The commentary notes that this group includes serious conditions such as rohiṇī and valmīka. It nevertheless bears the name kṣudraroga because the numerous relatively minor disorders give the collection its designation, just as a mixed group is called a group of umbrella-bearers when most carry umbrellas. Other interpreters say some are minor or mild relative to lesions such as tilaka, while kṣudra may mean sharp or severe relative to agnirohiṇī and valmīka. A final explanation treats the name simply as an established, non-causal term inherited from earlier teachers.
Key terms
kShudraroga (kṣudraroga)
The conventional collective name for the varied disorders in this chapter; it does not mean every condition is harmless.
rohiNI (rohiṇī)
A serious classical disorder cited to show that the group is not uniformly minor.
valmIka (valmīka)
Another serious lesion category included in the group.
nirhetukI sa~jj~jA (nirhetukī saṃjñā)
A conventional name without a derivation from disease severity.
Samāsena means ‘briefly’; the commentary says no fixed limit exists when the conditions are considered in full detail. Brahmadeva reads forty-eight by adding gardabhikā, irivellikā, gandhapiḍikā, and nīlikā. Jejjaṭa does not include those four, and earlier commentators such as Suvīranandi and Vārāha reject them because they are absent from parallel treatises. Gayadāsa includes them because they occur across manuscript readings despite their absence from parallel works; he instead places pāmā and three related minor conditions under kuṣṭha.
Key terms
catushcatvAriMshat (catuścatvāriṃśat)
Forty-four, the count given by the main text.
aShTacatvAriMshat (aṣṭacatvāriṃśat)
Forty-eight, Brahmadeva's expanded count.
samAnatantra (samānatantra)
A parallel or related authoritative treatise used to assess variant inclusions.
pAThabheda (pāṭhabheda)
Variation in textual reading or inclusion across authorities.
Ajagallikā is described mainly in children as a smooth or unctuous, skin-coloured, knotted, painless lesion resembling a mung bean and arising from kapha and vāta.
Some interpreters say that the word ‘mainly’ should be understood though it is absent from the transmitted wording; on that reading, ajagallikā may occasionally occur in adults as well.
Key terms
ajagallikA (ajagallikā)
A classical small lesion described especially in children.
Avaktrā means having only a small mouth or opening, and parimaṇḍala means round. The commentary explains andhālajī as extending along a sinew or ligament while opening inward.
Key terms
andhAlajI (andhālajī)
A classical raised lesion with a small opening and little pus.
avaktrA (avaktrā)
Having a small mouth or opening.
parimaNDala (parimaṇḍala)
Round in form.
snAyuprasRuta (snāyu-prasṛta)
Described as extending along a sinew, tendon, or ligament-like structure.
Valmīka is described as a mound-like nodular lesion that slowly enlarges on the palms, soles, joints, neck, or regions above the clavicles. It is covered with multiple openings that produce pricking pain, moisture or discharge, intense burning, and itching, and is attributed to kapha, pitta, and vāta.
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গ্রন্থয ইত্যাদি||৯-১০||
Meaning of the commentary
The supplied commentary only points to these verses and provides no additional explanation.
Key terms
valmIka (valmīka)
A classical slowly enlarging, many-opened lesion compared with an anthill.
Indravṛddhā is described as a lesion densely covered at its centre with smaller eruptions, like the seed-head or central receptacle of a lotus, and attributed to vāta and pitta. The supplied passage also gives a second verse describing gardabhikā as a round, raised, reddish patch covered with lesions, painful, and likewise attributed to vāta and pitta.
The commentary explains padmapuṣkara as the central seed-head of a lotus. It notes that Gayī reads the gardabhikā verse here and quotes it. The supplied commentary ends with an incomplete marker after verse 11.
Key terms
indravRuddhA (indravṛddhā)
A classical lesion with clustered eruptions concentrated at the centre.
padmapuShkara (padma-puṣkara)
The lotus's central seed-head or receptacle used as a visual comparison.
gardabhikA (gardabhikā)
A variantly included painful, raised, reddish lesion covered with eruptions.
Panasikā is described as a very painful lesion, shaped like an edible lotus rhizome, occurring around the ear on all sides or toward its back, and attributed to kapha and vāta.
