An omitted word meaning and related matters is understood after svabhava, so the title includes alteration of svabhava and associated features. Svabhava here means prakriti, the natural or usual constitution and characteristics.
Key terms
svabhAva (svabhava)
The natural or usual constitution and characteristics, equated here with prakriti.
vipratipatti
A contrary alteration or reversal of the expected natural state.
According to the source, a spontaneous reversal in body parts whose characteristics are established by nature indicates death. Examples are white parts becoming black, black parts becoming white, red parts assuming another colour, firm parts becoming soft, soft parts becoming firm, mobile parts becoming immobile, immobile parts becoming mobile, broad parts becoming contracted, contracted parts becoming broad, long parts becoming short, short parts becoming long, structures not naturally shed beginning to fall, normally discharged substances ceasing to be discharged, and spontaneous coldness, heat, unctuousness, dryness, marked rigidity, discolouration or functional collapse of the limbs.
The alteration can concern qualities or actions and can also result from conjunction with a particular other substance; later examples include visible vessels on the forehead or an eruption on the bridge of the nose. The examples here are then expanded. Spontaneous darkening of normally white parts of the eye is an arishta sign. Whitening of the dark centre of the eye, or of hair, beard and body hair in youth, is also included. Red structures such as the corners of the eyes, soles, palms, palate, lips and tongue may unexpectedly become white, yellow, black or blue. Normally firm structures such as hair, beard, nails, teeth, vessels, ligaments and channels may become soft. Normally soft structures such as flesh, blood, medas, marrow, shukra, navel, heart, liver and spleen may become hard; some read not firm in place of soft. Mobile structures such as vata sites, vessels, joints and tongue may stop moving. The commentary states that ten vessels are mobile and says they will be described in Sharirasthana. Normally immobile flesh, medas, bone and navel may move; others instead name the flesh of the nose and ears. Broad structures such as the head, forehead, face, shoulders, chest and back may contract, while small structures such as the visual disc, nails, hair and ankles may broaden. Long structures such as the eyes, arms, finger joints and exhalation may shorten, while short structures such as the lower legs, penis and neck may lengthen. Hair, beard, body hair and nails, classed as not naturally shed, may begin falling. Sweat, urine and feces, classed as naturally discharged, may cease to pass. The word suddenly or without cause applies individually to all these changes and to the qualities that follow. Coldness can occur in normally warm hands, feet or exhalation, and heat in normally cool blowing breath. Dryness can affect normally unctuous structures such as the pupils, while oiliness can appear in unanointed hair or skin that is normally dry. Prastambha is extreme stiffness. Vaivarnya is reversal of normal bodily colour. Avasada means non-function or impairment. A variant reads discolouration and upasarjana of the limbs, with upasarjana explained as assuming that altered state.
Key terms
anyabhAvitva (anyabhavitva)
Becoming otherwise through reversal of a natural quality or action.
prastambha
Marked or extreme rigidity.
avasAda (avasada)
