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गम्भीरे श्वयथुः स्तब्धः कठिनोऽन्तर्भृशार्तिमान्| श्यावस्ताम्रोऽथवा दाहतोदस्फुरणपाकवान् ||२१||   

गम्भीरे श्वयथुः स्तब्धः कठिनोऽन्तर्भृशार्तिमान्| श्यावस्ताम्रोऽथवा दाहतोदस्फुरणपाकवान् ||२१||   

रुग्विदाहान्वितोऽभीक्ष्णं वायुः सन्ध्यस्थिमज्जसु |   

रुग्विदाहान्वितोऽभीक्ष्णं वायुः सन्ध्यस्थिमज्जसु |   

छिन्दन्निव चरत्यन्तर्वक्रीकुर्वंश्च वेगवान् ||२२||   

छिन्दन्निव चरत्यन्तर्वक्रीकुर्वंश्च वेगवान् ||२२||   

करोति खञ्जं पङ्गुं वा शरीरे सर्वतश्चरन् |   

करोति खञ्जं पङ्गुं वा शरीरे सर्वतश्चरन् |   

सर्वैर्लिङ्गैश्च विज्ञेयं वातासृगुभयाश्रयम् ||२३||

सर्वैर्लिङ्गैश्च विज्ञेयं वातासृगुभयाश्रयम् ||२३||

gambhīrē śvayathuḥ stabdhaḥ kaṭhinō'ntarbhr̥śārtimān|   

gambhīrē śvayathuḥ stabdhaḥ kaṭhinō'ntarbhr̥śārtimān|   

śyāvastāmrō'thavā dāhatōdasphuraṇapākavān||21||   

śyāvastāmrō'thavā dāhatōdasphuraṇapākavān||21||   

rugvidāhānvitō'bhīkṣṇaṁ vāyuḥ sandhyasthimajjasu|   

rugvidāhānvitō'bhīkṣṇaṁ vāyuḥ sandhyasthimajjasu|   

chindanniva caratyantarvakrīkurvaṁśca vēgavān||22||   

chindanniva caratyantarvakrīkurvaṁśca vēgavān||22||  

   

karōti khañjaṁ paṅguṁ vā śarīrē sarvātaścaran|   

karōti khañjaṁ paṅguṁ vā śarīrē sarvātaścaran|   

sarvairliṅgaiśca vijñēyaṁ vātāsr̥gubhayāśrayam||23||

sarvairliṅgaiśca vijñēyaṁ vātāsr̥gubhayāśrayam||23||

gambhIre shvayathuH stabdhaH kaThino~antarbhRushArtimAn |  

gambhIre shvayathuH stabdhaH kaThino~antarbhRushArtimAn |  

shyAvastAmro~athavA dAhatodasphuraNapAkavAn ||21||  

shyAvastAmro~athavA dAhatodasphuraNapAkavAn ||21||  

rugvidAhAnvito~abhIkShNaM vAyuH sandhyasthimajjasu |   

rugvidAhAnvito~abhIkShNaM vAyuH sandhyasthimajjasu |   

chindanniva caratyantarvakrIkurvaMshca vegavAn ||22||   

chindanniva caratyantarvakrIkurvaMshca vegavAn ||22||   

karoti kha~jjaM pa~gguM vA sharIre sarvātashcaran |   

karoti kha~jjaM pa~gguM vA sharIre sarvātashcaran |   

sarvairli~ggaishca vij~jeyaM vātasRugubhayAshrayam ||23||

sarvairli~ggaishca vij~jeyaM vātasRugubhayAshrayam ||23||

Symptoms of gambhira vata shonita are – edema in the involved parts of the body, stiffness of joints, hardness of the part, severe pain inside, the colour of the part involved becomes either blackish or coppery. There is burning sensation, pricking pain, fasciculation and finally the part become inflamed and ulcerated. When vayu reaches sandhi, asthi and majja (joints, bones and bone marrow) it causes severe pain and burning sensation. The forcefully moving vayu having reached the joints causes cutting nature of pain whereby making them crooked, produces limping or lameness while moving all over the body. When the symptoms of both types – uttāna and gambhira are present in a patient, it should be considered as ubhayashrita (superficial and deep both). (21 – 23)

