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AYANAACADEMYby Dr Vijaya Dwarampudi
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24. vyādhisamuddēśīyādhyāyaḥ

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Adhikarana 1 (1-2) · Śloka 2

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

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

Meaning of the śloka

Now the chapter giving a concise classification of diseases will be explained, as taught by Bhagavan Dhanvantari.

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vyādhisamuddēśīyamityādi| vyādhīnāṁ samāsēnōddēśaḥ kathanaṁ, tadadhikr̥tya kr̥tō'dhyāyō vyādhisamuddēśīyaḥ, vyādhisaṅkṣēpōddēśīya ityarthaḥ||1-2||

Meaning of the commentary

Vyadhisamuddeshiya means a chapter composed to state diseases briefly or to provide a concise outline of them.

Key terms

vyAdhisamuddesha (vyadhisamuddesha)
A concise statement, outline or classification of diseases.

Adhikarana 2 (3) · Śloka 3

dvividhāstu vyādhayaḥ- śastrasādhyāḥ, snēhādikriyāsādhyāśca | tatra śastrasādhyēṣu snēhādikriyā na pratiṣidhyatē, snēhādikriyāsādhyēṣu śastrakarma na kriyatē ||3||

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द्विविधास्तु व्याधयः- शस्त्रसाध्याः, स्नेहादिक्रियासाध्याश्च | तत्र शस्त्रसाध्येषु स्नेहादिक्रिया न प्रतिषिध्यते, स्नेहादिक्रियासाध्येषु शस्त्रकर्म न क्रियते ||३||

Meaning of the śloka

Diseases are of two kinds: those treated by surgical instruments and those treated by measures beginning with oleation. Measures such as oleation are not prohibited in diseases requiring surgery, but surgical procedures are not performed in diseases treatable by oleation and related measures.

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śastrasādhyatvēna snēhādisādhyatvēna ca vyādhīnāṁ dvaividhyaṁ darśayannāha,- dvividhā ityādi| śastrasādhyā iti chēdyādiprakārēṇa; snēhādikriyāsādhyā iti atrādiśabdēna svēdanavamanavirēcanādayaḥ| tatrēti tayōrmadhyē| śastrasādhyēṣu aṣṭavidhaśastrakarmīyōktēṣu bhagandaragranthiprabhr̥tiṣu||3||

Meaning of the commentary

The first class is treated through excision and the other types of operative procedure. In the second class, the inclusive ending after oleation covers fomentation, emesis, purgation and similar measures. The surgically treated group includes bhagandara, granthi and other disorders described under the eight kinds of surgical procedure. Supportive oleation and related measures may still be used in that group.

Key terms

shastrasAdhya (shastrasadhya)
A disease classified as requiring treatment with a surgical instrument or operative procedure.
snehAdikriyAsAdhya (snehadikriyasadhya)
A disease treated by non-operative measures beginning with oleation and including procedures such as fomentation, emesis and purgation.

Adhikarana 3 (4) · Śloka 4

asmin punaḥ śāstrē sarvatantrasāmānyāt sarvēṣāṁ vyādhīnāṁ yathāsthūlamavarōdhaḥ kriyatē | prāgabhihitaṁ ‘tadduḥkhasaṁyōgā vyādhaya’ (sū. a. 1) iti | tacca duḥkhaṁ trividham- ādhyātmikam, ādhibhautikam, ādhidaivikamiti | tattu saptavidhē vyādhāvupanipatati | tē punaḥ saptavidhā vyādhayaḥ; tadyathā- ādibalapravr̥ttāḥ, janmabalapravr̥ttāḥ, dōṣabalapravr̥ttāḥ, saṅghātabalapravr̥ttāḥ, kālabalapravr̥ttāḥ, daivabalapravr̥ttāḥ, svabhāvabalapravr̥ttā iti ||4||

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अस्मिन् पुनः शास्त्रे सर्वतन्त्रसामान्यात् सर्वेषां व्याधीनां यथास्थूलमवरोधः क्रियते | प्रागभिहितं ‘तद्दुःखसंयोगा व्याधय’ (सू. अ. १) इति | तच्च दुःखं त्रिविधम्- आध्यात्मिकम्, आधिभौतिकम्, आधिदैविकमिति | तत्तु सप्तविधे व्याधावुपनिपतति | ते पुनः सप्तविधा व्याधयः; तद्यथा- आदिबलप्रवृत्ताः, जन्मबलप्रवृत्ताः, दोषबलप्रवृत्ताः, सङ्घातबलप्रवृत्ताः, कालबलप्रवृत्ताः, दैवबलप्रवृत्ताः, स्वभावबलप्रवृत्ता इति ||४||

Meaning of the śloka

Because this treatise shares common ground with all branches, it includes all diseases in broad outline. Disease was previously defined as conjunction with suffering. That suffering is threefold: adhyatmika, adhibhautika and adhidaivika. These occur within a sevenfold classification of disease: arising from primordial or hereditary force, birth-related force, dosha force, traumatic conjunction, time, divine or unseen force, and inherent nature.

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śalyatantratvādasya tantrasya śastrakriyaivārhati na snēhādikriyētyāśaṅkyōbhayakriyādhikāraṁ darśayannāha- asminnityādi| asminniti sauśrutē śalyatantrē| punaḥśabdō'tra ēvārthē| sarvatantrasāmānyāditi śālākyādīnāṁ sāmānyāt tulyatvāt| yathāsthūlamiti sthūladr̥ṣṭyā, na sūkṣmadr̥ṣṭyētyarthaḥ| ētēna yē sanāmakā vyādhayastēṣāmavarōdhaḥ, nirnāmakānāṁ punarlakṣaṇadvārēṇa, avarōdhaḥ saṅgrahaḥ| kaḥ punarayaṁ vyādhirityāha- prāgabhihitamityādi| taditi tayōḥ śarīraśarīriṇōḥ; ‘śarīramanasōḥ’ iti kēcit| tacca duḥkhaṁ trividhamiti cakārānna kēvalaṁ trividhaṁ saptavidhaṁ ca| ātmaśabdēna samanaskaṁ śarīramucyatē| tatra vātapittakaphōtthāḥ śarīrabhavā ādhyātmikāḥ, tathā rajastamōbhavāśca; ātmanyadhi adhyātmaṁ, tatra bhavamādhyātmikam| bhūtāni prāṇinaḥ, bhūtēṣvadhikr̥tya yadvartatē tadādhibhautikam| dēvāḥ surāḥ surayōnayaśca, dēvēṣvadhikr̥tya yadvartatē tadādhidaivikam| tadēva trividhaṁ duḥkhaṁ bhēdāntarahētubhirbahuprakārabhūtē vyādhau samavaitītyāha- tadityādi|- taditi trividhaṁ duḥkham| upanipatati madhyē nipatati| tē punariti tē trividhā vyādhayaḥ punaḥ saptavidhā bhavantītyarthaḥ||4||

Meaning of the commentary

Although this is a surgical treatise, it has authority over both operative and measures such as oleation because it shares subject matter with branches such as Shalakya. Its inclusion of diseases is broad rather than minutely exhaustive. Named diseases are included by name, while unnamed ones are included through their signs. In the earlier definition, conjunction with suffering can refer to body and embodied self; some instead read body and mind. The conjunction in the present passage indicates that suffering is both threefold and, through another basis of division, sevenfold. Atman here means the body together with mind. Adhyatmika suffering arises in that embodied complex, including bodily conditions from vata, pitta and kapha and mental conditions from rajas and tamas. Adhibhautika concerns living beings, while adhidaivika concerns deities, divine classes or forces. The same threefold suffering falls within diseases made various by the causal bases of the sevenfold scheme.

