Chapter VII - Pathology of the diseases of the Pupil

Now we shall discourse on the chapter which deals with the pathology of the diseases which are peculiar to the Drishti (pupil) of the eye (Drishti-gata-Roga-Vijnaniya). 1.

Experts well-versed in the anatomy of the eye aver that the Drishti (pupil) of the eye is the quintessence of the five material elements with that of the eternal light predominating therein—this principle of light neither increasing nor decreasing in this case. It is naturally accustomed to cold from the very nature of its temperament and is covered by the outer coating (Patala) of the organ proper. It looks like a hole and is equal in dimension to that of a Masūra seed or pulse^[1]. The pupil of the eye resembles in its action the phosphorescent flash of a glow-worm or that of a minute particle of fire (in not burning the things coming in contact with it). Now we shall describe the pathology of the twelve kinds of disease peculiar to the region of the Drishti (pupil), as well as of the one which is known as Timira (loss of vision) affecting the Patala (coating over the pupil). 2.

All external objects appear dim and hazy to the sight when the deranged Doshas of the locality passing through the veins (Sira) of the eye, get into and are incarcerated within the first Patala (innermost coat) of the pupil (Drishti). 3.

Symptoms—when second Patala attacked:—

False images of gnats, flies, hairs, nets or cob-webs, rings (circular patches), flags, ear-rings appear to the sight, and the external objects seem to be enveloped in mist or haze or as if laid under a sheet of water or as viewed in rain and on cloudy days, and meteors of different colours seem to be falling constantly in all directions in the event of the deranged Doshas being similarly confined in the second Patala (coat) of the Drishti. In such cases the near appearance of an actually remote object and the contrary (Miopia and Biopia) also should be ascribed to some deficiency in the range of vision (error of refraction in the crystalline lens) which incapacitates the patient from looking through the eye and hence from threading a needle. 4.

Symptoms—when third Patala attacked:—

Objects situate high above are seen and those placed below remain unobserved when the deranged Dosha are infiltrated into the Third Patala (coat) of the Drishti. The Doshas affecting the Drishti (crystalline lens), if highly enraged, impart their specific colours to the objects of vision. Even large objects seem to be covered with a piece of cloth. The images of objects and persons with ears and eyes, etc., seem to be otherwise i.e., bereft of those organs. The deranged Doshas situated at and obstructing the lower, upper and lateral parts of the Drishti (crystalline lens) respectively shut out the view of near, distant and laterally-situate objects. A dim and confused view of the external world is all that can be had when the deranged Doshas spread over and affect the whole of the Drishti (crystalline lens). A thing appears to the sight as if cut into two (bifurcated) when the deranged Doshas affect the middle part of the lens, and as triply divided and severed when the Doshas are scattered in two parts; while a multifarious image of the same object is the result of the manifold distributions of movability of the Doshas over the Drishti. 5.

Symptoms—when fourth Patala attacked:—

Loss of vision (Timira) results from the fact of the deranged bodily Doshas being confined within the fourth Patala (choroid) of the organ. When the vision is completely obstructed by the aforesaid cause, it is called a case of Linga-nasha (blindness). Only a faint perception of the images of the sun, the moon and the stars, the heaven, a flash of lightning or any other such highly brilliant objects is possible in a case of superficial (not deep-seated) Linga-nasha. The Linga-nasha (blindness) is also called Nīlika and Kacha. 6.

Specific traits of Timira:—

All external objects are viewed as cloudy, moving, crooked and red-coloured in the Vataja type (of Timira), while in the Pittaja type they appear to be invested with the different colours of the spectrum or of the rain-bow, of the glowworm, of the flash of lightning, or of the feathers of the pea-cock, or with a dark blue tint bordering on black; while in a case of Kaphaja. Timira, a thick white coat like that of a pack of white clouds or a deep white chowri (Chamara) seems to intervene in everything which look white and oily and dull and appear hazy and cloudy in a fine day, or as if laid under a sheet of water. In a case of the Raktaja type of Timira, all objects appear red or envoloped in gloom, and they assume a greyish, blackish or variegated colour. In a case of Sannipatika Timira, the outer world looks vareigated and confused, appears as doubled or trebled to the vision (of the patient), and stars and planets, either defective or supplied with additional limbs, seem to float about in the vision. 7-11.

Parimlayi:—

The quarters of the heaven look yellow and appear to the sight as if resplendent with the light of the rising sun, and trees seem as if sparkling with the tangles of fire-flies in a case of Parimlayi, which should be ascribed to the action of the deranged Pitta in concert with the vitiated blood. 12.

The different colours of the pupil in cases Of Linga-nasha:—

Now we shall describe the colours of the pupil in the six different types of Linga-nasha. The pupil assumes a reddish (Aruna) colour in the Vataja type of the disease; looks blue or bluish yellow in the Pittaja, white in the Kaphaja and blood-red in the blood-origined (Raktaja) one, while it assumes a variegated hue in the Sannipatika type of Linga-nasha. A circular patch (Mandala) tinged with a shade of bluish or bluish yellow colour and looking like fire or a piece of thick grass, is formed on the pupil owing to the diseased and aggravated condition of the blood (with pitta) in a case of Parimlayi. In this case the patient is sometimes permitted to catch faint glimpses of the external objects owing to the spontaneous and occasional filtering away of the deranged Doshas obstructing the vision. 13–1 5.

