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41. śōṣapratiṣēdhādhyāyaḥ

Adhikarana 1 (1-2) · Śloka 2

athātaḥ śōṣapratiṣēdhaṁ vyākhyāsyāmaḥ ||1|| yathōvāca bhagavān dhanvantariḥ ||2||

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अथातः शोषप्रतिषेधं व्याख्यास्यामः ||१|| यथोवाच भगवान् धन्वन्तरिः ||२||

Meaning of the śloka

Now, therefore, we shall explain the treatment (pratiṣedha) of śoṣa. Thus spoke Lord Dhanvantari.

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atīsārapratiṣēdhānantaraṁ śōṣē'pyatīsārasambhūtērathavā jvarātīsārābhyāṁ śōṣasyōtpattēḥ śōṣapratiṣēdhārambhō yukta ityata āha- athāta ityādi| athētyādikaṁ pūrvavadvyākhyēyam| śōṣapratiṣēdhaṁ śōṣacikitsitam||1-2||

Meaning of the commentary

The commentary explains why this chapter follows the one on atisāra: śoṣa can arise from atisāra, or śoṣa can arise from jvara and atisāra, so beginning the treatment of śoṣa here is fitting. The opening words 'atha' and 'ataḥ' are to be explained as before. Śoṣapratiṣedha means the treatment of śoṣa.

Key terms

śoṣa
Wasting or consumptive disorder, as named in this chapter.
pratiṣedha
Treatment or prevention.

Adhikarana 2 (3) · Śloka 3

anēkarōgānugatō bahurōgapurōgamaḥ | durvijñēyō durnivāraḥ śōṣō vyādhirmahābalaḥ ||3||

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अनेकरोगानुगतो बहुरोगपुरोगमः | दुर्विज्ञेयो दुर्निवारः शोषो व्याधिर्महाबलः ||३||

Meaning of the śloka

Śoṣa is a disease accompanied by many other diseases, preceded by many diseases, hard to recognise, hard to check, and of great strength.

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nanu, śōṣacikitsitaṁ vyākhyāsyāma iti pratijñāṁ kr̥tvā nidānābhidhānē kō hētuḥ? ucyatē- ajñātarōgasya vaidyasya cikitsāyāṁ pragalbhyaṁ na syādatō nidānārambha iti; tathā cōktaṁ- “rōgamādau parīkṣēta tatō'nantaramauṣadham”- iti| prāgēva vikārasvabhāvābhidhānāya vākyamāha- anēkarōgānugata ityādi| anēkarōgā upadravasañjñakāḥ, tairanugata āśritaḥ| bahavō rōgāḥ śvāsakāsāṅgasādakaphasaṁsravādayaḥ, purōgamāḥ pūrvarūpatvēnōpasthitā yasya sa tathā| durvijñēya iti tridōṣaliṅgatvādaṁśāṁśabalavikalpanābhiḥ prakupitadōṣāṇāṁ liṅgadarśanāt| durnivāra iti dōṣāṇāṁ parasparaviruddhōpakramatvāt; durnivāratvācca kr̥cchrō'yaṁ mahābalaḥ||3||

Meaning of the commentary

The commentary raises an objection: having announced the treatment of śoṣa, why begin with its causes? It answers that a physician who does not know the disease will lack confidence in treating, so the cause is stated first, citing 'examine the disease first, then the medicine'. Anekarogānugata means followed by many diseases called upadravas (complications). The many purogama (forerunners) are named as breathlessness, cough, limb-sinking, kapha discharge and the like. Durvijñeya means hard to know, because it has the signs of all three doṣas and the signs of aggravated doṣas are seen in varying strengths of parts. Durnivāra means hard to check, because the doṣas call for mutually opposed treatments. Hence the disease is difficult and of great strength.

Key terms

purogama
A preceding condition or forerunner.
upadrava
Complication.
durvijñeya
Hard to recognise.
durnivāra
Hard to check or treat.

Adhikarana 3 (4-5) · Śloka 5

saṁśōṣaṇādrasādīnāṁ śōṣa ityabhidhīyatē | kriyākṣayakaratvācca kṣaya ityucyatē punaḥ ||4|| rājñaścandramasō yasmādabhūdēṣa kilāmayaḥ | tasmāttaṁ rājayakṣmēti kēcidāhuḥ punarjanāḥ ||5||

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संशोषणाद्रसादीनां शोष इत्यभिधीयते | क्रियाक्षयकरत्वाच्च क्षय इत्युच्यते पुनः ||४|| राज्ञश्चन्द्रमसो यस्मादभूदेष किलामयः | तस्मात्तं राजयक्ष्मेति केचिदाहुः पुनर्जनाः ||५||

Meaning of the śloka

It is called śoṣa because of the drying up of rasa and the other dhātus. It is also called kṣaya because it causes wasting of (the effects of) treatment/activity. Because this disease once arose in the king Moon (Candra), some people call it rājayakṣmā.

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idānīmasya vyādhēryathā śōṣakṣayarājayakṣmēti nāmāni tathā''ha- saṁśōṣaṇādrasādīnāmityādi| kriyā cikitsā, kāyavāṅmānasaṁ vā karma, tasya kṣayakaratvāt| rājña iti ‘dvijānāṁ’ iti śēṣaḥ| candramasaḥ candrasya, āmayō yakṣmā rōgaḥ, kēciditi ātrēyaprabhr̥tayaḥ; yasmādēṣa āmayō dvijānāṁ rājñaścandramasaścandrasyābhūttasmāt taṁ rōgaṁ kēcit punarjanā rājayakṣmēti bruvatē; yatō'yaṁ yakṣmā rōgō rōgāṇāṁ rājā atō rājayakṣmēti vāgbhaṭō vyākhyānayati| kilēti vārtāyām| ēvaṁ khalu yathā śrūyatē- pūrvaṁ dakṣanāmā prajāpatirabhūt, tasya bahvayō duhitarō babhūvuḥ, tēna ca saptādhikā viṁśatiḥ kanyakāścandrāya vivōḍhē dattāḥ, sa candramāstāsu madhyē rōhiṇyāmēvānuraktō babhūva, tataśca saśōkābhiraśvinyādibhirduhitr̥bhirātmapitari dakṣasañjñakē candrasya rōhiṇyāmāsaktivr̥ttāntō nivēditaḥ, tatō duhitr̥̄ṇāṁ vārtāmākarṇya, candramāhūya, sarvāsvapi nijaputrīṣu samatayā vartanāya candrō'bhihitaḥ, sa ca tathēti svīkr̥tyāpi svagurōrvacanamanādr̥tya na tāsu samavartata, tatō dakṣaprajāpatēḥ krōdhō niśvāsarūpēṇa mūrtimān bhūtvā niḥsr̥tya yakṣmarūpēṇa rōhiṇyāmatiprasaṅgēnāvilaṁ candramāviśat, tatō'sau tēna rōgēṇābhibhūtaḥ san gataprabhō gatōtsāhaśca sañjātaḥ, guruvacanātikramēṇa dōṣaṁ matvā tamēva dakṣanāmānaṁ guruṁ śaraṇaṁ gatavān, tatō'nantaraṁ dēvavaidyābhyāmaśvibhyāṁ sa cikitsitaḥ, tataḥ prāptabalaścandrō (rarājātīva suprabhaḥ) laghvaguruprasādō'śvibhyāṁ cikitsitō'bhūt | ēvaṁ ca sati karmadōṣajō vyādhiriti darśitam||4-5||

Meaning of the commentary

The commentary explains the names śoṣa, kṣaya and rājayakṣmā. Kriyā means treatment, or bodily, verbal and mental action, and the disease wastes it. 'Some' refers to Ātreya and others: because this yakṣmā disease arose for the twice-born's king Candra, they call it rājayakṣmā. Vāgbhaṭa explains it differently: because yakṣmā is the king of diseases, it is rājayakṣmā. The commentary then relates the traditional account: Dakṣa Prajāpati had many daughters and gave twenty-seven to Candra in marriage; Candra became attached to Rohiṇī alone; the daughters told their father; Candra was summoned and told to treat all equally, agreed but did not comply; Dakṣa's anger took form as his breath and entered Candra as yakṣmā; Candra lost lustre and vigour, took refuge in Dakṣa recognising the fault of disobeying his teacher, was treated by the two divine physicians Aśvins, regained strength and became bright again. By this the disease is shown to be born of karma and doṣa.

Key terms

rājayakṣmā
Name of the disease, explained either from the King Moon or as the king of diseases.
kṣaya
Wasting.
karmadoṣaja
Born of karma and doṣa together.
aśvinau
The divine twin physicians.

Adhikarana 4 (6) · Śloka 6

sa vyastairjāyatē dōṣairiti kēcidvadanti hi |6|

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स व्यस्तैर्जायते दोषैरिति केचिद्वदन्ति हि |६|

Meaning of the śloka

Some say that it arises from the doṣas separately.

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ēkīyamatēnāsya vyādhēḥ pr̥thagdōṣajatvamāha- sa vyastairityādi| sa vyādhiḥ| vyastaiḥ pr̥thagbhūtaiḥ|6|-

Meaning of the commentary

The commentary says this states, according to one school, that the disease arises from single doṣas. 'Vyasta' means separate.

Key terms

vyasta
Separate, individual.
doṣaja
Born of doṣas.

Adhikarana 5 (6-7) · Śloka 7

ēkādaśānāmēkasmin sānnidhyāttantrayuktitaḥ ||6|| kriyāṇāmavibhāgēna prāgēkōtpādanēna ca | ēka ēva mataḥ śōṣaḥ sannipātātmakō hyataḥ ||7||

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एकादशानामेकस्मिन् सान्निध्यात्तन्त्रयुक्तितः ||६|| क्रियाणामविभागेन प्रागेकोत्पादनेन च | एक एव मतः शोषः सन्निपातात्मको ह्यतः ||७||

Meaning of the śloka

Because the eleven (signs) are present together in one, by the reasoning of the tantra, because treatments are not divided, and because it was first produced as one, śoṣa is held to be one only, of sannipāta nature.

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paramatanirākaraṇāya svamatamāha- ēkādaśānāmityādi| ēkādaśānāmiti svarabhēdaśūlādīnām| ēkasminniti rājayakṣmarōgē; anyē tu rājayakṣmātura iti vyākhyānayanti, sānnidhyāditi vidyamānatvāt| tantrayuktitaḥ arthayuktitaḥ ; anyē tantrētyatra tatrēti paṭhanti; tatra tasmin, yuktitō yuktivaśāditi vyākhyānayanti| kā sā yuktiḥ? yadvaśēnaika ēva śōṣa ityāha- kriyāṇāmavibhāgēnēti|- cikitsānāmapr̥thaktvēna darśitatvādityarthaḥ| ēkatvē tr̥tīyaṁ hētumāha- prāgēkōtpādanēna cēti|- yasmāt pūrvaṁ dakṣēṇa kruddhēnaikasyōtpādanaṁ kr̥tam| hiḥ yasmādarthē; yasmāt śōṣasyaikatvē hētutritayamatrōktam, ata ēka ēva śōṣaḥ sannipātātmakō mata iti sambandhaḥ||6-7||

Meaning of the commentary

The commentary says the author now refutes the other view and states his own. 'Eleven' means the signs such as voice change and pain. 'In one' means in rājayakṣmā; others read 'in the patient of rājayakṣmā'. 'From presence' means because they are found. 'Tantrayukti' means reasoning by sense; others read 'tatra yuktitaḥ', meaning by reasoning applied there. The reasoning is that treatments are shown as not separate, and that earlier it was produced by an angry Dakṣa as one. Thus three reasons are stated, and śoṣa is held to be one, of sannipāta nature.

Key terms

sannipātātmaka
Of the nature of all three doṣas together.
tantrayukti
Reasoning by the method of the treatise.
kriyāvibhāga
Division of treatments.

