Skip to content
AYANAACADEMYby Dr Vijaya Dwarampudi
Open Academy navigation

११. ग्रन्थ्यपच्यर्बुदगलगण्डनिदानम्

DevanagariIAST (Roman)TeluguTamilMalayalamKannadaGujaratiBengaliGurmukhi

Adhikarana १ (१-२) · Śloka २

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

Meaning of the śloka

Now we shall explain the diagnosis of granthi, apacī, arbuda, and galagaṇḍa. Thus spoke the revered Dhanvantari.

🔊 Audio coming soon

Show commentary

अथात इत्यादि||१-२||

Meaning of the commentary

The commentary only marks the conventional opening and its two verses and supplies no further explanation.

Key terms

granthi
A classical category of localized knot-like swelling.
apacI (apacī)
A classical category of glandular or nodular swelling discussed later in the chapter.
arbuda
A classical category of substantial localized swelling or mass.
galagaNDa (galagaṇḍa)
A classical swelling in the neck or throat region.
nidAna (nidāna)
The account of causes, development, and diagnostic features.

Adhikarana २ (३) · Śloka ३

वातादयो मांसमसृक् च दुष्टाः सन्दूष्य मेदश्च कफानुविद्धम् | वृत्तोन्नतं विग्रथितं तु शोफं कुर्वन्त्यतो ग्रन्थिरिति प्रदिष्टः ||३||

Meaning of the śloka

The disturbed doṣas, together with affected muscle and blood, are said to further vitiate fat associated with kapha and produce a rounded, raised, densely knotted or very hard swelling. For this reason it is designated granthi.

🔊 Audio coming soon

Show commentary

तेषां हेतुसम्प्राप्तिलक्षणनिरुक्तीराह- वातादय इत्यादि| वातादयो दोषा दुष्टा मांसमसृक् च सन्दूष्य शोफं कुर्वन्तीति सम्बन्धः| एतेन त्रयो ग्रन्थय उक्ताः| मेदश्च कफानुविद्धं कफसंसृष्टं वायुदूषितत्वाच्छोफं करोतीति सम्बन्धः| भोजेऽपि वातकर्तृत्वं मेदोग्रन्थावभिहितम्| तथा च,- “वायुर्मेदो यदा मांसे सङ्क्षिपेदथवा त्वचि| तत्र मेदोभवो ग्रन्थिः श्यावो भवति कण्डुलः”- इत्यादि| अयं चतुर्थो ग्रन्थिः| चकारात् सिराजो ग्रन्थिः पञ्चमो ग्राह्यः| दुष्टा वृद्धिं गता इत्यर्थः| वृत्तो वर्तुलः, उन्नत उच्छ्रितः| विग्रथितोऽत्यर्थं कठिनः| वातादयो दुष्टा इत्यनेन हेतूपदेशः, मांसमसृक् च सन्दूष्येति सम्प्राप्तिः, वृत्तोन्नतं विप्रथितं तु शोफमिति लक्षणोपदेशः, अतो ग्रन्थिरिति प्रदिष्ट इति निरुक्तिः||३||

Meaning of the commentary

The commentary presents the cause, development, signs, and derivation of the name. Disturbed vāta and the other doṣas affect muscle and blood and produce swelling; this accounts for three granthis, one for each doṣa. Fat combined with kapha is also affected through vāyu and produces a fourth, the medas-type granthi. Bhoja is cited as likewise assigning agency to vāyu in this type: when vāyu condenses fat in muscle or skin, a dark, itchy swelling due to fat arises. The word ‘and’ is taken to include a fifth type arising from vessels. Duṣṭa means increased or disturbed; vṛtta means round; unnata means raised; and vigrathita means extremely hard. The doṣas state the cause, disturbance of muscle and blood states development, the rounded, raised, hard swelling states its features, and its knotted character explains the name granthi.

Key terms

granthi
A knot-like swelling characterized here as round, raised, and very hard.
mAMsa (māṃsa)
Muscle or fleshy tissue affected in the classical account.
asRuk (asṛk)
Blood.
medas
Fat or adipose tissue in the classical tissue scheme.
kaphAnuviddha (kaphānuviddha)
Associated or intermixed with kapha.
vigrathita
Densely knotted or, according to the commentary, extremely hard.

Adhikarana ३ (४) · Śloka ४

आयम्यते व्यथ्यत एति तोदं प्रत्यस्यते कृत्यत एति भेदम् | कृष्णोऽमृदुर्बस्तिरिवाततश्च भिन्नः स्रवेच्चानिलजोऽस्रमच्छम् ||४||

Meaning of the śloka

A granthi attributed to vāta is described as becoming stretched or elongated, shifting or throbbing, producing pricking and splitting sensations, and seeming to be cast about, cut, or divided. It is dark, not soft but rough, and extended like a bladder. When opened, it discharges clear blood.

🔊 Audio coming soon

Show commentary

तेषां वातादिजानां प्रत्येकं विशिष्टं लक्षणमाह- आयम्यत इत्यादि| आयम्यते वायोराकर्षणेन दीर्घ इव क्रियते, ‘ग्रन्थिः’ इति शेषः| व्यथ्यते विधूयते| एति गच्छति| तोदं व्यथाम्| प्रत्यस्यते क्षिप्यते| कृत्यते छिद्यते| एति भेदमिति भेदं च गच्छति| अमृदुः कर्कशः| बस्तिरिवाततश्चेति मूत्राशयवद्दीर्घः| अस्रं रुधिरम्||४||

Meaning of the commentary

The commentary supplies ‘granthi’ as the subject throughout. Āyamyate means that vāyu draws it out so it appears elongated. Vyathyate is explained as being shaken or agitated; eti toda means it develops pricking pain; pratyasyate means it is thrown or displaced; kṛtyate means cut; and it also reaches bheda, splitting. Amṛdu means rough rather than soft. The bladder comparison describes an elongated form. Asra means blood.

