The 23rd chapter of Uttara Sthanam of Ashtanga Hridayam is named as Shiroroga Vijnaniya. This chapter deals with the explanation of ‘Knowledge of diseases of the head’.
The topics covered in this chapter include –
- Nidana of Shirorogas
- Shirastapa (Shirashula)
- Ardhavabheda
- Pittaja Shirastapa
- Kaphaja Shirastapa
- Raktaja and Sarvaja Shirastapa
- Krimija Shirastapa
- Shirahkampa
- Shankhaka
- Suryavarta
- Sum up of diseases of the head
- Upashirshaka
- Arumshika
- Darunaka
- Indralupta
- Khalate
- Palita
Pledge by the author(s)
अथात: शिरोरोगविज्ञानीयं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘Knowledge of the diseases of the head’.
Nidana of Shirorogas
धूमातपतुषाराम्बुक्रीडातिस्वप्नजागरैः ।
उत्स्वेदाधिपुरोवातबाष्पनिग्रहरोदनैः ॥ १ ॥
अत्यम्बुमद्यपानेन कृमिभिर्वेगधारणैः ।
उपधानमृजाभ्यङ्गद्वेषाधःप्रततेक्षणैः ॥ २ ॥
असात्म्यगन्धदुष्टामभाष्याद्यैश्च शिरोगताः ।
जनयन्त्यामयान् दोषाः
Exposure to smoke, sunlight and snow (mist, dew), over-indulgence in water sports, excessive sleep and keeping awake, severe sweating, exposure to heavy breeze and direct/eastern breeze, suppressing tears weeping too much, excessive water and wine intake, presence of worms (intestinal), suppression of urges (of urine) etc., avoiding pillow (cushion, bed), cleanliness (bath) and anointing the body; looking down continuously for long periods; exposure to unaccustomed, obnoxious and raw smell, too much of speaking etc.; by these causes the doshas getting localised in the head produce diseases.
Shirastapa (Shirashula)
तत्रमारुतकोपत् ॥ ३ ॥
निस्तुद्येते भृशं शङ्खौ घाटा सम्भिद्यते तथा ।
भ्रुवोर्मध्यं ललाटं च पततीवातिवेदनम् ॥ ४ ॥
बाध्येते स्वनतः श्रोत्रे निष्कृष्येते इवाक्षिणी ।
घूर्णतीव शिरः सर्वं सन्धिभ्य इव मुच्यते ॥ ५ ॥
स्फुरत्यति सिराजालं कन्धराहनुसङ्ग्रहः ।
प्रकाशासहता घ्राणस्रावोऽकस्माद्व्यथाशमौ ॥ ६ ॥
मार्दवं मर्दनस्नेहस्वेदबन्धैश्च जायते ।
शिरस्तापोऽयम्
By aggravation of Vata, appear symptoms such as severe pricking pain in the two temples, feeling of severe pain as though the ghata (area above the temples) gets open, severe pain as if the center of the brows and forehead fall out; ears are painful and have noise in them; eyes feel as though being plucked out, the head reels, and feels loose in all its joints, there is severe pulsations in the network of veins (blood vessels) rigidity of the lower jaw and the shoulders, intolerance to light, running in the nose, relief of pain (headache) without any reason occasionally, and reduction in its severity by massaging, anointing with oil and fomentation and by binding are manifested. This is Shirastapa (of Vata origin).
Ardhavabheda
अर्धे तु मूर्ध्नः सोऽर्धावभेदकः ॥ ७ ॥
पक्षात्कुप्यति मासाद्वा स्वयमेव च शाम्यति ।
अतिवृद्धस्तु नयनं श्रवणं वा विनाशयेत् ॥ ८ ॥
If it appears in half of the head, it is called Ardhavabhedaka. It occurs either by a fortnight or a month and subsides on its own accord; when greatly aggravated it destroys the eye (sight) or ears (hearing).
Pittaja Shirastapa
शिरोऽभितापे पित्तोत्थे शिरोधूमायनं ज्वरः ।
स्वेदोऽक्षिदहनं मूर्छा निशि शीतैश्च मार्दवम् ॥ ९ ॥
In Shirastapa of Pitta origin, there is a feeling of hot fumes coming out from the head, fever, profuse sweating, burning sensation in the eyes, fainting, pain becomes less at night and by cold things.
