Chapter 13 — Svara Bheda Nidanam

The 13th chapter of Madhava Nidanam is Svara Bheda Nidanam that is it deals with Hoarseness of Voice. Hoarseness (dysphonia) is when your voice sounds raspy, strained or breathy. The volume (how loud or soft you speak) may be different and so may the pitch (how high or low your voice sounds). There are many causes of hoarseness but, fortunately, most are not serious and tend to go away after a short time.

Causes of Svara Bheda — 

अत्युच्चभाषण – विषाध्ययनाभिघात – संदूषणैः प्रकुपिताः पवनादयस्तु |
स्रोतःसु ते स्वरवहेशु गताः प्रतिष्ठां हन्युः स्वरं भवति चापि हि षड्विधः सः || १ ||
(वातादिभिः पृथक् सर्वैर्मेदसा च क्षयेण च | )

atyuccabhāṣaṇa – viṣādhyayanābhighāta – sandūṣaṇaiḥ prakupitāḥ pavanādayastu |
srōtaḥsu tē svaravahēśu gatāḥ pratiṣṭhāṁ hanyuḥ svaraṁ bhavati cāpi hi ṣaḍvidhaḥ saḥ || 1 ||
(vātādibhiḥ pr̥thak sarvairmēdasā ca kṣayēṇa ca | )

The Vata and other doshas are vitiated due to the following reasons:

  • Ati Uchha Bhashana — Speaking in a loud voice,
  • Visha — Consuming Poison
  • Adhyanana — Reading loudly and
  • Abhighata — By being injured.

The vata subsequently enter the channels that are responsible for speech and causes disturbance to the svara (vocal cord). This problem is of six varieties,

  • Three from each of the three doshas
  • One from combination of all the three
  • Fifth from medas (adipose tissue)
  • Sixth from kshaya that is depletion of body tissues. 1
Vata Type of Svara Bheda –

वातेन कृष्ण नयनानन – मूत्र – वर्चा भिन्नं शनैर्वदति गर्दभवत् खरं च |

vātēna kr̥ṣṇa nayanānana – mūtra – varcā bhinnaṁ śanairvadati gardabhavat kharaṁ ca |

In the vatika type of Svara Bheda, the patient’s

  • Krishna Nayana, Aanana, Mutra and Varcha — Eyes, face, urine and faeces become blackish
  • Khara Shabda — His speech becomes hoarse, slow and rough
  • Gadarbhavat vadati — And it sounds like the braying of an ass.
Pitta type of Svara Bheda –

पित्तेन पीत नयनानन – मूत्र – वर्चा ब्रूयाद्गलेन स च दाह समन्वितेन || २ ||

pittēna pīta nayanānana – mūtra – varcā brūyādgalēna sa ca dāha samanvitēna || 2 ||

In the paittika type of Svara Bheda, the patient’s

  • Eyes, face urine and faeces turn yellowish
  • While speaking he gets burning sensation in the throat. 2
Kapha Type of Svarabheda –

ब्रूयात् कफेन सततं कफरुद्धकण्ठः स्वल्पं शनैर्वदति चापि दिवा विशेषात् |

brūyāt kaphēna satataṁ kapharuddhakaṇṭhaḥ svalpaṁ śanairvadati cāpi divā viśēṣāt |

In the kaphaja type, the following symptoms have been noted:

  • Blockage to the throat by the kapha or sputum
  • Slow and very little speech.

However, the speech is somewhat better during the daytime.

Sannipata Type of Svara Bheda –

सर्वात्मके भवति सर्वविकारसम्पत् तं चाप्यसाध्यमृषयः स्वरभेदमाहुः || ३ ||

sarvātmakē bhavati sarvavikārasampat taṁ cāpyasādhyamr̥ṣayaḥ svarabhēdamāhuḥ || 3 ||

Featues of all the doshas co exist together in this type of svarabheda which is incurable in the opinion of the learned ones. 3

Svara Bheda caused by Kshaya (Consumption) –

धूपयेत वाक् क्षयकृते क्षयमाप्नुयाच्च वागेष चापि हतवाक् परिवर्जनीयः |

dhūpayēta vāk kṣayakr̥tē kṣayamāpnuyācca vāgēṣa cāpi hatavāk parivarjanīyaḥ |

In the kshayaja type of Svara Bheda,

  • The voice comes out very feeble and
  • It is associated with feeling of warm fumes coming out of the throat.

The voice could be completely lost and in that stage, the disease turns incurable.

Svara Bheda caused by Medas (Fat) –

अन्तर्गतस्वरमलक्ष्यपदं चिरेण मेदो अन्वयाद्वदति दिग्धगलस्तृषार्तः || ४ ||

antargatasvaramalakṣyapadaṁ cirēṇa mēdō anvayādvadati digdhagalastr̥ṣārtaḥ || 4 ||

In the medaja type,

  • The voice appears as though coming from a great depth
  • Syllables pronounced are not clear and are very slow
  • The person affected will have coating (of fat or kapha) in the throat and he would also feel thirsty. 4
Incurability of Svara bheda –

क्षीणस्य वृद्धस्य कृशस्य वा अपि चिरोत्थितो यश्च सहोपजातः |
मेदस्विनः सर्व समुद्भवश्च स्वरामयो यो न स सिद्धिमेति || ५ ||

kṣīṇasya vr̥ddhasya kr̥śasya vā api cirōtthitō yaśca sahōpajātaḥ |
mēdasvinaḥ sarva samudbhavaśca svarāmayō yō na sa siddhimēti || 5 ||

Svara Bheda is incurable in the persons

  • Who are very weak
  • Very aged,
  • And emaciated.

Likewise, the following cases of svara bheda are also incurable:

  • If the disease has become old
  • And is congenital
  • Has affected a person who is obese
  • And which has been produced by all the three doshas together. 5

इति श्रीमाधवकरविरचिते माधवनिदाने स्वरभेदनिदानं समाप्तम् ||13 ||

iti śrīmādhavakaraviracitē mādhavanidānē svarabhēdanidānaṁ samāptam ||13 ||

Thus concludes the 13thchapter of Svara Bheda.

Source — 
  1. Hoarseness 

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