The commentary places the beginning of kaya-cikitsa after Kumaratantra. It gives two reasons: the preceding chapter points forward to later treatment, and children may also require kaya-cikitsa when disorders such as jvara arise. One explanation takes kaya as the aggregate of dosa, dhatu, and mala, so kaya-cikitsa treats disorders situated in that aggregate. Others understand kaya as kayagni, because jvara and related disorders pervade agni; another view takes it as the impaired body requiring treatment. Jvara is discussed first because it is regarded as especially serious among the many complications and as arising from Rudra's wrath. The commentary explains atha as indicating sequence, atah either as referring to the preceding chapter or as giving the reason, pratisedha as treatment, and vyakhyasyamah as a full and varied exposition.
Key terms
jvara
The classical disorder that forms the subject of this chapter.
kāyacikitsā
The branch of treatment interpreted here in several ways through the meaning of kāya.
doṣa-dhātu-mala-saṅghāta
The aggregate of doṣas, bodily constituents, and wastes, offered as one meaning of kāya.
kāyāgni
The bodily digestive or transformative fire, offered as an alternative meaning of kāya.
The disciples headed by Sushruta asked the seated divine teacher who, in a former divine birth, had drawn amrita from the ocean and from whom the gods obtained immortality: 'The complications of a wound have been stated. O foremost of physicians, now tell us, briefly and in detail, the complications affecting wounded persons.'
The commentary identifies the teacher as Dhanvantari and the waters as the milk ocean. Through his gift of amrita, the gods obtained immortality. Jejjata reads the line differently and explains that the gods thereby became lords among the gods. Mention of amrita and immortality serves as an auspicious opening to the chapter. Although Sushruta had earlier been the principal questioner, all the disciples participate here for everyone's benefit. One interpretation distinguishes wound features such as pain, color, and discharge from systemic complications of wounded persons, including jvara and atisara. Another says that both sets had already been summarized and that the request here is for detailed explanation, citing a list of sixteen complications.
Key terms
amṛta
The nectar said to have been obtained from the ocean and given to the gods.
Dhanvantari
The divine teacher addressed by the disciples.
vraṇa
A wound whose local features and related complications are under discussion.
upadrava
A complication arising in association with a wound or wounded person.
A wound in a person affected by a complication heals only with difficulty. Complications in a wounded person are also described as difficult to treat when strength and flesh have become depleted and the remaining dhatus have declined. Therefore, the disciples ask for all such complications, together with their treatment, as observed in kaya-cikitsa by the great sage.
The question is asked not merely because complications had not been described, but for two stated reasons: a wound accompanied by a complication subsides with difficulty, and the complications themselves are hard to treat. In one reading, the person is affected by jvara or another complication; another reading makes the wound itself pervaded by pain and similar complications. Some understand the complications of the wounded person as jvara and related disorders, while others include visarpa and the rest. Bala is explained as capacity or vigor, mamsa as bodily fullness, and the remaining dhatus as medas and those that follow; rakta is included through its dependence on mamsa. Cikitsa may mean a remedy, though some take it as the body of medical teaching and include earlier foundational treatises. A further reading has 'six kaya-cikitsas,' referring to six named medical traditions, with the corresponding plural reading 'great sages.'
Key terms
kṛcchrasādhya
Treatable only with difficulty.
bala
Strength or vigor, explained here through capacity for effort.
māṃsa
The bodily constituent associated here with fullness or tissue mass.
dhātu
A bodily constituent whose depletion contributes to difficulty of treatment.
cikitsā
Treatment, or in an alternative interpretation, a system of medical teaching.
Hearing the disciples' words, Dhanvantari, foremost among physicians, replied: 'I shall first explain jvara, remembered as the king of the host of diseases. It is said to have arisen from the fire of Rudra's anger, afflicts all living beings, and is known by various names among different creatures.'
The commentary identifies the speaker as Dhanvantari and explains roganikaraj as the king of the whole group of diseases. Among other living beings such as elephants and horses, the condition is designated by names such as pakala, abhitapaka, horaka, and bhramaraka.
Key terms
jvara
The principal classical disease category introduced first in this section.
rogānīkarāṭ
King of the host or collection of diseases.
Rudrakopāgni
The mythic fire of Rudra's anger from which jvara is said to arise.
The commentary says that this verse supports the previously stated description of jvara as king of the group of diseases and supplies its reason. The word prayah is explained as indicating particular prevalence rather than an absolute rule.
Key terms
janmādau
At or near the beginning of life.
nidhana
The end of life or death.
prāyaḥ
Generally or especially, without making the statement universal.
Apart from gods and human beings, no other creature can withstand jvara. Because a human may attain divinity through karma and, after falling from heaven, return to human existence, humans endure jvara through that divine association. Other creatures born in animal forms, when afflicted by it, perish.
The commentary presents this passage as an account of jvara's power. Gods withstand it through the greatness of their tapas. Human capacity is explained through the stated relation between human and divine births produced by karma. The commentator notes that some omit this passage and cautions that there is no certainty that one who falls from heaven necessarily becomes human.
Key terms
karma
Action understood here as conditioning movement between human and divine states.
devatva
Divine status said to be attainable from human existence.
tiryagyoni
Animal forms of birth referred to in the passage.
jvarārdita
Afflicted by jvara.
Adhikarana ७ (१३) · Śloka १४
स्वेदावरोधः सन्तापः सर्वाङ्गग्रहणं तथा ||१३||
विकारा युगपद्यस्मिन् ज्वरः स परिकीर्तितः |१४|
Meaning of the śloka
The simultaneous occurrence of obstruction of sweating, heat or distress, and painful stiffness or constriction throughout the body is designated jvara.
The commentary defines svedavarodha as failure of sweat to emerge but says this feature is usual rather than universal, because sweating may occur in pittaja jvara. Santapa includes mental as well as bodily distress. Sarvangagrahana is understood as painful involvement of the whole body. Yugapat means that the features occur together. Another reading has vegoparodha instead of svedavarodha, meaning obstruction of natural urges such as flatus, urine, and stool.
Key terms
svedāvarodha
Obstruction or absence of the normal emergence of sweat.
santāpa
Heat or distress affecting body and, according to the commentary, mind.
sarvāṅgagrahaṇa
Painful stiffness or constriction involving the whole body.
vegoparodha
Alternative reading referring to obstruction of natural urges.
Adhikarana ८ (१४) · Śloka १५
दोषैः पृथक् समस्तैश्च द्वन्द्वैरागन्तुरेव च ||१४||
अनेककारणोत्पन्नः स्मृतस्त्वष्टविधो ज्वरः |१५|
Meaning of the śloka
Jvara is remembered as eightfold according to its diverse causes: three forms arising separately from each dosa, one from all dosas together, three from each pairing of two dosas, and one agantu form.
The commentary enumerates the eight types: three produced by the individual dosas, one by all three combined, three arising from the three possible pairs, and one agantu type. Although the causes are many, the classification remains eightfold.
Key terms
doṣa
A classical regulatory and pathological principle used to classify jvara.
dvandvaja
Arising from a combination of two dosas.
samasta-doṣa
A form involving all three dosas together.
āgantu
A type attributed to an external or adventitious cause in this classification.
Dosas aggravated in their own times and by their respective provoking factors pervade the entire body and produce jvara. Having reached the amasaya together with heat, they approach rasa, obstruct the channels that carry rasa and sweat, weaken the digestive fire, drive heat outward from its place of digestion, and pervade the body. At their characteristic times they cause the onset or increase of jvara and produce their own characteristic coloration in the skin and related sites.
This is explained as the samprapti of jvara. Aggravation in the dosas' seasonal and daily times accounts for prakrta jvara, while their particular provoking factors account for vaikrta jvara. Brahmadeva separately supplies a long list of causes for sannipata aggravation, including irregular eating, unsuitable foods and drinks, environmental and seasonal disturbances, trauma or other affliction, improper use of therapies, complications of rasayana, difficult delivery, and improper postpartum regimens; this list reflects the cited classical source. Other readers have a variant line about strong aggravation from unwholesome food. A further transmitted version begins with dosas disturbed by their own causes. The commentary variously identifies the accompanying heat as fire's heat, dhatu heat, or dosa heat. The dosas reach rasa in the heart, weaken jatharagni, displace its heat from the digestive site, spread throughout the body, produce onset or increase according to seasonal and daily timing, and show their characteristic color in nails, skin, eyes, and similar sites.
Key terms
samprāpti
The classical account of how a disorder develops.
āmāśaya
The internal site reached by the aggravated dosas in this account.
rasa
The first bodily constituent, whose channels are described as becoming obstructed.
srotas
Channels carrying rasa and sweat in the described mechanism.
hutāśana
The digestive fire said to become weakened.
prākṛta-vaikṛta jvara
Jvara related respectively to regular timing and to particular disturbing causes.
Jvara may also be set in motion through improper or excessive use of therapies beginning with oleation; varied trauma; the arising or suppuration of disease; exhaustion; wasting; indigestion; poison; disruption of what is habitual or of the season; the odor of poisonous herbs or flowers; grief; astrological affliction; ritual assault or curse; affliction of mind or by beings; and, in women after abnormal or normal childbirth, through unsuitable practices and at the onset of lactation. In these circumstances the dosas initiate jvara.
The commentary says that dosas produce jvara not only through their previously stated provoking factors but through these additional causes. Improper or excessive therapies include oleation, fomentation, emesis, and purgation. Trauma includes blows from weapons, clods, or wood. Disease arising and suppuration refer to disorders such as vidradhi. Srama is excessive exertion, ksaya is linked here with rajayaksma, and ama with indigestion. Disruption of suitability and season are both intended. The commentator supplies an omitted word 'poison' before herbs, yielding the odor of poisonous herbs or flowers. Astrological affliction is explained through one's birth constellation or malefic planets; abhicara as ritual or mantra-based harm; abhisapa as a curse; mental affliction through desire and related states; and bhuta affliction through divine or similar beings. Apaprajata means one who has delivered abnormally, prajata one who has delivered normally, and stanyavatarana the first onset of milk. Some read 'becomes aggravated' in place of 'is set in motion.'
Key terms
mithyātiyoga
Improper or excessive application of a therapy.
snehādi karma
Procedures beginning with oleation, including those named by the commentary.
abhighāta
Trauma or bodily injury.
abhicāra
Ritual or mantra-based affliction within the classical explanatory framework.
apaprajātā
A woman described by the commentary as having undergone abnormal delivery.
When the forceful dosas move in many disturbed and abnormal directions, they quickly drive the internal fire outward. Because this outward-moving heat obstructs the watery constituent, sweat, the person with jvara becomes extremely hot throughout the body and is therefore called jvarita.
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एवं ज्वरहेतूनुदाहृत्य यथोष्णगात्रत्वां स्यात्तथा दर्शयति- तैर्वेगवद्भिर्बहुधेत्यादि| तैः दोषैः| वेगवद्भिः प्रसरणशीलैः| समुद्भ्रान्तैः इतश्चेतश्च विक्षिप्तैः| विमार्गगैः तिर्यग्गतैः| विक्षिप्यमाणः प्रेर्यमाणः| अन्तरग्निर्बहिश्चरो भवति ‘रोमकूपैः’ इति शेषः| अपान्धातुं स्वेदं, रुणद्धि| स एव बहिर्निःसृतोऽन्तरग्निर्यस्मादपान्धातुं रुणद्धि तस्मादत्युष्णसर्वाङ्गो भवति, यतोऽत्युष्ण सर्वाङ्गः स्यात्तेन कारणेन ज्वरित इत्युच्यते| अन्ये तु ‘ज्वरितस्तेन चोच्यते’ इत्यत्र ‘न च स्विद्यति सर्वशः’ इति पठन्ति (व्याख्यानयन्ति च सर्वत्र न स्विद्यति, च क्वचित् स्विद्यतीत्यर्थः)||२३-२४||
Meaning of the commentary
The commentary explains the dosas as rapidly spreading, scattered in different directions, and moving outside their proper pathways. They propel the internal fire outward, with 'through the hair follicles' understood but unstated, and obstruct sweat, called the watery constituent. The resulting generalized heat accounts for the designation jvarita. Another reading replaces the final phrase with 'and does not sweat everywhere'; its explanation allows that sweating may still occur in some places.
Key terms
vimārgaga
Moving through an abnormal or improper pathway.
antaragni
The internal fire described as being driven outward.
apāṃ dhātu
The watery constituent, identified by the commentary here as sweat.
jvarita
A person affected by jvara, linked here to intense bodily heat.
General premonitory features of an approaching jvara include fatigue, discomfort, altered complexion or taste, tear-filled eyes, shifting desire for and aversion to cold, wind, sunlight, and similar conditions, yawning, aching limbs, heaviness, horripilation, loss of appetite, darkness before the eyes, lack of cheerfulness, and chill. More specifically, excessive yawning is associated with vata, burning of the eyes with pitta, and lack of interest in food with kapha. A form arising from all dosas displays the full collection of features, while a dvandvaja form is recognized by features belonging to each of its two dosas.
The commentary presents these as purvarupa, signs occurring before jvara becomes manifest. Arati is lack of comfort in lying, sitting, or any position; nayanaplava is filling of the eyes with tears; 'and so forth' also includes preferences concerning bed and seat; tamas is seeing darkness; and apraharsa is absence of joy. The initial list is general to every jvara. The later features distinguish the individual dosa forms: marked yawning for vata, burning eyes for pitta, and no desire for food for kapha. The combined and paired forms gather the relevant signs accordingly.
Key terms
pūrvarūpa
A premonitory feature appearing before the disorder is fully manifest.
arati
Inability to find comfort in lying, sitting, or other positions.
nayanaplava
Eyes filling with tears.
romaharṣa
Horripilation or gooseflesh.
dvandvaja
A form characterized by the features of two dosas together.
Adhikarana १३ (२९-३०) · Śloka ३०
वेपथुर्विषमो वेगः कण्ठौष्ठपरिशोषणम् |
निद्रानाशः क्षुतः स्तम्भो गात्राणां रौक्ष्यमेव च ||२९||
शिरोहृद्गात्ररुग्वक्त्रवैरस्यं बद्धविट्कता |
जृम्भाऽऽध्मानं तथा शूलं भवत्यनिलजे ज्वरे ||३०||
Meaning of the śloka
In fever arising from vāta, there are trembling; an irregular intensity of the attack; dryness of the throat and lips; loss of sleep; obstruction of sneezing; and dryness of the limbs. There are also pain in the head, cardiac region, and body; an unpleasant taste in the mouth; constipation; yawning; abdominal distension; and colicky pain.
The commentary introduces the features of fever according to the predominating doṣa. Vepathu means trembling, and an irregular attack means that its force is sometimes intense and sometimes mild. Kṣutaḥ stambhaḥ is explained as a sneeze that is held back and cannot emerge; another reading has kṣava, 'sneezing,' followed separately by stiffness of the body. Sneezing by itself may also occur when vāta fever subsides, so freedom from fever should be inferred from the absence of the other features such as trembling, rather than from sneezing alone. Dryness applies to the limbs; according to an explanatory addition it also implies a dark reddish coloration, while ca adds dark stool and urine. Another reading replaces limb dryness with dusky discoloration of the body, excreta, and eyes. The head is mentioned separately to emphasize severe headache, although bodily pain would otherwise include it. A further variant reads dizziness together with yawning, distension, and pain.
Key terms
vepathu
Trembling or shaking.
viṣamo vegaḥ
An attack whose intensity varies between strong and mild.
kṣutaḥ stambhaḥ
Obstruction or suppression of a sneeze, with a noted variant reading.
In fever arising from pitta, the attack is sharp, with diarrhea, reduced sleep, and vomiting. Inflammation or soreness develops in the throat, lips, mouth, and nose, and sweating occurs. There may be delirious speech, a pungent taste in the mouth, fainting, burning, intoxication-like impairment, thirst, yellow discoloration of stool, urine, and eyes, and dizziness.
The commentary records a variant for 'delirious speech and pungency in the mouth': some read it as 'delirious speech and a bitter taste in the mouth.' Mada is explained as a state resembling intoxication after areca nut. The listed signs are presented within the classical category of paittika fever.
Key terms
paittika jvara
Fever classified as arising predominantly from pitta.
pāka
Inflammatory soreness or suppurative change in the named regions.
In fever arising from kapha, there are bodily heaviness, coldness, an urge to expel kapha, horripilation, excessive sleep, obstruction of the channels, relatively little pain, excessive salivation, and a sweet taste in the mouth. The body is not excessively hot; vomiting, bodily lassitude, indigestion, nasal catarrh, loss of appetite, cough, and whiteness of the eyes may occur.
Heaviness is understood as heaviness of the limbs. Utkleśa is explained as the urge to spit out śleṣman, praseka as flow of saliva, and aṅgasāda as fatigue or languor of the limbs. An alternative recension lists immobility, a steady or sluggish attack, laziness, sweetness in the mouth, pale or white urine and stool, stiffness, satiety, heaviness, coldness, kapha agitation, horripilation, excessive sleep, catarrh, poor appetite, cough, and whiteness of the eyes. Staimitya means immobility of the fevered person. Stimito vega may mean an attack that remains steadily present, while others interpret it as a slowly arising attack.
Key terms
kaphaja jvara
Fever classified as arising predominantly from kapha.
gaurava
Heaviness, here of the body or limbs.
utkleśa
Agitation of kapha with an urge to expectorate.
praseka
Excessive flow of saliva.
staimitya
Immobility or lack of movement in the alternative reading.
In fever involving all three doṣas, there may be sleeplessness, dizziness, difficult breathing, stupor, loss of bodily sensation, loss of appetite, thirst, fainting, intoxication-like impairment, stiffness, burning, coldness, and pain in the cardiac region. The doṣas mature only after a long time; mental derangement, dusky teeth, and a rough, dark tongue occur, with pain in the joints, head, and bones. The eyes are distorted and turbid; the ears have abnormal sounds and pain. There are incoherent speech, inflammatory change in the bodily openings or channels, indistinct sounds in the throat, loss of consciousness, and only scant, delayed discharge of sweat, urine, and stool.
After describing fevers attributed to each doṣa separately, the commentary identifies these as features of sannipātika fever. Dizziness is compared to the sensation of turning on a wheel. Tandrā is defined through lack of awareness of sense objects, heaviness, yawning, fatigue, and behavior like that of one overcome by sleep. Suptāṅgatā means loss of tactile sensation in the limbs; moha here means fainting, mada an intoxication-like state, and stambha stiffness. Unmāda is a mental disturbance, and rasanā means the tongue, which becomes rough. Pain is assigned separately to the joints, head, and bones. Another reading has shaking or tossing of the head with headache. Nirbhugna means crooked or distorted, and kaluṣa means turbid. The ears have both sounds and pain; pralāpa is incoherent speech. Srotas refers here to openings such as the mouth and nose, kūjana to an indistinct sound arising in the throat, and cetanācyuti to loss of consciousness. The final statement means that sweat, urine, and stool emerge only in small quantities after a long delay.
Key terms
sannipātika jvara
Fever described as involving all three doṣas.
tandrā
A stuporous, sleep-like state with reduced sensory awareness, heaviness, yawning, and fatigue.
suptāṅgatā
Loss or marked reduction of tactile sensation in the limbs.
cetanācyuti
Loss of consciousness or awareness.
srotasāṃ pāka
Inflammatory change in openings or channels such as the mouth and nose.
Adhikarana १७ (३८) · Śloka ३८
सर्वजे सर्वलिङ्गानि... |३८|
Meaning of the śloka
In fever arising from all the doṣas, all the characteristic signs are present.
The preceding verses are said to describe sannipāta in which the doṣas combine in an altered and unequal manner. This brief statement instead describes their combination in their ordinary, balanced manner: in sarvadoṣaja fever, the signs previously stated for each of the vāta, pitta, and kapha fevers are all found.
Key terms
sarvaja
Arising from all three doṣas.
sarvaliṅgāni
All the characteristic signs described for the individual doṣa-based fevers.
prakṛtisamasamaveta
A combination described as ordinary and proportionate in the commentary.
Hear the particular form of this condition: the body feels neither markedly hot nor cold; awareness is diminished; perception is confused; the voice is lost or weakened; the tongue is rough; and the throat is dry. Sweat, stool, and urine are absent. The eyes are tear-filled, the cardiac region is described as distorted, appetite is lost, and bodily luster is diminished. The person breathes with difficulty, lies as though collapsed, and is greatly afflicted by delirious speech. This is called abhinyāsa, while others call it hataujas.
The commentary begins the named subdivisions of sannipāta fever. 'Neither very hot nor cold' means that the body has an ordinary temperature to touch. Bhrāntaprekṣī is one who sees objects incorrectly; sāsra means eyes filled with tears; and nirbhugnahṛdaya is glossed literally as a crooked or distorted cardiac region. The patient breathes laboriously and lies as if fallen, indicating disabled limbs. Delirious speech is singled out as an especially pronounced complication. This particular sannipāta form is called abhinyāsa, and another tradition calls it hataujas.
Key terms
abhinyāsa
A named severe form of sannipāta fever described by diminished awareness and systemic signs.
hataujas
An alternative name indicating severely impaired ojas.
bhrāntaprekṣī
One whose perception of objects is confused or incorrect.
pralāpa
Incoherent or delirious speech.
Adhikarana १९ (४१) · Śloka ४१
सन्निपातज्वरं कृच्छ्रमसाध्यमपरे विदुः ||४१||
Meaning of the śloka
Some authorities regard sannipāta fever as difficult to cure, while others regard it as incurable.
The differing opinions are explained conditionally. When only some of the signs are present, sannipāta fever is considered difficult to treat. When all signs are present together, the doṣas are obstructed, and agni is destroyed, it is considered incurable within this classical framework.
Key terms
sannipātajvara
Fever involving the combined doṣas.
kṛcchrasādhya
Considered difficult to treat.
asādhya
Considered incurable in the source's prognostic framework.
agni
The digestive and transformative principle said here to be destroyed in the gravest state.
In fever involving all the doṣas, abhinyāsa accompanied by sleep is called abhinyāsa; when the person is depleted it is called hataujas; and when the limbs lie abandoned or powerless it is called sannyāsa.
The verse presents distinctions within abhinyāsa: the sleep-associated state retains that name, the depleted state is called hataujas, and the state with powerless or abandoned limbs is termed sannyāsa. Some recensions omit this sentence. The commentary then records, but rejects as unnecessary here, additional passages used by some authorities: a description of pralepaka already stated elsewhere in this work, a description of vātanalāsaka attributed to Kṣārapāṇi, and verses on tṛṇapuṣpaka fever. The last describe a state in which wind takes up floral scent and pollen, constrains prāṇa and apāna, penetrates the tissues and vital points, and impairs action, memory, strength, and knowledge; companions mistake the unresponsive person for sleeping, headache arises, and smelling either foul or pleasant odors suddenly causes fainting. The commentator says these verses need not be read here because that condition is included under fevers caused by medicinal odors and environmental occurrence.
Key terms
abhinyāsa
A named severe sannipāta state, here specified as accompanied by sleep.
hataujas
The depleted form, associated with loss or obstruction of ojas.
sannyāsa
A state marked by powerless or abandoned limbs.
tṛṇapuṣpaka
A disputed or externally cited fever category associated in the quoted verses with floral odors and sudden fainting.
When ojas slips from its normal state through the rise of pitta and vāta, the person has bodily stiffness and coldness, wishes to lie down, and lacks awareness. Whether apparently awake or asleep, the person remains unconscious, drowsy, and delirious, with horripilation, slack limbs, and only mild perception of heat or distress. A skilled physician should recognize these features as arising from obstruction of ojas.
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केचिदत्र हतौजसलक्षणं पठन्ति; यथा- ओजो विस्रंसते यस्येत्यादि| स ज्वरी गात्रस्तम्भशीताभ्यां कृत्वा शयनेप्सुः स्वपितुमिच्छुः जाग्रदवस्थायां स्वप्नावस्थायां च चेतनारहितो भवति, तस्य सन्निपातिन एतद्गात्रस्तम्भादिकमोजोनिरोधजं लक्षणं जानीयात्| यद्यपि तन्त्रान्तरे सन्निपातभेदास्त्रयोदश प्रोक्ताः, तथाऽपि दोषोत्कर्षापकर्षतारतम्येन धात्वावरणभेदेन च सन्निपातभेदानामानन्त्यान्नेह प्रदर्शिताः||४३-४४||-
Meaning of the commentary
Some authorities read these verses here as the signs of hataujas. The fevered person, because of bodily stiffness and coldness, wants to sleep and lacks consciousness both while awake and while asleep. In a person with sannipāta, the cluster beginning with stiffness is understood as produced by obstruction of ojas. Although another treatise enumerates thirteen kinds of sannipāta, this text does not display all of them because variations in the relative increase and decrease of the doṣas and in their obstruction of the tissues make their subdivisions innumerable.
Key terms
ojas
A vital sustaining principle whose displacement or obstruction is central to this passage.
hataujas
A severe state described by some authorities through impairment of ojas.
ojonirodhaja
Arising from obstruction of ojas.
tandrālu
Drowsy or stuporous.
Adhikarana २२ (४५) · Śloka ४६
सप्तमे दिवसे प्राप्ते दशमे द्वादशेऽपि वा ||४५||
पुनर्घोरतरो भूत्वा प्रशमं याति हन्ति वा |४६|
Meaning of the śloka
On reaching the seventh, tenth, or twelfth day, the fever again becomes more severe and then either subsides or proves fatal.
