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Chapter 55 – Kshudra Roga Nidanam

The 55th chapter of Madhava Nidana is Kshudra Roga Nidana and deals with Minor Diseases.


Ajagallikaa –

स्निग्धाः सवर्णा ग्रथिता नीरुजो मुद्गसन्निभाः |
कफ – वातोत्थिता ज्ञेया बालानामजगल्लिकाः || १ ||

snigdhāḥ savarṇā grathitā nīrujō mudgasannibhāḥ |
kapha – vātōtthitā jñēyā bālānāmajagallikāḥ || 1 ||

The Ajagallikaa is a disease characterized by appearance of waxy, non – discolored, painless papules on the skin of the green gram generated by vitiation of kapha and vata together. It specially affects the children. 1

Yavaprakhyaa —

यवाकारा सुकठिना ग्रथिता मांससंश्रिता |
पिडका कफ- वाताभ्यां यवप्रख्येति सोच्यते || २ ||

yavākārā sukaṭhinā grathitā mānsasanśritā |
piḍakā kapha- vātābhyāṁ yavaprakhyēti sōcyatē || 2 ||

Yavaprakhya has been identified as the disease in which there is Pidaka (pimples) of the size of barley. They are hard in shape and are usually localized in the muscle. The illness is generated by vitiation of the kapha and vata together. 2

Antralaaji —

घनामवक्रां पिडकामुन्नतां परिमण्डलाम् |
अन्त्रालजिमल्पपूयां तां विध्यात् कफ – वातजाम् || ३ ||

ghanāmavakrāṁ piḍakāmunnatāṁ parimaṇḍalām |
antrālajimalpapūyāṁ tāṁ vidhyāt kapha – vātajām || 3 ||

The disease Antralaji is identified through a hard pidaka (papule) that appears without an opening. It is roundly in shape and it contains a little amount of pus inside. It is allegedly generated by vitiation of kapha and vata in combination. 3

Vivrta —

विवृतास्यां महादाहां पक्वोदुम्बरसन्निभाम् |
विवृतामिति तां विध्यात् पित्तोत्थां परि मण्डलाम् || ४ ||

vivr̥tāsyāṁ mahādāhāṁ pakvōdumbarasannibhām |
vivr̥tāmiti tāṁ vidhyāt pittōtthāṁ pari maṇḍalām || 4 ||

The pidaka that consists of a wide opening, that is the size of a ripened udumbara fruit (the plan Ficus glomerata), round in shape and is associated with severe burning sensation has been identified as the disease Vivrta. It is generated by vitiated pitta. 4

Kacchapika —

ग्रथिताः पञ्च वा षड् वा दारुणाः कच्छपोपमाः |
कफानिलाभ्यां पिडका ज्ञेयाः कच्छपिका बुधैः || ५ ||

grathitāḥ pañca vā ṣaḍ vā dāruṇāḥ kacchapōpamāḥ |
kaphānilābhyāṁ piḍakā jñēyāḥ kacchapikā budhaiḥ || 5 ||

Five or six pidakas that are hard, resembling to the shell of a tortoise, and those generated by kapha and vata together have been identified as the disease Kacchapika by the wise. 5 

Valmika —

ग्रीवांस – कक्षा – कर – पाददेशे सन्धौ गले वा त्रिभिरेव दोषैः |
ग्रन्थिः स वल्मीकवदक्रियाणां जातः क्रमेणैव गतः प्रव्रुद्धिम् || ६ ||
मुखैरनैकैः सृति – तोदवद्भिर्विसर्पवत् सर्पति चोन्नताग्रेः |
वल्मीकमाहुर्भिषजो विकारं निष्प्रत्यनीकं चिरजं विशेषात् || ७ ||

grīvānsa – kakṣā – kara – pādadēśē sandhau galē vā tribhirēva dōṣaiḥ |
granthiḥ sa valmīkavadakriyāṇāṁ jātaḥ kramēṇaiva gataḥ pravruddhim || 6 ||
mukhairanaikaiḥ sr̥ti – tōdavadbhirvisarpavat sarpati cōnnatāgrēḥ |
valmīkamāhurbhiṣajō vikāraṁ niṣpratyanīkaṁ cirajaṁ viśēṣāt || 7 ||

