Ashtanga Hridayam UttaraSthanam Chapter 33: Guhyaroga Vijnaniyam (Knowledge of Diseases of Genital Organs)

The 33rd chapter of Uttara Sthanam of Ashtanga Hridayam is named as ‘Guhyaroga Vijnaniya’. This chapter deals with the explanation of ‘Knowledge of diseases of genital organs’.

The topics covered in this chapter include –

• Nidana – causes
• Upadamsha
• Medhrarshas – Yonyarshas
• Sarshapika
• Avamantha
• Kumbhika
• Alaji & Uttama
• Pushkarika
• Samvyudha Pitika
• Mridita
• Asthilika
• Nivritta
• Avapatika
• Niruddhamani
• Gratitha
• Sparshahani
• Shataponaka
• Tvakpaka
• Mamsapaka
• Raktarbuda – Mamsarbuda – Vidradhi
• Tilakalaka
• Sadhyasadhya – prognosis
• Yoni Vyapat – disorders of vagina
• Vatiki Yoni Vyapat
• Aticharana
• Prakcharana
• Udavritta
• Jataghni
• Antarmukhi
• Suchimukhi
• Shushka Yoni
• Vamini
• Shandha
• Mahayoni
• Paittiki Yoni Vyapat
• Rakta Yoni Vyapat
• Shlaishmiki – Yoni Vyapat
• Lohitakshaya
• Paripluta
• Upapluta
• Vipluta
• Karnini
• Sannipatika Yoni Vyapat

Pledge by the author(s)

अथातो गुह्यरोगविज्ञानीयं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘Knowledge of diseases of the genital organs’. Thus, say (pledge) Atreya and other sages.

Nidana: Causes

स्त्रीव्यवायनिवृत्तस्य सहसा भजतोऽथवा ।
दोषाध्युषितसङ्कीर्णमलिनाणुरजःपथाम् ॥ १ ॥
अन्ययोनिमनिच्छन्तीमगम्यां नवसूतिकाम् ।
दूषितं स्पृशतस्तोयं रतान्तेष्वपि नैव वा ॥ २ ॥
विवर्धयिषया तीक्ष्णान् प्रलेपादीन् प्रयच्छतः ।
मुष्टिदन्तनखोत्पीडाविषवच्छूकपातनैः ॥ ३ ॥
वेगनिग्रहदीर्घातिखरस्पर्शविघट्टनैः ।
दोषा दुष्टा गता गुह्यं त्रयोविंशतिमामयान् ॥ ४ ॥
जनयन्त्युपदंशादीन
Indulging in copulation suddenly (for the second time), immediately after retiring from the first, copulating with women having their menstrual tract (vagina) vitiated by the doshas, congested, contaminated and greatly narrowed, copulating with the other vagina (of animals); with the woman who is unwilling, who is forbidden, who has just delivered, touching (washing the penis in) dirty water, not washing it all after copulation applying strong acting pastes (of herbs etc.) desire to increase penis, getting injured (bruised) from assault by the fist, teeth, nails and application of paste of poisonous insects, suppression of the urges, long contact with very rough materials, hot or blow (by accident); by these causes the doshas become aggravated, get localized in the genital organ (penis) and produce twenty-three diseases such as Upadamsha etc.

Upadamsha

उपदंशोऽत्र पञ्चधा ।
पृथग्दोषैः सरुधिरैः समस्तैश्चात्र मारुतात् ॥ ५ ॥
मेढ्रे शोफो रुजश्चित्राः स्तम्भस्त्वक्परिपोटनम् ।
पक्वोदुम्बरसङ्काशः पित्तेन श्वयथुर्ज्वरः ॥ ६ ॥
श्लेष्मणा कठिनः स्निग्धः कण्डूमाञ्छीतलो गुरुः ।
शोणितेनासितस्फोटसम्भवोऽस्रस्रुतिर्ज्वरः ॥ ७ ॥
सर्वजे सर्वलिङ्गत्वं श्वयथुर्मुष्कयोरपि ।
तीव्रा रुगाशुपचनं दरणं कृमिसम्भवः ॥ ८ ॥
याप्यो रक्तोद्भवस्तेषां मृत्यवे सन्निपातजः ।
Upadamsha is of five kinds; one from each dosha separately, one from blood and the fifth from all the doshas together. In that caused by Vata, there is swelling in the penis, pain of various kinds, stiffness, cracks on skin of penis. It appears like the ripe fruit of Ficus racemosa, along with swelling and fever in that caused by Pitta; in that caused by Kapha, the penis appears hard, greasy, itching, cold and heavy; that due to blood, is prone to develop black colored vesicles, bleeding and fever. That caused by all the doshas, has features of all the doshas, swelling even of the scrotum, severe pain, ripens (suppurates) quickly, putrefaction and appearance of worms are likely. Among these, that born from blood is controllable but persist long, that from all the doshas together is going to kill the person.