The main commentary places it within the ear and rejects an interpretation that ‘on all sides’ permits a site outside the ear, because ‘outside’ is neither established by all parts of the verse nor found in parallel texts. It quotes Bhoja: aggravated kapha and vāta, situated in the flesh of the ears, produce a fixed, firm, irregular lesion around them with burning. Although Bhoja includes burning in this vāta-kapha condition, the commentary explains it as arising from an unusual interaction of factors or from the particular influence of the affected site.
Key terms
panasikA (panasikā)
A classical painful lesion associated with the ear.
karNau pari samantAt (karṇau pari samantāt)
Around the ear on all sides; its exact internal or external location is disputed.
shAlUkavat (śālūkavat)
Compared in shape with an edible lotus rhizome.
adhiShThAnaprabhAva (adhiṣṭhāna-prabhāva)
A feature attributed to the special influence of the affected site.
The commentary interprets apāka as having slight suppuration, taking the negative prefix in the sense of ‘a little,’ because complete absence of suppuration would be inconsistent with its pitta origin. The name is explained through a fine network of small, slightly suppurating lesions. Pitta means markedly increased pitta. Elsewhere the condition is attributed to all three doṣas with pitta predominant. Bhoja describes the doṣas, dominated by pitta and situated in skin, as producing a thin dusky-red, very painful, suppurating swelling that spreads with burning, thirst, and fever; some call that visarpa and others jālagardabha.
Key terms
jAlagardabha (jālagardabha)
A classical spreading network-like swelling with fever and burning.
apAka (apāka)
Interpreted here as slight, rather than absent, suppuration.
The commentary explains sarvajā as produced by all the doṣas. Because the combined condition arises through the natural contributions of each, signs of the characteristic actions of vāta, pitta, and kapha are expected. Earlier commentators say irivellikā occurs in all manuscript readings here but not in parallel treatises.
Key terms
irivellikA (irivellikā)
A classical round, painful, febrile lesion on the head.
uttamA~ggastha (uttamāṅga-stha)
Situated on the head.
sarvAtmaka (sarvātmaka)
Involving all three doṣas.
sarvali~gga (sarva-liṅga)
Displaying the characteristic signs attributed to all of them.
samAnatantra (samānatantra)
Parallel treatises in which earlier commentators say this lesion is absent.
अग्निदग्धनिभाः स्फोटाः सज्वराः पित्तरक्ततः |
क्वचित् सर्वत्र वा देहे स्मृता विस्फोटका इति ||१८||
Meaning of the śloka
Visphoṭaka is described as fever-associated blisters resembling burns from fire, arising from pitta and blood and occurring either in one area or throughout the body.
The commentary identifies these burn-like blisters as visphoṭaka. Some authorities omit them here because they consider them a subtype of visarpa; related treatises therefore describe their features according to doṣa subtypes. The commentary says such subdivision is unsuitable when visphoṭaka is listed among kṣudrarogas. Bhoja instead states that aggravated pitta and blood, accompanied by vāta and situated in the skin, produce burn-like blisters throughout the body with fever and intense burning; these are called visphoṭaka.
Key terms
visphoTaka (visphoṭaka)
A classical fever-associated blistering disorder resembling burns.
agnidagdhanibha (agni-dagdha-nibha)
Resembling skin burned by fire.
pittarakta (pitta-rakta)
Pitta and blood, the principal factors named in the verse.
visarpabheda (visarpa-bheda)
A subtype of visarpa according to authorities who omit it from this list.
sarvadehaga (sarva-deha-ga)
Occurring throughout the body in Bhoja's description.
Blisters arising in the axillary regions, tearing into tissue and resembling blazing fire, with internal burning and fever, are called agnirohini. The sannipata-born condition is historically called incurable and said to cause death within seven, ten, or fifteen days.
The commentary says no treatment is given because the condition is considered incurable. It records the variant mamsadarana. Another treatise describes intensely burning, painful, feverish blisters that damage tissue and may be fatal without intervention. The commentary assigns seven days to vata predominance, ten to pitta, and a fortnight to kapha.
Key terms
agnirohiNI (agnirohini)
A grave classical blistering lesion of the axillary region.
sphoTa (sphota)
A blister or eruptive lesion.
mAMsadAraNa (mamsadarana)
Tearing or destruction of tissue; also a recorded reading.
