Charak Samhita - User contributions [en]

Uttar Basti Siddhi

2019-03-06T04:16:48Z

Pallavmishra:

{{Infobox
|title = Uttar Basti Siddhi
|label1 = Section/Chapter
|data1 = [[Siddhi Sthana]] Chapter 12
|label2 = Preceding Chapter
|data2 = [[Phalamatra Siddhi]]
|label4 = Succeeding Chapter
|data4 = None
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]

|header3 =

}}

==[[Siddhi Sthana]] Chapter 12, Chapter on Successful administration of best enema therapy ==

=== Abstract ===

The last chapter of [[Siddhi Sthana]], [[Uttar Basti Siddhi]] emphasizes upon the following:
#Diet regimen known as ''samsarjana krama'', to be followed after ''samshodhana'' (purification) therapy, in order to achieve normal health by enhancing appetite. Eight impediments occur if the prescribed precautions are not taken after undergoing a purification therapy. Their treatment is described.
#Understanding the twenty nine ''yapana bastis'' (a type of therapeutic enema) that are suitable for all persons in all seasons, as well as their ingredients, methods of preparation and benefits.
#Steps for compiling a treatise that is understandable by most readers by using thirty six ''tantra yuktis'' (canons of exposition or tricks to understand treatise). Their importance and application is described in some detail in this chapter.

'''Keywords''': ''Ashta Maha Dosha'', eight impediments, ''Yapana basti'', therapeutic enema, ''Tantra Yukti'', tricks to understand the text.

=== Introduction ===
The ''Samshodhana'' therapy is practiced in different form for the elimination of ''doshas'' from different routes. This last section consists of 12 chapters dealing with different procedures like ''vamana'' (therapeutic emesis), ''virechana'' (therapeutic purgation) and ''basti'' (therapeutic enema), etc. for the purification of body. In the entire section, the [[Panchakarma]] therapy regarding its different aspects like methods of preparation used for different procedures, administration, indications, contraindications and complications are described in detail. ''Samshodhana'' (purification) therapy is also used in the healthy state to maintain the health and prevent disease.

The chapter mainly deals with the precautionary measures practiced after [[Panchakarma]] therapy and therapeutic enemas that are good for all persons in all seasons. After [[Panchakarma]] therapy the patient needs special care in terms of diet and life style, in order to achieve positive health after purification. The eight impediments occur after therapy if, patient speaks loud, has jolting, excessive sitting, unwholesome diet and day time sleep etc. These are prohibited after [[Panchakarma]] therapy because they vitiate ''doshas''. These types of improper diet and lifestyle factors vitiate ''vata'' leading to various disorders. ''Basti'' (therapeutic enema) is considered an excellent method for the pacification of ''vata'' and treatment of various ''vata'' dominant disorders. Two hundred and sixteen enemas that are useful for all persons and can be taken in all seasons are described in this chapter.

In this concluding chapter, thirty six tricks named ''tantra yukti'' to understand text better are enlisted. These indicate the technical aspect of writing a large text avoiding repetitions, useful cross linkage of texts, remembering the references given earlier and later in the text. These are useful as learning techniques of ancient text. The chapter concludes with brief description about overall attributes of [[Charak Samhita]] and its constitution.

===Sanskrit text, Transliteration and English Translation===

अथातउत्तरबस्तिसिद्धिंव्याख्यास्यामः||१||

इतिहस्माहभगवानात्रेयः||२||

athātauttarabastisiddhiṁvyākhyāsyāmaḥ||1||

itihasmāhabhagavānātrēyaḥ||2||

athAtauttarabastisiddhiMvyAkhyAsyAmaH||1||

itihasmAhabhagavAnAtreyaH||2||

Now I will describe the chapter dealing with the successful application of ''uttara basti'' (medicated preparation for enema). Thus said Lord Atreya. [1-2]

==== Patient’s care after purification therapy ====

अथस्वल्वातुरंवैद्यःसंशुद्धंवमनादिभिः|
दुर्बलंकृशमल्पाग्निंमुक्तसन्धानबन्धनम्||३||

निर्हृतानिलविण्मूत्रकफपित्तंकृशाशयम्|
शून्यदेहंप्रतीकारासहिष्णुंपरिपालयेत्||४||

यथाऽण्डंतरुणंपूर्णंतैलपात्रंयथैव[१]च|
गोपालइवदण्डीगाःसर्वस्मादपचारतः||५||

athasvalvāturaṁvaidyaḥsaṁśuddhaṁvamanādibhiḥ|
durbalaṁkr̥śamalpāgniṁmuktasandhānabandhanam||3||

nirhr̥tānilaviṇmūtrakaphapittaṁkr̥śāśayam|
śūnyadēhaṁpratīkārāsahiṣṇuṁparipālayēt||4||

yathā'ṇḍaṁtaruṇaṁpūrṇaṁtailapātraṁyathaiva[1]ca|
gōpālaivadaṇḍīgāḥsarvasmādapacāratḥ||5||

athasvalvAturaMvaidyaHsaMshuddhaMvamanAdibhiH|
durbalaMkRushamalpAgniMmuktasandhAnabandhanam||3||

nirhRutAnilaviNmUtrakaphapittaMkRushAshayam|
shUnyadehaMpratIkArAsahiShNuMparipAlayet||4||

yathA~aNDaMtaruNaMpUrNaMtailapAtraMyathaiva[1]ca|
gopAlaivadaNDIgAHsarvasmAdapacAratH||5||

A person, after purification therapies like ''vamana'' and ''virechana'', becomes ''durbala''(weak), ''krisha''(emaciated), has ''alpagni'' (decreased digestive power), ''mukta sandhanabandhan'' (the joints of body become loose), whose ''vata'' (flatus), ''mala'' (stool), ''mutra'' (urine), ''kapha'' and ''pitta'' (body ''doshas'') have been evacuated, visceras, gastro-intestinal tract, urinary and gall bladder and other organ feel like empty. The body becomes free from vitiated ''dosha'' (body humor), ''dhatu'' (tissues) and ''malas'' (wastes). Not able to tolerate any type of therapeutic measures due to excessive weakness, the patient should be protected like "a freshly hatched egg", like a brimful pot of oil or like cattle that are protected by a cowherd with a stick in his hand. The physician should carefully protect the patient from the unwholesome effects of diet and lifestyle, etc. [3-5]

==== Sequence and diet regimen ====

अग्निसन्धुक्षणार्थंतुपूर्वंपेयादिनाभिषक्|
रसोत्तरेणोपचरेत्क्रमेणक्रमकोविदः||६||

स्निग्धाम्लस्वादुहृद्यानिततोऽम्ललवणौरसौ|
स्वादुतिक्तौततोभूयःकषायकटुकौततः||७||

अन्योऽन्यप्रत्यनीकानांरसानांस्निग्धरूक्षयोः|
व्यत्यासादुपयोगेनप्रकृतिंगमयेद्भिषक्||८||

agnisandhukṣaṇārthaṁtupūrvaṁpēyādinābhiṣak|
rasōttarēṇōpacarētkramēṇakramakōvidaḥ||6||

snigdhāmlasvāduhr̥dyānitatō'mlalavaṇaurasau|
svādutiktautatōbhūyaḥkaṣāyakaṭukautataḥ||7||

anyō'nyapratyanīkānāṁrasānāṁsnigdharūkṣayōḥ|
vyatyāsādupayōgēnaprakr̥tiṁgamayēdbhiṣak||8||

agnisandhukShaNArthaMtupUrvaMpeyAdinAbhiShak|
rasottareNopacaretkrameNakramakovidaH||6||

snigdhAmlasvAduhRudyAnitato~amlalavaNaurasau|
svAdutiktautatobhUyaHkaShAyakaTukautataH||7||

anyo~anyapratyanIkAnAMrasAnAMsnigdharUkShayoH|
vyatyAsAdupayogenaprakRutiMgamayedbhiShak||8||

For the enhancement of ''agni'' (power of digestion and metabolism), the physician should advise the patient to consume a ''peya'' (thin gruel) and certain dietary preparations (as described earlier in [[Sutra Sthana]]) after ''vamana'' and ''virechana'', followed by ''mamsa rasa'' (meat soup), for the protection of his health. The patient should be given ''snigdha'' (unctous), ''amla'' (sour), ''swadu'' (sweet) and ''hridya'' (pleasing) food. A sequence of ''rasas'' (taste) with sour and salty tastes should be given first, then the food having ''swadu'' (sweet) and ''tikta'' (bitter) taste and lastly the food articles having astringent and pungent tastes should be given.[6-8]

==== Natural state of health after purification ====

सर्वक्षमोह्यसंसर्गोरतियुक्तःस्थिरेन्द्रियः|
बलवान्सत्त्वसम्पन्नोविज्ञेयःप्रकृतिंगतः||९||

sarvakṣamōhyasaṁsargōratiyuktaḥsthirēndriyaḥ|
balavānsattvasampannōvijñēyaḥprakr̥tiṁgataḥ||9||

sarvakShamohyasaMsargoratiyuktaHsthirendriyaH|
balavAnsattvasampannovij~jeyaHprakRutiMgataH||9||

A patient is considered to be in a ''prakritik'' (natural) state of health if he exhibits characteristics such as ''sarvaksham'' (ability to tolerate (and adapt to) various types of diets and lifestyle), ''asamsarga'' (ability to manage natural urges), ''ratiyukta'' (endowed with a zest for life, i.e., is motivated to live), ''sthirendriya'' (has stable (not excited) senses), ''balwaan'' (strength of body and mind) and ''satvasampanna'' (endowed with strong will power).[9]

==== Eight impediments ====

एतांप्रकृतिमप्राप्तःसर्ववर्ज्यानिवर्जयेत्|
महादोषकराण्यष्टाविमानितुविशेषतः||१०||

उच्चैर्भाष्यंरथक्षोभमविचङ्क्रमणासने|
अजीर्णाहितभोज्येचदिवास्वप्नंसमैथुनम्||११||

तज्जादेहोर्ध्वसर्वाधोमध्यपीडामदोषजाः|
श्लेष्मजाःक्षयजाश्चैवव्याध्यःस्युर्यथाक्रमम्||१२||

ētāṁprakr̥timaprāptaḥsarvavarjyānivarjayēt|
mahādōṣakarāṇyaṣṭāvimānituviśēṣataḥ||10||

uccairbhāṣyaṁrathakṣōbhamavicaṅkramaṇāsanē|
ajīrṇāhitabhōjyēcadivāsvapnaṁsamaithunam||11||

tajjādēhōrdhvasarvādhōmadhyapīḍāmadōṣajāḥ|
ślēṣmajāḥkṣayajāścaivavyādhyaḥsyuryathākramam||12||

etAMprakRutimaprAptaHsarvavarjyAnivarjayet|
mahAdoShakarANyaShTAvimAnituvisheShataH||10||

uccairbhAShyaMrathakShobhamavica~gkramaNAsane|
ajIrNAhitabhojyecadivAsvapnaMsamaithunam||11||

tajjAdehordhvasarvAdhomadhyapIDAmadoShajAH|
shleShmajAHkShayajAshcaivavyAdhyaHsyuryathAkramam||12||

Until the normal state of health is restored as mentioned above, the patient should avoid all the prohibited activities during that period. He should avoid the following eight dietary and lifestyle activities in particular which are considered very harmful:
#''Ucchaih bhasya'' (loudly speaking) : This causes pain in the upper part of the body.
#''Ratha-kshobha'' (jolting /inconvenience during journey): This causes pain all over the body.
#''Ati-chakramana'' (excessive walking): This causes pain in the lower part of the body.
#''Ati-asana'' (excessive /continuous sitting): This causes pain in the middle part of the body;
#''Ajirna'' (indigestion) : This cause diseases due to ''ama'' (undigested material)
#''Ahita-bhojana'' (intake of unwholesome diet): This causes diseases due to vitiated ''doshas''.
#''Diva-svapna'' (sleeping during day time): This gives rise to diseases due to vitiated ''kapha dosha''
#''Maithuna'' (sexual intercourse): This cause diseases due to ''dhatu kshaya'' ( wasting/decay of body tissue )

तेषांविस्तरतोलिङ्गमेकैकस्यचभेषजम्|
यथावत्सम्प्रवक्ष्यामिसिद्धान्बस्तींश्चयापनान्||१३||

तत्रोच्चैर्भाष्यातिभाष्याभ्यांशिरस्तापशङ्खकर्णनिस्तोदश्रोत्रोपरोधमुखतालुकण्ठशोषतैमिर्यपिपासाज्वरतमक-हनुग्रहमन्यास्तम्भनिष्ठीवनोरःपार्श्वशूलस्वरभेदहिक्काश्वासादयःस्युः(१)|

रथक्षोभात्सन्धिपर्वशैथिल्यहनुनासाकर्णशिरःशूलतोदकुक्षिक्षोभाटोपान्त्रकूजनाध्मानहृदयेन्द्रियोपरोध-स्फिक्पार्श्ववङ्क्षणवृषणकटीपृष्ठवेदनासन्धिस्कन्धग्रीवादौर्बल्याङ्गाभितापपादशोफप्रस्वापहर्षणादयः (२)|

अतिचङ्कमणात्पादजङ्घोरुजानुवङ्क्षणश्रोणीपृष्ठशूलसक्थिसादनिस्तोद-पिण्डिकोद्वेष्टनाङ्गमर्दांसाभितापसिराधमनीहर्षश्वासकासादयः(३)|

अत्यासनाद्रथक्षोभजाःस्फिक्पार्श्ववङ्क्षणवृषणकटीपृष्ठवेदनादयः(४)|

अजीर्णाध्यशनाभ्यांतुमुखशोषाध्मानशूलनिस्तोदपिपासागात्रसादच्छर्द्यतीसारमूर्च्छाज्वरप्रवाहणामविषादयः(५)|

विषमाहिताशनाभ्यामनन्नाभिलाषदौर्बल्यवैवर्ण्यकण्डूपामागात्रसादवातादिप्रकोपजाश्चग्रहण्यर्शोविकारादयः(६)|

दिवास्वप्नादरोचकाविपाकाग्निनाशस्तैमित्यपाण्डुत्वकण्डूपामादाहच्छर्द्यङ्गमर्दहृत्स्तम्भजाड्यतन्द्रानिद्रा-प्रसङ्गग्रन्थिजन्मदौर्बल्यरक्तमूत्राक्षितातालुलेपाः(७)|

व्यवायादाशुबलनाशोरुसादशिरोबस्तिगुदमेढ्रवङ्क्षणोरुजानुजङ्घापादशूलहृदयस्पन्दननेत्रपीडाङ्गशैथिल्य-शुक्रमार्गशोणितागमनकासश्वासशोणितष्ठीवनस्वरावसादकटीदौर्बल्यैकाङ्गसर्वाङ्गरोगमुष्कश्वयथु-वातवर्चोमूत्रसङ्गशुक्रविसर्गजाड्यवेपथुबाधिर्यविषादादयःस्युः;अवलुप्यतइवगुदः,ताड्यतइवमेढ्रम्,अवसीदतीवमनो,वेपतेहृदयं,पीड्यन्तेसन्धयः,तमःप्रवेश्यतइवच(८)|

इत्येवमेभिरष्टभिरपचारैरेतेप्रादुर्भवन्त्युपद्रवाः||१४||

tēṣāṁvistaratōliṅgamēkaikasyacabhēṣajam|
yathāvatsampravakṣyāmisiddhānbastīṁścayāpanān||13||

tatrōccairbhāṣyātibhāṣyābhyāṁśirastāpaśaṅkhakarṇanistōdaśrōtrōparōdhamukhatālukaṇṭhaśōṣataimiryapipāsājvaratamaka-hanugrahamanyāstambhaniṣṭhīvanōraḥpārśvaśūlasvarabhēdahikkāśvāsādayaḥ syuḥ(1)|

rathakṣōbhātsandhiparvaśaithilyahanunāsākarṇaśiraḥśūlatōdakukṣikṣōbhāṭōpāntrakūjanādhmānahr̥dayēndriyōparōdha-sphikpārśvavaṅkṣaṇavr̥ṣaṇakaṭīpr̥ṣṭhavēdanāsandhiskandhagrīvādaurbalyāṅgābhitāpapādaśōphaprasvāpaharṣaṇādayaḥ (2)|

aticaṅkamaṇātpādajaṅghōrujānuvaṅkṣaṇaśrōṇīpr̥ṣṭhaśūlasakthisādanistōda-piṇḍikōdvēṣṭanāṅgamardāṁsābhitāpasirādhamanīharṣaśvāsakāsādayaḥ(3)|

atyāsanādrathakṣōbhajāḥsphikpārśvavaṅkṣaṇavr̥ṣaṇakaṭīpr̥ṣṭhavēdanādayaḥ(4)|

ajīrṇādhyaśanābhyāṁtumukhaśōṣādhmānaśūlanistōdapipāsāgātrasādacchardyatīsāramūrcchājvarapravāhaṇāmaviṣādayaḥ(5)|

viṣamāhitāśanābhyāmanannābhilāṣadaurbalyavaivarṇyakaṇḍūpāmāgātrasādavātādiprakōpajāścagrahaṇyarśōvikārādayaḥ(6)|

divāsvapnādarōcakāvipākāgnināśastaimityapāṇḍutvakaṇḍūpāmādāhacchardyaṅgamardahr̥tstambhajāḍyatandrānidrā-prasaṅgagranthijanmadaurbalyaraktamūtrākṣitātālulēpāḥ(7)|

vyavāyādāśubalanāśōrusādaśirōbastigudamēḍhravaṅkṣaṇōrujānujaṅghāpādaśūlahr̥dayaspandananētrapīḍāṅgaśaithilya-śukramārgaśōṇitāgamanakāsaśvāsaśōṇitaṣṭhīvanasvarāvasādakaṭīdaurbalyaikāṅgasarvāṅgarōgamuṣkaśvayathu-vātavarcōmūtrasaṅgaśukravisargajāḍyavēpathubādhiryaviṣādādayaḥsyuḥ;avalupyataivagudaḥ,tāḍyata[4]

ivamēḍhram,avasīdatīvamanō,vēpatēhr̥dayaṁ,pīḍyantēsandhayaḥ,tamaḥpravēśyataivaca(8)|

ityēvamēbhiraṣṭabhirapacārairētēprādurbhavantyupadravāḥ||14||

teShAMvistaratoli~ggamekaikasyacabheShajam|
yathAvatsampravakShyAmisiddhAnbastIMshcayApanAn||13||

tatroccairbhAShyAtibhAShyAbhyAMshirastApasha~gkhakarNanistodashrotroparodhamukhatAlukaNThashoShataimiryapipAsAjvaratamaka-hanugrahamanyAstambhaniShThIvanoraHpArshvashUlasvarabhedahikkAshvAsAdayaH syuH(1)|

rathakShobhAtsandhiparvashaithilyahanunAsAkarNashiraHshUlatodakukShikShobhATopAntrakUjanAdhmAnahRudayendriyoparodha-sphikpArshvava~gkShaNavRuShaNakaTIpRuShThavedanAsandhiskandhagrIvAdaurbalyA~ggAbhitApapAdashophaprasvApaharShaNAdayaH (2)|

atica~gkamaNAtpAdaja~gghorujAnuva~gkShaNashroNIpRuShThashUlasakthisAdanistoda-piNDikodveShTanA~ggamardAMsAbhitApasirAdhamanIharShashvAsakAsAdayaH(3)|

atyAsanAdrathakShobhajAHsphikpArshvava~gkShaNavRuShaNakaTIpRuShThavedanAdayaH(4)|

ajIrNAdhyashanAbhyAMtumukhashoShAdhmAnashUlanistodapipAsAgAtrasAdacchardyatIsAramUrcchAjvarapravAhaNAmaviShAdayaH(5)|

viShamAhitAshanAbhyAmanannAbhilAShadaurbalyavaivarNyakaNDUpAmAgAtrasAdavAtAdiprakopajAshcagrahaNyarshovikArAdayaH(6)|

divAsvapnAdarocakAvipAkAgninAshastaimityapANDutvakaNDUpAmAdAhacchardya~ggamardahRutstambhajADyatandrAnidrA-prasa~ggagranthijanmadaurbalyaraktamUtrAkShitAtAlulepAH(7)|

vyavAyAdAshubalanAshorusAdashirobastigudameDhrava~gkShaNorujAnuja~gghApAdashUlahRudayaspandananetrapIDA~ggashaithilya-shukramArgashoNitAgamanakAsashvAsashoNitaShThIvanasvarAvasAdakaTIdaurbalyaikA~ggasarvA~ggarogamuShkashvayathu-vAtavarcomUtrasa~ggashukravisargajADyavepathubAdhiryaviShAdAdayaH syuH;avalupyataivagudaH,tADyata ivameDhram,avasIdatIvamano,vepatehRudayaM,pIDyantesandhayaH,tamaHpraveshyataivaca(8)|

ityevamebhiraShTabhirapacAraireteprAdurbhavantyupadravAH||14||

The description of eight type of Impediments:

Now the details of signs, symptoms, treatment and effective ''yapana bastis'' (medicated enemas) for each impediment are described:

Due to speaking loudly or in excess before attaining the normal state of health after purification therapy,various diseases like ''shirahstapa'' (headache), ''shankha karna nistod'' (pricking pain in the temporal region and ears), ''shrotovarodha'' (obstruction in channels/deafness), ''mukha talu kantha shosha'' (dryness of mouth and throat), ''timir'' (black out), ''pipasa'' (excussive thirst), ''jwara'' (fever), ''tama'' (feeling like entering into dark), ''hanugrahamanyastmbha'' (spasticity of jaws, torticolis and ptyalism), ''nishthivan urah parshvashula'' (excess sputum and pain in the chest and sides of the chest), ''swarabheda'' (hoarseness of voice), ''hikka'' and ''shwasa'' (hiccup and dyspnea) etc.

===== Disease cause due to jolting by conveyance =====

The inconvenience caused by ''rathakshobha'' (jolting) results into various disorder if practiced after purification therapy, before gaining normal health are ''sandhiparva shaithilya'' (looseness of big and small joints) ''hanu nasa karnashirahshula-toda'' (pain and pricking in jaws, nose, ears and head), ''kukshi kshobha'' (pain the pelvic region), ''aatopa'' (meteorism), ''antrakujana'' (gurgling in intestines) and ''adhmana'' (flatulence), ''hridayendriyoparodha'' (congestion in heart region and senses), ''sphik, parshva, vankshana, vrushana, kati,'' ''prishtha vedana'' (pain in the hips, sides of the chest, groin, scrotum, waist and back) ''sandhi-skandha-greeva dourbalya'' (weakness of joints, shoulders and neck), ''angabhitapa'' (burning sensation in limbs), ''pada shotha, praswapa, harshabadaya'' (edema, numbness and tingling sensation in feet), etc.

===== Disease due to excessive walking =====

Before regaining normal health after the purification therapy excessive walking causes ''shula'' ( pain in the feet, calf regions, thighs, knees, groins, waist and back), ''sakthi sada nistoda'' (asthenia and pricking pain in legs), ''pidikodveshtana'' (cramps in the calf muscles) ''angamarda'' (malaise), ''amsabhitap'' (burning sensation in the shoulders), ''siradhamniharsha'' (swelling of the veins and arteries) ''shwasa, kasa'' (dyspnea and cough) and such other complications.

===== Disease due to constant sitting =====

Before regaining normal health after the purification therapy excessive/constant sitting causes ''sphik, parshva, vankshana, vrihana, kati, prushtha vedana'' (pain in the hips, sides of the chest, groins, scrotum, waist and back) and diseases that are described earlier in case of jolting.

===== Disease due to ''ajeerna'' and ''adhyashana'' (indigestion/ eating before the digestion of previous food) =====

Before attaining the normal health after the purification therapy, ''ajeerna'' (indigestion) and ''adhyashana'' (intake of food before the digestion of previous meal) results in to various health problems like ''mukhshosha'' (dryness of the mouth), ''adhmana'' (flatulence), ''shola nistoda'' (colicky and pricking pain), ''pipasa''(thirst), ''gatrasad'' (bodyache), ''chhardi'' (vomiting), ''atisara'' (diarrhea), ''murchha'' (fainting), ''jwara'' (fever), ''pravahana'' (gripping pain) and ''ama-visha'' (food poisoning due to ''ama'') and such other complications.

===== Disease due to ''vishama'' and ''ahitbhojana'' (irregular and unwholesome diet) =====

Irregular and unwholesome food is strictly prohibited before attaining the normal state of health. If it is not followed, health problems like ''aruchi'' (lack of desire for taking food), ''durbalta'' (weakness), ''vaivarnya'' (discoloration of the skin), ''kandu'' (itching), ''pama'' (scabies) and ''gatravasada'' (prostration of the body and ''grahani'' (sprue like disease, ''arsha'' (piles) and other diseases caused due to the vitiation and aggravation of ''vata''.

===== Disorders due to day time sleep =====

Before regaining normal health after purification therapy day time sleep causes disorders like ''arochak'' (anorexia), ''avipaka'' (indigestion) and ''agninasha'' (suppression of the power of digestion), ''staimitya'' (feeling like body is covered with wet cloths), ''pandu'' (anemea), ''kandu'' (itching), ''pama'' and ''daha'' (scabies and burning sensation), ''chhardi'' (vomiting) ''angamarda'' (malaise), ''hridsthambh'' (impairment of the cardiac function), ''jadya'' (stiffness), ''tandra'' (drowsiness) ''nidra'' (sleep), ''prasamga granthi'' (appearance of nodular swelling), ''dourbalya'' (weakness), ''raktamutrakshi'' (red coloration of urine and eyes), ''talulepa'' (coating of the palate).

===== Disorders due to ''vyavaya'' (sexual intercourse) =====

Indulgence in the sexual intercourse without restoration of normal health after purification therapy causes various disorders such as sudden loss of strength, ''urusad'' (prostration of thighs) headache, pain in the region of urinary bladder, anus, phallus, groins, thighs, knees, calf muscles and feet), ''hridayaspandan'' (palpitation), ''netrapeeda'' (pain in the eyes), ''angashethilya'' (asthenia), ''shukra marga shonita gaman'' (bleeding through the seminal rout), ''kasa'' (cough), ''shwas'' (dyspnoea), ''shonita shthivan'' (hemoptysis) and ''swaravsada'' (asthenia of the voice), ''katidourbalya'' (weakness of lumbosacral region), ''ekanga sarvanga'' (paralysis of part or the whole body), ''muskshvayatu'' (edema in the scrotum/hydrocele), ''vata-varchas-mutra sanga'' (retention of flatus, stool and urine), ''sukravisarga'' (excessive discharge of semen), ''jadya-vepathu-badhirya-vishada'' (numbness, trembling, deafness and depression etc.), ''avalupyata iva guda'' (piercing pain in anus), ''tadyata iva medhram'' (cutting pain in the phallus), ''avaseedat iva mana'' (feeling like mind is shrinking), ''veptehridyam'' (trembling of the heart), ''peedyante sandhi'' (pain in joints), ''tamapravesha'' (feeling like entering into the darkness.) [14/8]

Hence the disorders caused due to eight types of impediments are described in detail. [13-14]

==== Treatment of these impediments ====

तेषांसिद्धिः-तत्रोच्चैर्भाष्यातिभाष्यजानामभ्यङ्गस्वेदोपनाहधूमनस्योपरिभक्तस्नेहपानरसक्षीरादिर्वातहरःसर्वोविधिर्मौनंच(१)|

रथक्षोभातिचङ्क्रमणात्यासनजानांस्नेहस्वेदादिवातहरंकर्मसर्वंनिदानवर्जनंच(२)|

अजीर्णाध्यशनजानांनिरवशेषतश्छर्दनंरूक्षःस्वेदोलङ्घनीयपाचनीयदीपनीयौषधावचारणंच(३)|

विषमाहिताशनजानांयथास्वंदोषहराःक्रियाः(४)|

दिवास्वप्नजानांधूमपानलङ्घनवमनशिरोविरेचनव्यायामरूक्षाशनारिष्टदीपनीयौषधोपयोगःप्रघर्षणोन्मर्दनपरिषेचनादिश्चश्लेष्महरःसर्वोविधिः(५)|

मैथुनजानांजीवनीयसिद्धयोःक्षीरसर्पिषोरुपयोगः,तथावातहराःस्वेदाभ्यङ्गोपनाहावृष्याश्चाहाराःस्नेहाःस्नेहविधयोयापनाबस्तयोऽनुवासनंच;
मूत्रवैकृतबस्तिशूलेषुचोत्तरबस्तिर्विदारीगन्धादिगणजीवनीयक्षीरसंसिद्धंतैलंस्यात्||१५||

tēṣāṁsiddhiḥ-tatrōccairbhāṣyātibhāṣyajānāmabhyaṅgasvēdōpanāhadhūmanasyōparibhaktasnēhapānarasakṣīrādirvātaharaḥsarvōvidhirmaunaṁca(1)|

rathakṣōbhāticaṅkramaṇātyāsanajānāṁsnēhasvēdādivātaharaṁkarmasarvaṁnidānavarjanaṁca(2)|

ajīrṇādhyaśanajānāṁniravaśēṣataśchardanaṁrūkṣaḥsvēdōlaṅghanīyapācanīyadīpanīyauṣadhāvacāraṇaṁca(3)|

viṣamāhitāśanajānāṁyathāsvaṁdōṣaharāḥkriyāḥ(4)|

divāsvapnajānāṁdhūmapānalaṅghanavamanaśirōvirēcanavyāyāmarūkṣāśanāriṣṭadīpanīyauṣadhōpayōgaḥpragharṣaṇōnmardanapariṣēcanādiścaślēṣmaharaḥsarvōvidhiḥ(5)|

maithunajānāṁjīvanīyasiddhayōḥkṣīrasarpiṣōrupayōgaḥ,tathāvātaharāḥsvēdābhyaṅgōpanāhāvr̥ṣyāścāhārāḥsnēhāḥ-

snēhavidhayōyāpanābastayō'nuvāsanaṁca;mūtravaikr̥tabastiśūlēṣucōttarabastirvidārīgandhādigaṇajīvanīyakṣīrasaṁsiddhaṁtailaṁsyāt||15||

teShAMsiddhiH-tatroccairbhAShyAtibhAShyajAnAmabhya~ggasvedopanAhadhUmanasyoparibhaktasnehapAnarasakShIrAdirvAtaharaHsarvovidhirmaunaMca(1)|

rathakShobhAtica~gkramaNAtyAsanajAnAMsnehasvedAdivAtaharaMkarmasarvaMnidAnavarjanaMca(2)|

ajIrNAdhyashanajAnAMniravasheShatashchardanaMrUkShaHsvedo la~gghanIyapAcanIyadIpanIyauShadhAvacAraNaMca(3)|

viShamAhitAshanajAnAMyathAsvaMdoShaharAHkriyAH(4)|

divAsvapnajAnAMdhUmapAnala~gghanavamanashirovirecanavyAyAmarUkShAshanAriShTadIpanIyauShadhopayogaHpragharShaNonmardanapariShecanAdishcashleShmaharaHsarvovidhiH(5)|

maithunajAnAMjIvanIyasiddhayoHkShIrasarpiShorupayogaH,tathAvAtaharAHsvedAbhya~ggopanAhAvRuShyAsh-

cAhArAHsnehAHsnehavidhayoyApanAbastayo~anuvAsanaMca;mUtravaikRutabastishUleShucottarabastirvidArIgandhAdigaNajIvanIyakShIrasaMsiddhaMtailaMsyAt||15||

The treatment of eight type of Impediments-

Apart from the various disorders and their characteristics, the successful treatment of the same is described.

===== Treatment of the various disorders caused due loud and excessive speech =====

The disorders caused due loud and excessive speech can be cured by all the ''vata shamaka'' (''vayu''-alleviating) measures along with the methods like ''abhyanga'' (massage), ''sweda'' (fomentation), ''upanaha'' (application of hot poultices), ''dhuma'' (smoking therapy), ''nasya'' (inhalation therapy), ''upari-bhakta sneha-pana'' (intake of medicated ghee after the meal), ''ksheera'' (intake of milk), and ''moun'' (maintenance of silence), etc.

===== Treatment of the various disorders caused due to jolting, excessive walking and prolong sitting =====

The disorder caused due to jolting, long walking and prolonged sitting can be cured by the vata shamaka (vayu-alleviating) ahar (diet) vihar (life style) aushadha therapies like oleation, fomentation, etc. The patient should avoid vata vitiating factors.

===== Treatment of disorders Caused by ''Ajeerna'' and ''Adhyashana'' (Indigestion and frequent eating) =====

Indigestion and taking food before the previous meal is digested can be cured by the methods like ''vamana'' (emesis) ''ruksha-sweda'' (dry fomentation). Use of drugs which produce ''langhaniya'' (lightening effect), ''pachaniya'' (which digest ''ama''/undigested food materials) and ''dipaniya'' (stimulant of digestive power) effect.

===== Treatment of disorder caused ''vishama'' and ''ahitshana'' (irregular and unwholesome diet) =====

The of disorder caused due to ''vishama'' and ''ahitashana'' (irregular and unwholesome diet) can be cured by the pacifying respective vitiated ''doshas'' by respective diet drug and lifestyle.

===== Treatment of disorders caused due to day time sleeping =====

The treatment of disorders caused due to day time sleep should be treated by all the ''kapha''-alleviating measures including the diet drug and lifestyle by the following methods like ''dhuma-pana'' (medicated smoking), ''langhana'' (fasting or taking liquid diet), ''vamana'' (emesis), ''shiro-virechana'' (therapy of elimination of ''doshas'' from the head), ''vyayama'' (exercise), ''ruksha-asana'' (taking of dry diet), ''arishta'' (fermented syrup like preparations ), ''dipaniya'' (intake digestive stimulant), and ''pragharshana'' (friction massage), ''unmardana'' (kneading the body) ''parisechana'' (hot liquid fomentation).

===== Treatment of disorders caused by sexual intercourse =====

The health hazards caused due sexual intercourse should be treated by the administration of milk and ghee cooked by adding drugs belonging to ''jivaniya'' group, i.e., ''jivaka, rishabhaka, meda, maha-meda, kakoli, kshira-kakoli, mudga-parni, masha-parni, jivanti'' and ''madhuka'' ([[Sutra Sthana]] 4:9:1), (administration of fomentation, massage and ''upanaha'' (application of hot poultice) which pacify the ''vata dosha'' (taking food which promote virility like milk, intake of unctuous food and application of unctuous therapies), ''yapana'' and ''anuvasana basti'' (medicated enema which pacify ''vata''). If there are urinary morbidities, and pain in the region of urinary bladder, then ''uttara-basti'' (urethral douche) should be given with oil cooked by adding milk boiled with ''vidari-gandhadi'' and ''jivaniya'' (groups of drugs which promoting vitality Ch.Su.5). [15]

==== ''Yapana basti'' ====

यापनाश्चबस्तयःसर्वकालंदेयाः;तानुपदेक्ष्यामः

मुस्तोशीरबलारग्वधरास्नामञ्जिष्ठाकटुरोहिणीत्रायमाणापुनर्नवाबिभीतकगुडूचीस्थिरादिपञ्चमूलानिपलिकानिखण्डशःक्लृप्तान्यष्टौचमदनफलानिप्रक्षाल्यजलाढकेपरिक्वाथ्यपादशेषोरसःक्षीरद्विप्रस्थसंयुक्तःपुनःशृतःक्षीरावशे

षःपादजाङ्गलरसस्तुल्यमधुघृतःशतकुसुमामधुककुटजफलरसाञ्जनप्रियङ्गुकल्कीकृतःससैन्धवःसुखोष्णोबस्तिःशुक्रमांसबलजननःक्षतक्षीणकासगुल्मशूलविषमज्वरब्रध्न(वर्ध्म)

-कुण्डलोदावर्तकुक्षिशूलमूत्रकृच्छ्रासृग्रजोविसर्पप्रवाहिकाशिरोरुजा-जानूरुजङ्घाबस्तिग्रहाश्मर्युन्मादार्शःप्रमेहाध्मानवातरक्तपित्तश्लेष्मव्याधिहरःसद्योबलजननोरसायनश्चेति(१)|

एरण्डमूलपलाशात्षट्पलंशालिपर्णीपृश्निपर्णीबृहतीकण्टकारिकागोक्षुरकोरास्नाऽश्वगन्धागुडूचीवर्षाभूरारग्वधोदेवदार्वितिपलिकानिखण्डशःक्लृप्तानिफलानिचाष्टौप्रक्षाल्यजलाढकेक्षीरपादेपचेत्|

पादशेषंकषायंपूतंशतकुसुमाकुष्ठमुस्तपिप्पलीहपुषाबिल्ववचावत्सकफलरसाञ्जनप्रियङ्गुयवानिप्रक्षेपकल्कितं[१]मधुघृततैलसैन्धवयुक्तंसुखोष्णंनिरूहमेकंद्वौत्रीन्वादद्यात्|

सर्वेषांप्रशस्तोविशेषतोललितसुकुमारस्त्रीविहारक्षीणक्षतस्थविरचिरार्शसामपत्यकामानां[२]च(२)|

तद्वत्सहचरबलादर्भमूलसारिवासिद्धेनपयसा(३)|

तथाबृहतीकण्टकारीशतावरीच्छिन्नरुहाशृतेनपयसामधुकमदनपिप्पलीकल्कितेनपूर्ववद्वस्तिः(४)|

तथाबलातिबलाविदारीशालिपर्णीपृश्निपर्णीबृहतीकण्टकारिकादर्भमूलपरूषककाश्मर्यबिल्वफलयवसिद्धेनपयसामधुक-

मदनकल्कितेनमधुघृतसौवर्चलयुक्तेनकासज्वरगुल्मप्लीहार्दितस्त्रीमद्यक्लिष्टानांसद्योबलजननोरसायनश्च(५)|

बलातिबलारास्नारग्वधमदनबिल्वगुडूचीपुनर्नवैरण्डाश्वगन्धासहचरपलाशदेवदारुद्विपञ्चमूलानि[३]पलिकानियवकोलकुलत्थद्विप्रसृतंशुष्कमूलकानां[४]

चजलद्रोणसिद्धंनिरूहप्रमाणावशेषंकषायंपूतंमधुकमदनशतपुष्पाकुष्ठपिप्पलीवचावत्सकफलरसाञ्जनप्रियङ्गुयवानीकल्किकृतंगुडघृत

तैलक्षौद्रक्षीरमांसरसाम्लकाञ्जिकसैन्धवयुक्तंसुखोष्णंबस्तिंदद्याच्छुक्रमूत्रवर्चःसङ्गेऽनिलजेगुल्महृद्रोगाध्मानब्रध्नपार्श्वपृष्ठकटीग्रहसञ्ज्ञानाशबलक्षयेषुच(६)|

हपुषार्धकुडवोद्विगुणार्धक्षुण्णयवःक्षीरोदकसिद्धःक्षीरशेषोमधुघृततैललवणयुक्तःसर्वाङ्गविसृतवातरक्तसक्तविण्मूत्रस्त्रीखेदितहितोवातहरोबुद्धिमेधाग्निबलजननश्च(७)|

ह्रस्वपञ्चमूलीकषायःक्षीरोदकसिद्धःपिप्पलीमधुकमदनकल्कीकृतःसगुडघृततैललवणःक्षीणविषमज्वरकर्शितस्यबस्तिः(८)|

बलातिबलापामार्गात्मगुप्ताष्टपलार्धक्षुण्णयवाञ्जलिकषायःसगुडघृततैललवणयुक्तःपूर्ववद्बस्तिःस्थविरदुर्बलक्षीणशुक्ररुधिराणांपथ्यतमः(९)|

बलामधुकविदारीदर्भमूलमृद्वीकायवैःकषायमाजेनपयसापक्त्वामधुकमदनकल्कितंसमधुघृतसैन्धवंज्वरार्तेभ्योबस्तिंदद्यात्(१०)|

शालिपर्णीपृश्निपर्णीगोक्षुरकमूलकाश्मर्यपरूषकखर्जूरफलमधूकपुष्पैरजाक्षीरजलप्रस्थाभ्यांसिद्धःकषायःपिप्पलीमधुकोत्पलकल्कितःसघृतसैन्धवःक्षीणेन्द्रियविषमज्वरकर्शितस्यबस्तिःशस्तः(११)|

स्थिरादिपञ्चमूलीपञ्चपलेनशालिषष्टिकयवगोधूममाषपञ्चप्रसृतेनछागंपयःशृतंपादशेषंकुक्कुटाण्डरससममधुघृतशर्करासैन्धवसौवर्चलयुक्तोवस्तिर्वृष्यतमोबलवर्णजननश्च[५]|

इतियापनाबस्तयोद्वादश||१६||

कल्पश्चैषशिखिगोनर्दहंससारसाण्डरसेषुस्यात्||१७||

yāpanāścabastayaḥsarvakālaṁdēyāḥ;tānupadēkṣyāmaḥ

mustōśīrabalāragvadharāsnāmañjiṣṭhākaṭurōhiṇītrāyamāṇāpunarnavābibhītakaguḍūcīsthirādipañca-

mūlānipalikānikhaṇḍaśaḥklr̥ptānyaṣṭaucamadanaphalā

niprakṣālyajalāḍhakēparikvāthyapādaśēṣōrasaḥkṣīradviprasthasaṁyuktaḥpunaḥśr̥taḥkṣīrāvaśēṣaḥpāda-

jāṅgalarasastulyamadhughr̥taḥśatakusumāmadhukak

uṭajaphalarasāñjanapriyaṅgukalkīkr̥taḥsasaindhavaḥsukhōṣṇōbastiḥśukramāṁsabalajananaḥkṣatakṣīṇakā-

sagulmaśūlaviṣamajvarabradhna(vardhma)

-kuṇḍalōdāvartakukṣiśūlamūtrakr̥cchrāsr̥grajōvisarpapravāhikāśirōrujā-

jānūrujaṅghābastigrahāśmaryunmādārśaḥpramēhādhmānavātaraktapittaślēṣmavyādhiharaḥsadyōbalajananōrasāyanaścēti(1)|

ēraṇḍamūlapalāśātṣaṭpalaṁśāliparṇīpr̥śniparṇībr̥hatīkaṇṭakārikāgōkṣurakōrāsnā'śvagandhāguḍūcīvar-

ṣābhūrāragvadhōdēvadārvitipalikānikhaṇḍaśaḥklr̥

ptāniphalānicāṣṭauprakṣālyajalāḍhakēkṣīrapādēpacēt|

pādaśēṣaṁkaṣāyaṁpūtaṁśatakusumākuṣṭhamustapippalīhapuṣābilvavacāvatsakaphalarasāñjanapriyaṅguyavāniprakṣēpakalkitaṁ[1]

madhughr̥tatailasaindhavayuktaṁsukhōṣṇaṁnirūhamēkaṁdvautrīnvādadyāt|

sarvēṣāṁpraśastōviśēṣatōlalitasukumārastrīvihārakṣīṇakṣatasthaviracirārśasāmapatyakāmānāṁ[2]ca(2)|

tadvatsahacarabalādarbhamūlasārivāsiddhēnapayasā(3)|

tathābr̥hatīkaṇṭakārīśatāvarīcchinnaruhāśr̥tēnapayasāmadhukamadanapippalīkalkitēnapūrvavadvastiḥ(4)|

tathābalātibalāvidārīśāliparṇīpr̥śniparṇībr̥hatīkaṇṭakārikādarbhamūlaparūṣakakā-

śmaryabilvaphalayavasiddhēnapayasāmadhukamadanakalkitēnamadhugh

r̥tasauvarcalayuktēnakāsajvaragulmaplīhārditastrīmadyakliṣṭānāṁsadyōbalajananōrasāyanaśca(5)|

balātibalārāsnāragvadhamadanabilvaguḍūcīpunarnavairaṇḍāśvagandhāsahacarapalāśadēvadārudvipañcamūlāni[3]

palikāniyavakōlakulatthadviprasr̥taṁśuṣkamūlakānāṁ[4]

cajaladrōṇasiddhaṁnirūhapramāṇāvaśēṣaṁkaṣāyaṁpūtaṁmadhukamadanaśatapuṣpā-

kuṣṭhapippalīvacāvatsakaphalarasāñjanapriyaṅguyavānīkalkikr̥taṁguḍagh

r̥tatailakṣaudrakṣīramāṁsarasāmlakāñjikasaindhavayuktaṁsukhōṣṇaṁbastiṁdadyācchukramūtra-

varcaḥsaṅgē'nilajēgulmahr̥drōgādhmānabradhnapārśvapr̥ṣṭh

akaṭīgrahasañjñānāśabalakṣayēṣuca(6)|

hapuṣārdhakuḍavōdviguṇārdhakṣuṇṇayavaḥkṣīrōdakasiddhaḥkṣīraśēṣōmadhughr̥tatailala-

vaṇayuktaḥsarvāṅgavisr̥tavātaraktasaktaviṇmūtrastrīkhēditahit

ōvātaharōbuddhimēdhāgnibalajananaśca(7)|

hrasvapañcamūlīkaṣāyaḥkṣīrōdakasiddhaḥpippalīmadhukamadanakalkīkr̥taḥsaguḍaghr̥tatailalavaṇaḥkṣīṇaviṣamajvarakarśitasyabastiḥ(8)|

balātibalāpāmārgātmaguptāṣṭapalārdhakṣuṇṇayavāñjalikaṣāyaḥsaguḍaghr̥tatailalavaṇa-

yuktaḥpūrvavadbastiḥsthaviradurbalakṣīṇaśukrarudhirāṇāṁpathy

atamaḥ(9)|

balāmadhukavidārīdarbhamūlamr̥dvīkāyavaiḥkaṣāyamājēnapayasāpaktvāmadhukamadanakalkitaṁsamadhughr̥tasaindhavaṁjvarārtēbhyōbastiṁdadyāt(10)|

śāliparṇīpr̥śniparṇīgōkṣurakamūlakāśmaryaparūṣakakharjūraphalamadhūkapuṣpairajākṣīrajalaprasthābhyāṁsiddhaḥkaṣāyaḥpippalīmadhukōtpalakalkitaḥ

saghr̥tasaindhavaḥkṣīṇēndriyaviṣamajvarakarśitasyabastiḥśastaḥ(11)|

sthirādipañcamūlīpañcapalēnaśāliṣaṣṭikayavagōdhūmamāṣapañcaprasr̥tēnachāgaṁpayaḥśr̥taṁpādaśēṣaṁkukkuṭāṇḍarasasamamadhughr̥taśarkarāsaindhavasau

varcalayuktōvastirvr̥ṣyatamōbalavarṇajananaśca[5]|

itiyāpanābastayōdvādaśa||16||

kalpaścaiṣaśikhigōnardahaṁsasārasāṇḍarasēṣusyāt||17||

yApanAshcabastayaHsarvakAlaMdeyAH;tAnupadekShyAmaH

mustoshIrabalAragvadharAsnAma~jjiShThAkaTurohiNItrAyamANApunarnavAbibhItakaguDUcIsthirAdipa~jcamUlAnipalikAnikhaNDashaHklRuptAnyaShTaucamada

naphalAniprakShAlyajalADhakeparikvAthyapAdasheShorasaHkShIradviprasthasaMyuktaHpunaHshRutaHkShIrAvasheShaHpAdajA~ggalarasastulyamadhughRutaH

shatakusumAmadhukakuTajaphalarasA~jjanapriya~ggukalkIkRutaHsasaindhavaHsukhoShNobastiHshukramAMsabalajananaHkShatakShINakAsagulmashUlaviSham

ajvarabradhna(vardhma)-kuNDalodAvartakukShishUlamUtrakRucchrAsRugrajovisarpapravAhikAshirorujA-

jAnUruja~gghAbastigrahAshmaryunmAdArshaHpramehAdhmAnavAtaraktapittashleShmavyAdhiharaHsadyobalajananorasAyanashceti(1)|

eraNDamUlapalAshAtShaTpalaMshAliparNIpRushniparNIbRuhatIkaNTakArikAgokShurakorAsnA~ashvagandhAguDUcIvarShAbhUrAragvadhodevadArvitipalikAnikh

aNDashaHklRuptAniphalAnicAShTauprakShAlyajalADhakekShIrapAdepacet|

pAdasheShaMkaShAyaMpUtaMshatakusumAkuShThamustapippalIhapuShAbilvavacAvatsakaphalarasA~jjanapriya~gguyavAniprakShepakalkitaM[1]

madhughRutatailasaindhavayuktaMsukhoShNaMnirUhamekaMdvautrInvAdadyAt|

sarveShAMprashastovisheShatolalitasukumArastrIvihArakShINakShatasthaviracirArshasAmapatyakAmAnAM[2]ca(2)|

tadvatsahacarabalAdarbhamUlasArivAsiddhenapayasA(3)|

tathAbRuhatIkaNTakArIshatAvarIcchinnaruhAshRutenapayasAmadhukamadanapippalIkalkitenapUrvavadvastiH(4)|

tathAbalAtibalAvidArIshAliparNIpRushniparNIbRuhatIkaNTakArikAdarbhamUlaparUShakakAshmaryabilvaphalayavasiddhenapayasAmadhukamadanakalkitenam

adhughRutasauvarcalayuktenakAsajvaragulmaplIhArditastrImadyakliShTAnAMsadyobalajananorasAyanashca(5)|

balAtibalArAsnAragvadhamadanabilvaguDUcIpunarnavairaNDAshvagandhAsahacarapalAshadevadArudvipa~jcamUlAni[3]

palikAniyavakolakulatthadviprasRutaMshuShkamUlakAnAM[4]

cajaladroNasiddhaMnirUhapramANAvasheShaMkaShAyaMpUtaMmadhukamadanashatapuShpAkuShThapippalIvacAvatsakaphalarasA~jjanapriya~gguyavAnIkalkikRu

taMguDaghRutatailakShaudrakShIramAMsarasAmlakA~jjikasaindhavayuktaMsukhoShNaMbastiMdadyAcchukramUtravarcaHsa~gge~anilajegulmahRudrogAdhmAnab

radhnapArshvapRuShThakaTIgrahasa~jj~jAnAshabalakShayeShuca(6)|

hapuShArdhakuDavodviguNArdhakShuNNayavaHkShIrodakasiddhaHkShIrasheShomadhughRutatailalavaNayuktaHsarvA~ggavisRutavAtaraktasaktaviNmUtrastrIk

heditahitovAtaharobuddhimedhAgnibalajananashca(7)|

hrasvapa~jcamUlIkaShAyaHkShIrodakasiddhaHpippalImadhukamadanakalkIkRutaHsaguDaghRutatailalavaNaHkShINaviShamajvarakarshitasyabastiH(8)|

balAtibalApAmArgAtmaguptAShTapalArdhakShuNNayavA~jjalikaShAyaHsaguDaghRutatailalavaNayuktaHpUrvavadbastiHsthaviradurbalakShINashukrarudhirAN

AMpathyatamaH(9)|

balAmadhukavidArIdarbhamUlamRudvIkAyavaiHkaShAyamAjenapayasApaktvAmadhukamadanakalkitaMsamadhughRutasaindhavaMjvarArtebhyobastiMdadyAt(10)|

shAliparNIpRushniparNIgokShurakamUlakAshmaryaparUShakakharjUraphalamadhUkapuShpairajAkShIrajalaprasthAbhyAMsiddhaHkaShAyaHpippalImadhukotpal

akalkitaHsaghRutasaindhavaHkShINendriyaviShamajvarakarshitasyabastiHshastaH(11)|

sthirAdipa~jcamUlIpa~jcapalenashAliShaShTikayavagodhUmamAShapa~jcaprasRutenachAgaMpayaHshRutaMpAdasheShaMkukkuTANDarasasamamadhughRutasharka

rAsaindhavasauvarcalayuktovastirvRuShyatamobalavarNajananashca[5]|

itiyApanAbastayodvAdasha||16||

kalpashcaiShashikhigonardahaMsasArasANDaraseShusyAt||17||

''Yapana Basti-Yapana basti'' can be administered at any time. (These are called ''yapana-basti'' because they prolong the span of life).

===== ''Mustadya Yapana-basti'' =====

One ''pala'' (48 gm) each of ''musta'' (Cyperus rotundus), ''ushira'' (Vetiveria zizanioidis), ''bala'' (Sida cordifolia), ''aragvadha'' (Cassia fistula), ''rasna'' (Pluchea lanceolata), ''manjishtha'' (Rubia cordifolia), ''katu-rohini'' (Picrorhiza kurroa), ''trayamana'' (Gentiana kurroo), ''punarnava'' (Boerhavia diffusa), ''bibhitaka'' (Terminalia bellirica), ''guduchi'' (Tinospora cordifolia), ''shala-parni'' (Desmodium gangeticum), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum surattense) and ''gokshura'' (Tribulus terrestris) should be cut into small pieces. Eight fruits of ''madana'' (Xeromphis spinosa) should be added to this. All ingredients should be washed well first and then boiled by adding one ''adhaka'' (256 tolas) or (256x12 gm) of water till one-fourth of the water remains. To this decoction, two ''prasthas'' (2x768gm) of cow’s milk should be added, and then boil again till two ''prasthas'' of the liquid remains. To this remaining liquid, half ''prastha'' of ''mamsarasa'' (soup of meat of arid zone animals), ghee and honey equal to ''mamsarasa'', and the paste of ''shata-kusuma/shata-pushpa'' (Anethum sowa), ''madhuka'' (Glycyrrhiza glabra),fruit of ''kutaja'' (Holarrhena antidysenterica), ''rasanjana'' (extract of Barberis aristata), ''priyangu'' (Callicarpa macrophylla) as well as a little of ''saindhava lavana'' (rock-salt) should be added. This lukewarm preparation should be used for ''basti''.

This medicated preparation which is used for ''basti'' (enema) therapy has the various therapeutic effects such as ''shukra mamsa bala janana'' (increases sperm, muscle and strength), cures ''kshata-kshina'' (debilitation), ''kasa'' (cough), ''gulma'' ( abdominal lump), ''shula'' (pain), ''vishama jwara'' (chronic/irregular fever), ''bradhna'' or ''vardhma'' (inguinal swelling/hernia), ''kundala'' (..), ''kundloudavarta'' (moving pain abdomen), ''kukshi shula'' (pain in pelvic region), ''mutrakrichchha'' (dysuria), ''asrig-rajah'' (bleeding per vagina), ''visarpa'' (erysipelas), ''pravahika'' (dysentery), ''shiroruja'' (headache) ''januurujanghabastigrahasmaryaunmada'' (stiffness of knee-joints, thighs, calf regions and the region of urinary bladder, ''asmari'' (calculus), ''unmada'' (insanity), ''arsha'' (piles), ''prameha'' (urinary disorders including diabetes), ''adhman'' (abdomen distension), ''vata-rakta'' (gout) and cure diseases caused due to aggravated ''pitta'' and ''kapha'', ''sadyabalajanan'' and ''rasayana'' (promotes strength and rejuvenates) also.[16/1]

===== ''Eranda-muladya yapana-basti'' =====

Six ''palas'' (6x48gm) of the root of ''eranda'' (castor) and bark of leaves of ''palash'' (Butea monosperma), three ''pala'' (3x48 gm) of each, ''shala-parni'' (Desmodium gangeticum), ''prishniparni''(Uraria picta), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum surattense), ''gokshura'' (Tribulus terrestris), ''rasna'' (Pluchea lanceolata), ''ashvagandha'' (Withania somnifera), ''guduchi'' (Tinospora cordifolia), ''varsabhu'' (punarnava or Boerhavia diffusa), ''aragvadha'' (Cassia fistula), and ''devadaru'' (Cedrus deodara) should be cut into small pieces, washed properly, and cooked by adding one ''adhaka'' (3.72 kg) of water and one-fourth ''adhaka'' of milk till remaining one fourth of the same. To this the paste of ''shata-kusuma'' (shata-pushpa or Anethum sowa), ''kushtha'' (Saussurea lappa), ''musta'' (Cyperus rotundus), ''pippali'' (Piper longum), ''hapusha'' (Juniperus communis), ''bilva'' (Aegle marmelos), ''vacha'' (Acorus calamus), fruit of ''vatsaka'' (Holarrhena antidysenterica), ''rasanjana'' (Extract of Barberis Aristata), ''priyangu'' (Callicarpa macrophylla) and ''yavani'' (Trachyspermum ammi) should be added. Honey, ghee, oil and rock-salt should also be added to this preparation, It should be given when ''sukhoshna'' (luke-warm), in the form of ''niruha basti'' (evacuative enema) once, twice or thrice a day.

This ''basti'' is beneficial, for the pleasure-loving people, those having compromised health, those indulging in sex in excess, emaciated persons and those suffering from phthisis; old persons, suffering from chronic piles, and those desiring of progeny.

===== ''Sahacharadya yapana-basti'' =====

By following the same procedure, the ''basti'' preparation prepared by boiling milk with ''sahachara'' (Barleria prionitis)), ''bala'' (Sida cordifolia), root of ''darbha'' (Imperata cylindrica) and ''sariva'' (Hemidesmus indicus).

===== ''Brihatyadi yapana-basti'' =====

In this ''basti'' milk is boiled by adding ''brihati'' (Solanum indicum), ''kantakari'' (Solanum surattense), ''shatavari'' (Asparagus racemosus) and ''chinna-ruha'' (guduchi-Tinospora cordifolia). To this preparation, the ''kalka'' (paste) of ''mulethi'' (Glycyrrhiza glabra), ''madanaphala'' (Xeromphis spinosa) and ''pippali'' (Piper longum), should be added. In both of these the honey, ghee, oil and rock-salt should also be added before the administration of ''basti''. The beneficial effects of these ''bastis'' are same as the previous one.

===== ''Baladi yapana basti'' – I =====

Milk boiled with ''bala'' (Sida cordifolia), ''ati-bala'' (Abutilon indicum), ''vidari kandi'' (Pueraria tuberose), ''shali-parni'' (Desmodium gangeticum), ''prishni-parni'' (Uraria picta), ''brihati'' (Solanum indicum), ''kantakarika'' (Solanum surattense), root of ''darbha'' (Imperata cylindrical), ''parushaka'' (Grewia asiatica), ''kashmarya'' (Gmelina arborea), fruit of ''bilva'' (Aegle marmelos) and ''yava'' (Hordeum vulgare) should be added with the ''kalka'' (paste) of ''madhuka'' (Glycyrrhiza glabra), and ''madana'' (Xeromphis spinosa) along with honey, ghee as well as ''sauvarchala'' salt. This ''basti'' instantaneously promotes strength, and rejuvenates the persons suffering from ''kasa'' (cough), ''jwara'' (fever), ''gulma'' (abdominal lumps), ''pliha vikara'' (splenic disorders) and ''ardita'' (facial paralysis).

This also promotes the strength, and rejuvenates persons who are indulging in (excessive sex) and alcoholism.

===== ''Baladi Yapana Basti''- II =====

One ''pala'' (48gm) each of ''bala'' (Sida cordifolia), ''ati-bala'' (Abutilon indicum), ''rasna'' (Pluchea lanceolata), ''aragvadha'' (Cassia fistula), ''madana'' (Xeromphis spinosa), ''bilva'' fruit (Aegle marmelos), ''guduchi'' (Tinospora cordifolia), ''punarnava'' (Boerhavia diffusa), ''eranda'' (Ricinus communis), ''ashvagandha'' (Withania somnifera), ''sahachara'' (Barleria prionitis), ''palasha'' (Butea monosperma), ''deva-daru'' (Cedrus deodara), root of ''bilva'' (Aegle marmelos), ''shyonaka'' (Oroxylum indicum), ''gambhari'' (Gmelina arborea), ''patala'' (Stereospermum suaveolens), ''ganikarika'' (Premna mucronata), ''shala-parni'' (Desmodium gangeticum), ''prishni-parni'' (Uraria picta), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum surattense), and ''gokshura'' (Tribulus terrestris), and two ''prasthas'' (192gm) each of ''yava'' (Hordeum vulgare), ''kola'' (Piper longum ), ''kulattha'' (Dolichos biflorus ) as well as ''shushka-mulaka'' (dry Raphanus sativus) should be boiled by adding one drone (12.288kg ) of water till five ''prasthas'' (5x96gm) of liquid remains.

To this ''kwath'' (decoction), the paste of ''madhuka'' (Glycyrrhiza glabra), ''madana'' (Xeromphis spinosa), ''shata-pushpa'' (anethum sowa), ''kustha'' (saussurea lappa), ''pippali'' (piper longum), ''vacha'' (Acorus calamus), fruit of ''vatsaka'' (Holarrhena antidysenterica), ''rasanjana, priyangu'' (Callicarpa macrophylla) and ''yavani'' (Trachyspermum ammi) should be added. ''Payasa'' (Jiggery), ghee, ''taila'' (oil), ''madhu'' (honey), ''dugdha'' (milk), ''mamsa rasa'' (meat soup), ''amla-kanjika'' (sour vinegar) and ''saindhva lavana'' (rock salt),should be added to this preparation, when it is lukewarm, and then should be used for application of ''basti''. This ''basti'' helps in curing the disorders caused due to retention of ''shukra'' (semen), ''mutra'' (urine) and ''mala'' (stool) because of aggravated ''vata, gulma'' (phantom tumor), ''hrid-roga'' (heart-diseases), ''adhmana'' (flatulence), ''bradhna'' (inguinal hernia/swellings), (stiffness of the sides of the chest, back and lumbar region), ''sangyanash'' (unconsciousness) and ''balaksayesu'' (diminution of strength). The quantity of decoction is sufficient for the application of three ''basti''.

===== ''Hapushadya yapana basti'' =====

Half ''kudava'' (96 gm) of ''hapusha'' (Juniperus communis) and one ''kudava''(192 gm) of half crushed grains of ''yava'' (Hordeum vulgare) boiled by adding water and milk till the quantity of remaining liquid is equal to the quantity of milk. Then honey, ghee, oil and rock-salt should be added to this preparation for the application of ''basti''. The beneficial effects of this therapy are seen in ''vata-rakta'' (resembling with gout), ''saktahavinmutra'' (retention of stool and urine), ''streekhedita'' (excessive sexual intercourse), ''buddhi, medha jatharagni'' (promotion of wisdom, intellect, ''agni'' (power of digestion and metabolism) and ''bala'' (strength).

===== ''Laghu-panchamuladhya yapana basti'' =====

The ''kwath'' (decoction) of ''laghu panchamula shala-parni'' (Desmodium gangeticum), ''prishna-parni'' (Uraria picta), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum surattense), and ''gokshura'' (Tribulus terrestris) is prepared by boiling with milk and water and the paste of ''pippali'' (Piper longum), ''madhuka'' (Glycyrrhiza glabra), and ''madana'' (Xeromphis spinosa) should be added. Jaggery, ghee, oil and rock-salt is added to this preparation and used for ''basti''. This ''basti'' is useful for the ''karshita'' (emaciated) person because of ''vishama-jwara'' (chronic/irregular fever).

===== ''Baladi yapana basti''-III =====

Eight ''palas'' (8x48 gm) of ''bala'' (Sida cordifolia), ''ati-bala'' (Abutilon indicum), ''apamarga'' (Achyranthes aspera) and ''atma-gupta'' (Mucuna prurita), and one ''anjali'' of water. To this decoction, jaggery, ghee, oil and rock-salt should be added, and used for basti. This ''basti'' is extremely beneficial for old and weak persons, as well as those suffering from ''shukra'' and ''rakta kshaya'' (diminished semen and blood).

===== ''Baladi yapana basti'' - fourth =====

The decoction of ''bala'' (Sida cordifolia), ''madhuka'' (Glycyrrhiza glabra), ''vidari'' (Pueraria tuberose), root of ''darbha'' (Imperata cylindrical), ''mridvika'' (Vitis vinifera) and ''yava'' (Hordeum vulgare) should be boiled by adding goat’s milk till the quantity of the remaining liquid is equal to the quantity of milk added to it. After that this ''kwatha'' (decoction) preparation for ''basti'' should be mixed with the ''kalka'' (paste) of ''madhuka'' (Glycyrrhiza glabra), and ''madana'' (Xeromphis spinosa), ''madhu'' (honey), ghee and ''sandhava'' (rock salt). The ''basti'' used of this preparation is beneficial for cure of ''jwara'' (fever).

===== ''Shala parnyadya yapana basti'' =====

Roots of ''shalaparni'' (Desmodium gangeticum), ''prishni-parni'' (Uraria picta), and ''gokshura'' (Tribulus terrestris), ''kashmarya'' (Gmelina arborea), ''parushaka'' (Grewia asiatica), fruits of ''kharjura'' (Phoenix sylvestris) and flowers of ''madhuka'' (Glycyrrhiza glabra), should be added with one ''prastha'' (768gm) of goat’s milk and water each, and then boiled. The paste of ''pippali'' (Piper longum), ''madhuka'' (Glycyrrhiza glabra), and ''utpala'' (Saussurea lappa) should be added. The ghee and rock-salt, should be added this preparation and used for ''basti''.

This ''basti'' is useful for the person suffering from ''kseenendriya'' (weakened senses) and ''karshita'' (emaciation) caused by ''vishama-jwara'' (chronic/irregular fever).

===== ''Sthiradi yapana basti'' =====

Five ''palas'' (5x48 gm) of ''sthiradi pancha-mula shal parni'' (Desmodium gangeticum), ''prishni-parni'' (Uraria picta), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum surattense), and ''goksura'' (Tribulus terrestris), and five ''prasthas'' (5x96 gm) of ''shali'' (Oryza sativa), ''shastika, yava'' (Hordeum vulgare), ''godhuma'' (Triticum aestivum) and ''masha'' (Phaseolus munga) should be boiled by adding goat’s milk and reduced to one-fourth. In this preparation, equal quantity of the sap of hen’s egg should be mixed. The honey, ghee, sugar, rock-salt and ''sauvarchala'' should be added to this preparation, and given to the patient. This ''basti'' is useful as aphrodisiac, and promotes strength as well as complexion of the patient.

This is the end of description of twelve preparations of ''yapana'' type of ''basti'' meant for promotion of health and longevity.

In addition to ''sthiradi basti'', the ''basti'' is prepared like the soup of hen’s egg, the soup of ''sikkhi'' eggs (pea-hen) , ''gonarda'' (crane) or ''hamsa'' (swan).[16-17]

सतित्तिरिःसमयूरःसराजहंसःपञ्चमूलीपयःसिद्धःशतपुष्पामधुकरास्नाकुटजमदनफलपिप्पलीकल्कोघृततैलगुडसैन्धवयुक्तोबस्तिर्बलवर्णशुक्रजननोरसायनश्च(१)|

द्विपञ्चमूलीकुक्कुटरससिद्धंपयःपादशेषंपिप्पलीमधुकरास्नामदनकल्कंशर्करामधुघृतयुक्तंस्त्रीष्वतिकामानांबलजननोबस्तिः(२)|

मयूरमपित्तपक्षपादास्यान्त्रंस्थिरादिभिःपलिकैःसजलेपयसिपक्त्वाक्षीरशेषंमदनपिप्पलीविदारीशतकुसुमामधुककल्कीकृतंमधुघृतसैन्धवयुक्तंबस्तिंदद्यात्स्त्रीष्वतिप्रसक्तक्षीणेन्द्रियेभ्योबलवर्णकरम्(३)|

कल्पश्चैषविष्किरप्रतुदप्रसहाम्बुचरेषुस्यात्,अक्षीरोरोहितादिषुचमत्स्येषु(४)|

गोधानकुलमार्जारमूषिकशल्लकमांसानांदशपलान्भागान्सपञ्चमूलान्पयसिपक्त्वातत्पयःपिप्पलीफलकल्कसैन्धवसौवर्चलशर्करामधुघृततैलयुक्तोबस्तिर्बल्योरसायनःक्षीणक्षतस्यसन्धानकरोमथितोरस्क
रथगजहयभग्नवातबलासकप्रभृत्युदावर्तवातसक्तमूत्रवर्चश्शुकाणांहिततमश्च(५)|

कूर्मादीनामन्यतमपिशितसिद्धंपयोगोवृषनागहयनक्रहंसकुक्कुटाण्डरसमधुघृतशर्करासैन्धवेक्षुरकात्मगुप्ताफलकल्कसंसृष्टोबस्तिर्वृद्धानामपिबलजननः(६)|

कर्कटकरसश्चटकाण्डरसयुक्तःसमधुघृतशर्करोबस्तिः;इत्येतेबस्तयःपरमवृष्याःउच्चटकेक्षुरकात्मगुप्ताशृतक्षीरप्रतिभोजनानुपानात्स्त्रीशतगामिनंनरंकुर्युः(७)|

गोवृषबस्तवराहवृषणकर्कटचटकसिद्धंक्षीरमुच्चटकेक्षुरकात्मगुप्तामधुघृतसैन्धवयुक्तःकिञ्चिल्लवणितोबस्तिः(८)|

दशमूलमयूरहंसकुक्कुटक्वाथात्पञ्चप्रसृतंतैलघृतवसामज्जचतुष्प्रसृतयुक्तंशतपुष्पामुस्तहपुषाकल्कीकृतःसलवणोबस्तिःपादगुल्फोरुजानुजङ्घात्रिकवङ्क्षणबस्तिवृषणानिलरोगहरः(९)|

मृगविष्किरानूपबिलेशयानामेतेनैवकल्पेनबस्तयोदेयाः(१०)|

मधुघृतद्विप्रसृतस्तुल्योष्णोदकःशतपुष्पार्धपलःसैन्धवार्धाक्षयुक्तोबस्तिर्वृष्यतमोमूत्रकृच्छ्रपित्तवातहरः(११)|

सद्योघृततैलवसामज्जचतुष्प्रस्थंहपुषार्धपलंसैन्धवार्धाक्षयुक्तोबस्तिर्वृष्यतमोमूत्रकृच्छ्रपित्तव्याधिहरोरसायनः(१२)|

मधुतैलंचतुःप्रसृतंशतपुष्पार्धपलंसैन्धवार्धाक्षयुक्तोबस्तिर्दीपनोबृंहणोबलवर्णकरोनिरुपद्रवोवृष्यतमोरसायनःक्रिमिकुष्ठोदावर्तगुल्मार्शोब्रध्नप्लीहमेहहरः(१३)|

तद्वन्मधुघृताभ्यांपयस्तुल्योबस्तिःपूर्वकल्केनबलवर्णकरोवृष्यतमोनिरुपद्रवोबस्तिमेढ्रपाकपरिकर्तिकामूत्रकृच्छ्रपित्तव्याधिहरोरसायनश्च(१४)|

तद्वन्मधुघृताभ्यांमांसरसतुल्यो[मुस्ताक्षयुक्तः

पूर्ववद्बस्तिर्वातबलासपादहर्षगुल्मत्रिकोरुजानूरुनिकुञ्चनबस्तिवृषणमेढ्रत्रिकपृष्ठशूलहरः(१५)|

सुरासौवीरककुलत्थमांसरसमधुघृततैलसप्तप्रसृतोमुस्तशताह्वाकल्कितःसलवणोबस्तिःसर्ववातरोगहरः(१६)|

द्विपञ्चमूलत्रिफलाबिल्वमदनफलकषायोगोमूत्रसिद्धःकुटजमदनफलमुस्तपाठाकल्कितःसैन्धवयावशूकक्षौद्रतैलयुक्तोबस्तिःश्लेष्मव्याधिबस्त्याटोपवातशुक्रसङ्गपाण्डुरोगाजीर्णविसूचिकालसकेषु[५]देयइति||१८||

satittiriḥsamayūraḥsarājahaṁsaḥ[1]

pañcamūlīpayaḥsiddhaḥśatapuṣpāmadhukarāsnākuṭajamadanaphalapippalīkalkōghr̥tatailaguḍasaindhavayuktōbastirbalavarṇaśukrajananōrasāyanaśca(1)|

dvipañcamūlīkukkuṭarasasiddhaṁpayaḥpādaśēṣaṁpippalīmadhukarāsnāmadanakalkaṁśarkarāmadhughr̥tayuktaṁstrīṣvatikāmānāṁbalajananōbastiḥ(2)|

mayūramapittapakṣapādāsyāntraṁ[2]

sthirādibhiḥpalikaiḥsajalēpayasipaktvākṣīraśēṣaṁmadanapippalīvidārīśatakusumāmadhukakalkīkr̥taṁmadhughr̥tasaindhavayuktaṁbastiṁdadyātstrīṣvati

prasaktakṣīṇēndriyēbhyōbalavarṇakaram(3)|

kalpaścaiṣaviṣkirapratudaprasahāmbucarēṣusyāt,akṣīrōrōhitādiṣucamatsyēṣu(4)|

gōdhānakulamārjāramūṣikaśallakamāṁsānāṁdaśapalānbhāgānsapañcamūlānpayasipaktvātatpayaḥpippalīphalakalkasaindhavasauvarcalaśarkarāmadhughr̥tat

ailayuktōbastirbalyōrasāyanaḥkṣīṇakṣatasyasandhānakarōmathitōraskarathagajahayabhagnavātabalāsakaprabhr̥tyudāvartavātasaktamūtravarcaśśukāṇāṁ

hitatamaśca(5)|

kūrmādīnāmanyatamapiśitasiddhaṁpayōgōvr̥ṣanāgahayanakrahaṁsakukkuṭāṇḍarasamadhughr̥taśarkarāsaindhavēkṣurakātmaguptāphalakalkasaṁsr̥ṣṭōbastirvr̥

ddhānāmapibalajananaḥ(6)|

karkaṭakarasaścaṭakāṇḍarasayuktaḥsamadhughr̥taśarkarōbastiḥ;ityētēbastayaḥparamavr̥ṣyāḥuccaṭakēkṣurakātmaguptāśr̥takṣīrapratibhōjanānupānātstrī

śatagāminaṁnaraṁkuryuḥ(7)|

gōvr̥ṣabastavarāhavr̥ṣaṇakarkaṭacaṭakasiddhaṁkṣīramuccaṭakēkṣurakātmaguptāmadhughr̥tasaindhavayuktaḥkiñcillavaṇitōbastiḥ(8)|

daśamūlamayūrahaṁsakukkuṭakvāthātpañcaprasr̥taṁtailaghr̥tavasāmajjacatuṣprasr̥tayuktaṁśatapuṣpāmustahapuṣākalkīkr̥taḥsalavaṇōbastiḥpādagulphōruj

ānujaṅghātrikavaṅkṣaṇabastivr̥ṣaṇānilarōgaharaḥ(9)|

mr̥gaviṣkirānūpabilēśayānāmētēnaivakalpēnabastayōdēyāḥ(10)|

madhughr̥tadviprasr̥tastulyōṣṇōdakaḥśatapuṣpārdhapalaḥ[3]saindhavārdhākṣayuktōbastirvr̥ṣyatamōmūtrakr̥cchrapittavātaharaḥ(11)|

sadyōghr̥tatailavasāmajjacatuṣprasthaṁhapuṣārdhapalaṁsaindhavārdhākṣayuktōbastirvr̥ṣyatamōmūtrakr̥cchrapittavyādhiharōrasāyanaḥ(12)|

madhutailaṁcatuḥprasr̥taṁśatapuṣpārdhapalaṁsaindhavārdhākṣayuktōbastirdīpanōbr̥ṁhaṇōbalavarṇakarōnirupadravōvr̥ṣyatamōrasāyanaḥkrimikuṣṭhōdāvar

tagulmārśōbradhnaplīhamēhaharaḥ(13)|

tadvanmadhughr̥tābhyāṁpayastulyōbastiḥpūrvakalkēnabalavarṇakarōvr̥ṣyatamōnirupadravōbastimēḍhrapākaparikartikāmūtrakr̥cchrapittavyādhiharōrasāy

anaśca(14)|

tadvanmadhughr̥tābhyāṁmāṁsarasatulyō[4]mustākṣayuktaḥ

pūrvavadbastirvātabalāsapādaharṣagulmatrikōrujānūrunikuñcanabastivr̥ṣaṇamēḍhratrikapr̥ṣṭhaśūlaharaḥ(15)|

surāsauvīrakakulatthamāṁsarasamadhughr̥tatailasaptaprasr̥tōmustaśatāhvākalkitaḥsalavaṇōbastiḥsarvavātarōgaharaḥ(16)|

dvipañcamūlatriphalābilvamadanaphalakaṣāyōgōmūtrasiddhaḥkuṭajamadanaphalamustapāṭhākalkitaḥsaindhavayāvaśūkakṣaudratailayuktōbastiḥślēṣmavyā

dhibastyāṭōpavātaśukrasaṅgapāṇḍurōgājīrṇavisūcikālasakēṣu[5]dēyaiti||18||

satittiriHsamayUraHsarAjahaMsaH[1]

pa~jcamUlIpayaHsiddhaHshatapuShpAmadhukarAsnAkuTajamadanaphalapippalIkalkoghRutatailaguDasaindhavayuktobastirbalavarNashukrajananorasAyanash

ca(1)|

dvipa~jcamUlIkukkuTarasasiddhaMpayaHpAdasheShaMpippalImadhukarAsnAmadanakalkaMsharkarAmadhughRutayuktaMstrIShvatikAmAnAMbalajananobastiH(2)|

mayUramapittapakShapAdAsyAntraM[2]

sthirAdibhiHpalikaiHsajalepayasipaktvAkShIrasheShaMmadanapippalIvidArIshatakusumAmadhukakalkIkRutaMmadhughRutasaindhavayuktaMbastiMdadyAtstr

IShvatiprasaktakShINendriyebhyobalavarNakaram(3)|

kalpashcaiShaviShkirapratudaprasahAmbucareShusyAt,akShIrorohitAdiShucamatsyeShu(4)|

godhAnakulamArjAramUShikashallakamAMsAnAMdashapalAnbhAgAnsapa~jcamUlAnpayasipaktvAtatpayaHpippalIphalakalkasaindhavasauvarcalasharkarAmadhug

hRutatailayuktobastirbalyorasAyanaHkShINakShatasyasandhAnakaromathitoraskarathagajahayabhagnavAtabalAsakaprabhRutyudAvartavAtasaktamUtravarc

ashshukANAMhitatamashca(5)|

kUrmAdInAmanyatamapishitasiddhaMpayogovRuShanAgahayanakrahaMsakukkuTANDarasamadhughRutasharkarAsaindhavekShurakAtmaguptAphalakalkasaMsRuShTo

bastirvRuddhAnAmapibalajananaH(6)|

karkaTakarasashcaTakANDarasayuktaHsamadhughRutasharkarobastiH;ityetebastayaHparamavRuShyAHuccaTakekShurakAtmaguptAshRutakShIrapratibhojanAnu

pAnAtstrIshatagAminaMnaraMkuryuH(7)|

govRuShabastavarAhavRuShaNakarkaTacaTakasiddhaMkShIramuccaTakekShurakAtmaguptAmadhughRutasaindhavayuktaHki~jcillavaNitobastiH(8)|

dashamUlamayUrahaMsakukkuTakvAthAtpa~jcaprasRutaMtailaghRutavasAmajjacatuShprasRutayuktaMshatapuShpAmustahapuShAkalkIkRutaHsalavaNobastiHpAd

agulphorujAnuja~gghAtrikava~gkShaNabastivRuShaNAnilarogaharaH(9)|

mRugaviShkirAnUpabileshayAnAmetenaivakalpenabastayodeyAH(10)|

madhughRutadviprasRutastulyoShNodakaHshatapuShpArdhapalaH[3]saindhavArdhAkShayuktobastirvRuShyatamomUtrakRucchrapittavAtaharaH(11)|

sadyoghRutatailavasAmajjacatuShprasthaMhapuShArdhapalaMsaindhavArdhAkShayuktobastirvRuShyatamomUtrakRucchrapittavyAdhiharorasAyanaH(12)|

madhutailaMcatuHprasRutaMshatapuShpArdhapalaMsaindhavArdhAkShayuktobastirdIpanobRuMhaNobalavarNakaronirupadravovRuShyatamorasAyanaHkrimikuSh

ThodAvartagulmArshobradhnaplIhamehaharaH(13)|

tadvanmadhughRutAbhyAMpayastulyobastiHpUrvakalkenabalavarNakarovRuShyatamonirupadravobastimeDhrapAkaparikartikAmUtrakRucchrapittavyAdhiharor

asAyanashca(14)|

tadvanmadhughRutAbhyAMmAMsarasatulyo[4]mustAkShayuktaH

pUrvavadbastirvAtabalAsapAdaharShagulmatrikorujAnUruniku~jcanabastivRuShaNameDhratrikapRuShThashUlaharaH(15)|

surAsauvIrakakulatthamAMsarasamadhughRutatailasaptaprasRutomustashatAhvAkalkitaHsalavaNobastiHsarvavAtarogaharaH(16)|

dvipa~jcamUlatriphalAbilvamadanaphalakaShAyogomUtrasiddhaHkuTajamadanaphalamustapAThAkalkitaHsaindhavayAvashUkakShaudratailayuktobastiHshleShmavyAdhibastyATopavAtashukrasa~ggapANDurogAjIrNavisUcikAlasakeShu[5]deyaiti||18||

===== ''Tittiradya yapana basti''=====
The meats of ''tittiri'' (patridge), ''mayura'' (peacock) and ''raja-hamsa'' (swan), and the roots,barks or extracts of plants such as ''pancha-mula'' (roots of ''shala-parni'' (Desmodium gangeticum), ''prishni-parni'' (Uraria picta), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum surattense) and ''goksura'' (Tribulus terrestris)) should be boiled with goat milk. To this preparation of milk, the paste of ''sata-pushpa'' (Anethum sowa), ''madhuka'' (Glycyrrhiza glabra), ''rasna'' (Pluchea lanceolata), ''kutaja'' (Holarrhena antidysenterica), ''madana-phala'' (Xeromphis spinosa) and ''pippali'' (Piper longum) should be added. Then ghee, oil, jaggery and rock-salt, should be mixed to this preparation and used for ''basti'' (enema).

The ''basti'' (enema) of this preparation promotes ''bala'' (strength), ''varna'' (complexion) and ''shukra'' (semen). This act as a rejuvenator also. [18/1]

===== ''Dvi-pancha-muladhya yapana basti'' =====
Drugs belonging to two types of ''pancha-mula'' (''bilva, syonaka, gambhari, patala, ganikarika, sala-parni, prisni-parni, brihati kantakari'' and ''gokshura'') and chicken-soup should be boiled by adding milk till one fourth of the liquid remains. To this liquid, the paste of ''pippali, madhuka, rasna'' and ''madana'' should be added. After adding sugar, honey and ghee, this preparation should be used for ''basti'' (enema).

The use of this ''basti'' promotes strength of those persons who indulge in excessive sex. [18/2]

===== ''Mayuradya yapana basti'' =====

The (gall-bladder/bile), ''paksha'' (feather), ''pada'' (legs), (beak) and ''antra'' (intestines) of ''mayura'' (peacock) should be removed. The meat of this peacock should be added with one ''pala'' each of ''sala-parni, prisni-parni, brihati, kantakari'' and ''gokshura'', and cooked by adding water and milk till the remaining liquid is equal to the quantity of milk. To this preparation, the paste of ''madana, pippali, vidari, sata-kusuma (sata-puspa)'' and ''madhuka'' should be added. Again the honey, ghee and rock-salt should also be added and used for ''basti'' therapy. The use of this ''basti'' promotes strength and complexion along with sensory and motor function of those who lost the same due to indulgence in excessive sex. [18/3]

===== The alternative/substitute of ''mayuradya yapana basti'' =====

The above mentioned ''basti'' i.e. ''mayuradya yapana basti'' can be prepared by substituting peacock-meat with the meat of animals and birds of ''vishkira'' (gallinaceous birds), ''pratuda'' (pecker birds), ''prasaha'' (animals and birds who eat by snatching their food), and ''varicara'' (birds moving in the water) categories.

Similarly, the meat of different types of fish like ''rohita'', etc. can be used in the place of the meat of peacock. Milk should not be added while preparing the ''basti'' with fish meat because the combination of fish and milk is considered ''viruddha'' (incompatible) in context of ''viruddha ahara'' i.e. incompatible diet (18/4)

[ Note: These ''basti'' preparations are 115 in number as -
#Twenty ''basti'' preparations containing birds belonging to ''viskira''-group (gallinaceous birds), ''lava'', (group-1) and ''vartaka'' (group-2) etc. as described in [[Charak Samhita]] [[Sutra Sthana]] chapter 27 (Ch.Su. 27/47-49).
#Thirty ''basti'' preparations containing the meat of birds belonging to ''pratuda''-group (pecker birds) as described in the same chapter (Ch.Su. 27/50-52)
#Twenty nine ''basti'' preparations containing the meat of animals and birds of ''prasaha'' group (those who eat food by snatching) are described in the same context (Ch.Su. 27/35-37).
#Twenty seven ''basti'' preparations containing the meat of birds belonging to ''ambuchara'' or ''varichara'' group (moving in water) are also described at the same place (Ch.Su. 27/41-44).
#Nine ''basti'' preparations containing the meat of fish, like ''rohita'' etc.

So there are total 115 ''basti'' preparations witch are prepared by the meat of these various kind of birds and animals.]

===== ''Godhadya yapana basti'' =====

The ''aushadha dravya'' (drugs) belonging to the group of ''panchamula'' i.e. ''bilva'' (Aegle marmelos), ''syonaka'' (Oroxylum indicum), ''gambhari'' (Gmelina arborea), ''patala'' (Stereospermum suaveoiens), ''ganikarika'' (Premna mucronata), and ten ''palas'' (10x48gm) of the meat of ''godha'' (iguana), ''nakula'' (mongoose), ''marjara'' (cat) and ''musika'' (mouse) is cooked with milk. To this preparation, the paste of ''madana-phala'' (Xeromphis spinosa), ''pippali'' (Piper longum), should be added. Again this should be added with rock-salt, ''sauvarchala'', sugar, honey, ghee and oil and used for ''basti''. This ''basti'' is beneficial for promoting the strength and rejuvenate the body, healing of the phthisis lesion, helps in curing the ailments caused due to the compression of the chest, correction of fractures caused due to riding the ''ratha'' (wooden cart), elephant and horse etc. It cures ''vata-balasaka'' (diseases caused by ''vata'' and ''kapha''), ''udavarta'' (diseases caused due to upward movement of ''vata'' in abdomen), ''sakta mutra varcha shukra'' (retention of urine, stool and semen due to ''vata'') and such other diseases. [18/5]

===== ''Kurmadya yapana basti'' =====

The meat of any one type of ''kurma'' (tortoise) is boiled with milk. This is added with the soup of testicles of ''vrisha'' (bull), elephant, ''nakra'' (crocodile), ''hamsa'' (swan) and ''kukkutandrasa'' (sap of the eggs of hen). The honey, ghee, sugar, rock-salt, the paste of ''ikshurasa'' (Juice of Saccharum officinarum) and fruit of ''atma-gupta'' (Mucuna prurita) should be added and used for ''basti''. This ''basti'' provide strength even in the old age person also. The term ''kurmadya'' meaning ''kurma'', etc. includes ten other animals like ''karkata'' (crab), ''matsya'' (fish), ''sisumara'' (esturine crocodile), ''timingila'' (whale), ''shukti'' (pearl oyster), ''sankha'' (conch-shell), ''udra'' (cat-fish), ''kumbhira'' (crocodile), ''culuke'' (gangetic dolphin) and ''makara'' (great Indian crocodile) in addition to ''kurma'' (tortoise). The ''basti'' prepared with the meat of tortoise is to be enumerated as one of the 29 main ''bastis''. The other ten prepared with the remaining ten animals should be treated as extension ''basti''.[18/6]

===== ''Karkata rasadya yapana basti'' =====

The soup of ''karkataka'' (crab) meat is added with the sap of the egg of ''cataka'', honey, ghee and sugar, should be used for ''basti''. This ''basti'' is strong aphrodisiac. If the milk boiled with ''uccataka, iksuraka'' (''kokilaksa'') and ''atma-gupta'' (Mucuna prurita) is taken after the administration of this ''basti'', then a person becomes capable of having sex with many women. [18/7]

===== ''Gau vrishadya yapana basti'' =====

Milk boiled with the ''gau-vrisha'' (testicles of bull), goat and pig, ''karkataka'' and ''cataka'' should be added with the paste of ''ucchata'', ''ikshuraka'' (kokilaksha) and ''atma-gupta'', honey, ghee rock-salt and small quantity of sea-salt should be used for ''basti''. This is used for aphrodisiac purpose.[18/8]

===== ''Dasamuladya yapana basti'' =====

The five ''prasritas'' (5 x 96 gm) of the decoction of ''dasha-mula bilva'' (Aegle marmelos), ''shyonaka'' (Oroxylum indicum), ''gambhari'' (Gmelina arborea), ''patala'' (Stereospermum suaveoiens), ''ganikarika'' (Premna mucronata), ''sala-parni'' (Desmodium gangeticum), ''prishni-parni'' (Uraria picta), ''brihati'' (Solanum indicum), ''kantakari'' (Solanum surattense) and ''gokshura'' (Tribulus terrestris) and the meat of peacock, swan as well as domestic fowl, four ''prasritas'' (4x96gm) of oil, ghee, ''vasa'' (fat) and ''majja'' (bone-marrow) should be added. This liquid should be added with the paste of ''shata-pushpa'' (Anethum sowa), ''musta'' (Cyperus rotundus) and ''hapusha'' (Juniperus communis). After adding rock-salt, this preparation should be used for ''basti''. This cures ''vatika'' diseases of feet, ankle-joints, thighs, knee-joints, calf-region, lumbar region, groins, urinary bladder region and testicles etc. [18/9]

====== Extension of preparation no. twenty ======

Following the same procedure as mentioned above, the ''basti'' should be prepared with the meat of ''mriga'' (animals living on dry land), ''vishkira'' (gallinaceous birds), ''anupa'' (animals living on marshy land) and ''bileshaya'' (animals living in the burrows in earth).

The ''bastis'' prepared by these birds and animals are 59 in number as:
#Seventeen by the meat of ''mrigas'' (antelopes) as mentioned in [[Charak Samhita]] [[Sutra Sthana]] chapter27 (Ch.Su.27 / 45-46).
#Nineteen ''bastis'' are prepared with the meat of ''viskiras pakshis'' (gallinaceous birds) mentioned in the same context (Ch.Su. 27/ 47-49). 21 birds are described there but here only 19 are mentioned excluding the ''mayura'' (peacock) and ''kukkuta'' (domestic fowl) because use of their meat is already mentioned in the ''basti'' no. 20.
#Nine ''bastis'' are prepaired with the meat of ''anupas desha pakshis'' (animals living on marshy land) (Ch. Su. 27/39)
#Fourteen ''bastis'' are prepared with the meat of ''bilesayas'' (animals living in burrows in the earth) Ch.Su. 27/39.(18/11)

===== ''Madhvadya yapana basti'' =====

Two ''prasritas'' of ''madhu'' (honey) and ''ghrita'' (ghee) should be added with two ''prasithas'' of warm water. To this, half ''pala'' of the paste of ''shata-pushpa'' and half ''aksha'' of rock salt should be added. ''Basti'' prepared with this method is extremely aphrodisiac. It cures ''mutra-kricchra'' (dysuria), and diseases caused by ''pitta'' as well as ''vayu''. (18/11)

===== ''Sadyo'' (immediate/fresh) ''ghritadya yapana basti'' =====

Four ''prasthas'' of freshly collected ghee, oil, ''vasa'' (fat of muscle) and ''majja'' (bone marrow) should be added with half ''pala'' paste of ''hapusa'', and half ''aksa'' of rock-salt, and used for ''basti''. This ''basti'' is extremely aphrodisiac. It cures ''mutra-kricchra'' (dysuria) and diseases caused due to ''pitta''. It rejuvenates the body too. (18/12)

===== ''Madhu-tailadya yapana basti'' =====

Four ''prasritas'' of ''madhu'' (honey) and ''taila'' (oil) should be added with half ''pala'' paste of ''sata-pushpa'', and half ''aksa'' of rock-salt and used for ''basti''. This is beneficial for ''dipana'' (stimulating the power of digestion and metabolism), ''brimhana'' (nourishment of the body) ''bala-varna-kara'' (promotes strength and complexion), ''nirupadrava'' (free from harmful effects),''vrisyatama'' (promotes virility), ''andrasayana'' (rejuvenator). Cures ''krimi'' (worm/parasitic infestation), ''kustha'' (obstinate skin diseases including leprosy), ''udavarta'' (upward movement of ''vata'' in the abdomen), ''gulma'' (phantom tumor), ''arsas'' (piles), ''bradhna'' (inguinal swelling), ''plihan'' (splenic disorder) and ''meha/prameha'' (obstinate urinary disorders including diabetes). (18/13)

===== ''Madhu-ghrtadya yapana basti''-first ''basti'' =====

The ''madhu'' (honey) and ''ghrita'' (ghee), added with equal quantity of milk, mixed with the paste of drugs described above in ''basti'' no. 23. ''Basti'' with this preparation is beneficial for ''bala-varna-kara'' (promoting the strength and complexion), ''vrisyatama'' (aphrodisiac), ''nirupadrava'' (free from harmful effects) Cures ''basti-medhra-paka'' (inflammation of urinary bladder and phallus), ''parikartika'' (sawing pain), ''mutra-kricchra'' (dysuria) and diseases caused vitiated ''pitta''. It act as ''rasayana'' (rejuvenation) therapy for the body.

===== ''Madhu-ghrtadya yapana basti'' – second ''basti'' =====

Following the same method, honey (''madhu'') and ghee (''ghrita'') should be added with equal quantity of meat-soup and one ''aksha kalka'' of ''musta''. This ''basti'' is prepared following the same method as earlier in preparation no. 23. It cures ''vata-balasa'' (a disease caused by aggravated ''vayu'' and ''kapha''), ''pada-harsa'' (tingling sensation in the feet), ''gulma'' (phantom tumor), contraction /stiffness of lumbar region, thighs and knee-joints, and pain in the region of urinary bladder, scrotum, phallus, lumbar region and back etc.

===== ''Suradya yapana basti'' =====

Seven ''prasthas'' of ''sura'' (type of alcohol), ''sauviraka'' (vinegar), ''kulattha''-soup, meat-soup, honey, ghee and oil should be added with the paste of ''musta'' and ''shatahva''. To this preparation salt is added and used for ''basti'' which cures all the ''vatika'' diseases.

===== ''Dvi-pancha-muladya yapana basti'' =====

Both types of ''panchamula'' (''laghu'' and ''brihata'') ie roots of ''bilva, shyonaka, gambhari, patala, ganikarika, shalaparni, prishniparni, brhati, kantakari'' and ''goksura''), ''triphala'' (''haritaki, bibhitaka'' and ''amalaki''), ''bilva'' fruit and ''madanaphala'' is boiled by adding cow’s urine. To this ''kwatha'' (decoction), the ''kalka'' (paste) of ''kutaja, madana-phala, musta'' and ''patha'' should be added. After adding rock-salt, ''yava-ksara'' (alkali prepared of barley), honey and oil, this preparation should be used for ''basti''. This ''basti'' should be used for the treatment of diseases caused by ''kapha, bastyatopa'' (flatulence in the urinary bladder region), ''vata shukra sanga'' (retention of flatus and semen), ''pandu'' (anemia), ''ajeerna'' (indigestion), ''visuchika'' (choleric diarrhea) and ''alasaka'' (intestinal obstruction).

अतऊर्ध्वंवृष्यतमान्स्नेहान्वक्ष्यामः|
शतावरीगुडूचीक्षुविदार्यामलकद्राक्षाखर्जूराणांयन्त्रपीडितानांरसप्रस्थंपृथगेकैकंतद्वद्घृततैलगोमहिष्यजाक्षीराणांद्वौद्वौदद्यात्,जीवकर्षभकमेदामहामेदात्वक्क्षीरीशृङ्गाटकमधूलिकामधुकोच्चटापिप्पलीपुष्करबीज
नीलोत्पलकदम्बपुष्प-पुण्डरीककेशरकल्कान्पृषततरक्षुमांसकुक्कुटचटकचकोरमत्ताक्षबर्हिजीवञ्जीवकुलिङ्गहंसाण्डरसवसामज्जादेश्चप्रस्थंदत्त्वासाधयेत्|
ब्रह्मघोषशङ्खपटहभेरीनिनादैःसिद्धंसितच्छत्रकृतच्छायंगजस्कन्धमारोपयेद्भगवन्तंवृषध्वजमभिपूज्य,तंस्नेहंत्रिभागमाक्षिकंमङ्गलाशीःस्तुतिदेवतार्चनैर्बस्तिंगमयेत्|
नृणांस्त्रीविहारिणांनष्टरेतसांक्षतक्षीणविषमज्वरार्तानांव्यापन्नयोनीनांवन्ध्यानांरक्तगुल्मिनीनां[१]मृतापत्यानामनार्तवानांचस्त्रीणांक्षीणमांसरुधिराणांपथ्यतमंरसायनमुत्तमंवलीपलितनाशनंविद्यात्(१)|१९|

ataūrdhvaṁvr̥ṣyatamānsnēhānvakṣyāmaḥ|
śatāvarīguḍūcīkṣuvidāryāmalakadrākṣākharjūrāṇāṁyantrapīḍitānāṁrasaprasthaṁpr̥thagēkaikaṁtadvadghr̥tatailagōmahiṣyajākṣīrāṇāṁdvaudvaudadyāt,
jīvakarṣabhakamēdāmahāmēdātvakkṣīrīśr̥ṅgāṭakamadhūlikāmadhukōccaṭāpippalīpuṣkarabījanīlōtpalakadambapuṣpa-puṇḍarīkakēśarakalkānpr̥ṣatatarakṣumāṁsakukkuṭacaṭakacakōramattākṣabarhijīvañjīvakuliṅgahaṁsāṇḍarasavasāmajjādēścaprasthaṁdattvāsādhayēt|
brahmaghōṣaśaṅkhapaṭahabhērīninādaiḥsiddhaṁsitacchatrakr̥tacchāyaṁgajaskandhamārōpayēdbhagavantaṁvr̥ṣadhvajamabhipūjya,
taṁsnēhaṁtribhāgamākṣikaṁmaṅgalāśīḥstutidēvatārcanairbastiṁgamayēt|
nr̥ṇāṁstrīvihāriṇāṁnaṣṭarētasāṁkṣatakṣīṇaviṣamajvarārtānāṁvyāpannayōnīnāṁvandhyānāṁraktagulminīnāṁ[1]
mr̥tāpatyānāmanārtavānāṁcastrīṇāṁkṣīṇamāṁsarudhirāṇāṁpathyatamaṁrasāyanamuttamaṁvalīpalitanāśanaṁvidyāt(1)|19|

ataUrdhvaMvRuShyatamAnsnehAnvakShyAmaH|
shatAvarIguDUcIkShuvidAryAmalakadrAkShAkharjUrANAMyantrapIDitAnAMrasaprasthaMpRuthagekaikaMtadvadghRutatailagomahiShyajAkShIrANAMdvaudvaudadyAt,
jIvakarShabhakamedAmahAmedAtvakkShIrIshRu~ggATakamadhUlikAmadhukoccaTApippalIpuShkarabIjanIlotpalakadambapuShpa-puNDarIkakesharakalkAnpRuShatatarakShumAMsakukkuTacaTakacakoramattAkShabarhijIva~jjIvakuli~ggahaMsANDarasavasAmajjAdeshcaprasthaMdattvAsAdhayet|
brahmaghoShasha~gkhapaTahabherIninAdaiHsiddhaMsitacchatrakRutacchAyaMgajaskandhamAropayedbhagavantaMvRuShadhvajamabhipUjya,
taMsnehaMtribhAgamAkShikaMma~ggalAshIHstutidevatArcanairbastiMgamayet|
nRuNAMstrIvihAriNAMnaShTaretasAMkShatakShINaviShamajvarArtAnAMvyApannayonInAMvandhyAnAMraktagulminInAM[1]
mRutApatyAnAmanArtavAnAMcastrINAMkShINamAMsarudhirANAMpathyatamaMrasAyanamuttamaMvalIpalitanAshanaMvidyAt(1)|19|

==== ''Sneha Basti'' ====
Here some oleating (''anuvasana'') ''bastis'' will be described.

===== ''Satavaryadi sneha basti'' =====

The ''swarasa'' (juice) of ''satavari, guduchi, ikshu, vidari, amalaki, draksa'' and ''kharjura'', one ''prastha'' each and to this, two ''prasthas'' of ghee, oil, cow’s milk, buffalo-milk and goat-milk each should be added. Then the ''kalka'' (paste) of ''jivaka, rsabhaka, meda, maha-meda, tvak-ksiri'' (''vamsa-lochana''), ''sringataka, madhulika, madhuka, uchchata, pippali'', seeds of ''pushkara, nilotpala'', flower of ''kadamba pundarika'' and ''kesara'' should be added. This preparation should be boiled by adding one ''prastha'' meat-soup of ''mriga'' (antelope) and ''taraksu'' (type of lion), along with the sap of the eggs of ''kukkuta, chataka, chakora, mattaksa'' (''kokila'') ''barhi, jivanjivaka, kulinga'' and ''hamsa, vasa'' (muscle-fat), ''majja'' (bone-marrow), etc. To this medicated ''basti,'' one-third in quantity honey should be added. With auspicious benedictions, prayers and worshipping of the gods, this ''basti'' should be administered.

This ''basti'' is beneficial for a person indulging in excessive sex, suffering from ''nashtretas'' (loss of semen), suffering from ''kshata-kshina'' (phthisis) and ''vishamajwara'' (chronic/irregular fever), female suffering from ''yoni vyapada'' (gynecological disorders), ''bandhyatva'' (sterility) and ''raktagulma'' (uterine tumor), whose offspring succumb to death before or after delivery, suffering from anartava (amenorrhoea) and a person suffering from ksheen mamsa rudhira(diminished muscular tissue and blood). It acts as an excellent ''rasayana'' (rejuvenation therapy) and also cures ''vali'' (wrinkles of skin) and ''palita'' (graying of hair).[19/1]

बलागोक्षुरकरास्नाश्वगन्धाशतावरीसहचराणांशतंशतमापोथ्यजलद्रोणशतेप्रसाध्यं,तस्मिन्जलद्रोणावशेषेरसेवस्त्रपूतेविदार्यामलकस्वरसयोर्बस्तमहिषवराहवृषकुक्कुटबर्हिहंसकारण्डवसारसाण्डरसानांघृततैलयोश्चैकैकंप्रस्थमष्टौप्रस्थान्क्षीरस्यदत्त्वाचन्दनमधुकमधूलिकात्वक्क्षीरीबिसमृणालनीलोत्पलपटोलात्मगुप्तान्नपाकितालमस्तकखर्जूरमृद्वीकातामलकी-कण्टकारीजीवकर्षभकक्षुद्रसहामहासहाशतावरीमेदापिप्पलीह्रीबेरत्वक्पत्रकल्कांश्चदत्त्वासाधयेत्|
ब्रह्मघोषादिनाविधिनासिद्धंबस्तिंदद्यात्|
तेनस्त्रीशतंगच्छेत्;नचात्रास्तेविहाराहारयन्त्रणाकाचित्|
एषवृष्योबल्योबृंहणआयुष्योवलीपलितनुत्क्षतक्षीणनष्टशुक्रविषमज्वरार्तानांव्यापन्नयोनीनांचपथ्यतमः(२)|

balāgōkṣurakarāsnāśvagandhāśatāvarīsahacarāṇāṁśataṁśatamāpōthyajaladrōṇaśatēprasādhyaṁ,tasminjaladrōṇāvaśēṣērasēvastrapūtēvidāryāmalakasvarasayōrbastamahiṣavarāhavr̥ṣakukkuṭabarhihaṁsakāraṇḍavasārasāṇḍarasānāṁghr̥tatailayōścaikaikaṁprasthamaṣṭauprasthānkṣīrasyadattvācandanamadhukamadhūlikātvakkṣīrībisamr̥ṇālanīlōtpalapaṭōlātmaguptānnapākitālamastakakharjūramr̥dvīkātāmalakī-kaṇṭakārījīvakarṣabhakakṣudrasahāmahāsahāśatāvarīmēdāpippalīhrībēratvakpatrakalkāṁścadattvāsādhayēt|
brahmaghōṣādināvidhināsiddhaṁbastiṁdadyāt|
tēnastrīśataṁgacchēt;nacātrāstēvihārāhārayantraṇākācit|
ēṣavr̥ṣyōbalyōbr̥ṁhaṇaāyuṣyōvalīpalitanutkṣatakṣīṇanaṣṭaśukraviṣamajvarārtānāṁvyāpannayōnīnāṁcapathyatamaḥ(2)|19|

balAgokShurakarAsnAshvagandhAshatAvarIsahacarANAMshataMshatamApothyajaladroNashateprasAdhyaM,tasminjaladroNAvasheSherasevastrapUtevidAryAmalakasvarasayorbastamahiShavarAhavRuShakukkuTabarhihaMsakAraNDavasArasANDarasAnAMghRutatailayoshcaikaikaMprasthamaShTauprasthAnkShIrasyadattvAcandanamadhukamadhUlikAtvakkShIrIbisamRuNAlanIlotpalapaTolAtmaguptAnnapAkitAlamastakakharjUramRudvIkAtAmalakI-kaNTakArIjIvakarShabhakakShudrasahAmahAsahAshatAvarImedApippalIhrIberatvakpatrakalkAMshcadattvAsAdhayet|
brahmaghoShAdinAvidhinAsiddhaMbastiMdadyAt|
tenastrIshataMgacchet;nacAtrAstevihArAhArayantraNAkAcit|
eShavRuShyobalyobRuMhaNaAyuShyovalIpalitanutkShatakShINanaShTashukraviShamajvarArtAnAMvyApannayonInAMcapathyatamaH(2)|19|

===== ''Baladi Sneha Basti'' =====

One hundred ''palas'' (100x48gm) of each of ''bala'' (Sida cordifolia), ''goksuraka'' (Tribulus terrestris), ''rasna'' (Pluchea lanceolata), ''ashvagandha'' (Withania somnifera), ''shatavari'' (Asparagus racemosus) and ''sahachara'' (Barleria prionitis) should be crushed into small pieces and boiled by adding one hundred ''dronas'' (100x12.288kg) of water till one-fourth of the liquid remains. Then this liquid should be filtered by a cloth. This should be boiled by adding the one ''prastha'' (768gm) ''swaras'' (juice) of ''vidari'' (Pueraria tuberosa) and ''amalaki'' (Emblica officinalis) each, one ''prastha'' (768gm) meat-soup of goat, buffalo, pig and bull each, one ''prastha'' (768gm) saps of the eggs of domestic fowl, pea-hen, swan, ''karandava'' and ''sarasa'' each, one ''prastha'' (768gm) ghee and oil each, eight ''prasthas'' (8x768gm) of milk and kalka ( Paste) of ''chandana'' (Santalum album), ''madhuka'' (Glycirrhiza glabra), ''madhulika, tvak-ksiri'' (''vamsa-lochana'' or Bambusa arundinacea), bias, ''mrinala, nilotpala'' (Nymphaea stellata)), ''patola'' (Trichosanthes dioica), ''atma-gupta'' (Mucuna prurita), ''anna-paki'' (odana-paki), ''tala-mastaka, kharjura'' (Phoenix sylvestris), ''mridvika'' (Vitis vinifera), ''tamalaki'' (Phyllanthus urinaria), ''kantakari'' (Solanum surattense), ''jivaka'' (Microstylis wallichii), ''rishabhaka'' (Microstylis mucifera), ''kshudra-saha'' (''mudga-parni'' or Phaseolus trilobus), ''maha saha'' (''masa-parni'' or Teramnus labialis), ''shatavari'' (Asparagus racemosus), ''meda'' (Polygonumverticillatum), ''pippali'' (Piper longum), ''hribera, tvak'' (Cinnamomum zeylanicum) and ''patra'' (Cinnamomum tamala).

With the chanting of ''vedic mantras'' and such other rituals described earlier ''basti'' should be given with this preparation.
After having this ''basti'' a person becomes sexually active. This ''basti'' does not involve any restriction of diet or regimen. It promotes virility, strength, corpulence and longevity. It cures ''vali'' (wrinkles) on the skin and ''palita'' (graying of hair). It is exceedingly wholesome for patients suffering from phthisis, loss of semen, ''vishama-jwara'' (irregular fever) and female disorders.19(2)

सहचरपलशतमुदकद्रोणचतुष्ट्येपक्त्वाद्रोणशेषेरसेसुपूतेविदारीक्षुरसप्रस्थाभ्यामष्टगुणक्षीरंघृततैलप्रस्थंबलामधुकमधूकचन्दनमधूलिकासारिवामेदामहामेदाकाकोलिक्षीरकाकोलीपयस्यागुरुमञ्जिष्ठाव्याघ्रनख-शटीसहचरसहस्रवीर्यावराङ्गलोध्राणामक्षमात्रैर्द्विगुणशर्करैःकल्कैःसाधयेत्|
बह्मघोषादिनाविधिनासिद्धंबस्तिंदद्यात्|
एषसर्वरोगहरोरसायनोललितानांश्रेष्ठोऽन्तःपुरचारिणीनांक्षतक्षयवातपित्तवेदनाश्वासकासहरस्त्रिभागमाक्षिकोवलीपलितनुद्वर्णरूपबलमांसशुक्रवर्धनः(३) |

इत्येतेरसायनाःस्नेहबस्तयःसतिविभवेशतपाकाःसहस्रपाकावाकार्यावीर्यबलाधानार्थमिति||१९||

sahacarapalaśatamudakadrōṇacatuṣṭyēpaktvādrōṇaśēṣērasēsupūtēvidārīkṣurasaprasthābhyāmaṣṭaguṇakṣīraṁghr̥tatailaprasthaṁbalāmadhukamadhūkacandanamadhūlikāsārivāmēdāmahāmēdākākōlikṣīrakākōlīpayasyāgurumañjiṣṭhāvyāghranakha-śaṭīsahacarasahasravīryāvarāṅgalōdhrāṇāmakṣamātrairdviguṇaśarkaraiḥkalkaiḥsādhayēt|
bahmaghōṣādināvidhināsiddhaṁbastiṁdadyāt|
ēṣasarvarōgaharōrasāyanōlalitānāṁśrēṣṭhō'ntaḥpuracāriṇīnāṁkṣatakṣayavātapittavēdanāśvāsakāsaharastribhāgamākṣikōvalīpalitanudvarṇarūpabalamāṁsaśukravardhanaḥ(3)|

ityētērasāyanāḥsnēhabastayaḥsativibhavēśatapākāḥsahasrapākāvākāryāvīryabalādhānārthamiti||19||

sahacarapalashatamudakadroNacatuShTyepaktvAdroNasheSherasesupUtevidArIkShurasaprasthAbhyAmaShTaguNakShIraMghRutatailaprasthaMbalAmadhukamadhUkacandanamadhUlikAsArivAmedAmahAmedAkAkolikShIrakAkolIpayasyAguruma~jjiShThAvyAghranakha-shaTIsahacarasahasravIryAvarA~ggalodhrANAmakShamAtrairdviguNasharkaraiHkalkaiHsAdhayet|
bahmaghoShAdinAvidhinAsiddhaMbastiMdadyAt|
eShasarvarogaharorasAyanolalitAnAMshreShTho~antaHpuracAriNInAMkShatakShayavAtapittavedanAshvAsakAsaharastribhAgamAkShikovalIpalitanudvarNarUpabalamAMsashukravardhanaH(3)|

ityeterasAyanAHsnehabastayaHsativibhaveshatapAkAHsahasrapAkAvAkAryAvIryabalAdhAnArthamiti 3||19||

===== ''Sahacharadya sneha basti'' =====

One hundred ''palas'' (100x48gm) of ''sahachara'' (Barleria prionitis) should be added with four ''dronas'' (4x12.288kg) of water, and boiled till one drone (12.288kg) of the liquid remains. This ''kwatha'' (decoction) should be strained out, and then boiled by adding one ''prastha'' (768gm), ''kwatha'' (juice ) of ''vidari'' (Pueraria tuberosa) and sugar cane each, sixteen ''prasthas'' (16x768gm) of milk, one ''prastha'' (768gm) ghee and oil each, ''kwatha'' (paste) of one ''aksa'' (12gm ), ''bala'' (Sida cordifolia), ''madhuka'' (Glycyrrhiza glabra), ''chandana'' (Santalum album), ''madhulika, sariva'' (Hemidesmus indicus), ''meda'' (Polygonatum verticillatum), ''maha-meda'' (Polygonatum cirrhifolium), ''kakoli'' (Nomocharis oxypetala), ''ksira-kakoli'' (Lilium polyphyllum), payasya(Impomoea paniculata), ''aguru'' (Aquilaria agallocha), ''manjistha'' (Rubia cordifolia), ''vyaghra-nakha, sati'' (Hedychium spicatium), ''sahacara'' (Barleria prionitis), ''sahasra-virya'' (''durva'' or Cynodon dactylon), ''varanga'' (''guda-tvak'') and ''lodhra'' (Symplocos racemosa) each , and two ''aksas'' (2x12gm) of sugar. This ''basti'' should be given while chanting the Vedic ''mantras'' and other rituals.This ''basti'' is beneficial for all the diseases, delicate women living in homes, it rejuvenates the body. It cures ''kshata-kshina'' (phthisis), pain caused by ''vayu'' and ''pitta'', ''shwasa'' and ''kasa'' (dyspnea and cough). When it is used after adding honey of one third in quantity of the already prepared ''basti'', it cures ''vali'' (wrinkles), ''palita'' (graying of hairs), and promotes (color), (complexion), ''roopa'' (beauty), ''bala'' (strength), ''mamsa'' (muscle) and ''shukra'' (semen).

If these above mentioned ''rasayana sneha bastis'' are concentrated by ''shatpaka sahasra paka'' (by cooking hundred or thousands times) their potency and strength increases with improved benefits (19)

भवन्तिचात्र-

इत्येतेबस्तयःस्नेहाश्चोक्तायापनसञ्ज्ञिताः|
स्वस्थानामातुराणांचवृद्धानांचाविरोधिनाः||२०||

अतिव्यवायशीलानांशुक्रमांसबलप्रदाः|
सर्वरोगप्रशमनाःसर्वेष्वृतुषुयौगिकाः||२१||

नारीणामप्रजातानांनराणांचाप्यपत्यदाः|
उभयार्थकरादृष्टाःस्नेहबस्तिनिरूहयोः||२२||

bhavanticātra-

ityētēbastayaḥsnēhāścōktāyāpanasañjñitāḥ|
svasthānāmāturāṇāṁcavr̥ddhānāṁcāvirōdhināḥ||20||

ativyavāyaśīlānāṁśukramāṁsabalapradāḥ|
sarvarōgapraśamanāḥsarvēṣvr̥tuṣuyaugikāḥ||21||

nārīṇāmaprajātānāṁnarāṇāṁcāpyapatyadāḥ|
ubhayārthakarādr̥ṣṭāḥsnēhabastinirūhayōḥ||22||

bhavanticAtra-

ityetebastayaHsnehAshcoktAyApanasa~jj~jitAH|
svasthAnAmAturANAMcavRuddhAnAMcAvirodhinAH||20||

ativyavAyashIlAnAMshukramAMsabalapradAH|
sarvarogaprashamanAHsarveShvRutuShuyaugikAH||21||

nArINAmaprajAtAnAMnarANAMcApyapatyadAH|
ubhayArthakarAdRuShTAHsnehabastinirUhayoH||22||

The benefits of ''yapana sneha'' and ''niruha basti'':

The above mentioned oleating ''basti'' preparations are called ''yapana basti''. These are ''avirodhi'' (not contraindicated) either for healthy persons, patients or for old persons also. They promote ''shukra'' and ''mamsa'' (semen and muscular tissue) of a person, indulging in excessive sex. They cure all diseases, and can be administered in all seasons. They help the sterile women and men to conceive and have the progeny. Both, ''sneha'' and ''niruha basti'' (medicated enema with and without oil) give ''ishta'' (desired) results. These ''yapana bastis'' serve both the purposes i.e. ''snehana'' (oleation) and ''shodhana'' (elimination of vitiated ''doshas'') from the body.[20-22]

व्यायामोमैथुनंमद्यंमधूनिशिशिराम्बुच|

सम्भोजनंरथक्षोभोबस्तिष्वेतेषुगर्हितम्||२३||

vyāyāmōmaithunaṁmadyaṁmadhūniśiśirāmbuca|

sambhōjanaṁrathakṣōbhōbastiṣvētēṣugarhitam||23||

vyAyAmomaithunaMmadyaMmadhUnishishirAmbuca|

sambhojanaMrathakShobhobastiShveteShugarhitam||23||

Apathya(Contraindications) during the course of ''Yapana Bastis'':

During the course of above mentioned ''yapana bastis'', the patient should avoid ''vyayama'' (exercise), ''maithuna'' (sexual intercourse), intake of ''madya'' and ''madhu'' (alcohol and honey), ''shishirambu'' (cold water), taking of full meal and jolting by conveyances. (23)

तत्रश्लोकाः[१]-

शिखिगोनर्दहंसाण्डैर्दक्षवद्बस्तयस्त्रयः|

विंशतिर्विष्किरैस्त्रिंशत्प्रतुदैःप्रसहैर्नव||२४||

विंशतिश्चतथासप्तविंशतिश्चाम्बुचारिभिः|

नवमत्स्यादिभिश्चैवशिखिकल्पेनबस्तयः||२५||

दशकर्कटकाद्यैश्चकूर्मकल्केनबस्तयः|

मृगैःसप्तदशैकोनविंशतिर्विष्किरैर्दश[२]||२६||

आनूपैर्दक्षशिखिवद्भूशयैश्चचतुर्दश|

एकोनत्रिंशदित्येतेसहस्नेहैःसमासतः||२७||

प्रोक्ताविस्तरशोभिन्नाद्वेशतेषोडशोत्तरे|

एतेमाक्षिकसंयुक्ताःकुर्वन्त्यतिवृषं[३]नरम्||२८||

नातियोगंनवाऽयोगंस्तम्भितास्तेचकुर्वते||

tatraślōkāḥ[1]-

śikhigōnardahaṁsāṇḍairdakṣavadbastayastrayaḥ|

viṁśatirviṣkiraistriṁśatpratudaiḥprasahairnava||24||

viṁśatiścatathāsaptaviṁśatiścāmbucāribhiḥ|

navamatsyādibhiścaivaśikhikalpēnabastayaḥ||25||

daśakarkaṭakādyaiścakūrmakalkēnabastayaḥ|

mr̥gaiḥsaptadaśaikōnaviṁśatirviṣkirairdaśa[2]||26||

ānūpairdakṣaśikhivadbhūśayaiścacaturdaśa|

ēkōnatriṁśadityētēsahasnēhaiḥsamāsataḥ||27||

prōktāvistaraśōbhinnādvēśatēṣōḍaśōttarē|

ētēmākṣikasaṁyuktāḥkurvantyativr̥ṣaṁ[3]naram||28||

tatra shlokAH [1] -

shikhigonardahaMsANDairdakShavadbastayastrayaH|

viMshatirviShkiraistriMshatpratudaiH prasahairnava||24||

viMshatishca tathA saptaviMshatishcAmbucAribhiH|

nava matsyAdibhishcaiva shikhikalpena bastayaH||25||

dasha karkaTakAdyaishca kUrmakalkena bastayaH|

mRugaiH saptadashaikonaviMshatirviShkirairdasha [2] ||26||

AnUpairdakShashikhivadbhUshayaishca caturdasha|

ekonatriMshadityete saha snehaiH samAsataH||27||

proktA vistarasho bhinnA dve shate ShoDashottare|

ete mAkShikasaMyuktAH kurvantyativRuShaM [3] naram||28||

nAtiyogaM na vA~ayogaM stambhitAste ca kurvate|29|

Summary of ''basti'' preparations:

{|class = "wikitable"
|-
|''Basti'' preparations with egg
|3
|-
|With the meat of ''karkata'' etc.
|10
|-
|With the meat of ''mrigas''
|17
|-
|With the meat of ''viskiras''
|19
|-
|With the meat of ''anupas''
|9
|-
|With the meat of ''bhusayas''
|14
|-
|With the meat of ''prashas''
|29
|-
|With the meat of ''pratuds''
|30
|-
|With the meat of ''ambuchar''
|27
|-
|With the meat of ''matasya''
|9
|}
Thus, when classified in detail, the 29 original and 187 extended, total 216 ''basti'' preparations.

Augmenting the potency of ''basti'' preparations.

Use of the above mentioned enema-recipes by adding honey makes a person exceedingly virile. When fortified (with honey), they do not allow any over-action (''atiyoga'') or under-action (''ayoga'').[24-28]

मृदुत्वान्ननिवर्तन्तेयस्यत्वेतेप्रयोजिताः||२९||

समूत्रैर्बस्तिभिस्तीक्ष्णैरास्थाप्यःक्षिप्रमेवसः||

mr̥dutvānnanivartantēyasyatvētēprayōjitāḥ||29||

samūtrairbastibhistīkṣṇairāsthāpyaḥkṣipramēvasaḥ||

mRudutvAnnanivartanteyasyatveteprayojitAH||29||

samUtrairbastibhistIkShNairAsthApyaHkShipramevasaH||

==== Management of non eliminated ''basti'' ====

There are some ''bastis'' which are not eliminated because of their soft nature, so to treat this complication the ''asthapana-basti'' prepared by cow’s urine and other ingredients having ''teekshna'' (irritant nature) should be given immediately.[29]

शोफाग्निनाशपाण्डुत्वशूलार्शःपरिकर्तिकाः||३०||

स्युर्ज्वरश्चातिसारश्चयापनात्यर्थसेवनात्||

śōphāgnināśapāṇḍutvaśūlārśaḥparikartikāḥ||30||

syurjvaraścātisāraścayāpanātyarthasēvanāt||

shophAgninAshapANDutvashUlArshaHparikartikAH||30||

syurjvarashcAtisArashcayApanAtyarthasevanAt||

==== Disorders of excessive use of ''yapana-bastis'' ====

The excessive use of ''yapana-basti'' results in ''shopha'' (edema), ''agni-nasha'' (loss of the power of digestion and metabolism), ''pandu'' (anemia), ''shula'' (pain), ''arsha'' (piles), ''pari-kartika'' (sawing pain), ''jwara'' (fever) and ''atisara'' (diarrhea).[30]

अरिष्टक्षीरसीध्वाद्यातत्रेष्टादीपनीक्रिया||३१||

युक्त्यातस्मान्निषेवेतयापनान्नप्रसङ्गतः|

इत्युच्चैर्भाष्यपूर्वाणांव्यापदःसचिकित्सिताः||३२||

विस्तरेणपृथक्प्रोक्तास्तेभ्योरक्षेन्नरंसदा||

ariṣṭakṣīrasīdhvādyātatrēṣṭādīpanīkriyā||31||

yuktyātasmānniṣēvētayāpanānnaprasaṅgataḥ|

ityuccairbhāṣyapūrvāṇāṁvyāpadaḥsacikitsitāḥ||32||

vistarēṇapr̥thakprōktāstēbhyōrakṣēnnaraṁsadā||

ShTakShIrasIdhvAdyAtatreShTAdIpanIkriyA||31||

yuktyAtasmAnniShevetayApanAnnaprasa~ggataH|

ityuccairbhAShyapUrvANAMvyApadaHsacikitsitAH||32||

vistareNapRuthakproktAstebhyorakShennaraMsadA||

==== Treatment of ''yapana basti vyapada'' (complications) ====

The complications due to ''yapan basti'' should be treated by the use of ''arishtas'' (medicated wines), milk, ''sidhu'' ( type of wine ), and ''agnideepak aushadhis'' ( appetizers) etc.[31]

The disorders caused due to various impediments like loudly speaking etc. and their treatment has been described in detail. Thus the patient should be protected from these all. [32]

कर्मणांवमनादिनामसम्यक्करणापदाम्||३३||

यत्रोक्तंसाधनंस्थानेसिद्धिस्थानंतदुच्यते||

karmaṇāṁvamanādināmasamyakkaraṇāpadām||33||

yatrōktaṁsādhanaṁsthānēsiddhisthānaṁtaducyatē||

karmaNAMvamanAdinAmasamyakkaraNApadAm||33||

yatroktaMsAdhanaMsthAnesiddhisthAnaMtaducyate||

The ''nirukti'' (derivation) of [[Siddhi Sthana]]: The section (''sthana'') in which the successful (''siddhi'') administration of purification therapy (emesis, purgation etc.), their complications arising due to various reasons, and management of the same is described is called as [[Siddhi Sthana]].[331/2]

इत्यध्यायशतंविंशमात्रेयमुनिवाङ्मयम्||३४||

हितार्थंप्राणिनांप्रोक्तमग्निवेशेनधीमता||

ityadhyāyaśataṁviṁśamātrēyamunivāṅmayam||34||

hitārthaṁprāṇināṁprōktamagnivēśēnadhīmatā||

ityadhyAyashataMviMshamAtreyamunivA~gmayam||34||

hitArthaMprANinAMproktamagniveshenadhImatA||

==== Number of Chapters in Agnivesha Samhita ====

The wise Agnivesha, has compiled the entire literature of his guru’s statements, the sage Atreya in this treatise in one hundred and twenty chapters for the welfare of all the living beings. [34-341/2]

दीर्घमायुर्यशःस्वास्थ्यं[१]त्रिवर्गंचापिपुष्कलम्||३५||

सिद्धिंचानुत्तमांलोकेप्राप्नोतिविधिनापठन्||

dīrghamāyuryaśaḥsvāsthyaṁ[1]trivargaṁcāpipuṣkalam||35||

siddhiṁcānuttamāṁlōkēprāpnōtividhināpaṭhan|36|

dIrghamAyuryashaHsvAsthyaM[1]trivargaMcApipuShkalam||35||

siddhiMcAnuttamAMlokeprApnotividhinApaThan||

==== Benefits of studying the [[Charak Samhita]] ====

By the ''vidhina pathan'' (systematic study) of this treatise ([[Charak Samhita]]) a person achieves ''deerghayu'' (longevity), ''yasha'' (fame), ''swasthya'' (health), ''trivarga'' (''dharma, artha'' and ''kama'' /the three basic desires of life) and ''pushkala'' (''moksha'' / salvation) as well as ''siddhi'' (professional accomplishment) also in this world.[35-36]

विस्तारयतिलेशोक्तंसङ्क्षिपत्यतिविस्तरम्||३६||

संस्कर्ताकुरुतेतन्त्रंपुराणंचपुनर्नवम्|

अतस्तन्त्रोत्तममिदंचरकेणातिबुद्धिना||३७||

संस्कृतंतत्त्वसम्पूर्णंत्रिभागेनोपलक्ष्यते|

तच्छङ्करंभूतपतिंसम्प्रसाद्यसमापयत्||३८||

अखण्डार्थंदृढबलोजातःपञ्चनदेपुरे|

कृत्वाबहुभ्यस्तन्त्रेभ्योविशेषोञ्छशिलोच्चयम्||३९||

सप्तदशौषधाध्यायसिद्धिकल्पैरपूरयत्|

इदमन्यूनशब्दार्थंतन्त्रदोषविवर्जितम्||४०||

षड्विंशताविचित्राभिर्भूषितंतन्त्रयुक्तिभिः||

vistārayatilēśōktaṁsaṅkṣipatyativistaram||36||

saṁskartākurutētantraṁpurāṇaṁcapunarnavam|

atastantrōttamamidaṁcarakēṇātibuddhinā||37||

saṁskr̥taṁtattvasampūrṇaṁtribhāgēnōpalakṣyatē|

tacchaṅkaraṁbhūtapatiṁsamprasādyasamāpayat||38||

akhaṇḍārthaṁdr̥ḍhabalōjātaḥpañcanadēpurē|

kr̥tvābahubhyastantrēbhyōviśēṣōñchaśilōccayam||39||

saptadaśauṣadhādhyāyasiddhikalpairapūrayat|

idamanyūnaśabdārthaṁtantradōṣavivarjitam||40||

ṣaḍviṁśatāvicitrābhirbhūṣitaṁtantrayuktibhiḥ|41|

vistArayatileshoktaMsa~gkShipatyativistaram||36||

saMskartAkurutetantraMpurANaMcapunarnavam|

atastantrottamamidaMcarakeNAtibuddhinA||37||

saMskRutaMtattvasampUrNaMtribhAgenopalakShyate|

taccha~gkaraMbhUtapatiMsamprasAdyasamApayat||38||

akhaNDArthaMdRuDhabalojAtaHpa~jcanadepure|

kRutvAbahubhyastantrebhyovisheSho~jchashiloccayam||39||

saptadashauShadhAdhyAyasiddhikalpairapUrayat|

idamanyUnashabdArthaMtantradoShavivarjitam||40||

ShaDviMshatAvicitrAbhirbhUShitaMtantrayuktibhiH||

==== The function of ''pratisamskarta'' (redactor) ====

A redactor expands the concise statements and the expanded statements into concised ones along with the addition of new thoughts in the old work, and puts it in new (revised) form.

Therefore, Charak, having the excellent intelect and wisdom redacted this illustrious treatise, which was lacking as one-third of its present form. This incomplete or missing text was completed by Dridhabala, the resident of Panchanadpur, by adding 17 chapters of [[Chikitsa Sthana]], 12 chapters in [[Kalpa Sthana]] and [[Siddhi Sthana]] each. Total 41 chapters were added by Dridhabala. He collected the subject matter from different sources like picking up the grains, the completed the text in excellent form which is available today. Hence this text is not deficient in shabda (words) their meanings and free from textual blemishes. It is ''vichitrabhibhushitam'' (decorated/endowed/embellished) with thirty six ''tantrayuktis'' (canons of exposition). [36-40]

==== ''Tantrayukti'' (canons of exposition/tricks to understand text) ====

तत्राधिकरणंयोगोहेत्वर्थोऽर्थःपदस्यच||४१||

प्रदेशोद्देशनिर्देशवाक्यशेषाःप्रयोजनम्|

उपदेशापदेशातिदेशार्थापत्तिनिर्णयाः||४२||

प्रसङ्गैकान्तनैकान्ताःसापवर्गोविपर्ययः|

पूर्वपक्षविधानानुमतव्याख्यानसंशयाः||४३||

अतीतानागतावेक्षास्वसञ्ज्ञोह्यसमुच्चयाः|

निदर्शनंनिर्वचनंसन्नियोगोविकल्पनम्||४४||

प्रत्युत्सारस्तथोद्धारःसम्भवस्तन्त्रयुक्तयः||

tatrādhikaraṇaṁyōgōhētvarthō'rthaḥpadasyaca||41||

pradēśōddēśanirdēśavākyaśēṣāḥprayōjanam|

upadēśāpadēśātidēśārthāpattinirṇayāḥ||42||

prasaṅgaikāntanaikāntāḥsāpavargōviparyayaḥ|

pūrvapakṣavidhānānumatavyākhyānasaṁśayāḥ||43||

atītānāgatāvēkṣāsvasañjñōhyasamuccayāḥ|

nidarśanaṁnirvacanaṁsanniyōgōvikalpanam||44||

pratyutsārastathōddhāraḥsambhavastantrayuktayaḥ|

tatrAdhikaraNaMyogohetvartho~arthaHpadasyaca||41||

pradeshoddeshanirdeshavAkyasheShAHprayojanam|

upadeshApadeshAtideshArthApattinirNayAH||42||

prasa~ggaikAntanaikAntAHsApavargoviparyayaH|

pUrvapakShavidhAnAnumatavyAkhyAnasaMshayAH||43||

atItAnAgatAvekShAsvasa~jj~johyasamuccayAH|

nidarshanaMnirvacanaMsanniyogovikalpanam||44||

pratyutsArastathoddhAraHsambhavastantrayuktayaH||

===== Number of ''tantra yuktis'' (36 Canons of exposition) =====

#''Adhikaraṇa'' (subject matter)
#''Yoga'' (rational combination)
#''Hetvarth'' (extension of argument)
#''Padarth'' (implication or import of words)
#''Pradesh'' (partial enunciation)
#''Uddesha'' (concise statement)
#''Nirdesha'' (amplification)
#''Vakyashesha'' (supply of ellipsis)
#''Prayojana'' (aim/object)
#''Upadesha'' (Authoritative instruction),
#''Apadesh'' (adducement of reasons),
#''Atidesha'' (indication)
#''Arthapatti'' (implication),
#''Nirṇaya'' (decision),
#''Prasanga'' (restatement)
#''Ekanta'' (categorical statement),
#''Anekanta'' (compromising statement),
#''Apavarga'' (exception) ,
#''Viparyaya'' (opposite) ,
#''Purvapaksha'' (amplification of earlier statement),
#''Vidhana'' (correct interpretation) ,
#''Anumata'' (confession) ,
#''Vyakhyana'' (explanation) ,
#''Samsaya'' (doubt) ,
#''Atitavekekshna'' (retrospective reference),
#''Anagatavekshna'' (prospective reference),
#''Svasangya'' (technical terms)
#''Uhya'' (deduction),
#''Samuchya'' (specification),
#''Nidarshana'' (Illustration),
#''Nirvachana'' (citation of analogy),
#''Sanniyoga'' (injuction) ,
#''Vikalpana'' (option),
#''Pratyutsara'' (rebuttal),
#''Uddhara'' (re-affirmation),
#''Sambhava'' (possibility). [41-44]

तन्त्रेसमासव्यासोक्तेभवन्त्येताहिकृत्स्नशः||४५||

एकदेशेनदृश्यन्तेसमासाभिहितेतथा||

tantrēsamāsavyāsōktēbhavantyētāhikr̥tsnaśaḥ||45||

ēkadēśēnadr̥śyantēsamāsābhihitētathā||

tantresamAsavyAsoktebhavantyetAhikRutsnashaH||45||

ekadeshenadRushyantesamAsAbhihitetathA||

These ''tantrayuktis'' are found in concise/aphoristic or extended/expository form in all text to make the subject clear and understandable but where the text itself is composed inconcise/aphoristic form, they are adopted partially only. [45]

यथाऽम्बुजवनस्यार्कःप्रदीपोवेश्मनोयथा||४६||

प्रबोधनप्रकाशार्थास्तथातन्त्रस्ययुक्तयः||

yathā'mbujavanasyārkaḥpradīpōvēśmanōyathā||46||

prabōdhanaprakāśārthāstathātantrasyayuktayaḥ||

yathA~ambujavanasyArkaHpradIpoveshmanoyathA||46||

prabodhanaprakAshArthAstathAtantrasyayuktayaH||

=====Importance of ''tantrayuktis'' =====

As the Lotus blossom in ponds in the presence of Sun light, the dark house enlightened by the lamp, in the same way these ''tantrayuktis'' help to understand the treatise in holistic way i.e. ''prabodhan'' (knowledge) and ''prakashan'' (making clear).[46]

एकस्मिन्नपियस्येहशास्त्रेलब्धास्पदामतिः||४७||

सशास्त्रमन्यदप्याशुयुक्तिज्ञत्वात्प्रबुध्यते|

अधीयानोऽपिशास्त्राणितन्त्रयुक्त्याविनाभिषक्|

नाधिगच्छतिशास्त्रार्थानर्थान्भाग्यक्षयेयथा||४८||

ēkasminnapiyasyēhaśāstrēlabdhāspadāmatiḥ||47||

saśāstramanyadapyāśuyuktijñatvātprabudhyatē|

adhīyānō'piśāstrāṇitantrayuktyāvinābhiṣak|

nādhigacchatiśāstrārthānarthānbhāgyakṣayēyathā||48||

ekasminnapiyasyehashAstrelabdhAspadAmatiH||47||

sashAstramanyadapyAshuyuktij~jatvAtprabudhyate|

adhIyAno~apishAstrANitantrayuktyA[1]vinAbhiShak|

nAdhigacchatishAstrArthAnarthAnbhAgyakShayeyathA||48||

===== The Application of ''tantrayuktis'' =====

The person who is having the knowledge of one subject along with these ''tantrayuktis'', can understand the other subject also with the help of them. But one who is not conversant with ''tantrayuktis'' can not understand his own texts as well the others too at any cost, same as a person fails to get wealth in spite of all efforts when his fortune does not favors him. [47-48]

दुर्गृहीतंक्षिणोत्येवशास्त्रंशस्त्रमिवाबुधम्|

सुगृहीतंतदेवज्ञंशास्त्रंशस्त्रंचरक्षति||४९||

(तस्मादेताःप्रवक्ष्यन्तेविस्तरेणोत्तरेपुनः|

तत्त्वज्ञानार्थमस्यैवतन्त्रस्यगुणदोषतः)||५०||

durgr̥hītaṁkṣiṇōtyēvaśāstraṁśastramivābudham|

sugr̥hītaṁtadēvajñaṁśāstraṁśastraṁcarakṣati||49||

(tasmādētāḥpravakṣyantēvistarēṇōttarēpunaḥ|

tattvajñānārthamasyaivatantrasyaguṇadōṣataḥ)||50||

durgRuhItaMkShiNotyevashAstraMshastramivAbudham|

sugRuhItaMtadevaj~jaMshAstraMshastraMcarakShati||49||

(tasmAdetAHpravakShyantevistareNottarepunaH|

tattvaj~jAnArthamasyaivatantrasyaguNadoShataH)||50||

==== Merits and demerits regarding the text ====

If a person does not know how to handle a weapon, he destroys himself by using the same. Similarly, the text/subject which is not understood well or properly, will destroy the person by practicing the same. On the other hand, as the weapon in the hands of wise protect him in trouble, in the same way the well understood text/treatise protect the physician in terms of his name fame and wealth too. [49]

It is also said that the ''tantrayuktis'' will be described in detail again from critical analysis point of view, for understanding the good and bad qualities of this treatise ([[Charak Samhita]]) in ''uttar-tantra''. [50]

(Note: One thing which is important to mention here that this is a controversial statement given here because the present [[Charak Samhita]] which is available today, does not have any extension like ''uttar tantra''. So it requires further study and exploration of this subject matter.)

इदमखिलमधीत्यसम्यगर्थान्विमृशतियोऽविमनाःप्रयोगनित्यः|

समनुजसुखजीवितप्रदाताभवतिधृतिस्मृतिबुद्धिधर्मवृद्धः||५१||

idamakhilamadhītyasamyagarthānvimr̥śatiyō'vimanāḥprayōganityaḥ|

samanujasukhajīvitapradātābhavatidhr̥tismr̥tibuddhidharmavr̥ddhaḥ||51||

idamakhilamadhItyasamyagarthAnvimRushatiyo~avimanAHprayoganityaH|

samanujasukhajIvitapradAtAbhavatidhRutismRutibuddhidharmavRuddhaH||51||

==== Benefits of studying the [[Charak Samhita]] ====

The physician, who studies this text with concentrated mind and try to understand the same by critical and analytical way as well as apply those ''yogas''/formulas/prescriptions in his practice which are mentioned in this text, attains the patience, memory, knowledge and righteousness. He becomes the bestower of happiness and long life to the human beings. [51]

(यस्यद्वादशसाहस्रीहृदितिष्ठतिसंहिता|

सोऽर्थज्ञःसविचारज्ञश्चिकित्साकुशलश्चसः||५२||

रोगांस्तेषांचिकित्सांचसकिमर्थंनबुध्यते|

चिकित्सावह्निवेशस्यसुस्थातुरहितंप्रति||५३||

यदिहास्तितदन्यत्रयन्नेहास्तिनतत्क्वचित्|

अग्निवेशकृतेतन्त्रेचरकप्रतिसंस्कृते||५४||

सिद्धिस्थानेऽष्टमेप्राप्तेतस्मिन्दृढबलेनतु|

सिद्धिस्थानंस्वसिद्ध्यर्थंसमासेनसमापितम्)||५५||

(yasyadvādaśasāhasrīhr̥ditiṣṭhatisaṁhitā|

sō'rthajñaḥsavicārajñaścikitsākuśalaścasaḥ||52||

rōgāṁstēṣāṁcikitsāṁcasakimarthaṁnabudhyatē|

cikitsāvahnivēśasyasusthāturahitaṁprati||53||

yadihāstitadanyatrayannēhāstinatatkvacit|

agnivēśakr̥tētantrēcarakapratisaṁskr̥tē||54||

siddhisthānē'ṣṭamēprāptētasmindr̥ḍhabalēnatu|

siddhisthānaṁsvasiddhyarthaṁsamāsēnasamāpitam)||55||

(yasyadvAdashasAhasrIhRuditiShThatisaMhitA|

so~arthaj~jaHsavicAraj~jashcikitsAkushalashcasaH||52||

rogAMsteShAMcikitsAMcasakimarthaMnabudhyate|

cikitsAvahniveshasyasusthAturahitaMprati||53||

yadihAstitadanyatrayannehAstinatatkvacit|

agniveshakRutetantrecarakapratisaMskRute||54||

siddhisthAne~aShTameprAptetasmindRuDhabalenatu|

siddhisthAnaMsvasiddhyarthaMsamAsenasamApitam)||55||

The person who know this text of twelve thousand verses and paragraph by heart, he is the knower of meanings and thinker of this treatise as well as an efficient physician.

The therapeutic measures described in this text of Agnivesha are useful both for healthy persons and the patients too.

What so ever knowledge of medicine is available in this treatise is also present in other text of Ayurveda, and what so ever knowledge is not available here can not be found any text of Ayurveda. This indicates the greatness of [[Charak Samhita]].

The text of Agnivesha as redacted by Charak is supplemented by Dridhabala .[52-55]

इत्यग्निवेशकृतेतन्त्रेचरकप्रतिसंस्कृतेऽप्राप्तेदृढबलसम्पूरित

सिद्धिस्थानेउत्तरबस्तिसिद्धिर्नामद्वादशोऽध्यायः||१२||

इतिचरकसंहितायांअष्टमंसिद्धिस्थानंसम्पूर्णम्|

समाप्तेयंचरकसंहिता|

ityagnivēśakr̥tētantrēcarakapratisaṁskr̥tē'prāptēdr̥ḍhabalasampūritē

siddhisthānēuttarabastisiddhirnāmadvādaśō'dhyāyaḥ||12||

iticarakasaṁhitāyāṁaṣṭamaṁsiddhisthānaṁsampūrṇam|

samāptēyaṁcarakasaṁhitā|

ityagniveshakRutetantrecarakapratisaMskRute~aprAptedRuDhabalasampUrite

siddhisthAneuttarabastisiddhirnAmadvAdasho~adhyAyaH||12||

iticarakasaMhitAyAMaShTamaMsiddhisthAnaMsampUrNam|

samApteyaMcarakasaMhitA|

==== End of [[Uttar Basti Siddhi]] ''adhyaya''(chapter) ====

Thus here in this ''Tantra'' (treatise) which was expounded by Agnivesha, redacted by Charak and supplemented by Dridhbala, it is the end of this 12th chapter, [[Uttar Basti Siddhi]], the last section of [[Siddhi Sthana]] of [[Charak Samhita]].[12]

=== ''Tattva Vimarsha'' ===

*Purification therapies evacuate excess accumulated wastes from body leading to transient disturbance in homeostasis. Therefore utmost care of patient should be taken after purification therapies.
*The patient shall follow prescribed rules of diet and lifestyle for regaining positive health after purification.
*If the rules are not followed properly, it leads to vitiation of ''vata dosha'' resulting in various ''vata'' related disorders.
*These disorders are treated with ''yapana basti'' i.e. medicated enema that sustain health.
*The treatise shall be learnt and understood by applying techniques called ''tantrayukti'' (canons of exposition/tricks for understanding treatise).

=== ''Vidhi Vimarsha'' ===

The term ''siddhi'' means accomplishment with perfection in the administration of therapies for the treatment of diseases.

''Ahara'' (diet) is predominantly endowed with six ''rasas'' (taste) and they act through their properties by contradicting each other, resulting in equilibrium. Thus the patient should be given diet having mutually contradictory tastes, and mutually contradictory properties like unctuousness and ununctuousness alternatively till equilibrium is attained. Because the state of complete health as stated by Sushruta ie the the equilibrium state of ''dosha, dhatu, agni, mala'' causing pleasant state of soul, senses and mind. ''Samadosha samagnishcha samdhatu malkriyah''--–''Prasnnatmen driyamanah'' (Su. Su. 15/8).

The ''ashta mahadosha'' mentioned in this chapter are all held responsible for the vitiation of ''doshas'' mainly the ''vata'', causing various disorders. Initiation of speech is the action of ''vata'' (''udana vayu'') so ''uchha bhashya'' (loudness) ''ati-bhashya'' (excessive speaking), jolting, constant sitting etc. cause various disorders. Thus it advisable as precautionary measure to avoid strain due to these activities, that one should speak slowly and less to prevent the disorders caused by the same. (13-14)

Measures in terms of diet and life style having pacifying properties specially, ''vata'' along with ''pitta'' and ''kapha'' are helpful in managing the eight impediments.

After the purification therapy, the patient becomes physically and mentally weak so the experienced physician advises the patient to gradually progress diet from lighter to heavier. Starting with ''peya'' (thin gruel) and ending with ''mamsa rasa'' (meat-soup) for the stimulation of ''agni'' (power of digestion and metabolism). In view of some scholars, this protocol of specific dietary regimen is necessary after ''vamana'' (emesis) and ''virechana'' (purgation) therapy only and not in ''niruha'' and ''shiro-virechana''.

''Yapana basti''- ''Yapana basti'' means medicated preparation which can be used all the time for ''basti'' and they promote longevity, preserve health and cure of diseases too.

There are 216 ''bastis'' mentioned in this chapter for the maintenance of health and cure of disease, having various ingredients. Some of the ingredients are not available now or difficult to get but seems to be very effective, as referred in the literature and experienced by various scholars. These ''bastis'' are effective for the maintenance of health and cure of disease as it pacifies ''vata'' and considered as half treatment of any disease. It serves the purpose of ''virechana'' also as described by many scholars and it requires extensive clinical experience in this field. This ''uttara basti'' is very effective in gynecology disorders. It acts in the pelvic region /lower part of umbilical region due to that the ''apana vayu'' is pacified by the same.

It is also very effective in ''vatashthila'' (Benign Prostatic Hypertrophy). Various studies have been conducted in the Department of ''shalya tantra'' of IMS BHU in BPH cases. The ''basti'' was prepared with different ''kwatha'' and oily preparations like ''dashamoola kwatha'' and ''narayana taila''(oil)etc. After the application of this procedure, the signs and symptons like pain & swelling, urgency, dysurea, burning micturation were reduced to great extent and the size of prostate reduced. Those patients who required surgery, the bleeding during and after operation was less and removal of prostate was easier in comparison to the control group. The probable mechanism of action is increased permeability of cells, which results in exchange of materials between intra and extracellular space. ''Dashmula kwatha'' (decoction) and narayan tail are good for pacification of ''vata''. These remedies help to clean the urethral passage, decrease inflammation, edema and residual urine, relieving signs and symptoms of BPH. [1]
So there are many benefits achieved by application of ''uttara basti'' in BPH and gynecological disorders as well as pelvic region diseases.

==== ''Tantra Yukti'' ====

Agnivesha, while composing this treatise followed the statements of his /guru preceptor Atreya. Since Ayurveda is a science of spirituality also, there is a tradition of worshiping gods and natural powers having good result of action. Thus after worshiping Lord Shiva, these medicated preparations are used, while chanting Vedic mantras and blowing conch-shell accompanied with the beating sound of ''pataha'' (hand-drum) as well as ''bheri'' (kettle drum). This helps to attain the real goal of life, ''tri-varga'' or the three basic desires of human life such as ''dharma'' (performance of duties), ''artha'' (satisfaction of senses with their objects / acquirement of wealth) and ''kama'' (fulfillment of desires).

After the detailed discreption of ''yapana basti'' and their extended form, thirty six ''Tantra Yuktis'' are mentioned in very brief.

Thirty two ''tantra yuktis'' are described in ''uttar tantra'' of Sushrat samhita. The commentator of [[Charak Samhita]], Bhattar Harisha Chandra, has described forty ''Tantra Yuktis''. So there is difference in number due to difference in opinion.

The word ''Tantra Yukti'' is formed of two words, ''tantra'' and ''yukti''. ''Tantra'' means ''shastra''(treatise) like Ayurveda.

The word ''yukti'' means planning. So the word ''tantra yukti'' means the planning of compilation of treatise and treatment in scientific way. In the etiology, cinical features and management of diseases the application of tantra yukti is seen very frequently. For example, in the management of prameha the application of vikalp tantra yukti is seen in context of udaka pana/medicated water of different ingredients (Ch.Chi.6/46) Similarly in the compilation of any treatise one word has been used in different context like prayojana, adhikarana and uhya etc. A compilation of any knowledge after its experience is very important for its preservation and future generation. “Vidhina pathan” (systematic studies) as mentioned in this chapter, reflect the importance of tantra yuktis, as the procedure of study described in Vimana Sthana of Charak Samhita (8/ 7).

There are two aim of these Tantra Yuktis, mentioned in Sushruta Samhita:

#Vakya yojana- Planing of construction/formation of sentences in scientific way logically so that the meaning should be clear.
#Arthayojana- The way of compilation of any treatise to make the meaning of words clear, or the specific meaning of the words.

The importance and application of tantra yukti is mentioned as prabodhana (knowledge) and prakashana (making clear or manifest) in [[Charak Samhita]]. Sushruta said that having the knowledge of a single subject one can not become expert, even his own discipline requires a multi disciplinary knowledge for holistic approach as of Ayurveda. Charak has expressed this view in context of tantra yuktis that without knowing the same one can not understand his own subject as wellas others.

At the same time there is controversial remark is given after naming the thirty six tantra yuktis that the detail description will be geven in uttar tantra, practically which is not present in the available text today. Over this issue Dr. Richa Vishvakarma has thrown some light by her small effort and concluded that-

In the present scenario, the available editions of [[Charak Samhita]] contain eight Sthanas only. [[Charak Samhita]] does not contain Uttara-Tantra like Sushruta Samhita and Samhitas of Vagbhata. On contrary the twelfth chapter of [[Siddhi Sthana]] Charak has mentioned about Uttara Tantra of [[Charak Samhita]]. So it is essential to emphasize on this issue, which was not explained in length by commentators of [[Charak Samhita]] . Many controversies raised on the existence and recognition of uttara-tantra of [[Charak Samhita]]. On the other hand, some scholars who belong to a later period have mentioned certain references in their work, which are claimed to be from uttara tantra of [[Charak Samhita]]. After a thorough study and scanning of available literature, it is concluded that Charak uttar tantra was existing up to the time of Nishchalakara (13th century AD.). Nishchalakara has quoted a number of references in Ratnaprabha, which are from uttar tantra of [[Charak Samhita]]. Furthermore, there is a need to discuss about existence of uttara tantra of [[Charak Samhita]] by further more detailed study and scanning of literatures of Ayurveda and allied literatures[2]

==== ''Tantrayukti'' (Canons of exposition of texts) ====

''Meemansa'' (name of a philosophy trend), Nyaya (name of a philosophy trend) and vyakarana ( grammar) are used for proper interpretation of Vedas,. Commentator Dalhana in Sushruta samhita (Su.4.7) said that a vaidya should have knowledge of Saankhya, Jyotish Shastra and Vaisheshika etc. Being part of Vaidic literature, Meemansa, Nyaya and Vyakarana are most useful for proper interpretation of Ayurveda also. But Ayurveda has developed its own unique methodology for proper interpretation, termed as Tantrayukti in which certain important points from these Darshana or other sciences are already incorporated.

Tantra here means Shastra, i.e. guiding principles of Ayurveda. Yukti is a methodology in which multiple observations are correlated, to understand appropriate meaning. Understanding Tantrayukti is very much important, for proper understanding of Ayurveda. Following are important sources to understand Tantrayukti:
#[[Charak Samhita]] [[Siddhi Sthana]] 12th chapter with commentaries
#Sushruta samhita Uttara tantra 65th chapter with commentaries
#Ashtanga sangraha Uttara tantra 50th chapter with commentaries
#Tantrayukti Vichara by Neelamegha Vaidya
#Kautileeya Arthashastra 15
#Other allied Shastras like Nyaya, Meemansa, Vyakarana etc.

Tantrayukti are important because of following benefits:

#शास्त्राधिगमः।(सुगृहीतं शास्त्रं रक्षति, दुर्गृहीतं क्षिणोति) (Ch.Si.12/48,49)Shastradhigama : proper understanding of Ayurveda. Because only proper understanding helps for maintenance of health and curing diseases. Improper knowledge may be harmful.
#प्रबोधनम्- अम्बुजवनस्यार्कः। (Ch.Si..12/46, Su.U.65/7) Prabodhanam Ambujavanasyarka: Just like the lotus blooms, in sunlight, with Tantrayukti, the meaning of Ayurvedic texts is elaborated.
#प्रकाशनम्- प्रदीपो वेश्मनो। (Ch.Si. 12/46, Su.U. 65/7) Prakashanam Padeepo Veshmano: Just like a light removes darkness in the house, with Tantrayukti, meaning of difficult topics becomes lucid.
#अनुक्तार्थज्ञानम्। (Su.U..65/6) Anuktartha Jnanartham: Tantrayukti enables to understand even the unsaid hidden meanings.
#आशु अन्यशास्त्रप्रबोधनम्। (Ch.Si.12/47) Aashu anyashatraprabodhanam: By knowing Tantrayukti, not only Ayurveda, but one becomes capable of understanding other allied sciences also.
#स्ववाक्यसिद्ध्यर्थम्। (Su.U..65/5) Swavakya siddhyartham:The meanings drawn with help of Tantrayukti, justifies ones statements in a scientific discourse.
#असद्वादिवाक्यप्रतिषेधनम्। (Su.U. 65/5) Asadvadi Vakya patishedham: In a scientific discourse, statements of those who are misinterpreting texts, can be refuted with the help of Tantrayukti.

==== Thirty Six Tantrayukti ====

===== 1. Adhikarana (Topic of discourse) =====

Adhikarana is the topic of discourse. e.g. specific information on rasa and dosha, like rasaprabhava and dosha is the adhikarana in the first chapter of Vimanasthana.

In a Adhyaya(chapter), there may be multiple adhikarana. The meaning of the words or statements, is to be understood based on the adhikarana in which they are used. Therefore, knowing adhikarana, is important. Even the modes of action of medicines can be understood as per the aadhikarana. E.g. In Chikitsasthana 8th chapter, Under Rajayakshma Chikitsa, there are multiple adhikarana. Sitopaladi choorna is used in kasa adhikara, while talisadi choorna is used in arochaka adhikara. This enables us to understand the peculiarities of the actions of both these formulations.

===== 2. Yoga (Arrangement) =====

Various terms placed at different places are arranged to draw appropriate meaning. E.g .Five step methodology --i.e. Pratijna (Proposition- hypothesis), Hetu (Reasoning, evidences for support, testimony), Drishtanta (examples), Upanaya (analogy) and Nigamana (deduction) is used to explain the relation between Matrija (mother engendered), Pitrija (father engendered) etc. factors which altogether lead to formation of the embryo.

===== 3. Hetvartha (Extension of concepts) =====

It illustrates the condition of invisible things by visible and known examples. The concepts introduced in certain initial chapters of Samhita, are extended and applied to later contexts, for getting appropriate meaning and applications like clinical applications. E.g. In Charak Su.12/5, a concept is explained, that continuous use of food or medicines leads to augmentation of body constituents homologous to it. This concept is further applied in various contexts like Ch.Sha.6.9. This concept is then applied in Chikitsasthana.

===== 4. Padartha (Import of words) =====

It means that, when a word having two or more senses is used, then that meaning alone has to be accepted which suits the previous and later contexts. Here various words are aligned together, to draw appropriate meaning. The meaning here, is according to the context. The individual words, here may have different meaning in some other context, but when combined together in this context, they provide a specific meaning, which is the technical meaning, in the present context. e.g. Svabhavoparamavada described in Su.16. Svabhava- Uparama-Vada all these words are having different meanings in other contexts. But when joined together, in this context , it means a proposed theory, which suggests that for the formation and manifestation of any objects certain causative factors are responsible, but for their destruction and annihilation, no other cause is required, because, it is nature of anything which is produced to get destroyed.

===== 5. Pradesha (Partial adumbration) =====

When the information on a particular subject is vast, it’s not possible to provide all the details. In such conditions, small part is described in such a way, that it acts as an example for readers, to guide about further details which can’t be furnished. E.g. after providing guidelines about preparation of medicinal formulations in Ch.Su.4.,Ch.Ka.12 etc. places, 600 formulations are described in Kalpasthana. It is explained that these provide guidelines. If one understands these guidelines, one can prepare millions of such formulations.

===== 6. Uddesha (Concise statement) =====

Uddesha is the method of briefly touching a subject without going in detail. Thus, when one says “disease” (shalya), it means both internal and external diseases without any kind of specification. Uddesha is a concise statement like Ch.Su.1.24 mentions that Lord Indra explained Ayurveda to Sage Bharadvaja with trifold methodology i.e. Hetu (Causes), Linga (symptoms and signs) and Aushadha (treatment modalities). This is further described in the whole text, in relation to health and diseases. E.g. causes of (factors leading to) health, and causes of diseases, and so on.

===== 7. Nirdesha (Amplification) =====

It is the method of describing thing in detail. E.g. In Sutrasthana 1st chapter three Doshas pertaining to the body are mentioned as Vayu, Pitta and Kapha. This is like Uddesha. Now further details about these Doshas like their properties, their functions, causes for their vitiation and treatment for them are described further in the Sutrasthana 1st chapter and also in Su.12, 20, Vimanasthana 6th chapter etc. this is Nirdesha.

===== 8. Vakyashesha (Supply of ellipsis) =====

It consists in supplying an idea suggested by the context, but not expressly mentioned. Here authors of ancient texts(Samhita), don’t mention certain words in a statement, to keep the text concise. However such words can be easily understood, and are necessary for drawing correct meaning of the statement. E.g. Ch.Su.16.28 states that for utpatti (formation, manifestation) of objects causative factors (are necessary), but not for their nirodha (cessation, annihilation). In this statement, the words in the bracket-‘are necessary’ – are not directly mentioned, but can be understood and are necessary.

===== 9. Prayojana (Purpose) =====

It is the purpose for which a description is given or for which a doer initiates his actions. E.g. to produce dhatusamya (balanced state of all body constituents) is mentioned as the prayojana (purpose for promulgation) of Ayurveda.

===== 10. Upadesha (Authoritative instruction) =====

It is the method of giving general instruction. These are important guidelines by the ancient sages, which are otherwise difficult to understand for a layman. It explains what exactly should be done in a given condition, while treating a patient, or for maintenance and promotion of health. It explains what to do, how to do and in which order to be done. E.g. Ch.Su.13.99 explains that swedana should be always preceded by snehana. Such advice comes from vast knowledge, experience and wisdom of the sages. Thus this is practically very important.

===== 11. Apadesha ( Adducement of reason) =====

It is the method of showing the reasons of things. After stating a certain fact, here reasoning is provided. E.g. Ch.Vi.3rd chapter, while describing epidemics, it is stated that factors like wind, water and the land are gradually more and more influential. The reasoning is further provided, that these factors are more and more difficult to avoid. Somehow a person can hide at the residence to avoid exposure to polluted abnormal wind, but avoiding water will be even more difficult, because although polluted, the water sources may be finite and limited.

===== 12. Atidesha (Indication) =====

Is that of anticipating a future event from a present indication or prognostication. Thus, from the fact of increasing and uprising of vata in a man’s system may predict that he will have specific bowel disease(udavarta).

===== 13. Arthapatti (Implication) =====

It is that which is understood, by implication, though not directly mentioned, is called arthapatti. E.g. it is advised that eating curds during night should be avoided. By implication of this, it is understood that eating curds in daytime won’t harm health.

===== 14. Nirnaya (Decision) =====

Is the decision taken after a scientific discussion, taking into consideration both sides of the arguments. E.g. in the Ch.Su.10th chapter, there is a discussion between Lord Atreya and the sage Maitreya over the significance of the quadruple (consisting of the physician, attendants and nursing staff, medicines and the patient. The argument of Maitreya, that these four factors don’t have any significant role in the disease cure, is refuted by Lord Atreya and their role is proven. The concluding statement of Lord Atreya, that these four factors when endowed with good qualities, are significant for the treatment, is called as Nirnaya.

===== 15. Prasanga (Restatement) =====

It is a virtue by which allusion is made to things repeatedly described in other chapter. Here since it is necessary, to quote certain facts, for proper understanding in other contexts also. So this is not mere repetition. E.g. As per [[Charak Samhita]], only ''sama prakriti'' (balanced state of all three doshas) is Prakriti, and Vatala (Vata dominant) etc. Prakriti (specific body constitution with predominance of one or two doshas) are termed as in fact vikriti (imbalance, abnormality). Therefore, the treatment for them is described in Ch.Su.7.41. Again in Ch.Vi.6.14-18 since in that context also it was needed, treatment for vatala etc. is again described.

===== 16. Ekanta (Categorical statement) =====

It allows of affirming a specific action of things unexceptionably e.g. Madanaphala fruit induces vomiting i.e. under all circumstances. Here there is no scope for difference of opinion and arguments; as such things are true in any circumstances.

===== 17. Anekanta (Compromising statement) =====

It is the virtue of which one understands that different opinions prevail on a particular subject. E.g. in Ch.Su.25.1-25, various opinions about the principles from Purusha (living being or a human being) is originated are quoted. None of them is absolutely wrong. But none of these factors are capable of originating Purusha, alone or independently. So none of these opinions, can be accepted as complete truth. Therefore in verse number 26-29, Lord Atreya concluded, that a Purusha originates from all these factors, collectively. If one would adhere to unilateral view, he wouldn’t be able to know the complete truth ever. This is called as Anekanta.

===== 18. Apavarga (Exception) =====

It consists in allowing exceptions to general directions. E.g. in Ch.Su.8.20. As a general rule, stale food should not be used, it’s not healthy. But fruits, dried meat, dried vegetables etc. are the exceptions to this general rule.

===== 19. Viparyaya (Assertion to contrary) =====

It is that by virtue of which from a positive or a negative assertion, its contrary is also asserted. E.g. In Ch.Su.1.66, it is mentioned, that foods or medicines having madhura (sweet), amla (sour), and lavana (salty, saline) tastes, subdue vata. This also implies, that the opposite of them i.e. katu (pungent), tikta (bitter) and kashaya (astringent), provoke it.

===== 20. Purvapaksha (Objection) =====

This is the objection raised on a statement. E.g.in Ch.Sha.1.6 , Agnivesha asked Lord Atreya, that if Atma (the soul) is said to be devoid of actions, then how at the same time it is considered as responsible for all the actions? Such questions are asked to initiate a debate, which will ultimately help to understand the scientific truth.

===== 21. Vidhana (Right interpretation) =====

It is that by virtue of which one understands that, when certain descriptions follow certain enumeration, the former are to be taken in the order in which the later are related. Here certain concepts in the texts are elaborated, in the subsequent description in the text itself. E.g. in Ch.Su.7.42-43, first it is mentioned that the channels for elimination of mala (waste products)are affected by abnormally increased or decreased malas. Just after that we find further explanation, that such increase or decrease in the malas can be inferred by observing hampered elimination or excessive elimination from these channels, through external orifices.

===== 22. Anumata (Acceptance of other interpretations) =====

By virtue of Anumata, it is to be understood that, when the opinion of other authorities is referred to and not contradicted, it is signified that it is approved. The authors of the texts give their own interpretations and opinions. But sometimes important opinions of others are also quoted. Some of these opinions of others are refuted. But some are not refuted. Here it means that as per the authors of texts, this is not the best interpretation. But it’s not an interpretation which can be totally rejected also. It has got some valid point. Such opinions are not found refuted, indicating that they are acceptable. E.g. in Ch.Chi.14.33, opinions of other authorities, regarding treatment of hemorrhoids are quoted. But further Lord Atreya has given his own opinion. Although opinion of other authorities, that hemorrhoids can be treated with surgery etc. is also not refuted. In other words, it is accepted, that these also can be the ways of treatment.

===== 23. Vyakhyana (Elaboration) =====

The method of elaborate description is called vyakhyanam. Certain topics are elaborately described by the author himself. E.g. in Ch.Sha.1.17 mentions about Purusha(living being, human being) composed of conglomeration of 24 principles. Further from 18th to 42nd verse, details about the same concept are provided.

===== 24. Samshaya (Doubt) =====

It allows a way of statement which may create doubt & confusion in the mind of the reader. Creating this doubt is necessary for clarity. Many times both ways of interpretation also may be correct. E.g. In Ch.Su.11.6 It is mentioned that as per some authorities, the parents are the cause of birth, while as per others, svabhava (nature) is the cause and so on. After raising these doubts, the answers are given, which brings clarity in understanding.

===== 25. Ateetavekshana (Retrospective reference =====

It permits alluding to things described before. Certain concepts or information mentioned in the initial sections or chapters of the text, are to be applied in the next chapters or sections, for proper understanding. E.g. Concepts from all other sections described in prior sections, are to be applied in Chikitsasthana, while understanding the treatments. E.g. in Ch.Chi.3.269, it is said that specific types of Sveda (sudation), mentioned in Sutrasthana 14th chapter are to be used here. Since they are already described in Sutrasthana, here it isn’t necessary to repeat the description, rather one can go to the previous reference.

===== 26. Anagataveksha (Prospective reference) =====

It allows to leave certain things for future description and elaboration. Certain concepts or information is supposed to be described in later sections or chapters. But in that particular context, it is mentioned that one can refer later chapters or section. E.g. in Ch.Ni.1.36, although the chapter deals with the diagnosis part of jwara (fever), the treatments are also hinted in brief. In order to understand them, one has to refer the chapter 3 of Chikitsasthana.

===== 27. Svasanjnya (Technical nomenclature) =====

The method of using words in a sense different from what they have in other literatures i.e. technical use. Certain technical terms, may have different meaning in other contemporary sciences or in Sanskrit literature. But, since it is applied as a technical term, a specific meaning is attached to that word. E.g. jentaka or holaka are some unique words, hardly found in literature, but in [[Charak Samhita]], they are used as specific types of sweda (sudation). Whereas samsarga or sannipata may be used in literature with a different sense, but in Ayurveda, they are used in the sense of pathologies in which two or three doshas are involved respectively. Similarly word dhatu may be used in the sense of metals in alchemy, or in the sense of root in grammar, but in Ayurveda, it is used in the sense of most important body constituents, which bear the existence of the body.

===== 28. Uhya (Deduction) =====

Is the by which things which are apparent from the context can be understood. Texts provide guidelines, but while treating the patient, the vaidya(physician) ultimately has to take the decision. A vaidya has to apply the guidelines given in the text for the patient, who is under his treatment. So a vaidya has to use his own intelligence and wisdom. The texts have advised a vaidya to use his own wisdom at many places. E.g. while describing the medicines which can be used for basti, it is said at Ch.Vi.8.149, that a vaidya can exclude the medicines not suitable for a particular patient, and he may add similar medicines which are appropriate for the patient, but not mentioned in the text.

===== 29. Samucchaya (Specification) =====

It means the taking of two or more things together as having equal value. In certain sentences from the texts multiple words are used, while highlighting and giving stress on each word. This type of method is called as samucchaya. E.g. in Ch.I.1.3, the important points to be discussed in Indriyasthana are enlisted. Here each word is written as vanashcha, svarashcha etc. By adding ‘Cha’, each word is specified. This is to denote that each of these topics is equally important.

===== 30. Nidarshana (Illustration) =====

It allows to describe anything after the analogy of other things. Here simple examples are given, which everyone can understand. These examples are taken from the things, which are well known to the society, therefore even a fool can understand. E.g. in Ch.Sha.1.43-44, it is said that Atma (soul) has to be accepted as responsible for all the actions. Because the other factors are inanimate, so they are not capable of doing anything on their own. Those who do not accept existence of Atma, will have to say that the clay, the rod, the wheel, all come together in absence of a potter to produce a pot. Such examples are known as Nidarshana.

===== 31. Nirvachana (Scientific illustrations/ Definition) =====

A scientific illustration or definition is called Nirvachana. Here such examples are given which can be understood only by the experts of that field. E.g. in Ch.Su.16.32, Svabhavoparamavada is described. According to it for production and manifestation of objects, specific causative factors are required, but for their destruction or annihilation their nature itself is the cause, so no other cause is required. Every object which is produced, gets destroyed, it is the nature of the objects. To explain this, it is said that no other cause except their nature can be found, for destruction of objects. Kala (time) is continuous, and there is no cause for elapse of time except time itself. Similarly for destruction and annihilation of objects their nature itself is the cause and no other cause can be found out. Such type of examples are called as Nirvachana.

===== 32. Niyoga (Injunction) =====

It means the direction. The sages like lord Atreya, have given certain directions. These directions are based on their deep knowledge, vast experience and their enlightened state. Therefore, these directions must be followed. Such directions are called as Niyoga. A student may also understand significance of such directions, as his studies progress. E.g. in Ch.Su.14.46, under jjentaka sweda, it is advised to the patient that even if he sweats profusely or feels giddiness, then also he shouldn’t leave the jentaka house.

===== 33. Vikalpana (Option) =====

It is method of giving alternative or optional direction. Certain options are given and any appropriate options from them may be selected. E.g. in Ch.Chi.6.46, for patients of Prameha (diabetes) water processed with heartwood of medicinal plants like asana is advised. But optionally water processed with kusha grass also can be used.

===== 34. Pratutsara (Rebuttal) =====

In a scientific discussion, opinions of each other are refuted, with scientific reasoning. E.g. in Ch.Su.25, the opinion of Parikshi Maudgalya, that Purusha (living being or human being) is made up of Atma (soul), is further refuted by Sharaloma, who proposed that Purusha is produced from mana(mind). Further his opinion is also refuted. This type of methodology is called as pratyutsara.

===== 35. Uddhara (Re-affirmation) =====

When in a scientific discussion, not only opinion of others is refuted, but own opinion is supported with scientific reasoning, then it is called as uddhara. E.g. in Ch.Su.25th chapter, with regards to origin of a Purusha, various experts not only refuted opinions of others, but also have substantiated their own opinions. Like Parikshi Maudgalya supported his opinion that Atma (soul) is responsible for the origin of a Purusha. He said that since Atma alone is animate, and other factors are inanimate, it is responsible for all the actions. Since it is responsible for all the actions, it will also take responsibility for the fruits of those actions, for which, it takes birth. Thus it is responsible for the origin of a Purusha.

===== 36. Sambhava (Possibility) =====

The substratum or base for origin of anything, is called sambhava. E.g. for the disease vyanga (freckles), face is the site of origin.

Tantrayukti, is very important tool for proper understanding of Ayurveda, not just theoretically, but for practical application of it also.

In the last, the importance of [[Charak Samhita]] is mentioned that this treatise comprising one hundred and twenty chapters which expounds the statements of sage Atreya by eminent disciple Agnivesa, endowed with therapeutic wisdom for the benefit of all the living beings. In the original work of Agnivesa, some topics were dealt with in great detail, and some others, very briefly which hindered its proper comprehension. For removing these defects, the redactor Caraka made efforts because a text in brief is not understandable and detailed text is not comprehensible. Therefore, the original text was redacted to make it more convenient for the readers. Agnivesa tantra which is redacted by Caraka, one-third of it was not available at the time of Drdhabala. He supplemented 41 non-available chapters. These are 17 chapters of Chikitsa Sthana and 12 chapters each in Kalpa and Siddi Sthana. So in this way this text is available in present form.

=== References ===

#Servesh Kumar, Lakshman Singh, Role of Uttara Basti as PoorvaKarma in the Management of BPH, MD Thesis-June2001
#Richa Vishvkarma, P.K. Goswami, reviw article published in AYU, Vol 34/ Jan-March 2013issue1/17-20

=== Bibliography ===

#Vaman shivram Apte. The practical Sanskrit-english dictionary,4 revised and enlargeded. Delhi; Motilal Banrsidass publishers private limited;1985
#SABDA-SAGARA by Pandit-Kulpati jibananda Vidyasagar; Chaukhamba Sanskrit Series office Varanasi,
#Kanjiv Locha, Dictionary of Ayurveda, Chaukhamba Sanskrit Bhwan Series 55 office Varanasi, UP,2nd Edition,2009
#Agnivesha, Charak,Dridhbala,Charak Samhita, Siddhi Sthana,Uttarbastisiddhi naam Adhyaya edited and translated in English by Prof. P.V.sharma, 5th edition,vol.4 varanasi; Chaukhamba orientalia,Varanasi,2003
#Agnivesha, Charak,Dridhbala,Charak Samhita, Siddhi Sthana,uttarbastisiddhi naam Adhyaya English translated by Sharma R.K. and Bhagwan Dash vol.4 chaukhamba Sanskrit series office:Varanasi,2003
#Agnivesha, Charak, Dridhbala,Charak Samhita, siddhi sthana,uttarbastisiddhi naam Adhyaya edited and translated in English by Prof. P.V.sharma,,vol.4 varanasi; chaukhamba orientalia,Varanasi,2009
#Agnivesha, Charak, Dridhbala,Charak Samhita, Siddhi Sthana,uttarbastisiddhi naam Adhyaya Hindi,Gujarati English translated jaikrishnadas Ayurveda series vol.4,Reprint chaukhamba orientalia,Varanasi,2008
#Agnivesha, Charak,Dridhbala,Charak Samhita, Siddhi Sthana,uttarbastisiddhi naam Adhyaya Hindi translated by Sri.Satyanarayana Shastri,Pandit Kashinath Shastri,Dr.Gorakhanath Chaturvedi 2006 Reprint chaukhamba Bharti Akadami Varanasi 2009
#Kaviraj Atrideva Gupta, Astanga Hridaya,Vidyotini Tika,Uttara tantra Chap.25;Reprint 2005, chaukhamba Sanskrit Sansthan,Varanasi

=== Glossary ===

#Vaman(vaman;वमन)-Emesis or Induced vomitting
#Durbalaṁ(durbala;कृश)- weak
#kr̥śam(kRusham ; कृशम)-Emaciated
#agnisandhukṣaṇ(agnisandhukShaN; अग्निसन्धुक्षण)- For the enhancement of Agni ( power of digestion and metabolism)
#uccairbhāṣyaṁ(uccairbhAShyaM; उच्चैर्भाष्यं)- loudlly speaking
#divāsvapna(divAsvapna; दिवास्वप्नं)-sleeping during day time
#avicaṅkramaṇ (avica~gkramaN; ; अविचङ्क्रमण)-excessive walking
#atiāsanē(AtiAsane; असने)-excessive /continous sitting
#aṅgamar(a~ggamard; अङ्गमर्द)- malaise
#vyavāy(vyavAy;व्यवाय)- sexual intercourse
#svarabhēd(svarabhed;स्वरभेद.)-hoarseness of voice
#mūtrakr̥cch(mUtrakRucchमूत्रकृच्छ्र)- dysuria
#udāvarta(udAvarta; उदावर्त)- diseases caused due to upward movement of vata in abdomen
#vātasaktamūtravarca (vAtasaktamUtravarca; वातसक्तमूत्रवर्च )-retention of urine, stool and semen
#ānūpa(AnUpaअIनूप)- animals living on marshy land)
#Bilēśayā(bileshay;बिलेशया)-animals living in the burrows in earth) 17prayōjana(prayojana;प्रयोजन)-aim/object
#Yōga(yoga;योग)- rational combination
#arthaḥpadasya;(arthaHpadasya अर्थःपदस्य)- Implication or import of words
#ōddēś(oddesh; उद्देश )-Concise stateme
#Vidhān(vidhAn; विधान.)-Correct interpretation)
#vikalpana( vikalpana; विकल्पन)- Option
#upadēś(upadesh; उपदेश )-Authoritative instruction
#prabōdhana (prabodhana; प्रबोधन प्रकाशा)-knowledge
#prakāś (prakAsh; प्रकाश)-Making clear
#tantrayuktibhiḥ (tantrayuktibhiH; तन्त्रयुक्ति )-Canons of exposition)
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Shosha Nidana

2019-03-06T04:10:02Z

Pallavmishra:

{{Infobox
|title = Shosha Nidana
|label1 = Section/Chapter
|data1 = [[Nidana Sthana]] Chapter 6
|label2 = Preceding Chapter
|data2 = [[Kushtha Nidana]]

|label3 = Succeeding Chapter
|data3 = [[Unmada Nidana]]
|label4 = Other Sections
|data4 = [[Sutra Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

==[[Nidana Sthana]] Chapter 6, Shosha Nidana (Chapter on progressive wasting disease)==

=== Abstract ===
<div style="text-align:justify;">
Chapter six of [[Nidana Sthana]], titled [[Shosha Nidana]], describes the basics of etiopathogenesis of ''shosharoga'' and its culmination in ''rajayakshma'' vis-à-vis pulmonary tuberculosis. ''Shosha'' is a progressive wasting disease (also called phthisis) which could be a precursor of tuberculosis as known today which occurs due to tubercular infection, phthisis and immune-compromised state. According to Charak there are four primary causes of ''shosha'' viz. ''sahasa'' or over exertion, ''vegavidharana'' or suppression of natural urges, ''kshaya'' or pre-existing emaciation, and ''vishamasana'' or dietary errors. These four basic factors lead to progressive loss of strength (including immunity), vitiating the three doshas and culminating in ''rajayakshma'', a major organic disease that seems to be similar to various similar progressively wasting diseases presenting characteristically with signs and symptoms of Pulmonary Tuberculosis as seen today and has been described in great clinical and therapeutic detail in [[Charak Samhita]] [[Chikitsa Sthana]] chapter 8.

'''Keywords''': ''kshaya'', ''shosha'', ''yakshma'', ''sahasa'', ''visamashan'', ''Nidanarthakara Roga Vyadhiksamatva'', ''Ojakshaya'', chronic wasting diseases, Immune defense, ''Rasayana''.
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=== Introduction ===
<div style="text-align:justify;">
There are three interrelated entities mentioned by Charak in three distinct chapters within [[Charak Samhita]]: [[Shosha Nidana]] (Ni.6), ''rajayakshma'' (Chi.8) and ''kshataksheena'' (Chi. 11).

''Shosha'' is the preparatory stage of gradual, generalized emaciation due to four distinct causative factors mentioned earlier which, if untreated or ignored, may lead to ''rajayakshma''. One of the contributing factors of ''shosha'' is indicative of systemic depletion of ''dhatu'' occurring due to divergent causes. An important point to note here is that ''shosha'' is different from ''kshataksheena'', a post-treatment stage of localized or generalized emaciation needing further intensive treatment.

Another commonly used term for ''shosha'' is ''kshaya'' (emaciation). However, it is imperative to clarify here that while ''shosha'' and ''kshaya'' are contextually similar and synonymous to ''yakshma'' , the specific meaning in [[Charak Samhita]] is different for all the three stages of the disease. Ayurveda is not very stringent when it comes to discerning cause-effect. Cause and effect are largely considered a continuum. While discussing the issue of cause-effect relationship between ''kshaya-shosha-yakshma'', the concept of ''nidanarthakara roga'' has also to be kept in mind where one known disease or a morbid state can play as the ''nidana'' of another disease. That is why, ''kshaya'' is sometimes mentioned as cause of ''shosha'' too. The word ''kshaya'' in this particular context refers to pre-existing ''kshaya''. ''Kshaya'' is of two distinct types - ''anuloma kshaya'' and ''pratiloma kshaya''. ''Anulomakshaya'' is caused by the initial depletion of the ''ojas rasa'' situated in the heart, while ''pratiloma kshaya'' occurs due to an excessive indulgence in sexual activities leading to the depletion of ''shukradhatu'' which in turn leads to generalized ''vata vriddhi'' and ''vata'' induces ''shoshana'' of ''dhatus''. Both these variants contribute to ''shoshana'' (qualitative and quantitative depletion of ''sharira dhatus'' or body tissues).

''Shosha'' and ''kshaya'' can be considered as independent clinical entities warranting independent strategies for diagnosis and treatment. Either of these may prove to be a ''nidanarthakara'' factor for the occurrence of ''rajayakshma'' (i.e., if ''shosha'' or ''kshaya'' are left untreated, could lead to ''rajayakshma''). ''Shosha'' is essentially a state of intractable emaciation, cachexia or consumption that could be equated to phthisis. It could be considered to be an intermediate state that may not necessarily exhibit any evidence of tubercular infection but because of persistent ''dhatukshaya''(depletion of tissues) it could be logically associated with an immunocompromised state. Some patients may catch infections that may manifest into a febrile state with probable bacteriological invasion warranting appropriate treatment on the lines of ''rajayakshma''. Because ''shosha'' and ''kshaya'' are intermediary states that are more of diagnostic significance than of significance from a core treatment perspective. Charak wrote the chapter on ''shosha'' in [[Nidana Sthana]] , while on ''rajayakshma'' in [[Chikitsa Sthana]] with the same motive.

It may appear that ''shosha'' and ''rajayakshma'' are synonymous because in this chapter there are brief descriptions of ''poorvarupa'' (preliminary signs) and ''ekadasha rupa'' (advanced stage) of ''yakshma''. However, the manifestation of ''rajayakshma'' has been described in detail only in the [[Chikitsa Sthana]].

While the focus of this chapter is to delineate the views of Charak, Sushruta in his text differs in his views on the relationship between ''shosha'' and ''yakshma''. While Charak considers them as dependent entities as mentioned above, Susruta considers ''shosha'' distinctly different disease that could manifest itself in any of seven different variants caused by seven different causative factors (''vyavaya'' or excessive sexual indulgence, ''shoka'' or sorrow, ''jara'' or rapid aging process, ''vyayama'' or excessive exercise, ''adhwagaman'' or excessive travelling, ''vrana'' or wound/trauma, and ''urakshata'' or chest injury.
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===Sanskrit text, Transliteration and English Translation===

अथातःशोषनिदानंव्याख्यास्यामः||१||

इतिहस्माहभगवानात्रेयः||२||

AthÁtah ÐoÒanidÁnam vyÁkhyÁsyÁmah ||1||

iti ha smÁha bhagavÁnÁtreyah ||2||

Now I shall expound upon the chapter on diagnosis of ''shosha'', said Lord Atreya. [1-2]

==== Four Causes of ''shosha'' ====

इहखलुचत्वारिशोषस्यायतनानिभवन्ति|

तद्यथा- साहसंसन्धारणंक्षयोविषमाशनमिति||३||

Ih khalu catvÁri ÐoÒasyÁyatanÁni bhavanti

tadyathÁ- sÁhasam sa¿dhÁranam kÒayo viÒamÁÐanamiti ||3||

There are four causes of ''shosha'': overexertion, suppression of urges, wasting, and irregular consumption of improper food articles [3].

Each of these causes will be explained here in detail:

===== 1. Overexertion as a cause =====

तत्रसाहसंशोषस्यायतनमितियदुक्तंतदनुव्याख्यास्यामः-

यदापुरुषोदुर्बलोहिसन्बलवतासहविगृह्णाति, अतिमहतावाधनुषाव्यायच्छति, जल्पतिवाऽप्यतिमात्रम्, अतिमात्रंवाभारमुद्वहति,
अप्सुवाप्लवतेचातिदूरम्, उत्सादनपदाघातनेवाऽतिप्रगाढमासेवते, अतिप्रकृष्टंवाऽध्वानंद्रुतमभिपतति, अभिहन्यतेवा, अन्यद्वाकिञ्चिदेवंविधंविषममतिमात्रंवाव्यायामजातमारभते,
तस्यातिमात्रेणकर्मणोरःक्षण्यते|

तस्योरःक्षतमुपप्लवतेवायुः|

सतत्रावस्थितःश्लेष्माणमुरःस्थमुपसङ्गृह्यपित्तंचदूषयन्विहरत्यूर्ध्वमधस्तिर्यक्च|

तस्ययोंऽशःशरीरसन्धीनाविशतितेनास्यजृम्भाऽङ्गमर्दोज्वरश्चोपजायते, यस्त्वामाशयमभ्युपैतितेनरोगाभवन्तिउरस्याअरोचकश्चयःकण्ठमभिप्रपद्यतेकण्ठस्तेनोद्ध्वंस्यतेस्वरश्चावसीदति, यः
प्राणवहानिस्रोतांस्यन्वेतितेनश्वासःप्रतिश्यायश्चजायते, यःशिरस्यवतिष्ठतेशिरस्तेनोपहन्यते|

ततःक्षणनाच्चैवोरसोविषमगतित्वाच्चवायोःकण्ठस्यचोद्ध्वंसनात्कासःसततमस्यसञ्जायते,
सकासप्रसङ्गादुरसिक्षतेशोणितंष्ठीवति, शोणितागमनाच्चास्यदौर्बल्यमुपजायते; एवमेतेसाहसप्रभवाःसाहसिकमुपद्रवाःस्पृशन्ति|

ततःसउपशोषणैरेतैरुपद्रवैरुपद्रुतःशनैःशनैरुपशुष्यति|

तस्मात्पुरुषोमतिमान्बलमात्मनःसमीक्ष्यतदनुरूपाणिकर्माण्यारभेतकर्तुं|

बलसमाधानंहिशरीरं, शरीरमूलश्चपुरुषइति||४||

भवतिचात्र-

साहसंवर्जयेत्कर्मरक्षञ्जीवितमात्मनः|

जीवन्हिपुरुषस्त्विष्टंकर्मणःफलमश्नुते||५||

Tatra sÁhasam ÐoÒasyÁyatanamiti yaduktam tadanu vyÁkhyÁsyÁmah -

yadÁ puruÒo durbalo hi san balavatÁ saha vigruhnÁti, atimahatÁ vÁ dhanuÒÁ vyÁyacachati,jalpativÁ~apyatimÁtram, atimÁtramvÁ bhÁramudvahati, apsuvÁ plavateca atidÚram, utsÁdanapadÁghÁtane vÁ~atipragÁ±hamÁsevate, atiprakruÒÔamvÁ~adhvÁnamdrutamabhipatati,abhihanyatevÁ, anyadvÁ kijcidevamvidhamviÒamam atimÁtramvÁ vyÁyÁmajÁtamÁrabhate, tasyÁtimÁtreÆakarmaÆorahkÒanyate|tasyorahkÒatamupaplavatevÁyuh |

Sa tatravasthitah ÐleÒmÁÆam urahsthamupasagruhya pittam ca dÚÒayan viharaty Úrdhvamadhastiryak Ca |

tasya yomaÐah ÐarÍrasandhÍnÁviÐati tenÁsya jªambhÁ angamardo jvaraÐcopajÁyate, yastvÁmÁÐayamabhyupaiti tena rogÁ bhavanti urasyÁ arocakaÐca yah kaÆÔhamabhiprapadyate kaÆÔhastenoddhvamsyate svaraÐcavasÍdati, yah prÁÆavahÁni srotÁmsyanveti tena ÐvÁsah pratiÐyÁyashca jÁyate, yah ÐirasyavatiÒÔhate Ðirastenopahanyate|

tatah kÒaÆana ca caiv uraso viÒamagatitvÁcca vÁyoh kaÆÔhasya coddhvamsanÁt kÁsah satatamasya sa¿jÁyate, sakÁsaprasa¿gÁdurasi kÒhate ÐoÆitam ÒaÔhÍvati, ÐoÆitatÁgamanÁt ca asya dauªbalyamupajÁyate|

evamete sÁhasaprabhavÁh sÁhasikamupadravÁh spªuÐanti |

tatah sa upaÐoÒaÆairetairÚpadravairÚpadrutah Ðanaih ÐanairupaÐuÒyati |

tasmÁt purÚÒo matimÁn balamÁtmanah samÍkÒya tadanurÚpÁÆi karmÁÆyÁrabheta kartu¿|

balasamÁdhÁnam hi ÐarÍram, ÐarÍramÚlaÐca purÚÒa iti ||4||

Bhavati cÁtra-

sÁhasam varjayet karma rakÒatjÍvitamÁtmanah|

jÍvan hi purÚÒastviÒÔam karmaÆah phalamaÐnute ||5||
<div style="text-align:justify;">
When a weak person fights against a strong one, or exercises with an excessively large (or weighty) bow (weapon), or speaks too much, or physically carries a lot of weight, or swims across a long distance in water, or is habitually subjected to forceful massage including kneading with feet, or sprints over a long distance, or is assaulted, or practices various complicated or excessive physical exercises, his lungs are “traumatized” due to excessive exertion. This aggravates ''vayu'' in the lung region, taking along ''kapha'' residing in the lungs while also affecting ''pitta'', causing the vitiated ''doshas'' to spread upwards, downwards and obliquely. A portion of this afflicted ''dosha'' system that gets into body joints causes yawning, body ache, and fever. That which gets into the ''amashaya'' causes diseases of lungs and anorexia. That which gets into the throat causes irritation of the throat and hoarseness of voice. That which gets into the channels carrying vital breath (bronchial channels) causes dyspnea and coryza. And that which gets into the head produces distress in the head. Thus, due to wound in lungs, irregular movement of ''vayu'' causes a variety of diseases depending upon the organs it gets into. The lungs get damaged further, triggering conditions such as hemoptysis and consequently weakening the patient. This verse, therefore, advises the reader to engage in laborious activities appropriate to his strength and not overexert himself. [4-5]
</div>

===== 2. Suppression of natural urges as a cause =====

सन्धारणंशोषस्यायतनमितियदुक्तंतदनुव्याख्यास्यामः-

यदापुरुषोराजसमीपेभर्तुःसमीपेवागुरोर्वापादमूलेद्यूतसभमन्यंवासतांसमाजंस्त्रीमध्यंवासमनुप्रविश्ययानैर्वाऽ
प्युच्चावचैरभियान्भयात्प्रसङ्गाद्ध्रीमत्त्वाद्धृणित्वाद्वानिरुणद्ध्यागतान्वातमूत्रपुरीषवेगान्तदातस्यसन्धारणाद्वायुःप्रकोपमापद्यते, सप्रकुपितःपित्तश्लेष्माणौसमुदीर्योर्ध्वमधस्तिर्यक्चविहरति;
ततश्चांशविशेषेणपूर्ववच्छरीरावयवविशेषंप्रविश्यशूलमुपजनयति, भिनत्तिपुरीषमुच्छोषयतिवा, पार्श्वेचातिरुजति, अंसाववमृद्गाति, कण्ठमुरश्चावधमति, शिरश्चोपहन्ति,
कासंश्वासंज्वरंस्वरभेदंप्रतिश्यायंचोपजनयति|

ततःसउपशोषणैरेतैरुपद्रवैरुपद्रुतःशनैःशनैरुपशुष्यति|

तस्मात्पुरुषोमतिमानात्मनःशारीरेष्वेवयोगक्षेमकरेषुप्रयतेतविशेषेण; शरीरंह्यस्यमूलं, शरीरमूलश्चपुरुषोभवति||६||

भवतिचात्र-

सर्वमन्यत्परित्यज्यशरीरमनुपालयेत्|

तदभावेहिभावानांसर्वाभावःशरीरिणाम्||७||

sa¿dhÁranam ÐoÒasyÁyatanamiti yaduktam tadanuvyÁkhyÁsyÁmah -

yadÁ purÚÒo rÁjasamÍpe bhartuh samÍpe vÁ gurorvÁ pÁdamÚle dyÚtasabhamanyam vÁ satÁm samÁjam strÍmadhyam vÁ samanupraviÐya yÁnairvÁ apyuccÁvacairabhiyÁn bhayÁt prasa¿gÁddhrÍmattvÁddhªuÆitvÁdvÁ nirÚÆaddhyÁgatÁn vÁtamÚtrapurÍÒavegÁn tadÁ tasya sa¿dhÁranÁdvÁyuh prakopamÁpadyate, sa prakupitah pittaÐleÒmÁÆau samudÍryordhvamadhastiryaka ca viharati|

tataÐcÁ¿ÐaviÐeÒeÆa pÚrvavaccharÍrÁvayavaviÐeÒeÆam praviÐya ÐÚlamupajanayati, bhinatti purÍÒamucchoÒayati vÁ, pÁrÐve cÁtirujati, a¿sÁvavamªudgÁti, kaÆÔhamuraÐcÁvadhamati, shiraÐcopahanti, kÁsam ÐvÁsam jvaram svarabhedam pratiÐyÁyam copajanayati; tatah sa upaÐoÒaÆairetairÚpadravairÚpadrutah Ðanaih ÐanairÚpaÐuÒyati |

tasmÁt purÚÒo matimÁnÁtmanah ÐÁrÍreÒveva yogakÒemakareÒu prayateta viÐeÒeÆa; ÐÁrÍram hyasya mÚlam, ÐÁrÍramÚlaÐca purÚÒo bhavati ||6||

bhavati cÁtra-

sarvamanyat parityajya ÐÁrÍramanupÁlayet |

tadabhÁve hi bhÁvÁnÁm sarvÁbhÁvah ÐÁrÍriÆÁm ||7||
<div style="text-align:justify;">
When a person suppresses the urge to pass flatulence, urination, and bowel movement due to various reasons such as attending a royalty, being in a formal setting (in the company of sages, teachers, nobles, etc), being in the midst of women, society of gambling, or while traveling on uneven vehicle, or due to fear, environment, bashfulness or disgust, ''vayu'' gets vitiated due to suppression of urges. This vitiated ''vayu'' aggravates ''pitta'' and/or ''kapha'', spreading upwards, downwards or obliquely depending upon the combination of afflicted ''doshas''. As said earlier, when a portion gets into specific body parts, it causes pain, diarrhea or drying up of feces, excessive pain in sides of the chest, pain in the shoulders, irritation in throat and lungs, headache, cough, dyspnea, fever, hoarseness of voice and coryza. Thereafter, having been afflicted with these wasting complications, the patient gradually gets afflicted with ''shosha''. Hence the wise should carefully observe the ways that promote and protect the body.

Here is the verse: Setting all other things aside, one should protect the body, because in its absence there will be complete absence of all the bodily entities. [6-7]
</div>
===== 3. Wasting as cause =====

क्षयःशोषस्यायतनमितियदुक्तंतदनुव्याख्यास्यामः-

यदापुरुषोऽतिमात्रंशोकचिन्तापरिगतहृदयोभवति, ईर्ष्योत्कण्ठाभयक्रोधादिभिर्वासमाविश्यते, कृशोवासन्रूक्षान्नपानसेवीभवति, दुर्बलप्रकृतिरनाहारोऽल्पाहारोवाभवति, तदातस्यहृदयस्थायीरसःक्षयमुपैति; सतस्योपक्षयाच्छोषंप्राप्नोति, अप्रतीकाराच्चानुबध्यतेयक्ष्मणा |

यथोपदेक्ष्यमाणरूपेण|८|

kÒayah ÐoÒasyÁyatanamiti yaduktam tadanuvyÁkhyÁsyÁmah –

yadÁpurÚÒoatimÁtram ÐokacintÁparigatahªidayo bhavati, ÍrÒyotkaÆÔhÁbhayakrodhÁdibhirvÁ samÁviÐyate, kªuÐo vÁ
san rÚkÒÁnnapÁnasevÍ bhavati, durbalaprakªutiranÁhÁroalpÁhÁro vÁ bhavati, tadÁ tasya hªidayasthÁyÍ rasah kÒayamupaiti; sa tasyopakÒayÁcchoÒam prÁpnoti, apratÍkÁrÁccÁnubadhyate yakÒmaÆÁ |

yathopadekÒyamÁÆarÚpeÆa |8|

<div style="text-align:justify;">
Now explained is wasting as the cause of ''shosha''. When a person is suffering excessively from anxiety and grief, or from emotions like envy, fear, anger, etc., and if the person is also afflicted with a wasting disorder and/or using rough food and drinks, or if a congenitally weak person is subjected to fasting or malnutrition, his ''ojas'' gets diminished leading to ''shosha''. Due to want of proper management and care, he could get afflicted with the disease having symptoms to be described later. [8]
</div>

===== 4.Excessive sexual indulgence as a cause* =====

यदावापुरुषोऽतिहर्षादतिप्रसक्तभावःस्त्रीष्वतिप्रसङ्गमारभते, तस्यातिमात्रप्रसङ्गाद्रेतःक्षयमेति|

क्षयमपिचोपगच्छतिरेतसियदिमनःस्त्रीभ्योनैवास्यनिवर्तते, तस्यचातिप्रणीतसङ्कल्पस्यमैथुनमापद्यमानस्यनशुक्रंप्रवर्ततेऽतिमात्रोपक्षीणरेतस्त्वात्, तथाऽस्यवायुर्व्यायच्छमानशरीरस्यैवधमनीरनुप्रविश्यशोणितवाहिनीस्ताभ्यःशोणितंप्रच्यावयति, तच्छुक्रक्षयादस्यपुनःशुक्रमार्गेणशोणितंप्रवर्ततेवातानुसृतलिङ्गम्|

अथास्यशुक्रक्षयाच्छोणितप्रवर्तनाच्चसन्धयःशिथिलीभवन्ति, रौक्ष्यमुपजायते, भूयःशरीरंदौर्बल्यमाविशतिवायुःप्रकोपमापद्यते; सप्रकुपितोवशिकंशरीरमनुसर्पन्नुदीर्यश्लेष्मपित्तेपरिशोषयतिमांसशोणिते, प्रच्यावयतिश्लेष्मपित्तेसंरुजतिपार्श्वे,
अवमृद्गात्यंसौकण्ठमुद्ध्वंसति, शिरःश्लेष्माणमुपत्क्लेश्यप्रतिपूरयतिश्लेष्मणा, सन्धींश्चप्रपीडयन्करोत्यङ्गमर्दमरोचकाविपाकौच, पित्तश्लेष्मोत्क्लेशात्प्रतिलोमगत्वाच्चवायुर्ज्वरंकासंश्वासंस्वरभेदंप्रतिश्यायंचोपजनयति;सकासप्रसङ्गादुरसिक्षतेशोणितंष्ठीवति,शोणितगमनाच्चास्यदौर्बल्यमुपजायते, ततःसउपशोषणैरेतैरुपद्रवैरुपद्रुतःशनैःशनैरुपशुष्यति| तस्मात्पुरुषोमतिमानात्मनः|

शरीरमनुरक्षञ्छुक्रमनुरक्षेत्| पराह्येषाफलनिर्वृत्तिराहारस्येति||८||

भवतिचात्र-

आहारस्यपरंधामशुक्रंतद्रक्ष्यमात्मनः|

क्षयोह्यस्यबहून्रोगान्मरणंवानियच्छति||९||

yadÁ vÁ purÚÒoatiharÒÁdatiprasaktabhÁvah strÍÒvatiprasa¿gamÁrabhate, tasyÁtimÁtraprasa¿gÁdretah kÒayameti |

kÒayamapi copagacchati retasi yadi manah strÍbhyo naivÁsya nivartate, tasya cÁtipraÆÍtasa¿kalpasya maithunamÁpadyamÁnasya na Ðukram pravartateatimÁtropakÒÍÆaretastvÁt, tathÁ asya vÁyurvyÁyacchamÁnaÐÁrÍrasyaiva dhamanÍranupraviÐya ÐoÆitavÁhinÍstÁbhyah ÐoÆitam pracayÁvayati, tacchukrakÒayÁdasya punah ÐukramÁrgeÆa ÐoÆitam pravartate vÁtÁnusªutali¿gam |

athÁsya ÐukrakÒayÁcchoÆitapravartanÁcca sandhayah ÐithilÍbhavanti, raukÒyamupajÁyate, bhÚyah ÐarÍram daurbalyamÁviÐati vÁyuh prakopamÁpadyate; saprakupito vaÐikam ÐarÍramanusarpannudÍrya ÐleÒmapitte pariÐoÒayati mÁ¿saÐoÆite, pracayÁvayati ÐleÒmapitte sa¿rujati pÁrÐve, avamªudgÁtya¿sau kaÆÔhamuddhva¿sati, Ðirah ÐleÒmÁÆamupatkleÐya pratipÚrayati ÐleÒmÁÆa, sandhÍ¿Ðca prapÍ±ayan karotya¿gamardamarocakÁvipÁkau ca, pittaÐleÒmotkleÐÁt pratilomagatvÁcca vÁyurjvaram kÁsam ÐvÁsam svarabhedam pratiÐyÁyam copajanayati; sa kÁsaprasa¿gÁdurasi kÒate ÐoÆitam ÒÔhÍvati, ÐoÆitagamanÁccÁsya daurbalyamupajÁyate, tatah sa upaÐoÒaÆairetairupadravairupadrutah Ðanaih ÐanairupaÐuÒyati |tasmÁt purÚÒo matimÁnÁtmanah ÐarÍramanurakÒat ÐukramanurakÒet |

parÁ hyeÐÁ phalanirvªuttirÁhÁrasyeti ||8||

bhavati cÁtra-

ÁhÁrasya param dhÁma Ðukram tadrakÒyamÁtmanah |

kÒayo hyasya bahÚn rogÁnmaraÆam vÁ niyacchati ||9||

<div style="text-align:justify;">
When a person indulges in excessive sexual intercourse habitually, his semen gets diminished. In spite of diminished semen, if he obsesses about sex mentally as well as physically and continues to engage in sexual acts with excessively determined passion, his semen is not discharged because of its already diminished state causing ''vayu'' to enter his blood vessels and blood getting discharged from the seminal passage. Now, due to loss of semen and hemorrhage, his joints loosen, the skin loses its suppleness and becomes rough or scaly, body weakens further and ''vayu'' gets vitiated. The vitiated ''vayu''spreads in the body deficient of semen and blood, aggravating ''kapha'' and ''pitta'' and drying up the muscles and blood. Further, the vitiated vayu expels kapha and pitta, causing pain in the sides of the chest and shoulders, irritation of throat, aggravating ''kapha'' of the head and replacing it with the vitiated ''kapha'' expelled from their natural locations, causing pain in joints, body ache, anorexia and indigestion. Due to frequent cough the lungs get damaged and hemoptysis ensues, debilitating the patient further and afflicting him with wasting complications. If untreated, the patient gradually is afflicted with phthisis.

Here is the verse: Semen is the final essence of one’s food hence it should be protected because its depletion leads to many diseases or even death. [8-9]

- * This is not mentioned as a main cause of ''shosha'' in verse 3, but is a derivation of verses 8-9.
</div>

===== 5. Irregular meals/Improper meals as a cause =====

विषमाशनंशोषस्यायतनमितियदुक्तं,तदनुव्याख्यास्यामः-

यदापुरुषःपानाशनभक्ष्यलेह्योपयोगान्प्रकृतिकरणसंयोगराशिदेशकालोपयोगसंस्थोपशयविषमानासेवते, तदातस्यतेभ्योवातपित्तश्लेष्माणोवैषम्यमापद्यन्ते; तेविषमाःशरीरमनुसृत्ययदास्रोतसामयनमुखानिप्रतिवार्यावतिष्ठन्तेतदाजन्तुर्यद्यदाहारजातमाहरतितत्तदस्यमूत्रपुरीषमेवोपजायतेभूयिष्ठंनान्यस्तथाशरीरधातुः; सपुरीषोपष्टम्भाद्वर्तयति, तस्माच्छुष्यतोविशेषेणपुरीषमनुरक्ष्यंतथाऽन्येषामतिकृशदुर्बलानां; तस्यानाप्यायमानस्यविषमाशनोपचितादोषाःपृथक्पृथगुपद्रवैर्युञ्जन्तोभूयःशरीरमुपशोषयन्ति|

तत्रवातःशूलमङ्गमर्दंकण्ठोद्ध्वंसनंपार्श्वसंरुजनमंसावमर्दंस्वरभेदंप्रतिश्यायंचोपजनयति; पित्तंज्वरमतीसारमन्तर्दाहंच; श्लेष्मातुप्रतिश्यायंशिरसोगुरुत्वमरोचकंकासंच, सकासप्रसङ्गादुरसिक्षतेशोणितंनिष्ठीवति,शोणितगमनाच्चास्यदौर्बल्यमुपजायते|

एवमेतेविषमाशनोपचितास्त्रयोदोषाराजयक्ष्याणमभिनिर्वर्तयन्ति|

सतैरुपशोषणैरुपद्रवैरुपद्रुतःशनैःशनैःशुष्यति|

तस्मात्पुरुषोमतिमान्प्रकृतिकरणसंयोगराशिदेशकालोपयोगसंस्थोपशयादविषममाहारमाहरेत्||१०||

भवतिचात्र-

हिताशीस्यान्मिताशीस्यात्कालभोजीजितेन्द्रियः|

पश्यन्रोगान्बहून्कष्टान्बुद्धिमान्विषमाशनात्||११||

viÒamÁÐanam ÐoÒasyÁyatanamiti yaduktam tadanuvyÁkhyÁsyÁmah –

yadÁ purÚÒah pÁnÁÐanabhakÒalehyopayogÁn,prakªtikaraÆasa¿yogarÁÐideÐakÁlopayogasa¿sthopaÐayaviÒamÁnÁsevate, tadÁ tasya tebhyo vÁtapittaÐleÒmaÆo vaiÒamyamÁpadyante; te viÒamÁh ÐarÍramanusªutya yadÁ srotasÁmayanamukhÁni prativÁryÁvatiÒÔhante tadÁ janturyadyadÁhÁrajÁtamÁharati tattadasya mÚtrapurÍÒamevopajÁyate bhÚyiÒÔham nÁnyastathÁ ÐarÍraadhÁtuh; sa purÍÒopaÒtambhÁdvartayati, tasmÁcchuÒyato viÐeÒeÆa purÍÒamanurakÒyam tathÁ anyeÒÁmatikªuÐadurbalÁnÁm; tasyÁnÁpyÁyamÁnasya viÒamÁÐanopacitÁ doÒÁh pªuthak pªuthagupadravairyu¿janto bhÚyah ÐarÍramupaÐoÒayanti|

tatra vÁtah ÐÚlama¿gamardam kaÆÔhoddhva¿sanam pÁrÐvasa¿rujanama¿sÁvamardam svarabhedam pratiÐyÁyam copajanayati; pittam jvaramatÍsÁramantardÁham ca; ÐleÒmmÁ tu pratiÐyÁyam Ðiraso gurutvamarocakam kÁsam ca, sa kÁsaprasa¿gÁdurasi kÒate ÐoÆitam niÒÔhÍvati, ÐoÆitagamanÁccÁsya daurbalyamupajÁyate|

evamete viÒamÁÐanopacitÁstrayo doÒÁ rÁjayakÒyÁÆamabhinirvartayanti |

sa tairupaÐoÒaÆairupadravairupadrutah Ðanaih Ðanaih ÐuÒyati|

tasmÁt purÚÒo matimÁn prakªtikaraÆasa¿yogarÁÐideÐakÁlopayogasa¿sthopaÐayaviÒamamÁhÁramÁharet ||10||

bhavati cÁtra-

hitÁÐÍ syÁnmitÁÐÍ syÁtkÁlabhojÍ jitendriyah |

paÐyan rogÁn bahÚn kaÒtÁn buddhimÁn viÒamÁÐanÁt ||11||
<div style="text-align:justify;">
This verse talks of irregular diet as a cause of ''shosha''. When a person takes food – drinkable, eatable, chewable and lickable – irregularly in terms of nature, preparation, combination, quantity, place, time, and various dietary rules (do’s and don’ts) appropriate for his constitution, his ''doshas'' get imbalanced. These imbalanced ''doshas'' spread in the body, obstructing the openings of various channels and the flow of ''dhatus''. In such cases, the body survives on the support of ''malas''. Hence ''mala'' should be protected, particularly in case where the patient has already been afflicted with phthisis and in cases where the individual is emaciated or very weak. The vitiated ''vata'' causes pain, body ache, irritation of throat, chest pain, pain in shoulders, hoarseness of voice and coryza. Vitiated ''pitta'' causes fever, diarrhea, internal heat and vitiated ''kapha'' causes coryza, heaviness of head, anorexia and cough. Due to frequent bouts of cough, lungs get damaged and hemoptysis ensues, consequently debilitating the patient further and causing ''shosha''. Having been afflicted with these wasting complications, the patient gradually becomes very weak and gaunt.

The final verse advises thus: Observing many troublesome diseases caused by irregular dieting, the wise should eat wholesome, measured and timely food with self-restraint. [10-11]
</div>
एतैश्चतुर्भिःशोषस्यायतनैरुपसेवितैर्वातपित्तश्लेष्माणःप्रकोपमापद्यन्ते|

तेप्रकुपितानानाविधैरुपद्रवैःशरीरमुपशोषयन्ति|

तंसर्वरोगाणांकष्टतमत्वाद्राजयक्ष्माणमाचक्षतेभिषजः;

यस्माद्वापूर्वमासीद्भगवतःसोमस्योडुराजस्यतस्माद्राजयक्ष्मेति||१२||

EtaiÐca caturbhi ÐoÒasyÁyatanairÚpasevitairvÁtapittaÐleÒmÁÆah prakopamÁpadyante|

Te prakupitÁ nÁnÁvidhairÚpadravaih ÐarÍramupaÐoÒayanti |

tam sarvarogÁÆÁm kaÒtatamatvÁdrÁjayakÒmÁÆamÁcakÒate bhiÒajah; yasmÁdvÁ pÚrvamÁsÍdbhagavatahsomasyo±urÁjasya tasmÁdrÁjayakÒmeti ||12||
<div style="text-align:justify;">
Regular use of the four etiological factors of ''shosha'' vitiates the ''doshas''. These vitiated ''doshas'' dry up the body while afflicting it with various complications. Physicians call it ''rajayakshma'' because it is most troublesome among all the diseases (''rajayakshma'' would literally translate to the “king of ''yakshmas''”) or because in ''vedic'' mythologies, it afflicted Lord Moon, the king of stars. [12]
</div>

==== Prodromal symptoms ====

तस्येमानिपूर्वरूपाणिभवन्ति; तद्यथा- प्रतिश्यायः, क्षवथुरभीक्ष्णं, श्लेष्मप्रसेकः, मुखमाधुर्यम्, अनन्नाभिलाषः, अन्नकालेचायासः, दोषदर्शनमदोषेष्वल्पदोषेषुवाभावेषुपात्रोदकान्नसूपापूपोपदंशपरिवेशकेषु, भुक्तवतश्चास्यहृल्लासः, तथोल्लेखनमप्याहारस्यान्तरान्तरा, मुखस्यपादयोश्चशोफःपाण्योश्चावेक्षणमत्यर्थम्, अक्ष्णोःश्वेतावभासताचातिमात्रं, बाह्वोश्चप्रमाणजिज्ञासा, स्त्रीकामता,निर्घृणित्वं, बीभत्सदर्शनताचास्यकाये,
स्वप्नेचाभीक्ष्णंदर्शनमनुदकानामुदकस्थानानांशून्यानांचग्रामनगरनिगमजनपदानांशुष्कदग्धभग्नानांचवनानांकृकलासमयूरवानरशुकसर्पकाकोलूकादिभिः
संस्पर्शनमधिरोहणंयानंवाश्वोष्ट्रखरवराहैःकेशास्थिभस्मतुषाङ्गारराशीनांचाधिरोहणमिति (शोषपूर्वरूपाणिभवन्ति)||१३||

tasyemÁni pÚrvarÚpÁÆi bhavanti; tadyathÁ- pratiÐyÁyah, kÒavathurabhIkÒÆam, ÐleÒmaprasekah, mukhamÁdhuryam, anannÁbhilÁÒah, annakÁle cÁyÁsah, doÒadarÐanamadoÒeÒvalpadoÒeÒu vÁ bhÁveÒu pÁtrodakÁnnasÚpÁpÚpopada¿ÐapariveÐakeÒu, bhuktavataÐcÁsya hªullÁsah, tathollekhanamapyÁhÁrasyÁntarÁntarÁ, mukhasya pÁdayoÐca Ðophah pÁÆyoÐcÁvekÒaÆamatyartham, akÒÆoh ÐvetÁvabhÁsatÁ cÁtimÁtram, bÁhvoÐca pramÁÆajijúÁsÁ, strÍkÁmatÁ, nirghªuÆitvam, bIbhatsadarÐanatÁ cÁsya kÁye, svapne cÁbhIkÒÆam darÐanamanudakÁnÁmudakasthÁnÁnÁm ÐÚnyÁnÁm ca grÁmanagaranigamajanapadÁnÁm ÐuÒkadagdhabhagnÁnÁm ca vanÁnÁm kªukalÁsamayÚravÁnaraÐukasarpakÁkolÚkÁdibhih sa¿sparÐanamadhirohaÆam yÁnam vÁ ÐvoÒtrakharavarÁhaih keÐÁsthibhasmatuÒÁa¿gÁrarÁshÍnÁm cÁdhirohaÆamiti (ÐoÒapÚrvarÚpÁÆi bhavanti) ||13||
<div style="text-align:justify;">
''Shosha''’s prodromal symptoms include coryza, frequent sneezing, excessive secretion of mucus, a sweet aftertaste in the mouth, aversion to food, exhaustion during meal time, finding fault with utensils, water, cereals, pulses flour preparations, spicy preparation and caterers who are free from fault or have a little fault. A person afflicted with ''shosha'' will experience nausea after meals, intermittent vomiting during meals, swellings in the face and feet, tendency of frequently looking at the hands, excessive whitishness in the eyes, curiosity about measurement of arms, longing for women, disgust, loathsome view of his body, frequent dreams of waterless/arid places as well as places such as deserted villages, cities, districts and regions, of forests dried, burnt and destroyed. Such a person would often be using vehicles drawn by, or coming in contact with, or riding animals like chameleon, peacock, monkey, parrot, serpent, crow, owl, dog, camel, ass and boar, and riding over heaps of hair, bones, ash, chaff and charcoal. [13]
</div>
==== Eleven symptoms ====

अतऊर्ध्वमेकादशरूपाणितस्यभवन्ति; तद्यथा- शिरसःपरिपूर्णत्वं, कासः, श्वासः, स्वरभेदः, श्लेष्मणश्छर्दनं, शोणितष्ठीवनं, पार्श्वसंरोजनम्, अंसावमर्दः, ज्वरः, अतीसारः, अरोचकश्चेति||१४||

Ata ÚrdhvamekÁdaÐarÚpÁÆi tasya bhavanti; tadyathÁ- Ðirasah paripÚrÆatvam, kÁsah, ÐvÁsah, svarabhedah, ÐleÒmÁÆaÐchardanam, ÐoÆitaÒÔhÍvanam, pÁrÐvasa¿rojanam, a¿sÁvamardah, jvarah, atÍsÁrah, arocakaÐceti ||14||

There are eleven typical symptoms of ''shosha'' (mentioned in this verse) such as fullness of head, cough, dyspnea, hoarseness of voice, vomiting of sputum, hemoptysis, chest-pain, pain in shoulders, fever, diarrhea, and anorexia. [14]

==== Prognosis of disease ====

तत्रापरिक्षीणबलमांसशोणितोबलवानजातारिष्टःसर्वैरपिशोषलिङ्गैरुपद्रुतःसाध्योज्ञेयः| बलवानुपचितोहिसहत्वाद्व्याध्यौषधबलस्यकामंसुबहुलिङ्गोऽप्यल्पलिङ्गएवमन्तव्यः||१५||

Tatra parikÒÍÆabalama¿saÐoÆito balavÁnajÁtÁriÒtah sarvairapi ÐoÒali¿gairÚpadrutah sÁdhyo jÆayah | balavÁnupacito hi sahatvÁdvyÁdhyauÒadhabalasya kÁmam subahuli¿goapyalpali¿ga eva mantavyah ||15||
<div style="text-align:justify;">
One having all the above symptoms of ''shosha'' should be considered curable in case his strength, muscles and blood are not wasted, he is strong and the fatal signs have not appeared. The strong and well-nourished, because of tolerance to intensity of disease and drugs, should be assumed to have fewer symptoms even if they have many, and treated accordingly. [15]
</div>

दुर्बलंत्वतिक्षीणबलमांसशोणितमल्पलिङ्गमजातारिष्टमपिबहुलिङ्गंजातारिष्टंचविद्यात्, असहत्वाद्व्याध्यौषधबलस्य; तंपरिवर्जयेत्, क्षणेनैवहिप्रादुर्भवन्त्यरिष्टानि, अनिमित्तश्चारिष्टप्रादुर्भावइति||१६||

Durbalam tvatikÒÍÆabalama¿saÐoÆitamalpali¿gamajÁtÁriÒtamapi bahuli¿gam jÁtÁriÒtam ca
vidyÁt, asahatvÁdvyÁdhyauÒadhabalasya; tam parivarjayet, kÒaÆenaiva hi prÁdurbhavantyariÒtÁni, animittaÐcÁriÒtaprÁdurbhÁva iti ||16||

On the contrary, the patient who is weak and has excessively diminished strength, muscles and blood should be taken as having numerous symptoms including the fatal ones, even if he has few symptoms and no fatal signs because of his intolerance to the intensity of disease and drugs. Hence he should be discarded (for treatment) because the fatal signs appear in a moment and without any apparent cause.[16]

==== Summary ====

तत्रश्लोकः-
समुत्थानंचलिङ्गंचयःशोषस्यावबुध्यते|
पूर्वरूपंचतत्त्वेनसराज्ञःकर्तुमर्हति||१७||

tatra Ðlokah-
samutthÁnam ca li¿gam ca yah ÐoÒasyÁvabudhyate|
pÚrvarÚpam ca tattvena sa rÁjÆah kartumarhati ||17||
<div style="text-align:justify;">

Now the (summing up) verse –

He is capable of treating the king who knows, in essence, the etiology, symptoms and prodroma of ''shosha''.

Thus, ends the sixth chapter on diagnosis of ''shosha'' in [[Nidana Sthana]] in the treatise composed by Agnivesha and redacted by Charak. [16-17]

=== ''Tattva Vimarsha'' ===

* Wasting or emaciating conditions like ''shosha'' occur because of four factors: ''Sahasa'' (overexertion), ''Sandhaarana'' (suppression of natural urges), ''Kshaya'' (emaciation), and ''Vishamasana'' (Dietary error).

* The common effect of the four factors is ''dhatukshaya'' (loss of body tissue), especially rasa which is responsible for maintaining ''vyadhikshamatya'' (Immunity).

* ''Sahajabala'' (Innate immunity) is fundamental to prognosis of the disease. If ''sahajabala'' is intact, the outcome of treatment is favorable, even if the symptoms are full blown.

* Etiological factors, ''dosha'' vitiation and clinical features help in understanding the pathophysiology of the disease.

=== ''Vidhi Vimarsha'' ===

The point of significance in this chapter is the identification of the intermediary clinical state called ''shosha'' which is the precursor to ''rajayakshma'', a pathological state warranting early diagnosis and treatment as a promotive health care strategy. Sushruta acknowledges the specific role of microbial infection through direct physical contacts as the real cause, while Charak emphasizes upon the role of pre-existing progressive weakness and emaciation accompanied with lowered ''vyadhikshamatva'' (poor immune strength) as some of the key causative factors responsible for the entire spectrum of the disease complex that includes ''shosha, kshaya,'' and ''rajayakshma''. This fundamental idea for which Charak devotes one full chapter in [[Nidana Sthana]] is an original contribution of Charak, drawing specific attention to the fact that the host factor and host resistance against disease is more important than the causative microbial organism in case of contagious diseases like tuberculosis. It also endorses the Ayurvedic stand that the solution lies in enhancing or strengthening the immunity of the host and not merely in tackling the microorganisms afflicting the person. Use of antibiotics, as is prevalent in western medicine, is now dwindling because of their adverse side effects and rapidly emerging problems associated with drug resistance. In fact, there is now a growing consensus that an idea of an antibiotic war in medicine is anti-life and anti-health.

The recent advances in biomedical sciences unfolding the shape and role of genome, epigenome and microbiome in human health have partly proven the generic fact that our genes, our environment and “friendly” microbes are our collective friends and are an integral part of our being. They are protective tool for the immune-enhancing through positive life style, healthy dietetics and regulated use of ''rasayana'' remedies. ''Rasayanas'' are described in Ayurveda for promotive and preventive health care as well as for promotion of longevity.

Recent researches on ''rasayana'' drugs such as ''amalaki'' and ''ashwagandha'' have appeared in certain high impact journals. Lakhotia et al, in their 2012 study on drosophilia model, have recorded marked DNA repairing effects besides better maturation rate and healthier and longer life span in fruit flies treated with ''amalaki rasayana''. Similarly, Kuboyama et al (2005) have reported that withanolide-A, isolated from the ''ashwagandha rasayana'', has significant regenerative effect on neurons. Singh et al (2008) reported neuro-nutrient impact of Ayurvedic ''rasayana'' therapy while Jayprakash et al (2013) reported the neuroprotective role of ''ashwagandha'' in experimentally induced Parkinsonism. In view of the conceptual strength and the recent scientific studies now it could be suggested that ''rasayanas'' like ''amalaki, chyavanprasha'' and ''ashwagandha'' should be used in the management of ''shosha, kshaya'' and ''yakshma'' with great advantage, besides administration of other therapeutics described in Ayurvedic texts.

As mentioned earlier, Ayurvedic texts propound the doctrine of an immunocompromised state as the precursor of chronic wasting diseases like ''shosha, kshaya'' and ''yakshma''. Sushruta, while describing the ''samkramaka'' (contagious diseases) specially, observes that ''jwara'', ''shosha, rajayakshma, abhisyanda'' or conjunctivitis, and ''kushtha'' (or dermatoses such as leprosy) spread from person to person by contact. The spread of such diseases may be prevented by avoiding personal contacts and by promoting ''vyadhiksamatva'' or immunity with the help of leading a healthy lifestyle, following good nutrition and through administration of ''rasayana'' therapy.

==== ''Ojas'' (vital essence of the body) ====

The Ayurvedic classics describe a unique hitherto-less-known concept of ''ojas'' (vital essence of the body) that is responsible for biological strength (including immunity). ''Ojas'' is the final product of tissue nourishment and is quintessential to all the seven ''dhatus'' namely ''rasa, rakta, mamsa, meda, asthi, majja,'' and ''shukra''. Sushruta describes ''ojas'' as the ''param teja'' of the ''saptadhatus'' and as the ''bala'' or biological strength of an individual. ''Ojas'' is of two kinds, namely, ''para ojas'' and ''apara ojas''. ''Para ojas'' is subtle and present in very minute quantities in the heart while ''apara ojas'' is gross and as much as half an ''anjali'' (handful) in quantity spread all over the body. ''Para ojas'' is vital to life and any damage or vitiation of it may lead to instant death. ''Apara ojas'' is responsible for gross immune strength.

The ''oja-bala'' (''ojas'' strength) derived from ''ojas'' has been categorized to be of three kinds: ''sahaja bala'' or primary natural immunity, ''kalaja bala'' or acquired immunity through environmental factors such as climate etc., and ''yuktikrit bala'' or artificially-induced acquired immunity. The classics prompt to utilize these three resources to enhance the bala/immunity in order to prevent all ailments especially chronic wasting diseases and contagious diseases, such as ''shosha, kshaya'' and ''yakshma''.

The texts describe three categories of ''bala-dosha'' or disorders of ''bala'' which are comparable to three categories of immune disorders such as :
#''Oja-vyapat'' (immune-aberrations and allergies),
#''Oja-visransa'' (dislodged immunity and autoimmune disorders), and
#''Oja-kshaya'' (immunodeficiency).

There are specific methods and approaches to tackle the three categories of immune disorders.

It cannot be overemphasized that while looking at the above mentioned ancient classical descriptions on ''ojabala'' and ''bala-dosha'' it seems immunology was already highly advanced in the ''Samhita'' period of Ayurveda and the knowledge in this field was almost comparable with the latest basic knowledge of immunology as known today.

==== Ancient Ayurvedic leads in Microbiology ====

It will be pertinent to review the concept of microbiology and parasitology in Ayurvedic classics in the context of immunity and body resistance. ''Ojas, bala'' and ''vyadhikshamatva'' need to be adequate within the body for it to possess immunity. Though the role of microbes in pathology was not known in modern medicine 200 years ago, Ayurveda had a good knowledge of their role, albeit of a primitive nature. Ayurveda describes two kinds of organisms, namely ''prakrita'' (non-pathogenic) and ''vaikrita'' (pathogenic). Also described are two categories of pathogens/parasites, namely, external and internal. The internal organisms are mainly of three categories in terms of their natural environments: those that thrive on mucus (''shleshma''), those thriving in fecal matter, and those thriving in blood. Some of these, particularly the ones thriving in fecal matter seem to be intestinal parasites while others simulate microbes. The texts repeatedly advocate protecting surgical wounds from these organisms. There is also a clear description of vector borne diseases and that diseases such as leprosy, tuberculosis, conjunctivitis and fever as contagious diseases spread by contact with other patients or vectors.

It is interesting to note that these ancient texts recognized the existence of “friendly” non-pathogenic organisms and their functions - something that is only now being considered the greatest discovery in microbiology .It is claimed by modern scientists that our living body is made up of 10 trillion somatic cells and is home to some 100 trillion friendly microbes. This “empire” of microbes is called Microbiome. Understanding the relationship between the microbiome and the human being, the animal and the environment - is as important as unravelling human genome. The microbiome is like a well structured organ with unique functions and hence needs to be protected in the same way as we protect our other vital organs like liver, heart or kidney. This recognition of the existence of these friendly ''prakrita'' (non-pathogenic organisms) by Ayurveda thousands of years ago is of great historical significance.

==== Research Topics on this Subject ====

#A literary and conceptual study to identify the nature and strength of Bala or immune strength of human body and its scope in prevention and treatment of various diseases and to evaluate its contemporary application.
#Clinical and experimental studies on different ''rasayana'' remedies for their immunoenhancing effect in cases of ''kshaya,shosha'' and ''yakshma''.
#To develop precise diagnostic criteria for the three disease states described by Charak namely ''kshaya, shosha'' and ''yakshma'' including attempts to identify biomarkers, indicators and clinical rating scales to develop good diagnostic methodology to be used by Ayurvedic practitioners.

=== Glossary ===

#Shosha - A chronic wasting disease such as pthisis and Tuberculosis.
#Saahasa - Overexertion
#Kshaya - Emaciation and depletion of all Dhatus.
#Visamasana – Dietary indiscretion.
#Sandharana – Suppression of natural urges.
#Jrimbha – Yawning.
#Angamarda – Generalized bodyache.
#Arochaka – Anorexia.
#Pratisyaya – Common cold and cough.
#Swarabheda – Hoarseness of voice.
#Kasa – cough, dry or productive.
#Urah kshata – Organic disruptive disease of the chest (lungs).
#Yaksma – A disease simulating Pulmonary Tuberculosis
#Ahara – Food
#Hitasi – One who consumes wholesome food only
#Mitasi – Who takes measured amount of food i.e. one who avoids over eating.
#Kalabhoji – one who takes food at proper time.
#Ksawathu – Nausea
#Slesmapraseka – Salivation.
#Mukha-madhurya – Sweetish taste in the mouth.
#Anannabhilasa – Disinterest in eating
#Sopha – Inflammation or Edema.
#Ekadasarupa yaksma – Fully manifest disease with 11 features in Pulmonary Tuberculosis.
#Ojas – Biological Quintessence of all Dhatus responsible for biological strength and Immunity.
#Bala – Bio-strength resultant of Ojas status.

=== References ===

#Charak Samhita Vimana 7.9 on natural non-pathogenic organisms.
#Chakrapani on Charak Samhita Vimana 7.9. “ÏarÍra- sahajÁstvaikÁh”
#Charak Samhita Vimana 11.13 about the pathogenic organism that grow in blood, mucus and faeces.
#Charak Samhita Vimana 7.11, Sushruta Uttara Tantra 54.19-20 and Vagbhata Nidana 14.51 stating that pathogens grown on blood are minute and are invisible.
#Sushruta Samhita Nidana 5.33-34 on the mode of transmission of diseases from person to person.
#Charak Samhita Nidana 3.6. Description on epidemics.
#Lakhotia and associates Amalaki Rasayan in Drosophilia model
#Kuboyama,T. etal (2005) Neuritic regeneration and synoptic reconstruction induced by Withanolide-A.British Jour.Pharmacol. 144/7:961-971
#Singh,RH ; Narasimhamurthy,K and Singh,Girish (2008) Neuronutrient Impact of Ayurvedic Rasayana therapy in brain aging. Biogerontology 09:369-374.
#Jay Prakash et al 2013 Neuroprotective role of Withania somnifera root extract in Moneb-paraquat induced mouse model of Parkinsonism. Neurochem Res. Feb. 2013
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Bastisutriyam Siddhi

2019-03-06T04:08:12Z

Pallavmishra:

{{Infobox
|title = Bastrisutriyam Siddhi
|label1 = Section/Chapter
|data1 = [[Siddhi Sthana]] Chapter 3
|label2 = Preceding Chapter
|data2 = [[Panchakarmiya Siddhi]]
|label4 = Succeeding Chapter
|data4 = [[Snehavyapat Siddhi]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]

|header3 =

}}

==[[Siddhi Sthana]] Chapter 3, Chapter on best practices of therapeutic enema==

=== Abstract ===

The chapter [[Bastisutriyam Siddhi]] deals with the best practices and procedure of ''basti'' (therapeutic enema) in detail. The examination before ''basti'' administration, features of ''basti netra'' (nozzle in enema apparatus), features of ''basti putaka'' (enema bag/pot), dose, preparation, procedure and formulations of ''niruha basti'' (enema with decoction) are explained. It also describes the procedure of ''anuvasana basti'' (enema with oil or unctuous substance), posture for ''basti'', and post-operative procedure.

''Keywords'': ''Anuvasana basti, basti netra, basti putaka, basti vidhi, niruha basti''

=== Introduction ===

The previous chapter ([[Panchakarmiya Siddhi]]) dealt with the indications and contra-indications of [[Panchakarma]] and its applications. Now one of the content of [[Kalpana Siddhi]], ''basti kalpana'' is elaborated in the present chapter. ''Basti chikitsa'' is regarded as the prime treatment modality within [[Panchakarma]]. It not only has curative action, but also has preventive and promotive actions. ''Basti'' therapy is considered as ''chikitsardha'' (half of major treatments) among all therapy and some physicians even recognize it as a complete therapy because ''basti'' has a wide therapeutic area. It not only cures ''vatika'' disorders but also ''samsarga'' and ''sannipata'' condition of ''dosha, kaphaja'' and ''pittaja'' disorder, ''shakhagata'' (diseases of limbs) and ''koshthagata rogas'' (diseases of GIT) by making various permutations and combinations of different types of medicaments. Considering this rationale the third chapter is devoted for ''basti karma'' and given first place in the [[Siddhi Sthana]] among the [[Panchakarma]].

''Basti'' is not merely termed as ‘enema’; rather it is a highly complex, sophisticated, and systemic therapy having a wide range of therapeutic actions and indications. It is considered as prime treatment modality for ''vata dosha''. Contrary to this, enema is simply used for evacuation of colon and in few instances to rehydrate for therapeutic purpose.