The disease identified as Valmika is marked by

  • appearance of a Granthi (tumor) resembling an ants’ hill,
  • gradually increasing in size,
  • appearing at the neck, shoulders,axillae, hands, feet, joints or throat.
  • It consists of several mouths discharging fluid.
  • The tumor is painful, spreading to other parts like visarpa (erysipelas), with pointed sprouts.
  • It is generated by the morbid increase in all the three doshas together.
  • This is incurable, especially when chronic. 6-7
Indraviddha —

पद्मकर्णिकवन्मध्ये पिडकाभिः समाचिताम् |
इन्द्रविद्धां तु तां विध्याद्वात – पित्तोत्थितां भिषक् || ८ ||

padmakarṇikavanmadhyē piḍakābhiḥ samācitām |
indraviddhāṁ tu tāṁ vidhyādvāta – pittōtthitāṁ bhiṣak || 8||

Small pidakas resembling the central part of a lotus flower have been identified as the disease Indraviddha. It is allegedly generated by vitiation of vata and pitta together. 8

Gardabhikaa —

मण्डलं वृत्तमुत्सन्नं सरक्तं पिडकाचितं |
रुजाकरीं गर्दभिकां तां विध्याद् वातपित्तजाम् || ९ ||

maṇḍalaṁ vr̥ttamutsannaṁ saraktaṁ piḍakācitaṁ |
rujākarīṁ gardabhikāṁ tāṁ vidhyād vātapittajām || 9 ||

Appearance of round, elevated, red mandalas (patches), studded with small pidakas causing pain have been identified as the disease Gardhabhika. It is due to the combined vitiation of Vata and pitta. 9

Pashanagardabha —

वातश्लेष्मसमुद्भूतः श्वयथुर्हनुसन्धिजः |
स्थिरो मन्दरुजः स्निग्धो ज्ञेयः पाषणगर्दभः || १० ||

vātaślēṣmasamudbhūtaḥ śvayathurhanusandhijaḥ |
sthirō mandarujaḥ snigdhō jñēyaḥ pāṣaṇagardabhaḥ || 10 ||

A shotha (swelling) which is hard, slightly painful and greasy, appearing at the joint of the lower jaw generated by morbid increase in the vatakapha duo has been identified as the disease Pasanagardabha. 10

Panasika —

कर्णस्याभ्यन्तरे जातां पिडकामुग्रवेदनाम् |
स्थिरां पनसिकां तां तु विध्याद् वातकफोत्थिताम् || ११ ||

karṇasyābhyantarē jātāṁ piḍakāmugravēdanām |
sthirāṁ panasikāṁ tāṁ tu vidhyād vātakaphōtthitām || 11 ||

A pidaka (papule) inside the ear, hard and very painful generated by Vatakapha together has been identified as the disease Panasika. 11

Jaalagardabha —

विसर्पवत् सर्पति यः शोथस्तनुरपाकवान् |
दाह – ज्वरकरः पित्तात् स ज्ञेयो जालगदर्भः || १२ ||

visarpavat sarpati yaḥ śōthastanurapākavān |
dāha – jvarakaraḥ pittāt sa jñēyō jālagadarbhaḥ || 12 ||

The illness identified as Jaalagardhabha is marked by appearance of a thin swelling that spreads quickly like visarpa. There is no pus formation in it but there is a burning sensation and fever in it. This is so due to the morbid increase in pitta that is instrumental in the disease. 12

Irivellika —

पिडकामुत्तमाङ्गस्थां वृत्तामुग्ररुजा – ज्वरं |
सर्वात्मिकां सर्वलिङ्गां जानीयादिरिवेल्लिकाम् || १३ ||

piḍakāmuttamāṅgasthāṁ vr̥ttāmugrarujā – jvaraṁ |
sarvātmikāṁ sarvaliṅgāṁ jānīyādirivēllikām || 13 ||