Kaphaja Shirastapa
अरुचिः कफजे मूर्ध्नो गुरुस्तिमितशीतता ।
सिरानिष्पन्दताऽऽलस्यं रुङ्मन्दाह्न्यधिका निशि ॥ १० ॥
तन्द्रा शूनाक्षिकूटत्वं कर्णकण्डूयनं वमिः ।
In that born from Kapha, there is loss of taste, feeling of heaviness of the head, rigidity and cold, veins not pulsating, lassitude, pain is mild during day and severe at nights, stupor, swelling of the eye sockets, itching inside the ears and vomiting are present.
Raktaja and Sarvaja Shirastapa
रक्तात्पित्ताधिकरुजः सर्वैः स्यात्सर्वलक्षणः ॥ ११ ॥
In those born from Rakta, the pain is similar to that of Pitta origin, but more severe pain and in that caused by all the doshas, features of all them will be present simultaneously.
Krimija Shirastapa
सङ्कीर्णैर्भोजनैर्मूर्ध्नि क्लेदिते रुधिरामिषे ।
कोपिते सन्निपाते च जायन्ते मूर्ध्नि जन्तवः ॥ १२ ॥
शिरसस्ते पिबन्तोऽस्रं घोराः कुर्वन्ति वेदनाः ।
चित्तविभ्रंशजननीर्ज्वरः कासो बलक्षयः ॥ १३ ॥
रौक्ष्यशोफव्यधच्छेददाहस्फुरणपूतिताः ।
कपाले तालुशिरसोः कण्डूः शोषः प्रमीलकः ॥ १४ ॥
ताम्राच्छसिङ्घाणकता कर्णनादश्च जन्तुजे ।
By indulgence in incompatible foods, the blood and muscles in the head become over-hydrated and become vitiated by all the doshas and lead to growth of worms in the head. These, drinking blood from the head cause severe pain, causes disorders of the mind, fever, cough, loss of strength, dryness, swelling, pricking and cutting types of pain, burning sensation, throbbing and bad smell in the scalp, itching, dryness in the palate and head, lassitude, coppery red and thin nasal discharge and noise in the ears are caused in headache due to worms.
Shirahkampa
वातोल्बणाः शिरःकम्पं तत्संज्ञं कुर्वते मलाः ॥ १५ ॥
Doshas with the predominance of Vata, produce shaking of the head known by that term Shirahkampa.
Shankhaka
पित्तप्रधानैर्वाताद्यैः शङ्खे शोफः सशोणितैः ।
तीव्रदाहरुजारागप्रलापज्वरतृड्भ्रमाः ॥ १६ ॥
तिक्तास्यः पीतवदनः क्षिप्रकारी स शङ्खकः ।
त्रिरात्राज्जीवितं हन्ति सिध्यत्यप्याशु साधितः ॥ १७ ॥
Vata and other doshas, with the predominance of Pitta associated with Shonita (blood), produce swelling in the shankha (temples), accompanied with severe burning sensation, pain, redness, delirium, fever, thirst, giddiness, bitter taste in the mouth, yellowish face and producing quick effects, kill the patient within three days; gets cured with immediate treatment sometimes (but not always) this disease is Shankhaka.
Suryavarta
पित्तानुबद्धः शङ्खाक्षिभ्रूललाटेषु मारुतः ।
रुजं सस्पन्दनां कुर्यादनुसूर्योदयोदयाम् ॥ १८ ॥
आमध्याह्नं विवर्धिष्णुः क्षुद्वतः सा विशेषतः ।
अव्यवस्थितशीतोष्णसुखा शाम्यत्यतः परम् ॥ १९ ॥
सूर्यावर्तः स
Vata followed by Pitta, produces severe throbbing pain in temples, eyes, brows and forehead, commencing in the morning with the rise of the sun, increases in severity in the midday and on being hungry specifically; of uncertain comfort to hot or cold and subsides later (after the sun sets). This disease is Suryavarta.
Summary of diseases of the head
इत्युक्ता दश रोगाः शिरोगताः ।
शिरस्येव च वक्ष्यन्ते कपाले व्याधयो नव ॥ २० ॥
Thus, were described the ten diseases of the head; Now, will be described nine diseases of the head, affecting the scalp.
Upashirshaka
कपाले पवने दुष्टे गर्भस्थस्यापि जायते ।
सवर्णो नीरुजः शोफस्तं विद्यादुपशीर्षकम् ॥ २१ ॥
The scalp, when it is still in the womb, gets vitiated by Vata develops a swelling of the same color (of the skin) and devoid of pain; this is known as Upashirshaka.
