The ninth chapter of Nidanasthana of Sushruta Samhita is called as Visarpa Nadi Stanaroga Nidanam Adhyaya. This chapter offers with Erysipelas, Sinus Ulcer and Illnesses of the Breast.
अथातो विसर्पनाडीस्तनरोगनिदानं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We are going to now expound Visarpa – nadi – sthana roga Nidanam – prognosis of erysipelas, sinus ulcer and illnesses of the breasts; as revealed by the venerable Dhanvantari.
1. Visarpa: Erysipelas
Samprarti: Pathogenesis
त्वङ्मांसशोणितगताः कुपितास्तु दोषाः सर्वाङ्गसारिणमिहास्थितमात्मलिङ्गम् |
कुर्वन्ति विस्तृतमनुन्नतमाशु शोफं तं सर्वतो विसरणाच्च विसर्पमाहुः ||३||
The doshas get aggravated and invade the pores and skin, muscular tissues and blood and produce swelling which manifests in fast time.
The swelling would unfold to all of the components of the physique and would have their very own particular options. The lesions are huge and canopy massive areas of the physique however won’t bulge up.
Because it spreads to all of the components of the physique, this illness known as Visarpa.
Lakshana: Indicators and signs
Vataja Visarpa
वातात्मकोऽसितमृदुः परुषोऽङ्गमर्दसम्भेदतोदपवनज्वरलिङ्गयुक्तः |
गण्डैर्यदा तु विषमैरतिदूषितत्वाद्युक्तः स एव कथितः खलु वर्जनीयः ||४||
Under talked about are the signs of Visarpa produced by Vata –
– Colour – black
– It’s gentle and tough
– Accompanied by physique ache
– Reducing and pricking sorts of ache
– Signs of fever of vata origin
Prognosis – The vata sort of visarpa shall be rejected when on account of nice vitiation of the tissues, uneven nodules / small tumors develop within the illness.
Pittaja Visarpa
पित्तात्मको द्रुतगतिर्ज्वरदाहपाकस्फोटप्रभेदबहुलः क्षतजप्रकाशः |
दोषप्रवृद्धिहतमांससिरो यदा स्यात् स्रोतोजकर्दमनिभो न तदा स सिध्येत् ||५||
Under talked about are the options of Visarpa attributable to pitta –
– Colour – resembles the colour of blood
– Lesions unfold shortly from one place of the physique to the opposite
– Accompanied by – fever, burning sensation
– Ripens – there’s formation of pus
– Vesicles of various varieties seem
Prognosis – Pitta sort of visarpa can’t be cured when the tremendously elevated dosha i.e. pitta causes destruction of the muscular tissues and blood vessels making them gangrenous / sloughy.
Kaphaja and Sarvatmaka (Tridoshaja) Visarpa
श्लेष्मात्मकः सरति मन्दमशीघ्रपाकः स्निग्धः सितश्वयथुरल्परुगुग्रकण्डुः |६|
सर्वात्मकस्त्रिविधवर्णरुजोऽवगाढः पक्वो न सिध्यति च मांससिराप्रशातात् ||६||
Under talked about are the options of Visarpa attributable to kapha –
– Colour – white
– Swelling – which spreads slowly
– Ripens – after a very long time
– Is unctuous
– Presents with slight ache and extreme itching
Under talked about are the options of Visarpa attributable to all of the three doshas collectively –
– The swelling presents with colour and ache of all of the three doshas in combined proportions
– It’s deep rooted
Prognosis – This situation turns into incurable when it ripens due to the falling off of the muscular tissues and blood vessels.
Kshataja Visarpa
सद्यःक्षतव्रणमुपेत्य नरस्य पित्तं रक्तं च दोषबहुलस्य करोति शोफम् |
श्यावं सलोहितमतिज्वरदाहपाकं स्फोटैः कुलत्थसदृशैरसितैश्च कीर्णम् ||७||
In an individual who already has severely aggravated doshas in his physique, the aggravated pitta and rakta invade a lately brought about unintended wound. By doing so, the doshas give rise to swelling. That is Kshataja Visarpa which can current with the under talked about options.
Options of Kshataja Visarpa –
– Colour – blue and barely crimson
– Has bleeding
– Presents with extreme fever and burning sensation
– There’s formation of pus
– It’s surrounded by black eruptions which resemble horse gram in form and colour
Sadhyasadhyata: Prognosis
सिध्यन्ति वातकफपित्तकृता विसर्पाः सर्वात्मकः क्षतकृतश्च न सिद्धिमेति |
पैत्तानिलावपि च दर्शितपूर्वलिङ्गौ सर्वे च मर्मसु भवन्ति हि कृच्छ्रसाध्याः ||८||
Curable sorts of Visarpa – Visarpa attributable to particular person doshas i.e.