When pitta and vata affect the nail and surrounding flesh, they cause pain, burning, and suppuration; this is called cippa. It is also called akshataroga or upanakha. A nail made rough, dark, and coarse by trauma is called kunakha, also named kulina.
A physician should recognize anushayi as a deep lesion with little visible inflammation, the same color as surrounding tissue, situated on the head, and undergoing suppuration internally because of kapha.
Its depth is inferred from internal suppuration; alpasamrambha means little swelling, and uparisthita is glossed as situated on the head. The commentary ends incompletely.
Key terms
anushayI (anushayi)
A deep, subtly presenting lesion described on the head.
A red, round swelling resembling a vidari tuber, arising at the axilla or groin joints and showing the collective signs of all doshas, is called vidarika.
The groin joint is identified as gandaka. Sarvaja means sannipata-born, but the commentary stresses that this form may still be treatable. Collective dosha signs are not merely each sign added together. Others infer seven doshic varieties; Gayi rejects that inference and, citing another tradition, favors predominant vata and kapha with lesser pitta.
Key terms
vidArikA (vidarika)
A red, round axillary or groin swelling in this classification.
va~gkShaNa (vankshana)
The groin.
sarvaja
Arising from combined doshas.
sarvalakShaNa (sarvalakshana)
Showing the collective pattern of the dosha combination.
Kapha, medas, and vata affecting flesh, vessels, and ligaments form a nodule. When opened it releases abundant material resembling honey, ghee, or fat. Increased vata dries the flesh and produces a hard, stone-like mass; vessels then suddenly discharge foul, moist, variably colored blood. This is called sharkararbuda.
The hard sharkara is presented as the cause of sharkararbuda, named for stone-like hardness; depth and elevation make it an arbuda. Gayi rejects the view that sharkara and sharkararbuda are two separate diseases because that would disrupt the chapter's count and sharkara is not independently listed.
Key terms
sharkarArbuda (sharkararbuda)
A hard, deep classical mass with discharge and bleeding.
sharkarA (sharkara)
A stone-like hard formation within the lesion.
granthi
A nodule or knot-like swelling.
durgandha
Foul-smelling.
Adhikarana ২২ (২৮) · Śloka ২৮
পামাবিচর্চ্যৌ কুষ্ঠেষু রকসা চ প্রকীর্তিতা ||২৮||
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पामाविचर्च्यौ कुष्ठेषु रकसा च प्रकीर्तिता ||२८||
Meaning of the śloka
Pama and vicharchika have already been described among kushtha disorders, and rakasa has also been mentioned there.
After the foot is injured by pottery fragments, gravel, thorns, or similar objects, doshas associated with medas and blood form kadara: a painful, discharging, hard nodule about the size of a kola, with a peg-like core and either a depressed or raised center.
Sharkara includes broken pottery and similar sharp fragments. Sakilakathina means hard and resembling a peg. Bhoja adds that the condition can also occur on the hands.
Key terms
kadara
A hard, painful nodule of the foot following repeated injury.
When the spaces between the toes remain moist and develop itching, burning, and pain after contact with contaminated mud, the condition is called alasa.
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ক্লিন্নেত্যাদি| অযং কফেন সশোণিতেন||৩২||
Meaning of the commentary
The commentary attributes this condition to kapha associated with blood.
Key terms
alasa
An itchy, burning, painful condition between moist toes.
Pitta combined with vata reaches the hair follicles and causes the hairs to fall. Kapha associated with blood then blocks the follicles so that new hair does not arise. This is called indralupta, khalitya, or ruji.
The commentary claims khalitya occurs only in men, quoting Videha's historical explanation that women are protected by bodily delicacy, menstrual discharge, and less exercise.
Daruna means hard, kandura means itchy, and prapatyate indicates marked splitting or flaking. On Videha's authority, pitta and blood may also be secondarily involved. The commentary gives paha as a local name.
Key terms
dAruNaka (darunaka)
A dry, itchy, scaling or fissuring scalp disorder.
The commentary distinguishes atypical greying caused by body heat from ordinary greying attributed to pitta. A subcommentator instead holds that bodily fire and its supporting pitta unite to alter the hair, avoiding an explanation entirely outside the doshas.
Their copper color is taken to show involvement of blood. Another treatise describes blood-associated pitta affecting skin and producing eruptions ranging from lentil or pulse size to kola size over the body. The commentary also records shitalika as a popular name.
