Krimi Nidanam – 7th Chapter Of Madhava Nidana

Introduction

Krimi Nidanam is an important topic of Ayurvedic literature which deals with the classification, causes, clinical features and diagnosis of Krimi. The Krimi Nidanam in Madhava Nidana provides a systematic account that helps in understanding the classical Ayurvedic approach to identifying and assessing Krimi disorders. The aim of this article is to discuss the concept of Krimi by reviewing the relevant textual descriptions including its types, origin, habitat and characteristic signs and symptoms. The study is based on classical Ayurvedic references and their interpretation. The study of Krimi Nidanam is helpful for understanding the traditional principles of diagnosis and serves as a basis for comparative research with modern knowledge of parasitic and infectious diseases .This review emphasizes the importance of conservation of ancient ayurvedic knowledge and further need of scientific research.

Krimi Bheda

कृमयश्च द्विधा प्रोक्ता बाह्याभ्यन्तरभेदतः।
बहिर्मलकफासृग्विड्जन्मभेदाच्चतुर्विधाः॥१॥
नामतो विंशतिविधाः। (Madhava Nidana Chapter 7, Shloka 1)

The Classification Is Broadly Divided Into Four Main Groups

Bahya Krimi (बाह्य कृमि) — External parasites.
Abhyantara Krimi (आभ्यन्तर कृमि) — Internal parasites.
Internal Krimi arising from Kapha.
Internal Krimi arising from Rakta.

Bahya Krimi (External Parasites)

Bahya Krimi is an Ayurvedic term used to describe external parasites that live on the surface of the body, particularly on the skin and scalp. These may include lice, mites, and other organisms that can cause irritation or skin problems.In Ayurveda, Bahya Krimi are discussed in the context of skin hygiene, personal cleanliness, and maintaining external body health.

2 Types

Yuka
Liksa

Abhyantara Krimi (Internal Parasites)

Abhyantara Krimi is an Ayurvedic term used to describe organisms or parasites that reside inside the body, particularly in the gastrointestinal tract. In Ayurveda, these are discussed in relation to digestion, intestinal health, and disturbances in normal bodily functions.

18 Types

Kaphaja — 7
Raktaja — 6
Purisaja — 5

Bahya Krimi Lakshana(Signs And Symptoms)

बाह्यास्तत्र मलोद्भवाः।२
तिलप्रमाणसंस्थानवर्णाः केशाम्बराश्रयाः ॥२॥
बहुपादाश्च सूक्ष्माश्च यूका लिक्षाश्च नामतः।
द्विधा ते कोठपिडकाकण्डूगण्डान् प्रकुर्वते ॥३॥ (Madhava Nidana Chapter 7, Shloka 2-3)

According to Madhava Nidana, Bahya Krimi are external parasites that arise from external impurities and reside in the hair and clothing. They are described as very small, approximately the size of sesame seeds, and include Yuka (lice) and Liksha (lice eggs or nits). Their infestation produces Kotha (wheal-like eruptions), Pidaka (small skin bumps), Kandu (itching), and Ganda (nodular swellings). These symptoms are associated with external parasitic infestation in the classical Ayurvedic description.

Abhyantara Krimi Nidana (Causative Factors)

अजीर्णभोजी मधुराम्लनित्यो द्रवप्रियः पिष्टगुडोपभोक्ता ।
व्यायामवर्जी च दिवाशयानो विरुद्धभुक् संलभते क्रिमींस्तु ॥४ (Madhava Nidana Chapter 7, Shloka 4)

According to Madhava Nidana, the development of Krimi is associated with various dietary and lifestyle habits, such as consuming food before the previous meal has been digested, regularly eating sweet and sour foods, preferring liquid diets, excessive intake of flour preparations and jaggery, lack of physical activity, sleeping during the daytime, and eating incompatible food combinations.

Nidana According To The Origin Of Abhyantara Krimi

माषपिष्टाम्ललवणगुडशोकैः पुरीषजाः ।
मांसमत्स्यगुडक्षीरदधिशुक्तैः कफोद्भवाः ॥
विरुद्धाजीर्णशाकाद्यैः शोणितोत्था भवन्ति हि ।५॥ (Madhava Nidana Chapter 7, Shloka 5)

Krimi Purishaja: This is attributed in Ayurvedic texts to eating of foods like black gram, preparations made out of flour, sour and salty items and jaggery.
Kaphaja Krimi: Their origin is traditionally linked with the intake of meat, fish, jaggery, milk, curd and fermented food products.
Raktaja Krimi: These are said to be related with incompatible food combinations, indigestion and eating certain vegetables.

These associations are in accord with the classical Ayurvedic rationale for Krimi formation and should not be taken as evidence that these dietary factors are a direct causative of parasitic infections.

Abhyantara Krimi Lakshana(Signs And Symptoms)

ज्वरो विवर्णता शूलं हृद्रोगः सदनं भ्रमः ।
भक्तद्वेषोऽतिसारश्च सञ्जातक्रिमिलक्षणम्॥६॥ (Madhava Nidana Chapter 7, Shloka 6)

The clinical features of Krimi as described in Ayurveda are Jvara (fever), Vivarṇata (change in body colour), Sula (pain), Hṛdroga (cardiac distress), Sadana (general debility), Brahma (dizziness), Bhaktadveṣa (loss of interest in food), and Atisāra (diarrhoea).