Adhikarana 6 (8) · Śloka 8

udrēkāttatra liṅgāni dōṣāṇāṁ nipatanti hi |8|

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उद्रेकात्तत्र लिङ्गानि दोषाणां निपतन्ति हि |८|

Meaning of the śloka

In it, the signs of the doṣas appear according to the predominance of each.

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nanu, yadi sannipātātmaka ēka ēvāyaṁ tat kathamatra ēkaikadōṣapr̥thagliṅgajñānamityāha - udrēkādityādi| udrēkāt ādhikyāt| tatra śōṣē| hiśabdō hētau, sa ca hēturbahuprakārō'pi caturvidhatvaṁ na tyajati|8|-

Meaning of the commentary

The commentary raises an objection: if śoṣa is of sannipāta nature alone, how is a sign of each single doṣa known? The reply is 'from predominance'. The cause is of many kinds, yet it does not give up the fourfold nature.

Key terms

udreka
Predominance or excess.
liṅga
Sign or symptom.

Adhikarana 7 (8) · Śloka 9

kṣayādvēgapratīghātādāghātādviṣamāśanāt ||8|| jāyatē kupitairdōṣairvyāptadēhasya dēhinaḥ |9|

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क्षयाद्वेगप्रतीघातादाघाताद्विषमाशनात् ||८|| जायते कुपितैर्दोषैर्व्याप्तदेहस्य देहिनः |९|

Meaning of the śloka

It arises from depletion, suppression of natural urges, injury, and irregular eating, when the doṣas are aggravated and pervade the body of the person.

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tamēva caturvidhaṁ hētumāha- kṣayādvēgapratīghātādityādi| kṣayāt rasādiśukrāntānāṁ dhātūnāṁ kṣayāt| vēgapratīghātāt vātamūtrapurīṣādīnāṁ pravr̥ttyunmukhānāmavarōdhāt| āghātāt patanāditaḥ, ayathābalamārambhāditi bōddhavyam| viṣamāśanāditi aprāptātītakālabahvalpabhōjanāt| kṣayādityādihētubhiḥ kupitairdōṣairvyāptadēhasya śōṣō jāyatē iti sambandhaḥ| anyē tvēvaṁ paṭhanti- ‘vēgāghātāt pūraṇādvā saṅghātāt saṅkṣayādapi’ iti; vyākhyānayanti ca- pūraṇaṁ viṣamāśanamabhiprētaṁ, saṅghātō'tra sāhasaḥ, śēṣaṁ pūrvavadvyākhyēyam||8||-

Meaning of the commentary

The commentary says the fourfold cause is now stated. Kṣaya is depletion of the dhātus from rasa to śukra. Vegapratīghāta is holding back of urges such as wind, urine and stool that are about to come. Āghāta is injury, such as from a fall, and includes exertion beyond one's strength. Viṣamāśana is eating too much or too little, before or after the proper time. Others read 'vegāghātāt pūraṇād vā saṅghātāt saṅkṣayād api', explaining pūraṇa as irregular eating and saṅghāta as rashness; the rest is explained as before.

Key terms

kṣaya
Depletion of the dhātus.
vegapratīghāta
Suppression of natural urges.
viṣamāśana
Irregular eating.

Adhikarana 8 (9) · Śloka 9

kaphapradhānairdōṣairhi ruddhēṣu rasavartmasu ||9||

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कफप्रधानैर्दोषैर्हि रुद्धेषु रसवर्त्मसु ||९||

Meaning of the śloka

When the channels of rasa are blocked by doṣas in which kapha predominates...

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kaphapradhānairityādi| kaphapradhānaiḥ utkaṭakaphaiḥ| hiśabdō hētau| rasavartmasvityatrādiśabdō luptō jñēyaḥ; vartma mārgaḥ, tēna rasādivāhinīṣu dhamanīṣvityarthaḥ||9||

Meaning of the commentary

The commentary says 'kapha-predominant' means with abundant kapha. In 'rasavartmasu' the word 'ādi' (rasa and others) is understood to be omitted; vartma means path, so it means the vessels carrying rasa and the other dhātus.

Key terms

rasavartma
Channels or paths of rasa.
kaphapradhāna
Kapha-predominant.

Adhikarana 9 (10) · Śloka 10

ativyavāyinō vā'pi kṣīṇē rētasyanantaram | kṣīyantē dhātavaḥ sarvē tataḥ śuṣyati mānavaḥ ||10||

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अतिव्यवायिनो वाऽपि क्षीणे रेतस्यनन्तरम् | क्षीयन्ते धातवः सर्वे ततः शुष्यति मानवः ||१०||

Meaning of the śloka

Or in one who is excessively given to sexual intercourse, after the semen is depleted, all the dhātus become depleted, and thereby the person wastes.

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aparaprakārēṇa dhātukṣayādrājayakṣmasambhavaṁ darśayannāha- atītyādi| ativyavāyinaḥ atyarthaṁ grāmyadharmasēvinaḥ| kṣīṇē rētasi śukrē, śukrakṣayaśca mēḍhravr̥ṣaṇavēdanētyādinā jñēyaḥ| anantaraṁ rētasaḥ kṣayādityarthaḥ| kṣīyantē dhātavaḥ sarvē iti paraṁ yadi strībhyō na nivartatē| nanu, rasavartmarōdhādrasēna raktasyābr̥ṁhaṇāttadapacayaḥ raktāpacayācca māṁsasyāpacaya ityādipūrvapūrvadhātukṣīṇatayā kr̥tvā śukrasya yuktaḥ kṣayaḥ, śukrakṣayē tu pūrvadhātūnāṁ kathaṁ kṣayaḥ? ucyatē- yathā mahājalādhāraparikṣayē tatra praviśatāṁ jalaprāyāṇāṁ (jantūnāṁ) kṣayastadvadatrāpīti| svamārgāvarōdhādrasō'sañcaran kiṁ karōti? hr̥dayē vidahyatē, kāsavēgēna mukhamārgāt picchilabahalavisraharitapītaśvētaḥ pravartatē||10||

Meaning of the commentary

The commentary says this shows another way rājayakṣmā arises from depletion of dhātus. Ativyavāyin is one excessively given to sexual activity. Depletion of semen is to be recognised by pain in the penis and testes and the like. 'Afterwards' means following depletion of semen. All the dhātus become depleted if he does not stop from women. An objection is raised: when the rasa channels are blocked, rasa does not nourish blood, so blood is reduced, then flesh, and so on in sequence, making depletion of semen fitting; but how can prior dhātus be depleted after semen is depleted? The reply is by analogy: as when a great water source dries, the water-dwelling creatures in it perish, so here as well. The rasa, unable to move through its blocked path, is burned in the heart, and with the force of cough comes out through the mouth as sticky, thick, foul-smelling, greenish, yellowish or white matter.

Key terms

ativyavāyin
One excessively given to sexual activity.
retas
Semen.
dhātu
Body tissue.

Adhikarana 10 (11) · Śloka 11

bhaktadvēṣō jvaraḥ śvāsaḥ kāsaḥ śōṇitadarśanam | svarabhēdaśca jāyēta ṣaḍrūpē rājayakṣmaṇi ||11||

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भक्तद्वेषो ज्वरः श्वासः कासः शोणितदर्शनम् | स्वरभेदश्च जायेत षड्रूपे राजयक्ष्मणि ||११||

Meaning of the śloka

Dislike of food, fever, breathlessness, cough, seeing of blood, and change of voice arise in rājayakṣmā of six signs.

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idānīṁ madhyabaladōṣārabdhasya śōṣasya ṣaḍrūpāṇi darśayannāha- bhaktadvēṣō jvara ityādi| svarabhēdaḥ ghargharādisvaraḥ||11||

Meaning of the commentary

The commentary says that the six signs are now shown for śoṣa produced by doṣas of moderate strength. Svarabheda is a rattling or hoarse voice.

Key terms

ṣaḍrūpa
Having six signs.
svarabheda
Change or breaking of voice.
śoṇitadarśana
Seeing blood (in sputum or elsewhere).

Adhikarana 11 (12-13) · Śloka 13

svarabhēdō'nilāñchūlaṁ saṁlōcaścāṁsapārśvayōḥ | jvarō dāhō'tisāraśca pittādraktasya cāgamaḥ ||12|| śirasaḥ paripūrṇatvamabhaktacchanda ēva ca | kāsaḥ kaṇṭhasya cōddhvaṁsō vijñēyaḥ kaphakōpataḥ ||13||

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स्वरभेदोऽनिलाञ्छूलं संलोचश्चांसपार्श्वयोः | ज्वरो दाहोऽतिसारश्च पित्ताद्रक्तस्य चागमः ||१२|| शिरसः परिपूर्णत्वमभक्तच्छन्द एव च | कासः कण्ठस्य चोद्ध्वंसो विज्ञेयः कफकोपतः ||१३||

Meaning of the śloka

From vāta: change of voice, pain, and a plucking sensation in the shoulders and sides. From pitta: fever, burning, loose stools and blood-tinged expectoration. From kapha: a feeling of fullness of the head, dislike of food, cough, and hoarseness or breaking of the throat.

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ṣaḍrūpāṇi nirdiśya dōṣabhēdēnaikādaśarūpāṇi balavatsamadōṣārabdhasya śōṣasya darśayannāha- svarabhēda ityādi| saṁlōcō luñcanamiva, aṁsayōḥ pārśvayōḥ; ‘saṁlōca’ ityatrānyē ‘saṅkōca’ iti paṭhanti, tatra saṅkōcanamivētyarthaḥ| śirasaḥ paripūrṇatvaṁ ‘kaphēna’ iti śēṣaḥ| abhaktacchandō bhaktāruciḥ| kaṇṭhasya cōddhvaṁsaḥ kaṇṭhabhaṅgaḥ; anyē uddhvaṁsa utkāsikēti vyākhyānayanti| svarabhēdādiliṅgatrayaṁ rājayakṣmaṇi vātēna, jvarādīni catvāri pittēna, śirasaḥ paripūrṇatvādīni catvāri kaphēna; ēvaṁ ṣaḍrūpāṇyapi vātādibhēdēna jñēyāni||12-13||

Meaning of the commentary

The commentary says that after naming the six signs, the eleven signs are now given by doṣa for śoṣa produced by a strong equal-measure of doṣas. Saṃloca is like plucking, in the shoulders and sides; others read 'saṅkoca', meaning like contraction. Fullness of the head is 'from kapha'. Abhaktacchanda is dislike of food. Kaṇṭhasya uddhvaṃsa is breaking of the throat; others explain uddhvaṃsa as frequent coughing. Change of voice and the next two signs in rājayakṣmā are from vāta; the four beginning with fever are from pitta; the four beginning with fullness of the head are from kapha. So the six signs too should be understood by vāta and the other doṣas.

Key terms

saṃloca
Plucking-like pain; variant saṅkoca means contraction.
abhaktacchanda
Dislike of food.
uddhvaṃsa
Breaking of the throat, or frequent cough per others.

Adhikarana 12 (14-15) · Śloka 15

ēkādaśabhirēbhirvā ṣaḍbhirvā'pi samanvitam | (kāsātīsārapārśvārtisvarabhēdārucijvaraiḥ ||14|| tribhirvā pīḍitaṁ liṅgairjvarakāsāsr̥gāmayaiḥ) | jahyācchōṣārditaṁ jantumicchan suvipulaṁ yaśaḥ ||15||

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एकादशभिरेभिर्वा षड्भिर्वाऽपि समन्वितम् | (कासातीसारपार्श्वार्तिस्वरभेदारुचिज्वरैः ||१४|| त्रिभिर्वा पीडितं लिङ्गैर्ज्वरकासासृगामयैः) | जह्याच्छोषार्दितं जन्तुमिच्छन् सुविपुलं यशः ||१५||

Meaning of the śloka

A patient afflicted with śoṣa who has all eleven of these signs, or six, should be given up by the physician who desires great fame. (The bracketed lines: with three signs, fever, cough and blood, also.)

