The chapter on the treatment of kushtha is introduced according to the teaching of Dhanvantari. The text states that disorders of the skin arise from incompatible eating, eating again before the previous meal is digested, unsuitable habits, suppression of natural urges, improper commencement of oleation and related measures, wrongful conduct, and the conjunction of deeds performed previously.
The commentary explains that incompatible eating and the other listed factors are specifically causes of kushtha. Although they were taught earlier, they are repeated here because of their particular relevance to this disorder.
Key terms
kuShTha (kushtha)
The classical disease category treated in this chapter; it is not assigned a single modern diagnosis here.
viruddhAdhyashana (viruddha-adhyashana)
Incompatible eating and eating again before the previous food is digested.
vegavighAta (vega-vighata)
Suppression or obstruction of natural urges.
tvagdoSha (tvag-dosha)
A disorder affecting the skin in the language of the passage.
Adhikarana 2 (4) · Śloka 4
tatra tvagdōṣī māṁsavasādugdhadadhitailakulatthamāṣaniṣpāvēkṣupiṣṭavikārāmlaviruddhādhyaśanājīrṇavidāhyabhiṣyandīni divāsvapnaṁ vyavāyaṁ ca pariharēt ||4||
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तत्र त्वग्दोषी मांसवसादुग्धदधितैलकुलत्थमाषनिष्पावेक्षुपिष्टविकाराम्लविरुद्धाध्यशनाजीर्णविदाह्यभिष्यन्दीनि दिवास्वप्नं व्यवायं च परिहरेत् ||४||
Meaning of the śloka
A person with a disorder of the skin is instructed to avoid meat, animal fat, milk, curd, oil, kulattha, masha, nishpava, sugarcane products, preparations made from flour, sour substances, incompatible food combinations, eating before digestion is complete, foods described as causing burning or obstruction, daytime sleep, and sexual intercourse.
The commentary identifies nishpava as rajashimbi. It defines abhishyandi as something that produces excess moistness or clogging in the doshas, tissues, wastes, and bodily channels.
Key terms
tvagdoShI (tvag-doshi)
A person affected by a disorder of the skin.
niShpAva (nishpava)
A pulse identified by the commentary as rajashimbi.
abhiShyandi (abhishyandi)
Described here as producing moistness or clogging in doshas, tissues, wastes, and channels.
ततः शालिषष्टिकयवगोधूमकोरदूषश्यामाकोद्दालकादीननवान् भुञ्जीत मुद्गाढक्योरन्यतरस्य यूषेण सूपेन वा निम्बपत्रारुष्करव्यामिश्रेण, मण्डूकपर्ण्यवल्गुजाटरूषकरूपिकापुष्पैः सर्पिःसिद्धैः सर्षपतैलसिद्धैर्वा, तिक्तवर्गेण वाऽभिहितेन; मांससात्म्याय वा जाङ्गलमांसममेदस्कं वितरेत्; तैलं वज्रकमभ्यङ्गार्थे; आरग्वधादिकषायमुत्सादनार्थे; पानपरिषेकावगाहादिषु च खदिरकषायम्; इत्येष आहाराचारविभागः ||५||
Meaning of the śloka
The text prescribes old shali and shashtika rice, barley, wheat, koradusha, shyamaka, uddalaka, and similar grains. These may be eaten with soup made from either mudga or adhaki and mixed with neem leaves and arushkara, or with specified leafy materials cooked in ghee or mustard oil, or with substances of the previously described bitter group. For one accustomed to meat, lean meat of jangala animals may be given. Vajraka oil is assigned for external oiling, aragvadhadi preparations for rubbing the body, and a khadira decoction for drinking, pouring, immersion, and related uses. This is presented as the division of diet and conduct.
The commentary identifies uddalaka as wild kodrava and explains that mudga and adhaki are the two soup ingredients, with neem leaf, arushkara, mandukaparni and the other plants serving as vegetables. It identifies mandukaparni as a variety of brahmi and rupika flowers as arka flowers. Some authorities reject mustard oil because they consider it harmful to rakta and pitta, while others allow it in vata- and kapha-associated kushtha; the disagreement is preserved. The bitter group includes prapunnada, avalguja, patola, vartaka and others. Although meat was prohibited elsewhere, lean jangala meat is allowed for a person habituated to meat. Aragvadhadi kashaya may mean a paste or powder appropriate for rubbing, or possibly a means of raising a depressed wound. The final statement is understood as instruction concerning the substances and tastes used in the diet.
Key terms
purANa dhAnya (purana dhanya)
Older, rather than newly harvested, grain as specified in the regimen.
jA~ggalamAMsa (jangala-mamsa)
Meat of animals associated with dry-land habitat, here specified without fat.
vajraka taila
A named medicated oil assigned here for external application.
utsAdana (utsadana)
Rubbing or upward-promoting application; the commentary preserves more than one contextual explanation.
