The Diagnosis of Kushtha (Skin Disease)

Verse 1 (garuda.1.164.1)

श्रीगरुडमहापुराणम् १६४ धन्वन्तरिरुवाच । मिथ्याहारविहारेण विशेषेण विरोधिना । साधुनिन्दावधाद्युद्धहरणाद्यैश्च सेवितैः

śrīgaruḍamahāpurāṇam 164 dhanvantariruvāca mithyāhāravihāreṇa viśeṣeṇa virodhinā sādhunindāvadhādyuddhaharaṇādyaiśca sevitaiḥ

Dhanvantari said: From wrong diet and regimen, especially from mutually incompatible foods, and from sinful acts practised — reviling the virtuous, killing, warfare, theft, and the like —

Verse 2 (garuda.1.164.2)

पाप्मभिः कर्मभिः सद्यः प्राक्तनैः प्रेरितामलाः । शिराः प्रपद्य तैर्युक्तास्त्वग्वसारक्तमामिषम्

pāpmabhiḥ karmabhiḥ sadyaḥ prāktanaiḥ preritāmalāḥ śirāḥ prapadya tairyuktāstvagvasāraktamāmiṣam

— and driven at once by these together with deeds from a former birth, the corrupted wastes enter the veins, and, joining with them, corrupt the skin, fat, blood, and flesh —

Verse 3 (garuda.1.164.3)

दूषयन्ति च संशोष्य निश्चरन्तस्ततो बहिः । त्वचः कुर्वान्ति वैवर्ण्यं शिष्टाः कुष्ठमुशन्तितम्

dūṣayanti ca saṁśoṣya niścarantastato bahiḥ tvacaḥ kurvānti vaivarṇyaṁ śiṣṭāḥ kuṣṭhamuśantitam

— corrupting and drying them, and issuing forth to the surface, they produce discoloration of the skin; the learned call this kushtha.

Verse 4 (garuda.1.164.4)

कालेनोपेक्षितं यत्स्यात्सर्वं कोष्ठानि तद्वपुः । प्रपद्य धातून्बाह्यान्तः सर्वान्संक्लेद्य चावहेत्

kālenopekṣitaṁ yatsyātsarvaṁ koṣṭhāni tadvapuḥ prapadya dhātūnbāhyāntaḥ sarvānsaṁkledya cāvahet

If neglected over time, it enters the body's inner cavity entirely, pervading all the tissues both outer and inner, and reduces them all to a state of moist decay.

Verse 5 (garuda.1.164.5)

सस्वेदक्लेदसङ्कोचान्कृमीन् सूक्ष्मांश्चदारुणान् । लोमत्वक्स्नायुधमनीराक्रामति यथाक्रमम्

sasvedakledasaṅkocānkṛmīn sūkṣmāṁścadāruṇān lomatvaksnāyudhamanīrākrāmati yathākramam

It generates, from sweat and moisture, minute and dreadful worms, which invade, in due order, the hair, skin, sinews, and vessels.

Verse 6 (garuda.1.164.6)

भस्माच्छादितवत्कुर्याद्बाह्यं कुष्ठमुदाहृतम् । कुष्ठानि सप्तधा दोषैः पृथग्द्वन्द्वैः समागतैः

bhasmācchāditavatkuryādbāhyaṁ kuṣṭhamudāhṛtam kuṣṭhāni saptadhā doṣaiḥ pṛthagdvandvaiḥ samāgataiḥ

This external kushtha makes the body appear as though covered over with ash. Kushtha is of seven kinds — arising from the separate doshas, and from their combinations in pairs.

Verse 7 (garuda.1.164.7)

सर्वेष्वपि त्रिदोषेषु व्यपदेशोऽधिकस्ततः । वातेन कुष्ठं कापालं पित्तेनौदुम्बरं कफात्

sarveṣvapi tridoṣeṣu vyapadeśo'dhikastataḥ vātena kuṣṭhaṁ kāpālaṁ pittenaudumbaraṁ kaphāt

Even where all three doshas combine, the name is given according to whichever dosha predominates. From vata arises kapala kushtha; from pitta, audumbara; from kapha —

Verse 8 (garuda.1.164.8)

मण्डलाख्यं विचर्चो च ऋष्याख्यं वातपित्तजम् । चर्मैककुष्ठं किटिमं सिध्मालसविपादिकाः

maṇḍalākhyaṁ vicarco ca ṛṣyākhyaṁ vātapittajam carmaikakuṣṭhaṁ kiṭimaṁ sidhmālasavipādikāḥ

