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AYANAACADEMYby Dr Vijaya Dwarampudi
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೨. ಸಂಧಿಗತರೋಗವಿಜ್ಞಾನೀಯಾಧ್ಯಾಯಃ

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Adhikarana ೧ (೧-೨) · Śloka ೨

ಅಥಾತಃ ಸನ್ಧಿಗತರೋಗವಿಜ್ಞಾನೀಯಮಧ್ಯಾಯಂ ವ್ಯಾಖ್ಯಾಸ್ಯಾಮಃ ||೧|| ಯಥೋವಾಚ ಭಗವಾನ್ ಧನ್ವನ್ತರಿಃ ||೨||

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

Meaning of the śloka

Now the chapter concerning the recognition of diseases situated at the junctions of the eye will be explained, as taught by the venerable Dhanvantari.

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ಪೂರ್ವಸ್ಮಿನ್ನಧ್ಯಾಯೇ ಸನ್ಧ್ಯಾದಿಕ್ರಮೇಣ ನಯನಗತರೋಗಾ ಅಭಿಹಿತಾಃ, ಅತ ಔಪದ್ರವಿಕಾನನ್ತರಂ ಪ್ರಾಕ್ ಸನ್ಧಿಗತಾ ರೋಗಾಃ ಪ್ರತಿಪಾದ್ಯಾ ಭವನ್ತೀತ್ಯತ ಆಹ- ಅಥಾತ ಇತ್ಯಾದಿ| ಗತಶಬ್ದ ಆಶ್ರಯವಚನಃ||೧-೨||

Meaning of the commentary

The commentary explains the chapter's sequence. The preceding chapter presented diseases of the eye in an order beginning with the junctions; therefore, after the Aupadravika chapter, the diseases located at those junctions are described first. It adds that gata indicates the site or locus in which a disease is situated.

Key terms

सन्धिगत (sandhigata)
Situated at the junctional regions of the eye.
रोगविज्ञानीय (rogavijñānīya)
Concerning the recognition or understanding of diseases.
गत (gata)
A word understood here as indicating the site or locus of a disorder.
धन्वन्तरि (Dhanvantari)
The authoritative teacher to whom the teaching is attributed.

Adhikarana ೨ (೩) · Śloka ೩

ಪೂಯಾಲಸಃ ಸೋಪನಾಹಃ ಸ್ರಾವಾಃ ಪರ್ವಣಿಕಾಽಲಜೀ | ಕ್ರಿಮಿಗ್ರನ್ಥಿಶ್ಚ ವಿಜ್ಞೇಯಾ ರೋಗಾಃ ಸನ್ಧಿಗತಾ ನವ ||೩||

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पूयालसः सोपनाहः स्रावाः पर्वणिकाऽलजी | क्रिमिग्रन्थिश्च विज्ञेया रोगाः सन्धिगता नव ||३||

Meaning of the śloka

Nine diseases are to be recognized as occurring at the junctions of the eye: pūyālasa, upanāha, the discharges, parvaṇikā, alajī, and krimigranthi.

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ಸ್ರಾವಾಃ ಚತ್ವಾರಃ ಪೂಯಾಸ್ರಾವ ಇತ್ಯಾದಯಃ||೩||

Meaning of the commentary

The commentary clarifies that the plural 'discharges' represents four disorders, beginning with pūyāsrāva. Together with the other named conditions, these make the stated total of nine junctional diseases.

Key terms

पूयालस (pūyālasa)
A named junctional eye disorder listed in this classification.
उपनाह (upanāha)
A named disease situated at an ocular junction.
स्राव (srāva)
Ocular discharge; the commentary states that four discharge disorders are included.
कृमिग्रन्थि (krimigranthi)
A named junctional disorder described literally as a krimi-associated swelling or nodule.

Adhikarana ೩ (೪) · Śloka ೪

ಪಕ್ವಃ ಶೋಫಃ ಸನ್ಧಿಜಃ ಸಂಸ್ರವೇದ್ಯಃ ಸಾನ್ದ್ರಂ ಪೂಯಂ ಪೂತಿ ಪೂಯಾಲಸಃ ಸಃ |೪|

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पक्वः शोफः सन्धिजः संस्रवेद्यः सान्द्रं पूयं पूति पूयालसः सः |४|

Meaning of the śloka

A mature swelling arising at an ocular junction that discharges thick, foul-smelling pus is called pūyālasa.