Key terms
masUrikA (masurika)
A classical generalized febrile eruptive disorder.
tAmra (tamra)
Copper-colored.
sphoTa (sphota)
An eruption or blister-like lesion.
shItalikA (shitalika)
A popular alternative name recorded by the commentary.
Adhikarana ৩১ (৩৯) · Śloka ৩৯
শাল্মলীকণ্টকপ্রখ্যাঃ কফমারুতশোণিতৈঃ |
জাযন্তে পিডকা যূনাং বক্ত্রে যা মুখদূষিকাঃ ||৩৯||
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शाल्मलीकण्टकप्रख्याः कफमारुतशोणितैः |
जायन्ते पिडका यूनां वक्त्रे या मुखदूषिकाः ||३९||
Meaning of the śloka
Eruptions resembling the thorns of a shalmali tree that arise on the faces of young people through kapha, vata, and blood are called mukhadushika.
A round, itchy, pale patch covered with projections resembling the thorns of a lotus plant is called padminikantaka and is attributed to kapha and vata.
The commentary explains that the projections resemble lotus-plant thorns, achita means that the patch is covered by them, and the lesion receives its name, padminikantaka, from this resemblance.
Key terms
padminIkaNTaka (padminikantaka)
The classical lesion named for projections resembling lotus-plant thorns.
A painless, fine or even, raised patch that is present from birth, slightly red, and smooth is known as jatukamani and is attributed to kapha and rakta.
The commentary glosses sama as fine or subtle, utsanna as raised, sahaja as arising by the force of birth, and shlakshna as not rough. It adds that jatukamani is popularly called jadula.
Key terms
jatumaNi (jatukamani)
A congenital smooth, slightly red, raised patch in this classical classification.
कृष्णानि तिलमात्राणि नीरुजानि समानि च |
वातपित्तकफोच्छोषात्तान् विद्यात्तिलकालकान् ||४३||
Meaning of the śloka
Black, painless, flat spots about the size of sesame seeds are called tilakalaka. The main reading attributes them to drying of kapha by vata and pitta.
The commentary explains the main reading as kapha being dried by vata and pitta. Others read 'through the drying of blood by vata and pitta,' using this to explain the black color. Another manuscript reads 'through increase of vata, pitta, and kapha,' but the commentary objects that the lesion shows no sign of increased kapha.
Key terms
tilakAlaka (tilakalaka)
A classical small, black, flat, painless spot.
tilamAtra (tilamatra)
Approximately the size of a sesame seed.
kaphocchoSha (kaphocchosha)
Drying of kapha in the main reading.
asRugucchoSha (asrigucchosha)
Drying of blood in an alternative reading.
kaphodreka
Increase of kapha in another reading rejected by the commentary.
Adhikarana ৩৬ (৪৪) · Śloka ৪৪
মণ্ডলং মহদল্পং বা শ্যামং বা যদি বা সিতম্ |
সহজং নীরুজং গাত্রে ন্যচ্ছমিত্যভিধীযতে ||৪৪||
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मण्डलं महदल्पं वा श्यामं वा यदि वा सितम् |
सहजं नीरुजं गात्रे न्यच्छमित्यभिधीयते ||४४||
Meaning of the śloka
A painless patch on the body, large or small, dark or white, and present from birth is called nyaccha.
The commentary explains sahaja as present from birth. It says people call nyaccha a lanchana, or bodily mark, and attributes it to vata associated with pitta and rakta.
Key terms
nyaccha
A congenital painless dark or light bodily patch.
lA~jchana (lanchana)
A mark or distinguishing bodily sign, given as a popular term.
sahaja
Present from birth.
maNDala (mandala)
A patch or circumscribed area.
Adhikarana ৩৭ (৪৫) · Śloka ৪৫
সমুত্থাননিদানাভ্যাং চর্মকীলং প্রকীর্তিতম্ |৪৫|
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समुत्थाननिदानाभ्यां चर्मकीलं प्रकीर्तितम् |४५|
Meaning of the śloka
Carmakila has been described through its mode of development and its diagnostic account.
The commentary defines samutthana as pathogenesis and nidana as the statement of cause and signs. Gayi does not read this sentence about carmakila at all.
Vata aggravated by anger and exertion and joined with pitta is said to reach the face suddenly and produce a painless, thin, dusky patch called vyanga. A black patch with the same qualities on the body or face is known as nilika.
