Author: Dr.Malini Bhat

The 22^nd chapter of Madhava Nidana deals with Vata Vyadhi Nidana which is the diagnosis of the diseases of the nervous system. 

रुक्ष – शीताल्प – लघ्वन्न – व्यवायातिप्रजागरैः |
विषमादुपचाराच्चदोषासृक् स्रवणादपि || १ ||
लङ्घन – प्लवनात्यध्व – व्यव्यामादिविचेष्टितैः |
धातूनां संक्षयाच्चिन्ता – शोक – रोगाति कर्षणात् || २||
वेगसन्धारणादामादभिघातादभोजनात्|
मर्माबाधाद्गजोष्ट्राश्वशीघ्रयानापतंसनात्||३||
देहे स्रोतांसि रिक्तानिपूरयित्वा अनिलो बली |
करोति विविधान् व्याधीन्सर्वाङ्गैकाङ्ग संश्रयान् || ४ ||
rukṣa – śītālpa – laghvanna – vyavāyātiprajāgaraiḥ |
viṣamādupacārāccadōṣāsr̥k sravaṇādapi || 1 ||
laṅghana – plavanātyadhva – vyavyāmādivicēṣṭitaiḥ |
dhātūnāṁ saṅkṣayāccintā – śōka – rōgāti karṣaṇāt || 2||
vēgasandhāraṇādāmādabhighātādabhōjanāt|
marmābādhādgajōṣṭrāśvaśīghrayānāpatansanāt||3||
dēhē srōtānsi riktānipūrayitvā anilō balī |
karōti vividhān vyādhīnsarvāṅgaikāṅga sanśrayān || 4 ||
These causes gives rise to various generalised diseases or to those localized to a certain part of the body which afflict the patent channels of the body –

• Excessive indulgence in eatables that are dry,cold, scanty, quickly digestible.
• Sexual intercourse
• Keeping awake at nights
• Improper treatments
• Excessive discharge of doshas and blood from the body due to administration of inappropriate (Panchakarma and other)therapies, fasting, swimming, walking long distance
• Loss or depletion of body tissues
• Worry, grief, extreme debility due to protracted diseases.
• Habit of suppression of natural urges of the body
• Production of ama (undigested intermediary metabolites)
• Trauma
• Fasting or diseases of vital organs
• Riding fast on elephants, camel, horse or falling during such riding and the like,

Force the channels (of Vata) in the body to become empty or dry which in turn aggravates Vayu which, afflicting the patent channels of the body, gives rise to various generalised diseases or to those localized to a certain part of the body. 1-4

Purvarupa (prodromal features) of Apasmara –
अव्यक्तं लक्षणं तेषां पूर्वरुपमिति स्मृतं |
आत्मरूपं तु यद् व्यक्तमपायो लघुता पुनः || ५ ||
avyaktaṁ lakṣaṇaṁ tēṣāṁ pūrvarupamiti smr̥taṁ |
ātmarūpaṁ tu yad vyaktamapāyō laghutā punaḥ || 5 ||
In their premonitory stage, diseases of the nervous system are characterized by appearance of features of the disease in milder form. The same features become significant and severe at a later stage of manifestation. When the disease of nervous system gets cured there is absence of characteristic features and lightness of the body. 5

Various Ailments caused by Vata (General clinical features) –

संकोचः पर्वणां स्तम्भो भङ्गो अस्थ्नां पर्वणामपि |
रोमहर्षः प्रलापश्च पाणि – पृष्ठ – शिरोग्रहः || ६ ||
खान्ज्य – पाङ्गुल्या – कुब्जत्वं शोथो अङ्गानामनिद्रता |
गर्भ – शुक्र – रजोनाशः स्पन्दनं गात्रसुप्तता || ७ ||
शिरो – नासाक्षि – जत्रूणां ग्रीवायश्चापि हुण्डनं |
भेदस्तोदो अर्तिराक्षेपो मुहुश्चायास एव च || ८ ||
एवंविधानि रूपाणि करोति कुपितो अनिलः |
हेतुस्थानविशेषाच्च भवेद्रोगविशेषकृत् || ९ ||
saṅkōcaḥ parvaṇāṁ stambhō bhaṅgō asthnāṁ parvaṇāmapi |
rōmaharṣaḥ pralāpaśca pāṇi – pr̥ṣṭha – śirōgrahaḥ || 6 ||
khānjya – pāṅgulyā – kubjatvaṁ śōthō aṅgānāmanidratā |
garbha – śukra – rajōnāśaḥ spandanaṁ gātrasuptatā ||7||
śirō – nāsākṣi – jatrūṇāṁ grīvāyaścāpi huṇḍanaṁ |
bhēdastōdō artirākṣēpō muhuścāyāsa ēva ca || 8 ||
ēvanvidhāni rūpāṇi karōti kupitō anilaḥ |
hētusthānaviśēṣācca bhavēdrōgaviśēṣakr̥t || 9 ||
The signs and symptoms caused by the vitiated Vata corresponding to the causes of and sites of the influence are —  

• Contractures of the body parts,
• Rigidity of joints
• Fractures or breaking pain in the bones and joints
• Horripilation
• Irrelevant speech
• Gripping sensation in the hands, back and head
• Lameness
• Rigidity in the legs
• Dwarfism
• Swelling of the body
• Sleeplessness
• Instability or loss of pregnancy
• Loss of semen and menstrual flow
• Pulsation or tickling sensation
• Numbness of the body
• Gripping and displacement of head, neck and nose
• Breaking sensation
• Pricking sensation
• Pain
• Fatigue and such other signs.

Koshtaashrita Vata Lakshana(Symptomatology of Vata when situated on the alimentary canal) –
तत्र कोष्टाश्रिते दुष्टे निग्रहो मूत्र – वर्चसोः |
ब्रध्न – हृद्रोग – गुल्मार्शः – पार्श्वशूलं च मारुते || १० ||
tatra kōṣṭāśritē duṣṭē nigrahō mūtra – varcasōḥ |
bradhna – hr̥drōga – gulmārśaḥ – pārśvaśūlaṁ ca mārutē || 10 ||
When vayu gets vitiated and localized in the kostha, it causes –

• Blockage to the passage of urine and faeces
• Enlargement of the scrotum
• Heart diseases
• Tumors of the abdomen
• Hemorrhoids
• Pain in the sides of the chest and the abdomen. 10 

सर्वाङ्गकुपिते वाते गात्रस्फुरण – भञ्जनम् |
वेदनाभिः परीताश्च स्फुटन्तीवास्य सन्धयः || ११ ||
sarvāṅgakupitē vātē gātrasphuraṇa – bhañjanam |
vēdanābhiḥ parītāśca sphuṭantīvāsya sandhayaḥ || 11 ||
The features of the vitiated vata manifest as per the location of the same. If Vata is vitiated all over the body, there could be –