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सन्निपातज्वरस्य मोक्षवधयोरवधिमाह- सप्तमे दिवसे प्राप्ते इत्यादि| शीघ्रमध्यमन्दशक्तित्वाद्वातादीनां सप्तमे दिने वाताधिकः सन्निपातज्वरः, दशमे दिने पित्ताधिकः, द्वादशे दिने श्लेष्मधिको विमुञ्चति मलपाकात्, हन्ति च धातुपाकात्; यदि हि तस्य दीर्घजीवनं(ने) कर्मास्ति तदा मलपाको भवति, अन्यथा धातुपाकः| अन्ये तु सप्ताहेऽभिन्यासो, दशाहे हतौजाः, द्वादशाहे सन्न्यासः, मलपाकात् प्रशमं याति धातुपाकाद्धन्तीति मन्यन्ते| धातुपाकास्य लक्षणमाह- “सम्बाध्यमानो हृदि नाभिदेशे गात्रेषु वा पाकरुजोज्झितेषु| पक्वेष्विवाचैति रुजं ज्वरार्तः स धातुपाकी कथितो भिषग्भिः”- इति| शकुनैररिष्टैर्वा मरणकारी धातुपाकी(को) ज्ञेय इति वृद्धाः| ‘द्वादशेऽपि वा’ इत्यत्रापिशब्दाद्भालुकिप्रोक्तः सन्निपातज्वरस्य मोक्षवधयोरवधिः प्राप्यते| तेन “सप्तमी द्विगुणा या तु नवम्येकादशी तथा| एषा त्रिदोषमर्यादा मोक्षाय च वधाय च” इति लब्धम्| पुनर्घोरतर इति पुनःशब्दात् पूर्वं घोर आसीत् ततः पुनर्घोरतर इति लभ्यते||४५||-
Meaning of the commentary
The commentary treats these days as possible limits for recovery or death in sannipāta fever. Because vāta, pitta, and kapha are respectively described as swift, intermediate, and slow in action, a vāta-predominant sannipāta is said to resolve on the seventh day, a pitta-predominant one on the tenth, and a kapha-predominant one on the twelfth, through maturation of mala; death is attributed instead to maturation of the dhātus. The text links the former with a destiny of longer life and the latter with its absence. Another opinion assigns abhinyāsa to the seventh day, hataujas to the tenth, and sannyāsa to the twelfth, again distinguishing subsidence through mala-pāka from death through dhātu-pāka. A quoted definition describes dhātu-pāka as intense cooked-like pain in the cardiac, umbilical, or bodily regions; elders also infer a fatal form from omens or signs of impending death. The word api is used to include Bhāluki's alternative series of seventh, fourteenth, ninth, and eleventh days as boundaries for recovery or death. 'Again more severe' indicates that the fever was already severe before this renewed intensification.
Key terms
mala-pāka
Maturation of morbid waste or doṣic material, associated here with subsidence.
dhātu-pāka
A classical state of tissue involvement associated here with severe pain and fatal prognosis.
abhinyāsa
A named severe sannipāta form assigned by one opinion to the seventh day.
tridoṣamaryādā
A temporal boundary for the course of fever involving all three doṣas.
The commentary now introduces three dvandvaja fevers in which two doṣas combine in their ordinary mode. The word ucchrāya indicates that each of the two doṣas has been increased by its own causes. The count of three refers here to the three possible pairings in which two doṣas are equally increased.
Key terms
dvandvaja
Arising from a paired combination of two doṣas.
dvidoṣa
A combination involving two doṣas.
ucchrāya
Increase or predominance, here produced by each doṣa's own causes.
The form of vāta-pitta fever includes thirst, fainting, dizziness, burning, loss of sleep, headache, dryness of the throat and mouth, vomiting, horripilation, loss of appetite, aching or breaking pain in the joints, and yawning.
The commentary introduces dvandvaja fevers in which the two doṣas are combined in an altered and unequal manner. Dryness applies to both the throat and the mouth, and vamathu means vomiting. Because this is such an unequal combination, horripilation and loss of appetite are included in vāta-pitta fever; by the same reasoning, stupor is mentioned in the kapha-pitta form elsewhere.
Key terms
vāta-pitta jvara
Fever classified as involving a paired predominance of vāta and pitta.
mūrcchā
Fainting or loss of awareness.
parvabheda
Aching or breaking pain in the joints.
vikṛtiviṣamasamaveta
An altered, unequal combination of doṣas in the commentary's classification.
The features of vāta-śleṣma fever are described as stiffness or immobility, a breaking sensation in the joints, sleepiness, heaviness, a feeling of constriction in the head, nasal discharge, cough, the onset of sweating, heat, and a fever of moderate intensity.
The commentary explains staimitya as the fevered person's immobility; parvaṇāṃ bheda as a sensation like the joints are splitting; śirograha as feeling as though the head is held or constrained; and pratiśyāya as discharge from the nose.
Key terms
staimitya
Stiffness or immobility in the fevered person.
parvaṇāṃ bheda
A breaking or splitting sensation at the joints.
śirograha
A feeling that the head is held or constrained.
vāta-śleṣma-jvara
The classical fever category attributed jointly to vāta and śleṣma.
The features of śleṣma-pitta fever include a coated and bitter mouth, drowsiness, confusion, cough, loss of appetite, thirst, and alternating episodes of burning and cold. The alternative verses list signs for paired-doṣa fevers: in vāta-pitta fever, yawning, distension, intoxication-like disturbance, trembling, joint pain or breaking sensations, wasting, thirst, delirious speech, and intense heat; in vāta-śleṣma fever, pain, cough, agitation of phlegm, cold, trembling, nasal discharge, heaviness, loss of appetite, and obstruction; and in śleṣma-pitta fever, cold, burning, loss of appetite, stiffness, sweating, confusion, intoxication-like disturbance, dizziness, cough, bodily exhaustion, and nausea.
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लिप्तेत्यादि| लिप्तास्यता तिक्तास्यता च| जेज्जटाचार्यस्तु द्वन्द्वजज्वरपाठमेकमेव पठति- जृम्भेत्यादिना| अयं वा पठनीयः पूर्वो वा, न तु द्वयम्||५०||
Meaning of the commentary
The commentary clarifies that both a coated mouth and a bitter mouth are intended. It then records Jejjaṭa's reading, which gives only the alternative set of verses beginning with yawning for the paired-doṣa fevers. According to the commentator, either that alternative passage or the preceding account should be read, but not both as cumulative descriptions.
Key terms
liptāsyatā
A sensation of coating in the mouth.
tandrā
Drowsiness or torpor.
dvandvaja-jvara
A fever classically attributed to a pair of doṣas.
śleṣma-pitta-jvara
The classical fever category attributed jointly to śleṣma and pitta.
In people who have become emaciated, in those who have recently recovered from fever, and in those following unsuitable diet and conduct, even a small amount of doṣa may increase and, propelled by vāta, produce the periodic fever patterns called satata, anyedyuṣka, tṛtīyaka, cāturthaka, and pralepaka. These are assigned in sequence according to the classical divisions of the locations of kapha.
After discussing santata fever, the commentary introduces the irregular fevers beginning with satata. It supplies the sense that even a small doṣa, increased through unsuitable diet and conduct and driven by vāta, produces these patterns according to its location. The kapha locations are listed in order as the stomach, chest, throat, head, and joints: residence in the stomach produces satata; in the chest, anyedyuṣka; in the throat, tṛtīyaka; in the head, cāturthaka; and in the joints, pralepaka. A doṣa distributed through all kapha locations is said to produce santata. Here doṣa may mean vāta and the other doṣas singly, in pairs, or together. The commentator also explains that even vāta already situated there may be propelled by another vāta intensified by an external cause.
Key terms
mithyāhāra-vihāra
Diet and conduct regarded as unsuitable in the classical account.
viṣama-jvara
A class of fevers characterized here by irregular or periodic patterns.
kapha-sthāna
A classical location associated with kapha, used to differentiate fever patterns.
pralepaka
One of the named periodic fever patterns, associated here with the joints.
The doṣa is described as moving from one location to another over successive day-and-night periods; after reaching the stomach, it produces fever in the person.
The commentary explains the timing scheme used for the periodic fevers. A doṣa in the chest reaches the stomach after one day and night and produces anyedyuṣka on the following day. From the throat, it takes two day-and-night periods and produces tṛtīyaka on the third day. From the head, it passes through three locations and produces cāturthaka on the fourth day. A doṣa situated in the joints continually produces pralepaka, which the commentary associates specifically with people suffering from rājayakṣman.
Key terms
ahorātra
A complete day-and-night period used in the timing sequence.
anyedyuṣka
A named periodic fever pattern arising on the next day in this scheme.
tṛtīyaka
A named fever pattern associated here with the third day.
cāturthaka
A named fever pattern associated here with the fourth day.
Pralepaka is described as a fever occurring in persons with śoṣa, destructive to life, extremely difficult to treat, low in intensity, grievous, and causing depletion of the bodily dhātus.
The commentary states that pralepaka is considered extremely difficult to treat because its causation involves the combined doṣas, or sannipāta. It explains manda as mild or low in force, and understands the description sukaṣṭa in relation to its grave, potentially fatal outcome.
Key terms
pralepaka
A grave named fever pattern described in this passage.
śoṣa
A classical condition characterized here by wasting or depletion.
sannipāta
Combined involvement of all three doṣas in the commentator's explanation.
dhātu-śoṣa
Depletion or wasting of the bodily dhātus.
Adhikarana ३० (५५) · Śloka ५५
कफस्थानेषु वा दोषस्तिष्ठन् द्वित्रिचतुर्षु वा |
विपर्ययाख्यान् कुरुते विषमान् कृच्छ्रसाधनान् ||५५||
Meaning of the śloka
When a doṣa remains in two, three, or four of the classical kapha locations, it produces difficult-to-treat irregular fevers known as the reverse patterns, or viparyaya forms.
The commentary describes these viparyaya patterns in detail. A doṣa occupying the chest and stomach produces the reverse of anyedyuṣka: it leaves one time-period of the day and persists through the rest of the day and night. Occupying the throat, chest, and stomach, it produces the reverse tṛtīyaka, which remits on the third day. Occupying the head, throat, chest, and stomach, it produces the reverse cāturthaka, which remits on the fourth day. No reverse form of satata is recognized, either because satata is produced by a doṣa in only one kapha location or because that is the nature of the disorder. Here doṣa includes single, paired, and combined doṣa configurations.
Key terms
viparyaya
A reverse or inverted temporal pattern of a named irregular fever.
kapha-sthāna
A classical site associated with kapha in the fever classification.
viṣama-jvara
An irregular or periodic fever category in the source.
satata
A named fever pattern for which the commentary recognizes no reverse form.
Adhikarana ३१ (५६) · Śloka ५६
परो हेतुः स्वभावो वा विषमे कैश्चिदीरितः |
आगन्तुश्चानुबन्धो हि प्रायशो विषमज्वरे ||५६||
Meaning of the śloka
Some authorities state that an external or superior cause, or else the inherent nature of the condition, accounts for viṣama fever. The verse adds that an āgantu, an externally arising factor, is often associated with viṣama fever.
The commentary presents alternative explanations for why irregular fevers recur at a fixed time. In one interpretation, para means an external agency such as a bhūta, offered together with the disorder's own nature as a cause. Other interpreters take the statement to mean that some teachers regard the condition's own nature as the paramount cause. The second half is then read as support for the first view: an external factor such as a bhūta is often an associated cause. These are preserved as distinct classical interpretations.
Key terms
para
Interpreted either as an external agency or as 'paramount' in an alternative reading.
svabhāva
The inherent nature of the fever, proposed as one explanation of its timing.
āgantu
An externally arising or supervening factor.
bhūta
A classical category invoked here as an external agency; its interpretation is source-dependent.
Adhikarana ३२ (५७-५८) · Śloka ५८
वाताधिकत्वात् प्रवदन्ति तज्ज्ञास्तृतीयकं चापि चतुर्थकं च |
औपत्यके मद्यसमुद्भवे च हेतुं ज्वरे पित्तकृतं वदन्ति ||५७||
प्रलेपकं वातबलासकं च कफाधिकत्वेन वदन्ति तज्ज्ञाः |
मूर्च्छानुबन्धा विषमज्वरा ये प्रायेण ते द्वन्द्वसमुत्थितास्तु ||५८||
Meaning of the śloka
Those knowledgeable in the subject describe tṛtīyaka and cāturthaka fevers as having a predominance of vāta. They state that pitta is the causal doṣa in fever arising near mountainous terrain and in fever arising from alcohol. They describe pralepaka and vāta-balāsaka as having a predominance of kapha. Irregular fevers accompanied by fainting are said generally to arise from a combination of two doṣas.
The commentary explains that another text attributes tṛtīyaka and cāturthaka to paired doṣas, yet in this work they are to be understood as vāta-predominant even when signs of pitta and śleṣma appear. Aupatyaka is explained as fever arising in land near mountains, where pungent, hot-potency, strong-smelling plants are said to provoke pitta; in alcohol-related fever, alcohol itself is the pitta-producing cause. An alternative reading joins aupatyaka with fever arising from excessive drinking. Although vāyu impels pralepaka, its location in the joints, regarded as sites of śleṣma, makes it śleṣma-predominant; vāta-balāsaka is supported by another textual description of constant mild fever, dryness, swelling, stiffness, and difficult treatment. For the final line, one reading understands mūrcchānubandha as irregular fever continually accompanied by fainting and usually arising from paired doṣas. Other readings are also preserved: muñcānubandha refers to fevers that remit and recur; muktvā'nubandhān excludes associated fevers; and another interpretation excludes complication-fevers and applies the statement to primary irregular fevers. The word 'generally' allows origin from single or all doṣas as well.
Key terms
aupatyaka
Fever associated in the commentary with terrain near mountains; an alternative reading links the phrase differently.
vāta-balāsaka
A named fever condition described as śleṣma-predominant in this discussion.
mūrcchānubandha
Accompanied continuously by fainting, according to one reading.
dvandva-samutthita
Arising from a pair of doṣas.
Adhikarana ३३ (५९-६१) · Śloka ६१
त्वक्स्थौ श्लेष्मानिलौ शीतमादौ जनयतो ज्वरे |
तयोः प्रशान्तयोः पित्तमन्ते दाहं करोति च ||५९||
करोत्यादौ तथा पित्तं त्वक्स्थं दाहमतीव च |
प्रशान्ते कुरुतस्तस्मिंश्छीतमन्ते च तावपि ||६०||
द्वावेतौ दाहशीतादी ज्वरौ संसर्गजौ स्मृतौ |
दाहपूर्वस्तयोः कष्टः कृच्छ्रसाध्यश्च स स्मृतः ||६१||
Meaning of the śloka
When śleṣma and vāta are situated in the skin, they first produce cold during fever; after they subside, pitta produces burning at the end. Conversely, pitta situated in the skin first produces intense burning; after it subsides, the other two produce cold at the end. These two fevers, beginning respectively with burning and cold, are described as saṃsargaja. Of them, the fever beginning with burning is regarded as severe and difficult to treat.
The commentary uses these verses to divide the previously named fevers according to whether cold or burning comes first. Śleṣma and vāta may subside because their time has passed or because an opposing factor has appeared; the word 'and' after burning also includes confusion and fainting. When pitta subsides, śleṣma and vāta produce cold, with the wording also implying vomiting, drowsiness, and related signs. Although both fevers involve all three doṣas, they are called saṃsargaja, involving two, because kapha and vāta perform one function and may be designated together. The two types are burning-first and cold-first. The paired descriptions 'severe' and 'difficult to treat' emphasize great difficulty: the burning-first form is said to be exceedingly difficult, while the cold-first form is said to be easier. The commentator attributes the distinction to the condition's unpredictable power.
Key terms
dāha-pūrva
A fever pattern in which burning occurs first.
śīta-pūrva
A fever pattern in which cold occurs first.
saṃsargaja
Arising through the association of two doṣas in this classification.
tvak-stha
Situated in the skin in the classical account.
Adhikarana ३४ (६२) · Śloka ६२
प्रसक्तश्चाभिघातोत्थश्चेतनाप्रभवस्तु यः |६२|
Meaning of the śloka
The verse refers to a persistent fever arising from physical injury and to one arising from mental or conscious experience.
The commentary says that the verse emphasizes the extreme severity of fevers arising from injury and from states such as desire. Prasakta means strongly persistent and qualifies both types. Abhighātottha is fever attributed to a blow from objects such as wood or a clod, while cetanāprabhava is fever attributed to factors such as desire.
Key terms
prasakta
Strongly persistent or continuously attached.
abhighātottha
Arising after physical injury or a blow in the classical account.
cetanāprabhava
Attributed to a mental or conscious factor such as desire.
The commentary identifies the six periods as forenoon, midday, afternoon, early night, midnight, and dawn, referring back to their earlier description. Kapha is said to increase in the forenoon and early night, pitta at midday and midnight, and vāta in the afternoon and at dawn. Irregular fever is described as forcefully pervading and attacking at the period associated with the increase of its respective doṣa. 'In many ways' may mean twice in a day and night, once in that span, every other day, or after two days. Other interpreters take it to refer to changing manifestations: sometimes cold, sometimes hot, sometimes affecting the hands and feet, sometimes the shoulders or other parts, and varying in regularity and duration. This indicates the many possible forms of viṣama fever.
Key terms
ṣaṭ kāla
The six specified periods of day and night.
pradoṣa
The early part of the night in the six-period scheme.
pratyūṣa
Dawn in the six-period scheme.
viṣama-jvara
Irregular fever with diverse timing and manifestations in this account.
Adhikarana ३६ (६३-६४) · Śloka ६४
स चापि विषमो देहं न कदाचिद्विमुञ्चति ||६३||
ग्लानिगौरवकार्श्येभ्यः स यस्मान्न प्रमुच्यते |
वेगे तु समतिक्रान्ते गतोऽयमिति लक्ष्यते ||६४||
Meaning of the śloka
Viṣama fever is said never to leave the body completely. Because the person remains affected by languor, heaviness, and emaciation, the fever has not truly departed, even though it appears gone after the acute episode has passed.
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विषमज्वराणामुपशान्तवेगानामपि देहावस्थानं दर्शयति- स चापीत्यादि| विषमो विषमज्वरः| समाहारत्वेन कार्श्यादिति सिद्धे यत् कार्श्येभ्य इति बहुवचनं तेन लक्षणान्तरमपि गृह्यते| तथा च- “शिरसो गौरवं ग्लानिर्नातिश्रद्धा च भोजने| माधुर्यमथ वैरस्यं तिक्तत्वमथवा पुनः| वक्त्रस्य जायते यस्मात् प्रवेगेऽपि गते सति| तस्मात्तु नियतो लीनः शरीरे विषमज्वरः”- इति||६३-६४||
Meaning of the commentary
The commentary explains that an irregular fever remains in the body even when its active episode has subsided. The plural form in the expression ending with emaciation is taken to include additional signs. A cited verse lists heaviness of the head, languor, reduced desire for food, and a sweet, unpleasant, or bitter taste in the mouth even after the episode has passed; these are presented as evidence that viṣama fever remains latent in the body.
Because it lies concealed in another dhātu and is subtle, the fever is not perceived. Having only a small amount of doṣa as its fuel, it becomes weak like a fire whose fuel has diminished.
The commentary answers why fever is not apparent even though it has not entirely left after an episode. Dhātvantara is explained as a dhātu other than the one previously involved; other interpreters understand it as the seven kalās. Līnatva means remaining confined in one place, and subtlety means minuteness. One explanation compares the diminished fever to a fire weakened by little fuel; another parses alpadoṣendhana as a fever whose very fuel consists of a small quantity of doṣa.
Key terms
dhātvantara
Another dhātu; alternatively, the seven kalās according to a different interpretation.
līnatva
A concealed state produced by remaining localized in one place.
alpadoṣendhana
Having a small amount of doṣa as the fuel sustaining the fever.
Adhikarana ३८ (६६) · Śloka ६६
दोषोऽल्पोऽहितसम्भूतो ज्वरोत्सृष्टस्य वा पुनः |
धातुमन्यतमं प्राप्य करोति विषमज्वरम् ||६६||
Meaning of the śloka
In a person recently released from fever, a small doṣa increased by unsuitable factors may enter any one dhātu and produce viṣama-jvara.
Having first presented the surgical authorities' account of viṣama fever, the commentary now introduces the view of physicians such as Agniveśa, who explain these fevers through doṣas situated in particular dhātus. Ahitasambhūta means increased through unsuitable diet or conduct. Jvarotsṛṣṭa means one who has recovered from fever, while the particle vā also includes an emaciated person. The earlier classification distinguished satata and related fevers by kapha locations; this account distinguishes them by the dhātu entered, so the commentator does not regard it as repetition.
Key terms
ahitasambhūta
Increased through factors regarded as unsuitable in the classical account.
jvarotsṛṣṭa
A person recently released from or recovered from fever.
viṣama-jvara
An irregular or periodic fever category explained here through dhātu location.
A doṣa situated in rasa and rakta produces satata fever; when lodged in flesh it produces anyedyuṣka, and when in medas it produces tṛtīyaka on the third day. When situated in bone and marrow, it produces a grave cāturthaka fever that is destructive and associated with a mixture of disorders.
The commentary assigns fever patterns according to the dhātu occupied by the doṣa. Its main reading treats doṣa in rasa and rakta as producing satata. A variant says that a doṣa in rakta generally produces satata, but the qualifier 'generally' is taken to include rasa because the doṣas cause fever after taking up rasa. Another reading has santata instead of satata: some explain rasa as producing santata and rakta as producing satata, while others treat the two words as synonyms. The commentator notes that santata itself is not a viṣama fever and explains why it is mentioned beside these patterns. Doṣa in flesh produces anyedyuṣka, doṣa in medas produces tṛtīyaka, and the bone-and-marrow condition produces cāturthaka, described as grievous, prolonged, and potentially fatal.
Key terms
rasa-rakta-stha
Situated in rasa and rakta in the classical dhātu-based classification.
anyedyuṣka
A named periodic fever pattern associated here with flesh.
tṛtīyaka
A fever pattern occurring on the third day and associated here with medas.
cāturthaka
A grave fourth-day fever pattern associated here with bone and marrow.
Adhikarana ४० (६८) · Śloka ६८
केचिद्भूताभिषङ्गोत्थं ब्रुवते विषमज्वरम् ||६८||
Meaning of the śloka
Some authorities state that viṣama-jvara arises from bhūtābhiṣaṅga.
Although the discussion explains satata and related fevers through doṣas situated in different dhātus, the commentary records another school's view that bhūtābhiṣaṅga, glossed as possession by a graha, may be the cause. An earlier passage mentioned an external cause while discussing doṣa-origin fevers; here the same idea appears specifically within the dhātu-based discussion, so the commentator does not consider it redundant.
Key terms
bhūtābhiṣaṅga
A historically situated external-agency category, glossed by the commentary as graha possession.
grahāveśa
Possession or entry by a graha in the commentator's traditional explanation.
viṣama-jvara
An irregular or periodic fever category.
Adhikarana ४१ (६९) · Śloka ६९
सप्ताहं वा दशाहं वा द्वादशाहमथापि वा |
सन्तत्या योऽविसर्गी स्यात्सन्ततः स निगद्यते ||६९||
Meaning of the śloka
A fever that continues without remission for seven, ten, or even twelve days is called santata.
After previously describing the possible resolution or fatal limit of a santata fever produced by sannipāta, the commentary defines the duration of santata arising from one or two doṣas. Santatyā means continuously, and avisargī means not letting go or not remitting. A cited verse says that another form of santata, arising from a small or weak cause and involving one or two doṣas, is considered readily treatable.
Key terms
santata-jvara
A fever characterized here by continuous persistence without remission.
Within a day and night, satataka persists through two time periods. Anyedyuṣka appears for one time period on the next day; tṛtīyaka appears on the third day, and cāturthaka on the fourth.
The commentary defines the temporal patterns of satata and related fevers. Satataka continues through two of the periods such as the forenoon. Anyedyuṣka appears for one period in another day-and-night cycle; the phrase 'one period' also applies to tṛtīyaka on the third day and cāturthaka on the fourth. The commentator cautions that greater or lesser duration can occur according to the increase or decrease of doṣa, so these timings are not absolute rules.
Key terms
satataka
A named fever pattern persisting through two time periods in a day and night.
anyedyuṣka
A named fever pattern appearing for one period on the following day.
tṛtīyaka
A named fever pattern appearing on the third day.
cāturthaka
A named fever pattern appearing on the fourth day.
Single or paired doṣas, impelled and drawn about by vāta, repeatedly produce a fever episode at the same stated time on its appointed day. A parenthetical variant compares this with the sea being raised by wind: as water covers the shore when the surge arrives and withdraws when it subsides, fever rises when the doṣa's force increases and calms when that force declines.
The commentary applies the previously stated times to viṣama fevers arising from doṣas situated in the dhātus. Single or paired doṣas, intensified and drawn from all sides by vāta, repeatedly produce the fever episode at that same time, such as the forenoon, on the specified day. Some read 'because of the fever episode' instead. Certain witnesses include the extended sea-and-wind comparison, but the commentator says it merely repeats the meaning, was rejected by the compilers, and should not be read as part of the accepted text.
Key terms
jvara-vega
An active episode or surge of fever.
ekadvidoṣa
A single doṣa or a paired-doṣa configuration.
velā
The recurring appointed time of the fever episode.
After describing the seven fevers produced by vāta and the other doṣas, the text introduces āgantu fever in its many forms. 'Various injury' includes injury by weapons, clods, wood, and similar objects. Although doṣa aggravation participates in the process, the fever is named injury-born because the initial precipitating cause is the injury.
Key terms
abhighāta
Physical injury or impact, including that caused by weapons, clods, or wood.
āgantu-jvara
Fever attributed to an external precipitating cause.
Fever attributed to poison is marked by a darkened mouth, burning, diarrhea, constriction in the heart region, loss of appetite, thirst, piercing pain, fainting, and loss of strength. Fever attributed to the odor of medicinal plants includes fainting, headache, vomiting, and sneezing. That attributed to desire includes mental disturbance, drowsiness, lassitude, loss of appetite, pain in the heart region, and drying of the body. Fear is associated with delirious speech, grief and anger with trembling, ritual attack or a curse with confusion and thirst, and bhūtābhiṣaṅga with agitation, laughter, trembling, and crying.
The commentary lists distinctive signs for particular attributed causes. Although poison is said to affect all three doṣas, dark discoloration of the mouth is linked to its strong effect on pitta. Abhaktaruk means loss of appetite; vamathu means vomiting; and kṣava means sneezing. In the desire-associated condition, cittavibhraṃśa is explained as confusion about what to do. Pralāpa is incoherent speech, whose particular cause is to be distinguished from the history and other evidence, while vepathu means trembling. Abhicāra is explained as a lethal rite using mantras, abhiśāpa as a curse uttered by revered authorities, and bhūtābhiṣaṅga as comprehensive contact with divine and other grahas; udvega means mental agitation.
Key terms
viṣakṛta
Attributed to poison in the source.
cittavibhraṃśa
Mental confusion, explained as uncertainty about what to do.
pralāpa
Incoherent or disconnected speech.
bhūtābhiṣaṅga
A historically situated external-agency category involving grahas.
