The 20th chapter of Uttaratantra of Sushruta Samhita is named as Karṇaroga Vijñānīya Adhyaya. This chapter deals with the Knowledge of Diseases of the Ears.

अथातः कर्णगतरोगविज्ञानीयमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः || २ ||

We will now expound the chapter by name Karnaroga vijňaniya – knowledge of diseases of the ear; as revealed by the venerable Dhanvantari.

Karnaroga nama – sankhya – names and number of diseases

कर्णशूलं प्रणादश्च बाधिर्य क्ष्वेड एव च ।।
कर्णस्रावः कर्णकण्डूः कर्णवर्चस्तथैव च || ३ ||
कृमिकर्णप्रतिनाही विद्रधिर्द्विविधस्तथा ।।
कर्णपाकः पूतिकर्णस्तथैवार्शश्चतुर्विधम् ।।४।।
कर्णार्बुदं सप्तविधं शोफश्चापि चतुर्विधः ।।
एते कर्णगता रोगा अष्टाविंशतिरीरिताः ||५||

Name of Karna Roga – ear disease	Number
Karna Sula	1
Karna Pranada	1
Karna Badhirya	1
Karna Ksveda	1
Karna Srava	1
Karna Kandu	1
Karna Varca	1
Krimi Karna	1
Karna Pratinaha	1
Karna Vidradhi	2
Karna Paka	1
Puti Karna	1
Karna Arsha	4
Karna Arbuda	7
Karna Sopha	4
Total	28

Karnaśula

समीरणः श्रोत्रगतोऽन्यथाचरः समन्ततः शूलमतीव कर्णयोः ।।
करोति दोषैश्च यथास्वमावृतः स कर्णशूलः कथितो दुराचरः ||६||

Vitiated vata gets localized in the ear. Here, it gets the association of other doshas i.e. pitta and kapha. Along with these doshas, Vata moves in wrong directions and gives rise to severe pain in the ears. This condition is called Karnasula and is difficult to cure.

Karņanāda

यदा तु नाडीषु विमार्गमागतः स एव शब्दाभिवहासु तिष्ठति ।।
शृणोति शब्दान् विविधांस्तदा नरः प्रणादमेनं कथयन्ति चामयम् ।।७।।

The aggravated vata moves abnormally in wrong paths and passages. While doing so, it occupies Sabdavaha Nadi i.e. channels carrying the sound and afflict them. In this condition, due to the effect of vata, the person hears many kinds of sounds. This disease is called Karna Pranada.

Bādhirya

स एव शब्दानुवहा यदा सिराः कफानुयातो व्यनुसृत्य तिष्ठति ।।
तदा नरस्याप्रतिकारसेविनो भवेत्तु बाधिर्यमसंशयं खलु ।।८।।

Badhirya means deafness. This is also caused by the same aggravated vata. In this condition, the aggravated vata associated with kapha and the duo get localized in the Sabdavaha Sira – blood vessels carrying sound or supplying the channels responsible for carrying sound / sound waves. Being there, they produce deafness in a person who does not take early treatment. This condition is called Badhirya.

Karna kşveda

श्रमात् क्षयाद्रूक्षकषायभोजनात् समीरणः शब्दपथे प्रतिष्ठितः ।।
विरिक्तशीर्षस्य च शीतसेविनः करोति हि क्ष्वेडमतीव कर्णयोः ।।९।।

Causes –

–        exertion,

–        depletion of tissues,

–        excessive consumption foods which are dry in nature and predominantly astringent in taste

–        excessively done shirovirechana i.e. head purging and its after effects

–        excessive intake of cold foods and exposure to cold

Pathogenesis – Due to the above said causes, vata gets aggravated. This aggravated vata gets localized in the shabdapatha – passages of sound and afflicts them.

Symptoms – Due to this pathogenesis caused by aggravated vata, the person starts hearing more sounds in the ears. These sounds are constant and are in high pitch. This condition is called Karnaksveda.

Karna srāva

शिरोभिघातादथवा निमज्जतो जले प्रपाकादथवाऽपि विद्रधेः ।।
स्त्रवेंत्तु पूयं श्रवणोऽनिलावृतः स कर्णसंत्राव इति प्रकीर्तितः ।।१०।।

Causes –

–        head injury

–        immersing in cold water

–        suppuration or ripening of vidradhi – abscess

Pathogenesis – Due to the above said causes, vata gets aggravated, gets localized in the ear and vitiates the ear. This condition is called Karna Srava.

