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1. vātavyādhinidānam

Adhikarana 1 (1-2) · Śloka 2

athātō vātavyādhinidānaṁ vyākhyāsyāmaḥ ||1|| yathōvāca bhagavān dhanvantariḥ ||2||

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अथातो वातव्याधिनिदानं व्याख्यास्यामः ||१|| यथोवाच भगवान् धन्वन्तरिः ||२||

Meaning of the śloka

Now the diagnosis of disorders of vāta will be explained, as taught by the revered Dhanvantari.

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hētuliṅgauṣadhajñānabījabhūtēna sūtrasthānēna saṅkṣēpōddiṣṭasya hētuliṅgauṣadhasya vivaraṇē sarvāṇyēva sthānāni prastutāni, tēṣu ca prastutēṣu svādhikāriṇāṁ śalyatantravyādhīnāṁ hētulakṣaṇapratipādakatayā nidānasthānasyārambhaḥ, tatrāpi dōṣāṇāṁ vātasya pradhānatvāttadvyādhīnāṁ hētulakṣaṇābhyāṁ prāk pratipādanaṁ yujyata ityāha- athāta ityādi| vātavyādhērākṣēpakādērnidānaṁ hētulakṣaṇanirdēśaḥ| athātō vātavyādhinidānamityādi yadyapi prathamamēva sūtramasti tathā'pi ‘prābravīdbhiṣajāṁvaraḥ’ ityanantaraṁ draṣṭavyam, anupāsitāprārthitagurōḥ śiṣyāṇāṁ vyākhyānē'nadhikārāt||1-2||

Meaning of the commentary

The Sūtrasthāna briefly supplied the foundations for knowing causes, signs, and treatment; the later sections expand them. Nidānasthāna begins because it states the causes and features of diseases relevant to surgery. Vāta disorders, such as ākṣepaka, are discussed first because vāta is considered foremost among the doṣas. Here nidāna includes both cause and defining signs. The commentary says this opening formula should be understood after the later phrase 'the best of physicians spoke,' because students who have neither approached nor requested instruction from a teacher are not entitled to the exposition.

Key terms

vAtavyAdhi (vāta-vyādhi)
A disorder attributed to disturbed vāta.
nidAna (nidāna)
The account of causes and diagnostic features.
hetu
A cause or etiological factor.
li~gga (liṅga)
A sign or defining clinical feature.

Adhikarana 2 (3-4) · Śloka 4

dhanvantariṁ dharmabhr̥tāṁ variṣṭhamamr̥tōdbhavam | caraṇāvupasaṅgr̥hya suśrutaḥ paripr̥cchati ||3|| vāyōḥ prakr̥tibhūtasya vyāpannasya ca kōpanaiḥ | sthānaṁ karma ca rōgāṁśca vada mē vadatāṁ vara ||4||

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धन्वन्तरिं धर्मभृतां वरिष्ठममृतोद्भवम् | चरणावुपसङ्गृह्य सुश्रुतः परिपृच्छति ||३|| वायोः प्रकृतिभूतस्य व्यापन्नस्य च कोपनैः | स्थानं कर्म च रोगांश्च वद मे वदतां वर ||४||

Meaning of the śloka

Sushruta respectfully takes the feet of Dhanvantari, foremost among the upholders of dharma and born with amṛta, and asks: 'Best of teachers, tell me the locations, functions, and diseases of vāyu in its normal state and when disturbed, together with the factors that provoke it.'

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kaḥ punarēvaṁ pratijñātavāniti tamēva prakārēṇa darśayannāha- dhanvantarimityādi| dharmabhr̥tāṁ dhārmikāṇāṁ, variṣṭhaṁ śrēṣṭham| amr̥tēna saha udbhava utpatiryasya tam| caraṇāvupasaṅgr̥hyēti pādapatanaṁ kr̥tvētyarthaḥ| kiṁ paripr̥cchatītyāha- vāyōrityādi| prakr̥tibhūtasya svabhāvāvasthitasya, vyāpannasya vikr̥tasya| kōpanaiḥ dravyaguṇakarmabhirvāyusamānaiḥ| sthānaṁ śrōṇigudādi, tacca prakr̥tibhūtasya vāyōḥ; vikr̥tasya tu sarvaśarīram| karma sāmānyaṁ viśiṣṭaṁ ca; sāmānyam ‘indriyārthōpasamprāptiṁ’ ityādi, viśiṣṭaṁ ‘sa prāṇō nāma dēhadhr̥k’ ityādi| rōgāṁścēti hikkāśvāsādikān| yadāha- “prāyaśaḥ kurutē duṣṭō hikkāśvāsādikān gadān” iti| cakārānnāma ca| vadatāṁ vara vyākhyātr̥̄ṇāṁ madhyē śrēṣṭha! ‘kōpanaiḥ’ ityatra ‘bhūpatē’ iti kēcit paṭhanti; ‘vada mē’ ityatra ca ‘vadasva’ iti paṭhanti; tatra bhūpatē iti dhanvantarisambōdhanaṁ; vadasva vadēti caika ēvārthaḥ| mē mama| karmagrahaṇaṁ kēcinnādhīyatē; tanmatē, ‘sthānaṁ rōgavibhāgaṁ ca’ iti pāṭhaḥ||3-4||

Meaning of the commentary

The commentary identifies Dhanvantari as the speaker and explains the respectful gesture as falling at his feet. Normal vāyu is that which remains in its natural condition; disturbed vāyu is altered. Provoking factors are substances, qualities, and activities similar to vāyu. The normal locations include the pelvis and rectum, whereas disturbed vāyu can occupy the whole body. Its functions are both general and specific, and its diseases include hiccup, dyspnea, and others. Some read bhūpate instead of kopanaiḥ, making it an address to Dhanvantari, and some read vadasva for vada me. Some omit 'function' and read 'location and division of diseases' instead.

Key terms

prakRutibhUta vAyu (prakṛtibhūta vāyu)
Vāyu remaining in its normal state.
vyApanna vAyu (vyāpanna vāyu)
Vāyu that has become disturbed or altered.
kopana
A substance, quality, or action held to provoke vāyu.
sthAna (sthāna)
The bodily location assigned to vāyu.

Adhikarana 3 (5-8) · Śloka 9

tasya tadvacanaṁ śrutvā prābravīdbhiṣajāṁ varaḥ | svayambhūrēṣa bhagavān vāyurityabhiśabditaḥ ||5|| svātantryānnityabhāvācca sarvagatvāttathaiva ca | sarvēṣāmēva sarvātmā sarvalōkanamaskr̥taḥ ||6|| sthityutpattivināśēṣu bhūtānāmēṣa kāraṇam | avyaktō vyaktakarmā ca rūkṣaḥ śītō laghuḥ kharaḥ ||7|| tiryaggō dviguṇaścaiva rajōbahula ēva ca | acintyavīryō dōṣāṇāṁ nētā rōgasamūharāṭ ||8|| āśukārī muhuścārī pakvādhānagudālayaḥ |9|

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तस्य तद्वचनं श्रुत्वा प्राब्रवीद्भिषजां वरः | स्वयम्भूरेष भगवान् वायुरित्यभिशब्दितः ||५|| स्वातन्त्र्यान्नित्यभावाच्च सर्वगत्वात्तथैव च | सर्वेषामेव सर्वात्मा सर्वलोकनमस्कृतः ||६|| स्थित्युत्पत्तिविनाशेषु भूतानामेष कारणम् | अव्यक्तो व्यक्तकर्मा च रूक्षः शीतो लघुः खरः ||७|| तिर्यग्गो द्विगुणश्चैव रजोबहुल एव च | अचिन्त्यवीर्यो दोषाणां नेता रोगसमूहराट् ||८|| आशुकारी मुहुश्चारी पक्वाधानगुदालयः |९|

Meaning of the śloka

Dhanvantari replies that vāyu is called self-existent and revered: independent, eternal, all-pervading, and the inner principle of all beings. It is the cause of their maintenance, arising, and dissolution. Though itself unseen, its actions are manifest. It is dry, cool, light, rough, moves transversely, possesses two perceptible qualities, and is especially associated with rajas. Its power is said to be inconceivable; it directs the doṣas and stands foremost among causes of disease. It acts rapidly, moves repeatedly, and resides in the pakvādhāna and rectum.

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tasyētyādi| tasya suśrutasya| tat pūrvōktam| bhiṣajāṁ varō dhanvantariḥ| ‘bhiṣajāṁ guruḥ’ iti kēcit paṭhanti| prābravīt jagāda| ēṣa vāyuriti sambandhaḥ| bhagavān samastaiśvaryaguṇayuktaḥ, aṇimādiguṇayukta ityarthaḥ| abhiśabditaḥ kīrttitaḥ| svayambhūtvē hētutritayamāha- svātantryādityādi| svātantryāditi svakarmaviṣayē nānyēna prēryata ityarthaḥ| nityabhāvāt nityasya hi kāraṇarahitatvēna svatantratvaṁ, tataśca svayambhūtvamityarthaḥ; sarvagatvāccēti yō hi sarvagataḥ sa svayambhūḥ, ākāśavat| cakārāt sūkṣmatvamapi paramāṇōriva svayambhūtvē hētuḥ samuccīyatē| kathaṁ punarasya sarvagatvaṁ yāvatā pārthivadravyamūrttiṣu vāyurnāstītyāha- sarvēṣāmityādi| sarvēṣāṁ sthāvarajaṅgamānāṁ, sarvātmā kāraṇakāryātmakatvēna sarvasvarūpaḥ, ‘sarvaprayōjanahētuḥ’ iti kēcit| sarvalōkanamaskr̥ta iti kuta ityāha- sthityutpattivināśēṣvityādi| sthitiḥ jīvanam| avyaktō'dr̥śyamūrtiḥ| vyaktakarmā prakaṭakriyaḥ| śīta iti asaṁyuktasya vāyōrguṇō'yaṁ saṁyuktastūṣṇō'pi| kharaḥ kharasparśaḥ, karkōṭakaphalavat| tiryaggaḥ tiryaggāmī| dviguṇaḥ śabdasparśaguṇaḥ| rajōbahula iti triguṇatvē'pyutkarṣaviśēṣādrajaḥ prabalatvamasya| acintyavīryō'cintyaśaktiḥ, sā cāsya śaktiḥ śarīradōṣamūtrapurīṣādivibhāgō'vayavādisaṁsthānakā(ka)raṇaṁ dōṣadhātumalasaṁvahanādiśca, śarīrādbahistu sañcaratō dharaṇīdhāraṇādiḥ| dōṣāṇāṁ nētā dōṣadhātumalānāṁ prēraka ityarthaḥ, anyē tu vāyōrapi vāyurēva nētēti bahuvacanaṁ samarthayanti| rōgasamūharāḍiti rōgasamūhē rōgahētuvr̥ndē pittakapharaktādau rājatē śōbhatē iti rōgasamūharāṭ; na tu rāṭśabdō rājaparyāyaḥ, ‘sa rōgānīkarāṭ smr̥ta’ ityagrētanēna saha virōdhāpattēḥ| āśukārī śīghramatyayakāritvāt| muhurmuhuḥ prakr̥tibhūtō'pi caratīti muhuścārī| pakvādhānagudālaya iti pakvāśayagudau sthānamasyētyarthaḥ||5-8||-

Meaning of the commentary

The commentary gives independence, eternality, and all-pervasiveness as reasons for calling vāyu self-existent, adding subtlety through the conjunction. Its being the self of all is interpreted as pervading stationary and moving beings as cause and effect; another reading calls it the cause of every purpose. 'Maintenance' means life. Vāyu is invisible but known through evident action. Coolness belongs to uncombined vāyu, while in combination it may be hot. Its two qualities are sound and touch, and rajas predominates although all three guṇas are present. Its proposed powers include organizing bodily wastes and structures, moving doṣa, dhātu, and mala, and sustaining the earth externally. 'Leader of the doṣas' usually means their mover, though some say vāyu directs even vāyu. The compound rogasamūharāṭ is interpreted as shining or foremost among disease-causing factors rather than literally as king, to avoid conflict with a later phrase. Rapid action refers to quickly causing grave outcomes. Some read 'teacher of physicians' instead of 'best of physicians.'

Key terms

svayambhU (svayambhū)
Self-existent in the commentary's cosmological account.
avyakta
Unmanifest or not directly visible.
vyaktakarman (vyakta-karman)
Having actions that are manifest or observable.
rajovahula (rajo-bahula)
Characterized by predominance of rajas.
pakvAdhAna (pakvādhāna)
The lower digestive or fecal-holding region named as a seat of vāyu.

Adhikarana 4 (9-10) · Śloka 10

dēhē vicaratastasya lakṣaṇāni nibōdha mē ||9|| dōṣadhātvagnisamatāṁ samprāptiṁ viṣayēṣu ca | kriyāṇāmānulōmyaṁ ca karōtyakupitō'nilaḥ ||10|| (indriyārthōpasamprāptiṁ dōṣadhātvagnyavaikr̥tam| kriyāṇāmānulōmyaṁ ca kuryādvāyuradūṣitaḥ ||10||) |

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देहे विचरतस्तस्य लक्षणानि निबोध मे ||९|| दोषधात्वग्निसमतां सम्प्राप्तिं विषयेषु च | क्रियाणामानुलोम्यं च करोत्यकुपितोऽनिलः ||१०|| (इन्द्रियार्थोपसम्प्राप्तिं दोषधात्वग्न्यवैकृतम्| क्रियाणामानुलोम्यं च कुर्याद्वायुरदूषितः ||१०||) |

Meaning of the śloka

Learn the signs of vāyu as it moves through the body. When not aggravated, it maintains balance among doṣas, dhātus, and agni, enables contact with sensory objects, and allows bodily, verbal, and mental activities to proceed in their proper direction. An alternate recension says that undisturbed vāyu enables the senses to reach their objects, keeps doṣa, dhātu, and agni unaltered, and supports orderly activity.

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nibōdha mē iti nibōdha jānīhi, mē matsakāśāt| dhātuśabdānantaramādiśabdō luptō draṣṭavyaḥ| tēna malōpadhātūnāmapi grahaṇam; athavā dhātuśabdēna malōpadhātava ucyantē, śarīradhāraṇakāraṇāt| viṣayēṣu śabdasparśarūparasagandhēṣu| kriyāṇāṁ kāyavāṅmānasīnām| ānulōmyaṁ pravarttakatvam| gayadāsācāryastu imaṁ ślōkam ‘indriyārthōpasamprāptiṁ’ ityādi kr̥tvā paṭhati, sa ca vistarabhayānna likhitaḥ||9-10||

Meaning of the commentary

The commentary says an omitted 'and so forth' after dhātu includes mala and upadhātu; alternatively, dhātu itself may include them because they help sustain the body. Sensory objects are sound, touch, form, taste, and smell. Activities are those of body, speech, and mind, and anulomya means enabling their proper movement. Gayadāsa reads the alternate verse beginning indriyārthopasamprāpti, which the commentator says was not written out fully for fear of excessive length.

Key terms

doShadhAtvagnisamatA (doṣa-dhātv-agni-samatā)
Balance of doṣas, tissues, and digestive/metabolic fire in the classical framework.
indriyArtha (indriyārtha)
An object of a sense: sound, touch, form, taste, or smell.
Anulomya (ānulomya)
Orderly or properly directed functioning.
upadhAtu (upadhātu)
A subsidiary tissue category included by the commentary.