Key terms

AdhyAtmika (adhyatmika)
Suffering arising within the body-mind complex, including bodily and mental sources in this commentary.
Adhibhautika (adhibhautika)
Suffering connected with other living beings.
Adhidaivika (adhidaivika)
Suffering connected with divine, unseen or superhuman agencies in the source's classification.

Adhikarana 4 (5) · Śloka 5

tatra, ādibalapravr̥ttā yē śukraśōṇitadōṣānvayāḥ kuṣṭhārśaḥprabhr̥tayaḥ; tē'pi dvividhāḥ- mātr̥jāḥ, pitr̥jāśca | janmabalapravr̥ttā yē māturapacārāt paṅgujātyandhabadhiramūkaminminavāmanaprabhr̥tayō jāyantē; tē'pi dvividhāḥ rasakr̥tāḥ, dauhr̥dāpacārakr̥tāśca | dōṣabalapravr̥ttā yē ātaṅkasamutpannā mithyāhārācārakr̥tāśca; tē'pi dvividhāḥ āmāśayasamutthāḥ , pakvāśayasamutthāśca; punaśca dvividhāḥ- śārīrā, mānasāśca | ta ētē ādhyātmikāḥ ||5||

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तत्र, आदिबलप्रवृत्ता ये शुक्रशोणितदोषान्वयाः कुष्ठार्शःप्रभृतयः; तेऽपि द्विविधाः- मातृजाः, पितृजाश्च | जन्मबलप्रवृत्ता ये मातुरपचारात् पङ्गुजात्यन्धबधिरमूकमिन्मिनवामनप्रभृतयो जायन्ते; तेऽपि द्विविधाः रसकृताः, दौहृदापचारकृताश्च | दोषबलप्रवृत्ता ये आतङ्कसमुत्पन्ना मिथ्याहाराचारकृताश्च; तेऽपि द्विविधाः आमाशयसमुत्थाः , पक्वाशयसमुत्थाश्च; पुनश्च द्विविधाः- शारीरा, मानसाश्च | त एते आध्यात्मिकाः ||५||

Meaning of the śloka

Diseases arising from primordial or hereditary force are those linked to defects in semen or menstrual blood, such as kushtha and arshas; they are divided into maternal and paternal types. Diseases arising from birth-related force develop through improper conduct of the mother and include congenital lameness, blindness, deafness, muteness, nasal speech, and extreme shortness; they are divided into those caused through rasa and those caused by disregard of dauhrida. Diseases arising through dosha force develop from another disease or from improper diet and conduct. They are divided into those arising from amashaya and those from pakvashaya, and again into bodily and mental types. These three disease classes are adhyatmika.

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tēṣāṁ saptavidhavyādhīnāṁ kramēṇa lakṣaṇānyāha- tatra ādibalapravr̥ttā ityādi| tatra tēṣu madhyē| ādibalapravr̥ttā duṣṭaśukraśōṇitabalajātāḥ| kē tē ityāha- yē śukraśōṇitadōṣānvayā iti; śukraśōṇitasthitavātādidōṣajanitāḥ| tānēva nāmatō darśayati- kuṣṭhārśaḥprabhr̥taya iti| prabhr̥tigrahaṇānmēhakṣayādayaḥ| mātr̥jā iti mātuḥ śōṇitajāḥ, pitr̥jāścēti pituḥ śukrajāḥ| dvitīyaṁ vyādhibhēdaṁ darśayannāha- janmabalapravr̥ttā ityādi| janmabalapravr̥ttā iti śukraśōṇitaduṣṭiṁ vinā'pi māturapacārabalajātāḥ; apacāra iti duṣṭāhārācārāvapacāraḥ| mūkā avācaḥ, minmināḥ sānunāsikāḥ, vāmanā atyantahrasvaśarīrāḥ| dauhr̥dāpacārakr̥tāścēti garbhānubhāvānmātuścaturthādimāsēṣvindriyārthaprārthanā ‘dauhr̥dam’ ityācakṣatē; tasyāpacārastu dauhr̥damēvāpamānitam, apamānitamalabdhaṁ garbhasyāhitaṁ vā| atra ‘mūkaminminavāmanaprabhr̥tayō jāyantē’ ityasyāgrē kēcit ‘bhuñjatē’ ityādi pāṭhaṁ paṭhanti, sa ca pūrṇō na dr̥śyatē nibandhēṣviti na likhitaḥ| tr̥tīyaṁ vyādhibhēdaṁ nirdiśannāha- dōṣētyādi| dōṣā vātādayō rajastamasī ca, balaṁ śaktiḥ, pravr̥ttā jātāḥ| kē punasta ityāha- yē ātaṅkasamutpannā iti| ātaṅkā rōgāḥ; yathā- pratiśyāyāt kāsaḥ, kāsāt kṣaya ityādi| ētē ādhyātmikā iti ētē ādibalapravr̥ttā janmabalapravr̥ttā dōṣabalapravr̥ttāstraya ādhyātmikāḥ; śarīrasthavātādirajaḥprabhr̥tidōṣajanitatvāt||5||

Meaning of the commentary

Adibalapravritta diseases arise through the force of vitiated semen or blood, specifically through vata and other doshas located in them. The inclusive ending after kushtha and arshas covers meha, wasting and other conditions. Maternal forms arise from the mother's blood and paternal forms from the father's semen. Janmabalapravritta diseases can arise through the mother's unsuitable food and conduct even without a defect in semen or blood. Muka means unable to speak, minmina nasal in speech, and vamana extremely short in bodily stature. Dauhrida is the mother's desire for sense objects from about the fourth month onward, attributed to the influence of the fetus. Its disregard means insulting or denying the desire, failing to obtain the desired thing, or providing something harmful to the fetus. Some manuscripts add words after the congenital list, but the complete passage is unavailable in the commentarial sources and is therefore not reproduced. In doshabalapravritta disease, dosha includes vata, pitta and kapha as well as rajas and tamas. Disease can produce another disease, as pratishyaya may lead to cough and cough to wasting. The first three of the seven classes are called adhyatmika because they arise through bodily doshas and mental factors such as rajas.

