The Nidanam of diseases of the nervous system ||166||

1Dhanvantari said: -Here me, O Susruta, now discourse on the Nidanam of the diseases of the nervous system (Vata Vyadhi). A disturbance of the normal equilibrium among the different fundamental principles of the organism is the root of all bodily distempers.
2-3The bodily Vayu, deranged through any unknown or invisible factor, makes the body inert and inoperative. A man should always endeavor to keep his body in health in conjunction with the efforts of Visvakarma, (the architect of the universe), Visvarupa (the shaper of the universe), Prajapati (the lord of created beings) Srashta (creator), Vibhu (lord), Vishnu (the all-pervading one). Sarnharta (destroyer) and Mrityu (Dealth) to that end.
4-5A correct knowledge of physiological and pathological (Prakrita and Vaikrta) processes is necessary for a correct diagnosis of a disease. The combined and several actions of the morbific principles should be taken into consideration in arriving at a correct diagnosis. Nidanam (Aetology) premonitory symptoms, specific features, spontaneous aggravation or amelioration, and the exciting causes are the five factors which are included within the Prakrita Karma (physiological cogitations).
6I shall now discourse on the causes and symptoms of Vata Vyadhi (diseases of the nervous system) in the light of this Prakrita Karma.
7One should at once abjure the use of articles that tend to destroy any fundamental principle of the organism whenever there may be symptoms to indicate that the bodily Vayu has been agitated or affected by their use.
8-9The deranged Vayu chokes up the orifices of the vessels and keeps them stuffed. The vessels, thus stuffed up with the morbific principles of the body, send the deranged Vayu to its surface, which, in its tum, chokes up the pores of the skin, causing colic, tympanites, rumbling in the intestines, suppression of the stool, loss of voice. and obstruction of sight, with a catching pain at the waist and back as precursors to more dreadful diseases. Vata Vyiidhi located in (diseases of the nerves of) the stomach gives rise to vomiting, dyspnea, cough, violent purging, itching sensations and diverse kinds of diseases above the region of the umbilicus.
10-11Similarly, the deranged Vayu, located in the internal ducts (Srotras) of the body, produces cracking and dryness of the skin, excruciating pain, sallowness of complexion, symptoms of poisoning, tympanites with a non-relish for food, emaciation of the body, vertigo, glandular growths, and roughness of the skin.
12The body seems heavy and painful as if it has been violently beaten with a cudgel, and an aching pain is felt the in bones, and vertebraes. The pain in the bones and vertebrae becomes so intense as to leave no repose to the patient, who sits up waking in the night.
13The emission of semen becomes rapid or involuntary when the nerves (Vayu) of the genitourinary tracts are affected in this disease, which in a pregnant woman leads to an abortion or miscarriage, and brings on constipation of the bowels with an excruciating head-ache in both the sexes.
14Swelling and inflammation are found to set in about the place where the enraged Vayu lies incarcerated, first determining the locality of Vata Vyadhi, and causing an intense pain to the patient.
15The body appears like a full water-drum, and the enraged Vayu, by entering into the joints of the body, produces local atrophy.
16Lying stuffed through the whole organism, the enraged Vayu produces an aching pain, throbbing, breaking of skin and bones, numbness of the body, convulsive movements of the limbs, somnolence, and palsy. When the enraged Vayu courses through the nerve of the body it produces constant convulsions of the limbs and the disease, thus generated, is called Akshepaka (convulsions).
17The enraged Vayu, any wise obstructed in its downward course, recoils back upon itself, and goes upward, pressing the heart and the templar bones, and the cranium.
18Thereafter it (Vayu) spreads through the whole organism, causing the cheek bones of the patient to hang down, numb and paralyzed, and producing distortion of the whole face.
19-20The eyes remain permanently open, and the patient suffer from difficulty of breathing, and lies unconscious, moaning, indistinctly like a pigeon. This disease is called Apatantraka and is one of the most difficult of difficult diseases to cure the patient sometimes feels a little respite when the enraged Vayu with the essence of the disease descends into his heart and left nostril and feels troubles at other times. A case of paralysis, which is the outcome of a blow or fall, should be regarded as indicating an unfavorable prognosis, or almost beyond the pale or medicine.
21-22The enraged Vayu, taking lodgment in the internal vital principles of the organism, produces suppression of locomotion, obstruction of the sight, yawning, dirty deposits on the teeth, and loss of energy.
23-24This disease is found to further develop the symptoms of numbed pain at the external sides, catching pain about the cheekbones, numbness of the back, headache, curvature or bending of the body on the posterior side, and sensation of heaviness at the back and cardiac region. The patient constantly suffers from fits of vertigo, the shoulders drop down, and the teeth and face of the patient suffers discolouring.
25-26A patient, suffering from numbness of the jaws and external curvature of the body, should be set down as suffering from an attack of Vata Vyadhi. The enraged Vayu in this disease takes lodgment in the blood and excrements of the system, causing the morbific principles to surcharge the whole economy, and producing ulcers, exhaustion, and palour. In all forms of Vata Vyadhi the patient derives a little comfort from massage.