A round pidaka (papule) on the head manifesting severe pain, fever and other features of morbid increase in all the three doshas has been identified as the disease Irivellika. 13

Kakshaa —

बाहु – पार्श्वांस – कक्षेषु कृष्णस्फोटा सवेदनाम् |
पित्तप्रकोपसंभूतां कक्षामित्यभिर्निर्दिशेत् || १४ ||

bāhu – pārśvānsa – kakṣēṣu kr̥ṣṇasphōṭā savēdanām |
pittaprakōpasambhūtāṁ kakṣāmityabhirnirdiśēt || 14 ||

Appearance of the black coloured, painful sphota (vesicle) in the sides of the arms, shoulders, or axillae due to morbid increase in pitta has been identified as the disease Kaksha.14 

Gandhamaalaa —

एकामेतादृशीं दृष्ट्वा पिडकां स्फोटसन्निभाम् |
त्वग्गतां पित्तकोपेन गन्धमालां प्रचक्षते || १५ ||

ēkāmētādr̥śīṁ dr̥ṣṭvā piḍakāṁ sphōṭasannibhām |
tvaggatāṁ pittakōpēna gandhamālāṁ pracakṣatē || 15 ||

An identical vesicle manifesting superficially on the skin which bursts out and which is generated by morbid increase in pitta has been identified as the disease Gandhamaala. 15

Agnirohini —

कक्षाभागेषु ये स्फोट जायन्ते मांसदारुणाः |
अन्तर्दाह – ज्वरकरा दीप्तपावकसन्निभाः || १६ ||
सप्ताहाद्वा दशाहाद्वा पक्षाद्वा हन्ति मानवम् |
तामग्निरोहिणीं विध्यादसाध्यां सर्वदोषजाम् || १७ ||

kakṣābhāgēṣu yē sphōṭa jāyantē mānsadāruṇāḥ |
antardāha – jvarakarā dīptapāvakasannibhāḥ || 16 ||
saptāhādvā daśāhādvā pakṣādvā hanti mānavam |
tāmagnirōhiṇīṁ vidhyādasādhyāṁ sarvadōṣajām || 17 ||

The  manifestation of disease Agnirohini is marked through these symptoms:

  • There develop vesicles in the axillae of the patient;
  • These burrow into the muscles and destroy them.

They are associated with —

  • severe burning sensation inside the body, and
  • The temperatures of the patients soars as high as if he or she has contacted fire.

The illness is allegedly generated by morbid increase in all the three doshas and it could kill the patient within seven, twelve or fifteen days and is thus incurable. 16-17 

Chippa —

नखमांससमाधिष्ताय वायुः पित्तं च देहिनाम् |
कुर्वाते दाह -पाकौ च तं व्याधिं चिप्पमादिशेत् || १८ ||
तदेवाल्पतरैर्दोषैः परुषं कुनखं वदेत् || १९ ||

nakhamānsasamādhiṣtāya vāyuḥ pittaṁ ca dēhinām |
kurvātē dāha -pākau ca taṁ vyādhiṁ cippamādiśēt || 18 ||
tadēvālpatarairdōṣaiḥ paruṣaṁ kunakhaṁ vadēt || 19 ||

Vata and pitta together undergoing growth and vitiation are localized in the muscles surrounding the nails. They generate a burning sensation and form pus. This morbidity has been identified as the disease Chippa. The condition in Kunakha that is generated by a mild increase in doshas is identical one. 18-19

Anushaayi —

गम्भीरामल्पसंरम्भां सवर्णामुरिपरिस्थिताम् |
पादस्यानुशयीं तां तु विध्यादन्तःप्रपाकिनीम् || २० ||

gambhīrāmalpasanrambhāṁ savarṇāmuriparisthitām |
pādasyānuśayīṁ tāṁ tu vidhyādantaḥprapākinīm || 20 ||