• Throbbing
• Twitching
• Pulsations and
• Cutting or mild type of pain, and
• A feeling of pain in the joints as though they are bursting out and the like. 11

Signs and symptoms when vata gets lodged in the Guda (anus) and Aamashaya (stomach) –
ग्रहो विण्मूत्र – वातानां शूलाध्मानाश्म – शर्कराः |
जङ्घोरु – त्रिक – पात्पृष्टरोग – शोषौ गुदे स्थिते || १२ ||
grahō viṇmūtra – vātānāṁ śūlādhmānāśma – śarkarāḥ |
jaṅghōru – trika – pātpr̥ṣṭarōga – śōṣau gudē sthite ||12 ||
If Vata gets vitiated and occupies in the region of Guda these symptoms can be seen –

• There could be stoppage of movement of urine, faeces and flatus
• Pain and distension of the abdomen
• Formation of Urinary calculus and gravel
• Pain in the calves, thighs, pelvis, legs and back
• Emaciation

रुक् पार्श्वोदर – हृन्नाभेस्तृष्णोद्गार – विसूचिकाः |
कासः कण्ठास्यशोषश्च श्वासश्चामाशयस्थिते || १३ ||
ruk pārśvōdara – hr̥nnābhēstr̥ṣṇōdgāra – visūcikāḥ |
kāsaḥ kaṇṭhāsyaśōṣaśca śvāsaścāmāśayasthitē || 13 ||
When Vata occupies the stomach, there will be –

• Pain in the flanks, Abdomen, heart and navel
• Thirst
• Belching
• Pricking sensation in the abdomen
• Cough
• Dryness in the mouth and throat
• Dyspnea

Signs and symptoms caused by vata seated in the intestines –
पक्वाशयस्थो अन्त्रकूजं शूलाटोपौ करोति च |
कृच्छ्रमूत्र – पुरिषत्वमानाहं त्रिकवेदनाम् || १४ ||
pakvāśayasthō antrakūjaṁ śūlāṭōpau karōti ca |
kr̥cchramūtra – puriṣatvamānāhaṁ trikavēdanām || 14 ||
The vitiated Vayu afflicting the colonic area produces –

• Intestinal gurgling and pain
• Dysuria
• A difficulty in passing stool
• Or acute constipation and a
• Severe pain in the sacral region. 14

श्रोत्रादिष्विन्द्रियवधं कुर्याद्दुष्ट समीरणः |
śrōtrādiṣvindriyavadhaṁ kuryādduṣṭa samīraṇaḥ |
If Vata is vitiated in the sense organs (indriyas) it generates –

• Loss of functions of those organs

Signs and symptoms of Vata seated in the skin –
त्वग्रूक्षा स्फुटिता सुप्ता कृशा कृष्णा च तुध्यते |
आतन्यते सरागा च पर्वरुक् त्वग्गते अनिले || १५ ||
tvagrūkṣā sphuṭitā suptā kr̥śā kr̥ṣṇā ca tudhyatē |
ātanyatē sarāgā ca parvaruk tvaggatē anilē || 15 ||
If the vitiated Vata gets located in the skin (twak), it generates –

• Dryness
• Cracks
• Loss of sensation
• Thinning
• Blackish discolouration
• Pricking pain
• Stretching
• Redness
• And Pain in the joints. 15

Signs and symptoms of Vata getting into Asrk (blood) –
रुजस्तीव्राः ससन्तापा वैवर्ण्यं कृशता अरुचिः |
गात्रे चारुंषि भुक्तस्य स्तम्भश्चासृग्गते अनिले || १६ ||
rujastīvrāḥ sasantāpā vaivarṇyaṁ kr̥śatā aruciḥ |
gātrē cārunṣi bhuktasya stambhaścāsr̥ggatē anilē || 16|| 
If the vitiated Vata gets lodged in the Blood (asrk), there could be

• Severe pain
• Heightened feeling of the heat
• Discolouration
• Emaciation
• Loss of taste
• Appearance of ulcers or boils on the skin
• Stiffness of body after intake of the meals. 16

Signs and symptoms which occur when vata reaches mamsa and medas; majja and asthi –
गुर्वङ्गं तुध्यते अत्यर्थं दण्डमुष्टिहतं यथा |
सरुक् श्रमितमत्यर्थं मांस – मेदोगते अनिले || १७ ||
gurvaṅgaṁ tudhyatē atyarthaṁ daṇḍamuṣṭihataṁ yathā |
saruk śramitamatyarthaṁ mānsa – mēdōgatē anilē || 17 ||
If the vitiated Vata gets lodged in the Mamsa and Meda (Muscles and fat) it generates –

• Feeling of heaviness of the body parts associated with
• Severe pain as though one is being beaten by a stick or by fist and
• There is a feeling of extreme exhaustion. 17

भेदो अस्थिपर्वणां संधिशूलं मांस बलक्षयः |
अस्वप्नः सन्तता रुक् च मज्जास्थिकुपिते अनिले || १८ ||
bhēdō asthiparvaṇāṁ sandhiśūlaṁ mānsa balakṣayaḥ |
asvapnaḥ santatā ruk ca majjāsthikupitē anilē || 18 ||
When the vitiated Vayu gets located in the bone and bone marrow there may occur –

• Splitting pain in the bones and the small joints of the hands and feet
• Severe pain in the big joints
• Wasting of muscles and
• Depletion of strength
• Insomnia and
• Persistent pain across the body. 18

Features of vitiated vata when it reaches Shukra (semen) –
क्षिप्रं मुञ्चति बध्नाति शुक्रं गर्भमथापि वा |
विकृतिं जनयेच्चापि शुक्रस्थः कुपितो अनिलः || १९ ||
kṣipraṁ muñcati badhnāti śukraṁ garbhamathāpi vā |
vikr̥tiṁ janayēccāpi śukrasthaḥ kupitō anilaḥ || 19 ||
If the vitiated Vata affects the reproductive elements (shukra) there could be either premature or delayed expulsion of semen and foetus or abnormalities in the embryo. 19

Siragata Vata (Vata seated in the veins) –
कुर्यात् सिरागतः शूलं सिराकुञ्चन – पूरणम् |
kuryāt sirāgataḥ śūlaṁ sirākuñcana – pūraṇam |
Likewise, the vitiated Vata lodged in the Sira (veins) causes –

• Numbness
• Thinness or thickness
• Constriction (aakunchana) and
• Filling up (purana) by which the veins are bulged.

