The 17th chapter of Uttara Sthanam of Ashtanga Hridayam is named as Karnaroga Vijnaniya. This chapter deals with the explanation of ‘Knowledge of diseases of the ears’.
The topics covered in this chapter include –
- Karnashoola – Vataja
- Pittaja Karnashoola
- Kaphaja Karnashoola
- Raktaja Karnashoola
- Sannipataja Karnashoola
- Karnanada
- Badhirya
- Pratinaha
- Kandu – Shopha
- Putikarnaka
- Krimikarnaka
- Karna Vidradhi, Shopha, Arshas, Arbuda
- Kuchikarnaka
- Karna Pippali
- Karna Vidarika
- Palishosha
- Tantrika
- Paripota
- Utpata
- Unmantha or Gallira
- Dukha Vardhana
- Lehyakhya Pitaka
Pledge by the author(s)
अथात: कर्णरोगविज्ञानीयं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘Knowledge of diseases of the ears’.Thus, say (pledge) Atreya and other sages.
Karnashula: Vataja
प्रतिश्यायजलक्रीडाकर्णकण्डूयनैर्मरुत् ।
मिथ्यायोगेन शब्दस्य कुपितोऽन्यैश्च कोपनैः ॥ १ ॥
प्राप्य श्रोत्रसिराः कुर्याच्छूलं स्रोतसि वेगवत् ।
अर्धावभेदकं स्तम्भं शिशिरानभिनन्दनम् ॥ २ ॥
चिराच्च पाकं पक्वं तु लसीकामल्पशः स्रवेत् ।
श्रोत्रं शून्यमकस्माच्च स्यात्सञ्चारविचारवत् ॥ ३ ॥
Vata getting aggravated by nasal catarrh, water sports and by inserting sticks etc. into the ears, exposure to improper sound and such other aggravating causes; invades the veins (channels) of the ears and produces pain in the ears suddenly and with great severity, associated with a partial headache, stiffness of the head and non-desire for cold; undergoes suppuration after a long time, when ripe discharges little quantity of lasika (thin, watery fluid), appears either as empty (or full), sometimes closed, without any other apparent cause.
Pittaja Karnashoola
शूलं पित्तात्सदाहोषाशीतेच्छाश्वयथुज्वरम् ।
आशुपाकं प्रपक्वं च सपीतलसिकास्रुति ॥ ४ ॥
सा लसीका स्पृशेद्यद्यत्तत्तत्पाकमुपैति च ।
By increase of Pitta, there is pain associated with burning sensation, desire for cold things, swelling, fever, quick suppuration, after suppurating, discharges yellowish thin fluid; the places which this fluid come in contact with, gets ulcerated (suppurated).
Kaphaja Karnashoola
कफाच्छिरोहनुग्रीवागौरवं मन्दता रुजः ॥ ५ ॥
कण्डूः श्वयथुरुष्णेच्छा पाकाच्छ्वेतघनस्रुतिः ।
That caused by Kapha, has feelings of heaviness of the head, lower jaw and neck; mild degree of pain, itching, swelling, desire for hot comforts and after suppuration, discharge of white thick liquid.
Raktaja Karnashoola
करोति श्रवणे शूलमभिघातादिदूषितम् ॥ ६ ॥
रक्तं पित्तसमानार्ति किञ्चिद्वाऽधिकलक्षणम् ।
Blood vitiated by injury etc. produces earache, which has the same symptoms of that caused by Pitta, but little more in severity.
Sannipataja Karnashoola
शूलं समुदितैर्दोषैः सशोफज्वरतीव्ररुक् ॥ ७ ॥
पर्यायादुष्णशीतेच्छां जायते श्रुतिजाड्यवत् ।
पक्वं सितासितारक्तघनपूयप्रवाहि च ॥ ८ ॥
Earache produced by the combination of all the doshas is accompanied with swelling, fever, severe pain, desire for hot and cold comforts alternately, sluggishness of hearing occurs; when ripe (after suppuration), copious quantities of white, black and red thick pus flows out.
