Sushruta Samhita Nidanasthana Chapter 13 Ksudra Roga Nidanam (Minor ailments)

The thirteenth chapter of Nidanasthana of Sushruta Samhita is known as as Ksudra Roga Nidanam Adhyaya. This chapter offers with Minor ailments.

अथातः क्षुद्ररोगाणां निदानं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We are going to now expound Ksudra roga- nidana-diagnosis of Minor ailments, as revealed by the venerable Dhanvantari.

Sankhya and Laksana-number and options

समासेन चतुश्चत्वारिंशत् क्षुद्ररोगा भवन्ति |
तद्यथा,- अजगल्लिका, यवप्रख्या, अन्धालजी, विवृता, कच्छपिका, वल्मीकं, इन्द्रवृद्धा, पनसिका, पाषाणगर्दभः, जालगर्दभः, कक्षा, विस्फोटकः, अग्निरोहिणी, चिप्पं, कुनखः, अनुशयी, विदारिका शर्करार्बुदं, पामा, विचर्चिका, रकसा, पाददारिका, कदरं, अलसेन्द्रलुप्तौ, दारुणकः, अरुंषिका, पलितं, मसूरिका, यौवनपिडका, पद्मिनीकण्टकः, जतुमणिः, मशकः, चर्मकीलः, तिलकालकः, न्यच्छं, व्यङ्गः, परिवर्तिका, अवपाटिका, निरुद्धप्रकशः सन्निरुद्धगुदः, अहिपूतनं, वृषणकच्छ्रः, गुदभ्रंशश्चेति ||३||

Briefly, there are forty-four varieties of Ksudra Rogas. The names of those 44 Ksudra rogas are – Ajagallika, Yavaprakhya, Andhalaji, Vivruta, Kachchapika, Valmika, Indraviddha, Panasika, Pasanagardabha, Jalagardabha, Kaksa, Visphotaka, Agnirohini, Cippa, Kunakha, Anusayi, Vidarika, Sarkararbuda, Pama, Vicarcika, Rakasa, Padadarika, Kadara, Alasa, Indralupta, Darunaka, Arumsika, Palita, Masurika, Yauvanapidaka, Padminikantaka, Jatumani, Masaka, Carmakila, Tilakalaka, Nyaccha, Vyanga, Parivartika, Avapatika, Niruddhaprakasa, sanniruddhaguda, Ahiputana, Vrsanakacchu and Gudabhramsa.

1. Ajagalika

स्निग्धा सवर्णा ग्रथिता नीरुजा मुद्गसन्निभा |
कफवातोत्थिता ज्ञेया बालानामजगल्लिका ||४||

Ajagallika is a situation brought on by aggravated kapha and vata. It primarily manifests in youngsters. It presents within the type of a granthi – small tumor or cystic swelling which has the beneath talked about options –

• It’s unctuous
• Has similar colour as that of the pores and skin
• Is tough
• Painless and
• Of the scale of mudga – inexperienced gram

2. Yavaprakhya

यवाकारा सुकठिना ग्रथिता मांससंश्रिता |
पिडका श्लेष्मवाताभ्यां यवप्रख्येति सोच्यते ||५||

Yavaprakhya is a situation brought on by aggravated kapha and vata. It manifests within the type of a pidaka – eruption which has the beneath talked about options –

• It’s of the scale of yava – barley
• Very exhausting
• Is cystic – seems like a small sized tumor
• Resides within the muscle groups

3. Andhalaji

घनामवक्त्रां पिडकामुन्नतां परिमण्डलाम् |
अन्धालजीमल्पपूयां तां विद्यात् कफवातजाम् ||६||

Andhalaji is a situation brought on by aggravated kapha and vata.

