೨. ಅರ್ಶೋನಿದಾನಮ್

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Adhikarana ೧ (೧-೨) · Śloka ೨

ಅಥಾತೋಽರ್ಶಸಾಂ ನಿದಾನಂ ವ್ಯಾಖ್ಯಾಸ್ಯಾಮಃ ||೧|| ಯಥೋವಾಚ ಭಗವಾನ್ ಧನ್ವನ್ತರಿಃ ||೨||

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अथातोऽर्शसां निदानं व्याख्यास्यामः ||१|| यथोवाच भगवान् धन्वन्तरिः ||२||

Meaning of the śloka

Now the diagnosis of arśas will be explained, as taught by the revered Dhanvantari.

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ಅಥೇತ್ಯಾದಿ| ನಿದಾನಂ ಹೇತುಲಕ್ಷಣನಿರ್ದೇಶಃ||೧-೨||

Meaning of the commentary

The commentary explains nidāna here as the statement of causes and diagnostic features.

Key terms

arshas (arśas): A classical anorectal disease category, commonly associated with hemorrhoidal growths.
nidAna (nidāna): An account of causes and diagnostic signs.

Adhikarana ೨ (೩) · Śloka ೩

ಷಡರ್ಶಾಂಸಿ ಭವನ್ತಿ ವಾತಪಿತ್ತಕಫಶೋಣಿತಸನ್ನಿಪಾತೈಃ ಸಹಜಾನಿ ಚೇತಿ ||೩||

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षडर्शांसि भवन्ति वातपित्तकफशोणितसन्निपातैः सहजानि चेति ||३||

Meaning of the śloka

Arśas is classified into six types: those associated with vāta, pitta, kapha, blood, combined doṣas, and those present from birth.

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ಷಡರ್ಶಾಂಸೀತ್ಯಾದಿ| ನನು, ವಾತಪಿತ್ತಕಫಶೋಣಿತಸನ್ನಿಪಾತೈಃ ಸಹಜಾನಿ ಚೇತ್ಯನೇನೈವ ಷಟ್ಸಙ್ಖ್ಯಾಯಾ ಲಬ್ಧತ್ವಾತ್ ಕಥಂ ಷಡಿತಿ ಸಙ್ಖ್ಯಾನಿರ್ದೇಶಃ? ಉಚ್ಯತೇ- ದ್ವಿದೋಷಜನಿತಾರ್ಶೋಗಣನಾಪರಿಹಾರಾರ್ಥಮ್| ಯದ್ಯಪಿ ಶೋಣಿತಾಧಿಷ್ಠಾನಾ ವಾತಾದಯೋ ರಕ್ತಾರ್ಶಸಾಮಾರಮ್ಭಕಾಃ, ತಥಾಽಪ್ಯುಪಚಾರಾತ್ ‘ಶೋಣಿತಜಾನಿ’ ಇತ್ಯುಚ್ಯನ್ತೇ; ಯಥಾ- ಘೃತಾಧಿಷ್ಠಾನೇನಾಗ್ನಿನಾ ದಗ್ಧೋ ‘ಘೃತದಗ್ಧ’ ಇತ್ಯುಚ್ಯತೇ||೩||

Meaning of the commentary

The commentary asks why the number six is explicitly stated when the listed categories already total six. It answers that the number prevents additional types produced by pairs of doṣas from being counted separately. Although vāta and the other doṣas acting in the site of blood initiate the blood-associated form, it is conventionally called 'born of blood,' just as something burned by fire supported by ghee may be called 'ghee-burned.'

Key terms

ShaDarshAMsi (ṣaḍ-arśāṃsi): The six classified forms of arśas.
shoNitajAni (śoṇita-jāni): The form conventionally described as arising from blood.
sannipAta (sannipāta): Combined involvement of all three doṣas.
sahaja: Present from birth or congenital.