===Sanskrit text, Transliteration and English Translation===

अथातो बस्तिसूत्रीयां सिद्धिं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō bastisūtrīyāṁ siddhiṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto bastisUtrIyAM siddhiM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall discuss the Chapter which deals with formulation of ''Basti'' . Thus said Lord Atreya.[1-2]

==== Questions of Agnivesha ====

कृतक्षणं शैलवरस्य रम्ये स्थितं धनेशायतनस्य पार्श्वे|

महर्षिसङ्घैर्वृतमग्निवेशः पुनर्वसुं प्राञ्जलिरन्वपृच्छत्||३||

बस्तिर्नरेभ्यः किमपेक्ष्य दत्तः स्यात् सिद्धिमान् किम्मयमस्य नेत्रम्|

कीदृक्प्रमाणाकृति किङ्गुणं च केभ्यश्च किंयोनिगुणश्च बस्तिः||४||

निरूहकल्पः प्रणिधानमात्रा स्नेहस्य का वा शयने विधिः कः|

के बस्तयः केषु हिता इतीदं श्रुत्वोत्तरं प्राह वचो महर्षिः||५||

kr̥takṣaṇaṁ śailavarasya ramyē sthitaṁ dhanēśāyatanasya pārśvē|

maharṣisaṅghairvr̥tamagnivēśaḥ punarvasuṁ prāñjaliranvapr̥cchat||3||

bastirnarēbhyaḥ kimapēkṣya dattaḥ syāt siddhimān kimmayamasya nētram|

kīdr̥kpramāṇākr̥ti kiṅguṇaṁ ca kēbhyaśca kiṁyōniguṇaśca bastiḥ||4||

nirūhakalpaḥ praṇidhānamātrā snēhasya kā vā śayanē vidhiḥ kaḥ|

kē bastayaḥ kēṣu hitā itīdaṁ śrutvōttaraṁ prāha vacō maharṣiḥ||5||

kRutakShaNaM shailavarasya ramye sthitaM dhaneshAyatanasya pArshve|

maharShisa~gghairvRutamagniveshaH punarvasuM prA~jjaliranvapRucchat||3||

bastirnarebhyaH kimapekShya dattaH syAt siddhimAn kimmayamasya netram|

kIdRukpramANAkRuti ki~gguNaM ca kebhyashca kiMyoniguNashca bastiH||4||

nirUhakalpaH praNidhAnamAtrA snehasya kA vA shayane vidhiH kaH|

ke bastayaH keShu hitA itIdaM shrutvottaraM prAha vaco maharShiH||5||

Agnivesha, with folded hands, asked following questions to Punarvasu, as he was sitting at leisure surrounded by a host of great sages amidst the pleasant Himalaya as in the neighborhood of the abode of Kubera, the God of wealth.

*“What are the factors observing which the enema can be administered with success?
*What material shall be used to prepare a nozzle?
*What is its length and shape?
*What is its quality and what are the sources of enema bag/receptacle and what should be their qualities?
*What is the pharmaceutical formula of the ''niruha'' (enema with decoction)?
*What is its mode of administration?
*What is the measure of enema solution?
*What is the proportion of unctuous substance?
*What is the position and procedure followed for enema while the patient on examination bed?
*What are the varieties of enema and in whom are they indicated?"

Hearing these questions, the great sage Punarvasu spoke to answer. [3-5]

==== Consideration before administration of ''basti'' ====

समीक्ष्य दोषौषधदेशकालसात्म्याग्निसत्त्वादिवयोबलानि|

बस्तिः प्रयुक्तो नियतं गुणाय स्यात् सर्वकर्माणि च सिद्धिमन्ति||६||

samīkṣya dōṣauṣadhadēśakālasātmyāgnisattvādivayōbalāni|

bastiḥ prayuktō niyataṁ guṇāya syāt sarvakarmāṇi ca siddhimanti||6||

samIkShya doShauShadhadeshakAlasAtmyAgnisattvAdivayobalAni|

bastiH prayukto niyataM guNAya syAt sarvakarmANi ca siddhimanti||6||

''Basti'' administered after careful examination of ''dosha'' (vitiating factors), ''aushadha'' (potency of drugs), ''desha'' (place of living and body of patient), ''kala'' (season and time of administration), ''satmya'' (accustom), ''agni'' (factor responsible for process of digestion and metabolism), ''sattva'' (mind), ''oka'' (habituation due to continuous use), ''vaya'' (age) and ''bala'' (strength) is certainly capable of providing the significant results, the benefits of the therapy and ultimately success.[6]

==== ''Basti netra'' (nozzle apparatus) ====

सुवर्णरूप्यत्रपुताम्ररीतिकांस्यास्थिशस्त्रद्रुमवेणुदन्तैः |

नलैर्विषाणैर्मणिभिश्च तैस्तैर्नेत्राणि कार्याणि सु(त्रि)कर्णिकानि ||७||

suvarṇarūpyatraputāmrarītikāṁsyāsthiśastradrumavēṇudantaiḥ |

nalairviṣāṇairmaṇibhiśca taistairnētrāṇi kāryāṇi su(tri)karṇikāni ||7||

suvarNarUpyatraputAmrarItikAMsyAsthishastradrumaveNudantaiH |

nalairviShANairmaNibhishca taistairnetrANi kAryANi su(tri)karNikAni ||7||

For preparing ''basti netra'' having three ''karnika'' (ridges) the following materials are used: gold, silver, copper, bronze, cow’s horn, bones of animals and others.[7]

षड्द्वादशाष्टाङ्गुलसम्मितानि षड्विंशतिद्वादशवर्षजानाम्|

स्युर्मुद्गकर्कन्धुसतीनवाहिच्छिद्राणि वर्त्याऽपिहितानि चैव||८||

यथावयोऽङ्गुष्ठकनिष्ठिकाभ्यां मूलाग्रयोः स्युः परिणाहवन्ति|

ऋजूनि गोपुच्छसमाकृतीनि श्लक्ष्णानि च स्युर्गुडिकामुखानि||९||

स्यात् कर्णिकैकाऽग्रचतुर्थभागे मूलाश्रिते बस्तिनिबन्धने द्वे|१०|

ṣaḍdvādaśāṣṭāṅgulasammitāni ṣaḍviṁśatidvādaśavarṣajānām|

syurmudgakarkandhusatīnavāhicchidrāṇi vartyā'pihitāni caiva||8||

yathāvayō'ṅguṣṭhakaniṣṭhikābhyāṁ mūlāgrayōḥ syuḥ pariṇāhavanti|

r̥jūni gōpucchasamākr̥tīni ślakṣṇāni ca syurguḍikāmukhāni||9||

syāt karṇikaikā'gracaturthabhāgē mūlāśritē bastinibandhanē dvē|10|

ShaDdvAdashAShTA~ggulasammitAni ShaDviMshatidvAdashavarShajAnAm|

syurmudgakarkandhusatInavAhicchidrANi vartyA~apihitAni caiva||8||

yathAvayo~a~gguShThakaniShThikAbhyAM mUlAgrayoH syuH pariNAhavanti|

RujUni gopucchasamAkRutIni shlakShNAni ca syurguDikAmukhAni||9||

syAt karNikaikA~agracaturthabhAge mUlAshrite bastinibandhane dve|10|

For the patients of the age of six, twenty and twelve years, the length of the nozzle should be of six, twelve and eight ''Angula'' respectively.

The caliber of the hole inside the nozzle should be such as to allow the passage of a seed of ''mudga'' (green gram), ''karkandhu'' (jujube berry- Zizyphus Jujuba) and ''satina'' (peanut) respectively. This hole should be corked with a ''varti'' (wick).

The circumference of the nozzle at the base and top should be the same as that of the thumb and little finger of the patient of that age respectively.

It should be straight and tapering like the tail of a cow. The mouth of the nozzle should be smooth and globular.

One ring should be fixed at the level of one fourth from the top, and two other rings should be fixed at the base in order to facilitate tying the mouth of the bladder around the nozzle. [8-91/2]

जारद्गवो माहिषहारिणौ वा स्याच्छौकरो बस्तिरजस्य वाऽपि||१०||

दृढस्तनुर्नष्टसिरो विगन्धः कषायरक्तः सुमृदुः सुशुद्धः |

नृणां वयो वीक्ष्य यथानुरूपं नेत्रेषु योज्यस्तु सुबद्धसूत्रः||११||

jāradgavō māhiṣahāriṇau vā syācchaukarō bastirajasya vā'pi||10||

dr̥ḍhastanurnaṣṭasirō vigandhaḥ kaṣāyaraktaḥ sumr̥duḥ suśuddhaḥ |

nr̥ṇāṁ vayō vīkṣya yathānurūpaṁ nētrēṣu yōjyastu subaddhasūtraḥ||11||

jAradgavo mAhiShahAriNau vA syAcchaukaro bastirajasya vA~api||10||

dRuDhastanurnaShTasiro vigandhaH kaShAyaraktaH sumRuduH sushuddhaH |

nRuNAM vayo vIkShya yathAnurUpaM netreShu yojyastu subaddhasUtraH||11||

The urinary bladder of the animals such as buffalo, sheep, goat, cow etc. should be used to prepare ''basti'' (the holder bag of ''basti dravya'').

Features: ''Drudha'' (strong), ''tanu'' (thin), ''nashta shira'' (devoid of veins), ''vigandha'' (devoid of odor), ''kashayarakta'' (saffron-red), ''sumridu'' (soft), ''sushuddha'' (well cleaned), and ''yathanurupa'' (size accordingly).[10-11]

बस्तेरलाभे प्लवजो गलो वा स्यादङ्कपादः सुघनः पटो वा|१२|

bastēralābhē plavajō galō vā syādaṅkapādaḥ sughanaḥ paṭō vā|12|

basteralAbhe plavajo galo vA syAda~gkapAdaH sughanaH paTo vA|12|

In case of non availability, ''plavaja gala'' (throat of a pelican), ''ankapada'' (skin of a bat), ''ghana pata'' (strong cloth) should be used.[12]

[Note: Presently plastic bags are in use.]

आस्थापनार्हं पुरुषं विधिज्ञः समीक्ष्य पुण्येऽहनि शुक्लपक्षे||१२||

प्रशस्तनक्षत्रमुहूर्तयोगे जीर्णान्नमेकाग्रमुपक्रमेत |१३|

āsthāpanārhaṁ puruṣaṁ vidhijñaḥ samīkṣya puṇyē'hani śuklapakṣē||12||

praśastanakṣatramuhūrtayōgē jīrṇānnamēkāgramupakramēta|13|

AsthApanArhaM puruShaM vidhij~jaH samIkShya puNye~ahani shuklapakShe||12||

prashastanakShatramuhUrtayoge jIrNAnnamekAgramupakrameta |13|

The physician well versed in the method of administering ''basti'' should administer this therapy to a patient who is fit, after the digestion of the meal consumed by him and who has a complete focus of mind on the therapy. It should be given on an auspicious day in the ''shukla paksha'' having a propitious ''nakshatra, muhurta'' and ''yoga''.[12-121/2]

==== Preparation and administration of ''basti'' formulation ====

बलां गुडूचीं त्रिफलां सरास्नां द्वे पञ्चमूले च पलोन्मितानि||१३||

अष्टौ फलान्यर्धतुलां च मांसाच्छागात् पचेदप्सु चतुर्थशेषम्|

पूतं यवानीफलबिल्वकुष्ठवचाशताह्वाघनपिप्पलीनाम्||१४||

कल्कैर्गुडक्षौद्रघृतैः सतैलैर्युतं सुखोष्णैस्तु पिचुप्रमाणैः|

गुडात् पलं द्विप्रसृतां तु मात्रां स्नेहस्य युक्त्या मधु सैन्धवं च||१५||

प्रक्षिप्य बस्तौ मथितं खजेन सुबद्धमुच्छ्वास्य च निर्वलीकम्|

अङ्गुष्ठमध्येन मुखं पिधाय नेत्राग्रसंस्थामपनीय वर्तिम्||१६||

तैलाक्तगात्रं कृतमूत्रविट्कं नातिक्षुधार्तं शयने मनुष्यम्|

समेऽथवेषन्नतशीर्षके वा नात्युच्छ्रिते स्वास्तरणोपपन्ने||१७||

सव्येन पार्श्वेन सुखं शयानं कृत्वर्जुदेहं स्वभुजोपधानम्|

सङ्कोच्य सव्येतरदस्य सक्थि वामं प्रसार्य प्रणयेत्ततस्तम्||१८||

स्निग्धे गुदे नेत्रचतुर्थभागं स्निग्धं शनैरृज्वन पृष्ठवंशम्|

अकम्पनावेपनलाघवादीन् पाण्योर्गुणांश्चापि विदर्शयंस्तम् ||१९||

प्रपीड्य चैकग्रहणेन दत्तं नेत्रं शनैरेव ततोऽपकर्षेत्|२०|

balāṁ guḍūcīṁ triphalāṁ sarāsnāṁ dvē pañcamūlē ca palōnmitāni||13||

aṣṭau phalānyardhatulāṁ ca māṁsācchāgāt pacēdapsu caturthaśēṣam|

pūtaṁ yavānīphalabilvakuṣṭhavacāśatāhvāghanapippalīnām||14||

kalkairguḍakṣaudraghr̥taiḥ satailairyutaṁ sukhōṣṇaistu picupramāṇaiḥ|

guḍāt palaṁ dviprasr̥tāṁ tu mātrāṁ snēhasya yuktyā madhu saindhavaṁ ca||15||

prakṣipya bastau mathitaṁ khajēna subaddhamucchvāsya ca nirvalīkam|

aṅguṣṭhamadhyēna mukhaṁ pidhāya nētrāgrasaṁsthāmapanīya vartim||16||

tailāktagātraṁ kr̥tamūtraviṭkaṁ nātikṣudhārtaṁ śayanē manuṣyam|

samē'thavēṣannataśīrṣakē vā nātyucchritē svāstaraṇōpapannē||17||

savyēna pārśvēna sukhaṁ śayānaṁ kr̥tvarjudēhaṁ svabhujōpadhānam|

saṅkōcya savyētaradasya sakthi vāmaṁ prasārya praṇayēttatastam||18||

snigdhē gudē nētracaturthabhāgaṁ snigdhaṁ śanaiṟujvana pr̥ṣṭhavaṁśam|

akampanāvēpanalāghavādīn pāṇyōrguṇāṁścāpi vidarśayaṁstam ||19||

prapīḍya caikagrahaṇēna dattaṁ nētraṁ śanairēva tatō'pakarṣēt|20|

balAM guDUcIM triphalAM sarAsnAM dve pa~jcamUle ca palonmitAni||13||

aShTau phalAnyardhatulAM ca mAMsAcchAgAt pacedapsu caturthasheSham|

pUtaM yavAnIphalabilvakuShThavacAshatAhvAghanapippalInAm||14||

kalkairguDakShaudraghRutaiH satailairyutaM sukhoShNaistu picupramANaiH|

guDAt palaM dviprasRutAM tu mAtrAM snehasya yuktyA madhu saindhavaM ca||15||

prakShipya bastau mathitaM khajena subaddhamucchvAsya ca nirvalIkam|

a~gguShThamadhyena mukhaM pidhAya netrAgrasaMsthAmapanIya vartim||16||

tailAktagAtraM kRutamUtraviTkaM nAtikShudhArtaM shayane manuShyam|

same~athaveShannatashIrShake vA nAtyucchrite svAstaraNopapanne||17||

savyena pArshvena sukhaM shayAnaM kRutvarjudehaM svabhujopadhAnam|

sa~gkocya savyetaradasya sakthi vAmaM prasArya praNayettatastam||18||

snigdhe gude netracaturthabhAgaM snigdhaM shanairRujvana pRuShThavaMsham|

akampanAvepanalAghavAdIn pANyorguNAMshcApi vidarshayaMstam ||19||

prapIDya caikagrahaNena dattaM netraM shanaireva tato~apakarShet|20|

One ''pala'' each of ''bala, guduchi, haritaki, vibhitaki, amalaki, rasna, bilva, shyonaka, gambhari, patala, shalaparni, prishniparni, brihati, kantakari'' and ''gokshura'', eight fruits of ''madana'' and half ''tula'' of goat meat should be added with water, and boiled till one fourth of water remains. Then the decoction should be collected by filtration. To this decoction, one ''pichu'' (tola) each of the paste of ''yavani, madana phala, bilva, kushtha, vacha, shatahva, ghana'' and ''pippali,'' one ''pala'' of ''jaggery'', two ''prasruta'' each of ghee and oil, and appropriate quantities of honey and rock salt should be added. The recipe should then be stirred with a stirrer, and kept inside the ''basti''. The bladder should then be tied to the base of the nozzle, the air inside the bladder should be removed, and the bladder should be free from folds. Thereafter, ''varti'' (cotton plug) kept at the opening should be removed, and the opening should be covered with the middle part of the thumb.

The patient whose body is anointed with oil, who has passed urine and stool, and who is not very hungry should be made to sleep over a well spread and not very high bed which is uniform in level or which is slightly low in level at the head.

The patient should lay comfortably on his left side. He should keep his body straight, and use his folded left hand as pillow. He should then flex his right leg, keeping the left leg straight.

The anus of the patient should be lubricated, and the lubricated nozzle should be inserted into it up to one fourth part from the top slowly and straight following the position of the vertebral column.

The physician should not shake his hand, and quickly compress the bladder so that the content goes inside at one stretch. Thereafter, he should take out the nozzle slowly. [13-191/2]

==== Sequels of wrong administration of nozzle ====

तिर्यक् प्रणीते तु न याति धारा गुदे व्रणः स्याच्चलिते तु नेत्रे||२०||

दत्तः शनैर्नाशयमेति बस्तिः कण्ठं प्रधावत्यतिपीडितश्च|

शीतस्त्वतिस्तम्भकरो विदाहं मूर्च्छां च कुर्यादतिमात्रमुष्णः||२१||

स्निग्धोऽतिजाड्यं पवनं तु रूक्षस्तन्वल्पमात्रालवणस्त्वयोगम्|

करोति मात्राभ्यधिकोऽतियोगं क्षामं तु सान्द्रः सुचिरेण चैति||२२||

दाहातिसारौ लवणोऽति कुर्यात्तस्मात् सुयुक्तं सममेव दद्यात्|२३|

tiryak praṇītē tu na yāti dhārā gudē vraṇaḥ syāccalitē tu nētrē||20||

dattaḥ śanairnāśayamēti bastiḥ kaṇṭhaṁ pradhāvatyatipīḍitaśca|

śītastvatistambhakarō vidāhaṁ mūrcchāṁ ca kuryādatimātramuṣṇaḥ||21||

snigdhō'tijāḍyaṁ pavanaṁ tu rūkṣastanvalpamātrālavaṇastvayōgam|

karōti mātrābhyadhikō'tiyōgaṁ kṣāmaṁ tu sāndraḥ sucirēṇa caiti||22||

dāhātisārau lavaṇō'ti kuryāttasmāt suyuktaṁ samamēva dadyāt|23|

tiryak praNIte tu na yAti dhArA gude vraNaH syAccalite tu netre||20||

dattaH shanairnAshayameti bastiH kaNThaM pradhAvatyatipIDitashca|

shItastvatistambhakaro vidAhaM mUrcchAM ca kuryAdatimAtramuShNaH||21||

snigdho~atijADyaM pavanaM tu rUkShastanvalpamAtrAlavaNastvayogam|

karoti mAtrAbhyadhiko~atiyogaM kShAmaM tu sAndraH sucireNa caiti||22||

dAhAtisArau lavaNo~ati kuryAttasmAt suyuktaM samameva dadyAt|23|

If the nozzle is obliquely inserted, then the fluid will not flow into the rectum. If the nozzle is shifted from one place to the other, then this may cause anal injury. If the bladder is compressed slowly, then the enema- fluid may not reach the colon. If the bladder is strongly compressed, then the fluid may rush very fast even up to the throat. If the enema- fluid is very cold, then it may cause stiffness. If the enema – fluid is very hot, then it may cause burning sensation and fainting. If the enema – fluid is very unctuous, then it may cause numbness. If the enema- fluid is ''ati ruksha'', then it may cause aggravation of ''vayu''. If the enema – fluid is very thin or added with less quantity of salt, then it may lead to ''ayoga''. If the enema- fluid is administered in large quantity, then it may cause ''ati-yoga''. If the enema-fluid is viscid, then it may cause emaciation of the patient, and it moves in the colon very slowly. If the enema- fluid contains salt in excess, then it may cause burning sensation and diarrhea. Therefore, ''basti'' should be properly administered.[20-221/2]

==== Sequence in preparation of ''basti'' formulation ====

पूर्वं हि दद्यान्मधु सैन्धवं तु स्नेहं विनिर्मथ्यं ततोऽनु कल्कम्||२३||

विमथ्य संयोज्य पुनर्द्रवैस्तं बस्तौ निदध्यान्मथितं खजेन|२४|

pūrvaṁ hi dadyānmadhu saindhavaṁ tu snēhaṁ vinirmathyaṁ tatō'nu kalkam||23||

vimathya saṁyōjya punardravaistaṁ bastau nidadhyānmathitaṁkhajēna|24|

pUrvaM hi dadyAnmadhu saindhavaM tu snehaM vinirmathyaM tato~anu kalkam||23||

vimathya saMyojya punardravaistaM bastau nidadhyAnmathitaMkhajena|24|

At first ''madhu'' (honey) and ''saindhava'' (rock salt) should be taken ''khalva'', then ''sneha'' followed by ''kalka, kashaya'' and ''avapa,'' churning should be while adding these ''dravya''. [23-231/2]

वामाश्रये हि ग्रहणीगुद च तत् पार्श्वसंस्थस्य सुखोपलब्धिः||२४||

लीयन्त एवं वलयश्च तस्मात् सव्यं शयानोऽर्हति बस्तिदानम्|२५|

vāmāśrayē hi grahaṇīgudē ca tat pārśvasaṁsthasya sukhōpalabdhiḥ||24||

līyanta ēvaṁ valayaśca tasmāt savyaṁ śayānō'rhati bastidānam|25|

vAmAshraye hi grahaNIgude ca tat pArshvasaMsthasya sukhopalabdhiH||24||

lIyanta evaM valayashca tasmAt savyaM shayAno~arhati bastidAnam|25|

It is said that the ''basti'' should be administered to the patient lying on left lateral side as the ''grahani'' and ''guda'' are situated on the left side of the body, and the ''vali'' (valves) get relaxed. Therefore, ''basti'' should be given when the patient is lying on his left side.[24-241/2]

विड्वातवेगो यदि चार्धदत्ते निष्कृष्य मुक्ते प्रणयेदशेषम् ||२५||

उत्तानदेहश्च कृतोपधानः स्याद्वीर्यमाप्नोति तथाऽस्य देहम् |२६|

viḍvātavēgō yadi cārdhadattē niṣkr̥ṣya muktē praṇayēdaśēṣam ||25||

uttānadēhaśca kr̥tōpadhānaḥ syādvīryamāpnōti tathā'sya dēham |26|

viDvAtavego yadi cArdhadatte niShkRuShya mukte praNayedasheSham ||25||

uttAnadehashca kRutopadhAnaH syAdvIryamApnoti tathA~asya deham |26|

If during middle of enema administration, the patient gets an urge to pass feces or flatus, the enema nozzle should be drawn out and the when the urge has passed away, the remaining solution, should be injected. The patient should lie supine on bed with his body in a raised position by means of a pillow in such a way that the effect of the enema pervades the whole body. [25-251/2]

एकोऽपकर्षत्यनिलं स्वमार्गात् पित्तं द्वितीयस्तु कफं तृतीयः||२६||

ēkō'pakarṣatyanilaṁ svamārgāt pittaṁ dvitīyastu kaphaṁ tr̥tīyaḥ||26||

eko~apakarShatyanilaM svamArgAt pittaM dvitIyastu kaphaM tRutIyaH||26||

The first enema helps in the elimination of ''vata'', the second enema helps in the elimination of ''pitta'', and the third enema helps in the elimination of ''kapha'' from their ''ashaya'' (locations).[26]

==== Follow up regimen after ''basti'' administration ====

प्रत्यागते कोष्णजलावसिक्तः शाल्यन्नमद्यात्तनुना रसेन|

जीर्णे तु सायं लघु चाल्पमात्रं भुक्तोऽनुवास्यः परिबृंहणार्थम्||२७||

निरूहपादांशसमेन तैलेनाम्लानिलघ्नौषधसाधितेन|

दत्त्वा स्फिचौ पाणितलेन हन्यात् स्नेहस्य शीघ्रागमरक्षणार्थम्||२८||

ईषच्च पादाङ्गुलियुग्ममाञ्छेदुत्तानदेहस्य तलौ प्रमृज्यात्|

स्नेहेन पार्ष्ण्यङ्गुलिपिण्डिकाश्च ये चास्य गात्रावयवा रुगार्ताः||२९||

तांश्चावमद्गीत सुखं ततश्च निद्रामुपासीत कृतोपधानः|३०|

pratyāgatē kōṣṇajalāvasiktaḥ śālyannamadyāttanunā rasēna|

jīrṇē tu sāyaṁ laghu cālpamātraṁ bhuktō'nuvāsyaḥ paribr̥ṁhaṇārtham||27||

nirūhapādāṁśasamēna tailēnāmlānilaghnauṣadhasādhitēna|

dattvā sphicau pāṇitalēna hanyāt snēhasya śīghrāgamarakṣaṇārtham||28||

īṣacca pādāṅguliyugmamāñchēduttānadēhasya talau pramr̥jyāt|

snēhēna pārṣṇyaṅgulipiṇḍikāśca yē cāsya gātrāvayavā rugārtāḥ||29||

tāṁścāvamadgīta sukhaṁ tataśca nidrāmupāsīta kr̥tōpadhānaḥ|30|

pratyAgate koShNajalAvasiktaH shAlyannamadyAttanunA rasena|

jIrNe tu sAyaM laghu cAlpamAtraM bhukto~anuvAsyaH paribRuMhaNArtham||27||

nirUhapAdAMshasamena tailenAmlAnilaghnauShadhasAdhitena|

dattvA sphicau pANitalena hanyAt snehasya shIghrAgamarakShaNArtham||28||

IShacca pAdA~gguliyugmamA~jcheduttAnadehasya talau pramRujyAt|

snehena pArShNya~ggulipiNDikAshca ye cAsya gAtrAvayavA rugArtAH||29||

tAMshcAvamadgIta sukhaM tatashca nidrAmupAsIta kRutopadhAnaH|30|

After the ''basti dravya'' has come out, the patient should be sprinkled with tepid water, and thereafter, the diet containing ''shali''- rice along with thin meat – soup should be given.

In the evening, after the previous meal is digested, light food in small quantity should be given. Thereafter, ''anuvasana basti'' should be given to the patient for the over all nourishment.

For ''anuvasana basti'', medicated oil cooked by adding ''amla'' and ''vataghna dravya'' should be one- fourth in quantity of the fluid used for ''niruha basti''. After the administration of oil, the buttocks of the patient should be tapped with palms to prevent early return of the ''basti dravya''.

The patient should lie on the bed in supine position, and the toe- joints of both of his legs should be pulled gently. The heel, calf and other painful parts should be massaged with the oil. Thereafter, the patient should take rest comfortably by keeping his head over a pillow.[27-291/2]

==== Proportion according to ''dosha'' dominance ====

भागाः कषायस्य तु पञ्च, पित्ते स्नेहस्य षष्ठः प्रकृतौ स्थिते च||३०||

वाते विवृद्धे तु चतुर्थभागो, मात्रा निरूहेषु कफेऽष्टभागः|३१ |

bhāgāḥ kaṣāyasya tu pañca, pittē snēhasya ṣaṣṭhaḥ prakr̥tau sthitē ca||30||

vātē vivr̥ddhē tu caturthabhāgō, mātrā nirūhēṣu kaphē'ṣṭabhāgaḥ|31|

bhAgAH kaShAyasya tu pa~jca, pitte snehasya ShaShThaH prakRutau sthite ca||30||

vAte vivRuddhe tu caturthabhAgo, mAtrA nirUheShu kaphe~aShTabhAgaH|31|

In ''niruha basti'', the decoction should be five parts. If this is intended to be given to a patient suffering from ''paittika'' disease or to a healthy person, then the quantity of ''sneha'' should be one sixth of the total quantity. For ''vatika'' diseases, the quantity should be one fourth of the total quantity. For ''kaphaja'' diseases, the quantity of ''sneha'' should be about 1/8th of the total quantity.[30-301/2]

==== Dose of ''niruha basti'' ====

निरूहमात्रा प्रसृतार्धमाद्ये वर्षे ततोऽर्धप्रसृताभिवृद्धिः||३१||

आद्वादशात् स्यात् प्रसृताभिवृद्धिरष्टादशाद् द्वादशतः परं स्युः|

आसप्ततेस्तद्विहितं प्रमाणमतः परं षोडशवद्विधेयम्||३२||

निरूहमात्रा प्रसृतप्रमाणा बाले च वृद्धे च मृदुर्विशेषः|३३|

nirūhamātrā prasr̥tārdhamādyē varṣē tatō'rdhaprasr̥tābhivr̥ddhiḥ||31||

ādvādaśāt syāt prasr̥tābhivr̥ddhiraṣṭādaśād dvādaśataḥ paraṁ syuḥ|

āsaptatēstadvihitaṁ pramāṇamataḥ paraṁ ṣōḍaśavadvidhēyam||32||

nirūhamātrā prasr̥tapramāṇā bālē ca vr̥ddhē ca mr̥durviśēṣaḥ|33|

nirUhamAtrA prasRutArdhamAdye varShe tato~ardhaprasRutAbhivRuddhiH||31||

AdvAdashAt syAt prasRutAbhivRuddhiraShTAdashAd dvAdashataH paraM syuH|

AsaptatestadvihitaM pramANamataH paraM ShoDashavadvidheyam||32||

nirUhamAtrA prasRutapramANA bAle ca vRuddhe ca mRudurvisheShaH|33|

Start the dose of ''niruha'' with one ''prasrita'' (approx.80 ml) on 1st year, then increase ½ ''prasrita'' till 12th year; then increase one''prasrita'' till 18th year, reaching the maximum dose i.e., twelve''prasrita''. The dose after 70 years is equal to the dose of 16th year. In children and elderly person ''mridu basti'' should be given. [32-321/2]

==== Table/cot for administration of ''basti'' ====

नात्युच्छ्रितं नाप्यतिनीचपादं सपादपीठं शयनं प्रशस्तम्||३३||

प्रधानमृद्वास्तरणोपपन्नं प्राक्शीर्षकं शुक्लपटोत्तरीयम्|३४|

nātyucchritaṁ nāpyatinīcapādaṁ sapādapīṭhaṁ śayanaṁ praśastam||33||

pradhānamr̥dvāstaraṇōpapannaṁ prākśīrṣakaṁ śuklapaṭōttarīyam|34|

nAtyucchritaM nApyatinIcapAdaM sapAdapIThaM shayanaM prashastam||33||

pradhAnamRudvAstaraNopapannaM prAkshIrShakaM shuklapaTottarIyam|34|

The cot or table used for ''basti'' should not be too high at head end, foot end should not be too low, having foot step. The table should be covered with soft bed and the patient should wear white dress and lie on the table facing the head to east. [33-331/2]

==== Diet after ''basti'' ====

भोज्यं पुनर्व्याधिमवेक्ष्य तद्वत् प्रकल्पयेद्यूषपयोरसाद्यैः||३४||

सर्वेषु विद्याद्विधिमेतमाद्यं वक्ष्यामि बस्तीनत उत्तरीयान्|३५|

bhōjyaṁ punarvyādhimavēkṣya tadvat prakalpayēdyūṣapayōrasādyaiḥ||34||

sarvēṣu vidyādvidhimētamādyaṁ vakṣyāmi bastīnata uttarīyān|35|

bhojyaM punarvyAdhimavekShya tadvat prakalpayedyUShapayorasAdyaiH||34||

sarveShu vidyAdvidhimetamAdyaM vakShyAmi bastInata uttarIyAn|35|

''Yusha, kshira'' and ''mamsa rasa'' should be given as per the disease (''kapha, pitta'' and ''vata'' respectively). [34-341/2]

==== Various ''basti'' formulations ====

द्विपञ्चमूलस्य रसोऽम्लयुक्तः सच्छागमांसस्य सपूर्वपेष्यः||३५||

त्रिस्नेहयुक्तः प्रवरो निरूहः सर्वानिलव्याधिहरः प्रदिष्टः|

dvipañcamūlasya rasō'mlayuktaḥ sacchāgamāṁsasya sapūrvapēṣyaḥ||35||

trisnēhayuktaḥ pravarō nirūhaḥ sarvānilavyādhiharaḥ pradiṣṭaḥ|

dvipa~jcamUlasya raso~amlayuktaH sacchAgamAMsasya sapUrvapeShyaH||35||

trisnehayuktaH pravaro nirUhaH sarvAnilavyAdhiharaH pradiShTaH|

'''''Dvipanchamuladi''''':
*''Dravya''
*''Madhu''
*''Saindhava''
*''Sneha-trisneha''
*''Kalka''
*''Kvatha dravya-laghupanchamoola, bruhatpanchamoola''
*''Āvapa dravya-amla rasa, ajamamsa''
*''Guna- Sarva vatavyadhihara'' [35-351/2]

स्थिरादिवर्गस्य बलापटोलत्रायन्तिकैरण्डयवैर्युतस्य||३६||

प्रस्थो रसाच्छागरसार्धयुक्तः साध्यः पुनः प्रस्थसमस्तु यावत्|

प्रियङ्गुकृष्णाघनकल्कयुक्तः सतैलसर्पिर्मधुसैन्धवश्च||३७||

स्याद्दीपनो मांसबलप्रदश्च चक्षुर्बलं चापि ददाति बस्तिः |

sthirādivargasya balāpaṭōlatrāyantikairaṇḍayavairyutasya||36||

prasthō rasācchāgarasārdhayuktaḥ sādhyaḥ punaḥ prasthasamastu yāvat|

priyaṅgukr̥ṣṇāghanakalkayuktaḥ satailasarpirmadhusaindhavaśca||37||

syāddīpanō māṁsabalapradaśca cakṣurbalaṁ cāpi dadāti bastiḥ |

sthirAdivargasya balApaTolatrAyantikairaNDayavairyutasya||36||

prastho rasAcchAgarasArdhayuktaH sAdhyaH punaH prasthasamastu yAvat|

priya~ggukRuShNAghanakalkayuktaH satailasarpirmadhusaindhavashca||37||

syAddIpano mAMsabalapradashca cakShurbalaM cApi dadAti bastiH |

{| class="wikitable" style="text-align: center;
|-
! scope="col"| ''Dravya''
! scope="col"| Dose
|-
| ''Madhu''
| 2 ''Prasrita''
|-
| ''Saindhava''
| 1 ''Karsha''
|-
| ''Sneha-taila, ghrita''
| 3 ''Prasrita''
|-
| ''Kalka dravya-priyangu, pippali, musta''
| 1 ''Prasrita''
|-
| ''Kwatha dravya-sthiradi panchamula, bala, patola, trayamana, eranda, yava'' (1 ''prastha'' each); reduced to 1 ''prastha''
| 4 ''Prasrita''
|-
| ''Avapa-aja mamsa''
| 2 ''Prasrita''
|}

''Guna-Dipana'', increases ''mamsa'' and ''bala''; ''chakshushya''.

एरण्डमूलं त्रिपलं पलाशा ह्रस्वानि मूलानि च यानि पञ्च||३८||

रास्नाश्वगन्धातिबलागुडूची पुनर्नवारग्वधदेवदारु|

भागाः पलांशा मदनाष्टयुक्ता जलद्विकंसे क्वथितेऽष्टशेषे||३९||

पेष्याः शताह्वा हपुषा प्रियङ्गुः सपिप्पलीकं मधुकं बला च|

रसाञ्जनं वत्सकबीजमुस्तं भागाक्षमात्रं लवणांशयुक्तम्||४०||

समाक्षिकस्तैलयुतः समूत्रो बस्तिर्नृणां दीपनलेखनीयः|

जङ्घोरुपादत्रिकपृष्ठशूलं कफावृतिं मारुतनिग्रहं च||४१||

विण्मूत्रवातग्रहणं सशूलमाध्मानतामश्मरिशर्करे च|

आनाहमर्शोग्रहणीप्रदोषानेरण्डबस्तिः शमयेत् प्रयुक्तः||४२||

चतुष्पले तैलघृतस्य भृष्टाच्छागाच्छतार्धो दधिदाडिमाम्लः|

रसः सपेष्यो बलमांसवर्णरेतोग्निदश्चान्ध्यशिरोर्तिशस्तः ||४३||

जलद्विकंसेऽष्टपलं पलाशात् पक्त्वा रसोऽर्धाढकमात्रशेषः|

कल्कैर्वचामागधिकापलाभ्यां युक्तः शताह्वाद्विपलेन चापि||४४||

ससैन्धवः क्षौद्रयुतः सतैलो देयो निरूहो बलवर्णकारी|

आनाहपार्श्वामययोनिदोषान् गुल्मानुदावर्तरुजं च हन्यात्||४५||

ēraṇḍamūlaṁ tripalaṁ palāśā hrasvāni mūlāni ca yāni pañca||38||

rāsnāśvagandhātibalāguḍūcī punarnavāragvadhadēvadāru|

bhāgāḥ palāṁśā madanāṣṭayuktā jaladvikaṁsē kvathitē'ṣṭaśēṣē||39||

pēṣyāḥ śatāhvā hapuṣā priyaṅguḥ sapippalīkaṁ madhukaṁ balā ca|

rasāñjanaṁ vatsakabījamustaṁ bhāgākṣamātraṁ lavaṇāṁśayuktam||40||

samākṣikastailayutaḥ samūtrō bastirnr̥ṇāṁ dīpanalēkhanīyaḥ|

jaṅghōrupādatrikapr̥ṣṭhaśūlaṁ kaphāvr̥tiṁ mārutanigrahaṁ ca||41||

viṇmūtravātagrahaṇaṁ saśūlamādhmānatāmaśmariśarkarē ca|

ānāhamarśōgrahaṇīpradōṣānēraṇḍabastiḥ śamayēt prayuktaḥ||42||

catuṣpalē tailaghr̥tasya bhr̥ṣṭācchāgācchatārdhō dadhidāḍimāmlaḥ|

rasaḥ sapēṣyō balamāṁsavarṇarētōgnidaścāndhyaśirōrtiśastaḥ ||43||

jaladvikaṁsē'ṣṭapalaṁ palāśāt paktvā rasō'rdhāḍhakamātraśēṣaḥ|

kalkairvacāmāgadhikāpalābhyāṁ yuktaḥ śatāhvādvipalēna cāpi||44||

sasaindhavaḥ kṣaudrayutaḥ satailō dēyō nirūhō balavarṇakārī|

ānāhapārśvāmayayōnidōṣān gulmānudāvartarujaṁ ca hanyāt||45||

eraNDamUlaM tripalaM palAshA hrasvAni mUlAni ca yAni pa~jca||38||

rAsnAshvagandhAtibalAguDUcI punarnavAragvadhadevadAru|

bhAgAH palAMshA madanAShTayuktA jaladvikaMse kvathite~aShTasheShe||39||

peShyAH shatAhvA hapuShA priya~gguH sapippalIkaM madhukaM balA ca|

rasA~jjanaM vatsakabIjamustaM bhAgAkShamAtraM lavaNAMshayuktam||40||

samAkShikastailayutaH samUtro bastirnRuNAM dIpanalekhanIyaH|

ja~gghorupAdatrikapRuShThashUlaM kaphAvRutiM mArutanigrahaM ca||41||

viNmUtravAtagrahaNaM sashUlamAdhmAnatAmashmarisharkare ca|

AnAhamarshograhaNIpradoShAneraNDabastiH shamayet prayuktaH||42||

catuShpale tailaghRutasya bhRuShTAcchAgAcchatArdho dadhidADimAmlaH|

rasaH sapeShyo balamAMsavarNaretognidashcAndhyashirortishastaH ||43||

jaladvikaMse~aShTapalaM palAshAt paktvA raso~ardhADhakamAtrasheShaH|

kalkairvacAmAgadhikApalAbhyAM yuktaH shatAhvAdvipalena cApi||44||

sasaindhavaH kShaudrayutaH satailo deyo nirUho balavarNakArI|

AnAhapArshvAmayayonidoShAn gulmAnudAvartarujaM ca hanyAt||45||
{| class="wikitable" style="text-align: center;
|-
! scope="col"| ''Dravya''
! scope="col"| Dose
|-
| ''Madhu''
| 1.5 ''Prasrita''
|-
| ''Saindhava''
| 1 ''Karsha''
|-
| ''Sneha-taila''
| 3 ''Prasrita''
|-
| ''Kalka dravya-shatahva, hapusha, priyangu, pippali, madhuka, bala, rasanjana, vatsaka bija, musta''.
| 1 ''Prasrita''
|-
| ''Kvatha dravya-erandamūla''-3 ''pala, palasha, laghupanchamula, rasna, ashvagandha, atibala, guduchi, punarnava, aragvadha, devadaru'' (1 ''Pala'' each), ''madanaphala''-8, ''jala''-2 ''adhaka''; reduced to 1/8th
| 4 ''Prasrita''
|-
| ''Avapa-gomutra''
| 2 ''Prasrita''
|}

''Guna''- ''Dipana, lekhana,'' relieves the ''shula'' of ''uru, jangha, pada, prushtha'' and ''trik''. It pacifies the ''kaphavrita vata, vid-mutra-vata graha, adhmana, anaha, ashmari, sharkara, arsha, & grahanii dosha''. [38-45]

यष्ट्याह्वयस्याष्टपलेन सिद्धं पयः शताह्वाफलपिप्पलीभिः|

युक्तं ससर्पिर्मधु वातरक्तवैस्वर्यवीसर्पहितो निरूहः||४६||

यष्ट्याह्वलोध्राभयचन्दनैश्च शृतं पयोऽग्र्यं कमलोत्पलैश्च|

सशर्करं क्षौद्रयुतं सुशीतं पित्तामयान् हन्ति सजीवनीयम्||४७||

yaṣṭyāhvayasyāṣṭapalēna siddhaṁ payaḥ śatāhvāphalapippalībhiḥ|

yuktaṁ sasarpirmadhu vātaraktavaisvaryavīsarpahitō nirūhaḥ||46||

yaṣṭyāhvalōdhrābhayacandanaiśca śr̥taṁ payō'gryaṁ kamalōtpalaiśca|

saśarkaraṁ kṣaudrayutaṁ suśītaṁ pittāmayān hanti sajīvanīyam||47||

yaShTyAhvayasyAShTapalena siddhaM payaH shatAhvAphalapippalIbhiH|

yuktaM sasarpirmadhu vAtaraktavaisvaryavIsarpahito nirUhaH||46||

yaShTyAhvalodhrAbhayacandanaishca shRutaM payo~agryaM kamalotpalaishca|

sasharkaraM kShaudrayutaM sushItaM pittAmayAn hanti sajIvanIyam||47||

{| class="wikitable" style="text-align: center;
|-
! scope="col"| ''Dravya''
! scope="col"| Dose
|-
| ''Madhu''
| 2 ''Madhu-prasrita''
|-
| ''Saindhava''
| 1 ''Karsha''
|-
| ''Sneha-ghrita''
| 2 ''Prasrita''
|-
| ''Kalka jeevaniya gana''
| 1 ''Prasrita''
|-
| ''Kwatha dravya-ksheerapaakaartha kalka dravya- yashthi, lodhra, usheera, chandana, padma, utpala''
| 4 ''Prasrita''
|-
| ''Avapa-sharkara''
|
|}

''Guna- Pitta roga naashaka''[46-47]

द्विकार्षिकाश्चन्दनपद्मकर्धियष्ट्याह्वरास्नावृषसारिवाश्च|

सलोध्रमञ्जिष्ठमथाप्यनन्ताबलास्थिरादितृणपञ्चमूलम् ||४८||

तोये समुत्क्वाथ्य रसेन तेन शृतं पयोऽर्धाढकमम्बुहीनम्|

जीवन्तिमेदर्धिशतावरीभिर्वीराद्विकाकोलिकशेरुकाभिः||४९||

सितोपलाजीवकपद्मरेणु प्रपौण्डरीकैः कमलोत्पलैश्च|

लोध्रात्मगुप्तामधुकैर्विदारीमुञ्जातकैः केशरचन्दनैश्च||५०||

पिष्टैर्घृतक्षौद्रयुतैर्निरूहं ससैन्धवं शीतलमेव दद्यात्|

प्रत्यागते धन्वरसेन शालीन् क्षीरेण वाऽद्यात् परिषिक्तगात्रः||५१||

दाहातिसारप्रदरास्रपित्तहृत्पाण्डुरोगान् विषमज्वरं च|

सगुल्ममूत्रग्रहकामलादीन् सर्वामयान् पित्तकृतान्निहन्ति||५२||

dvikārṣikāścandanapadmakardhiyaṣṭyāhvarāsnāvr̥ṣasārivāśca|

salōdhramañjiṣṭhamathāpyanantābalāsthirāditr̥ṇapañcamūlam ||48||

tōyē samutkvāthya rasēna tēna śr̥taṁ payō'rdhāḍhakamambuhīnam|

jīvantimēdardhiśatāvarībhirvīrādvikākōlikaśērukābhiḥ||49||

sitōpalājīvakapadmarēṇu prapauṇḍarīkaiḥ kamalōtpalaiśca|

lōdhrātmaguptāmadhukairvidārīmuñjātakaiḥ kēśaracandanaiśca||50||

piṣṭairghr̥takṣaudrayutairnirūhaṁ sasaindhavaṁ śītalamēva dadyāt|

pratyāgatē dhanvarasēna śālīn kṣīrēṇa vā'dyāt pariṣiktagātraḥ||51||

dāhātisārapradarāsrapittahr̥tpāṇḍurōgān viṣamajvaraṁ ca|

sagulmamūtragrahakāmalādīn sarvāmayān pittakr̥tānnihanti||52||

dvikArShikAshcandanapadmakardhiyaShTyAhvarAsnAvRuShasArivAshca|

salodhrama~jjiShThamathApyanantAbalAsthirAditRuNapa~jcamUlam ||48||

toye samutkvAthya rasena tena shRutaM payo~ardhADhakamambuhInam|

jIvantimedardhishatAvarIbhirvIrAdvikAkolikasherukAbhiH||49||

sitopalAjIvakapadmareNu prapauNDarIkaiH kamalotpalaishca|

lodhrAtmaguptAmadhukairvidArImu~jjAtakaiH kesharacandanaishca||50||

piShTairghRutakShaudrayutairnirUhaM sasaindhavaM shItalameva dadyAt|

pratyAgate dhanvarasena shAlIn kShIreNa vA~adyAt pariShiktagAtraH||51||

dAhAtisArapradarAsrapittahRutpANDurogAn viShamajvaraM ca|

sagulmamUtragrahakAmalAdIn sarvAmayAn pittakRutAnnihanti||52||

{| class="wikitable" style="text-align: center;
|-
! scope="col"| ''Dravya''
! scope="col"| Dose
|-
| ''Madhu''
| 2 ''Madhu-prasrita''
|-
| ''Saindhava''
| 1 ''Karsha''
|-
| ''Sneha-ghrita''
| 2 ''Prasrita''
|-
| ''Kalka dravya- Jivanti, Meda, Vriddhi, Shatavari, Kshiravidari, Kakoli, Kasheru, Mishri, Jivaka, Kamala Kesara, Pundarika kashtha, Rakta Kamala, Nila Kamala, Atmagupta, Yashti,Vidarikanda, Munjataka, Nagakesara, Chandana''
| 1 ''Prasrita''
|-
| ''Kvatha dravya- Chandana, Padmakashtha, Vriddhi, Yashti, Rasna, Vasa, Anantamula, Lodhra,Manjishtha, Ananta, Balamula, Sthiradi Varga, Trunapanchamula'' (2 ''Tola'' each)''Jala''-8 parts; reduced to 1/4th ''Kshira''-½ Adhaka; Boiled till ''Kshiravasesha''.
| 4 ''Prasrita''
|}

''Guna''- destroys ''daha, atisara, pradara, raktapitta, hrodroga, pandu roga, vishama jwara, gulma, mūtrakricchra, kaamala'' and ''pittaja vikara''.[48-52]

द्राक्षादिकाश्मर्यमधूकसेव्यैः ससारिवाचन्दनशीतपाक्यैः|

पयः शृतं श्रावणिमुद्गपर्णीतुगात्मगुप्तामधुयष्टिकल्कैः||५३||

गोधूमचूर्णैश्च तथाऽक्षमात्रैः सक्षौद्रसर्पिर्मधुयष्टितैलैः|

पथ्याविदारीक्षुरसैर्गुडेन बस्तिं युतं पित्तहरं विदध्यात्||५४||

हृन्नाभिपार्श्वोत्तमदेहदाहे दाहेऽन्तरस्थे च सकृच्छ्रमूत्रे|

क्षीणे क्षते रेतसि चापि नष्टे पैत्तेऽतिसारे च नृणां प्रशस्तः||५५||

drākṣādikāśmaryamadhūkasēvyaiḥ sasārivācandanaśītapākyaiḥ|

payaḥ śr̥taṁ śrāvaṇimudgaparṇītugātmaguptāmadhuyaṣṭikalkaiḥ||53||

gōdhūmacūrṇaiśca tathā'kṣamātraiḥ sakṣaudrasarpirmadhuyaṣṭitailaiḥ|

pathyāvidārīkṣurasairguḍēna bastiṁ yutaṁ pittaharaṁ vidadhyāt||54||

hr̥nnābhipārśvōttamadēhadāhē dāhē'ntarasthē ca sakr̥cchramūtrē|

kṣīṇē kṣatē rētasi cāpi naṣṭē paittē'tisārē ca nr̥ṇāṁ praśastaḥ||55||

drAkShAdikAshmaryamadhUkasevyaiH sasArivAcandanashItapAkyaiH|

payaH shRutaM shrAvaNimudgaparNItugAtmaguptAmadhuyaShTikalkaiH||53||

godhUmacUrNaishca tathA~akShamAtraiH sakShaudrasarpirmadhuyaShTitailaiH|

pathyAvidArIkShurasairguDena bastiM yutaM pittaharaM vidadhyAt||54||

hRunnAbhipArshvottamadehadAhe dAhe~antarasthe ca sakRucchramUtre|

kShINe kShate retasi cApi naShTe paitte~atisAre ca nRuNAM prashastaH||55||

{| class="wikitable" style="text-align: center;
|-
! scope="col"| Dravya
|-
| ''Kvatha Dravya: kshīrapākārtha dravya-draksha, kashmarya, madhuka, sariva, chandana
kalka dravyas- mundi, mudgaparni, vamshalochana, kapikachu,yastimadhu, godhooma choorna.
madhu, ghritha, vidaryadi swarasa, ikshu rasa''
|}

Indications:

''Daha, antardaha, pittaja atisara, mutrkricchra, kshataksheena, shukrakshaya'' [53-55]

कोषातकारग्वधदेवदारुशार्ङ्गेष्टमूर्वाकुटजार्कपाठाः |

पक्त्वा कुलत्थान् बृहतीं च तोये रसस्य तस्य प्रसृता दश स्युः||५६||

तान् सर्षपैलामदनैः सकुष्ठैरक्षप्रमाणैः प्रसृतैश्च युक्तान्|

फलाह्वतैलस्य समाक्षिकस्य क्षारस्य तैलस्य च सार्षपस्य||५७||

दद्यान्निरूहं कफरोगिणे ज्ञो मन्दाग्नये चाप्यशनद्विषे च|

kōṣātakāragvadhadēvadāruśārṅgēṣṭamūrvākuṭajārkapāṭhāḥ |

paktvā kulatthān br̥hatīṁ ca tōyē rasasya tasya prasr̥tā daśa syuḥ||56||

tān sarṣapailāmadanaiḥ sakuṣṭhairakṣapramāṇaiḥ prasr̥taiśca yuktān|

phalāhvatailasya samākṣikasya kṣārasya tailasya ca sārṣapasya||57||

dadyānnirūhaṁ kapharōgiṇē jñō mandāgnayē cāpyaśanadviṣē ca|

koShAtakAragvadhadevadArushAr~ggeShTamUrvAkuTajArkapAThAH |

paktvA kulatthAn bRuhatIM ca toye rasasya tasya prasRutA dasha syuH||56||

tAn sarShapailAmadanaiH sakuShThairakShapramANaiH prasRutaishca yuktAn|

phalAhvatailasya samAkShikasya kShArasya tailasya ca sArShapasya||57||

dadyAnnirUhaM kapharogiNe j~jo mandAgnaye cApyashanadviShe ca|

{| class="wikitable" style="text-align: center;
|-
! scope="col"| ''Dravya''
! scope="col"| Dose
|-
| ''Madhu''
| 1 ''Prasrita''
|-
| ''Saindhava''
| 1 ''Karsha''
|-
| ''Sneha-madanaphala siddha taila, sarshapa taila''
| 2 ''Pala'', 1 ''Prasrita''
|-
| ''Kalka sarshapa, ela, madanaphala, kushtha'' (1 ''karsha'' each)
| 1 ''Prasrita''
|-
| ''Kvatha dravya- koshātaki, aragvadha, arkamūla, devadāru, gunjā, murvā, kuţaja, pāţhā, kulattha, kanţhakāri'' (2 ''Pala'' each) + water 8 parts; reduced to 1/8th
| 5 ''Prasrita''
|-
| ''Avapa- yava kshāra''
| 1 ''Karsha''
|-
| ''Amla dravya'' (''kānji'')
| 1 ''Prasrita''
|}

''Guna- kapha roga, mandāgni, anna dvesha''.[56-571/2]

पटोलपथ्यामरदारुभिर्वा सपिप्पलीकैः क्वथितैर्जलेऽग्नौ||५८||

द्विपञ्चमूले त्रिफलां सबिल्वां फलानि गोमूत्रयुतः कषायः|

कलिङ्गपाठाफलमुस्तकल्कः ससैन्धवः क्षारयुतः सतैलः||५९||

निरूहमुख्यः कफजान् विकारान् सपाण्डुरोगालसकामदोषान्|

हन्यात्तथा मारुतमूत्रसङ्गं बस्तेस्तथाऽऽटोपमथापि घोरम्||६०||

paṭōlapathyāmaradārubhirvā sapippalīkaiḥ kvathitairjalē'gnau||58||

dvipañcamūlē triphalāṁ sabilvāṁ phalāni gōmūtrayutaḥ kaṣāyaḥ|

kaliṅgapāṭhāphalamustakalkaḥ sasaindhavaḥ kṣārayutaḥ satailaḥ||59||

nirūhamukhyaḥ kaphajān vikārān sapāṇḍurōgālasakāmadōṣān|

hanyāttathā mārutamūtrasaṅgaṁ bastēstathā''ṭōpamathāpi ghōram||60||

paTolapathyAmaradArubhirvA sapippalIkaiH kvathitairjale~agnau||58||

dvipa~jcamUle triphalAM sabilvAM phalAni gomUtrayutaH kaShAyaH|

kali~ggapAThAphalamustakalkaH sasaindhavaH kShArayutaH satailaH||59||

nirUhamukhyaH kaphajAn vikArAn sapANDurogAlasakAmadoShAn|

hanyAttathA mArutamUtrasa~ggaM bastestathA~a~aTopamathApi ghoram||60||

{| class="wikitable" style="text-align: center;
|-
! scope="col"| ''Dravya''
! scope="col"| Dose
|-
| ''Madhu''
| 1 ''Prasrita''
|-
| ''Saindhava''
| 1 ''Karsha''
|-
| ''Sneha-madanaphala siddha taila, sarshapa taila''
| 2 ''Pala'', 1 ''Prasrita''
|-
| ''Kalka sarshapa, ela, madanaphala, kushtha'' (1 ''karsha'' each)
| 1 ''Prasrita''
|-
| ''Kvatha Dravya- Patola, Haritaki, Pippali, Devadaru'' + 8 parts of ''Jala'', reduced to 1/8th
| 5 ''Prasrita''
|-
| ''Avapa-yava kshāra''
| 1 ''Karsha''
|-
| ''Amla dravya'' (kānji)
| 1 ''Prasrita''
|}

''Guņa- kapha roga, pandu roga, alasaka, aam dosha, maruta sanga, mutra sanga, basti atopa''.[58-60]

रास्नामृतैरण्डविडङ्गदार्वीसप्तच्छदोशीरसुराह्वनिम्बैः|

शम्पाकभूनिम्बपटोलपाठातिक्ताखुपर्णीदशमूलमुस्तैः||६१||

त्रायन्तिकाशिग्रुफलत्रिकैश्च क्वाथः सपिण्डीतकतोयमूत्रः|

यष्ट्याह्वकृष्णाफलिनीशताह्वारसाञ्जनश्वेतवचाविडङ्गैः||६२||

कलिङ्गपाठाम्बुदसैन्धवैश्च कल्कैः ससर्पिर्मधुतैलमिश्रः|

अयं निरूहः क्रिमिकुष्ठमेहब्रध्नोदराजीर्णकफातुरेभ्यः||६३||

रूक्षौषधैरप्यपतर्पितेभ्य एतेषु रोगेष्वपि सत्सु दत्तः|

निहत्य वातं ज्वलनं प्रदीप्य विजित्य रोगांश्च बलं करोति||६४||

rāsnāmr̥tairaṇḍaviḍaṅgadārvīsaptacchadōśīrasurāhvanimbaiḥ|

śampākabhūnimbapaṭōlapāṭhātiktākhuparṇīdaśamūlamustaiḥ||61||

trāyantikāśigruphalatrikaiśca kvāthaḥ sapiṇḍītakatōyamūtraḥ|

yaṣṭyāhvakr̥ṣṇāphalinīśatāhvārasāñjanaśvētavacāviḍaṅgaiḥ||62||

kaliṅgapāṭhāmbudasaindhavaiśca kalkaiḥ sasarpirmadhutailamiśraḥ|

ayaṁ nirūhaḥ krimikuṣṭhamēhabradhnōdarājīrṇakaphāturēbhyaḥ||63||

rūkṣauṣadhairapyapatarpitēbhya ētēṣu rōgēṣvapi satsu dattaḥ|

nihatya vātaṁ jvalanaṁ pradīpya vijitya rōgāṁśca balaṁ karōti||64||

rAsnAmRutairaNDaviDa~ggadArvIsaptacchadoshIrasurAhvanimbaiH|

shampAkabhUnimbapaTolapAThAtiktAkhuparNIdashamUlamustaiH||61||

trAyantikAshigruphalatrikaishca kvAthaH sapiNDItakatoyamUtraH|

yaShTyAhvakRuShNAphalinIshatAhvArasA~jjanashvetavacAviDa~ggaiH||62||

kali~ggapAThAmbudasaindhavaishca kalkaiH sasarpirmadhutailamishraH|

ayaM nirUhaH krimikuShThamehabradhnodarAjIrNakaphAturebhyaH||63||

rUkShauShadhairapyapatarpitebhya eteShu rogeShvapi satsu dattaH|

nihatya vAtaM jvalanaM pradIpya vijitya rogAMshca balaM karoti||64||

{| class="wikitable" style="text-align: center;
|-
! scope="col"| ''Dravya''
! scope="col"| Dose
|-
| ''Madhu''
| 3 ''Prasrita''
|-
| ''Saindhava''
| 1 ''Karsha''
|-
| ''Sneha-Ghrita, Taila''
| 2 ''Prasrita''
|-
| ''Kalka Dravya- Madanaphala, Sugandhavala, Gomutra, Yashti, Pippali, Priyangu, Satahva, Rasanjana, Sveta Vacha, Vidanga, Kalinga, Patha, Musta.''
| 1 ''Prasrita''
|-
| ''Kvatha Dravya- Rasna, Eranda, Guduchi, Nimba, Patola, Patha,Katuki, Kirata, Vidanga, Daruharidra, Saptacchada, Usira, Devadaru, Aragvadha, Mushakakarni, Dasamula, Musta, Trayamana, Sighru, Triphala'' + 8 parts of ''Jala''; reduced to 1/4th
| 5 ''Prasrita''
|-
| ''Avapa – Gomutra''
|
|}

''Guņa''- Indicated in ''krimi, kushţha, prameha, bradhna, udara, ajīrņa, kapha roga''. Can also be given in ''apatarpita rogi'' due to ''ruksha aushadha''. It pacifies the ''vata'', increases ''agni'' & ''bala''.[61-64]

पुनर्नवैरण्डवृषाश्मभेदवृश्चीरभूतीकबलापलाशाः |

द्विपञ्चमूलं च पलांशिकानि क्षुण्णानि धौतानि फलानि चाष्टौ||६५||

बिल्वं यवान् कोलकुलत्थधान्यफलानि चैव प्रसृतोन्मितानि|

पयोजलद्व्याढकवच्छृतं तत् क्षीरावशेषं सितवस्त्रपूतम्||६६||

वचाशताह्वामरदारुकुष्ठयष्ट्याह्वसिद्धार्थकपिप्पलीनाम् |

कल्कैर्यवान्या मदनैश्च युक्तं नात्युष्णशीतं गुडसैन्धवाक्तम्||६७||

क्षौद्रस्य तैलस्य च सर्पिषश्च तथैव युक्तं प्रसृतैस्त्रिभिश्च |

दद्यान्निरूहं विधिना विविज्ञः स सर्वसंसर्गकृतामयघ्नः||६८||

punarnavairaṇḍavr̥ṣāśmabhēdavr̥ścīrabhūtīkabalāpalāśāḥ |

dvipañcamūlaṁ ca palāṁśikāni kṣuṇṇāni dhautāni phalāni cāṣṭau||65||

bilvaṁ yavān kōlakulatthadhānyaphalāni caiva prasr̥tōnmitāni|

payōjaladvyāḍhakavacchr̥taṁ tat kṣīrāvaśēṣaṁ sitavastrapūtam||66||

vacāśatāhvāmaradārukuṣṭhayaṣṭyāhvasiddhārthakapippalīnām |

kalkairyavānyā madanaiśca yuktaṁ nātyuṣṇaśītaṁ guḍasaindhavāktam||67||

kṣaudrasya tailasya ca sarpiṣaśca tathaiva yuktaṁ prasr̥taistribhiśca |

dadyānnirūhaṁ vidhinā vivijñaḥ sa sarvasaṁsargakr̥tāmayaghnaḥ||68||

punarnavairaNDavRuShAshmabhedavRushcIrabhUtIkabalApalAshAH |

dvipa~jcamUlaM ca palAMshikAni kShuNNAni dhautAni phalAni cAShTau||65||

bilvaM yavAn kolakulatthadhAnyaphalAni caiva prasRutonmitAni|

payojaladvyADhakavacchRutaM tat kShIrAvasheShaM sitavastrapUtam||66||

vacAshatAhvAmaradArukuShThayaShTyAhvasiddhArthakapippalInAm |

kalkairyavAnyA madanaishca yuktaM nAtyuShNashItaM guDasaindhavAktam||67||

kShaudrasya tailasya ca sarpiShashca tathaiva yuktaM prasRutaistribhishca |

dadyAnnirUhaM vidhinA vivij~jaH sa sarvasaMsargakRutAmayaghnaH||68||

{| class="wikitable" style="text-align: center;
|-
! scope="col"| ''Dravya''
! scope="col"| Dose
|-
| ''Madhu''
| 1 ''Prasrita''
|-
| ''Saindhava''
| 1 ''Karsha''
|-
| ''Sneha-Ghrita, Taila''
| 2 ''Prasrita''
|-
| ''Kalka Dravya- Vacha, Satahva, Devadaru, Kushtha, Yashti, Sarshapa, Pippali, Ajamoda, Madanaphala,Gud''a
| 1 ''Prasrita''
|-
| ''Kvatha Dravya- Punarnava, Eranda, Bala, Vasa, Pashanabheda, Rakta Punarnava, Palasa,Dasamula'' (Each 1 ''Pala'') ''Madanaphala''-8 ''Bilva Majja, kulattha, Yava, Badara'', + 1 '''Adhaka Jala''' + 1 ''Adhaka Kshira''; Reduced to ''kshiravasesha''
| 5 ''Prasrita''
|}

''Guņa- Tridoshaja and dvandaja roga nāshaka.''[65-68]

==== Maximum numbers of ''niruha basti'' ====

स्निग्धोष्ण एकः पवने समांसो द्वौ स्वादुशीतौ पयसा च पित्ते|

त्रयः समूत्राः कटुकोष्णतीक्ष्णाः कफे निरूहा न परं विधेयाः||६९||

snigdhōṣṇa ēkaḥ pavanē samāṁsō dvau svāduśītau payasā ca pittē|

trayaḥ samūtrāḥ kaṭukōṣṇatīkṣṇāḥ kaphē nirūhā na paraṁ vidhēyāḥ||69||

snigdhoShNa ekaH pavane samAMso dvau svAdushItau payasA ca pitte|

trayaH samUtrAH kaTukoShNatIkShNAH kaphe nirUhA na paraM vidheyAH||69||

The number of ''niruha basti'' is as follows-

''Vataja roga - snigdha, ushņa, mamsarasayukta'' – 1

''Pittaja roga - madhura, sheeta , dugdha'' – 2

''Kaphaja roga- mutra, katu, ushņa, tīkshņa'' - 3

''Niruha basti'' should not be given in excess of these specified numbers.[69]

==== Follow up diet for ''dosha'' dominance ====

रसेन वाते प्रतिभोजनं स्यात् क्षीरेण पित्ते तु कफे च यूषैः|

तथाऽनुवास्येषु च बिल्वतैलं स्याज्जीवनीयं फलसाधितं च||७०||

इतीदमुक्तं निखिलं यथावद्बस्तिप्रदानस्य विधानमग्र्यम्|

योऽधीत्य विद्वानिह बस्तिकर्म करोति लोके लभते स सिद्धिम्||७१||

rasēna vātē pratibhōjanaṁ syāt kṣīrēṇa pittē tu kaphē ca yūṣaiḥ|

tathā'nuvāsyēṣu ca bilvatailaṁ syājjīvanīyaṁ phalasādhitaṁ ca||70||

itīdamuktaṁ nikhilaṁ yathāvadbastipradānasya vidhānamagryam|

yō'dhītya vidvāniha bastikarma karōti lōkē labhatē sa siddhim||71||

rasena vAte pratibhojanaM syAt kShIreNa pitte tu kaphe ca yUShaiH|

tathA~anuvAsyeShu ca bilvatailaM syAjjIvanIyaM phalasAdhitaM ca||70||

itIdamuktaM nikhilaM yathAvadbastipradAnasya vidhAnamagryam|

yo~adhItya vidvAniha bastikarma karoti loke labhate sa siddhim||71||

After the return of ''niruha basti, mamsarasa, ksheera,'' and ''yusha'' should be given along with rice in ''vata, pitta,'' and ''kapha'' diseases respectively. After prescribed light meal, in persons fit for ''anuvasana'' with ''bilva taila, jeevaniya taila'' and ''madanaphala siddha taila'' should be given in ''vata, pitta'' and ''kapha'' diseases respectively. Here the complete details of best practices of ''basti'' administration are described; the intelligent physician who adopts it in practice will get success in the world. [70-71]

Thus ends the chapter [[Bastisutriyam Siddhi]]

=== ''Tattva Vimarsha'' ===

*Careful examination of ''dosha'' (vitiating factors), ''aushadha'' (potency of drugs), ''desha'' (place of living and body of patient), ''kala'' (season and time of administration), ''satmya'' (accustom), ''agni'' (factor responsible for process of digestion and metabolism), ''sattva'' (mind), ''oka'' (accustom due to continuous use), ''vaya'' (age) and ''bala'' (strength) is essential for success of ''basti'' therapy (enema). [Verse 6]
*The size, shape of enema apparatus should be decided as per patient’s ano-rectal dimensions.
*The sequence of adding ''madhu'' (honey), ''saindhava'' (rock salt), then ''sneha'' followed by ''kalka'' (paste of herbs), ''kashaya'' (decoction) and ''avapa'' (additional powdered medicine) is important to prepare a ''basti'' formulation.
*''Basti'' shall always be administered when the patient is lying in left lateral position.
*Incorrect insertion of nozzle into anal canal, faulty enema pot, incorrect administration of ''basti'' may lead to complications.
*Penetration and distribution of ''basti'' drugs increases as the number of consequently given ''basti'' increases. The first enema helps in the elimination of ''vata dosha'' from its own site i.e. from large intestine; the second enema helps in the elimination of ''pitta dosha'' from its site i.e. small intestine and duodenum, and the third enema helps in the elimination of ''kapha'' from its site i.e. stomach and upper gastro-intestinal tract.
*The follow-up diet and lifestyle instructions are important to be followed by patient in order to achieve maximum efficacy of ''basti''.
*The proportion of decoction in preparation of ''basti'' formulation shall be decided as per ''dosha'' dominance.
*The dose of ''basti'' differs according to age of patient. The minimum dose for patient of one year is half ''prasrita'' (approximately 40 ml) and maximum dose from age 18 years to 70 years is twelve ''prasrita'' (approximately 960 ml).

=== ''Vidhi Vimarsha'' ===

==== Factors to be considered before ''basti'' administration ====

Ten fold examination is advised before the administration of ''basti''. These examinations are slightly different from the ''dashavisha pariksha'' explained in the [[Vimana Sthana]].

''Basti'' should be administered after considering ''kala'' (''teekshna'' in ''sheeta kala, mridu'' in ''ushna kala''), ''bala, dosha'' (''teekshnadi basti'' in ''uttamadi bala'' of ''dosha''), ''roga'' (''teekshna, madhyama, mridu basti'' in ''uttamadi bala'' of ''dosha'', ''teekshna'' in ''kapha vata, mridu'' in ''raktapitta'', and ''madhyama'' in ''kaphapitta'')<ref>Dalhana, Commentator. Sushruta Samhita, Chikitsa Samhita, 38/71, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref> (Verse 6)

==== Age wise differentiation ====

While describing the age of the patient as 6, 20 and 12, the sequence changed to emphasize the fact that before 6th year and after 20th year of age there should be no variation in the size of ''netra'' (nozzle). After the 6th year, the size of the ''netra'' should be increased 1/3rd ''angula'' every year. Thus for the 12th year of age, the size of the ''netra'' becomes 8 ''angula''. After 12th year of age, the size should be increased ½ ''angula'' every year. Thus for a patient of 20 year age the size of ''netra'' becomes 12 ''angula''.

For 20 year old patient, the size of the ''calibre'' (diameter) of the opening in the nozzle should be of the diameter of a seed of ''karkandhu'' (''karkandhu vahi''). This ''karkandhu'' is ''srigala badari'' which is smaller in size. Keeping this in view Sushruta stated that the diameter of ''netra'' should allow the passage of ''kolasthi'' (seed of ''kola''). If, ''karkandhu'' is interpreted as ''brihad badari'' (big jujube fruit), then its size will be larger than the opening of ''netra'' and hence, In view of this contradiction, some ''vaidya'' interpret the term kola as the pulp inside the seed of fruit ''kolasthi majja'' which is obviously smaller in size.

The mouth of the ''netra'' is plugged with a ''varti'' to prevent foreign matter to enter into it when not in use.

One of the ''karnika'' fixed at level of 1/4th ''angula'' from the ''agrabhaga'' (anterior or rectal end) to limit the entry of ''netra'' beyond the ''guda vali''. The other 2 ''karnika'' placed at the ''mula bhaga'' (posterior or ''putaka'' end) will help in tying the ''basti putaka''.<ref>Chakrapanidutta, Commentator. Charak samhita, Siddhi Sthana, 3/8-10, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

''Vriņa basti netra''- 8 ''angula'' & ''mudgavahi srota'' at ''agrabhāga''.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 35/11, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

'''Table showing measurements of Basti Netra<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 35/7-11, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>'''

==== ''Basti yantra'' (instrument used for administration of enema) ====
In present practice enema can or pot are used for administering the ''niruha basti'' as it is having following advantages over the classical ''basti yantra''.
*Easy & simple to administer
*Easy for cleaning
*Sterile and disposable and hence no chances of infection

In olden days due to non availability of rubber, the use of metallic nozzle as ''basti netra'' was seen. Texts have have given freedom for the changes if better options are available. Some conservative Ayurvedic practitioners believe that ''basti'' given by ''basti netra'' provides better result than the methods that are used in current practice. Vaidya H.S.Kasture has disapproved this fact by saying that among the 17 lakh ''basti'' given using the enema pot and enema catheter by him (till 2005) he has observed same efficacy as that of classical ''basti yantra'' except for a very few complications due to the enema pot and catheter (lecture given at national seminar held in 2005 at Jamnagar). In a research work carried out by Juneja.Y et.al. (Jamnagar, 2008)<ref>Juneja.Y et.al. Standardization of procedure of administration of Basti w.s.r. to Kshinashukra (oligozoospermia), Gujrat Ayured University, Jamnagar, 2008</ref> have concluded work that ''basti'' administered by classical ''yantra'' and enema pot - rubber catheter provided same effect. Considering all these it can be concluded that the use of enema pot and catheter is simple, economical, safe, and free from complications.(verse 10-11)

==== Time of administration ====

''Shukla paksha'' of a lunar month is auspicious for initiating all good activities. Planning of ''basti'' according to ''paksha'' may not be practical in diseased. It may be ideally adopted in healthy.

''Harita'' has described ''krishna paksha'' of lunar month is suitable for the ''basti prayoga'' because, all the diseases treated during this period get cured forever (radical cure) and the Gods appear during the ''shukla paksha'' where as demons as well as diseases appear during the ''krishna paksha''. Therefore, according to Harita, diseases should be treated during ''krishna paksha''.)<ref>Chakrapanidutta, Commentator. Charak samhita, Siddhi Sthana, 3/12-13, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> (Verse 12 -13)

==== Precautions during administration of enema ====

The ''basti dravya'' should be administered in one squeeze or compress. If there is interruption, and the ''putaka'' is compressed again to push the remaining ''basti dravya'' into rectum, then there is possibility of entry of air into the ''pakvashaya'' which is not desirable.<ref>Chakrapanidutta, Commentator. Charak samhita, Siddhi Sthana, 3/13-20, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> (Verse 13-19)

===== ''Kalka'' =====

''Putoyavanyadi kalka'':

{|class = "wikitable"
|-
!scope = "col"| Name of drug
!scope = "col"| Botanical Name
!scope = "col"| Parts used
|-
|''Puto Yavani''
|Tachyspermum ammi
|Seeds
|-
|''Madanaphala''
|Randia Duamtorum
|Whole dried fruit
|-
|''Bilva''
|Aegle marmaleos
|Root
|-
|''Kushta''
|Sasuurea Lappa
|Root
|-
|''Vacha''
|Acorus calomus
|Rhizome
|-
|''Shatapushpa''
|Anethum Graveolense
|Seeds
|-
|''Musta''
|Cypurus rotundus
|Tuber
|-
|''Pippali''
|Piper longum
|Dried seeds
|-
|}

This is most commonly used ''kalka'' in the ''niruha'' described by Charak. Whenever there is no mention of ''kalka dravya'', then it should be used. It is having ''vata-kaphahara, vatanulomana, malanulomana, deepana, pachana, srotoshodhana'' properties.

According to the condition, ''hinguvachadi, shaddharana, vaishvanara churna'' can also be used.

===== Preparation of ''kalka'' =====

Very fine powder of the prescribed drug are taken in ''khalva'' and combined one by one with the pestle. Add warm water to the powder and mash the mixture with pestle for 1-2 minutes. Now ''kalka'' is ready for use.

===== Dose of ''kalka'' =====

*Charak has not mentioned the dose of ''kalka''
*Sushruta mentions it as one ''prasrita''
*According to Vriddha Vagbhata, 1/8th of 12 ''prasrita''=1.5 ''prasrita''
*Jatukarna, Vrinda Madhava, Chakrapani told two ''Pala''

===== Utility of ''kalka'' =====

*''Kalka'' confers the viscosity (''sandrata'') to the ''basti dravya'' and will not change the volume.
*''Kalka'' helps in retention of enema
*''Kalka'' helps in ''pratyagamana'' (return)of ''basti dravya'' within the stipulated time
*Prevents ''ayoga'' (insufficient action), ''adhmana'' (flatulence) etc. ''upadrava''

==== Rationale for mixing sequence of ''basti'' ====

*''Madhu''- ''mangalakaraka'' auspicious
*''Saindhava''- disintegrates (''bhedana'') the ''picchilata, bahulatva'' and ''kashayatva'' of ''madhu''
*''Sneha''- ''ekibhavaya kalpate'' (homogeneous)
*''Kalka''- ''samsrujyate cha ashu'' (quickly disperses & mixes)
*''Kashaya'' for ''samatam vrajet'' (mixture becomes homogenous)
*''Mutra''- increases the action & potency ''basti''.<ref>Kashyapa, Kashyapa Samhita, Siddhisthana, chapter 1, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

==== Suitable position for administration ====

The patient, before the ''basti pranidana'' (administration), is required to lie down on his left side on a bed which has uniform level or which is low in the head side. These two alternatives are described for the comfort of the patient. This can be explained in a different way also. If the patient has a bulky buttock, then the head side of the cot should be uniform. If he has thin buttock, then the head side of bed should be lowered to facilitate the uniform distribution of ''basti dravya'' in the body.

When the patient lies on his left side, both the grahaņi and guda remain in normal position. ''Basti'' administered in this position gets absorbed properly and distributed easily. In this position, the sphincters remain relaxed. Therefore, the enema fluid enters into rectum easily without any obstruction and impregnates the ''grahani'' to produce the desired therapeutic effect.<ref>Chakrapanidutta, Commentator. Charak samhita, Siddhi Sthana, 3/24-25, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

''Basti'' drug reaches first to the ''pakvashaya'' and then to the ''grahani''. ''Pakvashaya'' is the site of ''pureeshadhara kala'' and ''grahani'' is the site of ''pittadhara kala''. So basti directly acts on ''pureeshadhara kala'' and ''pittadhara kala''.

Commentator Dalhana has commented that ''pureeshadhara kala'' and ''asthidhara kala'' are same and ''pittadhara kala'' and ''majjadhara kala'' are one and same.<ref>Dalhana, Commentator. Sushruta Samhita, Kalpasthana, 4/40, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>. So from these evidences it is clear that ''basti'' has direct action on ''asthi'' and ''majja dhatu''. ''Majja'' is present in the ''asthi''. Also ''mastulunga'' is considered as ''mastaka majja''.<ref>Dalhana, Commentator. Sushruta Samhita, Sutrasthana, 32/12, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref> ''Vata nadi'' are also made by ''majja'' which is the seat of ''vata dosha''. So in this way, ''basti'' is useful in the disorders of central nervous system.

It is thought that an enema introduced would never ascend so high as the stomach. There is a reference from the Best and Taylor that “materials introduced by enema, in some instances pass through the walls into the ilium, such incompetence may permit the enema fluid to reach the duodenum.” Also the possibility of materials from even the lower bowel, reaching the mouth is strongly suggested by the fact that lycopodium sporce, introduced into the colon by enema, has been recovered some hours later from washing of the stomach.<ref>Best and Taylor, Physiological Basis of Medicine</ref>

==== ''Dosha'' specific dose ====

For ''vata prakopa'', one ''basti'', for ''pitta prakopa'' one ''basti'' and for ''kapha prakopa'' one ''basti'' should be given. It is not that three ''basti prayoga'' for ''tridosha prakopa'', the first ''basti'' eliminates the ''vata'', second ''pitta'' and third, ''kapha''. The author himself will explain the need of giving one ''basti'' for ''vayu,'' two for ''pitta'' and three for ''kapha'' in verse no. 69. Thus, the one ''basti'' eliminates the aggravated ''vata'' from its location, two of them (given on after the other) eliminate the ''pitta'' from its location and three of them (given on after the other) eliminate ''kapha'' from its location.

''Basti'' is given to eliminate the aggravated ''vata'' from ''pakvashaya''. But as specific effect, this ''basti'' is also capable of eliminating the aggravated ''dosha'' even from the locations of ''pitta'' and ''kapha''. Thus, in general ''basti'' eliminates the ''vata'' from ''pakvashaya''. But by the application of special methods, this ''basti'' becomes capable of eliminating the ''dosha'' from other parts.
''Basti'' is, no doubt, not the most effective therapy for aggravated ''pitta'' and ''kapha''. But it is very effective only when these two ''dosha'' are associated with aggravated ''vata''.<ref>Chakrapanidutta, Commentator. Charak samhita, Siddhi Sthana, 3/26, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

==== Diet ====

The patient is instructed to take the thin meat soup etc. after ''niruha basti'' to protect his ''agni'' which is slightly reduced due to therapy. ''Peyadi krama'' is not necessary after ''niruha''.

''Niruha basti'' does not cause ''agnimandya, bala kshaya, prana kshaya'' like ''virechana'', so ''peyadi krama'' is not needed. Bhoja stated that the ''virechana'' causes ''agnimandya'' by ''adhisthana samplavat'' whereas ''basti'' does not decrease the ''agni'' instead kindles it.<ref>Chakrapanidutta, Commentator. Charak samhita, Siddhi Sthana, 1/20-21, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

==== Ratio of combination ====

The above-mentioned ratio of decoction and ''sneha'' should be adopted even if the ''niruha basti'' is administered in minimum quantity. Apart from the decoction and ''sneha'', the ''niruha kalpana'' also contains ''madhu, kalka,'' and ''saindhava'' etc. The quantity of these ingredients is variable according to the ''dosha, prakriti'' etc. of the patient. However, the quantity of the ingredients should be such that it should make the kalpana equal to 12 ''prasrita'' in total.

''Jatukarna'' has prescribed two ''pala'' of paste to be added to the ''basti kalpana''. According to him, six ''pala'' of ''sneha'' for ''vata roga'' and for healthy persons; four ''pala'' of ghee should be added for ''pitta roga'' and three ''pala'' of ''taila'' for ''kapha roga''. ''Saindhava'' should be added in one ''tola'' dose.

Sushruta has described one ''tola saindhava'' and 2 ''prasrita madhu'' for ''basti kalpana''.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/37, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

''Harita'' has prescribed one ''prasrita'' of honey and one ''tola'' of ''saindhava''.

Use of these ''avapa'' is also described in Harita Samhita.

In the exact quantity of these ingredients are told as follows - ''saindhava''-1 ''tola'', ''madhu''-2 ''prasrita'', ''sneha''-3 ''prasrita'', ''kalka''-1 ''prasrita'', kashaya-4 ''prasrita'' and ''avapa''-2 ''prasrita''. Thus, the total quantity becomes 12 ''prasrita'' ½ which is rounded to 12 prasruta. This kalpanā is meant for vāta roga.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/37-39, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

Charak recommended five ''prasrita'' of ''kashaya'' to be added. Sushruta recommended four ''prasrita''.This change in the quantity of ''kashaya'' is not acceptable.<ref>Chakrapanidutta, Commentator. Charak samhita, Siddhi Sthana, 30/31, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref>

''Basti kalpana'' according to ''dosha'':<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/29-32, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

{|class = "wikitable"
|-
!scope = "col"|Ingredients of ''Basti''
!scope = "col"|''Vata''
!scope = "col"|''Pitta''
!scope = "col"|''Kapha''
!scope = "col"|''Swastha''
|-
|''Madhu''
|1 ½ ''Prasrita''
|2 ''Prasrita''
|3 ''Prasrita''
|2 ''Prasrita''
|-
|''Saindhava''
|1 ''Tola''
|1 ''Tola''
|1 ''Tola''
|1 ''Tola''
|-
|''Sneha''
|3 ''Prasrita''
|2 ''Prasrita''
|1 ½ ''Prasrita''
|2 ''Prasrita''
|-
|''Kalka''
|1 ''Prasrita''
|1 ''Prasrita''
|1 ''Prasrita''
|1 ''Prasrita''
|-
|''Kwatha''
|5 ''Prasrita''
|5 ''Prasrita''
|5 ''Prasrita''
|5 ''Prasrita''
|-
|''Avapa Dravya ''
|1 ½ ''Prasrita''
|2 ''Prasrita''
|1 ½ ''Prasrita''
|2 ''Prasrita''
|-
|}

In case of a healthy person (marked by an equilibrium of ''vata, pitta'' and ''kapha''), the solution to be administered should be composed of four parts of the decoction of drugs and one part (a fifth part of the ''basti'') of the ''sneha'' (any oleaginous substance). In any case marked by a preponderance of the deranged ''vata'', the ''sneha'' should measure a quarter part of the whole, one-sixth in a case of a preponderance of the deranged ''pitta'' and an eighth part in a case of the deranged ''kapha''. In a case of aggravation of all the (three) ''dosha'', the ''kalka'' should measure an eighth part (of the entire quantity of ''basti dravya''), and the following drugs, viz. salt, honey, cow's urine, ''phala'' (''madana''), milk, ''avapa'' (additives) such as ''kanjika'', etc. and soup of meat. In formulating ''niruha basti'' the dosage should be determined by a due consideration of the requirements in each case. When the ''kalka'', the ''sneha'', and the decoction would be well mixed together, the solution for administration should be considered to have been well prepared. The application of such a solution would be supposed to produce the desired results. Dalhana says that of the whole mixture measuring 12 ''prasrita'' (twenty-four ''palas''), there should be four ''prasrita'' of the decoction, and so on.<ref>Dalhana, Commentator. Sushruta Samhita, Sutrasthana, 38/29-32, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

''Vrinda Madhava'' has given different formula as follows: <ref>Vrinda Madhava</ref>

{|class = "wikitable"
|-
!scope = "col"|''Kalpana''
!scope = "col"|Qty in ''Pala'' for ''Vata''
!scope = "col"|Qty in ''Pala'' for ''Pitta''
!scope = "col"|Qty in ''Pala'' for ''Kapha''
|-
|''Madhu''
|3
|4
|6
|-
|''Sneha''
|6
|4
|3
|-
|''Kalka''
|2
|2
|2
|-
|''Kashaya''
|10
|10
|10
|-
|''Avapa''
|3
|4
|3
|-
!scope = "col"|Total
!scope = "col"|24 ''pala'' or 12 ''prasrita''
!scope = "col"|24 ''pala''
!scope = "col"|24 ''pala''
|-
|}

==== Procedures after ''basti'' ====

After the manifestation of ''samyak nirudha'' symptoms, the patient should be advised to take bathe (in hot water) and to take meat-soup (''rasa''), milk and pulse-soup (''yusha'') in diseases due to the action of the deranged ''vata, pitta'' and ''kapha'' respectively. The essence (''rasa'') of the meat of any ''jangala'' animal may, however, be prescribed in all cases under the circumstances, since it would produce no harm. Only a quarter, a half or three-quarter part of the usual diet should be prescribed according to the digestive capacity of the patient, and the nature and intensity of the ''dosha'' involved in each case.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 38/11-13, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

After ''anuvasana, yusha, ksheera'' and ''mamsa rasa, yusha, ksheera'' and ''mamsa rasa'' should be given along with ''anna'' in ''kapha, pitta'' and ''vata'' respectively. ''Peya'' should not be given as it causes ''abhishyandana'' of ''koshtha'' because of ''sneha'' in ''koshtha''.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 37/57, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

==== ''Dvipanchalamudi basti'' ====

This ''basti'' is also highlighted in Ashtanga Hridaya which is detailed below for a practical understanding.

''Dvipanchalamudi'' (A.H.Ka.4/4):

{|class = "wikitable"
|-
!scope = "col"|''Dravya''
!scope = "col"|Dose (classics)
!scope = "col"|Practicing Dose
|-
|''Madhu''
|2 ''Prasrita''
|200ml
|-
|''Saindhava''
|1 ''Karsha''
|12gm
|-
|''Sneha-trisneha''(''sukumara ghrita +sahacharadi taila + vasa'')
|4 ''Prasrita''
|150ml+150ml
|-
|''Kalka- putoyavanadi''*
|1 ''Prasrita''
|30gm
|-
|''Kvatha dravya-laghupanchamula, brihatpanchamula''
|5 ''Prasrita''
|400ml
|-
|''Avapa dravya-amla rasa, ajamamsa''
|1 ''Pala''
|50gm
|-
|}

''Guņa- Sarva vātavyādhihara''

==== ''Niruha basti'' ====

In the same method given in verses, the skilled physician should administer second, third or fourth ''niruha basti'' or till ''samyak nirudha'' and then stop.<ref>Sushruta, Sushruta Samhita, Chikitsa Samhita, 37/6-7, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref> Dalhaņa while commenting has justified that, in ''krura koshtha'' if improperly administered or if ''sunirudha lakshana'' not observed and ''dosha'' to be eliminated are present, in such condition fourth ''basti'' should be used judiciously.<ref>Dalhana, Commentator. Sushruta Samhita, Sutrasthana, 38/3-6, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

Some other considered fourth ''basti'' is advocated for ''rakta''. Some other considered that the fourth ''basti'' with ''madhura'' and ''sheeta dravya'' for ''daha nirvapana''.<ref>Dalhana, Commentator. Sushruta Samhita, Sutrasthana, 38/7, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1996</ref>

Some others opine that the ''utkleshana, shodhana'' and ''shamana basti'' should be formulated sequentially.<ref>Vagbhata, Ashtanga Hridaya, Sutrasthana, 19/61, Choukhambha Sanskrit Sansthan, Varanasi, 2002</ref>

In case of ''sannipata dosha'' also three ''basti'' are enough as mentioned in order of ''dosha'' above. Hence, some other physicians do not desire a fourth ''basti'' as there is no fourth ''dosha'' for which ''basti'' is to be given.<ref>Vagbhata, Ashtanga Hridaya, Sutrasthana, 19/56, Choukhambha Sanskrit Sansthan, Varanasi, 2002</ref>

The physicians regard that there is no more than three ''basti'' should be given because there is no fourth ''dosha'' to give ''basti''.<ref>Vagbhata, Ashtanga Hridaya, Sutrasthana, 19/60, Choukhambha Sanskrit Sansthan, Varanasi, 2002</ref>
Vagbhata another context in the same chapter told that after self returning (''svayam nivritti'') second, third or fourth ''basti'' should be given or till ''samyak nirudha lakshana''.<ref>Vagbhata, Ashtanga Hridaya, Sutrasthana, 19/49-50, Choukhambha Sanskrit Sansthan, Varanasi, 2002</ref>

Arunadatta commenting on above verse, told that ''svayameva'' means, without stimulation by ''phalavarti'' etc. If by stimulus i.e. ''phalavarti, tīkshņa virechana'' etc. are used, then subsequent ''basti'' should not be given. Fourth, fifth ''basti'' etc. can be given till ''samyak nirudha lakshana'' are observed.<ref>Arunadatta, Commentator. Ashtanga Hridaya, Sutrasthana, 19/49-50, Choukhambha Sanskrit Sansthan, Varanasi, 2002</ref>

''Vaidya'' Kasture referring to the Sushruta’s view told that, one should not administer more than four ''basti'' in a day; otherwise it causes ''pakvashaya kshobha'' (irritation of colon).

So the above discussion may be concluded that the second, third or fourth ''basti'' can be given after assessing the ''doshadi'' factors<ref>Charak, Charak samhita, Siddhi Sthana, 3/6, edited by Vaidya Jadavaji Trikamji Acharya, 2nd edition, Chaukhamba Sanskrit Sansthan, Varanasi, 1990</ref> in following conditions-
*After the self returning of first ''basti'' without any stimulation.
*If ''sunirudha lakshana'' are not observed
*If the ''dosha'' and ''mala'' are not eliminated in ''krura koshtha'' patient

=== Glossary ===

#''Abhisyandi'' (''dravya''): The diet or drug which on account of its heavy and slimy properties causes retention of secretions, thus giving rise to heaviness and fullness e.g. curd.
#''Abhyanga'': Massage or rubbing of body or body parts usually with simple or medicated oil.
#''Anuvasana basti'': Medicated oil enemata meant to be retained in the colon for some time. It is also referred as ''snigdhabasti'' (unctuous).
#''Karsha'': measurement equal to 12gms
#''Niruha basti'': Medicated enemata prepared from herbal decoctions, milk, oil to be retained in the colon.
#''Nirvapana'': Extinguishing, alleviation, pacifying. To alleviate or reduce pain and burning of a suppurating inflammatory swelling by application of refrigerant or cooling application.
#''Pala'': measurement equal to 4 ''karsha'' (48gms)
#''Prasrita'': measurement equal to 8 ''Karsha'' (96gms)

=== References ===
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Prasrita Yogiyam Siddhi

2019-03-06T04:06:45Z

Pallavmishra:

{{Infobox
|title = Prasrita Yogiyam Siddhi
|label1 = Section/Chapter
|data1 = [[Siddhi Sthana]] Chapter 8
|label2 = Preceding Chapter
|data2 = [[Bastivyapat Siddhi]]
|label4 = Succeeding Chapter
|data4 = [[Trimarmiya Siddhi]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]

|header3 =

}}

==[[Siddhi Sthana]] Chapter 8, Chapter on Successful ''basti'' formulations in ''Prasrita'' Unit ==

=== Abstract ===

This chapter describes recipes of ''prasritayogiya bastis'' (enema formulation in which ingredients are measured in unit of ''prasrita''). ''Prasrita'' is a measurement, which is approximately equal to 100 milliliter. Nine types of ''basti'' therapies for various clinical conditions including ''prameha'' (urinary disorders including diabetes), ''abhishyanda'' (oozing), ''kushtha'' (skin diseases), ''krimi'' (worm infestation), ''mutrakrichchra'' (dysuria) and alike are described. ''Atisara'', a clinical condition characterized by frequent defecation with altered composition and consistency of stool is described in detail. ''Atisara'' has various forms depending upon involvement of six morbid components in the pathogenesis viz. ''ama'' (stool with undigested material), ''shakrita'' (stool only), ''vata'' (with dominant flatulence), ''asrik'' (stool with blood), ''pitta'' and ''kapha''. Different recipes of ''basti'', oral medicaments and food preparations are described to treat these ''atisara'' conditions. These remedies are practically quite useful in several modern diseases like ulcerative colitis and irritable bowel syndrome.

'''Keywords''': ''atisara, basti, doshanulomana, grahi, karsha, karmanaviplutanam, niruha, pachana,'' [[Panchakarma]], ''prasrita, prastha, snehabasti, vyapat,'' enema in delicate persons, complication of [[Panchakarma]].

=== Introduction ===

There are two main types of ''basti'' according to the composition and the action. ''Anuvasana basti'' is composed of unctuous substance and it is to be retained for minimum nine hours. ''Asthapana basti'' contains mainly decoction with least oil and is evacuated after few minutes. ''Basti'' is administered through ano-rectal route and acting through the ''pakvashaya'' (colon). It is useful in several diseases particularly vata disorders having roots in ''pakvashaya''. It is claimed to be half a treatment or even a complete treatment by ancient practitioners<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna , chapter 1/38-40; edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 683-684.</ref>. It is not only a procedure of ''shodhana'' but also providing a recto-colonic route of drug administration.

Previous chapter ([[Bastivyapat Siddhi]]) deals with the ''vyapat'' (complications) arising due to faulty application of ''bastis''. Present chapter begins with the treatment of those patients who developed complications as a result of faulty application of therapies (''karmana viplutanam'') and for the tender persons who are not able to tolerate strong measures. For this purpose, chapter describes mild form of ''niruha bastis''. The ingredients of these ''bastis'' are measured in the unit of ''prasrita''. Therefore the name of the chapter is [[Prasrita Yogiyam Siddhi]]. The unit ''prasrita'' is equal to two ''palas'', which is approximately equal to 100 milliliter (1 ''pala''= approx. 50 ml).<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 8/4 (Cakrapāṇi commentary); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713</ref><ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 7-20</ref>

===Sanskrit text, Transliteration and English Translation===

अथातः प्रासृतयोगीयां सिद्धिं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

Athātaḥ prāsṛtayōgīyāṁ siddhiṁ vyākhyāsyāmaḥ ||1||

iti ha smāha bhagavānātrēyaḥ ||2||

athAtaH prAsRutayogIyAM siddhiM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now, we shall discuss the chapter [[Prasrita Yogiyam Siddhi]] (the chapter of [[Siddhi Sthana]] which describes the ''basti'' procedures with recipes having ingredients measured in the unit ''prasrita''). Thus, said Lord Atreya. [1-2]

==== Objective of ''prasrita basti'' ====

अथेमान् सुकुमाराणां निरूहान् स्नेहनान् मृदून्|

कर्मणा विप्लुतानां च वक्ष्यामि प्रसृतैः पृथक्||३||

athēmān sukumārāṇāṁ nirūhān snēhanān mṛdūn|

karmaṇā viplutānāṁ ca vakṣyāmi prasṛtaiḥ pṛthak||3||

athemAn sukumArANAM nirUhAn snehanAn mRudUn|

karmaNA viplutAnAM ca vakShyAmi prasRutaiH pRuthak||3||

Now, I (Atreya) shall explain oleaginous and mild form of ''niruha bastis'', for the tender persons and the patients suffered from complications as a result of therapies. Composition of those will be in the unit of ''prasrita''. [3]

==== ''Pancha prasritiki Basti''-I ====

क्षीराद्द्वौ प्रसृतौ कार्यौ मधुतैलघृतात्त्रयः|

खजेन मथितो बस्तिर्वातघ्नो बलवर्णकृत्||४||

kṣīrāddvau prasṛtau kāryau madhutailaghṛtāttrayaḥ|

khajēna mathitō bastirvātaghno balavarṇakṛt||4||

kShIrAddvau prasRutau kAryau madhutailaghRutAttrayaH|

khajena mathito bastirvAtaghno balavarNakRut||4||

Two ''prasritas'' of milk and three ''prasritas'' of ''madhu'' (honey), ''taila'' (sesame oil) and ''ghrita'' (clarified butter) are taken together and churned with a churning stick. This ''basti'' eliminates ''vata'', and promotes strength as well as complexion. [4]

==== ''Ashta-prasritiki basti'' ====

एकैकः प्रसृतस्तैलप्रसन्नाक्षौद्रसर्पिषाम्|

बिल्वादिमूलक्वाथाद्द्वौ कौलत्थाद्द्वौ स वातनुत्||५||

ēkaikaḥ prasṛtastailaprasannākṣaudrasarpiṣām|

bilvādimūlakvāthāddvau kaulatthāddvau sa vātanut||5||

ekaikaH prasRutastailaprasannAkShaudrasarpiShAm|

bilvAdimUlakvAthAddvau kaulatthAddvau sa vAtanut||5||

''Basti'', composed of one ''prasrita'' each of ''taila'' (sesame oil), ''prasanna''(supernatant part of ''sura''- a type of alcoholic preparation), ''kshaudra'' (honey) and ''ghrita'' (clarified butter) and two ''prasritas'' each of the decoctions of roots of ''bilvadi'' (a group of plants that begins with ''bilva''-Aegle marmelos Carr.) as well as two ''prasritas'' of ''kulattha'' (Phaseolus biflorus Linn.), antagonizes ''vata''. [5]

==== ''Nava--prasritiki basti'' ====

पञ्चमूलरसात् पञ्च द्वौ तैलात् क्षौद्रसर्पिषोः|

एकैकः प्रसृतो बस्तिः स्नेहनीयोऽनिलापहः||६||

pañcamūlarasāt pañca dvau tailāt kṣaudrasarpiṣoḥ|

ēkaikaḥ prasṛto bastiḥ snēhanīyō'nilāpahaḥ||6||

pa~jcamUlarasAt pa~jca dvau tailAt kShaudrasarpiShoH|

ekaikaH prasRuto bastiH snehanIyo~anilApahaH||6||

''Basti'' prepared with five ''prasritas'' of the decoction of ''panchamula'' (''bilva, shyonaka, gambhari, patala'' and ''agnimantha''), two ''prasritas'' of ''taila'' (sesame oil) and one ''prasrita'' each of ''kshaudra'' (honey) as well as ''sarpi'' (''ghrita''), oleates (the body) and expels ''vata''. [6]

==== ''Chatu-prasritiki basti''-I ====

सैन्धवार्धाक्ष एकैकः क्षौद्रतैलपयोघृतात्|

प्रसृतो हपुषाकर्षो निरूहः शुक्रकृत् परम्||७||

saindhavārdhākṣa ēkaikaḥ kṣaudratailapayōghṛtāt|

prasṛtō hapuṣākarṣō nirūhaḥ śukrakṛt param||7||

saindhavArdhAkSha ekaikaH kShaudratailapayoghRutAt|

prasRuto hapuShAkarSho nirUhaH shukrakRut param||7||

''Niruha basti'', prepared with half ''aksha'' (about 6 grams) of ''saindhava'' (rock salt) one ''prasrita'' each of honey, sesame oil, milk, and ''ghrita'', and one ''karsha'' (about 12 grams) of ''hapusha'' (Juniperus communis Linn.), is an excellent promoter of ''shukra''. [7]

==== ''Panchatikta niruha basti'' ====

पटोलनिम्बभूनिम्बरास्नासप्तच्छदाम्भसः|

चत्वारः प्रसृता एको घृतात् सर्षपकल्कितः||८||

निरूहः पञ्चतिक्तोऽयं मेहाभिष्यन्दकुष्ठनुत् |९|

paṭōlanimbabhūnimbarāsnāsaptacchadāmbhasaḥ|

catvāraḥ prasṛtā ēkō ghṛtāt sarṣapakalkitaḥ||8||

nirūhaḥ pañcatiktō'yaṁ mēhābhiṣyandakuṣṭhanut |9|

paTolanimbabhUnimbarAsnAsaptacchadAmbhasaH|

catvAraH prasRutA eko ghRutAt sarShapakalkitaH||8||

nirUhaH pa~jcatikto~ayaM mehAbhiShyandakuShThanut |9|

A ''basti'' prepared by mixing four ''prasritas'' of decoction of ''patola'' (Trichosanthes dioica Roxb.), ''nimba'' (Azadirachta indica A.Juss.), ''bhunimba'' (Andrographis paniculata Nees.), ''rasna'' (Pluchea lanceolata Oliver &Hiern.), ''saptacchada'' (Alstonia scholaris R.Br.); one ''prasrita'' of ''ghrita'', mixed with a ''kalka'' (paste) of ''sarshapa'' (Brassica campestris Linn.) is known as ''panchatikta niruha'' and is acting against ''prameha, abhishyanda'' and ''kushtha''. [8-8½]

'''Note''': The quantity of ''kalka'' of ''sarshapa'' is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 8/8-9 (Cakrapāṇi commentary); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref>In the ''niruha basti'' with an amount of twelve ''prasritas'', the amount of ''kalka'' is usually two ''palas'' (about 100 gms). In present recipe, the amount is five ''prasritas'' and therefore the amount of ''kalka'' of ''sarshapa'' would be about 40 gms. This principle is applicable in latter recipes also where the amount of ''kalka'' is not mentioned.

==== ''Shat-prasritika basti'' ====

विडङ्गत्रिफलाशिग्रुफलमुस्ताखुपर्णिजात्||९||

कषायात् प्रसृताः पञ्च तैलादेको विमथ्य तान्|

विडङ्गपिप्पलीकल्को निरूहः क्रिमिनाशनः||१०||

viḍaṅgatriphalāśigruphalamustākhuparṇijāt||9||

kaṣāyāt prasṛtāḥ pañca tailādēkō vimathya tān|

viḍaṅgapippalīkalkō nirūhaḥ krimināśanaḥ||10||

viDa~ggatriphalAshigruphalamustAkhuparNijAt||9||

kaShAyAt prasRutAH pa~jca tailAdeko vimathya tAn|

viDa~ggapippalIkalko nirUhaH kriminAshanaH||10||

Five ''prasritas'' of decoction of ''vidanga'' (Embelia ribes Burm.), ''triphala'' (a combination of three fruits viz. Emblica officinalis Gaertn, terminalia chebula Retz. and terminalia belerica Roxb.), ''shigru'' (Moringa oleifera Linn.), ''madanaphala'' (Randia dumetorum Lam.), ''musta'' (Cyperus rotundus Linn.) and ''akhuparni'' (Merremia emarginata Burm.) and one ''prasrita'' of ''tila taila'' (sesame oil) churned together with a paste of ''vidanga'' (Embelia ribes Burm.) and ''pippali'' (Piper longum Linn.) is ''kriminashana niruha'' (''niruha'' acting against parasites) [9-10]

==== ''Sapta-prasritika basti'' ====

पयस्येक्षुस्थिरारास्नाविदारीक्षौद्रसर्पिषाम्|

एकैकः प्रसृतो बस्तिः कृष्णाकल्को वृषत्वकृत्||११||

payasyēkṣusthirārāsnāvidārīkṣaudrasarpiṣām|

ēkaikaḥ prasṛtō bastiḥ kṛṣṇākalkō vṛṣatvakṛt||11||

payasyekShusthirArAsnAvidArIkShaudrasarpiShAm|

ekaikaH prasRuto bastiH kRuShNAkalko vRuShatvakRut||11||

''Basti'' prepared with decoction of one ''prasrita'' of each of ''payasya'' (Fritillaria roylei Hook.), ''ikshu'' (Saccharum officinarum Linn.), ''sthira'' (Desmodium gangeticum DC.), ''rasna'' (Pluchea lanceolata Oliver & Hiern.) and ''vidari'' (Pueraria tuberosa DC.); one ''prasrita'' each of honey and ''ghrita'', and paste of ''pippali'' (Piper longum Linn.) is ''vrishya'' (enhancing libido and sexual vigour). [11]

==== ''Chatu-prasritika basti''-II ====

चत्वारस्तैलगोमूत्रदधिमण्डाम्लकाञ्जिकात्|

प्रसृताः सर्षपैः कल्कैर्विट्सङ्गानाहभेदनः ||१२||

catvārastailagōmūtradadhimaṇḍāmlakāñjikāt

prasṛtāḥ sarṣapaiḥ kalkairviṭsaṅgānāhabhēdanaḥ ||12||

catvArastailagomUtradadhimaNDAmlakA~jjikAt|

prasRutAH sarShapaiH kalkairviTsa~ggAnAhabhedanaH ||12||

''Basti'' prepared with a total of four ''prasritas'' of ''tila taila'' (sesame oil), cow’s urine, ''dadhimanda'' (whey) and ''amlakanji'' (fermented sour gruel) mixed with a paste of ''sarshapa'' (Brassica campestris Linn.) relieves the stagnation of stool and constipation. [12]

==== ''Pancha-prasritika basti''-II ====

श्वदंष्ट्राश्मभिदेरण्डरसात्तैलात् सुरासवात्|

प्रसृताः पञ्च यष्ट्याह्वकौन्तीमागधिकासिताः||१३||

कल्कः स्यान्मूत्रकृच्छ्रे तु सानाहे बस्तिरुत्तमः|

एते सलवणाः कोष्णा निरूहाः प्रसृतैर्नव||१४||

śvadaṁṣṭrāśmabhidēraṇḍarasāttailāt surāsavāt|

prasṛtāḥ pañca yaṣṭyāhvakauntīmāgadhikāsitāḥ||13||

kalkaḥ syānmūtrakṛcchrē tu sānāhē bastiruttamaḥ|

ētē salavaṇāḥ kōṣṇā nirūhāḥ prasṛtairnava||14||

shvadaMShTrAshmabhideraNDarasAttailAt surAsavAt|

prasRutAH pa~jca yaShTyAhvakauntImAgadhikAsitAH||13||

kalkaH syAnmUtrakRucchre tu sAnAhe bastiruttamaH|

ete salavaNAH koShNA nirUhAH prasRutairnava||14||

''Basti'' prepared with five ''prasritas'' decoction of ''shvadamshtra'' (Tribulus terrestris Linn.), ''ashmabhida'' (Bergenia ligulata Wall.), ''eranda'' (Ricinus communis Linn.) together, ''taila'' and ''surasava'' (an alcoholic preparation) added with paste of ''yashti'' (Glycyrrhiza glabra Linn.), ''kaunti'' (Piper aurantiacum Wall.), ''magadhika'' (Piper longum Linn.) and ''sitah'' (sugar candy) is useful in ''mutrakricchra'' (a condition characterized by difficult and painful micturition) and ''anaha'' (constipation). These nine ''prasrita bastis'' are given with salt and moderately warm. [13-14]

==== Treatment of stagnated ''basti'' ====

मृदुबस्तिजडीभूते तीक्ष्णोऽन्यो बस्तिरिष्यते|

तीक्ष्णैर्विकर्षिते स्वादु प्रत्यास्थापनमिष्यते ||१५||

mṛdubastijaḍībhūtē tīkṣṇō'nyō bastiriṣyatē|

tīkṣṇairvikarṣitē svādu pratyāsthāpanamiṣyatē [1] ||15||

mRudubastijaDIbhUte tIkShNo~anyo bastiriShyate|

tIkShNairvikarShite svAdu pratyAsthApanamiShyate ||15||

If a ''mridubasti'' (mild acting ''basti'') gets stagnated, that needs another ''teekshna basti'' (strong and sharp acting ''basti''). One, who is emaciated because of strong ''bastis'', requires ''asthapana basti'' prepared with ''madhura'' (sweet) substances. [15]

==== Treatment of ''guda-daha'' (burning sensation in anus) ====

वातोपसृष्टस्योष्णैः स्युर्गुददाहादयो यदि|

द्राक्षाम्बुना त्रिवृत्कल्कं दद्याद्दोषानुलोमनम्||१६||

तद्धि पित्तशकृद्वातान् हृत्वा दाहादिकाञ्जयेत्|

शुद्धश्चापि पिबेच्छीतां यवागूं शर्करायुताम्||१७||

vātōpasṛṣṭasyōṣṇaiḥ syurgudadāhādayō yadi|

drākṣāmbunā trivṛtkalkaṁ dadyāddōṣānulōmanam||16||

taddhi pittaśakṛdvātān hṛtvā dāhādikāñjayēt|

śuddhaścāpi pibēcchītāṁ yavāgūṁ śarkarāyutām||17||

vAtopasRuShTasyoShNaiH syurgudadAhAdayoyadi|

drAkShAmbunA trivRutkalkaM dadyAddoShAnulomanam||16||

taddhi pittashakRudvAtAn hRutvA dAhAdikA~jjayet|

shuddhashcApi pibecchItAM yavAgUM sharkarAyutAm||17||

If a patient with ''vata'' disorder suffers from anorectal burning (and other similar ''pitta''-related symptoms) due to (administration of) hot ''bastis'', a mixture of ''drakshambu'' (grape juice or decoction of raisins) and ''trivritkalka'' (paste of Operculina turpethum Linn.), which is ''doshanulshmana'' (bringing the movement of ''dosha'' in right direction) is given. This relieves burning sensation and similar conditions by expelling the ''pitta'', stool and ''vata''. After the body is cleansed, the patient has to take cold ''yavagu'' added with sugar. [16-17]

==== Treatment of ''mala kshaya'' (depletion of stool) ====

अथवाऽतिविरिक्तः स्यात् क्षीणविट्कः स भक्षयेत्|

माषयूषेण कुल्माषान् पिबेन्मध्वथवा सुराम्||१८||

athavā'tiviriktaḥ syāt kṣīṇaviṭkaḥ sa bhakṣayēt

māṣayūṣēṇa kulmāṣān pibēnmadhvathavā surām||18||

athavA~ativiriktaH syAt kShINaviTkaH sa bhakShayet|

mAShayUSheNa kulmAShAn pibenmadhvathavA surAm||18||

On the other hand, if a patient has excessive purgation and suffers from depletion of stool (and other essential body components e.g. fluids), he or she has to take ''kulmasha'' (half cooked grains) with ''mashayoosha'' (soup of Phaseolus mungo Linn.), or ''sura'' (an alcoholic preparation) or honey. [18]

==== Treatment of ''amaja shula'' (abdominal pain due to improper digestion) ====

सामं चेत् कुणपं शूलैरुपविशेदरोचकी|

स घनातिविषाकुष्ठनतदारुवचाः पिबेत्||१९||

sāmaṁ cēt kuṇapaṁ śūlairupaviśēdarōcakī|

sa ghanātiviṣākuṣṭhanatadāruvacāḥ pibēt||19||

sAmaM cet kuNapaM shUlairupavishedarocakI|

sa ghanAtiviShAkuShThanatadAruvacAH pibet||19||

(A decoction of) ''musta'' (Cyperus rotundus Linn.), ''ativisha'' (Aconitum heterophyllum wall.), ''kushtha'' (Saussurea lappa C.B.Clarke.), ''nata'' (Valeriana wallichii DC.), ''daru'' (Cedrus deodara Roxb.) and ''vacha'' (Acorus calamus Linn.) is recommended to a patient with loss of appetite, passing ''sama'' stool (i.e., stool containing ''ama'') smelling like a dead (decomposing) body and with abdominal pain. [19]

==== Treatment of ''atisara'' (diarrhea) ====

शकृद्वातमसृक् पित्तं कफं वा योऽतिसार्यते|

पक्वं , तत्र स्ववर्गीयैर्बस्तिः श्रेष्ठं भिषग्जितम्||२०||

śakṛdvātamasṛk pittaṁ kaphaṁ vā yō'tisāryatē|

pakvaṁ , tatra svavargīyairbastiḥ śrēṣṭhaṁ bhiṣagjitam||20||

shakRudvAtamasRuk pittaM kaphaM vA yo~atisAryate|

pakvaM , tatra svavargIyairbastiH shreShThaM bhiShagjitam||20||

When a patient has ''pakva atisara'' (without undigested material) passing ''shakrita'' (stool), ''vata, asrika'' (blood), ''pitta'' or ''kapha'', then ''basti'' prepared with a specific group of medicines acting against each of these pathologies is best measure. [20]

==== Six types of ''atisara'' and its common complications ====

षण्णामेषां द्विसंसर्गात् त्रिंशद्भेदा भवन्ति तु|

केवलैः सह षट्त्रिंशद्विद्यात् सोपद्रवानपि||२१||

शूलप्रवाहिकाध्मानपरिकर्त्यरुचिज्वरान्|

तृष्णोष्णदाहमूर्च्छादींश्चैषां विद्यादुपद्रवान्||२२||

ṣaṇṇāmēṣāṁ dvisaṁsargāt triṁśadbhēdā bhavanti tu|

kēvalaiḥ saha ṣaṭtriṁśadvidyāt sōpadravānapi||21||

śūlapravāhikādhmānaparikartyarucijvarān|

tṛṣṇōṣṇadāhamūrcchādīṁścaiṣāṁ vidyādupadravān||22||

ShaNNAmeShAM dvisaMsargAt triMshadbhedA bhavanti tu|

kevalaiH saha ShaTtriMshadvidyAt sopadravAnapi||21||

shUlapravAhikAdhmAnaparikartyarucijvarAn|

tRuShNoShNadAhamUrcchAdIMshcaiShAM vidyAdupadravAn||22||

These six types of ''atisara'' may have thirty variants as a result of mutual combination of two morbid factors. Together with basic six, they constitute thirty six types, which manifest along with their complications. ''Shoola'' (abdominal pain), ''pravahika'' (dysentery), ''adhmana'' (abdominal distension) ''parikarti'' (anal pain), ''aruchi'' (distaste for food), ''jwara'' (fever), ''tṛishna'' (thirst), ''ushnatva'' (feeling of heat), ''daha'' (burning sensation) and ''murccha''(syncope) are its complications (''upadrava''). [21-22]

==== Treatment of ''ama-atisara'' ( diarrhea with improper digestion) ====

तत्रामेऽन्तरपानं स्यात् व्योषाम्ललवणैर्युतम्|

पाचनं शस्यते बस्तिरामे हि प्रतिषिध्यते||२३||

tatrāmē'ntarapānaṁ syāt vyōṣāmlalavaṇairyutam|

ṁ śasyatē bastirāmē hi pratiṣidhyatē||23||

tatrAme~antarapAnaM syAt vyoShAmlalavaNairyutam|

pAcanaM shasyate bastirAme hi pratiShidhyate||23||

In case of ''amatisara'', a drink having ''pachana'' action added with ''trikatu'' (a group of three pungent drugs viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), ''amla'' (sour) and ''lavana'' (salty) substances is recommended. ''Bastis'' are contraindicated in ''ama'' condition. [23]

==== Treatment of ''shakrita-atisara'' and ''vata atisara''( diarrhea with excess stools and ''vata'') ====

वातघ्नैर्ग्राहिवर्गीयैर्बस्तिः शकृति शस्यते |

स्वाद्वम्ललवणैः शस्तः स्नेहबस्तिः समीरणे||२४||

vātaghnairgrāhivargīyairbastiḥ śakṛti śasyatē

svādvamlalavaṇaiḥ śastaḥ snēhabastiḥ samīraṇē||24||

vAtaghnairgrAhivargIyairbastiH shakRuti shasyate

svAdvamlalavaNaiH shastaH snehabastiH samIraNe||24||

In ''shakritatisara'' (''atisara'' in which only stool is passed), ''basti'' with ''vataghna'' and ''grahi'' category of medicines is recommended. In ''vata'' related ''atisara, snehabasti'' with ''svadu'' (sweet), ''amla'' (sour) and ''lavana'' (salty) substances is acclaimed. [24]

==== Treatment of ''rakta atisara, pitta atisara'' and ''kapha atisara'' (diarrhea with blood, ''pitta'' and ''kapha'') ====

रक्ते रक्तेन, पित्ते तु कषायस्वादुतिक्तकैः|

सार्यमाणे कफे बस्तिः कषायकटुतिक्तकैः||२५||

raktē raktēna, pittē tu kaṣāyasvādutiktakaiḥ|

sāryamāṇē kaphē bastiḥ kaṣāyakaṭutiktakaiḥ||25||

rakte raktena, pitte tu kaShAyasvAdutiktakaiH|

sAryamANe kaphe bastiH kaShAyakaTutiktakaiH||25||

In ''raktaatisara'' (diarrhea with blood) ''basti'' with blood, in ''pittaatisara basti'' with ''kashaya'' (astringent), ''madhura'' (sweet) and ''tikta'' (bitter) substances and in ''kaphaatisara'' with ''kashaya'' (astringent), ''katu'' (pungent) and ''tikta'' (bitter) substances is to be administered. [25]

==== Treatment of ''atisara'' (diarrhea) mixed with ''shakrita-ama'' and ''vata'' ====

शकृता वायुना वाऽऽमे तेन वर्चस्यथानिले|

संसृष्टेऽन्तरपानं स्याद् व्योषाम्ललवणैर्युतम्||२६||

śakṛtā vāyunā vā”me tena varcasyathānilē|

saṁsṛṣṭē'ntarapānaṁ syād vyōṣāmlalavaṇairyutam||26||

shakRutA vAyunA vA~a~ame tena varcasyathAnile|

saMsRuShTe~antarapAnaM syAd vyoShAmlalavaNairyutam||26||

In the conditions where ''ama'' is associated with ''shakrita'' (stool) or ''vata'', or ''shakrita'' (stool) or ''vata'' is associated with ''ama'' a drink, prepared with ''vyosha'' (a group of three pungent drugs, commonly known as ''trikatu'', viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), sour and salty substances, is recommended. [26]

==== Treatment of ''atisara'' (diarrhea) mixed with ''pitta-rakta'' and ''ama'' ====

पित्तेनामेऽसृजा वाऽपि तयोरामेन वा पुनः|

संसृष्टयोर्भवेत् पानं सव्योषस्वादुतिक्तकम्||२७||

pittēnāmē'sṛjā vā'pi tayōrāmēna vā punaḥ|

saṁsṛṣṭayōrbhavēt pānaṁ savyōṣasvādutiktakam||27||

pittenAme~asRujA vA~api tayorAmena vA punaH|

saMsRuShTayorbhavet pAnaM savyoShasvAdutiktakam||27||

If there is association of ''ama'' with ''pitta'' or ''rakta'' or of both separately with ''ama'' then a drink with ''trikaṭu'', sweet and bitter substances is indicated. [27]

==== Treatment of ''atisara'' (diarrhea)mixed with ''kapha-ama'' ====

तथाऽऽमे कफसंसृष्टे कषायव्योषतिक्तकम्|

आमेन तु कफे व्योषकषायलवणैर्युतम्||२८||

tathā''mē kaphasaṁsṛṣṭē kaṣāyavyōṣatiktakam|

āmēna tu kaphē vyōṣakaṣāyalavaṇairyutam||28||

tathA~a~ame kaphasaMsRuShTe kaShAyavyoShatiktakam|

Amena tu kaphe vyoShakaShAyalavaNairyutam||28||

If ''ama'' is associated with ''kapha'', a ''basti'' containing ''kashaya'' (astringent), ''trikatu'' and bitter substances and when ''kapha'' is associated with ''ama'', a ''basti'' containing ''trikatu, kashaya'' (astringent) and salty substances is recommended. [28]

==== Treatment of ''atisara'' (diarrhea) mixed with ''pitta-vata-shakrita'' ====

वातेन विशि पित्ते वा विट्पित्ताभ्यां तथाऽनिले|

मधुराम्लकषायः स्यात् संसृष्टे बस्तिरुत्तमः||२९||

vātēna viśi pittē vā viṭpittābhyāṁ tathā'nilē|

madhurāmlakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||29||

vAtena vishi pitte vA viTpittAbhyAM tathA~anile|

madhurAmlakaShAyaH syAt saMsRuShTe bastiruttamaH||29||

When stool or ''pitta'' is associated with ''vata'' or ''vata'' is associated with stool and ''pitta'', a ''basti'' with sweet, sour and astringent substances, is excellent. [29]

==== Treatment of ''atisara'' (diarrhea) mixed with ''pitta-rakta-shakrita'' ====

शकृच्छोणितयोः पित्तशकृतो रक्तपित्तयोः|

बस्तिरन्योन्यसंसर्गे कषायस्वादुतिक्तकः||३०||

śakṛcchōṇitayōḥ pittaśakṛtō raktapittayōḥ|

bastiranyōnyasaṁsargē kaṣāyasvādutiktakaḥ||30||

shakRucchoNitayoH pittashakRuto raktapittayoH|

bastiranyonyasaMsarge kaShAyasvAdutiktakaH||30||

In case of morbid mutual associations of ''pitta'' with stool and ''rakta'', as well as stool with ''rakta'' and ''pitta, basti'' with astringent, sweet and bitter ingredients. [30]

==== Treatment of ''atisara'' (diarrhea) mixed with ''kapa-rakta-pitta-shakrita'' ====

कफेन विशि पित्ते वा कफे विट्पित्तशोणितैः|

व्योषतिक्तकषायः स्यात् संसृष्टे बस्तिरुत्तमः||३१||

kaphēna viśi pittē vā kaphē viṭpittaśōṇitaiḥ|

vyōṣatiktakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||31||

kaphena vishi pitte vA kaphe viTpittashoNitaiH|

vyoShatiktakaShAyaH syAt saMsRuShTe bastiruttamaH||31||

In case of similar associations of ''kapha'' with stool or ''pitta''; or of stool or ''pitta'' or ''rakta'' with ''kapha'', a ''basti'' with ''trikatu'', bitter and ''kashaya'' ingredients is to be recommended. [31]

==== Treatment of ''atisara'' (diarrhea) mixed with ''vata-kapha-shakrita'' and ''rakta-kapha'' ====

स्याद्बस्तिर्व्योषतिक्ताम्लः संसृष्टे वायुना कफे|

मधुरव्योषतिक्तस्तु रक्ते कफविमूर्च्छिते||३२||

syādbastirvyōṣatiktāmlaḥ saṁsṛṣṭē vāyunā kaphē|

madhuravyōṣatiktastu raktē kaphavimūrcchitē||32||

syAdbastirvyoShatiktAmlaH saMsRuShTe vAyunA kaphe|

madhuravyoShatiktastu rakte kaphavimUrcchite||32||

In ''atisara'' where ''kapha'' is associated with ''vata, basti'' with ''trikatu'', bitter and sour ingredients, and if ''rakta'' is associated with ''kapha'' then with sweet, ''trikatu'' and bitter is recommended. [32]

==== Treatment of ''atisara'' (diarrhea) mixed with ''kapha- vata -shakrita'' and ''vata-pitta'' ====

मारुते कफसंसृष्टे व्योषाम्ललवणो भवेत्|

बस्तिर्वातेन पित्ते तु कार्यः स्वाद्वम्लतिक्तकः||३३||

mārutē kaphasaṁsṛṣṭē vyōṣāmlalavaṇō bhavēt|

bastirvātēna pittē tu kāryaḥ svādvamlatiktakaḥ||33||

mArute kaphasaMsRuShTe vyoShAmlalavaNo bhavet|

bastirvAtena pitte [2] tu kAryaH svAdvamlatiktakaH||33||

If ''vata'' is accompanied by ''kapha'', a ''basti'' with ''trikatu'', sour and salty ingredients; and when ''pitta'' is associated with ''vata, basti'' with sweet, sour and bitter substances is to be administered. [33]

==== Treatment for conditions due to ''samsarga'' (combination of ''dosha'') ====

त्रिचतुःपञ्चसंसर्गानेवमेव विकल्पयेत्|

युक्तिश्चैषातिसारोक्ता सर्वरोगेष्वपि स्मृता||३४||

tricatuḥpañcasaṁsargānēvamēva vikalpayēt|

yuktiścaiṣātisārōktā sarvarōgēṣvapi smṛtā||34||

tricatuHpa~jcasaMsargAnevameva vikalpayet|

yuktishcaiShAtisAroktA sarvarogeShvapi smRutA||34||

Similarly a plan may be designed in cases of morbid combinations of three, four or five components. This planning for ''atisara'' is applicable in all disease conditions. [34]

युगपत् षड्रसं षण्णां संसर्गे पाचनं भवेत् |

निरामाणां तु पञ्चानां बस्तिः षाड्रसिको मतः||३५||

yugapat ṣaḍrasaṁ ṣaṇṇāṁ saṁsargē pācanaṁ bhavēt [1] |

nirāmāṇāṁ tu pañcānāṁ bastiḥ ṣāḍrasikō mataḥ||35||

yugapat ShaDrasaM ShaNNAM saMsarge pAcanaM bhavet [1] |

nirAmANAM tu pa~jcAnAM bastiH ShADrasiko mataH||35||

In ''atisara'', if all six pathological components are simultaneously involved, a ''pachana'' (causing or promoting digestion or transformation) medicine containing the drugs of all six tastes is useful, while in ''nirama'' (without ''ama'') condition, where other five are involved a ''basti'' consisting of all six ''rasas'' (tastes) is indicated. [35]

==== ''Sarvatisara nashaka ghrita'' (medicated ghee for treatment of all types of diarrhea) ====

उदुम्बरशलाटूनि जम्ब्वाम्रोदुम्बरत्वचः|

शङ्खं सर्जरसं लाक्षां कर्दमं च पलांशिकम्||३६||

पिष्ट्वा तैः सर्पिषः प्रस्थं क्षीरद्विगुणितं पचेत्|

अतीसारेषु सर्वेषु पेयमेतद्यथाबलम्||३७||

udumbarani jambvāmrōdumbaratvacaḥ|

śaṅkhaṁ sarjarasaṁ lākṣāṁ kardamaṁ ca palāṁśikam||36||

piṣṭvā taiḥ sarpiṣaḥ prasthaṁ kṣīradviguṇitaṁ pacēt|

atīsārēṣu sarvēṣu pēyamētadyathābalam||37||

udumbarashalATUni jambvAmrodumbaratvacaH|

sha~gkhaM sarjarasaM lAkShAM kardamaM ca palAMshikam||36||

piShTvA taiH sarpiShaH prasthaM kShIradviguNitaM pacet|

atIsAreShu sarveShu peyametadyathAbalam||37||

A freshly prepared paste of ''udumbarashalaatu'' (unripe fruits of Ficus glomerata Roxb.), bark of ''jaambu'' (Syzygium cumini Skeels.), ''amra'' (Mangifera indica Linn.) and ''udumbara'' (Ficus glomerata Roxb.); ''sankha'' (conch shell), ''sarjarasa'' (resin of Vateria indica Linn.), ''laaksha'' (resinous secretion of Laccifera lacca Kerr.) and ''kardama'' (a type of rice), each one ''pala'' (about 50 grams) is to be cooked with one ''prastha'' (about 800 ml.) of ''ghrita'', and two ''prastha'' of milk. This (thus prepared ''ghrita'') is to be taken in all types of ''atisara'' according to ''bala'' (strength of the patient as well as disease). [36-37]

==== ''Sarvatisara nashaka yavagu'' (medicated gruel for treatment of all types of diarrhea) ====

कच्छुराधातकीबिल्वसमङ्गारक्तशालिभिः|

मसूराश्वत्थशुङ्गैश्च यवागूः स्याज्जले शृतैः||३८||

बालोदुम्बरकट्वङ्गसमङ्गाप्लक्षपल्लवैः |

मसूरधातकीपुष्पबलाभिश्च तथा भवेत्||३९||

kacchurādhātakībilvasamaṅgāraktaśālibhiḥ|

masūrāśvatthaśuṅgaiśca yavāgūḥ syājjalē śṛtaiḥ||38||

bālōdumbarakaṭvaṅgasamaṅgāplakṣapallavaiḥ |

masūradhātakīpuṣpabalābhiśca tathā bhavēt||39||

kacchurAdhAtakIbilvasama~ggAraktashAlibhiH|

masUrAshvatthashu~ggaishca yavAgUH syAjjale shRutaiH||38||

bAlodumbarakaTva~ggasama~ggAplakShapallavaiH |

masUradhAtakIpuShpabalAbhishca tathA bhavet||39||

A ''yavagu'' (gruel) prepared by cooking ''raktashali'' (a variety of rice brownish in color) and ''masura'' (Lens culinaris Medic.)) in a decoction of ''kacchura'' (Mucuna pruriens Baker. ), ''dhataki'' (Woodfordia fruticosa Kurz.), ''bilva'' (Aegle marmelos Carr.), ''samanga'' (Mimosa pudica Linn.) and ''ashvatthashunga'' (leaf bud of Ficus religiosa Linn.) is beneficial in ''atisara''.

Similar preparation can be made with unripe fruit of ''udumbara'', leaves of ''kathvanga'' (Ailanthus excelsa Roxb.) and ''samanga'' as well as ''plaksha'' (Ficus lacor Buch.), ''masura'' (Lens culinaris Medic.) and ''dhataki'' flowers. [38-39]

==== Treatment of all types of diarrhea ====

स्थिरादीनां बलादीनामिक्ष्वादीनामथापि वा|

क्वाथेषु समसूराणां यवाग्वः स्युः पृथक् पृथक्||४०||

कच्छुरामूलशाल्यादितण्डुलैरुपसाधिताः|

दधितक्रारनालाम्लक्षीरेष्विक्षुरसेऽपि वा||४१||

शीताः सशर्कराक्षौद्राः सर्वातिसारनाशनाः|

ससर्पिर्मरिचाजाज्यो मधुरा लवणाः शिवाः||४२||

sthirādīnāṁ balādīnāmikṣvādīnāmathāpi vā|

kvāthēṣu samasūrāṇāṁ yavāgvaḥ syuḥ pṛthak pṛthak||40||

kacchurāmūlaśālyāditaṇḍulairupasādhitāḥ|

dadhitakrāranālāmlakṣīrēṣvikṣurasē'pi vā||41||

śītāḥ saśarkarākṣaudrāḥ sarvātisāranāśanāḥ|

sasarpirmaricājājyō madhurā lavaṇāḥ śivāḥ||42||

sthirAdInAM balAdInAmikShvAdInAmathApi vA|

kvAtheShu samasUrANAM yavAgvaH syuH pRuthak pRuthak||40||

kacchurAmUlashAlyAditaNDulairupasAdhitAH|

dadhitakrAranAlAmlakShIreShvikShurase~api vA||41||

shItAH sasharkarAkShaudrAH sarvAtisAranAshanAH|

sasarpirmaricAjAjyo madhurA lavaNAH shivAH||42||

Different ''yavagus'' can be prepared by combining ''masura'' (Lens culinaris Medic.) with the decoctions of ''sthiradi, baladi'' and ''ikshvadi'' (groups of plants). [40]

Roots of ''kacchura'' (Mucuna pruriens Baker.) and rice of ''shali'' and other varieties cooked with ''dadhi'' (yogurt), ''takra'' (churned yogurt), ''aranala'' (sour fermented supernatant of cooked rice), ''ksheera'' (milk) or ''ikshurasa'' (sugarcane juice), and after being cooled added with sugar and honey, is able to treat all types of ''atisara''. The above-mentioned gruels are promising (anti-diarreal) when added with ''ghrita'', pepper and cumin (Cuminum cyminum Linn.), sweet substances and rock salt. [41-42]

==== Treatment principles ====

भवन्ति चात्र श्लोकाः-

स्निग्धाम्ललवणमधुरं पानं बस्तिश्च मारुते कोष्णः|

शीतं तिक्तकषायं मधुरं पित्ते च रक्ते च||४३||

तिक्तोष्णकषायकटुश्लेष्मणि सङ्ग्राहि वातनुच्छकृति|

पाचनमामे पानं पिच्छासृग्बस्तयो रक्ते||४४||

अतिसारं प्रत्युक्तं मिश्रं द्वन्द्वादियोगजेष्वपि च|

तत्रोद्रेकविशेषाद्दोषेषूपक्रमः कार्यः||४५||

bhavanti cātra ślōkāḥ-

snigdhāmlalavaṇamadhuraṁ pānaṁ bastiśca mārutē kōṣṇaḥ|

śītaṁ tiktakaṣāyaṁ madhuraṁ pittē ca raktē ca||43||

tiktōṣṇakaṣāyakaṭuślēṣmaṇi saṅgrāhi vātanucchakṛti|

pācanamāmē pānaṁ picchāsṛgbastayō raktē||44||

atisāraṁ pratyuktaṁ miśraṁ dvandvādiyōgajēṣvapi [1] ca|

tatrōdrēkaviśēṣāddōṣēṣūpakramaḥ kāryaḥ||45||

bhavanti cAtra shlokAH-

snigdhAmlalavaNamadhuraM pAnaM bastishca mArute koShNaH|

shItaM tiktakaShAyaM madhuraM pitte ca rakte ca||43||

tiktoShNakaShAyakaTushleShmaNi sa~ggrAhi vAtanucchakRuti|

pAcanamAme pAnaM picchAsRugbastayo rakte||44||

atisAraM pratyuktaM mishraM dvandvAdiyogajeShvapi ca|

tatrodrekavisheShAddoSheShUpakramaH kAryaH||45||

Here the ''shlokas'' (verses) remain-

(Besides the above some more treatment-principles useful in ''atisaras'' are given below as per the factors involved)

#''Vata: snigdha'' (unctuous) ''amla'' (sour) ''lavana'' (salty) and ''madhura'' (sweet) liquids orally and warm ''bastis'' with same substances.
#''Pitta'' and ''rakta'': cold bitter astringent and sweet substances.
#''Kapha'': bitter, hot, astringent and pungent substances.
#''Shakrita'' (stool): ''sangrahi'' (checks ''atisara'' through improving the digestion) and ''vataghna'' (measures)
#''Ama: pachana'' (measures digesting ''ama'')
#''Rakta: picchabasti'' and ''raktabasti''
#''Atisara'' may also be in combination of two or more factors. In those conditions treatment is to be planned according to dominance of the ''doshas'' (and the factors involved). [43-45]

==== Summary ====

तत्र श्लोकः-

प्रासृतिकाः सव्यापत्क्रिया निरूहास्तथाऽतिसारहिताः|

रसकल्पघृतयवाग्वश्चोक्ता गुरुणा प्रसृतसिद्धौ||४६||

tatra ślōkaḥ-

prāsṛtikāḥ savyāpatkriyā nirūhāstathā'tisārahitāḥ|

rasakalpaghṛtayavāgvaścōktā [1] guruṇā prasṛtasiddhau||46||

tatra shlokaH-

prAsRutikAH savyApatkriyA nirUhAstathA~atisArahitAH|

rasakalpaghRutayavAgvashcoktA [1] guruNA prasRutasiddhau||46||

In this chapter of [[Prasrita Yogiyam Siddhi]] management of the complications, ''prasritika niruhas'', and the ''bastis,'' decoctions, ''ghrita'', gruels useful in the management of ''atisaras'' are presented by the teacher. [46]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते

दृढबलसम्पूरिते सिद्धिस्थाने प्रासृतयोगीयसिद्धिर्नामाष्टमोऽध्यायः ||८||

ityagnivēśakṛtē tantrē carakapratisaṁskṛtē'prāptē

dṛḍhabalasampūritē siddhisthānē prāsṛtayōgīyasiddhirnāmāṣṭamō'dhyāyaḥ [1] ||8||

ityagniveshakRute tantre carakapratisaMskRute~aprApte

dRuDhabalasampUrite siddhisthAne prAsRutayogIyasiddhirnAmAShTamo~adhyAyaH [1] ||8||

Thus in the treatise (originally) prepared by Agnivesha, edited by Charak and supplemented the lost parts by Dridhabala, in [[Siddhi Sthana]], the eighth chapter entitled [[Prasrita Yogiyam Siddhi]] is concluded.

=== ''Tattva Vimarsha'' ===

*A milder form of ''basti'' can get stagnated inside leading to complications of not eliminating ''doshas''. This may result into ''ayoga'' or ''heenayoga'' (insufficient action). On the contrary if a ''basti'' is stronger it may cause an ''atiyoga'' (action in excess) causing excessive evacuation of ''dosha'' along with body constituents.
*Faulty application of ''bastis'' may cause a complication in the form of ''atisara'' (diarrhea).
*''Atisara'' (diarrhea) may be either acute with undigested material associated with ''ama'' or chronic without much undigested material/ ''pakwa''.
*''Pakwa'' type of ''atisara'' is again of five types as with ''shakrita'' (fecal matter), with ''vata'' (flatus), with ''asrika'' (blood), with ''pitta'' and with ''kapha''.
*Basic principle of treatment of every condition associated with ''ama'' is ''amapachana''. Decoction / powder of ''musta, ativisha, kushtha, nata, daru'' and ''vacha'' are ideal for ''amapachana''. This recipe is useful in ''amatisara''.
*To manage ''pakvatisara'', medicines of two categories viz. ''vataghna'' (anti-''vata'') and ''grahi'' (anti-diarrheal by promoting digestion and absorption) are used.
*''Picchabasti'' and ''raktabasti'' are treatments for diarrhea with blood.These can be considered as ''stambhana'' (stop bleeding) and ''vishesha brimhana'' (enhance internal strength).
*The treatment principles of various types of ''atisara'' due to complications of ''basti'' therapy:
**''Vata'': ''snigdha'' (unctuous), ''amla'' (sour), ''lavana'' (salty) and ''madhura'' (sweet) liquids orally and warm ''bastis'' with same substances.
**''Pitta'' and ''rakta'': cold bitter astringent and sweet substances.
**''Kapha'': bitter, hot, astringent and pungent substances.
**''Shakrita'' (stool): ''sangrahi'' (checks ''atisara'' through improving the digestion) and ''vataghna'' (measures)
**''Ama: pachana'' (measures digesting ''ama'')
**''Rakta: picchabasti'' and ''raktabasti''.

=== ''Vidhi Vimarsha'' ===

The unit ''prasrita'', according to [[Charak Samhita]] is an amount of two ''palas'' which is approximately equal to 100 milliliter (1''pala''=50ml).<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 8/4 (Cakrapāṇi commentary); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713</ref>,<ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 7-20.</ref> (verse 1-2)[[Charak Samhita]] is written in the form of dialogue between the teacher (Atreya) and his disciples (mainly Agnivesha). Mild form of ''shodhana'' measures are for those subjects who are not suitable for strong measures and for the patients who suffered with the complications of the measures described in previous chapters. ''Vamana'' and ''virechana'' are major procedures for ''shodhana''. However, these are contraindicated for the tender persons. Tender persons may not tolerate even ''basti''. Therefore, mild forms of ''bastis'' are described for them. Similarly, the measures to treat the complications developed due to the faulty application of the procedures especially the ''basti''.

Some translators interpreted the phrase ''karmana viplutanama'' as ‘exhausted of hard work’.<ref>Dash Bhagavan & Sharma R K; Caraka saṁhitā(English translation); siddhisthāna, chapter 8/3; Chowkhamba Sanskrit Series, Varanasi; 2nd edition, 2005; P 310</ref> However, the meaning of this phrase can be taken as ‘complicated by the consequences of the therapies’, which seems to be more appropriate in this context. The complications may be natural consequences of the therapies or may be due to faulty application. (verse 3)

The recipe in verse 4 is composed of total five ''prasritas'' (2 ''prasritas'' of milk, 1 ''prasrita'' each of honey, sesame oil and ''ghrita''), therefore this ''basti'' is named by Gangadhara as ''panchaprasrtika basti''.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, (only samskrita), 5th part, siddhisthāna, chapter 8 (Commentary of Gaṅgādhara); edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3735.</ref> This ''basti'' is useful for eliminating ''vata'' as well as promoting the strength and the complexion.

''Vata'' eliminating measures usually promotes quality of ''dhatus'' and ''upadhatus'' (structural components of the body). This eventually results in promotion of the body strength and the complexion. Word ''bala'' also denotes the immune function; hence this may also be interpreted as promoting immune activity. In ancient time to mix a ''basti'' material, churning stick was used. In modern time an electric blender is an ideal alternative. With a blender the mixture is better homogenized than a manual churning stick.

Chakrapani considered ''bilvadi'' group in his Ayurveda ''deepika'' commentary as ''dashamula''.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 8/5 (commentary of Cakrapāṇi); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref> This group consists of roots of ten plants viz. ''bilva'' (Aegle marmelos Carr.), ''shyonaka'' (Oroxylum indicumVent.),''gambhari'' (Gmelina arborea Roxb.), ''patala'' (Stereospermum suaveolensDC.),''agnimantha'' (Premna integrifolia Roxb.), ''shalaparni'' (Desmodium gangeticumDC.), ''prishniparni'' (Uraria picta Desr.) ''brihati'' (Solanum indicum Linn.), ''kantakari'' (Solanum suranttense Burm.) and ''gokshura'' (Tribulus terrestris Linn.).

While Gangadhara in his ''Jalpakalpataru'' commentary mentions this as ''panchamula'' –the roots of a group of five plants viz. ''bilva,shyonaka, gambhari, patala'' and ''agnimantha.''<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, (only samskrita), 5th part, siddhisthana, chapter 8/5 (Commentary of Gaṅgādhara); edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3735.</ref>Since next verse (5th) describes a recipe with ''panchamula'', in this verse considering ''bilvadi'' as ''dashamula'' is more logical and practical. This ''basti'' consists a total of eight ''prasritas'' (one ''prasrita'' each of ''taila, prasanna, madhu'' and ''ghrita'' and two ''prasritas'' each of ''bilvadi'' decoction and ''kulattha'' decoction). Therefore, Gangadhara names this as ''ashtaprasritika basti''.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā (only samskrita), 5th part, siddhisthāna, chapter 8 (Commentary of Gaṅgādhara); edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3735.</ref>

The ''basti'' in verse six, consists of total nine ''prasritas'' i.e. ''panchamula'' decoction- five ''prasritas'', sesame oil - two ''prasritas'', honey- one ''prasrita, ghrita''- one ''prasrita''. Therefore, Gangadhara names this as ''navaprasritika basti''.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā (only samskrita), 5th part, siddhisthāna, chapter 8 (Commentary of Gaṅgādhara); edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3736</ref> (verses 4-6)

''Aksha'' and ''karsha'' are the units of same amount, which is equal to about twelve grams. Hence the amount of rock salt in this basti would be about 6 grams. ''Shukra'' is one of the seven ''dhatus'' (structural components). ''Shukra'' is not a single entity. It comprises male reproductive cells and substances including the androgenic hormones responsible for manhood in a man. This ''basti'' promotes quality and quantity of all these entities in the body.

The usual contents of a ''niruha basti'' are salt, honey, oil'', kalka'' and decoction (or a liquid). These are to be mixed by churning in the sequence as mentioned above. Here the mixing may be in this sequence- ''saindhava'', honey, oil, ''ghrita, hapusha'' (fruits of Juniperus communis Linn.)and milk.(verse 7)

''Basti'' is usually contraindicated in ''kushtha'' [Ca. Si. 2/14]<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 2/14; edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 688.</ref>. However, Sushruta Samhita recommends ''niruhabastis'' in this condition [Su.Ci.35/22].<ref>Susruta, Susruta Samhita, Chikitsa sthana, Chapter 35/22; Edited by Yadavji Trikamji Acharya and Narayana Ram Acharya; 4th edithion, 1980, P 527 </ref> Practically ''niruha basti'', with bitter substances e.g. ''panchatikta niruha'', is useful in ''kushtha''.

The quantity of ''kalka'' of ''sarshapa'' is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided. <ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 8/8-9 (Cakrapāṇi commentary); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref> In the ''niruha bastis'' with an amount of twelve ''prasritas'', the amount of ''kalka'' is usually two ''palas'' (about 100gms). In present recipe, the amount is five ''prasritas'' and therefore the amount of ''kalka'' of ''sarshapa'' would be about 40 gms. This principle is applicable in latter recipes also where the amount of ''kalka'' is not mentioned.

This ''basti'' contains ''vidanga'' (Embelia ribes Burm.) which is the best among ''krimighna''(anti-parasitic) [Ca.Su. 25/40] substances. Therefore, it has a ''kriminashana'' effect. (verse 9-10)

Gangadhara in his ''Jalpakalpataru'' commentary considers ''payasyas ksheerakakoli'', which is Fritillaria roylei Hook. Some scholars consider ''payasyaas vidari'', but at present, ''vidari'' recipies already include one ingredient therefore to consider it ''ksheerakakoli'' is appropriate.

In the recipes of verse 11-12, the amount of paste is not mentioned. This may be calculated as stated in earlier verse 8th -9th. (verse 11-12)

In above verses from 4 to 14, nine recipes of ''prasrita bastis'' are described. Here a special and practical instruction is given that even if salt is not mentioned in any of the recipes, rock salt is to be added and these ''bastis'' are always given with a moderate warm temperature.

While preparing the ''bastis'', rock salt is to be added. The amount is to be calculated according to the principle described in the 7th verse i.e. about 6 gms. After preparing the ''basti'', to keep it warm until it is administered, a hot water bath may be used. (verse 13-14)

In the verse 15-16, two opposite possibilities are described. It may be milder than normal or it may be stronger than a normal. A mild ''basti'' is unable not only to eliminate ''doshas'', but it itself is not ableto come out. This is ''ayoga'' or ''heenayoga'' (insufficient action). In such a case a ''basti'' is to be repeated with a stronger recipe. Contrary to this, if a ''basti'' is stronger it may cause an ''atiyoga'' (action in excess) causing evacuation of colonic contents more than required and eventually loss of essential substances.

A soft acting ''basti'' is not able to eliminate the ''doshas'' and may get stagnated and cause disturbance. To eliminate it, a strong and sharp acting ''basti'' is recommended. If strong ''bastis'' have caused emaciation, dehydration or weakness, the ''bastis'' with ''madhura'' (sweet) substances are useful because ''madhura'' substances are nourishing in action. (verses 15-16)

In ''vata''-related disorders, ''basti'' material with physically and pharmacologically hot property is preferred. It may cause ''pitta'' aggravation resulting in burning sensation and other such ''pitta''-related symptoms. In such a condition, grape juice or decoction of raisins added with a ''kalka'' (paste) of ''trivrita'' (Operculina turpethum Linn.) is given. In case of unavailability of ''kalka'', its powder can be used. This cures the burning sensation and other ''pitta''-related symptoms with its anti-''pitta'' action and expulsion of stool, ''pitta'' and ''vata''. ''Yavagu'' with sugar is given for nourishing purpose after this laxation. (verses 16-17)

If the purgation is in excess, it may cause significant loss of stool along with essential substances (e.g.water and electrolytes). This requires immediate attention to prevent the harm due to depletion of essential body components.

In such a condition it is to be corrected by eating ''mashayusha'' (soup of black beans) and ''kulmasha'' (half cooked grains); and by taking honey or ''sura''. ''Kulmasha'' is also interpreted as a sour gruel (prepared by the spontaneous fermentation of fruit-juices or boiled rice). However, according to Chakrapani this is half cooked grain (barley etc.), which is popularly known as ''ghughuni''.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 8/18 (Cakrapāṇi commentary); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref>,<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā (only samskrita), 5th part, siddhisthāna, chapter 8 (Commentary of Cakrapāṇi on 13-14); edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3738.</ref>. This is known as ''ghughari'' in Gujarat and western Madhya Pradesh. This is more suitable interpretation. This is considered to be well nourishing food article. (verse 18)

Faulty application of ''bastis'' may cause a complication in the form of atisāra. ''Atisāra'' is a clinical condition of colon characterized by excessive and frequent defecation with altered consistency of stool. In short it may be interpreted as diarrhea. In next verse different forms of atisāra and their management are described. In this verse the condition is characterized by sāma stool (stool containing āma- undigested material), which smells like a decomposing body (putrid smell) and is associated with abdominal pain. Āma is a substance produced due to weak agni resulting in incomplete transformation of substance. In the present context, due to weak jatharāgni the transformation of food in to digested absorbable substances is incomplete resulting in to production of some intermediate substances.<ref>Vāgbhata; Aṣtāṅga Hṛdaya, chapter 13/25; edited by Bhiṣagācārya Hariśāstrī Parādakara Vaidya; Chaukhambha Orientalia, Varanasi; Reprint 10th edition, 2014; P 216.</ref>,<ref>Śrī Mādhavakara; Mādhavanidāna, volume 1, chapter 25 (madhukośa tīkā of vijayarakṣita and śrī kaṅṭhadatta on 5th verse); edited with madhudhārā hindi commentary by Brakmanand Tripathi; Chaukhamba Surabharati Prakashan, Varanasi, 2012; P 573-574.</ref> These substances are known as āma. Because of its adherent quality it is supposed to be a pathogenic substance.In this condition a decoction of ''mustā, ativiṣā, kuṣṭha, nata, dāru'' and ''vacā'' is recommended. These medicines help in ''pāchana'' (termination) of āma.

This chapter describes six types of ''atisāra'' based on the pathogens being excreted in excess. This verse explains the remedy for one of them in which patient passes stool with significant undigested material. This undigested material causes putrid smell after decomposition. Decomposition also produces some toxic substances, which cause abdominal pain and loss of appetite. The recipe described here is not useful in atisāra produced as complication of basti but also in āmātisāra of any origin. (verse 19)

This verse number 20 describes other five types of atisāra. In this way, six types of atisāras those are depicted in above verses are as follow.

#''Atisara'' (diarrhea) in which stool contains ''ama'' (undigested material)
#Atisāra (diarrhea) in which stool is pakva i.e.free from āma (undigested material)
#Atisāra (diarrhea) in which stool is pakva and containing vāta i.e. significant flatulence.
#Atisāra (diarrhea) in which stool is pakva and containing asṛk (blood).
#Atisāra (diarrhea) in which stool is pakva and containing pitta.
#Atisāra (diarrhea) in which stool is pakva and containing kapha.

For the management of these conditions bastis prepared with the svavargīya medicines (group of medicines acting against particular pathologies) are given.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 8/20 (Cakrapāṇi commentary); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.</ref> For example the vargas (classified groups) described in Ṣaḍvirecanaśatāśrīya chapter (chapter 4th) of sūtrasthāna of Carakasaṁhitā. So, the recommended group of medicines for last five conditions of pathology is purīṣasaṁgrahaṇīya [Ca.Sū.4/8/31], vātaghna, śoṇitasthāpana [Ca.Sū.4/8/46], pittaghna and kaphaghna vargas respectively.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 4/8; edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 33 & 34.</ref>. Purīṣasaṁgrahaṇīya group consists of priyaṅgu (Callicarpa macrophylla R.Br.), ananta (Hemidesmus indicusR.Br.), Seed of mango, kaṭvaṅga (Ailanthus excelsa Roxb.), lodhra (Symplocos racemosa Roxb.), mocharasa (secretion of Salmalia malabarica Scott&Endl.), samṅgā (Mimosa pudica Linn.), dhātakī (Woodfordia fruticosa Kurz.), padmā (Clerodendrum serratum Linn.) and padmakesara (Stamen of Nelumbo nucifera Gaertn.). shoṇitasthāpana group consists of honey, madhuka (Glycyrrhiza glabra Linn.), saffron, mocarasa (secretion of Salmalia malabarica Scott &Endl.), broken earthen vessel, lodhra (Symplocos racemosa Roxb.), gairika (red ochre), priyaṅgu (Callicarpa macrophylla R.Br.), sharkarā(sugar) and lājā (puffed rice).<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 4/8; edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 33 & 34.</ref>The form of basti is not described here. However, this may be decided according to disease condition and patient’s tolerance. (verse 20)

In this version of [[Charak Samhita]] thirty six variants are cited, but another version ‘kēvalaiḥ saha ceṭ triṁśadvidyāt sōpadravānapi’ mentions only thirty.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā (only samskrita), 5th part, siddhisthāna, chapter 8; edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3739.</ref> Gaṅgādhara also explains thirty forms in the following manner.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā (only samskrita), 5th part, siddhisthāna, chapter 8 (Commentary of Gaṅgādhara on 17); edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3739.</ref>

The six basic forms of atisāra are:
#āmātisāra (diarrhea with undigested material)
#śakṛdatisāra (frequent stool only)
#vātātisāra (that with significant flatulence)
#asṛkātisāra (that with blood)
#pittātisāra (that with pitta) and
#kaphātisāra (that with kapha).

Due to saṁsarga (mutual combinations of two) a total of fifteen variants occur, viz.
#āma-śakṛd, āma-vāta, āma-asṛk, āma-pitta, āma-kapha,
#śakṛd-vāta, śakṛd-asṛk, śakṛd-pitta, śakṛd-kapha,
#vāta-asṛk, vāta-pitta, vāta-kapha,
#asṛk-pitta, asṛk-kapha, and
#pitta-kapha.

Nine ''upadrava'' as cited above.

The upadravas in present version of chapter are ten. Gaṅgādhara has taken description of nine upadravas from another version.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā (only samskrita), 5th part, siddhisthāna, chapter 8/17 ; edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3739.,</ref> But upadravas cannot be counted among types of a disease. Hence the thirtysix variants would be in following manner.

The six basic forms of atisāra are as mentioned above.

Due to saṁsarga (mutual combinations of two) atotal of thirtyvariants occur, viz. fifteen samsargas as mentioned above and other fifteen are as below:
#śakṛd- āma, vāta-āma, asṛk-āma, pitta-āma, kapha-āma,
#vāta-śakṛd, asṛk-śakṛd, pitta-śakṛd, kapha-śakṛd,
#asṛk-vāta, pitta-vāta, kapha-vāta,
#pitta-asṛk, kapha-asṛk, and
#kapha-pitta.

Moreover [[Charak Samhita]] describes types of atisāra in its chapter 19th of [[Sutra Sthana]] and 19th chapter of [[Chikitsa Sthana]] differently. <ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, Sūtrasthāna, chapter 19/4/3; edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 110.</ref>,<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, Cikitsāsthāna, chapter 19; edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 547-549.</ref> The context of the topic atisāra in present chapter is absolutely different. Here it is described first as a complication of basti, which eloborted further in the chapter. In earlier sections atisāra was described as a primary disease manifested because of its own physical and mental etiological factors. (verse 21-22)

Basic principle of treatment of every condition associated with āma is āmapāchana (termination of āma by promoting function of agni). For this purpose mustā, ativiṣā, kuṣṭha, nata, dāru and vacā (which are mentioned in 19th verse) are to be given. This combination may be given in form of powder or as decoction. This recipe is useful in āmātisāra every origin. (verse 23)

For vātaghna medicines to be used in vata associated atisara, Cakrapāṇi recommends daśhamula, while Gaṅgādhara considers bṛhat pañchamūla (see the commentary on 5th verse). For grāhī purpose the medicines of purīṣasaṁgrahaṇīya varga [Ca.Sū.4/8/31] are to be used.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, Sūtrasthāna, chapter 4/8; edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 33 & 34.</ref>

Next condition in which atisāra is associated with dominance of vāta, snēhabasti supplemented with sweet, sourand salty substances is recommended. Being opposite to the properties of vāta, the substances in this basti antagonizes the vāta principle. (verse 24)

Now the management of other conditions - raktātisāra, pittātisāra and kaphātisāra is explained. In raktātisāra, a basti with blood of animals e.g. goat, is given. This not only stops the bleeding but also supplements the substances to produce blood, which is lost due to colonic bleeding. Pitta pacifying remedies also helpful in this condition and therefore the remedies useful in pittātisāra can also be given in raktātisāra. Substances with astringent, sweetandbitter tastes have pitta-antagonizing action and hence the basti consists of such substances are helpful in management of pittātisāra. Substances with astringent, pungent and bitter tastes have kapha-antagonizing action; therefore, a basti with such medicines is beneficial in kaphātisāra.

The basti used in pittātisārais useful in raktātisāra also. Applying this principle, this type of basti may be used in a disease entity known as ulcerative colitis. (verse 25)

These verses number 26-27 describe management plan for the saṁsargaja atisāras (in which two morbid components are associated and have mutual vitiation). Cakrapāṇi in his commentary decides the main and secondary role of the involved components on the basis of vibhakti (noun case) of the words. 7thvibhakti signifies the main role while 3rd expresses secondary role of the factors.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, siddhisthāna, chapter 8/26-31 (Cakrapāṇi commentary); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.</ref>

In the 26th verse the possible combination are-
#āma is associated with śakṛt i.e.stool (āma is primary and stool is secondary)
#āma is associated with vāta (āma is primary and vāta is secondary)
#śakṛt (stool) is associated with āma (stool is primary āma is secondary)
#vāta is associated with āma (vāta is primary and āma is secondary)

In the 27th verse the possible combination are-
#āma is associated with pitta (āma is primary and pitta is secondary)
#āma is associated with rakta (āma is primary and rakta is secondary)
#pitta is associated with āma (pitta is primary and āma is secondary)
#rakta is associated with āma (rakta is primary and āma is secondary)

In these conditions in mentioned in 26th verse, a drink prepared with trikaṭu, sour and salty substances is recommended. While the conditions mentioned in 27th verse, are manageable with adrink, prepared with trikaṭu, sweetand bitter substances is useful. (verse 26-27)

The description of saṁsargaja atisāras continues in these verses 28-29. In the 28th verse, the possible combination are-

#āma is associated with kapha (āma is primary and kapha is secondary)
#kapha is associated with āma (kapha is primary and āma is secondary)

In 1st condition the recommended basti is with trikaṭu, astringent and bitter substances while in 2nd condition with trikaṭu, astringent and salty medicines.

In a pāthabheda (another version) of 29th verse<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā (only samskrita), 5th part, siddhisthāna, chapter 8 (verse 23 in this version); edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3741.</ref>, rakta is also included. With this inclusion the the possible combination are-

#śakṛt (stool) is associated with vāta (stool is primary and vāta is secondary)
#pitta is associated with vāta (pitta is primary and vāta is secondary)
#rakta is associated with vāta (pitta is primary and āma is secondary)
#vāta is associated withstool(vāta is primary and stool is secondary)
#vāta is associated with pitta (vāta is primary and pitta is secondary)
#vāta is associated with rakta (vāta is primary and rakta is secondary)

In these pathological conditions a basti with sweet, sour and astringent materials is acclaimed. (verse 28-29)

The management of saṁsargaja atisāras further continues in these verses. In the 30th verse the possible combination are-
#rakta is associated with śakṛt i.e. stool(rakta is primary andstool is secondary)
#rakta is associated with pitta (rakta is primary and pitta is secondary)
#śakṛt (stool) is associated with pitta (stool is primary and pitta is secondary)
#śakṛt stoolis associated with rakta (stool is primary and rakta is secondary)
#pitta is associated with rakta (pitta is primary and rakta is secondary)
#pitta is associated with śakṛt stool (pitta is primary and stool is secondary)

In the 31st verse the possible combination are-
#stool is associated with kapha (stoolis primary and kapha is secondary)
#pitta is associated with kapha (pitta is primary and kapha is secondary)
#kapha is associated with stool (kapha is primary andstool is secondary)
#kapha is associated with pitta (kapha is primary and pitta is secondary)
#kapha is associated with rakta (kapha is primary and rakta issecondary)

The conditions mentioned in 30th verse are managed by administration of basti prepared with astringent, sweet and bitter ingredients. While the pathologies in 31stverse, are manageable by a basti with trikaṭu, bitter and astringent ingredients. (verse 30-31)

In these verses 32-33, four more combinations of pathology are described with their management. In 32nd verse the kapha is main factor with vāta as secondary and rakta as main with kapha as secondary while in 33rd verse vāta is main factor with kapha as secondary and pitta as main with vāta as secondary.

Type of atisāra according to involvement of factors. Reccommended material for basti
Kapha is main factor with vāta as secondary trikaṭu, bitter and sour ingredients
Rakta as main with kapha as secondary sweet,trikaṭu and bitter
Vāta is main factor with kapha as secondary trikaṭu,sour and salty
Pitta is main with vāta as secondary. sweet, sour and bitter(verse 32-33)

There are six components involved in the pathogenesis of atisāra. In earlier verses the combinations of two components are described. The combinations of three, four or five are also possible. Gaṅgādhara in his Jalpakalpataru commentary mentions the possibility of combination of all six also.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā (only samskrita), 5th part, siddhisthāna, chapter 8 (Commentary of Gaṅgādhara on 28); edited by Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Rastriya Samskrita Samsthana, New Delhi, 2002; P 3742-43.</ref> This appears logical, as when five may combine six together may also be possible.

According to Gaṅgādhara, the following combinations may happen viz. ten clinical forms due to combinations of three, six forms due to combinations of four, three forms due to combinations of five and one form with all six. In this way twenty forms are possible. These combinations are as below.

Combinations of three Combinations of four Combinations of five Combination of six
āmaviḍvātaja
āmaviḍasṛja
āmaviḍpittaja
āmaviḍkaphaja
viḍvātāsṛja
viḍvātapittaja
viḍvātakaphaja
vātāsṛkpittaja
vātāsṛkkaphaja
asṛkpittakaphaja
āmaviḍvātāsṛja
āmaviḍvātapittaja
āmaviḍvātakaphaja
viḍvātāsṛkpittaja
viḍvātāsṛkkaphaja
vātāsṛkpittakaphaja
āmaviḍvātāsṛkpittaja
āmaviḍvātāsṛkkaphaja
viḍvātāsṛkpitta kaphaja
āmaviḍvātāsṛkpittakaphaja(verse 34)

If case of association of āma, bastis are contraindicated. This is a general rule. In such condition the āmapācana (preparation to terminate āma)is given. However, in nirāma condition (without association of āma), bastis are recommended. (verse 35)

In these verses 36-37, two new units of measurement are described i.e. pala and prastha. After calculating these amounts in modern units of metric system, pala is around 50 gms or 50 ml while prastha around 800 ml. Though, in previous verses the management of different types of atisāras, has been described. In coherence of the topic, more remedies for atisāra are described in present verses.

This medicated ghṛta is processed with plants having staṁbhana action. Therefore, it is useful in all types of atisāra. Being a nourishing preparation, it is useful in compensating the loss of the essential body substances. A basti may also be given with this preparation and should be retained as much as possible. This type of basti may be useful in inflammatory bowel diseases. (verse 36-37)

The remedies for atisāra continue in these verses 38-39. These verses describe recipe of medicated gruels useful in management of this disease. First the decoction is prepared according to the recipe of ṣaḍaṅgapānīya.<ref>Agniveśa, Caraka, Dṛḍhabala; Caraka saṁhitā, Cikitsāsthāna, chapter 3/145 (Cakrapāṇi commentary on it); edited by Yadavji trikamji acharya; Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 410.</ref>,<ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 146-147.</ref>

For this purpose one part of the course powder of all plants is boiled with 64 parts of water. When water is reduced to half, this is to be taken to cook yavāgū. There are three varieties of yavāgū-maṇḍa, peyā and vilepī. These three are gradually thicker in consistency and may be chosen according to strength of a patient and his agni. (verse 38-39)

Gaṅgādhara considers Sthirādi group of plantsas Svalpapañcamūlaconsists of śālaparṇī (Desmodium gangeticum DC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.). About balādi group there is no clarification by any commentator however the plants Sida cordifolia Linn., abutilon indicum Linn., Sida rhombifolia Linn. and Grewia hirsute Vahl. may be taken for this purpose. Ikṣvādi is considered by Cakrapāṇi as roots of Saccharum officinarum Linn., Desmostachya bipinnata Stapf., Saccharum spontaneum Linn. and roots of rice.
There is another version of verse 42, which mentions last line as ‘sasarpirlavaṇā yojyā madhurā lavaṇāpi vā’ which means that this preparation can be used with ghṛta and rock salt in sweet or salty form.

Above verses give some more recipes for medicated yavāgūs those are helpful in management of atisāra. (verse 40-42)
In these verses some additional and useful remedies for management of various types of atisāra are given. It is to be recalled that in this chapter, authors have considered six factors responsible in pathogenesis and manifestation of atisāra viz. āma vāta, pitta, kapha, rakta and sakṛt (stool). The treatments are to be considered as per the factors involved. (verse 43-45)
The chapter describes various clinical forms of atisara according to the components involved in the pathogenesis. The therapeutics for these various forms of atisāra is described in a planned manner. Ayurvedic management is not merely medicaments but it recommends the food preparations those are helpful in restoring the normalcy of the body components of the patient. Thus the chapter is significantly useful for clinical practice of basti therapies and the treatment of disease atisāra, which includes several modern diseases such as ulcerative colitis, Crohn’s dieases and irritable bowel syndrome. (verse 46)
The basti formulations mentioned in this chapter are used widely in today’s clinical practice. However, though atisara (diarrhea) is explained in detail as complication of improperly administered basti, in todays clinical practice, this complication is observed rarely.

=== Glossary ===

#Abhiṣyanda (abhiShyanda; अभिष्यन्द): Oozing; The term signifies excessive oozing of body fluids.
#Ādhmāna (AdhmAna; आध्मान): Distention: The term signifies distention of a bodypart caused due to stagnation of the substances inside it; but generally, is taken for distention of the abdomen associated with pain due to various reasons like obstruction to the urine and feces, accumulation of blood in abdomen etc.
#Akṣa (akSha; अक्ष): A measurement equivalent to approximately 12gms.
#Āmātisāra (AmAtisAra; आमातिसार): a clinical condition in which frequency of defecation is associated with āma (undigested substance)
#Ānāha (AnAha; आनाह): Obstruction, constipation; Obstruction of the feces in the intestine is to be termed as constipation. The term also signifies obstruction to the flow or normal movements of any substance in nay part of the body
#Āranāla (AranAala; आरनाल): a fermented sour gruel.
#Arōchaka (arochaka; अरोचक): lack of interest; anorexia, A disease where in the person has dislikes towards all kinds of food and drink
#Aruchi (aruchi; अरुचि): The term signifies the complete or partial loss of the taste. Disapproval of food even after it has been taken in the mouth due to lack of perception of the taste in the mouth
#Asṛk (asruk; असृक्): blood, rakta dhātu
#Atisāra (atisAra; अतिसार): Diarrhoea; A disease of large intestine having cardinal feature as excessive and frequent defecation of atisāras
#Balavarṇakṛt (balavarNakRut; बलवर्णकृत्): Promoting bala (strength and immunity) and varṇa (complexion)
#Basti (basti; बस्ति): Urinary bladder, enema.
#Bhēdana (bhedana; भेदन): Breaking pain, breaking- reduction of the hard substances into small pieces.
#Dadhimaṇḍa (dadhimaNDa; दधिमण्ड): Whey, supernatant fluid in yogurt.
#Dāha (dAha; दाह): Burning sensation
#Dōshānulōmana (doShAnulomana; दोषानुलोमन): Bringing the movement of the dōsha(s) in right direction.
#Ghṛt: (ghRut; घृत्), ghee, clarified butter.
#khaja (khaja; खज): Churner.
#Aṣṭaprāsṛtika basti (aShTaprAsrRutika basti; अष्टप्रासृतिक बस्ति): A basti consisting of total amount of eight prāsṛtas
#Grāhī (grAhI; ग्राही): Substances which increase appetite, digestive power and absorb liquid from stool; e.g. dry ginger and piper longum
#Gudadāha (gudadAha; गुददाह): Burning in anal region.
#Tṛṣṇā (tRuShNA; तृष्णा): Polydipsia; the condition resembles to morbid thirst in which the person even after continuous water intake fails to quench his thirst.
#Kāñjī (kA~jI; काञ्जी): Prepared by using cereals (rice and horse gram) and pulses and fermented till it attains acidity
#Kapha (kapha; कफ): A synonym for śleṣhmā. One of the three body doṣhas responsible for stability, unctousness, lubrication, immunity, and cohesion. This is predominant of pṛthvī and jalamahābhūtas. The attributes of kapha are: guru (heavy), manda (dull), hima (cold), snigdha (unctuous), ślakṣṇa (smooth), mṛtsna (soft) and sthira (stable). Major seats of kapha are: thorax, throat, head, kloma, joints, stomach, rasa, meda, nose and tongue. This is of five types: avalaṃbaka, kledaka, bodhaka, sleṣhaka, and tarpaka.
#Kardama (kardama; कर्दम): a type of rice.
#Karṣa (karSha; कर्ष): A unit of measurement; Two kolas make one karṣa= 12 g of metric units
#Kaṣāya (kashAya; कषाय): Astringent; One among the six rasas; Boiled and filtered decoction of herbs, used for the therapeutics & pharmaceutical manufacturing
#Kōṣṇa (koShna; कोष्ण): moderately warm
#Kṛmi (kRmi; कृमि):Parasitic infestation; Diseases caused due to worm infestation.
#Kṣaudra (kShaudra; क्षौद्र): Honey
#Kṣīra (kShira; क्षीर):Milk; Synonym of Dugdha;Latex of plants; milky exudation
#Kulmāṣa (kulmASha; कुल्माष): Half cooked grains.
#Kuṇapa (kuNapa; कुणप): Deadbody
#Kuṣṭha(kuShTha; कुष्ठ): Multiple dermatological manifestations; Chronic Dermatological diseases characterized by disfiguring and discoloration chronic skin disorders
#Kvātha(kvAtha; क्वाथ): synonym of kaṣāya - boiled & filtered liquid of herbs for specific time used for the therapeutics & pharmaceutical manufacturing
#Mēha (meha; मेह): also known as prameha, a condition of polyuria with altered consistency and composition of urine.
#Mṛdu (mRudu; मृदु): Softness/mildness; One of the 20 gurvādiguṇas. Caused due activated akāśa &jala; denotes physiological & pharmacological softness & mildness; causes relaxation; relieves burning sensation
#Karmaṇā viplutānāṁ(karmaNAviplutAnAm; कर्मणाविप्लुतानाम्): suffered from complications by the consequences of the therapies.
#Mūrcchā (mUrcchA; मूर्च्छा): Syncope; A condition characterized by loss of consciousness and postural tone due to vitiation of blood.
#Mūtrakṛcchra (mUtrakRucchra; मूत्रकृच्छ्र): Dysuria; A disease characterized by difficult and painful micturation without any structural abnormality in the genitourinary system
#Lavaṇa (lavaNa; लवण): Salty; one of the six rasa; Salt; e.g. Common table salt, rock salt
#Pācana (pAchana; पाचन): 1. Digestives; substances having capacity to digest but not necessarily increases the apetite; 2. Wound Suppuration
#Pala (pala; पल): A unit of Measurement; Four karṣas will make one pala i.e. 48 g of metric units
#Pallava (pallava; पल्लव): Tender leaves; Synonym of leaf
#Pañcakarma (panchakarma; पञ्चकर्म): A group of five therapies viz. Vamana(therapeutic emesis),virecana(therapeutic purgation), anuvāsana(oily enema), āsthāpana(enema with decoctions) and nasya( nasal administration).
#Pitta (pitta; पित्त): One of the three bodily doṣas that is responsible for digestion and metabolism in the body. It is situated in umbilicus, stomach, sweat, lymph, blood, watery fluids of the body, eye and skin. It is predominant of Agni mahābhūta. Its attributes are: sasneha (slightly unctuous), tīkṣṇa (sharp), uṣṇa (hot), laghu (light), visra (of pungent odour), sara (flowing) and drava (liquid). pitta is of five types: pāchaka, ālochaka, raṅjaka, bhrājaka and sādhaka.
#Prasannā (prasannA; प्रसन्ना): supernatant part of surā (an alcoholic preparation)
#Prasṛta (prasRita; प्रसृत): An amount equal to about 100 milliliter.
#Prastha (prastha; प्रस्थ): An amount equal to about 800 milliliter.
#Pravāhik (pravAhik; प्रवाहिक्): dysentery, a condition characterized by frequency of defecation withtenesmus.
#Rakta (rakta; रक्त): The second dhātu among seven dhātus whose function is jīvana(to give life). It is formed in Yakṛt (liver) and Plīhā (spleen) with the help of Raṅjaka pitta and rakta dhātvagni. This is dominant in agni mahābhūta. Is named so because of its rakta i.e. red color.
#Raktaśālī (raktashAlI;रक्तशाली): A variety of rice having brown or reddish color.
#Raktātisāra (raktAtisAra; रक्तातिसार): Blood containing diarrhea
#Saindhava (saindhava; सैन्धव): Rock salt
#Śakṛd (shakRud; शकृद्): Feces, synonym of purīṣa
#Śālūta (shAlUta; शालूत): Unripe fruit.
#Sāma (sAma; साम): Associated with āma (an intermediate product during digestion and metabolism)
#Saṁsarga (saMsarga; संसर्ग): Association, Mixture, Adjoining; The term literally means association of two. Generally the term is used to signify association of two vitiated humors in the pathogenesis
#Śaṅkha (shaMkha; शंख): 1. Temples 2. Conch
#Siddhiḥ (siddhiH; सिध्धिः): Achievement, success.
#Snēhabasti (snehabasti; स्नेहबस्ति): A form of unctousenema; Medicated unctous enema having quantity four times less to that of decocotion enema.
#Śōṇita (shoNita; शोणित): 1. Synonym of rakta2. Synonym of ārtava pala (pala; पल): an amount equal to approximately 50gms.
#Sōpadrava (sopadrava; सोपद्रव): Associated with upadrava(complications)
#Śṛta (shruta; शृत): A form of decoction.
#Śukrakṛt (shukrakrut; शुक्रकृत्): Promoting śukra.
#Śūla (shUla; शूल): -The term indicates continuous pinning like pain arising in different parts of the body
#Śuṅga (shuMga; शुंग): Leaf bud of a tree.
#Surā (surA; सुरा): Indigenous beerbeverage prepared from fermented cereals. The cereals that are either cooked or ground are mixed with jaggery and other spices and are subjected to naturalfermentation. Beneficial for emaciated, suffering from obstruction in urine, piles, alleviates vāta and useful in anaemia
#Svādu (svAdu; स्वादु): Synonym of madhura, sweet.
#Tīkṣṇa (tIkShNa; तीक्ष्ण): The property of the substance which causes sharpness and quick penetration;sharpness/fast; one of the 20 gurvādi guṇas; caused due activated agni; denotes physiological & pharmacological quickening ofprocesses; instrumental for eliminative therapy; pacifies kapha &vāta , increases pitta; causes irritation, burning & excretion. An attribute of pitta.
#Uṣṇa (uShNa; उष्ण): Heat/hotness; one of the 20 gurvādi guṇas; caused due to activated agnimahābhūta; denotes physiological & pharmacological hotness; manifested by increasedagni, improved appetite & digestion, increased motion in channels, pacifies vāta, kapha, increases pitta. An attribute of Pitta
#Vāta (vAta; वात): A synonym of vāyu, one of the three bodily doṣas, that ispredominant of vāyu and ākāśa mahābhūtas. This is a vital biological force that performs the fuctions like all sensory perceptions, all motor activities, and higher mental activities. This is of five subtypes: prāṇa,vyāna, udāna, samāna and apāna. The major sites of distribution are: large intestine, pelvis, extremities, ears, bones and skin. The attributes of vāyu are: rūkṣa (dry), laghu (light), śīta (cold), khara(rough), sūkṣma(minute), cala (mobile).
#Vātaghna (vAtaghna; वातघ्न): Antagonizing vāta.
#Vātanut (vAtanut; वातनुत्): Synonym of vātaghna
#Viṭsaṅga (viTsaMga; विट्संग): Stagnation of stool.
#Vṛṣatva (vRuShatva; वृषत्व): Virility, manliness.
#Vyāpat (vyApat; व्यापत्): Complications; Complications caused in therapeutic procedures.
#Yavāgū (yavAgU; यवागू): Gruel; it is type of congenial preparation of cereals, like rice, wheat, barley etc. Is of three types: maṇḍa (is only the liquid portion of the prepared gruel), peyā and vilepī.

===References===

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Parimarshaneeyamindriyam Adhyaya

2019-03-06T04:04:52Z

Pallavmishra:

{{Infobox
|title = Parimarshaneeyamindriyam Adhyaya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 3
|label2 = Preceding Chapter
|data2 = [[Pushpitakamindriyam Adhyaya]]

|label3= Succeeding Chapter
|data3 = [[Indriyaneeka]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}
==[[Indriya Sthana]] Chapter 3, Chapter on the Signs and Symptoms of Imminent Death ==

=== Abstract ===
<div style="text-align:justify;">
Palpation and percussion enables a physician to make important observations that helps in understanding the disease. [[Parimarshaneeyamindriyam Adhyaya]] deals with signs and symptoms of imminent death; especially the ones which can be elicited by touch or palpation. The chapter talks about various changes that occur in different parts of the body along with various signs elicited by palpation like hardening, softening, bowing, displacement of body structures, changes in breathing patterns, extreme wasting along with deficiency of blood, structural and functional changes in eyes, body hair, and various body parts.

'''Keywords''': ''lingam, sparsha,'' touch, palpation, fatal signs.
</div>
=== Introduction ===
<div style="text-align:justify;">
[[Parimarshaneeyamindriyam Adhyaya]] is the third amongst the twelve chapters that make up the [[Indriya Sthana]] and mainly deals with the moribund symptoms based on palpating various regions of the body. It follows [[Pushpitakamindriyam Adhyaya]], the second chapter in [[Indriya Sthana]] that deals with the prognosis based on observing the changes in the odour or tastes in the body. The reason for this sequence can be understood as the changes in the odor or taste can be felt easily and from far whereas to palpate proximity to the patient is a must. The chapter also precedes [[Indriyaneeka]], which is the fourth chapter of the [[Indriya Sthana]] that deals with the prognosis based on observing the functioning of the sensory organs of the body.
</div>

===Sanskrit text, Transliteration and English Translation===

परिमर्शनीयेन्द्रियोपक्रमः
अथातः परिमर्शनीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

वर्णे स्वरे च गन्धे च रसे चोक्तं पृथक् पृथक्|
लिङ्गं मुमूर्षतां सम्यक् स्पर्शेष्वपि निबोधत||३||

athātaḥ parimarśanīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

varṇē svarē ca gandhē ca rasē cōktaṁ pr̥thak pr̥thak|
liṅgaṁ mumūrṣatāṁ samyak sparśēṣvapi nibōdhata||3||

athAtaH parimarshanIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

varNe svare ca gandhe ca rase coktaM pRuthak pRuthak|
li~ggaM mumUrShatAM samyak sparsheShvapi nibodhata||3||

Lord Atreya said,, now we shall explain all tangible observations related to palpation in relation with imminent death. [1-2]

The person who is about to die manifests various signs in terms of colour, voice, odour, taste (sense by person) which are described separately. Now we will learn about the signs of imminent death pertaining to touch. [3]

==== Assessment factors by palpation ====

स्पर्शप्राधान्येनैवातुरस्यायुषः प्रमाणावशेषं जिज्ञासुः प्रकृतिस्थेन पाणिना शरीरमस्य केवलं स्पृशेत्, परिमर्शयेद्वाऽन्ये|
परिमृशता तु खल्वातुरशरीरमिमे भावास्तत्र तत्रावबोद्धव्या भवन्ति|
तद्यथा- सततं स्पन्दमानानां शरीरदेशानामस्पन्दनं, नित्योष्मणां शीतीभावः, मृदूनां दारुणत्वं, श्लक्ष्णानां खरत्वं,सतामसद्भावः, सन्धीनां स्रंसभ्रंशच्यवनानि; मांसशोणितयोर्वीतीभावः, दारुणत्वं, स्वेदानुबन्धः, स्तम्भो वा; यच्चान्यदपिकिञ्चिदीदृशं स्पर्शानां लक्षणं भृशविकृतमनिमित्तं स्यात्|
इति लक्षणं स्पृश्यानां भावानामुक्तं समासेन||४||

sparśaprādhānyēnaivāturasyāyuṣaḥ pramāṇāvaśēṣaṁ jijñāsuḥ prakr̥tisthēna pāṇinā śarīramasyakēvalaṁ spr̥śēt, parimarśayēdvā'nyēna|
parimr̥śatā tu khalvāturaśarīramimē bhāvāstatra tatrāvabōddhavyā bhavanti|
tadyathā-satataṁ spandamānānāṁ śarīradēśānāmaspandanaṁ, nityōṣmaṇāṁ śītībhāvaḥ, mr̥dūnāṁdāruṇatva, ślakṣṇānāṁ kharatvaṁ, satāmasadbhāvaḥ, sandhīnāṁ sraṁsabhraṁśacyavanāni;māṁsaśōṇitayōrvītībhāvaḥ, dāruṇatvaṁ, svēdānubandhaḥ, stambhō vā; yaccānyadapi kiñcidīdr̥śaṁsparśānāṁ lakṣaṇaṁ bhr̥śavikr̥tamanimittaṁ syāt|
iti lakṣaṇaṁ spr̥śyānāṁ bhāvānāmuktaṁ samāsēna||4||

sparshaprAdhAnyenaivAturasyAyuShaH [1] pramANAvasheShaM [2] jij~jAsuH prakRutisthena pANinA sharIramasya kevalaM spRushet, parimarshayedvA~anyena|
parimRushatA tu khalvAturasharIramime bhAvAstatra tatrAvaboddhavyA bhavanti|
tadyathA- satataM spandamAnAnAM sharIradeshAnAmaspandanaM, nityoShmaNAM shItIbhAvaH, mRudUnAM dAruNatvaM, shlakShNAnAM kharatvaM,satAmasadbhAvaH [3] , sandhInAM sraMsabhraMshacyavanAni; mAMsashoNitayorvItIbhAvaH, dAruNatvaM, svedAnubandhaH, stambho vA; yaccAnyadapiki~jcidIdRushaM sparshAnAM lakShaNaM bhRushavikRutamanimittaM syAt|
iti lakShaNaM spRushyAnAM bhAvAnAmuktaM samAsena||4||
<div style="text-align:justify;">
The physician who wants to use the method of palpation for measuring the remaining lifespan of a patient, should palpate his (patient’s) entire body with his hands, the hands being in normal condition. If the hands of the physician are not in normal condition, he should do so by using another person as a substitute for palpating the patient’s body.

While palpating patient’s body; following deviations should be studied keeping normal anatomy and physiology of the body in mind; one should examine the person with palpation technique. Extreme deviations from normalcy in the body like the absence of pulsation in the pulsatile areas of the body, absence of warmth from warm regions of the body or the presence of hardness or rigidity in softer body structures can give important information in regards to the life span of the person. Similarly the presence of the signs like dislocation or displacement of joints, extreme alteration in perspiration, extreme emaciation or bulkiness of muscle etc. which are found without any apparent cause are to be studied to assess the span of life or the signs of death. [4]
</div>
तद्व्यासतोऽनुव्याख्यास्यामः- तस्य चेत् परिमृश्यमानं पृथक्त्वेनपादजङ्घोरुस्फिगुदरपार्श्वपृष्ठेषिकापाणिग्रीवाताल्वोष्ठललाटं स्विन्नं शीतं स्तब्धं दारुणं वीतमांसशोणितं वा स्यात्,परासुरयं पुरुषो न चिरात् कालं मरिष्यतीति विद्यात्|
तस्य चेत् परिमृश्यमानानि पृथक्त्वेनगुल्फजानुवङ्क्षणगुदवृषणमेढ्रनाभ्यंसस्तनमणिकपर्शुकाहनुनासिकाकर्णाक्षिभ्रूशङ्खादीनि स्रस्तानि व्यस्तानि च्युतानिस्थानेभ्यः स्कन्नानि वा स्युः, परासुरयं पुरुषोऽचिरात् कालं मरिष्यतीति विद्यात्||५||

tadvyāsatō'nuvyākhyāsyāmaḥ- tasya cēt parimr̥śyamānaṁ pr̥thaktvēnapādajaṅghōrusphigudarapārśvapr̥ṣṭhēṣikāpāṇigrīvātālvōṣṭhalalāṭaṁ svinnaṁ śītaṁ stabdhaṁ dāruṇaṁvītamāṁsaśōṇitaṁ vā syāt, parāsurayaṁ puruṣō na cirāt kālaṁ mariṣyatīti vidyāt|
tasya cēt parimr̥śyamānāni pr̥thaktvēnagulphajānuvaṅkṣaṇagudavr̥ṣaṇamēḍhranābhyaṁsastanamaṇikaparśukāhanunāsikākarṇākṣibhrūśaṅkhādīnisrastāni vyastāni cyutāni sthānēbhyaḥ skannāni vā syuḥ, parāsurayaṁ puruṣō'cirāt kālaṁ mariṣyatīti vidyāt||5||

tadvyAsato~anuvyAkhyAsyAmaH- tasya cet parimRushyamAnaM pRuthaktvena pAdaja~gghorusphigudarapArshvapRuShTheShikApANigrIvAtAlvoShThalalATaMsvinnaM shItaM stabdhaM [1] dAruNaM vItamAMsashoNitaM vA syAt, parAsurayaM puruSho na cirAt kAlaM [2] mariShyatIti vidyAt|
tasya cet parimRushyamAnAni pRuthaktvenagulphajAnuva~gkShaNagudavRuShaNameDhranAbhyaMsastanamaNikaparshukAhanunAsikAkarNAkShibhrUsha~gkhAdIni srastAni vyastAni cyutAni sthAnebhyaHskannAni [3] vA syuH, parAsurayaM puruSho~acirAt kAlaM mariShyatIti [4] vidyAt||5||
<div style="text-align:justify;">
Now I will elaborate upon what I have stated above. If on individual palpation; the feet, calves, thighs, buttocks, belly, both the flanks, vertebral column, hands, neck, palate, lips, forehead are found to be soaked in perspiration, are cold, show stiffness or absence of sensation, inflexibility, or are deficient of flesh or blood, then the physician should note that the person is nearing the end of his live and will die soon.

The physician should similarly palpate separately ankles, knees, pelvis, anus, scrotum, penis, navel, nipples, rib cage, chin, nostrils, ears, eyes, eyebrows, temples to see if these are lax, broken, loosened, displaced from their normal position. If so then the physician should consider that the patient will face death in a short span of time. [5]
</div>
तथाऽस्योच्छ्वासमन्यादन्तपक्ष्मचक्षुःकेशलोमोदरनखाङ्गुलीरालक्षयेत्|
तस्य चेदुच्छ्वासोऽतिदीर्घोऽतिह्रस्वो वा स्यात्, परासुरिति विद्यात्|
तस्य चेन्मन्ये परिमृश्यमाने न स्पन्देयातां, परासुरिति विद्यात्|
तस्य चेद्दन्ताः परिकीर्णाः श्वेता जातशर्कराः स्युः, परासुरिति विद्यात्|
तस्य चेत् पक्ष्माणि जटाबद्धानि स्युः, परासुरिति विद्यात्|
तस्य चेच्चक्षुषी प्रकृतिहीने, विकृतियुक्ते- अत्युत्पिण्डिते, अतिप्रविष्टे, अतिजिह्मे, अतिविषमे, अतिमुक्तबन्धने, अतिप्रस्रुते,सततोन्मिषिते, सततनिमिषिते, निमिषोन्मेषातिप्रवृत्ते, विभ्रान्तदृष्टिके, विपरीतदृष्टिके, हीनदृष्टिके, व्यस्तदृष्टिके,नकुलान्धे, कपोतान्धे, अलातवर्णे, कृष्णपीतनीलश्यावताम्रहरितहारिद्रशुक्लवैकारिकाणां वर्णानामन्यतमेनातिप्लुते वास्यातां, तदा परासुरिति विद्यात्|
अथास्य केशलोमान्यायच्छेत्, तस्य चेत् केशलोमान्यायम्यमानानि प्रलुच्येरन् न चेद्वेदयेयुस्तं परासुरिति विद्यात्|
तस्य चेदुदरे सिराः प्रकाशेरञ् श्यावताम्रनीलहारिद्रशुक्ला वा स्युः, परासुरिति विद्यात्|
तस्य चेन्नखा वीतमांसशोणिताः पक्वजाम्बववर्णाः स्युः, परासुरिति विद्यात्|
अथास्याङ्गुलीरायच्छेत्; तस्य चेदङ्गुलय आयम्यमाना न स्फुटेयुः, परासुरिति विद्यात्||६||

tathā'syōcchvāsamanyādantapakṣmacakṣuḥkēśalōmōdaranakhāṅgulīrālakṣayēt|
tasya cēducchvāsō'tidīrghō'tihrasvō vā syāt, parāsuriti vidyāt|
tasya cēnmanyē parimr̥śyamānē na spandēyātāṁ, parāsuriti vidyāt|
tasya cēddantāḥ parikīrṇāḥ śvētā jātaśarkarāḥ syuḥ, parāsuriti vidyāt|
tasya cēt pakṣmāṇi jaṭābaddhāni syuḥ, parāsuriti vidyāt|
tasya cēccakṣuṣī prakr̥tihīnē, vikr̥tiyuktē- atyutpiṇḍitē, atipraviṣṭē, atijihmē, ativiṣamē, atimuktabandhanē,atiprasrutē, satatōnmiṣitē, satatanimiṣitē, nimiṣōnmēṣātipravr̥ttē, vibhrāntadr̥ṣṭikē, viparītadr̥ṣṭikē,hīnadr̥ṣṭikē, vyastadr̥ṣṭikē , nakulāndhē, kapōtāndhē, alātavarṇē,kr̥ṣṇapītanīlaśyāvatāmraharitahāridraśuklavaikārikāṇāṁ varṇānāmanyatamēnātiplutē vā syātāṁ, tadāparāsuriti vidyāt|
athāsya kēśalōmānyāyacchēt, tasya cēt kēśalōmānyāyamyamānāni pralucyēran na cēdvēdayēyustaṁparāsuriti vidyāt|
tasya cēdudarē sirāḥ prakāśērañ śyāvatāmranīlahāridraśuklā vā syuḥ, parāsuriti vidyāt|
tasya cēnnakhā vītamāṁsaśōṇitāḥ pakvajāmbavavarṇāḥ syuḥ, parāsuriti vidyāt|
athāsyāṅgulīrāyacchēt; tasya cēdaṅgulaya āyamyamānā na sphuṭēyuḥ, parāsuriti vidyāt||6|| tathA~asyocchvAsamanyAdantapakShmacakShuHkeshalomodaranakhA~ggulIrAlakShayet|
tasya ceducchvAso~atidIrgho~atihrasvo vA syAt, parAsuriti vidyAt|
tasya cenmanye parimRushyamAne na spandeyAtAM, parAsuriti vidyAt|
tasya ceddantAH parikIrNAH shvetA jAtasharkarAH syuH, parAsuriti vidyAt|
tasya cet pakShmANi jaTAbaddhAni syuH, parAsuriti vidyAt|
tasya ceccakShuShI prakRutihIne, vikRutiyukte- atyutpiNDite, atipraviShTe, atijihme, ativiShame, atimuktabandhane, atiprasrute, satatonmiShite, satatanimiShite,nimiShonmeShAtipravRutte, vibhrAntadRuShTike, viparItadRuShTike, hInadRuShTike, vyastadRuShTike [5] , nakulAndhe, kapotAndhe, alAtavarNe,kRuShNapItanIlashyAvatAmraharitahAridrashuklavaikArikANAM varNAnAmanyatamenAtiplute vA syAtAM, tadA parAsuriti vidyAt|
athAsya keshalomAnyAyacchet, tasya cet keshalomAnyAyamyamAnAni pralucyeran na cedvedayeyustaM parAsuriti vidyAt|
tasya cedudare sirAH prakAshera~j shyAvatAmranIlahAridrashuklA vA syuH, parAsuriti vidyAt|
tasya cennakhA vItamAMsashoNitAH pakvajAmbavavarNAH syuH, parAsuriti vidyAt|
athAsyA~ggulIrAyacchet; tasya ceda~ggulaya AyamyamAnA na sphuTeyuH, parAsuriti vidyAt||6||
<div style="text-align:justify;">
The physician should similarly examine the patient’s respiration, two sides of the neck, teeth, eye-lashes, eyes, hair covering the head as well as body hair, abdomen, nails and fingers.

If patient breaths either too long or too short of a breath, then it is to be considered that he is nearing to death. While palpating both sides of the neck (''Manya'') of a patient, if absence of pulsation is noted then the person is considered to be closer to death. If his teeth are coated, abnormally white and have sugar/crystal like deposits on it, then the person is considered nearer to death. If his eye-lashes are matted together, he is considered closer to death. If his eyes have lost physiological characteristics or are seen abnormal in any manner like- too bulging, too retracted, too oblique or squinted, too distorted, too loosened within their structure, having too much watery discharge, are either continuously open or closed, continuously blinking, with unstable vision, abnormal vision, deficient vision, have lost their keenness of vision (or color blindness), night blind, sees everything complete white or black, or red like hot coals, if the vision is covered over much with an unhealthy ring of any of colors like- black, yellow, blue, blackish, coppery, green, turmeric, white or any other abnormal color then the person is considered to be standing on death door. Now physician should try to pluck a few hair from scalp and body of the patient, the absence of pain while plucking the hair denotes that the patient is closer to death. If the veins on abdominal region become visible and appear to have various colors like-black, copper, blue, turmeric-like or white, the patient should be considered to be ready to depart from his life. If the nails are drained of blood and flesh, they look dark purple in color, it is to be considered that the patient is not going to survive. Lastly physician should examine the patient’s finger. If while stretching or pulling they do not get cracked, it should be known that the person will not survive. [6]
</div>

==== Summary ====

तत्र श्लोकः-
एतान् स्पृश्यान् बहून् भावान् यः स्पृशन्नवबुध्यते|
आतुरे न स सम्मोहमायुर्ज्ञानस्य गच्छति||७||

tatra ślōkaḥ-
ētān spr̥śyān bahūn bhāvān yaḥ spr̥śannavabudhyatē|
āturē na sa sammōhamāyurjñānasya gacchati||7||

tatra shlokaH-
etAn spRushyAn bahUn bhAvAn yaH spRushannavabudhyate|
Ature na sa sammohamAyurj~jAnasya gacchati||7||

Here is the re-capitulatory verse:
<div style="text-align:justify;">
The physician who, by palpation ascertains various palpable signs, will never be confused regarding the matter of prognostic knowledge regarding life span of a patient. [7]

=== ''Tattva Vimarsha'' ===

Palpation of patient can suggest prognosis of disease.

=== ''Vidhi Vimarsha'' ===

The physician who, by palpation ascertains various palpable signs, will never be confused regarding the matter of prognostic knowledge regarding life span of a patient. [7]

[[Parimarshaneeyamindriyam Adhyaya]] deals with signs and symptoms of imminent death or moribund symptoms; specifically those are elicited by touch or palpation. The chapter commences with the importance of palpation as a modality for diagnosis and any changes in the body indicative of imminent death. The signs of imminent death are seen as abnormal manifestations which cannot be explained as they appear without any reason. These can be seen as absence of pulsation in the areas of the body that are pulsatile, coldness in the warm areas of the body, rigidity in softer body parts, roughness in the body parts that are slimy in nature, the inexplicable absence of body parts; laxity, bowing or displacement of joints, excessive deficiency of flesh or blood, solidity of flesh or blood, excessive perspiration or stiffness, and/or whatever other similar symptoms that can be demonstrated by palpation. The important point to note here is that all the signs and symptoms seen here as well as other chapters of [[Indriya Sthana]] are seen without any causative factors. The rest of the [[Charak Samhita]] excluding the [[Indriya Sthana]] comprises of various signs and symptoms due to ''dosha dushti'' or vitiation of ''doshas''. (Ch.In.3/4)

==== Some examples of palpation ====

Palpation is typically carried out to measure the pulse as well as determines any changes in the body physiology in various body structures like thorax and abdominal cavity. It also helps early detection and diagnosis of prostate or breast cancer. Palpation is also used to determine muscle responses in case of motor neuron diseases.

Arterial pulse can be felt physiologically in various areas as radial pulse, brachial pulse, carotid pulse, femoral pulse, popliteal pulse, posterior tibial pulse and dorsalis pedis pulse. Absence of pulsation in these areas indicates occlusion of the specific artery or aorta from where the pulse wave originates.

The carotid artery is palpated with the thumb or finger tips placed at the upper end of the thyroid cartilage along the medial border of the sternocleidomastoid muscle.<ref> Vakil RJ, Golwalla AF. Physical Diagnosis. 9th ed. Media Promoters & Publishers Pvt. Ltd. MumbaiJal pg231 </ref> The absence of pulsation in carotid artery usually results from atherosclerosis or carotid artery stenosis.
The pulsations of jugular veins or the study of carotid circulation by using color Doppler test can provide more information on cerebral health which can give important information on the life span of the individual.

Thermoregulatory center of hypothalamus actively monitors thermostasis. If this gets altered it’s a sign of fatality. Sudden drop of body temperature could be a result of an injury, hemorrhage, acute illness or shock. A persistently low temperature is commonly seen in emaciation or wasting diseases, hypothyroidism or Simmonds diseases (post-partum hypopituitarism).<ref> Vakil RJ, Golwalla AF. Physical Diagnosis. 9th ed. Media Promoters & Publishers Pvt. Ltd. MumbaiJal pg80 </ref>

Cancer is one of the leading causes of death and disease worldwide today. Various changes like rigidity in soft tissues (e.g. breast cancer) and roughness in mucosal membranes (changes seen in gastric cancer) or extreme wasting are a few changes associated with cancer.
Absence of normally existing body parts can be understood as atrophy of various glands or overall muscle atrophy.
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=== References ===

<references/>
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Vamana Virechana Vyapat Siddhi

2019-03-06T04:03:51Z

Pallavmishra:

{{Infobox
|title = Vamana Virechana Vyapat Siddhi
|label1 = Section/Chapter
|data1 = [[Siddhi Sthana]] Chapter 6
|label2 = Preceding Chapter
|data2 = [[Netrabastivyapat Siddhi]]
|label4 = Succeeding Chapter
|data4 = [[Bastivyapat Siddhi]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]

|header3 =

}}

==[[Siddhi Sthana]] Chapter 6, Chapter on Management of complications of improper therapeutic emesis and purgation==

=== Abstract ===

The chapter deals with complications due to improper administration of purification therapies ''vamana'' (therapeutic emesis) and ''virechana''( therapeutic purgation). Adequate dosage according to ''agni''(digestion power) and ''koshtha'' (bowel habit), proper quality of medicine, time of administration, follow up diet regimens are important to prevent complications. Observation of status of patient during purification therapy with the signs of proper, inadequate, excess elimination, causes and management of complications are described in detail in this chapter. The ten common complications like ''aadhmana'' (distension of abdomen), ''parikartika'' (fissure in ano), ''srava'' (excess discharge), ''hrid-graha'' (congestion in cardiac region), ''gatra-graha'' (body stiffness), ''jeevaadana'' (bleeding), ''vibhramsha'' (prolapse of rectum), ''stambha'' (body stiffness), ''upadrava'' (complications) and ''klama'' (fatigue without exertion) are elaborated. The causes behind this include incompetency either of the attendant, or drug, or physician or the patient.

'''Keywords''': ''Vamana'' (therapeutic emesis), ''Virechana'' (therapeutic purgation), ''Vyapad'' (complications), ''Shodhana'' (purification therapy).

=== Introduction ===

The chapter [[Vamana Virechana Vyapat Siddhi]] explains the complications of improper administration of ''shodhana karma'' and their effective management. Three earlier chapters dealt with complications of ''basti'' (therapeutic enema). In same sequence of describing complications of purification therapies, those of therapeutic emesis and purgation are described in this chapter.

Earlier in [[Sutra Sthana]] 15th chapter ([[Upakalpaniya Adhyaya]]), the procedure of ''vamana'' and ''virechana'' are explained in detail. Their further specifications like signs and symptoms of proper, inadequate and excess actions are explained in first chapter ([[Kalpana Siddhi]]) of this section. The indications and and contra-indications are described in the second chapter ([[Panchakarmiya Siddhi]]). The remaining details of therapeutic emesis and purgation are explained in the present chapter.

The suitable seasons for ''shodhana'', proper timing for the administration of ''snehana'' (oleation) and ''swedana'' (sudation) are required because ''doshas'' get naturally vitiated in specific seasons and are associated in case of disease. Specific pre-requisites for adequate purification are to be considered prior to the procedure. Assessment of vitiation of ''dosha, agni'' (digestive power), ''koshtha'' (bowel) and unctuousness of patient are most important factors for administration of purification therapy. Proper diet and digestion of previous day meal, stable mental state of patient is important to get benefits of purification.

The physician should keenly observe the patient during purification therapy for assessing signs of eliminating ''doshas'' otherwise complications may arise. The physician shall be well versed with diagnosis and management of these complications.

===Sanskrit text, Transliteration and English Translation===

अथातो वमनविरेचनव्यापत्सिद्धिम् व्याख्यास्याम: ||१||

इति ह स्माह भगवानात्रेय: ||२||

अथ शोधनयो: सम्यग्विधिमूर्ध्वानुलोमयो: |

असम्यकृतयोश्चैव दोषान् वक्ष्यामि सौषधान् ||३||

AthAto vamanavirechana vyApatsiddhim vyAkhyAsyAmah I

Iti ha SmAh BhagwAnAtreyah II

Atha Shodhanayoh Samyagvidhimurdhvanulomayoh I

Asamyak krutayohshchaiva doshAn vakshyAmi SaushadhAn II

Now we shall explore the chapter on the ‘complications of improper therapeutic emesis and purgation and their successful management’. Thus said Lord Atreya.

Now, let me explain:

*The procedure for proper administration of ''vamana'' and ''virechana''
*The complications appearing because of inappropriate administration
*The effective treatment for the management of complications.[1-3]

==== Seasons for purification ====

अत्युष्णवर्षशीता हि ग्रीष्मवर्षाहिमागमाः|

तदन्तरे प्रावृडाद्यास्तेषां साधारणास्त्रयः||४||

atyuṣṇavarṣaśītā hi grīṣmavarṣāhimāgamāḥ|

tadantarē prāvr̥ḍādyāstēṣāṁ sādhāraṇāstrayaḥ||4||

atyuShNavarShashItA hi grIShmavarShAhimAgamAH|

tadantare prAvRuDAdyAsteShAM sAdhAraNAstrayaH||4||

Excess heat, rain and cold are the signature features of summer (''greeshma''), rainy (''varsha'') and winter (''hemanta'') seasons respectively. The three seasons viz., the period between summer and rains (''pravrita''), autumn (''sharada'') and spring (''vasanta''), which come in between the above mentioned are known as general seasons (''sadharana ritu''). [4]

प्रावृट् शुचिनभौ ज्ञेयौ शरदूर्जसहौ पुनः|

तपस्यश्च मधुश्चैव वसन्तः शोधनं प्रति||५||

एतानृतून् विकल्प्यैवं दद्यात् संशोधनं भिषक्|

स्वस्थवृत्तमभिप्रेत्य व्याधौ व्याधिवशेन तु||६||

prāvr̥ṭ śucinabhau jñēyau śaradūrjasahau punaḥ|

tapasyaśca madhuścaiva vasantaḥ śōdhanaṁ prati||5||

ētānr̥tūn vikalpyaivaṁ dadyāt saṁśōdhanaṁ bhiṣak|

svasthavr̥ttamabhiprētya vyādhau vyādhivaśēna tu||6||

prAvRuT shucinabhau j~jeyau sharadUrjasahau punaH|

tapasyashca madhushcaiva vasantaH shodhanaM prati||5||

etAnRutUn vikalpyaivaM dadyAt saMshodhanaM bhiShak|

svasthavRuttamabhipretya vyAdhau vyAdhivashena tu||6||

The months ''Shuchi'' (''Aashadha'', Mid June to Mid July) and ''Nabha'' (''Shravana'', Mid July to Mid August) together are known as ''Pravrita ritu''. The months ''Urja'' (''Kartika'', Mid October to Mid November) and ''Saha'' (''Margashersha'' –Mid November to Mid December) are known as ''Sharada ritu''. The months ''Tapasya'' (''Phaalguna'' -Mid February to Mid March) and ''Madhu'' (''Chaitram''- mid March to mid April) are known as ''Vasanta ritu''. These seasons are specially mentioned here for the sake of administration of ''shodhana'' therapy (purificatory procedures). The physician shall select an appropriate purificatory procedure to preserve the health after determining the exact season. However, in case of disease, it has to be done with respect to the nature of the clinical condition in any of the seasons.[5-6]

==== Importance of oleation in [[Panchakarma]] ====

कर्मणां वमनादीनामन्तरेष्वन्तरेषु च|

स्नेहस्वेदौ प्रयुञ्जीत स्नेहं चान्ते प्रयोजयेत्||७||

karmaṇāṁ vamanādīnāmantarēṣvantarēṣu ca|

snēhasvēdau prayuñjīta snēhaṁ cāntē prayōjayēt||7||

karmaNAM vamanAdInAmantareShvantareShu ca|

snehasvedau prayu~jjIta snehaM cAnte prayojayet||7||

In between the sequential administration of purificatory procedures like ''vamana'' (emesis) etc., ''snehana'' (oleation) and ''swedana'' (sudation) therapies need to be administered and ''snehana'' (oleation) shall be administered at the end (also). [7]

==== Indications of purification ====

विसर्पपिडकाशोफकामलापाण्डुरोगिणः |

अभिघातविषार्तांश्च नातिस्निग्धान् विरेचयेत्||८||

visarpapiḍakāśōphakāmalāpāṇḍurōgiṇaḥ |

abhighātaviṣārtāṁśca nātisnigdhān virēcayēt||8||

visarpapiDakAshophakAmalApANDurogiNaH |

abhighAtaviShArtAMshca nAtisnigdhAn virecayet||8||

In case of clinical conditions like ''visarpa, pidaka, shopha, kamala, pandu'' as well as in trauma and toxication, and in those who are not excessively oleated purification therapies shall be administered. [8]

नातिस्निग्धशरीराय दद्यात् स्नेहविरेचनम्|

स्नेहोत्क्लिष्टशरीराय रूक्षं दद्याद्विरेचनम्||९||

nātisnigdhaśarīrāya dadyāt snēhavirēcanam|

snēhōtkliṣṭaśarīrāya rūkṣaṁ dadyādvirēcanam||9||

nAtisnigdhasharIrAya dadyAt snehavirecanam|

snehotkliShTasharIrAya rUkShaM dadyAdvirecanam||9||

The individual with excessively oleated body should never be given an unctuous or ''snigdha virechana''. The body with excessive oleation should be given un-unctuous or ''ruksha virechana''.[9]

==== Procedure of taking purgatives for therapy ====

स्नेहस्वेदोपपन्नेन जीर्णे मात्रावदौषधम्|

एकाग्रमनसा पीतं सम्यग्योगाय कल्पते||१०||

snēhasvēdōpapannēna jīrṇē mātrāvadauṣadham|

ēkāgramanasā pītaṁ samyagyōgāya kalpatē||10||

snehasvedopapannena jIrNe mAtrAvadauShadham|

ekAgramanasA pItaM samyagyogAya kalpate||10||

The person after undergoing ''snehana'' (oleation) and ''swedana'' (sudation procedures) can have the medicine for elimination with fully concentrated mind. In addition, it should be ensured that the medicine is taken only after the full digestion of previous food. Only then, the proper elimination ensues.[10]

स्निग्धात् पात्राद्यथा तोयमयत्नेन प्रणुद्यते|

कफादयः प्रणुद्यन्ते स्निग्धाद्देहात्तथौषधैः||११||

आर्द्रं काष्ठं यथा वह्निर्विष्यन्दयति सर्वतः|

तथा स्निग्धस्य वै दोषान् स्वेदो विष्यन्दयेत् स्थिरान्||१२||

क्लिष्टं वासो यथोत्क्लेश्य मलः संशोध्यतेऽम्भसा|

स्नेहस्वेदैस्तथोत्क्लेश्य शोध्यते शोधनैर्मलः ||१३||

snigdhāt pātrādyathā tōyamayatnēna praṇudyatē|

kaphādayaḥ praṇudyantē snigdhāddēhāttathauṣadhaiḥ||11||

ārdraṁ kāṣṭhaṁ yathā vahnirviṣyandayati sarvataḥ|

tathā snigdhasya vai dōṣān svēdō viṣyandayēt sthirān||12||

kliṣṭaṁ vāsō yathōtklēśya malaḥ saṁśōdhyatē'mbhasā|

snēhasvēdaistathōtklēśya śōdhyatē śōdhanairmalaḥ ||13||

snigdhAt pAtrAdyathA toyamayatnena praNudyate|

kaphAdayaH praNudyante snigdhAddehAttathauShadhaiH||11||

ArdraM kAShThaM yathA vahnirviShyandayati sarvataH|

tathA snigdhasya vai doShAn svedo viShyandayet sthirAn||12||

kliShTaM vAso yathotkleshya malaH saMshodhyate~ambhasA|

snehasvedaistathotkleshya shodhyate shodhanairmalaH || 13||

Like how water gets out of a vessel smeared with oil, similar is the removal of ''doshas'' from a properly oleated body. Just like the fire propels the water out from the wet log wood, similarly the sudation propels out the stable ''doshas'' from the pre-oleated body. The way in which the clothes adhered with dirt is cleaned using water, which removes the dirt, similarly the stable ''malas'' that are liquefied after oleation and sudation are removed by proper purificatory therapies.[11-13]

==== Consequences if medicines taken during indigestion ====

अजीर्णे वर्धते ग्लानिर्विबन्धश्चापि जायते|

पीतं संशोधनं चैव विपरीतं प्रवर्तते||१४||

ajīrṇē vardhatē glānirvibandhaścāpi jāyatē|

pītaṁ saṁśōdhanaṁ caiva viparītaṁ pravartatē||14||

ajIrNe vardhate glAnirvibandhashcApi jAyate|

pItaM saMshodhanaM caiva viparItaM pravartate||14||

If the medicine for purification is administered before the digestion of the previous meal, it will lead to ''glani'' (tiredness), ''vibandha'' (obstruction of feces and urine), and an action that is opposite to that intended by elimination therapy. (''virechana oushadha'' will lead to ''vamana'' and vice versa.)[14]

==== Characteristics of appropriate dosage of medicine ====

अल्पमात्रं महावेगं बहुदोषहरं सुखम्|

लघुपाकं सुखास्वादं प्रीणनं व्याधिनाशनम्||१५||

अविकारि च व्यापत्तौ नातिग्लानिकरं च यत्|

गन्धवर्णरसोपेतं विद्यान्मात्रावदौषधम्||१६||

alpamātraṁ mahāvēgaṁ bahudōṣaharaṁ sukham|

laghupākaṁ sukhāsvādaṁ prīṇanaṁ vyādhināśanam||15||

avikāri ca vyāpattau nātiglānikaraṁ ca yat|

gandhavarṇarasōpētaṁ vidyānmātrāvadauṣadham||16||

alpamAtraM mahAvegaM bahudoShaharaM sukham|

laghupAkaM sukhAsvAdaM prINanaM vyAdhinAshanam||15||

avikAri ca vyApattau nAtiglAnikaraM ca yat|

gandhavarNarasopetaM vidyAnmAtrAvadauShadham||16||

The following properties are characteristic to the appropriate dosage of medicines prescribed for purification:
*It should work optimally in small dosage
*It must have quick action
*It must eliminate large amounts of ''dosha''
*It should bring in comfort
*It should be easily digestible
*It must be palatable
*It must be vitalizing and disease pacifying
*It should not lead to any other complication
*It should not produce tiredness
*It should be endowed with good smell, color, taste etc. and should be pleasing in nature.[15-16]

विधूय मानसान् दोषान् कामादीनशुभोदयान् |

एकाग्रमनसा पीतं सम्यग्योगाय कल्पते||१७||

vidhūya mānasān dōṣān kāmādīnaśubhōdayān |

ēkāgramanasā pītaṁ samyagyōgāya kalpatē||17||

vidhUya mAnasAn doShAn kAmAdInashubhodayAn |

ekAgramanasA pItaM samyagyogAya kalpate||17||

The individual who drinks the medicine leaving away the negative mental feelings like lust etc. concentrating only on the medicines and the administration of the therapy, will bring the proper action of the medicine or therapy. [17]

==== Diet before purification therapy ====

नरः श्वो वमनं पाता भुञ्जीत कफवर्धनम्|

सुजरं द्रवभूयिष्ठं, लघ्वशीतं विरेचनम्||१८||

उत्क्लिष्टाल्पकफत्वेन क्षिप्रं दोषाः स्रवन्ति हि|१९|

naraḥ śvō vamanaṁ pātā bhuñjīta kaphavardhanam|

sujaraṁ dravabhūyiṣṭhaṁ, laghvaśītaṁ virēcanam||18||

utkliṣṭālpakaphatvēna kṣipraṁ dōṣāḥ sravanti hi|19|

naraH shvo vamanaM pAtA bhu~jjIta kaphavardhanam|

sujaraM dravabhUyiShThaM, laghvashItaM virecanam||18||

utkliShTAlpakaphatvena kShipraM doShAH sravanti hi|19|

The individual scheduled to undergo ''vamana'' on the next day should have foods which are easily digestible, rich in fluids and will increase the ''kapha dosha''. Similarly, the individual scheduled to undergo ''virechana'' should have foods which are light and hot. Since the first diet leads to vitiation and second diet leads to reduction of ''kapha'', the ''doshas'' are removed quickly and completely. [18-18½]

==== Signs of proper elimination ====

पीतौषधस्य तु भिषक् शुद्धिलिङ्गानि लक्षयेत्||१९||

ऊर्ध्वं कफानुगे पित्ते विट्पित्तेऽनुकफे त्वधः|

हृतदोषं वदेत् कार्श्यदौर्बल्ये चेत् सलाघवे||२०||

pītauṣadhasya tu bhiṣak śuddhiliṅgāni lakṣayēt||19||

ūrdhvaṁ kaphānugē pittē viṭpittē'nukaphē tvadhaḥ|

hr̥tadōṣaṁ vadēt kārśyadaurbalyē cēt salāghavē||20||

pItauShadhasya tu bhiShak shuddhili~ggAni lakShayet||19||

UrdhvaM kaphAnuge pitte viTpitte~anukaphe tvadhaH|

hRutadoShaM vadet kArshyadaurbalye cet salAghave||20||

The physician who had administered medicines for purification must be in observation for the following symptoms:
*For ''vamana'', the ''pitta'' is expelled out after the elimination of ''kapha''
*For ''virechana'', the elimination of fecal matter will be followed by ''pitta'' and thereafter by ''kapha''

When ''doshas'' are eliminated, the patient will experience emaciation, weakness and lightness of body.[19-20]

वामयेत्तु ततः शेषमौषधं न त्वलाघवे|

स्तैमित्येऽनिलसङ्गे च निरुद्गारेऽपि वामयेत्||२१||

आलाघवात्तनुत्वाच्च कफस्यापत् परं भवेत्|२२|

vāmayēttu tataḥ śēṣamauṣadhaṁ na tvalāghavē|

staimityē'nilasaṅgē ca nirudgārē'pi vāmayēt||21||

ālāghavāttanutvācca kaphasyāpat paraṁ bhavēt|22|

vAmayettu tataH sheShamauShadhaM na tvalAghave|

staimitye~anilasa~gge ca nirudgAre~api vAmayet||21||

AlAghavAttanutvAcca kaphasyApat paraM bhavet|22|

If after the completion of the purificatory procedures, there is presence of residual medicines, ''vamana'' must be administered. If there is no feeling of lightness, then also ''vamana'' should be performed. ''Vamana'' must be specifically performed, when there is ''staimitya'' (a feeling of wet covering), obstruction of ''vayu'' and absence of belching. ''Vamana'' should be continued till there is lightness of the body and reduction of ''kapha''. If continued, it can result in serious consequences. [21-21½]

वमिते वर्धते वह्निः शमं दोषा व्रजन्ति हि||२२||

वमितं लङ्घयेत् सम्यग्जीर्णलिङ्गान्यलक्षयन्|

तानि दृष्ट्वा तु पेयादिक्रमं कुर्यान्न लङ्घनम्||२३||

vamitē vardhatē vahniḥ śamaṁ dōṣā vrajanti hi||22||

vamitaṁ laṅghayēt samyagjīrṇaliṅgānyalakṣayan|

tāni dr̥ṣṭvā tu pēyādikramaṁ kuryānna laṅghanam||23||

vamite vardhate vahniH shamaM doShA vrajanti hi||22||

vamitaM la~gghayet samyagjIrNali~ggAnyalakShayan|

tAni dRuShTvA tu peyAdikramaM kuryAnna la~gghanam||23||

The one who has been purified by ''vamana'' will have augmented ''agni'', leading to the alleviation of ''dosha''. He need to undergo fasting till the signs of proper digestion of drugs for ''vamana'' is seen. For one having those signs, ''peyadi kramam'' (regulatory diet regimen) has to be initiated. He should not undergo further ''langhana'' (fasting). [22-23]

संशोधनाभ्यां शुद्धस्य हृतदोषस्य देहिनः|

यात्यग्निर्मन्दतां तस्मात् क्रमं पेयादिमाचरेत्||२४||

saṁśōdhanābhyāṁ śuddhasya hr̥tadōṣasya dēhinaḥ|

yātyagnirmandatāṁ tasmāt kramaṁ pēyādimācarēt||24||

saMshodhanAbhyAM shuddhasya hRutadoShasya dehinaH|

yAtyagnirmandatAM tasmAt kramaM peyAdimAcaret||24||

The individual who is purified after elimination therapy and removal of ''dosha'' from the body, has his ''agni'' diminished. Hence it is highly pertinent to institute dietary regimen termed ''peyaadi kramam''. [24]

कफपित्ते विशुद्धेऽल्पं मद्यपे वातपैत्तिके|

तर्पणादिक्रमं कुर्यात् पेयाऽभिष्यन्दयेद्धि तान्||२५||

kaphapittē viśuddhē'lpaṁ madyapē vātapaittikē|

tarpaṇādikramaṁ kuryāt pēyā'bhiṣyandayēddhi tān||25||

kaphapitte vishuddhe~alpaM madyape vAtapaittike|

tarpaNAdikramaM kuryAt peyA~abhiShyandayeddhi tAn||25||

When there is little elimination of ''kapha'' and ''pitta'' through purification therapy, in alcoholics and in persons with predominance of ''vata'' and ''pitta dosha'', the dietary regimen called ''tarpanaadi kramam'' need to be started instead of ''peyaadi kramam'', as ''peyadi'' may increase ''kapha'' causing ''abhishyandam'' (clogging of the channels of circulation).[25]

==== Signs of digested and undigested medicine ====

अनुलोमोऽनिलः स्वास्थ्यं क्षुत्तृष्णोर्जो मनस्विता|

लघुत्वमिन्द्रियोद्गारशुद्धिर्जीर्णौषधाकृतिः||२६||

क्लमो दाहोऽङ्गसदनं भ्रमो मूर्च्छा शिरोरुजा|

अरतिर्बलहानिश्च सावशेषौषधाकृतिः||२७||

anulōmō'nilaḥ svāsthyaṁ kṣuttr̥ṣṇōrjō manasvitā|

laghutvamindriyōdgāraśuddhirjīrṇauṣadhākr̥tiḥ||26||

klamō dāhō'ṅgasadanaṁ bhramō mūrcchā śirōrujā|

aratirbalahāniśca sāvaśēṣauṣadhākr̥tiḥ||27||

anulomo~anilaH svAsthyaM kShuttRuShNorjo manasvitA|

laghutvamindriyodgArashuddhirjIrNauShadhAkRutiH||26||

klamo dAho~a~ggasadanaM bhramo mUrcchA shirorujA|

aratirbalahAnishca sAvasheShauShadhAkRutiH||27||

The signs of properly digested medicine include:
*Normal movement of ''vayu''
*Timely manifestation of hunger
*Thirst
*Enthusiasm
*Mental happiness
*A feeling of lightness
*Proper functioning of sensorium
*Clear belching

The signs of presence of undigested medicinal residue are:
*Fatigue
*Burning sensation
*General weakness
*Giddiness
*Fainting
*Headache
*Restlessness
*Loss of strength

अकालेऽल्पातिमात्रं च पुराणं न च भावितम्|

असम्यक्संस्कृतं चैव व्यापद्येतौषधं द्रुतम्||२८||

akālē'lpātimātraṁ ca purāṇaṁ na ca bhāvitam|

asamyaksaṁskr̥taṁ caiva vyāpadyētauṣadhaṁ drutam||28||

akAle~alpAtimAtraM ca purANaM na ca bhAvitam|

asamyaksaMskRutaM caiva vyApadyetauShadhaM drutam||28||

The drug of the following nature may result in quick complication:
*Unseasonal use
*Being administered in sub or supra-optimal dose.
*Being stored for a longer time
*Being not properly triturated.
*Being not properly processed.

==== Ten complications of emesis and purgation ====

आध्मानं परिकर्तिश्च स्रावो हृद्गात्रयोर्ग्रहः|

जीवादानं सविभ्रंशः स्तम्भः सोपद्रवः क्लमः||२९||

अयोगादतियोगाच्च दशैता व्यापदो मताः|

प्रेष्यभैषज्यवैद्यानां वैगुण्यादातुरस्य च||३०||

ādhmānaṁ parikartiśca srāvō hr̥dgātrayōrgrahaḥ|

jīvādānaṁ savibhraṁśaḥ stambhaḥ sōpadravaḥ klamaḥ||29||

ayōgādatiyōgācca daśaitā vyāpadō matāḥ|

prēṣyabhaiṣajyavaidyānāṁ vaiguṇyādāturasya ca||30||

AdhmAnaM parikartishca srAvo hRudgAtrayorgrahaH|

jIvAdAnaM savibhraMshaH stambhaH sopadravaH klamaH||29||

ayogAdatiyogAcca dashaitA vyApado matAH|

preShyabhaiShajyavaidyAnAM vaiguNyAdAturasya ca||30||

The ten cardinal complications arising out of improper administration of emesis and purgation are:
*''Aadhmana'' (distension of abdomen)
*''Parikartika'' (fissure in ano)
*''Srava'' (excess discharge)
*''Hrid-graha'' (congestion in cardiac region)
*''Gaatra-graha'' (body stiffness )
*''Jeevaadana'' (bleeding)
*''Vibhramsha'' (prolapse of rectum)
*''Stambha'' (body stiffness)
*''Upadrava'' (complications)
*''Klama'' (fatigue without exertion)

The above complications arise out of either under activity or excessive activity of the drug because of the following:
*''Preshya-vaigunyam'' (incompetency of the attendant)
*''Bhaishajya-vaigunya'' (incompetency of drug)
*''Vaidya-vaigunya'' (incompetency of physician)
*''Aatura-vaigunya'' (incompetency of the patient). [29-30]

==== Three types of purification according to its signs ====

योगः सम्यक्प्रवृत्तिः स्यादतियोगोऽतिवर्तनम्|

अयोगः प्रातिलोम्येन न चाल्पं वा प्रवर्तनम्||३१||

श्लेष्मोत्क्लिष्टेन दुर्गन्धमहृद्यमति वा बहु|

विरेचनमजीर्णे च पीतमूर्ध्वं प्रवर्तते||३२||

क्षुधार्तमृदुकोष्ठाभ्यां स्वल्पोत्क्लिष्टकफेन वा|

तीक्ष्णं पीतं स्थितं क्षुब्धं वमनं स्याद्विरेचनम्||३३||

प्रातिलोम्येन दोषाणां हरणात्ते ह्यकृत्स्नशः|

अयोगसञ्ज्ञे, कृच्छ्रेण याति दोषो नवाऽल्पशः||३४||

yōgaḥ samyakpravr̥ttiḥ syādatiyōgō'tivartanam|

ayōgaḥ prātilōmyēna na cālpaṁ vā pravartanam||31||

ślēṣmōtkliṣṭēna durgandhamahr̥dyamati vā bahu|

virēcanamajīrṇē ca pītamūrdhvaṁ pravartatē||32||

kṣudhārtamr̥dukōṣṭhābhyāṁ svalpōtkliṣṭakaphēna vā|

tīkṣṇaṁ pītaṁ sthitaṁ kṣubdhaṁ vamanaṁ syādvirēcanam||33||

prātilōmyēna dōṣāṇāṁ haraṇāttē hyakr̥tsnaśaḥ|

ayōgasañjñē, kr̥cchrēṇa yāti dōṣō navā'lpaśaḥ||34||

yogaH samyakpravRuttiH syAdatiyogo~ativartanam|

ayogaH prAtilomyena na cAlpaM vA pravartanam||31||

shleShmotkliShTena durgandhamahRudyamati vA bahu|

virecanamajIrNe ca pItamUrdhvaM pravartate||32||

kShudhArtamRudukoShThAbhyAM svalpotkliShTakaphena vA|

tIkShNaM pItaM sthitaM kShubdhaM vamanaM syAdvirecanam||33||

prAtilomyena doShANAM haraNAtte hyakRutsnashaH|

ayogasa~jj~je, kRucchreNa yAti doSho navA~alpashaH||34||

The three types of outcome for ''Vamana'' and ''Virechana'' are:
*''Samyaka yoga'' indicates optimum action of elimination therapy
*''Ati-yoga'' indicates excess elimination
*''Ayoga'' indicates insufficient or no elimination

The medicines administered for ''virechana'', in a patient with aggravated and excited status of ''kapha'', will act as ''vamaka'' under the following conditions:
*If the medicine is having bad smell
*The drug not being wholesome
*Large quantity of medicine
*Intake of medicine before the previous meal is digested

The medicines administered for ''vamana'' will cause ''virechana'' under the following conditions:
*''Vamana'' is performed on an individual who is hungry,
*An individual with ''mridu –koshtha'',
*An individual with little increase of ''kapha'',
*If the medicine is ''tikshna'' (penetrating / potent),
*If the medicine is reminent and agitating

Whether in ''vamana'' or ''virechana'', if the medicines work in opposite, it is termed ''ayoga'' or inadequate action. It is also called the same, if ''doshas'' are not eliminated or eliminated with difficulty. [31-34]

==== Various conditions and management ====

पीतौषधो न शुद्धश्चेज्जीर्णे तस्मिन् पुनः पिबेत्|

औषधं न त्वजीर्णेऽन्यद्भयं स्यादतियोगतः||३५||

कोष्ठस्य गुरुतां ज्ञात्वा लघुत्वं बलमेव च|

अयोगे मृदु वा दद्यादौषधं तीक्ष्णमेव वा||३६||

pītauṣadhō na śuddhaścējjīrṇē tasmin punaḥ pibēt|

auṣadhaṁ na tvajīrṇē'nyadbhayaṁ syādatiyōgataḥ||35||

kōṣṭhasya gurutāṁ jñātvā laghutvaṁ balamēva ca|

ayōgē mr̥du vā dadyādauṣadhaṁ tīkṣṇamēva vā||36||

pItauShadho na shuddhashcejjIrNe tasmin punaH pibet|

auShadhaM na tvajIrNe~anyadbhayaM syAdatiyogataH||35||

koShThasya gurutAM j~jAtvA laghutvaM balameva ca|

ayoge mRudu vA dadyAdauShadhaM tIkShNameva vA||36||

If after intake of medicine for elimination, the medicine is digested and there is no elimination, then the medicine should be taken again.
If the medicine is not digested, it should not be given as it may lead to ''atiyoga''.

One has to understand the nature of ''koshtha'' (whether ''guru'' or ''laghu'') and the strength of the body for giving either mild (''mridu'') or potent (''teekshna'') medicine. [35-36]

वमनं न तु दुश्छर्दं दुष्कोष्ठं न विरेचनम्|

पाययेतौषधं भूयो हन्यात् पीतं पुनर्हि तौ||३७||

vamanaṁ na tu duśchardaṁ duṣkōṣṭhaṁ na virēcanam|

pāyayētauṣadhaṁ bhūyō hanyāt pītaṁ punarhi tau||37||

vamanaM na tu dushchardaM duShkoShThaM na virecanam|

pAyayetauShadhaM bhUyo hanyAt pItaM punarhi tau||37||

Never give emetic drug to people who are unsuitable for ''vamana; virechana'' to those with unsuitable ''koshtha'', if medicine intake happens in such conditions it may even lead to death.[37]

अस्निग्धास्विन्नदेहस्य रूक्षस्यानवमौषधम्|

दोषानुत्क्लिश्य निर्हर्तुमशक्तं जनयेद्गदान्||३८||

विभ्रंशं श्वयथुं हिक्कां तमसो दर्शनं भृशम् |

पिण्डिकोद्वेष्टनं कण्डूमूर्वोः सादं विवर्णताम्||३९||

asnigdhāsvinnadēhasya rūkṣasyānavamauṣadham|

dōṣānutkliśya nirhartumaśaktaṁ janayēdgadān||38||

vibhraṁśaṁ śvayathuṁ hikkāṁ tamasō darśanaṁ bhr̥śam |

piṇḍikōdvēṣṭanaṁ kaṇḍūmūrvōḥ sādaṁ vivarṇatām||39||

asnigdhAsvinnadehasya rUkShasyAnavamauShadham|

doShAnutklishya nirhartumashaktaM janayedgadAn||38||

vibhraMshaM shvayathuM hikkAM tamaso darshanaM bhRusham |

piNDikodveShTanaM kaNDUmUrvoH sAdaM vivarNatAm||39||

''Ayoga'' happens when ''asnigdha'' (under-oleated) and ''asvinna'' (under-sudated) person with ''ruksha'' nature of the body, is administered a recipe, which is stored for long duration. Here, the drug is unable to remove ''doshas'' from the body by creating ''dosha-utklesha''. Such a condition will lead to symptoms like ''vibhramsha'' (''virechana oushadha'' will lead to ''vamana'' and vice versa), swelling, hiccups, black-out, cramps in calf muscle, itching, fainting and discoloration.[38-39]

स्निग्धस्विन्नस्य चात्यल्पं दीप्ताग्नेर्जीर्णमौषधम्|

शीतैर्वा स्तब्धमामे वा दोषानुत्क्लिश्य नाहरेत्||४०||

तानेव जनयेद्रोगानयोगः सर्व एव सः|

विज्ञाय मतिमांस्तत्र यथोक्तां कारयेत् क्रियाम्||४१||

तं तैललवणाभ्यक्तं स्विन्नं प्रस्तरसङ्करैः|

पाययेत पुनर्जीर्णे समूत्रैर्वा निरूहयेत्||४२||

निरूढं च रसैर्धान्वैर्भोजयित्वाऽनुवासयेत्|

फलमागधिकादारुसिद्धतैलेन मात्रया||४३||

स्निग्धं वातहरैः स्नेहैः पुनस्तीक्ष्णेन शोधयेत्|

न चातितीक्ष्णेन ततो ह्यतियोगस्तु जायते||४४||

snigdhasvinnasya cātyalpaṁ dīptāgnērjīrṇamauṣadham|

śītairvā stabdhamāmē vā dōṣānutkliśya nāharēt||40||

tānēva janayēdrōgānayōgaḥ sarva ēva saḥ|

vijñāya matimāṁstatra yathōktāṁ kārayēt kriyām||41||

taṁ tailalavaṇābhyaktaṁ svinnaṁ prastarasaṅkaraiḥ|

pāyayēta punarjīrṇē samūtrairvā nirūhayēt||42||

nirūḍhaṁ ca rasairdhānvairbhōjayitvā'nuvāsayēt|

phalamāgadhikādārusiddhatailēna mātrayā||43||

snigdhaṁ vātaharaiḥ snēhaiḥ punastīkṣṇēna śōdhayēt|

na cātitīkṣṇēna tatō hyatiyōgastu jāyatē||44||

snigdhasvinnasya cAtyalpaM dIptAgnerjIrNamauShadham|

shItairvA stabdhamAme vA doShAnutklishya nAharet||40||

tAneva janayedrogAnayogaH sarva eva saH|

vij~jAya matimAMstatra yathoktAM kArayet kriyAm||41||

taM tailalavaNAbhyaktaM svinnaM prastarasa~gkaraiH|

pAyayeta punarjIrNe samUtrairvA nirUhayet||42||

nirUDhaM ca rasairdhAnvairbhojayitvA~anuvAsayet|

phalamAgadhikAdArusiddhatailena mAtrayA||43||

snigdhaM vAtaharaiH snehaiH punastIkShNena shodhayet|

na cAtitIkShNena tato hyatiyogastu jAyate||44||

''Ayoga'' happens in the following conditions too :
*Even after proper ''sneha-sweda'' there is sub-optimal dose of medicine
*Due to increased ''agni'' (digestive capacity), quick digestion of medicine happens

If there is ''ama dosha'', the medicine for ''vamana'' will not work in the desired manner. The case is similar also with ''virechana'' drugs.

