Adhyaya 160

Verse 1

ऽध्यायः धन्वन्तरिरुवाच / निदानं विद्रधेर्वक्ष्ये गुल्मस्य शृणु शुश्रुत ! / भुक्तैः पर्युषितात्युष्णशुष्करूक्षविदाहिभिः // गर्प्१,१६०।१ / धन्वन्तरिरुवाच / निदानं विद्रधेर्वक्ष्ये गुल्मस्य शृणु शुश्रुत ! / भुक्तैः पर्युषितात्युष्णशुष्करूक्षविदाहिभिः

Dhanvantari said: “I shall declare the causes of vidradhi (abscess) and of gulma (abdominal mass). Listen, O Suśruta. They arise from eating food that is stale, excessively hot, dry, rough, and burning—such as provokes pitta.”

Verse 2

जिह्मशय्याविचेष्टाभिस्तैस्तैश्चासृक्प्रदूषणैः / दुष्टसत्वङ्मांसमेदो ऽस्थिमदामृष्टोदराश्रयः

Through crooked postures in bed and faulty movements, and through various causes that vitiate the blood, the disturbed vital principle—together with flesh, fat, bone, and marrow—becomes afflicted and takes up residence in the abdomen.

Verse 3

यः शोथो बहिरन्तश्च महाशूलो महारुजः / वृत्तः स्यादायतो यो वा स्मृतो रोगः स विद्रधिः

That swelling which arises externally or internally, attended by intense pain and severe distress—whether round or elongated—is known as the disease called vidradhi (abscess).

Verse 4

दोषैः पृथक्समुदितैः शोणितेन स्त्रतेन च / वहते तत्र तत्राङ्गे दारुणे ग्रथितो ऽस्त्रुतः

When the doṣas rise separately and in excess, together with flowing blood, the condition spreads through various parts of the body; it becomes dreadful—knotted and obstructed, no longer discharging freely.

Verse 5

अन्तरा दारुणश्चैव गम्भीरो गुल्मवर्धनः / वल्मीकवत्समुत्स्त्रावी ह्यग्निमान्द्यञ्च जायते

It becomes internal, severe, and deep-seated, increasing gulma (abdominal masses); it oozes like an anthill, and weakness of the digestive fire (agnimāndya) arises.

Verse 6

नाभिबस्तियकृत्प्लीहक्लोमहृत्कुक्षिवङ्क्षणि / हृदये वेपमाने तु तत्रतत्रातितीव्ररुक्

In the region of the navel, the bladder, liver, spleen, kloma, heart, abdomen, and groin—when the heart trembles, an exceedingly intense pain arises in those very places.

Verse 7

श्यामारुणशिरोत्थानपाको विषमसंस्थितिः / संज्ञाच्छेदभ्रमानाहस्यन्दसर्पणशब्दवान्

Its eruption and suppuration appear dark-red and arise upon the head; it is irregular in form, and is attended by loss or interruption of consciousness, dizziness, abdominal distension, oozing discharge, a creeping spread, and characteristic sounds.

Verse 8

रक्तताम्रासितः पित्तात्तृण्मोहज्वरदाहवान् / क्षिप्तोत्थानप्रपाकश्च पाण्डुः कण्डूयुतः कफात्

From pitta it turns blood-red, coppery, or blackish, attended by thirst, faintness or delusion, fever, and burning; it arises suddenly and suppurates fiercely. From kapha it is pale and joined with itching.

Verse 9

संक्लेशशीतकस्तम्भजृम्भारोचकगौरवाः / चिरोत्थानो ऽविपाकश्च संकीर्णः सन्निपातजः

In the mixed condition (sannipāta) there are distress, chills, stiffness, yawning, loss of appetite, and heaviness; it arises slowly, does not suppurate properly, and shows a confused mixture of signs.