A minor swelling on the upper portion of the foot, developing gradually, without any discoloration of the skin but forming pus from deep inside has been identified as the disease Anushaayi. 20

Vidaarikaa —

विदारीकन्दवद्वृत्ता कक्षा – वङ्क्षणसन्धिषु |
विदारिका भवेद्रक्ता सर्वजा सर्वलक्षणा ||२१ ||

vidārīkandavadvr̥ttā kakṣā – vaṅkṣaṇasandhiṣu |
vidārikā bhavēdraktā sarvajā sarvalakṣaṇā ||21 ||

A round papule manifesting in the axillae or groins resembling the herb vidaarikanda (the plant Pueraria tuberosa) generated by and manifesting the features of all the three doshas vitiated together has been identified as the disease Vidarika. 21 

Sharkaraarbuda —

प्राप्य मांस – सिरा – स्नायूः श्लेष्मा मेदस्तथा अनिलः |
ग्रन्थिं करोत्यसौ भिन्नो मधु – सर्पिर्वसानिभम् || २२ ||
स्रवत्यास्रावमनिलस्तत्र वृद्धिं गतः पुनः |
मांसं संशोष्य ग्रथितां शर्करां जनयेत्ततः || २३ ||
दुर्गन्धि क्लिन्नमत्यर्थं नानावर्णं ततः सिराः |
स्रवन्ति रक्तं सहसा तं विध्याच्छर्करार्बुदम् ||२४ ||

prāpya mānsa – sirā – snāyūḥ ślēṣmā mēdastathā anilaḥ |
granthiṁ karōtyasau bhinnō madhu – sarpirvasānibham || 22 ||
sravatyāsrāvamanilastatra vr̥ddhiṁ gataḥ punaḥ |
mānsaṁ sanśōṣya grathitāṁ śarkarāṁ janayēttataḥ || 23 ||
durgandhi klinnamatyarthaṁ nānāvarṇaṁ tataḥ sirāḥ |
sravanti raktaṁ sahasā taṁ vidhyāccharkarārbudam ||24 ||

On occasions, the vitiated kapha, fatty tissue (medas) and vata produce a swelling from which, after bursting, a liquid resembling honey, ghrta or fat flows out. Later, the vata being further increased locally dries up the soft tissues and produces knotted granular concretions. The lesion subsequently emits a bad odour and occupies variegated colours. Thereafter, blood suddenly flows out from the vesicles. The condition has been identified as the disease Sharkarbuda. 22-24

Paadadaari —

परिक्रमणशीलस्य वायुरत्यर्थरुक्षयोः |
पादयोः कुरुते दारीं पाददारीं तमादिशेत् || २५ ||

parikramaṇaśīlasya vāyuratyartharukṣayōḥ |
pādayōḥ kurutē dārīṁ pādadārīṁ tamādiśēt || 25 ||

The vata is provoked if one regularly indulges in too much of walking on rough ground without footwear. This situation subsequently produces fissures in the soles of the feet. The symptom has been identified as the disease Paadadaari. 25

Kadara —

शर्करोन्मथिते पादे क्षते वा कण्टकादिभिः |
ग्रन्थिः कोलवदुत्सन्नो जायते कदरं हि तत् || २६ ||

śarkarōnmathitē pādē kṣatē vā kaṇṭakādibhiḥ |
granthiḥ kōlavadutsannō jāyatē kadaraṁ hi tat || 26 ||

Treading on rough stones or thorns causes wounds on the soles. It gradually develops a small swelling of the size of a kola fruit (of the plant zizyphus jujuba). The condition has been identified as the disease Kadara. 26

Alasa —

क्लिन्नाङ्गुल्यन्तरौ पादौ कण्डू – दाह – रुजान्वितौ |
दुष्टकर्दमसंस्पर्शादलसं तं विभावयेत् || २७ ||

klinnāṅgulyantarau pādau kaṇḍū – dāha – rujānvitau |
duṣṭakardamasansparśādalasaṁ taṁ vibhāvayēt || 27 ||