 

Differential features as per dosha dominance:

Symptoms of ''gambhira vatashonita'' are – edema in the involved parts of the body, stiffness of joints, hardness of the part, severe pain inside, the color of the part involved becomes either blackish or coppery. There is burning sensation, pricking pain, fasciculation and finally the part become inflamed and ulcerated. When ''vayu'' reaches ''sandhi, asthi'' and ''majja'' (joints, bones and bone marrow) it causes severe pain and burning sensation. The forcefully moving ''vayu'' having reached the joints causes cutting nature of pain whereby making them crooked, produces limping or lameness while moving all over the body. When the symptoms of both types – ''uttana'' and ''gambhira'' are present in a patient, it should be considered as ''ubhayashrita'' (superficial and deep both). [21–23]

 

==== Differential features as per ''dosha'' dominance ====

 

तत्र वातेऽधिके वा स्याद्रक्ते पित्ते कफेऽपि वा |   

तत्र वातेऽधिके वा स्याद्रक्ते पित्ते कफेऽपि वा |   

संसृष्टेषु समस्तेषु यच्च तच्छृणु लक्षणम् ||२४||   

संसृष्टेषु समस्तेषु यच्च तच्छृणु लक्षणम् ||२४||   

विशेषतः सिरायामशूलस्फुरणतोदनम् [१] |   

विशेषतः सिरायामशूलस्फुरणतोदनम् [१] |   

शोथस्य कार्ष्ण्यं रौक्ष्यं च श्यावतावृद्धिहानयः ||२५||   

शोथस्य कार्ष्ण्यं रौक्ष्यं च श्यावतावृद्धिहानयः ||२५||   

धमन्यङ्गुलिसन्धीनां सङ्कोचोऽङ्गग्रहोऽतिरुक् |   

धमन्यङ्गुलिसन्धीनां सङ्कोचोऽङ्गग्रहोऽतिरुक् |   

कुञ्चनस्तम्भने शीतप्रद्वेषश्चानिलेऽधिके ||२६||   

कुञ्चनस्तम्भने शीतप्रद्वेषश्चानिलेऽधिके ||२६||   

श्वयथुर्भृशरुक् [२] तोदस्ताम्रश्चिमिचिमायते |   

श्वयथुर्भृशरुक् [२] तोदस्ताम्रश्चिमिचिमायते |   

स्निग्धरूक्षैः शमं नैति कण्डूक्लेदान्वितोऽसृजि [३] ||२७||   

स्निग्धरूक्षैः शमं नैति कण्डूक्लेदान्वितोऽसृजि [३] ||२७||   

विदाहो वेदना मूर्च्छा स्वेदस्तृष्णा मदो भ्रमः |   

विदाहो वेदना मूर्च्छा स्वेदस्तृष्णा मदो भ्रमः |   

रागः पाकश्च भेदश्च शोषश्चोक्तानि पैत्तिके ||२८||   

रागः पाकश्च भेदश्च शोषश्चोक्तानि पैत्तिके ||२८||   

स्तैमित्यं गौरवं स्नेहः सुप्तिर्मन्दा च रुक् कफे |   

स्तैमित्यं गौरवं स्नेहः सुप्तिर्मन्दा च रुक् कफे |   

हेतुलक्षणसंसर्गाद्विद्याद्द्वन्द्वत्रिदोषजम् ||२९||

हेतुलक्षणसंसर्गाद्विद्याद्द्वन्द्वत्रिदोषजम् ||२९||

tatra vātē'dhikē vā syādraktē pittē kaphē'pi vā|   

tatra vātē'dhikē vā syādraktē pittē kaphē'pi vā|   

saṁsr̥ṣṭēṣu samastēṣu yacca tacchr̥ṇu lakṣaṇam||24||   

saṁsr̥ṣṭēṣu samastēṣu yacca tacchr̥ṇu lakṣaṇam||24||   

viśēṣataḥ sirāyāmaśūlasphuraṇatōdanam [1] |   

viśēṣataḥ sirāyāmaśūlasphuraṇatōdanam [1] |   

śōthasya kārṣṇyaṁ raukṣyaṁ ca śyāvātavr̥ddhihānayaḥ||25||   

śōthasya kārṣṇyaṁ raukṣyaṁ ca śyāvātavr̥ddhihānayaḥ||25||  

   

