Sushruta Samhita Uttaratantra Chapter 2 Sandhigata Roga Vijnaniya (Illnesses of the Fornices)

पक्वः शोफः सन्धिजः संस्रवेद्यः सान्द्रं पूयं पूति पूयालसः सः |४|

Puyalasa is a situation which manifests with swelling within the sandhi i.e. fornices of the attention. When this swelling will get ripe, it discharges thick and foul-smelling pus and therefore is named puyalasa.  

2. Upanaha

ग्रन्थिर्नाल्पो दृष्टिसन्धावपाकः कण्डूप्रायो नीरुजस्तूपनाहः ||४||

Upanaha is one more illness of the sandhi of the attention whereby an enormous granthi i.e. tumor or cyst like mass is fashioned within the drshti sandhi i.e. joint of the drshti mandala. This granthi doesn’t suppurate. It presents with itching however isn’t related to ache.

3. Srava

गत्वा सन्धीनश्रुमार्गेण दोषाः कुर्युः स्रावान् रुग्विहीनान् कनीनात् |
तान् वै स्रावान् नेत्रनाडीमथैके तस्या लिङ्गं कीर्तयिष्ये चतुर्धा ||५||
पाकः सन्धौ संस्रवेद्यश्च पूयं पूयास्रावो नैकरूपः प्रदिष्टः |
श्वेतं सान्द्रं पिच्छिलं संस्रवेद्यः श्लेष्मास्रावो नीरुजः स प्रदिष्टः ||६||
रक्तास्रावः शोणितोत्थः सरक्तमुष्णं नाल्पं संस्रवेन्नातिसान्द्रम् |
पीताभासं नीलमुष्णं जलाभं पित्तास्रावः संस्रवेत् सन्धिमध्यात् ||७||

Srava means discharges or exudates. It’s induced when the morbid doshas attain the netra sandhi i.e. fornices of the attention. When the morbid doshas travelling by way of the ashrumarga i.e. channels of the tears attain the sandhis, they offer rise to srava. This srava happens from the kaninika sandhi i.e. interior canthus or angle of the attention, the nostril finish of the attention. This situation has exudates however doesn’t have ache. This situation is named Netra Srava. It’s also referred to as Netranadi by some students. The options of various sorts of netra srava shall be described now.

There are 4 forms of srava. They’re –

Puyasrava – On this situation, there’s discharge of puya i.e. pus. This happens when paka i.e. suppuration happens on the sandhis. On account of this there’s discharge of pus of various nature from the attention. Since there’s discharge of puya, it’s referred to as puyasrava. 

Slesmasrava – On this situation there’s discharge of fluids which resemble slesma i.e. kapha in look. It presents with exudation of fluid which is white, thick and slimy. It isn’t related to ache. Because the exudes resemble sleshma, it’s referred to as slesmasrava.

Raktasrava – On this situation there’s exudation of fluids which resemble rakta – blood in color. This situation is produced by blood whereby the discharges are purple in color or combined with blood, heat, copious and never very thick. Because the discharges resemble rakta, this situation is named as raktasrava.

Pittasrava – On this situation there’s discharge of fluids which resemble the color of pitta. The discharges are barely yellow or blue in color, scorching, and resemble water. Because the discharges resemble pitta, it’s referred to as as pittasrava.

4. Parvani

ताम्रा तन्वी दाहशूलोपपन्ना रक्ताज्ज्ञेया पर्वणी वृत्तशोफा |

Parvani is one more illness which happens within the netra sandhi. It presents with a spherical swelling. The swelling is coppery in color and produced by morbid blood. It’s accompanied by ache and burning sensation.

5. Alaji

जाता सन्धौ कृष्णशुक्लेऽलजी स्यात्तस्मिन्नेव ख्यापिता पूर्वलिङ्गैः ||८||

Alaji is one other illness of netra sandhi which presents with swelling which has related options as these of Parvani. It develops in krshna-shuklagata sandhi i.e. fornices between black of the attention (cornea) and white of the attention (sclera).  

6. Krimi Granthi

क्रिमिग्रन्थिर्वर्त्मनः पक्ष्मणश्च कण्डूं कुर्युः क्रिमयः सन्धिजाताः |
नानारूपा वर्त्मशुक्लस्य सन्धौ चरन्तोऽन्तर्नयनं दूषयन्ति ||९||

Krimi Granthi is a situation which manifests within the joints / fornices of the eyes and are induced as a result of affliction of those fornices by krimi (worms, micro organism, virus and so on. microorganisms). The krimis current within the vartma-paksmagata sandhi i.e. joint between (assembly place of) eyelids and eyelashes and vartma-suklagata sandhi i.e. joint between eyelids and white of the eyes (sclera) causes this situation. These krimis are of various shapes. They vitiate the eyes (fornices) and produce itching and small granthis – small tumours or cyst like growths. This situation is named krimi granthi.

Signs – On this situation, the krimis will transfer round and eat away the joints of the eyelids and sclera. In later intervals, they will even vitiate the deeper layers of the attention.

इति सुश्रुतसंहितायामुत्तरतन्त्रे सन्धिगतरोगविज्ञानीयो नाम द्वितीयोऽध्ययः ||२||

Thus ends the second chapter by identify Sandhigata roga Vijnaniya in Uttara Sthana Of Susruta Samhita.