The 22nd chapter of Uttaratantra of Sushruta Samhita is named as Nasaroga Vijnaniya Adhyaya. This chapter deals with the Knowledge of Diseases of the Nose.
अथातो नासागतरोगविज्ञानीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound the chapter by name Nasagata roga Vijnaniya – knowledge of diseases of the nose; as revealed by the venerable Dhanvantari.
Roga Nama – Sankhya: Name and Number of Diseases
अपीनसः पूतिनस्यं नासापाकस्तथैव च |
तथा शोणितपित्तं च पूयशोणितमेव च ||३||
क्षवथुर्भ्रंशथुर्दीप्तो नासानाहः परिस्रवः |
नासाशोषेण सहिता दशैकाश्चेरिता गदाः ||४||
चत्वार्यर्शांसि चत्वारः शोफाः सप्तार्बुदानि च |
प्रतिश्यायाश्च ये पञ्च वक्ष्यन्ते सचिकित्सिताः |
एकत्रिंशन्मितास्ते तु नासारोगाः प्रकीर्तिताः ||५||
Here in this context, the thirty one diseases of the nose will be described along with their treatment. Below mentioned are those thirty one nasal diseases –
– Apinasa,
– Putinasya,
– Nasapaka,
– Sonitapitta,
– Puyasonita,
– Ksavathu,
– Bhramsathu,
– Dipta,
– Nasanaha,
– Parisrava,
– Nasasosa,
– Four kinds of Arsas and Sopha,
– Seven kinds of Arbuda and
– Five kinds of Pratisyaya
Apinasa
आनह्यते यस्य विधूप्यते च प्रक्लिद्यते शुष्यति चापि नासा |
न वेत्ति यो गन्धरसांश्च जन्तुर्जुष्टं व्यवस्येत्तमपीनसेन ||६||
तं चानिलश्लेष्मभवं विकारं ब्रूयात् प्रतिश्यायसमानलिङ्गम् |७|
The person who is afflicted by Apinasa born from vitiated vata and kapha will present with the below mentioned symptoms –
– Bloating of nose,
– Feeling of hot fumes coming out of the bose,
– Nose is very moist or dry,
– The person will not recognize smell and taste and
– Will have symptoms similar to Pratisyaya
Putinasa
दोषैर्विदग्धैर्गलतालुमूले संवासितो यस्य समीरणस्तु ||७||
निरेति पूतिर्मुखनासिकाभ्यां तं पूतिनासं प्रवदन्ति रोगम् |
The doshas which are undergoing ripening would get localized at the base of the throat and palate. These doshas flow out through the mouth and nose accompanied with foul smell, being forced by vata. This disease is called Putinasa.
Nasapaka
घ्राणाश्रितं पित्तमरूंषि कुर्याद्यस्मिन् विकारे बलवांश्च पाकः ||८||
तं नासिकापाकमिति व्यवस्येद्विक्लेदकोथावपि यत्र दृष्टौ |
Aggravated pitta gets localized in the nose. Following this, many small boils (eruptions) are formed in the nose. In them, severe suppuration (paka) occurs with excessive moistness and decaying. This condition should be understood as Nasapaka.
Raktapitta
चतुर्विधं द्विप्रभवं द्विमार्गं वक्ष्यामि भूयः खलु रक्तपित्तम् ||९||
Raktapitta disease produced by two origins and two routes i.e. pathways in which the disease gets manifested shall be described later.
Puyarakta
दोषैर्विदग्धैरथवाऽपि जन्तोर्ललाटदेशेऽभिहतस्य तैस्तु |
नासा स्रवेत् पूयमसृग्विमिश्रं तं पूयरक्तं प्रवदन्ति रोगम् ||१०||
Puyarakta is a disease in which pus mixed blood flows out from the nose. This happens either due to doshas undergoing ripening or blow over the forehead.
Ksavathu
घ्राणाश्रिते मर्मणि सम्प्रदुष्टे [१] यस्यानिलो नासिकया निरेति ||११||
कफानुयातो बहुशः सशब्दस्तं रोगमाहुः क्षवथुं विधिज्ञाः |१२|
The aggravated vata gets localized in the marma i.e. fatal spot in the nose and later comes out of the nose along with kapha. These doshas come out many times along with sound. Specialists call this disease Ksavathu.