Adhikarana 4 (6) · Śloka 6
tatra pūrvarūpēṣūbhayataḥ saṁśōdhanamāsēvēta |
tatra tvaksamprāptē śōdhanālēpanāni, śōṇitaprāptē saṁśōdhanālēpanakaṣāyapānaśōṇitāvasēcanāni, māṁsaprāptē śōdhanālēpanakaṣāyapānaśōṇitāvasēcanāriṣṭamanthaprāśāḥ, caturthakarmaguṇaprāptaṁ yāpyamātmavataḥ saṁvidhānavataśca, tatra saṁśōdhanācchōṇitāvasēcanāccōrdhvaṁ bhallātaśilājatudhātumākṣīkaguggulvagurutuvarakakhadirāsanāyaskr̥tividhānamāsēvēta; pañcamaṁ naivōpakramēt ||6||
At the premonitory stage, purification through both routes is prescribed. When the condition is located in tvak, purification and external applications are advised; when it reaches blood, these are joined by drinking decoctions and bloodletting; and when it reaches muscle, arishta and mantha preparations are added. A condition associated with the fourth tissue level is described as manageable, rather than curable, in a disciplined person who has the required arrangements. After purification and bloodletting, the text directs the regimens of bhallataka, shilajatu, dhatumakshika, guggulu, aguru, tuvaraka, khadira, asana, and ayaskriti. The fifth level is not to be treated.
The commentary takes purification through both routes as emesis and purgation, and explains tvak here through rasa because rasa occupies that location. Mention of arishta also includes asava and sura. One reading understands the fourth level as medas: kushtha established there is yapya when the effects of purification and related treatment can be maintained. Atmavat may describe a person with virtues such as patience and cleanliness, or one committed to correct diet, conduct, and avoidance of unsuitable habits. Samvidhanavat may mean equipped and diligent in carrying out treatment; some read samyagvidhanavat, meaning furnished with abundant resources. Another interpretation takes the phrase as kushtha possessing features such as foul smell, coating, and pus; still others read caturthakhyaprapta. The named regimens are referenced from other treatment contexts. The fifth level is left untreated because kushtha reaching bone and subsequent tissues is considered incurable in this account.
Key terms
saMshodhana (samshodhana)
Purificatory treatment, explained here as emesis and purgation.
shoNitAvasecana (shonitavasecana)
Removal or letting of blood.
yApya (yapya)
A condition considered manageable through continued measures rather than fully curable.
The person with kushtha is first to be prepared by the prescribed method of drinking an unctuous substance. The text assigns oil or ghee processed with meshashringi, shvadamshtra, sharngeshta, guduchi, and the two groups of five roots for drinking and external oiling in vata-associated kushtha. It gives a different medicated ghee for pitta-associated kushtha, and another for kapha-associated kushtha, with an alternative preparation containing bhallataka, abhaya, and vidanga. Tuvaraka oil or bhallataka oil is mentioned for all forms.
The commentary limits this drinking of unctuous substances to preparation for emesis and other purification, rather than independent oleation, because kushtha is considered to require drying measures. Once oleated, the person proceeds in sequence to emesis, purgation, and bloodletting, although those steps are not repeated in the verse. It records variant plant identifications, including meshashringi as karkatashringi while Gayi calls it a putranjivaka variety, and several names for sharngeshta. For vata-associated kushtha with kapha, oil is preferred; with pitta, ghee. Others instead assign ghee for drinking and oil for massage. The remaining plant identifications are then supplied.
Key terms
snehapAna (snehapana)
Drinking an unctuous preparation, here specifically as preparation for purification.
vAtakuShTha (vata-kushtha)
Kushtha classified here by association with vata.
bhallAtaka (bhallataka)
A potent botanical used in named historical preparations.
tuvaraka taila
A named medicinal oil mentioned for all forms in this passage.
The text gives two compound medicated ghees. Mahatiktaka ghee combines a long list of predominantly bitter and related substances with ghee, amalaki juice, and water, and is claimed in the source to pacify kushtha together with many other named disorders. Tiktaka ghee is prepared from a decoction of triphala, patola, neem, atarushaka, katurohini, duralabha, trayamana, and parpataka, with a paste of trayamana, musta, indrayava, candana, kiratatiktaka, and pippali in ghee. The source likewise attributes effects against kushtha and a broad range of other conditions to it.
The commentary says that the wording indicates two haridras and two upakulyas, namely pippali and gajapippali. It identifies vishala as indravaruni, murva as corasnayuh, and shadgrantha as vaca. For mahatiktaka, the usual general formula rules do not need to be applied because the quantities of paste, decoction, and other substances are stated explicitly. Shandhya is glossed as the state of being shandha. The commentary treats verses 8 and 9 together.
