Diagnosis of Parasites (Krimi) in Vagbhata Ashtanga Hridayam

 Diagnosis of Parasites (Krimi) in Vagbhata Ashtanga Hridayam

Krimi, (worms, parasites) are of two kinds viz bahya (external) and abhyantara (internal) and of four kinds on the basis of their origin (substance from which they develop) viz the external wastes (sweat), kapha, asrk (blood) and vit (faeces) and twenty kinds (species) by their names. 42b-43a. 

Rahya (External parasites): The external arise from uncleanliness, resemble tila (seed of sesame) in size, shape, and colour, dwell in the hairs and clothes, have many legs and are small in size; are of two kinds, yuka and liksa by name; they produce rashes, eruptions, itching and small tumors. 43b-45a. 

Notes: Yuka and liksa are the two kinds of louse, the head louse and body louse, both found in persons who are unclean. Head louse is black resides at the root of the hairs of the head. Body louse is white resides in the hairs of the axilla and pubis and take shelter inside the folds of clothes. Both spread from person to person by direct migration or indirect migration through combs, dress etc. or by their eggs being carried by air or hairs. 

Abhyantara Krimi (Internal parasites): Those born inside, have the same cause as those of kustha (leprosy and other skin diseases); in addition, ingestion of sweet foods, molasses, milk curds (yoghart, curdled milk), flour of grains and freshly harvested grains are special for slesmaja (kaphaja) krimi (worms born from kapha); those grains and leafy vegetables which produce more faeces and those pulses which are in green state are special for sakrijja (worms born from faeces). 45b-46. 

Kaphaja krimi: Those arising from kapha, reside in the amasaya (stomach and small intestine), when increased in number they move everywhere (inside the alimentary tract) some have big buttocks, some resemble earthworm, some others are like the sprouts of germinating grains; are thin, long or minute, white or coppery in colour; they are seven species by name, viz antrada, udaravesta, hrdayada, mahakuha, kuarva, darbhakusuma and sugandha; they give rise to nausea, more of salivation, indigestion, loss of taste/ appetite, fainting vomitting, fever, flatulence, (or distention of the abdomen) emaciation, more of sneezing and nasal catarrh. 47-50. 

Raktaja krimi: Those arising from blood reside in the blood vessels, are minute, devoid of legs, round, copper coloured, some are invisible being very minute; are of six species by namekesada, roma vidhvamsa, lomadvipa udumbara, aurasa and matara; these give rise to the same symptoms as those of kustha (leprosy and other skin diseases). 51-52. 

Purisaja krimi: Those arising from faeces reside in the pakvasaya (large intestine), usually moving downwards; when increased in number they travel up towards the amasaya (stomach and small intestine), then produce smell of faeces in the mouth, belchings and expiration; they are thick, round, thin (thread like) or thick, blue, yellow, white or black in colour; of five kinds (species) by name-viz kakeruka, makeruka, sausurada, suluna and leliha; they give rise to diarrhoea, abdominal pain, stasis of food undigested for long periods, emaciation, roughness of the skin, anaemia horripilations, weakness of digestion and itching in the rectum (anus) by coming out of it. 53-56. 

Notes: Mention of sweet foods, etc. as the cause is to stress that such foods cause weakness of digestive activity which in turn helps the growth of para sites insides the alimentary oanal. Kaphaja and purisaja krimi are intestinal parasites such as round worms (ascaris lumbricoides) hookworms (ankylostoma duodenale) thread worms ( oxyuris vermicularis), tape worm (tenia solium, tenia saginata), many kinds of amaeba (entaemaoba hystalatica etc., flagellae etc.) the eggs (ova) or parts of the body of these parasites gain entry into the human body through infected water, articles of food (leaves, vegetables, meat etc.) when these are consumed without proper cleaning and cooking. In persons who have strong digestive power, the ova etc. are destroyed by the hydrochloric acid in the stomach but in those who have poor digestive power, the acid being weak and insufficient the ova etc. escape into the intestines, hatch there and make their living, giving rise to many troubles to the person. Some of the names of these parasites are based on their physical features and function while some others are traditional names, different from one text to the other. It has not been possible to identify all of them with the common parasites affecting the Indian population in the present day. 

Raktaja krimi are the various parasites (of malaria, filaria) bacilli (leprosy), virus etc. found in the blood, organs such as liver and spleen. These come into the human body through the bites of musquitoes, fleas, bed bug etc. All the parasites described above are called vaikarika krimi pathogenic worms. There is mention of another kind of worms also, known as sahaja krimi-worms born along with the person-which are avaikarika-non pathogenic-present in the alimentary canal which help in the maintainance of health.