow. 

21. Prana located on the top of the clavicle produces constriction of the throat, loose motions, vomiting, nonrelish for food, flowing of the nose and such diseases as goitre (Galaganda), etc. 

22. Vyana (second type of Vayu) becomes vitiated and aggravated by too much of walking, bathing, playing, sexual exercises, coarse and incompatible (foodstuffs) fright, delight, sorrow, etc. 

23. It then impairs manliness, enthusiasm and strength, grief, confusion in the mind, fever, piercing pain all over the body, horripilation, insensibility (somnolence), etc. 

24. (Vyana produces) Kushtha, Erysipelas, exhaustion of the whole body and other disorders. Samana (Third type of Vayu) is defiled by incompatible and undigested foodstuffs that are too cold and of assorted nature. 

25. It is defiled by untimely sleeping and waking up and produces pain, enlargement of the spleen, diarrhoea and diseases of liver and lungs. 

26-27. Apana (fourth type of Vayu) is aggravated by the intake of coarse and heavy cooked rice, forcible blow, suppression of natural urges, too much of travelling, getting up and going round, etc. and produces disorders int he digestive organs and their seats, defects in urine and semen, piles, prolapse in the rectum and other places. 

28-29. Due to lassitude, rigidity and heaviness, the Sama (undigested mucous matter) pervades all the limbs. Due to its glossiness the disorders are lethargy, chillness, swelling and impaired digestion. The itching sensation is due to the loss of roughness and similar palliative measures. The Nirama (free from mucous) shall be known by the opposites of Tandra (lassitude), etc. 

30. They mention many enveloping factors for the Vayu. If it is enveloped by pitta and its symptoms, the disorders are: Burning sensation, thirst, pain, vertigo, darkness of vision and desire for pungent, hot, acid, saline, parchifying food and cool things. 

31. If it is enveloped by Kapha too much of yearning and craving is evinced for fasting, labour, hard and coarse things and hotness. Chillness and heaviness are felt. Pain is experienced. Butter and milk are desired much. Pungent things are liked. 

32. If Vayu is enveloped by Kapha, the disorders are pressure felt on limbs, disquietude, heaviness and non-relish for food. If Vayu is enveloped by blood acute pain and burning sensation in the skin and flesh is experienced. 

33. A red intumescence is found to occur with ringlike grooves all round. The swelling is hard with flesh. Disquietude and eruptions are also observed. 

34. If the Vayu is enveloped by fat it is called Adhyavata. The swelling produced by it is incurable. It is either shifting or fixed; soft to the touch and pleasing to the eyes. 

35. If it is covered it feels hot to the touch; it is cool to the touch when not covered. If the Vayu is enveloped by Majja (marrow) the swelling grows irregularly with surrounding eruptions. The patient feels pleasure in rubbing it with the hand otherwise it is painful. 

36. When the Vayu is enveloped by Semen, there is no rapidity or force in the swelling. When what is taken in is digested there is surely some relief. 

37. If the Vayu is enveloped by urine, urination takes place with the distension of the urinary bladder. If the Vayu is enveloped by pores there is constriction and it splits the place of its seat. 

38. The patient falls down with an attack of fever and the food taken is assimilated. The defiled semen further afflicted by food is discharged slowly. 

39. If the Vayu is enveloped by all the dhatus (seven fundamental constituents of the body) there is pain in the buttocks, thigh joints and the back. When the Vayu courses. in the opposite direction the heart is afflicted.

40. When the Prana is enveloped by Pitta the disorders are vertigo, fainting pain and burning sensation. When Vyana is enveloped all round by Pitta the disorders are pain, lassitude aphome and burning sensation. 

41. When Samana is enveloped by Pitta the disorders are exhaustion, obstruction to the activities of the limbs, distress of mind with pain, loss of heat, perspiration, disinclination (towards everything) and thirst. 

42. When Apana is enveloped by Pitta the disorders are burning sensation, yellow colour in the faecal matter, increase of Rajas (quality of passion, etc.), heat, and urination with distension. 