The commentary presents this as the classical pathogenesis of fevers arising from exhaustion, wasting, and injury. It glosses 'filling the whole body' as pervading it.
Key terms
śrama
Exhaustion or excessive exertion.
kṣaya
Wasting or depletion in this context.
abhighāta
Physical injury or trauma.
anila
Vāta, described here as aggravated and pervading the body.
Another kind of fever may arise with the development or suppuration of diseases, through an external cause, and from various other causes. Even though its cause differs, it does not depart from the signs of the doṣas.
The commentary introduces another account of āgantu fever. 'Diseases' refers to conditions such as vidradhi. One interpretation takes vidāha as suppuration of those conditions and āgantu as trauma, such as opening an unripe abscess; another explains vidāha more generally as heat or inflammation and āgantu as ordinary injury and similar causes. This fever is called 'another' because its precipitating causes differ, including the previously stated causes and other fever-producing factors. Despite those differences, it still displays signs attributed to vāta and the other doṣas.
Key terms
vidradhi
A classical disease example used in discussing fever associated with suppuration.
vidāha
Interpreted either as suppuration of the disease or more generally as heat or inflammation.
āgantu
An externally caused condition, interpreted here in relation to injury.
doṣa-liṅga
Signs attributed to the doṣas in the classical framework.
When fever is situated in rasa, its signs are heaviness, distress in the heart region, bodily weakness, vomiting, loss of appetite, and dejection. In rakta it brings blood-stained expectoration, burning, sweating, vomiting, confusion, delirious speech, eruptions, and thirst. In flesh it causes tightening pain in the calves, thirst, free passage of urine and stool, internal heat or burning, abnormal movements, and languor. In medas it causes profuse sweating, thirst, fainting, delirious speech, vomiting, unpleasant odor, loss of appetite, languor, and intolerance. In bone it causes splitting bone pain, contraction, breathing difficulty, diarrhea, vomiting, and abnormal limb movements. In marrow it causes darkness before the eyes, hiccup, cough, coldness, vomiting, internal burning, severe breathing distress, and a cutting pain in a vital region. Fever reaching the site of śukra is described as fatal, with penile rigidity and especially discharge of semen. Like fire ceasing after consuming its fuel, or poison after destroying the dhātus, fever is said to become quiet only after destroying the body.
The commentary first records a version of the signs of fever in rasa and the other dhātus that Jejjaṭa rejects: because santata fever pervades the whole body and satata and related fevers already occupy the dhātus, he sees no place for a separate category. Gayadāsa, however, reads and explains a different version, which the present commentator follows. He explains heaviness and weakness as bodily, and dainya as languor. The rasa signs are included to state otherwise undescribed dhātu-specific features. For the flesh signs, calf tightening is pain in the hollow below the knee, internal heat means internal burning, and vikṣepa means abnormal limb movement. In the medas account, asahiṣṇutā may mean irritability, though some understand inability to tolerate one's own odor. In the bone account, kuñcana means contraction of the bones. Darkness in the marrow account means seeing darkness; mahāśvāsa is a severe breathing pattern described later, and marmaccheda is pain as if the heart were being cut. The commentary defends the fatal prognosis assigned to śukra involvement by saying that, although śukra pervades the body, it is separated by successive kalās and is reached through progression across the dhātus. The closing comparisons explain fever as subsiding only when bodily warmth is absent after death, just as poison is considered quiet after the death of a poisoned animal.
Key terms
dhātu-gata jvara
Fever classified according to the dhātu in which it is said to be situated.
piṇḍikodveṣṭana
Tightening or painful cramping in the calf below the knee.
mahāśvāsa
A severe breathing pattern referenced in the marrow-associated signs.
marmaccheda
A sensation like cutting in a vital region, explained here in relation to the heart.
śukra-sthānagata
Having reached the site of śukra in the classical progression.
A discerning physician should describe the signs of fevers located in rasa and the other dhātus according to the same patterns already stated for fevers arising from vāta, pitta, and kapha. A dhātu-based fever involving all the doṣas should be identified from their combined signs, while a dual-doṣa fever should be identified from the signs of the corresponding pair.
The commentary says that fevers affecting each of the seven dhātus, beginning with rasa, are understood through the previously described signs of vāta, pitta, and kapha. It explains that combined doṣa signs indicate sannipāta, while signs produced by two doṣas indicate a dvandvaja fever. The wording is somewhat compressed at the boundary of verses 91 and 92 and should be checked against the continuation.
Key terms
rasādi dhātu
The seven bodily dhātus beginning with rasa, used here as locations of fever.
sannipāta
Combined involvement of all three doṣas, recognized through their collective signs.
A fever should be recognized as gambhīra when it is accompanied by internal burning, thirst, pronounced obstruction or distension, and the onset of breathlessness and cough.
The commentary explains ānaddhatva as obstruction involving the doṣas and feces. By the conjunction 'and,' it also includes delirious speech, dizziness, pain in the joints and bones, and similar signs. Other fevers are to be understood through the opposite pattern.
Key terms
gambhīra jvara
A deep-seated fever pattern identified here by severe internal signs.
antardāha
A sensation of burning within the body.
ānaddhatva
Pronounced obstruction or distension, explained as retention involving doṣas and feces.
The text advises withdrawing from treatment when a fevered person is emaciated, has lost bodily radiance or sensory capacity, is severely troubled by loss of appetite, and is afflicted by a deep and intensely forceful fever episode.
The commentary presents these as signs that gambhīra fever is incurable. Hataprabha-indriya is explained either as loss of bodily radiance together with impaired hearing, sight, and other faculties, or as loss of sensory power itself. Gambhīra refers to a deep internal episode, while tīkṣṇa indicates an extremely unbearable force both internally and externally. Several variant readings are preserved: instead of being oppressed by anorexia, some read 'afflicted in mind and beset by complications'; another reading says 'afflicted by harmful beings,' interpreted in the historical categories of preta, bhūta, piśāca, and rakṣas.
Key terms
hataprabha-indriya
Loss of bodily radiance and sensory function, with an alternative interpretation emphasizing lost sensory power.
kṣīṇa
Emaciated or severely depleted.
tīkṣṇa-vega
An intensely forceful and extremely difficult-to-bear fever episode.
upadrava
A complication accompanying fever in one variant reading.
According to whether the doṣas are slight, moderate, or abundant, an intense fever episode may last three, seven, or twelve days respectively. The earlier and shorter patterns are described as easier to treat than those that follow.
The commentary states that an intense episode produced by a smaller doṣa burden is manageable for three days, by a moderate burden for seven days, and by a greater burden for twelve days. 'Slight' and 'moderate' are relative to the increased state. Thus, a seven-day episode is easier to treat than a twelve-day one, and a three-day episode easier than a seven-day one. These durations indicate approximate limits rather than rigid categories; degrees of doṣa variation may produce shorter or longer limits.
Key terms
hīna-madhya-adhika doṣa
Slight, moderate, and greater degrees of doṣa involvement.
jvara-vega
An active or forceful episode of fever.
sukhakriya
Relatively easier to manage or treat in the source's prognosis.
avadhi
A stated duration or limit, treated by the commentary as approximate.
Adhikarana ५३ (९५-९६) · Śloka ९६
कालो ह्योष यमश्चैव नियतिर्मृत्युरेव च ||९५||
तस्मिन् व्यपगते देहाज्जन्मेह पुनरुच्यते |
इति ज्वराः समाख्याताः कर्मेदानीं प्रवक्ष्यते ||९६||
Meaning of the śloka
Fever is characterized as Kāla, Oṣa, Yama, Niyati, and Death. When it has departed from the body, the person's recovery is spoken of here as a new birth. The account of fevers is thus concluded, and treatment will now be explained.
The commentary says that these names of Kāla and related powers point to fever's capacity to kill, while freedom from fever is portrayed as being born again. The word iti marks the end of the diagnostic discussion. Karman here means treatment, which begins in the following section.
Key terms
Kāla
Time or death, used here as a grave epithet of fever.
Yama
The lord of death, invoked as an epithet emphasizing fever's danger.
punarjanma
Literally rebirth; here a figurative description of recovery from fever.
When the preliminary signs of fever are present, a discerning physician should give clear ghee; the person then obtains relief. This procedure is prescribed for fever arising from vāta. For preliminary signs of pitta fever, mild purgation is prescribed, and for kapha fever, mild therapeutic vomiting is similarly prescribed.
The commentary restricts the ghee instruction to nirāma vāta fever and specifies old, plain ghee, whose qualities are considered altered by time and preparation. 'Clear' excludes mixing it with another substance but not processing by cooking or aging. It applies to preliminary vāta-fever signs arising from causes such as exertion or depletion, not to sāma vāta fever developing in sequence from the stomach. Ghee is taken only until comfort is obtained, followed by light food. For pitta and kapha preliminary signs, the evacuative procedures are explicitly mild rather than strong.
Key terms
pūrvarūpa
A preliminary sign appearing before the fever is fully manifest.
nirāma
A classical state understood as free from āma in this treatment qualification.
svaccha ghṛta
Plain or clear ghee without another medicinal substance added.
pracchardana
Therapeutic induction of vomiting, specified here as mild.
Adhikarana ५५ (९९) · Śloka ९९
सर्वद्विदोषजेषूक्तं यथादोषं विकल्पयेत् |९९|
Meaning of the śloka
In all fevers involving all three doṣas or a pair of doṣas, the previously stated measures should be selected according to the doṣas involved.
The commentary applies this instruction to the preliminary signs of sannipāta fever and dvandvaja fever. Measures already described, beginning with taking ghee, are to be determined according to the particular doṣa pattern.
Key terms
sannipāta-jvara
A fever attributed to the combined involvement of all three doṣas.
dvandva-jvara
A fever attributed to a pair of doṣas.
yathādoṣa
According to the doṣa or doṣas judged to be involved.
vikalpayet
Should determine or select appropriately in context.
Adhikarana ५६ (९९) · Śloka ९९
अस्नेहनीयोऽशोध्यश्च संयोज्यो लङ्घनादिना ||९९||
Meaning of the śloka
A person who is unsuitable for oleation and unsuitable for purificatory evacuation should instead be managed with laṅghana and related measures.
The commentary gives indigestion and newly developed fever as examples of circumstances in which oleation is unsuitable. Aśodhya means unsuitable for therapeutic vomiting or purgation. The phrase 'and related measures' includes classically prepared water, such as water boiled with the ṣaḍaṅga group, and cooled or warm water according to the situation.
Key terms
asnehanīya
A person considered unsuitable for oleation in the classical regimen.
aśodhya
A person considered unsuitable for evacuative procedures such as emesis or purgation.
laṅghana
A lightening regimen; its exact form depends on the patient's state.
ṣaḍaṅga
A named six-ingredient preparation mentioned in relation to boiled water.
The commentary addresses why oleation and evacuative treatment may be taught for preliminary signs even though they are avoided in newly manifest fever. Rūpa and prāgrūpa are separate, but their distinction is analogous to fire and smoke rather than to two wholly unrelated objects such as a pot and cloth. Careful effort is therefore needed to tell them apart.
Key terms
rūpa
A fully manifest sign or clinical presentation.
prāgrūpa
A preliminary or premonitory sign.
vahni-dhūma
Fire and smoke, used as an analogy for related yet distinguishable stages.
nānātva
Distinctness or difference.
Adhikarana ५८ (१००) · Śloka १००
प्रव्यक्तरूपेषु हितमेकान्तेनापतर्पणम् ||१००||
Meaning of the śloka
When the signs of fever are clearly manifest, apatarpaṇa is considered especially beneficial.
Having discussed treatment at the preliminary stage, the commentary turns to treatment after the signs have become manifest. Here ekāntena means to a marked degree, and atarpaṇa is interpreted specifically as fasting because other forms of reducing therapy will be described for particular stages later. The instruction is limited to fevers that arise in sequence from the stomach and to people considered suitable for fasting.
Key terms
pravyakta-rūpa
A state in which the fever's signs are clearly manifest.
apatarpaṇa
A reducing or non-nourishing regimen, interpreted here specifically as fasting.
upavāsa
Fasting, as the commentary's interpretation of atarpaṇa in this passage.
āmāśaya
The stomach or upper digestive seat in the classical account.
Adhikarana ५९ (१०१) · Śloka १०१
आमाशयस्थे दोषे तु सोत्क्लेशे वमनं परम् |१०१|
Meaning of the śloka
When an aggravated doṣa is situated in the āmāśaya and is ready to be expelled, therapeutic vomiting is considered the principal measure.
The commentary presents this as a stage-specific form of apatarpaṇa. Doṣotkleśa, the state in which the doṣa is stirred and ready for expulsion, is to be recognized by signs such as nausea and excessive salivation.
Key terms
āmāśaya-stha
Situated in the stomach or upper digestive seat in the classical model.
doṣotkleśa
A stirred or excited state of doṣa considered ready for expulsion.
The patient should fast only for as long as the doṣas remain motionless and produce a bound or obstructed state. Once that state has ended, the patient should begin the graduated saṃsarjana regimen.
The commentary says that laṅghana continues while inactive doṣas, bound by āma-rasa, make the patient feel obstructed. Once this obstruction resolves and desire for food returns, a graduated sequence beginning with peyā should be followed. It also preserves a different reading of the second half: for that period the patient should eat light food as after purgation. In that reading, 'light' refers both to the nature of the food and, through the comparison with a purged patient, to a small quantity.
Key terms
stimita doṣa
Doṣas described as inactive or not moving in their manifested form.
āma-rasa
A classical substance said here to bind the doṣas.
saṃsarjana
A graduated return to nourishment, beginning here with peyā.
peyā
A thin liquid food used at the beginning of the graduated diet.
Adhikarana ६१ (१०२) · Śloka १०३
न लङ्घयेन्मारुतजे क्षयजे मानसे तथा ||१०२||
अलङ्घ्याश्चापि ये पूर्वं द्विव्रणीये प्रकीर्तिताः |१०३|
Meaning of the śloka
Laṅghana should not be employed in fever attributed to Vāta, in fever arising from depletion, or in fever associated with mental causes. It should also be avoided in the persons previously described in the Dvivraṇīya chapter as unsuitable for laṅghana.
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उचितस्यापि लङ्घनस्य क्वचिन्निषेधमाह- न लङ्घयेदित्यादि| क्षयजे धातुक्षयजे यक्ष्मज्वरे वा, मानसे कामक्रोधादिसम्भूते| अलङ्घ्या “गर्भिणीवृद्धबालदुर्बलभीरुभिः ” इत्यनेनोक्ताः| अन्ये तु व्याख्यानयन्ति- मारुतजे ज्वरे न लङ्घयेत्; किम्भूते? क्षयजे| एतेन धातुक्षयप्रकुपितवातज इत्युक्तं; अथवा क्षयजे न लङ्घयेत्; किम्भूते? मारुतजे| एतेन यक्ष्मज्वरे मारुतसम्भूते न लङ्घयेत्| (यः सामावस्थायां मारुतज्वरो यक्ष्मज्वरश्च स लङ्घनीय एव, निरामे मारुतजे ज्वरे न लङ्घयेत्)||१०२||-
Meaning of the commentary
The commentator identifies exceptions even where laṅghana would otherwise be appropriate. Kṣayaja may mean fever due to depletion of the dhātus or yakṣma-associated fever, while mānasa denotes fever arising from states such as desire or anger. Those unsuitable for laṅghana include the pregnant, elderly, children, the weak, and the fearful. An alternative interpretation links the qualifiers differently: the prohibition may concern Vāta fever caused by tissue depletion, or depletion-associated fever produced by Vāta. A parenthetical reading distinguishes the sāma stage, in which Vāta fever or yakṣma fever may still be treated with laṅghana, from the nirāma stage of Vāta fever, in which it should not be used.
Key terms
laṅghana
a reducing or fasting measure described in this fever regimen
mārutaja
attributed to Vāta
kṣayaja
arising from depletion; interpreted here in more than one way
For a person whose doṣas and agni are unsettled, laṅghana is said to digest the doṣas, reduce fever, kindle digestion, and produce desire for food, taste for food, and lightness.
The commentator explains that the doṣas are 'unsettled' because they have moved from their proper locations, while agni is unsettled because it has been displaced outward. Kāṅkṣā is the inward desire for food, whereas ruci is the tasting faculty's inclination toward food once it is brought to the mouth.
Key terms
doṣa
the functional factors described here as displaced from their locations
A person is considered properly subjected to laṅghana when flatus, stool, and urine pass freely; hunger and thirst become difficult to tolerate; the body feels light; the mind and senses are clear; and the person has become lean or reduced.
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सम्यग्लङ्घितलक्षणमाह- सृष्टमारुतविण्मूत्रमित्यादि| सृष्टमारुतविण्मूत्रमिति अधःप्रवृत्तवातपुरीषमूत्रं, क्षुत्पिपासासहमिति सम्यग्लङ्घनादेकस्मिन्नेव काले ये क्षुत्पिपासे समवेते भवतस्ते सोढुमशक्तम्| तथा च तन्त्रान्तरं,- “वातमूत्रपुरीषाणां विसर्गे गात्रलाघवे| हृदयोदरकण्ठास्यशुद्धौ तन्द्राक्लमे गते|| स्वेदे जाते रुचौ चापि क्षुत्पिपासासहोदये| कृतं लङ्घनमादेश्यं निर्व्यथे चान्तरात्मनि”- इति| लघुम् अङ्गगौरवादिरहितम्| आत्मा अन्तःकरणम्| क्षामं सर्वाक्षमम्| एवम्भूतं सुलङ्घितं विद्यात्||१०४||-
Meaning of the commentary
These are presented as the signs of adequate laṅghana. Free passage refers to the downward movement of flatus, feces, and urine. Hunger and thirst are said to arise together and become difficult to endure. Another cited text adds bodily lightness, clarity of the heart, abdomen, throat, and mouth, disappearance of drowsiness and fatigue, appearance of sweating and appetite, and absence of inner discomfort. Here laghu means freedom from heaviness, ātman denotes the inner faculty, and kṣāma is glossed as reduced or weakened in all respects.
Key terms
sulaṅghita
having undergone laṅghana to the degree considered adequate in the text
Excessive laṅghana may produce loss of strength, thirst, dryness, stupor or drowsiness, a sleep-like state or sleeplessness, dizziness, fatigue, and complications beginning with difficulty in breathing.
The commentator presents these as signs of excessive laṅghana. Loss of strength may refer to loss of time-dependent, acquired, and innate strengths, or specifically to depletion of ojas. Śoṣa is explained as dryness of the mouth. Tandrā is a type of altered drowsiness. A difficulty is raised because sleep is normally attributed to kapha, whereas excessive laṅghana reduces kapha; the reply is that the condition only resembles sleep because activity ceases. Other interpreters join the negative particle differently and read anidrā, sleeplessness. Bhrama is a spinning sensation, and klama is fatigue without exertion. 'Beginning with' also includes cough, loss of voice, vomiting, and hiccup; other adverse signs are to be inferred as opposites of the signs of adequate laṅghana.
Key terms
atilaṅghana
excessive use of the reducing or fasting measure
ojaḥkṣaya
depletion of ojas, offered as one interpretation of loss of strength
Warm water is described as kindling digestion, breaking up kapha, directing pitta and Vāta in their proper course, being suitable in fevers attributed to kapha, Vāta, or both, and relieving thirst. It is also said to soften the doṣas and their channels.
The passage concerns water boiled until half remains. 'Breaking up kapha' means dispersing congealed śleṣman. The plural expression is taken to include kapha fever, Vāta fever, and combined kapha-Vāta fever. Although qualities of warm water were given earlier, they are repeated here to establish additional application for both healthy and ill persons. The phrase about softness may mean that the water softens the doṣa-carrying channels, or that it softens both the doṣas and the channels. The teachers add that even water having these qualities should be given only in a small amount during fever.
Key terms
uṣṇāmbu
warm water; the commentary specifies water boiled until half remains
dīpana
kindling of digestive function in the classical account
kaphavicchedin
breaking apart congealed kapha
srotas
channels, including channels that carry doṣas in one interpretation
Cold, unboiled water is described as having qualities contrary to warm water; according to the passage, habitual use of cold water causes fever to increase.
The commentator glosses śīta here as unboiled water and anyathā as possessing qualities opposite to those of warm water. The second line answers whether cold water merely has the contrary qualities or also produces a distinct effect: the text states that its use increases fever.
For fevers said to arise from pitta, alcohol, or poison, the text recommends cooled boiled water prepared with bitter substances: gāṅgeya, nāgara, uśīra, parpaṭa, udīcya, and candana.
The commentary says that in these fevers water boiled with bitter substances and then cooled may be given; on the authority of another text, plain boiled-and-cooled water is also an option. It identifies gāṅgeya as musta, udīcya as vālaka, and candana as red sandalwood. It then records two differing preparation traditions with specific quantities and degrees of reduction. Although śuṇṭhī is not bitter, it is included for its pācana role and compatibility with the combination. Another text gives a further preparation rule, while the Pañjikā author reads only its first half and interprets 'with bitters' as referring to parpaṭa and similar substances.
Key terms
śrutaśītala
water that has been boiled and then cooled
gāṅgeya
identified by the commentary as musta
udīcya
identified by the commentary as vālaka
candana
identified here as red sandalwood
pācana
digestive or metabolizing action within the classical framework
Peyā is described as kindling and supporting digestion, being light, and alleviating fever. At the appropriate time for food, it is considered beneficial for a person with fever when prepared with digestive substances suited to the individual condition.
For 'the time of food,' one interpretation refers to the conditions later described in the regimen for health, beginning after stool and urine have been passed; others understand it as the end of the day. 'Prepared with the appropriate pācana substances' is explained as preparation with pañcamūlī and similar materials. Another reading takes the plural more broadly, covering substances classed as dīpana, pācana, and śamana. The qualities of peyā are repeated here for a distinct contextual purpose, just as the qualities of warm water were repeated, so the passage is not considered redundant.
Key terms
peyā
a thin gruel used in the classical dietary regimen
dīpanī
described as kindling digestive capacity
pācanī
described as promoting digestion or maturation
pañcamūlī
a group of five roots mentioned as one preparation option
When, after seven nights of fever in a person with abundant doṣa and weak agni, the doṣa has not matured despite laṅghana, water, and yavāgū, the person should be treated with decoctions that promote pācana, are agreeable to the heart, alleviate fever, and address altered taste in the mouth, thirst, and lack of appetite.
This passage states the stage at which pācana is to be given after laṅghana and related measures. Although another text names sweating and bitter taste for pācana, the commentator says both are already implied here: warm-water administration supplies sweating in kapha and Vāta fever, and the six-part water preparation includes bitter taste. The remedies to be stated later are aligned with Vāta-, pitta-, and kapha-fever because altered mouth taste, thirst, and lack of appetite are understood as signs of those doṣas. Kaṣāya here means decoction. An objection asks why yavāgū is used when āma is present; the answer distinguishes abundant from slight āmatā and restricts its use to the latter.
Key terms
mandāgni
weak digestive capacity in the classical assessment
yavāgū
a gruel used in the stated regimen
āmatā
the state of āma, distinguished here as abundant or slight
For fever attributed to Vāta, a pañcamūlī decoction is given for pācana. For pitta fever, the text gives a preparation of musta, kaṭuka, and indrayava with honey. For kapha fever, it gives a pippalī-group decoction. In fevers attributed to two doṣas, the corresponding preparations are to be combined.
The commentator assigns these pācana preparations according to doṣa. Pañcamūlī is first identified as the larger group, but other authorities use both forms: the larger pañcamūlī when kapha accompanies Vāta fever and the smaller when pitta accompanies it. Saṃsṛṣṭa means mixed. Treatment of sannipāta is considered included within the treatment of dual-doṣa fever and is therefore not stated separately.
Key terms
pañcamūlī
a five-root group, with larger and smaller forms distinguished by some interpreters
indrayava
a named ingredient in the pitta-oriented preparation
The omitted object of 'should avoid' is supplied as pācana. Pītāmbu means one who has just drunk water; laṅghita, one who has fasted; bhukta, one who has just eaten; and ajīrṇin, one whose food remains undigested.
Key terms
pācana
a digesting or maturating therapeutic measure in this context
laṅghita
one who has undergone fasting or a reducing measure
An included alternative verse says that severe fever, bodily heaviness, and obstructed excretions indicate fever with sāma doṣa, while the opposite indicates a matured state. The main reading says that when fever is mild, the body feels light, and the excretions move freely, the doṣa should be understood as matured; at that stage, medicine may be given for the fever.
The commentator identifies these as signs of a matured doṣa. 'That medicine' refers to the śamana and śodhana medicines that will be described subsequently.
Key terms
sāma doṣa
doṣa associated with āma in the included alternative verse
pakva doṣa
a doṣa assessed as matured
śamana
pacifying treatment to be described later
śodhana
eliminative treatment to be described later
Adhikarana ७३ (११६) · Śloka ११६
दोषप्रकृतिवैकृत्यादेकेषां पक्वलक्षणम् |११६|
Meaning of the śloka
According to one school, a change from the characteristic condition of the doṣas is a sign that they have matured.
The commentator introduces this as the view of one group. The expression doṣa-prakṛti-vaikṛtya means that the heightened condition of the doṣas which produced the fever has changed into another state; this alteration is taken as a sign of maturation.
Key terms
doṣaprakṛti (doṣa-prakṛti)
the characteristic state of the doṣas responsible for producing fever
vaikṛtya
alteration from that heightened state
pakvalakṣaṇa (pakva-lakṣaṇa)
a sign that the doṣa has reached the stage described as matured
The discerning physician should recognize āma fever by signs such as an oppressive or twisting sensation in the heart region, drowsiness, salivation, lack of appetite, inactivity of the doṣas, lassitude, obstruction, abundant urination, heaviness of the abdomen, absence of sweating, failure of stool to mature, mental restlessness, numbness or sleepiness, stiffness and heaviness of the limbs, weak digestive fire, impurity of the mouth, only slight relief, and a strong, persistent fever.
These verses give the general signs of āma fever. Hṛdayodveṣṭana is explained as a sensation like twisting or constriction of the heart region. Doṣāpravṛtti means that Vāta and the other doṣas remain immobile; vibandha is failure of stool and flatus to move; arati is the mind's inability to remain settled anywhere; aglāni means only slight calming; and prasaṅgī means continuously attached or persistent. These signs generally remain for about seven nights. The Pañjikā author preserves an alternative list: excessive salivation, nausea, impurity of the heart region, anorexia, drowsiness, lassitude, indigestion, unpleasant taste, heaviness of the body, loss of hunger, abundant urination, stiffness, and strong fever, with the instruction that medicine should not then be given.