Snayugata Vata (Vata seated in the ligaments) –
बाह्याभ्यन्तरमायामं खल्लीं कौब्ज्यमथापि वा || २० ||
सर्वाङ्गैकाङ्गरोगांश्च कुर्यात् स्नायुगतो अनिलः |
bāhyābhyantaramāyāmaṁ khallīṁ kaubjyamathāpi vā || 20 || sarvāṅgaikāṅgarōgānśca kuryāt snāyugatō anilaḥ |
The vitiated vata seated in the ligaments (snayu) causes –

• Bahyaama – Opisthotonos
• Khalli – Muscular spasm of head and feet
• Kubjatva – Kyphosis and
• Other diseases affecting all the body or one particular part. 20

Sandhigata Vata (Arthritis) –
हन्ति सन्धिगतः संधीन् शूलाटोपौ करोति च || २१ ||
hanti sandhigataḥ sandhīn śūlāṭōpau karōti ca || 21 ||
The Vata seated in the joints, destroys them and causes pain and sounds. 21

Signs of Trika shula —
[स्फिगस्थ्नोः पृष्ठवंशास्थ्नोर्यः सन्धिस्तत् त्रिकं मतम् |
तत्र वातेन या पीडा त्रिकशूलं तदुच्यते ||]
[sphigasthnōḥ pr̥ṣṭhavanśāsthnōryaḥ sandhistat trikaṁ matam |
tatra vātēna yā pīḍā trikaśūlaṁ taducyatē ||]
The joint, which connects both of the bones of buttocks with the spine, has been called Trik. The pain that affects this point is called Trikshula.

(प्राणोदानौ समानश्च व्यानश्चापान एव च |
स्थानस्था मारुताः पञ्च यापयन्ति शरीरिणं ||)
(prāṇōdānau samānaścavyānaścāpāna ēva ca |
sthānasthā mārutāḥ pañca yāpayanti śarīriṇaṁ ||)
Prana,udana, Samana, Vyana and Apana – these five kinds of Vatas in their normalstate sustain the body and a perfect health. 

प्राणे पित्तावृते छर्दिर्दाह चैवोपजायते |
दौर्बल्यं सदनं तन्द्रा वैरस्यं च कफावृते || २२ ||
उदाने पित्तयुक्ते तु दाहो मूर्च्छा भ्रमः क्लमः |
अस्वेद – हर्षौ मन्दो अग्निः शीतता च कफावृते || २३ ||
स्वेद – दाहौष्ण्य – मुर्च्छाः स्युः समाने पित्तसंवृते |
कफेन सक्ते विण्मूत्रे गात्रहर्षश्च जायते || २४ ||
अपाने पित्तयुक्ते तु दहौष्ण्यं रक्तमूत्रता |
अधः काये गुरुत्वं च शीतता च कफावृते || २५ ||
व्याने पित्तावृते दाहो गात्रविक्षेपणं क्लमः |
स्तम्भनो दण्डकश्चापि शूल – शोथौ कफावृते || २६ ||
prāṇē pittāvr̥tē chardirdāhacaivōpajāyatē |
daurbalyaṁ sadanaṁ tandrā vairasyaṁ ca kaphāvr̥tē || 22 ||
udānē pittayuktē tu dāhō mūrcchā bhramaḥ klamaḥ |
asvēda – harṣau mandō agniḥ śītatā ca kaphāvr̥tē ||23 ||
svēda – dāhauṣṇya – murcchāḥ syuḥsamānē pittasanvr̥tē |
kaphēna saktē viṇmūtrē gātraharṣaśca jāyatē ||24||
apānē pittayuktē tu dahauṣṇyaṁraktamūtratā |
adhaḥ kāyē gurutvaṁ ca śītatā ca kaphāvr̥tē ||25 ||
vyānē pittāvr̥tē dāhō gātravikṣēpaṇaṁ klamaḥ |
stambhanō daṇḍakaścāpi śūla – śōthau kaphāvr̥tē || 26 ||
If prana Vata gets Aavarana (encompassed, surrounded) by Pitta there could be –

• Vomitting
• Burning sensation

If Prana Vata gets disturbed by Kapha there could be –

• Debility
• Loss of strength
• Stupor and
• Bad taste in the mouth.

Udana Vata when encompassed by Pitta generates –

• Burning sensation
• Fainting
• Giddiness and
• Exhaustion

Udana Vata when encompassed by Kapha generates –

• Loss of perspiration
• Loss of enthusiasm
• Poor digestive ability and
• Feeling of cold.

Samana Vata encompassed by Pitta, gives rise to –

• Perspiration
• Burning sensation
• Rise in temperature
• Fainting

Samana Vata encompassed by Kapha, gives rise to –

• Blockage to elimination of urine mixed with blood and
• There is heaviness of lower limbs and
• Feeling of cold.

Vyana Vata encompassed by pitta gives rise to –

• Burning sensation
• Abnormal movements of the body parts
• Exhaustion

Vyana Vata encompassed by Kapha, it leads to –

• Stiffness of the body like a log,
• Pain and
• Swelling 22 – 26

General Features of Aakshepaka(Convulsions) –
यदा तु धमनीः सर्वाः कुपितो अभ्येति मारुतः |
तदा अक्षिपत्याशु मुहुर्मुहुर्देहं मुहुश्चरः || २७ ||
मुहुर्मुहुश्चाक्षेपणादाक्षेपक इति स्मृतः |
yadā tu dhamanīḥ sarvāḥ kupitōabhyēti mārutaḥ |
tadā akṣipatyāśu muhurmuhurdēhaṁ muhuścaraḥ || 27 ||
muhurmuhuścākṣēpaṇādākṣēpaka iti smr̥taḥ |
When the vitiated Vata is localized in all the blood vessels (dhamanis) of the body,it generates –

• Quick and frequent jerky movements of the body

This condition has been identified as the disease Akshepaka (convulsions). 27

Apatantraka and Apatanaka –
क्रुद्धः स्वैः कोपनैर्वायुः स्थानादूर्ध्वम् प्रवर्तते ||२८ ||
पीडयन् हृदयं गत्वा शिरः शङ्खौ च पीडयन् |
धनुर्वन्न मयेद्गात्राण्याक्षिपेन्मोहयेत्तदा || २९ ||
स कृच्छ्रादुच्छवसेच्चापि स्तब्धाक्षो अथ निमीलकः |
कपोत इव कूजेच्च निःसंज्ञ सो अपतन्त्रकः || ३० ||
kruddhaḥ svaiḥ kōpanairvāyuḥ sthānādūrdhvam pravartatē ||28 ||
pīḍayan hr̥dayaṁ gatvā śiraḥ śaṅkhau ca pīḍayan |
dhanurvanna mayēdgātrāṇyākṣipēnmōhayēttadā|| 29 ||
 sa kr̥cchrāducchavasēccāpi stabdhākṣō athanimīlakaḥ |
kapōta iva kūjēcca niḥsañjña sō apatantrakaḥ || 30 ||
Vayu,on getting provoked due to its own reasons moves out of its place and moves to the heart and head causing severe pain and bending the body like a bow shaking and making it swoon. The individual then breathes with difficulty with straight looks or closed eyes. He makes sounds like a pigeon and loses his senses. This condition is called Apatantraka. 28-30