Loss of activity, functional collapse or impairment in the affected part.
स्वेभ्यः स्थानेभ्यः शरीरैकदेशानामवस्त्रस्तोत्क्षिप्तभ्रान्तावक्षिप्तपतितविमुक्तनिर्गतान्तर्गतगुरुलघुत्वानि, प्रवालवर्णव्यङ्गप्रादुर्भावो वाऽप्यकस्मात्, सिराणां च दर्शनं ललाटे, नासावंशे वा पिडकोत्पत्तिः , ललाटे वा प्रभातकाले स्वेदः, नेत्ररोगाद्विना वाऽश्रुप्रवृत्तिः, गोमयचूर्णप्रकाशस्य वा रजसो दर्शनमुत्तमाङ्गे निलयनं वा कपोतकङ्ककाकप्रभृतीनां, मूत्रपुरीषवृद्धिरभुञ्जानानां, तत्प्रणाशो वा भुञ्जानानां, स्तनमूलहृदयोरःसु च शूलोत्पत्तयः, मध्ये शूनत्वमन्तेषु परिम्लायित्वं विपर्ययो वा, तथाऽर्धाङ्गे श्वयथुः शोषोऽङ्गपक्षयोर्वा, नष्टहीनविकलविकृतस्वरता वा, विवर्णपुष्पप्रादुर्भावो वा दन्तमुखनखशरीरेषु, यस्य वाऽप्सु कफपुरीषरेतांसि निमज्जन्ति, यस्य वा दृष्टिमण्डले भिन्नविकृतानि रूपाण्यालोक्यन्ते, स्नेहाभ्यक्तकेशाङ्ग इव यो भाति, यश्च दुर्बलो भक्तद्वेषातिसाराभ्यां पीड्यते, कासमानश्च तृष्णाभिभूतः, क्षीणश्छर्दिभक्तद्वेषयुक्तः सफेनपूयरुधिरोद्वामी हतस्वरः शूलाभिपन्नश्च मनुष्यः, शूनकरचरणवदनःक्षीणोऽन्नद्वेषी स्रस्तपिण्डिकांसपाणिपादो ज्वरकासाभिभूतः, यस्तु पूर्वाह्णे भुक्तमपराह्णे छर्दयत्यविदग्धमतिसार्यते वा स श्वासान्म्रियते, बस्तवद्विलपन् यश्च भूमौ पतति स्रस्तमुष्कः, स्तब्धमेढ्रो भग्नग्रीवः प्रनष्टमेहनश्च मनुष्यः, प्राग्विशुष्यमाणाहृदय आर्द्रशरीरः, यश्च लोष्टं लोष्टेनाभिहन्ति काष्ठं काष्ठेन, तृणानि वा छिनत्ति, अधरोष्ठं दशति, उत्तरोष्ठं वा लेढि, आलुञ्चति वा कर्णौ केशांश्च; देवद्विजगुरुसुहृद्वैद्यांश्च द्वेष्टि, यस्य वक्रानुवक्रगा ग्रहा गर्हितस्थानगताः पीडयन्ति, जन्मर्क्षं वा, यस्योल्काशनिभ्यामभिहन्यते होरा वा, गृहदारशयनासनयानवाहनमणिरत्नोपकरणगर्हितलक्षणनिमित्तप्रादुर्भावो वेति ||४||
Meaning of the śloka
The passage gives a long series of signs treated as arishta. These include displacement, abnormal elevation, rotation, lateral deviation, collapse, separation, protrusion, retraction, or reversal of heaviness and lightness in body parts; sudden coral-red vyanga, visible vessels on the forehead, a pustule on the bridge of the nose, morning sweat on the forehead, tears without eye disease, cow-dung-colored dust seen on the head, or pigeons, vultures, crows and similar birds settling there. It also includes increased urine and feces without eating or their disappearance despite eating; pain at the roots of the breasts, cardiac region or chest; swelling in the middle with wasting at the extremities or the reverse; swelling of half the body or wasting of one side; lost, diminished, impaired or unnaturally altered voice; dull flower-like spots on teeth, mouth, nails or body; sinking in water of kapha, feces and semen together; seeing divided or grotesquely altered forms within the visual field; appearing constantly as though hair and body were oiled; weakness accompanied by aversion to food and diarrhea, or cough with overpowering thirst; emaciation with vomiting, food aversion, frothy vomiting of pus and blood, lost voice and pain; swelling of hands, feet and face in an emaciated person who rejects food, with loosened calf, shoulder, hand and foot flesh and fever and cough; vomiting undigested morning food in the afternoon or passing it through diarrhea followed by death attributed to difficult breathing; falling to the ground crying like a goat being killed, with displaced testicles, rigid or retracted penis and bent neck; the cardiac region drying before the otherwise moist body; striking clods with clods or wood with wood, cutting grass, biting the lower lip, licking the upper lip, or pulling ears and hair; hatred of deities, brahmanas, teachers, friends and physicians; and adverse astrological, household, family, conveyance, animal, jewel or equipment signs.