Adhikarana ೩ (೪) · Śloka ೪

ತತ್ರಾನಾತ್ಮವತಾಂ ಯಥೋಕ್ತೈಃ ಪ್ರಕೋಪಣೈರ್ವಿರುದ್ಧಾಧ್ಯಶನಸ್ತ್ರೀಪ್ರಸಙ್ಗೋತ್ಕಟುಕಾಸನಪೃಷ್ಠಯಾನವೇಗವಿಧಾರಣಾದಿಭಿರ್ವಿಶೇಷೈಃ ಪ್ರಕುಪಿತಾ ದೋಷಾ ಏಕಶೋ ದ್ವಿಶಃ ಸಮಸ್ತಾಃ ಶೋಣಿತಸಹಿತಾ ವಾ ಯಥೋಕ್ತಂ ಪ್ರಸೃತಾಃ ಪ್ರಧಾನಧಮನೀರನುಪ್ರಪದ್ಯಾಧೋ ಗತ್ವಾ ಗುದಮಾಗಮ್ಯ ಪ್ರದೂಷ್ಯ ಗುದವಲೀರ್ಮಾಂಸಪ್ರರೋಹಾಞ್ಜನಯನ್ತಿ ವಿಶೇಷತೋ ಮನ್ದಾಗ್ನೇಃ, ತಥಾ ತೃಣಕಾಷ್ಠೋಪಲಲೋಷ್ಠವಸ್ತ್ರಾದಿಭಿಃ ಶೀತೋದಕಸಂಸ್ಪರ್ಶನಾದ್ವಾ ಕನ್ದಾಃ ಪರಿವೃದ್ಧಿಮಾಸಾದಯನ್ತಿ, ತಾನ್ಯರ್ಶಾಂಸೀತ್ಯಾಚಕ್ಷತೇ ||೪||

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तत्रानात्मवतां यथोक्तैः प्रकोपणैर्विरुद्धाध्यशनस्त्रीप्रसङ्गोत्कटुकासनपृष्ठयानवेगविधारणादिभिर्विशेषैः प्रकुपिता दोषा एकशो द्विशः समस्ताः शोणितसहिता वा यथोक्तं प्रसृताः प्रधानधमनीरनुप्रपद्याधो गत्वा गुदमागम्य प्रदूष्य गुदवलीर्मांसप्ररोहाञ्जनयन्ति विशेषतो मन्दाग्नेः, तथा तृणकाष्ठोपललोष्ठवस्त्रादिभिः शीतोदकसंस्पर्शनाद्वा कन्दाः परिवृद्धिमासादयन्ति, तान्यर्शांसीत्याचक्षते ||४||

Meaning of the śloka

In people lacking self-restraint, doṣas may be provoked singly, in pairs, together, or with blood by factors such as incompatible or excessive eating, excessive sexual activity, prolonged squatting, riding, and suppression of natural urges. Spreading through the principal channels and descending to the rectum, they are said to disturb the folds there and produce fleshy outgrowths, especially in those with weak digestive activity. Contact or injury from grass, wood, stone, clods, cloth, and similar objects, or contact with cold water, is also said to enlarge pre-existing swellings. These growths are called arśas.

