The 3rd chapter of Uttaratantra of Sushruta Samhita is named as Vartma Roga Vijnaniya Adhyaya. This chapter deals with Diseases of the Eyelids.
अथातो वर्त्मगतरोगविज्ञानीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound the chapter by name Vartma Roga Vijnaniya – knowledge of diseases of the eyelids; as revealed by the venerable Dhanvantari.
Samprapti Pathogenesis
पृथग्दोषाः समस्ता वा यदा वर्त्मव्यपाश्रयाः |
सिरा व्याप्यावतिष्ठन्ते वर्त्मस्वधिकमूर्च्छिताः ||३||
विवर्ध्य मांसं रक्तं च तदा वर्त्मव्यपाश्रयान् |
विकाराञ्जनयन्त्याशु नामतस्तान्निबोधत ||४||
Doshas which are aggravated either separately or all together
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Travel through the siras i.e. blood vessels, and
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Get lodged in the eyelids
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The doshas further get severely aggravated in the lids and
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Cause destruction of muscles and blood present therein and
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Gives rise to many diseases of the eyelids
Now, I will tell the names of those diseases, please listen.
Names of Vartma Rogas – diseases of the eyelids
उत्सङ्गिन्यथ कुम्भीका पोथक्यो वर्त्मशर्करा |
तथाऽर्शोवर्त्म शुष्कार्शस्तथैवाञ्जननामिका ||५||
बहलं वर्त्म यच्चापि व्याधिर्वर्त्मावबन्धकः |
क्लिष्टकर्दमवर्त्माख्यौ श्याववर्त्म तथैव च ||६||
प्रक्लिन्नमपरिक्लिन्नं वर्त्म वातहतं तु यत् |
अर्बुदं निमिषश्चापि शोणितार्शश्च यत् स्मृतम् ||७||
लगणो बिशनामा च पक्ष्मकोपस्तथैव च |
एकविंशतिरित्येते विकारा वर्त्मसंश्रयाः ||८||
नामभिस्ते समुद्दिष्टा लक्षणैस्तान् प्रचक्ष्महे |
There are in total twenty-one diseases which occur in the eyelids. Below mentioned are their names
– Utsangini
– Kumbhika
– Pothaki
– Vartmasarkara
– Arsovartma
– Suskarasas
– Anjananamika
– Bahala vartma
– Vartmavabandhaka
– Klistavartma
– Kardamavartma
– Syavavartma
– Praklinna vartma
– Apariklinna vartma
– Vatahata vartma
– Vartmaarbuda
– Nimesa
– Sonita (rakta) Arsa
– Lagana
– Bisa vartma and
– Paksmakopa
The features of each of these diseases will be described further on.
Utsangini Pidaka
अभ्यन्तरमुखी बाह्योत्सङ्गेऽधो वर्त्मनश्च या ||९||
विज्ञेयोत्सङ्गिनी नाम तद्रूपपिडकाचिता |
Features of Utsangini Pidaka
– It is a pidaka – eruption
– Nature of presentation – develops inside the eyelid, has mouth / opening pointing inwards, swelling seen outside the eyelid, on the external surface
– Surrounded by one or more pidakas which are similar to it
Kumbhika
कुम्भीकबीजप्रतिमाः पिडका यास्तु वर्त्मजाः ||१०||
आध्मापयन्ति भिन्ना याः कुम्भीकपिडकास्तु ताः |११|
Features of Kumbhika or Kumbhika Pidaka –
– It is a pidaka – eruption
– Presentation – develops inside (or outside according to Acharya Dalhana) the eyelid, resembles seed of kumbhika
– Symptoms – Causes swelling of eyelid when the pidaka is pricked / punctured
Pothaki
स्राविण्यः कण्डुरा गुर्व्यो रक्तसर्षपसन्निभाः |
पिडकाश्च रुजावत्यः पोथक्य इति सञ्ज्ञिताः ||११||
