Rasa is the exceedingly subtle essence produced when consumed food has been properly transformed. This food consists of the five elements, occurs in four forms, has six tastes, two kinds of potency or alternatively eight, and many qualities. Rasa is described as tejobhuta and has its seat at the heart. From there it enters twenty-four dhamanis: ten ascending, ten descending and four transverse. Through an action whose cause is unseen, it daily nourishes, promotes growth, maintains and sustains the whole body. Its movement through the body is to be inferred from depletion, increase and resulting disorders. Since it reaches bodily parts and the sites of doshas, dhatus and wastes, the question arises whether it is saumya or fiery. Its fluid nature and actions of moistening, sustaining life, nourishing and supporting indicate that it is saumya.
Rasa is explained first because blood arises in dependence upon it. The five elements begin with earth. The four food forms are drinks, lickable foods, foods eaten as a meal and foods chewed; six tastes begin with sweet. The two potencies are cold and hot; the alternative eight are cold, hot, unctuous, dry, clear, picchila, soft and sharp. The many qualities refer to the twenty qualities. Mention of consumption additionally requires proper use in accordance with the twelve dietary considerations taught under health maintenance. Tejobhuta is explained as produced by digestive fire. Others take tejas to mean ghee, yielding either 'produced like ghee' or 'resembling ghee.' Essence means free of wastes such as faeces; extreme subtlety means being able to follow minute channels.
Although rasa reaches the whole body, its seat is the region indicated by the heart, rather than the heart itself, which is the seat of ojas. Nourishing applies to children, adults and older people; others understand it particularly of the fetus, which does not itself consume food. Growth concerns childhood, maintenance adulthood with complete dhatus, and sustaining old age with declining tissue. Some read 'keeps alive' instead of 'maintains.' Some omit the description of passage from the heart through the twenty-four dhamanis. The unseen cause is explained as prior karma; others understand this as answering why nourishment fails in certain people who wish to die.
Movement of disturbed rasa is inferred from depletion signs such as cardiac distress and trembling, and increase signs such as excessive moistness in the heart region. The commentary supplies an understood 'and' so that normal movement is also inferred from whole-body nourishment and similar effects. The question is whether rasa resembles kapha in being saumya or pitta in being fiery. Its fluid movement, moistening, life-sustaining, nourishing, supporting and related actions establish the former account.
Key terms
rasaH
The subtle nourishing essence of properly transformed food.
tejobhUtaH
Explained as produced by fire, or alternatively as produced like or resembling ghee.
dhamanI
A channel through which rasa is described as moving.
Adhikarana ૩ (૪) · Śloka ૪
સ ખલ્વાપ્યો રસો યકૃત્પ્લીહાનૌ પ્રાપ્ય રાગમુપૈતિ ||૪||
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स खल्वाप्यो रसो यकृत्प्लीहानौ प्राप्य रागमुपैति ||४||
Meaning of the śloka
That rasa, although watery in nature, acquires colour on reaching the liver and spleen.
A verse explains that the bodily waters, remaining undisturbed and coloured by the clear, properly functioning tejas within the body, are called rakta.
'Within the body' specifically means within the liver and spleen. Prasanna means in its normal state. The tejas called ranjaka colours these undisturbed waters red, and they are then called blood. Waters here means rasa.
The commentary identifies menstrual artava with blood: rajas is another name for the blood discharged from the female genital passage at the menstrual time. The onset statement means that this blood begins after the twelfth year; the following words specify cessation. An alternative reading states that women's rajas flows from rasa each month for three days, after twelve years and up to fifty years. Samah means years.
Although both arise from saumya rasa, the particle tu marks a difference in their nature: artava and blood are agneya. Artava is agneya and shukra saumya, and the embryo formed from them has both aspects. If artava too were saumya, the embryo would be exclusively saumya; the embryo's dual character supports the stated inference. On this interpretation, establishing artava as agneya also establishes blood as such because their nature is the same. Others read the compound artavashonita, meaning menstrual blood, and take tu as emphatic, restricting the agneya assertion to artava. Those teachers regard ordinary blood as neither hot nor cold.