Medhrarshas: Yonyarshas

जायन्ते कुपितैर्दोषैर्गुह्यासृक्पिशिताश्रयैः ॥ ९ ॥
अन्तर्बहिर्वा मेढ्रस्य कण्डूला मांसकीलकाः ।
पिच्छिलास्रस्रवा योनौ तद्वच्च छत्रसन्निभाः ॥ १० ॥
तेऽर्शांस्युपेक्षया घ्नन्ति मेढ्रपुंस्त्वं भगार्तवं ।
Mamsakilaka (projections of muscle) produced by the aggravated doshas, localized in the blood and muscle of the penis, developing either inside or outside of penis, having itching and discharge of slimy blood. It occurs in the same way in the vagina, resembling an umbrella. These are called Arshas, when neglected (Medhrarshas) causes loss of penis and masculine potency; (and yonyarasas) causes loss of female genitals and menstruation.

Sarshapika

गुह्यस्य बहिरन्तर्वा पिटिकाः कफरक्तजाः ॥ ११ ॥
सर्षपामानसंस्थाना घनाः सर्षपिकाः स्मृताः ।
Eruptions developing either inside or outside the genitals (penis and vagina), caused by Kapha and rakta (blood) resembling Brassica juncea in size and shape and hard are known as Sarshapika.

Avamantha

पिटिका बहवो दीर्घा दीर्यन्ते मध्यतश्च याः ॥ १२ ॥
सोऽवमन्थः कफासृग्भ्यां वेदनारोमहर्षवान् ।
Pitikas caused by Kapha and blood, more than one in number, elongated, tearing in the middle, accompanied with pain and horripilation is Avamantha.

Kumbhika

कुम्भीका रक्तपित्तोत्था जाम्बवास्थिनिभाशुजा ॥१३॥
Kumbhika is born from Rakta and Pitta, resembles the Kernel of Syzygium cumini fruit and develops rapidly.

Alaji & Uttama

अलजीं मेहवद्विद्यादुत्तमां पित्तरक्तजाम् ।
पिटिकां माषमुद्गाभां

Alaji is similar to Alaji belonging to Prameha. Uttama is Pitika born from Pitta and rakta resembling Vigna mungo or Vigna radiata.

Pushkarika

पिटिका पिटिकाचिता ॥ १४ ॥
कर्णिका पुष्करस्येव ज्ञेया पुष्करिकेति सा
Pitika surrounded by small eruptions like the pushkara karnikka is known as Pushkarika.

Samvyudha Pitika

पाणिभ्यां भृशसंव्यूढे संव्यूढपिटिका भवेत् ॥ १५ ॥
Pitika caused by hard rubbing of the penis by the hands is Samvyudha Pitika.

Mridita

मृदितं मृदितं वस्त्रसंरब्धं वातकोपतः ।
Mridita is a contusion of the penis caused by rubbing it with rough cloth etc. and caused by aggravation of Vata.

Asthilika

विषमा कठिना भुग्ना वायुनाऽष्ठीलिका स्मृता ॥१६॥
The penis becoming curved/distorted, hard and bent caused by Vayu is known as Asthilika.

Nivritta

विमर्दनादिदुष्टेन वायुना चर्म मेढ्रजम् ।
निवर्तते सरुग्दाहं क्वचित्पाकं च गच्छति ॥ १७ ॥
पिण्डितं ग्रन्थितं चर्म तत्प्रलम्बमधो मणेः ।
निवृत्तसञ्ज्ञं सकफं कण्डूकाठिन्यवत्तु तत् ॥ १८ ॥
Vata undergoing aggravation by hard rubbing etc., the fore-skin of the penis goes back associated with pain, burning sensation and sometimes suppuration occurs, the skin becomes folded, knotted and hangs below the glans, having Kapha, itching and hardness, This is known as Nivritta.

Avapatika

दुरूढं स्फुटितं चर्म निर्दिष्टमवपाटिका ।
The skin which does not heal properly, which is cracked is known as Avapatika.