Features of Pothaki –
– It comprises of multiple pidakas
– Presentation – Many Pidakas are present, resembles red mustard in size
– Symptoms – discharges occur from eruptions, itching, heaviness, painful
Vartma Sarkara
पिडकाभिः सुसूक्ष्माभिर्घनाभिरभिसंवृता |
पिडका या खरा स्थूला सा ज्ञेया वर्त्मशर्करा ||१२||
Features of Vartma Sarkara –
– Vartma Sarkara is a big pidaka
– Presentation – it is thick and rough eruption, surrounded by small and hard eruptions
Arso Vartma
एर्वारुबीजप्रतिमाः पिडका मन्दवेदनाः |
सूक्ष्माः खराश्च वर्त्मस्थास्तदर्शोवर्त्म कीर्त्यते ||१३||
Features of Arso Vartma –
– It is a pidaka – eruption,
– Presentation – resembles ervaru – cucumber seed in appearance, small in size and is located inside the lid
– Symptoms – has mild pain and roughness
Suskarsa
दीर्घोऽङ्कुरः खरः स्तब्धो दारुणो वर्त्मसम्भवः |
व्याधिरेष समाख्यातः शुष्कार्श इति सञ्ज्ञितः ||१४||
Features of Suskarsa –
– Presentation – present in the form of long, rough and immovable ankura – sprout like structures, inside the eyelid
– Prognosis – difficult to cure
Anjananamika
दाहतोदवती ताम्रा पिडका वर्त्मसम्भवा |
मृद्वी मन्दरुजा सूक्ष्मा ज्ञेया साऽञ्जननामिका ||१५||
Features of Anjananamika –
– It is a pidaka
– Presentation – small, soft, coppery coloured eruptions, develop inside the eyelid
– Symptoms – burning sensation, pricking sensation, mild pain
- Bahala vartma
वर्त्मोपचीयते यस्य पिडकाभिः समन्ततः |
सवर्णाभिः समाभिश्च विद्याद्बहलवर्त्म तत् ||१६||
Features of Bahala Vartma –
– Presentation – eyelids are studded with small eruptions of the colour of the skin, which are even
– Signs – thickening of eyelid
- Vartma bandhaka
कण्डूमताऽल्पतोदेन वर्त्मशोफेन यो नरः |
न समं छादयेदक्षि भवेद्बन्धः स वर्त्मनः ||१७||
Features of Vartma Bandhaka –
– Presentation – eyelids swollen
– Signs / symptoms – itching, mild pricking pain, the eyes are not evenly covered by eyelids,
Klistavartma
मृदल्पवेदनं ताम्रं यद्वर्त्म सममेव च |
अकस्माच्च भवेद्रक्तं क्लिष्टवर्त्म तदादिशेत् ||१८||
Features of Klista Vartma –
– Presentation – softness of the eyelid, coppery coloured, even and becomes red suddenly without any cause
– Symptoms – mild pain
Kardamavartma
क्लिष्टं पुनः पित्तयुतं विदहेच्छोणितं यदा |
तदा क्लिन्नत्वमापन्नमुच्यते वर्त्मकर्दमः ||१९||
Features of Kardama Vartma –
– This condition manifests when the above mentioned Klista Vartma condition gets associated with pitta,
– The vitiated pitta destroys the rakta – blood therein
– Symptoms – moistness of eyelid
Syava vartma
यद्वर्त्म बाह्यतोऽन्तश्च श्यावं शूनं सवेदनम् |
दाहकण्डूपरिक्लेदि श्याववर्त्मेति तन्मतम् ||२०||
Features of Syava Vartma –
– The outside and inside of the eyelid become blue in colour
– Symptoms and signs – swelling, pain, burning sensation, itching, moistness of the eyelid
Klinna vartma
अरुजं बाह्यतः शूनमन्तः क्लिन्नं स्रवत्यपि |
कण्डूनिस्तोदभूयिष्ठं क्लिन्नवर्त्म तदुच्यते ||२१||
Features of Klinna Vartma –
– Presentation – external oedema of eyelids. The inner part of the eyelid is wet and has discharges.
