A History of Indian Medical Literature v3.c42.s18.4

v3.c42.s18.4

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