Adhikarana 5 (11) · Śloka 11

yathā'gniḥ pañcadhā bhinnō nāmasthānakriyāmayaiḥ | bhinnō'nilastasthā hyēkō nāmasthānakriyāmayaiḥ ||11||

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यथाऽग्निः पञ्चधा भिन्नो नामस्थानक्रियामयैः | भिन्नोऽनिलस्तस्था ह्येको नामस्थानक्रियामयैः ||११||

Meaning of the śloka

Just as agni, though one, is divided fivefold by name, location, function, and disorder, vāyu too is one but divided fivefold by its names, locations, functions, and disorders.

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tadēvaṁ sarvānilasya sāmānyēna svāsthyahētutvaṁ pradarśya sthānōpādhibhēdēna bhinnasya nāmāntaraviśiṣṭasya pratisthānaṁ viśiṣṭasvasthakriyā rōgāṁśca darśayannāha- yathā'gnirityādi| yathā'gniḥ pittaga ēka ēva pācakarañjakālōcakabhrājakasādhakēti nāmnā, sthānēnāmapakvāśayādinā, kriyayā annapācanādikayā, āmayēnāmlapākādinā pañcavidhaḥ; ēvamanilō'pyēka ēva nāmādibhiḥ pañcavidhaḥ| anyē tu punaratra bāhyāgnērgārhapatyāhavanīyadakṣiṇāgnyāvasathyasabhyalakṣaṇān pañca bhēdānāhuḥ, tannēcchati gayadāsācāryaḥ||11||

Meaning of the commentary

Having described vāyu generally as a cause of health, the commentary introduces its five forms according to bodily site, each with distinct normal functions and diseases. It compares them with the five forms of pitta-agni—pācaka, rañjaka, ālocaka, bhrājaka, and sādhaka—distinguished by name, site, action, and disorder. Some instead take the analogy from the five external ritual fires: gārhapatya, āhavanīya, dakṣiṇāgni, āvasathya, and sabhya; Gayadāsa does not accept that interpretation.

Key terms

pa~jcadhA (pañcadhā)
Divided into five forms.
pAcaka (pācaka)
The digestive form of pitta-agni used in the comparison.
kriyA (kriyā)
The particular function of a form.
Amaya (āmaya)
A disorder associated with a particular form.

Adhikarana 6 (12) · Śloka 12

prāṇōdānau samānaśca vyānaścāpāna ēva ca | sthānasthā mārutāḥ pañca yāpayanti śarīriṇam ||12||

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प्राणोदानौ समानश्च व्यानश्चापान एव च | स्थानस्था मारुताः पञ्च यापयन्ति शरीरिणम् ||१२||

Meaning of the śloka

The five forms of vāyu are prāṇa, udāna, samāna, vyāna, and apāna. When each remains in its proper state and location, they sustain the embodied person.

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tatra vāyōrnāmānyāha- prāṇōdānāvityādi| sthānasthāḥ sthānaśabdēnātra sāmyamucyatē| yāpayanti dhārayanti||12||

Meaning of the commentary

The commentary says the verse supplies the names of vāyu. Here 'remaining in their locations' is interpreted as remaining in equilibrium, and 'sustain' means uphold the body.

Key terms

prANa (prāṇa)
One of the five functional forms of vāyu.
udAna (udāna)
The upward-associated form of vāyu.
samAna (samāna)
The digestive-associated form of vāyu.
vyAna (vyāna)
The body-pervading circulatory and movement-associated form.
apAna (apāna)
The downward-moving eliminative and reproductive-associated form.

Adhikarana 7 (13) · Śloka 14

yō vāyurvaktrasañcārī sa prāṇō nāma dēhadhr̥k | sō'nnaṁ pravēśayatyantaḥ prāṇāṁścāpyavalambatē ||13|| prāyaśaḥ kurutē duṣṭō hikkāśvāsādikān gadān |14|

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यो वायुर्वक्त्रसञ्चारी स प्राणो नाम देहधृक् | सोऽन्नं प्रवेशयत्यन्तः प्राणांश्चाप्यवलम्बते ||१३|| प्रायशः कुरुते दुष्टो हिक्काश्वासादिकान् गदान् |१४|

Meaning of the śloka

The vāyu that moves through the mouth is called prāṇa and sustains the body. It carries food inward and supports the vital functions. When disturbed, it commonly produces disorders such as hiccup and dyspnea.

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vaktrasañcāritvaṁ cāsyōpalakṣaṇaṁ, tēna mūrdhōraḥkaṇṭhanāsikā api prāṇasya sthānam| antaḥ abhyantaramannaṁ pravēśayati dēhadhāraṇāya | prāṇāṁścāpyavalambata iti prāṇānagnyādīn, avalambatē svakriyāsu yōjayati| gayadāsācāryastvēvaṁ manyatē- prāṇānāmagnīṣōmādīnāmavalambanavacanēnādhārabhūtahr̥dayāvalambanamēvōcyatē, ētēna prāṇādhārahr̥dayadhāraṇēna prāṇadhāraṇamēvōktam| ata ēva prāṇānāmavalambanēna maraṇamūlatvamucyatē| yaduktaṁ śrutau- “yathā hi saindhavō'śvaḥ śaṅkumutpāṭya dhāvati, tadvat prāṇō ruddhaḥ sarvān vāyūnutpāṭya prayāṇakālē dhāvati”- iti| śvāsādikānityādiśabdāt pratiśyāyasvarabhēdakāsādayaḥ||13||-

Meaning of the commentary

Movement through the mouth is only an identifying indication; the head, chest, throat, and nose are also locations of prāṇa. It brings food inside to maintain the body. One explanation says it engages agni and other vital factors in their activities. Gayadāsa instead says that supporting the vital factors means supporting the heart that serves as their foundation, thereby sustaining life; a quoted teaching uses a tethered horse as an image for prāṇa departing at death and drawing the other vāyus with it. 'Such as dyspnea' also includes rhinitis, voice disturbance, and cough.

Key terms

prANa (prāṇa)
The form of vāyu associated here with intake, vital support, and the upper body.
dehadhRuk (deha-dhṛk)
Sustaining or upholding the body.
avalambana
Support, interpreted either functionally or as support of the heart.
shvAsa (śvāsa)
A classical disorder characterized by troubled breathing.

Adhikarana 8 (14-15) · Śloka 15

udānō nāma yastūrdhvamupaiti pavanōttamaḥ ||14|| tēna bhāṣitagītādiviśēṣō'bhipravartatē | ūrdhvajatrugatān rōgān karōti ca viśēṣataḥ ||15||

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उदानो नाम यस्तूर्ध्वमुपैति पवनोत्तमः ||१४|| तेन भाषितगीतादिविशेषोऽभिप्रवर्तते | ऊर्ध्वजत्रुगतान् रोगान् करोति च विशेषतः ||१५||

Meaning of the śloka

The foremost vāyu that moves upward is called udāna. Through it, distinct forms of speech, song, and related actions proceed. When disturbed, it especially causes disorders above the clavicular region.

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udānasya prakr̥tibhūtasya nāmādi vyāpannasya ca rōgānnirdiśannāha- udāna ityādi| upaiti gacchati| sthānaṁ punaranuktamapyasya nābhyuraḥkaṇṭhādi | bhāṣitagītādiriti ādiśabdāducchvāsādi| ‘viśēṣō'bhipravartatē’ ityatra kēcit ‘viṣayō'bhipravartatē’ iti paṭhanti| ūrdhvajatrugatāniti nayanavadanaghrāṇaśravaṇaśiraḥsaṁśrayān| cakārādanyānapi kāsādīn karōti||14-15||

Meaning of the commentary

The commentary presents udāna's normal identity and functions and the diseases of its disturbed state. Although not stated in the verse, its locations include the navel, chest, and throat. 'Speech, song, and so forth' also includes exhalation. Some read viṣayaḥ, 'the domain proceeds,' instead of viśeṣaḥ, 'the distinct form proceeds.' Disorders above the clavicle involve the eyes, mouth, nose, ears, and head; the conjunction also includes cough and other conditions.

Key terms

udAna (udāna)
The upward-moving form of vāyu associated with voice and exhalation.
Urdhvajatrugata (ūrdhva-jatrugata)
Located above the clavicular or neck-root region.
ucchvAsa (ucchvāsa)
Exhalation, included by the commentary.

Adhikarana 9 (16) · Śloka 17

āmapakvāśayacaraḥ samānō vahnisaṅgataḥ | sō'nnaṁ pacati tajjāṁśca viśēṣānvivinakti hi ||16|| gulmāgnisādātīsāraprabhr̥tīn kurutē gadān |17|

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आमपक्वाशयचरः समानो वह्निसङ्गतः | सोऽन्नं पचति तज्जांश्च विशेषान्विविनक्ति हि ||१६|| गुल्माग्निसादातीसारप्रभृतीन् कुरुते गदान् |१७|

Meaning of the śloka

Samāna moves through the region where food is being digested and remains associated with digestive fire. It digests food and separates the products arising from that digestion. When disturbed, it causes disorders such as gulma, weakened digestive activity, and diarrhea.

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pākaḥ pakvaṁ, napuṁsakē bhāvē ktaḥ; āmasya pakvamāmapakvaṁ, tasyāśayaḥ pacyamānāhārāśaya ityarthaḥ; tatra caratīti āmapakvāśayacaraḥ| ‘vahnisaṅgata’ ityatra ‘agnisahāyavān’ iti kēcit paṭhanti, tatrāpi sa ēvārthaḥ| sō'nnaṁ pacatīti agnisandhukṣaṇādbhaktakāra iva| tajjān annapākajān| viśēṣān rasadōṣamūtrapurīṣāṇi| vivinakti pr̥thak karōti||16||-

Meaning of the commentary

The commentary derives āmapakvāśaya as the receptacle where undigested food becomes digested. Some read 'assisting agni' instead of 'associated with agni,' with essentially the same meaning. Samāna is said to digest by kindling agni, like a cook. It separates digestion's products into rasa, doṣa, urine, and feces.

Key terms

samAna (samāna)
The form of vāyu associated with digestion and separation of digestive products.
AmapakvAshaya (āma-pakvāśaya)
The digestive receptacle where undigested food becomes cooked.
gulma
A classical abdominal disease category.
agnisAda (agni-sāda)
Weakening of digestive fire.

Adhikarana 10 (17-18) · Śloka 18

kr̥tsnadēhacarō vyānō rasasaṁvahanōdyataḥ ||17|| svēdāsr̥ksrāvaṇaścāpi pañcadhā cēṣṭayatyapi | kruddhaśca kurutē rōgān prāyaśaḥ sarvadēhagān ||18||

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कृत्स्नदेहचरो व्यानो रससंवहनोद्यतः ||१७|| स्वेदासृक्स्रावणश्चापि पञ्चधा चेष्टयत्यपि | क्रुद्धश्च कुरुते रोगान् प्रायशः सर्वदेहगान् ||१८||

Meaning of the śloka

Vyāna moves throughout the entire body and drives the circulation of rasa. It also promotes sweating and the flow of blood and produces five kinds of bodily movement. When aggravated, it generally causes diseases affecting the whole body.

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rasasaṁvahanōdyata ityatrādiśabdō draṣṭavyaḥ, tēna rasādisaṁvahanōdyata ityarthaḥ; saṁvahanaṁ prēraṇam| pañcadhā cēṣṭayatyapīti prasāraṇākuñcanavinamanōnnamanatiryaggamanāni pañca cēṣṭāḥ; anyē tu ‘gatiprasāraṇōtkṣēpaṇanimēṣōnmēṣaiḥ pañcabhiḥ prakāraiḥ pañcadhā’ iti vyākhyānayanti| sarvadēhagān jvarātīsāraraktapittaprabhr̥tīn||17-18||

Meaning of the commentary

The commentary understands an implicit 'and so forth,' so vyāna moves rasa and other bodily materials. Its five movements are extension, contraction, bending, elevation, and transverse movement. Others instead enumerate locomotion, extension, lifting, closing the eyes, and opening them. Whole-body disorders include fever, diarrhea, raktapitta, and others.

Key terms

vyAna (vyāna)
The body-pervading form of vāyu associated with transport and movement.
rasasaMvahana (rasa-saṃvahana)
Propulsion or circulation of rasa.
prasAraNa (prasāraṇa)
Extension, one of the listed bodily movements.
raktapitta
A classical bleeding disorder category.

Adhikarana 11 (19) · Śloka 20

pakvādhānālayō'pānaḥ kālē karṣati cāpyadhaḥ | samīraṇaḥ śakr̥nmūtraṁ śukragarbhārtavāni ca ||19|| kruddhaśca kurutē rōgān ghōrān bastigudāśrayān |20|

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पक्वाधानालयोऽपानः काले कर्षति चाप्यधः | समीरणः शकृन्मूत्रं शुक्रगर्भार्तवानि च ||१९|| क्रुद्धश्च कुरुते रोगान् घोरान् बस्तिगुदाश्रयान् |२०|

Meaning of the śloka

Apāna resides in the pakvādhāna and, at the proper time, draws feces, urine, semen, the fetus, and menstrual blood downward. When aggravated, it causes severe disorders centered in the bladder and rectal region.

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pakvādhānālayaḥ pakvāśayasthāna ityarthaḥ| bastyāśrayān aśmaryādīn, gudāśrayān bhagandarādīn||19||-

Meaning of the commentary

The commentary identifies pakvādhāna with the pakvāśaya. Disorders located in the bladder include urinary stones and related conditions, while disorders of the rectal region include fistula-in-ano and others.

Key terms

apAna (apāna)
The downward-moving form of vāyu associated with elimination and reproduction.
pakvAdhAna (pakvādhāna)
The lower digestive receptacle, glossed as pakvāśaya.
basti
The bladder region.
bhagandara
A classical fistula-in-ano disease category.

Adhikarana 12 (20) · Śloka 20

śukradōṣapramēhāstu vyānāpānaprakōpajāḥ ||20||

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शुक्रदोषप्रमेहास्तु व्यानापानप्रकोपजाः ||२०||

Meaning of the śloka

Disorders of śukra and prameha are said to arise from aggravation of both vyāna and apāna.

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idānīmupalakṣaṇārthaṁ vikr̥tavātadvayādikarma darśayannāha- śukradōṣētyādi| śukrasya sarvāṅgagatatvāt pramēhasya sarvadēhagatarasādidūṣyaprabhavatvādvyānakr̥tatvaṁ, mēḍhradvārasaṁśritatvādapānakr̥tatvaṁ ca||20||

Meaning of the commentary

The verse gives examples of the effects of two disturbed vāyus acting together. Because śukra is considered distributed throughout the body, and because prameha arises from rasa and other affected materials throughout the body, vyāna is involved. Because both manifest through the penile outlet, apāna is also involved.

Key terms

shukradoSha (śukra-doṣa)
A classical disorder involving reproductive material.
prameha
A classical group of urinary and metabolic disorders.
vyAnApAnaprakopa (vyānāpāna-prakopa)
Simultaneous aggravation of vyāna and apāna.

Adhikarana 13 (21) · Śloka 21

yugapat kupitāścāpi dēhaṁ bhindyurasaṁśayam |21|

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युगपत् कुपिताश्चापि देहं भिन्द्युरसंशयम् |२१|

Meaning of the śloka

If all five forms become aggravated at the same time, they are said without doubt to destroy the body.

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tēṣāṁ pañcānāṁ yugapat prakōpē niyamēna dēhanāśaṁ darśayannāha- yugapadityādi| yugapat ēkakālamityarthaḥ| bhindyuriti bhēdō'tra dēhavināśō'bhiprētaḥ|21|-

Meaning of the commentary

The commentary takes yugapat to mean simultaneously and interprets 'break the body' as destruction or death of the body, presenting this as the fixed outcome of simultaneous aggravation of all five vāyus.