Key terms

vAtaja granthi (vātaja granthi)
Granthi attributed to vāta in the classical classification.
Ayamyate (āyamyate)
Becomes drawn out or elongated.
toda
A pricking or piercing sensation.
bheda
A splitting sensation.
amRudu (amṛdu)
Not soft; glossed as rough.
accha asra
Clear blood described as the discharge after opening.

Adhikarana ४ (५) · Śloka ५

दन्दह्यते धूप्यति चूष्यते च पापच्यते प्रज्वलतीव चापि | रक्तः सपीतोऽप्यथवाऽपि पित्ताद्भिन्नः स्रवेदुष्णमतीव चास्रम् ||५||

Meaning of the śloka

A granthi attributed to pitta is described as intensely burning, producing a smoky heat sensation and a feeling of being sucked, undergoing marked suppuration, and seeming to blaze. It is red or yellowish-red, and when opened it releases very hot blood.

🔊 Audio coming soon

Show commentary

दन्दह्यते भृशं दह्यत इव| धूप्यति चातिमात्रम् अतिशयेन सन्तापं करोति| पापच्यते भृशं पच्यत इव| प्रज्वलतीव भस्मीभवतीव||५||

Meaning of the commentary

The commentary emphasizes the intensity of the sensations: dandahyate means it feels as though it burns severely; dhūpyati means it produces excessive heat; pāpacyate means it seems to suppurate strongly; and prajvalatīva means it feels as though it is blazing or being reduced to ash.

Key terms

pittaja granthi
Granthi attributed to pitta in the classical classification.
dandahyate
Feels intensely burning.
dhUpyati (dhūpyati)
Produces a smoky or excessive heat sensation.
cUShyate (cūṣyate)
Feels as if being sucked or drawn.
pApacyate (pāpacyate)
Seems to undergo intense suppuration.
uShNa asra (uṣṇa asra)
Blood described as very hot when discharged.

Adhikarana ५ (६) · Śloka ६

शीतोऽविवर्णोऽल्परुजोऽतिकण्डूः पाषाणवत् संहननोपपन्नः | चिराभिवृद्धिश्च कफप्रकोपाद्भिन्नः स्रवेच्छुक्लघनं च पूयम् ||६||

Meaning of the śloka

A granthi arising from aggravated kapha is described as cold, only slightly altered in colour, mildly painful, intensely itchy, stone-hard, large and compact, and slow to enlarge. When opened, it discharges thick white pus.

🔊 Audio coming soon

Show commentary

अविवर्ण ईषद्विवर्णः| पाषाणवत् पाषाण इव ‘कठिन’ इत्यध्याहारः| संहननोपपन्नः सङ्घातान्वितो महानित्यर्थः||६||

Meaning of the commentary

The commentary explains avivarṇa as only slightly discoloured. In the comparison with stone, ‘hard’ is understood though unstated. Saṃhananopapanna means possessing a compact mass or aggregation and therefore being large.

Key terms

kaphaja granthi
Granthi attributed to kapha in the classical classification.
avivarNa (avivarṇa)
Only slightly changed from the surrounding colour.
pAShANavat (pāṣāṇavat)
Stone-like, with hardness supplied by the commentary.
saMhananopapanna (saṃhananopapanna)
Compactly aggregated and large.
cirAbhivRuddhi (cirābhivṛddhi)
Slowly enlarging over time.
shuklaghana pUya (śukla-ghana pūya)
Thick white pus.

Adhikarana ६ (७) · Śloka ७

शरीरवृद्धिक्षयवृद्धिहानिः स्निग्धो महानल्परुजोऽतिकण्डूः | मेदःकृतो गच्छति चात्र भिन्ने पिण्याकसर्पिःप्रतिमं तु मेदः ||७||

Meaning of the śloka

A granthi arising from medas is described as enlarging and diminishing as the body itself gains and loses bulk. It is unctuous or smooth, large, only mildly painful, and intensely itchy. When opened, fatty material resembling sesame paste or congealed ghee flows from it.

🔊 Audio coming soon

Show commentary

शरीरवृद्धिक्षयवृद्धिहानिरिति देहाप्यायनह्रासाभ्यामाप्यायनह्रासौ यस्य स तथा| गच्छति स्रवति मेद इति सम्बन्धः| अत्र मेदोग्रन्थौ भिन्ने सति, पिण्याकसर्पिःप्रतिमं तिलकल्कस्त्यानघृतसदृशम्||७||

Meaning of the commentary

The commentary explains that the swelling's increase and decrease follow the nourishment and wasting of the body. In an opened medas-type granthi, medas is said to flow out. Its appearance is compared with sesame paste and thickened or congealed ghee.