Alasa is a disease characterized by exudating ulcers between the toes with itching, burning sensation and pain generated by a prolonged contact with dirty mud. 27

Indralupta —

रोमकूपानुगं पित्तं वातेन सह मूर्च्छितं |
प्रच्यावयति रोमाणि ततः श्लेष्मा सशोणितः || २८ ||
रुणाद्धि रोमकूपांस्तु ततो अन्येषामसम्भवः |
तदिन्द्रलुप्तं खालित्यं रुह्येति च विभाव्यते || २९ ||

rōmakūpānugaṁ pittaṁ vātēna saha mūrcchitaṁ |
pracyāvayati rōmāṇi tataḥ ślēṣmā saśōṇitaḥ || 28 ||
ruṇāddhi rōmakūpānstu tatō anyēṣāmasambhavaḥ |
tadindraluptaṁ khālityaṁ ruhyēti ca vibhāvyatē || 29 ||

Pitta located at the root of the hairs, getting provoked in association with Vata, makes for falling of the hairs. Then kapha and rakta together block follicles of the hairs and they do not allow fresh hairs to grow. This condition has been identified as the disease Indralupta, Khalitya or Ruhya. 28-29

Darunaka —

दारुणा कण्डुरा रूक्षा केशभूमिः प्रपाट्यते |
कफ – मारुतकोपेने विध्याद्दारुणकं तु तं || ३० ||

dāruṇā kaṇḍurā rūkṣā kēśabhūmiḥ prapāṭyatē |
kapha – mārutakōpēnē vidhyāddāruṇakaṁ tu taṁ || 30 ||

Due to morbid increase in kapha – vata combination, at times, the skin on scalp is cracked, becomes rough, dry and itching. This symptom has been identified as the disease Darunaka. 30

Arumshika —

अरुंषि बहुवक्त्राणि बहुक्लेदिनि मूर्ध्नि तु |
कफास्रुक्किमिकोपेन नृणां विध्याद रुंषिकाम् || ३१ ||

arunṣi bahuvaktrāṇi bahuklēdini mūrdhni tu |
kaphāsrukkimikōpēna nr̥ṇāṁ vidhyāda runṣikām || 31 ||

Small ulcers with several openings manifesting on the skin of the scalp due to agitated kapha – rakta and infection by bacteria (krmi) have been identified as the disease Arumshika. 31

Palita —

क्रोध – शोक – श्रमकृतः शरीरोष्मा शिरोगतः |
पित्तं च केशान् पचति पलितं तेन जायते || ३२ ||

krōdha – śōka – śramakr̥taḥ śarīrōṣmā śirōgataḥ |
pittaṁ ca kēśān pacati palitaṁ tēna jāyatē || 32 ||

The heat generated by frequent bouts of anger, grief and physical strain, at times reaches the head and makes the hairs to turn grey. This condition has been identified as the disease Palita. 32

Yuvanapidaka —

शाल्मलीकण्टकप्रख्याः कफ मारुतरक्तजाः |
युवानपिडका यूनां विज्ञेया मुखदूषिकाः || ३३ ||

śālmalīkaṇṭakaprakhyāḥ kapha mārutaraktajāḥ |
yuvānapiḍakā yūnāṁ vijñēyā mukhadūṣikāḥ || 33 ||

Papules, resembling the on bark of shalmali tree (the plant Bombax malabarica) appearing on the face of adolescents generated by morbid increase in kapha, vata and rakta together is known as Yuvanapidaka. 33

Padminikantaka —

कण्टकैराचितं वृत्तं मण्डलं पाण्डु – कण्डुरम् |
पद्मिनीकण्टकप्रख्यैस्तदाख्यं कफ – वातजम् || ३४ ||

kaṇṭakairācitaṁ vr̥ttaṁ maṇḍalaṁ pāṇḍu – kaṇḍuram |
padminīkaṇṭakaprakhyaistadākhyaṁ kapha – vātajam || 34 ||