– Vataja visarpa
– Pittaja visarpa and
– Kaphaja visarpa
Incurable sort of Visarpa
– Tridoshaja Visarpa – attributable to all three doshas collectively
– Ksataja Visarpa – that attributable to wound
– Vata-pittaja Visarpa – that attributable to mixed vitiation of vata and pitta
Under talked about sort of visarpa can also be troublesome to remedy –
– When the signs talked about earlier i.e. formation of slough and small tumors develop
– All types of visarpa occurring on the marmas i.e. important spots or organs
2. Nadi vrana: Sinus ulcer
शोफं न पक्वमिति पक्वमुपेक्षते यो यो वा व्रणं प्रचुरपूयमसाधुवृत्तः |
अभ्यन्तरं प्रविशति प्रविदार्य तस्य स्थानानि पूर्वविहितानि ततः स पूयः ||९||
तस्यातिमात्रगमनाद्गतिरित्यतश्च नाडीव यद्वहति तेन मता तु नाडी |१०|
He (the doctor) who neglects a ripe swelling considering it as unripe or he who neglects a wound filled with pus, then the pus goes deep inside, destroying the tissues talked about earlier (pores and skin and muscular tissues); due to its transferring inside tremendously it is named Gati and because the unfold is thru a tube it’s referred to as as Nadi (sinus) additionally.
Bheda-Lakshana: Sorts of sinus ulcers and their signs
दोषैस्त्रिभिर्भवति सा पृथगेकशश्च सम्मूर्च्छितैरपि च शल्यनिमित्ततोऽन्या ||१०||
Nadis are produced by every particular person dosha individually and in addition by all of the three doshas collectively. The opposite selection is attributable to international our bodies.
तत्रानिलात् परुषसूक्ष्ममुखी सशूला फेनानुविद्धमधिकं स्रवति क्षपायाम् |११|
तृट्तापतोदसदनज्वरभेदहेतुः पीतं स्रवत्यधिकमुष्णमहःसु पित्तात् ||११||
ज्ञेया कफाद्बहुघनार्जुनपिच्छिलास्रा रात्रिस्रुतिः स्तिमितरुक्कठिना सकण्डूः |१२|
दोषद्वयाभिहितलक्षणदर्शनेन तिस्रो गतीर्व्यतिकरप्रभवास्तु विद्यात् ||१२||
दाहज्वरश्वसनमूर्च्छनवक्त्रशोषा यस्यां भवन्त्यभिहितानि च लक्षणानि |
तामादिशेत् पवनपित्तकफप्रकोपाद्धोरामसुक्षयकरीमिव कालरात्रिम् ||१३||
नष्टं कथञ्चिदनुमार्गमुदीरितेषु [१] स्थानेषु शल्यमचिरेण गतिं करोति |
सा फेनिलं मथितमच्छमसृग्विमिश्रमुष्णं स्रवेत सहसा सरुजा च नित्यम् ||१४||
| Kind of Nadi | Options / Signs |
| Vataja | CoarseHas small opening / orificeIs painfulDischarges very frothy fluidSymptoms / discharges predominant at night time time |
| Pittaja | Discharge of yellow, copious and heat fluidsDischarges primarily occur throughout the day timeAssociated with thirst, elevated heat, pricking ache, debility, fever |
| Kaphaja | Sinus is hardExudates are massive in amount, thick, white and slimyDischarges / exudates happen primarily at nights,Related to fixed and gentle ache, itching |
| Samsarga | They’re of three varieties, attributable to mixed aggravation of two doshasSymptoms of mixture of two doshas are current |
| Sannipata | That is attributable to all of the three doshas aggravated togetherSymptoms embody burning sensation, fever, dyspnea, fainting and dryness of mouthIt is a dreadful situation. It results in loss of life, similar to Kalaratri – sister of Yama, the lord of loss of life. |
| Shalya janya | Any salya – international physique getting into into the tissue and getting misplaced (hidden) therein – throughout the tissues talked about earlier i.e. pores and skin, muscle and many others. would produce a sinus shortly. From the sinus there happens exudes of heat liquid, frothy, churned up, clear or blood combined. These happen immediately and all the time and are accompanied with ache. |
3. Stana rogas: Illnesses of the breasts
यावत्यो गतयो यैश्च कारणैः सम्भवन्ति हि |
तावन्तः स्तनरोगाः स्युः स्त्रीणां तैरेव हेतुभिः ||१५||
Stana rogas are the illnesses of the breast. The variety of stana rogas and their causes are the identical as these of gati – i.e. nadi – sinus ulcer.
The explanation why breast illnesses happen in those that have delivered kids and never in virgins
धमन्यः संवृतद्वाराः कन्यानां स्तनसंश्रिताः |
दोषाविसरणात्तासां [१] न भवन्ति स्तनामयाः ||१६||
तासामेव प्रजातानां गर्भिणीनां च ताः पुनः |
स्वभावादेव विवृता जायन्ते सम्भवन्त्यतः ||१७||
Within the virgins, the orifices of the breast are closed. Consequently, the doshas don’t unfold contained in the breasts. Therefore, the breast illnesses don’t happen within the virgins. These orifices are naturally open in girls who’ve delivered kids and in addition in those that are pregnant. Subsequently, these girls endure from breast illnesses.