It’s a pidaka – eruption which has the beneath talked about options –

• Thick
• Doesn’t have any opening, and therefore andha – blind
• Bulged up
• Spherical in form
• Has little amount of pus in it

4. Vivrta

विवृतास्यां महादाहां पक्वोदुम्बरसन्निभाम् |
विवृतामिति तां विद्यात् पित्तोत्थां परिमण्डलाम् ||७||
Vivrta is a situation brought on by elevated pitta. It’s a pidaka – eruption presenting with the beneath talked about options –

• The eruption has a large mouth (opening)
• Has extreme burning sensation
• It resembles ripe Udumbara fruit (Ficus racemosa) – bluish purple in colour
• Spherical in form
• Arising from the floor

5. Kacchapika

ग्रथिताः पञ्च वा षड्वा दारुणाः कच्छपोन्नताः |
कफानिलाभ्यां पिडका ज्ञेया कच्छपिका बुधैः ||८||

Kachchapika is produced by aggravated kapha and vata.

It’s

• a really troublesome situation,
• raised like a tortoise shell and
• is made up of 5 to 6 granthis i.e. small sized tumor like growths or cystic growths

6. Valmika

पाणिपादतले सन्धौ ग्रीवायामूर्ध्वजत्रुणि |
ग्रन्थिर्वल्मीकवद्यस्तु शनैः समुपचीयते ||९||
तोदक्लेदपरीदाहकण्डूमद्भिर्मुखैर्वृतः |
व्याधिर्वल्मीक इत्येष कफपित्तानिलोद्भवः ||१०||

Valmika is a situation produced by aggravated kapha, pitta and vata. It’s a granthi – small tumor / cystic swelling. It develops within the palms, soles, bony joints, neck and elements above the shoulders. It presents with the beneath talked about options.

• Grows in dimension slowly like an anthill and may have many openings
• Pricking sensation
• Exudation of fluids
• Burning sensation throughout
• Itching

7. Indravrddha

पद्मपुष्करवन्मध्ये पिडकाभिः समाचिताम् |
इन्द्रवृद्धां तु तां विद्याद्वातपित्तोत्थितां भिषक् ||११||

Indravrddha is a situation brought on by vitiated vata and pitta.

It presents as –

• A pidaka – eruption within the centre
• Surrounded by small eruptions and
• Resembling the bottom of petals of lotus

8. Gardabhika

मण्डलं वृत्तमुत्सन्नं सरक्तं पिडकाचितम् |
रुजाकरीं गदर्भिकां तां विद्याद्वातपित्तजाम् |

Gardabhika is a situation brought on by Vata and Pitta. Will probably be

spherical, elevated, purple in color, embedded with eruptions, and will probably be related to ache.

9. Panasika

कर्णौ परि समन्ताद्वा पृष्ठे वा पिडकोग्ररुक् |
शालूकवत्पनसिकां तां विद्याच्छ्लेष्मवातजाम् ||१२||

Panasika is a situation brought on by vitiated kapha and vata. It’s a pidaka – eruption presenting with the beneath talked about options –

• They develop on the ear or its environment or again
• Has extreme ache
• Resembles a Saluka – tuber of lotus plant in look

10. Pasanagardabha

हनुसन्धौ समुद्भूतं शोफमल्परुजं स्थिरम् |
पाषाणगर्दभं विद्याद्बलासपवनात्मकम् ||१३||

Pasanagardabha is a situation brought on by aggravated kapha and vata. It’s a sopha – swelling presenting with the beneath talked about options –

• It develops on the root of the decrease jaw
• Is barely painful
• Is mounted / immovable

11. Jala gardabha

विसर्पवत् सर्पति यो दाहज्वरकरस्तनुः |
अपाकः श्वयथुः पित्तात् स ज्ञेयो जालगर्दभः ||१४||

Jalagardabha is a situation brought on by aggravated pitta. It’s a sopha – swelling which presents with the beneath talked about options –

• It spreads like visarpa – erysipelas
• Has burning sensation
• Related to fever
• Skinny and
• Doesn’t suppurate i.e. pus isn’t fashioned in it

12. Irivellika

पिडिकामुत्तमाङ्गस्थां वृत्तामुग्ररुजाज्वराम् |
सर्वात्मकां सर्वलिङ्गां जानीयादिरिवेल्लिकाम् ||१५||

Irivellika is a situation the place Pidika or eruptions manifest on the scalp, that are spherical, trigger extreme ache and fever; it manifests as a consequence of all of the three doshas and exhibit signs of all of the three doshas.

