The 7th chapter of Uttaratantra of Sushruta Samhita is named as Drstigata Roga Vijnaniya Adhyaya. This chapter deals with Diseases of Pupil.
अथातो दृष्टिगतरोगविज्ञानीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound the chapter by name Drstigata roga Vijnaniya – knowledge of diseases of diseases of vision (pupil); as revealed by the venerable Dhanvantari.
Drsti Mandala area of vision / pupil
मसूरदलमात्रां तु पञ्चभूतप्रसादजाम् |
खद्योतविस्फुलिङ्गाभामिद्धां तेजोभिरव्ययैः ||३||
आवृतां पटलेनाक्ष्णोर्बाह्येन विवराकृतिम् |
शीतसात्म्यां नृणां दृष्टिमाहुर्नयनचिन्तकाः ||४||
According to the eye specialists, drshti – vision (area of eye sight) has the below mentioned features –
– it is of the size of a cotyledon of lentil,
– has its origin from pancha mahabhutas (five elements of nature / creation – primary elements).
– fully resembles the fire and spark of fire,
– it is sustained by everlasting Tejas i.e. rays of fire and
– is enveloped by the outer layer of the eye,
– is in the form of a hollow (hole / aperture) and
– is accustomed to comfort by cold
रोगांस्तदाश्रयान् घोरान् षट् च षट् च प्रचक्ष्महे |
पटलानुप्रविष्टस्य तिमिरस्य च लक्षणम् ||५||
Now, the twelve dreadful diseases localized in the drshti (vision, pupil) and features of Timira (a disease which affects the patalas – layers or sheaths) shall be described.
Prathama Patala Dusti Laksana – invasion of first layer
सिराभिरभिसम्प्राप्य विगुऽभ्यन्तरे भृशम् |
प्रथमे पटले दोषो यस्य दृष्टौ व्यवस्थितः ||६||
अव्यक्तानि स रूपाणि सर्वाण्येव प्रपश्यति |
The aggravated doshas travel through the siras (blood vessels), get lodged and localized in the first layer of the eye – prathama patala.
Effect – The person in whom this happens will see all the objects unclearly.
Dvitiya Patala Dusti Laksana – invasion of second layer
दृष्टिर्भृशं विह्वलति द्वितीयं पटलं गते ||७||
मक्षिका मशकान् केशाञ्जालकानि च पश्यति |
मण्डलानि पताकांश्च मरीचीः कुण्डलानि च ||८||
परिप्लवांश्च विविधान् वर्षमभ्रं तमांसि च |
दूरस्थान्यपि रूपाणि मन्यते च समीपतः ||९||
समीपस्थानि दूरे च दृष्टेर्गोचरविभ्रमात् |
यत्नवानपि चात्यर्थं सूचीपाशं न पश्यति ||१०||
Signs and symptoms of the second layer of the eye being invaded by the aggravated doshas –
– the vision (sight) gets deranged greatly,
– he sees different shapes of flies, mosquitoes, hairs, net, circles, flags, mirage, rings, different movements of the stars, raining sky and darkness
– far off objects are perceived to be very nearby,
– nearby objects are perceived as being far away
– inability to see the hole of the needle in spite of making great efforts
Trtiya Patala Dusti Laksana – invasion of third layer
ऊर्ध्वं पश्यति नाधस्तात्तृतीयं पटलं गते |
महान्त्यपि च रूपाणि च्छादितानीव वाससा ||११||
कर्णनासाक्षियुक्तानि विपरीतानि वीक्षते [१] |
यथादोषं च रज्येत दृष्टिर्दोषे बलीयसि ||१२||
अधःस्थिते समीपस्थं दूरस्थं चोपरिस्थिते |
पार्श्वस्थिते तथा दोषे पार्श्वस्थानि न पश्यति ||१३||
समन्ततः स्थिते दोषे सङ्कुलानीव [२] पश्यति |
दृष्टिमध्यगते दोषे स एकं मन्यते द्विधा ||१४||
द्विधास्थिते त्रिधा पश्येद्बहुधा चानवस्थिते |
तिमिराख्यः स वै दोषः…
Signs and symptoms of the third layer of the eye being invaded by aggravated doshas –
– the objects present above can be seen whereas those present below cannot be seen,
– even the big objects are seen as being covered by cloth (in spite of being not covered)
– the face of other persons are seen as being devoid of ears, nose and eyes
– disorders of vision also would increase as the doshas get more and more aggravated,
– the person will not see objects which are nearby when the doshas are localized at the bottom,
– the far away objects are not visible when the doshas are localized at the top,
– he cannot see the objects located on the sides when the doshas are located in the sides,
– when the doshas are located everywhere, all around, he will see the objects as getting mixed or super-imposed over each other
– when the doshas are located at the centre of the drshti he will see one object as two
– if the doshas are located at two places on (around) the drshti, he will see one object as three
– when the doshas are not localised at one place but are moving from one place to the other, he sees one object as many
This disease is known as Timira
Trtiya Patala Dusti Laksana – invasion of third layer
… चतुर्थं पटलं गतः ||१५||
रुणद्धि सर्वतो दृष्टिं लिङ्गनाशः स उच्यते |
तस्मिन्नपि तमोभूते नातिरूढे महागदे ||१६||
चन्द्रादित्यौ सनक्षत्रावन्तरीक्षे च विद्युतः |
निर्मलानि च तेजांसि भ्राजिष्णूनि [४] च पश्यति ||१७||
स एव लिङ्गनाशस्तु नीलिकाकाचसञ्ज्ञितः |१८|
Signs and symptoms of the fourth layer of the eye being invaded by aggravated doshas –
In this condition, the doshas would completely obstruct the sight. This condition is called Linganasa (loss of visual perception).
