Sushruta Samhita Nidanasthana Chapter 16 Mukha Roga Nidanam (Diseases of the Mouth)

The 16th chapter of Nidanasthana of Sushruta Samhita is named as Mukha Roga Nidanam Adhyaya. This chapter deals with Diseases of the Mouth.

अथातो मुखरोगाणां निदानं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound Mukharoga nidānam – diagnosis of diseases of the mouth; as revealed by the venerable Dhañvañtari .

 

Roga sañkhyā – number of diseases 

मुखरोगाः पञ्चषष्टिर्भवन्ति सप्तस्वायतनेषु |
तत्रायतनानि- ओष्ठौ, दन्तमूलानि, दन्ताः, जिह्वा, तालु, कण्ठः, सर्वाणि चेति |
तत्राष्टावोष्ठयोः, पञ्चदश दन्तमूलेषु, अष्टौ दन्तेषु, पञ्च जिह्वायां, नव तालुनि, सप्तदश कण्ठे, त्रयः सर्वेष्वायतनेषु ||३||

In total, there are sixty-five diseases of the mouth. They are localized in seven different seats. The seven seats of mukha rogas are –

1. Lips
2. Roots of the teeth (gums)
3. Teeth
4. Tongue
5. Palate
6. Throat
7. Entire mouth

Seat of diseases of the mouth	Number of diseases manifested
Lips	Eight in number
Root of the teeth (gums)	Fifteen in number
Teeth	Eight in number
Tongue	Five in number
Palate	Nine in number
Throat	Seventeen in number
All seats / entire mouth	Three in number

 

1. Ostha rogas – Diseases of the lips

Osthakopa

तत्रौष्ठप्रकोपा वातपित्तश्लेष्मसन्निपातरक्तमांसमेदोभिघातनिमित्ताः ||४||
कर्कशौ परुषौ स्तब्धौ कृष्णौ तीव्ररुगन्वितौ |
दाल्येते परिपाट्येते ह्योष्ठौ मारुतकोपतः ||५||
आचितौ पिडकाभिस्तु सर्षपाकृतिभिर्भृशम् |
सदाहपाकसंस्रावनीलौ पीतौ च पित्ततः ||६||
सवर्णाभिस्तु चीयेते पिडकाभिरवेदनौ |
कण्डूमन्तौ कफाच्छूनौ पिच्छिलौ शीतलौ गुरू ||७||

सकृत् कृष्णौ सकृत् पीतौ सकृच्छ्वेतौ तथैव च |
सन्निपातेन विज्ञेयावनेकपिडिकाचितौ ||८||
खर्जूरफलवर्णाभिः पिडकाभिः समाचितौ |
रक्तोपसृष्टौ रुधिरं स्रवतः शोणितप्रभौ ||९||
मांसदुष्टौ गुरू स्थूलौ मांसपिण्डवदुद्गतौ |
जन्तवश्चात्र मूर्च्छन्ति सृक्कस्योभयतो मुखात् ||१०||
मेदसा घृतमण्डाभौ कण्डूमन्तौ स्थिरौ मृदू |
अच्छं स्फटिकसङ्काशमास्रावं स्रवतो गुरू [८] ||११||
क्षतजाभौ विदीर्येते पाट्येते चाभिघाततः |
ग्रथितौ च समाख्यातावोष्ठौ कण्डूसमन्वितौ ||१२||

Ostha Prakopa – are eight in number. They are produced by –

• Vata
• Pitta
• Sleshma / Kapha
• Sannipata – all doshas together
• Rakta – blood
• Mamsa – muscles
• Medas – fat
• Abhighata – trauma

 

