The tenth chapter of Uttara Sthanam of Ashtanga Hridayam is known as as Sandhi Sita Asita Roga Vijnaniya. This chapter offers with the reason of ‘Information of ailments of the fornixes, Sclera and Cornea’.

The subjects lined on this chapter embrace –

• Sandhigata Roga – ailments of the fornixes
• Jalasrava
• Kaphasrava
• Upanaha
• Raktasrava
• Parvani
• Puyasrava
• Puyalasa
• Alaji
• Krmi Granthi
• Indication of surgical strategies in Upanaha and different circumstances
• Sita / Shuklagata Roga – Ailments of the Sclera
• Suklarma and Balasa Grthita
• Pistaka
• Sirotpata
• Siraharsa
• Sirajala
• Sonitarma
• Arjuna
• Prastaryarma
• Adhimamsarma
• Siraja Pitaka
• Strategies of intervention and prognosis
• Asita – Krsnagata Roga – Ailments of the Cornea
• Ksata Sukra
• Suddha Sukra
• Ajaka
• Sirasukra
• Pakatyaya

Pledge by the creator(s)

अथात: सन्धिसितासितरोगविज्ञानीयं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
अथात: सन्धि सित असित रोग विज्ञानीयं व्याख्यास्याम: – athāta: sandhi sita asita roga vijñānīyaṃ vyākhyāsyāma: – After having provided prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘Information of ailments of the fornices, Sclera and Cornea’.
इति ह स्माहु: आत्रेयादयो महर्षय: – iti ha smāhu: ātreyādayo maharṣaya: – Thus say (pledge) Atreya and different sages.

Sandhigata Roga: Ailments of the fornices

Jalasrava

वायुः क्रुद्धः सिराः प्राप्य जलाभं जलवाहिनीः ।
अश्रु स्रावयते वर्त्मशुक्लसन्धेः कनीनकात् ॥ १ ॥
तेन नेत्रं सरुग्रागशोफं स्यात्स जलास्रवः ।
Vata present process improve, getting localized within the channels of water (tears) causes extra move of tears, resembling water from the joints of the lids and the white portion (sclera), by means of the Kaninaka (inside canthus). By this the attention develops ache, redness, and swelling. This illness known as Jalasrava.

Kaphasrava

कफात्कफास्रवे श्वेतं पिच्छिलं बहलं स्रवेत् ॥ २ ॥
From (improve of) Kapha arises Kaphasrava. The exuding fluid will probably be white, slimy and thick.

Upanaha

कफेन शोफस्तीक्ष्णाग्रः क्षारबुद्बुदकोपमः ।
पृथुमूलबलः स्निग्धः सवर्णो मृदुपिच्छिलः ॥ ३ ॥
महानपाकः कण्डूमानुपनाहः स नीरुजः ।
From Kapha, arises an enormous swelling with a pointed tip, resembling the bubbles of kshara (Alkali) with thick base, robust, unctuous, of the colour (as of the bottom), comfortable and slimy, large in dimension, non-suppurating and having itching however no ache. That is Upanaha.

Raktasrava

रक्ताद्रक्तास्रावे ताम्रं बहूष्णं चाश्रु संस्रवेत् ॥ ४ ॥
From the blood arises Raktasrava, wherein the exudation is coppery crimson, bahu – copious, together with heat tears.

Parvani

वर्त्मसन्ध्याश्रया शुक्ले पिटिका दाहशूलिनी ।
ताम्रा मुद्गोपमा भिन्ना रक्तं स्रवति पर्वणी ॥ ५ ॥
Pitaka (eruptions) seem within the joints between the eyelid and sclera having burning sensation and ache, coppery crimson, of the dimensions of a inexperienced gram, exuding blood when burst. This illness is named Parvani.

Puyasrava

पूयास्रवे मलाः सास्रा वर्त्मसन्धेः कनीनकात् ।
स्रावयन्ति मुहुः पूयं सास्रं त्वङ्मांसपाकतः ॥ ६ ॥
In Puyasrava, the malas (doshas) related to blood, discharge pus blended with blood, typically from the joints of the lids, although the inside canthus, on account of suppuration/ulceration of the pores and skin and muscular tissues.

Puyalasa

पूयालसो व्रणः सूक्ष्मः शोफसंरम्भपूर्वकः ।
कनीनसन्धावाध्मायी पूयास्रावी सवेदनः ॥ ७ ॥
Puyalasa is a small ulcer, preceded with swelling and ache, redness and so on. inflicting swelling of the inside canthus, discharge of pus and ache.

Alaji

कनीनस्यान्तरलजी शोफो रुक्तोददाहवान् ।
Alaji is a swelling contained in the inside canthus, having ache, pricking sensation and burning sensation.

Krimi Granthi

अपाङ्गे वा कनीने वा कण्डूषापक्ष्मपोटवान् ॥ ८ ॥
पूयास्रावी कृमिग्रन्थिर्ग्रन्थिः कृमियुतोऽर्तिमान् ।
A tumor growing both on the outer canthus or inside canthus, accompanied with itching, native burning sensation, falling of eyelashes, discharge of pus, having worms (micro organism and so on.) inside and painful. This illness known as Krmigranthi.

