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Rogabhishagjitiya Vimana

2020-09-16T08:39:48Z

Vidyadhishkashikar: /* Search of ideal preceptor */

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|title=Rogabhishagjitiya Vimana
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|keywords=Preceptor, student, teaching methodology, learning methods, discussion techniques, examination techniques of patient, prakriti, sara, purification therapies, pharmacovigilance, Ayurveda, Indian system of medicine, charak samhita.
|description=Vimana Sthana Chapter 8. Methods of conquering debate and disease
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<big>'''Vimana Sthana Chapter 8. Methods of conquering debate and disease '''</big>
{{Infobox
|title = Rogabhishagjitiya Vimana
|label1 = Section/Chapter
|data1 = [[Vimana Sthana]] Chapter 8
|label2 = Preceding Chapter
|data2 = [[Vyadhita Rupiya Vimana]]

|label3= Succeeding Chapter
|data3 = None
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|data6 = Dubey S.D., Singh A.N., Singh A., Singh A., Samant A., Deole Y. S.
|label7 = Reviewer
|data7 = Khandel S.K., Ram J.P.
|label8 = Editor
|data8 = Khandel S.K., Deole Y. S.
|label9 = Date of publication
|data9 = December 17, 2018
|label10 = DOI
|data10 =
|header3 =

}}
<big>'''Abstract'''</big>

<div style="text-align:justify;">This comprehensive and detailed chapter deals with assessment criteria of standard quality treatise, the teacher and the disciple, the means for receiving the knowledge from the treatise, method of discussion and its types- friendly or hostile, result of discussion, worth considering or worth discarding. It describes examination of ten entities to understand the state of health of the patient before starting the treatment. For providing treatment, physician should consider the strength of patient, severity of disease, prakriti (constitution), vikriti (nature of abnormalities), potency of drugs, season for purification therapy, and the status of the patients in context to use of drugs. Thus, this chapter gives a glimpse of how advanced the medical education in India was over two thousand years ago and how well the phenomenon of health was understood and managed. </div>

'''Keywords''': Preceptor, student, teaching methodology, learning methods, discussion techniques, examination techniques of patient, ''prakriti'', ''sara'', purification therapies, pharmacovigilance.
</div>

== Introduction ==
<div style="text-align:justify;">
The preceding chapter [[Vyadhita Rupiya Vimana]] the seventh chapter dealt with knowledge of diseased person. The present chapter guides an aspiring student who wishes to be a successful physician. It is important to know the scope, depth and reputation of the branch of health science to be studied which is obtained by ''shastra pariksha'' (review of literature). Secondly, the examination of the preceptor (''acharya'') who teaches the science of [[Ayurveda]] is important because it is he, who enlightens the students with the knowledge of the health science. The chapter further deals with means of learning of health sciences (''shastra upaya''), methodology of study (''adhyayana vidhi'') and teaching (''adhyapana'') along with when and how to begin academic session and Do’s and Dont’s by the student have been explained so that a student attains the depth of knowledge about the health science. It also details about medical ethics while in practice and guidelines for behaviour of doctor at a patient’s house.

Along with study (''adhyayana'') and teaching (''adhyapana'') it is the seminar and symposia of experts (''tadvidya sambhasha'') which is essential to improve the quality of knowledge. Types of seminar/symposium, possible types of attendees, how to deal with them for most benefit and rules are mentioned. The description addresses essential information about discussion at a symposium. Those are: when to discuss? where to discuss? what to discuss? how to discuss? and what will be the final conclusion?

The methodology of discussion to be done with the types of assembly. During unfriendly discussion (''vigrihya'') 44 terms such as ''vada'' etc. are worth knowing for the course of discussion among physician. These ''vada marga'' not only help in winning discussion but improves knowledge and enhances the thinking.

Similarly, for the physician to improve his medical knowledge ''karana'', (reasoning/doer) ''karana'' (knowledge of means), ''karyayoni'' (objective), ''karya'' (action), ''karyaphala'' (attainment of objective and happiness), ''anubandha'' (after effect), ''desha'' (habitat/patient), ''kala'' (year and phase of disease), ''pravritti'' (initiation of therapy) and ''upaya'' (proper management) are necessary.

Complete knowledge of patient’s condition is required before starting the treatment, which is done by tenfold examination. The specific investigations to be considered are ''desha'' (place-habitat and patient’s body), ''prakṛiti'' and ''vikriti'' according to ''dosha'', ''sara'' (essence of body tissues), compactness, structure and body mass, measurement of body parts, specific suitability of a person, ''sattva'' (mental status), power of digestion and assimilation, exercise endurance and age.

Seven types of ''prakriti'' and their features are explained to understand normal state of body, whereas the pathological condition is termed as ''vikriti''. These factors help the physician to classify the strength of the patient into three categories viz. superior (''pravar''), medium (''madhya'') and inferior (''avar''). It is on this basis that physician decides to give strong (''tikshna''), mild (''mridu'') and moderate (''madhya'') medicaments. The appropriate time for purification therapies is explained with reasoning. Similarly, medicine should be given at appropriate time to the patient (''kala'') and when not to be given (''akala''). Lastly initiation of therapy (''pravritti'') and excellance of physician etc. ''chatuspada'' (''upaya'') have been explained.

All the above ten examinations help in deciding the actual and specific treatment like ''vamana, virechana, asthapana, anuvasana'' and ''shirovirechana''. Therefore, in the concluding part of the chapter drugs useful for ''vamana'' and ''virechana'' have been enlisted. In case of ''asthapana'' as per the condition of patient and disease the drug classification can be innumerable therefore to prevent the ''ativistara'' (prolonged deliberation/expansion). Drugs are classified on the basis of ''rasa'' into six groups for example ''madhura rasa'' drugs having ''madhura vipaka'' and ''madhur prabhava'' are classified into ''madhur skanda'' so is the case with other five ''rasa''. The physician has been given freedom to permutate and combine drugs as per requirement in patient and its availability.

The same ''asthapana gana'' (group of drugs for non-unctuous enema) can be fortified with specific ''sneha'' as per ''dosha'' and be administered as ''anuvasana''. ''Taila'' for ''vata, vasa'' and ''majja'' for ''kapha'' and ''ghrita'' for ''pitta''. Lastly drugs useful in ''shirovirechana'' have been explained along with the part of the plant (flower, fruit, bark etc.) to be used.

For the purpose of accurate diagnosis and treatment one must have complete knowledge for which this chapter is designed.
</div>

== Sanskrit Text, Transliteration and English Translation ==
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अथातो रोगभिषग्जितीयं विमानं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||
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athātō rōgabhiṣagjitīyaṁ vimānaṁ vyākhyāsyāmaḥ||1|| iti ha smāha bhagavānātrēyaḥ||2||

athAto rogabhiShagjitIyaM vimAnaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||
</div></div>

Now we shall expound the chapter "Rogabhishagjitiya Vimana" (Methods of conquering debate and disease). Thus said Lord Atreya. [1-2]

=== Aspects of medical education ===

==== Selection of medical treatise ====
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बुद्धिमानात्मनः कार्यगुरुलाघवं कर्मफलमनुबन्धं देशकालौ च विदित्वा युक्तिदर्शनाद्भिषग्बुभूषुः शास्त्रमेवादितः परीक्षेत|

विविधानि हि शास्त्राणि भिषजां प्रचरन्ति लोके;

तत्र यन्मन्येत सुमहद्यशस्विधीरपुरुषासेवितमर्थबहुलमाप्तजनपूजितं त्रिविधशिष्यबुद्धिहितमपगतपुनरुक्तदोषमार्षं सुप्रणीतसूत्रभाष्यसङ्ग्रहक्रमं स्वाधारमनवपतितशब्दमकष्टशब्दं

पुष्कलाभिधानं क्रमागतार्थमर्थतत्त्वविनिश्चयप्रधानं सङ्गतार्थमसङ्कुलप्रकरणमाशुप्रबोधकं लक्षणवच्चोदाहरणवच्च,

तदभिप्रपद्येत शास्त्रम्|

शास्त्रं ह्येवंविधममल इवादित्यस्तमो विधूय प्रकाशयति सर्वम्||३||
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buddhimānātmanaḥkāryagurulāghavaṁkarmaphalamanubandhaṁdēśakālaucaviditvā
yuktidarśanādbhiṣagbubhūṣuḥśāstramēvāditaḥparīkṣēta|vividhānihiśāstrāṇibhiṣajāṁpracarantilōkē;
tatrayanmanyētasumahadyaśasvidhīrapuruṣāsēvitamarthabahulamāptajanapūjitaṁtrividhaśiṣya
buddhihitamapagatapunaruktadōṣamārṣaṁsupraṇītasūtrabhāṣyasaṅgrahakramaṁsvādhāramanavapatita
śabdamakaṣṭaśabdaṁpuṣkalābhidhānaṁkramāgatārthamarthatattvaviniścayapradhānaṁsaṅgatārthamasaṅkulaprakaraṇamāśuprabōdhakaṁ lakṣaṇavaccōdāharaṇavacca, tadabhiprapadyēta śāstram| śāstraṁ hyēvaṁvidhamamala ivādityastamō vidhūya prakāśayati sarvam||3||

buddhimAnAtmanaH kAryagurulAghavaM [1] karmaphalamanubandhaM deshakAlau ca viditvAyuktidarshanAdbhiShagbubhUShuH shAstramevAditaH parIkSheta|
vividhAni hi shAstrANi bhiShajAM pracaranti loke; tatra yanmanyetasumahadyashasvidhIrapuruShAsevitamarthabahulamAptajanapUjitaMtrividhashiShyabuddhihitamapagatapunaruktadoShamArShaM supraNItasUtrabhAShyasa~ggrahakramaMsvAdhAramanavapatitashabdamakaShTashabdaM puShkalAbhidhAnaMkramAgatArthamarthatattvavinishcayapradhAnaMsa~ggatArthamasa~gkulaprakaraNamAshuprabodhakaM lakShaNavaccodAharaNavacca,tadabhiprapadyeta shAstram|
shAstraM hyevaMvidhamamala ivAdityastamo vidhUya prakAshayati sarvam||3||
</div></div>

<div style="text-align:justify;">
The shrewd who wishes to be a physician, first of all, should analyze his own strength and weakness in profession, the after-impacts of his profession, his inclination, habitat and favourable time (age of learning) and thenafter wisely search for a medical treatise. Different medical treatises (and traditions) are available in society, from which one might select that has following characters:

*which is comprehensive providing all information
*successful, followed by prominent and wise men(successful practitioners),
*with detailed meanings
*regarded by authorities,
*useful to all three types of learners ( with good, moderate and poor intellect),
*free from the deformity of reiteration,
*descending from the sages (which is written by experienced, intuitive person),
*with well- formed presentation, discussion and conclusion,
*having informative title and firm base free from weak and difficult words,
*having comprehensive knowledge of subject
*with proper sequencing of its contents
*committed principally to arriving at the essence of thoughts, which reveals cleary meanings and concrete conclusion
*focused on the particular subject without wavering ideas and irrelevant content,
*quicky understandable with separated topics, effectively comprehensible, and having definitions showed with examples.

Such treatise with pure knowledge is similar to sun which enlightens the whole subject while warding off the darkness. [3]
</div>

==== Search of ideal preceptor ====
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ततोऽनन्तरमाचार्यं परीक्षेत; तद्यथा-

पर्यवदातश्रुतं परिदृष्टकर्माणं दक्षं दक्षिणं शुचिं जितहस्तमुपकरणवन्तं सर्वेन्द्रियोपपन्नं प्रकृतिज्ञं

प्रतिपत्तिज्ञमनुपस्कृतविद्यमनहङ्कृतमनसूयकमकोपनं क्लेशक्षमं शिष्यवत्सलमध्यापकं ज्ञापनसमर्थं चेति |

एवङ्गुणो ह्याचार्यः सुक्षेत्रमार्तवो मेघ इव शस्यगुणैः सुशिष्यमाशु वैद्यगुणैः

सम्पादयति||४||
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tatō'nantaramācāryaṁ parīkṣēta; tadyathā- paryavadātaśrutaṁ paridr̥ṣṭakarmāṇaṁ dakṣaṁ dakṣiṇaṁ śuciṁ jitahastamupakaraṇavantaṁ sarvēndriyōpapannaṁ prakr̥tijñaṁ pratipattijñamanupaskr̥tavidyamanahaṅkr̥tamanasūyakamakōpanaṁ
klēśakṣamaṁ śiṣyavatsalamadhyāpakaṁ jñāpanasamarthaṁ cēti| ēvaṅguṇō hyācāryaḥ sukṣētramārtavō mēgha iva śasyaguṇaiḥ suśiṣyamāśu vaidyaguṇaiḥ sampādayati||4||

tato~anantaramAcAryaM parIkSheta; tadyathA- paryavadAtashrutaM paridRuShTakarmANaM dakShaMdakShiNaM shuciM jitahastamupakaraNavantaM sarvendriyopapannaM prakRutij~jaMpratipattij~jamanupaskRutavidyamanaha~gkRutamanasUyakamakopanaM [1] kleshakShamaMshiShyavatsalamadhyApakaM j~jApanasamarthaM ceti|
eva~gguNo hyAcAryaH sukShetramArtavo megha iva shasyaguNaiH sushiShyamAshu vaidyaguNaiHsampAdayati||4||
</div></div>

Thereafter one should search a preceptor to guide who

*have clear knowledge of the subject and practical experience,
*be diligent, dexterous, virtuous, with skilled hand,
*well equipped, possessing all the senses in normal condition,
*acquainted with constitutions, well- versed in courses of emergency management and quick actions,
*having his knowledge uncensured,
*free from ego, envy, anger, forbearing,
*paternal to disciples,
*having characteristics of a good teacher and fit for imbue understanding.

The teacher holding such qualities quickly inculcates physician’s qualities in his disciple as the seasonal cloud furnishes good crop in a suitable land. [4]

==== Means of learning in medical science ====
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तमुपसृत्यारिराधयिषुरुपचरेदग्निवच्च देववच्च राजवच्च पितृवच्च भर्तृवच्चाप्रमत्तः|

ततस्तत्प्रसादात्कृत्स्नं शास्त्रमधिगम्य शास्त्रस्य दृढतायामभिधानस्य

सौष्ठवेऽर्थस्य विज्ञाने वचनशक्तौ च भूयो भूयः प्रयतेत सम्यक्||५||
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tamupasr̥tyārirādhayiṣurupacarēdagnivacca dēvavacca rājavacca pitr̥vacca bhartr̥vaccāpramattaḥ| tatastatprasādāt kr̥tsnaṁ śāstramadhigamya śāstrasya dr̥ḍhatāyāmabhidhānasya sauṣṭhavē'rthasya vijñānē vacanaśaktau ca bhūyō bhūyaḥ prayatēta samyak||5||

tamupasRutyArirAdhayiShurupacaredagnivacca devavacca rAjavacca pitRuvacca bhartRuvaccApramattaH|
tatastatprasAdAt kRutsnaM shAstramadhigamya shAstrasya dRuDhatAyAmabhidhAnasyasauShThave~arthasya vij~jAne vacanashaktau ca bhUyo bhUyaH prayateta samyak||5||
</div></div>

<div style="text-align:justify;">
The student desirous of learning from such an ideal preceptor, should sincerely follow him as like worshipping fire, god, king, father and guardian. Subsequently after satisfactorily gaining knowledge of whole medical treatise, the student should always continually attempt to improve further depth of knowledge, understand the (hidden) precise meanings, gain more scientific knowledge, express it impressively with comprehension of ideas and power of speaking. [5]
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तत्रोपायाननुव्याख्यास्यामः-

अध्ययनम्, अध्यापनं, तद्विद्यसम्भाषा चेत्युपायाः||६||
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tatrōpāyānanuvyākhyāsyāmaḥ- adhyayanam, adhyāpanaṁ, tadvidyasambhāṣā cētyupāyāḥ||6||

tatropAyAnanuvyAkhyAsyAmaH- adhyayanam, adhyApanaM, tadvidyasambhAShA cetyupAyAH||6||
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The means for enhancing depth of knowledge are- study, teaching and discussion with authorities. [6]

==== Method of study ====
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तत्रायमध्ययनविधिः-

कल्यः कृतक्षणः प्रातरुत्थायोपव्यूषं वा कृत्वाऽऽवश्यकमुपस्पृश्योदकं

देवर्षिगोब्राह्मणगुरुवृद्धसिद्धाचार्येभ्यो नमस्कृत्य समे शुचौ देशे सुखोपविष्टो मनःपुरःसराभिर्वाग्भिः सूत्रमनुक्रामन्

पुनः पुनरावर्तयेद्बुद्ध्वा सम्यगनुप्रविश्यार्थतत्त्वं स्वदोषपरिहारार्थं

परदोषप्रमाणार्थं च;

एवं मध्यन्दिनेऽपराह्णे रात्रौ च शश्वदपरिहापयन्नध्ययनमभ्यस्येत्|

इत्यध्ययनविधिः||७||
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tatrāyamadhyayanavidhiḥ- kalyaḥ kr̥takṣaṇaḥ prātarutthāyōpavyūṣaṁ vā kr̥tvā''vaśyakamupaspr̥śyōdakaṁ dēvarṣigōbrāhmaṇaguruvr̥ddhasiddhācāryēbhyō namaskr̥tya samē śucau dēśē sukhōpaviṣṭō manaḥpuraḥsarābhirvāgbhiḥsūtramanukrāman punaḥ punarāvartayēd buddhvā samyaganupraviśyārthatattvaṁ svadōṣaparihārārthaṁ paradōṣapramāṇārthaṁ ca; ēvaṁ madhyandinē'parāhṇē rātrau ca śaśvadaparihāpayannadhyayanamabhyasyēt| ityadhyayanavidhiḥ||7||

tatrAyamadhyayanavidhiH- kalyaH kRutakShaNaH prAtarutthAyopavyUShaM vAkRutvA~a~avashyakamupaspRushyodakaM devarShigobrAhmaNaguruvRuddhasiddhAcAryebhyonamaskRutya same shucau deshe sukhopaviShTo manaHpuraHsarAbhirvAgbhiHsUtramanukrAman punaHpunarAvartayed buddhvA [1] samyaganupravishyArthatattvaM svadoShaparihArArthaMparadoShapramANArthaM ca; evaM madhyandine~aparAhNe rAtrau cashashvadaparihApayannadhyayanamabhyasyet|
ityadhyayanavidhiH||7||
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<div style="text-align:justify;">
One desirous of study with a calm mind and at a proper time, should get up early in the morning. After passing the natural urges and cleaning body (as per daily schedule), should do the spiritual rituals like sprinkling water, worshiping gods, sages, cow, ''brahmana'', preceptors, elders, accomplished persons and the teacher. Then sitting comfortably on even and clean ground should present the aphorisms in order as learnt from teacher with clear voice attentively repeating it over and over. At the same time, he should think about the meaning and principle to get rid off his own defects and to know others' defects. In this way, he should proceed the study without squandering time in midday, afternoon, and night. This is the method of study. [7]
</div>

==== Characteristics of ideal student and method of teaching ====
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अथाध्यापनविधिः-

अध्यापने कृतबुद्धिराचार्यः शिष्यमेवादितः परीक्षेत; तद्यथा-

प्रशान्तमार्यप्रकृतिकमक्षुद्रकर्माणमृजुचक्षुर्मुखनासावंशं

तनुरक्तविशदजिह्वमविकृतदन्तौष्ठममिन्मिनं

धृतिमन्तमनहङ्कृतं मेधाविनं वितर्कस्मृतिसम्पन्नमुदारसत्त्वं

तद्विद्यकुलजमथवा तद्विद्यवृत्तं तत्त्वाभिनिवेशिनमव्यङ्गमव्यापन्नेन्द्रियं

निभृतमनुद्धतमर्थतत्त्वभावकमकोपनमव्यसनिनं

शीलशौचाचारानुरागदाक्ष्यप्रादक्षिण्योपपन्नमध्ययनाभिकाममर्थविज्ञाने

कर्मदर्शने चानन्यकार्यमलुब्धमनलसं सर्वभूतहितैषिणमाचार्यसर्वानुशिष्टिप्रतिकरमनुरक्तं च,

एवङ्गुणसमुदितमध्याप्यमाहुः||८||
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athādhyāpanavidhiḥ- adhyāpanē kr̥tabuddhirācāryaḥ śiṣyamēvāditaḥ parīkṣēta; tadyathā- praśāntamāryaprakr̥tikamakṣudrakarmāṇamr̥jucakṣurmukhanāsāvaṁśaṁ tanuraktaviśadajihvamavikr̥tadantauṣṭhamaminminaṁ dhr̥timantamanahaṅkr̥taṁ mēdhāvinaṁ vitarkasmr̥tisampannamudārasattvaṁ tadvidyakulajamathavā tadvidyavr̥ttaṁ tattvābhinivēśinamavyaṅgamavyāpannēndriyaṁ nibhr̥tamanuddhatamarthatattvabhāvakamakōpanamavyasaninaṁ śīlaśaucācārānurāgadākṣyaprādakṣiṇyōpapannamadhyayanābhikāmamarthavijñānē karmadarśanē cānanyakāryamalubdhamanalasaṁ sarvabhūtahitaiṣiṇamācāryasarvānuśiṣṭipratikaramanuraktaṁ ca, ēvaṅguṇasamuditamadhyāpyamāhuḥ||8||

athAdhyApanavidhiH- adhyApane kRutabuddhirAcAryaH shiShyamevAditaH parIkSheta; tadyathA-prashAntamAryaprakRutikamakShudrakarmANamRujucakShurmukhanAsAvaMshaMtanuraktavishadajihvamavikRutadantauShThamaminminaM dhRutimantamanaha~gkRutaM medhAvinaMvitarkasmRutisampannamudArasattvaM tadvidyakulajamathavA tadvidyavRuttaMtattvAbhiniveshinamavya~ggamavyApannendriyaMnibhRutamanuddhatamarthatattvabhAvakamakopanamavyasaninaM [1]shIlashaucAcArAnurAgadAkShyaprAdakShiNyopapannamadhyayanAbhikAmamarthavij~jAnekarmadarshane cAnanyakAryamalubdhamanalasaMsarvabhUtahitaiShiNamAcAryasarvAnushiShTipratikaramanuraktaM [2] ca,eva~gguNasamuditamadhyApyamAhuH||8||
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Now following is the method of teaching: The teacher, having decided to teach should, first of all examine the ideal disciple with following characteristics:

*should be very calm, with superior qualities,
*not involved in mean acts,
*with straight eyes, mouth and nasal edge (without any defect in eyes, nose and mouth);
*having thin, red and clear tongue; with no abnormality in teeth and lips, not talking with nasal utterance,
*having forebearance, without vanity, intelligent, endowed with logical reasoning and memory,
*broad minded,
*born in a family of physicians or aware with the conduct and behavior of physicians
*desirous of gaining scientific knowledge
*without any physical deformity or disability of senses,
*humble, keeping the knowledge safely, un-haughty,
*having capacity to comprehend essence of the ideas,
*without anger and addictions,
*endowed with modesty, purity, good conduct, affection, dexterity and sincerity, interested in study,
*dedicated to comprehension of ideas and practical knowledge without any distraction,
*having no greed or idleness, empathetic to all creatures,
*following all the instructions of the teacher and being attached to his teacher.[8]

==== Commencement of academic session/teaching ====
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एवंविधमध्ययनार्थिनमुपस्थितमारिराधयिषुमाचार्योऽनुभाषेत

उदगयने शुक्लपक्षे प्रशस्तेऽहनि तिष्यहस्तश्रवणाश्वयुजामन्यतमेन

नक्षत्रेण योगमुपगते भगवति शशिनि कल्याणे कल्याणे च करणे मैत्रे मुहूर्ते मुण्डः कृतोपवासः स्नातः काषायवस्त्रसंवीतः सगन्धहस्तः समिधोऽग्निमाज्यमुपलेपनमुदकुम्भान्

माल्यदामदीपहिरण्यहेमरजतमणिमुक्ताविद्रुमक्षौमपरिधीन्

कुशलाजसर्षपाक्षतांश्च शुक्लानि

सुमनांसि ग्रथिताग्रथितानि मेध्यान् भक्ष्यान् गन्धांश्च घृष्टानादायोपतिष्ठस्वेति||९||
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ēvaṁvidhamadhyayanārthinamupasthitamārirādhayiṣumācāryō'nubhāṣēta - udagayanē śuklapakṣē praśastē'hani tiṣyahastaśravaṇāśvayujāmanyatamēna nakṣatrēṇa yōgamupagatē bhagavati śaśini kalyāṇē kalyāṇē ca karaṇē maitrē muhūrtē muṇḍaḥ kr̥tōpavāsaḥ snātaḥ kāṣāyavastrasaṁvītaḥ sagandhahastaḥ samidhō'gnimājyamupalēpanamudakumbhān mālyadāmadīpahiraṇyahēmarajatamaṇimuktāvidrumakṣaumaparidhīn kuśalājasarṣapākṣatāṁśca śuklāni sumanāṁsi grathitāgrathitāni mēdhyān bhakṣyān gandhāṁśca ghr̥ṣṭānādāyōpatiṣṭhasvēti||9||

evaMvidhamadhyayanArthinamupasthitamArirAdhayiShumAcAryo~anubhASheta [1] - udagayaneshuklapakShe prashaste~ahani tiShyahastashravaNAshvayujAmanyatamena nakShatreNa yogamupagatebhagavati shashini kalyANe kalyANe ca karaNe maitre muhUrte muNDaH kRutopavAsaH snAtaHkAShAyavastrasaMvItaH sagandhahastaH samidho~agnimAjyamupalepanamudakumbhAnmAlyadAmadIpahiraNyahemarajatamaNimuktAvidrumakShaumaparidhIn kushalAjasarShapAkShatAMshcashuklAni sumanAMsi grathitAgrathitAni medhyAn bhakShyAn gandhAMshcaghRuShTAnAdAyopatiShThasveti||9||
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When such a disciple with desire of study and feeling of commitment approaches the teacher, then teacher should address the student as- “when the sun is in the northernly course and during the full moon phase, on propitious day the benevolent lord moon having conjunction with one of the ''tishya'' (''pushya''), ''hasta, shravana'' and ''ashvayuja'' constellations in ''kalyanekarana'' and ''maitramuhurta'' come with shaved head, after following fast, had bath, wearing ochre-colored clothes and sacred thread and with fragrance sacred fire wood, fire, ghee, means of besmearing (cow-dung etc.), water jars, garland, rope, lamp, vessels of gold, silver, jewels, pearls, corals, silken cloth and sticks for edge of the sacrificial ground, holy grass, fried paddy, mustard seeds, barley grains, white-flowers, with or without strung, eatables increasing memory power and paste of fragrant wood.”[9]
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स तथा कुर्यात्||१०||

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sa tathā kuryāt||10||

sa [2] tathA kuryAt||10||
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The student should follow instructions of preceptor. [10]
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तमुपस्थितमाज्ञाय समे शुचौ देशे प्राक्प्रवणे उदक्प्रवणे वा चतुष्किष्कुमात्रं चतुरस्रं स्थण्डिलं गोमयोदकेनोपलिप्तं कुशास्तीर्णं सुपरिहितं

परिधिभिश्चतुर्दिशं यथोक्तचन्दनोदकुम्भक्षौमहेमहिरण्यरजतमणिमुक्ताविद्रुमालङ्कृतं मेध्यभक्ष्यगन्धशुक्लपुष्पलाजसर्षपाक्षतोपशोभितं कृत्वा,

तत्र पालाशीभिरैङ्गुदीभिरौदुम्बरीभिर्माधुकीभिर्वा समिद्भिरग्निमुपसमाधाय प्राङ्मुखः शुचिरध्ययनविधिमनुविधाय मधुसर्पिर्भ्यां त्रिस्त्रिर्जुहुयादग्निमाशीःसम्प्रयुक्तैर्मन्त्रैर्ब्रह्माणमग्निं धन्वन्तरिं प्रजापतिमश्विनाविन्द्रमृषींश्च सूत्रकारानभिमन्त्रयमाणः पूर्वं स्वाहेति||११||
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tamupasthitamājñāya samē śucau dēśē prākpravaṇē udakpravaṇē vā catuṣkiṣkumātraṁ caturasraṁ sthaṇḍilaṁ gōmayōdakēnōpaliptaṁ kuśāstīrṇaṁ

suparihitaṁ paridhibhiścaturdiśaṁ yathōktacandanōdakumbhakṣaumahēmahiraṇyarajatamaṇimuktāvidrumālaṅkr̥taṁ

mēdhyabhakṣyagandhaśuklapuṣpalājasarṣapākṣatōpaśōbhitaṁ kr̥tvā, tatra pālāśībhiraiṅgudībhiraudumbarībhirmādhukībhirvā

samidbhiragnimupasamādhāya prāṅmukhaḥ śuciradhyayanavidhimanuvidhāya madhusarpirbhyāṁ

tristrirjuhuyādagnimāśīḥsamprayuktairmantrairbrahmāṇamagniṁ dhanvantariṁ prajāpatimaśvināvindramr̥ṣīṁśca sūtrakārānabhimantrayamāṇaḥ pūrvaṁ

svāhēti||11||

tamupasthitamAj~jAya same shucau deshe prAkpravaNe [1] udakpravaNe vA catuShkiShkumAtraMcaturasraM sthaNDilaM gomayodakenopaliptaM

kushAstIrNaM suparihitaM [2]

paridhibhishcaturdishaMyathoktacandanodakumbhakShaumahemahiraNyarajatamaNimuktAvidrumAla~gkRutaMmedhyabhakShyagandhashuklapuShpalAjasarShapAk

ShatopashobhitaM kRutvA, tatrapAlAshIbhirai~ggudIbhiraudumbarIbhirmAdhukIbhirvA samidbhiragnimupasamAdhAya

prA~gmukhaHshuciradhyayanavidhimanuvidhAya madhusarpirbhyAMtristrirjuhuyAdagnimAshIHsamprayuktairmantrairbrahmANamagniM

dhanvantariMprajApatimashvinAvindramRuShIMshca sUtrakArAnabhimantrayamANaH pUrvaM svAheti||11||
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Knowing that the student has come, the preceptor should make rectangular platform measuring four cubits and sloping eastward or northward, in an even and pure place. This ought to be spread with cow-dung, covered with sacred grass and bound on borders with ''paridhi''. Further it ought to be equipped with the said articles, for example sandal, water jar, silken garment, gold, golden vessel, silver, jewel, pearl and coral and beautified with eatables increasing memory power, aromas, white flowers, fried paddy, mustard and barley grains. Then attending to the fire with the fuel-sticks made of ''palash, ingudi, udumbara, madhuka'' while in pure condition and facing eastward, as recommended under the method of study, he should offer oblations of honey and ghee to the fire reciting benedictory mantras first invoking Brahma, Agni, Dhanwantari, Prajapati, Ashvinis, Indra and various sages, the authors of the aphorism and ending with ''svaaha'' three times each.[11]
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शिष्यश्चैनमन्वालभेत।
हुत्वा च प्रदक्षिणमग्निमनुपरिक्रामेत्| परिक्रम्य ब्राह्मणान् स्वस्ति वाचयेत्;भिषजश्चाभिपूजयेत्||१२||
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śiṣyaścainamanvālabhēta| hutvā ca pradakṣiṇamagnimanuparikrāmēt| parikramya brāhmaṇān svasti vācayēt; bhiṣajaścābhipūjayēt||12||
shiShyashcainamanvAlabheta|
hutvA ca pradakShiNamagnimanuparikrAmet|
parikramya brAhmaNAn svasti vAcayet; bhiShajashcAbhipUjayet||12||
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The disciple should follow him. After offering oblations he should go round the fire keeping it to the right side, than ''brahmanas'' should recite ''svasti''. At the end, he should pay regards to the physicians in the society. [12]

==== Code of conduct for medical student and professional ====
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अथैनमग्निसकाशे ब्राह्मणसकाशे भिषक्सकाशे चानुशिष्यात्-ब्रह्मचारिणा श्मश्रुधारिणा सत्यवादिनाऽमांसादेन मेध्यसेविना निर्मत्सरेणाशस्त्रधारिणा च भवितव्यं,न च ते मद्वचनात्किञ्चिदकार्यं स्यादन्यत्र राजद्विष्टात्प्राणहराद्विपुलादधर्म्यादनर्थसम्प्रयुक्ताद्वाऽप्यर्थात्;
मदर्पणेन मत्प्रधानेन मदधीनेन मत्प्रियहितानुवर्तिना च शश्वद्भवितव्यं,
पुत्रवद्दासवदर्थिवच्चोपचरताऽनुवस्तव्योऽहम्,
अनुत्सेकेनावहितेनानन्यमनसा विनीतेनावेक्ष्यावेक्ष्यकारिणाऽनसूयकेन चाभ्यनुज्ञातेन प्रविचरितव्यम्,
अनुज्ञातेन(चाननुज्ञातेन च)प्रविचरता पूर्वं गुर्वर्थोपाहरणे यथाशक्ति प्रयतितव्यं,कर्मसिद्धिमर्थसिद्धं यशोलाभं प्रेत्य च स्वर्गमिच्छता भिषजा त्वया
गोब्राह्मणमादौ कृत्वा सर्वप्राणभृतां शर्माशासितव्यमहरहरुत्तिष्ठता चोपविशता च,सर्वात्मना चातुराणामारोग्याय प्रयतितव्यं, जीवितहेतोरपि चातुरेभ्यो नाभिद्रोग्धव्यं,
मनसाऽपि च परस्त्रियो नाभिगमनीयास्तथा सर्वमेवपरस्वं,निभृतवेशपरिच्छदेन भवितव्यम्, अशौण्डेनापापेनापापसहायेन च,
श्लक्ष्णशुक्लधर्म्यशर्म्यधन्यसत्यहितमितवचसा देशकालविचारिणा स्मृतिमता ज्ञानोत्थानोपकरणसम्पत्सु नित्यं यत्नवता च;
न च कदाचिद्राजद्विष्टानां राजद्वेषिणां वा महाजनद्विष्टानां महाजनद्वेषिणां वाऽप्यौषधमनुविधातव्यं,तथा
सर्वेषामत्यर्थविकृतदुष्टदुःखशीलाचारोपचाराणामनपवादप्रतिकाराणां मुमूर्षूणां च,तथैवासन्निहितेश्वराणां स्त्रीणामनध्यक्षाणां वा;न च कदाचित्स्त्रीदत्तमामिषमादातव्यमननुज्ञातं भर्त्राऽथवाऽध्यक्षेण,आतुरकुलं
चानुप्रविशता विदितेनानुमतप्रवेशिना सार्धं पुरुषेण सुसंवीतेनावाक्शिरसा स्मृतिमतास्तिमितेनावेक्ष्यावेक्ष्य मनसा सर्वमाचरता सम्यगनुप्रवेष्टव्यम्,अनुप्रविश्य च वाङ्मनोबुद्धीन्द्रियाणि न क्वचित् प्रणिधातव्यान्यन्यत्रातुरादातुरोपकारार्थादातुरगतेष्वन्येषु वा भावेषु,न चातुरकुलप्रवृत्तयो बहिर्निश्चारयितव्याः, ह्रसितं चायुषः प्रमाणमातुरस्य जानताऽपि त्वया न वर्णयितव्यं तत्र यत्रोच्यमानमातुरस्यान्यस्य वाऽप्युपघाताय सम्पद्यते;ज्ञानवताऽपि च नात्यर्थमात्मनो ज्ञाने विकत्थितव्यम्,आप्तादपि हि विकत्थमानादत्यर्थमुद्विजन्त्यनेके||१३||
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athainamagnisakāśē brāhmaṇasakāśē bhiṣaksakāśē cānuśiṣyāt- brahmacāriṇā śmaśrudhāriṇa satyavādinā'māṁsādēna mēdhyasēvinā nirmatsarēṇāśastradhāriṇā ca bhavitavyaṁ, na ca tē madvacanāt kiñcidakāryaṁ syādanyatra rājadviṣṭāt prāṇaharādvipulādadharmyādanarthasamprayuktādvā'pyarthāt; madarpaṇēna matpradhānēna madadhīnēna matpriyahitānuvartinā ca śaśvadbhavitavyaṁ, putravaddāsavadarthivaccōpacaratā'nuvastavyō'ham,anutsēkēnāvahitēnānanyamanasā vinītēnāvēkṣyāvēkṣyakāriṇā'nasūyakēna cābhyanujñātēna pravicaritavyam, anujñātēna (cānanujñātēna ca) pravicaratā pūrvaṁ gurvarthōpāharaṇē yathāśakti prayatitavyaṁ, karmasiddhimarthasiddhaṁ yaśōlābhaṁ prētya ca svargamicchatā bhiṣajā tvayā gōbrāhmaṇamādau kr̥tvā sarvaprāṇabhr̥tāṁ śarmāśāsitavyamaharaharuttiṣṭhatā cōpaviśatā ca, sarvātmanā cāturāṇāmārōgyāya prayatitavyaṁ, jīvitahētōrapi cāturēbhyō nābhidrōgdhavyaṁ, manasā'pi ca parastriyō nābhigamanīyāstathā sarvamēva parasvaṁ, nibhr̥tavēśaparicchadēna bhavitavyam, aśauṇḍēnāpāpēnāpāpasahāyēna ca, ślakṣṇaśukladharmyaśarmyadhanyasatyahitamitavacasā dēśakālavicāriṇā smr̥timatā jñānōtthānōpakaraṇasampatsu nityaṁ yatnavatā ca; na ca kadācidrājadviṣṭānāṁ rājadvēṣiṇāṁ vā mahājanadviṣṭānāṁmahājanadvēṣiṇāṁvā'pyauṣadhamanuvidhātavyaṁ,tathāsarvēṣāmatyarthavikr̥taduṣṭaduḥkhaśīlācārōpacārāṇāmanapavādapratikāraṇāṁ mumūrṣūṇāṁ ca, tathaivāsannihitēśvarāṇāṁ strīṇāmanadhyakṣāṇāṁ vā; na ca kadācit strīdattamāmiṣamādātavyamananujñātaṁ bhartrā'thavā'dhyakṣēṇa, āturakulaṁ cānupraviśatā viditēnānumatapravēśinā sārdhaṁ puruṣēṇa susaṁvītēnāvākśirasā smr̥timatā stimitēnāvēkṣyāvēkṣya manasā sarvamācaratā samyaganupravēṣṭavyam, anupraviśya ca vāṅmanōbuddhīndriyāṇi na kvacit praṇidhātavyānyanyatrāturādāturōpakārārthādāturagatēṣvanyēṣu vā bhāvēṣu, na cāturakulapravr̥ttayō bahirniścārayitavyāḥ, hrasitaṁ cāyuṣaḥ pramāṇamāturasya jānatā'pi tvayā na varṇayitavyaṁ tatra yatrōcyamānamāturasyānyasya vā'pyupaghātāya sampadyatē; jñānavatā'pi ca nātyarthamātmanō jñānē vikatthitavyam, āptādapi hi vikatthamānādatyarthamudvijantyanēkē||13||

athainamagnisakAshe brAhmaNasakAshe bhiShaksakAshe cAnushiShyAt- brahmacAriNA shmashrudhAriNasatyavAdinA~amAMsAdena medhyasevinA nirmatsareNAshastradhAriNA ca bhavitavyaM, na ca temadvacanAt ki~jcidakAryaM syAdanyatra rAjadviShTAtprANaharAdvipulAdadharmyAdanarthasamprayuktAdvA~apyarthAt; madarpaNena matpradhAnenamadadhInena matpriyahitAnuvartinA ca shashvadbhavitavyaM,putravaddAsavadarthivaccopacaratA~anuvastavyo~aham [1] , anutsekenAvahitenAnanyamanasAvinItenAvekShyAvekShyakAriNA~anasUyakena cAbhyanuj~jAtena pravicaritavyam, anuj~jAtena(cAnanuj~jAtena ca) pravicaratA pUrvaM gurvarthopAharaNe yathAshakti prayatitavyaM,karmasiddhimarthasiddhaM yasholAbhaM pretya ca svargamicchatA bhiShajA tvayA gobrAhmaNamAdaukRutvA sarvaprANabhRutAM sharmAshAsitavyamaharaharuttiShThatA copavishatA ca, sarvAtmanAcAturANAmArogyAya prayatitavyaM, jIvitahetorapi cAturebhyo nAbhidrogdhavyaM, manasA~api caparastriyo nAbhigamanIyAstathA sarvameva parasvaM, nibhRutaveshaparicchadena bhavitavyam,ashauNDenApApenApApasahAyena ca, shlakShNashukladharmyasharmyadhanyasatyahitamitavacasAdeshakAlavicAriNA smRutimatA j~jAnotthAnopakaraNasampatsu nityaM yatnavatA ca; na cakadAcidrAjadviShTAnAM rAjadveShiNAM vA mahAjanadviShTAnAM mahAjanadveShiNAMvA~apyauShadhamanuvidhAtavyaM, tathAsarveShAmatyarthavikRutaduShTaduHkhashIlAcAropacArANAmanapavAdapratikAraNAM [2]mumUrShUNAM ca, tathaivAsannihiteshvarANAM strINAmanadhyakShANAM vA; na ca kadAcitstrIdattamAmiShamAdAtavyamananuj~jAtaM bhartrA~athavA~adhyakSheNa, AturakulaM cAnupravishatAviditenAnumatapraveshinA sArdhaM puruSheNa susaMvItenAvAkshirasA smRutimatAstimitenAvekShyAvekShya manasA sarvamAcaratA samyaganupraveShTavyam, anupravishya cavA~gmanobuddhIndriyANi na kvacitpraNidhAtavyAnyanyatrAturAdAturopakArArthAdAturagateShvanyeShu vA bhAveShu, nacAturakulapravRuttayo bahirnishcArayitavyAH, hrasitaM cAyuShaH pramANamAturasya jAnatA~api tvayAna varNayitavyaM tatra yatrocyamAnamAturasyAnyasya vA~apyupaghAtAya sampadyate; j~jAnavatA~apica nAtyarthamAtmano j~jAne vikatthitavyam, AptAdapi hi vikatthamAnAdatyarthamudvijantyaneke||13||
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Now the teacher should instruct the student in presence of sacred fire, brahmanas and physicians,
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*“You shall follow abstinence, keep beard and mustaches,
*speak truth only,
*shall not eat meat,
*follow pure and intellectual functions,
*do things without jealousy and weapons.
*You should always follow my (teacher’s) instructions except in case they lead to king’s wrath, end of life, great unrighteousness and other such calamity.
*You should always entrust me, see me as head, be submissive to me and follow the course which is liked by and advantageous to me. You should live with me behaving as son, servant and suppliant.
*You should live with modesty, alertness, with focused mind, humbleness and constant vigilance about work, without seeing defect in other’s qualities, and not leave without my permission.
*When permitted to move out, you should first make effort as far as possible to furnish things told by the teacher.
*When you join the medical profession and wish success in work(treating patients), in purposes of life (''purushartha'' like ''dharma, artha,'' ''kama'' and ''moksha''), fame and heaven after death then you should always pray for the welfare of cow, ''brahmana'' and all the living creatures.
*You should try to furnish health to the patients and all creatures by all means.
*You should not hate the patients even at your daily expenses (even if the poor patient is not able to pay your fees).
*You should not think bad about other women and any other’s property even in imagination.
*Your dress and accessories should be modest.
*You should not be addicted to alcohol, indulged in sins and accompanied by sinners;
*You should be soft spoken, talking flawless, righteous, blissful, thankful, truthful, useful and measured statements keeping in mind place and season or time. with good remembrance, striving constantly for knowledge, progress and excellence of equipment (medicines etc.).
*You should not treat the persons disliked by the king (thieves etc.) or disliking the king (rebellions), disliked by good persons or disliking them and all those who are excessively diseased, wicked; having troublesome conduct, behavior and management, have never counteracted their censors and one nearing death;
*You should not treat the women in absence of their husbands or guardians, you should not accept meat provided by the women without permission of their husband or guardian.
*At the time of entering into the patient's house you should take along a known individual whose entrance is allowed; should be well-dressed, with head lowered, having good memory, with stability, thinking deliberately and moving as needs be; having entered there, you should never engage your speech, mind and sense organs any place except the patient, his well-being and other entities of the patient's body respectively. The matters of the patient's house should never be revealed outside, in spite of the fact that you know the diminution in life-span of the patient, you should not specify it where it is liable to cause harm to the patient or others. Even though you are learned enough you should not boast too much for your knowledge because mostly the people become anxious for the excessive boasting even it comes from an authority. [13]
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नचैवह्यस्तिसुतरमायुर्वेदस्यपारं, तस्मादप्रमत्तःशश्वदभियोगमस्मिन्गच्छेत्, एतच्चकार्यम्, एवम्भूयश्चवृत्तसौष्ठवमनसूयतापरेभ्योऽप्यागमयितव्यं, कृत्स्नोहिलोकोबुद्धिमतामाचार्यःशत्रुश्चाबुद्धिमताम्, अतश्चाभिसमीक्ष्यबुद्धिमताऽमित्रस्यापिधन्यंयशस्यमायुष्यंपौष्टिकंलौक्यमभ्युपदिशतोवचःश्रोतव्यमनुविधातव्यंचेति|
अतःपरमिदंब्रूयात्- देवताग्निद्विजगुरुवृद्धसिद्धाचार्येषुतेनित्यंसम्यग्वर्तितव्यं, तेषुतेसम्यग्वर्तमानस्यायमग्निःसर्वगन्धरसरत्नबीजानियथेरिताश्चदेवताःशिवायस्युः, अतोऽन्यथावर्तमानस्याशिवायेति| एवंब्रुवतिचाचार्येशिष्यः‘तथा’इतिब्रूयात्| यथोपदेशं
चकुर्वन्नध्याप्यः, अतोऽन्यथात्वनध्याप्यः| अध्याप्यमध्यापयन्ह्याचार्योयथोक्तैश्चाध्यापनफलैर्योगमाप्नोत्यन्यैश्चानुक्तैः
श्रेयस्करैर्गुणैःशिष्यमात्मानंचयुनक्ति| इत्यध्यापनविधिरुक्तः||१४||
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na caiva hyasti sutaramāyurvēdasya pāraṁ, tasmādapramattaḥ śaśvadabhiyōgamasmin gacchēt, ētacca kāryam, ēvambhūyaśca vr̥ttasauṣṭhavamanasūyatā parēbhyō'pyāgamayitavyaṁ, kr̥tsnō hi lōkō buddhimatāmācāryaḥ śatruścābuddhimatām, ataścābhisamīkṣya buddhimatā'mitrasyāpi dhanyaṁ yaśasyamāyuṣyaṁ pauṣṭikaṁ laukyamabhyupadiśatō vacaḥ śrōtavyamanuvidhātavyaṁ cēti| ataḥ paramidaṁ brūyāt- dēvatāgnidvijaguruvr̥ddhasiddhācāryēṣu tē nityaṁ samyagvartitavyaṁ, tēṣutēsamyagvartamānasyāyamagniḥsarvagandharasaratnabījāniyathēritāśca
dēvatāḥśivāyasyuḥ,atō'nyathāvartamānasyāśivāyēti|ēvaṁbruvaticācāryēśiṣyaḥ‘tathā’itibrūyāt|
yathōpadēśaṁcakurvannadhyāpyaḥ,atō'nyathātvanadhyāpyaḥ|
adhyāpyamadhyāpayanhyācāryōyathōktaiścādhyāpanaphalairyōgamāpnōtyanyaiścānuktaiḥśrēyaskarairguṇaiḥ śiṣyamātmānaṁ ca yunakti| ityadhyāpanavidhiruktaḥ||14||

na caiva hyasti sutaram[[Ayurveda]]sya pAraM, tasmAdapramattaH shashvadabhiyogamasmin gacchet,etacca [1] kAryam, evambhUyashca vRuttasauShThavamanasUyatA parebhyo~apyAgamayitavyaM,kRutsno hi loko buddhimatAmAcAryaH shatrushcAbuddhimatAm, atashcAbhisamIkShyabuddhimatA~amitrasyApi dhanyaM yashasyamAyuShyaM pauShTikaM laukyamabhyupadishato [2] vacaHshrotavyamanuvidhAtavyaM ceti|
ataH paramidaM brUyAt- devatAgnidvijaguruvRuddhasiddhAcAryeShu te nityaM samyagvartitavyaM, teShute samyagvartamAnasyAyamagniH sarvagandharasaratnabIjAni yatheritAshca devatAH shivAya syuH,ato~anyathA vartamAnasyAshivAyeti|
evaM bruvati cAcArye shiShyaH ‘tathA’ iti brUyAt|
yathopadeshaM ca kurvannadhyApyaH, ato~anyathA tvanadhyApyaH|
adhyApyamadhyApayan hyAcAryo yathoktaishcAdhyApanaphalairyogam
ApnotyanyaishcAnuktaiHshreyaskarairguNaiH shiShyamAtmAnaM ca yunakti|
ityadhyApanavidhiruktaH||14||
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There is no limit for knowing the science of life i.e. [[Ayurveda]]. Therefore, one should dedicate himself to it (i.e., study [[Ayurveda]]) continuously and without any carelessness. This is worth-doing and to be followed.

Further one should keep good behavior with everyone, without pointing the defect in other’s qualities. Because for the wise the whole world is a teacher, while for the unwise it is enemy. Consequently, the wise, after due consideration, should follow the advice which is prosperous, promoting fame, life-span, strength and useful to the society even if it comes from an enemy.

After that he (the teacher) should speak this, “You should always behave properly (worship) to gods, fire, ''brahmanas'', preceptors, elders, accomplished ones and teacher, thus this fire along with all the perfumes, eatables, gem, grins and aforesaid gods would bless you with prosperity, and if you behave in opposite manner they would curse you. When the teacher has said like this, the disciple should say ‘Yes’ (will behave similarly).

If the disciple follows these instructions then he should be taught, otherwise not. The teacher when teaches such a worthy disciple obtains the aforesaid fruits of teaching and enjoins the disciple and himself with other not mentioned beneficial qualities. Thus, the method of teaching is said. [14]
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=== Organization of discussion meetings ===

==== Method of conducting discussion in seminars and symposia of experts ====
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सम्भाषाविधिमतऊर्ध्वंव्याख्यास्यामः- भिषक्भिषजासहसम्भाषेत| तद्विद्यसम्भाषाहिज्ञानाभियोगसंहर्षकरीभवति, वैशारद्यमपिचाभिनिर्वर्तयति, वचनशक्तिमपिचाधत्ते, यशश्चाभिदीपयति, पूर्वश्रुतेचसन्देहवतःपुनःश्रवणाच्छ्रुतसंशयमपकर्षति, श्रुतेचासन्देहवतोभूयोऽध्यवसायमभिनिर्वर्तयति, अश्रुतमपिचकञ्चिदर्थंश्रोत्रविषयमापादयति, यच्चाचार्यःशिष्यायशुश्रूषवेप्रसन्नःक्रमेणोपदिशतिगुह्याभिमतमर्थजातंतत्परस्परेणसहजल्पन्पिण्डेनविजिगीषुराहसंहर्षात्, तस्मात्तद्विद्यसम्भाषामभिप्रशंसन्तिकुशलाः||१५||
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sambhāṣāvidhimata ūrdhvaṁ vyākhyāsyāmaḥ- bhiṣak bhiṣajā saha sambhāṣēta| tadvidyasambhāṣā hi jñānābhiyōgasaṁharṣakarī bhavati, vaiśāradyamapi cābhinirvartayati, vacanaśaktimapi cādhattē, yaśaścābhidīpayati, pūrvaśrutē ca sandēhavataḥ punaḥ śravaṇācchrutasaṁśayamapakarṣati, śrutē cāsandēhavatō bhūyō'dhyavasāyamabhinirvartayati, aśrutamapi ca kañcidarthaṁ śrōtraviṣayamāpādayati, yaccācāryaḥ śiṣyāya śuśrūṣavē prasannaḥ kramēṇōpadiśati guhyābhimatamarthajātaṁ tat parasparēṇa saha jalpan piṇḍēna vijigīṣurāha saṁharṣāt, tasmāttadvidyasambhāṣāmabhipraśaṁsanti kuśalāḥ||15||

sambhAShAvidhimata UrdhvaM vyAkhyAsyAmaH- bhiShak bhiShajA saha sambhASheta|
tadvidyasambhAShA hi j~jAnAbhiyogasaMharShakarI bhavati, vaishAradyamapi cAbhinirvartayati,vacanashaktimapi cAdhatte, yashashcAbhidIpayati, pUrvashrute ca sandehavataH punaHshravaNAcchrutasaMshayamapakarShati, shrute cAsandehavato bhUyo~adhyavasAyamabhinirvartayati,ashrutamapi ca ka~jcidarthaM shrotraviShayamApAdayati, yaccAcAryaH shiShyAya shushrUShaveprasannaH krameNopadishati guhyAbhimatamarthajAtaM tat paraspareNa saha jalpan piNDena [1]vijigIShurAha saMharShAt, tasmAttadvidyasambhAShAmabhiprashaMsanti kushalAH||15||
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Henceforth, I shall expound the method of discussion. A physician should discuss with physicians. Discussion with experts promotes pursuit and advancement of knowledge, provides dexterity, improves power of speaking, illumines fame, removes doubts in scriptures, if any, by repeatedly listening the topics, and creates confidence with doubtless knowledge, , brings forth some new ideas hitherto unknown, the reason is that whatever secret ideas are gradually delivered by the teacher pleased over the devoted disciple, the same are expressed by him in enthusiasm during discussion in order to gain victory. Hence the experts recommend discussion with the specialists. [15]
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==== Two types of discussions ====
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द्विविधातुखलुतद्विद्यसम्भाषाभवति- सन्धायसम्भाषा, विगृह्यसम्भाषाच||१६||
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dvividhā tu khalu tadvidyasambhāṣā bhavati- sandhāyasambhāṣā, vigr̥hyasambhāṣā ca||16||

dvividhA tu khalu tadvidyasambhAShA bhavati- sandhAyasambhAShA, vigRuhyasambhAShA ca||16||
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Discussion with experts is of two types- friendly discussion and hostile discussion. [16]

==== Friendly discussion ====
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तत्रज्ञानविज्ञानवचनप्रतिवचनशक्तिसम्पन्नेनाकोपनेनानुपस्कृतविद्येनानसूयकेनानुनेयेनानुनयकोविदेनक्लेशक्षमेणप्रियसम्भाषणेनचसहसन्धायसम्भाषाविधीयते| तथाविधेनसहकथयन्विस्रब्धःकथयेत्, पृच्छेदपिचविस्रब्धः, पृच्छतेचास्मैविस्रब्धायविशदमर्थंब्रूयात्, नचनिग्रहभयादुद्विजेत, निगृह्यचैनंनहृष्येत्, नचपरेषुविकत्थेत, नचमोहादेकान्तग्राहीस्यात्, नचाविदितमर्थमनुवर्णयेत्, सम्यक्चानुनयेनानुनयेत्, तत्रचावहितःस्यात्| इत्यनुलोमसम्भाषाविधिः||१७||
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tatra
jñānavijñānavacanaprativacanaśaktisampannēnākōpanēnānupaskr̥tavidyēnānasūyakēnānunēyēnānunayakōvidēna klēśakṣamēṇa priyasambhāṣaṇēna ca saha sandhāyasambhāṣā vidhīyatē| tathāvidhēna saha kathayan visrabdhaḥ kathayēt, pr̥cchēdapi ca visrabdhaḥ, pr̥cchatē cāsmai visrabdhāya viśadamarthaṁ brūyāt, na ca nigrahabhayādudvijēta, nigr̥hya cainaṁ na hr̥ṣyēt, na ca parēṣu vikatthēta, na ca mōhādēkāntagrāhī syāt, na cāviditamarthamanuvarṇayēt, samyak cānunayēnānunayēt, tatra cāvahitaḥ syāt| ityanulōmasambhāṣāvidhiḥ||17||

tatraj~jAnavij~jAnavacanaprativacanashaktisampannenAkopanenAnupaskRutavidyenAnasUyakenAnuneyenAnunayakovidenakleshakShameNa priyasambhAShaNena ca saha sandhAyasambhAShA vidhIyate|
tathAvidhena saha kathayan visrabdhaH kathayet, pRucchedapi ca visrabdhaH, pRucchate cAsmai visrabdhAyavishadamarthaM brUyAt, na ca nigrahabhayAdudvijeta, nigRuhya cainaM na hRuShyet, na ca pareShu vikattheta, na camohAdekAntagrAhI syAt, na cAviditamarthamanuvarNayet, samyak [1] cAnunayenAnunayet, tatra cAvahitaH syAt|
ityanulomasambhAShAvidhiH||17||
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The friendly discussion is held as follow:
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*It is discussed with one who is endowed with general and specific knowledge of related topic, opinions and counter-opinions, powerful expressions, devoid of irritability, having uncensored knowledge, without jealously, able to be convinced and who can convince others, enduring and adept in art of sweet conversation.
*When discussion with such a person one should speak confidently, put question unhesitatingly, reply to the sincere questioner with elaborateness, not be agitated with fear of defeat, not be exhilarated on defeating the partner, not boast before others, not hold fastly his solitary view due to attachment, not explain what is unknown to him, convince the other party with politeness and be caution in that. This is the method of friendly discussion. [17]
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==== Hostile discussion ====
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अतऊर्ध्वमितरेणसहविगृह्यसम्भाषायांजल्पेच्छ्रेयसायोगमात्मनःपश्यन्| प्रागेवचजल्पाज्जल्पान्तरंपरावरान्तरंपरिषद्विशेषांश्चसम्यक्परीक्षेत| सम्यक्परीक्षाहिबुद्धिमतांकार्यप्रवृत्तिनिवृत्तिकालौशंसति, तस्मात्परीक्षामभिप्रशंसन्तिकुशलाः| परीक्षमाणस्तुखलुपरावरान्तरमिमान्जल्पकगुणाञ्श्रेयस्करान्दोषवतश्चपरीक्षेतसम्यक्; तद्यथा- श्रुतंविज्ञानंधारणंप्रतिभानंवचनशक्तिरिति, एतान्गुणान्श्रेयस्करानाहुः; इमान्पुनर्दोषवतः, तद्यथा- कोपनत्वमवैशारद्यंभीरुत्वमधारणत्वमनवहितत्वमिति| एतान्गुणान्गुरुलाघवतःपरस्यचैवात्मनश्चतुलयेत्||१८||
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ata ūrdhvamitarēṇa saha vigr̥hya sambhāṣāyāṁ jalpēcchrēyasā yōgamātmanaḥ paśyan| prāgēva ca jalpājjalpāntaraṁ parāvarāntaraṁ pariṣadviśēṣāṁśca samyak parīkṣēta| samyakparīkṣā hi buddhimatāṁ kāryapravr̥ttinivr̥ttikālau śaṁsati, tasmāt parīkṣāmabhipraśaṁsanti kuśalāḥ| parīkṣamāṇastu khalu parāvarāntaramimān jalpakaguṇāñ śrēyaskarāndōṣavataśca parīkṣēta samyak; tadyathā- śrutaṁ vijñānaṁ dhāraṇaṁ pratibhānaṁ vacanaśaktiriti, ētān guṇān śrēyaskarānāhuḥ; imān punardōṣavataḥ, tadyathā- kōpanatvamavaiśāradyaṁ bhīrutvamadhāraṇatvamanavahitatvamiti| ētān guṇān gurulāghavataḥ parasya caivātmanaśca tulayēt||18||

ata UrdhvamitareNa saha vigRuhya sambhAShAyAM [1] jalpecchreyasA yogamAtmanaH pashyan|
prAgeva ca jalpAjjalpAntaraM [2] parAvarAntaraM pariShadvisheShAMshca samyak parIkSheta|
samyakparIkShA hi buddhimatAM kAryapravRuttinivRuttikAlau shaMsati, tasmAtparIkShAmabhiprashaMsanti kushalAH|
parIkShamANastu khalu parAvarAntaramimAn jalpakaguNA~j shreyaskarAndoShavatashca parIkShetasamyak; tadyathA- shrutaM vij~jAnaM dhAraNaM pratibhAnaM vacanashaktiriti, etAn guNAnshreyaskarAnAhuH; imAn punardoShavataH, tadyathA- kopanatvamavaishAradyaMbhIrutvamadhAraNatvamanavahitatvamiti|
etAn guNAn gurulAghavataH parasya caivAtmanashca tulayet||18||
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Further one should take part in hostile discussion with others after understansing the self benefit. Before arguing, he should examine properly the difference of opinion with opponent, superiority or inferiority of opponent, and the nature of the participants in the discussion. This proper examination guides the wise about the initiation and cessation of discussion, hence the experts recomend the examination.
While examining the difference, between him and the opponent, one should also examine the merits and demerits of the speaker properly – merits such as scriptural knowledge, understanding, retention, imagination and eloquence and demerits such as irritability, lack of skill, cowardice, lack of retention and carelessness. One should compare himself and the opponent in superiority- inferiority with respect to these qualities.[18]
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==== Three categories of opponent ====
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तत्रत्रिविधःपरःसम्पद्यते- प्रवरः, प्रत्यवरः, समोवा, गुणविनिक्षेपतः; नत्वेवकार्त्स्न्येन||१९||
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tatra trividhaḥ paraḥ sampadyatē- pravaraḥ, pratyavaraḥ, samō vā,guṇavinikṣēpataḥ; natvēva kārtsnyēna||19||

tatra trividhaH paraH sampadyate- pravaraH, pratyavaraH, samo vA, guNavinikShepataH; natvevakArtsnyena||19||
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The opponent may be of three types – superior, inferior or equal, according to the above mentioned qualities for discussion and not all aspects .[19]

==== Types of assembly ====
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परिषत्तुखलुद्विविधा- ज्ञानवती, मूढपरिषच्च| सैवद्विविधासतीत्रिविधापुनरनेनकारणविभागेन- सुहृत्परिषत्, उदासीनपरिषत्, प्रतिनिविष्टपरिषच्चेति | तत्रप्रतिनिविष्टायांपरिषदिज्ञानविज्ञानवचनप्रतिवचनशक्तिसम्पन्नायांमूढायांवानकथंचित्केनचित्सहजल्पोविधीयते; मूढायांतुसुहृत्परिषद्युदासीनायांवाज्ञानविज्ञानवचनप्रतिवचनशक्तीरन्तरेणाप्यदीप्तयशसा
महाजनविद्विष्टेनापिसहजल्पोविधीयते| तद्विधेनचसहकथयताआविद्धदीर्घसूत्रसङ्कुलैर्वाक्यदण्डकैःकथयितव्यम्, अतिहृष्टंमुहुर्मुहुरुपहसतापरंनिरूपयताचपर्षदमाकारैर्ब्रुवतश्चास्यवाक्यावकाशोनदेयः; कष्टशब्दंचब्रुवतावक्तव्योनोच्यते, अथवापुनर्हीनातेप्रतिज्ञा, इति| पुनश्चाहू(ह्व)यमानःप्रतिवक्तव्यः- परिसंवत्सरोभवान्शिक्षस्वतावत्; नत्वयागुरुरुपासितोनूनम्, अथवापर्याप्तमेतावत्ते; सकृदपिहिपरिक्षेपिकंनिहतंनिहतमाहुरितिनास्ययोगःकर्तव्यःकथञ्चित्| अप्येवंश्रेयसासहविगृह्यवक्तव्यमित्याहुरेके; नत्वेवंज्यायसासहविग्रहंप्रशंसन्तिकुशलाः||२०||
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pariṣattu khalu dvividhā- jñānavatī, mūḍhapariṣacca| saiva dvividhā satī trividhā punaranēna kāraṇavibhāgēna- suhr̥tpariṣat, udāsīnapariṣat, pratiniviṣṭapariṣaccēti | tatra pratiniviṣṭāyāṁ pariṣadi jñānavijñānavacanaprativacanaśaktisampannāyāṁ mūḍhāyāṁ vā na kathaṁ cit kēnacit saha jalpō vidhīyatē; mūḍhāyāṁ tu suhr̥tpariṣadyudāsīnāyāṁ vā jñānavijñānavacanaprativacanaśaktīrantarēṇāpyadīptayaśasā mahājanavidviṣṭēnāpi saha jalpō vidhīyatē| tadvidhēna ca saha kathayatā āviddhadīrghasūtrasaṅkulairvākyadaṇḍakaiḥ kathayitavyam, atihr̥ṣṭaṁ muhurmuhurupahasatā paraṁ nirūpayatā ca parṣadamākārairbruvataścāsya vākyāvakāśō na dēyaḥ; kaṣṭaśabdaṁ ca bruvatā vaktavyō nōcyatē, athavā punarhīnā tē pratijñā, iti| punaścāhū(hva)yamānaḥ prativaktavyaḥ- parisaṁvatsarō bhavān śikṣasva tāvat; na tvayā gururupāsitō nūnam, athavā paryāptamētāvattē; sakr̥dapi hi parikṣēpikaṁ nihataṁ nihatamāhuriti nāsya yōgaḥ kartavyaḥ kathañcit| apyēvaṁ śrēyasā saha vigr̥hya vaktavyamityāhurēkē; natvēvaṁ jyāyasā saha vigrahaṁ praśaṁsanti kuśalāḥ||20||

pariShattu khalu dvividhA- j~jAnavatI, mUDhapariShacca|
saiva dvividhA satI trividhA punaranena kAraNavibhAgena- suhRutpariShat, udAsInapariShat,pratiniviShTapariShacceti [1] |
tatra pratiniviShTAyAM pariShadi j~jAnavij~jAnavacanaprativacanashaktisampannAyAM mUDhAyAM vA nakathaM cit kenacit saha jalpo vidhIyate; mUDhAyAM tu suhRutpariShadyudAsInAyAM vAj~jAnavij~jAnavacanaprativacanashaktIrantareNApyadIptayashasA [2] mahAjanavidviShTenApi saha jalpovidhIyate|
tadvidhena ca saha kathayatA AviddhadIrghasUtrasa~gkulairvAkyadaNDakaiH kathayitavyam,atihRuShTaM muhurmuhurupahasatA paraM nirUpayatA ca parShadamAkArairbruvatashcAsyavAkyAvakAsho na deyaH; kaShTashabdaM ca bruvatA [3] vaktavyo nocyate, athavA punarhInA te pratij~jA,iti|
punashcAhU(hva)yamAnaH prativaktavyaH- parisaMvatsaro [4] bhavAn shikShasva tAvat; na tvayAgururupAsito nUnam, athavA paryAptametAvatte; sakRudapi hi parikShepikaM nihataM nihatamAhuritinAsya yogaH kartavyaH katha~jcit|
apyevaM shreyasA saha vigRuhya vaktavyamityAhureke; natvevaM jyAyasA saha vigrahaM prashaMsantikushalAH||20||
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Assembly may also be of two types - learned and ignorant. Again from the other point of view, it is of three types – friendly, neutral and prejudiced.
One should not disucss anything, or anything cannot be discussed in the the assembly of learned prejudiced persons endowed with general and specific knowledge, powerful expressions,discussion techniques and assembly of ignorant prejudiced persons.
In the ignorant friendly or ignorant neutral assembly, however, one may discuss with another who is devoid of learning, understanding, discussion techniques, and is not famous and is despised by great men. While discussing with such a person one should use long sentences having incomprehensible and long aphorisms.One should ridicule the opponent again and again with body guestures before the gathering and should not give opportunity to him to speak, while using difficult words one should remind the opponent that he is not speaking or his proposition does not stand. Again calling him one should say- you should learn for one year, perhaps you have not learnt from a preceptor or it is sufficient for you. The opponent, having defeated once, is always considered defeated and should not be entertained again. Some say that the same method is applicable in case of hostile discussion with a superior opponent but, in fact, confrontation with a superior person is not at all desirable. [20]
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प्रत्यवरेणतुसहसमानाभिमतेनवाविगृह्यजल्पतासुहृत्परिषदिकथयितव्यम्,अथवाऽप्युदासीनपरिषद्यवधानश्रवणज्ञानविज्ञानोपधारणवचनप्रतिवचनशक्तिसम्पन्नायांकथयताचावहितेनपरस्यसाद्गुण्यदोष<br>बलमवेक्षितव्यं, समवेक्ष्यचयत्रैनंश्रेष्ठंमन्येतनास्यतत्रजल्पंयोजयेदनाविष्कृतमयोगंकुर्वन्; यत्रत्वेनमवरंमन्येततत्रैवैनमाशुनिगृह्णीयात्| तत्रखल्विमेप्रत्यवराणामाशुनिग्रहेभवन्त्युपायाः; तद्यथा- श्रुतहीनंमहतासूत्रपाठेनाभिभवेत्, विज्ञानहीनंपुनःकष्टशब्देनवाक्येन, वाक्यधारणाहीनमाविद्धदीर्घसूत्रसङ्कुलैर्वाक्यदण्डकैः, प्रतिभाहीनंपुनर्वचनेनैकविधेनानेकार्थवाचिना , वचनशक्तिहीनमर्धोक्तस्यवाक्यस्याक्षेपेणअविशारदमपत्रपणेन, कोपनमायासनेन, भीरुंवित्रासनेन, अनवहितंनियमनेनेति| एवमेतैरुपायैःपरमवरमभिभवेच्छीघ्रम्||२१||
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pratyavarēṇa tu saha samānābhimatēna vā vigr̥hya jalpatā suhr̥tpariṣadikathayitavyam,athavā'pyudāsīnapariṣadyavadhānaśravaṇajñānavijñānōpadhāraṇavacanaprativacanaśaktisampannāyāṁ kathayatā cāvahitēna parasya sādguṇyadōṣabalamavēkṣitavyaṁ, samavēkṣya ca yatrainaṁ śrēṣṭhaṁ manyēta nāsya tatra jalpaṁ yōjayēdanāviṣkr̥tamayōgaṁ kurvan; yatra tvēnamavaraṁ manyēta tatraivainamāśu nigr̥hṇīyāt| tatra khalvimē pratyavarāṇāmāśu nigrahē bhavantyupāyāḥ; tadyathā- śrutahīnaṁ mahatā sūtrapāṭhēnābhibhavēt, vijñānahīnaṁ punaḥ kaṣṭaśabdēna vākyēna, vākyadhāraṇāhīnamāviddhadīrghasūtrasaṅkulairvākyadaṇḍakaiḥ, pratibhāhīnaṁ punarvacanēnaikavidhēnānēkārthavācinā, vacanaśaktihīnamardhōktasya vākyasyākṣēpēṇa, aviśāradamapatrapaṇēna, kōpanamāyāsanēna, bhīruṁ vitrāsanēna, anavahitaṁ niyamanēnēti| ēvamētairupāyaiḥ paramavaramabhibhavēcchīghram||21||

pratyavareNa tu saha samAnAbhimatena vA vigRuhya jalpatA suhRutpariShadi kathayitavyam,athavA~apyudAsInapariShadyavadhAnashravaNaj~jAnavij~jAnopadhAraNavacanaprativacanashaktisampannAyAMkathayatA cAvahitena parasya sAdguNyadoShabalamavekShitavyaM, samavekShya ca yatrainaM shreShThaMmanyeta nAsya tatra jalpaM yojayedanAviShkRutamayogaM kurvan; yatra tvenamavaraM manyetatatraivainamAshu nigRuhNIyAt|
tatra khalvime pratyavarANAmAshu nigrahe bhavantyupAyAH; tadyathA- shrutahInaM mahatAsUtrapAThenAbhibhavet, vij~jAnahInaM punaH kaShTashabdena vAkyena,vAkyadhAraNAhInamAviddhadIrghasUtrasa~gkulairvAkyadaNDakaiH, pratibhAhInaMpunarvacanenaikavidhenAnekArthavAcinA [1] , vacanashaktihInamardhoktasya vAkyasyAkShepeNa [2] ,avishAradamapatrapaNena, kopanamAyAsanena, bhIruM vitrAsanena, anavahitaM niyamaneneti|
evametairupAyaiH paramavaramabhibhavecchIghram||21||
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In a learned friendly or ignorant friendly assembly, one should initiate hostile discussion with an inferior or equal opponent.
Or in a friendly neutral assembly having persons with attentive listening, learning, understanding abilities, power of discussion one should initiate discussion after carefully examining the strength and weakness of the opponent. If opponent is stronger then one should not continue discussion giving it up without any apparent sign; but where the opponent is weak he should be subdued immediately.
The means adopted to subdue the inferior opponent immediately are as follows:
opponent having no scriptural knowledge should be defeated by quoting long aphorisms; opponent devoid of confirmed meaning of sentences should be defeated by using sentences with incomprehensible and long aphorisms;
one devoid of imagination should be defeated with similar sentences having various meanings;
one devoid of power of speaking should be defeated by contradicting the half-said sentence;
one devoid of skill should be defeated by putting him in embarrassing situation;
one with irritability should be defeated by teasing him;
one with cowardice should be defeated by terrorizing;
one devoid of carefulness should be defeated by imposing discipline.
Thus by these means one should subdue the inferior opponent immediately. [21]
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==== Summary of discussion technique ====
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तत्रश्लोकौ- विगृह्यकथयेद्युक्त्यायुक्तंचननिवारयेत्| विगृह्यभाषातीव्रंहिकेषाञ्चिद्द्रोहमावहेत्||२२||

नाकार्यमस्तिक्रुद्धस्यनावाच्यमपिविद्यते| कुशलानाभिनन्दन्तिकलहंसमितौसताम्||२३||

एवंप्रवृत्तेवादेकुर्यात्||२४||
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tatra ślōkau- vigr̥hya kathayēdyuktyā yuktaṁ ca na nivārayēt| vigr̥hyabhāṣā tīvraṁ hi kēṣāñciddrōhamāvahēt||22||

nākāryamasti kruddhasya nāvācyamapi vidyatē| kuśalā nābhinandanti kalahaṁ samitau satām||23||

ēvaṁ pravr̥ttē vādē kuryāt||24||

tatra shlokau-
vigRuhya kathayedyuktyA yuktaM ca na nivArayet|
vigRuhyabhAShA tIvraM hi keShA~jciddrohamAvahet||22||

nAkAryamasti kruddhasya nAvAcyamapi vidyate|
kushalA nAbhinandanti kalahaM samitau satAm||23||

evaM pravRutte vAde kuryAt||24||
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In a hostile discussion, one should speak reasonably and should not withdraw the words once spoken. A hostile speech gives rise to strong agitation in some persons. The agitated person, may do some unfavourable things or may speak some unwanted words. Hence the wise do not recommend quarrel in the assembly of noble persons. Thus one should perform in discussion initiated. [22-24]