तीक्ष्णोपयोगादतिजिघ्रतो वा भावान् कटूनर्कनिरीक्षणाद्वा ||१२||
सूत्रादिभिर्वा तरुणास्थिमर्मण्युद्घाटितेऽन्यः क्षवथुर्निरेति |
Another type of Ksavathu called Agantuja Ksavathu is caused due to the external factors which are also its causes. They are as below mentioned –
– Administration of herbs having penetrating properties,
– Excessive indulgence in smelling pungent smells for long periods or
– By constantly seeing the sun for prolonged periods or
– When things like threads etc are inserted into the nose,
– By displacement of cartilage and
– Trauma to fatal spots
Bhramsathu
प्रभ्रश्यते नासिकयैव यश्च सान्द्रो विदग्धो लवणः कफस्तु ||१३||
प्राक् सञ्चितो मूर्धनि पित्ततप्तस्तं भ्रंशथुं व्याधिमुदाहरन्ति |
The heat of pitta liquifies the kapha which had accumulated in the head earlier. The kapha which is thus liquified flows out of the nose in great quantity, often. It is a thick, half ripe and salty liquid. This disease is called Bhramsathu.
Dipta
घ्राणे भृशं दाहसमन्विते तु विनिःसरेद्धूम इवेह वायुः ||१४||
नासा प्रदीप्तेव च यस्य जन्तोर्व्याधिं तु तं दीप्तमुदाहरन्ति |
A condition in which there is a severe burning sensation in the person’s nose always, and air comes out of the nose as hot smoke and the person keeps feeling as if his nose is burning (from fire) is described as Dipta Roga.
Nasapratinaha
कफावृतो वायुरुदानसञ्ज्ञो यदा स्वमार्गे विगुणः स्थितः स्यात् ||१५||
घ्राणं वृणोतीव तदा स रोगो नासाप्रतीनाह इति प्रदिष्टः |
Udana Vata getting aggravated in its own passages accumulates in the nose being enveloped by kapha. In this condition, the nose would get blocked, especially during the nights. This disease is called NNasa Pratinaha.
Nasaparisrava
अजस्रमच्छं सलिलप्रकाशं यस्याविवर्णं स्रवतीह नासा ||१६||
रात्रौ विशेषेण हि तं विकारं नासापरिस्रावमिति व्यवस्येत् |
Nasaparisrava is a disease in which there is continuous flow of clear, watery, colorless fluid from the nose, especially during nights.
Nasa Sosa
घ्राणाश्रिते श्लेष्मणि मारुतेन पित्तेन गाढं परिशोषिते च ||१७||
समुच्छ्वसित्यूर्ध्वमधश्च कृच्छ्राद्यस्तस्य नासापरिशोष उक्तः |
Nasa Parisosa is a condition in which kapha present in the nose gets dried up greatly by vata and pitta. The person would find it difficult to breathe upwards or downwards i.e. both expiration and inspiration would become difficult.
Nasa Arsas and Sopha
दोषैस्त्रिभिस्तैः पृथगेकशश्च ब्रूयात्तथाऽर्शांसि तथैव शोफान् ||१८||
शालाक्यसिद्धान्तमवेक्ष्य चापि सर्वात्मकं सप्तममर्बुदं तु |
Nasa Arsas is of four types – three types caused by each one of the doshas separately and one by combination of all three doshas. Nasa Sopha is also of similar four types (as in Nasa Arsas). According to the principles of Salakya, apart from the six arbudas explained in the Nidana (nidana sthana), there will be yet another i.e. seventh type of arbuda which is sarvatmaka i.e. caused by simultaneous aggravation of all the three doshas.
Pratiśyāya
रोग: प्रतिश्याय इहोपदिष्टः स वक्ष्यते पञ्चविधः पुरस्तात् ।।१९।।
The five kinds of Pratisyayas mentioned in this context (chapter) will be described later (in future chapter – chapter 24).
(नासास्त्रोतोगता रोगास्त्रिंशदेकच कीर्तिताः ।।
स्रोतः पथे यद्विपुलं कोशवच्चार्बुदं भवेत् ।।२०।। )
शोफास्तु शोफविज्ञाना नासास्त्रोतोव्यवस्थिताः ।।
निदानेऽशांसि निर्दिष्टान्येवं तानि विभावयेत् ।। २१ ।।
Thus, thirty one nasal diseases have been described herein. The Nasa Sopha and Nasa Arshas should be understood similar to those described in the respective chapters of Sutra Sthana (chapter 17) and Nidana Sthana (chapter 2) sections.
इति श्रीसुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे नासागतरोगविज्ञानीयो नाम द्वाविंशोऽध्यायः ||२२||
Thus ends the twenty second chapter by name Näsāroga vijñānīya in Uttara sthana of Suśruta samhita.