13. Kaksa

बाहुपार्श्वांसकक्षासु कृष्णस्फोटां सवेदनाम् |
पित्तप्रकोपसम्भूतां कक्षामिति विनिर्दिशेत् ||१६||

Kaksa is a situation brought on by aggravated pitta. It’s a sphota – vesicle which presents with beneath talked about options –

• Black in colour
• Arises within the sides of the arm, shoulder or axilla
• Has ache

14. Gandhanama

एकामेवंविधां दृष्ट्वा पिटिकां स्फोटसन्निभाम् |

त्वग्गतां पित्तकोपेन गन्धनामां प्रचक्षते ||१७||

Gandhanama is a situation brought on by the aggravation of pitta dosha. There might be a single Pitika (eruption) resembling a sphota (vesicle) located on the pores and skin.

15. Visphotaka

अग्निदग्धनिभाः स्फोटाः सज्वराः पित्तरक्ततः |
क्वचित् सर्वत्र वा देहे स्मृता विस्फोटका इति ||१८||

Visphotaka is a situation brought on by aggravation of pitta and rakta – blood. It’s a sphota – vesicle / blister which presents with beneath talked about options –

• It seems like burns brought on by hearth,
• Related to fever
• Happens in a area of the physique or in your complete physique

16. Agnirohini

कक्षाभागेषु ये स्फोटा जायन्ते मांसदारु(र)णाः |
अन्तर्दाहज्वरकरा दीप्तपावकसन्निभाः ||१९||
सप्ताहाद्वा दशाहाद्वा पक्षाद्वा न्घन्ति मानवम् |
तामग्निरोहिणीं विद्यादसाध्यां सन्निपाततः ||२०||

Agnirohini is a situation produced by all of the three doshas aggravated collectively. It’s a sphota – vesicle which presents with beneath talked about options –

• Happens within the area of axilla
• It tears / splits the muscle groups
• Causes burning sensation contained in the physique
• Has fever
• It seems as if produced by flame,
• Killing the individual in seven, ten or fifteen days
• It’s incurable

17, 18 Cippa-Kunakha

नखमांसमधिष्ठाय पित्तं वातश्च वेदनाम् |
करोति दाहपाकौ च तं व्याधिं चिप्पमादिशेत् ||२१||
तदेवाक्षतरोगाख्यं तथोपनखमित्यपि |
अभिघातात् प्रदुष्टो यो नखो रूक्षोऽसितः खरः ||२२||
भवेत्तं कुनखं विद्यात् कुलीनमिति सञ्ज्ञितम् |

Cippa –

Cippa is a situation brought on by aggravated pitta and vata. It will get localized within the muscle of the nail and produces the beneath talked about signs –

• Ache
• Burning sensation
• Formation of pus

Synonyms of Cippa – Aksta roga, Upanakha

Kunakha –

It’s a situation whereby the nail is broken as a consequence of harm / hit.

The nail on this situation turns into –

Kunakha can also be referred to as Kulina.

19. Anusayi

गम्भीरामल्पसंरम्भां सवर्णामुपरिस्थिताम् ||२३||

कफादन्तःप्रपाकां तां विद्यादनुशयीं भिषक् |

Anusayi is a situation brought on by vitiated kapha. It’s a deep seated, gentle swelling which presents with the beneath talked about options –

• It’s of the identical colour as that of the encompassing pores and skin
• It’s located on the scalp
• Pus is fashioned inside it

20. Vidarika

विदारीकन्दवद्वृत्तां कक्षावङ्क्षणसन्धिषु ||२४||
रक्तां विदारिकां विद्यात् सर्वजां सर्वलक्षणाम् |

Vidarika is a situation which is produced by all of the doshas. It’s a pidaka – eruption, which presents with the beneath talked about options –