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ಇದಾನೀಂ ತೇಷಾಂ ನವಾನಾಮಪಿ ಪ್ರತ್ಯೇಕಂ ಲಕ್ಷಣಮಾಹ- ಪಕ್ವ ಇತ್ಯಾದಿ| ಸನ್ಧಿಜಃ ಕನೀನಸನ್ಧಿಜಃ| ಪೂತಿ ದುರ್ಗನ್ಧಮ್| ಅಯಂ ಸನ್ನಿಪಾತಜಃ ಸಾಧ್ಯಶ್ಚ|೪|-

Meaning of the commentary

Beginning the individual descriptions of the nine disorders, the commentary specifies that the junction meant here is the kanīna junction. It explains pūti as foul-smelling, attributes this disorder to the combined involvement of the doṣas (sannipāta), and classifies it as treatable in the text's historical prognosis.

Key terms

पक्व शोफ (pakva śopha)
A swelling described as mature or suppurated.
कनीनसन्धि (kanīna-sandhi)
The particular ocular junction identified by the commentary as the site of this disorder.
सान्द्र पूय (sāndra pūya)
Thick pus discharged from the swelling.
सन्निपातज (sannipātaja)
Attributed by the commentary to the combined involvement of the doṣas.

Adhikarana ೪ (೪) · Śloka ೪

ಗ್ರನ್ಥಿರ್ನಾಲ್ಪೋ ದೃಷ್ಟಿಸನ್ಧಾವಪಾಕಃ ಕಣ್ಡೂಪ್ರಾಯೋ ನೀರುಜಸ್ತೂಪನಾಹಃ ||೪||

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ग्रन्थिर्नाल्पो दृष्टिसन्धावपाकः कण्डूप्रायो नीरुजस्तूपनाहः ||४||

Meaning of the śloka

Upanāha is described as a large nodular swelling at the junction of the eye, showing little suppuration, chiefly characterized by itching, and free from pain.

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ಗ್ರನ್ಥಿರಿತ್ಯಾದಿ| ನಾಲ್ಪೋ ಮಹಾನಿತ್ಯರ್ಥಃ| ಅಪಾಕ ಈಷತ್ಪಾಕಃ| ಉಪನಾಹಃ ಶ್ಲೇಷ್ಮೋಪನಾಹಃ| ಕಫಜೋಽಯಂ ಸಾಧ್ಯಶ್ಚ||೪||

Meaning of the commentary

The commentary explains that nālpa means large and that apāka indicates only slight suppuration. It identifies the condition as śleṣmopanāha, states that it arises from kapha, and classifies it as treatable.

Key terms

उपनाह (upanāha)
The named nodular disorder of an ocular junction described in this passage.
ग्रन्थि (granthi)
A knot-like or nodular swelling.
दृष्टिसन्धि (dṛṣṭi-sandhi)
A junctional region of the eye in the text's anatomical classification.
अपाक (apāka)
Explained by the commentary here as slight suppuration.

Adhikarana ೫ (೫-೭) · Śloka ೭

ಗತ್ವಾ ಸನ್ಧೀನಶ್ರುಮಾರ್ಗೇಣ ದೋಷಾಃ ಕುರ್ಯುಃ ಸ್ರಾವಾನ್ ರುಗ್ವಿಹೀನಾನ್ ಕನೀನಾತ್ | ತಾನ್ ವೈ ಸ್ರಾವಾನ್ ನೇತ್ರನಾಡೀಮಥೈಕೇ ತಸ್ಯಾ ಲಿಙ್ಗಂ ಕೀರ್ತಯಿಷ್ಯೇ ಚತುರ್ಧಾ ||೫|| ಪಾಕಃ ಸನ್ಧೌ ಸಂಸ್ರವೇದ್ಯಶ್ಚ ಪೂಯಂ ಪೂಯಾಸ್ರಾವೋ ನೈಕರೂಪಃ ಪ್ರದಿಷ್ಟಃ | ಶ್ವೇತಂ ಸಾನ್ದ್ರಂ ಪಿಚ್ಛಿಲಂ ಸಂಸ್ರವೇದ್ಯಃ ಶ್ಲೇಷ್ಮಾಸ್ರಾವೋ ನೀರುಜಃ ಸ ಪ್ರದಿಷ್ಟಃ ||೬|| ರಕ್ತಾಸ್ರಾವಃ ಶೋಣಿತೋತ್ಥಃ ಸರಕ್ತಮುಷ್ಣಂ ನಾಲ್ಪಂ ಸಂಸ್ರವೇನ್ನಾತಿಸಾನ್ದ್ರಮ್ | ಪೀತಾಭಾಸಂ ನೀಲಮುಷ್ಣಂ ಜಲಾಭಂ ಪಿತ್ತಾಸ್ರಾವಃ ಸಂಸ್ರವೇತ್ ಸನ್ಧಿಮಧ್ಯಾತ್ ||೭||