Key terms
mahAtiktaka sarpis (mahatiktaka sarpis)
The first named compound bitter medicated ghee.
tiktaka sarpis
The second named compound medicated ghee.
dhAtrIphalarasa (dhatri-phala-rasa)
Juice of dhatri or amalaki fruit used in the first formulation.
After oleation and fomentation with one of the preceding ghees, the text directs puncturing one to five veins. Raised patches are to be repeatedly scraped or punctured, or rubbed with specified rough leaves, and then treated with one of seven groups of topical pastes. These groups contain resins, seeds, pungent plants, salts, mineral substances, alkaline materials, animal bile in one stated option, and other ingredients, sometimes ground with urine. One group is incorporated into filtered palasha alkali and cooked to a molasses-like consistency. The passage concludes that these seven established pastes remove kushtha.
The commentary identifies several plants and explains that pittapishta means ground with cow bile. For the alkaline preparation, nihsruta means filtered; the method includes burning plant stalks, extracting with six parts water, and adding a specified fraction of powders containing substances such as tuttha and kasisa. Further botanical identifications are supplied. The word siddha is explained as asserting certainty of the claimed result in the source.
Key terms
sirAviddha (sira-viddha)
Puncturing a vein for blood removal in the historical procedure.
avalikh
To scrape a raised lesion.
kShAra (kshara)
A caustic alkaline preparation used in a topical paste.
tuttha
A mineral substance included in some of the historical topical mixtures.
The text now introduces specific preparations for dadru and shvitra. For dadru, it prescribes a topical paste made by combining laksha, kushtha, mustard, shriniketa, haridra, the three pungent substances, and cakramarda seed, grinding them with buttermilk, and adding mulaka seed.
The commentary identifies shriniketa as the fumigated product of fresh butter or as the resin of sarala, and identifies ratri as haridra. These identifications accompany the transition to condition-specific formulations.
Key terms
dadrU (dadru)
A named classical skin-disorder category for which this paste is prescribed.
shvitra
Another classical skin-disorder category introduced here; it is not automatically equated with a modern diagnosis.
shrIniketa (shriniketa)
Identified alternatively as a product from fresh butter or as sarala resin.
The passage describes a paste of saindhava, cakramarda seed, guda, bakula kesara, and rasanjana, ground with kapittha juice. The source claims that this formulation quickly removes dadru.
Hemakshiri, vyadhighata, shirisha, neem, sarja, vatsaka, and ajakarna are said to act strongly and quickly against dadru when used for bathing, topical application, or rubbing.
The commentary identifies hemakshiri as kankushtha, vyadhighata as kiramalaka, sarja as laghusarja, and ajakarna as mahasarja, while noting that some call the latter gandhamunda. Some authorities read drinking rather than bathing in the list of uses. For grinding materials used in topical application and rubbing, one view carries forward sour buttermilk, while another carries forward kapittha juice.
Key terms
hemakShIrI (hemakshiri)
A substance identified by the commentary as kankushtha.
ajakarNa (ajakarna)
Identified as mahasarja, with gandhamunda preserved as another name.
snAna (snana)
Bathing; some recensions instead read pana, drinking.
Equal quantities of the roots of bhadra udumbari and malapu are crushed and cooked in water. The resulting liquid is drunk lukewarm while the person remains in the heat; the text states that this produces blisters in shvitra and pundarika.
After three formulations for dadru, the commentary introduces this one for shvitra. It identifies udumbari called bhadra as the larger woody udumbara and malapu as the same type with smaller branches. It supplies detailed historical preparation conditions and says the person is placed in sunlight after anointing with pungent oil. After digestion, food is taken with churned cow's-milk preparation or pomegranate soup.
Key terms
shvitra
A classical skin-disorder category treated in this passage without assigning a modern equivalent.
puNDarIka (pundarika)
A named skin-disorder form mentioned alongside shvitra.
sphoTa (sphota)
A blister intentionally produced by the described historical measure.
AtapasaMstha (atapa-samstha)
Remaining exposed to heat or sunlight during the described procedure.
The commentary presents this as subsequent care for a person with shvitra once the induced blister has formed and broken. It identifies dvipin here as a spotted tiger and matanga as an elephant. The oil is said to be processed with vishanika. A cited formulation describes oil prepared with avartaki root and dusting with ash of elephant or tiger hide, or alternatively with powders of triphala and iron.
Key terms
bhinna sphoTa (bhinna sphota)
A blister that has ruptured or opened.
dvaipa carma
Hide attributed by the commentary to a spotted tiger.
mAta~ggaja carma (matangaja carma)
Elephant hide.
masI (masi)
Ash or charred powder used in the cited topical application.