==== Guidelines for preparation before initiation and recording the debate ====
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प्रागेवतावदिदंकर्तुंयतेत- सन्धायपर्षदाऽयनभूतमात्मनःप्रकरणमादेशयितव्यं, यद्वापरस्यभृशदुर्गंस्यात्, पक्षमथवापरस्यभृशंविमुखमानयेत्; परिषदिचोपसंहितायामशक्यमस्माभिर्वक्तुम्, एषैवतेपरिषद्यथेष्टंयथायोगंयथाभिप्रायंवादंवादमर्यादांचस्थापयिष्यतीत्युक्त्वातूष्णीमासीत||२५||
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prāgēva tāvadidaṁ kartuṁ yatēta- sandhāya parṣadā'yanabhūtamātmanaḥ prakaraṇamādēśayitavyaṁ, yadvā parasya bhr̥śadurgaṁ syāt, pakṣamathavā parasya bhr̥śaṁ vimukhamānayēt; pariṣadi cōpasaṁhitāyāmaśakyamasmābhirvaktum, ēṣaiva tē pariṣadyathēṣṭaṁ yathāyōgaṁ yathābhiprāyaṁ vādaṁ vādamaryādāṁ ca sthāpayiṣyatītyuktvā tūṣṇīmāsīta||25||

prAgeva [1] tAvadidaM kartuM yateta- sandhAya parShadA~ayanabhUtamAtmanaHprakaraNamAdeshayitavyaM, yadvA parasya bhRushadurgaM syAt, pakShamathavA parasya bhRushaMvimukhamAnayet; pariShadi copasaMhitAyAmashakyamasmAbhirvaktum, eShaiva te pariShadyatheShTaMyathAyogaM yathAbhiprAyaM vAdaM vAdamaryAdAM ca sthApayiShyatItyuktvA tUShNImAsIta||25||
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Before discussion, one should follow like this: In connivance with the participants of assembly, one should get the topic selected as is favourable to him or which is very difficult for the opponent or the opponent should be given such topic of discussion which will be quite adverse to the assembly’s views. Nothing can be discussed if the participants of assembly are congregated together. Then one should speak, ‘I have nothing to say more, now this assembly itself will take proper decision about the discussion and its result according to its choice, circumstances and views of the members’, having said this he should keep quiet. [25]
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तत्रेदंवादमर्यादालक्षणंभवति- इदंवाच्यम्, इदमवाच्यम्, एवंपराजितोभवतीति||२६||
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tatrēdaṁ vādamaryādālakṣaṇaṁ bhavati- idaṁ vācyam, idamavācyam, ēvaṁ parājitō bhavatīti||26||

tatredaM vAdamaryAdAlakShaNaM bhavati- idaM vAcyam, idamavAcyam, evaM parAjito bhavatIti||26||
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The result of the discussion should be recorded like this; this is worth-speaking, this is not worth-speaking, therefore one has been defeated. [26]

=== Terms for debate ===
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इमानितुखलुपदानिभिषग्वादमार्गज्ञानार्थमधिगम्यानिभवन्ति; तद्यथा-
वादः, द्रव्यं, गुणाः, कर्म, सामान्यं, विशेषः, समवायः, प्रतिज्ञा,स्थापना, प्रतिष्ठापना, हेतुः, दृष्टान्तः, उपनयः, निगमनम्, उत्तरं, सिद्धान्तः, शब्दः, प्रत्यक्षम्, अनुमानम्, ऐतिह्यम्, औपम्यं, संशयः, प्रयोजनं, सव्यभिचारं, जिज्ञासा, व्यवसायः, अर्थप्राप्तिः, सम्भवः, अनुयोज्यम्, अननुयोज्यम्, अनुयोगः, प्रत्यनुयोगः, वाक्यदोषः, वाक्यप्रशंसा, छलम्, अहेतुः, अतीतकालम्, उपालम्भः, परिहारः, प्रतिज्ञाहानिः, अभ्यनुज्ञा, हेत्वन्तरम्, अर्थान्तरं, निग्रहस्थानमिति||२७||
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imāni tu khalu padāni bhiṣagvādamārgajñānārthamadhigamyāni bhavanti; tadyathā- vādaḥ, dravyaṁ, guṇāḥ, karma, sāmānyaṁ, viśēṣaḥ, samavāyaḥ, pratijñā, sthāpanā, pratiṣṭhāpanā, hētuḥ, dr̥ṣṭāntaḥ, upanayaḥ, nigamanam, uttaraṁ, siddhāntaḥ, śabdaḥ, pratyakṣam, anumānam, aitihyam, aupamyaṁ, saṁśayaḥ, prayōjanaṁ, savyabhicāraṁ, jijñāsā, vyavasāyaḥ, arthaprāptiḥ, sambhavaḥ, anuyōjyam, ananuyōjyam, anuyōgaḥ, pratyanuyōgaḥ, vākyadōṣaḥ, vākyapraśaṁsā, chalam, ahētuḥ, atītakālam, upālambhaḥ, parihāraḥ, pratijñāhāniḥ, abhyanujñā, hētvantaram, arthāntaraṁ, nigrahasthānamiti||27||

imAni tu khalu padAni bhiShagvAdamArgaj~jAnArthamadhigamyAni [1] bhavanti; tadyathA- vAdaH,dravyaM, guNAH, karma, sAmAnyaM, visheShaH, samavAyaH, pratij~jA, sthApanA, pratiShThApanA,hetuH, dRuShTAntaH, upanayaH, nigamanam, uttaraM, siddhAntaH, shabdaH, pratyakSham, anumAnam,aitihyam, aupamyaM, saMshayaH, prayojanaM, savyabhicAraM, jij~jAsA, vyavasAyaH, arthaprAptiH,sambhavaH, anuyojyam, ananuyojyam, anuyogaH, pratyanuyogaH, vAkyadoShaH, vAkyaprashaMsA,chalam, ahetuH, atItakAlam, upAlambhaH, parihAraH, pratij~jAhAniH, abhyanuj~jA, hetvantaram,arthAntaraM, nigrahasthAnamiti||27||
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These terms are worth-knowing for acquaintance of the course of discussion among physicians such as – ''vada, dravya, guna, karma, samanya, vishesha, samavaya, pratijna, sthapana, pratishthapana, hetu, drishtanta, upanaya, nigamana, uttara, siddhanta, shabda, pratyaksha, anumana, aitihya, aupamya, samshaya, prayojana, savyabhichara, jijnasa, vyavasaya, arthaprapti, sambhava, anuyojya, ananuyojya, anuyoga, pratyanuyoga, vakyadosha, vakyaprashamsa, chhala, ahetu, atitakala, upalambha, parihara, pratijnahani, abhyanujna, hetvantara, arthantara, nigrahasthana.'' [27]
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==== 1. ''Vada'' (debate) ====
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तत्रवादोनामसयत्परेणसहशास्त्रपूर्वकंविगृह्यकथयति| सचद्विविधःसङ्ग्रहेण- जल्पः, वितण्डाच| तत्रपक्षाश्रितयोर्वचनंजल्पः, जल्पविपर्ययोवितण्डा| यथा- एकस्यपक्षःपुनर्भवोऽस्तीति,नास्तीत्यपरस्य; तौचस्वस्वपक्षहेतुभिःस्वस्वपक्षंस्थापयतः, परपक्षमुद्भावयतः, एषजल्पः| जल्पविपर्ययोवितण्डा| वितण्डानामपरपक्षेदोषवचनमात्रमेव||२८||
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tatra vādō nāma sa yat parēṇa saha śāstrapūrvakaṁ vigr̥hya kathayati| sa ca dvividhaḥ saṅgrahēṇa- jalpaḥ, vitaṇḍā ca| tatra pakṣāśritayōrvacanaṁ jalpaḥ, jalpaviparyayō vitaṇḍā| yathā- ēkasya pakṣaḥ punarbhavō'stīti, nāstītyaparasya; tau ca svasvapakṣahētubhiḥ svasvapakṣaṁ sthāpayataḥ, parapakṣamudbhāvayataḥ, ēṣa jalpaḥ| jalpaviparyayō vitaṇḍā| vitaṇḍā nāma parapakṣē dōṣavacanamātramēva||28||

tatra vAdo nAma sa yat pareNa saha shAstrapUrvakaM vigRuhya kathayati|
sa ca dvividhaH sa~ggraheNa- jalpaH, vitaNDA ca|
tatra pakShAshritayorvacanaM jalpaH, jalpaviparyayo vitaNDA|
yathA- ekasya pakShaH punarbhavo~astIti, nAstItyaparasya; tau ca svasvapakShahetubhiHsvasvapakShaM sthApayataH, parapakShamudbhAvayataH, eSha jalpaH|
jalpaviparyayo vitaNDA|
vitaNDA nAma parapakShe doShavacanamAtrameva||28||
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<div style="text-align:justify;">
''Vada'' is that in which one holds academic discussion with a contending opponent. This is briefly of two types – ''jalpa, vitanda''.
''Jalpa'' is the statement of speaker’s own view contradicting the opponent’s view.
''Vitanda'' is opposite to ''jalpa''. For instance, one holds the view that rebirth exist while the other holds the view just against it. During such discussion (''vada''), they (participants) advance arguments in support of their own views and contradict the opponent’s view, this is ''jalpa''. ''Vitanda'' is opposite to ''jalpa'' in which the speaker without having any positive approach only finds faults in the opponent’s view point. [28]
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==== 2-7: ''Dravya'' to ''Samavaya'' ====
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द्रव्य-गुण-कर्म-सामान्य-विशेष-समवायाः
स्वलक्षणैःश्लोकस्थानेपूर्वमुक्ताः||२९||
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dravya-guṇa-karma-sāmānya-viśēṣa-samavāyāḥ
svalakṣaṇaiḥ ślōkasthānē pūrvamuktāḥ||29||

dravya-guNa-karma-sAmAnya-visheSha-samavAyAH svalakShaNaiH shlokasthAne pUrvamuktAH||29||
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''Dravya, guna, karma, samanya, vishesha and samavaya''– these are mentioned earlier along with their definitions in ''shloka sthana'' ([[Sutra Sthana]] chapters). [29]

==== 8. ''Pratijna'' (proposition) ====
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अथप्रतिज्ञा- प्रतिज्ञानामसाध्यवचनं; यथा- नित्यःपुरुषइति||३०||
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atha pratijñā- pratijñā nāma sādhyavacanaṁ; yathā- nityaḥ puruṣa iti||30||

atha pratij~jA- pratij~jA nAma sAdhyavacanaM; yathA- nityaH puruSha iti||30||
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''Pratijna''(proposition) is the statement which is to be proved. For instance, ''purusha'' is eternal. [30]

==== 9. ''Sthapana'' (establishment) ====
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अथस्थापना- स्थापनानामतस्याएवप्रतिज्ञायाहेतुदृष्टान्तोपनयनिगमनैःस्थापना| पूर्वंहिप्रतिज्ञा, पश्चातस्थापना, किंह्यप्रतिज्ञातंस्थापयिष्यति; यथा- नित्यःपुरुषइतिप्रतिज्ञा; हेतुः- अकृतकत्वादिति; दृष्टान्तः- यथाऽऽकाशमिति; उपनयः- यथाचाकृतकमाकाशं, तच्चनित्यं, तथापुरुषइति; निगमनं- तस्मान्नित्यइति||३१||
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atha sthāpanā- sthāpanā nāma tasyā ēva pratijñāyā hētudr̥ṣṭāntōpanayanigamanaiḥ sthāpanā| pūrvaṁ hi pratijñā, paścāt sthāpanā, kiṁ hyapratijñātaṁ sthāpayiṣyati; yathā- nityaḥ puruṣa iti pratijñā; hētuḥ- akr̥takatvāditi; dr̥ṣṭāntaḥ - yathā''kāśamiti; upanayaḥ- yathā cākr̥takamākāśaṁ, tacca nityaṁ, tathā puruṣa iti; nigamanaṁ- tasmānnitya iti||31||

atha sthApanA- sthApanA nAma tasyA eva pratij~jAyA hetudRuShTAntopanayanigamanaiH sthApanA|
pUrvaM [1] hi pratij~jA, pashcAt sthApanA, kiM hyapratij~jAtaM sthApayiShyati; yathA- nityaH puruSha itipratij~jA; hetuH- akRutakatvAditi; dRuShTAntaH [2] - yathA~a~akAshamiti; upanayaH- yathAcAkRutakamAkAshaM, tacca nityaM, tathA puruSha iti; nigamanaM- tasmAnnitya iti||31||
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<div style="text-align:justify;">
''Sthapana'' is establishing the same proposition on firm ground with the help of ''hetu'' (reason), ''drishtanta'' (instance), ''upanaya'' (correlation) and ''nigamana'' (conclusion). First there is proposition (''pratijna'') and then establishment (''sthapana'') because what can be established (nothing) in absence of proposition? For instance, ‘''purusha'' is eternal’ – this is proposition, reason (''hetu'') is - ‘because of not being created’; instance (''drishtanta'') is – ‘as sky’; correlation (''upanaya'') is – ‘as the sky is uncreated and is eternal so is ''purusha''’; conclusion (''nigamana'') is - ‘therefore, ''purusha'' is eternal.’[31]
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==== 10. ''Pratishthapana'' (counter-assertion) ====
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अथप्रतिष्ठापना- प्रतिष्ठापनानामयातस्याएवपरप्रतिज्ञायाविपरीतार्थस्थापना| यथा- अनित्यःपुरुषइतिप्रतिज्ञा; हेतुः- ऐन्द्रियकत्वादिति; दृष्टान्तः- यथाघटइति, उपनयो- यथाघटऐन्द्रियकःचानित्यः, तथाचायमिति; निगमनं- तस्मादनित्यइति||३२||
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atha pratiṣṭhāpanā- pratiṣṭhāpanā nāma yā tasyā ēva parapratijñāyā viparītārthasthāpanā| yathā- anityaḥ puruṣa iti pratijñā ; hētuḥ- aindriyakatvāditi; dr̥ṣṭāntaḥ- yathā ghaṭa iti, upanayō- yathā ghaṭa aindriyakaḥ sa cānityaḥ, tathā cāyamiti; nigamanaṁ- tasmādanitya iti||32||

atha pratiShThApanA- pratiShThApanA nAma yA tasyA eva parapratij~jAyA [1] viparItArthasthApanA|
yathA- anityaH puruSha iti pratij~jA [2] ; hetuH- aindriyakatvAditi; dRuShTAntaH- yathA ghaTa [3] iti,upanayo- yathA ghaTa aindriyakaH sa cAnityaH, tathA cAyamiti; nigamanaM- tasmAdanitya iti||32||
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<div style="text-align:justify;">
''Pratishthapana'' is giving a contrary statement to the opponent’s proposition. For instance, ‘self is non-eternal’ is proposition (''pratijna''); reason (''hetu'') is-‘because of being perceived by senses’; instance (''drishtanta'') is – ‘as pitcher’; correlation (''upanaya'') is – ‘as pitcher is perceived by senses and is non-eternal so is ‘self’; conclusion (''nigamana'') is – therefore, self is non eternal.[32]
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==== 11. ''Hetu'' (cause) ====
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अथहेतुः- हेतुर्नामोपलब्धिकारणं; तत्प्रत्यक्षम्, अनुमानम्, ऐतिह्यम्, औपम्यमिति; एभिर्हेतुभिर्यदुपलभ्यतेतत्तत्त्वम्||३३||
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atha hētuḥ- hēturnāmōpalabdhikāraṇaṁ; tat pratyakṣam, anumānam, aitihyam, aupamyamiti; ēbhirhētubhiryadupalabhyatē tat tattvam||33||

atha hetuH- heturnAmopalabdhikAraNaM; tat pratyakSham, anumAnam, aitihyam, aupamyamiti;ebhirhetubhiryadupalabhyate tat tattvam||33||
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''Hetu'' is the cause of knowledge such as ''pratyaksha'' (direct perception), ''anumana'' (inference), ''aitihya'' (traditional instruction) and ''aupamya'' (analogy). That which is revealed by these reasons is ''tattva'' (truth).[33]

==== 12. ''Drishtanta'' (instance) ====
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अथदृष्टान्तः- दृष्टान्तोनामयत्रमूर्खविदुषांबुद्धिसाम्यं, योवर्ण्यंवर्णयति| यथा- अग्निरुष्णः, द्रवमुदकं, स्थिरापृथिवी, आदित्यःप्रकाशकइति; यथाआदित्यःप्रकाशकस्तथासाङ्ख्यज्ञानंप्रकाशकमिति||३४||
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atha dr̥ṣṭāntaḥ- dr̥ṣṭāntō nāma yatra mūrkhaviduṣāṁ buddhisāmyaṁ, yō varṇyaṁ varṇayati | yathā- agniruṣṇaḥ, dravamudakaṁ, sthirā pr̥thivī, ādityaḥ prakāśaka iti; yathā ādityaḥ prakāśakastathā sāṅkhyajñānaṁ prakāśakamiti||34||

atha dRuShTAntaH- dRuShTAnto nAma yatra mUrkhaviduShAM buddhisAmyaM, yo varNyaM varNayati [1] |
yathA- agniruShNaH, dravamudakaM, sthirA pRuthivI, AdityaH prakAshaka iti; yathA AdityaH [2]prakAshakastathA sA~gkhyaj~jAnaM [3] prakAshakamiti||34||
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''Drishtanta'' is that which arouses alike understanding in the fools and the learned. It presents a picturesque image of the objective to be defined. For instance, hot like fire, fluid like water, stable like earth and illuminating like the sun, as the sun illuminates similarly the knowledge of the ''Sankhya'' is also illuminating. [34]
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==== 13-14. ''Upanaya'' (correlation) and ''Nigamana''(conclusion) ====
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उपनयोनिगमनंचोक्तंस्थापनाप्रतिष्ठापनाव्याख्यायाम्||३५||
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upanayō nigamanaṁ cōktaṁ sthāpanāpratiṣṭhāpanāvyākhyāyām||35||

upanayo nigamanaM coktaM sthApanApratiShThApanAvyAkhyAyAm||35||
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''Upanaya'' and ''Nigamana'' are explained under the headings ''sthapana'' and ''pratishthapana''.[35]

==== 15. ''Uttara'' (rejoinder) ====
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अथोत्तरम्- उत्तरंनामसाधर्म्योपदिष्टेहेतौवैधर्म्यवचनं, वैधर्म्योपदिष्टेवाहेतौसाधर्म्यवचनम्| यथा- ‘हेतुसधर्माणोविकाराः, शीतकस्यहिव्याधेर्हेतुभिःसाधर्म्यंहिमशिशिरवातसंस्पर्शाः’, इतिब्रुवतःपरोब्रूयात्- हेतुविधर्माणोविकाराः, यथाशरीरावयवानांदाहौष्ण्यकोथप्रपचनेहेतुवैधर्म्यंहिमशिशिरवातसंस्पर्शाइति| एतत्सविपर्ययमुत्तरम्||३६||
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athōttaram- uttaraṁ nāma sādharmyōpadiṣṭē hētau vaidharmyavacanaṁ, vaidharmyōpadiṣṭē vā hētau sādharmyavacanam| yathā- ‘hētusadharmāṇō vikārāḥ, śītakasya hi vyādhērhētubhiḥ sādharmyaṁ himaśiśiravātasaṁsparśāḥ’, iti bruvataḥ parō brūyāt- hētuvidharmāṇō vikārāḥ, yathā śarīrāvayavānāṁ dāhauṣṇyakōthaprapacanē hētuvaidharmyaṁ himaśiśiravātasaṁsparśā iti| ētat saviparyayamuttaram||36||

athottaram- uttaraM nAma sAdharmyopadiShTe hetau vaidharmyavacanaM, vaidharmyopadiShTe vAhetau sAdharmyavacanam|
yathA- ‘hetusadharmANo vikArAH, shItakasya hi vyAdherhetubhiH sAdharmyaMhimashishiravAtasaMsparshAH’, iti bruvataH paro brUyAt- hetuvidharmANo vikArAH, yathAsharIrAvayavAnAM dAhauShNyakothaprapacane hetuvaidharmyaM [1] himashishiravAtasaMsparshA iti|
etat saviparyayamuttaram||36||
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<div style="text-align:justify;">
''Uttara'' is the statement made in opposition (heterogeneous) to the homologous nature shown between ''hetu'' and ''karya'' and vice versa. For instance , if somebody says – disorders are similar to cause, as ''shitaka'' disease has similar causes like exposure to snow and cold wave, the opponent may say – disorders are dissimilar to cause as burning sensation, heat, sloughing and suppuration of body parts are caused by cold wave which is dissimilar. This is ''uttara'' (rejoinder) with contrary statements.[36]
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==== 16. ''Siddhanta'' (theory/doctrine) ====
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अथसिद्धान्तः- सिद्धान्तोनामसयःपरीक्षकैर्बहुविधंपरीक्ष्यहेतुभिश्चसाधयित्वास्थाप्यतेनिर्णयः| सचतुर्विधः- सर्वतन्त्रसिद्धान्तः, प्रतितन्त्रसिद्धान्तः, अधिकरणसिद्धान्तः, अभ्युपगमसिद्धान्तश्चेति| तत्रसर्वतन्त्रसिद्धान्तोनामतस्मिंस्तस्मिन्सर्वस्मिंस्तन्त्रेतत्तत्प्रसिद्धं; यथासन्तिनिदानानि, सन्तिव्याधयः, सन्तिसिद्ध्युपायाःसाध्यानामिति| प्रतितन्त्रसिद्धान्तोनामतस्मिंस्तस्मिन्नेकैकस्मिंस्तन्त्रेतत्तत्प्रसिद्धं; यथा- अन्यत्राष्टौरसाःषडत्र, पञ्चेन्द्रियाण्यत्रषडिन्द्रियाण्यन्यत्रतन्त्रे, वातादिकृताःसर्वेविकारायथाऽन्यत्र, अत्रवातादिकृताभूतकृताश्चप्रसिद्धाः| अधिकरणसिद्धान्तोनामसयस्मिन्नधिकरणेप्रस्तूयमानेसिद्धान्यन्यान्यप्यधिकरणानिभवन्ति, यथा- ‘नमुक्तःकर्मानुबन्धिकंकुरुते, निस्पृहत्वात्इतिप्रस्तुतेसिद्धाःकर्मफल-मोक्ष-पुरुष-प्रेत्यभावाभवन्ति| अभ्युपगमसिद्धान्तोनामसयमर्थमसिद्धमपरीक्षितमनुपदिष्टमहेतुकंवावादकालेऽभ्युपगच्छन्तिभिषजः; तद्यथा- द्रव्यंप्रधानमितिकृत्वावक्ष्यामः, गुणाःप्रधानमितिकृत्वावक्ष्यामः, वीर्यंप्रधानमितिकृत्वावक्ष्यामः, इत्येवमादिः| इतिचतुर्विधःसिद्धान्तः||३७||
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atha siddhāntaḥ- siddhāntō nāma sa yaḥ parīkṣakairbahuvidhaṁ parīkṣya hētubhiśca sādhayitvā sthāpyatē nirṇayaḥ| sa caturvidhaḥ- sarvatantrasiddhāntaḥ, pratitantrasiddhāntaḥ, adhikaraṇasiddhāntaḥ, abhyupagamasiddhāntaścēti| tatra sarvatantrasiddhāntō nāma tasmiṁstasmin sarvasmiṁstantrē tattat prasiddhaṁ; yathā santi nidānāni, santi vyādhayaḥ, santi siddhyupāyāḥ sādhyānāmiti| pratitantrasiddhāntō nāma tasmiṁstasminnēkaikasmiṁstantrē tattat prasiddhaṁ; yathā- anyatrāṣṭau rasāḥ ṣaḍatra, pañcēndriyāṇyatra ṣaḍindriyāṇyanyatra tantrē, vātādikr̥tāḥ sarvē vikārā yathā'nyatra, atra vātādikr̥tā bhūtakr̥tāśca prasiddhāḥ| adhikaraṇasiddhāntō nāma sa yasminnadhikaraṇē prastūyamānē siddhānyanyānyapyadhikaraṇāni bhavanti, yathā- ‘na muktaḥ karmānubandhikaṁ kurutē, nispr̥hatvāt iti prastutē siddhāḥ karmaphala-mōkṣa-puruṣa-prētyabhāvā bhavanti| abhyupagamasiddhāntō nāma sa yamarthamasiddhamaparīkṣitamanupadiṣṭamahētukaṁ vā vādakālē'bhyupagacchanti bhiṣajaḥ; tadyathā- dravyaṁ pradhānamiti kr̥tvā vakṣyāmaḥ, guṇāḥ pradhānamiti kr̥tvā vakṣyāmaḥ, vīryaṁ pradhānamiti kr̥tvā vakṣyāmaḥ, ityēvamādiḥ| iti caturvidhaḥ siddhāntaḥ||37||

atha siddhAntaH- siddhAnto nAma sa yaH parIkShakairbahuvidhaM parIkShya hetubhishca sAdhayitvAsthApyate nirNayaH|
sa caturvidhaH- sarvatantrasiddhAntaH, pratitantrasiddhAntaH, adhikaraNasiddhAntaH,abhyupagamasiddhAntashceti|
tatra sarvatantrasiddhAnto nAma tasmiMstasmin sarvasmiMstantre tattat prasiddhaM; yathA santinidAnAni, santi vyAdhayaH, santi siddhyupAyAH sAdhyAnAmiti|
pratitantrasiddhAnto nAma tasmiMstasminnekaikasmiMstantre tattat prasiddhaM; yathA- anyatrAShTaurasAH ShaDatra, pa~jcendriyANyatra ShaDindriyANyanyatra tantre, vAtAdikRutAH sarve vikArAyathA~anyatra, atra vAtAdikRutA bhUtakRutAshca prasiddhAH|
adhikaraNasiddhAnto nAma sa yasminnadhikaraNe prastUyamAne siddhAnyanyAnyapyadhikaraNAnibhavanti, yathA- ‘na muktaH karmAnubandhikaM kurute, nispRuhatvAt iti prastute siddhAH karmaphala-mokSha-puruSha-pretyabhAvA bhavanti|
abhyupagamasiddhAnto nAma sa yamarthamasiddhamaparIkShitamanupadiShTamahetukaM vAvAdakAle~abhyupagacchanti bhiShajaH; tadyathA- dravyaM pradhAnamiti kRutvA vakShyAmaH, guNAHpradhAnamiti kRutvA vakShyAmaH, vIryaM [1] pradhAnamiti kRutvA vakShyAmaH, ityevamAdiH|
iti caturvidhaH siddhAntaH||37||
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<div style="text-align:justify;">
''Siddhanta'' is the conclusion established by scientists/investigators after testing in several ways and on proving it with reasoning. It is of four types – ''sarvatantra siddhanta, pratitantra siddhanta, adhikaraṇa siddhanta'', and ''abhyupagama siddhanta''.

*'''''Sarvatantra siddhanta''''' is that which is accepted universally by all the treatises such as – there are causes, there are diseases and there are remedies for the curable disorders.
*'''''Pratitantra siddhanta''''' is that which is not universal in nature and is held by only one of the treatises such as – in other treatises there are eight ''rasas'' but here are six; here are the five sense organs while in other texts there are six sense organs; per other texts all diseases are caused by ''vata'', etc. , but in this text they are considered to be caused by ''vata'' and other ''dosha'' as well as ''bhutas''.
*'''''Adhikarana siddhanta''''' is that which is established by implication of other proofs. Such as – the emancipated cannot show any good or bad consequent effect of deeds because of absence of desires. This proves the effects of deeds, emancipation, presence of self and the other world.
*'''''Abhyupagama siddhanta''''' is that which is held up by physicians temporarily and hypothetically during debate though the idea is unproved, untested, uninstructed and irrational such as – proposing that ''dravya'' is predominant or ''guna'' or properties are predominant or ''veerya'' is predominant.
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These are four types of doctrines. [37]

==== 17. ''Shabda'' (word/correct expression) ====
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अथशब्दः- शब्दोनामवर्णसमाम्नायः; सचतुर्विधः- दृष्टार्थश्च, अदृष्टार्थश्च, सत्यश्च, अनृतश्चेति| तत्रदृष्टार्थोनाम- त्रिभिर्हेतुभिर्दोषाःप्रकुप्यन्ति, षड्भिरुपक्रमैश्चप्रशाम्यन्ति, सतिश्रोत्रादिसद्भावेशब्दादिग्रहणमिति| अदृष्टार्थःपुनः- अस्तिप्रेत्यभावः, अस्तिमोक्षइति| सत्योनाम- यथार्थभूतः; सन्त्यायुर्वेदोपदेशाः, सन्तिसिद्ध्युपायाःसाध्यानांव्याधीनां, सन्त्यारम्भफलानीति| सत्यविपर्ययश्चानृतः||३८||
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śabdaḥ- śabdō nāma varṇasamāmnāyaḥ; sa caturvidhaḥ- dr̥ṣṭārthaśca, adr̥ṣṭārthaśca, satyaśca, anr̥taścēti| tatra dr̥ṣṭārthō nāma- tribhirhētubhirdōṣāḥ prakupyanti, ṣaḍbhirupakramaiśca praśāmyanti, sati śrōtrādisadbhāvē śabdādigrahaṇamiti| adr̥ṣṭārthaḥ punaḥ- asti prētyabhāvaḥ, asti mōkṣa iti| satyō nāma- yathārthabhūtaḥ; santyāyurvēdōpadēśāḥ, santi siddhyupāyāḥ sādhyānāṁ vyādhīnāṁ, santyārambhaphalānīti| satyaviparyayaścānr̥taḥ||38||

atha shabdaH- shabdo nAma varNasamAmnAyaH; sa caturvidhaH- dRuShTArthashca, adRuShTArthashca,satyashca, anRutashceti|
tatra dRuShTArtho nAma- tribhirhetubhirdoShAH prakupyanti, ShaDbhirupakramaishca prashAmyanti, satishrotrAdisadbhAve shabdAdigrahaNamiti|
adRuShTArthaH punaH- asti pretyabhAvaH, asti mokSha iti|
satyo nAma- yathArthabhUtaH; santyAyurvedopadeshAH, santi siddhyupAyAH sAdhyAnAM vyAdhInAM,santyArambhaphalAnIti|
satyaviparyayashcAnRutaH||38||
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<div style="text-align:justify;">
''Shabda'' is an aggregate of letters. This is of four types – ''drishtartha, adrishtartha, satya,'' and ''anrita''.

''Drishtartha'' is that which connotes observable meanings; such as ''dosha'' are aggravated by three etiological factors; they are pacified by six therapeutic measures; the sense objects are perceived through the sense organs.

''Adrishtartha'' is that which connotes unobservable ideas, such as the other world exists; there is emancipation.

''Satya'' is that which is consistent to the facts, such as these are instructions of [[Ayurveda]]; these are the remedial measures for the curable diseases and there exist a result of every action.

''Anrita'' is contrary to ''satya'' (that which is not consistent with facts).[38]
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==== 18. ''Pratyaksha'' (direct perception) ====
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अथप्रत्यक्षं- प्रत्यक्षंनामतद्यदात्मनाचेन्द्रियैश्चस्वयमुपलभ्यते; तत्रात्मप्रत्यक्षाःसुखदुःखेच्छाद्वेषादयः, शब्दादयस्त्विन्द्रियप्रत्यक्षाः||३९||
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atha pratyakṣaṁ- pratyakṣaṁ nāma tadyadātmanā cēndriyaiśca svayamupalabhyatē; tatrātmapratyakṣāḥ sukhaduḥkhēcchādvēṣādayaḥ, śabdādayastvindriyapratyakṣāḥ||39||

atha pratyakShaM- pratyakShaM nAma tadyadAtmanA cendriyaishca svayamupalabhyate;tatrAtmapratyakShAH sukhaduHkhecchAdveShAdayaH, shabdAdayastvindriyapratyakShAH||39||
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''Pratyaksha'' is the knowledge which is directly perceived by the self and the sense organs. Self-perceived are pleasure, pain, desire, aversion etc., while sound etc. are perceived by the sense organs.[39]

==== 19. ''Anumana'' (inference) ====
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अथानुमानम्- अनुमानंनामतर्कोयुक्त्यपेक्षः; यथा- अग्निंजरणशक्त्या, बलंव्यायामशक्त्या, श्रोत्रादीनिशब्दादिग्रहणेनेत्येवमादि||४०||
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athānumānam- anumānaṁ nāma tarkō yuktyapēkṣaḥ; yathā- agniṁ jaraṇaśaktyā, balaṁ vyāyāmaśaktyā, śrōtrādīni śabdādigrahaṇēnētyēvamādi||40||

athAnumAnam- anumAnaM nAma tarko yuktyapekShaH; yathA- agniM jaraNashaktyA, balaMvyAyAmashaktyA, shrotrAdIni shabdAdigrahaNenetyevamAdi||40||
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''Anumana'' is the reasoning supported by invariable concomitance such as the knowledge of ''agni'' (is examined) by the power of digestion; that of strength of a person by examining the power to exercise, auditory organ etc. by the ability of perception of sound, etc.[40]
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==== 20. ''Aitihya'' (traditional instruction) ====
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अलौकिकाप्तोपदेशऐतिह्यपदेनोच्यतइत्याह- वेदादिरिति||४१||
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athaitihyam- aitihyaṁ nāmāptōpadēśō vēdādiḥ||41||

athaitihyam- aitihyaM nAmAptopadesho vedAdiH||41||
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''Aitihya'' is the divine authoritative (or traditional) source of knowledge such as ''veda'' etc.[41]

==== 21.''Aupamya'' (analogy) ====
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अथौपम्यम्- औपम्यंनामयदन्येनान्यस्यसादृश्यमधिकृत्यप्रकाशनं; यथा- दण्डेनदण्डकस्य, धनुषाधनुःस्तम्भस्य, इष्वासेनाऽऽरोग्यदस्येति||४२||
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athaupamyam- aupamyaṁ nāma yadanyēnānyasya sādr̥śyamadhikr̥tya prakāśanaṁ; yathā- daṇḍēna daṇḍakasya, dhanuṣā dhanuḥstambhasya, iṣvāsēnā''rōgyadasyēti||42||

athaupamyam- aupamyaM nAma yadanyenAnyasya sAdRushyamadhikRutya prakAshanaM; yathA-daNDena daNDakasya, dhanuShA dhanuHstambhasya, iShvAsenA~a~arogyadasyeti||42||
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''Aupamya'' is the description of similarity between things such as analogy of ''dandaka'' (a disease in which body is rigid like rod) with ''danda'' (rod); that of ''dhanustambha'' (tetany) with bow and that of the health provider with the archer.[42]

==== 22. ''Samshayah'' (uncertainity) ====
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अथसंशयः- संशयोनामसन्देहलक्षणानुसन्दिग्धेष्वर्थेष्वनिश्चयः ; यथा- दृष्टाह्यायुष्मल्लक्षणैरुपेताश्चानुपेताश्चतथासक्रियाश्चाक्रियाश्चपुरुषाःशीघ्रभङ्गाश्चिरजीविनश्च, एतदुभयदृष्टत्वात्संशयः- किमस्तिखल्वकालमृत्युरुतनास्तीति||४३||
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athasaṁśayaḥ-saṁśayō nāma sandēhalakṣaṇānusandigdhēṣvarthēṣvaniścayaḥ; yathā- dr̥ṣṭā hyāyuṣmallakṣaṇairupētāścānupētāśca tathā sakriyāścākriyāśca puruṣāḥ śīghrabhaṅgāścirajīvinaśca, ētadubhayadr̥ṣṭatvāt saṁśayaḥ- kimasti khalvakālamr̥tyuruta nāstīti ||43||

atha saMshayaH- saMshayo nAma sandehalakShaNAnusandigdheShvartheShvanishcayaH [1] ; yathA-dRuShTA hyAyuShmallakShaNairupetAshcAnupetAshca tathA sakriyAshcAkriyAshca puruShAHshIghrabha~ggAshcirajIvinashca, etadubhayadRuShTatvAt saMshayaH- kimasti khalvakAlamRutyurutanAstIti||43||
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<div style="text-align:justify;">
''Samshayaḥ'' is the state of indecision about the concerned entity. For instance, on observing that both types of persons having signs of longevity or not and they adopting the therapeutic measures or not – die early or live long life, therefore doubt arises as whether there is untimely death or not .[43]
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==== 23. ''Prayojana'' (purpose or intention) ====
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अथप्रयोजनं- प्रयोजनंनामयदर्थमारभ्यन्तआरम्भाः; यथा- यद्यकालमृत्युरस्तिततोऽहमात्मानमायुष्यैरुपचरिष्याम्यनायुष्याणिचपरिहरिष्यामि, कथंमामकालमृत्युःप्रसहेतेति||४४||
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atha prayōjanaṁ- prayōjanaṁ nāma yadarthamārabhyanta ārambhāḥ; yathā- yadyakālamr̥tyurasti tatō'hamātmānamāyuṣyairupacariṣyāmyanāyuṣyāṇi ca parihariṣyāmi, kathaṁ māmakālamr̥tyuḥ prasahētēti||44||

atha prayojanaM- prayojanaM nAma yadarthamArabhyanta ArambhAH; yathA- yadyakAlamRutyurastitato~ahamAtmAnamAyuShyairupacariShyAmyanAyuShyANi ca parihariShyAmi, kathaMmAmakAlamRutyuH prasaheteti||44||
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''Prayojana'' is that for which the actions is initiated. Such as – ‘if there is untimely death then I will use life-promoting measures and avoid the contrary ones. In such condition how would the untimely death subdue me?[44]

==== 24. ''Savyabhichara'' (incompatible argument) ====
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अथसव्यभिचारं- सव्यभिचारंनामयद्व्यभिचरणं; यथा- भवेदिदमौषधमस्मिन्व्याधौयौगिकमथवानेति||४५||
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atha savyabhicāraṁ- savyabhicāraṁ nāma yadvyabhicaraṇaṁ; yathā- bhavēdidamauṣadhamasmin vyādhau yaugikamathavā nēti||45||

atha savyabhicAraM- savyabhicAraM nAma yadvyabhicaraNaM; yathA- bhavedidamauShadhamasminvyAdhau yaugikamathavA neti||45||
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''Savyabhichara''is that argument incompatible with the conclusion drawn from it, such as ‘this medicine may or may not be applicable to this disease.’[45]

==== 25. ''Jijnasa'' (examination) ====
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अथजिज्ञासा- जिज्ञासानामपरीक्षा; यथाभेषजपरीक्षोत्तरकालमुपदेक्ष्यते||४६||
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atha jijñāsā- jijñāsā nāma parīkṣā; yathā bhēṣajaparīkṣōttarakālamupadēkṣyatē||46||

atha jij~jAsA- jij~jAsA nAma parIkShA; yathA bheShajaparIkShottarakAlamupadekShyate||46||
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''Jijnasa'' is the examination. Such as- the examination of drugs will be described later on.[46]

==== 26. ''Vyavasaya'' (resolution) ====
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अथव्यवसायः- व्यवसायोनामनिश्चयः; यथा- वातिकएवायंव्याधिः, इदमेवास्यभेषजंचेति||४७||
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atha vyavasāyaḥ- vyavasāyō nāma niścayaḥ; yathā- vātika ēvāyaṁ vyādhiḥ, idamēvāsya bhēṣajaṁ cēti||47||

atha vyavasAyaH- vyavasAyo nAma nishcayaH; yathA- vAtika evAyaM vyAdhiH, idamevAsya [1] bheShajaMceti||47||
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''Vyavasaya'' is resolution or firm decision, such as- this disease is certainly ''vataja'' and this is the medicament for this.[47]

==== 27. ''Arthaprapti'' ( attainment of meaning) ====
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अथार्थप्राप्तिः- अर्थप्राप्तिर्नामयत्रैकेनार्थेनोक्तेनापरस्यार्थस्यानुक्तस्यापिसिद्धिः; यथा- नायंसन्तर्पणसाध्योव्याधिरित्युक्तेभवत्यर्थप्राप्तिः- अपतर्पणसाध्योऽयमिति, नानेनदिवाभोक्तव्यमित्युक्तेभवत्यर्थप्राप्तिः- निशिभोक्तव्यमिति||४८||
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athārthaprāptiḥ- arthaprāptirnāma yatraikēnārthēnōktēnāparasyārthasyānuktasyāpi siddhiḥ; yathā- nāyaṁ santarpaṇasādhyō vyādhirityuktē bhavatyarthaprāptiḥ- apatarpaṇasādhyō'yamiti, nānēna divā bhōktavyamityuktē bhavatyarthaprāptiḥ- niśi bhōktavyamiti||48||

athArthaprAptiH- arthaprAptirnAma yatraikenArthenoktenAparasyArthasyAnuktasyApi siddhiH; yathA-nAyaM santarpaNasAdhyo vyAdhirityukte bhavatyarthaprAptiH- apatarpaNasAdhyo~ayamiti, nAnena divAbhoktavyamityukte bhavatyarthaprAptiH- nishi bhoktavyamiti||48||
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''Arthaprapti'' is that where another unsaid idea is conveyed by the said one, such as when one says that the disease is not to be managed with saturating therapy it implies that it is to be managed with desaturation therapy. He should not eat during day, implies that he should eat during night. [48]
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==== 28. ''Sambhava'' (source) ====
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अथसम्भवः- योयतःसम्भवतिसतस्यसम्भवः; यथा- षड्धातवोगर्भस्य, व्याधेरहितं, हितमारोग्यस्येति||४९||
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atha sambhavaḥ- yō yataḥ sambhavati sa tasya sambhavaḥ; yathā- ṣaḍdhātavō garbhasya, vyādhērahitaṁ, hitamārōgyasyēti||49||

atha sambhavaH- yo yataH sambhavati sa tasya sambhavaH; yathA- ShaDdhAtavo garbhasya,vyAdherahitaM, hitamArogyasyeti||49||
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''Sambhava'' is that from which something is originated, such as six dhatus from which foetus has origin, disease have origin from unwholesome things and health have origin from wholesome things.[49]

==== 29. ''Anuyojya'' (censurable) ====
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अथानुयोज्यम्- अनुयोज्यंनामयद्वाक्यंवाक्यदोषयुक्तंतत्| सामान्यतोव्याहृतेष्वर्थेषुवाविशेषग्रहणार्थंयद्वाक्यंतदप्यनुयोज्यं; यथा- ‘संशोधनसाध्योऽयंव्याधिः’इत्युक्ते‘किंवमनसाध्योऽयं, किंवाविरेचनसाध्यः’इत्यनुयुज्यते||५०||
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athānuyōjyam- anuyōjyaṁ nāma yadvākyaṁ vākyadōṣayuktaṁ tat| sāmānyatō vyāhr̥tēṣvarthēṣu vā viśēṣagrahaṇārthaṁ yadvākyaṁ tadapyanuyōjyaṁ; yathā- ‘saṁśōdhanasādhyō'yaṁ vyādhiḥ’ ityuktē ‘kiṁ vamanasādhyō'yaṁ, kiṁvā virēcanasādhyaḥ’ ityanuyujyatē||50||

athAnuyojyam- anuyojyaM nAma yadvAkyaM vAkyadoShayuktaM tat|
sAmAnyato [1] vyAhRuteShvartheShu vA visheShagrahaNArthaM yadvAkyaM tadapyanuyojyaM; yathA-‘saMshodhanasAdhyo~ayaM vyAdhiH’ ityukte ‘kiM vamanasAdhyo~ayaM, kiMvA virecanasAdhyaH’ityanuyujyate||50||
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''Anuyojya''–is that where sentence is defective or has unspecified meaning inviting further questions, such as if somebody says ‘the disease is to be managed with evacuative therapy’ it invites further question as to ‘whether it is to be managed with emesis or purgation.[50]
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==== 30. ''Ananuyojya'' (incensurable) ====
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अथाननुयोज्यम्- अननुयोज्यंनामातोविपर्ययेण; यथा- अयमसाध्यः||५१||
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athānanuyōjyam- ananuyōjyaṁ nāmātō viparyayēṇa; yathā- ayamasādhyaḥ||51||

athAnanuyojyam- ananuyojyaM nAmAto viparyayeNa; yathA- ayamasAdhyaH||51||
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''Ananuyojya'' is contrary to the above. Such as this is incurable.[51]

==== 31. ''Anuyoga'' (query with example) ====
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अथानुयोगः- अनुयोगोनामसयत्तद्विद्यानांतद्विद्यैरेवसार्धंतन्त्रेतन्त्रैकदेशेवाप्रश्नःप्रश्नैकदेशोवाज्ञानविज्ञानवचनप्रतिवचनपरीक्षार्थमादिश्यते| यथा- ‘नित्यःपुरुषः’इतिप्रतिज्ञातेयत्परः‘कोहेतुः’इत्याह, सोऽनुयोगः||५२||
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athānuyōgaḥ- anuyōgō nāma sa yat tadvidyānāṁ tadvidyairēva sārdhaṁ tantrē tantraikadēśē vā praśnaḥpraśnaikadēśō vā jñānavijñānavacanaprativacanaparīkṣārthamādiśyatē| yathā- ‘nityaḥ puruṣaḥ’ iti pratijñātē yat paraḥ ‘kō hētuḥ’ ityāha, sō'nuyōgaḥ||52||

athAnuyogaH- anuyogo nAma sa yat tadvidyAnAM tadvidyaireva sArdhaM tantre tantraikadeshe vAprashnaHprashnaikadesho vA j~jAnavij~jAnavacanaprativacanaparIkShArthamAdishyate|
yathA- ‘nityaH puruShaH’ iti pratij~jAte yat paraH ‘ko hetuH’ ityAha, so~anuyogaH||52||
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''Anuyoga'' is that which is put as query, wholly or partly, on the text or its part during discussion of experts for the test of learning, understanding, speaking and contradiction, such as on the statement of self eternal, somebody says, what is the reason, this is ''anuyoga''. [52]
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==== 32. ''Pratyanuyoga''(counter-question)====
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अथप्रत्यनुयोगः- प्रत्यनुयोगोनामानुयोगस्यानुयोगः; यथा- अस्यानुयोगस्यपुनःकोहेतुरिति||५३||
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atha pratyanuyōgaḥ- pratyanuyōgō nāmānuyōgasyānuyōgaḥ; yathā- asyānuyōgasya punaḥ kō hēturiti||53||

atha pratyanuyogaH- pratyanuyogo nAmAnuyogasyAnuyogaH; yathA- asyAnuyogasya punaH koheturiti||53||
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''Pratyanuyoga'' is questioning the questions, such as when ''anuyoga'' i.e query has been raised then again questioning what is the reason of this query is called as ''pratyanuyoga'' .[53]

====33. ''Vakyadosha'' (syntactical defects)====
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अथवाक्यदोषः- वाक्यदोषोनामयथाखल्वस्मिन्नर्थेन्यूनम्, अधिकम्, अनर्थकम्, अपार्थकं, विरुद्धंचेति; एतानिह्यन्तरेणनप्रकृतोऽर्थःप्रणशयेत्| तत्रन्यूनं- प्रतिज्ञाहेतूदाहरणोपनयनिगमनानामन्यतमेनापिन्यूनंन्यूनंभवति; यद्वाबहूपदिष्टहेतुकमेकेनहेतुनासाध्यतेतच्चन्यूनम्| अथाधिकम्- अधिकंनामयन्न्यूनविपरीतं, यद्वाऽऽयुर्वेदेभाष्यमाणेबार्हस्पत्यमौशनसमन्यद्वायत्किञ्चिदप्रतिसम्बद्धार्थमुच्यते, यद्वासम्बद्धार्थमपिद्विरभिधीयतेतत्पुनरुक्तदोषत्वादधिकं; तच्चपुनरुक्तंद्विविधम्- अर्थपुनरुक्तं, शब्दपुनरुक्तंच; तत्रार्थपुनरुक्तंयथा- भेषजमौषधंसाधनमिति, शब्दपुनरुक्तंपुनर्भेषजंभेषजमिति| अथानर्थकम्- अनर्थकंनामयद्वचनमक्षरग्राममात्रमेवस्यात्पञ्चवर्गवन्नचार्थतोगृह्यते| अथापार्थकम्- अपार्थकंनामयदर्थवच्चपरस्परेणासंयुज्यमानार्थकं; यथा- चक्र-न(त)क्र-वंश-वज्र-निशाकराइति| अथविरुद्धं- विरुद्धंनामयद्दृष्टान्तसिद्धान्तसमयैर्विरुद्धं; तत्रपूर्वंदृष्टान्तसिद्धान्तावुक्तौःसमयःपुनस्त्रिधाभवति; यथा- आयुर्वैदिकसमयः, याज्ञिकसमयः, मोक्षशास्त्रिकसमयश्चेति; तत्रायुर्वैदिकसमयः- चतुष्पादंभेषजमिति, याज्ञिकसमयः- आलभ्यायजमानैःपशवइति, मोक्षशास्त्रिकसमयः- सर्वभूतेष्वहिंसेति; तत्रस्वसमयविपरीतमुच्यमानंविरुद्धंभवति| इतिवाक्यदोषाः||५४||
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atha vākyadōṣaḥ- vākyadōṣō nāma yathā khalvasminnarthē nyūnam, adhikam, anarthakam, apārthakaṁ, viruddhaṁ cēti; ētāni hyantarēṇa na prakr̥tō'rthaḥ praṇaśayēt| tatra nyūnaṁ- pratijñāhētūdāharaṇōpanayanigamanānāmanyatamēnāpi nyūnaṁ nyūnaṁ bhavati; yadvā bahūpadiṣṭahētukamēkēna hētunā sādhyatē tacca nyūnam| athādhikam- adhikaṁ nāma yannyūnaviparītaṁ, yadvā yurvēdē bhāṣyamāṇē bārhaspatyamauśanasamanyadvā yatkiñcidapratisambaddhārthamucyatē, yadvā sambaddhārthamapi dvirabhidhīyatē tat punaruktadōṣatvādadhikaṁ; tacca punaruktaṁ dvividham- arthapunaruktaṁ, śabdapunaruktaṁ ca; tatrārthapunaruktaṁ yathā- bhēṣajamauṣadhaṁ sādhanamiti, śabdapunaruktaṁ punarbhēṣajaṁ bhēṣajamiti| athānarthakam- anarthakaṁ nāma yadvacanamakṣaragrāmamātramēva syāt pañcavargavanna cārthatō gr̥hyatē| athāpārthakam- apārthakaṁ nāma yadarthavacca parasparēṇāsaṁyujyamānārthakaṁ; yathā- cakra-na(ta)kra-vaṁśa-vajra-niśākarā iti| atha viruddhaṁ- viruddhaṁ nāma yaddr̥ṣṭāntasiddhāntasamayairviruddhaṁ; tatra pūrvaṁ dr̥ṣṭāntasiddhāntāvuktauḥ samayaḥ punastridhā bhavati; yathā- āyurvaidikasamayaḥ, yājñikasamayaḥ, mōkṣaśāstrikasamayaścēti; tatrāyurvaidikasamayaḥ- catuṣpādaṁ bhēṣajamiti, yājñikasamayaḥ- ālabhyā yajamānaiḥ paśava iti, mōkṣaśāstrikasamayaḥ- sarvabhūtēṣvahiṁsēti; tatra svasamayaviparītamucyamānaṁ viruddhaṁ bhavati| iti vākyadōṣāḥ||54||

atha vAkyadoShaH- vAkyadoSho nAma yathA khalvasminnarthe nyUnam, adhikam, anarthakam,apArthakaM, viruddhaM ceti; etAni hyantareNa na prakRuto~arthaH praNashayet|
tatra nyUnaM- pratij~jAhetUdAharaNopanayanigamanAnAmanyatamenApi nyUnaM nyUnaM bhavati;yadvA bahUpadiShTahetukamekena hetunA sAdhyate tacca nyUnam|
athAdhikam- adhikaM nAma yannyUnaviparItaM, yadvA~a~ayurvede bhAShyamANebArhaspatyamaushanasamanyadvA yatki~jcidapratisambaddhArthamucyate, yadvA sambaddhArthamapidvirabhidhIyate tat punaruktadoShatvAdadhikaM; tacca punaruktaM dvividham- arthapunaruktaM,shabdapunaruktaM ca; tatrArthapunaruktaM yathA- bheShajamauShadhaM sAdhanamiti,shabdapunaruktaM punarbheShajaM bheShajamiti|
athAnarthakam- anarthakaM nAma yadvacanamakSharagrAmamAtrameva syAt pa~jcavargavannacArthato gRuhyate|
athApArthakam- apArthakaM nAma yadarthavacca paraspareNAsaMyujyamAnArthakaM; yathA- cakra-na(ta)kra-vaMsha-vajra-nishAkarA iti|
atha viruddhaM- viruddhaM nAma yaddRuShTAntasiddhAntasamayairviruddhaM; tatra pUrvaMdRuShTAntasiddhAntAvuktauH samayaH punastridhA bhavati; yathA- AyurvaidikasamayaH,yAj~jikasamayaH, mokShashAstrikasamayashceti; tatrAyurvaidikasamayaH- catuShpAdaM bheShajamiti,yAj~jikasamayaH- AlabhyA yajamAnaiH pashava iti, mokShashAstrikasamayaH- sarvabhUteShvahiMseti;tatra svasamayaviparItamucyamAnaM viruddhaM bhavati|
iti vAkyadoShAH||54||
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<div style="text-align:justify;">
''Vakyadosha'' (syntactical defects), in this context, is of five types – ''nyunam, adhikam, anarthakam, aparthakam, viruddham''. Without these there is no damage to the contextual sense.

#''Nyunam'' (semantic deficiency) such as – if there is lack of even one of the five – proposition (''pratijna''), reason (''hetu''), instance (''udaharan''), correlation (''upanaya'') and conclusion (''nigaman'') or if there be many reasons and only one reason is resorted to for proving something than it is defined as ''nyunam''.
#Adhikam (superfluity) is just contrary to nyunam such as while talking about [[Ayurveda]] one says about some irrelevant texts such as that composed by Barhaspatyam or Aushana or even if relevant it is repeated unnecessarily than the repetition (''punarikti'') also comes under ''adhikam'' (superfluity). Repetition (''punarikta'') is of two types – ''arthapunaruktam'' (semantic repetition) and ''shabdapunaruktam'' (verbal repetition). The former (''arthapunaruktam'') consists of the repetition of the same idea by different synonymous words such as ''bheshajam, aushadham'' and ''sadhanam'' and the repetition of the same word such as, ''bheshaja'' is called as ''shabdapunaruktam''.
#''Anarthakam'' (nonessential statement) is that where there is only jumble of alphabets devoid of any sense. ''Aparthakam'' is deprivation of meaning due to lack of mutual connection of otherwise meaningful words such as, ''chakra-na(ta)kra-vamsha-vajra-nishakara''.
#''Viruddham''(Incongruity) is considered in relation to instance (''drishtanta''), theory (''siddhanta'') and convention (''samaya'').

Instance (''drishtanta'') and theory have already been described earlier.

Now convention (''samaya'') is of three types – ''Ayurvedic samaya, yajnika samaya,'' (ritual) and ethical (''mokshashastrika''). Ayurvedic ''samaya'' (ayurvedic convention) such as four aspects of health care, ''yajnika samaya'' (ritual convention) such as animals are to be sacrificed by persons following rituals, ''mokshashastrika'' (ethical convention) such as non-violence towards all creatures. The statement incongruous in respect of the respective convention is taken as ''viruddha'' (incongruity). Thus are the ''vakyadosha'' (syntactical defects).[54]
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====34.''Vakyaprashamsa'' (syntactical excellence) ====
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अथवाक्यप्रशंसा- वाक्यप्रशंसानामयथाखल्वस्मिन्नर्थेत्वन्यूनम्, अनधिकम्, अर्थवत्, अनपार्थकम्, अविरुद्धम्, अधिगतपदार्थंचेतियत्तद्वाक्यमननुयोज्यमितिप्रशस्यते||५५||
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atha vākyapraśaṁsā- vākyapraśaṁsā nāma yathā khalvasminnarthē tvanyūnam, anadhikam, arthavat, anapārthakam, aviruddham, adhigatapadārthaṁ cēti yattadvākyamananuyōjyamiti praśasyatē||55||

atha vAkyaprashaMsA- vAkyaprashaMsA nAma yathA khalvasminnarthe tvanyUnam, anadhikam, arthavat, anapArthakam, aviruddham, adhigatapadArthaM ceti yattadvAkyamananuyojyamiti prashasyate||55||
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<div style="text-align:justify;">
''Vakyaprashamsa'' (syntactical excellence) is that where the statement is free from deficiency (''anyunam'') and superfluity (''anadhikam''), is meaningful (''arthavat''), devoid of deprivation of meaning (''anaparthaka'') and incongruity (''aviruddham'') and comprehensible (''adhigatapadartham''). Further there is no room for any question. Such statement is commended. [55]
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==== 35. ''Chhala'' (knavery) ====
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अथच्छलं- छलंनामपरिशठमर्थाभासमनर्थकंवाग्वस्तुमात्रमेव| तद्द्विविधं- वाक्छलं, सामान्यच्छलंच| तत्रवाक्छलंनामयथा- कश्चिद्ब्रूयात्- नवतन्त्रोऽयंभिषगिति, अथभिषग्ब्रूयात्- नाहंनवतन्त्रएकतन्त्रोऽहमिति; परोब्रूयात्- नाहंब्रवीमिनवतन्त्राणितवेति, अपितुनवाभ्यस्तंतेतन्त्रमिति; भिषक्ब्रूयात्- नमयानवाभ्यस्तंतन्त्रम्, अनेकधाऽभ्यस्तंमयातन्त्रमिति; एतद्वाक्छलम्| सामान्यच्छलंनामयथा- व्याधिप्रशमनायौषधमित्युक्ते, परोब्रूयात्- सत्सत्प्रशमनायेतिकिंनुभवानाह; सन्हिरोगः, सदौषधं; यदिचसत्सत्प्रशमनायभवति, तत्रसत्कासः, सत्क्षयः, सत्सामान्यात्कासस्तेक्षयप्रशमनायभविष्यतीति|
एतत्सामान्यच्छलम्||५६||
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atha chhalaṁ- chalaṁ nāma pariśaṭhamarthābhāsamanarthakaṁ vāgvastumātramēva| taddvividhaṁ- vākchalaṁ, sāmānyacchalaṁ ca| tatra vākchalaṁ nāma yathā- kaścidbrūyāt- navatantrō'yaṁ bhiṣagiti, atha bhiṣag brūyāt- nāhaṁ navatantra ēkatantrō'hamiti; parō brūyāt- nāhaṁ bravīmi nava tantrāṇi tavēti, api tu navābhyastaṁ tē tantramiti; bhiṣak brūyāt- na mayā navābhyastaṁ tantram, anēkadhā'bhyastaṁ mayā tantramiti; ētadvākchalam| sāmānyacchalaṁ nāma yathā- vyādhipraśamanāyauṣadhamityuktē, parō brūyāt- sat satpraśamanāyēti kiṁ nu bhavānāha; san hi rōgaḥ, sadauṣadhaṁ; yadi ca sat satpraśamanāya bhavati, tatra sat kāsaḥ, sat kṣayaḥ, satsāmānyāt kāsastē kṣayapraśamanāya bhaviṣyatīti| ētat sāmānyacchalam||56||

atha cchalaM- chalaM nAma parishaThamarthAbhAsamanarthakaM vAgvastumAtrameva|
taddvividhaM- vAkchalaM, sAmAnyacchalaM ca|
tatra vAkchalaM nAma yathA- kashcidbrUyAt- navatantro~ayaM bhiShagiti, atha bhiShag brUyAt- nAhaMnavatantra ekatantro~ahamiti; paro brUyAt- nAhaM bravImi nava tantrANi taveti, api tu navAbhyastaM tetantramiti; bhiShak brUyAt- na mayA navAbhyastaM tantram, anekadhA~abhyastaM mayA tantramiti;etadvAkchalam|
sAmAnyacchalaM nAma yathA- vyAdhiprashamanAyauShadhamityukte, paro brUyAt- satsatprashamanAyeti kiM nu bhavAnAha; san hi rogaH, sadauShadhaM; yadi ca sat satprashamanAyabhavati, tatra sat kAsaH, sat kShayaH, satsAmAnyAt kAsaste kShayaprashamanAya bhaviShyatIti|
etat sAmAnyacchalam||56||
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<div style="text-align:justify;">
''Chhala'' is only a jugglery of words in which the words are used knavishly, with apparent meaning or without meaning. This is of two types – ''vakchchalam'' and ''samanyachhala.''

''Vakchhala'' (verbal knavery), such as – if somebody says – this physician is ''navatantra'', then the physician retorts – I have not studied nine texts but only one ''tantra''. Opponent if replies that I do not mean you have read nine ''tantra'' but you are new in this field. On this the physician says – I have not practiced the text nine times but many times. This is verbal knavery.

''Samanya chhala'' (knavery in general), such as – when somebody says – medicament is for alleviating the disease. The other says – how do you say the existent is for alleviating the existent because disease is existent and also the medicament, if the existent is capable of alleviating the existent, then both cough and wasting being existent, cough may be able to alleviate wasting. This is a knavery in general. [56]
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==== 36. ''Ahetu'' (fallacious reason) ====
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अथाहेतुः- अहेतुर्नामप्रकरणसमः, संशयसमः, वर्ण्यसमश्चेति| तत्रप्रकरणसमोनामाहेतुर्यथा- अन्यःशरीरादात्मानित्यइति; परोब्रूयात्- यस्मादन्यःशरीरादात्मा, तस्मान्नित्यः; शरीरंह्यनित्यमतोविधर्मिणाचात्मनाभवितव्यमित्येषचाहेतुः; नहियएवपक्षःसएवहेतुरिति| संशयसमोनामाहेतुर्यएवसंशयहेतुःसएवसंशयच्छेदहेतुः; यथा- अयमायुर्वेदैकदेशमाह, किन्न्वयंचिकित्सकःस्यान्नवेतिसंशयेपरोब्रूयात्- यस्मादयमायुर्वेदैकदेशमाहतस्माच्चिकित्सकोऽयमिति, नचसंशयच्छेदहेतुंविशेषयति, एषचाहेतुः; नहियएवसंशयहेतुः, सएवसंशयच्छेदहेतुर्भवति| वर्ण्यसमोनामाहेतुः- योहेतुर्वर्ण्याविशिष्टः; यथा- कश्चिद्बूयात्- अस्पर्शत्वाद्बुद्धिरनित्याशब्दवदिति; अत्रवर्ण्यःशब्दोबुद्धिरपिवर्ण्या, तदुभयवर्ण्याविशिष्टत्वाद्वर्ण्यसमोऽप्यहेतुः||५७||
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athāhētuḥ- ahēturnāmaprakaraṇasamaḥ, saṁśayasamaḥ, varṇyasamaścēti| tatra prakaraṇasamō nāmāhēturyathā- anyaḥ śarīrādātmā nitya iti; parō brūyāt- yasmādanyaḥ śarīrādātmā, tasmānnityaḥ; śarīraṁ hyanityamatō vidharmiṇā cātmanā bhavitavyamityēṣa cāhētuḥ; nahi ya ēva pakṣaḥ sa ēva hēturiti| saṁśayasamō nāmāhēturya ēva saṁśayahētuḥ sa ēva saṁśayacchēdahētuḥ; yathā- ayamāyurvēdaikadēśamāha, kinnvayaṁ cikitsakaḥ syānna vēti saṁśayē parō brūyāt- yasmādayamāyurvēdaikadēśamāha tasmāccikitsakō'yamiti, na ca saṁśayacchēdahētuṁ viśēṣayati, ēṣa cāhētuḥ; na hi ya ēva saṁśayahētuḥ, sa ēva saṁśayacchēdahēturbhavati| varṇyasamō nāmāhētuḥ- yō hēturvarṇyāviśiṣṭaḥ; yathā- kaścidbūyāt- asparśatvādbuddhiranityā śabdavaditi; atra varṇyaḥ śabdō buddhirapi varṇyā, tadubhayavarṇyāviśiṣṭatvādvarṇyasamō'pyahētuḥ||57||

athAhetuH- aheturnAmaprakaraNasamaH, saMshayasamaH, varNyasamashceti|
tatra prakaraNasamo nAmAheturyathA- anyaH sharIrAdAtmA nitya iti; paro brUyAt- yasmAdanyaHsharIrAdAtmA, tasmAnnityaH; sharIraM hyanityamato vidharmiNA cAtmanA [1] bhavitavyamityeShacAhetuH; nahi ya eva pakShaH sa eva heturiti|
saMshayasamo nAmAheturya eva saMshayahetuH sa eva saMshayacchedahetuH; yathA-ayam[[Ayurveda]]ikadeshamAha, kinnvayaM cikitsakaH syAnna veti saMshaye paro brUyAt-yasmAdayam[[Ayurveda]]ikadeshamAha tasmAccikitsako~ayamiti, na ca saMshayacchedahetuMvisheShayati, eSha cAhetuH; na hi ya eva saMshayahetuH, sa eva saMshayacchedaheturbhavati|
varNyasamo nAmAhetuH- yo heturvarNyAvishiShTaH; yathA- kashcidbUyAt- asparshatvAdbuddhiranityAshabdavaditi; atra varNyaH shabdo buddhirapi varNyA,tadubhayavarNyAvishiShTatvAdvarNyasamo~apyahetuH||57||
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<div style="text-align:justify;">
''Ahetu'' is of three types – ''prakaranasamah, samshayasamaḥ, varnyasama''.

''Prakaranasama ahetu'' is like saying – ‘the ''atma'' (soul) other than the body is eternal.’ On this opponent says that ‘because the self is other than the body, it is eternal, then as the body is non-eternal the dissimilar self must be eternal. This is ''ahetu'' (fallacious reason) because here the ''paksha'' (minor term) itself has been used as reason.

''Samshayasama ahetu'' the reason similar to doubt is that which though being cause of doubt is used as cause of eliminating the same such as, if someone says only a part of [[Ayurveda]] , it creates doubt as to whether he is a physician or not; On this opponent says – ‘as he has said a part of [[Ayurveda]], he is a physician.’ The doubt can not be the cause of removing the same.

