Now the treatment of vata disorders will be explained, as taught by the revered Dhanvantari. For vata located in the amashaya, the text first prescribes induced vomiting according to the proper sequence, followed for seven nights by the Shaddharana formulation with mildly warm water. That formulation contains one dharana each of chitraka, indrayava, patha, katuka, ativisha, and abhaya and is said to calm this vata disorder.
Vomiting is restricted to a strong person with abundant dosha and signs that material is ready to be expelled; it is chosen because the amashaya is regarded as kapha's site. 'According to sequence' includes prior and later oiling, sweating, drinking, assessment of signs and dose, cleansing, graded diet, and related steps. A dharana is said to equal twenty-one medium nishpavas. The commentary struggles to reconcile six dharanas with seven days, offering either a daily karsha calculation or the possibility that Shaddharana is simply the formulation's name. Some read kshapa instead of abhaya. 'Vata disorder' is limited by one interpretation to vata in the amashaya, not convulsive disorders; another reads 'great disorder' and interprets it as vata associated with medas.
Key terms
AmAshayagata vAta (amashaya-gata-vata)
Vata considered located in the upper digestive receptacle.
ShaDdharaNa (shaddharana)
A six-ingredient formulation, also linked to a traditional measure.
vamana
Therapeutically induced vomiting.
niShpAva (nishpava)
A seed-based traditional unit used in the dose calculation.
For vata located in the pakvashaya, the text prescribes unctuous purgation, cleansing enemas, and ingestible preparations or foods in which salt predominates.
Unctuous purgation includes preparations such as ghee with tilvaka. Cleansing enemas use decoctions with paste and fat. Some understand prasha as linctus preparations such as Snehalavana and Kalyanakalavana, while others understand it as food rather than linctus. Gayi divides pakvashaya into pitta and vata sites: vata in the pitta site receives oily purgation, while vata in its own site, obstructed by feces, kapha, or pitta, receives differently composed enemas—warm alkaline and oily for fecal obstruction, markedly warm and alkaline for kapha, and cool without alkali for pitta.
Key terms
pakvAshaya (pakvashaya)
The lower digestive receptacle in the classical framework.
snehavirecana (sneha-virecana)
Purgation using an unctuous preparation.
shodhanabasti (shodhana-basti)
A cleansing medicated enema.
prAsha (prasha)
Interpreted either as a linctus preparation or as food.
Adhikarana ৩ (৬) · Śloka ৬
কার্যো বস্তিগতে চাপি বিধির্বস্তিবিশোধনঃ |৬|
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कार्यो बस्तिगते चापि विधिर्बस्तिविशोधनः |६|
Meaning of the śloka
For vata located in the basti, the text directs use of methods that cleanse the basti.
The other organs are skin, nose, tongue, and eyes. The sequence beginning with unction, sweating, and massage is selected to oppose the dosha and affected tissue and is adapted to what is suitable for each sense organ. Thus, despite the general word for fat, the eyes receive nourishment with milk-ghee, while the ears and similar organs receive oil.
Key terms
shrotra
The ear or faculty of hearing.
indriya
A sense organ or sensory faculty.
tarpaNa (tarpana)
A nourishing topical procedure, here applied differently by organ.
स्नेहाभ्यङ्गोपनाहाश्च मर्दनालेपनानि च |
त्वङ्मांसासृक्सिराप्राप्ते कुर्यात् चासृग्विमोक्षणम् ||७||
Meaning of the śloka
When vata is considered to have reached the skin, flesh, blood, or vessels, the text prescribes unction, oil massage, poultices, rubbing, pastes, and bloodletting.
The conjunction also supplies pleasing food and drink for vata in the skin. Here 'skin' is interpreted as rasa, and sira as a secondary product of blood. Bloodletting is said to remove vata situated in blood, but only after selected oiling and massage substances fail and obstruction by blood is judged certain. Treatment for vata in medas is omitted here because ordinary vata measures based on fat are considered unsuitable; it is deferred to the later discussion of major vata disorder and obstruction.
Key terms
tvaggata vAta (tvag-gata-vata)
Vata considered located in skin, interpreted here through rasa.
sirA (sira)
A vessel-like structure treated as a secondary product of blood.