Key terms
Agneya
Having the nature of agni.
agnIShomIya
Having both agni and soma aspects.
Adhikarana ૭ (૮) · Śloka ૮
પાઞ્ચભૌતિકં ત્વપરે જીવરક્તમાહુરાચાર્યાઃ ||૮||
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पाञ्चभौतिकं त्वपरे जीवरक्तमाहुराचार्याः ||८||
Meaning of the śloka
Other teachers describe jivarakta as composed of all five elements.
This presents another view of blood's nature. Jivarakta means blood comparable to life, on the stated grounds that blood is observed in a living body but not in a dead one. It does not mean ojas here: that interpretation would leave the blood under discussion undescribed.
The raw or fleshy odour belongs to earth; fluidity to water; redness to tejas; slight movement to vayu; and absence of heaviness to akasha. Since these five elemental properties are observed in blood, the commentary concludes that blood is composed of five elements.
The repeated statement that blood comes from rasa restricts the sequence: rasa gives rise immediately to blood, rather than directly to the later dhatus. The commentator rejects another treatise's account that rasa simultaneously reaches and nourishes all dhatus. An objection asks whether complete transformation would eliminate the earlier tissues, or continuous transformation leave little of the earlier and much of the later. The answer divides transformation into waste, a gross portion retaining the current dhatu, and a subtle portion forming the next.
Digested food yields faeces and urine as waste and rasa as essence. Rasa processed by fire yields kapha as waste, rasa as the gross portion and blood as the subtle portion. Blood yields pitta as waste, blood as gross and flesh as subtle. Flesh processed by its own fire yields wastes of channels including the ears, nose, eyes and genital passage, flesh as gross and medas as subtle. Medas yields sweat, medas and bone respectively. Bone yields scalp hair, body hair and beard as waste, bone as gross and marrow as subtle. Marrow yields the unctuous matter of eyes, faeces and skin as waste, marrow as gross and shukra as subtle. Shukra, like gold heated repeatedly, yields no further waste; its gross portion remains shukra, while its subtle unctuous, tejobhuta portion is ojas. Two quoted verses restate the division and the absence of waste from shukra.
Some call beard hair a waste of shukra because removal of the testes is followed by loss of beard. The commentator rejects this because shukra occurs even in someone without a beard. The apparently redundant verb for production in the flesh-to-medas clause is explained as drawing attention to additional products of rasa through medas: breast milk and artava from rasa, kandaras and vessels from blood, vasa and skin from flesh, and sinews and joints from medas. These upadhatus are not said to arise similarly from bone and later tissues. The second verb concerning shukra marks its special nature: even when processed by its own fire, it does not produce a subsequent subtle tissue portion. Others read 'proceeds' for the medas clause and 'sambhava of shukra' for the final clause; they interpret sambhava as nourishment, not first production, because all dhatus from rasa to shukra exist from embryonic life.
Key terms
dhAtu
A bodily constituent in the stated sequence.
upadhAtavaH
Additional products attributed to rasa through medas.
The essence of food and drink nourishes these dhatus. One should understand the person as arising from rasa. A wise person should diligently protect rasa through food, drink and conduct, without negligence.
The passage emphasises rasa's importance among the previously mentioned dhatus beginning with blood. Annapana-rasa means the essence of food and drink, and its nourishing action means satisfying or sustaining them. Atandrita means without laziness.
Key terms
annapAnarasaH
The nourishing essence of food and drink.
Adhikarana ૧૧ (૧૩) · Śloka ૧૩
તત્ર ‘રસ’ ગતૌ ધાતુઃ, અહરહર્ગચ્છતીત્યતો રસઃ ||૧૩||
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तत्र ‘रस’ गतौ धातुः, अहरहर्गच्छतीत्यतो रसः ||१३||
Meaning of the śloka
The verbal root 'rasa' has the sense of movement. Because it moves day after day, it is called rasa.