Because of the above mentioned causes, the earlier mentioned conditions like ''vibhramsha'' will happen. These come under ''ayoga''. The intelligent physician must understand the same and treat accordingly.

Here the ''taila'' (oil) processed with ''lavana'' (salt) has to be applied and made to undergo ''prastara'' and ''sankara'' kind of sudation. Once the medicine for ''vamana'' or ''virechana'' must be administered again or else ''kashaya basti'' (decoction enema) with cow’s urine has to be done. After the administration of ''kashaya basti'', food with meats of animals of arid regions (''jangala mamsa rasa'') should be taken and should be followed by administration of ''sneha basti'' (oil enema).

''Sneha basti'' can be done by oil processed with ''madana'' (Randia dumetorum), ''pippali'' (Piper longum), ''devadaru'' (Cedrus deodara), in proper dose. Once adequate oleation happens, elimination must be done with a recipe containing ''teekshna'' drugs.

However, the medicines that are ''ati-teekshna'' should not be given, as it may result in ''atiyoga''.[40-44]

==== Signs of excess elimination and management ====

अतितीक्ष्णं क्षुधार्तस्य मृदुकोष्ठस्य भेषजम्|

हृत्वाऽऽशु विट्पित्तकफान् धातून्विस्रावयेद्द्रवान्||४५||

बलस्वरक्षयं दाहं कण्ठशोषं भ्रमं तृषाम्|

कुर्याच्च मधुरैस्तत्र शेषमौषधमुल्लिखेत्||४६||

वमने तु विरेकः स्याद्विरेके वमनं पुनः |

परिषेकावगाहाद्यैः सुशीतैः स्तम्भयेच्च तत्||४७||

कषायमधुरैः शीतैरन्नपानौषधैस्तथा|

रक्तपित्तातिसारघ्नैर्दाहज्वरहरैरपि||४८||

अञ्जनं चन्दनोशीरमज्जासृक्शर्करोदकम्|

लाजचूर्णैः पिबेन्मन्थमतियोगहरं परम्||४९||

शुङ्गाभिर्वा वटादीनां सिद्धां पेयां समाक्षिकाम्|

वर्चःसाङ्ग्राहिकैः सिद्धं क्षीरं भोज्यं च दापयेत्||५०||

जाङ्गलैर्वा रसैर्भोज्यं पिच्छाबस्तिश्च शस्यते|

मधुरैरनुवास्यश्च सिद्धेन क्षीरसर्पिषा||५१||

atitīkṣṇaṁ kṣudhārtasya mr̥dukōṣṭhasya bhēṣajam|

hr̥tvā''śu viṭpittakaphān dhātūnvisrāvayēddravān||45||

balasvarakṣayaṁ dāhaṁ kaṇṭhaśōṣaṁ bhramaṁ tr̥ṣām|

kuryācca madhuraistatra śēṣamauṣadhamullikhēt||46||

vamanē tu virēkaḥ syādvirēkē vamanaṁ punaḥ |

pariṣēkāvagāhādyaiḥ suśītaiḥ stambhayēcca tat||47||

kaṣāyamadhuraiḥ śītairannapānauṣadhaistathā|

raktapittātisāraghnairdāhajvaraharairapi||48||

añjanaṁ candanōśīramajjāsr̥kśarkarōdakam|

lājacūrṇaiḥ pibēnmanthamatiyōgaharaṁ param||49||

śuṅgābhirvā vaṭādīnāṁ siddhāṁ pēyāṁ samākṣikām|

varcaḥsāṅgrāhikaiḥ siddhaṁ kṣīraṁ bhōjyaṁ ca dāpayēt||50||

jāṅgalairvā rasairbhōjyaṁ picchābastiśca śasyatē|

madhurairanuvāsyaśca siddhēna kṣīrasarpiṣā||51||

atitIkShNaM kShudhArtasya mRudukoShThasya bheShajam|

hRutvA~a~ashu viTpittakaphAn dhAtUnvisrAvayeddravAn||45||

balasvarakShayaM dAhaM kaNThashoShaM bhramaM tRuShAm|

kuryAcca madhuraistatra sheShamauShadhamullikhet||46||

vamane tu virekaH syAdvireke vamanaM punaH |

pariShekAvagAhAdyaiH sushItaiH stambhayecca tat||47||

kaShAyamadhuraiH shItairannapAnauShadhaistathA|

raktapittAtisAraghnairdAhajvaraharairapi||48||

a~jjanaM candanoshIramajjAsRuksharkarodakam|

lAjacUrNaiH pibenmanthamatiyogaharaM param||49||

shu~ggAbhirvA vaTAdInAM siddhAM peyAM samAkShikAm|

varcaHsA~ggrAhikaiH siddhaM kShIraM bhojyaM ca dApayet||50||

jA~ggalairvA rasairbhojyaM picchAbastishca shasyate|

madhurairanuvAsyashca siddhena kShIrasarpiShA||51||

When a patient who is with ''mridukoshtha'', who is affected with hunger, is provided with an exceedingly strong ''vamana'' or ''virechana'', it results in the quick elimination of not only the faecal matter, ''pitta'' and ''kapha'', but also the ''drava-dhatu'' (liquid content of the body). Consequently, there will be sudden depression of strength and voice, dryness of throat, giddiness and thirst. In such a condition, it is preferable to eliminate the residual drug in the ''koshtha'' using the drugs of ''madhura gana'' (mentioned in sweet category).

If ''ati-yoga'' happens like this during attempting ''vamana'', the residual ''doshas'' are eliminated by initiating a ''virechana'' and vice-versa.

The following remedies need to be instituted fast for ''stambhana'' (To check the supra-optimal purificatory effect of therapy).

By providing cold irrigation (''parishekam'') and tub bath (''avagaaham'')

By providing foods, drinks and medicine which are ''sheeta'' (cold), ''kashaya'' (astrigent) and ''madhura'' (sweet).

By following appropriate regimens prescribed for ''rakta-pitta, atisaara, daaha'' and ''jwara''.

For ''ati-yoga'' of ''virechana, sharkarodakam'' (sugar syrup) added with ''rasaanjana'' (Berberis aristata), ''chandana'' (Santalum album), ''usheera'' (Vetivera zizanoides), blood of goat, cornflake powder etc. can be taken to stop excessive loss of fluid. Then ''peya'' made from ''vata shunga'' (leaf buds of banyan tree) added with honey, milk or porridge processed with samgraahi substances (that which pacifies excess bowel movements) like the priyangvaadi gana, food added with jaangala maamsa rasam (meat soup of animals from arid region), picchha basti mentioned in rakta-arshas, sneha basti using ghee made out of milk processed with madhura aushadha (sweet drugs).[46-51]

वमनस्यातियोगे तु शीताम्बुपरिषेचितः|

पिबेत् कफहरैर्मन्थं सघृतक्षौद्रशर्करम्||५२||

सोद्गारायां भृशं वम्यां मूर्च्छायां धान्यमुस्तयोः|

समधूकाञ्जनं चूर्णं लेहयेन्मधुसंयुतम्||५३||

वमतोऽन्तःप्रविष्टायां जिह्वायां कवलग्रहाः|

स्निग्धाम्ललवणैर्हृद्यैर्यूषक्षीररसैर्हिताः||५४||

फलान्यम्लानि खादेयुस्तस्य चान्येऽग्रतो नराः|

निःसृतां तु तिलद्राक्षाकल्कलिप्तां प्रवेशयेत्||५५||

वाग्ग्रहानिलरोगेषु घृतमांसोपसाधिताम्|

यवागूं तनुकां दद्यात् स्नेहस्वेदौ च बुद्धिमान्||५६||

vamanasyātiyōgē tu śītāmbupariṣēcitaḥ|

pibēt kaphaharairmanthaṁ saghr̥takṣaudraśarkaram||52||

sōdgārāyāṁ bhr̥śaṁ vamyāṁ mūrcchāyāṁ dhānyamustayōḥ|

samadhūkāñjanaṁ cūrṇaṁ lēhayēnmadhusaṁyutam||53||

vamatō'ntaḥpraviṣṭāyāṁ jihvāyāṁ kavalagrahāḥ|

snigdhāmlalavaṇairhr̥dyairyūṣakṣīrarasairhitāḥ||54||

phalānyamlāni khādēyustasya cānyē'gratō narāḥ|

niḥsr̥tāṁ tu tiladrākṣākalkaliptāṁ pravēśayēt||55||

vāggrahānilarōgēṣu ghr̥tamāṁsōpasādhitām|

yavāgūṁ tanukāṁ dadyāt snēhasvēdau ca buddhimān||56||

vamanasyAtiyoge tu shItAmbupariShecitaH|

pibet kaphaharairmanthaM saghRutakShaudrasharkaram||52||

sodgArAyAM bhRushaM vamyAM mUrcchAyAM dhAnyamustayoH|

samadhUkA~jjanaM cUrNaM lehayenmadhusaMyutam||53||

vamato~antaHpraviShTAyAM jihvAyAM kavalagrahAH|

snigdhAmlalavaNairhRudyairyUShakShIrarasairhitAH||54||

phalAnyamlAni khAdeyustasya cAnye~agrato narAH|

niHsRutAM tu tiladrAkShAkalkaliptAM praveshayet||55||

vAggrahAnilarogeShu ghRutamAMsopasAdhitAm|

yavAgUM tanukAM dadyAt snehasvedau ca buddhimAn||56||

In ''atiyoga'' of ''vamana'', the whole body irrigation must be done with cold water. ''Mantha'' must be prepared with ghee, honey and sugar.

If ''atiyoga'' happens with belching and fainting, powdered ''dhanyaka'' (Coriandum sativum), ''musta'' (Cyonodon dactylon), ''rasanjana'' (Berberis aristata) etc. added with honey can be licked.

If due to excessive ''vamana'', his tongue goes inside, a vegetable soup milk or meat soup which are prepared by incorporating unctuous, salty, sour and pleasant ingredients can be used for gargling. Eating sour fruits in front of him by others will also be helpful.

If the tongue comes out, a paste of ''tila''(sesame) and ''draksha'' (grapes) can be applied over it and can be made to move out.

If there is problem in speech or other disorders of ''vata'', he can be given a porridge made of ghee and meat juice. The intelligent physician then must do ''snehana'' (oleation) and ''swedana'' (sudation).[52-56]

==== Importance of diet after purification ====

वमितश्च विरिक्तश्च मन्दाग्निश्च विलङ्घितः|

अग्निप्राणविवृद्ध्यर्थं क्रमं पेयादिकं भजेत् ||५७||

vamitaśca viriktaśca mandāgniśca vilaṅghitaḥ|

agniprāṇavivr̥ddhyarthaṁ kramaṁ pēyādikaṁ bhajēt ||57||

vamitashca viriktashca mandAgnishca vila~gghitaH|

agniprANavivRuddhyarthaM kramaM peyAdikaM bhajet ||57||

''Peyadi krama'' (''peyadi'' diet regimen) must be followed by those who undergo ''Vamana'' and ''Virechana'', who have diminished ''agni'' and who is under fasting for improving the ''jatharaagni'' ( digestion and metabolism) and ''prana shakti''(vitality)

==== Complication of ''adhmana'' (abdominal distension) and its management ====

बहुदोषस्य रूक्षस्य हीनाग्नेरल्पमौषधम्|

सोदावर्तस्य चोत्क्लिश्य दोषान्मार्गान्निरुध्य च||५८||

भृशमाध्मापयेन्नाभिं पृष्ठपार्श्वशिरोरुजम्|

श्वासविण्मूत्रवातानां सङ्गं कुर्याच्च दारुणम्||५९||

अभ्यङ्गस्वेदवर्त्यादि सनिरूहानुवासनम्|

उदावर्तहरं सर्वं कर्माध्मातस्य शस्यते||६०||

bahudōṣasya rūkṣasya hīnāgnēralpamauṣadham|

sōdāvartasya cōtkliśya dōṣānmārgānnirudhya ca||58||

bhr̥śamādhmāpayēnnābhiṁ pr̥ṣṭhapārśvaśirōrujam|

śvāsaviṇmūtravātānāṁ saṅgaṁ kuryācca dāruṇam||59||

abhyaṅgasvēdavartyādi sanirūhānuvāsanam|

udāvartaharaṁ sarvaṁ karmādhmātasya śasyatē||60||

bahudoShasya rUkShasya hInAgneralpamauShadham|

sodAvartasya cotklishya doShAnmArgAnnirudhya ca||58||

bhRushamAdhmApayennAbhiM pRuShThapArshvashirorujam|

shvAsaviNmUtravAtAnAM sa~ggaM kuryAcca dAruNam||59||

abhya~ggasvedavartyAdi sanirUhAnuvAsanam|

udAvartaharaM sarvaM karmAdhmAtasya shasyate||60||

If medicine with low potency and in small quantity is given in patients with excessively vitiated ''dosha'', excess dryness in body, low digestive power and ''udavarta'' then it leads to further aggravation of ''dosha'' resulting in obstruction in channels, severe abdominal distension in umbilical region, pain in the back, flanks and head, severe dyspnea, retention of urine, feces and flatus. This condition shall be treated with ''abhyanga'' (oil massage), ''swedana'' (sudation), ''varti'' (use of suppositories), ''niruha'' along with ''anuvasana'' (decoction and oil enema) and all the treatment that cure ''udavarta''. [58-60]

==== Complication of ''parikartika'' (fissure in ano) and its management ====

स्निग्धेन गुरुकोष्ठेन सामे बलवदौषधम्|
क्षामेण मृदुकोष्ठेन श्रान्तेनाल्पबलेन वा||६१||

पीतं गत्वा गुदं साममाशु दोषं निरस्य च|
तीव्रशूलां सपिच्छास्रां करोति परिकर्तिकाम्||६२||

लङ्घनं पाचनं सामे रूक्षोष्णं लघुभोजनम्|
बृंहणीयो विधिः सर्वः क्षामस्य मधुरस्तथा||६३||

snigdhēna gurukōṣṭhēna sāmē balavadauṣadham|
kṣāmēṇa mr̥dukōṣṭhēna śrāntēnālpabalēna vā||61||

pītaṁ gatvā gudaṁ sāmamāśu dōṣaṁ nirasya ca|
tīvraśūlāṁ sapicchāsrāṁ karōti parikartikām||62||

laṅghanaṁ pācanaṁ sāmē rūkṣōṣṇaṁ laghubhōjanam|
br̥ṁhaṇīyō vidhiḥ sarvaḥ kṣāmasya madhurastathā||63||

snigdhena gurukoShThena sAme balavadauShadham|
kShAmeNa mRudukoShThena shrAntenAlpabalena vA||61||

pItaM gatvA gudaM sAmamAshu doShaM nirasya ca|
tIvrashUlAM sapicchAsrAM karoti parikartikAm||62||

la~gghanaM pAcanaM sAme rUkShoShNaM laghubhojanam|
bRuMhaNIyo vidhiH sarvaH kShAmasya madhurastathA||63||

If potent (purification) medicine is given in properly oleated patients, with ''guru koshtha''(heavy bowel), in cases of ''ama dosha'', body being lean with ''mridu koshtha'' (soft bowel), fatigued and less strength, then ''doshas'' reach ''guda'' (rectum) in ''sama'' condition and get expelled out immediately. It results in ''parikartika'' (fissure in ano) with severe pain, mucous and bloody secretions. In ''amadosha'' or ''sama'' conditions, fasting (''langhana''), digestive (''pachana''), drying (''rukshana''), should be done and easily digestible (light) and hot food must be taken. For those whose body is emaciated, every ''brimhana'' (nourishing) measure like food with ''madhura rasa'' (sweet taste) dominance must be taken. [61-63]

आमे जीर्णेऽनुबन्धश्चेत् क्षाराम्लं लघु शस्यते|
पुष्पकासीसमिश्रं वा क्षारेण लवणेन वा||६४||

सदाडिमरसं सर्पिः पिबेद्वातेऽधिके सति|
दध्यम्लं भोजने पाने संयुक्तं दाडिमत्वचा||६५||

देवदारुतिलानां वा कल्कमुष्णाम्बुना पिबेत्|
अश्वत्थोदुम्बरप्लक्षकदम्बैर्वा शृतं पयः||६६||

कषायमधुरं शीतं पिच्छाबस्तिमथापि वा|
यष्टीमधुकसिद्धं वा स्नेहबस्तिं प्रदापयेत्||६७||

āmē jīrṇē'nubandhaścēt kṣārāmlaṁ laghu śasyatē|
puṣpakāsīsamiśraṁ vā kṣārēṇa lavaṇēna vā||64||

sadāḍimarasaṁ sarpiḥ pibēdvātē'dhikē sati|
dadhyamlaṁ bhōjanē pānē saṁyuktaṁ dāḍimatvacā||65||

dēvadārutilānāṁ vā kalkamuṣṇāmbunā pibēt|
aśvatthōdumbaraplakṣakadambairvā śr̥taṁ payaḥ||66||

kaṣāyamadhuraṁ śītaṁ picchābastimathāpi vā|
yaṣṭīmadhukasiddhaṁ vā snēhabastiṁ pradāpayēt||67||

Ame jIrNe~anubandhashcet kShArAmlaM laghu shasyate|
puShpakAsIsamishraM vA kShAreNa lavaNena vA||64||

sadADimarasaM sarpiH pibedvAte~adhike sati|
dadhyamlaM bhojane pAne saMyuktaM dADimatvacA||65||

devadArutilAnAM vA kalkamuShNAmbunA pibet|
ashvatthodumbaraplakShakadambairvA shRutaM payaH||66||

kaShAyamadhuraM shItaM picchAbastimathApi vA|
yaShTImadhukasiddhaM vA snehabastiM pradApayet||67||

If ''parikartika'' continues even if the ''ama'' got digested, light food added with ''kshara'' (alkalizing) and ''amla'' (sour) is good. For aggravated ''vayu'', ghee medicated with pomegranate juice, ''puspa-kaaseesa'' (green vitriol- Ferrous sulphate), ''kshara'' (alkalies), ''lavana''(salts) and ''dadima'' (Punica granatum) can be used. The powder of skin of ''dadima'' along with sour curd can be taken or with other food. The paste made of ''devadaru'' (Cedrus deodara) and ''tila'' (sesame) can be taken in hot water. Milk processed with the skin of ''ashwatha'' (Ficus bengalensis), ''udumbara'' (Ficus glomerata), ''plaksha'' (Ficus lacor) and ''kadamba'' (Anthocephalus kadamba) can be taken. ''Pichchha basti'' can be done using ''madhura rasa'' (drugs with sweet taste) and cooling ingredients and ''sneha basti'' with oil processed with ''yashti madhu'' (Glycerrhiza glabra) can be done.[64-67]

==== Complication of ''paristrava'' (discharge) and its management ====

अल्पं तु बहुदोषस्य दोषमुत्क्लिश्य भेषजम्|

अल्पाल्पं स्रावयेत् कण्डूं शोफं कुष्ठानि गौरवम्||६८||

कुर्याच्चाग्निबलोत्क्लेशस्तैमित्यारुचिपाण्डुताः|

परिस्रावः स, तं दोषं शमयेद्वामयेदपि||६९||

स्नेहितं वा पुनस्तीक्ष्णं पाययेत् विरेचनम्|

शुद्धे चूर्णासवारिष्टान् संस्कृतांश्च प्रदापयेत्||७०||

alpaṁ tu bahudōṣasya dōṣamutkliśya bhēṣajam|

alpālpaṁ srāvayēt kaṇḍūṁ śōphaṁ kuṣṭhāni gauravam||68||

kuryāccāgnibalōtklēśastaimityārucipāṇḍutāḥ|

parisrāvaḥ sa, taṁ dōṣaṁ śamayēdvāmayēdapi||69||

snēhitaṁ vā punastīkṣṇaṁ pāyayēt virēcanam|

śuddhē cūrṇāsavāriṣṭān saṁskr̥tāṁśca pradāpayēt||70||

alpaM tu bahudoShasya doShamutklishya bheShajam|

alpAlpaM srAvayet kaNDUM shophaM kuShThAni gauravam||68||

kuryAccAgnibalotkleshastaimityArucipANDutAH|

parisrAvaH sa, taM doShaM shamayedvAmayedapi||69||

snehitaM vA punastIkShNaM pAyayet virecanam|

shuddhe cUrNAsavAriShTAn saMskRutAMshca pradApayet||70||

In the patients with excessively vitiated ''doshas'', when only a small dose of medicine is given, the ''dosha'' get aggravated and discharged out in little quantity frequently. This result in ''alpa shopha'' (swelling), ''kandu'' (itching), ''kushtam'' (skin diseases), ''gauravam'' (heaviness), ''agni naasham'' (destruction of digestive power), ''utklesham'' (nausea), ''staimityam'' ( feeling of body covered with wet cloths), ''aruchi'' (ageusia) and ''pandu'' (anemia). The entire spectrum is called ''parisravam''. In this condition, the aggravated ''dosha'' must either be alleviated or removed out by emesis. Otherwise after oleation, potent ''virechana'' medicine can be given again for purification after which ''arishta'' (alcoholic medicated preparations) processed with drugs that enhance ''agni'' (digestive power) can be used. [68-70]

==== Complication of ''hridgraha'' (chest congestion) and its management ====

पीतौषधस्य वेगानां निग्रहान्मारुतादयः|

कुपिता हृदयं गत्वा घोरं कुर्वन्ति हृद्ग्रहम्||७१||

स हिक्काकासपार्श्वार्तिदैन्यलालाक्षिविभ्रमैः|

जिह्वां खादति निःसञ्ज्ञो दन्तान् किटिकिटापयन्||७२||

न गच्छेद्विभ्रमं तत्र वामयेदाशु तं भिषक्|

मधुरैः पित्तमूर्च्छार्तं कटुभिः कफमूर्च्छितम्||७३||

पाचनीयैस्ततश्चास्य दोषशेषं विपाचयेत्|

कायाग्निं च बलं चास्य क्रमेणोत्थापयेत्ततः ||७४||

पवनेनातिवमतो हृदयं यस्य पीड्यते|

तस्मै स्निग्धाम्ललवणं दद्यात् पित्तकफेऽन्यथा||७५||

pītauṣadhasya vēgānāṁ nigrahānmārutādayaḥ|

kupitā hr̥dayaṁ gatvā ghōraṁ kurvanti hr̥dgraham||71||

sa hikkākāsapārśvārtidainyalālākṣivibhramaiḥ|

jihvāṁ khādati niḥsañjñō dantān kiṭikiṭāpayan||72||

na gacchēdvibhramaṁ tatra vāmayēdāśu taṁ bhiṣak|

madhuraiḥ pittamūrcchārtaṁ kaṭubhiḥ kaphamūrcchitam||73||

pācanīyaistataścāsya dōṣaśēṣaṁ vipācayēt|

kāyāgniṁ ca balaṁ cāsya kramēṇōtthāpayēttataḥ ||74||

pavanēnātivamatō hr̥dayaṁ yasya pīḍyatē|

tasmai snigdhāmlalavaṇaṁ dadyāt pittakaphē'nyathā||75||

pItauShadhasya vegAnAM nigrahAnmArutAdayaH|

kupitA hRudayaM gatvA ghoraM kurvanti hRudgraham||71||

sa hikkAkAsapArshvArtidainyalAlAkShivibhramaiH|

jihvAM khAdati niHsa~jj~jo dantAn kiTikiTApayan||72||

na gacchedvibhramaM tatra vAmayedAshu taM bhiShak|

madhuraiH pittamUrcchArtaM kaTubhiH kaphamUrcchitam||73||

pAcanIyaistatashcAsya doShasheShaM vipAcayet|

kAyAgniM ca balaM cAsya krameNotthApayettataH ||74||

pavanenAtivamato hRudayaM yasya pIDyate|

tasmai snigdhAmlalavaNaM dadyAt pittakaphe~anyathA||75||

After taking (emetic) medicine, if one restricts the urges (of vomiting bouts), ''vata'' etc. ''dosha'' get aggravated and located in precordium, resulting in severe chest congestion. This leads to hiccups, pain in flanks, cough, fatigue, salivation, perplexion of eyes/rolling of eyes, fainting with tongue bite and severe grinding of teeth. In this case, without getting confused, the physician must immediately make the patient to vomit. For ''pitta murchita'' (fainting due to aggravation of ''pitta''), ''madhura rasa'' (sweet taste) medicines need to be used and for ''kapha murchita'' (fainting due to aggravation of ''kapha''), ''katu rasa'' (pungent taste) need to be used.

Digestive medicines shall be given to digest remaining ''dosha'' and sequential rehabilitation to re-instate ''agni'' (digestive power) and strength of the body shall be done. If there is excessive vomiting because of vitiation of ''vayu'' leading to chest congestion, then it shall be treated with unctuous, sour and salty medicines. If there is increase in ''kapha'' and ''pitta'', those opposite to unctuous, sour and salty properties that is un-unctuous, bitter and pungent tastes need to be taken.[71-75]

==== Complication of ''gatra-graha'' (body stiffness) and its management ====

पीतौषधस्य वेगानां निग्रहेण कफेन वा|

रुद्धोऽति वा विशुद्धस्य गृह्णात्यङ्गानि मारुतः||७६||

स्तम्भवेपथुनिस्तोदसादोद्वेष्टनमन्थनैः|

तत्र वातहरं सर्वं स्नेहस्वेदादि कारयेत् ||७७||

pītauṣadhasya vēgānāṁ nigrahēṇa kaphēna vā|

ruddhō'ti vā viśuddhasya gr̥hṇātyaṅgāni mārutaḥ||76||

stambhavēpathunistōdasādōdvēṣṭanamanthanaiḥ|

tatra vātaharaṁ sarvaṁ snēhasvēdādi kārayēt ||77||

pItauShadhasya vegAnAM nigraheNa kaphena vA|

ruddho~ati vA vishuddhasya gRuhNAtya~ggAni mArutaH||76||

stambhavepathunistodasAdodveShTanamanthanaiH|

tatra vAtaharaM sarvaM snehasvedAdi kArayet ||77||

After taking (emetic) medicines, if one restricts the urges (vomiting bouts) or get obstructed because of vitiated ''kapha'', then the excessively vitiated ''vata'' causes body stiffness. This results in stiffness, tremor, pricking pain, fainting, cramps and fatigue. This condition shall be managed with all ''vata'' alleviating treatments like oleation, sudation etc. [76-77]

==== Complication of ''jeevadana'' (bleeding) and its management ====

अतितीक्ष्णं मृदौ कोष्ठे लघुदोषस्य भेषजम्|

दोषान् हृत्वा विनिर्मथ्य जीवं हरति शोणितम्||७८||

तेनान्नं मिश्रितं दद्याद्वायसाय शुनेऽपि वा|

भुङ्क्ते तच्चेद्वदेज्जीवं न भुङ्क्ते पित्तमादिशेत्||७९||

शुक्लं वा भावितं वस्त्रमावानं कोष्णवारिणा|

प्रक्षालितं विवर्णं स्यात् पित्ते शुद्धं तु शोणिते||८०||

तृष्णामूर्च्छामदार्तस्य कुर्यादामरणात् क्रियाम्|

तस्य पित्तहरीं सर्वामतियोगे च या हिता ||८१||

मृगगोमहिषाजानां सद्यस्कं जीवतामसृक्|

पिबेज्जीवाभिसन्धानं जीवं तद्ध्याशु गच्छति ||८२||

तदेव दर्भमृदितं रक्तं बस्तिं प्रदापयेत्|

श्यामाकाश्मर्यबदरीदूर्वोशीरैः शृतं पयः||८३||

घृतमण्डाञ्जनयुतं शीतं बस्तिं प्रदापयेत्|

पिच्छाबस्तिं सुशीतं वा घृतमण्डानुवासनम्||८४||

atitīkṣṇaṁ mr̥dau kōṣṭhē laghudōṣasya bhēṣajam|

dōṣān hr̥tvā vinirmathya jīvaṁ harati śōṇitam||78||

tēnānnaṁ miśritaṁ dadyādvāyasāya śunē'pi vā|

bhuṅktē taccēdvadējjīvaṁ na bhuṅktē pittamādiśēt||79||

śuklaṁ vā bhāvitaṁ vastramāvānaṁ kōṣṇavāriṇā|

prakṣālitaṁ vivarṇaṁ syāt pittē śuddhaṁ tu śōṇitē||80||

tr̥ṣṇāmūrcchāmadārtasya kuryādāmaraṇāt kriyām|

tasya pittaharīṁ sarvāmatiyōgē ca yā hitā ||81||

mr̥gagōmahiṣājānāṁ sadyaskaṁ jīvatāmasr̥k|

pibējjīvābhisandhānaṁ jīvaṁ taddhyāśu gacchati ||82||

tadēva darbhamr̥ditaṁ raktaṁ bastiṁ pradāpayēt|

śyāmākāśmaryabadarīdūrvōśīraiḥ śr̥taṁ payaḥ||83||

ghr̥tamaṇḍāñjanayutaṁ śītaṁ bastiṁ pradāpayēt|

picchābastiṁ suśītaṁ vā ghr̥tamaṇḍānuvāsanam||84||

atitIkShNaM mRudau koShThe laghudoShasya bheShajam|

doShAn hRutvA vinirmathya jIvaM harati shoNitam||78||

tenAnnaM mishritaM dadyAdvAyasAya shune~api vA|

bhu~gkte taccedvadejjIvaM na bhu~gkte pittamAdishet||79||

shuklaM vA bhAvitaM vastramAvAnaM koShNavAriNA|

prakShAlitaM vivarNaM syAt pitte shuddhaM tu shoNite||80||

tRuShNAmUrcchAmadArtasya kuryAdAmaraNAt kriyAm|

tasya pittaharIM sarvAmatiyoge ca yA hitA ||81||

mRugagomahiShAjAnAM sadyaskaM jIvatAmasRuk|

pibejjIvAbhisandhAnaM jIvaM taddhyAshu gacchati ||82||

tadeva darbhamRuditaM raktaM bastiM pradApayet|

shyAmAkAshmaryabadarIdUrvoshIraiH shRutaM payaH||83||

ghRutamaNDA~jjanayutaM shItaM bastiM pradApayet|

picchAbastiM sushItaM vA ghRutamaNDAnuvAsanam||84||

If in the individual with ''mridu koshtha'' (soft bowel), and less aggravated ''dosha'', highly potent (''virechana'') medicine is administered, that will result in the removal of ''dosha'' after which bleeding ensues and then finally lead to evacuation of ''jeeva rakta'' (pure, functioning blood).

If the evacuated material is mixed with food and given to crow or dog, if they eat it, it can be confirmed that it is ''jeeva-rakta''. If, they do not eat, then the blood is mixed with ''pitta'' (as seen in ''rakta-pitta'').

If the evacuated blood is applied over a cloth and the cloth is washed with hot water, if the blood remains, it is bile and if the cloth clears off, it is ''jeeva-rakta''.

When ''jeeva-rakta'' gets evacuated, it results in burning sensation, fainting and intoxication. Here all treatments for impending death, all kinds of ''pitta nashaka'' treatments and treatments told in ''atiyoga'' must be done. For those whose ''jeeva-rakta'' is getting evacuated immediately, the blood of deer, cow, buffalo, goat etc. need to be given orally. That will sustain life because blood of animals gets immediately transformed to the human. The same blood can be used for ''basti'' by adding ''churna'' of ''darbha'' (Desmostachya bipinnata).

''Basti'', coolant in nature, using milk processed with drugs like ''shyama'' (Cassia fistula), ''kashmari'' (Gmelina arborea), ''badara'' (Zizyphus mauritiana), ''durva'' (Cyonodon dactylon), ''usheera'' (Vetiveria zizanoides) need to be done. Or coolant ''pichchha basti'' or ''sneha basti'' with ''ghrita manda'' is effective. [78-84]

==== Complication of ''gudavibhramsha'' (rectum prolapse) and its management ====

गुदं भ्रष्टं कषायैश्च स्तम्भयित्वा प्रवेशयेत्|

साम गान्धर्वशब्दांश्च सञ्ज्ञानाशेऽस्य कारयेत्||८५||

यदा विरेचनं पीतं विडन्तमवतिष्ठते|

वमनं भेषजान्तं वा दोषानुत्क्लिश्य नावहेत्||८६||

तदा कुर्वन्ति कण्ड्वादीन् दोषाः प्रकुपिता गदान्|

स विभ्रंशो मतस्तत्र स्याद्यथाव्याधि भेषजम्||८७||

gudaṁ bhraṣṭaṁ kaṣāyaiśca stambhayitvā pravēśayēt|

sāma gāndharvaśabdāṁśca sañjñānāśē'sya kārayēt||85||

yadā virēcanaṁ pītaṁ viḍantamavatiṣṭhatē|

vamanaṁ bhēṣajāntaṁ vā dōṣānutkliśya nāvahēt||86||

tadā kurvanti kaṇḍvādīn dōṣāḥ prakupitā gadān|

sa vibhraṁśō matastatra syādyathāvyādhi bhēṣajam||87||

gudaM bhraShTaM kaShAyaishca stambhayitvA praveshayet|

sAma gAndharvashabdAMshca sa~jj~jAnAshe~asya kArayet||85||

yadA virecanaM pItaM viDantamavatiShThate|

vamanaM bheShajAntaM vA doShAnutklishya nAvahet||86||

tadA kurvanti kaNDvAdIn doShAH prakupitA gadAn|

sa vibhraMsho matastatra syAdyathAvyAdhi bheShajam||87||

If there is rectal prolapse, it should be positioned by using ''kashaya dravya'' (astringent drugs) and pushed in its own location. If there is loss of consciousness, then he should be consoled and exposed to music therapy.

If the ''virechana'' drug stops action after the elimination of the fecal matter and the emetic recipe stops action after the elimination of medicine, the excited ''doshas'' do not get properly eliminated leading to symptoms like itching etc. This spectrum is termed as ''vibhramsha''. These should be managed as per their individual disease protocols. [85-87]

==== Complication of ''stambha'' (stiffness) and its management ====

पीतं स्निग्धेन सस्नेहं तद्दोषैर्मार्दवाद्वृतम्|

न वाहयति दोषांस्तु स्वस्थानात् स्तम्भयेच्च्युतान्||८८||

वातसङ्गगुदस्तम्भशूलैः क्षरति चाल्पशः|

तीक्ष्णं बस्तिं विरेकं वा सोऽर्हो लङ्घितपाचितः||८९||

pītaṁ snigdhēna sasnēhaṁ taddōṣairmārdavādvr̥tam|

na vāhayati dōṣāṁstu svasthānāt stambhayēccyutān||88||

vātasaṅgagudastambhaśūlaiḥ kṣarati cālpaśaḥ|

tīkṣṇaṁ bastiṁ virēkaṁ vā sō'rhō laṅghitapācitaḥ||89||

pItaM snigdhena sasnehaM taddoShairmArdavAdvRutam|

na vAhayati doShAMstu svasthAnAt stambhayeccyutAn||88||

vAtasa~ggagudastambhashUlaiH kSharati cAlpashaH|

tIkShNaM bastiM virekaM vA so~arho la~gghitapAcitaH||89||

Unctuous medicine for ''virechana'' when given to a person with an oleated body, because of the mild nature of ''doshas'', they are not let out and cause occlusion in its own site. Because of the obstructed ''vayu'', there will be obstruction and pain in the rectum and there will be frequent expulsion of ''doshas'' in little quantity.

Here highly potent ''basti'' or ''virechana'', need to be given. First he must observe fast or take light food (''langhana''), then give ''pachana'' (digestive medicine ). [88-89]

==== Complications and its management ====

रूक्षं विरेचनं पीतं रूक्षेणाल्पबलेन वा|

मारुतं कोपयित्वाऽऽशु कुर्याद्धोरानुपद्रवान्||९०||

स्तम्भशूलानि घोराणि सर्वगात्रेषु मुह्यतः|

स्नेहस्वेदादिकस्तत्र कार्यो वातहरो विधिः||९१||

rūkṣaṁ virēcanaṁ pītaṁ rūkṣēṇālpabalēna vā|

mārutaṁ kōpayitvā''śu kuryāddhōrānupadravān||90||

stambhaśūlāni ghōrāṇi sarvagātrēṣu muhyataḥ|

snēhasvēdādikastatra kāryō vātaharō vidhiḥ||91||

rUkShaM virecanaM pItaM rUkSheNAlpabalena vA|

mArutaM kopayitvA~a~ashu kuryAddhorAnupadravAn||90||

stambhashUlAni ghorANi sarvagAtreShu muhyataH|

snehasvedAdikastatra kAryo vAtaharo vidhiH||91||

Individual with un-unctuous body and who is weak, when given an un-unctuous ''virechana'' recipe, will result in severe vitiation of ''vayu'' and cause serious complications. Vitiated ''vayu'' results in whole body stiffness and colicky pain. Here oleation and sudation therapies along with protocol for management of ''vata'' needs to be adopted. [90-91]

==== ''Klama'' (fatigue without exertion) and its management ====

स्निग्धस्य मृदुकोष्ठस्य मृदूत्क्लिश्यौषधं कफम्|

पित्तं वातं च संरुध्य सतन्द्रागौरवं क्लमम्||९२||

दौर्बल्यं चाङ्गसादं च कुर्यादाशु तदुल्लिखेत्|

लङ्घनं पाचनं चात्र स्निग्धं तीक्ष्णं च शोधनम्||९३||

snigdhasya mr̥dukōṣṭhasya mr̥dūtkliśyauṣadhaṁ kapham|

pittaṁ vātaṁ ca saṁrudhya satandrāgauravaṁ klamam||92||

daurbalyaṁ cāṅgasādaṁ ca kuryādāśu tadullikhēt|

laṅghanaṁ pācanaṁ cātra snigdhaṁ tīkṣṇaṁ ca śōdhanam||93||

snigdhasya mRudukoShThasya mRudUtklishyauShadhaM kapham|

pittaM vAtaM ca saMrudhya satandrAgauravaM klamam||92||

daurbalyaM cA~ggasAdaM ca kuryAdAshu tadullikhet|

la~gghanaM pAcanaM cAtra snigdhaM tIkShNaM ca shodhanam||93||

For those with unctuous and ''mridu koshtha'', if mild purificatory medicine is given, there is aggravation of ''kapha'' causing obstruction to ''pitta'' and ''vata'' resulting in fatigue, heaviness of body, loss of strength, excruciating pain. Here the medicine must be given to vomit immediately. Then accordingly ''langhana'' (fasting) and ''pachana'' (digestive medicine) need to be done followed by purification with strong and unctuous medicines. [92-93]

==== Summary ====

तत्र श्लोकौ-

इत्येता व्यापदः प्रोक्ताः सरूपाः सचिकित्सिताः|

वमनस्य विरेकस्य कृतस्याकुशलैर्नृणाम् ||९४||

एता विज्ञाय मतिमानवस्थाश्चैव तत्त्वतः|

दद्यात् संशोधनं सम्यगारोग्यार्थी नृणां सदा||९५||

tatra ślōkau-

ityētā vyāpadaḥ prōktāḥ sarūpāḥ sacikitsitāḥ|

vamanasya virēkasya kr̥tasyākuśalairnr̥ṇām ||94||

ētā vijñāya matimānavasthāścaiva tattvataḥ|

dadyāt saṁśōdhanaṁ samyagārōgyārthī nr̥ṇāṁ sadā||95||

tatra shlokau-

ityetA vyApadaH proktAH sarUpAH sacikitsitAH|

vamanasya virekasya kRutasyAkushalairnRuNAm ||94||

etA vij~jAya matimAnavasthAshcaiva tattvataH|

dadyAt saMshodhanaM samyagArogyArthI nRuNAM sadA||95||

Thus the features of complications that may arise due to ''vamana'' and ''virechana'' by un-skilled physician and their management are described. Intelligent ones must always properly understand these states and administer proper purification therapy in the persons desiring health. [94-95]

=== ''Tattva Vimarsha'' ===

*The purification treatments shall be done in specific seasons in which the ''doshas'' are in vitiated state naturally. In case of disease, it can be followed anytime.
*''Vamana'' (therapeutic emesis) for ''kapha dosha'' shall be followed in ''vasanta'' (spring season from mid February to mid April in India); ''virechana'' (therapeutic purgation) for ''pitta dosha'' shall be followed in ''sharada'' (Autumn season from mid October to mid December in India); ''basti'' (therapeutic enema) for ''vata dosha'' shall be followed in ''pravrita'' (early rains season from mid June to mid August in India).
*''Snehana'' (oleation) therapy shall be done in between two purification therapies and at the end of purification. This is to prevent vitiation of ''vata dosha'' after purification.
*Oleation shall neither be excess nor be less for proper purification.
*Purification therapy shall always be taken after proper digestion of previous day meal and in appropriate dosage.
*The stable mental state of patient is important to get benefits of purification.
*Diet before and after purification is important for maximum sustaining effects. The previous day meal before ''vamana'' shall be easily digestible, rich in fluids and increasing ''kapha''. The previous day meal before ''virechana'' shall be light to digest and hot.
*In proper ''vamana'', the ''pitta'' is expelled out at the end. In proper ''virechana, kapha'' is expelled out at the end. Emaciation, weakness and lightness of body are other signs of proper purification.
*The physician should keenly observe the patient during purification therapy for assessing signs of eliminating ''doshas''. The conditions and complications shall be treated based on ''dosha'' dominance and disease protocols.
*Assessment of vitiation of ''dosha, agni'' (digestive power), ''koshtha'' (bowel) and unctuousness of patient are most important factors for administration of purification therapy. Otherwise complications may arise due to improper dosage, potency of medicines.

=== ''Vidhi Vimarsha'' ===

==== Importance of oleation and sudation therapies before purification ====

The ''shloka'' highlights the importance of the spacing of ''sneha-sweda'' in between the therapies. ''Shodhanaanga snehapaana'' and ''swedana'' before ''vamana'' or ''virechana'' brings in the ''utklishta doshas'' (after ''snehapaana''), to the ''koshtha'' (after swedana) and eliminates it (A.H.Su.17/29).

Chakrapani while commenting here says, one should not misunderstand the context as ''sneha sweda'' is required only once before all ''shodhana''. The mentioning of ''sneham ca ante prayojayet'', is important in clinical practice. Once the patient gets discharged from the hospital after ''shodhana'', the physician must use a ''sneha'' internally after ''peyadikramam''. Chakrapani says, it is to control the fatigue caused by the ''samshodhana karma'' that the use of ''samshamana sneha'' is told here.(Verse 7)

==== Indications of ''Virechana'' ====

On analyzing the ''samprapti'' of the conditions (''visarpa, pidaka'' etc.) mentioned here, it is well evident that the common thread in them is ''kapha-pitta dushti''. ''Shopha'' is also a clinical condition where there is prohibition to use oleating substances like ''guda, aanoopa-amisha'' etc. (A.H.Su.16/43). Here ''abhighaata'' and ''visha'' which is always an acute emergency presenting ''kapha-pitta dushti'' also requires immediate ''shodhana'' without much ''swedana''. ''Pandu roga'' is a condition which is entitled for the use of ''sneha prayoga'' like ''kalyanakaghrita''. Here, Acharya cautions not to reach ''ati-snigdhatwam''. ''Visarpa'' is also a condition where in ''snehana'' is prohibited.

In practice, usually in all these conditions ''virechana'' is done with ''ruuksha prayoga'' like ''churna, kashaya'' etc. ''Avipathi churna'' (A.H.Ka), ''Vidangatandulaadi churna'' (A.H.Ka), ''Trivrita kashaya, Maanibhadra churna'' (''churna'' form of ''Maanibhadra gudam''- A.H.Ci), ''Patolaadi shodhana kashayam'' (''sahasrayoga'') are used.(Verse 8)

==== Indications of ''Sneha Virechana and Ruksha Virechana'' ====

Following the principle, ''vridhisamane sarvesham vipareetai viparyata'' (A.H.Su.1/14) if an excessively oleated person is administered a drug which is unctuous in nature, it will not work, rather when medicine of opposite guna like ''ruksha'' is used for ''shodhana'', the appropriate action will happen. Chakrapani says ''sneha virechana'' means ''snigdha virechana'', that is ''virechana'' with ''snigdha'' (unctuous) ''dravya''. If ''sneha virechana'' is given to an ''atisnigdha shareera'', because of ''sneha prakarsha'' (excess ''sneha'') the vitiated ''doshas'' already in a the morbid state cannot be removed. These vitiated ''doshas'' that has already moved from their site will clog the ''srotas''. Hence to remove this vitiated ''dosha ununctuous/ruksha'' kind of ''shodhana'' need to be performed. (Verse 9)

==== Procedure of ''virechana'' ====

''Samyak'' is the word used to indicate appropriate/ optimum action in many contexts. Any ''kriyakrama'' is performed for its appropriate outcome as desired by the physician. The ''shloka'' here reveals the four important limbs of it, which are equally important. The first being the proper preparation of the patient in the form of ''sneha sweda'', the second being the physiological status of the patient with respect to ''ahaara,'' only then can the agni do its duty. So the medicine has to be given after the ''ahaara'' is digested. The third being the importance of ''maatra'' which is previously well explained in [[Trividhakukshiya Vimana]]. There, the Acharya lays importance to the appropriate ''maatra'' of ''ahaara''. Here Acharya, gives importance to the appropriate ''maatra'' of ''aushadha''. Only the desired dosage is acted upon by ''agni'' to create the optimum response in the body.

Fourthly, the relevance of focused mind is explained. Chakrapani says the patient must concentrate only on the action of ''shodhana'', the presence of negative emotions like lust, anger, jealousy will only have negative effect on the outcome.(Verse 10)

==== Similes for action of ''virechana'' ====

We can see the use of similes at various contexts in Ayurvedic classics. It not only gives the reader a clear idea behind the concept, but it also reveal observational talent of Ayurvedic seers to relate external world (macrocosm) with the internal world (microcosm), principles acting inside the body are similar to that act outside and vice versa. The simile of pot smeared with oil to oleated body and water that can be taken out linked to ''shodhana'' therapy explain the action to its fullest. Similarly, the ''malas'' removed from the body by ''shodhana'' similar to the dirt adhered to the cloth by rinsing in water also explains the mechanism of action in the most understandable way. (Verses 11-13)

==== Contraindication in state of indigestion ====

The importance of understanding the physiological state of the human body during the ''shodhana'' therapy is revealed here. We can see the ''lakshana'' indicating ''srotorodha'' and ''ama-avastha'' like ''glaani'' and ''vibandha'' on administering medicine to patient in ''ajeerna avastha''. Here this ''ajeerna'' will definitely lead to ''ama'', which will again aggravate the condition.

For the practical assessment of the ''jeerna-ahaara'' in the patient to be administered with the ''shodhana'' therapy, the following signs and symptoms can be assessed like the elimination of the feces and urine unobstructed, when the mind is clear, belching are pure, hunger is well manifest, flatus moving downward, digestive activity is clean, sense organs are clear, body is light as mentioned in A.H.Suu. Maatrasheetiyam Adhyayam (A.H.Su.8/55) can be taken into account. (Verses 14)

==== Characteristics of proper dosage ====

The ''lakshana'' of ''maatravada aushadham'' touches all aspects of an ideal drug. We can see the pharmacoleptic, pharmacological and pharmacokinetic aspects being mentioned here for selecting the right drug in the appropriate dosage.

Each formulation has its own ''guna'' with respect to its contents. Even though the drug has its ''guna'', the outcome of the ''kriyakrama'' in the patient will also depend on the physiological and the environmental factors too. However, an ideal drug and its ideal dosage in a particular clinical condition, in a particular patient can only be assessed only after the continuous practice and experience of the physician. The same medicine may have different outcome in different patients. Hence, an ideal drug even though is important, more important is fixing the dosage appropriately considering all other factors.(Verses 15-16)

==== Importance of concentration while taking purification treatment ====

The ''shloka'' 17 explains the context of ''ekagra manah'', as mentioned earlier. It reinforces the idea that negative emotions of mind like ''kaamaadi'' would hinder the effective outcome of ''shodhana'' for which the mind must be free and fully concentrating only on ''shodhana'' therapy.(Verse 17 )

==== Diet before purification treatment ====

After warning about ''ajeerna ahaara'', the present context explain the ''guna'' of ''ahaara''. For ''vamana'', all kind of ''kapha''-aggravating ''ahaara'' that is easily digestible and liquid in nature is advised on the previous day which is to facilitate the intending ''karma''. The increased ''kapha'' state as specified in [[Kalpana Siddhi]] as well as the decreased ''kapha'' state are important for ''vamana'' and ''virechana'' respectively. ''Kapha'' is the ''dosha'' that basically decides the action (C.S.Si.1/9)

For ''virechana'', the ''ahaara'' on the previous day is mentioned to be ''laghu'' and ''asheeta'', that is, easily digestible and hot. Hence, the action of ''vamana'' happens with ''utklishta kapha'' and for ''virechana'' with ''alpa kapha''. In similar context, Susruta Samhita Chikitsa Sthana, he speaks of ''pitta-utklehsa'' before ''virechana'', with ''amla dravya'' like ''beeja-purka rasa''. This will also ultimately result in ''alpa-kaphatvam''.

In practice, we give porridge made of ''maasha'' (black gram) with sugar, yogurt, boiled fish with no spices, preparation of ''masha'' like ''idli'' (south Indian dish), rice and milk porridge, milk ''peda, jalebi'' (north indian sweet) as ''kaphakara ahaara'' before ''vamana''. On previous day of ''virechana'' like hot ''rasam'' (A south Indian dish mainly of tamarind juice, lime juice etc. with meal.) (Verse 18)

==== Signs of proper purification ====

The ''sloka'' explains specific objective signs to assess optimum activity of the ''shodhana karma''. Like in ''vamana'', the output of ''kapha'' is succeeded by bile and in ''virechana'', first feces must come out followed by ''pitta'' and then ''kapha''. However, after both the procedure, if done properly, will make the patient feel light, fatigued and emaciated which indicates the expulsion or mitigation of ''kapha'' and ''pitta'' and increase of ''vata'' as expected after any ''shodhana'' therapy. (Verse 19-20)

Even though ''acharya'' gives us practical tips to understand the presence of residual drug and emesis to be done to remove the residue, in our limited experience, we have not come across such practice. The practice of ''vamana'' as a correction therapy other than main procedure is seldom done. (Verse 21)

==== After measures of ''vamana'' ====

The after-measure of ''vamana'' is specifically told here. It probably highlights the seriousness of the procedure, which is the only one done in the ''pratiloma'' direction among the [[Panchakarma]]. Hence, the removal of residual ''dosha'' becomes even more pertinent. (Verse 22-23)

==== Importance of specific diet after purification treatment ====

As explained already in the first chapter of [[Siddhi Sthana]], the mentioning of ''peyaadikrama'' here again, is only to reinforce its importance in the practice of ''shodhana karma''. However, Chakrapani, in his commentary reminds the fact that, after ''vasti'', ''peyadi'' is not mentioned because the status of ''agni'' after ''vasti'' is not hampered as much as in ''virechana'' and ''vamana''.

Chakrapani intelligently compare the context wherein it is mentioned that ''shodhanakriya'' improves / kindles ''agni''. He says it is as mentioned in Siddhi 1/17,22. He says the ''agni'' is kindled when compared to the earlier status of ''agni'' before ''shodhana''. (Verse 24-25)

==== Signs of digestion of purification medicine ====

We can see ''jeerna-aushadha lakshana'' exhibits all types of ''jeerna-ahaara lakshana'' too. Signs of residual drug indicate ''lakshana'' of ''ama''. In the next ''shloka'', he warns of inappropriate medicine, which is unseasonal, untimely collected, stored for long period, improperly processed etc. This ''shloka'' sequentially expresses the idea that if there are signs of residual drug, the factors considered here may be reasoned upon. (Verse 26-28)

==== Complications of purification treatment ====

The 10 sets of ''vyapat'' are explained either as ''ayoga'' or ''atiyoga'', because ultimately drug can act broadly only in these contexts. Very intelligently ''acharya'' says, this can happen because of defect in ''preshya'' (attendant), ''bhaishajya'' (drug), ''vaidya'' (physician) and ''atura'' (patient). These are also the ''chatushpada'' mentioned in Ayurveda. (A.H.Su.1/27). In the above context, we can see the change in the order. The attendant comes in first, then drug, then the physician and then only the patient.

Probably the clinical observation of ''acharya'' might have lead him to this conclusion, but most of the time, it is the attendant who becomes responsible, because of ill-equipped expertise, then comes the drug. However, the position of ''rogi'' is the last one, because the ''vaidya'' must have the capability to correct even the ''rogi''. (Verse 29-30)

Any procedure can have the outcome only in three ways, which is explained here. Hence, the procedure has to be analyzed within the frame of these three outcomes. (Verse 31)

==== Signs of improper purification and its consequences ====

When ''virechana dravya'' with the said qualities causes ''vamana'', two conditions mentioned here are ''shleshmotklishta avastha'' and ''ajeerna avastha''. In both cases, there is always a tendency for ''vamana'' which is of course not the classical ''shodhana'' but just to let out the things because the body could not assimilate the ''virechana aushadha'' intended to cause ''virechana''. Now similarly, when the patient who is hungry with less ''kapha'' and has the potent drug for ''vamana'' will lead to ''virechana'' . The reason being the digestion of ''aushadha'' by the ''agni''. It is very well told that the ''virechana aushadha'' can act only in ''paripakwa avastha'' and ''vamana'' in ''avipaakwa avastha''. (Verse 32-34)

Finally the status of ''koshtha'' and strength of the patient decides which kind of medicine has to be given in case of ''ayoga''. The mentioning of avoiding repeated dose if the patient is not suitable also gains clinical relevance. ''Acharya'' warns in the context that such usage inappropriately can even lead to death. (Verse 35-37)

==== ''Ayoga'' (less purification) ====

Before going for specific ''vyapat'', the general presentation of ''ayoga'' is explained. Here also, the aspect touching the preparation of the individual, quality of medicine is touched upon. The medicine that is stored for a long time is used in an improperly oleated and sudated individual will not be able to move out the morbid ''doshas'' properly. Here we can see mostly the ''vata kopa lakshanas'', like the ''pindikodweshtana, tamaso darshanam'' etc. ''Kapha-pitta dushti lakshana'' like ''kandu'' is also seen.

Usually in clinical practice, this is encountered commonly, when the ''snehapana'' is compromised for various reasons without attaining proper ''samyak lakshana'', medicines with low quality or long stored ones is also seen to play its role. (Verse 38-39)

These verses explain the possibility of ''ayoga'' even after proper ''sneha sweda''. The relevance of ''agni'' and quality of medicine are reinforced here. (Verse 40-41)

The treatment mentioned here is again reversing the ''dosha dushti'' using various ''kriya krama''. The role of ''niruha basti'' here relates to the context where in ''durvirechya'', due to ''ruksha bahvaanila krura koshta'' are advised to undergo ''niruha'' first. (Verse 42-44)

==== Hazards of excess purification and its management ====

Chakrapani in the context comments that this indicates ''atiyoga'' of ''virechana'' only since seeing of ''vata, pitta, kapha'' is mentioned and on administering medicine in patient who is hungry and with ''mridu koshtha'' is mentioned. He also adds that the context can also be interpreted as ''atiyoga'' of ''vamana'' by using the ''ati-teekshna dravya'' and ''atiyoga'' of ''virechana'' if medicine is used in a hungry patient with ''mridu koshta''. He says, the order of ''vata, pitta'' and ''kapha'' should be changed and applied to the context logically.

The signs and symptoms presented here points to many emergency contexts. The practice of going for ''vamana'' in case of ''atiyoga'' of ''virechana'' and vice-versa is not done widely. However, the use of ''parisheka, avagaaha'' and managing with internal medicines are done more. ''Vilwadi gutika, sidhamakara dhwaja, dhanwantaram gutika, kalashakadi kashaya'' etc are the commonly used ones. (Verse 45-48)

The treatment for ''atiyoga'' of ''vamana'' and ''virechana'' is mentioned separately. For ''virechana'', the effect of internal medicines is told. The use of milk which itself is ''rechana'' in nature is used while processing with drugs of opposite ''guna''. ''Picha basti'' and ''anuvasana basti'' with ''madhura gana dravya'' will definitely be ''sthambhana'' in action. (Verse 49-51)

==== Management of excess emesis====

For ''vamanatiyoga, kaphahara dravya'' has to be considered. Here we can see many emergency situations like fainting, protrusion of tongue inside and outside, ''vakgraha'' etc. the management has also to be fixed by using simple techniques like eating tamarind in front of the patient which will stimulate the physiology to correct itself. Techniques like pushing back of the tongue to normal after applying the paste of ''tila'' and ''draaksha'' demand the skill of the physician. (Verse 52-56)

==== Diet after procedure ====

The ''shloka'' lays importance to the use of ''peyadi'' after ''atiyoga'' of ''vamana'' and ''virechana'' considering the excessively hampered ''agni''. (Verse 57)

==== Significant concepts in the chapter ====

The ten ''vyapat adhmana, parikatika, parisraava, hrdayopasarana, anga graham, jeevaadaana, vibhramsha, sthambha, upadrava'' and ''klama'' are explained in a systematic manner. Each ''vyapat'' represent a cluster of signs and symptoms. However, every context begins with explaining the possible causative factors for the happening. On analyzing the various causes told for ''vyapat'', we can see the ''doshic'' status, the general quality of the ''sharira'' and the ''koshtha'', the status of ''agni'', the physiological state of the individual-all plays an important role. The treatments mentioned are also grouped. The physician may not see all the signs and symptoms for each as told in the text, but can infer from some of the presentation. It becomes the responsibility of the intelligent physician to select the appropriate ''karma'' for the treatment of the complication presented. The presentation of ''vyapat'' itself reveals the clinical skill of Charak to observe the minute presentation in the body. Each complication is self-explanatory as mentioned in the text. However, in the present day practice, how much a modern day Ayurveda physician encounters these complications is an issue to be discussed about. Whether the lack of quality of the ''shodhana'' performed, change in practical standards, problem at all four levels of the ''chatushpada'' could be the cause.(Verse 58-90)

The chapter ends by reinforcing the idea of a knowledgeable physician who knows, where, when, how to apply ''shodhana'' therapy accurately and thus avoid complications.
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Netrabastivyapat Siddhi

2019-03-06T04:03:13Z

Pallavmishra:

{{Infobox
|title = Netrabastivyapat Siddhi
|label1 = Section/Chapter
|data1 = [[Siddhi Sthana]] Chapter 5
|label2 = Preceding Chapter
|data2 = [[Snehavyapat Siddhi]]
|label4 = Succeeding Chapter
|data4 = [[Vamana Virechana Vyapat Siddhi]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]

|header3 =

}}
==[[Siddhi Sthana]] Chapter 5, Chapter on Management of complications due to enema nozzle ==

== Abstract ==

[[Netrabastivyapat Siddhi]] deals with possible complications during ''basti'' procedure, due to improper choice of ''netra'' (injection pipe/nozzle) and ''bastiputaka'' (medicinal bag) as well as their inappropriate handling during the course of action by the ''praneta'' (administrator). The total number of improper ''bastinetra'' to be avoided are eight and the consequent ''dosha''( defects) are also eight. Also, abnormal ''bastiputaka'' to be avoided while the procedure as well as their corresponding ''dosha'' are eight in number. ''Pranetradosha'' (administrator error) are ten in number and they are categorized into ''pranayana'' (introduction of ''netra''), ''baddha'' (filling and tying of ''basti'') and ''peedana'' (squeezing of ''basti'') ''dosha'' respectively.

'''Keywords''': ''Netra, basti, praneta, dosha'' and ''siddhi'', nozzle, insertion, injection of enema, impediments.

=== Introduction ===

The preceding chapter ([[Snehavyapat Siddhi]]) dealt with the management strategies for ''snehabastivyapat'' and therefore this chapter elucidates the ''vyapat'' (complications) related to the instrumentation involved in either kind of ''basti''. ''Netra'' (nozzles designed for enema) and ''basti'' (bag designed for enema) that are to be avoided in procedures and ''vyapat'' (complications) arising due to inappropriate appliance of ''netra'' along with their management are explained in the chapter.

Even though the title of the chapter encompasses the term ''netra'' and ''basti''; ''vyapat'' caused by praṇēta are also dealt in here. It is supposed that a physician’s skill is usually tested when he enters the arena of ''basti'' practice. Lot of factors apart from clinical and theoretical knowledge are involved in a proper conduct of ''basti''. Instrumentation and technique are two such important factors cited here. Instrumentation whilst the days of Charak were based on the most suitable and available material and hence such descriptions are expounded here. However, scientific advancement based on safety, feasibility and practicality in the present era has resulted in recent innovations such as use of metallic syringe in ''matrabasti'', use of plastic bags replacing animal urinary bladders, nozzles made of disposable materials etc. The fact remains that such innovations need to be put into practice protecting the essence as well as the fundamental principles behind ''basti'' procedure and not interfering or rather limiting its effect in relation to the technique. Much criticism has been made on the use of enema cans (as in Naturopathy) instead of conventional ''basti'', as it hinders the technique.

Preventing complications while the procedure reflects two aspects of a physician; the extent of theoretical knowledge regarding ''basti'' and his expertise in the procedure. Identifying specific complications is made possible as a part of regular event evaluation irrespective of manifestation of any complications. Rectification of mistakes committed in technique are of immense value with respect to development of a standard operative procedure. Management of complications with respect to acute and chronic events is also an important aspect in ''siddhi''.

===Sanskrit text, Transliteration and English Translation===

अथातो नेत्रबस्तिव्यापत्सिद्धिं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

अथ नेत्राणि बस्तींश्च शृणु वर्ज्यानि कर्मसु|

नेत्रस्याज्ञप्रणीतस्य व्यापदः सचिकित्सिताः||३||

athātō nētrabastivyāpatsiddhiṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

atha nētrāṇi bastīṁśca śr̥ṇu varjyāni karmasu|

nētrasyājñapraṇītasya vyāpadaḥ sacikitsitāḥ||3||

athAto netrabastivyApatsiddhiM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

atha netrANi bastIMshca shRuNu varjyAni karmasu|

netrasyAj~japraNItasya vyApadaH sacikitsitAH||3||

Now we shall expound the chapter upon management of complications due to enema nozzle. Thus said Lord Atreya, henceforth listen to the description of defects in enema nozzles, their complications if used for ''basti'' and their management. [1-3]

==== Eight defects of nozzle and its harmful effect ====

ह्रस्वं दीर्घं तनु स्थूलं जीर्णं शिथिलबन्धनम्|

पार्श्वच्छिद्रं तथा वक्रमष्टौ नेत्राणि वर्जयेत्||४||

अप्राप्त्यतिगतिक्षोभकर्षणक्षणनस्रवाः|

गुदपीडा गतिर्जिह्मा तेषां दोषा यथाक्रमम्||५||

hrasvaṁ dīrghaṁ tanu sthūlaṁ jīrṇaṁ śithilabandhanam|

pārśvacchidraṁ tathā vakram aṣṭau nētrāṇi varjayēt||4||

aprāptyatigatikṣōbhakarṣaṇakṣaṇanasravāḥ|

gudapīḍā gatirjihmā tēṣāṁ dōṣā yathākramam||5||

hrasvaM dIrghaM tanu sthUlaM jIrNaM shithilabandhanam|
pArshvacchidraM tathA vakramaShTau netrANi varjayet||4||

aprAptyatigatikShobhakarShaNakShaNanasravAH|

gudapIDA gatirjihmA teShAM doShA yathAkramam||5||

''Netra'' which are

# ''hrashvam'' (too small),
# ''deergham'' (too long),
#''tanu'' (too thin),
#''sthoolam'' (too thick),
#''jeernam'' old and mutilated),
#''shithilabandhanam'' (having loosely tied/inappropriate fastening of ''basti putaka'' with ''netra'' ),
#''parshvachhidram'' (having hole – laterally on one side of ''netra'') and
#''vakram'' (having bents or curves) are to be avoided. If these sort of nozzles are used while ''basti'' procedure, it results in corresponding eight doshas. These ''doshas'' (harmful effects) in the body as tabulated below:

{| class="wikitable"
|-
! scope="col"| No.
! scope="col"| Defect in ''Netra''
! scope="col"| Resultant ''dosha'' if used in procedure
|-
| 1
| ''Hrasvam''
| ''Aprapti'' (medication not reaching the intended site)
|-
| 2
| ''Deergham''
| ''Atigati'' (medication overreaching/crossing the intended site)
|-
| 3
| ''Tanu''
| ''Kshobha'' (Medication reaches ''guda'' only and causes ''kshobha'' (discomfort by its movement there/hitting the anal walls due to its loose dimensions))
|-
| 4
| ''Sthoolam''
| ''Karshana'' (attrition due to oversize)
|-
| 5
| ''Jeernam''
| ''Kshanana''(inflicts wound)
|-
| 6
| ''Shithilabandhanam''
| ''Sravah'' (leakage of medication while administering)
|-
| 7
| ''Parshvachhidram''
| ''Gudapeedha'' (causing pain/discomfort to the ''guda'')
|-
| 8
| ''Vakram''
| ''Gatirjihma'' (medication travels transversely into the colon)
|}

[4-5]

==== ''Basti putaka'' (defects of bladder/enema holding bag) ====

विषममांसलच्छिन्नस्थूलजालिकवातलाः|

स्निग्धः क्लिन्नश्च तानष्टौ बस्तीन् कर्मसु वर्जयेत्||६||

गतिवैषम्यविस्रत्वस्रावदौर्ग्राह्यनिस्रवाः|

फेनिलच्युत्यधार्यत्वं बस्तेः स्युर्बस्तिदोषतः||७||

viṣamamāṁsalacchinnasthūlajālikavātalāḥ|

snigdhaḥ klinnaśca tānaṣṭau bastīn karmasu varjayēt||6||

gativaiṣamyavisratvasrāvadaurgrāhyanisravāḥ|

phēnilacyutyadhāryatvaṁ bastēḥ syurbastidōṣataḥ||7||

viShamamAMsalacchinnasthUlajAlikavAtalAH|

snigdhaH klinnashca tAnaShTau bastIn karmasu varjayet||6||

gativaiShamyavisratvasrAvadaurgrAhyanisravAH|

phenilacyutyadhAryatvaM basteH syurbastidoShataH||7||

''Basti'' which are

#''vishama'' (irregular/uneven structure),
#''mamsala'' (fleshy/bulky/pulpy),
#''Chhinna'' (perforated/cut through/torn),
#''Sthoola'' (thick/large),
#''Jalika'' (having many pores),
#''Vatala'' (containing air),
#''Snigdha'' (viscous/oily/slippery/greasy) and
#''Klinna'' (putrefied/rotted) are to be avoided. They if used in the procedure cause ''dosha'' (harmful effects) in the body and are tabulated below in their respective order:

{| class="wikitable"
|-
! scope="col"| No.
! scope="col"| Defect in ''Basti''
! scope="col"| Resultant ''dosha'' if used in procedure
|-
| 1
| ''Visama''
| ''Gativaisamya'' (difficult passage of medication)
|-
| 2
| ''Mamsala''
| ''Visratva'' (mustiness) of ''basti''
|-
| 3
| ''Chhinna''
| ''Sraava'' (abrupt leakage of medication)
|-
| 4
| ''Sthoolam''
| ''Daurgrahya'' (difficult to hold/grip while administration)
|-
| 5
| ''Jaalika''
| ''Nisrava''(flowing out of medication)
|-
| 6
| ''Vaatala''
| ''Phenilatva'' (frothiness of medication)
|-
| 7
| ''Snigdha''
| ''Chyuti'' (slippery while administration)
|-
| 8
| ''Klinna''
| ''Adhaaryatva'' (not effective for administration)
|}
[6-7]

==== Errors by ''basti'' administrator ====

सवातातिद्रुतोत्क्षिप्ततिर्यगुल्लुप्तकम्पिताः|

अतिबाह्यगमन्दातिवेगदोषाः प्रणेतृतः||८||

savātātidrutōtkṣiptatiryagulluptakampitāḥ|

atibāhyagamandātivēgadōṣāḥ praṇētr̥taḥ||8||

savAtAtidrutotkShiptatiryagulluptakampitAH|

atibAhyagamandAtivegadoShAH praNetRutaH||8||

Defects related to ''pranetru'' (administrator or attendant who applies procedure) are ''savata'' (''basti'' filled with air), ''atidruta'' (very fast), ''utkshipta'' (raised/upwards), ''tiryak'' (oblique/sideways/transverse), ''ullupta'' (taken out), ''kampita'' (trembling/shaking), ''ati'' (excess/too far), ''bahyaga'' (outside/diverging from), ''mandavega'' (slow) and ''ativega'' (speedy) administration of ''basti'' and they cause harm to the body. [8]

==== Effect of ''savata dosha'' ====

अनुच्छ्वास्य च बद्धे वा दत्ते निःशेष एव वा|

प्रविश्य कुपितो वायुः शूलतोदकरो भवेत्||९||

तत्राभ्यङ्गो गुदे स्वेदो वातघ्नान्यशनानि च|१०|

anucchvāsya ca baddhē vā dattē niḥśēṣa ēva vā|

praviśya kupitō vāyuḥ śūlatōdakarō bhavēt||9||

tatrābhyaṅgō gudē svēdō vātaghnānyaśanāni ca|10|

anucchvAsya ca baddhe vA datte niHsheSha eva vA|

pravishya kupito vAyuH shUlatodakaro bhavet||9||

tatrAbhya~ggo gude svedo vAtaghnAnyashanAni ca|10|

Administration of medication from an improperly filled and/or tied ''basti'' and complete emptying of ''basti'' will cause entry of air into the rectum. ''Vata dosha'' gets vitiated inducing ''shoola'' (sharp, acute pain) and ''toda'' (pricking pain). ''Abhyanga'' (inunction), ''sveda'' (fomentation) to ''guda'' and consumption of diet comprising of ''vata dosha'' pacifying items are to be done as management.[9-10]

==== ''Atidruta'' and ''utkshipta dosha'' ====

द्रुतं प्रणीते निष्कृष्टे सहसोत्क्षिप्त एव वा||१०||

स्यात् कटीगुदजङ्घार्तिबस्तिस्तम्भोरुवेदनाः |

भोजनं तत्र वातघ्नं स्नेहाः स्वेदाः सबस्तयः||११||

drutaṁ praṇītē niṣkr̥ṣṭē sahasōtkṣipta ēva vā||10||

syāt kaṭīgudajaṅghārtibastistambhōruvēdanāḥ |

bhōjanaṁ tatra vātaghnaṁ snēhāḥ svēdāḥ sabastayaḥ||11||

drutaM praNIte niShkRuShTe sahasotkShipta eva vA||10||

syAt kaTIgudaja~gghArtibastistambhoruvedanAH |

bhojanaM tatra vAtaghnaM snehAH svedAH sabastayaH||11||

In case of very fast introduction and withdrawal of ''netra'' and introduction of ''netra'' in upward direction, ''arti'' (pain) occurs in waist, rectum and calf along with thighs. Consumption of diet comprising of ''vata dosha'' pacifying items, unction, fomentation and ''basti'' are to be advised as management.[10-11]

==== ''Tiryakdosha'' ====

तिर्यग्वल्यावृतद्वारे बद्धे वाऽपि न गच्छति|

नेत्रे तदृजु निष्कृष्य संशोध्य च प्रवेशयेत्||१२||

tiryagvalyāvr̥tadvārē baddhē vā'pi na gacchati|

nētrē tadr̥ju niṣkr̥ṣya saṁśōdhya ca pravēśayēt||12||

tiryagvalyAvRutadvAre baddhe vA~api na gacchati|

netre tadRuju niShkRuShya saMshodhya ca praveshayet||12||

This occurs due to:

#introduction of ''netra'' in improper direction where, the aperture gets obstructed by ''gudavali'' and
#some material like thread knot occluding the aperture from inside. Here, the ''netra'' should be withdrawn, either re-introduced in proper direction or obstruction removed and re-introduced.[12]

==== ''Ullupta'' and ''kampita dosha'' ====

पीड्यमानेऽन्तरा मुक्ते गुदे प्रतिहतोऽनिलः|

उरःशिरोर्तिमूर्वोश्च सदनं जनयेद्बली||१३||

बस्तिः स्यात्तत्र बिल्वादिफलश्यामादिमूत्रवान्|

स्याद्दाहो दवथुः शोफः कम्पनाभिहते गुदे||१४||

कषायमधुराः शीताः सेकास्तत्र सबस्तयः|१५|

pīḍyamānē'ntarā muktē gudē pratihatō'nilaḥ|

uraḥśirōrtimūrvōśca sadanaṁ janayēdbalī||13||

bastiḥ syāttatra bilvādiphalaśyāmādimūtravān|

syāddāhō davathuḥ śōphaḥ kampanābhihatē gudē||14||

kaṣāyamadhurāḥ śītāḥ sēkāstatra sabastayaḥ|15|

pIDyamAne~antarA mukte gude pratihato~anilaH|

uraHshirortimUrvoshca sadanaM janayedbalI||13||

bastiH syAttatra bilvAdiphalashyAmAdimUtravAn|

syAddAho davathuH shophaH kampanAbhihate gude||14||

kaShAyamadhurAH shItAH sekAstatra sabastayaH|15|

If the squeezing of ''basti'' is interrupted in between (and re-done), that will cause obstruction to ''vata dosha'' and in turn vitiates it resulting in pain in chest and head along with weakness of thighs. Management should be done by administering ''basti'' comprising of ''dashamoola, shyama'' and ''gomutra''.

In case of trembling of hands while introduction of ''netra'', burning sensation, ''davathuḥ'' (pain heat/inflammation) and swelling occur in ''guda''. ''Seka'' (pouring) and ''basti'' has to be dome with medicines having astringent and sweet taste and in cold state. [13-15]

==== ''Ati dosha'' ====

अतिमात्रप्रणीतेन नेत्रेण क्षणनाद्वलेः||१५||

स्यात् सार्तिदाहनिस्तोदगुदवर्चःप्रवर्तनम्|

तत्र सर्पिः पिचुः क्षीरं पिच्छाबस्तिश्च शस्यते||१६||

atimātrapraṇītēna nētrēṇa kṣaṇanādvalēḥ||15||

syāt sārti dāhanistōdagudavarcaḥpravartanam|

tatra sarpiḥ picuḥ kṣīraṁ picchābastiśca śasyatē||16||

atimAtrapraNItena netreNa kShaNanAdvaleH||15||

syAt sArti dAhanistodagudavarcaHpravartanam|

tatra sarpiH picuH kShIraM picchAbastishca shasyate||16||

Extensive introduction of ''netra'' into ''guda'' inflicts injury to ''gudavali'' and results in pain, burning sensation, pricking pain, prolapse of ''guda'' and abrupt / unexpected defecation. ''Picu'' with cow’s ghee and milk and ''picchabasti'' are to be done here.[15-16]

==== ''Manda vega'' and ''ativega dosha'' ====

न भावयति मन्दस्तु बाह्यस्त्वाशु निवर्तते|

स्नेहस्तत्र पुनः सम्यक् प्रणेयः सिद्धिमिच्छता||१७||

अतिप्रपीडितः कोष्ठे तिष्ठत्यायाति वा गलम्|

तत्र बस्तिर्विरेकश्च गलपीडादि कर्म च||१८||

na bhāvayati mandastu bāhyastvāśu nivartatē|

snēhastatra punaḥ samyak praṇēyaḥ siddhimicchatā||17||

atiprapīḍitaḥ kōṣṭhē tiṣṭhatyāyāti vā galam|

tatra bastirvirēkaśca galapīḍādi karma ca||18||

na bhAvayati mandastu bAhyastvAshu nivartate|

snehastatra punaH samyak praNeyaH siddhimicchatA||17||

atiprapIDitaH koShThe tiShThatyAyAti vA galam|

tatra bastirvirekashca galapIDAdi karma ca||18||

In case of first one (slow administration), medicine doesn’t reach ''pakvashaya'' and is ineffective. Administration diverging from ''guda'' (second one), medicine is expelled out faster. In both cases, the ''snehabasti'' has to be done.

In case of speedy administration, either medicine stays in ''koshtha'' or ascends up to ''gala'' (throat). There, ''basti'', ''vireka'' (purgation) and tight gripping of neck are to be done. [17-18]

==== Summary ====

तत्र श्लोकः-

नेत्रबस्तिप्रणेतॄणां दोषानेतान् सभेषजान्|

वेत्ति यस्तेन मतिमान् बस्तिकर्माणि कारयेत्||१९||

tatra ślōkaḥ-

nētrabastipraṇētr̥̄ṇāṁ dōṣānētān sabhēṣajān|

vētti yastēna matimān bastikarmāṇi kārayēt||19||

tatra shlokaH-

netrabastipraNetRUNAM doShAnetAn sabheShajAn|

vetti yastena matimAn bastikarmANi kArayet||19||

An intelligent physician who learns the ''dosha'' of ''netra, basti'' and ''praneta'' properly along with management shall practice ''basti''. [19]

=== ''Tattva Vimarsha'' ===

*The ''basti netra'' (nozzle), ''basti putaka'' (bladder/enema pot) should be non-defective to avoid complications of ''basti'' therapy.
*''Basti'' therapy should be administered with utmost care by well trained, skilled and experienced ''praneta'' (administrator). If this is not followed, complications can occur in ''basti'' therapy.

=== ''Vidhi Vimarsha'' ===

The knowledge on apt instruments to be used in respective procedure is vital in ensuring the procedure effect. In the case of ''basti'' (procedure), the knowledge on properly designed ''netra'' and ''basti'' is essential for physicians. Also, Inappropriate appliance of ''netra'' in the procedure leads to ''vyapat'' and needs to be managed by the physician. Hence, this aspect is being dealt further in the chapter.

Research works have proved the importance of instruments and technique of administration which influences the total procedure and thereby its effect on the body. Usage of proper ''netra'' and ''basti'' in the procedure had influenced the time taken for administration by the maintenance of uniform pressure and gradual squeezing of the content during administration of ''niruha'' (decoction type of enema)<ref>Gundeti MS, Raut AA, Kamat NM. Basti: Does the equipment and method of administration matter?. J Ayurveda Integr Med 2013;4:9-12</ref>. Also, it influenced the extent of reach of medication in the colon and its quantity. Usage of animal bladder for preparation of ''bastiputaka'' (bag or vessel) was possible and justified in earlier days, however, is not feasible and practical today. As an alternative, a plastic bag of 50 microns thickness and having 1.5 l capacity has been reported recently and is disposed of after single use.<ref>Nampoothiri MR, Mahadevan L. Principles and Practice of Vasti. 1st ed. Derisanamcope: Y. Mahadeva Iyer’s Sri Sarada Ayurvedic Hospital; 2007. p. 49</ref>

==== Defects of ''basti'' nozzle ====

Defect in ''netra'' are eight in number and each of them affects the proper administration of ''basti'' procedure. Recommendable ''netra'' according to Charak, should have the following attributes: apertures(at the tip, i.e outlet aperture and at the base (inlet aperture) of the ''netra'') equal to little and thumb in circumference (यथावयोऽङ्गुष्ठकनिष्ठिकाभ्यां मूलाग्रयोः स्युः परिणाहवन्ति), straight (ऋजूनि), alike tail of a cow in shape (गोपुच्छसमाकृतीनि), smooth (श्लक्ष्णानि), curved in tip/round or circular (र्गुडिकामुखानि) and two round protuberances – one at the distal ¼ and other at the proximal end (कर्णिकैकाऽग्रचतुर्थभागे मूलाश्रिते बस्तिनिबन्धने द्वे). (Ca.Si-3/3)

Chakrapani has made it clear that ''aprapti'' and ''atigati'' of the ''dravya'' happens. He has interpreted ''tanu'' as ''krisha'' (thin, emaciated) having equivalent meaning. He also adds that this limits the reach of medication to ''guda'' alone and causes discomfort locally. ''Jeernam'' has been interpreted by him as ''karkasha'' (meaning rough), thereby the term ''jeernam'' implying two characters – disintegrated and/or rough.

On a critical view, one may note that two kinds of harmful effect of defective ''netra'' are grouped here –
#before administration such as leakage of medication in ''shithilabandhanam'' and
#after the administration such as transverse travel of medication in the colon ''vakram''. Majority of them fall in the second category.

The ''dosha'' resulting from ''sthoolam'' is mentioned as ''karshana'' meaning emaciation which lacks clarity. The ''vyapat'' of ''atisthoola'' is considered along with those caused by ''karkasha, asrimat'' (''netra'' having edges/having hole) and ''avanata'' (downwards) by Sushruta and explained as causing ''gharshana'' (friction/rubbing), ''gudakshata'' (injury to ''guda'') and ''ruk'' (pain)<ref>Suśruta, Suśrutasamhita Cikitsāsthāna chapter 36. Varanasi: Krishnadas Academy; 1980. p. 513. (Krishnadas Ayurveda series 51) </ref>

This explanation of Sushruta seems to be more apt to the context. Also, the number of ''netra dosha'' varies in Sushruta and eleven are considered there viz. ''atisthoola, avanata, karkasha, anubhinnam, sannikrushtakarnika'' (round protuberance designed close to the outlet aperture), ''viprakrushtakarnika'' (round protuberance designed far from outlet aperture), ''sookshmachidra'' (subtle aperture), ''atichhidra'' (wider aperture), ''atideergha, atihrasva'' and ''asrimat''<ref>Suśruta, Suśrutasamhita Cikitsāsthāna chapter 35. Varanasi: Krishnadas Academy; 1980. p. 515. (Krishnadas Ayurveda series 51)</ref> (Verse 4- 5)

==== Defects of ''basti putaka'' (enema pot) ====

Defective ''basti putaka'' are eight in number and each of them affects the proper appliance in the procedure. When ''basti'' was used in olden times, a ''basti'' devoid of veins was selected from a dead animal (natural death/healthy and butchered) and it was processed prior by soaking in ''kashaya'', (decoctions) gently rubbed and dried (दृढस्तनुर्नष्टसिरो विगन्धः कषायरक्तः सुमृदुः सुशुद्धः)<ref>Agnivēśa, Carakasamitha Sidhisthāna chapter 3</ref>

''Chakrapani'' has commented upon the terms ''vishama, sthoola, jalika, vatala, snigdha'' and ''klinna'' among defective ''basti''. He has also elaborated on ''visratva, daurgrahya, chyuti'' and ''adharyatva''. As discussed earlier, practicality and feasibility issues and stringent laws in procuring animal parts have led to the replacement of ''basti'' (''putaka'') with plastic bags.

Sushruta has limited the number to five viz. ''praasteerna'' [prāstIrNa; प्रास्तीर्ण (extended/flat/having network of veins)], ''bahala'' [bahala; बहल (thick/bushy/dense)], ''durbaddha'' [durbaddha; दुर्बद्ध (badly fastened)], ''sacchidra'' [sacchidra; सछिद्र (along with holes)] and ''alpa'' [alpa; अल्प (tiny)]<ref>Suśruta, Suśrutasamhitha Cikitsāsthāna chapter 36. Varanasi: Krishnadas Academy; 1980. p. 513. (Krishnadas Ayurveda series 51)</ref>

''Praasteerna'' causes leakage of medication and ''alpa'' in less effective due to less amount of medication getting administered<ref>Suśruta, Suśrutasamhitha Cikitsāsthāna chapter 35. Varanasi: Krishnadas Academy; 1980. p. 515. (Krishnadas Ayurveda series 51)</ref> (Verse 6-7)

==== Errors during administration and management of complications ====

The probable errors committed by the person who administers ''basti'' are 10 in number. Charak in 3rd chapter of ''siddhi'' has laid down the standard operative procedure of administration as follows:

''Guda'' (and the distal ¼ of the ''netra'') should be anointed first (स्निग्धे गुदे नेत्रचतुर्थभागं स्निग्धं) and slowly the ''netra'' should be introduced in the direction of spine (शनैरृज्वनपृष्ठवंशम्), without any trembling, tremor etc., with skilled hands (अकम्पनावेपनलाघवादीन् पाण्योर्गुणांश्चापि विदर्शयंस्तम्) and the medication should be emptied in a single squeeze from ''basti'' (प्रपीड्य चैकग्रहणेन दत्तं) and slowly ''netra'' can be withdrawn (नेत्रं शनैरेव ततोऽपकर्षेत्). (Ca.Si.3/19, 20)

Chakrapani categorizes these as ''pranayana, badha'' and ''peedana''. ''Savata'' is a defect committed during ''badha'' (filling and tying of ''basti'') and ''peedana'' (squeezing of ''basti''). ''Atidruta, utkshipta, tiryak, kampita, ati,'' and ''bahyaga'' are considered as defects committed during ''pranayana'' (introduction of ''netra'' into the anus). ''Ullupta, mandavega'' and ''ativega'' are committed while ''peedana''.

Sushruta has explained ''pranidhanadosha'' and ''peedana dosha'' separately and are six and four in number respectively<ref>Suśruta, Suśrutasamhitha Cikitsāsthāna chapter 35. Varanasi: Krishnadas Academy; 1980. p. 515. (Krishnadas Ayurveda series 51).</ref>. ''Peedanakala'' was not specified by Charak and Vagbhata have mentioned its significance in the procedure. Direct reference to peedanakala by Sushruta lacks clarity, even though Dalhana gives commentary on ''peedanakala'' as thirty ''matra'' for a person with ''mridu'' (delicate/tender) ''koshtha'' कोष्ठ (bowels)<ref>Suśruta, Suśrutasamhitha Cikitsāsthāna chapter 38. Varanasi: Krishnadas Academy; 1980. p. 534. (Krishnadas Ayurveda series 51)</ref>

Practically, it is seen that conducting a per rectal examination prior to the introduction of ''netra'' provides not only valuable information on the condition of rectum but also de-sensitizes<ref>Manojkumar A K, Jigeesh P P, Binitha A, Subin V R. Kaśhāyavasti. In, Manojkumar A K (ed). Standard Operative Procedure of Pancakarma, 1st edition. Kottakkal, Regional Offset, 2013.</ref> the rectum thereby ensuring smooth conduct of the procedure. It is observed that chances of most defects in introduction are done away with the adoption of this maneuver in practice. Also, during squeezing of ''basti'', if any resistance is felt, it is better to retract the ''netra'' and re-introduce it as chances are likely that the aperture of ''netra'' may be directed towards the wall of the anal canal. (Verse 8)

Chakrapani comments that even though wrong practices in administration were non-recommended earlier itself, details are being discussed further focusing their management. Sushruta has explained the entry of air into rectum as a resultant of repeated squeezing of ''basti'' and is manifested with abdominal distension and severe stomach ache. Suitable ''basti'' is advised as management. (Verse 9-10)

If any pain/discomfort is reported by the patient during the procedure, it is better to retract the ''netra'' and re-introduce it. (Verse 10-11)

Sushruta has expressed views consistent to that of Charak in this case. It is important to remember that as per the standard procedure of ''basti'', a ''varti'' (thread/pad) has to be placed in the aperture of ''netra'' after tying it to ''basti'', and then medication has to be poured to the ''basti''. So, there are chances that a piece of the thread/pad may remain inside the aperture and care has to be taken to check it before introduction into ''guda''. (Verse 12)

Even though the ''karnika'' near to the distal end of ''netra'' prevents extensive introduction of the ''netra'' into ''guda'', sometimes the force with which ''netra'' is introduced into ''guda'' inflicts injury. ''Picchabasti'', explained elsewhere arrests the prolapse and controls the inflammation of the local structures. Sushruta has advised all measures explained in ''sadyakshata'' (acute injury) as management. (Verse 16)

Chakrapani clarifies that the term ''bhavyati'' used here means its non-entry to ''pakvashaya''. He adds that in ''manda'' and ''ativega'', ''avarana'' of ''vata'' occurs and in ''ativega'', it is due to the absence of ''avarana'' that results medicine ascending up to throat. He further says that in case of retention of medicine ''basti'' or ''vireka'' is advisable and in case of medicine reaching the throat, ''galapeeda'' has to be done.

Sushruta has explained that in ''ativega'', the medicine may come out through nose, mouth etc. He has advised ''teekshananasya'' in addition to ''vireka, galapeeda'' and pouring of medicines in cold state. Also, Dalhana has commented on a maneuver mentioned as ''avadhoonana'' as holding the head by hairs and shaking it.

Retention of ''basti'' medicine inside the body is a serious complication and measures have to be adopted with an emergency management perspective. It is mandatory to monitor the retention time in ''basti'' and many a times it suggests the pharmacokinetics also. (Verse 17-18)

As discussed earlier, with the knowledge of ''siddhi'' one acquires not only routine practice but expertise in prevention, identification, rectification and management of complications related to the respective ''karma''.(Verse 19)

=== Glossary ===
#''Basti netra'' (बस्तिनेत्र) – Nozzle made of various metals designed for administering ''basti'' in anal route
#''Basti'' (बस्ति) – Enema / Also some time used to mention the bladder used for ''Bastikarma'' for filling the ingredients
#''Vapadah'' (व्यापदः) – Complications
#''Netra dosha'' (नेत्रदोषा) – Defects of enema nozzle
#''Basti doshah'' (बस्तिदोष) – Defects enema bladders
#''Pranetru doshah'' (प्रणेतृदोषाः) – Administration errors

=== References ===
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Grahani Chikitsa

2019-03-06T04:02:05Z

Pallavmishra:

{{Infobox
|title = Grahani Chikitsa
|label1 = Section/Chapter
|data1 = [[Chikitsa Sthana]] Chapter 15
|label2 = Preceding Chapter
|data2 = [[Arsha Chikitsa]]

|label3= Succeeding Chapter
|data3 = [[Pandu Chikitsa]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

==[[Chikitsa Sthana]] Chapter 15, Chapter on Management of Grahani (Digestive Disorders)==

=== Abstract ===

[[Grahani Chikitsa]] consists of three parts. The first part explains the concept of normal digestion process. The second part describes the abnormal digestion and third part is about diseases caused by abnormality of digestive fire and its interaction with proximal intestine or ''grahani''. These disorders are called ''grahanidosha''.

''Agni'' (digestive and metabolic agents), based on their specific functions of conversion of food into biological elements of the body are classified into thirteen types. First, the ''jatharagni'' is most important because it is the initiator of digestive process and it strengthens the digestive ability of other twelve ''agnis''. Five ''bhutagnis'' transform the ''panchmahabhauika'' components of ''ahara rasa'' created by ''jatharagni'' into different structures of the body. Seven ''dhatvagnis'' create seven tissues elements(''dhatu'').

''Jatharagni'' initiates the first phase of digestion process by conversion of food into nutrient fluid (''ahara rasa''). This nutrient fluid is further trifurcated into three biological substances ''kapha, pitta'' and ''vata'' in three stages to ''madhura, amla'' and ''katu awastha paka'' respectively. This biofluid is separated into excretable waste or impure products by ''samana vata'' in ''grahani'' (middle part of GI Tract) and useful, pure circulable products. ''Samana vata'' analyzes and separates the useful products (''prasada'') and waste (''kitta''). Useful products get absorbed by ''rasayani'' (villi) of the intestine, sent to the micro channels (''srotas'') by ''vyanvata'', simutaneouly, to the entire body. Waste products are excreted out by ''apana vayu'' through urine, feces and sweat.

Now second and third phase of digestion process occur simultaneously in the ''srotas'' (microchannels). Five ''bhutagnis'' work on the formation of anatomical structure of the body from respective ''panchamahabhuta'' in the form of micro channels, by digesting needful components present in biofluid. Each gross and subtle particle of body is ''panchabhautika'', but each one is having different proportion of ''mahabhuta''.

Now the third phase of digestion is processed in seven micro channels (''srotas'') specified for seven body tissues (''dhatu'') for the formation of body tissues by their specific seven tissue transformers (''dhatvagnis'') Excreable waste products are carried out by three excreatory channels as feces, urine and sweat, along with sub tissues and sub excreta of sensory organs.

Second part of this chapter explains the etiopathology of abnormal digestion, and formation of intermediate products as seed cause of various diseases in the form of ''ama, shukta'' and ''amavisha''.

Third part explicates the etiopathology, types, symptoms and treatments of ''grahanidosha'' as a syndrome of various digestive disorders. The chapter sums up in defining abnormal dietary habits.

'''Keywords''': Digestion in Ayurveda, metabolism in Ayurveda, ''jatharagni, bhutagni, dhatvagni, grahani, grahanidosha, grahani roga, annavisha, atyagni, samashana, viṣamaśana, adhyashana''.

=== Introduction ===

[[Grahani Chikitsa]] is one of the most important chapters of this compendium because most of the diseases originate from disorders of digestion. This chapter is described after ''arsha roga'' (hemorrhoids) because pathophysiology of ''arsha'' influences ''agni'' and before [[Panduroga Chikitsa]] because ''grahani roga'' influences ''panduroga''. The initial portion of this chapter discusses the details of the physiological process of digestion and metabolism in human body. ''Agni'', being the fundamental factor in maintaining health and in producing diseases, has been described in detail. The chapter begins with explanation of importance of normally functioning ''agni'' and then goes on to explain the various aspects of digestion, metabolism and tissue nourishment.

Different theories of tissue nourishment as explained by the commentators play a crucial role in the entire process. The concept of ''upadhatu'' and ''dhatumala'' has also been dealt with. These descriptions are followed by the pathophysiology of ''grahanidosha'' syndrome and its management. This chapter underscores that the knowledge of physiology is crucial in understanding the pathophysiology and therapeutics of a disease.

Protection of ''agni'' is very essential in treatment of all diseases.(Chakrapani Ca.Ci.14/244-246 )''Arsha, atisara'' and ''grahanidosha'' are said to be ''paraspara hetu'' which means one disease becomes cause for another disease(Ca.Ci.14/244) e.g. in patients with chronic colitis, intestinal polyps are seen, in patients suffering from diarrhea colitis is observed. Therefore, one finds interrelation between these disorders and as explained earlier, special precaution should be taken with respect to ''agni bala''.

Certain drugs like ''chitraka'' (Plumbago zeylanica), ''pippali'' (Piper longum), ''pippalimula'' (root of Piper longum), ''shunthi'' (Zingiber officinale), ''nagakesara, haridra, danti, duralabha, haritaki'' etc have been used in combinations with other drugs for the treatment of ''arsha'' considering the concept of ''agnibala vriddhi'' and ''vata anulomanam'' (facilitating passage of ''vata'') and the same drugs have been used in ''grahani chikitsa'' with the same concept. Charak explains that all the above three diseases are caused by ''agnimandya'' and if increase in ''agni'' is done then relief in the disease takes place. (Chakrapani Ca.Ci.14/244-246)

Further, ''vata'' is said to be ''agnisakha'' i.e. ''agnibala'' depends on ''vata''. ''Vatakshaya'' or ''prakopa'' results in ''agnimandya''. Therefore, ''anna, pana'' and ''ausadha'' which bring about ''vata anulomana'' are very useful in treatment of diseases like ''arsha'' and ''grahani dosha''.

''Vata anulomanam'' means to facilitate the ''gati'' (motion) of ''vata'' downwards to anus. Among five types of ''vata, samana'' and ''apana'' have major role in diseases like ''arsha, atisara'' and ''grahanidosha''. Obstruction to movement of ''vata'' (''avarudha gati'') or diarrhea (''atisaraṇa'') leads to ''agni kshaya''. ''Avarudha gati'' is the cause for ''vibandha'' (constipation), ''malavibandha'' (obstruction to feces) along with ''pravahana'' (urge to defecate) which increases the intra-lumen pressure leading to incompetency of valves in rectal veins leading to their varicosity which causes hemorrhoids where as ''atisarana'' (diarrhea) causes increased motility of intestine. Hence ''vata anulomanam'' should not be understood as ''virechana'' or laxation but regularization of ''vata gati'' so that there is no ''avarodha'' or ''atisarana''. The same concept of ''vata anulomana'' is also mentioned in [[Grahani Chikitsa]].(Ca.Ci.14/247)

Therefore, the line of treatment used in ''arsha'' with regard to ''agni bala'' and ''vata anulomanam'' is basically similar to that of ''grahanidosha'' hence Charak has explained [[Grahani Chikitsa]] after [[Arsha Chikitsa]].( Chakrapani Ca.Ci.15/1) Charak could have restricted the name of chapter to [[Grahani Chikitsa]] i.e. treatment of the ''avayava grahani'' whereas he has increased the scope of chapter by using the word ''grahanidosha''.(Chakrapani Ca.Ci.15/1).

There is always an inter-relationship between ''avayava'' (organ) and ''avayavi'' (part of organ) or ''ashraya''(seat) and ''ashrayi'' (seated). Either of the one has an impact on the other, hence if ''grahaniavayava'' is in normal state then ''agni'' the ''avayavi'' functions normally and vice versa also holds true, whereas if ''dusti'' of ''grahani'' takes place ''agni vaishamyata'' (imbalance) is seen e.g. ileitis, wherein digestion is hampered. ''Grahani'' is the seat for ''jatharagni''. (Ca.Ci.15 /56) ''Agni'' is responsible for ''ayu'' (longevity of life), ''varna'' (complexion), ''bala'' (strength), ''svasthya'' (health), ''utsaha'' (enthusiasm), ''upachaya'' (proper metabolism), ''prabha'' (glow) and ''oja'' (core energy). ''Prakrita agni'' (normal digestive power) is essential for long and healthy life while, vitiated ''agni'' is responsible for ''roga avastha''(disease).(Ca. Ci. 15/3-4)

In this chapter, Charak describes formation of body tissues in detail with the role of ''ahara'' which is supplied continuously to maintain homeostasis. ''Vyana vata'' is promoter of ''rasa raktadi'' circulation.( Ca. Ci. 15/36) It transports ''rasa raktadi drava'' ''dhatu'' throughout body continuously and as per metabolic demand. This explanation shows that closed circulation in human was known to Charak.

''Grahani'' is prime place where digestion and absorption of ''ahara rasa'' takes place. ''Ahara rasa'' provides nutrition for the ''rasadi sapta dhatu'', along-with three ''sharirika dosha'' and three ''manasika dosha''. Nourishment of ''sattva, raja'' and ''tama'' is influenced by ''sattvika, rajasika'' and ''tamasika ahara''. ''Tamasika'' and ''rajasika ahara'' suppresses ''sattva guna'' thereby causing ''alpa sattva'' in individual, a common predisposing factor of psychiatric disorders for e.g. ''alpa sattva'' as mentioned in ''unmada'' (Ca. Ci. 9/5)In ''vataja grahanivyadhishanka'' (feeling of suffering from disease) manifests in patients with ''alpa sattva''.

Homeostasis at cellular level and gross level is maintained by ''vata, pitta'' and ''kapha'' in which digestive and metabolic contributions are due to ''agni''. This chapter has been dedicated to ''agni'' to understand the manner in which it gets vitiated by ''dosha'' and accordingly the line of treatment for the ''agni dosha'' is explained. As the functions of ''agni'' take place in ''grahani'' hence disease related to ''grahani'' has been given the name.

Secondly, ''pandu roga'' is due to ''alpata'' of ''raktaposhaka sara bhaga'' (Chakrapani Ca. Ci. 16/3-7) and, one of the main causes of this ''alpata'' is mal-digestion and mal-absorption which takes place in ''grahani''. It is well known fact, that various contributory factors for blood formation have their absorption in gastrointestinal tract such as folic acid, vitamin B12, iron, etc which if not absorbed causes anemia this is the reason why Charak has placed this chapter in between ''arsha'' and ''pandu roga''.

===Sanskrit Text, Transliteration and English Translation===

अथातो ग्रहणीदोषचिकित्सितं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō Grahaṇī dōṣacikitsitaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto grahaNIdoShacikitsitaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall describe the chapter on the management of ''grahani dosha'', so said respectable Atreya [1-2]

==== Importance of ''dehagni'' ====

आयुर्वर्णो बलं स्वास्थ्यमुत्साहोपचयौ प्रभा|

ओजस्तेजोऽग्नयः प्राणाश्चोक्ता देहाग्निहेतुकाः||३||

āyurvarṇō balaṁ svāsthyamutsāhōpacayau prabhā|

ōjastējō'gnayaḥ prāṇāścōktā dēhāgnihētukāḥ||3||

AyurvarNo balaM svAsthyamutsAhopacayau prabhA|

ojastejo~agnayaH prANAshcoktA dehAgnihetukAH||3||

''Dehagni'' (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''ojas'', normal body temperature and various other forms of ''agni''. Even the existence of an individual is said to be because of ''dehagni'' [3]

शान्तेऽग्नौ म्रियते, युक्ते चिरं जीवत्यनामयः|

रोगी स्याद्विकृते, मूलमग्निस्तस्मान्निरुच्यते||४||

śāntē'gnau mriyatē, yuktē ciraṁ jīvatyanāmayaḥ|

rōgī syādvikr̥tē, mūlamAgnistasmānnirucyatē||4||

shAnte~agnau mriyate, yukte ciraM jIvatyanAmayaH|

rogI syAdvikRute, mUlamagnistasmAnnirucyate||4||

When the ''agni'' stops functioning, the individual dies; if the ''agni'' functions normally, the individual can lead a healthy and long life. Similarly, if the ''agni'' becomes abnormal, the individual suffers from various diseases; and hence, the ''agni'' is said to be the root cause of health and longevity [4]

यदन्नं देहधात्वोजोबलवर्णादिपोषकम्|

तत्राग्निर्हेतुराहारान्न ह्यपक्वाद्रसादयः||५||

yadannaṁ dēhadhātvōjōbalavarṇādipōṣakam|

tatrāgnirhēturāhārānna hyapakvādrasādayaḥ||5||

yadannaM dehadhAtvojobalavarNAdipoShakam|

tatrAgnirheturAhArAnna hyapakvAdrasAdayaH||5||

The food one consumes becomes capable of nourishing the body tissues and of promoting the ''ojas'' (vital essence), strength, complexion etc., only in the presence of normally functioning ''agni''. In the absence of normal digestion (and metabolism), the normal body tissues such as ''rasa'' cannot be formed nor nourished [5]

==== Process of digestion-first phase ====

अन्नमादानकर्मा तु प्राणः कोष्ठं प्रकर्षति|

तद्द्रवैर्भिन्नसङ्घातं स्नेहेन मृदुतां गतम्||६||

समानेनावधूतोऽग्निरुदर्यः पवनोद्वहः|

काले भुक्तं समं सम्यक् पचत्यायुर्विवृद्धये||७||

एवं रसमलायान्नमाशयस्थमधः स्थितः|

पचत्यग्निर्यथा स्थाल्यामोदनायाम्बुतण्डुलम्||८||

annamādānakarmā tu prāṇaḥ kōṣṭhaṁ prakarṣati|

taddravairbhinnasaṅghātaṁ snēhēna mr̥dutāṁ gatam||6||

samānēnāvadhūtō'gnirudaryaḥ [1] pavanōdvahaḥ|

kālē bhuktaṁ samaṁ samyak pacatyāyurvivr̥ddhayē||7||

ēvaṁ rasamalāyānnamāśayasthamadhaḥ sthitaḥ|

pacatyAgniryathā sthālyāmōdanāyāmbutaṇḍulam||8||

annamAdAnakarmA tu prANaH koShThaM prakarShati|

taddravairbhinnasa~gghAtaM snehena mRudutAM gatam||6||

samAnenAvadhUto~agnirudaryaH [1] pavanodvahaH|

kAle bhuktaM samaM samyak pacatyAyurvivRuddhaye||7||

evaM rasamalAyAnnamAshayasthamadhaH sthitaH|

pacatyagniryathA sthAlyAmodanAyAmbutaNDulam||8||

The ingested food is carried to ''koshtha'' by ''prana vata''. The food disintegrates because of the liquids, and further it becomes soft because of the fatty substances. The ''samana vata'', that has an inherent ability to intensify the ''agni,'' intensifies the digestive enzymes and properly digests the food that one consumes timely and in an appropriate quantity, thus leading to longevity. This process of digestion by ''agni'' in the gut which leads to the formation of ''rasa'' and ''mala'' is comparable to the process of cooking of the raw rice kept in an earthen vessel containing water on a fire [6-8]

==== Three states of digestion and provoking ''dosha'' ====

अन्नस्य भुक्तमात्रस्य षड्रसस्य प्रपाकतः|

मधुराद्यात् कफो भावात् फेनभूत [४] उदीर्यते||९||

परं तु पच्यमानस्य विदग्धस्याम्लभावतः|

आशयाच्च्यवमानस्य पित्तमच्छमुदीर्यते||१०||

पक्वाशयं तु प्राप्तस्य शोष्यमाणस्य वह्निना|

परिपिण्डितपक्वस्य वायुः स्यात् कटुभावतः||११||

annasya bhuktamātrasya ṣaḍrasasya prapākataḥ|

madhurādyāt kaphō bhāvāt phēnabhūta udīryatē||9||

paraṁ tu pacyamānasya vidagdhasyāmlabhāvataḥ|

āśayāccyavamānasya Pittamacchamudīryatē||10||

pakvāśayaṁ tu prāptasya śōṣyamāṇasya vahninā|

paripiṇḍitapakvasya Vātaḥ syāt kaṭubhāvataḥ||11||

annasya bhuktamAtrasya ShaDrasasya prapAkataH|

madhurAdyAt kapho bhAvAt phenabhUta [4] udIryate||9||

paraM tu pacyamAnasya vidagdhasyAmlabhAvataH|

AshayAccyavamAnasya pittamacchamudIryate||10||

pakvAshayaM tu prAptasya shoShyamANasya vahninA|

paripiNDitapakvasya vAyuH syAt kaTubhAvataH||11||

As soon as the food that has all the six tastes is consumed, it undergoes the first stage of digestion known as ''madhura'' (sweet) state during which ''kapha'' is produced which is like froth. Afterwards, while the food undergoing digestion is in its partially digested form, it attains ''amla'' (sour) state.

When the semi-digested food leaves the stomach, the release of liquid form of pitta known as ''accha-pitta'' occurs.

When the ''pakva'' part (the non-absorbable remnant part after the absorption of the nutrients), reaches the ''pakvashaya'' (the colon), the drying effect of ''agni'' converts it into a solid mass. There also occurs the release of ''vata'' which is ''katu'' (pungent) state [9-11]

==== Second phase of digestion by ''pancha-mahabhuta'' ====

अन्नमिष्टं ह्युपहितमिष्टैर्गन्धादिभिः पृथक्|

देहे प्रीणाति गन्धादीन् घ्राणादीनीन्द्रियाणि च||१२||

annamiṣṭaṁ hyupahitamiṣṭairgandhādibhiḥ pr̥thak|

dēhē prīṇāti gandhādīn ghrāṇādīnīndriyāṇi ca||12||

annamiShTaM hyupahitamiShTairgandhAdibhiH [1] pRuthak|

dehe prINAti gandhAdIn ghrANAdInIndriyANi [2] ca||12||

The food that possesses pleasant smell (taste, appearance, consistency,) etc., nourishes the similar entities in the body such as the sensory organs of smell by ''gandha'' etc (e.g. taste, vision, touch etc senses by respective ''mahabhuta'') [12]

भौमाप्याग्नेयवायव्याः पञ्चोष्माणः सनाभसाः|

पञ्चाहारगुणान्स्वान्स्वान्पार्थिवादीन्पचन्ति हि||१३||

bhaumāpyāgnēyavāyavyāḥ pañcōṣmāṇaḥ sanābhasāḥ|

pañcāhāraguṇānsvānsvānpārthivādīnpacanti hi||13||

bhaumApyAgneyavAyavyAH pa~jcoShmANaH sanAbhasAH|

pa~jcAhAraguNAnsvAnsvAnpArthivAdInpacanti hi||13||

There are five types of ''agni'' namely, ''bhauma, apya, agneya, vayavya'' and ''nabhasa''. These five ''bhutagni'' are one of each ''mahabhuta'' transform/metabolize those components of the food that are homologous to them in their composition of structure of human organism. (such as ''parthiva, apya'' etc) [13]

यथास्वं स्वं च पुष्णन्ति देहे द्रव्यगुणाः पृथक्|

पार्थिवाः पार्थिवानेव शेषाः शेषांश्च कृत्स्नशः||१४||

yathāsvaṁ svaṁ ca puṣṇanti dēhē dravyaguṇāḥ pr̥thak|

pārthivāḥ pārthivānēva śēṣāḥ śēṣāṁśca kr̥tsnaśaḥ||14||

yathAsvaM svaM ca puShNanti dehe dravyaguNAH pRuthak|

pArthivAH pArthivAneva sheShAH sheShAMshca kRutsnashaH||14||

Specific categories of entities in the body having specific attributes can be nourished by only those substances that belong to the same category having those same attributes. This means that ''parthiva'' entities in the body (one that is dominated by ''prithvi mahabhuta'' in its composition) can be nourished only by the ''parthiva'' substances in the food and so on. The same rule applies to the whole body [14]

==== Third phase of digestion and metabolism at level of ''dhatu'' ====

सप्तभिर्देहधातारो धातवो द्विविधं पुनः|

यथास्वमग्निभिः पाकं यान्ति किट्टप्रसादवत् ||१५||

saptabhirdēhadhātārō dhātavō dvividhaṁ punaḥ|

yathāsvamAgnibhiḥ pākaṁ yānti kiṭṭaprasādavat ||15||

saptabhirdehadhAtAro dhAtavo dvividhaM punaH|

yathAsvamagnibhiH pAkaM yAnti kiTTaprasAdavat [1] ||15||

Further, the seven components that sustain the body, known as ''dhatu'' (tissues), are metabolized/transformed into two kinds of products known as ''sara'' (nutrition) and ''kitta'' (waste). This process is the function of seven specific entities known as ''dhatvagni''; each ''dhatvagni'' is specific for its corresponding ''dhatu'' [15]

रसाद्रक्तं ततो मांसं मांसान्मेदस्ततोऽस्थि च|

अस्थ्नो मज्जा ततः शुक्रं शुक्राद्गर्भः प्रसादजः||१६||

rasādraktaṁ tatō māṁsaṁ māṁsānmēdastatō'sthi ca|

asthnō majjā tataḥ śukraṁ śukrādgarbhaḥ prasādajaḥ||16||

rasAdraktaM tato mAMsaM mAMsAnmedastato~asthi ca|

asthno majjA tataH shukraM shukrAdgarbhaH prasAdajaH||16||

''Rakta'' is produced after ''rasa'' and then ''mamsa''. After ''mamsa'' the ''medas'' is formed and then ''asthi'' is produced. After ''asthi'' the ''majja'' is derived and then ''shukra'' is produced and finally fine ''shukra'' leads to ''garbha'' [16]

==== ''Upadhatu'' (metabolic products) ====

रसात् स्तन्यं ततो रक्तमसृजः कण्डराः सिराः|

मांसाद्वसा त्वचः षट् च मेदसः स्नायुसम्भवः||१७||

rasāt stanyaṁ tatō raktamasr̥jaḥ kaṇḍarāḥ sirāḥ|

māṁsādvasā tvacaḥ ṣaṭ ca mēdasaḥ snāyusambhavaḥ ||17||

rasAt stanyaM tato [2] raktamasRujaH kaNDarAH sirAH|

mAMsAdvasA tvacaH ShaT ca medasaH snAyusambhavaH [3] ||17||

''Stanya'' (breast milk) and the menstrual blood are derived after rasa. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''rakta''. ''Vasa''(fat) and the six layers of ''tvacha'' (skin) are derived after ''mamsa'' (muscle) and ''snayu''(ligament) are derived after ''medas'' (adipose tissue) [17]

==== ''Mala'' formed at tissue level metabolism ====

किट्टमन्नस्य विण्मूत्रं, रसस्य तु कफोऽसृजः|

पित्तं, मांसस्य खमला, मलः स्वेदस्तु मेदसः||१८||

स्यात्किट्टं केशलोमास्थ्नो, मज्ज्ञः स्नेहोऽक्षिविट्त्वचाम्|

प्रसादकिट्टे धातूनां पाकादेवंविधर्च्छतः ||१९||

परस्परोपसंस्तब्धा धातुस्नेहपरम्परा |

kiṭṭamannasya viṇmūtraṁ, rasasya tu kaphō'sr̥jaḥ|

Pittaṁ, māṁsasya khamalā, malaḥ svēdastu mēdasaḥ||18||

syātkiṭṭaṁ kēśalōmāsthnō, majjñaḥ snēhō'kṣiviṭtvacām|

prasādakiṭṭē dhātūnāṁ pākādēvaṁvidharcchataḥ ||19||

parasparōpasaṁstabdhā dhātusnēhaparamparā |

kiTTamannasya viNmUtraM, rasasya tu kapho~asRujaH|

pittaM, mAMsasya khamalA, malaH svedastu medasaH||18||

syAtkiTTaM keshalomAsthno, majj~jaH sneho~akShiviTtvacAm|

prasAdakiTTe dhAtUnAM pAkAdevaMvidharcchataH [4] ||19||

parasparopasaMstabdhA dhAtusnehaparamparA [5] |

The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kitta'' of ''rasa'' is ''mala-kapha'' (excretions). ''Mala-pitta'' (bile pigment) is the ''kitta'' of ''rakta''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''mamsa''. ''Sweda'' (sweat) is the ''mala'' of ''medas''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''mala'' of ''asthi''. The ''mala'' of ''majja'' is the oily excretion of the eye and the skin (sebum). Thus, the ''dhatus'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''dhatu'' is thus inter dependent [18-19½]

==== Modes of transformation ====

वृष्यादीनां प्रभावस्तु पुष्णाति बलमाशु हि||२०||

vr̥ṣyādīnāṁ prabhāvastu puṣṇāti balamāśu hi||20||

vRuShyAdInAM prabhAvastu puShNAti balamAshu hi||20||

''Vrishya'' substance (the substance that promotes sexual vigor) nourishes the ''shukra'' immediately due to its specific influential effect (''prabhava'') [20]

षड्भिः केचिदहोरात्रैरिच्छन्ति परिवर्तनम्|

सन्तत्या भोज्यधातूनां परिवृत्तिस्तु चक्रवत्||२१||

ṣaḍbhiḥ kēcidahōrātrairicchanti parivartanam|

santatyā bhōjyadhātūnāṁ parivr̥ttistu cakravat||21||

ShaDbhiH kecidahorAtrairicchanti parivartanam|

santatyA bhojyadhAtUnAM parivRuttistu cakravat||21||

Some scholars believe that the conversion of ''rasa'' up to ''shukra'' occurs in a span of six days and six nights. This process of transformation of nourishing portion of the digested food is continuous similar to rotating wheel [21]

Note: Adulterated Verses:

Verses from 22 to 35 are available in the text in bracket and Chakrapani has also not offered the commentary on these verses, hence these verses are considered as adulterated.

(इत्युक्तवन्तमाचार्यं शिष्यस्त्विदमचोदयत्|

रसाद्रक्तं विसदृशात् कथं देहेऽभिजायते||२२||

रसस्य च न रागोऽस्ति स कथं याति रक्तताम्|

द्रवाद्रक्तात्स्थिरं मांसं कथं तज्जायते नृणाम्||२३||

द्रवधातोः स्थिरान्मांसान्मेदसः सम्भवः कथम्|

श्लक्ष्णाभ्यां मांसमेदोभ्यां खरत्वं कथमस्थिषु||२४||

खरेष्वस्थिषु मज्जा च केन स्निग्धो मृदुस्तथा|

मज्ज्ञश्च परिणामेन यदि शुक्रं प्रवर्तते||२५||

सर्वदेहगतं शुक्रं प्रवदन्ति मनीषिणः|

तथाऽस्थिमध्यमज्ज्ञश्च शुक्रं भवति देहिनाम्||२६||

छिद्रं न दृश्यतेऽस्थ्नां च तन्निःसरति वा कथम्|

(ityuktavantamācāryaṁ śiṣyastvidamacōdayat|

rasādraktaṁ visadr̥śāt kathaṁ dēhē'bhijāyatē||22||

rasasya ca na rāgō'sti sa kathaṁ yāti raktatām|

dravādraktātsthiraṁ māṁsaṁ kathaṁ tajjāyatē nr̥ṇām||23||

dravadhātōḥ sthirānmāṁsānmēdasaḥ sambhavaḥ katham|

ślakṣṇābhyāṁ māṁsamēdōbhyāṁ kharatvaṁ kathamasthiṣu||24||

kharēṣvasthiṣu majjā ca kēna snigdhō mr̥dustathā|

majjñaśca pariṇāmēna yadi śukraṁ pravartatē||25||

sarvadēhagataṁ śukraṁ pravadanti manīṣiṇaḥ|

tathā'sthimadhyamajjñaśca śukraṁ bhavati dēhinām||26||

chidraṁ na dr̥śyatē'sthnāṁ ca tanniḥsarati vā katham|

(ityuktavantamAcAryaM [6] shiShyastvidamacodayat|

rasAdraktaM visadRushAt [7] kathaM dehe~abhijAyate||22||

rasasya ca na rAgo~asti sa kathaM yAti raktatAm|

dravAdraktAtsthiraM mAMsaM kathaM tajjAyate nRuNAm||23||

dravadhAtoH [8] sthirAnmAMsAnmedasaH sambhavaH katham|

shlakShNAbhyAM mAMsamedobhyAM kharatvaM kathamasthiShu||24||

khareShvasthiShu majjA ca kena snigdho mRudustathA|

majj~jashca pariNAmena yadi shukraM pravartate||25||

sarvadehagataM shukraM pravadanti manIShiNaH|

(After listening to the above explanation by his teacher, the student asked the following doubt:

How is it that ''rakta'' is formed in the body out of ''rasa,'' though being different from it? ''Rasa'' is in fact colorless, and how does it attain the red color of ''rakta''? How is it that a solid structure such as ''mamsa'' is formed out of ''rakta'' which is a fluid by its nature? How is it that, again, from the ''mamsa'', which is solid, a fluid substance such as ''meda'' is formed?

How is it that a rough ''asthi'' is formed out of smooth structures such as ''mamsa'' and ''meda''? How does the soft and fatty ''majja'' form out of rough structures such as ''asthi''? If at all ''shukra'', which is present everywhere in the body is formed out of ''majja'' that is located inside the ''asthi'', how does it come out as one cannot see pores on ''asthi''? [22-26]

==== Formation of ''rasa'' and ''rakta'' ====

एवमुक्तस्तु शिष्येण गुरुः प्राहेदमुत्तरम्||२७||

तेजो रसानां सर्वेषां मनुजानां यदुच्यते|

पित्तोष्मणः स रागेण रसो रक्तत्वमृच्छति||२८||

ēvamuktastu śiṣyēṇa guruḥ prāhēdamuttaram||27||

tējō rasānāṁ sarvēṣāṁ manujānāṁ yaducyatē|

pittōṣmaṇaḥ sa rāgēṇa rasō raktatvamr̥cchati||28||

tathA~asthimadhyamajj~jashca shukraM bhavati dehinAm||26||

chidraM na dRushyate~asthnAM ca tanniHsarati vA katham|

evamuktastu shiShyeNa guruH prAhedamuttaram||27||

tejo rasAnAM sarveShAM manujAnAM yaducyate|

pittoShmaNaH sa rAgeNa raso raktatvamRucchati||28||

After listening to the query raised by the student, the teacher replied as follows:

The nourishment fluid formed, known as ''rasa'', undergoes transformation by the ''ushma'' (heat) of ''pitta'' and gets converted into the red colored tissue known as ''rakta'' [27-28]

==== Formation of ''mamsa dhatu'' ====

वाय्वम्बुतेजसा रक्तमूष्मणा चाभिसंयुतम्|

स्थिरतां प्राप्य मांसं स्यात् स्वोष्मणा पक्वमेव तत् ||२९||

vāyvambutējasā raktamūṣmaṇā cābhisaṁyutam|

sthiratāṁ prāpya māṁsaṁ syāt svōṣmaṇā pakvamēva tat ||29||

vAyvambutejasA raktamUShmaNA cAbhisaMyutam|

sthiratAM prApya mAMsaM syAt svoShmaNA pakvameva tat [9] ||29||

Due to the action of heat along with the ''vata, ambu'' (water) and ''tejas,'' the ''rakta'' is converted into stable ''mamsa,'' after being acted upon by its own ''agni'' (''mamsadhatvagni'') [29]

==== Formation of ''meda dhatu'' ====

स्वतेजोऽम्बुगुणस्निग्धोद्रिक्तं मेदोऽभिजायते|

svatējō'mbuguṇasnigdhōdriktaṁ mēdō'bhijāyatē|

svatejo~ambuguNasnigdhodriktaM medo~abhijAyate|

Because of the action of ''medo-dhatvagni'' on the excessively dominant ''snigdha'' attribute of aṃbu, the ''medo-dhatu'' is formed [29½]

==== Formation of ''asthi dhatu'' ====

पृथिव्यग्न्यनिलादीनां सङ्घातः स्वोष्मणा कृतः||३०||

खरत्वं प्रकरोत्यस्य जायतेऽस्थि ततो नृणाम्|

pr̥thivyagnyanilādīnāṁ saṅghātaḥ svōṣmaṇā kr̥taḥ||30||

kharatvaṁ prakarōtyasya jāyatē'sthi tatō nr̥ṇām|

pRuthivyagnyanilAdInAM sa~gghAtaH svoShmaNA [10] kRutaH||30||

kharatvaM prakarotyasya jAyate~asthi tato nRuNAm|

Because of the action of ''asthi dhātvagni'' on the aggregation of ''prithvi, agni'' and ''anila'', roughness is attained during the formation of the ''asthi'' [30]

==== Formation of ''majja dhatu'' ====

करोति तत्र सौषिर्यमस्थ्नां मध्ये समीरणः||३१||

मेदसस्तानि पूर्यन्ते स्नेहो मज्जा ततः स्मृतः|

karōti tatra sauṣiryamasthnāṁ madhyē samīraṇaḥ||31||

mēdasastāni pūryantē snēhō majjā tataḥ smr̥taḥ|

karoti tatra sauShiryamasthnAM madhye samIraNaH||31||

medasastAni pUryante sneho majjA tataH smRutaH|

''Vata'' produces hollowness inside the ''asthi dhatu'', and after which, these hollow cavities get filled up by fatty tissue which is known as ''majja'' [31]

==== Formation of ''shukra dhatu'' ====

तस्मान्मज्ज्ञस्तु यः स्नेहः शुक्रं सञ्जायते ततः||३२||

वाय्वाकाशादिभिर्भावैः सौषिर्यं जायतेऽस्थिषु|

तेन स्रवति तच्छुक्रं नवात् कुम्भादिवोदकम्||३३||

स्रोतोभिः स्यन्दते देहात् समन्ताच्छुक्रवाहिभिः |

हर्षेणोदीरितं वेगात् सङ्कल्पाच्च मनोभवात्||३४||

विलीनं घृतवद्व्यायामोष्मणा स्थानविच्युतम्|

बस्तौ सम्भृत्य निर्याति स्थलान्निम्नादिवोदकम्)||३५||

tasmānmajjñastu yaḥ snēhaḥ śukraṁ sañjāyatē tataḥ||32||

vāyvākāśādibhirbhāvaiḥ sauṣiryaṁ jāyatē'sthiṣu|

tēna sravati tacchukraṁ navāt kumbhādivōdakam||33||

srōtōbhiḥ syandatē dēhāt samantācchukravāhibhiḥ |

harṣēṇōdīritaṁ vēgāt saṅkalpācca manōbhavāt||34||

vilīnaṁ ghr̥tavadvyāyāmōṣmaṇā sthānavicyutam|

bastau sambhr̥tya niryāti sthalānnimnādivōdakam)||35||

tasmAnmajj~jastu yaH snehaH shukraM sa~jjAyate tataH||32||

vAyvAkAshAdibhirbhAvaiH sauShiryaM jAyate~asthiShu|

tena sravati tacchukraM navAt kumbhAdivodakam||33||

srotobhiH syandate dehAt samantAcchukravAhibhiH [11] |

harSheNodIritaM vegAt sa~gkalpAcca manobhavAt||34||

vilInaM ghRutavadvyAyAmoShmaNA sthAnavicyutam|

bastau sambhRutya niryAti sthalAnnimnAdivodakam)||35||

The ''sneha'' (fatty) portion of ''majja'' produces shukra. The porosity in the ''asthi'' is produced because of the factors such as ''vata'' and ''akasha.'' ''Shukra'' comes out of ''asthi'' through these pores just as the water comes out of a new earthen vessel. Through the channels known as ''shukravaha srotamsi'', this ''shukra'' spreads all over the body. This ''shukra'' is discharged through the urethra (which is connected to the urinary bladder) because of several factors such as sexual excitation, reflex activities (''vega''), and mental determination (''samkalpa''). Just as the ghee moves out with ease when heated, the ''shukra'' too, is discharged due to the heat liberated during the sexual activity. This process of seminal discharge is comparable with the movement of water from a place of lower altitude to a place of higher altitude) [32-35]

==== Continuous circulation of ''rasa'' all over the body ====

व्यानेन रसधातुर्हि विक्षेपोचितकर्मणा|

युगपत् सर्वतोऽजस्रं देहे विक्षिप्यते सदा||३६||

vyānēna rasadhāturhi vikṣēpōcitakarmaṇā|

yugapat sarvatō'jasraṁ dēhē vikṣipyatē sadā||36||

vyAnena rasadhAturhi vikShepocitakarmaNA|

yugapat sarvato~ajasraM dehe vikShipyate sadA||36||

Because of being forcefully propelled (out of the heart) by the action of ''vyana vata'', the ''rasa dhatu'' spreads all over the body simultaneously, continuously and for the entire life [36]

==== Significance of ''Kha-Vaigunya'' (abnormality in body system) in causing disease state ====

क्षिप्यमाणः खवैगुण्याद्रसः सज्जति यत्र सः|

करोति विकृतिं तत्र खे वर्षमिव तोयदः||३७||

kṣipyamāṇaḥ khavaiguṇyādrasaḥ sajjati yatra saḥ|

karōti vikr̥tiṁ tatra khē varṣamiva tōyadaḥ||37||

kShipyamANaH khavaiguNyAdrasaH sajjati yatra saH|

karoti [12] vikRutiM tatra khe varShamiva toyadaH||37||

Wherever the ''rasa'' experiences obstacle due to abnormality in ''srotas, rasa'' readily produces disease in that very same location. This process is comparable with that of the clouds producing rainfall in a localized region that is favorable for rainfall [37]

दोषाणामपि चैवं स्यादेकदेशप्रकोपणम् |

dōṣāṇāmapi caivaṁ syādēkadēśaprakōpaṇam |

doShANAmapi caivaM syAdekadeshaprakopaNam [13] |

This principle is applicable even in case of ''dosha'', where ''ekadesha prakopa'' (abnormal increase at a local site) occurs [37½]

इति भौतिकधात्वन्नपक्तॄणां कर्म भाषितम्||३८||

iti bhautikadhātvannapaktr̥̄ṇāṁ karma bhāṣitam||38||

iti bhautikadhAtvannapaktRUNAM karma bhAShitam||38||

Thus ends the description of the physiological functions of ''bhutagni, dhatvagni'' and ''jatharagni'' [38]

==== Significance of ''jatharagni'' ====

अन्नस्य पक्ता सर्वेषां पक्तॄणामधिपो मतः|

तन्मूलास्ते हि तद्वृद्धिक्षयवृद्धिक्षयात्मकाः||३९||

annasya paktā sarvēṣāṁ paktr̥̄ṇāmadhipō mataḥ|

tanmūlāstē hi tadvr̥ddhikṣayavr̥ddhikṣayātmakāḥ||39||

annasya paktA sarveShAM paktRUNAmadhipo mataH|

tanmUlAste hi tadvRuddhikShayavRuddhikShayAtmakAH||39||

''Jatharagni'' is known as the King among all the forms of ''agni''. The intensification and diminution of all other forms of ''agni'' is in fact dependent on ''jatharagni'' [39]

तस्मात्तं विधिवद्युक्तैरन्नपानेन्धनैर्हितैः|

पालयेत् प्रयतस्तस्य स्थितौ ह्ययुर्बलस्थितिः||४०||

tasmāttaṁ vidhivadyuktairannapānēndhanairhitaiḥ|

pālayēt prayatastasya sthitau hyayurbalasthitiḥ||40||

tasmAttaM vidhivadyuktairannapAnendhanairhitaiH|

pAlayet prayatastasya sthitau hyayurbalasthitiH||40||

An individual should take utmost care to maintain the ''agni'' by providing fuel in the form of food and drinks which should be taken as per the rules mentioned, because life and strength of an individual depends on ''agni'' [40]

==== Initiation of ''grahani dosha'' ====

यो हि भुङ्क्ते विधिं त्याक्त्वा ग्रहणीदोषजान् गदान्|

स लौल्याल्लभते शीघ्रं, वक्ष्यन्तेऽतः परं तु ते||४१||

yō hi bhuṅktē vidhiṁ tyāktvā Grahaṇī dōṣajān gadān|

sa laulyāllabhatē śīghraṁ, vakṣyantē'taḥ paraṁ tu tē||41||

yo hi bhu~gkte vidhiM tyAktvA grahaNIdoShajAn gadAn|

sa laulyAllabhate shIghraM, vakShyante~ataH paraM tu te||41||

If an individual indulges in food without following the rules and regulation of diet intake, then he quickly suffers from diseases caused by the vitiation of ''grahani'' because of his greedy habits. Such diseases are being described henceforth [41]

==== Causes of vitiation of ''agni'' ====

अभोजनादजीर्णातिभोजनाद्विषमाशनात्|

असात्म्यगुरुशीतातिरूक्षसन्दुष्टभोजनात्||४२||

विरेकवमनस्नेहविभ्रमाद्व्याधिकर्षणात्|

देशकालर्तुवैषम्याद्वेगानां च विधारणात्||४३||

दुष्यत्यग्निः, स दुष्टोऽन्नं न तत् पचति लघ्वपि|

अपच्यमानं शुक्तत्वं यात्यन्नं विषरूपताम् ||४४||

abhōjanādajīrṇātibhōjanādviṣamāśanāt|

asātmyaguruśītātirūkṣasanduṣṭabhōjanāt||42||

virēkavāmanasnēhavibhramādvyādhikarṣaṇāt|

dēśakālartuvaiṣamyādvēgānāṁ ca vidhāraṇāt||43||

duṣyatyāgniḥ, sa duṣṭō'nnaṁ na tat pacati laghvapi|

apacyamānaṁ śuktatvaṁ yātyannaṁ viṣarūpatām ||44||

abhojanAdajIrNAtibhojanAdviShamAshanAt|

asAtmyagurushItAtirUkShasanduShTabhojanAt||42||

virekavamanasnehavibhramAdvyAdhikarShaNAt|

deshakAlartuvaiShamyAdvegAnAM ca vidhAraNAt||43||

duShyatyagniH, sa duShTo~annaM na tat pacati laghvapi|

apacyamAnaM shuktatvaM yAtyannaM viSharUpatAm [14] ||44||

Excessive starvation, indulging in food intake although there is indigestion, overeating, irregular habit of eating, eating unwholesome food, indulging in food which is heavy to digest or having excessive nutritional value, food which is having cold qualities or eating chilled or frozen items, food which is dry in nature or food which brings about emaciation, contaminated food, perversion of procedures like ''vamana, virechana'' and ''sneha'', emaciation of body due to disease, sudden migration to unsuitable place and of time and of season, suppression of natural urges are causes for vitiation of ''agni''. Thus, vitiated ''agni'' is unable to digest even the light food. [42-43]

This vitiated digestive agent forms an intermediate substance called ''ama'', which turns sour (''shukta'') during fermentation and finaly turns in poisonous substance (''amavisha'') [44]

==== Signs and symptoms of ''ajirna''(indigestion) ====

तस्य लिङ्गमजीर्णस्य विष्टम्भः सदनं तथा|

शिरसो रुक् च मूर्च्छा च भ्रमः पृष्ठकटिग्रहः||४५||

जृम्भाऽङ्गमर्दस्तृष्णा च ज्वरश्छर्दिः प्रवाहणम्|

अरोचकोऽविपाकश्च, घोरमन्नविषं च तत्||४६||

tasya liṅgāmajīrṇasya viṣṭambhaḥ sadanaṁ tathā|

śirasō ruk ca mūrcchā ca bhrāmaḥ pr̥ṣṭhakaṭigrahaḥ||45||

jr̥mbhā'ṅgāmardastr̥ṣṇā ca jvaraśchardiḥ pravāhaṇam|

arōcakō'vipākaśca, ghōrāmannaviṣaṁ ca tat||46||

tasya li~ggamajIrNasya viShTambhaH sadanaM tathA|

shiraso ruk ca mUrcchA ca bhramaH pRuShThakaTigrahaH||45||

jRumbhA~a~ggamardastRuShNA ca jvarashchardiH pravAhaNam|

arocako~avipAkashca, ghoramannaviShaM ca tat||46||

This poisonous substance (''amavisha'') manifests clinical features like flatulence, uncomfortable physical and mental miseries, headache, altered consciousness, giddiness, stiffness of back and lumbar region, yawning, body-ache, malaise, morbid thirst, fever, vomiting, tenesmus, anorexia and indigestion and it is similar to antigenic poison. [45-46]

==== Associated disorders of ''annavisha'' ====

संसृज्यमानं पित्तेन दाहं तृष्णां मुखामयान्|

जनयत्यम्लपित्तं च पित्तजांश्चापरान् गदान्||४७||

यक्ष्मपीनसमेहादीन् कफजान् कफसङ्गतम्|

करोति वातसंसृष्टं वातजांश्च गदान् बहून्||४८||

मूत्ररोगांश्च मूत्रस्थं कुक्षिरोगान् शकृद्गतम्|

रसादिभिश्च संसृष्टं कुर्याद्रोगान् रसादिजान्||४९||

saṁsr̥jyamānaṁ pittēna dāhaṁ tr̥ṣṇāṁ mukhāmayān|

janayatyamlaPitta ṁ ca Pitta jāṁścāparān gadān||47||

yakṣmapīnasamēhādīn kaphajān kaphasaṅgatam|

karōti Vātasaṁsr̥ṣṭaṁ Vātajāṁśca gadān bahūn||48||

mūtrarōgāṁśca mūtrasthaṁ kukṣirōgān śakr̥dgatam|

rasādibhiśca saṁsr̥ṣṭaṁ kuryādrōgān rasādijān||49||

saMsRujyamAnaM [15] pittena dAhaM tRuShNAM mukhAmayAn|

janayatyamlapittaM ca pittajAMshcAparAn gadAn||47||

yakShmapInasamehAdIn kaphajAn kaphasa~ggatam|

karoti vAtasaMsRuShTaM vAtajAMshca [16] gadAn bahUn||48||

mUtrarogAMshca mUtrasthaM kukShirogAn shakRudgatam|

rasAdibhishca saMsRuShTaM kuryAdrogAn rasAdijAn||49||

The ''annavisha'' when associated with ''pitta'' causes ''daha'', morbid thirst, oral diseases, ''amlapitta'' (acid peptic disorders) and various other ''pitta'' related disorders.

The same ''annavisha'' when gets associated with ''kapha'' it leads to condition like ''yakshma'' (pthiasis), ''peenas'' (coryza) and ''prameha'' (20 types of diabetes) and various other ''kaphaja'' disorders, whereas several ''vatika'' disease are caused by association of ''vata'' with the ''annavisha''.

The ''annavisha'' when enters renal system, urine related disorders occur; similarly, ''kukshigata roga'' (ailments related to abdomen) have their origin when ''sakrita'' (feces) is involved. ''Rasadi pradoshaja vikara'' (tissue related ailments) occur when ''rasadi srotas'' are involved [47-49]

==== Effects of ''Vishamagni'' (irregular ''agni'')and ''tikshanagni''( excessive ''agni'') ====

विषमो धातुवैषम्यं करोति विषमं पचन्|

तीक्ष्णो मन्देन्धनो धातून् विशोषयति पावकः||५०||

viṣamō dhātuvaiṣamyaṁ karōti viṣāmaṁ pacan|

tīkṣṇō mandēndhanō dhātūn viśōṣayati pāvakaḥ||50||

viShamo dhAtuvaiShamyaM karoti viShamaM pacan|

tIkShNo mandendhano dhAtUn vishoShayati pAvakaH||50||

The ''vishamagni'' (improper ''agni'') causes irregularity in digestion and therefore defective formation of ''dhatu'' takes place whereas, ''tikshanagni'' (excessive ''agni'') when associated with little quantity of fuel (in the form of food) causes depletion of ''dhatu'' (tissue elements) [50]

==== ''Samagni'' ====

युक्तं भुक्तवतो युक्तो धातुसाम्यं समं पचन्|

yuktaṁ bhuktavatō yuktō dhātusāmyaṁ sāmaṁ pacan|

yuktaM bhuktavato yukto dhAtusAmyaM samaM pacan|

If ''agni'' is ''sama'' i.e. in balanced condition and correct diet regimen (as explained in Ca. Su. 5 and Ca.Vi.1/21) are also followed then there is proper digestion of food which helps in maintaining proper balance within the ''dhatu'' [50½]

==== ''Durbala'' (weak) ''agni'' ====

दुर्बलो विदहत्यन्नं तद्यात्यूर्ध्वमधोऽपि वा||५१||

durbalō vidahatyannaṁ tadyātyūrdhvāmadhō'pi vā||51||

durbalo vidahatyannaM tadyAtyUrdhvamadho~api vA||51||

''Durbala'' (weak) ''agni'' brings about partial digestion of food. These partially digested bio substances then enter in circulation, which may move either in upward or downward direction [51]

==== ''Grahani gada''(diseases of ''grahani'') ====

अधस्तु पक्वमामं वा प्रवृत्तं ग्रहणीगदः|

उच्यते सर्वमेवान्नं प्रायो ह्यस्य विदह्यते||५२||

अतिसृष्टं विबद्धं वा द्रवं तदुपदिश्यते|

तृष्णारोचकवैरस्यप्रसेकतमकान्वितः||५३||

शूनपादकरः सास्थिपर्वरुक् छर्दनं ज्वरः|

लोहामगन्धिस्तिक्ताम्ल [१७] उद्गारश्चास्य जायते||५४||

adhastu pakvamāmaṁ vā pravr̥ttaṁ Grahaṇī gadaḥ|

ucyatē sarvamēvānnaṁ prāyō hyasya vidahyatē||52||

atisr̥ṣṭaṁ vibaddhaṁ vā dravaṁ tadupadiśyatē|

tr̥ṣṇārōcakavairasyaprasēkatāmakānvitaḥ||53||

śūnapādakaraḥ sāsthiparvaruk chardanaṁ jvaraḥ|

lōhāmagandhistiktāmla [17] udgāraścāsya jāyatē||54||

adhastu pakvamAmaM vA pravRuttaM grahaNIgadaH|

ucyate sarvamevAnnaM prAyo hyasya vidahyate||52||

atisRuShTaM vibaddhaM vA dravaM tadupadishyate|

tRuShNArocakavairasyaprasekatamakAnvitaH||53||

shUnapAdakaraH sAsthiparvaruk chardanaM jvaraH|

lohAmagandhistiktAmla [17] udgArashcAsya jAyate||54||

When partially digested and partially undigested bio substances moves downward in gastrointestinal tract it produces a disorder known as ''grahanigada''. In this particular stage the entire food material remains in the state of ''vidagdha'' state (partially transformed/sour).

In this condition the individual may pass stools in excessive quantity or frequency wherein stools may be loose, with thin consistency or in the form of pellet like stool/bound stool (''vibaddham'') and morbid thirst, anorexia, distaste, excessive watering of mouth, blackout, edema of legs and hands, pain in bones and finger joints, vomiting, fever, eructation having either metallic smell or undigested food and having bitter or sour taste are observed [52-54]

==== Premonitory symptoms of ''Grahani gada'' ====

पूर्वरूपं तु तस्येदं तृष्णाऽऽलस्यं बलक्षयः|

विदाहोऽन्नस्य पाकश्च चिरात् कायस्य गौरवम्||५५||

pūrvarūpaṁ tu tasyēdaṁ tr̥ṣṇā''lasyaṁ balakṣayaḥ|

vidāhō'nnasya pākaśca cirāt kāyasya gauravam||55||

pUrvarUpaM tu tasyedaM tRuShNA~a~alasyaM balakShayaH|

vidAho~annasya pAkashca cirAt kAyasya gauravam||55||

Premonitory signs and symptoms are thirst, malaise, diminution of strength, burning sensation; delay in digestion and heaviness in body [55]

==== Functions of ''grahani'' ====

अग्न्यधिष्ठानमन्नस्य ग्रहणाद्ग्रहणी मता|

नाभेरुपर्यह्यग्निबलेनोपष्टब्धोपबृंहिता [१८] ||५६||

अपक्वं धारत्यन्नं पक्वं सृजति पार्श्वतः|

दुर्बलाग्निबला दुष्टा [१९] त्वाममेव विमुञ्चति||५७||

agnyadhiṣṭhānāmannasya grahaṇādGrahaṇī matā|

nābhēruparyahyAgnibalēnōpaṣṭabdhōpabr̥ṁhitā [18] ||56||

apakvaṁ dhāratyannaṁ pakvaṁ sr̥jati pārśvataḥ|

durbalāgnibalā duṣṭā [19] tvāmamēva vimuñcati||57||

agnyadhiShThAnamannasya grahaNAdgrahaNI matA|

nAbheruparyahyagnibalenopaShTabdhopabRuMhitA [18] ||56||

apakvaM dhAratyannaM pakvaM sRujati pArshvataH|

durbalAgnibalA duShTA [19] tvAmameva vimu~jcati||57||

''Grahani'' is seat of ''agni'' and it is so called since it holds/retains the food (for proper digestion and assimilation). It holds the food just above the umbilical region and it is supported and nourished by the ''agni''. ''Grahani'' with help of ''agni'' holds the undigested food and pushes forward digested food, but when ''agni'' becomes weak and vitiated due to ''vidagdha ahara murchita dosha'' (afflicted by improperly digested food) i.e ''sama dosha''(''dosha'' associated with ''ama'') it vitiates the ''grahani'' and releases food in the form of ''ama'' i.e. undigested form [56-57]

==== Four types of ''grahani'' disease ====

वातात् पित्तात् कफाच्च स्यात्तद्रोगस्त्रिभ्य एव च|

हेतुं लिङ्गं रूपभेदाञ् शृणु तस्य पृथक् पृथक्||५८||

vātāt pittāt kaphācca syāttadrōgastribhya ēva ca|

hētuṁ liṅgaṁ rūpabhēdāñ śr̥ṇu tasya pr̥thak pr̥thak||58||

vAtAt pittAt kaphAcca syAttadrogastribhya eva ca|

hetuM li~ggaM rUpabhedA~j [21] shRuNu tasya pRuthak pRuthak||58||

''Grahani'' is classified into four types viz ''vataja, pittaja, kaphaja'' and ''sannipataja''. On the basis of the classification, etiological factors, symptoms and signs are being mentioned one by one [58]

==== Causes of ''vataja grahani'' ====

कटुतिक्तकषायातिरूक्षशीतलभोजनैः|

प्रमितानशनात्यध्ववेगनिग्रहमैथुनैः||५९||

करोति कुपितो मन्दमग्निं सञ्छाद्य मारुतः [२२] |

kaṭutiktakaṣāyātirūkṣaśītalabhōjanaiḥ|

pramitānaśanātyadhvavēganigrahāmaithunaiḥ||59||

karōti kupitō mandāmAgniṁ sañchādya mārutaḥ [22] |

kaTutiktakaShAyAtirUkShashItalabhojanaiH|

pramitAnashanAtyadhvaveganigrahamaithunaiH||59||

karoti kupito mandamagniM sa~jchAdya mArutaH [22] |

Excessive indulgence in diet having ''katu'' (pungent), ''tikta'' (bitter), ''kashaya'' (astringent) dominant food, which is dry in nature or having absorptive or emaciative qualities; cold, chilled or frozen items, eating quantitatively less amount of food, suppression of natural urges and excessive sexual intercourse contribute to aggravation of ''vata dosha'' which encompass the ''agni'' causing suppression of ''agni'' [59½]

==== Symptoms of ''vataja grahani'' ====

तस्यान्नं पच्यते दुःखं शुक्तपाकं खराङ्गता||६०||

कण्ठास्यशोषः क्षुत्तृष्णा तिमिरं कर्णयोः स्वनः|

पार्श्वोरुवङ्क्षणग्रीवारुजोऽभीक्ष्णं विसूचिका||६१||

हृत्पीडा कार्श्यदौर्बल्यं वैरस्यं परिकर्तिका|

गृद्धिः सर्वरसानां च मनसः सदनं तथा||६२||

जीर्णे जीर्यति चाध्मानं भुक्ते स्वास्थ्यमुपैति च|

स वातगुल्महृद्रोगप्लीहाशङ्की च मानवः||६३||

चिरादुःखं द्रवं शुष्कं तन्वामं शब्दफेनवत्|

पुनः पुनः सृजेद्वर्चः कासश्वासार्दितोऽनिलात्||६४||

tasyānnaṁ pacyatē duḥkhaṁ śuktapākaṁ kharāṅgatā||60||

kaṇṭhāsyaśōṣaḥ kṣuttr̥ṣṇā timiraṁ karṇayōḥ svanaḥ|

pārśvōruvaṅkṣaṇagrīvārujō'bhīkṣṇaṁ visūcikā||61||

hr̥tpīḍā kārśyadaurbalyaṁ vairasyaṁ parikartikā|

gr̥ddhiḥ sarvarasānāṁ ca manasaḥ sadanaṁ tathā||62||

jīrṇē jīryati cādhmānaṁ bhuktē svāsthyamupaiti ca|

sa Vātagulmahr̥drōgaplīhāśaṅkī ca mānavaḥ||63||

cirāduḥkhaṁ dravaṁ śuṣkaṁ tanvāmaṁ śabdaphēnavat|

punaḥ punaḥ sr̥jēdvarcaḥ kāsaśvāsārditō'nilāt||64||

tasyAnnaM pacyate duHkhaM shuktapAkaM kharA~ggatA||60||

kaNThAsyashoShaH kShuttRuShNA timiraM karNayoH svanaH|

pArshvoruva~gkShaNagrIvArujo~abhIkShNaM visUcikA||61||

hRutpIDA kArshyadaurbalyaM vairasyaM parikartikA|

gRuddhiH sarvarasAnAM ca manasaH sadanaM tathA||62||

jIrNe jIryati cAdhmAnaM bhukte svAsthyamupaiti ca|

sa vAtagulmahRudrogaplIhAsha~gkI ca mAnavaH||63||

cirAduHkhaM dravaM shuShkaM tanvAmaM shabdaphenavat|

punaH punaH sRujedvarcaH kAsashvAsArdito~anilAt||64||

Symptoms of ''vatika grahani'' are as follows:

Food is not easily digested and gets fermented (leading to sourness), roughness of skin, dryness of throat and mouth, craving for food and thirst is increased, ''timira'' (blurred vision), tinnitus, continuous pain in flanks, thighs, pelvis, neck region, ''vishuchika'' (piercing pain all over the body with vomiting and diarhea), chest pain/discomfort in cardiac region, emaciation, weakness, distaste, cutting pain, craving for sweets, sour and saline food (''madhuradi rasa''), reduced mental strength, ''adhmana'' (distention of abdomen) occurs during digestion and after completion of digestion whereas the patient feels abdominal comfort just after eating the food.

Patient expresses repeated doubts that he is suffering from ''vatika'' disorders, ''gulma'' (abdominal tumor), heart disease and splenomegaly.

Stools are evacuated with difficulty and consume time. Feces are either watery, dry, small sized associated with flatus and undigested food. Frequency of stool is increased and patient may suffer from cough and breathing difficulty [60-64]

==== Causes of ''pittaja grahani'' ====

कट्वजीर्णविदाह्यम्लक्षाराद्यैः पित्तमुल्बणम्|

अग्निमाप्लावयद्धन्ति [२३] जलं तप्तमिवानलम्||६५||

kaṭvajīrṇavidāhyamlakṣārādyaiḥ Pittamulbaṇam|

Agnimāplāvayaddhanti [23] jalaṁ taptamivānalam||65||

kaTvajIrNavidAhyamlakShArAdyaiH pittamulbaNam|

agnimAplAvayaddhanti [23] jalaM taptamivAnalam||65||

''Katu'' (spicy), ''ajeerna'' (undigestable food), ''vidahi'' (food causing eructation), ''amla'' (sour), ''kshara'' (alkali) and other food items which aggravate ''pitta'' are causes for ''pittaja grahani''. The aggravated ''pitta'' hampers the function of ''agni'' similar to condition wherein hot water extinguishes fire [65]

==== Symptoms of ''pittaja grahani'' ====

सोऽजीर्णं नीलपीताभं पीताभः सार्यते द्रवम्|

पूत्यम्लोद्गारहृत्कण्ठदाहारुचितृडर्दितः||६६||

sō'jīrṇaṁ nīlapītābhaṁ pītābhaḥ sāryatē dravam|

pūtyamlōdgārahr̥tkaṇṭhadāhārucitr̥ḍarditaḥ||66||

so~ajIrNaM nIlapItAbhaM pItAbhaH sAryate dravam|

pUtyamlodgArahRutkaNThadAhArucitRuDarditaH||66||

The stools have undigested food particles having either bluish-yellowish tinge or yellow in color and are loose/watery. The eructions have foul smell and sour taste, there is burning sensation in the cardiac region (retro-sternal) and throat, anorexia and thirst are the symptoms of ''pittaja grahani'' [66]

==== Causes of ''kaphaja grahani'' ====

गुर्वतिस्निग्धशीतादिभोजनादतिभोजनात्|

भुक्तमात्रस्य च स्वप्नाद्धन्त्यग्निं कुपितः कफः||६७||

gurvatisnigdhaśītādibhōjanādatibhōjanāt|

bhuktamātrasya ca svapnāddhantyAgniṁ kupitaḥ kaphaḥ||67||

gurvatisnigdhashItAdibhojanAdatibhojanAt|

bhuktamAtrasya ca svapnAddhantyagniM kupitaH kaphaH||67||

Heavy to digest or excessively unctuous foods, frozen or chilled items or food having cold nature or food which has qualities similar to ''kapha'', excessive intake of food and sleeping just after the meals hamper the function of ''agni'' and simultaneously vitiates ''kapha'' [67]

==== Symptoms of ''kaphaja grahani'' ====

तस्यान्नं पच्यते दुःखं हृल्लासच्छर्द्यरोचकाः|

आस्योपदेहमाधुर्यकासष्ठीवनपीनसाः||६८||

हृदयं मन्यते स्त्यानमुदरं स्तिमितं गुरु|

दुष्टो मधुर उद्गारः सदनं स्त्रीष्वहर्षणम्||६९||

भिन्नामश्लेष्मसंसृष्टगुरुवर्चःप्रवर्तनम्|

अकृशस्यापि दौर्बल्यमालस्यं च कफात्मके||७०||

tasyānnaṁ pacyatē duḥkhaṁ hr̥llāsacchardyarōcakāḥ|

āsyōpadēhamādhuryakāsaṣṭhīvanapīnasāḥ||68||

hr̥dayaṁ manyatē styānamudaraṁ stimitaṁ guru|

duṣṭō madhura udgāraḥ sadanaṁ strīṣvaharṣaṇam||69||

bhinnāmaślēṣmasaṁsr̥ṣṭaguruvarcaḥpravartanam|

akr̥śasyāpi daurbalyamālasyaṁ ca kaphātmakē||70||

tasyAnnaM pacyate duHkhaM hRullAsacchardyarocakAH|

AsyopadehamAdhuryakAsaShThIvanapInasAH||68||

hRudayaM manyate styAnamudaraM stimitaM guru|

duShTo madhura udgAraH sadanaM strIShvaharShaNam||69||

bhinnAmashleShmasaMsRuShTaguruvarcaHpravartanam|

akRushasyApi daurbalyamAlasyaM ca kaphAtmake||70||

Food is digested with difficulty, nausea, vomiting and anorexia are its symptoms. The other symptoms are feeling of coated mouth and sweet taste, has cough, increased tendency to spit, ''pinasa'' (nasal discharge), feeling of heaviness in chest, feeling as if there is no movement in abdomen, heavy abdomen, eructation with foul smelling and sweet taste; patient does not feel enthusiastic and there is suppression of libido. Stools are mixed with undigested items and mucous and are heavy; although patient is not emaciated still he feels weakness and laziness [68-70]

यश्चाग्निः पूर्वमुद्दिष्टो रोगानीके चतुर्विधः|

तं चापि ग्रहणीदोषं समवर्जं प्रचक्ष्महे||७१||

yaścāgniḥ pūrvamuddiṣṭō rōgānīkē caturvidhaḥ|

taṁ cāpi Grahaṇī dōṣaṁ sāmavarjaṁ pracakṣmahē||71||

yashcAgniH pUrvamuddiShTo rogAnIke caturvidhaH|

taM cApi grahaNIdoShaM samavarjaM pracakShmahe||71||

Four types of ''agni'' have been previously explained in [[Roganika Vimana]]. Except ''samagni'' other three types of ''agni'' contribute to the ''grahani dosha'' [71]

==== ''Sannipataja grahani'' ====

पृथग्वातादिनिर्दिष्टहेतुलिङ्गसमागमे|

त्रिदोषं निर्दिशेत्तेषां भेषजं [२४] शृण्वतः परम्||७२||

pr̥thagvātādinirdiṣṭahētuliṅgasamāgamē|

tridōṣaṁ nirdiśēttēṣāṁ bhēṣajaṁ [24]

śr̥ṇVātaḥ param||72||

pRuthagvAtAdinirdiShTahetuli~ggasamAgame|

tridoShaM nirdishetteShAM bheShajaM [24]

shRuNvataH param||72||

''Sannipataja grahani'' occurs by simultaneous vitiation of ''vata, pitta'' and ''kapha''. In such conditions etiological factors, symptoms and signs are of all the three ''dosha'' appear. Hereafter treatment of ''grahanidosha'' is expounded [72]

==== ''Vamana'' in ''grahanidosha'' ====

ग्रहणीमाश्रितं दोषं विदग्धाहारमूर्च्छितम्|

सविष्टम्भप्रसेकार्तिविदाहारुचिगौरवैः||७३||

आमलिङ्गान्वितं दृष्ट्वा सुखोष्णेनाम्बुनोद्धरेत्|

फलानां वा कषायेण पिप्पलीसर्षपैस्तथा||७४||

Grahaṇī māśritaṁ dōṣaṁ vidagdhāhāramūrcchitam|

saviṣṭambhaprasēkārtividāhārucigauravaiḥ||73||

āmaliṅgānvitaṁ dr̥ṣṭvā sukhōṣṇēnāmbunōddharēt|

phalānāṁ vā kaṣāyēṇa pippalīsarṣapaistathā||74||

grahaNImAshritaM doShaM vidagdhAhAramUrcchitam|

saviShTambhaprasekArtividAhArucigauravaiH||73||

Amali~ggAnvitaM dRuShTvA sukhoShNenAmbunoddharet|

phalAnAM vA kaShAyeNa pippalIsarShapaistathA||74||

When the ''doshas'' are located in ''grahani'' and are associated with incomplete digested food then ''vishtambha'' (constipation), excessive salivation, bodyache, burning sensation, anorexia and heaviness is felt by patient which are symptoms of ''ama'' and in such a condition ''vamana'' (emetic therapy) with lukewarm water or with decoction of ''madanaphala'' (Randia spinosa), ''pippali'' (Piper longum) and ''sarshapa'' (Brassica campestris) should be administered [73-74]

==== Treatment of ''leena dosha'' ====

लीनं पक्वाशयस्थं वाऽऽप्यामं स्राव्यं सदीपनैः|

शरीरानुगते सामे रसे लङ्घनपाचनम्||७५||

līnaṁ pakvāśayasthaṁ vā''pyāmaṁ srāvyaṁ sadīpanaiḥ|

śarīrānugatē sāmē rasē laṅghanapācanam||75||

lInaM pakvAshayasthaM vA~a~apyAmaM srAvyaM sadIpanaiH|

sharIrAnugate sAme rase la~gghanapAcanam||75||

If the ''ama'' is in ''pakvashaya'' and in ''anutklishtha'' (stuck, not ready to come out) condition then ''stravana'' (increasing secretion) with ''deepana dravyas'' should be administered whereas if ama gets absorbed along with ''rasa dhatu'' and if it pervades throughout the body then ''langhana'' and ''pachana'' should be advised [75]

==== ''Panchakoladi shritam and peya'' ====

विशुद्धामाशयायास्मै पञ्चकोलादिभिः शृतम्|

दद्यात् पेयादि लघ्वन्नं पुनर्योगांश्च दीपनान्||७६||

viśuddhāmāśayāyāsmai pañcakōlādibhiḥ śr̥tam|

dadyāt pēyādi laghvannaṁ punaryōgāṁśca dīpanān||76||

vishuddhAmAshayAyAsmai pa~jcakolAdibhiH shRutam|

dadyAt peyAdi laghvannaM punaryogAMshca dIpanAn||76||

After cleansing of ''amashaya'', liquid gruel of rice (''peya'') fortified with ''panchakola'' etc. drugs should be administered. Light and easy to digest food along with ''deepana'' drugs may be given [76]

ज्ञात्वा तु परिपक्वामं मारुतग्रहणीगदम्|

दीपनीययुतं सर्पिः पाययेताल्पशो भिषक्||७७||

jñātvā tu paripakvāmaṁ mārutaGrahaṇī gadam|

dīpanīyayutaṁ sarpiḥ pāyayētālpaśō bhiṣak||77||

j~jAtvA tu paripakvAmaM mArutagrahaNIgadam|

dIpanIyayutaM sarpiH pAyayetAlpasho bhiShak||77||

In patients with ''vataja grahani'' after ascertaining that ''ama'' is digested, medicated ghee starting with very minimum quantity prepared from ''deepaneeya gana'' be administered [Ca.Su.4/9/6]- [77]

==== ''Niruha basti'' ====

किञ्चित्सन्धुक्षिते त्वग्नौ सक्तविण्मूत्रमारुतम्|

द्व्यहं त्र्यहं वा संस्नेह्य स्विन्नाभ्यक्तं निरूहयेत्||७८||

kiñcitsandhukṣitē tvagnau saktaviṇmūtramārutam|

dvyahaṁ tryahaṁ vā saṁsnēhya svinnābhyaktaṁ nirūhayēt||78||

ki~jcitsandhukShite tvagnau saktaviNmUtramArutam|

dvyahaM tryahaM vA saMsnehya svinnAbhyaktaM nirUhayet||78||

As stimulation of ''agni'' is observed and still if patient finds difficulty in passing stool, urine and flatus then in such condition every two or three days ''niruha basti'' should be administered after proper ''snehana'' and ''swedana'' [78]

==== ''Virechana'' ====

तत एरण्डतैलेन सर्पिषा तैल्वकेन वा|

सक्षारेणानिले शान्ते स्रस्तदोषं विरेचयेत्||७९||

tata ēraṇḍatailēna sarpiṣā tailvakēna vā|

sakṣārēṇānilē śāntē srastadōṣaṁ virēcayēt||79||

tata eraNDatailena sarpiShA tailvakena vA|

sakShAreNAnile shAnte srastadoShaM virecayet||79||

After ''niruha'', the ''strasta dosha'' (''dosha'' ready to come out) should be cleaned with purgative drugs like ''eranda taila'' (castor oil) or ''tilvaka ghrita'' mixed with ''kshara'' (medicine with alkaline nature) [79]

==== ''Anuvasana basti'' ====

शुद्धं रूक्षाशयं बद्धवर्चसं चानुवासयेत्|

दीपनीयाम्लवातघ्नसिद्धातैलेन मात्रया||८०||

śuddhaṁ rūkṣāśayaṁ baddhavarcasaṁ cānuvāsayēt|

dīpanīyāmlaVātaghnasiddhātailēna mātrayā||80||

shuddhaM rUkShAshayaM baddhavarcasaM cAnuvAsayet|

dIpanIyAmlavAtaghnasiddhAtailena mAtrayA||80||

After ''shodhana'' of intestine if ''rukshata'' and ''baddha'' (pellet-like) stools are seen then ''anuvasana basti'' with ''taila'' fortified with ''deepana'' drugs having sour and ''vata'' alleviating action may be administered [80]

निरूढं च विरिक्तं च सम्यक् चैवानुवासितम्|

लघ्वन्नं प्रतिसम्भुक्तं सर्पिरभ्यासयेत् पुनः||८१||

nirūḍhaṁ ca viriktaṁ ca samyak caivānuvāsitam|

laghvannaṁ pratisambhuktaṁ sarpirabhyāsayēt punaḥ||81||

nirUDhaM ca viriktaM ca samyak caivAnuvAsitam|

laghvannaM pratisambhuktaM sarpirabhyAsayet punaH||81||

After appropriate administration of ''niruha, virechana'' and ''anuvasana'', light diet should be taken daily and ghee should be taken repeatedly [81]

==== ''Dashamooladya ghrita''====

द्वे पञ्चमूले सरलं देवदारु सनागरम्|

पिप्पलीं पिप्पलीमूलं चित्रकं हस्तिपिप्पलीम्||८२||

शणबीजं यवान् कोलन् कुलत्थान् सुषवीं तथा [२७] |

पाचयेदारनालेन दध्ना सौवीरकेण वा||८३||

चतुर्भागावशेषेण पचेत्तेन घृताढकम्|

स्वर्जिकायावशूकाख्यौ क्षारौ दत्त्वा च युक्तितः||८४||

सैन्धवौद्भिदसामुद्रबिडानां रोमकस्य च|

ससौवर्चलपाक्यानां भागान्द्विपलिकान् पृथक्||८५||

विनीय चूर्णितान् तस्मात् पाययेत् प्रसृतं बुधः|

करोत्यग्निं बलं वर्णं वातघ्नं भुक्तपाचनम्||८६||

इति दशमूलाद्यं घृतम्

dvē pañcamūlē saralaṁ dēvadāru sanāgaram|

pippalīṁ pippalīmūlaṁ citrakaṁ hastipippalīm||82||

śaṇabījaṁ yavān kōlan kulatthān suṣavīṁ tathā [27] |

pācayēdāranālēna dadhnā sauvīrakēṇa vā||83||

caturbhāgāvaśēṣēṇa pacēttēna ghr̥tāḍhakam|

svarjikāyāvaśūkākhyau kṣārau dattvā ca yuktitaḥ||84||

saindhavaudbhidasāmudrabiḍānāṁ rōmakasya ca|

sasauvarcalapākyānāṁ bhāgāndvipalikān pr̥thak||85||

vinīya cūrṇitān tasmāt pāyayēt prasr̥taṁ budhaḥ|

karōtyAgniṁ balaṁ varṇaṁ Vātaghnaṁ bhuktapācanam||86||

iti daśamūlādyaṁ ghr̥tam

dve pa~jcamUle saralaM devadAru sanAgaram|

pippalIM pippalImUlaM citrakaM hastipippalIm||82||

shaNabIjaM yavAn kolan kulatthAn suShavIM tathA [27] |

pAcayedAranAlena dadhnA sauvIrakeNa vA||83||

caturbhAgAvasheSheNa pacettena ghRutADhakam|

svarjikAyAvashUkAkhyau kShArau dattvA ca yuktitaH||84||

saindhavaudbhidasAmudrabiDAnAM romakasya ca|

sasauvarcalapAkyAnAM bhAgAndvipalikAn pRuthak||85||

vinIya cUrNitAn tasmAt pAyayet prasRutaM budhaH|

karotyagniM balaM varNaM vAtaghnaM bhuktapAcanam||86||

iti dashamUlAdyaM ghRutam

Boil the ''svarasa'' of two ''panchamoola'' (''brihat'' and ''laghu''), ''sarala'' ((''trivrita'') Operculina turpethum), ''devadaru'' (Cedrus deodara), ''nagara'' (Zingiber officinale), ''pippali'' (Piper longum), ''pippalimoola, chitraka'' (Plumbago zeylanica), ''gajapippali'' (Piper retofractum), ''sanabeeja'' (seeds of Crotalaria juncea), barley, ''kola, kulatta'' and ''susavi'' (Woodfordia fruticosa) with ''aranala, dadhimanda'' or ''sauviraka''. After one fourth reductions add one ''adhaka'' (3.073 kg) of ghee and ''svarjikakshara'' and ''yavashukakshara'' as per ''yukti pramana'' i.e. either in small quantity or at the time of ''ghrita siddhi lakshana'' alongwith ''saindhava'' (rock salt), ''audbhida'' (salts derived from plants), ''samudra'' (table salt), ''bidha'' (red granular salt), ''romaka, sauvarchala'' and ''pakya'' (''pakaja'') types of salt in two ''pala'' quantity each (96 gm each). After preparation, it may be administered up to one ''prasrita'' i.e. 96 gm. It increases ''agni'', strength and complexion and helps in alleviation of ''vata'' and thus digestion of food [82-86]

==== ''Tryushanadya ghrita'' ====

त्र्यूषणत्रिफलाकल्के बिल्वमात्रे गुडात् पले|

सर्पिषोऽष्टपलं पक्त्वा मात्रां मन्दानलः पिबेत्||८७||

इति त्र्यूषणाद्यं घृतम्

tryūṣaṇatriphalākalkē bilvamātrē guḍāt palē|

sarpiṣō'ṣṭapalaṁ paktvā mātrāṁ mandānalaḥ pibēt||87||

iti tryūṣaṇādyaṁ ghr̥tam

tryUShaNatriphalAkalke bilvamAtre guDAt pale|

sarpiSho~aShTapalaM paktvA mAtrAM mandAnalaH pibet||87||

iti tryUShaNAdyaM ghRutam

Prepare paste of ''trikatu'' and ''triphala'' in quantity of one ''bilva'' and add one ''pala'' (48g) of jaggery and do ''sneha siddhi'' by adding eight ''palas'' (384 gm) of ghee. This medicated ''ghrita'' is indicated in ''mandagni'' i.e. low digestive power [87]

==== ''Panchamooladya ghrita'' and ''choorna'' ====

पञ्चमूलाभयाव्योषपिप्पलीमूलसैन्धवैः|

रास्नाक्षारद्वयाजाजीविडङ्गशटिभिर्घृतम्||८८||

शुक्तेन मातुलुङ्गस्य स्वरसेनार्द्रकस्य च|

शुष्कमूलककोलाम्बुचुक्रिकादाडिमस्य च||८९||

तक्रमस्तुसुरामण्डसौवीरकतुषोदकैः|

काञ्जिकेन च तत् पक्वमग्निदीप्तिकरं परम्||९०||

शूलगुल्मोदरश्वासकासानिलकफापहम्|

सबीजपूरकरसं सिद्धं वा पाययेद्घृतम्||९१||

सिद्धमभ्यञ्जनार्थं च तैलमेतैः प्रयोजयेत्|

एतेषामौषधानां वा पिबेच्चूर्णं सुखाम्बुना||९२||

वाते श्लेष्मावृते सामे कफे वा वायुनोद्धते|

दद्याच्चूर्णं पाचनार्थमग्निसन्दीपनं परम्||९३||

इति पञ्चमूलाद्यं घृतं चूर्णं च

pañcamūlābhayāvyōṣapippalīmūlasaindhavaiḥ|

rāsnākṣāradvayājājīviḍaṅgaśaṭibhirghr̥tam||88||

śuktēna mātuluṅgasya svarasēnārdrakasya ca|

śuṣkamūlakakōlāmbucukrikādāḍimasya ca||89||

takrāmastusurāmaṇḍasauvīrakatuṣōdakaiḥ|

kāñjikēna ca tat pakvāmAgnidīptikaraṁ param||90||

śūlagulmōdaraśvāsakāsānilakaphāpaham|

sabījapūrakarasaṁ siddhaṁ vā pāyayēdghr̥tam||91||

siddhāmabhyañjanārthaṁ ca tailamētaiḥ prayōjayēt|

ētēṣāmauṣadhānāṁ vā pibēccūrṇaṁ sukhāmbunā||92||

vātē ślēṣmāvr̥tē sāmē kaphē vā Vātanōddhatē|

dadyāccūrṇaṁ pācanārthāmAgnisandīpanaṁ param||93||

iti pañcamūlādyaṁ ghr̥taṁ cūrṇaṁ ca

pa~jcamUlAbhayAvyoShapippalImUlasaindhavaiH|

rAsnAkShAradvayAjAjIviDa~ggashaTibhirghRutam||88||

shuktena mAtulu~ggasya svarasenArdrakasya ca|

shuShkamUlakakolAmbucukrikAdADimasya ca||89||

takramastusurAmaNDasauvIrakatuShodakaiH|

kA~jjikena ca tat pakvamagnidIptikaraM param||90||

shUlagulmodarashvAsakAsAnilakaphApaham|

sabIjapUrakarasaM siddhaM vA pAyayedghRutam||91||

siddhamabhya~jjanArthaM ca tailametaiH prayojayet|

eteShAmauShadhAnAM vA pibeccUrNaM sukhAmbunA||92||

vAte shleShmAvRute sAme kaphe vA vAyunoddhate|

dadyAccUrNaM pAcanArthamagnisandIpanaM param||93||

iti pa~jcamUlAdyaM ghRutaM cUrNaM ca

Make paste of ''panchamoola'' (''bilva, shyonaka, gambhari, patala'' and ''gambharika''), ''abhaya'', ''trikatu, pippalimoola, saindhava, rasna,'' two ''kshara'' (''sarjika'' and ''yavakshara''), ''ajaji, vidanga'' and ''sati'' and prepare medicated ghee with ''sukta,'' juice of ''matulunga'' and ''ardraka, suṣkamoolaka, kolambu, chukrika,'' pomengranate, butter milk, ''mastu'' (supplement liquid portion in the curd/yoghurt), ''suramanda'' (indigenous beer beverage prepared from fermented cereals) ''sauviraka'' (acidic fermented liquid obtained from wheat), ''tushodaka'' (fermented liquid using the coarse grains of barley) and ''kanji'' (fermented liquid).

The medicated ghee helps in digestion and increase strength of ''agni'' and cures colicky pain, ''gulma, udara'', asthma and cough. It also pacifies ''vata'' and ''kapha''. ''Beejapuraka svarasa'' can also be used for ''sneha siddhi''.

''Taila siddhi'' with above medicine may be used for ''abhyanga'' (massage) and the ''choorna'' used in above preparation may be taken with lukewarm water.

In condition such as ''kapha avrite vata'' (''vata'' occluded by ''kapha''), ''sama kapha'' and ''vata'' aggravated due to ''kapha'' give the above ''choorna'' for digestion and to stimulate ''agni''. The medicine is known as ''panchamooladyam ghritam choornam'' [88-93]

==== Examination of feces ====

मज्जत्यामा गुरुत्वाद्विट् पक्वा तूत्प्लवते जले|

विनाऽतिद्रवसङ्घातशैत्यश्लेष्मप्रदूषणात्||९४||

majjatyāmā gurutvādviṭ pakvā tūtplavatē jalē|

vinā'tidravasaṅghātaśaityaślēṣmapradūṣaṇāt||94||

majjatyAmA gurutvAdviT pakvA tUtplavate jale|

vinA~atidravasa~gghAtashaityashleShmapradUShaNAt||94||

''Sama mala'' (stools) sinks into water due to ''gurutva'' (heaviness) of ''ama'' whereas ''pakva'' or ''nirama mala'' floats over the water; provided the stools consistency is not watery or not very compact and if not vitiated by ''sheeta guna'' and ''kapha'' [94]

परीक्ष्यैवं पुरा सामं निरामं चामदोषिणम्|

विधिनोपाचरेत् सम्यक् पाचनेनेतरेण वा||९५||

parīkṣyaivaṁ purā sāmaṁ nirāmaṁ cāmadōṣiṇam|

vidhinōpācarēt samyak pācanēnētarēṇa vā||95||

parIkShyaivaM purA sAmaM nirAmaM cAmadoShiNam|

vidhinopAcaret samyak pAcanenetareNa vA||95||

Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''pachana'' etc. treatment [95]

==== ''Chitrakadya gutika'' ====

चित्रकं पिप्पलीमूलं द्वौ क्षारौ लवणानि च|

व्योषं हिङ्ग्वजमोदां च चव्यं चैकत्र चूर्णयेत्||९६||

गुटिका मातुलुङ्गस्य दाडिमस्य रसेन वा|

कृता विपाचयत्यामं दीपयत्याशु चानलम्||९७||

इति चित्रकाद्या गुटिका

citrakaṁ pippalīmūlaṁ dvau kṣārau lavaṇāni ca|

vyōṣaṁ hiṅgvajamōdāṁ ca cavyaṁ caikatra cūrṇayēt||96||

guṭikā mātuluṅgasya dāḍimasya rasēna vā|

kr̥tā vipācayatyāmaṁ dīpayatyāśu cālanam||97||

iti citrakādyā guṭikā

citrakaM pippalImUlaM dvau kShArau lavaNAni ca|

vyoShaM hi~ggvajamodAM ca cavyaM caikatra cUrNayet||96||

guTikA mAtulu~ggasya dADimasya rasena vA|

kRutA vipAcayatyAmaM dIpayatyAshu cAlanam||97||

iti citrakAdyA guTikA

''Chitraka, pippalimoola,'' two ''kshara'' (''yavakshara'' and ''sarjikshara''), salt, ''trikatu, hingu, ajamoda'' and ''chavya'' are mixed together and trichurated with either ''matulunga svarasa'' or ''dadima svarasa'' and tablets are prepared. This ''chitrakadya guthi'' is useful for digestion of ''ama'' and stimulation of the ''agni'' [96-97]

==== Recipes for ''pachana'' of ''ama'' ====

नागरातिविषामुस्तक्वाथः स्यादामपाचनः|

मुस्तान्तकल्कः पथ्या वा नागरं चोष्णवारिणा||९८||

nāgarātiviṣāmustakvāthaḥ syādāmapācanaḥ|

mustāntakalkaḥ pathyā vā nāgaraṁ cōṣṇavāriṇā||98||

nAgarAtiviShAmustakvAthaH syAdAmapAcanaH|

mustAntakalkaH pathyA vA nAgaraM coShNavAriNA||98||

''Shunthi, ativisha'' and ''musta'' decoction helps in ''pachana'' of ''ama''. ''Kalka'' (paste) of ''shunthi, ativisha'' and ''musta'' or ''haritaki'' or ''shunthi'' alongwith warm water also does ''ama pachana'' [98]

देवदारुवचामुस्तनागरातिविषाभयाः|

वारुण्यामासुतास्तोये कोष्णे वाऽलवणाः पिबेत्||९९||

वर्चस्यामे सशूले च पिबेद्वा दाडिमाम्बुना|

dēvadāruvacāmustanāgarātiviṣābhayāḥ|

vāruṇyāmāsutāstōyē kōṣṇē vā'lavaṇāḥ pibēt||99||

varcasyāmē saśūlē ca pibēdvā dāḍimāmbunā|

devadAruvacAmustanAgarAtiviShAbhayAH|

vAruNyAmAsutAstoye koShNe vA~alavaNAH pibet||99||

varcasyAme sashUle ca pibedvA dADimAmbunA|

Soak powder of ''devadaru, vacha, musta, nagara, ativisha'' and ''haritaki'' in ''varuni'' (fermented liquid obtained from palm trees like dates) and take with warm water without adding salt or be taken with juice of ''dadima'' in condition wherein there is colicky pain along with mucus or undigested food in stool [99-99½]

विडेन [२९] लवणं पिष्टं बिल्वं चित्रकनागरम्||१००||

सामे वा सकफे वाते कोष्ठशूलकरे पिबेत्|

viḍēna [29] lavaṇaṁ piṣṭaṁ bilvaṁ citrakanāgaram||100||

sāmē vā sakaphē vātē kōṣṭhaśūlakarē pibēt|

Paste of ''bilva, chitraka'' and ''nagara'' should be added with ''vida lavana'' and administered in ''sama'' stool or mucus in stool and pain in abdomen due to vāta aggravation [100]

कलिङ्गहिङ्ग्वतिविषावचासौवर्चलाभयाः||१०१||

छर्द्यर्शोग्रन्थिशूलेषु पिबेदुष्णेन वारिणा|

पथ्यासौवर्चलाजाजीचूर्णं मरिचसंयुतम्||१०२||

kaliṅgahiṅgvativiṣāvacāsauvarcalābhayāḥ||101||

chardyarśōgranthiśūlēṣu pibēduṣṇēna vāriṇā|

pathyāsauvarcalājājīcūrṇaṁ maricasaṁyutam||102||

viDena [29] lavaNaM piShTaM bilvaM citrakanAgaram||100||

sAme vA sakaphe vAte koShThashUlakare pibet|

kali~ggahi~ggvativiShAvacAsauvarcalAbhayAH||101||

chardyarshogranthishUleShu pibeduShNena vAriNA|

pathyAsauvarcalAjAjIcUrNaM maricasaMyutam||102||

''Kalinga, hingu, ativisha, vacha, sauvarchala'' and ''haritaki'' with warm water is useful in vomiting, ''arshogranthi'' (analpolyp with pellet stool) and pain in abdomen. Similarly, combination of ''haritaki, sauvarchala'' and ''ajaji'' along with maricha can be used for same condition [101-102]

==== Recipe for ''pitta-kapha grahani'' ====

अभयां पिप्पलीमूलं वचां कटुकरोहिणीम्|

पाठां वत्सकबीजानि चित्रकं विश्वभेषजम्||१०३||

पिबेन्निष्क्वाथ्य चूर्णं वा कृत्वा कोष्णेन वारिणा|

पित्तश्लेष्माभिभृतायां ग्रहण्यां शूलनुद्धितम्||१०४||

abhayāṁ pippalīmūlaṁ vacāṁ kaṭukarōhiṇīm|

pāṭhāṁ vatsakabījāni citrakaṁ viśvabhēṣajam||103||

pibēnniṣkvāthya cūrṇaṁ vā kr̥tvā kōṣṇēna vāriṇā|

Pitta ślēṣmābhibhr̥tāyāṁ grahaṇyāṁ śūlanuddhitam||104||

abhayAM pippalImUlaM vacAM kaTukarohiNIm|

pAThAM vatsakabIjAni citrakaM vishvabheShajam||103||

pibenniShkvAthya cUrNaM vA kRutvA koShNena vAriNA|

pittashleShmAbhibhRutAyAM grahaNyAM shUlanuddhitam||104||

Decoction of the ''haritaki, pippalimoola, vacha, katukarohineem, patha,'' seeds of ''kutaja, chitraka, vishvabheshaja'' (''sunthi'') or ''choorna'' of the above contents should be administered with warm water. It is helpful when colic pain is associated with ''pitta-kapha'' dominant ''grahani'' [103-104]

सामे सातिविषं व्योषं लवणक्षारहिङ्गु च|

निःक्वाथ्य पाययेच्चूर्णं कृत्वा वा कोष्णवारिणा||१०५||

sāmē sātiviṣaṁ vyōṣaṁ lavaṇakṣārahiṅgu ca|

niḥkvāthya pāyayēccūrṇaṁ kr̥tvā vā kōṣṇavāriṇā||105||

sAme sAtiviShaM vyoShaM lavaNakShArahi~ggu ca|

niHkvAthya pAyayeccUrNaM kRutvA vA koShNavAriNA||105||

In ''ama'' condition, decoction of ''ativisha, trikatu, lavana, kshara'' (''yavakshara'') and ''hingu'' may be given or powders of above medicines with warm water may be administered [105]

पिप्पलीं नागरं पाठां सारिवां बृहतीद्वयम्|

चित्रकं कौटजं बीजं लवणान्यथ पञ्च च||१०६||

तच्चूर्णं सयवक्षारं दध्युष्णाम्बुसुरादिभिः|

पिबेदग्निविवृद्ध्यर्थं कोष्ठवातहरं नरः||१०७||

pippalīṁ nāgaraṁ pāṭhāṁ sārivāṁ br̥hatīdvayam|

citrakaṁ kauṭajaṁ bījaṁ lavaṇānyatha pañca ca||106||

taccūrṇaṁ sayavakṣāraṁ dadhyuṣṇāmbusurādibhiḥ|

pibēdAgnivivr̥ddhyarthaṁ kōṣṭhaVātaharaṁ naraḥ||107||

pippalIM nAgaraM pAThAM sArivAM bRuhatIdvayam|

citrakaM kauTajaM bIjaM lavaNAnyatha pa~jca ca||106||

taccUrNaM sayavakShAraM dadhyuShNAmbusurAdibhiH|

pibedagnivivRuddhyarthaM koShThavAtaharaM naraH||107||

''Choorna'' of ''pippali, nagara, patha, sariva, brihatidvayam'' (''brihati, kantakari''), ''chitraka,'' seeds of ''kutaja'', five types of ''lavana'', along with ''yavakshara,'' curd, hot water and different types of fermented liquids such as ''kanji, sauviraka'' etc is taken for increasing the power of ''agni'' and to eliminate the ''vata'' in abdomen [106-107]

==== ''Marichadya choorna'' ====

मरिचं कुञ्चिकाम्बष्ठावृक्षाम्लाः कुडवाः पृथक्|

पलानि [३०] दश चाम्लस्य वेतसस्य पलार्धिकम्||१०८||

सौवर्चलं बिडं पाक्यं यवक्षारः ससैन्धवः|

शटीपुष्करमूलानि हिङ्गु हिङ्गुशिवाटिका||१०९||

तत् सर्वमेकतः सूक्ष्मं चूर्णं कृत्वा प्रयोजयेत्|

हितं वाताभिभूतायां ग्रहण्यामरुचौ तथा||११०||

इति मरिचाद्यं चूर्णम्

maricaṁ kuñcikāmbaṣṭhāvr̥kṣāmlāḥ kuḍavāḥ pr̥thak|

palāni [30] daśa cāmlasya vētasasya palārdhikam||108||

sauvarcalaṁ biḍaṁ pākyaṁ yavakṣāraḥ sasaindhavaḥ|

śaṭīpuṣkaramūlāni hiṅgu hiṅguśivāṭikā||109||

tat sarvamēkataḥ sūkṣmaṁ cūrṇaṁ kr̥tvā prayōjayēt|

hitaṁ vātābhibhūtāyāṁ grahaṇyāmarucau tathā||110||

iti maricādyaṁ cūrṇam

maricaM ku~jcikAmbaShThAvRukShAmlAH kuDavAH pRuthak|

palAni [30] dasha cAmlasya vetasasya palArdhikam||108||

sauvarcalaM biDaM pAkyaM yavakShAraH sasaindhavaH|

shaTIpuShkaramUlAni hi~ggu hi~ggushivATikA||109||

tat sarvamekataH sUkShmaM cUrNaM kRutvA prayojayet|

hitaM vAtAbhibhUtAyAM grahaNyAmarucau tathA||110||

iti maricAdyaM cUrNam

''Marichadyam choornam'' contains one ''kudava'' (192 gm) of ''maricha, kunchika, ambashtha'' (''patha''), ''vrikshamlah'', ten ''pala'' (480 gm) of ''amlavetas,'' half ''pala'' (24 gm) each of ''sauvarchala, bidha, pakya, yavakshara, saindhava, sathi, pushkaramoola, hingu'' and ''hingushivatika'' (''vamsapatri''). It is useful in ''vata'' dominant ''grahani'' and anorexia [108-110]

चतुर्णां प्रस्थमम्लानां त्र्यूषणस्य पलत्रयम्|

लवणानां च चत्वारि शर्करायाः पलाष्टकम्|

सञ्चूर्ण्य शाकसूपान्नरागादिष्ववचारयेत्||१११||

कासाजीर्णारुचिश्वासाहृत्पाण्ड्वामयशूलनुत्|

caturṇāṁ prasthāmamlānāṁ tryūṣaṇasya palatrayam|

lavaṇānāṁ ca catvāri śarkarāyāḥ palāṣṭakam|

sañcūrṇya śākasūpānnarāgādiṣvavacārayēt||111||

kāsājīrṇāruciśvāsāhr̥tpāṇḍvāmayaśūlanut|

caturNAM prasthamamlAnAM tryUShaNasya palatrayam|

lavaNAnAM ca catvAri sharkarAyAH palAShTakam|

sa~jcUrNya shAkasUpAnnarAgAdiShvavacArayet||111||

kAsAjIrNArucishvAsAhRutpANDvAmayashUlanut|

Make powder of one ''prastha'' (768 gm) of four ''amla'' drugs, three ''pala'' (144 gm) of ''trikatu'', four ''pala'' (192 gm) of ''lavana'' (''saindhava'') and eight ''pala'' (384 gm) of sugar and mix together. It is to be taken with vegetable preparations such as soup cooked food and ''raga'' for cure of cough, indigestion, anorexia, dyspnea, heart disease, anemia and pain in abdomen [111]

==== Five types of ''yavagu'' ====

चव्यत्वक्पिप्पलीमूलधातकीव्योषचित्रकान्||११२||

कपित्थं बिल्वमम्बष्ठां शाल्मलं हस्तिपिप्पलीम्|

शिलोद्भेदं तथाऽजाजीं पिष्ट्वा बदरसम्मितम्||११३||

परिभर्ज्य घृते दध्ना यवागूं साधयेद्भिषक्|

रसैः कपित्थचुक्रीकावृक्षाम्लैर्दाडिमस्य च||११४||

सर्वातिसारग्रहणीगुल्मार्शःप्लीहनाशिनी|

cavyatvakpippalīmūladhātakīvyōṣacitrakān||112||

kapitthaṁ bilvāmambaṣṭhāṁ śālmalaṁ hastipippalīm|

śilōdbhēdaṁ tathā'jājīṁ piṣṭvā badarasammitam||113||

paribharjya ghr̥tē dadhnā yavāgūṁ sādhayēdbhiṣak|

rasaiḥ kapitthacukrīkāvr̥kṣāmlairdāḍimasya ca||114||

sarvātisāragrahaṇī gulmārśaḥplīhanāśinī|

cavyatvakpippalImUladhAtakIvyoShacitrakAn||112||

kapitthaM bilvamambaShThAM shAlmalaM hastipippalIm|

shilodbhedaM tathA~ajAjIM piShTvA badarasammitam||113||

paribharjya ghRute dadhnA yavAgUM sAdhayedbhiShak|

rasaiH kapitthacukrIkAvRukShAmlairdADimasya ca||114||

sarvAtisAragrahaNIgulmArshaHplIhanAshinI|

Make paste of ''chavya, tvak, pippalīmūla, dhātakī, trikatu, chitraka, kapittha, bilva, pāṭhā, sālmali, gajapippalī, slōdbhēda'' (''shilajeet'') and ''ajājī,'' each taken in quantity equal to ''badara'' (about 6 gm). Fry it in ghee and prepare ''yavāgu'' by adding curd or ''svarasa'' of ''kapittha'' or ''chukrikā'' or ''vrikshāmla'' or ''dadima''. It helps in curing all types of ''atisara, grahani, gulma, arsha'' and ''pleeha'' disease [112-114]

==== Beverages ====

पञ्चकोलकयूषश्च मूलकानां च सोषणः||११५||

स्निग्धो दाडिमतक्राम्लो जाङ्गलः संस्कृतो रसः|

क्रव्यादस्वरसः शस्तो भोजनार्थे सदीपनः||११६||

तक्रारनालमद्यानि पानायारिष्ट एव च|

pañcakōlakayūṣaśca mūlakānāṁ ca sōṣaṇaḥ||115||

snigdhō dāḍimatakrāmlō jāṅgalaḥ saṁskr̥tō rasaḥ|

kravyādasvarasaḥ śastō bhōjanārthē sadīpanaḥ||116||

takrāranālāmadyāni pānāyāriṣṭa ēva ca|

pa~jcakolakayUShashca mUlakAnAM ca soShaNaH||115||

snigdho dADimatakrAmlo jA~ggalaH saMskRuto rasaH|

kravyAdasvarasaH shasto bhojanArthe sadIpanaH||116||

takrAranAlamadyAni pAnAyAriShTa eva ca|

Fortified soup with ''panchakola'' or soup of ''mulaka'' with ''maricha'' or medicated soup prepared from animals inhabiting in arid land added with ghee, ''dadima, takra, amla dravyas'' or soup of animals that eat other animals fortified with medicines having ''deepana'' qualities be given for drink.

Patient may be given buttermilk, ''aranala'' (sour drink), ''madya'' (medicated alcohol) and ''arishtha'' as liquid diets [115-116]

==== Qualities and benefits of buttermilk ====

तक्रं तु ग्रहणीदोषे दीपनग्राहिलाघवात्||११७||

श्रेष्ठं मधुरपाकित्वान्न च पित्तं प्रकोपयेत्|

कषायोष्णविकाशित्वाद्रौक्ष्याच्चैव कफे हितम्||११८||

वाते स्वाद्वम्लसान्द्रत्वात् सद्यस्कमविदाहि तत्|

तस्मात् तक्रप्रयोगा ये जठराणां तथाऽर्शसाम्||११९||

विहिता ग्रहणीदोषे सर्वशस्तान् प्रयोजयेत्|

takraṁ tu Grahaṇī dōṣē dīpanagrāhilāghavāt||117||

śrēṣṭhaṁ madhurapākitvānna ca Pittaṁ prakōpayēt|

kaṣāyōṣṇavikāśitvādraukṣyāccaiva kaphē hitam||118||

vātē svādvamlasāndratvāt sadyaskāmavidāhi tat|

tasmāt takraprayōgā yē jaṭharāṇāṁ tathā'rśasām||119||

vihitā Grahaṇī dōṣē sarvaśastān prayōjayēt|

takraM tu grahaNIdoShe dIpanagrAhilAghavAt||117||

shreShThaM madhurapAkitvAnna ca pittaM prakopayet|

kaShAyoShNavikAshitvAdraukShyAccaiva kaphe hitam||118||

vAte svAdvamlasAndratvAt sadyaskamavidAhi tat|

tasmAt takraprayogA ye jaTharANAM tathA~arshasAm||119||

vihitA grahaNIdoShe sarvashastAn prayojayet|

Buttermilk due to its ''dīpana, grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''. It is ''madhura'' in ''vipaka'' therefore reduces ''pitta''; due to ''kashaya'' (astringent) taste, ''ushna virya'' (hot potency), ''vikashi'' and ''ruksha guna'' it is useful in ''kapha'' dominated disorders and due to ''madhura'' and ''amla rasa, sandra guna'' it reduces ''vata''. Freshly churned butter milk does not cause burning sensation; therefore, buttermilk is very useful in treatment of ''udara, arśa'' and all ''grahanidosha'' [117-119]

==== ''Takrarishtha'' ====

यवान्यामलके पथ्या मरिचं त्रिपलंशिकम्||१२०||

लवणानि पलांशानि पञ्च चैकत्र चूर्णयेत्|

तक्रे तदासुतं [३१] जातं तक्रारिष्टं पिबेन्नरः|

दीपनं शोथगुल्मार्शःक्रिमिमेहोदरापहम्||१२१||

इति तक्रारिष्टः

yavānyāmalakē pathyā maricaṁ tripalaṁśikam||120||

lavaṇāni palāṁśāni pañca caikatra cūrṇayēt|

takrē tadāsutaṁ [31] jātaṁ takrāriṣṭaṁ pibēnnaraḥ|

dīpanaṁ śōthagulmārśaḥkrimimēhōdarāpaham||121||

iti takrāriṣṭaḥ

yavAnyAmalake pathyA maricaM tripalaMshikam||120||

lavaNAni palAMshAni pa~jca caikatra cUrNayet|

takre tadAsutaM [31] jAtaM takrAriShTaM pibennaraH|

dIpanaM shothagulmArshaHkrimimehodarApaham||121||

iti takrAriShTaH

Take ''yavani, amalaki, haritaki'' and ''maricha'' each in three ''pala'' (144 gm) and ''pancha-lavana'' in one ''pala'' (48 gm) and powder together and add buttermilk to it and ferment till sour taste is obtained. This preparation called ''takrarishtha'' stimulates the digestive power and relieves ''sotha, gulma, arsha, krimi, prameha'' and ''udara roga'' [120-121]

==== Management of ''pitta'' dominant ''grahani'' ====

स्वस्थानगतमुत्क्लिष्टमग्निनिर्वापकं भिषक्|

पित्तं ज्ञात्वा विरेकेण निर्हरेद्वमनेन वा||१२२||

svasthānagatamutkliṣṭāmAgninirvāpakaṁ bhiṣak|

Pittaṁ jñātvā virēkēṇa nirharēdvāmanēna vā||122||

svasthAnagatamutkliShTamagninirvApakaM bhiShak|

pittaM j~jAtvA virekeNa nirharedvamanena vA||122||

If ''agnimandyata'' is due to ''utklishtha'' (ready to come out) ''pitta'' in its own place then in such a situation ''virechana'' or ''vamana'' should be administered for removal of ''pitta'' [122]

==== Diet after ''shodhana'' ====

अविदाहिभिरन्नैश्च लघुभिस्तिक्तसंयुतैः|

जाङ्गलानां रसैर्यूषैर्मुद्गादीनां खडैरपि||१२३||

दाडिमाम्लैः ससर्पिष्कैर्दीपनग्राहिसंयुतैः|

तस्याग्निं दीपयेच्चूर्णैः सर्पिर्भिश्चापि तिक्तकैः||१२४||

avidāhibhirannaiśca laghubhistiktasaṁyutaiḥ|

jāṅgalānāṁ rasairyūṣairmudgādīnāṁ khaḍairapi||123||

dāḍimāmlaiḥ sasarpiṣkairdīpanagrāhisaṁyutaiḥ|

tasyāgniṁ dīpayēccūrṇaiḥ sarpirbhiścāpi tiktakaiḥ||124||

avidAhibhirannaishca laghubhistiktasaMyutaiH|

jA~ggalAnAM rasairyUShairmudgAdInAM khaDairapi||123||

dADimAmlaiH sasarpiShkairdIpanagrAhisaMyutaiH|

tasyAgniM dIpayeccUrNaiH sarpirbhishcApi tiktakaiH||124||

After proper ''shodhana'', diet which does not cause burning sensation, which is easy to digest and added with ingredients having bitter taste should be taken. Soup of animals of arid zone, soup of cereals such as ''mudga'', etc. and ''khada'' should be given.

Pomegranate having sour taste should be taken along with ghee, ''deepana'' and ''grahi dravyas''. With help of powders of ''deepaniya'' drugs and ghee fortified with bitter drugs, the digestive power should be increased (123-124).

==== ''Chandanadya ghrita'' ====

चन्दनं पद्मकोशीरं पाठां मूर्वां कुटन्नटम्|

षड्ग्रन्थासारिवास्फोतासप्तपर्णाटरूषकान्||१२५||

पटोलोदुम्बराश्वत्थवटप्लक्षकपीतनान्|

कटुकां रोहिणीं मुस्तं निम्बं च द्विपलांशिकम्||१२६||

द्रोणेऽपां साधयेत् पादशेषे प्रस्थं घृतात् पचेत्|

किराततिक्तेन्द्रयववीरामागधिकोत्पलैः||१२७||

कल्कैरक्षसमैः पेयं तत् पित्तग्रहणीगदे|

इति चन्दनाद्यं घृतम्

candanaṁ padmakōśīraṁ pāṭhāṁ mūrvāṁ kuṭannaṭam|

ṣaḍgranthāsārivāsphōtāsaptaparṇāṭarūṣakān||125||

paṭōlōdumbarāśvatthavaṭaplakṣakapītanān|

kaṭukāṁ rōhiṇīṁ mustaṁ nimbaṁ ca dvipalāṁśikam||126||

drōṇē'pāṁ sādhayēt pādaśēṣē prasthaṁ ghr̥tāt pacēt|

kirātatiktēndrayavavīrāmāgadhikōtpalaiḥ||127||

kalkairakṣasāmaiḥ pēyaṁ tat Pitta Grahaṇī gadē|

iti candanādyaṁ ghr̥tam

candanaM padmakoshIraM pAThAM mUrvAM kuTannaTam|

ShaDgranthAsArivAsphotAsaptaparNATarUShakAn||125||

paTolodumbarAshvatthavaTaplakShakapItanAn|

kaTukAM rohiNIM mustaM nimbaM ca dvipalAMshikam||126||

droNe~apAM sAdhayet pAdasheShe prasthaM ghRutAt pacet|

kirAtatiktendrayavavIrAmAgadhikotpalaiH||127||

kalkairakShasamaiH peyaM tat pittagrahaNIgade|

iti candanAdyaM ghRutam

Take two ''pala'' (96 gm) each of ''chandana, padmaka, usheera, patha, murva, kuthannatha'' (''kaivarta musta''), ''shadhgrantha'' (''vacha''), ''sariva, asphota'' (''aspurmallika''), ''saptaparna, aṭarushakana'' (''vasa''), ''patola, udumbara, ashvattha, vata, plaksa, kapeetana'' (''gandha musta''), ''kathuki, musta'' and ''nimba'' and prepare decoction by adding one ''drona'' (12.228 Kg) of water with 1/4th reduction. ''Ghrita siddhi'' is done adding one ''prastha'' (96 gm) of ghee to the above decoction and paste of one ''aksa'' (12 gm) each of ''kiratatikta, indrayava, vira, pippalī'' and ''utpala'' is added. This medicated ghee is known as ''chandanadya ghrita'' and is indicated in ''pittaja grahani'' [125-127]

तिक्तकं यद्घृतं चोक्तं कौष्ठिके तच्च दापयेत्||१२८||

tiktakaṁ yadghr̥taṁ cōktaṁ kauṣṭhikē tacca dāpayēt||128||

''Tikta ghrita'' as mentioned in [[Kushtha Chikitsa]] [Ca.Ci.7/140-150] may also be prescribed in ''pittaja grahani'' [128]

==== ''Nagaradya churna'' ====

नागरातिविषे मुस्तं धातकीं च रसाञ्जनम्|

वत्सकत्वक्फलं बिल्वं पाठां कटुकरोहिणीम्||१२९||

पिबेत् समांशं तच्चूर्णं सक्षौद्रं तण्डुलाम्बुना|

पैत्तिके ग्रहणीदोषे रक्तं यच्चोपवेश्यते||१३०||

अर्शांसि च गुदे शूलं जयेच्चैव प्रवाहिकाम्|

नागराद्यमिदं चूर्णं कृष्णात्रेयेण पूजितम्||१३१||

इति नागराद्यं चूर्णम्

nāgarātiviṣē mustaṁ dhātakīṁ ca rasāñjanam|

vatsakatvakphalaṁ bilvaṁ pāṭhāṁ kaṭukarōhiṇīm||129||

pibēt samāṁśaṁ taccūrṇaṁ sakṣaudraṁ taṇḍulāmbunā|

paittikē Grahaṇī dōṣē raktaṁ yaccōpavēśyatē||130||

arśāṁsi ca gudē śūlaṁ jayēccaiva pravāhikām|

nāgarādyamidaṁ cūrṇaṁ kr̥ṣṇātrēyēṇa pūjitam||131||

iti nāgarādyaṁ cūrṇam

nAgarAtiviShe mustaM dhAtakIM ca rasA~jjanam|

vatsakatvakphalaM bilvaM pAThAM kaTukarohiNIm||129||

pibet samAMshaM taccUrNaM sakShaudraM taNDulAmbunA|

paittike grahaNIdoShe raktaM yaccopaveshyate||130||

arshAMsi ca gude shUlaM jayeccaiva pravAhikAm|

nAgarAdyamidaM cUrNaM kRuShNAtreyeNa pUjitam||131||

iti nAgarAdyaM cUrNam

Take equal quantity of ''nagara, ativisha, musta, dhataki, rasanjana,'' bark and fruit of ''vatsaka, bilva, patha'' and ''katuki'' and powder together, is known as ''nagaradya churna'' explained by ''krishnatreyena''. It is to be taken along with honey and ''tandulodaka'' (rice water, prepared cold) by patient suffering from ''paittika grahani'' with bloody stools, hemorrhoids, pain in anal area and dysentery. [129-131]

==== ''Bhunimbadya churna'' ====

भूनिम्बकटुकाव्योषमुस्तकेन्द्रयवान् समान्|

द्वौ चित्रकाद्वत्सकत्वग्भागान् षोडश चूर्णयेत्||१३२||

गुडशीताम्बुना पीतं ग्रहणीदोषगुल्मनुत्|

कामलाज्वरपाण्डुत्वमेहारुच्यतिसारनुत्||१३३||

इति भूनिम्बाद्यं चूर्णम्

bhūnimbakaṭukāvyōṣamustakēndrayavān samān|

dvau citrakādvatsakatvagbhāgān ṣōḍaśa cūrṇayēt||132||

guḍaśītāmbunā pītaṁ Grahaṇī dōṣagulmanut|

kāmalājvarapāṇḍutvamēhārucyatisāranut||133||

iti bhūnimbādyaṁ cūrṇam

bhUnimbakaTukAvyoShamustakendrayavAn samAn|

dvau citrakAdvatsakatvagbhAgAn ShoDasha cUrNayet||132||

guDashItAmbunA pItaM grahaNIdoShagulmanut|

kAmalAjvarapANDutvamehArucyatisAranut||133||

iti bhUnimbAdyaM cUrNam

''Bhunimba, kutaki, trikatu, musta'' and ''indrayava'' are taken in equal quantity. Two parts of ''chitraka'' and 16 parts of bark and ''vatsaka'' are taken together and powdered. The combination is called as ''bhunimbadya churna'' is advised with jaggery and cold water as ''anupana'' in ''grahani dosha, gulma, kamala, jwara, pandu, prameha, aruchi'' and ''atisara'' [132-133]

वचामतिविषां पाठां सप्तपर्णं रसाञ्जनम्|

स्योनाकोदीच्यकट्वङ्गवत्सकत्वग्दुरालभाः||१३४||

दार्वीं पर्पटकं पाठां यवानीं मधुशिग्रुकम्|

पटोलपत्रं सिद्धार्थान् यूथिकां जातिपल्लवान्||१३५||

जम्ब्वाम्रबिल्वमध्यानि निम्बशाकफलानि च|

तद्रोगशममन्विच्छन् भूनिम्बाद्येन योजयेत्||१३६||

vacāmativiṣāṁ pāṭhāṁ saptaparṇaṁ rasāñjanam|

syōnākōdīcyakaṭvaṅgavatsakatvagdurālabhāḥ||134||

dārvīṁ parpaṭakaṁ pāṭhāṁ yavānīṁ madhuśigrukam|

paṭōlapatraṁ siddhārthān yūthikāṁ jātipallavān||135||

jambvāmrabilvāmadhyāni nimbaśākaphalāni ca|

tadrōgaśāmamanvicchan bhūnimbādyēna yōjayēt||136||

vacAmativiShAM pAThAM saptaparNaM rasA~jjanam|

syonAkodIcyakaTva~ggavatsakatvagdurAlabhAH||134||

dArvIM parpaTakaM pAThAM yavAnIM madhushigrukam|

paTolapatraM siddhArthAn yUthikAM jAtipallavAn||135||

jambvAmrabilvamadhyAni nimbashAkaphalAni ca|

tadrogashamamanvicchan bhUnimbAdyena yojayet||136||

The combination of ''vacha, ativisha, patha, saptaparna, rasanjana, syonaka, udeechya, kathvanga'' (type of ''syonaka'' having small fruits), bark of ''vatsaka, duralabha, darvi, parpataka, patha, yavani, madhushigru,'' leaf of ''patola, siddhartha, yuthika,'' fresh new leaf of ''jati,'' seeds of ''jambu'' and ''amra'', pulp of ''bilva'' and leaves and fruits of ''nimba'' is useful in all condition as mentioned for ''bhunimbadya churna'' [134-136]

==== ''Kiratadya churna'' ====

किराततिक्तः षड्ग्रन्था त्रायमाणा कटुत्रिकम्|

चन्दनं पद्मकोशीरं दार्वीत्वक् कटुरोहिणी||१३७||

कुटजत्वक्फलं मुस्तं यवानी देवदारु च|

पटोलनिम्बपत्रैलासौराष्ट्रयतिविषात्वचः||१३८||

मधुशिग्रोश्च बीजानि मूर्वा पर्पटकस्तथा|

तच्चूर्णं मधुना लेह्यं पेयं मद्यैर्जलेन वा||१३९||

हृत्पाण्डुग्रहणीरोगगुल्मशूलारुचिज्वरान्|

कामलां सन्निपातं च मुखरोगांश्च नाशयेत्||१४०||

इति किराताद्यं चूर्णम्

kirātatiktaḥ ṣaḍgranthā trāyamāṇā kaṭutrikam|

candanaṁ padmakōśīraṁ dārvītvak kaṭurōhiṇī||137||

kuṭajatvakphalaṁ mustaṁ yavānī dēvadāru ca|

paṭōlanimbapatrailāsaurāṣṭrayativiṣātvacaḥ||138||

madhuśigrōśca bījāni mūrvā parpaṭakastathā|

taccūrṇaṁ madhunā lēhyaṁ pēyaṁ madyairjalēna vā||139||

hr̥tpāṇḍuGrahaṇī rōgagulmaśūlārucijvarān|

kāmalāṁ sannipātaṁ ca mukharōgāṁśca nāśayēt||140||

iti kirātādyaṁ cūrṇam

kirAtatiktaH ShaDgranthA trAyamANA kaTutrikam|

candanaM padmakoshIraM dArvItvak kaTurohiNI||137||

kuTajatvakphalaM mustaM yavAnI devadAru ca|

paTolanimbapatrailAsaurAShTrayativiShAtvacaH||138||

madhushigroshca bIjAni mUrvA parpaTakastathA|

taccUrNaM madhunA lehyaM peyaM madyairjalena vA||139||

hRutpANDugrahaNIrogagulmashUlArucijvarAn|

kAmalAM sannipAtaM ca mukharogAMshca nAshayet||140||

iti kirAtAdyaM cUrNam

Mix powder of ''kiratatikta, shadgrantha, trayamana, trikatu, chandana, padmaka, usheera,'' bark of ''darvi, katurohini,'' bark and fruit of ''kutaja, mushta, yavani, devadaru, patola,'' leaves of ''nimba, ela, saurashtra, ativisha, tvak,'' seeds of ''madhushigru, murva'' and ''parpataka'' and prescribe it as linctus prepared with honey or may be taken with water or alcoholic preparation. This preparation is known as ''kiratadyam churna'' whih cures ''hridaya roga, pandu, grahaniroga, gulma, shula, aruchi, jwara, kamala, sannipatika'' type of diarrhea and eight types of ''mukharoga'' [137-140]

==== Treatment of ''kaphaja grahani'' ====

ग्रहण्यां श्लेष्मदुष्टायां वमितस्य यथाविधि|

कट्वम्ललवणक्षारैस्तिक्तैश्चाग्निं विवर्धयेत्||१४१||

grahaṇyāṁ ślēṣmaduṣṭāyāṁ vamitasya yathāvidhi|

kaṭvamlalavaṇakṣāraistiktaiścāgniṁ vivardhayēt||141||

grahaNyAM shleShmaduShTAyAM vamitasya yathAvidhi|

kaTvamlalavaNakShAraistiktaishcAgniM vivardhayet||141||

In ''kaphaja grahani'' first administer ''vamana'' and then increase ''agni'' (digestive power) with help of drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' [141]

पलाशं चित्रकं चव्यं मातुलुङ्गं हरीतकीम्|

पिप्पलीं पिप्पलीमूलं पाठां नागरधान्यकम्||१४२||

कार्षिकाण्युदकप्रस्थे पक्त्वा पादावशेषितम्|

पानीयार्थं प्रयुञ्जीत यवागूं तैश्च साधयेत्||१४३||

palāśaṁ citrakaṁ cavyaṁ mātuluṅgaṁ harītakīm|

pippalīṁ pippalīmūlaṁ pāṭhāṁ nāgaradhānyakam||142||

kārṣikāṇyudakaprasthē paktvā pādāvaśēṣitam|

pānīyārthaṁ prayuñjīta yavāgūṁ taiśca sādhayēt||143||

palAshaM citrakaM cavyaM mAtulu~ggaM harItakIm|

pippalIM pippalImUlaM pAThAM nAgaradhAnyakam||142||

kArShikANyudakaprasthe paktvA pAdAvasheShitam|

pAnIyArthaM prayu~jjIta yavAgUM taishca sAdhayet||143||

''Palasha, chitraka, chavya, matulunga, haritaki pippali, pippalimoola, patha, nagara'' and ''dhanyaka'' are taken each in 12 gm and decoction is prepared in one 768 ml of water and reduced to one fourth. This decoction is administered as a ''paniya'' (drink) or ''yavagu'' (gruel) prepared using this decoction [142-143]

शुष्कमूलकयूषेण कौलत्थेनाथवा पुनः|

कट्वम्लक्षारपटुना लघून्यन्नानि भोजयेत्||१४४||

अम्लं चानु पिबेत्तक्रं तक्रारिष्टमथापि वा|

मदिरां मध्वरिष्टं वा निगदं सीधुमेव वा||१४५||

śuṣkamūlakayūṣēṇa kaulatthēnāthavā punaḥ|

kaṭvamlakṣārapaṭunā laghūnyannāni bhōjayēt||144||

amlaṁ cānu pibēttakraṁ takrāriṣṭāmathāpi vā|

madirāṁ madhvariṣṭaṁ vā nigadaṁ sīdhumēva vā||145||

shuShkamUlakayUSheNa kaulatthenAthavA punaH|

kaTvamlakShArapaTunA laghUnyannAni bhojayet||144||

amlaM cAnu pibettakraM takrAriShTamathApi vA|

madirAM madhvariShTaM vA nigadaM sIdhumeva vA||145||

Soup of dried radish or ''kulatha'' is to be given regularly and repeatedly. Food which is easy to digest should be fortified with ''katu, amla, kshara'' and ''lavana rasa''. Patient should take such foods which are easy to digest, along with buttermilk slightly sour or ''takrarishtha, madira'' (medicated alcoholic preparation), ''madhvarishtha'' or well prepared ''seedhu'' [144-145]

==== ''Madhukasava'' ====

द्रोणं मधूकपुष्पाणां विडङ्गानां ततोऽर्धतः|

चित्रकस्य ततोऽर्धं स्यात्तथा भल्लातकाढकम्||१४६||

मञ्जिष्ठाष्टपलं [३२] चैव त्रिद्रोणेऽपां विपाचयेत्|

द्रोणशेषं तु तच्छीतं मध्वर्धाढकसंयुतम्||१४७||

एलामृणालागुरुभिश्चन्दनेन च रूषिते|

कुम्भे मासस्थितं जातमासवं तं प्रयोजयेत्||१४८||

ग्रहणीं दीपयत्येव बृंहणः [३३] कफपित्तजित्|

शोथं कुष्ठं किलासं च प्रमेहांश्च प्रणाशयेत्||१४९||

इति मधूकासवः

drōṇaṁ madhūkapuṣpāṇāṁ viḍaṅgānāṁ tatō'rdhataḥ|

citrakasya tatō'rdhaṁ syāttathā bhallātakāḍhakam||146||

mañjiṣṭhāṣṭapalaṁ [32] caiva tridrōṇē'pāṁ vipācayēt|

drōṇaśēṣaṁ tu tacchītaṁ madhvardhāḍhakasaṁyutam||147||

ēlāmr̥ṇālāgurubhiścandanēna ca rūṣitē|

kumbhē māsasthitaṁ jātamāsavaṁ taṁ prayōjayēt||148||

Grahaṇī ṁ dīpayatyēva br̥ṁhaṇaḥ [33] kaphaPittajit|

śōthaṁ kuṣṭhaṁ kilāsaṁ ca pramēhāṁśca praṇāśayēt||149||

iti madhūkāsavaḥ

droNaM madhUkapuShpANAM viDa~ggAnAM tato~ardhataH|

citrakasya tato~ardhaM syAttathA bhallAtakADhakam||146||

ma~jjiShThAShTapalaM [32] caiva tridroNe~apAM vipAcayet|

droNasheShaM tu tacchItaM madhvardhADhakasaMyutam||147||

elAmRuNAlAgurubhishcandanena ca rUShite|

kumbhe mAsasthitaM jAtamAsavaM taM prayojayet||148||

grahaNIM dIpayatyeva bRuMhaNaH [33] kaphapittajit|

shothaM kuShThaM kilAsaM ca pramehAMshca praNAshayet||149||

iti madhUkAsavaH

Take one ''drona'' (12.22 kg/l) flowers of ''madhuka,'' half ''drona'' (6.11 kg/l) of ''vidanga, chitraka'' half of ''vidanga'' i.e. 1/4th ''drona'' (3.05 kg/l), ''bhallataka'' one ''adhaka'' (3.073 kg) and eight ''pala'' (384 gm) of ''manjishtha'' and mix with three ''drona'' (36.66 kg/l) of water and reduce to one ''drona'' (12.22 L) and after the decoction comes to room temperature add half ''adhaka'' (1.53 kg) of honey. Keep this preparation in a pot lined with paste of ''ela, mrinala, agaru'' and ''chandana'' and store for period of one month till ''asava siddhi'' occurs. This preparation is called ''madhukasava'' and is useful in ''grahani,'' helps empowering of ''agni,'' promotes nutrition and normalizes ''kapha'' and ''pitta''. It is indicated in ''shotha, kushtha, kilasa'' and ''prameha'' [146-149]

मधूकपुष्पस्वरसं शृतमर्धक्षयीकृतम्|

क्षौद्रपादयुतं शीतं पूर्ववत् सन्निधापयेत्||१५०||

तं पिबन् ग्रहणीदोषाञ्जयेत् सर्वान् हिताशनः|

तद्वद्द्राक्षेक्षुखर्जूरस्वरसानासुतान् [३४] पिबेत्||१५१||

madhūkapuṣpasvarasaṁ śr̥tāmardhakṣayīkr̥tam|

kṣaudrapādayutaṁ śītaṁ pūrvavat sannidhāpayēt||150||

taṁ piban Grahaṇī dōṣāñjayēt sarvān hitāśanaḥ|

tadvaddrākṣēkṣukharjūrasvarasānāsutān [34] pibēt||151||

madhUkapuShpasvarasaM shRutamardhakShayIkRutam|

kShaudrapAdayutaM shItaM pUrvavat sannidhApayet||150||

taM piban grahaNIdoShA~jjayet sarvAn hitAshanaH|

tadvaddrAkShekShukharjUrasvarasAnAsutAn [34] pibet||151||

Boil ''svarasa'' of flowers of ''madhuka'' till reduced to half the quantity. When cooled one fourth of honey is added and kept for fermentation as mentioned above. This preparation relieves all types of ''grahani dosha'' provided patient takes ''pathya ahara''.

In the same manner fermentation of ''svarasa'' of ''draksha'' (grapes), sugarcane and date palm is helpful for the patient [150-151]

==== ''Duralabhasava'' ====

प्रस्थौ दुरालभाया द्वौ पस्थमामलकस्य च|

दन्तीचित्रकमुष्टी [३५] द्वे प्रत्यग्रं चाभयाशतम्||१५२||

चतुर्द्रोणेऽम्भसः पक्त्वा शीतं द्रोणावशेषितम्|

सगुडद्विशतं पूतं मधुनः कुडवायुतम्||१५३||

तद्वत् प्रियङ्गोः पिप्पल्या विडङ्गानां च चूर्णितैः|

कुडवैर्घृतकुम्भस्थं पक्षाज्जातं ततः पिबेत्||१५४||

ग्रहणीपाण्डुरोगार्शःकुष्ठवीसर्पमेहनुत्|

स्वरवर्णकरश्चैष रक्तपित्तकफापहः||१५५||

इति दुरालभासवः

prasthau durālabhāyā dvau prasthamāmalakasya ca|

dantīcitrakamuṣṭī [35] dvē pratyagraṁ cābhayāśatam||152||

caturdrōṇē'mbhasaḥ paktvā śītaṁ drōṇāvaśēṣitam|

saguḍadviśataṁ pūtaṁ madhunaḥ kuḍaVātatam||153||

tadvat priyaṅgōḥ pippalyā viḍaṅgānāṁ ca cūrṇitaiḥ|

kuḍavairghr̥takumbhasthaṁ pakṣājjātaṁ tataḥ pibēt||154||

Grahaṇī pāṇḍurōgārśaḥkuṣṭhavīsarpamēhanut|

svaravarṇakaraścaiṣa raktaPittakaphāpahaḥ||155||

iti durālabhāsavaḥ

prasthau durAlabhAyA dvau pasthamAmalakasya ca|

dantIcitrakamuShTI [35] dve pratyagraM cAbhayAshatam||152||

caturdroNe~ambhasaH paktvA shItaM droNAvasheShitam|

saguDadvishataM pUtaM madhunaH kuDavAyutam||153||

tadvat priya~ggoH pippalyA viDa~ggAnAM ca cUrNitaiH|

kuDavairghRutakumbhasthaM pakShAjjAtaM tataH pibet||154||

grahaNIpANDurogArshaHkuShThavIsarpamehanut|

svaravarNakarashcaiSha raktapittakaphApahaH||155||

iti durAlabhAsavaH

Boil two ''prastha'' (1.53 kg) each of ''duralabha'' and ''amalaki'', one ''mushthi'' each of ''danti'' and ''chitraka'' and two hundred matured fruits of ''haritaki'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.228 kg/l). When it comes to room temperature add two hundred ''pala'' (9600 gm) of jaggery and one ''kudava'' (192 gm) of honey as well as powder of ''priyangu, pippali'' and ''vidanga'' each in one ''kudava'' (192 gm) and keep in jar pasted with ghee on the inner wall for period of fifteen days. This preparation is known as ''duralabhasava'' and is indicated in ''grahani, pandu, arsha, kushtha, visarpa'' and ''prameha''. It promotes voice and complexion and cures ''raktapitta'' and other ''kaphaja'' disorders [152-155]

==== ''Moolasava'' ====

हरिद्रा पञ्चमूले द्वे वीरर्षभकजीवकम्|

एषां [३६] पञ्चपलान् भागांश्चतुर्द्रोणेऽम्भसः पचेत्||१५६||

द्रोणशेषे रसे पूते गुडस्य द्विशतं भिषक्|

चूर्णितान् कुडवार्धांशान् प्रक्षिपेच्च समाक्षिकान्||१५७||

प्रियङ्गुमुस्तमञ्जिष्ठाविडङ्गमधुकप्लवान्|

लोध्रं शाबरकं चैव मासार्धस्थं पिबेत्तु तम्||१५८||

एष मूलासवः सिद्धो दीपनो रक्तपित्तजित्|

आनाहकफहृद्रोगपाण्डुरोगाङ्गसादनुत्||१५९||

इति मूलासवः

haridrā pañcamūlē dvē vīrarṣabhakajīvakam|

ēṣāṁ [36] pañcapalān bhāgāṁścaturdrōṇē'mbhasaḥ pacēt||156||

drōṇaśēṣē rasē pūtē guḍasya dviśataṁ bhiṣak|

cūrṇitān kuḍavārdhāṁśān prakṣipēcca samākṣikān||157||

priyaṅgumustāmañjiṣṭhāviḍaṅgāmadhukaplavān|

lōdhraṁ śābarakaṁ caiva māsārdhasthaṁ pibēttu tam||158||

ēṣa mūlāsavaḥ siddhō dīpanō raktaPitta jit|

ānāhakaphahr̥drōgapāṇḍurōgāṅgasādanut||159||

iti mūlāsavaḥ

haridrA pa~jcamUle dve vIrarShabhakajIvakam|

eShAM [36] pa~jcapalAn bhAgAMshcaturdroNe~ambhasaH pacet||156||

droNasheShe rase pUte guDasya dvishataM bhiShak|

cUrNitAn kuDavArdhAMshAn prakShipecca samAkShikAn||157||

priya~ggumustama~jjiShThAviDa~ggamadhukaplavAn|

lodhraM shAbarakaM caiva mAsArdhasthaM pibettu tam||158||

eSha mUlAsavaH siddho dIpano raktapittajit|

AnAhakaphahRudrogapANDurogA~ggasAdanut||159||

iti mUlAsavaH

Boil five ''pala'' (240 gm) each of ''haridra,'' two types of ''panchamoola'' i.e. ''brihat'' and ''laghu panchamoola, veera'' (''shatavari''), ''rishabhaka, jeevaka'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.22 kg/l); to this add two hundred ''pala'' (9600 gm) of jaggery and half ''kudava'' (96 gm) of honey as well as powders of ''priyangu, musta, manjishtha, vidanga, madhuka, plava,'' and ''sabaraka lodhra'' and fermented for a fortnight. This ''mulasava'' does ''deepana'' and is effective in ''raktapitta, anaha, kaphaja vikara, hridroga, pandu'' and ''angasada'' [156-159]

==== ''Pindasava'' ====

प्रास्थिकं [३७] पिप्पलीं पिष्ट्वा गुडं मध्यं बिभीतकात्|

उदकप्रस्थसंयुक्तं यवपल्ले निधापयेत्||१६०||

तस्मात् पलं सुजातात्तु सलिलाञ्जलिसंयुतम्|

पिबेत्पिण्डासवो ह्येष रोगानीकविनाशनः||१६१||

स्वस्थोऽप्येनं पिबेन्मासं नरः स्निग्धरसाशनः [३८] |

इच्छंस्तेषामनुत्पत्तिं रोगाणां येऽत्र कीर्तिताः||१६२||

इति पिण्डासवः

prāsthikaṁ [37] pippalīṁ piṣṭvā guḍaṁ madhyaṁ bibhītakāt|

udakaprasthasaṁyuktaṁ yavapallē nidhāpayēt||160||

tasmāt palaṁ sujātāttu salilāñjalisaṁyutam|

pibētpiṇḍāsavō hyēṣa rōgānīkavināśanaḥ||161||

svasthō'pyēnaṁ pibēnmāsaṁ naraḥ snigdharasāśanaḥ [38] |

icchaṁstēṣāmanutpattiṁ rōgāṇāṁ yē'tra kīrtitāḥ||162||

iti piṇḍāsavaḥ

prAsthikaM [37] pippalIM piShTvA guDaM madhyaM bibhItakAt|

udakaprasthasaMyuktaM yavapalle nidhApayet||160||

tasmAt palaM sujAtAttu salilA~jjalisaMyutam|

pibetpiNDAsavo hyeSha rogAnIkavinAshanaH||161||

svastho~apyenaM pibenmAsaM naraH snigdharasAshanaH [38] |

icchaMsteShAmanutpattiM rogANAM ye~atra kIrtitAH||162||

iti piNDAsavaH

One ''prastha'' of ''pippali'' is mixed with jaggery and seed pulp of ''bibhitaki'' and to it one ''prastha'' of water is added and kept in a vessel covered with ''yava'' (barley) for fermentation; this is called as ''pindasava''. One ''pala'' (48 gm) of ''pindasava'' is mixed with one ''anjali'' (192 gm) of water and is given to patient. It is helpful in earlier mentioned disorders. Even a healthy person may take this preparation for period of one month and take unctuous and liquid diet (mainly soups). It helps in prevention of genesis of disease [160-162]

==== ''Madhvarishtha'' ====

नवे पिप्पलिमध्वाक्ते कलसेऽगुरुधूपिते|

मध्वाढकं जलसमं चूर्णानीमानि दापयेत्||१६३||

कुडवार्धं विडङ्गानां पिप्पल्याः कुडवं तथा|

चतुर्थिकांशां त्वक्क्षीरीं केशरं मरिचानि च||१६४||

त्वगेलापत्रकशटीक्रमुकातिविषाघनान्|

हरेण्वेल्वालुतेजोह्वापिप्पलीमूलचित्रकान्||१६५||

कार्षिकांस्तत् स्थितं मासमत ऊर्ध्वं प्रयोजयेत्|

मन्दं सन्दपयत्यग्निं करोति विषमं समम्||१६६||

हृत्पाण्डुग्रहणीरोगकुष्ठार्शःश्वयथुज्वरान्|

वातश्लेष्मामयांश्चान्यान्मध्वरिष्टो व्यपोहति||१६७||

इति मध्वरिष्टः

navē pippalīmadhvāktē kalasē'gurudhūpitē|

madhvāḍhakaṁ jalasāmaṁ cūrṇānīmāni dāpayēt||163||

kuḍavārdhaṁ viḍaṅgānāṁ pippalyāḥ kuḍavaṁ tathā|

caturthikāṁśāṁ tvakkṣīrīṁ kēśaraṁ maricāni ca||164||

tvagēlāpatrakaśaṭīkramukātiviṣāghanān|

harēṇvēlvālutējōhvāpippalīmūlacitrakān||165||

kārṣikāṁstat sthitaṁ māsāmata ūrdhvaṁ prayōjayēt|

mandaṁ sandapayatyāgniṁ karōti viṣāmaṁ sāmam||166||

hr̥tpāṇḍuGrahaṇī rōgakuṣṭhārśaḥśvayathujvarān|

Vātaślēṣmāmayāṁścānyānmadhvariṣṭō vyapōhati||167||

iti madhvariṣṭaḥ

nave pippalimadhvAkte kalase~agurudhUpite|

madhvADhakaM jalasamaM cUrNAnImAni dApayet||163||

kuDavArdhaM viDa~ggAnAM pippalyAH kuDavaM tathA|

caturthikAMshAM tvakkShIrIM kesharaM maricAni ca||164||

tvagelApatrakashaTIkramukAtiviShAghanAn|

hareNvelvAlutejohvApippalImUlacitrakAn||165||

kArShikAMstat sthitaM mAsamata UrdhvaM prayojayet|

mandaM sandapayatyagniM karoti viShamaM samam||166||

hRutpANDugrahaNIrogakuShThArshaHshvayathujvarAn|

vAtashleShmAmayAMshcAnyAnmadhvariShTo vyapohati||167||

iti madhvariShTaH

New earthen pot should be pasted internally by ''pippali'' and honey and fumigated with ''aguru''. One ''adhaka'' (3.073 kg) of honey and equal quantity of water should be added. To this add half ''kudava'' (1.53 kg) of powder of ''vidanga'' and one ''kudava'' (192 gm) of ''pippali,'' one fourth ''kudava'' (48 gm) of ''vamsha'' and one ''karsha'' (12 gm) each of ''tvak, ela, keshara, maricha, patra, sati, kramuka, ativisha, ghana'' (''chandana''), ''harenu, elvaluka, tejohva, pippalimoola'' and ''chitraka'' and fermented for period of one month and later on administered. It stimulates the power of digestion and regularizes the ''vishama agni''. It is useful in ''hridroga, pandu, grahani, kushtha, arsha, shvayathu, jwara'' and other disorders caused by ''vata'' and '' kapha dosha''. Thus, completes description of ''madhvariṣṭa'' [163-167]

समूलां पिप्पलीं क्षारौ द्वौ पञ्च लवणानि च|

मातुलुङ्गाभयारास्नाशटीमरिचनागरम्||१६८||

कृत्वा समांशं तच्चूर्णं पिबेत् प्रातः सुखाम्बुना|

श्लेष्मिके ग्रहणीदोषे बलवर्णाग्निवर्धनम्||१६९||

एतैरेवौषधैः सिद्धं सर्पिः पेयं समारुते|

samūlāṁ pippalīṁ kṣārau dvau pañca lavaṇāni ca|

mātuluṅgābhayārāsnāśaṭīmaricanāgaram||168||

kr̥tvā samāṁśaṁ taccūrṇaṁ pibēt prātaḥ sukhāmbunā|

ślēṣmikē Grahaṇī dōṣē balavarṇāgnivardhanam||169||

samUlAM pippalIM kShArau dvau pa~jca lavaNAni ca|

mAtulu~ggAbhayArAsnAshaTImaricanAgaram||168||

kRutvA samAMshaM taccUrNaM pibet prAtaH sukhAmbunA|

shleShmike grahaNIdoShe balavarNAgnivardhanam||169||

etairevauShadhaiH siddhaM sarpiH peyaM samArute|

''Pippali, pippalimoola,'' two types of ''kshara'' (''yavakshara, svarjikakshara''), five types of ''lavana, matulunga, haritaki, rasna, saṭi, maricha'' and ''nagara'' are taken in equal quantity and powdered and administered with warm water early in the morning. It cures ''kaphaja grahani dosha'' and improves ''bala,'' complexion and ''agni''.