Key terms

yugapat prakopa
Simultaneous aggravation of all five forms.
dehabheda (deha-bheda)
Literally breaking the body, interpreted here as bodily destruction or death.

Adhikarana 14 (21-24) · Śloka 24

ata ūrdhvaṁ pravakṣyāmi nānāsthānāntarāśritaḥ ||21|| bahuśaḥ kupitō vāyurvikārān kurutē hi yān | vāyurāmāśayē kruddhaśchardyādīn kurutē gadān ||22|| mōhaṁ mūrcchāṁ pipāsāṁ ca hr̥dgrahaṁ pārśvavēdanām | pakvāśayasthō'ntrakūjaṁ śūlaṁ nābhau karōti ca ||23|| kr̥cchramūtrapurīṣatvamānāhaṁ trikavēdanām | śrōtrādiṣvindriyavadhaṁ kuryāt kruddhaḥ samīraṇaḥ ||24||

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अत ऊर्ध्वं प्रवक्ष्यामि नानास्थानान्तराश्रितः ||२१|| बहुशः कुपितो वायुर्विकारान् कुरुते हि यान् | वायुरामाशये क्रुद्धश्छर्द्यादीन् कुरुते गदान् ||२२|| मोहं मूर्च्छां पिपासां च हृद्ग्रहं पार्श्ववेदनाम् | पक्वाशयस्थोऽन्त्रकूजं शूलं नाभौ करोति च ||२३|| कृच्छ्रमूत्रपुरीषत्वमानाहं त्रिकवेदनाम् | श्रोत्रादिष्विन्द्रियवधं कुर्यात् क्रुद्धः समीरणः ||२४||

Meaning of the śloka

The text next describes disorders caused when aggravated vāyu occupies different locations. In the stomach it causes vomiting and related disorders, confusion, fainting, thirst, constriction in the cardiac region, and pain in the flanks. In the lower intestinal region it causes intestinal sounds, pain at the navel, difficult passage of urine and feces, abdominal distension, and pain around the sacral region. When lodged in the sensory organs beginning with the ear, it causes loss of their functions.

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ata ityādi| nānāsthānāntarāśritaḥ kupitaḥ san vāyurbahuśō yān vikārān kurutē tān pravakṣyāmīti sambandhaḥ| chardyādīniti ādiśabdādrujaḥ pārśvōdarahr̥tstambhatōdādikā grāhyāḥ, athavā ūrdhvagaraktapittādikāḥ| mōhō naivātyantaṁ cittanāśaḥ| mūrcchā cētanācyutiḥ| pakvētyādi antrakūjaṁ antrē'vyaktaśabdam| cakārādvātaviṇmūtrasaṅgaṁ jaṅghōrutrikapārśvapr̥ṣṭhādīn prati śūlaṁ ca kurutē| ‘śūlaṁ nābhau’ ityatra ‘śūlānāhau’ iti kēcit paṭhanti, vyākhyānayanti ca- pakvāśaya ānahyatē samantādvibadhyata ivēti vēdanāprakāra ēka ānāhaḥ, dvitīyastu visūcikāpratiṣēdhē prōktalakṣaṇa ēva| śrōtrādiṣu kruddhaḥ san samīraṇa indriyavadhaṁ kuryāditi sambandhaḥ| śrōtrādiṣu śrōtraghrāṇadarśanarasanatvakṣu| indriyavadhamityanēnāśrutyaghrāṇādarśanārasanāsparśāni vēditavyāni||21-24||

Meaning of the commentary

The commentary says disturbed vāyu produces many conditions according to its location. 'Vomiting and others' may include pain, stiffness or pricking in the flank, abdomen, and heart region, or upward-moving raktapitta and related conditions. Moha is impairment short of complete loss of mind, while mūrcchā is loss of consciousness. Antrakūja is indistinct intestinal sound. The conjunction adds retention of flatus, feces, and urine and pain in the legs, thighs, sacrum, flanks, and back. Some read śūlānāhau instead of śūlaṃ nābhau and interpret ānāha as a surrounding sense of binding in the pakvāśaya, distinct from another type described elsewhere. The sensory losses are inability to hear, smell, see, taste, or feel touch.

Key terms

AmAshaya (āmāśaya)
The stomach or upper digestive receptacle.
pakvAshaya (pakvāśaya)
The lower intestinal or digested-food receptacle.
antrakUja (antra-kūja)
Indistinct rumbling or sound in the intestines.
AnAha (ānāha)
Abdominal obstruction or distension, with a variant interpretation here.
indriyavadha (indriya-vadha)
Loss of sensory function.

Adhikarana 15 (25-29) · Śloka 29

vaivarṇyaṁ sphuraṇaṁ raukṣyaṁ suptiṁ cumucumāyanam | tvaksthō nistōdanaṁ kuryāt tvagbhēdaṁ paripōṭanam ||25|| vraṇāṁśca raktagō, granthīn saśūlān māṁsasaṁśritaḥ | tathā mēdaḥśritaḥ kuryādgranthīnmandarujō'vraṇān ||26|| kuryāt sirāgataḥ śūlaṁ sirākuñcanapūraṇam | snāyuprāptaḥ stambhakampau śūlamākṣēpaṇaṁ tathā ||27|| hanti sandhigataḥ sandhīn śūlaśōphau karōti ca | asthiśōṣaṁ prabhēdaṁ ca kuryācchūlaṁ ca tacchritaḥ ||28|| tathā majjagatē ruk ca na kadācit praśāmyati | apravr̥ttiḥ pravr̥ttirvā vikr̥tā śukragē'nilē ||29||

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वैवर्ण्यं स्फुरणं रौक्ष्यं सुप्तिं चुमुचुमायनम् | त्वक्स्थो निस्तोदनं कुर्यात् त्वग्भेदं परिपोटनम् ||२५|| व्रणांश्च रक्तगो, ग्रन्थीन् सशूलान् मांससंश्रितः | तथा मेदःश्रितः कुर्याद्ग्रन्थीन्मन्दरुजोऽव्रणान् ||२६|| कुर्यात् सिरागतः शूलं सिराकुञ्चनपूरणम् | स्नायुप्राप्तः स्तम्भकम्पौ शूलमाक्षेपणं तथा ||२७|| हन्ति सन्धिगतः सन्धीन् शूलशोफौ करोति च | अस्थिशोषं प्रभेदं च कुर्याच्छूलं च तच्छ्रितः ||२८|| तथा मज्जगते रुक् च न कदाचित् प्रशाम्यति | अप्रवृत्तिः प्रवृत्तिर्वा विकृता शुक्रगेऽनिले ||२९||

Meaning of the śloka

According to its tissue or structure, disturbed vāyu produces different signs. In skin or rasa it causes discoloration, twitching, dryness, numbness, tingling, pricking, splitting, and peeling. In blood it causes wounds; in muscle, painful nodules; and in medas, mildly painful nodules without ulceration. In vessels it produces pain, contraction, or fullness; in sinews, stiffness, tremor, pain, and spasmodic movement. In joints it damages movement and causes pain and swelling. In bone it causes wasting, splitting, and pain; in marrow, pain that never subsides. In śukra it causes absent or abnormal discharge.

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tvaksthō rasasthaḥ samīraṇō vaivarṇyādi kuryāditi sambandhaḥ| suptiṁ sparśājñānam| cumucumāyanaṁ sarṣapakalkāvaliptānāmivāṅgānāṁ vēdanām| tvagbhēdaṁ tvacō bhēdamēva| paripōṭanaṁ sarvataḥ puṭanaṁ tvaca ēva| vraṇāṁśca raktagaḥ ‘kuryāt’ iti śēṣaḥ| amuṁ pāṭhaṁ kēcinna paṭhanti; tanna, gayadāsācāryasya sammatatvāt| granthīn saśūlān māṁsasamāśritaḥ samīraṇa iti sambandhaḥ| avraṇān vraṇarahitān| sirākuñcanaṁ ‘kuṭilā sirā’ iti lōkē vadanti | stambhō niścalīkaraṇam| ākṣēpaṇaṁ cālanam| hantītyādi ētēnākuñcanaprasāraṇayōrabhāva uktaḥ| tacchrita iti asthyāśrita ityarthaḥ| tathā majjagatē yathā asthyāśritō'sthiśōṣaṁ, tathā majjāśritō majjaśōṣaṁ kuryādityarthaḥ| kiṁviśiṣṭā pravr̥ttirityāha- vikr̥tā; atiśīghrātimandagrathitavivarṇādiyuktētyarthaḥ||25-29||

Meaning of the commentary

The commentary treats vāyu in skin as vāyu in rasa. Supti is loss of touch sensation, and cumucumāyana is a mustard-paste-like tingling pain. Some omit the phrase about wounds in blood, but the commentator retains it because Gayadāsa accepts it. Muscle-associated nodules are painful, whereas those in medas lack wounds and have little pain. Vessel contraction is the condition popularly described as crooked vessels. Stambha means immobilization and ākṣepaṇa means involuntary movement. Joint involvement prevents contraction and extension. By analogy with bone wasting, marrow involvement also causes marrow wasting. Abnormal śukra discharge may be excessively rapid, delayed, clotted, discolored, or otherwise altered.

Key terms

supti
Numbness or loss of touch sensation.
cumucumAyana (cumucumāyana)
A tingling or prickling sensation compared to mustard paste.
granthi
A nodule or localized swelling.
AkShepaNa (ākṣepaṇa)
Spasmodic or involuntary movement.
shukrapravRutti (śukra-pravṛtti)
Discharge or flow of reproductive material.

Adhikarana 16 (30) · Śloka 30

hastapādaśirōdhātūṁstathā sañcarati kramāt | vyāpnuyādvā'khilaṁ dēhaṁ vāyuḥ sarvagatō nr̥ṇām ||30||

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हस्तपादशिरोधातूंस्तथा सञ्चरति क्रमात् | व्याप्नुयाद्वाऽखिलं देहं वायुः सर्वगतो नृणाम् ||३०||

Meaning of the śloka

Vāyu may proceed successively through the hands, feet, head, and bodily tissues, or it may spread throughout the entire body and become all-pervading in a person.

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ēkāṅgagata ēkadhātugatō vā'pyupēkṣitaḥ sarvāṅgagataḥ sarvadhātugatō vā bhavatīti darśayannāha- hastētyādi| vāyustathā hastapādaśiraḥ kramāt sañcarati yathā upēkṣitaḥ sannakhilaṁ dēhaṁ vyāpnuyāt, tathā dhātūn kramāt sañcarati yathā sarvagatō vā bhavati sarvadhātugatō vā bhavatītyarthaḥ| vyāpnuyādvēti vāśabdō bhinnakramē, sarvagatō vētyatra draṣṭavyaḥ||30||

Meaning of the commentary

The commentary says vāyu initially confined to one limb or one tissue may, if neglected, become distributed through all limbs or all tissues. The syntax places the alternative particle with 'all-pervading': vāyu may move successively through the hands, feet, and head, just as it may spread through the whole body; similarly, it may move successively through the tissues or become present in them all.

Key terms

ekA~ggagata (ekāṅga-gata)
Located in a single limb or bodily part.
ekadhAtugata (eka-dhātu-gata)
Located in one tissue category.
sarvagata (sarva-gata)
Spread throughout the whole body or all tissues.

Adhikarana 17 (31) · Śloka 31

stambhanākṣēpaṇasvāpaśōphaśūlāni sarvagaḥ |31|

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स्तम्भनाक्षेपणस्वापशोफशूलानि सर्वगः |३१|

Meaning of the śloka

When vāyu has spread throughout the body, it causes stiffness, spasmodic movement, numbness, swelling, and pain.

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tasyēdānīṁ sarvāṅgagatasya liṅgaṁ darśayannāha- stambhanētyādi| sarvagō vāyuḥ sarvasmiñ śarīrē stambhanādikaṁ karōti|31|-

Meaning of the commentary

The commentary identifies these as the signs of vāyu affecting all the limbs and says that body-wide vāyu produces stiffness and the other listed manifestations throughout the body.

Key terms

stambhana
Stiffness or loss of normal movement.
AkShepaNa (ākṣepaṇa)
Spasmodic or involuntary movement.
svApa (svāpa)
Numbness or loss of sensation.
shopha (śopha)
Swelling.

Adhikarana 18 (31) · Śloka 31

sthānēṣūktēṣu sammiśraḥ sammiśrāḥ kurutē rujaḥ ||31||

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स्थानेषूक्तेषु सम्मिश्रः सम्मिश्राः कुरुते रुजः ||३१||

Meaning of the śloka

When vāyu in the previously described locations is mixed with other doṣas, it produces correspondingly mixed forms of pain and disorder.

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tasya vāyōḥ prasaraṇē pittādisaṁyuktasya pittādyāvaraṇapratipattihētuṁ darśayannāha- sthānēṣvityādi| miśraḥ pittādibhiḥ| pittādīnāmauṣṇyādisvabhāvaliṅgadarśanāddāhādikāryaliṅgadarśanācca pittādyāvaraṇaṁ jñēyaṁ; kēvalasya vāyōḥ śītasvabhāvatvāddāhaḥ pittaṁ vinā nōtpadyata iti||31||

Meaning of the commentary

The commentary explains 'mixed' as associated with pitta and the other doṣas. Obstruction of vāyu by pitta or another doṣa is inferred from seeing that doṣa's intrinsic qualities and effects—for example heat and burning indicate pitta, because vāyu alone is considered cool and cannot produce burning without pitta.

Key terms

sammishra (sammiśra)
Mixed or combined with another doṣa.
AvaraNa (āvaraṇa)
Obstruction or covering of vāyu by another factor.
dAha (dāha)
Burning sensation, taken here as evidence of pitta involvement.

Adhikarana 19 (32) · Śloka 32

kuryādavayavaprāptō mārutastvamitān gadān |32|

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कुर्यादवयवप्राप्तो मारुतस्त्वमितान् गदान् |३२|

Meaning of the śloka

When māruta reaches individual parts of the body, it can produce innumerable disorders.

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tasyēdānīmavayavagatasyānēkarōgakāraṇatvaṁ darśayannāha- kuryādityādi|32|-

Meaning of the commentary

The commentary introduces the capacity of vāta, when located in particular bodily parts, to cause many different diseases.

Key terms

avayavaprApta (avayava-prāpta)
Having reached or become situated in a particular bodily part.
mAruta (māruta)
Vāta, the doṣa discussed as producing disorders here.
amita gadA (amita gadāḥ)
Innumerable diseases or disorders.