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રસસ્યૈવ નિરુક્તિમાહ- તત્ર રસગતાવિત્યાદિ||૧૩||
Meaning of the commentary
The commentary identifies this as the explanation of the derivation of the word rasa.
Key terms
rasaH (rasaḥ)
The bodily constituent whose name is explained here through continual movement.
स खलु त्रीणि त्रीणि कलासहस्राणि पञ्चदश च कला एकैकस्मिन् धाताववतिष्ठते; एवं मासेन रसः शुक्रं स्त्रीणां चार्तवं भवति ||१४||
भवति चात्र- अष्टादशसहस्राणि सङ्ख्या ह्यस्मिन् समुच्चये |
कलानां नवतिः प्रोक्ता स्वतन्त्रपरतन्त्रयोः ||१५||
Meaning of the śloka
Rasa remains in each successive dhatu for three thousand and fifteen kalas. In this way, over a month, rasa becomes shukra and, in women, artava. A verse gives the combined total as eighteen thousand and ninety kalas, according to this and other treatises.
The question is how long rasa remains while bringing about the nature of each successive dhatu. Remaining does not mean that movement stops: it remains while undergoing transformation, like rice cooking in a pot. Rasa itself is said to form in one day; the following six dhatus each form over five days. The total of 18,090 kalas is explained as thirty days.
The meaning of artava is disputed. The first interpretation takes it here as female shukra, not menstrual blood, because menstrual blood is said to arise from rasa on the seventh day, like rakta. It further argues that, if female shukra were omitted in this discussion of shukra formation, women would be left with only six dhatus. Other interpreters retain artava in the sense of menstrual blood and take the connecting word 'and' to include female shukra, indicating the latter's generative capacity. They cite a passage in Sharirasthana describing two sexually desirous women discharging shukra together and asserting a resulting boneless formation. This is a claim quoted within that interpretation. In this second account, the monthly formation of artava means its accumulation and manifestation, since its initial formation is held to occur in seven days, like blood. 'In one's own and other treatises' is glossed as in corresponding and other traditions of teaching.
Key terms
kalA (kalā)
A unit of time used in the account of successive dhatu formation.
ArtavaM (ārtavam)
A disputed term here: female shukra in one interpretation, menstrual blood in another.
shukraM (śukram)
The reproductive dhatu described as the outcome of the month-long sequence.
The word for continuity applies separately to each of the three examples. Subtle means occurring in a fine manner, moving means circulating, and the whole body means the entire body. In the first explanation, the spread of sound represents movement across the body, flame represents upward movement, and water downward movement. Others interpret the three examples as corresponding to strong, medium and weak agni: rasa moves like sound in someone with strong agni, like flame with medium agni, and like water with weak agni. On that view, rasa becomes shukra in eight days with strong agni and in a month with weak agni. Gayadasa is said to have criticised this interpretation in several ways. The commentator considers it more reasonable that shukra forms in a little less than a month with strong agni and a little more than a month with weak agni.
Key terms
santAna (santāna)
Continuous spread, applied separately to sound, flame and water.
Vajikarana medicines, when used, are said to bring about the prompt discharge of shukra through the excellence of their own potency and qualities, in a manner compared with purgative medicines.
This answers the objection that, if rasa takes a month to become shukra, powerful vajikarana medicines would be ineffective. Vajikarana refers to measures by which a man is said to become sexually capable like a stallion. The words 'own' and 'excellence' apply separately to potency and qualities. Some measures act through exceptional inherent potency, some through their qualities, and some through both. Desire or mental resolve, an application to the feet, and the touch of a particular beloved woman illustrate inherent potency, or prabhava. Ghee and milk illustrate excellence of qualities such as unctuousness. Masha and similar materials illustrate both inherent potency and unctuous qualities. The plural reference to vajikarana is understood inclusively, extending the same principle to strengthening, nourishing, life-supporting and retaining or consolidating groups of measures.