Niruddhamani

वातेन दूषितं चर्म मणौ सक्तं रुणद्धि चेत् ॥ १९ ॥
स्रोतो मूत्रं ततोऽभ्येति मन्दधारमवेदनम् ।
मणेर्विकाशरोधश्च स निरुद्धमणिर्गदः ॥ २० ॥

The skin vitiated by Vata, adhering to the penis obstructs the channel of urine, then the urine flows out in slow stream and without pain, there is obstruction to the exposure of the glans. This disease is called Niruddhamani.

Gratitha

लिङ्गं शूकैरिवापूर्णं ग्रथिताख्यं कफोद्भवम् ।
The penis appearing as though full of thorns is known as Gratitha and is of Kapha origin.

Sparshahani

शूकदूषितरक्तोत्था स्पर्शहानिस्तदाह्वया ॥ २१ ॥
Sparshahani is that which arises from blood and arises due to vitiated poisonous worms.

Shataponaka

छिद्रैरणुमुखैर्यत्तु मेहनं सर्वतश्चितम् ।
वातशोणितकोपेन तं विद्याच्छतपोनकम् ॥ २२ ॥
Penis developing small holes all over its surface caused by the aggravation of Vata and Shonita (blood) is known as Shataponaka.

Tvakpaka

पित्तासृग्भ्यां त्वचः पाकस्त्वक्पाको ज्वरदाहवान् ।
The skin undergoing paka (suppuration ulceration) caused by Pitta and asrik (blood) accompanied with fever and burning sensation is Tvakpaka.

Mamsapaka

मांसपाकः सर्वजः सर्ववेदनो मांसशातनः ॥ २३ ॥
Mamsapaka is caused by all the doshas together, having all the features and leads to the muscles falling off.

Raktarbuda, Mamsarbuda, Vidradhi

सरागैरसितैः स्फोटैः पिटिकाभिश्च पीडितम् ।
मेहनं वेदना चोग्रा तं विद्यादसृगर्बुदम् ॥ २४ ॥
Penis developing red and black vesicles and eruptions, having severe pain should be understood as Asrik Arbuda.

मांसार्बुदं प्रागुदितं विद्रधिश्च त्रिदोषजः ।
Mamsarbuda has been described earlier (chapter 29), so also Vidrdhi which arises from all the three doshas (Chapter 11 of Nidana Sthana).

Tilakalaka

कृष्णानि भूत्वा मांसानि विशीर्यन्ते समन्ततः ॥२५॥
पक्वानि सन्निपातेन तान् विद्यात्तिलकालकान् ।
Black moles develop on the penis, the muscles fall off everywhere, undergoes suppuration / ulceration soon caused by all the doshas together is known as Tilakalaka.

Sadhyasadhyata: Prognosis

मांसोत्थमर्बुदं पाकं विद्रधिं तिलकालकान् ॥ २६ ॥
चतुरो वर्जयेदेषां शेषाञ्छीघ्रमुपाचरेत् ।
Mamsarbuda, Mamsapaka, Vidradhi and Tilakalaka these four diseases should be rejected, the remaining should be treated quickly.

Yoni Vyapat: Disorders of vagina

विंशतिर्व्यापदो योनेर्जायन्ते दुष्टभोजनात् ॥ २७
Twenty diseases of the vagina arise because of consuming bad food.

Vatiki Yoni Vyapat

विषमस्थाङ्गशयनभृशमैथुनसेवनैः ।
दुष्टार्तवादपद्रवैर्बीजदोषेण दैवतः ॥ २८ ॥
योनौ क्रुद्धोऽनिलः कुर्याद्रुक्तोदायामसुप्तताः ।
पिपीलिकासृप्तिमिव स्तम्भं कर्कशतां स्वनम् ॥ २९ ॥ फेनिलारुणकृष्णाल्पतनुरूक्षार्तवस्रुतिम् ।
स्रंसं वङ्क्षणपार्श्वादौ व्यथां गुल्मं क्रमेण च ॥ ३० ॥
तांस्तांश्च स्वान् गदान् व्यापद्वातिकी नाम सा स्मृता |
Improper postures during living, sleeping, excess of sexual intercourse, vitiation of the menstrual flow, use of bad materials (as substitutes for the phallus), disorders of the seed (ovum) and effects of actions of previous lives, by these causes Vata gets aggravated in the vagina and produces pain, pricking and dilating types of pain, loss of sensation, feeling of ants crawling, loss of movement, roughness and noise (gas coming out with noise) and discharge of menstrual blood which is frothy, slight reddish black, thin and dry (non- unctuous), drooping of groins and flanks, discomfort and gradual development of abdominal tumor. All these different kinds of diseases are called Vatiki (Yoni Vyapat).