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ಅರ್ಶಸಾಂ ಹೇತೂನ್ ಸಮ್ಪ್ರಾಪ್ತಿ ಚ ದರ್ಶಯನ್ನಾಹ- ತತ್ರೇತ್ಯಾದಿ| ಪ್ರಕುಪಿತಾ ದೋಷಾ ಮಾಂಸಪ್ರರೋಹಾಞ್ಜನಯನ್ತೀತಿ ಸಮ್ಬನ್ಧಃ| ಅನಾತ್ಮವತಾಮ್ ಅಜಿತೇನ್ದ್ರಿಯಾಣಾಮ್| ಯಥೋಕ್ತೈಃ ಪ್ರಕೋಪಣೈರ್ಬಲವದ್ವಿಗ್ರಹಾದಿಕ್ರೋಧಶೋಕಾದಿದಿವಾಸ್ವಪ್ನಾದಿಭಿಃ| ವಿರುದ್ಧಂ ಬಹುಧಾ ಹಿತಾಹಿತೀಯೋಕ್ತಮ್| ಸ್ತ್ರೀಪ್ರಸಙ್ಗ ಇತ್ಯತ್ರ ಪ್ರಶಬ್ದೇನಾತ್ಯನ್ತಸಕ್ತಿಃ ಪ್ರತಿಪಾದ್ಯತೇ| ‘ಗುದಪಾರ್ಷ್ಣೀಸಮಾಯೋಗಃ ಪ್ರಾಹುರುತ್ಕಟುಕಾಸನಮ್’, ‘ಉಕುಡು’ ಇತಿ ಲೋಕೇ| ಅಶ್ವಾದೀನಾಂ ಪೃಷ್ಠೇನ ಗಮನಂ ಪೃಷ್ಠಯಾನಮ್| ವೇಗವಿಧಾರಣಶಬ್ದೇನ ವಾತವಿಣ್ಮೂತ್ರಾದೀನಾಂ ವೇಗಧಾರಣಮ್| ವಿರುದ್ಧಾಶನಶಬ್ದೇನ ಗುರುಶೀತಾಭಿಷ್ಯನ್ದಿವಿದಾಹ್ಯಸಾತ್ಮ್ಯಪ್ರಮಿತಾಶನಾದೀನಿ ಗೃಹ್ಯನ್ತೇ| ವಿಶೇಷೈರ್ಭೇದೈಃ| ತೇಷಾಂ ನಿದಾನಮಭಿಧಾಯ ಸಮ್ಪ್ರಾಪ್ತಿಮಾಹ- ಯಥೋಕ್ತಮಿತ್ಯಾದಿ| ಪ್ರಸೃತಾ ಇತಿ ‘ಕಿಣ್ವೋದಕಪಿಷ್ಟಸಮವಾಯ ಇವೋದ್ರಿಕ್ತಾನಾಂ ಪ್ರಸರೋ ಭವತಿ’ (ಸೂ. ೨೧) ಇತ್ಯಾದಿಕ್ರಮೇಣ ಪ್ರಸೃತಾಃ| ಪ್ರಧಾನಧಮನೀಃ ಪುರೀಷವಾಹಿನೀಃ| ಅನು ಪಶ್ಚಾತ್, ಪ್ರಪದ್ಯ ಪ್ರಾಪ್ಯ| ಗುದವಲೀರಿತಿ ವಲಿಸ್ತ್ವಕ್ಸಙ್ಕೋಚಃ| ಮನ್ದಾಗ್ನೇರ್ವಿಶೇಷತೋಽತಿಶಯೇನ ಮಾಂಸಪ್ರರೋಹಾಞ್ಜನಯನ್ತೀತಿ ಸಮ್ಬನ್ಧಃ| ತಥಾ ತೃಣೇತ್ಯಾದಿ| ಪರಿವೃದ್ಧಿಮಾಸಾದಯನ್ತಿ ಪ್ರಾಪ್ನುವನ್ತೀತ್ಯರ್ಥಃ| ಆಚಕ್ಷತ ಇತಿ ‘ಪೂರ್ವಾಚಾರ್ಯಾ’ ಇತ್ಯಧ್ಯಾಹಾರಃ||೪||

Meaning of the commentary

The commentary supplies the etiological sequence: provoked doṣas produce fleshy growths. Anātmavat is glossed as a person whose senses are uncontrolled. Previously described provocations include struggle with stronger persons, anger, grief, daytime sleep, and others. The prefix in strīprasaṅga conveys extreme attachment or excess. Utkaṭukāsana is explained as squatting with the anus and heels in contact, popularly called ukuḍu, while pṛṣṭhayāna means travel on the back of a horse or similar animal. Suppression includes urges for flatus, feces, and urine. Viruddhāśana is extended to heavy, cold, channel-clogging, burning, unaccustomed, and improperly measured food. The doṣas spread as described earlier, enter the feces-carrying principal vessels, descend to the rectum, disturb its skin folds, and particularly in weak digestion form outgrowths. The final term is attributed to earlier teachers.

Key terms

viruddhAshana (viruddhāśana): Eating regarded as incompatible or otherwise unsuitable in the classical framework.
adhyashana (adhyaśana): Eating again before the preceding meal is digested or excessive superimposed eating.
utkaTukAsana (utkaṭukāsana): A prolonged squatting posture with heels near the anal region, as explained here.
vegavidhAraNa (vega-vidhāraṇa): Suppression of natural urges such as flatus, stool, or urine.
gudavalI (guda-valī): A fold of the anal canal in the text's anatomy.