Key terms
vAjIkaraNyaH (vājīkaraṇyaḥ)
Measures described as promoting sexual capacity and the discharge of shukra.
prabhAva (prabhāva)
Inherent specific potency, distinguished here from qualities such as unctuousness.
यथाहि पुष्पमुकुलस्थो गन्धो न शक्यमिहास्तीति वक्तुं, नैव नास्तीति; अथ चास्ति, सतां भावानामभिव्यक्तिरिति ज्ञात्वा , केवलं सौक्ष्म्यान्नाभिव्यज्यते; स एव विवृतपत्रकेशरे पुष्पे कालान्तरेणाभिव्यक्तिं गच्छति; एवं बालानामपि वयःपरिणामाच्छुक्रप्रादुर्भावो भवति, रोमराज्यादयश्च विशेषा नारीणाम् ||१८||
Meaning of the śloka
Fragrance within a flower bud cannot readily be declared present or absent, yet it exists: things already present become manifest, and only their subtlety prevents their appearance beforehand. That same fragrance becomes evident later when the petals and stamens open. Likewise, shukra becomes manifest in children as age advances, and features such as rows of body hair appear in women.
The analogy answers why shukra is not evident in children who eat, if rasa becomes shukra within a month. Although fragrance cannot be confidently perceived in the bud, the passage affirms its existence. The reasoning is that already existing things become manifest when their conditions are supplied, as with oil in sesame. Subtlety explains why the fragrance is initially unmanifest; with time it increases and becomes evident in the opened flower. In the same way shukra becomes evident with maturation. The wording includes the development of breast milk and artava among the changes in women. The connecting word is also understood to include men's features such as facial hair. Some readers add that, as rajas gradually increases, the breasts, uterus and yoni grow. The nibandha authors do not include that addition, because they regard its meaning as already included by 'and other features'.
Key terms
abhivyaktiH (abhivyaktiḥ)
Manifestation of something held already to exist in an unmanifest state.
This addresses the objection that, if rasa produces bodily increase, an elderly person should also keep growing. Although the essence of food nourishes all the dhatus, 'not nourishing' here means nourishing only slightly: it merely maintains life. The reason given is that the body has reached its fully aged condition.
Key terms
aprINano (aprīṇanaḥ)
Not nourishing, qualified by the commentary as giving slight nourishment sufficient to maintain life.
Adhikarana ૧૭ (૨૦) · Śloka ૨૦
ત એતે શરીરધારણાદ્ધાતવ ઇત્યુચ્યન્તે ||૨૦||
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त एते शरीरधारणाद्धातव इत्युच्यन्ते ||२०||
Meaning of the śloka
These are called dhatus because they support the body.
This derives the name of rasa and the following dhatus from their sustaining function. Although undisturbed doshas are sometimes also called dhatus because they sustain the body, the present discussion specifically concerns rasa and the other dhatus already introduced.
Key terms
dhAtavaH (dhātavaḥ)
The sustaining constituents, here rasa and those that follow it.
The decrease and increase of the dhatus are connected with blood, so the text turns to blood. Blood affected by vata is frothy, reddish or dark, rough, thin, quick-flowing and non-clotting. Blood affected by pitta is blue, yellow, green or dusky, has a raw-flesh odour, is unattractive to ants and flies, and does not clot. Blood affected by shleshma resembles water coloured with gairika, is unctuous, cool, thick and slimy, flows slowly and resembles a piece of flesh. Blood affected by all three doshas combines their signs, resembles kanjika and is particularly foul-smelling. Mixed involvement shows the signs of two doshas.