''Varnyasam ahetu''- the reason (''hetu'') given is similar to object and not different from the object, such as somebody says – ''buddhi'' (intellect) is non-eternal because of the absence of touch like ''shabda'' (sound). Here both ''buddhi'' (intellect) and ''shabda'' (sound)are objects; hence because of the absence of difference between them, the reason is similar to object and as such is fallacious.[57]
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==== 37. ''Atitakala'' (delayed performance) ====
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अथातीतकालम्- अतीतकालंनामयत्पूर्वंवाच्यंतत्पश्चादुच्यते, तत्कालातीतत्वादग्राह्यंभवतीति; पूर्वंवानिग्रहप्राप्तमनिगृह्यपरिगृह्यपक्षान्तरितंपश्चान्निगृहीते, तत्तस्यातीतकालत्वान्निग्रहवचनमसमर्थंभवतीति||५८||
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athātītakālam- atītakālaṁ nāma yat pūrvaṁ vācyaṁ tat paścāducyatē, tat kālātītatvādagrāhyaṁ bhavatīti; pūrvaṁ vā nigrahaprāptamanigr̥hya parigr̥hya pakṣāntaritaṁ paścānnigr̥hītē, tattasyātītakālatvānnigrahavacanamasamarthaṁ bhavatīti||58||

athAtItakAlam- atItakAlaM nAma yat pUrvaM vAcyaM tat pashcAducyate, tat kAlAtItatvAdagrAhyaMbhavatIti; pUrvaM [1] vA nigrahaprAptamanigRuhya parigRuhya pakShAntaritaM pashcAnnigRuhIte,tattasyAtItakAlatvAnnigrahavacanamasamarthaM bhavatIti||58||
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<div style="text-align:justify;">
''Atitakala'' is that which actually was to be said earlier but is said later, and because of delayed presentation becomes unacceptable. For instance, if somebody does not defeat the opponent at the opportune moment but applies it on some other point later on, then, because of delayed application that becomes quite ineffective. [58]
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==== 38. ''Upalambha'' (pointing defects in causality) ====
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अथोपालम्भः- उपालम्भोनामहेतोर्दोषवचनं; यथा- पूर्वमहेतवोहेत्वाभासाव्याख्याताः||५९||
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athōpālambhaḥ- upālambhō nāma hētōrdōṣavacanaṁ; yathā- pūrvamahētavō hētvābhāsā vyākhyātāḥ||59||

athopAlambhaH- upAlambho nAma hetordoShavacanaM; yathA- pUrvamahetavo hetvAbhAsAvyAkhyAtAH||59||
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''Upalambha'' is pointing out defects in causality as explained earlier under the heading ''hetu'' fallacious or apparent reason which is unable to prove the ''sadhya''.[59]

==== 39. ''Parihara'' (refuting defects) ====
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अथपरिहारः- परिहारोनामतस्यैवदोषवचनस्यपरिहरणं; यथा- नित्यमात्मनिशरीरस्थेजीवलिङ्गान्युपलभ्यन्ते, तस्यचापगमान्नोपलभ्यन्ते, तस्मादन्यःशरीरादात्मानित्यश्चेति||६०||
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atha parihāraḥ- parihārō nāma tasyaiva dōṣavacanasya pariharaṇaṁ; yathā- nityamātmani śarīrasthē jīvaliṅgānyupalabhyantē, tasya cāpagamānnōpalabhyantē, tasmādanyaḥ arīrādātmā nityaścēti||60||

atha parihAraH- parihAro nAma tasyaiva doShavacanasya pariharaNaM; yathA- nityamAtmani sharIrasthejIvali~ggAnyupalabhyante, tasya cApagamAnnopalabhyante, tasmAdanyaH sharIrAdAtmAnityashceti||60||
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''Parihara'' is refuting the above points out of defects, such as the signs of life are available constantly till the life is in the body, and are not available after it goes out. Therefore, the ''atma'' (self) is different from the body and is eternal.[60]

==== 40. ''Pratijnahani'' (change of proposition) ====
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अथप्रतिज्ञाहानिः- प्रतिज्ञाहानिर्नामसापूर्वपरिगृहीतांप्रतिज्ञांपर्यनुयुक्तोयत्परित्यजति, यथाप्राक्प्रतिज्ञांकृत्वानित्यःपुरुषइति, पर्यनुयुक्तस्त्वाह- अनित्यइति||६१||
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atha pratijñāhāniḥ- pratijñāhānirnāma sā pūrvaparigr̥hītāṁ pratijñāṁ paryanuyuktō yat parityajati, yathā prāk pratijñāṁ kr̥tvā nityaḥ puruṣa iti, paryanuyuktastvāha- anitya iti||61||

atha pratij~jAhAniH- pratij~jAhAnirnAma sA pUrvaparigRuhItAM pratij~jAM paryanuyukto yat parityajati,yathA prAk pratij~jAM kRutvA nityaH puruSha iti, paryanuyuktastvAha- anitya iti||61||
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<div style="text-align:justify;">
''Pratijnahani'' is defined as when one gives up the original proposition after having been questioned. For instance, somebody puts proposition in the beginning as, the self (''purusha'') is eternal, but when questioned says that it is non-eternal then such change of proposition after questioning is called as ''Pratijnahani''.[61]
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==== 41. ''Abhyanujna'' (acceptance) ====
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अथाभ्यनुज्ञा- अभ्यनुज्ञानामसायइष्टानिष्टाभ्युपगमः||६२||
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athābhyanujñā- abhyanujñā nāma sā ya iṣṭāniṣṭābhyupagamaḥ||62||

athAbhyanuj~jA- abhyanuj~jA nAma sA ya iShTAniShTAbhyupagamaH||62||
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''Abhyanujna'' is acceptance of the desired as well as the undesired situations.[62]

==== 42. ''Hetvantara'' (change in statement of cause) ====
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अथहेत्वन्तरं- हेत्वन्तरंनामप्रकृतहेतौवाच्येयद्विकृतहेतुमाह||६३||
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atha hētvantaraṁ- hētvantaraṁ nāma prakr̥tahētau vācyē yadvikr̥tahētumāha||63||

atha hetvantaraM- hetvantaraM nAma prakRutahetau vAcye yadvikRutahetumAha||63||
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''Hetvantara'' is that where some imperfect reason (''vikritahetu'') is stated instead of perfect reason (''prakritahetu''). [63]

==== 43. ''Arthantara'' (statement of irrelevant meaning) ====
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अथार्थान्तरम्- अर्थान्तरंनामैकस्मिन्वक्तव्येऽपरंयदाह| यथा- ज्वरलक्षणेवाच्येप्रमेहलक्षणमाह||६४||
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athārthāntaram- arthāntaraṁ nāmaikasmin vaktavyē'paraṁ yadāha| yathā- jvaralakṣaṇē vācyē pramēhalakṣaṇamāha||64||

athArthAntaram- arthAntaraM nAmaikasmin vaktavye~aparaM yadAha|
yathA- jvaralakShaNe vAcye pramehalakShaNamAha||64||
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''Arthantara'' is that where some other thing is said instead of the relevant one. For instance, one has to say the symptoms of ''jwara'' (fever) but instead he says those of ''prameha''.[64]

==== 44.''Nigrahasthana'' (stage of defeat and its reasons) ====
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अथनिग्रहस्थानं- निग्रहस्थानंनामपराजयप्राप्तिः; तच्चत्रिरभिहितस्यवाक्यस्यापरिज्ञानंपरिषदिविज्ञानवत्यां, यद्वाअननुयोज्यस्यानुयोगोऽनुयोज्यस्यचाननुयोगः| प्रतिज्ञाहानिः, अभ्यनुज्ञा, कालातीतवचनम्, अहेतुः, न्यूनम्, अधिकं, व्यर्थम्, अनर्थकं, पुनरुक्तं, विरुद्धं, हेत्वन्तरम्, अर्थान्तरंचनिग्रहस्थानम्||६५||
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atha nigrahasthānaṁ- nigrahasthānaṁ nāma parājayaprāptiḥ; tacca trirabhihitasya vākyasyāparijñānaṁ pariṣadi vijñānavatyāṁ, yadvā ananuyōjyasyānuyōgō'nuyōjyasya cānanuyōgaḥ| pratijñāhāniḥ, abhyanujñā, kālātītavacanam, ahētuḥ, nyūnam, adhikaṁ, vyartham, anarthakaṁ, punaruktaṁ, viruddhaṁ, hētvantaram, arthāntaraṁ ca nigrahasthānam||65||

atha nigrahasthAnaM- nigrahasthAnaM nAma parAjayaprAptiH; tacca trirabhihitasya vAkyasyAparij~jAnaMpariShadi vij~jAnavatyAM, yadvA ananuyojyasyAnuyogo~anuyojyasya cAnanuyogaH|
pratij~jAhAniH, abhyanuj~jA, kAlAtItavacanam, ahetuH, nyUnam, adhikaM, vyartham, anarthakaM,punaruktaM, viruddhaM, hetvantaram, arthAntaraM ca nigrahasthAnam||65||
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<div style="text-align:justify;">
''Nigrahasthana'' is that by which one is defeated. It consists of not understanding a statement even if repeated thrice in a learned assembly or questioning where it is not pertinent and not questioning where it is pertinent. Over and above, ''pratijnahani, abhyanujna, kalatita vachana, ahetu, nyuna, adhika, vyartha, anarthaka, punarukta, viruddha, hetvantara'' and ''arthantara'' are reasons of defeat.[65]
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इतिवादमार्गपदानियथोद्देशमभिनिर्दिष्टानिभवन्ति||६६||
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iti vādamārgapadāni yathōddēśamabhinirdiṣṭāni bhavanti||66||

iti vAdamArgapadAni yathoddeshamabhinirdiShTAni bhavanti||66||
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Thus the terms used in course of debate are explained as proposed.[66]

=== Importance of debate ===
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वादस्तुखलुभिषजांप्रवर्तमानोप्रवर्तेतायुर्वेदएव, नान्यत्र| अत्रहिवाक्यप्रतिवाक्यविस्तराःकेवलाश्चोपपत्तयःसर्वाधिकरणेषु| ताःसर्वाःसमवेक्ष्यावेक्ष्यसर्वंवाक्यंब्रूयात्, नाप्रकृतकमशास्त्रमपरीक्षितमसाधकमाकुलमव्यापकंवा| सर्वंचहेतुमद्ब्रूयात्| हेतुमन्तोह्यकलुषाःसर्वएववादविग्रहाश्चिकित्सितेकारणभूताः, प्रशस्तबुद्धिवर्धकत्वात्; सर्वारम्भसिद्धिंह्यावहत्यनुपहताबुद्धिः||६७||
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vādastu khalu bhiṣajāṁ pravartamānō pravartētāyurvēda ēva, nānyatra| atra hi vākyaprativākyavistarāḥ kēvalāścōpapattayaḥ sarvādhikaraṇēṣu| nāprakr̥takamaśāstramaparīkṣitamasādhakamākulamavyāpakaṁ vā| sarvaṁ ca hētumadbrūyāt| hētumantō hyakaluṣāḥ sarva ēva vādavigrahāścikitsitē kāraṇabhūtāḥ, praśastabuddhivardhakatvāt; sarvārambhasiddhiṁ hyāvahatyanupahatā buddhiḥ||67||

vAdastu khalu bhiShajAM pravartamAno pravartet[[Ayurveda]] eva, nAnyatra|
atra hi vAkyaprativAkyavistarAH kevalAshcopapattayaH sarvAdhikaraNeShu|
tAH sarvAH samavekShyAvekShya sarvaM vAkyaM brUyAt,nAprakRutakamashAstramaparIkShitamasAdhakamAkulamavyApakaM vA|
sarvaM ca hetumadbrUyAt|
hetumanto hyakaluShAH sarva eva vAdavigrahAshcikitsite kAraNabhUtAH, prashastabuddhivardhakatvAt;sarvArambhasiddhiM hyAvahatyanupahatA buddhiH||67||
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<div style="text-align:justify;">
The debate among physicians should be held only on [[Ayurveda]] and not on any other topic. Here, in detail the statements and counter-statements and also all the arguments have been mentioned in the entire text. After keeping them in mind one should speak something and not anything which is irrelevant, unscriptural, unexamined, inappropriate, confused and unpervasive. He should speak everything with reasoning. All the conflicts of debate if endowed with reasoning, are devoid of malice and promote the medicine due to its property of enhancing the excellence of intellect, because indefective intellect leads to success in all actions. [67]
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=== Ten means of knowledge for physician ===
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इमानिखलुतावदिहकानिचित्प्रकरणानिभिषजांज्ञानार्थमुपदेक्ष्यामः|
ज्ञानपूर्वकंहिकर्मणांसमारम्भंप्रशंसन्तिकुशलाः| ज्ञात्वाहिकारण-करण-कार्ययोनि-कार्य-कार्यफलानुबन्ध-देश-काल-प्रवृत्त्युपायान्सम्यगभिनिर्वर्तमानःकार्याभिनिर्वृत्ताविष्टफलानुबन्धंकार्यमभिनिर्वर्तयत्यनतिमहतायत्नेनकर्ता||६८||
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imāni khalu tāvadiha kānicit prakaraṇāni bhiṣajāṁ jñānārthamupadēkṣyāmaḥ| jñānapūrvakaṁ hi karmaṇāṁ samārambhaṁ praśaṁsanti kuśalāḥ| jñātvā hi kāraṇa-karaṇa-kāryayōni-kārya-kāryaphalānubandha-dēśa-kāla-pravr̥ttyupāyān samyagabhinirvartamānaḥ kāryābhinirvr̥ttāviṣṭaphalānubandhaṁ kāryamabhinirvartayatyanatimahatā yatnēna kartā||68||

imAni khalu tAvadiha kAnicit prakaraNAni bhiShajAM j~jAnArthamupadekShyAmaH|
j~jAnapUrvakaM hi karmaNAM samArambhaM prashaMsanti kushalAH|
j~jAtvA hi kAraNa-karaNa-kAryayoni-kArya-kAryaphalAnubandha-desha-kAla-pravRuttyupAyAnsamyagabhinirvartamAnaH kAryAbhinirvRuttAviShTaphalAnubandhaM kAryamabhinirvartayatyanatimahatAyatnena kartA||68||
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<div style="text-align:justify;">
Now I shall explain some topics for the knowledge of physicians because the wise commend initiation of all actions with prior knowledge. If after knowing well ''karana, karana, karyayoni, karya, karyaphala, anubandha, desha, kala, pravritti'' and ''upaya'' one proceeds for some action, he obtains the desired fruit and subsequent benefit in that without any great effort.[68]
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==== ''Karana'' (cause or doer) ====
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तत्रकारणंनामतद्यत्करोति, सएवहेतुः, सकर्ता||६९||
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tatra kāraṇaṁ nāma tad yat karōti, sa ēva hētuḥ, sa kartā||69||

tatra kAraNaM nAma tad yat [1] karoti, sa eva hetuH, sa kartA||69||
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''Karana'' is defined as the one who does the action, he is the cause and doer.[69]

==== ''Karana'' (means or equipments) ====
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करणंपुनस्तद्यदुपकरणायोपकल्पतेकर्तुःकार्याभिनिर्वृत्तौप्रयतमानस्य||७०||
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karaṇaṁ punastad yadupakaraṇāyōpakalpatē kartuḥ kāryābhinirvr̥ttau prayatamānasya||70||

karaNaM punastad yadupakaraNAyopakalpate kartuH kAryAbhinirvRuttau prayatamAnasya||70||
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''Karana'' is that which serves as means or equipment for the ''karana'' (doer) making effort for performing the action.[70]

==== ''Karyayoni'' (source) ====
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कार्ययोनिस्तुसायाविक्रियमाणाकार्यत्वमापद्यते||७१||
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kāryayōnistu sā yā vikriyamāṇā kāryatvamāpadyatē||71||

kAryayonistu sA yA vikriyamANA kAryatvamApadyate||71||
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''Karyayoni'' is that which (intimate cause) is converted into action (''karya'') after transformation. [71]

==== ''Karya'' (action) ====
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कार्यंतुतद्यस्याभिनिर्वृत्तिमभिसन्धायकर्ताप्रवर्तते||७२||
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kāryaṁ tu tadyasyābhinirvr̥ttimabhisandhāya kartā pravartatē||72||

kAryaM tu tadyasyAbhinirvRuttimabhisandhAya kartA pravartate||72||
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''Karya'' is that action which the doer performs with the objective of accomplishment. [72]

==== ''Karyaphala'' (expected outcome) ====
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कार्यफलंपुनस्तद्यत्प्रयोजनाकार्याभिनिर्वृत्तिरिष्यते||७३||
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kāryaphalaṁ punastad yatprayōjanā kāryābhinirvr̥ttiriṣyatē||73||

kAryaphalaM punastad yatprayojanA kAryAbhinirvRuttiriShyate||73||
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''Karyaphala'' is the aim (expected outcome) with which the action is performed. [73]

==== ''Anubandha''(consequence) ====
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अनुबन्धःखलुसयःकर्तारमवश्यमनुबध्नाति
कार्यादुत्तरकालंकार्यनिमित्तःशुभोवाऽप्यशुभोभावः||७४||
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anubandhaḥ khalu sa yaḥ kartāramavaśyamanubadhnāti kāryāduttarakālaṁ kāryanimittaḥ śubhō vā'pyaśubhō bhāvaḥ||74||

anubandhaH khalu sa yaH kartAramavashyamanubadhnAti kAryAduttarakAlaM kAryanimittaH shubhovA~apyashubho bhAvaH||74||
</div></div>

''Anubandha'' is that which essentially enjoins the doer as after-effect of the action, good or bad. [74]

==== ''Desha''(place) ====
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देशस्त्वधिष्ठानम्||७५||
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dēśastvadhiṣṭhānam||75||

deshastvadhiShThAnam||75||
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''Desha'' is location/ place.[75]

==== ''Kala'' (time required for transformation) ====
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कालःपुनःपरिणामः||७६||
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kālaḥ punaḥ pariṇāmaḥ||76||

kAlaH punaH pariNAmaH||76||
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''Kala'' is the one which undergoes transformation.[76]

==== ''Pravritti'' (consistent efforts) ====
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प्रवृत्तिस्तुखलुचेष्टाकार्यार्था; सैवक्रिया, कर्म, यत्नः, कार्यसमारम्भश्च||७७||
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pravr̥ttistu khalu cēṣṭā kāryārthā; saiva kriyā, karma, yatnaḥ, kāryasamārambhaśca||77||

pravRuttistu khalu ceShTA kAryArthA; saiva kriyA, karma, yatnaH, kAryasamArambhashca||77||
</div></div>

''Pravritti'' is the effort taken for the accomplishment of objective. This is also known as ''kriya, karma'' (action), ''yatna''(effort), ''karyasamarambha'' (commencement). [77]

==== ''Upaya'' (means of successful management) ====
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उपायःपुनस्त्रयाणांकारणादीनांसौष्ठवमभिविधानंचसम्यक्कार्यकार्यफलानुबन्धवर्ज्यानां, कार्याणामभिनिर्वर्तकइत्यतस्तूपायः ; कृतेनोपायार्थोऽस्ति, नचविद्यतेतदात्वे, कृताच्चोत्तरकालंफलं, फलाच्चानुबन्धइति||७८||
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upāyaḥ punastrayāṇāṁ kāraṇādīnāṁ sauṣṭhavamabhividhānaṁ ca samyak kāryakāryaphalānubandhavarjyānāṁ, kāryāṇāmabhinirvartaka ityatastūpāyaḥ ; kr̥tē nōpāyārthō'sti, na ca vidyatē tadātvē, kr̥tāccōttarakālaṁ phalaṁ, phalāccānubandha iti||78||

upAyaH punastrayANAM kAraNAdInAM sauShThavamabhividhAnaM [1] ca samyakkAryakAryaphalAnubandhavarjyAnAM, kAryANAmabhinirvartaka ityatastUpAyaH [2] ; kRutenopAyArtho~asti, na ca vidyate tadAtve, kRutAccottarakAlaM phalaM, phalAccAnubandha iti||78||
</div></div>

<div style="text-align:justify;">
''Upaya'' is excellence of the first three factors, ''karana'' etc., and their proper management leaving aside the ''karya, karyaphala'' and ''anubandha''. Procedure leads to performance of an action and thus it is said as ''upaya''. After the action is performed there is no function of procedure nor is it at the time of performance, after action is the result and thereafter consequence.[78]
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=== Importance of ten fold examinations ===
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एतद्दशविधमग्रेपरीक्ष्यं, ततोऽनन्तरंकार्यार्थाप्रवृत्तिरिष्टा| तस्माद्भिषक्कार्यंचिकीर्षुःप्राक्कार्यसमारम्भात्परीक्षयाकेवलंपरीक्ष्यंपरीक्ष्यकर्मसमारभेतकर्तुम्||७९||
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ētaddaśavidhamagrē parīkṣyaṁ, tatō'nantaraṁ kāryārthā pravr̥ttiriṣṭā| tasmādbhiṣak kāryaṁ cikīrṣuḥ prāk kāryasamārambhāt parīkṣayā kēvalaṁ parīkṣyaṁ parīkṣya karma samārabhēta kartum||79||

etaddashavidhamagre parIkShyaM, tato~anantaraM kAryArthA pravRuttiriShTA|
tasmAdbhiShak kAryaM cikIrShuH prAk kAryasamArambhAt parIkShayA kevalaM parIkShyaM parIkShyakarma samArabheta kartum||79||
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These ten entities should be examined first and thereafter one should proceed for action. Hence the physician desirous of taking up action should beforehand examine the entire situation by proper methods and then initiate the action(treatment). [79]

==== Questions for discussion ====
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तत्रचेद्भिषगभिषग्वाभिषजंकश्चिदेवंखलुपृच्छेद्- वमनविरेचनास्थापनानुवासनशिरोविरेचनानिप्रयोक्तुकामेनभिषजाकतिविधयापरीक्षयाकतिविधमेवपरीक्ष्यं, कश्चात्रपरीक्ष्यविशेषः, कथंचपरीक्षितव्यः, किम्प्रयोजनाचपरीक्षा, क्वचवमनादीनांप्रवृत्तिः, क्वचनिवृत्तिः, प्रवृत्तिनिवृत्तिलक्षणसंयोगेचकिंनैष्ठिकं, कानिचवमनादीनांभेषजद्रव्याण्युपयोगंगच्छन्तीति||८०||
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tatra cēdbhiṣagabhiṣagvā bhiṣajaṁ kaścidēvaṁ khalu pr̥cchēd- vamanavirēcanāsthāpanānuvāsanaśirōvirēcanāni prayōktukāmēna bhiṣajā katividhayā parīkṣayā katividhamēva parīkṣyaṁ, kaścātra parīkṣyaviśēṣaḥ, kathaṁ ca parīkṣitavyaḥ, kimprayōjanā ca parīkṣā, kva ca vamanādīnāṁ pravr̥ttiḥ, kva ca nivr̥ttiḥ, pravr̥ttinivr̥ttilakṣaṇasaṁyōgē ca kiṁ naiṣṭhikaṁ, kāni ca vamanādīnāṁ bhēṣajadravyāṇyupayōgaṁ gacchantīti||80||

tatra cedbhiShagabhiShagvA bhiShajaM kashcidevaM khalu pRucched-vamanavirecanAsthApanAnuvAsanashirovirecanAni prayoktukAmena bhiShajA katividhayA parIkShayAkatividhameva parIkShyaM, kashcAtra parIkShyavisheShaH, kathaM ca parIkShitavyaH, kimprayojanA caparIkShA, kva ca vamanAdInAM pravRuttiH, kva ca nivRuttiH, pravRuttinivRuttilakShaNasaMyoge ca kiMnaiShThikaM, kAni ca vamanAdInAM bheShajadravyANyupayogaM gacchantIti||80||
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<div style="text-align:justify;">
There, if some other physician or person asks this physician –“how many types of examination should be adopted by the physician desirous of applying therapeutic emesis, purgation, non-unctuous and unctuous enema and nasal errhines? How many types of entities are to be examined? What are the entities to be examined? How are they to be examined? What is the object of examination? In which condition are emesis etc. purificatory procedures to be applied or contra-indicated? What is to be done in combination of the situations for both application and contra- indication? What drugs are useful for emesis etc.?[80]
</div>
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सएवंपृष्टोयदिमोहयितुमिच्छेत्, ब्रूयादेनं- बहुविधाहिपरीक्षातथापरीक्ष्यविधिभेदः, कतमेनविधिभेदप्रकृत्यन्तरेणभिन्नयापरीक्षयाकेनवाविधिभेदप्रकृत्यन्तरेणपरीक्ष्यस्यभिन्नस्यभेदाग्रंभवान्पृच्छत्याख्यायमानं ;नेदानींभवतोऽन्येनविधिभेदप्रकृत्यन्तरेणभिन्नयापरीक्षयाऽन्येनवाविधिभेदप्रकृत्यन्तरेणपरीक्ष्यस्यभिन्नस्याभिलषितमर्थंश्रोतुमहमन्येनपरीक्षाविधिभेदेनान्येनवाविधिभेदप्रकृत्यन्तरेणपरीक्ष्यंभित्त्वाऽ<br>न्यथाऽऽचक्षाणइच्छांपूरयेयमिति||८१||
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sa ēvaṁ pr̥ṣṭō yadi mōhayitumicchēt, brūyādēnaṁ- bahuvidhā hi parīkṣā tathā parīkṣyavidhibhēdaḥ, katamēna vidhibhēdaprakr̥tyantarēṇa bhinnayā parīkṣayā kēna vāvidhibhēdaprakr̥tyantarēṇa parīkṣyasya bhinnasya bhēdāgraṁ bhavān pr̥cchatyākhyāyamānaṁ ; nēdānīṁ bhavatō'nyēna vidhibhēdaprakr̥tyantarēṇa bhinnayā parīkṣayā'nyēna vā vidhibhēdaprakr̥tyantarēṇa parīkṣyasya bhinnasyābhilaṣitamarthaṁ śrōtumahamanyēna parīkṣāvidhibhēdēnānyēna vā vidhibhēdaprakr̥tyantarēṇa parīkṣyaṁ bhittvā'nyathā''cakṣāṇa icchāṁ pūrayēyamiti||81||

sa evaM pRuShTo yadi mohayitumicchet, brUyAdenaM- bahuvidhA hi parIkShA tathAparIkShyavidhibhedaH, katamena vidhibhedaprakRutyantareNa bhinnayA parIkShayA kena vAvidhibhedaprakRutyantareNa parIkShyasya bhinnasya bhedAgraM bhavAn pRucchatyAkhyAyamAnaM [1] ;nedAnIM bhavato~anyena vidhibhedaprakRutyantareNa bhinnayA parIkShayA~anyena vAvidhibhedaprakRutyantareNa parIkShyasya bhinnasyAbhilaShitamarthaM shrotumahamanyenaparIkShAvidhibhedenAnyena vA vidhibhedaprakRutyantareNa parIkShyaMbhittvA~anyathA~a~acakShANa [2] icchAM pUrayeyamiti||81||
</div></div>

<div style="text-align:justify;">
If he wants to confuse the questioner he should say – there are many types of examination and groups of the types of entities to be examined. Kindly tell me from what point of view grouped examination or entities to be examined you mean, because I can not satisfy you if I explain them taking as grouped from another point of view when, in case, you want to be examined them as grouped from another point of view.[81]
</div>
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सयदुत्तरंब्रूयात्तत्समीक्ष्योत्तरंवाच्यंस्याद्यथोक्तंचप्रतिवचनविधिमवेक्ष्य; सम्यक्यदितुब्रूयान्नचैनंमोहयितुमिच्छेत्, प्राप्तंतुवचनकालंमन्येत, काममस्मैब्रूयादाप्तमेवनिखिलेन||८२||
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sa yaduttaraṁ brūyāttat samīkṣyōttaraṁ vācyaṁ syādyathōktaṁ ca prativacanavidhimavēkṣya; samyak yadi tu brūyānna cainaṁ mōhayitumicchēt, prāptaṁ tu vacanakālaṁ manyēta, kāmamasmai brūyādāptamēva nikhilēna||82||

sa yaduttaraM brUyAttat samIkShyottaraM vAcyaM syAdyathoktaM ca prativacanavidhimavekShya;samyak [1] yadi tu brUyAnna cainaM mohayitumicchet, prAptaM tu vacanakAlaM manyeta, kAmamasmaibrUyAdAptameva nikhilena||82||
</div></div>

<div style="text-align:justify;">
After considering the reply given by opponent, one should analyze and further say according to the method of contradiction. In case, he speaks properly one should not try to confuse him, rather he should explain in detail as explained by the ''apta'' (authority). [82]
</div>

==== Types of examinations ====
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द्विविधातुखलुपरीक्षाज्ञानवतां- प्रत्यक्षम्, अनुमानंच| एतद्धिद्वयमुपदेशश्चपरीक्षास्यात्| एवमेषाद्विविधापरीक्षा, त्रिविधावासहोपदेशेन||८३||
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dvividhā tu khalu parīkṣā jñānavatāṁ- pratyakṣam, anumānaṁ ca| ētaddhi dvayamupadēśaśca parīkṣā syāt| ēvamēṣā dvividhā parīkṣā, trividhā vā sahōpadēśēna||83||

dvividhA tu khalu parIkShA j~jAnavatAM- pratyakSham, anumAnaM ca|
etaddhi dvayamupadeshashca parIkShA syAt|
evameShA dvividhA parIkShA, trividhA vA sahopadeshena||83||
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There are two types of examination for learned persons – direct perception (''pratyaksha'') and inference (''anumana''). These two along with the authoritative instruction constitute the examination. This examination is of two types or of three types including authoritative instruction (''upadesha'').[83]

=== Ten factors for examination in therapeutics ===
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दशविधंतुपरीक्ष्यंकारणादियदुक्तमग्रे, तदिहभिषगादिषुसंसार्यसन्दर्शयिष्यामः- इहकार्यप्राप्तौकारणंभिषक्, करणंपुनर्भेषजं, कार्ययोनिर्धातुवैषम्यं, कार्यंधातुसाम्यं, कार्यफलंसुखावाप्तिः, अनुबन्धःखल्वायुः, देशोभूमिरातुरश्च, कालःपुनःसंवत्सरश्चातुरावस्थाच, प्रवृत्तिःप्रतिकर्मसमारम्भः, उपायस्तुभिषगादीनांसौष्ठवमभिविधानंचसम्यक्| इहाप्यस्योपायस्यविषयःपूर्वेणैवोपायविशेषेणव्याख्यातः| इतिकारणादीनिदशदशसुभिषगादिषुसंसार्यसन्दर्शितानि, तथैवानुपूर्व्यैतद्दशविधंपरीक्ष्यमुक्तंच||८४||
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daśavidhaṁ tu parīkṣyaṁ kāraṇādi yaduktamagrē, tadiha bhiṣagādiṣu saṁsārya sandarśayiṣyāmaḥ- iha kāryaprāptau kāraṇaṁ bhiṣak, karaṇaṁ punarbhēṣajaṁ, kāryayōnirdhātuvaiṣamyaṁ, kāryaṁ dhātusāmyaṁ, kāryaphalaṁ sukhāvāptiḥ, anubandhaḥ khalvāyuḥ, dēśō bhūmirāturaśca, kālaḥ punaḥ saṁvatsaraścāturāvasthā ca, pravr̥ttiḥ pratikarmasamārambhaḥ, upāyastu bhiṣagādīnāṁ sauṣṭhavamabhividhānaṁ ca samyak| ihāpyasyōpāyasya viṣayaḥ pūrvēṇaivōpāyaviśēṣēṇa vyākhyātaḥ| iti kāraṇādīni daśa daśasu bhiṣagādiṣu saṁsārya sandarśitāni, tathaivānupūrvyaitaddaśavidhaṁ parīkṣyamuktaṁ ca||84||

dashavidhaM tu parIkShyaM kAraNAdi yaduktamagre, tadiha bhiShagAdiShu saMsAryasandarshayiShyAmaH- iha kAryaprAptau kAraNaM bhiShak, karaNaM punarbheShajaM,kAryayonirdhAtuvaiShamyaM, kAryaM dhAtusAmyaM, kAryaphalaM sukhAvAptiH, anubandhaH khalvAyuH,desho bhUmirAturashca, kAlaH punaH saMvatsarashcAturAvasthA ca, pravRuttiHpratikarmasamArambhaH, upAyastu bhiShagAdInAM sauShThavamabhividhAnaM [1] ca samyak|
ihApyasyopAyasya viShayaH pUrveNaivopAyavisheSheNa vyAkhyAtaH|
iti kAraNAdIni dasha dashasu bhiShagAdiShu saMsArya sandarshitAni, tathaivAnupUrvyaitaddashavidhaMparIkShyamuktaM ca||84||
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<div style="text-align:justify;">
Previously explained ''karana'' etc. ten entities are elaborately discussed in relation to specific features of therapeutics diseases ten entities are to be examined such as physician acts like a doer (''karana''),drugs act like instrument (''karan''), imbalance of ''dhatu'' (''karyayoni''), balance of ''dhatu'' (''karya''), attainment of health and happiness (''karyaphala''), life-span (''anubandha''), land as well as patient (''desha''), year and phase of disease (''kala''), initiation of therapy (''pravritti'') and excellence of physician etc. and proper management (''upaya'').[84]
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तस्ययोयोविशेषोयथायथाचपरीक्षितव्यः, सतथातथाव्याख्यास्यते||८५||
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tasya yō yō viśēṣō yathā yathā ca parīkṣitavyaḥ, sa tathā tathā vyākhyāsyatē||85||

tasya yo yo visheSho [1] yathA yathA ca parIkShitavyaH, sa tathA tathA vyAkhyAsyate||85||
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So, these entities should be specifically examined with great emphasis.[85]

==== Assessment of physician and qualities of good physician ====
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कारणंभिषगित्युक्तमग्रे, तस्यपरीक्षा- भिषङ्नामयोभिषज्यति, यःसूत्रार्थप्रयोगकुशलः, यस्यचायुःसर्वथाविदितंयथावत्| सचसर्वधातुसाम्यंचिकीर्षन्नात्मानमेवादितःपरीक्षेतगुणिषुगुणतःकार्याभिनिर्वृत्तिंपश्यन्, कच्चिदहमस्यकार्यस्याभिनिर्वर्तनेसमर्थोनवेति; तत्रेमेभिषग्गुणायैरुपपन्नोभिषग्धातुसाम्याभिनिर्वर्तनेसमर्थोभवति; तद्यथा- पर्यवदातश्रुतता, परिदृष्टकर्मता, दाक्ष्यं, शौचं, जितहस्तता, उपकरणवत्ता, सर्वेन्द्रियोपपन्नता, प्रकृतिज्ञता, प्रतिपत्तिज्ञाताचेति||८६||
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kāraṇaṁ bhiṣagityuktamagrē, tasya parīkṣā- bhiṣaṅnāma yō bhiṣajyati, yaḥ sūtrārthaprayōgakuśalaḥ, yasya cāyuḥ sarvathā viditaṁ yathāvat| sa ca sarvadhātusāmyaṁ cikīrṣannātmānamēvāditaḥ parīkṣēta guṇiṣu guṇataḥ kāryābhinirvr̥ttiṁ paśyan, kaccidahamasya kāryasyābhinirvartanē samarthō na vēti; tatrēmē bhiṣagguṇā yairupapannō bhiṣagdhātusāmyābhinirvartanē samarthō bhavati; tadyathā- paryavadātaśrutatā, paridr̥ṣṭakarmatā, dākṣyaṁ, śaucaṁ, jitahastatā, upakaraṇavattā, sarvēndriyōpapannatā, prakr̥tijñatā, pratipattijñātā cēti||86||

kAraNaM bhiShagityuktamagre, tasya parIkShA- bhiSha~gnAma yo bhiShajyati, yaHsUtrArthaprayogakushalaH, yasya cAyuH sarvathA viditaM yathAvat|
sa ca sarvadhAtusAmyaM cikIrShannAtmAnamevAditaH parIkSheta guNiShu guNataH kAryAbhinirvRuttiMpashyan, kaccidahamasya kAryasyAbhinirvartane samartho na veti; tatreme bhiShagguNA yairupapannobhiShagdhAtusAmyAbhinirvartane samartho bhavati; tadyathA- paryavadAtashrutatA,paridRuShTakarmatA, dAkShyaM, shaucaM, jitahastatA, upakaraNavattA, sarvendriyopapannatA,prakRutij~jatA, pratipattij~jAtA ceti||86||
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<div style="text-align:justify;">
Earlier, physician has been mentioned as doer (''karana''). ''Bhishak'' is the one who should be able to win over the diseases and expert in applying the ideas of the aphorisms and knows the pros and cons of life (science) properly from all aspects. He should know how to bring about balance between ''dhatus'' (''dhatu samya''), must be learned, trained in scriptures and qualified enough for the same and has received practical training and expertise in duties. He should be introspective, desirous of maintaining balance of all ''dhatus'', considering the consequence of treatment in appropriate patients, with proper qualities of management, with due considerations of one’s own capabilities and limitations.

The physician endowed with the following qualities is capable of bringing forth the equilibrium of ''dhatus'': clear scientific knowledge , practical knowledge, alert, purity, skill, and possession of all required equipment, with proper sense perceptions (all sense and motor organs), acquaintance with human constitution and the knowledge of the course of action. [86]
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==== Assessment of medicine and categories ====
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करणंपुनर्भेषजम्| भेषजंनामतद्यदुपकरणायोपकल्पतेभिषजोधातुसाम्याभिनिर्वृत्तौप्रयतमानस्यविशेषतश्चोपायान्तेभ्यः| तद्द्विविधंव्यपाश्रयभेदात्- दैवव्यपाश्रयं, युक्तिव्यपाश्रयंचेति|तत्रदैवव्यपाश्रयंमन्त्रौषधिमणिमङ्गलबल्युपहारहोमनियमप्रायश्चित्तोपवासस्वस्त्ययनप्रणिपातगमनादि, युक्तिव्यपाश्रयं- संशोधनोपशमनेचेष्टाश्चदृष्टफलाः| एतच्चैवभेषजमङ्गभेदादपिद्विविधं- द्रव्यभूतमः, अद्रव्यभूतंच| तत्रयदद्रव्यभूतंतदुपायाभिप्लुतम्| उपायोनामभयदर्शनविस्मापनविस्मारणक्षोभणहर्षणभर्त्सनवधबन्धस्वप्नसंवाहनादिरमूर्तोभावविशेषोयथोक्ताःसिद्ध्युपायाश्चोपायाभिप्लुताइति| यत्तुद्रव्यभूतंतद्वमनादिषुयोगमुपैति| तस्यापीयंपरीक्षा- इदमेवम्प्रकृत्यैवङ्गुणमेवम्प्रभावमस्मिन्देशेजातमस्मिन्नृतावेवंगृहीतमेवंनिहितमेवमुपस्कृतमनयाचमात्रयायुक्तमस्मिन्व्याधावेवंविधस्यपुरुषस्यैवतावन्तंदोषमपकर्षत्युपशमयतिवा, यदन्यदपिचैवंविधंभेषजंभवेत्तच्चानेनविशेषेणयुक्तमिति||८७||
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karaṇaṁ punarbhēṣajam|bhēṣajaṁ nāma tadyadupakaraṇāyōpakalpatē bhiṣajō dhātusāmyābhinirvr̥ttau prayatamānasya viśēṣataścōpāyāntēbhyaḥ| taddvividhaṁ vyapāśrayabhēdāt- daivavyapāśrayaṁ, yuktivyapāśrayaṁ cēti| tatra daivavyapāśrayaṁ- mantrauṣadhimaṇimaṅgalabalyupahārahōmaniyamaprāyaścittōpavāsasvastyayanapraṇipātagamanādi, yuktivyapāśrayaṁ- saṁśōdhanōpaśamanē cēṣṭāśca dr̥ṣṭaphalāḥ| ētaccaiva bhēṣajamaṅgabhēdādapi dvividhaṁ- dravyabhūtamḥ, adravyabhūtaṁ ca| tatra yadadravyabhūtaṁ tadupāyābhiplutam| upāyō nāma bhayadarśanavismāpanavismāraṇakṣōbhaṇaharṣaṇabhartsanavadhabandhasvapnasaṁvāhanādiramūrtō bhāvaviśēṣō yathōktāḥ siddhyupāyāścōpāyābhiplutā iti| yattu dravyabhūtaṁ tadvamanādiṣu yōgamupaiti| tasyāpīyaṁ parīkṣā- idamēvamprakr̥tyaivaṅguṇamēvamprabhāvamasmin dēśē jātamasminnr̥tāvēvaṁ gr̥hītamēvaṁ nihitamēvamupaskr̥tamanayā ca mātrayā yuktamasmin vyādhāvēvaṁvidhasya puruṣasyaivatāvantaṁ dōṣamapakarṣatyupaśamayati vā, yadanyadapi caivaṁvidhaṁ bhēṣajaṁ bhavēttaccānēna viśēṣēṇa yuktamiti||87||

karaNaM punarbheShajam|
bheShajaM nAma tadyadupakaraNAyopakalpate bhiShajo dhAtusAmyAbhinirvRuttau prayatamAnasyavisheShatashcopAyAntebhyaH|
taddvividhaM vyapAshrayabhedAt- daivavyapAshrayaM, yuktivyapAshrayaM ceti|
tatra daivavyapAshrayaM-mantrauShadhimaNima~ggalabalyupahArahomaniyamaprAyashcittopavAsasvastyayanapraNipAtagamanAdi,yuktivyapAshrayaM- saMshodhanopashamane ceShTAshca dRuShTaphalAH|
etaccaiva bheShajama~ggabhedAdapi dvividhaM- dravyabhUtamH, adravyabhUtaM ca|
tatra yadadravyabhUtaM tadupAyAbhiplutam|
upAyo nAmabhayadarshanavismApanavismAraNakShobhaNaharShaNabhartsanavadhabandhasvapnasaMvAhanAdiramUrtobhAvavisheSho yathoktAH siddhyupAyAshcopAyAbhiplutA [1] iti|
yattu dravyabhUtaM tadvamanAdiShu yogamupaiti|
tasyApIyaM parIkShA- idamevamprakRutyaiva~gguNamevamprabhAvamasmin deshejAtamasminnRutAvevaM gRuhItamevaM nihitamevamupaskRutamanayA ca mAtrayA yuktamasminvyAdhAvevaMvidhasya puruShasyaivatAvantaM doShamapakarShatyupashamayati vA, yadanyadapicaivaMvidhaM bheShajaM bhavettaccAnena [2] visheSheNa yuktamiti||87||
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<div style="text-align:justify;">
The medicament has been mentioned here as instrument (''karana'') which serves as equipment for the physician making effort for effective balance of ''dhatus'' particularly different from the entities ending with procedure (original source, inclination, place, time and procedure). In view of agents applied medicament or therapy is advocated as of two types – spiritual (''daivavyapashraya'') and rational (''yuktivyapashayam'').

In spiritual therapy, incantation, roots, gems, auspicious rites, expiation, fasting, blessings, bowing, visit to temples(sacred places) etc. are employed.

In rational therapy, evacuative and pacifying measures as well as fruitful activities are employed. According to form of medicament, it is again of two types – material and non-material. The non-material therapy includes drug less therapies (''upayas''). ''Upaya'' means formless entity like terrorizing, creating surprise, forgetfulness, agitation, exhilaration, hiding, threatening for murder, binding, inducing sleep, gentle massage etc. It also includes the aforesaid means of treatment. The material therapy consists of drugs which are used for emesis etc.

The drugs are examined in respect of nature (natural composition), properties, action, habit, time and mode of collection, storage, processing dosage, indication for use, the constitution of patient and the effect on disorder whether eliminates it or pacifies it, any other drug of this type should have the same characters.[87]
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==== Assessment of disequilibrium of ''dhatu'' ====
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कार्ययोनिर्धातुवैषम्यं, तस्यलक्षणंविकारागमः| परीक्षात्वस्यविकारप्रकृतेश्चैवोनातिरिक्तलिङ्गविशेषावेक्षणंविकारस्यचसाध्यासाध्यमृदुदारुणलिङ्गविशेषावेक्षणमिति||८८||
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kāryayōnirdhātuvaiṣamyaṁ, tasya lakṣaṇaṁ vikārāgamaḥ| parīkṣā tvasya vikāraprakr̥tēścaivōnātiriktaliṅgaviśēṣāvēkṣaṇaṁ vikārasya ca sādhyāsādhyamr̥dudāruṇaliṅgaviśēṣāvēkṣaṇamiti||88||

kAryayonirdhAtuvaiShamyaM, tasya lakShaNaM vikArAgamaH|
parIkShA tvasya vikAraprakRuteshcaivonAtiriktali~ggavisheShAvekShaNaM vikArasya casAdhyAsAdhyamRududAruNali~ggavisheShAvekShaNamiti||88||
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<div style="text-align:justify;">
The original source is disequilibrium of ''dhatus'' known by the emergence of signs of the disorder. Examination regarding this and the material cause of the disorder consists of the observation of the characters of their diminution or aggravation and also of those denoting curability, incurability, mildness and severity of the disorder.[88]
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==== Assessment of equilibrium of ''dhatu'' ====
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कार्यंधातुसाम्यं, तस्यलक्षणंविकारोपशमः| परीक्षात्वस्य- रुगुपशमनं, स्वरवर्णयोगः, शरीरोपचयः, बलवृद्धिः, अभ्यवहार्याभिलाषः, रुचिराहारकाले, अभ्यवहृतस्यचाहारस्यकालेसम्यग्जरणं, निद्रालाभोयथाकालं, वैकारिणांचस्वप्नानामदर्शनं, सुखेनचप्रतिबोधनं, वातमूत्रपुरीषरेतसांमुक्तिः, सर्वाकारैर्मनोबुद्धीन्द्रियाणांचाव्यापत्तिरिति||८९||
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kāryaṁ dhātusāmyaṁ, tasya lakṣaṇaṁ vikārōpaśamaḥ| parīkṣā tvasya- rugupaśamanaṁ, svaravarṇayōgaḥ, śarīrōpacayaḥ, balavr̥ddhiḥ, abhyavahāryābhilāṣaḥ, rucirāhārakālē, abhyavahr̥tasya cāhārasya kālē samyagjaraṇaṁ, nidrālābhō yathākālaṁ, vaikāriṇāṁ ca svapnānāmadarśanaṁ, sukhēna ca pratibōdhanaṁ, vātamūtrapurīṣarētasāṁ muktiḥ, sarvākārairmanōbuddhīndriyāṇāṁ cāvyāpattiriti||89||

kAryaM dhAtusAmyaM, tasya lakShaNaM vikAropashamaH|
parIkShA tvasya- rugupashamanaM, svaravarNayogaH, sharIropacayaH, balavRuddhiH,abhyavahAryAbhilAShaH, rucirAhArakAle, abhyavahRutasya cAhArasya kAle samyagjaraNaM, nidrAlAbhoyathAkAlaM, vaikAriNAM ca svapnAnAmadarshanaM, sukhena ca pratibodhanaM,vAtamUtrapurISharetasAM muktiH, sarvAkArairmanobuddhIndriyANAM cAvyApattiriti||89||
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<div style="text-align:justify;">
Action (''karya'') is to bring about equilibrium of ''dhatus'' and its feature is absence of disease. Its examination is based on following criteria: alleviation of the disorder, normalcy of voice and complexion, nourishment of body, increase in strength, desire for food, relish at meal time, proper and timely digestion of the ingested food, timely sleep, non-appearance of abnormal dreams, easy awakening, easy elimination of urine, feces and semen, overall normalcy of mind, intellect and sense organs and associated with no other unhealthy features.[89]
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==== Outcome of therapeutic management ====
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कार्यफलंसुखावाप्तिः, तस्यलक्षणं- मनोबुद्धीन्द्रियशरीरतुष्टिः||९०||
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kāryaphalaṁ sukhāvāptiḥ, tasya lakṣaṇaṁ- manōbuddhīndriyaśarīratuṣṭiḥ||90||

kAryaphalaM sukhAvAptiH, tasya lakShaNaM- manobuddhIndriyasharIratuShTiH||90||
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The result of the act (''karyaphala'') is attainment of happiness. It is featured as satisfaction of mind, intellect, sense organs and the body pleasure.[90]

==== Consequence of therapeutic management ====
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अनुबन्धस्तुखल्वायुः, तस्यलक्षणं- प्राणैःसहसंयोगः||९१||
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anubandhastu khalvāyuḥ, tasya lakṣaṇaṁ- prāṇaiḥ saha saṁyōgaḥ||91||

anubandhastu khalvAyuH, tasya lakShaNaM- prANaiH saha saMyogaH||91||
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After effect (''anubandha'') is life and it is characterized by union with ''prana''(vitality).[91]

==== Field of action and its assessment ====
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देशस्तुभूमिरातुरश्च||९२||

तत्रभूमिपरीक्षाआतुरपरिज्ञानहेतोर्वास्यादौषधपरिज्ञानहेतोर्वा| तत्रतावदियमातुरपरिज्ञानहेतोः| तद्यथा- अयंकस्मिन्भूमिदेशेजातःसंवृद्धोव्याधितोवा; तस्मिंश्चभूमिदेशेमनुष्याणामिदमाहारजातम्, इदंविहारजातम्, इदमाचारजातम्, एतावच्चबलम्, एवंविधंसत्त्वम्, एवंविधंसात्म्यम्, एवंविधोदोषः, भक्तिरियम्, इमेव्याधयः, हितमिदम्, अहितमिदमितिप्रायोग्रहणेन| औषधपरिज्ञानहेतोस्तुकल्पेषुभूमिपरीक्षावक्ष्यते||९३||
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dēśastu bhūmirāturaśca||92||

tatra bhūmiparīkṣā āturaparijñānahētōrvā syādauṣadhaparijñānahētōrvā| tatra tāvadiyamāturaparijñānahētōḥ| tadyathā- ayaṁ kasmin bhūmidēśē jātaḥ saṁvr̥ddhō vyādhitō vā; tasmiṁśca bhūmidēśē manuṣyāṇāmidamāhārajātam, idaṁ vihārajātam, idamācārajātam, ētāvacca balam, ēvaṁvidhaṁ sattvam, ēvaṁvidhaṁ sātmyam, ēvaṁvidhō dōṣaḥ, bhaktiriyam, imē vyādhayaḥ, hitamidam, ahitamidamiti prāyōgrahaṇēna | auṣadhaparijñānahētōstu kalpēṣu bhūmiparīkṣā vakṣyatē||93||

deshastu bhUmirAturashca||92||

tatra bhUmiparIkShA Aturaparij~jAnahetorvA syAdauShadhaparij~jAnahetorvA|
tatra tAvadiyamAturaparij~jAnahetoH|
tadyathA- ayaM kasmin bhUmideshe jAtaH saMvRuddho vyAdhito vA; tasmiMshca bhUmideshemanuShyANAmidamAhArajAtam, idaM vihArajAtam, idamAcArajAtam, etAvacca balam, evaMvidhaMsattvam, evaMvidhaM sAtmyam, evaMvidho doShaH, bhaktiriyam, ime vyAdhayaH, hitamidam,ahitamidamiti prAyograhaNena [1] |
auShadhaparij~jAnahetostu kalpeShu bhUmiparIkShA vakShyate||93||
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The place of living and patients’ body constitutes the field of action (''karya desha'').
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Assessment of place of living is done with a view considering the patient and medicine. Regarding patient the things to be considered are – in which area patient is born, grown or diseased; in that particular area, the people mostly have such diet, such lifestyle, such behavior and conduct, such strength, such mind setup, this particular things are naturally accustomed, these are the wrong habits/ or the domination of ''dosha'', liking, area associated disorders, these are the wholesome entities and unwholesome entities for the people. The knowledge regarding place of living examination about drugs will be described in [[Kalpa Sthana]] section. [92-93]
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==== Examination of patient ====
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आतुरस्तुखलुकार्यदेशः| तस्यपरीक्षाआयुषःप्रमाणज्ञानहेतोर्वास्याद्, बलदोषप्रमाणज्ञानहेतोर्वा| तत्रतावदियंबलदोषप्रमाणज्ञानहेतोः; दोषप्रमाणानुरूपोहिभेषजप्रमाणविकल्पोबलप्रमाणविशेषापेक्षोभवति| सहसाह्यतिबलमौषधमपरीक्षकप्रयुक्तमल्पबलमातुरमतिपातयेत्; नह्यतिबलान्याग्नेयवायवीयान्यौषधान्यग्निक्षारशस्त्रकर्माणिवाशक्यन्तेऽल्पबलैःसोढुम्; असह्यातितीक्ष्णवेगत्वाद्धितानिसद्यःप्राणहराणिस्युः| एतच्चैवकारणमपेक्षमाणाहीनबलमातुरमविषादकरैर्मृदुसुकुमारप्रायैरुत्तरोत्तरगुरुभिरविभ्रमैरनात्ययिकैश्चोपचरन्त्यौषधैः; विशेषतश्चनारीः, ताह्यनवस्थितमृदुविवृतविक्लवहृदयाःप्रायःसुकुमार्योऽबलाःपरसंस्तभ्याश्च| तथाबलवतिबलवद्व्याधिपरिगतेस्वल्पबलमौषधमपरीक्षकप्रयुक्तमसाधकमेवभवति| तस्मादातुरंपरीक्षेतप्रकृतितश्च, विकृतितश्च, सारतश्च, संहननतश्च, प्रमाणतश्च, सात्म्यतश्च, सत्त्वतश्च, आहारशक्तितश्च, व्यायामशक्तितश्च, वयस्तश्चेति, बलप्रमाणविशेषग्रहणहेतोः||९४||
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āturastu khalu kāryadēśaḥ| tasya parīkṣā āyuṣaḥ pramāṇajñānahētōrvā syād, baladōṣapramāṇajñānahētōrvā| tatra tāvadiyaṁ baladōṣapramāṇajñānahētōḥ; dōṣapramāṇānurūpō hi bhēṣajapramāṇavikalpō balapramāṇaviśēṣāpēkṣō bhavati| sahasā hyatibalamauṣadhamaparīkṣakaprayuktamalpabalamāturamatipātayēt; na hyatibalānyāgnēyavāyavīyānyauṣadhānyagnikṣāraśastrakarmāṇi vā śakyantē'lpabalaiḥ sōḍhum; asahyātitīkṣṇavēgatvāddhitāni sadyaḥprāṇaharāṇi syuḥ| ētaccaiva kāraṇamapēkṣamāṇā hīnabalamāturamaviṣādakarairmr̥dusukumāraprāyairuttarōttaragurubhiravibhramairanātyayikaiścōpacarantyauṣadhaiḥ; viśēṣataśca nārīḥ, tā hyanavasthitamr̥duvivr̥taviklavahr̥dayāḥ prāyaḥ sukumāryō'balāḥ parasaṁstabhyāśca| tathā balavati balavadvyādhiparigatē svalpabalamauṣadhamaparīkṣakaprayuktamasādhakamēva bhavati| tasmādāturaṁ parīkṣēta prakr̥titaśca, vikr̥titaśca, sārataśca, saṁhananataśca, pramāṇataśca, sātmyataśca, sattvataśca, āhāraśaktitaśca, vyāyāmaśaktitaśca, vayastaścēti, balapramāṇaviśēṣagrahaṇahētōḥ||94||

Aturastu khalu kAryadeshaH|
tasya parIkShA AyuShaH pramANaj~jAnahetorvA syAd, baladoShapramANaj~jAnahetorvA|
tatra tAvadiyaM baladoShapramANaj~jAnahetoH; doShapramANAnurUpo hi bheShajapramANavikalpo [1]balapramANavisheShApekSho bhavati|
sahasA hyatibalamauShadhamaparIkShakaprayuktamalpabalamAturamatipAtayet; nahyatibalAnyAgneyavAyavIyAnyauShadhAnyagnikShArashastrakarmANi vA shakyante~alpabalaiH soDhum;asahyAtitIkShNavegatvAddhitAni sadyaHprANaharANi syuH|
etaccaiva kAraNamapekShamANAhInabalamAturamaviShAdakarairmRudusukumAraprAyairuttarottaragurubhiravibhramairanAtyayikaishcopacarantyauShadhaiH;visheShatashca nArIH, tA hyanavasthitamRuduvivRutaviklavahRudayAH prAyaH sukumAryo~abalAH parasaMstabhyAshca|
tathA balavati balavadvyAdhiparigate svalpabalamauShadhamaparIkShakaprayuktamasAdhakameva bhavati|
tasmAdAturaM parIkSheta prakRutitashca, vikRutitashca, sAratashca, saMhananatashca, pramANatashca, sAtmyatashca,sattvatashca, AhArashaktitashca, vyAyAmashaktitashca, vayastashceti, balapramANavisheShagrahaNahetoH||94||
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Patient is the substratum of the act (''karyadesha''). Examination of the patient is conducted for the knowledge of life span or the degree of strength and morbidity. The variations in dosage and potency of prescribed drugs is according to the degree of morbidity and the degree of strength of patient, because if potent drug is administered suddenly by a physician having not been examined properly, it may kill the weak patient; the weak patients are not able to bear intensely potent drugs which are predominant in ''agni'' and ''vayu'' or cauterization, application of alkali and surgical operation. They may cause instantaneous death due to unbearable and over intense impulse of the drug. Keeping this fact in mind, the physician should treat the weak patient with drug which is not harmful, mild, delicate, and progressively strong in order, without complication and not creating any emergent condition, particularly ladies, because they have unstable, soft, bare and timid heart, they are mostly delicate, weak and dependent on others. On the other hand, the drugs having low potency and applied by one who has not been examined properly in strong patients having severe disorder becomes ineffective. Hence the patient should be examined in respect of constitution (''prakriti''), morbidty (''vikriti''), constitution of ''dhatu'' (''sara''), compactness (''samhanana''), measurement (''pramana''), suitability (''satmya''), psyche (''sattva''), power of intake and digestion of food (''aharashakti''), power of exercise (''vyayamashakti'') and age (''vaya'') for the knowledge of the degree of strength.[94]
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==== ''[[Prakriti]] pariksha'' (Assessment of basic constitution of patient) ====
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तत्रप्रकृत्यादीन्भावाननुव्याख्यास्यामः| तद्यथा- शुक्रशोणितप्रकृतिं, कालगर्भाशयप्रकृतिं, आतुराहारविहारप्रकृतिं, महाभूतविकारप्रकृतिंचगर्भशरीरमपेक्षते| एतानियेनयेनदोषेणाधिकेनैकेनानेकेनवासमनुबध्यन्ते, तेनतेनदोषेणगर्भोऽनुबध्यते; ततःसासादोषप्रकृतिरुच्यतेमनुष्याणांगर्भादिप्रवृत्ता| तस्माच्छ्लेष्मलाःप्रकृत्याकेचित्, पित्तलाःकेचित्, वातलाःकेचित्, संसृष्टाःकेचित्, समधातवःकेचिद्भवन्ति| तेषांहिलक्षणानिव्याख्यास्यामः||९५||
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tatra prakr̥tyādīn bhāvānanuvyākhyāsyāmaḥ | tadyathā- śukraśōṇitaprakr̥tiṁ, kālagarbhāśayaprakr̥tiṁ, āturāhāravihāraprakr̥tiṁ, mahābhūtavikāraprakr̥tiṁ ca garbhaśarīramapēkṣatē| ētāni hi yēna yēna dōṣēṇādhikēnaikēnānēkēna vā samanubadhyantē, tēna tēna dōṣēṇa garbhō'nubadhyatē; tataḥ sā sā dōṣaprakr̥tirucyatē manuṣyāṇāṁ garbhādipravr̥ttā| tasmācchlēṣmalāḥ prakr̥tyā kēcit, pittalāḥ kēcit, vātalāḥ kēcit, saṁsr̥ṣṭāḥ kēcit, samadhātavaḥ kēcidbhavanti| tēṣāṁ hi lakṣaṇāni vyākhyāsyāmaḥ||95||

tatra prakRutyAdIn bhAvAnanuvyAkhyAsyAmaH [1] |
tadyathA- shukrashoNitaprakRutiM, kAlagarbhAshayaprakRutiM, AturAhAravihAraprakRutiM,mahAbhUtavikAraprakRutiM ca garbhasharIramapekShate|
etAni [2] hi yena yena doSheNAdhikenaikenAnekena [3] vA samanubadhyante, tena tena doSheNagarbho~anubadhyate; tataH sA sA doShaprakRutirucyate manuShyANAM garbhAdipravRuttA|
tasmAcchleShmalAH prakRutyA kecit, pittalAH kecit, vAtalAH kecit, saMsRuShTAH kecit, samadhAtavaHkecidbhavanti|
teShAM hi lakShaNAni vyAkhyAsyAmaH||95||
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<div style="text-align:justify;">
Explanation regarding factors ''prakriti'' etc. are explained henceforth– the constitution (''prakriti'') associated with fetus (''garbha'') is determined by constitution of sperm and ovum, the time (of conception) and status of health of uterus, diet and lifestyle of mother (during pregnancy) and interaction of ''mahabhutas''. Body humors (''dosha''), one or more than one which predominates in these factors gets attached to the fetus which is called physical or ''doshika'' constitution (''dosha prakriti'') of human beings which is emerged from the initial stage of fetus. Hence some persons are constitutionally having predominance of ''kapha''(''shleshma'') some ''pittala'', some ''vatala'' some having, combined ''dosha'' and some with balanced ''dhatus''. Their characters are described here. [95]
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===== Characteristics of ''kapha prakriti'' =====
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श्लेष्माहिस्निग्धश्लक्ष्णमृदुमधुरसारसान्द्रमन्दस्तिमितगुरुशीतविज्जलाच्छः| तस्यस्नेहाच्छ्लेष्मलाःस्निग्धाङ्गाः, श्लक्ष्णत्वाच्छ्लक्ष्णाङ्गाः, मृदुत्वाद्दृष्टिसुखसुकुमारावदातगात्राः, माधुर्यात्प्रभूतशुक्रव्यवायापत्याः, सारत्वात्सारसंहतस्थिरशरीराः, सान्द्रत्वादुपचितपरिपूर्णसर्वाङ्गाः, मन्दत्वान्मन्दचेष्टाहारव्याहाराः, स्तैमित्यादशीघ्रारम्भक्षोभविकाराः, गुरुत्वात्साराधिष्ठितावस्थितगतयः, शैत्यादल्पक्षुत्तृष्णासन्तापस्वेददोषाः, विज्जलत्वात्सुश्लिष्टसारसन्धिबन्धनाः, तथाऽच्छत्वात्प्रसन्नदर्शनाननाःप्रसन्नस्निग्धवर्णस्वराश्चभवन्ति| तएवङ्गुणयोगाच्छ्लेष्मलाबलवन्तोवसुमन्तोविद्यावन्तओजस्विनःशान्ताआयुष्मन्तश्चभवन्ति||९६||
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ślēṣmā hi snigdhaślakṣṇamr̥dumadhurasārasāndramandastimitaguruśītavijjalācchaḥ| tasya snēhācchlēṣmalāḥ snigdhāṅgāḥ, ślakṣṇatvācchlakṣṇāṅgāḥ, mr̥dutvāddr̥ṣṭisukhasukumārāvadātagātrāḥ, mādhuryāt prabhūtaśukravyavāyāpatyāḥ, sāratvāt sārasaṁhatasthiraśarīrāḥ, sāndratvādupacitaparipūrṇasarvāṅgāḥ, mandatvānmandacēṣṭāhāravyāhārāḥ, staimityādaśīghrārambhakṣōbhavikārāḥ, gurutvāt sārādhiṣṭhitāvasthitagatayaḥ, śaityādalpakṣuttr̥ṣṇāsantāpasvēdadōṣāḥ, vijjalatvāt suśliṣṭasārasandhibandhanāḥ, tathā'cchatvāt prasannadarśanānanāḥ prasannasnigdhavarṇasvarāśca bhavanti| ta ēvaṅguṇayōgācchlēṣmalā balavantō vasumantō vidyāvanta ōjasvinaḥ śāntā āyuṣmantaśca bhavanti||96||

shleShmA hi snigdhashlakShNamRudumadhurasArasAndramandastimitagurushItavijjalAcchaH|
tasya snehAcchleShmalAH snigdhA~ggAH, shlakShNatvAcchlakShNA~ggAH,mRudutvAddRuShTisukhasukumArAvadAtagAtrAH, mAdhuryAt prabhUtashukravyavAyApatyAH, sAratvAtsArasaMhatasthirasharIrAH, sAndratvAdupacitaparipUrNasarvA~ggAH,mandatvAnmandaceShTAhAravyAhArAH, staimityAdashIghrArambhakShobhavikArAH, gurutvAtsArAdhiShThitAvasthitagatayaH, shaityAdalpakShuttRuShNAsantApasvedadoShAH, vijjalatvAtsushliShTasArasandhibandhanAH, tathA~acchatvAt prasannadarshanAnanAHprasannasnigdhavarNasvarAshca bhavanti|
ta eva~gguNayogAcchleShmalA balavanto vasumanto vidyAvanta ojasvinaH shAntA AyuShmantashcabhavanti||96||
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''Shleshma'' is unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), sweet (''madhura''), essence (''sara''), dense (''sandra''), slow acting (''manda''), stable (''stimita''), heavy (''guru''), cold (''sheeta''), slimy (''vijjala'') and clear (''acchah''). Because of its unctuousness the person with predominance of ''kapha'' has unctuous organs; due to smoothness smooth organs; due to softness he has pleasing, delicate and fair organs; due to sweetness person has abundant semen, libido and more progeny; due to nature of essence excellent person has compact and stable body; due to density, all organs are well developed and perfect; due to slowness, dull/ slow in activities, diet and speech; due to stability delayed initiation, irritation and slow in change of attitude /(disorders are slowly progressive); due to heaviness movements are supported with essence and stability; due to coldness little hunger, thirst, heat and perspiration, due to sliminess well united and strong joint ligaments, due to clarity clear eyes, face with clear and unctuous complexion and affectionate voice. Because of presence of these qualities the ''kapha'' dominated personality(''shleshmala'') persons are strong, wealthy, learned, brave, calm and long lived.[96]
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===== Characteristics of ''pitta prakriti'' =====
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पित्तमुष्णंतीक्ष्णंद्रवंविस्रमम्लंकटुकञ्च| तस्यौष्ण्यात्पित्तलाभवन्त्युष्णासहा, उष्णमुखाः, सुकुमारावदातगात्राः , प्रभूतविप्लुव्यङ्गतिलपिडकाः, क्षुत्पिपासावन्तः, क्षिप्रवलीपलितखालित्यदोषाः, प्रायोमृद्वल्पकपिलश्मश्रुलोमकेशाश्च; तैक्ष्ण्यात्तीक्ष्णपराक्रमाः, तीक्ष्णाग्नयः, प्रभूताशनपानाः, क्लेशासहिष्णवो, दन्दशूकाः; द्रवत्वाच्छिथिलमृदुसन्धिमांसाः, प्रभूतसृष्टस्वेदमूत्रपुरीषाश्च; विस्रत्वात्प्रभूतपूतिकक्षास्यशिरःशरीरगन्धाः; कट्वम्लत्वादल्पशुक्रव्यवायापत्याः; तएवङ्गुणयोगात्पित्तलामध्यबलामध्यायुषोमध्यज्ञानविज्ञानवित्तोपकरणवन्तश्चभवन्ति||९७||
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pittamuṣṇaṁ tīkṣṇaṁ dravaṁ visramamlaṁ kaṭukañca| tasyauṣṇyāt pittalā bhavantyuṣṇāsahā, uṣṇamukhāḥ, sukumārāvadātagātrāḥ , prabhūtavipluvyaṅgatilapiḍakāḥ, kṣutpipāsāvantaḥ, kṣipravalīpalitakhālityadōṣāḥ, prāyōmr̥dvalpakapilaśmaśrulōmakēśāśca; taikṣṇyāttīkṣṇaparākramāḥ, tīkṣṇāgnayaḥ, prabhūtāśanapānāḥ, klēśāsahiṣṇavō, dandaśūkāḥ; dravatvācchithilamr̥dusandhimāṁsāḥ, prabhūtasr̥ṣṭasvēdamūtrapurīṣāśca; visratvāt prabhūtapūtikakṣāsyaśiraḥśarīragandhāḥ; kaṭvamlatvādalpaśukravyavāyāpatyāḥ; ta ēvaṅguṇayōgāt pittalā madhyabalā madhyāyuṣō madhyajñānavijñānavittōpakaraṇavantaśca bhavanti||97||

pittamuShNaM tIkShNaM dravaM visramamlaM kaTuka~jca|
tasyauShNyAt pittalA bhavantyuShNAsahA, uShNamukhAH, sukumArAvadAtagAtrAH [1] ,prabhUtavipluvya~ggatilapiDakAH, kShutpipAsAvantaH, kShipravalIpalitakhAlityadoShAH,prAyomRudvalpakapilashmashrulomakeshAshca; taikShNyAttIkShNaparAkramAH, tIkShNAgnayaH,prabhUtAshanapAnAH, kleshAsahiShNavo, dandashUkAH; dravatvAcchithilamRudusandhimAMsAH,prabhUtasRuShTasvedamUtrapurIShAshca; visratvAt prabhUtapUtikakShAsyashiraHsharIragandhAH;kaTvamlatvAdalpashukravyavAyApatyAH; ta eva~gguNayogAt pittalA madhyabalA madhyAyuShomadhyaj~jAnavij~jAnavittopakaraNavantashca bhavanti||97||
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<div style="text-align:justify;">
''Pitta'' is hot (''ushna''), sharply/acutely acting (''tikshna''), liquid (''drava''), of fleshy smell (''visram''), sour (''amla'') and pungent (''katu''). Due to hotness, the persons having predominance of ''pitta'' are intolerant to heat, vulnerable to disorders due to heat delicate and beautiful body, plenty of moles, freckles, black-moles and pimples, excessive hunger and thirst, early appearance of wrinkles, graying and falling of hairs, mostly soft, scanty and brown beard/mustaches, hairs; due to sharpness/acuteness, sharply acting and valor, intense digestive power, intake of plenty of food and drink, lack of endurance, frequently eating; due to liquidity, lax and soft joints and muscles, excess perspiration, urination and defecation; due to fleshy smell foul smell in axilla, mouth, head and body; due to pungency and sourness there is less semen, libido and few progeny; because of presence of these qualities persons having predominance of pitta are moderate in strength, lifespan, knowledge, understanding, wealth and means.[97]
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===== Characteristics of ''vata prakriti'' =====
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वातस्तुरूक्षलघुचलबहुशीघ्रशीतपरुषविशदः| तस्यरौक्ष्याद्वातलारूक्षापचिताल्पशरीराःप्रततरूक्षक्षामसन्नसक्तजर्जरस्वराजागरूकाश्चभवन्ति, लघुत्वाल्लघुचपलगतिचेष्टाहारव्याहाराः, चलत्वादनवस्थितसन्ध्यक्षिभ्रूहन्वोष्ठजिह्वाशिरःस्कन्धपाणिपादाः, बहुत्वाद्बहुप्रलापकण्डरासिराप्रतानाः, शीघ्रत्वाच्छ्रीघ्रसमारम्भक्षोभविकाराःशीघ्रत्रासरागविरागाःश्रुतग्राहिणोऽल्पस्मृतयश्च, शैत्याच्छीतासहिष्णवःप्रततशीतकोद्वेपकस्तम्भाः, पारुष्यात्परुषकेशश्मश्रुरोमनखदशनवदनपाणिपादाः, वैशद्यात्स्फुटिताङ्गावयवाःसततसन्धिशब्दगामिनश्चभवन्ति; तएवङ्गुणयोगाद्वातलाःप्रायेणाल्पबलाश्चाल्पायुषश्चाल्पापत्याश्चाल्पसाधनाश्चाल्पधनाश्चभवन्ति||९८||
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vātastu rūkṣalaghucalabahuśīghraśītaparuṣaviśadaḥ| tasya raukṣyādvātalā rūkṣāpacitālpaśarīrāḥ pratatarūkṣakṣāmasannasaktajarjarasvarā jāgarūkāśca bhavanti,laghutvāllaghucapalagaticēṣṭāhāravyāhārāḥ, calatvādanavasthitasandhyakṣibhrūhanvōṣṭhajihvāśiraḥskandhapāṇipādāḥ, bahutvādbahupralāpakaṇḍarāsirāpratānāḥ, śīghratvācchrīghrasamārambhakṣōbhavikārāḥ śīghratrāsarāgavirāgāḥ śrutagrāhiṇō'lpasmr̥tayaśca, śaityācchītāsahiṣṇavaḥ pratataśītakōdvēpakastambhāḥ, pāruṣyāt paruṣakēśaśmaśrurōmanakhadaśanavadanapāṇipādāḥ, vaiśadyāt sphuṭitāṅgāvayavāḥ satatasandhiśabdagāminaśca bhavanti; ta ēvaṅguṇayōgādvātalāḥ prāyēṇālpabalāścālpāyuṣaścālpāpatyāścālpasādhanāścālpadhanāśca bhavanti||98||

vAtastu rUkShalaghucalabahushIghrashItaparuShavishadaH|
tasya raukShyAdvAtalA rUkShApacitAlpasharIrAH pratatarUkShakShAmasannasaktajarjarasvarA [1]jAgarUkAshca bhavanti, laghutvAllaghucapalagaticeShTAhAravyAhArAH,calatvAdanavasthitasandhyakShibhrUhanvoShThajihvAshiraHskandhapANipAdAH,bahutvAdbahupralApakaNDarAsirApra<br>tAnAH, shIghratvAcchrIghrasamArambhakShobhavikArAHshIghratrAsarAgavirAgAH shrutagrAhiNo~alpasmRutayashca, shaityAcchItAsahiShNavaHpratatashItakodvepakastambhAH, pAruShyAtparuShakeshashmashruromanakhadashanavadanapANipAdAH, vaishadyAt sphuTitA~ggAvayavAHsatatasandhishabdagAminashca bhavanti; ta eva~gguNayogAdvAtalAHprAyeNAlpabalAshcAlpAyuShashcAlpApatyAshcAlpasAdhanAshcAlpadhanAshca bhavanti||98||
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''Vata'' is rough (''ruksha''), light (''laghu''), mobile (''chala''), abundant (''bahu''), swift (''shighra''), cold (''sheeta''), coarse (''parusha'') and non-slimy (''vishada'').
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Due to roughness the persons with predominance of ''vata'' have rough, underdeveloped and short stature, constant rough, weak, low, adhered and hoarse voice, wakeful; due to lightness, light and fickle movements, activities, diet and speech; due to mobility, unstable joints, eye brows, jaw, lips, tongue, head, shoulder, hands and feet; due to abundance, talkativeness and visually abundance of tendons and venous network; due to swiftness hasty initiation, quick irritation and disorder, quick in fear attachment and disenchantment, quick in acquisition but with a poor memory (retention); due to coldness intolerance to cold, continuously infliction with cold, shivering and stiffness; due to coarseness, coarse hairs, beard-mustaches, hairs, nails, teeth, face, hands and feet, due to non-sliminess cracked body parts and constant sound in joints during movement. Because of presence of these qualities the persons having predominance of ''vata'' have mostly low degree of strength, life-span, progeny, means and wealth. [98]
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संसर्गात्संसृष्टलक्षणाः||९९||
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saṁsargāt saṁsr̥ṣṭalakṣaṇāḥ||99||

saMsargAt saMsRuShTalakShaNAH||99||
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And due to combination of ''doshas'', characters are found accordingly.[99]
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सर्वगुणसमुदितास्तुसमधातवः| इत्येवंप्रकृतितःपरीक्षेत||१००||
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sarvaguṇasamuditāstu samadhātavaḥ| ityēvaṁ prakr̥titaḥ parīkṣēta||100||

sarvaguNasamuditAstu samadhAtavaH|
ityevaM prakRutitaH parIkSheta||100||
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In persons having equilibrium of all ''dhatus'', the characters of all of the three are found. Thus one should examine the constitution.[100]

==== Assessment of ''vikriti'' (disorder) ====
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विकृतितश्चेतिविकृतिरुच्यतेविकारः| तत्रविकारंहेतु-दोष-दूष्य-प्रकृति-देश-काल-बलविशेषैर्लिङ्गतश्चपरीक्षेत, नह्यन्तरेणहेत्वादीनांबलविशेषंव्याधिबलविशेषोपलब्धिः| यस्यहिव्याधेर्दोष-दूष्य-प्रकृति-देश-काल-बलसाम्यंभवति, महच्चहेतुलिङ्गबलं, सव्याधिर्बलवान्भवति; तद्विपर्ययाच्चाल्पबलः; मध्यबलस्तुदोषदूष्यादीनामन्यतमसामान्याद्धेतुलिङ्गमध्यबलत्वाच्चोपलभ्यते||१०१||
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vikr̥titaścēti vikr̥tirucyatē vikāraḥ| tatra vikāraṁ hētu-dōṣa-dūṣya-prakr̥ti-dēśa-kāla-balaviśēṣairliṅgataśca parīkṣēta, na hyantarēṇa hētvādīnāṁ balaviśēṣaṁ vyādhibalaviśēṣōpalabdhiḥ| yasya hi vyādhērdōṣa-dūṣya-prakr̥ti-dēśa-kāla-balasāmyaṁ bhavati, mahacca hētuliṅgabalaṁ, sa vyādhirbalavān bhavati; tadviparyayāccālpabalaḥ; madhyabalastu dōṣadūṣyādīnāmanyatamasāmānyāddhētuliṅgamadhyabalatvāccōpalabhyatē||101||

vikRutitashceti vikRutirucyate vikAraH|
tatra vikAraM hetu-doSha-dUShya-prakRuti-desha-kAla-balavisheShairli~ggatashca parIkSheta, nahyantareNa hetvAdInAM balavisheShaM vyAdhibalavisheShopalabdhiH|
yasya hi vyAdherdoSha-dUShya-prakRuti-desha-kAla-balasAmyaM bhavati, mahacca hetuli~ggabalaM, savyAdhirbalavAn bhavati; tadviparyayAccAlpabalaH; madhyabalastudoShadUShyAdInAmanyatamasAmAnyAddhetuli~ggamadhyabalatvAccopalabhyate||101||
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Patient examination should be done with respect of ''vikriti'' as well. ''Vikriti'' is ''vikara'' (disorder or pathological manifestation). The disorder should be examined in terms of the strength of the cause (''hetu''), ''dosha''(vitiating factors), ''dushya''(vitiated factors), constitution (''prakriti''), place (''desha''), time (''kala'') and the symptoms. The severity of the disease cannot be known without knowing the strength of the cause etc. factors. The disease having common ''dushya'', constitution, place and time along with strong cause and severity of symptoms is more, then such diseases are severe. The contrary is mild. The moderate disease has similarity in one of the ''dosha'', ''dushya'' etc. and as such moderate strength of cause and severity of symptoms.[101]
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==== Assessment of ''sara'' (best qualities of body tissues) ====
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सारतश्चेतिसाराण्यष्टौपुरुषाणांबलमानविशेषज्ञानार्थमुपदिश्यन्ते; तद्यथा- त्वग्रक्तमांसमेदोऽस्थिमज्जशुक्रसत्त्वानीति||१०२||
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sārataścēti sārāṇyaṣṭau puruṣāṇāṁ balamānaviśēṣajñānārthamupadiśyantē; tadyathā- tvagraktamāṁsamēdō'sthimajjaśukrasattvānīti||102||

sAratashceti sArANyaShTau puruShANAM balamAnavisheShaj~jAnArthamupadishyante; tadyathA-tvagraktamAMsamedo~asthimajjashukrasattvAnIti||102||
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Moreover a patient should be examined in respect of ''sara'' i.e. (best qualities of body tissues). There are eight types of ''sara'' in human beings which are described here for the knowledge of degree of strength such as –''tvak, rakta, mamsa, meda, asthi, majja, shukra'' and ''sattva''.[102]

===== Characteristics of ''twak sara'' (best quality of skin) =====
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तत्रस्निग्धश्लक्ष्णमृदुप्रसन्नसूक्ष्माल्पगम्भीरसुकुमारलोमासप्रभेवचत्वक्त्वक्साराणाम्| सासारतासुखसौभाग्यैश्वर्योपभोगबुद्धिविद्यारोग्यप्रहर्षणान्यायुष्यत्वंचाचष्टे||१०३||
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tatra snigdhaślakṣṇamr̥duprasannasūkṣmālpagambhīrasukumāralōmā saprabhēva ca tvak tvaksārāṇām| sā sāratā sukhasaubhāgyaiśvaryōpabhōgabuddhividyārōgyapraharṣaṇānyāyuṣyatvaṁ cācaṣṭē||103||

tatra snigdhashlakShNamRuduprasannasUkShmAlpagambhIrasukumAralomA saprabheva ca tvaktvaksArANAm|
sA sAratA sukhasaubhAgyaishvaryopabhogabuddhividyArogyapraharShaNAnyAyuShyatvaMcAcaShTe||103||
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In persons who are ''tvaksara'' (having constitutional essence of skin), the skin is unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), clean and adorable (''prasanna'') with fine (''sukshma''), thin (''alpa''), deep rooted (''gambhira'') and delicate (''sukumara'') hairs and is lustrous (''prabha''). This essence indicates happiness, good fortune, power, enjoyment, intelligence, knowledge, health, cheerfulness and longevity. [103]
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===== Characteristics of ''rakta sara'' (best quality of blood tissue) =====
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कर्णाक्षिमुखजिह्वानासौष्ठपाणिपादतलनखललाटमेहनंस्निग्धरक्तवर्णंश्रीमद्भ्राजिष्णुरक्तसाराणाम्| सासारतासुखमुद्धतांमेधांमनस्वित्वंसौकुमार्यमनतिबलमक्लेशसहिष्णुत्वमुष्णासहिष्णुत्वंचाचष्टे||१०४||
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karṇākṣimukhajihvānāsauṣṭhapāṇipādatalanakhalalāṭamēhanaṁ snigdharaktavarṇaṁ śrīmadbhrājiṣṇu raktasārāṇām| sā sāratā sukhamuddhatāṁ mēdhāṁ manasvitvaṁ saukumāryamanatibalamaklēśasahiṣṇutvamuṣṇāsahiṣṇutvaṁ cācaṣṭē||104||

karNAkShimukhajihvAnAsauShThapANipAdatalanakhalalATamehanaM snigdharaktavarNaMshrImadbhrAjiShNu raktasArANAm|
sA sAratA sukhamuddhatAM medhAM manasvitvaMsaukumAryamanatibalamakleshasahiShNutvamuShNAsahiShNutvaM cAcaShTe||104||
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In persons with essence of ''rakta'' have their ear, eye, face, tongue, nose, lips, palms, soles, nails, forehead and genitals to be unctuous, red, beautiful and shining. This essence indicates happiness, sharp intellect, magnanimity, tenderness, moderate strength, lack for endurance and intolerance to heat.[104]

===== Characteristics of ''mamsa sara'' (best quality of muscular tissue) =====
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शङ्खललाटकृकाटिकाक्षिगण्डहनुग्रीवास्कन्धोदरकक्षवक्षःपाणिपादसन्धयःस्थिरगुरुशुभमांसोपचितामांससाराणाम्| सासारताक्षमांधृतिमलौल्यंवित्तंविद्यांसुखमार्जवमारोग्यंबलमायुश्चदीर्घमाचष्टे||१०५||
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śaṅkhalalāṭakr̥kāṭikākṣigaṇḍahanugrīvāskandhōdarakakṣavakṣaḥpāṇipādasandhayaḥ sthiraguruśubhamāṁsōpacitā māṁsasārāṇām| sā sāratā kṣamāṁ dhr̥timalaulyaṁ vittaṁ vidyāṁ sukhamārjavamārōgyaṁ balamāyuśca dīrghamācaṣṭē||105||

sha~gkhalalATakRukATikAkShigaNDahanugrIvAskandhodarakakShavakShaHpANipAdasandhayaHsthiragurushubhamAMsopacitA mAMsasArANAm|
sA sAratA kShamAM dhRutimalaulyaM vittaM vidyAM sukhamArjavamArogyaM balamAyushcadIrghamAcaShTe||105||
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The persons having essence of ''mamsa'' have their temples (''shankha''), forehead (''lalata''), nape (''krikatika''), eyes (''akshi''), cheek (''ganda''), jaws (''hanu''), neck (''griva''), shoulder (''skandha''), abdomen (''udara''), axillae (''kaksha''), chest (''vaksha''), hands (''pani''), feet (''pada'')and joints (''sandhi'') well developed with firm, heavy and good looking muscles. This essence indicates forbearance, restraint, and lack of greed, wealth, knowledge, happiness, simplicity, health, strength and longevity.[105]
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===== Characteristics of ''meda sara'' (best quality of lipid tissues) =====
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वर्णस्वरनेत्रकेशलोमनखदन्तौष्ठमूत्रपुरीषेषुविशेषतःस्नेहोमेदःसाराणाम्| सासारतावित्तैश्वर्यसुखोपभोगप्रदानान्यार्जवंसुकुमारोपचारतांचाचष्टे||१०६||
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varṇasvaranētrakēśalōmanakhadantauṣṭhamūtrapurīṣēṣu viśēṣataḥ snēhōmēdaḥsārāṇām|sāsāratāvittaiśvaryasukhōpabhōgapradānānyārjavaṁ sukumārōpacāratāṁ cā caṣṭē||106||

varNasvaranetrakeshalomanakhadantauShThamUtrapurISheShu visheShataH sneho medaHsArANAm|
sA sAratA vittaishvaryasukhopabhogapradAnAnyArjavaM sukumAropacAratAM cA caShTe||106||
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The person endowed with essence of ''meda'' have significant unctuousness specifically in complexion, voice, eyes, hair, skin hairs, nails, teeth, lips, urine and feces. This indicates wealth, power, happiness, enjoyment, charity, simplicity and delicacy in dealings.[106]

===== Characteristics of ''asthi sara'' (best quality of bone) =====
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पार्ष्णिगुल्फजान्वरत्निजत्रुचिबुकशिरःपर्वस्थूलाःस्थूलास्थिनखदन्ताश्चास्थिसाराः| तेमहोत्साहाःक्रियावन्तःक्लेशसहाःसारस्थिरशरीराभवन्त्यायुष्मन्तश्च||१०७||
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pārṣṇigulphajānvaratnijatrucibukaśiraḥparvasthūlāḥ
|sthūlāsthinakhadantāścāsthisārāḥ|tēmahōtsāhāḥkriyāvantaḥ klēśasahāḥ sārasthiraśarīrā bhavantyāyuṣmantaśca||107||

pArShNigulphajAnvaratnijatrucibukashiraHparvasthUlAH sthUlAsthinakhadantAshcAsthisArAH|
te mahotsAhAH kriyAvantaH kleshasahAH sArasthirasharIrA bhavantyAyuShmantashca||107||
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Person with ''asthi sara'' has prominent heels (''parshni''), ankles (''gulpha''), knee joint (''janu''), elbows (''aratni''), collarbones (''jatru''), chin (''chibuka''), head (''shira''), flanks (''parshva'') and joints and also bones and teeth. Such persons are excess enthusiastic, very active, enduring, having strong and firm body as well as longevity.[107]

===== Characteristics of ''majja sara''(best quality of bone marrow tissue) =====
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मृद्वङ्गाबलवन्तःस्निग्धवर्णस्वराःस्थूलदीर्घवृत्तसन्धयश्चमज्जसाराः| तेदीर्घायुषोबलवन्तःश्रुतवित्तविज्ञानापत्यसम्मानभाजश्चभवन्ति||१०८||
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mr̥dvaṅgā balavantaḥ snigdhavarṇasvarāḥ sthūladīrghavr̥ttasandhayaśca majjasārāḥ| tē dīrghāyuṣō balavantaḥ śrutavittavijñānāpatyasammānabhājaśca bhavanti||108||

mRudva~ggA balavantaH snigdhavarNasvarAH sthUladIrghavRuttasandhayashca majjasArAH|
te dIrghAyuSho balavantaH shrutavittavij~jAnApatyasammAnabhAjashca bhavanti||108||
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The persons with soft body parts, strong, unctuous complexion and sweet voice, prominent (''sthula''), long (''dirgha'') and rounded joints should be known as ''majjasara'' (or the essence of''majja''). They are long-lived, strong and endowed with learning ability, wealth, understanding, progeny and respectful image.[108]

===== Characteristics of ''shukra sara''(best quality of reproductive tissues) =====
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सौम्याःसौम्यप्रेक्षिणःक्षीरपूर्णलोचनाइवप्रहर्षबहुलाःस्निग्धवृत्तसारसमसंहतशिखरदशनाःप्रसन्नस्निग्धवर्णस्वराभ्राजिष्णवोमहास्फिचश्चशुक्रसाराः| तेस्त्रीप्रियोपभोगा बलवन्तःसुखैश्वर्यारोग्यवित्तसम्मानापत्यभाजश्चभवन्ति||१०९||
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saumyāḥsaumyaprēkṣiṇaḥkṣīrapūrṇalōcanāivapraharṣabahulāḥsnigdhavr̥ttasārasamasaṁhataśikharadaśanāḥprasannasnigdhavarṇasvarābhrājiṣṇavōmahāsphicaścaśukr<br>asārāḥ|tēstrīpriyōpabhōgā balavantaḥsukhaiśvaryārōgyavittasammānāpatyabhājaścabhavanti||109||

saumyAH saumyaprekShiNaH kShIrapUrNalocanA iva praharShabahulAHsnigdhavRuttasArasamasaMhatashikharadashanAH prasannasnigdhavarNasvarA bhrAjiShNavomahAsphicashca shukrasArAH|
te strIpriyopabhogA [1] balavantaH sukhaishvaryArogyavittasammAnApatyabhAjashca bhavanti||109||
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The ''shukra sara'' (having essence in form of reproductive tissues) individuals are gentle and charming (''saumya''), charming and gentle look (''saumyaprekshina''), have beautiful eyes as if filled with milk (''kshirapurnalochana''), immensely exhilarated (''praharshabahula''), teeth are unctuous, rounded, firm, even and compact; having pleasant and unctuous complexion and voice, brilliant, having prominent buttocks.