• It’s spherical in form resembling Vidarikanda – tuber of Pueraria tuberosa
• Develops in axilla or groin
• Is purple in colour
• Displays the signs of all of the three doshas

21. Sarkarabuda

प्राप्य मांससिरास्नायु श्लेष्मा मेदस्तथाऽनिलः ||२५||
ग्रन्थिं कुर्वन्ति भिन्नोऽसौ मधुसर्पिर्वसानिभम् |
स्रवत्यास्रावमत्यर्थं तत्र वृद्धिं गतोऽनिलः ||२६||
मांसं विशोष्य ग्रथितां शर्करां जनयेत् पुनः |
दुर्गन्धं क्लिन्नमत्यर्थं नानावर्णं ततः सिराः ||२७||
स्रवन्ति सहसा रक्तं तद्विद्याच्छर्करार्बुदम् |

Sarkararbuda is a situation brought on by aggravated kapha, medas – fats and vata.

Kapha, medas and vata will get localized within the muscle groups, veins and ligaments and

↓

Provides rise to granthi – small sized tumor / cystic swelling which

↓

Bursts open and

↓

Exudes giant portions of fluids resembling honey, ghee or muscle fats

↓

Now, Vata getting elevated would dry up the muscle groups and

↓

Produces exhausting crystals

↓

Instantly there’s discharge of blood which smells unhealthy and could be very moist from the veins

↓

This situation is known as Sarkararbuda

 

22, 23, 24 – Pama, Vicarcika, Rakasa

पामाविचर्च्यौ कुष्ठेषु रकसा च प्रकीर्तिता ||२८||

Three situations i.e. pama, vicarcika and rakasa have been described in Kustha Nidana chapter (chapter 5) earlier.

25. Padadari

परिक्रमणशीलस्य वायुरत्यर्थरूक्षयोः |
पादयोः कुरुते दारीं सरुजां तलसंश्रितः ||२९||

Causes – strolling an excessive amount of

Vata turns into very dry and produces painful cracks / fissures within the soles in individuals who stroll an excessive amount of. This situation is known as as Padadari.

26. Kadara

शर्करोन्मथिते पादे क्षते वा कण्टकादिभिः |
मेदोरक्तानुगैश्चैव दोषैर्वा जायते नृणाम् ||३०||
सकीलकठिनो ग्रन्थिर्निम्नमध्योन्नतोऽपि वा |
कोलमात्रः सरुक् स्रावी जायते कदरस्तु सः ||३१||

Causes –

• Putting the toes on exhausting or tough surfaces like stone or gravel
• Wounds brought on by thorns and so forth.
• Doshas getting aggravated together with fats and blood

Pathogenesis –

Because of the above mentioned causes, a tumor is fashioned which presents with the beneath talked about options –

• Onerous like a bolt
• Flat on the edges
• Elevated on the heart
• Is of the scale of Kola – jujube fruit
• Has ache
• Has exudation of fluids

The situation brought on by the above mentioned causes and presenting with the signs talked about above is known as as Kadara.

27. Alasa

क्लिन्नाङ्गुल्यन्तरौ पादौ कण्डूदाहरुगन्वितौ |
दुष्टकर्दमसंस्पर्शादलसं तं विनिर्दिशेत् ||३२||

Causes of Alasa – extreme contact of the foot with unhealthy slush

Signs –

• Moistness in between the toes
• Itching
• Burning sensation
• Ache

28. Indralupta

रोमकूपानुगं पित्तं वातेन सह मूर्च्छितम् |
प्रच्यावयति रोमाणि ततः श्लेष्मा सशोणितः ||३३||
रुणद्धि रोमकूपांस्तु ततोऽन्येषामसम्भवः |
तदिन्द्रलुप्तं खालित्यं रुज्येति च विभाव्यते ||३४||

Aggravated pitta positioned within the hair follicles

↓

Will get related to aggravated vata and

↓

Causes the hairs of the top to fall off following which

↓

Kapha and rakta – blood collectively blocks the hair follicles

↓

Making the expansion of latest hairs not possible and

↓

The illness thus brought about is known as by names Indralupta or Khalitya or Rujya

29. Darunaka

दारुणा कण्डुरा रूक्षा केशभूमिः प्रपाट्यते |
कफवातप्रकोपेण विद्याद्दारुणकं तु तम् ||३५||

Darunaka is a situation brought on by aggravated kapha and vata.

