Chapter 29 – Hrdroga Nidanam

The 29th chapter of Madhava Nidana deals with Hrdroga Nidanam i.e.,  Diseases of the heart. Heart disease describes a range of conditions that affect the heart. 

 

Causes of Hrdroga — 

अत्युष्णगुर्वन्न – कषाय – तिक्त – श्रमाभिघाताध्यशनप्रसङ्गैः |
सञ्चितनैर्वेगविधारणैश्च ह्रुदामयः पञ्चविधः प्रदिष्टः || १ ||

atyuṣṇagurvanna – kaṣāya – tikta – śramābhighātādhyaśanaprasaṅgaiḥ |
sañcitanairvēgavidhāraṇaiśca hrudāmayaḥ pañcavidhaḥ pradiṣṭaḥ || 1 ||

The causes of five kinds of heart diseases include —

• intake of eatables that are very hot,
• Hard to digest
• Astringent and bitter;
• Excess fatigue
• Injury
• Reading loudly for long hours,
• Too much of worry and
• Suppression of the urges of the body. 1

Pathogenesis and main features of Hrdroga (heart diseases) — 

दूषयित्वा रसं दोषा विगुणा हृदयं गताः |
हृदि बाधां प्रकुर्वन्ति हृद्रोगं तं प्रचक्षते || २ ||

dūṣayitvā rasaṁ dōṣā viguṇā hr̥dayaṁ gatāḥ |
hr̥di bādhāṁ prakurvanti hr̥drōgaṁ taṁ pracakṣatē || 2 ||

In Hrdroga when the dosha are increased, they vitiate the rasa dhatu located in the heart and cause pain. 2

Vata Type of Hrdroga —

आयम्यते मारुतजे हृदयं तुध्यते तथा |
निर्मथ्यते दीर्यते च स्फोटय्ते पाटय्ते अपि च || ३ || 

āyamyatē mārutajē hr̥dayaṁ tudhyatē tathā |
nirmathyatē dīryatē ca sphōṭaytē pāṭaytē api ca || 3 ||

The pain is of these kinds in Vataja Hrdroga —

• Constricting
• Piercing
• Rinsing
• Bursting or
• Scarring nature. 3

Pitta Type of Hrdroga —

तृष्णोष्मा – दाह – चोषाः स्युः पैत्तिके हृदयक्लमः |
धूमायनं च मूर्च्छा च स्वेदः शोषो मुखस्य च || ४ ||

tr̥ṣṇōṣmā – dāha – cōṣāḥ syuḥ paittikē hr̥dayaklamaḥ |
dhūmāyanaṁ ca mūrcchā ca svēdaḥ śōṣō mukhasya ca || 4 ||

Features of Pittaja Hrdroga include the following symptoms:

• Thirst
• Increase in body temperature
• Burning sensation
• Localized heat
• Weakness of the heart and
• Feeling of movement of warm air inside the chest
• Fainting
• Perspiration and
• dryness of the mouth. 4

Kaphaja —

गौरवं कफसंस्रावो अरुचिः स्तम्भो अग्निमार्दवं |
माधुर्यमपि चास्यस्य बलासावतते हृदि || ५ ||

gauravaṁ kaphasansrāvō aruciḥ stambhō agnimārdavaṁ |
mādhuryamapi cāsyasya balāsāvatatē hr̥di || 5 ||

Features of Kaphaja Hrdroga include the following symptoms —

• Feeling of heaviness in the body,
• Overflowing of watery secretions from mouth, nose, eyes,
• Anorexia and
• Stiffness of the body,
• Poor digestive ability and
• Sweet taste in the mouth. 5

Sannipata and Krmi types of Hrdroga —

विध्यात् त्रिदोषं त्वपि सर्वलिङ्गं —

vidhyāt tridōṣaṁ tvapi sarvaliṅgaṁ —

In Tridoshaja Hrdroga, presence of all the above features together is seen.

Features of Krimija Hrdroga — 

तीव्रार्तितोदं क्रिमिजम् सकण्डु |
उत्क्लेद ष्टीवनं तोदः शूलं हृल्लासकस्तमः |
अरुचिः श्यावनेत्रत्वं शोथश्च क्रिमिजे भवेत् || ६ ||

tīvrārtitōdaṁ krimijam sakaṇḍu |
utklēda ṣṭīvanaṁ tōdaḥ śūlaṁ hr̥llāsakastamaḥ |
aruciḥ śyāvanētratvaṁ śōthaśca krimijē bhavēt || 6 ||

Features of krimija hrdroga include the following symptoms —

• Nausea
• Salivation
• Pricking pain
• Oppression in the chest
• Drowsiness
• Loss of Taste
• Blackish appearance of the eyes and
• Oedema. 6

Upadrava (complications)–

क्लमः सादो भ्रमः शोषो ज्ञेयास्तेषामुपद्रवाः |
क्रिमिजे क्रिमिजातीनां श्लेष्मिकाणां च ये मताः || ७ ||

klamaḥ sādō bhramaḥ śōṣō jñēyāstēṣāmupadravāḥ |
krimijē krimijātīnāṁ ślēṣmikāṇāṁ ca yē matāḥ || 7 ||

In krimija hrdroga, the symptoms of kaphaja krimi roga can be seen, such as

• Debility
• Exhaustion
• Giddiness and
• Emaciation. 7

इति श्री विजयरक्षितकृतायां मधुकोशव्यख्यायां हृद्रोगनिदानं समाप्तम् ||29||

iti śrī vijayarakṣitakr̥tāyāṁ madhukōśavyakhyāyāṁ hr̥drōganidānaṁ samāptam ||29||

Thus concludes the Chapter on Hrdroga

 

Source — 

1. Heart Disease