स्नेहोपनाहाग्निकर्मबन्धनोन्मर्दनानि च |
स्नायुसन्ध्यस्थिसम्प्राप्ते कुर्याद्वायावतन्द्रितः ||८||
Meaning of the śloka
When vata is considered to have reached ligaments or tendons, joints, or bones, the text directs persistent use of internal and external unction, poultices, cautery, bandaging, and rubbing.
Sneha includes both external and internal use. Atandrita means tirelessly, indicating that the measures are to be continued for a long time without interruption.
Key terms
snAyu (snayu)
A classical fibrous structure, often referring contextually to ligament or tendon.
For vata believed to be trapped in bone, the text describes opening the overlying tissues, boring the bone with a hand drill, inserting a two-ended tube into the hole, and drawing out vata by suction with the mouth.
The commentary makes the procedure explicit: skin and flesh are cut with an instrument, the bone is pierced with an ara-type drill, a double-ended tube is placed in the opening, and suction is applied by mouth. The operator must be strong. Some manuscripts instead add external and internal unction; external measures include pouring, immersion, massage, head applications, and shirobasti, while internal measures include drinking and enemas. Because that reading is absent from the commentator's source, no conclusion is made about it.
The cross-referenced treatment includes material on purification of shukra and blood, vajikarana, urinary disorders, and the earlier passage beginning with the first three shukra disorders.
Key terms
shukra
A classical reproductive substance or function.
shukradoSha (shukra-dosha)
A disorder attributed to shukra.
vAjIkaraNa (vajikarana)
The classical branch concerned with virility and reproductive support.
For vata affecting the whole body, the text prescribes immersion, heated chambers, heated pits, heated beds, oil massage, enemas, and repeated opening of veins. For vata confined to one body part, it also prescribes repeated use of animal horns where the disorder is considered fixed.
Immersion is liquid sweating in a tub filled with a vata-reducing decoction. The four-doored chamber is heated with smokeless coals and sprinkled with such liquid. A karshu is a body-length pit in heated ground, likewise sprinkled, in which the patient lies. Prastara is lying on a surface spread with warmed husk, grain, or similar material. These follow unction and are applied to the whole body; poultice sweating can be local, while dry direct heat is rejected. Although whole-body vata is often attributed to tissue depletion, repeated bloodletting from five veins is accepted if oiling and related measures fail because blood is regarded as its site. For localized vata, plural 'horns' signifies repeated application; immersion and the other measures also apply when it is mobile, while horns are reserved for a fixed condition.
Key terms
sarvA~ggagata vAta (sarvanga-gata-vata)
Vata considered to affect the whole body.
kuTIsveda (kuti-sveda)
Sweating in a heated chamber.
karShUsveda (karshu-sveda)
Sweating while lying in a prepared heated pit.
sirAmokSha (sira-moksha)
Opening a vein for bloodletting.
shRu~gga (shringa)
An animal horn used as a suction instrument.
Adhikarana ১০ (১২) · Śloka ১২
বলাসপিত্তরক্তৈস্তু সংসৃষ্টমবিরোধিভিঃ |১২|
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बलासपित्तरक्तैस्तु संसृष्टमविरोधिभिः |१२|
Meaning of the śloka
When vata is combined with balasa, pitta, or rakta, the treatment is to use measures that do not conflict with the associated factor.
The commentary identifies this as the treatment principle for mixed dosha association and says the meaning is straightforward. The supplied root text is a short fragment whose governing instruction depends on the preceding passage.
For suptivata, the physician is instructed to perform small bloodlettings repeatedly and apply a paste of salt and soot from a house or hearth mixed with oil.
The commentary defines suptivata as vata recognized by loss of touch sensation caused by obstruction from rakta. It excludes numbness attributed to rasa obstruction, for which oleation and poultices are assigned, and says drawing blood is unsuitable when vata occupies other dhatus. Repetition means many small bleedings, since a large loss could aggravate vata. Other authorities identify suptivata with vata located in the skin and regard bloodletting as a repeated instruction, with the salt-soot-oil paste as the added measure. The supplied commentary ends incompletely.
Key terms
suptivAta (suptivata)
A classical condition characterized here by loss of touch sensation.
supti
Numbness or failure to perceive touch.
raktAvaraNa (raktavarana)
Obstruction of vata by rakta in the commentary's explanation.