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idānīṁ rūpaprastāvādbahurūpānvitasyāsādhyatvamāha- ēkādaśabhirityādi| ētairēbhiḥ svarabhēdō'nilācchūlamityādikaiḥ, ṣaḍbhirvā'pīti bhaktadvēṣō jvara ityādibhiḥ, apiśabdāttribhirvā śvāsakāsāsr̥gāmayaistantrāntarōktaiḥ, samanvitamiti samuccīyatē| jahyāditi tyajēt, paraṁ vahnau mandē balamāṁsakṣayē satīti bōddhavyam| nanu, sarvarūpādardhatrirūpau laghutarau, tatkathaṁ tāvapyasādhyau? ucyatē- balavahnayapacayē kālaprakarṣāttayōrapi mahattvāt; ētēna sarvarūpōpapanna ēvāsādhyaḥ, itarau tu kālaprakarṣēṇēti| ayaṁ pāṭhaḥ pustakāntarēṣvanyathā paṭhyatē, sa ca nibandhakārairna paṭhitaḥ||14-15||

Meaning of the commentary

The commentary says that having spoken of signs, the incurability of one with many signs is now stated. 'These eleven' are svarabheda, śūla and so on; 'six' are dislike of food, fever and so on; 'also' includes three signs from another tantra, breathlessness, cough and blood. 'Give up' means abandon, particularly when agni is weak and strength and flesh are depleted. An objection: the half-set of three and a half signs are milder, so why are they incurable? Reply: when strength and agni decline, with lapse of time even they become severe; so one with all the signs is incurable, and the other two only with lapse of time. The commentary adds that this text is read differently in other manuscripts, and the commentators did not read the bracketed lines.

Key terms

asādhya
Incurable, to be given up.
vahni-mandya (vahnimandya)
Weak digestive fire.
balamāṃsakṣaya
Depletion of strength and flesh.

Adhikarana 13 (16) · Śloka 16

vyavāyaśōkasthāviryavyāyāmādhvōpavāsataḥ | vraṇōraḥkṣatapīḍābhyāṁ śōṣananyē vadanti hi ||16||

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व्यवायशोकस्थाविर्यव्यायामाध्वोपवासतः | व्रणोरःक्षतपीडाभ्यां शोषनन्ये वदन्ति हि ||१६||

Meaning of the śloka

Others say there are (separate) śoṣas from sexual excess, grief, old age, exertion, travelling, fasting, and from the pain of wounds and chest injury.

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ēkīyamatēna śōṣabhēdānnirdiśannāha- vyavāyaśōkētyādi| vyavāyaḥ strīsēvā, śōkaḥ putrādiviyōgēna cittōdvēgaḥ, sthāviryaṁ vr̥ddhatvaṁ; anyē vārdhakyamiti paṭhanti, tatrāpyēkō'rthaḥ; vyāyāmaḥ śarīrāyāsajanakaṁ karma; adhvā dīrghamārgāṭanaṁ; vyavāyādyupavāsāntairhētubhistathā vraṇapīḍayā uraḥkṣatapīḍayā cānyē śōṣān vadantīti sambandhaḥ||16||

Meaning of the commentary

The commentary says that, according to another school, the types of śoṣa are now listed. Vyavāya is sexual indulgence; śoka is mental distress from separation from a son and the like; sthāvirya is old age (others read vārdhakya, with the same meaning); vyāyāma is exertion that tires the body; adhvā is long walking. By these causes up to fasting, and by wound pain and chest-injury pain, others describe (different) śoṣas.

Key terms

vyavāya
Sexual indulgence.
sthāvirya
Old age.
uraḥkṣata
Chest injury.

Adhikarana 14 (17) · Śloka 17

vyavāyaśōṣī śukrasya kṣayaliṅgairupadrutaḥ | pāṇḍudēhō yathāpūrvaṁ kṣīyantē cāsya dhātavaḥ ||17||

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व्यवायशोषी शुक्रस्य क्षयलिङ्गैरुपद्रुतः | पाण्डुदेहो यथापूर्वं क्षीयन्ते चास्य धातवः ||१७||

Meaning of the śloka

One with vyavāya-śoṣa is afflicted by the signs of depletion of semen, has a pale body, and the dhātus of that person waste in reverse order, one before the other.

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vyavāyaśōṣiṇō lakṣaṇānyāha- vyavāyētyādi| śukrasya kṣayaliṅgairiti ‘śukrakṣayē mēḍhravr̥ṣaṇavēdanā’ ityādibhiḥ| yathāpūrvamiti yathāpūrvaṁ tatra śukrasya pūrvaṁ majjā, majjñō'sthi, asthnō mēdaḥ, mēdasō māṁsaṁ, māṁsasya raktamityēvaṁ kṣīyantē dhātavaḥ prāgvadēva darśitanyāyāt, paraṁ yadi strībhyō na nivartatē||17||

Meaning of the commentary

The commentary says this gives the signs of vyavāya-śoṣa. The signs of semen depletion are those such as 'pain in the penis and testes' in the depletion of semen. 'As before' means that, following the sequence shown earlier, the dhātu before semen (majjā), then asthi, meda, māṃsa and rakta waste in turn, if he does not turn away from women.

Key terms

vyavāyaśoṣī
One wasting from sexual excess.
śukrakṣaya
Depletion of semen.
pāṇḍudeha
Pale body.

Adhikarana 15 (18) · Śloka 18

pradhyānaśīlaḥ srastāṅgaḥ śōkaśōṣyapi tādr̥śaḥ | vinā śukrakṣayakr̥tairvikārairabhilakṣitaḥ ||18||

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प्रध्यानशीलः स्रस्ताङ्गः शोकशोष्यपि तादृशः | विना शुक्रक्षयकृतैर्विकारैरभिलक्षितः ||१८||

Meaning of the śloka

One with shoka-śoṣa is given to brooding, has limp limbs, and is similar (to the previous), but is marked by the disorders without those due to depletion of semen.

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śōkaśōṣiṇamāha- pradhyānaśīla ityādi| pradhyānaśīlaḥ cintāparaḥ, srastāṅgaḥ avasannagātraḥ| tādr̥śa iti vyavāyaśōṣitavadabhilakṣitaḥ, paraṁ śukrakṣayakr̥tairliṅgairvinā; ētēna pāṇḍudēha ityarthaḥ||18||

Meaning of the commentary

The commentary says pradhyānaśīla means absorbed in worry and srastāṅga means with drooping limbs. 'Similar' means like the vyavāya-śoṣī, but without the signs from depletion of semen; thus he too has a pale body.

Key terms

pradhyānaśīla
Given to brooding or worry.
srastāṅga
With limp or drooping limbs.
śokaśoṣī
One wasting from grief.

Adhikarana 16 (19-20) · Śloka 20

jarāśōṣī kr̥śō mandavīryabuddhibalēndriyaḥ | kampanō'rucimān bhinnakāṁsyapātrahatasvaraḥ(naḥ) ||19|| ṣṭhīvati ślēṣmaṇā hīnaṁ gauravārucipīḍitaḥ | samprasrutāsyanāsākṣaḥ suptarūkṣamalacchaviḥ ||20||

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जराशोषी कृशो मन्दवीर्यबुद्धिबलेन्द्रियः | कम्पनोऽरुचिमान् भिन्नकांस्यपात्रहतस्वरः(नः) ||१९|| ष्ठीवति श्लेष्मणा हीनं गौरवारुचिपीडितः | सम्प्रस्रुतास्यनासाक्षः सुप्तरूक्षमलच्छविः ||२०||

Meaning of the śloka

One with jarā-śoṣa is emaciated, with poor virility, intellect, strength and senses, trembling, with distaste for food, and with a voice like a broken bronze vessel. He spits out phlegm that is thin, is troubled by heaviness and distaste, with watering of mouth, nose and eyes, with dull, dry and unclean complexion.

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jarāśōṣiṇamāha- jarāśōṣī kr̥śō mandētyādi| mandaśabdō vīryādibhiḥ pratyēkaṁ sambadhyatē, vīryaṁ śaktiḥ, balam ōjō hr̥di sthitaṁ saptadhātudhāmabhūtam| punararucikathanamatyantārōcakakhyāpanārtham | samprasrutētyādi samprasrutaśabda āsyādibhistribhiḥ pratyēkaṁ sambadhyatē| āsyaṁ mukhakuharam, akṣi lōcanam| suptarūkṣatvaṁ prabhāyāḥ, rūkṣatvaṁ ca malasya; yadyapi satparūkṣatvaṁ tvaci bhavati na prabhāyāṁ, tathā'pi ‘mañcāḥ krōśanti’ itivadupacārāt prabhāyāṁ bōddhavyam| jējjaṭācāryastu jarāśōṣiṇō lakṣaṇamatra na paṭhati, saptatēstūrdhvaṁ kṣīyamāṇētyādinā āturōpakramaṇīyē uktatvāt||19-20||

Meaning of the commentary

The commentary says 'manda' (weak) attaches to each of vīrya, buddhi, bala and indriya. Vīrya is capacity; bala is ojas resting in the heart, the abode of the seven dhātus. Aruci is stated again to emphasise extreme distaste for food. 'Flowing' attaches to mouth, nose and eyes. Asya is the oral cavity and akṣi the eye. 'Suptarūkṣa' is dull and dry complexion (prabhā) and dry excreta. Although dryness belongs to the skin and not the lustre, it is taken figuratively, as in 'the cots shout'. Jejjaṭācārya does not read the signs of jarā-śoṣī here, since they are given in the chapter on patient approach, beginning 'saptater ūrdhvaṃ kṣīyamāṇa'.

Key terms

jarāśoṣī
One wasting due to old age.
ojas
Vital essence seated in the heart (here called bala).
kāṃsyapātrahatasvara (bhinnakāṃsyapātrahatasvara)
Voice like a struck, cracked bronze vessel.

Adhikarana 17 (21) · Śloka 21

adhvapraśōṣī srastāṅgaḥ sambhr̥ṣṭaparuṣacchaviḥ | prasuptagātrāvayavaḥ śuṣkaklōmagalānanaḥ ||21||

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अध्वप्रशोषी स्रस्ताङ्गः सम्भृष्टपरुषच्छविः | प्रसुप्तगात्रावयवः शुष्कक्लोमगलाननः ||२१||

Meaning of the śloka

One with adhva-śoṣa (from travelling) has limp limbs, dry and rough skin, numb parts of the body, and dry sites such as the kloma, throat and mouth.

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adhvaśōṣiṇamāha- adhvapraśōṣītyādi| srastāṅgaḥ śithilagātrāvayavaḥ| prasuptamātrāvayava ityanēna akarmaṇyaśarīrapradēśa uktaḥ| śuṣkaśabdaḥ klōmādibhiḥ pratyēkaṁ sambadhyatē; klōma tilakam, ānanaṁ mukhakuharam| sambhr̥ṣṭaparuṣacchaviriti dagdhasyēva paruṣā chaviryasyētyarthaḥ; kēcit ‘sambhr̥ṣṭaparuṣacchaviḥ’ ityatra ‘saṁsr̥ṣṭaparuṣacchaviḥ’ iti paṭhitvā saṁsr̥ṣṭā paruṣā chaviḥ yasya sa iti vyākhyānayanti| yadyapi jarāśōṣyanantaraṁ vyāyāmaśōṣī vācyō nādhvaśōṣī, tathā'pyadhvaśōṣilakṣaṇānāṁ vyāyāmaśōṣiṇyatidēśāt pūrvamatrādhvaśōṣi nirdiṣṭaḥ| yadyēvaṁ tarhi vyāyāmaśōṣilakṣaṇānyēva kutō'dhvaśōṣiṇi nātidiśyantē? satyam, uraḥkṣataliṅgānāmadhikānāṁ vyāyāmaśōṣiṇi sadbhāvāt| kēcidatra ‘tr̥ḍaṅgamardadaurbalyapāruṣyairarditō'dhvanā’ iti pāṭhaṁ paṭhanti, tatrāpi sa ēvārthaḥ||21||

Meaning of the commentary

The commentary says srastāṅga means loose limbs. 'Numb parts' shows areas of the body that do not function. 'Dry' attaches to kloma (a site), throat and the like; kloma is tilaka, and ānana is the mouth cavity. Sambhṛṣṭaparuṣacchavi means having skin as if scorched and rough; some read 'saṃsṛṣṭaparuṣacchavi' and explain it as 'skin mixed with roughness'. Although after jarā-śoṣī the vyāyāma-śoṣī should be named next, the adhva-śoṣī is placed first because the vyāyāma-śoṣī's signs are extended from adhva-śoṣī. Why not extend the signs of vyāyāma-śoṣī to adhva-śoṣī? Because the vyāyāma-śoṣī has the additional signs of chest injury. Some read 'tṛḍaṅgamardadaurbalyapāruṣyair ardito 'dhvanā', with the same sense.

