The commentary says that after the chapter on visūcikā, beginning arocaka is fitting because both arise from disorders of rasa and because both cause dull digestive fire. The word 'ādi' is understood to be omitted after arocaka, so avipāka (indigestion) is also included.
When the doṣas, separately or together, or from disturbance of the mind, greatly pervade the channels of food and the heart, and there is no liking for food: physicians describe here that disorder, obstruction of food (bhaktopaghāta), as fivefold.
The commentary gives the number by way of pathogenesis. Three arise from the doṣas separately, one from all together, and one from disturbance of the mind (from desire, grief, fear and the like); some read 'from a surge of grief', which would exclude those from desire and the rest. 'Channels of food' means the tongue, as another tantra shows: 'by doṣas separately and together, spread on the tongue and heart, distaste for food arises, and from hateful and mental causes'. Arocaka, abhaktacchanda and annadveṣa are synonyms; others hold they differ, quoting Vṛddhabhoja on three types: food put in the mouth is not relished (arocaka), disgust arising on thinking of, seeing or hearing of food (bhaktadveṣa), and lack of desire for food (abhaktacchanda). The number 'five' is stated to fix it, so mind-caused kinds from desire and the rest are not counted separately.
The commentary gives the signs of vātika arocaka. 'With heart pain and oppression' qualifies the tasteless mouth; others say it means the heart is afflicted by pain and pressure. Premonitory signs of arocaka are not given, since indistinct signs are themselves premonitory.
The commentary gives the signs of kaphaja arocaka. Some read 'kaṇṭhasāda' (throat sinking) in place of 'limb-sinking and drowsiness' and explain it as inability to swallow.
The commentary gives the signs of sannipātika arocaka. Although the signs of sannipātika heart disease and of sannipātika arocaka are largely the same, they differ in pathogenesis and slightly in signs. Sannipātika arocaka is incurable, as another tantra says 'one should also abandon that from all doṣas'.
The commentary says the fifth kind is of mind-cause. Saṃrāga is desire; viplutacetas is one whose mind is disturbed; ashucidarśana is seeing filthy or disgusting things. Since separate signs are given only for the worry-caused kind, the others are to be known by the doṣa, since desire and other emotions aggravate the doṣas, as the quoted line says: 'from desire, grief and fear vāta is aggravated; from anger pitta; from joy kapha'. Others read separate signs by doṣa for the worry-caused type; the commentary rejects this reading as not original (anārṣa).
In the vāta type, after emesis with vacā water, he should drink (ghee and other) snehas, with surā, or a powder in warm water of kṛṣṇā, viḍaṅga, barley ash, hareṇu, bhārgī, rāsnā, elā, hiṅgu, the best salt and nāgara.
The commentary gives treatment of vātika arocaka. Vāta here means the vāta type. 'After emesis with vacā water' means emesis with vacā decoction. Some take 'elā' as elavāluka and read 'with warm water' for 'with elā water'. The best salt is saindhava. The powder is given to one whose stomach has been cleansed by emetics. Kārttikakuṇḍa reads the verse differently; not shown.
The commentary gives treatment of kaphaja arocaka. Nimbāmbu is neem decoction; after such emesis, a decoction of girimālaka with honey and ajamodā is the after-drink, given after the meal, as another tantra shows. Some take dīpyaka as yavānī.
Key terms
rājadruma
Girimālaka (Cassia fistula).
dīpyaka
Ajamodā, or yavānī per some.
Adhikarana ౧౧ (౮) · Śloka ౮
చూర్ణం యదుక్తమథవాఽనిలజే తదేవ... |8|
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चूर्णं यदुक्तमथवाऽनिलजे तदेव... |८|
Meaning of the śloka
The powder already described, or that (also) in vātaja (arocaka)... (the verse is cut off).
The commentary extends the treatment: the powder of kṛṣṇā, viḍaṅga, barley ash and the rest, described earlier, is also given in the kapha type when vāta is involved.
Key terms
cūrṇa
Powder formula.