Karnanada
शब्दवाहिसिरासंस्थे शृणोति पवने मुहुः ।
नादानकस्माद्विविधान् कर्णनादं वदन्ति तम् ॥ ९ ॥
When Vata gets localized in the sira (channels) which convey sound, the person often hears different kinds of sound without any reason. This is said to be Karna Nada.
Badhirya
श्लेष्मणाऽनुगतो वायुर्नादो वा समुपेक्षितः ।
उच्चैः कृच्छ्राच्छ्रुतिं कुर्याद्बधिरत्वं क्रमेण च ॥ १० ॥
Vata associated with Kapha and getting increased or by neglecting Karnanada gives rise to hearing of loud sounds only with difficulty and to deafness gradually.
Pratinaha
वातेन शोषितः श्लेष्मा श्रोतो लिम्पेत्ततो भवेत् ।
रुग्गौरवं पिधानं च स प्रतीनाहसंज्ञितः ॥ ११ ॥
Kapha desiccated by Vata, gets coated to the interior of the ears, leading to pain, feeling of heaviness and closure of the ears. This disease is known as Pratinaha.
Kandu: Shopha
कण्डूशोफौ कफाच्छ्रोत्रे स्थिरौ तत्संज्ञया स्मृतौ ।
Itching and swelling are caused by Kapha in the ears. These persist for some time, known by the same name.
Putikarnaka
कफो विदग्धः पित्तेन सरुजं नीरुजं त्वपि ॥ १२ ॥
घनपूतिबहुक्लेदं कुरुते पूतिकर्णकम् ।
Kapha getting improperly cooked by Pitta, leads to discharge of thick, foul smelling, copious fluid accompanied with pain or without pain. This is Putikarnaka.
Krimikarnaka
वातादिदूषितं श्रोत्रं मांसासृक्क्लेदजा रुजम् ॥ १३ ॥
खादन्तो जन्तवः कुर्युस्तीव्रां स कृमिकर्णकः ।
Worms (bacteria) born in the muscles, blood and fluids of the ears vitiated by Vata and other doshas eat away the earsand cause pain. This is Krimikarnaka.
Karna Vidradhi, Shopha, Arshas, Arbuda
श्रोत्रकण्डूयनाज्जाते क्षते स्यात्पूर्वलक्षणः ॥ १४ ॥
विद्रधिः पूर्ववच्चान्यः शोफोऽर्शोऽर्बुदमीरितम् ।
तेषु रुक् पूतिकर्णत्वं बधिरत्वं च बाधते ॥ १५ ॥
Karna Vidradhi arises as a result of the ulcer caused by scratching the ears (with sticks etc. inserted into it) having the prodromal symptoms as described previously (chapter 11 of Nidana Stana). Other ear disorders are Shopha, Arsha and Arbuda. In these, pain, foul smell and deafness trouble the person.
Kuchikarnaka
गर्भेऽनिलात्सङ्कुचिता शष्कुली कुचिकर्णकः ।
Vata constricts the shashkuli (pinna of the ears) inside and produces Kuchikarnaka.
Karna Pippali
एको नीरुगनेको वा गर्भे मांसाङ्कुरः स्थिरः ॥ १६ ॥
पिप्पली पिप्पलीमानः
One or more painless, immovable sprouts of muscle resembling pippali (Piper longum) develop inside the ears, this disease is known as Karnapippali.
Karna Vidarika
सन्निपाताद्विदारिका ।
सवर्णः सरुजः स्तब्धः श्वयथुः स उपेक्षितः ॥ १७ ॥
कटुतैलनिभं पक्वः स्रवेत्कृच्छ्रेण रोहति ।
सङ्कोचयति रूढा च सा ध्रुवं कर्णशष्कुलीम् ॥ १८ ॥
Vidarika arising from the combination of all the doshas, is a swelling having the same color, painful and immovable; when neglected it ripens (suppurates) and discharges a fluid resembling Katutaila (mustard oil); heels with difficulty and after healing definitely constricts the Karnashashkuli (pinna).