Type of Ostha Prakopa	Symptoms
Vataja Ostha Kopa	Lips are – Rough Coarse Static Black Has severe pain (splitting, throbbing etc.)
Pittaja Ostha Kopa	Lips are – Full of eruptions, of the size of mustard Burning sensation Presence of ulcers Exudation Blue and yellow in color
Kaphaja Ostha Kopa	Lips are – Full of eruptions Eruptions are of the same color of the lips Absence of pain Has itching Swollen Big, slimy, cold and heavy
Sannipataja Ostha Kopa – produced by aggravation of all three doshas simultaneously	Lips are – Black, yellow or white in color Studded with many eruptions
Raktaja Ostha Kopa – produced by vitiated blood	Lips are Full of eruptions Eruptions resemble color of Kharjura fruits – dates – dark brown in color Having symptoms of aggravation of blood Exudes blood
Mamsaja Ostha Kopa – caused by vitiation of muscles	Lips are – Heavy Thick Bulged like a ball of muscle Worms develop at both the angles of the mouth
Medoja Ostha Kopa – caused by vitiation of fat	Lips are Like ghee scum – light yellow in color Itching Static – immovable Soft Exude fluids which are clear like rock crystal Heavy
Abhighataja Ostha Kopa – caused due to trauma	Lips are – Similar to the lip disorder caused by vitiation of blood Cut or broken / cracked Knotted – has small nodes Itching

 

2. Dantamula rogas – Diseases of the gums

 

दन्तमूलगतास्तु- शीतादो, दन्तपुप्पुटको, दन्तवेष्टकः, शौषिरो, महाशौषिरः, परिदर, उपकुशो, दन्तवैदर्भो, वर्धनः, अधिमांसो, नाड्यः पञ्चेति ||१३||

Below mentioned are the names of the diseases of dantamula i.e. roots of the teeth / gums –

• Sitada,
• Danta Pupputaka,
• Danta Vestaka,
• Sausira,
• Mahasausira,
• Paridara,
• Upakusa,
• Danta Vaidarbha,
• Vardhana,
• Adhimāmsa and
• the five kinds of nādi

 

Śītāda

शोणितं दन्तवेष्टेभ्यो यस्याकस्मात् प्रवर्तते |
दुर्गन्धीनि सकृष्णानि प्रक्लेदीनि मृदूनि च ||१४||
दन्तमांसानि शीर्यन्ते पचन्ति च परस्परम् |
शीतादो नाम स व्याधिः कफशोणितसम्भवः ||१५|| Sitada is a condition caused by aggravation of kapha and rakta – blood.

Below mentioned are its symptoms –

• bleeding from the gums without any obvious reasons
• blood has bad smell, black in color
• gums are very moist (slimy) and soft)
• looseness of gums,
• falling off of gums
• formation of pus

Dañta puppuțaka 

दन्तयोस्त्रिषु वा यस्य श्वयथुः सरुजो महान् |
दन्तपुप्पुटको ज्ञेयः कफरक्तनिमित्तजः ||१६||

Due to aggravated kapha and rakta (blood), profound swelling along with pain occurs in the gums of the teeth or three teeth. This condition is known as Dantapupputaka.

Dantavesta 

स्रवन्ति पूयरुधिरं चला दन्ता भवन्ति च |
दन्तवेष्टः स विज्ञेयो दुष्टशोणितसम्भवः ||१७||

Dantavesta is a disease of the gums caused by vitiation of blood. In this condition, there is exudation of pus and blood from the gums. The teeth also become shaky.

 Sausira

श्वयथुर्दन्तमूलेषु रुजावान् कफरक्तजः |
लालास्रावी स विज्ञेयः कण्डूमाञ् शौषिरो गदः ||१८||

The disease produced by kapha and rakta and having painful swelling at the roots of the teeth, increased salivation and accompanied with itching is known as Sausira.

Mahāsaușira 

 दन्ताश्चलन्ति वेष्टेभ्यस्तालु चाप्यवदीर्यते |
दन्तमांसानि पच्यन्ते मुखं च परिपीड्यते ||१९||
यस्मिन् स सर्वजो व्याधिर्महाशौषिरसञ्ज्ञकः |

Teeth are shaky within the gums and the palate is fissured. Here is also suppuration of gums and pain manifests (develops) in the entire mouth (face). This disease produced by all the three doshas together is known as Maha Sausira.

Paridara

दन्तमांसानि शीर्यन्ते यस्मिन् ष्ठीवति चाप्यसृक् [४] ||२०||
पित्तासृक्कफजो व्याधिर्ज्ञेयः परिदरो हि सः |

The disease produced by pitta, asrk (rakta) and Kapha in which the gums become loose (or fall off) and the patient spits blood (and pus) is known as Paridara.

