28. viparītāviparītavraṇavijñānīyādhyāyaḥ

Meaning of the commentary

The several analogies distinguish uncertain from certain arishta. A flower indicates that fruit may follow and a cloud that rain may fall, but the effect does not necessarily arise merely because its cause is present. These uncertain examples represent arishta inferred from a messenger or omen. Smoke, as an observed effect, provides certain knowledge of its cause, fire. This more determinate example represents arishta arising from dosha. Arishta here means signs regarded as indicating death, and the implied qualification is future death.

Meaning of the commentary

The signs may be as subtle as an atom. Inattention is compared with an intoxicated person's failure to examine an object. One explanation of rapid passing says that death occurs at the very moment the sign appears, compared with piercing a stack of one hundred lotus petals. Others take it to mean that the sign itself disappears as soon as it arises. The point of saying not through non-occurrence is that the signs do occur but are missed for the stated reasons. The final assertion of certain death concerns dosha-origin arishta.

Meaning of the commentary

The particle kila marks this as a teaching reported from authoritative tradition. Amala means free from faults such as attachment. Those devoted to rasayana are described as considering special medicines intended to counter natural decline and disease and as averting death through the effects of taste, potency and medicine. Ascetics are said to act through the power of exceptional austerity, and accomplished mantra practitioners through mantra power. The commentary says this should be understood in relation to both determinate and uncertain arishta.

Meaning of the commentary

The verse answers how an affliction indicated by arishta could manifest much later, even after twenty-five years according to the commentary's framing. Vipacyate means that it bears its result, and paka means the resulting fruit or outcome.

Meaning of the commentary

The verse states the perceived fault of failing to recognise arishta. Asiddhi means loss or failure concerning dharma, wealth, desire and related aims.

Meaning of the commentary

Because this treatise concerns surgery and gives wounds a central place, it first states fatal prognostic signs connected with a wound. 'Odor, color, taste and the others' also includes sound and touch, thereby covering all five sensory objects, with form included under color. Vaikrta means deviation from the natural state. Pakvalakshana is explained here as a sign of falling or death: just as a ripe fruit inevitably falls, the wounded person displaying the sign is said to fall.

Meaning of the commentary

The commentary assigns the three comparison odors in sequence to paired dosha conditions: parched grain to vata-pitta, linseed oil to vata-kapha, and sesame oil to pitta-kapha. All three are naturally somewhat visra. Atasi denotes linseed oil, while taila here means sesame oil. Some witnesses read tivra, intense, instead of tikshna, penetrating.

Meaning of the commentary

The passage lists altered rather than natural wound odors. Sumana is identified as jati. Sagandha means having an odor similar to the named substance, while divine odors includes other exceptionally fine fragrances. Mumurshu means a living being approaching death. Dhvanksha is crow, putivallura is dried meat containing pus, and matkuna is a small insect found in bedding and similar places.

Meaning of the commentary

These verses describe abnormal combinations of color and sensation used for adverse prognosis. Dhyama means slightly black. In the pitta-colored wound, absence of the expected pitta sensations of burning and cosha constitutes the abnormality; cosha is a sucking type of pain. Some witnesses instead read colors like shyama, kumkuma and kankushtha due to pitta, without burning or aching. They identify shyama as priyangu and kankushtha as resin of suvarnakshiri, and explain that such wounds have only mild heat. The commentator rejects this alternate text because it is absent from the older compilations and appears to have been copied uncritically. In a kapha-colored wound, burning and pain are the abnormal features. In a black, thinly discharging vata wound that heats a vital point, absence of even slight pain is abnormal. Taste abnormality is not explicitly listed, but the commentary infers it from the introductory mention of taste: in vata, pitta and kapha wounds, normally astringent, pungent and sweet tastes respectively are inferred through whether ants and similar creatures approach.

Meaning of the commentary

This passage describes altered sound. Kshvedanti means producing a khata-khata clicking or rattling sound. Ghurghura is the internal growling sound made by angry dogs, cats and similar animals. 'As though blazing' describes their appearance. Audible passage of air is abnormal for wounds in skin and flesh, whereas it is considered natural for wounds situated in a body cavity. The supplied commentary explains verse 16 only and does not interpret the incomplete following fragment about vital-point wounds.

Meaning of the commentary

The commentary identifies these statements as abnormalities in the tactile or temperature qualities of a wound.

Meaning of the commentary

These are abnormalities of visible form. Shakti is a particular weapon and dhvaja the staff of a banner. Prasada means a dwelling of a deity or king; here akriti means visible form, an object of sight among the five senses. The powder-like appearance is another visual feature and should be understood by general resemblance.

Meaning of the commentary

After completing the abnormalities of smell and other wound qualities, the passage adds complications indicating incurability. Loss of prana means loss of strength understood as functional power; loss of flesh means loss of strength understood as bodily development.

Meaning of the commentary

The verse gathers under this rule all other unstated arishta signs indicating an adverse prognosis.

Meaning of the commentary

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