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गत्वा सन्धीनश्रुमार्गेण दोषाः कुर्युः स्रावान् रुग्विहीनान् कनीनात् | तान् वै स्रावान् नेत्रनाडीमथैके तस्या लिङ्गं कीर्तयिष्ये चतुर्धा ||५|| पाकः सन्धौ संस्रवेद्यश्च पूयं पूयास्रावो नैकरूपः प्रदिष्टः | श्वेतं सान्द्रं पिच्छिलं संस्रवेद्यः श्लेष्मास्रावो नीरुजः स प्रदिष्टः ||६|| रक्तास्रावः शोणितोत्थः सरक्तमुष्णं नाल्पं संस्रवेन्नातिसान्द्रम् | पीताभासं नीलमुष्णं जलाभं पित्तास्रावः संस्रवेत् सन्धिमध्यात् ||७||

Meaning of the śloka

When the doṣas travel through the tear passage to the junctions of the eye, they produce painless discharges from the kanīnaka region; some call these disorders netranāḍī. Their four forms are described as follows. Pūyāsrāva is a variable discharge of pus from suppuration at the junction. Śleṣmāsrāva is a painless, white, thick, slimy discharge. Raktāsrāva, arising from blood, discharges a warm, blood-tinged, copious fluid that is not extremely thick. Pittāsrāva releases from the middle of the junction a warm, water-like fluid described as yellowish or blue.

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ಸನ್ಧಯೋ ನೇತ್ರಾನ್ತರ್ಗತಾಶ್ಚತ್ವಾರಃ| ಅಶ್ರುಮಾರ್ಗಶಬ್ದೇನಾತ್ರ ಸಿರಾ ಅಭಿಪ್ರೇತಾಃ| ತಥಾಚ ವಿದೇಹಃ,- “ಅಶ್ರುಸ್ರಾವಃ ಸಿರಾ ಗತ್ವಾ ನೇತ್ರಸನ್ಧಿಷು ತಿಷ್ಠತಿ| ತತಃ ಕನೀನಕಂ ಗತ್ವಾ ಚಾಶ್ರು ಕೃತ್ವಾ ಕನೀನಕೇ|| ತತಃ ಸ್ರವತ್ಯಥಾಸ್ರಾವಂ ಯಥಾದೋಷಮವೇದನಮ್”- ಇತಿ| ಅಶ್ರುಸ್ರಾವಶಬ್ದೇನಾತ್ರ ತತ್ಸಹಿತೋ ದೋಷೋಽಭಿಧೀಯತೇ| ಕಥಂ ಚತುರ್ಧೇತ್ಯಾಹ- ಪಾಕ ಇತ್ಯಾದಿ|- ನೈಕರೂಪ ಇತಿ ಅಸ್ಯ ಸನ್ನಿಪಾತಜತ್ವಾದ್ಬಹುರೂಪತ್ವಮ್| ಸನ್ಧಿರತ್ರ ಕನೀನಕಸನ್ಧಿಃ| ಅಸಾಧ್ಯೋಽಯಮ್| ಶ್ವೇತ ಇತ್ಯಾದಿ|- ಅಯಮಪ್ಯಸಾಧ್ಯಃ| ರಕ್ತೇತ್ಯಾದಿ|- ಅಸಾವಪ್ಯಸಾಧ್ಯಃ| ಪೀತೇತ್ಯಾದಿ|- ಕನೀನಕಸನ್ಧಿಮಧ್ಯಾದಿತ್ಯರ್ಥಃ| ವ್ಯಾಧಿಸ್ವಭಾವತೋ ವಾತಾಸ್ರಾವೋ ನಾಸ್ತಿ, ಪಿತ್ತಜಗಲಗಣ್ಡಚಾತುರ್ಥಿಕವತ್| ಏಷೋಽಪ್ಯಸಾಧ್ಯಃ||೫-೭||

Meaning of the commentary

The commentary states that there are four internal junctions of the eye and understands aśrumārga here as the vessels. It cites Videha to explain that the doṣa, together with the tear-flow, reaches the ocular junctions and then the kanīnaka, from which a painless discharge occurs according to the doṣa. It explains that pūyāsrāva has varied appearances because it arises from sannipāta and locates the junction here at the kanīnaka. It classifies pūyāsrāva, śleṣmāsrāva, raktāsrāva, and pittāsrāva as untreatable. For pittāsrāva, it clarifies that the discharge comes from the middle of the kanīnaka junction. It also says that no vāta-origin discharge exists by the nature of this disease, comparing this absence with other traditional classifications.

