Now the treatment of major vata disorders will be explained, as taught by the revered Dhanvantari. Some authorities divide vata-shonita into a superficial and a deep form, but the text rejects this as inaccurate: like kushtha, it first remains superficial and later becomes deep, so it is not two separate diseases.
The commentary explicitly rejects the twofold classification given in another treatise. Uttana is located in skin and flesh, while avagadha is situated internally.
Key terms
vAtashoNita (vata-shonita)
A classical disorder involving vata and blood.
uttAna (uttana)
Superficial, situated in skin and flesh.
avagADha (avagadha)
Deep or internally situated.
kuShTha (kushtha)
A broad classical category of skin disease used here as an analogy.
The text says that vata aggravated by strenuous struggle and related causes joins with disturbed blood produced by habitual heavy, hot, and excessive eating. The blood obstructs vata's pathway, and together they cause the pain called vata-rakta. It first settles in the hands and feet and later spreads through the body. Premonitory signs include pricking, burning, itching, swelling, stiffness, rough skin, pulsation in vessels and fibrous structures, weakness of the thighs, and sudden dusky-red patches on the palms, soles, fingers, ankles, wrists, and related sites. Without appropriate care, or with unsuitable conduct, the disease becomes manifest and may produce disability.
The causal factors are cross-referenced to the earlier wound discussion. Yugapat means simultaneously, and manibandha is the wrist or root of the hand. Although the causal account also appears in Nidanasthana, it is repeated to show the disorder's difficulty of treatment. In the premonitory stage, unsuitable conduct makes the disorder clearer; once manifest, disability is said to indicate incurability.
Key terms
mArgAvaraNa (marga-avarana)
Obstruction of vata's pathway.
vAtarakta (vata-rakta)
The named classical disorder produced by association of vata and disturbed blood.
The verse says vata-rakta most often becomes aggravated in delicate, well-nourished people who follow unsuitable diet and conduct, particularly those described as stout and accustomed to comfort.
The commentary reasons that people who are not delicate or stout, or who live with hardship, usually exercise; exercise is said to reduce or remove the harmful effect of unsuitable diet and conduct and therefore make the disorder less likely.
The text recommends undertaking treatment only when the person is strong, self-controlled, and has adequate resources, and is not complicated by depletion of vitality or flesh, thirst, fever, fainting, breathlessness, cough, stiffness, loss of appetite, indigestion, spreading of the disorder, or contracture.
Strength includes both bodily build and functional capacity. The compound describing loss of prana and flesh excludes both forms of strength, so the eligible person is expected to possess both.
When vata predominates, the text first advises repeated small bloodletting for blood believed to obstruct the pathway, except in a very dry and wasted person with marked vata. It then gives an extensive regimen: emesis, purgation, cleansing and oil enemas, graded diet, old ghee, goat milk mixed with oil and various herbs, several medicated oils, milk or sour-liquid pouring, herbal pastes, rich poultices prepared from grains, fats, milk, fish or meat, and other compound applications.
The initial focus is treatment of blood as the affected tissue, followed by treatment of dosha. Blood is let repeatedly in small amounts to avoid aggravating vata. Vamana and related measures include purgation, asthapana, and anuvasana. The sequence differs by site: hand disease is linked with upward dosha and kapha-pitta, while foot disease is linked with downward dosha and vata. The commentary supplies a nine-day sequence before old ghee. Goat milk with half as much oil applies across four alternative herb preparations. It gives detailed identities, decoction reductions, and uses of medicated oils internally and externally. Five grain-based payasa poultices are neither too liquid nor too thick. Several manuscript variants concern fish or marsh-animal meat in another poultice, and sesame paste may mean sesame ground with citron juice and other ingredients or sesame alone.
Key terms
mArgAvaraNa (marga-avarana)
Obstruction of a pathway, here by disturbed blood.