This happens in scalp and makes the pores and skin of the scalp –

• Cracked
• Dreadful
• Itchy
• Dry

30. Arumsika

अरूंषि बहुवक्त्राणि बहुक्लेदीनि मूर्धनि |
कफासृक्कृमिकोपेन नृणां विद्यादरुंषिकाम् ||३६||

Arumsika is a situation produced by improve of kapha, rakta and krimi – worms.

They manifest with eruptions creating on the pores and skin with the beneath talked about options –

• Every eruption has many openings
• Copious exudation happens from these a number of openings

31. Palita

क्रोधशोकश्रमकृतः शरीरोष्मा शिरोगतः |
पित्तं च केशान् पचति पलितं तेन जायते ||३७||

 

Extreme anger, grief or exertion

↓

Causes extreme improve of warmth within the physique which

↓

Will get blended with elevated pitta and

↓

Will get localized within the head and

↓

Trigger ripening of hairs and makes them gray and

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This situation is known as as Palita

 

32. Masurika

दाहज्वररुजावन्तस्ताम्राः स्फोटाः सपीतकाः |
गात्रेषु वदने चान्तर्विज्ञेयास्ता मसूरिकाः ||३८||

Masurika presents within the type of Sphota – vesicles which current with the beneath talked about options –

• Coppery or barely yellow in colour
• Has burning sensation and ache
• Related to fever
• Seems on the physique, face and contained in the mouth

 

33. Mukhadusika

शाल्मलीकण्टकप्रख्याः कफमारुतशोणितैः |
जायन्ते पिडका यूनां वक्त्रे या मुखदूषिकाः ||३९||

Mukhadushika, which is also called Yuvana Pidaka are pidakas – eruptions brought on by aggravated kapha, vata and rakta. They seem on the face of younger individuals and resemble thorns of Salmali tree (Salmalia malabarica, Bombax ceiba) in look.

 

34. Padmini Kantaka

कण्टकैराचितं वृत्तं कण्डूमत् पाण्डुमण्डलम् |
पद्मिनीकण्टकप्रख्यैस्तदाख्यं कफवातजम् ||४०||

Padmini Kantaka is a situation brought on by aggravated kapha and vata.

It’s a mandala i.e. patch which seems on the pores and skin and manifests with the beneath talked about options –

• Spherical in form
• Is itching
• Yellowish-white in colour
• Studded with thorn like projections
• Resembles these of lotus flowers

 

35. Jatumani

नीरुजं सममुत्सन्नं मण्डलं कफरक्तजम् |
सहजं रक्तमीषच्च श्लक्ष्णं जतुमणिं विदुः ||४१||

A mandala (patch of pores and skin) produced by the aggravation of kapha and rakta (blood), painless and evenly elevated on all sides, current proper from the start, barely purple and tender is known as as Jatumani.

 

36. Masaka

अवेदनं स्थिरं चैव यस्य गात्रेषु दृश्यते |
माषवत्कृष्णमुत्सन्नमनिलान्मषकं वदेत् ||४२||

Masaka is a situation brought on by aggravated vata. It presents within the type of raised lesions on the physique that are painless, static (immovable) and black in colour like Masa – black gram in look.

 

37. Carmakila

समुत्थाननिदानाभ्यां चर्मकीलं प्रकीर्तितम ।

The pathogenesis and causative elements of Carmakila have been described earlier (in chapter 2).

 

38. Tila Kalaka

कृष्णानि तिलमात्राणि नीरुजानि समानि च |
वातपित्तकफोच्छोषात्तान् विद्यात्तिलकालकान् ||४३||

Tilakalaka is a situation produced when kapha is dried up by vata and pitta.