Circular white patches, studded with papules, with itching, generated by morbid increase in kapha and vaata together have been identified as the disease Padminikantaka. 34

Jatumani —

समुत्सन्नमरुजं मण्डलं कफ – रक्तजम् |
सहजं लक्ष्म चैकेपां लक्ष्यो जतुमणिस्तु सः ||३५ ||

samutsannamarujaṁ maṇḍalaṁ kapha – raktajam |
sahajaṁ lakṣma caikēpāṁ lakṣyō jatumaṇistu saḥ ||35 ||

A congenital, slightly elevated, even, and painless patch on the skin generated by kapha and rakta has been identified as the disease Lakshma. It is also called Jatumani by some scholars. 35

Mashaka —

अवेदनं स्थिरं चैव यस्मिन् गात्रे प्रदृश्यते |
माषवत्कृष्णमुत्सन्नमनिलान्मषकं तु तत् || ३६ ||

avēdanaṁ sthiraṁ caiva yasmin gātrē pradr̥śyatē |
māṣavatkr̥ṣṇamutsannamanilānmaṣakaṁ tu tat || 36 ||

Painless, immovable, black, round nodules on the skin resembling black gram have been identified as the disease Mashaka. It is generated by the vitiated Vata. 36

Tilakaalaka —

कृष्णानि तिलामात्राणि नीरुजानि समानि च |
वात – पित्त – कफोच्छ्रायात्तान् विध्यात्तिलकालकान् || ३७ ||

kr̥ṣṇāni tilāmātrāṇi nīrujāni samāni ca |
vāta – pitta – kaphōcchrāyāttān vidhyāttilakālakān || 37 ||

Black, painless spots resembling sesame seeds, not raised above the level of the skin have been identified as the symptoms of Tilakaalaka. It allegedly develops through agitation of the vata, pitta and kapha in combination. 37

Nyaccha —

महद्वा यदि वा चाल्पं श्यावं वा यदि वास्मिन् |
नीरुजं मण्डलं गात्रे न्यच्छमित्यभिधीयते || ३८ ||

mahadvā yadi vā cālpaṁ śyāvaṁ vā yadi vāsmin |
nīrujaṁ maṇḍalaṁ gātrē nyacchamityabhidhīyatē || 38 ||

The broad or small, blue or black, painless patches on skin have been identified as the disease Nyaccha. 38

Vyanga —

क्रोधायासप्रकुपितो वायुः पित्तेन संयुतः |
मुखमागत्य सहसा मण्डलं विसृजत्यतः || ३९ ||
नीरुजं तनुकं श्यावं मुखे व्यङ्गं तमादिशेत् |

krōdhāyāsaprakupitō vāyuḥ pittēna sanyutaḥ |
mukhamāgatya sahasā maṇḍalaṁ visr̥jatyataḥ || 39 ||
nīrujaṁ tanukaṁ śyāvaṁ mukhē vyaṅgaṁ tamādiśēt |

Vata undergoing growth, in association with pitta, due to anger and physical exertion, is localized in the face prodducing painless, thin, black patches on the skin. This condition has been identified as the symptom of Vyanga. 39

Nilika —

कृष्णमेवंगुणं गात्रे मुखे वा नीलिकां विदुः || ४० ||

kr̥ṣṇamēvaṅguṇaṁ gātrē mukhē vā nīlikāṁ viduḥ || 40 ||

Identical black spots appearing in different parts of the body have been identified as the disease Nilika. 40