Verse 10

सामर्थ्याच्चात्र विड्भेदो बाह्याभ्यन्तरलक्षणम् / कृष्णस्फोटावृतश्यामस्तीव्रदाहरुजाज्वरः

Here, according to the strength of the causative factors, viḍbheda (diarrhoeal/dysenteric discharge) manifests with outward and inward signs: a dark discoloration covered with black eruptions, together with intense burning pain and fever.

Verse 11

पित्तलिङ्गो ऽसृजा बाह्ये स्त्रीणामेव तथान्तरम् / शस्त्राद्यैरभिघातोत्थरक्तैश्च रोगकारणम्

Bleeding that bears the marks of pitta appears outwardly; in women it also arises within. Blood born of injury by weapons and the like likewise becomes a cause of disease.

Verse 12

क्षतोत्थो वायुना क्षिप्तः स रक्तः पित्तमीरयन् / पित्तासृग्लक्षणं कुर्याद्विद्रधिं भूर्युपद्रवम्

Blood produced from a wound, driven about by vāyu, agitates pitta; it then brings forth the signs of pitta-associated bleeding and causes vidradhi (abscess) with many complications.

Verse 13

तेनोपद्रवभेदश्च स्मृतो ऽधिष्ठानभेदतः / नाभौ हि ध्मातं चेद्बस्तौ मूत्रकृच्छ्रञ्चजायते

Thus the varieties of complications are remembered as differing according to the site involved. If the swelling is in the navel region, then in the bladder there arises difficulty in passing urine.

Verse 14

श्वासप्रश्वासरोधश्च प्लीहायामतितृट् परम् / गलरोधश्च क्लोम्नि स्यात्सर्वाङ्गप्ररुजा हृदि

When the spleen is afflicted, inhalation and exhalation are obstructed and an overwhelming, excessive thirst arises. When the kloman is afflicted, there is choking in the throat; when the heart is afflicted, piercing pain spreads through all the limbs.

Verse 15

प्रमोहस्तमकः कासौ हृदयोद्धट्टनन्तथा / कुक्षिपार्श्वान्तरे चैव कुक्षौ दोषोपजन्म च

Described are delusion and stupefaction, asthma and cough, and likewise violent palpitations of the heart; pain in the flanks and sides of the abdomen, and in the belly too—ailments that arise from the body’s doṣas.

Verse 16

तथा चेदूरुसन्धौ च वङ्क्षणे कटिपृष्ठयोः / पार्श्वयोश्च व्यथा पायौ पवनस्य निरोधनम्

Likewise, if there is pain in the hip-joint, the groin, the waist and back, and also in the flanks—together with distress in the anus and obstruction of the passing wind—these should be understood as specific signs of the disorder described.

Verse 17

आमपक्वविदग्धत्वं तेषां शोथवदादिशेत् / नाभेरूर्ध्वमुखात्पक्वात्प्रद्रवन्त्यपरे गुदात्

One should diagnose in them the states of ‘āma’ (undigested), ‘pakva’ (ripened/suppurated), and ‘vidagdha’ (burnt/acidified), along with swelling. In some cases, when it is ‘pakva’, the discharge flows from the navel through an upward-facing opening; in others, it flows from the anus.

Verse 18

गुदास्तनाभिजे विद्याद्दोषक्लेदोच्चविद्रधौ / कुरुते स्वाधिष्ठानस्य विवर्तं सन्निपातजः

In the abscess (vidradhi) arising in the regions of the anus, the breast, and the navel, one should understand an excessive, oozing vitiation of the doṣas. When it is born of a combined derangement (sannipāta), it causes a distortion of the svādhiṣṭhāna region.

Verse 19

पक्वो हि नाभिवस्तिस्थो भिन्नो ऽन्तर्बहिरेव वा / पाकश्चान्तः प्रवृद्धस्य क्षीणस्योपद्रवार्दितः

Indeed, a suppurating abscess may arise in the region of the navel or the bladder; it may rupture inwardly or outwardly. In one whose internal suppuration has grown severe, the debilitated person is tormented by complications.