''Ghrita'' fortified with above medicines is useful in ''kapha'' associated with ''vataja grahanidosha'' [168-169]

गौल्मिके षट्पलं प्रोक्तं भल्लातकघृतं च यत्||१७०||

gaulmikē ṣaṭpalaṁ prōktaṁ bhallātakaghr̥taṁ ca yat||170||

gaulmike ShaTpalaM proktaM bhallAtakaghRutaM ca yat||170||

''Satpala ghrita'' (Ca.Ci. 5/147-148) and ''bhallataka ghrita'' (Ca.Ci.5/143-146) as explained in [[Gulma Chikitsa]] may also be administered [170]

==== ''Ksharaghrita'' ====

बिडं कालोत्थलवणं सर्जिकायवशूकजम्|

सप्तलां कण्टकारीं च चित्रकं चेति दाहयेत्||१७१||

सप्तकृत्वः स्रुतस्यास्य क्षारस्य [३९] द्व्याढकेन तु|

आढकं सर्पिषः पक्त्वा पिबेदग्निविवर्धनम्||१७२||

इति क्षारघृत

biḍaṁ kālōtthalavaṇaṁ sarjikāyavaśūkajam|

saptalāṁ kaṇṭakārīṁ ca citrakaṁ cēti dāhayēt||171||

saptakr̥tvaḥ srutasyāsya kṣārasya [39] dvyāḍhakēna tu|

āḍhakaṁ sarpiṣaḥ paktvā pibēdAgnivivardhanam||172||

iti kṣāraghr̥tam

biDaM kAlotthalavaNaM sarjikAyavashUkajam|

saptalAM kaNTakArIM ca citrakaM ceti dAhayet||171||

saptakRutvaH srutasyAsya kShArasya [39] dvyADhakena tu|

ADhakaM sarpiShaH paktvA pibedagnivivardhanam||172||

iti kShAraghRutam

''Bida lavana, kalottha lavana, sarjikakshara, yavakshara, saptala, kanthakari'' and ''chitraka'' are burned together and later on mixed in water and filtered seven times. One ''adhaka'' (3.073 kg) of this ''kshara'' is added to one ''adhaka'' (3.073 kg) of ''ghrita'' and ''sneha siddhi'' is done. This ''ksharaghrita'' is indicated for increasing the digestive power [171-172]

समूलां पिप्पलीं पाठां चव्येन्द्रयवनागरम्|

चित्रकातिविषे हिङ्गु श्वदंष्ट्रां कटुरोहिणीम्||१७३||

वचां च कार्षिकं पञ्चलवणानां पलानि च|

दध्नः प्रस्थद्वये तैलसर्पिषोः कुडवद्वये||१७४||

खण्डीकृतानि निष्क्वाथ्य शनैरन्तर्गते रसे|

अन्तर्धूमं ततो दग्धवा चूर्णं कृत्वा घृताप्लुतम्||१७५||

पिबेत् पाणितलं तस्मिञ्जीर्णे स्यान्मधुराशनः|

वातश्लेष्मामयान्सर्वान्हन्याद्विषगरांश्च सः||१७६||

samūlāṁ pippalīṁ pāṭhāṁ cavyēndrayavanāgaram|

citrakātiviṣē hiṅgu śvadaṁṣṭrāṁ kaṭurōhiṇīm||173||

vacāṁ ca kārṣikaṁ pañcalavaṇānāṁ palāni ca|

dadhnaḥ prasthadvayē tailasarpiṣōḥ kuḍavadvayē||174||

khaṇḍīkr̥tāni niṣkvāthya śanairantargatē rasē|

antardhūmaṁ tatō dagdhavā cūrṇaṁ kr̥tvā ghr̥tāplutam||175||

pibēt pāṇitalaṁ tasmiñjīrṇē syānmadhurāśanaḥ|

Vātaślēṣmāmayānsarvānhanyādviṣagarāṁśca saḥ||176||

samUlAM pippalIM pAThAM cavyendrayavanAgaram|

citrakAtiviShe hi~ggu shvadaMShTrAM kaTurohiNIm||173||

vacAM ca kArShikaM pa~jcalavaNAnAM palAni ca|

dadhnaH prasthadvaye tailasarpiShoH kuDavadvaye||174||

khaNDIkRutAni niShkvAthya shanairantargate rase|

antardhUmaM tato dagdhavA cUrNaM kRutvA ghRutAplutam||175||

pibet pANitalaM tasmi~jjIrNe syAnmadhurAshanaH|

vAtashleShmAmayAnsarvAnhanyAdviShagarAMshca saH||176||

''Pippali, pippalimoola, patha, chavya, indrayava, nagara, chitraka, ativisha, hingu, svadamishthra'' (''gokshura''), ''katurohini'' and ''vacha'' are taken in one ''karsha'' (12 gm) quantity each. To this one ''pala'' (12 gm) of ''panchalavana'' is added along with two ''prastha'' of curds and two ''kudava'' (384 gm) of ''taila'' and ''ghrita''. The combination is boiled till water is completely evaporated. It is again burned by ''antaradhooma'' method and the end product is powdered and mixed with ghee its dosage is one ''panitala'' and when medicine gets digested patient is advised to take sweet diet. It is indicated in ''vata kaphaja'' disorders and in ''visha'' and ''gara visha'' [173-176]

==== ''Kshara'' preparations ====

भल्लातकं त्रिकटुकं त्रिफलां लवणत्रयम्|

अन्तर्धूमं द्विपलिकं गोपुरीषाग्निना दहेत्||१७७||

स क्षारः सर्पिषा पीतो भोज्ये वाऽप्यवचूर्णितः|

हृत्पाण्डुग्रहणीदोषगुल्मोदावर्तशूलनुत्||१७८||

bhallātakaṁ trikaṭukaṁ triphalāṁ lavaṇatrayam|

antardhūmaṁ dvipalikaṁ gōpurīṣāgninā dahēt||177||

sa kṣāraḥ sarpiṣā pītō bhōjyē vā'pyavacūrṇitaḥ|

hr̥tpāṇḍuGrahaṇī dōṣagulmōdāvartaśūlanut||178||

bhallAtakaM trikaTukaM triphalAM lavaNatrayam|

antardhUmaM dvipalikaM gopurIShAgninA dahet||177||

sa kShAraH sarpiShA pIto bhojye vA~apyavacUrNitaH|

hRutpANDugrahaNIdoShagulmodAvartashUlanut||178||

''Bhallataka, trikaṭu, triphala,'' three types of ''lavana'' (''saindhva, sauvarchala'' and ''bida'') should be burned by ''antaradhooma'' method with help of cow dung cakes. This ''kshara'' should be administered with ghee or by sprinkling over prepared food.

It is indicated in ''hridroga, pandu, grahanidosha, gulma, udavarta'' and pain (especially spasmodic pain)[177-178]

दुरालभां करञ्जौ द्वौ सप्तपर्णं सवत्सकम्|

षड्ग्रन्थां मदनं मूर्वां पाठामारग्वधं तथा||१७९||

गोमूत्रेण समांशानि कृत्वा चूर्णानि दाहयेत्|

दग्ध्वा च तं पिबेत् क्षारं ग्रहणीबलवर्धनम्||१८०||

durālabhāṁ karañjau dvau saptaparṇaṁ savatsakam|

ṣaḍgranthāṁ madanaṁ mūrvāṁ pāṭhāmāragvadhaṁ tathā||179||

gōmūtrēṇa samāṁśāni kr̥tvā cūrṇāni dāhayēt|

dagdhvā ca taṁ pibēt kṣāraṁ Grahaṇī balavardhanam||180||

durAlabhAM kara~jjau dvau saptaparNaM savatsakam|

ShaDgranthAM madanaM mUrvAM pAThAmAragvadhaM tathA||179||

gomUtreNa samAMshAni kRutvA cUrNAni dAhayet|

dagdhvA ca taM pibet kShAraM grahaNIbalavardhanam||180||

''Duralabha'', two types of ''karanja'' (''karanja, lata karanja''), ''saptaparna, vatsaka, sadgrantha'' (''vacha''), ''madanaphala, murva, patha'' and ''aragvadha'' should be mixed with equal quantity of ''gomutra'' and boiled and prepared as per ''kshara kalpana''. This ''kshara'' increases ''bala'' of ''grahani'' i.e. of ''agni'' [179-180]

भूनिम्बं रोहिणीं तिक्तां पटोलं निम्बपर्पटम्|

दहेन्माहिषमूत्रेण क्षार एषोऽग्निवर्धनः||१८१||

bhūnimbaṁ rōhiṇīṁ tiktāṁ paṭōlaṁ nimbaparpaṭam|

dahēnmāhiṣamūtrēṇa kṣāra ēṣō'gnivardhanaḥ||181||

bhUnimbaM rohiNIM tiktAM paTolaM nimbaparpaTam|

dahenmAhiShamUtreNa kShAra eSho~agnivardhanaH||181||

''Bhunimba, kutaki, tikta, patola, nimba'' and ''parpataka'' are burned with buffalo urine and prepared as per ''kshara kalpana''. Such ''kshara'' promotes ''agnibala'' [181]

द्वे हरिद्रे वचा कुष्ठं चित्रकः कटुरोहिणी|

मुस्तं च बस्तमूत्रेण दहेत् क्षारोऽग्निवर्धनः||१८२||

dvē haridrē vacā kuṣṭhaṁ citrakaḥ kaṭurōhiṇī|

mustaṁ ca bastamūtrēṇa dahēt kṣārō'gnivardhanaḥ||182||

dve haridre vacA kuShThaM citrakaH kaTurohiNI|

mustaM ca bastamUtreNa dahet kShAro~agnivardhanaH||182||

Two types of ''haridra'' (''haridra'' and ''daruharidra''), ''vacha, kuṣṭha, chitraka, kutaki'' and ''musta'' after mixing in goat's urine are burned and ''kshara'' is prepared as per ''kshara kalpana''. It helps in increasing ''agnibala'' [182]

==== ''Ksharagudika'' ====

चतुष्पलं सुधाकाण्डात्त्रिपलं लवणत्रयात्|

वार्ताकीकुडवं चार्कादष्टौ द्वे चित्रकात् पले||१८३||

दग्धानि वार्ताकुरसे गुटिका भोजनोत्तराः|

भुक्तं भुक्तं पचन्त्याशु कासश्वासार्शसां हिताः||१८४||

विसूचिकाप्रतिश्यायहृद्रोगशमनाश्च ताः|

इत्येषा क्षारगुटिका कृष्णात्रेयेण कीर्तिता||१८५||

इति क्षारगुडिका

catuṣpalaṁ sudhākāṇḍāttripalaṁ lavaṇatrayāt|

vārtākīkuḍavaṁ cārkādaṣṭau dvē citrakāt palē||183||

dagdhāni vārtākurasē guṭikā bhōjanōttarāḥ|

bhuktaṁ bhuktaṁ pacantyāśu kāsaśvāsārśasāṁ hitāḥ||184||

visūcikāpratiśyāyahr̥drōgaśāmanāśca tāḥ|

ityēṣā kṣāraguṭikā kr̥ṣṇātrēyēṇa kīrtitā||185||

iti kṣāraguḍikā

catuShpalaM sudhAkANDAttripalaM lavaNatrayAt|

vArtAkIkuDavaM cArkAdaShTau dve citrakAt pale||183||

dagdhAni vArtAkurase guTikA bhojanottarAH|

bhuktaM bhuktaM pacantyAshu kAsashvAsArshasAM hitAH||184||

visUcikApratishyAyahRudrogashamanAshca tAH|

ityeShA kShAraguTikA kRuShNAtreyeNa kIrtitA||185||

iti kShAraguDikA

Four ''pala'' (192 gm) of stems of ''sudha'', three ''pala'' (144 gm) of three types of ''lavana'' i.e. one ''pala'' (48 gm) each of ''saindhava, sauvarchala'' and ''bida'', one ''kudava'' (192 gm) of ''vartaki,'' eight ''pala'' (388 gm) of ''arka'' and two ''pala'' (96 gm) of ''chitraka'' are burned and the ''kshara'' thus prepared is triturated with ''svarasa'' of ''vartaku'' and pills are prepared. Its administration after food helps in quick digestion and useful in ''kasa, shvasa, arsha, vishuchika, pratishyaya'' and ''hridroga''. This preparation is called ''ksharagudika'' and is propounded by ''krishnatre'' [183-185]

==== ''Chaturtha-kshara'' ====

वत्सकातिविषे पाठां दुःस्पर्शां हिङ्गु चित्रकम्|

चूर्णीकृत्य पलाशाग्रक्षारे मूत्रस्रुते पचेत्||१८६||

आयसे भाजने सान्द्रात्तस्मात् [४०] कोलं सुखाम्बुना|

मद्यैर्वा ग्रहणीदोषशोथार्शःपाण्डुमान् पिबेत्||१८७||

इति चतुर्थक्षारः

vatsakātiviṣē pāṭhāṁ duḥsparśāṁ hiṅgu citrakam|

cūrṇīkr̥tya palāśāgrakṣārē mūtrasrutē pacēt||186||

āyasē bhājanē sāndrāttasmāt [40] kōlaṁ sukhāmbunā|

madyairvā Grahaṇī dōṣaśōthārśaḥpāṇḍumān pibēt||187||

iti caturthakṣāraḥ

vatsakAtiviShe pAThAM duHsparshAM hi~ggu citrakam|

cUrNIkRutya palAshAgrakShAre mUtrasrute pacet||186||

Ayase bhAjane sAndrAttasmAt [40] kolaM sukhAmbunA|

madyairvA grahaNIdoShashothArshaHpANDumAn pibet||187||

iti caturthakShAraH

''Vatsaka, ativisha, patha, duhasparsha, hingu'' and ''chitraka'' should be powdered together and mixed with ''palashagrakshara''. It is cooked in cow’s urine in an iron pan till it becomes semisolid. Its dosage is one ''kola'' (6 gm) to be taken with lukewarm water or with ''madya'' (medicated alcohol). It is indicated in ''grahanidosha, shotha, arsha'' and ''pandu''. The preparation is known as ''chaturtha kshara'' [186-187]

==== ''Panchamakshara'' ====

त्रिफलां कटभीं चव्यं बिल्वमध्यमयोरजः|

रोहिणीं कटुकां मुस्तं कुष्ठं पाठां च हिङ्गु च||१८८||

मधुकं मुष्ककयवक्षारौ त्रिकटुकं वचाम्|

विडङ्गं पिप्पलीमूलं स्वर्जिकां निम्बचित्रकौ||१८९||

मूर्वाजमोदेन्द्रयवान् गुडूचीं देवदारु च|

कार्षिकं लवणानां च पञ्चानां पलिकान्पृथक्||१९०||

भागान् दध्नि त्रिकुडवे घृततैलेन मूर्च्छितम्|

अन्तर्धूमं शनैर्दग्ध्वा तस्मात् पाणितलं पिबेत्||१९१||

सर्पिषा कफवातार्शोग्रहणीपाण्डुरोगवान्|

प्लीहमूत्रग्रहश्वासहिक्काकासक्रिमिज्वरान्||१९२||

शोषातिसारौ श्वयथुं प्रमेहानाहहृद्ग्रहान्|

हन्यात् सर्वविषं [४१] चैव क्षारोऽग्निजननो वरः||१९३||

जीर्णे रसैर्वा मधुरैरश्नीयात् पयसाऽपि वाइति पञ्चमक्षारः

triphalāṁ kaṭabhīṁ cavyaṁ bilvāmadhyāmayōrajaḥ|

rōhiṇīṁ kaṭukāṁ mustaṁ kuṣṭhaṁ pāṭhāṁ ca hiṅgu ca||188||

madhukaṁ muṣkakayavakṣārau trikaṭukaṁ vacām|

viḍaṅgaṁ pippalīmūlaṁ svarjikāṁ nimbacitrakau||189||

mūrvājamōdēndrayavān guḍūcīṁ dēvadāru ca|

kārṣikaṁ lavaṇānāṁ ca pañcānāṁ palikānpr̥thak||190||

bhāgān dadhni trikuḍavē ghr̥tatailēna mūrcchitam|

antardhūmaṁ śanairdagdhvā tasmāt pāṇitalaṁ pibēt||191||

sarpiṣā kaphavātārśōGrahaṇī pāṇḍurōgavān|

plīhamūtragrahaśvāsahikkākāsakrimijvarān||192||

śōṣātisārau śvayathuṁ pramēhānāhahr̥dgrahān|

hanyāt sarvaviṣaṁ [41] caiva kṣārō'gnijananō varaḥ||193||

jīrṇē rasairvā madhurairaśnīyāt payasā'pi vāiti pañcāmakṣāraḥ

triphalAM kaTabhIM cavyaM bilvamadhyamayorajaH|

rohiNIM kaTukAM mustaM kuShThaM pAThAM ca hi~ggu ca||188||

madhukaM muShkakayavakShArau trikaTukaM vacAm|

viDa~ggaM pippalImUlaM svarjikAM nimbacitrakau||189||

mUrvAjamodendrayavAn guDUcIM devadAru ca|

kArShikaM lavaNAnAM ca pa~jcAnAM palikAnpRuthak||190||

bhAgAn dadhni trikuDave ghRutatailena mUrcchitam|

antardhUmaM shanairdagdhvA tasmAt pANitalaM pibet||191||

sarpiShA kaphavAtArshograhaNIpANDurogavAn|

plIhamUtragrahashvAsahikkAkAsakrimijvarAn||192||

shoShAtisArau shvayathuM pramehAnAhahRudgrahAn|

hanyAt sarvaviShaM [41] caiva kShAro~agnijanano varaH||193||

jIrNe rasairvA madhurairashnIyAt payasA~api vAiti pa~jcamakShAraH

''Triphala, kaṭabhi, chavya,'' pulp of ''bilva'', powder of ''ayoraja'' (''mandura''), ''katutki, musta, kushtha, patha, hingu, madhuka, kshara'' of ''muskaka'' and ''yavakshara, trikatu, vacha, vidanga, pippalimoola, svarjikakshara, nimba, chitraka, murva, ajamoda, indrayava, guḍuchi'' and ''devadaru'' are taken in one ''karsha'' (12 gm) quantity and one ''pala'' each of five salts are taken. All are mixed with three ''kudavas'' (576 gm) of ''dadhi, ghrita'' and ''taila''. The mixture is burned by ''antardhooma'' method. One ''panitala'' is the dose which is given with ghee. It is indicated in ''kapha'' and ''vataja arsha, grahani, pandu, pleeha, mutragraha, svasa, hikka, kasa, krimi, jwara, sosha, atisara, sotha, prameha, anaha, hridgraha'' and in all types of toxicity.

It is one among the best stimulants of ''agni''. Once the medicine is digested ''mamsarasa'' or sweet diet or milk should be administered. This ends the explanation of the ''panchamakshara'' [188-193]

==== Treatment of ''tridoshaja grahani''====

त्रिदोषे विधिविद्वैद्यः पञ्च कर्माणि कारयेत्||१९४||

घृतक्षारासवारिष्टान् दद्याच्चाग्निविवर्धनान्|

क्रिया या चानिलादीनां निर्दिष्टा ग्रहणीं प्रति||१९५||

व्यत्यासात्तां समस्तां वा कुर्याद्दोषविशेषवित्|

tridōṣē vidhividvaidyaḥ pañca karmāṇi kārayēt||194||

ghr̥takṣārāsavāriṣṭān dadyāccāgnivivardhanān|

kriyā yā cānilādīnāṁ nirdiṣṭā Grahaṇī ṁ prati||195||

vyatyāsāttāṁ sāmastāṁ vā kuryāddōṣaviśēṣavit|

tridoShe vidhividvaidyaH pa~jca karmANi kArayet||194||

ghRutakShArAsavAriShTAn dadyAccAgnivivardhanAn|

kriyA yA cAnilAdInAM nirdiShTA grahaNIM prati||195||

vyatyAsAttAM samastAM vA kuryAddoShavisheShavit|

In ''tridoshaja grahani, [[Panchakarma]]'' should be carried out as per predominance of ''dosha''. Various ghee, ''kshara, asava'' and ''arishtha'' preparation useful in stimulation of ''agni'' should be administered.

Previously described line of treatment for ''vataja'' etc ''grahani'' should be accordingly followed. This line of treatment should be done either separately or jointly after finding the predominance of ''dosha'' [194-195]

स्नेहनं स्वेदनं शुद्धिर्लङ्घनं दीपनं च यत्||१९६||

चूर्णानि लवणक्षारमध्वरिष्टसुरासवाः|

विविधास्तक्रयोगाश्च दीपनानां च सर्पिषाम्||१९७||

ग्रहणीरोगिभिः सेव्याः

snēhanaṁ svēdanaṁ śuddhirlaṅghanaṁ dīpanaṁ ca yat||196||

cūrṇāni lavaṇakṣārāmadhvariṣṭasurāsavāḥ|

vividhāstakrayōgāśca dīpanānāṁ ca sarpiṣām||197||

Grahaṇī rōgibhiḥ sēvyāḥ

snehanaM svedanaM shuddhirla~gghanaM dIpanaM ca yat||196||

cUrNAni lavaNakShAramadhvariShTasurAsavAH|

vividhAstakrayogAshca dIpanAnAM ca sarpiShAm||197||

grahaNIrogibhiH sevyAH

''Snehana, swedana, shodhana, langhana, deepana,'' various powder preparation of ''lavana, kshara, madhvarishtha, surasava,'' various ''takra'' preparation, ''deepaniya ghrita'' are to be prescribed to the ''grahanidosha'' patient [196-197]

==== Treatment of various states of disease and ''dosha'' aggravation ====

क्रियां चावस्थिकीं शृणु|

ष्ठीवनं श्लैष्मिके रूक्षं दीपनं तिक्तसंयुतम्||१९८||

kriyāṁ cāvasthikīṁ śr̥ṇu|

ṣṭhīvanaṁ ślaiṣmikē rūkṣaṁ dīpanaṁ tiktasaṁyutam||198||

kriyAM cAvasthikIM shRuNu|

ShThIvanaM shlaiShmike rUkShaM dIpanaM tiktasaMyutam||198||

Henceforth treatment as per condition is being mentioned.

In ''kaphaja grahani'' if there is excess sputum, then ''ruksha'' (ununctuous) and ''deepana'' drugs having bitter taste should be administered [198]

सकृद्रूक्षं सकृत्स्निग्धं कृशे बहुकफे हितम्|

परीक्ष्यामं शरीरस्य दीपनं स्नेहसंयुतम्||१९९||

sakr̥drūkṣaṁ sakr̥tsnigdhaṁ kr̥śē bahukaphē hitam|

parīkṣyāmaṁ śarīrasya dīpanaṁ snēhasaṁyutam||199||

sakRudrUkShaM sakRutsnigdhaM kRushe bahukaphe hitam|

parIkShyAmaM sharIrasya dIpanaM snehasaMyutam||199||

If patient is weak, but ''kapha'' is excessive then alternately ununctous and unctuous therapies should be administered repeatedly. After complete examination; if ''pachana'' of ''ama'' has taken place than administer ghee fortified by ''deepaniya'' medicines [199]

दीपनं बहुपित्तस्य तिक्तं मधुरसंयुतम्|

बहुवातस्य तु स्नेहलवणाम्लयुतं हितम्||२००||

dīpanaṁ bahuPittasya tiktaṁ madhurasaṁyutam|

bahuVātasya tu snēhalavaṇāmlayutaṁ hitam||200||

dIpanaM bahupittasya tiktaM madhurasaMyutam|

bahuvAtasya tu snehalavaNAmlayutaM hitam||200||

If ''pitta'' is aggravated then ''deepana'' drugs having bitter taste along with medicines having sweet taste should be administered whereas if ''vata'' is aggravated then ''deepaniya'' drugs along with ''sneha, lavana'' and ''amla'' dominated drugs should be administered [200]

सन्धुक्षति तथा वह्निरेषां विधिवदिन्धनैः|

स्नेहमेव परं विद्याद्दुर्बलानलदीपनम्||२०१||

sandhukṣati tathā vahnirēṣāṁ vidhivadindhanaiḥ|

snēhamēva paraṁ vidyāddurbalānaladīpanam||201||

sandhukShati tathA vahnireShAM vidhivadindhanaiH|

snehameva paraM vidyAddurbalAnaladIpanam||201||

Proper management as mentioned in earlier verses stimulates the ''agni'' (digestive power). ''Sneha'' is the best among the ''deepana dravya'' which helps in stimulating the inefficient ''agni'' [201]

नालं स्नेहसमिद्धस्य शमायान्नं सुगुर्वपि|

मन्दाग्निरविपक्वं तु पुरीषं योऽतिसार्यते||२०२||

दीपनीयौषधैर्युक्तां घृतमात्रां पिबेत्तु सः|

तया समानः पवनः प्रसन्नो [४२] मार्गमास्थितः||२०३||

अग्नेः समीपचारित्वादाशु प्रकुरुते बलम्|

nālaṁ snēhasamiddhasya śamāyānnaṁ sugurvapi|

mandāgniravipakvaṁ tu purīṣaṁ yō'tisāryatē||202||

dīpanīyauṣadhairyuktāṁ ghr̥tamātrāṁ pibēttu saḥ|

tayā samānaḥ pavanaḥ prasannō [42] mārgamāsthitaḥ||203||

agnēḥ samīpacāritvādāśu prakurutē balam|

nAlaM snehasamiddhasya shamAyAnnaM sugurvapi|

mandAgniravipakvaM tu purIShaM yo~atisAryate||202||

dIpanIyauShadhairyuktAM ghRutamAtrAM pibettu saH|

tayA samAnaH pavanaH prasanno [42] mArgamAsthitaH||203||

agneH samIpacAritvAdAshu prakurute balam|

If the patient has inefficient digestive power and voids undigested food in excess in stools or frequency of motions is more, then appropriate quantity of ''ghrita'' fortified by ''deepana'' medicines should again be given. Thus, ''samana vata'' is regularized and moves in its normal tract. As ''samana vata'' is associated with ''agni'' it instantaneously promotes the strength of ''agni''.

Digestive power thus stimulated by ''ghrita'' cannot be suppressed even by heavy meals [202-203]

काठिन्याद्यः पुरीषं तु कृच्छ्रान्मुञ्चति मानवः||२०४||

सघृतं लवणैर्युक्तं नरोऽन्नावग्रहं पिबेत्|

kāṭhinyādyaḥ purīṣaṁ tu kr̥cchrānmuñcati mānavaḥ||204||

saghr̥taṁ lavaṇairyuktaṁ narō'nnāvagrahaṁ pibēt|

kAThinyAdyaH purIShaM tu kRucchrAnmu~jcati mAnavaH||204||

saghRutaM lavaNairyuktaM naro~annAvagrahaM pibet|

If patient finds difficulty in evacuation of stools due to hardness in stools then salt mixed ''ghrita'' should be administered in between the food.

('''Note''':''Lavana rasa'' has ''vata anulomana'' action and also increases secretions, therefore hardness of stool is reduced and stools are easily evacuated) [204]

रौक्ष्यान्मन्दे पिबेत्सर्पिस्तैलं वा दीपनैर्युतम्||२०५||

raukṣyānmandē pibētsarpistailaṁ vā dīpanairyutam||205||

raukShyAnmande pibetsarpistailaM vA dIpanairyutam||205||

If ''agni'' is suppressed due to ''ruksha guna'' then either ''ghrita'' or ''taila'' fortified with ''deepaniya'' drugs should be administered [205]

अतिस्नेहात्तु मन्देऽग्नौ चूर्णारिष्टासवा हिताः|

भिन्ने गुदोपलेपात्तु मले तैलसुरासवाः||२०६||

atisnēhāttu mandē'gnau cūrṇāriṣṭāsavā hitāḥ|

bhinnē gudōpalēpāttu malē tailasurāsavāḥ||206||

atisnehAttu mande~agnau cUrNAriShTAsavA hitAH|

bhinne gudopalepAttu male tailasurAsavAH||206||

If excessive intake of ''sneha'' is cause for ''agnimandya'' then powder preparation, ''arishta asava'' as mentioned earlier are beneficial; whereas if anal area gets adhered by unformed stools then ''taila, sura'' and ''asava'' preparation should be administered [206]

उदावर्तात्तु मन्देऽग्नौ निरूहाः स्नेहबस्तयः|

दोषवृद्ध्या तु मन्देऽग्नौ शुद्धो दोषविधिं चरेत्||२०७||

udāvartāttu mandē'gnau nirūhāḥ snēhabastayaḥ|

dōṣavr̥ddhyā tu mandē'gnau śuddhō dōṣavidhiṁ carēt||207||

udAvartAttu mande~agnau nirUhAH snehabastayaH|

doShavRuddhyA tu mande~agnau shuddho doShavidhiM caret||207||

If ''udavarta'' (mis-peristalsis) is responsible for suppression of ''agni'' then ''niruha'' and ''sneha basti'' should be administered; whereas if ''dosha vriddhi'' is the cause for suppression of ''agni'' then ''shodhana'' as per ''dosha'' is indicated [207]

व्याधियुक्तस्य मन्दे तु सर्पिरेवाग्निदीपनम्|

उपवासाच्च मन्देऽग्नौ यवागूभिः पिबेद्घृतम्||२०८||

अन्नावपीडितं बल्यं दीपनं बृंहणं च तत्|

vyādhiyuktasya mandē tu sarpirēvāgnidīpanam|

upavāsācca mandē'gnau yavāgūbhiḥ pibēdghr̥tam||208||

annāvapīḍitaṁ balyaṁ dīpanaṁ br̥ṁhaṇaṁ ca tat|

vyAdhiyuktasya mande tu sarpirevAgnidIpanam|

upavAsAcca mande~agnau yavAgUbhiH pibedghRutam||208||

If suppression of ''agni'' has taken place due to diseases than ''ghrita'' is best for ''agni deepana'' but if fasting is the causes of ''agni'' suppression than ''yavagu'' (gruel) along with ''ghrita'' should be taken. ''Ghrita'' when taken in between the meal, it increases the strength, stimulates the digestion and nourishes the body [208]

दीर्घकालप्रसङ्गात्तु क्षामक्षीणकृशान्नरान्||२०९||

प्रसहानां रसैः साम्लैर्भोजयेत् पिशिताशिनाम्|

लघु, तीक्ष्णोष्णशोधित्वाद्दीपयन्त्याशु तेऽनलम्||२१०||

मांसोपचितमांसत्वात्तथाऽऽशुतरबृंहणाः|

dīrghakālaprasaṅgāttu kṣāmakṣīṇakr̥śānnarān||209||

prasahānāṁ rasaiḥ sāmlairbhōjayēt piśitāśinām|

laghu, tīkṣṇōṣṇaśōdhitvāddīpayantyāśu tē'nalam||210||

māṁsōpacitamāṁsatvāttathā''śutarabr̥ṁhaṇāḥ|

annAvapIDitaM balyaM dIpanaM bRuMhaNaM ca tat|

dIrghakAlaprasa~ggAttu kShAmakShINakRushAnnarAn||209||

prasahAnAM rasaiH sAmlairbhojayet pishitAshinAm|

laghu, tIkShNoShNashodhitvAddIpayantyAshu te~analam||210||

mAMsopacitamAMsatvAttathA~a~ashutarabRuMhaNAH|

If ''agnimandya'' has been chronic and patient has become indolent, weak and emaciated then soup of ''prasaha'' group of animals (animals who snatch their food) fortified with ''amla'' drugs is advised. As this meat soups are light for digestion having penetrating, hot, purifying qualities stimulates the ''agni''. Further as the animals feed on other animals their meat ''mamsa'' is well nourished and compact therefore causes quick nourishment [209-210]

==== Factors affecting status of ''agni'' ====

नाभोजनेन कायाग्निर्दीप्यते नातिभोजनात्||२११||

यथा निरिन्धनो वह्निरल्पो वाऽतीन्धनावृतः|

nābhōjanēna kāyāgnirdīpyatē nātibhōjanāt||211||

yathā nirindhanō vahniralpō vā'tīndhanāvr̥taḥ|

nAbhojanena kAyAgnirdIpyate nAtibhojanAt||211||

yathA nirindhano vahniralpo vA~atIndhanAvRutaH|

Fasting or over eating does not stimulate ''agni'', as like fire in environment is extinguished if there is no fuel supply or if excessive fuel covers the ''agni''. [211]

स्नेहान्नविधिभिश्चित्रैश्चूर्णारिष्टसुरासवैः ||२१२||

सम्यक्प्रयुक्तैर्भिषजा बलमग्नेः प्रवर्धते|

यथा हि सारदार्वग्निः स्थिरः सन्तिष्ठते चिरम्||२१३||

snēhānnavidhibhiścitraiścūrṇāriṣṭasurāsavaiḥ [44] ||212||

samyakprayuktairbhiṣajā balāmagnēḥ pravardhatē|

yathā hi sāradārvAgniḥ sthiraḥ santiṣṭhatē ciram||213||

snehAnnavidhibhishcitraishcUrNAriShTasurAsavaiH [44] ||212||

samyakprayuktairbhiShajA balamagneH pravardhate|

yathA hi sAradArvagniH sthiraH santiShThate ciram||213||

Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishtha, sura'' and ''asava'' along with proper medication as per condition, enhances the power of ''agni'' similar to the environmental fire which remains stable for long duration when good hard wood catches fire [212-213]

स्नेहान्नविधिभिस्तद्वदन्तरग्निर्भवेत् स्थिरः|

हितं जीर्णे मितं चाश्नंश्चिरमारोग्यमश्नुते||२१४||

अवैषम्येण धातूनामग्निवृद्धौ यतेत ना|

समैर्दोषैः समो मध्ये देहस्योष्माऽग्निसंस्थितः||२१५||

पचत्यन्नं तदारोग्यपुष्ट्यायुर्बलवृद्धये|

दोषैर्मन्दोऽतिवृद्धो वा विषमैर्जनयेद्गदान्||२१६||

वाच्यं मन्दस्य तत्रोक्तमतिवृद्धस्य वक्ष्यते|

snēhānnavidhibhistadvadantarAgnirbhavēt sthiraḥ|

hitaṁ jīrṇē mitaṁ cāśnaṁściramārōgyāmaśnutē||214||

avaiṣamyēṇa dhātūnāmAgnivr̥ddhau yatēta nā|

sāmairdōṣaiḥ samō madhyē dēhasyōṣmā'gnisaṁsthitaḥ||215||

pacatyannaṁ tadārōgyapuṣṭyāyurbalavr̥ddhayē|

dōṣairmandō'tivr̥ddhō vā viṣāmairjanayēdgadān||216||

vācyaṁ mandasya tatrōktam ativr̥ddhasya vakṣyatē|

snehAnnavidhibhistadvadantaragnirbhavet sthiraH|

hitaM jIrNe mitaM cAshnaMshciramArogyamashnute||214||

avaiShamyeNa dhAtUnAmagnivRuddhau yateta nA|

samairdoShaiH samo madhye dehasyoShmA~agnisaMsthitaH||215||

pacatyannaM tadArogyapuShTyAyurbalavRuddhaye|

doShairmando~ativRuddho vA viShamairjanayedgadAn||216||

vAcyaM mandasya tatroktamativRuddhasya vakShyate|

Intake of food mixed with ''sneha'' and as per dietetic rules and regulation stabilizes the digestive power.

Eating wholesome diet in appropriate quantity after previously eaten food is digested helps in maintaining good health for long duration.

A person should workout so that ''agni vriddhi'' takes place without disturbing the balance of ''dhatus''. Such ''agni'' digests the food, maintains health and nourishment, promotes longevity and increases strength. The same ''dosha'' when vitiated causes ''mandagni, tikshnagni'' and ''vishamagni'' and such a vitiated ''agni'' gives rise to various diseases.

Management of ''mandagni'' has been explained previously henceforth management of ''ativriddha agni'' will be explained [214-216]

==== ''Samprapti'' of ''atyagni'' ====

नरे क्षीणकफे पित्तं कुपितं मारुतानुगम्||२१७||

स्वोष्मणा पावकस्थाने बलमग्नेः प्रयच्छति|

तदा लब्धबलो देहे विरूक्षे सानिलोऽनलः||२१८||

परिभूय पचत्यन्नं तैक्ष्ण्यादाशु मुहुर्मुहुः|

पक्त्वाऽन्नं स ततो धातूञ्छोणितादीन् पचत्यपि||२१९||

narē kṣīṇakaphē Pittaṁ kupitaṁ mārutānugam||217||

svōṣmaṇā pāvakasthānē balāmagnēḥ prayacchati|

tadā labdhabalō dēhē virūkṣē sānilō'nalaḥ||218||

paribhūya pacatyannaṁ taikṣṇyādāśu muhurmuhuḥ|

paktvā'nnaṁ sa tatō dhātūñchōṇitādīn pacatyapi||219||

nare kShINakaphe pittaM kupitaM mArutAnugam||217||

svoShmaNA pAvakasthAne balamagneH prayacchati|

tadA labdhabalo dehe virUkShe sAnilo~analaH||218||

paribhUya pacatyannaM taikShNyAdAshu muhurmuhuH|

paktvA~annaM sa tato dhAtU~jchoNitAdIn pacatyapi||219||

Person having diminished ''kapha'', aggravated ''pitta'' and associated ''vata'' leads to increase in the ''ushma'' of ''agni'' resulting in enhancing the capacity and power of ''agni''. In such patient if the body is already undernourished, ''vata'' increases which further strengths the ''agni'' wherein both, together with help of ''tikshna guna'' digests the food even if taken frequently. After digestion of food, the increased ''agni'' starts digesting ''rakta'', etc ''dhatus'' also [217-219]

ततो दौर्बल्यमातङ्कान्मृत्युं चोपनयेन्नरम्|

भुक्तेऽन्ने लभते शान्तिं जीर्णमात्रे प्रताम्यति||२२०||

तृट्श्वासदाहमूर्च्छाद्या व्याधयोऽत्यग्निसम्भवाः|

तमत्यग्निं गुरुस्निग्धशीतैर्मधुरविज्जलैः||२२१||

अन्नपानैर्नयेच्छान्तिं दीप्तमग्निमिवाम्बुभिः|

मुहुर्मुहुरजीर्णेऽपि भोज्यान्यस्योपहारयेत्||२२२||

निरिन्धनोऽन्तरं लब्ध्वा यथैनं न विपादयेत्|

tatō daurbalyamātaṅkānmr̥tyuṁ cōpanayēnnaram|

bhuktē'nnē labhatē śāntiṁ jīrṇamātrē pratāmyati||220||

tr̥ṭśvāsadāhamūrcchādyā vyādhayō'tyAgnisambhavāḥ|

tāmatyāgniṁ gurusnigdhaśītairmadhuravijjalaiḥ||221||

annapānairnayēcchāntiṁ dīptāmAgnimivāmbubhiḥ|

muhurmuhurajīrṇē'pi bhōjyānyasyōpahārayēt||222||

nirindhanō'ntaraṁ labdhvā yathainaṁ na vipādayēt|

tato daurbalyamAta~gkAnmRutyuM copanayennaram|

bhukte~anne labhate shAntiM jIrNamAtre pratAmyati||220||

tRuTshvAsadAhamUrcchAdyA vyAdhayo~atyagnisambhavAH|

tamatyagniM gurusnigdhashItairmadhuravijjalaiH||221||

annapAnairnayecchAntiM dIptamagnimivAmbubhiH|

muhurmuhurajIrNe~api bhojyAnyasyopahArayet||222||

nirindhano~antaraM labdhvA yathainaM na vipAdayet|

Consequently, the patient becomes weak and death may occur due to disease. The patient feels better on consuming the food but feels worn out along with blackouts when food is digested. Morbid thirst, dyspnea, burning sensation, fainting etc are observed in disease caused due to ''atyagni''.

Digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid same way as fire is extinguishes by water in nature. The patient should be administered food at regular interval although previously eaten meal is undigested so that ''atyagni'' due to lack of fuel does not digest the tissues [220-222]

==== Management of ''atyagni'' ====

पायसं कृशरां स्निग्धं पैष्टिकं गुडवैकृतम्||२२३||

अद्यात्तथौदकानूपपिशितानि भृतानि च|

मत्स्यान्विशेषतः श्लक्ष्णान्स्थिरतोयचरांस्तथा||२२४||

आविकं च भृतं मांसमद्यादत्यग्निनाशनम् [४६] |

pāyasaṁ kr̥śarāṁ snigdhaṁ paiṣṭikaṁ guḍavaikr̥tam||223||

adyāttathaudakānūpapiśitāni bhr̥tāni ca|

matsyānviśēṣataḥ ślakṣṇānsthiratōyacarāṁstathā||224||

āvikaṁ ca bhr̥taṁ māṁsāmadyādatyāgnināśanam [46] |

pAyasaM kRusharAM snigdhaM paiShTikaM guDavaikRutam||223||

adyAttathaudakAnUpapishitAni bhRutAni ca|

matsyAnvisheShataH shlakShNAnsthiratoyacarAMstathA||224||

AvikaM ca bhRutaM mAMsamadyAdatyagninAshanam [46] |

''Payasa'' (milk pudding), ''krishara'' (thick gruel prepared of rice and lentils), ''snigdha'' (unctuous), ''paiṣṭika'' (resembling flour paste), various jaggery products, meat of aquatic animals or marshy area especially fish which is mainly in smooth (not salty) and stable water and roasted meat of sheep may be given to pacify the ''atyagni'' [223-224]

यवागूं समधूच्छिष्टां घृतं वा क्षुधितः पिबेत्||२२५||

गोधूमचूर्णमन्थं वा व्यधयित्वा सिरां पिबेत्|

पयो वा शर्करासर्पिर्जीवनीयौषधैः शृतम्||२२६||

yavāgūṁ sāmadhūcchiṣṭāṁ ghr̥taṁ vā kṣudhitaḥ pibēt||225||

gōdhūmacūrṇāmanthaṁ vā vyadhayitvā sirāṁ pibēt|

payō vā śarkarāsarpirjīvanīyauṣadhaiḥ śr̥tam||226||

yavAgUM samadhUcchiShTAM ghRutaM vA kShudhitaH pibet||225||

godhUmacUrNamanthaM vA vyadhayitvA sirAM pibet|

payo vA sharkarAsarpirjIvanIyauShadhaiH shRutam||226||

''Yavagu'' (thick gruel) mixed with bee wax or ''ghrita'' should be given whenever patient feels hungry. ''Mantha'' prepared from wheat flour or venesection may be advised. Milk medicated with ''jeevaniya'' group of drugs along with sugar and ''ghrita'' may be given [225-226]

फलानां तैलयोनीनामुत्क्रुञ्चाश्च [४७] सशर्कराः|

मार्दवं जनयन्त्यग्नेः स्निग्धा मांसरसास्तथा||२२७||

phalānāṁ tailayōnīnāmutkruñcāśca [47] saśarkarāḥ|

mārdavaṁ janayantyagnēḥ snigdhā māṁsarasāstathā||227||

phalAnAM tailayonInAmutkru~jcAshca [47] sasharkarAH|

mArdavaM janayantyagneH snigdhA mAMsarasAstathA||227||

Paste of fruits, substances containing oil like ''tila'' (sesame seeds) with sugar and meat soup with ghee pacifies the ''agni'' [227]

पिबेच्छीताम्बुना सर्पिर्मधूच्छिष्टेन संयुतम्|

गोधूमचूर्णं पयसा ससर्पिष्कं पिबेन्नरः||२२८||

आनूपरससिद्धान् वा त्रीन् स्नेहांस्तैलवर्जितान्|

पयसा सम्मितं [४८] चापि घनं त्रिस्नेहसंयुतम्||२२९||

नारिस्तन्येन संयुक्तां पिबेदौदुम्बरीं त्वचम्|

ताभ्यां वा पायसं सिद्धमद्यादत्यग्निशान्तये||२३०||

pibēcchītāmbunā sarpirmadhūcchiṣṭēna saṁyutam|

gōdhūmacūrṇaṁ payasā sasarpiṣkaṁ pibēnnaraḥ||228||

ānūparasasiddhān vā trīn snēhāṁstailavarjitān|

payasā sammitaṁ [48] cāpi ghanaṁ trisnēhasaṁyutam||229||

nāristanyēna saṁyuktāṁ pibēdaudumbarīṁ tvacam|

tābhyāṁ vā pāyasaṁ siddhāmadyādatyāgniśāntayē||230||

pibecchItAmbunA sarpirmadhUcchiShTena saMyutam|

godhUmacUrNaM payasA sasarpiShkaM pibennaraH||228||

AnUparasasiddhAn vA trIn snehAMstailavarjitAn|

payasA sammitaM [48] cApi ghanaM trisnehasaMyutam||229||

nAristanyena saMyuktAM pibedaudumbarIM tvacam|

tAbhyAM vA pAyasaM siddhamadyAdatyagnishAntaye||230||

The patient should take ''ghrita'' with beeswax along with cold water as ''anupana''. Patient may take wheat flour with milk and ghee.

Patient may be advised to take three ''sneha'' i.e. ghee, abinal fat, bone-marrow fortified with meat soup of animals residing in marshy areas. Milk mixed with wheat flour and curd along with three ''sneha'' (''ghrita, vasa, majja'') may be given. Bark of ''udumbara'' mixed with human milk and milk pudding prepared from ''udumbara'' and human milk helps in pacifying the ''atyagni'' [228-230]

श्यामात्रिवृद्विपक्वं वा पयो दद्याद्विरेचनम्|

असकृत् पित्तशान्त्यर्थं पायसप्रतिभोजनम्||२३१||

प्रसमीक्ष्य भिषक् प्राज्ञस्तस्मै दद्याद्विधानवित्|

śyāmātrivr̥dvipakvaṁ vā payō dadyādvirēcanam|

asakr̥t Pitta śāntyarthaṁ pāyasapratibhōjanam||231||

prasamīkṣya bhiṣak prājñastasmai dadyādvidhānavit|

shyAmAtrivRudvipakvaM vA payo dadyAdvirecanam|

asakRut pittashAntyarthaM pAyasapratibhojanam||231||

prasamIkShya bhiShak prAj~jastasmai dadyAdvidhAnavit|

Milk medicated with ''syama'' and ''trivritta'' may be advised for ''virechana'' for alleviating the ''pitta'' followed by diet of milk pudding. Expert physician should follow the line of treatment after proper examination of patient [231]

यत्किञ्चिन्मधुरं मेद्यं श्लेष्मलं गुरुभोजनम्||२३२||

सर्वं तदत्यग्निहितं भुक्त्वा प्रस्वपनं दिवा|

मेद्यान्यन्नानि योऽत्यग्नावप्रतान्तः [४९] समश्नुते||२३३||

न तन्निमित्तं व्यसनं लभते पुष्टिमेव च|

कफे वृद्धे जिते पित्ते मारुते चानलः समः||२३४||

yatkiñcinmadhuraṁ mēdyaṁ ślēṣmalaṁ gurubhōjanam||232||

sarvaṁ tadatyāgnihitaṁ bhuktvā prasvapanaṁ divā|

mēdyānyannāni yō'tyagnāvapratāntaḥ [49] sāmaśnutē||233||

na tannimittaṁ vyasanaṁ labhatē puṣṭimēva ca|

kaphē vr̥ddhē jitē pittē mārutē cānalaḥ sāmaḥ||234||

sāmadhātōḥ pacatyannaṁ puṣṭyāyurbalavr̥ddhayē|

yatki~jcinmadhuraM medyaM shleShmalaM gurubhojanam||232||

sarvaM tadatyagnihitaM bhuktvA prasvapanaM divA|

medyAnyannAni yo~atyagnAvapratAntaH [49] samashnute||233||

na tannimittaM vyasanaM labhate puShTimeva ca|

kaphe vRuddhe jite pitte mArute cAnalaH samaH||234||

samadhAtoH pacatyannaM puShTyAyurbalavRuddhaye|

Foods which are sweet in taste, fatty, increases ''kapha'' and heavy to digest should be given. All food items are good for ''atyagni'' and sleeping after meals during day time is beneficial in ''atyagni''. Patient who takes fatty diet even though he is not hungry does not succumb to death. If he is suffering from ''atyagni'' on the other hand such diet pattern is nutritional. Whenever due to medication and diet, ''kapha'' is increased; it subdues ''pitta'' and ''vata'' and normalizes the ''agni''.

When ''dhatus'' are in equilibrium ''anna'' gets digested resulting in increase in nutrition, longevity and strength [232-234]

==== Improper dietary habits ====

भवन्ति चात्र-

पथ्यापथ्यमिहैकत्र भुक्तं समशनं मतम्||२३५||

विषमं बहु वाऽल्पं वाऽप्यप्राप्तातीतकालयोः|

भुक्तं पूर्वान्नशेषे तु पुनरध्यशनं मतम्||२३६||

त्रीण्यप्येतानि मृत्युं वा घोरान् व्याधीन्सृजन्ति वा|

bhavanti cātra-

pathyāpathyamihaikatra bhuktaṁ sāmaśanaṁ matam||235||

viṣāmaṁ bahu vā'lpaṁ vā'pyaprāptātītakālayōḥ|

bhuktaṁ pūrvānnaśēṣē tu punaradhyaśanaṁ matam||236||

trīṇyapyētāni mr̥tyuṁ vā ghōrān vyādhīnsr̥janti vā|

bhavanti cAtra-

pathyApathyamihaikatra bhuktaM samashanaM matam||235||

viShamaM bahu vA~alpaM vA~apyaprAptAtItakAlayoH|

bhuktaM pUrvAnnasheShe tu punaradhyashanaM matam||236||

trINyapyetAni mRutyuM vA ghorAn vyAdhInsRujanti vA|

Taking of wholesome and unwholesome foods together in diet is known as ''samashana''.

''Vishamashana'' is defined as taking food either in excess quantity or very little quantity and also if taken before or after appropriate time.

''Adhyashana'' is having food even though previously eaten food is not yet digested.

All the above three are causes for death or give rise to serious disorders [235-236]

==== Variation in digestion as per day-night cycle ====

प्रातराशे त्वजीर्णेऽपि सायमाशो न दुष्यति||२३७||

दिवा प्रबुध्यतेऽर्केण हृदयं पुण्डरीकवत्|

तस्मिन्विबुद्धे स्रोतांसि स्फुटत्वं यान्ति सर्वशः||२३८||

व्यायामाच्च विहाराच्च विक्षिप्तत्वाच्च चेतसः|

न क्लेदमुपगच्छन्ति दिवा तेनास्य धातवः||२३९||

prātarāśē tvajīrṇē'pi sāyamāśō na duṣyati||237||

divā prabudhyatē'rkēṇa hr̥dayaṁ puṇḍarīkavat|

tasminvibuddhē srōtāṁsi sphuṭatvaṁ yānti sarvaśaḥ||238||

vyāyāmācca vihārācca vikṣiptatvācca cētasaḥ|

na klēdamupagacchanti divā tēnāsya dhātavaḥ||239||

prAtarAshe tvajIrNe~api sAyamAsho na duShyati||237||

divA prabudhyate~arkeNa hRudayaM puNDarIkavat|

tasminvibuddhe srotAMsi sphuTatvaM yAnti sarvashaH||238||

vyAyAmAcca vihArAcca vikShiptatvAcca cetasaH|

na kledamupagacchanti divA tenAsya dhAtavaH||239||

If morning eaten food is undigested and still if anyone takes evening food it may not be more vitiative since in day time all the ''srotas'' (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of ''kleda'' (excess moisture) in various ''dhatus'' [237-239]

अक्लिन्नेष्वन्नमासिक्तमन्यत्तेषु न दुष्यति|

अविदग्ध इव क्षीरे क्षीरमन्यद्विमिश्रितम्||२४०||

नैव दूष्यति तेनैव समं सम्पद्यते यथा|

aklinnēṣvannamāsiktāmanyattēṣu na duṣyati|

avidagdha iva kṣīrē kṣīrāmanyadvimiśritam||240||

naiva dūṣyati tēnaiva sāmaṁ sampadyatē yathā|

aklinneShvannamAsiktamanyatteShu na duShyati|

avidagdha iva kShIre kShIramanyadvimishritam||240||

naiva dUShyati tenaiva samaM sampadyate yathA|

As unspoiled milk when mixed with fresh milk, the mixture does not get spoiled and will get uniformly mixed, so is the condition when in daytime previously eaten food although not digested still a person can digest another meal [240]

रात्रौ तु हृदये म्लाने संवृतेष्वयनेषु च|

यान्ति कोष्ठे परिक्लेदं संवृते देहधातवः||२४१||

क्लिन्नेष्वन्यदपक्वेषु तेष्वासिक्तं प्रदुष्यति|

विदग्धेषु पयःस्वन्यत् पयस्तप्तमिवार्पितम्||२४२||

नैशेष्वाहारजातेषु नाविपक्वेषु बुद्धिमान्|

तस्मादन्यत्समश्नीयात्पालयिष्यन्बलायुषी||२४३||

rātrau tu hr̥dayē mlānē saṁvr̥tēṣvayanēṣu ca|

yānti kōṣṭhē pariklēdaṁ saṁvr̥tē dēhadhātavaḥ||241||

klinnēṣvanyadapakvēṣu tēṣvāsiktaṁ praduṣyati|

vidagdhēṣu payaḥsvanyat payastaptamivārpitam||242||

naiśēṣvāhārajātēṣu nāvipakvēṣu buddhimān|

tasmādanyatsāmaśnīyātpālayiṣyanbalāyuṣī||243||

rAtrau tu hRudaye mlAne saMvRuteShvayaneShu ca|

yAnti koShThe parikledaM saMvRute dehadhAtavaH||241||

klinneShvanyadapakveShu teShvAsiktaM praduShyati|

vidagdheShu payaHsvanyat payastaptamivArpitam||242||

naisheShvAhArajAteShu nAvipakveShu buddhimAn|

tasmAdanyatsamashnIyAtpAlayiShyanbalAyuShI||243||

In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''dhatus'' and if another food is taken the indigestion causes more ''apakva ahara rasa'' causing disease. The condition resembles, wherein uncooked milk mixed with warm milk gets spoiled. Therefore, a wise person should not take meals if food taken at night is not digested; this will surely effect strength and life of a person [241-243]

==== Summary ====

तत्र श्लोकाः-

अन्तरग्निगुणा देहं यथा धारयते च सः|

यथाऽन्नं पच्यते यांश्च यथाऽऽहारः करोत्यपि||२४४||

येऽग्नयो यांश्च पुष्यन्ति यावन्तो ये पचन्ति यान्|

रसादीनां क्रमोत्पत्तिर्मलानां तेभ्य एव च||२४५||

वृष्याणामाशुकृद्धेतुर्धातुकालोद्भवक्रमः|

रोगैकदेशकृद्धेतुरन्तरग्निर्यथाऽधिकः||२४६||

प्रदुष्यति यथा दुष्टो यान् रोगाञ्जनयत्यपि|

ग्रहणी या यथा [५३] यच्च ग्रहणीदोषलक्षणम्||२४७||

पूर्वरूपं पृथक् चैव व्यञ्जनं सचिकित्सितम्|

चतुर्विधस्य निर्दिष्टं तथा चावस्थिकी क्रिया||२४८||

जायते च यथाऽत्यग्निर्यच्च तस्य चिकित्सितम्|

उक्तवानिह तत् सर्वं ग्रहणीदोषके मुनिः||२४९||

tatra ślōkāḥ-

antarAgniguṇā dēhaṁ yathā dhārayatē ca saḥ|

yathā'nnaṁ pacyatē yāṁśca yathā''hāraḥ karōtyapi||244||

yē'gnayō yāṁśca puṣyanti yāvantō yē pacanti yān|

rasādīnāṁ kramōtpattirmalānāṁ tēbhya ēva ca||245||

vr̥ṣyāṇāmāśukr̥ddhēturdhātukālōdbhavakrāmaḥ|

rōgaikadēśakr̥ddhēturantarAgniryathā'dhikaḥ||246||

praduṣyati yathā duṣṭō yān rōgāñjanayatyapi|

Grahaṇī yā yathā [53] yacca Grahaṇī dōṣalakṣaṇam||247||

pūrvarūpaṁ pr̥thak caiva vyañjanaṁ sacikitsitam|

caturvidhasya nirdiṣṭaṁ tathā cāvasthikī kriyā||248||

jāyatē ca yathā'tyAgniryacca tasya cikitsitam|

uktavāniha tat sarvaṁ Grahaṇī dōṣakē muniḥ||249||

tatra shlokAH-

antaragniguNA dehaM yathA dhArayate ca saH|

yathA~annaM pacyate yAMshca yathA~a~ahAraH karotyapi||244||

ye~agnayo yAMshca puShyanti yAvanto ye pacanti yAn|

rasAdInAM kramotpattirmalAnAM tebhya eva ca||245||

vRuShyANAmAshukRuddheturdhAtukAlodbhavakramaH|

rogaikadeshakRuddheturantaragniryathA~adhikaH||246||

praduShyati yathA duShTo yAn rogA~jjanayatyapi|

grahaNI yA yathA [53] yacca grahaNIdoShalakShaNam||247||

pUrvarUpaM pRuthak caiva vya~jjanaM sacikitsitam|

caturvidhasya nirdiShTaM tathA cAvasthikI kriyA||248||

jAyate ca yathA~atyagniryacca tasya cikitsitam|

uktavAniha tat sarvaM grahaNIdoShake muniH||249||

To conclude, this chapter has addressed the following points:
#Qualities of ''antaragni'',
#Manner in which ''agni'' does ''dharana'' (sustenance) of the body,
#Manner in which food is digested,
#How digested food functions?
#How different types of ''agni'' does nutrition after digesting the fuel?
#Development of ''rasadi dhatus'' and their associated waste products after digestions at ''dhatu'' level (tissue level)
#How aphrodisiacs act instantly and time taken for the ''dhatu'' formation and order of development?
#Reason why diseases are located in one part of the body and role of ''antaragni'' in disease formation,
#Diseases caused by abnormal ''agni''
#Definition of ''grahani'' and sign and symptoms of ''grahani dosha'',
#Premonitory symptoms along with four types of ''grahani dosha'' their signs and symptoms with treatment as per various condition,
#How condition of ''atyagni'' is generated and its treatment. [244-249]

इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने

ग्रहणीचिकित्सितं नाम पञ्चदशोऽध्यायः||१५||

ityAgnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē

Grahaṇī cikitsitaṁ nāma pañcadaśō'dhyāyaḥ||15||

ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne

grahaNIcikitsitaM nAma pa~jcadasho~adhyAyaH||15||

Herewith, fifteenth chapter related to [[Grahani Chikitsa]] which was unavailable as part of [[Chikitsa Sthana]] of Agnivesha Tantra supplemented by Dridhabala has been completed (15).

=== ''Tattva Vimarsha'' ===

*''Dehagni'' (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''ojas'', normal body temperature and various other forms of ''agni''. Even the existence of an individual is said to be because of ''dehagni'' (3).
*When the ''agni'' stops functioning, the individual dies; if the ''agni'' functions normally, the individual can lead a healthy and long life. Similarly, if the ''agni'' becomes abnormal, the individual suffers from various diseases; and hence, the ''agni'' is said to be the root cause of health and longevity (4).
*Normal functioning of ''agni'' is essential to make the consumed food capable of nourishing the body tissues and of promoting the ''ojas'' (vital essence), strength, complexion etc. In the absence of normal digestion (and metabolism), the normal body tissues such as ''rasa'' cannot be formed nor nourished (5).
*''Vata dosha'', specifically ''prana vata'' and ''samana vata'' play significant role in process of digestion and metabolism.
*Three ''doshas'' are produced in three consequent stages of digestion after consumption of food. ''Kapha'' is produced in first stage of ''madhura avasthapaka''; pitta in second stage of ''amla avasthapaka'' and ''vata'' is produced in third stage of ''katu avasthapaka''. The site of production and time of production of ''dosha'' is in sequence as the process of digestion proceeds. Increase or decrease in quantity of ''dosha'' depends upon similarity or dis-similarity of basic composition of food consumed.
*The first phase of digestion is carried out by ''jatharagni'', second phase by ''bhutagni'' and third phase by ''dhatvagni''. These are different levels of action of ''agni'' where various digestive and metabolic processes take place.
*During the processing by ''dhatvagni, stanya'' (breast milk) and the menstrual blood are derived after ''rasa''. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''rakta''. ''Vasa''(fat) and the six layers of ''tvacha'' (skin) are derived after ''mamsa'' (muscle) and ''snayu''(ligament) are derived after ''medas'' (adipose tissue) (17).
*The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kiṭṭa'' of ''rasa'' is ''mala-kapha'' (excretions). ''Mala-pitta'' (bile pigment) is the ''kitta'' of ''rakta''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''mamsa''. ''Sweda'' (sweat) is the ''mala'' of ''medas''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''mala'' of ''asthi''. The ''mala'' of ''majja'' is the oily excretion of the eye and the skin (sebum). Thus, the ''dhatus'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''dhatu'' is thus inter dependent (18-19½ ).
*Disorders of various factors mentioned above shall be treated after considering the original ''dhatu'' from which the factor is derived.
*''Vyana vata'' forcefully propels the ''rasa dhatu'' out of the heart and spreads it all over the body simultaneously, continuously and for the entire life (36).
*Disease is produced only at the site of abnormality of body systems.
*Life and strength of an individual depends on ''agni'' hence one should take utmost care to maintain the ''agni'' by providing fuel in the form of food and drinks which should be taken as per the rules mentioned. (40)
*If the rules of diet and dietary habits are not followed due to greed, then disease of ''grahani'' occurs.
*The ''anna-visha'' (toxins) produced due to improper digestion and metabolism causes diseases at the sites of affliction.
*The ''vishamagni'' (improper ''agni'') causes irregularity in digestion and therefore defective formation of ''dhatu'' takes place. Whereas, ''teekshnagni'' (excessive ''agni'') when associated with little quantity of fuel (in the form of food) causes depletion of ''dhatu'' (tissue elements) (50).
*The digestive disorder of ''grahani'' can lead to secondary disorders related with other body systems along with digestive system.
*''Grahani'' disease is classified into four types viz ''vataja, pittaja, kaphaja'' and ''sannipataja'' depending upon the dominance of ''dosha'' and on the basis of the classification, etiological factors, symptoms and signs are varied.
*When the ''doshas'' are located in ''grahani'' and are associated with incomplete digested food then ''vamana'' (emetic therapy) is advised.
*If the ''ama'' is in ''pakvashaya'' and in ''anutklishta'' (stuck, not ready to come out) condition, then ''stravana'' (increasing secretion) with ''deepana dravyas'' should be administered.
*If ''ama'' gets absorbed along with ''rasa dhatu'' and if it pervades throughout the body then ''langhana'' and ''pachana'' should be advised.
*Various purification procedures are advised as per the state of ''dosha'' aggravation and site of affliction in disease. Ghee processed with digestive stimulant drugs,sour media like buttermilk is advised.
*Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''pachana'' etc. treatment (95).
*Buttermilk due to its ''deepana, grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''.
*''Vata'' dominant ''grahani'' shall be treated with ''basti, virechana'' and unctuous preparations.
*If ''pitta'' is dominant in its own place then ''virechana'' or ''vamana'' should be administered for removal of ''pitta'' (122).
*In ''kaphaja grahani'', ''vamana'' and then drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' shall be administered to increase ''agni'' (digestive power) (141).
*In ''tridoshaja grahani'', [[Panchakarma]] should be carried out as per predominance of ''dosha''. Various ghee, ''kshara'', ''asava'' and ''arishta'' preparation useful in stimulation of ''agni'' should be administered.
*''Sneha'' is the best among the ''deepana dravya'' which helps in stimulating the inefficient ''agni'' (201)
*Fasting or over eating doesn’t stimulate ''agni''. Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishta, sura'' and ''asava'' along with proper medication as per condition, enhances the power of ''agni''.
*''Atyagni'' is caused by diminished ''kapha'', aggravated ''pitta'' and associated ''vata''. This leads to emaciation if proper food is not consumed. Excessively increased digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid.
*''Samashana'' is taking wholesome and unwholesome foods together in diet. ''Vishamashana'' is taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. ''Adhyashana'' is having food even though previously eaten food is not yet digested. All the above three are causes for death or give rise to serious disorders (235-236).
*If morning eaten food is undigested and still if anyone takes evening food, it may not be more vitiative since in day time all the ''srotas'' (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of ''kleda'' (excess moisture) in various ''dhatus''. In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''dhatus'' and if another food is taken in the morning the indigestion causes more ''apakva ahara rasa'' causing disease.

=== ''Vidhi Vimarsha'' ===

==== Importance of ''agni'' ====

The functions of gut are vital for maintenance and preservation of health. ''Grahani'' is the seat of ''jatharagni'', which is the initiator of digestive process and strengthens the other 12 ''agnis''. ''Jatharagni'' transforms food into biological substance (''ahara rasa'') which is further trifurcated into ''madhura, amla'' and ''katu avastha paka'' which gets transformed into three biological energies ''kapha, pitta'' and ''vata'' respectively. From the physiological point of view, the ''jatharagni'' or the active form of ''pachaka pitta'' is responsible for the digestion of all kinds of foods in the gut. Therefore, this should include all amylolytic, proteolytic and lipolytic enzymes secreted by various kinds of exocrine glands in the gut, which actually cause digestion, i.e., breaking down of different macromolecules into their constituent units.

There are five ''bhutagnis'' and their function is to metabolize ''panchabhautic'' components of the food that are homologous to them in their composition. For instance, ''bhauma agni'' acts on the component that is ''bhauma'' or ''parthiva'' in its composition. ''Bhutagnis'' act on the products of digestion (''jatharagni paka''), hence, must be acting after the absorption of the nutrients, but before the action of ''dhatvagni''. The major site where the absorbed nutrients undergo biochemical transformation is in the liver, which plays an important role in metabolism, wherein several processes such as trans-amination, de-amination, beta-oxidation of fatty acids, glycolysis etc. take place. Therefore, the overall intermediary metabolism (involving fats, carbohydrates and proteins) can be understood as the functioning of the ''bhutagni''.

''Dhatvagni'' acts at tissue-level (in fact, at cellular level) upon the products of ''bhutagni paka'' and are responsible for the building of the respective ''dhatus''. In other words, the bio-energetic processes of a cell seem to be under the regulation of ''dhatvagni''. For instance, the common product of intermediary metabolism (involving fats, carbohydrates and proteins) is Acetyl-Co-A, which enters into Kreb’s cycle in the mitochondria of a cell. This is followed by electron transfer and oxidative phosphorylation. [ ] It is interesting to note that the Kreb’s cycle is also known as the ‘final common pathway’ in the process of catabolism of carbohydrates, proteins and fats. However, for the entry of amino acids, glucose and fatty acids into the cell, certain other factors such as hormones too are needed. For instance, insulin promotes the transportation of glucose, amino acids and fatty acids into the cell. Therefore, all these hormones (such as insulin, growth hormone, thyroid hormones, testosterone etc.) that promote the transportation of various nutrients into the cells, along with the enzymes participating in the Kreb’s cycle are to be included under the term ''dhatvagni''.

Thus, the three major stages of the catabolism (involving fats, carbohydrates and proteins) i.e. digestion, intermediary metabolism and Kreb’s cycle - seem to represent the three sets of ''agnis,'' viz., ''jatharagni, bhutagni'' and ''dhatvagni'' respectively.

==== Role of ''vata'' in digestion ====

''Samana vayu'' separates nutritive (''prasad'') and waste (''kitta'') part from ''ahara rasa''. Nutritive part is circulated to entire body after absorption through ''rasayini'' (villi) by ''vyana vayu''. Waste part is excreted as feces, urine and sweat through their excretory channels by ''apana vata''. Absorbed nutritive substances circulate all over the body through seven specific micro channels of each of the seven ''dhatus''.

==== ''Dhatvagni'' ====

Each ''dhatu'' has its own transforming ''agni'' and ''srotas''. ''Srotas'' or micro channels have two functions of carrying and transforming the tissues with the help of their specific ''dhatvagni''. Five ''bhutagnis'', one for each ''mahabhuta'', transform five ''bhautic'' elements into the body tissues and organs. Seven ''dhatvagni'' or tissue transformers, form the tissue elements of seven ''dhatus'' by their needed nutrients. After formation of ''dhatu'', the microchannels permeates them into the organs for functioning. During this transformation process, ''upadhatu'' or subtissues and ''dhatumala'' or waste products are formed. ''Updhatus'' of ''rasa dhatu'' is breast milk, menstrual blood is ''upadhatu'' of ''rakta'' and tendons and six layers of skin is ''upadhatu'' of ''mamsa dhatu'' etc.

Apart from digestion, the gut performs various other significant functions as well. The gut has its own protective mechanism in the form of gut-associated lymphoid tissue, which prevents the entry of pathogens into the bloodstream. The micro-biota in the gut serves vital functions related to various aspects of health. The enteric nervous system of the gut has its own functional significance and has been proven to be very closely associated with the central nervous system functions. The gut secretes several hormone-like substances that are helpful in regulating long-term energy balance. All the factors mentioned are either directly or indirectly dependent on these functional domains of the gut. [ ] [ ] Other forms of ''agni'' in this context are indicative of ''bhutagni'' and ''dhatvagni'', which in turn, are functionally dependent on ''jatharagni''. ''Prana'' in this context may stand for all types of ''vata'' as well.

==== Three stages of digestion ====

There are three stages of digestion in the gut. The first stage (''madhura'') takes place in the upper gastro-intestinal tract, i.e., inside the esophagus and stomach; the second stage (''amla'') takes place in the middle portion of the gut, i.e., in the small intestine; and the last stage (''katu'') takes place in the colon.

The froth-like ''kapha'' seems to be the thick mucus that covers the entire stomach, providing a protective coating that prevents the gastric mucosa being digested and damaged due to the acid-pepsin mixture.

''Accha pitta'' is ‘liquid’ in nature, released in the duodenum and can be correlated with bile.

''Pachaka pitta'' has the functional site between ''amashaya'' (stomach) and ''pakvashaya'' (colon), which is indicative of small intestine. It is composed of five ''mahabhutas'' but the ''agni mahabhuta'' is predominant; and hence, it becomes devoid of fluidity and therefore is also known as ''agni''. It splits the food into sāra (nutritive) and ''kitta'' (non-nutritive) portions. (Ashtanga Hridaya, Sutra Sthana, 12/10-12).

''Sara'' of the food is the minutest fraction (''parama sukshma''). This portion reaches the heart in the form of ''ahara rasa''. From the heart, it then gets re-distributed into 24 pulsatile vessels to be carried into the whole body. (Sushruta Samhita, Sutra Sthana, 14/3)

The portion that reaches the colon is the one that is designated as ''kitta''. During the third stage of digestion, there occurs the solidification of fecal matter and formation of certain pungent gases such as ammonia, methane, hydrogen sulfide etc. The term ''pakva'' in this context indicates ''pakva mala''; not ''pakva ahara'' (Verse 9-11).

==== Formation of the seven ''dhatus'' ====
''Rasa, rakta, mamsa, meda, asthi, majja'' and ''shukra'' are the seven fundamental entities that sustain the human body. These can be called ‘tissues’ for the sake of convenience, though some of them are not tissues in a strict sense. It will be pertinent to look into these individual entities at this stage to understand what they really are in terms of anatomy. [ ]

''Rasa'': A colorless fluid that gets ejected out of the heart and nourishes the entire body.

''Rakta'': The red colored fraction that is formed in liver and spleen after the action of ''ranjaka pitta'' on ''rasa''. It is essential for life and its function is to supply the life principle (''jeeva'').

''Rasa'' and ''rakta'' together form what is generally known as blood: ''rakta'' being the red fraction (red blood corpuscles) and ''rasa'' being the colorless fluid (plasma).

''Mamsa'': The correct translation of this term would be ‘flesh’. Flesh generally means all kinds of muscles and also the parenchyma of the different viscera such as thyroid, liver, spleen, kidneys etc.

''Medas'': This generally stands for fatty tissue, however, it is to be noted that it is of two types: ''Baddha'' (bound, stable, fixed, stored) and ''abaddha'' (free, unbound). The ''baddha'' form, therefore, must include the stored fat in the form of adipose tissue; and the ''abaddha'' form must include the circulating lipids such as cholesterol, LDL, HDL etc.

''Asthi'': Though the term ''asthi'' generally stands for bony tissue, it may in some contexts, include all such relatively hard structures that resist easy decaying, viz., teeth, nails and hair.

''Majja'': Generally, the substance that fills all the bony cavities is called ''majja''. However, the brain substance that fills the cranial cavity too, must be included in ''majja''. Therefore, ''majja'' is of two types: ''asthigata'' (bony) and ''mastakagata'' (cranial).

''Shukra'': The term ''shukra'' has been described to be of two forms in Ayurveda textbooks:
#The one that is ejaculated during the process of mating, which is responsible for fertilization of ovum and thus embryogenesis.
#The one that is formed from ''majja'' (the tissue that fills the bony cavities) which in turn circulates all over the body both in males and females. Reproduction is the function of this second form of ''shukra'' too. Therefore, on careful examination, it seems that the first form of ''shukra'' stands for the semen in general and for sperms in particular; and, the second form of ''shukra'' stands for hypothalamo-pituitary-gonadal axis of hormones that circulate all over the body.

==== The process of nourishment of ''dhatu'' ====

The process of nourishment of ''dhatus'' is explained by three analogies: ''Ksheera-dadhi'' (milk curdling analogy), ''khalekapota'' (analogy of pigeons picking up the choicest grains) and ''kedari-kulya'' (irrigation analogy).

==== ''Ksheera-dadhi nyaya'' (milk curdling analogy) ====

According to this analogy, the nourishment of a ''dhatu'' takes place according to the rule of conversion (of one substance into another). Just as the milk is converted into different forms (from milk to curd, curd to butter, butter to ghee) successively, the preceding ''dhatu'' too is converted into the next one. The sequence of this conversion is as follows: ''rasa, rakta, mamsa, meda, asthi, majja'' and ''shukra'' in the same order.

The transformation of various substances that takes place due to various biochemical reactions could be one way of understanding this analogy. For instance, the process of glycolysis involves different enzymes acting on different substrates at different steps and converting them from one to another. The ability of one kind of stem cell derived from one tissue in giving rise to different forms of cell types of different tissues is known. The response of mesenchymal stem cells to certain stimuli such as hypoxia in the form of migration and tissue regeneration is also known, which can further support this analogy.

==== ''Khalekapota nyaya'' (analogy of pigeons picking up the choicest grains) ====

According to this analogy, the nourishment of different ''dhatus'' takes place according to the rule of selectivity. Just as the pigeons coming from far off places, picking up the grains of their choice from the granary (a storehouse for thrashed grain, ''khala'') and flying back to their destination, the different ''dhatus'' too, pick up the required nourishment from the common nutrient pool known as ''rasa''. The ''dhatu'' that is situated nearer to ''rasa'' is nourished first and the remaining later, just as the pigeon from a nearer place gets a chance to pick up grains quickly in the given analogy.

In this analogy, the choice that the pigeons have in picking up the grain (selectivity) and the energy they spend in the process of obtaining grains (actively) are the vital features. The tissue metabolism can influence the extent of vasodilatation and thus its own perfusion. This is known as auto-regulation of blood supply. Similarly, the specific kind of tissue has affinity for specific nutrient and other substances. For example, the calcium gets deposited normally in bones, but not in the mucous membranes. Similarly, vitamin B-12 is stored in liver and not in other tissues.

==== ''Kedari-kulya nyaya'' (analogy of irrigation) ====

According to this analogy, the nourishment of ''dhatu'' takes place according to the rule of irrigation. Just as the ''kulyas'' (small canals / trenches / channels) receive water from the ''kedarika'' (the bigger water reservoir) and then irrigate the nearest field first, the ''rasa'' too, nourishes the ''dhatus'' in a sequential fashion depending on the location of the ''dhatu''.

The anatomical location of a cell in the body can influence the amount of perfusion it receives. For instance, the apical regions of the lungs are less perfused than the other areas of the lung, and hence, are susceptible to be affected in some infectious conditions such as tuberculosis. Similarly, the hepatocytes that surround the central vein in a hepatic lobule are more susceptible to hypoxic injury than those situated in the periphery. Sub-endocardial region of the heart is, in the same manner, is more susceptible to ischemia than the epicardial region.

Another important feature to be noted in this analogy is the passive flow of water from higher altitude to lower altitude, where no external energy is spent. This is in contrast to the pigeons expending their energy to pick up the grains of their choice actively. It is interesting to note the process of transportation of substances across the cell membrane, which has been divided into two major types: active transport and passive transport (Verse-16).

Bilirubin is a metabolic byproduct of heme portion of the hemoglobin. This is secreted into bile juice in the liver which is in turn released during the process of digestion. Features of pitta ''vriddhi'' therefore, are yellowish discoloration of sclera, skin, urine and feces. Mucous is rich in water that is derived from extracellular fluid while it is being formed. The cerumen, sebum, and other similar external secretions perform some functions such as providing a waxy protective layer. Sweat and urine share similarities in function as well as composition. Therefore, ''vrikka'' mentioned as the site of origin of ''medavaha srotas'' makes sense when one considers ''sweda'' as the ''mala'' of ''meda''. Hair and bones share similarity when it comes to the power to resist easy biodegradation. They also grow weaker in old age. Therefore, hair are the ''mala'' of ''asthi'' (Verse 19).

Circulating provoked ''dosha'' settles in a tissue whose channels are defective (''kha-vaigunya'') and perfuce the lesion. This pathogenesis has been compared with rain production. The obstruction to the moving ''rasa'' by the abnormality of ''srotas,'' results in causation of disease, just as the obstruction to the cloud laden monsoon winds by the tall mountains results in the causation of rainfall (Verse 37).

==== Causes of ''grahani'' disorder ====

''Abhojana'' (starvation) leads to increase in ''vata'' and in turn ''agnimandya''.(Ca.Vi/ 2/7) Starvation and protein malnutrition disrupts the normal indigenous gastrointestinal tract micro-flora and impairs host antibacterial defenses. Both starvation and protein malnutrition increases the cecal levels of gram negative enteric bacilli and decrease the level of lactobacillus and promote growth of anaerobes that in turn disturb the gut flora. Gut flora also known as gut microbiome has a unique role in digestion and absorption. Once the gut microbiome gets vitiated it leads to indigestion and malabsorption.

''Atibhojana'' (excessive intake) causes provocation of all the ''dosha'' and thereby causing ''agnimandya''. Protein rich diet or fat laden diet or excessive diet takes longer time for emptying of stomach. Longer stay of food explains increase of acidic pH. Therefore, whenever such chyme enters the duodenum the liver and pancreas need to increase secretion of alkali pH. Repeated, such dietary habits lead to indigestion. Further increase of alkali pH causes reduced transit time in small intestine leading to the symptoms like diarrhea. Diet which is ''atiguru'' (heavy) and indulging ''vishamashana''( irregular food habit) will have similar effect. ''Atiruksha ahara'' or diet has low protein value. Protein malnutrition leads to decrease of enzyme secretion as proteins are the building blocks of enzymes. ''Asatmya desha, kala, ritu'' only explain the dietary changes which dramatically alter the balance of bacteria in the gut on daily basis. Research shows that these fluctuations could lead to various digestive and absorptive problems. ''Dushita bhojana'' or contaminated food reacts directly with intestinal flora disturbing their quantitative and qualitative growth causing indigestion. Intake of unctuous substances in ''sama pitta'' condition leads to ''grahani dosha'' and various other disorders.( Ca. Su 13/76 ) Emaciation due to disease also has its own impact on digestion. ''Mandagni'' is a causative factor for all diseases but if patient continuously indulges in ''apathya'' then complications may increase or the prognosis turns bad.

Suppression of manifested natural urges may have impact on nervous system resulting in effect either on enzymatic secretion or on the hormonal secretion.These factors have role in digestion and absorption as may be understood in case of ''adhovata'' (accumulation of ''vata'' in rectum and pelvic region) and ''purisha vegadharana'' (suppression of urge of defecation), wherein regular urge suppression disturbs the intestinal pro-kinetic movement.( Ca. Su. 7/ 6,8,12) Disturbed pro-kinesia increases the transit time leading to the change in pH which further has its impact on electrolytes and enzymatic secretion leading to reduced digestive power (''agnimandya'').

Further ''kshudha vegadharana'' (avoiding sense of hunger) effect will be similar to ''abhojana'' (not eating). It may also be noted that repeated ''kshudha vegadharana'' leads to atrophy of the stomach which further weakens the perception of hunger which is controlled by the percentage of the stomach that remains empty similar to the explanation given by Charak that excessive fasting leads to diminution in ''agni''.(Ca.Su.22/37) ''Trishna vegadharana'' (avoiding thirst) leads to reduced fluid balance in the body.

Nearly seven liters of water is secreted during various gastrointestinal secretions. Reduced water intake in long term will reduce gastrointestinal secretion leading to impaired digestion.

Abnormal digestion is from faulty food habits and unwholesome diet, that causes ''jatharagni dushti'' or vitiation of digestive power. The improperly digested food turns into toxic substance called aamavisha, basic cause of most diseases. If ''amavisha'' associates with any balanced ''dosha'' or healthy ''dhatu'', they turn pathogenic. ''Grahanidosha'' is an important example of ''amavisha'' and ''agnidushti''.

''Grahanidosha'' is of four types. It starts with inflammation of elementary canal at different places and is called by different names e.g gastritis, duodenitis and colitis. In the second stage erosions and ulcers develop. In third stage mental symptoms like anxiety, illusions, fear, and IBS like symptoms. Fourth stage is ''sannipatic'' with clinical features resembling ulcerative colitis.

Treatment of ''grahanidosha'' is to enhance ''jatharagni, bhutagni'' and ''dhatvagni'' which encompasses the whole digestive process. Food and drinks are also medicated depending upon the patient and the stage of disease, for extended period of time.

==== Effect on immunity ====

''Prayatna'' (effort), ''urja'' (energy) and ''bala'' (strength) are the role played by ''vata, pitta'' and ''kapha'' in building up of immunity. When the ''dosha'' gets vitiated ''prayatna, urja'' and ''bala'' are hampered leading to suppression of immunity.

Exogenous and endogenous factors vitiate the doṣha which when associated with ama produce either local or systemic disorders.

''Tridosha'' play role in impairing immunity and depending on the dominance of a particular ''dosha'' they are classified as ''vataja, pittaka'' and ''kaphaja'' disorders.(Ca. Su. 28/7)

==== Equilibrium of ''agni'' ====

''Agni'' should be associated with balance of ''vata, pitta'' and ''kapha'' or ''samagni''. Digestive enzyme secretion is controlled by sympathetic and parasympathetic nerve supply. ''Samagni'' may be compared with balanced state of sympathetic/ parasympathetic activity which explains the role of balanced or ''samana vata''. It may also be noted that ''prana vata'' and ''apana vata'' also have impact on balancing the normal status of ''agni''.

Acidic and alkaline pH of digestive secretions explains the balanced ''pitta''. Modern science explains specific range of pH of digestive secretions e.g. pancreatic juice has pH in range of 7.1 – 8.2 that buffers acidic gastric juice in chyme, stops the action of pepsin from the stomach and creates proper pH for action of digestive enzymes in small intestine. Specific pH of gastric juice is essential to convert pepsinogen into pepsin, an active form of proteolytic enzyme thus improper pH will cause variation in digestion.

Mucosal resistance explains role of ''kapha'' in maintaining ''samagni''. Intact mucosal lining is present in stomach and small intestine. Breach in mucosal lining causes gastritis, burning sensation etc whereas increased size of mucosal cells alters the pH thereby a balanced ''kapha'' plays essential role in ''samagni''. Role of prostaglandins to maintain gastric mucosal resistance to prevent the action of HCl in gastric mucosa is to be considered as part of ''kledaka kapha'' as sodium bicarbonate and mucus is secreted by prostaglandins. Drugs which inhibit prostaglandins e.g. aspirin, impairs gastric mucosal barriers leading to gastritis, duodenitis and peptic ulcers.

==== Clinical features ====

''Arochaka'' (aversion to food), ''vairasya'' (distaste), ''praseka'' (excessive salivation) are general gastrointestinal manifestations of indigestion. ''Tamaka'' or blackout occurs due to nutritional deficiency. Mal-absorption causes diarrhea which leads to decrease in circulating liquid, a cause of hypo-tension a reason for blackout. Impaired absorption of iron, folate, vit. B12 leads to anemia which may be the cause for blackout (''tamakanvitah''). Resulting anemia and electrolyte depletion (particularly K+) leads to weakness.
#Peripheral neuropathy due to Vit. B12 and thiamine deficiency
#Dermatitis due to deficiency of Vit. A, Zinc and essential fatty acid
#Night Blindness/Xeropthalmia due to Vit A mal-absorption.
#Bleeding due to Vit K malabsorption and hypo prothrombinemia
#Anemia impaired absorption of iron, folate, and vitamin B12
#Amenorrhea, decreased libido due to protein depletion decreased calories and secondary hypo-pituitarism.
#Tetany, paresthesia due to calcium and magnesium mal-absorption
#Glossitis, cheilosis, stomatitis due to deficiency of iron, Vit B12, folate and Vit A (Verse 52-54).

Spices are basically a combination of acids. When too much of these acids are introduced in gastrointestinal tract which has its own acidic contents it starts damaging the mucosal lining of walls of gastrointestinal tract. It also reduces the pH thus activation of enzyme is hampered leading to indigestion.

Etiological factors as mentioned in the text have impact mainly on the neural stimulation of digestive secretions affecting the flow of gastrointestinal secretions into the gastrointestinal tract thereby hampering the digestion.

Hence it is explained that aggravated ''vata'' encompasses the ''agni''. Altered canalicular functions hampers digestion, easily understood in primary biliary cirrhosis wherein biliary secretion is restricted. Atrophy of gastric mucosa reduces HCl secretion causing indigestion. The gastric gland contains three types of exocrine gland cells that secrete their products into stomach lumen.''Srotasam kharatvam'' (hardness in channels) quality of ''tikta rasa'' destroys the exocrine gland cell reducing their secretions. Gastric glands include a type of enteroendocrine cell, the G cell which is located mainly in the pyloric antrum and secretes the hormone gastrin into the blood stream which stimulates parietal cells to secrete HCl and chief cells to secrete pepsinogen, it also contracts the lower esophageal sphincter, increases motility of the stomach and relaxes pyloric sphincter.

G cells when get destroyed the above action of ''kapha'', in turn, ''agni'' is hampered so also contraction and relaxation karma of ''vata'' is vitiated.

Further ''kashaya rasa'' reduces peristaltic movements called as mixing waves which reduces the maceration and mixing of food with secretions of gastric glands, thus improper chyme is formed. Deficiency of gastrointestinal secretions due to damage to the glands or canaliculi or intestine may be mostly considered as having vātaja origin. Loss of ''pravartana karma'' is to be understood where the transport of secretions is hampered (except in obstructive pathology where ''kapha'' to be considered). Hartnup’s syndrome a defect in neutral amino acid transport and cystinuria a defect in dibasic amino acid transport explain the rare genetic disorders (''Bija Dusti'') involved in protein digestion absorption.

Further due to ''vata prakopa'', intestinal activity is increased which is manifested as malabsorption. For e.g. lactose intolerance is related to rate of gastric emptying. Symptoms are more likely when gastric emptying is rapid than when gastric emptying is slower. Therefore it is more likely that skim milk will be associated with symptoms of lactose intolerance than with whole milk as rate of gastric emptying is more rapid in skim milk. Milk proteins, particularly caseins have appropriate amino acids composition for growth and development of young.

Caseins are highly digestible in intestine and high quality source of amino acids. Most of whey proteins are relatively less digestible in intestine, although all of them are digested to some degree. When substantial whey proteins are not digested fully, some of intact protein may stimulate a localized intestinal or systemic immune response this is due to beta lactoglobullin referred to milk protein allergy. Similarly, diarrhea observed following subtotal gastrectomy is often a result of lactose intolerance as gastric emptying is accelerated in patients with gastrojejunostomy, rapid small intestinal transit time develops symptoms of lactose intolerance.

''Kanthasya-shosah'' (dryness of mouth also known as xerostomia) occurs due to diminish salivary gland secretion.

Primary cause being fluid loss through diarrhea secondarily it may be association of Sjogren's syndrome with autoimmune disease like primary biliary cirrhosis ~ a secondary Sjogrens syndrome. In this syndrome involvement of other exocrine glands occur leading to diminished secretion of exocrine glands of the gastrointestinal tract, leading to esophageal mucosal atrophy, atrophic gastritis and subclinical pancreatitis.

Increased appetite (''Kshudha'') is seen because of a negative feedback due to malabsorption or it may be understood under ''rasasheshajeerna''.

''Trishna'' is manifested due to increased ''ruksha guna'' of ''vata'' and decreased ''jaladi ansha'' due to diarrhea and low fluid intake.

''Timira'' (blurred vision) results from vitamin A malabsorption and anemia.

Tinnitus is a symptom also found in ''Pandu'' (anemia)(Ca. Ci. 15/61), which is observed due to malabsorption of essential elements like vitamin B12.

Pain in flanks, thigh, pelvis, cervical area occurs due to calcium and Vitamin D malabsorption. Pain is also contributed by protein deficiency due to low nutritional diet, osteoporosis, anemia and decrease lactic acid neutralization due to reduce peripheral circulation.

Whipple’s disease is chronic multisystem disease associated with diarrhea, steatorrhea, weight loss, arthralgia and CNS and cardiac problems caused due to tropheryma whipple.

''Hritpeedha'' is chest discomfort or chest pain which may be resultant of anemia but most probably due to gastro-esophageal reflux disease.

Malabsorption may be for single entity or for various minerals and vitamins and may lead to emaciation and weakness.

''Vairasyam'' (distaste) is probably because of taste projections to the hypothalamus and limbic system, there is a strong link between the taste and pleasant and unpleasant emotions. ''Parikartika'' (cutting pain) is due to ''shushka-mala pravritti'' (pellet stools) which causes pressure and rupture of anal-mucosal lining that may lead to cutting pain.

Craving for all types of food (''griddhih sarvarasanam'') is seen due to malabsorption of various elements, mineral and vitamins causing deficiency of the essential requirements of elements. The negative feedback system creates the craving for essential elements which is presented in the form of craving for all six ''rasa''. ''Rasa'' should be understood for food which will fulfill the requirements.

Mood disorders are observed due to depletion of essential vitamins, mineral and other elements. Electrolyte difference creates confusion which may be the cause for ''mano avasada''.

Bloating of abdomen is manifested while digestion is in process or after digestion is completed because of indigestion that causes abnormal growth of gut microbiome. Bacterial fermentation of unabsorbed carbohydrates leads to flatus. Carbohydrates metabolism occurs in small and large intestine therefore the symptom occurs during ''Jeerne jeeryati chadhmanam'' i.e. during and after the process of digestion. Once the patient takes food, circulation towards stomach is increased and digestive activity in the colon is reduced thus carbohydrate metabolism is depressed reducing the formation of flatus in rectum thereby reducing the bloating of abdomen.

Patient doubts as if he may be suffering from following of the disorders like ''vatavikara, gulma, hridroga'' and ''pleeha''. Due to formation of flatus and later on bloating of abdomen makes the patient feel he is suffering from ''vatika'' disorders related to gastrointestinal tract. Especially ''gulma'' since the patient feels the movement of flatus, so doubts about ''gulma''.

''Ushna'' and ''teekshna guna'' of ''pitta'' trigger inflammatory response by irritating the intestinal mucosa.

Indigestion causes depletion of beneficial gut bacteria thus breakdown in the balance between the putative protective and harmful intestinal bacteria leads to chronic inflammation.

Antigenic nature of endogenous factors can be understood when helpful bacteria and ''ushna, teekshna guna'' of ''kapha'' trigger inflammatory response leading to autoimmune pathogenesis.

In case of hypersecretion of gastrin in gastrinoma (Zollingers – Ellison Syndrome) stimulate the parietal cells of the stomach to secrete acid to their maximal capacity and increase the parietal cell mass three to six fold. The acid output may be so great that it reaches the upper small intestine reducing the luminal pH to two or less.

Pancreatic lipase is inactivated and bile acids are precipitated. It results in diarrhea and steatorrhea. Subtotal villous atrophy occurs due to hyper-secretion which may cause malabsorption. Excessive gastrointestinal secretions cause derangement in fluid and electrolyte transport across the entero-colonic mucosa leading to diarrhea. They are characterized clinically by watery, large volume fecal outputs that are typically painless and persist with fasting because there is no malabsorbed solute; stool osmolalirity is accounted for normal endogenous electrolytes with no fecal osmotic gap.

Other than excessive secretion, condition like ileal dysfunction caused by either Crohn’s disease or surgical resection results in a decrease in bile acid re absorption in the ileum and an increase in the delivery of bile acids to the large intestine. The resultant is a diarrhea with or without steatorrhea. It becomes a cause for mal-absorption syndrome.

Inflammatory Bowel Disease needs consideration in ''pittaja grahani''. Exogenous factors trigger inflammatory response that the mucosal immune system may fail to control. With mild inflammation the mucosa is erythematous and in severe condition the mucosa becomes hemorrhagic, edematous and ulcerated (Verse 65).

Loose motions (''Drava Mala Pravritti'') are mainly due to excessive secretion of bile juice (''Drava guna'' of ''pitta''). Excessive secretion may be due excessive formation in liver or decrease absorption in the intestine.

Bile acids are not present in the diet but are synthesized in the liver by a series of enzymatic steps that also include cholesterol catabolism. Bile acids are either primary or secondary. Primary bile acids are synthesized in the liver from cholesterol and secondary bile acids are synthesized from primary bile acids in the intestine by colonic bacterial enzymes. Bile acids are primarily absorbed by active, sodium dependent process that is located exclusively in the ileum; secondly bile acids can also be absorbed to a lesser extent by non carrier mediated transport processes in the jejunum, ileum and colon. Conjugated bile acids that enter the colon are de-conjugated by colonic bacterial enzyme to unconjugated bile acids and are rapidly absorbed. Colonic bacterial enzymes also dehydroxylate bile acids to secondary bile acids, thus if exogenous factors like diet as discussed above disturb the colonic bacterial growth than bile acids are not absorbed. A decrease in the amount of bile acids returning to the liver from the intestine is associated with an increase in bile acids synthesis/cholesterol catabolism, which helps keep bile acid pool size relatively constant. Defects in any of the steps of the enterohepatic circulation of bile acids can result in decrease in duodenal concentration of conjugated bile acids as a result steatorrhea. Thus steatorrhea can be caused by abnormalities in bile acid synthesis and excretion, their physical state in the intestinal lumen and reabsorption. The bile gives the yellowish nature to the stools (Verse 66).

''Guru, snigdha'' and ''seeta ahara'' is dominated by ''prithvi'' and ''jala mahabhuta'', these qualities help in reducing the impact of ''agni mahabhuta'' thus causing ''jatharagni mandyata'' resulting in indigestion leading to formation ''ama''. Such ''ama'' is responsible for ''dosha prakopa''.(Madhukoshatika Ma. Ni. Jwara adhyaya/2)

''Klinna''(moist), ''guru, pishtanna''(malt), ''abhishyandi''(which increases secretions) ''ahara''(food) and ''adhyashana''(over eating) are source for extra calories. Fast foods are defined as any food that contributes little or no nutrient values to the diet, but instead provides excess calories and fat. Common foods include salted snack foods, gum, sweet desserts, fried fast foods, carbonated beverages and candy.

Diets rich in trans-fatty acids like deep fried fast food, cake mixes, chips and packed cookies, all have inclusion in ''guru, pishtanna, vishtambi''(causing obstruction) ''ahara''. People consuming ''snigdha ahara'' (fatty food) and have sedentary lifestyle with very little energy expenditure, and most fat is stored. The above two concepts explain why ''agnimandya'' and ''ajeerna'' have been mentioned after taking heavy food. Excessive heavy food (''guru ahara'') slows down emptying of stomach (''samana vata karma'' is hampered) and enzymes are not secreted into lumen (''pitta'' action hampered) causing ''agnimandya''.

Substances of ''seeta veerya'' causes constriction reducing the secretion (''stambhana'') of gastrointestinal juices thus hampering lipase activity therefore leading to steatorrhea.

Further heavy meals increase the transit time causing functional stasis which may cause bacterial overgrowth syndrome. Sleeping just after meals may also lead to functional stasis (further study required). Peristalses are also reduced with heavy meals and sleeping after meals causes bacterial overgrowth. Bacteria deconjugate conjugated bile acids and as a result intraduodenal concentration of bile acids will be reduced resulting in steatorrhoea and macrocytic anemia. Bacterial overgrowth also occurs with stasis from a blind loop, small bowel diverticulum or dysmotility.

Postmucosal lymphatic obstruction- The pathophysiology of this condition which is due to the rare congenital intestinal lymphangectasia or due to acquired lymphatic obstruction secondary to trauma, tumor or infections, leads to the unique constellation of fat malabsorption with enteric loss of protein (often causing edema) and lymphocytopenia. Carbohydrates and amino acid absorption are preserved (Verse 67).

Nausea and vomiting are both caused by stimulation at one of the four sites: the gastrointestinal tract, the vestibular system, the chemoreceptor trigger zone and the cerebral cortex. Nausea and vomiting occurs due to disturbed gastric motility caused by heavy meal and delayed gastric emptying. The same is the cause for heavy abdomen and eructation with foul smell and sweet taste. As the food stays for long time in gastrointestinal tract blood flow increases centrally and reduces the enthusiasm and decrease in libido. The sluggish activity of gastrointestinal tract causes symptoms such as absence of movement in the abdomen (''udaram stimitam guru''). The heavy abdomen puts pressure on the diaphragm causing symptoms of heaviness in chest (''hridayam manyate styanam'').

Bacterial overgrowth due to undigested ''guru, klinna, snigdha'' and ''abhishyandi ahara'' causes increased mucoid secretion, thus formed stool is not observed instead ''bhinnamashleshma-samsrishta varcha''(loose stools with ''ama'' and ''kapha'') is seen; which is also cause for heaviness of stools (''guru-varchah-pravartanam'') Due to diet pattern and sedentary lifestyle there is accumulation of fat (obesity) but due to decrease protein absorption and malabsorption of essential elements patient feels weakness and laziness without weight loss (Verse 68-70).

Normalcy of ''vata pitta'' and ''kapha'' keeps the ''agni'' in balanced condition, it means that a specific pH is maintained (''pitta''); secretion, transportation and villi movement are normal (''vata'') and mucosal bed secretes normal mucus and is healthy (''kapha''), thus maintains ''samagni'' or a normal digestive process (Verse 71).

Protein losing enteropathy is increased protein loss into the gastrointestinal tract which is classified into three groups.

#Mucosal ulceration; there is protein loss by exudation across damaged mucosa e.g. Ulcerative colitis, peptic ulcer, gastro intestinal carcinoma. In such cases dominance of ''pitta dosha'' needs to be considered.
#Non ulcerated mucosa but evidence of mucosal damage; Protein loss primarily represents loss across epithelia with altered permeability e.g. celiac sprue and menetrier’s disease in small intestine and stomach respectively, ''vata dosha'' and/or ''kapha dosha'' dominance should be considered.
#Lymphatic dysfunction, represents either primary lymphatic disease or secondary to partial lymphatic obstruction that may occur as a result of enlarged lymph nodes or cardiac disease. Patient with increased protein loss into gastrointestinal tract due to lymphatic obstruction often have steatorrhea and diarrhea. The steatorrhea is a result of altered lymphatic flow as lipid containing chylomicrons exit from intestinal epithelial cells via intestinal lymphatic’s which may be compared with flow of ''ahara rasa'' and/ or presence of ''vata'' and ''kapha''.

Genetic factors (''bija dushti'') almost all patients with celiac sprue express the HLA-DQ2 allele. Environmental factor, gliadin a component of gluten that is present in wheat, barley and rye contributes to the disease. Immunologic component (''prayatna, bala'' and ''urja'' of ''vata, kapha'' and ''pitta'' respectively), serum antibodies – IgA antigliadin, IgA antiendomyasial and IgA antibodies and IgG antibodies are present. In addition, gliadin peptides may interact with gliadin specific T cells that may either mediate tissue injury or induce the release of one or more cytokines that cause tissue injury (Verse 72).

Further research shows that incase of uncontrolled growth of gut microbiome, flushing of gut reduces both psycho-somatic symptoms. ''Shodhana'' therapy not only flushes the vitiated gut microbiome but also flushes out the substrata due to which growth of microbiome is controlled (Verse 73-74).

''Kshara'' has been advised along with ''tilvaka sneha; kshara'' has alkaline pH. In duodenum and small intestine, enzymes with alkaline pH are secreted. ''Ushna, teekshna'' and ''laghu guna'' help in digestion. ''Kledayati ado paschata visoshayati''(Ca. Vi. 1/17 ) i.e. secretion are first increased and later on absorbed is very essential in ''grahani dosha''. Both these actions help in secretion of digestive enzymes thereby increasing ''agni'' and by absorption correct the malabsorption. Therefore use of ''kshara'' is more in ''grahani dosha'' and ''gulma'' (Verse 79).

''Aranala''(a fermented preparation), ''dadhimanda''(curd whey) or ''sauviraka'' are all fermented liquids. Fermented liquids contain probiotic organisms. Probiotic foods are produced by chemical action of lactic acid, bacteria, yeast or combination of both. These useful microorganisms help in breaking down carbohydrates, sugars making them easily digestible. Probiotics improves absorption of nutrients; improve synthesis of vitamins, essential fatty acids and enhance nutritional qualities of food grains. Fermented foods increase the absorption of vital minerals from gastrointestinal tract thus preventing mineral deficiencies and also treat the diarrhea. It explains the role of helpful gut microbiome (Verse 82-86). Use of fermented products explains the concept of gut microbiome and use of ''kshara'' and ''amla'' drug for maintaining pH (Verse 88-93).

''Vamana'' (medicated emesis) reduces gastro-paresis by emptying the gastrointestinal contents (Verse 101-102).

Fermented liquids are rich source of gut microbiome which will help to replace the unhealthy microbiome. These fermented liquids also help to balance the pH of the gastrointestinal tract. Further study is required to decide impact of above mentioned liquid diet on pH and specific enzymes (Verse 115-116).

One cup of buttermilk contains 152 calories and 8.11 grams of fat, of which 4.65 grams are saturated, 282 milligrams of calcium and 127 international units of vitamin D. The vitamin also helps to maintain normal phosphorus levels. Phosphorus is another nutrient that contributes to bone health (Verse 117-119).

''Samana vata'' regularizes the secretion of pancreatic and intestinal enzymes. Initially the enzymes are in zymogens (inactive form). ''Samana vata'' helps in conversion of zymogens into active enzymes so all the factors which help in stimulating exocytosis can be considered as functional components of ''samana vata.'' Once ''samana vata'' is stimulated efficiently the digestive process becomes intact to digest all types of nutrients (Verse 202-203 -1/2).

Hyperthyroidism is one of the causes for hypermetabolic disorders but extra thyroidal causes are also important. Hypermetabolism typically occurs after significant injury to the body. Infections, sepsis, burns, multiple traumas, fever, long bone fractures, prolonged steroid therapy, pheocromocytoma, surgery and bone marrow transplants. Hypermetabolism may occur particularly in the brain after traumatic brain injury (Verse 217-219).

Hypermetabolism is accompanied by a variety of internal and external symptoms most notably extreme weight loss. External symptoms of hypermetabolism may include anemia, fatigue, elevated heart rate, irregular heartbeat, insomnia, shortness of breath, dysautonomia, muscle weakness, excessive sweating while internal symptoms include peripheral insulin resistance, elevated catabolism of proteins, carbohydrates triglycerides and negative nitrogen in the body.

In this context there is increased function due to excess secretion of thyroid hormones. Thyroid hormones act as catabolic hormones and promote calorigenesis and develops hypermetabolic state which may result in gluconeogenesis, lipolysis and glycogenolysis causing decreased muscle mass and weight loss. Metabolic rate is enhanced, because of vitiated ''pitta'' and associated ''vata''.

This is the condition where increased appetite with weight loss is seen due to insufficient supply of nutrients in relation to ''agnibala''. Thyroid storm/ thyroid-toxic crisis is rare and life threatening exacerbation of hyperthyroidism, accompanied by fever, delirium, seizures, vomiting, diarrhea and jaundice. Death may occur due to cardiac failure, arrhythmia and hyperthermia.

Management requires intensive monitoring, supportive care, identification of the precipitating causes (stroke, infection, trauma, diabetic ketoacidosis, surgery and radio iodine treatment), and measures that reduce thyroid hormone synthesis (Verse 220-222½).

''Kleda'' can also be considered as inter-mediory product of metabolism like ketones, pyruvate, lactate which are well utilized in active/healthy persons as fuel and therefore does not cause inflammation/disease process (Verse 237-239).

==== Current clinical practices ====

{| class="wikitable"
|-
! scope="col"| S.No.
! scope="col"| Name
! scope="col"| Dose
! scope="col"| Time of Administration
! scope="col"| Anupana
|-
| 1
| ''Chitrakadi Vati''
| 250-500 mg
| Between meals
| Buttermilk or lukewarm water
|-
| 2
| ''Shankha Vati''
| 250-500 mg
| Between meals
| Buttermilk or lukewarm water
|-
| 3
| ''Lashunadi Vati''
| 250-500 mg
| Between meals
| Buttermilk or lukewarm water
|-
| 4
| ''Hingvadi Vati''
| 250-500 mg
| Between meals
| Buttermilk or lukewarm water
|-
| 5
| ''Shiva Kshana Pachana Churna''
| 1 - 5 grams
| Between meals
| Buttermilk or lukewarm water
|-
| 6
| ''Hingvashtaka Churna''
| 1 - 5 grams
| Between meals
| Buttermilk or lukewarm water
|-
| 7
| ''Bhunimbadi Churna''
| 1 - 5 grams
| Between meals
| Lukewarm water
|-
| 8
| ''Avipattikara Churna''
| 1 - 5 grams
| Between meals
| Lukewarm water
|-
| 9
| ''Lavana Bhaskar Churna''
| 1 - 5 grams
| Between meals
| Buttermilk or lukewarm water
|-
| 10
| ''Swadishta Virechana Churna''
| 1 - 5 grams
| Between meals
| Lukewarm water
|-
| 11
| ''Nagaradi Churna''
| 1 - 5 grams
| Between meals
| Buttermilk and lukewarm water
|-
| 12
| ''Dadimashtaka Churna''
| 1 - 5 grams
| Between meals
| Nimbu panaka and lukewarm water
|-
| 13
| ''Pippalyasava''
| 10 - 40 ml
| Between meals
| Lukewarm water
|-
| 14
| ''Jeerakadyarishta''
| 10 - 40 ml
| Between meals
| Lukewarm water
|-
| 15
| ''Abhayarishta''
| 10 - 40 ml
| Between meals
| Lukewarm water
|-
| 16
| ''Takrarishta''
| 10 - 40 ml
| Between meals
| Lukewarm water
|-
| 17
| ''Chitrakadi ghrita''
| 5 - 40 ml
| Between meals
| Lukewarm water
|-
| 18
| ''Dadimadi ghrita''
| 5 - 40 ml
| Between meals
| Lukewarm water
|-
| 19
| ''Kiratadi churna''
| 1 - 5 grams
| Between meals
| Honey or lukewarm water
|-
| 20
| ''Marichyadi churna''
| 1 - 5 grams
| Between meals
| Buttermilk or lukewarm water
|}

=== Areas of Further Research ===

*To study ''asava'' and ''arishta'' in relation with microbioma.
*To understand concept of ''ama'' with relation to autoimmune diseases.

=== References ===

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Arsha Chikitsa

2019-03-06T03:58:28Z

Pallavmishra:

{{Infobox
|title = Arsha Chikitsa
|label1 = Section/Chapter
|data1 = [[Chikitsa Sthana]] Chapter 14
|label2 = Preceding Chapter
|data2 = [[Udara Chikitsa]]

|label3= Succeeding Chapter
|data3 = [[Grahani Chikitsa]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

== [[Chikitsa Sthana]] Chapter 14, Chapter on management of ''Arsha'' (Hemorrhoids) ==

=== Abstract ===

This chapter of [[Chikitsa Sthana]] exclusively deals with the treatment of ''guda arsha'' (piles/hemorrhoids). Congenital and acquired types, their causes, clinical features of ''dosha'' dominance and management are elaborated. The usual treatment of hemorrhoids is surgical, but if proper treatment is received it can be best managed with medicinal treatment. The disease ''arsha'' is mentioned in the ''Ashtomahagada'' (group of eight diseases that are difficult to cure).

Recurrence rate of hemorrhoids is high, even after surgical intervention. Sushruta has mentioned that any disease, if can be cured with the medicine is not required to be treated with ''shodhana'' and ''shastrakarma'' (surgical intervention). So, every attempt should be made to treat hemorrhoids with medicinal treatment, diet and lifestyle changes. Different medicinal formulations for conservative management and local applications, soothing therapy, sitz bath, fumigation, and sprinkling with the herbs are some of the modes of treatment prescribed to relieve the local inflammation, bleeding and maintain the peri-anal hygiene to control the disease. The principal of treatment is to avoid the ''nidana'' (causative factors), with diet being one of them. Digestive power of the person should be strong, which can be maintained with the consumption of different types of thin and thick gruels. ''Anuvasana basti'' is used for management of constipation, the root cause of ''arsha''. ''Raktamokshana'' (bloodletting), in cases of vitiation of ''rakta'', is advised. Finally, it is evident that treatment of hemorrhoids is multifocal and no single modality is effective including surgery.

'''Keywords''': ''Arsha, anuvasana basti, raktamokshana,'' hemorrhoids, ''shodhana chikitsa'', soothing therapy, sitz bath, fumigation, ''asava, arishta, churna, vati''

=== Introduction ===

This chapter is followed by ''udara roga'' because the causative factors for both the diseases are similar like vitiation of ''tridosha''. Both the diseases are related to the same system i.e. gastrointestinal tract. Further, ''arsha'' is one of the causative factors of ''udara roga'' (''Boddhagudedara''- intestinal obstruction) Therefore the chapter dealing with ''arshas'' (hemorrhoids) follows the chapter on the treatment of ''udara'' (obstinate abdominal disorders).

The chapter describes types of ''arsha'' (such as congenital or acquired), sites of manifestation other than the ano-rectal region, ''doshic'' signs and symptoms, etio-pathogenosis, etiology of the ''doshaja arsha'', and prognosis along with the symptoms of curable and incurable hemorrhoids. Hemorrhoids can be ''shushka'' (dry or non-bleeding) and ''sravi'' (wet or bleeding) with different modes of treatment for each of these. In the bleeding type hemostatic management is essential while in non- bleeding type hemostatic treatment is not needed.

The dry hemorrhoids can be correlated with the external hemorrhoids where protrusion of mucosal folds occur, without bleeding. Local treatment includes, fomentation, sitz bath, sprinkling, smearing and fumigation and topical medicament. The need of proper hygiene of the peri-anal area is important. ''Raktamokshana'' (bloodletting) was advised as one of the para-surgical procedure and in cases of vitiation of ''rakta'' and predominance of ''pitta dosha''. Oral intake of the herbal powders, ''takraarishta, abhayaarishta, dantyaarishta, phalaarishta'' are described along with their method of preparation. In ''pathya'' the recipes like thick gruel, curd, buttermilk, leafy vegetables for vegetarian and meat as well as meat soup for non-vegetarian was advised in cases of constipated bowel. It proves that along with the other causative factors constipation is an important cause. The role of ''haritaki'' with jaggery is one of the requirements for ''deepana'' and ''pachana'' because the cause of ''arsha'' is depressed digestive power. The other recipes like ''ghrita,'' preparations like ''pippalyadi ghrita, chavyadi ghrita, nagaradi ghrita'' in constipated patients. The ''anuvasana basti'' is advisable with medicated ''taila'' in the management of dry or external hemorrhoids.

The wet hemorrhoids have the predominance of ''kapha'' along with ''vata'' and can be correlated with internal hemorrhoids which are usually bleeding in nature. The line of treatment as per predominance of ''vata'' or ''kapha'' has been described. In initial stage the bleeding should not be stopped as the vitiated blood should be let out. Later on ''kutajadi rasakriya'' for hemostatis, thick and thin gruel remedies were explained. Cooling therapy, sprinkling therapy with different herbal preparations, warm and cold water sitz bath was advised in the cases of bleeding. Recipes of curds and rice in the diet are also recommended. For local treatment external application of cold leaves, soothing ointment, rubbing recipes and topical application in the bleeding hemorrhoids are described.

===Sanskrit text, Transliteration and English Translation===

अथातोऽर्शश्चिकित्सितं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athāto’rśaścikitsitaṃ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātreyaḥ||2||

athAto~arshashcikitsitaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the treatment of hemorrhoids. Thus said Lord Atreya. [1-2]

आसीनं मुनिमव्यग्रं कृतजाप्यं कृतक्षणम्|

पृष्टवानर्शसां युक्तमग्निवेशः पुनर्वसुम्||३||

प्रकोप हेतुं संस्थानं स्थानं लिङ्गं चिकित्सितम्|

साध्यासाध्य विभागं च तस्मै तन्मुनिरब्रवीत्||४||

āsīnaṃ munimavyagraṃ kṛtajāpyaṃ kṛtakṣaṇam|

pṛṣṭavānarśasāṃ yuktamagniveśaḥ punarvasum||3||

prakopa hetuṃ saṃsthānaṃ sthānaṃ liṅgaṃ cikitsitam|

sādhyāsādhya vibhāgaṃ ca tasmai tanmunirabravīt||4||

AsInaM munimavyagraM kRutajApyaM kRutakShaNam|

pRuShTavAnarshasAM yuktamagniveshaH [1] punarvasum||3||

prakopahetuM saMsthAnaM sthAnaM li~ggaM cikitsitam|

sAdhyAsAdhyavibhAgaM ca tasmai tanmunirabravIt||4||

To Punarvasu (Lord Atreya), who was in calm pose after having completed his religious rituals, Agnivesha inquired about the etiology, aggravating factors, shape, size, location, clinical features, treatment and prognosis of ''arsha'' (hemorrhoids). Then Lord Atreya responded. [3-4]

==== Types of hemorrhoids ====

इह खल्वग्निवेश! द्विविधान्यर्शांसि- कानिचित् सहजानि, कानिचिज्जातस्योत्तरकालजानि|

तत्र बीजं गुदवलि बीजोप तप्तमायतनमर्शसां सहजानाम्|

तत्र द्विविधो बीजोपतप्तौ हेतुः- मातापित्रोरपचारः, पूर्वकृतं च कर्म; तथाऽन्येषामपि सहजानां विकाराणाम्|

तत्र सहजानि सह जातानि शरीरेण, अर्शांसीत्यधिमांसविकाराः||५||

iha khalvagniveśa! dvividhānyarśāṃsi- kānicit sahajāni, kānicijjātasyottarakālajāni|

tatra bījaṃ gudavali bījopa taptamāyatanamarśasāṃ sahajānām|

tatra dvividho bījopataptau hetuḥ- mātāpitrorapacāraḥ, pūrvakṛtaṃ ca karma; tathā’nyeṣāmapi sahajānāṃ vikārāṇām|

tatra sahajāni saha jātāni śarīreṇa, arśāṃsītyadhimāṃsavikārāḥ||5||

iha khalvagnivesha! dvividhAnyarshAMsi- kAnicit sahajAni, kAnicijjAtasyottarakAlajAni|

tatra bIjaM gudavalibIjopataptamAyatanamarshasAM sahajAnAm|

tatra dvividho bIjopataptau hetuH- mAtApitrorapacAraH, pUrvakRutaM ca karma; tathA~anyeShAmapisahajAnAM vikArANAm|

tatra sahajAni saha jAtAni sharIreNa, arshAMsItyadhimAMsavikArAH||5||

O Agnivesha!, The ''arsha'' is of two types:
#Congenital
#Acquired (manifested after the birth).

Congenital hemorrhoids are caused by the vitiation of the ''beeja dosha'' (deformity in sperm and ovum), specially the part of the anal canal or anal sphincters. This vitiation of the ''beeja dosha'' is caused by two groups of factors:
#The wrong diet and regimen of parents (father/mother)
#The sinful acts of the past life of individuals.

These two categories of causative factors are also responsible for all the other congenital disorders in the human body. ''Sahaja'' means the disorder which is manifested along with the appearance of the body parts since birth. ''Arsha'' (hemorrhoids) is characterized by morbid growth in the muscle tissue. [5]

==== Locations of hemorrhoids ====

सर्वेषां चार्शसां क्षेत्रं- गुदस्यार्ध पञ्चमाङ्गुलावकाशे त्रिभागान्तरास्तिस्रो गुदवलयः क्षेत्रमिति; केचित्तु भूयांसमेव देशमुपदिशन्त्यर्शसां- शिश्नमपत्यपथं गल तालु मुख नासिका कर्णाक्षि वर्त्मानि त्वक् चेति|

तदस्त्यधि मांस देशतया, गुदवलिजानां त्वर्शांसीति सञ्ज्ञा तन्त्रेऽस्मिन्|

सर्वेषां चार्शसामधिष्ठानं- मेदो मांसं त्वक् च||६||

sarveṣāṃ cārśasāṃ kṣetraṃ- gudasyārdha pañcamāṅgulāvakāśe tribhāgāntarāstisro gudavalayaḥ kṣetramiti; kecittu bhūyāṃsameva deśamupadiśantyarśasāṃ- śiśnamapatyapathaṃ gala tālu mukha nāsikā karṇākṣi vartmāni tvak ceti|

tadastyadhi māṃsa deśatayā, gudavalijānāṃ tvarśāṃsīti sañjñā tantre’smin|

sarveṣāṃ cārśasāmadhiṣṭhānaṃ- medo māṃsaṃ tvak ca||6||

sarveShAM cArshasAM kShetraM- gudasyArdhapa~jcamA~ggulAvakAshe tribhAgAntarAstisro gudavalayaHkShetramiti; kecittu bhUyAMsameva deshamupadishantyarshasAM- shishnamapatyapathaMgalatAlumukhanAsikAkarNAkShivartmAni tvak ceti|

tadastyadhimAMsadeshatayA, gudavalijAnAM [1] tvarshAMsIti sa~jj~jA tantre~asmin|

sarveShAM cArshasAmadhiShThAnaM- medo mAMsaM tvak ca||6||

The hemorrhoids are located in the space of four and half ''angulas'' (or approximately 8-10 cm) in the lower part of rectum and anal canal. This area has three sphincters dividing the space into three parts (''guda vali''). There are other locations of ''arshas'' (hemorrhoids) in the body in which excessive and unnatural growth of the muscle tissue also takes place, such as, pudendum, female genital tract, throat, palate, mouth, nose, ears, eyelids and skins. However, in this chapter the ''arsha'' occurring in the anal region are only considered as ''arsha'' (hemorrhoids). The ''adhishthana'' (involved morbid tissue elements) of all the types of ''arsha'' are ''medas'' (fatty tissue), ''mamsa'' (muscular tissue) and ''tvaka'' (skin and mucous membrane). [6]

==== Forms of congenital hemorrhoids ====

तत्र सहजान्यर्शांसि कानिचिदणूनि, कानिचिन्महान्ति, कानिचिद्दीर्घाणि, कानिचिद्ध्रस्वानि, कानिचिद्वृत्तानि, कानिचिद्विषमविसृतानि, कानिचिदन्तःकुटिलानि, कानिचिद्बहिःकुटिलानि, कानिचिज्जटिलानि, कानिचिदन्तर्मुखानि, यथास्वं दोषानुबन्धवर्णानि||७||

tatra sahajānyarśāṃsi kānicidaṇūni, kānicinmahānti, kāniciddīrghāṇi, kāniciddhrasvāni, kānicidvṛttāni, kānicidviṣamavisṛtāni, kānicidantaḥkuṭilāni, kānicidbahiḥkuṭilāni, kānicijjaṭilāni, kānicidantarmukhāni, yathāsvaṃ doṣānubandhavarṇāni||7||

tatra sahajAnyarshAMsi kAnicidaNUni, kAnicinmahAnti, kAniciddIrghANi, kAniciddhrasvAni, kAnicidvRuttAni,kAnicidviShamavisRutAni, kAnicidantaHkuTilAni, kAnicidbahiHkuTilAni, kAnicijjaTilAni,kAnicidantarmukhAni, yathAsvaM doShAnubandhavarNAni||7||

Among the congenital hemorrhoids, some are small, some are large, some are long, some are short, some are round, some are irregularly spread, some are curved internally, some are curved externally, some are matted together, and some are introverted. Their characteristics or forms are as per the ''doshas'' involved in their formation. [7]

==== Signs and symptoms of congenital hemorrhoids ====

तैरुपहतो जन्म प्रभृति भवत्यतिकृशो विवर्णः क्षामो दीनः प्रचुर विबद्ध वात मूत्र पुरीषः शर्कराश्मरीमान्, तथाऽनियतविबद्धमुक्तपक्वामशुष्कभिन्नवर्चा अन्तराऽन्तरा श्वेत पाण्डु हरित पीत रक्तारुण तनु सान्द्र पिच्छिल कुणपगन्ध्याम पुरीषोपवेशी, नाभि बस्ति वङ्क्षणोद्देशे प्रचुर परिकर्तिकान्वितः, सगुदशूल प्रवाहिका परिहर्ष प्रमेह प्रसक्त विष्टम्भान्त्रकूजोदावर्त हृदयेन्द्रियोपलेपः प्रचुर विबद्ध तिक्ताम्लोद्गारः, सुदुर्बलः, सुदुर्बलाग्निः, अल्पशुक्रः, क्रोधनो, दुःखोपचारशीलः, कास श्वास तमक तृष्णा हृल्लास च्छर्द्यरोचका विपाक पीनस क्षवथु परीतः, तैमिरिकः, शिरःशूली, क्षामभिन्नसन्नसक्तजर्जरस्वरः, कर्णरोगी, शून पाणिपाद वदनाक्षिकूटः, सज्वरः, साङ्गमर्दः, सर्व पर्वास्थि शूली च, अन्तराऽन्तरा पार्श्व कुक्षि बस्ति हृदय पृष्ठ त्रिकग्रहोपतप्तः, प्रध्यानपरः, परमालसश्चेति; जन्म प्रभृत्यस्य गुदजैरावृतो मार्गोपरोधाद्वायुरपानः प्रत्यारोहन् समानव्यानप्राणोदानान् पित्तश्लेष्माणौ च प्रकोपयति, एते सर्व एव प्रकुपिताः पञ्च वायवः पित्तश्लेष्माणौ चार्शसमभिद्रवन्त एतान् विकारानुपजनयन्ति; इत्युक्तानि सहजान्यर्शांसि||८||

tairupahato janma prabhṛti bhavatyatikṛśo vivarṇaḥ kṣāmo dīnaḥ pracura vibaddha vāta mūtra purīṣaḥ śarkarāśmarīmān, tathā’niyatavibaddhamuktapakvāmaśuṣkabhinnavarcā antarā’ntarā

=== ''Tattva Vimarsha'' ===

*The ''arsha'' is of two types viz. congenital and acquired (manifested after the birth).
*The congenital hemorrhoids are caused by the vitiation of the ''beeja dosha'' (deformity in sperm and ovum), specially the part of the anal canal or anal sphincters. This vitiation of the ''beeja dosha'' is caused by either wrong diet, lifestyle regimen of parents (father/mother) or by sinful acts of the past life of patient. These are also causes for all other congenital disorders.
*''Arsha'' (hemorrhoids) is characterized by morbid growth in the muscle tissue. The ''adhishthana'' (involved morbid tissue elements) of all the types of ''arsha'' are ''medas'' (fatty tissue), ''mamsa'' (muscular tissue) and ''tvaka'' (skin and mucous membrane).
*Characteristics or forms of all hemorrhoids are as per the ''doshas'' involved in their formation.
*In pathophysiology of ''arsha'', ''apana vayu'' gets obstructed by the hemorrhoid-mass and moves upwards leading to aggravation of ''samana vayu, vyana vayu, prana vayu, udana vayu, pitta'' and ''kapha dosha''. When all these five types of ''vayu, pitta'' and ''kapha'' get aggravated the individual suffers from morbidities of hemorrhoids.
*The causes of ''vataja arsha'' include habitual intake of astringent, pungent, bitter, ununctuous, cold and light food; habitual intake of ''pramitashana'' (food measured in extremely small quantities), intake of less quantity of food, intake of excess alcoholic drinks and indulgence in sexual acts; fasting, living in cold country and cold season, excess physical exercise, grief and exposure to sun and wind.
*The causes of ''pittaja arsha'' include intake of pungent, hot, salty and alkaline food; excess exercise and exposure to the heat of fire and Sun; living in a place and season which are not cold, intake of alcohol and envy; Intake of drinks, food and drugs having ''vidahi'' (causing burning sensation), sharp and hot properties.
*The causes of ''kaphaja arsha'' (hemorrhoids) include sweet, unctuous, cold, salty, sour and heavy food; lack of exercise, sleeping during day time, excess sleeping and sitting; direct exposure to wind, living in cold place and exposure to cold season and mental inactivity.
*Hemorrhoids always include aggravation of all the three ''doshas''. Predominance of one or all the ''doshas'' determine the type of hemorrhoids.
*Five types of ''vayu'' (''prana, apana, vyana, udana'' and ''samana''), ''pitta'' and ''kapha'' - all these morbid factors in their aggravated state afflict the three anal sphincters at ano-rectum and lead to hemorrhoids.
*Excision of the hemorrhoids by sharp instruments, cauterization with ''ksharakarma'' (alkalies) and ''agnikarma'' (thermal cauterization) are three modalities in the management of ''arsha''.
*Hemorrhoids caused by aggravation of ''vayu'' and ''kapha'' are ‘dry hemorrhoids’. Whereas those with excess discharge (bleeding) and wetness are caused by aggravation of ''rakta'' and ''pitta''.
*Dry, hard, inflamed and painful hemorrhoids should be first treated with fomentation in the form of ''avagaha'' (sitz bath in medicated decoction), ''abhyanga'' (local massage with medicated oils), sprinkling of medicated water, fumigation, ointment and external application. Then the vitiated blood shall be removed out by blood letting therapy. Bloodletting with the help of application of leeches or sharp instruments or needles should be done in ''raktaja arsha'', if blood doesn't come out on its own. Simultaneously with this localized treatment, generalized treatment to correct the ''agni'' is advised to patients.
*Butter-milk is the best medicine for the treatment of hemorrhoids caused by aggravation of ''vayu'' and ''kapha''. Butter-milk should be taken along with fat (for ''vayu'') or in an ununctuous form (for ''kapha''). It can be given in various forms, at different times depending upon the state of disease.
*''Anuvasana basti'' (unctuous enema) is best treatment for ''arsha'' associated with dysfunction of ''vata''.
*The bleeding hemorrhoids shall be treated after assessment of association with ''vata'' dominance and ''kapha'' dominance in its patho-physiology. Unctuous and cold things should be used in cases of vitiation of ''vayu'' in bleeding hemorrhoids. In case of vitiation of ''kapha'' in bleeding hemorrhoids, ununctuous and cold-things are useful.
*If there is predominance of ''pitta'' and ''kapha dosha, shodhana'' (elimination) therapies are indicated.
*Bleeding should not be stopped immediately by giving hemostatic therapies. One should wait for appropriate time till the vitiated blood goes out and the patient can be given fasting therapy.
*If the blood vitiated by ''doshas'', which comes out from the hemorrhoids is arrested in the beginning then it may lead to several other complications. Therefore, only after elimination of vitiated blood hemostatic measures are useful. The physician should be well aware of the etiology, signs and symptoms, nature of the time, strength and color of the blood and should wait for appropriate time before administering hemostatic therapies unless there is an emergency.
*Bitter drugs should be given for stimulation of the digestive power, hemostasis and ''pachana'' (metabolic transformation).
*In hemorrhoids with predominance of ''vayu'', if bleeding continues even after the aggravated ''doshas'' are eliminated, then the patient should be given unctuous therapies in the form of drinks, massage and ''anuvasana basti''.
*In summer season, ''pitta'' predominant hemorrhoids without secondary predominance of ''vayu'' and ''kapha'', should be treated with hemostatic therapies immediately to stop bleeding.
*In case of excessive bleeding, the ''arsha'' becomes ''vata'' dominant. Even if ''pitta'' and ''kapha'' are predominantly vitiated, then also predominance of ''vata'' shall be considered in excessive bleeding.
*If there is predominance of ''rakta'' and ''pitta'' and there is less of the signs and symptoms of aggravated ''kapha'' and ''vayu'', then the patient should be given cooling remedies.
*If bleeding continues in spite of the above mentioned remedies and cooling therapies, then a wise physician should administer at the appropriate time, meat-soup which is unctuous and hot. Patient should be given medicated ghee which is administered, prior to taking food. His anus should be massaged with lukewarm ghee or oil, or the hemorrhoid mass should be fomented with lukewarm milk, ghee or oil. These remedies should be administered quickly.
*If bleeding doesn't stop and there is aggravation of ''vayu'' then the patient should be given ''anuvsana'' type of enema with the help of lukewarm ''ghritamanda'' (upper portion of the ghee). He should be given the effective ''piccha basti'' (recipe of which is described below) at the appropriate time.
*The power of digestion should always be preserved in the patients of hemorrhoids by giving sometimes cold articles and sometimes hot articles, sometimes sweet or sour taste drugs or food having opposite characters.
*''Arsha'' (hemorrhoids), ''atisara'' (diarrhea) and ''grahani'' these three diseases are interdependent. In all patients of these three diseases, if the digestive power is low then disease gets aggravated and if digestive power is strong then relief occurs.
*The foods that lead to downward movement of ''vayu'' and promote digestive power should be daily consumed by patients of hemorrhoids. Those foods having opposite properties and those described in the etiology of hemorrhoids should never be used by the patients.

=== ''Vidhi Vimarsha'' ===

In modern surgery, the primary hemorrhoids are located at 3, 7, and 11' 0 clock position while secondary hemorrhoids are located in other positions as well. The sizes of the hemorrhoids differ from patient to patient as well as duration of disease.

The symptoms described for the incurable hemorrhoids develop due to severe bleeding in third and fourth grade of hemorrhoids and secondary complications may develop due to severe anemia and became incurable. But in the present era this type of condition rarely develops and can be managed with the help of blood transfusion. So, any kind of hemorrhoid is curable in present era except one associated with ano-rectal carcinoma.

''Bhallataka'' (Semecarpus anacardium) is strong medicine and if given as single drug in oil form it leads to ulceration in mouth so refreshing drink should be added to dilute and to avoid the complication.

Charak mentioned in most of the verses the effect of the formulation like ''dantyarishta'' helps in the downward movement of flatus and feces and stimulates the digestive power. It shows that the main cause of the disease is ''agnimandya'' and constipation.

In recent studies the sitz bath is advised with warm water in all kind of hemorrhoids or ano-rectal disorders. Charak mentioned sitz bath with warm and cold water. The warm water should be used in cases of ''vataja'' and ''kaphaja'' type of hemorrhoids while cold water sitz bath should be given in cases of ''pittaja'' or ''rakataja'' predominant hemorrhoids.

==== Color atlas of various conditions of ''arsha'' ====
<gallery>
Arsha1.jpg|thumb|Fig 1: Rectal polyp (''sahaja arsha'')
File:Arsha2.jpg|thumb|Fig.2: ''Vataja arsha''
File:Arsha3.jpg|thumb|Fig.3: ''Vataja arsha''
File:Arsha4.jpg|thumb|Fig.4: ''Pittaja arsha''
File:Arsha5.jpg|thumb|Fig.5: ''Pittaja arsha''
File:Arsha6.jpg|thumb|Fig.6: ''Kaphaja arsha''
File:Arsha7.jpg|thumb|Fig.7: ''Kaphaja arsha''
File:Arsha8.jpg|thumb|Fig.8: External Piles
File:Arsha9.jpg|thumb|Fig.9: External Piles
File:Arsha10.jpg|thumb|Fig.10: Internal Piles
File:Arsha11.jpg|thumb|Fig.11: Internal Piles
</gallery>

==== Current Clinical Management ====
{| class="wikitable"
|-
! scope="col"| Type
! scope="col"| Medicine
! scope="col"| Dosage
! scope="col"| Time
! scope="col"| ''Anupana''
|-
| rowspan="3"|''Shushka'' (Dry)
| ''Kankayana Guti''
| 500-1000 mg
| Before Meals
| Butter and sugar
|-
| ''Bhallatakvaleha''
| 10-15 gms
| After meals
| Milk and ghee
|-
| ''Abhayarishta''
| 10-25 ml
| After meals
| Water
|-
| rowspan="2"|Wet
| ''Nagakeshara'' mixture
| 125-250 mg
| Between two meals, three times
| Milk
|-
| ''Samasharkara'' mixture
| 200-400 mg
| Between two meals, three times
| Butter and sugar/Milk and sugar
|}

==== Surgical Management ====

''Ksharasutra'' is the widely accepted effective method.

=== Further reading ===

#Dudhamal TS, Gupta SK, Bhuyan C, Singh K. Clinical study of kutaja and palasha Kshara in the management of Arsha. Indian Journal of Ancient Medicine and Yoga (IJAMY) 2009; 2(2):117-22.
#Bhuyan C, Gupta SK, Dudhamal TS. Importance of Ksharasutra in the management of Arsha (A study of 3586 cases). AYU International Research Journal of Ayurved. 2009;30(2):232-35.
#Dudhamal TS, Gupta SK, Bhuyan C, Singh K. The role of Apamarga Kshara in the management of Arsha. AYU 2010;31(2): 232-35.
#Tomar V, Dudhamal TS, Mahanta VD, Gupta SK. Review of Researches conducted on Arsha (Hemorrhoids) at Institute for Post Graduate Teaching and Research in Ayurveda, Jamnagar. Asian Resonance 2013;2(4): 118-124.
#Dudhamal TS, Gupta SK, Solanki Milan. Effect of Arshohara Malahara and Adjuvant Drugs in the management of Arsha (1st and 2nd Degree hemorrhoids). Ayurlog; National Journal of Research in Ayurveda Science 2013; 2(3): 1-10.
#Das BS, Gupta SK, Dudhamal TS, Mahanta VD. Ksharasutra ligation in Arsha (second degree intero-external piles)-A Case Report. PunarnaV 2014; 2(4): 1-7.
#Gupta SK, Dudhamal TS, Baghel MS, Patil PD. Clinical Efficacy of Arshonyt Tablet and Ointment in hemorrhoids & Fissure-in-ano. Annals of Ayurvedic Medicine (AAM) 2014;3(3-4):81-87.
#Rao MM, Kar AC, Bhattacharya P. A clinical study on the effect of Kankayan Vati, Kaseesadi Taila Vasti and Triphala Churna in the management of Arsha (haemorrhoids). Journal of Research in Ayurveda and Siddha. 2004;25( 3-4): 9-21
#Rao MM, Kar AC, Bhattacharya P, Devidas KV. A clinical study on the effect of Kravyadi Rasa, Kaseesadi Taila Vasti and Triphala Churna in the management of arshas (haemorrhoids). Journal of Research in Ayurveda and Siddha 2004;25(1-2) : 1-10
#Rao MM, Kar AC, Bhattacharya P. A clinical study on the management of Arsha (haemorrhoids) by ayurvedic drug regimen. Journal of Research in Ayurveda and Siddha 2006;27(3-4):48-58
#Pathak A, Hemantha K. P. A case discussion on effect of Apamarga Pratsaraneeya Kshara in the management of Ardra Arshas w.s.r to histopathological examination. International Journal of Ayurvedic Medicine. 2012; 3(4):193-195.
#Reddy RG, Mangal A, Jadhav AD, Tathed PS. A case study of thrombosed haemorrhoids treated with leech application. Journal of Research in Ayurveda and Siddha. 2010; 31( 4) :101-112.
#Mehra M, Makhija R, Vyas N. A clinical study on the role of indigenous formulation on Arsha (piles). Journal of Ayurveda 2010;4(1): 15-22
#Mehra M, Makhija R, Vyas N. A clinical study on the role of ksara Vasti and Triphala Guggulu in Raktarsha (bleeding piles). AYU 2011;32(2):192-195
#Reddy RG, Mangal A, Jadhav AD, Tathed PS Venkateshwarlu G. A clinical evalution of efficacy of certain Ayurvedic formulations in the management of Arsha (haemorrhoids). Journal of Research in Ayurveda and Siddha. 2011; 32 3(4) : 31-46.
#Borkar KM, Shekokar AV, Patange V. A clinical study of Kankayan Vati in the management of Arshas (piles) International Journal of Ayurvedic Medicine.2012; 3 ( 3):177-181.
#Pal A,Sharma PP, Mukherjee PK. A clinical study of kutaja (Holarrhena antidysenterica wall) on Shonitarsha. AYU .2009; 30(4):369-372.
#Rao MM, Kar AC, Bhattacharya P, Hazra J. A comparative clinical study on the effect of some compound Ayurvedic preparations in the management of Arsha (haemorrhoids). Journal of Research in Ayurveda and Siddha .2010; 31(3): 1-14
#Singh R, Ramesh C Arya RC, Minhas SS, Dutt A. A comparative study of barron's rubber band ligation with Ksharsutra ligation in hemorrhoids. International Journal of Ayurveda Research. 2010;1(2):73-81.
#Singh R, Ramesh C Arya RC, Minhas SS, Dutt A. A comparative study of Guggul Based Apamarga Kshar Sutra ligation with barron s rubber band ligation in haemorrhoids. Journal of Pharmacy Research. 2009; 2(3): 514-523.
#Shekokar AAV, Borkar KM. A comparative study of Ksharkarma and cryo surgery in the management of Arsha (haemorrhoids). International Journal of Ayurvedic Medicine. 2012;3(3):186-192.
#Reddy RG, Mangal A, Jadhav AD,Venkateshwarlu GV, Lavekar GS. A single blind clinical study to evaluate the efficacy of herbo-mineral formulation in the treatment of Arsha (haemorrhoids). Journal of Research in Ayurveda and Siddha 2010; 31(4):85-100.
#Anant Kumar V. Shekokar , 2.Kanchan M. Borkar, 3.Pratik Raut A study on clinical efficacy of nagaradi Modak in the management of Arsha w.s.r to piles. International Journal of Ayurvedic Medicine. 2013;4(1): 72-76.
#Prasad N, Dash NC, Das BK. A study on medicinal management (Bhesaja Cikitsa) of piles with a patent medicine Pilosap. Journal of Research in Ayurveda and Siddha.2004;25(1-2):11-27.
#Dongargaon TN, Emmi SV, Wali AA, Kulkarni YS. A unique nonsurgical management of internal hemorrhoids by Jimutaka lepa. Ancient Science of Life. 2014 ;33(3) :176-181
#Bhagat PJ Raut SY, Lakhapati AM.Clinical efficacy of Jalaukawacharana (leech application) in thrombosed piles. AYU.2012; 33(2): 261-263.
#Yousefi M etal, Clinical evaluation of commiphora mukul, a botanical resin, in the management of hemorrhoids: a randomized controlled trial. Pharmacognocy Magazine. 2013; 9(36):350-356.
#Vendateshwarlu G, Pushpalatha H, Sridhar BN. Clinical evaluation of herbo mineral formulations in the management of Arsas (haemorrhoids). Aryavaidyan. 2009; 22(3):153-157.
#Rao BM. Comparative clinical evaluation of Kshara injection technique in the management of internal hemorrhoids. Ancient Science of Life.1999;19(1 & 2): 39-45.
#Gupta ML, Gupta SK, Bhuyan C. Comparative clinical evaluation of Kshara Sutra ligation and hemorrhoidectomy in Arsha (hemorrhoids). AYU.2011;32(2): 225-229.
#Pathak A, Hemantha KP. Comparative study of Apamarga Pratisaraniya Kshara and palasha Pratisaraniya Kshara in the management of Ardra Arsha. International Journal of Ayurvedic Medicine. 2013;4(1):59-71.
#Rao MM, Kar AC,Bhattacharya P, Hazra J. Evaluation of ayurvedic therapy for arsha (haemorroids) management - a therapeutic study. Journal of Research in Ayurveda and Siddha. 2010;31(1) :29-36.
#V.P. Ukhalkar Evaluation of effects of Yavakshar ointment on Abhyantar Arsha (internal piles). International Journal of Research in Ayurveda and Pharmacy. 2013; 4(4): 574-582.
#Ravishankar AG, Rao RS, Mahesh TS,Subrahmanya P, Krishnamurthy MS. Leech on external thrombosed hemorrhoids. International Research Journal of Pharmacy. 2013; 4(11):50-52.
#Mahapatra A, Srinivasan A, Sujithra R, Bhat RP. Management of internal hemorrhoids by Kshara Karma: an educational case report. Journal of Ayurveda and Integrative Medicine. 2012; 3(3):115-118.
#Singh S, Kedar NM,Raut SY, Lakhapati AM.Role of jaloukavacharan in thrombosed hemorrhoids- a case study. International Journal of Ayurveda and Pharma Research. 2014; 2(3):100-103.
#Singh OP, Singh R, Singh SK, Singh US. Role of Kankayan Vati, Triphala Churna and Kasishadi Taila in the management of Arsha (anorectal piles). Journal of Research in Ayurveda and Siddha. 2005; 26(1-2):59-65.
#Sonawane A, Dharne V. Role of Pippalyadi Tail Matrabasti in Arsha Roga. Punarnav. 2014; 2(1):59-65.
#Gujarathi NN, Singh K. Role of Raktamokshana with special reference to Arsha. AYU. 1988; 9(4):24-28.
#Zimare SB, Morwadkar PK, Ukhalkar VP. The comparative study between Kasisadi Tail Abhyang and barrons band ligation in the management of Abhyantar Arsh (internal haemorrhoids).Journal of Ayurveda.2012; 5(1):68-72.
#Rao MM, Kar AC, Bhattacharya P, Hazra J. The effect of Ayurvedic drug regimen in the management of Arsha (haemorrhoids) - a comparative therapeutic study. Journal of Research In Ayurveda and Siddha. 2009;30(3):77-92.
#Reddy RG, Mangal A, Jadhav AD, Lavekar GS. The efficacy of herbo-mineral formulations in the management of Arsha (haemorrhoids). Journal of Research in Ayurveda and Siddha. 2012;33(1-4):1-14.
#Rao MM, Das B, Nanda GC, Padhi MM. The role of Pichu (Taila) application in the management of Arsha (haemorrhoids) - a pilot study. Journal of Research in Ayurveda and Siddha. 2006;27(1-2): 41-51.
#Rao MM, Kar AC, Bhattacharya P. Therapeutic evaluation of compound Ayurvedic formulations in the management of Arsha (haemorrhoids) - a clinical study. Journal of Research in Ayurveda and Siddha. 2006; 27(3-4):81-91.
#Chopade KM, Khatri SR, Raut SY, Lakhapati AM. To evaluate the efficacy of Kshiri - Vruksh Patra (Vata, Udumbara & Peepal) in management of Arsha. e-Journal Rasamruta. 2013; 5(14):1-5.
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Kshatakshina Chikitsa

2019-03-06T03:56:05Z

Pallavmishra:

{{Infobox
|title = Kshatakshina Chikitsa
|label1 = Section/Chapter
|data1 = [[Chikitsa Sthana]] Chapter 11
|label2 = Preceding Chapter
|data2 = [[Apasmara Chikitsa]]

|label3= Succeeding Chapter
|data3 = [[Shvayathu Chikitsa]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

==[[Chikitsa Sthana]] Chapter 11, Chapter on the Management of ''Kshata-kshina'' (Emaciation due to Trauma) ==

=== Abstract ===

''Kshatakshina'' is a condition with ''kshaya'' (wasting, debility, emaciation) due to injury/trauma. Trauma is usually from external injury but in the present context this term signifies rupture of lung tissue due to exogenous as well as endogenous causes. The etiology includes significant exertion beyond one’s capacity. The disease shows close resemblance with ''rajayakshma'' in pathogenesis, as both involve ''anuloma kshaya'' (the depletion of ''dhatus'' takes place in the direction of their nourishment i.e. ''rasa'' then ''rakta'' then ''mamsa'' and so on) and ''pratiloma kshaya'' (depletion of ''dhatus'' in the direction opposite to their nourishment i.e. ''shukra'' then ''majja'' then ''asthi'' and so on). Nourishment therapy is the principle of management in ''kshatakshina''. Various formulations to regain strength and replenishment of depleted tissues are described in this chapter.

'''Keywords''': ''Kshatakshina,'' adventures, occupational disease, pneumo-thorax, tuberculosis, nourishment therapy.

=== Introduction ===

In Ayurveda, rather than disease, mainly the syndromes are described and ''kshatakshina'' is also a syndrome. ''Kshata'' means injury and ''kshina'' means depletion of tissue. The term literally means depletion of tissues due to injury. It includes various pathologies leading to depletion of tissues in the body as a result of external and internal injuries. It shows close resemblance with tuberculosis, however the cardinal cause in ''kshatakshina'' is injury. Hemoptysis (symptom of pulmonary tuberculosis), hematuria (symptom of renal tuberculosis) and diarrhea (symptom of intestinal tuberculosis) all have cardinal symptoms of tuberculosis which are described as the symptom of ''kshatakshina''. It refers to those dreaded complications of tuberculosis that appear suddenly and require prompt treatment just as acute onset of chest-pain in patient of tuberculosis who suddenly develops pneumothorax due to rupture of subpleural blebs and massive painless hematuria in the patient of genitourinary tuberculosis. Similar to tuberculosis, there is impaired immunity in ''kshatakshina'' patients also. ''Kshatakshina'' refers to cluster of diseases like spontaneous pneumothorax and renal tuberculosis, whereas presence of hemoptysis and hematuria in a single disease suggests a pulmonary-renal syndrome (eg, Goodpasture's syndrome, Wegener's granulomatosis). The diseases due to excess exertion during work or occupational hazards can also be referred to ''kshatakshina''.

===Sanskrit text, Transliteration and English Translation===

अथातः क्षतक्षीणचिकित्सितं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ kṣatakṣīṇacikitsitaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH kShatakShINacikitsitaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter on the treatment of ''Kshatakshina''.

Thus, said Lord Atreya. [1-2]

उदारकीर्तिर्ब्रह्मर्षिरात्रेयः परमार्थवित्|
क्षतक्षीणचिकित्सार्थमिदमाह चिकित्सितम्||३||

udārakīrtirbrahmarṣirātrēyaḥ paramārthavit|
kṣatakṣīṇacikitsārthamidamāha cikitsitam||3||

udArakIrtirbrahmarShirAtreyaH paramArthavit|
kShatakShINacikitsArthamidamAha cikitsitam||3||

Atreya, the illustrious sage, the brahmin-seer and the knower of ultimate truth, (thereafter) expounded therapeutics for the treatment of ''kshatakshina'', as given below. [3]

==== ''Nidana'' (Etiology) of ''kshatakshina'' ====

धनुषाऽऽयस्यतोऽत्यर्थं भारमुद्वहतो गुरुम्|
पततो विषमोच्चेभ्यो बलिभिः सह युध्यतः||४||

वृषं हयं वा धावन्तं दम्यं वाऽन्यं निगृह्णतः|
शिलाकाष्ठाश्मनिर्घातान्क्षिपतो निघ्नतः परान्||५||

अधीयानस्य वाऽत्युच्चैर्दूरं वा व्रजतो द्रुतम्|
महानदीं वा तरतो हयैर्वा सह धावतः||६||

सहसोत्पततो दूरं[१] तूर्णं चातिप्रनृत्यतः|
तथाऽन्यैः कर्मभिः क्रूरैर्भृशमभ्याहतस्य च||७||

विक्षते वक्षसि व्याधिर्बलवान् समुदीर्यते|
स्त्रीषु चातिप्रसक्तस्य रूक्षाल्पप्रमिताशिनः||८||

dhanuṣā''yasyatō'tyarthaṁ bhāramudvahatō gurum|
patatō viṣamōccēbhyō balibhiḥ saha yudhyataḥ||4||

vr̥ṣaṁ hayaṁ vā dhāvantaṁ damyaṁ vā'nyaṁ nigr̥hṇataḥ|
śilākāṣṭhāśmanirghātān kṣipatō nighnataḥ parān||5||

adhīyānasya vā'tyuccairdūraṁ vā vrajatō drutam|
mahānadīṁ vā taratō hayairvā saha dhāvataḥ||6||

sahasōtpatatō dūraṁ [1] tūrṇaṁ cātipranr̥tyataḥ|
tathā'nyaiḥ karmabhiḥ krūrairbhr̥śamabhyāhatasya ca||7||

vikṣatē vakṣasi vyādhirbalavān samudīryatē|
strīṣu cātiprasaktasya rūkṣālpapramitāśinaḥ||8||

dhanuShA~a~ayasyato~atyarthaM bhAramudvahato
gurum| patato viShamoccebhyo balibhiH saha yudhyataH||4||

vRuShaM hayaM vA dhAvantaM damyaM vA~anyaM nigRuhNataH|
shilAkAShThAshmanirghAtAn kShipato nighnataH parAn||5||

adhIyAnasya vA~atyuccairdUraM vA vrajato drutam|
mahAnadIM vA tarato hayairvA saha dhAvataH||6||

sahasotpatato dUraM tUrNaM cAtipranRutyataH|
tathA~anyaiH karmabhiH krUrairbhRushamabhyAhatasya ca||7||

vikShate vakShasi vyAdhirbalavAn samudIryate|
strIShu cAtiprasaktasya rUkShAlpapramitAshinaH||8||

The person who (beyond his own power) subjects himself to following activities:
#Straining in excess with a hard bow
#Carrying heavy weight
#Falling or jumping over uneven place or from high altitude.
#Wrestling or fighting with stronger persons.
#Restraining a running bull, stallion or any other strong animal requiring control
#Throwing heavy stones, wooden blocks, or equipment made of stone or beating others with these
#Reciting scriptures loudly
#Running a long distance or walking too fast.
#Crossing a big river by swimming
#Running along with horse
#Sudden long and high jump
#Practicing violent dance for a long time; and
#Being excessively injured by other violent and cruel acts.
#One who indulges excessively in sexual intercourse
#Who indulges in excess dry, less quantity food or limited food

''Kshatakshina'', the formidable disease, gets manifested, as a result of the injury to the chest due to the above causative factors. [4-8]

==== Pathogenesis and clinical features ====

उरो विरुज्यते तस्य भिद्यतेऽथ विभज्यते|
प्रपीड्येते ततः पार्श्वे शुष्यत्यङ्गं प्रवेपते||९||

क्रमाद्वीर्यं बलं वर्णो रुचिरग्निश्च हीयते|
ज्वरो व्यथा मनोदैन्यं विड्भेदोऽग्निवधादपि||१०||

दुष्टः श्यावः सुदुर्गन्धः पीतो विग्रथितो बहुः|
कासमानस्य च[१] श्लेष्मा सरक्तः सम्प्रवर्तते||११||

स क्षतः क्षीयतेऽत्यर्थं तथा शुक्रौजसोः क्षयात्|१२|

urō virujyatē tasya bhidyatē'tha vibhajyatē|
prapīḍyētē tataḥ pārśvē śuṣyatyaṅgaṁ pravēpatē||9||

kramādvīryaṁ balaṁ varṇō ruciragniśca hīyatē|
jvarō vyathā manōdainyaṁ viḍbhēdō'gnivadhādapi||10||

duṣṭaḥ śyāvaḥ sudurgandhaḥ pītō vigrathitō bahuḥ|
kāsamānasya ca [1] ślēṣmā saraktaḥ sampravartatē||11||

sa kṣataḥ kṣīyatē'tyarthaṁ tathā śukraujasōḥ kṣayāt|

uro virujyate tasya bhidyate~atha vibhajyate|
prapIDyete tataH pArshve shuShyatya~ggaM pravepate||9||

kramAdvIryaM balaM varNo ruciragnishca hIyate|
jvaro vyathA manodainyaM viDbhedo~agnivadhAdapi||10||

duShTaH shyAvaH sudurgandhaH pIto vigrathito bahuH|
kAsamAnasya ca shleShmA saraktaH sampravartate||11||

sa kShataH kShIyate~atyarthaM tathA shukraujasoH kShayAt|12|

Because of the above mentioned causative factors, the chest gets broken, punctured and cracked; sides of the chest get pressed and there is emaciation as well as tremor in the limbs. Gradually the potency, strength, complexion, appetite and agni (the power of digestion) of the patient get reduced. The patient suffers from fever, pain, mental depression and diarrhea even with the diminution of ''agni'' (decreased power of digestion).

While coughing, the patient spits out phlegm which is putrid, grayish in color, foul smelling, and yellow and knotty, in large quantities along with blood. The person suffering from ''kshatakshina'' becomes excessively emaciated due to further wastage of ''shukra'' and ''ojas''. [9-12]

==== Prodromal signs and symptoms ====

अव्यक्तं लक्षणं तस्य पूर्वरूपमिति स्मृतम्||१२||

उरोरुक्शोणितच्छर्दिः कासो वैशेषिकः क्षते|
क्षीणे सरक्तमूत्रत्वं पार्श्वपृष्ठकटिग्रहः||१३||

avyaktaṁ lakṣaṇaṁ tasya pūrvarūpamiti smr̥tam||12||

urōrukśōṇitacchardiḥ kāsō vaiśēṣikaḥ kṣatē|
kṣīṇē saraktamūtratvaṁ pārśvapr̥ṣṭhakaṭigrahaḥ||13||

avyaktaM lakShaNaM tasya pUrvarUpamiti smRutam||12||

urorukshoNitacchardiH kAso vaisheShikaH kShate|
kShINe saraktamUtratvaM pArshvapRuShThakaTigrahaH||13||

Signs and symptoms in unmanifested form (less manifested) constitute the premonitory signs and symptoms of this disease. (There is no appearance of premonitory sings).

However, if there is ''kshata'' (injury), pain in the chest, blood vomiting and cough are specially manifested, and if there is ''kshaya'' (diminution of tissue elements), then hematuria and stiffness of the sides of the chest, back and lumbar region are specially manifested [121/2-13]

==== Prognosis ====

अल्पलिङ्गस्य दीप्ताग्नेः साध्यो बलवतो नवः|
परिसंवत्सरो याप्यः सर्वलिङ्गं तु वर्जयेत्||१४||

alpaliṅgasya dīptāgnēḥ sādhyō balavatō navaḥ|
parisaṁvatsarō yāpyaḥ sarvaliṅgaṁ tu varjayēt||14||

alpali~ggasya dIptAgneH sAdhyo balavato navaH|
parisaMvatsaro yApyaH sarvali~ggaM tu varjayet||14||

If the signs and symptoms are mild, the power of digestion (of the patient) is strong, patient has enough strength and if the disease is new (freshly occurred), then it is curable. If the disease is chronic i.e. more than one year, then it is ''yapya'' (palliable). If however, all the signs and symptoms of the disease are simultaneously manifested, then such a patient should not be treated, because the condition is incurable.[14]

==== Management ====

उरो मत्वा क्षतं लाक्षां पयसा मधुसंयुताम्|
सद्य एव पिबेज्जीर्णे पयसाऽद्यात् सशर्करम्||१५||

पार्श्वबस्तिरुजी चाल्पपित्ताग्निस्तां सुरायुताम्|
भिन्नविट्कः समुस्तातिविषापाठां सवत्सकाम्||१६||

लाक्षां सर्पिर्मधूच्छिष्टं जीवनीयगणं सिताम्|
त्वक्क्षीरीं समितां क्षीरे पक्त्वा दीप्तानलः पिबेत्||१७||

इक्ष्वालिकाबिसग्रन्थिपद्मकेशरचन्दनैः|
शृतं पयो मधुयुतं सन्धानार्थं पिबेत् क्षती||१८||

यवानां चूर्णमादाय क्षीरसिद्धं घृतप्लुतम्|
ज्वरे दाहे सिताक्षौद्रसक्तून् वा पयसा पिबेत्||१९||

मधूकमधुकद्राक्षात्वक्क्षीरीपिप्पलीबलाः|
कासी पार्श्वास्थिशूली च लिह्यात्सघृतमाक्षिकाः||२०||

urō matvā kṣataṁ lākṣāṁ payasā madhusaṁyutām|
sadya ēva pibējjīrṇē payasā'dyāt saśarkaram||15||

pārśvabastirujī cālpapittāgnistāṁ surāyutām|
bhinnaviṭkaḥ samustātiviṣāpāṭhāṁ savatsakām||16||

lākṣāṁ sarpirmadhūcchiṣṭaṁ jīvanīyagaṇaṁ sitām|
tvakkṣīrīṁ samitāṁ kṣīrē paktvā dīptānalaḥ pibēt||17||

ikṣvālikābisagranthipadmakēśaracandanaiḥ|
śr̥taṁ payō madhuyutaṁ sandhānārthaṁ pibēt kṣatī||18||

yavānāṁ cūrṇamādāya kṣīrasiddhaṁ ghr̥taplutam|
jvarē dāhē sitākṣaudrasaktūn vā payasā pibēt||19||

madhūkamadhukadrākṣātvakkṣīrīpippalībalāḥ|
kāsī pārśvāsthiśūlī ca lihyātsaghr̥tamākṣikāḥ||20||

Uro matvA kShataM lAkShAM payasA madhusaMyutAm|
sadya eva pibejjIrNe payasA~adyAt sasharkaram||15||

pArshvabastirujI cAlpapittAgnistAM surAyutAm|
bhinnaviTkaH samustAtiviShApAThAM savatsakAm||16||

lAkShAM sarpirmadhUcchiShTaM jIvanIyagaNaM sitAm|
tvakkShIrIM samitAM kShIre paktvA dIptAnalaH pibet||17||

ikShvAlikAbisagranthipadmakesharacandanaiH|
shRutaM payo madhuyutaM sandhAnArthaM pibet kShatI||18||

yavAnAM cUrNamAdAya kShIrasiddhaM ghRutaplutam|
jvare dAhe sitAkShaudrasaktUn vA payasA pibet||19||

madhUkamadhukadrAkShAtvakkShIrIpippalIbalAH|
kAsI pArshvAsthishUlI ca lihyAtsaghRutamAkShikAH||20||

If there is fresh injury to the chest, then the patient should be given ''laksha'' (lac) along with milk and honey. After the potion is digested, he should be given food along with milk and sugar.

If there is pain in the sides of the chest or in the region of the urinary bladder, and if there is less of ''pitta'' and ''agni'' (digestive power), then the patient should be given ''laksha'' (lac) along with ''sura'' (alcoholic drink).

If there is diarrhea, then the patient should be given ''laksha'' along with ''musta, ativisha, patha'' and ''vatsaka''.

If the patient has strong power of digestion, then he should be given milk cooked with laksha, ghee, bee’s wax, and drugs belonging to ''jivaniya'' group, sugar and ''tvaksiri''.

For healing of the injury, the patient should take milk boiled with ''ikshuvalika, bisagranthi, padma kesara'' and ''chandana'' with added honey.

If there is fever and burning sensation in the body, then the patient should take barley powder cooked with milk and added ghee. Alternatively, such a patient should take sugar, honey and ''saktu'' (roasted corn-flour) mixed with milk.

If the patient is suffering from cough and pain in the sides of the chest as well as bones, then he should take linctus prepared of the powder ''madhuka'' (flower), ''madhu, draksha, tvakshiri, pippali'' and ''bala'' mixed with ghee and honey. [15-20]

==== ''Eladi gutika'' ====

एलापत्रत्वचोऽर्धाक्षाः पिप्पल्यर्धपलं तथा|
सितामधुकखर्जूरमृद्वीकाश्च पलोन्मिताः||२१||

सञ्चूर्ण्य मधुना युक्ता गुटिकाः सम्प्रकल्पयेत्|
अक्षमात्रां ततश्चैकां भक्षयेन्ना दिने दिने||२२||

कासं श्वासं ज्वरं हिक्कां छर्दिं मूर्च्छां मदं भ्रमम्|
रक्तनिष्ठीवनं तृष्णां पार्श्वशूलमरोचकम्||२३||

शोषप्लीहाढ्यवातांश्च स्वरभेदं क्षतं क्षयम्|
गुटिका तर्पणी वृष्या रक्तपित्तं च नाशयेत्||२४||

इत्येलादिगुटिका|

ēlāpatratvacō'rdhākṣāḥ pippalyardhapalaṁ tathā|
sitāmadhukakharjūramr̥dvīkāśca palōnmitāḥ||21||

sañcūrṇya madhunā yuktā guṭikāḥ samprakalpayēt|
akṣamātrāṁ tataścaikāṁ bhakṣayēnnā dinē dinē||22||

kāsaṁ śvāsaṁ jvaraṁ hikkāṁ chardiṁ mūrcchāṁ madaṁ bhramam|
raktaniṣṭhīvanaṁ tr̥ṣṇāṁ pārśvaśūlamarōcakam||23||

śōṣaplīhāḍhyavātāṁśca svarabhēdaṁ kṣataṁ kṣayam|
guṭikā tarpaṇī vr̥ṣyā raktapittaṁ ca nāśayēt||24||

ityēlādiguṭikā

elApatratvaco~ardhAkShAH pippalyardhapalaM tathA|
sitAmadhukakharjUramRudvIkAshca palonmitAH||21||

sa~jcUrNya madhunA yuktA guTikAH samprakalpayet|
akShamAtrAM tatashcaikAM bhakShayennA dine dine||22||

kAsaM shvAsaM jvaraM hikkAM chardiM mUrcchAM madaM bhramam|
raktaniShThIvanaM tRuShNAM pArshvashUlamarocakam||23||

shoShaplIhADhyavAtAMshca svarabhedaM kShataM kShayam|
guTikA tarpaNI vRuShyA raktapittaM ca nAshayet||24||

ityelAdiguTikA|

Half ''aksha'' (five grams) each of ''ela, patra'' and ''tvak'', half ''pala'' (twenty grams) of ''pippali'', one ''pala'' each of ''sita''(forty grams), ''madhuka, kharjura'' and ''mridvika'' should be made to a powder. Honey should be added to this powder to make a paste. From this paste, pills of one ''aksha'' each should be prepared. One such pill should be taken every day. It cures ''kasa'' (cough), ''shvasa'' (dyspnea), ''jwara'' (fever), hiccup, vomiting, fainting, hemoptysis, morbid thirst, pain in the sides of the chest, anorexia, consumption, splenic enlargement, ''adhyavata'' (rheumatoid arthritis), hoarseness of voice, ''kshata'' (injury to the chest), ''kshaya'' (diminution of tissues elements) and ''raktapitta'' (a condition charcterised by bleeding from different parts of the body). This pill is refreshing and aphrodisiac. [21-24]

==== Treatment of excessive bleeding ====

रक्तेऽतिवृत्ते दक्षाण्डं यूषैस्तोयेन वा पिबेत्|
चटकाण्डरसं वाऽपि रक्तं वा छागजाङ्गलम्||२५||

चूर्णं पौनर्नवं रक्तशालितण्डुलशर्करम्|
रक्तष्ठीवी पिबेत् सिद्धं द्राक्षारसपयोघृतैः||२६||

raktē'tivr̥ttē dakṣāṇḍaṁ yūṣaistōyēna vā pibēt|
caṭakāṇḍarasaṁ vā'pi raktaṁ vā chāgajāṅgalam||25||

cūrṇaṁ paunarnavaṁ raktaśālitaṇḍulaśarkaram|
raktaṣṭhīvī pibēt siddhaṁ drākṣārasapayōghr̥taiḥ||26||

rakte~ativRutte dakShANDaM yUShaistoyena vA pibet|
caTakANDarasaM vA~api raktaM vA chAgajA~ggalam||25||

cUrNaM paunarnavaM raktashAlitaNDulasharkaram|
raktaShThIvI pibet siddhaM drAkShArasapayoghRutaiH||26||

If there is excessive bleeding, then the patient should take eggs of ''daksha'' (wild hen) along with green gram soup or water. He may also take the soup of eggs of sparrow or (preparations) of the blood of goat or wild animals (like deer, etc).

The patient having hemoptysis should take the powder of ''punarnava,'' red variety of shali rice and sugar cooked along with grape juice, milk and ghee. [25-26]

==== Various formulations ====

मधूकमधुकक्षीरसिद्धं वा तण्डुलीयकम्|
मूढवातस्त्वजामेदः सुराभृष्टं ससैन्धवम्||२७||

क्षामः क्षीणः क्षतोरस्कस्त्वनिद्रः सबलेऽनिले|
शृतक्षीरसरेणाद्यात् सक्षौद्रघृतशर्करम्||२८||

शर्करां यवगोधूमौ जीवकर्षभकौ मधु|
शृतक्षीरानुपानं वा लिह्यात् क्षीणः क्षती कृशः||२९||

क्रव्यादमांसनिर्यूहं घृतभृष्टं पिबेच्च सः|
पिप्पलीक्षौद्रसंयुक्तं मांसशोणितवर्धनम्||३०||

न्यग्रोधोदुम्बराश्वत्थप्लक्षशालप्रियङ्गुभिः|
तालमस्तकजम्बूत्वक्प्रियालैश्च सपद्मकैः||३१||

साश्वकर्णैः शृतात् क्षीरादद्याज्जातेन सर्पिषा|
शाल्योदनं क्षतोरस्कः क्षीणशुक्रश्च मानवः||३२||

यष्ट्याह्वनागबलयोः क्वाथे क्षीरसमं घृतम्|
पयस्यापिप्पलीवांशीकल्कसिद्धं क्षते शुभम्||३३||

कोललाक्षारसे तद्वत् क्षीराष्टगुणसाधितम्|
कल्कैः कट्वङ्गदार्वीत्वग्वत्सकत्वक्फलैर्घृतम्||३४||

madhūkamadhukakṣīrasiddhaṁ vā taṇḍulīyakam|
mūḍhavātastvajāmēdaḥ surābhr̥ṣṭaṁ sasaindhavam||27||

kṣāmaḥ kṣīṇaḥ kṣatōraskastvanidraḥ sabalē'nilē|
śr̥takṣīrasarēṇādyāt sakṣaudraghr̥taśarkaram||28||

śarkarāṁ yavagōdhūmau jīvakarṣabhakau madhu|
śr̥takṣīrānupānaṁ vā lihyāt kṣīṇaḥ kṣatī kr̥śaḥ||29||

kravyādamāṁsaniryūhaṁ ghr̥tabhr̥ṣṭaṁ pibēcca saḥ|
pippalīkṣaudrasaṁyuktaṁ māṁsaśōṇitavardhanam||30||

nyagrōdhōdumbarāśvatthaplakṣaśālapriyaṅgubhiḥ|
tālamastakajambūtvakpriyālaiśca sapadmakaiḥ||31||

sāśvakarṇaiḥ śr̥tāt kṣīrādadyājjātēna sarpiṣā|
śālyōdanaṁ kṣatōraskaḥ kṣīṇaśukraśca mānavaḥ||32||

yaṣṭyāhvanāgabalayōḥ kvāthē kṣīrasamaṁ ghr̥tam|
payasyāpippalīvāṁśīkalkasiddhaṁ kṣatē śubham||33||

kōlalākṣārasē tadvat kṣīrāṣṭaguṇasādhitam|
kalkaiḥ kaṭvaṅgadārvītvagvatsakatvakphalairghr̥tam||34||

madhUkamadhukakShIrasiddhaM vA taNDulIyakam|
mUDhavAtastvajAmedaH surAbhRuShTaM sasaindhavam||27||

kShAmaH kShINaH kShatoraskastvanidraH sabale~anile|
shRutakShIrasareNAdyAt sakShaudraghRutasharkaram||28||

sharkarAM yavagodhUmau jIvakarShabhakau madhu|
shRutakShIrAnupAnaM vA lihyAt kShINaH kShatI kRushaH||29||

kravyAdamAMsaniryUhaM ghRutabhRuShTaM pibecca saH|
pippalIkShaudrasaMyuktaM mAMsashoNitavardhanam||30||

nyagrodhodumbarAshvatthaplakShashAlapriya~ggubhiH|
tAlamastakajambUtvakpriyAlaishca sapadmakaiH||31||

sAshvakarNaiH shRutAt kShIrAdadyAjjAtena sarpiShA|
shAlyodanaM kShatoraskaH kShINashukrashca mAnavaH||32||

yaShTyAhvanAgabalayoH kvAthe kShIrasamaM ghRutam|
payasyApippalIvAMshIkalkasiddhaM kShate shubham||33||

kolalAkShArase tadvat kShIrAShTaguNasAdhitam|
kalkaiH kaTva~ggadArvItvagvatsakatvakphalairghRuta ||34||

Milk should be boiled with the paste of ''madhooka'' and ''madhuka''. With this milk, ''tanduliyaka'' should be cooked (which is useful for the patient suffering from the hemoptysis).

If there is ''mudhavata'' (claudication of ''vata''), the patient should take the fat of goat fried with ''sura'' (type of liquor) and mixed with rock salt.

If the patient is weak, emaciated and having injury in the chest, sleeplessness and excessive aggravation of ''vayu'', then he should take goat’s fat boiled with the cream of milk and added with honey, ghee and sugar.

If the patient is emaciated, having injury in the chest and cachectic, he may be given sugar, barley, wheat, ''jivaka, rushabhaka'' and honey in linctus form. Thereafter, he should take boiled milk.

The above mentioned patient should take the decoction of the meat of carnivorous animal sizzled with ghee and added with ''pippali'' and honey. This potion promotes muscles tissues and blood.

The patient having injury to the chest and diminution of semen, should take ''sali'' rice mixed with ghee which latter is prepared of the milk boiled with ''nyagrodha, udumbara, ashvattha, plaksha, sala, priyangu,'' tuft of ''tala'', bark of ''jambu, priyala, padmaka'' and ''asvakarna''.

===== ''Yashtyavahadi ghrita'' =====

Ghee should be cooked with equal quantity of milk, the decoction of ''madhuyashti'' and ''nagabala'' (four times of ghee in total), and the paste of ''payasya, pippali'' and ''vamshi'' (one fourth in total of ghee). The medicated ghee is useful in the treatment of ''kshata'' (injury to chest).

===== ''Koladi ghrita'' =====

Similarly, ghee should be cooked with the decoction of ''kola'' and ''laksha'' (four times in total of ghee), eight times of milk, and the paste of the bark of ''kaivanga'', bark of ''darvi'', bark of ''kutaja'' and fruit of ''kutaja'' (one fourth in total of ghee). This medicated ghee is useful in the treatment of ''kshata''.[27-34]

==== ''Amritaprasha ghee'' ====

जीवकर्षभकौ वीरां जीवन्तीं नागरं शटीम्|
चतस्रः पर्णिनीर्मेदे काकोल्यौ द्वे निदिग्धिके||३५||

पुनर्नवे द्वे मधुकमात्मगुप्तां शतावरीम्|
ऋद्धिं परूषकं भार्गीं मृद्वीकां बृहतीं तथा||३६||

शृङ्गाटकं तामलकीं पयस्यां पिप्पलीं बलाम्|
बदराक्षोटखर्जूरवातामाभिषुकाण्यपि||३७||

फलानि चैवमादीनि कल्कान् कुर्वीत कार्षिकान्|
धात्रीरसविदारीक्षुच्छागमांसरसं पयः||३८||

कुर्यात् प्रस्थोन्मितं तेन घृतप्रस्थं विपाचयेत्|
प्रस्थार्धं मधुनः शीते शर्करार्धतुलां तथा||३९||

द्विकार्षिकाणि[१] पत्रैलाहेमत्वङ्मरिचानि च|
विनीय चूर्णितं तस्माल्लिह्यान्मात्रां सदा नरः||४०||

अमृतप्राशमित्येतन्नराणाममृतं घृतम्|
सुधामृतरसं प्राश्यं क्षीरमांसरसाशिना||४१||

नष्टशुक्रक्षतक्षीणदुर्बलव्याधिकर्शितान्|
स्त्रीप्रसक्तान् कृशान् वर्णस्वरहीनांश्च बृंहयेत्||४२||

कासहिक्काज्वरश्वासदाहतृष्णास्रपित्तनुत्|
पुत्रदं वमिमूर्च्छाहृद्योनिमूत्रामयापहम्||४३||

इत्यमृतप्राशघृतम्|

jīvakarṣabhakau vīrāṁ jīvantīṁ nāgaraṁ śaṭīm|
catasraḥ parṇinīrmēdē kākōlyau dvē nidigdhikē||35||

punarnavē dvē madhukamātmaguptāṁ śatāvarīm|
r̥ddhiṁ parūṣakaṁ bhārgīṁ mr̥dvīkāṁ br̥hatīṁ tathā||36||

śr̥ṅgāṭakaṁ tāmalakīṁ payasyāṁ pippalīṁ balām|
badarākṣōṭakharjūravātāmābhiṣukāṇyapi||37||

phalāni caivamādīni kalkān kurvīta kārṣikān|
dhātrīrasavidārīkṣucchāgamāṁsarasaṁ payaḥ||38||

kuryāt prasthōnmitaṁ tēna ghr̥taprasthaṁ vipācayēt|
prasthārdhaṁ madhunaḥ śītē śarkarārdhatulāṁ tathā||39||

dvikārṣikāṇi [2] patrailāhēmatvaṅmaricāni ca|
vinīya cūrṇitaṁ tasmāllihyānmātrāṁ sadā naraḥ||40||

amr̥taprāśamityētannarāṇāmamr̥taṁ ghr̥tam|
sudhāmr̥tarasaṁ prāśyaṁ kṣīramāṁsarasāśinā||41||

naṣṭaśukrakṣatakṣīṇadurbalavyādhikarśitān|
strīprasaktān kr̥śān varṇasvarahīnāṁśca br̥ṁhayēt||42||

kāsahikkājvaraśvāsadāhatr̥ṣṇāsrapittanut|
putradaṁ vamimūrcchāhr̥dyōnimūtrāmayāpaham||43||

ityamr̥taprāśaghr̥tam

jIvakarShabhakau vIrAM jIvantIM nAgaraM shaTIm|
catasraH parNinIrmede kAkolyau dve nidigdhike||35||

punarnave dve madhukamAtmaguptAM shatAvarIm|
RuddhiM parUShakaM bhArgIM mRudvIkAM bRuhatIM tathA||36||

shRu~ggATakaM tAmalakIM payasyAM pippalIM balAm|
badarAkShoTakharjUravAtAmAbhiShukANyapi||37||

phalAni caivamAdIni kalkAn kurvIta kArShikAn|
dhAtrIrasavidArIkShucchAgamAMsarasaM payaH||38||

kuryAt prasthonmitaM tena ghRutaprasthaM vipAcayet|
prasthArdhaM madhunaH shIte sharkarArdhatulAM tathA||39||

dvikArShikANi patrailAhematva~gmaricAni ca|
vinIya cUrNitaM tasmAllihyAnmAtrAM sadA naraH||40||

amRutaprAshamityetannarANAmamRutaM ghRutam|
sudhAmRutarasaM prAshyaM kShIramAMsarasAshinA||41||

naShTashukrakShatakShINadurbalavyAdhikarshitAn|
strIprasaktAn kRushAn varNasvarahInAMshca bRuMhayet||42||

kAsahikkAjvarashvAsadAhatRuShNAsrapittanut|
putradaM vamimUrcchAhRudyonimUtrAmayApaham||43||

ityamRutaprAshaghRutam|

Two ''prasthas'' of ghee should be cooked with the juice ''dhatri'' (two ''prasthas''), juice of ''vidari'' (two ''prasthas''), sugarcane juice (two ''prasthas''), soup of the meat of goat (two ''prasthas''), milk (two ''prasthas''), and the paste (one ''karsha'' each) of ''jivaka, rsabhaka, vira, jivanti, nagara, shati, shalaparni, prushniparni, mashaparni, mudgaparni,meda, mahameda, kakoli, kshirakakoli, kantakari, bruhati, shveta punarnava, rakta punarnava,madhuka, atmagupta, shatavari, riddhi,parushaka, bharangi, mridvika, brihati, shringataka,tamalaki, payasya'' (''kshiravidari''), ''pippali, badara, akshota, kharjura, vatama, abhishuka'' (''pista'') and such other fruits which alleviate ''vayu'' and ''pitta''. After cooking when the the recipe is cooled, one ''prastha'' of honey, half ''tula'' of sugar, and the powder (two ''karshas'' each) of ''patra, ela, hema, tvak'' and ''maricha'' should be added to it. This medicated ghee should be taken by a person in appropriate dose regularly. This is called ''amrita prasa ghrita'' and it is like ''amrita'' (ambrosia) for human beings. This linctus is like ''sudha'' (ambrosia worth the consumption of worldly creatures) and the ''amrita'' (ambrosia worth the consumption of the gods). It should be taken along with milk and meat soup. It promotes nourishment of persons who had depleted ''shukra'' ( as in azoospermia or oligospermia), who are suffering from ''kshatakshina'', who are weak, who are emaciated because of chronic diseases, who are cachectic and who have lost their complexion and voice. It cures cough, hiccup, fever, asthma, burning sensation, morbid thirst, ''rakta-pitta'', vomiting, fainting and diseases of the heart, female genital tract and urinary tract. It helps in the treatment of infertility. [35-43]

==== ''Shvadamshtradi ghee'' ====

श्वदंष्ट्रोशीरमञ्जिष्ठाबलाकाश्मर्यकत्तृणम्|
दर्भमूलं पृथक्पर्णीं पलाशर्षभकौ स्थिराम्||४४||

पलिकं साधयेत्तेषां रसे क्षीरचतुर्गुणे|
कल्कः स्वगुप्ताजीवन्तीमेदर्षभकजीवकैः||४५||

शतावर्यृद्धिमृद्वीकाशर्कराश्रावणीबिसैः|
प्रस्थः सिद्धो घृताद्वातपित्तहृद्द्र(द्भ)वशूलनुत्||४६||

मूत्रकृच्छ्रप्रमेहार्शःकासशोषक्षयापहः|
धनुःस्त्रीमद्यभाराध्वखिन्नानां बलमांसदः||४७||

इति श्वदंष्ट्रादिघृतम्|

śvadaṁṣṭrōśīramañjiṣṭhābalākāśmaryakattr̥ṇam|
darbhamūlaṁ pr̥thakparṇīṁ palāśarṣabhakau sthirām||44||

palikaṁ sādhayēttēṣāṁ rasē kṣīracaturguṇē|
kalkaḥ svaguptājīvantīmēdarṣabhakajīvakaiḥ||45||

śatāvaryr̥ddhimr̥dvīkāśarkarāśrāvaṇībisaiḥ|
prasthaḥ siddhō ghr̥tādvātapittahr̥ddra(dbha)vaśūlanut||46||

mūtrakr̥cchrapramēhārśaḥkāsaśōṣakṣayāpahaḥ|
dhanuḥstrīmadyabhārādhvakhinnānāṁ balamāṁsadaḥ||47||

iti śvadaṁṣṭrādighr̥tam

shvadaMShTroshIrama~jjiShThAbalAkAshmaryakattRuNam|
darbhamUlaM pRuthakparNIM palAsharShabhakau sthirAm||44||

palikaM sAdhayetteShAM rase kShIracaturguNe|
kalkaH svaguptAjIvantImedarShabhakajIvakaiH||45||

shatAvaryRuddhimRudvIkAsharkarAshrAvaNIbisaiH|
prasthaH siddho ghRutAdvAtapittahRuddra(dbha)vashUlanut||46||

mUtrakRucchrapramehArshaHkAsashoShakShayApahaH|
dhanuHstrImadyabhArAdhvakhinnAnAM balamAMsadaH||47||

iti shvadaMShTrAdighRutam|

One ''pala'' of each of ''shvadamshtra, ushira, manjishtha, bala, kashmarya, katrna'', the root of ''darbha, prithak parni, palasha, rishabhaka,'' and ''sthira'' should be made to decoction. Two ''prasthas'' of ghee should be mixed with the above mentioned decoction, eight prasthas of milk, and the paste of ''svagupta, jivanti, meda, rishabhaka, jivaka, shatavari, riddhi, mridvika, sharkara, shravani'' and bias (lotus stalk), (half prastha in total) and cooked. This medicated ghee cures ''hridaya shula'' caused by ''vayu'' and ''pitta, mutrakrucchra'' (dysuria), ''prameha'' (diabetes mellitus), piles, bronchitis, and consumption and ''kshatakshina''. It promotes strength of muscles tissues of persons emaciated because of indulgence in archery, women, alcohol, carrying heavy weight and walking a long distance. [44-47]

==== ''Samasaktu ghee'' ====

मधुकाष्टपलद्राक्षाप्रस्थक्वाथे घृतं पचेत्|
पिप्पल्यष्टपले कल्के प्रस्थं सिद्धे च शीतले||४८||

पृथगष्टपलं क्षौद्रशर्कराभ्यां विमिश्रयेत्|
समसक्तु क्षतक्षीणे रक्तगुल्मे च तद्धितम्||४९||

madhukāṣṭapaladrākṣāprasthakvāthē ghr̥taṁ pacēt|
pippalyaṣṭapalē kalkē prasthaṁ siddhē ca śītalē||48||

pr̥thagaṣṭapalaṁ kṣaudraśarkarābhyāṁ vimiśrayēt|
samasaktu kṣatakṣīṇē raktagulmē ca taddhitam||49||

madhukAShTapaladrAkShAprasthakv the ghRutaM pacet|
pippalyaShTapale kalke prasthaM siddhe ca shItale||48||

pRuthagaShTapalaM kShaudrasharkarAbhyAM vimishrayet|
samasaktu kShatakShINe raktagulme ca taddhitam||49||

Two ''prasthas'' of ghee should be cooked by adding the decoction of ''madhuka'' (eight ''palas'') and ''draksha'' (one ''prastha''), and the paste of ''pippali'' (eight ''palas''). After it is cooked and cooled, eight ''palas'' of each of honey and sugar should be added and mixed well. This medicated ghee should be administered by adding ''saktu'' (roasted barley flour) in equal quantity. It is useful in the treatment of ''kshatakshina'' and ''rakta gulma''. [48-49]

==== ''Sarpi-gud'' ====

धात्रीफलविदारीक्षुजीवनीयरसैर्घृतम्|
अजागोपयसोश्चैव सप्त प्रस्थान् पचेद्भिषक्||५०||

सिद्धशीते सिताक्षौद्रद्विप्रस्थं विनयेच्च तत्|
यक्ष्मापस्मारपित्तासृक्कासमेहक्षयापहम्||५१||

वयःस्थापनमायुष्यं मांसशुक्रबलप्रदम्|
घृतं तु पित्तेऽभ्यधिके लिह्याद्वातेऽधिके पिबेत्||५२||

लीढं निर्वापयेत् पित्तमल्पत्वाद्धन्ति नानलम्|
आक्रामत्यनिलं पीतमूष्माणं निरुणद्धि च||५३||

क्षामक्षीणकृशाङ्गानामेतान्येव घृतानि तु|
त्वक्क्षीरीशर्करालाजचूर्णैः स्त्यानानि योजयेत्||५४||

सर्पिर्गुडान् समध्वंशाञ्जग्ध्वा चानु पयः पिबेत्|
रेतो वीर्यं बलं पुष्टिं तैराशुतरमाप्नुयात्||५५||

इति सर्पिर्गुडाः|

dhātrīphalavidārīkṣujīvanīyarasairghr̥tam|
ajāgōpayasōścaiva sapta prasthān pacēdbhiṣak||50||

siddhaśītē sitākṣaudradviprasthaṁ vinayēcca tat|
yakṣmāpasmārapittāsr̥kkāsamēhakṣayāpaham||51||

vayaḥsthāpanamāyuṣyaṁ māṁsaśukrabalapradam|
ghr̥taṁ tu pittē'bhyadhikē lihyādvātē'dhikē pibēt||52||

līḍhaṁ nirvāpayēt pittamalpatvāddhanti nānalam|
ākrāmatyanilaṁ pītamūṣmāṇaṁ niruṇaddhi ca||53||

kṣāmakṣīṇakr̥śāṅgānāmētānyēva ghr̥tāni tu|
tvakkṣīrīśarkarālājacūrṇaiḥ [3] styānāni yōjayēt||54||

sarpirguḍān samadhvaṁśāñjagdhvā cānu payaḥ pibēt|
rētō vīryaṁ balaṁ puṣṭiṁ tairāśutaramāpnuyāt||55||

iti sarpirguḍāḥ

dhAtrIphalavidArIkShujIvanIyarasairghRutam|
ajAgopayasoshcaiva sapta prasthAn pacedbhiShak||50||

siddhashIte sitAkShaudradviprasthaM vinayecca tat|
yakShmApasmArapittAsRukkAsamehakShayApaham||51||

vayaHsthApanamAyuShyaM mAMsashukrabalapradam|
ghRutaM tu pitte~abhyadhike lihyAdvAte~adhike pibet||52||

lIDhaM nirvApayet pittamalpatvAddhanti nAnalam|
AkrAmatyanilaM pItamUShmANaM niruNaddhi ca||53||

kShAmakShINakRushA~ggAnAmetAnyeva ghRutAni tu|
tvakkShIrIsharkarAlAjacUrNaiH styAnAni yojayet||54||

sarpirguDAn samadhvaMshA~jjagdhvA cAnu payaH pibet|
reto vIryaM balaM puShTiM tairAshutaramApnuyAt||55||

iti sarpirguDAH|

Two ''prasthas'' of ghee should be added with the juice of ''amalaka'' (two ''prasthas''), ''vidari'' (two ''prasthas'') and ''ikshu'' (two ''prasthas'') decoction of drugs belonging to ''jivaniya'' group (two ''prasthas''), goat’s milk (two ''prasthas'') and cow’s milk (two ''prasthas'') and cooked. After the cooking is over and the recipe is cooled, sugar (one ''prastha'') and honey (two ''prasthas'') should be added and mixed well. This medicated ghee is useful in the treatment of ''rajayaskshma, apasmara, raktapitta, prameha,'' and ''kshaya''. It prevents aging, promotes longevity and endows the person with muscle tissues, semen as well as strength. If the disease is caused by excess of ''pitta'', then this recipe should be used as linctus. If, however, the disease is caused by the excess of ''vayu'', then it should be taken as a drink.

When this medicated ghee is used (licked) in the form of a linctus, it alleviates ''pitta''. Since it is in small quantity, it however, doesn’t suppress the ''agni'' (power of digestion).

When it is used in the form of a drink, it alleviates ''vayu'' and obstructs ''pitta ushma''.

This and such other medicated ghee should be made to a thick paste by adding the powder of ''tvakkshiri,'' sugar and ''lajja'' (fried paddy), which should then be given to persons who are tired, weak and emaciated.

This and such other recipes of ''sarpigud'' [recipes of medicated ghee in which sugar, honey etc. are added] should be added with honey (which should be equal in quantity with the powder of ''tvak-kshiri'', etc.) and taken. Thereafter, the patient should drink milk. This instantaneously promotes semen, potency, strength and nourishment. [50-55]

==== ''Sarpi gud'' (second recipe) ====

बला विदारी ह्रस्वा च पञ्चमूली पुनर्नवा|
पञ्चानां क्षीरिवृक्षाणां शुङ्गा मुष्ट्यंशका अपि||५६||

एषां कषाये द्विक्षीरे विदार्याजरसांशिके|
जीवनीयैः पचेत् कल्कैरक्षमात्रैर्घृताढकम्||५७||

सितापलानि पूते च शीते द्वात्रिंशतं क्षिपेत्|
गोधूमपिप्पलीवांशीचूर्णं शृङ्गाटकस्य च||५८||

समाक्षिकं कौडविकं तत् सर्वं खजमूर्च्छितम्|
स्त्यानं सर्पिर्गुडान् कृत्वा भूर्जपत्रेण वेष्टयेत्||५९||

ताञ्जग्ध्वा पलिकान् क्षीरं मद्यं वाऽनुपिबेत् कफे|
शोषे कासे क्षते क्षीणे श्रमस्त्रीभारकर्शिते||६०||

रक्तनिष्ठीवने तापे पीनसे चोरसि स्थिते|
शस्ताः पार्श्वशिरःशूले भेदे च स्वरवर्णयोः||६१||

इति द्वितीयसर्पिर्गुडाः|

balā vidārī hrasvā ca pañcamūlī punarnavā|
pañcānāṁ kṣīrivr̥kṣāṇāṁ śuṅgā muṣṭyaṁśakā api||56||

ēṣāṁ kaṣāyē dvikṣīrē vidāryājarasāṁśikē|
jīvanīyaiḥ pacēt kalkairakṣamātrairghr̥tāḍhakam||57||

sitāpalāni pūtē ca śītē dvātriṁśataṁ kṣipēt|
gōdhūmapippalīvāṁśīcūrṇaṁ śr̥ṅgāṭakasya ca||58||

samākṣikaṁ kauḍavikaṁ tat sarvaṁ khajamūrcchitam|
styānaṁ sarpirguḍān kr̥tvā bhūrjapatrēṇa vēṣṭayēt||59||

tāñjagdhvā palikān kṣīraṁ madyaṁ vā'nupibēt kaphē|
śōṣē kāsē kṣatē kṣīṇē śramastrībhārakarśitē||60||

raktaniṣṭhīvanē tāpē pīnasē cōrasi sthitē|
śastāḥ pārśvaśiraḥśūlē bhēdē ca svaravarṇayōḥ||61||

iti dvitīyasarpirguḍāḥ

balA vidArI hrasvA ca pa~jcamUlI punarnavA|
pa~jcAnAM kShIrivRukShANAM shu~ggA muShTyaMshakA api||56||

eShAM kaShAye dvikShIre vidAryAjarasAMshike|
jIvanIyaiH pacet kalkairakShamAtrairghRutADhakam||57||

sitApalAni pUte ca shIte dvAtriMshataM kShipet|
godhUmapippalIvAMshIcUrNaM shRu~ggATakasya ca||58||

samAkShikaM kauDavikaM tat sarvaM khajamUrcchitam|
styAnaM sarpirguDAn kRutvA bhUrjapatreNa veShTayet||59||

tA~jjagdhvA palikAn kShIraM madyaM vA~anupibet kaphe|
shoShe kAse kShate kShINe shramastrIbhArakarshite||60||

raktaniShThIvane tApe pInase corasi sthite|
shastAH pArshvashiraHshUle bhede ca svaravarNayoH||61||

iti dvitIyasarpirguDAH|

''Bala, vidari, hrasva panchamula'' (''shalaparni, prsniparni, brihati, kantakari'' and ''gokshura''), ''punarnava'', and the ''sungas'' (terminal buds) of five ''kshirivrikshas'' (''nyagrodha, udumbara, asvattha, madhuka'' and ''plaksha'')- one ''pala'' of each of these drugs should be made to a decoction. To this, milk (two parts, i.e., double the quantity of the decoction), juice of ''vidari'' (one part), soup of goat meat (one part), ghee (two ''adhakas'') (in the text, actually one ''adhaka'' is mentioned. But in practice, it is to be taken double the quantity according to the general rule), and the paste of drugs belonging to the ''jivaniya'' group (one ''aksa'' each) should be added and cooked. When it is well cooked and cooled, thirty two ''palas'' of sugar should be added. Thereafter, one ''kudava'' of each of the powder of ''godhuma, pippali, vamsha lochana, shringataka'' and honey should be added. All of them should be stirred with the help of a stirrer. When it becomes dense, cakes (''sarpigud'') should be prepared and each of them should be wrapped with thin bark of ''bhurja'' tree. Having taken this cake one ''pala'' in weight, the patient should take milk or alcohol as post-prandial drink. These are useful in the treatment of disease caused by ''kapha, sosha, kasa'' and ''kshatakshina''. These are also helpful for persons who are emaciated because of excessive exertion, overindulgence in sex and exhaustion by lifting excessive weight. These cakes are efficacious in the treatment of ''rakta-nishthivana'' (hemoptysis), burning sensation, chronic rhinitis (''pinasa''), having residual infection in the chest, pain in the sides of the chest, headache, hoarseness of voice and loss of complexion. [56-61]

==== ''Sarpi gud''(third recipe) ====

त्वक्क्षीरीश्रावणीद्राक्षामूर्वर्षभकजीवकैः|
वीरर्धिक्षीरकाकोलीबृहतीकपिकच्छुभिः||६२||

खर्जूरफलमेदाभिः क्षीरपिष्टैः पलोन्मितैः|
धात्रीविदारीक्षुरसप्रस्थैः प्रस्थं घृतात् पचेत्||६३||

शर्करार्धतुलां शीते क्षौद्रार्धप्रस्थमेव च|
दत्त्वा सर्पिर्गुडान् कुर्यात्कासहिक्काज्वरापहान्||६४||

यक्ष्माणं तमकं श्वासं रक्तपित्तं हलीमकम्|
शुक्रनिद्राक्षयं तृष्णां हन्युः कार्श्यं सकामलम्||६५||

इति तृतीयाः सर्पिर्गुडाः|

tvakkṣīrīśrāvaṇīdrākṣāmūrvarṣabhakajīvakaiḥ|
vīrardhikṣīrakākōlībr̥hatīkapikacchubhiḥ||62||

kharjūraphalamēdābhiḥ kṣīrapiṣṭaiḥ palōnmitaiḥ|
dhātrīvidārīkṣurasaprasthaiḥ prasthaṁ ghr̥tāt pacēt||63||

śarkarārdhatulāṁ śītē kṣaudrārdhaprasthamēva ca|
dattvā sarpirguḍān kuryātkāsahikkājvarāpahān||64||

yakṣmāṇaṁ tamakaṁ śvāsaṁ raktapittaṁ halīmakam|
śukranidrākṣayaṁ tr̥ṣṇāṁ hanyuḥ kārśyaṁ sakāmalam||65||

iti tr̥tīyāḥ sarpirguḍāḥ

tvakkShIrIshrAvaNIdrAkShAmUrvarShabhakajIvakaiH|
vIrardhikShIrakAkolIbRuhatIkapikacchubhiH||62||

kharjUraphalamedAbhiH kShIrapiShTaiH palonmitaiH|
dhAtrIvidArIkShurasaprasthaiH prasthaM ghRutAt pacet||63||

sharkarArdhatulAM shIte kShaudrArdhaprasthameva ca|
dattvA sarpirguDAn kuryAtkAsahikkAjvarApahAn||64||

yakShmANaM tamakaM shvAsaM raktapittaM halImakam|
shukranidrAkShayaM tRuShNAM hanyuH kArshyaM sakAmalam||65||

iti tRutIyAH sarpirguDAH|

One ''pala'' of each of ''tvak-kshiri, shravani'' (''munditika''), ''draksha, murva, rushabhaka, jivaka, vira'' (''vidarikanda''), ''riddhi, kshirakakoli, brihati, kapikacchu,'' fruit of ''kharjura'' and ''meda'' should be made into paste by triturating with milk. This paste, juice of ''dhatri'' (two ''prasthas''), juice of ''vidari'' (two ''prasthas''), sugarcane juice (two ''prasthas''), and ghee (two ''prasthas'') should be cooked together. After the ghee is well cooked and cooled, half ''tulas'' of sugar and one ''prastha'' of honey should be added, out of which cakes (''sarpi gud'') should be prepared. These cakes cures cough, hiccup, fever, ''rajayakshma, tamaka svasa, rakta-pitta, halimaka'' ( a serious type of jaundice), ''shukra kshaya'' (diminution of ''shukra''), insomnia, ''trishna'' (morbid thirst), ''karshya'' (emaciation) and ''kamala'' (jaundice). (In transalation liquids, ghee and honey are taken double the prescribed quantity according to the rule) [ 62-65]

==== ''Sarpi gud'' (fourth recipe) ====

नवमामलकं द्राक्षामात्मगुप्तां पुनर्नवाम्|
शतावरीं विदारीं च समङ्गां पिप्पलीं तथा||६६||

पृथग्दशपलान् भागान् पलान्यष्टौ च नागरात्|
यष्ट्याह्वसौवर्चलयोर्द्विपलं मरिचस्य च||६७||

क्षीरतैलघृतानां च त्र्याढके शर्कराशते|
क्वथिते तानि चूर्णानि दत्त्वा बिल्वसमान् गुडान्||६८||

कुर्यात्तान् भक्षयेत् क्षीणः क्षतः शुष्कश्च मानवः|
तेन सद्यो रसादीनां वृद्ध्या पुष्टिं स विन्दति||६९||

इति चतुर्थसर्पिर्गुडाः|

navamāmalakaṁ drākṣāmātmaguptāṁ punarnavām|
śatāvarīṁ vidārīṁ ca samaṅgāṁ pippalīṁ tathā||66||

pr̥thagdaśapalān bhāgān palānyaṣṭau ca nāgarāt|
yaṣṭyāhvasauvarcalayōrdvipalaṁ maricasya ca||67||

kṣīratailaghr̥tānāṁ ca tryāḍhakē śarkarāśatē|
kvathitē tāni cūrṇāni dattvā bilvasamān guḍān||68||

kuryāttān bhakṣayēt kṣīṇaḥ kṣataḥ śuṣkaśca mānavaḥ|
tēna sadyō rasādīnāṁ vr̥ddhyā puṣṭiṁ sa vindati||69||

iti caturthasarpirguḍāḥ

navamAmalakaM drAkShAmAtmaguptAM punarnavAm|
shatAvarIM vidArIM ca sama~ggAM pippalIM tathA||66||

pRuthagdashapalAn bhAgAn palAnyaShTau ca nAgarAt|
yaShTyAhvasauvarcalayordvipalaM maricasya ca||67||

kShIratailaghRutAnAM ca tryADhake sharkarAshate|
kvathite tAni cUrNAni dattvA bilvasamAn guDAn||68||

kuryAttAn bhakShayet kShINaH kShataH shuShkashca mAnavaH|
tena sadyo rasAdInAM vRuddhyA puShTiM sa vindati||69||

iti caturthasarpirguDAH|

Freshly collected and dried ''amalaki'' (ten ''palas''), ''draksha'' (ten ''palas''), ''atmagupta'' (ten ''palas''), ''punarnava'' (ten ''palas''), ''shatavari'' (ten ''palas''), ''vidari'' (ten ''palas''), ''samanga'' (ten ''palas''), ''pippali'' (ten ''palas''), ''nagara'' (eight ''palas''), ''madhuyashti'' (one ''palas''), ''saurvachala'' (one ''pala'') and ''maricha'' (two ''palas'') – all these drugs should be made to powders. Milk (two ''adhakas''), ''tila taila'' (two ''adhakas''), ghee (two ''adhakas'') and sugar (one hundred ''palas'') should be cooked together. Thereafter, the above mentioned powder should be added to it. Out of this, cakes of one ''bilva'' or ''pala'' each should be prepared. These cakes should be taken by the person suffering from ''kshatakshina'' and consumption. Intake of these cakes instantaneously promote tissues elements like ''rasa'' etc. as a result of which the individual gets nourished. [66-69]

==== ''Sarpi modaka'' (fifth recipe) ====

गोक्षीरार्धाढकं सर्पिः प्रस्थमिक्षुरसाढकम्|
विदार्याः स्वरसात्प्रस्थं रसात्प्रस्थं च तैत्तिरात्||७०||

दद्यात् सिध्यति तस्मिंस्तु पिष्टानिक्षुरसैरिमान्|
मधूकपुष्पकुडवं प्रियालकुडवं तथा||७१||

कुडवार्धं तुगाक्षीर्याः खर्जूराणां च विंशतिम्|
पृथग्बिभीतकानां च पिप्पल्याश्च चतुर्थिकाम्||७२||

त्रिंशत्पलानि खण्डाच्च मधुकात् कर्षमेव च|
तथाऽर्धपलिकान्यत्र जीवनीयानि दापयेत्||७३||

सिद्धेऽस्मिन् कुडवं क्षौद्रं शीते क्षिप्त्वाऽथ मोदकान्|
कारयेन्मरिचाजाजीपलचूर्णावचूर्णितान्||७४||

वातासृक्पित्तरोगेषु क्षतकासक्षयेषु च|
शुष्यतां क्षीणशुक्राणां रक्ते चोरसि संस्थिते||७५||

कृशदुर्बलवृद्धानां पुष्टिवर्णबलार्थिनाम्|
योनिदोषकृतस्रावहतानां चापि योषिताम्||७६||

गर्भार्थिनीनां गर्भश्च स्रवेद्यासां म्रियेत वा|
धन्या बल्या हितास्ताभ्यः शुक्रशोणितवर्धनाः||७७||

इति पञ्चमसर्पिर्मोदकाः|

gōkṣīrārdhāḍhakaṁ sarpiḥ prasthamikṣurasāḍhakam|
vidāryāḥ svarasātprasthaṁ rasātprasthaṁ ca taittirāt||70||

dadyāt sidhyati tasmiṁstu piṣṭānikṣurasairimān|
madhūkapuṣpakuḍavaṁ priyālakuḍavaṁ tathā||71||

kuḍavārdhaṁ tugākṣīryāḥ kharjūrāṇāṁ ca viṁśatim|
pr̥thagbibhītakānāṁ ca pippalyāśca caturthikām||72||

triṁśatpalāni khaṇḍācca madhukāt karṣamēva ca|
tathā'rdhapalikānyatra jīvanīyāni dāpayēt||73||

siddhē'smin kuḍavaṁ kṣaudraṁ śītē kṣiptvā'tha mōdakān|
kārayēnmaricājājīpalacūrṇāvacūrṇitān||74||

vātāsr̥kpittarōgēṣu kṣatakāsakṣayēṣu ca|
śuṣyatāṁ kṣīṇaśukrāṇāṁ raktē cōrasi saṁsthitē||75||

kr̥śadurbalavr̥ddhānāṁ puṣṭivarṇabalārthinām|
yōnidōṣakr̥tasrāvahatānāṁ cāpi yōṣitām||76||

garbhārthinīnāṁ garbhaśca sravēdyāsāṁ mriyēta vā|
dhanyā balyā hitāstābhyaḥ śukraśōṇitavardhanāḥ||77||

iti pañcamasarpirmōdakāḥ

gokShIrArdhADhakaM sarpiH prasthamikShurasADhakam|
vidAryAH svarasAtprasthaM rasAtprasthaM ca taittirAt||70||

dadyAt sidhyati tasmiMstu piShTAnikShurasairimAn|
madhUkapuShpakuDavaM priyAlakuDavaM tathA||71||

kuDavArdhaM tugAkShIryAH kharjUrANAM ca viMshatim|
pRuthagbibhItakAnAM ca pippalyAshca caturthikAm||72||

triMshatpalAni khaNDAcca madhukAt karShameva ca|
tathA~ardhapalikAnyatra jIvanIyAni dApayet||73||

siddhe~asmin kuDavaM kShaudraM shIte kShiptvA~atha modakAn|
kArayenmaricAjAjIpalacUrNAvacUrNitAn||74||

vAtAsRukpittarogeShu kShatakAsakShayeShu ca|
shuShyatAM kShINashukrANAM rakte corasi saMsthite||75||

kRushadurbalavRuddhAnAM puShTivarNabalArthinAm|
yonidoShakRutasrAvahatAnAM cApi yoShitAm||76||

garbhArthinInAM garbhashca sravedyAsAM mriyeta vA|
dhanyA balyA hitAstAbhyaH shukrashoNitavardhanAH||77||

iti pa~jcamasarpirmodakAH|

Cow’s milk (one ''adhaka''), ghee (two ''prasthas''), sugar cane juice (two ''adhakas''), juice of ''vidari'' (two ''prasthas'') and soup of meat of ''tittira'' (two ''prasthas'') should be cooked together. During the final stage of cooking, the paste of ''madhuka pushpa'' (one ''kudava''), ''priyala'' (one ''kudava''), ''tugakshiri'' (half ''kudava''), ''kharjura'' (twenty fruits), ''bibhitaki'' (twenty fruits), ''pippali'' (one ''pala''), sugar (thirty ''palas''), ''madhuka'' (one ''karsa'') and drugs belonging to ''jivaniya'' group (half ''pala'' each) should be added. The above mentioned drugs should be made to a paste by triturating with sugarcane juice before adding to the recipe. After the recipe is fully cooked and cooled, honey (two ''kudavas'') should be added and from it, ''modaka'' (large size pills) should be prepared. Over these ''modakas'', one pala of the powder of ''maricha'' and ''ajaji'' should be sprinkled. These ''modakas'' cure ''vatasruka'', diseases caused by ''pitta, kshatakshina, kasa'' and ''kshaya''. These are useful for persons suffering from emaciation, who have reduced semen, whose blood is blocked in the chest, who are thin, weak and old, and also for those desirous of having nourishment, complexion and strength. These ''modakas'' are also helpful for ladies suffering from exudations through the vitiated genital tract, who desire conception and who suffer from miscarriages and death of the fetus in the womb. By the use of these pills, ladies are endowed with auspiciousness strength and wholesomeness. These are promoters of ''shukra'' (sperm) and ''shonita'' (ovum). [70-77]

==== Recipes ====

बस्तिदेशे विकुर्वाणे स्त्रीप्रसक्तस्य मारुते|
वातघ्नान् बृंहणान् वृष्यान् योगांस्तस्य प्रयोजयेत्||७८||

शर्करापिप्पलीचूर्णैः सर्पिषा माक्षिकेण च|
संयुक्तं वा शृतं क्षीरं पिबेत् कासज्वरापहम्||७९||

फलाम्लं सर्पिषा भृष्टं विदारीक्षुरसे शृतम्|
स्त्रीषु क्षीणः पिबेद्यूषं जीवनं बृंहणं परम्||८०||

सक्तूनां वस्त्रपूतानां मन्थं क्षौद्रघृतान्वितम्|
यवान्नसात्म्यो दीप्ताग्निः क्षतक्षीणः पिबेन्नरः||८१||

जीवनीयोपसिद्धं वा जाङ्गलं घृतभर्जितम्|
रसं प्रयोजयेत् क्षीणे व्यञ्जनार्थं सशर्करम्||८२||

गोमहिष्यश्वनागाजैः क्षीरैर्मांसरसैस्तथा|
यवान्नं भोजयेद्यूषैः फलाम्लैर्घृतसंस्कृतैः||८३||

दीप्तेऽग्नौ विधिरेषः स्यान्मन्दे दीपनपाचनः|
यक्ष्मिणां विहितो ग्राही भिन्ने शकृति चेष्यते||८४||

bastidēśē vikurvāṇē strīprasaktasya mārutē|
vātaghnān br̥ṁhaṇān vr̥ṣyān yōgāṁstasya prayōjayēt||78||

śarkarāpippalīcūrṇaiḥ sarpiṣā mākṣikēṇa ca|
saṁyuktaṁ vā śr̥taṁ kṣīraṁ pibēt kāsajvarāpaham||79||

phalāmlaṁ sarpiṣā bhr̥ṣṭaṁ vidārīkṣurasē śr̥tam|
strīṣu kṣīṇaḥ pibēdyūṣaṁ jīvanaṁ br̥ṁhaṇaṁ param||80||

saktūnāṁ vastrapūtānāṁ manthaṁ kṣaudraghr̥tānvitam|
yavānnasātmyō [4] dīptāgniḥ kṣatakṣīṇaḥ pibēnnaraḥ||81||

jīvanīyōpasiddhaṁ vā jāṅgalaṁ ghr̥tabharjitam|
rasaṁ prayōjayēt kṣīṇē vyañjanārthaṁ saśarkaram||82||

gōmahiṣyaśvanāgājaiḥ kṣīrairmāṁsarasaistathā|
yavānnaṁ [5] bhōjayēdyūṣaiḥ phalāmlairghr̥tasaṁskr̥taiḥ||83||

dīptē'gnau vidhirēṣaḥ syānmandē dīpanapācanaḥ|
yakṣmiṇāṁ vihitō grāhī bhinnē śakr̥ti cēṣyatē||84||

Bastideshe vikurvANe strIprasaktasya mArute|
vAtaghnAn bRuMhaNAn vRuShyAn yogAMstasya prayojayet||78||

sharkarApippalIcUrNaiH sarpiShA mAkShikeNa ca|
saMyuktaM vA shRutaM kShIraM pibet kAsajvarApaham||79||

phalAmlaM sarpiShA bhRuShTaM vidArIkShurase shRutam|
strIShu kShINaH pibedyUShaM jIvanaM bRuMhaNaM param||80||

saktUnAM vastrapUtAnAM manthaM kShaudraghRutAnvitam|
yavAnnasAtmyo dIptAgniH kShatakShINaH pibennaraH||81||

jIvanIyopasiddhaM vA jA~ggalaM ghRutabharjitam|
rasaM prayojayet kShINe vya~jjanArthaM sasharkaram||82||

gomahiShyashvanAgAjaiH kShIrairmAMsarasaistathA|
yavAnnaM bhojayedyUShaiH phalAmlairghRutasaMskRutaiH||83||

dIpte~agnau vidhireShaH syAnmande dIpanapAcanaH|
yakShmiNAM vihito grAhI bhinne shakRuti ceShyate||84||

In person induging in excess sexual intercourse with women, (vitiated) ''vayu'' afflicts pelvic region. To such patients, recipes which are alleviators of ''vayu,'' promoters of nourishment and aphrodisiacs are to be administered.

Sugar, powder of ''pippali'' ghee and/or honey should be added to milk and given to patient to drink for the cure of cough and fever. These ingredients can be added to milk after or before boiling, appropriately. (Whenever honey is to be used, it should be added to the milk after it is boiled and cooled.)

''Phalamla'' should be fried in ghee and boiled with the juice of ''vidari'' and sugar-cane. The vegetable soup, thus prepared, is useful for a patient who is emaciated because of excessive indulgence in women. This is an excellent recipe for the promotion of longevity and nourishment.

Roasted barley flour should be sieved through a cloth, and ''mantha'' (thin gruel) should be prepared out of it. This gruel should be added with honey and ghee, and given to a patient suffering from ''kshatakshina'', provided that he is accustomed to taking barley as one of the ingredients of the food and if he has strong power of digestion.

Alternatively, meat of animal inhabiting arid zone (''jangala'') should be boiled with the drugs belonging to the ''jivaniya'' group. The meat soup, thus prepared, should be sizzled with ghee, added with sugar and used as a said dish (''vyanjana'') for a patient suffering from ''kshatakshina''.

Boiled barley should be given to a patient suffering from ''kshatakshina'' along with the milk of buffalo, mare, elephant and goat or with the meat soup or with vegetable soup or with ''phalamla'' sizzled with ghee.

The above mentioned recipes should be given to a patient having strong power of digestion. If the power of digestion is suppressed, then the patient should be given recipes which are stimulants of digestion and carminative. If there is diarrhea in a patient suffering from ''kshatakshina'', then the bowel – binding recipes prescribed for the treatment of ''rajayakshma'' (chapter-8) should be used. [78-84]

==== ''Saindhavadi churna'' ====

पलिकं सैन्धवं शुण्ठी द्वे च सौवर्चलात् पले|
कुडवांशानि वृक्षाम्लं दाडिमं पत्रमर्जकात्||८५||

एकैकं मरिचाजाज्योर्धान्यकाद्द्वे चतुर्थिके|
शर्करायाः पलान्यत्र दश द्वे च प्रदापयेत्||८६||

कृत्वा चूर्णमतो मात्रामन्नपाने प्रयोजयेत्|
रोचनं दीपनं बल्यं पार्श्वार्तिश्वासकासनुत्||८७||

इति सैन्धवादिचूर्णम्|

palikaṁ saindhavaṁ śuṇṭhī dvē ca sauvarcalāt palē|
kuḍavāṁśāni vr̥kṣāmlaṁ dāḍimaṁ patramarjakāt||85||

ēkaikaṁ maricājājyōrdhānyakāddvē caturthikē|
śarkarāyāḥ palānyatra daśa dvē ca pradāpayēt||86||

kr̥tvā cūrṇamatō mātrāmannapānē prayōjayēt|
rōcanaṁ dīpanaṁ balyaṁ pārśvārtiśvāsakāsanut||87||

iti saindhavādicūrṇam

palikaM saindhavaM shuNThI dve ca sauvarcalAt pale|
kuDavAMshAni vRukShAmlaM dADimaM patramarjakAt||85||

ekaikaM maricAjAjyordhAnyakAddve caturthike|
sharkarAyAH palAnyatra dasha dve ca pradApayet||86||

kRutvA cUrNamato mAtrAmannapAne prayojayet|
rocanaM dIpanaM balyaM pArshvArtishvAsakAsanut||87||

iti saindhavAdicUrNam|

''Saindhava'' (one ''pala''), ''shunthi'' (one ''pala''), ''sauvarchala'' (two ''palas''), ''vrikshamla'' (one ''kudava''), ''dadima'' (one ''kudava''), leaf of ''arjaka'' (one ''kudava''), ''maricha'' (one ''pala''), ''ajaji'' (one ''pala''), ''dhanyaka'' (two ''palas'') and sugar (twelve ''palas'') should be made in to powder and mixed together. In appropriate quantity, this powder should be added to food and drinks. It is appetizer, stimulant of digestion and promoter of strength. It cures ''parshvashula'' (pain in the sides of the chest), ''shvasa'' (respiratory disorders including asthma) and ''kasa'' (cough). [85-87]

==== ''Shadava'' recipe ====

एका षोडशिका धान्याद्द्वे द्वेऽजाज्यजमोदयोः|
ताभ्यां दाडिमवृक्षाम्लं द्विर्द्विः सौवर्चलात्पलम्||८८||

शुण्ठ्याः कर्षं दधित्थस्य मध्यात् पञ्च पलानि च|
तच्चूर्णं षोडशपले शर्कराया विमिश्रयेत्||८९||

षाडवोऽयं प्रदेयः स्यादन्नपानेषु पूर्ववत्|
मन्दानले शकृद्भेदे यक्ष्मिणामग्निवर्धनः||९०||

इति षाडवः|

ēkā ṣōḍaśikā dhānyāddvē dvē'jājyajamōdayōḥ|
tābhyāṁ dāḍimavr̥kṣāmlaṁ dvirdviḥ sauvarcalātpalam||88||

śuṇṭhyāḥ karṣaṁ dadhitthasya madhyāt pañca palāni ca|
taccūrṇaṁ ṣōḍaśapalē śarkarāyā vimiśrayēt||89||

ṣāḍavō'yaṁ pradēyaḥ syādannapānēṣu pūrvavat|
mandānalē śakr̥dbhēdē yakṣmiṇāmagnivardhanaḥ||90||

iti ṣāḍavaḥ

ekA ShoDashikA dhAnyAddve dve~ajAjyajamodayoH|
tAbhyAM dADimavRukShAmlaM dvirdviH sauvarcalAtpalam||88||

shuNThyAH karShaM dadhitthasya madhyAt pa~jca palAni ca|
taccUrNaM ShoDashapale sharkarAyA vimishrayet||89||

ShADavo~ayaM pradeyaH syAdannapAneShu pUrvavat|
mandAnale shakRudbhede yakShmiNAmagnivardhanaH||90||

iti ShADavaH|

Powders of ''dhanyaka'' (one ''pala''), ''ajaji'' (two ''palas''), ''ajamoda'' (two ''palas''), ''dadima'' (four ''palas''), ''vrikshamla'' (four ''palas''), ''sauvarchala'' (one ''pala''), ''shunthi'' (one ''karsa''), pulp of ''kapittha'' (five ''palas'') and sugar (sixteen ''palas'') should be mixed together. Like the other recipe, the present ''shadava'' (delicious recipe having sweet and sour tastes) should be administered along with food and drinks for the treatment of ''mandanala'' (suppression of the power of digestion) and diarrhea. It promotes the digestive power of patients suffering from ''rajayakshma''. [88-90]

==== ''Nagabala kalpa'' ====

पिबेन्नागबलामूलमर्धकर्षविवर्धितम्[ |
पलं क्षीरयुतं मासं क्षीरवृत्तिरनन्नभुक्||९१||

एष प्रयोगः पुष्ट्यायुर्बलारोग्यकरः परः|
मण्डूकपर्ण्याः कल्पोऽयं शुण्ठीमधुकयोस्तथा||९२||

pibēnnāgabalāmūlamardhakarṣavivardhitam [6] |
palaṁ kṣīrayutaṁ māsaṁ kṣīravr̥ttiranannabhuk||91||

ēṣa prayōgaḥ puṣṭyāyurbalārōgyakaraḥ paraḥ|
maṇḍūkaparṇyāḥ kalpō'yaṁ śuṇṭhīmadhukayōstathā||92||

pibennAgabalAmUlamardhakarShavivardhitam|
palaM kShIrayutaM mAsaM kShIravRuttiranannabhuk||91||

eSha prayogaH puShTyAyurbalArogyakaraH paraH|
maNDUkaparNyAH kalpo~ayaM shuNThImadhukayostathA||92||

Half ''karsha'' of the root (bark) of ''nagabala'' should be boiled with milk and given to the patient on the first day. Thereafter, the powder of ''nagabala'' root (bark) should be increased by half ''karsha'' every day, and given by boiling with milk. On eighth day, the quantity of ''nagabala''- root will be one ''pala''. Thereafter the patient should continue to take this drug in the dose of one ''pala'' for one month. While taking this drug boiled with milk, the patient should refrain from taking any cereals. Whenever he feels hungry, he should take only milk. The recipe is excellent for the promotion of nourishment, longevity, strength and immunity to diseases.

In the above mentioned manner, ''mandukaparni, sunthi'' and ''madhuka'' should be administered for therapeutic effects described above.[91-92]

==== Diet and Drinks ====

यद्यत् सन्तर्पणं शीतमविदाहि हितं लघु|
अन्नपानं निषेव्यं तत्क्षतक्षीणैः सुखार्थिभिः||९३||

यच्चोक्तं यक्ष्मिणां पथ्यं कासिनां रक्तपित्तिनाम्|
तच्च कुर्यादवेक्ष्याग्निं व्याधिं सात्म्यं बलं तथा||९४||

yadyat santarpaṇaṁ śītamavidāhi hitaṁ laghu|
annapānaṁ niṣēvyaṁ tatkṣatakṣīṇaiḥ sukhārthibhiḥ||93||

yaccōktaṁ yakṣmiṇāṁ pathyaṁ kāsināṁ raktapittinām|
tacca kuryādavēkṣyāgniṁ vyādhiṁ sātmyaṁ balaṁ tathā||94||

Yadyat santarpaNaM shItamavidAhi hitaM laghu|
annapAnaM niShevyaM tatkShatakShINaiH sukhArthibhiH||93||

yaccoktaM yakShmiNAM pathyaM kAsinAM raktapittinAm|
tacca kuryAdavekShyAgniM vyAdhiM sAtmyaM balaM tathA||94||

Food and drinks which are nourishing, cooling, ''avidahi'' (which do not cause burning sensation), wholesome and light to digest, should be used by the patient suffering from ''kshatakshina'' and who is desirous of regaining health. With due regard to the ''agni'' (power of digestion), nature of disease, wholesomeness of diet, and regimens prescribed for ''rajayakshma, kasa'' and ''raktapitta''.[93-94]

==== Need for prompt attention ====

उपेक्षिते भवेत्तस्मिन्ननुबन्धो हि यक्ष्मणः|
प्रागेवागमनात्तस्य तस्मात्तं त्वरया जयेत्||९५||

upēkṣitē bhavēttasminnanubandhō hi yakṣmaṇaḥ|
prāgēvāgamanāttasya tasmāttaṁ tvarayā jayēt||95||

upekShite bhavettasminnanubandho hi yakShmaNaH|
prAgevAgamanAttasya tasmAttaM tvarayA jayet||95||

If the patient suffering from ''kshatakshina'' is not given appropriate treatment on time, then this may lead to ''rajayakshma''. Therefore well before the appearance of ''rajayakshma'', the ''kshatakhsina'' should be treated, subdued (cured). [95]

==== Summary ====

तत्र श्लोकौ-

क्षतक्षयसमुत्थानं सामान्यपृथगाकृतिम्|
असाध्ययाप्यसाध्यत्वं साध्यानां सिद्धिमेव च||९६||

उक्तवाञ्ज्येष्ठशिष्याय क्षतक्षीणचिकित्सिते|
तत्त्वार्थविद्वीतरजस्तमोदोषः[१] पुनर्वसुः||९७||

tatra ślōkau-

kṣatakṣayasamutthānaṁ sāmānyapr̥thagākr̥tim|
asādhyayāpyasādhyatvaṁ sādhyānāṁ siddhimēva ca||96||

uktavāñjyēṣṭhaśiṣyāya kṣatakṣīṇacikitsitē|
tattvārthavidvītarajastamōdōṣaḥ [7] punarvasuḥ||97||

tatra shlokau-

kShatakShayasamutthAnaM sAmAnyapRuthagAkRutim|
asAdhyayApyasAdhyatvaM sAdhyAnAM siddhimeva ca||96||

uktavA~jjyeShThashiShyAya kShatakShINacikitsite|
tattvArthavidvItarajastamodoShaH punarvasuH||97||

To sum up:

In this chapter, on the treatment of ''kshatakshina'', Lord Punarvasu who is conversant with truth and who is free from ''rajas'' (one of the three attributes representing fickle mindedness including passion) and ''tamas'' (one of the three attributes representing slackness including ignorance) imparted instincts to the senior disciple on the following points:
#Etiology of ''kshatakshina'';
#Signs and symptoms of ''kshatakshina'' in general and of each variety;
#Incurability, palliability and curability of ''kshatakshina''; and
#Successful treatment of curable variety of ''kshatakshina''. [96-97]

इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलपूरिते चिकित्सितस्थाने क्षतक्षीणचिकित्सितं नामैकादशोऽध्यायः||११||

ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalapūritē cikitsitasthānē
kṣatakṣīṇacikitsitaṁ nāmaikādaśō'dhyāyaḥ||11||

ityagniveshakRute tantre~aprApte dRuDhabalapUrite cikitsitasthAne kShatakShINacikitsitaM nAmaikAdasho~adhyAyaH||11||

Thus, ends the eleventh chapter (on the treatment of ''Kshatakshina'') of the [[Chikitsa Sthana]]; in the section on the therapeutics of Agnivesha’s work as redacted by Charak and not being available, restored by Dridhabala.

===''Tattva Vimarsha'' ===

*In ''Kshatakshina, kshata'' (injury) is caused due to indulgence in various physical activities beyond one’s capacity. ''Kshina'' is a consequence of that injury with improper dietary habit and excess sexual intercourse.
*The ''dhatu kshaya'' (depletion of tissues) is major pathological event in this disease. Hence ''brihana''(nourishment) and replenishment of depleted tissues is principle of management.
*The onset is acute without appearance of any premonitory symptom.
*If the manifestation of disease is mild, the power of digestion (of the patient) is strong, patient has enough strength and if the disease is new (freshly occurred), then it is curable. The disease is ''yapya'' (palliable), if the disease is chronic i.e. more than one year. If however, all the signs and symptoms of the disease are simultaneously manifested, then the condition is incurable.
*Milk, meat, ghee and honey processed with ''jivaniya'' herbs have significant role in treatment of ''kshatakshina''. Fresh blood of animals is also used in treatment of excess bleeding.
*Food and drinks which are nourishing, cooling, ''avidahi'' (which do not cause burning sensation), wholesome and light to digest, should be used by the patient suffering from ''kshatakshina''.
*With due regard to the ''agni'' (power of digestion), nature of disease, wholesomeness of diet, and regimens prescribed for ''rajayakshma, kasa'' and ''raktapitta''.
*''Kshatakshina'' , if untreated, results in ''rajayakshma''. Therefore, treatment at appropriate time is necessary to prevent ''rajayakshma''.

=== ''Vidhi Vimarsha'' ===

''Kshatakshina'' is a disease characterized by depletion of body tissues due to chest injury. In present era, the condition occurs due to over exertion, strenuous work beyond one’s capacity, direct or indirect injury to the chest. The conditions like pneumothorax, pleural effusion and related respiratory conditions need to be addressed simultaneously by the surgical team to prevent progression of emaciation and complications of injury to vital lung tissues.

==== Etiopathology ====

The etiological factors can be divided into two categories viz. (1) Exogenous factors related to over-exertion/ strenuous physical activity that causes trauma to the lung tissues, excess weight lifting and excess sexual intercourse. Studies showed that strenuous athletic activities like vigorous swimming, heavy weight lifting, jolting, etc. can cause pneumothorax (PTX), pleural effusion and pneumomediastinum (PTM) etc. (2) Endogenous factors related to malnutrition that cause depletion of body tissues and excess intake of food having dry properties (less intake of unctuous dietary substances like ghee, oil, fats. Lipids leading to dryness in body)
The etiological factors described for ''kshata'' are related to those that cause spontaneous lung injury.

==== Pathogenesis ====

The disease has acute onset without any premonitory signs. This shows sudden appearance of clinical features due to traumatic etiology. As disease progresses, it leads to depletion of body tissues causing emaciation.
*''Dosha'' : ''Vata-pitta'' aggravation, ''kapha'' depletion
*''Dhatu'': Rasa, shukra, mamsa and ojas
*''Samprapti'' type: ''Atipravritti'' and ''dhatukshaya janya''
*Clinical features and conditions resembling the disease

The patient suffers from fever, pain, mental depression, diarrhea, anorexia, indigestion, cough with putrid sputum grayish in color, foul smelling, and yellow and knotty, in large quantities, with blood.
*Subjective and objective parameters (scales with references)
*Clinical examination: Chest auscultation for added sounds, decreased air entry, Body mass index. Lung function tests including spirometry
*Pathological/radiological/ investigations: Sputum test for presence of Acid fast bacilli, RBCs, Chest X ray for fracture of ribs, opacity in lungs, pneumonia patch, pneumothorax, plural effusion etc.
*Differential diagnosis:Pulmonary tuberculosis, Carcinoma of lungs, oesophageal varieces
*Complications
**Pulmonary tuberculosis
*Prognosis: Curable if newly developed, and mildly emaciated, palliable in chronic stage, incurable in advanced stage and severely emaciated with multiple system involvement

===== Management of disease =====

*Experience based clinical practices:
**Applied principles in management of disease conditions
**Styptic agents to stop bleeding
**Binding agents for union of bones and injured tissues
**Nourishing regimen for depletion of body tissues
**Rejuvenation therapies

====== ''Shodhana chikitsa'' (body purification treatments) and procedures ======

Purification treatments are not indicated in this disease.

Therapeutic massage with ''kshirabala'' oil, ''Bala-ashwagandha lakshadi'' oil is done.

Chest physiotherapy for improving lung functions is advised.

====== ''Shamana chikitsa'' (pacification treatments) with list of formulations and medicines ======

{| class="wikitable"
|-
! scope="col"| S.No.
! scope="col"| Name of Medicine
! scope="col"| Dose
! scope="col"| Time of Administration
! scope="col"| Mode of Administration (''Anupana'')
|-
| 1
| ''Laksha Mixture''
| 10-20 grams
| Frequently
| ''Vasavaleha''
|-
| 2
| ''Amritaprasha ghee''
| 10-20 grams
| After meals
| Milk
|-
| 3
| ''Suvarna malini vasanta''
| 120-240 mg
| In between two meals
| Milk
|-
| 4
| ''Lakshmi Vilasa''
| 60-120 mg
| In between two meals
| Milk
|-
| 5
| ''Vanga mishrana''
| 250-500 mg
| In between two meals
| Milk
|}

*''Pathya'' or recommended diet: Light to digest food like ''shali'' rice, wheat, green gram, pomegranate, dry grapes, mango, ''amalaka'', goat milk and ghee prepared of it, medicated milk, meat juice of goat
*''Pathya'' or recommended activity: Total bed rest
*''Apathya'' or contraindicated diet: Excess hot, pungent, salty food causing burning sensation, heavy to digest food.
*''Apathya'' or contraindicated activity: Over exertion, strenuous exercise, weight lifting etc.

===== Parallel management of chest injury =====

Use of ''sandhaniya'' drugs like ''laksha'' (mainly indicated for the healing of fracture of bone) and ''madhuyashti'' clearly indicates that in ''kshatakshina'' there is external trauma (ribs fracture leading to pneumothorax) that should be managed with quick remedies. As only conservative management for the ''kshatakshina'' is described, it excludes the possibility of surgical interventions in ''kshatakshina'' in that era. However nowadays the surgical procedures like tube drainage with or without medical pleurodesis, vacuum-assisted thoracostomy (VATS) with pleurodesis and/or closure of leaks and bullectomy, and open surgical procedures such as thoracotomy for pleurectomy or pleurodesis) are conducted to decrease the chances of incurability of ''kshatakshina''. At the present time, it is necessary to elaborate the management of acute dreaded complications like pneumothorax and hematuria in separate chapter.

==== Future Scope for Research ====

*Exploring the clinical evidences for the immunomodulator and hemostatic properties of Sida Veronicaefolia Lam. (''Nagabala'').
*In-vitro and in-vivo evaluation of hemostatic property of Boerhavia diffusa and clinical demonstration of its use in hemoptysis.
*Exploring the role of auto-antibodies in the pathogenesis of tuberculosis and its relation with genetic suspectibility.
*Evaluating the role of ''laksha'' (Laccifer lacca) and ''madhuyasti'' (Glycyrrhiza glabra) in rehabilitating pulmonary tissues in acute pulmonary injury.
*Evaluating role of anti-oxidant drugs [like amalaki (Emblica officinalis)] and vitamin C in the management of chronic inflammatory as well as infectious pulmonary diseases.