Key terms
āmajvara (āma-jvara)
fever assessed as being in the āma or unprocessed stage
hṛdayodveṣṭana
an oppressive sensation likened by the commentary to twisting in the heart region
This gives other authorities' views on when a medicine of kaṣāya taste may be used. Here auṣadha includes astringent medicine and is not limited to bitter medicine, because bitter substances may be usable even in the sāma state. Although an earlier passage permits medicine when signs of doṣa maturation appear, the reference to seven nights prohibits even pācana before that point. The reference to ten nights indicates that medicine may be given after ten days even when signs of maturation are absent. The commentator identifies the latter position as that of physicians who make a definite determination.
Key terms
auṣadha
medicine; interpreted here to include medicine of astringent taste
kaṣāyarasa (kaṣāya-rasa)
astringent taste in this discussion
pācana
a digesting or maturating measure in the classical regimen
sāma
a state in which doṣa is associated with āma
Adhikarana ७६ (१२०) · Śloka १२१
पैत्तिके वा ज्वरे देयमल्पकालसमुत्थिते ||१२०||
अचिरज्वरितस्यापि देयं स्याद्दोषपाकतः |१२१|
Meaning of the śloka
In pitta fever, medicine may be given even when the fever has arisen only recently. Thus, medicine may be used in a person with a recent fever when the doṣa has matured.
The passage qualifies the preceding time rules. If, even before seven days, a pitta fever with only a small amount of doṣa quickly reaches maturation, the appropriate medicine may then be given. The word vā extends the same principle to Vāta, kapha, and other fevers: medicine may be used when maturation of the doṣa is present.
Key terms
paittika jvara
fever attributed predominantly to pitta
alpakālasamutthita (alpa-kāla-samutthita)
of recent or short duration
doṣapāka (doṣa-pāka)
maturation of the doṣa in the classical assessment
Medicine applied while the doṣa remains in the āma state is said to intensify the fever: eliminative medicine makes it flare, while pacifying medicine produces an irregular fever.
This explains why medicine is prescribed only after maturation of the doṣas. In a person whose doṣa remains āma, śodhana medicine is said to kindle or intensify the fever, while śamana medicine is said to cause viṣama-jvara. Some manuscripts read 'increases' in place of 'kindles.'
Key terms
āmadoṣa (āma-doṣa)
doṣa remaining in the unprocessed āma state
śodhana
eliminative treatment in the classical regimen
śamana
pacifying treatment
viṣamajvara (viṣama-jvara)
an irregular pattern of fever in this passage
Adhikarana ७८ (१२२) · Śloka १२३
च्यवमानं ज्वरोत्क्लिष्टमुपेक्षेत मलं सदा ||१२२||
अतिप्रवर्तमानं च साधयेदतिसारवत् |१२३|
Meaning of the śloka
Material set in motion and driven out by the fever should generally be allowed to pass. If it flows excessively, it should be managed in the manner described for atisāra.
This states what should be done according to the patient's stage. Mala that has been disturbed from the stomach by fever and is already moving outward should be left to pass, whether the fever is in the āma or the matured stage. If the discharge becomes excessive, the phrase 'as in atisāra' implies first promoting maturation and then bringing it under restraint. Mala does not mean feces alone, because when it does not emerge the text later directs elimination by emesis and other measures.
Key terms
cyavamāna
moving or passing out
utkliṣṭa
disturbed and set in motion from its location
mala
expelled material, interpreted here more broadly than feces alone
atisāra
the condition whose management is used as the comparison for excessive discharge
This specifies when śodhana is to be used. The commentator says that virecana here denotes elimination generally and does not mean only downward purgation. Some interpreters, however, take mala in this and the preceding sentence specifically to mean feces.
Key terms
koṣṭhānuga
having reached the central digestive tract or koṣṭha
pakva mala
mala assessed as matured
srotas
channels from which the malas are described as reaching the koṣṭha
virecana
interpreted here broadly as elimination, not solely downward purgation
Adhikarana ८० (१२४-१२५) · Śloka १२५
पक्वो ह्यनिर्हृतो दोषो देहे तिष्ठन् महात्ययम् ||१२४||
विषमं वा ज्वरं कुर्याद्बलव्यापदमेव च |
तस्मान्निर्हरणं कार्यं दोषाणां वमनादिभिः ||१२५||
Meaning of the śloka
A matured doṣa left unremoved in the body is said to cause grave danger, irregular fever, or loss of strength. Therefore the doṣas should be gently removed by emesis and related measures.
The commentator explains that 'unremoved' means not taken out by emesis and similar procedures. Mahātyaya denotes a grave condition, and balavyāpad means decline of strength. Nirharaṇa is glossed as a limited or gentle removal rather than indiscriminate elimination.
Key terms
pakva doṣa
a doṣa considered matured
mahātyaya
grave danger or a serious condition
balavyāpad (bala-vyāpad)
decline or loss of strength
nirharaṇa
removal, glossed here as gentle or limited elimination
Adhikarana ८१ (१२६) · Śloka १२७
प्राक्कर्म वमनं चास्य कार्यमास्थापनं तथा |
विरेचनं तथा कुर्याच्छिरसश्च विरेचनम् ||१२६||
क्रमशः... |१२७|
Meaning of the śloka
The procedures are to be used successively: first emesis, then āsthāpana, virecana, and evacuation through the head.
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इदानीं क्रमशो वमनादिपरिपाटीमाह- प्रागित्यादि| यद्यपि प्रथमं लङ्घनस्योपदेशः, तथाऽप्यवस्थाप्राप्तत्वाद्वमनस्यापि प्राक्कर्मत्वम्| क्रमश इति क्रमेण, न युगपत्; अथवा लङ्घनपाचनानन्तरं स्नेहादिना कोष्ठप्राप्तेषु दोषेषु मध्यमावस्थायां ज्वरस्येति क्रमशो देयम्| प्राक्कर्म वमनं चास्येत्यत्र चकारादग्रेऽनुवासनमित्यपि||१२६||-
Meaning of the commentary
The text now gives the sequence of emesis and the other procedures. Although laṅghana was taught first, emesis is also called an initial procedure when its proper clinical stage has arrived. Kramaśaḥ means that the measures are given in sequence rather than simultaneously. Alternatively, it means that after laṅghana and pācana, when oleation and related measures have brought the doṣas into the koṣṭha and the fever has reached its middle stage, the procedures are administered in order. The conjunction ca is also understood to include anuvāsana later in the sequence.
In a strong person with kapha fever, emesis is prescribed. When pitta predominates and the bowel is relaxed rather than obstructed, virecana is prescribed. In Vāta fever accompanied by abdominal pain, upward disturbance, and obstruction, nirūha is prescribed; for a person with constriction of the waist and back and strong agni, anuvāsana is prescribed. When kapha affects the head, mūrdhavirecana is prescribed to relieve heaviness and pain of the head and restore clarity of the senses.
The commentator assigns each procedure according to the person's strength, the fever pattern, and the clinical stage. Emesis in kapha fever applies when the doṣa is in the stomach and ready to be expelled, as described earlier. In pitta predominance, virecana is used when the lower bowel is not rigid or obstructed; the word tu may also allow emesis in pitta under appropriate conditions, supported by a cited verse about kapha and pitta situated in the stomach. Nirūha is associated with abdominal pain and obstructed upward movement, while anuvāsana is associated with painful restriction of the waist and back in a person with strong agni. Mūrdhavirecana is generally for chronic fever rather than recent fever, except that the commentary permits it in recent sannipāta to restore consciousness. The Pañjikā author reads the opening together with an earlier passage concerning the stage suitable for emesis.
Key terms
nirūha
a decoction-based enema procedure
anuvāsana
an oil-based enema procedure
udāvarta
obstructed upward movement in the classical account
For a weak person whose abdomen is painfully distended, the text prescribes a comfortably warm external application made from devadāru, haimavatī, kuṣṭha, śatāhvā, hiṅgu, and saindhava, ground with a sour liquid.
The commentator explains the composition of the suppository. In one interpretation it is made from the ingredients beginning with devadāru and haimavatī stated in the preceding passage. Others explain that it is made from conventionally combined substances such as madanaphala, saindhava, and pippalī.
Key terms
ūrdhvamāgata pavana
Vāta described as moving upward
ruddhamūtrapurīṣa (ruddha-mūtra-purīṣa)
obstruction of urine and feces
varti
a medicinal suppository placed rectally
madanaphala
one ingredient in the alternative formulation
pippalī
one ingredient in the alternative formulation
Adhikarana ८५ (१३२) · Śloka १३२
पिप्पलीपिप्पलीमूलयवानीचव्यसाधिताम् |
पाययेत यवागूं वा मारुताद्यनुलोमिनीम् ||१३२||
Meaning of the śloka
When vāyu has moved upward and urine and stool are obstructed, the patient may be given yavāgū prepared with Pippalī, Pippalīmūla, Yavānī, and Cavya, or another gruel that promotes the normal downward movement of vāta and the other doṣas.
The commentary introduces this prescription as a further measure for a person in whom vāyu has moved upward and the passage of urine and stool is obstructed.
Key terms
Pippalī (pippalī)
A medicinal substance included in the gruel.
Pippalīmūla (pippalīmūla)
The root of Pippalī, included in the preparation.
Yavānī (yavānī)
A medicinal ingredient named in the gruel.
anulominī
Promoting the normal downward movement of vāta and associated bodily flows.
If fever does not subside in a person who has undergone purification by both routes, and who remains dry with residual doṣa, the fever should be overcome with ghee.
The commentary explains that the fever persists because some doṣa remains and because the purified patient has become dry. The verse therefore gives a measure for such a dry, purified person whose fever has not settled.
Key terms
ubhayataḥ śuddha
Purified through both therapeutic routes in the classical treatment context.
saśeṣadoṣa
Having some residual doṣa remaining after purification.
rūkṣa
Dry or depleted in the context of the prior purification.
sarpiṣ
Ghee, prescribed here after purification in the stated condition.
Adhikarana ८७ (१३४) · Śloka १३४
कृशं चैवाल्पदोषं च शमनीयैरुपाचरेत् |
उपवासैर्बलस्थं तु ज्वरे सन्तर्पणोत्थिते ||१३४||
Meaning of the śloka
A thin person with only a small amount of doṣa should be treated with pacifying measures. In fever arising from over-nourishment, a person who retains strength should be managed with fasting or other appropriately selected forms of laṅghana.
After describing purification, the commentary says that the text now explains pacifying treatment. It glosses upavāsa as giving up food. Jejjaṭa, however, observes that fasting itself belongs among pacifying measures and understands the verse as specifying the particular situation in which it is to be used. Because the text uses the plural ‘fasts,’ he allows the ten forms of laṅghana to be selected according to the patient's state. A cited verse lists four kinds of purification along with thirst, exposure to wind and sun, digestive measures, fasting, and exercise as forms of laṅghana. The commentator notes that, under this interpretation, purification is mentioned again even though the present topic is pacification.
Key terms
śamanīya
A measure intended to pacify doṣa rather than expel it.
santarpaṇotthita jvara
Fever described as arising from excessive nourishment.
upavāsa
Fasting, explained here as abstaining from food.
laṅghana
A group of lightening measures, understood by the commentary to have ten forms.
Because food is considered foremost among pacifying measures, the commentary introduces this dietary instruction. It explains klinna as a gruel containing only a small amount of solid grain. Some read tanvī, ‘thin,’ in place of klinna, but the commentary says that the meaning remains the same.
Key terms
yavāgū
A grain gruel, here prepared with little solid matter.
mandāgni
A state of weak digestive capacity.
klinnā
Explained here as a gruel with only a small proportion of solid grain.
tanvī
A variant reading meaning ‘thin,’ understood to convey the same sense.
For a person troubled by thirst, vomiting, burning, and heat, or one accustomed to alcohol, the text prescribes a preparation of parched grain. After it has digested, a drink prepared with water and honey is followed at the appropriate meal time by pulse soup, meat broth, or rice. For fever associated with fasting or exhaustion, depletion, or predominance of vāta, a wise physician should feed a person with strong digestion rice accompanied by meat broth. Rice with Mudga soup is beneficial in fever arising from kapha; the same Mudga soup, served cool and combined with sugar, is beneficial in pitta fever.
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यवाग्वनर्हस्य तर्पणमाह- तृडित्यादि| हित इति ‘अन्नकाले’ इति शेषः| स इत्यादि| स एव मुद्गयूष एव||१३५-१३७||-
Meaning of the commentary
The commentary introduces tarpaṇa made from parched grain for a person not suited to yavāgū. It supplies ‘at meal time’ after the word ‘beneficial.’ It also clarifies that ‘the same’ in the final statement refers specifically to Mudga soup.
Key terms
lājatarpaṇa
A nourishing drink or preparation made from parched grain.
yūṣa
A pulse-based soup prescribed as part of the diet.
māṃsarasa
Meat broth named as a dietary accompaniment.
Mudga (mudga)
A pulse whose soup is advised in the stated fever contexts.
In fever involving vāta and pitta, soup prepared from pomegranate, Āmalaka, and Mudga is advised. In predominance of vāta and kapha, soup of the small radish is beneficial; in a pitta-kapha condition, soup of Paṭola and Nimba is suitable. A depleted person suffering from burning, vomiting, lack of food, and thirst should also be given a parched-grain drink combined with sugar and honey.
The commentary identifies these as suitable foods for fevers involving pairs of doṣas. It explains hrasvamūlaka as the small or light radish. Because the liquid for the parched-grain drink is not specified, one interpretation prepares it with cold water; some prefer water that has been boiled and cooled, while others consider fever-relieving fruit juices suitable. These alternatives are preserved rather than resolved into a single preparation.
Key terms
dvandvajvara
Fever described as involving a pair of doṣas.
hrasvamūlaka
Explained by the commentary as a small or light variety of radish.
Paṭola-Nimba-yūṣa (paṭola-nimba-yūṣa)
Soup made with Paṭola and Nimba, named for a pitta-kapha condition.
Yavāgū is not beneficial for a person overwhelmed by kapha and pitta, during summer, for one affected by raktapitta, or for a person habitually using alcohol. Such a patient should instead be managed with suitable sour or non-sour pulse soups and with suitable broths from animals of arid regions.
The commentary marks the special circumstances in which the generally praised yavāgū is unsuitable. ‘Overwhelmed by kapha and pitta’ means affected by both together. Although a later section on raktapitta teaches yavāgū mixed with ghee, the commentary distinguishes that combined condition from the present case of fever with raktapitta, in which yavāgū is said to be unsuitable. Sour or non-sour soups are alternatives chosen according to habituation and digestive capacity. The choice of pulse soup or broth from an animal of an arid region likewise depends on habituation and the patient's condition. For patients dominated by burning and related symptoms, this instruction is understood as appropriate only at the suitable time.
Key terms
kaphapittaparīta
Overwhelmed by kapha and pitta acting together.
raktapitta
A classical bleeding-related condition mentioned here together with fever.
sātmya
Habituation or suitability to the individual, used to choose among dietary alternatives.
jāṅgala rasa
Broth from animals associated with arid regions in the classical classification.
The commentary introduces alcohol and buttermilk as substances that may be suitable in particular states when combined with other ingredients. It explains ‘old’ alcohol as properly matured and attributes the stated suitability to its digestive-kindling and kapha-reducing qualities.
Key terms
madya purāṇa
Alcoholic drink that is aged or properly matured.
mandāgni
Weak digestive capacity.
yavānna
Food prepared from barley, used here as an accompaniment.
dīpanīya
Described as kindling digestive activity in the commentary's reasoning.
Adhikarana ९३ (१४३) · Śloka १४३
सव्योषं वितरेत्तक्रं कफारोचकपीडिते |१४३|
Meaning of the śloka
A person afflicted by kapha and loss of appetite should be given buttermilk prepared with Vyoṣa.
The commentary states that this is the instruction for using buttermilk. It explains savyoṣa as buttermilk processed with Trikaṭuka, and vitaret as ‘one should give.’
Key terms
takra
Buttermilk, used here as the base of the preparation.
Vyoṣa (vyoṣa)
The pungent combination identified here with Trikaṭuka.
Trikaṭuka (trikaṭuka)
The three-pungent formulation used to process the buttermilk.
arocaka
Loss of appetite or aversion to food in this context.
Adhikarana ९४ (१४३-१४४) · Śloka १४४
कृशोऽल्पदोषो दीनश्च नरो जीर्णज्वरार्दितः ||१४३||
विबद्धः सृष्टदोषश्च रूक्षः पित्तानिलज्वरी |
पिपासार्तः सदाहो वा पयसा स सुखी भवेत् ||१४४||
Meaning of the śloka
A thin, distressed person suffering from chronic fever with little doṣa, as well as a person with obstructed doṣa, slowly discharging doṣa, dryness, fever dominated by pitta and vāta, thirst, or burning, is said to become comfortable through milk.
The commentary introduces the circumstances for using milk and explains dīna as mentally distressed. Vibaddhadoṣa means doṣa that has not begun to move, while sṛṣṭadoṣa means doṣa that has become displaced or has started to move. To answer why milk is used in both apparently opposite states, the commentator says that milk possesses both relevant capacities. Alternatively, sṛṣṭadoṣa may mean that the doṣa is passing only little by little; milk is then used for its evacuating action so that the doṣa may move properly. The commentator adds that earlier compilers quoted only part of this reading and omitted another part, whereas the complete passage is written here because it was learned from elders.
Key terms
jīrṇajvara
A fever described as longstanding or chronic.
vibaddhadoṣa
Doṣa whose movement or discharge is obstructed.
sṛṣṭadoṣa
Doṣa that has moved or begun to discharge; alternatively, doṣa passing only in small amounts.
payas
Milk, prescribed in the specified chronic-fever states.
Adhikarana ९५ (१४५) · Śloka १४५
तदेव तरुणे पीतं विषवद्धन्ति मानवम् |१४५|
Meaning of the śloka
That same milk, if consumed in the early stage of fever, harms the person like poison.
The commentary asks what happens when milk is taken in taruṇajvara and clarifies that ‘that same’ refers to milk and taruṇa means an early or newly arisen fever.
Key terms
taruṇajvara
An early-stage or newly arisen fever.
payas
Milk, referred to by ‘that same’ from the preceding passage.
viṣavat
‘Like poison,’ an emphatic comparison expressing harmfulness in this context.
In every type of fever, very light food in a measured quantity is beneficial once the fever's acute bout has subsided. If given otherwise, that food increases the intensity of the fever.
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इदानीं सर्वज्वरोचितस्याहारस्य यथाकालमुपयोगमाह- सर्वज्वरेष्वित्यादि| सुलघु पुराणरक्तशाल्यादि, मात्रावत् अल्पं, वेगापाये ज्वरवेगहानौ, अन्यथा उक्तप्रकारवैपरीत्येन, तत् भोजनं, हि यस्मादर्थे| केचित् ‘वेगापाये’ इत्यत्र ‘दिनापाये’ इति पठन्ति; दिनान्ते इति च व्याख्यानयन्ति| ‘सर्वज्वरेषु सप्ताहं मात्रावल्लघु भोजयेत्’ इतीदृशं पूर्वार्धं केचित् पठन्ति, स च निबन्धेषु न दृश्यते||१४५||-
Meaning of the commentary
The commentary explains that this verse concerns the proper timing of food suitable for all fevers. Sulaghu is exemplified by aged red Śāli rice and similar light foods; mātrāvat means a small quantity; and vegāpāya means when the force of the fever has diminished. ‘Otherwise’ means contrary to these stated conditions. Some read dināpāya, interpreted as ‘at the end of the day,’ instead of vegāpāya. Some also read a different first half: ‘In all fevers, for seven days one should give light food in a measured quantity,’ but the commentator notes that this reading is not found in the compendia.
Key terms
sulaghu
Very light food, exemplified in the commentary by aged red Śāli rice and similar foods.
mātrāvat
Given in a measured, small quantity.
vegāpāya
Subsidence of the acute force or bout of fever.
dināpāya
A variant reading interpreted as the end of the day.
Adhikarana ९७ (१४६-१४८) · Śloka १४९
ज्वरितो हितमश्नीयाद्यद्यप्यस्यारुचिर्भवेत् ||१४६||
अन्नकाले ह्यभुञ्जानः क्षीयते म्रियतेऽथवा |
स क्षीणः कृच्छ्रतां याति यात्यसाध्यत्वमेव च ||१४७||
तस्माद्रक्षेद्बलं पुंसां बले सति हि जीवितम् |
गुर्वभिष्यन्द्यकाले च ज्वरी नाद्यात् कथञ्चन ||१४८||
न तु तस्याहितं भुक्तमायुषे वा सुखाय वा |१४९|
Meaning of the śloka
A person with fever should eat suitable food even if appetite is poor. Not eating at the proper mealtime leads to depletion and may even lead to death; when depleted, the person enters a difficult condition and the illness may become incurable. Strength should therefore be protected, because life depends on strength. A person with fever should never eat food that is heavy, channel-obstructing, or taken at an improper time, since unsuitable food does not support either longevity or comfort.
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इदानीं जीर्णज्वरितस्यारुचावपि हितभोजनोपदेशमाह- ज्वरित इत्यादि| अस्य जीर्णज्वरिणो यदि हितभोजने कथञ्चिदरुचिस्तदा हितमेवानेकप्रकाराभिः कल्पनाभिर्मुखाप्रियं कृत्वाऽरुचिनिवृत्त्यर्थं ज्वरितोऽश्नीयात्| तथा च तन्त्रान्तरं,- “सातत्यात् स्वाद्वभावाच्च पथ्यं द्वेष्यत्वामागतम्| कल्पनाविधिभिस्तैस्तैः प्रियत्वं गमयेत् पुनः”- इति| कस्मादेवंविधमपि कृत्वा ज्वरितोऽश्नीयादित्याह- अन्नकाले ह्यभुञ्जान इत्यादि| अन्ये तु यद्यस्य जीर्णज्वरिणोऽरुचिः स्यात्तदा अहितमप्यश्नीयादिति व्याख्यानयन्ति| ननु, यद्यरुचौ सत्यामहितभोजनं क्रियते तदा ‘गुर्वभिष्यन्द्यकाले च’ इत्याद्युत्तरोक्तश्लोकेन सह कथं न विरोधः? सत्यं, अहितस्य सातत्यसेवननिराकरणार्थं गुर्वभिष्यन्द्यकाले चेत्यादिश्लोकः| गुर्वित्यादि अभिष्यन्दि दोषधातुमलस्रोतसां क्लेदप्राप्तिजननम्| कथञ्चन सकृदपि| तुशब्दो यस्मादर्थे, तेन यस्मादहितं भुक्तं भोजनं ज्वरितस्य न आयुषोऽर्थे सुखार्थे वा भवति, तस्माद्गुर्वादि न भक्षयेत्| यद्यपि कैश्चिन्निबन्धकारैरेष पाठो न पठितस्तथाऽपि सर्वनिबन्धोपजीविना मया पञ्जिकाकारपठित्वात् पठितः||१४६-१४८||-
Meaning of the commentary
The commentator applies this advice to a person with established or resolving fever who dislikes otherwise suitable food. Such food should be made agreeable through different preparations so that poor appetite can be overcome. Another authority likewise says that wholesome food made disagreeable by repetition or its natural taste should be made pleasant by varied preparation. Some interpreters instead understand the passage to permit even unsuitable food when appetite is absent. The commentator reconciles this with the following prohibition by saying that the prohibition prevents repeated use of unsuitable food. Abhiṣyandin food is explained as causing excessive moisture in doṣas, tissues, wastes, and channels, and kathañcana rules it out even once. The final line is absent from some recensions but is retained because it was read by the Pañjikā author.
Key terms
hita
suitable or wholesome food in the stated condition
bala
strength whose preservation is linked with sustaining life
abhiṣyandin
described as producing excessive moisture or obstruction in doṣas, tissues, wastes, and channels
In a depleted person, a long-standing fever—whether continuous or irregular—should be managed with suitable, light foods offered in a nourishing manner.
This passage gives a nourishing dietary approach for a weak person with long-standing fever. Santata is glossed as continuously present, while viṣama includes recurrent patterns such as satata and anyedyuṣka. Sambhojana is explained as providing foods according to what the person desires, within the stated qualifications of suitability and lightness.
Key terms
santata
a fever described as continuously present
viṣama
an irregular or recurrent fever pattern
kṣīṇa
depleted or weakened
sambhojana
feeding with desired foods that remain suitable and light in this context
The commentator explains why this list of pulse soups is not redundant. Earlier, mudga and the other ingredients were mentioned because of their opposition to particular doṣas; here they are mentioned because of their opposition to the disease condition itself.
For people with fever, the text recommends as vegetables the leaves of paṭola and guḍūcī, together with vārtāka, kaṭhilla, pāpacailika, karkoṭaka, parpaṭaka, gojihvā, and young mūlaka.
The commentary identifies kaṭhilla as the leafy vegetable punarnavā, pāpacailika as the leafy vegetable pāṭhā, and gojihvā as the vegetable called gojī. It does not further explain the other listed items.
Key terms
paṭolapatra
paṭola leaf, listed as a vegetable
kaṭhilla
identified in the commentary as punarnavā vegetable
For a person with fever who is accustomed to eating meat, the text permits meat from lāva, kapiñjala, eṇa, pṛṣata, śarabha, hare, kālapuccha, kuraṅga, and mṛgamātṛkā.
The commentary identifies kapiñjala as the pale partridge, eṇa as the black antelope, pṛṣata as the spotted deer called cītala, and śarabha as a large, great-horned, eight-footed creature described as camel-sized. Kālapuccha is treated as well known, and kuraṅga is described as four-horned and locally called medulī. Māṃsārtha is usually taken to mean using meat as food; some understand it as use for nourishment, citing the principle that flesh is increased by flesh.
Key terms
māṃsasātmya
being accustomed or suited to meat consumption
kapiñjala
identified by the commentary as a pale partridge
pṛṣata
identified as spotted deer or cītala
bṛṃhaṇa
nourishing use, offered as an alternative interpretation of māṃsārtha
The commentator presents this as another medical opinion. Sārasa is described as a particular red-beaked bird, krauñca by its familiar name, śikhin as peacock, and tittira as the black partridge; the form tittiri is also attested. Although an earlier classification explicitly describes chicken and tittira as highly heating rather than all the birds in this list, the present rule and another statement about peacock and tittira are taken to establish that sārasa and the others are heating as well.