Verse 20

विद्रधिश्च भवेत्तत्र पापानां पापयोषिताम् / मृते तु गर्भगे चैव सम्भवेच्छ्वयथर्घनः

There, an abscess (vidradhi) arises for sinful men and for sinful women. And when the fetus within the womb dies, a hard, swelling tumor is said to occur.

Verse 21

स्तने समत्थे दुःखं वा बाह्यविद्रधिलक्षणम् / नारीणां सूक्ष्मरक्तत्वात्कन्यायान्तु न जायते

Pain in the breast together with swelling is a sign of an external abscess; yet because women’s blood is more subtle, it does not arise in a maiden.

Verse 22

क्रुद्धो रुद्धगतिर्वायुः शेफमूलकरो?हि सः / मुष्कवङ्क्षणतः प्राप्य फलकोषातिवाहिनीम्

When vāyu (the vital wind) is aggravated and its movement is obstructed, it afflicts the root of the penis; reaching from the testes and the groin, it spreads along the channels connected with the scrotal sac.

Verse 23

आपीड्य धमनीवृद्धिं करोति फलकोषयोः / दोषो मेदःसु तत्रास्ते सवृद्धिः सप्तधा गदः

By compressing the channels, it causes enlargement of the vessels in the scrotal sacs. The doṣa (morbid factor) lodges there in the fatty tissues; as it increases, the disease manifests in seven forms.

Verse 24

मूत्रन्तयोरप्यनिलाद्बाह्ये वाभ्यन्तरे तथा / वातपूर्णः खरस्पर्शो रूक्षो वाताच्च दाहकृत्

Even in the channels of urine and feces, outwardly or within, through the action of vāta (wind) there arises a wind-filled condition—harsh to the touch, dry in nature, and, because of vāta, producing burning.

Verse 25

पक्वोदुम्बरसङ्काशः पित्ताद्दाहोष्मपाकवान् / कफात्तीव्रो गुरुः स्निग्धः कण्डूमान्कठिनो ऽल्परुक्

It appears like a ripe udumbara fruit; through pitta it brings burning, heat, and suppurative ‘ripening’. Through kapha it becomes severe—heavy, unctuous, itchy, hard, and with little pain.

Verse 26

कृष्णः स्फोटावृतः पिण्डों वृद्धिलिङ्गश्च रक्ततः / कफवन्मेदसां वृद्धिर्मृदुतालफलोपमः

A blackish lump, covered with blisters, is a sign of increase arising from the blood. Likewise, the increase of fat is kapha-like in nature—soft, and comparable to the fruit of the palm.

Verse 27

मूत्रधारणशीलस्य मूत्रजस्तत्र गच्छतः / अलोभः पूर्णधृतिमान्क्षोभं याति सरन्मृदु

For one who habitually suppresses urine, the disorder born of urine moves on within the body. Even a person naturally free from greed and endowed with full self-restraint comes to agitation, though it may proceed gently and subtly.

Verse 28

मूत्रकृच्छ्रमधस्ताच्च वलयः फलकोषयोः / वातकोपिभिसहारैः शीततोयावगाहनैः

Difficulty in passing urine, and a ring-like swelling in the scrotal region, arises from the aggravation of vāta caused by overexertion and by immersion in cold water.

Verse 29

विण्मूत्रधारणाच्चैव विषमाङ्गविचेष्टनैः / क्षोभितैः क्षोभितौजाश्च क्षीणान्तर्देहिनो यदा

And through suppressing feces and urine, and by irregular or improper bodily movements, when a person is disturbed, his ojas—vital vigor—also becomes agitated, and the inner vitality of the embodied being declines.

Verse 30

पवनो विगुणीभूय शोणितं तदधोनयेत् / कुर्यात्तत्क्षणसन्धिस्थो ग्रन्थ्याभः श्वयथुस्तदा

When the vital wind (pavana/vāta) becomes disordered, it drives the blood downward; then, lodged at that very junction-region, it produces a gland-like swelling—thus a tumorous edema arises.