The commentary explains the body-part abnormalities in detail. Drooping applies to eyebrows, eyelashes and similar structures; elevation is their upward displacement; rotation applies to eyes and related parts; lateral casting is their sideways deviation; collapse means inability to hold up head or neck; separation concerns joints; protrusion includes tongue and eyes; retraction includes tongue, eyes and nose. Some read failure to protrude instead, with effectively the same meaning. Reversal of weight means heavy parts such as arms, head and thighs becoming light and normally light parts such as eyelashes becoming heavy. Coral is a very red marine growth; vyanga is normally dusky, so sudden redness is abnormal. Visible forehead vessels may be coral-colored or simply unnatural. The nose-bridge pustule may also be coral-colored; others take the alternative particle to separate pustules of the nose bridge and forehead. The commentary supplies a patient with lepa-fever for the morning forehead sweat from another treatise. The tear passage is absent from older compilations but retained from senior authorities. Cow-dung-like dust on the head is assigned one month, while birds settling there form a second sign. Pain at the breast-root, heart or chest is understood in someone eating and is adverse when combined with disappearance of wastes. Central swelling and dry extremities, or the reverse, are assigned one month. Half-body swelling is read with wasting of the other half. Voice loss ranges from complete absence to low volume, stammering or reversal of the natural voice. The flower-like marks are dull-colored spots. Sinking of kapha, feces and semen is adverse only when all three occur together and is assigned one month. Distorted forms may be many kinds of animals, triangular or many-headed forms, or forms missing an eye, arm or ear. Others qualify an unbroken visual field and explain that seeing distorted forms may indicate immediate or five-year prognosis. Constantly appearing oiled is required for that sign. Several symptom clusters apply only when all named features occur together in a weak or emaciated person. Loosened applies separately to calf, shoulder, hand and foot tissues. The goat-like crying and falling passage includes alternatives between rigid and retracted genital signs and is linked with death through difficult breathing. A moist body with the cardiac region drying first is assigned a fortnight. The behavior involving clods, wood, grass, lips, ears and hair is absent from older compilations but retained from senior authorities. Hatred of revered persons is assigned one year. The final signs use the chapter's historical astrological and omen doctrines: planets moving backward or returning forward in censured positions, afflicting the birth constellation; meteors or lightning striking the birth constellation, its time, or the birth ascendant; and adverse signs arising in the house, spouse, bed, seat, conveyance, riding animal, crystal and other jewels, or household equipment.
Key terms
svabhAvavipratipatti (svabhavavipratipatti)
A reversal or deviation from the natural state of body, function, perception or surrounding signs.
vivarNapuShpa (vivarnapushpa)
Dull-colored, flower-like spots appearing on teeth, mouth, nails or body.
janmarkSham (janmarksham)
The birth constellation within the passage's historical astrological prognosis.
Adhikarana ൪ (൫-൬) · Śloka ൬
ഭവന്തി ചാത്ര- ചികിത്സ്യമാനഃ സമ്യക് ച വികാരോ യോऽഭിവര്ധതേ |
പ്രക്ഷീണബലമാംസസ്യ ലക്ഷണം തദ്ഗതായുഷഃ ||൫||
നിവര്തതേ മഹാവ്യാധിഃ സഹസാ യസ്യ ദേഹിനഃ |
ന ചാഹാരഫലം യസ്യ ദൃശ്യതേ സ വിനശ്യതി ||൬||
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भवन्ति चात्र- चिकित्स्यमानः सम्यक् च विकारो योऽभिवर्धते |
प्रक्षीणबलमांसस्य लक्षणं तद्गतायुषः ||५||
निवर्तते महाव्याधिः सहसा यस्य देहिनः |
न चाहारफलं यस्य दृश्यते स विनश्यति ||६||
Meaning of the śloka
When a disorder continues to increase despite being treated correctly in a person whose strength and flesh are greatly depleted, the text regards this as a sign that the lifespan has ended. A person whose major disease suddenly disappears but who shows no nourishing result from food is likewise said to perish.
These verses state adverse signs applicable generally to diseases not separately discussed. Mahavyadhi may mean the eight major categories that include vata disease and prameha, or conditions such as shosha described in internal medicine. Sahasa means suddenly or with force.
Key terms
cikitsyamAnaH samyak (cikitsymanah samyak)
Being treated according to the proper method, despite which the disorder continues to increase.
AhAraphalam (aharaphalam)
The expected nourishing or sustaining result of consumed food.
mahAvyAdhiH (mahavyadhih)
A major disease, interpreted through two alternative groups in the commentary.
एतान्यरिष्टरूपाणि सम्यग् बुध्येत यो भिषक् |
साध्यासाध्यपरीक्षायां स राज्ञः सम्मतो भवेत् ||७||
Meaning of the śloka
A physician who correctly understands these forms of arishta becomes esteemed by the king for skill in examining whether a condition is treatable or untreatable.