௨. அர்ஶோநிதாநம்

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Adhikarana ௧ (௧-௨) · Śloka ௨

அதாதோऽர்ஶஸாஂ நிதாநஂ வ்யாக்யாஸ்யாமஃ ||௧|| யதோவாச பகவாந் தந்வந்தரிஃ ||௨||

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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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அதேத்யாதி| நிதாநஂ ஹேதுலக்ஷணநிர்தேஶஃ||௧-௨||

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 ௨ (௩) · Śloka ௩

ஷடர்ஶாஂஸி பவந்தி வாதபித்தகபஶோணிதஸந்நிபாதைஃ ஸஹஜாநி சேதி ||௩||

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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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ஷடர்ஶாஂஸீத்யாதி| நநு, வாதபித்தகபஶோணிதஸந்நிபாதைஃ ஸஹஜாநி சேத்யநேநைவ ஷட்ஸங்க்யாயா லப்தத்வாத் கதஂ ஷடிதி ஸங்க்யாநிர்தேஶஃ? உச்யதே- த்விதோஷஜநிதார்ஶோகணநாபரிஹாரார்தம்| யத்யபி ஶோணிதாதிஷ்டாநா வாதாதயோ ரக்தார்ஶஸாமாரம்பகாஃ, ததாऽப்யுபசாராத் ‘ஶோணிதஜாநி’ இத்யுச்யந்தே; யதா- கதாதிஷ்டாநேநாக்நிநா தக்தோ ‘கததக்த’ இத்யுச்யதே||௩||

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 ௩ (௪) · Śloka ௪

தத்ராநாத்மவதாஂ யதோக்தைஃ ப்ரகோபணைர்விருத்தாத்யஶநஸ்த்ரீப்ரஸங்கோத்கடுகாஸநபஷ்டயாநவேகவிதாரணாதிபிர்விஶேஷைஃ ப்ரகுபிதா தோஷா ஏகஶோ த்விஶஃ ஸமஸ்தாஃ ஶோணிதஸஹிதா வா யதோக்தஂ ப்ரஸதாஃ ப்ரதாநதமநீரநுப்ரபத்யாதோ கத்வா குதமாகம்ய ப்ரதூஷ்ய குதவலீர்மாஂஸப்ரரோஹாஞ்ஜநயந்தி விஶேஷதோ மந்தாக்நேஃ, ததா தணகாஷ்டோபலலோஷ்டவஸ்த்ராதிபிஃ ஶீதோதகஸஂஸ்பர்ஶநாத்வா கந்தாஃ பரிவத்திமாஸாதயந்தி, தாந்யர்ஶாஂஸீத்யாசக்ஷதே ||௪||

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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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அர்ஶஸாஂ ஹேதூந் ஸம்ப்ராப்தி ச தர்ஶயந்நாஹ- தத்ரேத்யாதி| ப்ரகுபிதா தோஷா மாஂஸப்ரரோஹாஞ்ஜநயந்தீதி ஸம்பந்தஃ| அநாத்மவதாம் அஜிதேந்த்ரியாணாம்| யதோக்தைஃ ப்ரகோபணைர்பலவத்விக்ரஹாதிக்ரோதஶோகாதிதிவாஸ்வப்நாதிபிஃ| விருத்தஂ பஹுதா ஹிதாஹிதீயோக்தம்| ஸ்த்ரீப்ரஸங்க இத்யத்ர ப்ரஶப்தேநாத்யந்தஸக்திஃ ப்ரதிபாத்யதே| ‘குதபார்ஷ்ணீஸமாயோகஃ ப்ராஹுருத்கடுகாஸநம்’, ‘உகுடு’ இதி லோகே| அஶ்வாதீநாஂ பஷ்டேந கமநஂ பஷ்டயாநம்| வேகவிதாரணஶப்தேந வாதவிண்மூத்ராதீநாஂ வேகதாரணம்| விருத்தாஶநஶப்தேந குருஶீதாபிஷ்யந்திவிதாஹ்யஸாத்ம்யப்ரமிதாஶநாதீநி கஹ்யந்தே| விஶேஷைர்பேதைஃ| தேஷாஂ நிதாநமபிதாய ஸம்ப்ராப்திமாஹ- யதோக்தமித்யாதி| ப்ரஸதா இதி ‘கிண்வோதகபிஷ்டஸமவாய இவோத்ரிக்தாநாஂ ப்ரஸரோ பவதி’ (ஸூ. ௨௧) இத்யாதிக்ரமேண ப்ரஸதாஃ| ப்ரதாநதமநீஃ புரீஷவாஹிநீஃ| அநு பஶ்சாத், ப்ரபத்ய ப்ராப்ய| குதவலீரிதி வலிஸ்த்வக்ஸங்கோசஃ| மந்தாக்நேர்விஶேஷதோऽதிஶயேந மாஂஸப்ரரோஹாஞ்ஜநயந்தீதி ஸம்பந்தஃ| ததா தணேத்யாதி| பரிவத்திமாஸாதயந்தி ப்ராப்நுவந்தீத்யர்தஃ| ஆசக்ஷத இதி ‘பூர்வாசார்யா’ இத்யத்யாஹாரஃ||௪||