=== Further reading ===

#Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed 2000;28:23 – 32.
#Miles JW, Barrett GR. Rib fractures in athletes. Sports Med 1991;12:66 – 9.
#Garcia VF, Gotschall CS, Eichelberger MR, Bowman LM. Rib fractures in children: a marker of severe trauma. J Trauma 1990;30:695 – 700.
#Armstrong CP, Vanderspuy J. The fractured scapula: importance in management based on series of 62 patients. Injury 1984;15:324 – 9.
#Ferro RT, McKeag DB. Neck pain and dyspnea in a swimmer. Phys Sports Med 1999;27.
#Neer II CS. Fractures about the shoulder. In: Rockwood Jr CA, Green DP, editors. Fractures. Philadelphia: JD Lippincott; 1984. p. 713 – 21.
#Pfeiffer RP, Young TR. Case report: spontaneous pneumothorax in a jogger. Phys Sportsmed 1980;8:65 – 7.
#Marnejon T, Sarac S, Cropp AJ. Spontaneous pneumothorax in weightlifters. J Sports Med Phys Fitness 1995;35:124 – 6.
#Simoneaux SF, Murphy BJ, Tehranzadeh J. Spontaneous pneumothorax in a weightlifter. Am J Sports Med 1990;18:647 – 8.
#Harker CP, Neuman TS, Olson LK, et al. The roentgenographic findings associated with air embolism in sport scuba divers. J Emerg Med 1993;11:443 – 9.
#Curtin SM, Tucker AM, Gens DR. Pneumothorax in sports: issues in recognition and follow-up care. Phys Sportsmed 2000;28:23 – 32.
#Partridge RA, Coley A, Bowie R, Woolard RH. Sports-related pneumothorax. Ann Emerg Med1997;30:539 – 41.
#Funk DA, McGanity PL, Hagemeier III KF, Schenck Jr RC. Pneumothorax in high school football. Tex Med 1998;94:72 – 4.
#Ziser A, Vaananen A, Melamed Y. Diving and chronic spontaneous pneumothorax. Chest 1985;87:264 – 5.
#Belham GJ, Adler M. Pneumothorax in a boxer. Br J Sports Med 1985;19:45.
#Sadat-Ali M, Al-Arfaj AL, Mohanna J. Pneumothorax due to soccer injury. Br J Sports Med 1986;20(2):91.
#Ciocca M. Pneumothorax in a weight lifter. Phys Sportsmed 2000;28.
#Harmer PA, Moriarty J, Walsh M, Bean M, Cramer J. Distant entry pneumothorax in a competitive fencer. Br J Sports Med 1996;30:265–6.
#Fischer RP, Flynn TC, Miller PW, Thompson DA. Scapular fractures and major ipsilateral upper torso injuries. Curr Concepts Trauma Care 1985;1:14– 6.
#Morgan EJ, Henderson DA. Pneumomediastinum as a complication of athletic competition. Thorax 1981;36:155–6.
#O’Kane J, O’Kane E, Marquet J. Delayed complication of a rib fracture. Phys Sports med 1998;26.
#Kizer KW, MacQuarrie MB. Pulmonary air leaks resulting from outdoor sports. A clinical series and literature review. Am J Sports Med 1999;27:517– 20.
#Volk CP, McFarland EG, Horsmon G. Pneumothorax: on field recognition. Phys Sportsmed 1995;23:43 – 6.
#Pasternak, M.S., & Rubin, R.H. (2001). Urinary tract tuberculosis. In R.W. Schrier (Ed.), Diseases of the kidney and urinary tract. (7th ed.) (pp. 1017-1037). Philadelphia: Lippincott Wil liams & Wilkins.
#Gibson, M.S., Puckett, M.L., & Shelly, M.E. (2004). Renal tuberculosis. RadioGraphics, 24, 251-256.
#Anwar, N., & Azher, A. (2002). Tuberculosis in a solitary kidney. Pakistan Journal of Medical Research, 41(4), 173-174.
#Soliman, M.S., Lessnau, K., & Hashmat, A. (2006). Tuberculosis of the genitourinary system. Retrieved March 11,2007, from http://www.emedicine.com/med/topic3073..htm.
#Centers for Disease Control and Prevention. (2005). Controlling tuberculosis in the United States. Mortality and Morbidity Weekly Reports (MMWR): Recommended Reports 54 (RR-12), 1-77.
#Khan, A.N., Chandramohan, M., & MacDonald, S. (2004, November 5). Tuberculosis, genitourinary tract. Retrieved March 11, 2007from http://www.emedicine.com/radio/topic721.ht
#Ahmed, M., & Murty, K. V. (2003). Isolated tuberculous pyonephrosis of a native kidney in a renal allograft recipient,an unusual manifestation of tuberculosis – A case report. Indian Journal of Nephrology, 13, 75-79.
#Kenney, P.J. (1990). Imaging of chronic renal infections. American Journal of Radiology, 155, 485-494.
#Christensen, W. (1974). Genitourinary tuberculosis: Review of 102 cases. Medicine (Baltimore), 53, 377-390.
#Kathuria, P; Sanghera, P; Stevenson, FT; Sharma, S; Lederer, E; Lohr, JW; Talavera, F; Verrelli, M (21 May 2013). "Goodpasture Syndrome Clinical Presentation". In Batuman, C. Medscape Reference. WebMD. Retrieved 14 March 2014.
#Schwarz, MI (November 2013). "Goodpasture Syndrome: Diffuse Alveolar Hemorrhage and Pulmonary-Renal Syndrome". Merck Manual Professional. Retrieved 14 March 2014.
#Seo P, Stone JH (July 2004). "The antineutrophil cytoplasmic antibody-associated vasculitides". Am. J. Med. 117 (1): 39–50.
#Berden, A; Göçeroglu, A; Jayne, D; Luqmani, R; Rasmussen, N; Bruijn, JA; Bajema, I (January 2012). "Diagnosis and management of ANCA associated vasculitis.". BMJ 344: e26.
#Pandey Manisha, Sonker Kanchan, Kanoujia Jovita, Koshy M. K., Saraf Shubhini A. Sida Veronicaefolia as a Source of Natural Antioxidant. International Journal of Pharmaceutical Sciences and Drug Research 2009; 1(3): 180-182.
#Bhattacharya A, Chatterjee A, Ghosal S, Bhattacharya SK. Antioxidant activity of active tannoid principles of Emblica officinalis (amla). Indian J Exp Biol. 1999 Jul;37(7):676-80.
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Avakshiraseeya

2019-03-06T03:53:33Z

Pallavmishra:

{{Infobox
|title = Avakshiraseeya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 8
|label2 = Preceding Chapter
|data2 = [[Pannarupiya]]

|label3= Succeeding Chapter
|data3 = [[Yasyashyavanimitta]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}
==[[Indriya Sthana]] Chapter 8, Avakshiraseeya (Chapter on fatal signs like inverted shadow of dying person) ==

=== Abstract ===
<div style="text-align:justify;">
In this chapter [[Avakshiraseeya]] thirty six moribund signs starting with ''avakshira'', i.e. inverted shadow of the dying person are described. These moribund signs mentioned in this chapter can be classified into:
#''lakshananimitta'' (whose causative factors are pre-determined by destiny),
#''lakshyanimitta'' (based on etio-pathological factors) and
#''nimittaanurupa'' (resembling with etiological factors).

The changes in eyelids, eyebrows, face, scalp, nose, tongue, ears, and in abnormal movements of body are described to indicate declining lifespan and death. An individual is a union of five elements and consciousness. The union is by no means permanent with the possibility of dissolution (i.e. death) lingers on throughout life. Even though all symptoms mentioned in this chapter cannot be explained by rational scientific parameters, some particular symptoms are experienced and documented by people worldwide. At the end of the chapter the physicians are advised to carefully look for the moribund signs so the therapeutic treatment is stopped at appropriate time.
Note: Thirty six moribund signs are mentioned in section of Sanskrit ''shloka'' and their translation in English and are not repeated here.

'''Keywords''': ''avakshira, Avakshiraseeyamindriyam,'' inverted shadow of the dying person, moribund signs, dissolution.
</div>
=== Introduction ===

The name given to this chapter, ''Avakshiraseeyamindriyam'' (or [[Avakshirsheeya]]) may be because of the significance of the particular symptom, ''avakshira'', which means inverted shadow of the dying person.

These moribund signs mentioned in this chapter can be classified into following types:
Table No.1: Classification of features:
{| class="wikitable"
! colspan="4"| Classifications
|-
! Three fold
| Lakṣaṇanimittā || Lakṣyanimittā || Nimittānurūpā.
|-
!Two fold
| Physical
|colspan="2"|Emotional-spiritual-psychological.
|-
!Two fold
| Featuring in Healthy
|colspan="2"|Appearing on unhealthy person.
|-
|}
<div style="text-align:justify;">
When a person enters the final stage of the dying process, two different dynamics are at work and are closely interrelated and interdependent. On the physical plane, the body begins the final process of shutting down, which will end when all the physical systems cease to function. Usually this is an orderly and undramatic progressive series of physical changes which are not medical emergencies requiring invasive interventions. These physical changes are a normal, natural way in which the body prepares itself for death.

The other dynamic of the dying process at work is on the emotional-spiritual psychological plane, and is a different kind of process. The spirit of the dying person begins the final process of release from the body, its immediate environment, and all attachments. This release also tends to follow its own priorities, which may include the resolution of whatever is unfinished of a practical nature and reception of permission to “let go” from family members. These events are the normal, natural way in which the spirit prepares to move from this existence into the next dimension of life. The most appropriate kinds of responses to the emotional-spiritual-psychological changes are those which support and encourage this release and transition. Some specific symptoms mentioned in this chapter are experienced and documented by people worldwide. The physician is advised to assess the moribund signs in order to stop treatment.
</div>
===Sanskrit text, Transliteration and English Translation===

अथातोऽवाक्शिरसीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō'vākśirasīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto~avAkshirasIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter on moribund signs like inverted physical shadow (of a being). Thus said Lord Atreya. [1-2]

==== Moribund feature of shadow ====

अवाक्शिरा वा जिह्मा वा यस्य वा विशिरा भवेत्|
जन्तो रूपप्रतिच्छाया नैनमिच्छेच्चिकित्सितुम्||३||

avākśirā vā jihmā vā yasya vā viśirā bhavēt|
jantō rūpapraticchāyā nainamicchēccikitsitum||3||

avAkshirA vA jihmA vA yasya vA vishirA bhavet|
janto rUpapraticchAyA nainamiccheccikitsitum||3||

If the physical shadow of the individual is found to be inverted (head downwards and legs upwards), irregular or without the head, he must not be treated. [3]

==== Moribund feature on eyelids ====

जटीभूतानि पक्ष्माणि दृष्टिश्चापि निगृह्यते |
यस्य जन्तोर्न तं धीरो भेषजेनोपपादयेत्||४||

jaṭībhūtāni pakṣmāṇi dr̥ṣṭiścāpi nigr̥hyatē |
yasya jantōrna taṁ dhīrō bhēṣajēnōpapādayēt||4||

jaTIbhUtAni pakShmANi dRuShTishcApi nigRuhyate [1]
yasya jantorna taM dhIro bheShajenopapAdayet||4||

A person, having complete matting of eye-lashes resulting in absence of vision should not be treated.[4]

यस्य शूनानि वर्त्मानि न समायान्ति शुष्यतः|
चक्षुषी चोपदिह्येते यथा प्रेतस्तथैव सः||५||

yasya śūnāni vartmāni na samāyānti śuṣyataḥ|
cakṣuṣī cōpadihyētē yathā prētastathaiva saḥ||5||

yasya shUnAni vartmAni na samAyAnti shuShyataH|
cakShuShI copadihyete [2] yathA pretastathaiva saH||5||

An emaciated person who is unable to close his eyes due to swollen eyelids and also accompanied by burning eyes should be considered as good as departed. [5]

==== Moribund feature on eyebrows and forehead ====

भ्रुवोर्वा यदि वा मूर्ध्नि सीमन्तावर्तकान् बहून्|
अपूर्वानकृतान् व्यक्तान् दृष्ट्वा मरणमादिशेत्||६||

bhruvōrvā yadi vā mūrdhni sīmantāvartakān bahūn|
apūrvānakr̥tān vyaktān dr̥ṣṭvā maraṇamādiśēt||6||

bhruvorvA yadi vA mUrdhni sImantAvartakAn bahUn|
apUrvAnakRutAn vyaktAn dRuShTvA maraNamAdishet||6||

A person having appearance of bare lines over the scalp, whirls over eye eyebrows or over scalp which were not present before, will die certainly. [6]

त्र्यहमेतेन जीवन्ति लक्षणेनातुरा नराः|
अरोगाणां पुनस्त्वेतत् षड्रात्रं परमुच्यते ||७||

tryahamētēna jīvanti lakṣaṇēnāturā narāḥ|
arōgāṇāṁ punastvētat ṣaḍrātraṁ paramucyatē ||7||

tryahametena jIvanti lakShaNenAturA narAH|
arogANAM punastvetat ShaDrAtraM paramucyate ||7||

These patients (having above mentioned signs), will survive for three days, and healthy individuals (having above mentioned signs) will survive maximum for 6 nights. [7]

==== Moribund feature of hairs ====

आयम्योत्पाटितान् केशान् यो नरो नावबुध्यते|
अनातुरो वा रोगी वा षड्रात्रं नातिवर्तते||८||

āyamyōtpāṭitān kēśān yō narō nāvabudhyatē|
anāturō vā rōgī vā ṣaḍrātraṁ nātivartatē||8||

AyamyotpATitAn keshAn yo naro nAvabudhyate|
anAturo vA rogI vA ShaDrAtraM nAtivartate||8||

An ill or healthy individual, who does not respond to pulling or uprooting of hairs, does not survive for more than six nights. [8]

यस्य केशा निरभ्यङ्गा दृश्यन्तेऽभ्यक्तसन्निभाः|
उपरुद्धायुषं ज्ञात्वा तं धीरः परिवर्जयेत्||९||

yasya kēśā nirabhyaṅgā dr̥śyantē'bhyaktasannibhāḥ|
uparuddhāyuṣaṁ jñātvā taṁ dhīraḥ parivarjayēt||9||

yasya keshA nirabhya~ggA dRushyante~abhyaktasannibhAH|
uparuddhAyuShaM j~jAtvA taM dhIraH parivarjayet||9||

If the hair of the individual appears to be unreasonably greasy then he should be considered as at the fag-end of his life and should not be treated.[9]

==== Moribund feature of nose ====

ग्लायते नासिकावंशः पृथुत्वं यस्य गच्छति|
अशूनः शूनसङ्काशः प्रत्याख्येयः स जानता||१०||

glāyatē nāsikāvaṁśaḥ pr̥thutvaṁ yasya gacchati|
aśūnaḥ śūnasaṅkāśaḥ pratyākhyēyaḥ sa jānatā||10||

glAyate nAsikAvaMshaH pRuthutvaM yasya gacchati|
ashUnaH shUnasa~gkAshaH pratyAkhyeyaH sa jAnatA||10||

A wise (physician) should consider (the patient) with depressed and thickened bridge? of the nose along with its pseudo – swollen appearance as incurable [10]

अत्यर्थविवृता यस्य यस्य चात्यर्थसंवृता|
जिह्मा वा परिशुष्का वा नासिका न स जीवति||११||

atyarthavivr̥tā yasya yasya cātyarthasaṁvr̥tā|
jihmā vā pariśuṣkā vā nāsikā na sa jīvati||11||

atyarthavivRutA yasya yasya cAtyarthasaMvRutA|
jihmA vA parishuShkA vA nAsikA na sa jIvati||11||

Excessive nasal flaring or constriction, distortion in shape and extreme dryness of the nose indicate that the individual will not survive. [11]

==== Incurable signs on face, ear and lips ====

मुखं शब्दश्रवावोष्ठौ शुक्लश्यावातिलोहितौ|
विकृत्या यस्य वा नीलौ न स रोगाद्विमुच्यते||१२||

mukhaṁ śabdaśravāvōṣṭhau śuklaśyāvātilōhitau|
vikr̥tyā yasya vā nīlau na sa rōgādvimucyatē||12||

mukhaM shabdashravAvoShThau [2] shuklashyAvAtilohitau|
vikRutyA yasya vA nIlau na sa rogAdvimucyate||12||

If the face, ears and lips become abnormally (without any visible cause) white, brown, excessively red or blue, then such a patient seldom recovers from the disease. [12]

==== Incurable signs on teeth ====

अस्थिश्वेता द्विजा यस्य पुष्पिताः पङ्कसंवृताः|
विकृत्या न स रोगं तं विहायारोग्यमश्नुते||१३||

asthiśvētā dvijā yasya puṣpitāḥ paṅkasaṁvr̥tāḥ|
vikr̥tyā na sa rōgaṁ taṁ vihāyārōgyamaśnutē||13||

asthishvetA dvijA yasya puShpitAH pa~gkasaMvRutAH|
vikRutyA na sa rogaM taM vihAyArogyamashnute||13||

A patient having morbid conditions like appearance of bony white teeth, white flower shaped spots and mud like appearance over teeth cannot recover from the disease. [13]

==== Fatal signs on tongue ====

स्तब्धा निश्चेतना गुर्वी कण्टकोपचिता भृशम्|
श्यावा शुष्काऽथवा शूना प्रेतजिह्वा विसर्पिणी||१४||

stabdhā niścētanā gurvī kaṇṭakōpacitā bhr̥śam|
śyāvā śuṣkā'thavā śūnā prētajihvā visarpiṇī||14||

stabdhA nishcetanA gurvI kaNTakopacitA bhRusham|
shyAvA shuShkA~athavA shUnA pretajihvA visarpiNI||14||

If the tongue becomes rigid, senseless, heavy, excessively coated with a thorn like fur, brown in color, dry or swollen and constantly mobile, then the patient having such signs should be considered as good as dead. [14]

==== Fatal sign of respiration ====

दीर्घमुच्छ्वस्य यो ह्रस्वं नरो निःश्वस्य ताम्यति|
उपरुद्धायुषं ज्ञात्वा तं धीरः परिवर्जयेत्||१५||

dīrghamucchvasya yō hrasvaṁ narō niḥśvasya tāmyati|
uparuddhāyuṣaṁ jñātvā taṁ dhīraḥ parivarjayēt||15||

dIrghamucchvasya yo hrasvaM naro niHshvasya tAmyati|
uparuddhAyuShaM j~jAtvA taM dhIraH parivarjayet||15||

If a person faints after a short expiration followed by a long inspiration, then he should be considered as nearing his end and must not be treated. [15]

==== Fatal sign of extremities and neck ====

हस्तौ पादौ च मन्ये च तालु चैवातिशीतलम्|
भवत्यायुःक्षये क्रूरमथवाऽपि भवेन्मृदु||१६||

hastau pādau ca manyē ca tālu caivātiśītalam|
bhavatyāyuḥkṣayē krūramathavā'pi bhavēnmr̥du||16||

hastau pAdau ca manye ca tAlu caivAtishItalam|
bhavatyAyuHkShaye krUramathavA~api bhavenmRudu||16||

Excessive coldness, roughness and softness in hands, legs and neck indicate the end of the life of the person. [16]

==== Fatal signs of abnormal movements ====

घट्टयञ्जानुना जानु पादावुद्यम्य पातयन्|
योऽपास्यति मुहुर्वक्रमातुरो न स जीवति||१७||

ghaṭṭayañjānunā jānu pādāvudyamya pātayan|
yō'pāsyati muhurvakramāturō na sa jīvati||17||

ghaTTaya~jjAnunA jAnu pAdAvudyamya pAtayan|
yo~apAsyati muhurvakramAturo na sa jIvati||17||

The person who strikes one knee with the other, throws down legs after lifting them up and frequently turns the face to one or the other side, does not survive. [17]

दन्तैश्छिन्दन्नखाग्राणि नखैच्छिन्दञ्छिरोरुहान्|
काष्ठेन भूमिं विलिखन्न रोगात् परिमुच्यते||१८||

dantaiśchindannakhāgrāṇi nakhaicchindañchirōruhān|
kāṣṭhēna bhūmiṁ vilikhanna rōgāt parimucyatē||18||

dantaishchindannakhAgrANi nakhaicchinda~jchiroruhAn|
kAShThena bhUmiM vilikhanna rogAt parimucyate||18||

The patient, who cuts tips of his nail by biting, clips hair by nail and writes on the ground with the help of a stick, succumbs to the disease. [18]

दन्तान् खादति यो जाग्रदसाम्ना विरुदन् हसन्|
विजानाति न चेद्दुःखं न स रोगाद्विमुच्यते||१९||

dantān khādati yō jāgra dasāmnā virudan hasan|
vijānāti na cēdduḥkhaṁ na sa rōgādvimucyatē||19||

dantAn khAdati yo jAgradasAmnA virudan hasan|
vijAnAti na cedduHkhaM na sa rogAdvimucyate||19||

The patient who gnashes teeth while awake, cries and laughs loudly and does not have the pain sensation, does not recover from the disease. [19]

मुहुर्हसन् मुहुः क्ष्वेडन् शय्यां पादेन हन्ति यः|
उच्चैश्छिद्राणि विमृशन्नातुरो न स जीवति||२०||

muhurhasan muhuḥ kṣvēḍan śayyāṁ pādēna hanti yaḥ|
uccaiśchidrāṇi vimr̥śannāturō na sa jīvati||20||

muhurhasan muhuH kShveDan shayyAM pAdena hanti yaH|
uccaishchidrANi [1] vimRushannAturo na sa jIvati||20||

The patient, who frequently laughs and shouts, strikes the bed by feet and puts finger into the nostrils, ears and eyes does not survive. [20]

यैर्विन्दति पुरा भावैः समेतैः परमां रतिम्|
तैरेवारममाणस्य ग्लास्नोर्मरणमादिशेत्||२१||

yairvindati purā bhāvaiḥ samētaiḥ paramāṁ ratim|
tairēvāramamāṇasya glāsnōrmaraṇamādiśēt||21||

yairvindati purA bhAvaiH sametaiH paramAM ratim|
tairevAramamANasya glAsnormaraNamAdishet||21||

If a debilitated patient develops disliking for such factors which, in the past, made him extremely happy, his death is imminent. [21]

न बिभर्ति शिरो ग्रीवा न पृष्ठं भारमात्मनः|
न हनू पिण्डमास्यस्थमातुरस्य मुमूर्षतः||२२||

na bibharti śirō grīvā na pr̥ṣṭhaṁ bhāramātmanaḥ|
na hanū piṇḍamāsyasthamāturasya mumūrṣataḥ||22||

na bibharti shiro grIvA na pRuShThaM bhAramAtmanaH|
na hanU piNDamAsyasthamAturasya mumUrShataH||22||

If the neck of the patient is unable to support the weight of the head, the back, that of the body, the jaw bones, morsel of food in the mouth, this indicates his imminent death. [22]

सहसा ज्वरसन्तापस्तृष्णा मूर्च्छा बलक्षयः|
विश्लेषणं च सन्धीनां मुमूर्षोरुपजायते||२३||

sahasā jvarasantāpastr̥ṣṇā mūrcchā balakṣayaḥ|
viślēṣaṇaṁ ca sandhīnāṁ mumūrṣōrupajāyatē||23||

sahasA jvarasantApastRuShNA mUrcchA balakShayaH|
vishleShaNaM ca sandhInAM mumUrShorupajAyate||23||

Sudden fever, thirst, fainting, debility and looseness of joints points to death. [23]

गोसर्गे वदनाद्यस्य स्वेदः प्रच्यवते भृशम्|
लेपज्वरोपतप्तस्य दुर्लभं तस्य जीवितम्||२४||

gōsargē vadanādyasya svēdaḥ pracyavatē bhr̥śam|
lēpajvarōpataptasya durlabhaṁ tasya jīvitam||24||

gosarge vadanAdyasya svedaH pracyavate bhRusham|
lepajvaropataptasya durlabhaM tasya jIvitam||24||

If a patient suffering from ''lepajwara'' i.e. a type of fever patient gets profuse perspiration in the face, there is little chance of his survival. [24]

नोपैति कण्ठमाहारो जिह्वा कण्ठमुपैति च|
आयुष्यन्तं गते जन्तोर्बलं च परिहीयते||२५||

nōpaiti kaṇṭhamāhārō jihvā kaṇṭhamupaiti ca|
āyuṣyantaṁ gatē jantōrbalaṁ ca parihīyatē||25||

nopaiti kaNThamAhAro jihvA kaNThamupaiti ca|
AyuShyantaM gate jantorbalaM ca parihIyate||25||

If the ingested food does not reach the throat, or the tongue falls back over the throat (thereby causing obstruction ) and there is diminution of strength, then the death of the person is imminent. [25]

शिरो विक्षिपते कृच्छ्रान्मुञ्चयित्वा प्रपाणिकौ|
ललाटस्रुप्रतस्वेदो मुमूर्षुश्च्युतबन्धनः ||२६||

śirō vikṣipatē kr̥cchrānmuñcayitvā prapāṇikau|
lalāṭasrupratasvēdō mumūrṣuścyutabandhanaḥ ||26||

shiro vikShipate kRucchrAnmu~jcayitvA prapANikau|
lalATasrupratasvedo mumUrShushcyutabandhanaH [1] ||26||

If the person moves his head with difficulty with the help of the fore-arms and if there is sweating in the forehead and is a sign of detachment from life, he is moribund. [26]

==== Summary ====

तत्र श्लोकः-
इमानि लिङ्गानि नरेषु बुद्धिमान् विभावयेतावहितो मुमूर्षुषु|
क्षणेन भूत्वा ह्युपयान्ति कानिचिन्नचाफलं लिङ्गमिहास्ति किञ्चन||२७||

tatra ślōkaḥ-
imāni liṅgāni narēṣu buddhimān vibhāvayētāvahitō mumūrṣuṣu|
kṣaṇēna bhūtvā hyupayānti kānicinnacāphalaṁ liṅgamihāsti kiñcana||27||

tatra shlokaH-
imAni li~ggAni nareShu buddhimAn vibhAvayetAvahito mumUrShuShu|
kShaNena bhUtvA hyupayAnti kAnicinnacAphalaM li~ggamihAsti ki~jcana||27||

Here is the re-capitulatory verse:
The wise physician should closely search for these signs repeatedly because some of them disappear in a short moment after their manifestation.

None of these signs remain without leading to the consequences already described i.e. all of them certainly indicate imminent death. [27 ]

=== ''Tattva Vimarsha'' ===

*The fatal signs can be observed on eyelids, eyebrows, scalp, nose, face, tongue, teeth, ears, and in abnormal movements of body parts. These signs indicate declining vitality of body.

=== ''Vidhi Vimarsha'' ===
<div style="text-align:justify;">
The sign of inverted shadow of dying person ''lakshanamitta'', should be understood. It is a classification and a unique sign which is not mentioned in contemporary science or in other alternative medicines. Naming a chapter in the [[Charak Samhita]] after the sign reflects its importance.[3]

Severe blepharitis comprises of matting of eyelids, swollen eyelids, burning vision and may cause death in patients in following conditions:
#having a neoplasm affecting the eyelid at the time of the clinical onset of blepharitis;
#or having xerophthalmia at the time of the clinical onset of blepharitis;
#or having diabetes mellitus at the time of the clinical onset of blepharitis;
#or being in an immune-compromised state at the time of the clinical onset of blepharitis; [4]

A condition of not having pain when uprooting the hairs is found in the end stage of leprosy featuring scalp numbness and alopecia.[5]

A condition of unctuous hairs without application of oil is found in the ''asadhya lakshanas'' of ''prameha''.[9]

In the Wegener’s granulomatosis the bridge of the nose can collapse resulting in a “saddle–nose deformity due to cartilage inflammation. Death occurs due to kidney failure in such a case. In traditional Chinese medicine a symptom painting (e.g., nasal flaring) is described as a near death sign.[10]

In Tibetan medicine, dryness of nose has been described as near death sign.[11]

In contemporary science, extreme pallor of skin and cyanosis is described as a sign for alertness to identify major cause.[12]

When death approaches a person his breathing may sound congested; may change in rate, depth and rhythm; there may be periods of breathlessness for 5-30 seconds resulting in Cheyne Stoke breathing.[15]

The sign of abnormal movements of knees resembles distressed state of the patient suffering from severe pain which is a common near death symptom wherein patient cannot share his experiences with the other people due to widely compromised ability to communicate-a condition resembles Dysdiadokinesia. [17]

At the end of life, Organs begin to fail, including the brain. Higher-order consciousness tends to change; the chemical balance of the body becomes completely upset leading to altered sensation.

Saavedra-Aguilar and Gomez-Jeria’s (1989) model invokes temporal-lobe dysfunction, hypoxia, psychological stress, and neurotransmitter changes to explain the NDE. According to this model, brain stress caused by traumatic events leads to the release of endogenous neuropeptides, neurotransmitters, or both, producing such effects as analgesia, euphoria, and detachment.

Terminal restlessness is a particularly distressing form of delirium that may occur in dying patients. It is characterized by anguish (spiritual, emotional, or physical), restlessness, anxiety, agitation, and cognitive failure, caused by decrease in oxygen circulation to the brain and by metabolic changes.<ref> Kinzbrunner, BM; Weinreb, NJ; Policzer, JS; 20 Common Problems: End of Life Care, McGraw-Hill Publishing, 2002 </ref> [18-20]

Many NDEs share with dissociation or disconnection of perception, cognition, emotion, and identity from the mainstream of the individual’s conscious awareness (Greyson, 1997).<ref> Greyson, B. - The near-death experience as a focus of clinical attention. J Nerv Ment Dis 185:327-334, 1997 </ref>

Hectic fever is a daily recurring fever with profound sweating, chills, and flushed appearance-- often associated with pulmonary tuberculosis or septic poisoning.[24]

Inability to swallow the oral food contents, leads to choking or enters the trachea causing fatality.[25]

Chyutabandhanaḥ (Detachment from life) symptom can be interpreted either as release of all bodily sphincters or complete detachment of the bindings of the world, both acknowledged by contemporary science.[26]
</div>
=== Similar references in other texts ===

Shloka 4 - 7: Su. Su. 31/10, A.H. Sha. 5/17,<br>
Shlok-08:Ca. I. 11/17<br>
Shlok-09: A.H. Sha. 5/16 & 19,<br>
Shlok-10-12: Su. Su. 31/08,<br>
Shlok-13: Su. Su. 31/06, A.H. Sha. 5/10<br>
Shlok-14: Su. Su. 31/07, A.H. Sha. 5/10,<br>
Shlok-18-19: Su. Su. 31/07, A.H. Sha. 5/10,<br>
Shlok-22: Su. Su. 31/11, A.H. Sha. 5/11<br>
Shlok-23: A.H. Sha. 5/109,<br>
Shlok-24: A.H. Sha. 5/110,<br>
Shlok-26:A.H. Sha. 5/57.<br>
Note: Thirty six moribund signs are mentioned in section of Sanskrit ''shloka'' and their translation in English and are not repeated here.

=== References ===

<references/>
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Purusha Vichaya Sharira

2019-03-06T03:52:59Z

Pallavmishra:

{{Infobox
|title = Purusha Vichaya Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 5
|label2 = Preceding Chapter
|data2 = [[Mahatigarbhavakranti Sharira]]

|label3= Succeeding Chapter
|data3 = [[Sharira Vichaya Sharira]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}
== [[Sharira Sthana]] Chapter 5, Purusha Vichaya Sharira (Chapter on a Detailed Study of the ''Purusha'') ==

=== Abstract ===
<div style="text-align:justify;">

''Purusha Vichaya'' literally means detailed (or comprehensive) search or analysis of the person (or ''purusha''). The preceding two chapters explained the developmental phase of an embryo to fetus and the birth of the child. This chapter deals with factors that help transform the child into a fully grown ''purusha''. An important message from this chapter is the view that the ''purusha'' is a microcosm mirroring the universe, or the macrocosm. This is briefly indicated in the preceding chapter ([[Mahatigarbhavakranti Sharira]], verse 13), where it is said that the ''purusha'' epitomizes the universe. All the structural forms that exist in the universe also exist in ''purusha'' and vice-versa. A study of the ''purusha'' is not simply restricted to exploring the anatomy and physiology of a human being. Rather, the ''purusha'' is said to be formed of the same ''shad dhatu'' (''pancha mahabhuta'', or the five fundamental elements, and the supreme consciousness) that the universe is made of. Thus, it signifies an interdependence between the microcosm and the macrocosm. This study underscores that a person – or a human being – should not be seen in isolation, but in the context of harmony between man and the environment.

'''Keywords''': ''Purusha'', man, microcosm, ''loka'', macrocosm, universe, cause of disease and happiness, serenity, path to emancipation.
</div>

=== Introduction ===
<div style="text-align:justify;">
The term ''purusha vichayam'' means the search of the purusha (individual person’s living body) or the analytical study of the ''purusha''. Since Vedic times, sages and practitioners of Ayurveda studied the environment and the various features that constituted the ''loka'' (realm or world) and its impact on the ''purusha'' (person). Many civilizations have acknowledged the relationship between man and his environment, but Vedic scholars recorded their observations of the similarities in the ''avyava'' (component) of ''loka'' and ''purusha'', concluding that the person is the replica of the universe (''Yatha Pinde Tatha Brahmande''). Lord Atreya dedicated this chapter to the study of the purusha underscoring this belief. Charak advised maintaining a harmony between man and his environment to attain the prime objectives of a human life – blissful life (''sukhayu''), useful life (''hitayu''), and salvation (''moksha'').
</div>
===Sanskrit text, Transliteration and English Translation===

अथातः पुरुषविचयं शारीरं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ puruṣavicayaṁ śārīraṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH puruShavicayaM shArIraM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now I shall expound the chapter on the study/analysis of the Purusha. Thus said Lord Atreya. [1-2]

==== The ''purusha'' (man/individual)-an epitome/ miniature of the ''loka'' (universe) ====

‘पुरुषोऽयं लोकसम्मितः’ इत्युवाच भगवान् पुनर्वसुरात्रेयः|
यावन्तो हि लोके (मूर्तिमन्तो ) भावविशेषास्तावन्तः पुरुषे, यावन्तः पुरुषे तावन्तो लोके; इत्येवंवादिनंभगवन्तमात्रेयमग्निवेश उवाच- नैतावता वाक्येनोक्तं वाक्यार्थमवगाहामहे, भगवता बुद्ध्या भूयस्तरमतोऽनुव्याख्यायमानंशुश्रूषामह इति||३||

‘puruṣō'yaṁ lōkasammitaḥ’ ityuvāca bhagavān punarvasurātrēyaḥ|
yāvantō hi lōkē (mūrtimantō ) bhāvaviśēṣāstāvantaḥ puruṣē, yāvantaḥ puruṣē tāvantō lōkē;ityēvaṁvādinaṁ bhagavantamātrēyamagnivēśa uvāca- naitāvatā vākyēnōktaṁ vākyārthamavagāhāmahē,bhagavatā buddhyā bhūyastaramatō'nuvyākhyāyamānaṁ śuśrūṣāmaha iti||3||

‘puruSho~ayaM lokasammitaH’ ityuvAca bhagavAn punarvasurAtreyaH|
yAvanto hi loke (mUrtimanto [1] ) bhAvavisheShAstAvantaH puruShe, yAvantaH puruShe tAvanto loke; ityevaMvAdinaM bhagavantamAtreyamagnivesha uvAca-naitAvatA vAkyenoktaM vAkyArthamavagAhAmahe, bhagavatA buddhyA bhUyastaramato~anuvyAkhyAyamAnaM shushrUShAmaha iti||3||
<div style="text-align:justify;">
Lord Punarvasu Atreya said that the ''purusha'' is similar to the ''loka''. Whatever specific ''murtimantabhava'' (embodiments) are present in the ''loka'', the same are in the ''purusha''. Similarly, whatever is in ''purusha'', is also in the ''loka''.
Having listened thus to Lord Atreya, Agnivesha said, "We are unable to grasp the idea contained in this aphoristic statement, hence we want to hear a more detailed exposition from you, O Lord!" [3]
</div>
तमुवाच भगवानात्रेयः- अपरिसङ्ख्येया लोकावयवविशेषाः, पुरुषावयवविशेषा अप्यपरिसङ्ख्येयाः; तेषां यथास्थूलंकतिचिद्भावान् सामान्यमभिप्रेत्योदाहरिष्यामः, तानेकमना निबोध सम्यगुपवर्ण्यमानानग्निवेश!|
षड्धातवः समुदिताः ‘लोक’ इति शब्दं लभन्ते; तद्यथा- पृथिव्यापस्तेजो वायुराकाशं ब्रह्म चाव्यक्तमिति, एत एव चषड्धातवः समुदिताः ‘पुरुष’ इति शब्दं लभन्ते||४||

tamuvāca bhagavānātrēyaḥ- aparisaṅkhyēyā lōkāvayavaviśēṣāḥ, puruṣāvayavaviśēṣāapyaparisaṅkhyēyāḥ; tēṣāṁ yathāsthūlaṁ katicidbhāvān sāmānyamabhiprētyōdāhariṣyāmaḥ,tānēkamanā nibōdha Sāmyagupavarṇyamānānagnivēśa!|
ṣaḍdhātavaḥ samuditāḥ ‘loka’ iti śabdaṁ labhantē; tadyathā- pr̥thivyāpastējō vāyurākāśaṁ brahmacāvyaktamiti, ēta ēva ca ṣaḍdhātavaḥ samuditāḥ ‘puruṣa’ iti śabdaṁ labhantē||4||

tamuvAca bhagavAnAtreyaH- aparisa~gkhyeyA lokAvayavavisheShAH, puruShAvayavavisheShA apyaparisa~gkhyeyAH; teShAM yathAsthUlaM katicidbhAvAnsAmAnyamabhipretyodAhariShyAmaH, tAnekamanA nibodha samyagupavarNyamAnAnagnivesha!|
ShaDdhAtavaH samuditAH ‘puruSha’ iti shabdaM labhante; tadyathA- pRuthivyApastejo vAyurAkAshaM brahma cAvyaktamiti, eta eva ca ShaDdhAtavaH samuditAH‘puruSha’ iti shabdaM labhante||4||
<div style="text-align:justify;">
Lord Atreya replied, "Innumerable are the specific parts (different unit constituents) of the ''loka'' and so are innumerable the specific parts (unit constituents) of a ''purusha''. I will explain (to you) some of the gross entities common (to the ''loka'' and ''purusha'') because it is very difficult to mention all of them, but the rest you understand yourself by inference.

Attentively, listen to me O Agnivesha!, The aggregate (collective combination) of the six ''dhatus'', viz. ''prithvi, apa, tejas, vayu,'' ''akasha'' and unmanifested ''Brahman'' is termed as ''loka'' (universe) and (similarly these) six constituents also make the ''purusha''. [3-4]
</div>

==== Identity of ''avayava'' /parts/ factors of ''samyatva'' (similarity) in ''purusha'' (man) with those of ''loka'' (universe) ====

तस्य पुरुषस्य पृथिवी मूर्तिः, आपः क्लेदः, तेजोऽभिसन्तापः, वायुः प्राणः, वियत् सुषिराणि, ब्रह्म अन्तरात्मा|
यथा खलु ब्राह्मी विभूतिर्लोके तथा पुरुषेऽप्यान्तरात्मिकी विभूतिः, ब्रह्मणो विभूतिर्लोके प्रजापतिरन्तरात्मनो विभूतिः पुरुषेसत्त्वं, यस्त्विन्द्रो लोके स पुरुषेऽहङ्कारः, आदित्यस्त्वादानं, रुद्रो रोषः, सोमः प्रसादः, वसवः सुखम्, अश्विनौ कान्तिः,मरुदुत्साहः, विश्वेदेवाः सर्वेन्द्रियाणि सर्वेन्द्रियार्थाश्च, तमो मोहः, ज्योतिर्ज्ञानं, यथा लोकस्य सर्गादिस्तथा पुरुषस्य गर्भाधानं,यथा कृतयुगमेवं बाल्यं, यथा त्रेता तथा यौवनं, यथा द्वापरस्तथा स्थाविर्यं, यथा कलिरेवमातुर्यं, यथा युगान्तस्तथामरणमिति|
एवमेतेनानुमानेनानुक्तानामपि लोकपुरुषयोरवयवविशेषाणामग्निवेश! सामान्यं विद्यादिति||५||

tasya puruṣasya pr̥thivī mūrtiḥ, āpaḥ klēdaḥ, tējō'bhisantāpaḥ, vāyuḥ prāṇaḥ, viyat suṣirāṇi, brahmaantarātmā|
yathā khalu brāhmī vibhūtirlōkē tathā puruṣē'pyāntarātmikī vibhūtiḥ, brahmaṇō vibhūtirlōkēprajāpatirantarātmanō vibhūtiḥ puruṣē sattvaṁ, yastvindrō lōkē sa puruṣē'haṅkāraḥ, ādityastvādānaṁ,rudrō rōṣaḥ, sōmaḥ prasādaḥ, vasavaḥ sukham, aśvinau kāntiḥ, marudutsāhaḥ, viśvēdēvāḥ sarvēndriyāṇisarvēndriyārthāśca, tamō mōhaḥ, jyōtirjñānaṁ, yathā lōkasya sargādistathā puruṣasya garbhādhānaṁ,yathā kr̥tayugamēvaṁ bālyaṁ, yathā trētā tathā yauvanaṁ, yathā dvāparastathā sthāviryaṁ, yathākalirēvamāturyaṁ, yathā yugāntastathā maraṇamiti|
ēvamētēnānumānēnānuktānāmapi lōkapuruṣayōravayavaviśēṣāṇāmagnivēśa! sāmānyaṁ vidyāditi||5||

tasya puruShasya pRuthivI mUrtiH, ApaH kledaH, tejo~abhisantApaH, vAyuH prANaH, viyat suShirANi, brahma antarAtmA|
yathA khalu brAhmI vibhUtirloke tathA puruShe~apyAntarAtmikI vibhUtiH, brahmaNo vibhUtirloke prajApatirantarAtmano vibhUtiH puruShe sattvaM, yastvindro lokesa puruShe~aha~gkAraH, AdityastvAdAnaM, rudro roShaH, somaH prasAdaH, vasavaH sukham, ashvinau kAntiH, marudutsAhaH, vishvedevAH sarvendriyANisarvendriyArthAshca, tamo mohaH, jyotirj~jAnaM, yathA lokasya sargAdistathA puruShasya garbhAdhAnaM, yathA kRutayugamevaM bAlyaM, yathA tretA tathAyauvanaM, yathA dvAparastathA sthAviryaM, yathA kalirevamAturyaM, yathA yugAntastathA maraNamiti|
evametenAnumAnenAnuktAnAmapi lokapuruShayoravayavavisheShANAmagnivesha! sAmAnyaM vidyAditi||5||
<div style="text-align:justify;">
In the person, ''prithvi, apa, tejas, vayu, akasha'' and ''Brahman'' are represented in the form of embodiments, moisture, heat, vital breath, space and the Self (''atman'') respectively. As is the magnificence of the ''Brahman'', the super-consciousness, in the universe so is that of the atman in the person. While in the universe, the splendor of the ''Brahman'' is personified by Prajapati, the ''atman'' in the ''purusha'' is represented by the mind. Similarly, Indra in the universe is represented by ego in the person, Aditya (the sun) is represented in the processes that consume nutrients, Rudra in agitation, Soma (the moon) in cheerfulness, Vasu in happiness, Marut (the air) in enthusiasm, Ashwin in luster, Vishvadeva in all sense organs and their objects, darkness in ignorance, light in knowledge. just as there is act of creation in the universe, so also in man there is conception. Corresponding to ''krita yuga''( the first age of universe), there is childhood. Corresponding to ''treta yuga'' (the second age), is youth. Corresponding to ''dwapara yuga'' (the third age), there is old age. Corresponding to ''kali yuga''(the last age), is infirmity or diseases. Thus corresponding to the end of world cycle, is death in man. Thus, O Agnivesha, analogies between various features and phenomena could be drawn from the macrocosm to understand the microcosm (and vice versa). [5]
</div>
==== Applied aspect of the knowledge of the ''purusha'' (man/individual) -an epitome / miniture of the ''loka'' (universe) ====

एवंवादिनं भगवन्तमात्रेयमग्निवेश उवाच- एवमेतत् सर्वमनपवादं यथोक्तं भगवता लोकपुरुषयोः सामान्यम्|
किन्न्वस्य सामान्योपदेशस्य प्रयोजनमिति||६||

ēvaṁvādinaṁ bhagavantamātrēyamagnivēśa uvāca- ēvamētat sarvamanapavādaṁ yathōktaṁ bhagavatālōkapuruṣayōḥ sāmānyam|
kinnvasya sāmānyōpadēśasya prayōjanamiti||6||

evaMvAdinaM bhagavantamAtreyamagnivesha uvAca- evametat sarvamanapavAdaM yathoktaM bhagavatA lokapuruShayoH sAmAnyam|
kinnvasya sAmAnyopadeshasya prayojanamiti||6||

When Lord Atreya finished his talk, Agnivesha said, “The similarity between ''purusha'' and the universe is undoubtedly logical. What is the purpose of this discourse in the context of medicine?”[6]

भगवानुवाच-शृण्वग्निवेश! सर्वलोकमात्मन्यात्मानं च सर्वलोके सममनुपश्यतः सत्या बुद्धिः समुत्पद्यते|
सर्वलोकं ह्यात्मनि पश्यतो भवत्यात्मैव सुखदुःखयोः कर्ता नान्य इति|कर्मात्मकत्वाच्च हेत्वादिभिर्युक्तः सर्वलोकोऽहमिति विदित्वा ज्ञानं पूर्वमुत्थाप्यतेऽपवर्गायेति|तत्र संयोगापेक्षीलोकशब्दः| षड्धातुसमुदायो हि सामान्यतः सर्वलोकः||७||

bhagavānuvāca-śr̥ṇvagnivēśa! sarvalōkamātmanyātmānaṁ ca sarvalōkē samamanupaśyataḥ satyā [1]buddhiḥ samutpadyatē|
sarvalōkaṁ hyātmani paśyatō Bhāvatyātmaiva sukhaduḥkhayōḥ kartā nānya iti|
karmātmakatvācca hētvādibhiryuktaḥ sarvalōkō'hamiti viditvā jñānaṁ pūrvamutthāpyatē'pavargāyēti|
tatra saṁyōgāpēkṣīlōkaśabdaḥ|
ṣaḍdhātusamudāyō hi sāmānyataḥ sarvalōkaḥ||7||

bhagavAnuvAca- shRuNvagnivesha! sarvalokamAtmanyAtmAnaM ca sarvaloke samamanupashyataH satyA [1] buddhiH samutpadyate|
sarvalokaM hyAtmani pashyato bhavatyAtmaiva sukhaduHkhayoH kartA nAnya iti|
karmAtmakatvAcca hetvAdibhiryuktaH sarvaloko~ahamiti viditvA j~jAnaM pUrvamutthApyate~apavargAyeti|
tatra saMyogApekShIlokashabdaH|
ShaDdhAtusamudAyo hi sAmAnyataH sarvalokaH||7||
<div style="text-align:justify;">
Lord Atreya replied that seeing the universe in the ''purusha'', and vice-versa, gives rise to true knowledge. With such (true) knowledge, one would realize that the ''atman'', or the Self, alone is responsible for bliss and sorrow and no one else. With this knowledge, one realizes that the whole world, being of the nature of activity and yoked to motivating factors etc. is as own self, one awakens the primary knowledge leading to salvation. The word ''loka'' here denotes aggregation. Generally, the entire universe (and the ''purusha'') is made up of six constituents. [7]
</div>
==== ''Dukha'' (miseries) and ''sukha'' (happiness) of the ''purusha'' (man / individual) ====

तस्य हेतुः, उत्पत्तिः, वृद्धिः, उपप्लवः, वियोगश्च|
तत्र हेतुरुत्पत्तिकारणं, उत्पत्तिर्जन्म, वृद्धिराप्यायनम्, उपप्लवो दुःखागमः, षड्धातुविभागो वियोगः सजीवापगमः सप्राणनिरोधः स भङ्गः स लोकस्वभावः|
तस्य मूलं सर्वोपप्लवानां च प्रवृत्तिः, निवृत्तिरुपरमः|
प्रवृत्तिर्दुःखं, निवृत्तिः सुखमिति यज्ज्ञानमुत्पद्यते तत् सत्यम्|
तस्य हेतुः सर्वलोकसामान्यज्ञानम्|
एतत्प्रयोजनं सामान्योपदेशस्येति||८||

tasya hētuḥ, utpattiḥ, vr̥ddhiḥ, upaplavaḥ, viyōgaśca|
tatra hēturutpattikāraṇaṁ, utpattirjanma, vr̥ddhirāpyāyanam, upaplavō duḥkhāgamaḥ, ṣaḍdhātuvibhāgōviyōgaḥ sajīvāpagamaḥ sa prāṇanirōdhaḥ sa bhaṅgaḥ sa lōkasvabhāvaḥ|tasya mUlaM sarvopaplavAnAM ca pravRuttiH, nivRuttiruparamaH|
pravRuttirduHkhaM, nivRuttiH sukhamiti yajj~jAnamutpadyate tat satyam|
tasya hetuH sarvalokasAmAnyaj~jAnam|
etatprayojanaM sAmAnyopadeshasyeti||8||

tasya hetuH, utpattiH, vRuddhiH, upaplavaH, viyogashca|
tatra heturutpattikAraNaM, utpattirjanma, vRuddhirApyAyanam, upaplavo duHkhAgamaH, ShaDdhAtuvibhAgo viyogaH sajIvApagamaH sa prANanirodhaH sabha~ggaH sa lokasvabhAvaH|
tasya mUlaM sarvopaplavAnAM ca pravRuttiH, nivRuttiruparamaH|
pravRuttirduHkhaM, nivRuttiH sukhamiti yajj~jAnamutpadyate tat satyam|
tasya hetuH sarvalokasAmAnyaj~jAnam|
etatprayojanaM sAmAnyopadeshasyeti||8||
<div style="text-align:justify;">
There are ''hetu, utpatti, vriddhi, upaplava'' and ''viyoga'' for ''purusha'' (man) and ''loka'' (universe). ''Hetu'' is the cause of manifestation, ''utpatti'' is germination or birth, ''vriddhi'' is growth, ''upaplava'' is advent of miseries. ''Viyoga'' is departure of soul, cessation of vital breath, disruption, dissolution of the six constituents and the reverting to the primordial state. The root cause of universe and all ''upaplava''(advent of miseries) is ''pravritti'' (action/attachment). ''Nivritti'' (inaction/detachment from worldly affairs) leads to its destruction (of all miseries). Attachment leads to miseries and detachment to bliss. Realization of this fact is truth (pure knowledge). Imparting this knowledge is the purpose of describing this principle. [8]
</div>
==== Cause of ''pravritti'' (attachment) and method of ''nivritti'' (detachment) ====

अथाग्निवेश उवाच- किम्मूला भगवन्! प्रवृत्तिः, निवृत्तौ च क उपाय इति||९||

athāgnivēśa uvāca- kimmūlā bhagavan! pravr̥ttiḥ, nivr̥ttau ca ka upāya iti||9||

athAgnivēśaa uvAca- kimmUlA bhagavan! pravRuttiH, nivRuttau ca ka upAya iti||9||

Agnivesha then asks, "What is cause of ''pravritti'' (attachment) and methods of ''nivritti'' (detachment) ?".[9]

भगवानुवाच- मोहेच्छाद्वेषकर्ममूला प्रवृत्तिः|
तज्जा ह्यहङ्कारसङ्गसंशयाभिसम्प्लवाभ्यवपातविप्रत्ययाविशेषानुपायास्तरुणमिव द्रुममतिविपुलशाखास्तरवोऽभिभूयपुरुषमवतत्यैवोत्तिष्ठन्ते; यैरभिभूतो न सत्तामतिवर्तते|
तत्रैवञ्जातिरूपवित्तवृत्तबुद्धिशीलविद्याभिजनवयोवीर्यप्रभावसम्पन्नोऽहमित्यहङ्कारः, यन्मनोवाक्कायकर्म नापवर्गाय ससङ्गः, कर्मफलमोक्षपुरुषप्रेत्यभावादयः सन्ति वा नेति संशयः, सर्वावस्थास्वनन्योऽहमहं स्रष्टा स्वभावसंसिद्धोऽहमहंशरीरेन्द्रियबुद्धिस्मृतिविशेषराशिरिति ग्रहणमभिसम्प्लवः, मम मातृपितृभ्रातृदारापत्यबन्धुमित्रभृत्यगणो गणस्यचाहमित्यभ्यवपातः, कार्याकार्यहिताहितशुभाशुभेषु विपरीताभिनिवेशो विप्रत्ययः, ज्ञाज्ञयोः प्रकृतिविकारयोः प्रवृत्तिनिवृत्त्योश्चसामान्यदर्शनमविशेषः, प्रोक्षणानशनाग्निहोत्रत्रिषवणाभ्युक्षणावाहनयाजनयजनयाचनसलिलहुताशनप्रवेशादयः समारम्भाःप्रोच्यन्ते ह्यनुपायाः|
एवमयमधीधृतिस्मृतिरहङ्काराभिनिविष्टः सक्तः ससंशयोऽभिसम्प्लुतबुद्धिरभ्यवपतितोऽन्यथादृष्टिरविशेषग्राहीविमार्गगतिर्निवासवृक्षः सत्त्वशरीरदोषमूलानां सर्वदुःखानां भवति|
एवमहङ्कारादिभिर्दोषैर्भ्राम्यमाणो नातिवर्तते प्रवृत्तिं, सा च मूलमघस्य||१०||

bhagavānuvāca- mōhēcchādvēṣakarmamūlā pravr̥ttiḥ|
tajjā hyahaṅkārasaṅgasaṁśayābhisamplavābhyavapātavipratyayāviśēṣānupāyāstaruṇamivadrumamativipulaśākhāstaravō'bhibhūya puruṣamavatatyaivōttiṣṭhantē; yairabhibhūtō na sattāmativartatē|
tatraivañjātirūpavittavr̥ttabuddhiśīlavidyābhijanavayōvīryaprabhāvasampannō'hamityahaṅkāraḥ,yanmanōvākkāyakarma nāpavargāya sa saṅgaḥ, karmaphalamōkṣapuruṣaprētyabhāvādayaḥ santi vā nētisaṁśayaḥ, sarvāvasthāsvananyō'hamahaṁ sraṣṭā svabhāvasaṁsiddhō'hamahaṁśarīrēndriyabuddhismr̥tiviśēṣarāśiriti grahaṇamabhisamplavaḥ, mamamātr̥pitr̥bhrātr̥dārāpatyabandhumitrabhr̥tyagaṇō gaṇasya cāhamityabhyavapātaḥ,kāryākāryahitāhitaśubhāśubhēṣu viparītābhinivēśō vipratyayaḥ, jñājñayōḥ prakr̥tivikārayōḥpravr̥ttinivr̥ttyōśca sāmānyadarśanamaviśēṣaḥ,prōkṣaṇānaśanāgnihōtratriṣavaṇābhyukṣaṇāvāhanayājanayajanayācanasalilahutāśanapravēśādayaḥsamārambhāḥ prōcyantē hyanupāyāḥ|
ēvamayamadhīdhr̥tismr̥tirahaṅkārābhiniviṣṭaḥ saktaḥsasaṁśayō'bhisamplutabuddhirabhyavapatitō'nyathādr̥ṣṭiraviśēṣagrāhī vimārgagatirnivāsavr̥kṣaḥsattvaśarīradōṣamūlānāṁ sarvaduḥkhānāṁ Bhāvati|
ēvamahaṅkārādibhirdōṣairbhrāmyamāṇō nātivartatē pravr̥ttiṁ, sā ca mūlamaghasya||10||

tajjA hyaha~gkArasa~ggasaMshayAbhisamplavAbhyavapAtavipratyayAvisheShAnupAyAstaruNamiva drumamativipulashAkhAstaravo~abhibhUyapuruShamavatatyaivottiShThante; yairabhibhUto na sattAmativartate|
tatraiva~jjAtirUpavittavRuttabuddhishIlavidyAbhijanavayovIryaprabhAvasampanno~ahamityaha~gkAraH, yanmanovAkkAyakarma nApavargAya sa sa~ggaH,karmaphalamokShapuruShapretyabhAvAdayaH santi vA neti saMshayaH, sarvAvasthAsvananyo~ahamahaM sraShTA svabhAvasaMsiddho~ahamahaMsharIrendriyabuddhismRutivisheSharAshiriti grahaNamabhisamplavaH, mama mAtRupitRubhrAtRudArApatyabandhumitrabhRutyagaNo gaNasyacAhamityabhyavapAtaH, kAryAkAryahitAhitashubhAshubheShu viparItAbhinivesho vipratyayaH, j~jAj~jayoH prakRutivikArayoH pravRuttinivRuttyoshcasAmAnyadarshanamavisheShaH, prokShaNAnashanAgnihotratriShavaNAbhyukShaNAvAhanayAjanayajanayAcanasalilahutAshanapraveshAdayaH samArambhAHprocyante hyanupAyAH|
evamayamadhIdhRutismRutiraha~gkArAbhiniviShTaH saktaH sasaMshayo~abhisamplutabuddhirabhyavapatito~anyathAdRuShTiravisheShagrAhIvimArgagatirnivAsavRukShaH sattvasharIradoShamUlAnAM sarvaduHkhAnAM bhavati|
evamaha~gkArAdibhirdoShairbhrAmyamANo nAtivartate pravRuttiM, sA ca mUlamaghasya||10||
<div style="text-align:justify;">
Lord Atreya replied, “The source of attachment are ignorance, desire, hatred and purposeful action. This in turns give rise to ''ahamkara'' (ego), ''sanga'' (attachment), ''samshaya'' (skepticism), ''abhisamplava'' (mistaken self-identity), ''abhyavapata'' (false sense of ownership), ''vipratyaya'' (sensing opposite of reality), ''avishesha'' (inability to distinguish between consciousness/unconsciousness) and ''anupaya'' (believing in outdated traditions) that engulf an individual just like the very long branches of a big tree smother a sapling. A person overwhelmed by these emotions stays trapped in the affairs of the world.

''Ahamkara'' means egoism. E.g., "I belong to a high descent and possess beauty, wealth, conduct, intelligence, character, modesty, learning, fame, age, power and influence."

''Sanga'', or attachment, includes the mental, vocal, or physical deeds associated with attachment that are not conducive to the attainment of emancipation or salvation.

''Samshaya'', or skepticism regarding the existence of the result of the past action, salvation, soul, life after death, etc.

''Abhisamplava'' is the mistaken perception of identifying one’s atman with one’s body, such as "I am second to none in any situation; I am the creator; I am an accomplished person by nature and I am the aggregate of body, sense organs, intelligence and memory.”

''Abhyavapata'' is the sense of ownership, such as " mother, father, brother, wife, progeny, keen, friend and servants belong to me and I am theirs."

''Vipratyaya'', or considering a desirable act as undesirable, a beneficial thing as harmful and an auspicious act/thing as inauspicious (and vice versa).

''Avishesha'', or the lack of distinction between a consciousness and unconsciousness, nature and its modifications, attachment and detachment.

''Anupaya'', or inefficient religious rituals such as ''prokshana'' (consecration), ''anashana'' (fasting), ''agnihotra'' (oblation to the fire), ''trishavana'' (worship with ''soma'' thrice a day while performing sacrifice), ''abhyukshana'' (wetting), ''aavahana'' (invocation), ''yajana'' (leading or guiding sacrificial rituals), ''yajna'' (sacrificial rituals), ''yachana'' (begging) and entering into water and fire.

Thus, if a person is devoid of intellect, restraint and memory, but is egoistic, skeptic, self-centered, is attached (to objects or actions), and is unable to discern between good or bad, self and the physical body, etc. he is an abode of all miseries. Such feelings are the root cause of vitiation of ''doshas'' relating to the mind and body. Such a person is trapped in the cycle of life and death and cannot attain salvation (from miseries). The ultimate goal of Ayurveda is salvation from all sorts of miseries which depends upon the wellbeing of the ''purusha'' - individually as well as socially. [10]
</div>
==== ''Moksha'' (Salvation) and ways and means of attaining it ====

निवृत्तिरपवर्गः; तत् परं प्रशान्तं तत्तदक्षरं तद्ब्रह्म स मोक्षः||११||

nivr̥ttirapavargaḥ; tat paraṁ praśāntaṁ tattadakṣaraṁ tadbrahma sa mōkṣaḥ||11||

nivRuttirapavargaH; tat paraM prashAntaM tattadakSharaM tadbrahma sa mokShaH||11||

Disinclination/detachment from worldly affairs is ''apavarga'' (salvation). It is the ''para'' (the supreme), ''prashanta'' (the serene), ''akshara'' (the immutable), the ''Brahman'' (the super-consciousness), and the ''moksha'' (emancipation). [11]

तत्र मुमुक्षूणामुदयनानि व्याख्यास्यामः|

तत्र लोकदोषदर्शिनो मुमुक्षोरादित एवाचार्याभिगमनं, तस्योपदेशानुष्ठानम्, अग्नेरेवोपचर्या, धर्मशास्त्रानुगमनं, तदार्थावबोधः,तेनावष्टम्भः, तत्र यथोक्ताः क्रियाः, सतामुपासनम्, असतां परिवर्जनम्, असङ्गतिर्दुर्जनेन, सत्यंसर्वभूतहितमपरुषमनतिकाले परीक्ष्य वचनं, सर्वप्राणिषु चात्मनीवावेक्षा, सर्वासामस्मरणमसङ्कल्पनमप्रार्थनमनभिभाषणं चस्त्रीणां, सर्वपरिग्रहत्यागः, कौपीनं प्रच्छादनार्थं, धातुरागनिवसनं, कन्थासीवनहेतोः सूचीपिप्पलकं, शौचाधानतोर्जलकुण्डिका,दण्डधारणं, भैक्षचर्यार्थं पात्रं, प्राणधारणार्थमेककालमग्राम्यो यथोपपन्नोऽभ्यवहारः, श्रमापनयनार्थंशीर्णशुष्कपर्णतृणास्तरणोपधानं, ध्यानहेतोः कायनिबन्धनं, वनेष्वनिकेतवासः, तन्द्रानिन्द्रालस्यादिकर्मवर्जनं,इन्द्रियार्थेष्वनुरागोपतापनिग्रहः, सुप्तस्थितगतप्रेक्षिता हारविहारप्रत्यङ्गचेष्टादिकेष्वारम्भेषु स्मृतिपूर्विका प्रवृत्तिः,सत्कारस्तुतिगर्हावमानक्षमत्वं, क्षुत्पिपासायासश्रमशीतोष्णवातवर्षासुखदुःखसंस्पर्शसहत्वं,शोकदैन्यमानोद्वेगमदलोभरागेर्ष्याभयक्रोधादिभिरसञ्चलनम्, अहङ्कारादिषूपसर्गसञ्ज्ञा, लोकपुरुषयोःसर्गादिसामान्यावेक्षणं, कार्यकालात्ययभयं, योगारम्भे सततमनिर्वेदः, सत्त्वोत्साहः, अपवर्गाय धीधृतिस्मृतिबलाधानं;नियमनमिन्द्रियाणां चेतसि, चेतस आत्मनि, आत्मनश्च; धातुभेदेन शरीरावयवसङ्ख्यानमभीक्ष्णं, सर्वंकारणवद्दुःखमस्वमनित्यमित्यभ्युपगमः, सर्वप्रवृत्तिष्वघसञ्ज्ञा [६] , सर्वसन्न्यासे सुखमित्यभिनिवेशः; एष मार्गोऽपवर्गाय,अतोऽन्यथा बध्यते; इत्युदयनानि व्याख्यातानि||१२||

tatra mumukṣūṇāmudayanāni vyākhyāsyāmaḥ|

tatra lōkadōṣadarśinō mumukṣōrādita ēvācāryābhigamanaṁ, tasyōpadēśānuṣṭhānam, agnērēvōpacaryā,dharmaśāstrānugamanaṁ, tadārthāvabōdhaḥ, tēnāvaṣṭambhaḥ, tatra yathōktāḥ kriyāḥ, satāmupāsanam,asatāṁ parivarjanam, asaṅgatirdurjanēna, satyaṁ sarvabhūtahitamaparuṣamanatikālē parīkṣya vacanaṁ,sarvaprāṇiṣu cātmanīvāvēkṣā, sarvāsāmasmaraṇamasaṅkalpanamaprārthanamanabhibhāṣaṇaṁ castrīṇāṁ, sarvaparigrahatyāgaḥ, kaupīnaṁ pracchādanārthaṁ, dhāturāganivasanaṁ, kanthāsīvanahētōḥsūcīpippalakaṁ, śaucādhānatōrjalakuṇḍikā, daṇḍadhāraṇaṁ, bhaikṣacaryārthaṁ pātraṁ,prāṇadhāraṇārthamēkakālamagrāmyō yathōpapannō'bhyavahāraḥ, śramāpanayanārthaṁśīrṇaśuṣkaparṇatr̥ṇāstaraṇōpadhānaṁ, dhyānahētōḥ kāyanibandhanaṁ, vanēṣvanikētavāsaḥ,tandrānindrālasyādikarmavarjanaṁ, indriyārthēṣvanurāgōpatāpanigrahaḥ, suptasthitagataprēkṣitāhāravihārapratyaṅgacēṣṭādikēṣvārambhēṣu smr̥tipūrvikā pravr̥ttiḥ, satkārastutigarhāvamānakṣamatvaṁ,kṣutpipāsāyāsaśramaśītōṣṇavātavarṣāsukhaduḥkhasaṁsparśasahatvaṁ,śōkadainyamānōdvēgamadalōbharāgērṣyābhayakrōdhādibhirasañcalanam, ahaṅkārādiṣūpasargasañjñā,lōkapuruṣayōḥ sargādisāmānyāvēkṣaṇaṁ, kāryakālātyayabhayaṁ, yōgārambhē satatamanirvēdaḥ,sattvōtsāhaḥ, apavargāya dhīdhr̥tismr̥tibalādhānaṁ; niyamanamindriyāṇāṁ cētasi, cētasa ātmani,ātmanaśca; dhātubhēdēna śarīrāvayavasaṅkhyānamabhīkṣṇaṁ, sarvaṁkāraṇavadduḥkhamasvamanityamityabhyupagamaḥ, sarvapravr̥ttiṣvaghasañjñā [6] , sarvasannyāsēsukhamityabhinivēśaḥ; ēṣa mārgō'pavargāya, atō'nyathā badhyatē; ityudayanāni vyākhyātāni||12||

tatra lokadoShadarshino mumukShorAdita evAcAryAbhigamanaM, tasyopadeshAnuShThAnam, agnerevopacaryA, dharmashAstrAnugamanaM, tadArthAvabodhaH,tenAvaShTambhaH, tatra yathoktAH kriyAH, satAmupAsanam, asatAM parivarjanam, asa~ggatirdurjanena, satyaM sarvabhUtahitamaparuShamanatikAle parIkShyavacanaM, sarvaprANiShu cAtmanIvAvekShA, sarvAsAmasmaraNamasa~gkalpanamaprArthanamanabhibhAShaNaM ca strINAM, sarvaparigrahatyAgaH, kaupInaMpracchAdanArthaM, dhAturAganivasanaM, kanthAsIvanahetoH sUcIpippalakaM, shaucAdhAnatorjalakuNDikA, daNDadhAraNaM, bhaikShacaryArthaM pAtraM,prANadhAraNArthamekakAlamagrAmyo yathopapanno~abhyavahAraH, shramApanayanArthaM shIrNashuShkaparNatRuNAstaraNopadhAnaM, dhyAnahetoHkAyanibandhanaM, vaneShvaniketavAsaH, tandrAnindrAlasyAdikarmavarjanaM, indriyArtheShvanurAgopatApanigrahaH, suptasthitagataprekShitAhAravihArapratya~ggaceShTAdikeShvArambheShu smRutipUrvikA pravRuttiH, satkArastutigarhAvamAnakShamatvaM,kShutpipAsAyAsashramashItoShNavAtavarShAsukhaduHkhasaMsparshasahatvaM, shokadainyamAnodvegamadalobharAgerShyAbhayakrodhAdibhirasa~jcalanam,aha~gkArAdiShUpasargasa~jj~jA, lokapuruShayoH sargAdisAmAnyAvekShaNaM, kAryakAlAtyayabhayaM, yogArambhe satatamanirvedaH, sattvotsAhaH,apavargAya dhIdhRutismRutibalAdhAnaM; niyamanamindriyANAM cetasi, cetasa Atmani, Atmanashca; dhAtubhedena sharIrAvayavasa~gkhyAnamabhIkShNaM,sarvaM kAraNavadduHkhamasvamanityamityabhyupagamaH, sarvapravRuttiShvaghasa~jj~jA [6] , sarvasannyAse sukhamityabhiniveshaH; eShamArgo~apavargAya, ato~anyathA badhyate; ityudayanAni vyAkhyAtAni||12||

We shall now describe the path and means for attaining emancipation. One who sees defects of the world (and therefore is disenchanted with it) and is desirous of attaining salvation should do the following:
#Submit to a teacher/ preceptor (who can impart instructions for attaining salvation)
#Put those instructions to practice
#Tend to exclusive service to the ceremonial fire;
#Study the sacred religious scriptures;
#Understand the meaning of such scriptures;
#Imbibe the teachings in those scriptures;
#Mould one’s conduct as prescribed therein;
#Seek the company of like-minded individuals and saints;
#Eschew the company of wicked ;
#Speak statements that are true, useful for all creatures and gentle; such statements should be made after pro¬per examination at appropriate time;
#View all creatures as if they are like him;
#Lead life as a celibate, avoiding all contacts - including remembering, thinking, questing and discourse with the opposite sex;
#Renounce all worldly acquisitions;
#Retain only the following to sustain one’s life as a seeker of salvation:
##Kaupina ( loin-cloth );
##Ochre/Saffron coloured dress;
##A needle-case for mending the clothing;
##A water pot for cleansing;
##A medicant’s staff;
##A bowl to collect alms;
##Meal only once-a-day, consisting of wild grains if possible, to sustain one’s life;
##In case of fatigue, shall take rest on bed made of dry leaves, grass, etc.;
##Kayanibandhana (wooden resting plank/arm rest) for aid in meditation;
##Staying lonely in the forest;
##Avoid drowsiness, lassitude, sleep, etc.;
##Avoiding attachment or hatred towards sensory objects (animate or inanimate);
##Introspect (thinking of the nature of one’s Self) while sleeping, seeing, eating, moving one’s limbs, etc.;
##Maintain equanimity and serenity when being praised or insulted, honoured or criticised;
##Tolerate hunger, thirst, physical stress, cold, heat, wind, rains, happiness, misery, and sensory contacts;
##Be unaffected by sorrow, dejection, ego, vanity, greed, attachment, envy, fear, anger, etc.;
##Regard ego as the root cause of all sufferings;
##Observe the similarity between manifestation, etc. of man and the universe
##Be afraid of procrastinations in performing these duties to attain salvation ;
##Never lose one’s inclination to performing yogic practices;
##Be in enthusiastic frame of mind;
##Intellect, restraint and memory should be empowered to attain emancipation;
##Restrain sense organs by means of the mind, the mind by the soul and the soul by itself;
##Constantly (try to know) the body constituents by knowing basic elements and think it is just a matter
##Realise that all worldly objects are painful, transient and not eternal.
##Regard all activities as cause of evil and renunciation of all things is true happiness

This is the path to attaining salvation else one finds himself in bondage. [11-12]

भवन्ति चात्र-

एतैरविमलं सत्त्वं शुद्ध्युपायैर्विशुध्यति|
मृज्यमान इवादर्शस्तैलचेलकचादिभिः||१३||

Bhāvanti cātra-

ētairavimalaṁ sattvaṁ śuddhyupāyairviśudhyati|
mr̥jyamāna ivādarśastailacēlakacādibhiḥ||13||

bhavanti cAtra-

etairavimalaM sattvaM shuddhyupAyairvishudhyati|
mRujyamAna ivAdarshastailacelakacAdibhiH||13||

Thus, it is said:
By these purifying factors, the vitiated mind gets purified like a mirror is cleansed with the help of brush and cleansing solutions , etc. [13]

ग्रहाम्बुदरजोधूमनीहारैरसमावृतम्|
यथाऽर्कमण्डलं भाति भाति सत्त्वं तथाऽमलम्||१४||

grahāmbudarajōdhūmanīhārairasamāvr̥tam|
yathā'rkamaṇḍalaṁ bhāti bhāti sattvaṁ tathā'malam||14||

grahAmbudarajodhUmanIhArairasamAvRutam|
yathA~arkamaNDalaM bhAti bhAti sattvaM tathA~amalam||14||

Thus, the purified mind shines like the sun’s orb that has emerged out of an eclipse, clouds, dust, smoke and fog. [14]

ज्वलत्यात्मनि संरुद्धं तत् सत्त्वं संवृतायने|
शुद्धः स्थिरः प्रसन्नार्चिर्दीपो दीपाशये यथा||१५||

jvalatyātmani saṁruddhaṁ tat sattvaṁ saṁvr̥tāyanē|
śuddhaḥ sthiraḥ prasannārcirdīpō dīpāśayē yathā||15||

jvalatyAtmani saMruddhaM tat sattvaM saMvRutAyane|
shuddhaH sthiraH prasannArcirdIpo dIpAshaye yathA||15||

The mind, focused on the soul with its movement obscured, pure and stable, shines as the lamp shines with steady and luminous bright flame in a lamp case. [15]

शुद्धसत्त्वस्य या शुद्धा सत्या बुद्धिः प्रवर्तते|
यया भिनत्त्यतिबलं महामोहमयं तमः||१६||

śuddhasattvasya yā śuddhā satyā buddhiḥ pravartatē|
yayā bhinattyatibalaṁ mahāmōhamayaṁ tamaḥ||16||

shuddhasattvasya yA shuddhA satyA buddhiH pravartate|
yayA bhinattyatibalaM mahAmohamayaM tamaH||16||

The pure and true wisdom that originates from a pure mind dispels the excessively thick darkness of illusion caused by ignorance. [16]

सर्वभावस्वभावज्ञो यया भवति निःस्पृहः|
योगं यया साधयते साङ्ख्यः सम्पद्यते यया||१७||

sarvabhāvasvabhāvajñō yayā Bhāvati niḥspr̥haḥ|
yōgaṁ yayā sādhayatē sāṅkhyaḥ sampadyatē yayā||17||

sarvabhAvasvabhAvaj~jo yayA bhavati niHspRuhaH|
yogaM yayA sAdhayate sA~gkhyaH sampadyate yayA||17||

After this, one realizes the true nature of all beings which brings about detachment to things i.e., one becomes desire less leading to attainment of yogic power and accomplishment of ''samkhya'' (knowledge of all categories). [17]

यया नोपैत्यहङ्कारं नोपास्ते कारणं यया|
यया नालम्बते किञ्चित् सर्वं सन्न्यस्यते यया||१८||

yayā nōpaityahaṅkāraṁ nōpāstē kāraṇaṁ yayā|
yayā nālambatē kiñcit sarvaṁ sannyasyatē yayā||18||

yayA nopaityaha~gkAraM nopAste kAraNaM yayA|
yayA nAlambate ki~jcit sarvaM sannyasyate yayA||18||

These realizations make the individual wise freeing him from ego, leading to freedom from vanity and detachment from the causes of misery. Such a person does not hold anything but renounces everything. [18]

याति ब्रह्म यया नित्यमजरं शान्तमव्ययम् |
विद्या सिद्धिर्मतिर्मेधा प्रज्ञा ज्ञानं च सा मता||१९||

yāti brahma yayā nityamajaraṁ śāntamavyayam |
vidyā siddhirmatirmēdhā prajñā jñānaṁ ca sā matā||19||

yAti brahma yayA nityamajaraM shAntamavyayam [13] |
vidyA siddhirmatirmedhA praj~jA j~jAnaM ca sA matA||19||

The ''Brahman'', the Eternal, Immutable, Tranquil and Indestructible, is, thus, attained and is the ultimate wisdom, also known as ''vidya'' (learning), ''siddhi'' (accomplishment), ''mati'' (wisdom), ''medha'' (power of retention), ''prajna'' (intellect) and ''jnana'' (knowledge). [19]

==== Identification of the ''purusha'' (man/individual) with the ''loka'' (universe) -the effect ====

लोके विततमात्मानं लोकं चात्मनि पश्यतः|
परावरदृशः शान्तिर्ज्ञानमूला न नश्यति||२०||

lōkē vitatamātmānaṁ lōkaṁ cātmani paśyataḥ|
parāvaradr̥śaḥ śāntirjñānamūlā na naśyati||20||

loke vitatamAtmAnaM lokaM cAtmani pashyataH|
parAvaradRushaH shAntirj~jAnamUlA na nashyati||20||

If one perceives himself as extended across entire universe and vice versa (i.e., identifies his true Self with the ''Brahman''), he is said to possess transcendental and worldly vision and his serenity of mind based on this wisdom never fades away. [20]

पश्यतः सर्वभावान् हि सर्वावस्थासु सर्वदा|
ब्रह्मभूतस्य संयोगो न शुद्धस्योपपद्यते||२१||

paśyataḥ sarvabhāvān hi sarvāvasthāsu sarvadā|
brahmabhūtasya saṁyōgō na śuddhasyōpapadyatē||21||

pashyataH sarvabhAvAn hi sarvAvasthAsu sarvadA|
brahmabhUtasya saMyogo na shuddhasyopapadyate||21||

When a person realizes the presence of everything in all situations, he becomes one with ''Brahman'', the pure. He no longer has any connection with the forces of attachment, which are the cause of misery. [21]

==== Liberation from bondage ====

नात्मनः करणाभावाल्लिङ्गमप्युपलभ्यते|
स सर्वकरणायोगान्मुक्त इत्यभिधीयते||२२||

nātmanaḥ karaṇābhāvālliṅgamapyupalabhyatē|
sa sarvakaraṇāyōgānmukta ityabhidhīyatē||22||

nAtmanaH karaNAbhAvAlli~ggamapyupalabhyate|
sa sarvakaraNAyogAnmukta ityabhidhIyate||22||

At this stage, even the signs of Self cannot be found because once there is detachment from all sensory organs, one is said to be emancipated. [22]

==== Synonyms of ''Shanti'' (Liberation) ====

विपापं विरजः शान्तं परमक्षरमव्ययम्|
अमृतं ब्रह्म निर्वाणं पर्यायैः शान्तिरुच्यते||२३||

vipāpaṁ virajaḥ śāntaṁ paramakṣaramavyayam|
amr̥taṁ brahma nirvāṇaṁ paryāyaiḥ śāntirucyatē||23||

vipApaM virajaH shAntaM paramakSharamavyayam|
amRutaM brahma nirvANaM paryAyaiH shAntirucyate||23||

''Shanti'' or ''Moksha'' is synonymous with the following –
*''Vipapa'' (free from sins),
*''Viraja'' (free from attachments),
*''Shanta'' (serene),
*''Para'' (absolute),
*''Akshara'' (indestructible),
*''Avyaya'' (immutable)
*''Amritam'' (immortal),
*''Brahman'' (supreme consciousness), and
*''Nirvana'' (the state at extinction of all miseries). [23]

एतत्तत् सौम्य! विज्ञानं यज्ज्ञात्वा मुक्तसंशयाः|
मुनयः प्रशमं जग्मुर्वीतमोहरजःस्पृहाः||२४||

ētattat saumya! vijñānaṁ yajjñātvā muktasaṁśayāḥ|
munayaḥ praśamaṁ jagmurvītamōharajaḥspr̥hāḥ||24||

etattat saumya! vij~jAnaM yajj~jAtvA muktasaMshayAH|
munayaH prashamaM jagmurvItamoharajaHspRuhAH||24||

O Gentle One! This is the knowledge that, when acquired by the sages, frees them from all skepticism while liberating them from ''moha'' (endearment), ''rajas'' (ignorance/ passion), leading them to the state of ''prashama'' (absolute tranquility) i.e., salvation. [24]

==== Summary ====

तत्र श्लोकौ-

सप्रयोजनमुद्दिष्टं लोकस्य पुरुषस्य च|
सामान्यं मूलमुत्पत्तौ निवृत्तौ मार्ग एव च||२५||

शुद्धसत्त्वसमाधानं सत्या बुद्धिश्च नैष्ठिकी|
विचये पुरुषस्योक्ता निष्ठा च परमर्षिणा||२६||

tatra ślōkau-

saprayōjanamuddiṣṭaṁ lōkasya puruṣasya ca|
sāmānyaṁ mūlamutpattau nivr̥ttau mārga ēva ca||25||

śuddhasattvasamādhānaṁ satyā buddhiśca naiṣṭhikī|
vicayē puruṣasyōktā niṣṭhā ca paramarṣiṇā||26||

tatra shlokau-

saprayojanamuddiShTaM lokasya puruShasya ca|
sAmAnyaM mUlamutpattau nivRuttau mArga eva ca||25||

shuddhasattvasamAdhAnaM satyA buddhishca naiShThikI|
vicaye puruShasyoktA niShThA ca paramarShiNA||26||

To summarize, in this chapter [[Purusha Vichaya Sharira]] (The analytical study/search of ''purusha'') the sage has explained:
#The similarities between the universe and the individual along with the purpose of such knowledge, and
#The cause of ''utapatti'' (soul’s bondage) and the means for release of the soul.
#Concentration of pure mind and true knowledge leading to final goal (salvation)
#The concept of ''nishtha'' (salvation)

All these concepts have been elaborated by the great sage in this chapter [25-26]

=== ''Tattva Vimarsha'' ===

*''Purusha'' (microcosm) is exactly similar to the ''loka'' (macrocosm). Whatever specific embodiments are present in the ''loka'', the same are in the ''purusha''. Similarly, whatever is in ''purusha'', is also in the ''loka''.
*The ''purusha'' and ''loka'', both are aggregate (collective combination) of six constituents viz. ''prithvi, apa, tejas, vayu, akasha'' and un-manifested ''Brahman'' (consciousness).
*Seeing the universe in Self and vice-versa, gives rise to true knowledge. With such (true) knowledge, one realizes that the ''atman'', or the Self, alone is responsible for bliss and sorrow and no one else.
*The realization of true knowledge leads to salvation.
*The ''purusha'' (man) and ''loka'' (universe) both have cause of manifestation, germination or birth, growth, advent of miseries and cessation.
*The root cause of universe and all miseries is ''pravritti'' (action/attachment). ''Nivritti'' (inaction/detachment from worldly affairs) leads to destruction (of all miseries). Attachment leads to miseries and detachment to bliss. Realization of this fact is truth (pure knowledge).
*The ignorance, hatred, desire are sources of all miseries and lead to attachment to worldly affairs.
*''Ahamkara'' (ego), ''sanga'' (attachment), ''samshaya'' (skepticism), ''abhisamplava'' (mistaken self-identity), ''abhyavapata'' (false sense of ownership), ''vipratyaya'' (sensing opposite of reality), ''avishesha'' (inability to distinguish between consciousness/unconsciousness) and ''anupaya'' (believing in outdated traditions) are self-destructive factors arouse due to above said attachment. These are the origins of all evils in the world.
*Disinclination/detachment from worldly affairs is ''apavarga'' (salvation). It is the ''para'' (the supreme), ''prashanta'' (the serene), ''akshara'' (the immutable), the ''Brahman'' (the super-consciousness), and the ''moksha'' (emancipation).
*In order to attain emancipation, one shall follow ''sadvritta'' i.e. instructions guided by Ayurveda. This will lead oneself to attain serenity, tranquility, freedom from all miseries.
*The pure and true wisdom that originates from a pure mind dispels the excessively thick darkness of illusion caused by ignorance.
*The supreme human being is the ''Brahman'', the Eternal, Immutable, Tranquil and Indestructible. It possesses the ultimate wisdom, also known as ''vidya'' (learning), ''siddhi'' (accomplishment), ''mati'' (wisdom), ''medha'' (power of retention), ''pranja'' (intellect) and ''jyana'' (knowledge).
*''Shanti'' or ''Moksha'' is a state which is ''vipapa'' (free from sins), ''viraja'' (free from attachments), ''shanta'' (serene), ''para'' (absolute), ''akshara'' (indestructible), ''avyaya'' (immutable), ''amritam'' (immortal), ''Brahman'' (supreme consciousness), and ''nirvana'' (the state at extinction of all miseries).

=== ''Vidhi Vimarsha'' ===

In Vedic philosophies, the ''atman'' (sole) transmigrates from one body to the other in the process of birth and death. The happiness and sorrow are cumulative result of self deeds in lifetime.

==== ''Eishana'' and ''purushartha'' ====

There are three primary instincts, or ''eishanas'', of the ''purusha'' – ''praneishana'' (longevity of life), ''dhanaeishana'' (desire for wealth), and ''paralokaeishana'' (liberation), etc. A person who possesses unimpaired intelligence, ability to discern, enthusiasm and desire to secure his wellbeing – both in this world and in the world after death – would have these three ''eishanas''. The primary objective is to afford ''arogya'' (health), which is essential to attain the four ''purusharthas'' (i.e., ''dharma'' (righteous life), ''artha'' (wealth), ''kama'' (pleasure), and ''moksha'' (salvation)).

Only when the person accepts the fact that he is one with the universe, that he is made up of the same six ''dhatus'' that makes the universe – the five ''mahabhuta'', and Consciousness-, and that egoism, vanity, selfishness, skepticism, etc. are only the manifestations of a mind that wrongly identifies the physical body with the Self, causing the person to suffer from miseries and trapping him into the perennial cycle of birth and death.

==== ''Lokapurusha Samya'' ====

===== Applied aspects of the concept of commonness of the ''purusha'' and the universe in the study of health and diseases =====

The whole premise is the maintaining a state of health that would help an individual attain salvation. To achieve such a state of health requires harmony (''samya'') between the person (''purusha'') and the environment around him, or rather, the entire universe (''loka''). Health cannot be defined only as the absence of disease within the human body, but rather, a state of consciousness where the person identifies himself with the universe, and gets detached from worldly emotions of bliss and grief (while still being able to discern the good and the bad, and avoiding the company of those who cling onto worldly feelings of attachment, ego, vanity, greed, etc.).

===== Connection of consciousness between man and the universe =====

The neurologist Dr. David Wiebers in his book “Theory of reality” coined the terms ‘C’ unit as the unit of consciousness in human body and ‘C’ field as the cosmic consciousness. The C unit is always connected with C field to carry out certain functions. The person is a unit of cosmos. Ayurveda narrates Human beings are a microcosm of the planet and exhibit holographic phenomenon. The Self-conscious i.e. ‘C’ unit is a unitary part of ‘C’ field (consciousness) in the cosmos. This C unit is controlling and regulating intellect, that controls mind; and the mind controls sense organs which lead the body as the horses lead a chariot. The interaction of C field with C unit for fetching positive energy from cosmos is of utmost importance. Empowerment of the self-conscious for communication with intellect in brain and mind seated at heart is important mechanism for mental health in holistic view. Therefore promotion of positive mental health shall be focused with a holistic view of all these factors thinking beyond reductionist’s approaches of neurotransmitter, endocrinal and genetic biological theories. Hologram for mental health, the constituents of human being that make the humans real “Humans” are considered vital for complete health.

===== ''Panchamahabhuta'': the building blocks of the ''purusha'' and the ''loka'' =====

The ''purusha'' is a microcosm, made up of the same dhatus that constitute the universe: the ''panchamahabhuta'' and consciousness (''atman'', or the Self, within the ''purusha'', and ''Brahman'', or the super consciousness, within the universe) is central to Vedic philosophy in general and Ayurveda in particular. Bodily components – ''doshas, dhatus'', and ''mala'' – are also made up of ''mahabhutas'', and so are ''ahara'' (food), and ''aushadha'' (medicine). A disequilibrium between the environment and the person could therefore vitiate the constitution of the person, the food he eats, and the efficacy of the medication he takes, making him physically or mentally diseased. A society made up of diseased individuals would only make the environment more diseased. Thus, Ayurveda is not just about the health of an individual, but also the health of the planet.

==== ''Panchabhautika chikitsa'' ====

The specific actions and effects of ''mahabhuta'' in development of various body constituents, organs, systems are described in previous chapter ([[Sharira Sthana]] chapter 4/12). The knowledge of similarity between man and universe can be applied for diagnosis of ailments and their treatments. The ''panchabhautika chikitsa'' system focuses on this principle. E.g. if certain body constituents originated from ''prithvi mahabhuta'' (bones) are disordered, then it can be treated with ''parthiva'' medicines available in the external world ( viz. shells, minerals).

==== Health and Disease: Causes ====

The principle causes of disease are:
#''Kala parinama'',
#''Prajnaparadha'', and
#''Asatmyaindriyartha Samayoga''. ([[Sutra Sthana]], 1/54 and [[Sharira Sthana]], 1/98).

In this context, it is important to note that ''kala'' (time), ''buddhi'' (intellect), and ''indriyartha'' (sense objects) are the three basic factors that govern an individual’s state of health and disease. ''Samayoga'', or favorable conditions, are conducive to health while ''vishamayoga'' (''ayoga, atiyoga'', and ''mithyayoga'') of ''kala, buddhi'', and ''indriyartha'' leads to disease. In the state of health, the basic components of the body – ''doshas, dhatus,'' and ''mala'' – are in a state of equilibrium, implied by the term ''samayoga''.

===== ''Desha'' (habitat or local environment), and its role in health and disease =====

The role of ''desha'' is significant in matters of health and disease. It denotes the habitat of an individual and is also considered among the ''karana dravyas'' in [[Deerghanjiviteeya Adhyaya]]. ''Desha'' influences the individual’s diet, etiological factors responsible for various diseases, availability of medicinal plants. In fact, extending the man-environment, relationship, examination of one’s locale to be an important factor in the diagnosis of a disease. ''Desha'' is classified into three types: ''anupa desha'' (marshy land), ''jangala desha'' (forested or wooded land), and ''sadharana desha'' (mix of marshy and forested land). ([[Kalpa Sthana]], 1/6). The concept of ''oka satmya'' (adjustment or adapting to a particular diet or behavior due to habitual use or practice) is also closely related to ''desha'' and season. A diet or medication suitable to a particular region or time may be contraindicated in another.

===== ''Kala'' (temporal factors), and its role in health and disease =====

''Kala'' plays a very important role, and is a universal factor that affects the ''purusha'' and the ''loka''. Vedic texts talk of various time spans, quite similar to those in modern sciences – describing the life-spans of the universe and various celestial objects, as well as that of the ''purusha''. It is also a ''karana dravya'', ([[Sutra Sthana]], 1/48). ''Kala'' does not only mean time, but also seasons (''ritu''), and from that standpoint, plays an important role in determining causative factors of diseases or prescribing therapies for maintaining health.([[Sutra Sthana]] , 11/23, [[Vimana Sthana]], 1/21/6, [[Sutra Sthana]] 6/4).

''Kala'' also influences ''doshika'' rhythm. External environmental changes brought about by changes in the season influence the pattern of ''doshika'' changes in the body. These have been described to be of three stages: ''chaya'' (or ''sanchaya'', accumulation), ''prakopa'' (vitiation, aggravation), and ''prashamana'' (remission to normalcy) ([[Sutra Sthana]], 17/114). These stages generally occur in a natural manner through normal seasonal variations, and therefore care and adjustment in diet and lifestyle to account for these changes is specially advised.

==== Influence of ''purusha'' on ''loka'': ''janapadodhwamsa'' ====

While the ''purusha'' is influenced by his environment, the ''loka'' is also influenced by ''purusha'' by his virtuous as well as destructive activities. The concept of ''janapadodhwamsa'' talks of natural as well as man-made calamities and epidemics ([[Sutra Sthana]], 1/41, [[Vimana Sthana]], 3/9/11). In their natural elements, air, water, land, and seasons are indispensable in this order. This indicates that ''desha'' and ''kala/ritu'' are the most important factors from the standpoint of maintenance of health or for the occurrence of diseases. Vitiation of these four factors, besides the actions of one’s past life, has a direct bearing on the state of physical and mental health of individuals in particular and societies in general.

The path to achieve a status of complete human being and salvation is described in this chapter.

In conclusion, the causes of somatic and mental health conditions are emphasized, and invariably all point to imbalances in the equilibrium between man and his environment.

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Apasmara Nidana

2019-03-06T03:52:14Z

Pallavmishra:

{{Infobox
|title = Apasmara Nidana
|label1 = Section/Chapter
|data1 = [[Nidana Sthana]] Chapter 8
|label2 = Preceding Chapter
|data2 = [[Unmada Nidana]]

|label3 = Succeeding Chapter
|data3 = None
|label4 = Other Sections
|data4 = [[Sutra Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

==[[Nidana Sthana]] Chapter 8, Apasmara Nidana (Chapter on diagnosis of seizure disorders)==

=== Abstract ===
<div style="text-align:justify;">
The eighth chapter of [[Nidana Sthana]] describes causative factors, predisposing conditions, pathogenesis, signs, types, and prognosis of ''apasmara''. The clinical presentation of this disease simulates the seizure disorders described in modern medical literature. ''Apasmara'' is a common neuropsychiatric disorder characterized by intermittent loss of memory, abnormal movements and blackouts. This chapter explores the basic principles of psychiatric disorders involving memory, mind, consciousness and intellect. These disorders are marked by major pathological obstacles in perception, impaired intellectual functioning, orientation, co-ordination and consciousness. Their management includes avoidance of etiological factors as well as pharmacological and non-pharmacological treatment (including psychological and spiritual therapies). The basic principles described in the present chapter can be helpful in preventing and managing neuro-psychiatric disorders like ''apasmara'' in a better way. This chapter also deals with some important aspects of diagnosis. It explains how one disease can trigger another disease i.e. ''Nidanarthakara roga'', leading to the presence of two or more diseases at the same time. This chapter lays down some principles of diagnosis to manage such conditions as well.

'''Keywords''': ''Apasmara'', transient loss of memory, seizure disorders, epilepsy, mind-heart connection, mind-brain connection.
</div>
=== Introduction ===
<div style="text-align:justify;">
In this important section dealing with the diagnoses of some common disorders of the body and the mind, the [[Nidana Sthana]], this eighth and concluding chapter deals with apasmara, a disorder afflicting the mind and sharing similar etiological and pathological factors as ''unmada'' (the subject of the preceding chapter). ''Apasmara'' (Sanskrit for ''apa'' (to lose) or leave, and ''smara'' (memory)) is a psychosomatic disorder involving memory, intellect and mind and present with cardinal features such as transient loss of memory, abnormal movements of body and blackouts. ''Apasmara'' is counted, in Ayurvedic texts, among the eight ''mahagada'' (most dreadful diseases). The extent of knowledge on the disease indicates that it must have been quite prevalent in antiquity. Ayurvedic scholars have observed that ''apasmara'' simulates epilepsy in its features<ref> Venkataraghvan S., Rajagopalan V, Srinivasan K. Study of doshik involvement in Apasmara (Epilepsy) and its utility. Ancient science of life, Vol.No.VI[3],1987.138-47 </ref> <ref> Murthy ARV, Singh RH.A Critical study on the Ayurvedic concept of the psychopathological basis of Apasmara. Journal of NIMA XXXII [6] 1990.7-11 </ref>. Epilepsy is a common neuropsychiatric condition involving mainly the brain, nervous system and the psyche. However, Ayurveda emphasizes heart, the abode of consciousness and mind, as its core pathological site while covering diseases of memory, intellect as well as psyche under the umbrella of ''apasmara''.

Causative factors of ''apasmara'' can be categorized under dietary, lifestyle, psychological and iatrogenic factors. Vitiated ''doshas'' get through the vessels of the heart and when exposed to predisposing psychological factors like excess worry, grief, anger, and fear, move upwards from the heart, the abode of all consciousness, to the brain, afflicting the senses while altering memory. This eventually leads to ''apasmara''. The etiology of the disease and specific features of the dominant ''doshas'' involved, and ''nidanarthakara roga'' (one disease causing other disease) and its importance in diagnosis and treatment have been described in detail in this chapter, with some important aspects of diagnosis addressed. In some cases, both diseases (the causative and the secondary ones) coexist while in other cases, the causative disease disappears and the new disease remains present. Thus, this chapter, while focusing on ''apasmara'', also talks of complications that lead to secondary conditions and their treatment.
</div>

===Sanskrit Text, Transliteration and English Translation===

अथातोऽपस्मारनिदानं व्याख्यास्यामः ||१||

इति ह स्माह भगवानात्रेयः ||२||

athātō'pasmāranidānaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto~apasmAranidAnaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

“Now we shall discuss the diagnosis of ''Apasmara''”, said Lord Atreya [1-2]

==== Four types of ''apasmara'' ====

इह खलु चत्वारोऽपस्मारा भवन्ति वातपित्तकफसन्निपातनिमित्ताः ||३||

iha khalu catvārō'pasmārā bhavanti vātapittakaphasannipātanimittāḥ||3||

iha khalu catvAro~apasmArA bhavanti vAtapittakaphasannipAtanimittAH||3||

There are four types of ''apasmara'' caused by ''vata, pitta, kapha'' and ''sannipatika'' (combination of all the three ''doshas'').[3]

==== Persons prone to ''apasmara'' ====

त एवंविधानां प्राणभृतां क्षिप्रमभिनिर्वर्तन्ते; तद्यथा- रजस्तमोभ्यामुपहतचेतसामुद्भ्रान्तविषमबहुदोषाणां समलविकृतोपहितान्यशुचीन्यभ्यवहारजातानि वैषम्ययुक्तेनोपयोगविधिनोपयुञ्जानानां
तन्त्रप्रयोगमपि च विषममाचरतामन्याश्च शरीरचेष्टा
विषमाः समाचरतामत्युपक्षयाद्वा दोषाः प्रकुपिता: रजस्तमोभ्यामुपहतचेतसामन्तरात्मनः श्रेष्ठतममायतनं हृदयमुपसृत्योपरि तिष्ठन्ते,
तथेन्द्रियायतनानि च | तत्र चावस्थिताः सन्तो यदा हृदयमिन्द्रियायतनानि चेरिताः कामक्रोधभयलोभमोहहर्षशोकचिन्तोद्वेगादिभिः सहसाऽभिपूरयन्ति, तदा जन्तुरपस्मरति ||४||

ta ēvaṁvidhānāṁ prāṇabhr̥tāṁ kṣipramabhinirvartantē; tadyathā- Rajas tamōbhyāmupahatacētasāmudbhrāntaviṣamabahudōṣāṇāṁ samalavikr̥tōpahitānyaśucīnyabhyavahārajātāni vaiṣamyayuktēnōpayōgavidhinōpayuñjānānāṁ tantraprayōgamapi
ca viṣamamācaratāmanyāśca śarīracēṣṭā viṣamāḥ samācaratāmatyupakṣayādvā dōṣāḥ prakupitā Rajas tamōbhyāmupahatacētasāmantarātmanaḥ śrēṣṭhatamamāyatanaṁ hr̥dayamupasr̥tyōpari tiṣṭhantē, tathēndriyāyatanāni ca| tatra cāvasthitāḥ santō yadā
hr̥dayamindriyāyatanāni cēritāḥ kāmakrōdhabhayalōbhamōhaharṣaśōkacintōdvēgādibhiḥ
sahasā'bhipūrayanti, tadā jantur Apasmarati||4||

ta evaMvidhAnAM prANabhRutAM kShipramabhinirvartante; tadyathA-rajastamobhyAmupahatacetasAmudbhrAntaviShamabahudoShANAMsamalavikRutopahitAnyashucInyabhyavahArajAtAni vaiShamyayuktenopayogavidhinopayu~jjAnAnAMtantraprayogamapi
ca viShamamAcaratAmanyAshca sharIraceShTA viShamAHsamAcaratAmatyupakShayAdvA doShAH prakupitA rajastamobhyAmupahatacetasAmantarAtmanaHshreShThatamamAyatanaM hRudayamupasRutyopari tiShThante, tathendriyAyatanAni ca|
tatra cAvasthitAH santo yadA hRudayamindriyAyatanAni ceritAHkAmakrodhabhayalobhamohaharShashokacintodvegAdibhiH sahasA~abhipUrayanti, tadAjanturapasmarati||4||

Individuals get quickly afflicted with ''apasmara'' if:
<div style="text-align:justify;">
*the mind of an individual is afflicted by ''rajas'' (mental ''dosha'' associated with hyperactivity) and ''tamas'' (mental ''dosha'' associated with hypoactivity);
*the three ''sharira doshas'' are imbalanced and excessively aggravated;
*an individual takes food that is impure, untimely, decomposed, possessing antagonistic properties, or touched/cooked by unclean hands
*an individual follows improper methods (of diet and lifestyle, conduct described in Ayurveda) and neglects prescribed rules;
*an individual observes improper techniques (of treatment) and resorts to unhealthy regimen and behavior
*an individual practices improper bodily movements and follows improper postures
*an individual suffers from excessive degeneration or debility.

In the situations mentioned above, the ''doshas'' get aggravated and affect individuals whose minds are already afflicted by ''rajas'' and ''tamas''. The ''doshas'' (so aggravated) pervade the heart which is, as mentioned earlier, the abode of consciousness, as well as the sense organs. While there, the ''doshas'' get further aggravated by emotions such as passion, anger, fear, greed, attachment, excitement, grief, anxiety, perturbation etc., consequently spreading throughout the heart and the sense organs. The individual is then said to have been afflicted with ''apasmara''. [4]
</div>
==== Characteristic features of ''apasmara'' ====

अपस्मारं पुनः स्मृतिबुद्धिसत्त्वसम्प्लवाद्बीभत्सचेष्टमावस्थिकं तमः प्रवेशमाचक्षते ||५||

apasmāraṁ punaḥ smr̥ti buddhi sattva samplavādbībhatsacēṣṭamāvasthikaṁ tamaḥ pravēśamācakṣatē||5||

apasmAraM punaH smRutibuddhisattvasamplavAdbIbhatsaceShTamAvasthikaM tamaHpraveshamAcakShate||5||

''Apasmara'' is characterized by occasional loss of consciousness associated with aberrant activities (like vomiting of froth and abnormal postures of the body) and behavior, due to perversion of memory, intellect and other psychic faculties. [5]

तस्येमानि पूर्वरूपाणि भवन्ति; तद्यथा- भ्रूव्युदासः सततमक्ष्णोर्वैकृतमशब्दश्रवणंलालासिङ्घाणप्रस्रवणमनन्नाभिलषणमरोचकाविपाकौ हृदयग्रहः कुक्षेराटोपो दौर्बल्यमस्थिभेदोऽङ्गमर्दो मोहस्तमसो दर्शनंमूर्च्छा भ्रमश्चाभीक्ष्णं स्वप्ने च मदनर्तनव्यधनव्यथनवेपनपतनादीनीति ||६||

ततोऽनन्तरमपस्माराभिनिर्वृत्तिरेव ||७||

tasyēmāni pūrvarūpāṇi bhavanti; tadyathā- bhrūvyudāsaḥ satatamakṣṇōrvaikr̥tamaśabdaśravaṇaṁ
lālāsiṅghāṇaprasravaṇamanannābhilaṣaṇamarōcakāvipākau hr̥dayagrahaḥ
kukṣērāṭōpō daurbalyamasthibhēdō'ṅgamardō mōhasTamasō darśanaṁ
mūrcchā bhramaścābhīkṣṇaṁ svapnē ca madanartanavyadhanavyathanavēpanapatanādīnīti||6||

tatō'nantaramapasmārābhinirvr̥ttirēva||7||

tasyemAni pUrvarUpANi bhavanti; tadyathA- bhrUvyudAsaHsatatamakShNorvaikRutamashabdashravaNaMlAlAsi~gghANaprasravaNamanannAbhilaShaNamarocakAvipAkau hRudayagrahaH kukSherATopodaurbalyamasthibhedo~a~ggamardo mohastamaso darshanaM mUrcchA bhramashcAbhIkShNaM svapneca madanartanavyadhanavyathanavepanapatanAdInIti||6||

tato~anantaramapasmArAbhinirvRuttireva||7||
<div style="text-align:justify;">
Premonitory symptoms of ''apasmara'' include contraction of eyebrows, erratic and constant movement of eyes, auditory hallucinations, excessive salivation, and nasal discharge. There is frequent accompaniment of anorexia, indigestion, and general disinclination towards food, chest congestion, distension of the lower abdomen accompanied with gurgling sound, weakness, cracking pain in bones and malaise, unconsciousness, a feeling of despondency or depression, fainting and giddiness, and frequent dreams of scenes of intoxication, dancing, murdering, aching, shivering and falling. [6]
</div>
These are some common premonitory symptoms of ''apasmara''. [7]

==== Specific types and features of ''apasmara'' ====

===== ''Vata dosha'' dominant ''apasmara'' =====

तत्रेदमपस्मारविशेषविज्ञानं भवति; तद्यथा-

अभीक्ष्णमपस्मरन्तं, क्षणेन सञ्ज्ञां प्रतिलभमानम्, उत्पिण्डिताक्षम्, असाम्नाविलपन्तम्,
उद्वमन्तं फेनम्, अतीवाध्मातग्रीवम्, आविद्धशिरस्कं, विषमविनताङ्गुलिम्, अनवस्थितपाणिपादम्, अरुणपरुषश्यावनखनयनवदनत्वचम्, अनवस्थितचपलपरुषरूक्षरूपदर्शिनं, वातलानुपशयं, विपरीतोपशयं च वातेनापस्मरन्तं विद्यात् ||८||

tatrēdamapasmāraviśēṣavijñānaṁ bhavati;
tadyathā-

abhīkṣṇamApasmarantaṁ, kṣaṇēna
sañjñāṁ pratilabhamānam, utpiṇḍitākṣam, asāmnā vilapantam, udvamantaṁ phēnam, atīvādhmātagrīvam, āviddhaśiraskaṁ, viṣamavinatāṅgulim, anavasthitapāṇipādam, aruṇaparuṣaśyāvanakhanayanavadanatvacam,
anavasthitacapalaparuṣarūkṣarūpadarśinaṁ, vātalānupaśayaṁ,
viparītōpaśayaṁ ca vātēnāpasmarantaṁ
vidyāt (1)||8||

tatredamapasmAravisheShavij~jAnaM bhavati; tadyathA-

abhIkShNamapasmarantaM, kShaNena sa~jj~jAM pratilabhamAnam, utpiNDitAkSham, asAmnA vilapantam, udvamantaM phenam,atIvAdhmAtagrIvam, AviddhashiraskaM, viShamavinatA~ggulim, anavasthitapANipAdam,aruNaparuShashyAvanakhanayanavadanatvacam, anavasthitacapalaparuSharUkSharUpadarshinaM,vAtalAnupashayaM, viparItopashayaM ca vAtenApasmarantaM vidyAt (1)||8||
<div style="text-align:justify;">
More frequent episodes of ''apasmara'', episodes of instant loss of consciousness and regain it quickly, bulging or rolling up of eyes, incoherent speech, frothy vomit, excessive stiffness of neck, drooping of the head to one side, irregular contraction of fingers, unstable upper and lower limbs, redness, dryness and grayish tint in the nails, eyes, face and skin, apparent vision or perception of unstable, fickle, coarse and dry objects, conditions associated with consuming ''vata''-aggravating diets and alleviation of ailments when subjected to ''vata''-pacifying diets.[8-1]
</div>

===== ''Pitta''-dominant ''apasmara'' =====

अभीक्ष्णमपस्मरन्तं क्षणेन सञ्ज्ञां प्रतिलभमानम्, अवकूजन्तम्, आस्फालयन्तं भूमिं, हरितहारिद्रताम्रनखनयनवदनत्वचं,रुधिरोक्षितोग्रभैरवादीप्तरुषितरूपदर्शिनं, पित्तलानुपशयं,विपरीतोपशयं च पित्तेनापस्मरन्तं विद्यात् ||८||

abhīkṣṇamapasmarantaṁ kṣaṇēna sañjñāṁ pratilabhamānam, avakūjantam, āsphālayantaṁ bhūmiṁ, haritahāridratāmranakhanayanavadanatvacaṁ, rudhirōkṣitōgrabhairavādīptaruṣitarūpadarśinaṁ, pittalānupaśayaṁ,viparītōpaśayaṁ ca pittēnāpasmarantaṁ vidyāt (2)||8||

abhIkShNamapasmarantaM kShaNena sa~jj~jAM pratilabhamAnam, avakUjantam, AsphAlayantaMbhUmiM, haritahAridratAmranakhanayanavadanatvacaM,rudhirokShitograbhairavAdIptaruShitarUpadarshinaM, pittalAnupashayaM,viparItopashayaM capittenApasmarantaM vidyAt (2)||8||
<div style="text-align:justify;">
Frequent episodes of ''apasmara'', instant loss of consciousness and regaining it quickly, stertorous breathing, abnormal, dragging-like movement, green, yellow or coppery tint of nails, eyes, face and skin, apparent vision or perception of bleeding, terrifying, horrible, burning and angry looking objects, conditions associated with ''pitta''-aggravating diets and alleviation of ailments when subjected to ''pitta''-pacifying diets [8-2]
</div>

===== ''Kapha''-dominant ''apasmara'' =====

चिरादपस्मरन्तं, चिराच्च सञ्ज्ञां प्रतिलभमानं, पतन्तम्, अनतिविकृतचेष्टं, लालामुद्वमन्तं, शुक्लनखनयनवदनत्वचं,शुक्लगुरुस्निग्धरूपदर्शिनं, श्लेष्मलानुपशयं, विपरीतोपशयं च श्लेष्मणाऽपस्मर-न्तं विद्यात् ||८||

cirādapasmarantaṁ, cirācca sañjñāṁ pratilabhamānaṁ, patantam, anativikr̥tacēṣṭaṁ, lālāmudvamantaṁ, śuklanakhanayanavadanatvacaṁ, śuklagurusnigdharūpadarśinaṁ, ślēṣmalānupaśayaṁ, viparītōpaśayaṁ ca ślēṣmaṇā'pasmarantaṁ vidyāt (3)||8||

cirAdapasmarantaM, cirAcca sa~jj~jAM pratilabhamAnaM, patantam, anativikRutaceShTaM,lAlAmudvamantaM, shuklanakhanayanavadanatvacaM, shuklagurusnigdharUpadarshinaM,shleShmalAnupashayaM, viparItopashayaM ca shleShmaNA~apasmarantaM vidyAt (3)||8||
<div style="text-align:justify;">
Less frequent episodes of ''apasmara'', gradual loss and regain of consciousness, frequently falling down, less pronounced abnormalities in movement, dribbling of saliva, whitish discoloration of nails, eyes, face, and skin, apparent vision or perception of white, heavy and unctuous objects, and conditions associated with consuming ''kapha''-aggravating diets and alleviation of ailments when subjected to ''kapha''-pacifying diets [8-3]
</div>
===== ''Sannipatika apasmara'' with dominance of all ''dosha'' =====

समवेतसर्वलिङ्गमपस्मारं सान्निपातिकं विद्यात्, तमसाध्यमाचक्षते
इति चत्वारोऽपस्मारा व्याख्याताः ||८||

samavētasarvaliṅgamapasmāraṁ sānnipātikaṁ vidyāt, Tamasādhyamācakṣatē ||

iti catvārō'pasmārā vyākhyātāḥ||8||

samavetasarvali~ggamapasmAraM sAnnipAtikaM vidyAt, tamasAdhyamAcakShate (4)

iti catvAro~apasmArA vyAkhyAtAH||8||

''Sannipatika apasmara'' (caused by the simultaneous vitiation of all the three ''doshas'') shares the symptoms of all the three ''doshas'' (described above). This condition is incurable.

Thus, four types of ''apasmara'' are explained. [8-4]

===== ''Apasmara'' with extrinsic factors =====

तेषामागन्तुरनुबन्धो भवत्येव कदाचित्, तमुत्तरकालमुपदेक्ष्यामः |

तस्य विशेषविज्ञानं यथोक्तलिङ्गैर्लिङ्गाधिक्यमदोषलिङ्गानुरूपं च किञ्चित् ||९||

tēṣāmāganturanubandhō bhavatyēva kadācit, tamuttarakālamupadēkṣyāmaḥ|

tasya viśēṣavijñānaṁ yathōktaliṅgairliṅgādhikyamadōṣaliṅgānurūpaṁ ca kiñcit||9||

teShAmAganturanubandho bhavatyeva kadAcit, tamuttarakAlamupadekShyAmaH|

tasya visheShavij~jAnaM yathoktali~ggairli~ggAdhikyamadoShali~ggAnurUpaM ca ki~jcit||9||

Sometimes these conditions are associated with extrinsic causative factors described later (in Cikitsa10:53). The symptoms that manifest in such cases, though, are not the same as those caused by vitiated ''doshas''. [9]

==== Management of ''apasmara'' ====

हितान्यपस्मारिभ्यस्तीक्ष्णानि संशोधनान्युपशमनानि च यथास्वं, मन्त्रादीनि चागन्तुसंयोगे ||१०||

hitānyapasmāribhyastīkṣṇāni saṁśōdhanānyupaśamanāni ca yathāsvaṁ, mantrādīni cāgantusaṁyōgē||10||

hitAnyapasmAribhyastIkShNAni saMshodhanAnyupashamanAni ca yathAsvaM, mantrAdInicAgantusaMyoge||10||

Strong elimination and alleviation therapies are effective in alleviating and curing ''apasmara''. When extrinsic causative factors are involved, then ''mantras'' etc., are considered useful. [10]

==== Manifestation of various diseases ====

तस्मिन् हि दक्षाध्वरध्वंसे देहिनां नानादिक्षु विद्रवतामभिद्रवणतरणधावनप्लवनलङ्घनाद्यैर्देहविक्षोभणैः पुरागुल्मोत्पत्तिरभूत्, हविष्प्राशात् प्रमेहकुष्ठानां, भयत्रासशोकैरुन्मादानां,
विविधभूताशुचिसंस्पर्शादपस्माराणां, ज्वरस्तु खलुमहेश्वरललाटप्रभवः ,
तत्सन्तापाद्रक्तपित्तम्, अतिव्यवायात् पुनर्नक्षत्रराजस्य राजयक्ष्मेति ||११||
tasmin hi dakṣādhvaradhvaṁsē dēhināṁ nānādikṣu
vidravatāmabhidravaṇataraṇadhāvanaplavanalaṅghanādyairdēhavikṣōbhaṇaiḥ purā gulmōtpattirabhūt, haviṣprāśāt pramēhakuṣṭhānāṁ,
bhayatrāsaśōkairunmādānāṁ, vividhabhūtāśucisaṁsparśādapasmārāṇāṁ,
jvarastu khalu mahēśvaralalāṭaprabhavaḥ , tatsantāpādraktapittam,
ativyavāyāt punarnakṣatrarājasya rājayakṣmēti||11||

tasmin hi dakShAdhvaradhvaMse dehinAM nAnAdikShuvidravatAmabhidravaNataraNadhAvanaplavanala~gghanAdyairdehavikShobhaNaiH purAgulmotpattirabhUt, haviShprAshAt pramehakuShThAnAM, bhayatrAsashokairunmAdAnAM,vividhabhUtAshucisaMsparshAdapasmArANAM, jvarastu khalu maheshvaralalATaprabhavaH ,tatsantApAdraktapittam, ativyavAyAt punarnakShatrarAjasya rAjayakShmeti||11||
<div style="text-align:justify;">
As per vedic legends, in the aftermath of destruction of Daksha’s ''yajna'' (holy sacrifice), ''gulma'' (disease similar to lumps in abdomen) was manifested first in human beings due to stress induced as a result of fleeing, swimming, running, flying, etc. in all directions. ''Prameha'' (disease of obstinate urinary disorders) and ''kushtha'' (obstinate skin diseases including leprosy) were manifested due to excess intake of ghee. Various types of ''unmada'' (insanity/psychosis) were manifested due to fear, apprehension and grief. ''Apasmara'' (epilepsy) set in due to coming in contact with various types of unclean objects. ''Jwara'' came out of the forehead of Lord Shiva, and ''raktapitta'' was manifested (a condition characterized by bleeding from different parts of the body) due to ''jwara''’s heat. Moon was afflicted with ''rajayakshma'' due to excessive sexual indulgence. [11]
</div>
==== Summary ====

भवन्ति चात्र-

अपस्मारो हि वातेन पित्तेन च कफेन च |

चतुर्थः सन्निपातेन प्रत्याख्येयस्तथाविधः ||१२||

साध्यांस्तु भिषजः प्राज्ञाः साधयन्ति समाहिताः |

तीक्ष्णैः संशोधनैश्चैव यथास्वं शमनैरपि ||१३||

यदा दोषनिमित्तस्य भवत्यागन्तुरन्वयः |

तदा साधारणं कर्म प्रवदन्ति भिषग्विदः ||१४||

bhavanti cātra-

apasmārō hi vātēna pittēna ca kaphēna ca|

caturthaḥ sannipātēna pratyākhyēyastathāvidhaḥ||12||

sādhyāṁstu bhiṣajaḥ prājñāḥ sādhayanti samāhitāḥ|

tīkṣṇaiḥ saṁśōdhanaiścaiva yathāsvaṁ śamanairapi||13||

yadā dōṣanimittasya bhavatyāganturanvayaḥ|

tadā sādhāraṇaṁ karma pravadanti bhiṣagvidaḥ||14||

bhavanti cAtra- apasmAro hi vAtena pittena ca kaphena ca|

caturthaH sannipAtena pratyAkhyeyastathAvidhaH||12||

sAdhyAMstu bhiShajaH prAj~jAH sAdhayanti samAhitAH|

tIkShNaiH saMshodhanaishcaiva yathAsvaM shamanairapi||13||

yadA doShanimittasya bhavatyAganturanvayaH|

tadA sAdhAraNaM karma pravadanti bhiShagvidaH||14||
<div style="text-align:justify;">
From the preceding verses, it can be said that ''apasmara'' manifests itself due to the vitiation of ''vata, pitta'' and ''kapha'' and ''sannipata'' (combined vitiation of all the three ''doshas''). The ''sannipata'' variation is incurable. [12]

The curable types of ''apasmara'' should be carefully treated by a physician possessing extensive knowledge and experience of administering elimination and alleviation therapies associated with the ''dosha''(s) causing the specific variant of ''apasmara''. [13]

When ''apasmara'' is caused by the vitiation of ''doshas'' associated with extrinsic causative factors, then general therapies addressing both (''doshic'' equilibrium and extrinsic causes) are advised by the best of physicians. [14]
</div>
सर्वरोगविशेषज्ञः सर्वौषधविशारदः|

भिषक् सर्वामयान् हन्ति न च मोहं निगच्छति ||१५||

sarvarōgaviśēṣajñaḥ sarvauṣadhaviśāradaḥ|

bhiṣak sarvāmayān hanti na ca mōhaṁ nigacchati ||15||

sarvarogavisheShaj~jaH sarvauShadhavishAradaH|

bhiShak sarvAmayAn hanti na ca mohaM nigacchati ||15||

An able physician, well versed in the specific characteristics of all diseases and the properties of all medicines, cures all (curable) diseases and does not get confused. [15]

इत्येतदखिलेनोक्तं निदानस्थानमुत्तमम् |१६|

ityētadakhilēnōktaṁ nidānasthānamuttamam|16|

ityetadakhilenoktaM nidAnasthAnamuttamam|16|

This concludes the (excellent section titled) [[Nidana Sthana]]. [16]

==== Diagnostic principles of diseases ====

===== ''Nidanarthakara roga'' (disease specific causes) =====

निदानार्थकरो रोगो रोगस्याप्युपलभ्यते ||१६||

nidānārthakarō rōgō rōgasyāpyupalabhyatē||16||

nidAnArthakaro rogo rogasyApyupalabhyate||16||

Diseases can act as causative factors of other diseases as well [16]

तद्यथा-

ज्वरसन्तापाद्रक्तपित्तमुदीर्यते |

रक्तपित्ताज्ज्वरस्ताभ्यां शोषश्चाप्युपजायते ||१७||

tadyathā-

jvarasantāpādraktapittamudīryatē|

raktapittājjvarastābhyāṁ śōṣaścāpyupajāyatē ||17||

tadyathA -

jvarasantApAdraktapittamudIryate|

raktapittAjjvarastAbhyAM shoShashcApyupajAyate ||17||

For example, elevated temperature in ''jwara'' can cause ''raktapitta'' and ''raktapitta'' can cause ''jwara''. Both the diseases (i.e ''jwara'' and ''raktapitta'') may lead to ''shosha'' (depletion of ''dhatus''). [17]

प्लीहाभिवृद्ध्या जठरं जठराच्छोथ एव च |

अर्शोभ्यो जठरं दुःखं गुल्मश्चाप्युपजायते ||१८||

plīhābhivr̥ddhyā jaṭharaṁ jaṭharācchōtha ēva ca|

arśōbhyō jaṭharaṁ duḥkhaṁ gulmaścāpyupajāyatē||18||

plIhAbhivRuddhyA jaTharaM jaTharAcchotha eva ca|

arshobhyo jaTharaM duHkhaM gulmashcApyupajAyate||18||

''Pleeha'' (enlargement of spleen) causes ''jathara'' (abdominal diseases including ascitis), which leads to ''shotha'' (generalized edema). ''Arsha'' (hemorrhoids) causes ''jathara'' (abdominal diseases including ascitis) that leads to ''gulma'' (abdominal lumps). [18]

प्रतिश्यायाद्भवेत् कासः कासात् सञ्जायते क्षयः |

क्षयो रोगस्य हेतुत्वे शोषस्याप्युपलभ्यते ||१९||

pratiśyāyādbhavēt kāsaḥ kāsāt sañjāyatē kṣayaḥ|

kṣayō rōgasya hētutvē śōṣasyāpyupalabhyatē||19||

pratishyAyAdbhavet kAsaH kAsAt sa~jjAyate kShayaH|

kShayo rogasya hetutve shoShasyApyupalabhyate||19||

''Pratishyaya'' (rhinitis) leads to ''kasa'' (cough) which further leads to ''kshaya'' (depletion of ''dhatu''), consequently resulting in ''sosha'' (emaciation). [19]

ते पूर्वं केवला रोगाः पश्चाद्धेत्वर्थकारिणः |

उभयार्थकरा दृष्टास्तथैवैकार्थकारिणः [१] ||२०||

tē pūrvaṁ kēvalā rōgāḥ paścāddhētvarthakāriṇaḥ|

ubhayārthakarā dr̥ṣṭāstathaivaikārthakāriṇaḥ [1] ||20||

te pUrvaM kevalA rogAH pashcAddhetvarthakAriNaH|

ubhayArthakarA dRuShTAstathaivaikArthakAriNaH ||20||
<div style="text-align:justify;">
Conditions in their primary stages or forms manifest themselves as diseases and subsequently act as causative factors for other diseases. They thus play a dual role - as a disease and as a causative factor. Some of these play just one role as well– either as a disease or as a causative factor. [20]
</div>
कश्चिद्धि रोगो रोगस्य हेतुर्भूत्वा प्रशाम्यति |

न प्रशाम्यति चाप्यन्यो हेत्वर्थं कुरुतेऽपि च ||२१||

kaściddhi rōgō rōgasya hēturbhūtvā praśāmyati|

na praśāmyati cāpyanyō hētvarthaṁ kurutē'pi ca||21||

kashciddhi rogo rogasya heturbhUtvA prashAmyati|

na prashAmyati cApyanyo hetvarthaM kurute~api ca ||21||

Some diseases subside after causing another disease, while some do not subside even after causing another disease. [21]

एवं कृच्छ्रतमा नॄणां दृश्यन्ते व्याधिसङ्कराः |

प्रयोगापरिशुद्धत्वात्तथा चान्योन्यसम्भवात् ||२२||

ēvaṁ kr̥cchratamā nr̥̄ṇāṁ dr̥śyantē vyādhisaṅkarāḥ|

prayōgāpariśuddhatvāttathā cānyōnyasambhavāt||22||

evaM kRucchratamA nRUNAM dRushyante vyAdhisa~gkarAH|

prayogAparishuddhatvAttathA cAnyonyasambhavAt||22||

Combinations of diseases in human beings are usually very difficult to treat, owing to the complexity of the line of treatment, and their serving as causative factors of each other. [22]

===== Ideal therapy without adverse effects =====

प्रयोगः शमयेद्व्याधिं योऽन्यमन्यमुदीरयेत् |

नासौ विशुद्धः, शुद्धस्तु शमयेद्यो न कोपयेत् ||२३||

prayōgaḥ śamayēdvyādhiṁ yō'nyamanyamudīrayēt|

nāsau viśuddhaḥ, śuddhastu śamayēdyō na kōpayēt||23||

prayogaH shamayedvyAdhiM yo~anyamanyamudIrayet|

nAsau vishuddhaH, shuddhastu shamayedyo na kopayet||23||

A therapy that alleviates one disease condition but provokes another disease is not ''shuddha'' (or is an impure or incorrect therapy). The ideal therapy is that which pacifies a disease without provoking any other disease. [23]

===== Diagnostic aspect of etiological factors =====

एको हेतुरनेकस्य तथैकस्यैक एव हि |

व्याधेरेकस्य चानेको बहूनां बहवोऽपि च ||२४||

ēkō hēturanēkasya tathaikasyaika ēva hi|

vyādhērēkasya cānēkō bahūnāṁ bahavō'pi ca||24||

eko heturanekasya tathaikasyaika eva hi|

vyAdherekasya cAneko bahUnAM bahavo~api ca||24||

One causative factor may cause one or many diseases. Many causative factors may result in a single disease or may cause several diseases. [24]

ज्वरभ्रमप्रलापाद्या दृश्यन्ते रूक्षहेतुजाः |

रूक्षेणैकेन चाप्येको ज्वर एवोपजायते ||२५||

jvarabhramapralāpādyā dr̥śyantē rūkṣahētujāḥ|

rūkṣēṇaikēna cāpyēkō jvara ēvōpajāyatē||25||

jvarabhramapralApAdyA dRushyante rUkShahetujAH|

rUkSheNaikena cApyeko jvara evopajAyate||25||

It is seen that a single causative factor, ruksha (dry) can cause many diseases such as ''jwara'' (fever), ''bhrama'' (vertigo) and ''pralapa'' (delirium) etc., while the same single factor (''ruksha'') may cause just one disease (''jwara'') [25]

हेतुभिर्बहुभिश्चैको ज्वरो रूक्षादिभिर्भवेत् |

रूक्षादिभिर्ज्वराद्याश्च व्याधयः सम्भवन्ति हि ||२६||

hētubhirbahubhiścaikō jvarō rūkṣādibhirbhavēt|

rūkṣādibhirjvarādyāśca vyādhayaḥ sambhavanti hi||26||

hetubhirbahubhishcaiko jvaro rUkShAdibhirbhavet|

rUkShAdibhirjvarAdyAshca vyAdhayaH sambhavanti hi||26||

''Jwara'' alone may be caused by a combination of several causative factors including but not limited to ''ruksha''(dry) etc. and many causes like, ''ruksha'' (dry, rough) etc. may lead to several diseases. [26]

===== Diagnostic aspect of symptoms =====

लिङ्गं चैकमनेकस्य तथैवैकस्य लक्ष्यते |

बहून्येकस्य च व्याधेर्बहूनां स्युर्बहूनि च ||२७||

liṅgaṁ caikamanēkasya tathaivaikasya lakṣyatē|

bahūnyēkasya ca vyādhērbahūnāṁ syurbahūni ca||27||

li~ggaM caikamanekasya tathaivaikasya lakShyate|

bahUnyekasya ca vyAdherbahUnAM syurbahUni ca||27||

Similarly, one symptom may be common to many diseases, one symptom may be related to only one disease, many symptoms may be associated with only one disease, and many symptoms may be common to many diseases. [27]

विषमारम्भमूलानां लिङ्गमेकं ज्वरो मतः |

ज्वरस्यैकस्य चाप्येकः सन्तापो लिङ्गमुच्यते ||२८||

viṣamārambhamūlānāṁ liṅgamēkaṁ jvarō mataḥ|

jvarasyaikasya cāpyēkaḥ santāpō liṅgamucyatē||28||

viShamArambhamUlAnAM li~ggamekaM jvaro mataH|

jvarasyaikasya cApyekaH santApo li~ggamucyate||28||

One symptom i.e. ''jwara'' can be considered common to many diseases that have irregular onset, while ''santapa'' (elevated temperature) is considered a symptom of only one disease i.e. ''jwara''.[28]

विषमारम्भमूलैश्च ज्वर एको निरुच्यते |

लिङ्गैरेतैर्ज्वरश्वासहिक्काद्याः सन्ति चामयाः ||२९||

viṣamārambhamūlaiśca jvara ēkō nirucyatē|

liṅgairētairjvaraśvāsahikkādyāḥ santi cāmayāḥ||29||

viShamArambhamUlaishca jvara eko nirucyate|

li~ggairetairjvarashvAsahikkAdyAH santi cAmayAH||29||

Irregular onset (and similar other symptoms) appear in the case of ''jwara'', while similar symptoms also occur in ''shwasa'' (dyspnea), ''hikka'' (hiccups), and other similar diseases. [29]

===== Therapeutic considerations =====

एका शान्तिरनेकस्य तथैवैकस्य लक्ष्यते |

व्याधेरेकस्य चानेका बहूनां बह्व्य एव च ||३०||

ēkā śāntiranēkasya tathaivaikasya lakṣyatē|

vyādhērēkasya cānēkā bahūnāṁ bahvya ēva ca||30||

ekA shAntiranekasya tathaivaikasya lakShyate|

vyAdherekasya cAnekA bahUnAM bahvya eva ca||30||

A single therapy can subside many diseases as well as a single disease. Multiple therapies may be needed to subside many diseases, whereas one disease could require multiple therapies to cure. [30]

शान्तिरामाशयोत्थानां व्याधीनां लङ्घनक्रिया |

ज्वरस्यैकस्य चाप्येका शान्तिर्लङ्घनमुच्यते ||३१||

śāntirāmāśayōtthānāṁ vyādhīnāṁ laṅghanakriyā|

jvarasyaikasya cāpyēkā śāntirlaṅghanamucyatē||31||

shAntirAmAshayotthAnAM vyAdhInAM la~gghanakriyA|

jvarasyaikasya cApyekA shAntirla~gghanamucyate||31||

The diseases originating from ''amashaya'' are cured by ''langhana'' (fasting), only whereas only a single disease entity ''jwara'' also can be treated by the single therapy of ''langhana'' (fasting). [31]

तथा लघ्वशनाद्याश्च ज्वरस्यैकस्य शान्तयः |

एताश्चैव ज्वरश्वासहिक्कादीनां प्रशान्तयः ||३२||

tathā laghvaśanādyāśca jvarasyaikasya śāntayaḥ|

ētāścaiva jvaraśvāsahikkādīnāṁ praśāntayaḥ||32||

tathA laghvashanAdyAshca jvarasyaikasya shAntayaH|

etAshcaiva jvarashvAsahikkAdInAM prashAntayaH||32||

For treating a single disease like ''jwara'', multiple therapies like light diet, etc. are needed and the same multiple therapies like light diet etc. are needed to subside many diseases like ''jwara''(fever), ''shwasa''(dyspnea), ''hikka''(hiccups) etc. [32]

===== Prognostic aspect in therapy =====

सुखसाध्यः सुखोपायः कालेनाल्पेन साध्यते |

साध्यते कृच्छ्रसाध्यस्तु यत्नेन महता चिरात् ||३३||

याति नाशेषतां व्याधिरसाध्यो याप्यसञ्ज्ञितः |

परोऽसाध्यः क्रियाः सर्वाः प्रत्याख्येयोऽतिवर्तते ||३४||

नासाध्यः साध्यतां याति साध्यो याति त्वसाध्यताम् |

पादापचाराद्दैवाद्वा यान्ति भावान्तरं गदाः ||३५||

sukhasādhyaḥ sukhōpāyaḥ kālēnālpēna sādhyatē|

sādhyatē kr̥cchrasādhyastu yatnēna mahatā cirāt||33||

yāti nāśēṣatāṁ vyādhirasādhyō yāpyasañjñitaḥ|

parō'sādhyaḥ kriyāḥ sarvāḥ pratyākhyēyō'tivartatē||34||

nāsādhyaḥ sādhyatāṁ yāti sādhyō yāti tvasādhyatām|

pādāpacārāddaivādvā yānti bhāvāntaraṁ gadāḥ||35||

sukhasAdhyaH sukhopAyaH kAlenAlpena sAdhyate|

sAdhyate kRucchrasAdhyastu yatnena mahatA cirAt||33||

yAti nAsheShatAM vyAdhirasAdhyo yApyasa~jj~jitaH|

paro~asAdhyaH kriyAH sarvAH pratyAkhyeyo~ativartate||34||

nAsAdhyaH sAdhyatAM yAti sAdhyo yAti tvasAdhyatAm|

pAdApacArAddaivAdvA yAnti bhAvAntaraM gadAH||35||
<div style="text-align:justify;">
Easily curable diseases can be managed in a short time by simple measures. Diseases which are difficult to cure may require more effort and time to cure. The palliable variety of incurable diseases can never be cured, but can be alleviated. Incurable diseases are not amenable to any type of treatment.

Conversely, incurable diseases never become curable, while the curable varieties may become incurable due to factors like incompetence of the four components of health management (the physician, the medicine, the attendant and the patient) and/or misfortune. The easily curable kinds may also become difficult to cure, if not incurable, while diseases that are difficult to cure may become palliable and palliable variety may become incurable. [33-35]
</div>

===== Examination of stages of disease =====

वृद्धिस्थानक्षयावस्थां रोगाणामुपलक्षयेत् |

सुसूक्ष्मामपि च प्राज्ञो देहाग्निबलचेतसाम् ||३६||

vr̥ddhisthānakṣayāvasthāṁ rōgāṇāmupalakṣayēt |

susūkṣmāmapi ca prājñō dēhāgnibalacētasām||36||

vRuddhisthAnakShayAvasthAM rogANAmupalakShayet |

susUkShmAmapi ca prAj~jo dehAgnibalacetasAm||36||

A wise physician should carefully observe the subtle changes in the state of diseases (aggravated, normal and diminished) while properly assessing the patient’s body strength, digestive power and mental ability. [36]

व्याध्यवस्थाविशेषान् हि ज्ञात्वा ज्ञात्वा विचक्षणः |

तस्यां तस्यामवस्थायां चतुःश्रेयः प्रपद्यते ||३७||

vyādhyavasthāviśēṣān hi jñātvā jñātvā vicakṣaṇaḥ|

tasyāṁ tasyāmavasthāyāṁ catuḥśrēyaḥ prapadyatē||37||

vyAdhyavasthAvisheShAn hi j~jAtvA j~jAtvA vicakShaNaH|

tasyAM tasyAmavasthAyAM catuHshreyaH prapadyate||37||

The physician, who is keenly observing variations in disease stages in the patient, should know it (the disease) well and prescribe such a treatment that would be helpful in attaining the fourfold effect of therapeutics. [37]

प्रायस्तिर्यग्गता दोषाः क्लेशयन्त्यातुरांश्चिरम् |

तेषु न त्वरया कुर्याद्देहाग्निबलवित् क्रियाम् ||३८||

प्रयोगैः क्षपयेद्वा तान् सुखं वा कोष्ठमानयेत् |

ज्ञात्वा कोष्ठप्रपन्नांस्तान् यथासन्नं हरेद्बुधः ||३९||

prāyastiryaggatā dōṣāḥ klēśayantyāturāṁściram|

tēṣu na tvarayā kuryāddēhāgnibalavit kriyām||38||

prayōgaiḥ kṣapayēdvā tān sukhaṁ vā kōṣṭhamānayēt|

jñātvā kōṣṭhaprapannāṁstān yathāsannaṁ harēdbudhaḥ||39||

prAyastiryaggatA doShAH kleshayantyAturAMshciram|

teShu na tvarayA kuryAddehAgnibalavit kriyAm||38||

prayogaiH kShapayedvA tAn sukhaM vA koShThamAnayet|

j~jAtvA koShThaprapannAMstAn yathAsannaM haredbudhaH||39||
<div style="text-align:justify;">
Generally, ''doshas'' that are spread over obliquely (in the transverse direction) afflict the patient for a longer time. In that condition, treatment should not be initiated in a hurry without proper assessment of body strength and digestive power.
These ''doshas'' should be alleviated first by treatment, or they should be carefully be drawn to the ''koshtha'' (bowel). After knowing their status in ''koshtha'', the wise physician should eliminate them through the nearest route. [38-39]
</div>
ज्ञानार्थं यानि चोक्तानि व्याधिलिङ्गानि सङ्ग्रहे |

व्याधयस्ते तदात्वे तु लिङ्गानीष्टानि नामयाः ||४०||

jñānārthaṁ yāni cōktāni vyādhiliṅgāni saṅgrahē|

vyādhayastē tadātvē tu liṅgānīṣṭāni nāmayāḥ||40||

j~jAnArthaM yAni coktAni vyAdhili~ggAni sa~ggrahe|

vyAdhayaste tadAtve tu li~ggAnIShTAni nAmayAH||40||
<div style="text-align:justify;">
In the [[Nidana Sthana]], a compendium of symptomatology has been provided as a reckoner for the Ayurveda practitioner to gain adequate knowledge of some of the major classes of diseases and diagnose them effectively. But these symptoms may independently develop into diseases and create emergency situations. [40]
</div>
विकारः प्रकृतिश्चैव द्वयं सर्वं समासतः |

तद्धेतुवशगं हेतोरभावान्नानुवर्तते ||४१||

vikāraḥ prakr̥tiścaiva dvayaṁ sarvaṁ samāsataḥ|

taddhētuvaśagaṁ hētōrabhāvānnānuvartatē||41||

vikAraH prakRutishcaiva dvayaM sarvaM samAsataH|

taddhetuvashagaM hetorabhAvAnnAnuvartate||41||

Everything can be categorized into being in a normal or an abnormal state. Both of these categories depend upon causes. Nothing can happen without a cause. [41]

==== Summary ====

तत्र श्लोकाः-

हेतवः पूर्वरूपाणि रूपाण्युपशयस्तथा |

सम्प्राप्तिः पूर्वमुत्पत्तिः सूत्रमात्रं चिकित्सितात् ||४२||

ज्वरादीनां विकाराणामष्टानां साध्यता न च |

पृथगेकैकशश्चोक्ता हेतुलिङ्गोपशान्तयः ||४३||

हेतुपर्यायनामानि व्याधीनां लक्षणस्य च |

निदानस्थानमेतावत् सङ्ग्रहेणोपदिश्यते ||४४||

tatra ślōkāḥ-

hētavaḥ pūrvarūpāṇi rūpāṇyupaśayastathā|

samprāptiḥ pūrvamutpattiḥ sūtramātraṁ cikitsitāt||42||

jvarādīnāṁ vikārāṇāmaṣṭānāṁ sādhyatā na ca|

pr̥thagēkaikaśaścōktā hētuliṅgōpaśāntayaḥ||43||

hētuparyāyanāmāni vyādhīnāṁ lakṣaṇasya ca|

nidānasthānamētāvat saṅgrahēṇōpadiśyatē||44||

tatra shlokAH-

hetavaH pUrvarUpANi rUpANyupashayastathA|

samprAptiH pUrvamutpattiH sUtramAtraM cikitsitAt||42||

jvarAdInAM vikArANAmaShTAnAM sAdhyatA na ca|

pRuthagekaikashashcoktA hetuli~ggopashAntayaH||43||

hetuparyAyanAmAni vyAdhInAM lakShaNasya ca|

nidAnasthAnametAvat sa~ggraheNopadishyate||44||
<div style="text-align:justify;">
To sum up this chapter, etiological factors, premonitory symptoms, signs and symptoms, therapeutic relief, pathogenesis, historical origins and brief line of treatment of ''apasmara'' have been described in this section. Since this is the concluding chapter of the [[Nidana Sthana]], a summary to the entire section has also been provided here, stating that starting from ''jwara'' all eight diseases have been dealt with separately in eight chapters, each with etiological factors, symptomatology, prognosis and brief line of management.

A compendium of diseases with etiological factors, their synonyms, symptoms of the diseases have been provided as an epilogue to the chapter. [42-44]
</div>
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते निदानस्थाने अपस्मारनिदानं नामाष्टमोऽध्यायः |

निदानस्थानं समाप्तम् ||८||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē nidānasthānē

apasmāranidānaṁ nāmāṣṭamō'dhyāyaḥ||8||

iti carakasaṁhitāyāṁ dvitīyaṁ nidānasthānaṁ samāptam|

Thus, ends the eighth chapter on the ‘diagnosis of ''apasmara''” of the section “Diagnosis of diseases” ([[Nidana Sthana]]) of Agnivesha , as redacted by Charak.

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*''Apasmara'' is a disease due to vitiation of three ''sharira doshas'' and two ''manas doshas''.
*The causative factors of ''apasmara'' mainly include consuming unhygienic, impure, decomposed food and encountering inauspicious things that are not compatible with one’s sensibilities.
*Diet is important for sustaining physical and psychological health. Improper dietary habits can lead to various psychosomatic disorders associated with ''apasmara''.
*''Apasmara'' originates from the heart, which is the center of consciousness and emotions per Vedic texts. The clinical presentation includes impaired heart-brain coordination leading to transient loss of memory, erratic movements, and blackouts. Analysis of the heart-brain connection is very important in the pathology of ''apasmara''.
*''Psychological'' stressors like excessive passion, anger, fear, greed, attachment, excitement, grief, anxiety, worry, perturbation etc. precipitate episodes of ''apasmara'' in a person afflicted with excessively aggravated ''dosha''.
*''Apasmara'', depending upon the predominant ''dosha'', can be diagnosed on the basis of frequency of episodes, duration of loss of consciousness, pattern of abnormal movements, and types of objects perceived (in aura phase) prior to the occurrence of an actual episode.
*Purification therapies using strong medicines, observing a healthy diet and lifestyle are considered the primary forms of treatment of ''apasmara''. Non-pharmacological measures like ''mantra'' (holy chants) and ''sattvavajaya chikitsa'' (mind training for restraint, such as cognitive behavior therapy) aid in the treatment of ''apasmara''.
*One disease can cause other disease, therefore it is important to track the history of ailments to prescribe the most effective course (or courses) of treatment.
*There can be one causative factor for many diseases or multiple causative factors for single disease.
*Similarly one symptom can be common in many diseases and one symptom can be seen in a single disease alone.
*There could be a single treatment for many diseases or many treatments for a single disease.
*The duration of treatment depends upon prognosis of the disease. A disease at the onset may be curable but if not treated, could worsen into a palliable or incurable variant.
*The subtle changes in ''dosha'', and the three states of a disease (aggravated, normal, or diminished) should be carefully observed along with proper assessment of body strength, digestive power and mental ability .
*The ''doshas'' that spread obliquely (in the transverse direction) afflict patient for a longer time. These ''doshas'' should be managed first, or they should be carefully drawn to ''koshtha'' (bowel) by proper measures. After analyzing them in ''koshtha'', the physician should eliminate them through the nearest route.

=== ''Vidhi Vimarsha'' ===

The chapter on ''apasmara'' is sequenced after the one on ''unmada''. The sequence is due to similarities of clinical origin as well as causative and pathophysiological factors, since both diseases are psychosomatic in nature.

==== History and origin of the disease in ancient medical literature ====

The origin of various diseases is narrated in the eleventh verse of the chapter. ''Apasmara'' originates from physical and mental contact with various unclean and unwholesome exogenous factors leading to imbalance at physical and psychological levels. The words ''ashuchi samsparsha'' literally mean direct contact of body and mind with unwholesome things. This is further supported by ''apasmara''’s etiology which points at improper diet and lifestyle as a major causative factor.

Review of ancient medical literature confirms that epilepsy was initially called sacred, because of the belief for its divine origin<ref>Emmanouil Magiorkinis, Kalliopi Sidiropoulou Aristidis Diamantis. Hallmarks in the History of Epilepsy: From Antiquity Till the Twentieth Century. Novel Aspects on Epilepsy Office for the Study of History of Hellenic Naval Medicine, Naval Hospital of Athens, Greece. </ref>. A chapter on epilepsy in Babylonian texts on medicine comprising 40 tablets dating as far back as 1067 BC accurately recorded many of the different seizure types recognized today. It emphasizes upon the supernatural nature of epilepsy, with each seizure type associated with a divinity, spirit or deity (usually evil)<ref> J. M. S. Pierce, a disease once sacred. A history of the medical understanding of epilepsy
By Mervyn J. Eadie and Peter F. Bladin2001. Eastleigh: John Libbey. Pp. 248. ISBN 0‐86196‐607‐4. Oxford Journals Medicine Brain Volume 125, Issue 2 Pp. 441-442.
</ref>. It was believed, in antiquity, that if a person comes in contact with things that are supernatural and evil, he/she would suffer from epilepsy. This view is consistent with those in ancient Greek, British, and Indian (Vedic) literature as well. The Ayurvedic theory of origin of epilepsy mentions contact with evil, unwholesome and unclean objects or experiences as key causative factors. References of ''grahas'' (celestial bodies) as a causative factor of ''apasmara'', specifically in children, can be found in vedic texts with terms such as ‘skanda’ and ‘skandapasmara. Though there are references of exogenous variants of epilepsy (''agantu apasmara'') in [[Charak Samhita]], a detailed description of these is not found. This indicates two things:
#Epilepsy originates from exposure to unwholesome, unclean and evil things either at a physical or at a psycho-spiritual plane.
#Management of the disease may include ''adhyatmik chikitsa'' (psycho-spiritual therapy) for better treatment.

==== Definition of ''Apasmara'' ====

''Apasmara'' is defined as the occasional loss of consciousness due to deterioration of ''smriti'' (memory), ''buddhi'' (intellect) and ''sattva'' (mind), characterized by ''tamahpravesha'' (entering darkness/ blackouts) and ''bibhatsa cheshta'' (abnormal movements).

As explained by Sushruta, ''smriti'' in context of apasmara is ''bhutarha vijnana'' i.e. orientation of external world and consciousness. ''Dhi-buddhi'' (intellect) is ''karya-akarya vibhaga karini'' i.e. discriminating power between right and wrong. ''Sattva'' is referred as ''mana'' (mind) and ''dhairya'' (temperance, patience). A patient of ''apasmara'' suffers from deterioration of all these three important mental faculties (''dhi, buddhi'' and ''smriti'').

The first cardinal sign of this deterioration is ''tamapravesha'' , i.e., ''jnana abhava'' or loss of knowledge and the ability to acquire new knowledge. The second cardinal sign, ''bibhatsa cheshta'', indicates involuntary movements of body due to lack of brain’s control or improper coordination. Sushruta narrated that due to these features of ''apasmara'', the disease often leads to death (''antakrita''). Dallhana comments that the dreadfulness of this disease is due to the fact that an afflicted person may fall into water or fire due to lack of orientation.

==== Impairment of knowledge and coordination ====

[[File:Co-ordination1.png|500px|
Fig. 2: Faculty involved in attainment of knowledge ]]

'''Fig. 2: Faculty involved in attainment of knowledge'''

According to Ayurveda, knowledge of external objects is processed through sense organs , to the mind-intellect, culminating in the spirit. This chain or sequence for attainment of knowledge is important for proper functioning of memory (encoding, storage and retrieval) and intellect (cognition) [Fig.2]. Occasional impairment of coordination in the sequence consisting of sense organs-intellect-mind-spirit is seen in ''apasmara''. This may lead to decrease in cognitive performance of an individual.

In conventional medicine, three major factors that cause disturbance in cerebral neurotransmission leading to blackouts and epilepsy viz. hypo-perfusion, hypo-metabolism, and hypoxia have been described in relevant medical texts. These disturbances lead to abnormal discharges, improper signal transduction in the neurotransmitter channels, and seizures. As a consequence, cellular dysfunctions in the brain, disruptions of the memory mechanism, and disturbed coordination of movements may occur causing the clinical manifestation of ''apasmara''. The role of these three factors and its impact on memory and cellular dysfunction in the pathogenesis of epilepsy need to be elucidated. The three pathological effects are comparable to the changes created by vitiation of ''kapha, pitta'' and ''vata''. Differentiation between these three types of manifestations is described further.

Per Ayurveda, ''smriti'' is ''atmaja'' (originated from the soul) and ''sattvaja'' (originated from the mind). This means that ''smriti'' (memory) of a person is essentially related with soul and mind. The Bhagavad Gita describes the consequences of excessive indulgence in sensory activities leading to excessive affliction resulting in an increase in passion, then anger, and then lack of knowledge. This further leads to deterioration of ''smriti'' and then affecting the intellect. This sequence lays the ground for ''apasmara''.

==== ''Tattva Sara'' ====

Three factors of mind, memory, intellect and consciousness are impaired in ''apasmara''. Due care should be taken to protect and manage these three. Herbs like ''medhya rasayana'' and treatment modalities like ''sattvajaya chikitsa'' are known to promote activities of mind, intellect and consciousness.

==== Predisposing factors for ''apasmara'' ====

The susceptible individuals and conditions for epilepsy are described in detail:

===== ''Rajas–tamas'' affliction =====

The first factor, ''rajas - tamas'' affliction, signifies the role of mind in etio-pathology of ''apasmara''. ''Rajas'' is a ''guna'' (tendency or attribute) responsible for the initiation of every kind of activity and symbolizes energy, while ''Tamas'' is the ''guna'' symbolizing inertia, dulling or stopping of activities. These two play an important role in the coordination of activities within the sequence of sense organs-mind-intellect-spirit, in the attainment of knowledge as well as to maintain the orientation of external world (consciousness). A ''rajas-tamas'' affliction, therefore, adversely impacts coordination of activities and perverts the mind and intellect, landing the patient into loss of orientation and consciousness. A “distressed” state of mind, caused by ''rajas-tamas'' affliction, is an important etiological factor responsible for various psychosomatic disorders such as epilepsy. Therefore, rehabilitating the ''rajas - tamas'' balance (and thus, achieving harmony between all the three ''gunas'') is of utmost importance in preventing the pathology and maintenance of health. Neurologically, initiation of action through neurotransmitters such as acetylcholine, while inhibition of action through dopamine can be categorized under ''rajas'' and ''tamas'' respectively. Synchronization of discharges in the cerebral region is a result of ''rajas-tamas'' balance. Disturbance in this ''rajas-tamas'' balance and depletion of ''sattva'' leads to hypersynchronization, resulting in seizures. Threshold of neuronal activity is due to balance between ''sattva, rajas'' and ''tamas''. It is ''sattva'' that maintains the normal threshold of neuronal activities. Decreased ''sattva'' and/or increased ''rajas'' and ''tamas'' can alter the threshold of neurons.

The state of mind afflicted due to ''rajas'' and ''tamas'' can be considered as ‘distressed mind’ observed as important causative factor for various psycho somatic disorders like epilepsy.

===== ''Sharira dosha'' vitiation =====

The second important factor is imbalance of ''doshas'' at the somatic level. There are three terms used to indicate the state of ''doshas'' which predisposes ''apasmara'':
*First is ''udbhranta'' (moving upwards in vitiated state). The upward direction of flow of ''doshas'' may indicate the pathway of ''apasmara'' from the heart to the brain. The pathology starts from the abode of consciousness i.e. heart, spreading upwards afflicting sense organs. In [[Chikitsa Sthana]], the term ''vibhranta'' is used to denote this condition.
*The second state is ''vishama'', meaning a state of disequilibrium. Imbalanced ''doshas'' create a favorable environment for ''apasmara''. *The third state is ''bahu'' (excessive), meaning that the imbalance is excessive enough to affect the brain-mind system. This suggests that the ''doshas'' are in an aggravated state of imbalance and predispose to the disease. The condition also points towards manifestation of ''apasmara'' as a result of other somatic disease pathologies.

The disease condition is a result of combination of the above states of ''doshas'' with the ''rajas-tamas'' affliction. These are ''sanchaya'' (accumulation), ''prakopa'' (aggravation) and ''prasara'' (spread) stages of the disease - important somatic factors for causation of ''apasmara''.

The cumulative presentation suggests the psychosomatic nature of the disease where the psyche and soma are equally involved in the pathogenesis. This is important while treating ''apasmara'', because this indicates that only administering anti-epileptic drugs is not enough in treating ''apasmara''. The treatment of underlying psychological factors shall also be given due emphasis.

===== Role of diet =====

The third key factor is the role of quality of diet in the causation of the disease. Charak uses terms like ''samala'' (impure), ''vikrita'' (deformed/altered), ''upahita'' (mixed), and ''ashuchi'' (unclean/unhygienic) as adjectives to describe food articles that cause ''apasmara''. Sushruta uses terms like ''viruddha'' (incompatible or of contradictory/antagonistic nature) and ''malina'' (bad) for the same factors. Besides providing nutrition to the body, diet plays a great impact on the mind as well. It is mentioned in the texts that the nutrition of soma and psyche occurs through food and food habits. Yogic texts narrate the role of food in nourishing five sheaths of the body, called ''annamaya kosha, pranamaya kosha, vijnanamaya kosha, manomaya kosha'' and ''anandmaya kosha''. Therefore, diet is not only important for proper functioning of the three ''doshas'', but also for nourishment of the mind and the soul. Charak as well as Sushruta have acknowledged the role of unclean, unhygienic, unwholesome, incompatible diet in the causation of ''apasmara''. Dallhana commented that this includes the diet that is ''dwishta'' (disliked by mind or taken with hatred feeling), ''amedhya'' (not satisfying mind) and ''paryushita'' (stale). All these types of diet can cause disturbance in the body and mind. As per conventional medicine, a diet that is deficient in certain vitamins and minerals and that which increases neurotoxins may lead to neurological disorders. Therefore, biochemical changes in the above mentioned causative foods may lead to deficiencies of important nutrients and cause increase in neurotoxins resulting in ''apasmara'' like disorders. Moreover, some gastrointestinal symptoms have been described further as premonitory symptoms of ''apasmara''. The role of diet and food habits as a cause of ''apasmara'' needs to be further researched. These factors are to be avoided during the treatment of apasmara. Not following /proper dietary rules is one of the key causes for the formation of ''ama''. ''Ama'' produces free radicals leading to excessive oxidative stress and tissue injuries. Therefore, following proper dietary habits is important in preventing the pathogenesis of the disease. Furthermore, this suggests the possibility of food contamination as a causative factor for epilepsy. A case of endrin-laced taquitos causing seizures in the US is an example of food contamination causing epileptic seizures .<ref> K Waller, T J Prendergast, A Slagle, R J Jackson.Seizures after eating a snack food contaminated with the pesticide endrin. The tale of the toxic taquitos. West J Med. 1992 Dec; 157(6): 648–651 </ref>

===== Improper methods – lifestyle factors =====

The fourth etiological factor of epilepsy is not following the prescribed rules of diet and lifestyle. The ''upayoga vidhi'' lists improper dietary habits, lifestyle and code of conduct that lead to disturbances in soma and psyche. Sushruta has elaborated the role of incorrect or excessive indulgence in activities of sense organs and locomotor organs as the foremost causative factor for ''apasmara''. This is suggestive of disturbances in the knowledge coordination chain leading to lack of attainment of knowledge. This factor also indicates role of unhealthy regimens and behavior in patho-physiology of epilepsy. The factor underlies ignorance towards proper ''dinacharya'' (diurnal regimen), ''ratricharya'' (night regimen) and ''ritucharya'' (seasonal regimen). The lifestyle and behavior of a person is important for achieving normalcy in the psychic plane and for avoiding psychological disorders. This also suggests the inclusion of ''prajnaparadha'' (intellectual blasphemy) described in [[Sharira Sthana]]. ''Achara rasayana'' (code of conduct) should be followed as a therapeutic regimen in the management of ''apasmara''. The psycho-neuro-biological basis of etiopathological factors causing neurological disorders is being extensively researched with positive outcomes. Psycho-social distress is an important underlying factor for such disorders through impairment of hypothalamo-pituitary-adrenal axis. The preventive measures to be included are correct and productive indulgence in the sensory and locomotor activities as per capacity of an individual. Psychotherapy is believed to be effective in the management of ''apasmara''.

===== Improper techniques =====

Observance of improper ''tantra'' (techniques/methods) makes the person prone to ''apasmara'' and is the fifth causative factor. This includes iatrogenic factors such as improper follow ups of [[Panchakarma]] procedures leading to vitiation of ''doshas'' in the body. The other meaning of ''tantra'' might be related to spiritual practices that are related to the supernatural powers mentioned earlier as reasons for causing epilepsy. Improper use of these tantric therapies can result in epilepsy.

Iatrogenic causes can increase susceptibility to ''apasmara''. Therefore all procedures should be followed properly in order to prevent complications.

===== Incorrect postures and movements =====

The sixth etiological factor constitutes of wrong postures and movements. Since the coordination of movements is regulated by ''dhi-buddhi-smriti'', any imbalance in the sense organs-mind-intellect-spirits sequence not only impairs movement of limbs but also increases the propensity of getting afflicted with ''apasmara''. Conversely, wrong postures and movements are a result of disturbances in the sense organs-spirits sequence that lead to incorrect attainment of knowledge with the manifestation of ''apasmara''.

Uncomfortable sitting, sleeping, positioning, irregular, uncoordinated movements of body (e.g. improper dance, sports etc.) can predispose ''apasmara''.

===== Excessive degeneration and debility =====

The seventh and last etiological factor i.e. excessive degeneration or debility may lead to pathogenesis of ''apasmara'' , pointing at ''dhatukshayajanya vataprakopa'' (vitiation of ''vata'' due to depletion of tissues) as a root cause. The degeneration might be a secondary condition resulting from other diseases. Hypo-perfusion and low levels of oxygen and metabolism could result in brain cell dysfunctions causing seizures. This is analogous to the concept of ''ati upakshaya'' in Ayurveda. Therefore, a clinical examination of depletion of tissues (''dhatukshaya'') could be considered as a treatment component in the management of ''apasmara''.

Acute and severe electrolyte imbalances (hyponatremia, hypocacemia and hypomagnesemia) frequently cause seizures.

The underlying etiology of other degenerative diseases should be considered while dealing with cases of epilepsy. In that case, management of epilepsy should be supported by proper nutrition, restorative, replenishing and rejuvenation therapies.

===== Additional factors by Sushruta =====

In addition to the above factors, Sushruta has quoted two more factors for predisposition of ''apasmara''. ''Veganigraha sheelanam'' i.e. habitual suppression of natural urges and ''gachchatam cha rajaswalam'' i.e., having sexual intercourse with menstruating women can make the individual more susceptible to epilepsy. Recent research suggests that menotoxins secreted by the female body during menstruation significantly impact the psyche of a person accompanying that female.

On the first of these two factors, per Ayurveda, suppression of any of the thirteen types of natural urges may lead to various disorders. Suppressing natural urges leads to ''vata''-dominant disorders and as ''vata'' is the regulator of mind-related activities, this consequently can result in neuropsychiatric disorders like ''apasmara''. All the urges are stimulated, regulated and completed by the nervous system. Inhibition of these factors might lead to impairment of neurotransmission which can be a cause for neuropsychiatric disorders. Furthermore, suppression of urges can lead to accumulation of waste materials inside the body creating various diseases.

On the second factor mentioned here, the correlation between having an intercourse with menstruating woman and getting afflicted with epilepsy needs to be researched further. Ayurveda strictly forbids sharing things with a menstruating woman, leave aside touching or having sexual relations with one. While there are reasons of following sacredness associated with this, sex with a menstruating woman is also indicative of exposure to unclean objects described earlier as the origin of ''apasmara''. The psycho-neuro-endocrinological axis behind this view of Sushruta needs to be explored.

Thus, from the above descriptions, etiopathological factors of ''apasmara'' can be categorized into dietary factors, lifestyle factors, psychological factors, behavioral factors and iatrogenic factors. All the above predisposing factors can be scanned for epigenetic modifications with respect to personality types, behavior patterns and occurrence of ''apasmara'' in such cases. This will be useful in identifying the disease at a primitive stage, breaking the pathogenesis at an intermedial stage and prevention of further deterioration and complications at later stage. There might be certain epigenetic patterns/changes due to the above mentioned etiological factors, which make the person more susceptible to get affected.

The above enlisted etiological factors cause depletion in psychological strength (objectively measured as Intelligence quotient (IQ) and Emotional Quotient (EQ). In the era of distress, it is important to know the etiology of a disease in order to prevent its harmful effects. In order to preserve and increase the psychological strength, one shall avoid the causative factors for ''apasmara''.
</div>

[[File:psycho-dynamics.png|500px|Fig.3: Psycho-dynamics in Apasmara ]]<br>
'''Fig.3: Psycho-dynamics in ''Apasmara'''''

[[File:pathogenesis.png|500px]]

[[File:pathogenesis part2.png|500px]]<br>
'''Fig.4: Satic presentation of pathogenesis of ''Apasmara'''''

==== Six stages of pathogenesis of epilepsy (''shatkriyakala'' for ''apasmara'') ====

===== ''Sanchaya'' =====
<div style="text-align:justify;">
The first stage of accumulation of pathogenic factors (vitiated ''doshas'') starts at their own sites. It is initiated right from the first exposure to unclean objects and other etiological factors mentioned earlier. This stage is characterized by mild disturbances in the psyche (''rajas'' and ''tamas'') and soma (''tridosha'').

===== ''Prakopa'' =====

If the individual excessively indulges in observing causative factors for a significant period, then the ''doshas'' proceed to the next stage of pathology i.e. ''prakopa''. The ''doshas'' are vitiated at their own site. In case of ''apasmara'', the doshas reside at the vessels, above the heart (the site of consciousness) in a leena (dormant) state.<ref> Agnivesha ,’Charak Samhita’, revised by Charak and Dridhbala with ‘Ayurveda Dipika’ commentary, by Chakrapanidatta, edited by Vaidya Jadavaji Trikamaji Acharya, Krishnadas Academy, Varanasi. reprint 2000. Chakrapani commentary Apasmara chikitsa 10/6.pg.475 </ref>

===== ''Prasara'' =====

Whenever the provocative emotional factors like worries, passion, anger etc. trigger these ''doshas'', the vitiated ''dosha'' moves upwards affecting the sense and locomotor organs. This will present the ''prasara avastha'' (stage of spread) of the disease.

===== ''Sthanasamshraya'' =====

Thereafter in ''sthanasamshraya avastha'' of ''apasmara'' (change in stage, triggering premonitory signs and symptoms), the stridden ''doshas'' take pathways of sense organs and locomotor organs alerting manifestation of the disease. This is called the aura stage of epilepsy.

===== ''Vyakta'' =====

Then, the ''vyakta'' i.e. manifestation stage of ''apasmara'' is apparent due to excessive aggravation of ''doshas''. The severity of paroxysms depends upon ''sharira bala'' (physical strength that helps do physical work as well as prevent manifestations of diseases, includes genetic predisposition as well), ''hetu'' (strength of causative agents depending upon their exposure) and ''sattva bala'' (strength of mind). The clinical manifestation will be a product of interactions between these factors. Common clinical features of the disease will start showing at this stage.

===== ''Bheda avastha'' =====

''Bheda avastha'' is the stage of differentiation depending upon the dominance of ''doshas''. This will predominantly depend upon the genetic constitution of the person as well as the intake of alleviators and pacifiers of that particular ''dosha''. If there are some pacification factors in between, then the progression of disease stops at that stage only blocking presentation of clinical features.
If we critically analyze and compare the pathophysiology, it can be observed that unlike modern research, the brain did not figure in Charak’s analysis of disease or their pathologic basis, nor did he emphasize the role of an exogenous or supernatural power (''agantuka'') factor in the causation of epilepsy. Charak has clearly mentioned heart, the abode of self and consciousness, as the origin for ''apasmara''. In the seizure state, ''doshas'' stride upwards through ''dhamanis'' (vessels), affecting the ''indriyas'' (sense and locomotor organs) leading to erratic movements and loss of consciousness. Sushruta and Vagbhata have specifically mentioned the ''samajnavahishu srotasu'' (channels of consciousness) as the pathway of spread of ''doshas'' and as a site for the disease.

As per Ayurveda, the heart (and not the brain), is the locus or abode of the mind, consciousness and soul , and emotional factors are considered as some of the root causes for triggering epilepsy. The clinical presentation of epilepsy represents the derangement of functions of neurons of central nervous system, but the origin of this derangement shall have been predisposed much earlier due to psycho-pathological factors enlisted above. The acute onset of seizure can be precipitated due to emotional factors. The mechanism of this phenomenon and exact psycho-neuronal pathways behind this are worthy of study.

''Prana vayu'' (''buddhi-hridaya-indriya-chitta dhruk'', i.e., regulation of intellect, heart, senses, mind functions), ''vyana vayu'' (seat at ''hridaya'' and regulating all types of movements), ''udana vayu'' (functions for energy and activities), ''sadhaka pitta'' (type of ''pitta dosha''), ''tarpaka'' (type of ''kapha'') and ''avalambaka kapha'' (type of ''kapha'') are important to be considered as patho-physiological factors in this context.

==== Types of ''Apasmara'' ====

There are four types of ''apasmara'' depending upon the predominance of ''dosha'' as shown in fig. 5. The first thing of significance is that all these are ''sharira doshas'' and not ''manasa doshas''. This implies that apasmara is predominantly a somatic disease in which psychological factors play a role in pathogenesis. The important aspect of management should be focused at the somatic level supported by psychotherapy. The role of genetic constitution is important in the study of clinical manifestations of ''apasmara'' as well as their response either to treatments involving allopathic anti-epileptic medications or to Ayurvedic treatment modalities. The diagnosis of dominance of ''dosha'' is also important in deciding the treatment modalities prescribed in cases of ''apasmara''. The epigenetic variation of the four types of ''apasmara'' and the categorization of etio-pathological factors to lead the epigenetic modification resulting into specific type of ''apasmara'' is worthy of study.

===== ''Agantu Apasmara'' =====

Chakrapani comments that ''Agantuka'' i.e. exogenous type of ''apasmara'' is excluded unlike ''unmada''. Thus Chakrapani rules out the possibility of external factors like ''deva, graha'' etc. to cause ''apasmara'' and emphasizes the endogenous patho-physiology of ''apasmara''. Charak describes the possibility of exogenous factors affecting the individual to suffer from ''apasmara'' in a verse described later. The management of ''apasmara'' due to exogenous factors is similar to that described in the management of ''agantuja unmada''.

===== ''Skanda graha'' and ''Skandapasmara'' =====

Per Ayurveda, children get afflicted by ''apasmara'' due to the effects of any of ''grahas'' (Sanskrit, means seizing) such as ''skandapasmara'' (due to the effects of ''graha''<ref> Sushruta, ‘Sushruta Samhita’, edited by Vaidya Jadavaji Trikamaji Acharya and Sharma PV, Eighth edition, Chaukhamba Orientalia, Varanasi; 2005 Uttara tantra 27/ 8-9.pg.659 </ref> <ref>Vagbhata, Ashtanga Hridayam, with the commentaries, ‘Sarvangasundara’ of Arunadatta and ‘Ayurvedarasayana’ of Hemadri collated by Dr.Anna Moreshvara Kunte, and Krishna Ramachandra Shastri Navre, edited by Pt. Harishastri Paradakar Vaidya, Krishanadas Academy, Varanasi. Reprint 2000.3/6-11.pg.786-7 </ref>.), ''skanda'', etc. knowledge of features of nine evil spirits which seize children is described, ''skanda'' and ''skandapasmara'' are the first two evil spirits which when affect a child, the clinical presentation is similar to that of epilepsy as narrated below.

A child seized by ''skanda graha'' has swelling of the eyes, smells like blood, has aversion to the breasts, distorted face, and eyelids or one eye having either loss of movement or more movements. The child could also be restless or irritable, have closed eyes, cry very little, hold its fists tight, and have hard bowel movement.

When the child is seized by ''skandapasmara'', it loses and regains consciousness, is irritable, makes dancing like movements with arms and legs, eliminates stools and passes urine accompanied with sound (crying), yawns more and emits froth from the mouth. These are the features of a child seized by the “friend of skanda graham”, i.e., ''skandapasmara''.

Similar to this, Vagbhata in Ashtanga Hridayam, has described the variants of the disease caused due to demons/evil spirits possessing the children. The cardinal signs of ''graha'' possession (or affliction) include continuous fever and crying. The general features are fear, too much yawning, movement of eyebrows, timidity, discharge of froth from mouth, upward gaze, biting of lips and teeth (grinding), wakefulness (absence of sleep), crying, moaning, aversion for the breast, change of voice, and scratching its own body or that of the mother by nails without any reason.<ref> Ibid Ashtanga Hrudayam Uttar Sthana.3/3-5. pp.786 </ref>

In conventional medicine, epilepsy in children is described in detail. However, the etiology of some variants of epilepsy is mentioned to be idiopathic. As described in context of ''skanda'' and ''skandapasmara'', the involvement of supernatural powers in causing ''apasmara'' is a matter of debate and falls in the purview of theology. Considering its importance and prevalence, ''apasmara'' of unknown etiology can be categorized as of the fifth type i.e. ''agantu apasmara''. Sushruta and his commentator Dallhana support this view that any variant of the disease which occurs without any reason, acutely and without any rational pathology shall be considered as ''agantu''. Per Charak [Chikitsa 10/53], the etiopathology, clinical features and management of this fifth type are on the lines of ''agantu unmada''. As commented by Chakrapani, in case of ''agantu'' or ''bhutapasmara'', the etiology of being seized by some external factors is considered primary and the involvement (''anubabdha'') of ''dosha'' as secondary. It is important to note here that since clinical patho-physiology cannot take place without the involvement of ''doshas'', therefore ''agantu'' should technically be considered as one of the four doshic variants of ''apasmara'' mentioned earlier, in order to follow the ''sankhya niyam''a i.e. rules of numeral classification.

==== Premonitory signs of ''apasmara'' ====

The table 1 depicts the premonitory signs of ''apasmara'' described in the Ayurvedic texts. Each sign has a specific patho-physiology in terms of ''dosha'' and ''dushya'' behind its manifestation. The enlisted signs are the alerting signals or premonitory symptoms of ''apasmara'' before the onset of seizures. The probable system involved as per conventional medicine is also enlisted for every sign, so that it would be easier to consider the pathophysiological similarities and differences between the two medical streams.
</div>

{| class="wikitable"
! rowspan="1"| Pūrvarūpā
! rowspan="1"| Translation
! rowspan="1"| Dosha
! rowspan="1"| Dushya
! rowspan="1"| System involved
|-
! Bhrūvyudāsa
| abnormal / twitching of eyebrows || vata – rajas || majja || nervous system [NS]
|-
! Satatam akshi vaikrutam
| constant abnormal/ irregular movements of eyes || vata – rajas || majja || NS
|-
! Ashabda shravanam
| auditory hallucinations || vata –rajas || manas || NS, psychiatric disorder
|-
! Lala prastrava
| excess secretion of saliva || kapha || rasa || NS, digestive system[DS]
|-
! Singhanaka prastrava
| excess nasal mucus discharge || kapha || rasa ||NS, respiratory system
|-
! Anannabhilashanam
| lack of appetite || kapha- Pitta || rasa || DS, NS
|-
! Arochaka
| aversion to food and drinks [anorexia] || Kapha –pitta –vata || rasa || DS, Psychiatric disorder
|-
! Avipaka
| indigestion || pitta || rasa || DS, NS
|-
! Hridaya graham
| heavyness of precordium/ congestion/ constriction in cardiac region || kapha, vata || mamsa,majja || NS, musculo skeletal system,
|-
! Kukshe aatopa
| puffiness/ swelling in the hypogastric region || vata, kapha || rasa, purisha, mutra || DS, urinary system
|-
! Daurbalyam
| debility, loss of strength || kapha, vata || rasa, mamsa, majja || NS, musculoskeletal system
|-
! Asthibheda
| splitting / breaking [pain] sensation in bones || vata || asthi, majja || skeletal system
|-
! Angamarda
| generalized bodyache/ twisting/churning pain in body || vata || mamsa, majja || musculo-skeletal system, NS
|-
! Moha
| confused state of mind [leading to lack of knowledge] || vata, kapha, Tama || rasa, majja || NS, psychiatric disorder
|-
! Tamas darshanam
| black outs / temporary loss of vision without alteration in consciousness || pitta, vata || rasa- rakta-majja || cardio-vascular/ cerebro vascular system, NS
|-
! Murchcha
| syncope / a fatal condition characterized by loss of consciousness and postural tone due to vitiation of blood || pitta, kapha || rasa, rakta, majja || cardio-vascular/ cerebro vascular system, NS
|-
! Abhikshnam Bhrama
| frequent vertigo/ dizziness || pitta, vata, rajas || rasa, rakta, rajas || cardio-vascular/ cerebro vascular system, NS, psychiatric disorder
|-
! Swapne cha || ! colspan="4" | In dreams
|-
! Mada
| slight intoxication, becoming out of senses showing uncanny or abnormal behaviour || rowspan="6" | vata, rajas, kapha || rasa, rakta, manas || rowspan="6" | Cardio-vascular/ Cerebro vascular system, NS, psychiatric disorder
|-
! Nartana
| dancing || majja
|-
! Vyadhana
| needling like sensation || majja
|-
! Vyathana
| pain || majja
|-
! Vepana
| tremors || majja
|-
! Patanadini
| falling etc. || rasa-rakta,
majja
|-
|}

<div style="text-align:justify;">
The abovementioned pre-clinical features are observed in the fourth stage of ''shatkriyakala'' (pathogenesis). These may be considered as aura in ''apasmara'' patients. These are important in view of prevention of ''apasmara'' progression to epileptic seizure. In conventional medicine text books, some of the above signs like auditory and visual hallucinations are referred. These signs need to be searched upon for their prevalence, categorization as per ''dosha'' dominance, involvement of ''dosha'' attributes in order to establish precise guidelines for early prevention and management of disease.
</div>
Table 2: Differentiation between types of apasmara

{| class="wikitable"
! rowspan="1"| Characteristic feature
! rowspan="1"| Vataja Apasmara
! rowspan="1"| Pittaja Apasmara
! rowspan="1"| Kaphaja Apasmara
|-
! Frequency of attacks
| Maximum [Twelve days] || More [Fifteen days] || Less [One Month]
|-
! Time required to lose consciousness
| Minimal || Less || More
|-
! Time required to regain consciousness
| Minimal || Less || More
|-
! Duration of attack
| Minimal || Less || More
|-
! Clinical appearance of nails, eyes [sclera],face and skin
| Aruna[ downy red], Shayva[gray] , parusha [rough] || Peeta [yellowish], harita [Greenish], Haridra [ turmeric yellow], Tamra [ coppery] || Shukla [whitish/ pallor]
|-
! Patient experiences aura of / vision of / views of
| Anavasthita [unstable], Chapal [Moving/fickle] parusha [rough], Ruksha [Dry] Rupa [ looking objects] Vikrutananam [abnormal faces] [AH] || Rudhirokshita [ blood], bleeding, terrifying (which is also injurious) Bhairava [frightful], Aadipta [burning] and Rushita [angry] looking objects || Shukla[ white], Guru [ heavy / large in size], Snigdha [ unctuous]
looking objects
|-
! rowspan="3" | Clinical picture of abnormal movements
| Vishama Vinata Angulim [irregularly contracted fingers || rowspan="3" | Not given specifically || Anati cheshtam [ not more movements/ less movements]
|-
| Anavasthita pani Padam [ instable or continuous shaking of upper and lower limbs] || rowspan="2" |Alpa Cheshtam [less abnormal movements ] [AH]
|-
| Parito Vikshipati Angam [ places body parts here and there irregularly/ involuntary movements] [AH]
|-
! Character of discharge from mouth
| Phenam [froth] || Not mentioned specific || Lalam Bhuyasi [excess saliva discharge]
|-
! Temperature of body
| Not specific || Tapa [rise in temperature/ hyperthermia] [Su] || Sheeta Anga [cold body/hypothermia] [Su]
|-
! rowspan="12" style="vertical-align: top;" | Other Specific features
| Utpinditaksham [ bulging of eyes/ upside rolling of eyes] || Avakujantam [epileptic cry] || Patantam [falling down]
|-
|rowspan="2" |Asamna Vilapantam [incoherent speech] || Aasphalayantam Bhumim [rubbing earth] || Hrullas [nausea] [Su]
|-
| Trushna [excess thirst] || Nidrarta [excess sleep] [Su]
|-
| Ateeva aadhmatgreevam [excess heaviness and rigidity in neck region] || Sweda [excess perspiration] [Su] ||
|-
| Aavidhdha Shiraskam [bending of head towards one side] || Murchcha [ syncope] [Su] ||
|-
| Kampate [ trembling/convulsions] || Dhunvan Angani [shakes all body parts] [Su] ||
|-
| Vepamano [ tremors] || Vivhala [agitated] [Su] ||
|-
| Dantan pradashet [grinding of teeth] || ||
|-
| Shwasiti [increased respiration/ dyspnea] || ||
|-
| Sakthi Sphurana [contraction like sensation in thigh region] || ||
|-
| Viswaram [epileptic cry] [AH] || ||
|-
| Virupam [AH] || ||
|-
|}
Su: As described by Sushruta in Sushruta Samhita AH: As described in Ashtang Hridaya
<div style="text-align:justify;">
The specific features of all the four types of ''apasmara'' are described in Table 2. ''Vata'' type of ''apasmara'' manifests itself with repeated seizures of short duration and increased frequency of attacks. The speed, severity and abnormality of movements are more in this case. This is due to ''chala'' (movable), ''laghu'' (light), and ''sukshma'' (minute) attributes of ''vata dosha''. ''Vata'' is the initiator of all activities including those of the body and the mind. The regulation and coordination of the sequence of sense and locomotor organs – mind-intellect-soul for attainment of knowledge is performed by ''vata''. ''Prana vata, udana vata'' and ''vyana vata'' are involved in the pathophysiology of ''apasmara''. The clinical manifestation of ''vataja'' ''apasmara'' may be due to repeated, excess, hyposynchronous discharges in neurons of the central nervous system. Transient hypoxia leading to dysregulation of brain functioning, and neurological diseases similar to epilepsy syndromes can be categorized under this type of ''apasmara''.

In ''pitta apasmara'', the frequency, duration of paroxysms will be comparatively less than those observed in ''vata'' type. The ''ushna'' (hot) and ''tikshna'' (acrid) attributes of ''pitta'' are responsible for the pathology of paroxysms. ''Sadhaka pitta'' located at the heart and the functions responsible for accomplishment of activities are responsible for this ''apasmara''. ''Tamahpravesha'' is a sign primarily of ''pitta''-dominance in which metabolism or transformation at the cellular level might be an underlying pathology. Derangement of ''sadhaka pitta'' implies the decrement or depletion in psychological performance in ''apasmara'' patients. Since ''pitta'' is responsible for all metabolic activities, the derangement of metabolism at the cellular level is an important pathological factor and the enzymatic pathways might be held responsible. The types of epileptic syndromes originating due to metabolic disorders like hepatic encephalopathy can be categorized under this type. Changes in body temperature, excess thirst, and perspiration are specific differentiating features of ''pitta apasmara''. The cerebral conditions due to derangement of metabolisms can be enlisted here.
In cases of ''kaphaja apasmara'', the ''sthira'' (stable), ''manda'' (slow), and ''snigdha'' (unctuous) attributes of ''kapha'' are responsible for delayed onset, prolonged duration as well as minimal frequency of paroxysms in ''apasmara''. Excessive sleep and hypothermia specifically suggest ''kaphaja apasmara''. Hypoperfusion and hypovolemic conditions leading to cerebral dysfunction can be considered as attributes of ''kaphaja apasmara''.

Finally, the ''sannipatika'' type of ''apasmara'' presents itself with complex mixed features due to overlapping of all ''doshas''. The prognosis is poor leading to incurability of disease. This might be a mixed presentation of neuronal, endocrinal, circulatory and metabolic pathways.

While considering the clinical pictures of a disease, the attributes of ''doshas'' responsible for variation in pathologies at somatic and psychological level should be emphasized. Important mechanisms of loss of consciousness and abnormal movements at the somatic level, and impairment of intelligence and memory at psycho-pathological levels needs to be focused. The epigenetic patterns related to particular signs and symptoms originated from ''doshic'' pathologies can be researched to reveal new treatment methods and management aspects. The genetic constitution of a person plays a significant role in making him prone to developing certain type of disorders. Therefore, as discussed above for ''vata apasmara'' can become more apparent after taking ''vata''-aggravating diet and lifestyle in ''vata prakriti'' individuals that can get alleviated by using ''vata shamana'' (i.e., ''vata''-pacifying) diet and lifestyle. Furthermore, if anti-epileptic drugs are used more judiciously depending upon the ''dosha'' and ''prakriti''-specific diagnosis, then the treatment regimen can be made much more precise leading to beneficial results in patients. As discussed in the section of predisposing factors, the preventive lifestyle and dietary regimens can be designed to prevent incidence of epilepsy, reduce the dose of drugs with supportive diet and lifestyle therapy and prevent further progression of disease. Therefore, training of epileptics regarding causative and avoidable factors is of utmost importance. The epigenetic variations in epileptics due to enlisted causative agents should be studied as a part of genomic and proteomic research.

==== Differential diagnosis of ''apasmara'' ====

Other disorders such as ''mada'' (intoxication) and ''murchcha'' (syncope) also show the signs of loss of consciousness, but ones without convulsions. In ''unmada'', there is impairment of ''buddhi'', and it does not manifest itself with loss of consciousness. ''Akshepa'' (abnormal movements) is a ''vata''-predominant disease characterized with convulsions, but the consciousness is intact and there is no froth discharge. This makes ''apasmara'' a distinct disease apart from other disorders.

==== Prognosis of ''apasmara'' ====

Epilepsy due to vitiation of all the three doshas and showing all clinical features of the ''sannipatika'' variant (i.e., of all the other three ''doshic'' variants) is chronic in nature and that, which has occurred in a person with excess degenerative condition and depleted ''dhatus'', is considered incurable. In case of degenerative conditions and chronic diseases, any case of ''apasmara'' due to vitiation of even a single ''dosha'' can be considered incurable.

Bad prognostic signs of ''apasmara'' patients can often turn fatal. If one, in his wakeful state sees darkness where there is no darkness and hears all types of sound even when there is no sound, he succumbs to ''apasmara''. If a patient, while dancing in an intoxicated state is caught by a ''preta'' (soul of a dead person) with his head facing downwards, he is sure to succumb to an attack of ''apasmara''.

==== Reasons behind aggressive and dormant stages of ''apasmara'' ====

From the above sections, it is clear that ''apasmara'' occurs in episodes. The patient after seizure regains consciousness like waking up from sleep (''suptavat pratibuddhyate''). Therefore, there are two stages of disease : one is aggressive stage of ''doshas'' and the second is dormant stage of ''doshas''. Sushruta describes that there are two forms of pathogenesis: One form follows the six stages viz. ''sanchaya'' etc.(''kramopayogad'') of the disease in sequence and takes considerable time to manifest disease with gradual onset. The other form manifests acutely in a short time (''kshanikatwat''). The first form is seen in ''nija'' (endogenous) pathologies of disease. The other form is seen in ''agantu'' (exogenous) ''apasmara''. Sushruta gives examples of a seed in the ground that sprouts only during ''sharad ritu'' (autumn) though it rains at other times. Analogous to this example, the virulent form of the disease develops due to a ''dosha'' getting aggravated in very short time and manifesting its different symptoms due to some factors catalyzing the accelerated aggravation. It is quite clear from the detailed descriptions in this chapter, though, that all forms of ''apasmara'' are caused by ''dosha'' only.<ref> Ibid Sushruta Samhita Uttar Tantra 61/18-21.pp.800-801. </ref>

The example states the fact that favorable environment for precipitating factors plays major role in diseases episodes. Depending upon the defense system of the body – its natural and acquired immunity - as the background for disease and factors aggravating the ''dosha'' as offending agents, the interaction between the two defines severity, intensity and frequency of occurrence of episodes of disease as shown in chart below.
[[File:mainfastation.png]]<br>
Therefore, for prevention and management of a disease, it is important either to build up the strength of defense system i.e. improving the ''sharira bala'' (physical strength) and ''sattva bala'' (mental strength), or pacify/weaken the aggravating causative factors or both.

==== Management of ''Apasmara'' ====

Although the management of ''apasmara'' is described further in [[Chikitsa Sthana]], principles of management are given in this chapter. The curable types of epilepsy should be carefully treated with strong elimination and alleviation therapies according to the vitiated dosha. ''Doshas'' present in the vessels above the heart need to be removed which require strong measures requiring medicines having higher penetrability, higher potency and highest bio-availability. With this objective, ''tikshna samshodhana'' (strong elimination) and ''samshamana'' (alleviation therapies) are employed. When extrinsic causative factors are involved (''agantu apasmara''), then ''mantras'' etc., will be useful.

The rationale behind advocating strong elimination therapies is the deeper location and excess vitiated state of ''doshas''. As described in patho-physiology earlier the ''dosha'' are in dormant state in the vessels above heart. Therefore to remove these ''dosha'', strong eliminatory therapies are needed. The strength of the prescribed medicine is decided by their higher penetrability, potency and bio-availability.

==== Practical application of principles ====

All the abovementioned principles are practically applicable. The methods for further research include the following:

#Supporting the clinical presentation with data of research papers on survey studies
#Preparing Checklist and proforma for
##Diagnosis of states susceptible for suffering from ''apasmara''
##Diagnosis of aura stage or premonitory stage of ''apasmara'' for early identification of status epilepticus in order to train the patient and arrange necessary preventive measures
#Diagnosis of ''apasmara'' and specific types of ''apasmara'' based on clinical presentation

==== Research areas ====

#Evaluation studies of various epigenetic pathways in conjunction with the patho-physiology of ''apasmara''
#Clinical correlation with modern radiological investigations like CT etc. and EEG for better clinical diagnosis of ''apasmara''
#Enlisting newly introduced disease commonly observed in society into the umbrella of ''apasmara'' e.g. Alzheimer’s dementia, depression etc.
#Retrospective analyses of all signs and symptoms enlisted in the modern text books and formulating probable ''samprapti'' / pathophysiology (''dosha-dushya sammurchchna'') based on ''dosha'' dominance behind manifestation of each sign and symptom can be formulated for better understanding in Ayurvedic perspective.
#Assessment criteria in Ayurveda and modern science, modern investigation methods and technologies, biomarkers which are well established may be enlisted.

==== Research works done on apasmara at post graduate/post doctoral level: ====

'''Institute for Post Graduate Teaching & Research in Ayurveda, Gujarat Ayurved University, Jamnagar, Gujarat, India.'''

1. Pandya M.B. Shukla C.P. Apasmara [A Treatise on Epilepsy].1962. P.G.Thesis.

2. Sutariya Bharati.A Clinical Study on the role of Rasayana Drugs in the management of Apasmara.1988. P.G.Thesis.

3. Usha K.S. Singh Gurdip. A Clincal Study on Apasmara [Epilespy] & its management with Maha Panchagavya Ghrita. 2001.P.G.Thesis.

'''Faculty of Ayurveda, Banaras Hindu University, Varanasi:'''

4. Dwivedi KK. A Clinicalstudy of Medhya Rasayana therapy in Apasmara.1989. PG thesis.

'''SDM Hassan:'''

5. Shetty Suhas Kumar. A comparative study of Brahmi Ghrita as Shamana & Brumhana sneha in Apasmara.2001-02
6. Unni G. Effect of Kushmanda Ghrita in Apasmara.2002.

'''National Institute of Ayurveda, Jaipur :'''

7. Bhatnagar P. Antardhooma evum Bahirdhooma Tamra sindoora kalpana evum Apasmara Roga par Prabhavatmaka Adhyayana. 1992.

8. Sharma U.K. Apasmara me Samshodhana poorvaka Vacha Churna evum Smritisagar Rasa ka Chikitsatmaka Adhyayana.1999.

'''Ayurveda College, Mysore:'''

9. Yatheesha HN. To evaluate the effect of Brahmi Ghrita & Vacha choorna in the management of Apasmara- A controlled clinical study. 2003.

'''Shri Ayurveda College, Nagpur, Maharashtra :'''

10. Potbhare SM.Comparative Clinical study of role of Saraswata Churna in Apasmara.1995.

'''Tilak Ayurveda Mahavidyalaya, Pune, Maharashtra:'''

11. Kuber Asmita. Apasmara grandhokta hetu va pratyakshataha adhalanare hetu yancha taulanika Abhyasa. 2000.

'''Trivendrum:'''

12. Nagarajan C. Apasmara & its management- A critical study. 1991.

13. Manju GL. Efficacy of Kushmanada Swarasa ghrita in Apasmara.2003.

14. Murthy Niranjan.Aetio-pathogenesis and principles of management of Apasmara. 1999.

15. Indukala PR. A classical study on Majja in relation with the manifestation of Apasmara. 2003.

'''Reference books on Manasa Roga further reading:'''

1. Thakar VJ. Man ane Manas Roga

2. Singh RH. Ayurvediya Manasa Roga Vijnana.

3. Pathak Balakrishna. Ayurvediya Bhutavidya Vivechana

4. Murthy ARV. Rationale of Ayurvedic Psychiatry.

5. Murthy ARV. Mind in Ayurveda and Indian traditions.

6. Gupta SP. Psychopathology in Indian Medicine.

7. Nanal Ramesh. Mana Ani Ayurveda.

==== Research papers published ====

• Mervyn j. Eadie. Peter f. Bladin. John libbey. A disease once sacred. A history of the medical understanding of epilepsy. Brain (2002) 125 (2): 441-442.

• Manyam BV. Epilepsy in ancient India. Epilepsia. 1992 May-Jun;33(3):473-5.

• Manyam BV. Dementia in Ayurveda. J Altern Complement Med. 1999 Feb;5(1):81-8.

• Ven Murthy MR, Ranjekar PK, Ramassamy C, Deshpande M. Scientific basis for the use of Indian ayurvedic medicinal plants in the treatment of neurodegenerative disorders: Ashwagandha. Cent Nerv Syst Agents Med Chem. 2010 Sep 1;10(3):238-46.

• Singh R.H., Murthy A.R.V. Medhya Rasayana Therapy in the management of Apasmara Vis-A-Vis Epilepsies. The Journal of Research and Education in Indian Medicine.1989.8 [1]:13-16.

• Dwivedi K.K. & Singh R.H. A Clinical Study of Medhya Rasayana Therapy in the management of Convulsive Disorders. Journal of Research in Ayurveda and Siddha.1992:13[3-4]: 97-106.

• Geetha L, Shetty S K, Prakash N B. A Randomized Control Trail of Brahmi Gritha In Apasmara With Reference To Generalized Tonic Clonic Seizures. 4th World Ayurveda Congress and Arogya Expo proceedings Pp. 135-136, 9-13 December 2010, Bengaluru, Karnataka, India.

• M.H. Hakim, M.M.H. Siddiqui. A.B. Khan. Anti-epileptic activity of Ustukhudus (Lavandula stoechas) – In a case of secondary epilepsy (A Case Report). Hamdard Medicus.1991.34[ 3] 33-39.

• Hakim M.H. Siddiqui, M.M.H. Siddiqui, A. Ismail, S.A.H. Jafri. Secondary (Symptomatic) epilepsy, an uncommon presentation. The Antiseptic.May 1991. 88[5].231-233.

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===References===
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Unmada Nidana

2019-03-06T03:50:42Z

Pallavmishra:

{{Infobox
|title = Unmada Nidana
|label1 = Section/Chapter
|data1 = [[Nidana Sthana]] Chapter 7
|label2 = Preceding Chapter
|data2 = [[Shosha Nidana]]

|label3 = Succeeding Chapter
|data3 = [[Apasmara Nidana]]
|label4 = Other Sections
|data4 = [[Sutra Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

==[[Nidana Sthana]] Chapter 7, Unmada Nidana (Chapter on diagnosis of psychosis disorders)==

=== Abstract ===
<div style="text-align:justify;">
The seventh chapter of [[Nidana Sthana]], titled [[Unmada Nidana]], describes the detailed etiopathogenesis and types of ''unmada'' a large class of major mental disorders or psychoses. ''Unmada'', in Sanskrit, literally means frenzy, madness or mental derangement. Thus, ''unmada'' is characterized by a disordered mental state in the faculties of ''manas'' (thought processes), ''buddhi'' (decision making and intelligence), ''sanjna jnana'' (orientation and responsiveness/ consciousness), ''smriti'' (memory), ''bhakti'' (desire), ''sheela'' (habits and character), ''cheshta'' (psychomotor activity ) and ''achara'' (conduct and behaviour). For the clinical diagnosis of ''unmada'', its etiology, psychopathogenesis, and prodromal features have been elaborately described in this chapter.

'''Keywords''': ''Unmada, Sanjna Jnana, Amarsha, himsa, Prajnaparadha'', Psychosis, insanity, mental factors examination.
</div>
=== Introduction ===
<div style="text-align:justify;">
''Unmada'', a major mental disorder, has been known to Ayurvedic practitioners since ancient times in India. In the Vedic period, the disease was thought to be caused due to ''grahas'' or demons, but in Ayurveda, it is considered a major mental illness. ''Unmada'' as such does not describe a lone clinical entity comparable to a modern diagnostic category, rather it is a group of psychotic disorders. As the psychotic disorders cover almost all the major mental illnesses, the different types and subtypes of ''unmada'' can be separately correlated with different psychotic disorders. The clinical features of the different types of ''unmada'' resemble various types of schizophrenia, manic psychosis, psychotic depression, and depressive disorders.

Thus, ''unmada'' covers a wide range of major mental disorders and is considered synonymous with madness and mental derangement, in which a person loses contact with reality and loses the ability to regulate his actions & conduct according to the norms of the society. When ''doshas'' move upwards in the body into the head, they could cause aberrations in the functioning of ''manas''(mind) while producing ''mada'' (delusional/ intoxicated state) in an individual. The mental status of psychotic patients is vividly described while explaining the clinical aspect of the disease. The description suggests that a patient of ''unmada'' develops derangement of all the activities of ''manas''(mind), ''buddhi''(intellect), ''ahamkara''(ego) and ''indriyas'' (sense organs). The patient develops thought disturbances in the form of abnormalities of ''chintana''(thinking), ''vichara''(discriminating) and ''uha''(analyzing), derangement of memory in the form of ''smriti nasa'' (memory loss.) and ''smriti bhramsha'' (memory impairment), behavioral, social and emotional disturbances in the form of abnormalities of ''achara, dharma'' and ''bhavas'' along with functional derangement of ''indriyas'' which is manifested clinically as disturbed speech and other variants such as incoherence (''abaddha vakyam''), thought blocking (''hridaya shunyata''), loosening of associations, neologism, echolalia etc. and various psychomotor disturbances.

''Unmada'' is classified into two broad categories: ''nija''(endogenous), or those caused by internal imbalance of ''dosha'' i.e. ''vata'', ''pitta, kapha'' and ''sannipataja'', and ''agantu nimitta'', i.e., those caused by exogenous factors. Sushruta (S. ut.62/4-5) and Vagbhatta - both are of the opinion that ''unmada'' is of six types, of which four are due to ''doshas'', the fifth is ''madyaja'' (like intoxications) and sixth is ''vishaja'' (poison-based or poison-like). Both have described the ''agantuja unmada'' separately as the condition of ''amanushopasarga'' (due to affliction of supra-human power) and ''bhuta badha'' (due to affliction of demons), under the heading ''amanusopasarga pratishedha'' (treatment of affliction of supra-human power) and ''bhuta badha pratisedha'' (treatment of affliction of demons) respectively. The body of knowledge within Ayurveda dedicated to psychiatry underscores the advancement in scientific knowledge on this subject that existed thousands of years ago.
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===Sanskrit Text, Transliteration and English Translation===

अथात उन्मादनिदानं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athāta unmādanidānaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAt UnmadaanidAnaM vyAkhyAsyAmaH||1||

Iti ha smAha bhagavAnAtreyaH||2||

I shall now describe the chapter on the diagnosis of ''unmada''. Thus said Lord Atreya.[1- 2]

==== Five types of ''unmada'' ====

इह खलु पञ्चोन्मादा भवन्ति|

तद्यथा- वातपित्तकफसन्निपातागन्तुनिमित्ताः||३||

iha khalu pañcōnmādā bhavanti|

tadyathā- vātapittakaphasannipātāgantunimittāḥ||3||

Iha Khalu pa~jconmAdA bhavanti|

tadyathA- vAtapittakaphasannipAtAgantunimittAH||3||

There are five types of ''unmada'' such as those caused due to the three ''doshas, sannipata'' (simultaneous vitiation of the three ''doshas''), and exogenous causes. [3]

==== Individuals prone to ''unmada'' ====

तत्र दोषनिमित्ताश्चत्वारः पुरुषाणामेवंविधानां क्षिप्रमभिनिर्वर्तन्ते; तद्यथा- भीरूणामुपक्लिष्टसत्त्वानामुत्सन्नदोषाणां समलविकृतोपहितान्यनुचितान्याहारजातानि वैषम्ययुक्तेनोपयोगविधिनोपयुञ्जानानां तन्त्रप्रयोगमपि विषममाचरतामन्याश्च शरीरचेष्टा विषमाः समाचरतामत्युपक्षीणदेहानां व्याधिवेगसमुद्भ्रमितानामुपहतमनसां वा कामक्रोधलोभहर्षभयमोहायासशोकचिन्तोद्वेगादिभिर्भूयोऽभिघाताभ्याहतानां वा मनस्युपहते बुद्धौ च प्रचलितायामभ्युदीर्णा दोषाः प्रकुपिता हृदयमुपसृत्य मनोवहानि स्रोतांस्यावृत्य जनयन्त्युन्मादम्||४||

tatra dōṣanimittāścatvāraḥ puruṣāṇāmēvaṁvidhānāṁ kṣipramabhinirvartantē; tadyathā- bhīrūṇāmupakliṣṭasattvānāmutsannadōṣāṇāṁsamalavikr̥tōpahitānyanucitānyāhārajātāni vaiṣamyayuktēnōpayōgavidhinōpayuñjānānāṁ tantraprayōgamapi viṣamamācaratāmanyāśca śarīracēṣṭā viṣamāḥsamācaratāmatyupakṣīṇadēhānāṁ vyādhivēgasamudbhramitānāmupahatamanasāṁ [1] vākāmakrōdhalōbhaharṣabhayamōhāyāsaśōkacintōdvēgādibhirbhūyō'bhighātābhyāhatānāṁ vā manasyupahatē buddhau ca pracalitāyāmabhyudīrṇā [2] dōṣāḥprakupitā hr̥dayamupasr̥tya manōvahāni srōtāṁsyāvr̥tya janayantyunmādam||4||

Tatra doṣanimitta scatvarah puruShANAm evaMvidhAnAM KShipramabhinirvartante; tadyathA ---bhIrUNAmupakliShTasattvAnAmutsannadoShANAMsamalavikRutopahitAnyanucitAnyAhArajAtAnivaiShamyayuktenopayogavidhinopayu~jjAnAnAM tantraprayogamapi viShamamAcaratAmanyAshcaharIraceShTA viShamAHsamAcaratA matyupakShINadehAnAM vyAdhivegasamudbhramitAn AmupahatamanasAMvA kAmakrodhalobhaharShabhayamohAy AsashokacintodvegAdibhirbhUyo~abhighAt AbhyAhatAnAM vA manasyupahate
buddhau ca pracalitAyAmabhyudIrNA doShAH prakupitAhRudayamupasRutya
manovahAni srotAMsyAvRutya janayantyUnmadaam||4||
tatra doShanimittAshcatvAraH
<div style="text-align:justify;">
This verse describes the qualities of a person prone to getting afflicted with ''unmada'', as well as the conditions that are conducive to the affliction of the disease:

*Four types of ''doshika unmada'' quickly manifest in individuals who are fearful, confused and complicated, who do not know societal rules and norms, and who lead erratic lifestyles and dietary habits (unclean, unwholesome, untimely eating habits, as well as neglecting any prescribed dietetic rules). ''Doshas'' in such individuals are in a volatile state and are prone to getting vitiated.
*Resorting to specific lifestyle activities that are not conducive to good health, especially when
**the body is exceedingly weak & cachexic;
**the person is ailing from various diseases;
**the mind is afflicted repeatedly by desires, anger, greed, excitement, fear, attachment, exertion, anxiety and grief; and
**the person is subjected to excessive mental trauma / physical assault.

Such individuals often get afflicted with subclinical mental disorders, leading to unstable intellect because of volatile ''doshas''. When the seat of consciousness, wisdom, and the system that regulates mental activities are badly affected, then all these factors lead to the manifestation of ''unmada''. [4]
</div>

==== Types of cognitive distortions ====

उन्मादं पुनर्मनोबुद्धिसञ्ज्ञाज्ञानस्मृतिभक्तिशीलचेष्टाचारविभ्रमंविद्यात्||५||

unmādaṁ punarmanōbuddhisañjñājñānasmr̥tibhaktiśīlacēṣṭācāravibhramaṁ [1] vidyāt||5||

Unmadaam punarmanobuddhisa~jj~jAj~jAnasmRutibhaktishIlaceShTAcAravibhramavidyAt||5||

''Unmada'' is again defined as cognitive distortion pertaining to mind, intellect, consciousness, knowledge, memory, desire, attitude, activities and behavior. [5]

==== Premonitory symptoms ====

तस्येमानि पूर्वरूपाणि; तद्यथा- शिरसः शून्यता, चक्षुषोराकुलता, स्वनः कर्णयोः, उच्छ्वासस्याधिक्यम्, आस्यसंस्रवणम्, अनन्नाभिलाषारोचकाविपाकाः, हृद्ग्रहः, ध्यानायाससम्मोहोद्वेगाश्चास्थाने, सततं लोमहर्षः,
ज्वरश्चाभीक्ष्णम् उन्मत्तचित्तत्वम्, उदर्दित्वम् अर्दिताकृतिकरणं च व्याधेः, स्वप्ने चाभीक्ष्णं दर्शनं भ्रान्तचलितानवस्थितानां रूपाणामप्रशस्तानां
च तिलपीडकचक्राधिरोहणं वातकुण्डलिकाभिश्चोन्मथनं निमज्जनं च कलुषाणामम्भसामावर्ते चक्षुषोश्चापसर्पणमिति(दोषनिमित्तानामुन्मादानां पूर्वरूपाणि भवन्ति)||६||

tasyēmāni pūrvarūpāṇi; tadyathā- śirasaḥ śūnyatā, cakṣuṣōrākulatā, svanaḥ karṇayōḥ, ucchvāsasyādhikyam, āsyasaṁsravaṇam, anannābhilāṣārōcakāvipākāḥ,hr̥dgrahaḥ, dhyānāyāsasammōhōdvēgāścāsthānē, satataṁ lōmaharṣaḥ, jvaraścābhīkṣṇam, unmattacittatvam, udarditvam [1] , arditākr̥tikaraṇaṁ ca vyādhēḥ, svapnēcābhīkṣṇaṁ darśanaṁ bhrāntacalitānavasthitānāṁ rūpāṇāmapraśastānāṁ ca tilapīḍakacakrādhirōhaṇaṁ vātakuṇḍalikābhiścōnmathanaṁ nimajjanaṁ cakaluṣāṇāmambhasāmāvartē cakṣuṣōścāpasarpaṇamiti [2] (dōṣanimittānāmunmādānāṁ pūrvarūpāṇi bhavanti)||6||

Tasyemani pUrvarUpANi; tadyathA- shirasaH shUnyatA, cakShuShorAkulatA, svanaH
karNayoH, ucchvAsasyAdhikyam, AsyasaMsravaNam, anannAbhilAShArocakAvipAkAH,
hRudgrahaH, dhyAnAyAsasammohodvegAshcAsthAne, satataM lomaharShaH, jvarashcAbhIkShNam,unmattacittatvam,udarditvamarditAkRutikaraNaM ca vyAdheH, svapne
cAbhIkShNaM darshanaM bhrAntacalitAnavasthitAnAM rUpANAmaprashastAnAM ca
tilapIDakacakrAdhirohaNaM vAtakuNDalikAbhishconmathana nimajjanaM ca
kaluShANAmambhasAm AvartecakShuShoshc ApasarpaNamiti (doShanimittAnAm UnmadaAnAM pUrvarUpANi bhavanti)||6||

Following are the premonitory symptoms of ''unmada'':

*Blankness of thought,
*Restless eyes,
*Tinnitus,
*Prolonged exhalation,
*Hyper-salivation,
*Disinclination towards food associated with anorexia and indigestion,
*Feeling of tightness in cardiac region,
*Uncalled for attention, fatigue, confusion and panic,
*Continuous horripilation,
*Frequent fever,
*Insanity,
*Erythematous rashes over the body,
*Distorted faces (as in Bell’s palsy or facial paralysis)
*Dreams with the following recurrent themes--
**Terrifying & inauspicious objects that are wandering, moving and unstable;
**Riding over the wheel of an oil press;
**Being churned by whirl-winds;
**Sinking in dirty whirl-pools; and
**Distortion of eyes.

These are the pre-monitory symptoms of ''unmada'' caused by the vitiation of ''doshas''. [6]

==== Specific features of ''vatika'' type ''unmada'' ====

ततोऽनन्तरमेवमुन्मादाभिनिर्वृत्तिरेव| तत्रेदमुन्मादविशेषविज्ञानं भवति; तद्यथा- परिसरणमजस्रम्, अक्षिभ्रुवौष्ठांसहन्वग्रहस्तपादाङ्गविक्षेपणमकस्मात्,सततमनियतानां च
गिरामुत्सर्गः, फेनागमनमास्यात्, अभीक्ष्णं स्मितहसितनृत्यगीतवादित्रसम्प्रयोगाश्चास्थाने, वीणावंशशङ्खशम्यातालशब्दानुकरणमसाम्ना, यानमयानैः, अलङ्करणमनलङ्कारिकैर्द्रव्यैः, लोभश्चाभ्यवहार्येष्वलब्धेषु, लब्धेषु चावमानस्तीव्रमात्सर्यं च, कार्श्यं, पारुष्यम्, उत्पिण्डितारुणाक्षता वातोपशयविपर्यासादनुपशयता च; इति वातोन्मादलिङ्गानि भवन्ति(१);

tatō'nantaramēvamunmādābhinirvr̥ttirēva|
tatrēdamunmādaviśēṣavijñānaṁ bhavati; tadyathā- parisaraṇamajasram, akṣibhruvauṣṭhāṁsahanvagrahastapādāṅgavikṣēpaṇamakasmāt [1] , satatamaniyatānāṁca girāmutsargaḥ, phēnāgamanamāsyāt, abhīkṣṇaṁ smitahasitanr̥tyagītavāditrasamprayōgāścāsthānē, vīṇāvaṁśaśaṅkhaśamyātālaśabdānukaraṇamasāmnā,yānamayānaiḥ, alaṅkaraṇamanalaṅkārikairdravyaiḥ, lōbhaścābhyavahāryēṣvalabdhēṣu, labdhēṣu [2] cāvamānastīvramātsaryaṁ ca, kārśyaṁ, pāruṣyam,utpiṇḍitāruṇākṣatā, vātōpaśayaviparyāsādanupaśayatā ca; iti vātōnmādaliṅgāni bhavanti(1);

tatredamUnmadaavisheShavij~jAnaM bhavati; tadyathA- parisaraNamajasram,
akShibhruvauShThAMsahanvagrahastapAdA~ggavikShepaNamakasmAt satatamaniyatAnAM
ca girAmutsargaH, phenAgamanamAsyAt, abhIkShNaM smitahasitanRutyagItavAditrasamprayogAshcAsthAne,vINAvaMshasha~gkhashamyAtAlashabdAnukaraNamasAmnA, yAnamayAnaiH, ala~gkaraNamanala~gkArikairdravyaiH,
lobhashcAbhyavahAryeShvalabdheShu,
labdheShu cAvamAnastIvramAtsaryaM ca, kArshyaM, pAruShyam, utpiNDitAruNAkShatA,
vAtopashayaviparyAsAdanupashayatA ca;
iti vAtonmAdali~ggAni bhavanti(1);
<div style="text-align:justify;">
After the above stage, ''unmada'' manifests. The distinctive features of ''vatika'' type of ''unmada'' are as follows:
*Constant wandering
*Sudden spasm of eyes, eyebrows, lips, jaws, and irregular movements of shoulder, fore-arms and legs;
*Continuous, irrelevant and incoherent speech;
*Frothing from the mouth;
*Frequent smiling, laughing, dancing, singing and playing musical instruments in inappropriate situations;
*Loudly imitating the sounds of lute, flute, conch, ''samya'' (cymbal played by right hand), and ''tala'' (cymbal played by left hand);
*Riding phantom vehicles;
*Adoration of self by false ornaments;
*Craving for food articles that are not available;
*Disgust and hatred for food articles that are readily available.
*Emaciation and roughness;
*Protruding dusky red eyes;
*Aggravation by ''vata''-provoking factors; and
*Pacification by factors which are opposite to ''vata''
</div>
These are the features of ''vatika'' type of ''unmada''. [7-1]

==== Features of ''paittika'' type ''unmada'' ====

अमर्षः, क्रोधः, संरम्भश्चास्थाने, शस्त्रलोष्ट्रकशाकाष्ठमुष्टिभिरभिहननं स्वेषां परेषां वा, अभिद्रवणं, प्रच्छायशीतोदकान्नाभिलाषः, सन्तापश्चातिवेलं, ताम्रहरितहारिद्रसंरब्धाक्षता, पित्तोपशयविपर्यासादनुपशयता च; इति पित्तोन्मादलिङ्गानि
भवन्ति(२) ;

amarṣaḥ, krōdhaḥ, saṁrambhaścāsthānē, śastralōṣṭrakaśākāṣṭhamuṣṭibhirabhihananaṁ svēṣāṁ parēṣāṁ vā, abhidravaṇaṁ, pracchāyaśītōdakānnābhilāṣaḥ,santāpaścātivēlaṁ, tāmraharitahāridrasaṁrabdhākṣatā, pittōpaśayaviparyāsādanupaśayatā ca; iti pittōnmādaliṅgāni bhavanti(2);

Amarshah krodhaH, saMrambhashcAsthAne,
shastraloShTrakashAkAShThamuShTibhirabhihananaM
sveShAM pareShAM vA, abhidravaNaM, pracchAyashItodakAnnAbhilAShaH,
santApashcAtivelaM, tAmraharitahAridrasaMrabdhAkShatA,pittopashayaviparyAsAdanupashayatA ca; iti pittonmAdali~ggAni bhavanti(2);

*Intolerance, anger and excitement at inappropriate occasions;
*Inflicting injury on self or on others by weapons, brickbats, whips, sticks and fist.
*Running around
*Desire for shade, cold water and food having cooling effect;
*Prolonged anguish;
*Ferocious eyes with coppery, green or yellow color;
*Aggravation of the signs and symptoms by ''pitta'' provoking factors
*Pacification by factors which are opposite to ''pitta''

are the features of ''paittika'' type of ''unmada.''[7-2]

==== Features of ''kaphaja'' type ''unmada'' ====

स्थानमेकदेशे, तूष्णीम्भावः, अल्पशश्चङ्क्रमणं, लालाशिङ्घाणकस्रवणम्,
अनन्नाभिलाषः,रहस्कामता, स्वप्ननित्यता, शौचद्वेषः, बीभत्सत्वं, श्वयथुरानने, शुक्लस्तिमितमलोपदिग्धाक्षत्वं,
श्लेष्मोपशयविपर्यासादनुपशयता च; इति श्लेष्मोन्मादलिङ्गानि
भवन्ति(३);त्रिदोषलिङ्गसन्निपाते तु सान्निपातिकं विद्यात्; तमसाध्यमाचक्षते कुशलाः||७||

sthānamēkadēśē, tūṣṇīmbhāvaḥ, alpaśaścaṅkramaṇaṁ, lālāśiṅghāṇakasravaṇam, anannābhilāṣaḥ, rahaskāmatā, bībhatsatvaṁ, śaucadvēṣaḥ, svapnanityatā,śvayathurānanē, śuklastimitamalōpadigdhākṣatvaṁ, ślēṣmōpaśayaviparyāsādanupaśayatā ca; iti ślēṣmōnmādaliṅgāni bhavanti(3);
tridōṣaliṅgasannipātē tu sānnipātikaṁ vidyāt; tamasādhyamācakṣatē kuśalāḥ||7||

sthAnamekadeshe, tUShNImbhAvaH, alpashashca~gkramaNaM, lAlAshi~gghANakasravaNam,
anannAbhilAShaH, rahaskAmatA, bIbhatsatvaM, shaucadveShaH, svapnanityatA, shvayathurAnane,shuklastimitamalopadigdhAkShatvaM,shleShmopashayaviparyA sAdanupashayatA ca; iti shleShmonmAdali~ggAni bhavanti(3); tridoShali~ggasannipAte
tu sAnnipAtikaM vidyAt; tamasAdhyamAcakShate kushalAH||7||

*Prefers to live at one place (doesn’t move/ immobility)
*Meek and mum, prefers not to speak;
*Excessive salivation and nasal secretions;
*Disinclination for food
*Prefers loneliness
*Frightening appearance;
*Aversion for cleanliness;
*Always drowsy;
*Edematous face;
*White and timid eyes full of dirt;
*Aggravation of the signs & symptoms by ''kapha'' provoking factors
*Pacification by factors which are opposite to ''kapha''

These are the features of ''kaphaja'' type of ''unmada''.

Features of ''sannipatika'' type ''unmada'':
In the ''unmada'' caused by the combined vitiation of all the three ''doshas'', all the symptoms mentioned above are simultaneously manifested. This type of ''unmada'' is considered to be incurable. [7-3]

==== Management of ''unmada'' ====

साध्यानां तु त्रयाणां साधनानि- स्नेहस्वेदवमन विरेचनास्थापनानुवासनोपशमन नस्तःकर्मधूमधूपनाञ्जनावपीड प्रधमनाभ्यङ्गप्रदेह परिषेकानुलेपनवधबन्धनावरोधन वित्रासनविस्मापनविस्मारणापतर्पण सिराव्यधनानि, - भोजनविधानं च यथास्वं युक्त्या, यच्चान्यदपि किञ्चिन्निदानविपरीतमौषधं तदपि कार्यं स्यादिति||८||

sādhyānāṁ tu trayāṇāṁ sādhanāni- snēhasvēdavamanavirēcanāsthāpanānuvāsanōpaśamananastaḥkarmadhūmadhūpanāñjanāvapīḍapradhamanābhyaṅgapradēhapariṣēkānulēpanavadhabandhanāvarōdhana-vitrāsanavismāpanavismāraṇāpatarpaṇasirāvyadhanāni, bhōjanavidhānaṁ ca yathāsvaṁ yuktyā, yaccānyadapi kiñcinnidānaviparītamauṣadhaṁ kāryaṁ tadapisyāditi||8||

SadhyanaM tu trayANAM sAdhanAni -snehasvedavamanavirecan AsthApanAnuvAsanopashamananastaHkarmadhUmadhUpanA~jjanAvapIDa pradhamanAbhya~ggapradehapariShekAnulepanavadhabandhanAvarodhana-
vitrAsanavismApanavismAraNApatarpaNasirAvyadhanAni,ca yathAsvaM
yuktyA, yaccAnyadapi ki~jcinnidAnaviparItamauShadhaM tadapi kAryaM syAditi||8||
<div style="text-align:justify;">
Modalities of treatment of the three types of curable ''unmada'' are:

*Oleation, fomentation, emesis, purgation, ''asthapana'' enema, ''anuvasana'' enema
*Alleviation therapies
*Nasal medication, smoking, fumigation, collyrium, ''avapida'' and ''pradhamana'' types of nasal medication
*Massage, ointment, affusion, and unction
*Assaulting at times, tying, solitary confinement, frightening, and inducing shock
*Depleting therapies and venesection.

Suitable diets should be given according to the requirement of the patient. Such other therapies as would work against the causative factors of the disease should also be given. [8]
</div>
भवति चात्र-

उन्मादान् दोषजान् साध्यान् साधयेद्भिषगुत्तमः|

अनेन विधियुक्तेन कर्मणा यत् प्रकीर्तितम्||९||

bhavati cātra-

unmādān dōṣajān sādhyān sādhayēdbhiṣaguttamaḥ|

anēna vidhiyuktēna karmaṇā yat prakīrtitam||9||

Bhavati cAtra-

UnmadaAn doShajA sAdhyAn sAdhayedbhiShaguttamaH|

Anena vidhiyuktena karmaNA yat prakIrtitam||9||

Thus it is said :

A competent physician should selectively employ the above-mentioned therapies to treat the curable types of ''unmada'' caused by the vitiation of ''doshas'' as per the fundamental principles of the prescribed therapy. [9]

==== Exogenous ''unmada'' ====

यस्तु दोषनिमित्तेभ्य उन्मादेभ्यः समुत्थानपूर्वरूपलिङ्गवेदनोपशयविशेषसमन्वितो भवत्युन्मादस्तमागन्तुकमाचक्षते|

केचित् पुनः पूर्वकृतं कर्माप्रशस्तमिच्छन्ति तस्य निमित्तम् |

तस्य च हेतुः प्रज्ञापराध एवेति भगवान् पुनर्वसुरात्रेयः|

प्रज्ञापराधाद्ध्ययं देवर्षिपितृगन्धर्वयक्षराक्षसपिशाच गुरुवृद्धसिद्धाचार्यपूज्यानवमत्याहितान्याचरति, अन्यद्वा किञ्चिदेवंविधं कर्माप्रशस्तमारभते; तमात्मना हतमुपघ्नन्तो देवादयःकुर्वन्त्युन्मत्तम्||१०||

yastu dōṣanimittēbhya unmādēbhyaḥ samutthānapūrvarūpaliṅgavēdanōpaśayaviśēṣasamanvitō bhavatyunmādastamāgantukamācakṣatē|

kēcit punaḥ pūrvakr̥taṁ karmāpraśastamicchanti tasya nimittam|

tasya [1] ca hētuḥ prajñāparādha ēvēti bhagavān punarvasurātrēyaḥ|

prajñāparādhāddhyayaṁ dēvarṣipitr̥gandharvayakṣarākṣasapiśācaguruvr̥ddhasiddhācāryapūjyānavamatyāhitānyācarati, anyadvā kiñcidēvaṁvidhaṁkarmāpraśastamārabhatē; tamātmanā hatamupaghnantō dēvādayaḥ kurvantyunmattam||10||

Yastu dosanimittebhyah Unmadaebhyah samutthAn purvarUpa linga vedanopaSaya visesa samanvito bhavatyUnmadaastamAgantukamAcakShate
Kecit punaH pUrvakRutaM karmAprashastamicchanti tasya nimittam|

hetuH ca praj~jAparAdha eveti bhagavAn punarvasurAtreyaH|

praj~jAparAdhAddhyayaM devarShipitRugandharvayakSharAkShasapishA caguruvRuddhasiddhAcAryapUjyAnavamatyAhitAnyAcarati, anyadvA
ki~jcidevaMvidhaM karmAprashastamArabhate; tamAtmanAhatamupaghnanto devAdayaH kurvantyunmattam||10||

<div style="text-align:justify;">
The type of ''unmada'' having etiology, premonitory symptoms, signs and symptoms, pain and favorable therapeutics (''upashaya'') different from those of the types of ''unmada'' caused by the vitiation of ''doshas'' are known to be of exogenous type. Some scholars hold the view that this type of ''unmada'' is caused by the effect of the activities of the past life. Lord Atreya considers intellectual errors as the causative factor of this condition. Due to intellectual errors, the patient disregards the Gods, ascetics, ancestors, ''gandharvas, yakshas,'' ''rakshasas, pishachas,'' preceptors, elders, teachers and the other respectable ones. He also resorts to undesirable and inauspicious (or blasphemous) activities. The gods etc. cause ''unmada'' in him because of his own inauspicious activities. [10]
</div>

==== Premonitory symptoms of exogenous ''unmada'' ====

तत्र देवादिप्रकोपनिमित्तेनागन्तुकोन्मादेन पुरस्कृतस्येमानि पूर्वरूपाणि भवन्ति; तद्यथा- देवगोब्राह्मणतपस्विनां हिंसारुचित्वं, कोपनत्वं, नृशंसाभिप्रायता,अरतिः ओजोवर्णच्छायाबल वपुषामुपतप्तिः, स्वप्ने च देवादिभिरभिभर्त्सनंप्रवर्तनं चेति; ततोऽनन्तरमुन्मादाभिनिर्वृत्तिः||११||

tatra dēvādiprakōpanimittēnāgantukōnmādēna puraskr̥tasyēmāni pūrvarūpāṇi bhavanti; tadyathā- dēvagōbrāhmaṇatapasvināṁ hiṁsārucitvaṁ, kōpanatvaṁ,nr̥śaṁsābhiprāyatā, aratiḥ, ōjōvarṇacchāyābalavapuṣāmupataptiḥ, svapnē ca dēvādibhirabhibhartsanaṁ pravartanaṁ cēti; tatō'nantaramunmādābhinirvr̥ttiḥ||11||

tatra devAdiprakopanimittenAgantukonmAdena puraskRutasyemAni
pUrvarUpANi bhavanti;tadyathA-devagobrAhmaNatapasvinAM
hiMsArucitvaM,kopanatvaM, nRushaMsAbhiprAyatA,
aratiH,ojovarNacchAyAbalavapuShAmupataptiH,svapne
ca devAdibhirabhibhartsanaM pravartanaM
ceti;tato~anantaramUnmadaAbhinirvRuttiH||11||

The premonitory symptoms of exogenous ''unmada'' are as follows:

*Desire for inflicting injury upon the gods, cows, brahmins and ascetics;
*Anger;
*Desire for inflicting cruel acts, torture, etc. on living beings
*Restlessness
*Impairment of ''ojas'', colour, complexion and physical strength
*Abuse and incitement of the gods etc. in dreams.

''Unmada'' manifests soon after the occurrence of these premonitory symptoms. [11]

तत्रायमुन्मादकराणां भूतानामुन्मादयिष्यतामारम्भविशेषो भवति; तद्यथा- अवलोकयन्तो देवा जनयन्त्युन्मादं,गुरुवृद्धसिद्धमहर्षयोऽभिशपन्तः , पितरो दर्शयन्त: स्पृशन्तो गन्धर्वाः, समाविशन्तो यक्षाः राक्षस्त्वात्मगन्धमाघ्रापयन्तः, पिशाचाः पुनरारुह्य वाहयन्तः||१२||

tatrāyamunmādakarāṇāṁ bhūtānāmunmādayiṣyatāmārambhaviśēṣō bhavati; tadyathā- avalōkayantō dēvā janayantyunmādaṁ,guruvr̥ddhasiddhamaharṣayō'bhiśapantaḥ, pitarō darśayantaḥ [1] , spr̥śantō gandharvāḥ, samāviśantō yakṣāḥ, rākṣasāstvātmagandhamāghrāpayantaḥ, piśācāḥpunarāruhya vāhayantaḥ||12||

tatrAyam Unmadakaranam bhUtAnAmUnmadaayiShyatAmArambhavisheSho
bhavati; tadyathA-avalokayanto devA janayantyUnmadaaM, guruvRuddhasiddhamaharShayo~abhishapantaH, pitaro darshayantaH
spRushanto gandharvAH, samAvishanto yakShAH, rAkShasAstvAtmagandhamAghrApayantaH,pishAcAH punarAruhya
vAhayantaH||12||

The various divine entities unleash their wrath on the individual as follows:

*Godly spirits cause ''devonmada'' (divine ''unmada'')
*Preceptors, elders, adepts and ascetics cause ''unmada'' by their curse
*Ancestors by manifesting themselves;
*''Gandharvas'' by their touch;
*''Yakshas'' by entering the host;
*''Rakshasas'' by making the person inhale the odor of their bodies,
*''Pishachas'' by seizing and riding the host.[12]

==== Symptoms of exogenous ''unmada'' ====

तस्येमानि रूपाणि भवन्ति ; तद्यथा- अत्यात्मबलवीर्य पौरुषपराक्रम ग्रहणधारणस्मरणज्ञानवचनविज्ञानानि; अनियतश्चोन्मादकालः||१३||

tasyēmāni rūpāṇi bhavanti; tadyathā- atyātmabalavīryapauruṣaparākramagrahaṇadhāraṇasmaraṇajñānavacanavijñānāni [1] , aniyataścōnmādakālaḥ||13||

rUpANi bhavanti;tadyathAatyAtmabalavIryapauruShaparAkramagrahaNadhAra NasmaraNaj~jAnavacanavij~jAnAni aniyatashconmAdakAlaH||13||

Characteristics of a patient afflicted with exogenous ''unmada'' are:

Untimely, uncertain and uncalled for manifestations superhuman strength, valor, manliness, enthusiasm, power of understanding and retention, memory, spirituality, logical and scientific knowledge and power of speech. [13]

उन्मादयिष्यतामपि खलु देवर्षिपितृगन्धर्वयक्षराक्षसपिशाचानां गुरुवृद्धसिद्धानां वा एष्वन्तरेष्वभिगमनीयाः पुरुषा भवन्ति; तद्यथा- पापस्य कर्मणः समारम्भे, पूर्वकृतस्य वा कर्मणः परिणामकाले,
एकस्य वा शून्यगृहवासे,चतुष्पथाधिष्ठाने वा, सन्ध्यावेलायामप्रयतभावे वा पर्वसन्धिषु वा मिथुनीभावे, रजस्वलाभिगमने वा विगुणे ,नियमव्रतब्रह्मचर्यभङ्गे वा, महाहवे वा, देशकुलपुरविनाशे वा, महाग्रहोपगमने वा, स्त्रिया वा प्रजननकाले, विविधभूताशुभाशुचिस्पर्शने वा, वमनविरेचनरुधिरस्रावे, अशुचेरप्रयतस्य वा चैत्यदेवायतनाभिगमने वा,मांसमधुतिलगुडमद्योच्छिष्टे वा, दिग्वाससि वा, निशि
नगरनिगमचतुष्पथोपवनश्मशानाघातनाभिगमने वा, द्विजगुरुसुरयतिपूज्याभिधर्षणे वा, धर्माख्यानव्यतिक्रमे वा, अन्यस्य वा कर्मणोऽप्रशस्तस्यारम्भे, इत्यभिघातकाला व्याख्याता भवन्ति||१४||

unmādayiṣyatāmapi khalu dēvarṣipitr̥gandharvayakṣarākṣasapiśācānāṁ guruvr̥ddhasiddhānāṁ vā ēṣvantarēṣvabhigamanīyāḥ puruṣā bhavanti; tadyathā-pāpasyakarmaṇaḥ samārambhē, pūrvakr̥tasya vā karmaṇaḥ pariṇāmakālē, ēkasya vā śūnyagr̥havāsē catuṣpathādhiṣṭhānē vā, sandhyāvēlāyāmaprayatabhāvē vāparvasandhiṣu vā mithunībhāvē, rajasvalābhigamanē vā, viguṇē vā'dhyayanabalimaṅgalahōmaprayōgē, niyamavratabrahmacaryabhaṅgē vā, mahāhavē vā,dēśakulapuravināśē vā, mahāgrahōpagamanē vā, striyā vā prajananakālē, vividhabhūtāśubhāśucisparśanē vā, vamanavirēcanarudhirasrāvē, aśucēraprayatasya vācaityadēvāyatanābhigamanē vā, māṁsamadhutilaguḍamadyōcchiṣṭē vā, digvāsasi vā, niśi nagaranigamacatuṣpathōpavanaśmaśānāghātanābhigamanē vā,dvijagurusurayatipūjyābhidharṣaṇē vā, dharmākhyānavyatikramē vā, anyasya vā karmaṇō'praśastasyārambhē, ityabhighātakālā vyākhyātā bhavanti||14||

Unmadayisyatamapi khalu devarShipitRugandharvayakSharAkShasapishAcAnAM guruvRuddhasiddhAnAM vA eShvantareShvabhigamanIyAH puruShA bhavanti;tadyathA- pApasyam,karmaNaH samArambhe, pUrvakRutasya vA NaH pariNAmakAle,ekasya vA shUnyagRuhavAse catuShpathAdhiShThAne vA,sandhyAvelAyAmaprayatabhAvevA parvasandhiShu vA mithunIbhAve, rajasvalAbhigamane vA, viguNe vA~adhyayanabalima~ggalahomaprayoge, niyamavratabrahmacaryabha~ggevA,mahAhave vA,deshakulapuravinAshe vA, mahAgrahopagamane vA, striyA vA prajananakAle, vividhabhUtAshubhAshucisparshanevA,vamanavirecanarudhirasrAve,ashuceraprayatasyavAcaityadevAyatanAbhigamanevA,
mAMsamadhutilaguDamadyocchiShTevA,digvAsasi vA,nishi nagaranigama catuShpathopavana shmashAnAghAtanAbhigamane vA,dvijagurusurayatipUjyAbhidharShaNe vA, dharmAkhyAnavyatikrame vA, anyasya vA karma No~aprashastasyArambhe, tyabhighAtakAlA vyAkhyAtA bhavanti||14||
<div style="text-align:justify;">
Persons get afflicted by ''unmada'' caused by godly spirits, ascetics, ancestors, ''gandharvas, yakshas, rakshasas, pishachas,'' preceptors, elders and adepts in the following circumstances, places and time:

*In the beginning of sinful acts;
*When the consequences of prior (sinful) acts of the person (committed in the present life or the past) manifest their effect (karmic effects);
*(Living) in a deserted house or crossing roads alone;
*Sexual intercourse during the junctures of day and night or during the new moon and full moon nights (considered inappropriate and inauspicious for sex).
*Sexual intercourse with a lady during her menstrual period;
*Recitation of scriptures, religious offerings, auspicious rites and sacrifices in improper manner.
*Dishonoring a vow and discontinuing a religious duty or observance of celibacy
*Fierce battles;
*Destruction of countries, communities and towns;
*Onset of inauspicious planets in the sky;
*Post-partum depression;
*Coming in contact with different types of inauspicious and unclean creatures;
*Emesis, purgation and bleeding;
*Visiting a ''chaitya'' (sacred tree) or temple when unclean and not following the prescribed rules;
*Not using mouthwash after eating meat, honey, sesame seeds, sugar candy and alcohol;
*While being naked;
*Visiting cities, towns, crossroads, gardens, cremation grounds, slaughter houses at night;

Insulting ''dvija'' (twice born), preceptors, Gods and divinities, ascetics and the learned;

Thus, described were some circumstances in which a person attracts the wrath of gods, divinities, and the sages and gets afflicted with ''unmada''. [14]
</div>
त्रिविधं तु खलु उन्मादकराणां भूतानामुन्मादने प्रयोजनं भवति; तद्यथा- हिंसा, रतिः, अभ्यर्चनं चेति तेषां तं प्रयोजनविशेषमुन्मत्ताचार विशेषलक्षणैर्विद्यात्| हिंसा, अप्सु वा स्थलाच्छ्वभ्रे निमज्जति, पतति, शस्त्रकशाकाष्ठलोष्टमुष्टिभिर्हन्त्यात्मानम्, अन्यच्च प्राणवधार्थमारभते किञ्चित्, विद्यात्; तमसाध्यं साध्यौ पुनर्द्वावितरौ||१५||

trividhaṁ tu khalūnmādakarāṇāṁ bhūtānāmunmādanē prayōjanaṁ bhavati; tadyathā- hiṁsā, ratiḥ, abhyarcanaṁ cēti|
tēṣāṁ taṁ prayōjanaviśēṣamunmattācāraviśēṣalakṣaṇairvidyāt|
tatra hiṁsārthinōnmādyamānō'gniṁ praviśati, apsu nimajjati, sthalācchvabhrē vā patati, śastrakaśākāṣṭhalōṣṭamuṣṭibhirhantyātmānam, anyaccaprāṇavadhārthamārabhatē kiñcit, tamasādhyaṁ vidyāt; sādhyau punardvāvitarau||15||

Trividham Tu khalUnmadaakarANAM bhUtAnAmUnmadaane prayojanaM bhavati;
yathA hiMsA,ratiH, abhyarcanaM ceti| teShAM taM
prayojanavisheShamunmattAcAravisheShalakShaNairvidyAt|
tatra hiMsArthinonmAdyamAno~agniM pravishati,apsu nimajjati,
sthalAcchvabhre vA patati, shastrakashAkAShThaloShTamuShTibhirhantyAtmAnam,
anyacca prANavadhArthamArabhate ki~jcit, vidyat tamasAdhyaM vidyAt; sAdhyau
punardvAvitarau||15||

''Unmada'' is caused by the above mentioned agents with the following objectives:

#as a consequence of one’s sinful acts
#affection/love/pleasure and
#to make the individual pay obeisance to Gods
<div style="text-align:justify;">
The prognosis of ''unmada'' can be judged from the characteristic features of the patient. When the intention of the afflicted agents is to inflict injury, then the patient enters into fire, sinks into water, falls into a pit, provokes others to hurt him, strikes himself with weapons, whips, sticks, brick bats, his own fist etc. He may also adopt to such other means of killing himself. This type of ''unmada'' is incurable.