दृष्टिं संस्तभ्य संज्ञां च हत्वा कण्ठेन कूजति |
हृदि मुक्ते नरः स्वास्थ्यं याति मोहं वृते पुनः || ३१ ||
वायुना दारुणं प्राहुरेके तमपतानकम् |
dr̥ṣṭiṁ sanstabhya sañjñāṁ cahatvā kaṇṭhēna kūjati |
hr̥di muktē naraḥ svāsthyaṁ yāti mōhaṁ vr̥tē punaḥ ||31||
vāyunā dāruṇaṁ prāhurēkē tamapatānakam |
When Vayu grips the heart, the patient develops a

• Rigid look
• Loses his senses
• And makes sounds in the throat.

When it loosens the grip, he becomes free from disease and when it grips again, he would go into syncope again. This disease is called Apatanaka. It is a severe disease. 31

Dandapataanaka (Plenosthothonos) –
कफान्वितो भृशं वायुस्तस्वेव यदि तिष्टति || ३२ ||
दण्डवत् स्तंभयेद्देहं स ङ्गतु दण्डापतानकः |
kaphānvitō bhr̥śaṁ vāyustasvēvayadi tiṣṭati || 32 ||
daṇḍavat stambhayēddēhaṁ sa ṅgatu daṇḍāpatānakaḥ |
If vata settles in these arteries suddenly along with kapha, it makes the body rigid like a stick or a log which disease is called Dandapataanaka. 32

Dhanustambha (Tetanus) –
धनुस्तुल्यं नमेध्यस्तु स धनुःस्तम्भ संज्ञकः || ३३ ||
dhanustulyaṁ namēdhyastu sa dhanuḥstambhasañjñakaḥ || 33 ||
When the same etiological factors as above bend the body like a bow, the condition is identified as Dhanustambha. 33

Specific Symptomatology of Abhyantarama and Bahirayama –
अन्गुली – गुल्फ – जठर – ह्रुद्वक्षो – गलसंश्रितः |
स्नायुप्रतानमनिलो यदा अक्षिपति वेगवान् || ३४ ||
विष्टब्धाक्षः स्तब्ध हनुर्भग्नपार्श्वः कफं वमन् |
अभ्यन्तरं धनुरिव यदा नमति मानवम् || ३५ ||
तदा अस्याभ्यन्तरायामं कुरुते मारुतो बली |
angulī – gulpha – jaṭhara -hrudvakṣō – galasanśritaḥ |
snāyupratānamanilō yadā akṣipati vēgavān ||34||
viṣṭabdhākṣaḥ stabdhahanurbhagnapārśvaḥ kaphaṁ vaman |
abhyantaraṁ dhanuriva yadā namati mānavam || 35 ||
tadā asyābhyantarāyāmaṁ kurutēmārutō balī |
When the provoked and virulent Vayu afflicts the muscles and tendons of the chest and the neck, it gives rise to convulsions. The patient develops a

• Staring look
• Lock jaw
• Pain on both the sides of the chest (that could even be fractured).

Moreover there is mucoid vomiting and the patient bends like a bow. The condition has been identified as Abyantarayaama. 34-35

बाह्यस्नायुप्रतानस्थो बाह्यायामं करोति च || ३६ ||
तमसाध्यं बुधाः प्राहुर्वक्षः – कत्युरुभञ्जनम् ||
bāhyasnāyupratānasthō bāhyāyāmaṁ karōti ca || 36||
tamasādhyaṁ budhāḥ prāhurvakṣaḥ – katyurubhañjanam |
Similarly when the provoked Vayu afflicts the external parts of the muscles and tendons,it bends the body dorsally. It may be associated with –

• Fractures of the chest, the pelvis and thighs

This condition is called Bahyayaama and in the opinion of experts this condition is incurable. 36

Signs of Kubja –
(हृदयं यदि वा पृष्ठमुन्नतं क्रमतः सरुक् |
क्रुद्धो वायुर्यदा कुर्यात् तदा तं कुब्जमादिशेत् ||)
(hr̥dayaṁ yadi vā pr̥ṣṭhamunnataṁ kramataḥ saruk |
kruddhō vāyuryadā kuryāt tadā taṁ kubjamādiśēt ||)
When the heart or chest area or the back gradually bulges up into a lump and there is a severe pain there owing to the aggravated vata, this morbid condition is identified as Kubja.

कफ – पित्तन्वितो वायुर्वायुरेव च केवलः || ३७ ||
कुर्यादक्षेपकं त्वन्यं चतुर्थमभिघातजम् |
kapha – pittanvitō vāyurvāyurēva ca kēvalaḥ || 37 ||
kuryādakṣēpakaṁ tvanyaṁ caturthamabhighātajam |
The fourth level of the disease Aakshepaka is produced due to the vitiation ofeither the kapha or pitta vitiated independently or due to the aggravated Vata only. However, the disease is originated through injury.

Incurability of Apataanaka –
गर्भपातनिमित्तश्च शोणिताति स्रवाच्च यः ||३८||
अभिघातनिमित्तश्च न सिद्द्यत्यपतानकः |
garbhapātanimittaśca śōṇitāti sravācca yaḥ ||38||
abhighātanimittaśca na siddyatyapatānakaḥ |
Due to trauma to the parts of the body, Vata associated with kapha and pitta or even alone generates a fourth kind of Akshepaka apataanaka that is generated by abortions, excessive haemorrhage and trauma. It is incurable. 38

Pakshavadha (Hemiplegia)
गृहीत्वा अर्धं तनोर्वायुः सिराः स्नायुर्विशोष्य च || ३९ ||
पक्षमन्यतरं हन्ति सन्धिबन्धान् विमोक्षयन् |
कृत्स्नो अर्ध कायस्तस्य स्यादकर्मण्यो विचेतनः || ४० ||
एकाङ्गरोगं तं केचिदन्ये पक्षवधं विदुः |
सर्वाङ्गरोगं तद्वच्च सर्वकायाश्रिते अनिले || ४१||
gr̥hītvā ardhaṁtanōrvāyuḥ sirāḥ snāyurviśōṣya ca || 39 ||
pakṣamanyataraṁ hanti sandhibandhān vimōkṣayan |
kr̥tsnō ardha kāyastasya syādakarmaṇyō vicētanaḥ || 40 ||
 ēkāṅgarōgaṁ taṁ kēcidanyē pakṣavadhaṁviduḥ |
sarvāṅgarōgaṁ tadvacca sarvakāyāśritē anilē || 41||
When Vata affects only the half part of the body and dries up the veins and ligaments of that half, and destroys either the left or right side loosening the firmness of the joints, the particular half of the body becomes troublesome and inactive with loss of sense.