Adhikarana 20 (32-39) · Śloka 39

dāhasantāpamūrcchāḥ syurvāyau pittasamanvitē ||32|| śaityaśōphagurutvāni tasminnēva kaphāvr̥tē | sūcībhiriva nistōdaḥ sparśadvēṣaḥ prasuptatā ||33|| śēṣāḥ pittavikārāḥ syurmārutē śōṇitānvitē | prāṇē pittāvr̥tē chardirdāhaścaivōpajāyatē ||34|| daurbalyaṁ sadanaṁ tandrā vaivarṇyaṁ ca kaphāvr̥tē | udānē pittasaṁyuktē mūrcchādāhabhramaklamāḥ ||35|| asvēdaharṣau mandō'gniḥ śītastambhau kaphāvr̥tē | samānē pittasaṁyuktē svēdadāhauṣṇyamūrcchanam ||36|| kaphādhikaṁ ca viṇmūtraṁ rōmaharṣaḥ kaphāvr̥tē | apānē pittasaṁyuktē dāhauṣṇyē syādasr̥gdaraḥ ||37|| adhaḥkāyagurutvaṁ ca tasminnēva kaphāvr̥tē | vyānē pittāvr̥tē dāhō gātravikṣēpaṇaṁ klamaḥ ||38|| gurūṇi sarvagātrāṇi stambhanaṁ cāsthiparvaṇām | liṅgaṁ kaphāvr̥tē vyānē cēṣṭāstambhastathaiva ca ||39||

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दाहसन्तापमूर्च्छाः स्युर्वायौ पित्तसमन्विते ||३२|| शैत्यशोफगुरुत्वानि तस्मिन्नेव कफावृते | सूचीभिरिव निस्तोदः स्पर्शद्वेषः प्रसुप्तता ||३३|| शेषाः पित्तविकाराः स्युर्मारुते शोणितान्विते | प्राणे पित्तावृते छर्दिर्दाहश्चैवोपजायते ||३४|| दौर्बल्यं सदनं तन्द्रा वैवर्ण्यं च कफावृते | उदाने पित्तसंयुक्ते मूर्च्छादाहभ्रमक्लमाः ||३५|| अस्वेदहर्षौ मन्दोऽग्निः शीतस्तम्भौ कफावृते | समाने पित्तसंयुक्ते स्वेददाहौष्ण्यमूर्च्छनम् ||३६|| कफाधिकं च विण्मूत्रं रोमहर्षः कफावृते | अपाने पित्तसंयुक्ते दाहौष्ण्ये स्यादसृग्दरः ||३७|| अधःकायगुरुत्वं च तस्मिन्नेव कफावृते | व्याने पित्तावृते दाहो गात्रविक्षेपणं क्लमः ||३८|| गुरूणि सर्वगात्राणि स्तम्भनं चास्थिपर्वणाम् | लिङ्गं कफावृते व्याने चेष्टास्तम्भस्तथैव च ||३९||

Meaning of the śloka

When vāyu is associated with pitta, burning, heat, and fainting may occur. When that vāyu is covered by kapha, coldness, swelling, and heaviness occur. When associated with blood, there may be needle-like pricking, intolerance of touch, numbness, and other pitta-type changes. If prāṇa vāyu is covered by pitta, vomiting and burning arise; if covered by kapha, weakness, fatigue, drowsiness, and altered colour arise. Pitta joined with udāna produces fainting, burning, dizziness, and exhaustion; kapha covering udāna produces absence of sweating, horripilation, weak digestive fire, coldness, and stiffness. Pitta joined with samāna produces sweating, burning, heat, and fainting; kapha covering it produces stool and urine rich in kapha and horripilation. Pitta joined with apāna produces burning, heat, and uterine bleeding; kapha covering it produces heaviness of the lower body. Pitta covering vyāna produces burning, limb-throwing movements, and exhaustion; kapha covering vyāna produces heaviness of all limbs, stiffness of bone-joints, and arrested movement.

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idānīṁ sammiśrāḥ kurutē ruja iti sūtritamāvaraṇaṁ vivr̥ṇvannāha- dāhētyādi| dāhō'gnidagdhasyēva, santāpō gharmādisaṁsthitasyēva| śaityaśōphētyādi| tasminnēva vāyau| sūcībhirityādi| sadanam aṅgaglāniḥ| klamō'nāyāsaśramaḥ| harṣō rōmaharṣaḥ| kaphādhikaṁ ślēṣmabahulaṁ viṣṭhāmūtram| asr̥gdaraḥ strīṇāmēva| asthiparvaṇām asthisandhīnām| cēṣṭā gamanādikāḥ||32-39||

Meaning of the commentary

The commentary expands the earlier statement that mixed causes produce mixed symptoms and explains āvaraṇa patterns. Burning is compared with fire injury, and santāpa with exposure to intense environmental heat. Needle-like pain, touch intolerance, dryness, and loss of touch perception describe blood-associated vāta. Sadana means bodily fatigue; klama is fatigue without exertion; harṣa means horripilation. ‘Kapha-rich stool and urine’ means stool and urine containing abundant śleṣman. Asṛgdara is specified as a condition of women. Asthi-parvan means the joints between bones, and ceṣṭā includes walking and other movements.

Key terms

AvaraNa (āvaraṇa)
Covering or obstruction of one functional principle by another in classical pathology.
prANa-udAna-samAna-apAna-vyAna (prāṇa-udāna-samāna-apāna-vyāna)
Five named functional divisions of vāta differentiated in the passage.
svApa (svāpa)
Loss or diminution of touch sensation.
asRugdara (asṛgdara)
A classical category of excessive uterine bleeding.
ceShTAstambha (ceṣṭā-stambha)
Arrest or severe restriction of movement.

Adhikarana 21 (40-41) · Śloka 41

(prāyaśaḥ sukumārāṇāṁ mithyā''hāravihāriṇām | rōgādhvapramadāmadyavyāyāmaiścātipīḍanāt ||40|| r̥tusātmyaviparyāsāt snēhādīnāṁ ca vibhramāt | avyavāyē tathā sthūlē vātaraktaṁ prakupyati ) ||41||

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(प्रायशः सुकुमाराणां मिथ्याऽऽहारविहारिणाम् | रोगाध्वप्रमदामद्यव्यायामैश्चातिपीडनात् ||४०|| ऋतुसात्म्यविपर्यासात् स्नेहादीनां च विभ्रमात् | अव्यवाये तथा स्थूले वातरक्तं प्रकुप्यति ) ||४१||

Meaning of the śloka

Vātarakta is said to become aggravated especially in delicate persons who follow unsuitable food and activity, who are excessively strained by illness, travel, sexual activity, alcohol, or exercise, who act contrary to seasonal suitability or misuse oleation and related measures, and in inactive or stout persons.

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sūcībhiriva nistōda ityādivākyēnāprakupitaśōṇitāvr̥tavātasya lakṣaṇamuktvā, idānīṁ prakupitaśōṇitāvr̥tavātajanyasya vātaraktasya prakōpakāraṇaṁ darśayannāha- prāyaśa ityādi| sukumārāṇāṁ vātaraktaṁ prakupyatīti sambandhaḥ| mithyāhāravihāriṇāmiti mithyā anucitaḥ, vihāraḥ kāyavāṅmanōvyāpāraḥ| adhvā mārgaḥ, vyāyāmaḥ śarīrāyāsajananaṁ karma| vibhramaḥ anyathākaraṇam| avyavāyē maithunavarjitē| kēcit ‘prāyaśaḥ sukumārāṇāṁ’ ityādigranthaṁ ‘vātaraktaṁ prakupyati’ iti yāvanna paṭhanti, cikitsitē paṭhiṣyamāṇatvāt||40-41||

Meaning of the commentary

After describing vāta covered by blood that is not itself aggravated, the commentary introduces causes for vātarakta produced when aggravated blood obstructs vāta. Sukumāra refers to a delicate person. Mithyā-vihāra means inappropriate actions of body, speech, and mind; adhvan is travel; vyāyāma is exertion-producing activity; vibhrama means performing oleation and similar measures incorrectly; and avyavāya is abstention from sexual activity. Some authorities omit this whole passage through ‘vātarakta becomes aggravated’ because it appears again in the treatment section.

Key terms

vAtarakta (vātarakta)
A classical disorder explained through interaction of vāta and aggravated blood.
mithyAhAravihAra (mithyāhāra-vihāra)
Inappropriate diet and bodily, verbal, or mental activity.
RutusAtmyaviparyAsa (ṛtu-sātmya-viparyāsa)
Conduct contrary to what is considered suitable for the season.
snehAdivibhrama (snehādi-vibhrama)
Incorrect use of oleation and related procedures.

Adhikarana 22 (42-44) · Śloka 44

hastyaśvōṣṭrairgacchatō'nyaiśca vāyuḥ kōpaṁ yātaḥ kāraṇai sēvitaiḥ svaiḥ | tīkṣṇōṣṇāmlakṣāraśākādibhōjyaiḥ santāpādyairbhūyasā sēvitaiśca ||42|| kṣipraṁ raktaṁ duṣṭimāyāti tacca vāyōrmārgaṁ saṁruṇaddhyāśu yātaḥ | kruddhō'tyarthaṁ mārgarōdhāt sa vāyuratyudriktaṁ dūṣayēdraktamāśu ||43|| tat sampr̥ktaṁ vāyunā dūṣitēna tatprābalyāducyatē vātaraktam | tadvat pittaṁ dūṣitēnāsr̥jā''ktaṁ ślēṣmā duṣṭō dūṣitēnāsr̥jā''ktaḥ ||44||

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हस्त्यश्वोष्ट्रैर्गच्छतोऽन्यैश्च वायुः कोपं यातः कारणै सेवितैः स्वैः | तीक्ष्णोष्णाम्लक्षारशाकादिभोज्यैः सन्तापाद्यैर्भूयसा सेवितैश्च ||४२|| क्षिप्रं रक्तं दुष्टिमायाति तच्च वायोर्मार्गं संरुणद्ध्याशु यातः | क्रुद्धोऽत्यर्थं मार्गरोधात् स वायुरत्युद्रिक्तं दूषयेद्रक्तमाशु ||४३|| तत् सम्पृक्तं वायुना दूषितेन तत्प्राबल्यादुच्यते वातरक्तम् | तद्वत् पित्तं दूषितेनासृजाऽऽक्तं श्लेष्मा दुष्टो दूषितेनासृजाऽऽक्तः ||४४||

Meaning of the śloka

Travel on elephants, horses, camels, or other comparable exertions, together with vāta-provoking causes, is said to aggravate vāyu. Frequent use of sharp, hot, sour, alkaline, leafy, and similar foods, heat exposure, and related causes quickly vitiates blood. The affected blood blocks the rapidly moving pathway of vāyu; vāyu, greatly aggravated by that obstruction, further vitiates the increased blood. Because vāyu predominates in their association, the condition is called vātarakta. Similarly, pitta or kapha may become mixed with vitiated blood.

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tasya samprāptiṁ darśayannāha- hastītyādi| anyaiścēti aparairbhāraharaṇādibhiḥ kāraṇairityarthaḥ| kōpaṁ yātaḥ kōpaṁ gata ityarthaḥ| kāraṇaiḥ sēvitaiḥ svairvidāhyādibhiḥ| tacca raktaṁ vāyōrmārgaṁ saṁruṇaddhi| kathambhūtasya vāyōrityāha- āśu yātaḥ, śīghraṁ gacchata ityarthaḥ| atyudriktam atiśayēna vr̥ddhiṅgataṁ raktam| tat sampr̥ktamiti tadraktaṁ, sampr̥ktaṁ saṁsr̥ṣṭam| vāyunā dūṣitēnēti dūṣitēna vāyunā saha| tatprābalyāt vātaprābalyācchōṇitasyāprābalyāt, tayōrvātaraktayōḥ prābalyāditi kēcit| tadvat pittamiti duṣṭaṁ pittamityarthaḥ, dūṣitēnāsr̥jā''ktamiti dūṣitēna raktēna miśram||42-44||

Meaning of the commentary

The commentary presents the classical pathogenesis. ‘Other’ causes include load carrying; vāyu’s own causes include foods producing burning and similar effects. Vitiated blood obstructs the path of quickly moving vāyu. The resulting, highly aggravated vāyu then affects the excessively increased blood. Tat-prābalya is interpreted as predominance of vāta and relative weakness of blood, though some understand it as the combined predominance of both vāta and blood. The closing lines similarly refer to vitiated pitta or kapha mixed with vitiated blood.

Key terms

samprApti (samprāpti)
The classical account of how the disorder develops.
mArgarodha (mārga-rodha)
Obstruction of vāyu’s pathway by affected blood.
vAtarakta (vātarakta)
The disorder named for the association and stated predominance of vāta with blood.
tatprAbalya (tat-prābalya)
Predominance interpreted either as vāta alone or as both vāta and blood.

Adhikarana 23 (45-46) · Śloka 46

sparśōdvignau tōdabhēdapraśōṣasvāpōpētau vātaraktēna pādau | pittāsr̥gbhyāmugradāhau bhavētāmatyarthōṣṇau raktaśōphau mr̥dū ca ||45|| kaṇḍūmantau śvētaśītau saśōphau pīnastabdhau ślēṣmaduṣṭē tu raktē | sarvairduṣṭē śōṇitē cāpi dōṣāḥ svaṁ svaṁ rūpaṁ pādayōrdarśayanti ||46||

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स्पर्शोद्विग्नौ तोदभेदप्रशोषस्वापोपेतौ वातरक्तेन पादौ | पित्तासृग्भ्यामुग्रदाहौ भवेतामत्यर्थोष्णौ रक्तशोफौ मृदू च ||४५|| कण्डूमन्तौ श्वेतशीतौ सशोफौ पीनस्तब्धौ श्लेष्मदुष्टे तु रक्ते | सर्वैर्दुष्टे शोणिते चापि दोषाः स्वं स्वं रूपं पादयोर्दर्शयन्ति ||४६||

Meaning of the śloka

When vāta predominates in vātarakta, the feet are intolerant of touch and have pricking, splitting pain, dryness, and numbness. When pitta and blood predominate, the feet show intense burning, marked heat, soft red swelling. When kapha affects the blood, the feet itch and are pale or white, cold, swollen, enlarged, and stiff. When all factors affect the blood, each displays its own features in the feet.

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tasyēdānīṁ vātādiviśēṣēṇa viśiṣṭaliṅgaṁ darśayannāha- sparśōdvignāvityādi| sparśōdvignau sparśāsahau pādāviti sambandhaḥ| praśōṣaḥ śuṣkatā, svāpaḥ sparśājñānam| ētēna vātaprabalavātaraktalakṣaṇamuktam| pittāsr̥gbhyāmiti vātaśōṇita ēva yadā pittamasr̥k ca balavattaraṁ bhavati tadētyarthaḥ| raktaśōphau raktavarṇaśōphau| kaṇḍūmantau pādāviti sambandhaḥ| pīnau sthūlau||45-46||

Meaning of the commentary

The commentary gives distinguishing signs according to the predominant doṣa. Sparśodvigna means that the feet cannot tolerate touch; praśoṣa is dryness and svāpa is loss of touch sensation. These characterize vāta-predominant vātarakta. In the next group, pitta and blood are especially strong within vāta-blood disease; rakta-śopha is red-coloured swelling. In the kapha pattern, the feet are itchy and pīna means enlarged or thick. When all are affected, their respective signs appear together.

Key terms

sparshodvigna (sparśodvigna)
Unable to tolerate touch.
svApa (svāpa)
Loss or diminution of touch sensation.
raktashopha (rakta-śopha)
Red-coloured swelling.
doShaprAbalya (doṣa-prābalya)
Predominance of a doṣa used to distinguish symptom patterns.

Adhikarana 24 (47) · Śloka 47

prāgrūpē śithilau svinnau śītalau saviparyayau | vaivarṇyatōdasuptatvagurutvauṣasamanvitau ||47||

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प्राग्रूपे शिथिलौ स्विन्नौ शीतलौ सविपर्ययौ | वैवर्ण्यतोदसुप्तत्वगुरुत्वौषसमन्वितौ ||४७||

Meaning of the śloka

As preliminary signs, the feet may be lax, sweaty, cold, or show their opposites—hardness, absence of sweat, and heat—together with altered colour, pricking pain, numbness, heaviness, and burning.