When Vāta becomes aggravated in a person with fever, even the meats just discouraged may be considered suitable if administered with proper attention to quantity and time.
The commentary states briefly that the passage permits, under this particular condition, the use of sārasa and the other meats that were prohibited in the preceding passage.
Key terms
samīraṇa
Vāta in this context
prakopa
aggravation
mātrā
appropriate quantity
kāla
appropriate timing
Adhikarana १०४ (१५६-१५८) · Śloka १५८
परिषेकान् प्रदेहांश्च स्नेहान् संशोधनानि च ||१५६||
(स्नानाभ्यङ्गदिवास्वप्नशीतव्यायामयोषितः) |
कषायगुरुरूक्षाणि क्रोधादीनि तथैव च ||१५७||
सारवन्ति च भोज्यानि वर्जयेत्तरुणज्वरी |
तथैव नवधान्यादिं वर्जयेच्च समासतः ||१५८||
Meaning of the śloka
A person in the early stage of fever should avoid pouring treatments, topical pastes, oils or fats, cleansing procedures, astringent decoctions, heavy and dry foods, anger and related states, rich or channel-obstructing foods, and newly harvested grains and related items. A parenthetical reading also lists bathing, oil massage, daytime sleep, cold exposure, exercise, and sexual activity.
The commentary explains pariṣeka as pouring a stream of liquid, avagāha as immersion in a vessel filled with water, sneha as internal use of oils or fats, and saṃśodhana as procedures beginning with emesis. Kaṣāya here is a decoction made from astringent substances; ‘anger and the rest’ includes grief. Sāravat foods are fatty and abhiṣyandin. The class beginning with new grain and ending with takra was described elsewhere, and samāsataḥ indicates that the list is concise. Although these restrictions might be expected immediately after the signs of āma fever, they are placed here to convey a complete restriction on medicines in early fever. The commentator also preserves another arrangement of the verse: that reading omits the parenthetical list, infers avoidance of immersion from avoidance of bathing and of massage from avoidance of sneha, and includes kaṣāya through the conjunction after anger.
Key terms
taruṇajvara
early or newly arisen fever
pariṣeka
pouring a stream of liquid over the body
saṃśodhana
cleansing procedures such as therapeutic emesis
sāravat
explained as fatty and abhiṣyandin food
navadhānya
newly harvested grain
Adhikarana १०५ (१५९) · Śloka १५९
अनवस्थितदोषाग्नेरेभिः सन्धुक्षितो ज्वरः |
गम्भीरतीक्ष्णवेगत्वं यात्यसाध्यत्वमेव च ||१५९||
Meaning of the śloka
In a person with newly arisen fever, whose doṣas and agni are not yet settled, the measures just listed are said to intensify the fever, making it deep-seated, severe in force, and ultimately incurable.
The commentator identifies a person with unsettled doṣas and agni as one with early fever. The preceding measures, beginning with pariṣeka, are said to kindle or increase the fever and give it deep and intense force. The doṣas are unsettled because they have moved into improper paths, while agni is unsettled because it has moved outward.
Key terms
anavasthitadoṣa
doṣas described as unsettled or moving through improper paths
anavasthitāgni
agni described as unsettled through outward displacement
After fever has subsided, a person should avoid cold water, daytime sleep, anger, exercise, and sexual activity until strength has returned. If a still-weak person quickly resumes unsuitable practices, fever may recur and consume the body like fire consuming a dry tree. One recovering from fever should therefore follow restrictions like a person who has undergone purgation until the doṣas and vital strength have returned to their normal state.
Jvarotsṛṣṭa means released from fever. The passage next explains the result of using cold water and the other discouraged factors: fever may return and damage the weakened body. For this reason, a recovering person should avoid unsuitable practices. Return to normal with respect to doṣas means that they once again perform their unaltered functions; return with respect to prāṇa is recognized by having the capacity for activities such as exercise.
Key terms
jvarotsṛṣṭa
one who has been released from fever
pratyāpanna
returned or recurrent, referring to fever
parihāra
a period of avoiding factors considered unsuitable during recovery
prakṛtistha
returned to the normal state of function and strength
Adhikarana १०७ (१६३) · Śloka १६३
ज्वरे प्रमोहो भवति स्वल्पैरप्यवचेष्टितैः |
निषण्णं भोजयेत्तस्मान्मूत्रोच्चारौ च कारयेत् ||१६३||
Meaning of the śloka
Because even slight activity may cause fainting in a person weakened by fever, the person should be fed while seated and should also pass urine and stool while seated.
The passage prohibits exertion in a person emaciated or weakened by fever. Pramoha here means fainting, and minor activity includes getting up and walking. Niṣaṇṇa means seated on the bed; the same qualification applies both to feeding and to passing urine and stool. Uccāra means feces.
Key terms
pramoha
fainting in this passage
avaceṣṭita
minor activity such as rising or walking
niṣaṇṇa
seated, specifically on the bed according to the commentary
Even when fever appears to have subsided, if loss of appetite, bodily weakness, altered complexion, bodily impurity, or similar signs remain, the person should undergo cleansing because of concern that the condition may persist or recur.
This passage addresses residual signs after apparent relief of fever. Gātrasāda means weariness or weakness of the limbs. The fever is only seemingly quiet—latent rather than completely resolved—because, in the commentator's reasoning, these signs would be absent after complete resolution. Śodhya means that cleansing is indicated, and anubandhabhaya means concern about renewed manifestation.
Key terms
arocaka
loss of appetite
gātrasāda
weariness or weakness of the limbs
līnajvara
fever understood as latent rather than fully resolved
śodhana
cleansing treatment within the classical regimen
anubandhabhaya
concern that illness may persist or arise again
Adhikarana १०९ (१६५) · Śloka १६५
न जातु स्नापयेत् प्राज्ञः सहसा ज्वरकर्शितम् |
तेन सन्दूषितो ह्यस्य पुनरेव भवेज्ज्वरः ||१६५||
Meaning of the śloka
A knowledgeable physician should never bathe a person suddenly while that person is still weakened by fever. Such bathing may disturb the recovering person and cause the fever to return.
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अतः परं ज्वरकर्शितस्य स्नाननिषेधमाह- न जातु स्नापयेदित्यादि| जातु कथञ्चन| प्राज्ञो वैद्यः| सहसा शीघ्रं, यावद्बलं न प्राप्नोतीत्यर्थः| तेन स्नानेन||१६५||
Meaning of the commentary
The commentary introduces a prohibition on bathing for someone emaciated or weakened by fever. Jātu is explained as ‘under no circumstances,’ prājña as the knowledgeable physician, and sahasā as acting quickly or prematurely—that is, before strength has returned. The stated cause of renewed fever is the bathing itself.
Key terms
jvarakarśita
weakened or emaciated by fever
prajña (prājña)
a knowledgeable physician
sahasā
suddenly or prematurely, before strength has returned
All fevers should be managed by measures contrary to their causes. When fever arises from exertion, depletion, or injury, the underlying disorder should be treated. In women after miscarriage or when fever occurs with the descent of breast milk, a physician who knows the method should use pacifying measures according to the involved doṣa.
The commentator summarizes general fever management as opposing its cause—for example, reducing measures for a condition arising from overnourishment and nourishing measures for one arising from undernourishment. In fever from exertion, depletion, or injury, ‘underlying disease’ is interpreted as the root doṣa, Vāta, because these causes aggravate Vāta; the word disease is applied to the cause through figurative usage. Apaprajātā refers to women who have miscarried. Fever after miscarriage or during the descent of breast milk is to be pacified according to whichever doṣa is aggravated. The term saṃśamana also includes digestive or ripening measures. Some authorities omit these verses, but the commentator retains them because Ācārya Jejjaṭa read them.
Key terms
nimittaviparyaya
a measure contrary to the identified cause
mūladoṣa
the underlying doṣa, interpreted here as Vāta
apaprajātā
a woman who has miscarried
saṃśamana
pacifying management, here stated also to include pācana
Now learn from me the pacifying decoctions that a knowledgeable physician may administer in the different kinds of fever.
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एवं सङ्क्षेपेण चिकित्सामुपदिश्य, अधुना संशमनकषायान् विवक्षुराह- अत इत्यादि| निबोध जानीहि| मे मत्सकाशात्||१६८||
Meaning of the commentary
After presenting treatment in summary, the text now begins the account of pacifying decoctions. Nibodha means ‘understand’ or ‘learn,’ and me means ‘from me.’
This is introduced as the first pacifying preparation for Vāta fever. Sārivā is identified as utpalasārivā, hareṇu as reṇukā, and śvasanaja as Vāta-produced. The commentary describes one traditional decoction method: a pala of the combined ingredients is boiled in sixteen palas of water until one quarter remains, after which a karṣa of jaggery is added. It cites a rule giving sixteen parts water and reduction to one quarter, and another source varying the ingredient quantity for superior, middling, and lower patients. Elder physicians instead describe using eight śarāvas of water, reducing it to one, while otherwise interpreting the preparation similarly; they also do not accept adding jaggery.
Key terms
pippalī
a named ingredient in the decoction
sārivā
identified here as utpalasārivā
hareṇu
identified by the commentary as reṇukā
śvasanaja jvara
fever interpreted by the commentary as arising from Vāta
Adhikarana ११३ (१७०) · Śloka १७०
शृतं शीतकषायं वा गुडूच्याः पेयमेव तु |१७०|
Meaning of the śloka
Guḍūcī may be taken either as a boiled decoction or as a cold infusion.
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शृतमित्यादि| शृतम् अनन्तरोक्तकल्पनया क्वाथीकृतम्| उष्णोदकपाचिताद्द्रव्याद्रात्रिपर्युषिताद्यो रसोऽभिनिर्याति स शीतकषायशब्दवाच्यः| तथा चोक्तं- “द्रव्यादापोत्थितात्तोये प्रतप्ते संस्थितान्निशि| कषायो योऽभिनिर्याति स शीतः समुदाहृतः”- इति| शृतकषायपानं कफानुबन्धवातज्वरे, पित्तानुबन्धे तु शीतकषायपानमिति|१७०|-
Meaning of the commentary
Śruta means prepared as a decoction by the method just described. Śītakaṣāya is defined as the extract that emerges when a substance is placed in previously heated water and left overnight. The boiled decoction is assigned to Vāta fever associated with Kapha, while the cold infusion is assigned when Pitta is associated with it.
Key terms
guḍūcī
the plant used for either preparation
śruta
boiled as a decoction according to the preceding method
śītakaṣāya
a cold infusion obtained after the substance remains overnight in previously heated water
The commentary identifies śvadaṃṣṭrā as gokṣuraka and says the decoction is prepared according to the method previously described. It assigns a karṣa each to the sugar and ghee.
Śatapuṣpā, vacā, kuṣṭha, devadāru, and hareṇukā—or kustumburu, nalada, and musta—are cooked in water. The decoction, combined with honey and sugar, is prescribed when Vāta predominates.
Hareṇukā is identified as reṇukā, kustumburu as dhānyaka, and nalada as uśīra. The quantities of sugar and honey are said to follow the preceding rule. The commentator distinguishes two formulations: one comprises śatapuṣpā through hareṇukā and omits sugar; the second comprises kustumburu and the following ingredients.
For fever attributed to Vāta, the text recommends a decoction of drākṣā, guḍūcī, kāśmarya, trāyamāṇā, and sārivā with jaggery. It also states that equal quantities of the fresh juices of guḍūcī and śatāvarī, taken with jaggery, promptly relieve such fever.
The commentary identifies kāśmarya as the fruit of gambhārī. In the first preparation, saguḍa means that a karṣa of jaggery is added after the decoction has been prepared. No further explanation is supplied for the fresh-juice preparation.
Key terms
kāśmarya
identified here as gambhārī fruit
trāyamāṇā
a named ingredient in the decoction
svarasa
freshly expressed plant juice
anilakṛta jvara
fever attributed to Vāta
Adhikarana ११७ (१७५) · Śloka १७५
घृताभ्यङ्गस्वेदलेपानवस्थासु च योजयेत् |१७५|
Meaning of the śloka
Ghee massage, sudation, and topical applications should be used according to the particular stage or presentation.
The commentator asks why oleation and related measures are taught while decoctions were promised, and answers that they appear because the discussion concerns management of Vāta fever. ‘According to the stages’ refers to presentations such as the onset of cold. Ghee massage is assigned when long-standing fever is located in the skin, while sudation and topical applications are assigned at the onset of cold.
Key terms
ghṛtābhyaṅga
massage with ghee
sveda
sudation or fomentation
lepa
a topical application
avasthā
the particular stage or presentation of the condition
This begins the pacifying preparations for Pitta fever. Śrīparṇī is interpreted as gambhārī fruit, candana as red sandalwood, and madhūka as the tree called guḍapuṣpa, whose fruit is to be used; parūṣaka is treated as known by that name. Sugar is added in the amount needed to make the decoction sweet, while elder physicians prescribe sugar equal in quantity to the original ingredients.
Key terms
śrīparṇī
interpreted here as gambhārī fruit
candana
identified here as red sandalwood
madhūka
identified as guḍapuṣpa, with its fruit specified for use
The commentator explains that the substances belonging to the group beginning with sārivā are prepared as a decoction. Taken with a karṣa measure of sugar, that decoction is said to relieve Pitta fever.
Key terms
sārivādi
the group of substances beginning with sārivā
kaṣāyakalpanā
preparation in the form of a decoction
pittajvara
fever attributed to Pitta
Adhikarana १२० (१७७) · Śloka १७७
सयष्टीमधुकं हन्यात्तथैवोत्पलपूर्वकम् |१७७|
Meaning of the śloka
Likewise, the group beginning with utpala, prepared together with yaṣṭīmadhuka, is stated to relieve Pitta fever.
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सयष्टीमधुकमित्यादि| उत्पलादिगणोक्तं द्रव्यजातं सयष्टीमधुकं निष्क्वाथ्य पीतं सत् पित्तज्वरं हन्यादिति सम्बन्धः| यद्यपि उत्पलादिगणेनैव यष्टीमधुकं प्राप्तं तथाऽपि पुनः सयष्टीमधुकमिति यत्कृतं तद्यष्टीमधुकस्य भागद्वयप्रतिपादनार्थम्|१७७|-
Meaning of the commentary
The substances of the utpalādi group are to be decocted with yaṣṭīmadhuka and taken for Pitta fever. Although yaṣṭīmadhuka is already included within the utpalādi group, the separate statement ‘with yaṣṭīmadhuka’ indicates that two portions of it are intended.
Key terms
utpalādi gaṇa
the group of substances beginning with utpala
yaṣṭīmadhuka
an ingredient intended in a double portion according to the commentary
pittajvara
fever attributed to Pitta
Adhikarana १२१ (१७७) · Śloka १७७
शृतं शीतकषायं वा सोत्पलं शर्करायुतम् ||१७७||
Meaning of the śloka
A boiled decoction or a cold infusion, combined with utpala and sugar, is indicated.
The choice between a boiled decoction and a cold infusion depends on the relative severity of burning and the other presenting features. The commentator says that an omitted word meaning ‘and the others’ should be understood after utpala; thus the preparation may contain the utpalādi group or be made from that group.
Key terms
śruta
a preparation made by boiling
śītakaṣāya
a cold infusion or cold-prepared decoction
utpala
a named plant ingredient, extended by the commentary to the utpalādi group
A cooled decoction of guḍūcī, padma, rodhra, sārivā, and utpala, sweetened with sugar, is said to relieve pitta-type fever.
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गुडूचीत्यादि| पद्मं कमलम्, उत्पलम् ईषन्नीलम्| एते च सर्व एवानन्तरोक्ताः पाक्यकषायाः शीतकषाया वा दोषादिबलं दृष्ट्वा वैद्येन योज्याः||१७८||
Meaning of the commentary
Padma is identified as lotus, while utpala is described as slightly blue. The physician is to choose either a boiled decoction or a cold infusion from these and the immediately preceding preparations after considering the strength of the doṣa and related factors.
Key terms
guḍūcī
a named ingredient in the preparation
padma
identified by the commentary as lotus
rodhra
a named ingredient in the preparation
sārivā
a named ingredient in the preparation
pittajvara
fever attributed to pitta in the classical framework
Adhikarana १२३ (१७९) · Śloka १८०
द्राक्षारग्वधयोश्चापि काश्मर्यस्याथवा पुनः |
स्वादुतिक्तकषायाणां कषायैः शर्करायुतैः ||१७९||
सुशीतैः शमयेत्तृष्णां प्रवृद्धां दाहमेव च |१८०|
Meaning of the śloka
Marked thirst and burning are to be calmed with very cool, sugar-containing preparations made from drākṣā and āragvadha together, from kāśmarya, or from substances having sweet, bitter, and astringent tastes.
The commentator presents this as a stage-specific measure in pitta fever and distinguishes three options: drākṣā with āragvadha; kāśmarya alone; or decoctions drawn from sweet, bitter, and astringent substances. Āragvadha is identified as the fruit of kṛtamāla and kāśmarya as gambhārī fruit. Examples of the three taste groups are respectively drākṣā, madhuka, and sārivā; durālabhā, parpaṭaka, and kirātatiktaka; and padma and utpala. Kārtikakuṇḍa understands suśīta as a cold infusion, whereas Jejjaṭa understands it as a preparation first boiled and then cooled.
Key terms
drākṣā
a sweet substance named in the first preparation
āragvadha
identified as kṛtamāla fruit
kāśmarya
identified as gambhārī fruit
svādu-tikta-kaṣāya
the sweet, bitter, and astringent taste groups used for the third option
For a person tormented by thirst, the text directs giving cold water with honey up to the throat and then inducing vomiting; it states that this calms the thirst.
This is presented as another stage-specific measure in pitta fever. Although therapeutic emesis would not ordinarily belong in a discussion of pacifying treatment, the commentator says it is taught here because, when thirst has become intense, emesis is considered to perform a pacifying function.
Key terms
madhuyuta toya
water combined with honey
ākaṇṭha
up to the throat, indicating a large intake in the source
For internal burning, measures using milk, cool decoctions of milk-bearing trees combined with candana, and other cooling substances are to be employed.
The milk-tree decoctions are identified as preparations from vaṭa and related trees. The measures may include drinking, topical application, pouring liquids over the body, or immersion. Kārtikakuṇḍa, however, accepts only external cleansing. Other cooling substances include the kākolyādi group and materials considered cooling either in potency or by touch.
Key terms
antardāha
a sensation of internal burning
kṣīrikaṣāya
a decoction of milk-bearing trees such as vaṭa
candana
a named cooling ingredient combined with the decoction
Padmaka, madhuka, drākṣā, puṇḍarīka, utpala, roasted yava, uśīra, samaṅgā, and kāśmarī fruit are placed in water and stirred, then left overnight. The text says that drinking the preparation with honey calms both fever and burning.
This is described as a cold infusion for a stage of pitta fever. Samaṅgā is identified as añjalikārikā, though others identify it as varāhakrāntā. Although kāśmarī fruit is named, the commentator prefers its pulp because it is considered especially pitta-reducing. The ingredients may be stirred in previously heated, half-boiled water, or, alternatively, unheated water containing the medicines may be left overnight as a cold infusion. The wording is understood to include burning associated with fever and burning occurring without fever. Another reading says directly that fever and burning subside. Some recensions omit the opening list from padmaka through utpala.
Key terms
samaṅgā
identified alternatively as añjalikārikā or varāhakrāntā
kāśmarīphala
kāśmarī fruit, interpreted here specifically as its pulp
niśāparyuṣita
left standing overnight
śītakaṣāya
a cold infusion prepared according to alternative water-processing explanations
jvaradāha
fever and burning, including the commentary's discussion of burning with or without fever
Adhikarana १२७ (१८४) · Śloka १८४
जिह्वातालुगलक्लोमशोषे मूर्ध्नि च दापयेत् ||१८४||
Meaning of the śloka
For dryness of the tongue, palate, throat, or kloma, and for a condition affecting the head, the preparation is to be administered at the head.
The commentator glosses kloma as tilaka and mūrdhan as the head. Some explain that the preceding cold infusion beginning with padmaka is to be used internally for dryness of the tongue and related sites and for headache, and also externally by contact. An objection asks why a head application and gargling are mentioned in a section on decoctions; the reply is that decoctions are named because they predominate, just as a mixed group may be named after those carrying umbrellas, so the inclusion is not considered inconsistent.
Key terms
jihvā-tālu-gala-śoṣa
dryness of the tongue, palate, and throat
kloma
glossed in this commentary as tilaka; the anatomical reference remains uncertain
mūrdhan
the head
dāpayet
should cause to be administered or applied; its exact mode is discussed in the commentary
Adhikarana १२८ (१८५) · Śloka १८६
केशरं मातुलङ्गस्य मधुसैन्धवसंयुतम् |
शर्करादाडिमाभ्यां वा द्राक्षाखर्जूरयोस्तथा ||१८५||
वैरस्ये धारयेत्कल्कं गण्डूषं च तथा हितम् |१८६|
Meaning of the śloka
For an unpleasant taste in the mouth, a moist paste of mātuluṅga kesara with honey and saindhava, or a preparation involving sugar with dāḍima and drākṣā with kharjūra, is to be held in the mouth; gargling is also considered beneficial.
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पित्तज्वरे आवस्थिकं क्रममाह- केशरमित्यादि| केशरादिः मधुसैन्धवसंयुतमित्यन्त एको योगः, शर्करादिः खर्जूरयोस्तथेत्यन्तो द्वितीयः| वैरस्ये मुखवैरस्ये| धारयेत् ‘मुखे’ इति शेषः| कल्को दृषदि पेषितः सद्रवः| तथा हितमिति विशिष्टदोषारब्धज्वरप्रत्यनीकमित्यर्थः| केचिज्जिह्वाताल्वादिशोषे मातुलुङ्गकेशरस्यैव केवलं मधुसैन्धवयुक्तस्य मूर्ध्नि धारणमिच्छन्ति, तथा द्राक्षाखर्जूरकल्कस्य शर्करादाडिमयुतस्य वैरस्ये आस्ये धारणमिच्छन्ति| यद्यपि मुखवैरस्यं वातलिङ्गं, तथाऽपि पित्तादपि वैरस्यं ज्ञेयं, तन्त्रान्तरोक्तत्वात्| केचित् ‘पद्मकं मधुकं द्राक्षां’ इत्यादिकं ‘गण्डूषं च तथा हितं’ इति पर्यन्तं न पठन्ति; स च पाठः पठनीयः, सर्वनिबन्धकारैः पठितत्वात्||१८५||-
Meaning of the commentary
The commentator distinguishes two formulations: the first extends from mātuluṅga kesara through honey and saindhava, and the second from sugar through kharjūra. The preparation is held in the mouth for oral unpleasantness, and kalka means a moist paste ground on a stone. ‘Beneficial’ means opposed to the particular doṣa producing the fever. Some interpret the instructions differently: mātuluṅga kesara with honey and saindhava alone is applied to the head for dryness of the tongue, palate, and related sites, while a paste of drākṣā and kharjūra with sugar and dāḍima is held in the mouth for unpleasant taste. Although oral unpleasantness is described as a vāta sign, it may also arise from pitta according to another treatise. Some omit the larger passage from the earlier padmaka list through the instruction on gargling, but the commentator retains it because all compilers read it.
Key terms
mātuluṅgakesara
the kesara of mātuluṅga used in the first formulation
saindhava
a salt combined with honey in the first formulation
vairasya
an unpleasant or altered taste in the mouth
kalka
a moist paste ground on a stone
gaṇḍūṣa
holding or rinsing a preparation in the mouth
Adhikarana १२९ (१८६) · Śloka १८७
सप्तच्छदं गुडूचीं च निम्बं स्फूर्जकमेव च ||१८६||
क्वाथयित्वा पिबेत् क्वाथं सक्षौद्रं कफजे ज्वरे |१८७|
Meaning of the śloka
For kapha-type fever, the text recommends drinking a honey-containing decoction of saptacchada, guḍūcī, nimba, and sphūrjaka.
Saptacchada is identified as saptaparṇa. Sphūrjaka is described as resembling wild kuraṇṭaka and as another name for phaṇijjaka. Some read kalka, paste, instead of kvātha, decoction. The preparation is to be drunk only after it has cooled because honey combined with heat is prohibited in this framework; the honey is stated to be one fourth of the quantity of the substances decocted.
Key terms
saptacchada
identified by the commentary as saptaparṇa
sphūrjaka
described as resembling wild kuraṇṭaka and also called phaṇijjaka
kvātha
a decoction; some read kalka, paste, instead
sakṣaudra
combined with honey
kaphajvara
fever attributed to kapha in the classical framework
For kapha-type fever, the text recommends drinking a preparation of haridrā, citraka, nimba, uśīra, ativiṣā, vacā, kuṣṭha, indrayava, mūrvā, and paṭola, combined with marica and honey.
The commentary first explains combined-doṣa treatment before sannipāta fever treatment in order to show that combined-doṣa measures are used in sannipāta. It identifies the Rājavṛkṣa group as the Āragvadhādi group and explains 'at the appropriate time' as administration at the proper time for medicine. It adds that this kapha-vāta treatment is presented ahead of the previously mentioned vāta-pitta sequence to indicate its applicability even in fever attributed solely to kapha.
Key terms
Rājavṛkṣādivarga (rājavṛkṣādivarga)
The plant group identified by the commentary as Āragvadhādi.
kaphavātajvara
A classical fever category involving kapha and vāta.
kāle avacārita
Administered at the appropriate medicinal time.
sannipāta
A condition involving all three doṣas, for which combined-doṣa treatment is discussed.
Nāgara, Dhānyaka, Bhārgī, Abhayā, Suradāru, Vacā, Parpaṭaka, Musta, Bhūtīka, and Kaṭphala are decocted and combined with honey and Hiṅgu for fever arising from kapha and vāta. The formulation is also described for difficulty in breathing, cough, excess kapha, obstruction of the throat, hiccup, swelling of the throat, and pain in the heart or chest and flanks.