Kaphaja Krimi Lakshana

कफादामाशये जाता वृद्धाः सर्पन्ति सर्वतः ॥ ७ ॥
पृथुब्रध्ननिभाः केचित् केचिद्गण्डूपदोपमाः ।
रूढधान्याङ्कुराकारास्तनुदीर्घास्तथा अणवः ॥ ८ ॥
श्वेतास्ताम्रावभासाश्च नामतः सप्तधा तु ते ।
अन्त्रादा उदरावेष्टा हृदयादा महागुदाः ॥ ९ ॥
चुरवो दर्भकुसुमाः सुगन्धास्ते च कुर्वते ।
हृल्लासमास्यस्रवणमविपाकमरोचकम् ॥ १० ॥
मूर्च्छा छर्दिर्ज्वरानाहकार्श्यक्षवथुपीनसान् । (Madhava Nidana Chapter 7, Shloka 7 -10)

Madhava Nidana describes Kaphaja Krimi as parasites that form in the Amashaya (stomach) and, as they grow, can spread to other parts of the body. They are variable in size and morphology, and appear as coiled bodies, worms or germinating grains. They are said to be white or of a copper color. Seven varieties are mentioned, viz., Antrada, Udaraveshta, Hridayada, Mahaguda, Churu, Darbhakusuma and Sugandha. Clinical features of Kaphaja Krimi are nausea (Hṛllāsa), drooling (Āsyasrāva), impaired digestion (Avipāka), anorexia (Aruchi), fainting (Mūrchhā), vomiting (Chardi), fever (Jvara), abdominal distension (Ānāha), weight loss or emaciation (Kārśya), sneezing (Kṣavathu) and nasal discharge (Pīnasa).

Raktaja Krimi Lakshana

रक्तवाहिसिरास्थानरक्तजा जन्तवोऽणवः ॥११॥
अपादा वृत्तताम्राश्च सौक्ष्म्यात् केचिददर्शनाः ।
केशादा रोमविध्वंसाः रोमद्वीपा उदुम्बराः ।
षट् ते कुष्ठैककर्माणः सहसौरसमातरः ॥१२॥ (Madhava Nidana Chapter 7, Shloka 11-12)

In Madhava Nidana, Raktaja Krimi are identified as microscopic organisms, which are related to blood vessels (Raktavahi Sira). They are round, copper-coloured, legless, and some are so small they can’t be seen with the naked eye. It mentions six varieties namely, Keshada, Romavidhvamsa, Romadvipa, Udumbara, Saurasa and Matara. In classical Ayurvedic literature these Krimi are also related with Kushtha and other skin disorders.

Purishaja Krimi Lakshana

पक्वाशये पुरीषोत्था जायन्तेऽधोविसर्पिणः ।
प्रवृद्धाः स्युर्भवेयुश्च ते यदाऽऽमाशयोन्मुखाः ॥१३॥
तदाऽऽस्योद्गारनिःश्वासा विड्गन्धानुविधायिनः ।
पृथुवृत्ततनुस्थूलाः श्यावपीतसितासिताः ॥१४॥
ते पञ्च नाम्ना क्रिमयः ककेरुकमकेरुकाः ।
सौसुरादाः सशूलाख्या लेलिहा जनयन्ति हि ॥१५॥
विड्भेदशूलविष्टम्भकार्श्यपारुष्यपाण्डुताः ।
रोमहर्षाग्निसदनं गुदकण्डूर्विमार्गगाः ॥१६॥ (Madhava Nidana Chapter 7, Shloka 13-16)

Purishaja Krimi originated in Pakwashaya (large intestine) and have a tendency to move downward. They may enlarge and extend into the Amashaya (stomach) and produce a fecal odor in the breath and belching. They are of different shape and size and of color from bluish-black and yellow to white and black. Five varieties are identified, namely Kakeruka, Makeruka, Sausarada, Sashula and Leliha. The symptoms of these Krimis are: changes in the bowel movements (Vidbheda), abdominal pain (Shula), constipation or intestinal obstruction (Vishtambha), emaciation (Karshya), dryness (Parushya), pallor (Panduta), horripilation (Romaharsha), reduced digestive capacity (Agnisadana) and pruritus in the anal area (Guda Kandu).

Conclusion

The discussion presented above gives a detailed account of the concepts and principles related to Krimi Nidana mentioned in Madhava Nidana. In particular, this section of the book outlines various aspects of Krimi, including classification, etiology, characteristics, and signs of these parasites from the viewpoint of Ayurveda. According to Madhava Nidana, Krimi can be classified as Bahya and Abhyantara, depending on their location. Moreover, there is a classification of Krimi in terms of their origin, such as Malaja, Kaphaja, Raktaja, and Purishaja. The information provided in the text explains the significance of food consumption, digestion process, and other factors in the traditional view on the development of Krimi and their signs and symptoms. Thus, studying this section may provide useful information about the classical way of disease diagnosis and pathogenesis.