A History of Indian Medical Literature v1.c13: Chapter 6
A History of Indian Medical Literature v1.c13
- Language
- English
Contents
- v1.c13.144 — 3 parts
- v1.c13.151 — 4 parts
- v1.c13.153 — 4 parts
Chapter 6
v1.c13.1
Chapter one, divided into four parts (pāda),¹ deals with rasāyana.²
v1.c13.2
Part one, called abhayāmalakīya, describes rasāyanas containing abhayā (= harītakī) and āmalakī.
v1.c13.3
Synonyms of therapy (bheṣaja, cikitsita, etc.) are enumerated (1.3–4a). Therapy is of two kinds: promoting vitality (ūrjas) in the healthy and dispelling disease (roganud) in patients (ārta); its opposite, adverse treatment (abheṣaja), produces its effects for a short or a long time³ (1.4b–5ab). Treatment aiming at the promotion of vitality consists of rasāyana and vājīkaraṇa; both types of therapy mentioned are, however, useful for these two purposes (1.5cd–6).⁴ Rasāyana and vājīkaraṇa are described according to the effects produced by them (1.7–12).
v1.c13.4
Rasāyana treatment⁵ is of two types: kuṭīprāveśika (inside a cottage constructed for the purpose)⁶ and vātātapika (in the open air).⁷ The cottage (kuṭī) and the preparatory stages of the treatment are described (1.16–28).
v1.c13.5
The properties and actions of harītakī are discussed;⁸ āmalakī has the same properties and actions, apart from its vīrya, which is the opposite of that of harītakī⁹ (1.29–37). The fruits of both plants should be collected in the Himālayas (1.38–40).
v1.c13.6
Six rasāyana formulations are described: two kinds of brāhmarasāyana,¹⁰ cyavanaprāśa,¹¹ āmalakarasāyana,¹² and two kinds of harītakīyoga. These preparations made the Vaikhānasas,¹³ Vālakhilyas,¹⁴ Cyavana, and other sages attain a very long span of life, free from disease and decrepitude (1.41–77).
v1.c13.7
Rasāyana preparations, comparable to the amṛta of the gods and the sudhā of the serpents, enabled the great sages to live, endowed with youthful vigour, for thousands of years. Someone who methodically employs rasāyana does not only live for a long time, but he also acquires the status of the divine sages and is finally united with the indestructible brahman (1.78–80).
v1.c13.8
Part two of chapter one, called prāṇakāmīya, begins with praising the effects of rasāyana treatment (2.3).
v1.c13.9
Several formulations are described: āmalakaghṛta (2.4–6), āmalakāvaleha (2.7), āmalakacūrṇa (2.8), viḍaṅgāvaleha (2.9),¹⁵ a second āmalakāvaleha (2.10), nāgabalārasāyana (2.11),¹⁶ a recipe without a name (2.12), bhallātakakṣīra (2.13),¹⁷ bhallātakakṣaudra (2.14), and bhallātakataila (2.15).¹⁸
v1.c13.10
Ten forms of bhallātaka preparations are employed: bhallātakaghṛta,¹⁹ -kṣīra, -kṣaudra, -guḍa,²⁰ -yūṣa, -taila, -palala, -saktu, -lavaṇa, and -tarpaṇa (2.16).²¹
v1.c13.11
Part three, called karapracītiya, describes sixteen rasāyana formulations (3.66).
v1.c13.12
It begins with preparations of āmalakī fruits, culled by hand (karapracita). The first of these is āmalakāyasabrāhmarasāyana, deriving from Brahmā, and successfully used by Vasiṣṭha, Kaśyapa, Aṅgiras, Jamadagni, Bharadvāja, Bhṛgu, and other ancient sages (3.3–6). The proper way of having recourse to rasāyana, illustrated by the behaviour of the great sages, is discussed (3.7–8). The kevalāmalakarasāyana is dealt with (3.9–14).
v1.c13.13
Other rasāyana preparations described are: lauhādirasāyana (3.15–23), 22 aindra rasāyana (3.24–29), 23 a series of four medhyarasāyanas 24 (3.30–31), 25 pippalīrasāyana (3.32–35), 26 pippalīvardhamāna (3.36–40), 27 and four kinds of triphalārasāyana 28 (3.41–47).
v1.c13.14
The properties, actions and uses of śilājatu 29 are discussed, a substance that cures all diseases. Its potency is enhanced (vīryotkarṣa) by steeping (bhāvanā 30, ālodana) this substance in various fluids. Four varieties are distinguished, originating from gold, silver, copper and iron ores, 31 to be used specifically against disorders caused by vāta and pitta, kapha and pitta, kapha, and all three doṣas. The variety deriving from iron ore is preferable for rasāyana purposes (3.48–65). 32
v1.c13.15
Part four, called āyurvedasamutthānīya, opens with a second story on the divine origin of āyurveda. 33
v1.c13.16
This narrative introduces a group of sages, consisting of Agastya, Aṅgiras, Asita, Atri, Bhṛgu, Gautama, Kaśyapa, Pulastya, Vāmadeva, Vasiṣṭha, and others. The health of these sages had deteriorated due to their adoption of the way of living customary in cities and villages. 34 Being no longer able to perform their duties, they repaired to the Himālayas, where Indra transmitted to them the āyurveda (4.3–5). 35
v1.c13.17
Indra makes the sages acquainted with a series of vitalizing (jīvanīya) plants, 36 growing in the Himālayas, which, when taken with milk for six months, bestow a maximum life span (paramāyus); the plants mentioned by name are: aindrī, brāhmī, 37 payasyā, kṣīrapuṣpī, śrāvaṇī, mahāśrāvaṇī, śatāvarī, 38 vidārī, 39 jīvantī, 40 punarnavā, nāgabalā, 41 sthirā, vacā, 42 chattrā, aticchattrā, medā, and mahāmedā (indrokta rasāyana; 4.6). 43
v1.c13.18
Indra proceeds with his teachings on rasāyana by describing nine divine herbs (divyauṣadhi): brahmasuvarcalā, ādityaparṇī (also called sūryakāntā), 44 aśvabalā, kāṣṭhagodhā, sarpanāmā, soma, padmā, ajā (also called ajaśṛṅgī), and nīlā, 45 and the use made of these herbs in a course of treatment that results in making one the equal of the gods in outward appearance and that provides a life span of a thousand years (4.7). 46 This treatment, perfectly suitable only to sages with a controlled mind (kṛtātman), will enable them to perform all their duties; vānaprasthas 47 and gṛhasthas 48 with a sufficiently disciplined mind (niyatātman) may also resort to it (4.8–10). The same herbs, when growing in another habitat than the Himālayas, have a less powerful effect.
v1.c13.19
Persons not belonging to the mentioned categories are advised to resort to other rasāyana procedures (4.11–12). 49
v1.c13.20
Such a procedure, of a complex nature, is described; the groups of ten drugs each which are balya, jīvanīya, bṛṃhaṇīya and vayaḥsthāpana, 50 together with many others, among which a series of powdered (cūrṇa) inorganic substances, are employed in it (4.13–26).