पित्तप्रबले द्राक्षारेवतकट्फलपयस्यामधुकचन्दनकाश्मर्यकषायं शर्करामधुमधुरं पाययेत्, शतावरीमधुकपटोलत्रिफलाकटुरोहिणीकषायं , गुडूचीकषायं वा, पित्तज्वरहरं वा चन्दनादिकषायं शर्करामधुमधुरं, मधुरतिक्तकषायसिद्धं वा सर्पिः; बिसमृणालभद्रश्रियपद्मककषायेणार्धक्षीरेण परिषेकः, क्षीरेक्षुरसैर्मधुकशर्करातण्डुलोदकैर्वा द्राक्षेक्षुकषायमिश्रैर्वा मस्तुमद्यधान्याम्लैः; जीवनीयसिद्धेन वा सर्पिषाऽभ्यङ्गः, शतधौतघृतेन वा, काकोल्यादिकल्ककषायविपक्वेन वा सर्पिषा; शालिषष्टिकनलवञ्जुलतालीसशृङ्गाटकगलोड्यगौरीगैरिकशैवलपद्मकपद्मपत्रप्रभृतिभिर्धान्याम्लपिष्टैः प्रदेहो घृतमिश्रः, वातप्रबलेऽप्येष सुखोष्णः प्रदेहः कार्यः ||८||
Meaning of the śloka
When pitta predominates, the text lists sweetened decoctions of grapes and other plants, Shatavari-based or Guduchi decoctions, a Chandana group preparation used for pitta fever, and ghee prepared with sweet, bitter, and astringent substances. It also prescribes cool pouring with lotus rhizome and related decoctions, milk, sugarcane juice, licorice, rice water, whey, alcohol, or fermented grain liquid; massage with medicated or repeatedly washed ghee; and a cool, thick herbal paste mixed with ghee. If vata predominates as well, that paste is mildly warm.
Arevata is kiramalaka; payasya is identified as arkapushpi, though others call it kshiravidari. Sweet, bitter, and astringent groups are cooked into ghee. Bisa and mrinala are lotus parts, bhadrashri is white sandalwood, and parisheka is pouring from all sides. The commentary distinguishes three sets of pouring liquids and alternative massage ghees. In the paste, vanjula is vetasa, galodya is lotus seed, gauri is haridra, and dhanyamla is kanjika. It should be cool and thick, or mildly warm when vata is strong.
Key terms
pittaprabala (pitta-prabala)
A presentation considered dominated by pitta.
pariSheka (parisheka)
Pouring liquid over the body or affected area.
shatadhautaghRuta (shata-dhauta-ghrita)
Ghee said to have been washed one hundred times.
payasyA (payasya)
A plant identified differently as arkapushpi or kshiravidari.
श्लेष्मप्रबले त्वामलकहरिद्राकषायं मधुमधुरं पाययेत्, त्रिफलाकषायं वा ; मधुकशृङ्गवेरहरीतकीतिक्तरोहिणीकल्कं वा सक्षौद्रं, मूत्रतोययोरन्यतरेण गुडहरीतकीं वा भक्षयेत्; तैलमूत्रक्षारोदकसुराशुक्तकफघ्नौषधनिःक्वाथैश्च परिषेकः, आरग्वधादिकषायैर्वोष्णैः; मस्तुमूत्रसुराशुक्तमधुकसारिवापद्मकसिद्धं वा घृतमभ्यङ्गः; तिलसर्षपातसीयवचूर्णानि श्लेष्मातककपित्थमधुशिग्रुमिश्राणि क्षारमूत्रपिष्टानि प्रदेहः; श्वेतसर्षपकल्कः, तिलाश्वगन्धाकल्कः, प्रियालसेलुकपित्थकल्कः, मधुशिग्रुपुनर्नवाकल्कः, व्योषतिक्तापृथक्पर्णीबृहतीकल्क इत्येतेषां पञ्च प्रदेहाः सुखोष्णाः क्षारोदकपिष्टाः, शालिपर्णी पृश्निपर्णी बृहत्यौ वा क्षीरपिष्टास्तर्पणमिश्राः ||१०||
Meaning of the śloka
When kapha predominates, the text gives several oral decoctions, herbal pastes with honey, and jaggery-haritaki with water or urine. It prescribes warm pouring with oil, urine, alkaline water, alcohol, sour fermented liquids, or kapha-reducing decoctions; massage with compound ghee; and multiple mildly warm pastes made from seeds and herbs, ground with alkali-water, urine, milk, or barley flour.
Some understand tikta-rohini as powder rather than paste, still combined with honey. The jaggery-haritaki may be taken with either urine or water. The ghee for massage is cooked with equal quantities of whey, urine, alcohol, and sour liquid and quarter-quantities of the three herbs. Shleshmataka is shelu. The commentary counts the ingredients in five successive pastes and adds a further paste of shaliparni, prishniparni, and the two brihatis ground with milk and mixed with barley flour.