Upakusa 

वेष्टेषु दाहः पाकश्च तेभ्यो दन्ताश्चलन्ति च ||२१||
आघट्टिताः प्रस्रवन्ति शोणितं मन्दवेदनाः |
आध्मायन्ते स्रुते रक्ते मुखं पूति च जायते ||२२||
यस्मिन्नुपकुशः स स्यात् पित्तरक्तकृतो गदः |

The gums have burning sensation and ulcers and because of these the teeth become shaky. When stroked it produces profuse bleeding, has slight pain. After bleeding, it swells up again, and bad smell develops in the mouth. This disease produced by pitta and rakta is known as Upakusa.

Vaidarbha 

घृष्टेषु दन्तमूलेषु संरम्भो जायते महान् ||२३||
भवन्ति च चला दन्ताः स वैदर्भोऽभिघातजः |

Vaidarbha is a condition caused in the gums caused by trauma / injury.

Below mentioned are its symptoms –

• profound swelling occurs at the roots of the teeth when the gums are brushes or kneaded
• teeth become shaky

Vardhana 

 मारुतेनाधिको दन्तो जायते तीव्रवेदनः ||२४||
वर्धनः स मतो व्याधिर्जाते रुक् च प्रशाम्यति |

Vardhana is a condition caused by aggravation of vata.

Below mentioned are its symptoms –

• eruption of extra tooth
• severe pain
• pain subsides after eruption of tooth

Adhimāmsaka 

हानव्ये पश्चिमे दन्ते महाञ्छोथो महारुजः ||२५||
लालास्रावी कफकृतो विज्ञेयः सोऽधिमांसकः |

Adhimamsaka is a condition caused by aggravated kapha.

Below mentioned are its symptoms –

• severe swelling of gums
• severe pain in the gums at the back portion of the cheeks i.e. molar teeth
• more salivation

Dañtamula nādi

दन्तमूलगता नाड्यः पञ्च ज्ञेया यथेरिताः ||२६||

There are five kinds of nadi – sinuses which occur at the toots of the teeth (gums). They should be understood on the lines of those (nadis) described earlier (chapter 10).

 

3. Dañta rogas – Diseases of the teeth 

दन्तगतास्तु- दालनः, क्रिमिदन्तको, दन्तहर्षो, भञ्जनकः, दन्तशर्करा, कपालिका, श्यावदन्तको, हनुमोक्षश्चेति ||२७||

Below mentioned are the names of the diseases of the teeth –

• Dalana
• Krimidanta
• Dantaharsa
• Bhanjanaka
• Dantasarkara
• Kapalika
• Syavadantaka and
• Hanumoksa

 Dālana 

 दाल्यन्ते बहुधा दन्ता यस्मिंस्तीव्ररुगन्विताः |
दालनः स इति ज्ञेयः सदागतिनिमित्तजः ||२८||

Dalana is a condition caused by aggravation of vata wherein the tooth affected by vata breaks into many splinters and is associated with severe pain.

Krimidañtaka 

कृष्णश्छिद्री चलः स्रावी ससंरम्भो महारुजः |
अनिमित्तरुजो वाताद्विज्ञेयः कृमिदन्तकः ||२९||

Krimidantaka is a disease of the tooth produced by aggravated vata. Below mentioned are its symptoms –

• Presence of black colored holes in the tooth
• Shaking of tooth
• Exudation of fluids
• Severe swelling
• Pain
• Pain develops without any other obvious cause

 Dañtaharşa 

शीतमुष्णं च दशनाः सहन्ते स्पर्शनं न च |
यस्य तं दन्तहर्षं तु व्याधिं विद्यात् समीरणात् ||३०||
The disease produced by samirana (vata) in which the teeth does not tolerate cold, heat or touch is known as Dañtaharsa.

