Twenty-eight different forms of ear-diseases are noticed in practice, viz., Karna-Sula (ear-ache), Pra-nada (ringing or noise in the ear), Vadhirya (deafness), Kshveda, Karna-Srava (discharge of pus, etc., from the ear), Karna-Kandu (itching in the ear), Karna-gutha, Krimi-karna (vermin-infested ears), Prati-naha, the two kinds of Vidradhi (local abscess), Karna-paka (suppuration of ear), Puti-karna (fetor in the ear), four kinds of Ars'as (Cysts or polypuses in the ear), seven kinds of Arvuda (tumour) and four kinds of Sopha (swelling). 2 .
The violent aching pain in the region of the ear and inside the tympanum caused by the deranged local Vayu, aggravated and obstructed by the other deranged Doshas in the locality is called the Karna-Sula (ear-ache). Ringing and various other sounds in the ear are heard when the deranged Vayu of the locality gets into the wrong way and remains there stuffed in the sound-carrying channels of the organ. This disease is called the Pra-na'da. 3-4.
Vadhirya (deafness) results from the continuance in the sound-carrying channels of the deranged local Vayu in combination with the deranged local Kapha in those localites without anyway being remedied or subdued. An attack of Karna-kshveda (expresing a peculiar sound in the ear) may be attributed to such causes, as to the use of any cold thing or exposure to cold after being treated with a head-purging remedy (errhines), or to the continuance of the deranged local Vayu in the sound-passage, aggravated by excessive labour, by any wasting process in the system or by taking articles of fare of astringent taste or of parching (Ruksha) property. * 5 - 6.
Symptoms of Karna-Srava and
Any discharge or secretion of pus from the ear caused by the deranged bodily Vayu stuffing the ear-cavity, owing to a blow on the head or a long immersion in water or a spontaneous suppuration (and bursting) of an abscess in the inner ear, is called Karna-srava. The excessive itching sensation in the ear due to the aggravation of the local Kapha is called Karna-kandu. 7 - 8.
Symptoms of Karna-gutha and
Any mucous accumulation in the ear dried and hardened by the heat of the local Pitta is called Karna-gutha; when the dried accumulation of the ear in cases of Karna-gutha becomes liquefied, (and comes out through) the cavity of the nose † and produces head-disease ‡ it is called Karna-Prati-naha. 9-10.
* Tha difference in the "Karna-nada" and "Kshveda" is that in the former the sound in the ear is produced by the deranged Vayu alone and is of various kinds, whereas, in the latter it is of a special kind, viz., that of a wind-pipe - the exciting cause being the deranged local Pitta, Kapha and blood. - Videha.
† Some explain to mean the cavity of the nose and of the mouth.
‡ In place of (producer of head-disease) Madhava in his Nidana reads i.e„ producer of the headdiseaae known as Ardha-vedhaka (see chapter XXV).
Symptoms of Krimi-karna and
Germination of vermins or of other local parasites in the cavities of the ear completely impairs the faculty of hearing and is called Krini-kirna from the existence of worms in the ear. Any abscess caused by any local ulcer or by a blow, as well as any idiopathic abscess in the cavity of the ear is known as Karna-vidrathi It is marked by a choked and burning sensation, and piercing and sucking pain, and it secretes red, yellow or reddish bloody discharges. 11-12.
A process of suppuration setting in (in any of these boils) in the ear through the aggravated condition of the deranged Pitta is marked by a blocked and putrid condition of the passage of the ear. The disease is called Karna-paka (suppuration of the ear). A discharge of condensed and fetid pus whether accompanied or not with pain is set up by the local mucous accumulation in the passage of the ear having been liquefied by the heat of the aggravated Pitta. This disease is called Puti-karna (pus in the car). The symptoms of swelling- (Sopha), tumours (Arvuda) and polypoid growths (Ars'as) * in general as have been described before should be carefully understood by an experinced physicain to be the symptoms of these diseases in the region of the ear. 13-15.
Thus ends the twentieth chapter of the Uttara-Tantra in the Sus'ruta Samhita which deals with the causes and symptoms of the diseases peculiar to the ear.
* See chapter VI (NidáNam Of Pra-Meha (Diseases Of The Urinary Tracts)), XVIII and XXIII, Chikitsita-Sthana.