The commentary identifies Bhūtīka as the fragrant grass commonly called Rohiṣa and says the decoction is prepared according to the previously stated method. It specifies a karṣa of honey and a māṣaka of Hiṅgu, citing the rule that Hiṅgu and rock salt are used in māṣaka measure. It explains śleṣmotseka as an increase of kapha and connects 'pain' with both the heart and flank. It identifies this as the Kaṭphalādi formulation with Śṛṅgī. Some authorities read the passage beginning with Devadāru and Abhayā instead.
Key terms
Bhūtīka (bhūtīka)
A fragrant grass identified in the commentary as Rohiṣa.
śleṣmotseka
An increase or predominance of kapha.
galagraha
Obstruction or constriction in the throat described among the indications.
Kaṭphalādi (kaṭphalādi)
The formulation name supplied by the commentary, said to include Śṛṅgī.
A decoction of Balā, Paṭola, Triphalā, Yaṣṭyāhva, and Vṛṣa, taken with honey, is described for pitta-kapha fever. A decoction prepared from Kaṭukā, Vijayā, Drākṣā, Musta, and Parpaṭaka is likewise said to alleviate fever arising from kapha and pitta. Another decoction containing Bhārgī, Vacā, Parpaṭaka, Dhānya, Hiṅgu, Abhayā, Ghana, Kāśmarya, and Nāgara, taken with honey, is prescribed for the same combined-doṣa fever. The passage also says that a person may take an akṣa measure of Kaṭukā with sugar and warm water for kapha-pitta fever.
For fever arising from vāta and pitta, Kirātatiktā, Amṛtā, Drākṣā, Āmalaka, and Śaṭī are decocted, and the decoction is taken with Guḍa. A prepared decoction of Rāsnā, Vṛṣa, Triphalā, and the fruits of Rājavṛkṣa is also said to overcome vāta-pitta fever.
The commentary notes that Ācārya Jejjaṭa places the treatment of combined two-doṣa fevers after the treatment of sannipāta fever, on the basis of the cited ordering: fevers caused by individual doṣas, all doṣas together, pairs of doṣas, and external causes.
Key terms
vātapittajvara
A classical fever category involving vāta and pitta.
Kirātatiktā (kirātatiktā)
A bitter herb included in the first decoction.
Guḍa (guḍa)
A sweet substance added to the first decoction.
dvandvaja
Arising from a pair of doṣas, the category whose textual ordering is discussed.
Adhikarana १३८ (२०१) · Śloka २०१
सर्वदोषसमुत्थे तु संसृष्टानवचारयेत् ||२०१||
Meaning of the śloka
When fever arises from all the doṣas, the prescribed measures are to be used in combination.
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इदानीं समसन्निपातज्वरचिकित्सामाह- सर्वदोषेत्यादि| सर्वदोषसमुत्थे समसन्निपाते| संसृष्टानवचारयेदिति वातादिविहितान् कषायानेकीकृत्य प्रयुञ्जीतेत्यर्थः| अस्याग्रे केचित् ‘वर्धनैः क्षपणैर्वापि’ इत्यादिकं पाठं पठन्ति, स च वर्तमानेषु पुस्तकेषु न दृश्यते, अतो न लिखितः||२०१||
Meaning of the commentary
Introducing treatment of equal sannipāta fever, the commentary explains that 'arising from all doṣas' means sama-sannipāta. Using measures in combination means combining decoctions prescribed for vāta and the other doṣas and administering them together. It also reports that some witnesses add a passage beginning 'by increasing or reducing measures,' but this is absent from the manuscripts then available and was therefore not written into the text.
Key terms
sarvadoṣasamuttha
Arising from all three doṣas.
sama-sannipāta
The commentary's designation for a fever involving the doṣas together in an equal or balanced combination.
saṃsṛṣṭa
Combined; explained here as bringing together doṣa-specific decoctions.
Adhikarana १३९ (२०२) · Śloka २०२
यथादोषोच्छ्रयं चापि ज्वरान् सर्वानुपाचरेत् |२०२|
Meaning of the śloka
All fevers should also be treated according to whichever doṣa is predominant.
The commentary introduces treatment of unequal sannipāta fever. It explains that treatment according to doṣa predominance means counteracting whichever doṣa is elevated, and that 'all' refers here to the unequal sannipāta fevers. It adds that this is a general principle applicable across the treatment of all fevers, including those attributed to external causes.
Key terms
doṣocchraya
Predominance or elevation of a particular doṣa.
viṣama-sannipāta
A combined-doṣa fever in which the doṣas are not equally prominent.
āgantu
A fever category attributed in the text to an external cause.
Adhikarana १४० (२०२) · Śloka २०३
वृश्चीवबिल्ववर्षाभ्वः पयश्चोदकमेव च ||२०२||
पचेत् क्षीरावशिष्टं तु तद्धि सर्वज्वरापहम् |२०३|
Meaning of the śloka
Vṛścīva, Bilva, Varṣābhū, milk, and water are cooked until only the milk portion remains; this is described as alleviating all fevers.
Before presenting general treatment for sannipāta, the commentary introduces this milk preparation because milk is regarded as sustaining life. It identifies Vṛścīva as white Punarnavā and Varṣābhū as red Punarnavā. For cooking, it cites the general rule of using milk in eight times the quantity of the drug and water in four times the quantity of the milk, reducing the mixture until the milk remains. Some authorities instead accept the water quantity stated in the following verse. Others regard the wording as two separate formulations on the authority of another tantra: one of Vṛścīva and Bilva, and a second beginning with Varṣābhū.
Key terms
Vṛścīva (vṛścīva)
Identified by the commentary as white Punarnavā.
Varṣābhū (varṣābhū)
Identified by the commentary as red Punarnavā.
kṣīrapāka
A preparation cooked with milk and water until the milk portion remains.
Milk is combined with three parts water and the heartwood of Śiṃśapā, then cooked until only the milk remains. The resulting preparation is described as a drink that alleviates all fevers.
The commentary presents this as another milk preparation for sannipāta. It states that the three parts of water are measured relative to the milk, specifying eight pala of milk and one pala of Śiṃśapā heartwood.
Key terms
Śiṃśapāsāra (śiṃśapāsāra)
The heartwood or essential woody part of Śiṃśapā used in the milk preparation.
udakāṃśāstrayaḥ (udakāṃśās trayaḥ)
Three parts of water, understood by the commentary relative to the milk portion.
kṣīraśeṣa
Cooked until the liquid is reduced to the milk portion.
Adhikarana १४२ (२०४-२०७) · Śloka २०७
नलवेतसयोर्मूले मूर्वायां देवदारुणि ||२०४||
कषायं विधिवत् कृत्वा पेयमेतज्ज्वरापहम् |
हरिद्रा भद्रमुस्तं च त्रिफला कटुरोहिणी ||२०५||
पिचुमन्दः पटोली च देवदारु निदिग्धिका |
एषां कषायः पीतस्तु सन्निपातज्वरं जयेत् ||२०६||
अविपक्तिं प्रसेकं च शोफं कासमरोचकम् |
त्रैफलो वा ससर्पिष्कः क्वाथः पेयस्त्रिदोषजे ||२०७||
Meaning of the śloka
A properly prepared decoction of the roots of Nala and Vetasa, together with Mūrvā and Devadāru, is described for fever. Another decoction of Haridrā, Bhadramusta, Triphalā, Kaṭurohiṇī, Picumanda, Paṭolī, Devadāru, and Nidigdhikā is said to overcome sannipāta fever. Alternatively, in tridoṣa fever accompanied by indigestion, excessive salivation, swelling, cough, and loss of appetite, a Triphalā decoction with ghee is prescribed as a drink.
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नलवेतसयोरित्यादि| कषायं विधिवत् कृत्वेति पूर्वोक्तकषायकल्पनया| क्षीरसाध्यायामवस्थायामयमपि योगो देयः| केचिन्नलवेतसादियोगं न पठन्ति; स च पठनीयः, सर्वनिबन्धकारैः पठितत्वात्||२०४-२०७||
Meaning of the commentary
The commentary says that 'properly prepared' refers to the decoction method stated earlier and that the Nala-Vetasa formulation may also be given when the condition is suitable for milk-based treatment. It notes that some authorities omit this formulation, but argues that it should be read because all the compilers of explanatory works include it.
Key terms
sannipātajvara
A classical fever category involving all three doṣas.
avipakti
Failure of digestion or indigestion listed among the associated features.
praseka
Excessive flow of saliva.
traiphala kvātha
A decoction based on Triphalā, here combined with ghee.
Anantā, Bālaka, Musta, Nāgara, and Kaṭurohiṇī, in an akṣa measure, are to be given with comfortably warm water before sunrise. The preparation is said to alleviate all fevers and quickly kindle agni.
The commentary identifies Anantā as Durālabhā. It understands sukhāmbu here as warm water in a pala measure. 'Before rising' refers to sunrise rather than the onset of fever, so the medicine is understood to be given early in the morning. It explains an akṣa measure as equal to a karṣa. Some read the instruction as 'having ground it into a paste with warm water before sunrise.'
Key terms
Anantā (anantā)
An ingredient identified by the commentary as Durālabhā.
prāgudayāt
Before sunrise, according to the commentary.
akṣasammita
An akṣa measure, explained as equal to a karṣa.
anala
Agni or digestive capacity, said here to be kindled.
Adhikarana १४४ (२०९) · Śloka २१०
द्रव्याणि दीपनीयानि तथा वैरेचनानि च ||२०९||
एकशो वा द्विशो वाऽपि ज्वरघ्नानि प्रयोजयेत् |२१०|
Meaning of the śloka
Substances classified as dīpanīya and as purgatives may be used singly or in pairs as fever-alleviating measures.
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इदानीमुक्तानुक्तसङ्ग्रहार्थमाह- द्रव्याणि दीपनीयानीत्यादि| दीपनीयानि पिप्पल्यादीनि, वैरेचनानि त्रिवृदभयादीनि, ज्वरघ्नानि दीर्घज्वरघ्नानि| प्रयोजयेत् दोषबलमपेक्ष्य सन्निपातजीर्णज्वरावस्थायामेकशो द्विशो वा दापयेत्| ये त्वेवं वदन्ति- पिप्पल्यादीनि प्रायशः कटुकानि, तानि च ज्वरे न प्रायोगिकान्युष्णवीर्यत्वात्; विरेचनान्यपि गुरुत्वादयौगिकानि; तेषां सम्यक् शास्त्रावबोधो नास्ति, पिप्पल्यादीनां ज्वरे पठितत्वात्||२०९||-
Meaning of the commentary
The commentary presents this as a summary of measures already stated and those not explicitly stated. It gives Pippalī and related substances as examples of dīpanīya drugs, and Trivṛt and Abhayā as examples of purgatives. Here, fever-alleviating means intended for prolonged fever. According to the strength of the doṣas, one or two such substances may be administered in the sannipāta stage of an established or chronic fever. The commentary rejects the view that predominantly pungent Pippalī-group substances are unsuitable in fever because of their heating potency, or that purgatives are unsuitable because of heaviness, arguing that Pippalī and related substances are explicitly taught for fever.
Key terms
dīpanīya
A class of substances represented here by Pippalī and related drugs.
vairecana
Purgative substances, exemplified by Trivṛt and Abhayā.
dīrghajvara
Prolonged fever, which the commentary associates with the term jvaraghna here.
doṣabala
The relative strength of the doṣas, used in the commentary to guide selection.
A linctus made with ghee, honey, Abhayā, and oil is said to calm fever arising from all the doṣas. Trivṛt taken with honey is also described for severe fever.
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सर्पिरित्यादि| प्रबलं दाहादिसमन्वितम्| लेहावस्था च तन्त्रान्तराज्ज्ञेया| तथा च तन्त्रान्तरं- “पथ्यातैलघृतक्षौद्रैर्लेहो दाहश्रमज्वरान्| कासासृक्पित्तवीसर्पश्वासान् हन्ति वमीरपि”- इति| ‘सक्षौद्रा विषमज्वरं’ इति केचित् पठन्ति; तन्न, विषमज्वरस्य परतोऽभिधास्यमानत्वात्||२१०||-
Meaning of the commentary
The commentary explains severe fever as fever accompanied by burning and similar symptoms. It says the proper consistency of the linctus should be learned from another tantra, which describes a linctus of Pathyā, oil, ghee, and honey for burning, fatigue, fever, cough, bleeding attributed to pitta, visarpa, difficult breathing, and vomiting. Some read the second prescription as Trivṛt with honey for viṣama fever, but the commentator rejects this because viṣama fever is discussed next.
Key terms
leha
A linctus or lickable preparation whose consistency is discussed by the commentary.
Abhayā (abhayā)
An ingredient in the linctus.
Trivṛt (trivṛt)
A purgative substance prescribed here with honey.
prabala jvara
Severe fever, explained as accompanied by burning and related symptoms.
Introducing treatment of viṣama fever, the commentary identifies upper purification as emesis, used when kapha predominates, and lower purification as purgation, used when pitta predominates. Thus, it understands emesis and purgation as selected according to kapha or pitta predominance across viṣama fevers. Another interpretation restricts the instruction to tṛtīyaka and cāturthaka fevers, since measures directed against vāta and the other doṣas—including āsthāpana enema, purgation, and emesis—are considered appropriate particularly in those two forms.
Key terms
viṣamajvara
A classical category of irregular or periodic fever discussed here.
ūrdhvaśodhana
Upward purification, explained as therapeutic emesis.
adhaḥśodhana
Downward purification, explained as therapeutic purgation.
tṛtīyaka-cāturthaka
Two periodic-fever forms to which some commentators restrict this instruction.
Adhikarana १४७ (२१२) · Śloka २१२
घृतं प्लीहोदरोक्तं वा निहन्याद्विषमज्वरम् |२१२|
Meaning of the śloka
Alternatively, the medicated ghee described in the treatment of plīhodara is said to overcome viṣama fever.
The commentary identifies this as the Ṣaṭpala ghṛta described under plīhodara and says it should be given in viṣama fever with predominant kapha because of its sharp or potent character.
Key terms
plīhodara
The condition in whose treatment the referenced medicated ghee is described.
Ṣaṭpala ghṛta (ṣaṭpala ghṛta)
The medicated ghee identified by the commentary.
kaphottara
Having kapha as the predominant doṣa.
tīkṣṇa
Sharp or potent, the property cited for its selection.
Adhikarana १४८ (२१२) · Śloka २१२
गुडप्रगाढां त्रिफलां पिबेद्वा विषमार्दितः ||२१२||
Meaning of the śloka
A person afflicted by viṣama fever may drink a Triphalā preparation containing a substantial amount of Guḍa.
The commentary explains that the Triphalā preparation contains slightly more than one karṣa of Guḍa and supplies the understood instruction that Triphalā is to be decocted. It glosses viṣamārdita as one afflicted by viṣama fever.
Key terms
guḍapragāḍha
Containing a substantial amount of Guḍa; the commentary specifies slightly more than one karṣa.
Triphalā (triphalā)
The three-fruit preparation understood here as a decoction.
viṣamārdita
A person afflicted by viṣama fever.
karṣa
A classical measure used by the commentary for the amount of Guḍa.
Adhikarana १४९ (२१३) · Śloka २१३
गुडूचीनिम्बधात्रीणां कषायं वा समाक्षिकम् |२१३|
Meaning of the śloka
Alternatively, a decoction of Guḍūcī, Nimba, and Dhātrī is taken with honey.
A decoction may be prepared using three, four, or five of the listed substances: Madhuka, Paṭola, Rohiṇī, Mustaka, and Harītakī. The formulation is thus understood in three forms.
The commentary identifies Madhuka as Yaṣṭīmadhu and Rohiṇī as Kaṭukā. Its primary explanation gives three formulations: Madhuka-Paṭola-Rohiṇī; those three with Mustaka; and all five with Harītakī. It then preserves another reading that substitutes Vatsaka for Mustaka and interprets every combination of three, four, or five ingredients, yielding ten three-drug options, five four-drug options, and one five-drug option—sixteen in all. A discerning physician is said to select among them according to the doṣas.
Key terms
Madhuka (madhuka)
Identified by the commentary as Yaṣṭīmadhu.
Rohiṇī (rohiṇī)
Identified by the commentary as Kaṭukā.
trividha yoga
The formulation in three-, four-, and five-ingredient forms.
Vatsaka (vatsaka)
The ingredient read by some authorities in place of Mustaka.
According to the person's strength, Māgadhī may be used with a combination of ghee, milk, sugar, and honey; alternatively, Māgadhī may be administered with a Daśamūla decoction.
The commentary says the combined use of ghee, milk, sugar, and honey is intended here for viṣama fever. For the alternative, the Daśamūla decoction is prepared by the standard drinkable-decoction method, and a karṣa measure of Pippalī is taken with it. It distinguishes this fixed quantity from the progressively increased Pippalī regimen described next.
Key terms
Māgadhī (māgadhī)
Pippalī, administered in the two preparations described.
yathābalam
According to the person's strength.
Daśamūla kaṣāya (daśamūla kaṣāya)
A decoction of Daśamūla used as the vehicle for Pippalī.
karṣa
The fixed classical measure assigned to Pippalī by the commentary.
Adhikarana १५३ (२१६) · Śloka २१६
पिप्पलीवर्धमानं वा पिबेत् क्षीररसाशनः ||२१६||
Meaning of the śloka
Alternatively, one may follow the progressively increased Pippalī regimen while taking milk and meat broth as food.
The commentary identifies Tāmracūḍa as a cock. It explains the excellent alcoholic drink as Mārdvīka and Sasyaka, while Ācārya Jejjaṭa reads Mādhvīka instead of Mārdvīka. Drinking it with cock meat is assigned to a person with predominant vāta and weak agni. The commentary adds that these following and preceding measures, though taught under viṣama fever, may also be given in chronic fever.
Key terms
Tāmracūḍa (tāmracūḍa)
Identified by the commentary as a cock.
Mārdvīka (mārdvīka)
One interpretation of the excellent alcoholic drink.
Mādhvīka (mādhvīka)
Jejjaṭa's alternative reading for the type of alcoholic drink.
jīrṇajvara
Chronic or long-standing fever to which the commentary also extends these measures.
Ghee is cooked with curd in a decoction of Kola, Agnimantha, and Triphalā, with Tilvaka added. This preparation is described as destroying viṣama fever.
The commentary interprets Kola as Pañcakola and identifies Tilvaka as Paṭṭikārodhra. It gives detailed classical proportions for the drugs, water, reduced decoction, curd, ghee, and Tilvaka, then presents the method as a general rule for oils and ghees whose quantities are unstated. Brahmadeva instead describes three separate decoctions and different proportions, but the commentator calls this an erroneous explanation because such a three-decoction method is not stated by Jejjaṭa and others.
Key terms
Kola (kola)
Interpreted by the commentary here as Pañcakola.
Tilvaka (tilvaka)
Identified as Paṭṭikārodhra and added to the medicated ghee.
āvāpa
An added medicinal ingredient, here Tilvaka.
Brahmadeva (brahmadeva)
An authority whose alternative preparation method is reported and rejected by the commentator.
Ghee is prepared with Pippalī, Ativiṣā, Drākṣā, Sārivā, Bilva, Candana, Kaṭukā, Indrayava, Uśīra, Siṃhī, Tāmalakī, Ghana, Trāyamāṇā, Sthirā, Dhātrī, Viśvabheṣaja, and Citraka. Taken as described, it is said to correct viṣamāgni and relieve chronic fever, headache, gulma, abdominal disorders, halīmaka, wasting with cough and heat, and pain in the flanks.
The commentary identifies Sārivā as Utpalasārivā with fragrant root, Siṃhī as the large Kaṇṭakārī, Tāmalakī as Daraphalikā, popularly called Bhūmyāmalakī, and Sthirā as Śālaparṇī. It directs that the ghee be prepared using both a paste and a decoction of these substances.
Key terms
viṣamāgni
Irregular agni, said in the verse to be overcome by the preparation.
Sārivā (sārivā)
Identified as fragrant-rooted Utpalasārivā.
Siṃhī (siṃhī)
Identified as the large Kaṇṭakārī.
Tāmalakī (tāmalakī)
Identified as Daraphalikā, popularly called Bhūmyāmalakī.
kalka-kaṣāya
The paste and decoction used together to prepare the medicated ghee.
A medicated ghṛta is prepared in the prescribed manner from a decoction of Guḍūcī, Triphalā, Vāsā, Trāyamāṇā, and Yavāsaka, together with equal quantities of pastes of Drākṣā, Māgadhikā, Ambhoda, Nāgara, Utpala, and Candana. When taken, it is said to overcome wasting, difficulty in breathing, cough, and chronic fever.
The commentary briefly indicates that the passage concerns the preparation with Drākṣā and the other listed substances; it adds no further detailed interpretation.
Key terms
ghṛta
Clarified butter used as the base of the medicated preparation.
jīrṇajvara
A chronic or long-standing fever in the classical description.
śvāsa
Difficulty in breathing listed among the conditions addressed.
kṣaya
Wasting or depletion in the context of the passage.
A medicated ghṛta is prepared from a decoction of Kalaśī, Bṛhatī, Drākṣā, Trāyantī, Nimba, Gokṣura, Balā, Parpaṭaka, Ambhoda, Śālapaṛṇī, and Yavāsaka, with pastes of Śaṭī, Tāmalakī, Bhārgī, Medā, Āmalaka, and Pauṣkara. It is combined with twice its quantity of milk and is described as alleviating chronic fever, pain in the head and flanks, cough, wasting, and related distress.
The commentary identifies Kalaśī as Pṛśniparṇī, Trāyantī as Trāyamāṇā, and Ambhoda as Mustā. It explains that the paste is made from Śaṭī and the substances that follow. Elder physicians state that four times the quantity of water should also be added even though it is not explicitly mentioned, because cooking would otherwise not be possible.
Key terms
Kalaśī (kalaśī)
An ingredient identified by the commentary as Pṛśniparṇī.
Trāyantī (trāyantī)
An ingredient identified as Trāyamāṇā.
Ambhoda (ambhoda)
A plant name identified by the commentary as Mustā.
jīrṇajvara
Chronic or long-standing fever in the classical account.
A ghṛta is prepared with pastes of the substances from Paṭolī through Kuṣṭha and with the expressed juices of Dhātrī, Bhṛṅgaraja, Bhīru, and Kākamācī. It is described as addressing apacī, kuṣṭha, fever, disorders of śukra, arjuna-type wounds, and diseases arising in the eyes, mouth, ears, and nose.
The commentary specifies that the plants from Paṭolī through Kuṣṭha are used as pastes, while Dhātrī and the following plants supply expressed juice. It identifies Ariṣṭa as Nimba, Vṛṣa as Vāsaka, Ambuda as Musta, Bhūnimba as Kirātatiktaka, Yāsa as Durālabhā, Śakrayava as Indrayava, and Utpala here as Kuṣṭha.
Key terms
apacī
A named swelling or glandular disorder in the classical list of indications.
śukra
A reproductive substance or function whose disorders are included in the passage.
arjunavraṇa
A named type of wound in the source; its precise contextual identification needs specialist review.
svarasa
Fresh expressed plant juice used in preparing the ghṛta.
A medicated ghṛta called Kalyāṇaka is prepared with a large group of aromatic and medicinal substances, including Viḍaṅga, Triphalā, Musta, Mañjiṣṭhā, Dāḍima, Utpala, Priyaṅgu, Elā, Candana, Devadāru, the two Rajanīs, the two Parṇinīs, the two Sārivās, Trivṛt, Dantī, Vacā, and others, and is cooked with two portions of milk and Mālatī flowers. The text praises it for chronic fever, breathing difficulty, cough, gulma, unmāda, poisoning, inauspicious influences, graha and rakṣas afflictions, weak digestion, apasmāra, and loss of reproductive capacity. It is further described as promoting conception, intellect, vision, longevity, and purification of the reproductive passage.
The commentary identifies several ingredients: Utpala as Nīlotpala, Elā as small cardamom, Candana as red sandalwood, Amaradāru as Devadāru, the two Rajanīs as Piṇḍaharidrā and Dāruharidrā, the two Parṇinīs as Śālapaṛṇī and Pṛśniparṇī, and the two Sārivās as Sārivā and Utpalasārivā. It prescribes eight pala of the herbal paste, one prastha of cow's ghṛta, and four prasthas of water. It also notes that Kārtikakuṇḍa reads this preparation differently, but that reading was not included because it was not available to the commentator.
Key terms
Kalyāṇaka ghṛta (kalyāṇaka ghṛta)
The named compound medicated ghṛta praised in the passage.
graha
A classical category of affliction presented within the source's historical framework.
apasmāra
A classical disorder category listed among the claimed indications.
retomārgaviśodhana
Purification of the reproductive passage, as praised by the text.
Adhikarana १६१ (२३४-२३९) · Śloka २४०
एतैरेव तथा द्रव्यैः सर्वगन्धैश्च साधितम् ||२३४||
कपिलाया घृतप्रस्थं सुवर्णमणिसंयुतम् |
तत्क्षीरेण सहैकध्यं प्रसाध्य कुसुमैरिमैः ||२३५||
सुमनश्चम्पकाशोकशिरीषकुसुमैर्वृतम् |
तथा नलदपद्मानां केशरैर्दाडिमस्य च ||२३६||
तिथौ प्रशस्ते नक्षत्रे साधकस्यातुरस्य च |
कृतं मनुष्यदेवाय ब्राह्मणैरभिमन्त्रितम् ||२३७||
दत्तं सर्वज्वरान् हन्ति महाकल्याणकं त्विदम् ||२३८||
दर्शनस्पर्शनाभ्यां च सर्वरोगहरं शिवम् |
अधृष्यः सर्वभूतानां वलीपलितवर्जितः ||२३९||
अस्याभ्यासाद्घृतस्येह जीवेद्वर्षशतत्रयम् |२४०|
Meaning of the śloka
Mahākalyāṇaka ghṛta is prepared from the substances of the preceding Kalyāṇaka formula together with the full group of aromatic substances, using a prastha of ghṛta from a tawny cow and adding gold and gems. It is processed with that cow's milk and flowers of Jātī, Campaka, Aśoka, Śirīṣa, Mālatī, Nalada, red lotus, and pomegranate. Prepared under an auspicious lunar date and constellation for the physician and patient, consecrated by Brahmins, and given to a king, it is praised as overcoming all fevers. The text further attributes to it auspicious protection, freedom from wrinkles and grey hair, invincibility, and a life span of three hundred years through repeated use.