Key terms

medaHkRuta granthi (medaḥ-kṛta granthi)
Granthi attributed to medas, or fatty tissue, in the classical classification.
sharIravRuddhikShayavRuddhihAni (śarīra-vṛddhi-kṣaya-vṛddhi-hāni)
Increasing and decreasing along with gain and loss of body bulk.
snigdha
Unctuous, smooth, or oily in character.
piNyAka (piṇyāka)
Pressed sesame paste used as a comparison for the discharged material.
styAna ghRuta (styāna ghṛta)
Congealed or thickened ghee used as a comparison.
medas
Fatty material in the classical tissue scheme.

Adhikarana ७ (८-९) · Śloka ९

व्यायामजातैरबलस्य तैस्तैराक्षिप्य वायुर्हि सिराप्रतानम् | सम्पीड्य सङ्कोच्य विशोष्य चापि ग्रन्थिं करोत्युन्नतमाशु वृत्तम् ||८|| ग्रन्थिः सिराजः स तु कृच्छ्रसाध्यो भवेद्यदि स्यात् सरुजश्चलश्च | अरुक् स एवाप्यचलो महांश्च मर्मोत्थितश्चापि विवर्जनीयः ||९|| इति ग्रन्थीनां निदानं समाप्तम् |

Meaning of the śloka

The passage says that repeated or strenuous exercise in a weak person may provoke vāyu, which draws, compresses, contracts, and dries the network of vessels and quickly produces a raised, round granthi. A vessel-origin granthi that is painful and mobile is considered difficult to treat. If it is painless, immobile, and large, or if it arises at a vital anatomical site, it is said to be unsuitable for curative treatment. This completes the diagnostic account of granthi.

🔊 Audio coming soon

Show commentary

सिराजस्य ग्रन्थेः सम्प्राप्तिं दर्शयन्नाह- व्यायामजातैरित्यादि| व्यायामजातैः व्यायामसमूहैः| अबलस्य पुरुषस्य| सिराप्रतानं सिराविस्तारम्| सिराजस्य कृच्छ्रसाध्यत्वमाह- स तु कृच्छ्रसाध्य इत्यादि| तस्यासाध्यत्वमाह- अरुगित्यादि| महांश्चेति चकारेण वातादिजा अप्येवंरूपा वर्जनीयाः| मर्मोत्थितश्चेति चकारेण अरुजोऽपि विवर्जनीयः| अन्ये पुनरत्र “मांसास्रजं चार्बुदलक्षणेन तुल्यं हि दृष्टं त्वथ लक्षणज्ञैः”- इति षष्ठं ग्रन्थिं पठन्ति| तन्न, जेज्जटादिभिः परिहृतत्वात्||८-९||

Meaning of the commentary

The commentary explains vyāyāmajātaiḥ as groups or repeated forms of exertion in a weak person, and sirāpratāna as the extended network of vessels. It first states the development of the vessel-origin granthi and then distinguishes its historical prognosis: painful and mobile is difficult to treat; painless, fixed, and large is regarded as incurable. The word ‘and’ extends the latter unfavorable description to vāta and other granthis with the same features. In ‘arising at a marma,’ the word ‘and’ further indicates that even a painless lesion there is to be left aside. Some sources read a sixth granthi arising from muscle and blood and say that experts find its signs identical to arbuda. The commentator rejects that reading because Jejjaṭa and other authorities omitted it.

Key terms

sirAja granthi (sirāja granthi)
A granthi described as arising from the network of vessels.
sirApratAna (sirā-pratāna)
The spread or network of vessels.
vyAyAmajAta (vyāyāma-jāta)
Repeated or grouped forms of exertion according to the commentary.
cala
Mobile or movable.
acala
Fixed or immobile.
marma
A vital anatomical site in the classical account.
vivarjanIya (vivarjanīya)
Historically regarded as unsuitable for curative treatment.

Adhikarana ८ (१०-१२) · Śloka १२

हन्वस्थिकक्षाक्षकबाहुसन्धिमन्यागलेषूपचितं तु मेदः | ग्रन्थिं स्थिरं वृत्तमथायतं वा स्निग्धं कफश्चाल्परुजं करोति ||१०|| तं ग्रन्थिभिस्त्वामलकास्थिमात्रैर्मत्स्याण्डजालप्रतिमैस्तथाऽन्यैः | अनन्यवर्णैरुपचीयमानं चयप्रकर्षादपचीं वदन्ति ||११|| कण्डूयुतास्तेऽल्परुजः प्रभिन्नाः स्रवन्ति नश्यन्ति भवन्ति चान्ये | मेदःकफाभ्यां खलु रोग एष सुदुस्तरो वर्षगणानुबन्धी ||१२||

Meaning of the śloka

Accumulated medas together with kapha is said to form firm, smooth, round or elongated, mildly painful nodules around the jaw bone, axilla, upper chest or shoulder region, elbow, vessels at the back of the neck, and throat. When the original nodule becomes surrounded by other enlarging, skin-colored nodules about the size of an amalaka seed or resembling clusters of fish eggs, the condition is called apaci because of this marked accumulation. The nodules itch and hurt little; after breaking open they discharge and disappear while others arise. The disorder is described as very difficult to overcome and continuing for years.