पञ्चमूलीशृतं क्षीरं फलाम्लो रस एव च ||१३||
सुस्निग्धो धान्ययूषो वा हितो वातविकारिणाम् |१४|
Meaning of the śloka
For people with vata disorders, the text recommends milk cooked with one of the pancamula groups, well-lubricated meat broth made sour with fruits, or a well-lubricated pulse or grain soup.
Pancamuli may mean the first or second group of five roots. The sour fruits include pomegranate. Rasa means meat broth, and dhanyayusha is soup from horse gram or other grains considered to reduce vata. 'Well-lubricated' applies to both soup and meat broth. Milk and the other foods are selected according to dosha, constitution, and individual suitability. Some read 'food beneficial for people with vata.' The supplied commentary ends incompletely.
Key terms
pa~jcamUlI (panchamuli)
One of two classical groups of five roots; the commentary leaves the choice open.
mAMsarasa (mamsarasa)
Meat broth.
dhAnyayUSha (dhanyayusha)
Pulse or grain soup, such as horse-gram soup.
sAtmya (satmya)
Individual suitability or accustomed compatibility.
A mildly warm, distinctly salty poultice called salvana is prepared from the kakolyadi group, vata-calming herbs, sour substances, meat of marsh and aquatic animals, and the four fats. The text recommends applying this poultice regularly to people with vata disorders.
Vata-calming plants include the bhadradaru or vidarigandhadi groups. Sour substances are variously listed as fermented liquids, curd, and whey, while some authorities instead use sour fruits such as pomegranate. Anupa is restricted here by one reading to shore-dwelling animals and audaka to aquatic shelled or footed creatures and fish; texts omitting audaka extend anupa more broadly. The four fats are ghee, oil, animal fat, and marrow. Salvana means thoroughly combined with salt. A cited rule gives equal meat and herbs, enough sour liquid for sourness, and enough of the fats for unctuousness; others say formulation should also consider ingredient nature and application site.
Key terms
sAlvaNa (salvana)
A distinctly salty historical poultice.
upanAha (upanaha)
A warm medicinal poultice or enclosing application.
AnUpa (anupa)
Animals associated with wet or shoreline habitats, with scope varying by reading.
audaka
Aquatic animals and fish.
catuHsneha (chatuhsneha)
The four fats: ghee, oil, animal fat, and marrow.
Adhikarana ১৪ (১৬-১৭) · Śloka ১৮
কুঞ্চ্যমানং রুজার্তং বা গাত্রং স্তব্ধমথাপি বা ||১৬||
গাঢং পট্টৈর্নিবধ্নীযাত্ ক্ষৌমকার্পাসিকৌর্ণিকৈঃ |
বিডালনকুলোন্দ্রাণাং চর্মগোণ্যাং মৃগস্য বা ||১৭||
প্রবেশযেদ্বা স্বভ্যক্তং সাল্বণেনোপনাহিতম্ |১৮|
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कुञ्च्यमानं रुजार्तं वा गात्रं स्तब्धमथापि वा ||१६||
गाढं पट्टैर्निबध्नीयात् क्षौमकार्पासिकौर्णिकैः |
बिडालनकुलोन्द्राणां चर्मगोण्यां मृगस्य वा ||१७||
प्रवेशयेद्वा स्वभ्यक्तं साल्वणेनोपनाहितम् |१८|
Meaning of the śloka
A limb that is contracting, painful, or rigid is to be firmly wrapped with linen, cotton, or woolen cloth. Alternatively, after being well anointed and covered with the salvana poultice, it is placed in a leather bag made from cat, mongoose, water-cat, or deer hide to provide warmth without fire.
Contracting is attributed to vata in the siras, while pain is attributed chiefly to vata. This indication excludes vata obstructed by pitta and rakta. Some read bark cloth instead of linen. Undra is identified as a water-cat, and charmagoṇi as a leather sack made from goat skin or similar hide.
स्कन्धवक्षस्त्रिकप्राप्तं वायुं मन्यागतं तथा ||१८||
वमनं हन्ति नस्यं च कुशलेन प्रयोजितम् |१९|
Meaning of the śloka
Vata situated in the shoulder, chest, upper back junction, or neck is said to be relieved by therapeutic emesis and nasal treatment when administered by a skilled practitioner.