Key terms

अश्रुमार्ग (aśrumārga)
The tear passage, interpreted by the commentary here as vessels.
कनीनक (kanīnaka)
The eye-junction region from which the discharges are described as emerging.
पूयास्राव (pūyāsrāva)
A variably appearing purulent discharge attributed by the commentary to combined doṣa involvement.
श्लेष्मास्राव (śleṣmāsrāva)
A white, thick, slimy, painless ocular discharge attributed to śleṣman.
रक्तास्राव (raktāsrāva)
A warm, blood-tinged and relatively fluid ocular discharge associated with blood.
पित्तास्राव (pittāsrāva)
A warm, water-like, yellowish or blue discharge attributed to pitta.

Adhikarana ೬ (೮) · Śloka ೮

ತಾಮ್ರಾ ತನ್ವೀ ದಾಹಶೂಲೋಪಪನ್ನಾ ರಕ್ತಾಜ್ಜ್ಞೇಯಾ ಪರ್ವಣೀ ವೃತ್ತಶೋಫಾ | ಜಾತಾ ಸನ್ಧೌ ಕೃಷ್ಣಶುಕ್ಲೇಽಲಜೀ ಸ್ಯಾತ್ತಸ್ಮಿನ್ನೇವ ಖ್ಯಾಪಿತಾ ಪೂರ್ವಲಿಙ್ಗೈಃ ||೮||

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ताम्रा तन्वी दाहशूलोपपन्ना रक्ताज्ज्ञेया पर्वणी वृत्तशोफा | जाता सन्धौ कृष्णशुक्लेऽलजी स्यात्तस्मिन्नेव ख्यापिता पूर्वलिङ्गैः ||८||

Meaning of the śloka

Parvaṇī is described as a thin, copper-colored, round swelling arising from blood and accompanied by burning and pain. Alajī arises at the junction of the dark and white parts of the eye and is described by the same preceding signs.

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ತಾಮ್ರೇತ್ಯಾದಿ| ಅಸಾಧ್ಯೋಽಯಮ್| ಅಲಜೀತ್ಯಾದಿ| ತಸ್ಮಿನ್ನೇವ ಕೃಷ್ಣಶುಕ್ಲಸನ್ಧಾವೇವ| ಪೂರ್ವಲಿಙ್ಗೈಃ ಪರ್ವಣೀಲಿಙ್ಗೈರಿತ್ಯರ್ಥಃ| ಪರ್ವಣ್ಯಲಜ್ಯೋಃ ಸ್ಥಾನಸ್ಯ ಲಕ್ಷಣಸ್ಯ ಚೈಕ್ಯೇಽಪಿ ತನುತ್ವಸ್ಥೂಲತ್ವಾಭ್ಯಾಂ ಭೇದಃ| ತನ್ವೀ ಪರ್ವಣೀ, ತತಃ ಸ್ಥೂಲಾ ಪುನರಲಜೀ| ಇಯಂ ಸನ್ನಿಪಾತಜಾ ಅಸಾಧ್ಯಾ ಚ||೮||

Meaning of the commentary

The commentary classifies parvaṇī as untreatable. It locates alajī at that same junction of the dark and white parts and explains that its preceding signs are those of parvaṇī. Although the two conditions share their location and signs, they are distinguished by thickness: parvaṇī is thin, whereas alajī is thicker. Alajī is attributed to the combined doṣas and is also classified as untreatable.

Key terms

पर्वणी (parvaṇī)
A thin, round, copper-colored swelling at an ocular junction, accompanied by burning and pain.
अलजी (alajī)
A thicker swelling at the junction of the dark and white ocular regions, sharing the signs attributed to parvaṇī.
कृष्णशुक्लसन्धि (kṛṣṇa-śukla-sandhi)
The junction between the dark and white regions of the eye in the text's anatomy.
सन्निपातज (sannipātaja)
Arising from the combined involvement of the doṣas, as stated for alajī.

Adhikarana ೭ (೯) · Śloka ೯

ಕ್ರಿಮಿಗ್ರನ್ಥಿರ್ವರ್ತ್ಮನಃ ಪಕ್ಷ್ಮಣಶ್ಚ ಕಣ್ಡೂಂ ಕುರ್ಯುಃ ಕ್ರಿಮಯಃ ಸನ್ಧಿಜಾತಾಃ | ನಾನಾರೂಪಾ ವರ್ತ್ಮಶುಕ್ಲಸ್ಯ ಸನ್ಧೌ ಚರನ್ತೋಽನ್ತರ್ನಯನಂ ದೂಷಯನ್ತಿ ||೯||

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क्रिमिग्रन्थिर्वर्त्मनः पक्ष्मणश्च कण्डूं कुर्युः क्रिमयः सन्धिजाताः | नानारूपा वर्त्मशुक्लस्य सन्धौ चरन्तोऽन्तर्नयनं दूषयन्ति ||९||

Meaning of the śloka

Krimigranthi is described at the junction of the eyelid and the white part of the eye. Organisms of various forms arising at this junction produce itching where the eyelid meets the eyelashes; moving within and feeding there, they injure or impair the eye.