'Their' refers to the dhatus, and blood is now made the subject. Frothy means containing foam. Aruna means slightly red; the commentary links its darkening with movement towards paka. Rough means lacking sliminess, or, according to others, dry. Thin is explained as clear, quick-flowing as spreading rapidly, and non-clotting as lacking thickening. In the pitta list the commentary discusses blue, green and dusky colours in connection with sama pitta, and yellow with nirama pitta; dusky is explained as green-black. Visra means a raw odour. Unattractiveness is inferred when ants and similar creatures do not approach.
The gairika-water resemblance is pale red. Thick means dense, and the resemblance to a piece of flesh comes from congealing. Combining all signs means combining those of vata and the other doshas. Some readers add wording describing extreme darkness in connection with pitta-affected blood, but the nibandha authors do not include it. Samsrishta means involvement of two doshas. Some manuscripts also add that jivashonita will be taught elsewhere; this addition is absent from the nibandhas.
Key terms
askandi
Not congealing or clotting, a property in the vata and pitta descriptions.
sannipAtaduShTaM (sannipātaduṣṭam)
Affected by the combined involvement of all three doshas.
After the altered states, the text describes the natural state. Indragopaka is described as appearing in the rainy season and is popularly called indravadhU. Although it has different colours, the red kind is intended here. Asamhata is explained as neither too thin nor too thick; others understand it as not congealing. Avivarna permits slight differences within the red colour, including the colours of lotus, lac dye and gunja fruit. Another interpretation takes it to mean that blood adhering to cloth and similar materials does not lose its colour even when washed.
Key terms
asaMhatam (asaṃhatam)
Neither excessively thin nor thick according to one gloss; not congealing according to another.
avivarNam (avivarṇam)
Without altered colour, with alternative explanations supplied in the commentary.
Adhikarana ૨૦ (૨૩) · Śloka ૨૩
વિસ્રાવ્યાણ્યન્યત્ર વક્ષ્યામઃ ||૨૩||
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विस्राव्याण्यन्यत्र वक्ष्यामः ||२३||
Meaning of the śloka
The conditions suitable for bloodletting will be described elsewhere.
अथाविस्राव्याः- सर्वाङ्गशोफः, क्षीणस्य चाम्लभोजननिमित्तः, पाण्डुरोग्यर्शसोदरिशोषिगर्भिणीनां च श्वयथवः ||२४||
Meaning of the śloka
The text excludes the following swellings from bloodletting: swelling of the whole body; swelling caused by sour food in an emaciated person; and swelling in someone with pandu, arshas, udara or shosha, or in a pregnant woman.
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વિસ્રાવ્યનિષેધવિષયં દર્શયન્નાહ- અથાવિસ્રાવ્યા ઇત્યાદિ| ક્ષીણસ્ય પુંસોઽમ્લભોજનનિમિત્તો યઃ સોઽવિસ્રાવ્ય ઇત્યર્થઃ| તથા પાણ્ડુરોગ્યાદીનાં શોથા અવિસ્રાવ્યાઃ; એતેષાં વ્રણશોથા એકાઙ્ગજા અપિ ન સ્રાવ્યાઃ||૨૪||
Meaning of the commentary
The swelling associated with sour food is specifically that of a depleted person. Swellings in the other listed groups are also excluded. Even wound-associated swelling confined to a single part in these people is not to be subjected to bloodletting in this account.
तत्र, ऋज्वसङ्कीर्णं सूक्ष्मं सममनवगाढमनुत्तानमाशु च शस्त्रं पातयेन्मर्मसिरास्नायुसन्धीनां चानुपघाति ||२६||
Meaning of the śloka
For that procedure, the text describes applying the instrument swiftly to make straight, uncrowded, fine and even incisions, neither too deep nor too superficial, without injuring marmas, siras, snayus or joints.
This concerns prachchhana. Straight means direct. Uncrowded means not cramped, with adequate space; others understand it as incisions that do not meet one another. Fine means not made with an excessively broad-edged instrument. Even means having equal lines. Not deep means not penetrating far, while not superficial means touching the flesh slightly. Swift means without delay.