Key terms

adhvaśoṣī (adhvapraśoṣī)
One wasting from long travel.
kloma
A site in the body, glossed as tilaka.
paruṣacchavi
Rough skin.

Adhikarana 18 (22) · Śloka 22

vyāyāmaśōṣī bhūyiṣṭhamēbhirēva samanvitaḥ | uraḥkṣatakr̥tairliṅgaiḥ saṁyuktaśca kṣatādvinā ||22||

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व्यायामशोषी भूयिष्ठमेभिरेव समन्वितः | उरःक्षतकृतैर्लिङ्गैः संयुक्तश्च क्षताद्विना ||२२||

Meaning of the śloka

One with vyāyāma-śoṣa is mostly endowed with these same signs, and is joined by the signs due to chest injury, though without an actual wound.

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vyāyāmaśōṣiṇamāha- vyāyāmaśōṣī bhūyiṣṭhamityādi| ēbhirēvēti anantarōktaiḥ adhvaśōṣilakṣaṇairityarthaḥ| upavāsaśōṣilakṣaṇaṁ dōṣadhātumalakṣayavr̥ddhivijñānīyōktaṁ ‘tatra vātalāhārasēvina’ ityādikaṁ jñātavyam||22||

Meaning of the commentary

The commentary says 'these same' means the signs of the adhva-śoṣī just stated. The signs of upavāsa-śoṣa (from fasting) are to be known from the chapter on knowledge of increase and decrease of doṣa, dhātu and mala, beginning 'in that, one who eats vāta-increasing food'.

Key terms

vyāyāmaśoṣī
One wasting from excessive exertion.
uraḥkṣatakṛta liṅga (uraḥkṣatakṛtaliṅga)
Signs caused by chest injury.
upavāsaśoṣa
Wasting from fasting.

Adhikarana 19 (23) · Śloka 23

raktakṣayādvēdanābhistathaivāhārayantraṇāt | vraṇitasya bhavēcchōṣaḥ sa cāsādhyatamaḥ smr̥taḥ ||23||

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रक्तक्षयाद्वेदनाभिस्तथैवाहारयन्त्रणात् | व्रणितस्य भवेच्छोषः स चासाध्यतमः स्मृतः ||२३||

Meaning of the śloka

Wasting occurs in a person with a wound, from loss of blood, from pain, and likewise from restriction of food; that is held to be the most incurable.

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vraṇaśōṣilakṣaṇamāha- raktakṣayādityādi| vraṇaśōṣiṇō vaiśēṣikalakṣaṇānupadēśāt sāmānyalakṣaṇaṁ jñēyam| yadyēvaṁ kutō'sya pr̥thagabhidhānamiti cēt, viśiṣṭakāraṇatayā asādhyatamatvakhyātēḥ ||23||

Meaning of the commentary

The commentary says this gives the signs of vraṇa-śoṣa. Since no specific signs are taught for the vraṇa-śoṣī, the general signs are to be understood. The question of why it is then named separately is answered: it is declared the most incurable because of its distinct cause.

Key terms

vraṇaśoṣa
Wasting associated with a wound.
asādhyatama
Most incurable.
raktakṣaya
Loss or depletion of blood.

Adhikarana 20 (24-25) · Śloka 26

vyāyāmabhārādhyayanairabhighātātimaithunaiḥ | karmaṇā cāpyurasyēna vakṣō yasya vidāritam | tasyōrasi kṣatē raktaṁ pūyaḥ ślēṣmā ca gacchati ||24|| kāsamānaśchardayēcca pītaraktāsitāruṇam | santaptavakṣāḥ sō'tyarthaṁ dūyanātparitāmyati ||25|| durgandhavadanōcchvāsō bhinnavarṇasvarō naraḥ |26|

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व्यायामभाराध्ययनैरभिघातातिमैथुनैः | कर्मणा चाप्युरस्येन वक्षो यस्य विदारितम् | तस्योरसि क्षते रक्तं पूयः श्लेष्मा च गच्छति ||२४|| कासमानश्छर्दयेच्च पीतरक्तासितारुणम् | सन्तप्तवक्षाः सोऽत्यर्थं दूयनात्परिताम्यति ||२५|| दुर्गन्धवदनोच्छ्वासो भिन्नवर्णस्वरो नरः |२६|

Meaning of the śloka

A person whose chest has been torn by exertion, carrying weight, study, blows, excessive sexual activity, or by work with the chest (such as bow-drawing), has blood, pus and phlegm going from the wounded chest when he coughs. He vomits yellow, red, blackish or reddish matter, with a heated chest, is greatly tormented from severe pain, has foul-smelling mouth and breath, and a broken colour and voice.

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uraḥkṣataśōṣiṇamāha- vyāyāmētyādi| karmaṇā cāpyurasyēnēti dhanurākarṣaṇādinētyarthaḥ| kṣatē atidāritē| asitam īṣatkr̥ṣṇam, aruṇam īṣadraktam| dūyanāt ativēdanāt, paritāmyati mōhaṁ yāti| durgandhaśabdō vadanōcchvāsābhyāṁ sambadhyatē||24-25||-

Meaning of the commentary

The commentary says this describes uraḥkṣata-śoṣī. 'Work with the chest' means such as drawing a bow. Kṣata means torn deeply. Asita is slightly black; aruṇa slightly red. Dūyana means severe pain; paritāmyati means falls into confusion. 'Foul-smelling' attaches to both mouth and breath.

Key terms

uraḥkṣata
Chest injury or tearing.
pūya
Pus.
paritāmyati
Becomes faint or confused.

Adhikarana 21 (26) · Śloka 27

kēṣāñcidēvaṁ śōṣō hi kāraṇairbhēdamāgataḥ ||26|| na tatra dōṣaliṅgānāṁ samastānāṁ nipātanam |27|

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केषाञ्चिदेवं शोषो हि कारणैर्भेदमागतः ||२६|| न तत्र दोषलिङ्गानां समस्तानां निपातनम् |२७|

Meaning of the śloka

For some (teachers), śoṣa has thus been divided into types by causes; in these the signs of all the doṣas together do not occur.

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ēkīyamatamāha- kēṣāñcidityādi| kēṣāñcidācāryāṇāṁ matē ēvaṁ vyavāyādibhiranēkaiḥ kāraṇaiḥ kr̥tvā hi yasmāt śōṣō bhēdamāgataḥ; ata ēka ēva svamatē śōṣō nētarē vyavāyādijāḥ| kutō vyavāyādijāḥ śōṣā na bhavantītyāha- na tatrētyādi| tatra tēṣu vyavāyādijēṣu||26||-

Meaning of the commentary

The commentary says this states the view of some. According to some teachers, śoṣa becomes divided by many causes such as vyavāya; therefore in their own view śoṣa is one alone and the others arising from vyavāya and so on are not śoṣas. Why are those not śoṣas? 'In those the signs of all doṣas together do not occur.' 'In those' means in those from vyavāya and the like.

Key terms

bheda
Division or type.
samasta
All together.
doṣaliṅga
Signs of the doṣas.

Adhikarana 22 (27) · Śloka 27

kṣayā ēva hi tē jñēyāḥ pratyēkaṁ dhātusañjñitāḥ ||27||

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क्षया एव हि ते ज्ञेयाः प्रत्येकं धातुसञ्ज्ञिताः ||२७||

Meaning of the śloka

Those are to be known as depletions (kṣaya) only, each named according to its dhātu.

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yadi tē vyavāyādijāḥ śōṣāḥ na bhavanti tarhi kinnāmadhēyā bhavantītyāha- kṣayā ēvētyādi| tē vyavāyādijāḥ kṣayā ēva, kiṁviśiṣṭāḥ? pratyēkaṁ dhātusañjñitāḥ dhātukṣayasañjñakā ityarthaḥ| yataḥ śukramārabhya vilōmēna vyavāyādibhirdhātūnāṁ yathāpūrvaṁ saṅkṣayāt||27||

Meaning of the commentary

The commentary asks, if those from vyavāya and the like are not śoṣas, what are they called? It answers that they are kṣayas, each named for the dhātu depleted, because from semen onward, in reverse order, the dhātus are depleted in sequence by vyavāya and the like.

Key terms

kṣaya
Depletion.
dhātusaṃjñita
Named by the dhātu concerned.

Adhikarana 23 (28) · Śloka 28

cikitsitaṁ tu tēṣāṁ hi prāguktaṁ dhātusaṅkṣayē ||28||

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चिकित्सितं तु तेषां हि प्रागुक्तं धातुसङ्क्षये ||२८||

Meaning of the śloka

Their treatment has already been told in the context of dhātu depletion.

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tēṣāṁ kiñciccikitsitamāha- cikitsitaṁ tu tēṣāmityādi| dhātusaṅkṣayē dōṣadhātumalakṣayavr̥ddhivijñānīyādhyāyē||28||

Meaning of the commentary

The commentary says the treatment of these is given in the chapter on knowledge of the depletion and increase of doṣa, dhātu and mala.

Key terms

dhātusaṅkṣaya
Depletion of dhātus.
prāguktam
Already stated.

Adhikarana 24 (29-30) · Śloka 30

śvāsāṅgasādakaphasaṁsravatāluśōṣacchardyagnisādamadapīnasapāṇḍunidrāḥ | śōṣē bhaviṣyati bhavanti sa cāpi jantuḥ śuklēkṣaṇō bhavati māṁsaparō riraṁsuḥ ||29|| svapnēṣu kākaśukaśallakinīlakaṇṭhagr̥dhrāstathaiva kapayaḥ kr̥kalāsakāśca | taṁ vāhayanti sa nadīrvijalāśca paśyēcchuṣkāṁstarūn pavanadhūmadavārditāṁśca ||30||

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श्वासाङ्गसादकफसंस्रवतालुशोषच्छर्द्यग्निसादमदपीनसपाण्डुनिद्राः | शोषे भविष्यति भवन्ति स चापि जन्तुः शुक्लेक्षणो भवति मांसपरो रिरंसुः ||२९|| स्वप्नेषु काकशुकशल्लकिनीलकण्ठगृध्रास्तथैव कपयः कृकलासकाश्च | तं वाहयन्ति स नदीर्विजलाश्च पश्येच्छुष्कांस्तरून् पवनधूमदवार्दितांश्च ||३०||

Meaning of the śloka

Breathlessness, limb-sinking, kapha discharge, dryness of the palate, vomiting, weak agni, intoxication-like state, plumpness (or swelling), pallor and sleep will occur in śoṣa; and such a person has white eyes and is desirous of meat and of sexual pleasure. In dreams crows, parrots, shallakī, blue jays, vultures, likewise monkeys, kṛkalāsa (lizards) carry him off, and he sees rivers without water and dry trees afflicted by wind and forest fire.