Aticharana

सैवातिचरणा शोफसंयुक्तातिव्यवायतः ॥ ३१ ॥
Aticharana is a similar one accompanied with swelling (of the vagina) caused by excess copulation.

Prakcharana

मैथुनादतिबालायाः पृष्ठजङ्घोरुवङ्क्षणम् ।
रुजन् सन्दूषयेद्योनिं वायुः प्राक्चरणेति सा ॥ ३२ ॥
Copulation in a very young girl, produces pain in her back, calves, thighs and groins and Vata vitiates the vagina. It is known as Prakcharana.

Udavarta

वेगोदावर्तनाद्योनिं प्रपीडयति मारुतः ।
सा फेनिलं रजः कृच्छ्रादुदावृत्तं विमुञ्चति ॥ ३३ ॥
इयंव्यापदुदावृत्ता
Vata aggravated by suppression of the urges, torments the vagina and expels frothy menstrual blood with difficulty, leading to the vaginal disease called Udavarta.

Jataghni

जातघ्नी तु यदानिलः ।
जातं जातं सुतं हन्ति रौक्ष्याद्दुष्टार्तवोद्भवम् ॥३४॥
Jataghni is caused by Vata by increasing the dryness of the vitiated menstrual blood; it kills every child that is born.

Antarmukhi

अत्याशिताया विषमं स्थितायाः सुरते मरुत् ।
अन्नेनोत्पीडितो योनेः स्थितः स्रोतसि वक्रयेत् ॥३५॥
सास्थिमांसं मुखं तीव्ररुजमन्तर्मुखीति सा ।
Indulging in copulation after a heavy meal or adopting abnormal postures, Vata pressed by the food, gets localised in the vagina and distorts the channels along with bones and muscles around the opening of vagina
along with severe pain, is called Antarmukhi.

Suchimukhi

वातलाहारसेविन्यां जनन्यां कुपितोऽनिलः ॥ ३६ ॥
स्त्रियो योनिमणुद्वारां कुर्यात्सूचीमुखीति सा
Vata getting aggravated in those women who indulge in Vata increasing foods, producing causes narrowing of the vaginal passage in women, this is called Suchimukhi.

Shushka Yoni

वेगरोधादृतौ वायुर्दुष्टो विण्मूत्रसङ्ग्रहम् ॥ ३७ ॥
करोति योनेः शोषं च शुष्काख्या सातिवेदना ।
Due to the habit of suppressing the urges (during the period of menstruation), Vata getting aggravated, causes accumulation of feces and urine and causes dryness of the vagina, accompanied with severe pain. This is called Shushka Yoni.

Vamini

षडहात्सप्तरात्राद्वा शुक्रं गर्भाशयान्मरुत् ॥ ३८ ॥
वमेत्सरुङ्नीरुजो वा यस्याः सा वामिनी मता ।
Either on the sixth day or seventh day, the semen is vomited (expelled) out of the uterus, either accompanied with pain or without pain by Vata this is called Vamini.

Shandha

योनौ वातोपतप्तायां स्त्रीगर्भे बीजदोषतः ॥ ३९ ॥
नृद्वेषिण्यस्तनी च स्यात्षण्ढसञ्ज्ञाऽनुपक्रमा ।
The woman who resents features of aggravation of Vata in uterus and vagina due to defect in the seed, who hates men and has no (developed) breasts is known as Shandha and cannot be cured.

Mahayoni

दुष्टो विष्टभ्य योन्यास्यं गर्भकोष्ठं च मारुतः ॥४०॥
कुरुते विवृतां स्रस्तां वातिकीमिव दुःखिताम् ।
उत्सन्नमांसां तामाहुर्महायोनिं महारुजाम् ॥४१॥
Vata getting vitiated, obstructing the vaginal passage, the mouth and cavity of the uterus, causes them to dilate, droop down and pain like that of Vatiki (described earlier) muscles protrude out and cause severe pain. This is known as Mahayoni.

Paittiki Yoni Vyapat

यथास्वैर्दूषणैर्दुष्टं पित्तं योनिमुपाश्रितम् ।
करोति दाहपाकोषापूतिगन्धिज्वरान्विताम् ॥ ४२ ॥
भृशोष्णभूरिकुणपनीलपीतासितार्तवाम् ।
सा व्यापत्पैत्तिकी
Pitta getting aggravated by its own causes getting localized in vagina produces burning sensation, suppuration/ ulceration, warmth, foul smell, fever, discharge of menstrual blood which is very hot, large in quantity, of cadaveric smell, blue, yellow or black in color. These are features of Paittika (yoni vyapat).