Key terms
shleShmaprabala (shleshma-prabala)
A presentation considered dominated by kapha.
kShArodaka (ksharodaka)
Alkaline water.
mastu
Whey or the watery part of curd.
tarpaNa (tarpana)
Barley flour in this preparation, according to the commentary.
Samsarga means a disorder arising from pairs of associated doshas, for which two treatment sets are combined. Sannipata means involvement of all three, for which all three sets are combined.
सर्वेषु च गुडहरीतकीमासेवेत; पिप्पलीर्वा क्षीरपिष्टा वारिपिष्टा वा पञ्चाभिवृद्ध्या दशाभिवृद्ध्या वा पिबेत् क्षीरौदनाहारो दशरात्रं, भूयश्चापकर्षयेत्, एवं यावत् पञ्च दश वेति; तदेतत् पिप्पलीवर्धमानकं वातशोणितविषमज्वरारोचकपाण्डुरोगप्लीहोदरार्शःकासश्वासशोफशोषाग्निसादहृद्रोगोदराण्यपहन्ति; जीवनीयप्रतीवापं सर्पिः पयसा पाचयित्वाऽभ्यज्यात्; सहासहदेवाचन्दनमूर्वामुस्ताप्रियालशतावरीकशेरुपद्मकमधुकशतपुष्पाविदारीकुष्ठानि क्षीरपिष्टः प्रदेहो घृतमण्डयुक्तः, सैरेयकाटरूषकबलातिबलाजीवन्तीसुषवीकल्को वा च्छागक्षीरपिष्टः, गोक्षीरपिष्टः काश्मर्यमधुकतर्पणकल्को वा; मधूच्छिष्टमञ्जिष्ठासर्जरससारिवाक्षीरसिद्धं पिण्डतैलमभ्यङ्गः; सर्वेषु च पुराणघृतमामलकरसविपक्वं वा पानार्थे; जीवनीयसिद्धं परिषेकार्थे, काकोल्यादिक्वाथकल्कसिद्धं वा; सुषवीक्वाथकल्कसिद्धं वा, कारवेल्लकक्वाथमात्रसिद्धं वा; बलातैलं वा परिषेकावगाहबस्तिभोजनेषु; शालिषष्टिकयवगोधूमान्नमनवं भुञ्जीत पयसा जाङ्गलरसेन वा मुद्गयूषेण वाऽनम्लेन; शोणितमोक्षं चाभीक्ष्णं कुर्वीत; उच्छ्रितदोषे च वमनविरेचनास्थापनानुवासनकर्म कर्तव्यम् ||१२||
(पटोलत्रिफलाभीरुगुडूचीकटुकाकृतम् |
क्वाथं पीत्वा जयत्याशु वातशोणितजां रुजम् ) ||१३||
Meaning of the śloka
For all forms, the text gives a broad regimen including jaggery-haritaki, an escalating then decreasing course of pippali with milk and rice, several herbal-ghee and milk pastes, pinda oil massage, old or amalaki-prepared ghee, medicated pouring, Bala oil for pouring, immersion, enema, and food, a diet of old grains with milk, jangala meat soup, or unsoured mudga soup, repeated bloodletting, and, when doshas are elevated, emesis, purgation, cleansing enema, and oil enema. It attributes relief of many disorders to the escalating pippali course and adds a decoction of patola, triphala, abhira, guduchi, and katuka for pain from vata-shonita.
This is general disease-directed treatment after bodily cleansing. Some manuscripts increase pippali by three or seven rather than five or ten, but that reading is uncommon. The commentary identifies numerous plants and explains pinda oil as unfiltered oil containing sediment; some add Shatavari. Old or amalaki ghee is applied across the five single and combined forms by the formulation's claimed special effect. Foods are selected by dominant dosha or habituation. Repeated bloodletting is reserved, within the text's logic, for confirmed obstruction by blood after vata has been calmed and after assessing patient, disease, strength, and season. Emesis is assigned to strong kapha, purgation to strong pitta-blood, and the two enemas to strong vata.
Key terms
pippalIvardhamAnaka (pippali-vardhamanaka)
A course in which the quantity of pippali is increased and then reduced.
The text says recently developed vata-asrik is treated readily by measures of the kinds just described, whereas a longstanding case can only be managed or controlled.