Bhanjanaka

 वक्त्रं वक्रं भवेद्यस्मिन् दन्तभङ्गश्च तीव्ररुक् |
कफवातकृतो व्याधिः स भञ्जनकसञ्ज्ञितः ||३१||

Bhanjanaka is a condition caused by aggravated kapha and vata. The symptoms include –

• Breaking of tooth
• Distortion of face
• Severe pain

Dantasarkara

 शर्करेव स्थिरीभूतो मलो दन्तेषु यस्य वै |
सा दन्तानां गुणहरी विज्ञेया दन्तशर्करा ||३२||

Dantasarkara is a condition wherein dirt of the teeth becomes hard like sugar crystals and gets adhered to the teeth. This would eventually destroy the qualities of the teeth like smoothness, whiteness, regularity, evenness etc.

Kapalika

दलन्ति दन्तवल्कानि यदा शर्करया सह |
ज्ञेया कपालिका सैव दशनानां विनाशिनी ||३३||

Kapalika is a disease of the teeth wherein the dirt accumulated on the teeth would break up the upper layer of the teeth (crown) and subsequently causes destruction of the teeth.

Syavadantaka

योऽसृङ्मिश्रेण पित्तेन दग्धो दन्तस्त्वशेषतः |
श्यावतां नीलतां वाऽपि गतः स श्यावदन्तकः ||३४||

Syavadantaka is a condition of the teeth produced by aggravated pitta and rakta – blood. In this condition there is burning / corrosion of the teeth. The teeth may also become black or blue in color.

 HanuMoksa

वातेन तैस्तैर्भावैस्तु हनुसन्धिर्विसंहतः |
हनुमोक्ष इति ज्ञेयो व्याधिरर्दितलक्षणः ||३५||

Causative factors of vata aggravation (like biting hard things, too much yawning or speaking etc.) causes

↓

Aggravation of vata which

↓

Burns the lower jaw and

↓

Produces the disease known as Hanumoksa which

↓

Would have the symptoms similar to those of ardita – facial paralysis

 

4. Jihva roga – Diseases of the tongue

 

जिह्वागतास्तु- कण्टकास्त्रिविधास्त्रिभिर्दोषैः, अलास, उपजिह्विका चेति ||३६|| There are three kinds of diseases of the tongue. They are –

• Jihva Kantaka – 3 types, produced by 3 doshas independently
• Alasa
• Upajihvaka

Jihvakantaka

जिह्वाऽनिलेन स्फुटिता प्रसुप्ता भवेच्च शाकच्छदनप्रकाशा |
पित्तेन पीता परिदह्यते च चिता सरक्तैरपि कण्टकैश्च |
कफेन गुर्वी बहला चिता च मांसोद्गमैः शाल्मलिकण्टकाभैः ||३७||

Type of Jihvakantaka	Symptoms
Vataja Jihvakantaka	Tongue resembles leaf of Saka tree in roughness Fissuring of tongue Loss of sensation in the tongue
Pittaja Jihvakantaka	Tongue becomes yellow Burning sensation of the tongue Tongue covered with eruptions which are filled with blood
Kaphaja Jihvakantaka	Tongue becomes heavy and thick Tongue is covered with muscular sprouts / eruptions The eruptions on the tongue resemble the thorns of Salmali tree – Salmalia malabarica / Bombax ceiba

Alasa

जिह्वातले यः श्वयथुः प्रगाढः सोऽलाससञ्ज्ञः कफरक्तमूर्तिः |
जिह्वां स तु स्तम्भयति प्रवृद्धो मूले तु जिह्वा भृशमेति पाकम् ||३८||

Alasa is a disease of the tongue caused by aggravated kapha and rakta.

The symptoms are as below mentioned –

• Profound swelling at the tongue base
• The swelling presents features of kapha and rakta
• When the disease gets advanced, it creates loss of movements of the tongue and suppuration at the root of the tongue

Upajihvika

 जिह्वाग्ररूपः श्वयथुर्हि जिह्वामुन्नम्य जातः कफरक्तयोनिः |
प्रसेककण्डूपरिदाहयुक्ता प्रकथ्यतेऽसावुपजिह्विकेति ||३९||

Upajihvika is a disease of the tongue produced by aggravated kapha and rakta. The symptoms include –

• Swelling in the tongue tip causing
• Elevation of the tongue
• Excessive salivation
• Itching
• Burning sensation all around