The text says that a certain puti insect mixed or applied with alkali derived from rajavriksha is an especially effective single measure against shvitra.
The commentary identifies the puti insect as a crop-eating, mottled insect appearing in the rainy season, locally called telini and, in the eastern region, pundalika. It is mixed with aragvadha alkali, rajavriksha being aragvadha. Eka is glossed as 'best.' Because of the intended scraping or peeling action, alkaline water is taken as the liquid. Some authorities read ukta rather than akta.
Key terms
pUti kITa (puti kita)
A rain-season crop-eating insect identified by several regional names.
rAjavRukSha (rajavriksha)
Identified here as aragvadha.
kShAra (kshara)
A caustic alkaline preparation derived here from aragvadha.
uddAlana (uddalana)
A scraping, peeling, or disruptive action attributed to the preparation.
The thoroughly burnt ash of a black snake is mixed and rubbed together with vibhitaka oil. Applied as a paste, the text claims that this quickly removes recent shvitra lesions.
The commentary explains that when a black snake being burned becomes intensely black, its powder is called masi. If continued burning makes it white, the resulting material is called kshara.
Key terms
kRuShNasarpasya masI (krishna-sarpasya masi)
Black charred powder made from a black snake in the historical account.
baibhItaka taila (baibhitaka taila)
Oil associated with vibhitaka, mixed with the ash.
kShAra (kshara)
The white alkaline residue said to result from further burning.
Oil is cooked seven times, by the method of preparing kshara, with four times its quantity of well-filtered kshara liquid made using one-and-a-half parts water. This is praised as a foremost external application for shvitra.
The commentary carries forward the reference to the kshara of the black snake from the preceding context. It explains adhyardha as one and a half, ksharasya kalpena as the kshara-processing method, saptakritvah as seven times, mrakshana as external application, and agrya as foremost.
Key terms
kShAra (kshara)
An alkaline preparation used in the described historical formulation.
shvitra
The classical disorder category addressed here; it should not automatically be equated with a modern diagnosis.
mrakShaNa (mrakshana)
External application or smearing.
Adhikarana 16 (19-20) · Śloka 20
ghr̥tēna yuktaṁ prapunāḍabījaṁ kuṣṭhaṁ ca yaṣṭīmadhukaṁ ca piṣṭvā |
śvētāya dadyādgr̥hakukkuṭāya caturthabhaktāya bubhukṣitāya ||19||
tasyōpasaṅgr̥hya ca tat purīṣamutpācitaṁ sarvata ēva limpēt |
abhyantaraṁ māsamimaṁ prayōgaṁ prayōjayēcchvitramathō nihanti ||20||
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घृतेन युक्तं प्रपुनाडबीजं कुष्ठं च यष्टीमधुकं च पिष्ट्वा |
श्वेताय दद्याद्गृहकुक्कुटाय चतुर्थभक्ताय बुभुक्षिताय ||१९||
तस्योपसङ्गृह्य च तत् पुरीषमुत्पाचितं सर्वत एव लिम्पेत् |
अभ्यन्तरं मासमिमं प्रयोगं प्रयोजयेच्छ्वित्रमथो निहन्ति ||२०||
Meaning of the śloka
Prapunada seed, kushtha, and yashtimadhuka are ground with ghee and fed to a hungry white domestic cock at its fourth meal. Its feces are then collected and applied for a month over shvitra that has first been brought to a ripened state; the passage claims that this removes shvitra situated internally.
The commentary explains the fourth meal as the evening of the second day after the bird has fasted for one day. It specifies an extremely hungry white domestic cock and says its feces are collected. The application is made for one month to shvitra understood as extending within the dhatus and previously brought to paka by measures such as malapu and blister-producing applications.
Key terms
shvitra
A classical disorder category addressed by the regimen.
abhyantara
Internal or situated within the bodily tissues in the commentary's explanation.
utpAcita (utpacita)
Brought to a ripened or suppurated state by prior measures.
A thoroughly calcined alkaline substance derived from jalaganda is repeatedly filtered with elephant urine. Avalguja seed is added in a stated proportion and cooked; once the mass becomes smooth, pills are formed. The passage says that, after rubbing shvitra, applying one of these restores similarity of color quickly.
The commentary identifies jalaganda as jalagandiraka, while others identify it as nadipippalika. It records another reading, 'kshara made from elephant dung,' but rejects it because it conflicts with another authoritative text. It explains that avalguja powder is added as one tenth of the preparation.
Key terms
jalagaNDa (jalaganda)
A disputed source substance identified as jalagandiraka or, by others, nadipippalika.