They are liked by women for enjoyment, are strong and endowed with happiness, leisure, health, wealth, honor and progeny.[109]
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===== Characteristics of ''sattva sara'' (best quality of mind) =====
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स्मृतिमन्तोभक्तिमन्तःकृतज्ञाःप्राज्ञाःशुचयोमहोत्साहादक्षाधीराःसमरविक्रान्तयोधिनस्त्यक्तविषादाःसुव्यवस्थितगतिगम्भीरबुद्धिचेष्टाःकल्याणाभिनिवेशिनश्चसत्त्वसाराः| तेषांस्वलक्षणैरेवगुणाव्याख्याताः||११०||
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smr̥timantōbhaktimantaḥkr̥tajñāḥprājñāḥśucayōmahōtsāhādakṣādhīrāḥsamaravikrāntayōdhinastyaktaviṣādāḥsuvyavasthitagatigambhīrabuddhicēṣṭāḥkalyāṇābhinivēśinaścas<br>attvasārāḥ|tēṣāṁsvalakṣaṇairēvaguṇāvyākhyātāḥ||110||

smRutimanto bhaktimantaH kRutaj~jAH prAj~jAH shucayo mahotsAhA dakShA dhIrAHsamaravikrAntayodhinastyaktaviShAdAH suvyavasthitagatigambhIrabuddhiceShTAHkalyANAbhiniveshinashca sattvasArAH|
teShAM svalakShaNaireva guNA vyAkhyAtAH||110||
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The ''sattva sara'' persons are endowed with memory (''smriti''), devotion (''bhakti''), are grateful (''kritajna''), knowledgeable (''prajna''), cleanliness (''shuchi''), enthusiastic (''mahotsaha''), skillful (''daksha''), courageous (''dhira''), fighting in battle with valor, free from anxiety (''tyaktavishada''), having well-organized activities and highly intellectual abilities engaged in virtuous act.

Their characters are explained by their qualities mentioned above. [110]
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===== Characteristics of ''sarva sara'' (best quality of all tissues) =====
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तत्रसर्वैःसारैरुपेताःपुरुषाभवन्त्यतिबलाःपरमसुखयुक्ताः] क्लेशसहाःसर्वारम्भेष्वात्मनिजातप्रत्ययाःकल्याणाभिनिवेशिनःस्थिरसमाहितशरीराःसुसमाहितगतयःसानुनादस्निग्धगम्भीरमहास्वराःसुखैश्वर्यवित्तोपभोगसम्मानभाजोमन्दजरसोमन्दविकाराः<br>प्रायस्तुल्यगुणविस्तीर्णापत्याश्चिरजीविनश्च||१११||
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tatrasarvaiḥsārairupētāḥpuruṣābhavantyatibalāḥ paramasukhayuktāḥklēśasahāḥsarvārambhēṣvātmanijātapratyayāḥkalyāṇābhinivēśinaḥsthirasamāhitaśarīrāḥsusamāhitagatayaḥsānunādasnigdhagambhī<br>ramahāsvarāḥsukhaiśvaryavittōpabhōgasammānabhājōmandajarasōmandavikārāḥprāyastulyaguṇavistīrṇāpatyāścirajīvinaśca||111||

tatra sarvaiH sArairupetAH puruShA bhavantyatibalAH paramasukhayuktAH [2] kleshasahAHsarvArambheShvAtmani jAtapratyayAH kalyANAbhiniveshinaH sthirasamAhitasharIrAHsusamAhitagatayaH sAnunAdasnigdhagambhIramahAsvarAH sukhaishvaryavittopabhogasammAnabhAjomandajaraso mandavikArAH prAyastulyaguNavistIrNApatyAshcirajIvinashca||111||
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The persons having all essences are very strong and happy, enduring, confident in all actions, inclined to benevolent acts, having firm and balanced body with balanced movements; resonant, melodious, deep and high voice; endowed with happiness supremacy, wealth, enjoyment and honor; with slow ageing and pathogenic process, mostly having similar and numerous offspring and which are long-lived.[111]
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===== Characteristics of ''Asara'' (no/low quality of tissues) =====
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अतोविपरीतास्त्वसाराः||११२||
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atōviparītāstvasārāḥ||112||

ato viparItAstvasArAH||112||
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And those persons having no or less essence of tissues are contrary to these individual.[112]

===== Characteristics of ''madhya sara''(moderate quality of tissues) =====
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मध्यानांमध्यैःसारविशेषैर्गुणविशेषाव्याख्याताभवन्ति||११३||
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madhyānāṁmadhyaiḥsāraviśēṣairguṇaviśēṣāvyākhyātābhavanti||113||

madhyAnAM madhyaiHsAravisheShairguNavisheShA vyAkhyAtA bhavanti||113||
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Individual having moderate essence should be known by their respective qualities in moderate degrees. [113]
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इतिसाराण्यष्टौपुरुषाणांबलप्रमाणविशेषज्ञानार्थमुपदिष्टानिभवन्ति||११४||
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itisārāṇyaṣṭaupuruṣāṇāṁbalapramāṇaviśēṣajñānārthamupadiṣṭānibhavanti||114||

iti sArANyaShTau puruShANAM balapramANavisheShaj~jAnArthamupadiShTAni bhavanti||114||
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Thus eight types of essence of persons have been described for the knowledge of the degree of strength. [114]
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कथंनुशरीरमात्रदर्शनादेवभिषङ्मुह्येदयमुपचितत्वाद्बलवान्, अयमल्पबलःकृशत्वात्, महाबलोऽयंमहाशरीरत्वात्, अयमल्पशरीरत्वादल्पबलइति; दृश्यन्तेह्यल्पशरीराःकृशाश्चैकेबलवन्तः; तत्रपिपीलिकाभारहरणवत्सिद्धिः| अतश्चसारतःपरीक्षेतेत्युक्तम्] ||११५||
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kathaṁ nu śarīramātradarśanādēva bhiṣaṅmuhyēdayamupacitatvādbalavān, ayamalpabalaḥ kr̥śatvāt, mahābalō'yaṁ mahāśarīratvāt, ayamalpaśarīratvādalpabala iti; dr̥śyantē hyalpaśarīrāḥ kr̥śāścaikē balavantaḥ; tatra pipīlikābhāraharaṇavat siddhiḥ| ataśca sārataḥ parīkṣētētyuktam ||115||

kathaM nu sharIramAtradarshanAdeva bhiSha~gmuhyedayamupacitatvAdbalavAn, ayamalpabalaHkRushatvAt, mahAbalo~ayaM mahAsharIratvAt, ayamalpasharIratvAdalpabala iti; dRushyantehyalpasharIrAH kRushAshcaike balavantaH; tatra pipIlikAbhAraharaNavat siddhiH|
atashca sArataH parIkShetetyuktam [3] ||115||
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Physician may sometimes take wrong decision only by looking at the patient such as the patient is strong because of being corpulent, he is weak because of leanness, he is very strong because of possessing big body and he is very weak because of possessing small body. But it is observed that some persons having small body and leanness are strong like the small ants carrying a big load. This is the reason why essence (''sarata'') of ''dhatus'' is to be examined before understanding the ''bala'' of a patient.[115]
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==== Assessment of ''samhanana'' (compactness) ====
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संहननतश्चेतिसंहननं, संहतिः], संयोजनमित्येकोऽर्थः| तत्रसमसुविभक्तास्थि, सुबद्धसन्धि, सुनिविष्टमांसशोणितं, सुसंहतंशरीरमित्युच्यते| तत्रसुसंहतशरीराःपुरुषाबलवन्तः, विपर्ययेणाल्पबलाः, मध्यत्वात्संहननस्यमध्यबलाभवन्ति||११६||
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saṁhananataścēti saṁhananaṁ, saṁhatiḥ , saṁyōjanamityēkō'rthaḥ| tatra samasuvibhaktāsthi, subaddhasandhi, suniviṣṭamāṁsaśōṇitaṁ, susaṁhataṁ śarīramityucyatē| tatra susaṁhataśarīrāḥ puruṣā balavantaḥ, viparyayēṇālpabalāḥ, madhyatvāt saṁhananasya madhyabalā bhavanti||116||

saMhananatashceti saMhananaM, saMhatiH [1] , saMyojanamityeko~arthaH|
tatra samasuvibhaktAsthi, subaddhasandhi, suniviShTamAMsashoNitaM, susaMhataM sharIramityucyate|
tatra susaMhatasharIrAH puruShA balavantaH, viparyayeNAlpabalAH, madhyatvAt saMhananasyamadhyabalA bhavanti||116||
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The patient should also be examined by ''samhanana'' (compactness). ''Samhanana, Samhati'' and ''Samyojana'' are synonymous. A well compact body is known by evenly well demarcated bones (''samasuvibhaktasthi''), well bound joints (''subaddhasandhi''), well formed muscles and blood (''sunivishtamamsashonitam''). Those having well compact body are strong, otherwise weak and those having moderate compactness have medium strength. [116]
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==== Assessment of ''pramana'' (proportion and measurements) ====
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प्रमाणतश्चेतिशरीरप्रमाणंपुनर्यथास्वेनाङ्गुलिप्रमाणेनोपदेक्ष्यतेउत्सेधविस्तारायामैर्यथाक्रमम्| तत्रपादौ] चत्वारिषट्चतुर्दशाङ्गुलानि, जङ्घेत्वष्टादशाङ्गुलेषोडशाङ्गुलपरिक्षेपेच, जानुनीचतुरङ्गुलेषोडशाङ्गुलपरिक्षेपे, त्रिंशदङ्गुलपरिक्षेपावष्टादशाङ्गुलावूरु, षडङ्गुलदीर्घौवृषणावष्टाङ्गुलपरिणाहौ, शेफःषडङ्गुलदीर्घंपञ्चाङ्गुलपरिणाहं, द्वादशाङ्गुलिपरिणाहोभगः, षोडशाङ्गुलविस्ताराकटी, दशाङ्गुलंबस्तिशिरः, दशाङ्गुलविस्तारंद्वादशाङ्गुलमुदरं, दशाङ्गुलविस्तीर्णेद्वादशाङ्गुलायामेपार्श्वे, द्वादशाङ्गुलंस्तनान्तरं, द्व्यङ्गुलंस्तनपर्यन्तं, चतुर्विशत्यङ्गुलविशालंद्वादशाङ्गुलोत्सेधमुरः, द्व्यङ्गुलं] हृदयम्, अष्टाङ्गुलौस्कन्धौ, षडङ्गुलावंसौ, षोडशाङ्गुलौप्रबाहू, पञ्चदशाङ्गुलौप्रपाणी, हस्तौद्वादशाङ्गुलौ] , कक्षावष्टाङ्गुलौ, त्रिकंद्वादशाङ्गुलोत्सेधम्, अष्टादशाङ्गुलोत्सेधंपृष्ठं, चतुरङ्गुलोत्सेधाद्वाविंशत्यङ्गुलपरिणाहाशिरोधरा, द्वादशाङ्गुलोत्सेधंचतुर्विंशत्यङ्गुलपरिणाहमाननं, पञ्चाङ्गुलमास्यं, चिबुकौष्ठकर्णाक्षिमध्यनासिकाललाटंचतुरङ्गुलं, षोडशाङ्गुलोत्सेधंद्वात्रिंशदङ्गुलपरिणाहंशिरः; इतिपृथक्त्वेनाङ्गावयवानांमानमुक्तम्| केवलंपुनःशरीरमङ्गुलिपर्वाणिचतुरशीतिः| तदायामविस्तारसमंसमुच्यते| तत्रायुर्बलमोजःसुखमैश्वर्यंवित्तमिष्टाश्चापरेभावाभवन्त्यायत्ताःप्रमाणवतिशरीरे; विपर्ययस्त्वतोहीनेऽधिकेवा||११७||
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pramāṇataścēti śarīrapramāṇaṁ punaryathāsvēnāṅgulipramāṇēnōpadēkṣyatē utsēdhavistārāyāmairyathākramam| tatra pādau catvāri ṣaṭ caturdaśāṅgulāni, jaṅghē tvaṣṭādaśāṅgulē ṣōḍaśāṅgulaparikṣēpē ca, jānunī caturaṅgulē ṣōḍaśāṅgulaparikṣēpē, triṁśadaṅgulaparikṣēpāvaṣṭādaśāṅgulāvūru, ṣaḍaṅguladīrghau vr̥ṣaṇāvaṣṭāṅgulapariṇāhau, śēphaḥ ṣaḍaṅguladīrghaṁ pañcāṅgulapariṇāhaṁ, dvādaśāṅgulipariṇāhō bhagaḥ, ṣōḍaśāṅgulavistārā kaṭī, daśāṅgulaṁ bastiśiraḥ, daśāṅgulavistāraṁ dvādaśāṅgulamudaraṁ, daśāṅgulavistīrṇē dvādaśāṅgulāyāmē pārśvē, dvādaśāṅgulaṁ stanāntaraṁ, dvyaṅgulaṁ stanaparyantaṁ, caturviśatyaṅgulaviśālaṁ dvādaśāṅgulōtsēdhamuraḥ, dvyaṅgulaṁ hr̥dayam, aṣṭāṅgulau skandhau, ṣaḍaṅgulāvaṁsau, ṣōḍaśāṅgulau prabāhū, pañcadaśāṅgulau prapāṇī, hastau dvādaśāṅgulau , kakṣāvaṣṭāṅgulau, trikaṁ dvādaśāṅgulōtsēdham, aṣṭādaśāṅgulōtsēdhaṁ pr̥ṣṭhaṁ, caturaṅgulōtsēdhā dvāviṁśatyaṅgulapariṇāhā śirōdharā, dvādaśāṅgulōtsēdhaṁ caturviṁśatyaṅgulapariṇāhamānanaṁ, pañcāṅgulamāsyaṁ, cibukauṣṭhakarṇākṣimadhyanāsikālalāṭaṁ caturaṅgulaṁ, ṣōḍaśāṅgulōtsēdhaṁ dvātriṁśadaṅgulapariṇāhaṁ śiraḥ; iti pr̥thaktvēnāṅgāvayavānāṁ mānamuktam| kēvalaṁ punaḥśarīramaṅguliparvāṇi caturaśītiḥ| tadāyāmavistārasamaṁ samucyatē| tatrāyurbalamōjaḥ sukhamaiśvaryaṁ vittamiṣṭāścāparē bhāvā bhavantyāyattāḥ pramāṇavati śarīrē; viparyayastvatō hīnē'dhikē vā||117||

pramANatashceti sharIrapramANaM punaryathAsvenA~ggulipramANenopadekShyateutsedhavistArAyAmairyathAkramam|
tatra pAdau [1] catvAri ShaT caturdashA~ggulAni, ja~gghe tvaShTAdashA~gguleShoDashA~ggulaparikShepe ca, jAnunI catura~ggule ShoDashA~ggulaparikShepe,triMshada~ggulaparikShepAvaShTAdashA~ggulAvUru, ShaDa~gguladIrghauvRuShaNAvaShTA~ggulapariNAhau, shephaH ShaDa~gguladIrghaM pa~jcA~ggulapariNAhaM,dvAdashA~ggulipariNAho bhagaH, ShoDashA~ggulavistArA kaTI, dashA~ggulaM bastishiraH,dashA~ggulavistAraM dvAdashA~ggulamudaraM, dashA~ggulavistIrNe dvAdashA~ggulAyAme pArshve,dvAdashA~ggulaM stanAntaraM, dvya~ggulaM stanaparyantaM, caturvishatya~ggulavishAlaMdvAdashA~ggulotsedhamuraH, dvya~ggulaM [2] hRudayam, aShTA~ggulau skandhau,ShaDa~ggulAvaMsau, ShoDashA~ggulau prabAhU, pa~jcadashA~ggulau prapANI, hastaudvAdashA~ggulau [3] , kakShAvaShTA~ggulau, trikaM dvAdashA~ggulotsedham,aShTAdashA~ggulotsedhaM pRuShThaM, catura~ggulotsedhA dvAviMshatya~ggulapariNAhA shirodharA,dvAdashA~ggulotsedhaM caturviMshatya~ggulapariNAhamAnanaM, pa~jcA~ggulamAsyaM,cibukauShThakarNAkShimadhyanAsikAlalATaM catura~ggulaM, ShoDashA~ggulotsedhaMdvAtriMshada~ggulapariNAhaM shiraH; iti pRuthaktvenA~ggAvayavAnAM mAnamuktam|
kevalaM punaHsharIrama~gguliparvANi caturashItiH|
tadAyAmavistArasamaM samucyate|
tatrAyurbalamojaH sukhamaishvaryaM vittamiShTAshcApare bhAvA bhavantyAyattAH pramANavatisharIre; viparyayastvato hIne~adhike vA||117||
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Examination regarding measurement of body is to be described by the measure of individual fingers in terms of height, breadth, and length respectively. It is dealt under anthropometry. Feet are four (H.) six (B.) and fourteen (L) fingers; Calf region are eighteen fingers long and with sixteen fingers circumference; knees four fingers long with sixteen fingers circumference; thighs eighteen fingers (long) with thirty finger circumference; testicles six fingers long with eight fingers circumference; penis six fingers long with five fingers circumference; vulva with twelve fingers circumference; waist sixteen fingers broad, ''bastishira'' ten fingers, abdomen ten fingers broad and twelve finger long; sides ten fingers broad and twelve fingers long; interval between the breasts twelve fingers, (apex of the) heart two fingers, blades six fingers, arms sixteen fingers (long) forearms fifteen fingers (long); hands twelve fingers (long), axillae eighth fingers, sacral region twelve fingers height, back eighteen fingers height, neck four fingers height with twenty two fingers circumference, face twelve finger high with twenty four fingers circumference; mouth five fingers; chin, lips, ears, middle of the eyes, nose and forehead four fingers; head sixteen fingers high with thirty two fingers circumference. Thus measurement of the body parts has been said separately. The entire body measures eighty four fingers in height and also in breadth such individuals possess longevity, strength, immunity, happiness, supremacy, wealth and other desired facilities. Those having body with less or more measurement have qualities contrary to these.[117]
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==== Assessment of [[satmya]] (suitability) ====
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सात्म्यतश्चेतिसात्म्यंनामतद्यत्सातत्येनोपसेव्यमानमुपशेते| तत्रयेघृतक्षीरतैलमांसरससात्म्याःसर्वरससात्म्याश्चतेबलवन्तःक्लेशसहाश्चिरजीविनश्चभवन्ति, रूक्षसात्म्याःपुनरेकरससात्म्याश्चयेतेप्रायेणाल्पबलाअल्पक्लेशसहाअल्पायुषोऽल्पसाधनाश्चभवन्ति, व्यामिश्रसात्म्यास्तुयेतेमध्यबलाःसात्म्यनिमित्ततोभवन्ति||११८||
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sātmyataścēti sātmyaṁ nāma tadyat sātatyēnōpasēvyamānamupaśētē| tatra yē ghr̥takṣīratailamāṁsarasasātmyāḥ sarvarasasātmyāśca tē balavantaḥ klēśasahāścirajīvinaśca bhavanti, rūkṣasātmyāḥ punarēkarasasātmyāśca yē tē prāyēṇālpabalā alpaklēśasahā alpāyuṣō'lpasādhanāśca bhavanti, vyāmiśrasātmyāstu yē tē madhyabalāḥ sātmyanimittatō bhavanti||118||

sAtmyatashceti sAtmyaM nAma tadyat sAtatyenopasevyamAnamupashete|
tatra ye ghRutakShIratailamAMsarasasAtmyAH sarvarasasAtmyAshca te balavantaHkleshasahAshcirajIvinashca bhavanti, rUkShasAtmyAH punarekarasasAtmyAshca ye te prAyeNAlpabalAalpakleshasahA alpAyuSho~alpasAdhanAshca bhavanti, vyAmishrasAtmyAstu ye te madhyabalAHsAtmyanimittato bhavanti||118||
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Examination in respect to suitability by practice (''satmya'') should also be done. Suitable is that, which being used constantly has wholesome effect, those suited to ghee, milk, oil and meat soup, and to all ''rasas'' are strong, enduring and long-lived. On the contrary, those suited to rough diet and single rasa are often weak, unenduring, and short-lived and are with little means. Those having mixed suitability have medium strength.[118]
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==== Assessment of ''Sattva'' (psyche/mental strength) ====
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सत्त्वतश्चेतिसत्त्वमुच्यतेमनः| तच्छरीरस्यतन्त्रकमात्मसंयोगात्| तत्त्रिविधंबलभेदेन- प्रवरं, मध्यम्, अवरंचेति; अतश्चप्रवरमध्यावरसत्त्वाःपुरुषाभवन्ति| तत्रप्रवरसत्त्वाःसत्त्वसारास्तेसारेषूपदिष्टाः, स्वल्पशरीराह्यपितेनिजागन्तुनिमित्तासुमहतीष्वपिपीडास्वव्यथा] दृश्यन्तेसत्त्वगुणवैशेष्यात्; मध्यसत्त्वास्त्वपरानात्मन्युपनिधाय] संस्तम्भयन्त्यात्मनाऽऽत्मानंपरैर्वाऽपिसंस्तभ्यन्ते; हीनसत्त्वास्तुनात्मनानापिपरैःसत्त्वबलंप्रतिशक्यन्तेउपस्तम्भयितुं, महाशरीराह्यपितेस्वल्पानामपिवेदनानामसहादृश्यन्ते, सन्निहितभयशोकलोभमोहमानारौद्रभैरवद्विष्टबीभत्सविकृतसङ्कथास्वपिचपशुपुरुषमांसशोणितानिचावेक्ष्यविषादवैवर्ण्यमूर्च्छोन्मादभ्रमप्रपतनानामन्यतममाप्नुवन्त्यथवामरणमिति||११९||
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sattvataścēti sattvamucyatē manaḥ| taccharīrasya tantrakamātmasaṁyōgāt| tat trividhaṁ balabhēdēna- pravaraṁ, madhyam, avaraṁ cēti; ataśca pravaramadhyāvarasattvāḥ puruṣā bhavanti| tatra pravarasattvāḥ sattvasārāstē sārēṣūpadiṣṭāḥ, svalpaśarīrā hyapi tē nijāgantunimittāsu mahatīṣvapi pīḍāsvavyathā dr̥śyantē sattvaguṇavaiśēṣyāt; madhyasattvāstvaparānātmanyupanidhāya saṁstambhayantyātmanā''tmānaṁ parairvā'pi saṁstabhyantē; hīnasattvāstu nātmanā nāpi paraiḥ sattvabalaṁ prati śakyantē upastambhayituṁ, mahāśarīrā hyapi tē svalpānāmapi vēdanānāmasahā dr̥śyantē, sannihitabhayaśōkalōbhamōhamānā raudrabhairavadviṣṭabībhatsavikr̥tasaṅkathāsvapi ca paśupuruṣamāṁsaśōṇitāni cāvēkṣya viṣādavaivarṇyamūrcchōnmādabhramaprapatanānāmanyatamamāpnuvantyathavā maraṇamiti||119||

sattvatashceti sattvamucyate manaH|
taccharIrasya tantrakamAtmasaMyogAt|
tat trividhaM balabhedena- pravaraM, madhyam, avaraM ceti; atashca pravaramadhyAvarasattvAHpuruShA bhavanti|
tatra pravarasattvAH sattvasArAste sAreShUpadiShTAH, svalpasharIrA hyapi te nijAgantunimittAsumahatIShvapi pIDAsvavyathA [1] dRushyante sattvaguNavaisheShyAt;madhyasattvAstvaparAnAtmanyupanidhAya [2] saMstambhayantyAtmanA~a~atmAnaM parairvA~apisaMstabhyante; hInasattvAstu nAtmanA nApi paraiH sattvabalaM prati shakyante upastambhayituM,mahAsharIrA hyapi te svalpAnAmapi vedanAnAmasahA dRushyante, sannihitabhayashokalobhamohamAnAraudrabhairavadviShTabIbhatsavikRutasa~gkathAsvapi ca pashupuruShamAMsashoNitAni cAvekShyaviShAdavaivarNyamUrcchonmAdabhramaprapatanAnAmanyatamamApnuvantyathavA maraNamiti||119||
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One should also be examined in respect of psyche/mental strength(''sattva''). ''Sattva'' is known as mind, which controls the body functions by conjunction with the self. It is of three types according to strength- superior, medium and inferior. Accordingly, the persons are also (of three types) having superior, medium and inferior psyche.

Amongst them, those having superior mental strength are, in fact, ''sattva sara'' (with ''sattva'' as essence) and have been described in context of ''sara''. They, though possessing small stature body are seen unmoved even in severe affections (innate or exogenous) due to predominance of ''sattva'' quality.

Those having medium quality of psyche sustain themselves at the instance of other or entirely by others.

But those having inferior mind can sustain neither by themselves nor by others, although having big stature, they are unable to endure even mild pain, they are associated with fear, grief, greed, confusion and conceit; and even during fierce, frightening, disliked, disgusting and ugly narratives or on seeing the animal or human flesh or blood get afflicted with anxiety, abnormal complexion, fainting, insanity, giddiness or falling on the ground or even succumb to death.[119]
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==== Assessment of ''aharashakti'' (power of assimilation) ====
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आहारशक्तितश्चेतिआहारशक्तिरभ्यवहरणशक्त्याजरणशक्तयाचपरीक्ष्या; बलायुषीह्याहारायत्ते||१२०||
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āhāraśaktitaścēti āhāraśaktirabhyavaharaṇaśaktyā jaraṇaśaktayā ca parīkṣyā; balāyuṣī hyāhārāyattē||120||

AhArashaktitashceti AhArashaktirabhyavaharaNashaktyA jaraNashaktayA ca parIkShyA; balAyuShIhyAhArAyatte||120||
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Examination regarding power for assimilation (''aharashakti'') is to be done in respect of power of ingestion as well as digestion. Strength and life depends on diet.[120]

==== Assessment of ''vyayamashakti'' (exercise capacity) ====
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व्यायामशक्तितश्चेतिव्यायामशक्तिरपिकर्मशक्त्यापरीक्ष्या| कर्मशक्त्याह्यनुमीयतेबलत्रैविध्यम् ||१२१||
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vyāyāmaśaktitaścēti vyāyāmaśaktirapi karmaśaktyā parīkṣyā| karmaśaktyā hyanumīyatē balatraividhyam ||121||

vyAyAmashaktitashceti vyAyAmashaktirapi karmashaktyA parIkShyA|
karmashaktyA hyanumIyate balatraividhyam [1] ||121||
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In respect of capacity of exercise (''vyayamashakti'') examination should be done by the capactiy for work. In accordance with capacity for work strength is inferred as of three types (poor, moderate and good). [121]

==== Assessment of ''vaya'' (age) ====
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वयस्तश्चेतिकालप्रमाणविशेषापेक्षिणीहिशरीरावस्थावयोऽभिधीयते| तद्वयोयथास्थूलभेदेनत्रिविधं- बालं, मध्यं, जीर्णमिति| तत्रबालमपरिपक्वधातुमजातव्यञ्जनंसुकुमारमक्लेशसहमसम्पूर्णबलंश्लेष्मधातुप्रायमाषोडशवर्षं, विवर्धमानधातुगुणंपुनःप्रायेणानवस्थितसत्त्वमात्रिंशद्वर्षमुपदिष्टं; मध्यंपुनःसमत्वागतबलवीर्यपौरुषपराक्रमग्रहणधारणस्मरणवचनविज्ञानसर्वधातुगुणंबलस्थितमवस्थितसत्त्वमविशीर्यमाणधातुगुणंपित्तधातुप्रायमाषष्टिवर्षमुपदिष्टम्; अतःपरं
हीयमानधात्विन्द्रियबलवीर्यपौरुषपराक्रमग्रहणधारणस्मरणवचनविज्ञानंभ्रश्यमानधातुगुणंवायुधातुप्रायंक्रमेणजीर्णमुच्यतेआवर्षशतम्| वर्षशतंखल्वायुषःप्रमाणमस्मिन्काले; सन्तिचपुनरधिकोनवर्षशतजीविनोऽपिमनुष्याः; तेषांविकृतिवर्ज्यैःप्रकृत्यादिबलविशेषैरायुषोलक्षणतश्चप्रमाणमुपलभ्यवयसस्त्रित्वंविभजेत्||१२२||
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vayastaścēti kālapramāṇaviśēṣāpēkṣiṇī hi śarīrāvasthā vayō'bhidhīyatē| tadvayō yathāsthūlabhēdēna trividhaṁ- bālaṁ, madhyaṁ, jīrṇamiti| tatra bālamaparipakvadhātumajātavyañjanaṁ sukumāramaklēśasahamasampūrṇabalaṁ ślēṣmadhātuprāyamāṣōḍaśavarṣaṁ, vivardhamānadhātuguṇaṁ punaḥ prāyēṇānavasthitasattvamātriṁśadvarṣamupadiṣṭaṁ; madhyaṁ punaḥ samatvāgatabalavīryapauruṣaparākramagrahaṇadhāraṇasmaraṇavacanavijñānasarvadhātuguṇaṁ balasthitamavasthitasattvamaviśīryamāṇadhātuguṇaṁ pittadhātuprāyamāṣaṣṭivarṣamupadiṣṭam; ataḥ paraṁ
hīyamānadhātvindriyabalavīryapauruṣaparākramagrahaṇadhāraṇasmaraṇavacanavijñānaṁ bhraśyamānadhātuguṇaṁ vāyudhātuprāyaṁ kramēṇa jīrṇamucyatē āvarṣaśatam| varṣaśataṁ khalvāyuṣaḥ pramāṇamasmin kālē; santi ca punaradhikōnavarṣaśatajīvinō'pi manuṣyāḥ; tēṣāṁ vikr̥tivarjyaiḥ prakr̥tyādibalaviśēṣairāyuṣō lakṣaṇataśca pramāṇamupalabhya vayasastritvaṁ vibhajēt||122||

vayastashceti kAlapramANavisheShApekShiNI hi sharIrAvasthA vayo~abhidhIyate|
tadvayo yathAsthUlabhedena [1] trividhaM- bAlaM, madhyaM, jIrNamiti|
tatra bAlamaparipakvadhAtumajAtavya~jjanaM sukumAramakleshasahamasampUrNabalaMshleShmadhAtuprAyamAShoDashavarShaM, vivardhamAnadhAtuguNaM punaHprAyeNAnavasthitasattvamAtriMshadvarShamupadiShTaM; madhyaM punaHsamatvAgatabalavIryapauruShaparAkramagrahaNadhAraNasmaraNavacanavij~jAnasarvadhAtuguNaMbalasthitamavasthitasattvamavishIryamANadhAtuguNaMpittadh<br>AtuprAyamAShaShTivarShamupadiShTam; ataH paraM
hIyamAnadhAtvindriyabalavIryapauruShaparAkramagrahaNadhAraNasmaraNavacanavij~jAnaMbhrashyamAnadhAtuguNaM vAyudhAtuprAyaM krameNa jIrNamucyate AvarShashatam|
varShashataM khalvAyuShaH pramANamasmin kAle; santi ca punaradhikonavarShashatajIvino~apimanuShyAH; teShAM vikRutivarjyaiH prakRutyAdibalavisheShairAyuSho lakShaNatashcapramANamupalabhya vayasastritvaM vibhajet||122||
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Examination of a person with respect to age should be done as the state of body corresponds to the length of time. Age is broadly divided into three stages viz. childhood, middle age and old age.

Childhood is determined upto the age of sixteen years when ''dhatus'' are immature, sexual characters are not manifested the body is delicate, unenduring with incomplete strength and predominance of ''kapha dhatu''.

This again is perceived in two subtypes viz. ''dhatus'' in developing stage up to sixteen years and fickle mind up to thirty years.

The middle age is characterized by strength, energy, virility, valor, acquisition, retention, recollection, speech, understanding and qualities of all ''dhatus'' having developed properly; with proper physical and mental strength, without degeneration in qualities of ''dhatus'', with predominance of ''pitta dhatu'' and is up to sixty years.

Later is the old age up to one hundred years. During this period ''dhatus'', sense organs, strength, energy, virility, prowess, acquisition, retention, recollection, speech and understanding generally or gradually degenerate, this phase is predominated by ''vayu''. During this stage the measure of life span is one hundred years.

There are persons who lived longer or shorter than that, in such cases, one should determine the three divisions of age on the basis of strength of the factors like ''prakriti'' etc. except ''vikriti'' and also by the features of different periods of life span.[122]
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एवंप्रकृत्यादीनांविकृतिवर्ज्यानांभावानांप्रवरमध्यावरविभागेनबलविशेषंविभजेत्| विकृतिबलत्रैविध्येनतुदोषबलंत्रिविधमनुमीयते| ततोभैषज्यस्यतीक्ष्णमृदुमध्यविभागेनत्रैविध्यंविभज्ययथादोषंभैषज्यमवचारयेदिति||१२३||
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ēvaṁ prakr̥tyādīnāṁ vikr̥tivarjyānāṁ bhāvānāṁ pravaramadhyāvaravibhāgēna balaviśēṣaṁ vibhajēt| vikr̥tibalatraividhyēna tu dōṣabalaṁ trividhamanumīyatē| tatō bhaiṣajyasya tīkṣṇamr̥dumadhyavibhāgēna traividhyaṁ vibhajya yathādōṣaṁ bhaiṣajyamavacārayēditi||123||

evaM prakRutyAdInAM vikRutivarjyAnAM bhAvAnAM pravaramadhyAvaravibhAgena balavisheShaMvibhajet|
vikRutibalatraividhyena tu doShabalaM trividhamanumIyate|
tato bhaiShajyasya tIkShNamRudumadhyavibhAgena traividhyaM vibhajya yathAdoShaMbhaiShajyamavacArayediti||123||
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Thus, the strength of the entities like ''prakriti'', etc. barring ''vikriti'' should be determined in three divisions – superior, medium and inferior. According to severity of morbidity (''vikriti'') the three degrees of strength of ''dosha'' are inferred. In accordance with the medicaments should also be divided into three degrees i.e. strong, mild and moderate in regard to ''dosha''.[123]
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===== Knowledge of lifespan =====
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आयुषःप्रमाणज्ञानहेतोःपुनरिन्द्रियेषु] जातिसूत्रीयेचलक्षणान्युपदेक्ष्यन्ते||१२४||
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āyuṣaḥ pramāṇajñānahētōḥ punarindriyēṣu jātisūtrīyē ca lakṣaṇānyupadēkṣyantē||124||

AyuShaH pramANaj~jAnahetoH punarindriyeShu [1] jAtisUtrIye ca lakShaNAnyupadekShyante||124||
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In regard to knowledge of measure of life span, there is description of symptoms in Indriya sthana and Jatisutriya adhyaya (eighth chapter of sharira sthana).[124]

==== Assessment of ''Kala'' (time or stage or season) ====
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कालःपुनःसंवत्सरश्चातुरावस्थाच| तत्रसंवत्सरोद्विधात्रिधाषोढाद्वादशधाभूयश्चाप्यतःप्रविभज्यतेतत्तत्कार्यमभिसमीक्ष्य| अत्रखलुतावत्षोढाप्रविभज्यकार्यमुपदेक्ष्यते- हेमन्तोग्रीष्मोवर्षाश्चेतिशीतोष्णवर्षलक्षणास्त्रयऋतवोभवन्ति, तेषामन्तरेष्वितरेसाधारणलक्षणास्त्रयऋतवः- प्रावृट्शरद्वसन्ताइति| प्रावृडितिप्रथमःप्रवृष्टःकालः, तस्यानुबन्धोहिवर्षाः| एवमेतेसंशोधनमधिकृत्यषट्विभज्यन्तेऋतवः||१२५||
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kālaḥ punaḥ saṁvatsaraścāturāvasthā ca| tatra saṁvatsarō dvidhā tridhā ṣōḍhā dvādaśadhā bhūyaścāpyataḥ pravibhajyatē tattatkāryamabhisamīkṣya| atra khalu tāvat ṣōḍhā pravibhajya kāryamupadēkṣyatē- hēmantō grīṣmō varṣāścēti śītōṣṇavarṣalakṣaṇāstraya r̥tavō bhavanti, tēṣāmantarēṣvitarē sādhāraṇalakṣaṇāstraya r̥tavaḥ- prāvr̥ṭśaradvasantā iti| prāvr̥ḍiti prathamaḥ pravr̥ṣṭaḥ kālaḥ, tasyānubandhō hi varṣāḥ| ēvamētē saṁśōdhanamadhikr̥tya ṣaṭ vibhajyantē r̥tavaḥ||125||

kAlaH punaH saMvatsarashcAturAvasthA ca|
tatra saMvatsaro dvidhA tridhA ShoDhA dvAdashadhA bhUyashcApyataH pravibhajyatetattatkAryamabhisamIkShya|
atra khalu tAvat ShoDhA pravibhajya kAryamupadekShyate- hemanto grIShmo varShAshcetishItoShNavarShalakShaNAstraya Rutavo bhavanti, teShAmantareShvitare sAdhAraNalakShaNAstrayaRutavaH- prAvRuTsharadvasantA iti|
prAvRuDiti prathamaH pravRuShTaH [1] kAlaH, tasyAnubandho hi varShAH|
evamete saMshodhanamadhikRutya ShaT vibhajyante RutavaH||125||
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''Kala'' (time) has been considered of two types viz. year aspect and status of the patient. The year has been divided into two, three, six, twelve or even more parts according to nature of action (to be taken). Now, dividing into six, the action will be said. ''Hemanta'' (early winter), ''grishma'' (summer) and ''varsha'' (rainy season) these are the three seasons characterised by cold, heat and rains. In between them, there are other three seasons having common characters as ''pravrit'' (early rain), ''sharada'' (autumn) and ''vasanta'' (spring). ''Pravrit'' denotes the early rain; ''varsha'' is the continuation of the same. Thus, these six divisions of the seasons have been made for the purpose of evacuative therapy.[125]

==== Appropriate season for purification therapies ====
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तत्रसाधारणलक्षणेष्वृतुषुवमनादीनांप्रवृत्तिर्विधीयते, निवृत्तिरितरेषु| साधारणलक्षणाहिमन्दशीतोष्णवर्षत्वात्सुखतमाश्चभवन्त्यविकल्पकाश्चशरीरौषधानाम्, इतरेपुनरत्यर्थशीतोष्णवर्षत्वाद्दुःखतमाश्च
भवन्तिविकल्पकाश्चशरीरौषधानाम्||१२६||
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tatra sādhāraṇalakṣaṇēṣvr̥tuṣu vamanādīnāṁ pravr̥ttirvidhīyatē, nivr̥ttiritarēṣu| sādhāraṇalakṣaṇā hi mandaśītōṣṇavarṣatvāt sukhatamāśca bhavantyavikalpakāśca śarīrauṣadhānām, itarē punaratyarthaśītōṣṇavarṣatvādduḥkhatamāśca bhavanti vikalpakāśca śarīrauṣadhānām||126||

tatra sAdhAraNalakShaNeShvRutuShu vamanAdInAM pravRuttirvidhIyate, nivRuttiritareShu|
sAdhAraNalakShaNA hi mandashItoShNavarShatvAt sukhatamAshca bhavantyavikalpakAshcasharIrauShadhAnAm, itare punaratyarthashItoShNavarShatvAdduHkhatamAshca bhavanti vikalpakAshcasharIrauShadhAnAm||126||
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Purification therapies such as emesis etc. are applied in seasons having similar characters(as of physiological vitiation of ''dosha'') and are stopped in other seasons. The seasons having similar characters are the most convenient ones and are not harmful to body and drugs because of moderate cold, heat and rains, while others, due to excessive cold, heat and rains are inconvenient ones and harmful to body and the drugs.[126]
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तत्रहेमन्तेह्यतिमात्रशीतोपहतत्वाच्छरीरमसुखोपपन्नंभवत्यतिशीतवाताध्मातमतिदारुणीभूतमवबद्धदोषंच, भेषजंपुनःसंशोधनार्थमुष्णस्वभावमतिशीतोपहतत्वान्मन्दवीर्यत्वमापद्यते, तस्मात्तयोःसंयोगेसंशोधनमयोगायोपपद्यतेशरीरमपिचवातोपद्रवाय| ग्रीष्मेपुनर्भृशोष्णोपहतत्वाच्छरीरमसुखोपपन्नंभवत्युष्णवातातपाध्मातमतिशिथिलमत्यर्थप्रविलीनदोषं, भेषजंपुनःसंशोधनार्थमुष्णस्वभावमुष्णानुगमनात्तीक्ष्णतरत्वमापद्यते, तस्मात्तयोःसंयोगेसंशोधनमतियोगायोपपद्यतेशरीरमपिपिपासोपद्रवाय| वर्षासुतुमेघजलावततेगूढार्कचन्द्रतारेधाराकुलेवियतिभूमौपङ्कजलपटलसंवृतायामत्यर्थोपक्लिन्नशरीरेषुभूतेषुविहतस्वभावेषुचकेवलेष्वौषधग्रामेषुतोयतोयदानुगतमारुतसंसर्गाद्गुरुप्रवृत्तीनिवमनादीनिभवन्ति, गुरुसमुत्थानानिचशरीराणि| तस्माद्वमनादीनांनिवृत्तिर्विधीयतेवर्षान्तेष्वृतुषु , नचेदात्ययिकंकर्म| आत्ययिकेपुनःकर्मणिकाममृतुंविकल्प्यकृत्रिमगुणोपधानेनयथर्तुगुणविपरीतेनभेषजंसंयोगसंस्कारप्रमाणविकल्पेनोपपाद्यप्रमाणवीर्यसमंकृत्वाततःप्रयोजयेदुत्तमेनयत्नेनावहितः||१२७||
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tatra hēmantē hyatimātraśītōpahatatvāccharīramasukhōpapannaṁ bhavatyatiśītavātādhmātamatidāruṇībhūtamavabaddhadōṣaṁ ca, bhēṣajaṁ punaḥ saṁśōdhanārthamuṣṇasvabhāvamatiśītōpahatatvānmandavīryatvamāpadyatē, tasmāttayōḥ saṁyōgē saṁśōdhanamayōgāyōpapadyatē śarīramapi ca vātōpadravāya| grīṣmē punarbhr̥śōṣṇōpahatatvāccharīramasukhōpapannaṁ bhavatyuṣṇavātātapādhmātamatiśithilamatyarthapravilīnadōṣaṁ, bhēṣajaṁ punaḥ saṁśōdhanārthamuṣṇasvabhāvamuṣṇānugamanāttīkṣṇataratvamāpadyatē, tasmāttayōḥ saṁyōgē saṁśōdhanamatiyōgāyōpapadyatē śarīramapi pipāsōpadravāya| varṣāsu tu mēghajalāvatatē gūḍhārkacandratārē dhārākulē viyati bhūmau paṅkajalapaṭalasaṁvr̥tāyāmatyarthōpaklinnaśarīrēṣu bhūtēṣu vihatasvabhāvēṣu ca kēvalēṣvauṣadhagrāmēṣu tōyatōyadānugatamārutasaṁsargād gurupravr̥ttīni vamanādīni bhavanti, gurusamutthānāni ca śarīrāṇi| tasmādvamanādīnāṁ nivr̥ttirvidhīyatē varṣāntēṣvr̥tuṣu , na cēdātyayikaṁ karma| ātyayikē punaḥ karmaṇi kāmamr̥tuṁ vikalpya kr̥trimaguṇōpadhānēna yathartuguṇaviparītēna bhēṣajaṁ saṁyōgasaṁskārapramāṇavikalpēnōpapādya pramāṇavīryasamaṁ kr̥tvā tataḥ prayōjayēduttamēna yatnēnāvahitaḥ||127||

tatra hemante hyatimAtrashItopahatatvAccharIramasukhopapannaMbhavatyatishItavAtAdhmAtamatidAruNIbhUtamavabaddhadoShaM ca, bheShajaM punaHsaMshodhanArthamuShNasvabhAvamatishItopahatatvAnmandavIryatvamApadyate, tasmAttayoHsaMyoge saMshodhanamayogAyopapadyate sharIramapi ca vAtopadravAya|
grIShme punarbhRushoShNopahatatvAccharIramasukhopapannaMbhavatyuShNavAtAtapAdhmAtamatishithilamatyarthapravilInadoShaM, bheShajaM punaHsaMshodhanArthamuShNasvabhAvamuShNAnugamanAttIkShNataratvamApadyate, tasmAttayoH saMyogesaMshodhanamatiyogAyopapadyate sharIramapi pipAsopadravAya|
varShAsu tu meghajalAvatate gUDhArkacandratAre dhArAkule viyati bhUmaupa~gkajalapaTalasaMvRutAyAmatyarthopaklinnasharIreShu bhUteShu vihatasvabhAveShu cakevaleShvauShadhagrAmeShu toyatoyadAnugatamArutasaMsargAd gurupravRuttIni vamanAdIni bhavanti,gurusamutthAnAni ca sharIrANi|
tasmAdvamanAdInAM nivRuttirvidhIyate varShAnteShvRutuShu [1] , na cedAtyayikaM karma|
Atyayike punaH karmaNi kAmamRutuM vikalpya kRutrimaguNopadhAnena yathartuguNaviparItenabheShajaM saMyogasaMskArapramANavikalpenopapAdya pramANavIryasamaM kRutvA tataHprayojayeduttamena yatnenAvahitaH||127||
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During ''hemanta'' (early winter) the body is affected by excessive cold and as such is distressed, exposed to excessively cold wind, is too much roughed and dry, and with ''doshas'' adhered; on the other hand, the drugs administered for evacuation are hot by nature which become mild in potency due to exposure to excessively cold wind. Hence in conjunction of both these, the evacuative therapy becomes ineffective and the body is inflicted with the ''vatika'' complication.

During summer season the body afflicted by excessive heat becomes distressed exposed to excessively hot winds too much lax and with excessively lignified ''doshas''; the drugs, on the other hand, administered for evacuation being hot in nature become more intense because of exposure to heat; hence in conjunction of both these, the evacuative therapy produces effects in excess and the body also gets complication like thirst etc.

During rainy season, when the sky is pervaded with cloud and water the sun, the moon and the stars are hidden and there are torrential rains. The earth is covered with mud and water; the body of living beings is moistened and the entire herbal wealth is damaged in nature, the evacuative measures become dull in action and the human bodies sluggish in recovery due to exposure to wind associated with moisture and clouds.

Therefore, the measures like emesis etc. are stopped in the seasons ending with the rains (early winter, summer and rainy seasons) except in case of emergency. In emergency too, one should administer the therapy with great care after modifying the seasonal effects sufficiently by artificial means producing qualities contrary to the seasons and by making the measure appropriate in standard potency with variation in combination, processing and quantity. [127]

==== Stage of disease ====
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आतुरावस्थास्वपितुकार्याकार्यंप्रतिकालाकालसञ्ज्ञा; तद्यथा- अस्यामवस्थायामस्यभेषजस्याकालः, कालःपुनरन्यस्येति; एतदपिहिभवत्यवस्थाविशेषेण; तस्मादातुरावस्थास्वपिहिकालाकालसञ्ज्ञा| तस्यपरीक्षा- मुहुर्मुहुरातुरस्यसर्वावस्थाविशेषावेक्षणंयथावद्भेषजप्रयोगार्थम्| नह्यतिपतितकालमप्राप्तकालंवाभेषजमुपयुज्यमानंयौगिकंभवति; कालोहिभैषज्यप्रयोगपर्याप्तिमभिनिर्वर्तयति||१२८||
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āturāvasthāsvapi tu kāryākāryaṁ prati kālākālasañjñā; tadyathā- asyāmavasthāyāmasya bhēṣajasyākālaḥ , kālaḥ punaranyasyēti; ētadapi hi bhavatyavasthāviśēṣēṇa; tasmādāturāvasthāsvapi hi kālākālasañjñā| tasya parīkṣā- muhurmuhurāturasya sarvāvasthāviśēṣāvēkṣaṇaṁ yathāvadbhēṣajaprayōgārtham| na hyatipatitakālamaprāptakālaṁ vā bhēṣajamupayujyamānaṁ yaugikaṁ bhavati; kālō hi bhaiṣajyaprayōgaparyāptimabhinirvartayati||128||

AturAvasthAsvapi tu kAryAkAryaM prati kAlAkAlasa~jj~jA; tadyathA- asyAmavasthAyAmasyabheShajasyAkAlaH [1] , kAlaH punaranyasyeti; etadapi hi bhavatyavasthAvisheSheNa;tasmAdAturAvasthAsvapi hi kAlAkAlasa~jj~jA|
tasya parIkShA- muhurmuhurAturasya sarvAvasthAvisheShAvekShaNaM yathAvadbheShajaprayogArtham|
na hyatipatitakAlamaprAptakAlaM vA bheShajamupayujyamAnaM yaugikaM bhavati; kAlo hibhaiShajyaprayogaparyAptimabhinirvartayati||128||
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The status of the patient is also called as timely or untimely in relation the act being performed or not. Such as, in a certain condition one drug is untimely, and the other one is timely. This is also due to specific condition, hence the nomenclature of ''kala'' (timely) and ''akala'' (untimely) is given to the conditions of the patients. This is examined like this- the physician should observe all the conditions of the patient again and again in order to administer the correct therapy. The therapy administered after or before the (opportune) time is not effective because time determines the sufficiency to the administration of therapy.[128]

==== ''Pravritti'' (inclination or action) ====
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प्रवृत्तिस्तुप्रतिकर्मसमारम्भः| तस्यलक्षणंभिषगौषधातुरपरिचारकाणांक्रियासमायोगः||१२९||
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pravr̥ttistu pratikarmasamārambhaḥ| tasya lakṣaṇaṁ bhiṣagauṣadhāturaparicārakāṇāṁ kriyāsamāyōgaḥ||129||

pravRuttistu pratikarmasamArambhaH|
tasya lakShaNaM bhiShagauShadhAturaparicArakANAM kriyAsamAyogaH||129||
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''Pravritti'' (inclination or action) is the initiation of the therapy which is characterized by the combination of physician, drug, patient and attendant in treatment. [129]

==== ''Upaya'' (management) ====
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उपायःपुनर्भिषगादीनांसौष्ठवमभिविधानंचसम्यक्| तस्यलक्षणं- भिषगादीनांयथोक्तगुणसम्पत्देशकालप्रमाणसात्म्यक्रियादिभिश्चसिद्धिकारणैःसम्यगुपपादितस्यौषधस्यावचारणमिति||१३०||
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upāyaḥ punarbhiṣagādīnāṁ sauṣṭhavamabhividhānaṁ ca samyak| tasya lakṣaṇaṁ- bhiṣagādīnāṁ yathōktaguṇasampat dēśakālapramāṇasātmyakriyādibhiśca siddhikāraṇaiḥ samyagupapāditasyauṣadhasyāvacāraṇamiti||130||

upAyaH punarbhiShagAdInAM sauShThavamabhividhAnaM [1] ca samyak|
tasya lakShaNaM- bhiShagAdInAM yathoktaguNasampat deshakAlapramANasAtmyakriyAdibhishcasiddhikAraNaiH samyagupapAditasyauShadhasyAvacAraNamiti||130||
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Regarding ''upaya'' it is excellence of physician etc. and their proper arrangement which is characterized by the physician etc. endowed with their respective qualities and proper application of therapy along with the consideration of place, time, quantitative measurement, suitability, processing etc. which are the factors which when considered and administered with specific medicine leads to success.[130]
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एवमेतेदशपरीक्ष्यविशेषाःपृथक्पृथक्परीक्षितव्याभवन्ति||१३१||
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ēvamētē daśa parīkṣyaviśēṣāḥ pr̥thak pr̥thak parīkṣitavyā bhavanti||131||

evamete dasha parIkShyavisheShAH pRuthak pRuthak parIkShitavyA bhavanti||131||
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Thus these mentioned ten entities should be examined separately and sincerely.[131]

==== Objective of examination ====
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परीक्षायास्तुखलुप्रयोजनंप्रतिपत्तिज्ञानम्प्रतिपत्तिर्नामयोविकारोयथाप्रतिपत्तव्यस्तस्यतथाऽनुष्ठानज्ञानम्||१३२||
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parīkṣāyāstu khalu prayōjanaṁ pratipattijñānam| pratipattirnāma yō vikārō yathā pratipattavyastasya tathā'nuṣṭhānajñānam||132||

parIkShAyAstu khalu prayojanaM pratipattij~jAnam|
pratipattirnAma yo vikAro yathA pratipattavyastasya tathA~anuShThAnaj~jAnam||132||
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''Pratipatti'' is the object of examination. In other words, it is the decision regarding course of action. More over ''pratipatti'' is the knowledge of treatment, with which the disorder is to be treated. [132]
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यत्रतुखलुवमनादीनांप्रवृत्तिः, यत्रचनिवृत्तिः, तद्व्यासतःसिद्धिषूत्तरमुपदेक्ष्यामः||१३३||
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yatra tu khalu vamanādīnāṁ pravr̥ttiḥ, yatra ca nivr̥ttiḥ, tadvyāsataḥ siddhiṣūttaramupadēkṣyāmaḥ||133||

yatra tu khalu vamanAdInAM pravRuttiH, yatra ca nivRuttiH, tadvyAsataHsiddhiShUttaramupadekShyAmaH||133||
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The conditions where emesis etc. are indicated or contraindicated will be described in detail in [[Siddhi Sthana]]. [133]
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प्रवृत्तिनिवृत्तिलक्षणसंयोगेतुगुरुलाघवंसम्प्रधार्यसम्यगध्यवस्येदन्यतरनिष्ठायाम्सन्तिहिव्याधयःशास्त्रेषूत्सर्गापवादैरुपक्रमंप्रतिनिर्दिष्टाः| तस्माद्गुरुलाघवंसम्प्रधार्यसम्यगध्यवस्येदित्युक्तम्||१३४||
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pravr̥ttinivr̥ttilakṣaṇasaṁyōgē tu gurulāghavaṁ sampradhārya samyagadhyavasyēdanyataraniṣṭhāyām| santi hi vyādhayaḥ śāstrēṣūtsargāpavādairupakramaṁ prati nirdiṣṭāḥ| tasmādgurulāghavaṁ sampradhārya samyagadhyavasyēdityuktam||134||

pravRuttinivRuttilakShaNasaMyoge tu gurulAghavaM sampradhAryasamyagadhyavasyedanyataraniShThAyAm|
santi hi vyAdhayaH shAstreShUtsargApavAdairupakramaM prati nirdiShTAH|
tasmAdgurulAghavaM sampradhArya samyagadhyavasyedityuktam||134||
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In situation where symptoms of both indication and contraindication conjoined, one should decide (the treatment protocol) after proper examination of dominant or recessive condition of ''dosha''. The diseases mentioned in treatises are in respect of their treatment as general rule or exception. Hence it is said that one should take action after considering the dominant or recessive condition of ''dosha''. [134]

==== List of medicines used in therapeutic emesis ====
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यानितुखलुवमनादिषुभेषजद्रव्याण्युपयोगंगच्छन्तितान्यनुव्याख्यास्यामः| तद्यथा- फलजीमूतकेक्ष्वाकुधामार्गवकुटजकृतवेधनफलानि, फलजीमूतकेक्ष्वाकुधामार्गवपत्रपुष्पाणिआरग्वधवृक्षकमदनस्वादुकण्टकपाठापाटलाशार्ङ्गेष्टामूर्वासप्तपर्णनक्तमालपिचुमर्दपटोलसुषवीगुडूची- चित्रकसोमवल्कशतावरीद्वीपीशिग्रुमूलकषायैः, मधुकमधूककोविदारकर्वुदारनीपविदुलबिम्बीशणपुष्पीसदापुष्पाप्रत्यक्पुष्पाकषायैश्च, एलाहरेणुप्रियङ्गुपृथ्वीकाकुस्तुम्बुरुतगरनलदह्रीवेरतालीशोशीरकषायैश्च , इक्षुकाण्डेक्ष्विक्षुवालिकादर्भपोटगलकालङ्कृ(ङ्क)तकषायैश्च,
सुमनासौमनस्यायनीहरिद्रादारुहरिद्रावृश्चीरपुनर्नवामहासहाक्षुद्रसहाकषायैश्च, शाल्मलिशाल्मलिकभद्रपर्ण्येलापर्ण्युपोदिकोद्दालकधन्वनराजादनोपचित्रागोपीशृङ्गाटिकाकषायैश्च, पिप्पलीपिप्पलीमूलचव्यचित्रकशृङ्गवेरसर्षपफाणितक्षीरक्षारलवणोदकैश्च, यथालाभंयथेष्टंवाऽप्युपसंस्कृत्यवर्तिक्रियाचूर्णावलेहस्नेहकषायमांसरसयवागूयूषकाम्बलिकक्षीरोपधेयान्मोदकानन्यांश्चभक्ष्यप्रकारान्विविधाननुविधाययथार्हंवमनार्हायदद्याद्विधिवद्वमनम्| इतिकल्पसङ्ग्रहोवमनद्रव्याणाम्| कल्पमेषांविस्तारेणोत्तरकालमुपदेक्ष्यामः||१३५||
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yāni tu khalu vamanādiṣu bhēṣajadravyāṇyupayōgaṁ gacchanti tānyanuvyākhyāsyāmaḥ| tadyathā- phalajīmūtakēkṣvākudhāmārgavakuṭajakr̥tavēdhanaphalāni, phalajīmūtakēkṣvākudhāmārgavapatrapuṣpāṇi āragvadhavr̥kṣakamadanasvādukaṇṭakapāṭhāpāṭalāśārṅgēṣṭāmūrvāsaptaparṇanaktamālapicumardapa<br>ṭōlasuṣavīguḍūcī- citrakasōmavalkaśatāvarīdvīpīśigrumūlakaṣāyaiḥ, madhukamadhūkakōvidārakarvudāranīpavidulabimbīśaṇapuṣpīsadāpuṣpāpratyakpuṣpākaṣāyaiśca, ēlāharēṇupriyaṅgupr̥thvīkākustumburutagaranaladahrīvēratālīśōśīrakaṣāyaiśca , ikṣukāṇḍēkṣvikṣuvālikādarbhapōṭagalakālaṅkr̥(ṅka)takaṣāyaiśca, sumanāsaumanasyāyanīharidrādāruharidrāvr̥ścīrapunarnavāmahāsahākṣudrasahākaṣāyaiśc, śālmaliśālmalikabhadraparṇyēlāparṇyupōdikōddālakadhanvan<br>arājādanōpacitrāgōpīśr̥ṅgāṭiākaṣāyaiśca, pippalīpippalīmūlacavyacitrakaśr̥ṅgavērasarṣapaphāṇitakṣīrakṣāralavaṇōdakaiśca, yathālābhaṁ yathēṣṭaṁ vā'pyupasaṁskr̥tya vartikriyācūrṇāvalēhasnēhakaṣāyamāṁsarasayavāgūyūṣakāmbalikakṣīrōpadhēyānmōdakānanyāṁśca bhakṣyaprakārān vividhānanuvidhāya yathārhaṁ vamanārhāya dadyādvidhivadvamanam| iti kalpasaṅgrahō vamanadravyāṇām| kalpamēṣāṁ vistārēṇōttarakālamupadēkṣyāmaḥ||135||

yAni tu khalu vamanAdiShu bheShajadravyANyupayogaM gacchanti tAnyanuvyAkhyAsyAmaH|
tadyathA- phalajImUtakekShvAkudhAmArgavakuTajakRutavedhanaphalAni, phalajImUtakekShvAkudhAmArgavapatrapuShpANiAragvadhavRukShakamadanasvAdukaNTakapAThApATalAshAr~ggeShTAmUrvAsaptaparNanaktamAlapic<br>umardapaTolasuShavIguDUcI-citrakasomavalkashatAvarIdvIpIshigrumUlakaShAyaiH,madhukamadhUkakovidArakarvudAranIpavidulabimbIshaNapuShpIsadApuShpApratyakpuShpAkaShAyaishca,elAha<br>reNupriya~ggupRuthvIkAkustumburutagaranaladahrIveratAlIshoshIrakaShAyaishca [1] ,ikShukANDekShvikShuvAlikAdarbhapoTagalakAla~gkRu(~gka)takaShAyaishca,
sumanAsaumanasyAyanIharidrAdAruharidrAvRushcIrapunarnavAmahAsahAkShudrasahAkaShAyaishca,shAlmalishAlmalikabhadraparNyelAparNyupodikoddAlakadhanva<br>narAjAdanopacitrAgopIshRu~ggATikAkaShAyaishca,pippalIpippalImUlacavyacitrakashRu~ggaverasarShapaphANitakShIrakShAralavaNodakaishca, yathAlAbhaM yatheShTaMvA~apyupasaMskRutya vartikriyAcUrNAvalehasnehakaShAyamAMsarasayavAgUyUShakAmbalikakShIropadheyAnmodakAnanyAMshcabhakShyaprakArAn vividhAnanuvidhAya yathArhaM vamanArhAya dadyAdvidhivadvamanam|
iti kalpasa~ggraho vamanadravyANAm|
kalpameShAM vistAreNottarakAlamupadekShyAmaH||135||
</div></div>

In this concern the drugs which are mentioned for therapeutic emesis etc. are being mentioned henceforth. They are as follows:
*Fruits of ''madanaphala, jimutaka, ikshvaku, dhamargava, kutaja, kritavedhana'' ;
*Leaves and flowers of ''madanaphala, jimutaka, ikshvaku, dhamargava'';
*Decoctions of the roots of ''aragvadha, vrikshaka (kutaja), madana, svadukanṭaka, paṭha, patala, sharangeshta, murva, saptaparna, naktamala, pichumarda (nimba), patola, sushavi, guduchi- chitraka, somavalka, shatavari, dvipi, shigrumula'';
*Decoction of ''madhuka, madhooka, kovidara, karvudara, nipa, vidula, bimbi, shaṇapushpi, sadapushpa (arka)'' and ''pratyakpushpa(apamarga)'';
*Decoction of ''ela, harenu, priyangu, prithvika, kustumburu, tagara, nalada, hrivera, talis, ushira,''
*Decoction of ''ikshu, kandekshu, ikshuvalika, darbha, potagala, kalankri(nka)ta'';
*Decoction of ''sumana, saumanasyayani, haridra, daruharidra, vrishchirq, punarnava, mahasaha, kshudrasaha;''
*Decoction of ''sumana, saumanasyayani'';
*Decoction of ''shalmali, shalmalika, bhadraparni, elaparni, upodika, uddalaka, dhanvana, rajadana, upachitra, gopi (sariva), shringataka; pippali, pippalimula, chavya, chitraka, shringavera, sarshapa, phanita, kshira, kshara,'' salt with water and made into bolus and other eatables added with ''vartti kriya'' (suppository), powder, linctus, processed in lipids, extract, meat soup, gruel, (vegetable) soup, ''kambalika'' and milk should be administered to the patient requiring emesis according to prescribed procedure. These are, in brief, the pharmaceutical forms of emetic drugs, which are described in detail latter on in [[Kalpa Sthana]].[135]

==== List of medicines used in therapeutic purgation ====
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विरेचनद्रव्याणितुश्यामात्रिवृच्चतुरङ्गुलतिल्वकमहावृक्षसप्तलाशङ्खिनीदन्तीद्रवन्तीनांक्षीरमूलत्वक्पत्रपुष्पफलानियथायोगंतैस्तैःक्षीरमूलत्वक्पत्रपुष्पफलैर्विक्लिप्ताविक्लिप्तैः , अजगन्धाश्वगन्धाजशृङ्गीक्षीरिणीनीलिनीक्लीतककषायैश्च, प्रकीर्योदकीर्यामसूरविदलाकम्पिल्लकविडङ्गगवाक्षीकषायैश्च, पीलुप्रियालमृद्वीकाकाश्मर्यपरूषकबदरदाडिमामलकहरीतकीबिभीतकवृश्चीरपुनर्नवाविदारिगन्धादिकषायैश्च,सीधुसुरासौवीरकतुषोदकमैरेयमेदकमदिरामधुमधूलकधान्याम्लकुवलबदरखर्जूरकर्कन्धुभिश्च, दधिदधिमण्डोदश्विद्भिश्च, गोमहिष्यजावीनांचक्षीरमूत्रैर्यथालाभंयथेष्टंवाऽप्युपसंस्कृत्यवर्तिक्रियाचूर्णासवलेहस्नेहकषायमांसरसयूषकाम्बलिकयवागूक्षीरोपधेयान्मोदकानन्यांश्चभक्ष्यप्र(वि)कारान्विविधांश्चयोगाननुविधाययथार्हंविरेच<br>नार्हायदद्याद्विरेचनम्| इतिकल्पसङ्ग्रहोविरेचनद्रव्याणाम्| कल्पमेषांविस्तरेणयथावदुत्तरकालमुपदेक्ष्यामः||१३६||
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virēcanadravyāṇi tu
śyāmātrivr̥ccaturaṅgulatilvakamahāvr̥kṣasaptalāśaṅkhinīdantīdravantīnāṁ kṣīramūlatvakpatrapuṣpaphalāni yathāyōgaṁ taistaiḥ kṣīramūlatvakpatrapuṣpaphalairvikliptāvikliptaiḥ , ajagandhāśvagandhājaśr̥ṅgīkṣīriṇīnīlinīklītakakaṣāyaiśca, prakīryōdakīryāmasūravidalākampillakaviḍaṅgagavākṣīkaṣāyaiśca, pīlupriyālamr̥dvīkākāśmaryaparūṣakabadaradāḍimāmalakaharītakībibhītakavr̥ścīrapunarnavāvidārigandhādikaṣāyaiśca, sīdhusurāsauvīrakatuṣōdakamairēyamēdakamadirāmadhumadhūlakadhānyāmlakuvalabadarakharjūrakarkandhubhiśca, dadhidadhimaṇḍōdaśvidbhiśca, gōmahiṣyajāvīnāṁ ca kṣīramūtrairyathālābhaṁ yathēṣṭaṁ vā'pyupasaṁskr̥tya vartikriyācūrṇāsavalēhasnēhakaṣāyamāṁsarasayūṣakāmbalikayavāgūkṣīrōpadhēyān mōdakānanyāṁśca bhakṣyapra(vi)kārān vividhāṁśca yōgānanuvidhāya yathārhaṁ virēcanārhāya dadyādvirēcanam| iti kalpasaṅgrahō virēcanadravyāṇām| kalpamēṣāṁ vistarēṇa yathāvaduttarakālamupadēkṣyāmaḥ||136||

virecanadravyANi tu shyAmAtrivRuccatura~ggulatilvakamahAvRukShasaptalAsha~gkhinIdantIdravantInAMkShIramUlatvakpatrapuShpaphalAni yathAyogaM taistaiH kShIramUlatvakpatrapuShpaphalairvikliptAvikliptaiH ,ajagandhAshvagandhAjashRu~ggIkShIriNInIlinIklItakakaShAyaishca,prakIryodakIryAmasUravidalAkampillakaviDa~ggagavAkShIkaShAyaishca,pIlupriyAlamRudvIkAkAsh<br>maryaparUShakabadaradADimAmalakaharItakIbibhItakavRushcIrapunarnavAvidArigandhAdikaShAyaishca,sIdhusurAsauvIrakatuShodakamaireyamedakamadirAmadhum<br>adhUlakadhAnyAmlakuvalabadarakharjUrakarkandhubhishca,dadhidadhimaNDodashvidbhishca, gomahiShyajAvInAM ca kShIramUtrairyathAlAbhaM yatheShTaM vA~apyupasaMskRutyavartikriyAcUrNAsavalehasnehakaShAyamAMsarasayUShakAmbalikayavAgUkShIropadheyAn modakAnanyAMshcabhakShyapra(vi)kArAn vividhAMshca [1] yogAnanuvidhAya yathArhaM virecanArhAya dadyAdvirecanam|
iti kalpasa~ggraho virecanadravyANAm|
kalpameShAM vistareNa yathAvaduttarakAlamupadekShyAmaH||136||
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Purgative drugs in parts of latex, root, bark, leaf, flower and fruit wholly or individually of ''shyama, trivrit, chaturangula'' (''aragvadha''), ''tilvaka, mahavriksha, saptala, shankhini, danti'' and ''dravanti'' are to be used according to requirement. They should be processed, according to need or availability with the following:
*decoction of ''ajagandha, ashvagandha, ajashringi, kshirini, nilini'' and ''klitaka'';
*''prakirya, udakirya, masuravidala, kampillaka, vidanga,'' and ''gavakshi'';
*''pilu, priyala, mrudvika, kashmarya, parushaka, badara, dadima, amalaki, haritaki, bibhitaki, vrushchira, punarnava'' and the drugs of ''vidarigandhadi gana'';
*''sidhu, sura, sauviraka, tushodaka, maireya, medaka, madira, madhu, madhulaka, dhanyamla, kuvala, badara, kharjura, karkandhu, dadhi, dadhimanda'' (curdwater), ''udashvid'' (buttermilk) and;
*milk and urine of cow, buffalo, goat and sheep;
*made into bolus and other eatables added with ''vartikriya'' (suppository), ''churna'' (powder), ''asava, leha'' (linctus), ''sneha'' (medicated fatty preparation), ''kashaya'' (decoction), ''mamsarasa'' (meat-soup), ''yusha'' (vegetable soup), ''kambalika'' (a kind of soup prepared from whey and green gram), ''yavagu'' (gruel), ''kshiropadheyan'' (milk administered), ''modaka'' (comparatively big tablet for high dose), and other forms of food preparation are to be used in patient requiring purgation. These are in brief the pharmaceutical preparation of purgative drugs, which will be further described in detail.[136]