🔊 Audio coming soon

Show commentary

इदानीमपच्याः सम्प्राप्त्यादीनाह- हन्वस्थीत्यादि| हन्वोरस्थि हन्वस्थि; सन्धिशब्दो हन्वस्थ्यादिभिर्बाह्वन्तैः प्रत्येकं सम्बध्यते; बाहुसन्धिशब्देन कूर्पसन्धिरुच्यते; अक्षकं कोष्ठकं तस्य सन्धिः, एतेन ग्रीवाग्रकसन्धिरुच्यते ; मन्या ग्रीवापश्चिमभागस्था धमनी| हन्वस्थीत्यादिसम्प्राप्तिः, ग्रन्थिं स्थिरं वृत्तमित्यादिलक्षणम्| तं ग्रन्थिभिरित्यादि तं पूर्वोक्तं ग्रन्थिम्| अनन्यवर्णैः समानवर्णैः| उपचीयमानं वर्धमानम्| चयप्रकर्षादिति उपचयातिशयादित्यर्थः| चयप्रकर्षादपचीमिति निरुक्तिः| खलुशब्दोऽप्यर्थः| तेन मेदःकफौ वातादिदोषान्तरानुविद्धौ ज्ञेयौ| तथाहि भोजः,- “वातपित्तकफा वृद्धा मेदश्चापि समाचितम्| जङ्घयोः कण्डराः प्राप्य मत्स्याण्डसदृशान् बहून्|| कुर्वन्ति ग्रथितांस्तेभ्यः पुनः प्रकुपितोऽनिलः| तान् दोषानूर्ध्वगो वक्षःकक्षामन्यागलाश्रितः|| नानाप्रकारान् कुरुते ग्रन्थीन् सा त्वपची स्मृता| व्यामिश्रदोषजाता सा कृच्छ्रसाध्या प्रकीर्तिता|| तासां वातोत्तरा रूक्षा वातवेदनयाऽन्विता| क्षिप्रपाकसमुत्थाना दाहयुक्ता तु पैत्तिकी|| गूढा वाऽपाककठिना कफात् स्निग्धाऽल्परुक्करा| मेदोऽधिका श्लैष्मिकी च विशेषादतिमार्दवा|| अपची कण्ठमन्यासु कक्षावङ्क्षणसन्धिसु| तां तु मालाकृतिं विद्यात् कण्ठहृद्धनुसन्धिषु|| गण्डमालां विजानीयादपचीतुल्यलक्षणाम्”- इति| चरके गण्डमाला गण्डे एव पठिता “मेदःकफाच्छोणितसञ्चयोत्थो गण्डस्य पार्श्वे गलगण्ड एकः| स्याद्गण्डमाला बहुभिस्तु गण्डैर्दीप्तानले यूनि बलान्विते च|| साध्या स्मृता पीनसपार्श्वशूलकासज्वरच्छर्दियुता त्वसाध्या” (च. चि. १२)- इति| अन्ये तु ‘मेदःकफाभ्यां पुनरेष रोगः’ इति पठन्ति; पुनःशब्दादधिकार्थाद्दोषान्तरसम्बन्धः स्थापितो भवतीति च वदन्ति| तत्रापि स एवार्थः| वर्षगणानुबन्धी वर्षसमूहसम्बन्धीत्यर्थः| एतेन दीर्घरोगित्वं सूचितम्| मेदःकफाभ्यामिति हेतूद्देशः||१०-१२||

Meaning of the commentary

The commentary relates sandhi separately to each listed region and identifies the arm joint as the elbow, akshaka-sandhi as a joint near the front of the neck, and manya as a vessel at the back of the neck. Ananyavarna means the same color as the surrounding skin, and the name apaci is derived from excessive accumulation. Medas and kapha are understood as associated with other doshas. A long quotation attributed to Bhoja describes many fish-egg-like nodules beginning near the leg tendons and later occupying the chest, axilla, neck vessels, and throat; it distinguishes vata-, pitta-, kapha-, and medas-predominant features and describes chain-like swellings. A Charaka quotation distinguishes a single galaganda beside the cheek from multiple swellings called gandamala and gives historical prognostic conditions. Some read 'this disease again arises from medas and kapha'; they use 'again' to support involvement of other doshas, without changing the intended sense. Varshagananubandhi indicates a disease lasting many years.

Key terms

apacI (apaci)
A chronic classical disorder of multiple enlarging nodules in specified regions.
granthi
A firm, rounded or elongated nodule.
manyA (manya)
A vessel or structure at the back of the neck in the commentary.
amalakAsthimAtra (amalakasthimatra)
About the size of an amalaka seed or stone.
matsyANDajAlapratima (matsyandajalapratima)
Resembling a cluster of fish eggs.
gaNDamAlA (gandamala)
A chain or group of swellings discussed in the quoted authorities.

Adhikarana ९ (१३) · Śloka १४

गात्रप्रदेशे क्वचिदेव दोषाः सम्मूर्च्छिता मांसमभिप्रदूष्य | वृत्तं स्थिरं मन्दरुजं महान्तमनल्पमूलं चिरवृद्ध्यपाकम् ||१३|| कुर्वन्ति मांसोपचयं तु शोफं तमर्बुदं शास्त्रविदो वदन्ति |१४|

Meaning of the śloka

When aggravated doshas affect mamsa at any part of the body, they are said to produce a swelling that is round, fixed, mildly painful, large, deep-rooted, slow-growing, and non-suppurating, with an accumulation of flesh. Authorities call this arbuda.