A wick is repeatedly treated with a decoction made from mango and haritaki bark and with banyan latex, then placed in a copper lamp and ignited. The resulting soot is further processed with a pathya decoction. Applied with pungent oil to repeatedly scarified kilasa, it is said to make the condition recede.
The commentary explains the liquid as a decoction of mango and haritaki bark and describes a cotton wick moistened with pungent oil, burned in a copper lamp, and its soot treated with banyan latex and then pathya decoction. It quotes a standard decoction ratio and a parallel formulation. Gayadasa instead explains that the cloth wick is first treated with banyan latex and then with pungent oil. Another reading says to apply the preparation over the whole area for relief.
Key terms
kilAsa (kilasa)
The classical discoloration category treated in the passage.
masI (masi)
Soot produced from the prepared burning wick.
sampracchita
Repeatedly scarified or superficially incised in this context.
Equal parts of superior avalguja seed, nadija, the fig called by the crow-name together with its lac, iron powder, magadhi, tarkshyashaila, and black sesame are formed into a wick after grinding with cow bile. Its application is said to remove shvitra. Peacock bile, or burnt hribera combined with it, is also stated to have this effect when applied.
The commentary glosses agrya as best, nadija as makshika mineral arising from the Tapi river, the crow-named fig as a particular udumbarika, and includes its associated lac. Tarkshyashaila is identified as rasanjana. It says black sesame is used in an equal amount. It preserves another reading that begins 'tapyudbhuta avalguja seed'; there too tapyudbhuta denotes makshika mineral. Shaikhina pitta means peacock bile.
Key terms
nadIja (nadija)
Explained as makshika mineral originating from the Tapi river.
The passage lists ingredients for two topical combinations: the first includes tuttha, ala, katuka, vyosha, simha, arka, hayamaraka, kushtha, avalguja, bhallataka, kshirini, mustard, and snuhi; the second includes leaves of tilvaka, arishta, pilu, and aragvadha, with seeds of vidanga and ashvahantṛ, the two haridras, and the two brihatis. It claims that applying these two preparations completely removes shvitra.
The commentary identifies ala as haritala, simha as red shobhanjana, and kshirini as arkapushpi. It clarifies that the two verses are to be understood as describing two separate formulations.
Key terms
tuttha
A mineral ingredient in the first topical group.
haritAla (haritala)
The mineral substance identified by the commentary as ala.
yogadvaya
Two distinct formulations described across the verses.
A decoction is prepared from stated quantities of vayasi, phalgu, tikta, iron powder, triphala, and asana, then processed further with ghee and fine pastes including indrayava, vyosha, tvak, daru, caturangula, paravatapadi, danti, bakuci, kesharahvaya, and kantakari. The medicated ghee is prescribed historically for kushtha. Taken internally it is said to address the condition lodged in dosha and dhatu, and by external application one situated in the skin; it is also claimed to restrain the otherwise incurable variety called nila.
The commentary identifies vayasi as kakatikta, popularly cirapotika, while others call it kakamaci. Phalgu is kakodumbarika, though another reading has avalgu, meaning bakuci; tikta means katuka. Paravatapadi is a slightly reddish variety of hamsapadi, and kesharahvaya is bakula. It explains that because water is fluid, twice the stated three dronas is used; two prasthas of asana heartwood are included. From the two parts remaining, one quarter is ghee, and paste beginning with indrayava is one quarter of the ghee.
Key terms
kuShTha (kushtha)
A broad classical disease category, not automatically a single modern skin disease.
nIla (nila)
A named variety of kushtha described as difficult or incurable.
vAyasI (vayasi)
Identified as kakatikta/cirapotika, with kakamaci as another opinion.
phalgu
Identified as kakodumbarika; an alternative reading gives avalgu or bakuci.
A large compound ghee called Mahanila is prepared from extensive groups of plant substances, liquids including cow-derived products, and further medicinal pastes. The text claims that it removes kushtha, restores similarity of body color in persons with shvitra when rubbed on externally, and restrains bhagandara, worms, arshas, and Mahanila.
The commentary identifies madayantika as henna, vayasi as kakamaci, and says the feces, expressed liquid, curd, milk, and urine are from cows. Nilika is identified as nilanjanika with autumn fruit, and nilini as nilika; mrakshana means rubbing or anointing. It notes that the Nila and Mahanila ghee passages are considered non-authorial, but Jejjata and Gayadasa explained such readings, so the commentator retains and explains them. Because the amount of decoction material seems excessive relative to water, it quotes a different Mahanila-ghrita formulation from Vriddha Vagbhata rather than collapsing the two accounts.