v1.c13.21
Persons who are wealthy, healthy and self-controlled are suitable to the kuṭīpraveśa type of rasāyana; others should make use of the sauryamārutika (= vātātapika) type (4.27–29).51
v1.c13.22
The requirements to be met for a successful use of rasāyana are discussed in detail (4.30–38).52
v1.c13.23
A qualified physician (prāṇācārya)53 deserves the same honour as that bestowed on the Aśvins by Indra. The feats of the Aśvins54 are referred to: they restored the cut-off head of the sacrifice, treated Pūṣan whose teeth had fallen out, cured Bhaga who had lost his eyesight, Indra when his arms were stiff, and Śītāmśu (= Candra), when he suffered from rājayakṣman; they made the old and decrepit Cyavana young again, etc. (4.39–44). The Aśvins are therefore honoured by Indra and other gods, and the twice-born offer to them grahas,55 stotras,56 various oblations (havis), and smoke-coloured sacrificial animals (4.45–49).57 Physicians should be honoured in the same way as the Aśvins (4.50–51).
v1.c13.24
A physician who has completed a full course of training obtains a sattva (mental disposition) of the brāhma or ārṣa type58 and is called thrice-born (trija)59 (4.52–54). The ethical principles he should adhere to are outlined (4.55–62).
v1.c13.25
Chapter two, on vājīkaraṇa (aphrodisiacs),60 is divided into four parts (pāda).
v1.c13.26
Part one, called saṃyogaśaramūlīya, begins with the praise of aphrodisiacs, a description of the type of woman most attractive to a man, and the merits of having a numerous offspring (1.3–24ab).
v1.c13.27
Fifteen61 aphrodisiac formulations are discussed, many of which contain substances of animal origin. These recipes are: bṛṃhaṇīguṭikā (1.24cd–33ab), vājīkaraṇaghṛta (1.33cd–38ab),62 four varieties of vājīkaraṇapiṇḍarasa (1.38cd–41),63 vṛṣyamāhiṣarasa (1.42–43),64 four different varieties of vṛṣyarasa (1.44–45),65 vṛṣyamāṃsa (1.46),66 vṛṣyamāṣayoga (1.47),67 vṛṣyakukkuṭamāṃsaprayoga (1.48),68 and vṛṣyandarasa (1.49–50ab).69
v1.c13.28
Part two, called āsiktakṣīrika, deals with a series of eight aphrodisiac recipes: ṣaṣṭikādigutikā (2.3–9),70 vṛṣyapūpalikādiyoga (2.10–13),71 apatyakarasavarasa (2.14–17),72 vṛṣyakṣīra (2.18–20),73 vṛṣyaghṛta (2.21–23),74 vṛṣyadadhirasaprayoga (2.24–26), vṛṣyaṣaṣṭikaudanaprayoga (2.27), and vṛṣyapūpalikā (2.28–29).75
v1.c13.29
Part three, called māṣaparṇabhṛtīya, is about sexually stimulating prescriptions which do not contain substances of animal origin, milk excepted (3.3–19).
v1.c13.30
Recipes with a name are: vṛṣyapippalīyoga (3.12–13), vṛṣyapāyasayoga (3.14), vṛṣyapūpalikā (3.15–17), vṛṣyaśatāvarīghṛta (3.18), and vṛṣyamadhukayoga (3.19).
v1.c13.31
This section is followed by the characteristics of a fully potent male, various circumstances favouring the sexual urge, diverse sources of sexual excitement, etc. (3.20–30).76
v1.c13.32
Part four, called pumāñjātabalādika, describes four types of sexual vigour in the male: dependent on the season (kāla), practice (abhyasana), effort (prayatna),77 and constitution (svabhāva) (4.3–7).
v1.c13.33
Twelve formulations are described which improve sexual vigour in the weak and further increase it in those already strong: vṛṣyamāṃsaguṭikā (4.11–14), vṛṣyamāhiṣarasa (4.15–16), vṛṣyaghṛtabhṛṣṭamatsyamāṃsa (4.17–18),78 two vṛ- syapūpalikāyogas (4.19–22),79 vṛṣyamāṣādīpūpalikā (4.23–24),80 apatyakaraghṛta (4.28–29), vṛṣyaguṭikā (4.30–32), and vṛṣyotkārikā (4.33–35).
v1.c13.34
Rules for sexual behaviour are formulated (4.36–45). Semen is described and the eight factors leading to its discharge: harṣa (physical sexual stimulation), tarṣa (mental sexual stimulation), saratva (fluidity of the semen), paicchilya (sliminess of the semen), gaurava (heaviness of the semen), aṇupraṇavabhāva (the tendency of the semen, although of a small amount, to be ejaculated), mārutadrutatva (the impulse of vāyu to expel the semen) (4.46–50).81
v1.c13.35
The chapters ends with a definition of vājīkaraṇa (4.51).
v1.c13.36
Chapter three is concerned with fevers (jvara) and their treatment.82
v1.c13.37
Agniveśa puts eighteen questions on these subjects, to be elucidated by Ātreya (3.4–10).
v1.c13.38
The synonyms of jvara are listed (3.11). Its directly causative factors (prakṛti)83 are the bodily and mental doṣas (3.12). The essence84 of fever can be defined as kṣaya (wasting), tamas (entering into darkness), pāpman (sinfulness)85 and mṛtyu (death), which are features belonging to Yama86 (3.13).
v1.c13.39
The appearance (pravṛtti) of fever is due to attachment to one’s property (parigraha)87 and to the wrath of Rudra88 (3.14). The mythic origin of jvara is described; it arose, as the being called Vīrabhadra,89 during the Tretāyuga from Śiva’s anger during Dakṣa’s sacrifice (3.15–25).90
v1.c13.40
Specific characteristics (prabhāva) of fever are saṃtāpa (heat), aruci (loss of appetite), tṛṣṇā (thirst), aṅgamarda (aches in the whole body) and hṛdvyathā (distress in the cardiac region) (3.26).91
v1.c13.41
The causes of the eight types of fever are not discussed, being dealt with already in the Nidānasthāna (3.27cd). The prodromes, however, are enumerated again (3.28–29).92 Fever is located in the entire body, along with the mind;93 the periods of time and its strength have been discussed in the Nidānasthāna (3.30).94 The invariable sign of fever is general heat (saṃtāpa) of body and mind (3.31).
v1.c13.42
Fevers are classified in various ways:95 somatic (śārīra) and psychic (mānasa), saumya and āgneya, antarvega and bahirvega, prākṛta and vaikṛta, curable and incurable; they are of five types according to the strength or weakness of the doṣas in relation to time: saṃtata, satata, anyedyuṣka, tṛtīyaka and caturthaka; they are of seven types according to their location in the elements of the body; they are of eight types according to their causes (i.e., the doṣas) (3.32–35).96
v1.c13.43
The types mentioned are described. A somatic fever starts in the body, a mental fever in the mind; the signs of mental heat are enumerated; bodily heat affects the organs of sense too (3.36–37ab). A fever predominant in vāta and pitta leads to a desire for cold and cooling things, a fever predominant in vāta and kapha to a desire for warmth and heating things (3.37cd–38ab);97 vāta is characterized as a synergist (yogavāha), producing heat in combination with pitta, coldness in combination with kapha (3.38cd–39ab).