🔊 Audio coming soon

Show commentary

इदानीमर्बुदादीनां सम्प्राप्त्यादीनाह- गात्रप्रदेशे इत्यादि| क्वचिदेव गात्रप्रदेशे दोषाः शोफं कुर्वन्तीति सम्बन्धः| सम्मूर्च्छिता वृद्धिं गताः| क्वचिदेवानियतप्रदेशे, न पुनरपचीवद्धन्वस्थ्यादिसन्धिष्वेव| अपाकम् अविद्यमानपाकम्| मांसोपचयं मांससङ्घातम्| गात्रप्रदेशे क्वचिदेवेति सम्प्राप्तिः| सम्मूर्च्छिता दोषा इति हेतुः| वृत्तं स्थिरमित्यादि स्वलक्षणम्| गयी तु ‘कुर्वन्ति मांसोच्छ्रयमत्यगाधम्’ इति पठति||१३||-

Meaning of the commentary

The commentary explains that arbuda may occur at an unspecified bodily site, unlike apaci, which favors the previously listed joints and regions. Sammurchhita means that the doshas have increased; apaka means lacking suppuration; and mamsopacaya means a mass or aggregation of flesh. The location, doshas, and listed physical qualities respectively supply its pathogenesis, cause, and particular signs. Gayi reads the final description differently as 'a very deep elevation of flesh.' The supplied commentary ends incompletely.

Key terms

arbuda
A classical category of a large, fixed, slowly enlarging tissue swelling.
mAMsa (mamsa)
Flesh or muscle tissue affected in the classical account.
analpamUla (analpamula)
Having a substantial or broad root.
ciravRuddhi (chiravriddhi)
Slow or prolonged growth.
apAka (apaka)
Not undergoing suppuration.
mAMsopacaya (mamsopacaya)
An accumulation or mass of flesh.

Adhikarana १० (१४) · Śloka १५

वातेन पित्तेन कफेन चापि रक्तेन मांसेन च मेदसा च ||१४|| तज्जायते तस्य च लक्षणानि ग्रन्थेः समानानि सदा भवन्ति |१५|

Meaning of the śloka

Arbuda is said to arise from vata, pitta, kapha, rakta, mamsa, or medas. The signs of each type correspond to those of the granthi arising from the same factor.

🔊 Audio coming soon

Show commentary

तज्जायते तदर्बुदं भवतीत्यर्थः| तस्य च लक्षणानि तस्य वातपित्तकफमेदोजस्य||१४||-

Meaning of the commentary

The commentary clarifies that 'it arises' refers to arbuda. It then restricts the direct comparison of signs to the vata-, pitta-, kapha-, and medas-born types. The supplied commentary ends incompletely and does not explain here how rakta- and mamsa-born forms fit the comparison.

Key terms

vAtaja arbuda (vataja arbuda)
An arbuda attributed to vata.
pittaja arbuda
An arbuda attributed to pitta.
kaphaja arbuda
An arbuda attributed to kapha.
raktaja arbuda
An arbuda attributed to rakta.
mAMsaja arbuda (mamsaja arbuda)
An arbuda attributed to mamsa.
medoja arbuda
An arbuda attributed to medas.

Adhikarana ११ (१५-१६) · Śloka १७

दोषः प्रदुष्टो रुधिरं सिरास्तु सम्पीड्य सङ्कोच्य गतस्त्वपाकम् ||१५|| सास्रावमुन्नह्यति मांसपिण्डं मांसाङ्कुरैराचितमाशुवृद्धिम् | स्रवत्यजस्रं रुधिरं प्रदुष्टमसाध्यमेतद्रुधिरात्मकं स्यात् ||१६|| रक्तक्षयोपद्रवपीडितत्वात् पाण्डुर्भवेत् सोऽर्बुदपीडितस्तु |१७|

Meaning of the śloka

In the account of raktaja arbuda, an aggravated dosha enters the vessels, compresses and constricts the blood, and produces a slightly suppurating, discharging mass of flesh. The mass is covered with fleshy sprouts, grows rapidly, and continually releases altered blood. This blood-natured arbuda is called incurable. The affected person becomes pale because of blood loss and associated complications.

🔊 Audio coming soon

Show commentary

रक्तजस्यार्बुदस्य लक्षणमाह- दोषः प्रदुष्ट इत्यादि| प्रदुष्टो दोषः सिरासु गतो रुधिरं सम्पीड्य सङ्कोच्य मांसपिण्डमुन्नह्यतीति सम्बन्धः| उन्नह्यति उद्बध्नातीव; अन्ये तु ‘प्रदुष्टो दोष उन्नह्यति उच्छ्रितो भवति, मांसपिण्डमाशुवृद्धिं शीघ्रवर्धनशीलं करोति’ इति व्याख्यानयन्ति| अपाकम् ईषत्पाकम्||१५-१६||-

Meaning of the commentary

The commentary connects the sentence by saying that the aggravated dosha reaches the vessels, compresses the blood, and seems to bind up a mass of flesh. Other interpreters instead take unnahyati to mean that the dosha itself becomes elevated and makes the flesh mass rapidly growing. Apaka is glossed here as having only slight suppuration. The supplied commentary ends before explaining the final statement on pallor.

Key terms

raktaja arbuda
An arbuda attributed to rakta in the classical classification.
sirA (sira)
Vessels entered by the aggravated dosha in the account.
mAMsapiNDa (mamsapinda)
A mass of flesh.
mAMsA~gkura (mamsankura)
Fleshy sprout-like projections covering the mass.
AshuvRuddhi (ashuvriddhi)
Rapid growth.
raktakShaya (raktakshaya)
Loss or depletion of blood, linked here with pallor.