Key terms
mahAnIlaghRuta (Mahanila-ghrita)
The named compound medicated ghee described here.
anArSha (anarsha)
Regarded by the commentator as not belonging to the authoritative original text.
mrakShaNa (mrakshana)
Rubbing or external anointing.
pa~jcagavya (panchagavya)
A group of five cow-derived substances in the cited alternative formulation.
Cow urine combined with citraka and vyosha is kept with honey in a ghee-coated vessel. After a fortnight, the passage prescribes it historically as a drink for persons with shvitra and directs that the regimen stated for kushtha also be followed in this condition.
The commentary says cow urine and honey are equal in amount, while citraka and vyosha are added only to impart slight pungency to the fermented preparation. Others understand those substances as intended only for coating the vessel. The final instruction extends the kushtha treatment regimen to kilasa in a concise manner.
Key terms
shvitra
The classical condition for which the fermented drink is stated.
ariShTa (arishta)
The fermented preparation referenced by the commentary.
atidesha
Extension of a previously stated regimen to the present condition.
Tender shoots of putika, arka, snuh, narendradruma, and sumana are ground with their respective urines and made into a topical application. The text claims that it removes shvitra, dadru, wounds, diseased arshas, and nadi-vrana.
After the vitiated blood has been let out and the person's strength has returned, the person is to be oleated with ghee. Strong formulations are then used for forceful emesis, after which the remaining dosha is to be expelled with great vigilance.
The commentary says that even a person with kushtha who has already undergone emesis and purgation at the outset should repeatedly undergo shodhana and bloodletting. This verse introduces that repeated requirement.
Key terms
duShTaraktaniHsaraNa (dushta-rakta-nihsarana)
Removal or letting of blood considered vitiated in the classical framework.
chardana
Therapeutically induced emesis.
shodhana
Classical evacuative treatment, including emesis or purgation here.
दुर्वान्तो वा दुर्विरिक्तोऽपि वा स्यात् कुष्ठी दोषैरुद्धतैर्व्याप्तदेहः |
निःसन्दिग्धं यात्यसाध्यत्वमाशु तस्मात् कृत्स्नान्निर्हरेत्तस्य दोषान् ||४२||
Meaning of the śloka
The passage states that if a person with kushtha, whose body is pervaded by aggravated doshas, has been inadequately treated by emesis or purgation, the condition rapidly becomes incurable. It therefore directs complete removal of the doshas.
Asked why the blood and doshas should be removed without remainder, the commentary explains this verse as the reason. It adds that the word api also includes the case in which vitiated blood has not been removed.
Key terms
durvAnta (durvanta)
Inadequately or unsuccessfully treated by emesis.
durvirikta
Inadequately or unsuccessfully treated by purgation.
asAdhyatva (asadhyatva)
The state of being considered incurable in the classical prognosis.
The passage gives a recurring schedule: emesis every fortnight, a purgative measure every month, a small bloodletting twice yearly, and nasya every third night.
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Show commentary
kēna kramēṇa śōdhanaṁ śōṇitāvasēcanaṁ ca kartavyamityāha- pakṣādityādi| vatsarē hi dviralpamiti varṣē dvau vārau ṣaḍbhiḥ ṣaḍbhirmāsairityarthaḥ||43||
Meaning of the commentary
In response to the question of the sequence for shodhana and bloodletting, the commentary explains that 'a small amount twice in a year' means bloodletting on two occasions, at intervals of six months.
Several internal preparations are described for kuṣṭha: combinations centered on pathyā and vyoṣa, dhātrī and related drugs, or single substances such as haridrā, citraka, pippalī, and tārkṣya taken according to the stated regimen. Rasāñjana is also prescribed for repeated external application. A large compound powder and several medicated ghee preparations are then said to remove kuṣṭha.
The commentator presents these as practical formulations. Although oil and jaggery can themselves contribute to kuṣṭha, their combination with harītakī and trikaṭu is explained as beneficial through the inconceivable power of combination; an alternative reading is preserved. Akṣa is identified as bibhītaka, and the quantities and month-long repetitions are clarified. Haridrā, citraka, pippalī, and tārkṣya or rasāñjana are described as both kuṣṭha-removing and rasāyana. Several variant readings and interpretations are acknowledged but omitted for brevity. The ghee formulas are to be understood by the general preparation rule; one is specified for a person with burning and pitta-predominant kuṣṭha. A formulation found in another tantra is rejected as non-Suśruta because Jejjaṭa did not cite it.
Key terms
kuShTha (kuṣṭha)
The classical disease category treated by the listed preparations.
saMyogashakti (saṃyoga-śakti)
The distinctive effect attributed to a combination of substances.
rasAyana (rasāyana)
A restorative quality attributed here to three of the preparations.
pittakuShThin (pitta-kuṣṭhin)
A person whose kuṣṭha is characterized by pitta and burning.