v1.c13.44
The symptoms of antarvega (internal)98 and bahirvega (external) fever are mentioned (3.39cd–41).99 Prākṛta and vaikṛta fevers are discussed; a fever is prākṛta if the predominant doṣa corresponds to the season in which it arises, vaikṛta if the doṣa disagrees with the season; 100 vāta fever is peculiar in being difficult to cure, even when it is prākṛta (3.42–49). Curable and incurable fevers are characterized (3.50–52ab). 101 Two special types of incurable fever are described (3.52cd–53ab). 102
v1.c13.45
The fevers called saṃtata, 103 satataka, 104 anyedyuṣka, 105 tṛtīyaka and caturthaka are dealt with; 106 tṛtīyaka is of three, caturthaka of two varieties (3.53cd–72). 107 A special type of viṣamajvara (irregular, intermittent fever) is the type called caturthakaviparyaya (reversed quartan fever) (3.73). 108 The five types of viṣamajvara mentioned 109 are usually caused by a combination of all three doṣas, but designated after the predominant one (3.74).
v1.c13.46
The symptoms of fevers seated in the elements of the body are described (3.76–83), 110 followed by those caused by two doṣas (3.84–89c). 111 Twelve varieties of saṃnipāta fever are described, distinguished according to the degree to which each of the three doṣas is excited (3.89d–102), 112 followed by a thirteenth variety in which all three doṣas are excited to an equal degree (3.103–109ab). 113 A saṃnipāta fever is incurable when all its symptoms have developed; when otherwise, it is curable with difficulty (3.109cd–110ab). 114
v1.c13.47
Āgantu fevers, which are secondarily associated with the doṣas, are of four types: caused by abhighāta (injury), abhiṣaṅga (intense emotions 115 and possession by evil beings), abhicāra (sorcery) 116 and abhiśāpa (curses); 117 these four types are discussed; some are said to regard a fever caused by the contact with air carrying poisonous substances from particular trees as belonging to the type called abhiṣaṅgaja (3.111cd–129ab). 118
v1.c13.48
The pathogenesis of fever is dealt with next (3.129cd–132ab). 119
v1.c13.49
Three stages of fever are discussed: fresh (taruṇa), 120 maturing (pacyamāna), and devoid of immature matter (nirāma) 121 (3.132cd–138ab). 122
v1.c13.50
The larger portion of the remaining part of the chapter (3.138cd–324ab) is devoted to the treatment of fevers. 123
v1.c13.51
Recipes provided with a name are candanādyataila (3.258) 124 and agurvādyataila (3.267). 125
v1.c13.52
A swelling (śotha) at the root of the ear 126 is described as a very serious complication of fever (3.287cd–289ab). A type of fever located in the peripheral parts of the body (the branches, śākhā), called śākhānusārin, should be treated by means of bloodletting (3.289cd–290ab). Fevers regarded as a complication of visarpa (erysipelas), abhighāta (trauma) and visphoṭaka (vesicular eruptions) are separately mentioned (3.290cd–291ab).
v1.c13.53
Worship of Śiva 127 and Umā, together with their attendants 128 and the group of the Mothers, 129 recitation of the Viṣṇusahasranāmastotra, i.e., an enumeration of the thousand names of Viṣṇu 130, sacrifices to Brahmā, the Aśvins, Indra, Agni, the Himālaya, the Ganges, and the groups of Maruts, 131 etc., are recommended as means to release from fever (3.310cd–315ab). 132
v1.c13.54
The chapter ends with the signs of release (mokṣa) from fever, the rules to be adhered to during convalescence, relapses (punarāvartana) and their management (3.324cd–343).
v1.c13.55
Chapter four, on raktapitta, begins with the nidāna (4.5–6) ¹³³ and samprāpti (4.7–8) of raktapitta, ¹³⁴ the elucidation of its name (4.9), ¹³⁵ and its location: spleen and liver, ¹³⁶ whence it spreads throughout the body (4.10). ¹³⁷
v1.c13.56
The symptoms of raktapitta associated with one, two or three doṣas are dealt with (4.11–13ab). ¹³⁸ It is curable when associated with one doṣa, palliable when associated with two, and incurable when associated with three doṣas; a series of other circumstances making it incurable are mentioned (4.13cd–14).
v1.c13.57
The upwards moving type is curable, the downwards moving type palliable, the type moving both upwards and downwards incurable (4.15–16). ¹³⁹ The type moving through all the holes ¹⁴⁰ and the pores of the hairs (romakūpa) leads to certain death (4.17). Other conditions making raktapitta incurable are mentioned (4.18–20). ¹⁴¹ Conditions making it palliable (4.21) or curable (4.22) are enumerated next.
v1.c13.58
Specific aetiological factors are discussed; oleaginous (snigdha) and hot substances usually lead to the upwards moving, oleaginous and dry (rūkṣa) substances to the downwards moving type; the upwards moving type is associated with kapha, the downwards moving type with vāyu ¹⁴² (4.23–24).
v1.c13.59
The remaining part of the chapter is devoted to the treatment of raktapitta (4.25–109). ¹⁴³ Specific prescriptions against bleeding from the urethra (4.85), anus (4.86–87) and nose (4.97–101) ¹⁴⁴ are described. Drugs useful against raktapitta are enumerated (4.102–104).
v1.c13.60
Recipes provided with a name are vāsāghṛta (4.88) ¹⁴⁵ and śatāvaryādighṛta (4.95–96). ¹⁴⁶
v1.c13.61
Chapter five, on gulma, deals with the following subjects: factors causing excitement of vāyu in the viscera (koṣṭha) (5.4–5); ¹⁴⁷ the samprāpti of the doṣic types of gulma (5.6–7); ¹⁴⁸ the five seats of gulma: the region of the urinary bladder (basti), umbilical region (nābhi), cardiac region (hṛd) and the two sides of the chest (pārśva) (5.8ab); ¹⁴⁹ the aetiology and symptomatology of gulma caused by vāta, pitta, kapha, two doṣas ¹⁵⁰ and all three doṣas ¹⁵¹ (5.8cd–17); the aetiology and symptomatology of gulma caused by blood, ¹⁵² occurring in fertile women only ¹⁵³ (5.18–19).
v1.c13.62
A large part of the chapter is devoted to the treatment of gulma (5.20–182). ¹⁵⁴
v1.c13.63
Immature (apakva) gulma (5.40) and gulma in the stage of maturation (vidāha; 5.41–45) ¹⁵⁵ are described, followed by the stage in which it may evacuate its doṣas on its own accord (svayamapravṛtta; 5.46–48ab). Treatment of gulma by means of alkaline fluids (kṣāra; 5.56cd–58ab) and cauterization (dāha; 5.60cd–64ab), methods belonging to the domain of specialists, ¹⁵⁶ is discussed.
v1.c13.64
Recipes against gulma which are provided with a name are: two kinds of tryūṣaṇādighṛta (5.65–66ab and 66cd–67ab), ¹⁵⁷ hiṅgusauvarcalādyaghṛta (5.69–70), ¹⁵⁸ hapuṣādyaghṛta (5.71–73), ¹⁵⁹ pippalyādyaghṛta (5.74–75), ¹⁶⁰ hiṅgvādicūrṇa ¹⁶¹ and -guṭikā (5.79–84), laśunakṣīra (5.94–95), ¹⁶² tailapañcaka (5.96), śilājatuprayoga (5.97), nīlinyādyaghṛta (5.105–109), ¹⁶³ rohiṇyādyaghṛta (5.114–117), trāyamāṇādyaghṛta (5.118–121), ¹⁶⁴ āmalakyādyaghṛta (5.122), drākṣādyaghṛta (5.123–125), ¹⁶⁵ vāsāghṛta (5.126–127), ¹⁶⁶ daśamūlīghṛta (5.142), bhallātakādyaghṛta (5.143–146), ¹⁶⁷ kṣīraṣaṭpalakaghṛta (5.147–148), 168 miśrakasneha (5.149–151), 169 and dantīharītakī (5.154–160). 170
v1.c13.65
Chapter six is concerned with prameha.
