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.
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.
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.
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 ೪ (೬) · Śloka ೬
ಸ ವ್ಯಸ್ತೈರ್ಜಾಯತೇ ದೋಷೈರಿತಿ ಕೇಚಿದ್ವದನ್ತಿ ಹಿ |೬|
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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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ಏಕೀಯಮತೇನಾಸ್ಯ ವ್ಯಾಧೇಃ ಪೃಥಗ್ದೋಷಜತ್ವಮಾಹ- ಸ ವ್ಯಸ್ತೈರಿತ್ಯಾದಿ| ಸ ವ್ಯಾಧಿಃ| ವ್ಯಸ್ತೈಃ ಪೃಥಗ್ಭೂತೈಃ|೬|-
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 ೫ (೬-೭) · Śloka ೭
ಏಕಾದಶಾನಾಮೇಕಸ್ಮಿನ್ ಸಾನ್ನಿಧ್ಯಾತ್ತನ್ತ್ರಯುಕ್ತಿತಃ ||೬||
ಕ್ರಿಯಾಣಾಮವಿಭಾಗೇನ ಪ್ರಾಗೇಕೋತ್ಪಾದನೇನ ಚ |
ಏಕ ಏವ ಮತಃ ಶೋಷಃ ಸನ್ನಿಪಾತಾತ್ಮಕೋ ಹ್ಯತಃ ||೭||
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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.
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 ೬ (೮) · Śloka ೮
ಉದ್ರೇಕಾತ್ತತ್ರ ಲಿಙ್ಗಾನಿ ದೋಷಾಣಾಂ ನಿಪತನ್ತಿ ಹಿ |೮|
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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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ನನು, ಯದಿ ಸನ್ನಿಪಾತಾತ್ಮಕ ಏಕ ಏವಾಯಂ ತತ್ ಕಥಮತ್ರ ಏಕೈಕದೋಷಪೃಥಗ್ಲಿಙ್ಗಜ್ಞಾನಮಿತ್ಯಾಹ - ಉದ್ರೇಕಾದಿತ್ಯಾದಿ| ಉದ್ರೇಕಾತ್ ಆಧಿಕ್ಯಾತ್| ತತ್ರ ಶೋಷೇ| ಹಿಶಬ್ದೋ ಹೇತೌ, ಸ ಚ ಹೇತುರ್ಬಹುಪ್ರಕಾರೋಽಪಿ ಚತುರ್ವಿಧತ್ವಂ ನ ತ್ಯಜತಿ|೮|-
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.
It arises from depletion, suppression of natural urges, injury, and irregular eating, when the doṣas are aggravated and pervade the body of the person.
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 ೮ (೯) · Śloka ೯
ಕಫಪ್ರಧಾನೈರ್ದೋಷೈರ್ಹಿ ರುದ್ಧೇಷು ರಸವರ್ತ್ಮಸು ||೯||
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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...
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.
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.
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.
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.
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.)
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.
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.
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.
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.
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.
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.
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.
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).
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.
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 ೧೯ (೨೩) · Śloka ೨೩
ರಕ್ತಕ್ಷಯಾದ್ವೇದನಾಭಿಸ್ತಥೈವಾಹಾರಯನ್ತ್ರಣಾತ್ |
ವ್ರಣಿತಸ್ಯ ಭವೇಚ್ಛೋಷಃ ಸ ಚಾಸಾಧ್ಯತಮಃ ಸ್ಮೃತಃ ||೨೩||
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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.
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.
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.
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.
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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ಏಕೀಯಮತಮಾಹ- ಕೇಷಾಞ್ಚಿದಿತ್ಯಾದಿ| ಕೇಷಾಞ್ಚಿದಾಚಾರ್ಯಾಣಾಂ ಮತೇ ಏವಂ ವ್ಯವಾಯಾದಿಭಿರನೇಕೈಃ ಕಾರಣೈಃ ಕೃತ್ವಾ ಹಿ ಯಸ್ಮಾತ್ ಶೋಷೋ ಭೇದಮಾಗತಃ; ಅತ ಏಕ ಏವ ಸ್ವಮತೇ ಶೋಷೋ ನೇತರೇ ವ್ಯವಾಯಾದಿಜಾಃ| ಕುತೋ ವ್ಯವಾಯಾದಿಜಾಃ ಶೋಷಾ ನ ಭವನ್ತೀತ್ಯಾಹ- ನ ತತ್ರೇತ್ಯಾದಿ| ತತ್ರ ತೇಷು ವ್ಯವಾಯಾದಿಜೇಷು||೨೬||-
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.
