Sushruta Samhita Nidanasthana Chapter 14 Sukadosa Nidanam (Diseases of the Penis)

The 14th chapter of Nidanasthana of Sushruta Samhita is named as Sukasosa Nidanam Adhyaya. This chapter deals with diseases of the Penis.

अथातः शूकदोषनिदानं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound the Suka Dosa Nidana- diagnosis of diseases of the penis produced by Sukas (poisonous insects), as revealed by the venerable Dhanvantari.

Roga Nama- Names of diseases

लिङ्गवृद्धिमिच्छतामक्रमप्रवृत्तानां शूकदोषनिमित्ता दश चाष्टौ च व्याधयो जायन्ते |
तद्यथा सर्षपिका, अष्ठीलिका, ग्रथितं, कुम्भीका, अलजी, मृदितं, सम्मूढपिडका, अवमन्थः, पुष्करिका, स्पर्शहानिः, उत्तमा, शतपोनकः, त्वक्पाकः, शोणितार्बुदं, मांसार्बुदं, मांसपाकः, विद्रधिः, तिलकालकश्चेति ||३||

Below mentioned are the eighteen kinds of diseases which are produced by the ill effects of the use of Suka – thorny insects living in water which are manifested in persons who indulge in improper activities while they are desirous of increasing the size of their penis –

• Sarsapika,
• Asthilika,
• Grathita,
• Kumbhika,
• Alaji,
• Mrdita,
• Sammudhapidaka,
• Avamantha,
• Puskarika,
• Sparsahani,
• Uttama,
• Sataponaka,
• Tvakkpaka,
• Sonitarbuda,
• Mamsaarbuda,
• Mamsapaka,
• Vidradhi and
• Tilakala

1. Sarsapika

गौरसर्षपतुल्या तु शूकदुर्भग्नहेतुका |
पिडका कफरक्ताभ्यां ज्ञेया सर्षपिका बुधैः ||४||

Sarsapika Suka Roga –

• Manifests in the form of pidaka – eruptions caused by improper usage of Sukas
• Produced by Kapha and Rakta
• Appearance – resembles Gaura Sarsapa – yellow mustard seeds in size and color

2. Asthilika

कठिना विषमैरन्तैर्मारुतस्य प्रकोपतः |
शूकैस्तु विषसम्भुग्नैः पिडकाऽष्ठीलिका भवेत् [२] ||५||

Asthilika Suka Roga presents with

• Pidakas – eruptions – which are hard, uneven inside
• Produced by aggravation of Vata
• Caused by use of poisonous Sukas

3. Grathita

शूकैर्यत् पूरितं शश्वद्ग्रथितं तत् कफोत्थितम् |६|

Grathita (tumor) develops by application of paste daily and is produced by Kapha.

Grathita Suka Roga presents with

• A tumor like growth which develops following the application of paste of suka
• Produced by aggravated kapha
• Present in the form of a granthi – small tumor or cystic swelling

4. Kumbhika

कुम्भीका रक्तपित्तोत्था जाम्बवास्थिनिभाऽशुभा ||६||

Kumbhika Suka Roga presents with

• Produced by aggravation of Rakta and Pitta
• Appearance – resembles the seed of Jambu fruit and is black in color

5. Alaji

अलजीलक्षणैर्युक्तामलजीं च वितर्कयेत् |

Alaji Suka Roga presents with

• Severe swelling in the penis if it is massaged or squeezed
• Produced by aggravation of Vata
• Appearance – similar to Alaji described in the context of Prameha Pidaka of the same name including the symptoms (Prameha Pidaka = diabetic eruption or carbuncle – as explained in chapter 6)

6-7. Mrdita & Sammudha Pidaka

मृदितं पीडितं यत्तु संरब्धं वायुकोपतः ||७||
पाणिभ्यां भृशसम्मूढे सम्मूढपिडका भवेत् |८|

Mrdita Suka Roga presents with –

• Swelling of penis
• Caused by aggravation of vata due to
• Excessive massaging of penis

Samuddha Pidaka Suka Roga presents with –

• Swelling of penis when –
• the penis or swelling of penis is squeezed by hand

8. Avamantha

दीर्घा बह्व्यश्च पिडका दीर्यन्ते मध्यतस्तु याः ||८||
सोऽवमन्थः कफासृग्भ्यां वेदनारोमहर्षकृत् |९|

Avamanthaka Suka Roga presents with

• Pidakas – eruptions – which are multiple and long (elongated), tearing of penis in the middle of penis, associated with pain and horripilations
• Produced by aggravation of kapha and Rakta
• Appearance – eruption is elongated and are multiple