Some experts identify this disease as the ekanga roga while others name it Pakshavadha(Hemiplegia). The same pathogenesis takes place when Vata occupies the complete body. However, this condition is identified as Sarvanga roga. 39-41

Association of Pitta and Kapha in Pakshvadha and the prognosis of this disease –
दाह – सन्ताप – मूर्च्छाः स्युर्वायो पित्तसमन्विते |
शैत्य – शोथ – गुरुत्वानि तस्मिन्नैव कफान्विते || ४२ ||
शुद्धवातहतं पक्षं कृच्छ्रसाध्यतमं विदुः |
साध्यमन्येन संयुक्तमसाध्यं क्षयहेतुकम् || ४३ ||
dāha – santāpa -mūrcchāḥ syurvāyō pittasamanvitē |
śaitya – śōtha – gurutvāni tasminnaiva kaphānvitē ||42 ||
śuddhavātahataṁ pakṣaṁ kr̥cchrasādhyatamaṁ viduḥ |
sādhyamanyēna sanyuktamasādhyaṁ kṣayahētukam || 43 ||
If in the above diseases, vata is associated with pitta, there could be –

• Burning sensation
• Increase of temperature of the affected parts and
• Fainting

If the case is associated with kapha,

• Cold
• Swelling and
• Heaviness of the affected parts appear.

Pakshvadha generated by vata alone is difficult to cure, that generated by vata associated with other doshas is easy to cure. However, the case that associates with emaciation or wasting is impossible to manage. 42-43

(गर्भिणी – सूतिका – बाल – वृद्ध – क्षीणेष्वसृक् स्रुते |
पक्षाघातं परिहरेत् वेदनारहितो यदि ||)
(garbhiṇī – sūtikā – bāla – vr̥ddha – kṣīṇēṣvasr̥k srutē |
pakṣāghātaṁ pariharēt vēdanārahitō yadi ||)
(The following cases of disease could be refused treatment:

• Pakshaghata in the pregnant
• In the woman who has only recently delivered
• The Pakshaghata in advanced stage
• In emaciated persons and
• The Pakshaghata accompanied with heavy bleeding and that in which patient has lost sense at all in the affected limbs.

Ardita vata (facial paralysis/ Bell’s palsy) –
उच्चैर्व्याहरतो अत्यर्थं खादतः कठिनानि वा |
हसतो जृम्भतो वा अपि भाराद्विषमशायिनः || ४४ ||
शिरो – नासौष्ट – चिबुक – ललाटेक्षणसन्धिगः |
अर्दयत्यनिलो वक्त्रमर्दितं जनयत्यतः |
uccairvyāharatō atyarthaṁ khādataḥ kaṭhināni vā |
hasatō jr̥mbhatō vā api bhārādviṣamaśāyinaḥ || 44 ||
śirō – nāsauṣṭa – cibuka – lalāṭēkṣaṇasandhigaḥ |
ardayatyanilō vaktramarditaṁ janayatyataḥ |
When a person shout persistently at the top of his voice, regularly eats heavy articles of diet, indulges in regular laughing or yawning, if he carries heavy load on the head, lies on uneven ground, vayu in relation of the head, nose,lips, chin, forehead, and the eyes afflicts his face and produces facial paralysis called Ardita. 44

वक्रीभवति वक्त्रार्धं ग्रीवा चाप्यपवर्तते || ४५ ||
शिरश्चलति वाक् सङ्गो नेत्रादीनां च वैकृतं |
ग्रीवा – चिबुक – दन्तानां तस्मिन् पार्श्वे च वेदना || ४६ ||
vakrībhavati vaktrārdhaṁ grīvā cāpyapavartatē || 45 ||
śiraścalati vāk saṅgō nētrādīnāṁ ca vaikr̥taṁ |
grīvā – cibuka – dantānāṁ tasmin pārśvē ca vēdanā || 46 ||
Because of the above condition, the person develops

• irregularity or asymmetry of the face,
• the angles of his mouth are bent
• his neck is turned outwards.
• He starts shaking the head
• He becomes unable to talk.

Moreover,there are abnormalities of movement of the eyes, neck, chin and jaws associated with pain. 45-46 

यस्याग्रजो रोमहर्षो वेपथुर्नेत्रमाविलम् |
वायुरुर्ध्वं त्वचि स्वापस्तोदो मन्या – हनुग्रहः ||
तमर्दितमिति प्राहुर्व्याधिं व्याधि विचक्षणाः |
yasyāgrajō rōmaharṣō vēpathurnētramāvilam |
vāyururdhvaṁ tvaci svāpastōdō manyā – hanugrahaḥ ||
tamarditamiti prāhurvyādhiṁ vyādhi vicakṣaṇāḥ |
The prodromal features of Ardita are –

• Horripilation
• Tremors
• Accumulation of dirt in the eyes
• Loss of sensation of the skin
• Pricking pain
• Stiffness of the neck and the lower jaw.

Expert clinicians call this disease Ardita.

Incurability of arditavata (Bell’s palsy) –
क्षीणस्यानिमिषाक्षस्य प्रसक्ताव्यक्तभाषिणः || ४७ ||
–न सिध्यत्यर्दितं गाढं त्रिवर्षं वेपनस्य च |
kṣīṇasyānimiṣākṣasya prasaktāvyaktabhāṣiṇaḥ || 47 ||
na sidhyatyarditaṁ gāḍhaṁ trivarṣaṁ vēpanasya ca |
If the patient of this disease is emaciated, he is not able to close the eye lid of the affected part, utters words with difficulty and if the disease is deep rooted and has crossed a duration of three years after onset, he cannot be relieved of his ailment. 47

The temporary relief in convulsion (Periodicity and remission) –
गते वेगे भवेत् स्वास्थ्यं सर्वेष्वाक्षेपकादिषु || ४८ ||
gatē vēgē bhavēt svāsthyaṁ sarvēṣvākṣēpakādiṣu || 48 ||
In all types of convulsive disorders (akshepaka) described above, the patients is considered as have regained when the episodes of attack pass off. 48