Specific Traits of Linga-nasha:—

The circular patch (over the pupil) in a case of Vataja Linga-nasha is red-coloured, and is moving and rough to the touch, while that in a case of Pittaja Linga-nasha is bluish or yellow or coloured like bell-metal. The circular patch in a case of Kaphaja Linga-nasha is thick, oily and as white as a conch-shell, a Kunda flower or the moon—resembling a white drop of water on the moving lotus leaf and moving away to and fro when the eye is rubbed. The circular patch over the pupil in a case of Raktaja (blood-origined) Linga-nasha is red-coloured like a coral or a (red) lotus-petal. A Sannipatika type of the disease is marked by a variegated colour of the Drishti (pupil) and by the specific symptoms of the different Doshas. 16.

The total number of diseases peculiar to the Drishti is twelve. The six types of Linga-nasha (Drishti) have been described above. The six other forms of the disease, peculiar to the Drishti (pupil) are named as Pitta-vidagdha-Drishti, Shleshma-vidagdha-Drishti, Dhūma-darshin, Hrasva-Jatya, Nakulandhyata and Gambhīrika. 17.

The disease in which the region of the Drishti (pupil) assumes a yellowish colour, and all external objects appear yellow to the sight owing to the presence of the vitaited (and augmented) Pitta in the region of the Drishti is called Pitta-Vidagdha-Drishti. It is due to an accumulation of the deranged Dosha (Pitta) in the third Patala (coat) of the eye, and the patient cannot see anything in the day, but can see only in the night. 18.

The external objects appear white to the sight when it is affected by the accumulation of the deranged Kapha. The deranged Dosha (Kapha), in this case, is simultaneously divided over all the three Patalas (coats) of the eye. In consequence of this the patient is attacked with nocturnal blindness, being able to see only in the daytime owing to the (melting and) decrease of the deranged Kapha through the heat of the sun. This is known as Shleshma-vidagdha-Drishti. 19.

The external objects appear dusky or smoke-coloured when the sight is affected through grief, (high and protracted) fever, over-straining or excessive physical exercise, or injury to the head, etc. The affection of vision thus engendered is called Dhuma-Drishti (smoky sight). 20.

The disease in which small things can be viewed only with the greatest difficulty (even) in the daytime, but can be viewed (easily and clearly) in the night owing to the subsidence of the deranged pitta through the coldness of the atmosphere (and a general cooling of the Earth’s surface)^[2] is called Hrasva-jatya^[3]. 21.

The form of occular affection in which the colour of Drishti (pupil) of a man affected by the Doshas resembles (and is found to emit (luminous) flashes like) that of a mungoose in consequence of which the external objects appear multi-coloured in the day time,^[4] is called Nakulandhya. The form of occular affection due to the action of the deranged Vayu, and in which the Drishti (pupil) is contracted and deformed and sinks into the socket, attended with an extreme pain in the affected parts, is called Gambhirika. 22-23.

Besides the above, there are two more forms of Linga-nasha of traumatic origin, viz., Sanimitta (of ascertainable origin) and Animitta (without any manifest or ascertainable cause). Under the first group may be arranged those which are produced by such causes as an over-heated^[5] condition of the head (brain, etc.), and marked by the specific symptoms of (blood-origined) Abhishyanda, while the second comprises those in which the loss of one’s vision is due to causes, such as the witnessing of divine halo or effulgence emanating from the ethereal person of a god, or a Gandharva (demigod), a holy saint, a celestial serpent, or such other highly bright object. In this case the eye is not outwardly affected and the pupil (Drishti) looks as bright and clear as a Vaidūrya gem, while in the former case (of ascertainable origin) the eye is characterised by a sunken or pierced or impaired aspect of the pupil. 24.

We have thus finished describing separately the diagnostic traits of the seventy-six forms of disease which affect the organ of vision. We shall hereafter separately deal with the nature of the medical treatment to be pursued in each case. 25.

 

Thus ends the seventh chapter of the Uttara-Tantra in the Sushruta Samhita which treats of the pathology of the diseases peculiar to the pupil of the eye.

Footnotes and references:

[1]:

According to Nimi, quoted in Mādhava’s commentary by Śrīkantha, the dimension of the Drishti is equal to only a half of that of a Masura-pulse.

[2]:

The latter part of the text here seems to be incongruous. Mādhava does not read the last line in his Nidāna, nor does Dallana include it in his commentary. Dallana, on the other hand, says that some read this line, but holds, on the authority of Videha, that the reading is incongruous, in as much as “Hrasva-jātya” is said to cause one of the four types of night-blindness.

[3]:

Some read Hrasva-jādya in place of Hrasva-jātya.

[4]:

This shows that a man affected with this form of disease cannot see anything in the night.

[5]:

The head is liable to be over-heated by the smelling of poison or poisonous objects or any other strong-scented flower, etc.