Key terms

AdibalapravRtta (adibalapravritta)
Arising through hereditary or primordial force associated in the source with defects in parental reproductive substances.
janmabalapravRtta (janmabalapravritta)
Arising through birth-related force, attributed here to the mother's diet, conduct or disregard of dauhrida.
doShabalapravRtta (doshabalapravritta)
Arising through the force of bodily or mental doshas, improper regimen, or progression from another disease.
dauhRda (dauhrida)
A pregnant mother's desire for particular sense objects, explained as influenced by the fetus.

Adhikarana 5 (6) · Śloka 6

saṅghātabalapravr̥ttā ya āgantavō durbalasya balavadvigrahāt; tē'pi dvividhāḥ- śastrakr̥tā, vyālakr̥tāśca | ētē ādhibhautikāḥ ||6||

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सङ्घातबलप्रवृत्ता य आगन्तवो दुर्बलस्य बलवद्विग्रहात्; तेऽपि द्विविधाः- शस्त्रकृता, व्यालकृताश्च | एते आधिभौतिकाः ||६||

Meaning of the śloka

Diseases arising through the force of collision are external in origin, such as those produced when a weaker person fights a stronger one. They are of two kinds: caused by weapons and caused by wild animals. These are classified as adhibhautika.

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caturthaṁ vyādhibhēdaṁ nirdiśannāha- saṅghātētyādi| saṅghātabalapravr̥ttā iti prahāraśaktijātāḥ| kē punasta ityāha- ya āgantava ityādi| vyālakr̥tā iti vyālā duṣṭavyāghrādayaḥ| ētē ādhibhautikā iti ētē pūrvōktā āgantavaḥ; ādhibhautikatvaṁ bhūtēṣu prāṇiṣvadhikr̥tatvāt||6||

Meaning of the commentary

This passage states the fourth division of disease. Arising through the force of collision means produced by the power of a blow. Wild animals include dangerous tigers and similar creatures. The previously described externally originating disorders are called adhibhautika because their causes operate among living beings.

Key terms

sa~gghAtabalapravRuttAH (sanghatabalapravrttah)
Arising from the force of impact or the power of a blow.
AdhibhautikAH (adhibhautikah)
The source's category for externally caused disorders operating through living beings.

Adhikarana 6 (7) · Śloka 7

kālabalapravr̥ttā yē śītōṣṇavātavarṣātapaprabhr̥tinimittāḥ; tē'pi dvividhāḥ- vyāpannartukr̥tāḥ, avyāpannartukr̥tāśca | daivabalapravr̥tā yē dēvadrōhādabhiśaptakā atharvaṇakr̥tā upasargajāśca; tē'pi dvividhāḥ- vidyudaśanikr̥tāḥ, piśācādikr̥tāśca; punaśca dvividhāḥ- saṁsargajā , ākasmikāśca | svabhāvabalapravr̥ttā yē kṣutpipāsājarāmr̥tyunidrāprabhr̥tayaḥ; tē'pi dvividhāḥ- kālajā, akālajāśca; tatra parirakṣaṇakr̥tāḥ kālajāḥ, aparirakṣaṇakr̥tā akālajāḥ | ētē ādhidaivikāḥ | atra sarvavyādhyavarōdhaḥ ||7||

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कालबलप्रवृत्ता ये शीतोष्णवातवर्षातपप्रभृतिनिमित्ताः; तेऽपि द्विविधाः- व्यापन्नर्तुकृताः, अव्यापन्नर्तुकृताश्च | दैवबलप्रवृता ये देवद्रोहादभिशप्तका अथर्वणकृता उपसर्गजाश्च; तेऽपि द्विविधाः- विद्युदशनिकृताः, पिशाचादिकृताश्च; पुनश्च द्विविधाः- संसर्गजा , आकस्मिकाश्च | स्वभावबलप्रवृत्ता ये क्षुत्पिपासाजरामृत्युनिद्राप्रभृतयः; तेऽपि द्विविधाः- कालजा, अकालजाश्च; तत्र परिरक्षणकृताः कालजाः, अपरिरक्षणकृता अकालजाः | एते आधिदैविकाः | अत्र सर्वव्याध्यवरोधः ||७||

Meaning of the śloka

Time-force disorders arise from causes such as cold, heat, wind, rain and sunlight. They are of two kinds: produced by a deranged season and produced by a season that is not deranged. Divine-force disorders are described as arising from offense against deities, curses, Atharvan rites and upasarga. They are divided into those caused by lightning or thunderbolt and those caused by pishacas and similar beings; they are also divided into those produced through contact and those occurring suddenly. Natural-force conditions include hunger, thirst, aging, death and sleep. They are timely or untimely: those that occur despite protective effort are timely, and those arising through lack of protection are untimely. These are classed as adhidaivika. All diseases are included within the categories stated here.