The commentary calls this Mahākalyāṇaka and summarizes the procedure: ghṛta from a tawny cow is cooked with the Kalyāṇaka ingredients and aromatic group, combined with gold and gems, then processed again with the cow's milk and the listed flowers before ritual consecration and administration to a king at an auspicious time. It identifies Sumanas as Jātī, Nalada as Māṃsī, Padma as red lotus, Sādhaka as the physician, and Manuṣyadeva as the king. It explains Adhṛṣya as unconquerable and states that the ghṛta undergoes two stages of cooking.
Key terms
Mahākalyāṇaka (mahākalyāṇaka)
The name of the elaborate medicated ghṛta described here.
Kapilā (kapilā)
A tawny cow whose ghṛta and milk are specified for the preparation.
manuṣyadeva
Literally a god among humans; interpreted by the commentary as a king.
abhimantrita
Ritually consecrated or empowered through recitation.
Adhikarana १६२ (२४०-२४२) · Śloka २४२
गव्यं दधि च मूत्रं च क्षीरं सर्पिः शकृद्रसः ||२४०||
समभागानि पाच्यानि कल्कांश्चैतान् समावपेत् |
त्रिफलां चित्रकं मुस्तं हरिद्रातिविषे वचाम् ||२४१||
विडङ्गं त्र्यूषणं चव्यं सुरदारु तथैव च |
पञ्चगव्यमिदं पानाद्विषमज्वरनाशनम् ||२४२||
Meaning of the śloka
Equal parts of cow's curd, urine, milk, ghṛta, and liquid derived from cow dung are cooked with pastes of Triphalā, Citraka, Musta, Haridrā, Ativiṣā, Vacā, Viḍaṅga, Tryūṣaṇa, Cavya, and Suradāru. This preparation, called Pañcagavya, is described as alleviating viṣamajvara when taken.
The commentary defines śakṛdrasa as liquid obtained from cow dung and clarifies that the ingredients are to be cooked. The quantity of herbal paste is stated to be one quarter of the fatty base.
Key terms
Pañcagavya (pañcagavya)
A preparation made from five cow-derived substances in the classical formulation.
śakṛdrasa
Liquid derived from cow dung, as defined by the commentary.
viṣamajvara
An irregular or intermittent fever category in the classical framework.
kalka
Herbal paste added at one quarter of the fatty base according to the commentary.
Adhikarana १६३ (२४३) · Śloka २४३
पञ्चगव्यमृते गर्भात्पाच्यमन्यद्... |२४३|
Meaning of the śloka
Another Pañcagavya preparation is to be cooked without the garbha, meaning without the herbal paste described for the preceding formula.
The commentary introduces this as Pañcagavya without garbha. It explains that this second Pañcagavya is cooked without kalka: the earlier preparation contains the paste, whereas this one does not. It states that the result attributed to both is the same.
Key terms
agarbha Pañcagavya (agarbha pañcagavya)
The second Pañcagavya preparation, made without the herbal paste.
garbha
Interpreted here as the internal herbal paste or kalka component.
kalka
The herbal paste omitted from this version of the preparation.
Adhikarana १६४ (२४३) · Śloka २४४
... वृषेण च |
बलयाऽथ परं पाच्यं गुडूच्या तद्वदेव तु ||२४३||
जीर्णज्वरे च शोफे च पाण्डुरोगे च पूजितम् |२४४|
Meaning of the śloka
Using the same method, three separate ghṛta preparations are described: one processed with Vṛṣa, another with Balā, and another with Guḍūcī. They are praised for chronic fever, swelling, and pāṇḍuroga.
The commentary explains that the Triphalā and other pastes stated for Pañcagavya are used while three separate ghṛtas are prepared with the individual expressed juices of Vṛṣa, Balā, and Guḍūcī. The word 'likewise' refers to the previously stated method and applies to all three ghṛta preparations.
Key terms
tadvat
In the same manner; the commentary applies this instruction to all three ghṛtas.
jīrṇajvara
Chronic or long-standing fever in the classical account.
śopha
Swelling or oedematous enlargement in the passage.
pāṇḍuroga
A classical disease category characterized by pallor; no single modern equivalent is asserted here.
By the same method, preparations are to be cooked using the five products of sheep, the five products of goats, the five products of buffaloes, and four products of camels.
The commentary explains that these animal-derived ghṛta preparations follow the method previously given for Pañcagavya. The camel preparation contains four products because liquid derived from dung is omitted.
Key terms
pañcāvika
A preparation involving five products derived from sheep.
pañcāja
A preparation involving five products derived from goats.
pañcamahiṣa
A preparation involving five products derived from buffaloes.
caturuṣṭra
A preparation involving four camel-derived products, excluding dung-derived liquid.
The passage describes two extensive medicated ghṛta preparations. The first is cooked with a large group of herbs and twice the quantity of Āmalaka fruit juice and is praised for parisarpā, fever, breathing difficulty, gulma, kuṣṭha, pāṇḍu, splenic disorders, and weakened agni. The second uses a decoction of Paṭola, Kaṭukā, Dārvī, Nimba, Vāsā, Triphalā, Durālabhā, Parpaṭaka, and Trāyamāṇā, reduced to one quarter, with ghṛta and pastes of Kuṭaja, Bhūnimba, Ghana, Yaṣṭyāhva, Candana, and Pippalī. It is described as beneficial for eye disorders of the white part, and for diseases or wounds of the nose, ears, eyes, mouth, and eyelids, while drying blood, pitta, kapha, sweat, moisture, and pus. It is also praised for kāmalā, fever, vīsarpa, and gaṇḍamālā.
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त्रिफलेत्यादि| शुक्लयोः नेत्रगतरोगयोः||२४५-२५३||-
Meaning of the commentary
The commentary only clarifies that 'the two white parts' refers to diseases located in the eye. It does not further explain the many ingredients or indications.
Key terms
śuklayoḥ
The white parts of the eyes; the commentary relates the term to eye diseases.
pariṣarpa
A named spreading disorder in the classical list of indications.
vīsarpa
A classical spreading disorder category; no single modern diagnosis is assigned here.
gaṇḍamālā
A classical condition involving a chain of swellings in the neck region.
Boiled milk, sugar, Pippalī, honey, and ghṛta are churned together to make the drink called Pañcasāra. It is described for viṣamajvara and is also commended in injury-associated depletion, wasting, difficulty in breathing, and disease of the heart region.
The commentary introduces the formula as Pañcasāra, explains śṛta payas as boiled milk, and supplies that the mixture is churned by hand.
Key terms
Pañcasāra (pañcasāra)
The named five-component drink described in the passage.
viṣamajvara
An irregular or intermittent fever category in the classical framework.
kṣatakṣīṇa
Depletion associated with injury or bodily damage in the source.
hṛdroga
A disorder of the heart or chest region in the classical account.
Adhikarana १६८ (२५६) · Śloka २५६
लाक्षाविश्वनिशामूर्वामञ्जिष्ठास्वर्जिकामयैः |
षड्गुणेन च तक्रेण सिद्धं तैलं ज्वरान्तकृत् ||२५६||
Meaning of the śloka
An oil is prepared with Lākṣā, Viśva, Niśā, Mūrvā, Mañjiṣṭhā, Svarjikā, and Āmaya, using six times the quantity of buttermilk. It is described as bringing fever to an end.
After discussing internal cleansing measures, the commentary presents this oil for external treatment. It identifies Viśva as Śuṇṭhī, Niśā as Haridrā, Mūrvā as Corasnāyu, and Āmaya as Kuṣṭha. It specifies eight pala of the Lākṣā and other pastes, thirty-two pala of oil, and buttermilk in six times the quantity of the oil. The phrase 'ending fever' is explained as addressing fevers that begin with chills or with burning.
Key terms
bahiḥparimārjana
External therapeutic application, as contrasted by the commentary with internal measures.
Viśva (viśva)
An ingredient identified by the commentary as Śuṇṭhī.
Svarjikā (svarjikā)
An alkaline substance included in the medicated oil.
jvarāntakṛt
Described as ending fever, interpreted for fever beginning with chills or burning.
An oil prepared with kṣīrivṛkṣas, Asana, Ariṣṭa, Jambū, Saptacchada, Arjuna, Śirīṣa, Khadira, Āsphoṭā, Amṛtavallī, Āṭarūṣaka, Kaṭukā, Parpaṭa, Uśīra, Vacā, Tejovatī, and Ghana is described as quickly alleviating chronic fever when used for anointing.
The commentary identifies the kṣīrivṛkṣas as Nyagrodha and related trees, Asana as Bījaka, Ariṣṭa as Nimba, Saptacchada as Saptaparṇa, Arjuna as Kakubha, and Tejovatī as Kākamardanikā. It gives Āsphoṭā alternatively as Sārivā or Arka. It states that one prastha of oil is cooked with eight pala of paste made from the listed substances and four times that quantity of water.
Key terms
kṣīrivṛkṣa
Milk-sapped trees, identified by the commentary as Nyagrodha and related trees.
Āsphoṭā (āsphoṭā)
An ingredient for which the commentary gives Sārivā or Arka as alternative identifications.
jīrṇajvara
Chronic or long-standing fever in this passage.
abhyaṅga
External anointing with the prepared oil.
Adhikarana १७० (२५९-२६१) · Śloka २६१
निर्विषैर्भुजगैर्नागैर्विनीतैः कृततस्करैः |
त्रासयेदागमे चैनं तदहर्भोजयेन्न च ||२५९||
अत्यभिष्यन्दिगुरुभिर्वामयेद्वा पुनः पुनः |
मद्यं तीक्ष्णं पाययेत घृतं वा ज्वरनाशनम् ||२६०||
पुराणं वा घृतं काममुदारं वा विरेचनम् |
निरूहयेद्वा मतिमान् सुस्विन्नं तदहर्नरम् ||२६१||
Meaning of the śloka
At the expected onset of fever, the person is to be frightened with nonvenomous snakes, trained elephants, or persons falsely presented as thieves, and is not to be fed that day. Alternatively, repeated emesis is prescribed using very heavy and channel-obstructing foods. Strong liquor or fever-alleviating ghee may be given, as may old medicated ghee or a mild purgative; after adequate fomentation, a wise physician may also administer a nirūha enema that day.
The commentary presents these measures for a special stage of viṣamajvara or for irregular fever attributed to bhūtābhiṣaṅga and related causes. It identifies the nonvenomous snakes as varieties such as Duṇḍubha and Ahipatāka, explains the elephants as trained and controlled, and the thieves as persons falsely accused for the performance. Fright is said either to disturb the doṣa approaching manifestation through agitated vāyu or to make the person forget the expected time of fever. Fasting on that day is intended to reduce the remaining doṣa. Milk, curd, or gruel prepared with Madanaphala are given as examples for inducing emesis, with the heavy substances said to protect strength. The fever-alleviating ghee is specified as six pala; old ghee is medicated, and the purgative is to be mild and not used in a person whose internal passages are insufficiently relaxed or who is unfit for purgation. The phrase 'that day' is applied throughout.
Key terms
viṣamajvara
An irregular or intermittent classical fever category discussed here at its expected onset.
vamana
Therapeutically induced emesis prescribed in the historical regimen.
virecana
Purgation, which the commentary says should be mild and restricted to a suitable person.
nirūha
A decoction-based enema mentioned after fomentation.
The commentary introduces this as fumigation for viṣamajvara. It identifies ajā as a she-goat, avi as a sheep, and Palaṅkaṣā as Guggulu. Although the formulation is stated for viṣamajvara, the commentary says it is also to be used for chronic fever and fever attributed to bhūta influence, citing its teaching in a parallel text.
Key terms
dhūpana
Fumigation with the listed animal and plant substances.
Palaṅkaṣā (palaṅkaṣā)
Identified by the commentary as Guggulu.
bhūtaviṣamajvara
An irregular fever understood in the classical text as associated with bhūta influence.
Adhikarana १७२ (२६३) · Śloka २६३
बैडालं वा शकृद्योज्यं वेपमानस्य धूपनम् |२६३|
Meaning of the śloka
For a person who is trembling, the passage prescribes fumigation using cat feces.
The commentary introduces this fumigation for a particular condition or stage and explicitly identifies baiḍāla śakṛt as cat feces.
Key terms
baiḍāla śakṛt
Cat feces, identified as the fumigation material.
vepamāna
A person who is trembling or shivering.
dhūpana
Fumigation, the historical mode of application described here.
Adhikarana १७३ (२६३) · Śloka २६३
पिप्पली सैन्धवं तैलं नेपाली चेक्षणाञ्जनम् ||२६३||
Meaning of the śloka
Pippalī, rock salt, oil, and Nepālī are prescribed as an application to the eyes.
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विषमज्वरेऽञ्जनमाह- पिप्पलीत्यादि| यद्यपि अञ्जनमित्युक्तोऽपि नेत्राञ्जनं प्राप्तं, तथाऽप्यत्रेक्षणाञ्जनमिति यदुक्तं तदभ्यङ्गवाचिनोऽञ्जनशब्दस्य निषेधार्थम्||२६३||
Meaning of the commentary
The commentary introduces this as an añjana for viṣamajvara. It explains that, although the word añjana itself could indicate an eye application, the explicit expression īkṣaṇāñjana is used to exclude the alternative sense of añjana as bodily anointing.
Key terms
īkṣaṇāñjana
An application specifically intended for the eyes.
Pippalī (pippalī)
One of the substances listed for the eye application.
saindhava
Rock salt included in the formulation.
Nepālī (nepālī)
A named ingredient whose precise identity requires expert verification.
The ghee preparations previously described in the treatment of abdominal disorders, together with the ghee named Ajita described in Kalpasthāna, are said to overcome fever when used.
The commentary explains kalpokta as 'stated in Kalpasthāna' and identifies Ajita as the preparation also called Ajeya. It preserves variant readings: some read 'one should employ it in all groups' in place of 'those previously stated by me' and interpret this as all groups of fevers, while others read 'in all fevers.'
Key terms
Ajita sarpis (ajita sarpis)
A medicated ghee described in Kalpasthāna and identified as also named Ajeya.
udarokta sarpis
Ghee preparations previously taught in the treatment of abdominal disorders.
sarvajvareṣu
A preserved variant reading meaning 'in all fevers.'
The commentary explains binding as the use of cords and similar objects together with mantras; āveśana as striking with mustard seeds and similar substances accompanied by mantras; and worship as offerings, oblations, praises, and related rites. It notes that, although fever from poison was discussed before fever from bhūta influence in the diagnostic section, placing this treatment first here indicates that the Bhūtavidyā procedures were also regarded as useful in viṣamajvara.
Key terms
Bhūtavidyā (bhūtavidyā)
The classical field from which the ritual procedures are referenced.
bandha
Binding with cords or similar objects accompanied by mantras, according to the commentary.
āveśana
Explained here as a mantra-associated procedure involving striking with mustard seeds or similar substances.
bhūtābhiṣaṅga
A classical attribution of illness to bhūta influence.
Adhikarana १७६ (२६५) · Śloka २६५
... विज्ञानाद्यैश्च मानसम् ||२६५||
Meaning of the śloka
Fever classified as mental in origin is to be overcome through discriminative knowledge and related mental disciplines.
The commentary connects vijñāna and the related measures with treatment of mānasa fever. The word 'and so forth' includes courage, recollection, knowledge, and mental composure or concentration. Mānasa fever is described as arising from desire, grief, anger, or fear. Some read 'through consoling the mind' instead of 'through discriminative knowledge and the others' and explain it as measures that bring serenity to the mind.
Key terms
mānasa jvara
A classical fever category associated here with desire, grief, anger, or fear.
vijñāna
Discriminative knowledge or understanding used as a mental measure.
samādhi
Mental composure or concentration included among the measures.
manaḥsāntva
Consoling or soothing the mind, preserved as an alternative reading.
Adhikarana १७७ (२६६) · Śloka २६६
श्रमक्षयोत्थे भुञ्जीत घृताभ्यक्तो रसौदनम् |२६६|
Meaning of the śloka
For fever arising from exertion or depletion, the person is to be anointed with ghee and eat rice with meat broth.
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श्रमक्षयोत्थे भुञ्जीतेत्यादि| यद्यपि रसौदनभोजनं पूर्वमेवोक्तं, तथाऽपि घृताभ्यङ्गयोगादधिकफलदर्शनार्थमत्रोक्तम्|२६६|-
Meaning of the commentary
The commentary notes that eating rice with meat broth was already prescribed earlier. It is repeated here to indicate an additional benefit when combined with anointing using ghee.
Key terms
śramakṣayaja jvara
Fever described as arising from exertion or depletion.
ghṛtābhyakta
Anointed externally with ghee.
rasodana
Rice served with meat broth.
Adhikarana १७८ (२६६) · Śloka २६६
अभिशापाभिचारोत्थौ ज्वरौ होमादिना जयेत् ||२६६||
Meaning of the śloka
Fevers attributed to a curse or hostile ritual action are said to be overcome through homa and related rites.
The commentary defines abhiśāpa as a curse or angry pronouncement by accomplished beings and abhicāra as harmful pressure exerted through ritual diagrams, mantras, and related means. The phrase 'and so forth' includes rites for pacification, expiation, auspicious observances, recitation, and similar practices.
Key terms
abhiśāpa
A curse or angry pronouncement understood in the classical explanatory framework.
abhicāra
Hostile ritual action described as operating through diagrams, mantras, and related means.
homa
A fire offering or ritual prescribed in this context.
prāyaścitta
Expiatory observance included by the commentary among the related rites.
Adhikarana १७९ (२६७) · Śloka २६७
दानस्वस्त्ययनातिथ्यैरुत्पातग्रहपीडितम् |२६७|
Meaning of the śloka
A person considered afflicted by ominous events or planetary influences is to be treated through giving, blessings or auspicious rites, and hospitality.
The commentary explains svastyayana as a blessing or benediction and ātithya as honoring a guest. Utpāta denotes an ominous event, such as an unusual destructive occurrence, while grahas here are celestial bodies beginning with the Sun.
Key terms
dāna
Giving or donation used as a religious or ethical measure.
svastyayana
A blessing, benediction, or auspicious rite.
ātithya
Hospitality expressed by honoring a guest.
utpāta
An event interpreted as an unfavorable omen.
Adhikarana १८० (२६७) · Śloka २६८
अभिघातज्वरे कुर्यात् क्रियामुष्णविवर्जिताम् ||२६७||
कषायमधुरां स्निग्धां यथादोषमथापि वा |२६८|
Meaning of the śloka
In fever arising after physical injury, treatment should avoid heating measures and should instead be astringent, sweet, and unctuous, or otherwise selected according to the doṣa.
The commentary explains that fever following injury is considered to involve a predominance of vāta and rakta; therefore, measures possessing the stated qualities are to be used.
Key terms
abhighātajvara
Fever described as arising following physical injury or trauma.
uṣṇavivarjita
Avoiding heating measures.
kaṣāyamadhura
Having astringent and sweet qualities.
vātarakta-bahula
Understood by the commentary as involving a predominance of vāta and rakta.
Adhikarana १८१ (२६८-२६९) · Śloka २६९
ओषधीगन्धविषजौ विषपित्तप्रसाधनैः ||२६८||
जयेत् कषायं च हितं सर्वगन्धकृतं तथा |
निम्बदारुकषायं वा हितं सौमनसं यथा ||२६९||
Meaning of the śloka
Fevers attributed to medicinal substances, odors, or poison are to be treated with measures that clarify or pacify poison and pitta. Beneficial preparations include a decoction made with the sarvagandha group or a decoction of Nimba and Dāru, prepared in the manner of a fragrant jasmine-based preparation.
The commentary explains viṣapittaprasādhana as treatments for poison and pitta. It preserves another reading, viṣapītaprasādhana, meaning treatments used for a person who has ingested poison. Sarvagandhakṛta is explained as prepared with Elā and related aromatic substances, and saumanasa as prepared with Jātī. The placement of fevers attributed to bhūta influence and similar causes among irregular fevers indicates that such fevers were also generally understood to occur irregularly.
The commentary defines yavānnavikṛti as preparations made from barley foods and says that ghee and alcoholic drink are mentioned again to emphasize their particular suitability in viṣamajvara. It preserves the alternative reading yāvānnavikṛti: yāvānna is interpreted as cooked barley rice and vikṛti as other barley preparations. On that reading, cooked barley is named separately to stress its special importance even though it is already included among barley preparations.
Key terms
yavānnavikṛti (yavānna-vikṛti)
Food preparations made from barley.
viṣamajvara
An irregular or intermittent classical fever category.
madya
Alcoholic drink mentioned in the historical dietary regimen.
After describing rationally based treatment for viṣamajvara, the commentary presents this as treatment based on divine recourse. It identifies Īśāna as Maheśvara and Ambikā as Caṇḍī, and says that honoring the twice-born and the others removes wrongdoing and generates religious merit.
Key terms
Īśāna (īśāna)
Identified by the commentary as Maheśvara.
Ambikā (ambikā)
Identified by the commentary as Caṇḍī.
daivavyapāśraya
A form of treatment based on religious or divine recourse.
For cold distress in chronic fever arising from kapha and vāta, the passage prescribes warm pastes, fomentation, warm sprinkling with fermented liquids, cow urine, or whey, leaf or herbal applications, massage with alkaline oil mixed with fermented liquid, a decoction beginning with Āragvadha, and a comfortably warm immersion bath with a vāta-pacifying decoction. After the cold is overcome, the weakened person is sprinkled with warm water, wrapped in woolen, cotton, and silk cloth, and placed in a sheltered room after applying dark Aguru. The passage then describes young women warming and comforting him through close bodily contact; once comfort has arisen they are to withdraw, and suitable food is to be given.
The commentary introduces external cleansing, pastes, sprinkling, massage, bedding, anointing, and bodily soothing for chronic fevers involving two doṣas. The warm group may be Bhadradāru, Surasā, or Elā and related groups, while the foremost warm measure is fomentation. Āranāla is sour rice gruel and śukta is a fermented sour preparation, for which a parallel recipe is quoted. Arjaka is identified as Kuṭheraka, though others call it Sitaparṇā; Śigru is interpreted either as a tree resembling Śobhāñjana or as Śobhāñjana itself. The commentary rejects one alternative identification of kṣāra oil because it would make the qualification 'with śukta' redundant. Avagāha means immersion in a liquid-filled vessel and sukhoṣṇa means mildly warm. It supplies 'in a draft-free room' and explains the fabrics. The women are said to provide gentle bodily massage and relieve dejection; they must be removed once delight arises because continued contact is considered harmful. The food should reduce vāta and śleṣman. Variant readings are preserved for the immersion/decoction phrase, for a particular woolen garment, and for whether dark Aguru is an ornament or an application.
Key terms
kaphavātaja jvara (kapha-vātaja jvara)
A classical fever involving kapha and vāta, here accompanied by cold distress.
sveda
Fomentation or induced warming, described as the foremost warm measure.
avagāha
Immersion in a vessel filled with a medicinal liquid.
śukta
A fermented sour liquid used in several external preparations.
Adhikarana १८५ (२८२-२८५) · Śloka २८६
दाहाभिभूते तु विधिं कुर्याद्दाहविनाशनम् |
मधुफाणितयुक्तेन निम्बपत्राम्भसाऽपि वा ||२८२||
दाहज्वरार्तं मतिमान् वामयेत् क्षिप्रमेव च |
शतधौतघृताभ्यक्तं दिह्याद्वा यवशत्कुभिः ||२८३||
कोलामलकसंयुक्तैः शुक्तधान्याम्लसंयुतैः |
अम्लपिष्टैः सुशीतैश्च फेनिलापल्लवैस्तथा ||२८४||
अम्लपिष्टैः सुशीतैर्वा पलाशतरुजैर्दिहेत् |
बदरीपल्लवोत्थेन फेनेनारिष्टकस्य च ||२८५||
लिप्तेऽङ्गे दाहतृण्मूर्च्छाः प्रशाम्यन्ति च सर्वशः |२८६|
Meaning of the śloka
For a person overwhelmed by burning, the passage prescribes measures intended to remove burning. It describes promptly inducing emesis with Nimba-leaf water mixed with honey and phāṇita, anointing with ghee washed one hundred times, and applying cool pastes made from barley flour with Kola and Āmalaka, sour fermented liquids, Phenilā shoots, or Palāśa shoots. It also describes foam prepared from Badarī shoots and Ariṣṭaka; when applied to the body, these measures are said to calm burning, thirst, and fainting.
The commentary emphasizes that this regimen is stated for burning even without fever, explaining why the verse does not specify pitta fever. Some read 'mixed with honey and phāṇita' as qualifying Nimba-leaf water, while others read that one should drink Nimba-leaf water mixed with them. Although emesis is ordinarily used for kapha rather than pitta, the commentary says markedly aggravated pitta may also be removed to some degree through emesis and quotes a parallel authority allowing emesis or purgation according to its location and condition. Śatadhauta ghṛta is ghee washed one hundred times with cold water. Alternative readings are preserved for the grain-sour preparation. Phenilā is identified as Upodikā, while Ariṣṭa may mean Nimba or the Phenilā tree. The commentary explains how the historical foam is produced by agitating sour-ground Badarī shoots in a sour liquid.
Key terms
dāha
A state of burning or intense heat addressed by the passage.
śatadhauta ghṛta
Ghee described as washed one hundred times with cold water.
vamana
Therapeutically induced emesis in the historical regimen.
dhānyāmla
A fermented sour grain liquid used in the external paste.
A cooling oil is described by cooking one prastha of oil with half a kuḍava of ground barley, half a pala of Mañjiṣṭhā, and one hundred prasthas of sour liquid. It is said to relieve burning associated with fever.
For burning, the passage recommends pastes made from the Nyagrodhādi, Kākolyādi, or Utpalādi groups; fats cooked with their decoctions and sour liquid for massage; or immersion in their cool decoction. After the acute burning subsides, the person is removed, sprinkled with cool water, and anointed with sandalwood and related substances. The dejected patient is then described as being comforted and cooled by finely clothed, ornamented women wearing lotus garlands and touching him with cool lotuses and their bodies. Once comfort arises, they should withdraw, and suitable pitta-reducing food is given.