Indication of surgical strategies in Upanaha and different circumstances

उपनाहकृमिग्रन्थिपूयालसकपर्वणीः ॥ ९ ॥
शस्त्रेण साधयेत्पञ्च सालजीनास्रवांस्त्यजेत् ।
Upanaha, Krmigranthi, Puyalasaka, Parvani and Alaji, these 5 are to be handled surgically, the (4) Asrava ought to be refused remedy.

Sita / Shuklagata Roga: Ailments of the Sclera

पित्तं कुर्यात्सिते बिन्दूनसितश्यावपीतकान् ॥ १० ॥
मलाक्तादर्शतुल्यं वा सर्वं शुक्लं सदाहरुक् ।
रोगोऽयं शुक्तिकासञ्ज्ञः सशकृद्भेदतृड्ज्वरः ॥ ११ ॥
Pitta elevated, produces within the sclera, small dots (spots) of black, blue or yellow colour; your complete sclera
showing like a mirror lined by filth and has burning sensation and ache. These ailments generally known as Shuktika, are accompanied with diarrhoea, thirst and fever.

Shuklarma and Balasa Grathita

कफाच्छुक्ले समं श्वेतं चिरवृद्ध्यधिमांसकम् ।
शुक्लार्म शोफस्त्वरुजः सवर्णो बहलोऽमृदुः ॥ १२ ॥ गुरुः स्निग्धोऽम्बुबिन्द्वाभो बलासग्रथितं स्मृतं ।
From Kapha, there develops on the sclera, an additional development of muscle which is even, white and rising very slowly, that is Suklarma. A swelling which is painless, of the identical colour (of the sclera), thick, not comfortable, heavy, greasy, resembling a water bubble is named Balasa Grathita.

Pistaka

बिन्दुभिः पिष्टधवलैरुत्सन्नैः पिष्टकं वदेत् ॥ १३ ॥
Presence of pasty white, raised dots on the sclera known as as Pisthaka.

Sirotpata

रक्तराजीततं शुक्लमुष्यते यत्सवेदनम् ।
अशोफाश्रूपदेहं च सिरोत्पातः स शोणितात् ॥ १४ ॥
The sclera is stuffed with crimson strains, has burning sensation, ache, with slight or no swelling, tears and thickening, this illness is Sirotpata and attributable to blood (vitiated).

Siraharsha

उपेक्षित: सिरोत्पातो राजीस्ता एव वर्धयन् ।
कुर्यात्सास्रं सिराहर्षं तेनाक्ष्युद्वीक्षणाक्षमम् ॥ १५ ॥
Sirotapata when uncared for results in Siraharsa with improve of crimson line and discharge of blood (from them); by that the attention turns into unable to see.

Sirajala

सिराजाले सिराजालं बृहद्रक्तं घनोन्नतम् ।
Sirajala is the looks of an enormous, blood crimson, laborious and elevated community of veins.

Shonitarma

शोणितार्म समं श्लक्ष्णं पद्माभमधिमांसकम् ॥ १६ ॥
Sonitarma is an additional development of muscle which is even, easy and resembling a lotus flower (in colour).

Arjuna

नीरुक् श्लक्ष्णोऽर्जुनं बिन्दुः शशलोहितलोहितः ।
Arjuna is a dot which is painless, easy and crimson in colour just like that of blood of the rabbit.

Prastaryarma

मृद्वाशुवृद्ध्यरुङ्मांसं प्रस्तारि श्यावलोहितम् ॥ १७ ॥ प्रस्तार्यर्म मलैः सास्रैः स्नावार्म स्नावसन्निभम् ।
A comfortable, fast growing, painless, development of muscle unfold side-wards, bluish crimson in colour is named Prastharyarma and is attributable to all of the Doshas along with blood. Snayvarma resembles a tendon.

Adhimamsarma

शुष्कासृक्पिण्डवच्छ्यावं यन्मांसं बहलं पृथु ॥ १८ ॥
अधिमांसार्म
The muscle (of the sclera) turns into thick and laborious, blue in colour just like the clump of dried blood; this is named Adhimamsarma.

Siraja Pitaka

दाहहघर्षवत्यः सिरावृताः ।
कृष्णासन्नाः सिरासञ्ज्ञाः पिटिकाः सर्षपोपमाः ॥ १९ ॥
Eruptions resembling mustard, surrounded by veins, having burning sensation and inflicting friction showing close to the cornea is named Siraja Pitaka.

Strategies of intervention and prognosis

शुक्तिहर्षसिरोत्पातपिष्टकग्रथितार्जुनम् ।
साधयेदौषधैः षट्कं शेषं शस्त्रेण सप्तकम् ॥ २० ॥ नवोत्थं तदपि द्रव्यैरर्मोक्तं यच्च पञ्चधा ।
तच्छेद्यमसितप्राप्तं मांसस्नावसिरावृतम् ॥ २१ ॥
चर्मोद्दालवदुच्छ्रायि दृष्टिप्राप्तं च वर्जयेत् ।
Suktika, Harsa (Siraharsa), Sirotpata, Pistaka, Balasagrahita, and Arjuna; these six ought to be handled with medicines. The remaining seven by surgical procedure; amongst these, these that are of current origin could also be handled with herbs. The 5 sorts of arma ought to be excised however not these which have reached the Cornea, that are surrounded by Muscle groups, tendons and veins, that which is elevated as if rearing the pores and skin, and has reached the Dristi (vision-pupil and hindering it) ought to be rejected.