They’re black spots which seem on the physique and presents with beneath talked about options –

• They’re of the scale of tila – seeds of sesame in look
• They’re painless
• They’re even i.e. on the degree of the pores and skin

 

39. Nyaccha

मण्डलं महदल्पं वा श्यामं वा यदि वा सितम् |
सहजं नीरुजं गात्रे न्यच्छमित्यभिधीयते ||४४||

Nyachcha is a situation current proper from the start and presents within the type of

• massive or small patches of pores and skin that are
• blue or white in colour and
• are painless

40. Charmakeela

समुत्थाननिदानाभ्यां चर्मकीलं प्रकीर्तितम् |

It’s already described about Charmakeela in beforehand enumerated chapter.

 

41. Vyanga

क्रोधायासप्रकुपितो वायुः पित्तेन संयुतः ||४५||
सहसा मुखमागत्य मण्डलं विसृजत्यतः |
नीरुजं तनुकं श्यावं मुखे व्यङ्गं तमादिशेत् ||४६||
कृष्णमेवङ्गुणं गात्रे मुखे वा नीलिकां विदुः |

Vyanga is a situation brought on by aggravated vata and pitta.

Causes – anger and exertion

Vata will get aggravated as a result of above mentioned etiological elements. This aggravated vata combines with pitta shortly reaches the face. Therein these doshas would give rise to patches on the pores and skin. These patches are referred to as as vyanga that are blue in colour, skinny and painless.

The patch with comparable options however black in colour, when develops on the face or physique, is understood by the identify Nilika.

42. Parivartika

मर्दनात् पीडनाच्चाति तथैवाप्यभिघाततः |
मेढ्रचर्म यदा वायुर्भजते सर्वतश्चरः ||४७||
तदा वातोपसृष्टं तु चर्म प्रतिनिवर्तते |
मणेरधस्तात् कोशश्च ग्रन्थिरूपेण लम्बते ||४८||
सवेदनः सदाहश्च पाकं च व्रजति क्वचित् |
मारुतागन्तुसम्भूतां विद्यात्तां परिवर्तिकाम् ||४९||
सकण्डूः कठिना चापि सैव श्लेष्मसमुत्थिता |५०|

Parivartika is a situation produced by Vata or exterior brokers.

Causes – an excessive amount of kneading squeezing or harm to the pores and skin of the penis.

Pathogenesis – as a result of above mentioned causes, vata will get aggravated. This aggravated vata turns into localized within the pores and skin of the penis and causes Parivartika.

Signs – It roles over the pores and skin of the penis. With this, the glans penis will get uncovered and assumes the shapes of a sac and hangs beneath the glans penis. There’s ache and burning sensation. In some individuals there’s additionally formation of pus.

When the identical situation is produced by Kapha, there might be itching and hardness.

43. Avapatika

अल्पीयःखां यदा हर्षाद्बालां गच्छेत् स्त्रियं नरः ||५०||
हस्ताभिघातादथवा चर्मण्युद्वर्तिते बलात् |
मर्दनात्पीडनाद्वाऽपि शुक्रवेगविघाततः ||५१||
यस्यावपाट्यते चर्म तां विद्यादवपाटिकाम् |५२|Causes –

• man copulating with a lady having slim vaginal orifice or
• copulating with a really younger lady or
• assaulting one’s penis by palms – like kneading or squeezing it – masturbating or
• by forcibly obstructing ejaculation of semen

Because of the above mentioned causes, the pores and skin of the penis turns into averted i.e. rolled up and cracked.

This illness is called Avapatika.

44. Niruddha Prakasa

वातोपसृष्टमेवं तु चर्म संश्रयते मणिम् ||५२|||
मणिश्चर्मोपनद्धस्तु  मूत्रस्रोतो रुणद्धि च |
निरुद्धप्रकशे तस्मिन्मन्दधारमवेदनम् ||५३||
मूत्रं प्रवर्तते जन्तोर्मणिर्न च विदीर्यते |
निरुद्धप्रकशं विद्याद्दुरूढां चावपाटिकाम् ||५४||

Niruddha Prakasa is a situation brought on by aggravated vata. When Avapatika turns into improperly healed, it would even be often called Niruddha Prakasa.