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idānīmēkīyamataṁ pradarśya samprāptyanantaraṁ rājayakṣmaṇaḥ pūrvarūpāṇyāha- śvāsāṅgasādakaphasaṁsravētyādi| aṅgasādaḥ aṅgānāmanutsāhaḥ, agnisādaḥ agnimāndyam| madaḥ pūgaphalēnēva mattatā| māṁsaparō māṁsābhilāṣī| riraṁsuḥ rantumicchuḥ| śallakī gōdhānukārī vajraśakalaḥ, ‘śallaka’ iti lōkē prasiddhaḥ, nīlakaṇṭhō mayūraḥ, gr̥dhraḥ āmiṣāśī yōjanadr̥ṣṭiḥ| kapayō vānarāḥ| kr̥kalāsaḥ kr̥kaṇṭakaḥ ‘giragiṭa’ iti pūrvadēśīyā bhāṣantē| taṁ śōṣiṇaṁ, vāhayanti prāpayanti sa śōṣī| nanu, samprāptyanantaraṁ pūrvarūpēṣu vaktavyēṣu kathaṁ rūpāṇyabhidhāya pūrvarūpōpādānaṁ kr̥tam? ucyatē- rūpāṇyavyaktāni pūrvarūpāṇyasyēti pratipādanārtham||29-30||

Meaning of the commentary

The commentary says that after presenting the view of some, the forerunners of rājayakṣmā are given following its manifestation. Aṅgasāda is lack of enthusiasm of limbs; agnisāda is weak agni; mada is intoxication as if from areca nut. Māṃsapara is one wanting meat; riraṃsu is one wishing to enjoy. Shallakī is a kind of porcupine-like animal resembling godhā, well known as 'shallaka'; nīlakaṇṭha is the peacock; gṛdhra is the vulture, a flesh-eater that sees from a distance of a yojana; kapayaḥ are monkeys; kṛkalāsa is the lizard, called 'giragiṭa' in the east. 'Carry him off' means lead the śoṣī. An objection: why are the signs given first and the forerunners afterward, when forerunners should come after manifestation? Answer: to show that these are the signs unclear at first, whose forerunners are described.

Key terms

pūrvarūpa
Premonitory signs.
māṃsapara
Desirous of meat.
riraṃsu
Desirous of sexual pleasure.
śallakī
A porcupine-like animal in the commentary.

Adhikarana 25 (31) · Śloka 31

mahāśanaṁ kṣīyamāṇamatīsāranipīḍitam | śūnamuṣkōdaraṁ caiva yakṣmiṇaṁ parivarjayēt ||31||

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महाशनं क्षीयमाणमतीसारनिपीडितम् | शूनमुष्कोदरं चैव यक्ष्मिणं परिवर्जयेत् ||३१||

Meaning of the śloka

A yakṣmin who eats voraciously yet wastes, is afflicted by atisāra, and has swollen testes and abdomen, should be avoided (not undertaken).

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varjyamāha- mahāśanamityādi| muṣkō vr̥ṣaṇam| ‘yakṣmiṇam’ ityatrānyē ‘śōṣiṇam’ iti paṭhanti||31||

Meaning of the commentary

The commentary says this states who is to be avoided. Muṣka is the testis. Others read 'śoṣiṇam' in place of 'yakṣmiṇam'.

Key terms

mahāśana
Eating excessively.
varjayet (parivarjayet)
Should avoid or decline (to treat).
yakṣmin
One afflicted with yakṣmā.

Adhikarana 26 (32) · Śloka 32

upācarēdātmavantaṁ dīptāgnimakr̥śaṁ navam |32|

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उपाचरेदात्मवन्तं दीप्ताग्निमकृशं नवम् |३२|

Meaning of the śloka

One should treat the person who is self-controlled, with kindled agni, not emaciated, and (the disease) recent.

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upakramyamāha- upācarēdātmavantamityādi| ātmavantaṁ jitēndriyam|32|-

Meaning of the commentary

The commentary says this states who is to be treated. Ātmavān means one who has conquered the senses.

Key terms

ātmavān
Self-controlled; one who has conquered the senses per the commentary.
dīptāgni
With kindled digestive fire.
nava
Recent.

Adhikarana 27 (32-33) · Śloka 33

sthirādivargasiddhēna ghr̥tēnājāvikēna ca ||32|| snigdhasya mr̥du kartavyamūrdhvaṁ cādhaśca śōdhanam | āsthāpanaṁ tathā kāryaṁ śirasaśca virēcanam ||33||

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स्थिरादिवर्गसिद्धेन घृतेनाजाविकेन च ||३२|| स्निग्धस्य मृदु कर्तव्यमूर्ध्वं चाधश्च शोधनम् | आस्थापनं तथा कार्यं शिरसश्च विरेचनम् ||३३||

Meaning of the śloka

For one oleated with ghṛta cooked with the sthirādi group and with goat or sheep ghṛta, a mild cleansing upward and downward should be done. Āsthāpana and cleansing of the head (śiras-virecana) should also be done.

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tadēva cikitsitamāha- sthirādivargasiddhēnētyādi| sthirādiḥ vidārigandhādiḥ| mr̥du yat karśanaṁ na bhavatītyarthaḥ| āsthāpanaṁ nirūhaḥ| tathēti mr̥dvityarthaḥ| śirasō virēcanaṁ nasyam||32-33||

Meaning of the commentary

The commentary says this states that treatment. Sthirādi is the vidārigandhādi group. 'Mild' means that which does not cause emaciation. Āsthāpana is nirūha basti; 'likewise' means mild. Śirovirecana is nasya.

Key terms

sthirādivarga
The vidārigandhādi group of drugs.
śodhana
Cleansing therapy.
āsthāpana
Nirūha basti.
śirovirecana
Cleansing of the head, nasya.

Adhikarana 28 (34) · Śloka 34

yavagōdhūmaśālīṁśca rasairbhuñjīta śōdhitaḥ |34|

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यवगोधूमशालींश्च रसैर्भुञ्जीत शोधितः |३४|

Meaning of the śloka

After cleansing, he should eat barley, wheat and śāli rice with meat juices.

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śōdhitasya paścātkarma āha- yavagōdhūmētyādi| rasaiḥ jāṅgalamāṁsarasaiḥ|34|-

Meaning of the commentary

The commentary says this states what follows after the cleansing. 'Juices' means the juices of jāṅgala meat.

Key terms

śāli
A variety of rice.
jāṅgalamāṃsarasa
Juice of meat of dry-land animals.

Adhikarana 29 (34) · Śloka 34

dr̥ḍhē'gnau br̥ṁhayēccāpi nivr̥ttōpadravaṁ naram ||34||

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दृढेऽग्नौ बृंहयेच्चापि निवृत्तोपद्रवं नरम् ||३४||

Meaning of the śloka

When agni is firm, he should also be given nourishing (bṛṃhaṇa) treatment, the person whose complications have subsided.

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br̥ṁhaṇaviṣayamāha- dr̥ḍhē'gnāvityādi| nivr̥ttōpadravamiti praśāntasvarabhēdādikamityarthaḥ||34||

Meaning of the commentary

The commentary says this states the field of nourishing therapy. 'Whose complications have subsided' means in whom voice change and the like have settled.

Key terms

bṛṃhaṇa
Nourishing, bulk-promoting therapy.
nivṛttopadrava
One whose complications have subsided.

Adhikarana 30 (35) · Śloka 35

vyavāyaśōṣiṇaṁ prāyō bhajantē vātajā gadāḥ | br̥ṁhaṇīyō vidhistasmai hitaḥ snigdhō'nilāpahaḥ ||35||

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व्यवायशोषिणं प्रायो भजन्ते वातजा गदाः | बृंहणीयो विधिस्तस्मै हितः स्निग्धोऽनिलापहः ||३५||

Meaning of the śloka

Vāta disorders mostly attach to one wasting from sexual excess; therefore a nourishing, unctuous, vāta-relieving regimen is suitable for him.

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idānīṁ vyavāyaśōṣiṇō viśiṣṭaṁ cikitsitamāha- vyavāyētyādi| ‘vyavāyaśōṣiṇam’ ityādivākyaṁ kēcinnēcchanti, ‘kriyāṇāṁ cāvibhāgēna’ ityuktasya vyāghātāt||35||

Meaning of the commentary

The commentary says a specific treatment for the vyavāya-śoṣī is now given. Some do not accept the sentence beginning 'vyavāyaśoṣiṇam', because it conflicts with the earlier statement that treatments are not divided ('kriyāṇāṃ cāvibhāgena').

Key terms

vyavāyaśoṣī (vyavāyaśoṣin)
One wasting from sexual excess.
vātajā gadāḥ
Vāta-born disorders.
bṛṃhaṇīya
Nourishing.

Adhikarana 31 (36-39) · Śloka 39

kākānulūkānnakulān biḍālān gaṇḍūpadān vyālabilēśayākhūn | gr̥dhrāṁśca dadyādvividhaiḥ pravādaiḥ sasaindhavān sarṣapatailabhr̥ṣṭān ||36|| dēyāni māṁsāni ca jāṅgalāni mudgāḍhakīsūparasāśca hr̥dyāḥ | kharōṣṭranāgāśvatarāśvajāni dēyāni māṁsāni sukalpitāni ||37|| māṁsōpadaṁśāṁśca pibēdariṣṭān mārdvīkayuktān madirāśca sēvyāḥ | arkāmr̥tākṣārajalōṣitēbhyaḥ kr̥tvā yavēbhyō vividhāṁśca bhakṣyān ||38|| khādēt, pibēt sarpirajāvikaṁ vā kr̥śō yavāgvā saha bhaktakālē | sarpirmadhubhyāṁ trikaṭu pralihyāccavyāviḍaṅgōpahitaṁ kṣayārtaḥ ||39||

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काकानुलूकान्नकुलान् बिडालान् गण्डूपदान् व्यालबिलेशयाखून् | गृध्रांश्च दद्याद्विविधैः प्रवादैः ससैन्धवान् सर्षपतैलभृष्टान् ||३६|| देयानि मांसानि च जाङ्गलानि मुद्गाढकीसूपरसाश्च हृद्याः | खरोष्ट्रनागाश्वतराश्वजानि देयानि मांसानि सुकल्पितानि ||३७|| मांसोपदंशांश्च पिबेदरिष्टान् मार्द्वीकयुक्तान् मदिराश्च सेव्याः | अर्कामृताक्षारजलोषितेभ्यः कृत्वा यवेभ्यो विविधांश्च भक्ष्यान् ||३८|| खादेत्, पिबेत् सर्पिरजाविकं वा कृशो यवाग्वा सह भक्तकाले | सर्पिर्मधुभ्यां त्रिकटु प्रलिह्याच्चव्याविडङ्गोपहितं क्षयार्तः ||३९||

Meaning of the śloka

One may give crows, owls, mongooses, cats, earthworms, animals living in holes, rats, and vultures under various pretexts, with rock salt, fried in mustard oil. Jāṅgala meats and delicious soups of mudga and āḍhakī are to be given; meats of donkey, camel, elephant and mule, and of goat and sheep, well prepared, are to be given. He may drink ariṣṭas with meat as accompaniment, with mārdvīka, and liquors are to be used; he should eat various foods made from barley soaked in solution of arka, guḍūcī and kṣāra. The emaciated may drink goat or sheep ghṛta with yavāgū at mealtime; and one wasted by kṣaya may lick trikaṭu with ghṛta and honey, with cavya and viḍaṅga added.

