The 6th chapter of Uttaratantra of Sushruta Samhita is named as Sarvagata Roga Vijnaniya Adhyaya. This chapter deals with Diseases of the Whole Eye.

अथातः सर्वगतरोगविज्ञानीयमध्यायं व्याख्यास्यामः ।।१।।
यथोवाच भगवान् धन्वन्तरिः ।।२।।

We will now expound the chapter by name Sarvagata roga vijñānīya – knowledge of diseases of the whole eye; as revealed by the venerable Dhanvantari.

स्यन्दास्तु चत्वार इहोपदिष्टास्तावन्त एवेह तथाऽधिमन्थाः ।।
शोफान्वितोऽशोफयुतश्च पाकावित्येवमेते दश संप्रदिष्टाः ।।३।।
हताधिमन्थोऽनिलपर्ययश्च शुष्काक्षिपाकोऽन्यत एव वातः ।।
दृष्टिस्तथाऽम्लाध्युषिता सिराणामुत्पातहर्षावपि सर्वभागाः ।।४।।

Below mentioned are the seventeen kinds of diseases which would affect the whole eye and the same will be described in this chapter –

–        four kinds of syanda / abhisyanda

–        four kinds of adhimantha,

–        two kinds of paka i.e. aksipaka / netrapaka

–        anila paryaya or vata paryaya – such as sasopha and asopha

–        hatadhimantha,

–        suskakshipaka,

–        anyatovata,

–        amladyushita,

–        sirotpata and

–        siraharsa

1. Abhisyanda

प्रायेण सर्वे नयनामयास्तु भवन्त्यभिष्यन्दनिमित्तमूलाः ।।
तस्मादभिष्यन्दमुदीर्यमाणमुपाचरेदाशु हिताय धीमान् ।।५।।

Abhisyanda is the chief cause of all eye diseases. Generally, all the eye diseases commence with Abhisyanda as their chief cause. Therefore, a wise physician should quickly be treated at its onset itself, for the health and well-being of the eye.

Vataja Abhisyanda

 निस्तोदनं स्तम्भनरोमहर्षसङ्घर्षपारुष्यशिरोभितापाः ।।
विशुष्कभावः शिशिराश्रुता च वाताभिपन्ने नयने भवन्ति ।।६।।

Below mentioned are the symptoms of Abhisyanda produced by Vata –

–        constant pricking pain in the eyes,

–        loss of movements in the eye,

–        horripilation,

–        friction and roughness, especially in the skin,

–        headache,

–        dryness of the eye and

–        flow of cold tears from the eyes

Pittaja Abhisyanda

दाहप्रपाको शिशिराभिनन्दा धूमायनं बाष्पसमुच्छ्यश्च ।।
उष्णाश्नुता पीतकनेत्रता च पित्ताभिपन्ने नयने भवन्ति ।।७।।

Below mentioned are the symptoms of Abhisyanda produced by aggravated pitta –

–        burning sensation in the eyes

–        quick ulceration in the eyes 

–        desire for cold comforts,

–        feeling of hot fumes coming out,

–        increased flow of tears from the eyes,

–        flow of warm tears from the eyes and

–        appearance of yellow colour in the eyes

Kaphaja Abhisyanda

उष्णाभिनन्दा गुरुताऽक्षिशोफः कण्डूपदेही सितताऽतिशैत्यम् ।।
स्रावो मुहुः पिच्छिल एव चापि कफाभिपन्ने नयने भवन्ति ।।८।।

Below mentioned are the symptoms of Abhisyanda produced by aggravated kapha –

–        desire for warm comforts,

–        heaviness,

–        swelling of the eye,

–        itching and thickening,

–        appearance of white colour in the eye,

–        feeling of severe cold and

–        frequent slimy exudations

Raktaja Abhisyanda

ताम्राश्श्रुता लोहितनेत्रता च राज्यः समन्तादतिलोहिताश्च ।।
पित्तस्य लिङ्गानि च यानि तानि रक्ताभिपन्ने नयने भवन्ति ।।९।।

Below mentioned are the symptoms produced by aggravated rakta – blood –

–        coppery coloured tears flow from the eyes,

–        redness of the eye,

–        bright red lines all over and

–        symptoms of aggravation of pitta in the body

Adhimañtha

वृद्धैरेतैरभिष्यन्दैर्नराणामक्रियावताम् ।।
तावन्तस्त्वधिमन्थाः स्युनयने तीव्रवेदनाः ।।१०।।
उत्पाट्यत इवात्यर्थ नेत्रं निर्मथ्यते तथा ।।
शिरसोऽधं च तं विद्यादधिमन्यं स्वलक्षणैः ।।११।।

The four kinds of Adhimantha develop in the eye along with severe pain when the four kinds of Abhisyanda are not treated quickly.