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tasya pūrvarūpamāha- prāgrūpē ityādi| saviparyayāviti kaṭhināsvinnōṣṇau, ‘pādau’ ityadhyāhāraḥ| ōṣō dāhaḥ| kēcidatra pūrvarūpaṁ na paṭhanti, cikitsāyāṁ paṭhiṣyamāṇatvāt||47||

Meaning of the commentary

The commentary identifies these as prodromal signs of vātarakta and supplies ‘the feet’ as the subject. Saviparyaya means that the opposite signs may also occur: hardness instead of laxity, lack of sweating instead of sweating, and heat instead of coldness. Oṣa means burning. Some authorities omit this prodromal passage here because it is read in the treatment section.

Key terms

prAgrUpa (prāgrūpa)
A preliminary or prodromal sign before the disease is fully expressed.
saviparyaya (sa-viparyaya)
Accompanied by the stated opposite signs.
vaivarNya (vaivarṇya)
Alteration or abnormality of colour.
oSha (oṣa)
Burning sensation.

Adhikarana 25 (48) · Śloka 48

pādayōrmūlamāsthāya kadāciddhastayōrapi | ākhōrviṣamiva kruddhaṁ taddēhamanusarpati ||48||

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पादयोर्मूलमास्थाय कदाचिद्धस्तयोरपि | आखोर्विषमिव क्रुद्धं तद्देहमनुसर्पति ||४८||

Meaning of the śloka

Beginning at the soles of the feet, and sometimes at the hands, the aggravated disorder is said to spread through the body like the poison of a rat.

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tasyēdānīṁ pādamātrē'bhijātasya kālēnāvayavāntarānusaraṇaṁ nirdiśannāha- pādayōrityādi| mūlamāsthāya talaṁ prāpya| ākhōrityādi undurasya viṣaṁ mūlamāsthāya paścāt kupitaṁ saddēhaṁ sakalamēvānuyāti||48||

Meaning of the commentary

The commentary describes vātarakta as initially limited to the feet and later following other body parts. Mūla is interpreted as the sole. The comparison says that rat poison first takes hold at its point of origin and, once aggravated, subsequently travels throughout the body.

Key terms

pAdayormUla (pādayor mūla)
The soles or basal part of the feet.
anusarpati
Spreads progressively into other parts.
AkhorviSha (ākhor viṣa)
Rat poison, used as a historical simile for spread from a point of origin.

Adhikarana 26 (49) · Śloka 50

ājānusphuṭitaṁ yacca prabhinnaṁ prasrutaṁ ca yat | upadravaiśca yajjuṣṭaṁ prāṇamāṁsakṣayādibhiḥ ||49|| śōṇitaṁ tadasādhyaṁ syādyāpyaṁ saṁvatsarōtthitam |50|

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आजानुस्फुटितं यच्च प्रभिन्नं प्रस्रुतं च यत् | उपद्रवैश्च यज्जुष्टं प्राणमांसक्षयादिभिः ||४९|| शोणितं तदसाध्यं स्याद्याप्यं संवत्सरोत्थितम् |५०|

Meaning of the śloka

Vātarakta that has fissured as far as the knees, has broken open and discharges, or is accompanied by complications such as loss of vitality and wasting of flesh is regarded as incurable. A case arising a year earlier is regarded as manageable but not fully curable.

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tasyēdānīmasādhyādilakṣaṇaṁ darśayannāha- ājānusphuṭitamityādi| ājānusphuṭitaṁ jānuparyantamuccaṭitam| prabhinnaṁ vidīrṇam| prasrutaṁ srāvayuktam| upadravaiḥ prāṇamāṁsakṣayādibhiravāraṇīyōktaiḥ | ādigrahaṇādaṅgulivakratārbudādayō'pi grāhyāḥ| juṣṭaṁ sahitam| yajjānuparyantaṁ sphuṭitaṁ vātaprābalyāt, yacca jānuparyantaṁ prabhinnaṁ prasrutaṁ ca pittaraktaprābalyāt, tadapyasādhyamēva||49||-

Meaning of the commentary

The commentary explains fissuring to the knees as splitting or eruption extending up to that level, prabhinna as ruptured, and prasruta as having discharge. The complications include those described as unavoidable, beginning with loss of vitality and flesh; the word ‘and others’ also includes deformity of the fingers or toes and arbuda-like growths. Fissuring to the knee is attributed to vāta predominance, while rupture and discharge to that level are attributed to predominance of pitta and blood; both are classified as incurable.

Key terms

AjAnusphuTita (ājānu-sphuṭita)
Fissured or erupted as far as the knee.
prabhinna-prasruta
Broken open and accompanied by discharge.
asAdhya (asādhya)
Classified as incurable in the historical prognosis.
yApya (yāpya)
Considered controllable or manageable rather than curable.

Adhikarana 27 (50-51) · Śloka 51

yadā tu dhamanīḥ sarvāḥ kupitō'bhyēti mārutaḥ ||50|| tadākṣipatyāśu muhurmuhurdēhaṁ muhuścaraḥ | muhurmuhustadākṣēpādākṣēpaka iti smr̥taḥ ||51||

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यदा तु धमनीः सर्वाः कुपितोऽभ्येति मारुतः ||५०|| तदाक्षिपत्याशु मुहुर्मुहुर्देहं मुहुश्चरः | मुहुर्मुहुस्तदाक्षेपादाक्षेपक इति स्मृतः ||५१||

Meaning of the śloka

When greatly aggravated māruta enters all the dhamanīs, its recurrent movement repeatedly throws or convulses the body. Because of that repeated bodily movement, the condition is called ākṣepaka.

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idānīṁ vātaraktamabhidhāyākṣēpakamāha- yadētyādi| dhamanyō nāḍyaḥ| abhyēti vyāpnōti| ākṣipati cālayati| muhuścara iti vāraṁvāraṁ calanaśīlō vāyuḥ, muhuścaratvēnaiva muhurmuhurākṣēpaṇaṁ yuktam; anyē tu ‘bahiścara’ iti paṭhanti, tannēcchati gayadāsācāryaḥ| tadākṣēpāt dēhākṣēpāt| idamākṣēpakasya sāmānyalakṣaṇamuktam||50-51||

Meaning of the commentary

The commentary introduces ākṣepaka after vātarakta. Dhamanīs are glossed as nāḍīs; abhyeti means pervades, and ākṣipati means moves or throws. Muhuścara describes vāyu as repeatedly moving and thereby causing recurrent convulsions. Some read bahiścara, ‘moving outward’, but Gayadāsa rejects this reading. This is the general definition of ākṣepaka.

Key terms

AkShepaka (ākṣepaka)
A classical syndrome named for repeated involuntary throwing or convulsive movement of the body.
dhamanI (dhamanī)
A bodily channel, glossed here as nāḍī.
muhushcara (muhuścara)
Moving repeatedly; a variant reads bahiścara, moving outward.

Adhikarana 28 (52-58) · Śloka 58

sō'patānakasañjñō yaḥ pātayatyantarā'ntarā | kaphānvitō bhr̥śaṁ vāyustāsvēva yadi tiṣṭhati ||52|| sa daṇḍavat stambhayati kr̥cchrō daṇḍāpatānakaḥ | hanugrahastadā'tyarthaṁ sō'nnaṁ kr̥cchrānniṣēvatē ||53|| dhanustulyaṁ namēdyastu sa dhanuḥstambhasañjñakaḥ | aṅgulīgulphajaṭharahr̥dvakṣōgalasaṁśritaḥ ||54|| snāyupratānamanilō yadā''kṣipati vēgavān | viṣṭabdhākṣaḥ stabdhahanurbhagnapārśvaḥ kaphaṁ vaman ||55|| abhyantaraṁ dhanuriva yadā namati mānavaḥ | tadā'syābhyantarāyāmaṁ kurutē mārutō balī ||56|| bāhyasnāyupratānasthō bāhyāyāmaṁ karōti ca | tamasādhyaṁ budhāḥ prāhurvakṣaḥkaṭyūrubhañjanam ||57|| kaphapittānvitō vāyurvāyurēva ca kēvalaḥ | kuryādākṣēpakaṁ tvanyaṁ caturthamabhighātajam ||58||

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सोऽपतानकसञ्ज्ञो यः पातयत्यन्तराऽन्तरा | कफान्वितो भृशं वायुस्तास्वेव यदि तिष्ठति ||५२|| स दण्डवत् स्तम्भयति कृच्छ्रो दण्डापतानकः | हनुग्रहस्तदाऽत्यर्थं सोऽन्नं कृच्छ्रान्निषेवते ||५३|| धनुस्तुल्यं नमेद्यस्तु स धनुःस्तम्भसञ्ज्ञकः | अङ्गुलीगुल्फजठरहृद्वक्षोगलसंश्रितः ||५४|| स्नायुप्रतानमनिलो यदाऽऽक्षिपति वेगवान् | विष्टब्धाक्षः स्तब्धहनुर्भग्नपार्श्वः कफं वमन् ||५५|| अभ्यन्तरं धनुरिव यदा नमति मानवः | तदाऽस्याभ्यन्तरायामं कुरुते मारुतो बली ||५६|| बाह्यस्नायुप्रतानस्थो बाह्यायामं करोति च | तमसाध्यं बुधाः प्राहुर्वक्षःकट्यूरुभञ्जनम् ||५७|| कफपित्तान्वितो वायुर्वायुरेव च केवलः | कुर्यादाक्षेपकं त्वन्यं चतुर्थमभिघातजम् ||५८||

Meaning of the śloka

An ākṣepaka that causes a person to fall intermittently is called apatānaka. When vāyu joined with kapha remains strongly in all those dhamanīs, it stiffens the body like a staff; this difficult condition is daṇḍāpatānaka, with severe jaw locking and difficulty taking food. A person who bends like a bow has dhanustambha. When forceful anila affects the network of snāyus associated with the toes, ankles, abdomen, heart, chest, and throat, the eyes and jaw become fixed, the side appears bent, and kapha is vomited; inward bowing is called antarāyāma. When located in the outer snāyu network, it produces outward bowing, bāhyāyāma. Cases with breaking or severe involvement of the chest, waist, and thighs are called incurable. Ākṣepaka is also classified as associated with kapha and pitta, caused by vāyu alone, or caused by trauma.

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ākṣēpakaviśēṣānāha- sō'patānaka ityādi| ya ākṣēpakō'ntarā'ntarā pātayati sō'patānaka ityarthaḥ| idaṁ sāmānyāpatānakalakṣaṇamuktaṁ; gayadāsēnāpatānakalakṣaṇaṁ ‘yēnāpatāmyatē’ ityādivākyēnābhidhāya vyākhyātaṁ, yathā- “yēna vāyunā kartr̥bhūtēna hētubhūtēna vā pumānapatāmyatē tamō dr̥śyatē mōhyatē iti yāvat sō'patānaka iti; sō'yaṁ hr̥disthamanō'dhiṣṭhānēna sakaphēna vāyunā janyatē” iti| sa ēvāpatānakastridhā- daṇḍāpatānakaḥ, antarāyāmaḥ, bahirāyāmaśca; tatra daṇḍāpatānakalakṣaṇamāha- kaphānvita ityādi| tāsvēva sarvāsu dhamanīṣu, bhr̥śaṁ tiṣṭhatīti sambandhaḥ| kr̥cchraḥ kaṣṭasādhyaḥ| hanugrahastu daṇḍāpatānakē'nyatrāpi vāyau syāt| sa daṇḍāpatānakavān puruṣaḥ| dhanuḥstambhasañjñakamantarāyāmaṁ darśayannāha- dhanustulyamityādi| tasyaiva bhāṣyaṁ vaktumāha- aṅgulītyādi| aṅgulyō'tra pādagatāḥ, gulphaḥ pārṣṇērupari granthiḥ, jaṭharamudaraṁ, hr̥t hr̥dayaṁ, vakṣaḥ stanayōrantarālaṁ, galaḥ kaṇṭhaḥ; ētēṣu sthānēṣu saṁśrita āśritō vāyuḥ| snāyupratānaṁ snāyuvistāram| bahirāyāmaṁ nirdiśannāha- bāhyasnāyupratānastha ityādi| bāhyasnāyupratānasthō bāhyasnāyuvistārasthaḥ, bāhyasnāyavaḥ pādamūlapiṇḍikākaṭīpr̥ṣṭhagrīvāpaścimabhāgāśrayāḥ| vakṣaḥkaṭyūrubhañjanamiti vakṣaḥkaṭyūrubhañjanatvē satyēvāsādhyatvam, abhagnavakṣaḥkaṭyādikastu nava upakramya ēva| tasyākṣēpakasyētaradōṣasaṁsargēṇa nidānaviśēṣācca saṅkhyābhēdaṁ darśayannāha- kaphapittānvita ityādi| ēkaḥ kaphānvitaḥ, dvitīyaḥ pittānvitaḥ, tr̥tīyaḥ kēvalavātakr̥taḥ, caturthō'bhighātajaḥ| caturthamabhighātajamiti nidānaviśēṣāt| daṇḍāpatānakādayastrayaścaturthaḥ punarabhighātaja iti śrījējjhaṭaḥ; tannēcchati gayī, garbhapātādinimittabhēdēna saṅkhyātirēkāt| śrībahmadēvastu “ākṣēpakaścaturdhā- apatānakaḥ, saṁsr̥ṣṭākṣēpakaḥ, kēvalākṣēpakaḥ, abhighātajaśca; tatrāpatānakaḥ ‘sō'patānaka’ ityādinā ‘vakṣaḥkaṭyūrubhañjanam’ iti paryantēnōktaḥ, ‘kaphānvitō vāyuḥ’ iti saṁsr̥ṣṭākṣēpakaḥ, ‘vāyurēva ca kēvalaḥ’ iti kēvalākṣēpakaḥ, caturthaḥ punarabhighātajaḥ” ityāha||52-58||

Meaning of the commentary

The commentary distinguishes forms of ākṣepaka. Apatānaka generally means intermittent falling; Gayadāsa elsewhere explains it as a state in which a person falls, sees darkness, or loses awareness, caused by vāyu with kapha acting through the heart and mind. Apatānaka has three forms: daṇḍāpatānaka, antarāyāma, and bahirāyāma. Daṇḍāpatānaka is difficult to cure; jaw locking may also occur in other vāta disorders. Dhanustambha names antarāyāma. The listed locations include toes, the ankle joint above the heel, abdomen, heart, chest, and throat. Outer snāyus are placed along the soles, calves, waist, back, and posterior neck. Bāhyāyāma is incurable only when the chest, waist, or thighs are described as broken; a new case without that feature may be treated. One classification counts kapha-associated, pitta-associated, pure-vāta, and traumatic forms. Jejjaṭa instead counts the first three bowing syndromes plus trauma; Gayī rejects this because miscarriage and other causes yield additional categories. Brahmadeva counts apatānaka, mixed-doṣa ākṣepaka, pure ākṣepaka, and traumatic ākṣepaka.

Key terms

apatAnaka (apatānaka)
A classical ākṣepaka syndrome marked by intermittent falling or loss of awareness.
daNDApatAnaka (daṇḍāpatānaka)
A form with staff-like rigidity and often severe jaw locking.
antarAyAma (antarāyāma)
A form with inward bow-like bending.
bAhyAyAma (bāhyāyāma)
A form with outward bow-like bending.
snAyupratAna (snāyu-pratāna)
An extended network of snāyus implicated in the described postures.

