The Nidanam of pulmonary consumption ||152||

1Dhanvantari said: -Now I shall discourse on the Nidanam of Raja Yashma (pulmonary consumption).
2-3The terms Raja Yakshma, wasting (Kshaya), Sofia (atrophy, lit. withering up) and Rogaraj (king of maladies) are all synonymous terms. The Moon God, the King of the Brahmanas and Asterisms, had-an-attack of pulmonary consumption in days of yore, and as it first appeared in that King (Raja) of Heavens, it has since been honored with the proud designation of King of Maladies. The disease may appear as a sequel to any other disease, and certainly runs as the harbinger of many. The disease is called Kshaya from the fact of its causing a general wasting of the body, as well as from the incapacity of any medicine in arresting that waste.
4It is called Sosha (Atrophy) from the fact of its withering up the fundamental organic principles of lymph chyle, blood, flesh, fat, bone, marrow, and semen in succession.
5-7Rash feats of strength, over-fatiguing physical exercise, loss of semen, albumen or any other albuminous principle of the organism, voluntary suppression of any natural propulsion of the body, and irregular or instifficient food may be set down as the exciting factors of Raja Yakshma. The Vayu, enraged by any of the preceding causes, affects the process of metabolism all through the organism, and hence the unutilised products of the body (Kapham or Vyartham), which becomes increased in consequence, are carried into the unions of bodily members and appendages (such as a mestomes of veins and arteries) and dilate or contract the orifices of the principal ducts of the body, giving rise to pain in regions above, below, about and across the heart.
8-10aSalivation with fever, hyperpyrexia and a sweet taste in the mouth, dullness of appetite, a gluttonous desire for food and drink, a thought of uncleanness in things clean and pure, a feeling as if his food and drink have been studded with bits of hair of flees’ wings, nausea, vomiting, a non-relish for food, extreme whiteness of the eyes, chest, palms of the hands and soles of the feet as well as of the armpits, and expectoration of thick mucous even without bathing are the symptoms which mark the premonitory stage of this disease.
10b-11aThe patient experiences a pain in the tongue and arms, learns to abhor his body, becomes unreasonably fond of wine and women or loathes their sight, and suffers from giddiness.
11b-12Hairs, and nails of toes or, fingers become marked by their, rapid and excessive growth, and sleep become chequered with fearful dreams. The patient dreams of lizards, serpents, monkeys, or of savage birds or beasts darting upon his head, or as if he is climbing a hill of ashes, hairs, paddy husks, or a withered tree.
13-14He sees deserted hamlets and homesteads in his sleep, or dreams of burning forests, and dry and empty river-beds. Catarrh, dyspnea, cough, headache, loss of voice, a non-relish for food, updrawn breath, emaciation, vomiting, fever, and pain at the sides, chest and joints are the eleven specific symptoms of the disease under discussion.
15-16The distressing symptoms, which are invariably found to supervene, are a breaking pain in the throat, yawning, aching pain in the limbs, spitting of blood, impaired digestion, and a foul smell in the mouth. Of these, headache, aching fain at the sides, and in the limbs, constriction of the throat, hoarseness, and kindred symptoms should be attributed to the action of the deranged Vayu, while to the deranged Pittam should be ascribed the burning sensation in the shoulders and extremities dysentery, blood-spitting, foul-smell in the mouth, fever, and the general excited condition of the body.
17-19Vomiting cough, feeling of heaviness in one half of the body, water bash, catarrh, dyspnea, and impaired digestion with a no relish for food are the symptoms, which owe their origin to the action of the deranged Kapham in Raja Yakshma. The enraged morbific diatheses, such as, the Vayu, Pittam and the Kapham, produce a general anasarca in these cases only on account of the impairment of digestive capacity. The burning sensation in the cardiac region, which is usually experienced in these cases, is only for the diminution which the fundamental principles of lymph cycle, and blood, suffer on account of the obstructed orifices of the vessels of the vascular system.
20-21The food undergoes a sort of aid reaction in the stomach, for which reason the food ingested by a phthisis patient cannot contribute to the formation of the healthy lymph cycle, and hence cannot make good the waste which incessantly goes on in the body, Accordingly, a phthisis patient may be described As living by drawing upon the reserve capital of life, and his body, in the absence of healthy nutrition and assimilation, becomes emaciated from day to day. A prudent physician should not take in hand a phthisis patient whose sense-organs have been affected even before the development of most of the specific symptoms of the disease.
22-23The disease occurring in a strong and young patient and well cared for from the outset, may not develop more unfavorable symptoms, and may ultimately prove amenable to medicine. Once its specific symptoms have been fully developed, the disease should be regarded as past all cure.
24The voice becomes weak or rough in this disease owing to the loss of the organic principle of fat. In the type due to the action of the deranged Vayu, the body loses its gloss and heat, and the patient feels as if his throat his been studded with the bristles of Suka Simnvi leaves.
25The gradual wasting of the body, and the burning-sensation in the throat and palate, in these cases, should be prescribed to the action of the deranged Pittam,
26The sensation of a sticky moucos, together with the specific wheezing sound, in the throat is due to the action of the deranged Kapham. Vertigo, darkness of vision and symptoms peculiar to the deranged Kapham are invariably present.
27Wasting of the body is accelerated by an unwholesome diet and injudicious and intemperate living in Raja Yakshma. This disease is seldom curable, and a wise physician should abandon the patient just as its specific symptoms would be but partially developed.