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A History of Indian Medical Literature v3.c42.s18: Special features of the Rogaviniścaya or Mādhavanidāna

A History of Indian Medical Literature v3.c42.s18

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Special features of the Rogaviniścaya or Mādhavanidāna

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A notable and substantial contribution of Mādhava consists of his description of new diseases absent from earlier works, and the development of some disorders which are only sketchily characterized or not recognized as fully independent diseases by his predecessors into autonomous nosological entities. These innovations became highly influential and were almost universally acknowledged by later writers.

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Two disorders recognized as independent entities for the first time by Mādhava are śūla (piercing, colic-like pain; 26) 38 and visphoṭa (diseases in which vesicles or blisters appear; 53). The *Suśrutasaṃhitā* deals with śūla in its chapter on the treatment of gulma (visceral swelling), where it is in the first place regarded as a secondary affection in cases of gulma (U.42.66cd–69ab), and secondly as an autonomous disease (U. 42.73cd–88a). Mādhava's chapter on śūla, made up of twenty-two verses which may have been composed by himself, precedes that on gulma (28), 39 and does not contain a single statement on a relationship between the two. The disease called visphoṭa is not absent from the classical saṃhitās, but is only cursorily referred to there as forming part of a group of disorders. The *Carakasaṃhitā* mentions it in the chapter on śvayathu (inflammatory swellings; Ci.12.90cd), together with kakṣāḥ (herpes zoster) and other skin eruptions, while Suśruta (Ni.13.18) and Vāgbhaṭa (A.h.U.31.9ab = A.s.U.36.9) regard it as one of the kṣudrarogas. 40 Mādhava gives the disorder an independent status, and devotes a separate chapter to it, consisting of eleven verses, which, with one exception, may be of his own making.

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The new diseases appearing for the first time in the *Mādhavanidāna* are: āmavāta (25), pariṇāmaśūla and annadravaśūla (26.15cd–22), medoroga (34), śītapitta (50), amlapitta (51), masūrikā (54), śūkaradamṣṭraka (55.55), kuñcana (59.96), pakṣmaśāta (59.99), and yonikaṇḍa (63).

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The disease called āmavāta 41 (often equated with rheumatoid arthritis) 42 is described in a separate chapter of twelve verses which may have been composed by Mādhava. The *Hārītasamhitā* (III.21) described it in its own manner, independently of Mādhava. The disorders called pariṇāmaśūla (a type of śūla manifesting itself during the digestion of food) and annadravaśūla (which may appear during the digestive process or precede or follow it), which are unknown in earlier medical treatises, 43 are dealt with in the chapter on śūla as varieties of this disease. Medoroga (obesity) 44 is characterized in four verses, which may again be by Mādhava; these verses are followed by five ślokas from the *Carakasaṃhitā* (Sū.21.5–9). Mādhava made medoroga into a nosological entity, whereas it was Caraka's aim not to characterize a disease in its own right, but an undesirable condition leading to afflictions of various kinds. An illness called śītapitta (urticaria), 45 not recorded in the classical saṃhitās, is described by Mādhava in a short chapter of six verses, the first five of which may be his own, whereas the sixth has been borrowed from Vāgbhaṭa (A.h.U.31.32–33ab = A.s.U.36.30).46 Three disorders closely related to śitapitta according to Mādhava's arrangement, namely udarda (a special form of urticaria), koṭha (an exanthematous, itching eruption), and utkoṭha (a disorder resembling koṭha), are discussed in the same chapter, thus forming a new cluster of Mādhava's making.47 The term amlapitta usually denotes a symptom in the classical saṃhitās, not a separately described nosological entity.48 Mādhava regards it as an independent disease (corresponding to a dyspepsia, accompanied by vomiting and diarrhoea or spitting of blood), characterized in a separate chapter of twelve verses, which may be his own. The chapter on amlapitta of the Hārītasamhitā (III.24) has possibly been influenced by the Mādhavanidāna, whereas that of the Kāśyapasamhitā (Khila 16) appears to be original. The chapter on amlapitta of the Rogaviniścaya ends with a verse on a related disorder, śleṣmapitta, but, since the commentators are silent on it, it can safely be assumed to be a later interpolation.49

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Very important is the fact that Mādhava is the earliest author to give a detailed description of masūrikā (smallpox, chicken pox, and other infectious, eruptive fevers). A disorder of this name is briefly mentioned in a single verse of the chapter on śvayathu of the Carakasamhitā (Ci.12.93), together with romāntikā (Ci.12.92), related to masūrikā, whereas Suśruta (Ni.13.38) and Vāgbhaṭa (A.h.U.31.8 = A.s.U.36.8) regard masūrikā as one of the kṣudrarogas. The Kāśyapasamhitā deals with masūrikā in a verse at the end of the chapter on visarpa (Khila 14), while the Hārītasamhitā (III.24) considers it to be a variety of contagious piḍakas (pustules).50 The Mādhavanidāna has a chapter of thirty-one verses, probably by Mādhava, on masūrikā and its various types, among which romāntī figures.51

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The disorder called śūkaradamṣṭraka52 was added by Mādhava to the group of kṣudrarogas. The Mādhavanidāna describes seventy-eight eye diseases, as opposed to the seventy-six of the Suśrutasamhitā, by adding two diseases of the eyelashes, called kuñcana53 and pakṣmaśāta.54 Śrīkaṇṭhadatta claims in his comments that kuñcana was borrowed from some other treatise, while pakṣmaśāta55 is equated by this commentator with kṛcchronmīla of Vāgbhaṭa (A.h.U.8.3–4 = A.s.U.11.4–5).56 The short chapter of four verses on yonikanda may have been composed by Mādhava. This disease, especially prevalent in elder women according to Śrīkaṇṭhadatta in his comments, probably corresponds to a prolapse of the vagina or uterus.57

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The group of puerperal disorders (65; sūtīkāroga) is an innovation of Mādhava; it consists of aṅgamarda, jvara, kampa, pipāsā, gurugātratā, śotha, śūla, and atisāra.58

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One of the diseases not described in the Mādhavanidāna is a disease of the head, called upaśīrṣaka;59 tuṇḍī, a children's disease, is also absent,60 as well as the term bradhna.61

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Several editions of the Mādhavanidāna contain additional verses, ignored in the Madhukośa. Some stanzas added to the end of the chapter on grahaṇī describe the varieties called saṃgrahagrahaṇī62 and ghaṭīyantragrahaṇī.63

Cites (7)