Adhikarana 29 (59) · Śloka 59

garbhapātanimittaśca śōṇitātisravācca yaḥ | abhighātanimittaśca na sidhyatyapatānakaḥ ||59||

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गर्भपातनिमित्तश्च शोणितातिस्रवाच्च यः | अभिघातनिमित्तश्च न सिध्यत्यपतानकः ||५९||

Meaning of the śloka

Apatānaka arising from miscarriage, excessive bleeding, or trauma is said not to be curable.

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tasyaivākṣēpakasyāpatānakasañjñāṁ prāptasyāsādhyatvaṁ darśayannāha- garbhapātanimittaścētyādi| garbhapātādinimittāstrayō'pyāgantavō'sādhyāḥ; yadi kathañciddaivayōgāt sidhyanti tadā vaikalyaṁ janayanti||59||

Meaning of the commentary

The commentary classifies these three causes as externally arising and incurable. It adds that if recovery occurs exceptionally through favourable fortune, disability remains.

Key terms

garbhapAtanimitta (garbha-pāta-nimitta)
Arising in connection with miscarriage or pregnancy loss.
shoNitAtisrava (śoṇitāti-srava)
Excessive loss of blood.
abhighAtaja (abhighāta-ja)
Arising from trauma.
asAdhya (asādhya)
Classified as incurable in the historical text.

Adhikarana 30 (60-62) · Śloka 62

adhōgamāḥ satiryaggā dhamanīrūrdhvadēhagāḥ | yadā prakupitō'tyarthaṁ mātariśvā prapadyatē ||60|| tadā'nyatarapakṣasya sandhibandhān vimōkṣayan | hanti pakṣaṁ tamāhurhi pakṣāghātaṁ bhiṣagvarāḥ ||61|| yasya kr̥tsnaṁ śarīrārdhamakarmaṇyamacētanam | tataḥ patatyasūn vā'pi tyajatyanilapīḍitaḥ ||62||

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अधोगमाः सतिर्यग्गा धमनीरूर्ध्वदेहगाः | यदा प्रकुपितोऽत्यर्थं मातरिश्वा प्रपद्यते ||६०|| तदाऽन्यतरपक्षस्य सन्धिबन्धान् विमोक्षयन् | हन्ति पक्षं तमाहुर्हि पक्षाघातं भिषग्वराः ||६१|| यस्य कृत्स्नं शरीरार्धमकर्मण्यमचेतनम् | ततः पतत्यसून् वाऽपि त्यजत्यनिलपीडितः ||६२||

Meaning of the śloka

When highly aggravated mātariśvan enters the upward-, downward-, and transverse-going dhamanīs of one half of the body, it loosens the joint-bindings and disables that side; physicians call this pakṣāghāta. The entire half of the body becomes functionally impaired and has diminished sensation or consciousness; the person may fall or lose life under the affliction of anila.

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pakṣāghātamāha- adhōgamā ityādi| ēkataraśarīrārdhadhamanīrūrdhvādhastiryaggatā yadā sa mātariśvā vāyuḥ, prapadyatē āśrayatītyarthaḥ, tadā'nyatarapakṣasyaikataraśarīrārdhasya, sandhibandhān vimōkṣayan vimōcayan, pakṣaṁ śarīrārdhaṁ hanti| yasya kr̥tsnamityādi| akarmaṇyam īṣatkarmakṣamam, acētanam alpacētanam; yadā akarmaṇyaṁ bhavati tadā patati; yadā acētanaṁ bhavati tadā asūn prāṇān parityajati||60-62||

Meaning of the commentary

The commentary explains that vāyu occupies the upward, downward, and transverse channels of one bodily half, loosens its joint-bindings, and strikes or disables that half. Akarmaṇya is interpreted as having only slight capacity for action, and acetana as having little sensation or awareness. It reads the final outcomes conditionally: functional incapacity causes falling, while loss of consciousness is associated with loss of life.

Key terms

pakShAghAta (pakṣāghāta)
A classical syndrome involving loss of function in one half of the body.
dhamanI (dhamanī)
Channels described as running upward, downward, and transversely.
sandhibandha (sandhi-bandha)
The binding or support of joints, said here to be loosened.
akarmaNya-acetana (akarmaṇya-acetana)
Functionally impaired and having reduced sensation or awareness.

Adhikarana 31 (63) · Śloka 63

śuddhavātahataṁ pakṣaṁ kr̥cchrasādhyatamaṁ viduḥ | sādhyamanyēna saṁsr̥ṣṭamasādhyaṁ kṣayahētukam ||63||

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शुद्धवातहतं पक्षं कृच्छ्रसाध्यतमं विदुः | साध्यमन्येन संसृष्टमसाध्यं क्षयहेतुकम् ||६३||

Meaning of the śloka

Pakṣāghāta caused by vāta alone is regarded as extremely difficult to cure; when associated with another doṣa it is described as curable; when caused by depletion it is incurable.

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pakṣāghātasya sādhyāsādhyatvaṁ darśayannāha- śuddhavātahatamityādi| śuddhaḥ kaphādyasaṁsr̥ṣṭaḥ| anyēna saṁsr̥ṣṭam itaradōṣasambaddham||63||

Meaning of the commentary

The commentary explains śuddha vāta as vāta not mixed with kapha or another doṣa, and ‘associated with another’ as joined with a different doṣa. The verse classifies prognosis according to these causes.

Key terms

shuddhavAta (śuddha-vāta)
Vāta acting alone, without association with kapha or another doṣa.
kRucchrasAdhya (kṛcchra-sādhya)
Considered very difficult to cure.
saMsRuShTa (saṃsṛṣṭa)
Associated or mixed with another doṣa.
kShayahetuka (kṣaya-hetuka)
Attributed to depletion or wasting.

Adhikarana 32 (64-66) · Śloka 66

vāyurūrdhvaṁ vrajēt sthānāt kupitō hr̥dayaṁ śiraḥ | śaṅkhau ca pīḍayatyaṅgānyākṣipēnnamayēcca saḥ ||64|| nimīlitākṣō niścēṣṭaḥ stabdhākṣō vā'pi kūjati | nirucchvāsō'thavā kr̥cchrāducchvasyānnaṣṭacētanaḥ ||65|| svasthaḥ syāddhr̥dayē muktē hyāvr̥tē tu pramuhyati | kaphānvitēna vātēna jñēya ēṣō'patantrakaḥ ||66||

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वायुरूर्ध्वं व्रजेत् स्थानात् कुपितो हृदयं शिरः | शङ्खौ च पीडयत्यङ्गान्याक्षिपेन्नमयेच्च सः ||६४|| निमीलिताक्षो निश्चेष्टः स्तब्धाक्षो वाऽपि कूजति | निरुच्छ्वासोऽथवा कृच्छ्रादुच्छ्वस्यान्नष्टचेतनः ||६५|| स्वस्थः स्याद्धृदये मुक्ते ह्यावृते तु प्रमुह्यति | कफान्वितेन वातेन ज्ञेय एषोऽपतन्त्रकः ||६६||

Meaning of the śloka

When aggravated vāyu rises from its place, it presses upon the heart, head, and temples, throws and bends the limbs, and the person may close the eyes, become motionless or fixed-eyed, make a cooing sound, cease breathing, breathe only with difficulty, and lose consciousness. When the heart is released the person becomes normal; when it is covered, the person loses awareness. This is known as apatantraka, caused by vāta associated with kapha.

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apatantrakamāha- vāyurūrdhvamityādi| hr̥dayaṁ śiraḥ śaṅkhau ca pīḍayatīti hr̥dayaṁ kamalamukulākāramadhōmukhaṁ, bhruvōrantōpari karṇalalāṭayōrmadhyē śaṅkhau, aṅgāni hastapādādīni| ākṣipēt pātayēt | kūjati kapōta iva śabdaṁ karōti; athavā kr̥cchrāducchvasyāditi kaṣṭēnōcchvāsaṁ kuryāt| kēcidapatantrakamamuṁ na paṭhanti, apatantrakāpatānakayōraikyāt||64-66||

Meaning of the commentary

The commentary describes apatantraka. It identifies the heart as the downward-facing lotus-bud-shaped organ, the temples as the regions above the ends of the eyebrows between ears and forehead, and the limbs as hands, feet, and other parts. Ākṣipet means throws down. Kūjati means making a pigeon-like sound; alternatively the person exhales or breathes with difficulty. Some authorities omit apatantraka as a separate condition because they regard apatantraka and apatānaka as identical.

Key terms

apatantraka
A classical episodic syndrome involving collapse, abnormal movement, breathing, and awareness.
sha~gkha (śaṅkha)
The temple region of the head.
kUjati (kūjati)
Makes a pigeon-like sound according to the commentary.
naShTacetana (naṣṭa-cetana)
Loss of consciousness or awareness.

Adhikarana 33 (67) · Śloka 67

divāsvapnāsanasthānavivr̥tādhvanirīkṣaṇaiḥ | manyāstambhaṁ prakurutē sa ēva ślēṣmaṇā''vr̥taḥ ||67||

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दिवास्वप्नासनस्थानविवृताध्वनिरीक्षणैः | मन्यास्तम्भं प्रकुरुते स एव श्लेष्मणाऽऽवृतः ||६७||

Meaning of the śloka

That same vāyu, covered by śleṣman, is said to produce manyāstambha through daytime sleep, prolonged sitting or standing, and looking along a path with the neck turned.

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manyāstambhamāha- divāsvapnētyādi| āsanam upavēśanaṁ, sthānam ūrdhvībhavanaṁ| vivr̥tādhvanirīkṣaṇaiḥ vakramārgāvalōkanaiḥ| sa ēva vāyuḥ| manyāstambhaṁ kēcidapatānakapūrvarūpaṁ manyantē||67||

Meaning of the commentary

The commentary defines āsana as sitting and sthāna as remaining upright. Vivṛtādhva-nirīkṣaṇa means looking along a path while turned or twisted. Some regard manyāstambha as a prodromal sign of apatānaka.

Key terms

manyAstambha (manyāstambha)
Stiffness of the neck region in this classical category.
divAsvapna (divāsvapna)
Sleeping during the daytime.
vivRutAdhvanirIkShaNa (vivṛtādhva-nirīkṣaṇa)
Looking along a route with the neck turned.
shleShmAvRuta vAyu (śleṣmāvṛta vāyu)
Vāyu described as covered or obstructed by kapha.

Adhikarana 34 (68-72) · Śloka 72

(garbhiṇīsūtikābālavr̥ddhakṣīṇēṣvasr̥kkṣayē |) uccairvyāharatō'tyarthaṁ khādataḥ kaṭhināni vā | hasatō jr̥mbhatō bhārādviṣamācchayanādapi ||68|| śirōnāsauṣṭhacibukalalāṭēkṣaṇasandhigaḥ | ardayitvā'nilō vaktramarditaṁ janayatyataḥ ||69|| vakrībhavati vaktrārdhaṁ grīvā cāpyapavartatē | śiraścalati vāksaṅgō nētrādīnāṁ ca vaikr̥tam ||70|| grīvācibukadantānāṁ tasmin pārśvē tu vēdanā | yasyāgrajō rōmaharṣō vēpathurnētramāvilam ||71|| vāyurūrdhvaṁ tvaci svāpastōdō manyāhanugrahaḥ | tamarditamiti prāhurvyādhiṁ vyādhiviśāradāḥ ||72||

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(गर्भिणीसूतिकाबालवृद्धक्षीणेष्वसृक्क्षये |) उच्चैर्व्याहरतोऽत्यर्थं खादतः कठिनानि वा | हसतो जृम्भतो भाराद्विषमाच्छयनादपि ||६८|| शिरोनासौष्ठचिबुकललाटेक्षणसन्धिगः | अर्दयित्वाऽनिलो वक्त्रमर्दितं जनयत्यतः ||६९|| वक्रीभवति वक्त्रार्धं ग्रीवा चाप्यपवर्तते | शिरश्चलति वाक्सङ्गो नेत्रादीनां च वैकृतम् ||७०|| ग्रीवाचिबुकदन्तानां तस्मिन् पार्श्वे तु वेदना | यस्याग्रजो रोमहर्षो वेपथुर्नेत्रमाविलम् ||७१|| वायुरूर्ध्वं त्वचि स्वापस्तोदो मन्याहनुग्रहः | तमर्दितमिति प्राहुर्व्याधिं व्याधिविशारदाः ||७२||

Meaning of the śloka

In pregnancy, after childbirth, childhood, old age, depletion, or loss of blood—and also after excessively loud speaking, chewing hard substances, laughing, yawning, carrying an uneven load, or lying awkwardly—anila affecting the joints of the head, nose, lips, chin, forehead, and eyes is said to cause ardita. One half of the face becomes crooked and the neck may turn; the head shakes, speech is obstructed, and the eyes and related structures become abnormal. Pain occurs in the neck, chin, and teeth on the affected side. Preceding signs include horripilation, tremor, a clouded eye, upward movement of vāyu, numbness and pricking of the skin, and stiffness of the neck and jaw. Specialists call this disorder ardita.

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arditamāha- garbhiṇītyādi| sūtikā prasūtā strī| vyāharataḥ śabdaṁ kurvataḥ| bhārādviṣamācchayanādapīti viṣamādbhārāt, viṣamācchayanāccētyarthaḥ| anyē tu ‘viṣamōcchvasanāt’ iti paṭhanti| ardayitvā vyathayitvā| apavartatē vakrībhavati| vāksaṅgō vācō'nirgamaḥ| nētrādīnāmityādiśabdād bhrūgaṇḍādyupasaṅgrahaḥ| tasmin pārśvē iti yasmin pārśvē'rditaṁ bhavati tasmin pārśvē grīvādayō vakrībhavanti| cibukaṁ mukhakuharasyādhōbhāgaḥ| tasya (pūrva)rūpamāha- yasyētyādi| agrajaḥ pūrvabhāvī| āvilaṁ samalam| vāyurūrdhvaṁ ‘prasarpati’ iti śēṣaḥ| tvaci svāpaḥ tvacaḥ sparśājñānam||68-72||

Meaning of the commentary

The commentary explains sūtikā as a woman who has recently given birth and vyāharataḥ as producing voice. It parses the cause as an uneven load or an uneven sleeping posture; another reading has viṣamocchvasana, irregular breathing. Ardayitvā means causing pain, and apavartate means becoming crooked. Vāk-saṅga is failure of speech to emerge; ‘eyes and others’ includes the eyebrows, cheeks, and related structures. The neck and other parts become crooked on the affected side. Cibuka is the lower part of the oral cavity. The preliminary signs are said to arise before the full disorder; āvila means clouded or impure, upward vāyu requires an understood verb ‘spreads’, and skin svāpa is loss of touch sensation.

Key terms

ardita
A classical syndrome of unilateral facial distortion with associated neurologic signs.
vAksa~gga (vāk-saṅga)
Obstruction or failure of speech to emerge.
manyAhanugraha (manyā-hanu-graha)
Stiffness or restriction of the neck and jaw.
viShamashayana (viṣama-śayana)
An awkward or uneven sleeping posture; a variant reads irregular breathing.
pUrvarUpa (pūrvarūpa)
A sign said to precede the fully expressed disorder.

Adhikarana 35 (73) · Śloka 73

kṣīṇasyānimiṣākṣasya prasaktaṁ saktabhāṣiṇaḥ | na sidhyatyarditaṁ bāḍhaṁ trivarṣaṁ vēpanasya ca ||73||

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क्षीणस्यानिमिषाक्षस्य प्रसक्तं सक्तभाषिणः | न सिध्यत्यर्दितं बाढं त्रिवर्षं वेपनस्य च ||७३||

Meaning of the śloka

Ardita is said not to be curable when the person is depleted, cannot blink because the eyes are fixed, has continuously obstructed or indistinct speech, has had the condition for three years, or has marked tremor.