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śōṣiṇāṁ yāni māṁsānyādēyāni tānyāha- kākānulūkānnakulānityādi| biḍālā grāmyādibhēdēna ṣaṭprakārā mārjārāḥ; tathā ca- “grāmyō vanyastōyajātaḥ pakṣimārjāravijjakau| sugandhavr̥ṣaṇaścēti mārjārāḥ ṣaṭ prakīrtitāḥ”- iti| vyālā vyāghrādayaḥ, bilēśayāḥ śvāvicchallakīprabhr̥tayaḥ ākhuratra vr̥kṣamūṣikaḥ| vividhaiḥ pravādairiti “kākāṁstittiriśabdēna matsyaśabdēna cōragān| bhr̥ṣṭamatsyāntraśabdēna dadyādgaṇḍūpadānapi” ityādibhirnānāprakārairvacanaiḥ| ēvaṁ prakārēṇa dānē kiṁ prayōjanamiti cēt? ajugupsayā bhakṣaṇaṁ bhakṣitasya cānullēkhanam| tathā cōktaṁ- “jānan jugupsurnaivādyādbhuktaṁ vā punarullikhēt| tasmācchadmōpasiddhāni māṁsānyētāni dāpayēt”- iti| jāṅgalāni jaṅghālaviṣkirapratudajāni, śēṣajāṅgalavargāṇāmatra viśēṣēṇābhidhānat| yadyapi jāṅgalaśabdēnaiva gr̥dhrādayō'pi labdhāḥ, tathā'pyatyantabr̥ṁhaṇatvādgr̥dhrādīnāṁ pr̥thagupādānam| mudgāḍhakīsūparasāḥ srōtaḥśuddhikatvāddēyāḥ| nāgō hastī, aśvatarō vēśaraḥ| sukalpitāni vēśavārīkr̥tāni nānāprakāraprakalpitāni | tathā ca vr̥ddhabhōjaḥ- “kharōṣṭrāśvataraṁ nāgaṁ māṁsaṁ māṁsābhivr̥ddhayē| dadyānmāhiṣaśabdēna vēsavārīkr̥taṁ bhiṣak”- iti| māṁsōpadaṁśānariṣṭān abhayāriṣṭaprabhr̥tīn, mārdvīkayuktān drākṣāsavayuktān, madirā madyam| bhakṣyānnirdēṣṭumāha- arkāmr̥takṣārajalōṣitēbhya ityādi| arkaguḍūcīkṣārapānīyōṣitēbhyō yavēbhyō bhakṣyān kr̥tvā khādēditi sambandhaḥ| uṣitēbhyō rātrau sthitēbhyaḥ| arkādibhasma caturguṇēna jalēna gālayitvā pacēdyāvadardhāvaśiṣṭaṁ bhavati| tathā cōktaṁ- “pānāya bhōjanāyātha bhasma srāvyaṁ caturguṇē| jalē'rdhamavaśiṣṭē(ṣṭaṁ) tu kṣārāmbhō grāhyamiṣyatē”- iti| pibēdityādi| ajāvikaṁ vēti ājaṁ vā āvikaṁ vētyarthaḥ| ajētyatra hrasvatvaṁ chandō'nurōdhāt| bhaktakālē bhōjanakālē| sarpirmadhubhyāmityādi| upahitaṁ saṁyuktam||36-39||

Meaning of the commentary

The commentary lists the flesh-foods for śoṣins. Biḍāla means cats of six kinds (domestic, wild, aquatic, and so on) as per a quoted verse. Vyāla are tigers and similar; bileśaya are dog-like animals and śallakī; ākhu here is the tree-rat. 'Under various pretexts' means using other names, as in quoted lines (such as calling crows 'tittiri' and earthworms 'fish'). The purpose is to avoid disgust in eating and vomiting after eating, citing that one who knows and is disgusted will not eat or will vomit; therefore they should be given disguised. Jāṅgala means the game-animal groups; the vultures and others are named separately for their very strong nourishing power. Soups of mudga and āḍhakī are to be given because they cleanse the channels. Nāga is elephant; aśvatara is mule; 'well prepared' means made into veśavāra. Ariṣṭas are abhayāriṣṭa and similar; mārdvīka means with grape āsava; madirā is liquor. For the foods: barley soaked overnight in water strained from ash of arka, guḍūcī and kṣāra (one part ash with four parts water, reduced to half). 'Ajāvika' means of goat or of sheep.

Key terms

jāṅgala
Meat of dry-land animals.
ariṣṭa
Fermented medicinal preparation.
veśavāra
A minced-meat style preparation.
kṣāra
Alkali from plant ash.

Adhikarana 32 (40) · Śloka 40

māṁsādamāṁsēṣu ghr̥taṁ ca siddhaṁ śōṣāpahaṁ kṣaudrakaṇāsamētam |40|

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मांसादमांसेषु घृतं च सिद्धं शोषापहं क्षौद्रकणासमेतम् |४०|

Meaning of the śloka

Ghṛta cooked with the meat of flesh-eating animals, with honey and kaṇā (pippalī), is remover of śoṣa.

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māṁsādamāṁsēṣvityādi| māṁsādā gr̥dhrādayaḥ, tanmāṁsarasē caturguṇē siddhaṁ sarpiḥ kṣaudrapippalīyuktaṁ śōṣāpahaṁ bhavati| kṣaudrakaṇētyatra dantikaṇēti kēcit paṭhanti|40|-

Meaning of the commentary

The commentary says māṃsāda means vultures and similar. Ghṛta cooked in four times their meat juice, with honey and pippalī, removes śoṣa. Some read 'dantikaṇā' for 'kṣaudrakaṇā'.

Key terms

māṃsāda
Flesh-eating creature, e.g. vulture.
kaṇā
Pippalī.

Adhikarana 33 (41) · Śloka 41

drākṣāsitāmāgadhikāvalēhaḥ sakṣaudratailaḥ kṣayarōgaghātī ||40|| ghr̥tēna cājēna samākṣikēṇa turaṅgagandhātilamāṣacūrṇam |41|

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द्राक्षासितामागधिकावलेहः सक्षौद्रतैलः क्षयरोगघाती ||४०|| घृतेन चाजेन समाक्षिकेण तुरङ्गगन्धातिलमाषचूर्णम् |४१|

Meaning of the śloka

A lick of drākṣā, sugar and pippalī, with honey and oil, destroys kṣayaroga. Powder of aśvagandhā, sesame and māṣa with goat ghṛta and honey is also to be licked.

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drākṣētyādi| avalēhō'yam|41|-

Meaning of the commentary

The commentary says only that this is an avaleha (medicinal lick).

Key terms

avaleha
Medicinal lick.
turaṅgagandhā
Aśvagandhā.
kṣayaroga
Wasting disease.

Adhikarana 34 (41) · Śloka 41

sitāśvagandhāmagadhōdbhavānāṁ cūrṇaṁ ghr̥takṣaudrayutaṁ pralihyāt ||41||

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सिताश्वगन्धामगधोद्भवानां चूर्णं घृतक्षौद्रयुतं प्रलिह्यात् ||४१||

Meaning of the śloka

A powder of sugar, aśvagandhā and pippalī, mixed with ghṛta and honey, may be licked.

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sitāśvagandhētyādi| sitā śarkarā, magadhōdbhavā pippalī||41||

Meaning of the commentary

The commentary says sitā is sugar and magadhodbhavā is pippalī.

Key terms

sitā
Sugar.
magadhodbhavā
Pippalī.

Adhikarana 35 (42) · Śloka 42

kṣīraṁ pibēdvā'pyatha vājigandhāvipakvamēvaṁ labhatē'ṅgapuṣṭim |42|

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क्षीरं पिबेद्वाऽप्यथ वाजिगन्धाविपक्वमेवं लभतेऽङ्गपुष्टिम् |४२|

Meaning of the śloka

Or he may drink milk cooked with aśvagandhā, and in this way gains bodily nourishment.

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kṣīramityādi| vājigandhāvipakvaṁ sāmānyakṣīrapākaparibhāṣayā| vājigandhā aśvagandhā|42|-

Meaning of the commentary

The commentary says the milk is cooked according to the general convention for cooking milk. Vājigandhā is aśvagandhā.

Key terms

vājigandhā
Aśvagandhā.
aṅgapuṣṭi
Nourishment of the body.

Adhikarana 36 (42) · Śloka 42

tadutthitaṁ kṣīraghr̥taṁ sitāḍhyaṁ prātaḥ pibēdvā'pi payōnupānam ||42||

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तदुत्थितं क्षीरघृतं सिताढ्यं प्रातः पिबेद्वाऽपि पयोनुपानम् ||४२||

Meaning of the śloka

Milk-ghṛta arising from that (milk), rich in sugar, may be drunk in the morning, followed by milk as an after-drink (anupāna).

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tadutthitaṁ kṣīraghr̥tamityādi| tadutthitam aśvagandhāvipakvakṣīrōtthaṁ, kṣīraghr̥taṁ kṣīradvilōḍitādudbhūtaṁ ghr̥tam||42||

Meaning of the commentary

The commentary says 'arising from that' means from the milk cooked with aśvagandhā. Kṣīraghṛta is ghṛta obtained from milk after churning.

Key terms

anupāna
Vehicle or drink taken after a medicine.
kṣīraghṛta
Ghee obtained from milk.

Adhikarana 37 (43) · Śloka 43

utsādanē cāpi turaṅgagandhā yōjyā yavāścaiva punarnavē ca |43|

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उत्सादने चापि तुरङ्गगन्धा योज्या यवाश्चैव पुनर्नवे च |४३|

Meaning of the śloka

For utsādana (rubbing/anointing), aśvagandhā, barley and punarnavā are to be used.

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udvartanamupacaryārthamāha- utsādanē ityādi| utsādanam udvartanam| turaṅgagandhā aśvagandhā| punarnavē śvētaraktē dvē| nanu, śōṣē br̥ṁhaṇamupayujyatē, ētāśca vilēkhanāḥ, tataḥ kathaṁ tadupayōgaḥ? satyaṁ, bāhyōpayōgēna tēṣāṁ br̥ṁhaṇatvēnōpayōgāt|43|-

Meaning of the commentary

The commentary says utsādana is udvartana (rubbing with powders). Turaṅgagandhā is aśvagandhā; the two punarnavās are the white and red. An objection: nourishing measures are used in śoṣa, but these are scraping (vilekhana) agents, so how are they used? Reply: yes, but used externally they serve as nourishing.

Key terms

utsādana
Rubbing with powder or paste.
udvartana
Dry powder massage.
vilekhana
Scraping (reducing) property.

Adhikarana 38 (43) · Śloka 44

kr̥tsnē vr̥ṣē tatkusumaiśca siddhaṁ sarpiḥ pibētkṣaudrayutaṁ hitāśī ||43|| yakṣmāṇamētat prabalaṁ ca kāsaṁ śvāsaṁ ca hanyādapi pāṇḍutāṁ ca |44|

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कृत्स्ने वृषे तत्कुसुमैश्च सिद्धं सर्पिः पिबेत्क्षौद्रयुतं हिताशी ||४३|| यक्ष्माणमेतत् प्रबलं च कासं श्वासं च हन्यादपि पाण्डुतां च |४४|

Meaning of the śloka

Ghṛta cooked with the whole vṛṣa (vāsā) and its flowers, taken with honey by one keeping a wholesome diet, destroys yakṣmā, severe cough, breathlessness and pallor.

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kr̥tsnē ityādi| kr̥tsnē vr̥ṣē iti samūlapatraśākhāṅkurē| vāsakāṅgēbhyaḥ kvāthē, tatkusumaiḥ vāsakapuṣpaiḥ, ‘kalkīkr̥taiḥ’ iti śēṣaḥ| siddhaṁ sarpiriti caturguṇakvāthēna puṣpakalkēnāṣṭamabhāgēna ca| tathā cōktaṁ,- “śaṇasya kōvidārasya vr̥ṣasya ca pr̥thak pr̥thak| kalkāḍhyatvānna śaṁsanti puṣpakalpaṁ catuṣpalam”- iti||43||-

Meaning of the commentary

The commentary says 'whole vṛṣa' means the plant with roots, leaves, branches and shoots, as a decoction of the parts of vāsaka. Its flowers are the vāsaka flowers, made into a paste. The ghṛta is cooked with a four-times decoction and one-eighth flower paste. A quoted line says that śaṇa, kovidāra and vṛṣa flowers are not recommended in the four-pala paste-rich form.