उपनाहपरीषेकप्रदेहाभ्यञ्जनानि च |
शरणान्यप्रवातानि मनोज्ञानि महान्ति च ||१५||
मृदुगण्डोपधानानि शयनानि सुखानि च |
वातरक्ते प्रशस्यन्ते मृदुसंवाहनानि च ||१६||
Meaning of the śloka
For vatarakta, the text recommends poultices, irrigation, pastes, massage, large pleasant dwellings protected from wind, comfortable soft beds and pillows, and gentle rubbing.
This gathers both previously stated and additional measures. Sharana means a house; apravata means sheltered from wind; manojna means pleasing; and mahat means spacious. Gandopadhana includes cushions for the cheek or neck and, by extension, supports for the head and other parts. Samvahana means gentle rubbing with the hands.
Key terms
vAtarakta (vatarakta)
A classical disorder involving vata and rakta.
upanAha (upanaha)
A medicinal poultice or enclosing application.
pradeha
A topical paste.
gaNDopadhAna (gandopadhana)
A soft cushion or support for cheek, neck, head, or another part.
व्यायामं मैथुनं कोपमुष्णाम्ललवणाशनम् |
दिवास्वप्नमभिष्यन्दि गुरु चान्नं विवर्जयेत् ||१७||
Meaning of the śloka
The text advises avoiding exercise, sexual activity, anger, foods considered heating, sour or salty foods, daytime sleep, and heavy or abhishyandi foods.
Exercise and sexual activity are bodily actions, while anger is mental. Ushna means heating in potency and therefore includes any such food, including certain marsh meats and pungent substances, whereas sour and salty are listed separately for emphasis. Abhishyandi food is defined as producing excessive moisture or obstruction in doshas, tissues, wastes, and channels.
Key terms
uShNa (ushna)
Heating in classical potency, not merely warm in temperature.
abhiShyandi (abhishyandi)
Considered to promote moisture, heaviness, or obstruction in bodily channels.
For a selected person with apatanaka who lacks several grave signs—drooping eyes, distorted brows, rigid genitalia, absence of sweating, tremor, delirium, collapse onto a cot, and backward arching—the text gives an extensive regimen. It begins with oiling and sudation, then strong nasal cleansing, medicated ghee, a complex preparation of herbs, grains, sour liquids, milk, fats, meat and sweet drugs for irrigation, immersion, massage, drinking, food, enemas, and nasal use. It also describes intense heating methods, poultice sudation, additional herbal oil, sour curd with pepper and vacha, fats and honey, repeated nasal dosing between attacks, animal fats, medicated milk and gruel, purgation and enemas after ten days without an attack, related vata treatment, and protective rites.
The commentary explains the selection signs and defines avapida as expressed juice of ground nasal-cleansing drugs, used here to awaken awareness because vata occupies a kapha site. It details several competing proportions for the multi-fat preparation and variant readings for its animal-meat groups. Traivrita means ghee combined with oil, animal fat, and marrow. Heating includes a pit filled with warm husk, chaff, and dung or lying on a heated artisan's hearth or stone sprinkled with sura and covered with leaves. Ingredient identifications and preparation methods are supplied for the additional oil. When pitta or kapha is associated, their opposing measures are combined; Jejjata instead applies the vatarakta method. Animal fats named include rooster, crab-like fish, dolphin or crocodilian aquatic animal, and boar.
Key terms
apatAnaka (apatanaka)
A severe classical vata disorder characterized by episodic spasmodic features.
avapIDa (avapida)
A forcefully expressed nasal preparation from ground drugs.
traivRuta (traivrita)
A compound of ghee with oil, animal fat, and marrow.
The text treats a person with pakshaghata only when the affected body remains unwasted, painful, the patient is self-controlled, and treatment resources are available. After oleation and sudation, mild cleansing, oil and decoction enemas, and the apatanaka regimen are applied in sequence. Special measures include a head oil dressing or shirobasti, anu oil for massage, salvana poultice, and bala oil for enema, continued diligently for three or four months.
Amlanagatra means that the affected half is not wasted. A completely insensible and motionless half is called incurable; slight movement and sensation make it difficult to cure. The sequence is time-specific: purgation after a fortnight following emesis, oil enema seven nights after purgation, decoction enema when oleation signs appear, then another oil enema immediately. The apatanaka method is used because the two disorders share a therapeutic field. Mastishkya is a special head application using oil-soaked pads or cloth. Atandrita means diligent.
Key terms
pakShAghAta (pakshaghata)
A classical disorder affecting one side of the body.
The commentary notes that this passage on treatment of manyastambha is read by some authorities, indicating that its textual inclusion is not universal.