==== List of medicines used in therapeutic non-unctuous enema ====
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आस्थापनेषुतुभूयिष्ठकल्पानिद्रव्याणियानियोगमुपयान्तितेषुतेष्ववस्थान्तरेष्वातुराणां, तानिद्रव्याणिनामतोविस्तरेणोपदिश्यमानान्यपरिसङ्ख्येयानिस्युरतिबहुत्वात्; इष्टश्चानतिसङ्क्षेपविस्तरोपदेशस्तन्त्रे, इष्टंचकेवलंज्ञानं, तस्माद्रसतएवतान्यत्रव्याख्यास्यामः| ससंसर्गविकल्पविस्तरोह्येषामपरिसङ्ख्येयः, समवेतानांरसानामंशांशबलविकल्पातिबहुत्वात्| तस्माद्द्रव्याणांचैकदेशमुदाहरणार्थंरसेष्वनुविभज्यरसैकैकश्येनचनामलक्षणार्थंषडास्थापनस्कन्धारसतोऽनुविभज्यव्याख्यास्तन्ते||१३७||
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āsthāpanēṣu tu bhūyiṣṭhakalpāni dravyāṇi yāni yōgamupayānti tēṣu tēṣvavasthāntarēṣvāturāṇāṁ, tāni dravyāṇi nāmatō vistarēṇōpadiśyamānānyaparisaṅkhyēyāni syuratibahutvāt; iṣṭaścānatisaṅkṣēpavistarōpadēśastantrē, iṣṭaṁ ca kēvalaṁ jñānaṁ, tasmādrasata ēva tānyatra vyākhyāsyāmaḥ| rasasaṁsargavikalpavistarō hyēṣāmaparisaṅkhyēyaḥ, samavētānāṁ rasānāmaṁśāṁśabalavikalpātibahutvāt| tasmāddravyāṇāṁ caikadēśamudāharaṇārthaṁ rasēṣvanuvibhajya rasaikaikaśyēna ca nāmalakṣaṇārthaṁ ṣaḍāsthāpanaskandhā rasatō'nuvibhajya vyākhyāstantē||137||

AsthApaneShu tu bhUyiShThakalpAni dravyANi yAni yogamupayAnti teShuteShvavasthAntareShvAturANAM, tAni dravyANi nAmato vistareNopadishyamAnAnyaparisa~gkhyeyAnisyuratibahutvAt; iShTashcAnatisa~gkShepavistaropadeshastantre, iShTaM ca kevalaM j~jAnaM,tasmAdrasata eva tAnyatra vyAkhyAsyAmaH|
rasasaMsargavikalpavistaro [1] hyeShAmaparisa~gkhyeyaH, samavetAnAMrasAnAmaMshAMshabalavikalpAtibahutvAt|
tasmAddravyANAM caikadeshamudAharaNArthaM raseShvanuvibhajya rasaikaikashyena canAmalakShaNArthaM ShaDAsthApanaskandhA rasato~anuvibhajya vyAkhyAstante||137||
</div></div>

The drugs which are mostly used in non-unctuous enema in different conditions of patients may become innumerable if they are described in detail by individual names, but as the dealing of the subject in the treatise is desired, they are mentioned here only according to ''rasas''. In respect of these, the details of the variations in combination of ''rasas'' are immeasurable because of the excessive numerousness of the proportional variations in combined ''rasas''. Hence for illustration, a part of drugs having been grouped in ''rasas'', six groups of (drugs used in) non-unctuous enema are mentioned here according to ''rasas'' for characterization according to name on the basis of individual ''rasa''. [137]
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यत्तुषड्विधमास्थापनमेकरसमित्याचक्षतेभिषजः, तद्दुर्लभतमंसंसृष्टरसभूयिष्ठत्वाद्द्रव्याणाम्| तस्मान्मधुराणिमधुरप्रायाणिमधुरविपाकानिमधुरप्रभावाणिचमधुरस्कन्धेमधुराण्येवकृत्वोपदेक्ष्यन्ते, तथेतराणिद्रव्याण्यपि||१३८||
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yattu ṣaḍvidhamāsthāpanamēkarasamityācakṣatē bhiṣajaḥ, taddurlabhatamaṁ saṁsr̥ṣṭarasabhūyiṣṭhatvāddravyāṇām| tasmānmadhurāṇi madhuraprāyāṇi madhuravipākāni madhuraprabhāvāṇi ca madhuraskandhē madhurāṇyēva kr̥tvōpadēkṣyantē, tathētarāṇi dravyāṇyapi||138||

yattu ShaDvidhamAsthApanamekarasamityAcakShate bhiShajaH, taddurlabhatamaMsaMsRuShTarasabhUyiShThatvAddravyANAm|
tasmAnmadhurANi madhuraprAyANi madhuravipAkAni madhuraprabhAvANi ca madhuraskandhemadhurANyeva kRutvopadekShyante, tathetarANi dravyANyapi||138||
</div></div>

That non-unctuous enema is of six types having single rasa as said by physician. Drugs possess mostly the combined ''rasa'' therefore grouping them in single group is not possible, hence the drugs included in ''madhura'' group mean those which are sweet, predominantly sweet, and sweet in ''vipaka'' or having effects similar to sweet drugs. This is same for other drugs also.[138]

==== ''Madhura skandha'' (group of sweet drugs) ====
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तद्यथा-

जीवकर्षभकौजीवन्तीवीरातामलकीकाकोलीक्षीरकाकोलीमुद्गपर्णीमाषपर्णीशालपर्णीपृश्निपर्ण्यसनपर्णीमधुपर्णीमेदामहामेदाकर्कटशृङ्गीशृङ्गाटिकाछिन्नरुहाच्छत्राऽतिच्छत्राश्रावणीमहाश्रावणीसहदेवाविश्वदे<br>वाशुक्लाक्षीरशुक्लाबलाऽतिबलाविदारीक्षीरविदारीक्षुद्रसहामहासहाऋष्यगन्धाऽश्वगन्धावृश्चीरःपुनर्नवाबृहतीकण्टकारिकोरुबूकोमोरटःश्वदंष्ट्रासंहर्षाशतावरीशतपुष्पामधूकपुष्पीयष्टीमधुमधूलिकामृद्वीकाखर्जू<br>रंपरूषकमात्मगुप्तापुष्करबीजंकशेरुकंराजकशेरुकंराजादनंकतकंकाश्मर्यंशीतपाक्योदनपाकीतालखर्जूरमस्तकमिक्षुरिक्षुवालिकादर्भःकुशःकाशःशालिर्गुन्द्रेत्कटकःशरमूलंराजक्षवकःऋष्यप्रोक्ताद्वारदाभारद्वाजी<br>वनत्रपुष्यभीरुपत्रीहंसपादीकाकनासिकाकुलिङ्गाक्षीक्षीरवल्लीकपोलवल्लीकपोतवल्लीसोमवल्लीगोपवल्लीमधुवल्लीचेति; एषामेवंविधानामन्येषांचमधुरवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वाप्रक्षाल्यपानीयेनसुप्रक्षालितायांस्थाल्यांसमावाप्यपयसाऽर्धोदकेनाभ्यासिच्यसाधयेद्दर्व्यासत<br>तमवघट्टयन्;तदुपयुक्तभूयिष्ठेऽम्भसिगतरसेष्वौषधेषुपयसिचानुपदग्धेस्थालीमुपहृत्यसुपरिपूतंपयःसुखोष्णंघृततैलवसामज्जलवणफाणितोपहितंबस्तिंवातविकारिणेविधिज्ञोविधिवद्दद्यात्; शीतंतुमधुसर्पिर्भ्यामुपसंसृज्यपित्तविकारिणेविधिवद्दद्यात्| इतिमधुरस्कन्धः||१३९||
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tadyathā-

jīvakarṣabhakau jīvantī vīrā tāmalakī kākōlī kṣīrakākōlī mudgaparṇī māṣaparṇī śālaparṇī pr̥śniparṇyasanaparṇī madhuparṇī mēdā mahāmēdā karkaṭaśr̥ṅgī śr̥ṅgāṭikā chinnaruhā cchatrā'ticchatrā śrāvaṇī mahāśrāvaṇī sahadēvā viśvadēvā śuklā kṣīraśuklā balā'tibalā vidārī kṣīravidārī kṣudrasahā mahāsahā r̥ṣyagandhā'śvagandhā vr̥ścīraḥ punarnavā br̥hatī kaṇṭakārikōrubūkō mōraṭaḥ śvadaṁṣṭrā saṁharṣā śatāvarī śatapuṣpā madhūkapuṣpī yaṣṭīmadhu madhūlikā mr̥dvīkā kharjūraṁ parūṣakamātmaguptā puṣkarabījaṁ kaśērukaṁ rājakaśērukaṁ rājādanaṁ katakaṁ kāśmaryaṁ śītapākyōdanapākī tālakharjūramastakamikṣurikṣuvālikā darbhaḥ kuśaḥ kāśaḥ śālirgundrētkaṭakaḥ śaramūlaṁ rājakṣavakaḥ r̥ṣyaprōktā dvāradā bhāradvājī vanatrapuṣyabhīrupatrī haṁsapādī kākanāsikā kuliṅgākṣī kṣīravallī kapōlavallī kapōtavallī sōmavallī gōpavallī madhuvallī cēti; ēṣāmēvaṁvidhānāmanyēṣāṁ ca madhuravargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā prakṣālya pānīyēna suprakṣālitāyāṁ sthālyāṁ samāvāpya payasā'rdhōdakēnābhyāsicya sādhayēddarvyā satatamavaghaṭṭayan; tadupayuktabhūyiṣṭhē'mbhasi gatarasēṣvauṣadhēṣu payasi cānupadagdhē sthālīmupahr̥tya suparipūtaṁ payaḥ sukhōṣṇaṁ ghr̥tatailavasāmajjalavaṇaphāṇitōpahitaṁ bastiṁ vātavikāriṇē vidhijñō vidhivaddadyāt; śītaṁ tu madhusarpirbhyāmupasaṁsr̥jya pittavikāriṇē vidhivaddadyāt| iti madhuraskandhaḥ||139||

tadyathA-

jIvakarShabhakau jIvantI vIrA tAmalakI kAkolI kShIrakAkolI mudgaparNI mAShaparNIshAlaparNI pRushniparNyasanaparNI [1] madhuparNI medA mahAmedA karkaTashRu~ggI shRu~ggATikAchinnaruhA cchatrA~aticchatrA shrAvaNI mahAshrAvaNI sahadevA vishvadevA shuklA kShIrashuklAbalA~atibalA vidArI kShIravidArI kShudrasahA mahAsahA RuShyagandhA~ashvagandhA vRushcIraHpunarnavA bRuhatI kaNTakArikorubUko moraTaH shvadaMShTrA saMharShA shatAvarI shatapuShpAmadhUkapuShpI yaShTImadhu madhUlikA mRudvIkA kharjUraM parUShakamAtmaguptA puShkarabIjaMkasherukaM rAjakasherukaM rAjAdanaM katakaM kAshmaryaM shItapAkyodanapAkItAlakharjUramastakamikShurikShuvAlikA darbhaH kushaH kAshaH shAlirgundretkaTakaH sharamUlaMrAjakShavakaH RuShyaproktA dvAradA bhAradvAjI vanatrapuShyabhIrupatrI haMsapAdI kAkanAsikAkuli~ggAkShI kShIravallI kapolavallI kapotavallI somavallI gopavallI madhuvallI ceti;eShAmevaMvidhAnAmanyeShAM ca madhuravargaparisa~gkhyAtAnAmauShadhadravyANAM chedyAnikhaNDashashchedayitvA bhedyAni cANusho bhedayitvA prakShAlya pAnIyena suprakShAlitAyAM sthAlyAMsamAvApya payasA~ardhodakenAbhyAsicya sAdhayeddarvyA satatamavaghaTTayan;tadupayuktabhUyiShThe~ambhasi gataraseShvauShadheShu payasi cAnupadagdhe sthAlImupahRutyasuparipUtaM [2] payaH sukhoShNaM ghRutatailavasAmajjalavaNaphANitopahitaM bastiM vAtavikAriNevidhij~jo vidhivaddadyAt; shItaM tu madhusarpirbhyAmupasaMsRujya pittavikAriNe vidhivaddadyAt|
iti madhuraskandhaH||139||
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The drugs mentioned in sweet group (''madhura skandha'') are ''jivaka, rushabhaka, jivanti, vira, amalaki, kakoli, kshirakakoli, mudgaparni, mashaparṇi, shalaparni, prushniparni, mashaparni, shalaparni, meda, mahameda, karkatashringi, shringataka, chinnaruha, cchatra, aticchatra, shravani, mahashravavani, sahadeva, vishvadeva, shukla, kshirashukla, bala, atibala, vidari, kshiravidari, kshudrasaha, mahasaha, rishyagandha, ashvagandha, vrishchira, punarnava, brihati, kantakari, korubuka, moraṭa, shwadamshtra, samharsha, shatavari, shaatapushpa, madhukapushpi, yashtimadhu, madhulika, mrudvika, kharjura, parushaka, atmagupta, pushkarabija, kasheruka, rajakasheruka, rajadana, kataka, kashmarya, shita, pakya, danapaki tala, kharjura, mastakam, ikshu, ikshuvalika, darbha, kusha, kasha, shali, gundrrtkataka, shaaramula, rajakshavaka, rushyaprokta, dvarada, bharadvaj, vanatrapushya, bhirupatri hamsapadi, kakanasa, kulinga, kshiravalli, kapolavalli, kapotavalli, somavalli'' and ''gopavalli''. These and such other drugs of sweet group should be taken. After cutting and breaking them into small pieces and washing with water properly, should be kept in a vessel. Adding to it milk diluted with half water should be cooked stirring till its major portion of water is absorbed, drugs are extracted and milk is not charred. The vessel should be brought down and the milk should be taken out of it and filtered well. This lukewarm milk added with ghee, oil, fat, marrow, salt and ''phanita'' should be used properly for enema by expert in ''vatika'' disorders. In ''paittika'' disorders, the same should be given cold and combined with honey and ghee. Thus, ends the sweet group of drugs. [139]

==== ''Amla skandha'' (group of sour drugs) ====
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आम्राम्रातकलकुचकरमर्दवृक्षाम्लाम्लवेतसकुवलबदरदाडिममातुलुङ्गगण्डीरामलकनन्दीतकशीतक- तिन्तिण्डीकदन्तशठैरावतककोशाम्रधन्वनानांफलानि, पत्राणिचाम्रातकाश्मन्तकचाङ्गेरीणांचतुर्विधानांचाम्लिकानांद्वयोश्चकोलयोश्चामशुष्कयोर्द्वयोश्चैवशुष्काम्लिकयोर्ग्राम्यारण्ययोः, आसवद्रव्याणिचसुरासौवीरकतुषोदकमैरेयमेदकमदिरामधुशुक्तशीधुदधिदधिमण्डोदश्विद्धान्याम्लादीनिच, एषामेवंविधानामन्येषांचाम्लवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वाद्रवैःस्थाल्यामभ्यासिच्यसाधयित्वोपसंस्कृत्ययथावत्तैलवसामज्जलवणफाणितोपहितंसु<br>खोष्णंबस्तिंवातविकारिणेविधिज्ञोविधिवद्दद्यात्| इत्यम्लस्कन्धः||१४०||
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Āmrāmrātakalakucakaramardavr̥kṣāmlāmlavētasakuvalabadaradāḍimamātuluṅgagaṇḍīrāmalakanandītakaśītaka- tintiṇḍīkadantaśaṭhairāvatakakōśāmradhanvanānāṁ phalāni, patrāṇi cāmrātakāśmantakacāṅgērīṇāṁ caturvidhānāṁ cāmlikānāṁ dvayōśca kōlayōścāmaśuṣkayōrdvayōścaiva śuṣkāmlikayōrgrāmyāraṇyayōḥ, āsavadravyāṇi ca surāsauvīrakatuṣōdakamairēyamēdakamadirāmadhuśuktaśīdhudadhidadhimaṇḍōdaśviddhānyāmlādīni ca, ēṣāmēvaṁvidhānāmanyēṣāṁ cāmlavargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā dravaiḥ sthālyāmabhyāsicya sādhayitvōpasaṁskr̥tya yathāvattailavasāmajjalavaṇaphāṇitōpahitaṁ sukhōṣṇaṁ bastiṁ vātavikāriṇē vidhijñō vidhivaddadyāt| ityamlaskandhaḥ||140||

AmrAmrAtakalakucakaramardavRukShAmlAmlavetasakuvalabadaradADimamAtulu~ggagaNDIrAmalakanandItakashItaka-tintiNDIkadantashaThairAvatakakoshAmradhanvanAnAM phalAni, patrANi cAmrAtakAshmantakacA~ggerINAMcaturvidhAnAM cAmlikAnAM dvayoshca kolayoshcAmashuShkayordvayoshcaiva shuShkAmlikayorgrAmyAraNyayoH,AsavadravyANi casurAsauvIrakatuShodakamaireyamedakamadirAmadhushuktashIdhudadhidadhimaNDodashviddhAnyAmlAdIni ca,eShAmevaMvidhAnAmanyeShAM cAmlavargaparisa~gkhyAtAnAmauShadhadravyANAM chedyAnikhaNDashashchedayitvA bhedyAni cANusho bhedayitvA dravaiH sthAlyAmabhyAsicya sAdhayitvopasaMskRutyayathAvattailavasAmajjalavaNaphANitopahitaM sukhoShNaM bastiM vAtavikAriNe vidhij~jo vidhivaddadyAt|
ityamlaskandhaH||140||
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The sour group (drugs of ''amlaskandha'') includes fruits of ''amra, amrataka, lakucha, karamarda, vrukshamla, amlavetasa, kuvala, badara, dadima, matulunga, gandira, amalaka, nanditaka, shitaka, tintindika, dantashath, airavataka, koshamra, dhanvan'';

*Leaves of ''amrataka, ashmantaka, changeri,'' four types of ''amlika'', two types of ''kola''- unripe and dried, two types of dried tamarind wild and cultivated, substances used in preparation of ''asava, sura, sauviraka, tushodaka, maireya, medaka, madira, madhu, shukta, sidhu, dadhimanda,'' buttermilk, ''dhanyamla'' etc.

These and such other drugs of the sour group should be taken and after cutting and breaking into small pieces should be placed in a vessel along with liquids and be cooked. The lukewarm product added properly with oil, fat, ''majja'', salt and ''phanita'' should be used for enema in ''vatika'' disorders according to procedure by the expert physician. Thus, ends the sour group. [140]

==== ''Lavana skandha'' (group of salty drugs) ====
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सैन्धवसौवर्चलकालविडपाक्यानूपकूप्यवालुकैलमौलकसामुद्ररोमकौद्भिदौषरपाटेयकपांशुजान्येवम्प्रकाराणिचान्यानिलवणवर्गपरिसङ्ख्यातानि, एतान्यम्लोपहितान्युष्णोदकोपहितानिवास्नेहवन्तिसुखोष्णंबस्तिंवातविकारिणेविधिज्ञोविधिवद्दद्यात्| इतिलवणस्कन्धः||१४१||
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saindhavasauvarcalakālaviḍapākyānūpakūpyavālukailamaulakasāmudrarōmakaudbhidauṣarapāṭēyakapāṁśujānyēvamprakārāṇi cānyāni lavaṇavargaparisaṅkhyātāni, ētānyamlōpahitānyuṣṇōdakōpahitāni vā snēhavanti sukhōṣṇaṁ bastiṁ vātavikāriṇē vidhijñō vidhivaddadyāt| iti lavaṇaskandhaḥ||141||

saindhavasauvarcalakAlaviDapAkyAnUpakUpyavAlukailamaulakasAmudraromakaudbhidauSharapATeyakapAMshujAnyevamprakArANicAnyAni lavaNavargaparisa~gkhyAtAni, etAnyamlopahitAnyuShNodakopahitAni vA snehavanti sukhoShNaM bastiM vAtavikAriNevidhij~jo vidhivaddadyAt|
iti lavaNaskandhaH||141||
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In the salty group (''lavana skandha''), the drugs mentioned are – ''saindhava, sauvarchala, kala, vida, pakya, anupa, valukaila, maulaka, samudra, romaka, audbhida, aushara, pateyaka, pamshuja'' and others. These drugs added with sour or warm water along with fatty substance in lukewarm condition should be used for enema in ''vatika'' disorders according to procedure by the expert. This concludes the salty group of drugs. [141]

==== ''Katu skandha'' (group of pungent drugs) ====
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पिप्पलीपिप्पलीमूलहस्तिपिप्पलीचव्यचित्रकशृङ्गवेरमरिचाजमोदार्द्रकविडङ्गकुस्तुम्बुरुपीलुतेजवत्येलाकुष्ठभल्लातकास्थिहिङ्गुनिर्यासकिलिममूलकसर्षपलशुनकरञ्जशिग्रुकमधुशिग्रुकखरपुष्प<br>भूस्तृणसुमखसुरसकुठेरकार्जक- गण्डीरकालमालकपर्णासक्षवकफणिज्झकक्षारमूत्रपित्तानीति; एषामेवंविधानांचान्येषांकटुकवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वागोमूत्रेणसहसाधयित्वोपसंस्कृत्ययथावन्मधुतैललवणोपहितंसुखोष्णंबस्तिंश्लेष्मविकारि<br>णेविधिज्ञोविधिवद्दद्यात्| इतिकटुकस्कन्धः||१४२||
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pippalīpippalīmūlahastipippalīcavyacitrakaśr̥ṅgavēramaricājamōdārdrakaviḍaṅgakustumburupīlutējōvatyēlākuṣṭhabhallātakāsthihiṅguniryāsakilimamūlakasarṣapalaśunakar<br>añjaśigrukamadhuśigrukakharapupabhūstr̥ṇasumukhasurasakuṭhērakārjaka- gaṇḍīrakālamālakaparṇāsakṣavakaphaṇijjhakakṣāramūtrapittānīti; ēṣāmēvaṁvidhānāṁ cānyēṣāṁ kaṭukavargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā gōmūtrēṇa saha sādhayitvōpasaṁskr̥tya yathāvanmadhutailalavaṇōpahitaṁ sukhōṣṇaṁ bastiṁ ślēṣmavikāriṇē vidhijñō vidhivaddadyāt| iti kaṭukaskandhaḥ||142||

pippalIpippalImUlahastipippalIcavyacitrakashRu~ggaveramaricAjamodArdrakaviDa~ggakustumburupIlutejovatyelAkuShTha-bhallAtakAsthihi~gguniryAsakilimamUlakasarShapalashunakara~jjashigrukamadhushigrukakharapuShpabhUstRuNasumukhasurasakuTherakArjaka-gaNDIrakAlamAlakaparNAsakShavakaphaNijjhakakShAramUtrapittAnIti; eShAmevaMvidhAnAM cAnyeShAMkaTukavargaparisa~gkhyAtAnAmauShadhadravyANAM chedyAni khaNDashashchedayitvA bhedyAni cANusho bhedayitvA gomUtreNa sahasAdhayitvopasaMskRutya yathAvanmadhutailalavaNopahitaM sukhoShNaM bastiM shleShmavikAriNe vidhij~jo vidhivaddadyAt|
iti kaTukaskandhaH||142||
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In pungent group (''katuka skandha'') the drugs included are – ''pippali, pippalimula, gajapippali, chavya, chitraka, shunţhi, maricha, ajamoda, ardraka, vidanga, dhanyaka, pilu, tejavati, ela, kushtha, bhallatakasthi, hinguniryasa, devadaru, mulaka, sarshapa, lashuna, karanja, shigru, madhu shigru, kharapushpa, bhustruna sumukha, surasa, kutheraka, arjaka, gandira, kalamalaka, parnasa, kshavaka, phanijjhaka,'' alkali, urines, and biles. These along with other similar drugs of group (pungent) should be taken and after cutting and breaking into pieces should be cooked with cow’s urine. This while lukewarm added with honey oil and salt should be used for enema in ''shlaishmika'' disorders according to procedure by experts. Thus ends the pungent group.[142]

==== ''Tikta skandha'' (group of bitter drugs) ====
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चन्दननलदकृतमालनक्तमालनिम्बतुम्बुरुकुटजहरिद्रादारुहरिद्रामुस्तमूर्वाकिराततिक्तककटुकरोहिणीत्रायमाणाकारवेल्लिकाकरीरकरवीरकेबुककठिल्लकवृषमण्डूकपर्णीकर्कोटकवार्ताकुकर्कशकाकमाचीकाको<br>दुम्बरिकासुषव्यतिविषापटोलकुलकपाठागुडूचीवेत्राग्रवेतसविकङ्कतबकुलसोमवल्कसप्तपर्णसुमनार्कावल्गुजवचातगरागुरुवालकोशीराणीति , एषामेवंविधानांचान्येषांतिक्तवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वाप्रक्षाल्यपानीयेनाभ्यासिच्यसाधयित्वोपसंस्कृत्ययथावन्मधुतैललवणोपहितंसुखोष्णंबस्तिं<br>श्लेष्मविकारिणेविधिज्ञोविधिवद्दद्यात्, शीतंतुमधुसर्पिर्भ्यामपसंसृज्यपित्तविकारिणेविधिज्ञोविधिवद्दद्यात्| इतितिक्तस्कन्धः||१४३||
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candananaladakr̥tamālanaktamālanimbatumburukuṭajaharidrādāruharidrāmustamūrvākirātatiktakakaṭukarōhiṇītrāyamāṇā- kāravēllikākarīrakaravīrakēbukakaṭhillakavr̥ṣamaṇḍūkaparṇīkarkōṭakavārtākukarkaśakākamācīkākōdumbarikāsuṣavyativiṣā- paṭōlakulakapāṭhāguḍūcīvētrāgravētasavikaṅkatabakulasōmavalkasaptaparṇasumanārkāvalgujavacātagarāguruvālakōśīrāṇīti , ēṣāmēvaṁvidhānāṁ cānyēṣāṁ tiktavargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā prakṣālya pānīyēnābhyāsicya sādhayitvōpasaṁskr̥tya yathāvanmadhutailalavaṇōpahitaṁ sukhōṣṇaṁ bastiṁ ślēṣmavikāriṇē vidhijñō vidhivaddadyāt, śītaṁ tu madhusarpirbhyāmapasaṁsr̥jya pittavikāriṇē vidhijñō vidhivaddadyāt| iti tiktaskandhaḥ||143||

candananaladakRutamAlanaktamAlanimbatumburukuTajaharidrAdAruharidrAmustamUrvAkirAtatiktakakaTukarohiNItrAyamANA-kAravellikAkarIrakaravIrakebukakaThillakavRuShamaNDUkaparNIkarkoTakavArtAkukarkashakAkamAcIkAkodumbarikAsuShavyativiShA-paTolakulakapAThAguDUcIvetrAgravetasavika~gkatabakulasomavalkasaptaparNasumanArkAvalgujavacAtagarAguruvAlakoshIrANIti [1] ,eShAmevaMvidhAnAM cAnyeShAM tiktavargaparisa~gkhyAtAnAmauShadhadravyANAM chedyAni khaNDashashchedayitvA bhedyAnicANusho bhedayitvA prakShAlya pAnIyenAbhyAsicya sAdhayitvopasaMskRutya yathAvanmadhutailalavaNopahitaM sukhoShNaM bastiMshleShmavikAriNe vidhij~jo vidhivaddadyAt, shItaM tu madhusarpirbhyAmapasaMsRujya pittavikAriNe vidhij~jo vidhivaddadyAt|
iti tiktaskandhaH||143||
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The drugs mentioned in bitter group (''tikta skandha'') are – ''Chandana, nalada, aragvadha, naktamala, nimba, tumburu, kutaja, haridra, daruharidra, musta, murva, kiratatikta, katurohini, trayamana, karvellika, karira, karavira, kebuka, kathillaka, vrusha, mandukaparni, karkotaka, vartaku, karkasha, kakamachi, kakodumbarika, sushavi, ativisha, patola, kulaka, patha, guduchi, tip of vetra, vetasa, vikankata, bakula, somavalka, saptaparna, sumana, arka, avalguja, vacha, tagara, agaru, balaka'' and ''ushira'', along with other similar drugs of the bitter group should be taken and after cutting and breaking them into pieces and washing properly be cooked with water. The product when lukewarm should be added with honey, oil and salt to be used in enema for ''kaphaja'' disorders according to procedure by the expert. In ''paittika'' disorders the same should be used while cold and added with honey and ghee. This ends the bitter group.[143]

==== ''Kashaya skandha'' (group of astringent drugs) ====
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प्रियङ्ग्वनन्ताम्रास्थ्यम्बष्ठकीकट्वङ्गलोध्रमोचरससमङ्गाधातकीपुष्पपद्मापद्मकेशरजम्ब्वाम्रप्लक्षवटकपीतनोदुम्बराश्वत्थभल्लातकास्थ्यश्मन्तकशिरीषशिंशपासोमवल्कतिन्दुकप्रियालबदरखदिरसप्तप<br>र्णाश्वकर्णस्यन्दनार्जुनारिमेदैलवालुकपरिपेलवकदम्बशल्लकीजिङ्गिनीकाशकशेरुकराजकशेरुकट्फलवंशपद्मकाशोकशालधवसर्जभूर्जशणखरपुष्पापुरशमीमाचीकवरकतुङ्गाजकर्णस्फूर्जकबिभीतककम्भीपु<br>ष्करबीज- बिसमृणालतालखर्जूरतरुणानीति , एषामेवंविधानांचान्येषांकषायवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वाप्रक्षाल्यपानीयेनाभ्यासिच्यसाधयित्वोपसंस्कृत्ययथावन्मधुतैललवणोपहितंसुखोष्णंब<br>स्तिंश्लेष्मविकारिणेविधिज्ञोविधिवद्दद्यात्, शीतंतुमधुसर्पिर्भ्यामुपसंसृज्यपित्तविकारिणेदद्यात्| इतिकषायस्कन्धः||१४४||
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priyaṅgvanantāmrāsthyambaṣṭhakīkaṭvaṅgalōdhramōcarasasamaṅgādhātakīpuṣpapadmāpadmakēśarajambvāmraplakṣavaṭa- kapītanōdumbarāśvatthabhallātakāsthyaśmantakaśirīṣaśiṁśapāsōmavalkatindukapriyālabadarakhadira- saptaparṇāśvakarṇasyandanārjunārimēdailavālukaparipēlavakadambaśallakījiṅginīkāśakaśērukarājakaśērukaṭphalavaṁśa- padmakāśōkaśāladhavasarjabhūrjaśaṇakharapuṣpāpuraśamīmācīkavarakatuṅgājakarṇasphūrjakabibhītakakumbhīpuṣkarabīja- bisamr̥ṇālatālakharjūrataruṇānīti , ēṣāmēvaṁvidhānāṁ cānyēṣāṁ kaṣāyavargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā prakṣālya pānīyēnābhyāsicya sādhayitvōpasaṁskr̥tya yathāvanmadhutailalavaṇōpahitaṁ sukhōṣṇaṁ bastiṁ ślēṣmavikāriṇē vidhijñō vidhivaddadyāt, śītaṁ tu madhusarpirbhyāmupasaṁsr̥jya pittavikāriṇē dadyāt| iti kaṣāyaskandhaḥ||144||

priya~ggvanantAmrAsthyambaShThakIkaTva~ggalodhramocarasasama~ggAdhAtakIpuShpapadmApadmakesharajambvAmraplakShavaTa-kapItanodumbarAshvatthabhallAtakAsthyashmantakashirIShashiMshapAsomavalkatindukapriyAlabadarakhadira-saptaparNAshvakarNasyandanArjunArimedailavAlukaparipelavakadambashallakIji~gginIkAshakasherukarAjakasherukaTphalavaMsha-padmakAshokashAladhavasarjabhUrjashaNakharapuShpApurashamImAcIkavarakatu~ggAjakarNasphUrjakabibhItakakumbhIpuShkarabIja-bisamRuNAlatAlakharjUrataruNAnIti [1] , eShAmevaMvidhAnAM cAnyeShAM kaShAyavargaparisa~gkhyAtAnAmauShadhadravyANAMchedyAni khaNDashashchedayitvA bhedyAni cANusho bhedayitvA prakShAlya pAnIyenAbhyAsicya sAdhayitvopasaMskRutyayathAvanmadhutailalavaNopahitaM sukhoShNaM bastiM shleShmavikAriNe vidhij~jo vidhivaddadyAt, shItaM tumadhusarpirbhyAmupasaMsRujya pittavikAriNe dadyAt|
iti kaShAyaskandhaH||144||
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The drugs of ''Kashaya skandha'' (astringent group) are – ''priyangu, ananta, amrasthi, ambashthaki, katvanga, lodhra, mocharasa, samanga, dhataki flowers, padma, padmakeshara, jambu, amra, plaksha, vata, kapitana, udumbara, ashwattha, bhallatakasthi, ashmantaka, shirisha, shimshapa, somavalka, tinduka, priyala, badara, khadira, saptaparna, ashwakarna, syandana, arjuna, arimeda, elavaluka, paripelava, kadamba, shallaki, jingini, kasha, kasheruka, rajakasheruka, katphala, vamsha, padmaka, ashoka, shala, dhava, sarja, bhuja, sana, kharapushpa, guggulu, shami, machika, varaka, tunga, ajakarna, sphurjaka, bibhitaka, kumbhi, pushkarabija,'' lotus stem, lotus stalk, tender, parts of ''tala'', and ''kharjura'', along with other similar drugs of astringent group should be taken and after cutting and breaking them into small pieces and washing be cooked with water. The lukewarm product being added with honey, oil and salt be used for enema in disorders of ''kapha'' according to procedure by expert. In ''paittika'' disorders the same should be used while cold and added with honey and ghee.
This is the astringent group. [144]
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तत्रश्लोकाः-

षड्वर्गाःपरिसङ्ख्यातायएतेरसभेदतः| आस्थापनमभिप्रेत्यतान्विद्यात्सार्वयौगिकान्||१४५||

सर्वशोहिप्रणिहिताःसर्वरोगेषुजानता| सर्वान्रोगान्नियच्छन्तियेभ्यआस्थापनंहितम्||१४६||
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tatra ślōkāḥ-

ṣaḍvargāḥ parisaṅkhyātā ya ētē rasabhēdataḥ| āsthāpanamabhiprētya tānvidyātsārvayaugikān||145||

sarvaśō hi praṇihitāḥ sarvarōgēṣu jānatā| sarvānrōgānniyacchanti yēbhya āsthāpanaṁ hitam||146||

tatra shlokAH-

ShaDvargAH parisa~gkhyAtA ya ete rasabhedataH|
AsthApanamabhipretya tAnvidyAtsArvayaugikAn||145||

sarvasho hi praNihitAH sarvarogeShu jAnatA|
sarvAnrogAnniyacchanti yebhya AsthApanaM hitam||146||
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Amongst two verses the six groups enumerated are according to ''rasa'' and should be known as applicable in all disorders being used in form of non- unctuous enema, which being employed in diseases according to the respective procedures by the learned expert physician controls all the diseases. [145-146]
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येषांयेषांप्रशान्त्यर्थंयेयेनपरिकीर्तिताः| द्रव्यवर्गाविकाराणांतेषांतेपरिकोपकाः||१४७||

इत्येतेषडास्थापनस्कन्धारसतोऽनुविभज्यव्याख्याताः||१४८||
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yēṣāṁ yēṣāṁ praśāntyarthaṁ yē yē na parikīrtitāḥ| dravyavargā vikārāṇāṁ tēṣāṁ tē parikōpakāḥ||147||

ityētē ṣaḍāsthāpanaskandhā rasatō'nuvibhajya vyākhyātāḥ||148||

yeShAM yeShAM prashAntyarthaM ye ye na parikIrtitAH|
dravyavargA vikArANAM teShAM te parikopakAH||147||

ityete ShaDAsthApanaskandhA rasato~anuvibhajya vyAkhyAtAH||148||
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And the groups of drugs which are not advocated in certain disorders should be considered as those aggravating the same. Thus, these six groups of non-unctuous enema are described dividing them according to ''rasa''. [147-148]

==== Guidelines for inclusion or exclusion of drugs ====
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तेभ्योभिषग्बुद्धिमान्परिसङ्ख्यातमपियद्यद्द्रव्यमयौगिकंमन्येत, तत्तदपकर्षयेत्; यद्यच्चानुक्तमपियौगिकंमन्येत, तत्तद्विदध्यात्; वर्गमपिवर्गेणोपसंसृजेदेकमेकेनानेकेनवायुक्तिंप्रमाणीकृत्य| प्रचरणमिवभिक्षुकस्यबीजमिवकर्षकस्यसूत्रंबुद्धिमतामल्पमप्यनल्पज्ञानायभवति; तस्माद्बुद्धिमतामूहापोहवितर्काः, मन्दबुद्धेस्तुयथोक्तानुगमनमेवश्रेयः| यथोक्तंहिमार्गमनुगच्छन्भिषक्संसाधयतिकार्यमनतिमहत्त्वाद्वाविनिपातयत्यनतिह्रस्वत्वादुदाहरणस्येति||१४९||
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tēbhyō bhiṣagbuddhimān parisaṅkhyātamapi yadyaddravyamayaugikaṁ manyēta, tattadapakarṣayēt; yadyaccānuktamapi yaugikaṁ manyēta, tattadvidadhyāt; vargamapi vargēṇōpasaṁsr̥jēdēkamēkēnānēkēna vā yuktiṁ pramāṇīkr̥tya| pracaraṇamiva bhikṣukasya bījamiva karṣakasya sūtraṁ buddhimatāmalpamapyanalpajñānāya bhavati; tasmādbuddhimatāmūhāpōhavitarkāḥ, mandabuddhēstu yathōktānugamanamēva śrēyaḥ| yathōktaṁ hi mārgamanugacchan bhiṣak saṁsādhayati kāryamanatimahattvādvā vinipātayatyanatihrasvatvādudāharaṇasyēti||149||

tebhyo bhiShagbuddhimAn parisa~gkhyAtamapi yadyaddravyamayaugikaM manyeta, tattadapakarShayet;yadyaccAnuktamapi yaugikaM manyeta, tattadvidadhyAt; vargamapivargeNopasaMsRujedekamekenAnekena vA yuktiM pramANIkRutya|
pracaraNamiva bhikShukasya bIjamiva karShakasya sUtraM buddhimatAmalpamapyanalpaj~jAnAyabhavati; tasmAdbuddhimatAmUhApohavitarkAH, mandabuddhestu yathoktAnugamanameva shreyaH|
yathoktaM hi mArgamanugacchan bhiShak saMsAdhayati kAryamanatimahattvAdvA [1]vinipAtayatyanatihrasvatvAdudAharaNasyeti||149||
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The wise physician should eliminate or exclude the drugs if it is not appropriate even if enumerated under the group and should add the appropriate one even if un-enumerated. In situation needed a group of drugs may be combined with other or several other groups based on the reasoning. The aphorism, though small, is able to provide wide knowledge to the wise like alms of a mendicant or seed of a farmer. The aphorism for the wise, gives rise to critical analysis and reasoning while on the other hand for the dull, it is better to follow the saying exactly. The physician following the said course succeeds in his endeavor or causes little risk because of the illustration being not too brief.[149]

==== List of drugs for unctuous enema ====
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अतःपरमनुवासनद्रव्याण्यनुव्याख्यास्यामः| अनुवासनंतुस्नेहएव| स्नेहस्तुद्विविधः- स्थावरात्मकः, जङ्गमात्मकश्च| तत्रस्थावरात्मकःस्नेहस्तैलमतैलंच| तद्द्वयंतैलमेवकृत्वोपदेक्ष्यामः, सर्वतस्तैलप्राधान्यात्| जङ्गमात्मकस्तुवसा, मज्जा, सर्पिरिति| तेषांतैलवसामज्जसर्पिषांयथापूर्वंश्रेष्ठंवातश्लेष्मविकारेष्वनुवासनीयेषु, यथोत्तरंतुपित्तविकारेषु, सर्वएववासर्वविकारेष्वपियोगमुपयान्तिसंस्कारविधिविशेषादिति||१५०||
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ataḥ paramanuvāsanadravyāṇyanuvyākhyāsyāmaḥ|
anuvāsanaṁ tu snēha ēva|
snēhastu dvividhaḥ- sthāvarātmakaḥ, jaṅgamātmakaśca|
tatra sthāvarātmakaḥ snēhastailamatailaṁ ca|
taddvayaṁ tailamēva kr̥tvōpadēkṣyāmaḥ, sarvatastailaprādhānyāt|
jaṅgamātmakastu vasā, majjā, sarpiriti|
tēṣāṁ tailavasāmajjasarpiṣāṁ yathāpūrvaṁ śrēṣṭhaṁ vātaślēṣmavikārēṣvanuvāsanīyēṣu, yathōttaraṁ tupittavikārēṣu, sarva ēva vā sarvavikārēṣvapi yōgamupayānti saṁskāravidhiviśēṣāditi||150||

ataH paramanuvAsanadravyANyanuvyAkhyAsyAmaH|
anuvAsanaM tu sneha eva|
snehastu dvividhaH- sthAvarAtmakaH, ja~ggamAtmakashca|
tatra sthAvarAtmakaH snehastailamatailaM ca|
taddvayaM tailameva kRutvopadekShyAmaH, sarvatastailaprAdhAnyAt|
ja~ggamAtmakastu vasA, majjA, sarpiriti|
teShAM tailavasAmajjasarpiShAM yathApUrvaM shreShThaM vAtashleShmavikAreShvanuvAsanIyeShu,yathottaraM tu pittavikAreShu, sarva eva vA sarvavikAreShvapi yogamupayAntisaMskAravidhivisheShAditi||150||
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Now the drugs used for unctuous enema are mentioned. ''Anuvasana'' (unctuous enema) is, in fact composed of unctuous substances, which are of two types – Vegetable products and animal products. The vegetable products are either ''taila'' (oil derived from ''tila'' – sesamum seeds) or ''ataila'' (other than the above) but both of them are described here as ''taila'' because of overall predominance of ''tila'' oil.

Animal products are fat, marrow and ghee. Out of the oil, fat, marrow and ghee, excellence of applicability as unctuous enema in disorders of ''vata'' and ''kapha'', is determined in regressive order and progressive order in ''paittika'' disorders, so all are applicable in all disorders according to particular procedure and processing. [150]

==== List of drugs for nasal errhines ====
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शिरोविरेचनद्रव्याणिपुनरपामार्गपिप्पलीमरिचविडङ्गशिग्रुशिरीषतुम्बुरुपिल्वजाज्यमोदावार्ताकीपृथ्वीकैलाहरेणुकाफलानि
च,सुमुखसुरसकुठेरकगण्डीरकालमालकपर्णासक्षवकफणिज्झकहरिद्राशृङ्गवेरमूलकलशुनतर्कारीसर्षपपत्राणिच,अर्कालर्ककुष्ठनागदन्तीवचापामार्गश्वेताज्योतिष्मतीगवाक्षीगण्डीरपुष्प्यवाक्पुष्पीवृश्चिकाली<br>वयस्थातिविषामूलानिच, हरिद्राशृङ्गवेरमूलकलशुनकन्दाश्च, लोध्रमदनसप्तपर्णनिम्बार्कपुष्पाणिच, देवदार्वगुरुसरलशल्लकीजिङ्गिन्यसनहिङ्गुनिर्यासाश्च, तेजोवतीवराङ्गेङ्गुदीशोभाञ्जनकबृहतीकण्टकारिकात्वचश्चेति| शिरोविरेचनंसप्तविधं, फल-पत्र-मूल-कन्द-पुष्प-निर्यास-त्वगाश्रयभेदात्| लवणकटुतिक्तकषायाणिचेन्द्रियोपशयानितथाऽपराण्यनुक्तान्यपिद्रव्याणियथायोगविहितानिशिरोविरेचनार्थमुपदिश्यन्तइति||१५१||
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śirōvirēcanadravyāṇipunarapāmārgapippalīmaricaviḍaṅgaśigruśirīṣatumburupilvajājyamōdāvārtākīpr̥thvīkailāharēṇukāphalāni ca,sumukhasurasakuṭhērakagaṇḍīrakālamālakaparṇāsakṣavakaphaṇijjhakaharidrāśr̥ṅgavēramūlakalaśunatarkārīsarṣapapatrāṇica, arkālarkakuṣṭhanāgadantīvacāpāmārgaśvētājyōtiṣmatīgavākṣīgaṇḍīrapuṣpyavākpuṣpīvr̥ścikālīvayasthātiviṣāmūlāni ca,haridrāśr̥ṅgavēramūlakalaśunakandāśca, lōdhramadanasaptaparṇanimbārkapuṣpāṇi ca,dēvadārvagurusaralaśallakījiṅginyasanahiṅguniryāsāśca, tējōvatīvarāṅgēṅgudīśōbhāñjanakabr̥hatīkaṇṭakārikātvacaścēti|
śirōvirēcanaṁ saptavidhaṁ, phala-patra-mūla-kanda-puṣpa-niryāsa-tvagāśrayabhēdāt|
lavaṇakaṭutiktakaṣāyāṇi cēndriyōpaśayāni tathā'parāṇyanuktānyapi dravyāṇi yathāyōgavihitāniśirōvirēcanārthamupadiśyanta iti||151||

shirovirecanadravyANipunarapAmArgapippalImaricaviDa~ggashigrushirIShatumburupilvajAjyamodAvArtAkIpRuthvIkailAhareNukAphalAni ca,sumukhasurasakuTherakagaNDIrakAlamAlakaparNAsakShavakaphaNijjhakaharidrAshRu~ggaveramUlakalashunatarkArIsarShapapatrANica, arkAlarkakuShThanAgadantIvacApAmArgashvetAjyotiShmatIgavAkShIgaNDIrapuShpyavAkpuShpIvRushcikAlIvayasthAtiviShAmUlAnica, haridrAshRu~ggaveramUlakalashunakandAshca, lodhramadanasaptaparNanimbArkapuShpANi ca,devadArvagurusaralashallakIji~gginyasanahi~gguniryAsAshca,tejovatIvarA~gge~ggudIshobhA~jjanakabRuhatIkaNTakArikAtvacashceti|
shirovirecanaM saptavidhaM, phala-patra-mUla-kanda-puShpa-niryAsa-tvagAshrayabhedAt|
lavaNakaTutiktakaShAyANi cendriyopashayAni tathA~aparANyanuktAnyapi dravyANi yathAyogavihitAni shirovirecanArthamupadishyantaiti||151||
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The drugs mentioned for use in head- evacuation are as follows:

*Fruits of ''apamarga, pippali, maricha, vidanga, shigru, shirisha, tumburu, pilu, ajaji, ajamoda, vartaki, prithvika, ela,'' and ''harenuka'';
*Leaves of ''sumukha, surasa, kutheraka, gandira, kalmalaka, parnasa, kshavaka, phannijhaka, haridra, shunţhi, mulaka, lashuna, tarkari'' and ''sarshapa'' ;
*Roots of ''arka, alarka, kushtha, naga-danti, vacha, apamarga, jyotishmati, gavakshi, gandirapushpi, avakpushpi, vrushchikali, vayastha'' and ''ativisha'';
*Tuberous rhizomes or roots of ''haridra, shunthi, mulaka and lashuna'';
*Flowers of ''lodhra, madana, saptaparna, nimba'' and ''arka'';
*Exudations of ''devadaru, aguru, sarala, shallaki, jingini, asana'',and '' hingu'';
*Bark of ''tejovati, varanga, ingudi, shobhanjana, bruhati'' and ''kantakarika.'' In this way according to substrate (of action) the nasal errhines is of seven types such as fruit, leaf, root, tuber, flower, exudation and bark; other saline, pungent bitter and astringent drugs which are wholesome to the sense organs and other unmentioned drugs may be used, according to condition needed for nasal errhines.[151]

=== Summary ===
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तत्रश्लोकाः

लक्षणाचार्यशिष्याणांपरीक्षाकारणंचयत्| अध्येयाध्यापनविधीसम्भाषाविधिरेवच||१५२||

षड्भिरूनानिपञ्चाशद्वादमार्गपदानिच| पदानिदशचान्यानिकारणादीनितत्त्वतः||१५३||

सम्प्रश्नश्चपरीक्षादेर्नवकोवमनादिषु| भिषग्जितीयेरोगाणांविमानेसम्प्रकाशितः||१५४||
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tatra ślōkāḥ-

lakṣaṇācāryaśiṣyāṇāṁ parīkṣā kāraṇaṁ ca yat|
adhyēyādhyāpanavidhī sambhāṣāvidhirēva ca||152||

ṣaḍbhirūnāni pañcāśadvādamārgapadāni ca|
padāni daśa cānyāni kāraṇādīni tattvataḥ||153||

sampraśnaśca parīkṣādērnavakō vamanādiṣu|
bhiṣagjitīyē rōgāṇāṁ vimānē samprakāśitaḥ||154||

tatra shlokAH-

lakShaNAcAryashiShyANAM parIkShA kAraNaM ca yat|
adhyeyAdhyApanavidhI sambhAShAvidhireva ca||152||

ShaDbhirUnAni pa~jcAshadvAdamArgapadAni ca|
padAni dasha cAnyAni kAraNAdIni tattvataH||153||

samprashnashca parIkShAdernavako vamanAdiShu|
bhiShagjitIye rogANAM vimAne samprakAshitaH||154||
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Summing the chapter regarding specific features of discussion of therapeutics of diseases, it has been mentioned that – examination of treatise, preceptor and disciple with reasons, method of study and teaching, method of discussion, forty four terms related to the course of discussion, ten other terms with application, nine questions related to examination etc. in emesis etc. has been described in the chapter. [152-154]
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बहुविधमिदमुक्तमर्थजातंबहुविधवाक्यविचित्रमर्थकान्तम्| बहुविधशुभशब्दसन्धियुक्तंबहुविधवादनिसूदनंपरेषाम्||१५५||

इमांमतिंबहुविधहेतुसंश्रयांविजज्ञिवान्परमतवादसूदनीम्| नसज्जतेपरवचनावमर्दनैर्नशक्यतेपरवचनैश्चमर्दितुम्||१५६||

दोषादीनांतुभावानांसर्वेषामेवहेतुमत्| मानात्सम्यग्विमानानिनिरुक्तानिविभागशः||१५७||
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bahuvidhamidamuktamarthajātaṁ bahuvidhavākyavicitramarthakāntam|
bahuvidhaśubhaśabdasandhiyuktaṁ bahuvidhavādanisūdanaṁ parēṣām||155||

imāṁ matiṁ bahuvidhahētusaṁśrayāṁ vijajñivān paramatavādasūdanīm|
na [1] sajjatē paravacanāvamardanairna śakyatē paravacanaiśca marditum||156||

dōṣādīnāṁ tu bhāvānāṁ sarvēṣāmēva hētumat|
mānāt samyagvimānāni niruktāni vibhāgaśaḥ||157||

bahuvidhamidamuktamarthajAtaM bahuvidhavAkyavicitramarthakAntam|
bahuvidhashubhashabdasandhiyuktaM bahuvidhavAdanisUdanaM pareShAm||155||

imAM matiM bahuvidhahetusaMshrayAM vijaj~jivAn paramatavAdasUdanIm|
na [1] sajjate paravacanAvamardanairna shakyate paravacanaishca marditum||156||

doShAdInAM tu bhAvAnAM sarveShAmeva hetumat|
mAnAt samyagvimAnAni niruktAni vibhAgashaH||157||
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This chapter containing various ideas, variegated with various sentences, pleasing with meanings, possessed with various auspicious words and their unions and capable of defeating opponents in various debates, it has been said; one who has acquired this knowledge based on various reasons and refuting the opponent’s view in debates does not get fastened by the pressure of opponents arguments nor does he get subdued by their arguments.

Etymologically ''vimana'' is termed because of providing proper and correct knowledge of the specific features of entities like ''dosha'' etc. with reasoning and classification. [155-157]
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इत्यग्निवेशकृतेतन्त्रेचरकप्रतिसंस्कृतेविमानस्थाने
रोगभिषग्जितीयविमानंनामाष्टमोऽध्यायः||८||

(अग्निवेशकृतेतन्त्रेचरकप्रतिसंस्कृते| अनेनावधिनास्थानंविमानानांसमर्थितम्|)|
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ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē vimānasthānē
rōgabhiṣagjitīyavimānaṁ nāmāṣṭamō'dhyāyaḥ||8||

(agnivēśakr̥tē tantrē carakapratisaṁskr̥tē|
anēnāvadhinā sthānaṁ vimānānāṁ samarthitam|)|
ityagniveshakRute tantre carakapratisaMskRute vimAnasthAne
rogabhiShagjitIyavimAnaM nAmAShTamo~adhyAyaH||8||

(agniveshakRute tantre carakapratisaMskRute|
anenAvadhinA sthAnaM vimAnAnAM samarthitam|)|
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Thus, gets end of eighth chapter on specific features of therapeutics of diseases in [[Vimana Sthana]] in the treatise composed by Agnivesha and redacted by Charak. With this, [[Vimana Sthana]] (section on specific features) also comes to an end.

== Tattva Vimarsha (Fundamental Principles) ==

*The ideal preceptor, ideal medical treatise and ideal student are considered as basic pillars for proper propagation of medical knowledge.
*In a conference, the discussion to improve one’s capabilities should be properly initiated according to the abilities of opponents and participants, topics for discussion, one’s own strength and weakness.
*A good Ayurvedic physician needs to have four qualifications:
**Knowledge of health science from appropriate ''Shastra'',
**Experience of practical knowledge and skill from excellent teachers,
**Character, mental & physical capability, and strong desire to be one.
**Participation in dialogue, discussion by participating in conferences,seminars and symposiums.

How to develop these qualities are described at length in this chapter.

*''Vakyaprashamsa'' (syntactical excellence) is achieved by a statement free from deficiency (''anyunama'') and superfluity (''anadhikama''), meaningfulness (''arthavata''), devoid of deprivation of meaning (''anaparthaka''), incongruity (''aviruddham'') and comprehensible (''adhigatapadartham'').
*For the physician to improve his medical knowledge ''karana'', (reasoning/doer), ''karana'' (knowledge of means), ''karyayoni'' (objective), ''karya'' (action), ''karyaphala'' (attainment of objective and happiness), ''anubandha'' (after effect), ''desha'' (land/patient), ''kala'' (year and phase of disease), ''pravritti'' (initiation of therapy) and ''upaya'' (proper management) are necessary.
*The signs of regaining health are equilibrium of ''dhatus'' and its feature is absence of disease.
*Assessment of regaining health is based on following criteria: alleviation of the disorder, normalcy of voice and complexion, nourishment of body, increase in strength, desire for food, relish at meal time, proper and timely digestion of the food taken, timely sleep, non-appearance of abnormal dreams, easy awakening, easy elimination of urine, faeces and semen, overall normalcy of mind, intellect and sense organs and associated with no other unhealthy features.
*The result of the act (''karyaphala'') is attainment of happiness. It is featured as satisfaction of mind, intellect, sense organs and the body pleasure.
*The dose and potency of drugs shall be decided after due consideration of patient’s place of living, his strength, and morbidity. If it is not considered, then the medicine may harm the patient and adverse reaction of drugs may occur.
*Complete knowledge of patient’s condition is required before starting the treatment, which is done by tenfold examination. These ten entities are:
#''Desha'' (place) which is of two types – habitat and patient’s body;
#Examination of ''prakriti'' and ''vikriti'' according to ''dosha'',
#Description of eight type of ''sara'' (essence of body tissues),
#Compactness, structure and body mass,
#Measurement of body parts,
#Specific suitability of a person,
#''Sattva'' (mental strength),
#Power of digestion and assimilation,
#Exercise endurance and
#Age.
*Knowledge of seven types of ''prakriti'' and their features are necessary to understand normal state of body.
*The factors such as constitution of sperm and ovum, the time (of conception) and status of health of uterus, diet and lifestyle of mother (during pregnancy), and interaction of ''mahabhutas'' determine the basic constitution (''prakriti'') of fetus (''garbha''). The genetic map of an individual is determined by these factors.
*''Shleshma'' is naturally unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), sweet (''madhura''), essence (''sara''), dense (''sandra''), slow acting (''manda''), stable (''stimita''), heavy (''guru''), cold (''sheeta''), slimy (''vijjala'') and clear (''acchah'').
*''Pitta'' is naturally hot (''ushna''), sharply/acutely acting (''tikshna''), liquid (''drava''), of fleshy smell (''visram''), sour (''amla'') and pungent (''katu'').
*''Vata'' is naturally rough (''ruksha''), light (''laghu''), mobile (''chala''), abundant (''bahu''), swift (''shighra''), cold (''sheeta''), coarse (''parusha'') and non-slimy (''vishada'').
*Pathological condition (''vikriti'') needs to be evaluated to be able to provide effective treatment. The disorder should be examined in terms of the strength of the cause (''hetu''), ''dosha'' (vitiating intermediary factors), ''dushya'' (vitiated factors), constitution (''prakriti''), place (''desha''), time (''kala'') and the symptoms. These factors determine the severity of disease.
*Eight types of ''sara'' (best quality of body tissues) determine the strength of body tissues. Indeed, innate immunity of body tissues depends upon ''sara'', and it can be examined by the given features.
*Assessment of ''samhanana'' (compactness) is important to examine the differentiation and organization of muscle, fat, bones. These determine the strength of person.
*Analyzing the compactness (''samhanana''), proportionate relation of different parts (''pramana''), suitability (''satmya''), mental state (''sattva''), intake and digestive capacity (''ahara''), exercise tolerance (''vyayama'') and age (''vaya'') helps the physician to classify the strength of the patient into three categories viz. superior (''pravara''), medium (''madhya'') and inferior (''avara''). It is on this basis that physician decides to give strong (''tikshna''), mild (''mridu'') and moderate (''madhya'') medicaments.
*The basic unit to measure the body parts is height, breadth and circumference of one’s own finger (''anguli''). This is used in personified medicine to determine one’s own standard proportion of body parts. There cannot be a single standard for overall population.
*Assessment of ''satmya'' (suitability) determines the overall diet and lifestyle of an individual and this affects lifespan of the person.
*The mental strength is important to assess the behavioral response of patient to disease. It is essential to assess mental strength in every disease, because, a person having big stature may pretend a mild disease as like a critical condition and physician may be misled to incorrect diagnosis.
*The physiological and psychological functions depend upon age of a person. Similarly, there is dominance of a specific ''dosha'' according to ''dosha''. ''Kapha'' is dominant is childhood, ''pitta'' in adulthood and ''vata'' in old age. If there is pathological dominance of a particular ''dosha'' in a certain age, then there will be changes according to respective ''dosha''. Thus, the lifespan will differ as per ''dosha'' dominance in respect to age.
*The severity of morbidity depends upon degree of ''dosha'' aggravation. Medicaments shall be prescribed considering severity of morbidity and strength of patient.
*Purificatory therapies need to be performed at appropriate time of the year (''kala'') which is divided into six ''ritus'', namely ''hemant'' (early winter), ''grishma'' (summer) and ''varsha'' (rainy season) these are the three season characterized by cold, heat and rains. In between them there are other three seasons having common characters as ''pravrita'' (early rain), ''sharad'' (autumn) and ''vasanta'' (spring). Last three are termed as ''sadharan ritu'' during which purificatory (''shodhana'') treatment can be done.

Similarly, medicine should be given at appropriate time to the patient (''kala'') and when not to be given (''akala'').

*Purification therapies shall be performed as per the seasonal vitiation of respective ''dosha''. The medicines shall be administered considering stage of disease and appropriate time as per the morbidity.

== Vidhi Vimarsha (Applied Inferences) ==

The text of [[Charak Samhita]] is several thousand years old. It provides holistic solutions for the people and society. World has changed since, with change in thinking, lifestyle and technological advancements but, many of the guiding principles are still applicable Following should be applicable now.

=== Selection of medical treatise ===

In the last century, there has been significant change in how medical education is imparted, specially Ayurvedic education. Since olden times, Ayurvedic teacher would select a student and provide both theoretical and practical training by a process called ''Guru''/''shishya'' (student/teacher) relationship. Student was also guided how to select the medical treatise, criteria for which is described in the text above. These days, books are recommended by the faculty of medical schools according to the syllabus. Guidelines given in the text are still useful in selecting any worth reading book on a particular subject.

=== Ideal presentation of text ===

Treatise should be such that is understood by all students with different levels of intelligence. Repetition of the same principles which only increases the exercise of studying should not be present. It should include a concise and accurate statement of fact or concept followed by explanation with supportive examples using common language words. The words used should not be difficult for hearing, spelling, remembering and use of infamous words should be avoided. The sentence used for explanation should give complete and correct meaning and sequencing should be in a way to achieve clear stepwise and comprehensive understanding of the topic. The chapter or subject should be well placed and related topic should follow in order. The content in the book should be very effective, attractive and giving complete knowledge without repetition. Various graphs, flow charts, diagrams pictures and color plates which generates interest within the readers should be included.

The conclusions of explanation should be perfect and unalterable. The principles mentioned in text should be the same from beginning to the end.

In present context, the guidelines for writing a research paper or an article or a monograph include all the points mentioned in the text. The principles to write considering reader’s psyche are important and shall be followed for making a good treatise. [[Charak Samhita]] follows the same principles of presentation.

=== Qualities of a teacher ===

Teacher influences the life of a student. A teacher should have complete theoretical and practical knowledge of [[Ayurveda]]. The qualities of an ideal teacher are described in the text. Furthermore, keeping the competency of medical education in mind, the teacher should have knowledge of contemporary sciences and should behave with care and unbiased to the students. Teacher should not be egoistic and jealous. He should enjoy his teaching and not feel burden of teaching even if he needs to repeat. He should understand the lifestyle, psychiatric and body constitution of his patients and convey the same to his students. Significance of each symptom and sign seen in patient should be noted with help of sense organs and the same clinical methods should be explained to the students.

A good teacher plays significant role in making life of a student. Even today, in Ayurvedic practice, ''guru-shishya parampara'' (traditional learning through students staying with teachers) exists, that is the most effective method of learning practical applications of principles of [[Ayurveda]].

=== Qualities of an ideal student ===

Today, with the increasing demand of education for all, the students are taught in the classrooms in a group. However, the best teacher develops a one-to-one interaction with each student to make him inform about the knowledge. The student must possess some qualities and develop learning skills to receive the information and follow instructions given by teacher. Student should be physically and mentally able to perform his duties as a future physician, surgeon, teacher, and/or researcher.

He should follow ''sadvritta'' and should be respectful to teacher so as to gain more and more knowledge in each aspect of life. He should engage in frequent academic dialogue with fellow students and teachers. His mind should be focused on his goal. He should have fixed aim of attaining the knowledge about the topic. Student should concentrate on acquiring good qualities and should participate in extra curricular activities like sports and debate etc. Retaining power of the student should be good.

Inference made after discussion and considering both the positive and negative points, student should have such qualities of understanding what and which are the positive and negative effects of each and every action he does. Secondly, he should have sharp memory, broad minded and he should be forgiving and should help others.

=== Medical ethics and social behaviors of a doctor ===

Manners and social behavior of doctor is very important. The doctor has prime importance in the society owing to his health-care responsibilities. Also, the medico-legal aspect while treating patient in emergency medical care, and treating patient of opposite gender must be kept in mind to avoid legal issues. The ethical code of conduct of the society or country where he/she lives shall be followed.

=== Conferences (acquiring cumulative wisdom) ===

In seminars and conferences, research papers and case reports are presented which help in acquiring knowledge to provide better care to the patients. Healthy discussion brings about growth in knowledge, increases enlightenment and is helpful in preparation for competition. Sharpness and clarity of knowledge is increased. Vocabulary is increased and also interpretation power is increased.

The guidelines to be followed while participating in a discussion to make it more beneficial are described in the text. The points that should be considered while preparing a paper for presentation are applicable for effective communication.

=== Examination of patient ===

It is important to assess physical and mental state of the patient and the nature of medicine for treatment.

=== ''Prakriti'' examination ===

The ''prakriti'' or basic constitution is very important to be investigated to know overall health status of a person. The place of birth, place of living, place of work is important for identifying the ethnic habits, suitability, and external causes of a disease. Accordingly, the do’s and don’ts in terms of diet and lifestyle are prescribed, that is the integral part of Ayurvedic prescription. Currently, concept of ''prakriti'' is being investigated further in personalized medicine to know the genotype and phenotype of an individual and predicting certain disorders in view of prevention.

=== ''Sara'' examination ===

To evaluate immunity or bodie’s resistance to disease, ''sara'' or ‘or the best qualities of tissues needs to be examined. The constitutional essence helps to understand the immunity of the person. More the ''sarata'' of ''dhatu'', more is the immunological strength of the person. Analogue of ant helps to understand the significance of essence of ''dhatus''. And although small and lean in size is able to lift more than its weight due to ''asthisarata'' present in it. In [[Vividhashitpitiya Adhyaya]] of [[Sutra Sthana]] (chapter 28), special importance is given to ''mamsa'' (muscle), ''shonita'' (blood) and ''asthi dhatu'' (bone) in ''Vyadhikshamatva'' (immunity) which needs to be researched more.

=== [[Satmya]] (suitability) ===

The effect of a drug depends upon its interaction with the body tissues. If it is not suitable to the body tissues, then adverse reaction may occur or drug may not be effective. Drug resistance also needs to be considered under the heading of ''satmya'' because it is observed that to a person who has developed resistance to certain antibiotics does not offer response to such medicament thus not attaining successful result in the person. Nowadays culture study is used to understand the usefulness of antibiotics in the patient. Therefore the suitability of the patient must be considered before prescribing a medicine.

=== The ideal time for purification procedures ===

If in emergency ''shodhana'' has to be done in unsuitable weather, then the surroundings of the patient should be made such that it resembles the ''sadharan kala'', for example, if it is very cold then room should be adjusted with warmness and if it is very hot as in ''grishma'', then the temperature in the room should be reduced. Also a physician must use ''yukti'' and accordingly use or make the necessary ''dravyas'' ''sheeta'' or ''ushna'' by appropriate ''samyoga'' (combination), ''samskara'' (processing) and ''pramana'' (dose).

=== Examination of stage of disease ===

''Aturavastha'' or the phase of disease in patient also matters in treatment as seen in context of ''jwara'' wherein in ''kashaya'' (decoction) should not be administered for seven days or till amapachana does not take place. This interprets that the body of patient shall be able to metabolize the drugs. In case of ''jwara'', the ''doshas'' are too vitiated with the poor status of ''agni'', therefore the body is unable to metabolize even the drugs also. Therefore ''langhana'' (fasting) is the first treatment in ''jwara''. In nutshell, the medicines shall be prescribed considering the phase of disease and status of the patient.

Nowadays, various software and decision support systems are available to help physicians regarding the diagnosis. Various subjective assessment scales to examine ''sara'' and questionnaires to assess ''prakriti'' are available to know the status of patient.

=== Examination of psyche of patient ===

''Mana''/''satva'' (mind) is said to be ''tantraka'' (technical operator) as the one who is ''preraka'' (inspirer) or ''dharaka'' (owner). ''Mana'' is the initiator of all activity but it can carry out its action in conjunction with ''atma'' only. If ''mana'' is weak it is unable to tolerate the symptoms of disease and he/she exaggerates those. If the doctor makes the mistake of considering the inferior mental strength of patient with severe disease depending on presentation of symptoms and gives strong medicine then he may end up with complication.

Symptoms of severely diseased and mildly diseased are mentioned in seventh chapter of [[Vimana Sthana]].

The mental status examination has a special importance in today’s medical practice. The physician has to modulate interaction with the patient, dose of medicine, potency of medicine considering the psychology of the patient. The physician who communicates better with the patient helps to heal disease naturally.

=== Assessment of ''ahara shakti'' (intake capacity) ===

''Aharashakti'' is not only the quantity of food intake, but also its digestive capacity. Quantity of food taken and digestive capacity of the person is to be considered. The assessment of ''agni'' is based upon the food intake capacity of the person. The proporation of body tissue depends upon intake of food and its assimilation inside body. This directly affects the health status. Hence, ''ahara shakti'' is important to be assessed.

Further, if the patient is not responding to oral administration of drugs, then the parenteral or any other route of drug administration is to be chosen.

=== Assessment of ''vyayama shakti'' (exercise endurance capacity) ===

''Vyayamashakti'' is described as ''bharvahanshakti'' i.e. capacity to work. People doing strenuous work or exercise have more forebearance and are strong. The capacity to exercise is directly related with the cardio-vascular, pulmonary, muscular and mental status of the patient, and hence it is linked with healthy lifespan. Nowadays, various stress tests are done for evaluation of these functions and are useful to determine the prognosis of disease to give guidance for necessary intervention.

=== Reference books for further reading ===

1. Charak Samhita by Agnivesha Edited By Yadavji Trikamji Acharya-Munshiram Manoharlal Publishers Pvt. Ltd. 4th Edition.

2. Sushruta Samhita of Sushruta Edited By Yadavji Trikamji Acharya- Chaukhamba Orientalia, Varanasi- 6th Edition.

3. Astanga Hrudaya By Vagbhat-Chaukhamba Publication

4. Caraka Samhita (Text With English Translation & Critical Exposition Based On Cakrapani Datta Ayurved Dipika) By R K Sharma And Bhagwan Dash, Chowkhamba Sanskrit Series Office, Varanasi.

5. Basic Principles Of [[Ayurveda]], Padarth Vijnana By Prof. Yogesh Chandra Mishra- Chaukhamba Sanskrit Bhawan, Varanasi.

6. Padarth Vigyan By Dr Krishnamurthy- Chaukhamba Sanskrit Bhawan, Varanasi.

7. Tarka Sangraha- Chaukhamba Sanskrit Bhawan, Varanasi.
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Rogabhishagjitiya Vimana

2020-09-16T07:34:43Z

Vidyadhishkashikar: /* Sanskrit Text, Transliteration and English Translation */Added missed contains, edited typping errors.

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|description=Vimana Sthana Chapter 8. Methods of conquering debate and disease
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<big>'''Vimana Sthana Chapter 8. Methods of conquering debate and disease '''</big>
{{Infobox
|title = Rogabhishagjitiya Vimana
|label1 = Section/Chapter
|data1 = [[Vimana Sthana]] Chapter 8
|label2 = Preceding Chapter
|data2 = [[Vyadhita Rupiya Vimana]]

|label3= Succeeding Chapter
|data3 = None
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|data6 = Dubey S.D., Singh A.N., Singh A., Singh A., Samant A., Deole Y. S.
|label7 = Reviewer
|data7 = Khandel S.K., Ram J.P.
|label8 = Editor
|data8 = Khandel S.K., Deole Y. S.
|label9 = Date of publication
|data9 = December 17, 2018
|label10 = DOI
|data10 =
|header3 =

}}
<big>'''Abstract'''</big>

<div style="text-align:justify;">This comprehensive and detailed chapter deals with assessment criteria of standard quality treatise, the teacher and the disciple, the means for receiving the knowledge from the treatise, method of discussion and its types- friendly or hostile, result of discussion, worth considering or worth discarding. It describes examination of ten entities to understand the state of health of the patient before starting the treatment. For providing treatment, physician should consider the strength of patient, severity of disease, prakriti (constitution), vikriti (nature of abnormalities), potency of drugs, season for purification therapy, and the status of the patients in context to use of drugs. Thus, this chapter gives a glimpse of how advanced the medical education in India was over two thousand years ago and how well the phenomenon of health was understood and managed. </div>

'''Keywords''': Preceptor, student, teaching methodology, learning methods, discussion techniques, examination techniques of patient, ''prakriti'', ''sara'', purification therapies, pharmacovigilance.
</div>

== Introduction ==
<div style="text-align:justify;">
The preceding chapter [[Vyadhita Rupiya Vimana]] the seventh chapter dealt with knowledge of diseased person. The present chapter guides an aspiring student who wishes to be a successful physician. It is important to know the scope, depth and reputation of the branch of health science to be studied which is obtained by ''shastra pariksha'' (review of literature). Secondly, the examination of the preceptor (''acharya'') who teaches the science of [[Ayurveda]] is important because it is he, who enlightens the students with the knowledge of the health science. The chapter further deals with means of learning of health sciences (''shastra upaya''), methodology of study (''adhyayana vidhi'') and teaching (''adhyapana'') along with when and how to begin academic session and Do’s and Dont’s by the student have been explained so that a student attains the depth of knowledge about the health science. It also details about medical ethics while in practice and guidelines for behaviour of doctor at a patient’s house.

Along with study (''adhyayana'') and teaching (''adhyapana'') it is the seminar and symposia of experts (''tadvidya sambhasha'') which is essential to improve the quality of knowledge. Types of seminar/symposium, possible types of attendees, how to deal with them for most benefit and rules are mentioned. The description addresses essential information about discussion at a symposium. Those are: when to discuss? where to discuss? what to discuss? how to discuss? and what will be the final conclusion?

The methodology of discussion to be done with the types of assembly. During unfriendly discussion (''vigrihya'') 44 terms such as ''vada'' etc. are worth knowing for the course of discussion among physician. These ''vada marga'' not only help in winning discussion but improves knowledge and enhances the thinking.

Similarly, for the physician to improve his medical knowledge ''karana'', (reasoning/doer) ''karana'' (knowledge of means), ''karyayoni'' (objective), ''karya'' (action), ''karyaphala'' (attainment of objective and happiness), ''anubandha'' (after effect), ''desha'' (habitat/patient), ''kala'' (year and phase of disease), ''pravritti'' (initiation of therapy) and ''upaya'' (proper management) are necessary.

Complete knowledge of patient’s condition is required before starting the treatment, which is done by tenfold examination. The specific investigations to be considered are ''desha'' (place-habitat and patient’s body), ''prakṛiti'' and ''vikriti'' according to ''dosha'', ''sara'' (essence of body tissues), compactness, structure and body mass, measurement of body parts, specific suitability of a person, ''sattva'' (mental status), power of digestion and assimilation, exercise endurance and age.

Seven types of ''prakriti'' and their features are explained to understand normal state of body, whereas the pathological condition is termed as ''vikriti''. These factors help the physician to classify the strength of the patient into three categories viz. superior (''pravar''), medium (''madhya'') and inferior (''avar''). It is on this basis that physician decides to give strong (''tikshna''), mild (''mridu'') and moderate (''madhya'') medicaments. The appropriate time for purification therapies is explained with reasoning. Similarly, medicine should be given at appropriate time to the patient (''kala'') and when not to be given (''akala''). Lastly initiation of therapy (''pravritti'') and excellance of physician etc. ''chatuspada'' (''upaya'') have been explained.

All the above ten examinations help in deciding the actual and specific treatment like ''vamana, virechana, asthapana, anuvasana'' and ''shirovirechana''. Therefore, in the concluding part of the chapter drugs useful for ''vamana'' and ''virechana'' have been enlisted. In case of ''asthapana'' as per the condition of patient and disease the drug classification can be innumerable therefore to prevent the ''ativistara'' (prolonged deliberation/expansion). Drugs are classified on the basis of ''rasa'' into six groups for example ''madhura rasa'' drugs having ''madhura vipaka'' and ''madhur prabhava'' are classified into ''madhur skanda'' so is the case with other five ''rasa''. The physician has been given freedom to permutate and combine drugs as per requirement in patient and its availability.

