೩೧. ಛಾಯಾವಿಪ್ರತಿಪತ್ತ್ಯಧ್ಯಾಯಃ

Meaning of the commentary

An omitted word meaning and related matters after chaya indicates that abnormalities of modesty, prosperity, contentment and similar qualities are also included. Chaya is that which rests upon bodily colour and radiance. The authorities distinguish chaya from prabha: chaya overlays colour and is observed nearby, while prabha reveals colour and can be observed from a distance. Colour, radiance and chaya differ both in characteristics and number. Colour is fourfold: fair, dark, dusky, and a mixture of fair and dusky. Prabha is sevenfold: red, yellow, white, grey-brown, green, pale, and black. Chaya is fivefold: unctuous, clear, dry, soiled, and contracted.

Meaning of the commentary

Grey-brown, reddish, blue and yellow chayas can occur naturally. The passage concerns those that appear unexpectedly for the first time or arise as a reversal of the person's usual condition. Abhidravanti means that such chayas follow, attend or come upon the person. Parasu means one whose life force has departed.

Meaning of the commentary

The passage combines alterations of conduct described in the preceding chapter with prabha, which resembles chaya. Hri is modesty, prabha the radiance previously defined, smriti recollection of prior experience, dhriti contentment grounded in self-restraint, and shri attractiveness or grace. Apart from altered prabha, the remaining changes are alterations of disposition. A variant reads that modesty and shri disappear, together with tejas, ojas, memory and radiance. Its interpreters take shri as wealth, tejas as strength manifested through activity, and ojas as a white sustaining essence located in the heart. They assign reversal of beauty, wealth and tejas to an arishta expected within a year, and reversal of memory, strength and related qualities to one expected within six months.

Meaning of the commentary

After abnormalities of chaya and related qualities, the passage describes abnormality of the lips and other body parts. The lower lip hangs downward and the upper lip is displaced upward; both may take the color of ripe jambu. Lip and tooth signs are assigned the time associated with sannipata. Dusky teeth are treated as a general arishta rather than one limited to visuci. Khanjana is described as bedding darkened by smoke in a maternity room, popularly called kharajima by drum players; others identify khanjarita, whose color combines white and black. For the tongue, the coating is an intrinsic coating-like appearance, not ordinary deposited impurity; actual coating in the preliminary signs of prameha is not arishta because it has a known cause. This group is assigned a fortnight. Crooked means bent, split means opened or fissured, and a sunken nose appears submerged. The nose and eye signs are assigned seven nights. Fixed eyes are motionless and drooping eyes fall downward. Simanta is the hair parting; contracted eyebrows are drawn together, downward-bent eyebrows droop, and eyelashes continually move. Some connect both eyebrows with the term simantini. This last group is said to indicate death after six nights in a healthy person and three nights in a patient. Some restrict the hair-parting, tongue and eye signs to fever because they were described in fever contexts; others reject that restriction because the signs are repeated here, while the first view considers the repetition unnecessary.

Meaning of the commentary

These verses concern abnormal bodily functions. Failure to take food means inability to swallow what is in the mouth. Mudhatman means forgetful or confused, and 'immediately' is explained as death on that very day. Sammoha in the next verse is fainting; repeated raising means attendants must lift the person again and again. Pakva means ripened by time and seized by death, and this sign is assigned seven nights. Abnormal movement of the feet means repeated extension and contraction; the commentary also glosses viprasaranashila as persistently contracting the feet despite its literal form. This group is assigned immediate death. The cold sign requires feet, hands and breath to become cold simultaneously. Interrupted breath rises in broken segments, and crow-like breath occurs with the mouth held open. These are also assigned immediate death. Unbroken sleep, constant wakefulness, or confusion when attempting speech warrant refusal of treatment in this prognosis. Lihyat means tasting or licking, utkara means belching, and preta means the dead.

Meaning of the commentary

The openings are bodily channels. The vata-asthila comparison is not necessarily the disease of that name described under vata disorders, although that same condition becomes an arishta if it reaches the cardiac region with these features. The swelling verse has several interpretations. The main explanation takes ananyopadravakrta as swelling produced by its own complications such as difficult breathing, thirst and weakness: in a man, such swelling beginning in the foot is fatal; in a woman, facial swelling is fatal; genital swelling is fatal in either. Others take the term as swelling arising from a cause other than disorders such as panduroga, udara or piles, regarding swelling caused by those disorders as potentially curable. Another reads ananyopadravagata as accompanied by its own complications but not by other diseases. Still another reads ananopadravagata and explains swelling traveling from the foot to the face with complications. In a person with cough or difficult breathing, the group beginning with diarrhea is assigned seven nights. Severe sweating, burning, hiccup and difficult breathing are assigned three nights. The dusky tongue, sunken left eye and putrid mouth together form one sign; some call it sannipatika and derive its time from that classification. Tears filling the face, simultaneous sweating of both feet and clouded eyes are assigned a muhurtika or one-prahara interval. Sudden lightness or heaviness is judged when attendants lift the limbs; alternatively, heavy may mean stout and light may mean emaciated. Vaivasvata is Yama. Mud and the other odors, including unexpectedly pleasant odor, are assigned one year. Lice on the forehead, crows refusing bali and absence of pleasure are also assigned one year, explained as attachment already directed toward the next world. Fever, diarrhea and swelling are 'mutually weakening' when each complicates the others. Strength here means functional vigor. Pravahika is a type of diarrhea, and 'death has approached' means it is near.

Meaning of the commentary

The verse explains why arishta signs arise before life ends. Treatment that considers constitution, strength and the other relevant factors is balanced treatment; treatment contrary to this is vishama. Past actions are those accumulated in a previous birth, with the word 'exhausted' understood in relation to actions that sustain the body. Impermanence means susceptibility to destruction. Others explain that death may also arise from causes apart from arishta. They classify three causes: treatment-based death indicated by improper care, fate- or karma-based death indicated by past actions, and natural mortality indicated by life's impermanence. An objection asks why other causes are needed if arishta always precedes death. The response is that both death and arishta are produced by doshas that have passed beyond the path of treatment, so arishta still arises from the same causal complex.

Meaning of the commentary

In the first explanation, pretas are beings who have died, bhutas attendants of Yama, pishachas flesh-eating divine classes, and rakshasas beings such as followers of Ravana. They approach, destroy medicinal power and render treatment fruitless. Another interpretation distinguishes prior explanations for failure of treatment in bodily diseases from this account of externally arising disorders associated with bhutas. It identifies pretas as future ancestors for whom the individual ancestral rite has not been performed, bhutas as types of pishacha, and the various rakshasas as classes such as brahmarakshasa. The repeated conjunctions indicate equal power among these groups to obstruct medicinal efficacy, paralleling the previously stated obstruction of treatment in bodily disease.

Meaning of the commentary

Thus ends the thirty-first chapter in the Sutrasthana of the Nibandhasangraha commentary on Sushruta, composed by Shri Dalhana.