Parivartikaa —

मर्दनात् पीडनाद्वा अति तथैवाप्यभिघाततः |
मेढ्रचर्म यदा वायुर्भजते सर्वतश्चरन् || ४१ ||
तदा वातोप सृष्टत्वात् तच्चर्म परिवर्तते |
मणेरधस्तात् कोशश्च ग्रन्थिरूपेण लम्बते || ४२ ||
सरुजां वातसम्भूतां तां विध्यात् परिवर्तिकाम् |
सकण्डूः कठिना चापि सैव श्लेष्मसमुत्थिता || ४३ ||

mardanāt pīḍanādvā ati tathaivāpyabhighātataḥ |
mēḍhracarma yadā vāyurbhajatē sarvataścaran || 41 ||
tadā vātōpa sr̥ṣṭatvāt taccarma parivartatē |
maṇēradhastāt kōśaśca granthirūpēṇa lambatē || 42 ||
sarujāṁ vātasambhūtāṁ tāṁ vidhyāt parivartikām |
sakaṇḍūḥ kaṭhinā cāpi saiva ślēṣmasamutthitā || 43 ||

The disease Parivartika has been identified as the condition when the vata reaches the foreskin of the penis due to indulgence in hard friction or squeezing it. The condition could be reached through injury, too. Subsequently, it hangs like a sac under the glanpenis. It causes pain if vata is predominant and if kapha is predominant there would be itching and hardness. 41-43

Avapaatikaa —

अल्पीयःखां यदा हर्षाद्वलाद्रच्छेत् स्त्रीयं नरः |
हस्ताभिघातादपि वा चर्मण्युद्वर्तिते बलात् || ४४ ||
यस्यावपाट्यते चर्म तां विध्यादव पाटिकाम् |

alpīyaḥkhāṁ yadā harṣādvalādracchēt strīyaṁ naraḥ |
hastābhighātādapi vā carmaṇyudvartitē balāt || 44 ||
yasyāvapāṭyatē carma tāṁ vidhyādava pāṭikām |

By forceable coitus with a woman having narrow vagina or by regular and intense masturbation, the skin on the glans of penis is forced upwards and gets torn. This condition has been identified as the disease Avapatika. 44

Niruddhaprakasha —

वातोपसृष्टे मेढ्रे वै चर्म संश्रयते मणिम् || ४५ ||
मणिश्चर्मोपनद्धस्तु मूत्रस्रोतो रुणद्धि च |
निरुद्धप्रकशे तस्मिन् मन्दधारमवेदनम् || ४६ ||
मूत्रं प्रवर्तते जन्तोर्मणिर्विव्रियते न च |
निरुद्धप्रकशं विध्यात् सरुजं वातसम्भवम् || ४७ ||

vātōpasr̥ṣṭē mēḍhrē vai carma sanśrayatē maṇim || 45 ||
maṇiścarmōpanaddhastu mūtrasrōtō ruṇaddhi ca |
niruddhaprakaśē tasmin mandadhāramavēdanam || 46 ||
mūtraṁ pravartatē jantōrmaṇirvivriyatē na ca |
niruddhaprakaśaṁ vidhyāt sarujaṁ vātasambhavam || 47 ||

The skin over the glanpenis covers it tightly by the action of provoked Vata or other causes. It in turn blocks the passage of urine. In this concealed glans, the urinary flow and without the sensation; the glans does not appear clearly and the condition is painful. This symptom has been identified as the disease Niruddhaprakasha. It is generated by vitiated vata. 45-47

Sanniruddhaguda —

वेगसन्धारणाद्वायुर्विहतो गुदसंश्रितः |
निरुणाद्धि महास्रोतः सूक्ष्मद्वारं करोति च || ४८ ||
मार्गस्य सौक्ष्म्यात् कृच्छ्रेण पुरीषं तस्य गच्छति |
सन्निरुद्धगुदं व्याधिमेतं विध्यात् सुदारुणम् || ४९ ||

vēgasandhāraṇādvāyurvihatō gudasanśritaḥ |
niruṇāddhi mahāsrōtaḥ sūkṣmadvāraṁ karōti ca || 48 ||
mārgasya saukṣmyāt kr̥cchrēṇa purīṣaṁ tasya gacchati |
sanniruddhagudaṁ vyādhimētaṁ vidhyāt sudāruṇam ||