Rakta Yoni Vyapat

रक्तयोन्याख्याऽसृगतिस्रुतेः ॥ ४३ ॥
When there is copious discharge of blood it is known as Raktayoni.

Shlaishmiki: Yoni Vyapat

कफोऽभिष्यन्दिभिः क्रुद्धः कुर्याद्योनिमवेदनाम् ।
शीतलां कण्डुलां पाण्डुपिच्छिलां तद्विधस्रुतिम् ॥४४॥
सा व्यापच्छ्लैष्मिकी
Kapha getting aggravated by use of foods which increase moisture leads to Shlaihsmiki (Kaphajayoni Vyapat), characterized by absence of pain, feeling of cold, itching and discharge of pale, slimy blood of that kind. This is called Shliahsmiki yoni vyapat.

Lohitakshaya

वातपित्ताभ्यां क्षीयते रजः ।
सदाहकार्श्यवैवर्ण्यं यस्याः सा लोहितक्षया ॥ ४५ ॥|
Loss or decrease of menstrual blood is caused by aggravation of Vata and Pitta together and is accompanied with burning sensation, emaciation, and discoloration. This is called Lohitakshaya.

Paripluta

पित्तलाया नृसंवासे क्षवथूद्गारधारणात् ।
इत्तयुक्तेन मरुता योनिर्भवति दूषिता ॥ ४६ ॥
शूना स्पर्शासहा सार्तिर्नीलपीतास्रवाहिनी ।
बस्तिकुक्षिगुरुत्वातीसारारोचककारिणी ॥ ४७ ॥
श्रोणिवङ्क्षणरुक्तोदज्वरकृत्सा परिप्लुता ।
The woman belonging to pitta constitution, who suppresses the urges of sneezing and belching during copulation, goes in for aggravation of Vata along with Pitta, which together vitiate the vagina, which becomes swollen, intolerant to touch, painful, exuding blue and yellow blood, associated with feeling of heaviness of the urinary bladder and abdomen, diarrhoea, loss of taste/appetite, pain in the waist, groin, pricking pain and fever. This disease is Paripluta.

Upapluta

वातश्लेष्मामयव्याप्ता श्वेतपिच्छिलवाहिनी ॥ ४८ ॥
उपप्लुता स्मृता
This having the features of increase of Vata and Kapha, exudes blood which is white and slimy, this is Upapluta yoni.

Vipluta

योनिर्विप्लुताख्या त्वधावनात् ।
सञ्जातजन्तुः कण्डूला कण्ड्वा चातिरतिप्रिया ॥ ४९
Vipluta is due to not washing the vagina (clearing again), gives rise to growth of worms (bacteria etc.) and itching, because of itching the woman desires copulation often.

Karnini

अकालवाहनाद्वायुः श्लेष्मरक्तविमूर्छितः ।
कर्णिकां जनयेद्योनौ रजोमार्गनिरोधिनीम् ॥ ५० ॥
सा कर्णिनी
By premature initiation of the urges, Vata getting aggravated along with Kapha and blood produces Karnika (sprouts of muscles) of vagina, obstructing the channel of the menstrual blood. This is known as Karnini.

Sannipatika Yoni Vyapat

त्रिभिर्दोषैर्योनिगर्भाशयाश्रितैः ।
यथास्वोपद्रवकरैर्व्यापत्सा सान्निपातिकी ॥ ५१
Diseases arise along with secondary affections from the aggravation of all the doshas together localized in vagina and uterus, having all the features. This is called Sannipatiki yoni Vyapat.

Yoni rogas leading to other diseases

इति योनिगदा नारी यैः शुक्रं न प्रतीच्छति ।
ततो गर्भं न गृह्णाति रोगांश्चाप्नोति दारुणान् |
असृग्दरार्शोगुल्मादीन् आबाधांश्चानिलादिभिः ॥ ५२ ॥
These are the diseases of the Vagina, by which the woman does not retain the semen, nor develop the embryo and acquire severe (difficult to cure) diseases such as menorrhagia, haemorrhoids, abdominal tumor etc. diseases produced by Vata.

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने गुह्यरोगविज्ञानीयो नाम त्रयस्त्रिंशोऽध्याय ॥ ३३ ॥
Thus, ends the chapter-Guhyarogavijnaniya- the thirty third in Uttarsthana of Astanga Hridaya Samhita composed by Srimad Vagbhata, son of Sri Vadiyapati Simhagupta.