Adhikarana ೧೩ (೧೫) · Śloka ೧೫

ಸಹಜಾನಿ ದುಷ್ಟಶೋಣಿತಶುಕ್ರನಿಮಿತ್ತಾನಿ, ತೇಷಾಂ ದೋಷತ ಏವ ಪ್ರಸಾಧನಂ ಕರ್ತ್ತವ್ಯಮ್, ವಿಶೇಷತಶ್ಚೈತಾನಿ ದುರ್ದರ್ಶನಾನಿ ಪರುಷಾಣಿ ಪಾಂಸೂನಿ ದಾರುಣಾನ್ಯನ್ತರ್ಮುಖಾನಿ; ತೈರುಪದ್ರುತಃ ಕೃಶೋಽಲ್ಪಭುಕ್ ಸಿರಾಸನ್ತತಗಾತ್ರೋಽಲ್ಪಪ್ರಜಃ ಕ್ಷೀಣರೇತಾಃ ಕ್ಷಾಮಸ್ವರಃ ಕ್ರೋಧನೋಽಲ್ಪಾಗ್ನಿಪ್ರಾಣಃ ಪರಮಲಸಶ್ಚ, ತಥಾ ಘ್ರಾಣಶಿರೋಽಕ್ಷಿನಾಸಾಶ್ರವಣರೋಗೀ, ಸತತಮನ್ತ್ರಕೂಜಾಟೋಪಹೃದಯೋಪಲೇಪಾರೋಚಕಪ್ರಭೃತಿಭಿಃ ಪೀಡ್ಯತೇ ||೧೫||

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सहजानि दुष्टशोणितशुक्रनिमित्तानि, तेषां दोषत एव प्रसाधनं कर्त्तव्यम्, विशेषतश्चैतानि दुर्दर्शनानि परुषाणि पांसूनि दारुणान्यन्तर्मुखानि; तैरुपद्रुतः कृशोऽल्पभुक् सिरासन्ततगात्रोऽल्पप्रजः क्षीणरेताः क्षामस्वरः क्रोधनोऽल्पाग्निप्राणः परमलसश्च, तथा घ्राणशिरोऽक्षिनासाश्रवणरोगी, सततमन्त्रकूजाटोपहृदयोपलेपारोचकप्रभृतिभिः पीड्यते ||१५||

Meaning of the śloka

Congenital arśas are attributed to affected parental reproductive blood and semen, and their assessment or management is to be determined from the responsible doṣa. They are described as difficult to see, rough, greyish, severe, and inward-facing. The affected person is thin, eats little, has prominent veins, few offspring, diminished reproductive strength, a weak voice, irritability, weak digestion and vitality, and marked lethargy. The person is also described as having disorders of smell, head, eyes, nose, and hearing, and as continually troubled by intestinal sounds, gurgling, distension, a coated or burdened feeling in the heart region, poor appetite, and related symptoms.

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ಶರೀರೇಣ ಸಹ ಜಾತಾನಾಮರ್ಶಸಾಂ ದೋಷೇಭ್ಯೋ ಭಿನ್ನಂ ಹೇತುಂ ದರ್ಶಯನ್ನಾಹ- ಸಹಜಾನೀತ್ಯಾದಿ| ದುಷ್ಟಶೋಣಿತಶುಕ್ರನಿಮಿತ್ತಾನೀತಿ ಗರ್ಭಗುದಾರಮ್ಭಕಮಾತ್ರಂ ಬೀಜಂ ದುಷ್ಟಂ ನ ಸರ್ವಂ, ಸರ್ವದುಷ್ಟತ್ವೇ ಹಿ ಪ್ರಜೋತ್ಪತ್ತಿರೇವ ನ ಸ್ಯಾತ್| ‘ತೇಷಾಂ ದೋಷತ ಏವ ಪ್ರಸಾಧನಂ ಕರ್ತವ್ಯಮಿತಿ ಯೇನ ದೋಷೇಣ ಯಸ್ಯ ಶುಕ್ರಶೋಣಿತಂ ದೂಷಿತಂ ಭವೇತ್ತಸ್ಯ ದೋಷಸ್ಯ ಲಕ್ಷಣವರ್ಣವೇದನಾಕೃತಿಭಿಃ ಪ್ರಸಾಧನಂ ವಿಜ್ಞಾನಮ್’ ಇತ್ಯೇಕೇ; ಅನ್ಯೇ ತು ‘ದೋಷತ ಇತಿ ದೋಷಲಿಙ್ಗಂ ಸಮೀಕ್ಷ್ಯ ಪ್ರಸಾಧನಂ ಚಿಕಿತ್ಸಾ’ ಇತ್ಯಾಹುಃ| ದುರ್ದರ್ಶನಾನಿ ದುಃಖೇನ ದೃಶ್ಯನ್ತೇ, ಅನ್ತರ್ವಿದ್ರಧಿವದಿತ್ಯರ್ಥಃ| ಪಾಂಸೂನಿ ಧೂಸರಾಣಿ| ದಾರುಣಾನಿ ಅತಿದುಃಖಕರಾಣಿ||೧೫||