v1.c13.66
It deals with the following subjects: the aetiology of prameha (6.4); 171 its saṃprāpti (6.5–6); 172 the curability of kaphaja prameha due to the similarity (samakriyatva) of the elements in its management; 173 the palliability of pittaja prameha on account of the dissimilarity (viṣamakriyatva) of these elements; the incurability of vātaja prameha due to the severity (mahātyayikatva) of its nature (6.7); the three doṣas and ten dūṣyas responsible for the appearance of prameha (6.8); 174 the ten varieties of kaphaja prameha, six varieties of pittaja prameha, and four varieties of vātaja prameha (6.9–11); 175 the characteristics of the varieties of prameha relating to the colour, taste, smell and tactile properties of the urine (6.12); the prodromes of prameha (6.13–14); 176 general principles of the treatment of prameha 177 (6.15–26); 178 recipes to be used in the treatment of kaphaja (6.27–29), pittaja (6.30–32), 179 vātaja (6.33–34), kapha- and pittaja prameha (6.35–39); various recipes and remedial measures (6.40–51); 180 the nature of vātolbaṇaprameha and its treatment (6.52); 181 the avoidance of causative factors during the treatment of prameha (6.53); the differential diagnosis of prameha and raktapitta (6.54); differential diagnosis when the urine is sweet, mucilaginous and resembling honey (6.55); special rules concerning the prognosis of prameha (6.56); incurability of prameha already present at birth, and of madhumeha inherited from one of the parents; the incurability of hereditary (kulaja) diseases in general (6.57); the seven types of piḍakā appearing in patients suffering from prameha, 182 which are to be treated by surgeons (śalyavidah) (6.58).
v1.c13.67
Chapter seven is devoted to kuṣṭha.
v1.c13.68
It begins with Ātreya's exposition of the subjects he is going to discuss in this chapter: the hetu (aetiology), dravya (i.e., doṣas and dūṣyas), 183 liṅga (symptomatology), āśraya (substrate) and praśamana (treatment) of the forms of kuṣṭha, disorders which in particular damage the skin as the seat of the tactile sense. 184
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The subjects dealt with are: the aetiology of kuṣṭha (7.4–8); 185 the seven and eleven forms of kuṣṭha are always brought about by all three doṣas, which corrupt the skin, blood, muscular tissue and watery element (ambu) (7.9–10); 186 the prodromes (7.11–12); 187 an enumeration of the eighteen varieties of kuṣṭha (7.13); 188 the description of the seven major varieties (mahākuṣṭha): kāpāla, audumbara, maṇḍala, ṛṣyajihva, puṇḍarīka, sidhma 189, and kākaṇa (7.14–20); 190 the description of the eleven minor varieties (kṣudrakuṣṭha): 191 ekakuṣṭha, 192 carmākhya, 193 kiṭima, 194 vaipādika, 195 alasaka, 196 dadrumaṇḍala, 197 carmadala, 198 pāmā, 199 visphoṭa, 200 śatārus, 201 and vicarcikā 202 (7.21–26); the doṣas preponderantly excited in these varieties: vāta in kāpāla, kapha in maṇḍala, pitta in audumbara, all three doṣas in kākaṇa, vāta and pitta in ṛṣyajihva, kapha and pitta in puṇḍarīka, vāta and kapha in sidhakuṣṭha, vāta and kapha usually in carmākhya, ekakuṣṭha, kiṭima, vipādikā and alasaka, pitta and kapha usually in pāmā, śatārus, visphoṭa, dadru and carmadala, kapha usually in vicarcikā (7.27–30); 203 all the varieties of kuṣṭha are, however, essentially brought about by the three doṣas; their relative strength (balābala) should be ascertained before beginning treatment; the predominant doṣa is to be counteracted first, the secondary one (anubandha) subsequently (7.31–32); the doṣas can be determined from the type of kuṣṭha present and the other way round (7.33); the signs which are characteristic for each doṣa in cases of kuṣṭha are enumerated (7.34–36); 204 a physician should refuse treating a patient presenting all the symptoms; cases of kuṣṭha in which one doṣa predominates or a combination of vāta and kapha are not difficult to cure, in contrast with cases with a predominance of kapha and pitta or vāta and pitta (7.37–38). 205
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The remaining part of the chapter is largely devoted to the treatment of kuṣṭha 206 (7.39–161). 207
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Recipes against kuṣṭha which are provided with a name are: nustādicūrṇa (7.65–67), 208 madhvāsava (7.73–75), 209 kanakabindvariṣṭa (7.76–79), śvetakaravīrādyataila (7.105), 210 śvetakaravīrapallavādyataila (7.106–107), tiktekṣvākvāditaila (7.108–110), 211 kanakakṣīritaila (7.111–116), 212 khadiraghṛta, nimbaghṛta, dārvīghṛta and paṭolaghṛta (7.135), tiktaṣatpalakaghṛta (7.140–143), 213 mahātiktakaghṛta (7.144–150), 214 and mahākhadiraghṛta (7.152–156). 215
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The last part of the chapter is concerned with the disease called kilāsa, 216 which is related to kuṣṭha; it is usually brought about by the three doṣas; three varieties are distinguished: dāruṇa, aruṇa and śvitra, which are characterized by red, copper-coloured (aruṇa) and white spots respectively; these varieties have their seat in blood, muscular tissue and fatty tissue respectively; their degree of severity corresponds with the order in which they are mentioned; the curable and incurable types of śvitra are described; bad acts in this life and in previous existences, as well as the intake of incompatible foods, are said to cause kilāsa (7.173–177); 217 the treatment of śvitra 218 precedes its description (7.162–172). 219
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Chapter eight, on rājayakṣman, 220 deals with the following subjects: the mythic origin of yakṣman, 221 which befell the moon-god (Indu, Candra, Candramas, Śaśin, Soma), due to his attachment to Rohiṇī, 222 one of the twenty-eight daughters of Prajāpati, and his neglect of the other ones; Prajāpati, full of wrath, afflicted him with the disease, from which he was cured by the Aśvins (8.3–10); 223 the names of the disease, which, ousted (from the heavenly world) by the Aśvins, came down to the world of human beings (8.11–12); the four causes of rājayakṣman: exertion beyond one's capacity, suppression of natural urges, wasting (kṣaya) (of bodily constituents), and irregular diet (viṣamāśana) (8.13); 224 a description of the way in which these four causes give rise to one form of the disease each; the eleven symptoms of these four forms 225 (8.14–32); 226 the prodromes (8.33–38ab); 227 the way in which the symptoms arise; a series of eleven symptoms is mentioned, 228 followed by a series of six symptoms; 229 irrespective of the number of symptoms present, a strong patient should be accepted for treatment, a weak patient rejected (8.38cd–47); 230 pratiśyāya is described, one of the prodromes of (rāja)yakṣman (8.48–50); 231 coughing with expectoration of rasa (8.51), one of the symptoms of rājayakṣman (8.43); a type of fever occurring in the disease (8.52); 232 svarabheda (impairment of the voice), one of the symptoms; 233 this disorder is of various types: caused by vāta, pitta, kapha, blood, the strain of coughing (kāsavega), and pīnasa (chronic rhinitis) (8.53–55); śūla (piercing pain) in the sides of the chest (pārśva) and in the head (śiras), which are symptoms²³⁴ (8.56); spitting of blood, one of the eleven symptoms²³⁵ (8.57); the way in which blood accumulates in the āmāśaya, gets excited (utkliṣṭa), and comes out by way of the throat (8.58); śvāsa (shortness of breath) and atisāra (diarrhoea), which are found among the symptoms²³⁶ (8.59); aruci (loss of appetite), one of the symptoms;²³⁷ five varieties are mentioned: caused by vāta, pitta, kapha, all three doṣas,²³⁸ and disgust (8.60–61); chardi (vomiting), ²³⁹ a disorder brought about by arocaka (loss of appetite), the strain of coughing (kāsavega), excitement (utkleśa)²⁴⁰ of the doṣas, and fear (8.62).