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pañcamaṁ vyādhibhēdaṁ nirdiśannāha- kālabalapravr̥ttā ityādi| kālaḥ śītōṣṇavarṣalakṣaṇaḥ ṣaḍr̥tukaḥ| kē punasta ityāha- śītōṣṇavātavarṣātapaprabhr̥tinimittāḥ; tē punarjāḍyadāhakampādayaḥ, tathā vraṇajvarāśca| atra vyāpannartukr̥tānāṁ pūrvōddhr̥tānnapānauṣadhibhirupacāraḥ, yathāsvaṁ ca vyādhivihitaṁ bhēṣajam r̥tuvyāpatpraśamanaṁ ca, daivavyapāśrayaṁ ca hōmādi; avyāpannartukr̥tānāṁ punaryathādōṣaṁ yathārōgamēvōpacāraḥ| ṣaṣṭhaṁ vyādhibhēdaṁ nirdiśannāha- daivabalapravr̥ttā ityādi| daivabalapravr̥ttā iti dēvaśaktijātā ityarthaḥ| kē punasta ityāha- yē dēvadrōhādityādi| dēvagōgurusiddhānāṁ drōhāt| abhiśaptakā iti r̥ṣīṇāmākrōśajāḥ| ātharvaṇakr̥tā atharvavēdapraṇītābhicārikamantraiḥ kr̥tā māraṇātmakā vyādhayaḥ| upasargajā iti upasr̥jyanta ityupasargāḥ pīḍitajanasamīpōtpannā jvarādayaḥ| vidyudaśanikr̥tā iti latākārā tiryakpatantī vahnirūpā vidyut, muśalavadadhaḥpatanaśīlō māraṇātmakō'śaniḥ| saṁsargajā iti dēvādidrōhakajanasamparkajā ityarthaḥ| ākasmikā iti vinaiva saṁsargaṁ prāktanakarmapīḍitatvēna jātā ityarthaḥ| upasargajasaṁsargajayōrayaṁ viśēṣaḥ- upasargajā jvarādirōgapīḍitajanasamparkādbhavanti; saṁsargajāśca dēvādidrōhakajanasamparkādbhavanti| ‘dēvadrōhābhiśaptakā’ ityatra kēcit ‘upasargābhiśāpābhicārābhiṣaṅgajā’ iti paṭhanti, sa cābhāvānna likhitaḥ| saptamaṁ vyādhibhēdaṁ darśayannāha- svabhāvabalapravr̥ttā ityādi| svabhāvabalapravr̥ttā iti prakr̥tiśaktijātā ityarthaḥ| kē punasta ityāha- kṣutpipāsētyādi| kālajā iti yē samayē prāptā bhavanti| akālajā asamayē jātā ityarthaḥ| tatra kālajākālajayōrhētubhēdēna bhēda iti darśayati- tatra parirakṣaṇakr̥tā ityādi| parirakṣaṇaṁ rakṣāprayatnaḥ, tasminnapi parirakṣaṇē yē bhavanti tē kālajāḥ; ata ēva kālakr̥tānāṁ nōpacārō'sti yāpyataivāsti bhōjanapānarasāyanādibhiḥ, ātyantikapratīkārō vā svabhāvavyādhicikitsitōktarasāyanavidhinā| aparirakṣaṇakr̥tā iti aparirakṣaṇaṁ rakṣaṇē'prayatnaḥ, tasmin yē bhavanti tē akālakr̥tāḥ| tēṣāṁ ca yathādōṣaṁ yathārōgaṁ ca pratīkāraḥ| ētē ādhidaivikā iti ētē kṣutpipāsādayō daivamadhikr̥tya bhavantītyādhidaivikāḥ| kēcit “ēta ādhidaivikāḥ” ityamuṁ pāṭhaṁ na paṭhanti| tēṣāṁ matē svabhāvabalapravr̥ttāḥ kṣutpipāsādaya ādhyātmikamadhyē nipatanti| tatra tēṣvēva saptasu vyādhibhēdēṣu sarvavyādhyuparōdhaṁ darśayannāha- atra sarvavyādhyuparōdha iti| atrēti atrōktasaptavidhavyādhau, uparōdhaḥ saṅgrahaḥ||7||

Meaning of the commentary

This passage gives the fifth, sixth and seventh divisions of disease. Time is the six-season cycle characterized by cold, heat and rain. Its disorders include stiffness, burning and trembling, as well as wounds and fever. The commentary assigns deranged-season disorders treatment with previously collected food, drink and medicines, measures appropriate to the disease and seasonal disturbance, and historical rites such as homa; disorders arising in a normal season are treated according to dosha and disease. Divine-force disorders are said to arise from divine power. Their causes include offense against deities, cows, teachers and siddhas; curses by sages; destructive rites using Atharvan mantras; and upasarga disorders such as fever arising near an afflicted person. Lightning is described as transverse, vine-like fire, while ashani falls downward like a pestle and is lethal. Contact-produced disease here means contact with someone who has offended deities or similar beings, whereas upasarga means contact with a person afflicted by fever or another disease. Sudden disease is explained through the source's doctrine of prior action without contact. Some witnesses read a different sequence involving upasarga, curses, ritual acts and abhishanga, but the commentator omits it because the reading was unavailable. Natural-force conditions arise from the power of nature. Timely means occurring at the expected time despite protective effort; the commentary regards such conditions as maintainable with food, drink, rasayana and related measures, or potentially addressed through the rasayana method taught for natural disease. Untimely means arising through failure to protect and is addressed according to dosha and disease. Some omit the statement classing these conditions as adhidaivika and instead place hunger, thirst and the other natural conditions under adhyatmika. The seven disease divisions together are said to encompass all diseases.

Key terms

kAlabalapravRuttAH (kalabalapravrttah)
Disorders attributed to the force of time, season or weather.
daivabalapravRuttAH (daivabalapravrttah)
Disorders attributed by the source to divine or supernatural force.
svabhAvabalapravRuttAH (svabhavabalapravrttah)
Conditions attributed to the force of nature, including hunger, thirst, aging, death and sleep.

Adhikarana 7 (8) · Śloka 8

sarvēṣāṁ ca vyādhīnāṁ vātapittaślēṣmāṇa ēva mūlaṁ; talliṅgatvāddr̥ṣṭaphalatvādāgamācca | yathā hi kr̥tsnaṁ vikārajātaṁ viśvarūpēṇāvasthitaṁ sattvarajastamāṁsi na vyatiricyantē, ēvamēva kr̥tsnaṁ vikārajātaṁ viśvarūpēṇāvasthitamavyatiricya vātapittaślēṣmāṇō vartantē | dōṣadhātumalasaṁsargādāyatanaviśēṣānnimittataścaiṣāṁ vikalpaḥ | dōṣadūṣitēṣvatyarthaṁ dhātuṣu sañjñā- rasajō'yaṁ, śōṇitajō'yaṁ, māṁsajō'yaṁ, mēdōjō'yaṁ, asthijō'yaṁ majjajō'yaṁ, śukrajō'yaṁ vyādhiriti ||8||

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सर्वेषां च व्याधीनां वातपित्तश्लेष्माण एव मूलं; तल्लिङ्गत्वाद्दृष्टफलत्वादागमाच्च | यथा हि कृत्स्नं विकारजातं विश्वरूपेणावस्थितं सत्त्वरजस्तमांसि न व्यतिरिच्यन्ते, एवमेव कृत्स्नं विकारजातं विश्वरूपेणावस्थितमव्यतिरिच्य वातपित्तश्लेष्माणो वर्तन्ते | दोषधातुमलसंसर्गादायतनविशेषान्निमित्ततश्चैषां विकल्पः | दोषदूषितेष्वत्यर्थं धातुषु सञ्ज्ञा- रसजोऽयं, शोणितजोऽयं, मांसजोऽयं, मेदोजोऽयं, अस्थिजोऽयं मज्जजोऽयं, शुक्रजोऽयं व्याधिरिति ||८||

Meaning of the śloka

Vata, pitta and kapha are the root of all diseases, because diseases bear their signs, because the effects of dosha-directed treatment are observed, and because authoritative teaching states it. Just as the entire range of transformations that constitutes the world does not exist apart from sattva, rajas and tamas, the entire range of diseases likewise does not occur apart from vata, pitta and kapha. Diseases differ through the combinations of doshas with tissues and wastes, through differences in their sites, and through their causes. When a tissue is greatly affected by doshas, the disorder is named after that tissue as rasa-born, blood-born, flesh-born, fat-born, bone-born, marrow-born or shukra-born.