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tasyāsādhyatvamāha- kṣīṇasyētyādi| animiṣākṣasya stabdhākṣasya| prasaktaṁ satataṁ, saktabhāṣiṇaḥ pīḍitāvyaktapadabhāṣiṇaḥ; anyē tu ‘prasaktāvyaktabhāṣiṇaḥ’ iti paṭhanti, prasaktaṁ prakarṣēṇa lagnamiti tatrārthaḥ| bāḍhamatiśayēna na sidhyatīti sambandhaḥ| trivarṣamiti saṁvatsaratrayātītam; anyē tu nāsākṣimukhasrāviṇaṁ trivarṣamāhuḥ| vēpanasya kampanaśīlasya| “garbhiṇīsūtikābālavr̥ddhakṣīṇēṣvasr̥kkṣayē” ityamuṁ pāṭhaṁ jējjhaṭādaya ācāryā na paṭhanti| ‘uccairvyāharatō'tyarthaṁ’ ityādau kr̥tvā paṭhanti, bahuvaidyapaṭhitatvādasmābhiḥ paṭhitaḥ||73||

Meaning of the commentary

The commentary glosses animiṣākṣa as fixed-eyed. Prasakta means continuous, and sakta-bhāṣin means speaking with difficulty and indistinct words. Another reading is prasaktāvyakta-bhāṣin, with prasakta understood as intensely fixed or persistent. Trivarṣa means lasting beyond three years, though others use the three-year qualification for a case with discharge from the nose, eyes, and mouth. Vepana means being prone to trembling. The earlier line listing pregnant, postpartum, young, old, depleted, and blood-depleted persons is omitted by Jejjaṭa and other teachers; this commentator includes it because many physicians read it.

Key terms

animiShAkSha (animiṣākṣa)
Having fixed eyes or inability to blink.
saktabhAShin (sakta-bhāṣin)
Having obstructed, difficult, or indistinct speech.
trivarSha (trivarṣa)
A three-year duration, alternatively linked to a discharging presentation.
vepana
Trembling or a tendency to tremor.

Adhikarana 36 (74) · Śloka 74

pārṣṇipratyaṅgulīnāṁ tu kaṇḍarā yā'nilārditā | sakthnaḥ kṣēpaṁ nigr̥hṇīyādgr̥dhrasīti hi sā smr̥tā ||74||

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पार्ष्णिप्रत्यङ्गुलीनां तु कण्डरा याऽनिलार्दिता | सक्थ्नः क्षेपं निगृह्णीयाद्गृध्रसीति हि सा स्मृता ||७४||

Meaning of the śloka

When the kandara extending in relation to the heel and toes is afflicted by anila and restricts extension of the leg, the condition is called gridhrasi.

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gr̥dhrasīmāha- pārṣṇītyādi| yā kaṇḍarā sakthnaḥ kṣēpaṁ nigr̥hṇīyāt sā gr̥dhrasīti smr̥tēti sambandhaḥ| pārṣṇirgulphasya pāścātyādhōbhāgaḥ, pratyaṅgulyō'ṅgulya ēva; ētēnōparyadhōbhāgagataṁ kaṇḍarādvayaṁ gr̥hyatē| kaṇḍarā mahāsnāyuḥ| gulphādiviṭapāntaṁ sakthi, tasya kṣēpaḥ prasāraṇaṁ, taṁ nigr̥hṇīyādavarundhyādityarthaḥ| gr̥dhrasī ‘raṅghiṇī’ iti lōkē| sā ca vātād vātakaphācca| khañjanavātē na sātiśayā vyathā yathā gr̥dhrasyām| kēcit ‘pārṣṇiṁ pratyaṅgulīnām’ iti dvitīyāntaṁ paṭhanti; tatrāpi pārṣṇiṁ lakṣīkr̥tya yā kaṇḍarā, aṅgulīnāṁ ca yā kaṇḍarēti kaṇḍarādvayam||74||

Meaning of the commentary

The commentary defines gridhrasi by restriction of leg extension. Parshni is the lower rear part of the ankle, and pratyanguli refers to the toes; together these indicate two major tendinous structures situated above and below. Kandara is a large snayu, and the leg is described as extending from the ankle to the groin. Gridhrasi is popularly called ranghini and may arise from vata alone or from vata with kapha. Unlike khanjana-vata, it has marked pain. A variant reads parshnim pratyangulinam in the accusative, but still identifies two kandaras, one directed toward the heel and one associated with the toes.

Key terms

gRudhrasI (gridhrasi)
A classical vata disorder marked here by painful restriction of leg extension.
kaNDarA (kandara)
A large tendinous or ligament-like structure, described as a major snayu.
sakthikShepa (sakthikshepa)
Extension or outward movement of the leg.
pArShNi (parshni)
The lower rear portion of the ankle or heel region.

Adhikarana 37 (75) · Śloka 75

talapratyaṅgulīnāṁ tu kaṇḍarā bāhupr̥ṣṭhataḥ | bāhvōḥ karmakṣayakarī viśvācīti hi sā smr̥tā ||75||

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तलप्रत्यङ्गुलीनां तु कण्डरा बाहुपृष्ठतः | बाह्वोः कर्मक्षयकरी विश्वाचीति हि सा स्मृता ||७५||

Meaning of the śloka

When the kandaras related to the palm and fingers and those at the back of the arm are affected, loss of arm function results; this is called vishvachi.

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gr̥dhrasīsadr̥śīmēkabāhugatāṁ viśvācīmāha- talētyādi| talaśabdō'yamupari vartatē, tēna karasyābhyantarakaṇḍarā gr̥hītā, bāhupr̥ṣṭhata ityanēna bāhyakaṇḍarā gr̥hītā| bāhvōriti dvivacanaṁ sāmānyāpēkṣayā , kadācit kasmiṁścidbāhau bhavati| ‘anilārditā’ ityatrāpi sambadhyatē| cakārō'tra gr̥dhrasīviśvācyōrnāmāntaramanuktaṁ khallyabhidhānaṁ samuccinōti| anyē tvatrāpi ‘talaṁ pratyaṅgulīnām’ iti pūrvavaddvitīyāntaṁ paṭhanti, tēna talaṁ lakṣīkr̥tya yā kaṇḍarā bāhupr̥ṣṭhataśca yā kaṇḍarēti kaṇḍarādvayaṁ gr̥hyatē||75||

Meaning of the commentary

The commentary presents vishvachi as resembling gridhrasi but occurring in one arm. Tala indicates the inner kandara of the hand, while bahuprishtha indicates the outer kandara. Although the verse uses the dual 'arms' in a general sense, the disorder may occur in either individual arm. The earlier phrase 'afflicted by anila' is understood here as well. The conjunction also gathers the unspoken alternative name khalli for gridhrasi and vishvachi. Another grammatical reading takes talam in the accusative, again yielding two kandaras: one directed toward the palm and one on the back of the arm.

Key terms

vishvAcI (vishvachi)
A classical disorder causing impairment of arm function.
bAhukarmakShaya (bahukarmakshaya)
Reduction or loss of functional movement of the arm.
tala
The palm or inner aspect of the hand in this explanation.
khallI (khalli)
An alternative name gathered by the commentary for gridhrasi and vishvachi.

Adhikarana 38 (76) · Śloka 76

vātaśōṇitajaḥ śōphō jānumadhyē mahārujaḥ | śiraḥ krōṣṭukapūrvaṁ tu sthūlaḥ krōṣṭukamūrdhavat ||76||

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वातशोणितजः शोफो जानुमध्ये महारुजः | शिरः क्रोष्टुकपूर्वं तु स्थूलः क्रोष्टुकमूर्धवत् ||७६||

Meaning of the śloka

A large, intensely painful swelling in the knee region, described as arising from vata and shonita and resembling a jackal's head, is known as kroshṭukashirsha.

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krōṣṭukaśira āha- vātētyādi| yō jānumadhyē vātaśōṇitajō mahārujaḥ krōṣṭukamūrdhavat sthūlaḥ śōphō bhavati sa krōṣṭukaśira iti jñēyaḥ| vātaśōṇitaja iti vātaśōṇitābhyāṁ jātō vātaśōṇitajaḥ, na punarvātaraktēna vyādhinā janitaḥ; anyē tu vātēna śōṇitēna ca jāta iti nēcchanti, kiṁ tarhi vātaraktaja iti rōgakāraṇamēva rōgamicchanti| śiraḥ krōṣṭukapūrvamiti krōṣṭukaśabdapūrvaṁ śiraḥ, tasya rōgasya ‘krōṣṭukaśira’ iti nāmētyarthaḥ| krōṣṭukamūrdhavat śr̥gālamastakavat||76||

Meaning of the commentary

The commentary identifies kroshṭukashirsha as a very painful, bulky swelling in the middle of the knee, shaped like a jackal's head. Its preferred explanation understands vatashonitaja as produced jointly by vata and blood, rather than caused by the named disease vatarakta. Others reject that derivation and interpret it as arising from vatarakta, treating the disease itself as the cause. The name literally places 'head' after kroshṭuka.

Key terms

kroShTukashira (kroshtukashirsha)
A classical painful knee swelling likened to a jackal's head.
vAtashoNitaja (vatashonitaja)
Interpreted either as arising from vata and blood or, alternatively, from vatarakta.
shopha
Swelling.
mahAruja (maharuja)
Marked or severe pain.

Adhikarana 39 (77) · Śloka 77

vāyuḥ kaṭyāṁ sthitaḥ sakthnaḥ kaṇḍarāmākṣipēdyadā | khañjastadā bhavējjantuḥ, paṅguḥ sakthnōrdvayōrvadhāt ||77||

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वायुः कट्यां स्थितः सक्थ्नः कण्डरामाक्षिपेद्यदा | खञ्जस्तदा भवेज्जन्तुः, पङ्गुः सक्थ्नोर्द्वयोर्वधात् ||७७||

Meaning of the śloka

When vayu situated in the waist affects a kandara of one leg, the person's gait becomes impaired and the condition is called khanja. When both legs are completely disabled, the person is described as pangu.

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khañjapaṅgulavātāvāha- vāyurityādi| ākṣipēditi īṣat kṣipēt, khañjē vikalagatērdarśanāt| sakthnōrdvayōrvadhāditi sarvathā gativighātāt paṅgurityarthaḥ| dvayōriti punaruktiprasaṅgādyugapat sakthidvayavadhādityarthaḥ||77||

Meaning of the commentary

The commentary distinguishes khanja from pangu. In khanja the kandara is affected only to a degree, producing an abnormal gait. Pangu denotes complete obstruction of movement from simultaneous impairment of both legs; 'both' is interpreted this way to avoid redundancy.

Key terms

kha~jja (khanja)
A classical category of impaired gait associated here with one leg.
pa~ggu (pangu)
A classical category of complete impairment of movement involving both legs.
kaTi (kati)
The waist or pelvic region.
gativighAta (gativighata)
Obstruction or loss of movement.

Adhikarana 40 (78) · Śloka 78

prakrāman vēpatē yastu khañjanniva ca gacchati | kalāyakhañjaṁ taṁ vidyānmuktasandhiprabandhanam ||78||

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प्रक्रामन् वेपते यस्तु खञ्जन्निव च गच्छति | कलायखञ्जं तं विद्यान्मुक्तसन्धिप्रबन्धनम् ||७८||

Meaning of the śloka

A person who trembles when beginning to step, walks as though limping, and has loosened joint bindings is described as having kalayakhanja.

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kalāyakhañjamāha- prakrāmannityādi| prakrāman pādavikramaṁ kurvan, gamanārambha ēva vēpatē kalāyakhañja ityayaṁ khañjādviśēṣaḥ| muktasandhiprabandhanamiti śithilasandhibandhanamityarthaḥ||78||

Meaning of the commentary

The commentary distinguishes kalayakhanja from khanja by trembling at the very start of walking or taking a step. Muktasandhiprabandhana is explained as looseness of the structures binding the joints.

Key terms

kalAyakha~jja (kalayakhanja)
A classical gait disorder characterized by trembling at initiation of walking.
prakrAman (prakraman)
Beginning to step or advance the foot.
vepate
Trembles.
muktasandhiprabandhana
Loosened binding structures of the joints.

Adhikarana 41 (79) · Śloka 79

nyastē tu viṣamaṁ(mē) pādē rujaḥ kuryāt samīraṇaḥ | vātakaṇṭaka ityēṣa vijñēyaḥ khaḍu(la)kāśritaḥ ||79||

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न्यस्ते तु विषमं(मे) पादे रुजः कुर्यात् समीरणः | वातकण्टक इत्येष विज्ञेयः खडु(ल)काश्रितः ||७९||

Meaning of the śloka

When the foot is placed unevenly and samirana produces pain in the ankle-foot region, the condition is known as vatakantaka.

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vātakaṇṭakamāha- nyasta ityādi| nyastē tu viṣamaṁ pāda iti viṣamasthānē nikṣiptē pādē ityarthaḥ| khuḍu(la)kāśrita iti pādajaṅghāsandhisaṁśraya ityarthaḥ, ‘pārṣṇyāśrayaḥ’ ityanyē||79||

Meaning of the commentary

The commentary explains that the foot has been set down on an uneven surface. The location indicated by the uncertain reading khudu(la)ka is taken as the joint between the foot and lower leg. Others read the condition as situated at the heel.

Key terms

vAtakaNTaka (vatakantaka)
A classical painful disorder of the foot or ankle region.
viShamasthAna (vishamasthana)
An uneven place or surface.
khuDu(la)ka
A textually uncertain anatomical term interpreted as the foot-lower-leg joint.
pArShNi (parshni)
The heel, given as an alternative location.

Adhikarana 42 (80) · Śloka 80

pādayōḥ kurutē dāhaṁ pittāsr̥ksahitō'nilaḥ | viśēṣataścaṅkramaṇāt pādadāhaṁ tamādiśēt ||80||

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पादयोः कुरुते दाहं पित्तासृक्सहितोऽनिलः | विशेषतश्चङ्क्रमणात् पाददाहं तमादिशेत् ||८०||

Meaning of the śloka

Anila associated with pitta and blood is said to cause burning in the feet, especially during walking; this is called padadaha.

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pādadāhamāha- pādayōrityādi| viśēṣataścaṅkramaṇāditi viśēṣēṇa gacchataḥ, tiṣṭhatastu sāmānyēna||80||

Meaning of the commentary

The commentary clarifies that the burning is especially marked while walking, while it may also occur to a lesser degree when standing still.

Key terms

pAdadAha (padadaha)
A classical condition characterized by burning of the feet.
pittAsRuksahita anila (pittasrik-sahita anila)
Anila described as associated with pitta and blood.
ca~gkramaNa (chankramana)
Walking or moving about.
dAha (daha)
A burning sensation.

Adhikarana 43 (81) · Śloka 81

hr̥ṣyataścaraṇau yasya bhavataśca prasuptavat | pādaharṣaḥ sa vijñēyaḥ kaphavātaprakōpajaḥ ||81||

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हृष्यतश्चरणौ यस्य भवतश्च प्रसुप्तवत् | पादहर्षः स विज्ञेयः कफवातप्रकोपजः ||८१||

Meaning of the śloka

When a person's feet experience a tingling, internally cold sensation and become as though asleep, the condition is called padaharsha and is attributed to aggravated kapha and vata.

