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.