Sushruta Samhita Uttaratantra Chapter 5 Krsnagata Roga Vijnaniya (Diseases of the Cornea)

The 5th chapter of Uttaratantra of Sushruta Samhita is named as Krsnagata Roga Vijnaniya Adhyaya. This chapter deals with Diseases of the Cornea.

अथातः कृष्णगतरोगविज्ञानीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will; now expound the chapter by name Krsnagata roga Vijnaniya knowledge of diseases of the cornea; as said by venerable Dhanvantari.

Roganama Sankhya – names and number of diseases

यत् सव्रणं शुक्र(क्ल)मथाव्रणं वा पाकात्ययश्चाप्यजका तथैव |
चत्वार एतेऽभिहिता विकाराः कृष्णाश्रयाः सङ्ग्रहतः पुरस्तात् ||३||

In brief, the four diseases arising in the Krsna Mandala (black portion of the eye) are –

1.   Savrana Sukra
2.   Avrana sukra
3.   Pakatyaya and

4.   Ajaka
   1. Savrana sukra

निमग्नरूपं हि भवेत्तु कृष्णे सूच्येव विद्धं प्रतिभाति यद्वै |
स्रावं स्रवेदुष्णमतीव रुक् च तत् सव्रणं शुक्र(क्ल)मुदाहरन्ति ||४||
दृष्टेः समीपे न भवेत्तु यच्च न चावगाढं न च संस्रवेद्धि |
अवेदनावन्न च युग्मशुक्रं तत्सिद्धिमाप्नोति कदाचिदेव ||५||
विच्छिन्नमध्यं पिशितावृतं वा चलं सिरासक्तमदृष्टिकृच्च |
द्वित्वग्गतं लोहितमन्ततश्च चिरोत्थितं चापि विवर्जनीयम् ||६||
उष्णाश्रुपातः पिडका च कृष्णे यस्मिन् भवेन्मुद्गनिभं च शुक्रम् |
तदप्यसाध्यं प्रवदन्ति केचिदन्यच्च यत्तित्तिरिपक्षतुल्यम् ||७||

Savrana Shukla (black of the eye with ulcer in it) presents with below mentioned features –

–        Nimnagra rupam – the black portion of the eye i.e. cornea appears as if depressed and has gone deep into the eye

–        Suchyeva viddham – appears as though punctured by needles

–        Sravam sraved ushnam ativa – discharge of plenty of warm fluids from the eye

–        Ruk cha – associated with severe pain

Prognosis –

1. Savrana Shukra gets cured sometimes when –

–        the vrana or ulcer is not located closer to the Drishti i.e. pupil

–        the vrana is not discharging fluids

–        the vrana is not associated with pain

–        and not having yugma shukra – double cornea i.e. one cornea appearing as two

1. Savrana Shukra shall be considered incurable and should be refused in the below mentioned conditions –

–        when the black of the eye appears to be split at the centre

–        when the black of the eye appears as if covered by the muscles

–        when the black of the eye appears unsteady

–        when the black of the eye is surrounded by veins obstructing the vision

–        when the ulcer invades two layers

–        when the ulcer has red coloured edges

–        when the ulcer persisted for long duration

1. Other opinions on prognosis

Below mentioned are some more signs of bad prognosis and hence incurable according to some authorities –

–        condition wherein there is flow of warm teats

–        development of eruptions resembling mudga i.e. green gram on the black of the eye

–        black of the eye resembling the feather of tittiri bird i.e. very white in colour

2. Avrana Sukra

सितं यदा भात्यसितप्रदेशे स्यन्दात्मकं नातिरुगश्रुयुक्तम् |
विहायसीवाच्छघनानुकारि [३] तदव्रणं साध्यतमं वदन्ति ||८||
गम्भीरजातं बहलं च शुक्रं चिरोत्थितं चापि वदन्ति कृच्छ्रम् |९|

Avrana Sukra (black of the eye, not having an ulcer on it) presents with the below mentioned features –

–        Sitam yada bhavati asitam syandatmakam – a condition wherein the black of the eye i.e. cornea appears white in colour due to the effect of other disease of the eye i.e. abisyanda – conjunctivitis

–        Nati ruk ashru yuktam – not associated with much of pain and flow of tears

–        Vihayasiva achcha ghananukari – the whiteness on the black of the eye resembles the sky enveloped with clear clouds

Prognosis –

Sadhya – Avrana Sukra presenting with above said features is said to be easily curable.

Krichra Sadhya – Avrana Sukra presenting with below mentioned features is said to be curable with difficulty –

–        that which is located deep within i.e. located in the second and third layers of the eye

–        that which is thick

–        that which has become chronic i.e. persisting for a long duration

3. Pakatyaya

सञ्च्छाद्यते श्वेतनिभेन सर्वं दोषेण यस्यासितमण्डलं तु ||९||
तमक्षिपाकात्ययमक्षिकोपसमुत्थितं तीव्ररुजं वदन्ति |

Pakatyaya presents with the below mentioned features –

Samchadhyate shwetanibena sarvam – disease in which the black of the eye is entirely covered by a white layer, caused by doshas or is considered to be the dosha of the black of the eye i.e. cornea is called as Akshipakatyaya.

Akshi kopa samuttham – it is caused due to aksi kopa or abhisyanda – conjunctivitis, inflammation of eyes

Tivra rujam – it is associated with severe pain

4. Ajakajata

अजापुरीषप्रतिमो रुजावान् सलोहितो लोहितपिच्छिलाश्रुः |
विदार्य कृष्णं प्रचयोऽभ्युपैति तं चाजकाजातमिति व्यवस्येत् ||१०||

Ajakajata presents with below mentioned features –

–        ajapurisha pratimo – a condition of the black of the eye wherein a new cyst like growth appears which resembles the goat excreta i.e. in the form of round pellets

–        rujavan – associated with pain

–        salohito – associated with redness

–        pichchila ashru srava – associated with discharge of sticky / slimy and red coloured tears

–        vidarya krshnam – which splits the black of the eye

इति सुश्रुतसंहितायामुत्तरतन्त्रे कृष्णगतरोगविज्ञानीयो नाम पञ्चमोऽध्यायः ||५||

Thus ends the fifth chapter by name Krsnagata roga Vijnaniya in Uttara-sthana of Susruta samhita.