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kathaṁ punaḥ sarvavyādhyuparōdha ityāha- sarvēṣāṁ ca vyādhīnāmityādi| mūlamiti kāraṇamityarthaḥ| talliṅgatvāditi vātādiliṅgatvāt| liṅgaṁ tu vātādīnāṁ raukṣyālpasnēhādayaḥ, tathā tōdadāhakaṇḍvādīni kāryāṇi ca| dr̥ṣṭaphalatvāditi vātādiharauṣadhairvātādivyādhērupaśamanadarśanāt| āgamācca saviṁśatyēkādaśaśatanāṁ vyādhīnāṁ kāryabhūtānāṁ vātapittaślēṣmāṇō hi kāraṇam| yathāhi kr̥tsnamityādi| vikārajātamiti vikārasamūhaṁ; vikārāścātra trayōviṁśatirmahadādyāḥ| viśvarūpēṇāvasthitamiti jagadrūpēṇa vyāpya sthitamityarthaḥ| na vyatiricyanta iti na pr̥thagbhavantītyarthaḥ| ēvamēva kr̥tsnaṁ vikārajātamityādi vikārajātamiti rōgasamūham| avyatiricyēti aparityajyētyarthaḥ| ētēna tālliṅgatvādityādinā anumānapratyakṣāgamōpamānāni catvāri pramāṇānyuktāni| nanu, dōṣatrayāt kathamādibalapravr̥ttādayō'nēkē vyādhaya ityāha- dōṣētyādi| dōṣadhātumalasaṁsargāditi saṁsargaḥ saṁyōgaḥ; tadyathā- vātādidōṣarasadhātusaṁsargājjvarādayō rasādhiṣṭhānāḥ,vātādidōṣarasadhātupurīṣamalasaṁsargādatīsārādayaḥ, vātādidōṣarasādidūṣyamūtramalasaṁsargādviṁśatirmōhāḥ, tathā vātādidōṣaraktadhātusaṁsargādvātaraktaraktapittavidradhiraktagulmādayaḥ| āyatanaviśēṣāditi āyatanāni sthānāni, tēṣāṁ viśēṣō bhēda ityarthaḥ; tadyathā- saptasvāyatanēṣu pañcaṣaṣṭirmukharōgāḥ, cakṣurindriyāyatanēṣu ṣaṭsaptatirnētrarōgāḥ, nimittataścēti nimittāni vātādayaḥ; tadyathā- pratyēkaṁ vātādijvarāstrayaḥ, sānnipātika ēkaḥ, dvandvajāstrayaḥ, āgantuścāṣṭamaḥ; ēvamanyadapi nimittatō vyādhīnāṁ nānātvaṁ jñēyam| ēṣāmiti vyādhīnāṁ, vikalpō bhēdaḥ nānātvamityarthaḥ| dūṣyajanmasañjñā lakṣaṇayā bhavatīti darśayannāha- dōṣadūṣitēṣvatyarthamityādi| dōṣairēva dūṣitēṣu dhātuṣvatyarthaṁ dōṣajēṣu vikārēṣu rasajādisañjñā; yathā- ghr̥tadagdhastailadagdhastāmradagdhō lōhadagdha iti| atra ghr̥tādiśabdēna ghr̥tādisthō vahnirlakṣyatē, ēvaṁ rasādijō vyādhirityatra rasādisthitavātādidōṣā lakṣyantē||8||

Meaning of the commentary

The passage explains how the preceding categories include all disease. Root means cause. Diseases show doshic signs such as dryness or reduced unctuousness and effects such as pricking pain, burning and itching. Their doshic basis is also inferred when medicines directed against a dosha calm the corresponding disease, and is supported by authoritative teaching that vata, pitta and kapha cause the stated diseases. In the comparison, the twenty-three transformations beginning with mahat pervade the form of the world without existing separately from sattva, rajas and tamas; similarly, the collection of diseases does not abandon the three doshas. The commentary sees inference, perception, authoritative testimony and analogy represented by these arguments. Variety arises when doshas combine with tissues and wastes: examples include fever based in rasa, diarrhea involving rasa and feces, prameha involving rasa and urine, and vatarakta, raktapitta, abscess and blood-gulma involving blood. Variety also arises from location, such as the many diseases of the mouth and eye, and from causes, as in the doshic, combined and external varieties of fever. Naming a disorder rasa-born or after another tissue is figurative: it denotes doshas situated in and severely affecting that tissue, just as 'burned by ghee' refers to fire situated in ghee rather than ghee itself as the burning agent.

Key terms

mUlam (mulam)
The causal root, here assigned to vata, pitta and kapha for all diseases.
doShadhAtumalasaMsargAt (doshadhatumalasamsargat)
Through combinations of doshas with tissues and bodily wastes, one basis for disease diversity.
rasajaH (rasajah)
Called rasa-born by figuratively naming the disorder after the tissue severely affected by doshas.

Adhikarana 8 (9) · Śloka 9

tatra, annāśraddhārōcakāvipākāṅgamardajvarahr̥llāsatr̥ptigauravahr̥tpāṇḍurōgamārgōparōdhakārśyavairasyāṅgasādākālajavalīpalitadarśanaprabhr̥tayō rasadōṣajā vikārāḥ; kuṣṭhavisarpapiḍakāmaśakanīlikātilakālakanyacchavyaṅgēndraluptaplīhavidradhigulmavātaśōṇitārśō'rbudāṅgamardāsr̥gdararaktapittaprabhr̥tayō raktadōṣajāḥ , gudamukhamēḍhrapākāśca; adhimāṁsārbudārśō'dhijihvōpajihvōpakuśagalaśuṇḍikālajīmāṁsasaṅghātauṣṭhaprakōpagalagaṇḍagaṇḍamālāprabhr̥tayō māṁsadōṣajāḥ; granthivr̥ddhigalagaṇḍārbudamēdōjauṣṭhaprakōpamadhumēhātisthaulyātisvēdaprabhr̥tayō mēdōdōṣajāḥ; adhyasthyadhidantāsthitōdaśūlakunakhaprabhr̥tayō'sthidōṣajāḥ; tamōdarśanamūrcchābhramaparvasthūlamūlārurjanmanētrābhiṣyandaprabhr̥tayō majjadōṣajāḥ; klaibyāpraharṣaśukrāśmarīśukramēhaśukradōṣādayaśca taddōṣāḥ; tvagdōṣāḥ saṅgō'tipravr̥ttirayathāpravr̥ttirvā malāyatanadōṣāḥ; indriyāṇāmapravr̥ttirayathāpravr̥ttirvēndriyāyatanadōṣāḥ; ityēṣa samāsa uktaḥ; vistaraṁ nimittāni caiṣāṁ pratirōgaṁ vakṣyāmaḥ ||9||