— arises mandala; and vicharchika as well. From vata-pitta arise rishyajihva kushtha, charma (a single-patch kushtha), kitima, sidhma, alasa, and vipadika —

Verse 9 (garuda.1.164.9)

वातश्लेष्मोद्भवाः श्लेष्मपित्ताद्दद्रूशतारुषी । पुण्डरीकं सविस्फोटं पामा चर्मदलं तथा

vātaśleṣmodbhavāḥ śleṣmapittāddadrūśatāruṣī puṇḍarīkaṁ savisphoṭaṁ pāmā carmadalaṁ tathā

— arise from vata-kapha. From kapha-pitta arise dadru, chaturasra, pundarika with vispota, pama, and charmadala —

Verse 10 (garuda.1.164.10)

सर्वेभ्यः काकणं पूर्वत्रिकं दद्रु सकाकणम् । पुण्डरीकर्यजिह्वे च महाकुष्ठानि सप्त तु

sarvebhyaḥ kākaṇaṁ pūrvatrikaṁ dadru sakākaṇam puṇḍarīkaryajihve ca mahākuṣṭhāni sapta tu

— and from all three doshas combined arises kakana. The first three (kapala, audumbara, mandala), together with dadru, kakana, pundarika, and rishyajihva — these are the seven maha-kushthas (major skin diseases).

Verse 11 (garuda.1.164.11)

अतिश्लक्ष्णखरस्पर्शस्वेदास्वेदविवर्णताः । दाहः कण्डूस्त्वचि स्वापस्तोदः कोचोन्नतिस्तमः

atiślakṣṇakharasparśasvedāsvedavivarṇatāḥ dāhaḥ kaṇḍūstvaci svāpastodaḥ koconnatistamaḥ

An excessively smooth or rough touch, sweating or its absence, discoloration, burning, itching, numbness of the skin, pricking pain, raised swelling, and a shadow of darkness —

Verse 12 (garuda.1.164.12)

व्रणानामधिकं शूलं शीघ्रोत्पत्तिश्चिरस्थितिः । रूढानामपि रूक्षत्वं निमित्तेऽल्पेऽतिकोपनम्

vraṇānāmadhikaṁ śūlaṁ śīghrotpattiścirasthitiḥ rūḍhānāmapi rūkṣatvaṁ nimitte'lpe'tikopanam

— excessive pain in the sores, quick to appear yet slow to leave; dryness even in healed sores; and violent aggravation from even a slight cause —

Verse 13 (garuda.1.164.13)

रोमहर्षोऽसृजः कार्ष्ण्यं कुष्ठलक्षणमग्रजम् । कृष्णारुणकपालाभं यद्रूक्षं परुषं तनु

romaharṣo'sṛjaḥ kārṣṇyaṁ kuṣṭhalakṣaṇamagrajam kṛṣṇāruṇakapālābhaṁ yadrūkṣaṁ paruṣaṁ tanu

— horripilation and a darkening of the blood: these are the general premonitory signs of kushtha. That kushtha coloured like a black-red potsherd, dry, hard, and thin,

Verse 14 (garuda.1.164.14)

विस्तृताकृतिपर्यस्तन्दूषितैर्लोमभिश्चितम् । कापालं तोदबहुलं तत्कुष्ठं विषमं स्मृतम्

vistṛtākṛtiparyastandūṣitairlomabhiścitam kāpālaṁ todabahulaṁ tatkuṣṭhaṁ viṣamaṁ smṛtam

— of a spread-out, irregular shape, covered with corrupted hairs, and marked by intense pricking pain — that is called the uneven kapala kushtha.

Verse 15 (garuda.1.164.15)

उदुम्बरफलाभासं कुष्ठमौदुम्बरं वदेत् । वर्तुलं बहुलकेत्युक्तं दाहरुजाधिकम्

udumbaraphalābhāsaṁ kuṣṭhamaudumbaraṁ vadet vartulaṁ bahulaketyuktaṁ dāharujādhikam

That kushtha resembling the colour of the udumbara (fig) fruit is called audumbara. It is round, occurs in large patches, and carries excessive burning and pain.

Verse 16 (garuda.1.164.16)

असंच्छन्नमदरणं कृमिवत्स्यादुदुम्बरम् । स्थिरं सत्यानं गुरु स्निग्धं श्वेतरक्तं मलान्वितम्

asaṁcchannamadaraṇaṁ kṛmivatsyādudumbaram sthiraṁ satyānaṁ guru snigdhaṁ śvetaraktaṁ malānvitam

It is not covered over, does not split open, and resembles a worm — this is audumbara. That which is fixed in place, heavy, unctuous, white-red in colour, and carries a discharge —

Verse 17 (garuda.1.164.17)

अन्योन्यसक्तपुच्छूनबहुकण्डूस्नुतिकृमि । श्लक्ष्णपीताभासंयुक्तं मण्डलं परिकीर्तितम्

anyonyasaktapucchūnabahukaṇḍūsnutikṛmi ślakṣṇapītābhāsaṁyuktaṁ maṇḍalaṁ parikīrtitam

— studded with organisms that are joined together, swollen, causing much itching and discharge, of a smooth yellowish hue — this is declared to be mandala.