dhamanyaṅgulisandhīnāṁ saṅkōcō'ṅgagrahō'tiruk|   

dhamanyaṅgulisandhīnāṁ saṅkōcō'ṅgagrahō'tiruk|   

kuñcanastambhanē śītapradvēṣaścānilē'dhikē||26||   

kuñcanastambhanē śītapradvēṣaścānilē'dhikē||26||  

   

śvayathurbhr̥śaruk [2] tōdastāmraścimicimāyatē|   

śvayathurbhr̥śaruk [2] tōdastāmraścimicimāyatē|   

snigdharūkṣaiḥ śamaṁ naiti kaṇḍūklēdānvitō'sr̥ji [3] ||27||   

snigdharūkṣaiḥ śamaṁ naiti kaṇḍūklēdānvitō'sr̥ji [3] ||27||   

vidāhō vēdanā mūrcchā svēdastr̥ṣṇā madō bhramaḥ|   

vidāhō vēdanā mūrcchā svēdastr̥ṣṇā madō bhramaḥ|   

rāgaḥ pākaśca bhēdaśca śōṣaścōktāni paittikē||28||   

rāgaḥ pākaśca bhēdaśca śōṣaścōktāni paittikē||28||   

staimityaṁ gauravaṁ snēhaḥ suptirmandā ca ruk kaphē|   

staimityaṁ gauravaṁ snēhaḥ suptirmandā ca ruk kaphē|   

hētulakṣaṇasaṁsargādvidyāddvandvatridōṣajam||29||  

hētulakṣaṇasaṁsargādvidyāddvandvatridōṣajam||29||  

tatra vAte~adhike vA syAdrakte pitte kaphe~api vA |   

tatra vAte~adhike vA syAdrakte pitte kaphe~api vA |   

saMsRuShTeShu samasteShu yacca tacchRuNu lakShaNam ||24||   

saMsRuShTeShu samasteShu yacca tacchRuNu lakShaNam ||24||   

visheShataH sirāyAmashUlasphuraNatodanam [1] |   

visheShataH sirāyAmashUlasphuraNatodanam [1] |   

shothasya kArShNyaM raukShyaM ca shyAvātavRuddhihAnayaH ||25||   

shothasya kArShNyaM raukShyaM ca shyAvātavRuddhihAnayaH ||25||  

   

dhamanya~ggulisandhInAM sa~gkoco~a~ggagraho~atiruk |   

dhamanya~ggulisandhInAM sa~gkoco~a~ggagraho~atiruk |   

ku~jcanastambhane shItapradveShashcAnile~adhike ||26||   

ku~jcanastambhane shItapradveShashcAnile~adhike ||26||  

   

shvayathurbhRusharuk [2] todastAmrashcimicimAyate |   

shvayathurbhRusharuk [2] todastAmrashcimicimAyate |   

snigdharUkShaiH shamaM naiti kaNDUkledAnvito~asRuji [3] ||27||   

snigdharUkShaiH shamaM naiti kaNDUkledAnvito~asRuji [3] ||27||   

vidAho vedanA mUrcchA svedastRuṣṇa mado bhramaH |   

vidAho vedanA mUrcchA svedastRuṣṇa mado bhramaH |   

rAgaH pAkashca bhedashca shoShashcoktAni paittike ||28||   

rAgaH pAkashca bhedashca shoShashcoktAni paittike ||28||   

staimityaM gauravaM snehaH suptirmandA ca ruk kaphe |   

staimityaM gauravaM snehaH suptirmandA ca ruk kaphe |   

hētulakShaNasaMsargAdvidyAddvandvatridośajam ||29||

hētulakShaNasaMsargAdvidyAddvandvatridośajam ||29||

Now listen the clinical features found in predominance of vata, rakta, pitta, kapha or in combination of two or all three dosha.