Adhikarana १२ (१७-१८) · Śloka १९

मुष्टिप्रहारादिभिरर्दितेऽङ्गे मांसं प्रदुष्टं प्रकरोति शोफम् ||१७|| अवेदनं स्निग्धमनन्यवर्णमपाकमश्मोपममप्रचाल्यम् | प्रदुष्टमांसस्य नरस्य बाढमेतद्भवेन्मांसपरायणस्य ||१८|| मांसार्बुदं त्वेतदसाध्यमुक्तं... |१९|

Meaning of the śloka

After a body part is struck by a fist or similar trauma, altered mamsa is said to produce a swelling. It is painless, smooth, the same color as the surrounding tissue, non-suppurating, stone-like, and immovable. The text says it occurs especially in a person whose mamsa is disturbed and who habitually eats meat, and calls this mamsarbuda incurable. The supplied verse then breaks off.

🔊 Audio coming soon

Show commentary

मांसजस्य सम्प्राप्तिं दर्शयन्नाह- मुष्टिप्रहारादिभिरित्यादि| समुपैति सम्यग्गच्छति| बाढम् अतिशयेन| मांसपरायणस्य मांसभक्षणशीलस्य| ‘मुष्टिप्रहारादिभिः’ इत्यत्र केचित् ‘काष्ठप्रहारादिभिः’ इति पठन्ति||१७-१८||-

Meaning of the commentary

The commentary presents the pathogenesis of the mamsa-born form. Badham means 'to a marked degree,' and mamsaparayana means a person accustomed to eating meat. Some read 'a blow with wood and similar objects' instead of 'a fist blow and similar injuries.' The commentary contains the unexplained phrase samupaiti, glossed as 'comes about fully,' although that word is not visible in the supplied verse, and its closing marker is incomplete.

Key terms

mAMsArbuda (mamsarbuda)
An arbuda attributed to altered mamsa.
muShTiprahAra (mushtiprahara)
A blow with the fist in the received reading.
kAShThaprahAra (kashthaprahara)
A blow with wood in an alternative reading.
ashmopama
Stone-like in firmness.
apracAlya (aprachalya)
Immobile or fixed.
mAMsaparAyaNa (mamsaparayana)
Habitually devoted to eating meat, according to the commentary.

Adhikarana १३ (१९-२०) · Śloka २०

...साध्येष्वपीमानि विवर्जयेत्तु | सम्प्रस्रुतं मर्मणि यच्च जातं स्रोतःसु वा यच्च भवेदचाल्यम् ||१९|| यज्जायतेऽन्यत् खलु पूर्वजाते ज्ञेयं तदध्यर्बुदमर्बुदज्ञैः | यद्द्वन्द्वजातं युगपत् क्रमाद्वा द्विरर्बुदं तच्च भवेदसाध्यम् ||२०||

Meaning of the śloka

Even among arbuda types otherwise considered treatable, the text advises leaving aside one that has spread, arises at a marma or within channels, or is immovable. A second arbuda that develops upon a pre-existing one is known as adhyarbuda. Two arbudas arising as a pair, either simultaneously or in sequence, constitute dvirarbuda; both patterns are called incurable.

🔊 Audio coming soon

Show commentary

साध्येष्वपीत्यादि| साध्येष्वपीमानि विवर्जयेदिति साध्येषु मध्ये इमानि वक्ष्यमाणानि विवर्जयेदित्यर्थः| अध्यर्बुदमपि द्विरर्बुदमेव, अन्ये ‘अत्यर्बुदं’ इति पठन्ति| यद्द्वन्द्वजातमित्यादि द्वन्द्वेन युग्मेन जातं द्वन्द्वजातं; न केवलमध्यर्बुदं द्विरर्बुदं, यद्द्वन्द्वजातं तदपि द्विरर्बुदमित्यर्थः| भेदश्च तयोरुपरिजातत्वेन पार्श्वजातत्वेन च| एतेन द्विरर्बुदद्वितयमप्यसाध्यमुक्तम्||१९-२०||

Meaning of the commentary

The commentary explains that these are exceptions within the otherwise treatable group. Adhyarbuda is itself a form of dvirarbuda, although some read the name as atyarbuda. Dvandvaja means arising as a pair. Thus dvirarbuda includes both a second lesion growing on top of the first and paired lesions growing beside one another, whether together or successively; both are assigned an incurable prognosis.

Key terms

samprasRuta (samprasrita)
Spread or extensively extended.
marma
A vital or vulnerable site in classical anatomy.
srotas
A bodily channel in the classical framework.
adhyarbuda
A second arbuda arising upon an existing one.
atyarbuda
An alternative reading for adhyarbuda.
dvirarbuda
Two arbudas occurring together or successively, above or beside one another.

Adhikarana १४ (२१) · Śloka २१

न पाकमायान्ति कफाधिकत्वान्मेदोबहुत्वाच्च विशेषतस्तु | दोषस्थिरत्वाद्ग्रथनाच्च तेषां सर्वार्बुदान्येव निसर्गतस्तु ||२१||

Meaning of the śloka

Arbudas are said not to undergo suppuration because kapha is especially predominant, medas is abundant, the doshas remain stable, and their constituents are knotted together; by their very nature, all arbudas therefore do not mature into pus.