Key terms
asa~gkIrNaM (asaṅkīrṇam)
Uncrowded or, in another interpretation, not intersecting.
anuttAnam (anuttānam)
Not excessively superficial, glossed as slightly reaching flesh.
तत्र, दुर्दिने दुर्विद्धे शीतवातयोरस्विन्ने भुक्तमात्रे स्कन्दत्वाच्छोणितं न स्रवत्यल्पं वा स्रवति ||२७||
मदमूर्च्छाश्रमार्तानां वातविण्मूत्रसङ्गिनाम् |
निद्राभिभूतभीतानां नृणां नासृक् प्रवर्तते ||२८||
Meaning of the śloka
On an overcast day, with a poorly made puncture, in cold or windy conditions, without prior warming, or immediately after eating, the text says blood may not flow or may flow only slightly because it congeals. Blood also fails to flow in people affected by intoxication, fainting or exhaustion, retention of flatus, stool or urine, sleepiness or fear.
The commentary introduces inadequate blood flow in order to discuss its management. An overcast day is a fault relating to recurring environmental time; some readers omit this condition. A poor puncture is a fault in the physician's action. Cold and wind are environmental faults. Having just eaten concerns the person's present state; others instead read 'one who has not eaten'. Congealing means thickening. Mada is a disturbed state caused by poison or alcohol. Being affected means being distressed, and retention means failure of flatus, stool or urine to pass.
Blood released in excessive heat, after excessive sweating, or by excessive puncturing performed by inexperienced people is said to flow excessively. The passage associates excessive blood loss with head pain, blindness, adhimantha and timira, tissue depletion, convulsive disorder, burning, hemiplegia, a disorder of one limb, hiccup, difficult breathing, cough, pandu and death.
Excessive heat means an excessively hot season or time, and excessive sweating means having been subjected to too much sudation. The inexperienced are those who have not observed the procedure. Shirobhitapa means headache, and andhya blindness. Adhimantha is an eye disorder preceded by abhishyanda, while timira is glossed as loss of visual perception. The commentator relates headache and the following eye disorders to excessive removal from the head; tissue depletion may follow excessive removal anywhere. The disorder confined to one limb is explained as caused by vata.
Key terms
dhAtukShayam (dhātukṣayam)
Depletion of bodily tissues, stated as a consequence of excessive blood loss.
The text therefore places blood removal in conditions that are neither cold nor excessively hot, after suitable sweating and without excessive heating, and after the patient has drunk yavagu.
The commentary calls for a moderate time or season, avoiding both absence of sweating and excessive sudation, and avoiding excessive heat from sunlight or similar sources. Yavagu is explained as sesame gruel because it is said to provide immediate unctuousness and stimulate the blood. One interpretation takes prati to indicate another drinking, so the procedure follows the second or third intake of gruel. Others describe yavagu as having relatively little liquid and many grains: its moistening, sweat-promoting, liquid and hot properties are said to liquefy the blood. They instead take prati to mean a measured quantity, so the patient has consumed an appropriate amount.
Key terms
yavAgU (yavāgū)
Gruel; explained either specifically as sesame gruel or by its consistency and effects in the alternative account.
The commentator derives two signs from the wording. Blood that emerges with its proper red colour indicates purity. Blood that has flowed properly and then stops spontaneously indicates proper drainage. The conjunction supports this pair of interpretations. Others explain the verse through a further verse and a half: blood flows neither excessively fast nor without force, emerges through proper procedure, leaves its vitiated condition and assumes its own appearance without requiring further effort; it is then recognised as pure.
The commentary adds these as further signs of purified blood and proper drainage. Lightness and the other bodily effects are physical signs, while clarity of mind is a mental sign.