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तत्र, अन्नाश्रद्धारोचकाविपाकाङ्गमर्दज्वरहृल्लासतृप्तिगौरवहृत्पाण्डुरोगमार्गोपरोधकार्श्यवैरस्याङ्गसादाकालजवलीपलितदर्शनप्रभृतयो रसदोषजा विकाराः; कुष्ठविसर्पपिडकामशकनीलिकातिलकालकन्यच्छव्यङ्गेन्द्रलुप्तप्लीहविद्रधिगुल्मवातशोणितार्शोऽर्बुदाङ्गमर्दासृग्दररक्तपित्तप्रभृतयो रक्तदोषजाः , गुदमुखमेढ्रपाकाश्च; अधिमांसार्बुदार्शोऽधिजिह्वोपजिह्वोपकुशगलशुण्डिकालजीमांससङ्घातौष्ठप्रकोपगलगण्डगण्डमालाप्रभृतयो मांसदोषजाः; ग्रन्थिवृद्धिगलगण्डार्बुदमेदोजौष्ठप्रकोपमधुमेहातिस्थौल्यातिस्वेदप्रभृतयो मेदोदोषजाः; अध्यस्थ्यधिदन्तास्थितोदशूलकुनखप्रभृतयोऽस्थिदोषजाः; तमोदर्शनमूर्च्छाभ्रमपर्वस्थूलमूलारुर्जन्मनेत्राभिष्यन्दप्रभृतयो मज्जदोषजाः; क्लैब्याप्रहर्षशुक्राश्मरीशुक्रमेहशुक्रदोषादयश्च तद्दोषाः; त्वग्दोषाः सङ्गोऽतिप्रवृत्तिरयथाप्रवृत्तिर्वा मलायतनदोषाः; इन्द्रियाणामप्रवृत्तिरयथाप्रवृत्तिर्वेन्द्रियायतनदोषाः; इत्येष समास उक्तः; विस्तरं निमित्तानि चैषां प्रतिरोगं वक्ष्यामः ||९||

Meaning of the śloka

Disorders attributed to impaired rasa include lack of desire for food, loss of appetite, impaired digestion, bodily aching, fever, nausea, satiety, heaviness, cardiac pallor disorder, obstruction of pathways, emaciation, altered taste, weakness of the limbs, premature wrinkles and graying, and similar conditions. Blood-related disorders include kushtha, visarpa, pidaka, mashaka, nilika, tilakalaka, nyaccha, vyanga, indralupta, splenic disease, abscess, gulma, vatarakta, piles, arbuda, bodily aching, abnormal uterine bleeding, raktapitta, and suppuration of the anus, mouth and penis. Flesh-related disorders include adhimamsa, arbuda, piles, adhijihva, upajihva, upakusha, galashundika, alaji, mamsasanghata, swelling of the lips, galaganda, gandamala and similar disorders. Fat-related disorders include granthi, vrddhi, galaganda, arbuda, fat-related lip swelling, madhumeha, excessive corpulence and excessive sweating. Bone-related disorders include extra bones, extra teeth, pricking pain and pain in bones, kunakha and similar conditions. Marrow-related disorders include seeing darkness, fainting, dizziness, thick-rooted ulcers arising at joints, eye discharge and similar conditions. Shukra-related disorders include klaibya, absence of sexual desire, shukra stone, shukrameha and other shukra disorders. Skin disorders include kushtha. Obstruction, excessive flow or improper flow are disorders of waste outlets. Failure or improper functioning of the senses are disorders of sensory sites. This is a concise account; the details and causes will be stated disease by disease.

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cikitsāviśēṣavijñānārthaṁ sukhasādhyatvādikarmabōdhārthaṁ ca pratyēkaṁ rasādidhātuvikārān darśayitumāha- tatrānnāśraddhārōcakētyādi| annāśraddhā annavidvēṣaḥ| aṅgamarda iti vēdanāviśēṣaḥ ‘sphuṭanikā’ iti lōkē| hr̥llāsō hr̥dayōtklēdō'sakr̥tṣṭhīvanam| aṅgasāda iti aṅgānāmanutsāhaḥ| rasadōṣajā iti dōṣadūṣitarasajātāḥ| rasajānabhidhāya raktajānabhidhātumāha- kuṣṭhētyādi| raktajānuktvā māṁsajānāha- adhimāṁsētyādi| māṁsasaṅghāta iti māṁsatānō nāma mukharōgēṣu; ‘māṁsōcchrāyaḥ sāmānya ēva’ ityanyē| māṁsajān kathayitvā mēdōjānāha- granthītyādi| mēdōjānuktvā'sthijānāha- adhyasthyadhidantētyādi| adhyasthīni adhikāsthīnītyarthaḥ| adhidantā iti adhikā dantā ityarthaḥ| tōdaśūlābhyāṁ sahāsthiśabdaḥ pratyēkaṁ sambadhyatē| asthidōṣānabhidhāya majjajānāha- tamōdarśanētyādi|- tamōdarśanam andhakāradarśanam| mūrcchā cētanācyutiḥ| bhramaḥ cakrārūḍhasyēva| pūrvasthūlamūlārurjanmēti sthūlamūlānāmaruṣāṁ vraṇānāṁ parvasu janmētyarthaḥ | anyē tvatra ‘parvagauravasthūlamūlārurjanma’ iti paṭhanti| majjadōṣānabhidhāya śukradōṣān darśayati- klaibyāpraharṣētyādi|- klaibyamiti ṣaṇḍhatētyarthaḥ| apraharṣa iti strīviṣayē'nabhilāṣaḥ| taddōṣā iti śukradōṣā ityarthaḥ| śukrajānuktvā malāyatanadōṣānāha- tvagdōṣā ityādi| tvagdōṣāḥ kuṣṭhāni| karṇanāsāmukhākṣimalāyatanēṣvanyēṣu ca prajananādyapatyapathēṣvapravr̥ttiḥ ‘saṅga’ ucyatē| malāyatanadōṣānabhidhāyēndriyāyatanadōṣānāha- indriyāṇāmapravr̥ttirityādi| samāsaḥ saṅkṣēpaḥ| dōṣadhātumalasaṁsargāditi yat prāguktaṁ vyādhinānātvakāraṇaṁ, tathā''yatanaviśēṣāditi yaddvitīyaṁ vyādhinānātvakāraṇamuktam, ētaddvayamapi saṅkṣēpēṇābhidhāya nimittataścēti yaduktaṁ tr̥tīyaṁ vyādhinānātvakāraṇaṁ tadabhidhātumāha- vistaramityādi| nimittāni vātādayaḥ tatkāraṇāni balavadvigrahādīni mithyāprayuktāni snēhādīni ca; jvarē tadyathā kāmajvaraḥ krōdhajvarō mr̥tpāṇḍurōga ityādi; tathā'tīsārē ‘gurvatisnigdharūkṣōṣṇadravasthūlātiśītalaiḥ’ (u. ta. a. 40) ityādi pratirōgaṁ nirdiṣṭāni| pratirōgaṁ vakṣyāma iti rōgē rōgē vakṣyāmaḥ||9||