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The remaining part of the chapter (8.63–189) is devoted to the treatment of rājayakṣman²⁴¹ and the disorders forming part of it.²⁴²
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Meat dishes are thought to be useful in cases of rājayakṣman, particularly dishes prepared with the flesh of carnivorous animals. Because of the dislike these foods would inspire, they are to be served under the pretext that other animals are their source (8.149–162).²⁴³
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Recipes provided with a name are: yavānīṣaḍava (8.141–144),²⁴⁴ tālīśādyacūrṇa and -guṭikā (8.145–148).²⁴⁵
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The last group of verses (8.179cd–189), preceding the summary (8.190–191), enumerates many practices, both medical and religious, which are beneficial to a patient suffering from rājayakṣman.²⁴⁶
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Chapter nine, on unmāda (mental disorders),²⁴⁷ deals with: the causative factors of this disease (9.4);²⁴⁸ its pathogenesis (samprāpti) (9.5);²⁴⁹ the symptoms (9.6–7);²⁵⁰ the essential characteristics of the two types of unmāda: nija (endogenous) and āgantu (exogenous) (9.8ab); ²⁵¹ the aetiology and symptomatology of unmāda caused by vāta (9.9–10),²⁵² pitta (9.11–12),²⁵³ kapha (9.13–14),²⁵⁴ samnipāta (9.15);²⁵⁵ the āgantu type of unmāda is caused by possession (abhidharṣaṇa)²⁵⁶ by gods, sages, gandharvas, etc., improper observance of niyama (mental discipline), vratas (vows),²⁵⁷ etc., and improper conduct in previous existences (9.16);²⁵⁸ the general characteristics of possession (bhūtottha unmāda) (9.17);²⁵⁹ the way in which possession comes about: gods, etc., who are invisible, enter into a human being, without affecting his body, by the special power (prabhāva) of the properties characteristic of them, in a way similar to the production of a reflection (chāyā) in a mirror or the penetration of the rays of the sun into a sūryakānta (sunstone) (9.18);²⁶⁰ the characteristics of possession by divine beings (deva),²⁶¹ sages (ṛṣi),²⁶² manes (pitar),²⁶³ gandharvas,²⁶⁴ yakṣas,²⁶⁵ rākṣasas,²⁶⁶ brahmarākṣasas,²⁶⁷ piśācas (9.20); ²⁶⁸ the characteristics of persons liable to possession by a divine being, etc., and the days of the month on which divine beings, etc., preferably attack human beings (9.21);²⁶⁹ signs of incurability (9.22); the treatment of unmāda caused by beings whose objective is rati or arcanā (9.23);²⁷⁰ the treatment of nija and āgantu types of unmāda²⁷¹ (9.24–89ab);²⁷² the cure of unmāda through paying homage to Śiva²⁷³ and his attendants, the Pramathas,²⁷⁴ through sacrifices (bali, homa),²⁷⁵ the wearing of herbs and amulets (oṣadhidhāraṇa and agadadhāraṇa), mantras, good conduct, penance (tapas),²⁷⁶ gifts (pradāna), niyama, vratas, etc.
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(9.89cd–94);277 treatment of unmāda in the same way as apasmāra (9.95);278 the prevention of unmāda (9.96); the signs indicating recovery (9.97).
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Recipes provided with a name are: kalyāṇakaghṛta (9.33cd–42ab),279 mahākalyāṇakaghṛta (9.42cd–44),280 mahāpaiśācikaghṛta (9.45–48),281 laśunādyaghṛta (9.49–51), and a second laśunādyaghṛta (9.52–56).282
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Chapter ten, on apasmāra (epilepsy), deals with: a definition of this disease (10.3);283 its aetiology (10.4–5) and pathogenesis (10.6–8ab);284 the four types of apasmāra: caused by vāta, pitta, kapha and sannipāta; their symptoms285 and degrees of curability; the intervals between the attacks (10.8cd–13); treatment of apasmāra (10.14–52);286 apasmāra, in which in āgantu factor is secondarily (as an anubandha) involved,287 added to the doṣic aetiology, should be treated in the same way as the āgantu type of unmāda (10.53); the aetiology, pathogenesis (samprāpti), symptomatology and therapy of the major disease (mahāgada) called atattvābhiniveśa (10.54–63);288 the treatment of chronic (cirakārin) epilepsy which has acquired a firm footing (kṛtāspada) (10.64–65); precautions to be taken by a patient suffering from apasmāra (10.66).
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Recipes provided with a name are: pañcagavyaghṛta (10.16–17)289 and mahāpañcagavyaghṛta (10.18–24). 290
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Chapter eleven is concerned with kṣatakṣīṇa (injury to the chest and its effects). 291
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The subjects dealt with are: the aetiology of this disease (11.4–8); its pathogenesis; kṣata (injury) of the chest leads to kṣaya (wasting), due to deficiency of śukra and ojas (11.9–12ab); the prodromes292 and symptoms (11.12cd–13); the degrees of curability (11.14); treatment (11.15–95).
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Recipes provided with a name are: elādigulikā (11.21–24),293 amṛtaprāśaghṛta (11.35–43),294 śvadamṣṭrādighṛta (11.44–47), five varieties of sarpirguḍa (11.50–55, 56–61, 62–65, 66–69, 70–77),295 saindhavādicūrṇa (11.85–87), and ṣāḍava (11.88–90).