The fats are explained as cooked with decoctions of the Nyagrodhādi, Kākolyādi, and Utpalādi groups together with Kāñjika. The patient is immersed in a cool astringent decoction made from those groups and removed after the force of burning has passed. Candanādi may mean the whole sandalwood group; others interpret it as Śrīcandana with Uśīra, Lāmajjakā, and other substances included by implication. The commentary explains dīnamanas as a distressed mind, pelava kṣauma as delicate linen or silk-like cloth, and the women as fully covered, bearing multicolored lotus garlands and offering cool contact. Suitable food is specified as pitta-reducing.
Key terms
Nyagrodhādi gaṇa (nyagrodhādi gaṇa)
A classical group of substances used here for cooling paste, medicated fat, and immersion.
śītakaṣāya avagāha (śīta-kaṣāya avagāha)
Immersion in a cool astringent decoction.
Candanādi (candanādi)
Sandalwood and related substances, with alternative commentary interpretations.
Adhikarana १८८ (२९४) · Śloka २९४
पित्तज्वरोक्तं शमनं विरेकोऽन्यद्धितं च यत् |२९४|
Meaning of the śloka
For burning associated with fever, the calming measures and purgation taught for pitta fever, together with whatever else is suitable, are prescribed.
The commentary says that the treatment of burning in fever is being extended by reference to the measures already stated for pitta fever; any other measure that is suitable should also be used.
Key terms
pittajvarokta śamana
Calming measures previously taught for pitta fever.
vireka
Purgation in the historical therapeutic framework.
jvaradāha
Burning associated with fever.
Adhikarana १८९ (२९४) · Śloka २९५
निर्हरेत्पित्तमेवादौ दोषेषु समवायिषु ||२९४||
दुर्निवारतरं तद्धि ज्वरार्तानां विशेषतः |२९५|
Meaning of the śloka
When doṣas occur in combination, pitta should first be eliminated, because in a person suffering from fever it is especially difficult to restrain.
The commentary initially applies the statement to saṃsarga, a combination of two doṣas, rather than sannipāta, since treatment of sannipāta was already stated earlier. It says that the plural may nevertheless indicate that, depending on constitution and season, pitta may sometimes be treated first even in sannipāta when this does not conflict with kapha. Another reading has 'first calm pitta in combined fevers.' On that interpretation, pitta is restored to its normal state through fasting, water, gruel, and similar measures because fever impairs agni and agni is understood as residing within pitta. The commentary reconciles this with the instruction to first dry up āma and reduce śleṣman in sannipāta by explaining that śamana here means restoring pitta to normal, not expelling it. Vāta and kapha are difficult to restrain in combination, but pitta is described as still more difficult.
Key terms
saṃsarga
A combined condition involving two doṣas.
sannipāta
A combined condition involving all three doṣas.
śamana
Here interpreted as restoring pitta to its normal state rather than expelling it.
nirharaṇa
Elimination or expulsion, distinguished from śamana by the commentary.
Adhikarana १९० (२९५) · Śloka २९६
छर्दिमूर्च्छापिपासादीनविरोधाज्ज्वरस्य च ||२९५||
उपद्रवाञ्जयेच्चापि प्रत्यनीकेन हेतुना |२९६|
Meaning of the śloka
Complications of fever, such as vomiting, fainting, and thirst, should be addressed with measures opposed to their causes while avoiding conflict with the treatment of the fever itself.
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इदानीं ज्वरचिकित्सितमभिधायोपद्रवचिकित्सितमाह- छर्दिमूर्च्छेत्यादि| छर्द्यादीनुपद्रवान् ज्वरस्याविरोधेन प्रत्यनीकेन हेतुना जयेदिति सम्बन्धः| ननु, छर्द्यादय उपद्रवाः कथं प्रोच्यन्ते, यावता ज्वरलक्षणान्येतानि? सत्यं, ये ज्वरेण सहोत्पन्नाश्छर्द्यादयस्ते ज्वरलक्षणानि, ये तु ज्वरस्योत्तरकालजास्त उपद्रवाः; तथा चोक्तं,- “व्याधेरुपरि यो व्याधिर्भवत्युत्तरकालजः| उपक्रमाविरोधी च स उपद्रव उच्यते”- इति| यद्यपि प्रागुक्तात्- ‘सोपद्रवमन्योन्याविरोधेनोपचरेद्बलवन्तमुपद्रवं च’- इति वाक्यादेवान्योन्याविरोधेन चिकित्सा सिद्धा, तथाऽपि ‘अविरोधाज्ज्वरस्य’ इति यत् पुनरुक्तं तन्नियमार्थं; तेन बलवन्तमुपद्रवं विहायान्यत्र सर्वत्राप्यविरोधेनैव चिकित्सा कर्तव्येति; अन्ये तु पूर्वं सामान्येनोक्तमत्र तु विशेषेणेति न दोषः| प्रत्यनीकेन स्वचिकित्सितेन| यद्येवं तर्हि हेतुनेति पदं व्यर्थं; तन्न, युक्तिव्यपाश्चयदैवव्यपाश्रयसत्त्वावजयेति त्रिप्रकारस्यापि चिकित्सितस्य सङ्ग्रहार्थत्वात्; अथवा हेतुग्रहणं हेतुविपरीतप्राप्त्यर्थं, यस्मात्त्रिविधमौषधं- हेतुविपरीतं व्याधिविपरीतं, तदर्थकारि चेति||२९५||
Meaning of the commentary
The commentary distinguishes vomiting and similar features that arise together with fever, which are signs of fever, from those that develop later, which are called complications. Treatment should oppose the particular complication while remaining compatible with treatment of the fever, except that a powerful complication may take priority. Some explain that this compatibility was stated generally before and specifically here. Pratyanīka means the complication's own appropriate treatment. The word hetu may gather all three modes of treatment—rational, divine, and psychological—or may indicate a measure opposed to the cause. The commentary accordingly recalls three kinds of medicine: opposed to the cause, opposed to the disease, and acting toward the intended therapeutic result.
Key terms
upadrava
A complication arising after the primary disease rather than simultaneously with it.
pratyanīka
A measure opposed to the particular complication or its cause.
avirodha
Compatibility with the treatment of the underlying fever.
A further external preparation for complications is described: Madhuka, Rajanī, Musta, Dāḍima, Amlavetasa, Añjana, Tintiḍīka, Nalada, Patra, Utpala, Tvac, and Vyāghranakha are combined with Mātuluṅga juice, honey, and madhuśukta and applied to the head of a person with fever. The paste is said to relieve headache or heat in the head, fainting, vomiting, hiccup, and trembling.
The commentary identifies Añjana as Rasāñjana, Nalada as Māṃsī, Patra as Patraka, Utpala as Nīlotpala, and Vyāghranakha as Nakha. Madhuśukta is explained as a special fermented preparation made with Jambīra juice; a parallel text describes combining that juice with Pippalī powder, placing it in a honey vessel within a heap of grain, and regarding the resulting liquid after one month as madhuśukta. Pradeha means an external paste, śirobhitāpa means head pain, and sammoha means fainting.
Key terms
pradeha
An external paste applied here to the head.
madhuśukta
A fermented preparation based on Jambīra juice, as explained by the commentary.
Powders of Madhūka, Hrībera, Utpala, and Madhūlikā are to be licked with honey and ghee. The preparation is said to relieve vomiting, excessive flow of kapha, bleeding attributed to pitta, severe hiccup, and difficult breathing.
The commentary identifies Hrībera as Vālaka and Madhūlikā as Jalayaṣṭī.
Key terms
Hrībera (hrībera)
Identified by the commentary as Vālaka.
Madhūlikā (madhūlikā)
Identified by the commentary as Jalayaṣṭī.
śvāsa
Difficult or distressed breathing in this passage.
asṛkpitta
Bleeding understood in the classical framework as associated with pitta.
Adhikarana १९३ (३०२) · Śloka ३०२
लिहन् ज्वरार्तस्त्रिफलां पिप्पलीं च समाक्षिकाम् |
कासे श्वासे च मधुना सर्पिषा च सुखी भवेत् ||३०२||
Meaning of the śloka
The passage states that a person afflicted by fever may lick a preparation of Triphala and Pippali combined with honey. In the presence of cough and difficult breathing, it describes honey and ghee as bringing comfort.
The commentary explains the repeated mention of honey in this formulation. It understands one portion of honey as being in the quantity used for grinding the ingredients, and the other as being in the quantity used for mixing or stirring the finished preparation.
Key terms
jvarArta (jvarārta)
a person distressed by fever
triphala (triphālā)
the classical group of three fruits named in the formulation
For a person distressed by thirst and burning, the passage describes applying a paste of Vidari, pomegranate, Lodhra, kapittha, and Bijapuraka to the head.
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विदारीमित्यादि| दधित्थं कपित्थम्||३०३||
Meaning of the commentary
The commentary identifies dadhittha in the verse as kapittha.
For an unpleasant taste in the mouth, the passage describes retaining a paste of pomegranate, sugar, grapes, and amalaki, and using a suitable mouth rinse. It then begins listing liquids for that rinse: milk, sugarcane juice, honey, ghee, oil, and warm water.
The commentary specifies that vairasya here means an unpleasant taste in the mouth. It explains makshika as honey and carries forward the instruction that the listed liquids are to be retained in the mouth for the same condition. The source passage is divided across verses 304 and 305, while the supplied commentary ends after verse 304.
The commentary glosses shunya as rikta, meaning empty or depleted. It says that the Jivaniya substances are the ten herbs beginning with Kakoli, and quotes a verse listing Jivanti, the two Kakolis, the two Medas, Mudgaparni, Mashaparni, Jivaka, Rishabhaka, and Madhuka as the group called Jivaniya.
Key terms
shUnya (śūnya)
empty or depleted, as glossed by the commentary
nasya
nasal administration in the classical therapeutic context
jIvanIya (jīvanīya)
the named classical group of ten sustaining substances
The passage praises a purgative made from powdered Triphala, Shyama, Trivrit, and Pippali, combined with honey and sugar. It then begins to name circumstances including a mature stage of pittaja fever, upward-flowing blood, and trembling; the sentence continues beyond the supplied excerpt.
The commentary identifies Shyama as Vriddhadaraka and explains urdhvaga rakta as blood moving or issuing upward. Its explanation covers verse 306, while the next line is incomplete in the supplied source.
Key terms
vireka
purgative therapy in the classical context
shyAmA (śyāmā)
identified by the commentary as Vriddhadaraka
trivRut (trivṛt)
a substance named in the purgative formulation
pakva pittajvara
a mature or developed stage of pittaja fever
Urdhvaga rakta (ūrdhvaga rakta)
blood issuing upward, according to the commentary
vepathu
trembling
Adhikarana १९८ (३०७) · Śloka ३०७
कफवातोत्थयोरेवं स्नेहाभ्यङ्गैर्विशोधयेत् ||३०७||
Meaning of the śloka
In this manner, conditions arising from kapha and vata are described as being brought to purification or relief by oleation and oil massage.
The commentary explains vishodhayet as bringing about purification, and takes the intended sense to be bringing about pacification. It also states that kapha and vata must be supplied grammatically as the objects of the action in this verse.
Key terms
kaphavAtottha (kaphavātottha)
arising from kapha and vata
sneha
oleation or unctuous application
abhya~gga (abhyaṅga)
oil massage
vishodhana (viśodhana)
purification, interpreted here in the intended sense of pacification
A person who remains troubled by dizziness even after the doshas have been removed is described as licking a preparation of honey, sugar, and Abhaya.
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हृतेत्यादि| हृतदोषोऽपि यो भ्रमार्तो भवेत् स क्षौद्रेण सिताभया लिह्यादिति पिण्डार्थः|३०८|-
Meaning of the commentary
The commentary gives the overall sense that even after dosha-removing treatment, a person afflicted by dizziness should lick Abhaya with honey and sugar.
Key terms
hRutadoSha (hṛtadoṣa)
one whose doshas have been removed by prior treatment
For vataja fever, the passage describes niruha basti prepared with vata-pacifying and sweet-class substances. It adds that the state of the dosha and the person's vital strength should be assessed, and that suitable anuvasana bastis should be selected accordingly.
Introducing the substances for niruha in vataja fever, the commentary gives Bhadradaru and related substances as examples of the vata-pacifying group, and Kakoli and related substances as examples of the sweet group. Assessing dosha and prana means evaluating the dosha and strength as mild, moderate, or severe/high. Accordingly, the niruha is described as small, medium, or greater when dosha aggravation is mild, moderate, or greater, with a corresponding assessment of strength. The anuvasana is explained as using an unctuous preparation processed with vata-pacifying substances.
Key terms
vAtaja jvara (vātaja jvara)
fever classified as arising from vata
nirUha basti (nirūha basti)
a classical decoction-based enema procedure
anuvAsana (anuvāsana)
a classical unctuous enema procedure
prANa (prāṇa)
the patient's vital strength in the commentary's assessment
For pittaja fever, the passage describes cooling niruha bastis based principally on a decoction of the Utpaladi group, combined with sandalwood and Ushira and made sweet with sugar. It then lists another preparation using bark from mango and related trees, conch, sandalwood, Madhuka, Utpala, mineral pigment, Anjana, Manjishtha, lotus stalks, and Padmaka, finely ground with milk and combined with sugar and honey. The well-filtered and cooled basti is described for a person experiencing intense burning.
The commentary introduces these as substances for niruha in pittaja fever and explains adya as principal, indicating niruha preparations possessing the stated qualities. It then gives an additional set: because mango and the related trees belong to the Nyagrodhadi group, the substances from mango through Nandivrikshaka are to be taken after excluding those already mentioned. It identifies chandana as red sandalwood, utpala as blue lotus, and anjana as sroto'njana; if that is unavailable, rasanjana or sauviranjana may be used according to the commentary. It further identifies mrinala as bisa, padmaka as padmaka wood, and basti as niruha basti.
Key terms
pittajvara
fever classified as arising from pitta
utpalAdi kaShAya (utpalādi kaṣāya)
a decoction based on the classical Utpaladi group
nirUha basti (nirūha basti)
the decoction-based enema specified by the commentary
a~jjana (añjana)
a mineral substance identified primarily as sroto'njana, with alternatives given
mRuNAla (mṛṇāla)
lotus stalk or bisa, according to the commentary
dahyamAna (dahyamāna)
a person experiencing intense burning
Adhikarana २०२ (३१२) · Śloka ३१२
ज्वरदाहापहं तेषु सिद्धं चैवानुवासनम् ||३१२||
Meaning of the śloka
The passage states that an anuvasana preparation processed with those substances is likewise considered to relieve fever and burning.
By extension, the commentary identifies the substances for anuvasana in pittaja fever. The word 'those' refers to the bark of Nyagrodhadi-group trees and the other substances described in the preceding passage.
Key terms
jvara
fever
dAha (dāha)
burning sensation
anuvAsana (anuvāsana)
a classical unctuous enema preparation
nyagrodhAdi (nyagrodhādi)
the classical group beginning with Nyagrodha, referenced from the preceding context
For kaphaja fever, the passage describes decoctions of the Aragvadha group combined with the Pippalyadi group, honey, and urine as niruha preparations intended to overcome the fever.
The commentary explains that 'they should be given' means that niruha bastis are to be administered. It also preserves an alternative reading: niruha preparations processed with Aragvadha and related substances and combined with honey overcome kaphaja fever, and anuvasana preparations processed with the same substances do so as well.
Key terms
kaphajvara
fever classified as arising from kapha
AragvadhagaNa (āragvadhagaṇa)
the classical group beginning with Aragvadha
pippalyAdi (pippalyādi)
the classical group beginning with Pippali
nirUha (nirūha)
a decoction-based enema, supplied by the commentary
anuvAsana (anuvāsana)
an unctuous enema mentioned in the alternative reading
mUtra (mūtra)
urine included in the main transmitted formulation
Adhikarana २०४ (३१४) · Śloka ३१४
कफघ्नैरेव संसिद्धा द्रव्यैश्चाप्यनुवासनाः |३१४|
Meaning of the śloka
The passage states that anuvasana preparations for this condition are likewise to be processed specifically with kapha-reducing substances.
Introducing anuvasana for kaphaja fever, the commentary explains that the kapha-reducing substances are Aragvadha and the other substances of that group.
Key terms
kaphaghna
described as countering or reducing kapha
anuvAsana (anuvāsana)
a classical unctuous enema preparation
Aragvadha (āragvadha)
the leading substance cited by the commentary for the kapha-reducing group
saMsiddha (saṃsiddha)
processed or prepared with the named substances
Adhikarana २०५ (३१४) · Śloka ३१४
संसर्गे सन्निपाते च संसृष्टा बस्तयो हिताः ||३१४||
Meaning of the śloka
In saṃsarga and sannipāta conditions, bastis prepared by combining the appropriate substances are considered beneficial.
The commentary introduces the ingredients for nirūha basti in saṃsarga and sannipāta. It explains saṃsṛṣṭa as combined or mixed and understands basti here specifically as nirūha basti.
Key terms
saṃsarga
A classical condition involving association of doṣas.
sannipāta
A classical condition involving all three doṣas.
saṃsṛṣṭa basti
A basti made with combined substances.
nirūha basti
The type of basti intended here according to the commentary.
Adhikarana २०६ (३१५) · Śloka ३१५
संसृष्टैरेव संसृष्टा द्रव्यैश्चाप्यनुवासनाः |३१५|
Meaning of the śloka
Anuvāsana bastis too are to be prepared from substances combined in the corresponding way.
By extending the preceding rule to saṃsarga and sannipāta, the commentary specifies the substances for anuvāsana. Both occurrences of saṃsṛṣṭa are explained as mixed or combined.
Key terms
anuvāsana
An unctuous type of basti discussed here.
saṃsṛṣṭa
Mixed or combined.
atideśa
Extension of the preceding rule to the present context.
Adhikarana २०७ (३१५) · Śloka ३१६
वातरोगापहाः सर्वे स्नेहा ये सम्यगीरिताः ||३१५||
विना तैलं त एव स्युर्योज्या मारुतजे ज्वरे |३१६|
Meaning of the śloka
In fever attributed to vāta, the unctuous substances properly described for alleviating vāta disorders may be used, except for oil.
The commentary states that this is a prohibition of oil specifically in anuvāsana for vāta-type fever. It lists the four unctuous substances as ghee, oil, animal fat, and marrow, and supplies that they are to be used in anuvāsana; the verse excludes oil in this setting.
Key terms
mārutaja jvara
Fever attributed in the classical framework to vāta.
sneha
Unctuous substances, here including ghee, oil, animal fat, and marrow.
anuvāsana
The basti context supplied by the commentary.
Adhikarana २०८ (३१६) · Śloka ३१६
निखिलेनोपयोज्याश्च त एवाभ्यञ्जनादिषु ||३१६||
Meaning of the śloka
Those same unctuous substances may all be employed in external applications such as abhyanga.
The commentary clarifies that oil, although prohibited in the preceding anuvāsana context, is included for abhyanga and related uses in vāta-type fever. The four snehas—ghee, oil, animal fat, and marrow—may be used separately or together and after suitable processing; this is why Ṣaṭkaṭvarādi oil is also commended.
Key terms
abhyanga
External anointing or massage.
sneha
The four unctuous substances named by the commentary.
Ṣaṭkaṭvarādi taila (ṣaṭkaṭvarādi taila)
A processed oil cited by the commentary as an example.
The commentary presents this as a particular sneha for abhyanga in pitta-type fever and explains that it is commended for abhyanga and related uses.
Key terms
paittika jvara
Fever attributed in the classical framework to pitta.
madhura
Sweet, describing one class of substances used to prepare the ghee.
tikta
Bitter, describing the other class of substances.
sarpiḥ
Ghee prepared with the stated substances.
Adhikarana २१० (३१७) · Śloka ३१७
श्लैष्मिके कटुतिक्तैश्च, संसृष्टानीतरेषु च ||३१७||
Meaning of the śloka
In kapha-type fever, ghee is prepared with pungent and bitter substances; in the other combined-doṣa conditions, the unctuous preparations are themselves combined.
The commentary supplies 'ghee is prepared' with pungent and bitter substances and applies it both for drinking and abhyanga in kapha-type fever. Although ghee shares qualities with kapha, it is said to be usable after special processing. Some infer oil from the word 'and,' but the commentator rejects this because it lacks support from another tantra. For saṃsarga and sannipāta, ghee and the other snehas are mixed with one another and prepared with a corresponding mixture of substances that alleviate vāta and the other doṣas.
Key terms
ślaiṣmika jvara
Fever attributed in the classical framework to kapha.
kaṭu-tikta
Pungent and bitter qualities used in preparing the ghee.
saṃsṛṣṭa
Combined, both among the snehas and among the doṣa-directed substances.
saṃskāra
Special processing said to alter the suitability of ghee in this context.
Residual pitta remaining in the skin is said to produce fever. In that condition, one should take sugarcane juice or cool sugar-water and eat rice of the Śāli or Ṣaṣṭika varieties well mixed with milk.
The commentary identifies the condition as fever caused by residual pitta after prior elimination and glosses anna as cooked rice. Although pitta situated in the skin might appear to call for external treatment rather than internal treatment, it explains the internal measures on the ground that the active qualities of the ingested liquid spread throughout the body.
Key terms
hṛtāvaśeṣa pitta
Pitta said to remain after earlier elimination.
tvakstha
Situated in the skin.
Śāli (śāli)
A rice variety named for the meal.
Ṣaṣṭika (ṣaṣṭika)
Another rice variety named for the meal.
Adhikarana २१२ (३१९) · Śloka ३१९
कफवातोत्थयोरेव स्वेदाभ्यङ्गौ प्रयोजयेत् ||३१९||
Meaning of the śloka
For fever arising from residual kapha or vāta, sveda and abhyanga are to be employed.
The commentary states that this gives the response to kapha- and vāta-type fevers remaining after prior elimination. It understands kaphavātottha specifically as fever arising from residual kapha or residual vāta.
Key terms
hṛtāvaśeṣa
Remaining after earlier elimination, as supplied by the commentary.
sveda
A sweating or heat procedure.
abhyanga
External anointing or massage.
Adhikarana २१३ (३२०) · Śloka ३२०
घृतं द्वादशरात्रात्तु देयं सर्वज्वरेषु च |
तेनान्तरेणाशयं स्वं गता दोषा भवन्ति हि ||३२०||
Meaning of the śloka
In all fevers, ghee is to be given after twelve nights, because by that interval the doṣas have reached their own seats.
The commentary limits this rule to fevers considered ripened through fasting, warm-water drinking, thin gruel, and digestive measures: ghee is then given after twelve days. It explains the interval as beyond the twelfth night, when vāta and the other doṣas are regarded as having returned to their own locations after reaching the ripened stage. Although fever may ripen after eight or ten days, twelve days is stated to show the timing for sannipāta fever. Some read this ghee as intended for nasya, but the commentator rejects that reading because ghee for nasya had already been taught earlier after gargling.
Key terms
dvādaśarātra
An interval of twelve nights or days.
jvarapāka
The classical stage in which fever is considered ripened.
āśaya
The respective seat said to be reached by each doṣa.
nasya
Nasal administration proposed by some readers and rejected here.
At the time when fever is releasing, the doṣa is described as strongly disturbing the dhātus. The person's mind becomes agitated and the body behaves as though the person were dying.
The commentary explains that severe distress may occur even as fever is subsiding. At the moment of release, the doṣa disturbs the dhātus and appears to act powerfully. Asked why it appears powerful when already diminished, the commentary attributes this to its particular effect and compares it to a lamp flaring brightly just before going out. Some interpret balīyate as 'becomes stronger.' Others read avalīyate and explain that the doṣa is no longer perceived in its former form. The resulting behavior is described as agitation or movements of the limbs resembling those of a dying person.
Key terms
mokṣakāla
The time when the fever is said to release or subside.
dhātu
Bodily constituents said here to be disturbed.
balīyate
Read as acting powerfully or becoming stronger.
avalīyate
An alternative reading interpreted as no longer being perceptible in the same form.
Adhikarana २१५ (३२२) · Śloka ३२२
लघुत्वं शिरसः स्वेदो मुखमापाण्डु पाकि च |
क्षवथुश्चान्नकाङ्क्षा च ज्वरमुक्तस्य लक्षणम् ||३२२||
Meaning of the śloka
Signs of release from fever are lightness of the head, sweating, a slightly pale yet maturing or clearing appearance of the face, sneezing, and a desire for food.
The commentary glosses lightness of the head, āpāṇḍu as slightly pale, and kṣavathu as sneezing. It says signs of release are specifically stated for fever and atisāra because they are major diseases. Some teachers instead assign the preceding description beginning with disturbance of the dhātus to release from sannipāta fever, and the present signs to release from the other fevers.
Key terms
jvaramukta
Released or recovered from fever in the classical description.
Fever is taught as terrible, arising from Śambhu's anger, diminishing strength, complexion, and agni, the king of diseases and an aggregate of disorders. Because it pervades all beings, affects the whole embodied person, is difficult and distressing, and may arise at life's end, fever is described as a destroyer of living beings.
To emphasize the seriousness of fever and the need to counter it, the commentary connects these reasons with calling fever antaka, a destroyer. It explains pervasiveness as affecting humans, animals, and other living beings; total contact as heating the body together with mind and senses; difficulty as injury to agni or extreme distress; and occurrence at the end as fever becoming the cause of death even in a person already afflicted by another disease. Antaka is used by comparison because fever may bring about an end. The commentator adds that other compilers recite this chapter in a different order, whereas he follows the sequence taught by his teacher.
Key terms
rogarāṭ
King of diseases, an epithet applied to fever.
agnisādaka
Diminishing or impairing agni.
sarvasaṃsparśa
Affecting the embodied person together with mind and senses.
antaka
A destroyer or bringer of an end, used to stress fever's gravity.
Thus ends the chapter called 'Prevention and Treatment of Fever' in the Kāyacikitsā portion of the Uttaratantra of the Suśruta Saṃhitā, the thirty-ninth chapter overall and identified in the parenthetical reading as the first chapter of this subsection.
The commentary colophon states that the thirty-ninth chapter, the chapter on the prevention and treatment of fever in Kāyacikitsā within the Uttaratantra, is completed in Dalhaṇa's Nibandhasaṅgraha commentary on the Suśruta Saṃhitā. The stored text preserves the name as Dalhaṇa with a parenthetical spelling variation.
Key terms
jvarapratiṣedha
The title of the chapter on fever prevention and treatment.
Kāyacikitsā (kāyacikitsā)
The medical subsection named in the chapter colophon.
Uttaratantra (uttaratantra)
The section of the Suśruta Saṃhitā containing this chapter.