Stanya lakshana: Breast milk and its options
रसप्रसादो मधुरः पक्वाहारनिमित्तजः |
कृत्स्नदेहात् स्तनौ प्राप्तः स्तन्यमित्यभिधीयते ||१८||
विशस्तेष्वपि गात्रेषु यथा शुक्रं न दृश्यते |
सर्वदेहाश्रितत्वाच्च शुक्रलक्षणमुच्यते ||१९||
तदेव चेष्टयुवतेर्दर्शनात् स्मरणादपि |
शब्दसंश्रवणात् स्पर्शात् संहर्षाच्च प्रवर्तते ||२०||
सुप्रसन्नं मनस्तत्र हर्षणे हेतुरुच्यते |
आहाररसयोनित्वादेवं स्तन्यमपि स्त्रियाः ||२१||
तदेवापत्यसंस्पर्शाद्दर्शनात् स्मरणादपि |
ग्रहणाच्च शरीरस्य शुक्रवत् सम्प्रवर्तते ||२२||
स्नेहो निरन्तरस्तत्र प्रस्रवे हेतुरुच्यते |२३|
Stanya means breastmilk. It’s the essence of rasa dhatu. When the meals will get correctly digested, the essence is shaped within the type of rasa dhatu. This essence is good and comes into the breast from your complete physique to kind stanya. Being current in your complete physique is claimed to be the attribute function of sukra (semen). This sukra (semen) won’t be seen when the physique components are lower (despite being current all by the physique). Stanya (breast milk) too is described as just like semen.
The semen flows out (ejaculates) as a result of under talked about causes –
– Sight of the beloved lady
– Remembrance of desired lady
– Listening to the voice of desired lady
– Contact of the specified lady and
– Love of the specified lady
For the thrill in intercourse to be brought about and for the circulation of semen (ejaculation), a relaxed and nice thoughts is desired.
The breastmilk can also be comparable in properties due to being produced by the essence of meals. The breast milk flows out of the lady’s breasts similar to the semen, as a result of under talked about causes –
– By the contact of the kid,
– By the sight of the kid,
– By remembrance of the kid
– By holding the kid
The principle reason for the circulation of breastmilk is the uninterrupted love of the mom in the direction of the kid.
Dusta and Suddha Stanya: Vitiated and pure breast milk
तत् कषायं भवेद्वातात् क्षिप्तं च प्लवतेऽम्भसि ||२३||
पित्तादम्लं सकटुकं राज्योऽम्भसि च पीतिकाः |
कफाद्घनं पिच्छिलं च जले चाप्यवसीदति |
सर्वैर्दुष्टैः सर्वलिङ्गमभिघाताच्च दुष्यति ||२४||
यत् क्षीरमुदके क्षिप्तमेकीभवति पाण्डुरम् |
मधुरं चाविवर्णं च प्रसन्नं तद्विनिर्दिशेत् ||२५||
| Kind of breast milk contamination | Options |
| Vata Dushta Stanya – breast milk contaminated by vata | Astringent in tasteFloats on water |
| Pitta Dushta Stanya – breast milk contaminated by pitta | Bitter and barely pungent in tasteProduces yellowish strains when placed on water |
| Kapha Dushta Stanya – breast milk contaminated by kapha | ThickSlimySinks in water |
| Tridosha Dushta Stanya – breastmilk contaminated by all of the three doshas orAbhighataja Stanya – breast milk contaminated by damage | May have signs of all of the three doshas collectively |
Options of regular breast milk –
– That which mixes nicely with the water when put into it
– White in colour
– Candy in style
– Not discolored
– Clear in look
Stana Roga Karana: Causes for illnesses of breasts
सक्षीरौ वाऽप्यदुग्धौ वा प्राप्य दोषः स्तनौ स्त्रियाः |
रक्तं मांसं च सन्दूष्य स्तनरोगाय कल्पते ||२६||
पञ्चानामपि तेषां तु हित्वा शोणितविद्रधिम् |
लक्षणानि समानानि बाह्यविद्रधिलक्षणैः ||२७||
Illnesses of the breasts are brought about as a result of localization of aggravated doshas within the breasts. These doshas get lodged within the breasts, immaterial of them having milk or not, vitiate the blood and muscle tissues and provides rise to the illnesses of the breasts.
The signs of all of the 5 sorts of breast illnesses are just like the signs of the bahya vidradhi – exterior abscesses of the identical names, apart from that produced by vitiated blood.
इति सुश्रुतसंहितायां निदानस्थाने विसर्पनाडीस्तनरोगनिदानं नाम दशमोऽध्यायः ||१०||
Thus ends the Tenth chapter by title Visarpa-Nadi- sthanaroga Nidanam in Nidana sthana of Susruta Samhita.