Symptoms – Puya srava – discharge of pus from the ears is the main symptom of Karna Srava.

Karnakandū

कफेन कण्डू: प्रचितेन कर्णयोर्भृशं भवेत् स्त्रोतसि कर्णसंज्ञिते ।।

Karna Kandu means itching in the ears. This is caused by aggravated kapha. When the aggravated kapha accumulates in great quantities in the passages and orifices of the ear, it produces severe itching in the ears. This condition is called Karna Kandu.

Karna gūthaka

विशोषिते श्लेष्मणि पित्ततेजसा नृणां भवेत् स्त्रोतसि कर्णगूथकः ।।११।।

Karna Guthaka is also caused by Kapha increase. Firstly the kapha gets increased and accumulates in the ear. This kapha later gets dried by the heat of the pitta. This would lead to a condition called Karna Guthaka. (Guthaka means hardened ear wax).

Karna pratināha

स कर्णविट्को द्रवतां यदा गतो विलायितो घ्राणमुखं प्रपद्यते ।।
तदा स कर्णप्रतिनाहसंज्ञितो भवेद्विकारः शिरसोऽभितापनः ।।१२।।

The karna vitka or guthaka i.e. wax which has formed in the ear starts getting liquified. This liquified wax starts flowing out from the nostrils. This would eventually give rise to many kinds of diseases of the head. This is known as Karna Pratinaha.

Krimikarnaka

यदा तु मूर्च्छन्त्यथवाऽपि जन्तवः सृजन्त्यपत्यान्यथवाऽपि यक्षिकाः ।।
तदञ्जनत्वाच्छ्रवणो निरुच्यते भिषग्धराद्यैः कृमिकर्णको गदः ।।१३।।

Jantu or krimi means microorganisms, like worms, bacteria etc. When these jantus develop inside the ears or when the flies deposit larvae / maggots inside the ears, the jantus gets adhered within the passages of sound. This condition caused by jantu or krimi is called Krimikarnaka by the physicians.

Karna vidradhi

क्षताभिघातप्रभवस्तु विद्रधिर्भवेत्तथा दोषकृतोऽपरः पुनः ।।
सरक्तपीतारुणमस्त्रमास्त्रवेत् प्रतोदधूमायनदाहचोषवान् ।। १४ । ।

Vidradhi means abscess. When vidradhi develops inside the ear, it is called Karna Vidradhi.

Vidradhi is produced by

–        abhighata i.e. injury or is

–        dosha krta i.e. caused by aggravation of doshas

Symptoms – Due to the above said causes, the below mentioned symptoms are manifested –

–        discharge of reddish yellow or mild red colored blood from the ears,

–        severe pain in the ear

–        feeling as if hot air is coming out of the ear

–        burning sensation in the ear

–        sucking pain in the ear

Karna pāka

भवेत् प्रपाकः खलु पित्तकोपतो विकोथविक्लेदकरश्च कर्णयोः ।।
pitta. In this condition suppuration and discharges happen inside the ears. This condition is called Karna Paka.

Pūtikarna

स्थिते कफे स्त्रोतसि पित्ततेजसा विलाय्यमाने भृशसंप्रतापवान् ।। १५ ।।
अवेदनो वाऽप्यथवा सवेदनो घनं स्त्रवेत् पूति च पूतिकर्णकः ।।

Puti means foul smell. The ear which emits a bad smell is called Puti Karna. This condition is caused by kapha and pitta.

Kapha which has increased abnormally accumulates in the passages of the ears. Later, this kapha gets liquified by the heat of pitta. Due to this, there occurs a flow of thick and bad smelling exudes / discharges from the ear. This condition is called Putikarna.

Karna sopha- arbuda

प्रदिष्टलिङ्गान्यरशांसि तत्त्वतस्तथैव शोफार्बुदलिङ्गमीरितम् ।।
मया पुरस्तात् प्रसमीक्ष्य योजयेदिहैव तावत् प्रयतो भिषग्वरः ।।१६।।

Master Sushruta says that symptoms of karna sopha (swelling or oedema of ear) and arbuda (malignant tumour of the ear) are similar to sopha and arbuda which have been enumerated by him in the concerned chapters and should be recognized and diagnosed on similar lines.

इति श्रीसुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे कर्णगतरोगविज्ञानीयो नाम विंशतितमोऽध्यायः ।।२०।।

Thus ends the twentieth chapter by name Karnaroga Vijñānīya in Uttara Sthana of Suśruta Samhita.