Key terms
manyAstambha (manyastambha)
A classical condition of neck rigidity or stiffness.
For apatantraka, another passage says not to deplete the patient and not to use emesis, oil enema, or decoction enema. When breathing is obstructed by vata and kapha, strong insufflated powders are used to release it. A drink of tumburu, pushkarahva, hingu, amlavetasa, pathya, and three salts with barley decoction is prescribed, as is ghee cooked with fifty pathya fruits, sauvarchala, and milk. Other measures that counter vata and kapha are also used.
The commentary notes that some authorities include this treatment. It specifies one aksha of the tumburu compound with two palas of barley decoction. The ghee preparation uses fifty pathya fruits, two palas of sauvarchala, fourfold milk, and one prastha of ghee. The final instruction broadens treatment to anything considered to dispel both vata and kapha.
Key terms
apatantraka
A severe classical disorder associated here with obstructed breathing.
pradhmApana (pradhmapana)
Forceful insufflation of medicinal powder into the nose.
For a strong, self-controlled person with ardita and adequate resources, the general vata regimen is prescribed, with special head oiling, shirobasti, nasal medicine, smoke, poultices, oleation, and tube-sudation. A complex milk-oil is prepared by decocting grasses, mahapancamula, kakolyadi, vidarigandhadi, aquatic and marsh-animal meats, and aquatic tubers in milk and water; the reduced milk is combined with oil, churned after cooling, and the separated fat is cooked again with sweet drugs, saha, and milk. It is used for drinking, massage, and related purposes. A version without oil is described as a milk-ghee preparation for ocular retention.
The commentary identifies the grass group, mahapancamula ingredients, aquatic creatures, marsh animals, and water tubers, while noting an alternate reading that groups marsh meats and aquatic tubers differently. It gives large traditional quantities and defines kshiranugata as oil integrated with milk. Sweet drugs are kakolyadi and saha is mashaparni, with fourfold milk. Some replace these with a quarter-portion paste of the earlier decoction ingredients.
Key terms
ardita
A classical disorder affecting facial or bodily movement.
गृध्रसीविश्वाचीक्रोष्टुकशिरःखञ्जपङ्गुलवातकण्टकपाददाहपादहर्षावबाहुकबाधिर्यधमनीगतवातरोगेषु यथोक्तं यथोद्देशं च सिराव्यधं कुर्यात्, अन्यत्रावबाहुकात्; वातव्याधिचिकित्सितं चावेक्षेत ||२३||
Meaning of the śloka
For gridhrasi, vishvaci, kroshtukashirsha, khanja, pangula, vatakantaka, burning or tingling of the feet, avabahuka, deafness, and vata disorders of the dhamanis, the text directs venesection at the previously specified sites, together with the general vata treatment, while giving an exception involving avabahuka.
The conjunction also invokes vatarakta treatment for kroshtukashirsha. One interpretation excludes venesection in avabahuka because it arises from tissue depletion. Gayi instead connects the exception to the general vata regimen: unctuous vata treatment would conflict with kapha-obstructed vata at a kapha site, where dry sudation is used, while venesection remains allowed because it is described elsewhere. In the other listed disorders, general treatment precedes venesection after obstruction by blood is established.
Key terms
sirAvyadha (siravyadha)
Venesection or puncture of a vein for bloodletting.
gRudhrasI (gridhrasi)
A classical pain and movement disorder of the lower limb.
vishvAcI (vishvachi)
A classical upper-limb disorder.
avabAhuka (avabahuka)
A classical shoulder-arm disorder whose exception is interpreted differently.
For ear pain, the text recommends placing mildly warm ginger juice mixed with oil, honey, and rock salt in the ear; alternatives include goat urine with honey and oil, or oils cooked with citrus, pomegranate, tintidika, urine, sour fermented liquids, alcohol, buttermilk, and salt. Tube-directed heating and the general vata regimen are also prescribed, with further treatment deferred to the ear-disease section.
Shrngavera juice means fresh ginger juice, and shukta is a sour fermented liquid. Nadi-sveda is heat or steam delivered through a hollow tube. The conjunction adds vatarakta treatment when vata is obstructed by pitta and rakta. The subject is discussed again in the Uttara-tantra.