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Chapter twelve is about śvayathu (swelling).296
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It deals with the following subjects: the classification of the types of this disorder: caused by vāta, pitta and kapha, nija and anija (= āgantu), localized (ekāṅgaja) and generalized (sarvaja)297 (12.4);298 the aetiology of the nija and āgantu types (12.5–7ab);299 three varieties of the nija and āgantu types according to their seat: the whole body, half of it, or part of it (12.7cd) the samprāpti of śvayathu (12.8); śvayathu occurring in the upper (ūrdhvaga), lower (adhoga) and middle part (madhyaga) of the body, śvayathu of the whole body (sarvāṅgaga), and localized forms, called after the part affected (12.9); the prodromes (12.10ab); all varieties of śvayathu are caused by the three concerted doṣas, but they are designated after the predominant doṣa and treated accordingly (12.10cd); the symptoms of śvayathu in general (12.11); the symptoms of śvayathu with a predominance of vāta (12.12), pitta (12.13) and kapha (12.14);300 six fatal complications (12.15);301 signs indicating curability (12.16ab); the treatment of śvayathu302 (12.16cd–73). 303
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Recipes provided with a name are: gaṇḍīrādyariṣṭa (12.29–31),³⁰⁴ aṣṭaśatāriṣṭa (12.32–33), punarnavādyariṣṭa (12.34–38),³⁰⁵ triphalādyariṣṭa (12.39–40), kṣāra-guḍikā (12.43–46),³⁰⁶ śilājatuprayoga (12.49), kaṃsaharītakī (12.50–52),³⁰⁷ and citrakaghṛta (12.58–59).³⁰⁸
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Some localized varieties of śvayathu are described; śiraḥśotha (12.75ab);³⁰⁹ śālūka of the throat (12.75cd);³¹⁰ biḍālikā (12.76);³¹¹ tāluvidradhi (12.77ab);³¹² upajihvikā³¹³ and adhijihvikā³¹⁴ (12.77cd); upakuśa (12.78ab);³¹⁵ dantavidradhi (12.78cd);³¹⁶ galagaṇḍa³¹⁷ and gaṇḍamālā;³¹⁸ curable and incurable forms of these disorders, and their treatment (12.79–80);³¹⁹ granthi and its treatment (12.81–86);³²⁰ arbuda, to be treated in the same way as granthi (12.87);³²¹ ala jī (12.88ab);³²² akṣata, located at the junction of skin and nails (carmanakhāntara), caused by corruption of muscular tissue and blood (12.88cd);³²³ vidārikā (12.89a-c);³²⁴ the treatment of alajī, akṣata and vidārikā (12.89d–90ab); visphoṭaka (12.90cd);³²⁵ kakṣā (12.91ab);³²⁶ various other piḍakās, caused by pitta (12.91cd);³²⁷ romāntikā (12.92);³²⁸ masūrikā (12.93ab);³²⁹ the treatment of visphoṭaka, kakṣā, romāntikā and masūrikā, which is similar to the treatment of visarpa and kuṣṭha (12.93cd);³³⁰ bradhna, a disorder in which the intestine repeatedly comes out and enters the scrotum;³³¹ it is caused by each of the three doṣas, which present their characteristic signs; a similar swelling is brought about by urine³³² and medas (fatty tissue); bradhna is to be treated on conservative lines or by means of surgery (12.94–95);³³³ bhagandara³³⁴ and its treatment by means of conservative measures or surgery³³⁵ (12.96–97); ślīpada³³⁶ and its treatment³³⁷ (12.98);³³⁸ jālakagardabha and its treatment (12.99–100).³³⁹
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The chapter ends with guidelines for the treatment of other local swellings (12.101); vāta, in combination with blood, is the agent in red swellings caused by a trauma (abhighāta); their treatment consists of measures prescribed against visarpa and disorders arising from vāta in combination with blood; swellings caused by poisonous substances should be counteracted through antitoxic measures (12.102).
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Chapter thirteen, devoted to udara, begins with a number of questions on this disease, put to (Ātreya) Punarvasu, dwelling on mount Kailāsa, by his pupil Agniveśa (13.3–8). Punarvasu answers these questions.
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The chapter describes the pathogenesis of udara (13.9–11); the aetiology (13.12–15);³⁴⁰ the prodromes (13.16–19);³⁴¹ pathogenesis again (13.20);³⁴² the general symptoms of udara (13.21);³⁴³ the eight types of udara: by each of the three doṣas and all three together (samnipāta), pīthodara, baddhodara, kṣatodara, and udakodara (13.22);³⁴⁴ the aetiology, pathogenesis and symptomatology of vātodara (13.23–26),³⁴⁵ pittodara (13.26–28),³⁴⁶ kaphodara (13.29–31),³⁴⁷ samnipātodara (13.32–34),³⁴⁸ pīthodara (splenomegalia)³⁴⁹ and a similar disorder affecting the liver (yakṛt)³⁵⁰ (13.35–38), baddhagudodara³⁵¹ (13.39–41),³⁵² chidrodara,³⁵³ which may develop into udakodara³⁵⁴ (13.42–44), udakodara (ascites, i.e. dropsy) (13.45–47);³⁵⁵ the way in which udakodara develops, its two stages³⁵⁶ and their symptoms (13.48); complications (upadrava), indicating incurability (13.49);³⁵⁷ vātodara, pittodara, kaphodara, pīthodara, samnipātodara and udakodara are in this order of increasing severity; baddhagudodara usually becomes incurable after a fortnight; udakodara in its jātodaka stage and chidrāntrodara³⁵⁸ are generally incurable right from the beginning (13.50–51);³⁵⁹ signs indicating incurability and a fatal outcome (13.52–53); the cure of all types of udara is generally very difficult (kṛcchratama), but, under a number of specified conditions, the efforts at treatment may be successful (13.54);³⁶⁰ the symptoms of the type of udara called jātodaka (13.55–58); the treatment of the various types of udara (13.59–95ab)³⁶¹ and udara in general³⁶² (13.95cd–146ab);³⁶³ treatment after the elimination of the doṣas (13.146cd–175ab);³⁶⁴ treatment of refractory cases of udara with snake venom (13.175cd–184ab);³⁶⁵ surgical treatment (13.184cd–188); draining of the fluid accumulated in the abdominal cavity by means of a trocar (nāḍī), applicable in all types of udara which have reached the jātodaka stage (13.189–190); treatment subsequent on draining (13.191–193ab); after-treatment in general (13.193cd–194).³⁶⁶
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Recipes provided with a name are: paṭolādyacūrṇa (13.119cd–124ab),³⁶⁷ nārāyaṇa-cūrṇa (13.124cd–133ab), hapuṣādyacūrṇa (13.133cd–137ab), nīlinādyacūrṇa (13.137cd–138ab), and snuhīkṣīraghṛta (13.138cd–140).³⁶⁸
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Chapter fourteen, on arśas (haemorrhoids),³⁶⁹ begins again with Agniveśa’s questioning Punarvasu and the topics to be discussed: the aetiology (prakopahetu), shapes (saṃsthāna), location (sthāna), signs (liṅga), treatment, and degrees of curability of haemorrhoids (14.3–4).
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The subjects dealt with are: the classification of haemorrhoids into those present at birth (sahaja) and those developing at a later time (uttarakālaja); the substrate (āyatana) of those present at birth is the damaged (upatapta) bīja,³⁷⁰ responsible for the development of the ano-rectal folds (gudavali); damage to the bīja is in this case, as in all sahaja disorders, caused by faulty behaviour (apacāra) of the parents and transgressions during a previous existence; haemorrhoids are defined as a disorder characterized by an excess of muscular tissue (adhimāṃsavikāra) (14.5); the site (kṣetra) of all haemorrhoids is composed of the three ano-rectal folds (gudavali),³⁷¹ which occupy a space (avakāśa) measuring five fingers (aṅgula) and a half³⁷² and divide this space into three parts; some are of the opinion that growths called arśas are also found on the penis (śiśna), the female genitals (apathyapatha), in the pharynx (gala), on the palate, in the oral cavity (mukha), nose and ears, on the eyelids and the skin; these also consist of an excess of muscular tissue (adhimāṃsa), but only those arising from the ano-rectal folds are regarded as haemorrhoids in the present treatise; the substratum (adhisṭhāna) of all haemorrhoids consists of fatty tissue, muscular tissue and skin (14.6);³⁷³ the shapes and colours of sahaja haemorrhoids (14.7); their symptoms (14.8);³⁷⁴ the aetiology and pathogenesis of acquired haemorrhoids (14.9); their shapes (14.10); the symptoms of haemorrhoids brought about by vāta (4.11) and their aetiology (14.12–13);³⁷⁵ the symptoms and aetiology of haemorrhoids brought about by pitta (14.14 and 15–16), kapha (14.17 and 18–19), and a combination of two or three doṣas (14.20);³⁷⁶ the prodromes (14.21–22);³⁷⁷ haemorrhoids are always caused by all three doṣas, but designated after the predominant one (14.23); the excitation of the five kinds of vāta, of pitta, kapha, and of the three ano-rectal folds collectively leads to the appearance of haemorrhoids, a painful disorder, usually difficult to cure (14.24–25); the degrees of curability and their determining factors (14.26–32);³⁷⁸ treatment by means of excision (kartana), caustics (kṣāra) or cauterization (dāha), to be performed by experienced specialists, on account of the risks involved; the complications that may arise from these treatments (śastrakṣārāgnivibhrama); the hazardous character of the mentioned methods of treatment is the reason for describing easier ones, less painful and perilous (14.33–37);³⁷⁹ the classification of haemorrhoids into two categories: dry (śuṣka), with a predominance of vāta and kapha, and discharging (prasrāvin), with a predominance of blood and pitta (14.38); treatment of haemorrhoids (14.39–169);³⁸⁰ bleeding haemorrhoids, in which kapha or vāta is secondarily involved (as an anubandha) (14.170); the treatment of bleeding haemorrhoids (14.171–242);³⁸¹ the general treatment of haemorrhoids (14.243 and 246–248); the interdependence of haemorrhoids, diarrhoea and grahaṇī (14.244–245).