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 ௧௩ (௧௫) · Śloka ௧௫

ஸஹஜாநி துஷ்டஶோணிதஶுக்ரநிமித்தாநி, தேஷாஂ தோஷத ஏவ ப்ரஸாதநஂ கர்த்தவ்யம், விஶேஷதஶ்சைதாநி துர்தர்ஶநாநி பருஷாணி பாஂஸூநி தாருணாந்யந்தர்முகாநி; தைருபத்ருதஃ கஶோऽல்பபுக் ஸிராஸந்ததகாத்ரோऽல்பப்ரஜஃ க்ஷீணரேதாஃ க்ஷாமஸ்வரஃ க்ரோதநோऽல்பாக்நிப்ராணஃ பரமலஸஶ்ச, ததா க்ராணஶிரோऽக்ஷிநாஸாஶ்ரவணரோகீ, ஸததமந்த்ரகூஜாடோபஹதயோபலேபாரோசகப்ரபதிபிஃ பீட்யதே ||௧௫||

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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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ஶரீரேண ஸஹ ஜாதாநாமர்ஶஸாஂ தோஷேப்யோ பிந்நஂ ஹேதுஂ தர்ஶயந்நாஹ- ஸஹஜாநீத்யாதி| துஷ்டஶோணிதஶுக்ரநிமித்தாநீதி கர்பகுதாரம்பகமாத்ரஂ பீஜஂ துஷ்டஂ ந ஸர்வஂ, ஸர்வதுஷ்டத்வே ஹி ப்ரஜோத்பத்திரேவ ந ஸ்யாத்| ‘தேஷாஂ தோஷத ஏவ ப்ரஸாதநஂ கர்தவ்யமிதி யேந தோஷேண யஸ்ய ஶுக்ரஶோணிதஂ தூஷிதஂ பவேத்தஸ்ய தோஷஸ்ய லக்ஷணவர்ணவேதநாகதிபிஃ ப்ரஸாதநஂ விஜ்ஞாநம்’ இத்யேகே; அந்யே து ‘தோஷத இதி தோஷலிங்கஂ ஸமீக்ஷ்ய ப்ரஸாதநஂ சிகித்ஸா’ இத்யாஹுஃ| துர்தர்ஶநாநி துஃகேந தஶ்யந்தே, அந்தர்வித்ரதிவதித்யர்தஃ| பாஂஸூநி தூஸராணி| தாருணாநி அதிதுஃககராணி||௧௫||

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 ௧௮ (௨௧) · Śloka ௨௧

அர்ஶஸாஂ லக்ஷணஂ வ்யாஸாதுக்தஂ ஸாமாந்யதஸ்து யத் | தத்ஸர்வஂ ப்ராக்விநிர்திஷ்டாத்ஸாதயேத்பிஷஜாஂ வரஃ ||௨௧||

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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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இதாநீஂ ஸர்வேஷாமேவ மேட்ராதிஜாநாஂ வாதாதிலக்ஷணமதிதேஶேந நிர்திஶந்நாஹ- அர்ஶஸாமித்யாதி| அர்ஶஸாஂ மேட்ராதிஜாநாஂ வாதாதிதோஷலக்ஷணஂ விநா யத் ஸங்க்ஷேபதோ லக்ஷணமுக்தஂ தத் ஸர்வஂ ஸாதயேத் ஜாநீயாத் சிகித்ஸேத்வா| கதமித்யாஹ- ப்ராக்விநிர்திஷ்டாதிதி; “ப்ராக் பூர்வஂ வ்யாஸேந ப்ரத்யேகஂ வாதாதிஜார்ஶோலக்ஷணமுக்தஂ வீக்ஷ்யேத்யர்தஃ” இதி கயதாஸாசார்யஃ; அந்யே து “ஸங்க்ஷேபதஃ ஷோடா, வ்யாஸதோ விஸ்தரேண, ப்ராக்விநிர்திஷ்டாத் பஞ்சதஶதா ப்ரஸராத் ஸாதயேத்” இதி மந்யந்தே||௨௧||

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 ௨௧ (௨௫-௨௬) · Śloka ௨௬

ஸர்வாஃ ஸ்யுர்வலயோ யேஷாஂ துர்நாமபிருபத்ருதாஃ | தைஸ்து ப்ரதிஹதோ வாயுரபாநஃ ஸந்நிவர்ததே ||௨௫|| ததோ வ்யாநேந ஸங்கம்ய ஜ்யோதிர்மத்நாதி தேஹிநாம் ||௨௬||

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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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ஸர்வவலிவ்யாபிநாமர்ஶஸாஂ பஞ்சாத்மகஸ்யாப்யக்நேர்மஹாநர்தகரத்வஂ தர்ஶயந்நாஹ- ஸர்வா இத்யாதி| யேஷாஂ தேஹிநாம்| துர்நாமபிஃ அர்ஶோபிஃ| தைஸ்து அர்ஶோபிரித்யர்தஃ| அபாநோ வாயுரிதி ஸம்பந்தஃ| ஸந்நிவர்ததே ஸ்திதிஂ பத்நாதி ந நிஃஸரதீத்யர்தஃ| ஸங்கம்ய மிலித்வா| ஜ்யோதிஃ பஞ்சாத்மகமக்நிஂ, மத்நாதி மந்தீகரோதி| அயஂ சோபத்ரவஃ, ப்ராயேண ஸஹஜேஷ்வர்ஶஃஸு ஜ்ஞேயஃ||௨௫-௨௬||

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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