The other two types of intentions i.e. for affection/love/pleasure or to offer prayer give rise to variants of ''unmada'' that are curable. [15]
</div>

==== Treatment of exogenous ''unmada'' ====

तयोः साधनानि-

मन्त्रौषधिमणिमङ्गलबल्युपहारहोमनियमव्रतप्रायश्चित्तोपवास स्वस्त्ययनप्रणिपातगमनादीनि||१६||

tayōḥ sādhanāni-

mantrauṣadhimaṇimaṅgalabalyupahārahōmaniyamavrataprāyaścittōpavāsa svastyayanapraṇipātagamanādīni||16||

tayoh sAdhanAni-

mantrauShadhimaNi ma~ggala balyupahArahomaniyama vrataprAyashcitopavAsa svastyayana praNipAtagamanAdIni||16||

For the curable variants of exogenous ''unmada'', the prescribed therapies are:

*Incantation of ''mantras'',
*Wearing of gems and jewels according to astrological indications,
*Performance of auspicious and religious rites and sacrifices, oblations
*Taking a vow, performing religious duties, penance, fasting, blessings, obeisance and pilgrimage. [16]

==== Role of ''dosha'' in causing various types of ''unmada'' ====

एवमेते पञ्चोन्मादा व्याख्याता भवन्ति||१७||

ēvamētē pañcōnmādā vyākhyātā bhavanti||17||

Evamete pa~jconmAdA vyAkhyAtA bhavanti||17||

In the following verses, the five types of ''unmada'' have been explained. [17]

ते तु खलु निजागन्तुविशेषेण साध्यासाध्यविशेषेण च प्रविभज्यमानाः

पञ्च सन्तो द्वावेव भवतः| तौ च परस्परमनुबध्नीतः कदाचिद्यथोक्तहेतुसंसर्गात् |

तयोः संसृष्टमेव पूर्वरूपं भवति, संसृष्टमेव च लिङ्गम्| तत्रासाध्यसंयोगं साध्यासाध्यसंयोगं चासाध्यं विद्यात्, साध्यं तु साध्यसंयोगम् |

तस्य साधनं साधनसंयोगमेव विद्यादिति||१८||

tē tu khalu nijāgantuviśēṣēṇa sādhyāsādhyaviśēṣēṇa ca pravibhajyamānāḥ pañca santō dvāvēva bhavataḥ|

tau ca parasparamanubadhnītaḥ kadācidyathōktahētusaṁsargāt|

tayōḥ saṁsr̥ṣṭamēva pūrvarūpaṁ bhavati, saṁsr̥ṣṭamēva ca liṅgam|

tatrāsādhyasaṁyōgaṁ sādhyāsādhyasaṁyōgaṁ cāsādhyaṁ vidyāt, sādhyaṁ tu sādhyasaṁyōgam|

tasya sādhanaṁ sādhanasaṁyōgamēva vidyāditi||18||

Te khalunijAgantuvisheSheNa sAdhyAsAdhyavisheSheNa capravibhajyamAnAH pa~jca santo dvAveva bhavataH |

tau ca parasparamanubadhnItaH kadAcidyathoktahetusaMsargAt |

tayoH saMsRuShTameva pUrvarUpaM bhavati,saMsRuShTameva ca li~ggam|

tatrAsAdhyasaMyogaM sAdhyAsAdhyasaMyogaM cAsAdhyaM vidyAt, sAdhyaM tu sAdhyasaMyogam| tasya sAdhanaM sAdhanasaMyogameva vidyAditi||18||

<div style="text-align:justify;">
The ''unmada'' of five types can be further classified as endogenous or exogenous or as curable or incurable. At times, due to the combination of etiological factors (of endogenous and exogenous types), these could also manifest in hybrid forms. Such forms would exhibit a combination of both the types of ''unmada'' in their premonitory as well as actual symptoms. However, it is important to note that:
*Combination of the incurable types or of the curable and incurable types result in an incurable condition.
*Combination of curable types results in curable conditions that should be treated using a combination of therapies. [18]
</div>

==== Responsible factors for ''unmada'' ====

भवन्ति चात्र-

नैव देवा न गन्धर्वा न पिशाचा न राक्षसाः|

न चान्ये स्वयमक्लिष्टमुपक्लिश्नन्ति मानवम्||१९||

bhavanti cātra-

naiva dēvā na gandharvā na piśācā na rākṣasāḥ|

na cānyē svayamakliṣṭamupakliśnanti mānavam||19||

cAtra-

naiva devA na gandharvA na pishAcA na rAkShasAH|

na cAnyesvayamakliShTamupaklishnanti mAnavam||19||

Neither gods, nor ''gandharvas'', nor ''pishachas'' nor ''rakshasas'' afflict a person who himself is free from misdeeds. The primary cause of ''unmada'' in an individual is the consequences of his own misdeeds and not other agents like the gods etc. [19]

ये त्वेनमनुवर्तन्ते क्लिश्यमानं स्वकर्मणा |

न स तद्धेतुकः क्लेशो न ह्यस्ति कृतकृत्यता||२०||

yē tvēnamanuvartantē kliśyamānaṁ svakarmaṇā|

na sa taddhētukaḥ klēśō [1] na hyasti kr̥takr̥tyatā||20||

ye tvenamanuvartante klishyamAnaM svakarmaNA|

na sa taddhetukaH klesho na hyasti kRutakRutyatA||20||

If the primary cause of ''unmada'' is misdeeds of the individual, then how could the causation of these exogenous ''unmada'' be attributed to divinities? Misdeeds committed already cannot be undone, but good deeds can pacify or neutralize the effects of these exogenous factors. [20]

प्रज्ञापराधात् सम्भूते व्याधौ कर्मज आत्मनः|

नाभिशंसेद्बुधो देवान्न पितॄन्नापि राक्षसान्||२१|

prajñāparādhāt sambhūtē vyādhau karmaja ātmanaḥ|

nābhiśaṁsēdbudhō dēvānna pitr̥̄nnāpi rākṣasān||21||

pragnAparAdhAt sambhUte vyAdhau karmaja AtmanaH|

nAbhishaMsedbudho devAnna pitRUnnApi rAkShasAn||21||

All the diseases whether ''karmaja'' (due to misdeeds) or ''atman'' (due to one’s self) are caused due to intellectual errors. The Gods, ancestors or ''rakshasas'' shall not be blamed for any disease. [21]

आत्मानमेव मन्येत कर्तारं सुखदुःखयोः|

तस्माच्छ्रेयस्करं मार्गं प्रतिपद्येत नो त्रसेत्||२२||

ātmānamēva manyēta kartāraṁ sukhaduḥkhayōḥ|

tasmācchrēyaskaraṁ mārgaṁ pratipadyēta nō trasēt||22||

AtmAnameva manyeta kartAraM sukhaduHkhayoH|

tasmAcchreyaskaraM mArgaM pratipadyeta no traset||22||

One should hold himself responsible for his happiness and miseries. Therefore, one should follow the path of welfare without apprehensions. [22]

देवादीनामपचितिर्हितानां चोपसेवनम्|

ते च तेभ्यो विरोधश्च सर्वमायत्तमात्मनि||२३||

dēvādīnāmapacitirhitānāṁ cōpasēvanam|

tē ca [1] tēbhyō virōdhaśca sarvamāyattamātmani||23||

devAnAmapacitirhitAnAM copasevanam|

te ca tebhyo virodhashca sarvamAyattamAtmani||23||

Prayers to the Gods etc. and resorting to wholesome dietary and lifestyle habits act as antidotes to the misdeeds of the individual. Thus, the choice either to avert or get afflicted with ''unmada'' rests with the individual himself. [23]

==== Summary ====

तत्र श्लोकः-

सङ्ख्या निमित्तं प्राग्रूपं लक्षणं साध्यता न च|

उन्मादानां निदानेऽस्मिन् क्रियासूत्रं च भाषितम्||२४||

tatra ślōkaḥ-

saṅkhyā nimittaṁ prāgrūpaṁ lakṣaṇaṁ sādhyatā na ca|

unmādānāṁ nidānē'smin kriyāsūtraṁ ca bhāṣitam||24||

Tatra shloka-

sa~gkhyA nimittaM prAgrUpaM lakShaNaM sAdhyatA na ca|

UnmadaAnAM nidAne~asmin kriyAsUtraM ca bhAShitam||24||

<div style="text-align:justify;">
In summary, types of ''unmada'' and their etiology, premonitory symptoms, symptoms, curability or otherwise, and their modes of treatment have been described in this chapter. [ 24]
Thus ends the seventh chapter on diagnosis of ''unmada'' in [[Nidana Sthana]] in the treatise composed by Agnivesha and redacted by Charak. [24]

=== ''Tattva Vimarsha'' ===

*The ''unmada'' pathology involves psychic ''dosha'' (''rajas'' and ''tamas'') and body ''doshas'' ( ''vata, pitta'' and ''kapha'').
*The individuals with low mental strength and emotionally unstable with the mind afflicted repeatedly by desires, anger, greed, excitement, fear, attachment, exertion, anxiety and grief are more prone for ''unmada''.
*Improper diet and lifestyle play important role in causing ''unmada''. Therefore these shall be checked in management.
*''Unmada'' involves cognitive distortion pertaining to mind, intellect, consciousness, knowledge, memory, desire, attitude, activities and behavior. These factors shall be assessed to determine severity of disease, management protocol and prognosis.
*The ''dosha'' dominance shall be assessed for deciding the protocol for management of ''nija''(endogenous) ''unmada''.
*Intellectual error is the basic cause of exogenous ''unmada''.
*Exogenous ''unmada'' is characterized by untimely, uncertain and uncalled for manifestations, superhuman strength, valor, manliness, enthusiasm, power of understanding and retention, memory, spirituality, logical and scientific knowledge and power of speech.
*The diagnosis of exogenous type is based upon clinical presentation resembling with specific extra-human factors mentioned in the text.
*The treatment of exogenous ''unmada'' includes psycho-spiritual therapies.
*No other factor can afflict a person who is free from misdeeds. The primary cause of ''unmada'' in an individual is the consequences of his own misdeeds and not other agents like the gods, etc.
*Misdeeds that are committed already cannot be undone, but good deeds can pacify or neutralize the effects of exogenous factors.
*All the diseases are caused due to intellectual errors. The Gods, ancestors or demons shall not be blamed for any disease. One should hold himself responsible for his happiness and miseries. Therefore, one should follow the path of welfare without apprehensions.

=== ''Vidhi Vimarsha'' ===

As the present chapter deals with the psychopathogenesis and diagnosis of ''unmada'', the fundamental approach of Ayurveda in the etiopathogenesis of psychiatric diseases needs to be discussed. Charak considers violation of dietetic rules as an important causative factor for ''unmada''. Both body and mind are affected by diet. ''Unmada'' occurs in individuals taking diet in manners forbidden by the dietetic rules, consuming improper dietary articles, food articles that are unclean and ill prepared, incompatible and vitiated. According to Chandogya Upanishad, quality of mind depends upon the food taken by the individual. Once digested, the food is divided into three components – gross (''sthula''), medium (''madhyam'') and (''sukshma''). The subtle portion of the food nourishes the mind. Bhagavad Gita also opines that the ''sattvika, rajasika'' and ''tamasika'' types of ''buddhi'' (intellect) is derived from the characteristics associated with the type of diet. Thus, Ayurveda considers that incompatible, vitiated food articles affect the physical as well as mental state of an individual, predisposing him to psychiatric illnesses in general, if he is already harboring other causative factors.

Secondly, psychiatric illnesses with special reference to ''unmada'' are not only associated with the vitiation of ''manas doshas'' but there is vitiation and provocation of ''sharira doshas'' as well. It points to the fact that though psychiatric illnesses are associated with subtle pathological changes at the bio-energetic level, they are also simultaneously accompanied by qualitative as well as quantitative changes/imbalances in the neurotransmitters and other bio-chemicals at the physical level. Thus, the normal psychological processes as well as the psychopathologies, operate simultaneously at multiple levels (biological, bio-energetic) and also at subtler levels where the intangible thought processes start appearing in the relatively tangible field of bio-energy. All this needs extensive exploration using the available scientific tools.

Thirdly, entire thought processes, attitudes, emotional experiences, desires and behaviors of an individual, which are relatively intangible, have the capacity to bring about qualitative as well as quantitative changes in the ''manas'' and ''sharira doshas, agni,'' and ''ojas''. These psychological factors are also capable of bringing about structural as well as functional changes in the ''dhatus'' (body tissues), ''malas'' (biological byproducts and wastes) and ''srotasas'' (macro and micro-channels). These are some of the most fundamental considerations. which needs special attention.

The eight psychological and behavioral factors are described here that get imbalanced when the individual is afflicted with mental diseases. These factors are- ''manas, buddhi, sanjna jnana, smriti, bhakti, sheela, chesta'' and ''aachara''. This provides a basis for objectively and empirically assessing the mental functions of a patient afflicted with ''unmada''. Using this understanding, Ayurvedic institutions have been able to create a rubric to analyze patients and conduct various mental health studies. A three-stepped approach to creating such a scale is as follows:-

#In depth study of various definitions, synonyms, commentaries available on the eight factors.
#Screening the available descriptions in a scientific way.
#Developing an elaborate and objective assessment scale based on Ayurvedic principles for making it more understandable and useful in a clinical set up. The scale has been named as ''ashta manas bhava pariksha'' (assessment of eight mental faculties).

Now described in some detail would be each of the eight psychological and behavioral factors used in Ayurvedic studies on mental health:

#The term ''manas'' in this context refers to the thought, affect and emotional aspect of mind. Therefore, the various kinds of thought abnormalities like delusions and delusional ideations, and states of mood e.g. depressed, elated, anxious etc are assessed under this factor.
#The term ''buddhi'' (''ya buddhi niscayatmika'' Ca. Sa 1/33) refers to intellect, decision making, and problem solving aspects of mental functioning. Standardized tools for assessing intelligence e.g. Weschler Intelligence scale, Bhatia Battery for Performance Test of Intelligence etc. and clinical methods of test judgement are useful in this regard.
#The term ''sanjna jnana'' refers to the awareness of surroundings and response to external stimuli and measures, phenomena such as orientation and responsiveness, and attention and consciousness. Clinical methods available for measuring these aspects should be used.
#The term ''smriti'' refers to all components of memory, such as immediate retention and recall, recent memory and remote memory including learning acquisition. The available tools of memory measurement viz. digit span, object recall, Weschler Memory scale, PGI Memory scale etc. are useful for assessing this factor.
#The term ''bhakti'' refers to the normal, intact, altered and unusual desires related to food, dress, entertainment, study, work, hobby, sex etc. which are measured under this aspect.
#The term ''sheela'' refers to habits, temperament and general behavior, which are measured under this aspect.
#The term ''cheshta'' measures the psychomotor activity by clinically observing the retardation, agitation, restlessness, co-operativeness/ non-co-operativeness etc. in a psychiatric patient.
#Finally, the term ''achara'' refers to personal and social conduct measured by misbehavior, quarrel, disrespect to elders and other respectable and other similar activities by a psychiatric patient.

Some exogenous causative factors of ''unmada'' along with their mode of psychiatric infliction in a person have been enumerated below. However, these details are taken with contemporary assumptions, experiences and clinical practices applicable to a particular disease. Many of these beliefs and practices are still extant in many parts of the world. One of the bodies of practices in this field of study, ''Bhutavidya'', was one of the eight branches of Ayurveda. The diagnosis of these exogenous factors is based upon the clinical features, behavior patterns and time of affliction. These factors are being studied well under the purview of demonology, parapsychology. The beliefs regarding ghosts, demons are noted and studied to know exact mechanism behind them. However psychiatrist caution to rule out any other mental disorder first before labeling it as a demon. The negative energies in the cosmos may be regarded in view of exogenous factors causing ''unmada''. ''Rajas'' and ''tamas'' are responsible for negativities, while ''sattva'' for positivity. Therefore these must be considered as psycho-dynamic factors to be treated.

Last but not the least, there is a clear message in the chapter that every individual is himself responsible for his wellbeing, happiness and miseries. The behavioral tendencies and lifestyles adopted by the individual are based on his own choices and all types of ''unmada'' are the result of intellectual blasphemy by the individual himself – be it endogenous or exogenous.
</div>
==== Table 1: Behavioral and psychological manifestation of ''triguna'' ====

{| class="wikitable"
! rowspan="1"| ''Sattva''
! rowspan="1"| ''Rajas''
! rowspan="1"| ''Tamas''
|-
| Enlightening || Propulsive & dynamic || Inhibitive
|-
| Efforts for more knowledge || Over expression of pain & pleasure || Ignorant
|-
| Cleanliness || Active || Excessive Fatigue of sense organs
|-
| Theism (Appreciates existence of Almighty) || Industrious || Atheism
|-
| Straight forward dealing || Egoistic || Inactive
|-
| Polite || Reacting || Poor
|-
| Gratitude || Angry || more sleep
|-
| Of good memory, intellect || Pretender || worrying
|-
| Prompt to learn || Jealous || Commits Mistakes
|-
| Serious || Brave || unhygienic
|-
| Welfare wisher || Greedy ||
|-
| || Cruel ||
|-
| || Tense ||
|-
|}

==== Table 2:Predominance of ''raja'' and ''vata'' ====

{| class="wikitable"
! rowspan="1"| Disease
! rowspan="1"| Clinical features
! rowspan="1"| Predominant ''dosha''
|-
| rowspan="12" style="vertical-align: top;" | 1. Panic attack
|-
| Palpitation, sweating || ''raja, pitta''
|-
| Trembling or shaking || ''vata''
|-
| Sensation of shortness of breath Feeling of choking|| ''vata''
|-
| Chest pain or discomfort || ''vata''
|-
| Nausea or abdomen distress || ''vata''
|-
| Feeling dizzy, unsteady lightheaded or Faint || ''pitta''
|-
| De-realization or depersonalization || ''raja, vata and pitta''
|-
| Feeling of losing control or going crazy || ''raja''
|-
| Fear of dying || ''raja, vata''
|-
| Paraesthesia || ''raja, vata''
|-
| Chills or hot flushes|| ''vata'' <hr>''vata-pitta''
|-
|}

==== Table 3:Predominance of ''raja'' and ''vata'' ====

{| class="wikitable"
! rowspan="1"| Disorder
! rowspan="1"| Clinical features
! rowspan="1"| Predominant ''dosha''
|-
| rowspan="8" style="vertical-align: top;"| Generalized Anxiety
|-
| Excessive anxiety & worry (apprehensive expectation) || ''raja, vata''
|-
| The person finds it difficult to control the worry || ''raja, vata''
|-
| Restlessness || ''raja, pitta''
|-
| Being easily fatigued || ''raja, vata''
|-
| Difficulty concentrating or mind going blank || ''raja, vata''
|-
| Irritability || ''raja, pitta vata''
|-
| Sleep disturbance || ''vata''
|-
|}

==== Table 4:Predominance of ''tamas'' and ''kapha dosha'' ====

{| class="wikitable"
! rowspan="1"| Disease
! rowspan="1"| Clinical Features
! rowspan="1"| Predominant ''dosha''
|-
| rowspan="14" style="vertical-align: top;"| Major Depressive Illness
|-
| Depressed mood most of day || ''tama, kapha''
|-
| nearly every day as indicated by either subjective report (eg. feels sad or empty) || ''tama, kapha''
|-
| or observation made by others (eg. appears fearful) || ''Vata''
|-
| Markedly diminished interest or || ''vata, kapha tama, kapha''
|-
| pleasure in all or almost all activities most of the day ||
|-
| Significant weight loss when not dieting or || ''tama''
|-
| weight gain or decrease or increase in appetite nearly every day. || ''kapha tama''
|-
| insomnia or hypersomnia nearly everyday || ''vata kapha tama''
|-
| Psychomotor retardation or agitation || ''tama''
|-
| fatigue or loss of energy nearly everyday || ''tama''
|-
| Feeling of worthlessness or excessive or inappropriate guilt || ''tama kapha''
|-
| Diminished ability to think or concentrate or indecisiveness || ''tama kapha''
|-
| Recurrent thoughts of death,recurrent suicidal ideas || ''tama, kapha''
|-
|}

==== Table 5:Predominance of ''Raja'' and ''Pitta dosha'' ====

{| class="wikitable"
|-
| rowspan ="11" style="vertical-align: top;" | Mania
|-
| A distinct period of abnormality and || ''raja, pitta''
|-
| persistently elevated, expansive or irritable mood.|| ''raja, pitta''
|-
| Inflated self esteem or grandiosity || ''raja pitta''
|-
| Decreased need for sleep || ''vata, raja''
|-
| More talkative than usual || ''vata''
|-
| Flight of ideas || ''raja vata''
|-
| increase in goal directed activity || ''raja pitta''
|-
| or psychomotor agitation || ''raja pitta''
|-
| Excessive involvement in pleasurable activities that have a high potential for painful consequences || ''raja, pitta, vata''
|-
| During the period of mood disturbance any three or more of above Symptoms have persisted ||
|-
|}

==== Table 6: Predominance of ''Raja'' and ''Vata'' ====

{| class="wikitable"
|-
| rowspan="12" style="vertical-align: top;"| Schizophrenia
|-
| Social withdrawal, often with deterioration in personal care, || ''tama, kapha''
|-
| Loss of ego boundaries with inability to perceive onself as Separate || ''Alpasatva'' with excessive ''raja'' and ''tama''
|-
| Loose thought association, often with slowed thinking or over inclusive || ''raja vata''
|-
| and rapid shifting from topic to topic || ''raja, vata''
|-
| Autistic absorption of inner thoughts || ''raja''
|-
| frequent sexual or religious preoccupation || ''raja tama, kapha''
|-
| Auditory hallucinations || ''raja, vata''
|-
| Delusions || ''raja''
|-
| Flat Affect || ''raja''
|-
| Hypersensitive to environmental stimuli || ''raja, vata''
|-
| Impaired concentration Depersonalization wherein one behaves like a detached observer of one's own actions. || ''raja'' and ''vata''
|-
|}

==== Case Paper Format Points ====
<div style="text-align:justify;">
The format for the clinical assessment of ''manovahasrotas'' or The psychiatric assessment:

Every psychiatric history should cover the following points:
#Complaints
#History of present illness
#Previous disorders and the nature and extent of treatment.
#Family history, important for genetic aspects and family influences, helping in understanding the familial traits.
#Personal history: childhood development, adolescent adjustment, level of education and adult coping patterns.
#Sexual history
#Current life functioning
#Current medications, alcohol or drug abuse
#Personality: is defined as the sum of those characteristics that make a person into individual he is. These characteristics include behaviour, both actions and reactions; attitude to self; ways of relating to others, both socially and sexually, attitude to authority, level of independence, mood, fantasy life, religious beliefs and moral altitudes and interests and hobbies.

===== The mental status examination =====
#Appearance: note unusual modes of dress, use of makeup etc. very helpful for evaluation of ''bhootonmada'' and ''vataja unmada''
#Activity and behavior: Gait, gestures, co-ordination of bodily movements. ''akshibhruvaushthamsahanvagrahastapadangavikshepanamakasmat''
#Affect: outward manifestation of emotion such as depression, anger, fear or lack of emotional response eg. ''krodha, sudeen''
#Mood: the patients report of feelings and observable emotional manifestations eg. ''rahasyakamata, narivivikta priyata, amarsha''
#Speech: coherence, spontaneity, articulation, hesitancy in answering and duration and response. Eg. ''vaka mandam pratihatavacchyam''
#Content of thought: Association, obsession, depersonalization, delusions, hallucinations, Paranoid, ideation, anger, fear or unusual experiences. Eg. ''amartya vaka vikrama virya cheshta dnyanadi vidnyan baladibhi''
#Cognition:
##Orientation to person, place, time and circumstances.
##Remote and recent memory and recall
##Calculation
##General knowledge
##Ability to identify by naming, reading and writing
##Right to Left differentiation
##Judgment regarding common sense problems
</div>
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Vajikarana

2019-03-06T03:49:58Z

Pallavmishra:

{{Infobox
|title = Vajikarana Chikitsa
|label1 = Section/Chapter
|data1 = [[Chikitsa Sthana]] Chapter 2
|label2 = Preceding Chapter
|data2 = [[Rasayana]]

|label3= Succeeding Chapter
|data3 = [[Jwara Chikitsa]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}
== [[Chikitsa Sthana]] Chapter 2, Chapter on virility and treatment of sexual dysfunctions ==

=== Abstract ===

<div style="text-align:justify;">''Vajikarana'' is a branch of Ayurveda which is intended to increase virility, improve quality of germinal cells as well treatment of various sexual dysfunctions. In this chapter code of conduct related to sex, dietary regime, qualities of normal sperm, factors affecting virility, qualities of sexual partner, role of mind in infertility, aphrodisiac and therapeutic formulations etc. are described. Simple and easy to prepare formulations are described in the chapter. Though these are described for males but we can apply same principles and formulations to female also for more preponderant effect. ''Vajikarana'' is generally misinterpreted as sexology. This myth is broken in this chapter by mentioning other effects of wider applicability and can be used for improving progeny and creating better world. The chapter is restricted to principles, regime and formulations. Aetiological factors, pathology of sexual dysfunctions and other aspects are mentioned in other chapters of this text.

'''Keywords''': ''Vajikarana, Shukra, Vrishya'', libido, sexual dysfunctions, infertility, healthy progeny.

=== Introduction ===

Sexual relationships are among the most important social and biological relationships in human life. India played a significant role in the history of sex, right from writing of the first literature that treated sexual intercourse as a science. Since ancient times, India pioneered the use of sexual education through art and literature. This subject was not considered taboo in Ayurveda and it was included as separate branch ''vajikarana'' in which various aspects related to sexuality are scientifically dealt. If we see the literal meaning of ''vajikarana'', we find that this word is made up of two words – ''Vaji'' and ''Karana''. ''Vaji'' refers to horse and karana refers to power. So, ''vajikarana'' can be said to be a modality by which one can perform sexual activity for long time and frequently like a horse. But the effect of this branch is much more and helps to achieve good physique, potency, strength and complexion; it revitalizes the reproductive power; helps in getting healthy and good progeny; resolves various sexual dysfunctions like erectile dysfunction, infertility, premature ejaculations etc. Hence it can be said that subject is concerned with aphrodisiacs, virility and improving health of progeny.

Literature related to ''vajikarana'' is present in all the three great treatises which show that this subject was considered paramount for betterment of humans. In [[Charak Samhita]] it is placed before describing treatment of various diseases and in ''Sushruta Samhita'', it is described after discussion of disease treatment. In ''Ashtanga'' it is mentioned in ''Uttara Sthana'' and is last chapter of this text. The order of placement depends upon basic theme of a text. Charak has given prime importance to promotion and preservation of health, whereas Sushruta and Vagbhata emphasized upon the treatment of diseases. This shows with time, Ayurvedic concept of promotion and prevention of health became less important in comparison to disease management.

[[Vajikarana]] is divided in four sections - ''Samyoga Sharamooliya'', ''Asikti Kshirika, Mashaparnabhritiya'' and ''Pumana Jata Baladika''. If we analyze the name of these sub-sections we will find that out of four, name of three sections (''Samyoga Sharamooliya, Asikti Kshirika, Mashaparnabhritiya'') are based on the first formulation described. Last section is named to give emphasis on their effect. The name of four sub-sections or ''pada'', itself suggests that in [[Vajikarana]] chapter, accentuation is given more to formulations. On analyzing these formulations one interesting fact which comes out is that out of 50 formulations mentioned very few can be considered as therapeutic preparations. Only four ''gutika'' or ''vati'' (tablets) are mentioned whereas seven ''mamsarasa'' (meat soup), ten types of milk preparations, four types of eggs, six types of ''pupalika, audana, payasa, rasala'' (different rice and milk preparations), etc. are given. Most of them are common dietary preparations included in normal diet and can be easily prepared. While stating difference in ''rasayana'' and ''vajikarana'', it is stated that ''vajikarana'' should be administered regularly to an individual.
Ayurveda considers ''brahmacharya'' as one of the three ''upastambha'' or pillars of life. It refers to a certain code of conduct related to sexual life. It is said that sexual activity should be neither practiced as complete celibacy nor excessive indulgence should be done as both will have detrimental effect on body as well as mind. It is recommended that the person below 17 years of age and more than 70 years of age should not consume ''vajikarana'' preparations. These preparations have to be consumed by ''Jitendriya Purusha'' or man who has control on his senses and desires. If ''vajikarana'' preparations are consumed by a man who has lost control over his senses and desire, he may prove harmful to society. Excessive coitus leads to ''shosha'' or loss of ''dhatus'' and suppression of sexual desire leads to impotency. Rules regarding coitus frequency, time, pattern changes due to seasonal variation, pre and post coitus preparations etc. are described at different places in ''Samhita''. Before administration of ''vajikarana'' therapy purification should be done so that vitiated ''doshas'' and toxins are removed from the body and blocked channels are opened. This leads to increased bio-availability of ''vajikarana'' drugs for beneficial results. ''Vajikarana'' treatment benefits include increased sexual performance, improving health of future progeny as well as treatment of many sexual disorders like infertility, erectile dysfunction and premature ejaculation.

Ayurveda has given immense importance to women in relation to sexual activity. Woman has been referred as ''kshetra'' or medium in which seed (or sperm) is implanted and fetal growth and development takes place. To get healthy progeny, woman should have certain qualities like she must be from different clan, physically and mentally salubrious and she should be pure (she should have taken post menstrual bath etc.). Such claims are still valid as it is seen that marriages in blood relatives or in same clan have more preponderance of genetic disorders. Chance of having healthy progeny is influenced by the mental state of partners. In ancient times, society was male dominant and females were not given equivalent status & rights like their male counterparts. At many places, social beliefs and rituals prevalent at that time has affected Ayurvedic literature. In ''vajikarana'' also most of the descriptions are related to males only. Rules, formulations, code of conduct etc. mentioned apply to females also and so ''vajikarana'' principles and formulations should not be restricted to males only and should be administered to females also.

It can be stated that ''vajikarana'' is the special branch of Ayurveda which improves the reproductive system and enhances sexual function. It deals with aphrodisiacs, virility and improving health of progeny. The principles described can provide solution to increasing sexual dysfunctions and declining fecundity. Scientific research is needed in the field of ''vajikarana'' therapies.
</div>

===Sanskrit text, Transliteration and English Translation===

==== I- ''Samyogasharamuliya Vajikaranapada'' ====

अथातः संयोगशरमूलीयं वाजीकरणपादं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ saṁyōgaśaramūlīyaṁ vājīkaraṇapādaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH saMyogasharamUlIyaM vAjIkaraNapAdaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the first quarter section entitled ''Samyoga Sharamooliya'' on the virilification. Thus, said Lord Atreya. [1-2]

===== Importance of ''vajikarana'' and woman as the best for virilification =====

वाजीकरणमन्विच्छेत् पुरुषो नित्यमात्मवान्|

तदायत्तौ हि धर्मार्थौ प्रीतिश्च यश एव च||३||

पुत्रस्यायतनं ह्येतद्गुणाश्चैते सुताश्रयाः|

वाजीकरणमग्र्यं च क्षेत्रं स्त्री या प्रहर्षिणी||४||

इष्टा ह्योकैकशोऽप्यर्था परं प्रीतिकरा स्मृताः|

किं पुनः स्त्रीशरीरे ये सङ्घातेन प्रतिष्ठिताः||५||

(सङ्घातो हीन्द्रियार्थानां स्त्रीषु नान्यत्र विद्यते)|

स्त्र्याश्रयो हीन्द्रियार्थो यः स प्रीतिजननोऽधिकम्|

स्त्रीषु प्रीतिर्विशेषेण स्त्रीष्वपत्यं प्रतिष्ठितम्||६||

धर्मार्थौ स्त्रीषु लक्ष्मीश्च स्त्रीषु लोकाः प्रतिष्ठिताः|

सुरूपा यौवनस्था या लक्षणैर्या विभूषिता||७||

या वश्या शिक्षिता या च सा स्त्री वृष्यतमा मता|

vājīkaraṇamanvicchēt puruṣō nityamātmavān|

tadāyattau hi dharmārthau prītiśca yaśa ēva ca||3||

putrasyāyatanaṁ hyētadguṇāścaitē sutāśrayāḥ|

vājīkaraṇamagryaṁ ca kṣētraṁ strī yā praharṣiṇī||4||

iṣṭā hyōkaikaśō'pyarthā paraṁ prītikarā smr̥tāḥ|

kiṁ punaḥ strīśarīrē yē saṅghātēna pratiṣṭhitāḥ||5||

(saṅghātō hīndriyārthānāṁ strīṣu nānyatra vidyatē)|

stryāśrayō hīndriyārthō yaḥ sa prītijananō'dhikam|

strīṣu prītirviśēṣēṇa strīṣvapatyaṁ pratiṣṭhitam||6||

dharmārthau strīṣu lakṣmīśca strīṣu lōkāḥ pratiṣṭhitāḥ|

surūpā yauvanasthā yā lakṣaṇairyā vibhūṣitā||7||

yā vaśyā śikṣitā yā ca sā strī vr̥ṣyatamā matā|8|

vAjIkaraNamanvicchet puruSho nityamAtmavAn|

tadAyattau hi dharmArthau prItishca yasha eva ca||3||

putrasyAyatanaM hyetadguNAshcaite sutAshrayAH|

vAjIkaraNamagryaM ca kShetraM strI yA praharShiNI||4||

iShTA hyokaikasho~apyarthA paraM prItikarA smRutAH|

kiM punaH strIsharIre ye sa~gghAtena pratiShThitAH||5||

(sa~gghAto hIndriyArthAnAM strIShu nAnyatra vidyate)|

stryAshrayo hIndriyArtho yaH sa prItijanano~adhikam|

strIShu prItirvisheSheNa strIShvapatyaM pratiShThitam||6||

dharmArthau strIShu lakShmIshca strIShu lokAH pratiShThitAH|

surUpA yauvanasthA yA lakShaNairyA vibhUShitA||7||

yA vashyA shikShitA yA ca sA strI vRuShyatamA matA|8|

A person should always seek the intake of aphrodisiacs because he can earn ''dharma'' (eternal duties), ''artha'' (wealth, means of pleasure), ''preeti'' (desire or love or affection) and ''yasha'' (success) through this therapy alone. He gets these benefits through his progeny and this therapy is the means of begetting a healthy progeny.

The best agent for virilification is a sexually excited female partner. Every sense can give immense pleasure, when involved separately (in act of sexual satisfaction); then what can be said (about the pleasure), if a woman whose all senses are extremely excited (for sexual satisfaction). In a woman only, all the sense objects are collected together (to give pleasure). Therefore, this type of woman can give maximum pleasure to a man. The woman is the most lovable object for a man. It is the woman, who procreates children. Righteousness, wealth, auspiciousness and the entire universe are established in a woman. The woman, who is good looking, young, endowed with auspicious signs, amiable and skilled, acts as the best virilific. [3-7]

===== Characteristics of good woman best for virilification =====

नानाभक्त्या तु लोकस्य दैवयोगाच्च योषिताम्||८||

तं तं प्राप्य विवर्धन्ते नरं रूपादयो गुणाः|

वयोरूपवचोहावैर्या यस्य परमाङ्गना||९||

प्रविशत्याशु हृदयं दैवाद्वा कर्मणोऽपि वा|

हृदयोत्सवरूपा या या समानमनःशया||१०||

समानसत्त्वा या वश्या या यस्य प्रीयते प्रियैः|

या पाशभूता सर्वेषामिन्द्रियाणां परैर्गुणैः||११||

यया वियुक्तो निस्त्रीकमरतिर्मन्यते जगत्|

यस्या ऋते शरीरं ना धत्ते शून्यमिवेन्द्रियैः||१२||

शोकोद्वेगारतिभयैर्यां दृष्ट्वा नाभिभूयते|

याति यां प्राप्य विस्रम्भं दृष्ट्वा हृष्यत्यतीव याम्||१३||

अपूर्वामिव यां याति नित्यं हर्षातिवेगतः|

गत्वा गत्वाऽपि बहुशो यां तृप्तिं नैव गच्छति||१४||

सा स्त्री वृष्यतमा तस्य नानाभावा हि मानवाः|

अतुल्यगोत्रां वृष्यां च प्रहृष्टां निरुपद्रवाम्||१५||

शुद्धस्नातां व्रजेन्नारीमपत्यार्थी निरामयः|

nānābhaktyā tu lōkasya daivayōgācca yōṣitām||8||

taṁ taṁ prāpya vivardhantē naraṁ rūpādayō guṇāḥ|

vayōrūpavacōhāvairyā yasya paramāṅganā||9||

praviśatyāśu hr̥dayaṁ daivādvā karmaṇō'pi vā|

hr̥dayōtsavarūpā yā yā samānamanaḥśayā||10||

samānasattvā yā vaśyā yā yasya prīyatē priyaiḥ|

yā pāśabhūtā sarvēṣāmindriyāṇāṁ parairguṇaiḥ||11||

yayā viyuktō nistrīkamaratirmanyatē jagat|

yasyā r̥tē śarīraṁ nā dhattē śūnyamivēndriyaiḥ||12||

śōkōdvēgāratibhayairyāṁ dr̥ṣṭvā nābhibhūyatē|

yāti yāṁ prāpya visrambhaṁ dr̥ṣṭvā hr̥ṣyatyatīva yām||13||

apūrvāmiva yāṁ yāti nityaṁ harṣātivēgataḥ|

gatvā gatvā'pi bahuśō yāṁ tr̥ptiṁ naiva gacchati||14||

sā strī vr̥ṣyatamā tasya nānābhāvā hi mānavāḥ|

atulyagōtrāṁ vr̥ṣyāṁ ca prahr̥ṣṭāṁ nirupadravām||15||

śuddhasnātāṁ vrajēnnārīmapatyārthī nirāmayaḥ|

nAnAbhaktyA tu lokasya daivayogAcca yoShitAm||8||

taM taM prApya vivardhante naraM rUpAdayo guNAH|

vayorUpavacohAvairyA yasya paramA~gganA||9||

pravishatyAshu hRudayaM daivAdvA karmaNo~api vA|

hRudayotsavarUpA yA yA samAnamanaHshayA||10||

samAnasattvA yA vashyA yA yasya prIyate priyaiH|

yA pAshabhUtA sarveShAmindriyANAM parairguNaiH||11||

yayA viyukto nistrIkamaratirmanyate jagat|

yasyA Rute sharIraM nA dhatte shUnyamivendriyaiH||12||

shokodvegAratibhayairyAM dRuShTvA nAbhibhUyate|

yAti yAM prApya visrambhaM dRuShTvA hRuShyatyatIva yAm||13||

apUrvAmiva yAM yAti nityaM harShAtivegataH|

gatvA gatvA~api bahusho yAM tRuptiM naiva gacchati||14||

sA strI vRuShyatamA tasya nAnAbhAvA hi mAnavAH|

atulyagotrAM vRuShyAM ca prahRuShTAM nirupadravAm||15||

shuddhasnAtAM vrajennArImapatyArthI nirAmayaH|

Every individual in this world has different likings based on the effects of the actions in the past life e.g a person gets a woman of his liking, then his complexion and other qualities grow. The woman endears herself into the heart of a person by the youthfulness, body, speech and gesture as a result of either ''daiva'' or ''karma'' (destiny, or the effects of the actions in the past life). The one, who delights the heart, who is like the god of sex, who bears similarities in mental faculties with those of her husband, who is amiable and loved by her lover and who enthralls all his senses by her excellent qualities, works like a noose of all the objects of senses. A person who is deprived of her i.e. who doesn’t have a wife, does not find any interest in this world. Without her, the person feels his body a burden and as if devoid of its senses, at the sight of whom, he does not get seriously afflicted even when he faces grief, anxiety, detachment and frightful situations. Because of her presence, the person becomes assured and excited and always rushes to her with excitement as if he remains unsatisfied. Such a woman is the best virilific to him. The aphrodisiac qualities of a woman differ from man to man.

The person, who is healthy and desirous of a child, should enter in to sexual intercourse with a woman who belongs to a different clan, who is free from diseases, who is sexually excited, cheerful and who has taken her post menstrual purifacatory bath. [8-15]

===== Disregard of childless person and benefits of ''vajikarana'' =====

अच्छायश्चैकशाखश्च निष्फलश्च यथा द्रुमः||१६||

अनिष्टगन्धश्चैकश्च निरपत्यस्तथा नरः|

चित्रदीपः सरः शुष्कमधातुर्धातुसन्निभः||१७||

निष्प्रजस्तृणपूलीति मन्तव्यः पुरुषाकृतिः|

अप्रतिष्ठश्च नग्नश्च शून्यश्चैकेन्द्रियश्च ना||१८||

मन्तव्यो निष्क्रियश्चैव यस्यापत्यं न विद्यते|

बहुमूर्तिर्बहुमुखो बहुव्यूहो बहुक्रियः||१९||

बहुचक्षुर्बहुज्ञानो बह्वात्मा च बहुप्रजः|

मङ्गल्येऽयं प्रशस्योऽयं धन्योऽयं वीर्यवानयम्||२०||

बहुशाखोऽयमिति च स्तूयते ना बहुप्रजः|

प्रीतिर्बलं सुखं वृत्तिर्विस्तारो विपुलं कुलम्||२१||

यशो लोकाः सुखोदर्कास्तुष्टिश्चापत्यसंश्रिताः|

तस्मादपत्यमन्विच्छन् गुणांश्चापत्यसंश्रितान्||२२||

वाजीकरणनित्यः स्यादिच्छन् कामसुखानि च|

उपभोगसुखान् सिद्धान् वीर्यापत्यविवर्धनान्||२३||

वाजीकरणसंयोगान् प्रवक्ष्याम्यत उत्तरम्|

acchāyaścaikaśākhaśca niṣphalaśca yathā drumaḥ||16||

aniṣṭagandhaścaikaśca nirapatyastathā naraḥ|

citradīpaḥ saraḥ śuṣkamadhāturdhātusannibhaḥ||17||

niṣprajastr̥ṇapūlīti mantavyaḥ puruṣākr̥tiḥ|

apratiṣṭhaśca nagnaśca śūnyaścaikēndriyaśca nā||18||

mantavyō niṣkriyaścaiva yasyāpatyaṁ na vidyatē|

bahumūrtirbahumukhō bahuvyūhō bahukriyaḥ||19||

bahucakṣurbahujñānō bahvātmā ca bahuprajaḥ|

maṅgalyē'yaṁ praśasyō'yaṁ dhanyō'yaṁ vīryavānayam||20||

bahuśākhō'yamiti ca stūyatē nā bahuprajaḥ|

prītirbalaṁ sukhaṁ vr̥ttirvistārō vipulaṁ kulam||21||

yaśō lōkāḥ sukhōdarkāstuṣṭiścāpatyasaṁśritāḥ|

tasmādapatyamanvicchan guṇāṁścāpatyasaṁśritān||22||

vājīkaraṇanityaḥ syādicchan kāmasukhāni ca|

upabhōgasukhān siddhān vīryāpatyavivardhanān||23||

vājīkaraṇasaṁyōgān pravakṣyāmyata uttaram|

acchAyashcaikashAkhashca niShphalashca yathA drumaH||16||

aniShTagandhashcaikashca nirapatyastathA naraH|

citradIpaH saraH shuShkamadhAturdhAtusannibhaH||17||

niShprajastRuNapUlIti mantavyaH puruShAkRutiH|

apratiShThashca nagnashca shUnyashcaikendriyashca nA||18||

mantavyo niShkriyashcaiva yasyApatyaM na vidyate|

bahumUrtirbahumukho bahuvyUho bahukriyaH||19||

bahucakShurbahuj~jAno bahvAtmA ca bahuprajaH|

ma~ggalye~ayaM prashasyo~ayaM dhanyo~ayaM vIryavAnayam||20||

bahushAkho~ayamiti ca stUyate nA bahuprajaH|

prItirbalaM sukhaM vRuttirvistAro vipulaM kulam||21||

yasho lokAH sukhodarkAstuShTishcApatyasaMshritAH|

tasmAdapatyamanvicchan guNAMshcApatyasaMshritAn||22||

vAjIkaraNanityaH syAdicchan kAmasukhAni ca|

upabhogasukhAn siddhAn vIryApatyavivardhanAn||23||

vAjIkaraNasaMyogAn pravakShyAmyata uttaram|

A person without a child is just like a solitary tree with branches devoid of fruits and shadows and is devoid of any pleasant smell. The man without progeny is like an idol made of grass wearing the grab of a man. He is regarded as a painted lamp, a dried up lake or a pseudo metal which has the appearance of a precious metal. He is regarded not to be well established, bare, like a void and possesses only one sense organ and as having lived a purposeless life.

While, the person having numerous progeny is praised as one possessing a multiplicity of forms, having many faces, many dimensions, having lot of activities and having many eyes and also having intellect and soul. Such kind of a person is auspicious, praiseworthy, blessed, virile and the source of many genealogical branches. Affection, strength, happiness, livelihood, wide spread influence, vastness of kinsmen, fame, utility of the world which gives happiness latter on and pleasure are all dependent up on progeny. Therefore, a person desirous of progeny and the qualities associated with them should always take the virilifying medications if he wants satisfaction of the worldly desires and happiness. [16-23]

===== Various preparations for improving virility =====
====== ''Brimhani Gutika'' ======

शरमूलेक्षुमूलानि काण्डेक्षुः सेक्षुवालिका||२४||

शतावरी पयस्या च विदारी कण्टकारिका|

जीवन्ती जीवको मेदा वीरा चर्षभको बला||२५||

ऋद्धिर्गोक्षुरकं रास्ना सात्मगुप्ता पुनर्नवा|

एषां त्रिपलिकान् भागान् माषाणामाढकं नवम्||२६||

विपाचयेज्जलद्रोणे चतुर्भागं च शेषयेत्|

तत्र पेष्याणि मधुकं द्राक्षा फल्गूनि पिप्पली||२७||

आत्मगुप्ता मधुकानि खर्जूराणि शतावरी|

विदार्यामलकेक्षूणां रसस्य च पृथक् पृथक्||२८||

सर्पिषश्चाढकं दद्यात् क्षीरद्रोणं च तद्भिषक्|

साधयेद्घृतशेषं च सुपूतं योजयेत् पुनः||२९||

शर्करायास्तुगाक्षीर्याश्चूर्णैः प्रस्थोन्मितैः पृथक्|

पलैश्चतुर्भिर्मागध्याः पलेन मरिचस्य च||३०||

त्वगेलाकेशराणां च चूर्णैरर्धपलोन्मितैः|

मधुनः कुडवाभ्यां च द्वाभ्यां तत्कारयेद्भिषक्||३१||

पलिका गुलिकास्त्यानास्ता यथाग्नि प्रयोजयेत्|

एष वृष्यः परं योगो बृंहणो बलवर्धनः||३२||

अनेनाश्व इवोदीर्णो बली लिङ्गं समर्पयेत्|३३|

(इति बृंहणीगुटिका)

śaramūlēkṣumūlāni kāṇḍēkṣuḥ sēkṣuvālikā||24||

śatāvarī payasyā ca vidārī kaṇṭakārikā|

jīvantī jīvakō mēdā vīrā carṣabhakō balā||25||

r̥ddhirgōkṣurakaṁ rāsnā sātmaguptā punarnavā|

ēṣāṁ tripalikān bhāgān [3] māṣāṇāmāḍhakaṁ navam||26||

vipācayējjaladrōṇē caturbhāgaṁ ca śēṣayēt|

tatra pēṣyāṇi madhukaṁ drākṣā phalgūni pippalī||27||

ātmaguptā madhukāni kharjūrāṇi śatāvarī|

vidāryāmalakēkṣūṇāṁ rasasya ca pr̥thak pr̥thak||28||

sarpiṣaścāḍhakaṁ dadyāt kṣīradrōṇaṁ ca tadbhiṣak|

sādhayēdghr̥taśēṣaṁ ca supūtaṁ yōjayēt punaḥ||29||

śarkarāyāstugākṣīryāścūrṇaiḥ prasthōnmitaiḥ pr̥thak|

palaiścaturbhirmāgadhyāḥ palēna maricasya ca||30||

tvagēlākēśarāṇāṁ ca cūrṇairardhapalōnmitaiḥ|

madhunaḥ kuḍavābhyāṁ ca dvābhyāṁ tatkārayēdbhiṣak||31||

palikā gulikāstyānāstā [4] yathāgni prayōjayēt|

ēṣa vr̥ṣyaḥ paraṁ yōgō br̥ṁhaṇō balavardhanaḥ||32||

anēnāśva ivōdīrṇō balī liṅgaṁ samarpayēt|33|

(iti br̥ṁhaṇīguṭikā)

sharamUlekShumUlAni kANDekShuH sekShuvAlikA||24||

shatAvarI payasyA ca vidArI kaNTakArikA|

jIvantI jIvako medA vIrA carShabhako balA||25||

RuddhirgokShurakaM rAsnA sAtmaguptA punarnavA|

eShAM tripalikAn bhAgAn [3] mAShANAmADhakaM navam||26||

vipAcayejjaladroNe caturbhAgaM ca sheShayet|

tatra peShyANi madhukaM drAkShA phalgUni pippalI||27||

AtmaguptA madhukAni kharjUrANi shatAvarI|

vidAryAmalakekShUNAM rasasya ca pRuthak pRuthak||28||

sarpiShashcADhakaM dadyAt kShIradroNaM ca tadbhiShak|

sAdhayedghRutasheShaM ca supUtaM yojayet punaH||29||

sharkarAyAstugAkShIryAshcUrNaiH prasthonmitaiH pRuthak|

palaishcaturbhirmAgadhyAH palena maricasya ca||30||

tvagelAkesharANAM ca cUrNairardhapalonmitaiH|

madhunaH kuDavAbhyAM ca dvAbhyAM tatkArayedbhiShak||31||

palikA gulikAstyAnAstA [4] yathAgni prayojayet|

eSha vRuShyaH paraM yogo bRuMhaNo balavardhanaH||32||

anenAshva ivodIrNo balI li~ggaM samarpayet|33|

(iti bRuMhaNIguTikA)

Three ''palas'' (1 ''pala''=approx.40 gram) of each of the roots of ''shara'' and sugarcane, giant sugarcane, ''ikshubaalika'', ''shatavari'', ''payasya, vidari, kantakari, jeevanti, jeevaka, meda, beera, rishbhaka, bala, ridhi, gokshura, raasna, atmagupta,'' and ''punarnava'' should be mixed with one ''adhaka'' of freshly collected ''masha'' and boiled in one ''drona'' of water till one fourth remains. After that, the paste of ''madhuka, draksha, falgu, pippali, atmagupta, madhuka, kharhura, shatavari, vidari, amalaki'' and the juice of sugarcane should be separately added and one ''adhaka'' of ghee and one ''drona'' of milk should be mixed to it. After boiling this should be filtered and one ''prastha'' of each of sugar and the powder of ''tugakshiri'', four ''palas'' of ''pippali'', one ''pala'' of ''maricha'', half ''pala'' each of the powder of ''twak, ela'' and saffron and two ''kudava'' of honey should be added. Now, semi-solid pills of size of one ''pala'' each in quantity should be prepared. This preparation is highly virilific, nourishing and promoter of strength. On administration of these pills, the person gets stallion like vigor in sexual intercourse. (Formulation: ''Brimhani Ghutika'') [24-32]

====== ''Vajikarana Ghritam'' ======

माषाणामात्मगुप्ताया बीजानामाढकं नवम्||३३||

जीवकर्षभकौ वीरां मेदामृद्धिं शतावरीम्|

मधुकं चाश्वगन्धां च साध्येत् कुडवोन्मिताम्||३४||

रसे तस्मिन् घृतप्रस्थं गव्यं दशगुणं पयः|

विदारीणां रसप्रस्थं प्रस्थमिक्षुरसस्य च||३५||

दत्त्वा मृद्वग्निना साध्यं सिद्धं सर्पिर्निधापयेत्|

शर्करायास्तुगाक्षीर्याः क्षौद्रस्य च पृथक् पृथक्||३६||

भागांश्चतुष्पलांस्तत्र पिप्पल्याश्चावपेत् पलम्|

पलं पूर्वमतो लीढ्वा ततोऽन्नमुपयोजयेत्||३७||

य इच्छेदक्षयं शुक्रं शेफसश्चोत्तमं बलम्|३८|

(इति वाजीकरणं घृतम्)

māṣāṇāmātmaguptāyā bījānāmāḍhakaṁ navam||33||

jīvakarṣabhakau vīrāṁ mēdāmr̥ddhiṁ śatāvarīm|

madhukaṁ cāśvagandhāṁ ca sādhyēt kuḍavōnmitām||34||

rasē tasmin ghr̥taprasthaṁ gavyaṁ daśaguṇaṁ payaḥ|

vidārīṇāṁ rasaprasthaṁ prasthamikṣurasasya ca||35||

dattvā mr̥dvagninā sādhyaṁ siddhaṁ sarpirnidhāpayēt|

śarkarāyāstugākṣīryāḥ kṣaudrasya ca pr̥thak pr̥thak||36||

bhāgāṁścatuṣpalāṁstatra pippalyāścāvapēt palam|

palaṁ pūrvamatō līḍhvā tatō'nnamupayōjayēt||37||

ya icchēdakṣayaṁ śukraṁ śēphasaścōttamaṁ balam|38|

(iti vājīkaraṇaṁ ghr̥tam)

mAShANAmAtmaguptAyA bIjAnAmADhakaM navam||33||

jIvakarShabhakau vIrAM medAmRuddhiM shatAvarIm|

madhukaM cAshvagandhAM ca sAdhyet kuDavonmitAm||34||

rase tasmin ghRutaprasthaM gavyaM dashaguNaM payaH|

vidArINAM rasaprasthaM prasthamikShurasasya ca||35||

dattvA mRudvagninA sAdhyaM siddhaM sarpirnidhApayet|

sharkarAyAstugAkShIryAH kShaudrasya ca pRuthak pRuthak||36||

bhAgAMshcatuShpalAMstatra pippalyAshcAvapet palam|

palaM pUrvamato lIDhvA tato~annamupayojayet||37||

ya icchedakShayaM shukraM shephasashcottamaM balam|38|

(iti vAjIkaraNaM ghRutam)

Decoction of one ''adhaka'' each of freshly collected ''masha'', seeds of ''atmagupta, jeevaka, rishbhaka, veera, meda, riddhi, shatavari, madhuka'' and ''ashwagandha'' should be prepared and one ''prastha'' of cow’s ghee, ten ''prastha'' of milk, one ''prastha'' of each of juice of ''vidari'' and sugarcane should be added. After that four ''palas'' of each of sugar ''tugakshiri'', and honey and one ''pala'' of ''pippali'' should be added to it. By taking one ''pala'' of this medicated ghee, the man should take food, if he wishes to have an inexhaustible store of semen and great phallic strength. (Formulation: ''Vajikarana Ghrita'') [33-38]

====== ''Vajikarana Pinda Rasa'' ======

शर्करा माषविदलास्तुगाक्षीरी पयो घृतम्||३८||

गोधूमचूर्णषष्ठानि सर्पिष्युत्कारिकां पचेत्|

तां नातिपक्वां मृदितां कौक्कुटे मधुरे रसे||३९||

सुगन्धे प्रक्षिपेदुष्णे यथा सान्द्रीभवेद्रसः|

एष पिण्डरसो वृष्यः पौष्टिको बलवर्धनः||४०||

अनेनाश्व इवोदीर्णो बली लिङ्गं समर्पयेत्|

शिखितित्तिरिहंसानामेवं पिण्डरसो मतः|

बलवर्णस्वरकरः पुमांस्तेन वृषायते||४१||

(इति वाजीकरणपिण्डरसाः [२] )

śarkarā māṣavidalāstugākṣīrī payō ghr̥tam||38||

gōdhūmacūrṇaṣaṣṭhāni sarpiṣyutkārikāṁ pacēt|

tāṁ nātipakvāṁ mr̥ditāṁ kaukkuṭē madhurē rasē||39||

sugandhē prakṣipēduṣṇē yathā sāndrībhavēdrasaḥ|

ēṣa piṇḍarasō vr̥ṣyaḥ pauṣṭikō balavardhanaḥ||40||

anēnāśva ivōdīrṇō balī [1] liṅgaṁ samarpayēt|

śikhitittirihaṁsānāmēvaṁ piṇḍarasō mataḥ|

balavarṇasvarakaraḥ pumāṁstēna vr̥ṣāyatē||41||

(iti vājīkaraṇapiṇḍarasāḥ [2] )

sharkarA mAShavidalAstugAkShIrI payo ghRutam||38||

godhUmacUrNaShaShThAni sarpiShyutkArikAM pacet|

tAM nAtipakvAM mRuditAM kaukkuTe madhure rase||39||

sugandhe prakShipeduShNe yathA sAndrIbhavedrasaH|

eSha piNDaraso vRuShyaH pauShTiko balavardhanaH||40||

anenAshva ivodIrNo balI [1] li~ggaM samarpayet|

shikhitittirihaMsAnAmevaM piNDaraso mataH|

balavarNasvarakaraH pumAMstena vRuShAyate||41||

(iti vAjIkaraNapiNDarasAH [2] )

By adding the six drugs, namely- sugar, dehusked grains of ''masha, tugakshiri,'' milk, ghee and wheat flour, an ''utkarika'' should be prepared in ghee. This, without being over cooked, should be removed and squeezed and to this, sweet, fragrant and hot meat soup of the cock should be added so that it becomes thickened. This preparation is called ''pinda rasa''. This is virilific, tonic and strengthening and by the use of this ''pinda rasa'', a person gets extremely excited, as a result of which, he acquires the stallion like vigor in sexual intercourse.

The ''pinda rasa'' (thickened juice) of the peacock, partridge, or swan in the similar manner , promote strength, complexion, voice and by taking a course of these recipes, a man acquires the increased virility.

(Formulation: ''Vajikarana Pinda Rasa'') [38-41]

====== Various other formulations ======

घृतं माषान् सबस्ताण्डान् साधयेन्माहिषे रसे|

भर्जयेत्तं रसं पूतं फलाम्लं नवसर्पिषि||४२||

ईषत्सलवणं युक्तं धान्यजीरकनागरैः|

एष वृष्यश्च बल्यश्च बृंहणश्च रसोत्तमः||४३||

(इति वृष्यमाहिषरसः)

चटकांस्तित्तिरिरसे तित्तिरीन् कौक्कुटे रसे|

कुक्कुटान् बार्हिणरसे हांसे बार्हिणमेव च||४४||

नवसर्पिषि सन्तप्तान् फलाम्लान् कारयेद्रसान्|

मधुरान् वा यथासात्म्यं गन्धाढ्यान् बलवर्धनान्||४५||

(इत्यन्ये वृष्यरसाः)

तृप्तिं चटकमांसानां गत्वा योऽनुपिबेत् पयः|

न तस्य लिङ्गशैथिल्यं स्यान्न शुक्रक्षयो निशि||४६||

(इति वृष्यमांसम्)

माषयूषेण यो भुक्त्वा घृताढ्यं षष्टिकौदनम्|

पयः पिबति रात्रिं स कृत्स्नां जागर्ति वेगवान्||४७||

(इति वृष्यमाषयोगः)

न ना स्वपिति रात्रिषु नित्यस्तब्धेन शेफसा|

तृप्तः कुक्कुटमांसाना भृष्टानां नक्ररेतसि||४८||

(इति वृष्यः कुक्कुटमांसप्रयोगः)

निःस्राव्य मत्स्याण्डरसं भृष्टं सर्पिषि भक्षयेत्|

हंसबर्हिणदक्षाणामेवमण्डानि भक्षयेत्||४९||

(इति वृष्योऽण्डरसः)

ghr̥taṁ māṣān sabastāṇḍān sādhayēnmāhiṣē rasē|

bharjayēttaṁ rasaṁ pūtaṁ phalāmlaṁ navasarpiṣi||42||

īṣatsalavaṇaṁ yuktaṁ dhānyajīrakanāgaraiḥ|

ēṣa vr̥ṣyaśca balyaśca br̥ṁhaṇaśca rasōttamaḥ||43||

(iti vr̥ṣyamāhiṣarasaḥ)

caṭakāṁstittirirasē tittirīn kaukkuṭē rasē|

kukkuṭān bārhiṇarasē hāṁsē bārhiṇamēva ca||44||

navasarpiṣi santaptān phalāmlān kārayēdrasān|

madhurān vā yathāsātmyaṁ gandhāḍhyān balavardhanān||45||

(ityanyē vr̥ṣyarasāḥ)

tr̥ptiṁ caṭakamāṁsānāṁ gatvā yō'nupibēt payaḥ|

na tasya liṅgaśaithilyaṁ syānna śukrakṣayō niśi||46||

(iti vr̥ṣyamāṁsam)

māṣayūṣēṇa yō bhuktvā ghr̥tāḍhyaṁ ṣaṣṭikaudanam|

payaḥ pibati rātriṁ sa kr̥tsnāṁ jāgarti vēgavān||47||

(iti vr̥ṣyamāṣayōgaḥ)

na nā svapiti rātriṣu nityastabdhēna [1] śēphasā|

tr̥ptaḥ kukkuṭamāṁsānā bhr̥ṣṭānāṁ nakrarētasi||48||

(iti vr̥ṣyaḥ kukkuṭamāṁsaprayōgaḥ)

niḥsrāvya matsyāṇḍarasaṁ bhr̥ṣṭaṁ sarpiṣi bhakṣayēt|

haṁsabarhiṇadakṣāṇāmēvamaṇḍāni bhakṣayēt||49||

(iti vr̥ṣyō'ṇḍarasaḥ)

ghRutaM mAShAn sabastANDAn sAdhayenmAhiShe rase|

bharjayettaM rasaM pUtaM phalAmlaM navasarpiShi||42||

IShatsalavaNaM yuktaM dhAnyajIrakanAgaraiH|

eSha vRuShyashca balyashca bRuMhaNashca rasottamaH||43||

(iti vRuShyamAhiSharasaH)

caTakAMstittirirase tittirIn kaukkuTe rase|

kukkuTAn bArhiNarase hAMse bArhiNameva ca||44||

navasarpiShi santaptAn phalAmlAn kArayedrasAn|

madhurAn vA yathAsAtmyaM gandhADhyAn balavardhanAn||45||

(ityanye vRuShyarasAH)

tRuptiM caTakamAMsAnAM gatvA yo~anupibet payaH|

na tasya li~ggashaithilyaM syAnna shukrakShayo nishi||46||

(iti vRuShyamAMsam)

mAShayUSheNa yo bhuktvA ghRutADhyaM ShaShTikaudanam|

payaH pibati rAtriM sa kRutsnAM jAgarti vegavAn||47||

(iti vRuShyamAShayogaH)

na nA svapiti rAtriShu nityastabdhena [1] shephasA|

tRuptaH kukkuTamAMsAnA bhRuShTAnAM nakraretasi||48||

(iti vRuShyaH kukkuTamAMsaprayogaH)

niHsrAvya matsyANDarasaM bhRuShTaM sarpiShi bhakShayet|

haMsabarhiNadakShANAmevamaNDAni bhakShayet||49||

(iti vRuShyo~aNDarasaH)

Ghee, ''masha'' and the testicles of goat should be cooked with the soup of the meat of buffalo. Then it should be fried in freshly collected ghee, after adding sour fruits. It should be then mixed with small quantity of salt, coriander, cumin seeds and dried ginger. This is an excellent recipe for the promotion of virility, strength and nourishment. (Formulation: ''Vrishya Mahisha Rasa'')

Sparrow cooked in the meat juice of partridge or partridge cooked in the meat juice of chicken, or chicken cooked in the meat juice of peacock, or the peacock cooked in the meat juice of the swan in fresh ghee, and added with juice of sour or sweet fruits according to one’s habituation and mixed with fragrant ingredients. These recipes promote strength. (Formulation: ''Vrishya Rasa'')

The person, who takes the meat of sparrow to his satisfaction and followed by milk, does not experience phallic depression and there will be no ejaculation of semen even if he indulges in sexual intercourse for the whole night. (Formulation: ''Vrishya Mamsa'')

If a person takes the ''shashtika'' type of rice along with soup of ''masha'' mixed with liberal quantity of ghee and followed by milk, remains awake with an undiminished sex urge through the entire night. (Formulation: ''Vrishya Mamsa Yoga'')

If a man takes the meat of chicken, fried with the semen of the crocodile to his satisfaction then he cannot sleep during the nights because of strong erection of his genital organs. (Formulation : ''Vrishya Kukkuta Mamsa Yoga'')

One should take the juice squeezed out of the eggs of fish, fried with ghee. Similarly, the eggs of swan, peacock and chicken should be taken. (Formulation : ''Vrishya Anda Rasa'')[42-49]

भवतश्चात्र-

स्रोतःसु शुद्धेष्वमले शरीरे वृष्यं यदा ना मितमत्ति काले|

वृषायते तेन परं मनुष्यस्तद्बृंहणं चैव बलप्रदं च||५०||

तस्मात् पुरा शोधनमेव कार्यं बलानुरूपं न हि वृष्ययोगाः|

सिध्यन्ति देहे मलिने प्रयुक्ताः क्लिष्टे यथा वाससि रागयोगाः||५१||

bhavataścātra-

srōtaḥsu śuddhēṣvamalē śarīrē vr̥ṣyaṁ yadā nā mitamatti kālē|

vr̥ṣāyatē tēna paraṁ manuṣyastadbr̥ṁhaṇaṁ caiva balapradaṁ ca||50||

tasmāt purā śōdhanamēva kāryaṁ balānurūpaṁ na hi vr̥ṣyayōgāḥ|

sidhyanti dēhē malinē prayuktāḥ kliṣṭē yathā vāsasi rāgayōgāḥ||51||

bhavatashcAtra-

srotaHsu shuddheShvamale sharIre vRuShyaM yadA nA mitamatti kAle|

vRuShAyate tena paraM manuShyastadbRuMhaNaM caiva balapradaM ca||50||

tasmAt purA shodhanameva kAryaM balAnurUpaM na hi vRuShyayogAH|

sidhyanti dehe maline prayuktAH kliShTe yathA vAsasi rAgayogAH||51||

Here are the two verses-

A person, who takes these virilifying preparations in due dose and at a proper time, when his body channels have been cleaned, attains the virility, nourishment and strength. Depending up on the strength of the person, purification should be done before he starts these aphrodisiac recipes, as a dirty cloth does not get properly colored, similarly in an uncleaned body, the aphrodisiac recipes do not produce the desired effects. [50-51]

===== Summary =====

तत्र श्लोकौ-

वाजीकरणसामर्थ्यं क्षेत्रं स्त्री यस्य चैव या|

ये दोषा निरपत्यानां गुणाः पुत्रवतां च ये||५२||

दश पञ्च च संयोगा वीर्यापत्यविवर्धनाः|

उक्तास्ते शरमूलीये पादे पुष्टिबलप्रदाः||५३||

tatra ślōkau-

vājīkaraṇasāmarthyaṁ kṣētraṁ strī yasya caiva yā|

yē dōṣā nirapatyānāṁ guṇāḥ putravatāṁ ca yē||52||

daśa pañca ca saṁyōgā vīryāpatyavivardhanāḥ|

uktāstē śaramūlīyē pādē puṣṭibalapradāḥ||53||

tatra shlokau-

vAjIkaraNasAmarthyaM kShetraM strI yasya caiva yA|

ye doShA nirapatyAnAM guNAH putravatAM ca ye||52||

dasha pa~jca ca saMyogA vIryApatyavivardhanAH|

uktAste sharamUlIye pAde puShTibalapradAH||53||

Here are the two recapitulatory verses-

In this quarter entitled, ''Samyoga Sharamooliya'', the importance of aphrodisiac therapy, qualities of the woman who is a proper sexual partner for a man, the disadvantages of men without progeny and the advantages of those with progeny, and the fifteen preparations for increasing the semen, progeny and providing nourishment and strength have been described. [52-53]

==== II-''Asikta Ksheerika Vajikarana'' ====

अथात आसिक्तक्षीरिकं वाजीकरणपादं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athāta āsiktakṣīrikaṁ vājīkaraṇapādaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAta AsiktakShIrikaM vAjIkaraNapAdaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the second quarter entitled ''Asiktakshirika'' on the virilification. Thus, said Lord Atreya. [1-2]

===== Various formulations =====

====== ''Apatyakari Shashtikadi Gutika'' ======

आसिक्तक्षीरमापूर्णमशुष्कं शुद्धषष्टिकम्|

उदूखले समापोथ्य पीडयेत् क्षीरमर्दितम्||३||

गृहीत्वा तं रसं पूतं गव्येन पयसा सह|

बीजानामात्मगुप्ताया धान्यमाषरसेन च||४||

बलायाः शूर्पपर्ण्योश्च जीवन्त्या जीवकस्य च [२] |

ऋद्ध्यर्षभककाकोलीश्वदंष्ट्रामधुकस्य च||५||

शतावर्या विदार्याश्च द्राक्षाखर्जूरयोरपि|

संयुक्तं मात्रया वैद्यः साधयेत्तत्र चावपेत्||६||

तुगाक्षीर्याः समाषाणां शालीनां षष्टिकस्य च|

गोधूमानां च चूर्णानि यैः स सान्द्रीभवेद्रसः||७||

सान्द्रीभूतं च कुर्यात् प्रभूतमधुशर्करम्|

गुलि(टि)का बदरैस्तुल्यास्ताश्च सर्पिषि भर्जयेत्||८||

ता यथाग्नि प्रयुञ्जानः क्षीरमांसरसाशनः|

पश्यत्यपत्यं विपुलं वृद्धोऽप्यात्मजमक्षयम्||९||

(इत्यपत्यकरी षष्टिकादिगुटिका)

āsiktakṣīramāpūrṇamaśuṣkaṁ śuddhaṣaṣṭikam|

udūkhalē samāpōthya pīḍayēt kṣīramarditam||3||

gr̥hītvā taṁ rasaṁ pūtaṁ gavyēna payasā saha|

bījānāmātmaguptāyā dhānyamāṣarasēna ca||4||

balāyāḥ śūrpaparṇyōśca jīvantyā jīvakasya ca [2] |

r̥ddhyarṣabhakakākōlīśvadaṁṣṭrāmadhukasya ca||5||

śatāvaryā vidāryāśca drākṣākharjūrayōrapi|

saṁyuktaṁ mātrayā vaidyaḥ sādhayēttatra cāvapēt||6||

tugākṣīryāḥ samāṣāṇāṁ śālīnāṁ ṣaṣṭikasya ca|

gōdhūmānāṁ ca cūrṇāni yaiḥ sa sāndrībhavēdrasaḥ||7||

sāndrībhūtaṁ ca kuryāt prabhūtamadhuśarkaram|

guli(ṭi)kā badaraistulyāstāśca sarpiṣi bharjayēt||8||

tā yathāgni prayuñjānaḥ kṣīramāṁsarasāśanaḥ|

paśyatyapatyaṁ vipulaṁ vr̥ddhō'pyātmajamakṣayam||9||

(ityapatyakarī ṣaṣṭikādiguṭikā)

AsiktakShIramApUrNamashuShkaM shuddhaShaShTikam|

udUkhale samApothya pIDayet kShIramarditam||3||

gRuhItvA taM rasaM pUtaM gavyena payasA saha|

bIjAnAmAtmaguptAyA dhAnyamASharasena ca||4||

balAyAH shUrpaparNyoshca jIvantyA jIvakasya ca [2] |

RuddhyarShabhakakAkolIshvadaMShTrAmadhukasya ca||5||

shatAvaryA vidAryAshca drAkShAkharjUrayorapi|

saMyuktaM mAtrayA vaidyaH sAdhayettatra cAvapet||6||

tugAkShIryAH samAShANAM shAlInAM ShaShTikasya ca|

godhUmAnAM ca cUrNAni yaiH sa sAndrIbhavedrasaH||7||

sAndrIbhUtaM ca kuryAt prabhUtamadhusharkaram|

guli(Ti)kA badaraistulyAstAshca sarpiShi bharjayet||8||

tA yathAgni prayu~jjAnaH kShIramAMsarasAshanaH|

pashyatyapatyaM vipulaM vRuddho~apyAtmajamakShayam||9||

(ityapatyakarI ShaShTikAdiguTikA)

Cleaned ''shashtika'' rice soaked in and completely saturated with milk, and when these are still wet, these should be crushed in pestle and mortar, after that by squeezing take that juice and mix it with cow’s milk, and the juice of the seeds of cowage, juice of coriander and black gram, and boil it. While boiling, the decoctions of ''shurpa parni, jeevanti, jeevaka, vriddhi, rishbhaka, kakoli, shwadamstra, madhuka, shatavri, vidari, draksha'' and ''kharjura'' should be added. At the end of boiling, add the powders of ''tugakshiri, masha, shali, shashtika'' and ''godhuma'' in such a way that the juice gets thickened. In that thickened juice, add honey and sugar in adequate quantity and pills should be prepared of the size of a ''badara'' and fried in ghee. Depending upon the digestive power of the individual, these pills should be administered with a diet of milk and meat juice. By taking this potion, even an old man becomes capable of procreating many children, and he enjoys undiminished secretion of semen.[3-9]

====== ''Vrishya Pupalikadi'' formulation ======

चटकानां सहंसानां दक्षाणां शिखिनां तथा|

शिशुमारस्य नक्रस्य भिषक् शुक्राणि संहरेत्||१०||

गव्यं सर्पिर्वराहस्य कुलिङ्गस्य वसामपि|

षष्टिकानां च चूर्णानि चूर्णं गोधूमकस्य च||११||

एभिः पूपलिकाः कार्याः शष्कुल्यो वर्तिकास्तथा|

पूपा धानाश्च विविधा भक्ष्याश्चान्ये पृथग्विधाः||१२||

एषां प्रयोगाद्भक्ष्याणां स्तब्धेनापूर्णरेतसा|

शेफसा वाजिवद्याति यावदिच्छं स्त्रियो नरः||१३||

(इति वृष्यपूपलिकादियोगाः)

caṭakānāṁ sahaṁsānāṁ dakṣāṇāṁ śikhināṁ tathā|

śiśumārasya nakrasya bhiṣak śukrāṇi saṁharēt||10||

gavyaṁ sarpirvarāhasya kuliṅgasya vasāmapi|

ṣaṣṭikānāṁ ca cūrṇāni cūrṇaṁ gōdhūmakasya [3] ca||11||

ēbhiḥ pūpalikāḥ kāryāḥ śaṣkulyō vartikāstathā|

pūpā dhānāśca vividhā bhakṣyāścānyē pr̥thagvidhāḥ||12||

ēṣāṁ prayōgādbhakṣyāṇāṁ stabdhēnāpūrṇarētasā|

śēphasā vājivadyāti yāvadicchaṁ striyō naraḥ||13||

(iti vr̥ṣyapūpalikādiyōgāḥ)

caTakAnAM sahaMsAnAM dakShANAM shikhinAM tathA|

shishumArasya nakrasya bhiShak shukrANi saMharet||10||

gavyaM sarpirvarAhasya kuli~ggasya vasAmapi|

ShaShTikAnAM ca cUrNAni cUrNaM godhUmakasya [3] ca||11||

ebhiH pUpalikAH kAryAH shaShkulyo vartikAstathA|

pUpA dhAnAshca vividhA bhakShyAshcAnye pRuthagvidhAH||12||

eShAM prayogAdbhakShyANAM stabdhenApUrNaretasA|

shephasA vAjivadyAti yAvadicchaM striyo naraH||13||

(iti vRuShyapUpalikAdiyogAH)

The physician should collect semen of the sparrow, swan, chicken, peacock, estruant crocodile, and the nekoo crocodile. He should also collect cow’s ghee, boar fat and sparrow fat, the flour of the ''shashtika'' rice and of wheat. With these drugs, ''pupalika, shashkuli, vartika, pupa, dhana,'' and such other varieties of eatables should be prepared. By the administration of these preparations, man becomes fully potent and with strongly erected genital organ, enjoys optimum sexual delight in women with stallion vigor. [10-13]

====== ''Apatyakara Swarasa'' ======

आत्मगुप्ताफलं माषान् खर्जूराणि शतावरीम्|

शृङ्गाटकानि मृद्वीकां साधयेत् प्रसृतोन्मितम्||१४||

क्षीरप्रस्थं जलप्रस्थमेतत् प्रस्थावशेषितम्|

शुद्धेन वाससा पूतं योजयेत् प्रसृतैस्त्रिभिः||१५||

शर्करायास्तुगाक्षीर्याः सर्पिषोऽभिनवस्य च|

तत् पाययेत सक्षौद्रं षष्टिकान्नं च भोजयेत्||१६||

जरापरीतोऽप्यबलो योगेनानेन विन्दति|

नरोऽपत्यं सुविपुलं युवेव च स हृष्यति||१७||

(इत्यपत्यकरः स्वरसः)

ātmaguptāphalaṁ māṣān kharjūrāṇi śatāvarīm|

śr̥ṅgāṭakāni mr̥dvīkāṁ sādhayēt prasr̥tōnmitam||14||

kṣīraprasthaṁ jalaprasthamētat prasthāvaśēṣitam|

śuddhēna vāsasā pūtaṁ yōjayēt prasr̥taistribhiḥ||15||

śarkarāyāstugākṣīryāḥ sarpiṣō'bhinavasya ca|

tat pāyayēta sakṣaudraṁ ṣaṣṭikānnaṁ ca bhōjayēt||16||

jarāparītō'pyabalō yōgēnānēna vindati|

narō'patyaṁ suvipulaṁ yuvēva ca sa hr̥ṣyati||17||

(ityapatyakaraḥ svarasaḥ)

AtmaguptAphalaM mAShAn kharjUrANi shatAvarIm|

shRu~ggATakAni mRudvIkAM sAdhayet prasRutonmitam||14||

kShIraprasthaM jalaprasthametat prasthAvasheShitam|

shuddhena vAsasA pUtaM yojayet prasRutaistribhiH||15||

sharkarAyAstugAkShIryAH sarpiSho~abhinavasya ca|

tat pAyayeta sakShaudraM ShaShTikAnnaM ca bhojayet||16||

jarAparIto~apyabalo yogenAnena vindati|

naro~apatyaM suvipulaM yuveva ca sa hRuShyati||17||

(ityapatyakaraH svarasaH)

Take seeds of ''atmagupta, masha, kharjura, shatavari, shringataka'' and ''mridvika'' in the quantity of one ''prasrita'' and boil with one ''prastha'' of milk and one ''prastha'' of water, till one ''prastha'' remains. Then after, this should be filtered in a piece of cloth and after that mix it with three ''prastha'' of sugar, ''tugakshiri'', and freshly collected ghee. This should be taken with honey followed by a meal of ''shashtika'' rice. By this preparation, even an old and a weak person becomes capable of procreating many children and acquires the virility of youth. [14-17]

====== ''Vrishya Ksheera'' (milk) ======

खर्जूरीमस्तकं माषान् पयस्यां च शतावरीम्|

खर्जूराणि मधूकानि मृद्वीकामजडाफलम्||१८||

पलोन्मितानि मतिमान् [४] साधयेत् सलिलाढके|

तेन पादावशेषेण क्षीरप्रस्थं विपाचयेत्||१९||

क्षीरशेषेण तेनाद्याद् घृताढ्यं षष्टिकौदनम्|

सशर्करेण संयोग एष वृष्यः परं स्मृतः||२०||

(इति वृष्यक्षीरम्)

kharjūrīmastakaṁ māṣān payasyāṁ ca śatāvarīm|

kharjūrāṇi madhūkāni mr̥dvīkāmajaḍāphalam||18||

palōnmitāni matimān [4] sādhayēt salilāḍhakē|

tēna pādāvaśēṣēṇa kṣīraprasthaṁ vipācayēt||19||

kṣīraśēṣēṇa tēnādyād ghr̥tāḍhyaṁ ṣaṣṭikaudanam|

saśarkarēṇa saṁyōga ēṣa vr̥ṣyaḥ paraṁ smr̥taḥ||20||

(iti vr̥ṣyakṣīram)

kharjUrImastakaM mAShAn payasyAM ca shatAvarIm|

kharjUrANi madhUkAni mRudvIkAmajaDAphalam||18||

palonmitAni matimAn [4] sAdhayet salilADhake|

tena pAdAvasheSheNa kShIraprasthaM vipAcayet||19||

kShIrasheSheNa tenAdyAd ghRutADhyaM ShaShTikaudanam|

sasharkareNa saMyoga eSha vRuShyaH paraM smRutaH||20||

(iti vRuShyakShIram)

Take ''kharjuri mastaka, masha, payasya, shatavari, kharjura, madhuka, mridvika'' and the fruit of ''ajada'' (''Shuka Shimbi'') in the quantity of one ''pala'' each with one ''adhaka'' of water till the whole is reduced to one fourth of the quantity. Then it should be cooked again in one ''prastha'' of milk till only milk remains. It should be taken with cooked ''shashtika'' rice, mixed liberally with ghee and with sugar. This is an excellent aphrodisiac. [18-20]

====== ''Vrishya Ghrita'' ======

जीवकर्षभकौ मेदां जीवन्तीं श्रावणीद्वयम्|

खर्जूरं मधुकं द्राक्षां पिप्पलीं विश्वभेषजम्||२१||

शृङ्गाटकं विदारीं च नवं सर्पिः पयो जलम्|

सिद्धं घृतावशेषं तच्छर्कराक्षौद्रपादिकम्||२२||

षष्टिकान्नेन संयुक्तमुपयोज्यं यथाबलम्|

वृष्यं बल्यं च वर्ण्यं च कण्ठ्यं बृंहणमुत्तमम्||२३||

(इति वृष्यघृतम्)

jīvakarṣabhakau mēdāṁ jīvantīṁ śrāvaṇīdvayam|

kharjūraṁ madhukaṁ drākṣāṁ pippalīṁ viśvabhēṣajam||21||

śr̥ṅgāṭakaṁ vidārīṁ ca navaṁ sarpiḥ payō jalam|

siddhaṁ ghr̥tāvaśēṣaṁ taccharkarākṣaudrapādikam||22||

ṣaṣṭikānnēna saṁyuktamupayōjyaṁ yathābalam|

vr̥ṣyaṁ balyaṁ ca varṇyaṁ ca kaṇṭhyaṁ br̥ṁhaṇamuttamam||23||

(iti vr̥ṣyaghr̥tam)

jIvakarShabhakau medAM jIvantIM shrAvaNIdvayam|

kharjUraM madhukaM drAkShAM pippalIM vishvabheShajam||21||

shRu~ggATakaM vidArIM ca navaM sarpiH payo jalam|

siddhaM ghRutAvasheShaM taccharkarAkShaudrapAdikam||22||

ShaShTikAnnena saMyuktamupayojyaM yathAbalam|

vRuShyaM balyaM ca varNyaM ca kaNThyaM bRuMhaNamuttamam||23||

(iti vRuShyaghRutam)

''Jeevaka, rishbhaka, meda, jeevanti,'' both types of ''shravani, kharjura, madhuka, draksha, pippali, vishwabheshaja, shringataka, vidari,'' freshly collected ghee, milk and water should be boiled together till ghee remains and then it should be mixed with one fourth of its quantity of sugar and honey. Depending up on the digestive power, it should be taken along with ''shashtika'' type of rice. This is an excellent recipe to promote virility, strength, complexion, voice and nourishment. [21-23]

====== ''Vrishya Dadhisara'' (cream of curd) ======

दध्नः सरं शरच्चन्द्रसन्निभं दोषवर्जितम्|

शर्कराक्षौद्रमरिचैस्तुगाक्षीर्या च बुद्धिमान्||२४||

युक्त्या युक्तं ससूक्ष्मैलं नवे कुम्भे [५] शुचौ पटे|

मार्जितं प्रक्षिपेच्छीते घृताढ्ये षष्टिकौदने||२५||

पिबेन्मात्रां रसालायास्तं भुक्त्वा षष्टिकौदनम् [६] |

वर्णस्वरबलोपेतः पुमांस्तेन वृषायते||२६||

(वृष्यो दधिसरप्रयोगः)

dadhnaḥ saraṁ śaraccandrasannibhaṁ dōṣavarjitam|

śarkarākṣaudramaricaistugākṣīryā ca buddhimān||24||

yuktyā yuktaṁ sasūkṣmailaṁ navē kumbhē [5] śucau paṭē|

mārjitaṁ prakṣipēcchītē ghr̥tāḍhyē ṣaṣṭikaudanē||25||

pibēnmātrāṁ rasālāyāstaṁ bhuktvā ṣaṣṭikaudanam [6] |

varṇasvarabalōpētaḥ pumāṁstēna vr̥ṣāyatē||26||

(vr̥ṣyō dadhisaraprayōgaḥ)

dadhnaH saraM sharaccandrasannibhaM doShavarjitam|

sharkarAkShaudramaricaistugAkShIryA ca buddhimAn||24||

yuktyA yuktaM sasUkShmailaM nave kumbhe [5] shucau paTe|

mArjitaM prakShipecchIte ghRutADhye ShaShTikaudane||25||

pibenmAtrAM rasAlAyAstaM bhuktvA ShaShTikaudanam [6] |

varNasvarabalopetaH pumAMstena vRuShAyate||26||

(vRuShyo dadhisaraprayogaH)

The cream of curd which is white as the autumnal moon and free from impurities, should be added with sugar, honey, ''maricha'' and ''tugakshiri'' by a wise physician, and to this ''sukshma ela'' should be added in appropriate quantity and then after it should be strained through a clean piece of cloth into a new earthen jar. This should be added with ''shashtika'' type of rice mixed with liberal quantity of ghee. This ''rasala'' should be taken in appropriate quantity and after that ''shashtika'' type of rice should be taken. This recipe promotes the complexion, voice strength and the virility of the man. [24-26]

====== ''Vrishya Shashtika Odana'' (rice) ======

चन्द्रांशुकल्पं पयसा घृताढ्यं षष्टिकौदनम्|

शर्करामधुसंयुक्तं प्रयुञ्जानो वृषायते||२७||

(इति वृष्यः षष्टिकौदनप्रयोगः)

candrāṁśukalpaṁ payasā ghr̥tāḍhyaṁ ṣaṣṭikaudanam|

śarkarāmadhusaṁyuktaṁ prayuñjānō vr̥ṣāyatē||27||

(iti vr̥ṣyaḥ ṣaṣṭikaudanaprayōgaḥ)

candrAMshukalpaM payasA ghRutADhyaM ShaShTikaudanam|

sharkarAmadhusaMyuktaM prayu~jjAno vRuShAyate||27||

(iti vRuShyaH ShaShTikaudanaprayogaH)

One who takes the ''shashtika'' rice which is white like the rays of moon, along with milk and ghee in liberal quantity, sugar and honey, gets virilified. [27]

====== ''Vrishya Pupalika'' ======

तप्ते सर्पिषि नक्राण्डं ताम्रचूडाण्डमिश्रितम्|

युक्तं षष्टिकचूर्णेन सर्पिषाऽभिनवेन च||२८||

पक्त्वा पूपलिकाः खादेद्वारुणीमण्डपो नरः|

य इच्छेदश्ववद्गन्तुं प्रसेक्तुं गजवच्च यः||२९||

(इति वृष्यपूपलिकाः)

taptē sarpiṣi nakrāṇḍaṁ tāmracūḍāṇḍamiśritam|

yuktaṁ ṣaṣṭikacūrṇēna sarpiṣā'bhinavēna ca||28||

paktvā pūpalikāḥ khādēdvāruṇīmaṇḍapō naraḥ|

ya icchēdaśvavadgantuṁ prasēktuṁ gajavacca yaḥ||29||

(iti vr̥ṣyapūpalikāḥ)

tapte sarpiShi nakrANDaM tAmracUDANDamishritam|

yuktaM ShaShTikacUrNena sarpiShA~abhinavena ca||28||

paktvA pUpalikAH khAdedvAruNImaNDapo naraH|

ya icchedashvavadgantuM prasektuM gajavacca yaH||29||

(iti vRuShyapUpalikAH)

The eggs of the crocodile and chicken should be fried in ghee and then it should be mixed with the powder of ''shashtika'' rice and the whole thing should be boiled in ghee. Out of this, pan cakes should be prepared. These sweet pan cakes should be taken followed by ''manda'' of ''varuni'', if he desires to have sexual intercourse the day after, and if he wants to indulge in it with the vigor of an elephant. [28-29]

===== Benefits =====

भवतश्चात्र-

एतैः प्रयोगैर्विधिवद्वपुष्मान् वीर्योपपन्नो [७] बलवर्णयुक्तः|

हर्षान्वितो वाजिवदष्टवर्षो भवेत् समर्थश्च वराङ्गनासु||३०||

यद्यच्च किञ्चिन्मनसः प्रियं स्याद्रम्या वनान्ताः पुलिनानि शैलाः|

इष्टाः स्त्रियो भूषणगन्धमाल्यं प्रिया वयस्याश्च तदत्र योग्यम् [८] ||३१||

bhavataścātra-

ētaiḥ prayōgairvidhivadvapuṣmān vīryōpapannō [7] balavarṇayuktaḥ|

harṣānvitō vājivadaṣṭavarṣō bhavēt samarthaśca varāṅganāsu||30||

yadyacca kiñcinmanasaḥ priyaṁ syādramyā vanāntāḥ pulināni śailāḥ|

iṣṭāḥ striyō bhūṣaṇagandhamālyaṁ priyā vayasyāśca tadatra yōgyam [8] ||31||

bhavatashcAtra-

etaiH prayogairvidhivadvapuShmAn vIryopapanno [7] balavarNayuktaH|

harShAnvito vAjivadaShTavarSho bhavet samarthashca varA~gganAsu||30||

yadyacca ki~jcinmanasaH priyaM syAdramyA vanAntAH pulinAni shailAH|

iShTAH striyo bhUShaNagandhamAlyaM priyA vayasyAshca tadatra yogyam [8] ||31||

Thus it is said:

By the systematic course of these recipes, man is endowed with adequate quantity of semen, strength and complexion and is capable of mating with the best of women with all the virility of a young horse of eight years of age. Whatever things gladden the heart, such as pleasant groves, ponds, hills, pleasing women, ornaments, perfumes, garlands and beloved friends and such other things which are liked by the man- all these acts as stimulating agents of virility. [30-31]

===== Summary =====
तत्र श्लोकः-

आसिक्तक्षीरिके पादे ये योगाः परिकीर्तिताः|

अष्टावपत्यकामैस्ते प्रयोज्याः पौरुषार्थिभिः||३२||

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सास्थाने वाजीकरणाध्याये आसिक्तक्षीरिको नाम वाजीकरणपादो द्वितीयः||२||

tatra ślōkaḥ-

āsiktakṣīrikē pādē yē yōgāḥ parikīrtitāḥ|

aṣṭāvapatyakāmaistē prayōjyāḥ pauruṣārthibhiḥ||32||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē vājīkaraṇādhyāyē āsiktakṣīrikō nāmavājīkaraṇapādō dvitīyaḥ||2||

tatra shlokaH-

AsiktakShIrike pAde ye yogAH parikIrtitAH|

aShTAvapatyakAmaiste prayojyAH pauruShArthibhiH||32||

ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne vAjIkaraNAdhyAye AsiktakShIriko nAmavAjIkaraNapAdo dvitIyaH||2||

Here is the recapitulatory verse-

The eight preparations that are described in this quarter entitled ''Asikti Kshirika'' should be restored to by those who are desirous of manliness and progeny. [32]

==== III- ''Mashaparnabhritiya Vajikarana pada'' ====

अथातो माषपर्णभृतीयं वाजीकरणपादं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō māṣaparṇabhr̥tīyaṁ vājīkaraṇapādaṁ vyakhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto mAShaparNabhRutIyaM vAjIkaraNapAdaM vyakhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the third quarter section entitled ''Mashaparnabhritiya'' on the virilification. Thus said Lord Atreya. [1-2]

===== Specific cow’s milk for ''vajikarana'' =====

माषपर्णभृतां धेनुं गृष्टिं पुष्टां चतुःस्तनीम्|

समानवर्णवत्सां च जीवद्वत्सां च बुद्धिमान्||३||

रोहिणीमथवा कृष्णामूर्ध्वशृङ्गीमदारुणाम्|

इक्ष्वादामर्जुनादां वा सान्द्रक्षीरां च धारयेत्||४||

केवलं तु पयस्तस्याः शृतं वाऽशृतमेव वा|

शर्कराक्षौद्रसर्पिर्भिर्युक्तं तद्वृष्यमुत्तमम्||५||

māṣaparṇabhr̥tāṁ dhēnuṁ gr̥ṣṭiṁ puṣṭāṁ catuḥstanīm|

samānavarṇavatsāṁ ca jīvadvatsāṁ ca buddhimān||3||

rōhiṇīmathavā kr̥ṣṇāmūrdhvaśr̥ṅgīmadāruṇām|

ikṣvādāmarjunādāṁ vā sāndrakṣīrāṁ ca dhārayēt||4||

kēvalaṁ tu payastasyāḥ śr̥taṁ vā'śr̥tamēva vā|

śarkarākṣaudrasarpirbhiryuktaṁ tadvr̥ṣyamuttamam||5||

mAShaparNabhRutAM dhenuM gRuShTiM puShTAM catuHstanIm|

samAnavarNavatsAM ca jIvadvatsAM ca buddhimAn||3||

rohiNImathavA kRuShNAmUrdhvashRu~ggImadAruNAm|

ikShvAdAmarjunAdAM vA sAndrakShIrAM ca dhArayet||4||

kevalaM tu payastasyAH shRutaM vA~ashRutameva vA|

sharkarAkShaudrasarpirbhiryuktaM tadvRuShyamuttamam||5||

The wise man should rear a cow which is fed with the leaves of ''masha''(black gram), stalks of sugar cane and leaves of ''arjuna'', which has calved for the first time, which is well nourished and has four teats, which has a living calf of identical color, which is red or black in color, whose horns are projected upwards and is not fierce and whose milk is thick. This milk can be taken either boiled or fresh or mixed with sugar, honey and ghee for excellent virilific action. [3-5]

===== Processing of milk for increasing semen =====

शुक्रलैर्जीवनीयैश्च बृंहणैर्बलवर्धनैः|

क्षीरसञ्जननैश्चैव पयः सिद्धं पृथक् पृथक्||६||

युक्तं गोधूमचूर्णेन सघृतक्षौद्रशर्करम्|

पर्यायेण प्रयोक्तव्यमिच्छता शुक्रमक्षयम्||७||

śukralairjīvanīyaiśca br̥ṁhaṇairbalavardhanaiḥ|

kṣīrasañjananaiścaiva payaḥ siddhaṁ pr̥thak pr̥thak||6||

yuktaṁ gōdhūmacūrṇēna saghr̥takṣaudraśarkaram|

paryāyēṇa prayōktavyamicchatā śukramakṣayam||7||

shukralairjIvanIyaishca bRuMhaNairbalavardhanaiH|

kShIrasa~jjananaishcaiva payaH siddhaM pRuthak pRuthak||6||

yuktaM godhUmacUrNena saghRutakShaudrasharkaram|

paryAyeNa prayoktavyamicchatA shukramakShayam||7||

Milk prepared with ''shukrala'' (increasing semen), ''jivaniya'' (increasing vitality), ''brimhaniya'' (anabolic), ''bala vardhana'' (increasing strength) and ''kshira samjanana'' (increasing lactation) groups separately and mixed with wheat flour, ghee, honey and sugar should be administered one after the other in succession by a person who is desirous of inexhaustible semen. [6-7]

मेदां पयस्यां जीवन्तीं विदारीं कण्टकारिकाम्|

श्वदंष्ट्रां क्षीरिकां माषान् गोधूमाञ्छालिषष्टिकान्||८||

पयस्यर्धोदके पक्त्वा कार्षिकानाढकोन्मिते|

विवर्जयेत् पयःशेषं तत् पूतं क्षौद्रसर्पिषा||९||

युक्तं सशर्करं पीत्वा वृद्धः सप्ततिकोऽपि वा|

विपुलं लभतेऽपत्यं युवेव च स हृष्यति||१०||

mēdāṁ payasyāṁ jīvantīṁ vidārīṁ kaṇṭakārikām|

śvadaṁṣṭrāṁ kṣīrikāṁ māṣān gōdhūmāñchāliṣaṣṭikān||8||

payasyardhōdakē paktvā kārṣikānāḍhakōnmitē|

vivarjayēt payaḥśēṣaṁ tat pūtaṁ kṣaudrasarpiṣā||9||

yuktaṁ saśarkaraṁ pītvā vr̥ddhaḥ saptatikō'pi vā|

vipulaṁ labhatē'patyaṁ yuvēva ca sa hr̥ṣyati||10||

medAM payasyAM jIvantIM vidArIM kaNTakArikAm|

shvadaMShTrAM kShIrikAM mAShAn godhUmA~jchAliShaShTikAn||8||

payasyardhodake paktvA kArShikAnADhakonmite|

vivarjayet payaHsheShaM tat pUtaM kShaudrasarpiShA||9||

yuktaM sasharkaraM pItvA vRuddhaH saptatiko~api vA|

vipulaM labhate~apatyaM yuveva ca sa hRuShyati||10||

Take one karsha of ''meda, payasya, jeevanti, vidari, kantakari, shvadamshtra, kshirika, masha, godhuma, shali, shashtika'' and boil in one ''adhaka'' of milk and half ''adhaka'' of water till the whole is reduced to one ''adhaka''. It should be then strained. By taking this medicated milk with honey, ghee and sugar, even an old man and a person who is 70 yrs. old, obtains numerous progeny and gets vigor like that of a young person.[8-10]

मण्डलैर्जातरूपस्य तस्या एव पयः शृतम्|

अपत्यजननं सिद्धं सघृतक्षौद्रशर्करम्||११||

maṇḍalairjātarūpasya tasyā ēva payaḥ śr̥tam|

apatyajananaṁ siddhaṁ saghr̥takṣaudraśarkaram||11||

maNDalairjAtarUpasya tasyA eva payaH shRutam|

apatyajananaM siddhaM saghRutakShaudrasharkaram||11||

The milk of above mentioned cow, when boiled with gold coins and then mixed with ghee, honey and sugar, is a tested procreant preparation. [11]

===== ''Vrishya Pippali'' and ''Payas'' formulation =====

त्रिंशत् सुपिष्टाः पिप्पल्यः प्रकुञ्चे तैलसर्पिषोः|

भृष्टाः सशर्कराक्षौद्राः क्षीरधारावदोहिताः||१२||

पीत्वा यथाबलं चोर्ध्वं षष्टिकं क्षीरसर्पिषा|

भुक्त्वा न रात्रिमस्तब्धं लिङ्गं पश्यति ना क्षरत्||१३||

(इति वृष्यः पिप्पलीयोगः)

श्वदंष्ट्राया विदार्याश्च रसे क्षीरचतुर्गुणे|

घृताढ्यः साधितो वृष्यो माषषष्टिकपायसः||१४||

(इति वृष्यपायसयोगः)

triṁśat supiṣṭāḥ pippalyaḥ prakuñcē tailasarpiṣōḥ|

bhr̥ṣṭāḥ saśarkarākṣaudrāḥ kṣīradhārāvadōhitāḥ||12||

pītvā yathābalaṁ cōrdhvaṁ ṣaṣṭikaṁ kṣīrasarpiṣā|

bhuktvā na rātrimastabdhaṁ liṅgaṁ paśyati nā kṣarat||13||

(iti vr̥ṣyaḥ pippalīyōgaḥ)

śvadaṁṣṭrāyā vidāryāśca rasē kṣīracaturguṇē|

ghr̥tāḍhyaḥ sādhitō vr̥ṣyō māṣaṣaṣṭikapāyasaḥ||14||

(iti vr̥ṣyapāyasayōgaḥ)

triMshat supiShTAH pippalyaH praku~jce tailasarpiShoH|

bhRuShTAH sasharkarAkShaudrAH kShIradhArAvadohitAH||12||

pItvA yathAbalaM cordhvaM ShaShTikaM kShIrasarpiShA|

bhuktvA na rAtrimastabdhaM li~ggaM pashyati nA kSharat||13||

(iti vRuShyaH pippalIyogaH)

shvadaMShTrAyA vidAryAshca rase kShIracaturguNe|

ghRutADhyaH sAdhito vRuShyo mAShaShaShTikapAyasaH||14||

(iti vRuShyapAyasayogaH)

A paste of thirty ''pippali'' shall be roasted in one ''prakuncha''(approximate 40 gram) of ghee and sesame oil and then mixed with one ''prakuncha'' sugar and honey each. This mixture shall be kept in a milking vessel. Then the above mentioned cow shall be milked in the vessel. This fresh milk shall be consumed as per one’s ''agni'' or digestive capacity. On feeling hungry, one shall take rice and milk mixed with ghee only. After consuming this, one will not ejaculate the semen early and can have intercourse throughout the night.

''Payasya'' made from ''masha'' and ''shashtika'' cooked in the juice of ''shvadamstra, vidari'' and four times of milk along with liberal quantity of ghee, acts as a virilific.[13-14]

===== ''Vrishya Pupalika'' =====

फलानां जीवनीयानां स्निग्धानां रुचिकारिणाम्|

कुडवश्चूर्णितानां स्यात् स्वयङ्गुप्ताफलस्य च||१५||

कुडवश्चैव माषाणां द्वौ द्वौ च तिलमुद्गयोः|

गोधूमशालिचूर्णानां कुडवः कुडवो भवेत्||१६||

सर्पिषः कुडवश्चैकस्तत् सर्वं क्षीरमर्दितम् [१] |

पक्त्वा पूपलिकाः खादेद्बह्व्यः स्युर्यस्य योषितः||१७||

(इति वृष्यपूपलिकाः)

phalānāṁ jīvanīyānāṁ snigdhānāṁ rucikāriṇām|

kuḍavaścūrṇitānāṁ syāt svayaṅguptāphalasya ca||15||

kuḍavaścaiva māṣāṇāṁ dvau dvau ca tilamudgayōḥ|

gōdhūmaśālicūrṇānāṁ kuḍavaḥ kuḍavō bhavēt||16||

sarpiṣaḥ kuḍavaścaikastat sarvaṁ kṣīramarditam [1] |

paktvā pūpalikāḥ khādēdbahvyaḥ syuryasya yōṣitaḥ||17||

(iti vr̥ṣyapūpalikāḥ)

phalAnAM jIvanIyAnAM snigdhAnAM rucikAriNAm|

kuDavashcUrNitAnAM syAt svaya~gguptAphalasya ca||15||

kuDavashcaiva mAShANAM dvau dvau ca tilamudgayoH|

godhUmashAlicUrNAnAM kuDavaH kuDavo bhavet||16||

sarpiShaH kuDavashcaikastat sarvaM kShIramarditam [1] |

paktvA pUpalikAH khAdedbahvyaH syuryasya yoShitaH||17||

(iti vRuShyapUpalikAH)

One ''kudava'' of each of the powders of fruits of ''jeevaniya, snigdha, ruchikara'' should be mixed with one ''kudava'' of each of the powders of the fruits of ''svayamgupta'' and ''masha'' and two ''kudava'' each of ''tila'' and ''mudga'', one ''kudava'' of each of the powders of ''godhuma'' and ''shali'', and one ''kudava'' of ghee. All these should be ground in milk and by boiling, ''pupalika'' should be prepared. These should be taken by a person who has many wives.[15-17]

===== ''Shatavari Ghrita'' =====

घृतं शतावरीगर्भं क्षीरे दशगुणे पचेत्|

शर्करापिप्पलीक्षौद्रयुक्तं तद्वृष्यमुत्तमम्||१८||

(इति वृष्यं शतावरीघृतम्)

ghr̥taṁ śatāvarīgarbhaṁ kṣīrē daśaguṇē pacēt|

śarkarāpippalīkṣaudrayuktaṁ tadvr̥ṣyamuttamam||18||

(iti vr̥ṣyaṁ śatāvarīghr̥tam)

ghRutaM shatAvarIgarbhaM kShIre dashaguNe pacet|

sharkarApippalIkShaudrayuktaM tadvRuShyamuttamam||18||

(iti vRuShyaM shatAvarIghRutam)

Ghee prepared with ''shatavari'', ten times of milk along with sugar, ''pippali'' and honey acts as an excellent virilific.[18]

===== ''Vrishya Madhuka'' powder formulation =====

कर्षं मधुकचूर्णस्य घृतक्षौद्रसमांशिकम् [१] |

प्रयुङ्क्ते यः पयश्चानु [२] नित्यवेगः स ना भवेत्||१९||

(इति वृष्यमधुकयोगः)

karṣaṁ madhukacūrṇasya ghr̥takṣaudrasamāṁśikam [1] |

prayuṅktē yaḥ payaścānu [2] nityavēgaḥ sa nā bhavēt||19||

(iti vr̥ṣyamadhukayōgaḥ)

karShaM madhukacUrNasya ghRutakShaudrasamAMshikam [1] |

prayu~gkte yaH payashcAnu [2] nityavegaH sa nA bhavet||19||

(iti vRuShyamadhukayogaH)

The person, who takes one ''karsha'' of the powder of ''madhuka'' mixed with equal quantity of ghee and honey followed by milk, gets sexual urge every day.[19]

===== Factors influencing virility =====

घृतक्षीराशनो निर्भीर्निर्व्याधिर्नित्यगो युवा|

सङ्कल्पप्रवणो नित्यं नरः स्त्रीषु वृषायते||२०||

कृतैककृत्याः सिद्धार्था ये चान्योऽन्यानुवर्तिनः|

कलासु कुशलास्तुल्याः सत्त्वेन वयसा च ये||२१||

कुलमाहात्म्यदाक्षिण्यशीलशौचसमन्विताः|

ये कामनित्या ये हृष्टा ये विशोका गतव्यथाः||२२||

ये तुल्यशीला ये भक्ता ये प्रिया ये प्रियंवदाः|

तैर्नरः सह विस्रब्धः सुवयस्यैर्वृषायते||२३||

अभ्यङ्गोत्सादनस्नानगन्धमाल्यविभूषणैः|

गृहशय्यासनसुखैर्वासोभिरहतैः प्रियैः||२४||

विहङ्गानां रुतैरिष्टैः स्त्रीणां चाभरणस्वनैः|

संवाहनैर्वरस्त्रीणामिष्टानां च वृषायते||२५||

मत्तद्विरेफाचरिताः सपद्माः सलिलाशयाः|

जात्युत्पलसुगन्धीनि शीतगर्भगृहणि च||२६||

नद्यः फेनोत्तरीयाश्च गिरयो नीलसानवः|

उन्नतिर्नीलमेघानां, रम्यचन्द्रोदया निशाः||२७||

वायवः सुखसंस्पर्शाः कुमुदाकरगन्धिनः|

रतिभोगक्षमा रात्र्यः सङ्कोचागुरुवल्लभाः||२८||

सुखाः सहायाः परपुष्टघुष्टाः फुल्ला वनान्ता विशदान्नपानाः|

गान्धर्वशब्दाश्च सुगन्धयोगाः सत्त्वं विशालं निरुपद्रवं च||२९||

सिद्धार्थता चाभिनवश्च कामः स्त्री चायुधं सर्वमिहात्मजस्य|

वयो नवं जातमदश्च कालो हर्षस्य योनिः परमा नराणाम्||३०||

ghr̥takṣīrāśanō nirbhīrnirvyādhirnityagō yuvā|

saṅkalpapravaṇō nityaṁ naraḥ strīṣu vr̥ṣāyatē||20||

kr̥taikakr̥tyāḥ siddhārthā yē cānyō'nyānuvartinaḥ|

kalāsu kuśalāstulyāḥ sattvēna vayasā ca yē||21||

kulamāhātmyadākṣiṇyaśīlaśaucasamanvitāḥ|

yē kāmanityā yē hr̥ṣṭā yē viśōkā gatavyathāḥ||22||

yē tulyaśīlā yē bhaktā yē priyā yē priyaṁvadāḥ|

tairnaraḥ saha visrabdhaḥ suvayasyairvr̥ṣāyatē||23||

abhyaṅgōtsādanasnānagandhamālyavibhūṣaṇaiḥ|

gr̥haśayyāsanasukhairvāsōbhirahataiḥ priyaiḥ||24||

vihaṅgānāṁ rutairiṣṭaiḥ strīṇāṁ cābharaṇasvanaiḥ|

saṁvāhanairvarastrīṇāmiṣṭānāṁ ca vr̥ṣāyatē||25||

mattadvirēphācaritāḥ sapadmāḥ salilāśayāḥ|

jātyutpalasugandhīni śītagarbhagr̥haṇi ca||26||

nadyaḥ phēnōttarīyāśca girayō nīlasānavaḥ|

unnatirnīlamēghānāṁ, ramyacandrōdayā niśāḥ||27||

vāyavaḥ sukhasaṁsparśāḥ kumudākaragandhinaḥ|

ratibhōgakṣamā rātryaḥ [1] saṅkōcāguruvallabhāḥ||28||

sukhāḥ sahāyāḥ parapuṣṭaghuṣṭāḥ phullā vanāntā viśadānnapānāḥ|

gāndharvaśabdāśca sugandhayōgāḥ sattvaṁ viśālaṁ nirupadravaṁ ca||29||

siddhārthatā cābhinavaśca kāmaḥ strī cāyudhaṁ sarvamihātmajasya|

vayō navaṁ jātamadaśca kālō harṣasya yōniḥ paramā narāṇām||30||

ghRutakShIrAshano nirbhIrnirvyAdhirnityago yuvA|

sa~gkalpapravaNo nityaM naraH strIShu vRuShAyate||20||

kRutaikakRutyAH siddhArthA ye cAnyo~anyAnuvartinaH|

kalAsu kushalAstulyAH sattvena vayasA ca ye||21||

kulamAhAtmyadAkShiNyashIlashaucasamanvitAH|

ye kAmanityA ye hRuShTA ye vishokA gatavyathAH||22||

ye tulyashIlA ye bhaktA ye priyA ye priyaMvadAH|

tairnaraH saha visrabdhaH suvayasyairvRuShAyate||23||

abhya~ggotsAdanasnAnagandhamAlyavibhUShaNaiH|

gRuhashayyAsanasukhairvAsobhirahataiH priyaiH||24||

viha~ggAnAM rutairiShTaiH strINAM cAbharaNasvanaiH|

saMvAhanairvarastrINAmiShTAnAM ca vRuShAyate||25||

mattadvirephAcaritAH sapadmAH salilAshayAH|

jAtyutpalasugandhIni shItagarbhagRuhaNi ca||26||

nadyaH phenottarIyAshca girayo nIlasAnavaH|

unnatirnIlameghAnAM, ramyacandrodayA nishAH||27||

vAyavaH sukhasaMsparshAH kumudAkaragandhinaH|

ratibhogakShamA rAtryaH [1] sa~gkocAguruvallabhAH||28||

sukhAH sahAyAH parapuShTaghuShTAH phullA vanAntA vishadAnnapAnAH|

gAndharvashabdAshca sugandhayogAH sattvaM vishAlaM nirupadravaM ca||29||

siddhArthatA cAbhinavashca kAmaH strI cAyudhaM sarvamihAtmajasya|

vayo navaM jAtamadashca kAlo harShasya yoniH paramA narANAm||30||

A person who takes ghee and milk, who is fearless and free from diseases and who indulges in sexual activity everyday, who is youthful and who has determination, gets sex vigor with women.

The man who has friends with similar profession, who have accomplished their objectives, who are attached to each other, skilled in fine arts, similar in mind and age, who have noble lineage, expertise, good conduct, and purity, who are ever desirous of enjoyment and are excited, free from grief and pain, who have similar conduct, who have lovable and pleasant disposition as well as speech, such a man gets increased virility. A man’s virility gets stimulated by inunction, dry massage, bath, use of scents, garlands ornaments, comfortable home, bed and seats new and pleasant clothes, pleasing sounds of birds, tinkling sounds of the ornaments of the women and ''samvahana'' (gentle massage without using any substance) by beautiful women.

Big ponds with lotus flowers frequented by honey-intoxicated bees, fragrances of jasmines and blue lotuses and underground rooms which are cold, rivers with waves of foam, mountains with blue peaks, onset of dark clouds, pleasant moonlit nights, pleasant wind with smell of the pond full of ''kumuda'' (water lily), nights that are agreeable for sexual enjoyment, women smeared with saffron and ''aguru'', pleasing companions, rich cooing of the cuckoo bird, gardens in bloom, pleasing food and drinks, musical sounds, perfumed articles, broad mind and free from anxiety, accomplishment of the objective, freshly initiated love and women- these are the weapons of cupid (the god of sex) at the start of youth, sexual excitement, and pleasing times are excellent erotic factors for men.[20-30]

===== Summary =====

तत्र श्लोकः-

प्रहर्षयोनयो योगा व्याख्याता दश पञ्च च|

माषपर्णभृतीयेऽस्मिन् पादे शुक्रबलप्रदाः [२] ||३१||

tatra ślōkaḥ-

praharṣayōnayō yōgā vyākhyātā daśa pañca ca|

māṣaparṇabhr̥tīyē'smin pādē śukrabalapradāḥ [2] ||31||

tatra shlokaH-

praharShayonayo yogA vyAkhyAtA dasha pa~jca ca|

mAShaparNabhRutIye~asmin pAde shukrabalapradAH [2] ||31||

In this sub-section on ''Mashaparnabhritiya'', fifteen preparations for virilification which also promote semen as well as strength, have been described.

====IV - ''Pumanjatabaladiko Vajikarana pada'' ====

अथातः पुमाञ्जातबलादिकं वाजीकरणपादं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pumāñjātabalādikaṁ vājīkaraṇapādaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pumA~jjAtabalAdikaM vAjIkaraNapAdaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the fourth quarter entitled ''Pumana jata Baladika'' on the Virilification. Thus said Lord Atreya.[1-2]

===== Variables in virility =====

पुमान् यथा जातबलो यावदिच्छं स्त्रियो व्रजेत्|

यथा चापत्यवान् सद्यो भवेत्तदुपदेक्ष्यते||३||

न हि जातबलाः सर्वे नराश्चापत्यभागिनः|

बृहच्छरीरा बलिनः सन्ति नारीषु दुर्बलाः||४||

सन्ति चाल्पाश्रयाः [१] स्त्रीषु बलवन्तो बहुप्रजाः|

प्रकृत्या चाबलाः सन्ति सन्ति चामयदुर्बलाः||५||

नराश्चटकवत् केचिद् व्रजन्ति बहुशः स्त्रियम्|

गजवच्च प्रसिञ्चन्ति केचिन्न बहुगामिनः||६||

कालयोगबलाः केचित् केचिदभ्यसनध्रुवाः|

केचित् प्रयत्नैर्व्यज्यन्ते [२] वृषाः केचित् स्वभावतः||७||

तस्मात् प्रयोगान् वक्ष्यामो दुर्बलानां बलप्रदान्|

सुखोपभोगान् बलिनां भूयश्च बलवर्धनान्||८||

पूर्वं शुद्धशरीराणां निरूहैः [३] सानुवासनैः|

बलापेक्षी प्रयुञ्जीत शुक्रापत्यविवर्धनान्||९||

घृततैलरसक्षीरशर्करामधुसंयुताः|

बस्तयः संविधातव्याः क्षीरमांसरसाशिनाम्||१०||

pumān yathā jātabalō yāvadicchaṁ striyō vrajēt|

yathā cāpatyavān sadyō bhavēttadupadēkṣyatē||3||

na hi jātabalāḥ sarvē narāścāpatyabhāginaḥ|

br̥haccharīrā balinaḥ santi nārīṣu durbalāḥ||4||

santi cālpāśrayāḥ [1] strīṣu balavantō bahuprajāḥ|

prakr̥tyā cābalāḥ santi santi cāmayadurbalāḥ||5||

narāścaṭakavat kēcid vrajanti bahuśaḥ striyam|

gajavacca prasiñcanti kēcinna bahugāminaḥ||6||

kālayōgabalāḥ kēcit kēcidabhyasanadhruvāḥ|

kēcit prayatnairvyajyantē [2] vr̥ṣāḥ kēcit svabhāvataḥ||7||

tasmāt prayōgān vakṣyāmō durbalānāṁ balapradān|

sukhōpabhōgān balināṁ bhūyaśca balavardhanān||8||

pūrvaṁ śuddhaśarīrāṇāṁ nirūhaiḥ [3] sānuvāsanaiḥ|

balāpēkṣī prayuñjīta śukrāpatyavivardhanān||9||

ghr̥tatailarasakṣīraśarkarāmadhusaṁyutāḥ|

bastayaḥ saṁvidhātavyāḥ kṣīramāṁsarasāśinām||10||

pumAn yathA jAtabalo yAvadicchaM striyo vrajet|

yathA cApatyavAn sadyo bhavettadupadekShyate||3||

na hi jAtabalAH sarve narAshcApatyabhAginaH|

bRuhaccharIrA balinaH santi nArIShu durbalAH||4||

santi cAlpAshrayAH [1] strIShu balavanto bahuprajAH|

prakRutyA cAbalAH santi santi cAmayadurbalAH||5||

narAshcaTakavat kecid vrajanti bahushaH striyam|

gajavacca prasi~jcanti kecinna bahugAminaH||6||

kAlayogabalAH kecit kecidabhyasanadhruvAH|

kecit prayatnairvyajyante [2] vRuShAH kecit svabhAvataH||7||

tasmAt prayogAn vakShyAmo durbalAnAM balapradAn|

sukhopabhogAn balinAM bhUyashca balavardhanAn||8||

pUrvaM shuddhasharIrANAM nirUhaiH [3] sAnuvAsanaiH|

balApekShI prayu~jjIta shukrApatyavivardhanAn||9||

ghRutatailarasakShIrasharkarAmadhusaMyutAH|

bastayaH saMvidhAtavyAH kShIramAMsarasAshinAm||10||

Now we shall describe how a man whose virility has been enhanced is enabled to have sexual intercourse with women to get the progeny very soon.

It is not that all men possessing physical strength get their progeny soon. There are persons who are great in body built and strength, but are very weak for sexual activities.

There are some persons who are lean and thin in body built but are sexually very strong and have many children. There are some persons who are weak by nature and some have become weak due to diseases.

There are some persons who indulge in sex very frequently like a sparrow and some others who are not mating frequently but ejaculate huge amount of semen during sexual activity.

There are some persons who get their sexual vitality at a particular season, some get because of regular habit, some by taking virilific preparations, and some are virile by nature.

Therefore, some preparations are mentioned here, which invigorate the infirm and which increase the virility of the strong and enhance their enjoyment.

Firstly, the person should be purified by the administration of ''niruha'' and ''anuvasana'' types of enema and after that, semen and progeny promoting preparations should be administered.

To the persons, enema prepared from ghee, oil, meat juice, milk, sugar and honey should be administered. During this therapy, the person shall consume milk and meat juice [3-10]

===== ''Vrishya Mamsa Gutika'' =====

पिष्ट्वा वराहमांसानि दत्त्वा मरिचसैन्धवे|

कोलवद्गुलिकाः कृत्वा तप्ते सर्पिषि वर्तयेत् [१] ||११||

वर्तनस्तम्भितास्ताश्च [२] प्रक्षेप्याः कौक्कुटे रसे|

घृताढ्ये गन्धपिशुने दधिदाडिमसारिके||१२||

यथा न भिन्द्याद्गुलि(टि)कास्तथा तं साधयेद्रसम्|

तं पिबन् भक्षयंस्ताश्च लभते शुक्रमक्षयम्||१३||

मांसानामेवमन्येषां मेद्यानां कारयेद्भिषक्|

गुटिकाः सरसास्तासं प्रयोगः शुक्रवर्धनः||१४||

(इति वृष्या मांसगुटिकाः)

piṣṭvā varāhamāṁsāni dattvā maricasaindhavē|

kōlavadgulikāḥ kr̥tvā taptē sarpiṣi vartayēt [1] ||11||

vartanastambhitāstāśca [2] prakṣēpyāḥ kaukkuṭē rasē|

ghr̥tāḍhyē gandhapiśunē dadhidāḍimasārikē||12||

yathā na bhindyādguli(ṭi)kāstathā taṁ sādhayēdrasam|

taṁ piban bhakṣayaṁstāśca labhatē śukramakṣayam||13||

māṁsānāmēvamanyēṣāṁ mēdyānāṁ kārayēdbhiṣak|

guṭikāḥ sarasāstāsaṁ prayōgaḥ śukravardhanaḥ||14||

(iti vr̥ṣyā māṁsaguṭikāḥ)

piShTvA varAhamAMsAni dattvA maricasaindhave|

kolavadgulikAH kRutvA tapte sarpiShi vartayet [1] ||11||

vartanastambhitAstAshca [2] prakShepyAH kaukkuTe rase|

ghRutADhye gandhapishune dadhidADimasArike||12||

yathA na bhindyAdguli(Ti)kAstathA taM sAdhayedrasam|

taM piban bhakShayaMstAshca labhate shukramakShayam||13||

mAMsAnAmevamanyeShAM medyAnAM kArayedbhiShak|

guTikAH sarasAstAsaM prayogaH shukravardhanaH||14||

(iti vRuShyA mAMsaguTikAH)

Pork should be made to a paste and mix it with black pepper and rock salt, and after that pills of size of a ''kola'', should be prepared and fried in ghee. On becoming hard by frying, these should be poured in to chicken soup mixed with large amount of ghee and powdered spices, curd and juice of pomegranate. This juice should be cooked with due care so that the pills do not break. By administration of this soup and the pills, the person acquires inexhaustible semen. Similarly, the physician should prepare the meat juice and the pills of the meat of other fatty animals. These recipes are promoters of semen. [11-14]

===== ''Vrishya Mahisha Rasa'' =====

माषानङ्कुरिताञ्छुद्धान् वितुषान् साजडाफलान्|

घृताढ्ये माहिषरसे दधिदाडिमसारिके||१५||

प्रक्षिपेन्मात्रया युक्तो धान्यजीरकनागरैः|

भुक्तः पीतश्च स रसः कुरुते शुक्रमक्षयम्||१६||

(इति वृष्यो माहिषरसः)

māṣānaṅkuritāñchuddhān vituṣān sājaḍāphalān|

ghr̥tāḍhyē māhiṣarasē dadhidāḍimasārikē||15||

prakṣipēnmātrayā yuktō dhānyajīrakanāgaraiḥ|

bhuktaḥ pītaśca sa rasaḥ kurutē śukramakṣayam||16||

(iti vr̥ṣyō māhiṣarasaḥ)

mAShAna~gkuritA~jchuddhAn vituShAn sAjaDAphalAn|

ghRutADhye mAhiSharase dadhidADimasArike||15||

prakShipenmAtrayA yukto dhAnyajIrakanAgaraiH|

bhuktaH pItashca sa rasaH kurute shukramakShayam||16||

(iti vRuShyo mAhiSharasaH)

Clean, husked and sprouted grains of ''masha'' should be mixed with the fruits of ''ajada'' and after that these should be added to the soup of meat of buffalo, mixed with large amount of ghee, curd and juice of the pomegranate, coriander, cumin seeds and ginger in appropriate quantity. This potion should be administered to produce inexhaustible semen. [15-16]

===== ''Vrishya Matsya-Mamsa'' =====

आर्द्राणि मत्स्यमांसानि शफरीर्वा सुभार्जिताः|

तप्ते सर्पिषि यः खादेत् स गच्छेत् स्त्रीषु न क्षयम्||१७||

घृतभृष्टान् रसे च्छागे रोहितान् फलसारिके|

अनुपीतरसान् स्निग्धानपत्यार्थी प्रयोजयेत्||१८||

(इति वृष्यघृतभृष्टमत्स्यमांसानि)

ārdrāṇi matsyamāṁsāni śapharīrvā subhārjitāḥ|

taptē sarpiṣi yaḥ khādēt sa gacchēt strīṣu na kṣayam||17||

ghr̥tabhr̥ṣṭān rasē cchāgē rōhitān phalasārikē|

anupītarasān snigdhānapatyārthī prayōjayēt||18||

(iti vr̥ṣyaghr̥tabhr̥ṣṭamatsyamāṁsāni)

ArdrANi matsyamAMsAni shapharIrvA subhArjitAH|

tapte sarpiShi yaH khAdet sa gacchet strIShu na kShayam||17||

ghRutabhRuShTAn rase cchAge rohitAn phalasArike|

anupItarasAn snigdhAnapatyArthI prayojayet||18||

(iti vRuShyaghRutabhRuShTamatsyamAMsAni)

Fresh fish and meat or ''shaphari'' (a type of fish), well fried in ghee, when administered, the person doesn’t get tired in the sex act. One, who is desirous of progeny, should take the ''rohita'' fish, fried in ghee and mixed with the soup of meat of goat and the juice of fruits. After that unctuous soup should be taken by the person.[17-18]

===== ''Vrishya Pupalika'' =====

कुट्टकं [१] मत्स्यमांसानां हिङ्गुसैन्धवधान्यकैः|

युक्तं गोधूमचूर्णेन घृते पूपलिकाः पचेत्||१९||

माहिषे च रसे मत्स्यान् स्निग्धाम्ललवणान् पचेत्|

रसे चानुगते मांसं पोथयेत्तत्र चावपेत्||२०||

मरिचं जीरकं धान्यमल्पं हिङ्गु नवं घृतम्|

माषपूपलिकानां तद्गर्भार्थमुपकल्पयेत्||२१||

एतौ पूपलिकायोगौ बृंहणौ बलवर्धनौ|

हर्षसौभाग्यदौ पुत्र्यौ परं शुक्राभिवर्धनौ||२२||

(इति वृष्यौ पूपलिकायोगौ)

kuṭṭakaṁ [1] matsyamāṁsānāṁ hiṅgusaindhavadhānyakaiḥ|

yuktaṁ gōdhūmacūrṇēna ghr̥tē pūpalikāḥ pacēt||19||

māhiṣē ca rasē matsyān snigdhāmlalavaṇān pacēt|

rasē cānugatē māṁsaṁ pōthayēttatra cāvapēt||20||

maricaṁ jīrakaṁ dhānyamalpaṁ hiṅgu navaṁ ghr̥tam|

māṣapūpalikānāṁ tadgarbhārthamupakalpayēt||21||

ētau pūpalikāyōgau br̥ṁhaṇau balavardhanau|

harṣasaubhāgyadau putryau paraṁ śukrābhivardhanau||22||

(iti vr̥ṣyau pūpalikāyōgau)

kuTTakaM [1] matsyamAMsAnAM hi~ggusaindhavadhAnyakaiH|

yuktaM godhUmacUrNena ghRute pUpalikAH pacet||19||

mAhiShe ca rase matsyAn snigdhAmlalavaNAn pacet|

rase cAnugate mAMsaM pothayettatra cAvapet||20||

maricaM jIrakaM dhAnyamalpaM hi~ggu navaM ghRutam|

mAShapUpalikAnAM tadgarbhArthamupakalpayet||21||

etau pUpalikAyogau bRuMhaNau balavardhanau|

harShasaubhAgyadau putryau paraM shukrAbhivardhanau||22||

(iti vRuShyau pUpalikAyogau)

Paste of flesh of fish mixed with ''hingu, saindhava, dhanyaka'' and wheat flour should be cooked in ghee to prepare the ''pupalika''.

Unctuous, sour and salted fish should be boiled in flesh juice of buffalo; when juice evaporates, the meat should be made to a paste and after that ''maricha, jiraka, dhanyaka'' and small quantity of ''hingu'' and fresh ghee should be mixed, this should be stuffed with in the ''pupalikas'' of ''masha''.

These two ''pupalikas'' are nourishing, strength giving, virilific, auspicious, and promotive of progeny and semen.[19-22]

माषात्मगुप्तागोधूमशालिषष्टिकपैष्टिकम्|

शर्कराया विदार्याश्च चूर्णमिक्षुरकस्य च||२३||

संयोज्य मसृणे क्षीरे घृते पूपलिकाः पचेत्|

पयोऽनुपानास्ताः शीघ्रं कुर्वन्ति वृषतां पराम्||२४||

(इति वृष्या माषादिपूपलिकाः)

शर्करायास्तुलैका स्यादेका गव्यस्य सर्पिषः|

प्रस्थो विदार्याश्चूर्णस्य पिप्पल्याः प्रस्थ एव च||२५||

अर्धाढकं तुगाक्षीर्याः क्षौद्रस्याभिनवस्य च|

तत्सर्वं मूर्च्छितं तिष्ठेन्मार्तिके घृतभाजने||२६||

मात्रामग्निसमां तस्य प्रातः प्रातः प्रयोजयेत्|

एष वृष्यः परं योगो बल्यो बृंहण एव च||२७||

māṣātmaguptāgōdhūmaśāliṣaṣṭikapaiṣṭikam|

śarkarāyā vidāryāśca cūrṇamikṣurakasya ca||23||

saṁyōjya masr̥ṇē kṣīrē ghr̥tē pūpalikāḥ pacēt|

payō'nupānāstāḥ śīghraṁ kurvanti vr̥ṣatāṁ parām||24||

(iti vr̥ṣyā māṣādipūpalikāḥ)śarkarāyāstulaikā syādēkā gavyasya sarpiṣaḥ|

prasthō vidāryāścūrṇasya pippalyāḥ prastha ēva ca||25||

ardhāḍhakaṁ tugākṣīryāḥ kṣaudrasyābhinavasya ca|

tatsarvaṁ mūrcchitaṁ tiṣṭhēnmārtikē ghr̥tabhājanē||26||

mātrāmagnisamāṁ tasya prātaḥ prātaḥ prayōjayēt|

ēṣa vr̥ṣyaḥ paraṁ yōgō balyō br̥ṁhaṇa ēva ca||27||

mAShAtmaguptAgodhUmashAliShaShTikapaiShTikam|

sharkarAyA vidAryAshca cUrNamikShurakasya ca||23||

saMyojya masRuNe kShIre ghRute pUpalikAH pacet|

payo~anupAnAstAH shIghraM kurvanti vRuShatAM parAm||24||

(iti vRuShyA mAShAdipUpalikAH)sharkarAyAstulaikA syAdekA gavyasya sarpiShaH|

prastho vidAryAshcUrNasya pippalyAH prastha eva ca||25||

ardhADhakaM tugAkShIryAH kShaudrasyAbhinavasya ca|

tatsarvaM mUrcchitaM tiShThenmArtike ghRutabhAjane||26||

mAtrAmagnisamAM tasya prAtaH prAtaH prayojayet|

eSha vRuShyaH paraM yogo balyo bRuMhaNa eva ca||27||

Powdered ''masha, atmagupta, shali, sharkara, vidari, ikshuraka'' should be mixed with thick milk and boiled in ghee for the preparation of ''pupalika'' (like pan cake). On administration, these ''pupalika'' followed by milk, the man instantaneously gets excellent vigor.

One ''tula'' of each of sugar and cow’s ghee, one ''prastha'' of each of the powder of ''vidari'' and ''pippali'' and half ''adhaka'' each of ''tugakshiri'' and fresh honey should be mixed and preserved in earthen jar lined with ghee. This potion should be taken in appropriate quantity every morning depending up on the digestive power. This preparation is an excellent virilific, strengthener and roborant.[23-27]

===== ''Apatyakara Ghrita'' =====

शतावर्या विदार्याश्च तथा माषात्मगुप्तयोः|

श्वदंष्ट्रायाश्च निष्क्वाथाञ्जलेषु [१] च पृथक् पृथक्||२८||

साधयित्वा घृतप्रस्थं पयस्यष्टगुणे पुनः|

शर्करामधुयुक्तं तदपत्यार्थी प्रयोजयेत्||२९||

(इत्यपत्यकरं घृतम्)

śatāvaryā vidāryāśca tathā māṣātmaguptayōḥ|

śvadaṁṣṭrāyāśca niṣkvāthāñjalēṣu [1] ca pr̥thak pr̥thak||28||

sādhayitvā ghr̥taprasthaṁ payasyaṣṭaguṇē punaḥ|

śarkarāmadhuyuktaṁ tadapatyārthī prayōjayēt||29||

(ityapatyakaraṁ ghr̥tam)

shatAvaryA vidAryAshca tathA mAShAtmaguptayoH|

shvadaMShTrAyAshca niShkvAthA~jjaleShu [1] ca pRuthak pRuthak||28||

sAdhayitvA ghRutaprasthaM payasyaShTaguNe punaH|

sharkarAmadhuyuktaM tadapatyArthI prayojayet||29||

(ityapatyakaraM ghRutam)

Decoction of ''shatavari, vidari, masha, atmagupta'' and ''shwadamstra'' by boiling them separately in water should be prepared. Along with this decoction, one ''prastha'' of ghee should be boiled with eight times of milk. This ghee should be mixed with sugar and honey. This should be taken by the person who is desirous of progeny.[28-29]

===== ''Vrishya Gutika'' =====

घृतपात्रं शतगुणे विदारीस्वरसे पचेत्|

सिद्धं पुनः शतगुणे गव्ये पयसि साधयेत्||३०||

शर्करायास्तुगाक्षीर्यां क्षौद्रस्येक्षुरकस्य च|

पिप्पल्याः साजडायाश्च भागैः पादांशिकैर्युतम्||३१||

गुलि(टि)काः कारयेद्वैद्यो यथा स्थुलमुदुम्बरम्|

तासां प्रयोगात् पुरुषः कुलिङ्ग इव हृष्यति||३२||

(इति वृष्यगुटिकाः)

ghr̥tapātraṁ śataguṇē vidārīsvarasē pacēt|

siddhaṁ punaḥ śataguṇē gavyē payasi sādhayēt||30||

śarkarāyāstugākṣīryāṁ kṣaudrasyēkṣurakasya ca|

pippalyāḥ sājaḍāyāśca bhāgaiḥ pādāṁśikairyutam||31||

guli(ṭi)kāḥ kārayēdvaidyō yathā sthulamudumbaram|

tāsāṁ prayōgāt puruṣaḥ kuliṅga iva hr̥ṣyati||32||

(iti vr̥ṣyaguṭikāḥ)

ghRutapAtraM shataguNe vidArIsvarase pacet|

siddhaM punaH shataguNe gavye payasi sAdhayet||30||

sharkarAyAstugAkShIryAM kShaudrasyekShurakasya ca|

pippalyAH sAjaDAyAshca bhAgaiH pAdAMshikairyutam||31||

guli(Ti)kAH kArayedvaidyo yathA sthulamudumbaram|

tAsAM prayogAt puruShaH kuli~gga iva hRuShyati||32||

(iti vRuShyaguTikAH)

One ''patra'' of ghee should be cooked in 100 times of juice of ''vidari''. After that it should be cooked in with 100 times of cow’s milk. Then it should be mixed with one fourth in quantity of ''sharkara, tugakshiri,'' honey, ''ikshuraka, pippali'' and ''ajada''. The pills of the size of fruit of ''udumbara'' should be made out of this preparation. By taking these pills, the person gets excited like a ''kulinga'' (sparrow).[30-32]

===== ''Vrishya Utkarika'' =====

सितोपलापलशतं तदर्धं नवसर्पिषः|

क्षौद्रपादेन संयुक्तं साधयेज्जलपादिकम्||३३||

सान्द्रं गोधूमचूर्णानां पादं स्तीर्णे शिलातले|

शुचौ श्लक्ष्णे समुत्कीर्य मर्दनेनोपपादयेत्||३४||

शुद्धा उत्कारिकाः कार्यश्चन्द्रमण्डलसन्निभाः|

तासां प्रयोगाद्गजवन्नारीः सन्तर्पयेन्नरः||३५||

(इति वृष्योत्कारिका)

sitōpalāpalaśataṁ tadardhaṁ navasarpiṣaḥ|

kṣaudrapādēna saṁyuktaṁ sādhayējjalapādikam||33||

sāndraṁ gōdhūmacūrṇānāṁ pādaṁ stīrṇē śilātalē|

śucau ślakṣṇē samutkīrya mardanēnōpapādayēt||34||

śuddhā utkārikāḥ kāryaścandramaṇḍalasannibhāḥ|

tāsāṁ prayōgādgajavannārīḥ santarpayēnnaraḥ||35||

(iti vr̥ṣyōtkārikā)

sitopalApalashataM tadardhaM navasarpiShaH|

kShaudrapAdena saMyuktaM sAdhayejjalapAdikam||33||

sAndraM godhUmacUrNAnAM pAdaM stIrNe shilAtale|

shucau shlakShNe samutkIrya mardanenopapAdayet||34||

shuddhA utkArikAH kAryashcandramaNDalasannibhAH|

tAsAM prayogAdgajavannArIH santarpayennaraH||35||

(iti vRuShyotkArikA)

One hundred ''palas'' of ''sitopala'', 50 ''palas'' of freshly collected ghee, and 25 ''palas'' of honey should be cooked together with 25 ''palas'' of water till it becomes thickened. After that it should be mixed with 25 ''palas'' of wheat flour and the paste then prepared should be spread over a clean and smooth stone slab. It should be kneaded by repeatedly spreading it. After that, ''utkarikas'' which are round and shining like moon, should be prepared. By taking these ''utkarikas'', man becomes capable of doing sexual act in an elephant’s vigor. [33-35]

===== Description of ''Vrishya'' =====

यत् किञ्चिन्मधुरं स्निग्धं जीवनं बृंहणं गुरु|

हर्षणं मनसश्चैव सर्वं तद्वृष्यमुच्यते||३६||

द्रव्यैरेवंविधैस्तस्माद्भावितः प्रमदां व्रजेत्|

आत्मवेगेन चोदीर्णः स्त्रीगुणैश्च प्रहर्षितः||३७||

गत्वा स्नात्वा पयः पीत्वा रसं वाऽनु शयीत ना|

तथाऽस्याप्यायते भूयः शुक्रं च बलमेव च||३८||

यथा मुकुलपुष्पस्य सु(ख) गन्धो नोपलभ्यते|

लभ्यते तद्विकाशात्तु तथा शुक्रं हि देहिनाम्||३९||

नर्ते वै षोडशाद्वर्षात् सप्तत्याः परतो न च|

आयुष्कामो नरः स्त्रीभिः संयोगं कर्तुमर्हति||४०||

अतिबालो ह्यसम्पूर्णसर्वधातुः स्त्रियं व्रजन्|

उपशुष्येत सहसा तडागमिव काजलम्||४१||

शुष्कं रूक्षं यथा काष्ठं जन्तुदग्धं विजर्जरम्|

स्पृष्टमाशु विशीर्येत तथा वृद्धः स्त्रियो व्रजन्||४२||

जरया चिन्तया शुक्रं व्याधिभिः कर्मकर्षणात्|

क्षयं गच्छत्यनशनात् स्त्रीणां चातिनिषेवणात्||४३||

क्षयाद्भयादविश्रम्भाच्छोकात् स्त्रीदोषदर्शनात्|

नारीणामरसज्ञत्वादविचारादसेवनात्||४४||

तृप्तस्यापि स्त्रियो गन्तुं न शक्तिरुपजायते|

देहसत्त्वबलापेक्षी हर्षः शक्तिश्च हर्षजा||४५||

yat kiñcinmadhuraṁ snigdhaṁ jīvanaṁ br̥ṁhaṇaṁ guru|

harṣaṇaṁ manasaścaiva sarvaṁ tadvr̥ṣyamucyatē||36||

dravyairēvaṁvidhaistasmādbhāvitaḥ pramadāṁ vrajēt|

ātmavēgēna cōdīrṇaḥ strīguṇaiśca praharṣitaḥ||37||

gatvā snātvā payaḥ pītvā rasaṁ vā'nu śayīta nā|

tathā'syāpyāyatē bhūyaḥ śukraṁ ca balamēva ca||38||

yathā mukulapuṣpasya su(kha) gandhō nōpalabhyatē|

labhyatē tadvikāśāttu tathā śukraṁ hi dēhinām||39||

nartē vai ṣōḍaśādvarṣāt saptatyāḥ paratō na ca|

āyuṣkāmō naraḥ strībhiḥ saṁyōgaṁ kartumarhati||40||

atibālō hyasampūrṇasarvadhātuḥ striyaṁ vrajan|

upaśuṣyēta sahasā taḍāgamiva kājalam||41||

śuṣkaṁ rūkṣaṁ yathā kāṣṭhaṁ jantudagdhaṁ vijarjaram|

spr̥ṣṭamāśu viśīryēta tathā vr̥ddhaḥ striyō vrajan||42||

jarayā cintayā śukraṁ vyādhibhiḥ karmakarṣaṇāt|

kṣayaṁ gacchatyanaśanāt strīṇāṁ cātiniṣēvaṇāt||43||

kṣayādbhayādaviśrambhācchōkāt strīdōṣadarśanāt|

nārīṇāmarasajñatvādavicārādasēvanāt||44||

tr̥ptasyāpi striyō gantuṁ na śaktirupajāyatē|

dēhasattvabalāpēkṣī harṣaḥ śaktiśca harṣajā||45||

yat ki~jcinmadhuraM snigdhaM jIvanaM bRuMhaNaM guru|

harShaNaM manasashcaiva sarvaM tadvRuShyamucyate||36||

dravyairevaMvidhaistasmAdbhAvitaH pramadAM vrajet|

Atmavegena codIrNaH strIguNaishca praharShitaH||37||

gatvA snAtvA payaH pItvA rasaM vA~anu shayIta nA|

tathA~asyApyAyate bhUyaH shukraM ca balameva ca||38||

yathA mukulapuShpasya su(kha) gandho nopalabhyate|

labhyate tadvikAshAttu tathA shukraM hi dehinAm||39||

narte vai ShoDashAdvarShAt saptatyAH parato na ca|

AyuShkAmo naraH strIbhiH saMyogaM kartumarhati||40||

atibAlo hyasampUrNasarvadhAtuH striyaM vrajan|

upashuShyeta sahasA taDAgamiva kAjalam||41||

shuShkaM rUkShaM yathA kAShThaM jantudagdhaM vijarjaram|

spRuShTamAshu vishIryeta tathA vRuddhaH striyo vrajan||42||

jarayA cintayA shukraM vyAdhibhiH karmakarShaNAt|

kShayaM gacchatyanashanAt strINAM cAtiniShevaNAt||43||

kShayAdbhayAdavishrambhAcchokAt strIdoShadarshanAt|

nArINAmarasaj~jatvAdavicArAdasevanAt||44||

tRuptasyApi striyo gantuM na shaktirupajAyate|

dehasattvabalApekShI harShaH shaktishca harShajA||45||

Any article which is sweet, unctuous, life promoting, nourishing and heavy to digest and causing mental excitement, is to be regarded as virilific.

Therefore, a person, first of all be impregnated with these articles, should approach for his woman. He gets excited by his own urge and also by the erotic attributes of the woman. After the sex act, the man should take bath and drink milk or meat juice and then go to sleep. By doing this, his semen and strength get replenished.

An unblossomed bud does not possess fragrance but fragrance appears when it blossoms. Similar phenomenon takes place in case of semen of the living beings.

It is not proper for a man, desirous of longevity, to enter in to sexual intercourse with woman when he is under sixteen or over seventy yrs. of age.

If a young boy of very tender age whose body elements are not yet fully formed, enters in to sex act with a woman, his body gets dried up like a pond having very little water.

Dried, sapless piece of wood, eaten by worms and has become porous, gets broken immediately by a little pressure. Similarly, the body of the old man gets decayed by sexual intercourse with a woman.

The semen gets diminished by old age, worry, anxiety, diseases, overexertion, fasting and excessive sexual indulgence. By consumption, fear, suspicion and grief, by seeing the deformities in woman, by non excitation of the woman, absence of passionate determination, by abstention from sex and just after full sexual enjoyment, a man is rendered incapable of mating with a woman. This depends on strength of the body and mind.[36-45]

===== Description of ''Shukra'' =====

रस इक्षौ यथा दध्नि सर्पिस्तैलं तिले यथा|

सर्वत्रानुगतं देहे शुक्रं संस्पर्शने तथा||४६||

तत् स्त्रीपुरुषसंयोगे चेष्टासङ्कल्पपीडनात्|

शुक्रं प्रच्यवते स्थानाज्जलमार्द्रात् पटादिव||४७||

हर्षात्तर्षात् सरत्वाच्च पैच्छिल्याद्गौरवादपि|

अणुप्रवणभावाच्च द्रुतत्वान्मारुतस्य च||४८||

अष्टाभ्य एभ्यो हेतुभ्यः शुक्रं देहात् प्रसिच्यते|

चरतो विश्वरूपस्य रूपद्रव्यं यदुच्यते||४९||

rasa ikṣau yathā dadhni sarpistailaṁ tilē yathā|

sarvatrānugataṁ dēhē śukraṁ saṁsparśanē tathā||46||

tat strīpuruṣasaṁyōgē cēṣṭāsaṅkalpapīḍanāt|

śukraṁ pracyavatē sthānājjalamārdrāt paṭādiva||47||

harṣāttarṣāt saratvācca paicchilyādgauravādapi|

aṇupravaṇabhāvācca drutatvānmārutasya ca||48||

aṣṭābhya ēbhyō hētubhyaḥ śukraṁ dēhāt prasicyatē|

caratō viśvarūpasya rūpadravyaṁ yaducyatē||49||

rasa ikShau yathA dadhni sarpistailaM tile yathA|

sarvatrAnugataM dehe shukraM saMsparshane tathA||46||

tat strIpuruShasaMyoge ceShTAsa~gkalpapIDanAt|

shukraM pracyavate sthAnAjjalamArdrAt paTAdiva||47||

harShAttarShAt saratvAcca paicchilyAdgauravAdapi|

aNupravaNabhAvAcca drutatvAnmArutasya ca||48||

aShTAbhya ebhyo hetubhyaH shukraM dehAt prasicyate|

carato vishvarUpasya rUpadravyaM yaducyate||49||

As the juice exists in the sugarcane, ghee in the whole curd, and oil exists in whole part of the sesame seed, in the same way, semen pervades in the entire body which has the sensation of touch.

The semen trickles down from its site during copulation between man and woman because of sex act, passionate attachment, and physical pressure, as water comes out of a wet cloth when squeezed. The semen is ejaculated from the body as a result of these eight factors- excitement, excessive desire, fluidity, viscosity, heaviness, atomicity and the tendency to flow out and the speedy motion of ''vata''. The un-manifested soul which takes different forms in this world, manifests itself in the form of semen.[46-49]

===== Characteristics of ''Shukra'' =====

बहलं मधुरं स्निग्धमविस्रं गुरु पिच्छिलम्|

शुक्लं बहु च यच्छुक्रं फलवत्तदसंशयम्||५०||

bahalaṁ madhuraṁ snigdhamavisraṁ guru picchilam|

śuklaṁ bahu ca yacchukraṁ phalavattadasaṁśayam||50||

bahalaM madhuraM snigdhamavisraM guru picchilam|

shuklaM bahu ca yacchukraM phalavattadasaMshayam||50||

The semen which is thick, sweet, unctuous, without any putrid smell, heavy, viscid, white in color, and abundant in quantity, invariably helps in procreation. This is undoubtful about the semen.[50]

===== ''Vajikarana'' =====

येन नारीषु सामर्थ्यं वाजीवल्लभते [१] नरः|

व्रजेच्चाभ्यधिकं येन वाजीकरणमेव तत्||५१||

yēna nārīṣu sāmarthyaṁ vājīvallabhatē [1] naraḥ|

vrajēccābhyadhikaṁ yēna vājīkaraṇamēva tat||51||

yena nArIShu sAmarthyaM vAjIvallabhate [1] naraH|

vrajeccAbhyadhikaM yena vAjIkaraNameva tat||51||

That process, which make a man capable of copulation with woman frequently and for a long time with stallion vigor, is called [[Vajikarana]].[51]

===== Summary =====

तत्र श्लोकौ-

हेतुर्योगोपदेशस्य योगा द्वादश चोत्तमाः|

यत् पूर्वं मैथुनात् सेव्यं सेव्यं यन्मैथुनादनु||५२||

यदा न सेव्याः प्रमदाः कृत्स्नः शुक्रविनिश्चयः|

निरुक्तं चेह निर्दिष्टं पुमाञ्जातबलादिके||५३||

tatra ślōkau-

hēturyōgōpadēśasya yōgā dvādaśa cōttamāḥ|

yat pūrvaṁ maithunāt sēvyaṁ sēvyaṁ yanmaithunādanu||52||

yadā na sēvyāḥ pramadāḥ kr̥tsnaḥ śukraviniścayaḥ|

niruktaṁ cēha nirdiṣṭaṁ pumāñjātabalādikē||53||

tatra shlokau-

heturyogopadeshasya yogA dvAdasha cottamAH|

yat pUrvaM maithunAt sevyaM sevyaM yanmaithunAdanu||52||

yadA na sevyAH pramadAH kRutsnaH shukravinishcayaH|

niruktaM ceha nirdiShTaM pumA~jjAtabalAdike||53||

To sum up-

In this quarter, called ''Pumanajata Baladika'', the purpose for which the virilifying preparations have been prescribed along with twelve excellent virilific recipes. Things which are to be taken before and after the intercourse; the time when women are not fit to be approached for sex and the determination of the semen in every aspect and the definition of [[Vajikarana]] have also been described in this quarter.[52-53]

=== ''Tattva Vimarsha'' ===

*In order to have healthy progeny and to have one of the pleasures of life (''Kama''), following are necessary:
#Qualities of sexual partners. All five senses functioning well, beautiful, youth, mutual affection, similar likes and dislikes, from different clan, without physical and mental ailments
#Increase the quantity and quality of semen. Agents used should have:
##Similar material like eggs or semen of other animals
##Similar property like cow’s milk, ghee.
##Similar pharmacological function of drugs.
#The male and female partners shall be physically and psychologically able to have pleasant coitus.
*''Vajikarana'' drugs besides helping get good progeny and pleasure is useful in living healthy and long life.
*For copulation, the ''shukra'' should possess qualities such as thickness, sweetness, unctuousness, without any putrid smell, heavyness, viscidity, white in colour, and abundant in quantity. This invariably helps in procreation.
*Mind plays a great role in ''vajikarana''. It is important to have a pleasant mind for proper sexual satisfaction. All those items which lead to pleasure increase virility.
*Sexual act should not be done before age16 and after age 70.

=== ''Vidhi Vimarsha'' ===

''Rasayana'' and ''vajikarana'' therapies have common aim to provide positive health and prevention of diseases by increasing vigor of healthy person and so, [[Vajikarana]] is described just after [[Rasayana]] chapter. Health scientists are showing great interest in screening classical ''rasayana'' drugs for their antioxidant activity and research reveals good results. Studies on ''amalaki rasayana'' <ref>Dwivedi V, Anandan EM, Mony RS, Muraleedharan TS, Valiathan MS, Mutsuddi M, et al. In vivo effects of traditional Ayurvedic formulations in Drosophila melanogaster relate with therapeutic applications. PLoS One. 2012;7:e37113.</ref> shows increased longevity and on Drosophila melanogaster <ref> Fontana L, Partridge L, Longo VD. Extending healthy life span – From yeast to humans. Science. 2010;328:321–6.</ref> there is reduced oxidative damage to extend lifespan. Many drugs are described as ''rasayanas'' and ''vajikara'' both. Reactive oxygen species (ROS) has deteriorating effect on sperm. This has been increasing due to changing lifestyle and exposure to environmental pollution. Spermatozoa normally produce ROS in a normal physiological process. The amount of ROS produced is to be carefully controlled. Imbalance between the generation and scavenging of ROS may lead to damage to DNA or other important structures. Spermatozoa lack cytoplasmic defensive enzymes, such as catalase, glutathione peroxidase, which are involved in the protection of most cell types from ROS induced peroxidative damage. Large amounts of unsaturated fatty acids are observed in plasma membranes of spermatozoa, those are particularly vulnerable to free radical attack.<ref>Jones R and Mann T (1973) Lipid peroxidation in spermatozoa. Proc R Soc Lond B Biol Sci 184,103–107.</ref> The subfertile men have higher concentrations of ROS in seminal plasma, whereas an inverse correlation exists between ROS concentration and motility.<ref>Carlsen E, Giwercman A, Keiding N, Skakkebaek NE, Review Evidence for decreasing quality of semen during past 50 years. BMJ. 1992 Sep 12; 305(6854):609-13</ref> Many ''rasayanas'' act as antioxidants, so they can also be used to enhance sperm quality and quantity. Thus, mutual correlation and common mode of action justifies description of ''vajikarana'' just after ''rasayana'' therapy.

For many years, decline in human semen quality and fertility rates has been a concern.<ref>MacLeod J, Heim L M. Characteristics and variations in semen specimens in 100 normal young men. Journal of Urology. 1945;54:474–482.</ref> Environmental and occupational pollutants, changes in lifestyles, exposure to toxic agents, and changes in dietary habits are observed among the most commonly cited factors associated with these declines.<ref>Tielemans E, Burdorf A, te Velde ER, Weber RF, van Kooij RJ, Veulemans H, Heederik DJ, Occupationally related exposures and reduced semen quality: a case-control study, Fertil Steril. 1999 Apr; 71(4):690-6.</ref> The environmental and lifestyle factors causing subfertility shall be targeted for curative or preventive measures. Environmental stress causes increase in the number of free radicals (i.e., hydrogen peroxide [H2O2] and reactive oxygen species [ROS] that cause apoptosis in the spermatogenic cell.<ref>Wang X, Sharma RK, Sikka SC. Oxidative stress is associated with increased apoptosis leading to spermatoozoa DNA damage in patients with male factor infertility. Fertil Steril. 2003;80:531–5.</ref> Chronic or severe stress leads to anovulation and amenorrhea in women <ref>Barnea, E. R., and Tal, J. Stress-r elated reproductive failure. J. In Vitro Fertil. Embryo Transfer 8: 15-23 (1991).</ref> and to decrease in sperm count, motility, and morphology in men.<ref>McGrady, A. V. Effects of psychological stress on male reproduction: a review. Arch. Androl. 131: 1-10 (1984).</ref> Smoking,<ref>Goverde HJ, Dekker HS, Janssen HJ, Bastiaans BA, Rolland R, Zielhuis GA.,Semen quality and frequency of smoking and alcohol consumption--an explorative study. Int J Fertil Menopausal Stud. 1995 May-Jun;40(3):135-8.</ref> alcohol,<ref>Joo KJ, Kwon YW, Myung SC, Kim TH, The effects of smoking and alcohol intake on sperm quality: light and transmission electron microscopy findings. J Int Med Res. 2012;40(6):2327-35.</ref> caffeine,<ref>Vine MF, Setzer RW Jr, Everson RB, Wyrobek AJ, Human sperm morphometry and smoking, caffeine, and alcohol consumption. Reprod Toxicol. 1997 Mar-Jun;11(2-3):179-84.</ref> pesticides, air pollution,<ref>Jurewicz J, Hanke W, Radwan M, Bonde JP, Environmental factors and semen quality.Int J Occup Med Environ Health. 2009;22(4):305-29.</ref> bisphenol A,<ref>Akingbemi BT, Sottas CM, Koulova AI, Klinefelter GR, Hardy MP. Inhibition of testicular steroidogenesis by the xenoestrogen bisphenol A is associated with reduced pituitary luteinizing hormone secretion and decreased steroidogenic enzyme gene expression in rat Leydig cells. Endocrinology. 2004;145:592–603</ref> diseases like hypertension, diabetes mellitus, obesity, cardio-vascular disease are related to deterioration of reproductive health<ref>Sunil Kumar, Archana Kumari, Shiva, Murarka, Lifestyle factors in deteriorating male reproductive health, Indian Journal of Experimental Biology, Vol 47, August 2009, pp.615-624.</ref> by affecting sperm quality.

==== Role of diet in ''vajikarana'' ====

Nutrition status is also a major cause of sub-fertility. Sexual dysfunction due to malnutrition can be easily overcome. Nutrition is important for DNA synthesis leading to development of spermatozoa and oocytes. Diet also provides exogenous antioxidants (vitamins C and E). Dietary formulations mentioned are perfect amalgamation of energy and nutrients required for production and maturation of sperm.
In Ayurveda, ''ahara'' or diet has been considered to be a form of medicine (''bhaishajya'') and the role of diet is not limited to nutrition only. Properly planned diet can be used for prevention as well as treatment of the diseases. ''Shukra'' is one of the seven ''dhatus'' and is formed by successive evolution of ''dhatus'' starting from ''rasa dhatu'' and diet forms the substrate (Cha. Chi. 15/16). So, ''ahara'' is one important factor on which quality of ''dhatu'' depends.

Various simple dietary preparations which can increase quantity as well as quality of sperm are mentioned. The substance acts in various modes in the body, one of those is the principle of ''dravya samanya'' (similarity in substance) i.e. consumption of food item similar to body tissues increase them due to similar constitution. Keeping this fact in mind semen of different animals has been used with fat. ''Snigdha dravya'' (unctuous substances) increase semen by similar properties. However, this mode of therapy may not have individual acceptance or practical in current period so principle of ''guna samanya'' (''dravya'' with similar properties) may be used.

===== Role of milk and dairy products =====

Milk is integral to Ayurvedic diet regime. In the list of best factors for sustaining life, milk is considered best among all substances providing life (Cha.Su.25/40). Milk has a nutrition value as it provides essential amino acids, vitamins, minerals and fatty acids, and affects absorption of nutrients. Milk fat has a wide-ranging spectrum of fatty acids and lipids. Milk protein is rich in amino acids leading to stimulation of muscle synthesis, positive health effects on blood pressure, inflammation, oxidation and tissue development.

In Ayurveda, milk has been said to have beneficial effect on semen quality. However, in present era due to change in feeding regime of dairy animals, composition of milk might have been changed. This change has resulted into increase in estrogens, fat content etc. which are attributed to cause adverse effect on semen quality. Few researches have claimed that milk and dairy products have negative effect on semen as observed in male mice.<ref>Ma YX, Ebine N, Aoki K, Kusunoki M, Misumi J, Effects of cow's milk on reproduction in ICR male mice, Biomed Environ Sci. 2009 Apr;22(2):161-3.</ref> In another study, intake of full-fat dairy was observed inversely related to sperm motility and morphology.<ref>Afeiche M, Williams PL, Mendiola J, Gaskins AJ, Jørgensen N, Swan SH,Chavarro JE., Dairy food intake in relation to semen quality and reproductive hormone levels among physically active young men. Hum Reprod 2013 Aug;28(8):2265-75</ref> High intake of saturated fats was negatively related to sperm concentration whereas higher intake of omega-3 fats was positively related to sperm morphology.<ref>Jill A. Attaman et al., Dietary fat and semen quality among men attending a fertility clinic, Hum. Reprod. (2012) doi: 10.1093/humrep/des065</ref> It has been suggested that environmental estrogens could be responsible for the decline in sperm counts.

===== Feeding of animal affects quality of milk =====

Milk composition can be altered by the feeding regime of cow. Content of several fatty acids such as c9, t11-CLA and the ratio between omega-6 and omega-3 fatty acids are affected by the amount of grass and supplemental feeds (concentrate) in the diet. Milk content of several vitamins and minerals are also influenced by the cow's diet.<ref>Anna Haug, Arne T Hostmark, and Odd M Harstad Bovine milk in human nutrition – a review, Lipids Health Dis. 2007; 6: 25.</ref> In a study it was found that concentrations of micro-components like CLA, and to a lesser extent EPA and DHA, can be significantly enhanced through the use of diet formulation and nutritional management of dairy cows.<ref>Lock AL, Bauman DE, Modifying milk fat composition of dairy cows to enhance fatty acids beneficial to human health, Lipids, 2004 Dec;39(12):1197-206</ref> In another study effect of diet and cooling interactions on milk composition were studied in cows. So, it can be said that diet definitely affects milk composition and in turn effects are also modulated. If cow is fed with ''masha'' then the qualities of milk will increase and thus such milk is said to be good aphrodisiac that have more beneficial effects on sperm quality. Masha itself has properties of increasing ''shukra'' as it has ''snigdha'' and ''madhura'' qualities.

According to Ayurveda, cow milk is better than other milk. Beneficial role of cow’s milk has been established by some recent researches. A study unambiguously clarified at the cellular level that cow's milk increased the activities of human PPARalpha, PPARdelta, and RXRalpha. The nuclear peroxisome proliferator-activated receptors (PPAR) have been shown to play crucial roles in regulating energy homeostasis including lipid and carbohydrate metabolism, inflammatory responses, and cell proliferation, differentiation, and survival because PPAR agonists have the potential to prevent or ameliorate diseases such as hyperlipidemia, diabetes, atherosclerosis, and obesity.<ref>Suhara W, Koide H, Okuzawa T, Hayashi D, Hashimoto T, Kojo H., Cow's milk increases the activities of human nuclear receptors peroxisome proliferator-activated receptors alpha and delta and retinoid X receptor alpha involved in the regulation of energy homeostasis, obesity, and inflammation, J Dairy Sci. 2009 Sep;92(9):4180-7</ref> Milk is itself regarded as ''Sadyo Shukrakara'' (means instant aphrodisiac) in Ayurveda as it increases sperm quality soon after the consumption.

===== Rice and its preparation with milk =====

''Shashitika'' rice is ''snigdha, madhura'' and ''sheeta'' and so by Ayurvedic principle of ''guna samanya'' (similar properties) it helps in improving semen quality.<ref>Chakrapani, Charak Samhita of Charak with Ayurveda Dipika commentary, Sutrasthana, 5/3, Rastriya Sanskrit Sansthana, Delhi, 2006.</ref> ''Balya'' and ''brimhaniya'' drugs are added to rice for increasing strength of patient. ''Masha, shali, shashtika, godhuma'' provide combination of both carbohydrate and protein. It can be taken with milk and meat juice which again adds nutritive value. As digestive power varies with persons, dose fixation should be done individually after assessment of ''agni''.

''Payasa'' is dietary preparation which is popular as sweet dish in India. It is prepared from combination of milk and rice. It has property to increase sperm quality. If made from various aphrodisiac drugs its effect is much more. ''Payasa'' is included in normal diet regime so it can be easy aphrodisiac formulation by changing contents of ''Payasa''.

==== Ghee ====

Clarified butter (''ghrita'' or ghee) is used as aphrodisiac because it is considered good for ''rasa, shukra'' and ''ojas'' ([[Charak Samhita]] [[Sutra Sthana]] 13/14). Intake of regular ghrita and milk is said to be best ''rasayana'' in ''Agrya Prakrana'' by Charak. Ghee is used as processing media that carries the therapeutic properties of herbs to all the body's tissues. Proper metabolism of drug is crucial in obtaining the maximum benefit. The lipophilic action of ghee facilitates transportation to a target organ and final delivery inside the cell, since the cell membrane also contains lipid. The effect of herb increases when it is used with ghee as compared to powder or tablet form.<ref> Illingworth D, Patil GR, Tamime AY. Anhydrous milk fat manufacture and fractionation. In: Tamime AY, editor. Dairy Fats and Related Products. Chichester, West Sussex: Wiley-Blackwell; 2009.</ref> ''Rasala'' has been said to be ''balya'' and ''shukrala'' (Bhavaprakasha Purva Khanda-12/124-127).

''Pupalika'' is a dietary preparation which increases strength and sexual power. When prepared with potent aphrodisiac drugs as mentioned above its efficacy increases many fold. Such preparation can be easily prepared and can be used as food supplement.

==== Animal proteins and fats for virility ====

Egg increases virility as they provide indispensable nutrients needed for sperm formation. Pork and chicken meat has been used in some formulations. For vegetarians, a diet rich in protein with high nutritive value can be used.

Fish has ''snigdha, madhura, vrimhaniya, balya'' and ''vrishya'' properties. ''Shaphari'' is a kind of small fish. ''Rohita'' is best among different varieties of fish. On basis of ''guna'', fish helps in improving sperm quality. Fish has various important constituents that are not synthesized by humans. Seafood, such as fish, crustacean and molluscan shellfish, and echinoderms, provides in the edible part (e. g., filet, abdominal muscle) many nutritional components beneficial for the human diet like n-3 polyunsaturated long chain fatty acids (PUFAs), namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), essential elements such as selenium and iodine, high potassium and low sodium concentrations, and the vitamins D, A, E, and B-12, as well as taurine (2-aminoethanesulfonic acid) among others. Omega-3 fatty acids are major components of neuronal, retinal, and myocardial membranes. Its protein is highly digestible due to low connective tissue content, and cholesterol content is also low in fish. Lean fish species are extremely low in fat content (<1 %), while fatty species are extremely rich in PUFAs.<ref>Oehlenschläger J Seafood: nutritional benefits and risk aspects, Int J Vitam Nutr Res. 2012 Jun;82(3):168-76. doi: 10.1024/0300-9831/a000108.</ref> Many of these are required for proper functioning of reproductive system of human. So, fish may help in improving sperm quality.

==== Non medicinal agents and mental factors for ''vajikarana'' ====

Mental factors play prime role in sexual behaviour and on this fact. ''Sankalpa'' (determination) is best aphrodisiac. Soumansaya (pleasant mental disposition) is the most important factor in ''garbha dharana'' or conception. While mentioning factors having beneficial role on sperm quality and quantity, mental factors have also been given importance. ''Harsha'' is termed as stimulating pleasure to initiate the sexual act by psychological means (Gangadhar commentary on 1-4/48). ''Harsha'' can be explained as the desire produced from ''Samkalpa'' (fantasy) leading to erection and ejaculation (Chakrapani commentary) .

Mental status and surroundings of the patient plays crucial role in determining virility of a person. Studies show that psychosocial distress contributes significantly to the etiology of some forms of infertility.<ref>Wasser SK, Sewall G, Soules MR.Psychosocial stress as a cause of infertility. Fertil Steril. 1993 Mar;59(3):685-9.</ref> Stress is one among important factor of increasing infertility. Psychological stress reduces semen quality with a central underlying mechanism being impairment of gonadotropin drive.<ref>Fenster L, Katz DF, Wyrobek AJ, Pieper C, Rempel DM, Oman D, Swan SH, Effects of psychological stress on human semen quality, J Androl. 1997 Mar-Apr; 18(2):194-202</ref> Stress also reduces sperm quality by increasing plasma ROS generation and decreasing antioxidant protection.<ref>Eskiocak S, Gozen AS, Taskiran A, Kilic AS, Eskiocak M, Gulen , Effect of psychological stress on the L-arginine-nitric oxide pathway and semen quality., Braz J Med Biol Res. 2006 May; 39(5):581-8.</ref> Lengthy sexual abstinence was found to affect all semen characteristics. Semen volume and concentration and total sperm count showed significant increases, whereas motility and normal morphology decreased significantly with duration of abstinence. With regard to fertility, a long abstinence period might induce senescence of spermatozoa.<ref>Levitas E, Fertil Steril. Relationship between the duration of sexual abstinence and semen quality: analysis of 9,489 semen samples., 2005 Jun;83(6):1680-6.</ref> Mental stress is one of the main causes of infertility. Healthy and stress free mind increases chances of conception. Advice on modifiable lifestyle factors should be given to people presenting for infertility treatment to help them make positive changes that may improve their chances of pregnancy.<ref>Anderson K, Nisenblat V, Norman R. Lifestyle factors in people seeking infertility treatment - A review. Aust N Z J Obstet Gynaecol. 2010 Feb;50(1):8-20. doi: 10.1111/j.1479-828X.2009.01119.x.</ref> Pleasant mind and environment can contribute a lot to improve virility.

Eight factors which are involved in ejaculation process are mentioned. ''Harsha'', as discussed earlier, is stimulating pleasure to initiate the sexual act by psychological means. ''Harsha'' is the desire produced from ''Sankalpa'' (determination) leading to erection and ejaculation. Chakrapani described ''tarsha'' as ''vanitanamabhilasha'' i.e. desire of female partner. The word ''tarsha'' is also used to denote ''trisha'' so it can be described as strong desire to have female partner. Both the ''harsha'' and ''tarsha'' are psychological entities. According to Hemadri, the substance which is having the potency of ''prerana'' (stimulation) is called ''sara''. So, ''sara'' is the natural quality of ''shukra'' and so it flows without retention. ''Picchilata'' refers to sliminess and so it helps in smooth ejaculation. ''Gurutva'' helps in falling of semen. ''Anu'' refers to small so due to ''anubhava'' semen comes out quickly. Chakrapani comments that due to ''anubhava shukra'' has tendency to come out. The factors ''sara, paicchilya, guru, anubhava'' and ''pravanabhava'' are the physical properties of ''shukra'' which helps in ejaculation.

There is immense need that we should change lifestyle to have content mind. Meditation, Yoga and Ayurvedic spiritual principles can contribute a lot in this field.

==== Explanation of ''Shukra'' ====

From the different descriptions given regarding ''shukra'', its structure and functional identity can be understood in a broader sense. The term ''shukra'' represents androgens, semen and sperm itself according to the suitability of the contexts. In above context the seat of ''shukra'' has been told as whole body so it can be taken as hormone. It has been clarified that semen exists in whole and it comes out after sexual arousal. The main object and mean of sexual arousal is tactile stimulation. ''Shukra'' pervades all over the body seated on the ''sparshanendriya'' (tactile sensorium). The mind has inseparable union with ''tvak''. According to Gangadhara the ''shukra'' present in the ''tvak'' (''Tvaggatam Shukram'') by continuous erotic stimulation gets ejaculated. Sushruta compares the ejaculatory physiology with that of lactation since both are deeply associated with psychological factors in [[Nidana Sthana]] 10th chapter. Sushruta explains the physiology of ejaculation as a combined activity of ''vata'' which is heightened by the heat generated in the act of copulation as a result of the rubbing of female and male genital organs which dispels the ''shukra''.

There are various parameters for normal ''shukra''. Beside physical parameters, the main criteria of normal ''shukra'' is that it should be able to procreate progeny.

==== Factors affecting virility ====

Virilty of a person may vary from person to person. Normal variations are described in here. Two parameters are given by which virility of a person can differ. In first example sparrow is mentioned to indicate frequency of sexual activity whereas in second example elephant is mentioned to indicate large amount of semen ejaculation. With help of two examples, sparrow and elephant variation in frequency and amount of semen ejaculation has been mentioned. These two parameters are important for determining fertility rate.

===== Frequency =====
Statistical estimates suggest that fecund ability rises sharply with frequency of intercourse. It is observed in a study that 94% of women aged 35 years and 77% women aged 38 years are conceived with regular intercourse for three years.<ref>Noord-Zaadstra BM, Looman CWN, Alsbach H, Habbema JDF, te Velde ER, Karbaat J. Delaying childbearing: effect of age on fecundity and outcome of pregnancy. BMJ. 1991;302:1361–5.</ref> The risk of erectile dysfunction in males aged among 30 to 75 years can be reduced by maintaining a regular frequency of intercourse.<ref>Zhanting Qin et al.Impact of frequency of intercourse on erectile dysfunction: a cross-sectional study in Wuhan, China, Journal of Huazhong University of Science and Technology (Impact Factor: 0.58). 06/2012; 32(3):396-9.</ref> Coital frequency is directly related to conception. Research shows that best sperm motility is found in semen emission every three to four days on average.<ref>MacLeod J, Gold RZ. The male factor in fertility and infertility. V. Effect of continence on semen quality. Fertil Steril.1952;3:297–315</ref> Intercourse every two to three days can maximize the overall chance of natural conception because spermatozoa can survive for up to seven days after insemination in the female reproductive tract.<ref>Perloff WH, Steinberger E. In vivo survival of spermatozoa in cervical mucus. Am J Obstet Gynecol. 1964;88:439–42.</ref> So, regular coitus with 3-4 days gap should be regarded as optimum coital frequency.

===== Volume =====
With the example of elephant, the second parameter of semen volume is mentioned. According to WHO guidelines, the normal semen volume is 2.0–5.0 mL. Adequate volume of semen is required to carry male gametes into the female reproductive tract. Therefore, ejaculate volume is an important component of a semen analysis done to investigate male factor infertility.<ref>Roberts M, Jarvi K. Steps in the investigation and management of low semen volume in the infertile man. Canadian Urological Association Journal. 2009;3(6):479-485.</ref>

===== Season =====
Effect of seasonal and individual variation on virility of a person has been mentioned. A particular code of conduct based on season has been told for coitus frequency. Such regime helps to preserve the strength of the person. According to Chakrapani, in ''Hemanta'' (early winter) and ''Shishira Ritu'' (winter) virility of a person is more. So one can have coitus regularly as per their strength in these seasons. In ''Vasanta Ritu'' (spring) coitus on every third day, and in ''Varsha Ritu'' (rainy season) in fortnight is advocated.

Human conception follows a seasonal rhythm. <ref>Cagnacci, A. and Volpe, A. (1996) Influence of melatonin and photoperiod on animal and human reproduction. J. Endocrinol. Invest., 19, 382–411</ref> Seasonal modifications of reproductive functions <ref>Meriggiola, M.C., Noonan, E.A., Paulsen, C.A. and Bremner, W.J. (1996) Annual patterns of luteinizing hormone, follicle stimulating hormone, testosterone and inhibin in normal men. Hum. Reprod., 11, 248–252.</ref> and semen parameters <ref>Levine, R.J., Brown, M.H., Bell, M. et al. (1992) Air-conditioned environments do not prevent deterioration of human semen quality during summer. Fertil. Steril., 57, 1075–1083.</ref> are documented in human males. Recent trends noted a decline in relation of seasonal variation and human conception rhythm. The increased industrialization leading to increase in people being shielded from both photoperiod (by indoor work) and temperature (by heating and air conditioning) might be the reason behind this.<ref>Till Roenneberg, Jürgen Aschoff, Annual Rhythm of Human Reproduction: II. Environmental Correlations, J Biol Rhythms September 1990 vol. 5 no. 3 217-239</ref>

==== Cause of infertility ====
In present era, even with availability of sophisticated diagnostics in approximately 15% to 30% of couples we are unable to find out the exact cause of infertility.<ref>Effectiveness and treatment for unexplained infertility, Practice Committee of the American Society for Reproductive Medicine, Fertil Steril. 2006 Nov; 86(5 Suppl 1):S111-4</ref> Ayurvedic Scholars included all conditions in which no evident cause of infertility was seen under broad term ''Prakritya''. The second important cause for infertility which is observed was affliction of diseases. A person who is afflicted with diseases gets debilitated and this result in decrease in fertility/virility. This is another important principle and it shows scientific vision of ancient Ayurvedic scholars.

==== Adverse impact of infertility ====
Infertility is one of the major stress factors<ref>Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):293–308.</ref> similar to the intensity of a life-threatening illness.<ref>Cook E: Characteristics of the biopsychosocial crisis of infertility. J Counsel Dev 1987;65:465-471</ref>,<ref> Leiblum SR, Aviv A and Hamer R (1998) Life after infertility treatment: a long-term investigation of marital and sexual function. Hum Reprod 13, 3569–3574</ref> This distress and its treatment can affect various aspects of personal and family life.<ref>Burns LH and Covington SH (1999) Psychology of Infertility. In Burns LH and Covington SH (eds) Infertility Counselling.A Comprehensive Handbook for Clinicians. Parthenon Publishing, New York, pp. 3–25.</ref> It also adversely affects the relationship in terms of support, satisfaction and communication,<ref>Lee T-Y, Sun G-H and Chao S-C (2001) The effect of an infertility diagnosis on the distress, marital and sexual satisfaction between husbands and wives in Taiwan. Hum Reprod 16, 1762–1767.</ref> increases anxiety, guilt, somatization and depression.<ref>Fassino S, Pièro A, Boggio S, Piccioni V and Garzano L (2002) Anxiety, depression and anger suppression in infertile couples: a controlled study. Hum Reprod 17, 2986–2994.</ref> It challenges one’s own beliefs and about the world.<ref>Domar A, Zuttermeister PC, Seibel M and Benson H (1992b) Psychological improvement in infertile women after behavioural treatment: a replication. Fertil Steril 58, 144–147.</ref> The social network is affected as well.<ref>Fekkes M, Buitendijk SE, Verrips GHW, Braat DDM, Brewaeys AMA, Dolfing JG, Kortman M, Leerentveld RA and Macklon NS (2003) Health-related quality of life in relation to gender to gender and age in couples planning IVF treatment. Hum Reprod 18, 1536–1543</ref> As purpose of life is terribly shattered person goes in depression and considers himself as useless.

==== Selected ''vajikarana'' herbs and formulations currently in use ====
''Shatavari, vidari, jeevanti, twakshiri, sita, godhuma, masha'' are referred to have aphrodisiac properties in recent ''nighantu''(glossaries of herbs). This is due to their inherent properties similar to ''shukra''.
#''Ikshu'': ''Ikshu'' or sugarcane has aphrodisiac properties and when cow is fed with sugarcane stalks than the milk will be more beneficial and rich in its aphrodisiac qualities.
#''Pippali'': ''Pippali'' is said to be ''vrishya'' or drug having property to increase sperm. ''Pippali'' has above mentioned properties only when it is used in proper dose and for short time.
#''Yashtimadhu'': ''Madhuka'' is ''guru, madhura, snigdha'' in properties. So, by ''guna samanya'' it acts as good aphrodisiac. When given with ghee, honey and milk it forms good aphrodisiac formulation.

==== Researches on herbs ====
===== ''Kapikachchu'' (Mucuna pruriens) =====

''Atmagupta'' or Mucuna pruriens has been established as potent aphrodisiac. M. pruriens efficiently recovers the spermatogenic loss induced due to Ethinyl estradiol administration by reduction in ROS, restoration of mitochondrial membrane potential (MMP), regulation of apoptosis and increase in the number of germ cells. L-DOPA largely accounts for pro-spermatogenic properties of M. pruriens.<ref>Singh AP, Sarkar S, Tripathi M, Rajender S. Mucuna pruriens and its major constituent L-DOPA recover spermatogenic loss by combating ROS, loss of mitochondrial membrane potential and apoptosis, PLoS One. 2013;8(1):e54655. doi: 10.1371/journal.pone.0054655. Epub 2013 Jan 22.</ref> In another study, seminal plasma of infertile patients, the levels of lipids, antioxidant vitamins, and corrected fructose were recovered after a decrease in lipid peroxides after treatment.<ref>Ahmad MK, Mahdi AA, Shukla KK, Islam N, Jaiswar SP, Ahmad S., Effect of Mucuna pruriens on semen profile and biochemical parameters in seminal plasma of infertile men, Fertil Steril. 2008 Sep;90(3):627-35. Epub 2007 Nov 14.</ref> Another study has clearly demonstrated the potency of M. pruriens to reduce the diabetic induced sperm damage induced by oxidative stress (OS).<ref>Suresh S, Prithiviraj E, Lakshmi NV, Ganesh MK, Ganesh L, Prakash S. Effect of Mucuna pruriens (Linn.) on mitochondrial dysfunction and DNA damage in epididymal sperm of streptozotocin induced diabetic rat, J Ethnopharmacol. 2013 Jan 9;145(1):32-41. doi: 10.1016/j.jep.2012.10.030. Epub 2012 Oct 26.</ref> In a study oral administration of M. pruriens to infertile men for 3 months not only resulted in general improvement in sperm count and motility but it also led to significant reduction in the level of psychological stress.<ref>Shukla K et al., Mucuna pruriens Reduces Stress and Improves the Quality of Semen in Infertile Men, Evid Based Complement Alternat Med. Mar 2010; 7(1): 137–144.</ref> Similar research studies of other drugs mentioned should be done to explore their aphrodisiac properties.

===== ''Arjuna'' (Terminalia arjuna) =====
Extract of T. arjuna could be used as a natural antioxidant and enhancing the phytosterol content in clarified butter. Antioxidant supplementation drastically improves sperm count and sperm motility.<ref>Wirleitner B, Dietary supplementation of antioxidants improves semen quality of IVF patients in terms of motility, sperm count, and nuclear vacuolization,Int J Vitam Nutr Res. 2012 Dec;82(6):391-8</ref> Some tribal communities of Assam, India use ''arjuna'' in cases of infertility as observed in an ethno-botanical survey.<ref>Deka j, Kalita J. C., Ethnobotanical important medicinal plants of Kamrup district, Assam, India, used in fertility treatment, International research journal of pharmacy, 2013, 4(3).</ref> ''Arjuna'' bark is widely used to decrease level of serum triglycerides and cholesterol, recover the level of high-density lipoprotein (HDL). As an anti-ischemic agent, it relieves myocardial necrosis, modulates platelet aggregation. It is an effective antioxidant.<ref>Sumitra M, Manikandan P, Kumar DA, Arutselvan N, Balakrishna K, Manohar BM, Puvanakrishnan R (2001). Experimental myocardial necrosis in rats: role of arjunolic acid on platelet aggregation, coagulation and antioxidant status. Mol. Cellular Biochem. 224: 135-142</ref> So, antioxidant properties of ''arjuna'' can be used to increase virility of a person.

All five ''Gana'' (''Shukrajanana, Jeevaniya, Brimhaniya, Balya'' and ''Kshira Samjanana'') as mentioned in [[Sutra Sthana]] 4th chapter are used in [[Vajikarana]]. The drugs mentioned in these ''gana'' are mainly ''madhura, sheeta, mridu'' in nature and so by similarity in properties, they increase sperm quality. For example, ''meda'' is included in ''jeevaniya'' and ''shukrajanana gana''; ''payasya'' in ''brimhaniya'' and ''balya''; ''jeevanti'' in ''jeevaniya''; ''shali'' and ''shashtika'' in ''stanyajanana''. These drugs may act on higher center of the brain, i.e. the hypothalamus and limbic system. This may have anti-stress, adaptogenic actions, which helps to alleviate anxiety associated with sexual desire and performance. Administration of ''vajikarana rasayana'' viz. C. orchioides, A. longifolia and M. pruriens ethanolic extracts modulates the level of the pituitary hormones FSH and LH.<ref>Chauhan NS, Saraf DK, Dixit VK. Effect of vajikaran rasayana herbs on pituitary–gonadal axis. Eur J Integr Med. 2010;2:89–91.</ref>

==== Current ''vajikarana'' formulations ====

Experienced ayurvedic physicians create ''vajikarana'' formulations based upon the properties of individual ''dravya'' and needs of the individual. Identification of some drugs mentioned in the text is controversial. Some drugs are endangered species. So, practically it is not possible to prepare some formulations with same ingredients, but ''Pratinidhi'' or ''Abhava'' drugs can be used in place of such drugs.

==== Further scope ====

Ayurvedic formulations for ''vajikarana'' lack research as per current scientific standards. Lack of standardization of formulations and difficulty in getting unadulterated herbs are realistic obstacles in the utility of ''vajikarana'' preparations. Randomized controlled trials of these formulations can be helpful in understanding efficacy, possible side effects and other treatment related parameters.

=== Glossary ===

#Alpaśukra (alpashukra, अल्पशुक्र) Oligozoospermia, Oligospermia : The term signifies decrease of the seminal fluid or decrease of the sperms than the normal.
#ānūpā (anUpA, आनूप) -marshy lands.
#aśvagandhā (AshvagandhA, अश्वगन्धा) Withania somnifera
#atipicchilaṁśukra (atIpicchila shukra, अतिपिच्छल शुक्र) : Increased viscosity of semen : Semen with excessive slimy and viscous
#ātmaguptā (AtmaguptA, आत्मगुप्ता) Mucuna prurita
#avasādi (avasAdi अवसादि): Increased specific gravity of semen : increased specific gravity of semen and reduced motility.
#bahalaṁ (bahalaM- बहलं) - Thick
#balā (balA, बला) Sida cordifolia
#bhayā (bhayA- भय) –Fear.
#br̥ṁhaṇā (bRuMhaNA- बृंहण)- All procedures and treatment which increase body weight and strength is called Brimhana. This therapy is indicated for emaciated, weak and debilitated and for those in convalescence from chronic illness like mal-absorption, tuberculosis, and anemia. Is reverse of reduction.This therapy consisting of rich diet, tonic herbs, rest and relaxing lifestyle. Food prepared with ghee, butter, seasame oil, milk, raw sugar and joggery.
#dāḍima (dADima, दाडिम) Punica granatum
#dhānyaka (dhAnyaka, धान्यक) Coriandrum sativum
#drākṣā (drAkShA, द्राक्षा) Vitis vinifera
#gauravaṁ (gauravaM – गौरवं) - Heavy feeling, Heaviness.
#ghr̥ta (ghRuta, घृत) Clarified butter
#ghr̥taṁ (ghRutA- घृत) - Ghee : clarified buter
#gōdhūma (godhUma, गोधूम) Triticum aestivum
#gōkṣura (gokShura, र्गोक्षुर) Tribulus terrestris
#hiṅgu (hi~ggu, हिङ्गु) Ferula narthex
#ikṣu (ikShu, इक्षु) Saccharum officinarum
#ikṣuvālikā (ikShuvAlikA इक्षुवालिका
#jīraka (jIrakaM, जीरक) Cuminum cyminum
#jīvaka (jIvaka, जीवक) Microstylis wallichi
#kaṇṭakārI (kaNTakArI, कण्टकारी) Solanum surratense
#kharjūra (kharjUra, खर्जूर) Phoenix sylvestris
#klaibya (klaibya,क्लैब्य) Erectile dysfunction, impotent : A person’s persistent inability to perform sexual intercourse with the beloved, willing and submissive partner, though having persistent desire due to the lack of erection and if at all attempted ends into failure without ejaculation due to flaccidity of penis associated with breathlessness and perspiration
#kṣaudrā (kShaudrA- क्षौद्र) Variety of honey collected from small type of honey-bee, its of brownish color.Its of ununctuous and astringent taste and cold in potency. It aggravates Vata and alleviator of Pitta.
#kṣīṇaŚukra (KshiNashukra la (shukrala, शुक्रल : Severe Oligozoopsermia, Oilgospermia : The term signifies severe decrease of the seminal fluid or decrease of the sperms than the normalcy.
#kṣīrā (ShIrA- क्षीर)- Milk; Synonym of Kshira.
#madhuka (madhuka, मधुक) Glycyrrhiza glabra
#maithuna maithuna मैथुन : It indicates sexual intercourse.
#māṁsā (mAMsa, मांस) meat
#marica (marica, मरिच) Piper nigrum
#māṣa (mASha, माष) Phaseolus mungu
#Ōtkārikā (otkArikA ; उत्कारिका) - Poultice- like preparation prepared with anti venomous drugs to soothe or aggravate and release the local doshas (impure body elements).
#pāyasā (pAyasa, पायस) - a sweet made from rice, milk and sugar.
#phalgū (phalgU, फल्गू) Ficus hispida
#phēnila rētōdōṣa (Phenila retodoSha, फेनिल रेतोदोष) : Frothy semen : Semen with excessive froth
#picchilaṁ (picchilaM- पिच्छिलं) - Slimy touch, gummy, Sticky, Sliminess
#pippalī (pippalI, पिप्पली) Piper longum
#praharṣakārī (praharṣakArA – प्रहर्षकारी)- Substances which produce sexual desire.
#punarnavā (punarnavA, पुनर्नवा) Boerhaavia diffusa
#pūpa (pUpa, पूप) a cake , a sort of bread
#pūpalikā (pUpalikA, पूपलिका) a kind of sweet cake fried with ghee or oil
#pūtiśukradōṣa (pUtishukradoSha पूतिशुक्रदोष) : Pyospermia : Semen with pus ( cells)
#rāsnā (rAsnA, रास्ना) Pluchea lanceolata
#rūkṣa rētōdōṣa (rUkSha retodoSha, रूक्ष रेतोदोष) Ruksha retodosha : educed viscosity of semen : Semen with reduced viscosity
#śālī (shAlI, शाली ) : Oryza sativa
#śara (shara,शर) Saccharum bengalense
#śatāvarī (shatAvarI, शतावरी) Asparagus racemosus)
#Sattvā (sattvA ; सत्व)-1.One of the three qualities (sattva, Rajas and Tamas) or constituents of everything in creation.2.Mind, harmony, Natural character, inborn dispostion, Consicious mind, Being in existence.
#śr̥ṅgāṭaka(shRu~ggATaka, शृङ्गाटक) Trapa bispinosa
#śukrajanana (shukrajanana, शुक्रजनन) : Spermatogenesis, The therapeutic measure having spermatogenic properties.
#śukrakṣaya (shukrakShaya, शुक्रक्षय) decrease in quantity of semen
#Śukrala (shukrala, शुक्रल) : The drugs which causes qualitative and quantitative increase in the Śukra(semen) are known as Śukrala.
#Śukrarēcanā (shukrarecana , शुक्र रेचन) : The drugs which help in ejaculation of semen may be known as ŚukraRecaka. The Bṛhatī-fruit and women belong to this group. These are useful for the conditions like aspermia. Milk, Māṣa, Bhallātaka-fruit pulp, Āmalakī-fruit etc. are both Śukrala and ŚukraRecaka
#śukraśōdhana (shukrashodana, शुक्रशोधन) Purification or bringing the normalcy : The therapy or medicines which have the potency of purifying the spermatogenesis there by producing normal and healthy sperm.
#ŚukraStambhaka : The drugs which increase the time of sexual intercourse are known as ŚukraStambhaka. The best indication of these drugs is premature ejaculation.
#śukravardhana (shukravardhana, शुक्रवर्धन) Qualitative and quantitative increase in the Śukra(semen)
#tanu rētōdōṣa (tanu retodoSha, तनु रेतोदोष): Increased liquidity or thin semen : Very thin semen
#vājīkaraṇa (vAjIkaraNa, वाजीकरण) One of the eight branches of Ayurveda which deals with management of defective sperm and spermatogenesis along with sexual potencification. In this, administration of therapeutic procedure or medicine is done which helps to have healthy progeny from generation to generation provides instant vigor, exhilaration, stallion sexual vigor and indulgence in sexual act without any obstacles, excessive affection of the women, enhance the body tissues and maintenance of the state of Semen even in the aged persons.
#vidārī (vidArI, विदारी) Pueraria tuberosa
#visraṁ (visraM- विस्रं) - A smell like that of raw meat, smell like blood ; An attribute of Pitta.
#vivarṇa rētōdōṣa (vivarNa retodoSha, विवर्ण रेतोदोष) : Semen of abnormal color : Discolored semen.
#vr̥ṣya (vRuShya, वृष्य) Substances that increases semen quality and quantity.
#vyavāyā (vyavAyA- व्यवाय)- It indicates sexual intercourse/sexual regimen.

=== References ===
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Rasayana

2019-03-06T03:48:35Z

Pallavmishra:

{{Infobox
|title = Rasayana Chikitsa
|label1 = Section/Chapter
|data1 = [[Chikitsa Sthana]] Chapter 1
|label2 = Preceding Chapter
|data2 = None

|label3= Succeeding Chapter
|data3 = [[Vajikarana]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

==[[Chikitsa Sthana]] Chapter 1, Chapter on the specialization of Rasayana (Rejuvenation therapy) ==

=== Abstract ===

<div style="text-align:justify;">[[Rasayana]], the first chapter of the [[Chikitsa Sthana]] deals with one of the most important specialties of ''Ashtanga'' (eight branches)Ayurveda, namely, ''Rasayana Tantra''. [[Rasayana]] essentially denotes medicinal nutrition, rejuvenation, longevity, immune-enhancing and geriatric health care. The ''rasayanas'' are not necessarily drugs. They may be in the form of a ''rasayana'' food, or a positive healthy life style with a ''rasayana'' effect or a ''rasayana'' drug or all the three together. The ''rasayana'' remedies promote good qualities of the cells and tissues of the body through improved nutrient effect, boosting the digestion, metabolism and/or augmenting the microcirculation and tissue perfusion. This chapter is divided in four ''padas'' (parts) dealing with different aspects of ''rasayana'' therapy.

The four ''padas'' are named as:
#''Abhayamalakiya Rasayana Pada''
#''Pranakamiya Rasayana Pada''
#''Karaprachitiya Rasayana Pada''
#''Ayurveda Samutthaniya Rasayana Pada''.

'''Keywords''':''Rasayana, Ojas , Ojabala, Vyadhikshamatva,'' Rejuvenation, Geriatrics, longevity, Immunity, Functional foods, nutraceuticals, Immune-enhancers, ''Amalaki, Abhaya, Triphala, Bhallataka, Shilajatu, Chyavanaprasha, Brahma Rasayana, Medhya Rasayana, Achara Rasayana, Kayakalpa''.

=== Introduction ===

The Ayurvedic classics, including [[Charak Samhita]], describe eight specialties of Ayurveda which were in vogue and practiced during the vedic period denoting that Ayurveda was already a highly evolved system of medicine with professional specialization. This is why Ayurveda is also called ''Ashtanga Ayurveda'' and its eight ''angas'' (or arms) are as mentioned below:
#''Kayachikitsa'' - Internal medicine
#''Shalya tantra'' - Surgery
#''Shalakya tantra'' - Ophthalmology, Ear Nose Throat
#''Kaumarabhritya'' - Gynecology. obstetrics and Pediatrics
#''Agada tantra'' - Toxicology
#''Rasayana'' - Nutrition, Rejuvenation, Immunology and Geriatrics
#''Vajikarana'' - Sexology, Aphrodisiac and Reproduction
#''Bhuta Vidya'' - Psychiatry and Demonology

The present chapter deals with ''Rasayana tantra'' of ''Ashtanga Ayurveda'' which has assumed a very high consideration in contemporary times in view of the potential role it could play today with increasing incidence of nutritional disorders, lifestyle related health issues and above all the rapid population aging world over, warranting newer strategies for geriatric health care and healthy aging where modern medicine has not much to offer.

''Rasayana'' is the means of obtaining the best qualities of body cells and tissues and is able to defeat aging and disease. All ''rasayanas'' are ''ojovardhaka'' i.e. promoter of ''ojas'' or immune strength in the body, imparting ''vyadhikshamatva'' i.e. immunity in the body. The mode of action of ''rasayana'' remedies has been deliberated for long. Many scholars consider ''rasayana'' effect as the ''prabhava'' (specific therapeutic effect) of these remedies without really giving rational interpretation. However, Professor RH Singh et al (1972) have suggested that the ''rasayana'' remedies and measures act at three levels and produce subtle molecular nutrient and immune-enhancing effect with a range of secondary impacts such as improved nutritional status, immune-enhancing, longevity, healthy aging, promotion of health and prevention of disease. The three levels of action are:

#At the level of ''rasa'' acting as a direct nutrient enriching the nutrient value of plasma.
#At the level of ''agni'' acting as digestive and metabolic booster.
#At the level of ''srotas'' acting as ''srotoprasadana'' promoting the microcirculation and tissue perfusion. The net effect of all the three levels of action is an improved nutrition.

The division of this chapter into four ''padas'' (parts) reflects an interesting style of classic writing simulating the style of the ''Yoga Sutras'' of Patanjali aiming to emphasize the continuum of the deliberations which could be fragmented in the chapterization style. The tendency of ''pada'' style can also be visualized in the [[Sutra Sthana]] of [[Charak Samhita]] where all the thirty chapters have been systematically clubbed in seven ''chatushkas'' i.e. four chapters clubbed in one ''chatuska'' containing allied subject matter. Thus, ''Rasayanadhyaya'' (this chapter) is of great significance both from literary as well as from the subject matter point of view.

The first part , ''Abhayamalakiya Rasayana Pada'', begins with the path breaking statement about ''bheshaja-abheshaja'' i.e. good medicine vs bad medicine. The bad medicines are poisons while the good medicines are of two categories:

#''Ojovardhaka'' i.e. heath promoting,
#''Roganut'' or disease curing.

The ''ojovardhaka'' remedies again are of two categories namely ''rasayana'' and ''vajikarana''. The chapter further describes the qualities of ''rasayana'' and the methods of its use. It specially dwells upon the best ''rasayana'' drugs like ''Amalaki, Abhaya, Chyavanaprasha, Brahma Rasayana, Amalaka Rasayana, Haritaki Yoga'' etc.

The second part, ''Pranakamiya Rasayana Pada'', deliberates on ''rasayana prabhava'' with examples of certain special ''aushadhi rasayanas'' like ''Amalaki Ghrita, Amalakyavaleha, Amalaka Churna, Vidangavaleha, Nagabala Rasayana, Baladi Rasayana, Bhallataka Kshira'' etc.

The third part, ''Karaprachitiya Rasayana Pada'' describes the role of ''brahmacharyadi karma'' (following code of conduct) in ''rasayana karma, kevalamalaka rasayana, lauhadi rasayana, aindri rasayana, medhya rasayana, pippali rasayana, shilajatu rasayan'' etc.

The fourth part, ''Ayurveda Samutthaniya Rasayana Pada'' deliberates on Ayurveda tradition, ''Indrokta rasayana, Dronipraveshika rasayana, Kutipraveshika rasayana, Achara rasayana'' besides the basic issues like ''Dharmartha Ayurveda prayoga'' (use of Ayurveda for performing eternal duties) and ''Bhishak prashansa'' (praise of physician).
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===Sanskrit text, Transliteration and English Translation===

==== Part- I: ''Abhayamalakiya Rasayana Pada'' ====

अथातोऽभयामलकीयं रसायनपादं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō'bhayāmalakīyaṁ rasāyanapādaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto~abhayAmalakIyaM rasAyanapAdaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now I shall deliberate on the first quarter of the chapter on ''rasayana'' i.e. promotive therapy specially dealing with ''Abhaya''(''Haritaki''), ''Amlaki'' etc. Thus said Lord Atreya.[1-2]

===== Synonyms of ''Bheshaja'' =====

चिकित्सितं व्याधिहरं पथ्यं साधनमौषधम्|

प्रायश्चित्तं प्रशमनंप्रकृतिस्थापनं हितम्||३||

विद्याद्भेषजनामानि,...|४|

cikitsitaṁ vyādhiharaṁ pathyaṁ sādhanamauṣadham|

prāyaścittaṁ praśamanaṁ prakr̥tisthāpanaṁ hitam||3||

vidyādbhēṣajanāmāni, ...|4|

cikitsitaM vyAdhiharaM pathyaM sAdhanamauShadham|

prAyashcittaM prashamanaM prakRutisthApanaM hitam||3||

vidyAdbheShajanAmAni, ...|4|

''Chikitsa'' (measures which alleviate disorders), ''vyadhihara'' (destroyer of diseases), ''pathya'' (beneficial for the bodily channels), ''sadhana'' (instrument for therapeutic action), ''aushadha'' (that which is prepared of herbes), ''prayashchitta'' (expiation), ''prashamana'' (pacification), ''prakritisthapana'' (that which helps recovery to normalcy), ''hita'' (wholesome) – these are the synonyms of ''bheshaja'' (therapeutics).[3-4]

===== Types of ''Bheshaja'' =====

भेषजं द्विविधं च तत्|

स्वस्थस्योर्जस्करं किञ्चित् किञ्चिदार्तस्य रोगनुत्||४||

bhēṣajaṁ dvividhaṁ ca tat|

svasthasyōrjaskaraṁ kiñcit kiñcidārtasya rōganut||4||

.. bheShajaM dvividhaM ca tat|

svasthasyorjaskaraM ki~jcit ki~jcidArtasya roganut||4||

Therapeutics is of two categories:

#that which promotes strength and immunity in the healthy,
#that which alleviates disorders. [4]

===== Types of ''Abheshaja'' =====

अभेषजं च द्विविधं बाधनं सानुबाधनम्||

abhēṣajaṁ ca dvividhaṁ bādhanaṁ sānubādhanam|5|

abheShajaM ca dvividhaM bAdhanaM sAnubAdhanam|5|

''Abheshaja'' (non-therapeutics) is also of two types – (1) ''badhana'' (acute), (2) ''sanubadhana'' (chronic).[5]

===== Objective of ''Rasayana'' and ''Vajikarana'' =====

स्वस्थस्योर्जस्करं यत्तु तद्वृष्यं तद्रसायनम्||५||

प्रायः, प्रायेण रोगाणां द्वितीयं प्रशमेमतम्|

प्रायःशब्दोविशेषार्थो ह्युभयं ह्युभयार्थकृत्||६||

svasthasyōrjaskaraṁ yattu tadvr̥ṣyaṁ tadrasāyanam||5||

prāyaḥ, prāyēṇa rōgāṇāṁ dvitīyaṁ praśamē matam|

prāyaḥśabdō viśēṣārthō hyubhayaṁ hyubhayārthakr̥t||6||

svasthasyorjaskaraM yattu tadvRuShyaM tadrasAyanam||5||

prAyaH, prAyeNa rogANAM dvitIyaM prashame matam|

prAyaHshabdo visheShArtho hyubhayaM hyubhayArthakRut||6||

Therapeutics which promotes strength and immunity is categorized in ''vrishya'' (aphrodisiac) and ''rasayana'' (promotives), while the therapy of the second category is mostly applied for alleviation of disorders. The word ''prayah'' specially denotes only particularity because both the groups perform both the above functions namely, promotion of strength including immunity and alleviation of diseases. [5-6]

===== Benefits of ''Rasayana'' =====

दीर्घमायुः स्मृतिं मेधामारोग्यं तरुणंवयः|

प्रभावर्णस्वरौदार्यं देहेन्द्रियबलं परम्||७||

वाक्सिद्धिं प्रणतिंकान्तिं लभते ना रसायनात्|

लाभोपायो हि शस्तानां रसादीनां रसायनम्||८||

dīrghamāyuḥ smr̥tiṁ mēdhāmārōgyaṁ taruṇaṁ vayaḥ|

prabhāvarṇasvaraudāryaṁ dēhēndriyabalaṁ param||7||

vāksiddhiṁ praṇatiṁ kāntiṁ labhatēnā rasāyanāt|

lābhōpāyō hi śastānāṁ rasādīnāṁ rasāyanam||8||

dIrghamAyuH smRutiM medhAmArogyaM taruNaM vayaH|

prabhAvarNasvaraudAryaM dehendriyabalaM param||7||

vAksiddhiM praNatiM kAntiM labhate nA rasAyanAt|

lAbhopAyo hi shastAnAM rasAdInAM rasAyanam||8||

By promotive treatment, one attains longevity, memory, intelligence, freedom from illness, youthfulness, excellence of lustre, complexion and voice, optimum strength of physique and sense organs, perfection in deliberation, respectability and brilliance. ''Rasayana'' is the means of attaining excellent qualities of ''rasa'' etc. ''dhatus'' i.e. body cells and tissues. [7-8]

===== Benefits of ''Vajikarana'' =====

अपत्यसन्तानकरं यत् सद्यः सम्प्रहर्षणम्|

वाजीवातिबलो येनयात्यप्रतिहतः स्त्रियः||९||

भवत्यतिप्रियः स्त्रीणां येन येनोपचीयते|

जीर्यतोऽप्यक्षयं शुक्रं फलवद्येन दृश्यते||१०||

प्रभूतशाखः शाखीव येन चैत्यो यथा महान्|

भवत्यर्च्योबहुमतः प्रजानां सुबहुप्रजः||११||

सन्तानमूलं येनेह प्रेत्य चानन्त्यमश्नुते|

यशः श्रियं बलं पुष्टिं वाजीकरणमेव तत्||१२||

apatyasantānakaraṁ yat sadyaḥsampraharṣaṇam|

vājīvātibalō yēna yātyapratihataḥ striyaḥ||9||

bhavatyatipriyaḥ strīṇāṁ yēna yēnōpacīyatē|

jīryatō'pyakṣayaṁ śukraṁ phalavadyēna dr̥śyatē||10||

prabhūtaśākhaḥ śākhīva yēna caityō yathā mahān|

bhavatyarcyō bahumataḥ prajānāṁsubahuprajaḥ||11||

santānamūlaṁ yēnēha prētya cānantyamaśnutē|

yaśaḥ śriyaṁ balaṁ puṣṭiṁ vājīkaraṇamēva tat||12||

apatyasantAnakaraM yat sadyaH sampraharShaNam|

vAjIvAtibalo yena yAtyapratihataH striyaH||9||

bhavatyatipriyaH strINAM yena yenopacIyate|

jIryato~apyakShayaM shukraM phalavadyena dRushyate||10||

prabhUtashAkhaH shAkhIva yena caityo yathA mahAn|

bhavatyarcyo bahumataH prajAnAM subahuprajaH||11||

santAnamUlaM yeneha pretya cAnantyamashnute|

yashaH shriyaM balaM puShTiM vAjIkaraNameva tat||12||

''Vajikarana'' (aphrodisiac treatment) is that which produces lineage of progeny, quick sexual stimulation, enables one to perform sexual act with the women uninterruptedly and vigorously like a horse, makes one charming for the women, promotes corpulence and infallible and indestructible semen even in the old persons, renders one great having a number of off-springs like a sacred tree branched profusely and commanding respect and popularity in the society. By this one attains eternality based on filial tradition here and hereafter along with fame, fortune, strength and corpulence. [9-12]

===== Two types of ''Aushadha'' (medicine) =====

स्वस्थस्योर्जस्करं त्वेतद्द्विविधं प्रोक्तमौषधम्|

यद्व्याधिनिर्घातकरं वक्ष्यते तच्चिकित्सिते||१३||

चिकित्सितार्थ एतावान् विकाराणां यदौषधम्|

रसायनविधिश्चाग्रे वाजीकरणमेव च||१४||

svasthasyōrjaskaraṁ tvētaddvividhaṁ prōktamauṣadham|

yadvyādhinirghātakaraṁ vakṣyatē taccikitsitē||13||

cikitsitārtha ētāvān vikārāṇāṁ yadauṣadham|

rasāyanavidhiścāgrē vājīkaraṇamēva ca||14||

svasthasyorjaskaraM tvetaddvividhaM proktamauShadham|

yadvyAdhinirghAtakaraM vakShyate taccikitsite||13||

cikitsitArtha etAvAn vikArANAM yadauShadham|

rasAyanavidhishcAgre vAjIkaraNameva ca||14||

Thus, the twofold promotive treatment for the healthy is described here. As regard the measures for alleviating diseases, those will be described in the concerned chapters on therapeutics. The sole purpose of therapeutics is to alleviate diseases. The method of ''rasayana'' has been described first and thereafter the aphrodisiac measures have been described. [13-14]

===== ''Abheshaja'' (non-therapeutics) =====

अभेषजमिति ज्ञेयं विपरीतं यदौषधात्|

तदसेव्यं निषेव्यं तु प्रवक्ष्यामि यदौषधम्||१५||

abhēṣajamiti jñēyaṁ viparītaṁ yadauṣadhāt|

tadasēvyaṁ niṣēvyaṁ tu pravakṣyāmi yadauṣadham||15||

abheShajamiti j~jeyaM viparItaM yadauShadhAt|

tadasevyaM niShevyaM tu pravakShyAmi yadauShadham||15||

''Abheshaja'' is that which is contrary to the ''bheshaja'' i.e. therapy. This is to be avoided whereas the ''bheshaja'' therapeutic measures are to be described further to be adopted. [15]

===== Modes of Administration of ''Kutipraveshika'' and ''Vatatapika Rasayana'' =====

रसायनानां द्विविधं प्रयोगमृषयो विदुः|

कुटीप्रावेशिकं चैव वातातपिकमेव च||१६||

कुटीप्रावेशिकस्यादौ विधिः समुपदेक्ष्यते|

नृपवैद्यद्विजातीनां साधूनांपुण्यकर्मणाम्||१७||

निवासे निर्भये शस्ते प्राप्योपकरणे पुरे|

दिशि पूर्वोत्तरस्यां च सुभूमौ कारयेत् कुटीम्||१८||

विस्तारोत्सेधसम्पन्नां त्रिगर्भां सूक्ष्मलोचनाम्|

घनभित्तिमृतुसुखां सुस्पष्टां मनसः प्रियाम्||१९||

शब्दादीनामशस्तानामगम्यं स्त्रीविवर्जिताम्|

इष्टोपकरणोपेतां सज्जवैद्यौषधद्विजाम्||२०||

अथोदगयने शुक्ले तिथिनक्षत्रपूजिते|

मुहूर्तकरणोपेते प्रशस्तेकृतवापनः||२१||

धृतिस्मृतिबलं कृत्वा श्रद्दधानः समाहितः|

विधूय मानसान् दोषान् मैत्रीं भूतेषु चिन्तयन्||२२||

देवताःपूजयित्वाऽग्रे द्विजातींश्च प्रदक्षिणम्|

देवगोब्राह्मणान् कृत्वा ततस्तां प्रविशेत्कुटीम्||२३||

तस्यां संशोधनैः शुद्धः सुखी जातबलः पुनः|

रसायनं प्रयुञ्जीत तत्प्रवक्ष्यामिशोधनम्||२४||

rasāyanānāṁ dvividhaṁ prayōgamr̥ṣayō viduḥ|

kuṭīprāvēśikaṁ caiva vātātapikamēva ca||16||

kuṭīprāvēśikasyādau vidhiḥ samupadēkṣyatē|

nr̥pavaidyadvijātīnāṁ sādhūnāṁ puṇyakarmaṇām||17||

nivāsē nirbhayē śastē prāpyōpakaraṇē purē|

diśi pūrvōttarasyāṁ ca subhūmau kārayēt kuṭīm||18||

vistārōtsēdhasampannāṁ trigarbhāṁ sūkṣmalōcanām|

ghanabhittimr̥tusukhāṁ suspaṣṭāṁ manasaḥ priyām||19||

śabdādīnāmaśastānāmagamyaṁstrīvivarjitām|

iṣṭōpakaraṇōpētāṁ sajjavaidyauṣadhadvijām ||20||

athōdagayanē śuklētithinakṣatrapūjitē|

muhūrtakaraṇōpētē praśastē kr̥tavāpanaḥ||21||

dhr̥tismr̥tibalaṁ kr̥tvā śraddadhānaḥ samāhitaḥ|

vidhūya mānasān dōṣān maitrīṁ bhūtēṣu cintayan||22||

dēvatāḥ pūjayitvā'grē dvijātīṁścapradakṣiṇam|

dēvagōbrāhmaṇān kr̥tvā tatastāṁ praviśēt kuṭīm||23||

tasyāṁ saṁśōdhanaiḥ śuddhaḥ sukhī jātabalaḥ punaḥ|

rasāyanaṁ prayuñjīta tatpravakṣyāmi śōdhanam||24||

rasAyanAnAM dvividhaM prayogamRuShayo viduH|

kuTIprAveshikaM caiva vAtAtapikameva ca||16||

kuTIprAveshikasyAdau vidhiH samupadekShyate|

nRupavaidyadvijAtInAM sAdhUnAM puNyakarmaNAm||17||

nivAse nirbhaye shaste prApyopakaraNe pure|

dishi pUrvottarasyAM ca subhUmau kArayet kuTIm||18||

vistArotsedhasampannAM trigarbhAM sUkShmalocanAm|

ghanabhittimRutusukhAM suspaShTAM manasaH priyAm||19||

shabdAdInAmashastAnAmagamyaM strIvivarjitAm|

iShTopakaraNopetAM sajjavaidyauShadhadvijAm [1] ||20||

athodagayane shukle tithinakShatrapUjite|

muhUrtakaraNopete prashaste kRutavApanaH||21||

dhRutismRutibalaM kRutvA shraddadhAnaH samAhitaH|

vidhUya mAnasAn doShAn maitrIM bhUteShu cintayan||22||

devatAH pUjayitvA~agre dvijAtIMshca pradakShiNam|

devagobrAhmaNAn kRutvA tatastAM pravishet kuTIm||23||

tasyAM saMshodhanaiH shuddhaH sukhI jAtabalaH punaH|

rasAyanaM prayu~jjIta tatpravakShyAmi shodhanam||24||

The propounders have described two methods of the administration of ''rasayana'' therapy, namely:

#''kutipraveshika'' (indoor) and
#''vatatapika'' (outdoor).

Firstly, the procedure of indoor treatment will be described. For this a cottage should be built in an auspicious ground, facing eastward or northward and in a locality inhabited by king, physicians and ''brahmanas'', holy saints, is free from dangers, is auspicious and has easy availability of necessary materials. The cottage should have sufficient space and height, three interior chambers one after the other, a small opening, and thick walls and should be comfortable for the seasons, neatly clean and favorable for the treatment. It should be impermeable for undesirable sound etc. (sense objects), free from women, equipped with necessary accessories and attended by physicians with medicines and ''brahmanas''.

Now, in northerly course of the sun, bright fortnight and auspicious date, star, hour and ''karana'', one having clean- shaved, with strong restraint and memory, faith and focused mind, and stress-free state, feeling companionship with all the creatures, having worshipped the gods and ''brahmanas'' first and keeping the gods, cow and ''brahmanas'' to the right side, one should enter the cottage and be cleansed and thereafter when he feels happy and strong, he should use ''rasayana'' treatment. Further I shall talk about the cleansing procedures. [16-24]

===== Body purification before ''rasayana'' treatment =====

हरीतकीनां चूर्णानि सैन्धवामलके गुडम्|

वचां विडङ्गं रजनीं पिप्पलीं विश्वभेषजम्||२५||

पिबेदुष्णाम्बुना जन्तुःस्नेहस्वेदोपपादितः|

तेन शुद्धशरीराय कृतसंसर्जनाय च||२६||

त्रिरात्रं यावकं दद्यात् पञ्चाहंवाऽपि सर्पिषा|

सप्ताहं वा पुराणस्य यावच्छुद्धेस्तु वर्चसः||२७||

शुद्धकोष्ठं तु तं ज्ञात्वा रसायनमुपाचरेत्|

वयःप्रकृतिसात्म्यज्ञो यौगिकं यस्य यद्भवेत्||२८||

harītakīnāṁ cūrṇāni saindhavāmalakē guḍam|

vacāṁ viḍaṅgaṁ rajanīṁ pippalīṁ viśvabhēṣajam||25||

pibēduṣṇāmbunā jantuḥ snēhasvēdōpapāditaḥ|

tēna śuddhaśarīrāya kr̥tasaṁsarjanāya ca||26||

trirātraṁ yāvakaṁ dadyāt pañcāhaṁ vā'pi sarpiṣā|

saptāhaṁ vā purāṇasya yāvacchuddhēstu varcasaḥ||27||

śuddhakōṣṭhaṁ tu taṁ jñātvā rasāyanamupācarēt|

vayaḥprakr̥tisātmyajñō yaugikaṁ yasya yadbhavēt||28||

harItakInAM cUrNAni saindhavAmalake guDam|

vacAM viDa~ggaM rajanIM pippalIM vishvabheShajam||25||

pibeduShNAmbunA jantuH snehasvedopapAditaH|

tena shuddhasharIrAya kRutasaMsarjanAya ca||26||

trirAtraM yAvakaM dadyAt pa~jcAhaM vA~api sarpiShA|

saptAhaM vA purANasya yAvacchuddhestu varcasaH||27||

shuddhakoShThaM tu taM j~jAtvA rasAyanamupAcaret|

vayaHprakRutisAtmyaj~jo yaugikaM yasya yadbhavet||28||

The individual scheduled to undergo ''rasayana'' treatment, adequately oleated and fomented, should take formulations with hot water consisting of the powders of ''haritaki'', rock salt, ''amalaka'', jaggery, ''vacha'', ''vidanga'', ''haridra'', long pepper and dry ginger. When he is evacuated properly by this procedure and has resumed the routine dietetic regimen, he should be given barley preparation added with ghee for three, five or seven days (according to measure of evacuation) till the accumulated feces are eliminated. Thus, when he is considered as having cleansed properly, the physician should administer the appropriately chosen ''rasayana'' (drug) in consideration of his age, constitution and suitability. [25-28]

===== Properties of ''Haritaki'' and ''Amalaki'' =====

हरीतकीं पञ्चरसामुष्णामलवणां शिवाम्|

दोषानुलोमनीं लघ्वींविद्याद्दीपनपाचनीम्||२९||

आयुष्यां पौष्टिकीं धन्यां वयसः स्थापनीं पराम्|

सर्वरोगप्रशमनींबुद्धीन्द्रियबलप्रदाम्||३०||

कुष्ठं गुल्ममुदावर्तं शोषं पाण्ड्वामयंमदम्|

अर्शांसि ग्रहणीदोषं पुराणं विषमज्वरम्||३१||

हृद्रोगं सशिरोरोगमतीसारमरोचकम्|

कासं प्रमेहमानाहं प्लीहानमुदरं नवम्||३२||

कफप्रसेकं वैस्वर्यं वैवर्ण्यं कामलां क्रिमीन्|

श्वयथुं तमकं छर्दिं क्लैब्यमङ्गावसादनम्||३३||

स्रोतोविबन्धान् विविधान् प्रलेपं हृदयोरसोः|

स्मृतिबुद्धिप्रमोहं च जयेच्छीघ्रं हरीतकी||३४||

(अजीर्णिनो रूक्षभुजः स्त्रीमद्यविषकर्शिताः|

सेवेरन्नाभयामेते क्षुत्तृष्णोष्णार्दिताश्चये)||३५||

तान् गुणांस्तानि कर्माणि विद्यादामलकीष्वपि|

यान्युक्तानि हरीतक्या वीर्यस्य तु विपर्ययः||३६||

अतश्चामृतकल्पानि विद्यात् कर्मभिरीदृशैः|

हरीतकीनां शस्यानि भिषगामलकस्य च||३७||

harītakīṁ pañcarasāmuṣṇāmalavaṇāṁ śivām|

dōṣānulōmanīṁ laghvīṁ vidyāddīpanapācanīm||29||

āyuṣyāṁ pauṣṭikīṁ dhanyāṁ vayasaḥ sthāpanīṁ parām|

sarvarōgapraśamanīṁ buddhīndriyabalapradām||30||

kuṣṭhaṁ gulmamudāvartaṁ śōṣaṁ pāṇḍvāmayaṁ madam|

arśāṁsi grahaṇīdōṣaṁ purāṇaṁ viṣamajvaram||31||

hr̥drōgaṁ saśirōrōgamatīsāramarōcakam|

kāsaṁ pramēhamānāhaṁ plīhānamudaraṁ navam||32||

kaphaprasēkaṁ vaisvaryaṁ vaivarṇyaṁ kāmalāṁ krimīn|

śvayathuṁ tamakaṁ chardiṁ klaibyamaṅgāvasādanam||33||

srōtōvibandhān vividhān pralēpaṁ hr̥dayōrasōḥ|

smr̥tibuddhipramōhaṁ ca jayēcchīghraṁ harītakī||34||

(ajīrṇinō rūkṣabhujaḥ strīmadyaviṣakarśitāḥ|

sēvērannābhayāmētē kṣuttr̥ṣṇōṣṇārditāśca yē)||35||

tān guṇāṁstāni karmāṇi vidyādāmalakīṣvapi|

yānyuktāni harītakyā vīryasya tu viparyayaḥ||36||

ataścāmr̥takalpāni vidyāt karmabhirīdr̥śaiḥ|

harītakīnāṁ śasyāni bhiṣagāmalakasya ca||37||

harItakIM pa~jcarasAmuShNAmalavaNAM shivAm|

doShAnulomanIM laghvIM vidyAddIpanapAcanIm||29||

AyuShyAM pauShTikIM dhanyAM vayasaH sthApanIM parAm|

sarvarogaprashamanIM buddhIndriyabalapradAm||30||

kuShThaM gulmamudAvartaM shoShaM pANDvAmayaM madam|

arshAMsi grahaNIdoShaM purANaM viShamajvaram||31||

hRudrogaM sashirorogamatIsAramarocakam|

kAsaM pramehamAnAhaM plIhAnamudaraM navam||32||

kaphaprasekaM vaisvaryaM vaivarNyaM kAmalAM krimIn|

shvayathuM tamakaM chardiM klaibyama~ggAvasAdanam||33||

srotovibandhAn vividhAn pralepaM hRudayorasoH|

smRutibuddhipramohaM ca jayecchIghraM harItakI||34||

(ajIrNino [1] rUkShabhujaH strImadyaviShakarshitAH|

severannAbhayAmete kShuttRuShNoShNArditAshca ye)||35||

tAn guNAMstAni karmANi vidyAdAmalakIShvapi|

yAnyuktAni harItakyA vIryasya tu viparyayaH||36||

atashcAmRutakalpAni vidyAt karmabhirIdRushaiH|

harItakInAM shasyAni bhiShagAmalakasya ca||37||

''Haritaki'' has five tastes devoid of saline taste, is hot, wholesome, carminative, light, appetizer, digestive, life promoting, tonic, excellent sustainer of youthfulness, relieves all diseases and affords strength to all sense organs. It alleviates skin disorders including leprosy, ''gulma, udavarta,'' phthisis, anemia, degeneration, piles, disorders of ''grahani'', chronic intermittent fever, heart disease, head disease, diarrhea, anorexia, cough, urinary diseases and diabetes, flatulence, splenomegaly, acute abdominal disorders, excessive secretion of mucus, hoarseness of voice, disorders of complexion, jaundice,worms oedema, bronchial asthma, vomiting, impotency, lassitude in organs, micro-obstructive disorders, feeling of slugged heart and chest, sudden impairment of memory and intellect.

(The individuals having indigestion, consumption of rough food, emaciated by indulgence in women, wine and poisonous substances and afflicted with hunger, thirst and heat should avoid prolong use of ''haritaki''.)

''Amlaki'' has the same properties and actions as ''haritaki'', only the bio-potency is different (''haritaki'' being hot while ''amalaki'' is cold.)

Thus, looking to these actions, one should regard the fruits of ''haritaki'' as well as ''amlaki'' like nectar. [29-37]

===== Qualities of ideal drugs for therapeutic use =====

ओषधीनां परा भूमिर्हिमवाञ् शैलसत्तमः|

तस्मात्फलानि तज्जानि ग्राहयेत्कालजानि तु||३८||

आपूर्णरसवीर्याणि काले काले यथाविधि|

आदित्यपवनच्छायासलिलप्रीणितानि च||३९||

यान्यजग्धान्यपूतीनि निर्व्रणान्यगदानि च|

तेषां प्रयोगं वक्ष्यामि फलानां कर्म चोत्तमम्||४०||

ōṣadhīnāṁ parā bhūmirhimavāñ śailasattamaḥ|

tasmātphalāni tajjāni grāhayētkālajāni tu||38||

āpūrṇarasavīryāṇi kālē kālē yathāvidhi|

ādityapavanacchāyāsalilaprīṇitāni ca||39||

yānyajagdhānyapūtīni nirvraṇānyagadāni ca|

tēṣāṁ prayōgaṁ vakṣyāmi phalānāṁ karma cōttamam||40||

oShadhInAM parA bhUmirhimavA~j shailasattamaH|

tasmAtphalAni tajjAni grAhayetkAlajAni tu||38||

ApUrNarasavIryANi kAle kAle yathAvidhi|

AdityapavanacchAyAsalilaprINitAni ca||39||

yAnyajagdhAnyapUtIni nirvraNAnyagadAni ca|

teShAM prayogaM vakShyAmi phalAnAM karma cottamam||40||

Himalaya is excellent among the mountains, which is the best habitat of medicinal plants. Hence one should obtain the fruits grown there in proper time, mature with taste and potency, replenished with the sun, air, shade and water in respective seasons according to need, and which are uneaten, un-purified, uninjured and non toxic. The excellent actions and uses of these fruits will be described now. [38-40]

===== ''Brahma Rasayanam'' =====

पञ्चानां पञ्चमूलानां भागान् दशपलोन्मितान्|

हरीतकीसहस्रं च त्रिगुणामलकं नवम्||४१||

विदारिगन्धां बृहतीं पृश्निपर्णीं निदिग्धिकाम्|

विद्याद्विदारिगन्धाद्यं श्वदंष्ट्रापञ्चमं गणम्||४२||

बिल्वाग्निमन्थश्योनाकं काश्मर्यमथ पाटलाम्|

पुनर्नवां शूर्पपर्ण्यौ बलामेरण्डमेव च||४३||

जीवकर्षभकौ मेदां जीवन्तीं सशतावरीम्|

शरेक्षुदर्भकाशानां शालीनां मूलमेव च||४४||

इत्येषां पञ्चमूलानां पञ्चानामुपकल्पयेत्|

भागान् यथोक्तांस्तत्सर्वं साध्यं दशगुणेऽम्भसि||४५||

दशभागावशेषं तु पूतं तं ग्राहयेद्रसम्|

हरीतकीश्च ताः सर्वाः सर्वाण्यामलकानि च||४६||

तानि सर्वाण्यनस्थीनि फलान्यापोथ्य कूर्चनैः|

विनीय तस्मिन्निर्यूहे चूर्णानीमानिदापयेत्||४७||

मण्डूकपर्ण्याः पिप्पल्याः शङ्खपुष्प्याः प्लवस्यच|

मुस्तानां सविडङ्गानां चन्दनागुरुणोस्तथा||४८||

मधुकस्य हरिद्राया वचायाः कनकस्य च|

भागांश्चतुष्पलान् कृत्वा सूक्ष्मैलायास्त्वचस्तथा||४९||

सितोपलासहस्रं च चूर्णितंतुलयाऽधिकम्|

तैलस्य द्व्याढकं तत्र दद्यात्त्रीणि च सर्पिषः||५०||

साध्यमौदुम्बरे पात्रे तत् सर्वं मृदुनाऽग्निना|

ज्ञात्वालेह्यमदग्धं च शीतं क्षौद्रेण संसृजेत्||५१||

क्षौद्रप्रमाणं स्नेहार्धं तत् सर्वं घृतभाजने|

तिष्ठेत्सम्मूर्च्छितं तस्य मात्रां काले प्रयोजयेत्||५२||

या नोपरुन्ध्यादाहारमेकं मात्रा जरांप्रति|

षष्टिकः पयसा चात्र जीर्णे भोजनमिष्यते||५३||

वैखानसा वालखिल्यास्तथा चान्ये तपोधनाः|

रसायनमिदं प्राश्यबभूवुरमितायुषः||५४||

मुक्त्वा जीर्णं वपुश्चाग्र्यमवापुस्तरुणं वयः|

वीततन्द्राक्लमश्वासा निरातङ्काः समाहिताः||५५||

मेधास्मृतिबलोपेताश्चिररात्रं तपोधनाः|

ब्राह्मं तपो ब्रह्मचर्यं चेरुश्चात्यन्तनिष्ठया||५६||

रसायनमिदं ब्राह्ममायुष्कामः प्रयोजयेत्|

दीर्घमायुर्वयश्चाग्र्यं कामांश्चेष्टान् समश्नुते||५७||

(इति ब्राह्मरसायनम्)|

pañcānāṁ pañcamūlānāṁ bhāgān daśapalōnmitān|

harītakīsahasraṁ ca triguṇāmalakaṁ navam||41||

vidārigandhāṁ br̥hatīṁ pr̥śniparṇīṁ nidigdhikām|

vidyādvidārigandhādyaṁśvadaṁṣṭrāpañcamaṁ gaṇam||42||

bilvāgnimanthaśyōnākaṁ kāśmaryamatha pāṭalām|

punarnavāṁ śūrpaparṇyau balāmēraṇḍamēva ca||43||

jīvakarṣabhakau mēdāṁ jīvantīṁ saśatāvarīm|

śarēkṣudarbhakāśānāṁ śālīnāṁ mūlamēva ca||44||

ityēṣāṁ pañcamūlānāṁ pañcānāmupakalpayēt|

bhāgān yathōktāṁstatsarvaṁ sādhyaṁ daśaguṇē'mbhasi||45||

daśabhāgāvaśēṣaṁ tu pūtaṁ taṁ grāhayēdrasam|

harītakīśca tāḥ sarvāḥ sarvāṇyāmalakāni ca||46||

tāni sarvāṇyanasthīni phalānyāpōthya kūrcanaiḥ|

vinīya tasminniryūhē cūrṇānīmāni dāpayēt||47||

maṇḍūkaparṇyāḥ pippalyāḥ śaṅkhapuṣpyāḥ plavasya ca|

mustānāṁ saviḍaṅgānāṁ candanāguruṇōstathā||48||

madhukasya haridrāyā vacāyāḥ kanakasyaca|

bhāgāṁścatuṣpalān kr̥tvā sūkṣmailāyāstvacastathā||49||

sitōpalāsahasraṁ ca cūrṇitaṁ tulayā'dhikam|

tailasya dvyāḍhakaṁ tatra dadyāttrīṇi ca sarpiṣaḥ||50||

sādhyamaudumbarē pātrē tat sarvaṁ mr̥dunā'gninā|

jñātvā lēhyamadagdhaṁ ca śītaṁ kṣaudrēṇa saṁsr̥jēt||51||

kṣaudrapramāṇaṁ snēhārdhaṁ tat sarvaṁ ghr̥tabhājanē|

tiṣṭhētsammūrcchitaṁ tasya mātrāṁ kālē prayōjayēt||52||

yā nōparundhyādāhāramēkaṁ mātrā jarāṁ prati|

ṣaṣṭikaḥ payasā cātra jīrṇēbhōjanamiṣyatē||53||

vaikhānasā vālakhilyāstathā cānyē tapōdhanāḥ|

rasāyanamidaṁ prāśya babhūvuramitāyuṣaḥ||54||

muktvā jīrṇaṁ vapuścāgryamavāpustaruṇaṁ vayaḥ|

vītatandrāklamaśvāsā nirātaṅkāḥ samāhitāḥ||55||

mēdhāsmr̥tibalōpētāścirarātraṁ tapōdhanāḥ|

brāhmaṁ tapō brahmacaryaṁ cēruścātyantaniṣṭhayā||56||

rasāyanamidaṁ brāhmamāyuṣkāmaḥ prayōjayēt|

dīrghamāyurvayaścāgryaṁ kāmāṁścēṣṭān samaśnutē||57||

(iti brāhmarasāyanam)

pa~jcAnAM pa~jcamUlAnAM bhAgAn dashapalonmitAn|

harItakIsahasraM ca triguNAmalakaM navam||41||

vidArigandhAM bRuhatIM pRushniparNIM nidigdhikAm|

vidyAdvidArigandhAdyaM shvadaMShTrApa~jcamaM gaNam||42||

bilvAgnimanthashyonAkaM kAshmaryamatha pATalAm|

punarnavAM shUrpaparNyau balAmeraNDameva ca||43||

jIvakarShabhakau medAM jIvantIM sashatAvarIm|

sharekShudarbhakAshAnAM shAlInAM mUlameva ca||44||

ityeShAM pa~jcamUlAnAM pa~jcAnAmupakalpayet|

bhAgAn yathoktAMstatsarvaM sAdhyaM dashaguNe~ambhasi||45||

dashabhAgAvasheShaM tu pUtaM taM grAhayedrasam|

harItakIshca tAH sarvAH sarvANyAmalakAni ca||46||

tAni sarvANyanasthIni phalAnyApothya kUrcanaiH|

vinIya tasminniryUhe cUrNAnImAni dApayet||47||

maNDUkaparNyAH pippalyAH sha~gkhapuShpyAH plavasya ca|

mustAnAM saviDa~ggAnAM candanAguruNostathA||48||

madhukasya haridrAyA vacAyAH kanakasya ca|

bhAgAMshcatuShpalAn kRutvA sUkShmailAyAstvacastathA||49||

sitopalAsahasraM ca cUrNitaM tulayA~adhikam|

tailasya dvyADhakaM tatra dadyAttrINi ca sarpiShaH||50||

sAdhyamaudumbare pAtre tat sarvaM mRudunA~agninA|

j~jAtvA lehyamadagdhaM ca shItaM kShaudreNa saMsRujet||51||

kShaudrapramANaM snehArdhaM tat sarvaM ghRutabhAjane|

tiShThetsammUrcchitaM tasya mAtrAM kAle prayojayet||52||

yA noparundhyAdAhAramekaM mAtrA jarAM prati|

ShaShTikaH payasA cAtra jIrNe bhojanamiShyate||53||

vaikhAnasA vAlakhilyAstathA cAnye tapodhanAH|

rasAyanamidaM prAshya babhUvuramitAyuShaH||54||

muktvA jIrNaM vapushcAgryamavApustaruNaM vayaH|

vItatandrAklamashvAsA nirAta~gkAH samAhitAH||55||

medhAsmRutibalopetAshcirarAtraM tapodhanAH|

brAhmaM tapo brahmacaryaM cerushcAtyantaniShThayA||56||

rasAyanamidaM brAhmamAyuShkAmaH prayojayet|

dIrghamAyurvayashcAgryaM kAmAMshceShTAn samashnute||57||

(iti brAhmarasAyanam)|

The five sets (or pentads) of ''panchamula'' are taken in quantities of 400gm (each of the pentad), along with the fresh fruits of ''haritaki'' and ''amlaki'' in number of one thousand and three thousand respectively. (The five pentads are as follows): ''shalaparni'', ''brihati'', ''prishiparni'', kanthakari, and ''gokshura'' constitute the ''vidarigandhadi'' group of five roots.