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Recipes provided with a name are: takrāriṣṭa (14.72–75),³⁸² abhayāriṣṭa (14.138–143),³⁸³ dantyariṣṭa (14.144–147),³⁸⁴ two varieties of phalāriṣṭa (14.148–152 and 153–157), kanakāriṣṭa (14.158–168),³⁸⁵ kuṭajādirasakriyā (14.188–192), picchā-basti (14.224–229), hrīverādighṛta (14.230–233),³⁸⁶ and suniṣaṇṇakācāṅgerīghṛta (14.234–242).³⁸⁷
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Chapter fifteen³⁸⁸ deals with the disorder called grahaṇīdoṣa.³⁸⁹
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The chapter begins with stressing the importance of the bodily fires (agni) (15.4–5). The prāṇa carries the food to the koṣṭha, where it is disintegrated (bhinnasaṃghāta) by fluids and softened by fatty substances, before being acted upon by the digestive fire,³⁹⁰ which is fanned (avadhūta) by the samāna; the fire, situated below the āmāśaya, cooks the food, which is separated into rasa and waste matter (mala) (15.6–8). The food, which has six tastes, is subjected to the process called prapāka; three stages are described; in the first stage the food becomes predominantly sweet and frothy (phenabhūta) by kapha; it becomes acid when being half-digested (vidagdha), descends (from the āmāśaya), and is acted upon by clear (accha) bile; having reached the pakvāśaya and being desiccated by the fire, it is converted into lumps (paripiṇḍita) and becomes pungent due to the activity of vāta (15.9–11).³⁹¹
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The senses and sense organs are nourished by the food (15.12). The fires of the five mahābhūtas digest the fractions of the food possessing the qualities of these bhūtas (15.13).³⁹² The products of this digestion nourish the bodily constituents possessing the same qualities (15.14).³⁹³ The seven bodily elements (dhātu), acted upon by their respective fires, are converted into a pure portion (prasāda) and a waste product (kiṭṭa) (15.15).³⁹⁴
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The formation of the bodily elements takes place in the following order, each element being transformed into the subsequent one: rasa, rakta, māṃsa, medas, asthi, majjā, śukra; a foetus arises from the pure portion of śukra (15.16).³⁹⁵
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These elements nourish in their turn other bodily constituents:³⁹⁶ rasa nourishes the breastmilk (stanya) and the blood (rakta) in women (that is transformed into the menstrual discharge), blood (asṛj) nourishes the kaṇḍarās and sirās, māṃsa nourishes vasā and the six layers of the skin, medas nourishes the snāyus and sandhis (15.17).
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The waste products (kiṭṭa, mala) of the food are faeces and urine; the waste product of rakta is bile (pitta); the waste products of māmsa consist of the impurities of the bodily orifices; the waste product of medas is sweat (sveda), of asthi the hairs of head (keśa) and body (loman), of majjā the fatty substance (sneha) of eyes, faeces and skin; these substances support (upastambha) each other and maintain the body (15.18–19).
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The intake of aphrodisiacs (vṛṣya) accelerates the processes described. Some are of the opinion that the process of conversion of the bodily elements (parivartana) is completed in a period of six days; however, the transformational processes (parivṛtti) take place continually in a cyclic way (cakravat) (15.20–21).397
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On the request of his pupil, Ātreya explains the changes of the properties of the bodily elements in the course of the transformational processes (15.22–35).398
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The vyāna disperses the element rasa continually throughout the body; a local morbid alteration (vikṛti) appears if this moving about of rasa is blocked at a particular place due to pathological changes of channels (khavaiguṇya); the doṣas are subsequently excited at that very place (15.35–38ab).
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The digestive fire is the chief one (adhipa) among all the bodily fires (paktar), which are dependent on it. For this reason it should be carefully protected, since, otherwise, grahaṇīdoṣa may develop (15.38cd–41).
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The aetiology of disorders of the digestive fire (agnidoṣa) is described,399 followed by their symptoms, in combination with excitation of one of the three doṣas (15.42–49).
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The actions on the dhātus of a normal digestive fire and of a disordered fire are described (15.50–51ab).
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A weak digestive fire leads to incomplete digestion (vidāha) of the ingested food, which then moves upwards or downwards; the disorder is called grahaṇīgada if it moves downwards. The symptoms are described, followed by the prodromes (15.51cd–55).400
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The grahaṇī and its functions are dealt with (15.56–57).401
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The aetiology and symptomatology of grahaṇīdoṣa caused by vāta, pitta, kapha and sannipāta are discussed.402 The three disorders of the digestive fire mentioned in the rogāmīka chapter403 are included under the heading of grahaṇīdoṣa (15.58–72).
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The remaining part of the chapter is devoted to the treatment of grahaṇīdoṣa 404 and agnidoṣa (15.73–243).
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Recipes provided with a name are: daśamūlādyaghṛta (15.82–86),405 tryūṣaṇādyaghṛta (15.87),406 pañcamūlādyaghṛta and -cūrṇa (15.88–93), citrakādyaguṭikā (15.96–97), maricādyacūrṇa (15.98–110),407 takrāriṣṭa (15.117cd–121),408 candanādyaghṛta (15.125–128), nāgarādyacūrṇa (15.129–131),409 bhūnim bādyacūrṇa (15.132–133), kirātādyacūrṇa (15.134–140),410 madhūkāsava (15.146–149),411 durālābhāsava (15.152–155),412 mūlāsava 15.156–159), piṇḍāsava (15.160–162), madhvariṣṭa (15.163–167), ṣaṭpalaghṛta (15.168–170),413 kṣāraghṛta (15.171–172),414 and several kinds of kṣāra (15.177–193).