The same ''asthapana gana'' (group of drugs for non-unctuous enema) can be fortified with specific ''sneha'' as per ''dosha'' and be administered as ''anuvasana''. ''Taila'' for ''vata, vasa'' and ''majja'' for ''kapha'' and ''ghrita'' for ''pitta''. Lastly drugs useful in ''shirovirechana'' have been explained along with the part of the plant (flower, fruit, bark etc.) to be used.

For the purpose of accurate diagnosis and treatment one must have complete knowledge for which this chapter is designed.
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== Sanskrit Text, Transliteration and English Translation ==
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अथातो रोगभिषग्जितीयं विमानं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||
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athātō rōgabhiṣagjitīyaṁ vimānaṁ vyākhyāsyāmaḥ||1|| iti ha smāha bhagavānātrēyaḥ||2||

athAto rogabhiShagjitIyaM vimAnaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||
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Now we shall expound the chapter "Rogabhishagjitiya Vimana" (Methods of conquering debate and disease). Thus said Lord Atreya. [1-2]

=== Aspects of medical education ===

==== Selection of medical treatise ====
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बुद्धिमानात्मनः कार्यगुरुलाघवं कर्मफलमनुबन्धं देशकालौ च विदित्वा युक्तिदर्शनाद्भिषग्बुभूषुः शास्त्रमेवादितः परीक्षेत|

विविधानि हि शास्त्राणि भिषजां प्रचरन्ति लोके;

तत्र यन्मन्येत सुमहद्यशस्विधीरपुरुषासेवितमर्थबहुलमाप्तजनपूजितं त्रिविधशिष्यबुद्धिहितमपगतपुनरुक्तदोषमार्षं सुप्रणीतसूत्रभाष्यसङ्ग्रहक्रमं स्वाधारमनवपतितशब्दमकष्टशब्दं

पुष्कलाभिधानं क्रमागतार्थमर्थतत्त्वविनिश्चयप्रधानं सङ्गतार्थमसङ्कुलप्रकरणमाशुप्रबोधकं लक्षणवच्चोदाहरणवच्च,

तदभिप्रपद्येत शास्त्रम्|

शास्त्रं ह्येवंविधममल इवादित्यस्तमो विधूय प्रकाशयति सर्वम्||३||
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buddhimānātmanaḥkāryagurulāghavaṁkarmaphalamanubandhaṁdēśakālaucaviditvā
yuktidarśanādbhiṣagbubhūṣuḥśāstramēvāditaḥparīkṣēta|vividhānihiśāstrāṇibhiṣajāṁpracarantilōkē;
tatrayanmanyētasumahadyaśasvidhīrapuruṣāsēvitamarthabahulamāptajanapūjitaṁtrividhaśiṣya
buddhihitamapagatapunaruktadōṣamārṣaṁsupraṇītasūtrabhāṣyasaṅgrahakramaṁsvādhāramanavapatita
śabdamakaṣṭaśabdaṁpuṣkalābhidhānaṁkramāgatārthamarthatattvaviniścayapradhānaṁsaṅgatārthamasaṅkulaprakaraṇamāśuprabōdhakaṁ lakṣaṇavaccōdāharaṇavacca, tadabhiprapadyēta śāstram| śāstraṁ hyēvaṁvidhamamala ivādityastamō vidhūya prakāśayati sarvam||3||

buddhimAnAtmanaH kAryagurulAghavaM [1] karmaphalamanubandhaM deshakAlau ca viditvAyuktidarshanAdbhiShagbubhUShuH shAstramevAditaH parIkSheta|
vividhAni hi shAstrANi bhiShajAM pracaranti loke; tatra yanmanyetasumahadyashasvidhIrapuruShAsevitamarthabahulamAptajanapUjitaMtrividhashiShyabuddhihitamapagatapunaruktadoShamArShaM supraNItasUtrabhAShyasa~ggrahakramaMsvAdhAramanavapatitashabdamakaShTashabdaM puShkalAbhidhAnaMkramAgatArthamarthatattvavinishcayapradhAnaMsa~ggatArthamasa~gkulaprakaraNamAshuprabodhakaM lakShaNavaccodAharaNavacca,tadabhiprapadyeta shAstram|
shAstraM hyevaMvidhamamala ivAdityastamo vidhUya prakAshayati sarvam||3||
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<div style="text-align:justify;">
The shrewd who wishes to be a physician, first of all, should analyze his own strength and weakness in profession, the after-impacts of his profession, his inclination, habitat and favourable time (age of learning) and thenafter wisely search for a medical treatise. Different medical treatises (and traditions) are available in society, from which one might select that has following characters:

*which is comprehensive providing all information
*successful, followed by prominent and wise men(successful practitioners),
*with detailed meanings
*regarded by authorities,
*useful to all three types of learners ( with good, moderate and poor intellect),
*free from the deformity of reiteration,
*descending from the sages (which is written by experienced, intuitive person),
*with well- formed presentation, discussion and conclusion,
*having informative title and firm base free from weak and difficult words,
*having comprehensive knowledge of subject
*with proper sequencing of its contents
*committed principally to arriving at the essence of thoughts, which reveals cleary meanings and concrete conclusion
*focused on the particular subject without wavering ideas and irrelevant content,
*quicky understandable with separated topics, effectively comprehensible, and having definitions showed with examples.

Such treatise with pure knowledge is similar to sun which enlightens the whole subject while warding off the darkness. [3]
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==== Search of ideal preceptor ====
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ततोऽनपरीक्षेत; तद्यथा-

पर्यवदातश्रुतं परिदृष्टकर्माणं दक्षं दक्षिणं शुचिं जितहस्तमुपकरणवन्तं सर्वेन्द्रियोपपन्नं प्रकृतिज्ञं

प्रतिपत्तिज्ञमनुपस्कृतविद्यमनहङ्कृतमनसूयकमकोपनं क्लेशक्षमं शिष्यवत्सलमध्यापकं ज्ञापनसमर्थं चेति |

एवङ्गुणो ह्याचार्यः सुक्षेत्रमार्तवो मेघ इव शस्यगुणैः सुशिष्यमाशु वैद्यगुणैः

सम्पादयति||४||
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tatō'nantaramācāryaṁ parīkṣēta; tadyathā- paryavadātaśrutaṁ paridr̥ṣṭakarmāṇaṁ dakṣaṁ dakṣiṇaṁ śuciṁ jitahastamupakaraṇavantaṁ sarvēndriyōpapannaṁ prakr̥tijñaṁ pratipattijñamanupaskr̥tavidyamanahaṅkr̥tamanasūyakamakōpanaṁ
klēśakṣamaṁ śiṣyavatsalamadhyāpakaṁ jñāpanasamarthaṁ cēti| ēvaṅguṇō hyācāryaḥ sukṣētramārtavō mēgha iva śasyaguṇaiḥ suśiṣyamāśu vaidyaguṇaiḥ sampādayati||4||

tato~anantaramAcAryaM parIkSheta; tadyathA- paryavadAtashrutaM paridRuShTakarmANaM dakShaMdakShiNaM shuciM jitahastamupakaraNavantaM sarvendriyopapannaM prakRutij~jaMpratipattij~jamanupaskRutavidyamanaha~gkRutamanasUyakamakopanaM [1] kleshakShamaMshiShyavatsalamadhyApakaM j~jApanasamarthaM ceti|
eva~gguNo hyAcAryaH sukShetramArtavo megha iva shasyaguNaiH sushiShyamAshu vaidyaguNaiHsampAdayati||4||
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Thereafter one should search a preceptor to guide who

*have clear knowledge of the subject and practical experience,
*be diligent, dexterous, virtuous, with skilled hand,
*well equipped, possessing all the senses in normal condition,
*acquainted with constitutions, well- versed in courses of emergency management and quick actions,
*having his knowledge uncensured,
*free from ego, envy, anger, forbearing,
*paternal to disciples,
*having characteristics of a good teacher and fit for imbue understanding.

The teacher holding such qualities quickly inculcates physician’s qualities in his disciple as the seasonal cloud furnishes good crop in a suitable land. [4]

==== Means of learning in medical science ====
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तमुपसृत्यारिराधयिषुरुपचरेदग्निवच्च देववच्च राजवच्च पितृवच्च भर्तृवच्चाप्रमत्तः|

ततस्तत्प्रसादात्कृत्स्नं शास्त्रमधिगम्य शास्त्रस्य दृढतायामभिधानस्य

सौष्ठवेऽर्थस्य विज्ञाने वचनशक्तौ च भूयो भूयः प्रयतेत सम्यक्||५||
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tamupasr̥tyārirādhayiṣurupacarēdagnivacca dēvavacca rājavacca pitr̥vacca bhartr̥vaccāpramattaḥ| tatastatprasādāt kr̥tsnaṁ śāstramadhigamya śāstrasya dr̥ḍhatāyāmabhidhānasya sauṣṭhavē'rthasya vijñānē vacanaśaktau ca bhūyō bhūyaḥ prayatēta samyak||5||

tamupasRutyArirAdhayiShurupacaredagnivacca devavacca rAjavacca pitRuvacca bhartRuvaccApramattaH|
tatastatprasAdAt kRutsnaM shAstramadhigamya shAstrasya dRuDhatAyAmabhidhAnasyasauShThave~arthasya vij~jAne vacanashaktau ca bhUyo bhUyaH prayateta samyak||5||
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<div style="text-align:justify;">
The student desirous of learning from such an ideal preceptor, should sincerely follow him as like worshipping fire, god, king, father and guardian. Subsequently after satisfactorily gaining knowledge of whole medical treatise, the student should always continually attempt to improve further depth of knowledge, understand the (hidden) precise meanings, gain more scientific knowledge, express it impressively with comprehension of ideas and power of speaking. [5]
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तत्रोपायाननुव्याख्यास्यामः-

अध्ययनम्, अध्यापनं, तद्विद्यसम्भाषा चेत्युपायाः||६||
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tatrōpāyānanuvyākhyāsyāmaḥ- adhyayanam, adhyāpanaṁ, tadvidyasambhāṣā cētyupāyāḥ||6||

tatropAyAnanuvyAkhyAsyAmaH- adhyayanam, adhyApanaM, tadvidyasambhAShA cetyupAyAH||6||
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The means for enhancing depth of knowledge are- study, teaching and discussion with authorities. [6]

==== Method of study ====
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तत्रायमध्ययनविधिः-

कल्यः कृतक्षणः प्रातरुत्थायोपव्यूषं वा कृत्वाऽऽवश्यकमुपस्पृश्योदकं

देवर्षिगोब्राह्मणगुरुवृद्धसिद्धाचार्येभ्यो नमस्कृत्य समे शुचौ देशे सुखोपविष्टो मनःपुरःसराभिर्वाग्भिः सूत्रमनुक्रामन्

पुनः पुनरावर्तयेद्बुद्ध्वा सम्यगनुप्रविश्यार्थतत्त्वं स्वदोषपरिहारार्थं

परदोषप्रमाणार्थं च;

एवं मध्यन्दिनेऽपराह्णे रात्रौ च शश्वदपरिहापयन्नध्ययनमभ्यस्येत्|

इत्यध्ययनविधिः||७||
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tatrāyamadhyayanavidhiḥ- kalyaḥ kr̥takṣaṇaḥ prātarutthāyōpavyūṣaṁ vā kr̥tvā''vaśyakamupaspr̥śyōdakaṁ dēvarṣigōbrāhmaṇaguruvr̥ddhasiddhācāryēbhyō namaskr̥tya samē śucau dēśē sukhōpaviṣṭō manaḥpuraḥsarābhirvāgbhiḥsūtramanukrāman punaḥ punarāvartayēd buddhvā samyaganupraviśyārthatattvaṁ svadōṣaparihārārthaṁ paradōṣapramāṇārthaṁ ca; ēvaṁ madhyandinē'parāhṇē rātrau ca śaśvadaparihāpayannadhyayanamabhyasyēt| ityadhyayanavidhiḥ||7||

tatrAyamadhyayanavidhiH- kalyaH kRutakShaNaH prAtarutthAyopavyUShaM vAkRutvA~a~avashyakamupaspRushyodakaM devarShigobrAhmaNaguruvRuddhasiddhAcAryebhyonamaskRutya same shucau deshe sukhopaviShTo manaHpuraHsarAbhirvAgbhiHsUtramanukrAman punaHpunarAvartayed buddhvA [1] samyaganupravishyArthatattvaM svadoShaparihArArthaMparadoShapramANArthaM ca; evaM madhyandine~aparAhNe rAtrau cashashvadaparihApayannadhyayanamabhyasyet|
ityadhyayanavidhiH||7||
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<div style="text-align:justify;">
One desirous of study with a calm mind and at a proper time, should get up early in the morning. After passing the natural urges and cleaning body (as per daily schedule), should do the spiritual rituals like sprinkling water, worshiping gods, sages, cow, ''brahmana'', preceptors, elders, accomplished persons and the teacher. Then sitting comfortably on even and clean ground should present the aphorisms in order as learnt from teacher with clear voice attentively repeating it over and over. At the same time, he should think about the meaning and principle to get rid off his own defects and to know others' defects. In this way, he should proceed the study without squandering time in midday, afternoon, and night. This is the method of study. [7]
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==== Characteristics of ideal student and method of teaching ====
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अथाध्यापनविधिः-

अध्यापने कृतबुद्धिराचार्यः शिष्यमेवादितः परीक्षेत; तद्यथा-

प्रशान्तमार्यप्रकृतिकमक्षुद्रकर्माणमृजुचक्षुर्मुखनासावंशं

तनुरक्तविशदजिह्वमविकृतदन्तौष्ठममिन्मिनं

धृतिमन्तमनहङ्कृतं मेधाविनं वितर्कस्मृतिसम्पन्नमुदारसत्त्वं

तद्विद्यकुलजमथवा तद्विद्यवृत्तं तत्त्वाभिनिवेशिनमव्यङ्गमव्यापन्नेन्द्रियं

निभृतमनुद्धतमर्थतत्त्वभावकमकोपनमव्यसनिनं

शीलशौचाचारानुरागदाक्ष्यप्रादक्षिण्योपपन्नमध्ययनाभिकाममर्थविज्ञाने

कर्मदर्शने चानन्यकार्यमलुब्धमनलसं सर्वभूतहितैषिणमाचार्यसर्वानुशिष्टिप्रतिकरमनुरक्तं च,

एवङ्गुणसमुदितमध्याप्यमाहुः||८||
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athādhyāpanavidhiḥ- adhyāpanē kr̥tabuddhirācāryaḥ śiṣyamēvāditaḥ parīkṣēta; tadyathā- praśāntamāryaprakr̥tikamakṣudrakarmāṇamr̥jucakṣurmukhanāsāvaṁśaṁ tanuraktaviśadajihvamavikr̥tadantauṣṭhamaminminaṁ dhr̥timantamanahaṅkr̥taṁ mēdhāvinaṁ vitarkasmr̥tisampannamudārasattvaṁ tadvidyakulajamathavā tadvidyavr̥ttaṁ tattvābhinivēśinamavyaṅgamavyāpannēndriyaṁ nibhr̥tamanuddhatamarthatattvabhāvakamakōpanamavyasaninaṁ śīlaśaucācārānurāgadākṣyaprādakṣiṇyōpapannamadhyayanābhikāmamarthavijñānē karmadarśanē cānanyakāryamalubdhamanalasaṁ sarvabhūtahitaiṣiṇamācāryasarvānuśiṣṭipratikaramanuraktaṁ ca, ēvaṅguṇasamuditamadhyāpyamāhuḥ||8||

athAdhyApanavidhiH- adhyApane kRutabuddhirAcAryaH shiShyamevAditaH parIkSheta; tadyathA-prashAntamAryaprakRutikamakShudrakarmANamRujucakShurmukhanAsAvaMshaMtanuraktavishadajihvamavikRutadantauShThamaminminaM dhRutimantamanaha~gkRutaM medhAvinaMvitarkasmRutisampannamudArasattvaM tadvidyakulajamathavA tadvidyavRuttaMtattvAbhiniveshinamavya~ggamavyApannendriyaMnibhRutamanuddhatamarthatattvabhAvakamakopanamavyasaninaM [1]shIlashaucAcArAnurAgadAkShyaprAdakShiNyopapannamadhyayanAbhikAmamarthavij~jAnekarmadarshane cAnanyakAryamalubdhamanalasaMsarvabhUtahitaiShiNamAcAryasarvAnushiShTipratikaramanuraktaM [2] ca,eva~gguNasamuditamadhyApyamAhuH||8||
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Now following is the method of teaching: The teacher, having decided to teach should, first of all examine the ideal disciple with following characteristics:

*should be very calm, with superior qualities,
*not involved in mean acts,
*with straight eyes, mouth and nasal edge (without any defect in eyes, nose and mouth);
*having thin, red and clear tongue; with no abnormality in teeth and lips, not talking with nasal utterance,
*having forebearance, without vanity, intelligent, endowed with logical reasoning and memory,
*broad minded,
*born in a family of physicians or aware with the conduct and behavior of physicians
*desirous of gaining scientific knowledge
*without any physical deformity or disability of senses,
*humble, keeping the knowledge safely, un-haughty,
*having capacity to comprehend essence of the ideas,
*without anger and addictions,
*endowed with modesty, purity, good conduct, affection, dexterity and sincerity, interested in study,
*dedicated to comprehension of ideas and practical knowledge without any distraction,
*having no greed or idleness, empathetic to all creatures,
*following all the instructions of the teacher and being attached to his teacher.[8]

==== Commencement of academic session/teaching ====
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एवंविधमध्ययनार्थिनमुपस्थितमारिराधयिषुमाचार्योऽनुभाषेत

उदगयने शुक्लपक्षे प्रशस्तेऽहनि तिष्यहस्तश्रवणाश्वयुजामन्यतमेन

नक्षत्रेण योगमुपगते भगवति शशिनि कल्याणे कल्याणे च करणे मैत्रे मुहूर्ते मुण्डः कृतोपवासः स्नातः काषायवस्त्रसंवीतः सगन्धहस्तः समिधोऽग्निमाज्यमुपलेपनमुदकुम्भान्

माल्यदामदीपहिरण्यहेमरजतमणिमुक्ताविद्रुमक्षौमपरिधीन्

कुशलाजसर्षपाक्षतांश्च शुक्लानि

सुमनांसि ग्रथिताग्रथितानि मेध्यान् भक्ष्यान् गन्धांश्च घृष्टानादायोपतिष्ठस्वेति||९||
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ēvaṁvidhamadhyayanārthinamupasthitamārirādhayiṣumācāryō'nubhāṣēta - udagayanē śuklapakṣē praśastē'hani tiṣyahastaśravaṇāśvayujāmanyatamēna nakṣatrēṇa yōgamupagatē bhagavati śaśini kalyāṇē kalyāṇē ca karaṇē maitrē muhūrtē muṇḍaḥ kr̥tōpavāsaḥ snātaḥ kāṣāyavastrasaṁvītaḥ sagandhahastaḥ samidhō'gnimājyamupalēpanamudakumbhān mālyadāmadīpahiraṇyahēmarajatamaṇimuktāvidrumakṣaumaparidhīn kuśalājasarṣapākṣatāṁśca śuklāni sumanāṁsi grathitāgrathitāni mēdhyān bhakṣyān gandhāṁśca ghr̥ṣṭānādāyōpatiṣṭhasvēti||9||

evaMvidhamadhyayanArthinamupasthitamArirAdhayiShumAcAryo~anubhASheta [1] - udagayaneshuklapakShe prashaste~ahani tiShyahastashravaNAshvayujAmanyatamena nakShatreNa yogamupagatebhagavati shashini kalyANe kalyANe ca karaNe maitre muhUrte muNDaH kRutopavAsaH snAtaHkAShAyavastrasaMvItaH sagandhahastaH samidho~agnimAjyamupalepanamudakumbhAnmAlyadAmadIpahiraNyahemarajatamaNimuktAvidrumakShaumaparidhIn kushalAjasarShapAkShatAMshcashuklAni sumanAMsi grathitAgrathitAni medhyAn bhakShyAn gandhAMshcaghRuShTAnAdAyopatiShThasveti||9||
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When such a disciple with desire of study and feeling of commitment approaches the teacher, then teacher should address the student as- “when the sun is in the northernly course and during the full moon phase, on propitious day the benevolent lord moon having conjunction with one of the ''tishya'' (''pushya''), ''hasta, shravana'' and ''ashvayuja'' constellations in ''kalyanekarana'' and ''maitramuhurta'' come with shaved head, after following fast, had bath, wearing ochre-colored clothes and sacred thread and with fragrance sacred fire wood, fire, ghee, means of besmearing (cow-dung etc.), water jars, garland, rope, lamp, vessels of gold, silver, jewels, pearls, corals, silken cloth and sticks for edge of the sacrificial ground, holy grass, fried paddy, mustard seeds, barley grains, white-flowers, with or without strung, eatables increasing memory power and paste of fragrant wood.”[9]
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स तथा कुर्यात्||१०||

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sa tathā kuryāt||10||

sa [2] tathA kuryAt||10||
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The student should follow instructions of preceptor. [10]
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तमुपस्थितमाज्ञाय समे शुचौ देशे प्राक्प्रवणे उदक्प्रवणे वा चतुष्किष्कुमात्रं चतुरस्रं स्थण्डिलं गोमयोदकेनोपलिप्तं कुशास्तीर्णं सुपरिहितं

परिधिभिश्चतुर्दिशं यथोक्तचन्दनोदकुम्भक्षौमहेमहिरण्यरजतमणिमुक्ताविद्रुमालङ्कृतं मेध्यभक्ष्यगन्धशुक्लपुष्पलाजसर्षपाक्षतोपशोभितं कृत्वा,

तत्र पालाशीभिरैङ्गुदीभिरौदुम्बरीभिर्माधुकीभिर्वा समिद्भिरग्निमुपसमाधाय प्राङ्मुखः शुचिरध्ययनविधिमनुविधाय मधुसर्पिर्भ्यां त्रिस्त्रिर्जुहुयादग्निमाशीःसम्प्रयुक्तैर्मन्त्रैर्ब्रह्माणमग्निं धन्वन्तरिं प्रजापतिमश्विनाविन्द्रमृषींश्च सूत्रकारानभिमन्त्रयमाणः पूर्वं स्वाहेति||११||
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tamupasthitamājñāya samē śucau dēśē prākpravaṇē udakpravaṇē vā catuṣkiṣkumātraṁ caturasraṁ sthaṇḍilaṁ gōmayōdakēnōpaliptaṁ kuśāstīrṇaṁ

suparihitaṁ paridhibhiścaturdiśaṁ yathōktacandanōdakumbhakṣaumahēmahiraṇyarajatamaṇimuktāvidrumālaṅkr̥taṁ

mēdhyabhakṣyagandhaśuklapuṣpalājasarṣapākṣatōpaśōbhitaṁ kr̥tvā, tatra pālāśībhiraiṅgudībhiraudumbarībhirmādhukībhirvā

samidbhiragnimupasamādhāya prāṅmukhaḥ śuciradhyayanavidhimanuvidhāya madhusarpirbhyāṁ

tristrirjuhuyādagnimāśīḥsamprayuktairmantrairbrahmāṇamagniṁ dhanvantariṁ prajāpatimaśvināvindramr̥ṣīṁśca sūtrakārānabhimantrayamāṇaḥ pūrvaṁ

svāhēti||11||

tamupasthitamAj~jAya same shucau deshe prAkpravaNe [1] udakpravaNe vA catuShkiShkumAtraMcaturasraM sthaNDilaM gomayodakenopaliptaM

kushAstIrNaM suparihitaM [2]

paridhibhishcaturdishaMyathoktacandanodakumbhakShaumahemahiraNyarajatamaNimuktAvidrumAla~gkRutaMmedhyabhakShyagandhashuklapuShpalAjasarShapAk

ShatopashobhitaM kRutvA, tatrapAlAshIbhirai~ggudIbhiraudumbarIbhirmAdhukIbhirvA samidbhiragnimupasamAdhAya

prA~gmukhaHshuciradhyayanavidhimanuvidhAya madhusarpirbhyAMtristrirjuhuyAdagnimAshIHsamprayuktairmantrairbrahmANamagniM

dhanvantariMprajApatimashvinAvindramRuShIMshca sUtrakArAnabhimantrayamANaH pUrvaM svAheti||11||
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Knowing that the student has come, the preceptor should make rectangular platform measuring four cubits and sloping eastward or northward, in an even and pure place. This ought to be spread with cow-dung, covered with sacred grass and bound on borders with ''paridhi''. Further it ought to be equipped with the said articles, for example sandal, water jar, silken garment, gold, golden vessel, silver, jewel, pearl and coral and beautified with eatables increasing memory power, aromas, white flowers, fried paddy, mustard and barley grains. Then attending to the fire with the fuel-sticks made of ''palash, ingudi, udumbara, madhuka'' while in pure condition and facing eastward, as recommended under the method of study, he should offer oblations of honey and ghee to the fire reciting benedictory mantras first invoking Brahma, Agni, Dhanwantari, Prajapati, Ashvinis, Indra and various sages, the authors of the aphorism and ending with ''svaaha'' three times each.[11]
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शिष्यश्चैनमन्वालभेत।
हुत्वा च प्रदक्षिणमग्निमनुपरिक्रामेत्| परिक्रम्य ब्राह्मणान् स्वस्ति वाचयेत्;भिषजश्चाभिपूजयेत्||१२||
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śiṣyaścainamanvālabhēta| hutvā ca pradakṣiṇamagnimanuparikrāmēt| parikramya brāhmaṇān svasti vācayēt; bhiṣajaścābhipūjayēt||12||
shiShyashcainamanvAlabheta|
hutvA ca pradakShiNamagnimanuparikrAmet|
parikramya brAhmaNAn svasti vAcayet; bhiShajashcAbhipUjayet||12||
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The disciple should follow him. After offering oblations he should go round the fire keeping it to the right side, than ''brahmanas'' should recite ''svasti''. At the end, he should pay regards to the physicians in the society. [12]

==== Code of conduct for medical student and professional ====
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अथैनमग्निसकाशे ब्राह्मणसकाशे भिषक्सकाशे चानुशिष्यात्-ब्रह्मचारिणा श्मश्रुधारिणा सत्यवादिनाऽमांसादेन मेध्यसेविना निर्मत्सरेणाशस्त्रधारिणा च भवितव्यं,न च ते मद्वचनात्किञ्चिदकार्यं स्यादन्यत्र राजद्विष्टात्प्राणहराद्विपुलादधर्म्यादनर्थसम्प्रयुक्ताद्वाऽप्यर्थात्;
मदर्पणेन मत्प्रधानेन मदधीनेन मत्प्रियहितानुवर्तिना च शश्वद्भवितव्यं,
पुत्रवद्दासवदर्थिवच्चोपचरताऽनुवस्तव्योऽहम्,
अनुत्सेकेनावहितेनानन्यमनसा विनीतेनावेक्ष्यावेक्ष्यकारिणाऽनसूयकेन चाभ्यनुज्ञातेन प्रविचरितव्यम्,
अनुज्ञातेन(चाननुज्ञातेन च)प्रविचरता पूर्वं गुर्वर्थोपाहरणे यथाशक्ति प्रयतितव्यं,कर्मसिद्धिमर्थसिद्धं यशोलाभं प्रेत्य च स्वर्गमिच्छता भिषजा त्वया
गोब्राह्मणमादौ कृत्वा सर्वप्राणभृतां शर्माशासितव्यमहरहरुत्तिष्ठता चोपविशता च,सर्वात्मना चातुराणामारोग्याय प्रयतितव्यं, जीवितहेतोरपि चातुरेभ्यो नाभिद्रोग्धव्यं,
मनसाऽपि च परस्त्रियो नाभिगमनीयास्तथा सर्वमेवपरस्वं,निभृतवेशपरिच्छदेन भवितव्यम्, अशौण्डेनापापेनापापसहायेन च,
श्लक्ष्णशुक्लधर्म्यशर्म्यधन्यसत्यहितमितवचसा देशकालविचारिणा स्मृतिमता ज्ञानोत्थानोपकरणसम्पत्सु नित्यं यत्नवता च;
न च कदाचिद्राजद्विष्टानां राजद्वेषिणां वा महाजनद्विष्टानां महाजनद्वेषिणां वाऽप्यौषधमनुविधातव्यं,तथा
सर्वेषामत्यर्थविकृतदुष्टदुःखशीलाचारोपचाराणामनपवादप्रतिकाराणां मुमूर्षूणां च,तथैवासन्निहितेश्वराणां स्त्रीणामनध्यक्षाणां वा;न च कदाचित्स्त्रीदत्तमामिषमादातव्यमननुज्ञातं भर्त्राऽथवाऽध्यक्षेण,आतुरकुलं
चानुप्रविशता विदितेनानुमतप्रवेशिना सार्धं पुरुषेण सुसंवीतेनावाक्शिरसा स्मृतिमतास्तिमितेनावेक्ष्यावेक्ष्य मनसा सर्वमाचरता सम्यगनुप्रवेष्टव्यम्,अनुप्रविश्य च वाङ्मनोबुद्धीन्द्रियाणि न क्वचित् प्रणिधातव्यान्यन्यत्रातुरादातुरोपकारार्थादातुरगतेष्वन्येषु वा भावेषु,न चातुरकुलप्रवृत्तयो बहिर्निश्चारयितव्याः, ह्रसितं चायुषः प्रमाणमातुरस्य जानताऽपि त्वया न वर्णयितव्यं तत्र यत्रोच्यमानमातुरस्यान्यस्य वाऽप्युपघाताय सम्पद्यते;ज्ञानवताऽपि च नात्यर्थमात्मनो ज्ञाने विकत्थितव्यम्,आप्तादपि हि विकत्थमानादत्यर्थमुद्विजन्त्यनेके||१३||
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athainamagnisakāśē brāhmaṇasakāśē bhiṣaksakāśē cānuśiṣyāt- brahmacāriṇā śmaśrudhāriṇa satyavādinā'māṁsādēna mēdhyasēvinā nirmatsarēṇāśastradhāriṇā ca bhavitavyaṁ, na ca tē madvacanāt kiñcidakāryaṁ syādanyatra rājadviṣṭāt prāṇaharādvipulādadharmyādanarthasamprayuktādvā'pyarthāt; madarpaṇēna matpradhānēna madadhīnēna matpriyahitānuvartinā ca śaśvadbhavitavyaṁ, putravaddāsavadarthivaccōpacaratā'nuvastavyō'ham,anutsēkēnāvahitēnānanyamanasā vinītēnāvēkṣyāvēkṣyakāriṇā'nasūyakēna cābhyanujñātēna pravicaritavyam, anujñātēna (cānanujñātēna ca) pravicaratā pūrvaṁ gurvarthōpāharaṇē yathāśakti prayatitavyaṁ, karmasiddhimarthasiddhaṁ yaśōlābhaṁ prētya ca svargamicchatā bhiṣajā tvayā gōbrāhmaṇamādau kr̥tvā sarvaprāṇabhr̥tāṁ śarmāśāsitavyamaharaharuttiṣṭhatā cōpaviśatā ca, sarvātmanā cāturāṇāmārōgyāya prayatitavyaṁ, jīvitahētōrapi cāturēbhyō nābhidrōgdhavyaṁ, manasā'pi ca parastriyō nābhigamanīyāstathā sarvamēva parasvaṁ, nibhr̥tavēśaparicchadēna bhavitavyam, aśauṇḍēnāpāpēnāpāpasahāyēna ca, ślakṣṇaśukladharmyaśarmyadhanyasatyahitamitavacasā dēśakālavicāriṇā smr̥timatā jñānōtthānōpakaraṇasampatsu nityaṁ yatnavatā ca; na ca kadācidrājadviṣṭānāṁ rājadvēṣiṇāṁ vā mahājanadviṣṭānāṁmahājanadvēṣiṇāṁvā'pyauṣadhamanuvidhātavyaṁ,tathāsarvēṣāmatyarthavikr̥taduṣṭaduḥkhaśīlācārōpacārāṇāmanapavādapratikāraṇāṁ mumūrṣūṇāṁ ca, tathaivāsannihitēśvarāṇāṁ strīṇāmanadhyakṣāṇāṁ vā; na ca kadācit strīdattamāmiṣamādātavyamananujñātaṁ bhartrā'thavā'dhyakṣēṇa, āturakulaṁ cānupraviśatā viditēnānumatapravēśinā sārdhaṁ puruṣēṇa susaṁvītēnāvākśirasā smr̥timatā stimitēnāvēkṣyāvēkṣya manasā sarvamācaratā samyaganupravēṣṭavyam, anupraviśya ca vāṅmanōbuddhīndriyāṇi na kvacit praṇidhātavyānyanyatrāturādāturōpakārārthādāturagatēṣvanyēṣu vā bhāvēṣu, na cāturakulapravr̥ttayō bahirniścārayitavyāḥ, hrasitaṁ cāyuṣaḥ pramāṇamāturasya jānatā'pi tvayā na varṇayitavyaṁ tatra yatrōcyamānamāturasyānyasya vā'pyupaghātāya sampadyatē; jñānavatā'pi ca nātyarthamātmanō jñānē vikatthitavyam, āptādapi hi vikatthamānādatyarthamudvijantyanēkē||13||

athainamagnisakAshe brAhmaNasakAshe bhiShaksakAshe cAnushiShyAt- brahmacAriNA shmashrudhAriNasatyavAdinA~amAMsAdena medhyasevinA nirmatsareNAshastradhAriNA ca bhavitavyaM, na ca temadvacanAt ki~jcidakAryaM syAdanyatra rAjadviShTAtprANaharAdvipulAdadharmyAdanarthasamprayuktAdvA~apyarthAt; madarpaNena matpradhAnenamadadhInena matpriyahitAnuvartinA ca shashvadbhavitavyaM,putravaddAsavadarthivaccopacaratA~anuvastavyo~aham [1] , anutsekenAvahitenAnanyamanasAvinItenAvekShyAvekShyakAriNA~anasUyakena cAbhyanuj~jAtena pravicaritavyam, anuj~jAtena(cAnanuj~jAtena ca) pravicaratA pUrvaM gurvarthopAharaNe yathAshakti prayatitavyaM,karmasiddhimarthasiddhaM yasholAbhaM pretya ca svargamicchatA bhiShajA tvayA gobrAhmaNamAdaukRutvA sarvaprANabhRutAM sharmAshAsitavyamaharaharuttiShThatA copavishatA ca, sarvAtmanAcAturANAmArogyAya prayatitavyaM, jIvitahetorapi cAturebhyo nAbhidrogdhavyaM, manasA~api caparastriyo nAbhigamanIyAstathA sarvameva parasvaM, nibhRutaveshaparicchadena bhavitavyam,ashauNDenApApenApApasahAyena ca, shlakShNashukladharmyasharmyadhanyasatyahitamitavacasAdeshakAlavicAriNA smRutimatA j~jAnotthAnopakaraNasampatsu nityaM yatnavatA ca; na cakadAcidrAjadviShTAnAM rAjadveShiNAM vA mahAjanadviShTAnAM mahAjanadveShiNAMvA~apyauShadhamanuvidhAtavyaM, tathAsarveShAmatyarthavikRutaduShTaduHkhashIlAcAropacArANAmanapavAdapratikAraNAM [2]mumUrShUNAM ca, tathaivAsannihiteshvarANAM strINAmanadhyakShANAM vA; na ca kadAcitstrIdattamAmiShamAdAtavyamananuj~jAtaM bhartrA~athavA~adhyakSheNa, AturakulaM cAnupravishatAviditenAnumatapraveshinA sArdhaM puruSheNa susaMvItenAvAkshirasA smRutimatAstimitenAvekShyAvekShya manasA sarvamAcaratA samyaganupraveShTavyam, anupravishya cavA~gmanobuddhIndriyANi na kvacitpraNidhAtavyAnyanyatrAturAdAturopakArArthAdAturagateShvanyeShu vA bhAveShu, nacAturakulapravRuttayo bahirnishcArayitavyAH, hrasitaM cAyuShaH pramANamAturasya jAnatA~api tvayAna varNayitavyaM tatra yatrocyamAnamAturasyAnyasya vA~apyupaghAtAya sampadyate; j~jAnavatA~apica nAtyarthamAtmano j~jAne vikatthitavyam, AptAdapi hi vikatthamAnAdatyarthamudvijantyaneke||13||
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Now the teacher should instruct the student in presence of sacred fire, brahmanas and physicians,
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*“You shall follow abstinence, keep beard and mustaches,
*speak truth only,
*shall not eat meat,
*follow pure and intellectual functions,
*do things without jealousy and weapons.
*You should always follow my (teacher’s) instructions except in case they lead to king’s wrath, end of life, great unrighteousness and other such calamity.
*You should always entrust me, see me as head, be submissive to me and follow the course which is liked by and advantageous to me. You should live with me behaving as son, servant and suppliant.
*You should live with modesty, alertness, with focused mind, humbleness and constant vigilance about work, without seeing defect in other’s qualities, and not leave without my permission.
*When permitted to move out, you should first make effort as far as possible to furnish things told by the teacher.
*When you join the medical profession and wish success in work(treating patients), in purposes of life (''purushartha'' like ''dharma, artha,'' ''kama'' and ''moksha''), fame and heaven after death then you should always pray for the welfare of cow, ''brahmana'' and all the living creatures.
*You should try to furnish health to the patients and all creatures by all means.
*You should not hate the patients even at your daily expenses (even if the poor patient is not able to pay your fees).
*You should not think bad about other women and any other’s property even in imagination.
*Your dress and accessories should be modest.
*You should not be addicted to alcohol, indulged in sins and accompanied by sinners;
*You should be soft spoken, talking flawless, righteous, blissful, thankful, truthful, useful and measured statements keeping in mind place and season or time. with good remembrance, striving constantly for knowledge, progress and excellence of equipment (medicines etc.).
*You should not treat the persons disliked by the king (thieves etc.) or disliking the king (rebellions), disliked by good persons or disliking them and all those who are excessively diseased, wicked; having troublesome conduct, behavior and management, have never counteracted their censors and one nearing death;
*You should not treat the women in absence of their husbands or guardians, you should not accept meat provided by the women without permission of their husband or guardian.
*At the time of entering into the patient's house you should take along a known individual whose entrance is allowed; should be well-dressed, with head lowered, having good memory, with stability, thinking deliberately and moving as needs be; having entered there, you should never engage your speech, mind and sense organs any place except the patient, his well-being and other entities of the patient's body respectively. The matters of the patient's house should never be revealed outside, in spite of the fact that you know the diminution in life-span of the patient, you should not specify it where it is liable to cause harm to the patient or others. Even though you are learned enough you should not boast too much for your knowledge because mostly the people become anxious for the excessive boasting even it comes from an authority. [13]
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नचैवह्यस्तिसुतरमायुर्वेदस्यपारं, तस्मादप्रमत्तःशश्वदभियोगमस्मिन्गच्छेत्, एतच्चकार्यम्, एवम्भूयश्चवृत्तसौष्ठवमनसूयतापरेभ्योऽप्यागमयितव्यं, कृत्स्नोहिलोकोबुद्धिमतामाचार्यःशत्रुश्चाबुद्धिमताम्, अतश्चाभिसमीक्ष्यबुद्धिमताऽमित्रस्यापिधन्यंयशस्यमायुष्यंपौष्टिकंलौक्यमभ्युपदिशतोवचःश्रोतव्यमनुविधातव्यंचेति|
अतःपरमिदंब्रूयात्- देवताग्निद्विजगुरुवृद्धसिद्धाचार्येषुतेनित्यंसम्यग्वर्तितव्यं, तेषुतेसम्यग्वर्तमानस्यायमग्निःसर्वगन्धरसरत्नबीजानियथेरिताश्चदेवताःशिवायस्युः, अतोऽन्यथावर्तमानस्याशिवायेति| एवंब्रुवतिचाचार्येशिष्यः‘तथा’इतिब्रूयात्| यथोपदेशं
चकुर्वन्नध्याप्यः, अतोऽन्यथात्वनध्याप्यः| अध्याप्यमध्यापयन्ह्याचार्योयथोक्तैश्चाध्यापनफलैर्योगमाप्नोत्यन्यैश्चानुक्तैः
श्रेयस्करैर्गुणैःशिष्यमात्मानंचयुनक्ति| इत्यध्यापनविधिरुक्तः||१४||
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na caiva hyasti sutaramāyurvēdasya pāraṁ, tasmādapramattaḥ śaśvadabhiyōgamasmin gacchēt, ētacca kāryam, ēvambhūyaśca vr̥ttasauṣṭhavamanasūyatā parēbhyō'pyāgamayitavyaṁ, kr̥tsnō hi lōkō buddhimatāmācāryaḥ śatruścābuddhimatām, ataścābhisamīkṣya buddhimatā'mitrasyāpi dhanyaṁ yaśasyamāyuṣyaṁ pauṣṭikaṁ laukyamabhyupadiśatō vacaḥ śrōtavyamanuvidhātavyaṁ cēti| ataḥ paramidaṁ brūyāt- dēvatāgnidvijaguruvr̥ddhasiddhācāryēṣu tē nityaṁ samyagvartitavyaṁ, tēṣutēsamyagvartamānasyāyamagniḥsarvagandharasaratnabījāniyathēritāśca
dēvatāḥśivāyasyuḥ,atō'nyathāvartamānasyāśivāyēti|ēvaṁbruvaticācāryēśiṣyaḥ‘tathā’itibrūyāt|
yathōpadēśaṁcakurvannadhyāpyaḥ,atō'nyathātvanadhyāpyaḥ|
adhyāpyamadhyāpayanhyācāryōyathōktaiścādhyāpanaphalairyōgamāpnōtyanyaiścānuktaiḥśrēyaskarairguṇaiḥ śiṣyamātmānaṁ ca yunakti| ityadhyāpanavidhiruktaḥ||14||

na caiva hyasti sutaram[[Ayurveda]]sya pAraM, tasmAdapramattaH shashvadabhiyogamasmin gacchet,etacca [1] kAryam, evambhUyashca vRuttasauShThavamanasUyatA parebhyo~apyAgamayitavyaM,kRutsno hi loko buddhimatAmAcAryaH shatrushcAbuddhimatAm, atashcAbhisamIkShyabuddhimatA~amitrasyApi dhanyaM yashasyamAyuShyaM pauShTikaM laukyamabhyupadishato [2] vacaHshrotavyamanuvidhAtavyaM ceti|
ataH paramidaM brUyAt- devatAgnidvijaguruvRuddhasiddhAcAryeShu te nityaM samyagvartitavyaM, teShute samyagvartamAnasyAyamagniH sarvagandharasaratnabIjAni yatheritAshca devatAH shivAya syuH,ato~anyathA vartamAnasyAshivAyeti|
evaM bruvati cAcArye shiShyaH ‘tathA’ iti brUyAt|
yathopadeshaM ca kurvannadhyApyaH, ato~anyathA tvanadhyApyaH|
adhyApyamadhyApayan hyAcAryo yathoktaishcAdhyApanaphalairyogam
ApnotyanyaishcAnuktaiHshreyaskarairguNaiH shiShyamAtmAnaM ca yunakti|
ityadhyApanavidhiruktaH||14||
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There is no limit for knowing the science of life i.e. [[Ayurveda]]. Therefore, one should dedicate himself to it (i.e., study [[Ayurveda]]) continuously and without any carelessness. This is worth-doing and to be followed.

Further one should keep good behavior with everyone, without pointing the defect in other’s qualities. Because for the wise the whole world is a teacher, while for the unwise it is enemy. Consequently, the wise, after due consideration, should follow the advice which is prosperous, promoting fame, life-span, strength and useful to the society even if it comes from an enemy.

After that he (the teacher) should speak this, “You should always behave properly (worship) to gods, fire, ''brahmanas'', preceptors, elders, accomplished ones and teacher, thus this fire along with all the perfumes, eatables, gem, grins and aforesaid gods would bless you with prosperity, and if you behave in opposite manner they would curse you. When the teacher has said like this, the disciple should say ‘Yes’ (will behave similarly).

If the disciple follows these instructions then he should be taught, otherwise not. The teacher when teaches such a worthy disciple obtains the aforesaid fruits of teaching and enjoins the disciple and himself with other not mentioned beneficial qualities. Thus, the method of teaching is said. [14]
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=== Organization of discussion meetings ===

==== Method of conducting discussion in seminars and symposia of experts ====
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सम्भाषाविधिमतऊर्ध्वंव्याख्यास्यामः- भिषक्भिषजासहसम्भाषेत| तद्विद्यसम्भाषाहिज्ञानाभियोगसंहर्षकरीभवति, वैशारद्यमपिचाभिनिर्वर्तयति, वचनशक्तिमपिचाधत्ते, यशश्चाभिदीपयति, पूर्वश्रुतेचसन्देहवतःपुनःश्रवणाच्छ्रुतसंशयमपकर्षति, श्रुतेचासन्देहवतोभूयोऽध्यवसायमभिनिर्वर्तयति, अश्रुतमपिचकञ्चिदर्थंश्रोत्रविषयमापादयति, यच्चाचार्यःशिष्यायशुश्रूषवेप्रसन्नःक्रमेणोपदिशतिगुह्याभिमतमर्थजातंतत्परस्परेणसहजल्पन्पिण्डेनविजिगीषुराहसंहर्षात्, तस्मात्तद्विद्यसम्भाषामभिप्रशंसन्तिकुशलाः||१५||
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sambhāṣāvidhimata ūrdhvaṁ vyākhyāsyāmaḥ- bhiṣak bhiṣajā saha sambhāṣēta| tadvidyasambhāṣā hi jñānābhiyōgasaṁharṣakarī bhavati, vaiśāradyamapi cābhinirvartayati, vacanaśaktimapi cādhattē, yaśaścābhidīpayati, pūrvaśrutē ca sandēhavataḥ punaḥ śravaṇācchrutasaṁśayamapakarṣati, śrutē cāsandēhavatō bhūyō'dhyavasāyamabhinirvartayati, aśrutamapi ca kañcidarthaṁ śrōtraviṣayamāpādayati, yaccācāryaḥ śiṣyāya śuśrūṣavē prasannaḥ kramēṇōpadiśati guhyābhimatamarthajātaṁ tat parasparēṇa saha jalpan piṇḍēna vijigīṣurāha saṁharṣāt, tasmāttadvidyasambhāṣāmabhipraśaṁsanti kuśalāḥ||15||

sambhAShAvidhimata UrdhvaM vyAkhyAsyAmaH- bhiShak bhiShajA saha sambhASheta|
tadvidyasambhAShA hi j~jAnAbhiyogasaMharShakarI bhavati, vaishAradyamapi cAbhinirvartayati,vacanashaktimapi cAdhatte, yashashcAbhidIpayati, pUrvashrute ca sandehavataH punaHshravaNAcchrutasaMshayamapakarShati, shrute cAsandehavato bhUyo~adhyavasAyamabhinirvartayati,ashrutamapi ca ka~jcidarthaM shrotraviShayamApAdayati, yaccAcAryaH shiShyAya shushrUShaveprasannaH krameNopadishati guhyAbhimatamarthajAtaM tat paraspareNa saha jalpan piNDena [1]vijigIShurAha saMharShAt, tasmAttadvidyasambhAShAmabhiprashaMsanti kushalAH||15||
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Henceforth, I shall expound the method of discussion. A physician should discuss with physicians. Discussion with experts promotes pursuit and advancement of knowledge, provides dexterity, improves power of speaking, illumines fame, removes doubts in scriptures, if any, by repeatedly listening the topics, and creates confidence with doubtless knowledge, , brings forth some new ideas hitherto unknown, the reason is that whatever secret ideas are gradually delivered by the teacher pleased over the devoted disciple, the same are expressed by him in enthusiasm during discussion in order to gain victory. Hence the experts recommend discussion with the specialists. [15]
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==== Two types of discussions ====
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द्विविधातुखलुतद्विद्यसम्भाषाभवति- सन्धायसम्भाषा, विगृह्यसम्भाषाच||१६||
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dvividhā tu khalu tadvidyasambhāṣā bhavati- sandhāyasambhāṣā, vigr̥hyasambhāṣā ca||16||

dvividhA tu khalu tadvidyasambhAShA bhavati- sandhAyasambhAShA, vigRuhyasambhAShA ca||16||
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Discussion with experts is of two types- friendly discussion and hostile discussion. [16]

==== Friendly discussion ====
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तत्रज्ञानविज्ञानवचनप्रतिवचनशक्तिसम्पन्नेनाकोपनेनानुपस्कृतविद्येनानसूयकेनानुनेयेनानुनयकोविदेनक्लेशक्षमेणप्रियसम्भाषणेनचसहसन्धायसम्भाषाविधीयते| तथाविधेनसहकथयन्विस्रब्धःकथयेत्, पृच्छेदपिचविस्रब्धः, पृच्छतेचास्मैविस्रब्धायविशदमर्थंब्रूयात्, नचनिग्रहभयादुद्विजेत, निगृह्यचैनंनहृष्येत्, नचपरेषुविकत्थेत, नचमोहादेकान्तग्राहीस्यात्, नचाविदितमर्थमनुवर्णयेत्, सम्यक्चानुनयेनानुनयेत्, तत्रचावहितःस्यात्| इत्यनुलोमसम्भाषाविधिः||१७||
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tatra
jñānavijñānavacanaprativacanaśaktisampannēnākōpanēnānupaskr̥tavidyēnānasūyakēnānunēyēnānunayakōvidēna klēśakṣamēṇa priyasambhāṣaṇēna ca saha sandhāyasambhāṣā vidhīyatē| tathāvidhēna saha kathayan visrabdhaḥ kathayēt, pr̥cchēdapi ca visrabdhaḥ, pr̥cchatē cāsmai visrabdhāya viśadamarthaṁ brūyāt, na ca nigrahabhayādudvijēta, nigr̥hya cainaṁ na hr̥ṣyēt, na ca parēṣu vikatthēta, na ca mōhādēkāntagrāhī syāt, na cāviditamarthamanuvarṇayēt, samyak cānunayēnānunayēt, tatra cāvahitaḥ syāt| ityanulōmasambhāṣāvidhiḥ||17||

tatraj~jAnavij~jAnavacanaprativacanashaktisampannenAkopanenAnupaskRutavidyenAnasUyakenAnuneyenAnunayakovidenakleshakShameNa priyasambhAShaNena ca saha sandhAyasambhAShA vidhIyate|
tathAvidhena saha kathayan visrabdhaH kathayet, pRucchedapi ca visrabdhaH, pRucchate cAsmai visrabdhAyavishadamarthaM brUyAt, na ca nigrahabhayAdudvijeta, nigRuhya cainaM na hRuShyet, na ca pareShu vikattheta, na camohAdekAntagrAhI syAt, na cAviditamarthamanuvarNayet, samyak [1] cAnunayenAnunayet, tatra cAvahitaH syAt|
ityanulomasambhAShAvidhiH||17||
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The friendly discussion is held as follow:
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*It is discussed with one who is endowed with general and specific knowledge of related topic, opinions and counter-opinions, powerful expressions, devoid of irritability, having uncensored knowledge, without jealously, able to be convinced and who can convince others, enduring and adept in art of sweet conversation.
*When discussion with such a person one should speak confidently, put question unhesitatingly, reply to the sincere questioner with elaborateness, not be agitated with fear of defeat, not be exhilarated on defeating the partner, not boast before others, not hold fastly his solitary view due to attachment, not explain what is unknown to him, convince the other party with politeness and be caution in that. This is the method of friendly discussion. [17]
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==== Hostile discussion ====
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अतऊर्ध्वमितरेणसहविगृह्यसम्भाषायांजल्पेच्छ्रेयसायोगमात्मनःपश्यन्| प्रागेवचजल्पाज्जल्पान्तरंपरावरान्तरंपरिषद्विशेषांश्चसम्यक्परीक्षेत| सम्यक्परीक्षाहिबुद्धिमतांकार्यप्रवृत्तिनिवृत्तिकालौशंसति, तस्मात्परीक्षामभिप्रशंसन्तिकुशलाः| परीक्षमाणस्तुखलुपरावरान्तरमिमान्जल्पकगुणाञ्श्रेयस्करान्दोषवतश्चपरीक्षेतसम्यक्; तद्यथा- श्रुतंविज्ञानंधारणंप्रतिभानंवचनशक्तिरिति, एतान्गुणान्श्रेयस्करानाहुः; इमान्पुनर्दोषवतः, तद्यथा- कोपनत्वमवैशारद्यंभीरुत्वमधारणत्वमनवहितत्वमिति| एतान्गुणान्गुरुलाघवतःपरस्यचैवात्मनश्चतुलयेत्||१८||
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ata ūrdhvamitarēṇa saha vigr̥hya sambhāṣāyāṁ jalpēcchrēyasā yōgamātmanaḥ paśyan| prāgēva ca jalpājjalpāntaraṁ parāvarāntaraṁ pariṣadviśēṣāṁśca samyak parīkṣēta| samyakparīkṣā hi buddhimatāṁ kāryapravr̥ttinivr̥ttikālau śaṁsati, tasmāt parīkṣāmabhipraśaṁsanti kuśalāḥ| parīkṣamāṇastu khalu parāvarāntaramimān jalpakaguṇāñ śrēyaskarāndōṣavataśca parīkṣēta samyak; tadyathā- śrutaṁ vijñānaṁ dhāraṇaṁ pratibhānaṁ vacanaśaktiriti, ētān guṇān śrēyaskarānāhuḥ; imān punardōṣavataḥ, tadyathā- kōpanatvamavaiśāradyaṁ bhīrutvamadhāraṇatvamanavahitatvamiti| ētān guṇān gurulāghavataḥ parasya caivātmanaśca tulayēt||18||

ata UrdhvamitareNa saha vigRuhya sambhAShAyAM [1] jalpecchreyasA yogamAtmanaH pashyan|
prAgeva ca jalpAjjalpAntaraM [2] parAvarAntaraM pariShadvisheShAMshca samyak parIkSheta|
samyakparIkShA hi buddhimatAM kAryapravRuttinivRuttikAlau shaMsati, tasmAtparIkShAmabhiprashaMsanti kushalAH|
parIkShamANastu khalu parAvarAntaramimAn jalpakaguNA~j shreyaskarAndoShavatashca parIkShetasamyak; tadyathA- shrutaM vij~jAnaM dhAraNaM pratibhAnaM vacanashaktiriti, etAn guNAnshreyaskarAnAhuH; imAn punardoShavataH, tadyathA- kopanatvamavaishAradyaMbhIrutvamadhAraNatvamanavahitatvamiti|
etAn guNAn gurulAghavataH parasya caivAtmanashca tulayet||18||
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Further one should take part in hostile discussion with others after understansing the self benefit. Before arguing, he should examine properly the difference of opinion with opponent, superiority or inferiority of opponent, and the nature of the participants in the discussion. This proper examination guides the wise about the initiation and cessation of discussion, hence the experts recomend the examination.
While examining the difference, between him and the opponent, one should also examine the merits and demerits of the speaker properly – merits such as scriptural knowledge, understanding, retention, imagination and eloquence and demerits such as irritability, lack of skill, cowardice, lack of retention and carelessness. One should compare himself and the opponent in superiority- inferiority with respect to these qualities.[18]
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==== Three categories of opponent ====
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तत्रत्रिविधःपरःसम्पद्यते- प्रवरः, प्रत्यवरः, समोवा, गुणविनिक्षेपतः; नत्वेवकार्त्स्न्येन||१९||
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tatra trividhaḥ paraḥ sampadyatē- pravaraḥ, pratyavaraḥ, samō vā,guṇavinikṣēpataḥ; natvēva kārtsnyēna||19||

tatra trividhaH paraH sampadyate- pravaraH, pratyavaraH, samo vA, guNavinikShepataH; natvevakArtsnyena||19||
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The opponent may be of three types – superior, inferior or equal, according to the above mentioned qualities for discussion and not all aspects .[19]

==== Types of assembly ====
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परिषत्तुखलुद्विविधा- ज्ञानवती, मूढपरिषच्च| सैवद्विविधासतीत्रिविधापुनरनेनकारणविभागेन- सुहृत्परिषत्, उदासीनपरिषत्, प्रतिनिविष्टपरिषच्चेति | तत्रप्रतिनिविष्टायांपरिषदिज्ञानविज्ञानवचनप्रतिवचनशक्तिसम्पन्नायांमूढायांवानकथंचित्केनचित्सहजल्पोविधीयते; मूढायांतुसुहृत्परिषद्युदासीनायांवाज्ञानविज्ञानवचनप्रतिवचनशक्तीरन्तरेणाप्यदीप्तयशसा
महाजनविद्विष्टेनापिसहजल्पोविधीयते| तद्विधेनचसहकथयताआविद्धदीर्घसूत्रसङ्कुलैर्वाक्यदण्डकैःकथयितव्यम्, अतिहृष्टंमुहुर्मुहुरुपहसतापरंनिरूपयताचपर्षदमाकारैर्ब्रुवतश्चास्यवाक्यावकाशोनदेयः; कष्टशब्दंचब्रुवतावक्तव्योनोच्यते, अथवापुनर्हीनातेप्रतिज्ञा, इति| पुनश्चाहू(ह्व)यमानःप्रतिवक्तव्यः- परिसंवत्सरोभवान्शिक्षस्वतावत्; नत्वयागुरुरुपासितोनूनम्, अथवापर्याप्तमेतावत्ते; सकृदपिहिपरिक्षेपिकंनिहतंनिहतमाहुरितिनास्ययोगःकर्तव्यःकथञ्चित्| अप्येवंश्रेयसासहविगृह्यवक्तव्यमित्याहुरेके; नत्वेवंज्यायसासहविग्रहंप्रशंसन्तिकुशलाः||२०||
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pariṣattu khalu dvividhā- jñānavatī, mūḍhapariṣacca| saiva dvividhā satī trividhā punaranēna kāraṇavibhāgēna- suhr̥tpariṣat, udāsīnapariṣat, pratiniviṣṭapariṣaccēti | tatra pratiniviṣṭāyāṁ pariṣadi jñānavijñānavacanaprativacanaśaktisampannāyāṁ mūḍhāyāṁ vā na kathaṁ cit kēnacit saha jalpō vidhīyatē; mūḍhāyāṁ tu suhr̥tpariṣadyudāsīnāyāṁ vā jñānavijñānavacanaprativacanaśaktīrantarēṇāpyadīptayaśasā mahājanavidviṣṭēnāpi saha jalpō vidhīyatē| tadvidhēna ca saha kathayatā āviddhadīrghasūtrasaṅkulairvākyadaṇḍakaiḥ kathayitavyam, atihr̥ṣṭaṁ muhurmuhurupahasatā paraṁ nirūpayatā ca parṣadamākārairbruvataścāsya vākyāvakāśō na dēyaḥ; kaṣṭaśabdaṁ ca bruvatā vaktavyō nōcyatē, athavā punarhīnā tē pratijñā, iti| punaścāhū(hva)yamānaḥ prativaktavyaḥ- parisaṁvatsarō bhavān śikṣasva tāvat; na tvayā gururupāsitō nūnam, athavā paryāptamētāvattē; sakr̥dapi hi parikṣēpikaṁ nihataṁ nihatamāhuriti nāsya yōgaḥ kartavyaḥ kathañcit| apyēvaṁ śrēyasā saha vigr̥hya vaktavyamityāhurēkē; natvēvaṁ jyāyasā saha vigrahaṁ praśaṁsanti kuśalāḥ||20||

pariShattu khalu dvividhA- j~jAnavatI, mUDhapariShacca|
saiva dvividhA satI trividhA punaranena kAraNavibhAgena- suhRutpariShat, udAsInapariShat,pratiniviShTapariShacceti [1] |
tatra pratiniviShTAyAM pariShadi j~jAnavij~jAnavacanaprativacanashaktisampannAyAM mUDhAyAM vA nakathaM cit kenacit saha jalpo vidhIyate; mUDhAyAM tu suhRutpariShadyudAsInAyAM vAj~jAnavij~jAnavacanaprativacanashaktIrantareNApyadIptayashasA [2] mahAjanavidviShTenApi saha jalpovidhIyate|
tadvidhena ca saha kathayatA AviddhadIrghasUtrasa~gkulairvAkyadaNDakaiH kathayitavyam,atihRuShTaM muhurmuhurupahasatA paraM nirUpayatA ca parShadamAkArairbruvatashcAsyavAkyAvakAsho na deyaH; kaShTashabdaM ca bruvatA [3] vaktavyo nocyate, athavA punarhInA te pratij~jA,iti|
punashcAhU(hva)yamAnaH prativaktavyaH- parisaMvatsaro [4] bhavAn shikShasva tAvat; na tvayAgururupAsito nUnam, athavA paryAptametAvatte; sakRudapi hi parikShepikaM nihataM nihatamAhuritinAsya yogaH kartavyaH katha~jcit|
apyevaM shreyasA saha vigRuhya vaktavyamityAhureke; natvevaM jyAyasA saha vigrahaM prashaMsantikushalAH||20||
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Assembly may also be of two types - learned and ignorant. Again from the other point of view, it is of three types – friendly, neutral and prejudiced.
One should not disucss anything, or anything cannot be discussed in the the assembly of learned prejudiced persons endowed with general and specific knowledge, powerful expressions,discussion techniques and assembly of ignorant prejudiced persons.
In the ignorant friendly or ignorant neutral assembly, however, one may discuss with another who is devoid of learning, understanding, discussion techniques, and is not famous and is despised by great men. While discussing with such a person one should use long sentences having incomprehensible and long aphorisms.One should ridicule the opponent again and again with body guestures before the gathering and should not give opportunity to him to speak, while using difficult words one should remind the opponent that he is not speaking or his proposition does not stand. Again calling him one should say- you should learn for one year, perhaps you have not learnt from a preceptor or it is sufficient for you. The opponent, having defeated once, is always considered defeated and should not be entertained again. Some say that the same method is applicable in case of hostile discussion with a superior opponent but, in fact, confrontation with a superior person is not at all desirable. [20]
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प्रत्यवरेणतुसहसमानाभिमतेनवाविगृह्यजल्पतासुहृत्परिषदिकथयितव्यम्,अथवाऽप्युदासीनपरिषद्यवधानश्रवणज्ञानविज्ञानोपधारणवचनप्रतिवचनशक्तिसम्पन्नायांकथयताचावहितेनपरस्यसाद्गुण्यदोष<br>बलमवेक्षितव्यं, समवेक्ष्यचयत्रैनंश्रेष्ठंमन्येतनास्यतत्रजल्पंयोजयेदनाविष्कृतमयोगंकुर्वन्; यत्रत्वेनमवरंमन्येततत्रैवैनमाशुनिगृह्णीयात्| तत्रखल्विमेप्रत्यवराणामाशुनिग्रहेभवन्त्युपायाः; तद्यथा- श्रुतहीनंमहतासूत्रपाठेनाभिभवेत्, विज्ञानहीनंपुनःकष्टशब्देनवाक्येन, वाक्यधारणाहीनमाविद्धदीर्घसूत्रसङ्कुलैर्वाक्यदण्डकैः, प्रतिभाहीनंपुनर्वचनेनैकविधेनानेकार्थवाचिना , वचनशक्तिहीनमर्धोक्तस्यवाक्यस्याक्षेपेणअविशारदमपत्रपणेन, कोपनमायासनेन, भीरुंवित्रासनेन, अनवहितंनियमनेनेति| एवमेतैरुपायैःपरमवरमभिभवेच्छीघ्रम्||२१||
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pratyavarēṇa tu saha samānābhimatēna vā vigr̥hya jalpatā suhr̥tpariṣadikathayitavyam,athavā'pyudāsīnapariṣadyavadhānaśravaṇajñānavijñānōpadhāraṇavacanaprativacanaśaktisampannāyāṁ kathayatā cāvahitēna parasya sādguṇyadōṣabalamavēkṣitavyaṁ, samavēkṣya ca yatrainaṁ śrēṣṭhaṁ manyēta nāsya tatra jalpaṁ yōjayēdanāviṣkr̥tamayōgaṁ kurvan; yatra tvēnamavaraṁ manyēta tatraivainamāśu nigr̥hṇīyāt| tatra khalvimē pratyavarāṇāmāśu nigrahē bhavantyupāyāḥ; tadyathā- śrutahīnaṁ mahatā sūtrapāṭhēnābhibhavēt, vijñānahīnaṁ punaḥ kaṣṭaśabdēna vākyēna, vākyadhāraṇāhīnamāviddhadīrghasūtrasaṅkulairvākyadaṇḍakaiḥ, pratibhāhīnaṁ punarvacanēnaikavidhēnānēkārthavācinā, vacanaśaktihīnamardhōktasya vākyasyākṣēpēṇa, aviśāradamapatrapaṇēna, kōpanamāyāsanēna, bhīruṁ vitrāsanēna, anavahitaṁ niyamanēnēti| ēvamētairupāyaiḥ paramavaramabhibhavēcchīghram||21||

pratyavareNa tu saha samAnAbhimatena vA vigRuhya jalpatA suhRutpariShadi kathayitavyam,athavA~apyudAsInapariShadyavadhAnashravaNaj~jAnavij~jAnopadhAraNavacanaprativacanashaktisampannAyAMkathayatA cAvahitena parasya sAdguNyadoShabalamavekShitavyaM, samavekShya ca yatrainaM shreShThaMmanyeta nAsya tatra jalpaM yojayedanAviShkRutamayogaM kurvan; yatra tvenamavaraM manyetatatraivainamAshu nigRuhNIyAt|
tatra khalvime pratyavarANAmAshu nigrahe bhavantyupAyAH; tadyathA- shrutahInaM mahatAsUtrapAThenAbhibhavet, vij~jAnahInaM punaH kaShTashabdena vAkyena,vAkyadhAraNAhInamAviddhadIrghasUtrasa~gkulairvAkyadaNDakaiH, pratibhAhInaMpunarvacanenaikavidhenAnekArthavAcinA [1] , vacanashaktihInamardhoktasya vAkyasyAkShepeNa [2] ,avishAradamapatrapaNena, kopanamAyAsanena, bhIruM vitrAsanena, anavahitaM niyamaneneti|
evametairupAyaiH paramavaramabhibhavecchIghram||21||
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In a learned friendly or ignorant friendly assembly, one should initiate hostile discussion with an inferior or equal opponent.
Or in a friendly neutral assembly having persons with attentive listening, learning, understanding abilities, power of discussion one should initiate discussion after carefully examining the strength and weakness of the opponent. If opponent is stronger then one should not continue discussion giving it up without any apparent sign; but where the opponent is weak he should be subdued immediately.
The means adopted to subdue the inferior opponent immediately are as follows:
opponent having no scriptural knowledge should be defeated by quoting long aphorisms; opponent devoid of confirmed meaning of sentences should be defeated by using sentences with incomprehensible and long aphorisms;
one devoid of imagination should be defeated with similar sentences having various meanings;
one devoid of power of speaking should be defeated by contradicting the half-said sentence;
one devoid of skill should be defeated by putting him in embarrassing situation;
one with irritability should be defeated by teasing him;
one with cowardice should be defeated by terrorizing;
one devoid of carefulness should be defeated by imposing discipline.
Thus by these means one should subdue the inferior opponent immediately. [21]
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==== Summary of discussion technique ====
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तत्रश्लोकौ- विगृह्यकथयेद्युक्त्यायुक्तंचननिवारयेत्| विगृह्यभाषातीव्रंहिकेषाञ्चिद्द्रोहमावहेत्||२२||

नाकार्यमस्तिक्रुद्धस्यनावाच्यमपिविद्यते| कुशलानाभिनन्दन्तिकलहंसमितौसताम्||२३||

एवंप्रवृत्तेवादेकुर्यात्||२४||
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tatra ślōkau- vigr̥hya kathayēdyuktyā yuktaṁ ca na nivārayēt| vigr̥hyabhāṣā tīvraṁ hi kēṣāñciddrōhamāvahēt||22||

nākāryamasti kruddhasya nāvācyamapi vidyatē| kuśalā nābhinandanti kalahaṁ samitau satām||23||

ēvaṁ pravr̥ttē vādē kuryāt||24||

tatra shlokau-
vigRuhya kathayedyuktyA yuktaM ca na nivArayet|
vigRuhyabhAShA tIvraM hi keShA~jciddrohamAvahet||22||

nAkAryamasti kruddhasya nAvAcyamapi vidyate|
kushalA nAbhinandanti kalahaM samitau satAm||23||

evaM pravRutte vAde kuryAt||24||
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In a hostile discussion, one should speak reasonably and should not withdraw the words once spoken. A hostile speech gives rise to strong agitation in some persons. The agitated person, may do some unfavourable things or may speak some unwanted words. Hence the wise do not recommend quarrel in the assembly of noble persons. Thus one should perform in discussion initiated. [22-24]

==== Guidelines for preparation before initiation and recording the debate ====
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प्रागेवतावदिदंकर्तुंयतेत- सन्धायपर्षदाऽयनभूतमात्मनःप्रकरणमादेशयितव्यं, यद्वापरस्यभृशदुर्गंस्यात्, पक्षमथवापरस्यभृशंविमुखमानयेत्; परिषदिचोपसंहितायामशक्यमस्माभिर्वक्तुम्, एषैवतेपरिषद्यथेष्टंयथायोगंयथाभिप्रायंवादंवादमर्यादांचस्थापयिष्यतीत्युक्त्वातूष्णीमासीत||२५||
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prāgēva tāvadidaṁ kartuṁ yatēta- sandhāya parṣadā'yanabhūtamātmanaḥ prakaraṇamādēśayitavyaṁ, yadvā parasya bhr̥śadurgaṁ syāt, pakṣamathavā parasya bhr̥śaṁ vimukhamānayēt; pariṣadi cōpasaṁhitāyāmaśakyamasmābhirvaktum, ēṣaiva tē pariṣadyathēṣṭaṁ yathāyōgaṁ yathābhiprāyaṁ vādaṁ vādamaryādāṁ ca sthāpayiṣyatītyuktvā tūṣṇīmāsīta||25||

prAgeva [1] tAvadidaM kartuM yateta- sandhAya parShadA~ayanabhUtamAtmanaHprakaraNamAdeshayitavyaM, yadvA parasya bhRushadurgaM syAt, pakShamathavA parasya bhRushaMvimukhamAnayet; pariShadi copasaMhitAyAmashakyamasmAbhirvaktum, eShaiva te pariShadyatheShTaMyathAyogaM yathAbhiprAyaM vAdaM vAdamaryAdAM ca sthApayiShyatItyuktvA tUShNImAsIta||25||
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Before discussion, one should follow like this: In connivance with the participants of assembly, one should get the topic selected as is favourable to him or which is very difficult for the opponent or the opponent should be given such topic of discussion which will be quite adverse to the assembly’s views. Nothing can be discussed if the participants of assembly are congregated together. Then one should speak, ‘I have nothing to say more, now this assembly itself will take proper decision about the discussion and its result according to its choice, circumstances and views of the members’, having said this he should keep quiet. [25]
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तत्रेदंवादमर्यादालक्षणंभवति- इदंवाच्यम्, इदमवाच्यम्, एवंपराजितोभवतीति||२६||
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tatrēdaṁ vādamaryādālakṣaṇaṁ bhavati- idaṁ vācyam, idamavācyam, ēvaṁ parājitō bhavatīti||26||

tatredaM vAdamaryAdAlakShaNaM bhavati- idaM vAcyam, idamavAcyam, evaM parAjito bhavatIti||26||
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The result of the discussion should be recorded like this; this is worth-speaking, this is not worth-speaking, therefore one has been defeated. [26]

=== Terms for debate ===
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इमानितुखलुपदानिभिषग्वादमार्गज्ञानार्थमधिगम्यानिभवन्ति; तद्यथा-
वादः, द्रव्यं, गुणाः, कर्म, सामान्यं, विशेषः, समवायः, प्रतिज्ञा,स्थापना, प्रतिष्ठापना, हेतुः, दृष्टान्तः, उपनयः, निगमनम्, उत्तरं, सिद्धान्तः, शब्दः, प्रत्यक्षम्, अनुमानम्, ऐतिह्यम्, औपम्यं, संशयः, प्रयोजनं, सव्यभिचारं, जिज्ञासा, व्यवसायः, अर्थप्राप्तिः, सम्भवः, अनुयोज्यम्, अननुयोज्यम्, अनुयोगः, प्रत्यनुयोगः, वाक्यदोषः, वाक्यप्रशंसा, छलम्, अहेतुः, अतीतकालम्, उपालम्भः, परिहारः, प्रतिज्ञाहानिः, अभ्यनुज्ञा, हेत्वन्तरम्, अर्थान्तरं, निग्रहस्थानमिति||२७||
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imāni tu khalu padāni bhiṣagvādamārgajñānārthamadhigamyāni bhavanti; tadyathā- vādaḥ, dravyaṁ, guṇāḥ, karma, sāmānyaṁ, viśēṣaḥ, samavāyaḥ, pratijñā, sthāpanā, pratiṣṭhāpanā, hētuḥ, dr̥ṣṭāntaḥ, upanayaḥ, nigamanam, uttaraṁ, siddhāntaḥ, śabdaḥ, pratyakṣam, anumānam, aitihyam, aupamyaṁ, saṁśayaḥ, prayōjanaṁ, savyabhicāraṁ, jijñāsā, vyavasāyaḥ, arthaprāptiḥ, sambhavaḥ, anuyōjyam, ananuyōjyam, anuyōgaḥ, pratyanuyōgaḥ, vākyadōṣaḥ, vākyapraśaṁsā, chalam, ahētuḥ, atītakālam, upālambhaḥ, parihāraḥ, pratijñāhāniḥ, abhyanujñā, hētvantaram, arthāntaraṁ, nigrahasthānamiti||27||

imAni tu khalu padAni bhiShagvAdamArgaj~jAnArthamadhigamyAni [1] bhavanti; tadyathA- vAdaH,dravyaM, guNAH, karma, sAmAnyaM, visheShaH, samavAyaH, pratij~jA, sthApanA, pratiShThApanA,hetuH, dRuShTAntaH, upanayaH, nigamanam, uttaraM, siddhAntaH, shabdaH, pratyakSham, anumAnam,aitihyam, aupamyaM, saMshayaH, prayojanaM, savyabhicAraM, jij~jAsA, vyavasAyaH, arthaprAptiH,sambhavaH, anuyojyam, ananuyojyam, anuyogaH, pratyanuyogaH, vAkyadoShaH, vAkyaprashaMsA,chalam, ahetuH, atItakAlam, upAlambhaH, parihAraH, pratij~jAhAniH, abhyanuj~jA, hetvantaram,arthAntaraM, nigrahasthAnamiti||27||
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These terms are worth-knowing for acquaintance of the course of discussion among physicians such as – ''vada, dravya, guna, karma, samanya, vishesha, samavaya, pratijna, sthapana, pratishthapana, hetu, drishtanta, upanaya, nigamana, uttara, siddhanta, shabda, pratyaksha, anumana, aitihya, aupamya, samshaya, prayojana, savyabhichara, jijnasa, vyavasaya, arthaprapti, sambhava, anuyojya, ananuyojya, anuyoga, pratyanuyoga, vakyadosha, vakyaprashamsa, chhala, ahetu, atitakala, upalambha, parihara, pratijnahani, abhyanujna, hetvantara, arthantara, nigrahasthana.'' [27]
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==== 1. ''Vada'' (debate) ====
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तत्रवादोनामसयत्परेणसहशास्त्रपूर्वकंविगृह्यकथयति| सचद्विविधःसङ्ग्रहेण- जल्पः, वितण्डाच| तत्रपक्षाश्रितयोर्वचनंजल्पः, जल्पविपर्ययोवितण्डा| यथा- एकस्यपक्षःपुनर्भवोऽस्तीति,नास्तीत्यपरस्य; तौचस्वस्वपक्षहेतुभिःस्वस्वपक्षंस्थापयतः, परपक्षमुद्भावयतः, एषजल्पः| जल्पविपर्ययोवितण्डा| वितण्डानामपरपक्षेदोषवचनमात्रमेव||२८||
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tatra vādō nāma sa yat parēṇa saha śāstrapūrvakaṁ vigr̥hya kathayati| sa ca dvividhaḥ saṅgrahēṇa- jalpaḥ, vitaṇḍā ca| tatra pakṣāśritayōrvacanaṁ jalpaḥ, jalpaviparyayō vitaṇḍā| yathā- ēkasya pakṣaḥ punarbhavō'stīti, nāstītyaparasya; tau ca svasvapakṣahētubhiḥ svasvapakṣaṁ sthāpayataḥ, parapakṣamudbhāvayataḥ, ēṣa jalpaḥ| jalpaviparyayō vitaṇḍā| vitaṇḍā nāma parapakṣē dōṣavacanamātramēva||28||

tatra vAdo nAma sa yat pareNa saha shAstrapUrvakaM vigRuhya kathayati|
sa ca dvividhaH sa~ggraheNa- jalpaH, vitaNDA ca|
tatra pakShAshritayorvacanaM jalpaH, jalpaviparyayo vitaNDA|
yathA- ekasya pakShaH punarbhavo~astIti, nAstItyaparasya; tau ca svasvapakShahetubhiHsvasvapakShaM sthApayataH, parapakShamudbhAvayataH, eSha jalpaH|
jalpaviparyayo vitaNDA|
vitaNDA nAma parapakShe doShavacanamAtrameva||28||
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<div style="text-align:justify;">
''Vada'' is that in which one holds academic discussion with a contending opponent. This is briefly of two types – ''jalpa, vitanda''.
''Jalpa'' is the statement of speaker’s own view contradicting the opponent’s view.
''Vitanda'' is opposite to ''jalpa''. For instance, one holds the view that rebirth exist while the other holds the view just against it. During such discussion (''vada''), they (participants) advance arguments in support of their own views and contradict the opponent’s view, this is ''jalpa''. ''Vitanda'' is opposite to ''jalpa'' in which the speaker without having any positive approach only finds faults in the opponent’s view point. [28]
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==== 2-7: ''Dravya'' to ''Samavaya'' ====
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द्रव्य-गुण-कर्म-सामान्य-विशेष-समवायाः
स्वलक्षणैःश्लोकस्थानेपूर्वमुक्ताः||२९||
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dravya-guṇa-karma-sāmānya-viśēṣa-samavāyāḥ
svalakṣaṇaiḥ ślōkasthānē pūrvamuktāḥ||29||

dravya-guNa-karma-sAmAnya-visheSha-samavAyAH svalakShaNaiH shlokasthAne pUrvamuktAH||29||
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''Dravya, guna, karma, samanya, vishesha and samavaya''– these are mentioned earlier along with their definitions in ''shloka sthana'' ([[Sutra Sthana]] chapters). [29]