Vata will get aggravated as a consequence of its personal causes and

↓

Will get localized within the pores and skin over the glans penis and

↓

Makes the pores and skin thick and swollen and blocks the urethra

↓

The glans penis turns into hid and

↓

Stream of urine will get gradual and is voided with or with out ache however

↓

The glans isn’t cracked or ulcerated and

↓

This illness is called Niruddha Prakasa

 

45. Sanniruddha
    

    guda

वेगसन्धारणाद्वायुर्विहतो गुदमाश्रितः |
निरुणद्धि महत्स्रोतः सूक्ष्मद्वारं करोति च ||५५||
मार्गस्य सौक्ष्म्यात् कृच्छ्रेण पुरीषं तस्य गच्छति |
सन्निरुद्धगुदं व्याधिमेनं विद्यात् सुदुस्तरम् ||५६||

Sanniruddha Guda is a ‘troublesome to treatment’ situation brought on by aggravated vata.

Suppression of the urges of feces / defecation results in

↓

Aggravation of vata which

↓

Produces blocking of the alimentary tract and

↓

Narrows the anal orifice and as a consequence of this narrowing

↓

The feces get eradicated with issue and

↓

This situation is called Sanniruddha Guda

 

46. Ahiputana

शकृन्मूत्रसमायुक्तेऽधौतेऽपाने शिशोर्भवेत् |
स्विन्नस्यास्नाप्यमानस्य कण्डू रक्तकफोद्भवा ||५७||
कण्डूयनात्ततः क्षिप्रं स्फोटाः स्रावश्च जायते |
एकीभूतं व्रणैर्घोरं तं विद्यादहिपूतनम् ||५८||

Ahiputana is a situation brought on by aggravated rakta and kapha in youngsters.

Causes –

• contact of rectum / anus for extended time with feces and urine (in youngsters)
• not correctly washing the anus after defecation / remaining unclean for a lot of days
• not bathing the kid despite the kid sweating so much

Pathogenesis – Rakta and Kapha getting aggravated by the above mentioned causative elements would produce itching within the anus of the kid.

Signs –

• extreme itching within the anus
• fast improvement of sphota – vesicles as a consequence of scratching
• exudation of fluids from these vesicles
• formation of ulcers
• formation of huge ulcer as a consequence of coalescing collectively of small ulcers

 

47. Vrsana kacchu

स्नानोत्सादनहीनस्य मलो वृषणसंश्रितः |
यदा प्रक्लिद्यते स्वेदात् कण्डूं सञ्जनयेत्तदा ||५९||
तत्र कण्डूयनात् क्षिप्रं स्फोटाः स्रावश्च जायते |
प्राहुर्वृषणकच्छूं तां श्लेष्मरक्तप्रकोपजाम् ||६०||

Vrushana Kacchu is a situation produced by aggravated kapha and rakta within the scrotal pores and skin.

Causes – not taking common bathtub or therapeutic massage

Signs – Because of the above mentioned causes the grime on the scrotum turns into soaked in sweat and produces extreme itching. When the individual scratches the scrotum when it itches, sphota – vesicles are fashioned shortly. These sphotas exude fluids.

 

48. Guda bhramsa

प्रवाहणातिसाराभ्यां निर्गच्छति गुदं बहिः |
रूक्षदुर्बलदेहस्य तं गुदभ्रंशमादिशेत् ||६१||

Guda Bhramsa is a situation whereby the rectum comes out in individuals who’ve dryness and weak spot within the physique. Extreme straining whereas within the act of defecation or extreme diarrhea are the principle causes of guda bhramsa.

 

इति सुश्रुतसंहितायां निदानस्थाने क्षुद्ररोगनिदानं नाम त्रयोदशोऽध्यायः ||१३||

Thus ends the Thirteenth chapter by identify Ksudraroga  Nidana  in Nidana sthana of Susruta Samhita.