Verse 31

उपेक्ष्यमाणस्य च गुल्मवृद्धिमाध्मानरुग्वै विविधाश्च रोगाः / सुपीडितो ऽन्तः स्वनवान् प्रयाति प्रध्मापयन्नेति पुनश्च मूर्ध्नि

When this condition is neglected, the abdominal mass (gulma) enlarges; distension and pain arise, along with many other diseases. Severely pressed within, the wind (vāta) moves about with rumbling sounds, inflating the body and then again rushing upward to the head.

Verse 32

रक्तवृद्धिरसाध्ये ऽयं वातवृद्धिसमाकृतिः / रूक्षकृष्णारुणशिरा ऊर्णावृतगवाक्षवत्

This is an incurable increase of blood, bearing the features of aggravated vāta. The veins appear dry, dark and reddish, like a window covered with wool—hazy and obscured.

Verse 33

वातो ऽष्टधा पृथदौषैः संस्पृष्टैर्निचयं गतः / आर्तवस्य च दोषेण नारीणां जायते ऽष्टमः

Vāta becomes eightfold when, coming into contact with other distinct doṣas, it accumulates in various combinations. And through a defect of ārtava (menstrual or reproductive fluid), an eighth type arises in women.

Verse 34

ज्वरमूर्छातिसारैश्च वमनाद्यैश्च कर्मभिः / कर्शितो बलवान्याति शीतार्तश्च बुभुक्षितः

Through fever, fainting, diarrhea, and procedures such as induced vomiting and the like, the body becomes emaciated. Even the strong grow weak, afflicted by cold and driven by hunger.

Verse 35

यः पिबत्यन्नपानानि लङ्घनप्लावनादिकम् / सेवते हीनसंज्ञाभिरर्दितः समुदीरयन्

Whoever consumes food and drink without discernment and resorts to practices such as fasting, purgation, and the like—thereby stirring inner disorders—becomes afflicted, tormented by low and degrading states of consciousness.

Verse 36

स्नेहस्वेदावनभ्यस्य शोषणं वा निषेवयेत् / शुद्धो वा सुद्धिहानिर्वा भजेत स्पन्दनानि वा

If one does not practice oleation (snehana) and sudation (svedana), one should instead resort to drying therapies; and whether one is pure or has lost purity, tremors and bodily spasms may still arise.

Verse 37

वातोल्बणास्तस्य मलाः पृथक्चैव हि ते ऽथवा / सर्वो रक्तयुतो वाताद्देहस्नोतो ऽनुसारिणः

When vāta becomes excessive, the malas (wastes) are disturbed—either they are discharged separately, or everything is expelled mixed with blood. Due to vāta, the body turns dry and emaciated, and the discharges keep flowing on.

Verse 38

ऊर्ध्वाधोमार्गमावृत्य वायुः शूलं करोति वै / स्पर्शोपलभ्यं गुल्मोत्थमुष्णं ग्रन्थिस्वरूपिणम्

When vāyu, the vital wind, blocks the upward and downward passages, it surely produces colicky pain—palpable to the touch—arising as a gulma-like mass, hot in nature, taking the form of a knot or swelling.

Verse 39

कर्षणात्कफविड्घातैर्मार्गस्यावरणेन वा / वायुः कृताश्रयः कोष्ठे रौक्ष्यात्काठिन्यमागतः

Due to depletion, or because kapha and feces obstruct the tract, or because the pathways are blocked, vāyu takes lodging in the koṣṭha (abdomen); from dryness it brings hardness and rigidity.

Verse 40

स्वतन्त्रः स्वाश्रये दुष्टः परतन्त्रः पराश्रये / ततः पिण्डकवच्छ्लेष्मा मलसंसृष्ट एव च

Vāta, when independent in its own seat and corrupted, becomes dūṣṭa; and when dependent in another seat, it is corrupted there as well. Thus śleṣman (phlegm) congeals like a ball, and it is also mingled with the malas (wastes).