When darkness envelopes or when the disease is not powerful (not deep rooted) in this great disease, the person would see the below mentioned –
– moon, sun, stars, lightnings etc. in the sky
– pure fire,
– light and
– bright / glistening objects
This Linganasa is also known as Nilika and Kaca.
Symptoms of Doshaja Timira
तत्र वातेन रूपाणि भ्रमन्तीव स पश्यति ||१८||
आविलान्यरुणाभानि व्याविद्धानि च मानवः |
पित्तेनादित्यखद्योतशक्रचापतडिद्गुणान् ||१९||
शिखिबर्हविचित्राणि नीलकृष्णानि पश्यति |
कफेन पश्येद्रूपाणि स्निग्धानि च सितानि च ||२०||
गौरचामरगौराणि श्वेताभ्रप्रतिमानि च |
पश्येदसूक्ष्माण्यत्यर्थं व्यभ्रे चैवाभ्रसम्प्लवम् ||२१||
सलिलप्लावितानीव परिजाड्यानि मानवः |
तथा रक्तेन रक्तानि तमांसि विविधानि च ||२२||
हरितश्यावकृष्णानि धूमधूम्राणि चेक्षते |
सन्निपातेन चित्राणि विप्लुतानि च पश्यति ||२३||
बहुधा वा द्विधा वाऽपि सर्वाण्येव समन्ततः |
हीनाधिकाङ्गान्यथवा ज्योतींष्यपि च पश्यति ||२४||
| Predominant dosha involved in the disease | Symptoms |
|
ata |
objects are seen as – moving, slightly red and irregular |
| Pitta | the person sees the sun, firefly, rainbow, lightening and feather of peacock – in different shapes, they are perceived to be blue or black in colour |
| Kapha | the person sees objects as being oily, white in colour resembling the hairs of camara (fly whisk) or white clouds,
he sees only big objects (or objects to be big in size), he sees the sky as having filled with moving clouds, he sees all the objects being soaked |
| Rakta – blood | all objects are seen to be red in colour,
he sees different kinds of darkness before his eyes, he sees colours such as green, blue-black, black and smoky |
| Sannipata – aggravation of all three doshas | the person sees the objects in different colours (as if they have different colours), irregular, double or multiple
he sees the objects as having less or more parts than usual or he sees stars in all the objects |
Parimlayi
पित्तं कुर्यात् परिम्लायि मूर्च्छितं रक्ततेजसा |
पीता दिशस्तथोद्यन्तमादित्यमिव पश्यति ||२५||
विकीर्यमाणान् खद्योतैर्वृक्षांस्तेजोभिरेव च |
Parimlayi is a disease produced by pitta associated with the heat (warmth) of blood.
The space around the patient is seen as being yellow in colour or having the colour of the rising sun. He also sees the sky as being full of fire flies and trees as though full of light rays.
Raga yukta linganasa
वक्ष्यामि षड्विधं रागैर्लिङ्गनाशमतः परम् ||२६||
रागोऽरुणो मारुतजः प्रदिष्टः पित्तात् परिम्लाय्यथवाऽपि नीलः |
कफात् सितः शोणितजस्तु रक्तः समस्तदोषोऽथ विचित्ररूपः ||२७||
After this, six kinds of Linganasa having raga i.e. colours shall be described by me.