🔊 Audio coming soon

Show commentary

तेषां पाकाभावे हेतुं दर्शयन्नाह- न पाकमित्यादि| ग्रन्थ्यादिष्वपि कफादयश्चत्वारो हेतवः सन्ति, परमर्बुदेषु विशेषतः कफस्य मेदसश्चाधिक्यं तस्मात्, तथा विशेषतो दोषस्थिरत्वाद् दोषकार्यस्य मांसोच्छ्रयस्य तेनैव स्वरूपेण चिरकालावस्थितिशीलत्वात्, तथा ग्रथनाद् ग्रन्थिरूपत्वात्तेषां मेदःप्रभृतीनां; निसर्गतस्त्विति तुशब्दोऽप्यर्थः, तेन स्वभावादप्यर्बुदानि पाकं न गच्छतीत्यर्थः||२१||

Meaning of the commentary

The commentary explains why arbudas do not suppurate. Although four factors beginning with kapha are also present in granthi and related swellings, kapha and medas are especially abundant in arbuda. The dosha-produced elevation of mamsa tends to remain in the same form for a long time, and medas and the other involved constituents are bound into a knot-like structure. The word tu in nisargatas tu is understood in the sense of 'also': besides these stated reasons, arbudas naturally do not suppurate.

Key terms

arbuda
A classical category of persistent swelling or mass described here as generally non-suppurating.
pAka (paka)
Maturation into suppuration in this context.
medas
The classical fatty tissue constituent said to be abundant in arbuda.
doShasthiratva (doshasthiratva)
Stability or persistence of the involved doshas and their effect.
grathana
Knotting or binding into a mass-like form.
mAMsocchraya (mamsocchraya)
An elevation or overgrowth of flesh in the commentary's description.

Adhikarana १५ (२२) · Śloka २२

वातः कफश्चैव गले प्रवृद्धौ मन्ये तु संसृत्य तथैव मेदः | कुर्वन्ति गण्डं क्रमशः स्वलिङ्गैः समन्वितं तं गलगण्डमाहुः ||२२||

Meaning of the śloka

When vata and kapha increase in the throat and medas likewise accumulates in the two manyas, they gradually produce a swelling with the characteristic signs of its cause; this is called galaganda.

🔊 Audio coming soon

Show commentary

इदानीं गलगण्डसम्प्राप्तिं दर्शयन्नाह- वात इत्यादि| वातादयो गण्डं क्रमशः कुर्वन्तीति सम्बन्धः| किंविशिष्टं गण्डं? स्वलिङ्गैः समन्वितम्| वातेन कफेन च गलगण्डो भवति, न पित्तेन; स्वभावेन पित्तजस्य गलगण्डस्याभावात्||२२||

Meaning of the commentary

The commentary presents the classical pathogenesis of galaganda: vata and the other stated factors gradually form a swelling marked by their own signs. It specifically says that galaganda arises from vata and kapha, not pitta, because a naturally pitta-origin form of galaganda is not recognized in this account.

Key terms

galagaNDa (galaganda)
A classical swelling of the neck or throat region.
manya
A paired region or structure at the sides of the neck in the classical anatomical context.
medas
The classical fatty tissue constituent said to accumulate in the neck region.
svali~gga (svalinga)
The characteristic signs of the causative factor.
samprApti (samprapti)
The classical account of how a disorder develops.

Adhikarana १६ (२३-२७) · Śloka २७

तोदान्वितः कृष्णसिरावनद्धः कृष्णोऽरुणो वा पवनात्मकस्तु | मेदोन्वितश्चोपचितश्च कालाद्भवेदतिस्निग्धतरोऽरुजश्च ||२३|| पारुष्ययुक्तश्चिरवृद्ध्यपाको यदृच्छया पाकमियात् कदाचित् वैरस्यमास्यस्य च तस्य जन्तोर्भवेत्तथा तालुगलप्रशोषः ||२४|| स्थिरः सवर्णोऽल्परुगुग्रकण्डूः शीतो महांश्चापि कफात्मकस्तु | चिराभिवृद्धिं कुरुते चिराच्च प्रपच्यते मन्दरुजः कदाचित् ||२५|| माधुर्यमास्यस्य च तस्य जन्तोर्भवेत्तथा तालुगलप्रलेपः | स्निग्धो मृदुः पाण्डुरनिष्टगन्धो मेदःकृतो नीरुगथातिकण्डूः ||२६|| प्रलम्बतेऽलाबुवदल्पमूलो देहानुरूपक्षयवृद्धियुक्तः | स्निग्धास्यता तस्य भवेच्च जन्तोर्गलेऽनुशब्दं कुरुते च नित्यम् ||२७||

Meaning of the śloka

Vata-type galaganda has pricking pain, is covered by dark vessels, and is dark or reddish. With time it may accumulate medas, become enlarged, very unctuous, and painless. It is rough, grows slowly, usually does not suppurate but may occasionally do so without an evident regular cause, and is associated with an unpleasant taste and dryness of the palate and throat. Kapha-type galaganda is firm, of the surrounding skin color, mildly painful, intensely itchy, cool, and large. It enlarges slowly and may mature only after a long time with little pain; the mouth tastes sweet and the palate and throat feel coated. The medas-type is unctuous, soft, pale, unpleasant-smelling, painless, and intensely itchy. It hangs like a bottle gourd from a narrow base, decreases or increases along with the body, makes the mouth feel unctuous, and continually produces an echo-like sound in the throat.