Verse 41

गुलम इत्युच्यते बस्तिनाभिहृत्पार्श्वसंश्रयः / वातजन्ये शिरः शूलज्वर प्लीहान्त्रकूजनम्

A “gulma” is said to be a hard, swollen mass lodged near the bladder, the navel, the heart-region, and the sides of the body. When born of vāta, it brings headache, colicky pain, fever, disorders of the spleen, and rumbling within the intestines.

Verse 42

वेधः सूच्येव विड्भ्रंशः कृच्छ्रे मूत्रं प्रवर्तते / गात्रे मुखे पदे शोथः ह्यग्निमान्द्यं तथैव च

There is piercing pain as though from a needle; the bowels are disturbed, and urine passes only with great difficulty. Swelling arises in the limbs, the face, and the feet, and the digestive fire (agni) likewise grows weak.

Verse 43

रूक्षकृष्णत्वगादित्वं चलत्वादनिलस्यच / अनिरूपितसंस्थानो विविधाञ्जनयेद्व्यथाम्

Because vāta is dry and mobile, it brings about roughness, darkening of the skin, and similar signs. Being of indeterminate form, it gives rise to many kinds of pain and distress.

Verse 44

पिपीलिकाव्याप्त इव गुल्मः स्फुरति नुद्यते / पित्ताद्दाहाम्लकौ मूर्छा विड्भेदः स्वेदतृड्ज्वराः

The gulma throbs and is pierced with pain, as though pervaded by ants. From pitta arise burning heat and sourness, fainting, diarrhea, sweating, thirst, and fever.

Verse 45

हारिद्रयं सर्वगात्रेषु गुल्माच्छोथस्य दर्शनम् / हीयते दीप्यते श्लेष्मा स्वस्थानं दहतीवच

A yellowish hue appears over all the limbs, and from gulma the swelling is also seen. Kapha diminishes and then flares up again; it feels as though it burns in its own seat.

Verse 46

कफात्स्तैमित्यमरुचिः सदनं शिरसि ज्वरः / पीनसालस्यहृल्लासौ शुक्लकृष्णत्वगादिता

From the aggravation of kapha arise heaviness and stiffness, loss of appetite, bodily languor, fever lodged in the head, catarrh, lethargy and nausea; and changes such as whitening or darkening of the skin and related signs.

Verse 47

गुल्मो गभीरः कठिनो गुरुर्गर्भस्थबालवत् / स्वस्थानस्था अधावन्तस्तत एवात्र मारकाः

A gulma (deep-seated abdominal mass) is profound, hard, and heavy—like a fetus situated in the womb. Remaining in its own seat, yet ‘running about’ (spreading from there), such a condition becomes deadly in this context.

Verse 48

प्रायस्तु यत्तद्द्वन्द्वोत्था गुल्माः संसृष्टमैथुनाः / सर्वजस्तीव्ररुग्दाहः शीघ्रपाकी घनोन्नतः

Most often, those gulmas arise from a dual-doṣa origin and from mixed causative factors. The all-doṣa type produces intense pain and burning, ripens quickly (suppurates rapidly), and becomes dense and raised.

Verse 49

सो ऽसाध्यो रक्तगुल्मस्तु स्त्रिया एव प्रजायते / ऋतौ या चैव शूलार्ता यति वा योनिरोगिणी

That incurable condition called raktagulma (a blood-born abdominal mass) arises only in women—especially in one who, during her menstrual period, suffers painful cramps, or who suppresses the flow, or who is afflicted with disorders of the womb.

Verse 50

सेवते वानिलांश्च स्त्री क्रुद्धस्तस्याः समीरणः / निरुध्यात्यार्तवं योन्यां प्रतिमासं व्यवस्थितम्

If a woman resorts to provoking the bodily winds (vāyu), then the samīraṇa—the vital air within her—becomes disturbed; it obstructs the menstrual flow that is ordinarily established in the womb each month.