9. Puskarika

पित्तशोणितसम्भूता पिडका पिडकाचिता ||९||
पद्मपुष्करसंस्थाना ज्ञेया पुष्करिकेति सा |१०|

Puskarika Suka Roga –

• Manifests in the form of pidaka surrounded by small eruptions
• Produced by aggravated pitta and Sonita – rakta
• Appearance – resembles base of the petals of a lotus flower

10. Sparsahani

जनयेत् स्पर्शहानिं तु शोणितं शूकदूषितम् ||१०||

Sparsahani Suka Roga –

• Manifests with loss of tactile / touch sensation
• Produced by sonita – blood vitiated by suka

11. Uttama

मुद्गमाषोपमा रक्ता पिडका रक्तपित्तजा |
उत्तमैषा तु विज्ञेया शूकाजीर्णनिमित्तजा ||११||

Uttama Suka Roga –

• Manifests in the form of pidaka – eruptions which are similar to mudga – green gram or masa – black gram in size, red in color
• Caused by uncooked suka
• Produced by aggravated rakta and pitta
• Appearance – of the size and color of green gram and black gram respectively

12. Sataponaka

छिद्रैरणुमुखैर्वस्तु चितं यस्य समन्ततः |
वातशोणितजो व्याधिर्विज्ञेयः शतपोनकः ||१२||

Sataponaka Suka Roga –

• Manifests with multiple holes / pores formed on the surface of the penis
• Produced by aggravated vata and sonita – blood
• Appearance – penis appears with many holes on its surface

13. Tvakpaka

पित्तरक्तकृतो ज्ञेयस्त्वक्पाको ज्वरदाहवान् |१३|

Twakpaka Suka Roga –

• Manifests with suppuration or ulceration of the penis skin
• Associated with – fever and burning sensation
• Produced by aggravated pitta and Rakta
• Appearance – ulcer and pus on the skin of penis

14. Sonitarbuda

कृष्णौः स्फोटैः सरक्तैश्च पिडकाभिश्च पीडितम् |
यस्य वस्तु रुजश्चोग्रा ज्ञेयं तच्छोणितार्बुदम् ||१३||

Sonitarbuda Suka Roga –

• Manifests with black colored vesicles on the penis along with reddish eruptions all over the skin
• Associated with severe pain

15. Mamsarbuda

मांसदोषेण जानीयादर्बुदं मांससम्भवम् |१४|

Mamsarbuda Suka Roga –

• Manifests in the form of big and hard tumor
• Caused due to the vitiation of the muscle

16. Mamsapaka

शीर्यन्ते यस्य मांसानि यत्र सर्वाश्च वेदनाः ||१४||
विद्यात्तं मांसपाकं तु सर्वदोषकृतं भिषक् |१५|

Mamsapaka Suka Roga –

• Manifests with the falling off of the penis following suppuration of penis
• Associated with all kinds of pains
• Produced by aggravation of all the doshas

17. Vidradhi

विद्रधिं सन्निपातेन यथोक्तमभिनिर्दिशेत् ||१५||

Vidradhi Suka Roga –

• Manifests in the form of abscess
• Associated with the symptoms of vidradhi – as described in chapter 17
• Produced by aggravation of all the three doshas together

18. Tilakalaka

कृष्णानि चित्राण्यथवा शूकानि सविषाणि च |
पातितानि पचन्त्याशु मेढ्रं निरवशेषतः ||१६||
कालानि भूत्वा मांसानि शीर्यन्ते यस्य देहिनः |
सन्निपातसमुत्थानं तं विद्यात्तिलकालकम् ||१७||

Tilakalaka Suka Roga –

• Manifests with blackish discoloration of the penis the muscle of which falls off in due course of time
• Caused due to application of paste of sukas (insects) which are black or variegated in color or poisonous in nature
• Produced by aggravation of all the doshas together
• Appearance – penis looks blackish in color

Prognosis

तत्र मांसार्बुदं यच्च मांसपाकश्च यः स्मृतः |
विद्रधिश्च न सिध्यन्ति ये च स्युस्तिलकालकाः ||१८||

Among these Sukarogas, the below mentioned conditions carry bad prognosis i.e. they cannot be cured –

• Mamsarbuda,
• Mamsapaka
• Vidradhi and
• Tilakalaka

इति सुश्रुतसंहितायां निदानस्थाने शूकदोषनिदानं नाम चतुर्दशोऽध्यायः ||१४||

Thus ends the Fourteenth chapter by name Sukadosa Nidana- In Nidana Sthana of Susrutha Samhita.