5. Talu Roga – diseases of the palate

तालुगतास्तु- गलशुण्डिका, तुण्डिकेरी, अध्रुषः, कच्छपः, अर्बुदं, मांससङ्घातः, तालुपुप्पुटः, तालुशोषः, तालुपाक इति ||४०||

Below mentioned are the names of the diseases of the talu – palate –

• Galasundika
• Tundikeri
• Adhrusa
• Kacchapa
• Arbuda
• Mamsasamghata
• Talupupputa
• Talusosa
• Talupaka

 Galasundi / Kanthasundi

श्लेष्मासृग्भ्यां तालुमूलात् प्रवृद्धो दीर्घः शोफो ध्मातबस्तिप्रकाशः |
तृष्णाकासश्वासकृत् सम्प्रदिष्टो व्याधिर्वैद्यैः कण्ठशुण्डीति नाम्ना ||४१|| Kanthasundi or Galasundi is a condition caused by aggravated kapha and rakta.

Below mentioned are its signs and symptoms –

• It is an elongated swelling
• The swelling resembles a bladder or bag filled with air, arising
• Located at the base / root of the palate
• Causes thirst, cough and dyspnea

Tundikeri

शोफः स्थूलस्तोददाहप्रपाकी प्रागुक्ताभ्यां तुण्डिकेरी मता तु |

Tundikeri is a condition which is also produced by the same doshas mentioned earlier in Galasundi i.e. kapha and rakta together.

Tundikeri is –

• A big swelling in the throat which has
• Pricking pain
• Burning sensation
• Suppuration

 Adhrusa

 शोफः स्तब्धो लोहितस्तालुदेशे रक्ताज्ज्ञेयः सोऽध्रुषो रुग्ज्वराढ्यः ||४२||

Adhrusa is a condition caused by aggravated blood.

Below mentioned are its features –

• It is an immovable swelling occurring in the palate
• The swelling is red in color
• Presence of pain and fever

Kacchapa 

कूर्मोत्सन्नोऽवेदनोऽशीघ्रजन्माऽरक्तो ज्ञेयः कच्छपः श्लेष्मणा स्यात् |

Kacchapa is a condition caused by aggravated kapha.

It is the swelling in the palate which presents with below mentioned features –

• It resembles tortoise shell
• There is absence of pain
• The swelling develops slowly and
• It is not of red color

Tālu arbuda 

 पद्माकारं तालुमध्ये तु शोफं विद्याद्रक्तादर्बुदं प्रोक्तलिङ्गम् ||४३||

Talu arbuda is a condition in which a swelling caused by aggravated blood is manifested at the middle of the palate. It resembles the lotus flower in shape. It is accompanied with symptoms of rakta arbuda mentioned earlier in chapter 11.

Māmsa sañghāta

दुष्टं मांसं श्लेष्मणा नीरुजं च ताल्वन्तःस्थं मांससङ्घातमाहुः |
Mamsa Sanghata is caused by vitiated mamsa – muscle and kapha together. It gives rise to painless thickening of the muscles inside the palate.

Tālu puppuța 

नीरुक् स्थायी कोलमात्रः कफात् स्यान्मेदोयुक्तात् पुप्पुटस्तालुदेशे ||४४||

Talupupputa is an immovable swelling occurring in the palate, produced by aggravated kapha. It presents with the below mentioned features –

• Swelling which is immovable
• Swelling is of the size of fruit of jujube and
• Contains fat in it and
• Is painless

 Talusosa, Talupaka

शोषोऽत्यर्थं दीर्यते चापि तालुः श्वासो वातात्तालुशोषः सपित्तात् |
पित्तं कुर्यात् पाकमत्यर्थघोरं तालुन्येनं तालुपाकं वदन्ति ||४५||

Talu Sosa is produced by combined vitiation of vata and pitta. In this condition there is severe dryness of the palate. This leads to cracks / fissures in the palate and dyspnea.

Talupaka, on the other hand is caused by aggravated pitta which presents with troublesome suppuration in the palate.