– Symptoms – excess and constant itching and pricking pain in the affected lid, is painless
Aklinna Vartma
यस्य धौतानि धौतानि सम्बध्यन्ते पुनः पुनः |
वर्त्मान्यपरिपक्वानि विद्यादक्लिन्नवर्त्म तत् ||२२||
Features of Aklinna Vartma –
– Presentation and sign – eyelids adhere to each other in spite of washing them often and which are not completely ripe.
Vatahata vartma
विमुक्तसन्धि निश्चेष्टं वर्त्म यस्य न मील्यते |
एतद्वातहतं विद्यात् सरुजं यदि वाऽरुजम् ||२३||
Features of Vatahata Vartma
– Presentation – eyelid is detached from its joint / junction with white of the eye, no movements in the eyelid,
– Signs and symptoms – eye remain open, do not close, some have pain in lid and some no not
Vartma arbuda
वर्त्मान्तरस्थं विषमं ग्रन्थिभूतमवेदनम् |
विज्ञेयमर्बुदं पुंसां सरक्तमवलम्बितम् ||२४||
Features of Vartma Arbuda –
– Presentation – it is a tumour present inside the eyelid. It is irregular / uneven.
– Signs and Symptoms – eyelid is red in colour due to association of vitiated blood, eyelid hangs from the edge of the eyelid
Nimesa
निमेषणीः सिरा वायुः प्रविष्टो वर्त्मसंश्रयाः |
चालयत्यति वर्त्मानि निमेषः स गदो मतः ||२५||
Features of Nimesa –
– Pathogenesis – The aggravated vata enters the blood vessels responsible for winking of eyes and gets lodged in the eyelid and causes Nimesa Eyelid disorder.
– Symptoms – excessive winking of the eyelids.
Vartma Arsas
छिन्नाश्छिन्ना विवर्धन्ते वर्त्मस्था मृदवोऽङ्कुराः |
दाहकण्डूरुजोपेतास्तेऽर्शः शोणितसम्भवाः ||२६||
Features of Vartma Arsas –
– Produced by – vitiated rakta – blood
– Presentation – It presents in the form of sprouts or warts, is soft and continue to grow, whether they are excised or not
– Symptoms – burning sensation, itching, pain
Lagana
अपाकः कठिनः स्थूलो ग्रन्थिर्वर्त्मभवोऽरुजः |
सकण्डूः पिच्छिलः कोलप्रमाणो लगणस्तु सः ||२७||
Features of Lagana –
– It is a tumour of the eyelid. It does not suppurate, is hard, big, painless, slimy and is of the size of Kola fruit i.e. jujube fruit.
– Symptoms – itching
Bisa vartma
शूनं यद्वर्त्म बहुभिः सूक्ष्मैश्छिद्रैः समन्वितम् |
बिसमन्तर्जल इव बिसवर्त्मेति तन्मतम् ||२८||
Features of Bisa Vartma –
– Presentation – swelling of eyelid which has many small pores on it as in bisa – stalks of lotus present in the water.
Paksma kopa
दोषाः पक्ष्माशयगतास्तीक्ष्णाग्राणि खराणि च |
निर्वर्तयन्ति पक्ष्माणि तैर्घुष्टं चाक्षि दूयते ||२९||
उद्धृतैरुद्धृतैः शान्तिः पक्ष्मभिश्चोपजायते |
वातातपानलद्वेषी पक्ष्मकोपः स उच्यते ||३०||
Features of Paksma Kopa –
– Pathogenesis – the doshas invade the seat of eyelashes. The doshas make the hairs i.e. eyelashes sharp, pointed and rough.
– Signs and Symptoms – friction of the eye when the lashes rub over it. There is aversion towards breeze, sunlight and fire.
– Relief factor – when the eyelashes are pulled out and plucked our (extraction) repeatedly, he finds relief.
इति सुश्रुतसंहितायामुत्तरतन्त्रे वर्त्मगतरोगविज्ञानीयो नाम तृतीयोऽध्ययः ||३||
Thus ends the third chapter by name ‘Vartma roga Vijnaniya’ in Uttara sthana of Susruta Samhita