तूनीप्रतून्योः स्नेहलवणमुष्णोदकेन पाययेत्, पिप्पल्यादिचूर्णं वा, हिङ्गुयवक्षारप्रगाढं वा सर्पिः, बस्तिभिश्चैनमुपक्रमेत् ||२५||
Meaning of the śloka
For tuni and pratuni, the text recommends taking an oily salty preparation with hot water, or pippalyadi powder, or ghee strongly compounded with hingu and barley alkali, together with basti treatment.
For abdominal distension, the text prescribes depletion, warming by the hands, digestive-stimulant powder according to a partly uncertain reading, rectal suppositories, digesting and kindling medicines, and enemas. After fasting, foods prepared with coriander, cumin, and similar stimulants are given at mealtime. For pratyadhmana, emesis, depletion, and kindling measures are prescribed.
The commentary identifies digestive medicines such as the pancakola group and then separately introduces treatment of pratyadhmana. It does not explain the corrupt or parenthetical wording around panitapa/dipana-curna.
Key terms
AdhmAna (adhmana)
Abdominal distension or bloating in the classical description.
pratyAdhmAna (pratyadhmana)
A distinct or reverse-pattern form of distension.
phalavarti
A medicated rectal suppository.
dIpana (dipana)
Measures intended to kindle digestive capacity.
pAcana (pachana)
Measures intended to digest incompletely processed material.
The text directs that a long list of pungent, aromatic, saline, alkaline, sour, and herbal ingredients be powdered, repeatedly processed with citron juice, and formed into pills of aksha size. A person with a vata disorder is to take one each morning. The formula is claimed to relieve cough, breathlessness, gulma, abdominal disorders, loss of appetite, heart disease, distension, pain of the flank, abdomen, or bladder, constipation or obstruction, difficult urination, splenic disorder, hemorrhoids, and tuni and pratuni.
The commentary identifies ajagandha as bovayika, while Gayi calls it field ajwain, and identifies matulunga-amla as citron juice. It understands the preparation as usable both as powder and pill based on another text. For vata-type gulma, alkali, hingu, amlavetasa, and related ingredients are said to be doubled, supported by a cited verse.
Key terms
hi~ggvAdiguTikA (hingvadi-gutika)
A pill formulation beginning with hingu.
akShamAtrA (aksha-matra)
A pill size based on the classical aksha measure.
ajagandhA (ajagandha)
A plant disputed between bovayika and field ajwain.
gulma
A classical abdominal mass or distension category.
Vata may occur alone, be joined with doshas, or be obstructed by bodily constituents. Its condition should be recognized from signs and reasoned inference, and treatment should be chosen so that measures for one factor do not oppose the others.
The commentary says 'alone' means not combined with doshas or other factors, but the verse's treatment rule concerns combined and obstructed forms because isolated vata was already discussed and poses no conflict of treatment. Association with pitta or kapha is simple combination, not necessarily obstruction. The obstructing dhatus are interpreted broadly to include bodily tissues, sweat, feces, urine, and even the doshas because they sustain the body. Recognition uses stated signs—such as pricking pain, dark-reddish color, and tremor for vata; heat, yellow color, and burning for pitta; itching, pallor, and excessive moisture for kapha—and inference where details are unstated. Citing Caraka and Gayi, it describes twenty mutual obstructions among the five subdivisions of vata and says obstruction involving prana and udana, and vata obstructed by fat, are especially grave. Obstruction may mean one current blocking another's direction or a stronger current forcing a weaker one backward.
Key terms
AvRta vAta (avrita-vata)
Vata understood as obstructed by another functional factor or bodily constituent.
saMsRuShTa (samsrishta)
Combined or associated with another dosha without necessarily being obstructed.
Uha (uha)
Reasoned inference used where a feature is not explicitly stated.
prANa (prana)
One of five functional subdivisions of vata, regarded as especially important.
udAna (udana)
An upward-moving subdivision of vata, whose obstruction is considered grave.
The commentary identifies the verse as giving the signs and treatment of vata obstructed by fat and specifies that the swelling is unripe or not suppurated.
कफमेदोवृतो वायुर्यदोरू प्रतिपद्यते |
तदाऽङ्गमर्दस्तैमित्य रोमहर्षरुजाज्वरैः ||३१||
निद्रया चार्दितौ स्तब्धौ शीतलावप्रचेतनौ |
गुरुकावस्थिरावूरू न स्वाविव च मन्यते ||३२||
तमूरुस्तम्भमित्याहुराढ्यवातमथापरे |३३|
Meaning of the śloka
When vata obstructed by kapha and fat settles in the thighs, the thighs are described as aching, numb, cold, stiff, heavy, unstable, and lacking normal awareness, with body ache, horripilation, pain, fever, and sleepiness. The person feels that the thighs are almost not their own. This condition is called Urustambha, and some call it Adhyavata.