Meaning of the commentary

The commentary distinguishes the cause of congenital lesions from doṣa-produced arśas. Only the portion of the reproductive seed forming the fetal anal region is said to be affected; if the whole seed were affected, conception could not occur. One interpretation of ‘prasādhana according to doṣa’ is diagnostic: determine the responsible doṣa through its signs, colour, pain, and form in the affected semen and blood. Another interpretation makes prasādhana treatment selected after examining doṣa signs. Durdarśana means difficult to visualize, like an internal abscess; pāṃsu means greyish, and dāruṇa means extremely distressing.

Key terms

sahaja arshas (sahaja arśas): Arśas described as congenital or present from birth.
duShTashoNitashukra (duṣṭa-śoṇita-śukra): Affected parental reproductive blood and semen in the classical etiological account.
prasAdhana (prasādhana): Interpreted either as diagnostic ascertainment or as treatment according to the doṣa.
antar mukha (antar-mukha): Facing or opening inward.
ATopa (āṭopa): Abdominal gurgling or distension in this symptom list.

Adhikarana ೧೮ (೨೧) · Śloka ೨೧

ಅರ್ಶಸಾಂ ಲಕ್ಷಣಂ ವ್ಯಾಸಾದುಕ್ತಂ ಸಾಮಾನ್ಯತಸ್ತು ಯತ್ | ತತ್ಸರ್ವಂ ಪ್ರಾಗ್ವಿನಿರ್ದಿಷ್ಟಾತ್ಸಾಧಯೇದ್ಭಿಷಜಾಂ ವರಃ ||೨೧||

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अर्शसां लक्षणं व्यासादुक्तं सामान्यतस्तु यत् | तत्सर्वं प्राग्विनिर्दिष्टात्साधयेद्भिषजां वरः ||२१||

Meaning of the śloka

The best physician should determine the general features of arshas described in detail by referring to what was set out previously.

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ಇದಾನೀಂ ಸರ್ವೇಷಾಮೇವ ಮೇಢ್ರಾದಿಜಾನಾಂ ವಾತಾದಿಲಕ್ಷಣಮತಿದೇಶೇನ ನಿರ್ದಿಶನ್ನಾಹ- ಅರ್ಶಸಾಮಿತ್ಯಾದಿ| ಅರ್ಶಸಾಂ ಮೇಢ್ರಾದಿಜಾನಾಂ ವಾತಾದಿದೋಷಲಕ್ಷಣಂ ವಿನಾ ಯತ್ ಸಙ್ಕ್ಷೇಪತೋ ಲಕ್ಷಣಮುಕ್ತಂ ತತ್ ಸರ್ವಂ ಸಾಧಯೇತ್ ಜಾನೀಯಾತ್ ಚಿಕಿತ್ಸೇದ್ವಾ| ಕಥಮಿತ್ಯಾಹ- ಪ್ರಾಗ್ವಿನಿರ್ದಿಷ್ಟಾದಿತಿ; “ಪ್ರಾಕ್ ಪೂರ್ವಂ ವ್ಯಾಸೇನ ಪ್ರತ್ಯೇಕಂ ವಾತಾದಿಜಾರ್ಶೋಲಕ್ಷಣಮುಕ್ತಂ ವೀಕ್ಷ್ಯೇತ್ಯರ್ಥಃ” ಇತಿ ಗಯದಾಸಾಚಾರ್ಯಃ; ಅನ್ಯೇ ತು “ಸಙ್ಕ್ಷೇಪತಃ ಷೋಢಾ, ವ್ಯಾಸತೋ ವಿಸ್ತರೇಣ, ಪ್ರಾಗ್ವಿನಿರ್ದಿಷ್ಟಾತ್ ಪಞ್ಚದಶಧಾ ಪ್ರಸರಾತ್ ಸಾಧಯೇತ್” ಇತಿ ಮನ್ಯನ್ತೇ||೨೧||

Meaning of the commentary

The commentary extends earlier dosha-based features to arshas arising at sites such as the genitals. Apart from the specific vata and other dosha signs, the general features stated briefly are to be determined from the earlier detailed account. Sadhayet may mean either 'should know or determine' or 'should treat.' Gayadasa understands the instruction as consulting the earlier detailed signs of each dosha type of arshas. Others distinguish six types in the concise account and fifteen modes of spread in the detailed earlier account, from which the physician should make the determination.

