The seventh chapter of Nidanasthanam of Ashtanga Hridayam is called as Arshasam Nidanam Adhyayah. This chapter offers with the reason of ‘prognosis of hemorrhoids / piles’.
The subjects coated on this chapter embody –
– Arshas nirvachana – definition of arshas
– Bheda – kinds of piles
– Guda – rectum
– Sahaja Arshas – congenital piles
– Janmottara arshas – piles occurring after start
– Nidana – causes of piles
– Purvarupa – premonitory signs of piles
– Samprapti – pathogenesis of piles
– Rupa – medical options of piles
– Vataja, Pittaja, Kaphaja, Tridoshaja, Raktaja Arshas
– Udavarta nidanam – prognosis of Udavarta
– Sadhyasadhyata – prognosis
– Anya sthana gata arshas – piles of different locations
– Carmakila – warts
– Urgency to treatment piles
Pledge by the writer(s)
अथातोऽर्शसां निदानं व्याख्यास्याम ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having supplied prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘prognosis of piles / hemorrhoids’. Thus say (pledge) atreya and different sages.
Arsas Nirvacana: Definition
अरिवत्प्राणिनो मांसकीलका विशसन्ति यत् ।
अर्शांसि तस्मादुच्यन्ते गुदमार्गनिरोधतः ॥ १ ॥
दोषास्त्वङ्मांसमेदांसि सन्दूष्य विविधाकृतीन् ।
मांसाङ्कुरानपानादौ कुर्वन्त्यर्शांसि तान् जगुः ॥ २ ॥
Simply as foes torment the individual, equally the sprouts of muscle tissue (give troubles) by obstructing the passage of the rectum, therefore it’s known as as Arsas. The Doshas, vitiating the pores and skin, muscle tissue and fats produce sprouts of muscle tissue, of various shapes within the rectum and many others, that are known as as Arsas (piles)
Notes: The etymology of the time period Arsas is ’Arivat’ like a foe ’Srnati’ provides hassle. The foe referred to right here just isn’t the one who resides far-off however one who stays close by and offers troubles incessantly for a very long time. Sprouts of muscle tissue, pores and skin or fats tissue, rising within the nostril, ears, pores and skin and many others., are additionally known as Arsas, however these are referred to together with the title of the organ involved; the time period Arsas, with out such a reputation of the organ refers solely to piles/haemorrhoids occurring within the rectum. These are literally, engorged veins and never sprouts of muscle tissue, as described above.
Bheda: varieties
सहजन्मोत्तरोत्थानभेदाद्द्वेधा समासतः ।
शुष्कस्राविविभेदाच्च
Sahaja (congenital) and Janmottaraja (arising after start) are its two varieties, briefly; additionally Suska (dry, non-exudative) and Sravi (exudative).
Guda: rectum
गुदः स्थूलान्त्रसंश्रयः ॥ ३ ॥
अर्धपञ्चाङ्गुलस्तस्मिंस्तिस्रोऽध्यर्धाङ्गुलाः स्थिताः ।
बल्यः प्रवाहिणी तासामन्तर्मध्ये विसर्जनी ॥ ४ ॥
बाह्या संवरणी तस्या गुदौष्ठो बहिरङ्गुले ।
यवाध्यर्धः प्रमाणेन रोमाण्यत्र ततः परम् ॥ ५ ॥
Guda (rectum) connected to the massive gut, is 4 and half Angulas (fingers breadth) lengthy, through which, three folds, every of 1 and half Angula are situated; of those, the Pravahini is located inside, Visarjini within the center and Samvarani on the exterior; in its outer portion (of Samvarani) of 1 Angula (in depth) is the Gudostha (anal lip), of the size of 1 and a half Yava – Barley – Hordeum vulgare (barley); and after that, there are the hair.
Notes: By way of fashionable measurement, the rectum or the terminal portion of the massive gut is 6½-7” in size. Pravahini is the fold which initiates the urge of defecation, Visarjini is that which expels the faeces and Samvarani is the sphincter which closes the orifice of the rectum. Pile lots develop in an space of about 3-4” from the outside.