Verse 51

सुक्षौ करोति तद्गर्भे लिङ्गमाविष्करोति च / हृल्लासदौहृदस्तन्यदर्शनं कामचारिता

Within the womb it fashions the subtle body and also brings forth the liṅga, the sign of that subtle form. Delight and the cravings of pregnancy arise; the forming of breast‑milk is perceived—these are movements impelled by desire.

Verse 52

क्रमेण वायोः संसर्गात्पित्तं योनिषु सञ्चयम् / रक्तस्य कुरुते तस्या वातपित्तोक्तगुल्मजान्

In due course, through association with vāyu, pitta gathers within the passages of the yoni; it then disturbs her blood and gives rise to gulma, said to be born of vāta and pitta.

Verse 53

गर्भाशये च सुतरां शूलांश्चैवासृगाश्रये / योनिस्त्रावश्च दौर्गन्ध्यं भूयः स्यन्दनवेदने

In the womb there is grievous torment—piercing pains and an abode filled with blood. There is discharge from the genital passage, foul odor, and repeated distress from ceaseless oozing.

Verse 54

कदापि गर्भवद्गुल्मः सर्वे ते रतिसम्भवाः / पाकञ्चिरेण भजते नैधते विद्रधिः पुनः

At times gulma, a mass, appears as though it were pregnancy; all such conditions arise from indulgence in sensual pleasure. It suppurates only after a long time, and thereafter it does not keep growing again like a vidradhi, an abscess.

Verse 55

पच्यते शीघ्रमत्यर्थं दुष्टरक्ताश्रयस्तु सः / अतः शीघ्रं विदाहित्वाद्वद्रधिः सो ऽभीधीयते

It ripens into suppuration swiftly and intensely, for it rests upon corrupted blood. Therefore, because it quickly burns with inflammation, it is called vidradhi—an abscess.

Verse 56

गुल्मान्तारश्रये बस्तिदाहश्च प्लीहवेदना / अग्निवर्णबलभ्रंशो वेगानां वा प्रवर्तनम्

When the gulma (abdominal mass) lies deep within, there arise burning in the urinary bladder, pain in the spleen, a fiery discoloration with loss of strength, and an abnormal stirring of the bodily urges.

Verse 57

अतो विपर्यये बाह्यकोष्ठाङ्गेषु च नातिरुक् / वैवर्ण्यमथ वा कासो बहिरुन्नतताधिकम्

Conversely, when the condition is reversed, there is little pain in the outer limbs and trunk; instead there may be discoloration, or coughing, and a greater swelling or protrusion outward.

Verse 58

साटोपमत्युग्ररुजमाध्मानमुदरे भृशम् / ऊर्ध्वाधो वातरोधेन तमानाहं प्रचक्षते

When the abdomen is greatly distended, with loud rumbling and intense pain, caused by obstruction of vāyu (wind) moving upward and downward, that condition is called ānāha (painful constipation/obstructed flatulence).

Verse 59

धनश्चाष्ठ्युपमो ग्रन्थिलो ऽष्ठीलातु समुन्नता / समस्तालिङ्गसंयुक्तः प्रत्यष्ठीला तदाकृतिः

It becomes like a hard, bony knot; the subtle lump called aṣṭhīlā rises up, and, joined with all the bodily signs, it appears as a counter-lump (pratyaṣṭhīlā) of the same form.

Verse 60

पक्वशयोद्भवो ऽप्येवं वायुस्तीव्ररुजाश्रयात् / उद्गारबाहुल्यपुरीषबन्धतृप्त्यक्षमत्वान्त्रविकूजनानि

Likewise, when vāyu (the bodily wind) arises from the large intestine and becomes lodged amid severe pain, it brings frequent belching, obstruction of stool (constipation), inability to feel satisfied even after eating, and rumbling sounds within the intestines.

Verse 61

आचोपमाध्मानमपक्तिशक्तिः आसन्नगुल्मस्य भवेच्च चिह्नम्

Bloating that resembles the swelling of a bruise, together with weakness of the digestive fire (agni), is said to be a sign that a gulma—an abdominal mass—is drawing near.