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Chapter sixteen is concerned with pāṇḍuroga (morbid pallor and related disorders).415
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Subjects dealt with are: the five types of pāṇḍuroga, caused respectively by vāta, pitta, kapha, sannipāta and the eating of earth (mṛdbhakṣaṇa)416 (16.3);417 the samprāpti and aetiology (16.4–11); 418 the prodromes (16.12b–d) 419 and general symptoms (16.13–16); the symptoms of pāṇḍuroga caused by vāta (16.17–18), 420 pitta (16.19–22), 421 kapha (16.23–25), 422 samnipāta (16.26), 423 and the eating of earth (16.27–30); signs indicating incurability (16.31–33); the aetiology and symptomatology of kāmalā (jaundice) 424 and kumbhakāmalā, due to pitta (16.34–37ab); 425 signs of incurability (16.37cd–39ab); 426 treatment of the diseases described 427 (16.39cd–132ab); 428 the symptoms of halīmaka, due to vāta and pitta (16.132cd–134ab); 429 its treatment (16.134cd–138ab). 430
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Recipes provided with a name are: dāḍimādyaghṛta (16.44–46), 431 kaṭukādyaghṛta (16.47–49), 432 pathyāghṛta (16.50), dantīghṛta (16.51), drākṣāghṛta (16.52), 433 haridrādighṛta (16.53), 434 navāyasacūrṇa (16.70–71), 435 maṇḍūravaṭaka (16.73–77), yogarāja (16.80cd–87ab), śilājatuvaṭaka (16.87cd–93ab), punarnavamaṇḍūra (16.93cd–96), 436 dhātryavaleha (16.100–102ab), 437 a second maṇḍūravaṭaka (16.102cd–105ab), gauḍāriṣṭa (16.105cd–106ab), bījakāriṣṭa (16.106cd–111ab), 438 and dhātryariṣṭa (16.111cd–114ab). 439
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Substances containing iron or an iron compound are frequently prescribed in this chapter, 440 as well as a number of minerals. 441
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Chapter seventeen contains an exposition on hikkā (hiccup) and śvāsa (shortness of breath).
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The chapter begins with Agniveśa’s questions about diseases caused by three doṣas and with three factors leading to excitement (prakopaṇa); 442 these diseases are difficult to overcome (durjaya) (17.3–4).
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Ātreya answers that hikkā and śvāsa are conspicuous among fatal diseases and often appear in the last stage of various other disorders (17.5–7).
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Hikkā and śvāsa show a predominance of vāta and kapha, arise from the seat of pitta, 443 and desiccate the heart and the dhātus, which makes them very difficult to overcome, leading to death if not properly managed (17.8–9).
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Hikkā and śvāsa are both of five types (17.10ab).
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Ātreya gives an exposition on their common aetiology (17.10cd–16) 444 and samprāpti (17.17–18ab), 445 the prodromes of hikkā and those of śvāsa (17.18cd–20), 446 and the specific samprāpti of hikkā (17.21).
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The five types of hikkā are described: mahāhikkā (17.22–26), 447 gambhīrā hikkā (17.27–30), 448 vyapetā hikkā (17.31–33), 449 kṣudrahikkā (17.34–37), 450 and annajā hikkā (17.38–41). 451 The characteristics of patients who are liable to die from hikkā are dealt with (17.42–43ab). 452 The type of hikkā called yamikā (having double bouts) 453 is described, followed by the degrees of curability of hikkā (17.43cd–44). 454
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The specific samprāpti of śvāsa 455 is dealt with (17.45), and the five types of this disease are described: mahāśvāsa (17.46–48), 456 ūrdhvaśvāsa (17.49–51), 457 chinnaśvāsa (17.52–54), 458 tamaka (17.55–62), 459 pratamaka, 460 and samtamaka (17.63–64). 461 Kṣudraśvāsa (a minor degree of śvāsa) is described as a disorder brought about by dry articles of food and exertion; it is curable in strong patients. The other types of śvāsa are curable if not fully manifest (avyaktalakṣaṇa) (17.65–68ab). 462 The fatal cases should be given up, the curable and palliable ones should be treated as quickly as possible (17.68cd–69).
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The remaining part of the chapter (17.70–151)⁴⁶³ is devoted to treatment⁴⁶⁴ (17.68–150).⁴⁶⁵
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Recipes provided with a name are: muktādyacūrṇa (17.125–128), tejovatyādighṛta (17.141cd–144),⁴⁶⁶ and manaḥśilādighṛta (17.145–146).
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Chapter eighteen is concerned with kāsa (cough).⁴⁶⁷
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Its subjects are: the five types of kāsa: three types caused by the doṣas, one caused by a trauma (kṣata); and one caused by wasting (kṣaya);⁴⁶⁸ they lead to wasting when they are progressive (18.3–4); the prodromes (18.5);⁴⁶⁹ the saṃprāpti (18.6–8);⁴⁷⁰ the causes of the specific characteristics (18.9); the aetiology and symptomatology of kāsa brought about by vāta (18.10–13),⁴⁷¹ pitta (18.14–16),⁴⁷² kapha (18.17–19),⁴⁷³ injury to the chest (uraḥkṣata) (18.20–23),⁴⁷⁴ and wasting (18.24–29a);⁴⁷⁵ kāsa due to wasting is fatal in wasted (kṣīṇa) patients, but curable in strong ones; kāsa of traumatic origin is palliable in strong patients; both types are sometimes curable if they are of recent origin and correctly treated; kāsa appearing in old age (jarākāsa) is palliable (18.29–30).⁴⁷⁶
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The remaining part of the chapter is devoted to treatment⁴⁷⁷ (18.31–190).⁴⁷⁸
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Recipes provided with a name are: kaṇṭakārīghṛta (18.35),⁴⁷⁹ pippalyādighṛta (18.36–38),⁴⁸⁰ tryūṣaṇādyaghṛta (18.39–42),⁴⁸¹ rāsnāghṛta (18.43–46),⁴⁸² citrakādileha (18.53–56), agastyaharītakī (18.57–62),⁴⁸³ daśamūlādighṛta (18.123–124),⁴⁸⁴ a second kaṇṭakārīghṛta (18.125–128), kulatthādighṛta (18.129),⁴⁸⁵ dvipañcamūlādighṛta (18.158–160), guḍūcyādighṛta (18.161–162),⁴⁸⁶ harītakīleha (18.168–169), and padmakādileha (18.174–175).⁴⁸⁷
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Chapter nineteen gives an exposition on atīsāra (diarrhoea).⁴⁸⁸
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It begins with a story on the first appearance⁴⁸⁹ of this disease. During the first age of the world (ādikāla) the sacrificial animals were not killed, but only taken hold of. Later, after Dakṣa's sacrifice,⁴⁹⁰ the animals began to be consecrated (prokṣaṇa)⁴⁹¹ with their own consent (abhyanujñāna), in the sacrificial rites (kratu) of the sons of (Vaivasvata) Manu, called Nariṣyant, Nābhāga, Ikṣvāku, Nṛga, Śaryāti,⁴⁹² etc. Still later, Ṛṣabha⁴⁹³ started sacrificing cattle, because other animals were not available for his prolonged soma ritual (dīrghasattra).⁴⁹⁴ This made all creatures grief-stricken, and, when the meat of these cattle was consumed, all creatures began, because of their mental affliction and, consequently, by an impaired digestive fire, to suffer from diarrhoea, due to the properties of this inauspicious (aśasta) food (19.4).
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Linked texts (3)
- Carakasaṃhitā — Agniveśa (Āyurveda) & Caraka, Sanskrit
- Suśrutasaṃhitā — Suśruta & Nāgārjuna (siddha/alchemist), Sanskrit
- Viṣṇusahasranāma — Sanskrit