Sahaja Arshas (congenital piles)
तत्र हेतुः सहोत्थानां वलीबीजोपतप्तता ।
अर्शसां बीजतप्तिस्तु मातापित्रपचारतः ॥ ६ ॥
दैवाच्च ताभ्यां कोपो हि सन्निपातस्य तान्यतः ।
असाध्यान्येवमाख्याताः सर्वे रोगाः कुलोद्भवाः ॥ ७ ॥
The reason for Sahaja Arsas (congenital piles) is the abnormalities of Valibija (seed/genes that are liable for the formation of the rectal folds), abnormalities of the seed are (as a consequence of) improper actions of the dad and mom and Daiva (windfall); their (of those two) aggravation is the trigger for Sannipata (improve of all of the Doshas collectively). Therefore this type (of Arsas) is described as incurable; equally, are all of the ailments that are Kulodbhava (familial/hereditary).
Sahaja Arshas (congenital piles)
सहजानि विशेषेण रूक्षदुर्दर्शनानि च ।
अन्तर्मुखानि पाण्डूनि दारुणोपद्रवाणि च ॥ ८ ॥
Sahaja Arsas (congenital piles) are particularly dry, ugly to have a look at, going through inward, yellowish-white and accompanied with grave issues (secondary ailments).
Janmottaraja Arshas (piles occurring after start)
षोढान्यानि पृथग्दोषसंसर्गनिचयास्रतः ।
The opposite variety is of six varieties; one from every Dosha individually, one from the mix of all and one from Asra (blood).
Janmottaraja Arshas (piles occurring after start)
शुष्काणि वातश्लेष्मभ्यामार्द्राणि त्वस्रपित्ततः ॥ ९ ॥
Shushka (dry, non-exudative) are brought on by Vata and Slesma (Kapha) and the Ardra (moist, exudative) by Asra (blood) and Pitta.
Nidana (causes)
दोषप्रकोपहेतुस्तु प्रागुक्तस्तेन सादिते ।
अग्नौ मलेऽतिनिचिते पुनश्चातिव्यवायतः ॥ १० ॥
यानसङ्क्षोभविषमकठिनोत्कटकासनात् ।
वस्तिनेत्राश्मलोष्टोर्वीतलचैलादिघट्टनात् ॥ ११ ॥
भृशं शीताम्बुसंस्पर्शात्प्रततातिप्रवाहणात् ।
वातमूत्रशकृद्वेगधारणात्तदुदीरणात् ॥ १२ ॥
ज्वरगुल्मातिसारामग्रहणीशोफपाण्डुभिः ।
कर्शनाद्विषमाभ्यश्च चेष्टाभ्यो योषितां पुनः ॥ १३ ॥
आमगर्भप्रपतनाद्गर्भवृद्धिप्रपीडनात् ।
ईदृशैश्चापरैर्वायुरपानः कुपितो मलम् ॥ १४ ॥
पायोर्वलीषु तं धत्ते तास्वभिष्यण्णमूर्तिषु ।
जायन्तेऽर्शांसि
The causes of aggravation of the Doshas have been enumerated beforehand (chapter. 1 of this part); they trigger weak spot of the fireplace (digestive exercise) and accumulation of wastes, the feces (which result in the manufacturing of piles). Additional, indulging an excessive amount of in copulation, driving, pressure, sitting for lengthy hours on uneven, onerous seats and on one’s personal heals, wound brought on by enema nozzle, stones, bricks, tough floor of the bottom, fabric and many others., contact with very chilly water, extra straining throughout defecation, suppression of urge of the flatus, urine, feces or untimely initiation. Emaciation brought on by fever, belly tumors, diarrhea, accumulation of Ama, (undigested materials), issues of duodenum, dropsy, and anemia. Indulging in improper actions like exertion, In ladies (extreme intercourse), as a consequence of abortion or miscarriage, and abnormalities of improvement of the foetus. By these and related different causes, Apana Vata will get aggravated, withholds the amassed faeces within the folds of the rectum. From such a tough and abrasive contact, piles come up.