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.
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.
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.
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 ೨೭ (೩೨-೩೩) · Śloka ೩೩
ಸ್ಥಿರಾದಿವರ್ಗಸಿದ್ಧೇನ ಘೃತೇನಾಜಾವಿಕೇನ ಚ ||೩೨||
ಸ್ನಿಗ್ಧಸ್ಯ ಮೃದು ಕರ್ತವ್ಯಮೂರ್ಧ್ವಂ ಚಾಧಶ್ಚ ಶೋಧನಮ್ |
ಆಸ್ಥಾಪನಂ ತಥಾ ಕಾರ್ಯಂ ಶಿರಸಶ್ಚ ವಿರೇಚನಮ್ ||೩೩||
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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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ತದೇವ ಚಿಕಿತ್ಸಿತಮಾಹ- ಸ್ಥಿರಾದಿವರ್ಗಸಿದ್ಧೇನೇತ್ಯಾದಿ| ಸ್ಥಿರಾದಿಃ ವಿದಾರಿಗನ್ಧಾದಿಃ| ಮೃದು ಯತ್ ಕರ್ಶನಂ ನ ಭವತೀತ್ಯರ್ಥಃ| ಆಸ್ಥಾಪನಂ ನಿರೂಹಃ| ತಥೇತಿ ಮೃದ್ವಿತ್ಯರ್ಥಃ| ಶಿರಸೋ ವಿರೇಚನಂ ನಸ್ಯಮ್||೩೨-೩೩||
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 ೨೮ (೩೪) · Śloka ೩೪
ಯವಗೋಧೂಮಶಾಲೀಂಶ್ಚ ರಸೈರ್ಭುಞ್ಜೀತ ಶೋಧಿತಃ |೩೪|
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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.
The commentary says this states the field of nourishing therapy. 'Whose complications have subsided' means in whom voice change and the like have settled.
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').
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.
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 ೩೨ (೪೦) · Śloka ೪೦
ಮಾಂಸಾದಮಾಂಸೇಷು ಘೃತಂ ಚ ಸಿದ್ಧಂ ಶೋಷಾಪಹಂ ಕ್ಷೌದ್ರಕಣಾಸಮೇತಮ್ |೪೦|
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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.
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'.
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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ದ್ರಾಕ್ಷೇತ್ಯಾದಿ| ಅವಲೇಹೋಽಯಮ್|೪೧|-
Meaning of the commentary
The commentary says only that this is an avaleha (medicinal lick).
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 ೩೮ (೪೩) · Śloka ೪೪
ಕೃತ್ಸ್ನೇ ವೃಷೇ ತತ್ಕುಸುಮೈಶ್ಚ ಸಿದ್ಧಂ ಸರ್ಪಿಃ ಪಿಬೇತ್ಕ್ಷೌದ್ರಯುತಂ ಹಿತಾಶೀ ||೪೩||
ಯಕ್ಷ್ಮಾಣಮೇತತ್ ಪ್ರಬಲಂ ಚ ಕಾಸಂ ಶ್ವಾಸಂ ಚ ಹನ್ಯಾದಪಿ ಪಾಣ್ಡುತಾಂ ಚ |೪೪|
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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.
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.
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.
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.
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.
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.
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.
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.
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.
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 ೪೩ (೫೫) · Śloka ೫೫
ಪ್ಲೀಹೋದರೋಕ್ತಂ ವಿಹಿತಂ ಚ ಸರ್ಪಿಸ್ತ್ರೀಣ್ಯೇವ ಚಾನ್ಯಾನಿ ಹಿತಾನಿ ಚಾತ್ರ |೫೫|
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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.
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.
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.
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.
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.
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 ೪೭ (೫೮) · Śloka ೫೮
ಶೋಕಂ ಸ್ತ್ರಿಯಂ ಕ್ರೋಧಮಸೂಯನಂ ಚ ತ್ಯಜೇ... |೫೮|
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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).
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.
... 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.
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.
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.
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.