By constantly indulging in suppression of the urge of defecation, the Vata functioning in the region of the rectum gets provoked. It in turn blocks the rectal passage by narrowing its lumen. Because of such narrowing, the movement of faeces becomes difficult. This is a highly distressing condition and it has been identified as the disease Sanniruddhaguda. 48-49

Ahiputana —

शकृन्मूत्रसमायुक्ते अधौते अपाने शिशोर्भवेत् |
स्विन्ने वा स्नाप्यमाने वा कण्डू रक्तकफोद्भवा || ५० ||
कण्डूयनात्ततः क्षिप्रं स्फोटः स्रावश्च जायते |
एकीभूतं व्रणैर्घोरं तं विध्यादहिपूतनम् || ५१ ||

In infants, whose anal region is not washed well of faeces and urine or during the act of fumigation or bathing; there develops itching in that region due to a morbid increase of rakta and kapha. Itching makes for scratching, this subsequently generates exudating pustules. In due course of time they join together forming an intractable ulcer. This condition has been identified as the disease Ahiputana. 50-51

Vrshanakacchu —

स्नानोत्सादनहीनस्य मलो वृषणसंस्थितः |
यदा प्रक्लिध्यते स्वेदात् कण्डुम् जनयते तदा || ५२ ||
कण्डूयनात्ततः क्षिप्रं स्फोटः स्रावश्च जायते |
प्राहुर्वृषणकच्छुं तां श्लेष्म – रक्तप्रकोपजाम् || ५३ ||

snānōtsādanahīnasya malō vr̥ṣaṇasansthitaḥ |
yadā praklidhyatē svēdāt kaṇḍum janayatē tadā || 52 ||
kaṇḍūyanāttataḥ kṣipraṁ sphōṭaḥ srāvaśca jāyatē |
prāhurvr̥ṣaṇakacchuṁ tāṁ ślēṣma – raktaprakōpajām || 53 ||

Filthy matter accumulates in the fold of the scrotum of a person who  does not apply cleansing oily pastes or take bath regularly. When the filth gets sodden due to sweat there is sensation of itching. Thereafter, due to itching, there quickly appears blisters in the related part of the body. The blisters discharge morbid liquid. This condition has been identified as the disease Vrsana Kacchu and is accepted as developed due to the vitiation of Kapha and Rakta. 52-53

Gudabhramsha —

प्रवाहणातीसाराभ्यां निर्गच्छति गुदं बहिः |
रूक्ष – दुर्बलदेहस्य गुदभ्रंशं तमादिशेत् || ५४ ||

pravāhaṇātīsārābhyāṁ nirgacchati gudaṁ bahiḥ |
rūkṣa – durbaladēhasya gudabhranśaṁ tamādiśēt || 54 ||

The muscles of the anus come out in persons who are emaciated and weak and who indulge in straining at stools or one who face frequent attacks of diarrohea. This condition is known as Gudabhramsha. 54

Shukadamstraka —

सदाहो रक्तपर्यन्तस्त्वक्पाकी तीव्रवेदनः |
कण्डुमान् ज्वरकारी च स स्याच्छूकरदंष्ट्रकः || ५५ ||

sadāhō raktaparyantastvakpākī tīvravēdanaḥ |
kaṇḍumān jvarakārī ca sa syācchūkaradanṣṭrakaḥ || 55 ||

The Shukara damshtraka has been identified as the disease characterized by severe burning sensation, reddish and edged ulcer of the skin with severe pain. In this disease, there appears itching accompanied with fever. 55 

इति श्रीमाधवकरविरचिते माधवनिदाने क्षुद्ररोगनिदानं समाप्तम् || ५५ ||

iti śrīmādhavakaraviracitē mādhavanidānē kṣudrarōganidānaṁ samāptam || 55 ||

Thus concludes the chapter on Kshudra Roga.