Hanugraha (Lock jaw) (Dislocation ofjaw) –
जिह्वानिर्लेखनाच्छुष्कभक्ष्णादभिघाततः |
कुपितो हनुमूलस्थः स्रंसयित्वा अनिलो हनुम् || ४९ ||
करोति विवृतास्यत्वमथवा संवृतास्यताम् |
हनुग्रहः स तेन स्यात् कृच्छ्राच्चवर्णभाषणम् || ५० ||
jihvānirlēkhanācchuṣkabhakṣṇādabhighātataḥ |
kupitō hanumūlasthaḥ sransayitvā anilō hanum || 49 ||
karōti vivr̥tāsyatvamathavā sanvr̥tāsyatām |
hanugrahaḥ sa tēna syāt kr̥cchrāccavarṇabhāṣaṇam || 50 ||
Indulgence in putting out the tongue too much for long periods, eating dry foods, and also due to trauma, the vayu situated at the temporomandibular joint of the jaw turns vitiated and dislocates the mandible making the mouth either remain open or closed. The condition is called Hanugraha (dislocation of the jaw) and it causes inability to masticate and to utter voice. 49-50

Manyastambha (Torticollis/ Wry Neck) –
दिवास्वप्नासनस्थान – विवृतोर्ध्वनिरीक्षणैः |
divāsvapnāsanasthāna – vivr̥tōrdhvanirīkṣaṇaiḥ |

Jihvaastambha (Glossal Palsy) –
मन्यास्तम्भं प्रकुरुते स एव श्लेष्मणा आवृतः || ५१ ||
manyāstambhaṁ prakurutē sa ēva ślēṣmaṇā āvr̥taḥ || 51 ||
Vata getting provoked either alone or in association with kapha by sleeping in daytime, irregular postures, looking in upward direction for long periods generates Manyastambha that is stiffness of the neck. 51

वाग्वाहिनीसिरासंस्थो जिह्वां स्तम्भयते अनिलः |
जिह्वास्तम्भः स तेनान्नपानवाक्येष्वनीशता || ५२ ||
vāgvāhinīsirāsansthō jihvāṁ stambhayatē anilaḥ |
jihvāstambhaḥ sa tēnānnapānavākyēṣvanīśatā || 52 ||
Likewise,the vata generates Jihvastambha (loss of movement of the tongue) affecting the tendons/ nerve near the vocal cord and because of this the person develops an inability to chew, drink and to talk. 52

Siragraha –
रक्तमाश्रित्य पवनः कुर्यान्मूर्धधराः सिराः |
रूक्षाः सवेदनाः कृष्णाः सो असाध्यः स्यात् सिराग्रहः || ५३ ||
raktamāśritya pavanaḥ kuryānmūrdhadharāḥ sirāḥ | 
rūkṣāḥ savēdanāḥ kr̥ṣṇāḥ sō asādhyaḥ syāt sirāgrahaḥ ||
The Vata promoted, being localized in the blood and blood vessels of the head, causes them to shrink, become painful and black. This condition known as Siragraha and it is difficult to manage. 53

Grdhrasi (Sciatica) –
स्फिक्क्पूर्वा कटि – पृष्टोरु – जानु – जङ्घा – पदं क्रमात् |
गृध्रसी स्तम्भरुक्तौदैर्ग्रुह्नाति स्पन्दते मुहुः || ५४ ||
वाताद् वातकफात् तन्द्रा – गौरवारोचकान्विता |
sphikkpūrvā kaṭi – pr̥ṣṭōru – jānu – jaṅghā – padaṁ kramāt |
gr̥dhrasī stambharuktaudairgruhnāti spandatē muhuḥ || 54 ||
vātād vātakaphāt tandrā – gauravārōcakānvitā |
The pain in sciatica (grdhrasi) starts from

• Buttock
• The waist or the back and

Radiates gradually towards the –

• Thigh
• The knee
• The leg and
• The foot.

Rigidity and throbbing are also experienced intermittently if the grdrasi has occurreddue only to vata. If it has developed due to association with kapha, therecould also be symptoms like stupor, heaviness, and anorexia. 54

(वातजायां भवेत्तोदो देहस्यापि प्रवक्रता |
जानुकट्युरुसन्धीनां स्फुरणं स्तब्धता भृशम् || ५५ ||
वात – श्लेष्मोद्भवायां तु निमित्तं वह्निमार्दवम् |
तन्द्रा मुखप्रसेकश्च भक्तद्वेषस्तथैव च || ५६ ||)
(vātajāyāṁ bhavēttōdō dēhasyāpi pravakratā |
jānukaṭyurusandhīnāṁ sphuraṇaṁ stabdhatā bhr̥śam || 55 ||
vāta – ślēṣmōdbhavāyāṁ tu nimittaṁ vahnimārdavam |
tandrā mukhaprasēkaśca bhaktadvēṣastathaiva ca || 56 ||)
If there is vitiation of Vata alone in Gridhrasi these are the symptoms seen –

• Pricking pain
• Irregular shape of the body parts.
• Throbbing and
• Severe stiffness of joints of knee and waist.

However, when it is associated with the vitiated kapha as well, there could be symptoms like

• Poor digestive ability
• Stupor
• Salivation and

Aversion to eatables. 55 – 56

Visvaachi (Radio – ulnar paralysis) –
प्रत्यङ्गुलीनां याः कण्डरा बाहुपृष्टतः || ५७||
बाह्वोः कर्मक्षयकरी विश्वाची चेति सोच्यते |
pratyaṅgulīnāṁ yāḥ kaṇḍarā bāhupr̥ṣṭataḥ || 57|| 
bāhvōḥ karmakṣayakarī viśvācī cēti sōcyatē |
Visvaachi or the brachial (related to arm) neuralgia is affection of the dorsal aspect of the arm including tendons/ nerves of the surface of the fingers, the arms and the shoulders. It results in the loss of function of the arm. 57

Krostukashirsha (inflamed knee) –
वातशोणितजः शोथो जानुमध्ये महारुजः || ५८||
ज्ञेयः क्रोष्तुकशीर्षस्तु स्थूलः क्रोष्तुक शीर्षवत् |
vātaśōṇitajaḥ śōthō jānumadhyē mahārujaḥ || 58|| 
jñēyaḥ krōṣtukaśīrṣastu sthūlaḥ krōṣtuka śīrṣavat |
The vata and rakta getting affected together generate a painful swelling in the knee joint. Because of this condition, the limb (knee) resembles the head of a fox (that is krostuka). This disease is known as Krostuka Shirsha. It could be identified as the synovitis of the knee joint. 58