Pitika, Arbuda and Vidradhi
यथादोषोदयं ब्रूयात्पिटिकार्बुदविद्रधीन् ।
Pitaka, Arbuda and Vidradhi also occur on the scalp which should be recognized by the features of the increased dosha.
Arumshika
कपाले क्लेदबहुलाः पित्तासृक्श्लेष्मजन्तुभिः ॥ २२ ॥
कङ्गुसिद्धार्थकनिभाः पिटिकाः स्युररूंषिकाः ।
Arumshika are eruptions on the scalp caused by Pitta, Asrik (blood), Kapha and jantu (worms, bacteria) which have more of fluid and resemble Setaria italic and Brassica juncea (in size).
Darunaka
कण्डूकेशच्युतिस्वापरौक्ष्यकृत्स्फुटनं त्वचः ॥ २३ ॥
सुसूक्ष्मं कफवाताभ्यां विद्याद्दारुणकं तु तत् ।
Itching, falling (loss) of hairs, loss of tactile sensation, dryness, skin cracks are the features of Darunaka, caused by Kapha and Vata.
Indralupta
रोमकूपानुगं पित्तं वातेन सह मूर्छितम् ॥ २४ ॥
प्रच्यावयति रोमाणि ततः श्लेष्मा सशोणितः ।
रोमकूपान् रुणद्ध्यस्य तेनान्येषामसम्भवः ॥ २५ ॥
तदिन्द्रलुप्तं रुज्यां च प्राहुश्चाचेति चापरे ।
Pitta present in the hair follicles associating with Vata, makes the hairs fall off, then after Kapha along with blood blocks the orifices of the hair follicles there is no growth of new hair. This disease is called Indralupta, and also as Rujya and Chacha by others.
Khalate
खलतेरपि जन्मैवं शातनं तत्र तु क्रमात् ॥ २६ ॥
सा वातादग्निदग्धाभा पित्तात्स्विन्नसिरावृता ।
कफाद्घनत्वग्वर्णांश्च यथास्वं निर्दिशेत्त्वचि ॥ २७ ॥
The symptom of Khalati is also falling of the hair but is gradual caused by Vata; it (scalp) resembles as though burnt by fire; caused by Pitta, sweating and covered with veins, due to Kapha, it is thick and of the same color as of the skin, thus, the color of the skin are to be understood with relevance to doshas.
Incurability
दोषैः सर्वाकृतिः सर्वैरसाध्या सा नखप्रभा ।
दग्धाग्निनेव नीरोमा सदाहा या च जायते ॥ २८ ॥
That which is caused by all the doshas, and having all the features, that which resembles the nail (in color)
and hairless as though burnt by fire, that having burning sensation, are incurable.
Palita
शोकश्रमक्रोधकृतः शरीरोष्मा शिरोगतः ।
केशान् सदोषः पचति पलितं सम्भवत्यतः ॥ २९ ॥
The heat of the body aggravated by grief, exertion and anger moving on the head and getting mixed with the doshas cooks (ripens) the hairs and produces the disease Palita.
Palita Dosha based symptoms
तद्वातात्स्फुटितं श्यावं खरं रूक्षं जलप्रभम् ।
पित्तात्सदाहं पीताभं कफात्स्निग्धं विवृद्धिमत् ॥ ३० ॥
स्थूलं सुशुक्लं सर्वैस्तु विद्याद्व्यामिश्रलक्षणम् ।|
In that caused by Vata, the hair is split (broken), black, rough dry and resemble water; in that caused by Pitta, there is burning sensation in the scalp and the hairs are yellowish; in that caused by Kapha, the scalp is unctuous and hairs are growing thick and white; in that caused by all the doshas, presence of all the features should be noticed.
Palita caused by headache
शिरोरुजोद्भवं चान्यद्विवर्णं स्पर्शनासहम् ॥ ३१ ॥
Another kind of Palita is caused by a headache which has discoloration and intolerance of touch.
Sadhya asadhyata
असाध्या सन्निपातेन खलतिः पलितानि च ।
Khalati and Palita caused by Sannipata are incurable.
Need for Rasayana treatment
शरीरपरिणामोत्थान्यपेक्षन्ते रसायनम् ॥ ३२ ॥
Those (Khalati and Palita) which are due to changes in the body (metabolism, old age, effects of diseases etc.) require Rasayana (rejuvenator therapy).
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने शिरोरोगविज्ञानीयो नाम त्रयोविंशोऽध्याय: ॥ २३ ॥
Thus, ends the chapter-Shiroroga Vijnaniya the twenty third in Uttarasthana of Astanga Hridaya Samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.