Predominant Dosha Colour produced
Vata light red colour
Pitta yellow colour (Parimlayi or Nila)
Kapha white colour
Rakta – blood red colour
Sannipata – all doshas aggravated together variegated mixed colours
| Predominant Dosha | Colour produced |
| Vata | light red colour |
| Pitta | yellow colour (Parimlayi or Nila) |
| Kapha | white colour |
| Rakta – blood | red colour |
| Sannipata – all doshas aggravated together | variegated mixed colours |
रक्तजं मण्डलं दृष्टौ स्थूलकाचानलप्रभम् |
परिम्लायिनि रोगे स्यान्म्लाय्यानीलं च मण्डलम् ||२८||
When Parimlayi disease is caused by rakta – blood, circular patches which are red in colour are visible. These patches shine like a thick glass bead or fire. On the other hand, blue circular patches appear when they are covered with blood. Sometimes the vision becomes restored on its own accord due to the decrease of doshas.
Note – According to Acharya Dalhana, Parimlayi is called as Timira when it is devoid of colours. When the same Parimlayi has covers, it is known as Kaca. When it destroys the vision, it is called Linganasa.
दोषक्षयात् कदाचित् स्यात्स्वयं तत्र च दर्शनम् |
अरुणं मण्डलं वाताच्चञ्चलं परुषं तथा ||२९||
पित्तान्मण्डलमानीलं कांस्याभं पीतमेव वा |
श्लेष्मणा बहलं स्निग्धं शङ्खकुन्देन्दुपाण्डुरम् ||३०||
चलत्पद्मपलाशस्थः शुक्लो बिन्दुरिवाम्भसः |
सङ्कुचत्यातपेऽत्यर्थं छायायां विस्तृतो भवेत् ||३१||
मृद्यमाने च नयने मण्डलं तद्विसर्पति |
प्रवालपद्मपत्राभं मण्डलं शोणितात्मकम् ||३२||
दृष्टिरागो भवेच्चित्रो लिङ्गनाशे त्रिदोषजे |
यथास्वं दोषलिङ्गानि सर्वेष्वेव भवन्ति हि ||३३||
| Dosha producing Linganasha | Signs and Symptoms |
| Vata | Patches which are round, light red, unsteady and rough appear on Dristi Mandala – pupil2 |
| Pitta | Patches which are slightly blue or resemble bronze in colour or yellow in colour are formed |
| Kapha | Thick and unctuous patches, white in colour resembling shells of conch, jasmine flower or moon and appearing like a water bubble moving on the lotus leaf are formed.
Pupil – greatly contracts in sunlight and dilates in shade. These patches become large and spread more when the eye is rubbed or massaged. |
| Rakta – blood | Patches resemble coral beads or lotus petals. |
| Tridoshas together | Vision / sight will be of mixed colours. |
The signs of the concerned doshas will also be present in all these kinds of Linganasa.
षड् लिङ्गनाशाः षडिमे च रोगा दृष्ट्याश्रयाः षट् च षडेव च स्युः |
तथा नरः पित्तविदग्धदृष्टिः कफेन चान्यस्त्वथ धूमदर्शी ||३४||
यो ह्रस्वजाड्यो(त्यो) नकुलान्धता च गम्भीरसञ्ज्ञा च तथैव दृष्टिः |
The twelve diseases localized in the drshti – pupil comprises of –
– the six kinds of Linganasa explained above and
– other six diseases which shall be described further
The other six diseases (other than the six kinds of Linganasa) are as below mentioned –
– Pitta Vidagdha Drshti,
– Kapha Vidagdha Drshti,
– Dhumadarsi,
– Hrsvajadya,
– Nakulandhya and
– Gambhira Drshti
Pitta vidagdha Drsti
पित्तेन दुष्टेन गतेन दृष्टिं पीता भवेद्यस्य नरस्य दृष्टिः ||३५||
पीतानि रूपाणि च मन्यते यः स मानवः पित्तविदग्धदृष्टिः |
प्राप्ते तृतीयं पटलं तु दोषे दिवा न पश्येन्निशि वीक्षते च ||३६||
(रात्रौ शीतानुगृहीतदृष्टिः पित्ताल्पभावादपि तानि पश्येत्) |
The sight of the person becomes yellow when the drshti becomes vitiated by pitta. He also sees all objects as being yellow in colour.
The person will not see anything during day time but can see them at night when the doshas get lodged in the third patala – layer of the eye. This happens when the drshti is made comfortable by the cold naturally prevailing at the night time and also due to the presence of less quantity of pitta at night. This condition is known as Pitta Vidagdha Drshti.