 

6. Kantharoga – Diseases of the throat 

कण्ठगतास्तु- रोहिण्यः पञ्च, कण्ठशालूकम्, अधिजिह्वो, बलयो, बलास, एकवृन्दो, वृन्दः, शतघ्नी, गिलायुः, गलविद्रधिः, गलौघः, स्वरघ्नो, मांसतानो, विदारी चेति ||४६||

Below mentioned are the names of the diseases of the throat –

• Rohini – five types
• Kanthasaluka
• Adhijihva
• Valaya
• Balasa
• Ekavrinda
• Vrinda
• Sataghni
• Gilayu
• Galavidradhi
• Galaugha
• Svaraghna
• Mamsatana
• Vidari

 

1-5. Rohini (Kantharohini) 

गलेऽनिलः पित्तकफौ च मूर्च्छितौ पृथक् समस्ताश्च तथैव शोणितम् |
प्रदूष्य मांसं गलरोधिनोऽङ्कुरान् सृजन्ति यान् साऽसुहरा हि रोहिणी ||४७||
जिह्वां समन्ताद्भृशवेदना ये मांसाङ्कुराः कण्ठनिरोधिनः स्युः |
तां रोहिणीं वातकृतां वदन्ति वातात्मकोपद्रवगाढयुक्ताम् ||४८||
क्षिप्रोद्गमा क्षिप्रविदाहपाका तीव्रज्वरा पित्तनिमित्तजा स्यात् |
स्रोतोनिरोधिन्यपि मन्दपाका गुर्वी स्थिरा सा कफसम्भवा वै ||४९||
गम्भीरपाकाऽप्रतिवारवीर्या त्रिदोषलिङ्गा त्रयसम्भवा स्यात् |
स्फोटाचिता पित्तसमानलिङ्गाऽसाध्या प्रदिष्टा रुधिरात्मिकेयम् ||५०||

Vata, Pitta and Kapha get aggravated individually or all together or along with rakta – blood and they in turn

↓

Vitiate the mamsa – muscle tissue and

↓

Give rise to sprouts of muscles which

↓

Block the throat and

↓

Cause death and

↓

The disease in which these events occur is called as Rohini or Kantharohini

 

Type of Rohini	Symptoms
Vataja Rohini – caused by aggravated vata	Produces severe pain of the entire tongue Has muscular sprouts causing obstruction of throat Many severe complications caused by aggravated vata are present
Pittaja Rohini – caused by aggravated pitta	It develops quickly Ripens to suppurate, leading to formation of pus and causes Burning sensation quickly Associated with severe fever
Kaphaja Rohini – caused by aggravated kapha	Obstructs the throat Suppurates, leading to slow formation of pus Is heavy and Immovable
Tridoshaja Rohini – caused by simultaneous aggravation of all three doshas	Is seated deep Pus is formed greatly, in excess Is of irresistible strength Presents with symptoms of all the three doshas
Raktaja Rohini – caused by aggravated blood	Is studded with small vesicles Presents with symptoms similar to those of pittaja rohini Is incurable

 

6. Kantha śālūka

 कोलास्थिमात्रः कफसम्भवो यो ग्रन्थिर्गले कण्टकशूकभूतः |
खरः स्थिरः शस्त्रनिपातसाध्यस्तं कण्ठशालूकमिति ब्रुवन्ति ||५१||

Kanthasaluka is a granthi – tumor or cystic swelling produced by aggravated kapha in the throat. It presents with below mentioned features –

• It is of the size of the seed of jujube fruit
• Has projections
• Is coarse and
• Immovable
• Can be treated by use of sharp instruments i.e. surgery

7. Adhijihva 

जिह्वाग्ररूपः श्वयथुः कफात्तु जिह्वाप्रबन्धोपरि रक्तमिश्रात् |
ज्ञेयोऽधिजिह्वः खलु रोग एष विवर्जयेदागतपाकमेनम् ||५२||

Adhijihva is a disease of the tongue caused by aggravated kapha and rakta – blood together. It is a swelling which presents with the below mentioned features –

• Resembles the tip of the tongue
• Swelling develops over the root of the tongue

This condition is fit to be rejected (should not be treated) when it undergoes suppuration / ripening (pus formation).

