The 48th chapter of Madhava Nidana is Shuka Dosha Nidana which deals with Disorders of Penis. The penis is an external organ in the male reproductive system. Disorders which can affect the penis include priapism, balanitis, penile cancer, erectile dysfunction and ejaculatory disorders.
Etiology —
अक्रमाच्छेफसो वृद्धिं यो अभिवाञ्च्छति मूढधीः |
व्याधयस्तस्य जायन्ते दश चाष्टौ च शूकजाः || १ ||
akramācchēphasō vr̥ddhiṁ yō abhivāñcchati mūḍhadhīḥ |
vyādhayastasya jāyantē daśa cāṣṭau ca śūkajāḥ || 1 ||
Eighteen kinds of diseases of penis, caused by poisonous worms and other substances (shookas) are produced in those people who try to increase the size of their penis by the unnatural method of application of the paste of poisonous insects and other materials. 1
Sharshapika —
गौरसर्षपसंस्थाना शूकदुर्भुग्नहेतुका |
पिडका श्लेष्म – वाताभ्यां ज्ञेया सर्षपिका तु सा || २ ||
gaurasarṣapasansthānā śūkadurbhugnahētukā |
piḍakā ślēṣma – vātābhyāṁ jñēyā sarṣapikā tu sā || 2 ||
Sharshapika means the vesicles of the size of white mustard, appearing on the penis due to morbid increase of kapha and vata by bad application of the paste. 2
कठिना विषमैर्भुग्नैर्वायुना अष्टीलिका भवेत् |
The disease Asthilika has been noted as the one that has been caused by the morbid increase of Vata. It makes the penis hard and irregular in shape.
Grathita —
शूकैर्यत् पूरितं शश्वद् ग्रथितं नाम तत् कफात् || ३ ||
śūkairyat pūritaṁ śaśvad grathitaṁ nāma tat kaphāt || 3 ||
The disease Grathita is caused by the vitiated kapha. There is appearance of nodules at the tip of penis due to constant administration of the paste. 3
Kumbhika —
कुम्भिका रक्तपित्तोत्था जाम्बवास्थिनिभा अशुभा |
kumbhikā raktapittōtthā jāmbavāsthinibhā aśubhā |
Due to increase of rakta and pitta, the disease Kumbhikaa is produced. It generates knot that resembles the seeds of Jambu fruit (the plant Euginia jambolina) and is black in colour.
Alaji —
तुल्यजां त्वलजीं विध्याध्यप्रोक्तां विचक्षणः || ४ ||
tulyajāṁ tvalajīṁ vidhyādhyaprōktāṁ vicakṣaṇaḥ || 4 ||
Experts have described Alaji as one of the unique types of Prameha Pidaka.4
Mrdita —
मृदितं पीडितं यच्च संरब्धं वातकोपतः |
mr̥ditaṁ pīḍitaṁ yacca sanrabdhaṁ vātakōpataḥ |
The pathological condition identified as mrditam is generated by masturbating the penis repeatedly. Such act vitiates the vata resulting in swelling in the penis.
Sammudha type of boil —
पाणिभ्यां भृश सम्मूढे सम्मूढपिडका भवेत् || ५ ||
pāṇibhyāṁ bhr̥śa sammūḍhē sammūḍhapiḍakā bhavēt || 5 ||
Swelling of the penis caused by rubbing the penis after removing the paste is Mrdita while appearance of blind papules by rubbing the penis briskly has been identified as Sammudha Pidaka. 5
Adhimantha —
दीर्घा बह्वयश्च पिडका दीर्यन्ते मध्यतस्तु याः |
सो अधिमन्थः कफास्रुग्भ्यां वेदना – रोमहर्षकृत् || ६ ||
dīrghā bahvayaśca piḍakā dīryantē madhyatastu yāḥ |
sō adhimanthaḥ kaphāsrugbhyāṁ vēdanā – rōmaharṣakr̥t || 6 ||
Vesicles, long in size, bursting in their centre, accompanied with pain and horripilation, due to promoted kapha and rakta have been identified as Adhimantha. 6
Pushkarikaa —
पिडका पिडकाव्याप्ता पित्तशोणितसम्भवा |
पद्मकर्णिक संस्थाना ज्ञेया पुष्करिका तु सा || ७ ||
piḍakā piḍakāvyāptā pittaśōṇitasambhavā |
padmakarṇika sansthānā jñēyā puṣkarikā tu sā || 7 ||
Vesicles generated by vitiated pitta and rakta, more than one in number and resembling sprouts of a lotus flower have been identified as Pushkarika. 7
Sparshahaani —
स्पर्शहानिं तु जनयेच्छोणितं शूकदूषितम् |
sparśahāniṁ tu janayēcchōṇitaṁ śūkadūṣitam |
A vesicle generated by vitiated rakta and infected by poison in that there is loss of tactile sensation on the penis has been identified as the pathological condition called Sparshahaani.