Key terms

vṛṣa
Vāsaka (adhatoda), per the commentary.
hitāśin
One who eats wholesome food.
pāṇḍutā
Pallor.

Adhikarana 39 (44-45) · Śloka 46

śakr̥drasā gōśvagajāvyajānāṁ kvāthā mitāścāpi tathaiva bhāgaiḥ ||44|| mūrvāharidrākhadiradrumāṇāṁ kṣīrasya bhāgastvaparō ghr̥tasya | bhāgān daśaitān vipacēdvidhijñō dattvā trivargaṁ madhuraṁ ca kr̥tsnam ||45|| kaṭutrikaṁ caiva sabhadradāru ghr̥tōttamaṁ yakṣmanivāraṇāya |46|

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शकृद्रसा गोश्वगजाव्यजानां क्वाथा मिताश्चापि तथैव भागैः ||४४|| मूर्वाहरिद्राखदिरद्रुमाणां क्षीरस्य भागस्त्वपरो घृतस्य | भागान् दशैतान् विपचेद्विधिज्ञो दत्त्वा त्रिवर्गं मधुरं च कृत्स्नम् ||४५|| कटुत्रिकं चैव सभद्रदारु घृतोत्तमं यक्ष्मनिवारणाय |४६|

Meaning of the śloka

The juices of the dung of cow, horse, elephant, sheep and goat, and decoctions of mūrvā, haridrā and khadira are measured in portions; another portion is milk and another ghṛta. The knowledgeable physician should cook these ten portions, adding the trivarga, the entire sweet group, kaṭutrika and bhadradāru; this is an excellent ghṛta for warding off yakṣmā.

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śakr̥drasā ityādi| gōśvagajāvicchagalīnāṁ pratyēkaṁ śakr̥drasāḥ, tathaiva mūrvāharidrākhadiradrumāṇāṁ kvāthabhāgairmitāḥ svalpā bhāgāḥ, tathā kṣīrasyāparō navamō bhāgaḥ, ghr̥tasya daśama iti , ētān daśabhāgān trivargādikēna kalkēna vipacēditi sambandhaḥ| mūrvā cōrasnāyuḥ| khadiradrumāṇāmiti drumagrahaṇaṁ madhyamavayasaḥ khadirasya grahaṇārtham| trivargaḥ triphalā| madhuraṁ ca kr̥tsnaṁ kākōlyādikam; aparē'ṣṭavargamāhuḥ||44-45||-

Meaning of the commentary

The commentary says dung-juice of cow, horse, elephant, sheep and goat is each measured in small portions, with decoctions of mūrvā, haridrā and khadira, milk as a ninth portion and ghṛta as a tenth; these ten portions are cooked with the paste of trivarga and the rest. Mūrvā is corasnāyu. The word 'druma' in khadira indicates a middle-aged khadira tree. Trivarga is triphalā; the entire sweet group is kākolī and the like, though others say the aṣṭavarga.

Key terms

śakṛdrasa
Juice expressed from dung.
trivarga
Triphalā, per the commentary.
kaṭutrika
Trikaṭu.
bhadradāru
A drug named in the formula (devadāru).

Adhikarana 40 (46-48) · Śloka 48

dvē pañcamūlyau varuṇaṁ karañjaṁ bhallātakaṁ bilvapunarnavē ca ||46|| yavān kulatthān badarāṇi bhārgīṁ pāṭhāṁ hutāśaṁ samahīkadambam | kr̥tvā kaṣāyaṁ vipacēddhi tasya ṣaḍbhirhi pātrairghr̥tapātramēkam ||47|| vyōṣaṁ mahāvr̥kṣapayō'bhayāṁ ca cavyaṁ surākhyaṁ lavaṇōttamaṁ ca | ētaddhi śōṣaṁ jaṭharāṇi caiva hanyāt pramēhāṁśca sahānilēna ||48||

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द्वे पञ्चमूल्यौ वरुणं करञ्जं भल्लातकं बिल्वपुनर्नवे च ||४६|| यवान् कुलत्थान् बदराणि भार्गीं पाठां हुताशं समहीकदम्बम् | कृत्वा कषायं विपचेद्धि तस्य षड्भिर्हि पात्रैर्घृतपात्रमेकम् ||४७|| व्योषं महावृक्षपयोऽभयां च चव्यं सुराख्यं लवणोत्तमं च | एतद्धि शोषं जठराणि चैव हन्यात् प्रमेहांश्च सहानिलेन ||४८||

Meaning of the śloka

Making a decoction of the two pañcamūlas, varuṇa, karañja, bhallātaka, bilva, punarnavā, barley, kulattha, badara, bhārgī, pāṭhā, citraka and mahīkadamba, one should cook one vessel of ghṛta with six vessels of it, adding vyoṣa, the milk of mahāvṛkṣa, abhayā, cavya, devadāru and the best of salts. This destroys śoṣa, jaṭhara diseases and also pramehas along with vāta.

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dvē pañcamūlyāvityādi| dvē pañcamūlyau daśamūlamityarthaḥ| bilvasya pr̥thakpāṭhādatra phalaṁ grāhyam| hutāśaḥ citrakaḥ, mahīkadambō muṇḍitikā| kr̥tvā kaṣāyamiti daśamūlādīnāmaṣṭaṣaṣṭyadhikāni saptaśatapalāni caturguṇēnāmbhasā niṣkvāthya caturbhāgāvaśiṣṭaḥ kvāthō grāhyaḥ| tasya kvāthasya, pātraiḥ āḍhakaiḥ| kalkadravyāṇyāha- vyōṣamityādi| vyōṣaṁ trikaṭukaṁ, mahāvr̥kṣapayaḥ sēhuṇḍakṣīraṁ, surākhyaṁ dēvadāru, lavaṇōttamaṁ saindhavam; kēcit ‘lavaṇōttamam’ ityatra ‘magadhōdbhavāṁ’ iti paṭhitvā pippalīmiti vyākhyānayanti| pramēhāṁśca sahānilēnēti vātikānapipramēhān hantītyarthaḥ; ētacca stutiparaṁ , vātikamēhānāmasādhyatvāt||46-48||

Meaning of the commentary

The commentary says the two pañcamūlas mean daśamūla. Since bilva is read separately, its fruit is meant here. Hutāśa is citraka, mahīkadamba is muṇḍitikā. For the decoction, 768 palas of the dashamūla and others are boiled with four times water and reduced to a quarter; 'vessels' are āḍhakas. The paste ingredients are vyoṣa (trikaṭu), mahāvṛkṣa milk (sehuṇḍa milk), surākhya (devadāru) and best salt (saindhava); some read 'magadhodbhavām' for 'lavaṇottamam' and take it as pippalī. Destroys 'pramehas with vāta' means vātika prameha; this is praise, since vātika prameha is incurable.

Key terms

dvipañcamūlī (dve pañcamūlyau)
Daśamūla, ten roots.
mahāvṛkṣapayas
Milk (latex) of sehuṇḍa.
jaṭhara
Abdominal disorders.
prameha
A classical urinary/metabolic disorder category.

Adhikarana 41 (49) · Śloka 49

gōśvāvyajēbhaiṇakharōṣṭrajātaiḥ śakr̥drasakṣīrarasakṣatōtthaiḥ | drākṣāśvagandhāmagadhāsitābhiḥ siddhaṁ ghr̥taṁ yakṣmavikārahāri ||49||

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गोश्वाव्यजेभैणखरोष्ट्रजातैः शकृद्रसक्षीररसक्षतोत्थैः | द्राक्षाश्वगन्धामगधासिताभिः सिद्धं घृतं यक्ष्मविकारहारि ||४९||

Meaning of the śloka

Ghṛta cooked with the dung juice, milk, meat juice and blood of cow, horse, sheep, goat, elephant, antelope and camel, and with a paste of drākṣā, aśvagandhā, pippalī and sugar, removes the disorders of yakṣmā.

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gōśvāvyajēbhaiṇētyādi| gōśvādīnāṁ śakr̥drasakṣīramāṁsarasarudhiraiḥ drākṣādīnāṁ kalkēna siddhaṁ ghr̥taṁ yakṣmavikārān hantīti sambandhaḥ| ibhā hastinī, ēṇaḥ kr̥ṣṇasāraḥ| kṣīraṁ yathāsambhavaṁ grāhyaṁ, na tu sarvēṣām||49||

Meaning of the commentary

The commentary says ghṛta cooked with the dung, juice, milk, meat juice and blood of cow, horse and the rest, with paste of drākṣā and the rest, destroys yakṣmā disorders. Ibhā is the female elephant; eṇa is the black antelope. Milk is to be taken as available, not necessarily from all.

Key terms

yakṣmavikāra
Disorders of yakṣmā.
rudhira
Blood.
eṇa
Black antelope.

Adhikarana 42 (50-54) · Śloka 54

ēlājamōdāmalakābhayākṣagāyatryariṣṭāsanaśālasārān | viḍaṅgabhallātakacitrakōgrākaṭutrikāmbhōdasurāṣṭrajāṁśca ||50|| paktvā jalē tēna pacēddhi sarpistasmin susiddhē tvavatāritē ca | triṁśatpalānyatra sitōpalāyā dattvā tugākṣīripalāni ṣaṭ ca ||51|| prasthē ghr̥tasya dviguṇaṁ ca dadyāt kṣaudraṁ tatō manthahataṁ vidadhyāt | palaṁ palaṁ prātarataḥ pralihya paścāt pibēt kṣīramatandritaśca ||52|| ētaddhi mēdhyaṁ paramaṁ pavitraṁ cakṣuṣyamāyuṣyamathō yaśasyam | yakṣmāṇamāśu vyapahanti caitat pāṇḍvāmayaṁ caiva bhagandaraṁ ca ||53|| śvāsaṁ ca hanti svarabhēdakāsahr̥tplīhagulmagrahaṇīgadāṁśca | na cātra kiñcit parivarjanīyaṁ rasāyanaṁ caitadupāsyamānam ||54||

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एलाजमोदामलकाभयाक्षगायत्र्यरिष्टासनशालसारान् | विडङ्गभल्लातकचित्रकोग्राकटुत्रिकाम्भोदसुराष्ट्रजांश्च ||५०|| पक्त्वा जले तेन पचेद्धि सर्पिस्तस्मिन् सुसिद्धे त्ववतारिते च | त्रिंशत्पलान्यत्र सितोपलाया दत्त्वा तुगाक्षीरिपलानि षट् च ||५१|| प्रस्थे घृतस्य द्विगुणं च दद्यात् क्षौद्रं ततो मन्थहतं विदध्यात् | पलं पलं प्रातरतः प्रलिह्य पश्चात् पिबेत् क्षीरमतन्द्रितश्च ||५२|| एतद्धि मेध्यं परमं पवित्रं चक्षुष्यमायुष्यमथो यशस्यम् | यक्ष्माणमाशु व्यपहन्ति चैतत् पाण्ड्वामयं चैव भगन्दरं च ||५३|| श्वासं च हन्ति स्वरभेदकासहृत्प्लीहगुल्मग्रहणीगदांश्च | न चात्र किञ्चित् परिवर्जनीयं रसायनं चैतदुपास्यमानम् ||५४||

Meaning of the śloka

A long formula: elā, ajamodā, āmalaka, abhayā, akṣa, gāyatrī, ariṣṭa, asana and śāla heartwood; viḍaṅga, bhallātaka, citraka, ugrā, kaṭutrika, ambhoda and surāṣṭrajā are cooked in water; a ghṛta is cooked with that decoction. When it is well done and removed, thirty palas of sugar and six palas of tugākṣīrī are added, twice the ghṛta's measure of honey is put in and it is churned. One should lick a pala each morning and afterwards drink milk without laziness. This is said to be excellent for the intellect, purifying, good for the eyes, life and fame, and quickly removes yakṣmā, pāṇḍu, bhagandara, breathlessness, voice change, cough, heart, spleen, gulma and grahaṇī disorders; nothing need be avoided during it, and it is a rasāyana when used.