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pādaharṣamāha- hr̥ṣyata ityādi| hr̥ṣata iti harṣō rōmāñcaprāyō vēdanāviśēṣō'ntaḥśītakaraḥ| bhavataśca prasuptavaditi sparśājñānāt suptāviva bhavata ityarthaḥ||81||

Meaning of the commentary

The commentary explains harsha as a distinctive sensation resembling horripilation and producing an internal feeling of cold. 'As though asleep' means that touch is not properly perceived, giving a numb sensation.

Key terms

pAdaharSha (padaharsha)
A classical condition involving tingling, cold sensation, and numbness of the feet.
harSha (harsha)
A sensation resembling horripilation, described here as internally cold.
prasuptavat
As though asleep or numb.
sparshAj~jAna (sparshajnana)
Failure or reduction of touch perception.

Adhikarana 44 (82) · Śloka 82

aṁsadēśasthitō vāyuḥ śōṣayitvāṁ'sabandhanam | sirāścākuñcya tatrasthō janayatyavabāhukam ||82||

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अंसदेशस्थितो वायुः शोषयित्वांऽसबन्धनम् | सिराश्चाकुञ्च्य तत्रस्थो जनयत्यवबाहुकम् ||८२||

Meaning of the śloka

Vayu located in the shoulder region dries the structure binding the shoulder and contracts the siras there; it thereby produces the condition called avabahuka.

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aṁsaśōṣāvabāhukāvāha- aṁsadēśētyādi| aṁsasamīpōpalakṣitō dēśōṁ'sadēśaḥ; aṁsō bāhuśiraḥ| aṁsabandhanaṁ ślēṣmāṇamityarthaḥ| aṁsabandhanaṁ śōṣayitvā ‘aṁsaśōṣaṁ rōgaṁ karōti’ iti vākyaśēṣō jñēyaḥ| tatrasthaḥ aṁsadēśasthita ityarthaḥ||82||

Meaning of the commentary

The commentary discusses amsashosha and avabahuka. Amsadesha is the area around the shoulder, and amsa is the head of the arm. Amsabandhana is interpreted as shleshma. After saying this binding is dried, the commentary supplies the implied clause that this produces the disease amsashosha. Vayu remaining in the same shoulder region then produces avabahuka.

Key terms

avabAhuka (avabahuka)
A classical disorder of the shoulder and arm.
aMsashoSha (amsashosha)
A classical condition understood from the implied clause as drying or wasting at the shoulder.
aMsabandhana (amsabandhana)
The binding structure of the shoulder, interpreted by the commentary as shleshma.
sirA Aku~jcana (sira akunchana)
Contraction of the vessels or channels described in the shoulder region.

Adhikarana 45 (83) · Śloka 83

yadā śabdavahaṁ srōtō vāyurāvr̥tya tiṣṭhati | śuddhaḥ ślēṣmānvitō vā'pi bādhiryaṁ tēna jāyatē ||83||

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यदा शब्दवहं स्रोतो वायुरावृत्य तिष्ठति | शुद्धः श्लेष्मान्वितो वाऽपि बाधिर्यं तेन जायते ||८३||

Meaning of the śloka

When vayu, either alone or accompanied by shleshma, obstructs the channel that carries sound, deafness is said to result.

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bādhiryamāha- yadētyādi| śuddhaḥ kēvalaḥ| apiśabdādraktapittāvaraṇayōrupasaṅgrahaḥ| yadyapyayaṁ vyādhiḥ śālākyē'pi paṭhyatē, tathā'pyatrāpi paṭhanīyaḥ, vr̥ddhasammatatvāt||83||

Meaning of the commentary

The commentary explains shuddha as vayu acting alone. The word api is understood to include obstruction by rakta and pitta as further possibilities. Although this disease is also taught in Shalakya, it is included here because authorities of the older tradition accepted it in this context.

Key terms

bAdhirya (badhirya)
Deafness or loss of hearing.
shabdavaha srotas
The channel understood to carry sound.
AvRuti (avriti)
Obstruction or covering.
shuddha vAyu (shuddha vayu)
Vayu acting alone, without the stated association.

Adhikarana 46 (84) · Śloka 84

hanuśaṅkhaśirōgrīvaṁ yasya bhindannivānilaḥ | karṇayōḥ kurutē śūlaṁ karṇaśūlaṁ taducyatē ||84||

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हनुशङ्खशिरोग्रीवं यस्य भिन्दन्निवानिलः | कर्णयोः कुरुते शूलं कर्णशूलं तदुच्यते ||८४||

Meaning of the śloka

When anila causes a splitting-like sensation through the jaw, temples, head, and neck and produces pain in the ears, the condition is called karnashula.

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karṇaśūlamāha- hanuśaṅkhētyādi||84||

Meaning of the commentary

The commentary simply introduces this verse as the description of karnashula and adds no further interpretation.

Key terms

karNashUla (karnashula)
Ear pain described in this classical passage.
bhindanniva
Feeling as though splitting or piercing.
hanu
The jaw.
sha~gkha (shankha)
The temple region of the head.

Adhikarana 47 (85) · Śloka 85

āvr̥tya sakaphō vāyurdhamanīḥ śabdavāhinīḥ | narān karōtyakriyakānmūkaminmiṇagadgadān ||85||

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आवृत्य सकफो वायुर्धमनीः शब्दवाहिनीः | नरान् करोत्यक्रियकान्मूकमिन्मिणगद्गदान् ||८५||

Meaning of the śloka

Vayu associated with kapha is said to obstruct the sound-carrying dhamanis and thereby make a person unable to perform speech normally, producing absence of speech, nasal speech, or indistinct and faltering speech.

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jihvāgatavātarōgaṁ darśayannāha- āvr̥tyētyādi| āvr̥tya avarundhyētyarthaḥ| mūkō vacanarahitaḥ, minmiṇaḥ sānunāsikavāk, gadgadō'vyaktavāk||85||

Meaning of the commentary

The commentary presents this as a vata disorder affecting the tongue. Avritya means obstructing. Muka denotes absence of speech, minmina denotes nasalized speech, and gadgada denotes indistinct speech.

Key terms

shabdavAhinI dhamanI (shabdavahini dhamani)
A channel described as carrying sound or speech.
mUka (muka)
Without speech in the commentary's classification.
minmiNa (minmina)
Having nasalized speech.
gadgada
Having indistinct or faltering speech.
akriyaka
Unable to perform the relevant function, here normal speech activity.

Adhikarana 48 (86-87) · Śloka 87

adhō yā vēdanā yāti varcōmūtrāśayōtthitā | bhindatīva gudōpasthaṁ sā tūnītyabhidhīyatē ||86|| gudōpasthōtthitā saiva pratilōmavisarpiṇī | vēgaiḥ pakvāśayaṁ yāti pratitūnīti sā smr̥tā ||87||

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अधो या वेदना याति वर्चोमूत्राशयोत्थिता | भिन्दतीव गुदोपस्थं सा तूनीत्यभिधीयते ||८६|| गुदोपस्थोत्थिता सैव प्रतिलोमविसर्पिणी | वेगैः पक्वाशयं याति प्रतितूनीति सा स्मृता ||८७||

Meaning of the śloka

Pain arising from the repositories of feces and urine and moving downward as though splitting the rectal and genital regions is called tuni. The same pain, when arising from the rectal-genital region and spreading upward in the reverse direction toward the pakvashaya in attacks, is called pratituni.

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tūnīvātamāha- adhō yētyādi| bhindatīva gudōpasthamiti bhēdaṁ kurvatīva gudōpasthasyētyarthaḥ| pratilōmavisarpiṇī adha-utthitōrdhvagāminī| vēgairiti vēdanāvēgairmuhurmuhuḥ svabhāvōpaśamōpalakṣitaiḥ, ‘pratilōmaṁ pradhāvitā ’ iti kēcit||86-87||

Meaning of the commentary

The commentary explains the splitting description as pain that feels as though it divides the rectal and genital regions. Pratilomavisarpini means beginning below and travelling upward. Vegaih refers to repeated attacks of pain that subside naturally between episodes. Some instead read 'driven in the reverse direction.'

Key terms

tUnI (tuni)
A classical pain pattern travelling downward from the fecal and urinary repositories.
pratitUnI (pratituni)
The reverse pain pattern travelling upward toward the pakvashaya.
pratilomavisarpiNI (pratilomavisarpini)
Spreading upward in a direction contrary to the normal course.
vega
A recurrent attack or surge of pain.
gudopastha
The rectal and genital regions.

Adhikarana 49 (88) · Śloka 88

sāṭōpamatyugrarujamādhmātamudaraṁ bhr̥śam | ādhmānamiti jānīyādghōraṁ vātanirōdhajam ||88||

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साटोपमत्युग्ररुजमाध्मातमुदरं भृशम् | आध्मानमिति जानीयाद्घोरं वातनिरोधजम् ||८८||

Meaning of the śloka

A markedly distended abdomen with internal movement or rumbling and extremely severe pain, arising from obstruction of vata, is called the grave condition adhmanam.

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ādhmānamāha- sāṭōpamityādi| āṭōpaṁ sañcalanaṁ, tēna saha vartata iti sāṭōpam| udaramatra pakvāśayaḥ| ghōraṁ kaṣṭakāri||88||

Meaning of the commentary

The commentary explains atopa as movement or rumbling, so satopa means accompanied by it. Udara here specifically denotes the pakvashaya. Ghora means distressing or difficult to bear.

Key terms

AdhmAna (adhmana)
A classical condition of severe painful distension.
ATopa (atopa)
Internal movement or rumbling.
vAtanirodha (vatanirodha)
Obstruction of vata.
pakvAshaya (pakvashaya)
The lower digestive repository identified here by udara.

Adhikarana 50 (89) · Śloka 89

vimuktapārśvahr̥dayaṁ tadēvāmāśayōtthitam | pratyādhmānaṁ vijānīyāt kaphavyākulitānilam ||89||

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विमुक्तपार्श्वहृदयं तदेवामाशयोत्थितम् | प्रत्याध्मानं विजानीयात् कफव्याकुलितानिलम् ||८९||

Meaning of the śloka

A similar distension arising from the amashaya, but sparing the flanks and heart region, is called pratyadhmana and is attributed to vayu obstructed by kapha.

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pratyādhmānamāha- vimuktētyādi| tadēva ādhmānamēva| āmāśayōtthitaṁ nābhistanāntarōtthitam| ata ēva hr̥dayapārśvayōrapyadhiṣṭhānamasya prāptaṁ nirasannāha- vimuktapārśvahr̥dayamiti| vyākulita āvr̥taḥ||89||

Meaning of the commentary

The commentary says this is a form of adhmanam arising in the amashaya, defined as the region between the navel and breasts. Because that location might suggest involvement of the heart and flanks, the verse explicitly excludes those regions. Vyakulita is explained as obstructed.

Key terms

pratyAdhmAna (pratyadhmana)
A classical distension arising in the amashaya while sparing the heart and flanks.
AmAshaya (amashaya)
The upper digestive repository, located here between the navel and breasts.
kaphavyAkulita anila (kaphavyakulita anila)
Vayu obstructed or disturbed by kapha.
vimuktapArshvahRudaya (vimuktaparshvahridaya)
Sparing the flanks and heart region.

Adhikarana 51 (90-91) · Śloka 91

aṣṭhīlāvadghanaṁ granthimūrdhvamāyatamunnatam | vātāṣṭhīlāṁ vijānīyādbahirmārgāvarōdhinīm ||90|| ēnāmēva rujāyuktāṁ vātaviṇmūtrarōdhinīm | pratyaṣṭhīlāmiti vadējjaṭharē tiryagutthitām ||91||

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अष्ठीलावद्घनं ग्रन्थिमूर्ध्वमायतमुन्नतम् | वाताष्ठीलां विजानीयाद्बहिर्मार्गावरोधिनीम् ||९०|| एनामेव रुजायुक्तां वातविण्मूत्ररोधिनीम् | प्रत्यष्ठीलामिति वदेज्जठरे तिर्यगुत्थिताम् ||९१||

Meaning of the śloka

A dense, raised, elongated abdominal mass resembling an ashthila and obstructing the outward passage of flatus, feces, and urine is known as vatashthila. When this mass is painful, obstructs flatus, feces, and urine, and arises transversely in the abdomen, it is called pratyashthila.

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vātāṣṭhīlāmāha- aṣṭhīlāvadityādi| “aṣṭhīlā uttarāpathē dīrghavartulapāṣāṇaviśēṣaḥ” ityēkē, “carmakārāṇāṁ vartuladīrghā lauhī bhāṇḍiḥ” ityaparē| ghanaḥ saṁhatāvayavaḥ| āyatō dīrghaḥ| bahirmārgāṇi vātaviṇmūtrāṇi| anyē'tra ‘nābhēradhastāt sañjātaṁ calaṁ vā yadi vā'calam’ iti paṭhanti| pratyaṣṭhīlāmāha- ēnāmēvētyādi| ēnāmēva aṣṭhīlām| tiryagutthitatvēnāṣṭhīlāyāḥ sakāśāt pratyaṣṭhīlāyā bhēdaḥ| asyāgrē kēcidūrustambhaṁ paṭhanti, tanna, cikitsāyāṁ paṭhiṣyamāṇatvānnibandhakārāṇāmasammatatvācca||90-91||

Meaning of the commentary

The commentary records two explanations of ashthila: some call it a long, rounded stone found in the northern region, while others call it a long, rounded iron vessel used by leatherworkers. Ghana means compact and ayata means long. The external pathways named are those of flatus, feces, and urine. Another reading adds that the mass arises below the navel and may be movable or immovable. Pratyashthila differs from vatashthila by arising transversely. Some insert urustambha after this passage, but the commentator rejects that placement because it is taught later in treatment and is not accepted by the compilers.

Key terms

vAtAShThIlA (vatashtila)
A classical elongated abdominal mass obstructing elimination.
pratyaShThIlA (pratyashtila)
A painful obstructive mass distinguished by transverse orientation.
aShThIlA (ashthila)
Compared either to a long rounded stone or a leatherworker's long rounded iron vessel.
bahirmArga (bahirmarga)
The outward pathways of flatus, feces, and urine.
tiryagutthita
Arising or oriented transversely.

Adhikarana puṣpikā · Śloka 1

iti suśrutasaṁhitāyāṁ nidānasthānē vātavyādhinidānaṁ nāma prathamō'dhyāyaḥ ||1||

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इति सुश्रुतसंहितायां निदानस्थाने वातव्याधिनिदानं नाम प्रथमोऽध्यायः ||१||

Meaning of the śloka

Thus ends the first chapter of the Nidanasthana in the Sushruta Samhita, entitled Vātavyādhinidāna, the diagnosis of disorders attributed to vata.

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iti śrīḍalhaṇaviracitāyāṁ nibandhasaṅgrahākhyāyāṁ suśrutavyākhyāyāṁ nidānasthānē prathamō'dhyāyaḥ||1||

Meaning of the commentary

The commentary colophon states that the first chapter of the Nidanasthana is complete in Shri Dalhana's explanation of Sushruta entitled Nibandhasangraha.

Key terms

nidAnasthAna (Nidanasthana)
The division concerned with causes and diagnostic descriptions.
vAtavyAdhinidAna (Vatavyadhinidana)
Diagnosis or description of disorders attributed to vata.
prathama adhyAya (prathama adhyaya)
The first chapter.
nibandhasa~ggraha (Nibandhasangraha)
The title of Dalhana's commentary.