8. Valaya 

बलास एवायतमुन्नतं च शोफं करोत्यन्नगतिं निवार्य |
तं सर्वथैवाप्रतिवारवीर्यं विवर्जनीयं वलयं वदन्ति ||५३||

Valaya is a swelling which occurs in the throat. It presents with the below mentioned features –

• Swelling in the throat
• The swelling is broad and is elevated / bulged up
• Similar to Balasa in features
• Obstructs the passage of food
• Resists treatments with its strength

This is an incurable condition and should be rejected.

9. Balāsa 

गले तु शोफं कुरुतः प्रवृद्धौ श्लेष्मानिलौ श्वासरुजोपपन्नम् |
मर्मच्छिदं दुस्तरमेतदाहुर्बलाससञ्ज्ञं निपुणा विकारम् ||५४||

Balasa is a disease caused by aggravated kapha and vata together. Below mentioned are its features –

• It is produced as a swelling in the throat which
• Gives rise to dyspnea and
• Pain as if cutting through the vital organs and this disease
• Is called as Balasa

This condition is difficult to cure.

10. Ekavrñda 

वृत्तोन्नतो यः श्वयथुः सदाहः कण्ड्वन्वितोऽपाक्यमृदुर्गुरुश्च |
नाम्नैकवृन्दः परिकीर्तितोऽसौ व्याधिर्बलासक्षतजप्रसूतः ||५५||

Ekavrnda is a swelling caused by kapha and rakta, together.

Below mentioned are its features –

• It manifests in the form of swelling in the throat
• The swelling is round in shape and
• Is bulged up and elevated and is
• Associated with burning sensation and itching
• It does not undergo suppuration and
• Is soft and heavy

11. Vrnda 

समुन्नतं वृत्तममन्ददाहं तीव्रज्वरं वृन्दमुदाहरन्ति |
तं चापि पित्तक्षतजप्रकोपाद्विद्यात् सतोदं पवनास्रजं तु ||५६||

Vrnda is a swelling which occurs in the throat and is caused by aggravated pitta and rakta. It presents with the below mentioned features –

• It manifests in the form of elevated and round swelling in the throat
• Has severe burning sensation and high fever

When Vrnda is produced by Vata and Rakta, it will also have pricking pain.

12. Sataghni

वर्तिर्घना कण्ठनिरोधिनी या चिताऽतिमात्रं पिशितप्ररोहैः |
नानारुजोच्छ्रायकरी त्रिदोषाज्ज्ञेया शतघ्नीव शतघ्न्यसाध्या ||५७||

Sataghni is produced by aggravation of all the three doshas together. It presents with the below mentioned features –

• It has thick wick like muscular sprouts which
• Cause obstruction of throat which also
• Greatly grow in size which gives rise to
• Different kinds of pain and this condition is
• Called as Sataghni because it is similar to Sataghni – a weapon of war with a ball of metal, having sharp spikes and fixed to a long chain

Sataghni is an incurable disease and should not be treated.

13. Gilayu

ग्रन्थिर्गले त्वामलकास्थिमात्रः स्थिरोऽल्परुक् स्यात् कफरक्तमूर्तिः |
संलक्ष्यते सक्तमिवाशनं च स शस्त्रसाध्यस्तु गिलायुसञ्ज्ञः ||५८||

Gilayu is a disease which is caused by aggravated kapha and rakta. It presents with the below mentioned features –

• It manifests in the form of a tumor or cystic swelling of the size of Amalaka seed (seed of Emblica officinalis) inside the throat
• The tumor is immovable and
• Has mild pain and presents
• Features of kapha and rakta – blood which
• Obstructs the passage of food
• It is curable with surgical treatment and
• Is known as Gilayu

14. Galavidradhi

सर्वं गलं व्याप्य समुत्थितो यः शोफो रुजो यत्र च सन्ति सर्वाः |
स सर्वदोषो गलविद्रधिस्तु तस्यैव तुल्यः खलु सर्वजस्य ||५९||

Galavidradhi is a swelling produced by aggravation of all the three doshas together.