Adhikarana ౧౨ (౮) · Śloka ౮
...సర్వైశ్చ సర్వకృతమేవముపక్రమేత ||8||
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...सर्वैश्च सर्वकृतमेवमुपक्रमेत ||८||
Meaning of the śloka
... by all (the remedies) one should treat the type made by all (doṣas), in the same way.
The commentary says that for the sannipātika kind the remedies of all the doṣa-types stated before are used, with emesis and the like done first; however, treatment is undertaken only after declaring it incurable, since it is incurable.
द्राक्षापटोलविडवेत्रकरीरनिम्बमूर्वाभयाक्षबदरामलकेन्द्रवृक्षैः |
बीजैः करञ्जनृपवृक्षभवैश्च पिष्टैर्लेहं पचेत् सुरभिमूत्रयुतं यथावत् ||९||
मुस्तां वचां त्रिकटुकं रजनीद्वयं च भार्गीं च कुष्ठमथ निर्दहनीं च पिष्ट्वा |
मूत्रेऽविजे द्विरदमूत्रयुते पचेद्वा पाठां तुगामतिविषां रजनीं च मुख्याम् ||१०||
मण्डूकिमर्कममृतां च सलाङ्गलाख्यां मूत्रे पचेत्तु महिषस्य विधानविद्वा |
एतान्न सन्ति चतुरो लिहतस्तु लेहान् गुल्मारुचिश्वसनकण्ठहृदामयाश्च ||११||
Meaning of the śloka
Four licks, one for each of the four kinds: (1) drākṣā, paṭola, viḍa, vetra, karīra, nimba, mūrvā, abhayā, akṣa, badara, āmalaka, indravṛkṣa and the seeds of karañja and nṛpavṛkṣa, ground and cooked into a lick with cow's urine. (2) mustā, vacā, trikaṭu, both haridrās, bhārgī, kuṣṭha and nirdahanī, ground and cooked in sheep's urine with elephant's urine. (3) pāṭhā, tugā, ativiṣā and haridrā, cooked in buffalo urine by one who knows the method. (4) maṇḍūkī, arka, amṛtā and lāṅgalī, cooked in urine. Taking these four licks, gulma, arocaka, breathlessness and diseases of the throat and heart are not (left).
The commentary explains that the four licks are for the four kinds of arocaka respectively. Karīra is a leafless thorny desert tree; mūrvā is corasnāyu; abhayā is harītakī, or uśīra per some; akṣa is bibhītaka; indravṛkṣa is kuṭaja; nṛpavṛkṣa is girimālaka. 'With surabhi-mūtra' means with cow's urine, four times the paste; 'as directed' means cooked until a thread forms. Nirdahanī is citraka, or ajamodā per others; avi is sheep; dviradamūtra is elephant urine. Tugā is a vaṃśarocanā-like earthy substance; 'the best haridrā' is piṇḍa-haridrā. Maṇḍūkī is brāhmī; amṛtā is guḍūcī; lāṅgalī is kalikārī. Kārttikakuṇḍa and others read the last line differently, saying the four licks are for the four kinds of gulma, arocaka, breathlessness, throat and heart disease.
He may take agreeable (sātmya) foods and various snacks made in his own country, drinks, and combinations of roots, fruits, ṣāḍava and rāga; and various juices in different ways; and take food that is light, dry and pleasing to the mind.
The commentary says sātmya means pleasant; foods made in the region are those commonly used in that country; 'many' applies to drinks too, so fruits with sugar and fragrant with camphor and the four fragrant drugs are meant. Roots are pippalīmūla and the like; fruits are pomegranate and the like; ṣāḍavas are mango-sour preparations; rāgas are kapittha preparations. Some give recipes for rāga and ṣāḍava (quoted lines), and another reads ṣāḍava as yavānī-ṣāḍava, and rāga-ṣāḍava as mudga soup with grapes and pomegranate. Juices are meat juices or sweet-taste juices. Light, dry food is suitable because the disorder lies in the seat of kapha; 'pleasing to the mind' means agreeable. Some read that foods should be made after considering suitability, country, disease and season.