The commentary reports another view: nilika is essentially vyanga differing only in its site and color. The supplied commentary ends incompletely after verses 45-46 although the source includes the line numbered 47.
Key terms
vya~gga (vyanga)
A painless, thin, dusky facial patch in the classical classification.
When vyana-vata affects the penile skin after excessive rubbing, compression, or injury, the skin retracts from around the glans and the preputial covering hangs below it like a knot. The condition may be painful and burning and sometimes suppurates; it is called parivartika arising from vata together with external injury. The same condition, when attributed to kapha, is itchy and hard.
The commentary applies 'excessive' separately to rubbing and compression, noting that properly performed rubbing or pressure would instead calm vata in its framework. Bhajate means takes residence, the all-moving vata is vyana, and retraction means the skin turns back from all around while leaving the glans exposed. Kosha denotes the skin covering. The final kapha description refers to the same parivartika. The supplied commentary ends incompletely after verses 47-49 although the source continues with line 50.
Key terms
parivartikA (parivartika)
A classical painful retraction and swelling of the penile preputial skin.
meDhracarma (medhracharman)
The skin or preputial covering of the penis.
maNi (mani)
The glans in this genital context.
kosha
The skin covering or prepuce.
vyAna (vyana)
The all-moving form of vata invoked in the commentary.
The text says that forceful sexual intercourse where the vaginal opening is comparatively small, a blow by the hand, forceful turning back of the penile skin, rubbing or compression, or obstruction of ejaculation may tear the skin; this condition is called avapatika.
The commentary explains alpiyahkha as having a comparatively small vaginal opening. Udvartita means that the penile skin has been turned upward and back. When rubbing, compression, or the other stated factors split or tear that skin, the condition is called avapatika. Another interpretation of udvartate is that it moves decisively upward. The supplied commentary ends incompletely after verses 50-51 although the source continues with line 52.
Key terms
avapATikA (avapatika)
A classical traumatic tearing of the penile skin.
alpIyaHkhA (alpiyahkha)
Having a comparatively small vaginal opening, as glossed by the commentary.
udvartita carma (udvartita charman)
Penile skin turned upward or retracted.
shukravegavighAta (shukravegavighata)
Obstruction of the impulse or flow of ejaculation.
When the penile skin affected by vata comes to cover the glans completely, it obstructs the urinary passage. With the opening narrowed, urine flows slowly but without pain, and the glans does not split. This is called niruddhaprakasha, also described as a poorly healed avapatika.
The commentary says 'in this way' refers to rubbing, compression, injury, and similar factors. Samshraya means that the skin covers the glans completely. An avapatika that heals badly acquires the designation niruddhaprakasha.
Key terms
niruddhaprakAsha (niruddhaprakasha)
A classical narrowing in which penile skin covers the glans and restricts the urinary opening.
From suppressing a natural urge, vata is said to have its movement obstructed and to lodge in the rectum, constricting this large passage and leaving only a narrow opening. Because the route is narrowed, stool passes with difficulty. This hard-to-treat condition is called sanniruddhaguda.
In an infant whose anal region remains soiled with stool and urine, is sweaty, and is not washed, itching attributed to rakta and kapha may arise. Scratching then quickly produces blisters and discharge, and the region becomes severely affected with merging sores; this is called ahiputana.
The commentary identifies apana here as the anus and adhauta as lack of cleaning. In such a sweaty, unwashed infant, itching is said to arise from rakta and kapha. The phrase about the region becoming one is completed with 'together with the sores.' Ahiputana is classified as arising from kapha and rakta.
Key terms
ahipUtana (ahiputana)
A classical infant perianal rash with itching, blisters, discharge, and sores.
When accumulated material on the scrotal skin becomes moist with sweat in a person lacking bathing and rubbing care, it causes itching. Scratching quickly leads to blisters and discharge. This is called vrishanakacchu and is attributed to aggravated kapha and rakta.
The commentary colophon states that the thirteenth chapter of the Nidanasthana is complete in Shri Dalhana's explanation of Sushruta entitled Nibandhasangraha.
Key terms
kShudraroganidAna (Kshudraroganidana)
The chapter title, concerning the causes and diagnostic description of a varied group of disorders.
nidAnasthAna (Nidanasthana)
The division concerned with causes and diagnostic descriptions.