Chapter CLXXII - The Nidanam of diseases of the head

Hear me, O Sushruta, now discourse on the Nidanam of shiro roga. There are several types of Shiro-roga, such as those due to the several actions of the deranged Vayu, Pittam and Kapha, Suryavarta, Anantavata, Ardhavabhedaka and Shankhaka, as well as those which are brought about through the concerted action of the deranged Vayu, Pittam and Kaphah, or are due to the action of parasites, or to the loss of any fundamental principle of the body, or to the vitiated condition of the blood. In the Vataja type of Shiro-roga a pain is suddenly experienced in the head which is aggravated in the night and relieved on pressure, or on application of oil to the head. In the Pittaja type, the patient feels as if his head is burning with live charcoal and fumes escaping out of his ostrils. The disease shows signs of amelioration after nightfall, and after cold applications to the head. In the Kaphaja type of Shiro-roga the head is felt cold to the touch and seems heavy and tight, as if closely tied with a compress. Swellings about the sockets of the eyes form one of its special characteristics. In the Sannipatika form all the symptoms of the three aforesaid types manifest themselves in unison. In the Raktaja type ail the symptoms of the Pittaja one are manifested, and the head, in special, cannot bear the least touch. The type known as Kshayaja is brought about through the loss of fat, blood, or of Kapham (mucous) of the head. This is one of the most distressing and virulent types of shira-roga and is extremely hard to cure. Applications of medicated oils, bleeding, errhines, emetics, etc., fail to give any relief in this type. Vertigo with a gone feeling in the limbs, and epileptic fits form the specific features of this disease. The patient feels as if needles are being pricked into his head which rolls about. In the type due to the action of the parasites, the patient suffers from a fluent coryza mixed with pus. The parasites gnaw at the membranes of the skull, the head throbs, and a pricking, piercing pain is felt in its inside. This disease is extremely hard to cure. In the type known as Suryavarta a slight pain about the eyes and eye-brows is commenced to be felt from the sunrise in the morning which increases as the sun travels towards the zenith, the pain reaching its climax at midday. With the decline of the sun in the west the pain shows signs of amelioration, entirely subsiding after night-fall. This disease is attributed to the aggravated action of the deranged Vayu, Pittam and Kaphah, and is extremely hard to cure.

The disease, in which the bodily Vayu, aggravated through the ingestion of parchifying articles of fare, or in consequence of eating before the digestion of a previous meal is completed, or enraged through an exposure to cold or east wind, or in consequence of over-fatiguing physical exercise, or aggravated through the suppression of any natural urging of the body, either alone or in unison with the deranged Kaphah, gives rise to an excruciating pain extending over the half of the head (Hemicrania) and affecting only one ear, one eye, one eye-brow, and one half of the region of the temple or neck, is called Ardhavabhedaka The affected half of the head seems as if it is being cut with a knife, or is being churned in the manner of, fire-churning (Arani). The disease in which the enraged blood, Pittam and Vayu, being augmented, and accumulated in the temporal regions, give rise to a swelling attended with a burning sensation, redness, and an intolerable pain is called shankhaka by the wise. The disease soon spreads to the head with the rapidity of a poison and brings on constriction of the larynx. It invariably proves fatal within three nights. A patient, not succom. bing within this period, may rally under an extremely cautious and judicious treatment.