Verse 18 (garuda.1.164.18)

सकण्डूपिटिका श्यावा सक्लेदा च विचर्चिका । परुषन्तत्ररक्तान्तमन्तः श्यामं समुन्नतम्

sakaṇḍūpiṭikā śyāvā sakledā ca vicarcikā paruṣantatraraktāntamantaḥ śyāmaṁ samunnatam

Vicharchika is marked by itching pustules of a dusky hue and moist discharge, rough, with reddish edges and blackish, raised patches within.

Verse 19 (garuda.1.164.19)

ऋष्यजिह्वाकृतिप्रोक्तं ऋष्यजिह्वं बहुक्रिमि । हस्तिचर्मखरस्पर्शं चर्माख्यं कुष्ठमुच्यते

ṛṣyajihvākṛtiproktaṁ ṛṣyajihvaṁ bahukrimi hasticarmakharasparśaṁ carmākhyaṁ kuṣṭhamucyate

Rishyajihva, shaped like a deer's tongue, teems with worms. That kushtha with a rough touch like an elephant's hide is called charma.

Verse 20 (garuda.1.164.20)

अस्वेदञ्चमत्स्यशल्कसन्निभं किटिमं पुनः । रूक्षाग्निवर्णं दुः स्पर्शं कण्डूमत्परुषासितम्

asvedañcamatsyaśalkasannibhaṁ kiṭimaṁ punaḥ rūkṣāgnivarṇaṁ duḥ sparśaṁ kaṇḍūmatparuṣāsitam

Kitima is without sweating and resembles fish-scales in appearance; it is dry, fire-coloured, unbearable to the touch, itchy, rough, and dark.

Verse 21 (garuda.1.164.21)

अन्ता रूक्षं बहिः स्निग्धमन्तर्घृष्टं रजः किरेत् । श्लक्ष्णस्पर्शं तनु स्निग्धं स्वच्छमस्वेदपुष्पवत्

antā rūkṣaṁ bahiḥ snigdhamantarghṛṣṭaṁ rajaḥ kiret ślakṣṇasparśaṁ tanu snigdhaṁ svacchamasvedapuṣpavat

It is dry within and smooth without; rubbed from inside it sheds a powder like dust. That which is smooth to the touch, thin, unctuous, clear, and sweat-free, shedding flower-like scales —

Verse 22 (garuda.1.164.22)

प्रायेण चोर्ध्वकार्श्यञ्च कुण्डैः कण्डूपरैश्चितम् । रक्तैरलंशुका पाणिपादे कुर्याद्विपादिका

prāyeṇa cordhvakārśyañca kuṇḍaiḥ kaṇḍūparaiścitam raktairalaṁśukā pāṇipāde kuryādvipādikā

— generally tapering above, covered with itchy round patches, and, when it appears on the hands and feet with red, cloth-like markings, is called vipadika.

Verse 23 (garuda.1.164.23)

तीव्रार्तिं गाढकण्डूञ्च सरागपिडिकाचितम् । दीर्घप्रतानदूर्वावदतसीकुसुमच्छवि

tīvrārtiṁ gāḍhakaṇḍūñca sarāgapiḍikācitam dīrghapratānadūrvāvadatasīkusumacchavi

With intense pain, deep itching, red pustules, a long spreading form, and a colour resembling durva grass or linseed flowers —

Verse 24 (garuda.1.164.24)

उच्छूनमण्डलो दद्रुः कण्डूमानिति कथ्यते । स्थूलमूलं सदाहार्ति रक्तस्त्रावं बहुव्रणम्

ucchūnamaṇḍalo dadruḥ kaṇḍūmāniti kathyate sthūlamūlaṁ sadāhārti raktastrāvaṁ bahuvraṇam

— such a kushtha with swollen, circular, itchy patches is called dadru. That with a thick base, marked by burning pain, discharging blood, and covered with many sores —

Verse 25 (garuda.1.164.25)

सादहकक्लेदरुजं प्रायशः सर्वजन्म च । रक्ताक्तमण्डलं पाण्डु कण्डूदाहरुजान्वितम्

sādahakakledarujaṁ prāyaśaḥ sarvajanma ca raktāktamaṇḍalaṁ pāṇḍu kaṇḍūdāharujānvitam