Khanja (limp/monoplegia) And Pangu(Paraplegia) –
वायुः कट्याश्रितः सक्थ्नः कण्डरामाक्षिपेध्यदा || ५९ ||
खञ्जस्तदा भवेज्जन्तुः पङ्गुः सक्थनोर्द्वयोर्वर्धात् |
vāyuḥ kaṭyāśritaḥ sakthnaḥ kaṇḍarāmākṣipēdhyadā || 59 || 
khañjastadā bhavējjantuḥ paṅguḥ sakthanōrdvayōrvardhāt |
Vata affecting the tendon/nerves of the lumbar region or the waist makes a man lame.It is identified as Khanja if one leg is affected. It is called pangu if both legs are affected. 59

Kalayakhanja (Lathyrism) –
प्रक्रमन् वेपते यस्तु खन्जन्निव च गच्छति || ६०||
कलायखन्जं तं विध्यान्मुक्तसन्धि प्रबन्धनम् |
prakraman vēpatē yastu khanjanniva ca gacchati || 60|| 
kalāyakhanjaṁ taṁ vidhyānmuktasandhi prabandhanam |
If person tremors like a khanja and his joints have loosened, he is considered as one suffering from the disease identified as Kalaya khanja. 60

Vatakantaka (Ankle sprain) –
रुक् पादे विषमे न्यस्ते श्रमाद्वा जायते यदा || ६१||
वातेन गुल्फमाश्रित्य तमाहुर्वातकण्टकं |
ruk pādē viṣamē nyastē śramādvā jāyatē yadā || 61||
vātēna gulphamāśritya tamāhurvātakaṇṭakaṁ |
When the legs are kept in an irregular pose due to strain, the vata gets provoked. It affects the ankle joints causing pain there. This condition has been identified as Vata kantaka. 61

Pada daha (burning feet) –
पादयोः कुरुते दाहं पित्तासृक् सहितो अनिलः || ६२ ||
विशेषतश्चङ्गक्रमतः पाददाहं  तमादिशेत् |
pādayōḥ kurutē dāhaṁ pittāsr̥k sahitō anilaḥ || 62 || 
viśēṣataścaṅgakramataḥ pādadāhaṁ  tamādiśēt |
Indulgence  in excessive walk provokes Vata. This vata gets associated with kapha and rakta and generates burning sensation in the soles of the feet. This condition has been identified as Pada Daha. 62

Padaharsha (Horripilation of the feet)–
हृष्येते चरणौ यस्य भवेतां चापि सुप्तकौ || ६३ ||
पादहर्षः स विज्ञेयः कफ – वातप्रकोपतः |
hr̥ṣyētē caraṇau yasya bhavētāṁ cāpi suptakau || 63 || 
pādaharṣaḥ sa vijñēyaḥ kapha – vātaprakōpataḥ |
One who feels the sensation of tingling in the feet associated with numbness is identified as the one suffering from Padaharsha. This disease is produced due to the aggravation of the kapha and Vata. 63

Avabahuka –
अंसदेशास्तिथो वायुः शोषयेदंसबन्धनम् ||६४ ||
ansadēśāstithō vāyuḥ śōṣayēdansabandhanam ||64 ||
The vata located in the region of the shoulder generates emaciation of muscles of the shoulder joints. This condition has been identified as Avabahuka.

Amsasosha –
सिराश्चाकुन्ज्य तत्रस्थो जनयेदवबाहुकम् |
sirāścākunjya tatrasthō janayēdavabāhukam |
Amsasosha is similarly a condition that emerges due to contraction of the tendons/nerves of that amsa desha (the shoulder region).

Muka, Minmina and gadgada (Dumbnessetc.) –
आवृत्य वायुः सकफो धमनीःशब्दवाहिनीः || ६५ ||
नरान् करोत्यक्रियकान्मूक- मिन्मिन – गद्गदान् |
āvr̥tya vāyuḥ sakaphō dhamanīḥśabdavāhinīḥ || 65 ||
narān karōtyakriyakānmūka- minmina – gadgadān |
The vata getting provoked along with kapha moves to the dhamanis of the vocal cord and subsequently turn the person unable to talk or make him talk through his nose. It could also generate stammering. 65

Tuni –
अधो या वेदना याति वर्चो – मूत्राशयोत्थिता || ६६ ||
भिन्दतीव गुदोपस्थं सा तूनि नाम नामतः |
adhō yā vēdanā yāti varcō -mūtrāśayōtthitā || 66 ||
bhindatīva gudōpasthaṁ sā tūni nāma nāmataḥ |
Tuni is the disease, in which severe pain is produced in the rectum, urinary bladder and the penis. The pain moves downwards. 66

Pratituni –
गुदोपस्थोत्थिता या तु प्रतिलोमं प्रधाविता || ६७ ||
वेगैः पक्वाशयं याति प्रतितूनिति सोच्यते |
gudōpasthōtthitā yā tu pratilōmaṁpradhāvitā || 67 ||
vēgaiḥ pakvāśayaṁ yāti pratitūniti sōcyatē |
The pain originating in the anus and genitalia and radiating upwards to the intestine has been identified as the disease Pratituni.

Aadhmana (General tympanitis) and Pratyaadhmana(Gastric tympanitis) –
साटोपमत्युग्ररुजमाध्मातमुदरं भृशम् || ६८ ||
आधमानमिति तं विध्याद् घोरं वातनिरोधजम् |
sāṭōpamatyugrarujamādhmātamudaraṁ bhr̥śam || 68 ||
ādhamānamiti taṁ vidhyād ghōraṁ vātanirōdhajam |
The disease aadhamana is a condition that is signified as the blockage to the movement of the flatus. This condition gives rise to the gurgling noise in the intestines. Moreover, there is severe pain and distension of the abdomen. 68

विमुक्त्तपार्श्वहृदयं तदेवामाशयोत्थितम् || ६९ ||
प्रत्याध्मानं विजानीयात् कफव्याकुलितानिलम् |
vimukttapārśvahr̥dayaṁtadēvāmāśayōtthitam || 69 ||
pratyādhmānaṁ vijānīyāt kaphavyākulitānilam |
The vitiated vata associated with Kapha causing the condition in the region of the stomach but away from the region of the heart and the flanks is known as symptom of Pratyaadhmana.