Similarly, ''bilwa, agnimantha,'' ''shyonaka, kashmarya'' and ''patala'' constitute the ''bilwadi'' pentad of roots. ''punarnava, mudagparni, mashaaparni, bala'' and ''eranda'' constitute ''punarnavadi'' pentad. ''jivaka rishabhaka, meda, jivanti'' and ''shatavari'' constitute ''jivakadi'' pentad. Roots of ''shara'', ''ikshu, darbha, kasha'' and ''shali'' constitute the ''sharadi'' pentad of roots. These five pentads are taken together and boiled in ten times quantity of water. When water is reduced to one tenth, it is brought down and filtered. On the other hand, the fruit of ''haritaki'' and ''amlaki'' are picked out, their seeds are removed and pounded well on stone slabs or in mortar. This is mixed in the above decoction and powder of the following drugs and substances are added to it- ''mandukaparni, pippali, shankhapushpi, plava, musta'', ''vidanga, chandana, aguru, manduka, haridra, vacha, nagakeshara, sukshma ela'' and ''twak'' each in quantity of 160 gm and sugar candy 44 kg, ''tila'' oil 5 kg 120 gm, ghee 7kg 680 gm are added to it. All this is cooked in copper utensil on mild fire. When it is converted in to linctus and is not burnt it is brought down. Honey is added to it in quantity of 3 kg 840gm, when it is cooked down. Now the preparation is kept in a vessel laced with ghee.

This preparation should be used in proper time and dose. The proper dose is that which does not disturb the digestion of the food. When the drug is digested the patient should take ''shashtika'' rice with milk.

By taking this ''rasayana'' drug the sages of ''vaikhanasa'' and ''balakhilya'' groups and other ones attained immeasurable life span; acquired excellent youth shedding off the rotten physique, became free from dullness, exhausation, dyspnoea and diseases; and endowed with full concentration, intellect and strength practised celibacy and spiritual penance with full devotion. An individual desirous of longevity should use this ''Brahma rasayana'' by which he attains long life, excellent (youthful) age and wellness. [41-57]

यथोक्तगुणानामामलकानां सहस्रं पिष्टस्वेदनविधिना पयस ऊष्मणा सुस्विन्नमनातपशुष्कमनस्थि चूर्णयेत्| तदामलकसहस्रस्वरसपरिपीतं स्थिरापुनर्नवाजीवन्तीनागबलाब्रह्मसुवर्चलामण्डूकपर्णीशतावरीशङ्खपुष्पीपिप्पलीवचाविडङ्गस्वयङ्गुप्तामृताचन्दनागुरुमधुकमधूकपुष्पोत्पलपद्ममालतीयुवतीयूथिकाचूर्णाष्टभागसंयुक्तं पुनर्नागबलासहस्रपलस्वरसपरिपीतमनातपशुष्कं द्विगुणितसर्पिषा क्षौद्रसर्पिषा वा क्षुद्रगुडाकृतिं कृत्वा शुचौ दृढे घृतभाविते कुम्भे भस्मराशेरधः स्थापयेदन्तर्भूमेः पक्षं कृतरक्षाविधानमथर्ववेदविदा, पक्षात्यये चोद्धृत्य कनकरजतताम्रप्रवालकालायसचूर्णाष्टभागसंयुक्तमर्धकर्षवृद्ध्या यथोक्तेन विधिना प्रातः प्रातः प्रयुञ्जानोऽग्निबलमभिसमीक्ष्य, जीर्णे च षष्टिकं पयसा ससर्पिष्कमुपसेवमानो यथोक्तान् गुणान् समश्नुत इति||५८||

yathōktaguṇānāmāmalakānāṁ sahasraṁ piṣṭasvēdanavidhinā payasa ūṣmaṇā susvinnamanātapaśuṣkamanasthi cūrṇayēt| tadāmalakasahasrasvarasaparipītaṁ
sthirāpunarnavājīvantīnāgabalābrahmasuvarcalāmaṇḍūkaparṇīśatāvarīśaṅkhapuṣpīpippalīvacāviḍaṅgasvayaṅguptāmr̥tācandanāguru
madhukamadhūkapuṣpōtpalapadmamālatīyuvatīyūthikācūrṇāṣṭabhāgasaṁyuktaṁ
punarnāgabalāsahasrapalasvarasaparipītamanātapaśuṣkaṁ dviguṇitasarpiṣā kṣaudrasarpiṣā vā kṣudraguḍākr̥tiṁ kr̥tvā śucau dr̥ḍhē ghr̥tabhāvitē kumbhē bhasmarāśēradhaḥ sthāpayēdantarbhūmēḥ pakṣaṁ kr̥tarakṣāvidhānamatharvavēdavidā, pakṣātyayē
cōddhr̥tyakanakarajatatāmrapravālakālāyasacūrṇāṣṭabhāgasaṁyuktamardhakarṣavr̥ddhyā yathōktēna vidhinā prātaḥ prātaḥ prayuñjānō'gnibalamabhisamīkṣya,
jīrṇē ca ṣaṣṭikaṁ payasā sasarpiṣkamupasēvamānō yathōktān guṇān samaśnuta
iti||58||

yathoktaguNAnAmAmalakAnAM sahasraM piShTasvedanavidhinA payasa UShmaNA susvinnamanAtapashuShkamanasthi cUrNayet|
tadAmalakasahasrasvarasaparipItaMsthirApunarnavAjIvantInAgabalAbrahmasuvarcalAmaNDUkaparNIshatAvarIsha~gkhapuShpIpippalIvacAviDa~ggasvaya~gguptAmRutA-candanAgurumadhukamadhUkapuShpotpalapadmamAlatIyuvatIyUthikAcUrNAShTabhAgasaMyuktaMpunarnAgabalAsahasrapalasvarasaparipItamanAtapashuShkaM dviguNitasarpiShA kShaudrasarpiShA vA kShudraguDAkRutiM kRutvA shucau dRuDhe ghRutabhAvitekumbhe bhasmarAsheradhaH sthApayedantarbhUmeH pakShaM kRutarakShAvidhAnamatharvavedavidA, pakShAtyaye coddhRutyakanakarajatatAmrapravAlakAlAyasacUrNAShTabhAgasaMyuktamardhakarShavRuddhyA yathoktena vidhinA prAtaH prAtaH prayu~jjAno~agnibalamabhisamIkShya,jIrNe ca ShaShTikaM payasA sasarpiShkamupasevamAno yathoktAn guNAn samashnuta iti||58||

The ''amlaki'' fruits having the above qualities are taken in the number of thousands and are steamed on the vapor of milk like the flour paste. When they are well steamed, they are taken out, dried in shade and are powdered after removing the seeds. This is impregnated with the juice of one thousand fresh fruits of ''amlaki'' and added with the powder of ''shalaparņi, punarnava, jivanti, nagabala,'' ''brahmasuvarchala, mandukaparni, shatavari, shankhapushpi, pippali, vacha, vidanga, kapikacchu, guduchi, chandan''. ''aguru'', ''madhuka'', flowers of ''madhuka, utpala, kamala, jati, taruņi,'' and ''yuthika'' in the quantity one eight of ''amlaki'' powder. This is again impregnated with the juice of ''nagabala'' in the quantity of 40 kg. and dried in shade. Then in double quantity ghee or ghee-honey mixed are added to it and is made in the shape of small boluses. This is kept in a clean and strong vessel oiled with ghee and is stored underground within the heap of ashes for a fortnight after having performed the spiritual rites through those who know Atharvaveda. After the fortnight is over, this should be taken out and added with the powder (''bhasma'') of gold, silver, copper, coral and iron in one eighth quantity.[58]

भवन्ति चात्र-

इदं रसायनं ब्राह्मं महर्षिगणसेवितम्|

भवत्यरोगो दीर्घायुः प्रयुञ्जानो महाबलः||५९||

कान्तः प्रजानांसिद्धार्थश्चन्द्रादित्यसमद्युतिः|

श्रुतं धारयते सत्त्वमार्षं चास्य प्रवर्तते||६०||

धरणीधरसारश्च वायुना समविक्रमः|

स भवत्यविषं चास्य गात्रे सम्पद्यते विषम्||६१||

(इति द्वितीयं ब्राह्मरसायनम्)|

bhavanti cātra-

idaṁ rasāyanaṁ brāhmaṁ maharṣigaṇasēvitam|

bhavatyarōgō dīrghāyuḥ prayuñjānō mahābalaḥ||59||

kāntaḥ prajānāṁ siddhārthaścandrādityasamadyutiḥ|

śrutaṁ dhārayatē sattvamārṣaṁ cāsya pravartatē||60||

dharaṇīdharasāraśca vāyunā samavikramaḥ|

sa bhavatyaviṣaṁ cāsya gātrē sampadyatēviṣam||61||

(iti dvitīyaṁ brāhmarasāyanam)|

bhavanti cAtra-

idaM rasAyanaM brAhmaM maharShigaNasevitam|

bhavatyarogo dIrghAyuH prayu~jjAno mahAbalaH||59||

kAntaH prajAnAM siddhArthashcandrAdityasamadyutiH|

shrutaM dhArayate sattvamArShaM cAsya pravartate||60||

dharaNIdharasArashca vAyunA samavikramaH|

sa bhavatyaviShaM cAsya gAtre sampadyate viSham||61||

(iti dvitIyaM brAhmarasAyanam)|

This ''rasayana'' preparation should be taken regularly in the dose of 5 gms gradually increasing with the same by the said method in every morning in consideration of the digestive capacity, after the consumed medication is digested, ''swastika'' rice along with milk added with ghee should be taken. This treatment affords one to achieve the therapeutic results mentioned above.

Here are the summarizing verses-

On using this ''brahma rasayana'', already used by great sages, the user becomes disease free, long lived and with great strength. He becomes charming to the world, with all mission fulfilled, having splendor like that of the moon and the sun, acquires and retains the knowledge. He is endowed with divine psyche, firmness like that of mountain, valor like that of wind. Even poison is reduced to non poison on coming in contact with his body. [59-61]

===== ''Chyavanaprasha'' =====

बिल्वोऽग्निमन्थः श्योनाकः काश्मर्यः पाटलिर्बला|

पर्ण्यश्चतस्रः पिप्पल्यः श्वदंष्ट्रा बृहतीद्वयम्||६२||

शृङ्गी तामलकी द्राक्षा जीवन्ती पुष्करागुरु|

अभया चामृता ऋद्धिर्जीवकर्षभकौ शटी||६३||

मुस्तं पुनर्नवा मेदा सैला चन्दनमुत्पलम्|

विदारी वृषमूलानि काकोली काकनासिका||६४||

एषां पलोन्मितान् भागाञ्छतान्यामलकस्य च|

पञ्च दद्यात्तदैकध्यं जलद्रोणे विपाचयेत्||६५||

ज्ञात्वा गतरसान्येतान्यौषधान्यथ तं रसम्|

तच्चामलकमुद्धृत्य निष्कुलं तैलसर्पिषोः||६६||

पलद्वादशके भृष्ट्वा दत्त्वा चार्धतुलां भिषक्|

मत्स्यण्डिकायाः पूताया लेहवत्साधु साधयेत्||६७||

षट्पलं मधुनश्चात्र सिद्धशीते प्रदापयेत्|

चतुष्पलं तुगाक्षीर्याः पिप्पलीद्विपलं तथा||६८||

पलमेकं निदध्याच्च त्वगेलापत्रकेशरात्|

इत्ययं च्यवनप्राशः परमुक्तो रसायनः||६९||

कासश्वासहरश्चैव विशेषेणोपदिश्यते|

क्षीणक्षतानां वृद्धानां बालानांचाङ्गवर्धनः||७०||

स्वरक्षयमुरोरोगं हृद्रोगं वातशोणितम्|

पिपासां मूत्रशुक्रस्थान् दोषांश्चाप्यपकर्षति||७१||

अस्य मात्रांप्रयुञ्जीत योपरुन्ध्यान्न भोजनम्|

अस्य प्रयोगाच्च्यवनःसुवृद्धोऽभूत्पुनर्युवा||७२||

मेधां स्मृतिं कान्तिमनामयत्वमायुःप्रकर्षं बलमिन्द्रियाणाम्|

स्त्रीषु प्रहर्षं परमग्निवृद्धिं वर्णप्रसादंपवनानुलोम्यम्||७३||

रसायनस्यास्य नरः प्रयोगाल्लभेत जीर्णोऽपि कुटीप्रवेशात्|

जराकृतं रूपमपास्य सर्वं बिभर्ति रूपं नवयौवनस्य||७४||

(इति च्यवनप्राशः)|

bilvō'gnimanthaḥ śyōnākaḥ kāśmaryaḥ pāṭalirbalā|

parṇyaścatasraḥ pippalyaḥ śvadaṁṣṭrā br̥hatīdvayam||62||

śr̥ṅgī tāmalakī drākṣā jīvantī puṣkarāguru|

abhayā cāmr̥tā r̥ddhirjīvakarṣabhakau śaṭī||63||

mustaṁ punarnavā mēdā sailā candanamutpalam|

vidārī vr̥ṣamūlāni kākōlī kākanāsikā||64||

ēṣāṁ palōnmitān bhāgāñchatānyāmalakasya ca|

pañca dadyāttadaikadhyaṁ jaladrōṇē vipācayēt||65||

jñātvā gatarasānyētānyauṣadhānyatha taṁ rasam|

taccāmalakamuddhr̥tya niṣkulaṁ tailasarpiṣōḥ||66||

paladvādaśakē bhr̥ṣṭvā dattvā cārdhatulāṁ bhiṣak|

matsyaṇḍikāyāḥ pūtāyā lēhavatsādhu sādhayēt||67||

ṣaṭpalaṁ madhunaścātra siddhaśītē pradāpayēt|

catuṣpalaṁ tugākṣīryāḥ pippalīdvipalaṁ tathā||68||

palamēkaṁ nidadhyācca tvagēlāpatrakēśarāt|

ityayaṁ cyavanaprāśaḥ paramuktō rasāyanaḥ||69||

kāsaśvāsaharaścaiva viśēṣēṇōpadiśyatē|

kṣīṇakṣatānāṁ vr̥ddhānāṁ bālānāṁ cāṅgavardhanaḥ||70||

svarakṣayamurōrōgaṁ hr̥drōgaṁ vātaśōṇitam|

pipāsāṁ mūtraśukrasthān dōṣāṁścāpyapakarṣati||71||

asya mātrāṁ prayuñjīta yōparundhyānna bhōjanam|

asya prayōgāccyavanaḥ suvr̥ddhō'bhūt punaryuvā||72||

mēdhāṁ smr̥tiṁ kāntimanāmayatvamāyuḥprakarṣaṁ balamindriyāṇām|

strīṣu praharṣaṁ paramagnivr̥ddhiṁ varṇaprasādaṁ pavanānulōmyam||73||

rasāyanasyāsya naraḥ prayōgāllabhēta jīrṇō'pi kuṭīpravēśāt|

jarākr̥taṁ rūpamapāsya sarvaṁ bibharti rūpaṁnavayauvanasya||74||

(iti cyavanaprāśaḥ)|

bilvo~agnimanthaH shyonAkaH kAshmaryaH pATalirbalA|

parNyashcatasraH pippalyaH shvadaMShTrA bRuhatIdvayam||62||

shRu~ggI tAmalakI drAkShA jIvantI puShkarAguru|

abhayA cAmRutA RuddhirjIvakarShabhakau shaTI||63||

mustaM punarnavA medA sailA candanamutpalam|

vidArI vRuShamUlAni kAkolI kAkanAsikA||64||

eShAM palonmitAn bhAgA~jchatAnyAmalakasya ca|

pa~jca dadyAttadaikadhyaM jaladroNe vipAcayet||65||

j~jAtvA gatarasAnyetAnyauShadhAnyatha taM rasam|

taccAmalakamuddhRutya niShkulaM tailasarpiShoH||66||

paladvAdashake bhRuShTvA dattvA cArdhatulAM bhiShak|

matsyaNDikAyAH pUtAyA lehavatsAdhu sAdhayet||67||

ShaTpalaM madhunashcAtra siddhashIte pradApayet|

catuShpalaM tugAkShIryAH pippalIdvipalaM tathA||68||

palamekaM nidadhyAcca tvagelApatrakesharAt|

ityayaM cyavanaprAshaH paramukto rasAyanaH||69||

kAsashvAsaharashcaiva visheSheNopadishyate|

kShINakShatAnAM vRuddhAnAM bAlAnAM cA~ggavardhanaH||70||

svarakShayamurorogaM hRudrogaM vAtashoNitam|

pipAsAM mUtrashukrasthAn doShAMshcApyapakarShati||71||

asya mAtrAM prayu~jjIta yoparundhyAnna bhojanam|

asya prayogAccyavanaH suvRuddho~abhUt punaryuvA||72||

medhAM smRutiM kAntimanAmayatvamAyuHprakarShaM balamindriyANAm|

strIShu praharShaM paramagnivRuddhiM varNaprasAdaM pavanAnulomyam||73||

rasAyanasyAsya naraH prayogAllabheta jIrNo~api kuTIpraveshAt|

jarAkRutaM rUpamapAsya sarvaM bibharti rUpaM navayauvanasya||74||

(iti cyavanaprAshaH)|

40 Gms of each of ''bilwa, agnimantha, shyonaka, kashmarya, patala, bala,'' four leaved herbs (''shalaparni, prishniparni, mudgaparni, mashaparni''), ''pippali, shvadamshtra, brihati, kantakari, karkatshringi, tamalaki, draksha, jivanti, pushkaramula, aguru, abhaya, amrita, riddhi, jivaka, rishabhaka, shati, musta, punarnava, meda, ela, chandana, utpala, vidari, vasa (roots), kakoli'' and ''kakanasa'' and 500 fruits of ''amalaki''– all these put together should be boiled in water measuring 100 litres 240 ml. when the drugs are extracted completely the decoction should be brought down. The fruits of ''amalaki'' also should be taken out and their seeds are removed. Then the fruit pulp should be fried in ''tila'' oil and ghee (mixed) in quantity of 480 gms. Now it should be cooked in the above decoction adding to it 2 kg of clean sugar candy and prepared into a linctus. When it is self cooked, 240 gms of honey should be added to it. in the end 160 gms ''twak, ela, patra'' and ''nagakeshara'' (combined together) should be added. This is the famous ''chyavanaprasha'', an excellent ''rasayana''. Particularly it alleviates cough and dyspnea, is useful for the wasted, injured and old people and promotes development of children. It alleviates hoarseness of voice, chest disease, heart disease, ''vatarakta'', thirst and disorders of urine and semen. It should be taken in the dose which does not interfere with the food intake and digestion. By consuming this ''rasayana'' preparation, the extremely old sage Chyavana regained youthful age. If this ''rasayana'' is used by the indoor method, even the old attains intellect, memory, luster, freedom from disease, longevity, strength of senses, sexual vigor, adequate ''agni'' function (digestion and metabolism), fairness of complexion and appropriate discharge of flatus. The consumer of this ''rasayana'' gets rid of senility and enjoys youthfulness. [62-74]

===== ''Amalaka Rasayana'' =====

अथामलकहरीतकीनामामलकबिभीतकानांहरीतकीबिभीतकानामामलकहरीतकीबिभीतकानां वा पलाशत्वगवनद्धानांमृदाऽवलिप्तानांकुकूलस्विन्नानामकुलकानां पलसहस्रमुलूखले सम्पोथ्य दधिघृतमधुपललतैलशर्करासंयुक्तं भक्षयेदनन्नभुग्यथोक्तेन विधिना; तस्यान्ते यवाग्वादिभिः प्रत्यवस्थापनम् अभ्यङ्गोत्सादनं सर्पिषा यवचूर्णैश्च, अयं च रसायनप्रयोगप्रकर्षो द्विस्तावदग्निबलमभिसमीक्ष्यप्रतिभोजनं यूषेण पयसा वा षष्टिकः ससर्पिष्कः, अतः परं यथासुखविहारः कामभक्ष्यः स्यात्| अनेन प्रयोगेणर्षयः पुनर्युवत्वमवापुर्बभूवुश्चानेकवर्षशतजीविनो निर्विकाराः परं शरीरबुद्धीन्द्रियबलसमुदिताश्चेरुश्चात्यन्तनिष्ठया तपः||७५||

(इतिचतुर्थामलकरसायनम्)|

athāmalakaharītakīnāmāmalakabibhītakānāṁharītakībibhītakānāmāmalakaharītakībibhītakānāṁ vā palāśatvagavanaddhānāṁ mr̥dā'valiptānāṁ kukūlasvinnānāmakulakānāṁ palasahasramulūkhalē sampōthya dadhighr̥tamadhupalalatailaśarkarāsaṁyuktaṁbhakṣayēdanannabhugyathōktēnavidhinā; tasyāntē yavāgvādibhiḥ pratyavasthāpanam abhyaṅgōtsādanaṁ
sarpiṣā yavacūrṇaiśca, ayaṁ ca rasāyanaprayōgaprakarṣō dvistāvadagnibalamabhisamīkṣyapratibhōjanaṁ yūṣēṇa payasā vā ṣaṣṭikaḥ sasarpiṣkaḥ, ataḥ paraṁ yathāsukhavihāraḥ kāmabhakṣyaḥ syāt| anēna prayōgēṇarṣayaḥ punaryuvatvamavāpurbabhūvuścānēkavarṣaśatajīvinō nirvikārāḥ paraṁ śarīrabuddhīndriyabalasamuditāścēruścātyantaniṣṭhayā tapaḥ||75||

(iti caturthāmalakarasāyanam)|

athAmalakaharItakInAmAmalakabibhItakAnAM harItakIbibhItakAnAmAmalakaharItakIbibhItakAnAM vA palAshatvagavanaddhAnAM mRudA~avaliptAnAMkukUlasvinnAnAmakulakAnAM palasahasramulUkhale sampothya dadhighRutamadhupalalatailasharkarAsaMyuktaM bhakShayedanannabhugyathoktena vidhinA;tasyAnte yavAgvAdibhiH pratyavasthApanam [1] , abhya~ggotsAdanaM sarpiShA yavacUrNaishca, ayaM ca rasAyanaprayogaprakarShodvistAvadagnibalamabhisamIkShya [2] , pratibhojanaM yUSheNa payasA vA ShaShTikaH sasarpiShkaH, ataH paraM yathAsukhavihAraH kAmabhakShyaH syAt|
anena prayogeNarShayaH punaryuvatvamavApurbabhUvushcAnekavarShashatajIvino nirvikArAH paraMsharIrabuddhIndriyabalasamuditAshcerushcAtyantaniShThayA tapaH||75||

(iti caturthAmalakarasAyanam)|

The fruits of ''haritaki'' and ''amalaka'' or ''amalaka'' and ''bibhitaka'' or ''haritaki'' and ''bibhitaka'' or ''haritaki'', ''amalaka'' and ''bibhitaka'' should be wrapped with the bark of ''palasha'' tree and after having been pasted with mud should be cooked on charcoal. (when they are well cooked) their seeds be removed and 40 kg of this material should be pounded in a mortar and added with curd, ghee, honey, sesame paste, ''tila'' oil and sugar. This should be consumed on empty stomach by the above method. After the course of treatment, one should be brought back to its normal state by intake of gruel etc. he should also be massaged and anointed with ghee and barley powder. This is the limit of the use of the ''rasayana''. Keeping in view the power of digestion, he should be given diet consisting of ''swastika'' rice added with ghee along with soup or milk for the period double of the same for treatment. Thereafter he may move and eat according to pleasure. By this treatment, the sages regained youthfulness and attained disease free life of many hundreds of years, and endowed with the strength of physique, intellect and sense practiced penance with utmost devotion. (75)

===== ''Haritaki'' formulation =====

हरीतक्यामलकबिभीतकपञ्चपञ्चमूलनिर्यूहेपिप्पलीमधुकमधूककाकोलीक्षीरकाकोल्यात्मगुप्ताजीवकर्षभकक्षीरशुक्लाकल्कसम्प्रयुक्तेनविदारीस्वरसेनक्षीराष्टगुणसम्प्रयुक्तेन च सर्पिषः कुम्भं साधयित्वा प्रयुञ्जानोऽग्निबलसमांमात्रां जीर्णे च क्षीरसर्पिर्भ्यां शालिषष्टिकमुष्णोदकानुपानमश्नञ्जराव्याधिपापाभिचारव्यपगतभयःशरीरेन्द्रियबुद्धिबलमतुलमुपलभ्याप्रतिहतसर्वारम्भःपरमायुरनवाप्नुयात्|७६||

(इति पञ्चमो हरीतकीयोगः)|

harītakyāmalakabibhītakapañcapañcamūlaniryūhēpippalīmadhukamadhūkakākōlīkṣīrakākōlyātmaguptājīvakarṣabhakakṣīraśuklākalkasamprayuktēnavidārīsvarasēna kṣīrāṣṭaguṇasamprayuktēna ca sarpiṣaḥ kumbhaṁ sādhayitvā prayuñjānō'gnibalasamāṁ mātrāṁ jīrṇē ca kṣīrasarpirbhyāṁśāliṣaṣṭikamuṣṇōdakānupānamaśnañjarāvyādhipāpābhicāravyapagatabhayaḥśarīrēndriyabuddhibalamatulamupalabhyāpratihatasarvārambhaḥ paramāyuranavāpnuyāt||76||

(iti pañcamō harītakīyōgaḥ)|

harItakyAmalakabibhItakapa~jcapa~jcamUlaniryUhe pippalImadhukamadhUkakAkolIkShIrakAkolyAtmaguptAjIvakarShabhakakShIrashuklAkalkasamprayuktenavidArIsvarasena kShIrAShTaguNasamprayuktena ca sarpiShaH kumbhaM sAdhayitvA prayu~jjAno~agnibalasamAM [1] mAtrAM jIrNe ca kShIrasarpirbhyAMshAliShaShTikamuShNodakAnupAnamashna~jjarAvyAdhipApAbhicAravyapagatabhayaH sharIrendriyabuddhibalamatulamupalabhyApratihatasarvArambhaHparamAyuranavApnuyAt||76||

(iti pa~jcamo harItakIyogaH)|

The decoction of ''haritaki, amalaka, bibhitaka,'' and five root pentads added with the paste of ''pippali, madhuka, kakoli, ksheerakakoli,'' ''atmagupta, jeevaka, rshabhaka and ksheeravidari,'' then juice of ''vidari'' and eight times milk is added to ghee in quantity of 20 kg 480 gms and cooked properly. One should use it in proper dose according to his digestive capacity. After the drug is digested, he should take the diet consisting of ''shali'' and ''shashtika'' rice along with milk and ghee with the after drink of warm water.

By this one becomes free from the fear of old age, diseases, afflictions and spells and attaining amazing bodily strength. His senses and intellect become unobstructed in all his activities and he enjoys full life span.[76]

हरीतक्यामलकबिभीतकहरिद्रास्थिराबलाविडङ्गामृतवल्लीविश्वभेषजमधुकपिप्पलीसोमवल्कसिद्धेन क्षीरसर्पिषा मधुशर्कराभ्यामपि च सन्नीयामलकस्वरसशतपरिपीतमामलकचूर्णमयश्चूर्णचतुर्भागसम्प्रयुक्तंपाणितलमात्रं प्रातः प्रातः प्राश्य यथोक्तेन विधिना सायं मुद्गयूषेण पयसा वा ससर्पिष्कंशालिषष्टिकान्नमश्नीयात्, त्रिवर्षप्रयोगादस्य वर्षशतमजरं वयस्तिष्ठति,श्रुतमवतिष्ठते, सर्वामयाः प्रशाम्यन्ति, विषमविषं भवति गात्रे, गात्रमश्मवत्स्थिरीभवति, अधृष्यो भूतानांभवति||७७||

harītakyāmalakabibhītakaharidrāsthirābalāviḍaṅgāmr̥tavallīviśvabhēṣajamadhukapippalīsōmavalkasiddhēna kṣīrasarpiṣāmadhuśarkarābhyāmapi ca sannīyāmalakasvarasaśataparipītamāmalakacūrṇamayaścūrṇacaturbhāgasamprayuktaṁ pāṇitalamātraṁ prātaḥ prātaḥ prāśya yathōktēna vidhinā sāyaṁ mudgayūṣēṇa payasā vā sasarpiṣkaṁ śāliṣaṣṭikānnamaśnīyāt, trivarṣaprayōgādasya varṣaśatamajaraṁ vayastiṣṭhati, śrutamavatiṣṭhatē, sarvāmayāḥ praśāmyanti, viṣamaviṣaṁ bhavati gātrē, gātramaśmavat sthirībhavati, adhr̥ṣyō bhūtānāṁbhavati||77||

harItakyAmalakabibhItakaharidrAsthirAbalAviDa~ggAmRutavallIvishvabheShajamadhukapippalIsomavalkasiddhena [1] kShIrasarpiShA madhusharkarAbhyAmapi casannIyAmalakasvarasashataparipItamAmalakacUrNamayashcUrNacaturbhAgasamprayuktaM pANitalamAtraM prAtaH prAtaH prAshya yathoktena vidhinA sAyaMmudgayUSheNa payasA vA sasarpiShkaM shAliShaShTikAnnamashnIyAt, trivarShaprayogAdasya varShashatamajaraM vayastiShThati, shrutamavatiShThate,sarvAmayAH prashAmyanti, viShamaviShaM bhavati gAtre, gAtramashmavat sthirIbhavati, adhRuShyo bhUtAnAM bhavati||77||

Ghee extracted from milk is cooked with ''haritaki, amalaka, bibhitaka, haridra, sthira, bala, vidanga, amritavalli, vishvabheshaja, madhuka,'' ''pippali'' and ''katphala''. This (ghee) along with honey and sugar is mixed with the ''amalaka'' powder impregnated hundred times with the juice of ''amalaka'' fruits and added with iron powder in ¼ quantity. 10 gms of this formulation should be taken in every morning by the above method. In the evening, patient should take diet consisting of ''shali'' and ''shashtika'' rice added with ghee along with the green gram soup or milk. If this formulation is used regularly for three years, the person attains a life span of hundred years free from old age, acquires knowledge, his diseases are alleviated, poison becomes in-effective in his body which is rendered as stone and he becomes invincible for the organisms. [77]

===== Summary =====

भवन्तिचात्र-

यथाऽमराणाममृतं यथा भोगवतांसुधा|

तथाऽभवन्महर्षीणां रसायनविधिपुरा||७८||

न जरां न च दौर्बल्यं नातुर्यं निधनं न च|

जग्मुर्वर्षसहस्राणि रसायनपराः पुरा||७९||

न केवलं दीर्घमिहायुरश्नुते रसायनं योविधिवन्निषेवते|

गतिं स देवर्षिनिषेवितां शुभां प्रपद्यते ब्रह्म तथेति चाक्षयम्||८०||

bhavanticātra-

yathā'marāṇāmamr̥taṁ yathā bhōgavatāṁ sudhā|

tathā'bhavanmaharṣīṇāṁ rasāyanavidhiḥpurā||78||

na jarāṁ na ca daurbalyaṁ nāturyaṁ nidhanaṁ na ca|

jagmurvarṣasahasrāṇi rasāyanaparāḥ purā||79||

na kēvalaṁ dīrghamihāyuraśnutē rasāyanaṁ yō vidhivanniṣēvatē|

gatiṁ sa dēvarṣiniṣēvitāṁ śubhāṁ prapadyatē brahma athēti cākṣayam||80||

bhavanti cAtra-

yathA~amarANAmamRutaM yathA bhogavatAM sudhA|

tathA~abhavanmaharShINAM rasAyanavidhiH purA||78||

na jarAM na ca daurbalyaM nAturyaM nidhanaM na ca|

jagmurvarShasahasrANi rasAyanaparAH purA||79||

na kevalaM dIrghamihAyurashnute rasAyanaM yo vidhivanniShevate|

gatiM sa devarShiniShevitAM shubhAM prapadyate brahma tatheti cAkShayam [2] ||80||

Here are the verses-
As was nectar for the Gods and ambrosia for the serpents so was the ''rasayana'' treatment for the great sages in early times. The individuals using ''rasayana'' treatment in the early ages lived for thousands of years unaffected by senescence, debility, illness and death.
One who uses the ''rasayana'' treatment methodically attains not only longevity but also the auspicious status enjoyed by the godly sages and finally oneness with indestructible God. [78-80]

तत्रश्लोकः-

अभयामलकीयेऽस्मिन् षड्योगाः परिकीर्तिताः|

रसायनानां सिद्धानामायुर्यैरनुवर्तते||८१||

tatra ślōkaḥ-

abhayāmalakīyē'smin ṣaḍyōgāḥ parikīrtitāḥ|

rasāyanānāṁ siddhānāmāyuryairanuvartatē||81||

tatra shlokaH-

abhayAmalakIye~asmin ShaDyogAH parikIrtitAH|

rasAyanAnAM siddhAnAmAyuryairanuvartate||81||

Now the summing up verse-
Thus, in the quarter of ''haritaki, amalaka'' etc. six accomplished ''rasayana'' formulations have been described which promote life.[81]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेचिकित्सास्थानेरसायनाध्यायेऽभयामलकीयो नाम रसायनपादः प्रथमः||१||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē rasāyanādhyāyē'bhayāmalakīyō nāma rasāyanapādaḥ prathamaḥ||1||

ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne rasAyanAdhyAye~abhayAmalakIyo nAma rasAyanapAdaH prathamaH||1||

Thus ends the first quarter of ''haritaki, amalaka'' etc. in the chapter on ''rasayana'' in [[Chikitsa Sthana]] in the treatise composed of Agnivesha and redacted by Charak. [1]

==== Part II- ''Pranakamiyam Rasayanapadam'' ====

अथातः प्राणकामीयं रसायनपादं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ prāṇakāmīyaṁ rasāyanapādaṁvyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH prANakAmIyaM rasAyanapAdaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now I shall deliberate on the quarter of the chapter on ''Rasayana'' on desire for vital breath etc. As propounded by Lord Atreya. [1-2]

===== Benefits of ''Rasayana'' and effects of domestic food and lifestyle =====

प्राणकामाःशुश्रूषध्वमिदमुच्यमानममृतमिवापरमदितिसुतहितकरमचिन्त्याद्भुतप्रभावमायुष्यमारोग्यकरं वयसः स्थापनं निद्रातन्द्राश्रमक्लमालस्यदौर्बल्यापहरमनिलकफपित्तसाम्यकरंस्थैर्यकरमबद्धमांसहरमन्तरग्निसन्धुक्षणं प्रभावर्णस्वरोत्तमकरं रसायनविधानम्| अनेन च्यवनादयो महर्षयः पुनर्युवत्वमापुर्नारीणां चेष्टतमा बभूवुः, स्थिरसमसुविभक्तमांसाः, सुसंहतस्थिरशरीराः, सुप्रसन्नबलवर्णेन्द्रियाः, सर्वत्राप्रतिहतपराक्रमाः, क्लेशसहाश्च| सर्वे शरीरदोषा भवन्ति ग्राम्याहारादम्ललवणकटुकक्षारशुष्कशाकमांसतिलपललपिष्टान्नभोजिनांविरूढनवशूकशमीधान्यविरुद्धासात्म्यरूक्षक्षाराभिष्यन्दिभोजिनांक्लिन्नगुरुपूतिपर्युषितभोजिनां विषमाध्यशनप्रायाणां दिवास्वप्नस्त्रीमद्यनित्यानांविषमातिमात्रव्यायामसङ्क्षोभितशरीराणांभयक्रोधशोकलोभमोहायासबहुलानाम्; अतोनिमित्तं हि शिथिलीभवन्ति मांसानि, विमुच्यन्ते सन्धयः, विदह्यते रक्तं, विष्यन्दते चानल्पं मेदः, नसन्धीयतेऽस्थिषुमज्जा, शुक्रं न प्रवर्तते, क्षयमुपैत्योजः; स एवम्भूतो ग्लायति, सीदति, निद्रातन्द्रालस्यसमन्वितो निरुत्साहः श्वसिति, असमर्थश्चेष्टानां शारीरमानसीनां, नष्टस्मृतिबुद्धिच्छायो रोगाणामधिष्ठानभूतो न सर्वमायुरवाप्नोति| तस्मादेतान् दोषानवेक्षमाणः सर्वान् यथोक्तानहितानपास्याहारविहारान् रसायनानि प्रयोक्तुमर्हतीत्युक्त्वा भगवान् पुनर्वसुरात्रेय उवाच-||३||

Prāṇakāmāḥśuśrūṣadhvamidamucyamānamamr̥tamivāparamaditisutahitakaramacintyādbhutaprabhāvamāyuṣyamārōgyakaraṁ vayasaḥ sthāpanaṁ nidrātandrāśramaklamālasyadaurbalyāpaharamanilakaphapittasāmyakaraṁ
sthairyakaramabaddhamāṁsaharamantaragnisandhukṣaṇaṁprabhāvarṇasvarōttamakaraṁ rasāyanavidhānam| anēna cyavanādayō maharṣayaḥ punaryuvatvamāpurnārīṇāṁ cēṣṭatamā babhūvuḥ, sthirasamasuvibhaktamāṁsāḥ, susaṁhatasthiraśarīrāḥ, suprasannabalavarṇēndriyāḥ, sarvatrāpratihataparākramāḥ, klēśasahāśca| sarvē śarīradōṣā bhavanti grāmyāhārādamlalavaṇakaṭukakṣāraśuṣkaśākamāṁsatilapalalapiṣṭānnabhōjināṁvirūḍhanavaśūkaśamīdhānyaviruddhāsātmyarūkṣakṣārābhiṣyandibhōjināṁ klinnagurupūtiparyuṣitabhōjināṁ viṣamādhyaśanaprāyāṇāṁ divāsvapnastrīmadyanityānāṁviṣamātimātravyāyāmasaṅkṣōbhitaśarīrāṇāṁ bhayakrōdhaśōkalōbhamōhāyāsabahulānām; atōnimittaṁ hi śithilībhavanti māṁsāni, vimucyantē sandhayaḥ, vidahyatē raktaṁ, viṣyandatē cānalpaṁ mēdaḥ, na sandhīyatē'sthiṣu majjā, śukraṁ na pravartatē, kṣayamupaityōjaḥ; sa ēvambhūtō glāyati, sīdati, nidrātandrālasyasamanvitō nirutsāhaḥ śvasiti, asamarthaścēṣṭānāṁ śārīramānasīnāṁ, naṣṭasmr̥tibuddhicchāyō rōgāṇāmadhiṣṭhānabhūtō na sarvamāyuravāpnōti| tasmādētān dōṣānavēkṣamāṇaḥ sarvān yathōktānahitānapāsyāhāravihārān rasāyanāni prayōktumarhatītyuktvā bhagavān punarvasurātrēya uvāca-||3||

prANakAmAH shushrUShadhvamidamucyamAnamamRutamivAparamaditisutahitakaramacintyAdbhutaprabhAvamAyuShyamArogyakaraM vayasaH sthApanaMnidrAtandrAshramaklamAlasyadaurbalyApaharamanilakaphapittasAmyakaraM sthairyakaramabaddhamAMsaharamantaragnisandhukShaNaMprabhAvarNasvarottamakaraM rasAyanavidhAnam|
anena cyavanAdayo maharShayaH punaryuvatvamApurnArINAM ceShTatamA babhUvuH, sthirasamasuvibhaktamAMsAH, susaMhatasthirasharIrAH,suprasannabalavarNendriyAH, sarvatrApratihataparAkramAH, kleshasahAshca|
sarve sharIradoShA bhavanti grAmyAhArAdamlalavaNakaTukakShArashuShkashAkamAMsatilapalalapiShTAnnabhojinAM [1]virUDhanavashUkashamIdhAnyaviruddhAsAtmyarUkShakShArAbhiShyandibhojinAM klinnagurupUtiparyuShitabhojinAM viShamAdhyashanaprAyANAMdivAsvapnastrImadyanityAnAM viShamAtimAtravyAyAmasa~gkShobhitasharIrANAM bhayakrodhashokalobhamohAyAsabahulAnAm; atonimittaM [2] hishithilIbhavanti mAMsAni, vimucyante sandhayaH, vidahyate raktaM, viShyandate cAnalpaM medaH, na sandhIyate~asthiShu majjA, shukraM na pravartate,kShayamupaityojaH; sa evambhUto glAyati, sIdati, nidrAtandrAlasyasamanvito nirutsAhaH shvasiti, asamarthashceShTAnAM shArIramAnasInAM,naShTasmRutibuddhicchAyo rogANAmadhiShThAnabhUto na sarvamAyuravApnoti|
tasmAdetAn doShAnavekShamANaH sarvAn yathoktAnahitAnapAsyAhAravihArAn rasAyanAni prayoktumarhatItyuktvA bhagavAn punarvasurAtreya uvAca-||3||

Oh desirous of vital breath! Listen to me explaining the procedure of ''rasayana'' therapy which is like another nectar, acceptable for the gods, having incomprehensible miraculous effects, prolongs life span, provides health, sustains age, relieves excessive sleep, drowsiness, exertion, exhaustion, lassitude and emaciation, restores ''tridoshika'' balance, brings stability, alleviates laxity of muscles, kindles internal fire and imparts excellent luster, complexion and voice. By using this, the great sages like Chyavana and others. regained youthful age and became charming for the women, they also attained firm, even and well divided muscles, compact and stable physique, blossomed strength, complexion and sense, uninterrupted prowess and endurance. All morbidity arise due to domestic food in those eating sour, saline, pungent, alkaline, dried vegetables, meat, sesame, sesame paste and preparation of (rice) flour, germinated or fresh, awned or leguminous cereals, incompatible, unsuitable, rough, alkaline and channel blocking substances, decomposed, heavy, putrefied, and staled food items, indulging in irregular diet or eating while the previous food is undigested, day sleep, women and wine, performing irregular and excessive physical exercise causing agitation in the body, affected with fear, anger, grief, greed, confusion and exhaustion. Because of this the muscles get laxed, joints get loosened, blood gets burnt, fat becomes abundant and liquefied, marrow does not mature in bones, semen does not manifest and ''ojas'' deteriorates. Thus, the person subdued with malaise, depression, sleep, drowsiness, lassitude, lack of enthusiasm, dyspnea, incapability in physical and mental activities, loss of memory, intellect and luster, becomes resort of illness and thus does not enjoy the normal life span. Hence looking to these defects, one should abstain from all the said unwholesome diet and activities so that he becomes fit for using the ''rasayana'' treatment- saying this Lord Punarvasu Atreya further added. [3]

===== ''Amalaki'' ghee =====

आमलकानां सुभूमिजानांकालजानामनुपहतगन्धवर्णरसानामापूर्णरसप्रमाणवीर्याणां स्वरसेन पुनर्नवाकल्कपादसम्प्रयुक्तेन सर्पिषः साधयेदाढकम्, अतः परं विदारीस्वरसेन जीवन्तीकल्कसम्प्रयुक्तेन, अतः परं चतुर्गुणेन पयसा बलातिबलाकषायेण शतावरीकल्कसंयुक्तेन; अनेन क्रमेणैकैकं शतपाकं सहस्रपाकं वा शर्कराक्षौद्रचतुर्भागसम्प्रयुक्तं सौवर्णे राजते मार्तिके वा शुचौ दृढे घृतभाविते कुम्भे स्थापयेत्; तद्यथोक्तेन विधिना यथाग्नि प्रातः प्रातः प्रयोजयेत्, जीर्णे च क्षीरसर्पिर्भ्यांशालिषष्टिकमश्नीयात्| अस्य प्रयोगाद्वर्षशतं वयोऽजरं तिष्ठति, श्रुतमवतिष्ठते, सर्वामयाः प्रशाम्यन्ति, अप्रतिहतगतिः स्त्रीषु, अपत्यवान् भवतीति||४||

भवतश्चात्र-

बृहच्छरीरं गिरिसारसारं स्थिरेन्द्रियं चातिबलेन्द्रियं च|

अधृष्यमन्यैरतिकान्तरूपं प्रशस्तिपूजासुखचित्तभाक् च||५||

बलं महद्वर्णविशुद्धिरग्र्या स्वरो घनौघस्तनितानुकारी|

भवत्यपत्यं विपुलं स्थिरं च समश्नतो योगमिमं नरस्य||६||

(इत्यामलकघृतम्)|

āmalakānāṁ subhūmijānāṁ kālajānāmanupahatagandhavarṇarasānāmāpūrṇarasapramāṇavīryāṇāṁsvarasēna punarnavākalkapādasamprayuktēna sarpiṣaḥ sādhayēdāḍhakam, ataḥ paraṁ vidārīsvarasēna jīvantīkalkasamprayuktēna, ataḥ paraṁ caturguṇēna payasā balātibalākaṣāyēṇa śatāvarīkalkasaṁyuktēna; anēna kramēṇaikaikaṁ śatapākaṁ sahasrapākaṁ vā śarkarākṣaudracaturbhāgasamprayuktaṁ sauvarṇē rājatē mārtikē vā śucau dr̥ḍhē ghr̥tabhāvitē kumbhē sthāpayēt; tadyathōktēna vidhinā yathāgni prātaḥ prātaḥ prayōjayēt, jīrṇē ca kṣīrasarpirbhyāṁ śāliṣaṣṭikamaśnīyāt| asya prayōgādvarṣaśataṁ vayō'jaraṁ tiṣṭhati, śrutamavatiṣṭhatē, sarvāmayāḥ praśāmyanti, apratihatagatiḥ strīṣu, apatyavān bhavatīti||4||

bhavataścātra-

br̥haccharīraṁ girisārasāraṁ sthirēndriyaṁ cātibalēndriyaṁ ca|

adhr̥ṣyamanyairatikāntarūpaṁ praśastipūjāsukhacittabhāk ca||5||

balaṁ mahadvarṇaviśuddhiragryā svarō ghanaughastanitānukārī|

bhavatyapatyaṁ vipulaṁ sthiraṁ ca samaśnatō yōgamimaṁ narasya||6||

(ityāmalakaghr̥tam)|

AmalakAnAM subhUmijAnAM kAlajAnAmanupahatagandhavarNarasAnAmApUrNarasapramANavIryANAM svarasena punarnavAkalkapAdasamprayuktena sarpiShaHsAdhayedADhakam, ataH paraM vidArIsvarasena jIvantIkalkasamprayuktena, ataH paraM caturguNena payasA balAtibalAkaShAyeNa shatAvarIkalkasaMyuktena;anena krameNaikaikaM shatapAkaM sahasrapAkaM vA sharkarAkShaudracaturbhAgasamprayuktaM sauvarNe rAjate mArtike vA shucau dRuDhe ghRutabhAvitekumbhe sthApayet; tadyathoktena vidhinA yathAgni prAtaH prAtaH prayojayet, jIrNe ca kShIrasarpirbhyAM shAliShaShTikamashnIyAt|
asya prayogAdvarShashataM vayo~ajaraM tiShThati, shrutamavatiShThate, sarvAmayAH prashAmyanti, apratihatagatiH strIShu, apatyavAn bhavatIti||4||

bhavatashcAtra-

bRuhaccharIraM girisArasAraM sthirendriyaM cAtibalendriyaM ca|

adhRuShyamanyairatikAntarUpaM prashastipUjAsukhacittabhAk ca||5||

balaM mahadvarNavishuddhiragryA svaro ghanaughastanitAnukArI|

bhavatyapatyaM vipulaM sthiraM ca samashnato yogamimaM narasya||6||

(ityAmalakaghRutam)|

Two kg 560 gms of ghee should be cooked with juice of ''amalaka'' fruit grown in a good soil and time, possessing unaffected smell, color and taste, which are mature with taste, size and potency, along with one fourth quantity of ''punarnava''. There after the process should be repeated with the juice of ''vidari'', along with the paste of ''jeevanti'', thereafter with the four times the quantity of milk and decoction of ''bala'' and ''atibala'' along with the paste of ''shatavari''. In this way the ghee should be cooked with each method hundred or thousand times. The prepared ghee should be added with one forth quantity of sugar and honey and be kept in a pitcher- golden, silver or earthen- which is clean, strong and lubricated with ghee. This should be used regularly by the said method every morning according to one’s digestive capacity. When the drug is digested, diet of ''shali'' and ''shashtika'' rice along with milk and ghee should be taken. By consumption of this preparation life span stands for hundred years devoid of old age, optimum cognitive ability is retained, all diseases are alleviated, one attains uninterrupted sexual vigor in women and is also blessed with pregnancy and progeny.

Here are the verses-
If the person uses this preparation properly he attains big body, compactness like essence of mountains, firm and strong sense organs, invincibility, charming look, popularity, respect, happiness and intellect. Moreover, by this strength he becomes great, complexion gets excellently purified, voice becomes like imitating the rumbling of dense thunder clouds, and the person is blessed with a large and stable progeny. [4-6]

===== ''Amalaki Avaleha'' =====

आमलकसहस्रं पिप्पलीसहस्रसम्प्रयुक्तं पलाशतरुणक्षारोदकोत्तरं तिष्ठेत्, तदनुगतक्षारोदकमनातपशुष्कमनस्थि चूर्णीकृतं चतुर्गुणाभ्यां मधुसर्पिर्भ्यां सन्नीय शर्कराचूर्णचतुर्भागसम्प्रयुक्तं घृतभाजनस्थं षण्मासान् स्थापयेदन्तर्भूमेः| तस्योत्तरकालमग्निबलसमां मात्रां खादेत्, पौर्वाह्णिकः प्रयोगो नापराह्णिकः, सात्म्यापेक्षश्चाहारविधिः| अस्य प्रयोगाद्वर्षशतमजरं वयस्तिष्ठतीति समानं पूर्वेण||७||

(इत्यामलकावलेहः)|

āmalakasahasraṁ pippalīsahasrasamprayuktaṁ palāśataruṇakṣārōdakōttaraṁ
tiṣṭhēt, tadanugatakṣārōdakamanātapaśuṣkamanasthi cūrṇīkr̥taṁ caturguṇābhyāṁ madhusarpirbhyāṁ sannīya śarkarācūrṇacaturbhāgasamprayuktaṁ ghr̥tabhājanasthaṁ ṣaṇmāsān sthāpayēdantarbhūmēḥ| tasyōttarakālamagnibalasamāṁ mātrāṁ khādēt, paurvāhṇikaḥ prayōgō nāparāhṇikaḥ, sātmyāpēkṣaścāhāravidhiḥ| asya prayōgādvarṣaśatamajaraṁ vayastiṣṭhatīti samānaṁ pūrvēṇa||7||

(ityāmalakāvalēhaḥ)|

AmalakasahasraM pippalIsahasrasamprayuktaM palAshataruNakShArodakottaraM tiShThet, tadanugatakShArodakamanAtapashuShkamanasthi cUrNIkRutaMcaturguNAbhyAM madhusarpirbhyAM sannIya sharkarAcUrNacaturbhAgasamprayuktaM ghRutabhAjanasthaM ShaNmAsAn sthApayedantarbhUmeH|
tasyottarakAlamagnibalasamAM mAtrAM khAdet, paurvAhNikaH prayogo nAparAhNikaH, sAtmyApekShashcAhAravidhiH|
asya prayogAdvarShashatamajaraM vayastiShThatIti samAnaM pUrveNa||7||

(ityAmalakAvalehaH)|

One thousand fruits of ''amalaki'' along with the same numbers of fruits of ''pippali'' should be dipped in to alkaline water prepared from the young ''palasha'' tree. After taking them out they should be dried in shade after removing seeds and powdered. This powder mixed with four times honey and ghee and stored underground for six months. Thereafter one should take its dose according to his digestive capacity only in forenoon and not in afternoon. The diet should be according to suitability. By its use, one attains the stable life span of hundred years without enduring senility. The other beneficial effects are as described earlier. [7]

===== ''Amalaki'' powder =====

आमलकचूर्णाढकमेकविंशतिरात्रमामलकस्वरसपरिपीतं मधुघृताढकाभ्यां द्वाभ्यामेकीकृतमष्टभागपिप्पलीकं शर्कराचूर्णचतुर्भागसम्प्रयुक्तं घृतभाजनस्थं प्रावृषि भस्मराशौ
निदध्यात्; तद्वर्षान्ते सात्म्यपथ्याशी प्रयोजयेत्; अस्य प्रयोगाद्वर्षशतमजरमायुस्तिष्ठतीति समानं पूर्वेण||८||

(इत्यामलकचूर्णम्)|

āmalakacūrṇāḍhakamēkaviṁśatirātramāmalakasvarasaparipītaṁmadhughr̥tāḍhakābhyāṁ dvābhyāmēkīkr̥tamaṣṭabhāgapippalīkaṁ śarkarācūrṇacaturbhāgasamprayuktaṁ ghr̥tabhājanasthaṁ prāvr̥ṣi bhasmarāśau nidadhyāt; tadvarṣāntē sātmyapathyāśī prayōjayēt; asya prayōgādvarṣaśatamajaramāyustiṣṭhatīti samānaṁ pūrvēṇa||8||

(ityāmalakacūrṇam)|

AmalakacUrNADhakamekaviMshatirAtramAmalakasvarasaparipItaM madhughRutADhakAbhyAM dvAbhyAmekIkRutamaShTabhAgapippalIkaMsharkarAcUrNacaturbhAgasamprayuktaM ghRutabhAjanasthaM prAvRuShi bhasmarAshau nidadhyAt; tadvarShAnte sAtmyapathyAshI prayojayet; asyaprayogAdvarShashatamajaramAyustiShThatIti samAnaM pUrveNa||8||

(ityAmalakacUrNam)|

Powder of ''amalaki'' fruits in quantity of 2 kg 560 gms is impregnated with ''amalaki'' fruits juice for twenty-one days and nights. This should be mixed with honey and ghee in the quantity of 5 kg 120 gms and added with ''pippali'' in one eighth quantity and fine sugar in one fourth quantity. This preparation now should be kept in a container lined with ghee and stored in early rains under a heap of ashes. After the rainy season is over, this should be uncovered and be used along with suitable and wholesome diet. This provides a stable life span of one hundred years devoid of senility. Other impacts affordable from this medication are as described earlier. [8]

===== ''Vidanga Avaleha'' =====

विडङ्गतण्डुलचूर्णानामाढकमाढकं पिप्पलीतण्डुलानामध्यर्धाढकं सितोपलायाः सर्पिस्तैलमध्वाढकैः षड्भिरेकीकृतं घृतभाजनस्थं प्रावृषि भस्मराशाविति सर्वं समानं पूर्वेण यावदाशीः||९||

(इति विडङ्गावलेहः)|

viḍaṅgataṇḍulacūrṇānāmāḍhakamāḍhakaṁpippalītaṇḍulānāmadhyardhāḍhakaṁ sitōpalāyāḥ sarpistailamadhvāḍhakaiḥ ṣaḍbhirēkīkr̥taṁ ghr̥tabhājanasthaṁ prāvr̥ṣi bhasmarāśāviti sarvaṁ samānaṁ pūrvēṇa yāvadāśīḥ||9||

(iti viḍaṅgāvalēhaḥ)|

viDa~ggataNDulacUrNAnAmADhakamADhakaM pippalItaNDulAnAmadhyardhADhakaM sitopalAyAH sarpistailamadhvADhakaiH ShaDbhirekIkRutaMghRutabhAjanasthaM prAvRuShi bhasmarAshAviti sarvaM samAnaM pUrveNa yAvadAshIH||9||

(iti viDa~ggAvalehaH)|

Powder of ''vidanga'' and ''pippali'' fruits each 2 kg 560 gms, sugar-candy 3 kg 840 gms, ghee, oil and honey together 15 kg 360 gms – all are mixed together and kept in a pot lined with ghee and stored in early rains under a heap of ashes. The therapeutic effects are as mentioned earlier. [9]

===== ''Amalaka Avaleha'' =====

यथोक्तगुणानामामलकानां सहस्रमार्द्रपलाशद्रोण्यां सपिधानायां बाष्पमनुद्वमन्त्यामारण्यगोमयाग्निभिरुपस्वेदयेत्, तानि सुस्विन्नशीतान्युद्धृतकुलकान्यापोथ्याढकेन पिप्पलीचूर्णानामाढकेन च विडङ्गतण्डुलचूर्णानामध्यर्धेन चाढकेन शर्कराया द्वाभ्यां द्वाभ्यामाढकाभ्यां तैलस्य मधुनः सर्पिषश्च संयोज्य शुचौ दृढे घृतभाविते कुम्भे स्थापयेदेकविंशतिरात्रम्, अत ऊर्ध्वं प्रयोगः; अस्य
प्रयोगाद्वर्षशतमजरमायुस्तिष्ठतीति समानं पूर्वेण||१०|||

(इत्यामलकावलेहोऽपरः)|

yathōktaguṇānāmāmalakānāṁ sahasramārdrapalāśadrōṇyāṁ sapidhānāyāṁ
bāṣpamanudvamantyāmāraṇyagōmayāgnibhirupasvēdayēt, tāni susvinnaśītānyuddhr̥takulakānyāpōthyāḍhakēna pippalīcūrṇānāmāḍhakēna caviḍaṅgataṇḍulacūrṇānāmadhyardhēna cāḍhakēna śarkarāyā dvābhyāṁ dvābhyāmāḍhakābhyāṁ tailasya madhunaḥ sarpiṣaśca saṁyōjya śucau dr̥ḍhē ghr̥tabhāvitē kumbhē sthāpayēdēkaviṁśatirātram, ata ūrdhvaṁ prayōgaḥ; asya prayōgādvarṣaśatamajaramāyustiṣṭhatīti samānaṁ pūrvēṇa||10||

(ityāmalakāvalēhō'paraḥ)|

yathoktaguNAnAmAmalakAnAM sahasramArdrapalAshadroNyAM sapidhAnAyAM bAShpamanudvamantyAmAraNyagomayAgnibhirupasvedayet, tAnisusvinnashItAnyuddhRutakulakAnyApothyADhakena pippalIcUrNAnAmADhakena ca viDa~ggataNDulacUrNAnAmadhyardhena cADhakena sharkarAyA dvAbhyAMdvAbhyAmADhakAbhyAM tailasya madhunaH sarpiShashca saMyojya shucau dRuDhe ghRutabhAvite kumbhe sthApayedekaviMshatirAtram, ata UrdhvaM prayogaH;asya prayogAdvarShashatamajaramAyustiShThatIti samAnaM pUrveNa||10||

(ityAmalakAvaleho~aparaH)|

One thousand ''amalaka'' fruits having aforesaid qualities should be heated in a covered tub made of fresh ''palasha'' wood which does not emit vapour with wild cow dung fire. When they are heated properly and when self cooled their seeds should be removed and the remaining material should be crushed. Thereafter ''pippali'' powder 2 kg 560 gms, ''vidanga'' powder 2 kg 560 gms, sugar 3 kg 840 gms, oil, honey and ghee each 5 kg 120 gms should be added to it. The preparation then should be kept in a clean and strong container laced with ghee and stored for twenty one days and nights. Thereafter it should be used. By its use, life span of one hundred years stands devoid of senility, other impacts are as said before. [10]

===== ''Nagabala Rasayana'' =====

धन्वनि कुशास्तीर्णे स्निग्धकृष्णमधुरमृत्तिके सुवर्णवर्णमृत्तिके वा व्यपगतविषश्वापदपवनसलिलाग्निदोषे कर्षणवल्मीकश्मशानचैत्योषरावसथवर्जिते देशे यथर्तुसुखपवनसलिलादित्यसेविते जातान्यनुपहतान्यनध्यारूढान्यबालान्यजीर्णान्यधिगतवीर्याणि शीर्णपुराणपर्णान्यसञ्जातान्यपर्णानि तपसि तपस्ये वा मासे शुचिः प्रयतः कृतदेवार्चनः स्वस्ति वाचयित्वा द्विजातीन् चले सुमुहूर्ते नागबलामूलान्युद्धरेत्, तेषां सुप्रक्षालितानां त्वक्पिण्डमाम्रमात्रमक्षमात्रं वा श्लक्ष्णपिष्टमालोड्य पयसा प्रातः प्रयोजयेत्, चूर्णीकृतानि वा पिबेत् पयसा, मधुसर्पिर्भ्यां वा संयोज्यभक्षयेत्, जीर्णे च क्षीरसर्पिर्भ्यां शालिषष्टिकमश्नीयात्| संवत्सरप्रयोगादस्य वर्षशतमजरं वयस्तिष्ठतीति समानं पूर्वेण||११||

(इति नागबलारसायनम्)|

dhanvani kuśāstīrṇē snigdhakr̥ṣṇamadhuramr̥ttikē suvarṇavarṇamr̥ttikē vā vyapagataviṣaśvāpadapavanasalilāgnidōṣēkarṣaṇavalmīkaśmaśānacaityōṣarāvasathavarjitē dēśē yathartusukhapavanasalilādityasēvitē jātānyanupahatānyanadhyārūḍhānyabālānyajīrṇānyadhigatavīryāṇiśīrṇapurāṇaparṇānyasañjātānyaparṇānitapasi tapasyē vā māsē śuciḥ prayataḥ kr̥tadēvārcanaḥ svasti vācayitvā dvijātīn calē sumuhūrtē nāgabalāmūlānyuddharēt, tēṣāṁ suprakṣālitānāṁ tvakpiṇḍamāmramātramakṣamātraṁ vā ślakṣṇapiṣṭamālōḍya payasā prātaḥ prayōjayēt, cūrṇīkr̥tāni vā pibēt payasā, madhusarpirbhyāṁ vā saṁyōjya bhakṣayēt, jīrṇē ca kṣīrasarpirbhyāṁ śāliṣaṣṭikamaśnīyāt| saṁvatsaraprayōgādasya varṣaśatamajaraṁ vayastiṣṭhatīti samānaṁ pūrvēṇa||11||

(iti nāgabalārasāyanam)|

dhanvani kushAstIrNe snigdhakRuShNamadhuramRuttike suvarNavarNamRuttike vA vyapagataviShashvApadapavanasalilAgnidoShekarShaNavalmIkashmashAnacaityoSharAvasathavarjite deshe yathartusukhapavanasalilAdityasevitejAtAnyanupahatAnyanadhyArUDhAnyabAlAnyajIrNAnyadhigatavIryANi shIrNapurANaparNAnyasa~jjAtAnyaparNAni [1] tapasi tapasye vA mAse shuciH prayataHkRutadevArcanaH svasti vAcayitvA dvijAtIn cale [2] sumuhUrte nAgabalAmUlAnyuddharet, teShAM suprakShAlitAnAM tvakpiNDamAmramAtramakShamAtraM vAshlakShNapiShTamAloDya payasA prAtaH prayojayet, cUrNIkRutAni vA pibet payasA, madhusarpirbhyAM vA saMyojya bhakShayet, jIrNe ca kShIrasarpirbhyAM [3]shAliShaShTikamashnIyAt|
saMvatsaraprayogAdasya varShashatamajaraM vayastiShThatIti samAnaM pUrveNa||11||

(iti nAgabalArasAyanam)|

One should collect the roots of ''nagabala'' in ''chala muhurta'' in the month of ''Magha'' or ''Phalguna'' while being clean and attentive, having worshipped the deities and engaging the ''brahmanas'' to recite auspicious mantras. The plant should have grown in a forest area covered in ''kusha'' grass, having soil unctuous, black and sweet or of golden color, devoid of poison, injurious animals and defect of wind, water and fire, and also of cultivation defects, ant-hill, cremation ground, sacred tree, infertile area and habitation and having proper access to air, water and the sun according to season, the roots should be undamaged, in-encroached, neither immature nor too old, possessed with potency, having shed off the old leaves and with new leaves not appeared. The roots should be washed well and the bark should be taken in the dose of 40 gms, finely pounded and mixed with milk in every morning or as powder with milk or along with honey and ghee. After the medicine is digested, one should take diet of ''shali'' and ''shashtika'' rice along with milk and ghee. If used regularly for a year, it makes the life span for one hundred years without senility. Other outcomes are as described before. [11]

बलातिबलाचन्दनागुरुधवतिनिशखदिरशिंशपासनस्वरसाः पुनर्नवान्ताश्चौषधयो दश नागबलया व्याख्याताः| स्वरसानामलाभे त्वयं स्वरसविधिः- चूर्णानामाढकमाढकमुदकस्याहोरात्रस्थितं मृदितपूतं स्वरसवत् प्रयोज्यम्||१२||

balātibalācandanāgurudhavatiniśakhadiraśiṁśapāsanasvarasāḥpunarnavāntāścauṣadhayō daśa nāgabalayā vyākhyātāḥ| svarasānāmalābhē tvayaṁ svarasavidhiḥ- cūrṇānāmāḍhakamāḍhakamudakasyāhōrātrasthitaṁ mr̥ditapūtaṁ svarasavat prayōjyam||12||

balAtibalAcandanAgurudhavatinishakhadirashiMshapAsanasvarasAH punarnavAntAshcauShadhayo dasha [1] nAgabalayA vyAkhyAtAH|
svarasAnAmalAbhe tvayaM svarasavidhiH- cUrNAnAmADhakamADhakamudakasyAhorAtrasthitaM mRuditapUtaM svarasavat prayojyam||12||

The juice of ''bala, atibala, chandana, aguru, dhava, tinisha, khadira,'' and ''shimshapa'' and the ten age sustaining drugs are used by the method as in case of ''nagabala''. If the fresh juice is not available this method should be adopted- 2 kg 560 gms drug should be dipped in equal quantity of water for the day and night, then it should be pressed and filtered and used as ''swarasa''. [12]

===== ''Bhallataka Ksheeram'' =====

भल्लातकान्यनुपहतान्यनामयान्यापूर्णरसप्रमाणवीर्याणि पक्वजाम्बवप्रकाशानि शुचौ शुक्रे वा मासेसङ्गृह्य यवपल्ले माषपल्ले वानिधापयेत्, तानि चतुर्मासस्थितानि सहसि सहस्ये वा मासे
प्रयोक्तुमारभेतशीतस्निग्धमधुरोपस्कृतशरीरः|
पूर्वं दशभल्लातकान्यापोथ्याष्टगुणेनाम्भसा साधुसाधयेत्, तेषां रसमष्टभागावशेषं पूतं सपयस्कं पिबेत्सर्पिषाऽन्तर्मुखमभ्यज्य|
तान्येकैकभल्लातकोत्कर्षापकर्षेण दशभल्लातकान्यात्रिंशतः प्रयोज्यानि, नातः परमुत्कर्षः|
प्रयोगविधानेन सहस्रपर एवभल्लातकप्रयोगः|
जीर्णे च ससर्पिषा पयसाशालिषष्टिकाशनमुपचारः, प्रयोगान्ते च द्विस्तावत् पयसैवोपचारः|
तत्प्रयोगाद्वर्षशतमजरं वयस्तिष्ठतीति समानं पूर्वेण||१३||

(इति भल्लातकक्षीरम्)|

bhallātakānyanupahatānyanāmayānyāpūrṇarasapramāṇavīryāṇipakvajāmbavaprakāśāni śucau śukrē vā māsē saṅgr̥hya yavapallē māṣapallē vā nidhāpayēt, tāni caturmāsasthitāni sahasi sahasyē vā māsē prayōktumārabhēta śītasnigdhamadhurōpaskr̥taśarīraḥ| pūrvaṁ daśabhallātakānyāpōthyāṣṭaguṇēnāmbhasā sādhu sādhayēt, tēṣāṁ rasamaṣṭabhāgāvaśēṣaṁ pūtaṁ sapayaskaṁ pibētsarpiṣā'ntarmukhamabhyajya|
tānyēkaikabhallātakōtkarṣāpakarṣēṇa daśabhallātakānyātriṁśataḥ prayōjyāni,
nātaḥ paramutkarṣaḥ| prayōgavidhānēna sahasrapara ēva bhallātakaprayōgaḥ|
jīrṇē ca sasarpiṣā payasā śāliṣaṣṭikāśanamupacāraḥ, prayōgāntē ca dvistāvat
payasaivōpacāraḥ| tatprayōgādvarṣaśatamajaraṁ vayastiṣṭhatīti samānaṁ pūrvēṇa||13||

(iti bhallātakakṣīram)|

bhallAtakAnyanupahatAnyanAmayAnyApUrNarasapramANavIryANi pakvajAmbavaprakAshAni shucau shukre vA mAse sa~ggRuhya yavapalle mAShapalle vAnidhApayet, tAni caturmAsasthitAni sahasi sahasye vA mAse prayoktumArabheta shItasnigdhamadhuropaskRutasharIraH|
pUrvaM dashabhallAtakAnyApothyAShTaguNenAmbhasA sAdhu sAdhayet, teShAM rasamaShTabhAgAvasheShaM pUtaM sapayaskaM pibetsarpiShA~antarmukhamabhyajya|
tAnyekaikabhallAtakotkarShApakarSheNa dashabhallAtakAnyAtriMshataH prayojyAni, nAtaH paramutkarShaH|
prayogavidhAnena sahasrapara eva bhallAtakaprayogaH|
jIrNe ca sasarpiShA payasA shAliShaShTikAshanamupacAraH, prayogAnte ca dvistAvat payasaivopacAraH|
tatprayogAdvarShashatamajaraM vayastiShThatIti samAnaM pUrveNa||13||

(iti bhallAtakakShIram)|

The fruits of ''bhallataka'' – undamaged, undiseased, mature in taste, size and potency, looking like ripe ''jamboo'' fruits should be collected in the month of ''jyeshtha'' and ''ashadha'' and be stored within the granary of barley or black gram. After four months, in the month of ''Agrahayana'' or ''Pausha'' they should be taken out for use by one who has made his body fit through the intake of cold, unctuous and sweet substances. At first ten fruits of ''bhallataka'' should be crushed and boiled in ten times of water, when 1/8 extract remains, it should be filtered and taken mixed with milk after smearing the inner part of the mouth with ghee. Gradually increasing the dose by one fruit per day it should be led to thirty which is the maximum dose. In this way the total number of fruits taken comes to one thousand. When the drug is digested, one should take ''shali'' and ''shashtika'' rice with milk added with ghee. After the treatment is over, the patient should live on milk diet for the period double to that of treatment. By this one attains stable life span of one hundred years without senility. Other impacts of the treatment are as mentioned before. [13]

===== ''Bhallataka Kshaudram'' =====

भल्लातकानां जर्जरीकृतानां पिष्टस्वेदनं पूरयित्वा भूमावाकण्ठं निखातस्य स्नेहभावितस्य दृढस्योपरि कुम्भस्यारोप्योडुपेनापिधाय कृष्णमृत्तिकावलिप्तंगोमयाग्निभिरुपस्वेदयेत्; तेषां यः स्वरसः कुम्भं प्रपद्येत, तमष्टभागमधुसम्प्रयुक्तं द्विगुणघृतमद्यात्; तत्प्रयोगाद्वर्षशतमजरं वयस्तिष्ठतीति समानं पूर्वेण||१४||

(इतिभल्लातकक्षौद्रम्)|

bhallātakānāṁ jarjarīkr̥tānāṁ piṣṭasvēdanaṁ pūrayitvā bhūmāvākaṇṭhaṁ nikhātasya snēhabhāvitasya dr̥ḍhasyōpari kumbhasyārōpyōḍupēnāpidhāya kr̥ṣṇamr̥ttikāvaliptaṁgōmayāgnibhirupasvēdayēt; tēṣāṁ yaḥ svarasaḥ kumbhaṁ prapadyēta, tamaṣṭabhāgamadhusamprayuktaṁ dviguṇaghr̥tamadyāt; tatprayōgādvarṣaśatamajaraṁ vayastiṣṭhatīti samānaṁ pūrvēṇa||14||

(iti bhallātakakṣaudram)|

bhallAtakAnAM jarjarIkRutAnAM piShTasvedanaM pUrayitvA bhUmAvAkaNThaM nikhAtasya snehabhAvitasya dRuDhasyopari kumbhasyAropyoDupenApidhAyakRuShNamRuttikAvaliptaM gomayAgnibhirupasvedayet; teShAM yaH svarasaH kumbhaM prapadyeta, tamaShTabhAgamadhusamprayuktaM dviguNaghRutamadyAt;tatprayogAdvarShashatamajaraM vayastiShThatIti samAnaM pUrveNa||14||

(iti bhallAtakakShaudram)|

The fruits of ''bhallataka'' should be crushed and filled in a heating pot which is put on a firm and oiled (with ghee) pitcher already dug underground up to the neck covered with a lid. Then after pushing it with black earth, it should be heated with cow dung fire. The extract which is collected in the lower pitcher should be taken out. It should be taken mixed with 1/8 honey and double the quantity of ghee. Regular use of this makes a person of the stable life span of one hundred years without senility. Other outcomes of this treatment are as described before. [14]

===== ''Bhallataka Tailam'' =====

भल्लातकतैलपात्रं सपयस्कं मधुकेन कल्केनाक्षमात्रेण शतपाकं कुर्यादिति समानं पूर्वेण||१५||

(इति भल्लातकतैलम्)|

bhallātakatailapātraṁ sapayaskaṁ madhukēna kalkēnākṣamātrēṇa śatapākaṁ
kuryāditi samānaṁ pūrvēṇa||15||

(iti bhallātakatailam)|

bhallAtakatailapAtraM sapayaskaM madhukena kalkenAkShamAtreNa shatapAkaM kuryAditi samAnaM pUrveNa||15||

(iti bhallAtakatailam)|

The above ''bhallataka taila'' should be taken in quantity of 2 kg 560 gms and cooked along with milk and paste of ''madhuka'' in 1/8 quantity. This should be repeated hundred times. Other details are as above.

====== Various preparations of ''bhallataka'' ======

भल्लातकसर्पिः भल्लातकक्षीरं, भल्लातकक्षौद्रं, गुडभल्लातकं, भल्लातकयूषः, भल्लातकतैलं, भल्लातकपललं, भल्लातकसक्तवः, भल्लातकलवणं,भल्लातकतर्पणम्, इति भल्लातकविधानमुक्तं भवति||१६||

bhallātakasarpiḥ bhallātakakṣīraṁ, bhallātakakṣaudraṁ, guḍabhallātakaṁ, bhallātakayūṣaḥ, bhallātakatailaṁ, bhallātakapalalaṁ, bhallātakasaktavaḥ, bhallātakalavaṇaṁ, bhallātakatarpaṇam, iti bhallātakavidhānamuktaṁ bhavati||16||

bhallAtakasarpiH [1] , bhallAtakakShIraM, bhallAtakakShaudraM, guDabhallAtakaM, bhallAtakayUShaH, bhallAtakatailaM, bhallAtakapalalaM, bhallAtakasaktavaH,bhallAtakalavaNaM, bhallAtakatarpaNam, iti bhallAtakavidhAnamuktaM bhavati||16||

''Bhallataka'' is used in the following forms - ''Bhallataka ghrita, bhallataka-ksheeram, bhallataka-kshaudra, guda-bhallataka, bhallataka-yusha, bhallataka-taila, bhallataka-palala, bhallataka-saktu, bhallataka-lavana, bhallataka-tarpana.'' [16]

====== Benefits of ''Bhallataka'' ======

भवन्तिचात्र-

भल्लातकानि तीक्ष्णानि पाकीन्यग्निसमानिच|

भवन्त्यमृतकल्पानि प्रयुक्तानि यथाविधि||१७||

एते दशविधास्त्वेषां प्रयोगाःपरिकीर्तिताः|

रोगप्रकृतिसात्म्यज्ञस्तान् प्रयोगान् प्रकल्पयेत्||१८||

कफजो न स रोगोऽस्ति न विबन्धोऽस्ति कश्चन|

यं न भल्लातकं हन्याच्छीघ्रं मेधाग्निवर्धनम्||१९||

(इति भल्लातकविधिः)|

प्राणकामाः पुरा जीर्णाश्च्यवनाद्या महर्षयः|

रसायनैः शिवैरेतैर्बभूवुरमितायुषः||२०||

ब्राह्मं तपो ब्रह्मचर्यमध्यात्मध्यानमेव च|

दीर्घायुषो यथाकामं सम्भृत्य त्रिदिवं गताः||२१||

तस्मादायुःप्रकर्षार्थं प्राणकामैःसुखार्थिभिः|

रसायनविधिः सेव्यो विधिवत्सुसमाहितैः||२२||

bhavanticātra-

bhallātakāni tīkṣṇāni pākīnyagnisamānica|

bhavantyamr̥takalpāni prayuktāni yathāvidhi||17||

ētē daśavidhāstvēṣāṁ prayōgāḥparikīrtitāḥ|

rōgaprakr̥tisātmyajñastān prayōgān prakalpayēt||18||

kaphajō na sa rōgō'sti navibandhō'stikaścana|

yaṁ na bhallātakaṁ hanyācchīghraṁ mēdhāgnivardhanam||19||

(iti bhallātakavidhiḥ)|

prāṇakāmāḥ purā jīrṇāścyavanādyāmaharṣayaḥ|

rasāyanaiḥ śivairētairbabhūvuramitāyuṣaḥ||20||

brāhmaṁ tapō brahmacaryamadhyātmadhyānamēva ca|

dīrghāyuṣō yathākāmaṁ sambhr̥tya tridivaṁ gatāḥ||21||

tasmādāyuḥprakarṣārthaṁ prāṇakāmaiḥ sukhārthibhiḥ|

rasāyanavidhiḥ sēvyō vidhivatsusamāhitaiḥ||22||

bhavanti cAtra-

bhallAtakAni tIkShNAni pAkInyagnisamAni ca|

bhavantyamRutakalpAni prayuktAni yathAvidhi||17||

ete dashavidhAstveShAM prayogAH parikIrtitAH|

rogaprakRutisAtmyaj~jastAn prayogAn prakalpayet||18||

kaphajo na sa rogo~asti na vibandho~asti kashcana|

yaM na bhallAtakaM hanyAcchIghraM medhAgnivardhanam||19||

(iti bhallAtakavidhiH)|

prANakAmAH purA jIrNAshcyavanAdyA maharShayaH|

rasAyanaiH shivairetairbabhUvuramitAyuShaH||20||

brAhmaM [1] tapo brahmacaryamadhyAtmadhyAnameva ca|

dIrghAyuSho yathAkAmaM sambhRutya tridivaM gatAH||21||

tasmAdAyuHprakarShArthaM prANakAmaiH sukhArthibhiH|

rasAyanavidhiH sevyo vidhivatsusamAhitaiH||22||

Here are the verses-

The fruits of ''bhallataka'' are irritant, inflaming and are like fire but they assume nectar like properties if used as prescribed. Their use in the above ten forms is described which should be prescribed considering the disease, constitution, and suitability. There is no disorder of ''kapha'' and obstructive condition which is not ameliorated by ''bhallataka'' quickly. Moreover, it promotes intellect and ''agni''.

In early days, the old great sages like Chyavana etc, who desiring vital strength, attained immeasurable life span by using these beneficial ''rasayana'' formulations. After attaining longevity they performed as desired, spiritual penance, celibacy and self- medications and ascended to the heaven. Hence those who desire longevity, vital strength and happiness should use the ''rasayana'' methodically and carefully. [17-22]

===== Summary =====

तत्र श्लोकः-

रसायनानां संयोगाः सिद्धाभूतहितैषिणा|

निर्दिष्टाः प्राणकामीये सप्तत्रिंशन्महर्षिणा ||२३||

tatra ślōkaḥ-

rasāyanānāṁ saṁyōgāḥ siddhā bhūtahitaiṣiṇā|

nirdiṣṭāḥ prāṇakāmīyē saptatriṁśanmaharṣiṇā ||23||

tatra shlokaH-

rasAyanAnAM saMyogAH siddhA bhUtahitaiShiNA|

nirdiShTAH prANakAmIye saptatriMshanmaharShiNA ||23||

Now the summing up verse -

In this quarter relating to desire for vital strength the great sage, compassionate on creatures, described thirty seven successful formulations of rasayana. [23]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सास्थाने रसायनाध्याये प्राणकामीयो नाम रसायनपादो द्वितीयः||२||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē rasāyanādhyāyē prāṇakāmīyō nāma rasāyanapādō dvitīyaḥ||2||

ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne rasAyanAdhyAye prANakAmIyo nAma rasAyanapAdo dvitIyaH||2||

Thus ends the second quarter on desire for vital strength in the chapter on [[Rasayana]] in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charak.[2]

==== Part III- ''Karaprachitiyam Rasayana Pada'' ====

अथातः करप्रचितीयं रसायनपादंव्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ karapracitīyaṁ rasāyanapādaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH karapracitIyaM rasAyanapAdaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now I shall deliberate on the quarter of [[Rasayana]] dealing with the hand- plucked (fruits of ''amalaki''). As propounded by Lord Atreya.[1-2]

===== ''Amalakayasa Brahma Rasayana'' =====

करप्रचितानां यथोक्तगुणानामामलकानामुद्धृतास्थ्नां शुष्कचूर्णितानां पुनर्माघे फाल्गुने वा मासे त्रिःसप्तकृत्वः स्वरसपरिपीतानां पुनः शुष्कचूर्णीकृतानामाढकमेकंग्राहयेत्, अथ जीवनीयानां बृंहणीयानां स्तन्यजननानां शुक्रजननानां वयःस्थापनानां षड्विरेचनशताश्रितीयोक्तानामौषधगणानांचन्दनागुरुधवतिनिशखदिरशिंशपासनसाराणांचाणुशःत्तानामभयाबिभीतकपिप्पलीवचाचव्यचित्रकविडङ्गानां च समस्तानामाढकमेकं दशगुणेनाम्भसा साधयेत्, तस्मिन्नाढकावशेषे रसे सुपूते तान्यामलकचूर्णानि दत्त्वा गोमयाग्निभिर्वंशविदलशरतेजनाग्निभिर्वा साधयेद्यावदपनयाद्रसस्य, तमनुपदग्धमुपहृत्यायसीषु पात्रीष्वास्तीर्य शोषयेत्, सुशुष्कं तत् कृष्णाजिनस्योपरि दृषदि श्लक्ष्णपिष्टमयःस्थाल्यां निधापयेत्सम्यक्, तच्चूर्णमयश्चूर्णाष्टभागसम्प्रयुक्तं मधुसर्पिर्भ्यामग्निबलमभिसमीक्ष्य प्रयोजयेदिति||३||

karapracitānāṁ yathōktaguṇānāmāmalakānāmuddhr̥tāsthnāṁ śuṣkacūrṇitānāṁ punarmāghē phālgunē vā māsē triḥsaptakr̥tvaḥ svarasaparipītānāṁ punaḥ śuṣkacūrṇīkr̥tānāmāḍhakamēkaṁ grāhayēt, atha jīvanīyānāṁ br̥ṁhaṇīyānāṁ stanyajananānāṁ śukrajananānāṁ vayaḥsthāpanānāṁ ṣaḍvirēcanaśatāśritīyōktānāmauṣadhagaṇānāṁcandanāgurudhavatiniśakhadiraśiṁśapāsanasārāṇāṁ cāṇuśaḥ kr̥ttānāmabhayābibhītakapippalīvacācavyacitrakaviḍaṅgānāṁ ca samastānāmāḍhakamēkaṁ daśaguṇēnāmbhasā sādhayēt, tasminnāḍhakāvaśēṣē rasē supūtē tānyāmalakacūrṇāni dattvā gōmayāgnibhirvaṁśavidalaśaratējanāgnibhirvā sādhayēdyāvadapanayādrasasya, tamanupadagdhamupahr̥tyāyasīṣu pātrīṣvāstīrya śōṣayēt, suśuṣkaṁ tat kr̥ṣṇājinasyōpari dr̥ṣadi ślakṣṇapiṣṭamayaḥsthālyāṁ nidhāpayēt samyak, taccūrṇamayaścūrṇāṣṭabhāgasamprayuktaṁmadhusarpirbhyāmagnibalamabhisamīkṣya prayōjayēditi||3||

karapracitAnAM yathoktaguNAnAmAmalakAnAmuddhRutAsthnAM shuShkacUrNitAnAM punarmAghe phAlgune vA mAse triHsaptakRutvaH svarasaparipItAnAMpunaH shuShkacUrNIkRutAnAmADhakamekaM grAhayet, atha jIvanIyAnAM bRuMhaNIyAnAM stanyajananAnAM shukrajananAnAM vayaHsthApanAnAMShaDvirecanashatAshritIyoktAnAmauShadhagaNAnAM [1] candanAgurudhavatinishakhadirashiMshapAsanasArANAM cANushaH [2]kRuttAnAmabhayAbibhItakapippalIvacAcavyacitrakaviDa~ggAnAM ca samastAnAmADhakamekaM dashaguNenAmbhasA sAdhayet, tasminnADhakAvasheShe rasesupUte tAnyAmalakacUrNAni dattvA gomayAgnibhirvaMshavidalasharatejanAgnibhirvA sAdhayedyAvadapanayAdrasasya, tamanupadagdhamupahRutyAyasIShupAtrIShvAstIrya shoShayet, sushuShkaM tat kRuShNAjinasyopari dRuShadi shlakShNapiShTamayaHsthAlyAM nidhApayet samyak,taccUrNamayashcUrNAShTabhAgasamprayuktaM madhusarpirbhyAmagnibalamabhisamIkShya prayojayediti||3||

The hand plucked fruits of ''amalaki'' having qualities described should be taken, their seeds are removed and they are dried and powdered. Later in the month of ''Magha'' and ''Phalguna'', this ''amalaki'' powder should be impregnated 21 times with the juice of fresh ''amalaki'' fruits, dried and powdered again. 2 kg 560 gms of this powder should be taken. Then the drugs belonging to the groups vitalizer, bulk promoting, galactogouge, semen promoting and age sustainers mentioned in the chapter on six hundred evacuatives and finely cut heartwood of sandal, ''aguru, dhava, tinisha, khadira, shimshapa, asana'' and also of ''haritaki, bibhitaka, pippali, vacha, chavya, chitraka and vidanga'' – all together should be taken in the quantity of 2 kg 560 gms and boiled in ten times of water. When one tenth of the original volume remains, the decoction should be filtered well and added with the above powder of ''amalaka''. Now this should be heated on cow dung fire or the fire of bamboo chips or reed stalks till the liquid portion is completely evaporated. This uncharred material should be collected and is spread on iron plates for drying. When it is dried well, it should be powdered finely with stone slabs on the deer hide and stored carefully in an iron pot. This powder added with one forth quantity of iron powder (''bhasma'') and mixed with honey and ghee should be used according to one’s digestive capacity. [3]

भवन्तिचात्र-

एतद्रसायनं पूर्वं वसिष्ठःकश्यपोऽङ्गिराः|

जमदग्निर्भरद्वाजो भृगुरन्ये च तद्विधाः||४||

प्रयुज्य प्रयता मुक्ताः श्रमव्याधिजराभयात्|

यावदैच्छंस्तपस्तेपुस्तत्प्रभावान्महाबलाः||५||

इदं रसायनं चक्रे ब्रह्मा वार्षसहस्रिकम्|

जराव्याधिप्रशमनं बुद्धीन्द्रियबलप्रदम्||६||

(इत्यामलकायसं ब्राह्मरसायनम्)|

bhavanticātra-

ētadrasāyanaṁ pūrvaṁ vasiṣṭhaḥ kaśyapō'ṅgirāḥ|

jamadagnirbharadvājō bhr̥guranyē ca tadvidhāḥ||4||

prayujya prayatā muktāḥ śramavyādhijarābhayāt|

yāvadaicchaṁstapastēpustatprabhāvānmahābalāḥ||5||

idaṁ rasāyanaṁ cakrē brahmā vārṣasahasrikam|

jarāvyādhipraśamanaṁ buddhīndriyabalapradam||6||

(ityāmalakāyasaṁ brāhmarasāyanam)

bhavanti cAtra-

etadrasAyanaM pUrvaM vasiShThaH kashyapo~a~ggirAH|

jamadagnirbharadvAjo bhRuguranye ca tadvidhAH||4||

prayujya prayatA muktAH shramavyAdhijarAbhayAt|

yAvadaicchaMstapastepustatprabhAvAnmahAbalAH||5||

idaM rasAyanaM cakre brahmA vArShasahasrikam|

jarAvyAdhiprashamanaM buddhIndriyabalapradam||6||

(ityAmalakAyasaM brAhmarasAyanam)|

Here are the verses-

This ''rasayana'' preparation in ancient times was used by Vasishtha, Kashyapa, Angiras, Jamadagni, Bharadwaja, Bhrigu and similar other ''rishis'' who by consumption of this medication became free from exertion, disease, senility and fear and acquired great strength due to its effect and performed penance as desired. This ''rasayana'' preparation was developed by Brahma and it provides a life span of one thousand years, alleviates senility and disease and promotes strength of intellect and senses. [4-6]

तपसा ब्रह्मचर्येण ध्यानेन प्रशमेन च|

रसायनविधानेन कालयुक्तेन चायुषा||७||

स्थिता महर्षयः पूर्वं, नहिकिञ्चिद्रसायनम्|

ग्राम्यानामन्यकार्याणां सिध्यत्यप्रयतात्मनाम्||८||

tapasā brahmacaryēṇa dhyānēna praśamēna ca|

rasāyanavidhānēna kālayuktēna cāyuṣā||7||

sthitā maharṣayaḥ pūrvaṁ, nahi kiñcidrasāyanam|

grāmyānāmanyakāryāṇāṁ sidhyatyaprayatātmanām||8||

tapasA brahmacaryeNa dhyAnena prashamena ca|

rasAyanavidhAnena kAlayuktena cAyuShA||7||

sthitA maharShayaH pUrvaM, nahi ki~jcidrasAyanam|

grAmyAnAmanyakAryANAM sidhyatyaprayatAtmanAm||8||

In ancient times, the great sages attained stable life span by using the ''rasayana'' treatment properly and timely due to penance, celibacy, meditation and serenity because no ''rasayana'' treatment is successful in individuals who are not attentive, are engaged in divergent activities and live in villages. [7-8]

===== ''Kevala Amalaka Rasayanam'' =====

संवत्सरं पयोवृत्तिर्गवां मध्ये वसेत् सदा|

सावित्रीं मनसा ध्यायन् ब्रह्मचारी यतेन्द्रियः||९||

संवत्सरान्ते पौषीं वा माघीं वा फाल्गुनीं तिथिम्|

त्र्यहोपवासी शुक्लस्य प्रविश्यामलकीवनम्||१०||

बृहत्फलाढ्यमारुह्य द्रुमं शाखागतं फलम्|

गृहीत्वा पाणिना तिष्ठेज्जपन् ब्रह्मामृतागमात्||११||

तदा ह्यवश्यममृतं वसत्यामलके क्षणम्|

शर्करामधुकल्पानि स्नेहवन्ति मृदूनि च||१२||

भवन्त्यमृतसंयोगात्तानि यावन्ति भक्षयेत्|

जीवेद्वर्षसहस्राणि तावन्त्यागतयौवनः||१३||

सौहित्यमेषां गत्वा तु भवत्यमरसन्निभः|

स्वयं चास्योपतिष्ठन्ते श्रीर्वेदा वाक् च रूपिणी||१४||

(इति केवलामलकरसायनम्)|

saṁvatsaraṁ payōvr̥ttirgavāṁ madhyē vasēt sadā|

sāvitrīṁ manasā dhyāyan brahmacārī yatēndriyaḥ||9||

saṁvatsarāntē pauṣīṁ vā māghīṁ vā phālgunīṁ tithim|

tryahōpavāsī śuklasya praviśyāmalakīvanam||10||

br̥hatphalāḍhyamāruhya drumaṁ śākhāgataṁ phalam|

gr̥hītvā pāṇinā tiṣṭhējjapan brahmāmr̥tāgamāt||11||

tadā hyavaśyamamr̥taṁ vasatyāmalakē kṣaṇam|

śarkarāmadhukalpāni snēhavanti mr̥dūni ca||12||

bhavantyamr̥tasaṁyōgāttāni yāvanti bhakṣayēt|

jīvēdvarṣasahasrāṇi tāvantyāgatayauvanaḥ||13||

sauhityamēṣāṁ gatvā tu bhavatyamarasannibhaḥ|

svayaṁ cāsyōpatiṣṭhantē śrīrvēdā vāk ca rūpiṇī||14||

(iti kēvalāmalakarasāyanam)|

saMvatsaraM payovRuttirgavAM madhye vaset sadA|

sAvitrIM manasA dhyAyan brahmacArI yatendriyaH||9||

saMvatsarAnte pauShIM vA mAghIM vA phAlgunIM tithim|

tryahopavAsI shuklasya pravishyAmalakIvanam||10||

bRuhatphalADhyamAruhya drumaM shAkhAgataM phalam|

gRuhItvA pANinA tiShThejjapan brahmAmRutAgamAt||11||

tadA hyavashyamamRutaM vasatyAmalake kShaNam|

sharkarAmadhukalpAni snehavanti mRudUni ca||12||

bhavantyamRutasaMyogAttAni yAvanti bhakShayet|

jIvedvarShasahasrANi tAvantyAgatayauvanaH||13||

sauhityameShAM gatvA tu bhavatyamarasannibhaH|

svayaM cAsyopatiShThante shrIrvedA vAk ca rUpiNI||14||

(iti kevalAmalakarasAyanam)|

One should live in amidst cows, remain on milk diet mediate on ''Savitri mantra(Gayatri mantra)'', observing celibacy and controlling his sense organs for a year. At the end of the year, he should fast for three days and then should enter in to a forest of ''amalaki'' trees on full moon day of the month of Pausha, Magha or Phalguna. Then he should climb on one of the ''amalaki'' trees having big fruits, should take the fruit situated on a branch by hand and should wait for some time repeating the Brahman mantras till nectar descends in the fruit. During this period nectar positively resides in ''amalaka'' fruit which, due to presence of nectar, becomes sweet like sugar and honey, unctuous and soft. The person having regained youthfulness lives the number of thousand of years equal to that of fruits eaten. After getting saturated fully with them one becomes like God and Shri, Vedas and personified knowledge enters in to him spontaneously. [9-14]

===== ''Lauhadi Rasayana'' =====

त्रिफलाया रसे मूत्रे गवां क्षारे च लवणे|

क्रमेणचेङ्गुदीक्षारे किंशुकक्षार एव च||१५||

तीक्ष्णायसस्य पत्राणि वह्निवर्णानि साधयेत् |

चतुरङ्गुलदीर्घाणि तिलोत्सेधतनूनि च||१६||

ज्ञात्वा तान्यञ्जनाभानि सूक्ष्मचूर्णानि कारयेत्|

तानि चूर्णानि मधुना रसेनामलकस्य च||१७||

युक्तानि लेहवत् कुम्भे स्थितानि घृतभाविते|

संवत्सरं निधेयानि यवपल्ले तथैवच||१८||

दद्यादालोडनं मासे सर्वत्रालोडयन् बुधः|

संवत्सरात्यये तस्य प्रयोगो मधुसर्पिषा||१९||

प्रातः प्रातर्बलापेक्षी सात्म्यं जीर्णे च भोजनम्|

एष एव च लौहानां प्रयोगः सम्प्रकीर्तितः||२०||

नाभिघातैर्न चातङ्कैर्जरयान च मृत्युना|

स धृष्यः स्याद्गजप्राणः सदा चातिबलेन्द्रियः||२१||

धीमान् यशस्वी वाक्सिद्धः श्रुतधारी महाधनः|

भवेत् समां प्रयुञ्जानो नरो लौहरसायनम्||२२||

अनेनैव विधानेन हेम्नश्च रजतस्यच|

आयुःप्रकर्षकृत्सिद्धः प्रयोगः सर्वरोगनुत्||२३||

(इति लौहादिरसायनम्)|

triphalāyā rasē mūtrē gavāṁ kṣārē ca lavaṇē|

kramēṇacēṅgudīkṣārē kiṁśukakṣāra ēva ca||15||

tīkṣṇāyasasya patrāṇi vahnivarṇāni sādhayēt |

caturaṅguladīrghāṇi tilōtsēdhatanūni ca||16||

jñātvā tānyañjanābhāni sūkṣmacūrṇāni kārayēt|

tāni cūrṇāni madhunā rasēnāmalakasya ca||17||

yuktāni lēhavat kumbhē sthitāni ghr̥tabhāvitē|

saṁvatsaraṁ nidhēyāni yavapallē tathaiva ca||18||

dadyādālōḍanaṁ māsē sarvatrālōḍayan budhaḥ|

saṁvatsarātyayē tasya prayōgō madhusarpiṣā||19||

prātaḥ prātarbalāpēkṣī sātmyaṁ jīrṇē ca bhōjanam|

ēṣa ēva ca lauhānāṁ prayōgaḥ samprakīrtitaḥ||20||

nābhighātairna cātaṅkairjarayā na ca mr̥tyunā|

sa dhr̥ṣyaḥ syādgajaprāṇaḥ sadācātibalēndriyaḥ||21||

dhīmān yaśasvī vāksiddhaḥ śrutadhārī mahādhanaḥ |

bhavēt samāṁ prayuñjānō narō lauharasāyanam||22||

anēnaiva vidhānēna hēmnaśca rajatasya ca|

āyuḥprakarṣakr̥tsiddhaḥ prayōgaḥ sarvarōganut||23||

(iti lauhādirasāyanam)|

triphalAyA rase mUtre gavAM kShAre ca lavaNe|

krameNa ce~ggudIkShAre kiMshukakShAra eva ca||15||

tIkShNAyasasya patrANi vahnivarNAni sAdhayet [1] |

catura~gguladIrghANi tilotsedhatanUni [2] ca||16||

j~jAtvA tAnya~jjanAbhAni sUkShmacUrNAni kArayet|

tAni cUrNAni madhunA rasenAmalakasya ca||17||

yuktAni lehavat kumbhe sthitAni ghRutabhAvite|

saMvatsaraM nidheyAni yavapalle tathaiva ca||18||

dadyAdAloDanaM mAse sarvatrAloDayan budhaH|

saMvatsarAtyaye tasya prayogo madhusarpiShA||19||

prAtaH prAtarbalApekShI sAtmyaM jIrNe ca bhojanam|

eSha eva ca lauhAnAM prayogaH samprakIrtitaH||20||

nAbhighAtairna cAta~gkairjarayA na ca mRutyunA|

sa dhRuShyaH syAdgajaprANaH sadA cAtibalendriyaH||21||

dhImAn yashasvI vAksiddhaH [3] shrutadhArI mahAdhanaH [4] |

bhavet samAM prayu~jjAno naro lauharasAyanam||22||

anenaiva vidhAnena hemnashca rajatasya ca|

AyuHprakarShakRutsiddhaH prayogaH sarvaroganut||23||

(iti lauhAdirasAyanam)|

The paper like pieces of sharp iron four fingers long and thin like sesame seeds should be heated till they are red hot. Then they should be dipped in triphala decoction, cow urine, alkali prepared from ''lavana, ingudi'' and ''palasha''. After they are transformed like collyrium they should be powdered finely. This powder mixed with honey and ''amalaka'' juice should be made in to linctuses, which should be kept in a ghee lined pot and stored for a year in granary of barley stirring it from all sides every month. After one year, it should be consumed mixed with honey and ghee every morning as per the strength along with prescribed diet after the drug is digested. This is the method of administration of all the metallic preparations.

The person who uses iron ''rasayana'', overcomes injury, disease, senility and death because he has acquired vital strength like that of elephant and strong sense organs. The user of the metallic ''rasayana'' for a year becomes intelligent, renowned orator, scholar and wealthy. So also the use of gold or silver ''rasayana'' also provide longevity and freedom from all ailments. [15-23]

===== ''Aindra Rasayana'' =====

ऐन्द्री मत्स्याख्यको ब्राह्मी वचा ब्रह्मसुवर्चला|

पिप्पल्यो लवणं हेम शङ्खपुष्पी विषंघृतम्||२४||

एषां त्रियवकान् भागान् हेमसर्पिर्विषैर्विना|

द्वौ यवौ तत्र हेम्नस्तु तिलं दद्याद्विषस्यच||२५||

सर्पिषश्च पलं दद्यात्तदैकध्यं प्रयोजयेत्|

घृतप्रभूतं सक्षौद्रं जीर्णे चान्नंप्रशस्यते||२६||

जराव्याधिप्रशमनं स्मृतिमेधाकरं परम्|

आयुष्यं पौष्टिकं धन्यं स्वरवर्णप्रसादनम्||२७||

परमोजस्करं चैतत् सिद्धमैन्द्रं रसायनम्|

नैनत् प्रसहते कृत्या नालक्ष्मीर्न विषं न रुक्||२८||

श्वित्रं सकुष्ठं जठराणि गुल्माः प्लीहा पुराणो विषमज्वरश्च|

मेधास्मृतिज्ञानहराश्च रोगाः शाम्यन्त्यनेनातिबलाश्च वाताः||२९||

(इत्यैन्द्रं रसायनम्)|

aindrī matsyākhyakō brāhmī vacā brahmasuvarcalā|

pippalyō lavaṇaṁ hēmaśaṅkhapuṣpī viṣaṁ ghr̥tam||24||

ēṣāṁ triyavakān bhāgān hēmasarpirviṣairvinā|

dvau yavau tatra hēmnastu tilaṁ dadyādviṣasya ca||25||

sarpiṣaśca palaṁ dadyāttadaikadhyaṁ prayōjayēt|

ghr̥taprabhūtaṁ sakṣaudraṁ jīrṇē cānnaṁpraśasyatē||26||

jarāvyādhipraśamanaṁ smr̥timēdhākaraṁ param|

āyuṣyaṁ pauṣṭikaṁ dhanyaṁ svaravarṇaprasādanam||27||

paramōjaskaraṁ caitat siddhamaindraṁ rasāyanam|

nainat prasahatē kr̥tyā nālakṣmīrna viṣaṁ na ruk||28||

śvitraṁ sakuṣṭhaṁ jaṭharāṇi gulmāḥ plīhā purāṇō viṣamajvaraśca|

mēdhāsmr̥tijñānaharāśca rōgāḥ śāmyantyanēnātibalāśca vātāḥ||29||

(ityaindraṁ rasāyanam)|

aindrI matsyAkhyako brAhmI vacA brahmasuvarcalA|

pippalyo lavaNaM hema sha~gkhapuShpI viShaM ghRutam||24||

eShAM triyavakAn bhAgAn hemasarpirviShairvinA|

dvau yavau tatra hemnastu tilaM dadyAdviShasya ca||25||

sarpiShashca palaM dadyAttadaikadhyaM prayojayet|

ghRutaprabhUtaM sakShaudraM jIrNe cAnnaM prashasyate||26||

jarAvyAdhiprashamanaM smRutimedhAkaraM param|

AyuShyaM pauShTikaM dhanyaM svaravarNaprasAdanam||27||

paramojaskaraM caitat siddhamaindraM rasAyanam|

nainat prasahate kRutyA nAlakShmIrna viShaM na ruk||28||

shvitraM sakuShThaM jaTharANi gulmAH plIhA purANo viShamajvarashca|

medhAsmRutij~jAnaharAshca rogAH shAmyantyanenAtibalAshca vAtAH||29||

(ityaindraM rasAyanam)|

''Aindri, matsyakhyaka, brahmi, vacha, brahmasuvarchala, pippali, lavana, shankhapushpi,'' all in quantity of three barley grains, gold in that of two barley grains, visa equal to one sesame seed and ghee 40 gms – mixed together and used. Once the food is digested, a diet consisting of honey and plenty of ghee is prescribed.

This precious ''aindra rasayana'' alleviates senility and diseases, promotes memory and intellect, enhances life span, and provides nourishment, excellence, clarity of voice, complexion, ''ojas'' and immunity. Magic spells, poison and pains cannot resist its effect. This ''rasayana'' alleviates leucoderma, leprosy, abdominal diseases, ''gulma'', spleenomegaly, chronic intermittent fever and the disease taking away intellect, memory and knowledge and also the severe ''vatika'' disorders. [24-29]

===== ''Medhya Rasayana'' =====

मण्डूकपर्ण्याः स्वरसः प्रयोज्यः क्षीरेण यष्टीमधुकस्य चूर्णम्|

रसो गुडूच्यास्तु समूलपुष्प्याः कल्कः प्रयोज्यः खलु शङ्खपुष्प्याः||३०||

आयुःप्रदान्यामयनाशनानि बलाग्निवर्णस्वरवर्धनानि|

मेध्यानि चैतानि रसायनानि मेध्या विशेषेण चशङ्खपुष्पी||३१||

(इतिमेध्यरसायनानि)|

maṇḍūkaparṇyāḥ svarasaḥ prayōjyaḥ kṣīrēṇa yaṣṭīmadhukasya cūrṇam|

rasō guḍūcyāstu samūlapuṣpyāḥ kalkaḥ prayōjyaḥ khalu śaṅkhapuṣpyāḥ||30||

āyuḥpradānyāmayanāśanāni balāgnivarṇasvaravardhanāni|

mēdhyāni caitāni rasāyanāni mēdhyā viśēṣēṇa ca śaṅkhapuṣpī||31||

(iti mēdhyarasāyanāni)|

maNDUkaparNyAH svarasaH prayojyaH kShIreNa yaShTImadhukasya cUrNam|

raso guDUcyAstu samUlapuShpyAH kalkaH prayojyaH khalu sha~gkhapuShpyAH||30||

AyuHpradAnyAmayanAshanAni balAgnivarNasvaravardhanAni|

medhyAni caitAni rasAyanAni medhyA visheSheNa ca sha~gkhapuShpI||31||

(iti medhyarasAyanAni)|

Consumption of ''mandukaparni'' juice, the powder of ''yashtimadhu'' with milk, the juice of ''guduchi'' along with its roots and flowers and the paste of ''shankhapushpi'' – these ''rasayana'' drugs are life promoting, disease alleviating, promoters of strength, ''agni'', complexion, voice and are intellect promoting. Of them ''shankhapushpi'' is specifically intellect promoting. [30-31]

===== ''Pippali Rasayana'' =====

पञ्चाष्टौ सप्त दश वा पिप्पलीर्मधुसर्पिषा|

रसायनगुणान्वेषी समामेकां प्रयोजयेत्||३२||

तिस्रस्तिस्रस्तु पूर्वाह्णे भुक्त्वाऽग्रे भोजनस्य च|

पिप्पल्यः किंशुकक्षारभाविता घृतभर्जिताः||३३||

प्रयोज्या मधुसम्मिश्रा रसायनगुणैषिणा|

जेतुं कासं क्षयं शोषं श्वासं हिक्कां गलामयान्||३४||

अर्शांसि ग्रहणीदोषं पाण्डुतां विषमज्वरम्|

वैस्वर्यं पीनसं शोफं गुल्मं वातबलासकम्||३५||

(इति पिप्पलीरसायनम्)|

pañcāṣṭau sapta daśa vā pippalīrmadhusarpiṣā|

rasāyanaguṇānvēṣī samāmēkāṁ prayōjayēt||32||

tisrastisrastu pūrvāhṇē bhuktvā'grē bhōjanasya ca|

pippalyaḥ kiṁśukakṣārabhāvitā ghr̥tabharjitāḥ||33||

prayōjyā madhusammiśrā rasāyanaguṇaiṣiṇā|

jētuṁ kāsaṁ kṣayaṁ śōṣaṁ śvāsaṁ hikkāṁgalāmayān||34||

arśāṁsi grahaṇīdōṣaṁ pāṇḍutāṁ viṣamajvaram|

vaisvaryaṁ pīnasaṁ śōphaṁ gulmaṁ vātabalāsakam||35||

(iti pippalīrasāyanam)|

pa~jcAShTau sapta dasha vA pippalIrmadhusarpiShA|

rasAyanaguNAnveShI samAmekAM prayojayet||32||

tisrastisrastu pUrvAhNe bhuktvA~agre bhojanasya ca|

pippalyaH kiMshukakShArabhAvitA ghRutabharjitAH||33||

prayojyA madhusammishrA rasAyanaguNaiShiNA|

jetuM kAsaM kShayaM shoShaM shvAsaM hikkAM galAmayAn||34||

arshAMsi grahaNIdoShaM pANDutAM viShamajvaram|

vaisvaryaM pInasaM shophaM gulmaM vAtabalAsakam||35||

(iti pippalIrasAyanam)|

The individuals desirous of ''rasayana'' effect should take ''pippali'' in number of five, seven, eight or ten with honey and ghee for a year. Three ''pippali'' fruits should be taken in the morning, after meal and before meal. These fruits should first be impregnated with alkali of ''palasha'' and then fried in ghee. These should be taken with honey by those who want ''rasayana'' effect particularly in order to alleviate cough, wasting, phthisis, dyspnea, hiccup, throat disorders, piles, disorders of ''grahani'', paleness, intermittent fever, disorders of voice, chronic rhinitis, swelling, ''gulma'' and ''vatabalasaka''. [32-35]

===== ''Pippali Vardhamana Rasayana'' =====

क्रमवृद्ध्या दशाहानि दशपैप्पलिकं दिनम्|

वर्धयेत् पयसा सार्धं तथैवापनयेत्पुनः||३६||

जीर्णे जीर्णे च भुञ्जीत षष्टिकं क्षीरसर्पिषा|

पिप्पलीनां सहस्रस्य प्रयोगोऽयंरसायनम्||३७||

पिष्टास्ता बलिभिः सेव्याः, शृता मध्यबलैर्नरैः|

चूर्णीकृता ह्रस्वबलैर्योज्या दोषामयान् प्रति||३८||

दशपैप्पलिकः श्रेष्ठो मध्यमः षट्प्रकीर्तितः|

प्रयोगो यस्त्रिपर्यन्तः स कनीयान् सचाबलैः||३९||

बृहणं स्वर्यमायुष्यं प्लीहोदरविनाशनम्|

वयसः स्थापनं मेध्यं पिप्पलीनां रसायनम्||४०||

(इति पिप्पलीवर्धमानं रसायनम्)|

kramavr̥ddhyā daśāhāni daśapaippalikaṁ dinam|

vardhayēt payasā sārdhaṁ tathaivāpanayēt punaḥ||36||

jīrṇē jīrṇē cabhuñjīta ṣaṣṭikaṁ kṣīrasarpiṣā|

pippalīnāṁ sahasrasya prayōgō'yaṁrasāyanam||37||

piṣṭāstā balibhiḥ sēvyāḥ, śr̥tā madhyabalairnaraiḥ|

cūrṇīkr̥tā hrasvabalairyōjyā dōṣāmayān prati||38||

daśapaippalikaḥ śrēṣṭhō madhyamaḥ ṣaṭ prakīrtitaḥ|

prayōgō yastriparyantaḥ sa kanīyān sa cābalaiḥ||39||

br̥haṇaṁ svaryamāyuṣyaṁ plīhōdaravināśanam|

vayasaḥ sthāpanaṁ mēdhyaṁ pippalīnāṁ rasāyanam||40||

(iti pippalīvardhamānaṁ rasāyanam)|

kramavRuddhyA dashAhAni dashapaippalikaM [1] dinam|

vardhayet payasA sArdhaM tathaivApanayet punaH||36||

jIrNe jIrNe ca bhu~jjIta ShaShTikaM kShIrasarpiShA|

pippalInAM sahasrasya prayogo~ayaM rasAyanam||37||

piShTAstA balibhiH sevyAH, shRutA madhyabalairnaraiH|

cUrNIkRutA [2] hrasvabalairyojyA doShAmayAn prati||38||

dashapaippalikaH shreShTho madhyamaH ShaT [3] prakIrtitaH|

prayogo yastriparyantaH sa kanIyAn sa cAbalaiH||39||

bRuhaNaM svaryamAyuShyaM plIhodaravinAshanam|

vayasaH sthApanaM medhyaM pippalInAM rasAyanam||40||

(iti pippalIvardhamAnaM [4] rasAyanam)|

Ten ''pippali'' should be taken with milk on the first day. From the second day onwards up to the tenth day ten fruits should be increased daily. From the eleventh day the number of fruits should be decreased gradually in the same order till it comes to ten. After the medicine is digested the person should take ''shashtika'' rice with ghee extracted from milk. Thus the use of ''pippali'' in total number of one thousand is ''rasayana'' in effect. The ''pippali'' fruits should be taken by the persons with high strength in the form of paste, by those with medium strength in that of decoction and by those with low strength in the form of powder keeping in view the ''doshas'' and diseases. The initial use of ten ''pippali'' fruits is maximum, that of six is medium and that of three is minimum. These numbers are also applicable according to the degree of strength of the patient. The ''rasayana'' use of ''pippali'' is bulk promoting, beneficial for voice and life span, alleviates spleen enlargement, sustains age and promotes intellect. [36-40]

===== ''Triphala Rasayana'' =====

जरणान्तेऽभयामेकां प्राग्भुक्ताद् द्वे बिभीतके|

भुक्त्वा तु मधुसर्पिर्भ्यां चत्वार्यामलकानि च||४१||

प्रयोजयन् समामेकां त्रिफलाया रसायनम्|

जीवेद्वर्षशतं पूर्णमजरोऽव्याधिरेव च||४२||

(इति त्रिफलारसायनम्)|

jaraṇāntē'bhayāmēkāṁ prāgbhuktād dvē bibhītakē|

bhuktvā tu madhusarpirbhyāṁ catvāryāmalakāni ca||41||

prayōjayan samāmēkāṁ triphalāyā rasāyanam|

jīvēdvarṣaśataṁ pūrṇamajarō'vyādhirēva ca||42||

(iti triphalārasāyanam)|

jaraNAnte~abhayAmekAM prAgbhuktAd dve bibhItake|

bhuktvA tu madhusarpirbhyAM catvAryAmalakAni ca||41||

prayojayan samAmekAM triphalAyA rasAyanam|

jIvedvarShashataM pUrNamajaro~avyAdhireva ca||42||

(iti triphalArasAyanam)|

One ''haritaki'' after digestion, two ''bibhitaka'' after meal and four ''amalaki'' after meal should be taken with honey and ghee for a year. This ''triphala rasayana'' helps a person live for one hundred years free from senility and disease. (41-42)

===== ''Triphala Rasayana'' =====

त्रैफलेनायसीं पात्रीं कल्केनालेपयेन्नवाम्|

तमहोरात्रिकं लेपं पिबेत्क्षौद्रोदकाप्लुतम्||४३||

प्रभूतस्नेहमशनं जीर्णे तत्र प्रशस्यते|

अजरोऽरुक् समाभ्यासाज्जीवेच्चैव समाः शतम्||४४||

(इति त्रिफलारसायनमपरम्)|

traiphalēnāyasīṁ pātrīṁ kalkēnālēpayēnnavām|

tamahōrātrikaṁ lēpaṁ pibēt kṣaudrōdakāplutam||43||

prabhūtasnēhamaśanaṁ jīrṇē tatra praśasyatē|

ajarō'ruk samābhyāsājjīvēccaiva samāḥ śatam||44||

(iti triphalārasāyanamaparam)|

traiphalenAyasIM pAtrIM kalkenAlepayennavAm|

tamahorAtrikaM lepaM pibet kShaudrodakAplutam||43||

prabhUtasnehamashanaM jIrNe tatra prashasyate|

ajaro~aruk samAbhyAsAjjIveccaiva samAH shatam||44||

(iti triphalArasAyanamaparam)|

A new iron plate should be pasted with the paste of ''triphala''. After twenty-four hours this paste should be collected and dissolved in honey water and consumed. After the medicine is digested one should take a meal with plenty of fat. By observing this procedure for a year one lives one hundred years free from senility and illness. [43-44]

===== ''Triphala Rasayana'' =====

मधुकेन तुगाक्षीर्या पिप्पल्या क्षौद्रसर्पिषा|

त्रिफला सितया चापि युक्ता सिद्धं रसायनम्||४५||

(इति त्रिफलारसायनमपरम्)|

madhukēna tugākṣīryā pippalyā kṣaudrasarpiṣā|

triphalā sitayā cāpi yuktā siddhaṁ rasāyanam||45||

(iti triphalārasāyanamaparam)|

madhukena tugAkShIryA pippalyA kShaudrasarpiShA|

triphalA sitayA cApi yuktA siddhaM rasAyanam||45||

(iti triphalArasAyanamaparam)|

''Triphala'' mixed with ''madhuka, tugaksheeri, pippali'' along with honey and ghee or ''triphala'' with sugar is an effective ''rasayana''. [45]

===== ''Triphala Rasayana'' =====

सर्वलौहैः सुवर्णेन वचयामधुसर्पिषा|

विडङ्गपिप्पलीभ्यां च त्रिफला लवणेन च||४६||

संवत्सरप्रयोगेण मेधास्मृतिबलप्रदा|

भवत्यायुःप्रदा धन्याजरारोगनिबर्हणी||४७||

(इति त्रिफलारसायनमपरम्)|

sarvalauhaiḥ suvarṇēna vacayā madhusarpiṣā|

viḍaṅgapippalībhyāṁ ca triphalā lavaṇēna ca||46||

saṁvatsaraprayōgēṇa mēdhāsmr̥tibalapradā|

bhavatyāyuḥpradā dhanyājarārōganibarhaṇī||47||

(iti trphalārasāyanamaparam)|

sarvalauhaiH [1] suvarNena vacayA madhusarpiShA|

viDa~ggapippalIbhyAM ca triphalA lavaNena ca||46||

saMvatsaraprayogeNa medhAsmRutibalapradA|

bhavatyAyuHpradA dhanyA jarAroganibarhaNI||47||

(iti triphalArasAyanamaparam)|

''Triphala'' along with all six metals including gold, ''vacha'' or with ''vidanga'' and ''pippali'' or with ''lavana'' taken with honey and ghee for a year promotes intellect, memory and strength, longevity and excellence and relieves senility and diseases. [46-47]

===== Properties of ''Shilajatu rasayana'' =====

अनम्लं च कषायं च कटु पाके शिलाजतु|

नात्युष्णशीतं धातुभ्यश्चतुर्भ्यस्तस्यसम्भवः||४८||

हेम्नश्च रजतात्ताम्राद्वरात् कृष्णायसादपि|

रसायनं तद्विधिभिस्तद्वृष्यं तच्च रोगनुत्||४९||

वातपित्तकफघ्नैश्च निर्यूहैस्तत् सुभावितम्|

वीर्योत्कर्षं परं याति सर्वैरेकैकशोऽपि वा||५०||

anamlaṁ ca kaṣāyaṁ ca kaṭu pākē śilājatu|

nātyuṣṇaśītaṁ dhātubhyaścaturbhyastasya sambhavaḥ||48||

hēmnaśca rajatāttāmrādvarāt kr̥ṣṇāyasādapi|

rasāyanaṁ tadvidhibhistadvr̥ṣyaṁ tacca rōganut||49||

vātapittakaphaghnaiśca niryūhaistat subhāvitam|

vīryōtkarṣaṁ paraṁ yāti sarvairēkaikaśō'pi vā||50||

anamlaM ca kaShAyaM ca kaTu pAke shilAjatu|

nAtyuShNashItaM dhAtubhyashcaturbhyastasya sambhavaH||48||

hemnashca rajatAttAmrAdvarAt [1] kRuShNAyasAdapi|

rasAyanaM tadvidhibhistadvRuShyaM tacca roganut||49||

vAtapittakaphaghnaishca niryUhaistat subhAvitam|

vIryotkarShaM paraM yAti sarvairekaikasho~api vA||50||

''Shilajatu'' originates from four metals – gold, silver, copper and black iron and is slightly sour, astringent in taste, ''katu'' in ''vipaka'' and is moderate in ''veerya''. This is ''rasayana'' in effect and if applied methodically it is aphrodisiac and alleviates diseases. Its potency enhances if it is impregnated with decoction of drugs alleviating ''vata, pitta'' and ''kapha'' either singly or in combination. [48-50]

प्रक्षिप्तोद्धृतमप्येनत् पुनस्तत् प्रक्षिपेद्रसे|

कोष्णे सप्ताहमेतेन विधिना तस्य भावना||५१||

पूर्वोक्तेन विधानेन लोहैश्चूर्णीकृतैः सह|

तत् पीतं पयसा दद्याद्दीर्घमायु सुखान्वितम्||५२||

जराव्याधिप्रशमनं देहदार्ढ्यकरं परम्|

मेधास्मृतिकरं धन्यं क्षीराशी तत् प्रयोजयेत्||५३||

प्रयोगः सप्तसप्ताहास्त्रयश्चैकश्च सप्तकः|

निर्दिष्टस्त्रिविधस्तस्य परो मध्योऽवरस्तथा||५४||

पलमर्धपलं कर्षो मात्रा तस्य त्रिधा मता |

prakṣiptōddhr̥tamapyēnat punastat prakṣipēdrasē|

kōṣṇē saptāhamētēna vidhinā tasyabhāvanā||51||

pūrvōktēna vidhānēna lōhaiścūrṇīkr̥taiḥ saha|

tat pītaṁ payasā dadyāddīrghamāyuḥ sukhānvitam||52||

jarāvyādhipraśamanaṁ dēhadārḍhyakaraṁ param|

mēdhāsmr̥tikaraṁ dhanyaṁ kṣīrāśī tat prayōjayēt||53||

prayōgaḥ saptasaptāhāstrayaścaikaśca saptakaḥ|

nirdiṣṭastrividhastasya parō madhyō'varastathā||54||

palamardhapalaṁ karṣō mātrā tasya tridhā matā|

prakShiptoddhRutamapyenat [1] punastat prakShipedrase|

koShNe saptAhametena vidhinA tasya bhAvanA||51||

pUrvoktena vidhAnena lohaishcUrNIkRutaiH saha|

tat pItaM payasA dadyAddIrghamAyuH sukhAnvitam||52||

jarAvyAdhiprashamanaM dehadArDhyakaraM param|

medhAsmRutikaraM dhanyaM kShIrAshI tat prayojayet||53||

prayogaH saptasaptAhAstrayashcaikashca saptakaH|

nirdiShTastrividhastasya paro madhyo~avarastathA||54||

palamardhapalaM karSho mAtrA tasya tridhA matA|55|

''Shilajatu'' is impregnated by dipping it in lukewarm decoction and then taking it out at the end of the day, repeating the process for a week. ''Shilajatu'' mixed with ashed metals should be taken with milk by the prescribed method. This formulation provides happy long life, retards aging and disease, stabilizes the body, and promotes intellect and memory and excellence if taken with milk diet. The method of use is threefold viz. for seven weeks, three weeks and one week regarded as maximum, medium and minimum. The dose also is of three grades – 40 gms, 20 gms and 10 gms. [51-55]

जातेर्विशेषं सविधिं तस्य वक्ष्याम्यतः परम्||५५||

हेमाद्याः सूर्यसन्तप्ताः स्रवन्ति गिरिधातवः|

जत्वाभं मृदुमृत्स्नाच्छं यन्मलं तच्छिलाजतु||५६||

मधुरश्च सतिक्तश्च जपापुष्पनिभश्च यः|

कटुर्विपाके शीतश्च स सुवर्णस्य निस्रवः ||५७||

रूप्यस्य कटुकः श्वेतः शीतः स्वादु विपच्यते|

ताम्रस्य बर्हिकण्ठाभस्तिक्तोष्णः पच्यते कटु ||५८||

यस्तु गुग्गुलुकाभासस्तिक्तको लवणान्वितः|

कटुर्विपाके शीतश्च सर्वश्रेष्ठः स चायसः ||५९||

गोमूत्रगन्धयः सर्वे सर्वकर्मसु यौगिकाः|

रसायनप्रयोगेषु पश्चिमस्तु विशिष्यते ||६०||

यथाक्रमं वातपित्ते श्लेष्मपित्ते कफे त्रिषु|

विशेषतः प्रशस्यन्ते मला हेमादिधातुजाः ||६१||

jātērviśēṣaṁ savidhiṁ tasya vakṣyāmyataḥ param||55||

hēmādyāḥ sūryasantaptāḥ sravanti giridhātavaḥ|

jatvābhaṁ mr̥du mr̥tsnācchaṁ yanmalaṁ tacchilājatu||56||

madhuraśca satiktaśca japāpuṣpanibhaśca yaḥ|

kaṭurvipākē śītaśca sa suvarṇasya nisravaḥ||57||

rūpyasya kaṭukaḥ śvētaḥ śītaḥ svādu vipacyatē|

tāmrasya barhikaṇṭhābhastiktōṣṇaḥ pacyatē kaṭu||58||

yastu guggulukābhāsastiktakō lavaṇānvitaḥ|

kaṭurvipākē śītaśca sarvaśrēṣṭhaḥ sa cāyasaḥ||59||

gōmūtragandhayaḥ sarvē sarvakarmasu yaugikāḥ|

rasāyanaprayōgēṣu paścimastu viśiṣyatē||60||

yathākramaṁ vātapittē ślēṣmapittē kaphē triṣu|

viśēṣataḥ praśasyantē malā hēmādidhātujāḥ||61||

jAtervisheShaM savidhiM tasya vakShyAmyataH param||55||

hemAdyAH sUryasantaptAH sravanti giridhAtavaH|

jatvAbhaM mRudu mRutsnAcchaM yanmalaM tacchilAjatu||56||

madhurashca satiktashca japApuShpanibhashca yaH|

kaTurvipAke shItashca sa suvarNasya nisravaH||57||

rUpyasya kaTukaH shvetaH shItaH svAdu vipacyate|

tAmrasya barhikaNThAbhastiktoShNaH pacyate kaTu||58||

yastu guggulukAbhAsastiktako lavaNAnvitaH|

kaTurvipAke shItashca sarvashreShThaH sa cAyasaH||59||

gomUtragandhayaH sarve sarvakarmasu yaugikAH|

rasAyanaprayogeShu pashcimastu vishiShyate||60||

yathAkramaM vAtapitte shleShmapitte kaphe triShu|

visheShataH prashasyante malA hemAdidhAtujAH||61||

Specific characters according to the source and the method of administration will be explained now. The rocky ores of gold etc., when heated by the sun ooze a material like lac, soft, smooth and clear. This is ''shilajatu''. ''Shilajatu'' obtained from gold ore is sweet, slightly bitter, having color like ''japa'' flower, pungent in ''vipaka'' and ''sheeta'' ''veerya''. That obtained from silver ore is pungent, white, cold and sweet in ''vipaka''. ''Shilajatu'' obtained from copper ore is like peacock neck, bitter, hot and pungent in ''vipaka''. That which is like ''gugguluka'' is the best of all. All types of ''shilajatu'' smell like cow urine and are applicable in all conditions. However, in the use of ''rasayana'', the last one is preferred, the above types of ''shilajatu'' are useful in ''vata-pitta'', ''kapha-pitta, kapha'' and ''tridosha'' respectively. [55-61]

शिलाजतुप्रयोगेषु विदाहीनि गुरूणि च|

वर्जयेत् सर्वकालं तु कुलत्थान् परिवर्जयेत्||६२||

ते ह्यत्यन्तविरुद्धत्वादश्मनो भेदनाः परम्|

लोके दृष्टास्ततस्तेषां प्रयोगःप्रतिषिध्यते||६३||

पयांसि तक्राणि रसाः सयूषास्तोयं समूत्रा विविधाः कषायाः|

आलोडनार्थं गिरिजस्य शस्तास्ते ते प्रयोज्याः प्रसमीक्ष्यकार्यम्||६४||

न सोऽस्ति रोगो भुवि साध्यरूपः शिलाह्वयं यं न जयेत् प्रसह्य|

तत् कालयोगैर्विधिभिः प्रयुक्तं स्वस्थस्य चोर्जां विपुलां ददाति||६५||

(इति शिलाजतुरसायनम्)|

śilājatuprayōgēṣu vidāhīni gurūṇica|

varjayēt sarvakālaṁ tu kulatthānparivarjayēt||62||

tē hyatyantaviruddhatvādaśmanō bhēdanāḥ param|

lōkē dr̥ṣṭāstatastēṣāṁ prayōgaḥ pratiṣidhyatē||63||

payāṁsi takrāṇirasāḥ sayūṣāstōyaṁ samūtrā vividhāḥ kaṣāyāḥ|

ālōḍanārthaṁ girijasya śastāstē tē prayōjyāḥ prasamīkṣya kāryam||64||

na sō'sti rōgō bhuvi sādhyarūpaḥ śilāhvayaṁ yaṁ na jayēt prasahya|

tat kālayōgairvidhibhiḥ prayuktaṁ svasthasya cōrjāṁ vipulāṁ dadāti||65||

(iti śilājaturasāyanam)|

shilAjatuprayogeShu vidAhIni gurUNi ca|

varjayet sarvakAlaM tu kulatthAn [1] parivarjayet||62||

te hyatyantaviruddhatvAdashmano bhedanAH param|

loke dRuShTAstatasteShAM prayogaH pratiShidhyate||63||

payAMsi takrANi [2] rasAH sayUShAstoyaM samUtrA vividhAH kaShAyAH|

AloDanArthaM girijasya shastAste te prayojyAH prasamIkShya kAryam||64||

na so~asti rogo bhuvi sAdhyarUpaH shilAhvayaM yaM na jayet prasahya|

tat kAlayogairvidhibhiH prayuktaM svasthasya corjAM vipulAM dadAti||65||

(iti shilAjaturasAyanam)|

One should avoid ''vidahi'' and heavy substances particularly horse gram during consumption of ''shilajatu''. Horse gram, due to exceedingly contradictory nature, breaks the stones as seen in the practice that is why its use is contraindicated. Milk, buttermilk, meat soup, vegetables soups, water, urine and various decoctions are used for dissolving ''shilajatu'' according to the object. There is no disease in the world which is not overcome by ''shilajatu''. It also provides great energy to the healthy person if used methodically as prescribed. [62-65]

तत्रश्लोकः-

करप्रचितिके पादे दश षट् च महर्षिणा|

रसायनानां सिद्धानां संयोगाः समुदाहृताः||६६||

tatra ślōkaḥ-

karapracitikē pādē daśa ṣaṭ ca maharṣiṇā|

rasāyanānāṁ siddhānāṁ saṁyōgāḥsamudāhr̥tāḥ||66||

tatra shlokaH-

karapracitike pAde dasha ShaT ca maharShiNA|

rasAyanAnAM siddhAnAM saMyogAH samudAhRutAH||66||

Now the summing up verses –

In the quarter on hand plucked ''amalaki'' fruits sixteen ''rasayana'' formulations have been described by the great sages. [66]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सास्थाने रसायनाध्याये करप्रचितीयो नाम रसायनपादस्तृतीयः||३||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē rasāyanādhyāyē karapracitīyō nāma rasāyanapādastr̥tīyaḥ||3||

ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne rasAyanAdhyAye karapracitIyo nAma rasAyanapAdastRutIyaH||3||

Thus ends the third quarter on hand plucked (''amalaki'' fruits) in the chapter on ''rasayana'' in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charak. [3]

==== Part IV: ''Ayurvedasamutthaniyam Rasayanapadam'' ====

अथात आयुर्वेदसमुत्थानीयं रसायनपादं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athāta āyurvēdasamutthānīyaṁ rasāyanapādaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAta AyurvedasamutthAnIyaM rasAyanapAdaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now I shall deliberate upon the fourth quarter (''pada'') in the chapter on ''rasayana'' dealing with the uplift of the science of life. As propounded by Lord Atreya. [1-2]

ऋषयः खलु कदाचिच्छालीना यायावराश्च ग्राम्यौषध्याहाराः सन्तः साम्पन्निका मन्दचेष्टा नातिकल्याश्च प्रायेण बभूवुः|

ते सर्वासामितिकर्तव्यतानामसमर्थाः सन्तो ग्राम्यवासकृतमात्मदोषं मत्वा पूर्वनिवासमपगतग्राम्यदोषं शिवं पुण्यमुदारं मेध्यमगम्यमसुकृतिभिर्गङ्गाप्रभवममरगन्धर्वकिन्नरानुचरितमनेकरत्ननिचयमचिन्त्याद्भुतप्रभावं ब्रह्मर्षिशिद्धचारणानुचरितं दिव्यतीर्थौषधिप्रभवमतिशरण्यं हिमवन्तममराधिपतिगुप्तं जग्मुर्भृग्वङ्गिरोऽत्रिवसिष्ठकश्यपागस्त्यपुलस्त्यवामदेवासितगौतमप्रभृतयो महर्षयः||३||

r̥ṣayaḥ khalu kadācicchālīnā yāyāvarāśca grāmyauṣadhyāhārāḥ santaḥ sāmpannikā mandacēṣṭā nātikalyāśca prāyēṇa babhūvuḥ|

tē sarvāsāmitikartavyatānāmasamarthāḥ santō grāmyavāsakr̥tamātmadōṣaṁ matvā pūrvanivāsamapagatagrāmyadōṣaṁ śivaṁ puṇyamudāraṁ mēdhyamagamyamasukr̥tibhirgaṅgāprabhavamamaragandharvakinnarānucaritamanēkaratnanicayamacintyādbhutaprabhāvaṁ brahmarṣiśiddhacāraṇānucaritaṁ divyatīrthauṣadhiprabhavamatiśaraṇyaṁ himavantamamarādhipatiguptaṁ jagmurbhr̥gu, aṅgira, atri, vasiṣṭha, kaśyapa, Agastya, pulastya, Vāmadēva, Asita, Gautamaprabhr̥tayō maharṣayaḥ||3||

RuShayaH khalu kadAcicchAlInA yAyAvarAshca [1] grAmyauShadhyAhArAH santaH sAmpannikA mandaceShTA nAtikalyAshca prAyeNa babhUvuH|

te sarvAsAmitikartavyatAnAmasamarthAH santo grAmyavAsakRutamAtmadoShaM matvA pUrvanivAsamapagatagrAmyadoShaM shivaM puNyamudAraMmedhyamagamyamasukRutibhirga~ggAprabhavamamaragandharvakinnarAnucaritamanekaratnanicayamacintyAdbhutaprabhAvaMbrahmarShishiddhacAraNAnucaritaM divyatIrthauShadhiprabhavamatisharaNyaM himavantamamarAdhipatiguptaMjagmurbhRugva~ggiro~atrivasiShThakashyapAgastyapulastyavAmadevAsitagautamaprabhRutayo maharShayaH||3||

The ''rishis'' hermits as well as wanderers, some times, due to consumption of household medicines and food often become obese, and slow in action and unhealthy trait. Being unable to perform their routine duties, they considered their own faults brought about by domestic living and thus shifted to their previous abode, Himalayas, which is free from domestic defects, propitious, pious, noble, favorable for intellect, unapproachable for the unholy, the source of origin of Ganga, frequented by the gods, ''gandharvas'' and ''kinnaras'', the place of many precious stones, having incomprehensible miraculous powers, resided by intellectual sages, accomplished persons and wanderers, the source of celestial centers and plants, the great savior and protected by the lord of gods. This group of great sages consisted of Bhrigu, Angiras, Atri, Vasishtha, Kashyapa, Agastya, Pulastya, Vamadeva, Asita, and Gautama etc. [3]

तानिन्द्रःसहस्रदृगमरगुरुरब्रवीत्- स्वागतं ब्रह्मविदांज्ञानतपोधनानां ब्रह्मर्षीणाम्| अस्ति ननु वो ग्लानिरप्रभावत्वं वैस्वर्यं वैवर्ण्यं च ग्राम्यवासकृतमसुखमसुखानुबन्धं च; ग्राम्यो हि वासो मूलमशस्तानां, तत् कृतः पुण्यकृद्भिरनुग्रहः प्रजानां, स्वशरीरमवेक्षितुं कालःकालश्चायमायुर्वेदोपदेशस्य ब्रह्मर्षीणाम्; आत्मनः प्रजानां चानुग्रहार्थमायुर्वेदमश्विनौ मह्यं प्रायच्छतां, प्रजापतिरश्विभ्यां, प्रजापतये ब्रह्मा, प्रजानामल्पमायुर्जराव्याधिबहुलमसुखमसुखानुबन्धमल्पत्वादल्पतपोदमनियमदानाध्ययनसञ्चयंमत्वा पुण्यतममायुःप्रकर्षकरं जराव्याधिप्रशमनमूर्जस्करममृतं शिवं शरण्यमुदारं भवन्तो मत्तः श्रोतुमर्हताथोपधारयितुं प्रकाशयितुं च प्रजानुग्रहार्थमार्षं ब्रह्म च प्रति मैत्रीं कारुण्यमात्मनश्चानुत्तमं पुण्यमुदारं ब्राह्ममक्षयं कर्मेति||४||

tānindraḥ sahasradr̥gamaragururabravīt- svāgataṁ brahmavidāṁ jñānatapōdhanānāṁ brahmarṣīṇām| asti nanu vō glāniraprabhāvatvaṁ vaisvaryaṁ vaivarṇyaṁ ca grāmyavāsakr̥tamasukhamasukhānubandhaṁ ca; grāmyō hi vāsō mūlamaśastānāṁ, tat kr̥taḥ puṇyakr̥dbhiranugrahaḥ prajānāṁ, svaśarīramavēkṣituṁ kālaḥ kālaścāyamāyurvēdōpadēśasya brahmarṣīṇām; ātmanaḥ prajānāṁ cānugrahārthamāyurvēdamaśvinau mahyaṁ prāyacchatāṁ, prajāpatiraśvibhyāṁ, prajāpatayē brahmā, prajānāmalpamāyurjarāvyādhibahulamasukhamasukhānubandhamalpatvādalpatapōdamaniyamadānādhyayanasañcayaṁ matvā puṇyatamamāyuḥprakarṣakaraṁ jarāvyādhipraśamanamūrjaskaramamr̥taṁ śivaṁ śaraṇyamudāraṁ bhavantō mattaḥ śrōtumarhatāthōpadhārayituṁ prakāśayituṁ ca prajānugrahārthamārṣaṁ brahma ca prati maitrīṁ kāruṇyamātmanaścānuttamaṁ puṇyamudāraṁ brāhmamakṣayaṁ karmēti||4||

tAnindraH sahasradRugamaragururabravIt- svAgataM brahmavidAM j~jAnatapodhanAnAM brahmarShINAm|
asti nanu vo glAniraprabhAvatvaM vaisvaryaM vaivarNyaM ca grAmyavAsakRutamasukhamasukhAnubandhaM ca; grAmyo hi vAso mUlamashastAnAM, tat kRutaHpuNyakRudbhiranugrahaH prajAnAM, svasharIramavekShituM kAlaH [1] kAlashcAyamAyurvedopadeshasya brahmarShINAm; AtmanaH prajAnAMcAnugrahArthamAyurvedamashvinau mahyaM prAyacchatAM, prajApatirashvibhyAM, prajApataye brahmA,prajAnAmalpamAyurjarAvyAdhibahulamasukhamasukhAnubandhamalpatvAdalpatapodamaniyamadAnAdhyayanasa~jcayaM matvApuNyatamamAyuHprakarShakaraM jarAvyAdhiprashamanamUrjaskaramamRutaM shivaM sharaNyamudAraM bhavanto mattaH shrotumarhatAthopadhArayituMprakAshayituM ca prajAnugrahArthamArShaM brahma ca prati maitrIM kAruNyamAtmanashcAnuttamaM puNyamudAraM brAhmamakShayaM karmeti||4||

Indra, the visionary preceptor of gods, addressed them saying – welcome to the intellectual sages, the knower of Brahman, endowed with wealth of knowledge and penance. You are having malaise, luster-lessness, derangement of voice and complexion and ill health along with its associated corollaries caused by domestic living. Domestic living is the root of all the inauspicious effects. You have committed great favor to the people, now it is the time for intellectual sages to look to their own self and to enrich the science of life for the well being of your own self as well as of the people in general.

Ayurveda is made available to me by Ashwin who received it from Prajapati, who again received this knowledge from Brahma. Now looking to the short life span of the human beings, that too affected with senility and diseases associated with unhappiness and continuous suffering disturbing their performance of penance, restraint, regular practices, clarity and study you should learn from me, understand propagate the divine knowledge which is the holiest, prolonging life span, alleviating senility and diseases, generating energy, the nectar like, propitious savoir and noble for the welfare of the humanity with friendliness and compassion to them and to create for yourselves the best, holy, noble and immortal intellectual activity. [4]

तच्छ्रुत्वा विबुधपतिवचनमृषयः सर्व एवामरवरमृग्भिस्तुष्टुवुः, प्रहृष्टाश्च तद्वचनमभिननन्दुश्चेति||५||

tacchrutvā vibudhapativacanamr̥ṣayaḥ sarva ēvāmaravaramr̥gbhistuṣṭuvuḥ, prahr̥ṣṭāśca tadvacanamabhinananduścēti||5||

tacchrutvA vibudhapativacanamRuShayaH sarva evAmaravaramRugbhistuShTuvuH, prahRuShTAshca tadvacanamabhinanandushceti||5||

After listening to the wisdom of the king of gods, all the rishis praised the precepter with incantations and applauded his statement with great pleasure. [5]

===== ''Indrokta Rasayana'' =====

अथेन्द्रस्तदायुर्वेदामृतमृषिभ्यः -सङ्क्रम्योवाच- एतत् सर्वमनुष्ठेयम्, अयं च शिवः कालो रसायनानां, दिव्याश्चौषधयो हिमवत्प्रभवाः [१] प्राप्तवीर्याः; तद्यथा- ऐन्द्री, ब्राह्मी, पयस्या, क्षीरपुष्पी, श्रावणी, महाश्रावणी, शतावरी, विदारी, जीवन्ती, पुनर्नवा, नागबला, स्थिरा, वचा, छत्रा, अतिच्छत्रा, मेदा, महामेदा, जीवनीयाश्चान्याः पयसा प्रयुक्ताः षण्मासात् परमायुर्वयश्च तरुणमनामयत्वं स्वरवर्णसम्पदमुपचयं मेधां स्मृतिमुत्तमबलमिष्टांश्चापरान् भावानावहन्ति सिद्धाः||६||

(इतीन्द्रोक्तं रसायनम्)|

athēndrastadāyurvēdāmr̥tamr̥ṣibhyaḥ - saṅkramyōvāca- ētat sarvamanuṣṭhēyam,
ayaṁ ca śivaḥ kālō rasāyanānāṁ, divyāścauṣadhayō himavatprabhavāḥprāptavīryāḥ; tadyathā- aindrī, brāhmī, payasyā, kṣīrapuṣpī, śrāvaṇī, mahāśrāvaṇī, śatāvarī, vidārī, jīvantī, punarnavā, nāgabalā, sthirā, vacā, chatrā, aticchatrā, mēdā, mahāmēdā, jīvanīyāścānyāḥ payasā prayuktāḥ ṣaṇmāsāt paramāyurvayaśca taruṇamanāmayatvaṁ svaravarṇasampadamupacayaṁ mēdhāṁ smr̥timuttamabalamiṣṭāṁścāparān bhāvānāvahanti siddhāḥ||6||

(itīndrōktaṁ rasāyanam)|

athendrastadAyurvedAmRutamRuShibhyaH sa~gkramyovAca- etat sarvamanuShTheyam, ayaM ca shivaH kAlo rasAyanAnAM, divyAshcauShadhayohimavatprabhavAH [1] prAptavIryAH; tadyathA- aindrI, brAhmI, payasyA, kShIrapuShpI, shrAvaNI, mahAshrAvaNI, shatAvarI, vidArI, jIvantI, punarnavA, nAgabalA,sthirA, vacA, chatrA, aticchatrA, medA, mahAmedA, jIvanIyAshcAnyAH payasA prayuktAH ShaNmAsAt paramAyurvayashca taruNamanAmayatvaMsvaravarNasampadamupacayaM medhAM smRutimuttamabalamiShTAMshcAparAn bhAvAnAvahanti siddhAH||6||

(itIndroktaM rasAyanam)|

Indra, having infused the nectar of Ayurveda to these ''rishis'' said – now all this has to be brought into action. Now is the auspicious time for ''rasayana'' and the celestial drugs grown in Himalaya are also matured such as ''aindri, brahmi, payasya, ksheerapushpi, shravani,'' ''mahashravani'', ''shatavari, vidari, jeevanti, punarnava, nagabala, sthira, vacha, chatra, atichchatra, meda, mahameda'' and other vitalizing drugs if taken with milk for six months will certainly induce maximum life span, youthful age, disease free, excellence of voice and complexion, corpulence, intellect, memory, quality strength and other desired effects. [6]

ब्रह्मसुवर्चला नामौषधिर्या हिरण्यक्षीरा पुष्करसदृशपत्रा, आदित्यपर्णी नामौषधिर्या ‘सूर्यकान्ता’ इति विज्ञायते सुवर्णक्षीरा सूर्यमण्डलाकारपुष्पाच, नारीनामौषधिः‘अश्वबला’ इति विज्ञायते या बल्वजसदृशपत्रा काष्ठगोधा नामौषधिर्गोधाकारा, सर्पानामौषधिः सर्पाकारा, सोमो नामौषधिराजः पञ्चदशपर्वा स सोम इव हीयते वर्धते च, पद्मा नामौषधिः पद्माकारा पद्मरक्ता पद्मगन्धाच, अजा नामौषधिः ‘अजशृङ्गी’ इति विज्ञायते, नीला नामौषधिस्तु नीलक्षीरा नीलपुष्पा लताप्रतानबहुलेति; आसामोषधीनां यां यामेवोपलभेत तस्यास्तस्याः स्वरसस्य सौहित्यं गत्वा स्नेहभावितायामार्द्रपलाशद्रोण्यां सपिधानायां दिग्वासाः शयीत, तत्र प्रलीयते, षण्मासेन पुनः सम्भवति, तस्याजं पयः प्रत्यवस्थापनं; षण्मासेन देवतानुकारी भवति वयोवर्णस्वराकृतिबलप्रभाभिः, स्वयं चास्य सर्ववाचोगतानि प्रादुर्भवन्ति, दिव्यं चास्य चक्षुः श्रोत्रं
च भवति, गतिर्योजनसहस्रं दशवर्षसहस्राण्यायुरनुपद्रवं चेति||७||

brahmasuvarcalā nāmauṣadhiryā hiraṇyakṣīrā puṣkarasadr̥śapatrā, ādityaparṇī nāmauṣadhiryā ‘sūryakāntā’ itivijñāyatē suvarṇakṣīrā sūryamaṇḍalākārapuṣpā ca, nārīnāmauṣadhiḥ ‘aśvabalā’ iti vijñāyatē yā balvajasadr̥śapatrā, kāṣṭhagōdhā nāmauṣadhirgōdhākārā, sarpānāmauṣadhiḥ sarpākārā, sōmō nāmauṣadhirājaḥ pañcadaśaparvā sa sōma iva hīyatē vardhatē ca, padmā nāmauṣadhiḥ padmākārā padmaraktā padmagandhā ca, ajā nāmauṣadhiḥ ‘ajaśr̥ṅgī’ iti vijñāyatē, nīlā nāmauṣadhistu nīlakṣīrā nīlapuṣpā latāpratānabahulēti; āsāmōṣadhīnāṁ yāṁ yāmēvōpalabhēta tasyāstasyāḥ svarasasya sauhityaṁ gatvā snēhabhāvitāyāmārdrapalāśadrōṇyāṁ sapidhānāyāṁ digvāsāḥ śayīta, tatra pralīyatē, ṣaṇmāsēna punaḥ sambhavati, tasyājaṁ payaḥ pratyavasthāpanaṁ; ṣaṇmāsēna dēvatānukārī bhavati vayōvarṇasvarākr̥tibalaprabhābhiḥ, svayaṁ cāsya sarvavācōgatāni prādurbhavanti, divyaṁ cāsya cakṣuḥ śrōtraṁ ca bhavati, gatiryōjanasahasraṁ daśavarṣasahasrāṇyāyuranupadravaṁ cēti||7||

brahmasuvarcalA nAmauShadhiryA hiraNyakShIrA puShkarasadRushapatrA, AdityaparNI nAmauShadhiryA ‘sUryakAntA’ iti vij~jAyate suvarNakShIrAsUryamaNDalAkArapuShpA ca, nArInAmauShadhiH ‘ashvabalA’ iti vij~jAyate yA balvajasadRushapatrA [1] , kAShThagodhA nAmauShadhirgodhAkArA,sarpAnAmauShadhiH sarpAkArA, somo nAmauShadhirAjaH pa~jcadashaparvA [2] sa soma iva hIyate vardhate ca, padmA nAmauShadhiH padmAkArA padmaraktApadmagandhA ca, ajA nAmauShadhiH ‘ajashRu~ggI’ iti vij~jAyate, nIlA nAmauShadhistu nIlakShIrA nIlapuShpA latApratAnabahuleti; AsAmoShadhInAM yAMyAmevopalabheta tasyAstasyAH svarasasya sauhityaM gatvA snehabhAvitAyAmArdrapalAshadroNyAM sapidhAnAyAM digvAsAH shayIta, tatra pralIyate, ShaNmAsenapunaH sambhavati, tasyAjaM payaH pratyavasthApanaM; ShaNmAsena devatAnukArI bhavati vayovarNasvarAkRutibalaprabhAbhiH, svayaM cAsya sarvavAcogatAniprAdurbhavanti, divyaM cAsya cakShuH shrotraM ca bhavati, gatiryojanasahasraM dashavarShasahasrANyAyuranupadravaM ceti||7||

''Brahmasuvarchala'' is the herb having golden latex and lotus like leaves, ''adityaparni'' is the herb which is known as the “sun’s beloved” and has golden latex and flowers like sun disc, ''nari'' is the herb known as ''ashvabala'' having leaves like those of ''balwaja'', ''kashthagodha'' is the iguana shaped herb, ''sarpa'' is the serpent shaped herb, ''soma'' is the king of herbs having fifteen nodes and increasing and decreasing according to the condition of the moon, ''padma'' is the herb having shape, colour and fragrance like that of lotus, ''aja'' is the herb known as ''ajashringi'', ''neela'' is the climber plant having blue latex and flowers and diffused branches. Of these plants whichever are available should be taken in the form of juice in full quantity. Thereafter one should sleep naked in the covered tube made of wet ''palasha'' wood and anointed with fat. Then he disappears and reappears in six months. Then he should live on goat’s milk. In six months such a person becomes gods like in age, complexion, voice, face, strength and luster, great intuition, he attains divine vision and audition, becomes able to move up to thousand ''yojana'' and assumes unaffected life span of thousand years. [7]

भवन्ति चात्र-

दिव्यानामोषधीनां यः प्रभावः स भवद्विधैः|

शक्यः सोढुमशक्यस्तु स्यात् सोढुमकृतात्मभिः||८||

ओषधीनां प्रभावेण तिष्ठतां स्वे च कर्मणि|

भवतां निखिलं श्रेयः सर्वमेवोपपत्स्यते||९||

वानप्रस्थैर्गृहस्थैश्च प्रयतैर्नियतात्मभिः|

शक्या ओषधयो ह्येताः सेवितुं विषयाभिजाः||१०||

bhavanti cātra-

divyānāmōṣadhīnāṁ yaḥ prabhāvaḥ sa bhavadvidhaiḥ|

śakyaḥ sōḍhumaśakyastu syāt sōḍhumakr̥tātmabhiḥ||8||

ōṣadhīnāṁ prabhāvēṇa tiṣṭhatāṁ svē ca karmaṇi|

bhavatāṁ nikhilaṁ śrēyaḥ sarvamēvōpapatsyatē||9||

vānaprasthairgr̥hasthaiśca prayatairniyatātmabhiḥ|

śakyā ōṣadhayō hyētāḥ sēvituṁ viṣayābhijāḥ||10||

bhavanti cAtra-

divyAnAmoShadhInAM yaH prabhAvaH sa bhavadvidhaiH|

shakyaH soDhumashakyastu syAt soDhumakRutAtmabhiH||8||

oShadhInAM prabhAveNa tiShThatAM sve ca karmaNi|

bhavatAM nikhilaM shreyaH sarvamevopapatsyate||9||

vAnaprasthairgRuhasthaishca prayatairniyatAtmabhiH|

shakyA oShadhayo hyetAH sevituM viShayAbhijAH||10||

Here are the verses –

The therapeutic impact of divine herbs can be sustained only by the individuals like you and not by those with uncontrolled self. By the effect of these herbs you will attain all desired merits while on your normal duties. The herbs growing in sacred lands can be utilized by forest dwellers as well as by householders as duly prescribed with self restraint. [8-10]

यास्तु क्षेत्रगुणैस्तेषां मध्यमेन च कर्मणा|

मृदुवीर्यतरास्तासां विधिर्ज्ञेयः स एव तु||११||

पर्येष्टुं ताः प्रयोक्तुं वा येऽसमर्थाः सुखार्थिनः|

रसायनविधिस्तेषामयमन्यः प्रशस्यते||१२||

Yāstu kṣētraguṇaistēṣāṁ madhyamēna ca karmaṇā|

mr̥duvīryatarāstāsāṁ vidhirjñēyaḥ sa ēva tu||11||

paryēṣṭuṁ tāḥ prayōktuṁ vā yē'samarthāḥ sukhārthinaḥ|

rasāyanavidhistēṣāmayamanyaḥ praśasyatē||12||

yAstu [1] kShetraguNaisteShAM madhyamena ca karmaNA|

mRuduvIryatarAstAsAM vidhirj~jeyaH sa eva tu||11||

paryeShTuM tAH prayoktuM vA ye~asamarthAH sukhArthinaH|

rasAyanavidhisteShAmayamanyaH prashasyate||12||

These divine herbs produce milder effect in case of different habitat, subject and mode of administration through the method of intake in the same for all. The individuals with luxurious living who are unable to search or use these herbs should resort to the other methods of ''rasayana'' which are described below. [11-12]

बल्यानां जीवनीयानां बृंहणीयाश्च या दश|

वयसः स्थापनानां च खदिरस्यासनस्य च||१३||

खर्जूराणां मधूकानां मुस्तानामुत्पलस्य च|

मृद्वीकानां विडङ्गानां वचायाश्चित्रकस्य च||१४||

शतावर्याः पयस्यायाः पिप्पल्या जोङ्गकस्य च|

ऋध्द्या नागबलायाश्च द्वारदाया धवस्य च||१५||

त्रिफलाकण्टकार्योश्च विदार्याश्चन्दनस्य च|

इक्षूणां शरमूलानां श्रीपर्ण्यास्तिनिशस्य च||१६||

रसाः पृथक् पृथग्ग्राह्याः पलाशक्षार एव च|

एषां पलोन्मितान् भागान् पयो गव्यं चतुर्गुणम्||१७||

द्वे पात्रे तिलतैलस्य द्वे च गव्यस्य सर्पिषः|

तत् साध्यं सर्वमेकत्र सुसिद्धं स्नेहमुद्धरेत्||१८||

तत्रामलकचूर्णानामाढकं शतभावितम् |

स्वरसेनैव दातव्यं क्षौद्रस्याभिनवस्य च||१९||

शर्कराचूर्णपात्रं च प्रस्थमेकं प्रदापयेत्|

तुगाक्षीर्याः सपिप्पल्याः स्थाप्यं सम्मूर्च्छितं च तत्||२०||

सुचौक्षे मार्तिके कुम्भे मासार्धं घृतभाविते|

मात्रामग्निसमां तस्य तत ऊर्ध्वं प्रयोजयेत्||२१||

हेमताम्रप्रवालानामयसः स्फटिकस्य च|

मुक्तावैदूर्यशङ्खानां चूर्णानां रजतस्य च||२२||

प्रक्षिप्य षोडशीं मात्रां विहायायासमैथुनम्|

जीर्णे जीर्णे च भुञ्जीत षष्टिकं क्षीरसर्पिषा||२३||

सर्वरोगप्रशमनं वृष्यमायुष्यमुत्तमम्|

सत्त्वस्मृतिशरीराग्निबुद्धीन्द्रियबलप्रदम्||२४||

परमूर्जस्करं चैव वर्णस्वरकरं तथा|

विषालक्ष्मीप्रशमनं सर्ववाचोगतप्रदम्||२५||

सिद्धार्थतां चाभिनवं वयश्च प्रजाप्रियत्वं च यशश्च लोके|

प्रयोज्यमिच्छद्भिरिदं यथावद्रसायनं ब्राह्ममुदारवीर्यम्||२६||

(इतीन्द्रोक्तरसायनमपरम्)|

balyānāṁ jīvanīyānāṁ br̥ṁhaṇīyāśca yā daśa|

vayasaḥ sthāpanānāṁ ca khadirasyāsanasya ca||13||

kharjūrāṇāṁ madhūkānāṁ mustānāmutpalasya ca|

mr̥dvīkānāṁ viḍaṅgānāṁ vacāyāścitrakasya ca||14||

śatāvaryāḥ payasyāyāḥ pippalyā jōṅgakasya ca|

r̥dhdyā nāgabalāyāśca dvāradāyā dhavasya ca||15||

triphalākaṇṭakāryōśca vidāryāścandanasya ca|

ikṣūṇāṁ śaramūlānāṁ śrīparṇyāstiniśasya ca||16||

rasāḥ pr̥thak pr̥thaggrāhyāḥ palāśakṣāra ēva ca|

ēṣāṁ palōnmitān bhāgān payō gavyaṁ caturguṇam||17||

dvē pātrē tilatailasya dvē ca gavyasya sarpiṣaḥ|

tat sādhyaṁ sarvamēkatra susiddhaṁ snēhamuddharēt||18||

tatrāmalakacūrṇānāmāḍhakaṁ śatabhāvitam|

svarasēnaiva dātavyaṁ kṣaudrasyābhinavasya ca||19||

śarkarācūrṇapātraṁ ca prasthamēkaṁ pradāpayēt|

tugākṣīryāḥ sapippalyāḥ sthāpyaṁ sammūrcchitaṁ ca tat||20||

sucaukṣē mārtikē kumbhē māsārdhaṁ ghr̥tabhāvitē|

mātrāmagnisamāṁ tasya tata ūrdhvaṁ prayōjayēt||21||

hēmatāmrapravālānāmayasaḥ sphaṭikasya ca|

muktāvaidūryaśaṅkhānāṁ cūrṇānāṁ rajatasya ca||22||

prakṣipya ṣōḍaśīṁ mātrāṁ vihāyāyāsamaithunam|

jīrṇē jīrṇē ca bhuñjīta ṣaṣṭikaṁ kṣīrasarpiṣā||23||

sarvarōgapraśamanaṁ vr̥ṣyamāyuṣyamuttamam|

sattvasmr̥tiśarīrāgnibuddhīndriyabalapradam||24||

paramūrjaskaraṁ caiva varṇasvarakaraṁ tathā|

viṣālakṣmīpraśamanaṁ sarvavācōgatapradam||25||

siddhārthatāṁ cābhinavaṁ vayaśca prajāpriyatvaṁ ca yaśaśca lōkē|

prayōjyamicchadbhiridaṁ yathāvadrasāyanaṁ brāhmamudāravīryam||26||

(itīndrōktarasāyanamaparam)|

balyAnAM jIvanIyAnAM bRuMhaNIyAshca yA dasha|

vayasaH sthApanAnAM ca khadirasyAsanasya ca||13||

kharjUrANAM madhUkAnAM mustAnAmutpalasya ca|

mRudvIkAnAM viDa~ggAnAM vacAyAshcitrakasya ca||14||

shatAvaryAH payasyAyAH pippalyA jo~ggakasya ca|

RudhdyA nAgabalAyAshca dvAradAyA dhavasya ca||15||

triphalAkaNTakAryoshca vidAryAshcandanasya ca|

ikShUNAM sharamUlAnAM shrIparNyAstinishasya ca||16||

rasAH pRuthak pRuthaggrAhyAH palAshakShAra eva ca|

eShAM palonmitAn bhAgAn payo gavyaM caturguNam||17||

dve pAtre tilatailasya dve ca gavyasya sarpiShaH|

tat sAdhyaM sarvamekatra susiddhaM snehamuddharet||18||

tatrAmalakacUrNAnAmADhakaM shatabhAvitam|

svarasenaiva dAtavyaM kShaudrasyAbhinavasya ca||19||

sharkarAcUrNapAtraM ca prasthamekaM pradApayet|

tugAkShIryAH sapippalyAH sthApyaM sammUrcchitaM ca tat||20||

sucaukShe mArtike kumbhe mAsArdhaM ghRutabhAvite|

mAtrAmagnisamAM tasya tata UrdhvaM prayojayet||21||

hematAmrapravAlAnAmayasaH sphaTikasya ca|

muktAvaidUryasha~gkhAnAM cUrNAnAM rajatasya ca||22||

prakShipya ShoDashIM mAtrAM vihAyAyAsamaithunam|

jIrNe jIrNe ca bhu~jjIta ShaShTikaM kShIrasarpiShA||23||

sarvarogaprashamanaM vRuShyamAyuShyamuttamam|

sattvasmRutisharIrAgnibuddhIndriyabalapradam||24||

paramUrjaskaraM caiva varNasvarakaraM tathA|

viShAlakShmIprashamanaM sarvavAcogatapradam||25||

siddhArthatAM cAbhinavaM vayashca prajApriyatvaM ca yashashca loke|

prayojyamicchadbhiridaM yathAvadrasAyanaM brAhmamudAravIryam||26||

(itIndroktarasAyanamaparam)|

Ten herbs of strength promoting, vitality promoting, bulk promoting and age sustaining groups, ''khadira, beejaka, kharjura, madhuka, musta, utpala, mridveeka, vidanga, vacha, chitraka, shatavari, payasya, pippali, aguru, riddhi, nagabala, shaka, dhava, triphala, kanthakari, vidari, chandana, ikshu,'' roots of ''shara, gambhari'' and ''tinisha'' – juice of all these drugs and ''palasha kshara'' should be taken in the quantity of 40 gms each, cow milk four times, ''tila'' oil and cow ghee each 5.12 kg, should be added to it and cooked together. After it is well cooked, the fatty preparation should be brought down. 2.56 kg each of ''amalaka'' powder impregnated hundred times with ''amalaka'' juice, fresh honey and powdered sugar 640 gms each of ''vamshalochana'' and ''pippali'' should be mixed together well. The preparation should be kept in a well cleansed earthen pot smeared with ghee for a fortnight. Then the dose as per the digestive capacity should be used mixing it with powder of gold, copper, coral, iron, quartz, pearl, cats eye, conch and silver in 1/16 quantity. During the period of medication the patient should avoid exertion and sexual intercourse and should take diet of ''shashtika'' rice along with ghee extracted from milk after the previous meal is digested. This ''rasayana'' remedy relieves all diseases, is aphrodisiac, excellent enhancer of life span, provides strength to psyche, memory, physique, digestive fire, intellect and senses, promotes energy, complexion, and voice, alleviates poison and inauspiciousness and renders the words truthful. This intellect promoting and broad spectrum ''rasayana'' formulation should be used properly by those who desire success, youthfulness, charming personality and social image. [13-26]

समर्थानामरोगाणां धीमतां नियतात्मनाम्|

कुटीप्रवेशः क्षणिनां परिच्छदवतां हितः||२७||

अतोऽन्यथा तु ये तेषां सौर्यमारुतिको विधिः|

तयोः श्रेष्ठतरः पूर्वो विधिः सतुसुदुष्करः||२८||

रसायनविधिभ्रंशाज्जायेरन् व्याधयो यदि|

यथास्वमौषधं तेषां कार्यं मुक्त्वा रसायनम्||२९||

samarthānāmarōgāṇāṁ dhīmatāṁ niyatātmanām|

kuṭīpravēśaḥ kṣaṇināṁ paricchadavatāṁ hitaḥ||27||

atō'nyathā tu yē tēṣāṁ sauryamārutikō vidhiḥ|

tayōḥ śrēṣṭhataraḥ pūrvō vidhiḥ sa tu suduṣkaraḥ||28||

rasāyanavidhibhraṁśājjāyēran vyādhayō yadi|

yathāsvamauṣadhaṁ tēṣāṁ kāryaṁ muktvā rasāyanam||29||

samarthAnAmarogANAM dhImatAM niyatAtmanAm|

kuTIpraveshaH kShaNinAM [1] paricchadavatAM hitaH||27||

ato~anyathA tu ye teShAM sauryamArutiko vidhiH|

tayoH shreShThataraH pUrvo vidhiH sa tu suduShkaraH||28||

rasAyanavidhibhraMshAjjAyeran vyAdhayo yadi|

yathAsvamauShadhaM teShAM kAryaM muktvA rasAyanam||29||

The indoor regimen of ''rasayana'' therapy is prescribed for those who are fit, disease free, wise, self controlled, leisurely and are wealthy otherwise the outdoor method of ''vatatapika rasayana'' therapy is advisable. The former kind of regimen is, no doubt superior but is difficult to operate. If during the treatment some complications arise due to faulty methods, better treatment is planned after discontinuing the initial course of ''rasayana'' therapy. [27-29]

===== ''Achara Rasayana'' =====

सत्यवादिनमक्रोधं निवृत्तं मद्यमैथुनात्|

अहिंसकमनायासं प्रशान्तं प्रियवादिनम्||३०||

जपशौचपरं धीरं दाननित्यं तपस्विनम्|

देवगोब्राह्मणाचार्यगुरुवृद्धार्चने रतम्||३१||

आनृशंस्यपरं नित्यं नित्यं करुणवेदिनम् |

समजागरणस्वप्नं नित्यं क्षीरघृताशिनम्||३२||

देशकालप्रमाणज्ञं युक्तिज्ञमनहङ्कृतम्|

शस्ताचारमसङ्कीर्णमध्यात्मप्रवणेन्द्रियम्||३३||

उपासितारं वृद्धानामास्तिकानां जितात्मनाम्|

धर्मशास्त्रपरं विद्यान्नरं नित्यरसायनम्||३४||

गुणैरेतैः समुदितैः प्रयुङ्क्ते यो रसायनम्|

रसायनगुणान् सर्वान् यथोक्तान् स समश्नुते||३५||

(इत्याचाररसायनम्)|

satyavādinamakrōdhaṁ nivr̥ttaṁ madyamaithunāt|

ahiṁsakamanāyāsaṁ praśāntaṁ priyavādinam||30||

japaśaucaparaṁ dhīraṁ dānanityaṁ tapasvinam|

dēvagōbrāhmaṇācāryaguruvr̥ddhārcanē ratam||31||

ānr̥śaṁsyaparaṁ nityaṁ nityaṁ karuṇavēdinam |

samajāgaraṇasvapnaṁ nityaṁ kṣīraghr̥tāśinam||32||

dēśakālapramāṇajñaṁ yuktijñamanahaṅkr̥tam|

śastācāramasaṅkīrṇamadhyātmapravaṇēndriyam||33||

upāsitāraṁ vr̥ddhānāmāstikānāṁ jitātmanām|

dharmaśāstraparaṁ vidyānnaraṁ nityarasāyanam||34||

guṇairētaiḥ samuditaiḥ prayuṅktē yō rasāyanam|

rasāyanaguṇān sarvān yathōktān sa samaśnutē||35||

(ityācārarasāyanam)|

satyavAdinamakrodhaM nivRuttaM madyamaithunAt|

ahiMsakamanAyAsaM prashAntaM priyavAdinam||30||

japashaucaparaM dhIraM dAnanityaM tapasvinam|

devagobrAhmaNAcAryaguruvRuddhArcane ratam||31||

AnRushaMsyaparaM nityaM nityaM karuNavedinam [1] |

samajAgaraNasvapnaM nityaM kShIraghRutAshinam||32||

deshakAlapramANaj~jaM yuktij~jamanaha~gkRutam|

shastAcAramasa~gkIrNamadhyAtmapravaNendriyam||33||

upAsitAraM vRuddhAnAmAstikAnAM jitAtmanAm|

dharmashAstraparaM vidyAnnaraM nityarasAyanam||34||

guNairetaiH samuditaiH prayu~gkte yo rasAyanam|

rasAyanaguNAn sarvAn yathoktAn sa samashnute||35||

(ityAcArarasAyanam)|

An individual who is truthful, free from anger, abstaining from wine and women, non violent, relaxed, calm, soft spoken, engaged in meditation and cleanliness, perseverance, observing charity, penance, worshiping gods, cow, ''brahmanas'', gurus, preceptors and elders, loving and compassionate, is vigilant and sleeps in balanced way, consumes routinely ghee extracted from milk, considering the measure of place and time with propriety, un-conceited, well behaved, simple, with his senses well concentrated to spirituality, keeping company of elders, positivist, self restrained and devoted to holy books should be regarded as using the ''rasayana'' for ever. Those, who, endowed with all the auspicious qualities, consumes ''rasayana'', gets all the aforesaid benefits of ''rasayana'' treatment. [30-35]

यथास्थूलमनिर्वाह्य दोषाञ्छारीरमानसान्|

रसायनगुणैर्जन्तुर्युज्यते न कदाचन||३६||

योगा ह्यायुःप्रकर्षार्था जरारोगनिबर्हणाः|

मनःशरीरशुद्धानां सिध्यन्ति प्रयतात्मनाम्||३७||

तदेतन्न भवेद्वाच्यं सर्वमेव हतात्मसु|

अरुजेभ्योऽद्विजातिभ्यः शुश्रूषा येषु नास्ति च||३८||

yathāsthūlamanirvāhyadōṣāñchārīramānasān|

rasāyanaguṇairjanturyujyatē na kadācana||36||

yōgā hyāyuḥprakarṣārthā jarārōganibarhaṇāḥ|

manaḥśarīraśuddhānāṁ sidhyanti prayatātmanām||37||

tadētanna bhavēdvācyaṁ sarvamēva hatātmasu|

arujēbhyō'dvijātibhyaḥ śuśrūṣā yēṣu nāsti ca||38||

yathAsthUlamanirvAhya doShA~jchArIramAnasAn|

rasAyanaguNairjanturyujyate na kadAcana||36||

yogA hyAyuHprakarShArthA jarAroganibarhaNAH|

manaHsharIrashuddhAnAM sidhyanti prayatAtmanAm||37||

tadetanna bhavedvAcyaM sarvameva hatAtmasu|

arujebhyo~advijAtibhyaH [1] shushrUShA yeShu nAsti ca||38||

An individual can never get the benefits of ''rasayana'' if he has not undergone grossly the process of ''samsodhana'' of his physical as well as mental impurities. The treatment meant for providing longevity and for relieving senility and disease succeed in persons having purified mind and body controlled self. Such a treatment should not be prescribed to those who have degenerate self, are disease free, are not twice born and who are reluctant to receive such a treatment. [36-38]

ये रसायनसंयोगा वृष्ययोगाश्च ये मताः|

यच्चौषधं विकाराणां सर्वं तद्वैद्यसंश्रयम्||३९||

प्राणाचार्यं बुधस्तस्माद्धीमन्तं वेदपारगम्|

अश्विनाविव देवेन्द्रः पूजयेदतिशक्तितः||४०||

अश्विनौ देवभिषजौ यज्ञवाहाविति स्मृतौ|

यज्ञस्य हि शिरश्छिन्नं पुनस्ताभ्यां समाहितम्||४१||

प्रशीर्णा दशनाः पूष्णो नेत्रे नष्टे भगस्य च|

वज्रिणश्च भुजस्तम्भस्ताभ्यामेव चिकित्सितः||४२||

चिकित्सितश्च शीतांशुर्गृहीतो राजयक्ष्मणा|

सोमाभिपतितश्चन्द्रः कृतस्ताभ्यां पुनः सुखी||४३||

भार्गवश्च्यवनः कामी वृद्धः सन् विकृतिं गतः|

वीतवर्णस्वरोपेतः कृतस्ताभ्यां पुनर्युवा||४४||

एतैश्चान्यैश्च बहुभिः कर्मभिर्भिषगुत्तमौ|

बभूवतुर्भृशं पूज्याविन्द्रादीनांमहात्मनाम्||४५||

ग्रहाः स्तोत्राणि मन्त्राणि तथा नानाहवींषि च|

धूम्राश्च पशवस्ताभ्यां प्रकल्प्यन्ते द्विजातिभिः||४६||

प्रातश्च सवने सोमं शक्रोऽश्विभ्यां सहाश्नुते|

सौत्रामण्यां च भगवानश्विभ्यां सह मोदते||४७||

इन्द्राग्नी चाश्विनौ चैव स्तूयन्ते प्रायशो द्विजैः|

स्तूयन्ते वेदवाक्येषु न तथाऽन्या हि देवताः||४८||

अजरैरमरैस्तावद्विबुधैः साधिपैर्ध्रुवैः|

पूज्येते प्रयतैरेवमश्विनौभिषजाविति||४९||

मृत्युव्याधिजरावश्यैर्दुःखप्रायैः सुखार्थिभिः|

किं पुनर्भिषजो मर्त्यैः पूज्याः स्युर्नातिशक्तितः||५०||

शीलवान्मतिमान् युक्तो द्विजातिः शास्त्रपारगः|

प्राणिभिर्गुरुवत् पूज्यः प्राणाचार्यः स हि स्मृतः||५१||

yē rasāyanasaṁyōgā vr̥ṣyayōgāśca yē matāḥ|

yaccauṣadhaṁ vikārāṇāṁ sarvaṁ tadvaidyasaṁśrayam||39||

prāṇācāryaṁ budhastasmāddhīmantaṁ vēdapāragam|

aśvināviva dēvēndraḥ pūjayēdatiśaktitaḥ||40||

aśvinau dēvabhiṣajau yajñavāhāviti smr̥tau|

yajñasya hi śiraśchinnaṁ punastābhyāṁ samāhitam||41||

praśīrṇā daśanāḥ pūṣṇō nētrē naṣṭē bhagasya ca|

vajriṇaśca bhujastambhastābhyāmēva cikitsitaḥ||42||

cikitsitaśca śītāṁśurgr̥hītō rājayakṣmaṇā|

sōmābhipatitaścandraḥ kr̥tastābhyāṁ punaḥ sukhī||43||

bhārgavaścyavanaḥ kāmī vr̥ddhaḥ san vikr̥tiṁ gataḥ|

vītavarṇasvarōpētaḥ kr̥tastābhyāṁ punaryuvā||44||

ētaiścānyaiśca bahubhiḥ karmabhirbhiṣaguttamau|

babhūvaturbhr̥śaṁ pūjyāvindrādīnāṁ mahātmanām||45||

grahāḥ stōtrāṇi mantrāṇi tathā nānāhavīṁṣi ca|

dhūmrāśca paśavastābhyāṁ prakalpyantē dvijātibhiḥ||46||

prātaśca savanē sōmaṁ śakrō'śvibhyāṁ sahāśnutē|

sautrāmaṇyāṁ ca bhagavānaśvibhyāṁ saha mōdatē||47||

indrāgnī cāśvinau caiva stūyantē prāyaśō dvijaiḥ|

stūyantē vēdavākyēṣu na tathā'nyā hi dēvatāḥ||48||

ajarairamaraistāvadvibudhaiḥ sādhipairdhruvaiḥ|

pūjyētē prayatairēvamaśvinau bhiṣajāviti||49||

mr̥tyuvyādhijarāvaśyairduḥkhaprāyaiḥ sukhārthibhiḥ|

kiṁ punarbhiṣajō martyaiḥ pūjyāḥ syurnātiśaktitaḥ||50||

śīlavānmatimān yuktō dvijātiḥ śāstrapāragaḥ|

prāṇibhirguruvat pūjyaḥ prāṇācāryaḥ sa hi smr̥taḥ||51||

ye rasAyanasaMyogA vRuShyayogAshca ye matAH|

yaccauShadhaM vikArANAM sarvaM tadvaidyasaMshrayam||39||

prANAcAryaM budhastasmAddhImantaM vedapAragam|

ashvinAviva devendraH pUjayedatishaktitaH||40||

ashvinau devabhiShajau yaj~javAhAviti smRutau|

yaj~jasya hi shirashchinnaM punastAbhyAM samAhitam||41||

prashIrNA dashanAH pUShNo netre naShTe bhagasya ca|

vajriNashca bhujastambhastAbhyAmeva cikitsitaH||42||

cikitsitashca shItAMshurgRuhIto rAjayakShmaNA|

somAbhipatitashcandraH kRutastAbhyAM punaH sukhI||43||

bhArgavashcyavanaH kAmI vRuddhaH san vikRutiM gataH|

vItavarNasvaropetaH kRutastAbhyAM punaryuvA||44||

etaishcAnyaishca bahubhiH karmabhirbhiShaguttamau|

babhUvaturbhRushaM pUjyAvindrAdInAM mahAtmanAm||45||

grahAH stotrANi mantrANi tathA [1] nAnAhavIMShi ca|

dhUmrAshca [2] pashavastAbhyAM prakalpyante dvijAtibhiH||46||

prAtashca savane somaM shakro~ashvibhyAM sahAshnute|

sautrAmaNyAM ca bhagavAnashvibhyAM saha modate||47||

indrAgnI cAshvinau caiva stUyante prAyasho dvijaiH|

stUyante vedavAkyeShu na tathA~anyA hi devatAH||48||

ajarairamaraistAvadvibudhaiH sAdhipairdhruvaiH|

pUjyete prayatairevamashvinau bhiShajAviti||49||

mRutyuvyAdhijarAvashyairduHkhaprAyaiH sukhArthibhiH|

kiM punarbhiShajo martyaiH pUjyAH syurnAtishaktitaH||50||

shIlavAnmatimAn yukto dvijAtiH [3] shAstrapAragaH|

prANibhirguruvat pUjyaH prANAcAryaH sa hi smRutaH||51||

The ''rasayana'' preparations, ''vajikarana'' recipes and remedies designed for the treatment of diseases – all depend on (vision and skill of) the physician. Hence the wise should honour with all means the treating physician who promotes life, is wise and well versed in the science of life as the king of gods honours Ashwins.

Ashwins are the physicians of gods and carriers of sacrifices. The head of sacrifice was cut which was joined by Ashwins. The fallen teeth of Pushan, destroyed eyes of Bhaga and the spastic arm of Vajrina were treated by them and thus he, addicted to ''soma'' drink, was again made happy. Chyavana, the descendent of Bhrigu, who was sexually indulged and became diseased, devoid of complexion and voice in old age, was reverted to youthful age. On account of these and other similar achievements, the two excellent physicians became highly adorable to the great selves like Indra, etc. and vessels, praises, recitations, various food preparations, incenses and animals are offered to them by the twins born. In the morning, Indra enjoys the ''soma'' drink in the company of Ashwins and he also makes pleasure along with them in the ''sautramani'' sacrifice. Indra, Agni and Ashwins were worshipped mostly by the twin born and are praised in the vedic hymns, not so the other gods. Thus the twin physicians Ashwins are worshipped by the gods and their masters. Then how should the physicians not be honored with all means by mortals who are affected by the death, diseases and senility and after the search of happiness? The physicians who is endowed with good conduct, wisdom and rationality, is thrice born, well versed in scriptures and master of life should be honored as preceptor by the people. [39-51]

विद्यासमाप्तौ भिषजो द्वितीया जातिरुच्यते|

अश्नुते वैद्यशब्दं हि न वैद्यः पूर्वजन्मना||५२||

विद्यासमाप्तौ ब्राह्मं वा सत्त्वमार्षमथापि वा|

ध्रुवमाविशति ज्ञानात्तस्माद्वैद्यो द्विजः स्मृतः||५३||

नाभिध्यायेन्न चाक्रोशेदहितं न समाचरेत्|

प्राणाचार्यं बुधः कश्चिदिच्छन्नायुरनित्वरम्||५४||

vidyāsamāptau bhiṣajō dvitīyā jātirucyatē|

aśnutē vaidyaśabdaṁ hi na vaidyaḥ pūrvajanmanā||52||

vidyāsamāptau brāhmaṁ vā sattvamārṣamathāpi vā|

dhruvamāviśati jñānāttasmādvaidyō dvijaḥ smr̥taḥ||53||

nābhidhyāyēnna cākrōśēdahitaṁ na samācarēt|

prāṇācāryaṁ budhaḥ kaścidicchannāyuranitvaram||54||

vidyAsamAptau bhiShajo [1] dvitIyA jAtirucyate|

ashnute vaidyashabdaM hi na vaidyaH pUrvajanmanA||52||

vidyAsamAptau brAhmaM vA sattvamArShamathApi vA|

dhruvamAvishati j~jAnAttasmAdvaidyo [2] dvijaH smRutaH||53||

nAbhidhyAyenna cAkroshedahitaM na samAcaret|

prANAcAryaM budhaH kashcidicchannAyuranitvaram||54||

After completing the course of training, it is the third birth of a physician because the physician does not carry the epithet ''vaidya'' from the previous birth. On completion of training, Brahma or Arsha psyche enters in to him certainly according to the knowledge. Hence the physician is known as the thrice born. The wise, desirous of stable life, should not backbite, re approach and harm the master of life. [52-54]

चिकित्सितस्तु संश्रुत्य योवाऽसंश्रुत्य मानवः|

नोपाकरोति वैद्याय नास्ति तस्येह निष्कृतिः||५५||

भिषगप्यातुरान् सर्वान् स्वसुतानिव यत्नवान्|

आबाधेभ्यो हि संरक्षेदिच्छन् धर्ममनुत्तमम्||५६||

धर्मार्थं चार्थकामार्थमायुर्वेदो महर्षिभिः|

प्रकाशितो धर्मपरैरिच्छद्भिः स्थानमक्षरम्||५७||

नार्थार्थं नापि कामार्थमथ भूतदयां प्रति|

वर्तते यश्चिकित्सायां स सर्वमतिवर्तते||५८||

कुर्वते ये तु वृत्त्यर्थं चिकित्सापण्यविक्रयम्|

ते हित्वाकाञ्चनं राशिं पांशुराशिमुपासते||५९||

दारुणैः कृष्यमाणानां गदैर्वैवस्वतक्षयम्|

छित्त्वा वैवस्वतान् पाशान् जीवितं यः प्रयच्छति||६०||

धर्मार्थदाता सदृशस्तस्य नेहोपलभ्यते|

न हि जीवितदानाद्धि दानमन्यद्विशिष्यते||६१||

परो भूतदया धर्म इति मत्वा चिकित्सया|

वर्तते यः स सिद्धार्थः सुखमत्यन्तमश्नुते||६२||

cikitsitastu saṁśrutya yōvā'saṁśrutya mānavaḥ|

nōpākarōti vaidyāya nāsti tasyēha niṣkr̥tiḥ||55||

bhiṣagapyāturān sarvān svasutāniva yatnavān|

ābādhēbhyō hi saṁrakṣēdicchan dharmamanuttamam||56||

dharmārthaṁ cārthakāmārthamāyurvēdō maharṣibhiḥ|

prakāśitō dharmaparairicchadbhiḥ sthānamakṣaram||57||

nārthārthaṁ nāpi kāmārthamatha bhūtadayāṁ prati|

vartatē yaścikitsāyāṁ sa sarvamativartatē||58||

kurvatē yē tu vr̥ttyarthaṁ cikitsāpaṇyavikrayam|

tē hitvā kāñcanaṁ rāśiṁ pāṁśurāśimupāsatē||59||

dāruṇaiḥ kr̥ṣyamāṇānāṁ gadairvaivasvatakṣayam|

chittvā vaivasvatān pāśān jīvitaṁ yaḥ prayacchati||60||

dharmārthadātā sadr̥śastasya nēhōpalabhyatē|

na hi jīvitadānāddhi dānamanyadviśiṣyatē||61||

parō bhūtadayā dharma iti matvā cikitsayā|

vartatē yaḥ sa siddhārthaḥ sukhamatyantamaśnutē||62||

cikitsitastu saMshrutya [1] yo vA~asaMshrutya mAnavaH|

nopAkaroti vaidyAya nAsti tasyeha niShkRutiH||55||

bhiShagapyAturAn sarvAn svasutAniva yatnavAn|

AbAdhebhyo hi saMrakShedicchan dharmamanuttamam||56||

dharmArthaM cArthakAmArthamAyurvedo [2] maharShibhiH|

prakAshito dharmaparairicchadbhiH sthAnamakSharam||57||

nArthArthaM nApi kAmArthamatha bhUtadayAM prati|

vartate yashcikitsAyAM sa sarvamativartate||58||

kurvate ye tu vRuttyarthaM cikitsApaNyavikrayam|

te hitvA kA~jcanaM rAshiM pAMshurAshimupAsate||59||

dAruNaiH kRuShyamANAnAM gadairvaivasvatakShayam|

chittvA vaivasvatAn pAshAn jIvitaM yaH prayacchati||60||

dharmArthadAtA sadRushastasya nehopalabhyate|

na hi jIvitadAnAddhi dAnamanyadvishiShyate||61||

paro bhUtadayA dharma iti matvA cikitsayA|

vartate yaH sa siddhArthaH sukhamatyantamashnute||62||

The treated patient, whether having promised or not, if does not offer any thing to the physician he is not freed. The physician too should consider all his patients as his own sons; protect them sincerely from all the ailments, wishing the excellent piety.

Ayurveda has been empowered by the great ''rishis'' devoted to piety and wishing immortality for welfare and not for earning or enjoyment. One who takes up the treatment only for human welfare and not for earning or self enjoyment supersedes all and those who sell the regimen of therapy for livelihood and devoted to the heap of dust leaving aside the store of gold. One who provides life to those being dragged to the abode of death by severe diseases while cutting the death nets cannot be simulated with any other donor of virtue and wealth because there is no charity better than providing life. The physician who is compassionate on living being as the highest virtue, proceeds in treatment of patients, achieves all objects and enjoy maximum happiness. [55-62]

===== Summary =====

तत्र श्लोकौ-

आयुर्वेदसमुत्थानं दिव्यौषधिविधिं शुभम्|

अमृताल्पान्तरगुणं सिद्धं रत्नरसायनम्||६३||

सिद्धेभ्यो ब्रह्मचारिभ्यो यदुवाचामरेश्वरः|

आयुर्वेदसमुत्थाने तत् सर्वं सम्प्रकाशितम्||६४||

tatra ślōkau-

āyurvēdasamutthānaṁ divyauṣadhividhiṁ śubham|

amr̥tālpāntaraguṇaṁ siddhaṁ ratnarasāyanam||63||

siddhēbhyō brahmacāribhyō yaduvācāmarēśvaraḥ|

āyurvēdasamutthānē tat sarvaṁ samprakāśitam||64||

tatra shlokau-

AyurvedasamutthAnaM divyauShadhividhiM shubham|

amRutAlpAntaraguNaM siddhaM ratnarasAyanam||63||

siddhebhyo brahmacAribhyo yaduvAcAmareshvaraH|

AyurvedasamutthAne tat sarvaM samprakAshitam||64||

Now the summing up verses –

The rising of the science of life, method of celestial ''rasayana'' drugs, ''ratnarasayana'' accomplished like nectar and delivered by the king of gods to the accomplished and intellectuals, all this has been explained in the quarter of the rising of the science of life. [63-64]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सितस्थाने रसायनाध्याये आयुर्वेदसमुत्थानीयो नामरसायनपादश्चतुर्थः||४||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsitasthānē rasāyanādhyāyē āyurvēdasamutthānīyō nāma rasāyanapādaścaturthaḥ||4||

ityagniveshakRute tantre carakapratisaMskRute cikitsitasthAne rasAyanAdhyAye AyurvedasamutthAnIyo nAma rasAyanapAdashcaturthaH||4||
samAptashcAyaM rasAyanAdhyAyaH||1||

Thus ends the fourth quarter on the rise of Ayurveda in the chapter of [[Rasayana]] in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charak.[4]

=== ''Tattva Vimarsha'' ===

#''Bheshaja'' (Therapeutics) is classified in two categories :
##that which sustains, promotes and enhances strength and immunity in the healthy,
##that which alleviates disorders. ( vesr 1.4)
#''Abheshaja'' (non-therapeutic agents) can is also of two types :
##''badhana'' (acutely acting),
##''sanubadhana'' (chronically acting).( verse 1.5)
#The objectives of Ayurveda healthcare management includes ''chikitsa'' (measures that alleviate disorders), ''vyadhihara'' (destroyer of diseases), ''pathya'' (beneficial for the bodily channels), ''sadhana'' (instrument for therapeutic action), ''aushadha'' (that which is prepared of herbs), ''prayashchitta'' (expiation), ''prashamana'' (pacification), ''prakritisthapana'' (that which helps and sustains recovery to normalcy), and ''hita'' (wholesome). (verse 3-4)
#The therapeutics for preservation of health include ''vrishya'' (aphrodisiac) and ''rasayana'' (promotives) that helps promoting strength and immunity.
#Objective of ''rasayana'' therapy is to attain longevity, memory, intelligence, freedom from illness, youthfulness, excellence of luster, complexion and voice, optimum strength of physique and sense organs, perfection in deliberation, respectability and brilliance. ''Rasayana'' is the means of attaining excellent qualities of ''rasa'' etc. ''dhatus'' i.e. bodily cells and tissues. (verse 7-8)
#Objective of ''vajikarana'' (aphrodisiac treatment) is to produce healthy progeny, and enhance libido with satisfactory sexual life. It can even help to arrest genetic disorders.
#Indoor residence of person in specific ''kutipraveshika'' method endows extraordinary benefits.
#''Rasayana'' may be in the form of specific single drugs or compound preparations of drugs, in the form of specific diet, specific regimen and activities or in the form of a specific good conduct.
#''Vajikarana'' improves the quality of ''shukra'' and thereby improves ''oja''. ''Shukra'' is not just semen but its effects can be observed allover body and on mind, in the form of genesis of new ''dhatu'' (important body constituents) , promoting proper growth and development of existing ''dhatu'', by helping to maintain mental health etc. as described in [[Vajikarana]], the second chapter of [[Chikitsa Sthana]].
#By adopting proper lifestyle and by using appropriate ''rasayana'', it is not only possible to regain freedom from diseases, but it is also possible to maintain and even positively promote health. For this, ''rasayana'' is very much important in the present era.
#Prior body purification is necessary before administration of ''rasayana'' treatment.

=== ''Vidhi Vimarsha'' ===

==== The order of sections ====

The order in which various ''sthana'' (sections) of [[Charak Samhita]] are arranged is also significant. [[Chikitsa Sthana]] is placed after [[Indriya Sthana]]. [[Indriya Sthana]] describes the signs and symptoms which indicate certain death of a person. The treatment in such conditions results in failure. Therefore, it must be avoided. The treatment in such conditions should be continued with proper knowledge and also with due consent. After describing limitations of treatment in [[Indriya Sthana]], [[Chikitsa Sthana]] describes successful treatment of rest of conditions.

==== Different levels of treatment ====

According to Ayurveda, the life is conglomeration of four factors namely ''shareera'' (the body made up of five ''mahabhootas''), ''indriya'' (the sensory faculty), ''sattva'' or ''mana'' (mind) and ''atma'' (the soul). On this basis, disease is also studied at different levels. Therefore, the treatment also is performed at different levels. After initial treatment for relief, Ayurveda describes ''prayoga'' (long term treatment for complete cure) and ''apunarbhava chikitsa'' (treatment which prevents recurrence of the disease) to maintain and promote health, ''rasayana'' is given.

==== Various aspects of ''Chikitsa'' (treatment) ====

At the beginning of the chapter, various aspects of treatment are explained by using various synonyms. ''Chikitsita'' are means for curing disease. ''Pathya'' means specific wholesome diet and regimens which will help to cure disease, it also means that which maintains normalcy of ''srotas'' (channels for transportation and transformation of nutrients in the destined body constituent). ''Sadhana'' means various instruments and procedures helpful for successful treatment. ''Aushadha'' are medicines obtained from herbs. ''Prayashchitta'' means the redressal for diseases originating from previous deeds of the person. ''Prashamana'' is that which leads to complete cure. ''Prakriti'' (specific constitution of a person) makes him prone for certain diseases. ''Prakritisthapana'' helps to protect a person from them by maintaining balance of all three ''doshas''. ''Hita'' is that which helps to make ''dhatus'' stable and protect them from diseases. (verse 3)

==== Benefits of ''Rasayana'' ====

''Rasayana'' produces best quality of ''dhatus'' (body tissues). Various benefits of using ''rasayana'' include long and healthy life, maintenance of youth and prevention of ageing, great ''bala'' (a broad term, which includes physical, mental strength and immunity) are obtained by ''rasayana''. Excellence of luster, complexion of skin and beauty, excellence of voice, enhanced capacity of senses, power of memory and intelligence are obtained.

''Vak Siddhi'' is a power by which whatever the person speaks, becomes true. ''Pranati'' is reverence from people. By use of ''rasayana'', the person gets physical strength, mental abilities and power of intellect and memory. So, whatever the person speaks, he has the capacity to practically act accordingly. Also, he speaks only the truth. So, his words come true. Because of such good qualities, he gets reverence from people. (verse 7,8)

==== Benefits of ''Vajikarana'' (verse 9-12) ====

#''Apatyasantanakara''- Not only the person using vajeekarana will have progeny, but even his further generations also won’t have infertility, so effects of vajeekarana are capable of making genetic changes
#''Sadya Sampraharshana''- produces erection instantly
#Develops sexual potency (like a horse, horse being symbol of best qualities of semen and sexual potency)
#Capacity for sexual act uninterruptedly
#Enhances beauty, personality and capacity to attract opposite sex
#Nourishes the body
#Even after indulging in sexual activities, ''shukra'' is still properly produced
#Not only quantitative increase, qualities of ''shukra'' improve, fertility is produced
#Like banyan tree, gets surrounded by good progeny
#Earns respect and honour in society
#Gets all the joy from the children in this world
#Gets as if immortality, because next generations carry on his good works
#Success, wealth and prosperity, strength, robustness

==== Two modes of administration of ''rasayana'' (verse 1.1.16) ====

''Rasayana'' can be used by two methods:

#''Kuti praveshika''- The person stays in a ''kuti'' (specially built house) for a specific period and uses ''rasayana''.
#''Vatatapika''- The person continues with his routine activities, while using ''rasayana''.

==== Construction of a ''Kuti'' (hut) (verse 1.1.16-20) ====

===== The place =====

''Kuti'' is built at a place near city or town, i.e. in civilised place, near the place of king or government officials for legal issues, permissions, near place of ''vaidyas'' (physicians) for advice of other senior ''vaidyas'' whenever required, where advice of experts in other fields of knowledge is available, place of well cultured gentlemen , decent place with social security, with availability of necessary instruments, equipment and amenities, located in east or north, for proper light and ventilation, selected as per the ''bhoomi pareeksha'' ( selection of good land) as described in [[Madanakalpa Adhyaya]].

=====Structure and design =====

Structure and design is decided by experts in that field, but the specific requirements are mentioned in this chapter, such as: with proper height ,width, with three concentric courts, having small windows on height, having thick walls, comfortable for all seasons, spacious, with proper lighting, pleasant for stay, protected from sound pollution ,other forms of pollution and unwanted sounds, smells etc., where celibacy can be maintained, equipped with necessary instruments, equipment and amenities, having on duty ''vaidyas'', consulting ''vaidyas'' and consultants in other fields. The following pictures can give an idea regarding this:
[[File:rasayana structure.jpg|500px]]

[[File:rasayana structure 2.png|500px]]

==== Entering the ''Kuti'' ====

The specific way of entering the kuti is described in the text. Not only by using specific purificatory methods, the body pf the person is prepared for the effects of ''rasayana'', but he is also prepared mentally. The person gets extraordinary qualities due to ''rasayana''. But he may use them only for his personal benefits and may harm others in the society. For this he is convinced to use his qualities for the benefit of the whole society. He also resolves to properly complete the procedure, since ceasing of the procedure midway may be harmful for health.

==== Quality control in selection of medicines (verse 1.1. 38-40) ====

#''Bhoomi pariksha'' (criteria to select good land for collection of medicines) as described in [[Madanakalpa Adhyaya]] verse 9, should be followed.
#Especially ''haritaki'' (Terminalia chebula) and ''amalaki'' ( Emblica officinalis) used as ''rasayana'' in this chapter are preferably collected from the range of mountain Himalaya.
#The medicines developed at proper season as per their natural life cycle are collected,
#The medicines which are fully grown, developed are collected.
#Medicines with optimum qualities like ''rasa, veerya'' etc. are selected.
#Medicines are collected from plants, which are properly exposed (not under or over exposed) to natural factors like sunlight, wind, rains etc. are selected.
#Not pecked at by birds etc., unspoiled and unmarked with cuts or diseases.
#Free from toxicity

==== ''Abhayamalakeeya Pada'' ====

This part of the chapter deals with ''rasayana'' prepared from ''haritaki'' (Terminalia chebula) and ''amalaki'' (Emblica officinalis) as the name suggests. These are the first two ''rasayana'' mentioned in this chapter denoting their importance.

==== ''Haritaki Rasayana'' (verse 1.1.29-32) ====

''Haritaki'' pacifies ''kapha'' and ''pitta''. It performs ''anulomana'' of ''vata'' i.e. helps to maintain normal movements of ''vata''. It moves out the accumulated ''dosha'' and ''mala'', thus helps to maintain patency and proper functions of ''srotas''. It also activates ''dhatvagni''. Although ''haritaki'' is not directly providing nourishment to ''dhatus'' (body tissues), but due to to proper function of ''srotas'', removes obstructions and helps the nutrients to reach to the ''dhatus''. Also by activating ''dhatvagni'', it helps in proper conversion of nutrients into ''dhatus''. Because of these actions, ''haritaki'' is very important ''rasayana''.

==== ''Amalaki Rasayana'' (verse 1.1.36-37) ====

Most of the qualities and actions of ''amalaki'' are similar to ''haritaki''. But ''amalaki'' is ''sheeta veerya'', whereas ''haritaki'' is ''ushna veerya''.

==== ''Rasayana'' in the first ''Pada'' ====

The first part of this chapter mentions six ''rasayana'', including ''Brahma Rasayana, Chyavanaprasha, Amalaka Rasayana, and Haritaki Rasayana'' (a combination of both ''haritaki'' and ''amalaki''). The contents and procedures for preparation of each of these ''rasayana'' is mentioned in the text. Commentator Gangadhara has given further details about steps in actual preparation. Apart from the commonly described benefits of ''rasayana'', at the beginning of the chapter, each ''rasayana'' has got certain specific benefits. A ''vaidya'' selects a ''rasayana'' for a person considering mode of action of ''rasayana'', based on qualities and actions, and based on specific benefits of that ''rasayana''.

===== ''Brahma Rasayana'' =====
This ''rasayana'' is prepared with thousand ''haritaki'' fruits and three thousand ''amalaki'' fruits, with 25 other medicines used for ''kvatha'' (decoction) and 14 other medicines used for ''kalka'' (in the form of paste). Specially this ''rasayana'', apart from general benefits of ''rasayana'', is described as useful for removing ''tandra'' (drowsiness), ''klama'' ( lassitude), ''shvasa'' (dyspnea). It also boosts intelligence and memory. These benefits of this ''rasayana'', are because it ignites ''agni'', performs digestion of ama, therefore improves the quality of rasa. Also since it eliminates accumulated malas from the body and performs pachana of ama, ''srotas'' become clear and patent. Thus, ''tamoguna'' is reduced and ''sattva guna'' increases.

While the second brahma ''rasayana'' is prepared with a thousand ''amalaki'' fruits triturated in the juice of a thousand ''amalaki'' fruits. With addition of 23 other medicines and ''bhasma'' (specific form which can be absorbed and assimilated in the body) of gold, silver, copper, praval and iron. Because of such ingredients, it specifically provides great physical strength, and also power of ''indriya'' (sensory faculty) is enhanced. Also the body develops the capacity to counteract the effects of poisons.

===== ''Chyavanaprasha Rasayana'' =====

''Chyanaprasha'' is prepared from the pulp of 500 ''amalaki'' fruits, with addition of 36 other medicines used for ''kvatha'' (decoction) and fine powders of four other medicines added at the end. It is specifically useful for maintaining youth and vigor. It helps to build body tissues in children, old and emaciated persons. Ignites ''agni'' and Improves beauty. Also useful in disorders of voice, diseases of chest, heart diseases, and disorders of urinary tract and genital organs.

==== Diseases from changing lifestyle and importance of ''rasayana'' ====

The second quarter starts with description of changing lifestyle and the resultant disorders. It is described that with their healthy lifestyle the ancient sages were free from diseases. But diseases originated due to urbanization and thereby changing lifestyle.

This description is even more important in present era, because many of the dietary articles and the activities mentioned here have become common now like more consumption of salt, sour and pungent items, sprouted grains, dried vegetables and meat, sleeping in day time, irregular timings of meals, irregular improper and excessive exercises and physical activities, using unhealthy combinations like milk with salty and sour items, or milk with fruits, continuously affected by anger, grief, greed fear like mental states etc. This results in diseases with laxity in muscles, muscular dystrophies etc., diseases of bone marrow, joint disorders, impotency and infertility and so on.

It is described that by following proper healthy lifestyle and by the use of ''rasayana'', one can get freedom from such diseases. Therefore, thorough study and application of ''rasayana'' is needed in the present era.

==== ''Rasayana'' in the second ''pada'' ====

In the second quarter 37 ''rasayana'' have been described. The name ''pranakameeya'' suggests desire or quest for living i.e. desire for longevity. For this purpose, ''rasayana'' prepared mainly from ''amalaki'' are described.

===== ''Nagabala Rasayana'' =====

As the name suggests provides strength and stability to body tissues. The same method of using ''nagabala'' as ''rasayana'' described here is applicable for using 10 other ''rasayana'' enlisted from ''bala'' to ''punarnava''.

===== ''Bhallataka Rasayana'' =====

This is extremely ''ushna-teekshna'' due to which it is used in ''kapha'' dominant conditions, or where ''kapha'' obstructs movements of ''vata''. Also, to remove obstruction in ''srotas'' and facilitate conduction and conversions going on in ''srotas''. ''Bhallataka'' is also excellent ''rasayana'' for igniting functions of ''agni''. It also increases intelligence, as it removes ''tamoguna'' (which is responsible for inhibition). 10 specific formulations of ''bhallataka'' are described, which can be used as ''rasayana'' .

Although ''bhallataka'' is very potent, it can result in unwanted effects, when improperly used. Therefore, the precautions to be taken while using it, are mentioned in the text.

==== ''Rasayana'' in the third ''pada'' ====

The third quarter is named as ''Karaprachitiya'' because the first ''rasayana'' mentioned here is prepared from ''amalaki'' fruits plucked by hands. In all 16 ''rasayana'' are described. Apart from ''rasayanas'' prepared from ''amalaki'', there is ''lauhadi rasayana''. Special benefits of this ''rasayana'' include increased physical strength, enhanced capacity of ''indriya'' (senses), body becomes capable of sustaining injuries and wounds heal quickly. This is because ''loha'' (iron) provides ''bala'' (strength) to ''rakta''. Also ''loha'' being dominated by ''Prithvi Mahabhuta'', provides strength to ''parthiva'' body constituents like ''asthi'' ( ~ osseous tissue) .

===== ''Medhya Rasayana'' =====

These four ''rasayana'' enhance intelligence. ''Yashtimadhu'' is ''sheeta'', pacifies ''vata-pitta'' and maintains normal ''kapha''. It controls ''rajoguna'' and increases ''sattva'', resulting in boosting intelligence. ''Yashtimadhu'' also nourishes ''dhatus'' and ultimately increases ''shukra'' and ''oja''. As explained by commentator Chakrapani, effects on ''indriya, mana'' and ''buddhi'' are mediated through ''oja''. ''Mandukaparni'' is ''sheeta'' and it specially pacifies ''pitta''. It also controls ''rajoguna'' and increases ''sattva''. ''Shankhapushpi'' is slightly ''ushna'', specially pacifies ''vata''. ''Shankhapushpi'' also controls ''rajoguna'' and increases ''sattva''. ''Shankhapushpi'' nourishes ''majja''. Whereas ''guduchi'' is also slightly ''ushna'', pacifies all three ''doshas'', controls tama and increases ''sattva''. Keeping in mind such peculiarities, specific ''rasayana'' is chosen for a specific person. Many researches have been conducted on these ''medhya rasayana''.<ref>Ray S, Ray A (2015) Medhya Rasayanas in Brain Function and Disease. Med chem 5:505-511. doi: 10.4172/2161-0444.1000309</ref>

===== ''Triphala Rasayana'' =====

''Triphala'' a combination of ''haritaki, amalaki'' and ''bibhitaka'' is one of the most important medicines in Ayurveda. Its an important ''rasayana'' also. ''Triphala'' mainly pacifies ''kapha'' and ''pitta''. By removing obstruction to its movements, it helps to maintain proper actions of ''vata''. It improves the functions of ''dhatvagni'' to digests ''ama'' and eliminates abnormally accumulated ''mala'' and ''doshas'', therefore makes the ''srotas'' clear and patent to enable nutrients to reach ''dhatus''. It also controls ''meda'' which helps to maintain balance in all the ''dhatus'', because abnormally increased ''meda'' blocks nutrition of other ''dhatus'' and produces imbalance.

===== ''Shilajatu'' =====

Being ''katu-tikta'' and ''ushna'', ''shilajatu'' pacifies ''kapha''. It also helps in digestion of ''ama''. Therefore, removes obstruction and helps normal movements of ''vata''. It controls formation of ''meda''. Abnormal ''meda'' blocks nutrition of other ''dhatus''. ''Shilajatu'', by controlling formation of ''meda'', regulates genesis of all the ''dhatus''. In the conditions originating from ''ati santarpana'', i.e. when ''dhatus'' are provided excessive nourishment, but proper transformation of these nutrients in the ''dhatus'' is not done, ''shilajatu'' is very effective. But in the conditions due to ''ati apatarpana'' i.e. when proper nourishment is not available for the genesis of ''dhatus, shiljatu'' is not the ''rasayana'' of choice.

The fourth quarter describes mainly two types of ''rasayana'' told by Indra and about ''soma'' as ''rasayana''.

==== ''Achara Rasayana'' (rasayana effects of good conduct) ====

Another important aspect of the fourth quarter is ''achara rasayana''. Good conduct like speaking truth, non violence, compassion etc. is considered very much important to obtain benefits of any ''rasayana'' described here.

==== ''Vaidya'' ====

For experts of Ayurveda, the term ''vaidya'' is used, which means one having proper knowledge. A ''vaidya'' may be of any cast, race etc. by birth, it doesn’t matter. Because it is said, that when he completes his education in Ayurveda, he is as if reborn. He is like guardian of life. Therefore, deserves respect from the society.

A ''vaidya'' has to care for the patients as if they were his children or family members. A ''vaidya'', by practicing with compassion towards the ailing, earns much more than wealth. Therefore, a ''vaidya'' should not consider treatment as a business. This advice of [[Charak Samhita]] holds true even today. Those who serve patients with this attitude, get such benefits from the society, which no other profession can get, and unmatched as compared to wealth.

===Contemporary researches===

Clinical trials on Rasayana have shown that Ashwagandha (Withania somnifera), Guduchi (Tinospora cordifolia) and Pippali (Piper longum) are effective in the treatment of allergic disorders such as eczema, urticaria, allergic rhinitis, and bronchial asthma; autoimmune disorders such as rheumatoid arthritis or cancer or pulmonary tuberculosis. It provide better and faster relief, prevent recurrences and also improve quality of life.Furthermore, Medhya Rasayana drugs are found effective in stress-induced conditions such as anxiety and insomnia or neurodegenerative conditions such as Parkinson's disease, Alzheimer's disease, and senile dementia. The findings of all these studies indicate that Rasayana has a definite role to play in the maintenance and preservation of health, and appropriate use of Rasayana can help to bring down the prevalence of many diseases, ultimately reducing health-care burden.<ref>Goyal M. Rasayana in perspective of the present scenario. AYU [serial online] 2018 [cited 2019 Feb 19];39:63-4. Available from: http://www.ayujournal.org/text.asp?2018/39/2/63/250779</ref>

=== Potential areas for future research ===

#''Rasayana Tantra'' is one of the Eight important branches of ''Astanga Ayurveda''. It deals with an important category of medicinal and non-medicinal rejuvenative remedies advocated for promotive and preventive health care including retarding aging and promoting longevity. These remedies are claimed to improve the quality of cells and tissues (even the genes) of the body through following mechanisms:
##Direct nutrient effects, acting at the level of ''rasa''
##Digestive and metabolic booster effect, acting at the level of ''agni''
##Promoting micro circulation and tissue perfusion, at the level of ''srotas''
There is a need to develop an appropriate research methodology of assessment of the effect of ''rasayana'' remedies on the above mentioned three levels.
#Clinical assessment of the effect of ''rasayana'' drugs and formulations described by Charak using appropriate biological and therapeutic parameters on clinical trial mode with emphasis on the nutritional effect, anti-aging effect and adaptogenic and immunomodulating effect of this important category of Ayurvedic drugs.
#Architectural study of the concept of ''trigarbha rasayana, kuti'' described in [[Charak Samhita]] and to examine the science behind this model for future use if found logical and scientific and for further development.
#Attempt to develop a new discipline of Ayurveda geriatrics and immunology through the ''rasayana'' leads available in the ''rasayana'' chapter of [[Charak Samhita]].

=== Glossary ===

#Bhesaja - Good medications
#Abhesaja – Harmful medications
#Rasayana - Rejuvenative remedies
#Bajikarana – Aphrodigiac and virilizing remedies
#Kayakapla - Rejuvenation
#Samsodhana - Biopurification
#Kamya rasayana – Health promoting rasayanas to be used in normal persons
#Naimittika rasayana - Disease specific Rasayana
#Pranakamiya rasayana- Longevity promoting Rasayana
#Srikamiya rasayana- Rasayanas promoting beauty and lusture of the body
#Medhakamiya rasayan - The Rasayanas promoting Intelligence and cognition.
#Medhya rasayana – Neuronutrient Rasayanas
#Kutipravesika Rasayana - Indoor Intensive Rasayan therapy procedure
#Vatatapika rasayana – Outdoor practice of Rasayana therapy.
#Trigarbha Rasayan kuti - Specially designed therapy chamber for Rasayana
#Chyavanprasha – A classical compound Rasayan formulated for Cyavana Risi
#Brahma rasayana – A special Compound Rasayana similar to Cyavanprasa
#Amalake rasayana – A Rasayana preparation made of Amalaki fruits.
#Bhallataka rasayana - Special Rasayana made of Bhallataka fruits
#Pippali Vardhamana rasayan – Use of Pippali in a vardhaman karma

=== Acknowledgement ===
The English translation presented in this chapter has been abridged from English translation of Caraka Samhita by late Prof. Priyavrata Sharma.

=== Research bibliography ===

#Archana, R. and Namshivayam, A. Antistress effect of Withania somnifera Dunal, J.Ethnopharmacology. 64:91-93, 1999
#Caraka Samhita redaction by Caraka based on Agnivesa Tantra of 700BC .Cikitsa sthana chapter 1,Pada 1-4. Edited by Sharma, PV, Choukhaba Orientalia, Varanasi , India 2002
#Caraka Samhita redaction by Caraka based on Agnivesa tantra of 700BC, Sutra sthana chapters -1 Edited by Sharma PV, Choukhamba Orientalia, Varanasi,India 2002
#Diana I Lurie, Ayurveda and Pharmacogenomics, Guest Editorial Annals of Ayurvedic Medicine ¼:126-128. 2012
#Dwivedi,KK and Singh,RH. A study on the psychiatric symptomsin in geriatric patients and response of Ayurvedic Rasayana therapy. Ph.D. thesis, Kayacikitsa, BHU1997.
#Ghodke, Y., Joshi, K and Patwardhan, B. Traditional medicine to modern pharmacogenomics Ayurveda Prakriti types and CYP2C19 Gene polymorphism associated with the metabolic variability. Evidence based Complementary Alternative Medicine, P 249528, 2011
#Juyal, RC et al. Potential of Ayurgenomics approach in complex trait research: leads from a pilot study on Rheumatoid arthritis. PLoSONE.2012,7/9;Pc45752
#Jayprakash et al. Neuroprotective role of Withania somnifera root extract in mouse model of Parkinsonism. Neurochem. Res.Feb.27,2013
#Kobayama,T.et al Neuritic regeneration and synoptic reconstruction induced by Withanolide-A . British J.Pharmacol.144/7:961-971,2005
#Madhava Kara 900 AD Mdhava Nidana, edited by Upadhyaya, YN Choukhamba publication, Varanasi/Delhi, India
#Mahalle, NP et al Association of constitutional types of Ayurveda with cardiovascular risk factors, inflammatory markers and Insulin resistance. J. Ayurveda and Integrative Medicine.2012,3/3.p,157-7
#Rastogi, S, Chiappelli, F. and Singh, RH. Evidence based practice of complementary alternative medicine. Special monograph pp 1-250 Springer publication, Germany 2012
#Rizzo-Sierra, CV. Ayurvedic genomics, constitutional psychology and endocrinology: The missing connection. J. Alternat.Complement.Med.2011, 17(5) :pp 465-8.
#Sarangdhara 1300AD Sarandhara samhita Choukhamba publications Varanasi/Delhi, India
#Sharma, PV. History of Medicine in India. Published by Indian National Science Academy, New Delhi, India, 1992
#Singh, RH , Integrative Medicine, Choukhamba surbharati publications Varanasi/Delhi, India 2009
#Singh, RH and associates. Advances in Ayurvedic medicine, Research monographs in Five volumes. Choukhamba Vishwa Bharati, Varanasi,.India,2005
#Singh, RH and Rastogi, S. Rasayana Therapy and Rejuvenation. In Evidence based practice of CAM, PP 177-190. Springer, Germany. 2012
#Singh, RH The science behind the concept of Ojas,Ojabala and Vyadhiksamattva. Editorial in Abhinava Dhanvantari vol.1,NO.I PP 17-20, 2014
#Singh, RH, Kayachikitsa vol.I-II, Pubishers Choukhamba surbharati prakashan, Varanasi/Delhi 2005
#Singh, RH, Narsimhamurthy, K.and Singh, Girish. Neuronutrient impact of Ayurvedic Rasayan therapy in brain aging, Biogerontology 2008, 9:360-374,
#Singh, RH. Basic Tenets of Ayurvedic Dietetics and Nutrition. In special monograph Ayurvedic Food science. Pub. Springer USA, 2014.
#Singh, RH. Ayurvediya Samsodhana Chikitsa ,the newer dimensions. Journal of Wiswa Ayurveda Parisad,2015
#Singh, RH. The holistic principles of Ayurvedic medicine. Choukhamba surbharati prakashan, Varanasi/ Delhi 1995
#Susruta Samhita redaction by Nagarjun based on Susrut’s Susruta Tantra OF Ssrita of 600 BC. sutra sthana chapters 4,15,21 edited by Singhal et al Choukhamba Surbharati 2nd edition Varanasi/Delhi, India, 2002
#Susruta Samhita redaction by Nagarjuna Based on Susruta Tantra of 600BC , Cikitsa sthana chapters 27-30 edited by Singhal et al. Pub. Choukhamba surbharati 2nd edition Varanasi/Delhi ,India 2002
#Udupa, KN and Singh, RH. Science and philosophy of Indian medicine. Baidyanath Ayurveda bhawan Nagpur, India 1980
#Vagbhatta 300 AD Astanga Sangraha Choukhamba publications Varanasi/Delhi, India
#Vagbhatta 300AD, Astanga Hridaya Uttara tantra, chapter 39 Rasayana chikitsa Choukhamba publications Varanasi, India

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Mahatigarbhavakranti Sharira

2019-03-06T03:45:53Z

Pallavmishra:

{{Infobox
|title = Mahatigarbhavakranti Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 4
|label2 = Preceding Chapter
|data2 = [[Khuddika Garbhavakranti Sharira]]

|label3= Succeeding Chapter
|data3 = [[Purusha Vichaya Sharira]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}
==[[Sharira Sthana]] Chapter 4, Mahatigarbhavakranti Sharira (Chapter on details of embryogenesis) ==

=== Abstract ===

<div style="text-align:justify;">In [[Charak Samhita]], this chapter focuses on ''garbha'' (embryo and/or fetus) in regards to the origin, definition its composition, consecutive development in the womb, factors for growth, destruction and hindering of the birth. Six factors responsible for the formation of ''garbha'' and sources of respective organs have been described in detail. Sequential growth and development of fetus has been explained systematically in the womb from first month to tenth month of gestation. Detailed description of ''garbhopaghatkarbhava'' (factors inhibiting growth of fetus) and significance of ''dauhrida'' (connection of two hearts and its manifestations, mother and fetus) has been made clear. Causes of the birth of genetically disordered fetus like ''putipraja'' (premature), ''varta'' (Female hypogonadism, chromosomalaneuploidy) and ''trinaputrika'' (male hypogonadism, chromosomal aneuploidy) have been discussed. This chapter also includes the description of classification of ''sharira'' (body) and ''manasa'' (mind). Further types of mind based on predominance of ''sattva, rajas'' and ''tamas'' have been sub-classified into 16 types under three major categories viz. ''sattvika, rajasika'' and ''tamasika'' with their distinguishing features. At the end of chapter, it is mentioned that knowledge of auspicious and inauspicious eight factors for the fetus makes a capable physician.

'''Keywords''': ''Garbha Poshana'' (Nourishment of fetus), ''Garbha Bhavas'' (Factors for fetal development), ''prakriti'' (basic body constitution), development of fetus, genetic and chromosomal deformities, ''manas prakriti'' (psychic traits).

=== Introduction ===

In the previous chapter ([[Khuddika Garbhavakranti Sharira]]), the six factors or ''bhavas'' which are responsible for formation of ''garbha'' are mentioned along with genetic inheritance in brief. The present chapter deals with complete concepts of Ayurvedic embryology, hence the name ''mahati''; meaning big or detailed. In the beginning Lord Atreya briefs about the contents of the chapter regarding embryo in the form of its definition, its formation and various factors responsible for its sequential development in the womb, factors responsible for growth and development, factors causing morbidity in fetus, different causes for destruction and anomalies in fetus.
Six factors responsible for the formation of embryo and sources of respective organs have been described in detail. The embryo is produced by five ''mahabhutas'' in association with consciousness (''chetana''). During the first month, the embryo is mucoid. Thereafter, in second month, it attains round shape. Subsequently, in third month, it develops all the sensory and motor organs, becomes stabilized and gains weight in fourth month, increases blood and muscle in fifth month, while increase in strength and complexion of fetus develops in sixth month. The fetus attains over-all maturity during the seventh month; and in eight month, due to instability of the ''ojas'', delivery of the fetus is prone to danger.

If the fetus remains in the womb after the period of parturition, which has been defined as the period between 9 to 10 months, it is considered abnormal or ''vaikarika prasavakala''. Normalcy of six factors is responsible for the growth and development of fetus; and growing fetus obtains nourishment through the ''upasneha'' (perfusion, osmosis, active and passive transport) and ''upasweda'' (warmth). Abnormality in these factors leads to destruction of fetus or still birth.

The diet consumed by the woman and her psychological state during pregnancy also affects the fetus. Wishes of the fetus are expressed through the mother and these should be fulfilled. Suppression of acute desires causes death of the fetus whereas mild ones cause abnormalities due to vitiation of ''vata''.
The factors responsible for genetic disorder of fetus due to abnormalities in male and female chromosomes and genes are described. By obtaining the knowledge of factors responsible for the proper growth or retardation of the fetus, one should avoid or modify those factors which come in the way of its proper development.
</div>

===Sanskrit text, Transliteration and English Translation===

अथातो महतीं गर्भावक्रान्तिं शारीरं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō mahatīṁ garbhāvakrāntiṁ śārīraṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto mahatIM garbhAvakrAntiM shArIraM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now I shall describe the chapter about the major factors involved in embryology. [1-2]

Thus said Lord Atreya.[1-2]

==== Queries about embryology ====

यतश्च गर्भः सम्भवति, यस्मिंश्च गर्भसञ्ज्ञा, यद्विकारश्च गर्भः, यया चानुपूर्व्याऽभिनिर्वर्तते कुक्षौ, यश्चास्य वृद्धिहेतुः,यतश्चास्याजन्म भवति, यतश्च जायमानः कुक्षौ विनाशं प्राप्नोति, यतश्च कार्त्स्न्येनाविनश्यन्
विकृतिमापद्यते,तदनुव्याख्यास्यामः||३||

yataśca garbhaḥ sambhavati, yasmiṁśca garbhasañjñā, yadvikāraśca garbhaḥ, yayācānupūrvyā'bhinirvartatē kukṣau, yaścāsya vr̥ddhihētuḥ, yataścāsyājanma bhavati, yataśca jāyamānaḥkukṣau vināśaṁ prāpnōti, yataśca kārtsnyēnāvinaśyan vikr̥timāpadyatē, tadanuvyākhyāsyāmaḥ||3||

yatashca garbhaH sambhavati, yasmiMshca garbhasa~jj~jA, yadvikArashca garbhaH, yayAcAnupUrvyA~abhinirvartate kukShau, yashcAsya vRuddhihetuH, yatashcAsyAjanma bhavati, yatashcajAyamAnaH kukShau vinAshaM prApnoti, yatashca kArtsnyenAvinashyan vikRutimApadyate,tadanuvyAkhyAsyAmaH||3||

Now I shall describe about the factors responsible for the origin of the embryo, its definition, composition, consecutive development in the womb, causes of growth, causes of the delayed/late birth, causes of demolition of the embryo in the womb and the causes of the morbidity without absolute demolition. [3]

==== Factors responsible for origin of embryo ====

मातृतः पितृत आत्मतः सात्म्यतो रसतः सत्त्वत इत्येतेभ्यो भावेभ्यः समुदितेभ्यो गर्भः सम्भवति|

तस्य ये येऽवयवा यतो यतः सम्भवतः सम्भवन्ति तान् विभज्य मातृजादीनवयवान् पृथक् पृथगुक्तमग्रे||४||

mātr̥taḥ pitr̥ta ātmataḥ sātmyatō rasataḥ sattvata ityētēbhyō bhāvēbhyaḥ samuditēbhyō garbhaḥsambhavati|

tasya yē yē'vayavā yatō yataḥ sambhavataḥ sambhavanti tān vibhajya mātr̥jādīnavayavān pr̥thakpr̥thaguktamagrē||4||

mAtRutaH pitRuta AtmataH sAtmyato rasataH sattvata ityetebhyo bhAvebhyaH samuditebhyo garbhaHsambhavati|

tasya ye ye~avayavA yato yataH sambhavataH sambhavanti tAn vibhajya mAtRujAdInavayavAn pRuthakpRuthaguktamagre||4||

The embryo is formed out of the aggregation of factors coming from mother, father, the soul, wholesome regimen, ''rasa'' (nutritive fluid) and the mind. The sources of the respective organs like maternal, paternal etc. have already been described in detail. [4]

==== Definition of ''garbha'' (embryo) ====

शुक्रशोणितजीवसंयोगे तु खलु कुक्षिगते गर्भसञ्ज्ञा भवति||५||

śukraśōṇitajīvasaṁyōgē tu khalu kukṣigatē garbhasañjñā bhavati||5||

shukrashoNitajIvasaMyoge tu khalu kukShigate garbhasa~jj~jA bhavati||5||

The unification of sperm, ovum and the soul in the womb is designated as ''garbha'' (embryo). [5]

==== Composition of embryo ====

गर्भस्तु खल्वन्तरिक्षवाय्वग्नितोयभूमिविकारश्चेतनाधिष्ठानभूतः|

एवमनया युक्त्या पञ्चमहाभूतविकारसमुदायात्मको गर्भश्चेतनाधिष्ठानभूतः; स ह्यस्य षष्ठो धातुरुक्तः||६|

garbhastu khalvantarikṣavāyvagnitōyabhūmivikāraścētanādhiṣṭhānabhūtaḥ|

ēvamanayā yuktyā pañcamahābhūtavikārasamudāyātmakō garbhaścētanādhiṣṭhānabhūtaḥ; sa hyasyaṣaṣṭhō dhāturuktaḥ||6||

garbhastu khalvantarikShavAyvagnitoyabhUmivikArashcetanAdhiShThAnabhUtaH|

evamanayA yuktyA pa~jcamahAbhUtavikArasamudAyAtmako garbhashcetanAdhiShThAnabhUtaH; sa hyasyaShaShTho dhAturuktaH||6||

''Garbha'' (embryo) is produced by the five ''mahabhutas'', i.e. ''akasha,vayu, agni, jala'' and ''prithvi'' and associated with the consciousness (''chetana''). It represents the combination of five ''mahabhutas'' and is also a holder of consciousness. Thus, the ''chetana'' constitutes the sixth ''dhatu'' and is responsible also for the formation of ''garbha'' (embryo).[6]

==== Development of embryo in the womb ====

यया चानुपूर्व्याऽभिनिर्वर्तते कुक्षौ तां व्याख्यास्यामः-

गते पुराणे रजसि नवे चावस्थिते शुद्धस्नातांस्त्रियमव्यापन्नयोनिशोणितगर्भाशयामृतुमतीमाचक्ष्महे|

तया सह तथाभूतया यदा पुमानव्यापन्नबीजो मिश्रीभावं गच्छति, तदा तस्य हर्षोदीरितः परः शरीरधात्वात्माशुक्रभूतोऽङ्गादङ्गात् सम्भवति|

स तथा हर्षभूतेनात्मनोदीरितश्चाधिष्ठितश्च बीजरूपो धातुः पुरुषशरीरादभिनिष्पत्त्योचितेन पथा गर्भाशयमनुप्रविश्यार्तवेनाभिसंसर्गमेति||७||

yayā cānupūrvyā'bhinirvartatē kukṣau tāṁ vyākhyāsyāmaḥ-

gatē purāṇē rajasi navē cāvasthitēśuddhasnātāṁ

striyamavyāpannayōniśōṇitagarbhāśayāmr̥tumatīmācakṣmahē|

tayā saha tathābhūtayā yadā pumānavyāpannabījō miśrībhāvaṁ gacchati, tadā tasya harṣōdīritaḥ paraḥśarīradhātvātmā

śukrabhūtō'ṅgādaṅgāt sambhavati|

sa tathā harṣabhūtēnātmanōdīritaścādhiṣṭhitaśca [4] bījarūpō dhātuḥ puruṣaśarīrādabhiniṣpattyōcitēnapathā

garbhāśayamanupraviśyārtavēnābhisaṁsargamēti||7||

yayA cAnupUrvyA~abhinirvartate kukShau tAM vyAkhyAsyAmaH-

gate purANe rajasi nave cAvasthiteshuddhasnAtAM

striyamavyApannayonishoNitagarbhAshayAmRutumatImAcakShmahe|

tayA saha tathAbhUtayA yadA pumAnavyApannabIjo mishrIbhAvaM gacchati, tadA tasya harShodIritaHparaH sharIradhAtvAtmA

shukrabhUto~a~ggAda~ggAt sambhavati|

sa tathA harShabhUtenAtmanodIritashcAdhiShThitashca [4] bIjarUpo dhAtuHpuruShasharIrAdabhiniShpattyocitena pathA

garbhAshayamanupravishyArtavenAbhisaMsargameti||7||

Now, the order in which the embryo develops in the womb is being explained. After the discharge of menstrual blood and the formation of fresh blood begins, a woman attains the ''ritumati'' (state of fertility) provided she has had bath and her genital tract, ovum and uterus are in normal condition. When a man with his unimpaired sperms cohabits with such a woman, his semen which constitutes the essence of the body tissues, comes out driven by orgasm. The semen consisting of sperms motivated by the orgasm is ejaculated from the body of the man and reaches the uterus through the genital tract. Finally, the sperm unites with the ovum. [7]

तत्र पूर्वं चेतनाधातुः सत्त्वकरणो गुणग्रहणाय प्रवर्तते; स हि हेतुः कारणं निमित्तमक्षरं कर्ता मन्ता वेदिता बोद्धा द्रष्टा धाताब्रह्मा विश्वकर्मा विश्वरूपः पुरुषः प्रभवोऽव्ययो नित्यो गुणी ग्रहणं

प्रधानमव्यक्तं जीवो ज्ञः पुद्गलश्चेतनावान् विभुर्भूतात्माचेन्द्रियात्मा चान्तरात्मा चेति|

स गुणोपादानकालेऽन्तरिक्षं पूर्वतरमन्येभ्यो गुणेभ्य उपादत्ते, यथा- प्रलयात्यये सिसृक्षुर्भूतान्यक्षरभूत आत्मा सत्त्वोपादानःपूर्वतरमाकाशं सृजति, ततः क्रमेण व्यक्ततरगुणान् धातून् वाय्वादिकांश्चतुरः; तथा

देहग्रहणेऽपि प्रवर्तमानःपूर्वतरमाकाशमेवोपादत्ते, ततः क्रमेण व्यक्ततरगुणान् धातून् वाय्वादिकांश्चतुरः|

सर्वमपि तु खल्वेतद्गुणोपादानमणुना कालेन भवति||८||

tatra pūrvaṁ cētanādhātuḥ sattvakaraṇō guṇagrahaṇāya pravartatē; sa hi hētuḥ kāraṇaṁnimittamakṣaraṁ kartā mantā vēditā bōddhā draṣṭā dhātā brahmā viśvakarmā viśvarūpaḥ puruṣaḥprabhavō'vyayō nityō guṇī grahaṇaṁ pradhānamavyaktaṁ jīvō jñaḥ pudgalaścētanāvān vibhurbhūtātmācēndriyātmā cāntarātmā cēti|

sa guṇōpādānakālē'ntarikṣaṁ pūrvataramanyēbhyō guṇēbhya upādattē, yathā- pralayātyayēsisr̥kṣurbhūtānyakṣarabhūta ātmā sattvōpādānaḥ pūrvataramākāśaṁ sr̥jati, tataḥ kramēṇavyaktataraguṇān dhātūn vāyvādikāṁścaturaḥ; tathā dēhagrahaṇē'pi pravartamānaḥpūrvataramākāśamēvōpādattē, tataḥ kramēṇa vyaktataraguṇān dhātūn vāyvādikāṁścaturaḥ|

sarvamapi tu khalvētadguṇōpādānamaṇunā kālēna bhavati||8||

tatra pUrvaM cetanAdhAtuH sattvakaraNo guNagrahaNAya pravartate; sa hi hetuH kAraNaMnimittamakSharaM kartA mantA veditA boddhA draShTA dhAtA brahmA vishvakarmA vishvarUpaHpuruShaH prabhavo~avyayo nityo guNI grahaNaM pradhAnamavyaktaM jIvo j~jaH pudgalashcetanAvAnvibhurbhUtAtmA cendriyAtmA cAntarAtmA ceti|

sa guNopAdAnakAle~antarikShaM pUrvataramanyebhyo guNebhya upAdatte, yathA- pralayAtyayesisRukShurbhUtAnyakSharabhUta AtmA sattvopAdAnaH pUrvataramAkAshaM sRujati, tataH krameNavyaktataraguNAn dhAtUn vAyvAdikAMshcaturaH; tathA dehagrahaNe~api pravartamAnaHpUrvataramAkAshamevopAdatte, tataH krameNa vyaktataraguNAn dhAtUn vAyvAdikAMshcaturaH|

sarvamapi tu khalvetadguNopAdAnamaNunA kAlena bhavati||8||

First of all the ''chetana dhatu'' (consciousness) i.e. the soul endowed with mind proceeds for taking hold of qualities. This ''chetana'' (consciousness) is known as ''hetu'' (associated cause), ''karana'' (non-constituent cause), ''nimitta'' (competent cause), ''akshara'' (the everlasting one), ''karta'' (the means), ''manta'' (the thinker), ''vedita'' (the knower), ''boddha'' (the intelligent one), ''drashta'' (the prophet), ''dhata'' (the supporter), ''brahma'' (the creator), ''vishwakarma'' (the builder of the universe/fetus), ''vishvarupa'' (taking universal form), ''purusha'' (lying in the body), ''prabhava'' (the source of origin), ''avyaya'' (the immutable) ''nitya'' (the eternal) ''guni'' (the receptacle of ''mahabhutas''), ''grahana'' (receiver), ''pradhana'' (the foremost), ''avyakta'' (the unmanifested one), ''jeeva'' (the lively one), ''jna'' (the mindful one), ''pudgala'' (the ego), ''chetnavan'' (one having consciousness), ''vibhu'' (omnipresent), ''bhutatma'' (pragmatic soul), ''indriyatma'' (essence of sense organs) and ''antaratma'' (inner soul). Thus, the soul, at the time of beholding the qualities first of all, creates ''akasha'' in the same way as after complete obliteration of entire universe, the God of creation, Brahma created ''akasha'' with the support of mind followed by creation of other four elements ''vayu'' etc. which have higher degrees of materialistic qualities sequentially. In the same way, the soul, desirous of creating same events in the body, first of all, unites with the ''akasha'' and then with other four ''bhutas'' whose attributes are more and more manifested sequentially. All these actions take place in a very short time. (''anu kala'').[8]

==== Development in first month ====

स सर्वगुणवान् गर्भत्वमापन्नः प्रथमे मासि सम्मूर्च्छितः सर्वधातुकलुषीकृतः खेटभूतो भवत्यव्यक्तविग्रहःसदसद्भूताङ्गावयवः||९||

sa sarvaguṇavān garbhatvamāpannaḥ prathamē māsi sammūrcchitaḥ sarvadhātukaluṣīkr̥taḥ khēṭabhūtō bhavatyavyaktavigrahaḥ sadasadbhūtāṅgāvayavaḥ||9||

sa sarvaguNavAn garbhatvamApannaH prathame mAsi sammUrcchitaH sarvadhAtukaluShIkRutaH kheTabhUto bhavatyavyaktavigrahaH sadasadbhUtA~ggAvayavaH||9||

In the first month of gestation, the soul possessing all the qualities gets amalgamated with all the ''dhatus'' to form ''khetabhuta'' (semisolid, sticky substance) in which all the body parts are not manifested in spite of their presence in explicated or non-explicated form. [9]

==== Features in second month ====

द्वितीये मासि घनः सम्पद्यते पिण्डः पेश्यर्बुदं वा|

तत्र घनः पुरुषः, पेशी स्त्री, अर्बुदं नपुंसकम्||१०||

dvitīyē māsi ghanaḥ sampadyatē piṇḍaḥ pēśyarbudaṁ vā|

tatra ghanaḥ puruṣaḥ, pēśī strī, arbudaṁ napuṁsakam||10||

dvitIye mAsi ghanaH sampadyate piNDaH peshyarbudaM vA|

tatra ghanaH puruShaH, peshI strI, arbudaM napuMsakam||10||

During the second month of gestation, the embryo takes the form of solid mass. If it takes oval shape, then the born child would be a male, if it takes elongated shape, the female child will be born, and in the case of tumor shaped (round and elevated) mass, the hermaphrodite. [10]

==== Features in third month ====

तृतीये मासि सर्वेन्द्रियाणि सर्वाङ्गावयवाश्च यौगपद्येनाभिनिर्वर्तन्ते||११||

tr̥tīyē māsi sarvēndriyāṇi sarvāṅgāvayavāśca yaugapadyēnābhinirvartantē||11||

tRutIye mAsi sarvendriyANi sarvA~ggAvayavAshca yaugapadyenAbhinirvartante||11||

In third month, all the sense organs along with all the body parts are manifested simultaneously. [11]

==== ''Mahabhuta''-specific features ====

तत्रास्य केचिदङ्गावयवा मातृजादीनवयवान् विभज्य पूर्वमुक्ता यथावत्|

महाभूतविकारप्रविभागेन त्विदानीमस्य तांश्चैवाङ्गावयवान् कांश्चित् पर्यायान्तरेणापरांश्चानुव्याख्यास्यामः|

मातृजादयोऽप्यस्य महाभूतविकारा एव|

तत्रास्याकाशात्मकं शब्दः श्रोत्रं लाघवं सौक्ष्म्यं विवेकश्च, वाय्वात्मकं स्पर्शः स्पर्शनं रौक्ष्यं प्रेरणं धातुव्यूहनं चेष्टाश्च शारीर्यः, अग्न्यात्मकं रूपं दर्शनं प्रकाशः पक्तिरौष्ण्यं च, अबात्मकं रसो रसनं शैत्यं मार्दवं स्नेहःक्लेदश्च, पृथिव्यात्मकं गन्धो घ्राणं गौरवं स्थैर्यं मूर्तिश्चेति||१२||

tatrāsya kēcidaṅgāvayavā mātr̥jādīnavayavān vibhajya pūrvamuktā yathāvat|

mahābhūtavikārapravibhāgēna tvidānīmasya tāṁścaivāṅgāvayavān kāṁścit paryāyāntarēṇāparāṁścānuvyākhyāsyāmaḥ|

mātr̥jādayō'pyasya mahābhūtavikārā ēva|

tatrāsyākāśātmakaṁ śabdaḥ śrōtraṁ lāghavaṁ saukṣmyaṁ vivēkaśca, vāyvātmakaṁ sparśaḥ sparśanaṁ raukṣyaṁ prēraṇaṁ dhātuvyūhanaṁ cēṣṭāśca śārīryaḥ,agnyātmakaṁ rūpaṁ darśanaṁ prakāśaḥ paktirauṣṇyaṁ ca, abātmakaṁ rasō rasanaṁ śaityaṁ mārdavaṁ snēhaḥ klēdaśca, pr̥thivyātmakaṁ gandhō ghrāṇaṁgauravaṁ sthairyaṁ mūrtiścēti||12||

tatrAsya kecida~ggAvayavA mAtRujAdInavayavAn vibhajya pUrvamuktA yathAvat|

mahAbhUtavikArapravibhAgena tvidAnImasya tAMshcaivA~ggAvayavAn kAMshcit paryAyAntareNAparAMshcAnuvyAkhyAsyAmaH|

mAtRujAdayo~apyasya mahAbhUtavikArA eva|

tatrAsyAkAshAtmakaM shabdaH shrotraM lAghavaM saukShmyaM vivekashca, vAyvAtmakaM sparshaH sparshanaM raukShyaM preraNaM dhAtuvyUhanaMceShTAshca shArIryaH, agnyAtmakaM rUpaM darshanaM prakAshaH paktirauShNyaM ca, abAtmakaM raso rasanaM shaityaM mArdavaM snehaH kledashca,pRuthivyAtmakaM gandho ghrANaM gauravaM sthairyaM mUrtishceti||12||

Some of the body parts of fetus like those having origin in mother etc. have already been enumerated earlier. Now we will enlist them according to the category based on modifications of the ''pancha mahabhuta'' (five elements) with some additional ones.
Even those parts originated from mother etc. are also due to modifications on ''pancha mahabhuta''.