Purvarupa (premonitory signs)
तत्पूर्वलक्षणं मन्दवह्निता ॥ १५ ॥
विष्टम्भः सक्थिसदनं पिण्डिकोद्वेष्टनं भ्रमः ।
सादोऽङ्गे नेत्रयोः शोफः शकृद्भेदोऽथवा ग्रहः ॥ १६ ॥
मारुतः प्रचुरो मूढः प्रायो नाभेरधश्चरन् ।
सरुक् सपरिकर्तश्च कृच्छ्रान्निर्गच्छति स्वनम् ॥ १७ ॥
अन्त्रकूजनमाटोपः क्षामतोद्गारभूरिता ।
प्रभूतं मूत्रमल्पा विडश्रद्धा धूमकोऽम्लकः ॥ १८ ॥
शिरःपृष्ठोरसां शूलमालस्यं भिन्नवर्णता ।
तन्द्रेन्द्रियाणां दौर्बल्यं क्रोधो दुःखोपचारता ॥ १९ ॥
आशङ्का ग्रहणीदोषपाण्डुगुल्मोदरेषु च ।
एतान्येव विवर्धन्ते जातेषु हतनामसु ॥ २० ॥
Its premonitory signs are weak fireplace (digestive exercise), indigestion, weak spot of the thighs, twisting ache within the calves, dizziness, debility of the physique components, swelling of the eyes, both diarrhoea or constipation, Maruta (Vayu, right here refers to flatus) accumulates in giant amount shifting downwards under the umbilicus, accompanied with ache (within the decrease stomach) and reducing ache within the anus, comes out with issue and nice noise, intestinal gurgling, distention of the stomach, emaciation, too many belching, giant amount of urine and little of feces, absence of inclination to void faeces, feeling of sizzling fumes popping out, elevated sourness (acidity), ache within the head, again and chest; lassitude, discoloration of the pores and skin, stupor, weak spot of the sense organs, anger, feeling of unhappiness, all these creating doubt of (the presence of) issues of duodenum, anemia, belly tumors and enlargement of the stomach; these (ailments) get elevated when Hatanama (Arsas-piles) manifests.
Samprapti (pathogenesis)
निवर्तमानोऽपानो हि तैरधोमार्गरोधतः ।
क्षोभयन्ननिलानन्यान् सर्वेन्द्रियशरीरगान् ॥ २१ ॥
तथा मूत्रशकृत्पित्तकफान् धातूंश्च साशयान् ।
मृद्नात्यग्निं ततः सर्वो भवति प्रायशोऽर्शसः ॥ २२ ॥
Apana Vayu, shifting within the upward route, as a consequence of obstruction of the decrease passage (rectum), aggravates all the opposite divisions of Vata, current in your complete physique, and in addition the urine, faeces, Pitta, Kapha and the Dhatus (tissues) together with their locations of dwelling, causes weak spot of the fireplace (digestive exercise). Then all these collectively result in manufacturing of piles.
Rupa (medical options)
कृशो भृशं हतोत्साहो दीनः क्षामोऽतिनिष्प्रभः ।
असारो विगतच्छायो जन्तुजुष्ट इव द्रुमः ॥ २३ ॥
कृत्स्नैरुपद्रवैर्ग्रस्तो यथोक्तैर्मर्मपीडनैः |
तथा कासपिपासास्यवैरस्यश्वासपीनसैः ॥ २४ ॥
क्लमाङ्गभङ्गवमथुक्षवथुश्वयथुज्वरैः ।
क्लैब्यबाधिर्यतैमिर्यशर्कराश्मरिपीडितः ॥ २५ ॥
क्षामभिन्नस्वरो ध्यायन्मुहुः ष्ठीवन्नरोचकी ।
सर्वपर्वास्थिहृन्नाभिपायुवङ्क्षणशूलवान् ॥ २६ ॥
गुदेन स्रवता पिच्छां पुलाकोदकसन्निभाम् ।
विबद्धमुक्तं शुष्कार्द्रं पक्वामं चान्तरान्तरा ॥ २७ ॥
पाण्डु पीतं हरिद्रक्तं पिच्छिलं चोपवेश्यते ।
Profound emaciation, lack of enthusiasm, feeling of helplessness, feeble voice, profound lack of complexion, absence of excellence (well being) of the tissue, lack of capacity of giving shelter like a worm-eaten tree (unable to assist or help others), seized with many issues as enumerated earlier, ache within the important factors (or organs) and in addition with cough, thirst, unhealthy style within the mouth, dyspnoea, nasal catarrh, exhaustion, obscure pains within the physique, vomiting, extra of sneezes, oedema, fever, impotence, deafness, blindness, urinary gravel and calculi; voice feeble and damaged, fear, frequent spitting, lack of urge for food, ache in all of the joints, bones, coronary heart, umbilicus, anus and groins; slimy fluid resembling rice gruel popping out of the rectum, typically hindered and typically free; pile lots (showing) both dry or moist, ripe or unripe in between, white, yellow, inexperienced or crimson in color, and slimy (slippery).