Vakshas is the region between the breasts, and trika here is the upper trika region. Nasya is specifically head-cleansing nasal therapy. A skilled physician understands both procedure and disease stage. The supplied commentary ends incompletely.
Key terms
skandha
The shoulder region.
vakShas (vakshas)
The chest, described as the space between the breasts.
trika
The upper back junction in this passage.
manyA (manya)
The neck region.
vamana
Therapeutic emesis.
shirovirecana (shirovirechana)
A cleansing nasal procedure directed toward the head.
For vata located in the head, the text prescribes shirobasti or bloodletting. An oleaginous substance is retained for one thousand matras according to clinical judgment.
The conjunction is taken to include emesis and head-cleansing nasya even though they are not repeated. Bloodletting is reserved for a condition not calmed by other procedures. A matra is a unit of time compared with an eye blink, finger snap, or pronunciation of a short syllable. Jejjata explains the shorter duration relative to ten thousand matras elsewhere by the delicacy of vessels near the eyes. Gayi instead takes 'according to judgment' as prescribing one thousand matras for a healthy person, since the later procedure chapter gives six, eight, or ten thousand according to dosha but no healthy-person duration.
Key terms
shirobasti
Retention of warm oil on the head within a containing apparatus.
asRugvimokShaNa (asrigvimokshana)
Therapeutic bloodletting.
mAtrA (matra)
A traditional unit of time measured by a blink, finger snap, or short syllable.
yogataH (yogatah)
According to judgment; interpreted differently by Jejjata and Gayi.
स्नेहस्वेदस्तथाऽभ्यङ्गो बस्तिः स्नेहविरेचनम् ||२१||
शिरोबस्तिः शिरःस्नेहो धूमः स्नैहिक एव च |
सुखोष्णः स्नेहगण्डूषो नस्यं स्नैहिकमेव च ||२२||
रसाः क्षीराणि मांसानि स्नेहाः स्नेहान्वितं च यत् |
भोजनानि फलाम्लानि स्निग्धानि लवणानि च ||२३||
सुखोष्णाश्च परीषेकास्तथा संवाहनानि च |
कुङ्कुमागुरुपत्राणि कुष्ठैलातगराणि च ||२४||
कौशेयौर्णिकरौमाणि कार्पासानि गुरूणि च |
निवातातपयुक्तानि तथा गर्भगृहाणि च ||२५||
मृद्वी शय्याऽग्निसन्तापो ब्रह्मचर्यं तथैव च |
समासेनैवमादीनि योज्यान्यनिलरोगिषु ||२६||
Meaning of the śloka
The text summarizes general measures for vata disorders: oleaginous sudation, massage, medicated enemas, oily purgation, shirobasti, oiling of the head, oily fumigation, warm oil gargles and nasal preparations, meat broths, milk, meat, fats and fat-containing foods, sour fruits, oily and salty foods, warm irrigation, gentle rubbing, fragrant substances, heavy silk, wool, fur, and cotton coverings, sheltered sun-warmed rooms, a soft bed, warmth from fire, and celibacy. These are to be selected according to the condition.
Snehasveda is read as oleaginous sudation rather than dry heat, which is said to provoke vata; others divide the words into separate oleation and sudation, though that makes a later mention of oleaginous things repetitive. Rasa means meat broth and sneha includes ghee and related fats; snehanvita can mean food mixed with fat or possessing an unctuous quality. Sour fruits include pomegranate. Samvahana is pleasant gentle touch. The named textiles are understood as coverings, including silk produced by cocoons and materials made from animal hair. Garbhagriha means an enclosed inner room. Every measure is adjusted to disease and stage.
Key terms
snehasveda
Oleaginous sudation; alternatively read as separate oleation and sudation.
snehavirecana (snehavirechana)
Purgation using an oleaginous preparation.
snaihikadhUma (snaihikadhuma)
Oily medicinal fumigation.
snehagaNDUSha (snehagandusha)
Retention or gargling of an oily liquid in the mouth.
The text gives a medicated ghee called Tilvaka-sarpis. Measured portions of trivrit, danti, suvarnakshiri, saptala, shankhini, triphala, and vidanga are combined with larger pastes of tilvaka root and kampillaka, two vessels each of triphala decoction and curd, and one vessel of ghee, then cooked together. It is prescribed as an unctuous purgative for vata disorders. The same method may substitute ashoka or ramyaka for tilvaka.