Below mentioned are the general symptoms of Adhimantha –

–        feeling as if the eye is being pulled or plucked out of its socket,

–        feeling as if the eye is being churned or twisted and

–        feeling of churning or twisting pain in half of the head

Vataja Adhimantha

नेत्रमुत्पाट्यत इव मथ्यतेऽरणिवच्च यत् ।।
सङ्घर्षतोदनिर्भेदमांससंरब्धमाविलम् ।।१२।।
कुञ्छनास्फोटनाध्मानवेपथुव्यथनैर्युतम् ।।
शिरसोऽधं च येन स्यादधिमन्थः स मारुतात् ।।१३।।

Below mentioned are the symptoms of Adhimañtha produced by vāta –

–        feeling as though the eye is being pulled out or plucked out of its socket,

–        feeling as though the eye is being churned like the arani – wooden faggot used for producing fire by churning,

–        friction,

–        pricking pain,

–        splitting pain,

–        swelling of muscles,

–        turbidity of eye i.e. presence of excessive secretions in the eye,

–        contraction,

–        cracks on the body parts,

–        flatulence,

–        shivering,

–        discomfort in half of the head, on the side of the affected eye

Pittaja Adhimantha

रक्तराजिचितं स्रावि वह्निनेवावदह्यते ।।
यकृत्पिण्डोपमं दाहि क्षारेणाक्तमिव क्षतम् ।।१४।।
प्रपत्कोच्छूनवान्तं सस्वेदं पीतदर्शनम् ।।
मूर्च्छाशिरोदाहयुतं पित्तेनाक्ष्यधिमन्थितम् ।।१५।।

Below mentioned are the symptoms of Adhimantha produced by pitta –

–        eye filled with red lines,

–        feeling as though the eye is being burnt by fire

–        eye appears brownish in colour resembling a piece of liver,

–        severe burning sensation and

–        ulceration (injury) as though smeared or applied with caustic alkalies,

–        severe ulceration and swelling of edges of eyelids,

–        excessive sweating of the body,

–        yellow vision (appearance of yellow colour in the eyes),

–        fainting and

–        burning sensation in the head

Kaphaja Adhimantha

शोफवन्नातिसंरब्धं स्रावकण्डूसमन्वितम् ।।
शैत्यगौरवपैच्छिल्यदूषिकाहर्षणान्वितम् ।।१६।।
रूपं पश्यति दुःखेन पांशुपूर्णमिवाविलम् ।।
नासाध्यानशिरोदुःखयुतं श्लेष्माधिमन्थितम् ।।१७।।

Below mentioned are the symptoms of Adhimantha produced by aggravated kapha –

–        eye is swollen but not greatly,

–        exudation (discharges from the eye),

–        itching,

–        feeling cold,

–        heaviness,

–        sliminess,

–        excessive excretions and

–        tingling sensation

–        seeing becomes difficult,

–        surrounding objects appear as though filled with sand and having turbid (unclear) appearance,

–        nose swelling

–        headache

Raktaja Adhimantha

बन्धुजीवप्रतीकाशं ताम्यति स्पर्शनाक्षमम् |
रक्तास्त्रावं सनिस्तोदं पश्यत्यग्निनिभा दिशः ।।१८।।
रक्तमग्नारिष्टवच्च कृष्णभागश्च लक्ष्यते ।।
यद्दीप्तं रक्तपर्यन्तं तद्रक्तेनाधिमन्थितम् ।।१९।।

Below mentioned are the symptoms of Adhimantha produced by Rakta – blood –

–        eyes are red in colour, resembling the red flowers of bandhujiva,

–        is inactive,

–        tenderness – does not tolerate touch,

–        bleeding accompanied with pain,

–        the surroundings are seen as if covering with fire or flame,

–        the black portion of the eye i.e. cornea is red like flames or arista – round soap nut, bright and red at the edges

हन्यादृष्टिं सप्तरात्रात् कफोत्योऽधीमन्थोऽसृक्संभवः पञ्चरात्रात् ।।
बड़ानाद्वै मारुतोत्यो निहन्यान्मिथ्याचारात् पैत्तिकः सद्य एव ।।२०।।

With improper activities, adhimañtha destroys the vision in the below mentioned way –

Saśopha netrapāka

कण्डूपदेहा´ÉÑयुतः पक्कोदुम्बरसन्निभः ।।
दाहसंहर्षताम्रत्वशोफनिस्तोदगौरवैः ।। २१।।
जुष्टो मुहुः स्रवेच्चास्त्रमुष्णशीताम्बु पिच्छिलम् ।।
संरम्भी पच्यते यश्च नेत्रपाकः सशोफजः ।।२२।।