Meaning of the commentary

The tissue-based disorders are listed to distinguish treatment and understand relative ease of cure. Lack of desire for food means aversion to food. Angamarda is a particular kind of pain popularly called sphutanika. Hrllasa is cardiac queasiness with repeated spitting, and angasada is lack of vigor in the limbs. A rasa-related disorder is one produced from rasa affected by doshas. After rasa, the passage successively lists disorders of blood, flesh, fat, bone, marrow and shukra. Mamsasanghata is a mouth disease called mamsatana; others take it simply as a general elevation of flesh. Adhyasthi and adhidanta mean extra bones and teeth, and the word bone applies separately to pricking and aching pain. Seeing darkness is visual obscuration; murccha is loss of consciousness; and bhrama is a sensation like being mounted on something rotating. The main marrow reading describes thick-rooted ulcers arising at joints. Others read heaviness at the joints followed by thick-rooted ulcers. Klaibya is impotence, and apraharsa is absence of desire toward women in the commentary's wording. Following the shukra list, the passage turns to skin, waste outlets and sensory sites. Sanga is non-flow or obstruction in the ears, nose, mouth, eyes, reproductive passages and other channels. The passage concisely covers disease diversity due to dosha-tissue-waste combinations and differences of site; the promised detailed account addresses the third basis, causes, including doshas and factors such as conflict with stronger persons or misapplied oleation. These will be stated for each disease.

Key terms

rasadoShajAH vikArAH (rasadoshajah vikarah)
Disorders attributed to rasa affected by doshas.
malAyatanadoShAH (malayatanadoshah)
Disorders of bodily waste outlets, expressed as obstruction, excess flow or improper flow.
indriyAyatanadoShAH (indriyayatanadoshah)
Failure or improper functioning associated with the sensory sites.

Adhikarana 9 (10) · Śloka 10

bhavati cātra- kupitānāṁ hi dōṣāṇāṁ śarīrē paridhāvatām | yatra saṅgaḥ khavaiguṇyādvyādhistatrōpajāyatē ||10||

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भवति चात्र- कुपितानां हि दोषाणां शरीरे परिधावताम् | यत्र सङ्गः खवैगुण्याद्व्याधिस्तत्रोपजायते ||१०||

Meaning of the śloka

As aggravated doshas move throughout the body, disease arises wherever they become obstructed because of abnormality in a channel or space.

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vātādīnāṁ śarīrē prasaratāṁ sthānasaṁśrayasya vyādhinānātvakāraṇasya hētuṁ darśayannāha- kupitānāmityādi| khavaiguṇyāt srōtōvaiguṇyādityarthaḥ||10||

Meaning of the commentary

The verse explains the cause of sthanasamshraya, the localization that accounts for the variety of diseases produced as vata and the other doshas spread. Khavaigunya means abnormality or vulnerability of a srotas.

Key terms

khavaiguNyAt (khavaigunyat)
Because of abnormality or vulnerability in a bodily channel or space.

Adhikarana 10 (11) · Śloka 11

bhūyō'tra jijñāsyaṁ, kiṁ vātādīnāṁ jvarādīnāṁ ca nityaḥ saṁślēṣaḥ paricchēdō vā? iti; yadi nityaḥ saṁślēṣaḥ syāttarhi nityāturāḥ sarva ēva prāṇinaḥ syuḥ; athāpyanyathā vātādīnāṁ jvarādīnāṁ ca, ‘anyatra vartamānānāmanyatra liṅgaṁ na bhavati’ iti kr̥tvā yaducyatē vātādayō jvarādīnāṁ mūlānīti tanna | atrōcyatē- dōṣān pratyākhyāya jvarādayō na bhavanti; atha ca na (nityaḥ) sambandhaḥ; yathāhi vidyudvātāśanivarṣāṇyākāśaṁ pratyākhyāya na bhavanti, satyapyākāśē kadācinna bhavanti, atha ca nimittatastata ēvōtpattiriti; taraṅgabudbudādayaścōdakaviśēṣāḥ ēva; vātādīnāṁ jvarādīnāṁ ca nāpyēvaṁ saṁślēṣō na paricchēdaḥ śāśvatikaḥ, atha ca nimittata ēvōtpattiriti ||11||

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भूयोऽत्र जिज्ञास्यं, किं वातादीनां ज्वरादीनां च नित्यः संश्लेषः परिच्छेदो वा? इति; यदि नित्यः संश्लेषः स्यात्तर्हि नित्यातुराः सर्व एव प्राणिनः स्युः; अथाप्यन्यथा वातादीनां ज्वरादीनां च, ‘अन्यत्र वर्तमानानामन्यत्र लिङ्गं न भवति’ इति कृत्वा यदुच्यते वातादयो ज्वरादीनां मूलानीति तन्न | अत्रोच्यते- दोषान् प्रत्याख्याय ज्वरादयो न भवन्ति; अथ च न (नित्यः) सम्बन्धः; यथाहि विद्युद्वाताशनिवर्षाण्याकाशं प्रत्याख्याय न भवन्ति, सत्यप्याकाशे कदाचिन्न भवन्ति, अथ च निमित्ततस्तत एवोत्पत्तिरिति; तरङ्गबुद्बुदादयश्चोदकविशेषाः एव; वातादीनां ज्वरादीनां च नाप्येवं संश्लेषो न परिच्छेदः शाश्वतिकः, अथ च निमित्तत एवोत्पत्तिरिति ||११||

Meaning of the śloka

A further question is whether doshas such as vata and diseases such as fever are permanently joined or entirely separate. If permanently joined, every living being would always be ill. If wholly separate, a sign belonging in one could not appear in the other, so the claim that doshas are the roots of fever and other diseases would fail. The answer is that fever and other diseases do not arise apart from doshas, yet their relation is not permanent. Lightning, wind, thunderbolts and rain do not arise apart from the sky or cloud, but they are not always present when it is present; they arise from it when the required causes assemble. Waves and bubbles likewise are particular forms of water. In the same way, doshas and diseases are neither eternally inseparable nor eternally separate; disease arises from doshas when the necessary conditions occur.