43. When Prana is enveloped by Kapha the disorders are (rumbling) sound, obstruction to the ducts, ptyalism (excessive salivation), perspiration and difficulty in inhaling and exhaling. 

44. When Udana is enveloped by Kapha the disorders are heaviness of limbs, non-relish for food, aphasia (loss of speech) and aphonia (loss of Voice). When Vyana is enveloped by Kapha the disorders are loss of strength and colour and constriction of bones in the joints. 

45. When Samana is enveloped by Kapha the disorders are heaviness of limbs, obesity, loss of awareness of many functions, non-perspiration and impaired digestion. 

46. If Apana is enveloped by Kapha the disorders are mucous discharges along with urine and faeces. Thus, Vatarakta ailments are of twenty-two types. 

47. Each of the five types of Vayu can be enveloped by the other four. Thus, twenty different enveloping factors are obtained.

48. When Apana is enveloped by Prana the disorders are disquietude, dyspnea, cold, headache, palpitation of the heart and dryness of the mouth. 

49. When Prana is enveloped by Udana, debility is the result. All the other Avaranas (enveloping factors) must be carefully observed by the physician and understood. 

50. The increase and decrease of the activities of the Vayus are based on their seats. Pitta can be the enveloping factor of all the five (Prana, etc). 

51. When Pitta and other doshas are in combination, their scat is a long with the Prana and others in combination. There are many such combinations of Pitta etc. 

52. (The physician) shall observe them attentively from the symptoms shown. Their buying together is gradual. Even the firm ones recur again and again. 

53. Life and longevity depend on the Prana and strength depends on Udana. If the two are afflicted there is loss of life and strength.

54. If the Vayus with their enveloping factors, or their dislodgement from their seats are understood then even incurable ailments can with effort be made harmless. 

55. By neglecting the Vayus when enveloped these disorders occur: -Abscesses, enlarged spleen, palpitation of the heart, tumours, impaired digestion, etc. 

56. O Sushruta, the pathology of the different ailments as narrated by the sage Atreya has been explained by me to distinguish the different ailments and to know the means of increasing the longevity of men. 

57. Thus diagnosing the different ailments one should proceed ahead with the treatment. 

Triphala¹ (Three kinds of myrobalan) is the panacea for all ailments when used in conjunction with honey, ghee and jaggery.

1. Three fruits, viz., Terminalia Chebula. T. Bellerika and Emblica Officinalis.

58. Triphala used in conjunction with Vyosha,² Shatavari,³ Guduchi⁴, Agnividanga^5, removes all sickness.

2. Combination of Zingiber officinale, Piper longum, P. nigrum.

3. Asparagus racemosus.

4. Cocculus cordifolius.

5. Identity not clear.

59-60. Shatavari, Guduchi, Agni⁶, Shunthi,⁷ Mushalika,⁸ Bala¹, Punarnava², Bruhati³, Nirgundi⁴, Nimbapatra⁵, Bhrungaraja⁶, Amalaka⁷, and Vasaka⁸ shall be soaked in Vasaka juice along with Triphala and purified seven times or once.

6. Perhaps chitraka=plumbago zeylanica or P. rosea. (GVDB, PP. 4, 156). 

7. Zingiber officinale.

8. A species of chlorophytum or curcicligo orchioides (GVDB, PP. 312, 178).

1. Chrataeva Rexburghii.

2. Boerhavia Procumbens

3: Solanum indicum.

4. Vitex negundo.

5. Leal of Azadirachota Indica.

6. Eclipta prostrata or E. Erecta.

7. Emblica officianalis.

8. Lippia Nodiflora.

61. The above medicine can be used in powder form, or in pills or in the form of Vatikas (tablets) or prepared in ghee or squeezed into oil or in decoction. The same removes every illness especially emaciation. The dosage is one pala, or half a pala, one Karsha or half a Karsha.