Vataja Arshas
गुदाङ्कुरा बह्वनिलाः शुष्काश्चिमिचिमान्विताः ॥ २८ ॥
म्लानाः श्यावारुणाः स्तब्धा विषमाः परुषाः खराः ।
मिथो विसदृशा वक्रास्तीक्ष्णा विस्फुटिताननाः ॥ २९ ॥
बिम्बीकर्कन्धुखर्जूरकार्पासीफलसन्निभाः ।
केचित्कदम्बपुष्पाभाः केचित्सिद्धार्थकोपमाः ॥ ३० ॥
शिरःपार्श्वांसकट्यूरुवङ्क्षणाभ्यधिकव्यथाः ।
क्षवथूद्गारविष्टम्भहृद्ग्रहारोचकप्रदाः ॥ ३१ ॥
कासश्वासाग्निवैषम्यकर्णनादभ्रमावहाः ।
तैरार्तो ग्रथितं स्तोकं सशब्दं सप्रवाहिकम् ॥ ३२ ॥
रुक्फेनपिच्छानुगतं विबद्धमुपवेश्यते ।
कृष्णत्वङ्नखविण्मूत्रनेत्रवक्त्रश्च जायते ॥ ३३ ॥
गुल्मप्लीहोदराष्ठीलासम्भवस्तत एव च ।
Rectal sprouts brought on by predominance of Anila (Vata) are dry (non-exudative), having tingling sensation, boring or shriveled, bluish-red, static, irregular (uneven), coarse and onerous, every one totally different from the opposite (in form), curved, sharp, their face cracked, resemble the fruits of bimbi, Karkandhu, kharjura, and Karpasa, some just like the flower of Kadamba, some others like Siddharthaka; extreme ache within the head, flanks shoulders, waist, issues and groins; producing extra of sneezing, belching, stasis of meals with out digestion, catching ache within the area of the guts, lack of style or urge for food, cough, dyspnoea, irregularities of digestion, ringing within the ears and dizziness; struggling by all these the individual voids faeces which is scabellous, much less in amount, accompanied with noise and straining; adopted by painful expulsion of frothy and slimy fluid hindered in its passage; the pores and skin, nails, faeces, urine, eyes and face develop into black. Then right here is the potential of manifestation of belly tumors, enlargement of spleen, the stomach and the prostate.
Pittaja Arshas
पित्तोत्तरा नीलमुखा रक्तपीतासितप्रभाः ॥ ३४ ॥
तन्वस्रस्राविणो विस्रास्तनवो मृदवः श्लथाः ।
शुकजिह्वायकृत्खण्डजलौकोवक्त्रसन्निभाः ॥ ३५ ॥
दाहपाकज्वरस्वेदतृण्मूर्छारुचिमोहदाः ।
सोष्माणो द्रवनीलोष्णपीतरक्तामवर्चसः ॥ ३६ ॥
यवमध्या हरित्पीतहारिद्रत्वङ्नखादयः ।
That brought on by predominance of Pitta, the sprouts have blue, crimson, yellow or black complexion; exude skinny blood of foul odour; are skinny, gentle, supple; resemble the tongue of the parrot, piece of liver, mouth of a leech; produce burning sensation within the physique, ulceration, fever, perspiration, thirst, fainting, lack of style and urge for food and delusion; faeces is heat, watery, blue, yellow or crimson in color, and unripe (not effectively processed therefore heavy), the pores and skin, nails and many others. are of the color of center portion of barley (brownish), inexperienced, yellow, or turmeric (deep yellow).