The commentary interprets each of the first ingredients as one karsha, identifies suvarnakshiri as kankushtha, and treats saptala and shankhini as related varieties of yavatikta. Tilvaka is pattika-rodhra and kampillaka is the reddish fruit powder of the rocanika tree; each paste is bilva-sized. It defines the vessel measure as an adhaka of sixty-four palas, doubled in reckoning because the ingredients are liquids. In the variant preparations, only tilvaka is replaced by ashoka or ramyaka while all other ingredients and liquids remain unchanged. Ramyaka is identified as mountain neem, locally called rajanimba.
Key terms
tilvakasarpis (tilvaka-sarpis)
A medicated ghee formulated as a purgative.
snehavirecana (sneha-virechana)
Purgation using an unctuous medicinal preparation.
suvarNakShIrI (suvarnakshiri)
Identified here as kankushtha; the exact botanical or mineral identity requires verification.
kampillaka
Reddish powder from the fruit of the rocanika tree.
To prepare the oil called Anu-taila, wood from a sesame-oil press that has long absorbed oil is cut into tiny pieces, crushed, immersed in water, and boiled in a large vessel. The oil rising to the water's surface is collected and cooked by the medicated-oil method with a paste of vata-pacifying herbs. It is called Anu-taila because it is produced from minute oil-bearing particles and is prescribed for vata disorders.
The press parts include the wheel, pressing rod, and related wooden components that have remained saturated with oil for a long time. The pieces are finely crushed and powdered before boiling. The surface oil may be collected with an earthen vessel or by hand; Gayi instead understands the collecting vessel as bronze, copper, or another metal. The herbal paste includes bhadradaru and related substances. The standard ratio is paste equal to one quarter of the oil and liquid four times the oil. One view says the liquids are equal portions of decoction, meat broth, milk, and sour liquid, while another says that when liquids are not specified only four parts water are used. The name transfers the minuteness of the source particles to the resulting oil.
Key terms
aNutaila (anu-taila)
Oil obtained from minute, oil-saturated particles of press wood.
The passage describes an exceptionally elaborate Sahasrapaka oil. Ground is burned with large quantities of Mahapanchamula wood and left overnight. After the fire cools and ash is removed, the ground is saturated with one hundred jars of oil prepared with Vidarigandhadi herbs and an equal amount of milk. The oil-soaked earth is later washed with hot water and the oil that rises is collected. This is cooked repeatedly with very large quantities of vata-reducing decoction, meat broth, cow's milk, sour liquid, aromatic pastes from northern and southern regions, and other vata-reducing herbs. Ritual honors accompany the final cooking, and the oil is stored carefully in gold, silver, or earthenware. It is praised as a royal oil of unobstructed potency; preparation with one hundred parts is called Shatapaka.
The commentary explains each stage and preserves two authoritative interpretations of 'thousand-cooked.' Gayi understands one thousand successive cookings, each with quarter portions of the four liquids together equal to the oil. Jejjata understands all one thousand quarter-portions added in a single cooking and treats Sahasrapaka as the name, arguing that repeated cooking would exhaust the oil; Gayi disputes that objection because milk is added each time and expense is immaterial for wealthy kings. The commentator accepts both readings because major authorities support them and rejects a third interpretation involving one hundred cookings as erroneous. It identifies several northern and southern aromatics, describes ritual conch-blowing and feeding of one thousand Brahmanas as expressions of extraordinary potency, and rejects a variant adding milk and animal fat because respected teachers did not explain it.
Key terms
sahasrapAka (sahasra-paka)
The 'thousand-cooked' oil, interpreted either as repeated cooking or as a named large-scale process.
shatapAka (shata-paka)
A corresponding preparation made with one hundred parts or cookings.
vidArigandhAdi (Vidarigandhadi)
A classical group of herbs used to prepare the initial oil.
kA~jjika (kanjika)
A sour fermented liquid used among the cooking media.
prativApa (prativapa)
The aromatic medicinal paste added during processing.