Now listen the clinical features found in predominance of vata, rakta, pitta, kapha or in combination of two or all three dosha.

If vata is predominant, there is sirayama (stretching sensation in sira or veins), pain, fasciculation, pricking pain, swollen part becomes blackish , dry , increasing and decreasing grayish hue, constrictions of dhamani (arteries, ligaments) of fingers, stiffness of body parts and intense pain, constriction, stiffness and hatred to cold by the patient. These are the symptoms of vata predominance.

If vata is predominant, there is sirayama (stretching sensation in sira or veins), pain, fasciculation, pricking pain, swollen part becomes blackish , dry , increasing and decreasing grayish hue, constrictions of dhamani (arteries, ligaments) of fingers, stiffness of body parts and intense pain, constriction, stiffness and hatred to cold by the patient. These are the symptoms of vata predominance.

If rakta is predominant, there is swelling, severe pain of pricking nature, tingling sensation, colour of part of skin becomes coppery, not diminished by application of either unctuous or dry substances associated with itching and moistening over the part.

If rakta is predominant, there is swelling, severe pain of pricking nature, tingling sensation, colour of part of skin becomes coppery, not diminished by application of either unctuous or dry substances associated with itching and moistening over the part.

If pitta is predominant, there is burning sensation over the part, pain, fainting, perspiration, thirst, narcosis, giddiness, redness of the part affected, pain of tearing nature, inflammation and atrophy of the part.

If pitta is predominant, there is burning sensation over the part, pain, fainting, perspiration, thirst, narcosis, giddiness, redness of the part affected, pain of tearing nature, inflammation and atrophy of the part.

If kapha is predominant there is feeling of wetness of the skin, heaviness, unctuousness, numbness and mild pain.

If kapha is predominant there is feeling of wetness of the skin, heaviness, unctuousness, numbness and mild pain.

When there is predominance of two dosha or all three dosha there will be combination of symptoms and etiological factors as well. (24 – 29)

When there is predominance of two dosha or all three dosha there will be combination of symptoms and etiological factors as well. [24–29]

Prognosis:

 

==== Prognosis ====

 

एकदोषानुगं साध्यं नवं, याप्यं द्विदोषजम् |   

एकदोषानुगं साध्यं नवं, याप्यं द्विदोषजम् |   

त्रिदोषजमसाध्यं स्याद्यस्य च स्युरुपद्रवाः ||३०||  

त्रिदोषजमसाध्यं स्याद्यस्य च स्युरुपद्रवाः ||३०||  

ēkadōṣānugaṁ sādhyaṁ navaṁ, yāpyaṁ dvidōṣajam|   

ēkadōṣānugaṁ sādhyaṁ navaṁ, yāpyaṁ dvidōṣajam|   

tridōṣajamasādhyaṁ syādyasya ca syurupadravāḥ||30||   

tridōṣajamasādhyaṁ syādyasya ca syurupadravāḥ||30||   

ekadośanugaM sādhyaM navaM, yApyaM dvidośajam |   

ekadośanugaM sādhyaM navaM, yApyaM dvidośajam |   

tridośajamasādhyaM syAdyasya ca syurupadravAH ||30||   

tridośajamasādhyaM syAdyasya ca syurupadravAH ||30||  

When there is recent onset and predominance of single dosha, vāta shonita is sadhya (curable). The disease arising from predominance of two dosha is yapya (palliable). The disease arising from predominance of all three dosha and has developed upadrava (complications) as well, is asadhya (incurable). (30)

   

Complications:

When there is recent onset and predominance of single dosha, vāta shonita is sadhya (curable). The disease arising from predominance of two dosha is yapya (palliable). The disease arising from predominance of all three dosha and has developed upadrava (complications) as well, is asadhya (incurable). [30]

 

==== Complications ====

 

अस्वप्नारोचकश्वासमांसकोथशिरोग्रहाः |   

अस्वप्नारोचकश्वासमांसकोथशिरोग्रहाः |   

मूर्च्छायमदरुक्तृष्णाज्वरमोहप्रवेपकाः ||३१||   

मूर्च्छायमदरुक्तृष्णाज्वरमोहप्रवेपकाः ||३१||