Asita: Krishnagata Roga: Ailments of the Cornea

Kshata Shukra

पित्तं कृष्णेऽथवा दृष्टौ शुक्रं तोदाश्रुरागवत् ॥ २२ ॥
छित्त्वा त्वचं जनयति तेन स्यात्कृष्णमण्डलम् ।
पक्वजम्बूनिभं किञ्चिन्निम्नं च क्षतशुक्रकम् ॥ २३ ॥
तत्कृच्छ्रसाध्यं याप्यं तु द्वितीयपटलव्यधात् ।
तत्र तोदादिबाहुल्यं सूचीविद्धाभकृष्णता ॥ २४ ॥
तृतीयपटलच्छेदादसाध्यं निचितं व्रणैः ।
Pitta invading the Krsna (cornea) or the Drsti (pupil) causes shukra having pricking ache, discharge of tears and redness, by producing a tear by breaking the pores and skin (conjunctiva), by this the cornea seems like a ripe Jambu fruit (bluish black) in colour and barely depressed, known as Ksata shukra. That is troublesome to remedy; when it breaks the second layer, it causes a fantastic improve of pricking ache and so on. resembles the black gap made by the needle and the illness turns into controllable however persisting for a very long time. When the third layer is damaged it provides rise to many wounds/ ulcers and turns into incurable.

Suddha Sukra

शङ्खशुक्लं कफात्साध्यं नातिरुक् शुद्धशुक्रकम् ॥ २५ ॥
From Kapha Sudha Sukra is produced, wherein the cornea has white colour like that of a conch shell and with out a lot ache; that is curable.

Ajaka

आताम्रपिच्छिलास्रस्रुदाताम्रपिटिकाऽतिरुक् ।
अजाविट्सदृशोच्छ्रायकार्ष्ण्या वर्ज्याऽसृजाऽजका ॥ २६ ॥
Eruptions that are coppery crimson in colour, slimy, exuding blood, which is coppery crimson, very painful, resembling the excreta of the goat in dimension and black colour. This illness ajaka attributable to (vitiated) blood is to be rejected.

Sirashukra

सिराशुक्रं मलैः सास्रैस्तज्जुष्टं कृष्णमण्डलम् ।
सतोददाहताम्राभिः सिराभिरवतन्यते ॥ २७ ॥
अनिमित्तोष्णशीताच्छघनास्रस्रुच्च तत्त्यजेत् ।
Sirasukra is attributable to all of the Mala (Dosha) related to blood; vitiated by these, the Cornea turns into full of veins, which produce pricking ache, burning sensation and coppery colour, blood which is typically sizzling and generally chilly, clear and thick exuded out with none trigger. This ought to be rejected.

Pakatyaya

दोषैः सास्रैः सकृत्कृष्णं नीयते शुक्लरूपताम् ॥ २८ ॥ धवलाभ्रोपलिप्ताभं निष्पावार्धदलाकृति ।
अतितीव्ररुजारागदाहश्वयथुपीडितम् ॥ २९ ॥
पाकात्ययेन तच्छुक्रं वर्जयेत्तीव्रवेदनम् ।
All of the Doshas along with blood, abruptly; make the cornea to imagine the options of the Sclera. It seems as if lined with white clouds, has the form of cotyledon of a Dolicos lablab, related to extreme ache, redness, burning sensation and swelling, troubling the affected person on account of over ripening. This Sukra, having very extreme ache, ought to be rejected.

Pakatyaya

यस्य वा लिङ्गनाशोऽन्तः श्यावं यद्वा सलोहितम् ॥ ३० ॥
अत्युत्सेधावगाढं वा साश्रु नाडीव्रणावृतम् ।
पुराणं विषमं मध्ये विच्छिन्नं यच्च शुक्रकम् ॥ ३१ ॥
That (cornea) which has induced lack of imaginative and prescient, that which is blue inside, that which is barely crimson, that which is tremendously elevated or tremendously depressed with copious tears flowing out, surrounded by sinus ulcers, which is continual, uneven, torn within the heart and that having dots / sports activities ought to be rejected.

Pakatyaya

पञ्चेत्युक्ता गदाः कृष्णे साध्यासाध्यविभागतः ॥ ३१ऊअब् ॥  
Thus, had been described the 5 ailments of the Krsna (black portion/ cornea), labeled into curable incurable ailments.

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने सन्धिसितासितरोग विज्ञानीयो नाम दशमोऽध्याय: ॥ १० ॥
Thus, ends the chapter-Sandhisitasita Roga Vijnaniya, the tenth in Uttarasthana of Asthaga Hrdaya Samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.