Uttama —
मुद्ग – माषोपमा रक्ता रक्तपित्तोद्भवा तु या || ८ ||
व्याधिरेषोत्तमा नाम शूकाजीर्णनिमित्तजा |
mudga – māṣōpamā raktā raktapittōdbhavā tu yā || 8 ||
vyādhirēṣōttamā nāma śūkājīrṇanimittajā |
The Uttama has been identified as a disease in that papules of the size if green gram or blackgram, red in colour, appear due to vitiated rakta and pitta. It has been noted as being caused by poisonous paste used repeatedly. 8
Shataponaka —
छिद्रैरणुमुखैर्लिङ्गं चितं यस्य समन्ततः || ९ ||
वातशोणितजो व्याधिः स ज्ञेयः शतपोनकः |
chidrairaṇumukhairliṅgaṁ citaṁ yasya samantataḥ || 9 ||
vātaśōṇitajō vyādhiḥ sa jñēyaḥ śatapōnakaḥ |
A disease in that the penis develops small holes here and there has been identified as Shataponaka. It is caused by morbid increase of Vata and rakta. 9
Tvakpaaka —
वात – पित्तकृतो ज्ञेयस्त्वक्पाको ज्वर – दाहकृत् || १० ||
vāta – pittakr̥tō jñēyastvakpākō jvara – dāhakr̥t || 10 ||
The pathological condition in that there is ulceration on the skin of the penis associated with burning sensation and fever has been identified as Tvakpaka. This disease is caused by morbid increase of Vata and pitta. 10
Shonitaarbuda —
कृष्णैः स्फोटैः सरक्ताभिः पिडकाभिर्निपिडितम् |
यस्य वास्तुरुजस्चोग्रा ज्ञेयं तच्छोणितार्बुदम् || ११ ||
kr̥ṣṇaiḥ sphōṭaiḥ saraktābhiḥ piḍakābhirnipiḍitam |
yasya vāsturujascōgrā jñēyaṁ tacchōṇitārbudam || 11 ||
Black or reddish black vesicles appearing all over the penis associated with severe pain have been identified as Shonitarbuda. 11
Mamsarbuda —
मांसदोषेण जानीयादर्बुदं मांससम्भवम् |
mānsadōṣēṇa jānīyādarbudaṁ mānsasambhavam |
Involvement of muscle tissue has been identified as Mamsaarbuda.
Mamsapaaka —
शीर्यन्ते यस्य मांसानि यस्य सर्वाश्च वेदनाः || १२ ||
विध्यात्तं मांसपाकं तु सर्वदोषकृतं भिषक् |
śīryantē yasya mānsāni yasya sarvāśca vēdanāḥ || 12 ||
vidhyāttaṁ mānsapākaṁ tu sarvadōṣakr̥taṁ bhiṣak |
Mamsapaaka is a condition in which fleshy portion of the penis falls off, accompanied with severe pain. It is generated by a combination of all the three doshas. 12
Vidradhi (Abscess) —
विद्रधिं सन्निपातेन यथोक्तमिति निर्दिशेत् || १३ ||
vidradhiṁ sannipātēna yathōktamiti nirdiśēt || 13 ||
Disease caused by all the three doshas has been identified as Vidradhi. It resembles the sannipataja vidradhi that has been described previously. 13
Tilakaalaka —
कृष्णानि चित्राण्यथवा शूकानि सविषाणि वा |
पातितानि पचन्त्याशु मेढ्रं निरवशेषतः || १४ ||
कालानि भूत्वा मांसानि शीर्यन्ते यस्य देहिनः |
संनिपातसमुत्थांस्तु तान् विध्यात्तिलकालकान् || १५ ||
kr̥ṣṇāni citrāṇyathavā śūkāni saviṣāṇi vā |
pātitāni pacantyāśu mēḍhraṁ niravaśēṣataḥ || 14 ||
kālāni bhūtvā mānsāni śīryantē yasya dēhinaḥ |
sannipātasamutthānstu tān vidhyāttilakālakān || 15 ||
The condition identified as Tilakalaka has the following features:
- Dropping of the muscle and appearance of warts that resemble the black moles of the skin.
This disease is caused by the administration of paste of insects that are black or of several colours as well as the use of highly poisonous paste applied over the penis. Tilakaalaka is supposed to have been caused due to the morbid increase of all the three doshas together. 14 -15
Prognosis —
तत्र मांसार्बुदं यच्च मांसपाकश्च यः स्मृतः |
विद्रधिश्च न सिद्द्यन्ति ये च स्युस्तिलकालकाः || १६ ||
tatra mānsārbudaṁ yacca mānsapākaśca yaḥ smr̥taḥ |
vidradhiśca na siddyanti yē ca syustilakālakāḥ || 16 ||
Diseases like the mamsaarbuda, mamsapaaka, vidradhi and tilakaalaka cannot be cured. 16
इति श्रीमाधवकरविरचिते माधवनिदाने शूकदोषनिदानं समाप्तम् || ४८ ||
iti śrīmādhavakaraviracitē mādhavanidānē śūkadōṣanidānaṁ samāptam || 48 ||
Thus concludes the chapter on Shuka dosha.
Source —
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