Chapter CLXIX - The Nidanam of diseases of the ears

Now hear me, O Sushruta, discourse on the Nidanam of Karnaroga (diseases of the ear). The deranged Vayu, by coursing through the vessels of the ears, produces an extremely aching sensation therein which is called Karna-shula (Otalgia (O?a?gia?)). The vessels in their turn are choked up by the morbific principles (doshas) in this disease when the deranged Vayu lies incarcerated in the ducts of the ears. The patient bears a variety of sounds such as of drums, trumpets, etc. When the deranged Vayu affects the sound-carrying nerves of the ears, deafness is the result in as much as they are choked up with the deranged Kaphah. The deranged Vayu in conjunction with the deranged Pittam produces a flutelike sound in the ears. This disease is called Karna-ksheda. The disease in which on account of a hurt or injury to, or through the effect of long keeping the head immersed in water, or through the suppuration of a (local) abscess, pus is discharged from the ears, is called Karna-paka.

The deranged local Vayu in conjunction with the deranged Kaphah produces an itching sensation in the ducts of the ears which is called Karna-kandu. The deranged Kaphah, dried up by the heat of the Pittam, is transformed into a waxy substance called Karna-Guthakam. The same waxy substance, when melted, enters into the cavities of the mouth and nostrils and gives rise to a disease which is called Karna-Pratinaha, which is characterised by an aching sensation in the half of the body. The disease in which parasites or vermins, exist or germinate in the ducts of the ears is called Krimi-karnaka by the wise. Insects and Shatapadis by entering into the cavities of the ears produce a buzzing sound and pain therein. An extremely aching pain is felt when the insect moves about in the ear, which subsides when the insect lies still and quiet. Abscesses may also grow in the ears through the effects of blows or injuries, or through the agency of any of the deranged morbific principles, secreting a reddish or yellowish coloured discharge accompanied by a burning, sucking sensation. The patient feels as if fumes are escaping out of the affected ear-duct. The waxy deposit in the ears melted through the agency of the aggravated Pittam tends to set up a flow of pus from the ducts of the ears. Similar secretions from inflammed ear-ducts may be established as a consequence of a bursting abscess. The disease in which fetid pus is discharged from the ears is called Puti-karnam. The Nidanas of Abscesses, hæmorrhoids, Arvuds or other pappilatous growths in the ear-ducts are same as those described under their respective general heads.

In the Vataja type of the disease of the ears, the patient hears a variety of sounds in his ears which become extremely painful. The waxy deposits in the ears are dried up and a thin fluid is discharged from the ears, with loss of the faculty of hearing. In the Pittaja type of ear-disease red coloured swellings attended with a burning sensation crop up in the ears, which are found to discharge a fetid yellow coloured pus. In the Kaphaja type of this disease, the ears lose the faculty of correctly locating the sound or to catch it correctly, an itching sensation is experienced and hard swellings appear in the ears, which discharge a white glossy fluid, attended with a slight pain. In the Sannipatika type, the specific symptoms of all the several types of ear-diseases (Otalgia) enumerated above conjointly manifest themselves, and the predominant morbific principle (Dosha) in these cases impart its peculiar colour to the secretion, and tends to determine its nature as well.

Swelling and inflammation of the soft appendages of the ears (ear-lobes) brought about in consequence of an attempt at getting them elongated, and which burst out and assume a blackish (bluish) colour, should be attributed to the action of the deranged and aggravated Vayu of the locality. The disease is called Paripolaka. A red or reddish brown swelling of the ear-lobes, brought about through actions of the Doshas in the part, or through the effect of wearing heavy ear-ornaments attended with a burning sensation and suppuration and pain is called Upapaka. This disease is attributed to the action of the enraged blood and Pittam of the locality. A slightly painful swelling occurring about the lobulus through the effect of forcibly drawing it, attended with an itching sensation and a little numbness is called Unmathaka (Unmanthaka?). This disease is attributed to the action of the deranged Vayu and Kaphah of the locality. A swelling of the earlobes attended with an itching, burning sensation and pain in consequence of their perforation, or of their being violently pulled or attempted to be elongated is called Duhkhavardhanam, which should be attributed to the concerted action of the three morbific principles of the body (Sannipatika).

Parasites (krimi), offspring of the deranged Kaphah and vitiated blood, give rise to swellings about the ear-lobes attended with pain and itching, burning sensations. These pustular eruptions, engendered through the action of the deranged Kaphah and vitiated blood are gradually found to spread over and invade the concha and lobes of the ears. This disease is called Parichi.