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ēlājamōdētyādi| ēlādikān surāṣṭrajāntān kaṣāyakalpēna vipācya, tēna kvāthēna sarpirvipacēditi sambandhaḥ| tasmin kvāthē siddhē pūtē śarkarāyāstriṁśatpalāni dadyāt, tugākṣīryāśca ṣaṭpalāni, tathā ghr̥tasya prasthē dviguṇaṁ dviprasthamitaṁ kṣaudraṁ dadyāt| akṣaṁ bibhītakaṁ, gāyatrī khadiraḥ, ariṣṭō nimbaḥ, asanō bījakaḥ, śālaḥ prasiddhaḥ, sāraśabdaḥ khadirādibhiḥ sambadhyatē| ugrā vacā, ambhōdō mustaṁ, surāṣṭrajā tuvaramr̥ttikā| tugākṣīrī vaṁśalōcanam; anyē vaṁśalōcanānukāripārthivadravyamāhuḥ| manthahataṁ khajavilōḍitam| atō asmādrasāyanāt| atandritaḥ analasaḥ| mēdhyaṁ mēdhājanakam||50-54||

Meaning of the commentary

The commentary says the drugs from elā to surāṣṭrajā are cooked as a decoction, and the ghṛta is cooked with it. In that strained decoction, thirty palas of sugar, six palas of tugākṣīrī, and honey twice a prastha of ghṛta are added. Akṣa is bibhītaka; gāyatrī is khadira; ariṣṭa is neem; asana is bījaka; śāla is well known; sāra attaches to khadira and the others. Ugrā is vacā; ambhoda is mustā; surāṣṭrajā is tuvara clay (tūvarī earth). Tugākṣīrī is vaṃśalocana, though others say an earth-derived substance resembling it. Manthahata is churned with a churning stick. 'From this rasāyana' refers to what follows. Atandrita means not lazy. Medhya means intellect-generating.

Key terms

rasāyana
Rejuvenating therapy.
tugākṣīrī
Vaṃśalocana, per the commentary, or a similar substance per others.
surāṣṭrajā
Tuvara clay.
manthahata
Churned.

Adhikarana 43 (55) · Śloka 55

plīhōdarōktaṁ vihitaṁ ca sarpistrīṇyēva cānyāni hitāni cātra |55|

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प्लीहोदरोक्तं विहितं च सर्पिस्त्रीण्येव चान्यानि हितानि चात्र |५५|

Meaning of the śloka

The ghṛta prescribed in the plīhodara context, and the other three, are also beneficial here.

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atra rasāyanē'parāṇyapi ghr̥tānyatidēśēnāha- plīhōdarōktaṁ vihitamityādi| plīhōdarōktaṁ ṣaṭpalakaṁ, trīṇyēva cānyāni udarōktānyēva; tadyathā- ēkaṁ ‘harītakīcūrṇaprasthaṁ’ ityādikaṁ, dvitīyaṁ ‘gavyē payasi mahāvr̥kṣakṣīram’ ityādi, tr̥tīyaṁ ‘cavyacitrakadantyativiṣā’ ityādikam| atra śōṣē| ētāni srōtōvarōdhaśāntyarthaṁ rēcanatvēna hitāni|55|-

Meaning of the commentary

The commentary says other ghṛtas are also extended to this rasāyana by reference: the six-pala ghṛta taught in plīhodara, and the other three from the udara chapter: one beginning 'harītakī powder, a prastha', a second beginning 'in cow's milk, the milk of mahāvṛkṣa', and a third beginning 'cavya, citraka, dantī, ativiṣā'. Here in śoṣa they are beneficial for removing obstruction of the channels, by purging.

Key terms

ṣaṭpalaka ghṛta (ṣaṭpalakaghṛta)
The six-pala ghṛta of plīhodara.
srotovarodha
Obstruction of channels.
recana
Purging action.

Adhikarana 44 (55) · Śloka 55

upadravāṁśca svaravaikr̥tādīn jayēdyathāsvaṁ prasamīkṣya śāstram ||55||

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उपद्रवांश्च स्वरवैकृतादीन् जयेद्यथास्वं प्रसमीक्ष्य शास्त्रम् ||५५||

Meaning of the śloka

One should overcome the complications such as voice change, according to each, after examining the relevant treatise.

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svarabhēdādīnāṁ cikitsitamatidēśēnāha- upadravāṁśca svaravaikr̥tādīnityādi| yathāsvaṁ yasya yadātmīyaṁ svarabhēdādiśāstraṁ, tat prasamīkṣyētyarthaḥ||55||

Meaning of the commentary

The commentary says this extends the treatment of svarabheda and the other complications by reference: 'according to each' means the treatment of svarabheda and the like appropriate to that condition, as found in the treatise, having examined it.

Key terms

upadrava
Complication.
svaravaikṛta
Abnormality of voice.

Adhikarana 45 (56) · Śloka 56

ajāśakr̥nmūtrapayōghr̥tāsr̥ṅmāṁsālayāni pratisēvamānaḥ | snānādinānāvidhinā jahāti māsādaśēṣaṁ niyamēna śōṣam ||56||

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अजाशकृन्मूत्रपयोघृतासृङ्मांसालयानि प्रतिसेवमानः | स्नानादिनानाविधिना जहाति मासादशेषं नियमेन शोषम् ||५६||

Meaning of the śloka

One who uses goat's dung, urine, milk, ghṛta, blood, meat and dwelling, with bathing and various other methods, is said to give up the whole śoṣa within a month, by rule.

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idānīmajāyāḥ sarvaprakārēṇōpayōgamāha- ajāśakr̥nmūtrētyādi| ajāśakr̥dādikaṁ yathāsambhavaṁ snānādividhinā puruṣaḥ sēvamānō'śēṣaṁ śōṣaṁ māsājjahātīti sambandhaḥ| ajāśabdaḥ śakr̥dādibhirālayāntaiḥ pratyēkaṁ sambadhyatē| ālayaṁ gr̥ham, ajānāmēva||56||

Meaning of the commentary

The commentary says this now states the complete use of the goat: the man who uses goat's dung and the rest, as available, with the method of bathing and the like, gives up all śoṣa within a month. The word 'goat' attaches to each item from dung to dwelling. 'Dwelling' means the goats' own place.

Key terms

ajā
Goat.
ālaya
Dwelling place, here the goats' shed.
niyama
Discipline or fixed rule.

Adhikarana 46 (57) · Śloka 57

rasōnayōgaṁ vidhivat kṣayārtaḥ kṣīrēṇa vā nāgabalāprayōgam | sēvēta vā māgadhikāvidhānaṁ tathōpayōgaṁ jatunō'śmajasya ||57||

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रसोनयोगं विधिवत् क्षयार्तः क्षीरेण वा नागबलाप्रयोगम् | सेवेत वा मागधिकाविधानं तथोपयोगं जतुनोऽश्मजस्य ||५७||

Meaning of the śloka

One wasted by kṣaya should use rasona (garlic) in due manner, or nāgabalā with milk, or the regimen of pippalī, or likewise the use of śilājatu.

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rasōnayōgamityādi| vidhivat yathāśāstram| kṣīrēṇēti nāgabalāprayōgamāgadhikāvidhānābhyāṁ sambadhyatē| tathēti kṣīrēṇētyarthaḥ| jatunaḥ aśmajasya śilājatunaḥ||57||

Meaning of the commentary

The commentary says 'in due manner' means according to the treatise. 'With milk' connects with both the nāgabalā use and the pippalī regimen. 'Likewise' means also with milk. Jatu of ashmaja is śilājatu.

Key terms

rasona
Garlic.
nāgabalā
A herbal drug used in rasāyana.
śilājatu
Mineral pitch/exudate.

Adhikarana 47 (58) · Śloka 58

śōkaṁ striyaṁ krōdhamasūyanaṁ ca tyajē... |58|

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शोकं स्त्रियं क्रोधमसूयनं च त्यजे... |५८|

Meaning of the śloka

He should give up grief, women, anger and envy... (the verse continues in the next entry).

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idānīṁ parihāryamāha- śōkaṁ striyamityādi| krōdhaḥ parābhidrōhalakṣaṇaḥ; asūyanaṁ paraguṇēṣu dōṣārōpaṇam|58|-

Meaning of the commentary

The commentary says what is to be avoided is now stated. Krodha (anger) is characterised by wishing harm on others; asūyana is attributing faults to others' virtues.

Key terms

śoka
Grief.
krodha
Anger.
asūyana
Envy or fault-finding.

Adhikarana 48 (58) · Śloka 58

...dudārān viṣayān bhajēta | vaidyān dvijātīṁstridaśān gurūṁśca vācaśca puṇyāḥ śr̥ṇuyāddvijēbhyaḥ ||58||

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...दुदारान् विषयान् भजेत | वैद्यान् द्विजातींस्त्रिदशान् गुरूंश्च वाचश्च पुण्याः शृणुयाद्द्विजेभ्यः ||५८||

Meaning of the śloka

... he should engage in noble sense-objects; and he should hear the sacred words from Brahmins, and honour physicians, the twice-born, gods and elders.

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idānīṁ daivavyapāśrayāṁ cikitsāmāha- udārānityādi| udārā viṣayā dharmāviruddhā manōnukūlāśca śabdādayaḥ| bhajēta sēvēta| dvijātīn viprān, tridaśān dēvān, gurūn pitr̥mātr̥prabhr̥tīn| puṇyā vācō vēdōktā rudrastutiprabhr̥tayaḥ||58||

Meaning of the commentary

The commentary says this now states the daiva-vyapāśraya (divine-recourse) treatment. Udāra sense-objects are those such as sounds that do not conflict with dharma and are pleasing to the mind. Dvijāti are Brahmins; tridaśa are gods; gurus are father, mother and the like. Puṇya words are Vedic ones such as praises of Rudra.

Key terms

daivavyapāśraya
Treatment relying on the divine, ritual and devotional measures.
udāra viṣaya
Noble, pleasing sense-objects consistent with dharma.
puṇyā vācaḥ
Sacred utterances.

Adhikarana puṣpikā · Śloka 41

iti suśrutasaṁhitāyāmuttaratantrāntargatē kāyacikitsātantrē (tr̥tīyō'dhyāyaḥ, ādita) ēkacatvāriṁśō'dhyāyaḥ ||41||

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इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे (तृतीयोऽध्यायः, आदित) एकचत्वारिंशोऽध्यायः ||४१||

Meaning of the śloka

Thus ends the forty-first chapter (the third chapter from the beginning of this section) in the Kāyacikitsā-tantra within the Uttaratantra of the Suśruta Saṃhitā.

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iti śrīḍalha(hla)ṇaviracitāyāṁ nibandhasaṅgrahākhyāyāṁ suśrutavyākhyāyāmuttaratantrāntargatē kāyacikitsātantrē śōṣapratiṣēdhanāmaikacatvāriṁśattamō'dhyāyaḥ||41||

Meaning of the commentary

Thus ends the forty-first chapter, named Śoṣapratiṣedha, in the Kāyacikitsā-tantra of the Uttaratantra, in the Suśruta commentary called Nibandhasaṅgraha composed by Śrī Ḍalhaṇa.

Key terms

śoṣapratiṣedha
The chapter on measures against śoṣa.
kāyacikitsātantra
The internal-medicine division within the Uttaratantra.
nibandhasaṅgraha
Ḍalhaṇa's commentary on the Suśruta Saṃhitā.