🔊 Audio coming soon

Show commentary

तस्यैव वातादिविशेषलिङ्गानि निर्दिशन्नाह- तोदान्वित इत्यादि| अरुज इति सोऽपि वातगलगण्डो यदा कालात् कालेन कृत्वा मेदोऽन्वितो भवति, तदा अरुजो भवतीत्यर्थः| यदृच्छया अज्ञातहेतुनियमेन, पाकमियात् गच्छेत्| कदाचित् न सर्वकालम्| वातजं कफजं चोक्त्वा मेदोजमाह- स्निग्ध इत्यादि| गलेऽनुशब्दमनुनादं प्रतिशब्दमित्यर्थः||२३-२७||

Meaning of the commentary

The commentary identifies the distinguishing signs of vata-, kapha-, and medas-origin galaganda. A vata-type swelling becomes painless when, over time, it also acquires medas. Yadricchaya means that it may suppurate without a consistently identifiable cause, and kadachit stresses that this occurs only sometimes. After the vata and kapha forms, the passage describes the medas form. The sound in the throat is explained as an echo or reverberating response.

Key terms

vAtaja galagaNDa (vataja galaganda)
The vata-classified neck swelling, marked here by pricking pain, dark vessels, and slow growth.
kaphaja galagaNDa (kaphaja galaganda)
The kapha-classified neck swelling, described as firm, cool, itchy, and slowly enlarging.
medoja galagaNDa (medoja galaganda)
The medas-classified neck swelling, described as soft, pendulous, pale, and changing with body size.
pAruShya (parushya)
Roughness.
alAbuvat (alabuvat)
Like a bottle gourd, describing the hanging shape.
anushabda
An echo or reverberating sound in the throat.

Adhikarana १७ (२८) · Śloka २८

कृच्छ्राच्छ्वसन्तं मृदुसर्वगात्रं संवत्सरातीतमरोचकार्तम् | क्षीणं च वैद्यो गलगण्डिनं तु भिन्नस्वरं चैव विवर्जयेत्तु ||२८||

Meaning of the śloka

The physician is instructed to leave aside as incurable a person with galaganda who has difficult breathing, generalized softness or loss of firmness of the body, disease lasting beyond a year, loss of appetite, wasting, or an altered or broken voice.

🔊 Audio coming soon

Show commentary

इदानीं गलगण्डस्यासाध्यतामाह- कृच्छ्रादित्यादि||२८||

Meaning of the commentary

The commentary states only that this verse sets out the signs by which galaganda is considered incurable in the classical prognosis; it provides no further explanation of the individual signs.

Key terms

kRucchrAcchvasan (krichchhracchvasan)
Breathing with difficulty.
mRudusarvagAtra (mridusarvagatra)
Having generalized softness or loss of firmness of the body; the precise clinical implication is uncertain.
arocaka (arochaka)
Loss of appetite or aversion to food.
kShINa (kshina)
Wasted, depleted, or markedly weakened.
bhinnasvara
An altered, broken, or impaired voice.
vivarjayet
Should leave aside, expressing an unfavorable historical prognosis.

Adhikarana १८ (२९) · Śloka २९

निबद्धः श्वयथुर्यस्य मुष्कवल्लम्बते गले | महान् वा यदि वा ह्रस्वो गलगण्डं तमादिशेत् ||२९||

Meaning of the śloka

A firmly attached swelling that hangs from the neck like a scrotum or oval sac, whether large or small, is designated galaganda.

🔊 Audio coming soon

Show commentary

न सर्व एव गलाश्रयो गण्डो गलगण्डः, किं तर्हि कश्चिदेव वक्ष्यमाणस्वरूप इति दर्शयन्नाह- निबद्ध इत्यादि| नियमेन बद्धो निबद्धः| मुष्कवत् अण्डवत्||२९||

Meaning of the commentary

The commentary cautions that not every swelling located in the throat is galaganda; only one having the form described here receives that name. Nibaddha means firmly or consistently attached, and mushkavat is explained as egg-shaped or like a testicular sac.

Key terms

nibaddha shvayathu
A firmly attached or fixed swelling.
muShkavat (mushkavat)
Like a scrotum or oval sac; the commentary also glosses it as egg-like.
gala
The throat or neck region.
galagaNDa (galaganda)
The classical neck-swelling category defined by the stated form.

Adhikarana पुष्पिका · Śloka ११

इति सुश्रुतसंहितायां निदानस्थाने गलगण्डगण्डमालापच्यर्बुदनिदानं नामैकादशोऽध्यायः ||११||

Meaning of the śloka

Thus ends the eleventh chapter of the Nidanasthana in the Sushruta Samhita, entitled the diagnostic account of galaganda, gandamala, apachi, and arbuda.

🔊 Audio coming soon

Show commentary

इति श्रीडल्ह(ह्ल)णविरचितायां निबन्धसङ्ग्रहाख्यायां सुश्रुतव्याख्यायां निदानस्थाने एकादशोऽध्यायः||११||

Meaning of the commentary

The commentary colophon states that the eleventh chapter of the Nidanasthana is complete in Shri Dalhana's explanation of Sushruta entitled Nibandhasangraha.

Key terms

galagaNDa (galaganda)
A classical category of neck swelling.
gaNDamAlA (gandamala)
A classical category involving a chain or group of swellings.
apacI (apachi)
A classical swelling category named in the chapter title.
arbuda
A classical persistent mass category; it is not automatically equivalent to cancer.
nidAnasthAna (Nidanasthana)
The division concerned with causes and diagnostic descriptions.
nibandhasa~ggraha (Nibandhasangraha)
The title of Dalhana's commentary.
← 10. visarpanāḍīstanarōganidānam12. vr̥ddhyupadaṁśaślīpadanidānam →