==== 8. ''Pratijna'' (proposition) ====
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अथप्रतिज्ञा- प्रतिज्ञानामसाध्यवचनं; यथा- नित्यःपुरुषइति||३०||
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atha pratijñā- pratijñā nāma sādhyavacanaṁ; yathā- nityaḥ puruṣa iti||30||

atha pratij~jA- pratij~jA nAma sAdhyavacanaM; yathA- nityaH puruSha iti||30||
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''Pratijna''(proposition) is the statement which is to be proved. For instance, ''purusha'' is eternal. [30]

==== 9. ''Sthapana'' (establishment) ====
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अथस्थापना- स्थापनानामतस्याएवप्रतिज्ञायाहेतुदृष्टान्तोपनयनिगमनैःस्थापना| पूर्वंहिप्रतिज्ञा, पश्चातस्थापना, किंह्यप्रतिज्ञातंस्थापयिष्यति; यथा- नित्यःपुरुषइतिप्रतिज्ञा; हेतुः- अकृतकत्वादिति; दृष्टान्तः- यथाऽऽकाशमिति; उपनयः- यथाचाकृतकमाकाशं, तच्चनित्यं, तथापुरुषइति; निगमनं- तस्मान्नित्यइति||३१||
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atha sthāpanā- sthāpanā nāma tasyā ēva pratijñāyā hētudr̥ṣṭāntōpanayanigamanaiḥ sthāpanā| pūrvaṁ hi pratijñā, paścāt sthāpanā, kiṁ hyapratijñātaṁ sthāpayiṣyati; yathā- nityaḥ puruṣa iti pratijñā; hētuḥ- akr̥takatvāditi; dr̥ṣṭāntaḥ - yathā''kāśamiti; upanayaḥ- yathā cākr̥takamākāśaṁ, tacca nityaṁ, tathā puruṣa iti; nigamanaṁ- tasmānnitya iti||31||

atha sthApanA- sthApanA nAma tasyA eva pratij~jAyA hetudRuShTAntopanayanigamanaiH sthApanA|
pUrvaM [1] hi pratij~jA, pashcAt sthApanA, kiM hyapratij~jAtaM sthApayiShyati; yathA- nityaH puruSha itipratij~jA; hetuH- akRutakatvAditi; dRuShTAntaH [2] - yathA~a~akAshamiti; upanayaH- yathAcAkRutakamAkAshaM, tacca nityaM, tathA puruSha iti; nigamanaM- tasmAnnitya iti||31||
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<div style="text-align:justify;">
''Sthapana'' is establishing the same proposition on firm ground with the help of ''hetu'' (reason), ''drishtanta'' (instance), ''upanaya'' (correlation) and ''nigamana'' (conclusion). First there is proposition (''pratijna'') and then establishment (''sthapana'') because what can be established (nothing) in absence of proposition? For instance, ‘''purusha'' is eternal’ – this is proposition, reason (''hetu'') is - ‘because of not being created’; instance (''drishtanta'') is – ‘as sky’; correlation (''upanaya'') is – ‘as the sky is uncreated and is eternal so is ''purusha''’; conclusion (''nigamana'') is - ‘therefore, ''purusha'' is eternal.’[31]
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==== 10. ''Pratishthapana'' (counter-assertion) ====
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अथप्रतिष्ठापना- प्रतिष्ठापनानामयातस्याएवपरप्रतिज्ञायाविपरीतार्थस्थापना| यथा- अनित्यःपुरुषइतिप्रतिज्ञा; हेतुः- ऐन्द्रियकत्वादिति; दृष्टान्तः- यथाघटइति, उपनयो- यथाघटऐन्द्रियकःचानित्यः, तथाचायमिति; निगमनं- तस्मादनित्यइति||३२||
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atha pratiṣṭhāpanā- pratiṣṭhāpanā nāma yā tasyā ēva parapratijñāyā viparītārthasthāpanā| yathā- anityaḥ puruṣa iti pratijñā ; hētuḥ- aindriyakatvāditi; dr̥ṣṭāntaḥ- yathā ghaṭa iti, upanayō- yathā ghaṭa aindriyakaḥ sa cānityaḥ, tathā cāyamiti; nigamanaṁ- tasmādanitya iti||32||

atha pratiShThApanA- pratiShThApanA nAma yA tasyA eva parapratij~jAyA [1] viparItArthasthApanA|
yathA- anityaH puruSha iti pratij~jA [2] ; hetuH- aindriyakatvAditi; dRuShTAntaH- yathA ghaTa [3] iti,upanayo- yathA ghaTa aindriyakaH sa cAnityaH, tathA cAyamiti; nigamanaM- tasmAdanitya iti||32||
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<div style="text-align:justify;">
''Pratishthapana'' is giving a contrary statement to the opponent’s proposition. For instance, ‘self is non-eternal’ is proposition (''pratijna''); reason (''hetu'') is-‘because of being perceived by senses’; instance (''drishtanta'') is – ‘as pitcher’; correlation (''upanaya'') is – ‘as pitcher is perceived by senses and is non-eternal so is ‘self’; conclusion (''nigamana'') is – therefore, self is non eternal.[32]
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==== 11. ''Hetu'' (cause) ====
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अथहेतुः- हेतुर्नामोपलब्धिकारणं; तत्प्रत्यक्षम्, अनुमानम्, ऐतिह्यम्, औपम्यमिति; एभिर्हेतुभिर्यदुपलभ्यतेतत्तत्त्वम्||३३||
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atha hētuḥ- hēturnāmōpalabdhikāraṇaṁ; tat pratyakṣam, anumānam, aitihyam, aupamyamiti; ēbhirhētubhiryadupalabhyatē tat tattvam||33||

atha hetuH- heturnAmopalabdhikAraNaM; tat pratyakSham, anumAnam, aitihyam, aupamyamiti;ebhirhetubhiryadupalabhyate tat tattvam||33||
</div></div>

''Hetu'' is the cause of knowledge such as ''pratyaksha'' (direct perception), ''anumana'' (inference), ''aitihya'' (traditional instruction) and ''aupamya'' (analogy). That which is revealed by these reasons is ''tattva'' (truth).[33]

==== 12. ''Drishtanta'' (instance) ====
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अथदृष्टान्तः- दृष्टान्तोनामयत्रमूर्खविदुषांबुद्धिसाम्यं, योवर्ण्यंवर्णयति| यथा- अग्निरुष्णः, द्रवमुदकं, स्थिरापृथिवी, आदित्यःप्रकाशकइति; यथाआदित्यःप्रकाशकस्तथासाङ्ख्यज्ञानंप्रकाशकमिति||३४||
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atha dr̥ṣṭāntaḥ- dr̥ṣṭāntō nāma yatra mūrkhaviduṣāṁ buddhisāmyaṁ, yō varṇyaṁ varṇayati | yathā- agniruṣṇaḥ, dravamudakaṁ, sthirā pr̥thivī, ādityaḥ prakāśaka iti; yathā ādityaḥ prakāśakastathā sāṅkhyajñānaṁ prakāśakamiti||34||

atha dRuShTAntaH- dRuShTAnto nAma yatra mUrkhaviduShAM buddhisAmyaM, yo varNyaM varNayati [1] |
yathA- agniruShNaH, dravamudakaM, sthirA pRuthivI, AdityaH prakAshaka iti; yathA AdityaH [2]prakAshakastathA sA~gkhyaj~jAnaM [3] prakAshakamiti||34||
</div></div>

<div style="text-align:justify;">
''Drishtanta'' is that which arouses alike understanding in the fools and the learned. It presents a picturesque image of the objective to be defined. For instance, hot like fire, fluid like water, stable like earth and illuminating like the sun, as the sun illuminates similarly the knowledge of the ''Sankhya'' is also illuminating. [34]
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==== 13-14. ''Upanaya'' (correlation) and ''Nigamana''(conclusion) ====
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उपनयोनिगमनंचोक्तंस्थापनाप्रतिष्ठापनाव्याख्यायाम्||३५||
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upanayō nigamanaṁ cōktaṁ sthāpanāpratiṣṭhāpanāvyākhyāyām||35||

upanayo nigamanaM coktaM sthApanApratiShThApanAvyAkhyAyAm||35||
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''Upanaya'' and ''Nigamana'' are explained under the headings ''sthapana'' and ''pratishthapana''.[35]

==== 15. ''Uttara'' (rejoinder) ====
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अथोत्तरम्- उत्तरंनामसाधर्म्योपदिष्टेहेतौवैधर्म्यवचनं, वैधर्म्योपदिष्टेवाहेतौसाधर्म्यवचनम्| यथा- ‘हेतुसधर्माणोविकाराः, शीतकस्यहिव्याधेर्हेतुभिःसाधर्म्यंहिमशिशिरवातसंस्पर्शाः’, इतिब्रुवतःपरोब्रूयात्- हेतुविधर्माणोविकाराः, यथाशरीरावयवानांदाहौष्ण्यकोथप्रपचनेहेतुवैधर्म्यंहिमशिशिरवातसंस्पर्शाइति| एतत्सविपर्ययमुत्तरम्||३६||
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athōttaram- uttaraṁ nāma sādharmyōpadiṣṭē hētau vaidharmyavacanaṁ, vaidharmyōpadiṣṭē vā hētau sādharmyavacanam| yathā- ‘hētusadharmāṇō vikārāḥ, śītakasya hi vyādhērhētubhiḥ sādharmyaṁ himaśiśiravātasaṁsparśāḥ’, iti bruvataḥ parō brūyāt- hētuvidharmāṇō vikārāḥ, yathā śarīrāvayavānāṁ dāhauṣṇyakōthaprapacanē hētuvaidharmyaṁ himaśiśiravātasaṁsparśā iti| ētat saviparyayamuttaram||36||

athottaram- uttaraM nAma sAdharmyopadiShTe hetau vaidharmyavacanaM, vaidharmyopadiShTe vAhetau sAdharmyavacanam|
yathA- ‘hetusadharmANo vikArAH, shItakasya hi vyAdherhetubhiH sAdharmyaMhimashishiravAtasaMsparshAH’, iti bruvataH paro brUyAt- hetuvidharmANo vikArAH, yathAsharIrAvayavAnAM dAhauShNyakothaprapacane hetuvaidharmyaM [1] himashishiravAtasaMsparshA iti|
etat saviparyayamuttaram||36||
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<div style="text-align:justify;">
''Uttara'' is the statement made in opposition (heterogeneous) to the homologous nature shown between ''hetu'' and ''karya'' and vice versa. For instance , if somebody says – disorders are similar to cause, as ''shitaka'' disease has similar causes like exposure to snow and cold wave, the opponent may say – disorders are dissimilar to cause as burning sensation, heat, sloughing and suppuration of body parts are caused by cold wave which is dissimilar. This is ''uttara'' (rejoinder) with contrary statements.[36]
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==== 16. ''Siddhanta'' (theory/doctrine) ====
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अथसिद्धान्तः- सिद्धान्तोनामसयःपरीक्षकैर्बहुविधंपरीक्ष्यहेतुभिश्चसाधयित्वास्थाप्यतेनिर्णयः| सचतुर्विधः- सर्वतन्त्रसिद्धान्तः, प्रतितन्त्रसिद्धान्तः, अधिकरणसिद्धान्तः, अभ्युपगमसिद्धान्तश्चेति| तत्रसर्वतन्त्रसिद्धान्तोनामतस्मिंस्तस्मिन्सर्वस्मिंस्तन्त्रेतत्तत्प्रसिद्धं; यथासन्तिनिदानानि, सन्तिव्याधयः, सन्तिसिद्ध्युपायाःसाध्यानामिति| प्रतितन्त्रसिद्धान्तोनामतस्मिंस्तस्मिन्नेकैकस्मिंस्तन्त्रेतत्तत्प्रसिद्धं; यथा- अन्यत्राष्टौरसाःषडत्र, पञ्चेन्द्रियाण्यत्रषडिन्द्रियाण्यन्यत्रतन्त्रे, वातादिकृताःसर्वेविकारायथाऽन्यत्र, अत्रवातादिकृताभूतकृताश्चप्रसिद्धाः| अधिकरणसिद्धान्तोनामसयस्मिन्नधिकरणेप्रस्तूयमानेसिद्धान्यन्यान्यप्यधिकरणानिभवन्ति, यथा- ‘नमुक्तःकर्मानुबन्धिकंकुरुते, निस्पृहत्वात्इतिप्रस्तुतेसिद्धाःकर्मफल-मोक्ष-पुरुष-प्रेत्यभावाभवन्ति| अभ्युपगमसिद्धान्तोनामसयमर्थमसिद्धमपरीक्षितमनुपदिष्टमहेतुकंवावादकालेऽभ्युपगच्छन्तिभिषजः; तद्यथा- द्रव्यंप्रधानमितिकृत्वावक्ष्यामः, गुणाःप्रधानमितिकृत्वावक्ष्यामः, वीर्यंप्रधानमितिकृत्वावक्ष्यामः, इत्येवमादिः| इतिचतुर्विधःसिद्धान्तः||३७||
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atha siddhāntaḥ- siddhāntō nāma sa yaḥ parīkṣakairbahuvidhaṁ parīkṣya hētubhiśca sādhayitvā sthāpyatē nirṇayaḥ| sa caturvidhaḥ- sarvatantrasiddhāntaḥ, pratitantrasiddhāntaḥ, adhikaraṇasiddhāntaḥ, abhyupagamasiddhāntaścēti| tatra sarvatantrasiddhāntō nāma tasmiṁstasmin sarvasmiṁstantrē tattat prasiddhaṁ; yathā santi nidānāni, santi vyādhayaḥ, santi siddhyupāyāḥ sādhyānāmiti| pratitantrasiddhāntō nāma tasmiṁstasminnēkaikasmiṁstantrē tattat prasiddhaṁ; yathā- anyatrāṣṭau rasāḥ ṣaḍatra, pañcēndriyāṇyatra ṣaḍindriyāṇyanyatra tantrē, vātādikr̥tāḥ sarvē vikārā yathā'nyatra, atra vātādikr̥tā bhūtakr̥tāśca prasiddhāḥ| adhikaraṇasiddhāntō nāma sa yasminnadhikaraṇē prastūyamānē siddhānyanyānyapyadhikaraṇāni bhavanti, yathā- ‘na muktaḥ karmānubandhikaṁ kurutē, nispr̥hatvāt iti prastutē siddhāḥ karmaphala-mōkṣa-puruṣa-prētyabhāvā bhavanti| abhyupagamasiddhāntō nāma sa yamarthamasiddhamaparīkṣitamanupadiṣṭamahētukaṁ vā vādakālē'bhyupagacchanti bhiṣajaḥ; tadyathā- dravyaṁ pradhānamiti kr̥tvā vakṣyāmaḥ, guṇāḥ pradhānamiti kr̥tvā vakṣyāmaḥ, vīryaṁ pradhānamiti kr̥tvā vakṣyāmaḥ, ityēvamādiḥ| iti caturvidhaḥ siddhāntaḥ||37||

atha siddhAntaH- siddhAnto nAma sa yaH parIkShakairbahuvidhaM parIkShya hetubhishca sAdhayitvAsthApyate nirNayaH|
sa caturvidhaH- sarvatantrasiddhAntaH, pratitantrasiddhAntaH, adhikaraNasiddhAntaH,abhyupagamasiddhAntashceti|
tatra sarvatantrasiddhAnto nAma tasmiMstasmin sarvasmiMstantre tattat prasiddhaM; yathA santinidAnAni, santi vyAdhayaH, santi siddhyupAyAH sAdhyAnAmiti|
pratitantrasiddhAnto nAma tasmiMstasminnekaikasmiMstantre tattat prasiddhaM; yathA- anyatrAShTaurasAH ShaDatra, pa~jcendriyANyatra ShaDindriyANyanyatra tantre, vAtAdikRutAH sarve vikArAyathA~anyatra, atra vAtAdikRutA bhUtakRutAshca prasiddhAH|
adhikaraNasiddhAnto nAma sa yasminnadhikaraNe prastUyamAne siddhAnyanyAnyapyadhikaraNAnibhavanti, yathA- ‘na muktaH karmAnubandhikaM kurute, nispRuhatvAt iti prastute siddhAH karmaphala-mokSha-puruSha-pretyabhAvA bhavanti|
abhyupagamasiddhAnto nAma sa yamarthamasiddhamaparIkShitamanupadiShTamahetukaM vAvAdakAle~abhyupagacchanti bhiShajaH; tadyathA- dravyaM pradhAnamiti kRutvA vakShyAmaH, guNAHpradhAnamiti kRutvA vakShyAmaH, vIryaM [1] pradhAnamiti kRutvA vakShyAmaH, ityevamAdiH|
iti caturvidhaH siddhAntaH||37||
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<div style="text-align:justify;">
''Siddhanta'' is the conclusion established by scientists/investigators after testing in several ways and on proving it with reasoning. It is of four types – ''sarvatantra siddhanta, pratitantra siddhanta, adhikaraṇa siddhanta'', and ''abhyupagama siddhanta''.

*'''''Sarvatantra siddhanta''''' is that which is accepted universally by all the treatises such as – there are causes, there are diseases and there are remedies for the curable disorders.
*'''''Pratitantra siddhanta''''' is that which is not universal in nature and is held by only one of the treatises such as – in other treatises there are eight ''rasas'' but here are six; here are the five sense organs while in other texts there are six sense organs; per other texts all diseases are caused by ''vata'', etc. , but in this text they are considered to be caused by ''vata'' and other ''dosha'' as well as ''bhutas''.
*'''''Adhikarana siddhanta''''' is that which is established by implication of other proofs. Such as – the emancipated cannot show any good or bad consequent effect of deeds because of absence of desires. This proves the effects of deeds, emancipation, presence of self and the other world.
*'''''Abhyupagama siddhanta''''' is that which is held up by physicians temporarily and hypothetically during debate though the idea is unproved, untested, uninstructed and irrational such as – proposing that ''dravya'' is predominant or ''guna'' or properties are predominant or ''veerya'' is predominant.
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These are four types of doctrines. [37]

==== 17. ''Shabda'' (word/correct expression) ====
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अथशब्दः- शब्दोनामवर्णसमाम्नायः; सचतुर्विधः- दृष्टार्थश्च, अदृष्टार्थश्च, सत्यश्च, अनृतश्चेति| तत्रदृष्टार्थोनाम- त्रिभिर्हेतुभिर्दोषाःप्रकुप्यन्ति, षड्भिरुपक्रमैश्चप्रशाम्यन्ति, सतिश्रोत्रादिसद्भावेशब्दादिग्रहणमिति| अदृष्टार्थःपुनः- अस्तिप्रेत्यभावः, अस्तिमोक्षइति| सत्योनाम- यथार्थभूतः; सन्त्यायुर्वेदोपदेशाः, सन्तिसिद्ध्युपायाःसाध्यानांव्याधीनां, सन्त्यारम्भफलानीति| सत्यविपर्ययश्चानृतः||३८||
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śabdaḥ- śabdō nāma varṇasamāmnāyaḥ; sa caturvidhaḥ- dr̥ṣṭārthaśca, adr̥ṣṭārthaśca, satyaśca, anr̥taścēti| tatra dr̥ṣṭārthō nāma- tribhirhētubhirdōṣāḥ prakupyanti, ṣaḍbhirupakramaiśca praśāmyanti, sati śrōtrādisadbhāvē śabdādigrahaṇamiti| adr̥ṣṭārthaḥ punaḥ- asti prētyabhāvaḥ, asti mōkṣa iti| satyō nāma- yathārthabhūtaḥ; santyāyurvēdōpadēśāḥ, santi siddhyupāyāḥ sādhyānāṁ vyādhīnāṁ, santyārambhaphalānīti| satyaviparyayaścānr̥taḥ||38||

atha shabdaH- shabdo nAma varNasamAmnAyaH; sa caturvidhaH- dRuShTArthashca, adRuShTArthashca,satyashca, anRutashceti|
tatra dRuShTArtho nAma- tribhirhetubhirdoShAH prakupyanti, ShaDbhirupakramaishca prashAmyanti, satishrotrAdisadbhAve shabdAdigrahaNamiti|
adRuShTArthaH punaH- asti pretyabhAvaH, asti mokSha iti|
satyo nAma- yathArthabhUtaH; santyAyurvedopadeshAH, santi siddhyupAyAH sAdhyAnAM vyAdhInAM,santyArambhaphalAnIti|
satyaviparyayashcAnRutaH||38||
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<div style="text-align:justify;">
''Shabda'' is an aggregate of letters. This is of four types – ''drishtartha, adrishtartha, satya,'' and ''anrita''.

''Drishtartha'' is that which connotes observable meanings; such as ''dosha'' are aggravated by three etiological factors; they are pacified by six therapeutic measures; the sense objects are perceived through the sense organs.

''Adrishtartha'' is that which connotes unobservable ideas, such as the other world exists; there is emancipation.

''Satya'' is that which is consistent to the facts, such as these are instructions of [[Ayurveda]]; these are the remedial measures for the curable diseases and there exist a result of every action.

''Anrita'' is contrary to ''satya'' (that which is not consistent with facts).[38]
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==== 18. ''Pratyaksha'' (direct perception) ====
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अथप्रत्यक्षं- प्रत्यक्षंनामतद्यदात्मनाचेन्द्रियैश्चस्वयमुपलभ्यते; तत्रात्मप्रत्यक्षाःसुखदुःखेच्छाद्वेषादयः, शब्दादयस्त्विन्द्रियप्रत्यक्षाः||३९||
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atha pratyakṣaṁ- pratyakṣaṁ nāma tadyadātmanā cēndriyaiśca svayamupalabhyatē; tatrātmapratyakṣāḥ sukhaduḥkhēcchādvēṣādayaḥ, śabdādayastvindriyapratyakṣāḥ||39||

atha pratyakShaM- pratyakShaM nAma tadyadAtmanA cendriyaishca svayamupalabhyate;tatrAtmapratyakShAH sukhaduHkhecchAdveShAdayaH, shabdAdayastvindriyapratyakShAH||39||
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''Pratyaksha'' is the knowledge which is directly perceived by the self and the sense organs. Self-perceived are pleasure, pain, desire, aversion etc., while sound etc. are perceived by the sense organs.[39]

==== 19. ''Anumana'' (inference) ====
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अथानुमानम्- अनुमानंनामतर्कोयुक्त्यपेक्षः; यथा- अग्निंजरणशक्त्या, बलंव्यायामशक्त्या, श्रोत्रादीनिशब्दादिग्रहणेनेत्येवमादि||४०||
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athānumānam- anumānaṁ nāma tarkō yuktyapēkṣaḥ; yathā- agniṁ jaraṇaśaktyā, balaṁ vyāyāmaśaktyā, śrōtrādīni śabdādigrahaṇēnētyēvamādi||40||

athAnumAnam- anumAnaM nAma tarko yuktyapekShaH; yathA- agniM jaraNashaktyA, balaMvyAyAmashaktyA, shrotrAdIni shabdAdigrahaNenetyevamAdi||40||
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<div style="text-align:justify;">
''Anumana'' is the reasoning supported by invariable concomitance such as the knowledge of ''agni'' (is examined) by the power of digestion; that of strength of a person by examining the power to exercise, auditory organ etc. by the ability of perception of sound, etc.[40]
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==== 20. ''Aitihya'' (traditional instruction) ====
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अलौकिकाप्तोपदेशऐतिह्यपदेनोच्यतइत्याह- वेदादिरिति||४१||
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athaitihyam- aitihyaṁ nāmāptōpadēśō vēdādiḥ||41||

athaitihyam- aitihyaM nAmAptopadesho vedAdiH||41||
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''Aitihya'' is the divine authoritative (or traditional) source of knowledge such as ''veda'' etc.[41]

==== 21.''Aupamya'' (analogy) ====
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अथौपम्यम्- औपम्यंनामयदन्येनान्यस्यसादृश्यमधिकृत्यप्रकाशनं; यथा- दण्डेनदण्डकस्य, धनुषाधनुःस्तम्भस्य, इष्वासेनाऽऽरोग्यदस्येति||४२||
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athaupamyam- aupamyaṁ nāma yadanyēnānyasya sādr̥śyamadhikr̥tya prakāśanaṁ; yathā- daṇḍēna daṇḍakasya, dhanuṣā dhanuḥstambhasya, iṣvāsēnā''rōgyadasyēti||42||

athaupamyam- aupamyaM nAma yadanyenAnyasya sAdRushyamadhikRutya prakAshanaM; yathA-daNDena daNDakasya, dhanuShA dhanuHstambhasya, iShvAsenA~a~arogyadasyeti||42||
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''Aupamya'' is the description of similarity between things such as analogy of ''dandaka'' (a disease in which body is rigid like rod) with ''danda'' (rod); that of ''dhanustambha'' (tetany) with bow and that of the health provider with the archer.[42]

==== 22. ''Samshayah'' (uncertainity) ====
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अथसंशयः- संशयोनामसन्देहलक्षणानुसन्दिग्धेष्वर्थेष्वनिश्चयः ; यथा- दृष्टाह्यायुष्मल्लक्षणैरुपेताश्चानुपेताश्चतथासक्रियाश्चाक्रियाश्चपुरुषाःशीघ्रभङ्गाश्चिरजीविनश्च, एतदुभयदृष्टत्वात्संशयः- किमस्तिखल्वकालमृत्युरुतनास्तीति||४३||
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athasaṁśayaḥ-saṁśayō nāma sandēhalakṣaṇānusandigdhēṣvarthēṣvaniścayaḥ; yathā- dr̥ṣṭā hyāyuṣmallakṣaṇairupētāścānupētāśca tathā sakriyāścākriyāśca puruṣāḥ śīghrabhaṅgāścirajīvinaśca, ētadubhayadr̥ṣṭatvāt saṁśayaḥ- kimasti khalvakālamr̥tyuruta nāstīti ||43||

atha saMshayaH- saMshayo nAma sandehalakShaNAnusandigdheShvartheShvanishcayaH [1] ; yathA-dRuShTA hyAyuShmallakShaNairupetAshcAnupetAshca tathA sakriyAshcAkriyAshca puruShAHshIghrabha~ggAshcirajIvinashca, etadubhayadRuShTatvAt saMshayaH- kimasti khalvakAlamRutyurutanAstIti||43||
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<div style="text-align:justify;">
''Samshayaḥ'' is the state of indecision about the concerned entity. For instance, on observing that both types of persons having signs of longevity or not and they adopting the therapeutic measures or not – die early or live long life, therefore doubt arises as whether there is untimely death or not .[43]
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==== 23. ''Prayojana'' (purpose or intention) ====
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अथप्रयोजनं- प्रयोजनंनामयदर्थमारभ्यन्तआरम्भाः; यथा- यद्यकालमृत्युरस्तिततोऽहमात्मानमायुष्यैरुपचरिष्याम्यनायुष्याणिचपरिहरिष्यामि, कथंमामकालमृत्युःप्रसहेतेति||४४||
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atha prayōjanaṁ- prayōjanaṁ nāma yadarthamārabhyanta ārambhāḥ; yathā- yadyakālamr̥tyurasti tatō'hamātmānamāyuṣyairupacariṣyāmyanāyuṣyāṇi ca parihariṣyāmi, kathaṁ māmakālamr̥tyuḥ prasahētēti||44||

atha prayojanaM- prayojanaM nAma yadarthamArabhyanta ArambhAH; yathA- yadyakAlamRutyurastitato~ahamAtmAnamAyuShyairupacariShyAmyanAyuShyANi ca parihariShyAmi, kathaMmAmakAlamRutyuH prasaheteti||44||
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''Prayojana'' is that for which the actions is initiated. Such as – ‘if there is untimely death then I will use life-promoting measures and avoid the contrary ones. In such condition how would the untimely death subdue me?[44]

==== 24. ''Savyabhichara'' (incompatible argument) ====
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अथसव्यभिचारं- सव्यभिचारंनामयद्व्यभिचरणं; यथा- भवेदिदमौषधमस्मिन्व्याधौयौगिकमथवानेति||४५||
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atha savyabhicāraṁ- savyabhicāraṁ nāma yadvyabhicaraṇaṁ; yathā- bhavēdidamauṣadhamasmin vyādhau yaugikamathavā nēti||45||

atha savyabhicAraM- savyabhicAraM nAma yadvyabhicaraNaM; yathA- bhavedidamauShadhamasminvyAdhau yaugikamathavA neti||45||
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''Savyabhichara''is that argument incompatible with the conclusion drawn from it, such as ‘this medicine may or may not be applicable to this disease.’[45]

==== 25. ''Jijnasa'' (examination) ====
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अथजिज्ञासा- जिज्ञासानामपरीक्षा; यथाभेषजपरीक्षोत्तरकालमुपदेक्ष्यते||४६||
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atha jijñāsā- jijñāsā nāma parīkṣā; yathā bhēṣajaparīkṣōttarakālamupadēkṣyatē||46||

atha jij~jAsA- jij~jAsA nAma parIkShA; yathA bheShajaparIkShottarakAlamupadekShyate||46||
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''Jijnasa'' is the examination. Such as- the examination of drugs will be described later on.[46]

==== 26. ''Vyavasaya'' (resolution) ====
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अथव्यवसायः- व्यवसायोनामनिश्चयः; यथा- वातिकएवायंव्याधिः, इदमेवास्यभेषजंचेति||४७||
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atha vyavasāyaḥ- vyavasāyō nāma niścayaḥ; yathā- vātika ēvāyaṁ vyādhiḥ, idamēvāsya bhēṣajaṁ cēti||47||

atha vyavasAyaH- vyavasAyo nAma nishcayaH; yathA- vAtika evAyaM vyAdhiH, idamevAsya [1] bheShajaMceti||47||
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''Vyavasaya'' is resolution or firm decision, such as- this disease is certainly ''vataja'' and this is the medicament for this.[47]

==== 27. ''Arthaprapti'' ( attainment of meaning) ====
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अथार्थप्राप्तिः- अर्थप्राप्तिर्नामयत्रैकेनार्थेनोक्तेनापरस्यार्थस्यानुक्तस्यापिसिद्धिः; यथा- नायंसन्तर्पणसाध्योव्याधिरित्युक्तेभवत्यर्थप्राप्तिः- अपतर्पणसाध्योऽयमिति, नानेनदिवाभोक्तव्यमित्युक्तेभवत्यर्थप्राप्तिः- निशिभोक्तव्यमिति||४८||
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athārthaprāptiḥ- arthaprāptirnāma yatraikēnārthēnōktēnāparasyārthasyānuktasyāpi siddhiḥ; yathā- nāyaṁ santarpaṇasādhyō vyādhirityuktē bhavatyarthaprāptiḥ- apatarpaṇasādhyō'yamiti, nānēna divā bhōktavyamityuktē bhavatyarthaprāptiḥ- niśi bhōktavyamiti||48||

athArthaprAptiH- arthaprAptirnAma yatraikenArthenoktenAparasyArthasyAnuktasyApi siddhiH; yathA-nAyaM santarpaNasAdhyo vyAdhirityukte bhavatyarthaprAptiH- apatarpaNasAdhyo~ayamiti, nAnena divAbhoktavyamityukte bhavatyarthaprAptiH- nishi bhoktavyamiti||48||
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<div style="text-align:justify;">
''Arthaprapti'' is that where another unsaid idea is conveyed by the said one, such as when one says that the disease is not to be managed with saturating therapy it implies that it is to be managed with desaturation therapy. He should not eat during day, implies that he should eat during night. [48]
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==== 28. ''Sambhava'' (source) ====
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अथसम्भवः- योयतःसम्भवतिसतस्यसम्भवः; यथा- षड्धातवोगर्भस्य, व्याधेरहितं, हितमारोग्यस्येति||४९||
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atha sambhavaḥ- yō yataḥ sambhavati sa tasya sambhavaḥ; yathā- ṣaḍdhātavō garbhasya, vyādhērahitaṁ, hitamārōgyasyēti||49||

atha sambhavaH- yo yataH sambhavati sa tasya sambhavaH; yathA- ShaDdhAtavo garbhasya,vyAdherahitaM, hitamArogyasyeti||49||
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''Sambhava'' is that from which something is originated, such as six dhatus from which foetus has origin, disease have origin from unwholesome things and health have origin from wholesome things.[49]

==== 29. ''Anuyojya'' (censurable) ====
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अथानुयोज्यम्- अनुयोज्यंनामयद्वाक्यंवाक्यदोषयुक्तंतत्| सामान्यतोव्याहृतेष्वर्थेषुवाविशेषग्रहणार्थंयद्वाक्यंतदप्यनुयोज्यं; यथा- ‘संशोधनसाध्योऽयंव्याधिः’इत्युक्ते‘किंवमनसाध्योऽयं, किंवाविरेचनसाध्यः’इत्यनुयुज्यते||५०||
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athānuyōjyam- anuyōjyaṁ nāma yadvākyaṁ vākyadōṣayuktaṁ tat| sāmānyatō vyāhr̥tēṣvarthēṣu vā viśēṣagrahaṇārthaṁ yadvākyaṁ tadapyanuyōjyaṁ; yathā- ‘saṁśōdhanasādhyō'yaṁ vyādhiḥ’ ityuktē ‘kiṁ vamanasādhyō'yaṁ, kiṁvā virēcanasādhyaḥ’ ityanuyujyatē||50||

athAnuyojyam- anuyojyaM nAma yadvAkyaM vAkyadoShayuktaM tat|
sAmAnyato [1] vyAhRuteShvartheShu vA visheShagrahaNArthaM yadvAkyaM tadapyanuyojyaM; yathA-‘saMshodhanasAdhyo~ayaM vyAdhiH’ ityukte ‘kiM vamanasAdhyo~ayaM, kiMvA virecanasAdhyaH’ityanuyujyate||50||
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<div style="text-align:justify;">
''Anuyojya''–is that where sentence is defective or has unspecified meaning inviting further questions, such as if somebody says ‘the disease is to be managed with evacuative therapy’ it invites further question as to ‘whether it is to be managed with emesis or purgation.[50]
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==== 30. ''Ananuyojya'' (incensurable) ====
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अथाननुयोज्यम्- अननुयोज्यंनामातोविपर्ययेण; यथा- अयमसाध्यः||५१||
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athānanuyōjyam- ananuyōjyaṁ nāmātō viparyayēṇa; yathā- ayamasādhyaḥ||51||

athAnanuyojyam- ananuyojyaM nAmAto viparyayeNa; yathA- ayamasAdhyaH||51||
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''Ananuyojya'' is contrary to the above. Such as this is incurable.[51]

==== 31. ''Anuyoga'' (query with example) ====
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अथानुयोगः- अनुयोगोनामसयत्तद्विद्यानांतद्विद्यैरेवसार्धंतन्त्रेतन्त्रैकदेशेवाप्रश्नःप्रश्नैकदेशोवाज्ञानविज्ञानवचनप्रतिवचनपरीक्षार्थमादिश्यते| यथा- ‘नित्यःपुरुषः’इतिप्रतिज्ञातेयत्परः‘कोहेतुः’इत्याह, सोऽनुयोगः||५२||
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athānuyōgaḥ- anuyōgō nāma sa yat tadvidyānāṁ tadvidyairēva sārdhaṁ tantrē tantraikadēśē vā praśnaḥpraśnaikadēśō vā jñānavijñānavacanaprativacanaparīkṣārthamādiśyatē| yathā- ‘nityaḥ puruṣaḥ’ iti pratijñātē yat paraḥ ‘kō hētuḥ’ ityāha, sō'nuyōgaḥ||52||

athAnuyogaH- anuyogo nAma sa yat tadvidyAnAM tadvidyaireva sArdhaM tantre tantraikadeshe vAprashnaHprashnaikadesho vA j~jAnavij~jAnavacanaprativacanaparIkShArthamAdishyate|
yathA- ‘nityaH puruShaH’ iti pratij~jAte yat paraH ‘ko hetuH’ ityAha, so~anuyogaH||52||
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<div style="text-align:justify;">
''Anuyoga'' is that which is put as query, wholly or partly, on the text or its part during discussion of experts for the test of learning, understanding, speaking and contradiction, such as on the statement of self eternal, somebody says, what is the reason, this is ''anuyoga''. [52]
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==== 32. ''Pratyanuyoga''(counter-question)====
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अथप्रत्यनुयोगः- प्रत्यनुयोगोनामानुयोगस्यानुयोगः; यथा- अस्यानुयोगस्यपुनःकोहेतुरिति||५३||
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atha pratyanuyōgaḥ- pratyanuyōgō nāmānuyōgasyānuyōgaḥ; yathā- asyānuyōgasya punaḥ kō hēturiti||53||

atha pratyanuyogaH- pratyanuyogo nAmAnuyogasyAnuyogaH; yathA- asyAnuyogasya punaH koheturiti||53||
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''Pratyanuyoga'' is questioning the questions, such as when ''anuyoga'' i.e query has been raised then again questioning what is the reason of this query is called as ''pratyanuyoga'' .[53]

====33. ''Vakyadosha'' (syntactical defects)====
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अथवाक्यदोषः- वाक्यदोषोनामयथाखल्वस्मिन्नर्थेन्यूनम्, अधिकम्, अनर्थकम्, अपार्थकं, विरुद्धंचेति; एतानिह्यन्तरेणनप्रकृतोऽर्थःप्रणशयेत्| तत्रन्यूनं- प्रतिज्ञाहेतूदाहरणोपनयनिगमनानामन्यतमेनापिन्यूनंन्यूनंभवति; यद्वाबहूपदिष्टहेतुकमेकेनहेतुनासाध्यतेतच्चन्यूनम्| अथाधिकम्- अधिकंनामयन्न्यूनविपरीतं, यद्वाऽऽयुर्वेदेभाष्यमाणेबार्हस्पत्यमौशनसमन्यद्वायत्किञ्चिदप्रतिसम्बद्धार्थमुच्यते, यद्वासम्बद्धार्थमपिद्विरभिधीयतेतत्पुनरुक्तदोषत्वादधिकं; तच्चपुनरुक्तंद्विविधम्- अर्थपुनरुक्तं, शब्दपुनरुक्तंच; तत्रार्थपुनरुक्तंयथा- भेषजमौषधंसाधनमिति, शब्दपुनरुक्तंपुनर्भेषजंभेषजमिति| अथानर्थकम्- अनर्थकंनामयद्वचनमक्षरग्राममात्रमेवस्यात्पञ्चवर्गवन्नचार्थतोगृह्यते| अथापार्थकम्- अपार्थकंनामयदर्थवच्चपरस्परेणासंयुज्यमानार्थकं; यथा- चक्र-न(त)क्र-वंश-वज्र-निशाकराइति| अथविरुद्धं- विरुद्धंनामयद्दृष्टान्तसिद्धान्तसमयैर्विरुद्धं; तत्रपूर्वंदृष्टान्तसिद्धान्तावुक्तौःसमयःपुनस्त्रिधाभवति; यथा- आयुर्वैदिकसमयः, याज्ञिकसमयः, मोक्षशास्त्रिकसमयश्चेति; तत्रायुर्वैदिकसमयः- चतुष्पादंभेषजमिति, याज्ञिकसमयः- आलभ्यायजमानैःपशवइति, मोक्षशास्त्रिकसमयः- सर्वभूतेष्वहिंसेति; तत्रस्वसमयविपरीतमुच्यमानंविरुद्धंभवति| इतिवाक्यदोषाः||५४||
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atha vākyadōṣaḥ- vākyadōṣō nāma yathā khalvasminnarthē nyūnam, adhikam, anarthakam, apārthakaṁ, viruddhaṁ cēti; ētāni hyantarēṇa na prakr̥tō'rthaḥ praṇaśayēt| tatra nyūnaṁ- pratijñāhētūdāharaṇōpanayanigamanānāmanyatamēnāpi nyūnaṁ nyūnaṁ bhavati; yadvā bahūpadiṣṭahētukamēkēna hētunā sādhyatē tacca nyūnam| athādhikam- adhikaṁ nāma yannyūnaviparītaṁ, yadvā yurvēdē bhāṣyamāṇē bārhaspatyamauśanasamanyadvā yatkiñcidapratisambaddhārthamucyatē, yadvā sambaddhārthamapi dvirabhidhīyatē tat punaruktadōṣatvādadhikaṁ; tacca punaruktaṁ dvividham- arthapunaruktaṁ, śabdapunaruktaṁ ca; tatrārthapunaruktaṁ yathā- bhēṣajamauṣadhaṁ sādhanamiti, śabdapunaruktaṁ punarbhēṣajaṁ bhēṣajamiti| athānarthakam- anarthakaṁ nāma yadvacanamakṣaragrāmamātramēva syāt pañcavargavanna cārthatō gr̥hyatē| athāpārthakam- apārthakaṁ nāma yadarthavacca parasparēṇāsaṁyujyamānārthakaṁ; yathā- cakra-na(ta)kra-vaṁśa-vajra-niśākarā iti| atha viruddhaṁ- viruddhaṁ nāma yaddr̥ṣṭāntasiddhāntasamayairviruddhaṁ; tatra pūrvaṁ dr̥ṣṭāntasiddhāntāvuktauḥ samayaḥ punastridhā bhavati; yathā- āyurvaidikasamayaḥ, yājñikasamayaḥ, mōkṣaśāstrikasamayaścēti; tatrāyurvaidikasamayaḥ- catuṣpādaṁ bhēṣajamiti, yājñikasamayaḥ- ālabhyā yajamānaiḥ paśava iti, mōkṣaśāstrikasamayaḥ- sarvabhūtēṣvahiṁsēti; tatra svasamayaviparītamucyamānaṁ viruddhaṁ bhavati| iti vākyadōṣāḥ||54||

atha vAkyadoShaH- vAkyadoSho nAma yathA khalvasminnarthe nyUnam, adhikam, anarthakam,apArthakaM, viruddhaM ceti; etAni hyantareNa na prakRuto~arthaH praNashayet|
tatra nyUnaM- pratij~jAhetUdAharaNopanayanigamanAnAmanyatamenApi nyUnaM nyUnaM bhavati;yadvA bahUpadiShTahetukamekena hetunA sAdhyate tacca nyUnam|
athAdhikam- adhikaM nAma yannyUnaviparItaM, yadvA~a~ayurvede bhAShyamANebArhaspatyamaushanasamanyadvA yatki~jcidapratisambaddhArthamucyate, yadvA sambaddhArthamapidvirabhidhIyate tat punaruktadoShatvAdadhikaM; tacca punaruktaM dvividham- arthapunaruktaM,shabdapunaruktaM ca; tatrArthapunaruktaM yathA- bheShajamauShadhaM sAdhanamiti,shabdapunaruktaM punarbheShajaM bheShajamiti|
athAnarthakam- anarthakaM nAma yadvacanamakSharagrAmamAtrameva syAt pa~jcavargavannacArthato gRuhyate|
athApArthakam- apArthakaM nAma yadarthavacca paraspareNAsaMyujyamAnArthakaM; yathA- cakra-na(ta)kra-vaMsha-vajra-nishAkarA iti|
atha viruddhaM- viruddhaM nAma yaddRuShTAntasiddhAntasamayairviruddhaM; tatra pUrvaMdRuShTAntasiddhAntAvuktauH samayaH punastridhA bhavati; yathA- AyurvaidikasamayaH,yAj~jikasamayaH, mokShashAstrikasamayashceti; tatrAyurvaidikasamayaH- catuShpAdaM bheShajamiti,yAj~jikasamayaH- AlabhyA yajamAnaiH pashava iti, mokShashAstrikasamayaH- sarvabhUteShvahiMseti;tatra svasamayaviparItamucyamAnaM viruddhaM bhavati|
iti vAkyadoShAH||54||
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<div style="text-align:justify;">
''Vakyadosha'' (syntactical defects), in this context, is of five types – ''nyunam, adhikam, anarthakam, aparthakam, viruddham''. Without these there is no damage to the contextual sense.

#''Nyunam'' (semantic deficiency) such as – if there is lack of even one of the five – proposition (''pratijna''), reason (''hetu''), instance (''udaharan''), correlation (''upanaya'') and conclusion (''nigaman'') or if there be many reasons and only one reason is resorted to for proving something than it is defined as ''nyunam''.
#Adhikam (superfluity) is just contrary to nyunam such as while talking about [[Ayurveda]] one says about some irrelevant texts such as that composed by Barhaspatyam or Aushana or even if relevant it is repeated unnecessarily than the repetition (''punarikti'') also comes under ''adhikam'' (superfluity). Repetition (''punarikta'') is of two types – ''arthapunaruktam'' (semantic repetition) and ''shabdapunaruktam'' (verbal repetition). The former (''arthapunaruktam'') consists of the repetition of the same idea by different synonymous words such as ''bheshajam, aushadham'' and ''sadhanam'' and the repetition of the same word such as, ''bheshaja'' is called as ''shabdapunaruktam''.
#''Anarthakam'' (nonessential statement) is that where there is only jumble of alphabets devoid of any sense. ''Aparthakam'' is deprivation of meaning due to lack of mutual connection of otherwise meaningful words such as, ''chakra-na(ta)kra-vamsha-vajra-nishakara''.
#''Viruddham''(Incongruity) is considered in relation to instance (''drishtanta''), theory (''siddhanta'') and convention (''samaya'').

Instance (''drishtanta'') and theory have already been described earlier.

Now convention (''samaya'') is of three types – ''Ayurvedic samaya, yajnika samaya,'' (ritual) and ethical (''mokshashastrika''). Ayurvedic ''samaya'' (ayurvedic convention) such as four aspects of health care, ''yajnika samaya'' (ritual convention) such as animals are to be sacrificed by persons following rituals, ''mokshashastrika'' (ethical convention) such as non-violence towards all creatures. The statement incongruous in respect of the respective convention is taken as ''viruddha'' (incongruity). Thus are the ''vakyadosha'' (syntactical defects).[54]
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====34.''Vakyaprashamsa'' (syntactical excellence) ====
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अथवाक्यप्रशंसा- वाक्यप्रशंसानामयथाखल्वस्मिन्नर्थेत्वन्यूनम्, अनधिकम्, अर्थवत्, अनपार्थकम्, अविरुद्धम्, अधिगतपदार्थंचेतियत्तद्वाक्यमननुयोज्यमितिप्रशस्यते||५५||
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atha vākyapraśaṁsā- vākyapraśaṁsā nāma yathā khalvasminnarthē tvanyūnam, anadhikam, arthavat, anapārthakam, aviruddham, adhigatapadārthaṁ cēti yattadvākyamananuyōjyamiti praśasyatē||55||

atha vAkyaprashaMsA- vAkyaprashaMsA nAma yathA khalvasminnarthe tvanyUnam, anadhikam, arthavat, anapArthakam, aviruddham, adhigatapadArthaM ceti yattadvAkyamananuyojyamiti prashasyate||55||
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''Vakyaprashamsa'' (syntactical excellence) is that where the statement is free from deficiency (''anyunam'') and superfluity (''anadhikam''), is meaningful (''arthavat''), devoid of deprivation of meaning (''anaparthaka'') and incongruity (''aviruddham'') and comprehensible (''adhigatapadartham''). Further there is no room for any question. Such statement is commended. [55]
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==== 35. ''Chhala'' (knavery) ====
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अथच्छलं- छलंनामपरिशठमर्थाभासमनर्थकंवाग्वस्तुमात्रमेव| तद्द्विविधं- वाक्छलं, सामान्यच्छलंच| तत्रवाक्छलंनामयथा- कश्चिद्ब्रूयात्- नवतन्त्रोऽयंभिषगिति, अथभिषग्ब्रूयात्- नाहंनवतन्त्रएकतन्त्रोऽहमिति; परोब्रूयात्- नाहंब्रवीमिनवतन्त्राणितवेति, अपितुनवाभ्यस्तंतेतन्त्रमिति; भिषक्ब्रूयात्- नमयानवाभ्यस्तंतन्त्रम्, अनेकधाऽभ्यस्तंमयातन्त्रमिति; एतद्वाक्छलम्| सामान्यच्छलंनामयथा- व्याधिप्रशमनायौषधमित्युक्ते, परोब्रूयात्- सत्सत्प्रशमनायेतिकिंनुभवानाह; सन्हिरोगः, सदौषधं; यदिचसत्सत्प्रशमनायभवति, तत्रसत्कासः, सत्क्षयः, सत्सामान्यात्कासस्तेक्षयप्रशमनायभविष्यतीति|
एतत्सामान्यच्छलम्||५६||
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atha chhalaṁ- chalaṁ nāma pariśaṭhamarthābhāsamanarthakaṁ vāgvastumātramēva| taddvividhaṁ- vākchalaṁ, sāmānyacchalaṁ ca| tatra vākchalaṁ nāma yathā- kaścidbrūyāt- navatantrō'yaṁ bhiṣagiti, atha bhiṣag brūyāt- nāhaṁ navatantra ēkatantrō'hamiti; parō brūyāt- nāhaṁ bravīmi nava tantrāṇi tavēti, api tu navābhyastaṁ tē tantramiti; bhiṣak brūyāt- na mayā navābhyastaṁ tantram, anēkadhā'bhyastaṁ mayā tantramiti; ētadvākchalam| sāmānyacchalaṁ nāma yathā- vyādhipraśamanāyauṣadhamityuktē, parō brūyāt- sat satpraśamanāyēti kiṁ nu bhavānāha; san hi rōgaḥ, sadauṣadhaṁ; yadi ca sat satpraśamanāya bhavati, tatra sat kāsaḥ, sat kṣayaḥ, satsāmānyāt kāsastē kṣayapraśamanāya bhaviṣyatīti| ētat sāmānyacchalam||56||

atha cchalaM- chalaM nAma parishaThamarthAbhAsamanarthakaM vAgvastumAtrameva|
taddvividhaM- vAkchalaM, sAmAnyacchalaM ca|
tatra vAkchalaM nAma yathA- kashcidbrUyAt- navatantro~ayaM bhiShagiti, atha bhiShag brUyAt- nAhaMnavatantra ekatantro~ahamiti; paro brUyAt- nAhaM bravImi nava tantrANi taveti, api tu navAbhyastaM tetantramiti; bhiShak brUyAt- na mayA navAbhyastaM tantram, anekadhA~abhyastaM mayA tantramiti;etadvAkchalam|
sAmAnyacchalaM nAma yathA- vyAdhiprashamanAyauShadhamityukte, paro brUyAt- satsatprashamanAyeti kiM nu bhavAnAha; san hi rogaH, sadauShadhaM; yadi ca sat satprashamanAyabhavati, tatra sat kAsaH, sat kShayaH, satsAmAnyAt kAsaste kShayaprashamanAya bhaviShyatIti|
etat sAmAnyacchalam||56||
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''Chhala'' is only a jugglery of words in which the words are used knavishly, with apparent meaning or without meaning. This is of two types – ''vakchchalam'' and ''samanyachhala.''

''Vakchhala'' (verbal knavery), such as – if somebody says – this physician is ''navatantra'', then the physician retorts – I have not studied nine texts but only one ''tantra''. Opponent if replies that I do not mean you have read nine ''tantra'' but you are new in this field. On this the physician says – I have not practiced the text nine times but many times. This is verbal knavery.

''Samanya chhala'' (knavery in general), such as – when somebody says – medicament is for alleviating the disease. The other says – how do you say the existent is for alleviating the existent because disease is existent and also the medicament, if the existent is capable of alleviating the existent, then both cough and wasting being existent, cough may be able to alleviate wasting. This is a knavery in general. [56]
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==== 36. ''Ahetu'' (fallacious reason) ====
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अथाहेतुः- अहेतुर्नामप्रकरणसमः, संशयसमः, वर्ण्यसमश्चेति| तत्रप्रकरणसमोनामाहेतुर्यथा- अन्यःशरीरादात्मानित्यइति; परोब्रूयात्- यस्मादन्यःशरीरादात्मा, तस्मान्नित्यः; शरीरंह्यनित्यमतोविधर्मिणाचात्मनाभवितव्यमित्येषचाहेतुः; नहियएवपक्षःसएवहेतुरिति| संशयसमोनामाहेतुर्यएवसंशयहेतुःसएवसंशयच्छेदहेतुः; यथा- अयमायुर्वेदैकदेशमाह, किन्न्वयंचिकित्सकःस्यान्नवेतिसंशयेपरोब्रूयात्- यस्मादयमायुर्वेदैकदेशमाहतस्माच्चिकित्सकोऽयमिति, नचसंशयच्छेदहेतुंविशेषयति, एषचाहेतुः; नहियएवसंशयहेतुः, सएवसंशयच्छेदहेतुर्भवति| वर्ण्यसमोनामाहेतुः- योहेतुर्वर्ण्याविशिष्टः; यथा- कश्चिद्बूयात्- अस्पर्शत्वाद्बुद्धिरनित्याशब्दवदिति; अत्रवर्ण्यःशब्दोबुद्धिरपिवर्ण्या, तदुभयवर्ण्याविशिष्टत्वाद्वर्ण्यसमोऽप्यहेतुः||५७||
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athāhētuḥ- ahēturnāmaprakaraṇasamaḥ, saṁśayasamaḥ, varṇyasamaścēti| tatra prakaraṇasamō nāmāhēturyathā- anyaḥ śarīrādātmā nitya iti; parō brūyāt- yasmādanyaḥ śarīrādātmā, tasmānnityaḥ; śarīraṁ hyanityamatō vidharmiṇā cātmanā bhavitavyamityēṣa cāhētuḥ; nahi ya ēva pakṣaḥ sa ēva hēturiti| saṁśayasamō nāmāhēturya ēva saṁśayahētuḥ sa ēva saṁśayacchēdahētuḥ; yathā- ayamāyurvēdaikadēśamāha, kinnvayaṁ cikitsakaḥ syānna vēti saṁśayē parō brūyāt- yasmādayamāyurvēdaikadēśamāha tasmāccikitsakō'yamiti, na ca saṁśayacchēdahētuṁ viśēṣayati, ēṣa cāhētuḥ; na hi ya ēva saṁśayahētuḥ, sa ēva saṁśayacchēdahēturbhavati| varṇyasamō nāmāhētuḥ- yō hēturvarṇyāviśiṣṭaḥ; yathā- kaścidbūyāt- asparśatvādbuddhiranityā śabdavaditi; atra varṇyaḥ śabdō buddhirapi varṇyā, tadubhayavarṇyāviśiṣṭatvādvarṇyasamō'pyahētuḥ||57||

athAhetuH- aheturnAmaprakaraNasamaH, saMshayasamaH, varNyasamashceti|
tatra prakaraNasamo nAmAheturyathA- anyaH sharIrAdAtmA nitya iti; paro brUyAt- yasmAdanyaHsharIrAdAtmA, tasmAnnityaH; sharIraM hyanityamato vidharmiNA cAtmanA [1] bhavitavyamityeShacAhetuH; nahi ya eva pakShaH sa eva heturiti|
saMshayasamo nAmAheturya eva saMshayahetuH sa eva saMshayacchedahetuH; yathA-ayam[[Ayurveda]]ikadeshamAha, kinnvayaM cikitsakaH syAnna veti saMshaye paro brUyAt-yasmAdayam[[Ayurveda]]ikadeshamAha tasmAccikitsako~ayamiti, na ca saMshayacchedahetuMvisheShayati, eSha cAhetuH; na hi ya eva saMshayahetuH, sa eva saMshayacchedaheturbhavati|
varNyasamo nAmAhetuH- yo heturvarNyAvishiShTaH; yathA- kashcidbUyAt- asparshatvAdbuddhiranityAshabdavaditi; atra varNyaH shabdo buddhirapi varNyA,tadubhayavarNyAvishiShTatvAdvarNyasamo~apyahetuH||57||
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<div style="text-align:justify;">
''Ahetu'' is of three types – ''prakaranasamah, samshayasamaḥ, varnyasama''.

''Prakaranasama ahetu'' is like saying – ‘the ''atma'' (soul) other than the body is eternal.’ On this opponent says that ‘because the self is other than the body, it is eternal, then as the body is non-eternal the dissimilar self must be eternal. This is ''ahetu'' (fallacious reason) because here the ''paksha'' (minor term) itself has been used as reason.

''Samshayasama ahetu'' the reason similar to doubt is that which though being cause of doubt is used as cause of eliminating the same such as, if someone says only a part of [[Ayurveda]] , it creates doubt as to whether he is a physician or not; On this opponent says – ‘as he has said a part of [[Ayurveda]], he is a physician.’ The doubt can not be the cause of removing the same.

''Varnyasam ahetu''- the reason (''hetu'') given is similar to object and not different from the object, such as somebody says – ''buddhi'' (intellect) is non-eternal because of the absence of touch like ''shabda'' (sound). Here both ''buddhi'' (intellect) and ''shabda'' (sound)are objects; hence because of the absence of difference between them, the reason is similar to object and as such is fallacious.[57]
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==== 37. ''Atitakala'' (delayed performance) ====
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अथातीतकालम्- अतीतकालंनामयत्पूर्वंवाच्यंतत्पश्चादुच्यते, तत्कालातीतत्वादग्राह्यंभवतीति; पूर्वंवानिग्रहप्राप्तमनिगृह्यपरिगृह्यपक्षान्तरितंपश्चान्निगृहीते, तत्तस्यातीतकालत्वान्निग्रहवचनमसमर्थंभवतीति||५८||
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athātītakālam- atītakālaṁ nāma yat pūrvaṁ vācyaṁ tat paścāducyatē, tat kālātītatvādagrāhyaṁ bhavatīti; pūrvaṁ vā nigrahaprāptamanigr̥hya parigr̥hya pakṣāntaritaṁ paścānnigr̥hītē, tattasyātītakālatvānnigrahavacanamasamarthaṁ bhavatīti||58||

athAtItakAlam- atItakAlaM nAma yat pUrvaM vAcyaM tat pashcAducyate, tat kAlAtItatvAdagrAhyaMbhavatIti; pUrvaM [1] vA nigrahaprAptamanigRuhya parigRuhya pakShAntaritaM pashcAnnigRuhIte,tattasyAtItakAlatvAnnigrahavacanamasamarthaM bhavatIti||58||
</div></div>

<div style="text-align:justify;">
''Atitakala'' is that which actually was to be said earlier but is said later, and because of delayed presentation becomes unacceptable. For instance, if somebody does not defeat the opponent at the opportune moment but applies it on some other point later on, then, because of delayed application that becomes quite ineffective. [58]
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==== 38. ''Upalambha'' (pointing defects in causality) ====
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अथोपालम्भः- उपालम्भोनामहेतोर्दोषवचनं; यथा- पूर्वमहेतवोहेत्वाभासाव्याख्याताः||५९||
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athōpālambhaḥ- upālambhō nāma hētōrdōṣavacanaṁ; yathā- pūrvamahētavō hētvābhāsā vyākhyātāḥ||59||

athopAlambhaH- upAlambho nAma hetordoShavacanaM; yathA- pUrvamahetavo hetvAbhAsAvyAkhyAtAH||59||
</div></div>

''Upalambha'' is pointing out defects in causality as explained earlier under the heading ''hetu'' fallacious or apparent reason which is unable to prove the ''sadhya''.[59]

==== 39. ''Parihara'' (refuting defects) ====
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अथपरिहारः- परिहारोनामतस्यैवदोषवचनस्यपरिहरणं; यथा- नित्यमात्मनिशरीरस्थेजीवलिङ्गान्युपलभ्यन्ते, तस्यचापगमान्नोपलभ्यन्ते, तस्मादन्यःशरीरादात्मानित्यश्चेति||६०||
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atha parihāraḥ- parihārō nāma tasyaiva dōṣavacanasya pariharaṇaṁ; yathā- nityamātmani śarīrasthē jīvaliṅgānyupalabhyantē, tasya cāpagamānnōpalabhyantē, tasmādanyaḥ arīrādātmā nityaścēti||60||

atha parihAraH- parihAro nAma tasyaiva doShavacanasya pariharaNaM; yathA- nityamAtmani sharIrasthejIvali~ggAnyupalabhyante, tasya cApagamAnnopalabhyante, tasmAdanyaH sharIrAdAtmAnityashceti||60||
</div></div>

''Parihara'' is refuting the above points out of defects, such as the signs of life are available constantly till the life is in the body, and are not available after it goes out. Therefore, the ''atma'' (self) is different from the body and is eternal.[60]

==== 40. ''Pratijnahani'' (change of proposition) ====
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अथप्रतिज्ञाहानिः- प्रतिज्ञाहानिर्नामसापूर्वपरिगृहीतांप्रतिज्ञांपर्यनुयुक्तोयत्परित्यजति, यथाप्राक्प्रतिज्ञांकृत्वानित्यःपुरुषइति, पर्यनुयुक्तस्त्वाह- अनित्यइति||६१||
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atha pratijñāhāniḥ- pratijñāhānirnāma sā pūrvaparigr̥hītāṁ pratijñāṁ paryanuyuktō yat parityajati, yathā prāk pratijñāṁ kr̥tvā nityaḥ puruṣa iti, paryanuyuktastvāha- anitya iti||61||

atha pratij~jAhAniH- pratij~jAhAnirnAma sA pUrvaparigRuhItAM pratij~jAM paryanuyukto yat parityajati,yathA prAk pratij~jAM kRutvA nityaH puruSha iti, paryanuyuktastvAha- anitya iti||61||
</div></div>

<div style="text-align:justify;">
''Pratijnahani'' is defined as when one gives up the original proposition after having been questioned. For instance, somebody puts proposition in the beginning as, the self (''purusha'') is eternal, but when questioned says that it is non-eternal then such change of proposition after questioning is called as ''Pratijnahani''.[61]
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==== 41. ''Abhyanujna'' (acceptance) ====
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अथाभ्यनुज्ञा- अभ्यनुज्ञानामसायइष्टानिष्टाभ्युपगमः||६२||
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athābhyanujñā- abhyanujñā nāma sā ya iṣṭāniṣṭābhyupagamaḥ||62||

athAbhyanuj~jA- abhyanuj~jA nAma sA ya iShTAniShTAbhyupagamaH||62||
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''Abhyanujna'' is acceptance of the desired as well as the undesired situations.[62]

==== 42. ''Hetvantara'' (change in statement of cause) ====
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अथहेत्वन्तरं- हेत्वन्तरंनामप्रकृतहेतौवाच्येयद्विकृतहेतुमाह||६३||
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atha hētvantaraṁ- hētvantaraṁ nāma prakr̥tahētau vācyē yadvikr̥tahētumāha||63||

atha hetvantaraM- hetvantaraM nAma prakRutahetau vAcye yadvikRutahetumAha||63||
</div></div>

''Hetvantara'' is that where some imperfect reason (''vikritahetu'') is stated instead of perfect reason (''prakritahetu''). [63]

==== 43. ''Arthantara'' (statement of irrelevant meaning) ====
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अथार्थान्तरम्- अर्थान्तरंनामैकस्मिन्वक्तव्येऽपरंयदाह| यथा- ज्वरलक्षणेवाच्येप्रमेहलक्षणमाह||६४||
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athārthāntaram- arthāntaraṁ nāmaikasmin vaktavyē'paraṁ yadāha| yathā- jvaralakṣaṇē vācyē pramēhalakṣaṇamāha||64||

athArthAntaram- arthAntaraM nAmaikasmin vaktavye~aparaM yadAha|
yathA- jvaralakShaNe vAcye pramehalakShaNamAha||64||
</div></div>

''Arthantara'' is that where some other thing is said instead of the relevant one. For instance, one has to say the symptoms of ''jwara'' (fever) but instead he says those of ''prameha''.[64]

==== 44.''Nigrahasthana'' (stage of defeat and its reasons) ====
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अथनिग्रहस्थानं- निग्रहस्थानंनामपराजयप्राप्तिः; तच्चत्रिरभिहितस्यवाक्यस्यापरिज्ञानंपरिषदिविज्ञानवत्यां, यद्वाअननुयोज्यस्यानुयोगोऽनुयोज्यस्यचाननुयोगः| प्रतिज्ञाहानिः, अभ्यनुज्ञा, कालातीतवचनम्, अहेतुः, न्यूनम्, अधिकं, व्यर्थम्, अनर्थकं, पुनरुक्तं, विरुद्धं, हेत्वन्तरम्, अर्थान्तरंचनिग्रहस्थानम्||६५||
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atha nigrahasthānaṁ- nigrahasthānaṁ nāma parājayaprāptiḥ; tacca trirabhihitasya vākyasyāparijñānaṁ pariṣadi vijñānavatyāṁ, yadvā ananuyōjyasyānuyōgō'nuyōjyasya cānanuyōgaḥ| pratijñāhāniḥ, abhyanujñā, kālātītavacanam, ahētuḥ, nyūnam, adhikaṁ, vyartham, anarthakaṁ, punaruktaṁ, viruddhaṁ, hētvantaram, arthāntaraṁ ca nigrahasthānam||65||

atha nigrahasthAnaM- nigrahasthAnaM nAma parAjayaprAptiH; tacca trirabhihitasya vAkyasyAparij~jAnaMpariShadi vij~jAnavatyAM, yadvA ananuyojyasyAnuyogo~anuyojyasya cAnanuyogaH|
pratij~jAhAniH, abhyanuj~jA, kAlAtItavacanam, ahetuH, nyUnam, adhikaM, vyartham, anarthakaM,punaruktaM, viruddhaM, hetvantaram, arthAntaraM ca nigrahasthAnam||65||
</div></div>

<div style="text-align:justify;">
''Nigrahasthana'' is that by which one is defeated. It consists of not understanding a statement even if repeated thrice in a learned assembly or questioning where it is not pertinent and not questioning where it is pertinent. Over and above, ''pratijnahani, abhyanujna, kalatita vachana, ahetu, nyuna, adhika, vyartha, anarthaka, punarukta, viruddha, hetvantara'' and ''arthantara'' are reasons of defeat.[65]
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इतिवादमार्गपदानियथोद्देशमभिनिर्दिष्टानिभवन्ति||६६||
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iti vādamārgapadāni yathōddēśamabhinirdiṣṭāni bhavanti||66||

iti vAdamArgapadAni yathoddeshamabhinirdiShTAni bhavanti||66||
</div></div>

Thus the terms used in course of debate are explained as proposed.[66]

=== Importance of debate ===
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वादस्तुखलुभिषजांप्रवर्तमानोप्रवर्तेतायुर्वेदएव, नान्यत्र| अत्रहिवाक्यप्रतिवाक्यविस्तराःकेवलाश्चोपपत्तयःसर्वाधिकरणेषु| ताःसर्वाःसमवेक्ष्यावेक्ष्यसर्वंवाक्यंब्रूयात्, नाप्रकृतकमशास्त्रमपरीक्षितमसाधकमाकुलमव्यापकंवा| सर्वंचहेतुमद्ब्रूयात्| हेतुमन्तोह्यकलुषाःसर्वएववादविग्रहाश्चिकित्सितेकारणभूताः, प्रशस्तबुद्धिवर्धकत्वात्; सर्वारम्भसिद्धिंह्यावहत्यनुपहताबुद्धिः||६७||
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vādastu khalu bhiṣajāṁ pravartamānō pravartētāyurvēda ēva, nānyatra| atra hi vākyaprativākyavistarāḥ kēvalāścōpapattayaḥ sarvādhikaraṇēṣu| nāprakr̥takamaśāstramaparīkṣitamasādhakamākulamavyāpakaṁ vā| sarvaṁ ca hētumadbrūyāt| hētumantō hyakaluṣāḥ sarva ēva vādavigrahāścikitsitē kāraṇabhūtāḥ, praśastabuddhivardhakatvāt; sarvārambhasiddhiṁ hyāvahatyanupahatā buddhiḥ||67||

vAdastu khalu bhiShajAM pravartamAno pravartet[[Ayurveda]] eva, nAnyatra|
atra hi vAkyaprativAkyavistarAH kevalAshcopapattayaH sarvAdhikaraNeShu|
tAH sarvAH samavekShyAvekShya sarvaM vAkyaM brUyAt,nAprakRutakamashAstramaparIkShitamasAdhakamAkulamavyApakaM vA|
sarvaM ca hetumadbrUyAt|
hetumanto hyakaluShAH sarva eva vAdavigrahAshcikitsite kAraNabhUtAH, prashastabuddhivardhakatvAt;sarvArambhasiddhiM hyAvahatyanupahatA buddhiH||67||
</div></div>

<div style="text-align:justify;">
The debate among physicians should be held only on [[Ayurveda]] and not on any other topic. Here, in detail the statements and counter-statements and also all the arguments have been mentioned in the entire text. After keeping them in mind one should speak something and not anything which is irrelevant, unscriptural, unexamined, inappropriate, confused and unpervasive. He should speak everything with reasoning. All the conflicts of debate if endowed with reasoning, are devoid of malice and promote the medicine due to its property of enhancing the excellence of intellect, because indefective intellect leads to success in all actions. [67]
</div>

=== Ten means of knowledge for physician ===
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इमानिखलुतावदिहकानिचित्प्रकरणानिभिषजांज्ञानार्थमुपदेक्ष्यामः|
ज्ञानपूर्वकंहिकर्मणांसमारम्भंप्रशंसन्तिकुशलाः| ज्ञात्वाहिकारण-करण-कार्ययोनि-कार्य-कार्यफलानुबन्ध-देश-काल-प्रवृत्त्युपायान्सम्यगभिनिर्वर्तमानःकार्याभिनिर्वृत्ताविष्टफलानुबन्धंकार्यमभिनिर्वर्तयत्यनतिमहतायत्नेनकर्ता||६८||
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imāni khalu tāvadiha kānicit prakaraṇāni bhiṣajāṁ jñānārthamupadēkṣyāmaḥ| jñānapūrvakaṁ hi karmaṇāṁ samārambhaṁ praśaṁsanti kuśalāḥ| jñātvā hi kāraṇa-karaṇa-kāryayōni-kārya-kāryaphalānubandha-dēśa-kāla-pravr̥ttyupāyān samyagabhinirvartamānaḥ kāryābhinirvr̥ttāviṣṭaphalānubandhaṁ kāryamabhinirvartayatyanatimahatā yatnēna kartā||68||

imAni khalu tAvadiha kAnicit prakaraNAni bhiShajAM j~jAnArthamupadekShyAmaH|
j~jAnapUrvakaM hi karmaNAM samArambhaM prashaMsanti kushalAH|
j~jAtvA hi kAraNa-karaNa-kAryayoni-kArya-kAryaphalAnubandha-desha-kAla-pravRuttyupAyAnsamyagabhinirvartamAnaH kAryAbhinirvRuttAviShTaphalAnubandhaM kAryamabhinirvartayatyanatimahatAyatnena kartA||68||
</div></div>

<div style="text-align:justify;">
Now I shall explain some topics for the knowledge of physicians because the wise commend initiation of all actions with prior knowledge. If after knowing well ''karana, karana, karyayoni, karya, karyaphala, anubandha, desha, kala, pravritti'' and ''upaya'' one proceeds for some action, he obtains the desired fruit and subsequent benefit in that without any great effort.[68]
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==== ''Karana'' (cause or doer) ====
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तत्रकारणंनामतद्यत्करोति, सएवहेतुः, सकर्ता||६९||
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tatra kāraṇaṁ nāma tad yat karōti, sa ēva hētuḥ, sa kartā||69||

tatra kAraNaM nAma tad yat [1] karoti, sa eva hetuH, sa kartA||69||
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''Karana'' is defined as the one who does the action, he is the cause and doer.[69]

==== ''Karana'' (means or equipments) ====
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करणंपुनस्तद्यदुपकरणायोपकल्पतेकर्तुःकार्याभिनिर्वृत्तौप्रयतमानस्य||७०||
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karaṇaṁ punastad yadupakaraṇāyōpakalpatē kartuḥ kāryābhinirvr̥ttau prayatamānasya||70||

karaNaM punastad yadupakaraNAyopakalpate kartuH kAryAbhinirvRuttau prayatamAnasya||70||
</div></div>