Kaphaja Arshas
श्लेष्मोल्बणा महामूला घना मन्दरुजः सिताः ॥ ३७ ॥
उच्छूनोपाचिताः स्निग्धाः स्तब्धवृत्तगुरुस्थिराः ।
पिच्छिलाः स्तिमिताः श्लक्ष्णाः कण्ड्वाढ्याः स्पर्शनप्रियाः ॥ ३८ ॥
करीरपनसास्थ्याभास्तथा गोस्तनसन्निभाः ।
वङ्क्षणानाहिनः पायुवस्तिनाभिविकर्तिनः ॥ ३९ ॥
सकासश्वासहृल्लासप्रसेकारुचिपीनसाः ।
मेहकृच्छ्रशिरोजाड्यशिशिरज्वरकारिणः ॥ ४० ॥
क्लैब्याग्निमार्दवच्छर्दिरामप्रायविकारदाः ।
वसाभसकफप्राज्यपुरीषाः सप्रवाहिकाः ॥ ४१ ॥
न स्रवन्ति न भिद्यन्ते पाण्डुस्निग्धत्वगादयः ।
That produced by predominance of Slema (Kapha) the sprouts, are deep rooted, thick/onerous; with boring ache, spherical white, bulging, effectively grown, greasy, static (immovable), heavy steady, slimy, regular, easy, with extreme itching, likes touching (scratching); resemble the sprouts of Kanra, stone of Panasa fruit, or nipple of the cow; produce swelling of the groins, reducing ache within the anus, urinary bladder, and umbilicus, accompanied with cough, dyspnoea, nausea, salivation, anorexia with nasal catarrh; provides rise to dysuria, boring ache within the head, fever with rigors, impotence, dyspepsia, vomiting and ailments brought on by Ama; the faeces resembles muscle-fat blended with Kapha (mucus), extra in amount, related to straining; sprouts neither exude (blood) nor break (get cut up); the pores and skin and many others. are yellowish-white in color and greasy.
Tridoshaja Arshas
संसृष्टलिङ्गाः संसर्गान्निचयात्सर्वलक्षणाः ॥ ४२ ॥
saṃsṛṣṭaliṅgāḥ saṃsargānnicayātsarvalakṣaṇāḥ || 42 ||
That produced by all of the Doshas may have all of the signs concurrently.
Raktaja Arshas
रक्तोल्बणा गुदेकीलाः पित्ताकृतिसमन्विताः ।
वटप्ररोहसदृशा गुञ्जाविद्रुमसन्निभाः ॥ ४३ ॥
तेऽत्यर्थं दुष्टमुष्णं च गाढविट्प्रतिपीडिताः ।
स्रवन्ति सहसा रक्तं तस्य चातिप्रवृत्तितः ॥ ४४ ॥
भेकाभः पीड्यते दुःखैः शोणितक्षयसम्भवैः ।
हीनवर्णबलोत्साहो हतौजः कलुषेन्द्रियः ॥ ४५ ॥
Rectal sprouts produced by aggravation of Rakta (blood) are related with these brought on by Pitta (in signs), resemble the sprouts of Vata, the seeds of Gunja – Abrus precatorius and bead of coral; troubled by the onerous faeces, the pile lots exude impure and heat blood all of a sudden; from such heavy bleeding the individual develops the colour of the frog and suffers from ailments brought on by lack of blood, turns into poor in colour, power and enthusiasm; destroyed of vigor and impaired sensory actions.
Udavarta Nidanam (prognosis of udavarta)
मुद्गकोद्रवजूर्णाह्वकरीरचणकादिभिः ।
रूक्षैः सङ्ग्राहिभिर्वायुः स्वे स्थाने कुपितो बली ॥ ४६ ॥
अधोवहानि स्रोतांसि संरुध्याधः प्रशोषयन् ।
पुरीषं वातविण्मूत्रसङ्गं कुर्वीत दारुणम् ॥ ४७ ॥
तेन तीव्रा रुजा कोष्ठपृष्ठहृत्पार्श्वगा भवेत् ।
आध्मानमुदरावेष्टो हृल्लासो परिकर्तनम् ॥ ४८ ॥
वस्तौ च सुतरां शूलं गण्डश्वयथुसम्भवः ।
पवनस्योर्ध्वगामित्वं ततश्छर्द्यरुचिज्वराः ॥ ४९ ॥
हृद्रोगग्रहणीदोषमूत्रसङ्गप्रवाहिकाः ।
बाधिर्यतिमिरश्वासशिरोरुक्कासपीनसाः ॥ ५० ॥
मनोविकारस्तृष्णास्रपित्तगुल्मोदरादयः ।
ते ते च वातजा रोगा जायन्ते भृशदारुणाः ॥ ५१ ॥
दुर्नाम्नामित्युदावर्तः परमोऽयमुपद्रवः ।
वाताभिभूतकोष्ठानां तैर्विनापि स जायते ॥ ५२ ॥
By partaking of Mudga – inexperienced gram, Kodrava, Jurnahva, Karira, Canaka and many others, meals that are dry (water absorbent) and so constipating, Vata getting aggravated in its personal seat (Pakvasaya or giant gut) and turning into highly effective, blocks the downward channels, dries them up (of their moisture) and produces extreme obstruction to the motion of faeces, flatus and urine. By that, extreme ache develops within the stomach, again, area of the guts and flanks; flatulence, griping ache within the stomach, nausea, reducing ache within the rectum, extreme fixed ache within the urinary bladder; chance of swelling of the cheeks, upward motion of Pavana (Vata); then vomiting, anorexia and fever; different ailments of Vata origin corresponding to ailments of the guts and duodenum, suppression of urine, dysentery, deafness, blindness, dyspnoea, headache, cough, nasal catarrh, issues of the thoughts, thirst, bleeding ailments, belly tumor; enlargement of the stomach, and many others. that are troublesome to handle additionally develop as secondary affection of the Durnama (piles); thus (the illness) Udavarta is the chief complication/secondary illness. This Udavarta might come up in individuals who’ve predominance of Vata within the alimentary tract, even with out piles.