The commentator includes under skin disorders the eighteen kushtha conditions and nyaccha, nilika and similar conditions. Granthi includes nodules caused by vata and other factors, as well as siragranthi. Diseases arising from blood include raktagulma, vidradhi and visarpa. Those accustomed to blood removal means those who repeatedly practise it.
Key terms
raktamokShaNashIlAnAM (raktamokṣaṇaśīlānām)
Of those accustomed to repeated blood removal, the subjects of the verse's claim.
When blood does not flow, the historical procedure describes rubbing the wound opening with a powder of three, four or all of the available listed substances, made rich in salt and oil. The list comprises ela, shitashiva, kushtha, tagara, patha, bhadradaru, vidanga, chitraka, trikatuka, household soot, haridra, arka shoots and naktamala fruit. The text states that the blood then flows properly.
The commentary introduces this as a means of setting non-flowing blood in motion. Shitashiva is identified as camphor and naktamala as the larger karanja. Specifying three or four ingredients excludes using only one or two. The salt and oil are specifically saindhava and sesame oil, used abundantly.
For excessive bleeding, the text describes gently dusting the wound opening with powders of rodhra, madhuka, priyangu, pattanga, gairika, sarjarasa, rasanjana, shalmali flowers, conch, shell, masha, barley and wheat, then pressing with a fingertip. Alternatives include powdered bark of sala, sarja, arjuna, arimeda, meshashringa, dhava and dhanvana; burnt linen; or samudraphena and laksha powder. It also names firm bandaging, cooling coverings, food and accommodation, cooling pastes and pouring treatments, and cauterisation by kshara or fire as previously described. The passage also describes puncturing the same excessively bleeding sira in relation to the earlier puncture. Internally it names a kakolyadi decoction sweetened with sugar and honey, or blood from ena, harina, sheep, hare, buffalo or boar. Food is accompanied by well-uncted milk, pulse soup or meat broth, and complications are treated individually. The following verses explain that tissue depletion after blood loss weakens digestive fire and greatly aggravates vata. The stated diet is therefore light, unctuous, blood-replenishing and not excessively cold, with a slightly sour or non-sour taste.
Pattanga is identified as red sandalwood, sarjarasa as rala, and shukti as aquatic shell. Sala is called shanku, sarja a kind of sala, arjuna kakubha, arimeda the locally known arimanja, meshashringa karkatashringa, and dhanvana the locally known dhammana. The same dusting and fingertip-pressure instruction applies to the bark powders and burnt linen. Bandaging materials include linen and cotton cloth. Pradeha means paste and parisheka a poured stream. The reference to cauterisation includes the previously stated ring, dot and related forms. The second puncture is explained as below the original puncture in the same sira, with the aim of interrupting blood movement. Ena is the black deer and harina a copper-coloured deer. The animal blood is described as unvitiated and unprocessed, and its stated purpose is replenishing blood. Yusha means mudga soup, rasa meat broth, and unctuous means properly enriched with ghee; rice is eaten moistened with these liquids or milk. One explanation assigns milk to pitta-affected blood loss or a pitta constitution, pulse soup to kapha-affected loss or a kapha constitution, and meat broth to vata-affected loss or a vata constitution. Others assign milk, pulse soup and meat broth respectively to strong, moderate and weak digestive fire. Others base the choice on accustomed suitability. Complications such as headache receive their own treatments. The final dietary instructions aim to stimulate digestive fire, replenish blood and prevent complications. Slight sourness is exemplified by dadima and amalaka, regarded here as foremost among sour substances.
Key terms
sAtmya (sātmya)
Accustomed suitability, one basis given for choosing food after blood loss.
susnigdhaiH (susnigdhaiḥ)
Properly made unctuous with ghee, according to the commentary.
Four methods of stopping blood are named: sandhana, skandana, pachana and dahana. Astringent substances close the wound, cold causes the blood to coagulate, ash produces pachana, and burning contracts the sira.