The commentary says that although āsthāpana is forbidden in arocaka in the earlier passage listing conditions, it is given, after the sequence of emesis and the like, when vāta is involved, and not at the start. Virecana is purgation; śirovirecana is nasya.
The three pungents (trikaṭu) powdered with the two haridrās and triphalā, mixed with yavaśūka (barley alkali), should be given with honey to awaken the mouth (mukhabodhana)... (the verse is cut off).
The commentary says trīṇy ūṣaṇāni is trikaṭu; yavaśūka is yavakṣāra; 'to awaken the mouth' means that when taste in the mouth is awakened, the arocaka is removed. This is a lick.
... मन्यानि तिक्तकटुकानि च भेषजानि |
मुस्तादिराजतरुवर्गदशाङ्गसिद्धैः क्वाथैर्जयेन्मधुयुतैर्विविधैश्च लेहैः ||१४||
मूत्रासवैर्गुडकृतैश्च तथा त्वरिष्टैः क्षारासवैश्च मधुमाधवतुल्यगन्धैः |१५|
Meaning of the śloka
... also other bitter and pungent medicines; one may overcome (arocaka) with decoctions of the mustādi and rājataru groups and the daśāṅga (daśamūla), mixed with honey, and with various licks; with mūtrāsavas made with jaggery, with ariṣṭas, and with kṣārāsavas having a smell like honey and madhu (wine).
The commentary says this gathers what has not been stated. The mustādi group begins with mustā, kuṣṭha, haridrā; the rājataru group begins with āragvadha, madana, gopaghoṇṭā; daśāṅga is daśamūla. The licks made with honey are those of the mustā groups. Some read 'and by various yogas' and take it as vāta-kapha-relieving ones. Mūtrāsavas are fermented preparations with urine, made with jaggery and honey as described in the kuṣṭha treatment; ariṣṭas are abhayāriṣṭa and the like; kṣārāsavas are those made with palāśa-ash water together with honey, as taught in the great kuṣṭha section; 'smell like honey and madhu' means smelling like honey and honey-wine.
The commentary extends the regimen to indigestion: this very regimen. Kapha and vāta are named, not pitta, to show that indigestion does not arise from pitta. 'Fire that has become quiet' means indigestion, by figure of speech; and this shows that dull digestive fire is the cause of indigestion. 'And of that' means also of arocaka. Kārttika does not accept this and says it is for the pacification of indigestion alone; those who hold the regimen is only for weak fire and not for arocaka or indigestion hold that indigestion should not be stated in this chapter.
When the digestive fire within is impaired by thwarted desire, fear or grief, one should provide the desired things (bhāvas) that are attainable, to give relish; and, for things that are lost, one should again console him with hundreds of ancient tales. Encouragement is beneficial when the mind has sunk into dejection; whatever is dear, that should be attended to in arocaka.
The commentary gives treatment of the fifth (mind-caused) arocaka. Icchābhighāta is failure to attain what one wants. One provides attainable things to create relish; for unattainable or lost things, he is consoled by tales from the Purāṇas, such as the stories of Nala and Rāma, and similar. Some read 'ancient paths of śruti', explaining śruti as hearing and the path as the way. 'When the mind has sunk' means the mind is troubled; encouragement is by comfort and beneficial advice. Some do not read this verse.
इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रेऽरोचकप्रतिषेधो नाम (एकोनविंशोऽध्यायः, आदितः) सप्तपञ्चाशत्तमोऽध्यायः ||५७||
Meaning of the śloka
Thus ends the fifty-seventh chapter (the nineteenth from the beginning of this section), named Arocakapratiṣedha, in the Kāyacikitsā-tantra within the Uttaratantra of the Suśruta Saṃhitā.
Thus ends the fifty-seventh chapter, named Arocakapratiṣedha, in the Uttaratantra, in the Suśruta commentary called Nibandhasaṅgraha composed by Śrī Ḍalhaṇa.