For a person with burning, rodhra, ariṣṭa, padmaka, raktasāra, saptāhva, akṣa, vṛkṣaka, and bījaka are prescribed for bathing. Alternatively, tribhaṇḍī mixed with honey is to be taken as a drink.
The bathing preparation is given to relieve burning in a weak person with abundant pitta. Saptāhva is identified as saptaparṇa, and the water is to be prepared by the ṣaḍaṅgodaka method rather than as a decoction or a decoction bath. Honey-mixed tribhaṇḍī, identified as trivṛt, is instead explained for a strong person with abundant pitta; its quantity depends on the strength of the bowel.
Key terms
dahyamAna (dahyamāna)
A person experiencing burning in the context described.
ShaDa~ggodaka (ṣaḍaṅgodaka)
The particular medicated-water preparation method specified by the commentary.
tribhaNDI (tribhaṇḍī)
Identified by the commentary as trivṛt.
koShThabala (koṣṭha-bala)
The functional strength of the bowel used to judge quantity.
The commentator says this drink or dietary preparation is prescribed when flesh is being lost in pitta-associated kuṣṭha, even when organisms are present. Neem water is prepared by the ṣaḍaṅga method and used to cook the mudga.
Key terms
mAMsashAta (māṃsa-śāta)
Loss or destruction of bodily flesh in the passage's clinical description.
mudga
Green gram, specified here as old and cooked in medicated water.
nimbatoya (nimba-toya)
Neem medicated water used for cooking.
kRumi (kṛmi)
Organisms or infestation mentioned by the commentary in the affected tissue.
When organisms have arisen, the person is told to drink a decoction of neem or of arka, alarka, and saptacchada. On body parts eaten by organisms, a paste of aśvamāra root and viḍaṅga mixed with urine is applied; the area is sprinkled with urine, and foods are combined with viḍaṅga. Oils of karañja, mustard, śigru, or kośāmra are placed on wounds, or these oils are cooked with pungent and bitter substances. The remaining management follows that prescribed for a duṣṭa-vraṇa.
Jātasattva is glossed as the presence of kṛmi. The commentator specifies cow urine for grinding and sprinkling. Karañja, mustard, śobhāñjana, and kośāmra seed oils are said to belong naturally to the management of duṣṭa-vraṇa and may be used uncooked; alternatively they are cooked with pungent substances such as marica and bitter substances such as neem, using the general decoction rule. Another reading exists but is not reproduced. The final direction is interpreted as applying the management of duṣṭa-vraṇa because the treatment is similar. Variant readings say 'as before' or 'as for kuṣṭha'; Gayī rejects the latter.
Key terms
jAtasattva (jāta-sattva)
Glossed here as a condition in which kṛmi have arisen.
kRumi (kṛmi)
Organisms described as affecting the bodily parts.
duShTavraNa (duṣṭa-vraṇa)
A corrupted or difficult wound whose management is applied here.
viDa~gga (viḍaṅga)
A substance repeatedly included in the external and dietary regimen.
A long list of plant and mineral substances is ground with urine and cooked with oil to make vajraka oil, said to remove kuṣṭha, nāḍī-vraṇa, and duṣṭa-vraṇa when applied externally. A still larger combination, prepared with cow urine and sesame, karañja, or mustard oil, is called mahāvajraka oil and is claimed to remove all kuṣṭha, gaṇḍamālā, bhagandara, nāḍī-vraṇa, and severe duṣṭa-vraṇa.
The commentary identifies several ingredients, including mālatī as jātī, snuhī as sehuṇḍa, āsphoṭā as sārivā, and lāṅgala as kalihārikā. It explains the general ratio as herb paste equal to one fourth of the fat and liquid equal to four times the fat, with cow urine serving as the liquid for vajraka oil. The base oil is read as sesame oil, while Gayī argues for mustard oil from the preceding duṣṭa-vraṇa context. Some sources place mahāvajraka next, but the nibandha authors did not read it there.
Key terms
vajrakataila (vajraka-taila)
The medicated oil described in the first formulation.
mahAvajraka (mahāvajraka)
The name given to the larger medicated-oil formulation.
nADIduShTavraNa (nāḍī-duṣṭa-vraṇa)
A channel-like and corrupted wound category named among the indications.
bhagandara
A classical disease category included in the claimed scope of the oil.
Oil is prepared with substances beginning with lākṣā, ground in urine and supplemented with bile. The physician keeps it in a bitter gourd for seven days. After a person has drunk the prescribed quantity and has also been anointed with it, the person is made to lie in the sun; the doṣas are then said to leave in every direction.