Kapha Vidagdha drsti
The person sees all the objects as white in colour in this disease.
तथा नरः श्लेष्मविदग्धदृष्टिस्तान्येव शुक्लानि हि मन्यते तु ||३७||
Naktandhya
त्रिषु स्थितोल्पः पटलेषु दोषो नक्तान्ध्यमापादयति प्रसह्य |
दिवा स सूर्यानुगृहीतचक्षुरिक्षेत रूपाणि कफाल्पभावात् ||३८||
Naktandhya – night blindness is caused when the doshas which are less in quantity get localized in the third patala of the eye.
Such a person sees things during day time because the eyes get support from the sun and also since kapha is less dominant.
Dhumadarsi
शोकज्वरायासशिरोभितापैरभ्याहता यस्य नरस्य दृष्टिः |
सधूमकान् पश्यति सर्वभावांस्तं धूमदर्शीति वदन्ति रोगम् ||३९||
Dhumadarshi is a disease which presents with the below mentioned signs and symptoms –
– drushti gets vitiated by excessive grief, fever, fatigue, headache etc,
– the person sees all objects as being smoky in all respects
Hrasa Jadya
स ह्रस्वजाड्यो दिवसेषु कृच्छ्राद्ध्रस्वानि रूपाणि च येन पश्येत् |४०|
In this disease, the objects are seen as being small in size by the person, that too with great difficulty during day time.
Nakuandhya
विद्योतते येन नरस्य दृष्टिर्दोषाभिपन्ना नकुलस्य यद्वत् ||४०||
चित्राणि रूपाणि दिवा स पश्येत् स वै विकारो नकुलान्ध्यसञ्ज्ञः |
Nakulandhya is a disease produced when the pupil is vitiated by the doshas. In this condition, the pupil becomes reddish brown in colour and shines like the eye of the mongoose. He also sees objects as having many colours during the day.
Gambhir Drsti
दृष्टिर्विरूपा श्वसनोपसृष्टा सङ्कुच्यतेऽभ्यन्तरतश्च याति ||४१||
रुजावगाढा च तमक्षिरोगं गम्भीरिकेति प्रवदन्ति तज्ज्ञाः |
When vitiated by vata, the pupil becomes distorted, constricted and depressed inwards. This condition is accompanied with severe pain. The eye specialists call this disease Gambhirika.
Bahyaja Linganasa
बाह्यौ पुनर्द्वाविह सम्प्रदिष्टौ निमित्ततश्चाप्यनिमित्ततश्च ||४२||
निमित्ततस्तत्र शिरोभितापाज्ज्ञेयस्त्वभिष्यन्दनिदर्शनैश्च |४३|
सुरर्षिगन्धर्वमहोरगाणां सन्दर्शनेनापि च भास्वराणाम् ||४३||
हन्येत दृष्टिर्मनुजस्य यस्य स लिङ्गनाशस्त्वनिमित्तसञ्ज्ञः |
तत्राक्षि विस्पष्टमिवावभाति वैदूर्यवर्णा विमला च दृष्टिः ||४४||
There are two other kinds of Linganasa mentioned earlier. They are –
– Sanimittaja Linganasa – with an apparent cause and
– Animittaja Linganasa – caused without any apparent cause
The Samittaja kind of Linganasa should be understood by the presence of –
– headache and
– signs of abhisyanda (conjunctivitis)
Animittaja Linganasa is produced from destruction of the pupil by the below mentioned causes –
– by the sight or angry look of Gods, sages, Gandharvas (nymphs) or great serpents or
– by seeing very bright or shining objects
Herein, the eyes appear as
– very clean (shining),
– have the colour of a diamond (white colour) and
– pure (without any blemishes)
Abhighataja Linganasa
विदीर्यते सीदति हीयते वा नृणामभीघातहता तु दृष्टिः ||४५||
The sight of the person becomes split, decreased (becomes weak) or lost when the pupil gets hurt (damaged) by any kind of injury / trauma.
इत्येते नयनगता मया विकाराः सङ्ख्याताः पृथगिह षट् च सप्ततिश्च |
एतेषां पृथगिह विस्तरेण सर्वं वक्ष्येऽहं तदनु चिकित्सितं यथावत् ||४६||
Thus far I have described seventy six eye diseases separately. After this, I shall describe all these in detail along with their treatment.
इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे दृष्टिगतरोगविज्ञानीयो नाम सप्तमोऽध्ययः ||७||
Thus ends the seventh chapter by Name Drstigata roga Vijnaniya in Uttara sthana of Susruta Samhita.
