Chapter VI - Pathology of the diseases affecting the eyes as a whole

Now we shall discourse on the chapter which deals with the (symptoms and) pathology of the diseases affecting the eye as a whole (Sarva-gata-Roga-Vijnaniya). 1.

Names and causes:—

The four types of Abhishyandha (Ophthalmatis), the four types of Adhi-mantha, the two forms of Akshi-paka (suppuration of the eye) attended with or without swelling, these ten, as well as Hatadhimantha, Anila-Parjaya, Shuskakshi-paka, Anyato-vata, Amladhyushita, Drishti, Sirot-pata and Shira-Harsha are the names of the (seventeen kinds of) diseases which affect the eye as a whole. Nearly all these forms of eye-diseases may result from the Abhishyanda (Ophthalmitis). Hence a wise physician shall try speedily to remedy a case of Abhishyanda (Ophthalmitis) as soon as it is found out. 2.

Specific symptoms of Abhishyanda:—

The symptoms which mark a case of Abhishyanda due to the action of the deranged Vayu are pricking pain (in the eyes), numbness, horripilation and irritation in the eyes, roughness and parchedness of the organ, cold lachrymations and headache. A case of Pittaja-Abhishyanda exhibits the following features, viz., burning and inflammatory suppuration of the eyes, longing for coldness (in the eyes), excessive hot lachrymations, cloudy vision and a yellowness of the eye. In the Kaphaja type of the disease, the affected organ longs for the contact of warm articles and is attended with a heaviness, itching sensation, swelling, excessive whiteness and a constant deposit and discharge of slimy mucus. The special type of this disease which has its origin in the vitiated condition of the blood, i.e., the Raktaja type is marked by redness of the eyes, flow of copper-coloured tears, as well as the symptoms of the Pittaja type of the disease and the presence of deep red stripes all along. 3-6.

Causes of Adhimantha:—

All the (four) forms of chronic Abhishyanda, if not properly attended to and remedied at the outset, may run into as many cases of Adhimantha which is attended (invariably) with an excruciating pain in the eye, which seems as if being torn out, the pain extending upward to and crushing, as it were, the half the region of the head. The characteristic symptoms of the Doshas involved in each case are also seen to supervene. 7.

Symptoms of Vataja Adhimantha:—

In the Vataja type of Adhimantha the eye becomes cloudy and seems as if being torn out and churned as with an Arani (fire-producing wooden stick) attended with an irritating, piercing and cutting pain, as well as with a swelling of the local flesh, and a half of the head (on the side of the affected eye) is afflicted with a twisting and cracking sensation as well as with local swelling, shivering and pain. 8.

Symptoms of Pittaja Adhimantha:—

The symptoms which mark the Pittaja type of Adhimantha are the blood-streaked eye attended with secretion and a sensation therein of being burnt with fire, as well as swelling, perspiration and suppuration in the affected organs, yellowish vision, fainting fits and a burning sensation in the head. The eyes in this case become liver-coloured and seem as if ulcerated or rubbed with an alkali. 9.

Symptoms of Kaphaja Adhimantha:—

In the Kaphaja type of Adhimantha the eye is swollen with a slight congestion (inflammation). Discharges with a siensation of itching, coldness and heaviness in the localities set in, and there is horripilation. The eye becomes slimy with deposit of mucous matter. The sight becomes cloudy, the nostrils are dilated, the head aches and all objects seem to be full of dust. io.

Symptoms of Raktaja Adhimantha:—

A pricking pain in and a blood-streaked secretion from the affected organ which looks (bright red) like a Bandhujiva flower, are the symptoms which mark the type of Raktaja Adhimantha (due to the vitiated blood). The eye becomes painful and incapable of bearing the least touch or contact, and the objects of vision seem as if enveloped in flames. The extremities of the eye become red and the whole origin of the cornea (black coat of the eye) looks like an Arishta fruit submerged in blood. 11.

The prognosis:—

A course of injudicious diet, conduct or medical treatment may usher in the blindness of vision in seven days from an attack of the Kaphaja type of Adhimantha (Ophthalmia) and in five days from that of the blood-origined (Raktaja) type, in six days in a case of the Vataja Adhimantha and instantaneously within three days of the attack) in the Pittaja type of (t. e.y Adhimantha. 12.

Symptoms of Sashopha and Ashopha Akshi-paka:—

A case of Sashopha-Netra-paka exhibits the following symptoms, viz., itching sensation, deposit of mucous matter (in the eye), lachrymation and a redness of the eye like the colour of a ripe Udumbara fruit. There is a burning sensation in the eye-ball which becomes copper-coloured, heavy, and attended with a pricking pain and horripilation. The eye becomes swollen and constantly secretes either cold or hot slimy discharges, and ultimately suppurates. All these symptoms except swelling mark the (non-swollen) Ashopha-Netra-paka type of the disease. 13.

The deranged Vayu getting incarcerated in the optic nerve (Sira) impairs the faculty of sight, and gives rise to an incurable disease which is called Hatadhimantha (blinding Ophthalmia). A shifting pain experienced sometimes in the region of the eye-lashes^[1] or of the eye-brows and sometimes in the region of the eye, owing to the coursing of the deranged and incarcerated Vayu in those localities, is called Vata-Paryaya. 14-15.

The disease in which the eye-lids become dry and hard and remain always closed, the vision becomes cloudy and hazy, and it becomes very painful to open the eye-lids, is called the Shishkakshi-paka.^[2] The excessive pain in the eyes or in the eye-brows due to the action of the deranged Vayu incarcerated in the region of the head, the ears, the cheek-bones, the back of the neck (Avatu), the Manya (a particular nerve on either side of the neck), or in any other (adjacent) place, is called the Anyato-vata. 16-17.

The swelling of the eye attended with a bluish red tint all about, owing to the partakings of meals composed of an unduly large proportion of acid articles, or of such food as is followed by a digestionary acid reaction, is called the Amladhyushita-Drishti. The disease in which the veins all over the eye become copper-coloured and are frequently discoloured, whether attended with pain or not, is called the Sirotpata. 18-19.

A case of Sirotpata, if not attended to and remedied in time through ignorance, gives rise to transparent and copper-coloured discharges in copious quantities from the eyes and produce a complete blindness of vision. This is known as the Sira-harsha. 20.

 

Thus ends the sixth chapter of the Uttara-Tantra in the Sushruta Samhita which treats of the diseases affecting the eye as a whole.

Footnotes and references:

[1]:

Mādhava in the Nidāna does not mention the eye-lashes.

[2]:

Mādhava in the Nidāna reads “dandahyate” which means that a highly burning sensation is produced in the affected eye, in place of “vilokane”—a word which seems redundant.