After describing an oil for external cleansing in kuṣṭha and duṣṭa-vraṇa, the text now introduces an oil for internal cleansing. The commentary identifies the added bile as cow bile, the urine as cow urine, the oil as sesame oil, and offers two closely related readings of the lākṣā-based drug group. Kṛta means duly processed. 'The doṣas go in every direction' is explained as upward, downward, and across the body; Gayī instead understands sarvaśas as complete removal in the sense of their becoming ineffective.
Key terms
antaHshodhana (antaḥ-śodhana)
Internal cleansing, the stated purpose of drinking the oil.
pittAvApa (pittāvāpa)
An addition of bile, identified here as cow bile.
kaTukAlAbu (kaṭukālābu)
A bitter gourd used as the vessel in which the oil is kept.
doSha (doṣa)
The bodily factors said to be expelled or rendered ineffective.
The khadira water is prepared by the ṣaḍaṅgodaka method. The commentator addresses the objection that cold-water bathing after heating in the sun is said to cause kuṣṭha and eye disease: the prohibition concerns immersion in water, not pouring water over the body. A variant reading explicitly says the person is bathed with cold khadira water.
Key terms
srutadoSha (sruta-doṣa)
A person from whom the doṣas have flowed or been discharged.
khadiravAri (khadira-vāri)
Water medicated with khadira.
yavAgU (yavāgū)
A thin gruel prepared here with khadira water.
toyapariSheka (toya-pariṣeka)
Pouring water over the body, distinguished from immersion.
Adhikarana 35 (67) · Śloka 68
ēvaṁ saṁśōdhanē vargē kuṣṭhaghnēṣvauṣadhēṣu ca ||67||
kuryāttailāni sarpīṁṣi pradēhōddharṣaṇāni ca |68|
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एवं संशोधने वर्गे कुष्ठघ्नेष्वौषधेषु च ||६७||
कुर्यात्तैलानि सर्पींषि प्रदेहोद्धर्षणानि च |६८|
Meaning of the śloka
In this way, oils, ghees, external pastes, and rubbing preparations should be made from substances belonging to the cleansing group and from medicines regarded as kuṣṭha-removing.
The cleansing group refers to trivṛt and other substances taught in the chapter on śodhana and śamana drugs. The kuṣṭha-removing medicines include khadira and related substances.
Key terms
saMshodhana (saṃśodhana)
The cleansing drug group referenced from an earlier chapter.
kuShThaghna (kuṣṭhaghna)
Substances classically described as countering kuṣṭha.
Alternatively, the person drinks camel urine and, after it has digested, takes camel milk as food. The regimen is said to remove kuṣṭha in which organisms have arisen within six months.
Kārabha is explained as a female camel. Jejjaṭa states that this regimen is not part of Suśruta. The present commentator nevertheless explains it because Gayadāsa commented on it.
Key terms
kArabha (kārabha)
Identified in the commentary as a female camel.
jAtasattva kuShTha (jāta-sattva kuṣṭha)
Kuṣṭha described as having developed organisms or infestation.
jIrNa (jīrṇa)
The point at which the previously consumed substance is considered digested.
na saushruta (na sauśruta)
Jejjaṭa's judgment that the regimen does not belong to Suśruta's text.
A person afflicted with kuṣṭha who wishes to see its end should use khadira in every possible way, including bathing, drinking, and food. Just as advanced kuṣṭha destroys the afflicted person by its force, khadira when used is said to destroy kuṣṭha by its own force.
The passage is presented to show the comprehensive usefulness of khadira in kuṣṭha. Didṛkṣu means one who wishes to see, and anta means destruction or ending. In the phrase describing khadira's force, ojas signifies its special efficacy, potency, or power.
Key terms
khadira
The substance recommended throughout bathing, drinking, and food in this passage.
anta
The ending or destruction of kuṣṭha sought by the afflicted person.
ojas
In this context, the force, efficacy, potency, or power of kuṣṭha or khadira.
sarvathaiva
In every way, emphasizing comprehensive use in the historical regimen.
A person with kuṣṭha who keeps the hair and nails short, avoids exhaustion, eats what is beneficial, remains attentive to medicines, and abstains from sexual activity, meat, and alcoholic drink is said to overcome kuṣṭha.
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Show commentary
idānīṁ pratiṣēdhavidhimāha- nīcarōmētyādi||72||
Meaning of the commentary
The commentator introduces this verse as a statement of prohibitions and disciplined conduct.
Key terms
nIcaromanakha (nīca-roma-nakha)
Keeping the body hair and nails short or trimmed.
hitAshin (hitāśin)
One who eats foods regarded as beneficial in the regimen.
auShadhatatpara (auṣadha-tatpara)
One who remains attentive or devoted to the prescribed medicines.
pratiShedhavidhi (pratiṣedha-vidhi)
The set of restrictions or prohibitions identified by the commentary.