Key terms

arshas: The classical lesion or disease category discussed in this chapter.
sAmAnyalakShaNa (samanyalakshana): General features shared by the condition.
vyAsa (vyasa): Detailed exposition.
sAdhayet (sadhayet): May mean should determine or know, or alternatively should treat.
atidesha: Extension or application of an earlier rule to the present cases.

Adhikarana ೨೧ (೨೫-೨೬) · Śloka ೨೬

ಸರ್ವಾಃ ಸ್ಯುರ್ವಲಯೋ ಯೇಷಾಂ ದುರ್ನಾಮಭಿರುಪದ್ರುತಾಃ | ತೈಸ್ತು ಪ್ರತಿಹತೋ ವಾಯುರಪಾನಃ ಸನ್ನಿವರ್ತತೇ ||೨೫|| ತತೋ ವ್ಯಾನೇನ ಸಙ್ಗಮ್ಯ ಜ್ಯೋತಿರ್ಮೃದ್ನಾತಿ ದೇಹಿನಾಮ್ ||೨೬||

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सर्वाः स्युर्वलयो येषां दुर्नामभिरुपद्रुताः | तैस्तु प्रतिहतो वायुरपानः सन्निवर्तते ||२५|| ततो व्यानेन सङ्गम्य ज्योतिर्मृद्नाति देहिनाम् ||२६||

Meaning of the śloka

When all the anal folds are affected by arshas, apana vayu is obstructed by them and cannot move outward. Joining with vyana, it is then said to weaken the person's digestive fire.

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ಸರ್ವವಲಿವ್ಯಾಪಿನಾಮರ್ಶಸಾಂ ಪಞ್ಚಾತ್ಮಕಸ್ಯಾಪ್ಯಗ್ನೇರ್ಮಹಾನರ್ಥಕರತ್ವಂ ದರ್ಶಯನ್ನಾಹ- ಸರ್ವಾ ಇತ್ಯಾದಿ| ಯೇಷಾಂ ದೇಹಿನಾಮ್| ದುರ್ನಾಮಭಿಃ ಅರ್ಶೋಭಿಃ| ತೈಸ್ತು ಅರ್ಶೋಭಿರಿತ್ಯರ್ಥಃ| ಅಪಾನೋ ವಾಯುರಿತಿ ಸಮ್ಬನ್ಧಃ| ಸನ್ನಿವರ್ತತೇ ಸ್ಥಿತಿಂ ಬಧ್ನಾತಿ ನ ನಿಃಸರತೀತ್ಯರ್ಥಃ| ಸಙ್ಗಮ್ಯ ಮಿಲಿತ್ವಾ| ಜ್ಯೋತಿಃ ಪಞ್ಚಾತ್ಮಕಮಗ್ನಿಂ, ಮೃದ್ನಾತಿ ಮನ್ದೀಕರೋತಿ| ಅಯಂ ಚೋಪದ್ರವಃ, ಪ್ರಾಯೇಣ ಸಹಜೇಷ್ವರ್ಶಃಸು ಜ್ಞೇಯಃ||೨೫-೨೬||

Meaning of the commentary

The commentary describes the serious consequence of arshas occupying all the folds. Durnama here means arshas. The obstructed apana becomes fixed and does not pass outward; after combining with vyana, it diminishes jyotis, interpreted as the fivefold agni. This complication is said to occur especially in congenital arshas.

Key terms

sarvavalI (sarvavali): All of the anal folds.
durnAma (durnama): A euphemistic designation for arshas.
apAna vAyu (apana vayu): The form of vayu governing downward outward movement in the classical account.
vyAna (vyana): A form of vayu said here to combine with obstructed apana.
jyotis: The fivefold digestive fire or agni in the commentary.

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