— with burning, moistness, and pain, generally present since birth, its patches blood-tinged yet pale in hue, accompanied by itching, burning, and pain —

Verse 26 (garuda.1.164.26)

सोत्सेधमाचितं रक्तैः कञ्जपर्णमिवाम्बुभिः । पुण्डरीकं भवेत्तद्धि चितं स्फोटैः सितारुणैः

sotsedhamācitaṁ raktaiḥ kañjaparṇamivāmbubhiḥ puṇḍarīkaṁ bhavettaddhi citaṁ sphoṭaiḥ sitāruṇaiḥ

— raised, filled with blood as though a lotus-leaf upon water, covered with white-red blisters — this is pundarika kushtha.

Verse 27 (garuda.1.164.27)

विस्फोटपिटिका पामा कण्डूक्लेदरुजान्विताः । सूक्ष्मा श्यामारुणा रूक्षा प्रायः स्फिक्पाणिकूर्परे

visphoṭapiṭikā pāmā kaṇḍūkledarujānvitāḥ sūkṣmā śyāmāruṇā rūkṣā prāyaḥ sphikpāṇikūrpare

Pama, marked by blisters and small pustules, brings itching, moisture, and pain; it is minute, dusky-red, dry, and generally appears on the buttocks, hands, and elbows.

Verse 28 (garuda.1.164.28)

सस्फोटसंस्पर्शसहं कण्डूरक्तातिदाहवत् । रक्तदलं चर्मदलं काकणं तीव्रदाहरुक्

sasphoṭasaṁsparśasahaṁ kaṇḍūraktātidāhavat raktadalaṁ carmadalaṁ kākaṇaṁ tīvradāharuk

That marked by blisters, tolerant of touch, with itching, bleeding, and intense burning, is called charmadala; and that with severe burning pain is called kakana.

Verse 29 (garuda.1.164.29)

पूर्वरक्तञ्च कृष्णञ्च काकणं त्रिफलोपमम् । कृष्णलिङ्गैर्युतैः सर्वैः स्वस्वकारणतो भवेत्

pūrvaraktañca kṛṣṇañca kākaṇaṁ triphalopamam kṛṣṇaliṅgairyutaiḥ sarvaiḥ svasvakāraṇato bhavet

Kakana, first red and then turning black, resembles the triphala fruits; and all these arise, each according to its own cause, together with their respective dark characteristics.

Verse 30 (garuda.1.164.30)

दोषभेदाय विहितैरादिशेल्लिङ्गकर्मभिः । कुष्ठस्वदोषानुगतं सर्वदोषगतं त्यजेत्

doṣabhedāya vihitairādiśelliṅgakarmabhiḥ kuṣṭhasvadoṣānugataṁ sarvadoṣagataṁ tyajet

By these very stated signs and processes, one should determine the dosha and diagnose accordingly. A kushtha confined to its own single dosha should be treated; one involving all the doshas should be abandoned as incurable.

Verse 31 (garuda.1.164.31)

कुष्ठोक्तं यच्च यच्चास्थिमज्जाशुक्रसमाश्रयम् । कृच्छ्रं मेदोमतञ्चैव याप्यं स्नाप्वास्थिमांसगम्

kuṣṭhoktaṁ yacca yaccāsthimajjāśukrasamāśrayam kṛcchraṁ medomatañcaiva yāpyaṁ snāpvāsthimāṁsagam

That kushtha which has reached the bone, marrow, and semen is kricchra (hard to cure); one reaching the fat tissue is likewise yapya (only manageable); one reaching the sinews, bones, and flesh —

Verse 32 (garuda.1.164.32)

अकृच्छ्रं कफवातोत्थं त्वग्गतं त्वमलञ्च यत् । तत्र त्वचि स्थिते कष्ठे काये वैवर्ण्यरूक्षाता

akṛcchraṁ kaphavātotthaṁ tvaggataṁ tvamalañca yat tatra tvaci sthite kaṣṭhe kāye vaivarṇyarūkṣātā

— if it is born of kapha-vata and confined to the skin alone, being clear, it is not difficult to cure. When kushtha remains lodged only in the skin, there is discoloration and dryness of the body,

Verse 33 (garuda.1.164.33)

स्वेदतापश्वयथवः शोणिते पिशिते पुनः । पाणिपादाश्रिताः स्फोटाः क्लेशात्सन्धिषु चाधिकम्

svedatāpaśvayathavaḥ śoṇite piśite punaḥ pāṇipādāśritāḥ sphoṭāḥ kleśātsandhiṣu cādhikam

sweating, heat, and swelling; when it reaches the blood and flesh, blisters appear on the hands and feet, and there is especial distress at the joints.