27Ingestion of extremely hot food, and excessive scraping of the tongue are the factors which tend to enrage the local Vayu, which produces paralysis of the cheek bones and mandibles, causing the closing of the mouth, or keeping it fixedly open and gaping.
28-29Chewing of extremely hard substances, and constant speaking in overloud tone are the factors, which, by enraging the local Vayu, and causing it to be· incarcerated in the nerves traversing the organs of speech, bring about a paralysis of the tongue, which ultimately spreads to the muscles of the cheekbones and mandibles. In cases of paralysis of the tongue, digestion of food, drinking, and articulation of speech become seriously hampered or almost impossible.
30-31Carrying of extremely heavy loads on the head, loud laughters, loud talkings, resting of head on a hard and uneven pillow, and chewing of extremely hard articles of fare are the factors that tend to enrage the local Vayu, which takes lodgment in the upper part of the body.
32Similarly, the face of a man may suffer permanent distortion through loud laughing, or looking suddenly with extremely dilated eyes, or through in judicious straining of the eyes.
33-34In this type of (facial) paralysis, the tongue loses the faculty of speech, and the eyes become numbed and motionless. Gnashing of the teeth, loss of voice, impairment of hearing and sight, loss of smell and memory, fright, anguish and dyspnea are the distressing supervening symptoms which are manifested in almost all types of Viita Vyadhi; ptyalism, pain at the sides, incapacity of closing, the eye-lids with an excruciating pain in the upper part of the body and hemiplegia being its further characteristics.
35Several authorities call the first named disease as Arditmn (facial paralysis) and the last named one as Ekanga Vyadhi (Hemiplegia)
36The enraged Vayu, by interfering with the flow of blood in the arteries, and specially in those that traverse the head, produces a king of hemicrania in which rough, black veins appear on the regions of the temple. This type o~ headache in incurable. The enraged Vayu, by affecting the nerves and ligaments of the body, produces a kind of disease that strikes down either half of the body.
37The disease is called Paksha Ghata in which the organs and members of the affected side become inert and inoperative and lose all sensations.
38This disease is also called Kaksha-roga by several authorities. Similarly, the disease, in which the enraged Vayu instead of striking down either half of the body paralyses the whole of it, is called Sarvanga Roga.
39Cases of paralysis, which are due to the action of only the enraged Vayu, are curable, while those which are complicated with the presence of two of the morbific principles (Doshas), together with those in which all the characteristic symptoms are fully developed, should be regarded · as incurable, as they invariably prove fatal.
40The disease, in which the course of the Vayu, acting in concert with the deranged Kapham, is obstructed by mucous, and which is characterized by the loss of sensation, is called Dan Dapatanaka.
41The disease, in which the enraged Vayu contracts up the muscles that start up from behind the shoulder blades and in which all movements of the arms are lost, it called Avavahuka (Ebb’s paralysis).
42The disease in which the enraged Vayu paralyses the Kandara, that runs down the back of the arms, extending to the tips of the fingers, is called Vishvaci.
43The disease in whcih the enraged Vayu, taking lodgment in the region of the waist, draws up the great sacral muscles, producing lameness, is called Khanya. The disease in which both the knees are deprived of their strength and become inoperative is called Pangu.
44The type of Maha Vyadhi in which the patient walks in a tottering gait and the joints of the legs seem loose and unsteady is called Kalaya-khanja.
45-46The deranged Kapha in conjunction with the fat gets augmented through the ingestion of extremely cold, hot, dry, fluid, heavy (indiges-table) or emulsive articles of fare, or through excessive or extremely fatiguing physical labour immediately before or after the digestion of a meal, or through the effect of a blow, hurt or mental anguish, or through excessive night keeping, and the deranged Kapha tends to defile the other fundamental principles of the organism as well.
47The deranged Kapha, by being stuffed about thigh bones, produces numbness in the locality, which results in looseness of the thighs, which are felt cold to the touch.
48The complexion assumes a dull tawny brown hue; the patient feels as if he has been packed in a wet blanket, and fever, somnolence, epileptic fits with a non-relish for food supervene. This disease is called Urustambha, while several authorities designate it as Bahya Vatam.
49An extremely painful swelling occurring about the locality between the thigh and the knee joint is called Kroshtuka Sirsha
50A false step made at the time of walking, or a long pedestrian journey may give rise to an excruciating aching pain in the insteps which is called Maha Kantakam. This disease is due to an aggravated condition of the deranged Vayu of the locality.
51An extremely aching pain produced by the deranged bodily Vayu in the toes, in the sides of thighs, and about the regions of throat and umbilicus is called Gridhrasi (sciatica).
52The disease in which the deranged Vayu and Kapha produce a complete anaesthesia in the lower limbs, which become insensible to pinches and are characterized by constant horripilation, is called Padaharsha.
53The disease in which through the agency of the deranged Vayu and Pittam being combined with blood, the patient complains of an intolerable burning sensation in the lower limbs, which is little alleviated on locomotion, is called Padadaha.