The commentary presents this as kapha-and-fat obstruction of vata in a particular location. It explains asthira here as not hard and 'not one's own' as feeling that the thighs belong to someone else because touch is not perceived normally.
Key terms
Urustambha (uru-stambha)
A classical syndrome of stiff, heavy, numb, painful thighs.
ADhyavAta (adhya-vata)
An alternative name used by some for Urustambha.
staimitya
Numbness, inactivity, or loss of normal sensation.
For this condition the text avoids fats and prescribes Shaddharana powder with warm water or a powder made from the Pippalyadi group. It also allows triphala powder with honey and katuka, or guggulu or shilajatu taken with animal urine. These are claimed to overcome vata affected by kapha and fat and also heart disease, loss of appetite, gulma, and internal abscess.
The commentary explains that Shaddharana is given without the four fats because kapha and fat are to be dried strongly; other unctuous foods, including milk and meat, are also avoided. 'Made from Pippalyadi' supplies the omitted word 'powder.' Prabhanjana means vata.
Key terms
ShaDdharaNa (Shaddharana)
A named medicinal powder used without fatty substances.
सक्षारमूत्रस्वेदांश्च रूक्षाण्युत्सादनानि च ||३६||
कुर्याद्दिह्याच्च मूत्राढ्यैः करञ्जफलसर्षपैः |३७|
Meaning of the śloka
The text further prescribes alkaline animal-urine fomentation and dry rubbing treatments, together with a warm paste of karanja fruit and white mustard ground in cow urine.
The commentary shifts from internal to external treatment. Utsadana means dry rubbing or massage, here using barley alkali and cow urine. The external paste is made from karanja fruit and white mustard ground with cow urine and applied warm.
The dietary regimen consists of aged shyamaka, kodrava, uddalaka, and rice, eaten with soup of dried radish or juice of patola, meat of animals from dry regions without ghee, and suitable vegetables without salt.
The commentary identifies uddalaka as wild kodrava and aghrita as without ghee. Mustard oil is neither explicitly prescribed nor prohibited, because its heat and kapha-and-fat-reducing qualities could make it suitable. Saltless vegetables are intended, while alkaline salts such as barley alkali may be used because their dryness is considered to reduce kapha and fat.
The commentary presents this as an exception permitting fat-based treatment at a later stage and explains parikshina as depleted on all sides or thoroughly reduced.
Key terms
parikShINa (parikshina)
Thoroughly depleted or reduced.
kapha
A classical dosha understood here as needing initial reduction.
The passage describes guggulu as fragrant, light, subtle, sharp, hot, pungent in taste and post-digestive effect, flowing, pleasing to the heart, unctuous, and sticky. Fresh guggulu is said to nourish and promote virility, while aged guggulu is said to reduce tissue. Its qualities are claimed to counter kapha and vata, remove waste and pitta, correct a foul intestinal state, and kindle digestion. It is taken in the morning with various decoctions, animal urine, alkaline liquids, or warm water. After digestion, selected soups, broths, or milk are eaten. A month's use is claimed to remove a wide range of abdominal, urinary, skin, wound, swelling, channel, joint, bone, and vata disorders.
The commentary explains subtle as entering minute pathways. It distinguishes possible liquids: triphala, darvi, and patola together form one decoction; kusha forms another; and the plural may also permit a third formula containing all four. Some read 'milks' instead of 'alkaline liquids.' The choice of drinking medium and later food depends on dosha disorder, constitution, or habituation. Jejjata regards the entire descriptive passage beginning with 'fragrant' as non-authoritative, but the commentator explains it because Gayadasa did.
Key terms
guggulu
A resinous medicinal substance praised in this formulation.
sUkShma (sukshma)
Subtle, explained as capable of entering minute pathways.
purANa guggulu (purana-guggulu)
Aged guggulu, claimed to have reducing effects.
AvApa (avapa)
A liquid vehicle into which the guggulu is added.
anArSha (anarsha)
Considered by Jejjata not to belong to the authoritative original text.
The commentary states that the fifth chapter of the Cikitsasthana is complete in Dalhana's Nibandhasangraha commentary on Sushruta; the transmitted text notes a spelling variant in Dalhana's name.