Below mentioned are the features (symptoms) of Sasopha Netrapaka –

–        itching in the eyes,

–        thickening of eyes,

–        excessive tears reddish-brown in colour, resembling a ripe fruit of Udumbara,

–        burning sensation,

–        tingling,

–        coppery colour,

–        swelling,

–        constant pain,

–        heaviness,

–        exudes warm blood which is thin, clear and slimy and resembles cold water,

–        severe swelling and

–        quickly undergoes suppuration (forms ulcers quickly)

Asopha netrapāka

शोफहीनानि लिङ्गानि नेत्रपाके त्वशोफजे ।।

The main feature of Asopha Netrapaka is netra paka i.e. ulceration of the eye occurring without swelling.

Hatādhimañtha

उपेक्षणादक्षि यदाऽधिमन्यो वातात्मकः सादयति प्रसाहा ।।
रुजाभिरुग्राभिरसाध्य एष हताधिमन्थः खलु नाम रोगः ।।२३।।
अन्तःसिराणां श्वसनः स्थितो दृष्टिं प्रतिक्षिपन् ।।
हताधिमन्यं जनयेत्तमसाध्यं विदु धाः ।।२४।।

When Adhimantha caused by Vata is neglected and proper or timely treatment is not done, it becomes excessively exacerbated and produces another condition (disease) called Hatadhimantha. This condition presents with severe pain and is incurable.

The aggravated vata getting localized inside the sira i.e. blood vessels gives rise to Hatadhimantha. This condition destroys vision and is an incurable condition.

Vātaparyaya

पक्ष्मद्वयाक्षिध्रुवमाश्रितस्तु यत्रानिलः संचरति प्रदुष्टः ।।
पर्यायशश्चापि रुजः करोति तं वातपर्यायमुदाहरन्ति ।।२५।।

Vata which is aggravated starts moving in the area of eyelashes and brows. Doing so, it produces pain in the area of eyelashes sometimes. Alternatively, it would produce pain in the eyebrows sometimes. This disease is called Vataparyaya.

Suşkākşipāka

यत् कूणितं दारुणरूक्षवद्म विलोकने चाविलदर्शनं यत् ।।
सुदारुणं यत् प्रतिबोधने च शुष्काक्षिपाकोपहतं तदक्षि ।।२६।।

Eyes and eyelashes getting constricted and dry and hard on touch and the vision becoming turbid (hay, unclear) along with severe difficulty in opening the eyes – are considered as the features (symptoms) of Suskaksipaka.

Anyatovata

यस्यावटूकर्णशिरोहनुस्थो मन्यागतो वाऽप्यनिलोऽन्यतो वा |
कुर्याद्रुजोऽति भ्रुवि लोचने वा तमन्यतोवातमुदाहरन्ति ||२७||

Anyatovata is a condition in which the vata getting aggravated produces severe pain in the below mentioned regions –

–        avatu – root of the head and the back,

–        ears,

–        head,

–        lower jaw,

–        nape of the neck,

–        eyebrows and

–        the eyes

Amladhyusita

अम्लेन भुक्तेन विदाहिना च सञ्छाद्यते सर्वत एव नेत्रम् |
शोफान्वितं लोहितकैः सनीलैरेतादृगम्लाध्युषितं वदन्ति ||२८||

By consuming foods which are sour and which cause burning sensation inside (during digestion) for a long time, the pitta getting aggravated makes the entire eye of such persons red or blue coloured. Swelling of the eyes also occurs. This disease is called Amladyusita.

Sirotpata

अवेदना वाऽपि सवेदना वा यस्याक्षिराज्यो हि भवन्ति ताम्राः |
मुहुर्विरज्यन्ति च ताः समन्ताद् व्याधिः सिरोत्पात इति प्रदिष्टः ||२९||

Sirotpata is a disease which presents with the below mentioned features –

–        appearance of coppery coloured lines in the eye,

–        presence or absence of pain,

–        eye often becomes red with prominent blood vessels all over

Siraharsa

मोहात् सिरोत्पात उपेक्षितस्तु जायेत रोगस्तु सिराप्रहर्षः |
ताम्राच्छमस्रं स्रवति प्रगाढं तथा न शक्नोत्यभिवीक्षितुं च ||३०||

When sirotpata is neglected by ignorance and not promptly treated, another disease called Siraharsa develops. In this condition, the eyes become coppery red in colour and exude large amounts of blood. It also causes inability to see things.

इति श्रीसुक्षुतमाहेलाचामुत्तरतचे सर्वपतरोगविज्ञानीयो नाम शष्ठोऽध्यायः ॥६॥

Thus ends the sixth chapter by name Sarvagata roga vijinaniya Uttara sthana of Susruta samhita.