Verse 34 (garuda.1.164.34)

दोषस्याभीक्ष्णयोगेन दलनं स्याच्च मेदसि । नातिसंज्ञास्ति मज्जास्थिनेत्रवेगस्वरक्ष्यः

doṣasyābhīkṣṇayogena dalanaṁ syācca medasi nātisaṁjñāsti majjāsthinetravegasvarakṣyaḥ

Through the repeated involvement of the dosha, the fat tissue itself begins to split — this is no minor matter; the marrow, bones, eyesight, and voice must be specially guarded.

Verse 35 (garuda.1.164.35)

क्षते च क्रिमिभिः शुक्रे स्वदारापत्यबाधनम् । यथापूर्वाणि सर्वाणि स्वलिङ्गानि मृगादिषु

kṣate ca krimibhiḥ śukre svadārāpatyabādhanam yathāpūrvāṇi sarvāṇi svaliṅgāni mṛgādiṣu

When worms arise in the sore, and when it reaches the semen, it may afflict even one's own wife and offspring by transmission. In animals too, in the same order, their own respective signs appear.

Verse 36 (garuda.1.164.36)

कष्ठैकसम्भवं श्वित्रं किलासं दारुणं भवेत् । निर्दिष्टमपरिस्त्रावि त्रिधातूद्भवसंश्रयम्

kaṣṭhaikasambhavaṁ śvitraṁ kilāsaṁ dāruṇaṁ bhavet nirdiṣṭamaparistrāvi tridhātūdbhavasaṁśrayam

Besides these kushthas, another dreadful disease called shvitra, or kilasa, is described; it is without discharge, and arises from the corruption of the three tissues — skin, blood, and flesh.

Verse 37 (garuda.1.164.37)

वाताद्रूक्षारुणं पित्तात्ताम्रं कमलपत्रवत् । सदाहं रोमविध्वंसि कफाच्छ्वेतं घन गुरु

vātādrūkṣāruṇaṁ pittāttāmraṁ kamalapatravat sadāhaṁ romavidhvaṁsi kaphācchvetaṁ ghana guru

From vata it is dry and reddish; from pitta, copper-coloured like a lotus-leaf, burning, and causing the hair to fall out; and from kapha it is white, dense, and heavy.

Verse 38 (garuda.1.164.38)

सकण्डूरं क्रमाद्रक्तमांसमेदः सु चादिशेत् । वर्णेनैवेदृगुभयं कृच्छ्रं तच्चोत्तरोत्तरम्

sakaṇḍūraṁ kramādraktamāṁsamedaḥ su cādiśet varṇenaivedṛgubhayaṁ kṛcchraṁ taccottarottaram

As it involves the blood, then the flesh, then the fat in due order, itching also appears — it is recognized by colour alone; each subsequent stage becomes progressively harder to cure.

Verse 39 (garuda.1.164.39)

अशुक्लरोमबहुलमसंश्लिष्टं मिथो नवम् । अनग्निदग्धजं साध्यं श्वित्रं वर्ज्यमतोऽन्यथा

aśuklaromabahulamasaṁśliṣṭaṁ mitho navam anagnidagdhajaṁ sādhyaṁ śvitraṁ varjyamato'nyathā

That shvitra in which the body-hair is not white, which is dense but not joined to other patches, which is recent, and does not resemble a burn from fire — such is curable; its opposite should be abandoned as incurable.

Verse 40 (garuda.1.164.40)

गुह्यपाणितलौष्ठेषु जातमप्यचिरन्तरम् । वर्जनीयं विशेषेण किलासं सिद्धिमिच्छिता

guhyapāṇitalauṣṭheṣu jātamapyacirantaram varjanīyaṁ viśeṣeṇa kilāsaṁ siddhimicchitā

Kilasa arising on the private parts, palms, or lips — even if quite recent — should be regarded by the physician who seeks success as especially to be abandoned.

Verse 41 (garuda.1.164.41)

स्पर्शैकाहारसंगादिसेवनात्प्रायशो गदाः । एकशय्यासनाच्चैव वस्त्रमाल्यानुलेपनात्

sparśaikāhārasaṁgādisevanātprāyaśo gadāḥ ekaśayyāsanāccaiva vastramālyānulepanāt

Through touch, through sharing food and the like, and through sharing the same bed, seat, garment, garland, and unguent — in this way, these diseases generally spread from one person to another.