Asthila –
नाभेरधस्तात् सञ्जातः संचारी यदि वा अचलः || ७० ||
अष्ठीलावाद्घनो ग्रन्थिरुर्ध्वमायत उन्नतः |
वाताष्तीलां विजानियाद्वहिर्मार्गावरोधिनीं || ७१ ||
nābhēradhastāt sañjātaḥ sañcārīyadi vā acalaḥ || 70 ||
aṣṭhīlāvādghanō granthirurdhvamāyata unnataḥ |
vātāṣtīlāṁ vijāniyādvahirmārgāvarōdhinīṁ || 71 ||
When a stony hard globular gland enlarges upwards significantly and produces a fixed or mobile swelling below the umbilicus this condition is identified as Vatasthila.; it produces obstruction in passing urine and faecal matter. 70-71

एतामेव रुजोपेतां वात – विण्मूत्ररोधिनीं |
प्रत्यष्तीलामिति वदेज्जठरे तिर्यगुत्थिताम् || ७२||
ētāmēva rujōpētāṁ vāta – viṇmūtrarōdhinīṁ|
pratyaṣtīlāmiti vadējjaṭharē tiryagutthitām || 72||
When the same is associated with pain along with the obstruction to the passage of flatus, stool and urine, it is known as Pratyasthila. This enlargement is also irregular,and it is in oblique direction towards the abdomen. 72

Hindrance of Urination due to disturbance of Vata –
मारुते अनुगुणे बस्तौ मूत्रं सम्यक् प्रवर्तते |
विकारा विविधाश्चात्र प्रतिलोमे भवन्ति च || ७३ ||
mārutē anuguṇē bastau mūtraṁ samyak pravartatē |
vikārā vividhāścātra pratilōmē bhavanti ca || 73 ||
When the vata has its normal downward movement called anuloma, it makes for proper elimination of urine from the urinary bladder. However, it generates a painful disorder if it moves in the upward direction called Pratiloma. 73

Kampavaata (Shaking palsy) –
सर्वाङ्गकम्पः शिरसो वायुर्वेपथुसंज्ञकः |
sarvāṅgakampaḥ śirasō vāyurvēpathusañjñakaḥ |
Vepathu is that condition generated by Vata in which all the parts of the body including head have tremors.

Khallivata –
खल्ली तु पाद – जङ्घोरु – करमूलावमोटनी || ७४ ||
khallī tu pāda – jaṅghōru -karamūlāvamōṭanī || 74 ||
Khalli is the condition in which there could be distortion of the legs, calves, chest and arms. 74

Urdhva vaata (Over belching) –
(अधः प्रतिहतो वायुः श्लेष्मणा मारुतेन वा |
करोत्युद्गारबाहुल्यमूर्ध्ववातः स उच्यते || ७५||)
(adhaḥ pratihatō vāyuḥ ślēṣmaṇāmārutēna vā |
karōtyudgārabāhulyamūrdhvavātaḥ sa ucyatē || 75||)
The vata being obstructed in its downward movement either by kapha or by itself begins to move upwards and generates severe belching. This condition has been identified as Urdhva vata. 75

Knowing the remaining Vata Disorders –
स्थाननामानुरूपैश्च लिङ्गैः शेषान् विनिर्दिशेत् |
सर्वेष्वेतेषु संसर्गं पित्ताध्यैरूपलक्षयेत् ||७६ ||
sthānanāmānurūpaiśca liṅgaiḥ śēṣānvinirdiśēt |
sarvēṣvētēṣu sansargaṁ pittādhyairūpalakṣayēt ||76 ||
Features of the varieties of vata related diseases (vyadhis) that has not been discussed above are diagnosed considering their site of affliction and name, as well as their association with vata, pitta and other doshas. 76

Curability and incurability of certain Vata disorders –
हनुस्तम्भार्दिताक्षेप – पक्षाघातापतानकाः |
कालेन महता वाता यत्नात् सिध्यन्ति वा न वा || ७७ ||
नरान् बलवतस्त्वेतान् साधयेन्निरुपद्रवान् |
hanustambhārditākṣēpa – pakṣāghātāpatānakāḥ |
kālēna mahatā vātā yatnāt sidhyanti vā na vā || 77 ||
narān balavatastvētān sādhayēnnirupadravān |
Lockjaw (Manyastambha), Facial paralysis (Ardita), convulsive disorders(Aakshepaka), hemiplegia (Pakshaghata) and apataanaka (tetanus?) and other vatika diseases may be managed only after a careful management. Even then, they may not be cured. Hence, patients with good general condition and no complications should only be taken up by the wise physicians. 77

Upadrava (complications) of Vata disorders –
विसर्प – दाह – रुक्सङ्ग – मूर्च्छारुच्याग्निमार्दवैः ||७८ ||
क्षीणमांसबलं वाता घ्नन्ति पक्षावधादयः |
visarpa – dāha – ruksaṅga – mūrcchārucyāgnimārdavaiḥ ||78 ||
kṣīṇamānsabalaṁ vātā ghnanti pakṣāvadhādayaḥ |
The Vata disorders such as Pakshavadha could turn fatal if the patient also develops such symptoms as

• Visarpa- Eryiseplas
  
• Burning sensation
• Severe Pain
• Non elimination of flatus, Faeces, urine andthe like
• Fainting
• Anorexia
• Poor digestive capacity
• Wasting of muscles
• Loss of strength. 78

”शूनं सुप्तत्वचं भग्नं कम्पाध्माननिपिडितं |
रुजार्तिमन्तं च नरं वातव्याधिर्विनाशयेत् ‘’|| ७९ ||
”śūnaṁ suptatvacaṁ bhagnaṁ kampādhmānanipiḍitaṁ |
rujārtimantaṁ ca naraṁ vātavyādhirvināśayēt ‘’|| 79 ||
These are to be considered as fatal conditions –

• Swelling of the body
• Loss of tactile sensation
• Fractures of Joints
• Tremors
• Flatulence
• Or severe pain found in Vata Vyadhi

Normalcy of Vata –
अव्याहतगतिर्यस्य स्थानस्थः प्रकृतिस्थितः |
वायुः स्यात् सो अधिकं जीवेद्वीतरोगः समाः शतम् || ८० ||
avyāhatagatiryasya sthānasthaḥ prakr̥tisthitaḥ |
vāyuḥ syāt sō adhikaṁ jīvēdvītarōgaḥ samāḥ śatam || 80 ||
If vata having powers of unlimited movement remains in its normal locations, it helps man to live a hundred years without any disease. 80

इति श्रीमाधवकरविरचिते माधवनिदाने वातव्याधिनिदानं समाप्तम् ||22 ||
iti śrīmādhavakaraviracitē mādhavanidānē vātavyādhinidānaṁ samāptam||22||
Thus concludes the chapter on Vata Vyadhi

The 21st chapter of Madhava Nidana deals with Apasmara which is epilepsy.

Continue reading Chapter 21 – Apasmara Nidana