In the fetus, the parts originated from ''akasha mahabhuta'' are- sound, auditory sensation, lightness, fineness and space; the parts from ''vayu mahabhuta'' are – tangibility, sense of touch, roughness, impulsion, structuring of body tissues and maintaining of movements of the body and ''dosha''; the parts belonging to ''agni mahabhuta'' are visible form, vision, brightness, digestion and heat; those belonging to ''apa mahabhuta'' are taste, sense of taste, coldness, softness, unctuousness and moisture; those belonging to ''prithvi'' ''mahabhuta'' are odor, sensation of smell, heaviness, steadiness and material form. [12]

==== ''Loka purusha'' theory ====

एवमयं लोकसम्मितः पुरुषः|

यावन्तो हि लोके मूर्तिमन्तो भावविशेषास्तावन्तः पुरुषे, यावन्तः पुरुषे तावन्तो लोके इति; बुधास्त्वेवं द्रष्टुमिच्छन्ति||१३||

ēvamayaṁ lōkasammitaḥ puruṣaḥ|

yāvantō hi lōkē mūrtimantō bhāvaviśēṣāstāvantaḥ puruṣē, yāvantaḥ puruṣē tāvantō lōkē iti; budhāstvēvaṁdraṣṭumicchanti||13||

evamayaM lokasammitaH puruShaH|

yAvanto hi loke mUrtimanto bhAvavisheShAstAvantaH puruShe, yAvantaH puruShe tAvanto loke iti;budhAstvevaM draShTumicchanti||13||

Therefore the individual is an embodiment of the universe. All the material and spiritual phenomena of the universe are present in the individual and vice versa. This is how the wise desires to perceive. [13]

==== Gender specific features in development of fetus ====

एवमस्येन्द्रियाण्यङ्गावयवाश्च यौगपद्येनाभिनिर्वर्तन्तेऽन्यत्र तेभ्यो भावेभ्यो येऽस्य जातस्योत्तरकालं जायन्ते; तद्यथा-दन्ता व्यञ्जनानि व्यक्तीभावस्तथायुक्तानि चापराणि|

एषा प्रकृतिः, विकृतिः पुनरतोऽन्यथा|

सन्ति खल्वस्मिन् गर्भे केचिन्नित्या भावाः, सन्ति चानित्याः केचित्|

तस्य य एवाङ्गावयवाः सन्तिष्ठन्ते, त एव स्त्रीलिङ्गं पुरुषलिङ्गं नपुंसकलिङ्गं वा बिभ्रति|

तत्र स्त्रीपुरुषयोर्ये वैशेषिका भावाः प्रधानसंश्रया गुणसंश्रयाश्च, तेषां यतो भूयस्त्वं ततोऽन्यतरभावः|

तद्यथा- क्लैब्यं भीरुत्वमवैशारद्यं मोहोऽनवस्थानमधोगुरुत्वमसहनं शैथिल्यं मार्दवं गर्भाशयबीजभागस्तथायुक्तानिचापराणि स्त्रीकराणि, अतो विपरीतानि पुरुषकराणि, उभयभागावयवा नपुंसककराणि भवन्ति||१४||

ēvamasyēndriyāṇyaṅgāvayavāśca yaugapadyēnābhinirvartantē'nyatra tēbhyō bhāvēbhyō yē'syajātasyōttarakālaṁ jāyantē; tadyathā- dantā vyañjanāni vyaktībhāvastathāyuktāni [18] cāparāṇi|

ēṣā prakr̥tiḥ, vikr̥tiḥ punaratō'nyathā|

santi khalvasmin garbhē kēcinnityā bhāvāḥ, santi cānityāḥ kēcit|

tasya ya ēvāṅgāvayavāḥ santiṣṭhantē, ta ēva strīliṅgaṁ puruṣaliṅgaṁ napuṁsakaliṅgaṁ vā bibhrati|

tatra strīpuruṣayōryē vaiśēṣikā bhāvāḥ pradhānasaṁśrayā guṇasaṁśrayāśca, tēṣāṁ yatō bhūyastvaṁtatō'nyatarabhāvaḥ|

tadyathā- klaibyaṁ bhīrutvamavaiśāradyaṁ mōhō'navasthānamadhōgurutvamasahanaṁ śaithilyaṁmārdavaṁ garbhāśayabījabhāgastathāyuktāni cāparāṇi strīkarāṇi, atō viparītāni puruṣakarāṇi,ubhayabhāgāvayavā [19] napuṁsakakarāṇi bhavanti||14||

evamasyendriyANya~ggAvayavAshca yaugapadyenAbhinirvartante~anyatra tebhyo bhAvebhyo ye~asyajAtasyottarakAlaM jAyante; tadyathA- dantA vya~jjanAni vyaktIbhAvastathAyuktAni [18] cAparANi|

eShA prakRutiH, vikRutiH punarato~anyathA|

santi khalvasmin garbhe kecinnityA bhAvAH, santi cAnityAH kecit|

tasya ya evA~ggAvayavAH santiShThante, ta eva strIli~ggaM puruShali~ggaM napuMsakali~ggaM vAbibhrati|

tatra strIpuruShayorye vaisheShikA bhAvAH pradhAnasaMshrayA guNasaMshrayAshca, teShAM yatobhUyastvaM tato~anyatarabhAvaH|

tadyathA- klaibyaM bhIrutvamavaishAradyaM moho~anavasthAnamadhogurutvamasahanaM shaithilyaMmArdavaM garbhAshayabIjabhAgastathAyuktAni cAparANi strIkarANi, ato viparItAni puruShakarANi,ubhayabhAgAvayavA [19] napuMsakakarANi bhavanti||14||

Therefore, the senses and organs of the fetus are simultaneously manifested except the ones which are manifested only after birth such as teeth, secondary sexual characteristics like beard and breasts, signs of puberty like production of semen and ovum and alike traits are developed later. This is the normalcy and otherwise abnormal. In the fetus, there are certain characteristics, which are permanent whereas certain others are temporary. The permanent characteristics distinguish the male, female or hermaphrodite sex of the fetus. The characteristic features which determine its male or female sex depend on the self or the mahābhūtas and determined as per the dominance of one or the other of these factors such as cowardice, timidity, lack of skills, confusion, wavering nature, heaviness in lower body, intolerance, flabbiness, softness, presence of uterus and ovum and other such characters determine the female sex, opposite characters determine the male sex and mixture of both denote the hermaphrodite. [14]

तस्य यत्कालमेवेन्द्रियाणि सन्तिष्ठन्ते, तत्कालमेव चेतसि वेदना निर्बन्धं प्राप्नोति; तस्मात्तदा प्रभृति गर्भः स्पन्दते, प्रार्थयतेच जन्मान्तरानुभूतं यत् किञ्चित्, तद्द्वैहृदय्यमाचक्षते वृद्धाः|

मातृजं चास्य हृदयं मातृहृदयेनाभिसम्बद्धं भवति रसवाहिनीभिः संवाहिनीभिः; तस्मात्तयोस्ताभिर्भक्तिः संस्पन्दते |

तच्चैव कारणमवेक्षमाणा न द्वैहृदय्यस्य विमानितं गर्भमिच्छन्ति कर्तुम्|

विमानने ह्यस्य दृश्यते विनाशो विकृतिर्वा|

समानयोगक्षेमा हि तदा भवति गर्भेण केषुचिदर्थेषु माता|

तस्मात् प्रियहिताभ्यां गर्भिणीं विशेषेणोपचरन्ति कुशलाः||१५||

tasya yatkālamēvēndriyāṇi santiṣṭhantē, tatkālamēva cētasi vēdanā nirbandhaṁ prāpnōti; tasmāttadāprabhr̥ti garbhaḥ spandatē, prārthayatē ca janmāntarānubhūtaṁ yat kiñcit, taddvaihr̥dayyamācakṣatēvr̥ddhāḥ|

mātr̥jaṁ cāsya hr̥dayaṁ mātr̥hr̥dayēnābhisambaddhaṁ bhavati rasavāhinībhiḥ [26] saṁvāhinībhiḥ;tasmāttayōstābhirbhaktiḥ saṁspandatē [27] |

taccaiva kāraṇamavēkṣamāṇā na [28] dvaihr̥dayyasya vimānitaṁ garbhamicchanti kartum|

vimānanē hyasya dr̥śyatē vināśō vikr̥tirvā|

samānayōgakṣēmā hi tadā bhavati garbhēṇa kēṣucidarthēṣu mātā|

tasmāt priyahitābhyāṁ garbhiṇīṁ viśēṣēṇōpacaranti kuśalāḥ||15||

tasya yatkAlamevendriyANi santiShThante, tatkAlameva cetasi vedanA nirbandhaM prApnoti; tasmAttadAprabhRuti garbhaH spandate, prArthayate ca janmAntarAnubhUtaM yat ki~jcit, taddvaihRudayyamAcakShatevRuddhAH|

mAtRujaM cAsya hRudayaM mAtRuhRudayenAbhisambaddhaM bhavati rasavAhinIbhiH [26] saMvAhinIbhiH;tasmAttayostAbhirbhaktiH saMspandate [27] |

taccaiva kAraNamavekShamANA na [28] dvaihRudayyasya vimAnitaM garbhamicchanti kartum|

vimAnane hyasya dRushyate vinAsho vikRutirvA|

samAnayogakShemA hi tadA bhavati garbheNa keShucidartheShu mAtA|

tasmAt priyahitAbhyAM garbhiNIM visheSheNopacaranti kushalAH||15||

When senses of the fetus get manifested, its mind gets associated with feelings and due to this the fetus starts shuddering and expresses the wishes based on the experiences of prior life of the individual. According to elder persons, this condition is known as ''dauhrida'' (bi-cardiac condition). The heart of the fetus formed from the maternal component is linked to the mother’s heart through the ''rasavahi'' (nutrient material carrying channels) and through these channels fetus expresses its wishes through the mother.

Due to this view people, do not want to overlook the wishes of the fetus as reflected through the desires of the pregnant mother. If these wishes are overlooked, the fetus may either be damaged or get distorted. The appropriate protection and defense of the pregnant mother is as good as the protection and defense of the fetus itself. So, the intelligent individuals concentrate upon a pregnant mother with particular care to accomplish her beloved and beneficial requirements. [15]

==== Signs of pregnancy ====

तस्या गर्भापत्तेर्द्वैहृदय्यस्य च विज्ञानार्थं लिङ्गानि समासेनोपदेक्ष्यामः|

उपचारसाधनं ह्यस्य ज्ञाने, ज्ञानं च लिङ्गतः, तस्मादिष्टो लिङ्गोपदेशः|

तद्यथा- आर्तवादर्शनमास्यसंस्रवणमनन्नाभिलाषश्छर्दिररोचकोऽम्लकामता च विशेषेण श्रद्धाप्रणयनमुच्चावचेषु भावेषुगुरुगात्रत्वं चक्षुषोर्ग्लानिः स्तनयोः स्तन्यमोष्ठयोः स्तनमण्डलयोश्च कार्ष्ण्यमत्यर्थं श्वयथुः पादयोरीषल्लोमराज्युद्गमोयोन्याश्चाटालत्वमिति गर्भे पर्यागते रूपाणि भवन्ति||१६||

tasyā garbhāpattērdvaihr̥dayyasya ca vijñānārthaṁ liṅgāni samāsēnōpadēkṣyāmaḥ|

upacārasādhanaṁ [31] hyasya jñānē, jñānaṁ ca liṅgataḥ, tasmādiṣṭō liṅgōpadēśaḥ|

tadyathā- ārtavādarśanamāsyasaṁsravaṇamanannābhilāṣaśchardirarōcakō'mlakāmatā ca viśēṣēṇaśraddhāpraṇayanamuccāvacēṣu bhāvēṣu gurugātratvaṁ cakṣuṣōrglāniḥ stanayōḥ stanyamōṣṭhayōḥstanamaṇḍalayōśca kārṣṇyamatyarthaṁ śvayathuḥ pādayōrīṣallōmarājyudgamō yōnyāścāṭālatvamitigarbhē paryāgatē rūpāṇi bhavanti||16||

tasyA garbhApatterdvaihRudayyasya ca vij~jAnArthaM li~ggAni samAsenopadekShyAmaH|

upacArasAdhanaM [31] hyasya j~jAne, j~jAnaM ca li~ggataH, tasmAdiShTo li~ggopadeshaH|

tadyathA- ArtavAdarshanamAsyasaMsravaNamanannAbhilAShashchardirarocako~amlakAmatA cavisheSheNa shraddhApraNayanamuccAvaceShu bhAveShu gurugAtratvaM cakShuShorglAniH stanayoHstanyamoShThayoH stanamaNDalayoshca kArShNyamatyarthaM shvayathuH pAdayorIShallomarAjyudgamoyonyAshcATAlatvamiti garbhe paryAgate rUpANi bhavanti||16||

Now I shall explain in brief the signs and symptoms that are indicative of pregnancy as well as the bi-cardiac condition. The knowledge of signs and symptoms facilitate the management of these conditions. Therefore, it is necessary to explain their signs and symptoms such as- amenorrhoea, excessive salivation, lack of desire to take food, vomiting, loss of appetite, liking for sour things, liking for all types of food- both wholesome and unwholesome, heaviness of the body, feeling of heaviness in the eyes, appearance of milk in breasts, appearance of excessive darkness in the lips and the areola of breasts, mild edema on feet, appearance of small hairs and dilatation of vagina. [16]

सा यद्यदिच्छेत्तत्तदस्यै दद्यादन्यत्र गर्भोपघातकरेभ्यो भावेभ्यः||१७||

sā yadyadicchēttattadasyai dadyādanyatra garbhōpaghātakarēbhyō bhāvēbhyaḥ||17||

sA yadyadicchettattadasyai dadyAdanyatra garbhopaghAtakarebhyo bhAvebhyaH||17||

As the wishes of the fetus are expressed through the mother, all wishes of mother should be fulfilled. What-so-ever she desires during this period should be provided except the substances likely to injure the fetus. [17]

==== Harmful factors in pregnancy ====

गर्भोपघातकरास्त्विमे भावा भवन्तिः; तद्यथासर्वमतिगुरूष्णतीक्ष्णं दारुणाश्च चेष्टाः; इमांश्चान्यानुपदिशन्ति वृद्धाः-देवतारक्षोऽनुचरपरिरक्षणार्थं न रक्तानि वासांसि बिभृयान्न मदकराणि मद्यान्यभ्यवहरेन्न यानमधिरोहेन्न मांसमश्नीयात्सर्वेन्द्रियप्रतिकूलांश्च भावान् दूरतः परिवर्जयेत्, यच्चान्यदपि किञ्चित् स्त्रियो विद्युः||१८||

garbhōpaghātakarāstvimē bhāvā bhavantiḥ; tadyathā- sarvamatigurūṣṇatīkṣṇaṁ dāruṇāśca cēṣṭāḥ;imāṁścānyānupadiśanti vr̥ddhāḥ- dēvatārakṣō'nucaraparirakṣaṇārthaṁ na raktāni vāsāṁsi bibhr̥yānnamadakarāṇi madyānyabhyavaharēnna yānamadhirōhēnna māṁsamaśnīyāt sarvēndriyapratikūlāṁścabhāvān dūrataḥ parivarjayēt, yaccānyadapi kiñcit striyō vidyuḥ||18||

garbhopaghAtakarAstvime bhAvA bhavantiH; tadyathA- sarvamatigurUShNatIkShNaM dAruNAshca ceShTAH;imAMshcAnyAnupadishanti vRuddhAH- devatArakSho~anucaraparirakShaNArthaM na raktAni vAsAMsibibhRuyAnna madakarANi madyAnyabhyavaharenna yAnamadhirohenna mAMsamashnIyAtsarvendriyapratikUlAMshca bhAvAn dUrataH parivarjayet, yaccAnyadapi ki~jcit striyo vidyuH||18||

The following factors are harmful for the fetus for example-excessive use of heavy, hot and pungent substances, exertion activities, and others as instructed by elder persons. For the protection from the effect of gods, devils and their followers like she should not wear red apparel, she should not take intoxicating substances and wine, ride over rough riding vehicle, take meat and she should be far away from substances which are unwholesome to the senses and all other unwholesome substances should be avoided as advised by experienced ladies.[18]

तीव्रायां तु खलु प्रार्थनायां काममहितमप्यस्यै हितेनोपहितं दद्यात् प्रार्थनाविनयनार्थम्|

प्रार्थनासन्धारणाद्धि वायुः प्रकुपितोऽन्तःशरीरमनुचरन् गर्भस्यापद्यमानस्य विनाशं वैरूप्यं वा कुर्यात्||१९||

tīvrāyāṁ tu khalu prārthanāyāṁ kāmamahitamapyasyai hitēnōpahitaṁ dadyāt prārthanāvinayanārtham|

prārthanāsandhāraṇāddhi vāyuḥ prakupitō'ntaḥśarīramanucaran garbhasyāpadyamānasya vināśaṁvairūpyaṁ vā kuryāt||19||

tIvrAyAM tu khalu prArthanAyAM kAmamahitamapyasyai hitenopahitaM dadyAt prArthanAvinayanArtham|

prArthanAsandhAraNAddhi vAyuH prakupito~antaHsharIramanucaran garbhasyApadyamAnasya vinAshaMvairUpyaM vA kuryAt||19||

If the desire of the mother to use the substances likely to cause harm to the fetus is very acute, then even these substances can be given by addition of beneficial substances having capability to counteract the harmful effects. By the suppression of the desires, the ''vata'' gets vitiated, moves in the body of fetus produces different diseases, morphological abnormalities (dysmorphism) or even death. [19]

==== Features in fourth month ====

चतुर्थे मासि स्थिरत्वमापद्यते गर्भः, तस्मात्तदा गर्भिणी गुरुगात्रत्वमधिकमापद्यते विशेषेण||२०||

caturthē māsi sthiratvamāpadyatē garbhaḥ, tasmāttadā garbhiṇī gurugātratvamadhikamāpadyatēviśēṣēṇa||20||

caturthe mAsi sthiratvamApadyate garbhaH, tasmAttadA garbhiNI gurugAtratvamadhikamApadyatevisheSheNa||20||

During fourth month of gestation, the fetus attains stability due to which, the pregnant woman feels more heaviness in her body.[20]

==== Features in fifth month ====

पञ्चमे मासि गर्भस्य मांसशोणितोपचयो भवत्यधिकमन्येभ्यो मासेभ्यः, तस्मात्तदा गर्भिणी कार्श्यमापद्यते विशेषेण||२१||

pañcamē māsi garbhasya māṁsaśōṇitōpacayō bhavatyadhikamanyēbhyō māsēbhyaḥ

tasmāttadā garbhiṇīkārśyamāpadyatē viśēṣēṇa||21||

pa~jcame mAsi garbhasya mAMsashoNitopacayo bhavatyadhikamanyebhyo mAsebhyaH, tasmAttadAgarbhiNI kArshyamApadyate visheSheNa||21||

Due to increased anabolism of muscle tissue and blood of the fetus during the fifth month of gestation, the pregnant woman becomes emaciated. [21]

==== Features in sixth month ====

षष्ठे मासि गर्भस्य बलवर्णोपचयो भवत्यधिकमन्येभ्यो मासेभ्यः, तस्मात्तदा गर्भिणी बलवर्णहानिमापद्यते विशेषेण||२२||

ṣaṣṭhē māsi garbhasya balavarṇōpacayō bhavatyadhikamanyēbhyō māsēbhyaḥ, tasmāttadā garbhiṇībalavarṇahānimāpadyatē viśēṣēṇa||22||

ShaShThe mAsi garbhasya balavarNopacayo bhavatyadhikamanyebhyo mAsebhyaH, tasmAttadA garbhiNIbalavarNahAnimApadyate visheSheNa||22||

During sixth month, fetus derives more strength and complexion, therefore the pregnant woman loses her strength and complexion significantly. [22]

==== Features in seventh month ====

सप्तमे मासि गर्भः सर्वैर्भावैराप्याय्यते, तस्मात्तदा गर्भिणी सर्वाकारैः क्लान्ततमा भवति||२३||

saptamē māsi garbhaḥ sarvairbhāvairāpyāyyatē, tasmāttadā garbhiṇī sarvākāraiḥ klāntatamābhavati||23||

saptame mAsi garbhaH sarvairbhAvairApyAyyate, tasmAttadA garbhiNI sarvAkAraiH klAntatamAbhavati||23||

As during the seventh month of gestation the fetus attains over-all fulfillment of all elements. Therefore, a pregnant woman becomes excessively exhausted. [23]

==== Features in eighth month ====

अष्टमे मासि गर्भश्च मातृतो गर्भतश्च माता रसहारिणीभिः संवाहिनीभिर्मुहुर्मुहुरोजः परस्परत आददातेगर्भस्यासम्पूर्णत्वात् [३५] |

तस्मात्तदा गर्भिणीमुहुर्महुर्मुदा युक्ता भवति मुहुर्मुहुश्च म्लाना, तथा गर्भः; तस्मात्तदा गर्भस्य जन्मव्यापत्तिमद्भवत्योजसोऽनवस्थितत्वात् |

तं चैवार्थमभिसमीक्ष्याष्टमं मासमगण्यमित्याचक्षते कुशलाः||२४||

aṣṭamē māsi garbhaśca mātr̥tō garbhataśca mātā rasahāriṇībhiḥ saṁvāhinībhirmuhurmuhurōjaḥparasparata ādadātē garbhasyāsampūrṇatvāt |

tasmāttadā garbhiṇīmuhurmahurmudā yuktā bhavati muhurmuhuśca mlānā, tathā garbhaḥ; tasmāttadāgarbhasya janma vyāpattimadbhavatyōjasō'navasthitatvāt |

taṁ caivārthamabhisamīkṣyāṣṭamaṁ māsamagaṇyamityācakṣatē kuśalāḥ||24||

aShTame mAsi garbhashca mAtRuto garbhatashca mAtA rasahAriNIbhiH saMvAhinIbhirmuhurmuhurojaHparasparata AdadAte garbhasyAsampUrNatvAt |

tasmAttadA garbhiNImuhurmahurmudA yuktA bhavati muhurmuhushca mlAnA, tathA garbhaH; tasmAttadAgarbhasya janma vyApattimadbhavatyojaso~anavasthitatvAt |

taM caivArthamabhisamIkShyAShTamaM mAsamagaNyamityAcakShate kushalAH||24||

During the eighth month of gestation due to immaturity of the fetus, the ''ojas'' moves from the mother to fetus and from fetus to mother through the channels carrying ''rasa'' (nutritive fluid). As a result, at that time, the pregnant woman frequently becomes happy or dull (exhausted) parallel is the condition of the fetus. It is because of the instability of the ''ojas'', the delivery of the fetus during this month is prone to danger. In view of this, experts do not consider this month fit for labor. [24]

==== Time of delivery ====

तस्मिन्नेकदिवसातिक्रान्तेऽपि नवमं मासमुपादाय प्रसवकालमित्याहुरादशमान्मासात्|

एतावान् प्रसवकालः, वैकारिकमतः परं कुक्षाववस्थानं गर्भस्य||२५||

tasminnēkadivasātikrāntē'pi navamaṁ māsamupādāya prasavakālamityāhurādaśamānmāsāt|

ētāvān prasavakālaḥ, vaikārikamataḥ [37] paraṁ kukṣāvavasthānaṁ garbhasya||25||

tasminnekadivasAtikrAnte~api navamaM mAsamupAdAya prasavakAlamityAhurAdashamAnmAsAt|

etAvAn prasavakAlaH, vaikArikamataH [37] paraM kukShAvavasthAnaM garbhasya||25||

Even the first day after this eighth month i.e. from the first day of the ninth month till the tenth month is known as the period of parturition. Normally delivery takes place during this period. After this period, if there is retention of fetus in the uterus, it is considered abnormal. [25]

एवमनयाऽऽनुपूर्व्याऽभिनिर्वर्तते कुक्षौ||२६||

ēvamanayā nupūrvyā'bhinirvartatē kukṣau||26||

evamanayA~a~anupUrvyA~abhinirvartate kukShau||26||

In this way the fetus grows and develops sequentially in the womb. [26]

मात्रादीनां खलु गर्भकराणां भावानां सम्पदस्तथा वृत्तsस्य सौष्ठवान्मातृतश्चैवोपस्नेहोपस्वेदाभ्यां कालपरिणामात्स्वभावसंसिद्धेश्च कुक्षौ वृद्धिं प्राप्नोति||२७||

mātrādīnāṁ khalu garbhakarāṇāṁ bhāvānāṁ sampadastathā vr̥ttasyasauṣṭhavānmātr̥taścaivōpasnēhōpasvēdābhyāṁ kālapariṇāmāt svabhāvasaṁsiddhēśca kukṣau vr̥ddhiṁprāpnōti||27||

mAtrAdInAM khalu garbhakarANAM bhAvAnAM sampadastathA vRuttasyasauShThavAnmAtRutashcaivopasnehopasvedAbhyAM kAlapariNAmAt svabhAvasaMsiddheshca kukShauvRuddhiM prApnoti||27||

With the normalcy of the ''matrijadi'' (maternal etc.) six factors responsible for the production of the fetus viz. mother (ovum) father (sperm), ''satmya'' (adaptability), ''rasa'' (nutritive fluid) and ''sattva'' (mind) along with compliance to the code and conduct of dos and don’ts in the pregnancy by the mother, the fetus obtains its nourishment through ''upasneha'' (perfusion, osmosis, active and passive transport) and ''upasveda'' (warmth) from the mother as a result of passage of time and own nature fetus obtains growth and development in uterus. [27]

मात्रादीनामेव तु खलु गर्भकराणां भावानां व्यापत्तिनिमित्तमस्याजन्म भवति||२८||

mātrādīnāmēva tu khalu garbhakarāṇāṁ bhāvānāṁ vyāpattinimittamasyājanma bhavati||28||

mAtrAdInAmeva tu khalu garbhakarANAM bhAvAnAM vyApattinimittamasyAjanma bhavati||28||

Due to the abnormality in the mother (ovum), father (sperm) etc. factors accountable for the creation of the fetus leads no birth of the child. [28]

==== Causes of premature delivery and ante-natal death ====

ये ह्यस्य कुक्षौ वृद्धिहेतुसमाख्याता भावास्तेषां विपर्ययादुदरे विनाशमापद्यते, अथवाऽप्यचिरजातः स्यात्||२९||

yē hyasya kukṣau vr̥ddhihētusamākhyātā bhāvāstēṣāṁ viparyayādudarē vināśamāpadyatē,athavā'pyacirajātaḥ syāt||29||

ye hyasya kukShau vRuddhihetusamAkhyAtA bhAvAsteShAM viparyayAdudare vinAshamApadyate,athavA~apyacirajAtaH syAt||29||

The fetus gets destroyed in the womb of the mother or there is premature delivery if factors opposing to those described for its growth, are present. [29]

==== Causes of congenital abnormalities ====

यतस्तु कार्त्स्न्येनाविनश्यन् विकृतिमापद्यते, तदनुव्याख्यास्यामः- यदा स्त्रिया दोषप्रकोपणोक्तान्यासेवमानाया दोषाःप्रकुपिताः शरीरमुपसर्पन्तः शोणितगर्भाशयावुपपद्यन्ते , न च कार्त्स्न्येन शोणितगर्भाशयौ दूषयन्ति, तदेयं गर्भं लभतेस्त्री; तदा तस्य गर्भस्य मातृजानामवयवानामन्यतमोऽवयवो विकृतिमापद्यत एकोऽथवाऽनेके, यस्य यस्य ह्यवयवस्य बीजेबीजभागे वा दोषाः प्रकोपमापद्यन्ते, तं तमवयवं विकृतिराविशति|

यदा ह्यस्याः शोणिते गर्भाशयबीजभागः प्रदोषमापद्यते, तदा वन्ध्यां जनयति; यदा पुनरस्याः शोणितेगर्भाशयबीजभागावयवः प्रदोषमापद्यते, तदा पूतिप्रजां जनयति; यदा त्वस्याः शोणिते गर्भाशयबीजभागावयवः स्त्रीकराणां चशरीरबीजभागानामेकदेशः प्रदोषमापद्यते, तदा स्त्र्याकृतिभूयिष्ठामस्त्रियं वार्तां [४२] नाम जनयति, तां स्त्रीव्यापदमाचक्षते||३०||

yatastu kārtsnyēnāvinaśyan vikr̥timāpadyatē, tadanuvyākhyāsyāmaḥ- yadā striyādōṣaprakōpaṇōktānyāsēvamānāyā dōṣāḥ prakupitāḥ śarīramupasarpantaḥśōṇitagarbhāśayāvupapadyantē [40] , na ca kārtsnyēna śōṇitagarbhāśayau dūṣayanti, tadēyaṁ [41] garbhaṁlabhatē strī; tadā tasya garbhasya mātr̥jānāmavayavānāmanyatamō'vayavō vikr̥timāpadyataēkō'thavā'nēkē, yasya yasya hyavayavasya bījē bījabhāgē vā dōṣāḥ prakōpamāpadyantē, taṁtamavayavaṁ vikr̥tirāviśati|

yadā hyasyāḥ śōṇitē garbhāśayabījabhāgaḥ pradōṣamāpadyatē, tadā vandhyāṁ janayati; yadāpunarasyāḥ śōṇitē garbhāśayabījabhāgāvayavaḥ pradōṣamāpadyatē, tadā pūtiprajāṁ janayati; yadātvasyāḥ śōṇitē garbhāśayabījabhāgāvayavaḥ strīkarāṇāṁ ca śarīrabījabhāgānāmēkadēśaḥpradōṣamāpadyatē, tadā stryākr̥tibhūyiṣṭhāmastriyaṁ vārtāṁ [42] nāma janayati, tāṁstrīvyāpadamācakṣatē||30||

yatastu kArtsnyenAvinashyan vikRutimApadyate, tadanuvyAkhyAsyAmaH- yadA striyAdoShaprakopaNoktAnyAsevamAnAyA doShAH prakupitAH sharIramupasarpantaHshoNitagarbhAshayAvupapadyante [40] , na ca kArtsnyena shoNitagarbhAshayau dUShayanti, tadeyaM [41]garbhaM labhate strI; tadA tasya garbhasya mAtRujAnAmavayavAnAmanyatamo~avayavovikRutimApadyata eko~athavA~aneke, yasya yasya hyavayavasya bIje bIjabhAge vA doShAHprakopamApadyante, taM tamavayavaM vikRutirAvishati|

yadA hyasyAH shoNite garbhAshayabIjabhAgaH pradoShamApadyate, tadA vandhyAM janayati; yadApunarasyAH shoNite garbhAshayabIjabhAgAvayavaH pradoShamApadyate, tadA pUtiprajAM janayati; yadAtvasyAH shoNite garbhAshayabIjabhAgAvayavaH strIkarANAM ca sharIrabIjabhAgAnAmekadeshaHpradoShamApadyate, tadA stryAkRutibhUyiShThAmastriyaM vArtAM [42] nAma janayati, tAMstrIvyApadamAcakShate||30||

In this verse, Lord Atreya said that I will explain, how the fetus does not get destroyed completely, but gets abnormalities/anomalies with the exposure of causative factors. When a woman gets indulged in ''dosha'' aggravating factors (diet/activities), it results in spread of these ''dosha'' in her body. When they reach ''shonita'' (ovum) and ''garbhashaya'' (uterus including fallopian tubes) and do not cause complete vitiation of ''shonita'' and ''garbhashaya'', in this situation when the woman is conceived with partially vitiated ''shonita'' and ''garbhashaya'', then abnormality of one or more organs occur due to vitiation of maternally derived organs of that ''garbha''. Whatever the ''beeja'' forming organs or part of ''beeja'' gets vitiated, corresponding organ gets abnormality (''vikriti'').

When the ''garbhashayabijabhaga'' (gene related to uterus) in the ovum of the mother gets vitiated, then she produces an infertile or ''vandhya'' female child and when the ''garbhashayabijabhagavayava'' (chromosome) in the ovum of a woman gets vitiated, then she produces a ''putipraja'' ((whose child dies before delivery). When the ''garbhashayabijabhagavayava'' as well as a part of female body producing ''beejabhaga'' of ovum in a woman gets vitiated, birth of a child takes place called ''varta'' (birth with female appearance but actually is not a female).These deformities are caused by the vitiation of the ovum. These are the morbidities due to involvement of the female chromosomes. [30]

एवमेव पुरुषस्य यदा बीजे बीजभागः प्रदोषमापद्यते, तदा वन्ध्यं जनयति; यदा पुनरस्य बीजे बीजभागावयवःप्रदोषमापद्यते, तदा पूतिप्रजं जनयति; यदा त्वस्य बीजे बीजभागावयवः पुरुषकराणां च शरीरबीजभागानामेकदेशःप्रदोषमापद्यते, तदा पुरुषाकृतिभूयिष्ठमपुरुषं तृणपुत्रिकं नाम जनयति; तां पुरुषव्यापदमाचक्षते||३१||

ēvamēva puruṣasya yadā bījē bījabhāgaḥ pradōṣamāpadyatē, tadā vandhyaṁ janayati; yadāpunarasya bījē bījabhāgāvayavaḥ pradōṣamāpadyatē, tadā pūtiprajaṁ janayati; yadā tvasya bījēbījabhāgāvayavaḥ puruṣakarāṇāṁ ca śarīrabījabhāgānāmēkadēśaḥ pradōṣamāpadyatē, tadāpuruṣākr̥tibhūyiṣṭhamapuruṣaṁ tr̥ṇaputrikaṁ nāma janayati; tāṁ puruṣavyāpadamācakṣatē||31||

evameva puruShasya yadA bIje bIjabhAgaH pradoShamApadyate, tadA vandhyaM janayati; yadApunarasya bIje bIjabhAgAvayavaH pradoShamApadyate, tadA pUtiprajaM janayati; yadA tvasya bIjebIjabhAgAvayavaH puruShakarANAM ca sharIrabIjabhAgAnAmekadeshaH pradoShamApadyate, tadApuruShAkRutibhUyiShThamapuruShaM tRuNaputrikaM nAma janayati; tAMpuruShavyApadamAcakShate||31||

In the same way, when the part of the ''beeja'' (gene of a sperm) is markedly vitiated, then this gives birth to a ''vandhya'' (sterile) child. When the ''beejabhagavayava'' (chromosome) is extremely vitiated, then this gives birth to a ''putipraja'' (whose child dies before delivery). When the ''beejabhagavayava'' of sperm and also portions of the ''beejabhaga'', which are responsible for the production of organs that differentiate a male, are greatly vitiated, then this gives birth to a child who is not a male but only having masculine distinctiveness in abundance. Such a type of child is known as ''trinaputrika''. These deformities are caused by the vitiation of the sperm (male genes and chromosomes). [31]

एतेन मातृजानां पितृजानां चावयवानां विकृतिव्याख्यानेन सात्म्यजानां रसजानां सत्त्वजानां चावयवानां विकृतिर्व्याख्याताभवति||३२||

ētēna mātr̥jānāṁ pitr̥jānāṁ cāvayavānāṁ vikr̥tivyākhyānēna sātmyajānāṁ rasajānāṁ sattvajānāṁcāvayavānāṁ vikr̥tirvyākhyātā bhavati||32||

etena mAtRujAnAM pitRujAnAM cAvayavAnAM vikRutivyAkhyAnena sAtmyajAnAM rasajAnAM sattvajAnAMcAvayavAnAM vikRutirvyAkhyAtA bhavati||32||

Thus, the abnormalities of organs derived from the mother (ovum) and father (sperm) has been explained. On the same line, the abnormalities of the organs resulting from ''satmya'' (adaptability), ''rasa'' (digestive product of the mother’s food) and ''sattva'' (mind) should be considered. [32]

निर्विकारः परस्त्वात्मा सर्वभूतानां निर्विशेषः; सत्त्वशरीरयोस्तु विशेषाद्विशेषोपलब्धिः||३३||

nirvikāraḥ parastvātmā sarvabhūtānāṁ nirviśēṣaḥ; sattvaśarīrayōstu viśēṣādviśēṣōpalabdhiḥ||33||

nirvikAraH parastvAtmA sarvabhUtAnAM nirvisheShaH; sattvasharIrayostuvisheShAdvisheShopalabdhiH||33||

The soul is devoid of disorders and beholds supreme position. The soul in different living beings is not different (it is same or part of the same consciousness). The difference in its presence/existence is felt only due to diverse features of the body and mind of different living beings. [33]

==== Causes of psychic and somatic abnormalities ====

तत्र त्रयः शरीरदोषा वातपित्तश्लेष्माणः, ते शरीरं दूषयन्ति; द्वौ पुनः सत्त्वदोषौ रजस्तमश्च, तौ सत्त्वं दूषयतः|

ताभ्यां च सत्त्वशरीराभ्यां दुष्टाभ्यां विकृतिरुपजायते, नोपजायते चाप्रदुष्टाभ्याम्||३४||

tatra trayaḥ śarīradōṣā vātapittaślēṣmāṇaḥ, tē śarīraṁ dūṣayanti; dvau punaḥ sattvadōṣau rajastamaśca,tau sattvaṁ dūṣayataḥ|

tābhyāṁ ca sattvaśarīrābhyāṁ duṣṭābhyāṁ vikr̥tirupajāyatē, nōpajāyatē cāpraduṣṭābhyām||34||

tatra trayaH sharIradoShA vAtapittashleShmANaH, te sharIraM dUShayanti; dvau punaH sattvadoShaurajastamashca, tau sattvaM dUShayataH|

tAbhyAM ca sattvasharIrAbhyAM duShTAbhyAM vikRutirupajAyate, nopajAyate cApraduShTAbhyAm||34||

There are three bodily ''doshas'' i.e. ''vata, pitta'' and ''kapha''- they vitiate the body. Again, there are two ''doshas'' of mind i. e. ''rajas'' and ''tamas''- they vitiate the mind. Vitiation of the body and the mind causes the expression of diseases and no disease is caused without vitiation of ''doshas''.

==== Four types of body types ====

तत्र शरीरं योनिविशेषाच्चतुर्विधमुक्तमग्रे||३५||

tatra śarīraṁ yōniviśēṣāccaturvidhamuktamagrē||35||

tatra sharIraM yonivisheShAccaturvidhamuktamagre||35||

Based upon the ''yoni'' (origin), the body of living beings is of four types, which has been mentioned earlier. [35]

==== Three types of psyche ====

त्रिविधं खलु सत्त्वं- शुद्धं, राजसं, तामसमिति|

तत्र शुद्धमदोषमाख्यातं कल्याणांशत्वात्, राजसं सदोषमाख्यातं रोषांशत्वात्, तामसमपि सदोषमाख्यातं मोहांशत्वात्|

तेषां तु त्रयाणामपि सत्त्वानामेकैकस्य भेदाग्रमपरिसङ्ख्येयं तरतमयोगाच्छरीरयोनिविशेषेभ्यश्चान्योन्यानुविधानत्वाच्च|

शरीरं ह्यपि सत्त्वमनुविधीयते, सत्त्वं च शरीरम्| तस्मात् कतिचित्सत्त्वभेदाननूकाभिनिर्देशेन निदर्शनार्थमनुव्याख्यास्यामः||३६||

trividhaṁ khalu sattvaṁ- śuddhaṁ, rājasaṁ, tāmasamiti|

tatra śuddhamadōṣamākhyātaṁ kalyāṇāṁśatvāt, rājasaṁ sadōṣamākhyātaṁ rōṣāṁśatvāt, tāmasamapisadōṣamākhyātaṁ mōhāṁśatvāt|

tēṣāṁ tu trayāṇāmapi sattvānāmēkaikasya bhēdāgramaparisaṅkhyēyaṁtaratamayōgāccharīrayōniviśēṣēbhyaścānyōnyānuvidhānatvācca|
śarīraṁ hyapi sattvamanuvidhīyatē, sattvaṁ ca śarīram|

tasmāt katicitsattvabhēdānanūkābhinirdēśēna nidarśanārthamanuvyākhyāsyāmaḥ||36||

trividhaM khalu sattvaM- shuddhaM, rAjasaM, tAmasamiti|

tatra shuddhamadoShamAkhyAtaM kalyANAMshatvAt, rAjasaM sadoShamAkhyAtaM roShAMshatvAt,tAmasamapi sadoShamAkhyAtaM mohAMshatvAt|

teShAM tu trayANAmapi sattvAnAmekaikasya bhedAgramaparisa~gkhyeyaMtaratamayogAccharIrayonivisheShebhyashcAnyonyAnuvidhAnatvAcca|
sharIraM hyapi sattvamanuvidhIyate, sattvaM ca sharIram|

tasmAt katicitsattvabhedAnanUkAbhinirdeshena nidarshanArthamanuvyAkhyAsyAmaH||36||

The mind is of three types – pure ''sattvika, rajasika'' and ''tamasika''. The pure ''sattvika'' one is free from causing abnormalities as it is gifted with auspiciousness; whereas the ''rajasika'' type is impure because it promotes furious temperament. In the same way, the ''tamasika'' one is similarly impure because of bewilderment. Each of these three types of mind can be sub-divided into innumerable forms owing to comparative proportions and type of body and origin of the body it resides into. The body influences the mind and vice versa. Therefore, some of the varieties of mind have been described briefly depicting their resemblance with recognized symbols. [36]

==== Seven types of ''sattva'' dominant psychic constitution ====

तद्यथा-

शुचिं सत्याभिसन्धं जितात्मानं संविभागिनं ज्ञानविज्ञानवचनप्रतिवचनसम्पन्नं स्मृतिमन्तंकामक्रोधलोभमानमोहेर्ष्याहर्षामर्षापेतं समं सर्वभूतेषु ब्राह्मं विद्यात् (१)|

इज्याध्ययनव्रतहोमब्रह्मचर्यपरमतिथिव्रतमुपशान्तमदमानरागद्वेषमोहलोभरोषंप्रतिभावचनविज्ञानोपधारणशक्तिसम्पन्नमार्षं विद्यात् (२)|

ऐश्वर्यवन्तमादेयवाक्यं यज्वानं शूरमोजस्विनं तेजसोपेतमक्लिष्टकर्माणं दीर्घदर्शिनं धर्मार्थकामाभिरतमैन्द्रं विद्यात् (३)|

लेखास्थवृत्तं प्राप्तकारिणमसम्प्रहार्यमुत्थानवन्तं स्मृतिमन्तमैश्वर्यलम्भिनं [५३] व्यपगतरागेर्ष्याद्वेषमोहं याम्यं विद्यात् ())|

शूरं धीरं शुचिमशुचिद्वेषिणं यज्वानमम्भोविहाररतिमक्लिष्टकर्माणं स्थानकोपप्रसादं वारुणं विद्यात् (५)|

स्थानमानोपभोगपरिवारसम्पन्नं धर्मार्थकामनित्यं शुचिं सुखविहारं व्यक्तकोपप्रसादं कौबेरं विद्यात् (६)|

प्रियनृत्यगीतवादित्रोल्लापकश्लोकाख्यायिकेतिहासपुराणेषु कुशलं गन्धमाल्यानुलेपनवसनस्त्रीविहारकामनित्यमनसूयकंगान्धर्वं विद्यात् (७)|

इत्येवं शुद्धस्य सत्त्वस्य सप्तविधं भेदांशं विद्यात् कल्याणांशत्वात्; तत्संयोगात्तु ब्राह्ममत्यन्तशुद्धं व्यवस्येत्||३७||

tadyathā-

śuciṁ satyābhisandhaṁ jitātmānaṁ saṁvibhāginaṁjñānavijñānavacanaprativacanasampannaṁ

smr̥timantaṁkāmakrōdhalōbhamānamōhērṣyāharṣāmarṣāpētaṁ samaṁ sarvabhūtēṣu brāhmaṁ vidyāt (1)|

ijyādhyayanavratahōmabrahmacaryaparamatithivratamupaśāntamadamānarāgadvēṣamōhalōbharōṣaṁpratibhāvacanavijñānōpadhāraṇaśaktisampannamārṣaṁ vidyāt (2)|

aiśvaryavantamādēyavākyaṁ yajvānaṁ śūramōjasvinaṁ tējasōpētamakliṣṭakarmāṇaṁ dīrghadarśinaṁdharmārthakāmābhiratamaindraṁ vidyāt (3)|

lēkhāsthavr̥ttaṁ prāptakāriṇamasamprahāryamutthānavantaṁ smr̥timantamaiśvaryalambhinaṁ [53]vyapagatarāgērṣyādvēṣamōhaṁ yāmyaṁ vidyāt (4)|

śūraṁ dhīraṁ śucimaśucidvēṣiṇaṁ yajvānamambhōvihāraratimakliṣṭakarmāṇaṁ sthānakōpaprasādaṁvāruṇaṁ vidyāt (5)|

sthānamānōpabhōgaparivārasampannaṁ dharmārthakāmanityaṁ śuciṁ sukhavihāraṁvyaktakōpaprasādaṁ kaubēraṁ vidyāt (6)|

priyanr̥tyagītavāditrōllāpakaślōkākhyāyikētihāsapurāṇēṣu kuśalaṁgandhamālyānulēpanavasanastrīvihārakāmanityamanasūyakaṁ gāndharvaṁ vidyāt (7)|

ityēvaṁ śuddhasya sattvasya saptavidhaṁ bhēdāṁśaṁ vidyāt kalyāṇāṁśatvāt; tatsaṁyōgāttubrāhmamatyantaśuddhaṁ vyavasyēt||37||

tadyathA-

shuciM satyAbhisandhaM jitAtmAnaM saMvibhAginaMj~jAnavij~jAnavacanaprativacanasampannaM

smRutimantaMkAmakrodhalobhamAnamoherShyAharShAmarShApetaM samaM sarvabhUteShu brAhmaM vidyAt (1)|

ijyAdhyayanavratahomabrahmacaryaparamatithivratamupashAntamadamAnarAgadveShamohalobharoShaMpratibhAvacanavij~jAnopadhAraNashaktisampannamArShaM vidyAt (2)|

aishvaryavantamAdeyavAkyaM yajvAnaM shUramojasvinaM tejasopetamakliShTakarmANaMdIrghadarshinaM dharmArthakAmAbhiratamaindraM vidyAt (3)|

lekhAsthavRuttaM prAptakAriNamasamprahAryamutthAnavantaM smRutimantamaishvaryalambhinaM [53]vyapagatarAgerShyAdveShamohaM yAmyaM vidyAt (4)|

shUraM dhIraM shucimashucidveShiNaM yajvAnamambhovihAraratimakliShTakarmANaMsthAnakopaprasAdaM vAruNaM vidyAt (5)|

sthAnamAnopabhogaparivArasampannaM dharmArthakAmanityaM shuciM sukhavihAraMvyaktakopaprasAdaM kauberaM vidyAt (6)|

priyanRutyagItavAditrollApakashlokAkhyAyiketihAsapurANeShu kushalaMgandhamAlyAnulepanavasanastrIvihArakAmanityamanasUyakaM gAndharvaM vidyAt (7)|

ityevaM shuddhasya sattvasya saptavidhaM bhedAMshaM vidyAt kalyANAMshatvAt; tatsaMyogAttubrAhmamatyantashuddhaM vyavasyet||37||

The pure ''sattvika'' type of mind is positive and is of seven categories. Their distinguishing features are furnished in the statement given below:
#'''''Brahma''''' (giving out the qualities of Brahma): Clean, love for truth, having control over self, power of eliminating bias, capable of learning, perceptive, power of description, reply and memory. Freedom from overenthusiasm, anger, greediness, self-esteem, lack of knowledge, envy, misery and narrow-mindedness and favorable outlook equally for all the individuals. The individuals having such qualities should be known as ''Brahma'' in mind.
#'''''Arsha''''' (giving out the qualities of ''rishis''): Dedication to holy rituals, study, sacred vows, oblations and celibacy, welcoming nature to the guest. Has freedom from self-importance, self-esteem, affection, detestation, lack of knowledge, greed and annoyance. The person is capable of intellectual excellence and eloquence, power of understanding and retention. The individuals having such qualities should be known as ''Arsha'' in mind.
#'''''Aindra''''' (giving out the qualities of Indra): Supremacy and trustworthy words, involved in holy rituals, endowed with bravery, strength and splendor, involved in good acts, far sightedness, always engaged in achievement of virtue, wealth, devotion to virtuous acts, earning of wealth and pleasure. The individuals having such qualities should be known as ''Indra'' in mind.
#'''''Yamya''''' (giving out the qualities of Yama): Observance of the humility of actions, timely instigation of dealings, non- aggressive, accomplished with promptness and memory, attaining supremacy, free from affection, jealousy, detestation and ignorance. The individuals having such qualities should be known as ''Yama'' in mind.
#'''''Varuna''''' (giving out the qualities of Varuna): Bravery, patience, clean and disliking for uncleanliness, engaged in holy rituals, affection for enjoyment in water, hatred for mean-actions, expression of anger and happiness in proper time and place. The individuals having such qualities should be known as ''Varuna'' in mind.
#'''''Kaubera''''' (giving out the qualities of Kubera): Capable of position, honor, luxuries and having family members (attendants), constantly involved in virtuous acts, wealth and satisfaction of desires, clean, comfortable movement, obvious annoyance and happiness. The individuals having such qualities should be known as ''Kaubera'' in mind.
#'''''Gandharva''''' (giving out the qualities of Gandharva): Fond of dancing, singing, music and praise, expert in poetry, stories, historical narrations and epics, constantly use scents, garlands, pastes, clothing, engaged with women and passion. The individuals having such qualities should be known as ''Gandharva'' in mind.

As a result, the pure mind has been divided in to seven types because of advantageous character. Brahma is considered as purest due to predominance of pure mind. [37]

==== Six types of ''rajas'' dominant psychic constitution ====

शूरं चण्डमसूयकमैश्वर्यवन्तमौपधिकं रौद्रमननुक्रोशमात्मपूजकमासुरं विद्यात् (१)|

अमर्षिणमनुबन्धकोपं छिद्रप्रहारिणं क्रूरमाहारातिमात्ररुचिमामिषप्रियतमं स्वप्नायासबहुलमीर्ष्युं राक्षसं विद्यात् (२)|

महाशनं [५७] स्त्रैणं स्त्रीरहस्काममशुचिं शुचिद्वेषिणं भीरुं भीषयितारं विकृतविहाराहारशीलं पैशाचं विद्यात् (३)|

क्रुद्धशूरमक्रुद्धभीरुं तीक्ष्णमायासबहुलं सन्त्रस्तगोचरमाहारविहारपरं [५८] सार्पं विद्यात् (४)|

आहारकाममतिदुःखशीलाचारोपचारमसूयकमसंविभागिनमतिलोलुपमकर्मशीलं प्रैतं विद्यात् (५)|

अनुषक्तकाममजस्रमाहारविहारपरमनवस्थितममर्षणमसञ्चयं शाकुनं विद्यात् (६)|

इत्येवं खलु राजसस्य सत्त्वस्य षङ्विधं भेदांशं विद्यात्, रोषांशत्वात्||३८||

śūraṁ caṇḍamasūyakamaiśvaryavantamaupadhikaṁ raudramananukrōśamātmapūjakamāsuraṁvidyāt (1)|

amarṣiṇamanubandhakōpaṁ chidraprahāriṇaṁ krūramāhārātimātrarucimāmiṣapriyatamaṁsvapnāyāsabahulamīrṣyuṁ rākṣasaṁ vidyāt (2)|

mahāśanaṁ [57] straiṇaṁ strīrahaskāmamaśuciṁ śucidvēṣiṇaṁ bhīruṁ bhīṣayitāraṁ vikr̥tavihārāhāraśīlaṁpaiśācaṁ vidyāt (3)|

kruddhaśūramakruddhabhīruṁ tīkṣṇamāyāsabahulaṁ santrastagōcaramāhāravihāraparaṁ [58] sārpaṁvidyāt (4)|

āhārakāmamatiduḥkhaśīlācārōpacāramasūyakamasaṁvibhāginamatilōlupamakarmaśīlaṁ praitaṁ vidyāt(5)|

anuṣaktakāmamajasramāhāravihāraparamanavasthitamamarṣaṇamasañcayaṁ śākunaṁ vidyāt (6)|

ityēvaṁ khalu rājasasya sattvasya ṣaṅvidhaṁ bhēdāṁśaṁ vidyāt, rōṣāṁśatvāt||38||

shUraM caNDamasUyakamaishvaryavantamaupadhikaM raudramananukroshamAtmapUjakamAsuraMvidyAt (1)|

amarShiNamanubandhakopaM chidraprahAriNaM krUramAhArAtimAtrarucimAmiShapriyatamaMsvapnAyAsabahulamIrShyuM rAkShasaM vidyAt (2)|

mahAshanaM [57] straiNaM strIrahaskAmamashuciM shucidveShiNaM bhIruM bhIShayitAraMvikRutavihArAhArashIlaM paishAcaM vidyAt (3)|

kruddhashUramakruddhabhIruM tIkShNamAyAsabahulaM santrastagocaramAhAravihAraparaM [58] sArpaMvidyAt (4)|

AhArakAmamatiduHkhashIlAcAropacAramasUyakamasaMvibhAginamatilolupamakarmashIlaM praitaMvidyAt (5)|

anuShaktakAmamajasramAhAravihAraparamanavasthitamamarShaNamasa~jcayaM shAkunaM vidyAt (6)|

ityevaM khalu rAjasasya sattvasya Sha~gvidhaM bhedAMshaM vidyAt, roShAMshatvAt||38||

The ''rajasika'' type of mind represents wrathful disposition and is of six types:

#'''''Asura''''': Brave, cruel, jealousy, supremacy, fraudulent, violent, lack of kindness, self praising individuals should be designated as ''asura'' mind.
#'''''Rakshasa''''': Intolerant with annoyance, attacking at weak points, cruel, fond of overeating, most desirous for meat, indulged more in sleep and hard work and jealous individuals should be designated as ''rakshasa'' mind.
#'''''Paishacha''''' (sharing the traits of ''pishacha''): Voracious habit, fond of women, desire for staying with women in secluded place, unclean, have an aversion for cleanliness, fearfulness and terrifying disposition, and habitual user of abnormal diet and regimens individuals should be designated as ''paishacha'' mind.
#'''''Sarpa''''' (sharing the traits of ''sarpa'' or snake): Bravery when in furious disposition and cowardice when not in furious disposition, sharp reaction, excessive hard worker, terrorizing, indulged in food and regimens with a fearful temperament.
#'''''Praita''''' (sharing the traits of a ''praita''): Extreme craving for food, extremely painful disposition in character, jealousness, actions with prejudice, extreme meanness and inactive individuals should be designated as ''praita'' mind.
#'''''Shakuna''''' (sharing the traits of a ''shakuni'' or bird): Passionate, excessively indulged in food and regimen, unstable, intolerant, and un-acquisitiveness. Such individuals should be designated as ''shakuna'' mind.

In this way, six types of ''rajas sattva'' are described, all of them having agitation quality in common. [38]

==== Three types of ''tamas'' dominant psychic constitution ====

निराकरिष्णुममेधसं जुगुप्सिताचाराहरं मैथुनपरं स्वप्नशीलं पाशवं विद्यात् (१)|

भीरुमबुधमाहारलुब्धमनवस्थितमनुषक्तकामक्रोधं सरणशीलं तोयकामं मात्स्यं विद्यात् (२)|

अलसं केवलमभिनिविष्टमाहारे सर्वबुद्ध्यङ्गहीनं वानस्पत्यं विद्यात् (३)|

इत्येवं तामसस्य सत्त्वस्य त्रिविधं भेदांशं विद्यान्मोहांशत्वात्||३९||

nirākariṣṇumamēdhasaṁ jugupsitācārāharaṁ maithunaparaṁ svapnaśīlaṁ pāśavaṁ vidyāt (1)|

bhīrumabudhamāhāralubdhamanavasthitamanuṣaktakāmakrōdhaṁ saraṇaśīlaṁ tōyakāmaṁ mātsyaṁvidyāt (2)|

alasaṁ kēvalamabhiniviṣṭamāhārē sarvabuddhyaṅgahīnaṁ vānaspatyaṁ vidyāt (3)|

ityēvaṁ tāmasasya sattvasya trividhaṁ bhēdāṁśaṁ vidyānmōhāṁśatvāt||39||

nirAkariShNumamedhasaM jugupsitAcArAharaM maithunaparaM svapnashIlaM pAshavaM vidyAt (1)|

bhIrumabudhamAhAralubdhamanavasthitamanuShaktakAmakrodhaM saraNashIlaM toyakAmaM mAtsyaMvidyAt (2)|

alasaM kevalamabhiniviShTamAhAre sarvabuddhya~ggahInaM vAnaspatyaM vidyAt (3)|

ityevaM tAmasasya sattvasya trividhaM bhedAMshaM vidyAnmohAMshatvAt||39||

The ''tamasika'' type of mental faculty represents ignorant disposition and is of three types. Their characteristic features are:
#'''''Pashava''''' (sharing the traits of animal) Has forbidding disposition, lack of intelligence, terrible conduct and food habit, excessive sexual indulgence and sleep.
#'''''Matsya''''' (sharing the traits of fish) personality possess timid, lack of intelligence, greediness for food, unsteadiness, constantly passionate and wrathful disposition, fondness for constant movement and desire for water.
#'''''Vanaspataya''''' (sharing the traits of vegetable life) Sluggishness, indulgence in food, and deficiency of all the intellectual faculties. [39]

==== Innumerable types of mind based on combinations ====

इत्यपरिसङ्ख्येयभेदानां त्रयाणामपि सत्त्वानां भेदैकदेशो व्याख्यातः; शुद्धस्य सत्त्वस्य सप्तविधोब्रह्मर्षिशक्रयमवरुणकुबेरगन्धर्वसत्त्वानुकारेण, राजसस्य षड्विधो दैत्यपिशाचराक्षससर्पप्रेतशकुनिसत्त्वानुकारेण, तामसस्यत्रिविधः पशुमत्स्यवनस्पतिसत्त्वानुकारेण, कथं च यथासत्त्वमुपचारः स्यादिति||४०||

ityaparisaṅkhyēyabhēdānāṁ trayāṇāmapi sattvānāṁ bhēdaikadēśō vyākhyātaḥ; śuddhasya sattvasyasaptavidhō brahmarṣiśakrayamavaruṇakubēragandharvasattvānukārēṇa, rājasasya ṣaḍvidhōdaityapiśācarākṣasasarpaprētaśakunisattvānukārēṇa, tāmasasya trividhaḥpaśumatsyavanaspatisattvānukārēṇa, kathaṁ ca yathāsattvamupacāraḥ syāditi||40||

ityaparisa~gkhyeyabhedAnAM trayANAmapi sattvAnAM bhedaikadesho vyAkhyAtaH; shuddhasya sattvasyasaptavidho brahmarShishakrayamavaruNakuberagandharvasattvAnukAreNa, rAjasasya ShaDvidhodaityapishAcarAkShasasarpapretashakunisattvAnukAreNa, tAmasasya trividhaHpashumatsyavanaspatisattvAnukAreNa, kathaM ca yathAsattvamupacAraH syAditi||40||

In this way, three types of mind have innumerable varieties. The ''sattvika'' type of mental faculty is of seven types depending upon the disposition of Brahma, Rishi, Indra, Yama, Varuna, Kubera and Gandharva. The ''rajasa'' type of mind is of six types depending upon the dispositions of ''asura, rakshasa, paishacha, sarpa, preta'' and ''shakuni''. The ''tamasa'' type of mind faculty is of three types depending upon the dispositions of ''pashu'' (animal), ''matsya'' (fish) and ''vanaspati'' (vegetable life). All these descriptions are made with a view to indicate the general mode of mind treatment that should be provided. [40]

केवलश्चायमुद्देशो यथोद्देशमभिनिर्दिष्टो भवति गर्भावक्रान्तिसम्प्रयुक्तः ; तस्य चार्थस्य विज्ञाने सामर्थ्यं गर्भकराणां चभावानामनुसमाधिः, विधातश्च विघातकराणां भावानामिति||४१||

kēvalaścāyamuddēśō yathōddēśamabhinirdiṣṭō bhavati garbhāvakrāntisamprayuktaḥ ; tasya cārthasyavijñānē sāmarthyaṁ garbhakarāṇāṁ ca bhāvānāmanusamādhiḥ, vidhātaśca vighātakarāṇāṁbhāvānāmiti||41||

kevalashcAyamuddesho yathoddeshamabhinirdiShTo bhavati garbhAvakrAntisamprayuktaH ; tasyacArthasya vij~jAne sAmarthyaM garbhakarANAM ca bhAvAnAmanusamAdhiH, vidhAtashca vighAtakarANAMbhAvAnAmiti||41||

In this way, the entire description of descent into embryo is explained in keeping with the purpose with which the chapter was initiated i.e. to provide knowledge regarding the formation of embryo. By obtaining this knowledge one can help to way out to the factors which are responsible for the proper growth of the fetus and avoiding the factors which come in the way of its proper development. [41]

==== Summary ====

तत्र श्लोकाः-

निमित्तमात्मा प्रकृतिर्वृद्धिः कुक्षौ क्रमेण च|

वृद्धिहेतुश्च गर्भस्य पञ्चार्थाः शुभसञ्ज्ञिताः||४२||

tatra ślōkāḥ-

nimittamātmā prakr̥tirvr̥ddhiḥ kukṣau kramēṇa ca|

vr̥ddhihētuśca garbhasya pañcārthāḥ śubhasañjñitāḥ||42||

tatra shlokAH-

nimittamAtmA prakRutirvRuddhiH kukShau krameNa ca|

vRuddhihetushca garbhasya pa~jcArthAH shubhasa~jj~jitAH||42||

Competent cause (''nimitta''), soul, ''prakriti'', gradual development of the fetus in uterus and the factors responsible for the growth are the five auspicious things for the conception. [42]

अजन्मनि च यो हेतुर्विनाशे विकृतावपि|

इमांस्त्रीनशुभान् भावानाहुर्गर्भविघातकान्||४३||

ajanmani ca yō hēturvināśē vikr̥tāvapi|

imāṁstrīnaśubhān bhāvānāhurgarbhavighātakān||43||

ajanmani ca yo heturvinAshe vikRutAvapi|

imAMstrInashubhAn bhAvAnAhurgarbhavighAtakAn||43||

The factors which are responsible for the prevention of conception, damaging the fetus and teratological abnormalities are three inauspicious factors responsible for ''garbhavighataka'' or destructors of fetus. [43]

शुभाशुभसमाख्यातानष्टौ भावानिमान् भिषक्|

सर्वथा वेद यः सर्वान् स राज्ञः कर्तुमर्हति||४४||

śubhāśubhasamākhyātānaṣṭau bhāvānimān bhiṣak|

sarvathā vēda yaḥ sarvān sa rājñaḥ kartumarhati||44||

shubhAshubhasamAkhyAtAnaShTau bhAvAnimAn bhiShak|

sarvathA veda yaH sarvAn sa rAj~jaH kartumarhati||44||

The individual who knows all these eight factors which are auspicious and inauspicious for the fetus is capable to be a physician of king. [44]

अवाप्त्युपायान् गर्भस्य स एवं ज्ञातुमर्हति|

ये च गर्भविघातोक्ता भावास्तांश्चाप्युदारधीः||४५||

avāptyupāyān garbhasya sa ēvaṁ jñātumarhati|

yē ca garbhavighātōktā bhāvāstāṁścāpyudāradhīḥ||45||

avAptyupAyAn garbhasya sa evaM j~jAtumarhati|

ye ca garbhavighAtoktA bhAvAstAMshcApyudAradhIH||45||

The physician having intelligence, kindness should know those factors which help in the formation and growth of the fetus and also those which are responsible for the destruction of the fetus. [45]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते शारीरस्थाने

महतीगर्भावक्रान्तिशारीरं नाम चतुर्थोऽध्यायः||४||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē śārīrasthānē

mahatīgarbhāvakrāntiśārīraṁ nāma caturthō'dhyāyaḥ||4||

ityagniveshakRute tantre carakapratisaMskRute shArIrasthAne

mahatIgarbhAvakrAntishArIraM nAma caturtho~adhyAyaH||4||

Thus, ends the fourth chapter on “The chapter on the major information of the embryo as conducive to the understanding of the body.” of [[Sharira Sthana]] in the treatise by Agnivesha and redacted by Charak. [4]

=== ''Tattva Vimarsha'' ===

*The aggregation of factors coming from mother, father, the soul, wholesome regimen, ''rasa'' (nutritive fluid) and the mind is important for conception and development of embryo. Any irregularity or deformity in any of these factors will adversely affect the same.
*The unification of sperm and ovum with the soul in the womb will lead to formation of ''garbha'' (embryo). Soul is essential component to make the union of sperm and ovum alive.
*The ''mahabhutas'' are basic constituents of embryo. Chronological development of ''mahabhutas'' is owing to a sequence according to their production or creation in nature.
*In the fetus, the parts originated from ''akasha mahabhuta'' are- sound, auditory sensation, lightness, fineness and space; the parts from ''vayu mahabhuta'' are – tangibility, sense of touch, roughness, impulsion, structuring of body tissues and maintaining of movements of the body and ''dosha''; the parts belonging to ''agni mahabhuta'' are visible form, vision, brightness, digestion and heat; those belonging to ''apa mahabhuta'' are taste, sense of taste, coldness, softness, unctuousness and moisture; those belonging to ''prithvi mahabhuta'' are odor, sensation of smell, heaviness, steadiness and material form.
*The individual is an embodiment of the universe. All the material and spiritual phenomena of the universe are present in the individual and vice versa.
*The development of embryo takes place gradually in nine months and may be extended to ten months. Anything before this period or after this period will lead to complications during the birth.
*The common factors that are harmful for the fetus include excessive use of heavy to digest, hot and pungent substances, exertion activities.
*The health status of fetus profoundly depends upon the ''beeja'' (sperm and ovum), their ''beejabhaga'' (genes) and ''beejabhagavaya'' (chromosomes). If anyone of these are abnormal, then it leads to congenital disorders.
*The soul is devoid of disorders and beholds supreme position. The soul in different living beings is not different (it is same or part of the same consciousness). The difference in its presence/existence is felt only due to diverse features of the body and mind of different living beings.
*''Doshas'' are definite reasons behind production of disease in body and mind.
*The mind is of three types – pure ''sattvika, rajasika'' and ''tamasika''.
*The pure ''sattvika'' one is free from causing abnormalities as it is gifted with auspiciousness; whereas the ''rajasika'' type is impure because it promotes furious temperament. In the same way, the ''tamasika'' one is similarly impure because of bewilderment.
*Each of these three types of mind can be sub-divided into innumerable forms owing to comparative proportions and type of body and origin of the body it resides into.
*The behavior trait of a person depends upon the dominance of ''sattva, rajas'' or ''tamas'' in psychic constitution.
*The body influences the mind and vice versa. Thus each somatic disorder affects psyche and each psychiatric disorder affects soma.
*Competent cause (''nimitta''), soul, ''prakriti'', gradual development of the fetus in uterus and the factors responsible for the growth are the five auspicious things for the conception.
*The factors which are responsible for the prevention of conception, damaging the fetus and teratological abnormalities are three inauspicious factors responsible for ''garbhavighataka'' or destructors of fetus.

=== ''Vidhi Vimarsha'' ===

Following points are important in present context:

#The importance of soul in the process of conception in view of in vitro fertilization, test tube baby

#Development of embryo in nine months

#Beneficial and harmful factors for embryonic development

#Genetic and chromosomal relevance of statements on ''bijabhaga'', ''bijabhagavaya'' etc.

=== Glossary ===

#''Ritukala'' – Fertile period after menstruation. The best period in menstrual cycle in which chances of fertilization is maximum.
#''Garbhakarabhavas'' – Procreative factors for fetus. Factors responsible for formation and development of the fetus.
#''Mahati'' – Big, In detail
#''Garbhavakranti'' - Embryogeneis and development of fetus. The physiological process of union of sperm and ovum followed by growth and development of fetus throughout nine months.
#''Garbhini''¬- Pregnant female. After conception the female is termed as ''Garbhini''.
#''Garbhopghatkarbhava'' – Factors likely to harm the fetus.
#''Dauhridam'' – Desires of pregnant woman. A stage in pregnancy in which desires of baby are expressed through maternal cravings.
#''Dauhradini'' / ''Dauhrida'' - The term literally means lady with dual hearts one of herself and other of the baby.
#''Labdhagarbha'' – A lady who has achieved conception.
#''Vandhya'' – Female sterility. Absolute inability to conceive along with presence or absence of secondary sexual characteristics. An congenital condition according to Charak
#''Varta'' - Congenital anomalies of female in which she lacks feminine characteristics.
#''Upasneha'' – Attracting moisture. Hygroscopic. A pathway for fetal nourishment.
#''Upasweda'' – Body heat. Required for cell multiplication and survival.
#''Garbhavriddhi'' – Fetal growth and development
#''Beeja'' - Ovum or sperm, Male or female gamete
#''Beejabhaga'' – Chromosomes present in gametes
#''Beejabhagavayava'' - Genes
#''Beejadosha'' - Defective ovum leading to various congenital anomalies in fetus.
#''Putipraja'' - Putrified fetus. Can be termed as Intrauterine fetal death
#''Satvika'' - One of the three psychological traits.
#''Rajasika''- One of the three psychological traits.
#''Tamasika'' - One of the three psychological traits.
#''Kukshi''¬ - Abdomen. Here with reference to the context, ''kukshi'' refers to uterus.
#''Ritumati''– The female in the best suitable period of conception i.e. after completion of menstruation till further 12 nights.
#''Raja'' – Menstruation, Menstrual blood
#''Samudaya'' - Collection, aggregation
#''Khetbhuta'' – Which looks like mucus
#''Klaibya'' – cowardice
#''Bhirtuva'' – timidy, fearfulness
#''Avaisharadhyam'' – Lack of confidence, lack of skill
#''Moha'' – ignorance, delusion, foolishness
#''Anavasthana'' – unstable, fickle minded
#''Adhogurutvam'' – heaviness in the lower part of the body
#''Asahanam'' – not tolerating
#''Mardavam'' – softness
#''Shaithilyam'' – Laxity
#''Dauhrida Vimanana'' – Refusal of desires, Denial of desires
#''Stana'' - Breast
#''Stanamandala'' – Areola
#''Stanaostha'' / ''Stanachuchuk'' – Nipples
#''Oja'' – ''Oja'' is a Sanskrit word which literally means "vigor". According to the principles of Ayurveda, it is the essential energy of the body which can be equated with the "fluid of life," but its existence has not been proven in any way.
#''Prasavakala'' - Time of labor, Date of Delivery
#''Bhava Sampad'' - Excellence of factors
#''Vritta'' - Lifestyle
#''Trinaputrika'' – Congenital anomalies of male which lacks masculine characteristics.
#''Prakriti'' – Nature, constitution
#''Pathya'' – Digestible, wholesome, suitable
#''Apathya'' – Unsuitable, unwholesome
#''Asatmya'' – unwholesome
#''Bala'' – Strength, stamina
#''Avastha'' – State, condition
#''Kala'' – Season, era, time
#''Muhurmuhu'' – Again and again, repeatedly
#''Satmya'' – Constitution, habituation , wholesomeness
#''Sattva'' – Mental attitude
#''Sahaja'' – Congenital factor for disease
#''Vyayama'' – Exercise
#''Vyavaya'' – Sexual intercourse
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Khuddika Garbhavakranti Sharira

2019-03-06T03:45:09Z

Pallavmishra:

{{Infobox
|title = Khuddika Garbhavakranti Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 3
|label2 = Preceding Chapter
|data2 = [[Atulyagotriya Sharira]]

|label3= Succeeding Chapter
|data3 = [[Mahatigarbhavakranti Sharira]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

== [[Sharira Sthana]] Chapter 3, Khuddika Garbhavakranti Sharira (Chapter on Factors responsible for Embryogenesis)==

=== Abstract ===
<div style="text-align:justify;">
The present chapter titled [[Khuddika Garbhavakranti Sharira]] deals with six important factors that are responsible for embryogenesis: mother, father, ''atma'' (soul), ''satmya'' (suitability), ''rasa'' (nutritive fluid), and ''sattva'' (mind). The chapter emphasizes upon the fact that none of these factors has the ability to produce an embryo independently, but a combination of all the six is essential for this process.

'''Keywords''': ''Shadbhava, Garbha, Matrija, Pitrija, Sattvaja, Satmyaja, Rasaja, Atmaja,'' Embryogenesis, Influencing factors, Maternal inheritance
</div>
=== Introduction ===
<div style="text-align:justify;">
The previous chapter was on the union of male and female gametes resulting in the formation of embryo. The present chapter is a “minor” chapter on the formation of embryo, serving as a prologue to the “major” chapter on embryogenesis that follows this one ([[Mahatigarbhavakranti Sharira]]). In this chapter on embryogenesis, in the context of sharira (human biology), the following topics have been dealt with:
#Factors responsible for the formation, growth and birth of the embryo;
#The views of Lord Atreya and the sage Bharadvaja on this topic.
#Refutation on the conclusions (by Bharadvaja); and
#A detailed exposition on the nature of the soul.
</div>
===Sanskrit text, Transliteration and English Translation===

अथातः खुड्डिकां गर्भावक्रान्तिं शारीरं व्याख्यास्यामः||१|| इति ह स्माह भगवानात्रेयः||२||

iti ha smāha bhagavānātrēyaḥ||2|| athātaḥ khuḍḍikāṁ garbhāvakrāntiṁ śārīraṁ vyākhyāsyāmaḥ||1||

iti ha smAha bhagavAnAtreyaH||2|| athAtaH khuDDikAM garbhAvakrAntiM shArIraM vyAkhyAsyAmaH||1||

We shall now expound the chapter on “factors responsible for embryogenesis” in the context of ''sharira'' (human biology).Thus said Lord Atreya. [1-2]

====Debate on formation of ''Garbha'' (embryo) ====

पुरुषस्यानुपहतरेतसः स्त्रियाश्चाप्रदुष्टयोनिशोणितगर्भाशयाया यदा भवति संसर्गः ऋतुकाले, यदा चानयोस्तथायुक्ते संसर्गेशुक्रशोणितसंसर्गमन्तर्गर्भाशयगतं जीवोऽवक्रामति सत्त्वसम्प्रयोगात्तदा गर्भोऽभिनिर्वतेते, स सात्म्यरसोपयोगादरोगोऽभिवर्धते सम्यगुपचारैश्चोपचर्यमाणः, ततः प्राप्तकालः सर्वेन्द्रियोपपन्नः परिपूर्णशरीरो बलवर्णसत्त्वसंहननसम्पदुपेतः सुखेन जायतेसमुदयादेषां भावानां-मातृजश्चायं गर्भः पितृजश्चात्मजश्च सात्म्यजश्च रसजश्च, अस्ति च खलु सत्त्वमौपपादुकमिति होवाच भगवानात्रेयः||३||

puruṣasyānupahatarētasaḥ striyāścāpraduṣṭayōniśōṇitagarbhāśayāyā yadā bhavati saṁsargaḥ r̥tukālē, yadā cānayōstathāyuktē saṁsargē śukraśōṇitasaṁsargamantargarbhāśayagataṁ jīvō'vakrāmatisattvasamprayōgāttadā garbhō'bhinivartatē, sa sātmyarasōpayōgādarōgō'bhivardhatēsamyagupacāraiścōpacaryamāṇaḥ, tataḥ prāptakālaḥ sarvēndriyōpapannaḥ paripūrṇaśarīrōbalavarṇasattvasaṁhananasampadupētaḥ sukhēna jāyatē samudayādēṣāṁ bhāvānāṁ- mātr̥jaścāyaṁgarbhaḥ pitr̥jaścātmajaśca sātmyajaśca rasajaśca, asti ca khalu sattvamaupapādukamiti hōvācabhagavānātrēyaḥ||3||

puruShasyAnupahataretasaH striyAshcApraduShTayonishoNitagarbhAshayAyA yadA bhavati saMsargaH RutukAle,yadA cAnayostathAyukte saMsarge shukrashoNitasaMsargamantargarbhAshayagataM jIvo~avakrAmatisattvasamprayogAttadA garbho~abhinirvatete, sa sAtmyarasopayogAdarogo~abhivardhatesamyagupacAraishcopacaryamANaH, tataH prAptakAlaH sarvendriyopapannaH paripUrNasharIrobalavarNasattvasaMhananasampadupetaH sukhena jAyate samudayAdeShAM bhAvAnAM- mAtRujashcAyaM garbhaHpitRujashcAtmajashca sAtmyajashca rasajashca, asti ca khalu sattvamaupapAdukamiti hovAcabhagavAnAtreyaH||3||
<div style="text-align:justify;">
When a man with ''retas''(semen) not afflicted by any abnormality and a woman with disease-free ''yoni'' (genital tract), ''shonita'' (ovum), and ''garbhashaya'' (uterine bed) engage in the act of coitus during the fertile phase, the ''jeeva'' (soul), along with ''sattva'' (mind), descends into the union of sperm and ovum, i.e., zygote which is implanted in the uterus. This results in the formation of the ''garbha'' (embryo). The zygote receiving nourishment by the nutritious ''rasa'' (nutritive fluid) and, on being nursed with proper antenatal care, grows healthily. Later the fetus with all the ''indriyani'' (sensory and motor organs) is formed. The fetus thus formed is complete with all the body parts, and is equipped with optimum strength, complexion, mental faculties and compactness leading to comfortable and timely delivery. This occurs due to the combination of the factors derived from the ''mata'' (mother), ''pita'' (father), ''atma'' (soul), ''satmya'' (suitability), and, ''rasa'' (nutritive fluid). Another factor, ''sattva'' (mind), which is self-produced, also contributes to this process. So said Lord Atreya. [3]
</div>
नेति भरद्वाजः, किं कारणं- न हि माता न पिता नात्मा न सात्म्यं न पानाशनभक्ष्यलेह्योपयोगा गर्भं जनयन्ति, न चपरलोकादेत्य गर्भं सत्त्वमवक्रामति (१)|४|
nēti bharadvājaḥ, kiṁ kāraṇaṁ- na hi mātā na pitā nātmā na sātmyaṁ na pānāśanabhakṣyalēhyōpayōgāgarbhaṁ janayanti, na ca paralōkādētya garbhaṁ sattvamavakrāmati (1)|4|

neti bharadvAjaH, kiM kAraNaM- na hi mAtA na pitA nAtmA na sAtmyaM na pAnAshanabhakShyalehyopayogA garbhaMjanayanti, na ca paralokAdetya garbhaM sattvamavakrAmati (1)|4|
<div style="text-align:justify;">
Sage Bharadvaja said: “No. because neither mother, nor father, nor the soul, nor suitability (or articles that the person is accustomed to), nor the utilization of ''pana'' (drinks), ''ashana'' (foods), ''bhakshya'' (solid eatables) and ''lehya'' (semisolid eatables) can produce an embryo. Nor does the mind come from the world beyond to enter into the zygote”. [4.1]
</div>
यदि हि मातापितरौ गर्भं जनयेतां, भूयस्यः स्त्रियः पुमांसश्च भूयांसः पुत्रकामाः, ते सर्वे पुत्रजन्माभिसन्धायमैथुनधर्ममापद्यमानाः पुत्रानेव जनयेयुर्दुहितॄर्वा दुहितृकामाः, न तु काश्चित् स्त्रियः केचिद्वा पुरुषा निरपत्याः स्युरपत्यकामा वा परिदेवेरन् (२)|४|

yadi hi mātāpitarau garbhaṁ janayētāṁ, bhūyasyaḥ striyaḥ pumāṁsaśca bhūyāṁsaḥ putrakāmāḥ, tē sarvēputrajanmābhisandhāya maithunadharmamāpadyamānāḥ putrānēva janayēyurduhitr̥̄rvā duhitr̥kāmāḥ, na tukāścit striyaḥ kēcidvā puruṣā nirapatyāḥ syurapatyakāmā vā paridēvēran (2)|4|

yadi hi mAtApitarau garbhaM janayetAM, bhUyasyaH striyaH pumAMsashca bhUyAMsaH putrakAmAH, te sarveputrajanmAbhisandhAya maithunadharmamApadyamAnAH putrAneva janayeyurduhitRUrvA duhitRukAmAH, na tukAshcit striyaH kecidvA puruShA nirapatyAH syurapatyakAmA vA parideveran (2)|4|

If only parents could create a baby, then many couples who desire sons could beget them by simply resorting to coitus. Similarly, those who desire daughters could beget daughters. Childless couples would not have been craving for a child. [4.2]

न चात्माऽऽत्मानं जनयति|
यदि ह्यात्माऽऽत्मानं जनयेज्जातो वा जनयेदात्मानमजातो वा, तच्चोभयथाऽप्ययुक्तम्|
न हि जातो जनयति सत्त्वात्, न चाजातो जनयत्यसत्त्वात्, तस्मादुभयथाऽप्यनुपपत्तिः|
तिष्ठतु तावदेतत्|
यद्ययमात्माऽऽत्मानं शक्तो जनयितुं स्यात्, न त्वेनमिष्टास्वेव कथं योनिषु जनयेद्वशिनमप्रतिहतगतिं कामरूपिणंतेजोबलजववर्णसत्त्वसंहननसमुदितमजरमरुजममरम्; एवंविधं ह्यात्माऽऽत्मानमिच्छत्यतो वा भूयः (३)|४|

na cātmā''tmānaṁ janayati|
yadi hyātmā''tmānaṁ janayējjātō vā janayēdātmānamajātō vā, taccōbhayathā'pyayuktam|
na hi jātō janayati sattvāt, na cājātō janayatyasattvāt, tasmādubhayathā'pyanupapattiḥ|
tiṣṭhatu tāvadētat|
yadyayamātmā''tmānaṁ śaktō janayituṁ syāt, na tvēnamiṣṭāsvēva kathaṁ yōniṣujanayēdvaśinamapratihatagatiṁ kāmarūpiṇaṁtējōbalajavavarṇasattvasaṁhananasamuditamajaramarujamamaram; ēvaṁvidhaṁhyātmā''tmānamicchatyatō vā bhūyaḥ (3)|4|

na cAtmA~a~atmAnaM janayati|
yadi hyAtmA~a~atmAnaM janayejjAto vA janayedAtmAnamajAto vA, taccobhayathA~apyayuktam|
na hi jAto janayati sattvAt, na cAjAto janayatyasattvAt, tasmAdubhayathA~apyanupapattiH|
tiShThatu tAvadetat|
yadyayamAtmA~a~atmAnaM shakto janayituM syAt, na tvenamiShTAsveva kathaM yoniShujanayedvashinamapratihatagatiM kAmarUpiNaMtejobalajavavarNasattvasaMhananasamuditamajaramarujamamaram; evaMvidhaM hyAtmA~a~atmAnamicchatyatovA bhUyaH (3)|4|
<div style="text-align:justify;">
Soul is not born out of another soul. If one soul could beget another soul, it would lead to a question – which kind - born or unborn soul -would beget the other soul? Any argument supporting either of these would not be feasible. As the born soul already exists, it cannot beget itself. As the unborn soul does not exist, it cannot beget itself either. Therefore, the argument is unsustainable either ways. Let us view this from another perspective. If the soul could reproduce itself, then how come it does not choose a noble birth endowed with authority, unrestricted movement, capacity to take the forms as he wishes, luster, strength, agility, good complexion, healthy mind, structural integrity and free from aging, illness and death? The soul desiring to become so, should become so or even better. [4.3]
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असात्म्यजश्चायं गर्भः|
यदि हि सात्म्यजःस्यात्, तर्हि सात्म्यसेविनामेवैकान्तेन प्रजा स्यात्, असात्म्यसेविनश्च निखिलेनानपत्याः स्युः,तच्चोभयमुभयत्रैव दृश्यते (४)|४|

asātmyajaścāyaṁ garbhaḥ|
yadi hi sātmyajaḥsyāt, tarhi sātmyasēvināmēvaikāntēna prajā syāt, asātmyasēvinaśca nikhilēnānapatyāḥsyuḥ, taccōbhayamubhayatraiva dr̥śyatē (4)|4|

asAtmyajashcAyaM garbhaH|
yadi hi sAtmyajaHsyAt, tarhi sAtmyasevinAmevaikAntena prajA syAt, asAtmyasevinashca nikhilenAnapatyAH syuH,taccobhayamubhayatraiva dRushyate (4)|4|
<div style="text-align:justify;">
Regiment (suitable to one’s nature or accustomed to) is not responsible for the embryogenesis. If it were so, then only those who practice such regimen should beget children and the others who do not should never beget a child. However, we see that there is clearly no correlation. [4.4]
</div>
अरसजश्चायं गर्भः|
यदि हि रसजः स्यात्, न केचित् स्त्रीपुरुषेष्वनपत्याः स्युः, न हि कश्चिदस्त्येषां यो रसान्नोपयुङ्क्ते; श्रेष्ठरसोपयोगिनांचेद्गर्भा जायन्त इत्यभिप्रेतमिति, एवं सत्याजौरभ्रमार्गमायूरगोक्षीरदधिघृतमधुतैलसैन्धवेक्षुरसमुद्गशालिभृतानामेवैकान्तेनप्रजा स्यात्, श्यामाकवरकोद्दालककोरदूषककन्दमूलभक्षाश्च निखिलेनानपत्याः स्युः, तच्चोभयमुभयत्र दृश्यते (५)|४|

arasajaścāyaṁ garbhaḥ|
yadi hi rasajaḥ syāt, na kēcit strīpuruṣēṣvanapatyāḥ syuḥ, na hi kaścidastyēṣāṁ yō rasānnōpayuṅktē;śrēṣṭharasōpayōgināṁ cēdgarbhā jāyanta ityabhiprētamiti, ēvaṁsatyājaurabhramārgamāyūragōkṣīradadhighr̥tamadhutailasaindhavēkṣurasamudgaśālibhr̥tānāmēvaikāntēnaprajā syāt, śyāmākavarakōddālakakōradūṣakakandamūlabhakṣāśca nikhilēnānapatyāḥ syuḥ,taccōbhayamubhayatra dr̥śyatē (5)|4|

arasajashcAyaM garbhaH|
yadi hi rasajaH syAt, na kecit strIpuruSheShvanapatyAH syuH, na hi kashcidastyeShAM yo rasAnnopayu~gkte;shreShTharasopayoginAM cedgarbhA jAyanta ityabhipretamiti, evaMsatyAjaurabhramArgamAyUragokShIradadhighRutamadhutailasaindhavekShurasamudgashAlibhRutAnAmevaikAntenaprajA syAt, shyAmAkavarakoddAlakakoradUShakakandamUlabhakShAshca nikhilenAnapatyAH syuH,taccobhayamubhayatra dRushyate (5)|4|
<div style="text-align:justify;">
The embryo is not formed of ''rasa''. If it were so, then none of the couples would remain without a child, as none of them can live without ''rasa''. If only the individuals having ''rasa'' of the best quality were supposed to have children, then only those who consumed meat soup of goat, sheep, deer, and peacock, milk, yoghurt and ghee of the cow, honey, oil, rock salt, sugarcane juice, green gram and ''shali'' rice for nourishment should have been begetting children and the others who consume ''syamaka, varaka, uddalaka, koradushaka,'' rhizomes and roots should have been childless. However, in both these scenarios, we can see that that’s not the case. [4.5]
</div>
न खल्वपि परलोकादेत्य सत्त्वं गर्भमवक्रामति; यदि ह्येनमवक्रामेत्, नास्य किञ्चित् पौर्वदेहिकं स्यादविदितमश्रुतमदृष्टं वा,स च तच्च न किञ्चिदपि स्मरति (६)||४||

तस्मादेतद्ब्रूमहे-
अमातृजश्चायं गर्भोऽपितृजश्चानात्मजश्चासात्म्यजश्चारसजश्च, न चास्ति सत्त्वमौपपादुकमिति (होवाचभरद्वाजः)||४||

na khalvapi paralōkādētya sattvaṁ garbhamavakrāmati; yadi hyēnamavakrāmēt, nāsya kiñcitpaurvadēhikaṁ syādaviditamaśrutamadr̥ṣṭaṁ vā, sa ca tacca na kiñcidapi smarati (6)||4||
tasmādētadbrūmahē- amātr̥jaścāyaṁ garbhō'pitr̥jaścānātmajaścāsātmyajaścārasajaśca, na cāstisattvamaupapādukamiti (hōvāca bharadvājaḥ)||4||

na khalvapi paralokAdetya sattvaM garbhamavakrAmati; yadi hyenamavakrAmet, nAsya ki~jcit paurvadehikaMsyAdaviditamashrutamadRuShTaM vA, sa ca tacca na ki~jcidapi smarati (6)||4||
tasmAdetadbrUmahe- amAtRujashcAyaM garbho~apitRujashcAnAtmajashcAsAtmyajashcArasajashca, na cAstisattvamaupapAdukamiti (hovAca bharadvAjaH)||4||

To enter into the embryo, the ''sattva'' (mind) does not come from another world. If it were so, not even a little of its previous existence should remain unknown, unheard and unseen by it. However, it does not remember even a little bit of it. [4.6]

नेति भगवानात्रेयः, सर्वेभ्य एभ्यो भावेभ्यः समुदितेभ्यो गर्भोऽभिनिर्वर्तते||५||

nēti bhagavānātrēyaḥ, sarvēbhya ēbhyō bhāvēbhyaḥ samuditēbhyō garbhō'bhinirvartatē||5||

neti bhagavAnAtreyaH, sarvebhya ebhyo bhAvebhyaH samuditebhyo garbho~abhinirvartate||5||

Lord Atreya said “No. The embryogenesis requires the combination of aforementioned factors”. [5]

मातृजश्चायं गर्भः|
न हि मातुर्विना गर्भोत्पत्तिः स्यात्, न च जन्म जरायुजानाम्|
यानि खल्वस्य गर्भस्य मातृजानि, यानि चास्य मातृतः सम्भवतः सम्भवन्ति, तान्यनुव्याख्यास्यामः; तद्यथा- त्वक्चलोहितं च मांसं च मेदश्च नाभिश्च हृदयं च क्लोम च यकृच्च प्लीहा च वृक्कौ च बस्तिश्च पुरीषाधानं चामाशयश्चपक्वाशयश्चोत्तरगुदं चाधरगुदं च क्षुद्रान्त्रं च स्थूलान्त्रं च वपा च वपावहनं चेति (मातृजानि)||६||

mātr̥jaścāyaṁ garbhaḥ|
na hi māturvinā garbhōtpattiḥ syāt, na ca janma jarāyujānām|
yāni khalvasya garbhasya mātr̥jāni, yāni cāsya mātr̥taḥ sambhavataḥ sambhavanti, tānyanuvyākhyāsyāmaḥ;tadyathā- tvakca lōhitaṁ ca māṁsaṁ ca mēdaśca nābhiśca hr̥dayaṁ ca klōma ca yakr̥cca plīhā ca vr̥kkau cabastiśca purīṣādhānaṁ cāmāśayaśca pakvāśayaścōttaragudaṁ cādharagudaṁ ca kṣudrāntraṁ casthūlāntraṁ ca vāpā ca vapāvahanaṁ cēti (mātr̥jāni)||6||

mAtRujashcAyaM garbhaH|
na hi mAturvinA garbhotpattiH syAt, na ca janma jarAyujAnAm|
yAni khalvasya garbhasya mAtRujAni, yAni cAsya mAtRutaH sambhavataH sambhavanti, tAnyanuvyAkhyAsyAmaH;tadyathA- tvakca lohitaM ca mAMsaM ca medashca nAbhishca hRudayaM ca kloma ca yakRucca plIhA ca vRukkau cabastishca purIShAdhAnaM cAmAshayashca pakvAshayashcottaragudaM cAdharagudaM ca kShudrAntraM casthUlAntraM ca vApA ca vapAvahanaM ceti (mAtRujAni)||6||
<div style="text-align:justify;">
The mother contributes in the process of embryogenesis. There can be no conception and birth of viviparous animals without the mother. We shall hereby describe those bodily components which are derived from the maternal factor. These are: ''tvak'' (skin), ''lohita'' (blood), ''mamsa'' (flesh), ''meda'' (fat), ''nabhi'' (umbilicus), ''hridaya'' (heart), ''kloma'' (right lung), ''yakrit'' (liver), ''pleeha'' (spleen), ''vrikkau'' (kidneys), ''basti'' (bladder), ''purishadhana'' (rectum), ''amashaya'' (stomach), ''pakvashaya'' (colon), ''uttaraguda'' (upper part of the anus), ''adharaguda'' (lower part of the anus), ''kshudrantra'' (small intestine), ''sthulantra'' (large intestine), ''vapa'' (mesentery) and ''vapavahana'' (omentum). [6]
</div>
पितृजश्चायं गर्भः|
नहि पितुरृते गर्भोत्पत्तिः स्यात्, न च जन्म जरायुजानाम्|
यानि खल्वस्य गर्भस्य पितृजानि, यानि चास्य पितृतः सम्भवतः सम्भवन्ति, तान्यनुव्याख्यास्यामः; तद्यथा-केशश्मश्रुनखलोमदन्तास्थिसिरास्नायुधमन्यः शुक्रं चेति (पितृजानि)||७||

pitr̥jaścāyaṁ garbhaḥ|
nahi pituṟutē garbhōtpattiḥ syāt, na ca janma jarāyujānām|
yāni khalvasya garbhasya pitr̥jāni, yāni cāsya pitr̥taḥ sambhavataḥ sambhavanti, tānyanuvyākhyāsyāmaḥ;tadyathā-kēśaśmaśrunakhalōmadantāsthisirāsnāyudhamanyaḥ śukraṁ cēti (pitr̥jāni)||7||

pitRujashcAyaM garbhaH|
nahi piturRute garbhotpattiH syAt, na ca janma jarAyujAnAm|
yAni khalvasya garbhasya pitRujAni, yAni cAsya pitRutaH sambhavataH sambhavanti, tAnyanuvyAkhyAsyAmaH;tadyathA- keshashmashrunakhalomadantAsthisirAsnAyudhamanyaH shukraM ceti (pitRujAni)||7||
<div style="text-align:justify;">
The father contributes in the process of embryogenesis. There can be no conception and birth of viviparous animals without the father. We shall hereby describe those bodily components derived from the father. They are: ''kesha'' (hair of the head), ''smashru'' (facial hair), ''nakha'' (nail), ''loma'' (small hair on the body), ''danta'' (teeth), ''asthi'' (bones), ''sira'' (veins), ''snayu'' (ligaments), ''dhamnyah'' (arteries) and ''shukra'' (semen). [7]
</div>
आत्मजश्चायं गर्भः|
गर्भात्मा ह्यन्तरात्मा यः, तं ‘जीव’ इत्याचक्षते शाश्वतमरुजमजरममरमक्षयमभेद्यमच्छेद्यमलोड्यं विश्वरूपंविश्वकर्माणमव्यक्तमनादिमनिधनमक्षरमपि|
स गर्भाशयमनुप्रविश्य शुक्रशोणिताभ्यां संयोगमेत्य गर्भत्वेन जनयत्यात्मनाऽऽत्मानम्, आत्मसञ्ज्ञा हि गर्भे|
तस्य पुनरात्मनो जन्मानादित्वान्नोपपद्यते, तस्मान्न जात एवायमजातं गर्भं जनयति, अजातो ह्ययमजातं गर्भंजनयति; स चैव गर्भः कालान्तरेण बालयुवस्थविरभावान् प्राप्नोति, स यस्यां यस्यामवस्थायां वर्तते तस्यां तस्यां जातोभवति, या त्वस्य पुरस्कृतातस्यां जनिष्यमाणश्च, तस्मात् स एव जातश्चाजातश्च युगपद्भवति; यस्मिंश्चैतदुभयं सम्भवतिजातत्वं जनिष्यमाणत्वं च स जातो जन्यते, स चैवानागतेष्ववस्थान्तरेष्वजातो जन्ययत्यात्मनाऽऽत्मानम्|
सतो ह्यवस्थान्तरगमनमात्रमेव हि जन्म चोच्यते तत्र तत्र वयसि तस्यां तस्यामवस्थायां; यथा- सतामेव शुक्रशोणितजीवानांप्राक् संयोगाद्गर्भत्वं न भवति, तच्च संयोगाद्भवति; यथा- सतस्तस्यैव पुरुषस्य प्रागपत्यात् पितृत्वं न भवति,तच्चापत्याद्भवति; तथा सतस्तस्यैव गर्भस्य तस्यां तस्यामवस्थायां जातत्वमजातत्वं चोच्यते||८||

ātmajaścāyaṁ garbhaḥ|
garbhātmā hyantarātmā yaḥ, taṁ ‘jīva’ ityācakṣatēśāśvatamarujamajaramamaramakṣayamabhēdyamacchēdyamalōḍyaṁ viśvarūpaṁviśvakarmāṇamavyaktamanādimanidhanamakṣaramapi|
sa garbhāśayamanupraviśya śukraśōṇitābhyāṁ saṁyōgamētya garbhatvēna janayatyātmanā''tmānam,ātmasañjñā hi garbhē|
tasya punarātmanō janmānāditvānnōpapadyatē, tasmānna jāta ēvāyamajātaṁ garbhaṁ janayati, ajātōhyayamajātaṁ garbhaṁ janayati; sa caiva garbhaḥ kālāntarēṇa bālayuvasthavirabhāvān prāpnōti, sayasyāṁ yasyāmavasthāyāṁ vartatē tasyāṁ tasyāṁ jātō bhavati, yā tvasya puraskr̥tātasyāṁjaniṣyamāṇaśca, tasmāt sa ēva jātaścājātaśca yugapadbhavati; yasmiṁścaitadubhayaṁ sambhavatijātatvaṁ janiṣyamāṇatvaṁ ca sa jātō janyatē, sa caivānāgatēṣvavasthāntarēṣvajātōjanyayatyātmanā''tmānam|
satō hyavasthāntaragamanamātramēva hi janma cōcyatē tatra tatra vayasi tasyāṁ tasyāmavasthāyāṁ;yathā- satāmēva śukraśōṇitajīvānāṁ prāk saṁyōgādgarbhatvaṁ na bhavati, tacca saṁyōgādbhavati; yathā-satastasyaiva puruṣasya prāgapatyāt pitr̥tvaṁ na bhavati, taccāpatyādbhavati; tathā satastasyaivagarbhasya tasyāṁ tasyāmavasthāyāṁ jātatvamajātatvaṁ cōcyatē||8||

AtmajashcAyaM garbhaH|
garbhAtmA hyantarAtmA yaH, taM ‘jIva’ ityAcakShateshAshvatamarujamajaramamaramakShayamabhedyamacchedyamaloDyaM vishvarUpaMvishvakarmANamavyaktamanAdimanidhanamakSharamapi|
sa garbhAshayamanupravishya shukrashoNitAbhyAM saMyogametya garbhatvena janayatyAtmanA~a~atmAnam,Atmasa~jj~jA hi garbhe|
tasya punarAtmano janmAnAditvAnnopapadyate, tasmAnna jAta evAyamajAtaM garbhaM janayati, ajAtohyayamajAtaM garbhaM janayati; sa caiva garbhaH kAlAntareNa bAlayuvasthavirabhAvAn prApnoti, sa yasyAMyasyAmavasthAyAM vartate tasyAM tasyAM jAto bhavati, yA tvasya puraskRutAtasyAM janiShyamANashca, tasmAt saeva jAtashcAjAtashca yugapadbhavati; yasmiMshcaitadubhayaM sambhavati jAtatvaM janiShyamANatvaM ca sa jAtojanyate, sa caivAnAgateShvavasthAntareShvajAto janyayatyAtmanA~a~atmAnam|
sato hyavasthAntaragamanamAtrameva hi janma cocyate tatra tatra vayasi tasyAM tasyAmavasthAyAM; yathA-satAmeva shukrashoNitajIvAnAM prAk saMyogAdgarbhatvaM na bhavati, tacca saMyogAdbhavati; yathA-satastasyaiva puruShasya prAgapatyAt pitRutvaM na bhavati, taccApatyAdbhavati; tathA satastasyaiva garbhasyatasyAM tasyAmavasthAyAM jAtatvamajAtatvaM cocyate||8||
<div style="text-align:justify;">
The soul contributes in the process of embryogenesis. The ''antaratma'' (soul inside the body) is the same as ''garbhatma''(soul in the fetus) and is known as ''jeeva'' (life-form). According to scriptures, this soul is ''sashvata'' (eternal). It is ''aruja'' (disease-free), does not age (''ajara''), is immortal (''amara''), does not undergo decay (''akshaya''), is impenetrable (''abhedya''), is unbreakable (''achhedya''), is unperturbable (''alodya''), is omnipresent (''vishvarupa'') and omnipotent (''vishvakarma''). It is invisible (''avyakta''), neither has a beginning nor an end (''anadinidhana''), and is imperishable (''akshara''). By entering into the uterus, it combines with the ''shukra'' (sperm) and the ''shonita'' (ovum) and takes birth in the form of a fetus. Thus, the fetus derives its identification from the soul. Because the soul is without a beginning, the birth of the soul is not possible. Neither does the soul, being itself unborn, give rise to an unborn embryo, nor does the soul, being itself unborn, give rise to a born embryo. With the passage of time, the same embryo goes through the stages of childhood, youth, adulthood, and old age. And at each of these states or stages of life, the soul is said to be “born” in that stage. But, with reference to the future stages, it is considered to be unborn or yet to be born. Therefore, the soul is concurrently both born and unborn. In such situations, the soul creates those stages of life after taking birth. In other situations, where the stage of life is yet to come, the soul without being born manifests itself. In those specific stages of life, the change of the state is considered to be the birth of the ''atman''. For instance, mere existence of ''shukra- shonita'' (semen and ovum) before the union with the soul is not an embryo. ''Shukra-shonita'' are transformed into embryo only when the soul unites with them. A man cannot be called a father before the birth of his child. He is considered to be the father only after the birth of his child. Similarly, the embryo is said to be born or unborn depending upon the state attained or yet to be attained. [8]
</div>
न खलु गर्भस्य न च मातुर्न पितुर्न चात्मनः सर्वभावेषु यथेष्टकारित्वमस्ति; ते किञ्चित् स्ववशात् कुर्वन्ति, किञ्चित्कर्मवशात्, क्वचिच्चैषां करणशक्तिर्भवति, क्वचिन्न भवति|
यत्र सत्त्वादिकरणसम्पत्तत्र यथाबलमेव यथेष्टकारित्वम्, अतोऽन्यथा विपर्ययः|
न च करणदोषादकरणमात्मासम्भवति गर्भजनने, दृष्टं चेष्टा योनिरैश्वर्यं मोक्षश्चात्मविद्भिरात्मायत्तम्|
नह्यन्यः सुखदुःखयोः कर्ता|
न चान्यतो गर्भो जायते जायमानः, नाङ्कुरोत्पत्तिरबीजात्||९||

na khalu garbhasya na ca māturna piturna cātmanaḥ sarvabhāvēṣu yathēṣṭakāritvamasti; tē kiñcit svavaśātkurvanti, kiñcit karmavaśāt, kvaciccaiṣāṁ karaṇaśaktirbhavati, kvacinna bhavati|
yatra sattvādikaraṇasampattatra yathābalamēva yathēṣṭakāritvam, atō'nyathā viparyayaḥ|
na ca karaṇadōṣādakaraṇamātmāsambhavati garbhajananē, dr̥ṣṭaṁ cēṣṭā yōniraiśvaryaṁmōkṣaścātmavidbhirātmāyattam|
nahyanyaḥ sukhaduḥkhayōḥ kartā|
na cānyatō garbhō jāyatē jāyamānaḥ, nāṅkurōtpattirabījāt||9||

na khalu garbhasya na ca mAturna piturna cAtmanaH sarvabhAveShu yatheShTakAritvamasti; te ki~jcit svavashAtkurvanti, ki~jcit karmavashAt, kvaciccaiShAM karaNashaktirbhavati, kvacinna bhavati|
yatra sattvAdikaraNasampattatra yathAbalameva yatheShTakAritvam, ato~anyathA viparyayaH|
na ca karaNadoShAdakaraNamAtmAsambhavati garbhajanane, dRuShTaM ceShTA yoniraishvaryaMmokShashcAtmavidbhirAtmAyattam|
nahyanyaH sukhaduHkhayoH kartA|
na cAnyato garbho jAyate jAyamAnaH, nA~gkurotpattirabIjAt||9||
<div style="text-align:justify;">
The mother, the father and the soul independently cannot produce an embryo. They contribute to some extent independently and to some extent, they work under the influence of ''karma'' (results of actions of the past life). They possess the capacity to do certain things on their own, but for other few things, they do not. When these factors combine with other factors, such as mind, sense organs, sperm, ovum etc. in their excellent conditions, depending upon their ''karma'', they form the embryo by themselves. When there are deficiencies in these factors, the soul cannot form an embryo. It is well-known that self-realized souls can enter the wombs they desire and attain salvation. The soul itself is responsible for the pleasure and pain of the individual. The embryo is not formed by anything other than the soul. Nothing can be germinated without seeds. [9]
</div>

==== Origin of constituents of human being ====

यानि तु खल्वस्य गर्भस्यात्मजानि, यानि चास्यात्मतः सम्भवतः सम्भवन्ति, तान्यनुव्याख्यास्यामः तद्यथा- तासु तासुयोनिषूत्पत्तिरायुरात्मज्ञानं मन इन्द्रियाणि प्राणापानौ प्रेरणं धारणमाकृतिस्वरवर्णविशेषाः सुखदुःखे इच्छाद्वेषौ चेतनाधृतिर्बुद्धिः स्मृतिरहङ्कारः प्रयत्नश्चेति (आत्मजानि)||१०||

yāni tu khalvasya garbhasyātmajāni, yāni cāsyātmataḥ sambhavataḥ sambhavanti, tānyanuvyākhyāsyāmaḥtadyathā- tāsu tāsu yōniṣūtpattirāyurātmajñānaṁ mana indriyāṇi prāṇāpānau prēraṇaṁdhāraṇamākr̥tisvaravarṇaviśēṣāḥ sukhaduḥkhē icchādvēṣau cētanā dhr̥tirbuddhiḥ smr̥tirahaṅkāraḥprayatnaścēti (ātmajāni)||10||

yAni tu khalvasya garbhasyAtmajAni, yAni cAsyAtmataH sambhavataH sambhavanti, tAnyanuvyAkhyAsyAmaHtadyathA- tAsu tAsu yoniShUtpattirAyurAtmaj~jAnaM mana indriyANi prANApAnau preraNaMdhAraNamAkRutisvaravarNavisheShAH sukhaduHkhe icchAdveShau cetanA dhRutirbuddhiH smRutiraha~gkAraHprayatnashceti (AtmajAni)||10||
<div style="text-align:justify;">
We shall now describe those aspects of the individual which are derived from and are formed because of the soul. These are: taking birth in a specific womb, ''ayu'' (life span), ''atma, jnana'' (self realization), ''manas'' (mind), ''indriyani'' (sensory faculty), ''pranapana'' (inspiration-expiration), ''prerana'' (motivation) and ''dharana'' (sustenance), characteristic physique, voice and complexion of the individual, happiness and sorrow, like and dislike, ''chetana'' (consciousness), ''dhriti'' (courage), ''buddhi'' (intellect), ''smriti'' (memory), ''ahankara'' (ego) and ''prayatna'' (efforts). All these aspects of the individual are derived from the soul. [10]
</div>
सात्म्यजश्चायं गर्भः|
नह्यसात्म्यसेवित्वमन्तरेण स्त्रीपुरुषयोर्वन्ध्यत्वमस्ति, गर्भेषु वाऽप्यनिष्टो भावः|
यावत् खल्वसात्म्यसेविनां स्त्रीपुरुषाणां त्रयो दोषाः प्रकुपिताः शरीरमुपसर्पन्तो न शुक्रशोणितगर्भाशयोपघातायोपपद्यन्ते,तावत् समर्था गर्भजननाय भवन्ति|
सात्म्यसेविनां पुनः स्त्रीपुरुषाणामनुपहतशुक्रशोणितगर्भाशयानामृतकाले सन्निपतितानां जीवस्यानवक्रमणाद्गर्भा नप्रादुर्भवन्ति|
नहि केवलं सात्म्यज एवायं गर्भः, समुदयोऽत्र कारणमुच्यते|
यानि खल्वस्य गर्भस्य सात्म्यजानि, यानि चास्य सात्म्यतः सम्भवतः सम्भवन्ति, तान्यनुव्याख्यास्यामः; तद्यथा-आरोग्यमनालस्यमलोलुपत्वमिन्द्रियप्रसादः स्वरवर्णबीजसम्पत् प्रहर्षभूयस्त्वं चेति (सात्म्यजानि)||११||

sātmyajaścāyaṁ garbhaḥ|
nahyasātmyasēvitvamantarēṇa strīpuruṣayōrvandhyatvamasti, garbhēṣu vā'pyaniṣṭō bhāvaḥ|
yāvat khalvasātmyasēvināṁ strīpuruṣāṇāṁ trayō dōṣāḥ prakupitāḥ śarīramupasarpantō naśukraśōṇitagarbhāśayōpaghātāyōpapadyantē, tāvat samarthā garbhajananāya bhavanti|
sātmyasēvināṁ punaḥ strīpuruṣāṇāmanupahataśukraśōṇitagarbhāśayānāmr̥takālē sannipatitānāṁjīvasyānavakramaṇādgarbhā na prādurbhavanti|
nahi kēvalaṁ sātmyaja ēvāyaṁ garbhaḥ, samudayō'tra kāraṇamucyatē|
yāni khalvasya garbhasya sātmyajāni, yāni cāsya sātmyataḥ sambhavataḥ sambhavanti,tānyanuvyākhyāsyāmaḥ; tadyathā- ārōgyamanālasyamalōlupatvamindriyaprasādaḥ svaravarṇabījasampatpraharṣabhūyastvaṁ cēti (sātmyajāni)||11||

sAtmyajashcAyaM garbhaH|
nahyasAtmyasevitvamantareNa strIpuruShayorvandhyatvamasti, garbheShu vA~apyaniShTo bhAvaH|
yAvat khalvasAtmyasevinAM strIpuruShANAM trayo doShAH prakupitAH sharIramupasarpanto nashukrashoNitagarbhAshayopaghAtAyopapadyante, tAvat samarthA garbhajananAya bhavanti|
sAtmyasevinAM punaH strIpuruShANAmanupahatashukrashoNitagarbhAshayAnAmRutakAle sannipatitAnAMjIvasyAnavakramaNAdgarbhA na prAdurbhavanti|
nahi kevalaM sAtmyaja evAyaM garbhaH, samudayo~atra kAraNamucyate|
yAni khalvasya garbhasya sAtmyajAni, yAni cAsya sAtmyataH sambhavataH sambhavanti, tAnyanuvyAkhyAsyAmaH;tadyathA- ArogyamanAlasyamalolupatvamindriyaprasAdaH svaravarNabIjasampat praharShabhUyastvaM ceti(sAtmyajAni)||11||
<div style="text-align:justify;">
The embryo is created by the accustomed, wholesome regimen or ''satmya''. There cannot be sterility of the man, woman or defects in the embryo without resorting to unwholesome practices. Humans are capable of reproduction as long as the ''shukra'' (semen), ''shonita'' (ovum), and ''garbhashaya'' (uterus) are not afflicted by the vitiated ''doshas'' in the body, due to indulgence in unwholesome practices. Those couples who follow wholesome regimen even during the period of sexual union, and whose semen, ovum and uterus are unafflicted, do not produce the offspring if the soul does not enter into it. Therefore, wholesome regimen is solely not responsible for embryogenesis. It is the blending of all the factors that is responsible for embryogenesis. We shall hereby describe the aspects of the individual derived from and due to wholesome regimen. These are: ''arogya'' (the state of freedom from diseases), ''analasya'' (freedom from laziness) and ''alolupatva'' (freedom from greed), clarity of senses, excellence of voice and fertility and optimum libido. [11]
</div>
रसजश्चायं गर्भः|
न हि रसादृते मातुः प्राणयात्राऽपि स्यात्, किं पुनर्गर्भजन्म|
न चैवासम्यगुपयुज्यमाना रसा गर्भमभिनिर्वर्तयन्ति, न च केवलं सम्यगुपयोगादेव रसानां गर्भाभिनिर्वृत्तिर्भवति,समुदायोऽप्यत्र कारणमुच्यते|
यानि तु खल्वस्य गर्भस्य रसजानि, यानि चास्य रसतः सम्भवतः सम्भवन्ति, तान्यनुव्याख्यास्यामः; तद्यथा-शरीरस्याभिनिर्वृत्तिरभिवृद्धिः प्राणानुबन्धस्तृप्तिः पुष्टिरुत्साहश्चेति (रसजानि)||१२||

rasajaścāyaṁ garbhaḥ|
na hi rasādr̥tē mātuḥ prāṇayātrā'pi syāt, kiṁ punargarbhajanma|
na caivāsamyagupayujyamānā rasā garbhamabhinirvartayanti, na ca kēvalaṁ samyagupayōgādēvarasānāṁ garbhābhinirvr̥ttirbhavati, samudāyō'pyatra kāraṇamucyatē|
yāni tu khalvasya garbhasya rasajāni, yāni cāsya rasataḥ sambhavataḥ sambhavanti,tānyanuvyākhyāsyāmaḥ; tadyathā-śarīrasyābhinirvr̥ttirabhivr̥ddhiḥ prāṇānubandhastr̥ptiḥ puṣṭirutsāhaścēti(rasajāni)||12||

rasajashcAyaM garbhaH|
na hi rasAdRute mAtuH prANayAtrA~api syAt, kiM punargarbhajanma|
na caivAsamyagupayujyamAnA rasA garbhamabhinirvartayanti, na ca kevalaM samyagupayogAdeva rasAnAMgarbhAbhinirvRuttirbhavati, samudAyo~apyatra kAraNamucyate|
yAni tu khalvasya garbhasya rasajAni, yAni cAsya rasataH sambhavataH sambhavanti, tAnyanuvyAkhyAsyAmaH;tadyathA- sharIrasyAbhinirvRuttirabhivRuddhiH prANAnubandhastRuptiH puShTirutsAhashceti (rasajAni)||12||
<div style="text-align:justify;">
The embryo is produced from ''rasa''. Without ''rasa'' (nutritive fluid), even the mother cannot survive, hence neither can the embryo. Improper nourishment does not contribute to the embryogenesis. On the contrary, neither is an embryo formed simply due to adequate nourishment. In this case too, the blending of all the factors is responsible for embryogenesis. We shall hereby describe the aspects of the individual derived from ''rasa''. These are: formation and growth of the body, sustenance of life, satiety, nourishment and enthusiasm. [12]
</div>
अस्ति खलु सत्त्वमौपपादुकं; यज्जीवं स्पृक्शरीरेणाभिसम्बध्नाति, यस्मिन्नपगमनपुरस्कृते शीलमस्य व्यावर्तते,भक्तिर्विपर्यस्यते, सर्वेन्द्रियाण्युपतप्यन्ते, बलं हीयते, व्याधय आप्याय्यन्ते, यस्माद्धीनः प्राणाञ्जहाति,यदिन्द्रियाणामभिग्राहकं च ‘मन’ इत्यभिधीयते; तत्त्रिविधमाख्यायते- शुद्धं, राजसं, तामसमिति|
येनास्य खलु मनो भूयिष्ठं, तेन द्वितीयायामाजातौ सम्प्रयोगो भवति; यदा तु तेनैव शुद्धेन संयुज्यते, तदाजातेरतिक्रान्ताया अपि स्मरति|
स्मार्तं हि ज्ञानमात्मनस्तस्यैव मनसोऽनुबन्धादनुवर्तते, यस्यानुवृत्तिं पुरस्कृत्य पुरुषो ‘जातिस्मर’ इत्युच्यते|
यानि खल्वस्य गर्भस्य सत्त्वजानि, यान्यस्य सत्त्वतः सम्भवतः सम्भवन्ति, तान्यनुव्याख्यास्यामः; तद्यथा- भक्तिः शीलंशौचं द्वेषः स्मृतिर्मोहस्त्यागो मात्सर्यं शौर्यं भयं क्रोधस्तन्द्रोत्साहस्तैक्ष्ण्यं मार्दवं गाम्भीर्यमनवस्थितत्वमित्येवमादयश्चान्ये,ते सत्त्वविकारा यानुत्तरकालं सत्त्वभेदमधिकृत्योपदेक्ष्यामः|
नानाविधानि खलु सत्त्वानि, तानि सर्वाण्येकपुरुषे भवन्ति, न च भवन्त्येककालम्, एकं तु प्रायोवृत्त्याऽऽह ||१३||

asti khalu sattvamaupapādukaṁ; yajjīvaṁ spr̥kśarīrēṇābhisambadhnāti, yasminnapagamanapuraskr̥tēśīlamasya vyāvartatē, bhaktirviparyasyatē, sarvēndriyāṇyupatapyantē, balaṁ hīyatē, vyādhaya āpyāyyantē,yasmāddhīnaḥ prāṇāñjahāti, yadindriyāṇāmabhigrāhakaṁ ca ‘mana’ ityabhidhīyatē; tattrividhamākhyāyatē-śuddhaṁ, rājasaṁ, tāmasamiti|
yēnāsya khalu manō bhūyiṣṭhaṁ, tēna dvitīyāyāmājātau samprayōgō bhavati; yadā tu tēnaiva śuddhēnasaṁyujyatē, tadā jātēratikrāntāyā api smarati|
smārtaṁ hi jñānamātmanastasyaiva manasō'nubandhādanuvartatē, yasyānuvr̥ttiṁ puraskr̥tya puruṣō‘jātismara’ ityucyatē|
yāni khalvasya garbhasya sattvajāni, yānyasya sattvataḥ sambhavataḥ sambhavanti,tānyanuvyākhyāsyāmaḥ; tadyathā- bhaktiḥ śīlaṁ śaucaṁ dvēṣaḥ smr̥tirmōhastyāgō mātsaryaṁ śauryaṁbhayaṁ krōdhastandrōtsāhastaikṣṇyaṁ mārdavaṁ gāmbhīryamanavasthitatvamityēvamādayaścānyē, tēsattvavikārā yānuttarakālaṁ sattvabhēdamadhikr̥tyōpadēkṣyāmaḥ|
nānāvidhāni khalu sattvāni, tāni sarvāṇyēkapuruṣē bhavanti, na ca bhavantyēkakālam, ēkaṁ tuprāyōvr̥ttyā''ha ||13||

asti khalu sattvamaupapAdukaM; yajjIvaM spRuksharIreNAbhisambadhnAti, yasminnapagamanapuraskRuteshIlamasya vyAvartate, bhaktirviparyasyate, sarvendriyANyupatapyante, balaM hIyate, vyAdhaya ApyAyyante,yasmAddhInaH prANA~jjahAti, yadindriyANAmabhigrAhakaM ca ‘mana’ ityabhidhIyate; tattrividhamAkhyAyate-shuddhaM, rAjasaM, tAmasamiti|
yenAsya khalu mano bhUyiShThaM, tena dvitIyAyAmAjAtau samprayogo bhavati; yadA tu tenaiva shuddhenasaMyujyate, tadA jAteratikrAntAyA api smarati|
smArtaM hi j~jAnamAtmanastasyaiva manaso~anubandhAdanuvartate, yasyAnuvRuttiM puraskRutya puruSho‘jAtismara’ ityucyate|
yAni khalvasya garbhasya sattvajAni, yAnyasya sattvataH sambhavataH sambhavanti, tAnyanuvyAkhyAsyAmaH;tadyathA- bhaktiH shIlaM shaucaM dveShaH smRutirmohastyAgo mAtsaryaM shauryaM bhayaMkrodhastandrotsAhastaikShNyaM mArdavaM gAmbhIryamanavasthitatvamityevamAdayashcAnye, te sattvavikArAyAnuttarakAlaM sattvabhedamadhikRutyopadekShyAmaH|
nAnAvidhAni khalu sattvAni, tAni sarvANyekapuruShe bhavanti, na ca bhavantyekakAlam, ekaM tuprAyovRuttyA~a~aha ||13||
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Mind connects the soul and the body. So, on the threshold of death when the mind departs the body, normal behavior and tendencies change - the senses are disturbed, strength decreases and diseases progress. Individuals without mind die because mind controls the sense organs.
The mind is of three types, viz. ''shuddha'' (''sattvika'')'', rajas'' and ''tamas''. When any one attribute dominates the mind in one’s life, the same continues to dominate in the next life also. If the individual’s mind was characterized by ''shuddha'' attribute in the past life, then he can remember his past life. It is due to the continuity of the same mind that the person can remember things of his past life. Due to this power to recollect things of the past life, he is called ''jatismara''.

We shall hereby describe the aspects of the individual, which are derived from the mind. They are: ''bhakti'' (devotion), ''sheela'' (character), ''shaucha'' (purity), ''dvesha'' (hatred), ''smriti'' (memory), ''moha'' (attachment), ''tyaga'' (sacrifice), ''matsarya'' (jealousy), ''shaurya'' (valor), ''bhaya'' (fear), ''krodha'' (anger), ''tandra'' (drowsiness), ''utsaha'' (enthusiasm), ''taikshnya'' (sharpness), ''mardava'' (softness), ''gambhirya'' (seriousness), ''anavasthitatva'' (unsteadiness) and such other manifestations of the mind which will be described later while discussing the various types of mind. All these are present in the same person, however, not all manifest simultaneously. An individual is said to be of a particular type, based on the predominant type of mind. [13]
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एवमयं नानाविधानामेषां गर्भकराणां भावानां समुदायादभिनिर्वर्तते गर्भः; यथा- कूटागारं नानाद्रव्यसमुदायात्, यथा वा- रथोनानारथाङ्गसमुदायात्; तस्मादेतदवोचाम- मातृजश्चायं गर्भः, पितृजश्च, आत्मजश्च, सात्म्यजश्च, रसजश्च, अस्ति चसत्त्वमौपपादुकमिति (होवाच भगवानात्रेयः)||१४||

ēvamayaṁ nānāvidhānāmēṣāṁ garbhakarāṇāṁ bhāvānāṁ samudāyādabhinirvartatē garbhaḥ; yathā-kūṭāgāraṁ nānādravyasamudāyāt, yathā vā- rathō nānārathāṅgasamudāyāt; tasmādētadavōcāma-mātr̥jaścāyaṁ garbhaḥ, pitr̥jaśca, ātmajaśca, sātmyajaśca, rasajaśca, asti ca sattvamaupapādukamiti(hōvāca bhagavānātrēyaḥ)||14||

evamayaM nAnAvidhAnAmeShAM garbhakarANAM bhAvAnAM samudAyAdabhinirvartate garbhaH; yathA- kUTAgAraMnAnAdravyasamudAyAt, yathA vA- ratho nAnArathA~ggasamudAyAt; tasmAdetadavocAma- mAtRujashcAyaMgarbhaH, pitRujashca, Atmajashca, sAtmyajashca, rasajashca, asti ca sattvamaupapAdukamiti (hovAcabhagavAnAtreyaH)||14||
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Thus, by the combination of various factors, the embryo is formed just like a ''kutagara'' (circular cottage used for administering ''svedana''-hot fomentation therapy) is formed from various materials, or, like a chariot being constructed from various chariot parts. Therefore, we assert that the embryo is formed of various factors, viz. maternal factor, paternal factor, soul, wholesome regimen and ''rasa''. The mind serves as the connecting link. (Thus) said Lord Atreya. [14]
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भरद्वाज उवाच-यद्ययमेषां नानाविधानां गर्भकराणां भावानां समुदायादभिनिर्वर्तते गर्भः कथमयं सन्धीयते, यदि चापिसन्धीयते कस्मात् समुदायप्रभवः सन् गर्भो मनुष्यविग्रहेण जायते, मनुष्यश्च मनुष्यप्रभव उच्यते; तत्रचेदिष्टमेतद्यस्मान्मनुष्यो मनुष्यप्रभवस्तस्मादेव मनुष्यविग्रहेण जायते, यथा- गौर्गोप्रभवः, यथा- चाश्वोऽश्वप्रभव इति; एवंसति यदुक्तमग्रे समुदयात्मक इति तदयुक्तम्|
यदि च मनुष्यो मनुष्यप्रभवः, कस्माज्जडान्धकुब्जमूकवामनमिम्मिनव्यङ्गोन्मत्तकुष्ठिकिलासिभ्यो जाताः पितृसदृशरूपा न भवन्ति|
अथात्रापि बुद्धिरेवं स्यात्- स्वेनैवायमात्मा चक्षुषा रूपाणि वेत्ति, श्रोत्रेण शब्दान्, घ्राणेन गन्धान्, रसनेन रसान्, स्पर्शनेनस्पर्शान्, बुद्ध्या बोद्धव्यमित्यनेन हेतुना न जडादिभ्यो जाताः पितृसदृशा भवन्ति|
अत्रापि प्रतिज्ञाहानिदोषः स्यात्, एवमुक्ते ह्यात्मा सत्स्विन्द्रियेषु ज्ञः स्यादसत्स्वज्ञः; यत्र चैतदुभयं सम्भवति ज्ञत्वमज्ञत्वं च,सविकारश्चात्मा |
यदि च दर्शनादिभिरात्मा विषयान् वेत्ति, निरिन्द्रियो दर्शनादिविरहादज्ञः स्यात्, अज्ञत्वादकारणम्, अकारणत्वाच्च नात्मेतिवाग्वस्तुमात्रमेतद्वचनमनर्थं स्यादिति (होवाच भरद्वाजः)||१५||

bharadvāja uvāca- yadyayamēṣāṁ nānāvidhānāṁ garbhakarāṇāṁ bhāvānāṁ samudāyādabhinirvartatēgarbhaḥ kathamayaṁ sandhīyatē, yadi cāpi sandhīyatē kasmāt samudāyaprabhavaḥ san garbhōmanuṣyavigrahēṇa jāyatē, manuṣyaśca manuṣyaprabhava ucyatē; tatra cēdiṣṭamētadyasmānmanuṣyōmanuṣyaprabhavastasmādēva manuṣyavigrahēṇa jāyatē, yathā- gaurgōprabhavaḥ, yathā-cāśvō'śvaprabhava iti; ēvaṁ sati yaduktamagrē samudayātmaka iti tadayuktam|
yadi ca manuṣyō manuṣyaprabhavaḥ,kasmājjaḍāndhakubjamūkavāmanamimminavyaṅgōnmattakuṣṭhikilāsibhyō jātāḥ pitr̥sadr̥śarūpā nabhavanti|
athātrāpi buddhirēvaṁ syāt- svēnaivāyamātmā cakṣuṣā rūpāṇi vētti, śrōtrēṇa śabdān, ghrāṇēna gandhān,rasanēna rasān, sparśanēna sparśān, buddhyā bōddhavyamityanēna hētunā na jaḍādibhyō jātāḥ pitr̥sadr̥śā bhavanti|
atrāpi pratijñāhānidōṣaḥ syāt, ēvamuktē hyātmā satsvindriyēṣu jñaḥ syādasatsvajñaḥ; yatra caitadubhayaṁsambhavati jñatvamajñatvaṁ ca, savikāraścātmā |
yadi ca darśanādibhirātmā viṣayān vētti, nirindriyō darśanādivirahādajñaḥ syāt, ajñatvādakāraṇam,akāraṇatvācca nātmēti vāgvastumātramētadvacanamanarthaṁ syāditi (hōvāca bharadvājaḥ)||15||

bharadvAja uvAca- yadyayameShAM nAnAvidhAnAM garbhakarANAM bhAvAnAM samudAyAdabhinirvartate garbhaHkathamayaM sandhIyate, yadi cApi sandhIyate kasmAt samudAyaprabhavaH san garbho manuShyavigraheNa jAyate,manuShyashca manuShyaprabhava ucyate; tatra cediShTametadyasmAnmanuShyo manuShyaprabhavastasmAdevamanuShyavigraheNa jAyate, yathA- gaurgoprabhavaH, yathA- cAshvo~ashvaprabhava iti; evaM sati yaduktamagresamudayAtmaka iti tadayuktam|
yadi ca manuShyo manuShyaprabhavaH,kasmAjjaDAndhakubjamUkavAmanamimminavya~ggonmattakuShThikilAsibhyo jAtAH pitRusadRusharUpA nabhavanti|
athAtrApi buddhirevaM syAt- svenaivAyamAtmA cakShuShA rUpANi vetti, shrotreNa shabdAn, ghrANena gandhAn,rasanena rasAn, sparshanena sparshAn, buddhyA boddhavyamityanena hetunA na jaDAdibhyo jAtAH pitRusadRushA bhavanti|
atrApi pratij~jAhAnidoShaH syAt, evamukte hyAtmA satsvindriyeShu j~jaH syAdasatsvaj~jaH; yatra caitadubhayaMsambhavati j~jatvamaj~jatvaM ca, savikArashcAtmA |
yadi ca darshanAdibhirAtmA viShayAn vetti, nirindriyo darshanAdivirahAdaj~jaH syAt, aj~jatvAdakAraNam,akAraNatvAcca nAtmeti vAgvastumAtrametadvacanamanarthaM syAditi (hovAca bharadvAjaH)||15||
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Bharadvāja said, -If the embryo is formed out of the combination of these various reproductive factors, then how do they get united? If we put aside their combination, then how come the union of these factors results in the formation of a human offspring? Man is known to be born from another man. If it is argued that the individual takes the form of a human being because he is born out of a man, just as a cow is born out of a cow and a horse from a horse, then, the statement that the embryo is formed out of the combination of all these factors becomes wrong. If the man is born from another man, then why is the child, born to parents who are dull, blind, hunch-backed, mute, dwarf, lisping, suffering from freckles, insane, afflicted with ''kushtha'' (obstinate skin diseases including leprosy) and ''kilasa'' (leucoderma), is not afflicted with the same? To resolve this, if it is argued that the individuals born of the aforementioned afflictions do not suffer the defects of their parents because the soul perceives information through its own eyes, ears, nose, tongue, skin, and intellect etc., this too becomes false, because the soul will be endowed with consciousness only in the presence of sense organs and not otherwise. Thus, the soul will be both conscious and ignorant. Hence this would imply that the soul undergoes changes. If the soul understands things by vision etc., in the absence of these sense organs he won’t be able to perceive, due to which it cannot serve as a causative factor. And if the soul is not a causative factor, then it cannot be called atman (soul). Thus, this proposition will be ridiculed as meaningless. [15]
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आत्रेय उवाच- पुरस्तादेतत् प्रतिज्ञातं- सत्त्वं जीवं स्पृक्शरीरेणाभिसम्बध्नातीति|
यस्मात्तु समुदायप्रभवः सन् स गर्भो मनुष्यविग्रहेण जायते, मनुष्यो मनुष्यप्रभव इत्युच्यते, तद्वक्ष्यामः- भूतानां चतुर्विधायोनिर्भवति- जराय्वण्डस्वेदोद्भिदः|
तासां खलु चतसृणामपि योनीनामेकैका योनिरपरिसङ्ख्येयभेदा भवति, भूतानामाकृतिविशेषापरिसङ्ख्येयत्वात्|
तत्र जरायुजानामण्डजानां च प्राणिनामेते गर्भकरा भावा यां यां योनिमापद्यन्ते, तस्यां तस्यां योनौ तथातथारूपा भवन्ति;यथा- कनकरजतताम्रत्रपुसीसकान्यासिच्यमानानि तेषु तेषु मधूच्छिष्टविग्रहेषु, तानि यदा मनुष्यबिम्बमापद्यन्ते तदामनुष्यविग्रहेण जायन्ते, तस्मात् समुदायप्रभावः सन् गर्भो मनुष्यविग्रहेण जायते; मनुष्यश्च मनुष्यप्रभव उच्यते,तद्योनित्वात्||१६||

ātrēya uvāca- purastādētat pratijñātaṁ- sattvaṁ jīvaṁ spr̥kśarīrēṇābhisambadhnātīti|
yasmāttu samudāyaprabhavaḥ san sa garbhō manuṣyavigrahēṇa jāyatē, manuṣyō manuṣyaprabhavaityucyatē, tadvakṣyāmaḥ- bhūtānāṁ caturvidhā yōnirbhavati- jarāyvaṇḍasvēdōdbhidaḥ|
tāsāṁ khalu catasr̥ṇāmapi yōnīnāmēkaikā yōniraparisaṅkhyēyabhēdā bhavati,bhūtānāmākr̥tiviśēṣāparisaṅkhyēyatvāt|
tatra jarāyujānāmaṇḍajānāṁ ca prāṇināmētē garbhakarā bhāvā yāṁ yāṁ yōnimāpadyantē, tasyāṁ tasyāṁyōnau tathātathārūpā bhavanti; yathā- kanakarajatatāmratrapusīsakānyāsicyamānāni tēṣu tēṣumadhūcchiṣṭavigrahēṣu, tāni yadā manuṣyabimbamāpadyantē tadā manuṣyavigrahēṇa jāyantē, tasmātsamudāyaprabhāvaḥ san garbhō manuṣyavigrahēṇa jāyatē; manuṣyaśca manuṣyaprabhava ucyatē,tadyōnitvāt||16||

Atreya uvAca- purastAdetat pratij~jAtaM- sattvaM jIvaM spRuksharIreNAbhisambadhnAtIti|
yasmAttu samudAyaprabhavaH san sa garbho manuShyavigraheNa jAyate, manuShyo manuShyaprabhava ityucyate,tadvakShyAmaH- bhUtAnAM caturvidhA yonirbhavati- jarAyvaNDasvedodbhidaH|
tAsAM khalu catasRuNAmapi yonInAmekaikA yoniraparisa~gkhyeyabhedA bhavati,bhUtAnAmAkRutivisheShAparisa~gkhyeyatvAt|
tatra jarAyujAnAmaNDajAnAM ca prANinAmete garbhakarA bhAvA yAM yAM yonimApadyante, tasyAM tasyAM yonautathAtathArUpA bhavanti; yathA- kanakarajatatAmratrapusIsakAnyAsicyamAnAni teShu teShumadhUcchiShTavigraheShu, tAni yadA manuShyabimbamApadyante tadA manuShyavigraheNa jAyante, tasmAtsamudAyaprabhAvaH san garbho manuShyavigraheNa jAyate; manuShyashca manuShyaprabhava ucyate,tadyonitvAt||16||
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Lord Ātreya said, “It has already been concluded that the mind connects the soul with the body. A human being is considered to be a cause for the creation of another human being simply because an embryo is a combination of various factors that produce a human form.Thus there are four classes of living beings, viz. ''jarayuja'' (viviparous), ''andaja'' (oviparous), ''svedaja'' (living-beings born of damp heat) and ''udbhida'' (living-beings born by sprouting from the earth). Each of these four classes is of innumerable types. This is due to the countless distinct characters they possess. Just as molten gold, silver, copper, tin and lead , poured into various molds of beeswax, take the form of the mold, viviparous and oviparous beings take their specific forms based on the womb the reproductive factors enter into. So when they come in contact with the human womb, they get into the human form.” [16]
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यच्चोक्तं- यदि च मनुष्यो मनुष्यप्रभवः, कस्मान्न जडादिभ्यो जाताः पितृसदृशरूपा भवन्तीति; तत्रोच्यते-यस्य यस्यह्यङ्गावयवस्य बीजे बीज भाग उपतप्तो भवति, तस्य तस्याङ्गावयवस्य विकृतिरुपजायते, नोपजायते चानुपतापात्;तस्मादुभयोपपत्तिरप्यत्र|
सर्वस्य चात्मजानीन्द्रियाणि, तेषां भावाभावहेतुर्दैवं; तस्मान्नैकान्ततो जडादिभ्यो जाताः पितृसदृशरूपा भवन्ति||१७||

yaccōktaṁ-yadi ca manuṣyō manuṣyaprabhavaḥ, kasmānna jaḍādibhyō jātāḥ pitr̥sadr̥śarūpā bhavantīti;tatrōcyatē-yasya yasya hyaṅgāvayavasya bījē bīja bhāga upataptō bhavati, tasya tasyāṅgāvayavasyavikr̥tirupajāyatē, nōpajāyatē cānupatāpāt; tasmādubhayōpapattirapyatra|
sarvasya cātmajānīndriyāṇi, tēṣāṁ bhāvābhāvahēturdaivaṁ; tasmānnaikāntatō jaḍādibhyō jātāḥpitr̥sadr̥śarūpā bhavanti||17||

yaccoktaM-yadi ca manuShyo manuShyaprabhavaH, kasmAnna jaDAdibhyo jAtAH pitRusadRusharUpA bhavantIti;tatrocyate- yasya yasya hya~ggAvayavasya bIje bIja bhAga upatapto bhavati, tasya tasyA~ggAvayavasyavikRutirupajAyate, nopajAyate cAnupatApAt; tasmAdubhayopapattirapyatra|
sarvasya cAtmajAnIndriyANi, teShAM bhAvAbhAvaheturdaivaM; tasmAnnaikAntato jaDAdibhyo jAtAHpitRusadRusharUpA bhavanti||17||
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So, the answer to the previous question “if the human being is a product of another human being, why is a progeny of a dull human being not always dull?” is that, if the part of the ''beeja'' (seed - sperm or ovum) responsible for the development of a specific organ is afflicted, the respective organ will be afflicted too. However, if the ''beeja'' is not afflicted, there would be no affliction of the respective organ. So both the possibilities are there. In fact, the sense organs of all the living beings are derived from the soul and their presence or absence is determined by ''karma'' i.e. the result of the past action. So the offspring of dull parents do not necessarily resemble their parents in those qualities. [17]
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न चात्मा सत्स्विन्द्रियेषु ज्ञः, असत्सु वा भवत्यज्ञः; न ह्यसत्त्वः कदाचिदात्मा, सत्त्वविशेषाच्चोपलभ्यते ज्ञानविशेष इति||१८||

na cātmā satsvindriyēṣu jñaḥ, asatsu vā bhavatyajñaḥ; na hyasattvaḥ kadācidātmā,sattvaviśēṣāccōpalabhyatē jñānaviśēṣa iti||18||

na cAtmA satsvindriyeShu j~jaH, asatsu vA bhavatyaj~jaH; na hyasattvaH kadAcidAtmA,sattvavisheShAccopalabhyate j~jAnavisheSha iti||18||

It is not that the soul is conscious only when it possesses sense organs and is devoid of consciousness otherwise. The soul and mind are inseparable, hence always conscious. [18]

भवन्ति चात्र-
न कर्तुरिन्द्रियाभावात् कार्यज्ञानं प्रवर्तते|
या क्रिया वर्तते भावैः सा विना तैर्न वर्तते||१९||
bhavanti cātra-
na karturindriyābhāvāt kāryajñānaṁ pravartatē|
yā kriyā vartatē bhāvaiḥ sā vinā tairna vartatē||19||

bhavanti cAtra-
na karturindriyAbhAvAt kAryaj~jAnaM pravartate|
yA kriyA vartate bhAvaiH sA vinA tairna vartate||19||

It(the soul) cannot perform various actions in the absence of the sense organs though awareness exists. So it is not possible to perform any action in the absence of sense organs. [19]

जानन्नपि मृदोऽभावात् कुम्भकृन्न प्रवर्तते|
श्रूयतां चेदमध्यात्ममात्मज्ञानबलं महत्||२०||
jānannapi mr̥dō'bhāvāt kumbhakr̥nna pravartatē|
śrūyatāṁ cēdamadhyātmamātmajñānabalaṁ mahat||20||

jAnannapi mRudo~abhAvAt kumbhakRunna pravartate|
shrUyatAM cedamadhyAtmamAtmaj~jAnabalaM mahat||20||

A potter cannot function in the absence of clay even when he is knowledgeable and skilled. Listen to this spiritual wisdom- a greatly powerful knowledge of the soul. [20]

इन्द्रियाणि च सङ्क्षिप्य मनः सङ्क्षिप्य चञ्चलम्|
प्रविश्याध्यात्ममात्मज्ञः स्वे ज्ञाने पर्यवस्थितः||२१||

indriyāṇi ca saṅkṣipya manaḥ saṅkṣipya cañcalam|
praviśyādhyātmamātmajñaḥ svē jñānē paryavasthitaḥ||21||

indriyANi ca sa~gkShipya manaH sa~gkShipya ca~jcalam|
pravishyAdhyAtmamAtmaj~jaH sve j~jAne paryavasthitaH||21||

The knower of one's self should control his sense organs, and the fickle, restless mind and then enter spirituality to establish himself in self-knowledge. [21]

सर्वत्रावहितज्ञानः सर्वभावान् परीक्षते|
गृह्णीष्व चे(वे)दमपरं भरद्वाज विनिर्णयम्||२२||

sarvatrāvahitajñānaḥ sarvabhāvān parīkṣatē|
gr̥hṇīṣva cē(vē)damaparaṁ bharadvāja vinirṇayam||22||

sarvatrAvahitaj~jAnaH sarvabhAvAn parIkShate|
gRuhNIShva ce(ve)damaparaM bharadvAja vinirNayam||22||

Comprehend this another conclusion, Bharadvaja!- The awareness of harm, everywhere, should be examined from all the aspects. ||22||

निवृत्तेन्द्रियवाक्चेष्टः सुप्तः स्वप्नगतो यदा|
विषयान् सुखदुःखे च वेत्ति नाज्ञोऽप्यतः स्मृतः||२३||

nivr̥ttēndriyavākcēṣṭaḥ suptaḥ svapnagatō yadā|
viṣayān sukhaduḥkhē ca vētti nājñō'pyataḥ smr̥taḥ||23||

nivRuttendriyavAkceShTaH suptaH svapnagato yadA|
viShayAn sukhaduHkhe ca vetti nAj~jo~apyataH smRutaH||23||

A person who is asleep and dreaming experiences happiness and sorrow even in the absence of functioning senses, speech and other activities. So he isn't without consciousness. ||23||

नात्मज्ञानादृते चैकं ज्ञानं किञ्चित् प्रवर्तते|
न ह्येको वर्तते भावो वर्तते नाप्यहेतुकः||२४||

nātmajñānādr̥tē caikaṁ jñānaṁ kiñcit pravartatē|
na hyēkō vartatē bhāvō vartatē nāpyahētukaḥ||24||

nAtmaj~jAnAdRute caikaM j~jAnaM ki~jcit pravartate|
na hyeko vartate bhAvo vartate nApyahetukaH||24||

There can be no knowledge without the knowledge of the soul. Nothing functions solely without a causative agent. [24]

तस्माज्ज्ञः प्रकृतिश्चात्मा द्रष्टा कारणमेव च|
सर्वमेतद्भरद्वाज निर्णीतं जहि संशयम्||२५||

tasmājjñaḥ prakr̥tiścātmā draṣṭā kāraṇamēva ca|
sarvamētadbharadvāja nirṇītaṁ jahi saṁśayam||25||

tasmAjj~jaH prakRutishcAtmA draShTA kAraNameva ca|
sarvametadbharadvAja nirNItaM jahi saMshayam||25||

The soul is the knower, the nature, the viewer and the cause. This is the conclusion of everything, Bharadvāja. Hence, be doubt-free. [25]

==== Summary ====

तत्र श्लोकौ-
हेतुर्गर्भस्य निर्वृत्तौ वृद्धौ जन्मनि चैव यः|
पुनर्वसुमतिर्या च भरद्वाजमतिश्च या||२६||

प्रतिज्ञाप्रतिषेधश्च विशदश्चात्मनिर्णयः|
गर्भावक्रान्तिमुद्दिश्य खुड्डीकां तत्प्रकाशितम्||२७||

tatra ślōkau-
hēturgarbhasya nirvr̥ttau vr̥ddhau janmani caiva yaḥ|
punarvasumatiryā ca bharadvājamatiśca yā||26||

pratijñāpratiṣēdhaśca viśadaścātmanirṇayaḥ|
garbhāvakrāntimuddiśya khuḍḍīkāṁ tatprakāśitam||27||

tatra shlokau-
heturgarbhasya nirvRuttau vRuddhau janmani caiva yaH|
punarvasumatiryA ca bharadvAjamatishca yA||26||

pratij~jApratiShedhashca vishadashcAtmanirNayaH|
garbhAvakrAntimuddishya khuDDIkAM tatprakAshitam||27||
<div style="text-align:justify;">
In summary, in this minor chapter on the embryogenesis in the context of ''sharira'' (human biology), the following topics were discussed- factors responsible for the formation, growth and birth of the embryo, the dialogue between Punarvasu (Lord Atreya) and Bharadvāja on this topic, the refutation on the conclusions (by Bharadvāja), and a detailed exposition on the nature of the soul. [26-27]
</div>
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते शारीरस्थाने
खुड्डीकागर्भावक्रान्तिशारीरं नाम तृतीयोऽध्यायः||३||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē śārīrasthānē

khuḍḍīkāgarbhāvakrāntiśārīraṁ nāma tr̥tīyō'dhyāyaḥ||3||

ityagniveshakRute tantre carakapratisaMskRute shArIrasthAne
khuDDIkAgarbhAvakrAntishArIraM nAma tRutIyo~adhyAyaH||3||

Thus ends the third chapter on “the formation of embryo” in the context of Sharira of the [[Sharira Sthana]] of Agnivesha’s work redacted by Charak.

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*Six components interplay in the genesis, growth and development of ''garbha'' (fetus). These are - ''matrija'' (maternal), ''pitraja'' (paternal), ''atmaja'' (soul), ''satmyaja'' (suitable environment), ''rasaja'' (nourishment), and ''sattvaja'' or ''mana'' (psyche).
**There is equilibrium of interplay (''satmyaja'') between all the components.
**From the mother (X chromosome), skin, blood, muscles, fat, umbilicus, heart, ''kloma'' (interstitial space), liver, spleen, kidney, bladder, ''purishadhana'' (sigmoid colon), stomach, ''pakvashaya'' (intestines), rectum, anus, ''vapa'' (adipose tissue), and omentum contribute to the formation of the fetus. Examples of diseases from X chromosome are hemophilia, muscular dystrophy etc.
**From father (Y chromosome), scalp hair, beard, nail, teeth, bones, veins, ligaments, arteries and sperm are the contributing factors. Example of diseases from Y chromosome: hypertrichosis, azoospermia, retinitis, pigmentosa.
**From ''atma'': growth and development and all events in life.
**From ''satmyaja'': (suitable environment): creation of complete health.
**From ''rasaja'': (nourishment).
**From ''sattvaja'': manifestations of mind.
*Blind parent’s offspring will not be blind if there is no gene defect.

=== ''Vidhi Vimarsha'' ===

The following factors can be considered, keeping in mind the statement “a man with ''retas'' (semen), not afflicted by any abnormality, and a woman with disease-free ''yoni''(genital tract), ''shonita'' (ovum), and ''garbhashaya'' (uterine bed), when sexually unite during the fertile phase” is being put into context.

==== Male Factors ====
#Endocrine disorders: Hypothalamic dysfunction (Kallmann's syndrome), Pituitary failure (tumor, radiation, surgery, hyperprolactinemia (drug, tumor), exogenous androgens, thyroid disorders, adrenal hyperplasia
#Anatomic disorders: congenital absence of vas deferens, obstruction of vas deferens, congenital abnormalities of ejaculatory system
#Abnormal spermatogenesis: chromosomal abnormalities, mumps, orchitis, cryptorchidism, chemical or radiation exposure.
#Abnormal motility: absent cilia (kartagener's syndrome), varicocele, antibody formation
#Sexual dysfunction: retrograde ejaculation, impotence, decreased libido.
==== Female Factors ====
===== Ovulatory factors =====
#Central defects: chronic hyperandrogenemic anovulation, hyperprolactinemia (drug, tumor), hypothalamic insufficiency, pituitary insufficiency (trauma, tumor, congenital)
#Peripheral defects: gonadal dysgenesis, premature ovarian failure, ovarian tumor, ovarian resistance
#Metabolic disease: thyroid disease, liver disease, renal disease, obesity, androgen excess: adrenal or neoplastic
===== Pelvic factors =====
#Infection appendicitis, pelvic inflammatory disease, uterine adhesions (asherman's syndrome),
#Endometriosis
#Structural abnormalities diethylstilbestrol (DES) exposure, failure of normal fusion of the reproductive tract, myoma
===== Cervical factors =====
#Congenital: diethylstilbestrol (DES) exposure, müllerian duct abnormality
#Acquired: sequel of surgical treatment, Infection

The first class of foods (meat soups and others) is said to be of high nutritive value conducive for the formation of healthy ''rasa''. The second class of foods (''syamaka'' and others) is said to be otherwise.

It is known that folic acid supplementation starting before pregnancy can reduce the incidence of neural tube defects. Even deficient maternal vitamin B (12) status has been reported to be associated with a significantly increased risk of neural tube defects. <ref>MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet.1991;338 (8760):131– 137 </ref> <ref>Molloy AM, Kirke PN, Troendle JF, Burke H, Sutton M, Brody LC, Scott JM, Mills JL. Maternal vitamin B12 status and risk of neural tube defects in a population with high neural tube defect prevalence and no folic acid fortification. Pediatrics 2009;123:917–23. </ref>These studies are suggestive of the fact that maternal nutrition plays an important role in embryogenesis. The factor rasa in this context, in fact is indicative of maternal nutrition.

It may be noted that the nuclear genome is characterized by homologous pairs of chromosomes of biparental origin. However, the mitochondrial DNA is transferred exclusively from the mother to the offspring without undergoing any recombination as the paternal mitochondrial DNA undergoes degradation during fertilization. It is interesting to note that the organs afflicted by the diseases transmitted through mitochondrial inheritance are skeletal muscles, brain, heart, eye, colon, pancreas, inner ear, liver, kidney and blood.<ref>Mitochondrial DNA and Heritable Traits and Diseases. Anthony S. Fauci, Dennis L. Kasper, Dan L. Longo et al. (Editors) in: Harrison’s Principles of Internal Medicine. Seventeenth Edition. 2008. The McGraw-Hill Companies, Inc. USA. ISBN 978-0-07-146633-2 </ref>

The term ''shukra'' has been described to be of two forms in Ayurveda textbooks:
#The one that is ejaculated during the process of mating, which is responsible for fertilization of ovum and thus embryogenesis, and
#The one that is formed from ''majja'' (marrow, or the tissue that fills up bone cavities) which in turn circulates all over the body both in males and females. Reproduction is the function of this second form of ''shukra'' also. Therefore, on careful examination, it seems that the first form of ''shukra'' stands for semen in general and for sperms in particular and, the second form of ''shukra'' stands for hypothalamo-pituitary-gonadal axis of hormones that circulates all over the body. For instance, the GnRH of the hypothalamus stimulates the anterior pituitary to secrete LH which in turn stimulates testes and ovaries to form hormones such as testosterone, estrogen and progesterone. As per Ayurveda classics, the brain, and thus, the hypothalamus, is obviously a part of ''majja'' which is enclosed in ''mastaka''. <ref>Patwardhan K. Human Physiology in Ayurveda. Varanasi, India: Chaukhambha Orientalia, 2008, Jiakrishnadas series no. 134. </ref>

The term ''rasa'' has been translated by various authors as chyme, chyle, lymph, plasma etc. However, it is difficult to restrict the meaning of this term to any of such specific fluids. As ''rasa'' has been described to be a colorless fluid that gets propelled out of the heart by ''vyana vayu'' into the vascular tree, it is more logical to translate it as plasma. However, the fluids in the interstitial spaces and the fluid in the lymphatic vessels also are to be included under ''rasa'' because we find no other apt term that describes these fluids. Moreover, the word ''rasa'' includes all those bodily fluids that flow. As the major function of ''rasa'' is to nourish the other tissues, we have translated it as nutritive fluid in this context. <ref>Patwardhan K. The history of the discovery of blood circulation: unrecognized contributions of Ayurveda masters. Adv Physiol Educ. 2012;36:77–82. </ref>

=== References ===

<references/>

=== Further reading ===

#Dhiman K, Kumar A, Dhiman K S. Shad Garbhakara Bhavas vis-a-vis congenital and genetic disorders. AYU 2010;31:175-84. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215361/. (Date last accessed: 14th March 2014)
#D. G. Thatte and Bhuvesh Gupta. Embryology in Ayurveda (Textual Concepts with Recent Advances). Chowkhambha Sanskrit Series Office, Varanasi. 2011.
#Abhimanyu Kumar. Ayurvedic Concepts of Human Embryology. Chaukhamba Sanskrit Pratishthan, 2000.
#Hong Yi, Lu Xue, Ming-Xiong Guo et al. Gene expression atlas for human embryogenesis. FASEB J. Sep 2010; 24(9): 3341–3350
#Lu Xue, Hong Yi, Zan Huang et al. Global Gene Expression during the Human Organogenesis: From Transcription Profiles to Function Predictions. Int J Biol Sci. 2011; 7(7): 1068–1076
#Hai Fang, Ying Yang, Chunliang Li et al. Transcriptome Analysis of Early Organogenesis in Human Embryos. Developmental Cell. Volume 19, Issue 1, 20 July 2010, Pages 174–184.
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Atulyagotriya Sharira

2019-03-06T03:44:36Z

Pallavmishra:

{{Infobox
|title = Atulyagotriya Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 2
|label2 = Preceding Chapter
|data2 = [[Katidhapurusha Sharira]]

|label3= Succeeding Chapter
|data3 = [[Khuddika Garbhavakranti Sharira]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}

== [[Sharira Sthana]] Chapter 2, Atulyagotriya Sharira (Chapter on different clans and aspects of the Human Birth) ==

=== Abstract ===
<div style="text-align:justify;">
''Gotra'', in literal Sanskrit, means cowshed. However, in common parlance, it denotes the progeny (or a clan) of a common male ancestor (usually, a ''rishi'', or a sage). ''Atulya Gotra'', or diversity in clans, is what the sages of antiquity professed, thus laying the foundation of genetics in Ayurveda. In this chapter, Lord Atreya answers thirty six specific questions of Agnivesha on a wide range of topics such as the causes of human embryo, labor, sex determination of the embryo, congenital anomalies, transmigration of the ''atma'', and related phenomena. Apart from these, causes of disease, treatment, preventive measures and the role of past and present deeds of one-self in causation of disease etc. are discussed.

'''Keywords''': ''Atulya-gotra,Shukra, Garbha, Ojoshana, Bīja, Dwireta, Klība, Prajnyaparadha, Pratikarma, Daiva'' , and ''Paurusha''.
</div>
=== Introduction ===
<div style="text-align:justify;">
Vedic families – and societies – were largely divided into patrilineal clans (''gotras''), where each clan could trace their origins to a common male ancestor. The sages of antiquity knew of various disorders caused due to in-breeding within families, and thus forbade marriages within a ''gotra''. To them, the study of human physiology required an analysis of the human embryo within the womb, and that managing disorders right at the stage of conception was important in ensuring good health within families and societies.

The preceding chapter dealt with overarching concepts of physical and spiritual importance, such as ''purusha, atma, manas,'' and ''buddhi''. In continuation, this chapter begins with the “origin of a human being” as a result of sexual intercourse with a woman in her fertile period by a man from a different clan (''atulya-gotra''). It then talks of various factors influencing the embryogenesis, fetal growth and development, genetic abnormalities, features of ''sadya-grihita garbha'' (a female who has just conceived) etc. Consanguinity (''tulya gotra'') is being related to someone by blood, in contrast to ''atulya gotra''.
</div>
===Sanskrit text, Transliteration and English Translation===

अथातोऽतुल्यगोत्रीयं शारीरं व्याख्यास्यामः||१||

athātō'tulyagōtrīyaṁ śārīraṁ vyākhyāsyāmaḥ||1||

athAto~atulyagotrIyaM shArIraM vyAkhyAsyAmaH||1||

इति ह स्माह भगवानात्रेयः||२||

iti ha smāha bhagavānātrēyaḥ||2||

iti ha smAha bhagavAnAtreyaH||2||

Now (I) shall expound the chapter that talks of ''atulya gotra'' (different clan). Thus, said Lord Atreya. [1-2]

अतुल्यगोत्रस्य रजःक्षयान्ते रहोविसृष्टं मिथुनीकृतस्य|
किं स्याच्चतुष्पात्प्रभवं च षड्भ्यो [२] यत् स्त्रीषु गर्भत्वमुपैति पुंसः||३||

atulyagōtrasya rajaḥkṣayāntē rahōvisr̥ṣṭaṁ mithunīkr̥tasya|
kiṁ syāccatuṣpātprabhavaṁ ca ṣaḍbhyō [2] yat strīṣu garbhatvamupaiti puṁsaḥ||3||

atulyagotrasya rajaHkShayAnte rahovisRuShTaM mithunIkRutasya|
kiM syAccatuShpAtprabhavaM ca ShaDbhyo [2] yat strIShu garbhatvamupaiti puMsaH||3||

What is that of a man which has four constituents (''mahabhutas'') and six sources (''rasa'') and which comes out of him while he cohabits with a woman of a different clan in a lonely place after her menstrual cycle and is converted into embryo in the woman? [3]

शुक्रं तदस्य प्रवदन्ति धीरा यद्धीयते गर्भसमुद्भवाय|
वाय्वग्निभूम्यब्गुणपादवत्तत् षड्भ्यो रसेभ्यः प्रभवश्च तस्य||४||

śukraṁ tadasya pravadanti dhīrā yaddhīyatē garbhasamudbhavāya|
vāyvagnibhūmyabguṇapādavattat ṣaḍbhyō rasēbhyaḥ prabhavaśca tasya||4||

śukraM tadasya pravadanti dhIrA yaddhIyate garbhasamudbhavAya|
vAyvagnibhUmyabguNapAdavattat ShaDbhyo rasebhyaH prabhavashca tasya||4||
<div style="text-align:justify;">
The wise call it ''shukra'', that which is implanted for the conception of an embryo. It is made up of four elements-''vayu, agni, prithvi'' and ''apa'' (four ''mahabhutas'') which contribute one fourth of the attributes of each of the ''mahabhuta'' and is originated from six ''rasas''.[4]
</div>
सम्पूर्णदेहः समये सुखं च गर्भः कथं केन च जायते स्त्री|
गर्भं चिराद्विन्दति सप्रजाऽपि भूत्वाऽथवा नश्यति केन गर्भः||५||

sampūrṇadēhaḥ samayē sukhaṁ ca garbhaḥ kathaṁ kēna ca jāyatē strī|
garbhaṁ cirādvindati saprajā'pi bhūtvā'thavā naśyati kēna garbhaḥ||5||

sampUrNadehaH samaye sukhaM ca garbhaH kathaM kena ca jAyate strI|
garbhaM cirAdvindati saprajA~api bhUtvA~athavA nashyati kena garbhaH||5||

How and with what factors does the fully developed fetus get delivered in time and with ease? How does even a fertile woman face delays in conception? Why sometimes does the embryo get destroyed? [5]

शुक्रासृगात्माशयकालसम्पद् यस्योपचारश्च हितैस्तथाऽन्नैः ||५||

गर्भश्च काले च सुखी सुखं च सञ्जायते सम्परिपूर्णदेहः||६||

śukrāsr̥gātmāśayakālasampad yasyōpacāraśca hitaistathā'nnaiḥ ||5||

garbhaśca kālē ca sukhī sukhaṁ ca sañjāyatē samparipūrṇadēhaḥ||6||

śukrasRugAtmAshayakAlasampad yasyopacArashca hitaistathA~annaiH |5||

garbhashca kAle ca sukhI sukhaM ca sa~jjAyate samparipUrNadehaH||6||

By (the excellence of) healthy sperm, ovum, ''atma'', uterus, time and by management with wholesome diet, the normal fetus gets delivered in fully developed state in time and with ease.[6]

योनिप्रदोषान्मनसोऽभितापाच्छुक्रासृगाहारविहारदोषात्|
अकालयोगाद्बलसङ्क्षयाच्च गर्भं चिराद्विन्दति सप्रजाऽपि||७||

yōnipradōṣānmanasō'bhitāpācchukrāsr̥gāhāravihāradōṣāt|
akālayōgādbalasaṅkṣayācca garbhaṁ cirādvindati saprajā'pi||7||

yonipradoShAnmanaso~abhitApAcchukrAsRugAhAravihAradoShAt|
akAlayogAdbalasa~gkShayAcca garbhaM cirAdvindati saprajA~api||7||

Though fertile, a woman conceives after a long time due to defects in genitals, mental worry, derangement of sperm, ovum, diet and behavior, absence of proper timing and diminution of strength.[7]

असृङ्गिरुद्धं [६] पवनेन नार्या गर्भं व्यवस्यन्त्यबुधाः कदाचित्|
गर्भस्य रूपं हि करोति तस्यास्तदसृगस्रवि विवर्धमानम्||८||

asr̥ṅggniruddhaṁ [6] pavanēna nāryā garbhaṁ vyavasyantyabudhāḥ kadācit|
garbhasya rūpaṁ hi karōti tasyāstadasr̥gasraavi vivardhamānam||8||

asRu~ggniruddhaM [6] pavanena nAryA garbhaM vyavasyantyabudhAH kadAcit|
garbhasya rUpaM hi karoti tasyAstadasRugasraavi vivardhamAnam||8||

Menstrual blood obstructed by ''vayu'' in (the uterus of) a woman is mistaken as pregnancy sometimes by the ignorant. The blood that does not flow out but gradually accumulates within the uterus produces signs and symptoms similar to pregnancy.[8]

तदग्निसूर्यश्रमशोकरोगैरूष्णान्नपानैरथवा ||७||

प्रवृत्तम् दृष्ट्वाऽसृगेकं ||८||

न च गर्भसञ्ज्ञं केचिन्नरा भूतहृतं वदन्ति||९||

tadagnisūryaśramaśōkarōgairūṣṇānnapānairathavā ||7||

pravr̥ttam dr̥ṣṭvā'sr̥gēkaṁ ||8||

na ca garbhasañjñaṁ kēcinnarā bhūtahr̥taṁ vadanti||9||

tadagnisUryashramashokarogairUShNAnnapAnairathavA ||7||

pravRuttam dRuShTvA~asRugekaM ||8||

na ca garbhasa~jj~jaM kecinnarA bhUtahRutaM vadanti||9||

When that blood is discharged out due to exposure to fire, the sun, exertion, grief, various diseases and intake of hot food and drinks, it is mistaken as a fetus destroyed by evil spirits by some people. [9]

ओजोशनानां रजनीचराणामाहारहेतोर्न शरीरमिष्टम्|
गर्भं हरेयुर्यदि ते न मातुर्लब्धावकाशा न हरेयुरोजः||१०||

ōjōśanānāṁ rajanīcarāṇāmāhārahētōrna śarīramiṣṭam|
garbhaṁ harēyuryadi tē na māturlabdhāvakāśā na harēyurōjaḥ||10||

ojoshanAnAM rajanIcarANAmAhArahetorna sharIramiShTam|
garbhaM hareyuryadi te na mAturlabdhAvakAshA na hareyurojaH||10||

Evil spirits who move at night and eat away the ''ojas'' do not desire the body (of the fetus) as food. If these evil spirits take away the life of the fetus they can easily enter in to the mother’s body and eat away the ''ojas'', leading to her death also.[10]

कन्यां सुतं वा सहितौ पृथग्वा सुतौ सुते वा तनयान् बहून् वा|
कस्मात् प्रसूते सुचिरेण गर्भमेकोऽभिवृद्धिं च यमेऽभ्युपैति||११||

kanyāṁ sutaṁ vā sahitau pr̥thagvā sutau sutē vā tanayān bahūn vā|
kasmāt prasūtē sucirēṇa garbhamēkō'bhivr̥ddhiṁ ca yamē'bhyupaiti||11||

kanyAM sutaM vA sahitau pRuthagvA sutau sute vA tanayAn bahUn vA|
kasmAt prasUte sucireNa garbhameko~abhivRuddhiM ca yame~abhyupaiti||11||

Why does one get a female or a male child?. Why does one get twins, male or female, separate or conjoined, or multiple births? Why does one deliver a child with delay? Why does one twin, in many cases, develop more than the other? [11]

रक्तेन कन्यामधिकेन पुत्रं शुक्रेण तेन द्विविधीकृतेन|
बीजेन कन्यां च सुतं च सूते यथास्वबीजान्यतराधिकेन||१२||

raktēna kanyāmadhikēna putraṁ śukrēṇa tēna dvividhīkr̥tēna|
bījēna kanyāṁ ca sutaṁ ca sūtē yathāsvabījānyatarādhikēna||12||

raktena kanyAmadhikena putraM shukreNa tena dvividhIkRutena|
bIjena kanyAM ca sutaM ca sUte yathAsvabIjAnyatarAdhikena||12||

One gets female or male child due to dominance of ovum or sperm respectively. When zygote is split into two, twins are formed and the gender of each of the twins is determined by the relative predominance of ovum or sperm.||12||

शुक्राधिकं द्वैधमुपैति बीजं यस्याः सुतौ सा सहितौ प्रसूते|
रक्ताधिकं वा यदि भेदमेति द्विधा सुते सा सहिते प्रसूते||१३||

śukrādhikaṁ dvaidhamupaiti bījaṁ yasyāḥ sutau sā sahitau prasūtē|
raktādhikaṁ vā yadi bhēdamēti dvidhā sutē sā sahitē prasūtē||13||

śukradhikaM dvaidhamupaiti bIjaM yasyAH sutau sA sahitau prasUte|
raktAdhikaM vA yadi bhedameti dvidhA sute sA sahite prasUte||13||

When the zygote is bifurcated with dominance of sperm, the woman delivers male twins and when with dominance of ovum, female twins.[13]

भिनत्ति यावद्बहुधा प्रपन्नः शुक्रार्तवं वायुरतिप्रवृद्धः|
तावन्त्यपत्यानि यथाविभागं कर्मात्मकान्यस्ववशात् प्रसूते||१४||

bhinatti yāvadbahudhā prapannaḥ śukrārtavaṁ vāyuratipravr̥ddhaḥ|
tāvantyapatyāni yathāvibhāgaṁ karmātmakānyasvavaśāt prasūtē||14||

bhinatti yAvadbahudhA prapannaH śukrārtavaM vAyuratipravRuddhaH|
tAvantyapatyAni yathAvibhAgaM karmAtmakAnyasvavashAt prasUte||14||

A woman delivers multiples due to past deeds and God’s pleasure in which the excessively aggravated ''vayu'' afflicting the union of sperm and ovum splits the zygote in various ways.[14]

आहारमाप्नोति यदा न गर्भः शोषं समाप्नोति परिस्रुतिं वा|
तं स्त्री प्रसूते सुचिरेण गर्भं पुष्टो यदा वर्षगणैरपि स्यात्||१५||

āhāramāpnōti yadā na garbhaḥ śōṣaṁ samāpnōti parisrutiṁ vā|
taṁ strī prasūtē sucirēṇa garbhaṁ puṣṭō yadā varṣagaṇairapi syāt||15||

AhAramApnoti yadA na garbhaH shoShaM samApnoti parisrutiM vA|
taM strI prasUte sucireNa garbhaM puShTo yadA varShagaNairapi syAt||15||

If the fetus does not get adequate nourishment and consequently gets dried up or is discharged, the woman delivers the child after a long time which may even take years for delivery after proper nourishment.[15]

कर्मात्मकत्वाद्विषमांशभेदाच्छुक्रासृजोर्वृद्धिमुपैति कुक्षौ|
एकोऽधिको न्यूनतरो द्वितीय एवं [९] यमेऽप्यभ्यधिको विशेषः||१६||

karmātmakatvādviṣamāṁśabhēdācchukrāsr̥jōrvr̥ddhimupaiti kukṣau|
ēkō'dhikō nyūnatarō dvitīya ēvaṁ [9] yamē'pyabhyadhikō viśēṣaḥ||16||

karmAtmakatvAdviShamAMshabhedAcchukrAsRujorvRuddhimupaiti kukShau|
eko~adhiko nyUnataro dvitIya evaM [9] yame~apyabhyadhiko visheShaH||16||

Due to past deeds and uneven division of the union of sperm and ovum, one in the twin develops more in the womb while the other one is less. Thus, there is also difference in the twins. [16]

कस्माद्द्विरेताः पवनेन्द्रियो वा संस्कारवाही नरनारिषण्डौ|
वक्री तथेर्ष्याभिरतिः कथं वा सञ्जायते वातिकषण्डको वा||१७||

kasmāddvirētāḥ pavanēndriyō vā saṁskāravāhī naranāriṣaṇḍau|
vakrī tathērṣyābhiratiḥ kathaṁ vā sañjāyatē vātikaṣaṇḍakō vā||17||

kasmAddviretAH pavanendriyo vA saMskAravAhI naranAriShaNDau|
vakrI tatherShyAbhiratiH kathaM vA sa~jjAyate vAtikaShaNDako vA||17||
<div style="text-align:justify;">
Why does the progeny become ''dwireta'' (hermaphrodite), ''pavanendriya'' (devoid of semen), ''samskaravahi'' (one whose semen pathway is obstructed by ''vata''), ''narashanda'' (male sterility), ''narīshanda'' (female sterility), ''vakrī'' (curved), ''irshyabhirati'' (one with mixoscopia) and ''vatikashandaka'' (one whose testicles are destroyed due to ''vayu'' and ''agni'' (''pitta'')) [17]
</div>
बीजात् समांशादुपतप्तबीजात् स्त्रीपुंसलिङ्गी भवति द्विरेताः|
शुक्राशयं गर्भगतस्य हत्वा [१०] करोति वायुः पवनेन्द्रियत्वम्||१८||

bījāt samāṁśādupataptabījāt strīpuṁsaliṅgī bhavati dvirētāḥ|
śukrāśayaṁ garbhagatasya hatvā [10] karōti vāyuḥ pavanēndriyatvam||18||

bIjAt samAMshAdupataptabIjAt strIpuMsali~ggI bhavati dviretAH|
śukrashayaM garbhagatasya hatvA [10] karoti vAyuH pavanendriyatvam||18||
<div style="text-align:justify;">
In case the zygote is formed by sperm and ovum equally or is damaged, the progeny has characters of both female and male, resulting in ''dwireta'' (hermaphrodite). ''Vayu'' by afflicting the ''shukrashaya'' (site of semen) of the fetus causes ''pavanendriya'' (devoid of semen).[18]
</div>
शुक्राशयद्वारविघट्टनेन संस्कारवाहं [११] कुरुतेऽनिलश्च|
मन्दाल्पबीजावबलावहर्षौ क्लीबौ च हेतुर्विकृतिद्वयस्य||१९||

śukrāśayadvāravighaṭṭanēna saṁskāravāhaṁ [11] kurutē'nilaśca|
mandālpabījāvabalāvaharṣau klībau ca hēturvikr̥tidvayasya||19||

śukrashayadvAravighaTTanena saMskAravAhaM [11] kurute~anilashca|
mandAlpabIjAvabalAvaharShau klIbau ca heturvikRutidvayasya||19||
<div style="text-align:justify;">
When ''vayu'' obstructs the passage of the site of semen, it causes ''samskaravahī''. When the parents have sluggish and diminished reproductive factors, are weak, or are not excited or happy during coitus, they cause the two disorders—''narashanda'' and ''narīshanda'' (male and female sterility).[19]
</div>
मातुर्व्यवायप्रतिघेन वक्री स्याद्बीजदौर्बल्यतया पितुश्च|
ईर्ष्याभिभूतावपि मन्दहर्षावीर्ष्यारतेरेव [१२] वदन्ति हेतुम्||२०||

māturvyavāyapratighēna vakrī syādbījadaurbalyatayā pituśca|
īrṣyābhibhūtāvapi mandaharṣāvīrṣyāratērēva [12] vadanti hētum||20||

mAturvyavAyapratighena vakrI syAdbIjadaurbalyatayA pitushca|
IrShyAbhibhUtAvapi mandaharShAvIrShyAratereva [12] vadanti hetum||20||
<div style="text-align:justify;">
Due to the mother’s lack of desire (for coitus) or complicated posture (during coitus) and also due to ''shukra'' deficiency of the father, (the progeny) is born with ''vakrī'' (with curved organ). ''Irshyabhirati''(one with mixoscopia) is caused if the parents are subdued by jealousy and have mild passion.[20]
</div>
वाय्वग्निदोषाद्वृषणौ तु यस्य नाशं गतौ वातिकषण्डकः सः|
इत्येवमष्टौ विकृतिप्रकाराः कर्मात्मकानामुपलक्षणीयाः||२१||

vāyvagnidōṣādvr̥ṣaṇau tu yasya nāśaṁ gatau vātikaṣaṇḍakaḥ saḥ|
ityēvamaṣṭau vikr̥tiprakārāḥ karmātmakānāmupalakṣaṇīyāḥ||21||

vAyvagnidoShAdvRuShaNau tu yasya nAshaM gatau vAtikaShaNDakaH saH|
ityevamaShTau vikRutiprakArAH karmAtmakAnAmupalakShaNIyAH||21||

When the testicles get destroyed by aggravation of ''vayu'' and ''agni'', ''vatika shandaka'' is caused. These eight types of genetic sexual disorders described above (''dwireta, pawanendriya,'' etc)could be the consequences of past deeds.[21]

गर्भस्य सद्योऽनुगतस्य कुक्षौ स्त्रीपुन्नपुंसामुदरस्थितानाम्|
किं लक्षणं? कारणमिष्यते किं सरूपतां येन च यात्यपत्यम्||२२||

garbhasya sadyō'nugatasya kukṣau strīpunnapuṁsāmudarasthitānām|
kiṁ lakṣaṇaṁ? kāraṇamiṣyatē kiṁ sarūpatāṁ yēna ca yātyapatyam||22||

garbhasya sadyo~anugatasya kukShau strIpunnapuMsAmudarasthitAnAm|
kiM lakShaNaM? kAraNamiShyate kiM sarUpatAM yena ca yAtyapatyam||22||

What are the earliest signs of conception? What signs and symptoms indicate a female, male or hermaphrodite foetus developing in the womb? What is the reason of resemblance of the child to a particular person? [22]

निष्ठीविका गौरवमङ्गसादस्तन्द्राप्रहर्षौ हृदये व्यथा च|
तृप्तिश्च बीजग्रहणं च योन्यां गर्भस्य सद्योऽनुगतस्य लिङ्गम्||२३||

niṣṭhīvikā gauravamaṅgasādastandrāpraharṣau hr̥dayē vyathā ca|
tr̥ptiśca bījagrahaṇaṁ ca yōnyāṁ garbhasya sadyō'nugatasya liṅgam||23||

niShThIvikA gauravama~ggasAdastandrApraharShau hRudaye vyathA ca|
tRuptishca bIjagrahaNaM ca yonyAM garbhasya sadyo~anugatasya li~ggam||23||

Salivation, heaviness, malaise, drowsiness, horripilation, distress in cardiac region, contentment, fertilization in the uterus —these are the earliest signs of conception.||23||

सव्याङ्गचेष्टा पुरुषार्थिनी [१४] स्त्री स्त्रीस्वप्नपानाशनशीलचेष्टा|
सव्यात्तगर्भा [१५] न च वृत्तगर्भा सव्यप्रदुग्धा स्त्रियमेव सूते||२४||

savyāṅgacēṣṭā puruṣārthinī [14] strī strīsvapnapānāśanaśīlacēṣṭā|
savyāttagarbhā [15] na ca vr̥ttagarbhā savyapradugdhā striyamēva sūtē||24||

savyA~ggaceShTA puruShArthinI [14] strI strIsvapnapAnAshanashIlaceShTA|
savyAttagarbhA [15] na ca vRuttagarbhA savyapradugdhA striyameva sUte||24||

पुत्रं त्वतो लिङ्गविपर्ययेण व्यामिश्रलिङ्गा प्रकृतिं तृतीयाम्|
गर्भोपपत्तौ तु मनः स्त्रिया यं जन्तुं व्रजेत्तत्सदृशं प्रसूते||२५||

putraṁ tvatō liṅgaviparyayēṇa vyāmiśraliṅgā prakr̥tiṁ tr̥tīyām|
garbhōpapattau tu manaḥ striyā yaṁ jantuṁ vrajēttatsadr̥śaṁ prasūtē||25||

putraM tvato li~ggaviparyayeNa vyAmishrali~ggA prakRutiM tRutIyAm|
garbhopapattau tu manaH striyA yaM jantuM vrajettatsadRushaM prasUte||25||
<div style="text-align:justify;">
Activities mostly to the left side of the mother, desire for man, feminine dreams, as well as feminine drinks, foods, conducts and activities, foetus stationed in the left side of the womb, gravid uterus that is not round in shape, profuse lactation in the left breast—these indicate the female foetus. Signs- symptoms contrary to the above indicate the male foetus, while a mixture of the above indicate those of a hermaphrodite. A child resembles that person to whom the mother’s mind is attracted to during conception.||25-26||
</div>
गर्भस्य चत्वारि चतुर्विधानि भूतानि मातापितृसम्भवानि|
आहारजान्यात्मकृतानि चैव सर्वस्य सर्वाणि भवन्ति देहे||२६||

garbhasya catvāri caturvidhāni bhūtāni mātāpitr̥sambhavāni|
āhārajānyātmakr̥tāni caiva sarvasya sarvāṇi bhavanti dēhē||26||

garbhasya catvAri caturvidhAni bhUtAni mAtApitRusambhavAni|
AhArajAnyAtmakRutAni caiva sarvasya sarvANi bhavanti dehe||26||
तेषां विशेषाद्बलवन्ति यानि भवन्ति मातापितृकर्मजानि|
तानि व्यवस्येत् सदृशत्वहेतुं सत्त्वं यथानूकमपि व्यवस्येत्||२७||

tēṣāṁ viśēṣādbalavanti yāni bhavanti mātāpitr̥karmajāni|
tāni vyavasyēt sadr̥śatvahētuṁ sattvaṁ yathānūkamapi vyavasyēt||27||

teShAM visheShAdbalavanti yAni bhavanti mAtApitRukarmajAni|
tAni vyavasyet sadRushatvahetuM sattvaM yathAnUkamapi vyavasyet||27||
<div style="text-align:justify;">
Foetus is made up of four set of four ''mahabhutas'' (i.e., of all except ''akasha''), i.e., one set each from the mother, the father, nutrition from the mother, and the self. Out of these, factors the past deeds of the soul and the parents significantly influence the physical and psychological traits of the progeny. Like-wise, resemblance is also determined by the deeds of past life.||27||
</div>
कस्मात् प्रजां स्त्री विकृतां प्रसूते हीनाधिकाङ्गीं विकलेन्द्रियां वा|
देहात् कथं देहमुपैति चान्यमात्मा सदा कैरनुबध्यते च||२८||

kasmāt prajāṁ strī vikr̥tāṁ prasūtē hīnādhikāṅgīṁ vikalēndriyāṁ vā|
dēhāt kathaṁ dēhamupaiti cānyamātmā sadā kairanubadhyatē ca||28||

kasmAt prajAM strI vikRutAM prasUte hInAdhikA~ggIM vikalendriyAM vA|
dehAt kathaM dehamupaiti cAnyamAtmA sadA kairanubadhyate ca||28||

Why does a woman deliver an abnormal child with deficiencies or excess of organs or deranged sense organs? How does the soul transmigrate from one body to another and what is always associated with it? ||28||

बीजात्मकर्माशयकालदोषैर्मातुस्तथाऽऽहारविहारदोषैः|
कुर्वन्ति दोषा विविधानि दुष्टाः संस्थानवर्णेन्द्रियवैकृतानि||२९||

bījātmakarmāśayakāladōṣairmātustathā''hāravihāradōṣaiḥ|
kurvanti dōṣā vividhāni duṣṭāḥ saṁsthānavarṇēndriyavaikr̥tāni||29||

bIjAtmakarmAshayakAladoShairmAtustathA~a~ahAravihAradoShaiH|
kurvanti doShA vividhAni duShTAH saMsthAnavarNendriyavaikRutAni||29||

वर्षासु काष्टाश्मघनाम्बुवेगास्तरोः सरित्स्रोतसि संस्थितस्य|
यथैव कुर्युर्विकृतिं तथैव गर्भस्य कुक्षौ नियतस्य दोषाः||३०||
varṣāsu kāṣṭhāśmaghanāmbuvēgāstarōḥ saritsrōtasi saṁsthitasya|
yathaiva kuryurvikr̥tiṁ tathaiva garbhasya kukṣau niyatasya dōṣāḥ||30||

varShAsu kAShThAshmaghanAmbuvegAstaroH saritsrotasi saMsthitasya|
yathaiva kuryurvikRutiM tathaiva garbhasya kukShau niyatasya doShAH||30||
<div style="text-align:justify;">
Due to defects in the sperm/ovum, past deeds of the soul, uterus, time and mother’s food and behavior, ''doshas'' get vitiated causing various abnormalities in shape, complexion and sense organs. Just as in the rainy season, wood, stone pieces and water current cause derangements in a tree situated in the river stream, ''doshas'' cause abnormalities in fetus situated in the womb.||29-30||
</div>
भूतैश्चतुर्भिः सहितः सुसूक्ष्मैर्मनोजवो देहमुपैति देहात्|
कर्मात्मकत्वान्न तु तस्य दृश्यं दिव्यं विना दर्शनमस्ति रूपम्||३१||

bhūtaiścaturbhiḥ sahitaḥ susūkṣmairmanōjavō dēhamupaiti dēhāt|
karmātmakatvānna tu tasya dr̥śyaṁ divyaṁ vinā darśanamasti rūpam||31||

bhUtaishcaturbhiH sahitaH susUkShmairmanojavo dehamupaiti dehAt|
karmAtmakatvAnna tu tasya dRushyaM divyaM vinA darshanamasti rUpam||31||

The soul, along with four subtle ''bhutas'', at a speed like that of the mind, transmigrates from one body to the other according to past deeds. It cannot be seen without divine visual sense. ||31||

स सर्वगः सर्वशरीरभृच्च स विश्वकर्मा स च विश्वरूपः|
स चेतनाधातुरतीन्द्रियश्च स नित्ययुक् सानुशयः स एव [१६] ||३२||

sa sarvagaḥ sarvaśarīrabhr̥cca sa viśvakarmā sa ca viśvarūpaḥ|
sa cētanādhāturatīndriyaśca sa nityayuk sānuśayaḥ sa ēva [16] ||32||

sa sarvagaH sarvasharIrabhRucca sa vishvakarmA sa ca vishvarUpaH|
sa cetanAdhAturatIndriyashca sa nityayuk sAnushayaH sa eva [16] ||32||
<div style="text-align:justify;">
The soul is omnivagant/ omnipresent (can move anywhere and everywhere), sustains all bodies, performs all actions, and takes all forms. It is the source of consciousness, transcending all senses, as it is always associated (with intellect etc.), it gets involved in attachment etc.||32||
</div>
रसात्ममातापितृसम्भवानि भूतानि विद्याद्दश षट् च देहे|
चत्वारि तत्रात्मनि संश्रितानि स्थितस्तथाऽऽत्मा च चतुर्षु तेषु||३३||

rasātmamātāpitr̥sambhavāni bhūtāni vidyāddaśa ṣaṭ ca dēhē|
catvāri tatrātmani saṁśritāni sthitastathā''tmā ca caturṣu tēṣu||33||

rasAtmamAtApitRusambhavAni bhUtAni vidyAddasha ShaT ca dehe|
catvAri tatrAtmani saMshritAni sthitastathA~a~atmA ca caturShu teShu||33||

In the body, the ''bhutas'' are sixteen (each set of four ''bhutas'' is of four types), originating from maternal nutrition, the self, mother (ovum) and father (sperm). Out of these, four are associated with the self and the self, in turn, depends on these four.||33||

भूतानि मातापितृसम्भवानि रजश्च शुक्रं च वदन्ति गर्भे|
आप्याय्यते शुक्रमसृक् च भूतैर्यैस्तानि भूतानि [१७] रसोद्भवानि||३४||

bhūtāni mātāpitr̥sambhavāni rajaśca śukraṁ ca vadanti garbhē|
āpyāyyatē śukramasr̥k ca bhūtairyaistāni bhūtāni [17] rasōdbhavāni||34||

bhUtAni mAtApitRusambhavAni rajashca śukraM ca vadanti garbhe|
ApyAyyate śukramasRuk ca bhUtairyaistAni bhUtAni [17] rasodbhavAni||34||

The ''bhutas'' from the mother and the father are known as ovum and sperm in the fetus respectively. The ''bhutas'' which nourish these sperm and ovum are nourished from the mother’s nutrition. ||34||

भूतानि चत्वारि तु कर्मजानि यान्यात्मलीनानि विशन्ति गर्भम्|
स बीजधर्मा ह्यपरापराणि देहान्तराण्यात्मनि याति याति||३५||

bhūtāni catvāri tu karmajāni yānyātmalīnāni viśanti garbham|
sa bījadharmā hyaparāparāṇi dēhāntarāṇyātmani yāti yāti||35||

bhUtAni catvAri tu karmajAni yAnyAtmalInAni vishanti garbham|
sa bIjadharmA hyaparAparANi dehAntarANyAtmani yAti yAti||35||
<div style="text-align:justify;">
Four ''karmajabhutas'' (derived from the past deeds) which are ''atmaleena'' (associated with the soul) which enter into the fetus are known as ''beejadharma''. These (four ''bhutas'') along with the soul transmigrates from one body to the other (in a cyclic of birth and death). ||35||
</div>
रूपाद्धि रूपप्रभवः प्रसिद्धः कर्मात्मकानां मनसो मनस्तः|
भवन्ति ये त्वाकृतिबुद्धिभेदारजस्तमस्तत्र च कर्म हेतुः||३६||

rūpādhi rūpaprabhavaḥ prasiddhaḥ karmātmakānāṁ manasō manastaḥ|
bhavanti yē tvākr̥tibuddhibhēdārajastamastatra ca karma hētuḥ||36||

rUpAddhi rUpaprabhavaH prasiddhaH karmAtmakAnAM manaso manastaH|
bhavanti ye tvAkRutibuddhibhedArajastamastatra ca karma hetuH||36||
<div style="text-align:justify;">
Based on one’s past deeds, one’s physical form is influenced by the physical form of a past life, and one’s mind from that of a past life. Whatever difference is observed in the physique and psyche of one’s life from those of the other is caused by ''rajas, tamas'' and the past deeds.
</div>
अतीन्द्रियैस्तैरतिसूक्ष्मरूपैरात्मा कदाचिन्न वियुक्तरूपः|
न कर्मणा नैव मनोमतिभ्यां न चाप्यहङ्कारविकारदोषैः||३७||

atīndriyaistairatisūkṣmarūpairātmā kadācinna viyuktarūpaḥ|
na karmaṇā naiva manōmatibhyāṁ na cāpyahaṅkāravikāradōṣaiḥ||37||

atIndriyaistairatisUkShmarUpairAtmA kadAcinna viyuktarUpaH|
na karmaNA naiva manomatibhyAM na cApyaha~gkAravikAradoShaiH||37||

रजस्तमोभ्यां हि मनोऽनुबद्धं ज्ञानं विना तत्र हि सर्वदोषाः|
गतिप्रवृत्त्योस्तु निमित्तमुक्तं मनः सदोषं बलवच्च कर्म||३८||
rajastamōbhyāṁ hi manō'nubaddhaṁ jñānaṁ vinā tatra hi sarvadōṣāḥ|
gatipravr̥ttyōstu nimittamuktaṁ manaḥ sadōṣaṁ balavacca karma||38||

rajastamobhyAM hi mano~anubaddhaM j~jAnaM vinA tatra hi sarvadoShAH|
gatipravRuttyostu nimittamuktaM manaH sadoShaM balavacca karma||38||
<div style="text-align:justify;">
The soul is never dissociated with the subtle and sense-transcending ''bhutas'', past deeds, mind, intellect, ego and other ''doshas'' or ''vikara''. Mind is associated with ''rajas'' and ''tamas'', while all defects are caused by ignorance (''tamas''). The cause of movement and inclination of soul from one body to another is defective mind and potent past deeds. ||37-38||
</div>
रोगाः कुतः संशमनं किमेषां हर्षस्य शोकस्य च किं निमित्तम्|
शरीरसत्त्वप्रभवा विकाराः कथं न शान्ताः पुनरापतेयुः||३९||

rōgāḥ kutaḥ saṁśamanaṁ kimēṣāṁ harṣasya śōkasya ca kiṁ nimittam|
śarīrasattvaprabhavā vikārāḥ kathaṁ na śāntāḥ punarāpatēyuḥ||39||

rogAH kutaH saMshamanaM kimeShAM harShasya shokasya ca kiM nimittam|
sharIrasattvaprabhavA vikArAH kathaM na shAntAH punarApateyuH||39||

How do diseases occur? What is their remedy? What is the cause of happiness and sorrow? How could physical and mental disorders, once subdued, not recur? ||39||

प्रज्ञापराधो विषमास्तथाऽर्था हेतुस्तृतीयः परिणामकालः|
सर्वामयानां त्रिविधा च शान्तिर्ज्ञानार्थकालाः समयोगयुक्ताः||४०||

prajñāparādhō viṣamāstathā'rthā hētustr̥tīyaḥ pariṇāmakālaḥ|
sarvāmayānāṁ trividhā ca śāntirjñānārthakālāḥ samayōgayuktāḥ||40||

praj~jAparAdho viShamAstathA~arthA hetustRutIyaH pariNAmakAlaH|
sarvAmayAnAM trividhA ca shAntirj~jAnArthakAlAH samayogayuktAH||40||

Intellectual error (''pragyaparadha''), unbalanced use of senses and temporal effects- these three are the causes of all disorders. Similarly, the remedy of all disorders lies in the balanced use of intellect, senses and time. ||40||

धर्म्याः क्रिया हर्षनिमित्तमुक्तास्ततोऽन्यथा शोकवशं नयन्ति|
शरीरसत्त्वप्रभवास्तु रोगास्तयोरवृत्त्या न भवन्ति भूयः||४१||

dharmyāḥ kriyā harṣanimittamuktāstatō'nyathā śōkavaśaṁ nayanti|
śarīrasattvaprabhavāstu rōgāstayōravr̥ttyā na bhavanti bhūyaḥ||41||

dharmyAH kriyA harShanimittamuktAstato~anyathA shokavashaM nayanti|
sharIrasattvaprabhavAstu rogAstayoravRuttyA na bhavanti bhUyaH||41||

Virtuous acts bring forth happiness while the contrary ones cause sorrow. The source of all diseases is the body and the mind. When these (body and mind) are absent, the diseases can not recur. ||41||

रूपस्य सत्त्वस्य च सन्ततिर्या नोक्तस्तदादिर्नहि सोऽस्ति कश्चित्|
तयोरवृत्तिः क्रियते पराभ्यां धृतिस्मृतिभ्यां परया धिया च||४२||

rūpasya sattvasya ca santatiryā nōktastadādirnahi sō'sti kaścit|
tayōravr̥ttiḥ kriyatē parābhyāṁ dhr̥tismr̥tibhyāṁ parayā dhiyā ca||42||

rUpasya sattvasya ca santatiryA noktastadAdirnahi so~asti kashcit|
tayoravRuttiH kriyate parAbhyAM dhRutismRutibhyAM parayA dhiyA ca||42||

The beginning of the continuity of physique and psyche is not told and for sure there is no such beginning Their absence can be brought out only by excellent restraint, memory and knowledge. ||42||

सत्याश्रये वा द्विविधे यथोक्ते पूर्वं गदेभ्यः प्रतिकर्म नित्यम्|
जितेन्द्रियं नानुपतन्ति रोगास्तत्कालयुक्तं यदि नास्ति दैवम्||४३||

satyāśrayē vā dvividhē yathōktē pūrvaṁ gadēbhyaḥ pratikarma nityam|
jitēndriyaṁ nānupatanti rōgāstatkālayuktaṁ yadi nāsti daivam||43||

satyAshraye vA dvividhe yathokte pUrvaM gadebhyaH pratikarma nityam|
jitendriyaM nAnupatanti rogAstatkAlayuktaM yadi nAsti daivam||43||

Even though the above mentioned two-fold seats of diseases (body and mind) exist, one who always takes precautions against diseases and have control over the senses does not fall prey to diseases except when predestined. ||43||

दैवं पुरा यत् कृतमुच्यते तत् तत् [२८] पौरुषं यत्त्विह कर्म दृष्टम्|
प्रवृत्तिहेतुर्विषमः स दृष्टो निवृत्तिहेतुर्हि समः स एव||४४||

daivaṁ purā yat kr̥tamucyatē tat tat [28] pauruṣaṁ yattviha karma dr̥ṣṭam|
pravr̥ttihēturviṣamaḥ sa dr̥ṣṭō nivr̥ttihēturhi samaḥ sa ēva||44||

daivaM purA yat kRutamucyate tat tat [28] pauruShaM yattviha karma dRuShTam|
pravRuttiheturviShamaH sa dRuShTo nivRuttiheturhi samaH sa eva||44||

The deeds of the previous life are known as ''daiva'' (fate) and those of the present life as ''paurusha'' (personal effort). Imbalance of these (''daiva'' and ''paurusha'') leads to diseases and balance prevents the diseases||44||

हैमन्तिकं दोषचयं वसन्ते प्रवाहयन् ग्रैष्मिकमभ्रकाले|
घनात्यये वार्षिकमाशु सम्यक् प्राप्नोति रोगानृतुजान्न जातु [३१29] ||४५||

haimantikaṁ dōṣacayaṁ vasantē pravāhayan graiṣmikamabhrakālē|
ghanātyayē vārṣikamāśu samyak prāpnōti rōgānr̥tujānna jātu [31] ||45||

haimantikaM doShacayaM vasante pravAhayan graiShmikamabhrakAle|
ghanAtyaye vArShikamAshu samyak prApnoti rogAnRutujAnna jAtu [31] ||45||

One who eliminates the accumulation of ''doshas'' of early winter in spring, of summer in early rains and of rainy season in autumn, never suffers from seasonal disorders. ||45||

नरो हिताहारविहारसेवी समीक्ष्यकारी विषयेष्वसक्तः|
दाता समः सत्यपरः क्षमावानाप्तोपसेवी च भवत्यरोगः||४६||

narō hitāhāravihārasēvī samīkṣyakārī viṣayēṣvasaktaḥ|
dātā samaḥ satyaparaḥ kṣamāvānāptōpasēvī ca bhavatyarōgaḥ||46||

naro hitAhAravihArasevI samIkShyakArI viShayeShvasaktaH|
dAtA samaH satyaparaH kShamAvAnAptopasevI ca bhavatyarogaH||46||

The man who uses wholesome diet and behavior, moves cautiously, is unattached to sensual pleasures, donates, observes equality, is truthful, is forbearing and is devoted to venerable people becomes free from diseases. ||46||

मतिर्वचः कर्म सुखानुबन्धं सत्त्वं विधेयं विशदा च बुद्धिः|
ज्ञानं तपस्तत्परता च योगे यस्यास्ति तं नानुपतन्ति [३२] रोगाः||४७||

matirvacaḥ karma sukhānubandhaṁ sattvaṁ vidhēyaṁ viśadā ca buddhiḥ|
jñānaṁ tapastatparatā ca yōgē yasyāsti taṁ nānupatanti [32] rōgāḥ||47||

matirvacaH karma sukhAnubandhaM sattvaM vidheyaM vishadA ca buddhiH|
j~jAnaM tapastatparatA ca yoge yasyAsti taM nAnupatanti [32] rogAH||47||

One who is endowed with such an intellect, speech and (positive) actions which yield good results, who has a submissive mind, clear understanding, and knowledge, and who does penance and continued effort in ''yoga'', does not fall victim to diseases. ||47||

तत्र श्लोकः|
इहाग्निवेशस्य महार्थयुक्तं षट्त्रिंशकं प्रश्नगणं महर्षिः|
अतुल्यगोत्रे भगवान् यथावन्निर्णीतवान् ज्ञानविवर्धनार्थम्||४८||

tatra ślōkaḥ|
ihāgnivēśasya mahārthayuktaṁ ṣaṭtriṁśakaṁ praśnagaṇaṁ maharṣiḥ|
atulyagōtrē bhagavān yathāvannirṇītavān jñānavivardhanārtham||48||

tatra shlokaH|
ihAgniveshasya mahArthayuktaM ShaTtriMshakaM prashnagaNaM maharShiH|
atulyagotre bhagavAn yathAvannirNItavAn j~jAnavivardhanArtham||48||

Now summing it all up,

In this chapter on ''atulyagotra'' the great sage Atreya responded to the thirty six important questions of Agnivesha on conception and disorders at birth, furthering our knowledge in the matter. ||48||

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते शारीरस्थानेऽतुल्यगोत्रीयं शारीरं नाम द्वितीयोऽध्यायः||२||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē śārīrasthānē'tulyagōtrīyaṁ śārīraṁ nāma dvitīyō'dhyāyaḥ||2||

ityagniveshakRute tantre carakapratisaMskRute shArIrasthAne~atulyagotrIyaM shArIraM nAmadvitIyo~adhyAyaH||2||

Thus ends the second chapter titled [[Atulyagotriya Sharira]] in [[Sharira Sthana]], composed by Agnivesha and redacted by Charak.

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*The prerequisites of a healthy conception includethe clan (''gotra'') of male, ovulatory period (''rajah-kshayante''), psychic component (''rahovisrishta''), posture during coitus (''mithuna'') and ''shukra''. The expectant couples have to be very conscious of these facts to achieve a healthy embryo.
*The word ''shukra'' denotes different components in both male and female. In a broad sense, it could mean the whole semen, sperm, ovum and sex hormones. Here it refers to sperm, also called ''sukshma-beeja'' (CK on CS.Sa.2/3).
*Consanguineous marriages have been practiced since long. Since such unions increase the chances of genetic disorders in the offspring, sages forbade it. Lord Atreya advised against consanguineous marriages, as indicated in [[Charak Samhita]].
*''Shukra'' has four ''mahabhuta'' before fertilization and fifth (''akasha'') joins after fertilization.
*Requirement for normal healthy birth: ''Shukra'' (sperm), ''asrik'' (ovum), ''atma'' (soul), ''garbhayashaya sampat'' (healthy uterus), ''kalasampat'' (suitable time for conception),wholesome food and good antenatal care.
*Reasons for delayed conception in a fertile woman: Abnormal uterus and vagina, psychiatric illness, abnormal sperm and ovum, unwholesome diet, faulty lifestyle, wrong timing of intercourse and loss of physical strength.
*Reasons for abortion: Affliction by evil spirits.
*Reasons for multiple pregnancies (twins, etc.), differences in physique and other characteristics of twins: Improper division of the zygote by ''vayu''
*Reasons for congenital defects/sexual disorders: Primarily vitiated ''vayu''- but the reason behind vitiation is past deeds
*Three causes of diseases: Intellectual errors, unbalanced use of sense organs and temporal effects

=== ''Vidhi Vimarsha'' ===

This chapter is quite comprehensive and considers various principles of embryology. The important ones are related to twin formation and development and congenital/chromosomal diseases all of which are said to be caused by vitiated ''vayu''. These principles are backed up by cross references in the same ''samhita'' or other ''samhitas''. These cross references are well illustrated below. It can be inferred that if ''vayu'' is kept under control, many of the complications in pregnancy can be avoided.

==== Introduction to process of embryogenesis (Verse 2) ====

In the preceding chapter, pre-conception factors associated with the human origin, and spiritual factors applicable to treatment in the form of ''naishthika'' and ''moksha'' were discussed. In ''atulyagotriya'', characteristics of a healthy conception, and genetic disorders associated with consanguinity have been described (CK, on CS.Sa.2/1-2).

The word ''garbhadhirupa'' may be interpreted in a broader way to include the entire process of embryogenesis by which an embryo grows and develops into a healthy foetus. Here, ''garbha'' means the conjugation of ''shukra-shonita'' and ''jivatma'' as described in the texts and ''roopa'' means full manifestation. The word, ''adi'' denotes the entire process from the conjugation to full manifestation.(2)

==== Pre-requisites for conception (Verse 3) ====

Sexual intercourse within the same clan causes ''adharma'', thus contraindicated in ''dharmashastra'' (CK on CS.Sa.2/3). Hence ''atulyagotra'' implies non-consanguineous cohabitation. The term ''rajakshaya'' implies menstrual (bleeding) phase, which is of three days and during this period sexual intercourse is contraindicated (CK on CS.Sa.2/3). Post-menstrual phase is considered to be an appropriate time to conceive. This period is referred as ''ritu'' and the duration is expressly described in the texts (SS.Sa.2/33, Sa.3/6; AS.Sa.1/40; AH.Sa.1/27; KS.Sa.5/5, Manu.3/46-47). It is also observed that the first three days and the 16th day of ''ritukala'' is not suitable for conception (Dal.SS.Sa3/6). Analyzing the above facts, it could be stated that ''rajah-kshayante'' referred here is the post menstrual ovulatory phase and is from the 4th to the 15th day of the menstrual cycle.

The influence of psychic component is very important to conceive and is described in many ways. A lonely place (''rahovisrishta'') is advised because any hindrance to the act affects emission of semen during coitus (CK on CS.Sa.2/3). A positive, healthy state of mind (''saumanasya'') is said to be the best state to conceive (CS.Su.25/40). If the woman thinks about an animal during coitus, the progeny takes the character of that animal (CS.Sa.2/25, 8/14; SS.Sa.2/46; AS. Su.13/3, Sa.1/53, AH.Sa.1/31). Similarly, proper methods for sex (''mithuna'') are indicated and it is advised not to follow wrong methods (CK on CS.Sa.2/3).Normal and abnormal postures (CS.Sa.8/6,58, AS.Sa.1/58-59), contraindication of coitus for both male and female along with their effects (CS.Sa.8/6, SS.Sa.10/56, Ci.24/110-123, AS.Sa.1/21,58; BP.Pur.3/26,5/300-302; BhS.Su.7/5-7) are found in many places. Four ''mahabhutas'' and six sources are the constituents of the ''sukshma-beeja'' which is taken with word ''shukra'' (CK on CS.Sa.2/3) viz. the sperm. (3)

==== Description of ''shukra'' (Verse 4-6) ====

The word ''shukra'' referred here is described under the term ''beeja'' in the context of factors responsible for conception in different texts (CS.Su.11/23, SS.Sa.2/33, AS. Sa.1/68, KS.Sa.5/5). The author also uses ''aartava''(ovum) and ''shukra'' (sperm) interchangeably with the word ''beeja'' (Dal.SS.Sa.2/33). Similarly, healthy ''pum-beeja'' (quality sperm) is taken with ''shuddha shukra'' (AD, AH.Sa.1/8-9). Regarding the constituents and sources of ''shukra'', it is stated that all the four ''mahabhutas'' (i.e., all except ''akasha'') equally contribute in creating semen and the best qualities of these four constituents produce pure semen (CK on CS.Sa.2/4) otherwise it becomes abnormal (GD on CS.Sa.2/4). Though semen is ''panchabhautika'', ''akasha'' is not mentioned here since it does not have any kinetic property. Thus, ejaculated semen is said to be ''chatushpada''. However, ''akasha'' being all pervasive, it combines with semen in the uterus (where the semen finally becomes ''panchabhautika'').

The semen createdfrom a six-''rasa'' diet is said to be pure. Excessive use of ''madhura rasa'' promotes semen while ''amla'' etc. destroys it (CK on CS.Sa.2/4).It is also found that if there is unvitiated ''shukra'', healthy ''shonita'', healthy ''garbhashaya'', and observation of prescribed diets and specific lifestyles for both male and female partners, conception is definite (CS.Sa.8/17, Ci.30/125-26; AS.Ut.39/79; AH.Ut.34/61-62).The word ''sampad'' is related to all ''shukra, asriga, atma'', ''ashaya'' and ''kala''. Unafflicted (''adushta'') ''shukra'', ''asriga'' and ''ashaya'', conjugation of soul with ''shukra-shonita'', having auspicious deeds, and normal season (i.e., no extremities in weather conditions etc.) are characteristics of ideal factors for a healthy conception. From the standpoint of ''kala'', or time, the ideal time for delivery is ninth or tenth month of pregnancy (CK on C.S. Sha. 2/6 and C. S. Sha. 4/25 ) as up to this time the fetus gets well developed.

It is said that due to its specific nature, the ''garbha'' descends for labor in its appropriate time (SS.Ni.8/7-8). Development of ''vairagya'' (indifference) by fetus from its intrauterine stay (HS.6th sthana.1/23) and attainment of full maturity of the body (BhS.Sa.3/13) are also responsible for delivery of a mature fetus in proper time and with ease. (6)

==== Factors affecting conception (Verse 7) ====

Delays in conception (by fertile women) due to affliction by various ''yonivyapadas''(..) have been described in various texts (CS.Ci.30/38; AS.Ut.38/53; AH.Ut.33/52). There are several other reasons that have been documented under ''Naigameshahrita garbha'' or ''nagodara'' (delayed labor) (SS.Sa.10/57, KS.Kh 9/39), ''paripluta'' or ''divya-garbha''(..) (KS.Kh.9/39-40), ''bhootah rita garbha''(..) (AS.Sa.1/17, AH.Sa.2/62). All these phenomena could be termed subfertility. (7) It is important to remind the reader that the later stages of ''raktagulma'' resemble pregnancy in their signs and symptoms, as described by other commentators and sages such as Kashyapa (KS.Kh.9/37,AD.AH.Sa.2/61,CS.Ni.3/14, Ci.5/19; AS.Ni.11/45; AH.Ni.11/50; KS.Ci.8/17). Ignorant people could misjudge bleeding in ''raktagulma'' as destruction of the fetus by evil spirits(Dutta DC, 1998) or hydatidiform mole (Dawn CS,1998) (10)

==== Factors affecting sex of the fetus (Verse 12) ====

It is generally accepted in various Ayurvedic texts that there is predominance of ''artava'' and ''shukrain'' the female or male child respectively (SS.Sa.3/5; AS.Sa.2/5; AH.Sa.1/5; BP.Pur.3/40; BhS.Sa.3/10). The partner ejaculating his/her seed first would determine the respective sex of the progeny (AD,AH.Sa.1/5). Irrespective of quantity, the functional potency of ''shukra'' and ''artava'' influences the formation of sex (Dal, SS.Sa.3/5). ''Shukra'' and ''artava'' may be influenced by quantity of ''doshas'' affected by age, day, night, season, stage of food consumption (BP.Pur.3/40), thus impacting sex of fetus. Relative predominance of ''retas'' (semen) and ''indriya'' (sexual power) are also responsible for sex formation (HS.6th Sthan.1/26-27). ''Dakshina-nadi'' (right ovary) and ''vama-nadi'' (left ovary) are considered as “seats” for the formation of male and female child respectively (YR. ''Yonivyapada''). Per some texts, God’s will is also responsible for sex formation (ShrS. Pur.6/12). Apart from this, the day of coitus (either odd or even) is responsible for female or male child respectively (CS.Sa.8/5; SS.Sa.2/28,30, Sa.3/12; AS.Sa.1/48; AH.Sa1/28; KS.Sa.5/6, BhS.Sa5/5; BP.Pur.3/21). It is also explained that if there is predominance of ''shukra'' but female ejaculates her ovum first, the child will be born male with feminine characters and vice-versa (AD.AH.Sa.1/5) (12)

==== Cause of multiple pregnancies (Verse 14) ====

Multiple pregnancies happen due to division of the zygote (''orshukra-artava'') by vitiated ''vata'' - an observation noted in all Ayurvedic texts and accepted by all commentators (SS.Sa.2/37; AS.Sa.2/6; AH.Sa.1/6; KS.Ka.6/59; BP.Pur.3/39). Apart from this phenomenon, instability of mind of the couple during coitus is responsible for producing twins as it influences the ''doshas'' and ''dhatus'' that produce fetal parts (HS.6th sthana.1/38-39). And finally, there are karmic deeds of the soul of the fetus that the parents have no control over. (CK on CS.Sa.2/13-14). (14)

==== Long intrauterine stay (Verse 15) ====

Two conditions, namely ''garbha-shosha'' (..) and ''garbha-parisriti'' (..), have been cited as reasons for the phenomenon termed as “long intrauterine stay”. This kind of manifestation is also found in ''vata-abhipanna garbha'' (..) (SS.Sa.10/57), emaciated fetus afflicted with ''vataja'' disorders (AS.Sa.2/37) and ''vatodara'' (..) (BhS.Sa.3/6-7). This condition could be correlated with intrauterine growth retardation (IUGR). (15)

It is interesting to note that none of the ''vedic'' texts – Ayurvedic or otherwise – blamed the mother for complications and abnormalities in pregnancy. Instead, they seem to attribute those to God’s will and the karmic deeds of the children born with those defects. (16)

==== ''Dwireta''(Hermaphroditism) ====

Manifestations of ''dwireta'' could be any of these:
*Normal morphology like nose, eyes etc. of male and female, devoid of specific sexual organs such as vagina, penis etc. but having secondary characters of both the sexes, such as breast, moustaches etc. This is caused due to the combination of male and female seeds (sperm and ovum) in equal proportion, afflicted (''upatapta'') in the genetic code responsible for producing ''beeja'' (''beeja-janaka-beejabhaga'').
*Possessing appropriate sexual organs of a male or a female, but no secondary characters. In this case, ''kala'' and ''karma'' are considered to be key factors. The sexual organs are present since the time of conception, hence they manifest, but the factors that are responsible for the development of breasts and moustaches (in females and males respectively) become weaker during puberty. The afflicted seeds dominate only secondary sex characters and do not allow them to manifest at all. These phenomena are entirely dependent on past deeds. When ''shukra'' and ''shonita'' combine in equal proportion, there is equal dominance of ''shukra'' and ''artava'' causing genetic mutation (CK on CS.Sa.2/18, SS.Sa.3/5; AS.Sa.2/5; AH.Sa.1/5). It is referred as ''napunsaka'' in several vedic texts. In addition to this, Harita accepted that if ''doshas'', ''bala, prakriti'' and ''vikriti'' of a couple are present in equal proportions in the offspring, then a female hermaphrodite would take birth (HS.6th sthana.1/37-40). However, even in such cases, God’s will is said to be responsible (Shr.S.Pur.6/12).

==== Defects in conception due to non passage of ''shukra'' (Verse 19-20) ====

Among other disorders mentioned in this chapter, ''pavanendriya'' is a condition in which ''pavana'' (air) is ejaculated during coitus (CK on CS.Sa.2/18). In fact, it may be ‘devoid of semen’, and hence incapable to fertilize the ovum. ''Shandha'' is also an affliction where there is absence of semen (SS.Sa.2/44). (18)

''Samskaravaha'' is a condition in which ''shukra'' flows out after blockings in the channels (''shukrashaya dwara'') are cleared using therapeutic procedures (''basti, vajikarana'' etc.). ''Asekya, saugandhika, kumbhika'' and ''irshaka'' described by Sushruta (SS. Sa.2/44) could also be administered to help ejaculation of śhukra (CK on CS.Sa.2/19).

''Mandavega'' (sluggish desire), ''alpa- beeja'' (diminished seed), ''abala'' (devoid of inherent strength- ''nisargabala rahita''), ''aharsha'' (lack of passion) and ''kleeba'' (''dushtabeeja''; damaged genetic portion)- lead to ''stree- shanda'' or ''pum-shanda'', conditions that cause problems in conception and afflict female or male partners respectively (CK on CS.Sa.2/19). These are also referred, respectively, as ''stree-shandha'' and ''nara-shandha'' in other texts (SS.Sa.2/42-43). (19)

==== Signs and symptoms in pregnancy indicating the sex of the child (Verse 25) ====

Apart from the factors mentioned earlier, the sex of the child could also be influenced by certain traits of the mothers, such as milk secretion only from the right breast, walking with lifting right leg first, heaviness in right lateral abdomen, and ''romaraji'' (hair line) directed upwards - in all these cases, the mother will deliver a male child. If showing the opposite traits, the child would be a girl. If the abdomen is depressed on both sides and projected forward, while the woman would be showing mixed signs, the child born will be a hermaphrodite. It is also stated that if the yoni is thick in center the child will be a female, while if it is beautiful, protuberant and fatty then a male child will be born (KS.Su.28/6). Thoughts or mood of the mother during conception is also pointed by different scholars as key factors (CS.Sa.8/14;SS.Sa.2/46; AS.Sa.1/53; AH.Sa.1/31; BP.Pur.3/62). As already mentioned in this chapter, dreams, drinks, foods, conduct, and activities - if feminine, would result in a female child, if masculine, a male child, and if of mixed type, then a transgender child (CK on CS.Sa.2/24).

Regarding the resemblance of the child, as mentioned in this chapter, certain attributes or traits of the kid could resemble the person the mother is attracted to during conception. (CK on CS.Sa.2/25). Physical resemblance depends largely on factors such as the four sets of four ''mahabhutas'' (except ''akasha''), ''matrija'' (maternal), ''pitrija'' (paternal), ''aharaja''- from the mother’s nutrition prior to conception, and ''atmaja''- past deeds. Though all these factors are equally responsible, the resemblance depends on the predominance of either of the maternal and paternal factors (CK on CS.Sa.2/25). Factors responsible for behavioral and mental resemblances are also similar to those responsible for physical resemblance, with genetic factors (''jati'' )also counted in. (CK on CS.Sa.2/25,GD on CS.Sa.2/25).

==== Effects of ''shukra dosha'' (Verse 30) ====

Apart from the factors already analyzed earlier in the ''Vidhi Vimarsha'', ''shukra-dosha'' (CS.Su.28/18) and vitiated ''vata'' (CS.Su.12/8) including vitiated ''vata'' in ''shukra'' (CS.Ci.28/34) are said to be responsible for congenital abnormalities. Any part of the seed, or ''beeja'' (''beejabhaga''), if defective, would result in a defective body part, indicating chromosomal or genetic defects (CS.Sa.3/17). Defects in ''indriyas'' are attributed to ''daiva'', or fate, in the texts (CK.CS.Sa.3/17). Similarly, abnormalities in diet and behavior of women (CS.Sa.4/30), mental state of women (CS.Sa.2/25)) etc. influence the fetus. Bad deeds or sins (''paapa'') committed in the past life, vitiated ''vata'', non-fulfillment of ''dauhrida'', and skepticism of parents are also responsible for teratogenicity (SS.Sa.2/50-52).

Pregnancy before attaining 16 years of age, conception during first three days of menstrual cycle and bearing down in absence of labor pain are also responsible for abnormalities in the child (AS.Sa.1/5, KS.Sa.5/5). A woman not using proper ''rasas'' during ''ritukala'' delivers abnormal child (BhS.Sa 5/4). The couple suffering from ''udavarta'', consuming unwholesome diet (BhS.Su.12/15-16), vitiation of ''akasha'' as well as ''daiva'' could also cause abnormalities in the child (BhS.Sa.3/15-16). (30)

==== Effect of past deeds (Verse 31-36) ====

''Manojavo''- ‘self’ due to pervasive, does not transmigrate but along with pace of mind and subtle ''bhutas'' it moves from dying to an originating body. It all happens due to the influence of past deeds (CK on CS.Sa.2/31). (31)

''Beejadharma''-the ''bhutas'' inheriting in soul is like that of seed, as seed produces similar sprout, the inheriting ''bhutas'' also produce similar form of the body (CK on CS.Sa.2/35).

Chakrapani had accepted the views of Sankhya philosophy and stated that subtle body (''ativahika sharira'') gives rise to the gross body (''vyaktasharira''). Again, he explains that though the ''shukra'' and ''rajas'' is the cause of body (fetus), they only produce (fetus) when engrained in or combined with or attached with subtle body, and not otherwise. Thus, the subtle body (''sukshma bhuta'') inherited in soul combines with seeds (sperm and ovum) produces fetus, the cause of origin of body is being the past deeds (CK on CS.Sa.2/35).(35)
It is stated that due to ''tara-tama'' (quantitative) variations in ''rajas'' and ''tamas'' as well as multi focal ''karmas''; the variations occur in subtle bodies (CK on CS.Sa.2/36). (36)

==== Role of mind (Verse 38) ====

Mind is attached with all the subtle ''bhutas'' etc. due to the infliction of ''rajas'' and ''tamas''; the cause is being the devoid of ''tattvajnana''. Mind afflicted with ''doshas'' is responsible for transmigration (to other body) and inclination (to action related to ''dharma'' and ''adharma'') of soul thus cause for the whole universe. Again, the other factor responsible for such transmigration and inclination is potent past deeds (CK on CS.Sa.2/37-38). (38)

==== Use of intellect, senses and time (Verse 41) ====

Perverted (''mithyayoga''), negative (''ayoga'') and excessive (''atiyoga'') are three folds of ''vishamayoga'' of time etc. said as the cause of disorders (both psychic and somatic) described in the texts (CS.Su.1/54, Su.11/37, 43, Sa.1/98, 102,130-131). ''Samayoga'' (balanced combination) of time etc. is the cause of ''prakriti'' (normalcy) (CS.Su.11/43) or ''sukha'' (pleasure) (CS.Su.1/55, Sa.1/129). (40)

During salvation, the link between body and mind is totally disconnected, the stage where the continuity of disease recurrence is totally lost (CK on CS.Sa.2/41). (41)

Union of physique and psyche can be achieved through the state of ''yoga'' (union with self) and ''moksha'' (emancipation). In this context role of restraint, memory and knowledge is discussed (CS.Sa.1/143- 147) (42)

==== Control over body and mind to overcome diseases (Verse 43) ====

Preventive measures (''anagata chikitsa'') to be practiced regularly to overcome the diseases of body and mind. The word ''jitendriya'' is stated for abstinence from intellectual error and unbalanced use of senses. The disease occurring due to consequences of time cannot be prevented as the potent predestined (''daiva'') certainly cause disease at that moment (CK on CS.Sa.2/43).

For preventive purpose, one should practice those livelihoods which are not contradictory to ''dharma'' (social and religious ethics) (CS.Su.5/104), bodily ''dhatus'' having been stabilized in normal condition, diseases do not arise (CS. Su.7/49), wholesome practice of diet, conduct and actions are also advised as preventive measures (CS.Su.7/60). Similarly avoiding intellectual errors etc. are to be followed for preventing exogenous diseases (Su.7/53-54). (43)

''Pravritti-hetu'' (cause of inclination) means initiating cause of disease. ''Vishama'' and ''sama'' interpreted as ''adharma'' and ''dharma'' respectively. Some consider cause of ''samsara'' (creation) and ''moksha'' (salvation) with ''pravritti'' and ''nivritti-hetu'' respectively (CK on CS.Sa.2/44)

==== ''Daiva'' (Verse 44) ====

''Daiva'' is also said to be unavoidable, indestructible related to previous body and is continuing (CS.Su.11/31); cause of disease in (particular) time (CS.Sa.1/116).The coordination of ''daiva'' and ''purushakara'' (deeds self done in present life) in terms of inferiority etc. and their effects (CS.Vi.3/29-33) as well as influence to each other are well described (CS.Vi.3/33-35). Self deeds are also totally responsible for the disease (CS.Ni.7/19-23) (44)

Accumulated ''doshas'' should be evacuated in the first month of spring, rainy and winter to prevent the innate disorders (Su.7/46-50). (45)
''Sama''-equality in all living beings (CK on CS.Sa.2/46). (46)

Commentator interprets ''mati'' as ''smriti'' (memory), ''chinta'' (thoughts) etc., ''jnana'' as ''tattva-jnana'' (knowledge of the reality) (CK on CS.Sa.2/47). Different preventive measures against diseases are referred in many places (Su.7/47-50, 8/17-29, 28/34-44). (47)

=== References ===

#Agnivesha, Charak Samhitā with ‘Āyurveda-Dipikā’ commentary by Chakrapānidatta, edited by Acharya J T, Reprint edition, Chaukhamba Surbharati Prakashan, Varanasi, 2000.
#Sharma P V., editor, Charak Samhitā (critical notes), Vol I-II, Chaukhambha Orientalia, Varanasi.
#Sushruta Samhitā, edited by Acharya J T & N R, Reprint edition, Chaukhamba Surbharati Prakashan, Varanasi.
#Vriddha Vāgbhata, Ashtānga Samgraha with ‘Shashilekhā’ commentary by Indu, edited by Sharma S P, 1st edition, Chowkhamba Sanskrit Series Office, Varanasi, 2006.
#Vāgbhata, Ashtānga Hridayam with commentaries ‘Sarvāngasundarā’ of Arunadatta & ‘Āyurvedarasāyana’ of Hemādri, edited by Paradakara H S, Reprint 9th edition, Chaukhamba Orientalia, Varanasi, 2005.
#Bhāvaprakāsha (with Nighantu portion) of Shrimad Bhāvamishra, Edited by Mishra B S and Vaishya R L, Vol.1 (Purvārdha), Chaukhambha Sanskrit Bhawan, 11th edn, 2007.
#Tiwari PV, 2011. AyurvediyaPrasutitantra evam Streeroga, Reprint edition, Chaukhambha Orientalia, Varanasi, Part- 1; 38-39.
#Harit SamhitaText with Nirmala Hindi commentary, edited and translated by Vaidy Jaymini Pandey, Chaukhambha Visvabharati,Varanasi, 1st edn,2010.
#SharngadharaSamhita of Sharngadharacharya (with Anjananidana of Agnivesha and Dipika Hindi Commentaries), edited by Tripathi Brahmanand, Chaukhamba Surbharati Prakashan, Varanasi, 2008.
#VriddhaJivaka, KashyapaSamhita, edited by Km. P.V.Tiwari,1st edition, Chaukhambha Visvabharati, Varanasi,1996.
#Bhela Samhita(text with English translation, commentary and critical notes) by Krishnamurthy K.H, edited by Sharma P.V, Chaukhambha Visvabharati, Reprint edn. Varanasi, 2008.
#Manu-Smriti of Manu (with Sarala Hindi Commentary by Bhatt R), Chaukhamba Sanskrit Pratishthan, Delhi, Reprint edn, 2003.
#Dutta DC, 1998. Text Book of Obstetrics, edt. Konar L, 4th Edition, New Central Book Agency(P) Ltd. p173.
#Dawn C.S, Text Book of Obstetrics and Neonatology, 12th Edt., Sreemoti Arati Dawn, p. 308.

=== Glossary ===

#Atulya-gotra (Atulyagotra, अतुल्यगोत्र:): Dissimilar or different clan
#Garbha (Garbha, गर्भ:) : Union of sperm, ovum and self in the uterus; embryo, foetus.
#Ojōśanā (ōjōśanā, ओजोशना): that eats ojas, evil spirits.
#Bīja (Bīja, बीज:): The seed i.e either śukra (sperm) or ārtava (ovum)
#Klība (Klība, क्लीब:): Sterility, It is of two types— naraṣaṇḍa and nārīṣaṇḍa (male and female sterility).
#Manojavo (manōjavō, मनोजवो): Thetermusedtodenotethespeedofmind.Whenselfcombineswithmindittransmigratefromonebodytootherwiththatspeed.
#Prajñāparādha (prajñāparādh, प्रज्ञापराध:): It is defined as unwholesome action due to derangement of intellect, restraint and memory; intellectual error (CS.Sa.1/102)
#Pratikarma (Pratikarma, प्रतिकर्म:): Synonym of cikitsa; remedy, treatment, measure and so on.
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