Palishosha
सिरास्थः कुरुते वायुः पालीशोषं तदाह्वयम् ।
Vata localized in the sira (veins) produces emaciation/drying up, thinning of the lobe of the ears. This is known as Palishosha.
Tantrika
कृशा दृढा च तन्त्रीवत्पाली वातेन तन्त्रिका ॥ १९ ॥
The pinna (or ear lobe) becoming emaciated, static and resembling a wire is Tantrika, caused by Vata.
Paripota
सुकुमारे चिरोत्सर्गात्सहसैव प्रवर्धिते ।
कर्णे शोफः सरुक् पाल्यामरुणः परिपोटवान् ॥ २० ॥
परिपोटः स पवनात्
In children, the ear neglected for a long time (allowed to remain without puncturing) and punctured all of a sudden, gives rise to swelling in the pinna (ear lobe) accompanied with pain, light red in color and pulsating, this disease is called Paripota and caused by Vata.
Utpata
उत्पातः पित्तशोणितात् ।
गुर्वाभरणभाराद्यैः श्यावो रुग्दाहपाकवान् ॥ २१ ॥
श्वयथुः स्फोटपिटिकारागोषाक्लेदसंयुतः ।
By the weight of heavy ornaments etc. (and other such causes) Pitta and Shonita (blood) getting vitiated, produce swelling of the pinna (or the lobe) which is black, painful, with burning sensation and ulceration, associated with bursting eruptions, red in color, having burning sensation and collection of fluid inside. This disease is known as Utpata.
Unmantha or Gallira
पाल्यां शोफोऽनिलकफात्सर्वतो निर्व्यथः स्थिरः ॥२२॥
स्तब्धः सवर्णः कण्डूमान् उन्मन्थो गल्लिरश्च सः ।
Swelling of the pinna (or lobe) arising from Vata and Kapha, covering the entire pinna, nirvyathaḥ – painless, static, stiffness, of the same color and having itching. This is known as Unmantha or Gallira.
Dukha Vardhana
दुर्विद्धे वर्धिते कर्णे सकण्डूदाहपाकरुक् ॥ २३ ॥
श्वयथुः सन्निपातोत्थः स नाम्ना दुःखवर्धनः ।
Puncturing of the ear, not properly done leading to itching, burning sensation, ulceration, pain and swelling caused by sannipata (combination of all doshas), this is by name Duhkhavardhana.
Lehyakhya Pitaka
कफासृक्कृमिजाः सूक्ष्माः सकण्डूक्लेदवेदनाः ॥ २४ ॥
लेह्याख्याः पिटिकास्ता हि लिह्युः पालीमुपेक्षिताः
Small pitaka (eruptions) having itching, collection of fluid and pain caused by Kapha, blood and Krimi (bacteria); appear on the pinna (or lobe) and if neglected eat away the pinna. This is Lehyakhya Pitaka.
Sadhyaasadhyata of Karnaroga
पिप्पली सर्वजं शूलं विदारी कुचिकर्णकः ॥ २५ ॥
एषामसाध्या याप्यैका तन्त्रिकान्यांस्तु साधयेत् ।
पञ्चविंशतिरित्युक्ताः कर्णरोगा विभागतः ॥ २६ ॥
Among these diseases of the ears, Pippali (pipplimana), – Sarvaja (Sannipata), Shula, Vidari, Kuchikrnaka are incurable; Tantrika is controllable but persists for long and the others should be treated. Thus, were described twenty-five diseases of the ears, suitably classified.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने कर्णरोगविज्ञानीयो नाम सप्तदशोऽध्याय: ॥१७॥
Thus, ends the chapter-KarnarogaVijnaniya- the seventeenth in Uttara Sthana or Astanga Hridaya Samhita composed by Srimad Vagbhata, son of sri Vaidyapati Simhagupta.