Fresh leaves of gandharvahasta, mushkaka, naktamala, tarushaka, putika, aragvadha, citraka, and related plants are crushed with salt in a mortar, placed in and sealed within an oil jar, and burned using cow dung. The resulting Patra-lavana is prescribed as a dietary salt preparation for vata disorders.
The commentary says these salts are intended with food for conditions dominated by vata or kapha and characterized by stiffness, contraction, distension, and related features. Gandharvahasta is castor, mushkaka is the black-flowered variety, naktamala is karanja, and putika is cirabilva. Older physicians specify rock salt equal to the total quantity of all leaves. The particular indication is vata disease with prominent kapha.
Stems of snuhi, vartaku, shigru, and salt are crushed, packed in a jar with ghee, oil, animal fat, and marrow, sealed, and burned with cow dung. The resulting Sneha-lavana, also called Kanda-lavana here, is prescribed for vata disorders.
The commentary identifies the snuhi stem as a sehunda stalk. The four fats, rock salt, and combined plant materials are understood to be equal in quantity. The indication is a vata-predominant disorder.
Key terms
snehalavaNa (sneha-lavana)
A salt preparation processed with four fatty substances.
kANDalavaNa (kanda-lavana)
An alternative name for the stem-based salt preparation.
snuhI (snuhi)
A caustic latex-bearing plant identified here as sehunda.
The text lists a very large group of whole fresh plants, including roots, leaves, and branches. They are combined with salt, crushed, burned as previously described, filtered by the alkali-making method, cooked, and finished with hingu-group or pippali-group substances. The resulting Kalyanaka-lavana is prescribed in food and drink for vata disorders, gulma, splenic enlargement, weak digestive fire, indigestion, hemorrhoids, loss of appetite, cough and related conditions, and disorders accompanied by worms.
The commentary supplies numerous botanical identifications and variants, including two kinds of gandira, differing views of nirdahani, and a variant reading of two varshabhu plants for two bashpika plants. Rock salt equals the total plant quantity. After burning, the ash is separated, filtered like alkali, recombined with salt, and cooked over gentle heat. The finishing powder is one quarter the salt amount. Authorities variously choose the pippali group, the hingu group, or both, and the commentator accepts all three because earlier teachers supported them. Agni-sanga means weak digestion; ajirna includes alasaka and visucika; and the word 'and' extends cough to breathlessness, hiccup, and other kapha-vata disorders.
Key terms
kalyANakalavaNa (kalyanaka-lavana)
A complex alkaline plant-and-salt preparation.
kShArakalpa (kshara-kalpa)
The classical process of extracting and cooking an alkaline filtrate from ash.
prativApa (prativapa)
A finishing medicinal powder added during processing.
agniSha~gga (agni-sanga)
Impaired digestive function in the classical framework.
gulma
A classical category of abdominal mass or distension without a single modern equivalent.
भवति चात्र- विष्यन्दनादुष्णभावाद्दोषाणां च विपाचनात् |
संस्कारपाचनाच्चेदं वातरोगेषु शस्यते ||३३||
Meaning of the śloka
A verse praises this salt preparation for vata disorders because it promotes liquefaction or flow, possesses heat, ripens the doshas, and is transformed through processing and cooking.
The commentary explains vishyandana as causing flow or discharge and identifies the verse as praise of the salt's effects. Some authorities include the verse, while others regard it as not belonging to the original authoritative text.
Key terms
viShyandana (vishyandana)
Promoting liquefaction, flow, or discharge.
uShNabhAva (ushna-bhava)
The quality of heat in the classical framework.
doShavipAcana (dosha-vipachana)
Ripening or transforming doshas.
saMskArapAcana (samskara-pachana)
Transformation through processing and cooking.
anArSha (anarsha)
Considered by some not to belong to the authoritative original text.
Adhikarana পুষ্পিকা · Śloka ৪
ইতি সুশ্রুতসংহিতাযাং চিকিত্সাস্থানে বাতব্যাধিচিকিত্সিতং নাম চতুর্থোঽধ্যাযঃ ||৪||
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इति सुश्रुतसंहितायां चिकित्सास्थाने वातव्याधिचिकित्सितं नाम चतुर्थोऽध्यायः ||४||
Meaning of the śloka
Thus ends the fourth chapter of the Cikitsasthana in the Sushruta Samhita, entitled 'Treatment of Vata Disorders.'