Sandhana concerns closing the instrument wound. Skandana means making blood coagulate or become dense. Pachana and dahana concern the instrument wound. Astringent substances include lodhra and similar drugs; others specify haritaki or the panchavalkala group. Hima means cold. Ash is derived from linen and similar materials. Burning is performed with shalaka and related implements.
Key terms
sandhAnaM (sandhānam)
Closing or joining the instrument wound.
skandanaM (skandanam)
Coagulation or thickening of blood.
pAcanaM (pācanam)
The local ash-based action named as a method of stopping blood.
If blood does not coagulate, the text describes using measures that close the wound. If closure fails, pachana measures are used. The physician is to employ these three methods properly; if they fail, burning is considered the final measure.
The commentary explains a sequence in which each later method follows failure of the preceding one. Cooling treatment comes first. If blood does not coagulate and stop, haritaki or panchavalkala is used. If closure does not stop it, ash is applied for pachana. If none of these three methods stops the blood, burning is performed for that purpose.
Adhikarana ૩૫ (૪૩) · Śloka ૪૩
શેષદોષે યતો રક્તે ન વ્યાધિરતિવર્તતે |
સાવશેષે તતઃ સ્થેયં ન તુ કુર્યાદતિક્રમમ્ ||૪૩||
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शेषदोषे यतो रक्ते न व्याधिरतिवर्तते |
सावशेषे ततः स्थेयं न तु कुर्यादतिक्रमम् ||४३||
Meaning of the śloka
Because disease does not necessarily increase when some dosha remains in the blood, the text says to stop with a remainder rather than go beyond the proper limit of blood removal.
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ઇદાનીં રક્તાતિસ્રાવદોષં દર્શયન્નાહ- શેષેત્યાદિ| ન વ્યાધિરતિવર્તતે ન વૃદ્ધિં યાતિ| સાવશેષે તતઃ સ્થેયમિતિ સાવશેષે દોષે રક્તં પુનઃ સંશમનાદિભિર્જયેત્||૪૩||
Meaning of the commentary
The commentary explains na vyadhir ativartate as the disease not increasing. When some dosha remains, the blood is subsequently managed with pacifying and related measures.
Key terms
saMshamana (saṃśamana)
Pacifying measures for what remains after blood removal is stopped.
Blood is described as the foundation of the body and that by which it is sustained. It must therefore be carefully protected; the established teaching here identifies blood with life.
The commentary gives this as the reason not to exceed the proper limit in blood removal. Foundation means that blood is regarded as a cause in the body's origin, maintenance and dissolution. The body is upheld or maintained by it.
If cold pouring treatments and similar measures aggravate vata after blood removal and produce swelling with pricking pain, the text describes pouring lukewarm ghee over the swelling.
The commentary identifies this as care following blood removal.
Adhikarana પુષ્પિકા · Śloka ૧૪
ઇતિ સુશ્રુતસંહિતાયાં સૂત્રસ્થાને શોણિતવર્ણનીયો નામ ચતુર્દશોઽધ્યાય ||૧૪||
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इति सुश्रुतसंहितायां सूत्रस्थाने शोणितवर्णनीयो नाम चतुर्दशोऽध्याय ||१४||
Meaning of the śloka
Thus ends the fourteenth chapter, called Shonitavarnaniya, in the Sutrasthana of the Sushruta Samhita.
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ઇતિ શ્રીડલ્હ(હ્લ)ણવિરચિતાયાં નિબન્ધસઙ્ગ્રહાખ્યાયાં સુશ્રુતવ્યાખ્યાયાં સૂત્રસ્થાને શોણિતવર્ણનીયો નામ ચતુર્દશોઽધ્યાયઃ||૧૪||
Meaning of the commentary
Thus ends the fourteenth chapter, called Shonitavarnaniya, in the Sutrasthana of the commentary on Sushruta named Nibandhasangraha, composed by Shri Dalhana.