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pratipādya vyādhīnāṁ dōṣāṇāṁ ca kāryakāraṇasambandhaṁ punaranyathā jijñāsyamāha- bhūya ityādi|- bhūyaḥśabdaḥ punararthē| jijñāsyaṁ jñātumabhilaṣaṇīyam| ētēnaitaduktaṁ bhavati- prākkila vyādhīnāṁ vātādimūlatvaṁ jijñāsitam, atrānyat punarapi jñātumēṣṭavyamityarthaḥ; anyē bhūyō bahutaramiti vyākhyānayanti| kēcit ‘bhūyō'tra jijñāsyatē’ iti paṭhanti| nityaḥ saṁślēṣa iti sarvadā apr̥thaktvaṁ, yathā- sūryātapayōścandrajyōtsnayōḥ pāvakōṣṇatvayōriti| paricchēdō viślēṣaḥ pr̥thaktvaṁ; yathā- paṭakuvindakayōrghaṭakumbhakārayōḥ kuṇḍalasuvarṇakārayōrityādi| athāpyanyathēti kō'rthaḥ? anityaḥ saṁślēṣaḥ| pūrvapakṣamāśaṅkya samādhānamāha- atrōcyata ityādi| pratyākhyāyēti parityajyētyarthaḥ| nanu, yadi dōṣān parityajya jvarādayō na bhavanti, tarhi sambandhō'stītyāśaṅkānirākaraṇāyāha- atha ca na sambandha iti|- ‘sarvadā’ iti śēṣaḥ| kathaṁ na sarvadā sambandha ityatra dr̥ṣṭāntamāha- vidyudvātētyādi| ākāśaśabdēnākāśasthō mēgha ucyatē; satyapyākāśa iti vidyamānē'pi jalada ityarthaḥ| nimittata iti sāmagrīta ityarthaḥ| tata ēvēti tasyāḥ sāmagryā ēvētyarthaḥ| aparadr̥ṣṭāntamāha- taraṅgabudbudādaya iti| taraṅgaḥ jalalaharī| śāśvatika iti nitya ityarthaḥ||11||

Meaning of the commentary

The passage further examines the cause-and-effect relation between dosha and disease. Bhuyas means again, though others take it as 'more extensively'; a variant reads 'is further investigated.' Permanent conjunction is inseparability like sunlight from the sun, moonlight from the moon or heat from fire. Separation is like cloth and weaver, pot and potter, or ornament and goldsmith. Pratyakhyaya means leaving aside. Here akasha refers to a cloud in the sky, and nimitta means the assembled causal conditions. The wave-and-bubble example shows effects as particular states of their material cause.

Key terms

nityaH saMshleShaH (nityah samshleshah)
Permanent and inseparable conjunction of cause and effect.
paricchedaH (paricchedah)
Complete distinction or separateness between dosha and disease.

Adhikarana 11 (12) · Śloka 12

bhavati cātra- vikāraparimāṇaṁ ca saṅkhyā caiṣāṁ pr̥thak pr̥thak | vistarēṇōttarē tantrē sarvābādhāśca vakṣyatē ||12||

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भवति चात्र- विकारपरिमाणं च सङ्ख्या चैषां पृथक् पृथक् | विस्तरेणोत्तरे तन्त्रे सर्वाबाधाश्च वक्ष्यते ||१२||

Meaning of the śloka

The extent of disorders, their separate numerical classifications, and all diseases will be explained in detail in the Uttara Tantra.

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‘vistaraṁ nimittāni caiṣāṁ pratirōgaṁ vakṣyāma’ iti yaduktaṁ prāk tat pratipādayannāha- vikāraparimāṇaṁ cētyādi| vikāraparimāṇaṁ cēti iyaṁ samudāyasaṅkhyā, tathā ca ‘vyādhīnāṁ tu sahasraṁ yacchataṁ viṁśatirēva ca’- (u. taṁ. a. 66) ityuttarē tantrē vakṣyatē| saṅkhyā caiṣāṁ pr̥thak pr̥thagiti iyamavayavasaṅkhyā; tathā ca- ṣaḍarśāṁsi, catasrō'śmaryaḥ, aṣṭādaśa kuṣṭhānīti nidānasthānē vakṣyatē| sarvābādhāśca vakṣyata iti jvarātīsāraśōṣādayaḥ| cakārō'tra bhinnakramē| tēna vikāraparimāṇaṁ ca sarvābādhāścōttarē tantrē vakṣyata iti sambadhyatē; na punaḥ ‘uttarē tantrē’ iti ‘saṅkhyā caiṣāṁ pr̥thak pr̥thag’ ityatra sambadhyatē| anyē tu vyākhyānayanti “ vikārā jvarādīnāmupadravarūpatayā tr̥ṭchardiprabhr̥tayaḥ, tatparimāṇamadhikamadhyahīnabhēdēna vikāraparimāṇam; ‘aṣṭau jvarāḥ, ṣaḍatīsārāḥ’ ityādi saṅkhyā ca pr̥thak pr̥thak; sarvābādhāśca śārīramānasā iti; sarvamētaduttarē tantrē vakṣyatē vyākhyāsyatyācāryaḥ” iti||12||

Meaning of the commentary

One explanation takes vikara-parimana as the collective total, later stated as one thousand one hundred and twenty diseases, while separate enumeration means counts such as six types of piles, four urinary stones and eighteen kushthas, taught in the Nidanasthana. All diseases includes fever, diarrhea, shosha and others. By construing the conjunction out of sequence, the collective extent and all diseases are assigned to the Uttara Tantra, while the separate counts are not necessarily assigned there. Another interpretation takes vikara to mean complications of fever and other diseases, such as thirst and vomiting, and parimana as their greater, moderate or lesser degree; separate counts are examples such as eight fevers and six diarrheas; all diseases are bodily and mental; and all these topics are said to be explained in the Uttara Tantra.

Key terms

vikAraparimANam (vikaraparimanam)
Interpreted either as the total number of disorders or as the degree of complications associated with individual diseases.

Adhikarana puṣpikā · Śloka 24

iti suśrutasaṁhitāyāṁ sūtrasthānē vyādhisamuddēśīyō nāma caturviṁśō'dhyāyaḥ ||24||

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इति सुश्रुतसंहितायां सूत्रस्थाने व्याधिसमुद्देशीयो नाम चतुर्विंशोऽध्यायः ||२४||

Meaning of the śloka

Thus ends the twenty-fourth chapter, called Vyadhisamuddeshiya, in the Sutrasthana of the Sushruta Samhita.

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iti śrīḍalha(hla)ṇaviracitāyāṁ suśrutavyākhyāyāṁ nibandhasaṅgrahākhyāyāṁ sūtrasthānē caturviṁśatitamō'dhyāyaḥ||24||

Meaning of the commentary

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

← 23. kr̥tyākr̥tyavidhyadhyāyaḥ25. aṣṭavidhaśastrakarmīyādhyāyaḥ →