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ಕ್ರಿಮೀತ್ಯಾದಿ| ಕ್ರಿಮೀಗ್ರನ್ಥಿರ್ವರ್ತ್ಮಶುಕ್ಲಯೋಃ ಸನ್ಧೌ ಭವತಿ| ತತ್ರೈವ ನಾನಾರೂಪಾಃ ಕ್ರಿಮಯೋ ವರ್ತ್ಮನಃ ಪಕ್ಷ್ಮಣಶ್ಚ ಸನ್ಧಿಂ ಪ್ರಾಪ್ತಾಃ ಕಣ್ಡೂಂ ಜನಯನ್ತಿ, ಅನ್ತಶ್ಚರನ್ತೋ ಭಕ್ಷಯನ್ತೋ ನಯನಂ ದೂಷಯನ್ತಿ| ಅಸೌ ಕಫಜಃ ಸಾಧ್ಯಶ್ಚ||೯||

Meaning of the commentary

The commentary locates krimigranthi specifically at the junction between the eyelid and the white of the eye. It explains that varied forms of krimi reach the junction of the eyelid and eyelashes, cause itching, and harm the eye while moving and feeding internally. It classifies the condition as arising from kapha and as treatable within the text's historical system.

Key terms

क्रिमिग्रन्थि (krimigranthi)
A named disorder at the eyelid–ocular junction, associated here with itching and krimi.
वर्त्मशुक्लस्य सन्धि (vartma-śuklasya sandhi)
The junction between the eyelid and the white part of the eye.
कण्डू (kaṇḍū)
Itching, described as a principal feature of the condition.
क्रिमि (krimi)
Organisms or parasitic agents invoked by the text in explaining the disorder; the term should remain within its classical context.
कफज (kaphaja)
Classified by the commentary as arising from kapha.

Adhikarana ಪುಷ್ಪಿಕಾ · Śloka ೨

ಇತಿ ಸುಶ್ರುತಸಂಹಿತಾಯಾಮುತ್ತರತನ್ತ್ರೇ ಸನ್ಧಿಗತರೋಗವಿಜ್ಞಾನೀಯೋ ನಾಮ ದ್ವಿತೀಯೋಽಧ್ಯಯಃ ||೨||

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इति सुश्रुतसंहितायामुत्तरतन्त्रे सन्धिगतरोगविज्ञानीयो नाम द्वितीयोऽध्ययः ||२||

Meaning of the śloka

Thus ends the second chapter of the Uttaratantra in the Suśruta Saṃhitā, entitled ‘Knowledge of Diseases Located at the Ocular Junctions’ (Saṃdhigatarogavijñānīya).

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ಇತಿ ಶ್ರೀಡಲ್ಹ(ಹ್ಲ)ಣವಿರಚಿತಾಯಾಂ ನಿಬನ್ಧಸಙ್ಗ್ರಹಾಖ್ಯಾಯಾಂ ಸುಶ್ರುತವ್ಯಾಖ್ಯಾಮುತ್ತರತನ್ತ್ರಾನ್ತರ್ಗತೇ ಶಾಲಾಕ್ಯತನ್ತ್ರೇ ದ್ವಿತೀಯೋಽಧ್ಯಾಯಃ||೨||

Meaning of the commentary

The commentary colophon states that this is the second chapter in the Śālākyatantra section of the Uttaratantra commentary on Suśruta, called the Nibandhasaṅgraha and composed by Śrī Dalhaṇa. The supplied form ‘Dalha(hla)ṇa’ records a textual or editorial variation in the commentator's name.

Key terms

सन्धिगतरोगविज्ञानीय (saṃdhigatarogavijñānīya)
The chapter title, concerning knowledge of disorders situated at the ocular junctions.
उत्तर तन्त्र (Uttaratantra)
The division of the Suśruta Saṃhitā in which this chapter occurs.
शालाक्यतन्त्र (Śālākyatantra)
The specialty section identified by the commentary colophon.
निबन्धसङ्ग्रह (Nibandhasaṅgraha)
The title of Dalhaṇa's commentary on the Suśruta Saṃhitā.
← 1. aupadravikādhyāyaḥ3. vartmagatarōgavijñānīyādhyāyaḥ →