Sadhyasadhyata (prognosis)
सहजानि त्रिदोषाणि यानि चाभ्यन्तरे वलौ ।
स्थितानि तान्यसाध्यानि याप्यन्तेऽग्निबलादिभिः ॥ ५३ ॥
Piles that are congenital, born from all of the three Doshas, that are located within the inner-most fold (of the rectum) are incurable; or persist for a very long time relying on the power of the digestive fireplace and many others.
Sadhyasadhyata (prognosis)
द्वन्द्वजानि द्वितीयायां वलौ यान्याश्रितानि च ।
कृच्छ्रसाध्यानि तान्याहुः परिसंवत्सराणि च ॥ ५४ ॥
These that are born from two Doshas, that are situated within the second fold (of the rectum) are troublesome to treatment; so additionally these that are a couple of 12 months previous.
Sadhyasadhyata (prognosis)
बाह्यायां तु वलौ जातान्येकदोषोल्बणानि च ।
अर्शांसि सुखसाध्यानि न चोत्पतितानि च ॥ ५५ ॥
These that are located within the outer fold, that are brought on by the rise of anybody Dosha are simply curable; so additionally these which aren’t persistent.
Anya Sthana Gata Arshas (piles of different locations)
मेढ्रादिष्वपि वक्ष्यन्ते यथास्वं नाभिजानि तु ।
गण्डूपदास्यरूपाणि पिच्छिलानि मृदूनि च ॥ ५६ ॥
Arshas (piles) arising within the penis and many others. will likely be described at related contexts; that arising on the umbilicus resembles the mouth of the earthworm in form, slimy (slippery) and gentle.
Charmakila (warts)
व्यानो गृहीत्वा श्लेष्माणं करोत्यर्शस्त्वचो बहिः ।
कीलोपमं स्थिरखरं चर्मकीलं तु तं विदुः ॥ ५७ ॥
वातेन तोदः पारुष्यं पित्तादसितरक्तता ।
श्लेष्मणा स्निग्धता तस्य ग्रथितत्वं सवर्णता ॥ ५८ ॥
Vyana (division of Vata) combining with Shleshma (Kapha) produces piles on the outside of the pores and skin, resembling a nail, which is static (immovable) and tough (onerous) is named as Carmakila (warts); with predominance of Vata, it’s painful and tough, with Pitta, it’s blackish-red, with Slesma (Kapha), it’s greasy, knotty and of the identical colour (of the pores and skin).
Urgency to treatment piles
अर्शसां प्रशमे यत्नमाशु कुर्वीत बुद्धिमान् ।
तान्याशु हि गुदं बद्ध्वा कुर्युर्बद्धगुदोदरम् ॥ ५९ ॥
The clever doctor ought to attempt to treatment piles (of the rectum) shortly since it could shortly result in the illness – Buddhagudodara (intestinal obstruction) by blocking the rectum.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहिताया तृतीये निदानस्थानेऽर्शसां निदानं नाम सप्तमोऽध्याय: ।।१॥
Thus ends the chapter- Arsas Nidana- the seventh in Nidanasthana of Astanga Hrdaya Samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