Galavidradhi is

• A swelling which involves the entire throat which
• Has all kinds of pain and
• It is similar to vidradhi caused by all the three doshas in features

15. Galaugha

शोफो महानन्नजलावरोधी तीव्रज्वरो वातगतेर्निहन्ता |
कफेन जातो रुधिरान्वितेन गले गलौघः परिकीर्त्यतेऽसौ ||६०||

Galaugha is a condition produced by aggravated kapha and rakta together. It presents with the below mentioned features –

• Profound swelling in the throat which
• Causes obstruction of the passage of food and water
• And will also have high grade fever and would
• Disrupt the movements of air – respiration

16. Svaraghna

योऽतिप्रताम्यन् श्वसिति प्रसक्तं भिन्नस्वरः शुष्कविमुक्तकण्ठः |
कफोपदिग्धेष्वनिलायनेषु ज्ञेयः स रोगः श्वसनात् स्वरघ्नः ||६१||

Svaraghna is a disease caused by aggravated vata. It presents with the below mentioned features –

• The patient suffers from difficulty in breathing and breathes constantly in a hurried way
• Experiences darkness before his eyes and will have
• Broken voice and dryness of throat and
• The throat is wide open and
• The air passage is coated with kapha

17. Mamsatana

प्रतानवान् यः श्वयथुः सुकष्टो गलोपरोधं कुरुते क्रमेण |
स मांसतानः कथितोऽवलम्बी प्राणप्रणुत् सर्वकृतो विकारः ||६२||

Mamsatana is a disease of the throat produced by aggravation of all the three doshas together.

Mamsatana is a –

• Broad swelling in the throat which is
• Very difficult to bear and
• Gradually causes obstruction of the throat and
• It hangs loose and
• Hinders life (breathing)

18. Vidārī 

सदाहतोदं श्वयथुं सरक्तमन्तर्गले पूतिविशीर्णमांसम् |
पित्तेन विद्याद्वदने विदारीं पार्श्वे विशेषात् स तु येन शेते ||६३||

Vidari is a disease of the throat which is caused by aggravated pitta. It presents with the below mentioned features –

• It is a red colored swelling occurring inside the throat
• Burning sensation
• Pricking pain
• Has muscles (sprouts) having bad smell and pain
• Occurs especially on the side of the throat on (the side) which the person sleeps habitually

7. Sarvasara- diseases of the entire mouth 

सर्वसरास्तु वातपित्तकफशोणितनिमित्ताः ||६४||

Sarvasara – the diseases affecting the entire mouth are called as sarvasara. These diseases are caused by –

• Vata
• Pitta
• Kapha
• Sonita / rakta

स्फोटैः सतोदैर्वदनं समन्ताद्यस्याचितं सर्वसरः स वातात् |
रक्तैः सदाहैस्तनुभिः सपीतैर्यस्याचितं चापि स पित्तकोपात् ||६५||
कण्डूयुतैरल्परुजैः सवर्णैर्यस्याचितं चापि स वै कफेन |
रक्तेन पित्तोदित एक एव कैश्चित् प्रदिष्टो मुखपाकसञ्ज्ञः ||६६||

Type of Sarvasara Roga	Symptoms
Vataja Sarvasara	Entire mouth is filled with sphota – eruptions Pricking pain
Pittaja Sarvasara	Entire mouth has small eruptions They are red or yellow in color Burning sensation
Kaphaja Sarvasara	Entire mouth has eruptions with Itching, Mild pain and are Of the same color as that of the mouth
Raktaja Sarvasara	The features are the same as those of Pittaja Sarvasara

Sarvasara Mukha Roga is also called as Mukhapaka by some authors.

इति सुश्रुतसंहितायां निदानस्थाने मुखरोगनिदानं नाम षोडशोऽध्यायः ||१६||

Thus ends the Sixteenth chapter by name Mukharoga nidāna , in Nidāna sthāna of Suśruta samhita .

इति भगवता श्रीधन्वन्तरिणोपदिष्टायां तच्छिष्येण महर्षिणा सुश्रुतेन विरचितायां सुश्रुतसंहितायां द्वितीयं निदानस्थानं समाप्तम् |

Thus ends Nidāna sthāna , the second section in Suśruta samhita , as propounded by the venerable Dhañvañtari and written by his disciple , the great sage Suśruta.