''Karana'' is that which serves as means or equipment for the ''karana'' (doer) making effort for performing the action.[70]

==== ''Karyayoni'' (source) ====
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कार्ययोनिस्तुसायाविक्रियमाणाकार्यत्वमापद्यते||७१||
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kāryayōnistu sā yā vikriyamāṇā kāryatvamāpadyatē||71||

kAryayonistu sA yA vikriyamANA kAryatvamApadyate||71||
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''Karyayoni'' is that which (intimate cause) is converted into action (''karya'') after transformation. [71]

==== ''Karya'' (action) ====
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कार्यंतुतद्यस्याभिनिर्वृत्तिमभिसन्धायकर्ताप्रवर्तते||७२||
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kāryaṁ tu tadyasyābhinirvr̥ttimabhisandhāya kartā pravartatē||72||

kAryaM tu tadyasyAbhinirvRuttimabhisandhAya kartA pravartate||72||
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''Karya'' is that action which the doer performs with the objective of accomplishment. [72]

==== ''Karyaphala'' (expected outcome) ====
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कार्यफलंपुनस्तद्यत्प्रयोजनाकार्याभिनिर्वृत्तिरिष्यते||७३||
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kāryaphalaṁ punastad yatprayōjanā kāryābhinirvr̥ttiriṣyatē||73||

kAryaphalaM punastad yatprayojanA kAryAbhinirvRuttiriShyate||73||
</div></div>

''Karyaphala'' is the aim (expected outcome) with which the action is performed. [73]

==== ''Anubandha''(consequence) ====
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अनुबन्धःखलुसयःकर्तारमवश्यमनुबध्नाति
कार्यादुत्तरकालंकार्यनिमित्तःशुभोवाऽप्यशुभोभावः||७४||
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anubandhaḥ khalu sa yaḥ kartāramavaśyamanubadhnāti kāryāduttarakālaṁ kāryanimittaḥ śubhō vā'pyaśubhō bhāvaḥ||74||

anubandhaH khalu sa yaH kartAramavashyamanubadhnAti kAryAduttarakAlaM kAryanimittaH shubhovA~apyashubho bhAvaH||74||
</div></div>

''Anubandha'' is that which essentially enjoins the doer as after-effect of the action, good or bad. [74]

==== ''Desha''(place) ====
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देशस्त्वधिष्ठानम्||७५||
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dēśastvadhiṣṭhānam||75||

deshastvadhiShThAnam||75||
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''Desha'' is location/ place.[75]

==== ''Kala'' (time required for transformation) ====
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कालःपुनःपरिणामः||७६||
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kālaḥ punaḥ pariṇāmaḥ||76||

kAlaH punaH pariNAmaH||76||
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''Kala'' is the one which undergoes transformation.[76]

==== ''Pravritti'' (consistent efforts) ====
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प्रवृत्तिस्तुखलुचेष्टाकार्यार्था; सैवक्रिया, कर्म, यत्नः, कार्यसमारम्भश्च||७७||
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pravr̥ttistu khalu cēṣṭā kāryārthā; saiva kriyā, karma, yatnaḥ, kāryasamārambhaśca||77||

pravRuttistu khalu ceShTA kAryArthA; saiva kriyA, karma, yatnaH, kAryasamArambhashca||77||
</div></div>

''Pravritti'' is the effort taken for the accomplishment of objective. This is also known as ''kriya, karma'' (action), ''yatna''(effort), ''karyasamarambha'' (commencement). [77]

==== ''Upaya'' (means of successful management) ====
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उपायःपुनस्त्रयाणांकारणादीनांसौष्ठवमभिविधानंचसम्यक्कार्यकार्यफलानुबन्धवर्ज्यानां, कार्याणामभिनिर्वर्तकइत्यतस्तूपायः ; कृतेनोपायार्थोऽस्ति, नचविद्यतेतदात्वे, कृताच्चोत्तरकालंफलं, फलाच्चानुबन्धइति||७८||
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upāyaḥ punastrayāṇāṁ kāraṇādīnāṁ sauṣṭhavamabhividhānaṁ ca samyak kāryakāryaphalānubandhavarjyānāṁ, kāryāṇāmabhinirvartaka ityatastūpāyaḥ ; kr̥tē nōpāyārthō'sti, na ca vidyatē tadātvē, kr̥tāccōttarakālaṁ phalaṁ, phalāccānubandha iti||78||

upAyaH punastrayANAM kAraNAdInAM sauShThavamabhividhAnaM [1] ca samyakkAryakAryaphalAnubandhavarjyAnAM, kAryANAmabhinirvartaka ityatastUpAyaH [2] ; kRutenopAyArtho~asti, na ca vidyate tadAtve, kRutAccottarakAlaM phalaM, phalAccAnubandha iti||78||
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<div style="text-align:justify;">
''Upaya'' is excellence of the first three factors, ''karana'' etc., and their proper management leaving aside the ''karya, karyaphala'' and ''anubandha''. Procedure leads to performance of an action and thus it is said as ''upaya''. After the action is performed there is no function of procedure nor is it at the time of performance, after action is the result and thereafter consequence.[78]
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=== Importance of ten fold examinations ===
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एतद्दशविधमग्रेपरीक्ष्यं, ततोऽनन्तरंकार्यार्थाप्रवृत्तिरिष्टा| तस्माद्भिषक्कार्यंचिकीर्षुःप्राक्कार्यसमारम्भात्परीक्षयाकेवलंपरीक्ष्यंपरीक्ष्यकर्मसमारभेतकर्तुम्||७९||
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ētaddaśavidhamagrē parīkṣyaṁ, tatō'nantaraṁ kāryārthā pravr̥ttiriṣṭā| tasmādbhiṣak kāryaṁ cikīrṣuḥ prāk kāryasamārambhāt parīkṣayā kēvalaṁ parīkṣyaṁ parīkṣya karma samārabhēta kartum||79||

etaddashavidhamagre parIkShyaM, tato~anantaraM kAryArthA pravRuttiriShTA|
tasmAdbhiShak kAryaM cikIrShuH prAk kAryasamArambhAt parIkShayA kevalaM parIkShyaM parIkShyakarma samArabheta kartum||79||
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These ten entities should be examined first and thereafter one should proceed for action. Hence the physician desirous of taking up action should beforehand examine the entire situation by proper methods and then initiate the action(treatment). [79]

==== Questions for discussion ====
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तत्रचेद्भिषगभिषग्वाभिषजंकश्चिदेवंखलुपृच्छेद्- वमनविरेचनास्थापनानुवासनशिरोविरेचनानिप्रयोक्तुकामेनभिषजाकतिविधयापरीक्षयाकतिविधमेवपरीक्ष्यं, कश्चात्रपरीक्ष्यविशेषः, कथंचपरीक्षितव्यः, किम्प्रयोजनाचपरीक्षा, क्वचवमनादीनांप्रवृत्तिः, क्वचनिवृत्तिः, प्रवृत्तिनिवृत्तिलक्षणसंयोगेचकिंनैष्ठिकं, कानिचवमनादीनांभेषजद्रव्याण्युपयोगंगच्छन्तीति||८०||
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tatra cēdbhiṣagabhiṣagvā bhiṣajaṁ kaścidēvaṁ khalu pr̥cchēd- vamanavirēcanāsthāpanānuvāsanaśirōvirēcanāni prayōktukāmēna bhiṣajā katividhayā parīkṣayā katividhamēva parīkṣyaṁ, kaścātra parīkṣyaviśēṣaḥ, kathaṁ ca parīkṣitavyaḥ, kimprayōjanā ca parīkṣā, kva ca vamanādīnāṁ pravr̥ttiḥ, kva ca nivr̥ttiḥ, pravr̥ttinivr̥ttilakṣaṇasaṁyōgē ca kiṁ naiṣṭhikaṁ, kāni ca vamanādīnāṁ bhēṣajadravyāṇyupayōgaṁ gacchantīti||80||

tatra cedbhiShagabhiShagvA bhiShajaM kashcidevaM khalu pRucched-vamanavirecanAsthApanAnuvAsanashirovirecanAni prayoktukAmena bhiShajA katividhayA parIkShayAkatividhameva parIkShyaM, kashcAtra parIkShyavisheShaH, kathaM ca parIkShitavyaH, kimprayojanA caparIkShA, kva ca vamanAdInAM pravRuttiH, kva ca nivRuttiH, pravRuttinivRuttilakShaNasaMyoge ca kiMnaiShThikaM, kAni ca vamanAdInAM bheShajadravyANyupayogaM gacchantIti||80||
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<div style="text-align:justify;">
There, if some other physician or person asks this physician –“how many types of examination should be adopted by the physician desirous of applying therapeutic emesis, purgation, non-unctuous and unctuous enema and nasal errhines? How many types of entities are to be examined? What are the entities to be examined? How are they to be examined? What is the object of examination? In which condition are emesis etc. purificatory procedures to be applied or contra-indicated? What is to be done in combination of the situations for both application and contra- indication? What drugs are useful for emesis etc.?[80]
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सएवंपृष्टोयदिमोहयितुमिच्छेत्, ब्रूयादेनं- बहुविधाहिपरीक्षातथापरीक्ष्यविधिभेदः, कतमेनविधिभेदप्रकृत्यन्तरेणभिन्नयापरीक्षयाकेनवाविधिभेदप्रकृत्यन्तरेणपरीक्ष्यस्यभिन्नस्यभेदाग्रंभवान्पृच्छत्याख्यायमानं ;नेदानींभवतोऽन्येनविधिभेदप्रकृत्यन्तरेणभिन्नयापरीक्षयाऽन्येनवाविधिभेदप्रकृत्यन्तरेणपरीक्ष्यस्यभिन्नस्याभिलषितमर्थंश्रोतुमहमन्येनपरीक्षाविधिभेदेनान्येनवाविधिभेदप्रकृत्यन्तरेणपरीक्ष्यंभित्त्वाऽ<br>न्यथाऽऽचक्षाणइच्छांपूरयेयमिति||८१||
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sa ēvaṁ pr̥ṣṭō yadi mōhayitumicchēt, brūyādēnaṁ- bahuvidhā hi parīkṣā tathā parīkṣyavidhibhēdaḥ, katamēna vidhibhēdaprakr̥tyantarēṇa bhinnayā parīkṣayā kēna vāvidhibhēdaprakr̥tyantarēṇa parīkṣyasya bhinnasya bhēdāgraṁ bhavān pr̥cchatyākhyāyamānaṁ ; nēdānīṁ bhavatō'nyēna vidhibhēdaprakr̥tyantarēṇa bhinnayā parīkṣayā'nyēna vā vidhibhēdaprakr̥tyantarēṇa parīkṣyasya bhinnasyābhilaṣitamarthaṁ śrōtumahamanyēna parīkṣāvidhibhēdēnānyēna vā vidhibhēdaprakr̥tyantarēṇa parīkṣyaṁ bhittvā'nyathā''cakṣāṇa icchāṁ pūrayēyamiti||81||

sa evaM pRuShTo yadi mohayitumicchet, brUyAdenaM- bahuvidhA hi parIkShA tathAparIkShyavidhibhedaH, katamena vidhibhedaprakRutyantareNa bhinnayA parIkShayA kena vAvidhibhedaprakRutyantareNa parIkShyasya bhinnasya bhedAgraM bhavAn pRucchatyAkhyAyamAnaM [1] ;nedAnIM bhavato~anyena vidhibhedaprakRutyantareNa bhinnayA parIkShayA~anyena vAvidhibhedaprakRutyantareNa parIkShyasya bhinnasyAbhilaShitamarthaM shrotumahamanyenaparIkShAvidhibhedenAnyena vA vidhibhedaprakRutyantareNa parIkShyaMbhittvA~anyathA~a~acakShANa [2] icchAM pUrayeyamiti||81||
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<div style="text-align:justify;">
If he wants to confuse the questioner he should say – there are many types of examination and groups of the types of entities to be examined. Kindly tell me from what point of view grouped examination or entities to be examined you mean, because I can not satisfy you if I explain them taking as grouped from another point of view when, in case, you want to be examined them as grouped from another point of view.[81]
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सयदुत्तरंब्रूयात्तत्समीक्ष्योत्तरंवाच्यंस्याद्यथोक्तंचप्रतिवचनविधिमवेक्ष्य; सम्यक्यदितुब्रूयान्नचैनंमोहयितुमिच्छेत्, प्राप्तंतुवचनकालंमन्येत, काममस्मैब्रूयादाप्तमेवनिखिलेन||८२||
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sa yaduttaraṁ brūyāttat samīkṣyōttaraṁ vācyaṁ syādyathōktaṁ ca prativacanavidhimavēkṣya; samyak yadi tu brūyānna cainaṁ mōhayitumicchēt, prāptaṁ tu vacanakālaṁ manyēta, kāmamasmai brūyādāptamēva nikhilēna||82||

sa yaduttaraM brUyAttat samIkShyottaraM vAcyaM syAdyathoktaM ca prativacanavidhimavekShya;samyak [1] yadi tu brUyAnna cainaM mohayitumicchet, prAptaM tu vacanakAlaM manyeta, kAmamasmaibrUyAdAptameva nikhilena||82||
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<div style="text-align:justify;">
After considering the reply given by opponent, one should analyze and further say according to the method of contradiction. In case, he speaks properly one should not try to confuse him, rather he should explain in detail as explained by the ''apta'' (authority). [82]
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==== Types of examinations ====
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द्विविधातुखलुपरीक्षाज्ञानवतां- प्रत्यक्षम्, अनुमानंच| एतद्धिद्वयमुपदेशश्चपरीक्षास्यात्| एवमेषाद्विविधापरीक्षा, त्रिविधावासहोपदेशेन||८३||
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dvividhā tu khalu parīkṣā jñānavatāṁ- pratyakṣam, anumānaṁ ca| ētaddhi dvayamupadēśaśca parīkṣā syāt| ēvamēṣā dvividhā parīkṣā, trividhā vā sahōpadēśēna||83||

dvividhA tu khalu parIkShA j~jAnavatAM- pratyakSham, anumAnaM ca|
etaddhi dvayamupadeshashca parIkShA syAt|
evameShA dvividhA parIkShA, trividhA vA sahopadeshena||83||
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There are two types of examination for learned persons – direct perception (''pratyaksha'') and inference (''anumana''). These two along with the authoritative instruction constitute the examination. This examination is of two types or of three types including authoritative instruction (''upadesha'').[83]

=== Ten factors for examination in therapeutics ===
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दशविधंतुपरीक्ष्यंकारणादियदुक्तमग्रे, तदिहभिषगादिषुसंसार्यसन्दर्शयिष्यामः- इहकार्यप्राप्तौकारणंभिषक्, करणंपुनर्भेषजं, कार्ययोनिर्धातुवैषम्यं, कार्यंधातुसाम्यं, कार्यफलंसुखावाप्तिः, अनुबन्धःखल्वायुः, देशोभूमिरातुरश्च, कालःपुनःसंवत्सरश्चातुरावस्थाच, प्रवृत्तिःप्रतिकर्मसमारम्भः, उपायस्तुभिषगादीनांसौष्ठवमभिविधानंचसम्यक्| इहाप्यस्योपायस्यविषयःपूर्वेणैवोपायविशेषेणव्याख्यातः| इतिकारणादीनिदशदशसुभिषगादिषुसंसार्यसन्दर्शितानि, तथैवानुपूर्व्यैतद्दशविधंपरीक्ष्यमुक्तंच||८४||
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daśavidhaṁ tu parīkṣyaṁ kāraṇādi yaduktamagrē, tadiha bhiṣagādiṣu saṁsārya sandarśayiṣyāmaḥ- iha kāryaprāptau kāraṇaṁ bhiṣak, karaṇaṁ punarbhēṣajaṁ, kāryayōnirdhātuvaiṣamyaṁ, kāryaṁ dhātusāmyaṁ, kāryaphalaṁ sukhāvāptiḥ, anubandhaḥ khalvāyuḥ, dēśō bhūmirāturaśca, kālaḥ punaḥ saṁvatsaraścāturāvasthā ca, pravr̥ttiḥ pratikarmasamārambhaḥ, upāyastu bhiṣagādīnāṁ sauṣṭhavamabhividhānaṁ ca samyak| ihāpyasyōpāyasya viṣayaḥ pūrvēṇaivōpāyaviśēṣēṇa vyākhyātaḥ| iti kāraṇādīni daśa daśasu bhiṣagādiṣu saṁsārya sandarśitāni, tathaivānupūrvyaitaddaśavidhaṁ parīkṣyamuktaṁ ca||84||

dashavidhaM tu parIkShyaM kAraNAdi yaduktamagre, tadiha bhiShagAdiShu saMsAryasandarshayiShyAmaH- iha kAryaprAptau kAraNaM bhiShak, karaNaM punarbheShajaM,kAryayonirdhAtuvaiShamyaM, kAryaM dhAtusAmyaM, kAryaphalaM sukhAvAptiH, anubandhaH khalvAyuH,desho bhUmirAturashca, kAlaH punaH saMvatsarashcAturAvasthA ca, pravRuttiHpratikarmasamArambhaH, upAyastu bhiShagAdInAM sauShThavamabhividhAnaM [1] ca samyak|
ihApyasyopAyasya viShayaH pUrveNaivopAyavisheSheNa vyAkhyAtaH|
iti kAraNAdIni dasha dashasu bhiShagAdiShu saMsArya sandarshitAni, tathaivAnupUrvyaitaddashavidhaMparIkShyamuktaM ca||84||
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<div style="text-align:justify;">
Previously explained ''karana'' etc. ten entities are elaborately discussed in relation to specific features of therapeutics diseases ten entities are to be examined such as physician acts like a doer (''karana''),drugs act like instrument (''karan''), imbalance of ''dhatu'' (''karyayoni''), balance of ''dhatu'' (''karya''), attainment of health and happiness (''karyaphala''), life-span (''anubandha''), land as well as patient (''desha''), year and phase of disease (''kala''), initiation of therapy (''pravritti'') and excellence of physician etc. and proper management (''upaya'').[84]
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तस्ययोयोविशेषोयथायथाचपरीक्षितव्यः, सतथातथाव्याख्यास्यते||८५||
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tasya yō yō viśēṣō yathā yathā ca parīkṣitavyaḥ, sa tathā tathā vyākhyāsyatē||85||

tasya yo yo visheSho [1] yathA yathA ca parIkShitavyaH, sa tathA tathA vyAkhyAsyate||85||
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So, these entities should be specifically examined with great emphasis.[85]

==== Assessment of physician and qualities of good physician ====
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कारणंभिषगित्युक्तमग्रे, तस्यपरीक्षा- भिषङ्नामयोभिषज्यति, यःसूत्रार्थप्रयोगकुशलः, यस्यचायुःसर्वथाविदितंयथावत्| सचसर्वधातुसाम्यंचिकीर्षन्नात्मानमेवादितःपरीक्षेतगुणिषुगुणतःकार्याभिनिर्वृत्तिंपश्यन्, कच्चिदहमस्यकार्यस्याभिनिर्वर्तनेसमर्थोनवेति; तत्रेमेभिषग्गुणायैरुपपन्नोभिषग्धातुसाम्याभिनिर्वर्तनेसमर्थोभवति; तद्यथा- पर्यवदातश्रुतता, परिदृष्टकर्मता, दाक्ष्यं, शौचं, जितहस्तता, उपकरणवत्ता, सर्वेन्द्रियोपपन्नता, प्रकृतिज्ञता, प्रतिपत्तिज्ञाताचेति||८६||
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kāraṇaṁ bhiṣagityuktamagrē, tasya parīkṣā- bhiṣaṅnāma yō bhiṣajyati, yaḥ sūtrārthaprayōgakuśalaḥ, yasya cāyuḥ sarvathā viditaṁ yathāvat| sa ca sarvadhātusāmyaṁ cikīrṣannātmānamēvāditaḥ parīkṣēta guṇiṣu guṇataḥ kāryābhinirvr̥ttiṁ paśyan, kaccidahamasya kāryasyābhinirvartanē samarthō na vēti; tatrēmē bhiṣagguṇā yairupapannō bhiṣagdhātusāmyābhinirvartanē samarthō bhavati; tadyathā- paryavadātaśrutatā, paridr̥ṣṭakarmatā, dākṣyaṁ, śaucaṁ, jitahastatā, upakaraṇavattā, sarvēndriyōpapannatā, prakr̥tijñatā, pratipattijñātā cēti||86||

kAraNaM bhiShagityuktamagre, tasya parIkShA- bhiSha~gnAma yo bhiShajyati, yaHsUtrArthaprayogakushalaH, yasya cAyuH sarvathA viditaM yathAvat|
sa ca sarvadhAtusAmyaM cikIrShannAtmAnamevAditaH parIkSheta guNiShu guNataH kAryAbhinirvRuttiMpashyan, kaccidahamasya kAryasyAbhinirvartane samartho na veti; tatreme bhiShagguNA yairupapannobhiShagdhAtusAmyAbhinirvartane samartho bhavati; tadyathA- paryavadAtashrutatA,paridRuShTakarmatA, dAkShyaM, shaucaM, jitahastatA, upakaraNavattA, sarvendriyopapannatA,prakRutij~jatA, pratipattij~jAtA ceti||86||
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<div style="text-align:justify;">
Earlier, physician has been mentioned as doer (''karana''). ''Bhishak'' is the one who should be able to win over the diseases and expert in applying the ideas of the aphorisms and knows the pros and cons of life (science) properly from all aspects. He should know how to bring about balance between ''dhatus'' (''dhatu samya''), must be learned, trained in scriptures and qualified enough for the same and has received practical training and expertise in duties. He should be introspective, desirous of maintaining balance of all ''dhatus'', considering the consequence of treatment in appropriate patients, with proper qualities of management, with due considerations of one’s own capabilities and limitations.

The physician endowed with the following qualities is capable of bringing forth the equilibrium of ''dhatus'': clear scientific knowledge , practical knowledge, alert, purity, skill, and possession of all required equipment, with proper sense perceptions (all sense and motor organs), acquaintance with human constitution and the knowledge of the course of action. [86]
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==== Assessment of medicine and categories ====
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करणंपुनर्भेषजम्| भेषजंनामतद्यदुपकरणायोपकल्पतेभिषजोधातुसाम्याभिनिर्वृत्तौप्रयतमानस्यविशेषतश्चोपायान्तेभ्यः| तद्द्विविधंव्यपाश्रयभेदात्- दैवव्यपाश्रयं, युक्तिव्यपाश्रयंचेति|तत्रदैवव्यपाश्रयंमन्त्रौषधिमणिमङ्गलबल्युपहारहोमनियमप्रायश्चित्तोपवासस्वस्त्ययनप्रणिपातगमनादि, युक्तिव्यपाश्रयं- संशोधनोपशमनेचेष्टाश्चदृष्टफलाः| एतच्चैवभेषजमङ्गभेदादपिद्विविधं- द्रव्यभूतमः, अद्रव्यभूतंच| तत्रयदद्रव्यभूतंतदुपायाभिप्लुतम्| उपायोनामभयदर्शनविस्मापनविस्मारणक्षोभणहर्षणभर्त्सनवधबन्धस्वप्नसंवाहनादिरमूर्तोभावविशेषोयथोक्ताःसिद्ध्युपायाश्चोपायाभिप्लुताइति| यत्तुद्रव्यभूतंतद्वमनादिषुयोगमुपैति| तस्यापीयंपरीक्षा- इदमेवम्प्रकृत्यैवङ्गुणमेवम्प्रभावमस्मिन्देशेजातमस्मिन्नृतावेवंगृहीतमेवंनिहितमेवमुपस्कृतमनयाचमात्रयायुक्तमस्मिन्व्याधावेवंविधस्यपुरुषस्यैवतावन्तंदोषमपकर्षत्युपशमयतिवा, यदन्यदपिचैवंविधंभेषजंभवेत्तच्चानेनविशेषेणयुक्तमिति||८७||
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karaṇaṁ punarbhēṣajam|bhēṣajaṁ nāma tadyadupakaraṇāyōpakalpatē bhiṣajō dhātusāmyābhinirvr̥ttau prayatamānasya viśēṣataścōpāyāntēbhyaḥ| taddvividhaṁ vyapāśrayabhēdāt- daivavyapāśrayaṁ, yuktivyapāśrayaṁ cēti| tatra daivavyapāśrayaṁ- mantrauṣadhimaṇimaṅgalabalyupahārahōmaniyamaprāyaścittōpavāsasvastyayanapraṇipātagamanādi, yuktivyapāśrayaṁ- saṁśōdhanōpaśamanē cēṣṭāśca dr̥ṣṭaphalāḥ| ētaccaiva bhēṣajamaṅgabhēdādapi dvividhaṁ- dravyabhūtamḥ, adravyabhūtaṁ ca| tatra yadadravyabhūtaṁ tadupāyābhiplutam| upāyō nāma bhayadarśanavismāpanavismāraṇakṣōbhaṇaharṣaṇabhartsanavadhabandhasvapnasaṁvāhanādiramūrtō bhāvaviśēṣō yathōktāḥ siddhyupāyāścōpāyābhiplutā iti| yattu dravyabhūtaṁ tadvamanādiṣu yōgamupaiti| tasyāpīyaṁ parīkṣā- idamēvamprakr̥tyaivaṅguṇamēvamprabhāvamasmin dēśē jātamasminnr̥tāvēvaṁ gr̥hītamēvaṁ nihitamēvamupaskr̥tamanayā ca mātrayā yuktamasmin vyādhāvēvaṁvidhasya puruṣasyaivatāvantaṁ dōṣamapakarṣatyupaśamayati vā, yadanyadapi caivaṁvidhaṁ bhēṣajaṁ bhavēttaccānēna viśēṣēṇa yuktamiti||87||

karaNaM punarbheShajam|
bheShajaM nAma tadyadupakaraNAyopakalpate bhiShajo dhAtusAmyAbhinirvRuttau prayatamAnasyavisheShatashcopAyAntebhyaH|
taddvividhaM vyapAshrayabhedAt- daivavyapAshrayaM, yuktivyapAshrayaM ceti|
tatra daivavyapAshrayaM-mantrauShadhimaNima~ggalabalyupahArahomaniyamaprAyashcittopavAsasvastyayanapraNipAtagamanAdi,yuktivyapAshrayaM- saMshodhanopashamane ceShTAshca dRuShTaphalAH|
etaccaiva bheShajama~ggabhedAdapi dvividhaM- dravyabhUtamH, adravyabhUtaM ca|
tatra yadadravyabhUtaM tadupAyAbhiplutam|
upAyo nAmabhayadarshanavismApanavismAraNakShobhaNaharShaNabhartsanavadhabandhasvapnasaMvAhanAdiramUrtobhAvavisheSho yathoktAH siddhyupAyAshcopAyAbhiplutA [1] iti|
yattu dravyabhUtaM tadvamanAdiShu yogamupaiti|
tasyApIyaM parIkShA- idamevamprakRutyaiva~gguNamevamprabhAvamasmin deshejAtamasminnRutAvevaM gRuhItamevaM nihitamevamupaskRutamanayA ca mAtrayA yuktamasminvyAdhAvevaMvidhasya puruShasyaivatAvantaM doShamapakarShatyupashamayati vA, yadanyadapicaivaMvidhaM bheShajaM bhavettaccAnena [2] visheSheNa yuktamiti||87||
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The medicament has been mentioned here as instrument (''karana'') which serves as equipment for the physician making effort for effective balance of ''dhatus'' particularly different from the entities ending with procedure (original source, inclination, place, time and procedure). In view of agents applied medicament or therapy is advocated as of two types – spiritual (''daivavyapashraya'') and rational (''yuktivyapashayam'').

In spiritual therapy, incantation, roots, gems, auspicious rites, expiation, fasting, blessings, bowing, visit to temples(sacred places) etc. are employed.

In rational therapy, evacuative and pacifying measures as well as fruitful activities are employed. According to form of medicament, it is again of two types – material and non-material. The non-material therapy includes drug less therapies (''upayas''). ''Upaya'' means formless entity like terrorizing, creating surprise, forgetfulness, agitation, exhilaration, hiding, threatening for murder, binding, inducing sleep, gentle massage etc. It also includes the aforesaid means of treatment. The material therapy consists of drugs which are used for emesis etc.

The drugs are examined in respect of nature (natural composition), properties, action, habit, time and mode of collection, storage, processing dosage, indication for use, the constitution of patient and the effect on disorder whether eliminates it or pacifies it, any other drug of this type should have the same characters.[87]
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==== Assessment of disequilibrium of ''dhatu'' ====
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कार्ययोनिर्धातुवैषम्यं, तस्यलक्षणंविकारागमः| परीक्षात्वस्यविकारप्रकृतेश्चैवोनातिरिक्तलिङ्गविशेषावेक्षणंविकारस्यचसाध्यासाध्यमृदुदारुणलिङ्गविशेषावेक्षणमिति||८८||
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kāryayōnirdhātuvaiṣamyaṁ, tasya lakṣaṇaṁ vikārāgamaḥ| parīkṣā tvasya vikāraprakr̥tēścaivōnātiriktaliṅgaviśēṣāvēkṣaṇaṁ vikārasya ca sādhyāsādhyamr̥dudāruṇaliṅgaviśēṣāvēkṣaṇamiti||88||

kAryayonirdhAtuvaiShamyaM, tasya lakShaNaM vikArAgamaH|
parIkShA tvasya vikAraprakRuteshcaivonAtiriktali~ggavisheShAvekShaNaM vikArasya casAdhyAsAdhyamRududAruNali~ggavisheShAvekShaNamiti||88||
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The original source is disequilibrium of ''dhatus'' known by the emergence of signs of the disorder. Examination regarding this and the material cause of the disorder consists of the observation of the characters of their diminution or aggravation and also of those denoting curability, incurability, mildness and severity of the disorder.[88]
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==== Assessment of equilibrium of ''dhatu'' ====
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कार्यंधातुसाम्यं, तस्यलक्षणंविकारोपशमः| परीक्षात्वस्य- रुगुपशमनं, स्वरवर्णयोगः, शरीरोपचयः, बलवृद्धिः, अभ्यवहार्याभिलाषः, रुचिराहारकाले, अभ्यवहृतस्यचाहारस्यकालेसम्यग्जरणं, निद्रालाभोयथाकालं, वैकारिणांचस्वप्नानामदर्शनं, सुखेनचप्रतिबोधनं, वातमूत्रपुरीषरेतसांमुक्तिः, सर्वाकारैर्मनोबुद्धीन्द्रियाणांचाव्यापत्तिरिति||८९||
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kāryaṁ dhātusāmyaṁ, tasya lakṣaṇaṁ vikārōpaśamaḥ| parīkṣā tvasya- rugupaśamanaṁ, svaravarṇayōgaḥ, śarīrōpacayaḥ, balavr̥ddhiḥ, abhyavahāryābhilāṣaḥ, rucirāhārakālē, abhyavahr̥tasya cāhārasya kālē samyagjaraṇaṁ, nidrālābhō yathākālaṁ, vaikāriṇāṁ ca svapnānāmadarśanaṁ, sukhēna ca pratibōdhanaṁ, vātamūtrapurīṣarētasāṁ muktiḥ, sarvākārairmanōbuddhīndriyāṇāṁ cāvyāpattiriti||89||

kAryaM dhAtusAmyaM, tasya lakShaNaM vikAropashamaH|
parIkShA tvasya- rugupashamanaM, svaravarNayogaH, sharIropacayaH, balavRuddhiH,abhyavahAryAbhilAShaH, rucirAhArakAle, abhyavahRutasya cAhArasya kAle samyagjaraNaM, nidrAlAbhoyathAkAlaM, vaikAriNAM ca svapnAnAmadarshanaM, sukhena ca pratibodhanaM,vAtamUtrapurISharetasAM muktiH, sarvAkArairmanobuddhIndriyANAM cAvyApattiriti||89||
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Action (''karya'') is to bring about equilibrium of ''dhatus'' and its feature is absence of disease. Its examination is based on following criteria: alleviation of the disorder, normalcy of voice and complexion, nourishment of body, increase in strength, desire for food, relish at meal time, proper and timely digestion of the ingested food, timely sleep, non-appearance of abnormal dreams, easy awakening, easy elimination of urine, feces and semen, overall normalcy of mind, intellect and sense organs and associated with no other unhealthy features.[89]
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==== Outcome of therapeutic management ====
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कार्यफलंसुखावाप्तिः, तस्यलक्षणं- मनोबुद्धीन्द्रियशरीरतुष्टिः||९०||
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kāryaphalaṁ sukhāvāptiḥ, tasya lakṣaṇaṁ- manōbuddhīndriyaśarīratuṣṭiḥ||90||

kAryaphalaM sukhAvAptiH, tasya lakShaNaM- manobuddhIndriyasharIratuShTiH||90||
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The result of the act (''karyaphala'') is attainment of happiness. It is featured as satisfaction of mind, intellect, sense organs and the body pleasure.[90]

==== Consequence of therapeutic management ====
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अनुबन्धस्तुखल्वायुः, तस्यलक्षणं- प्राणैःसहसंयोगः||९१||
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anubandhastu khalvāyuḥ, tasya lakṣaṇaṁ- prāṇaiḥ saha saṁyōgaḥ||91||

anubandhastu khalvAyuH, tasya lakShaNaM- prANaiH saha saMyogaH||91||
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After effect (''anubandha'') is life and it is characterized by union with ''prana''(vitality).[91]

==== Field of action and its assessment ====
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देशस्तुभूमिरातुरश्च||९२||

तत्रभूमिपरीक्षाआतुरपरिज्ञानहेतोर्वास्यादौषधपरिज्ञानहेतोर्वा| तत्रतावदियमातुरपरिज्ञानहेतोः| तद्यथा- अयंकस्मिन्भूमिदेशेजातःसंवृद्धोव्याधितोवा; तस्मिंश्चभूमिदेशेमनुष्याणामिदमाहारजातम्, इदंविहारजातम्, इदमाचारजातम्, एतावच्चबलम्, एवंविधंसत्त्वम्, एवंविधंसात्म्यम्, एवंविधोदोषः, भक्तिरियम्, इमेव्याधयः, हितमिदम्, अहितमिदमितिप्रायोग्रहणेन| औषधपरिज्ञानहेतोस्तुकल्पेषुभूमिपरीक्षावक्ष्यते||९३||
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dēśastu bhūmirāturaśca||92||

tatra bhūmiparīkṣā āturaparijñānahētōrvā syādauṣadhaparijñānahētōrvā| tatra tāvadiyamāturaparijñānahētōḥ| tadyathā- ayaṁ kasmin bhūmidēśē jātaḥ saṁvr̥ddhō vyādhitō vā; tasmiṁśca bhūmidēśē manuṣyāṇāmidamāhārajātam, idaṁ vihārajātam, idamācārajātam, ētāvacca balam, ēvaṁvidhaṁ sattvam, ēvaṁvidhaṁ sātmyam, ēvaṁvidhō dōṣaḥ, bhaktiriyam, imē vyādhayaḥ, hitamidam, ahitamidamiti prāyōgrahaṇēna | auṣadhaparijñānahētōstu kalpēṣu bhūmiparīkṣā vakṣyatē||93||

deshastu bhUmirAturashca||92||

tatra bhUmiparIkShA Aturaparij~jAnahetorvA syAdauShadhaparij~jAnahetorvA|
tatra tAvadiyamAturaparij~jAnahetoH|
tadyathA- ayaM kasmin bhUmideshe jAtaH saMvRuddho vyAdhito vA; tasmiMshca bhUmideshemanuShyANAmidamAhArajAtam, idaM vihArajAtam, idamAcArajAtam, etAvacca balam, evaMvidhaMsattvam, evaMvidhaM sAtmyam, evaMvidho doShaH, bhaktiriyam, ime vyAdhayaH, hitamidam,ahitamidamiti prAyograhaNena [1] |
auShadhaparij~jAnahetostu kalpeShu bhUmiparIkShA vakShyate||93||
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The place of living and patients’ body constitutes the field of action (''karya desha'').
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Assessment of place of living is done with a view considering the patient and medicine. Regarding patient the things to be considered are – in which area patient is born, grown or diseased; in that particular area, the people mostly have such diet, such lifestyle, such behavior and conduct, such strength, such mind setup, this particular things are naturally accustomed, these are the wrong habits/ or the domination of ''dosha'', liking, area associated disorders, these are the wholesome entities and unwholesome entities for the people. The knowledge regarding place of living examination about drugs will be described in [[Kalpa Sthana]] section. [92-93]
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==== Examination of patient ====
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आतुरस्तुखलुकार्यदेशः| तस्यपरीक्षाआयुषःप्रमाणज्ञानहेतोर्वास्याद्, बलदोषप्रमाणज्ञानहेतोर्वा| तत्रतावदियंबलदोषप्रमाणज्ञानहेतोः; दोषप्रमाणानुरूपोहिभेषजप्रमाणविकल्पोबलप्रमाणविशेषापेक्षोभवति| सहसाह्यतिबलमौषधमपरीक्षकप्रयुक्तमल्पबलमातुरमतिपातयेत्; नह्यतिबलान्याग्नेयवायवीयान्यौषधान्यग्निक्षारशस्त्रकर्माणिवाशक्यन्तेऽल्पबलैःसोढुम्; असह्यातितीक्ष्णवेगत्वाद्धितानिसद्यःप्राणहराणिस्युः| एतच्चैवकारणमपेक्षमाणाहीनबलमातुरमविषादकरैर्मृदुसुकुमारप्रायैरुत्तरोत्तरगुरुभिरविभ्रमैरनात्ययिकैश्चोपचरन्त्यौषधैः; विशेषतश्चनारीः, ताह्यनवस्थितमृदुविवृतविक्लवहृदयाःप्रायःसुकुमार्योऽबलाःपरसंस्तभ्याश्च| तथाबलवतिबलवद्व्याधिपरिगतेस्वल्पबलमौषधमपरीक्षकप्रयुक्तमसाधकमेवभवति| तस्मादातुरंपरीक्षेतप्रकृतितश्च, विकृतितश्च, सारतश्च, संहननतश्च, प्रमाणतश्च, सात्म्यतश्च, सत्त्वतश्च, आहारशक्तितश्च, व्यायामशक्तितश्च, वयस्तश्चेति, बलप्रमाणविशेषग्रहणहेतोः||९४||
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āturastu khalu kāryadēśaḥ| tasya parīkṣā āyuṣaḥ pramāṇajñānahētōrvā syād, baladōṣapramāṇajñānahētōrvā| tatra tāvadiyaṁ baladōṣapramāṇajñānahētōḥ; dōṣapramāṇānurūpō hi bhēṣajapramāṇavikalpō balapramāṇaviśēṣāpēkṣō bhavati| sahasā hyatibalamauṣadhamaparīkṣakaprayuktamalpabalamāturamatipātayēt; na hyatibalānyāgnēyavāyavīyānyauṣadhānyagnikṣāraśastrakarmāṇi vā śakyantē'lpabalaiḥ sōḍhum; asahyātitīkṣṇavēgatvāddhitāni sadyaḥprāṇaharāṇi syuḥ| ētaccaiva kāraṇamapēkṣamāṇā hīnabalamāturamaviṣādakarairmr̥dusukumāraprāyairuttarōttaragurubhiravibhramairanātyayikaiścōpacarantyauṣadhaiḥ; viśēṣataśca nārīḥ, tā hyanavasthitamr̥duvivr̥taviklavahr̥dayāḥ prāyaḥ sukumāryō'balāḥ parasaṁstabhyāśca| tathā balavati balavadvyādhiparigatē svalpabalamauṣadhamaparīkṣakaprayuktamasādhakamēva bhavati| tasmādāturaṁ parīkṣēta prakr̥titaśca, vikr̥titaśca, sārataśca, saṁhananataśca, pramāṇataśca, sātmyataśca, sattvataśca, āhāraśaktitaśca, vyāyāmaśaktitaśca, vayastaścēti, balapramāṇaviśēṣagrahaṇahētōḥ||94||

Aturastu khalu kAryadeshaH|
tasya parIkShA AyuShaH pramANaj~jAnahetorvA syAd, baladoShapramANaj~jAnahetorvA|
tatra tAvadiyaM baladoShapramANaj~jAnahetoH; doShapramANAnurUpo hi bheShajapramANavikalpo [1]balapramANavisheShApekSho bhavati|
sahasA hyatibalamauShadhamaparIkShakaprayuktamalpabalamAturamatipAtayet; nahyatibalAnyAgneyavAyavIyAnyauShadhAnyagnikShArashastrakarmANi vA shakyante~alpabalaiH soDhum;asahyAtitIkShNavegatvAddhitAni sadyaHprANaharANi syuH|
etaccaiva kAraNamapekShamANAhInabalamAturamaviShAdakarairmRudusukumAraprAyairuttarottaragurubhiravibhramairanAtyayikaishcopacarantyauShadhaiH;visheShatashca nArIH, tA hyanavasthitamRuduvivRutaviklavahRudayAH prAyaH sukumAryo~abalAH parasaMstabhyAshca|
tathA balavati balavadvyAdhiparigate svalpabalamauShadhamaparIkShakaprayuktamasAdhakameva bhavati|
tasmAdAturaM parIkSheta prakRutitashca, vikRutitashca, sAratashca, saMhananatashca, pramANatashca, sAtmyatashca,sattvatashca, AhArashaktitashca, vyAyAmashaktitashca, vayastashceti, balapramANavisheShagrahaNahetoH||94||
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Patient is the substratum of the act (''karyadesha''). Examination of the patient is conducted for the knowledge of life span or the degree of strength and morbidity. The variations in dosage and potency of prescribed drugs is according to the degree of morbidity and the degree of strength of patient, because if potent drug is administered suddenly by a physician having not been examined properly, it may kill the weak patient; the weak patients are not able to bear intensely potent drugs which are predominant in ''agni'' and ''vayu'' or cauterization, application of alkali and surgical operation. They may cause instantaneous death due to unbearable and over intense impulse of the drug. Keeping this fact in mind, the physician should treat the weak patient with drug which is not harmful, mild, delicate, and progressively strong in order, without complication and not creating any emergent condition, particularly ladies, because they have unstable, soft, bare and timid heart, they are mostly delicate, weak and dependent on others. On the other hand, the drugs having low potency and applied by one who has not been examined properly in strong patients having severe disorder becomes ineffective. Hence the patient should be examined in respect of constitution (''prakriti''), morbidty (''vikriti''), constitution of ''dhatu'' (''sara''), compactness (''samhanana''), measurement (''pramana''), suitability (''satmya''), psyche (''sattva''), power of intake and digestion of food (''aharashakti''), power of exercise (''vyayamashakti'') and age (''vaya'') for the knowledge of the degree of strength.[94]
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==== ''[[Prakriti]] pariksha'' (Assessment of basic constitution of patient) ====
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तत्रप्रकृत्यादीन्भावाननुव्याख्यास्यामः| तद्यथा- शुक्रशोणितप्रकृतिं, कालगर्भाशयप्रकृतिं, आतुराहारविहारप्रकृतिं, महाभूतविकारप्रकृतिंचगर्भशरीरमपेक्षते| एतानियेनयेनदोषेणाधिकेनैकेनानेकेनवासमनुबध्यन्ते, तेनतेनदोषेणगर्भोऽनुबध्यते; ततःसासादोषप्रकृतिरुच्यतेमनुष्याणांगर्भादिप्रवृत्ता| तस्माच्छ्लेष्मलाःप्रकृत्याकेचित्, पित्तलाःकेचित्, वातलाःकेचित्, संसृष्टाःकेचित्, समधातवःकेचिद्भवन्ति| तेषांहिलक्षणानिव्याख्यास्यामः||९५||
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tatra prakr̥tyādīn bhāvānanuvyākhyāsyāmaḥ | tadyathā- śukraśōṇitaprakr̥tiṁ, kālagarbhāśayaprakr̥tiṁ, āturāhāravihāraprakr̥tiṁ, mahābhūtavikāraprakr̥tiṁ ca garbhaśarīramapēkṣatē| ētāni hi yēna yēna dōṣēṇādhikēnaikēnānēkēna vā samanubadhyantē, tēna tēna dōṣēṇa garbhō'nubadhyatē; tataḥ sā sā dōṣaprakr̥tirucyatē manuṣyāṇāṁ garbhādipravr̥ttā| tasmācchlēṣmalāḥ prakr̥tyā kēcit, pittalāḥ kēcit, vātalāḥ kēcit, saṁsr̥ṣṭāḥ kēcit, samadhātavaḥ kēcidbhavanti| tēṣāṁ hi lakṣaṇāni vyākhyāsyāmaḥ||95||

tatra prakRutyAdIn bhAvAnanuvyAkhyAsyAmaH [1] |
tadyathA- shukrashoNitaprakRutiM, kAlagarbhAshayaprakRutiM, AturAhAravihAraprakRutiM,mahAbhUtavikAraprakRutiM ca garbhasharIramapekShate|
etAni [2] hi yena yena doSheNAdhikenaikenAnekena [3] vA samanubadhyante, tena tena doSheNagarbho~anubadhyate; tataH sA sA doShaprakRutirucyate manuShyANAM garbhAdipravRuttA|
tasmAcchleShmalAH prakRutyA kecit, pittalAH kecit, vAtalAH kecit, saMsRuShTAH kecit, samadhAtavaHkecidbhavanti|
teShAM hi lakShaNAni vyAkhyAsyAmaH||95||
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<div style="text-align:justify;">
Explanation regarding factors ''prakriti'' etc. are explained henceforth– the constitution (''prakriti'') associated with fetus (''garbha'') is determined by constitution of sperm and ovum, the time (of conception) and status of health of uterus, diet and lifestyle of mother (during pregnancy) and interaction of ''mahabhutas''. Body humors (''dosha''), one or more than one which predominates in these factors gets attached to the fetus which is called physical or ''doshika'' constitution (''dosha prakriti'') of human beings which is emerged from the initial stage of fetus. Hence some persons are constitutionally having predominance of ''kapha''(''shleshma'') some ''pittala'', some ''vatala'' some having, combined ''dosha'' and some with balanced ''dhatus''. Their characters are described here. [95]
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===== Characteristics of ''kapha prakriti'' =====
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श्लेष्माहिस्निग्धश्लक्ष्णमृदुमधुरसारसान्द्रमन्दस्तिमितगुरुशीतविज्जलाच्छः| तस्यस्नेहाच्छ्लेष्मलाःस्निग्धाङ्गाः, श्लक्ष्णत्वाच्छ्लक्ष्णाङ्गाः, मृदुत्वाद्दृष्टिसुखसुकुमारावदातगात्राः, माधुर्यात्प्रभूतशुक्रव्यवायापत्याः, सारत्वात्सारसंहतस्थिरशरीराः, सान्द्रत्वादुपचितपरिपूर्णसर्वाङ्गाः, मन्दत्वान्मन्दचेष्टाहारव्याहाराः, स्तैमित्यादशीघ्रारम्भक्षोभविकाराः, गुरुत्वात्साराधिष्ठितावस्थितगतयः, शैत्यादल्पक्षुत्तृष्णासन्तापस्वेददोषाः, विज्जलत्वात्सुश्लिष्टसारसन्धिबन्धनाः, तथाऽच्छत्वात्प्रसन्नदर्शनाननाःप्रसन्नस्निग्धवर्णस्वराश्चभवन्ति| तएवङ्गुणयोगाच्छ्लेष्मलाबलवन्तोवसुमन्तोविद्यावन्तओजस्विनःशान्ताआयुष्मन्तश्चभवन्ति||९६||
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ślēṣmā hi snigdhaślakṣṇamr̥dumadhurasārasāndramandastimitaguruśītavijjalācchaḥ| tasya snēhācchlēṣmalāḥ snigdhāṅgāḥ, ślakṣṇatvācchlakṣṇāṅgāḥ, mr̥dutvāddr̥ṣṭisukhasukumārāvadātagātrāḥ, mādhuryāt prabhūtaśukravyavāyāpatyāḥ, sāratvāt sārasaṁhatasthiraśarīrāḥ, sāndratvādupacitaparipūrṇasarvāṅgāḥ, mandatvānmandacēṣṭāhāravyāhārāḥ, staimityādaśīghrārambhakṣōbhavikārāḥ, gurutvāt sārādhiṣṭhitāvasthitagatayaḥ, śaityādalpakṣuttr̥ṣṇāsantāpasvēdadōṣāḥ, vijjalatvāt suśliṣṭasārasandhibandhanāḥ, tathā'cchatvāt prasannadarśanānanāḥ prasannasnigdhavarṇasvarāśca bhavanti| ta ēvaṅguṇayōgācchlēṣmalā balavantō vasumantō vidyāvanta ōjasvinaḥ śāntā āyuṣmantaśca bhavanti||96||

shleShmA hi snigdhashlakShNamRudumadhurasArasAndramandastimitagurushItavijjalAcchaH|
tasya snehAcchleShmalAH snigdhA~ggAH, shlakShNatvAcchlakShNA~ggAH,mRudutvAddRuShTisukhasukumArAvadAtagAtrAH, mAdhuryAt prabhUtashukravyavAyApatyAH, sAratvAtsArasaMhatasthirasharIrAH, sAndratvAdupacitaparipUrNasarvA~ggAH,mandatvAnmandaceShTAhAravyAhArAH, staimityAdashIghrArambhakShobhavikArAH, gurutvAtsArAdhiShThitAvasthitagatayaH, shaityAdalpakShuttRuShNAsantApasvedadoShAH, vijjalatvAtsushliShTasArasandhibandhanAH, tathA~acchatvAt prasannadarshanAnanAHprasannasnigdhavarNasvarAshca bhavanti|
ta eva~gguNayogAcchleShmalA balavanto vasumanto vidyAvanta ojasvinaH shAntA AyuShmantashcabhavanti||96||
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<div style="text-align:justify;">
''Shleshma'' is unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), sweet (''madhura''), essence (''sara''), dense (''sandra''), slow acting (''manda''), stable (''stimita''), heavy (''guru''), cold (''sheeta''), slimy (''vijjala'') and clear (''acchah''). Because of its unctuousness the person with predominance of ''kapha'' has unctuous organs; due to smoothness smooth organs; due to softness he has pleasing, delicate and fair organs; due to sweetness person has abundant semen, libido and more progeny; due to nature of essence excellent person has compact and stable body; due to density, all organs are well developed and perfect; due to slowness, dull/ slow in activities, diet and speech; due to stability delayed initiation, irritation and slow in change of attitude /(disorders are slowly progressive); due to heaviness movements are supported with essence and stability; due to coldness little hunger, thirst, heat and perspiration, due to sliminess well united and strong joint ligaments, due to clarity clear eyes, face with clear and unctuous complexion and affectionate voice. Because of presence of these qualities the ''kapha'' dominated personality(''shleshmala'') persons are strong, wealthy, learned, brave, calm and long lived.[96]
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===== Characteristics of ''pitta prakriti'' =====
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पित्तमुष्णंतीक्ष्णंद्रवंविस्रमम्लंकटुकञ्च| तस्यौष्ण्यात्पित्तलाभवन्त्युष्णासहा, उष्णमुखाः, सुकुमारावदातगात्राः , प्रभूतविप्लुव्यङ्गतिलपिडकाः, क्षुत्पिपासावन्तः, क्षिप्रवलीपलितखालित्यदोषाः, प्रायोमृद्वल्पकपिलश्मश्रुलोमकेशाश्च; तैक्ष्ण्यात्तीक्ष्णपराक्रमाः, तीक्ष्णाग्नयः, प्रभूताशनपानाः, क्लेशासहिष्णवो, दन्दशूकाः; द्रवत्वाच्छिथिलमृदुसन्धिमांसाः, प्रभूतसृष्टस्वेदमूत्रपुरीषाश्च; विस्रत्वात्प्रभूतपूतिकक्षास्यशिरःशरीरगन्धाः; कट्वम्लत्वादल्पशुक्रव्यवायापत्याः; तएवङ्गुणयोगात्पित्तलामध्यबलामध्यायुषोमध्यज्ञानविज्ञानवित्तोपकरणवन्तश्चभवन्ति||९७||
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pittamuṣṇaṁ tīkṣṇaṁ dravaṁ visramamlaṁ kaṭukañca| tasyauṣṇyāt pittalā bhavantyuṣṇāsahā, uṣṇamukhāḥ, sukumārāvadātagātrāḥ , prabhūtavipluvyaṅgatilapiḍakāḥ, kṣutpipāsāvantaḥ, kṣipravalīpalitakhālityadōṣāḥ, prāyōmr̥dvalpakapilaśmaśrulōmakēśāśca; taikṣṇyāttīkṣṇaparākramāḥ, tīkṣṇāgnayaḥ, prabhūtāśanapānāḥ, klēśāsahiṣṇavō, dandaśūkāḥ; dravatvācchithilamr̥dusandhimāṁsāḥ, prabhūtasr̥ṣṭasvēdamūtrapurīṣāśca; visratvāt prabhūtapūtikakṣāsyaśiraḥśarīragandhāḥ; kaṭvamlatvādalpaśukravyavāyāpatyāḥ; ta ēvaṅguṇayōgāt pittalā madhyabalā madhyāyuṣō madhyajñānavijñānavittōpakaraṇavantaśca bhavanti||97||

pittamuShNaM tIkShNaM dravaM visramamlaM kaTuka~jca|
tasyauShNyAt pittalA bhavantyuShNAsahA, uShNamukhAH, sukumArAvadAtagAtrAH [1] ,prabhUtavipluvya~ggatilapiDakAH, kShutpipAsAvantaH, kShipravalIpalitakhAlityadoShAH,prAyomRudvalpakapilashmashrulomakeshAshca; taikShNyAttIkShNaparAkramAH, tIkShNAgnayaH,prabhUtAshanapAnAH, kleshAsahiShNavo, dandashUkAH; dravatvAcchithilamRudusandhimAMsAH,prabhUtasRuShTasvedamUtrapurIShAshca; visratvAt prabhUtapUtikakShAsyashiraHsharIragandhAH;kaTvamlatvAdalpashukravyavAyApatyAH; ta eva~gguNayogAt pittalA madhyabalA madhyAyuShomadhyaj~jAnavij~jAnavittopakaraNavantashca bhavanti||97||
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<div style="text-align:justify;">
''Pitta'' is hot (''ushna''), sharply/acutely acting (''tikshna''), liquid (''drava''), of fleshy smell (''visram''), sour (''amla'') and pungent (''katu''). Due to hotness, the persons having predominance of ''pitta'' are intolerant to heat, vulnerable to disorders due to heat delicate and beautiful body, plenty of moles, freckles, black-moles and pimples, excessive hunger and thirst, early appearance of wrinkles, graying and falling of hairs, mostly soft, scanty and brown beard/mustaches, hairs; due to sharpness/acuteness, sharply acting and valor, intense digestive power, intake of plenty of food and drink, lack of endurance, frequently eating; due to liquidity, lax and soft joints and muscles, excess perspiration, urination and defecation; due to fleshy smell foul smell in axilla, mouth, head and body; due to pungency and sourness there is less semen, libido and few progeny; because of presence of these qualities persons having predominance of pitta are moderate in strength, lifespan, knowledge, understanding, wealth and means.[97]
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===== Characteristics of ''vata prakriti'' =====
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वातस्तुरूक्षलघुचलबहुशीघ्रशीतपरुषविशदः| तस्यरौक्ष्याद्वातलारूक्षापचिताल्पशरीराःप्रततरूक्षक्षामसन्नसक्तजर्जरस्वराजागरूकाश्चभवन्ति, लघुत्वाल्लघुचपलगतिचेष्टाहारव्याहाराः, चलत्वादनवस्थितसन्ध्यक्षिभ्रूहन्वोष्ठजिह्वाशिरःस्कन्धपाणिपादाः, बहुत्वाद्बहुप्रलापकण्डरासिराप्रतानाः, शीघ्रत्वाच्छ्रीघ्रसमारम्भक्षोभविकाराःशीघ्रत्रासरागविरागाःश्रुतग्राहिणोऽल्पस्मृतयश्च, शैत्याच्छीतासहिष्णवःप्रततशीतकोद्वेपकस्तम्भाः, पारुष्यात्परुषकेशश्मश्रुरोमनखदशनवदनपाणिपादाः, वैशद्यात्स्फुटिताङ्गावयवाःसततसन्धिशब्दगामिनश्चभवन्ति; तएवङ्गुणयोगाद्वातलाःप्रायेणाल्पबलाश्चाल्पायुषश्चाल्पापत्याश्चाल्पसाधनाश्चाल्पधनाश्चभवन्ति||९८||
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vātastu rūkṣalaghucalabahuśīghraśītaparuṣaviśadaḥ| tasya raukṣyādvātalā rūkṣāpacitālpaśarīrāḥ pratatarūkṣakṣāmasannasaktajarjarasvarā jāgarūkāśca bhavanti,laghutvāllaghucapalagaticēṣṭāhāravyāhārāḥ, calatvādanavasthitasandhyakṣibhrūhanvōṣṭhajihvāśiraḥskandhapāṇipādāḥ, bahutvādbahupralāpakaṇḍarāsirāpratānāḥ, śīghratvācchrīghrasamārambhakṣōbhavikārāḥ śīghratrāsarāgavirāgāḥ śrutagrāhiṇō'lpasmr̥tayaśca, śaityācchītāsahiṣṇavaḥ pratataśītakōdvēpakastambhāḥ, pāruṣyāt paruṣakēśaśmaśrurōmanakhadaśanavadanapāṇipādāḥ, vaiśadyāt sphuṭitāṅgāvayavāḥ satatasandhiśabdagāminaśca bhavanti; ta ēvaṅguṇayōgādvātalāḥ prāyēṇālpabalāścālpāyuṣaścālpāpatyāścālpasādhanāścālpadhanāśca bhavanti||98||

vAtastu rUkShalaghucalabahushIghrashItaparuShavishadaH|
tasya raukShyAdvAtalA rUkShApacitAlpasharIrAH pratatarUkShakShAmasannasaktajarjarasvarA [1]jAgarUkAshca bhavanti, laghutvAllaghucapalagaticeShTAhAravyAhArAH,calatvAdanavasthitasandhyakShibhrUhanvoShThajihvAshiraHskandhapANipAdAH,bahutvAdbahupralApakaNDarAsirApra<br>tAnAH, shIghratvAcchrIghrasamArambhakShobhavikArAHshIghratrAsarAgavirAgAH shrutagrAhiNo~alpasmRutayashca, shaityAcchItAsahiShNavaHpratatashItakodvepakastambhAH, pAruShyAtparuShakeshashmashruromanakhadashanavadanapANipAdAH, vaishadyAt sphuTitA~ggAvayavAHsatatasandhishabdagAminashca bhavanti; ta eva~gguNayogAdvAtalAHprAyeNAlpabalAshcAlpAyuShashcAlpApatyAshcAlpasAdhanAshcAlpadhanAshca bhavanti||98||
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''Vata'' is rough (''ruksha''), light (''laghu''), mobile (''chala''), abundant (''bahu''), swift (''shighra''), cold (''sheeta''), coarse (''parusha'') and non-slimy (''vishada'').
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Due to roughness the persons with predominance of ''vata'' have rough, underdeveloped and short stature, constant rough, weak, low, adhered and hoarse voice, wakeful; due to lightness, light and fickle movements, activities, diet and speech; due to mobility, unstable joints, eye brows, jaw, lips, tongue, head, shoulder, hands and feet; due to abundance, talkativeness and visually abundance of tendons and venous network; due to swiftness hasty initiation, quick irritation and disorder, quick in fear attachment and disenchantment, quick in acquisition but with a poor memory (retention); due to coldness intolerance to cold, continuously infliction with cold, shivering and stiffness; due to coarseness, coarse hairs, beard-mustaches, hairs, nails, teeth, face, hands and feet, due to non-sliminess cracked body parts and constant sound in joints during movement. Because of presence of these qualities the persons having predominance of ''vata'' have mostly low degree of strength, life-span, progeny, means and wealth. [98]
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संसर्गात्संसृष्टलक्षणाः||९९||
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saṁsargāt saṁsr̥ṣṭalakṣaṇāḥ||99||

saMsargAt saMsRuShTalakShaNAH||99||
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And due to combination of ''doshas'', characters are found accordingly.[99]
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सर्वगुणसमुदितास्तुसमधातवः| इत्येवंप्रकृतितःपरीक्षेत||१००||
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sarvaguṇasamuditāstu samadhātavaḥ| ityēvaṁ prakr̥titaḥ parīkṣēta||100||

sarvaguNasamuditAstu samadhAtavaH|
ityevaM prakRutitaH parIkSheta||100||
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In persons having equilibrium of all ''dhatus'', the characters of all of the three are found. Thus one should examine the constitution.[100]

==== Assessment of ''vikriti'' (disorder) ====
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विकृतितश्चेतिविकृतिरुच्यतेविकारः| तत्रविकारंहेतु-दोष-दूष्य-प्रकृति-देश-काल-बलविशेषैर्लिङ्गतश्चपरीक्षेत, नह्यन्तरेणहेत्वादीनांबलविशेषंव्याधिबलविशेषोपलब्धिः| यस्यहिव्याधेर्दोष-दूष्य-प्रकृति-देश-काल-बलसाम्यंभवति, महच्चहेतुलिङ्गबलं, सव्याधिर्बलवान्भवति; तद्विपर्ययाच्चाल्पबलः; मध्यबलस्तुदोषदूष्यादीनामन्यतमसामान्याद्धेतुलिङ्गमध्यबलत्वाच्चोपलभ्यते||१०१||
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vikr̥titaścēti vikr̥tirucyatē vikāraḥ| tatra vikāraṁ hētu-dōṣa-dūṣya-prakr̥ti-dēśa-kāla-balaviśēṣairliṅgataśca parīkṣēta, na hyantarēṇa hētvādīnāṁ balaviśēṣaṁ vyādhibalaviśēṣōpalabdhiḥ| yasya hi vyādhērdōṣa-dūṣya-prakr̥ti-dēśa-kāla-balasāmyaṁ bhavati, mahacca hētuliṅgabalaṁ, sa vyādhirbalavān bhavati; tadviparyayāccālpabalaḥ; madhyabalastu dōṣadūṣyādīnāmanyatamasāmānyāddhētuliṅgamadhyabalatvāccōpalabhyatē||101||

vikRutitashceti vikRutirucyate vikAraH|
tatra vikAraM hetu-doSha-dUShya-prakRuti-desha-kAla-balavisheShairli~ggatashca parIkSheta, nahyantareNa hetvAdInAM balavisheShaM vyAdhibalavisheShopalabdhiH|
yasya hi vyAdherdoSha-dUShya-prakRuti-desha-kAla-balasAmyaM bhavati, mahacca hetuli~ggabalaM, savyAdhirbalavAn bhavati; tadviparyayAccAlpabalaH; madhyabalastudoShadUShyAdInAmanyatamasAmAnyAddhetuli~ggamadhyabalatvAccopalabhyate||101||
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<div style="text-align:justify;">
Patient examination should be done with respect of ''vikriti'' as well. ''Vikriti'' is ''vikara'' (disorder or pathological manifestation). The disorder should be examined in terms of the strength of the cause (''hetu''), ''dosha''(vitiating factors), ''dushya''(vitiated factors), constitution (''prakriti''), place (''desha''), time (''kala'') and the symptoms. The severity of the disease cannot be known without knowing the strength of the cause etc. factors. The disease having common ''dushya'', constitution, place and time along with strong cause and severity of symptoms is more, then such diseases are severe. The contrary is mild. The moderate disease has similarity in one of the ''dosha'', ''dushya'' etc. and as such moderate strength of cause and severity of symptoms.[101]
</div>

==== Assessment of ''sara'' (best qualities of body tissues) ====
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सारतश्चेतिसाराण्यष्टौपुरुषाणांबलमानविशेषज्ञानार्थमुपदिश्यन्ते; तद्यथा- त्वग्रक्तमांसमेदोऽस्थिमज्जशुक्रसत्त्वानीति||१०२||
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sārataścēti sārāṇyaṣṭau puruṣāṇāṁ balamānaviśēṣajñānārthamupadiśyantē; tadyathā- tvagraktamāṁsamēdō'sthimajjaśukrasattvānīti||102||

sAratashceti sArANyaShTau puruShANAM balamAnavisheShaj~jAnArthamupadishyante; tadyathA-tvagraktamAMsamedo~asthimajjashukrasattvAnIti||102||
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Moreover a patient should be examined in respect of ''sara'' i.e. (best qualities of body tissues). There are eight types of ''sara'' in human beings which are described here for the knowledge of degree of strength such as –''tvak, rakta, mamsa, meda, asthi, majja, shukra'' and ''sattva''.[102]

===== Characteristics of ''twak sara'' (best quality of skin) =====
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तत्रस्निग्धश्लक्ष्णमृदुप्रसन्नसूक्ष्माल्पगम्भीरसुकुमारलोमासप्रभेवचत्वक्त्वक्साराणाम्| सासारतासुखसौभाग्यैश्वर्योपभोगबुद्धिविद्यारोग्यप्रहर्षणान्यायुष्यत्वंचाचष्टे||१०३||
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tatra snigdhaślakṣṇamr̥duprasannasūkṣmālpagambhīrasukumāralōmā saprabhēva ca tvak tvaksārāṇām| sā sāratā sukhasaubhāgyaiśvaryōpabhōgabuddhividyārōgyapraharṣaṇānyāyuṣyatvaṁ cācaṣṭē||103||

tatra snigdhashlakShNamRuduprasannasUkShmAlpagambhIrasukumAralomA saprabheva ca tvaktvaksArANAm|
sA sAratA sukhasaubhAgyaishvaryopabhogabuddhividyArogyapraharShaNAnyAyuShyatvaMcAcaShTe||103||
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<div style="text-align:justify;">
In persons who are ''tvaksara'' (having constitutional essence of skin), the skin is unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), clean and adorable (''prasanna'') with fine (''sukshma''), thin (''alpa''), deep rooted (''gambhira'') and delicate (''sukumara'') hairs and is lustrous (''prabha''). This essence indicates happiness, good fortune, power, enjoyment, intelligence, knowledge, health, cheerfulness and longevity. [103]
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===== Characteristics of ''rakta sara'' (best quality of blood tissue) =====
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कर्णाक्षिमुखजिह्वानासौष्ठपाणिपादतलनखललाटमेहनंस्निग्धरक्तवर्णंश्रीमद्भ्राजिष्णुरक्तसाराणाम्| सासारतासुखमुद्धतांमेधांमनस्वित्वंसौकुमार्यमनतिबलमक्लेशसहिष्णुत्वमुष्णासहिष्णुत्वंचाचष्टे||१०४||
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karṇākṣimukhajihvānāsauṣṭhapāṇipādatalanakhalalāṭamēhanaṁ snigdharaktavarṇaṁ śrīmadbhrājiṣṇu raktasārāṇām| sā sāratā sukhamuddhatāṁ mēdhāṁ manasvitvaṁ saukumāryamanatibalamaklēśasahiṣṇutvamuṣṇāsahiṣṇutvaṁ cācaṣṭē||104||

karNAkShimukhajihvAnAsauShThapANipAdatalanakhalalATamehanaM snigdharaktavarNaMshrImadbhrAjiShNu raktasArANAm|
sA sAratA sukhamuddhatAM medhAM manasvitvaMsaukumAryamanatibalamakleshasahiShNutvamuShNAsahiShNutvaM cAcaShTe||104||
</div></div>

In persons with essence of ''rakta'' have their ear, eye, face, tongue, nose, lips, palms, soles, nails, forehead and genitals to be unctuous, red, beautiful and shining. This essence indicates happiness, sharp intellect, magnanimity, tenderness, moderate strength, lack for endurance and intolerance to heat.[104]

===== Characteristics of ''mamsa sara'' (best quality of muscular tissue) =====
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शङ्खललाटकृकाटिकाक्षिगण्डहनुग्रीवास्कन्धोदरकक्षवक्षःपाणिपादसन्धयःस्थिरगुरुशुभमांसोपचितामांससाराणाम्| सासारताक्षमांधृतिमलौल्यंवित्तंविद्यांसुखमार्जवमारोग्यंबलमायुश्चदीर्घमाचष्टे||१०५||
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śaṅkhalalāṭakr̥kāṭikākṣigaṇḍahanugrīvāskandhōdarakakṣavakṣaḥpāṇipādasandhayaḥ sthiraguruśubhamāṁsōpacitā māṁsasārāṇām| sā sāratā kṣamāṁ dhr̥timalaulyaṁ vittaṁ vidyāṁ sukhamārjavamārōgyaṁ balamāyuśca dīrghamācaṣṭē||105||

sha~gkhalalATakRukATikAkShigaNDahanugrIvAskandhodarakakShavakShaHpANipAdasandhayaHsthiragurushubhamAMsopacitA mAMsasArANAm|
sA sAratA kShamAM dhRutimalaulyaM vittaM vidyAM sukhamArjavamArogyaM balamAyushcadIrghamAcaShTe||105||
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<div style="text-align:justify;">
The persons having essence of ''mamsa'' have their temples (''shankha''), forehead (''lalata''), nape (''krikatika''), eyes (''akshi''), cheek (''ganda''), jaws (''hanu''), neck (''griva''), shoulder (''skandha''), abdomen (''udara''), axillae (''kaksha''), chest (''vaksha''), hands (''pani''), feet (''pada'')and joints (''sandhi'') well developed with firm, heavy and good looking muscles. This essence indicates forbearance, restraint, and lack of greed, wealth, knowledge, happiness, simplicity, health, strength and longevity.[105]
</div>

===== Characteristics of ''meda sara'' (best quality of lipid tissues) =====
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वर्णस्वरनेत्रकेशलोमनखदन्तौष्ठमूत्रपुरीषेषुविशेषतःस्नेहोमेदःसाराणाम्| सासारतावित्तैश्वर्यसुखोपभोगप्रदानान्यार्जवंसुकुमारोपचारतांचाचष्टे||१०६||
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varṇasvaranētrakēśalōmanakhadantauṣṭhamūtrapurīṣēṣu viśēṣataḥ snēhōmēdaḥsārāṇām|sāsāratāvittaiśvaryasukhōpabhōgapradānānyārjavaṁ sukumārōpacāratāṁ cā caṣṭē||106||

varNasvaranetrakeshalomanakhadantauShThamUtrapurISheShu visheShataH sneho medaHsArANAm|
sA sAratA vittaishvaryasukhopabhogapradAnAnyArjavaM sukumAropacAratAM cA caShTe||106||
</div></div>

The person endowed with essence of ''meda'' have significant unctuousness specifically in complexion, voice, eyes, hair, skin hairs, nails, teeth, lips, urine and feces. This indicates wealth, power, happiness, enjoyment, charity, simplicity and delicacy in dealings.[106]

===== Characteristics of ''asthi sara'' (best quality of bone) =====
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पार्ष्णिगुल्फजान्वरत्निजत्रुचिबुकशिरःपर्वस्थूलाःस्थूलास्थिनखदन्ताश्चास्थिसाराः| तेमहोत्साहाःक्रियावन्तःक्लेशसहाःसारस्थिरशरीराभवन्त्यायुष्मन्तश्च||१०७||
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pārṣṇigulphajānvaratnijatrucibukaśiraḥparvasthūlāḥ
|sthūlāsthinakhadantāścāsthisārāḥ|tēmahōtsāhāḥkriyāvantaḥ klēśasahāḥ sārasthiraśarīrā bhavantyāyuṣmantaśca||107||

pArShNigulphajAnvaratnijatrucibukashiraHparvasthUlAH sthUlAsthinakhadantAshcAsthisArAH|
te mahotsAhAH kriyAvantaH kleshasahAH sArasthirasharIrA bhavantyAyuShmantashca||107||
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Person with ''asthi sara'' has prominent heels (''parshni''), ankles (''gulpha''), knee joint (''janu''), elbows (''aratni''), collarbones (''jatru''), chin (''chibuka''), head (''shira''), flanks (''parshva'') and joints and also bones and teeth. Such persons are excess enthusiastic, very active, enduring, having strong and firm body as well as longevity.[107]

===== Characteristics of ''majja sara''(best quality of bone marrow tissue) =====
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मृद्वङ्गाबलवन्तःस्निग्धवर्णस्वराःस्थूलदीर्घवृत्तसन्धयश्चमज्जसाराः| तेदीर्घायुषोबलवन्तःश्रुतवित्तविज्ञानापत्यसम्मानभाजश्चभवन्ति||१०८||
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mr̥dvaṅgā balavantaḥ snigdhavarṇasvarāḥ sthūladīrghavr̥ttasandhayaśca majjasārāḥ| tē dīrghāyuṣō balavantaḥ śrutavittavijñānāpatyasammānabhājaśca bhavanti||108||

mRudva~ggA balavantaH snigdhavarNasvarAH sthUladIrghavRuttasandhayashca majjasArAH|
te dIrghAyuSho balavantaH shrutavittavij~jAnApatyasammAnabhAjashca bhavanti||108||
</div></div>

The persons with soft body parts, strong, unctuous complexion and sweet voice, prominent (''sthula''), long (''dirgha'') and rounded joints should be known as ''majjasara'' (or the essence of''majja''). They are long-lived, strong and endowed with learning ability, wealth, understanding, progeny and respectful image.[108]

===== Characteristics of ''shukra sara''(best quality of reproductive tissues) =====
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सौम्याःसौम्यप्रेक्षिणःक्षीरपूर्णलोचनाइवप्रहर्षबहुलाःस्निग्धवृत्तसारसमसंहतशिखरदशनाःप्रसन्नस्निग्धवर्णस्वराभ्राजिष्णवोमहास्फिचश्चशुक्रसाराः| तेस्त्रीप्रियोपभोगा बलवन्तःसुखैश्वर्यारोग्यवित्तसम्मानापत्यभाजश्चभवन्ति||१०९||
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saumyāḥsaumyaprēkṣiṇaḥkṣīrapūrṇalōcanāivapraharṣabahulāḥsnigdhavr̥ttasārasamasaṁhataśikharadaśanāḥprasannasnigdhavarṇasvarābhrājiṣṇavōmahāsphicaścaśukr<br>asārāḥ|tēstrīpriyōpabhōgā balavantaḥsukhaiśvaryārōgyavittasammānāpatyabhājaścabhavanti||109||

saumyAH saumyaprekShiNaH kShIrapUrNalocanA iva praharShabahulAHsnigdhavRuttasArasamasaMhatashikharadashanAH prasannasnigdhavarNasvarA bhrAjiShNavomahAsphicashca shukrasArAH|
te strIpriyopabhogA [1] balavantaH sukhaishvaryArogyavittasammAnApatyabhAjashca bhavanti||109||
</div></div>

<div style="text-align:justify;">
The ''shukra sara'' (having essence in form of reproductive tissues) individuals are gentle and charming (''saumya''), charming and gentle look (''saumyaprekshina''), have beautiful eyes as if filled with milk (''kshirapurnalochana''), immensely exhilarated (''praharshabahula''), teeth are unctuous, rounded, firm, even and compact; having pleasant and unctuous complexion and voice, brilliant, having prominent buttocks.

They are liked by women for enjoyment, are strong and endowed with happiness, leisure, health, wealth, honor and progeny.[109]
</div>

===== Characteristics of ''sattva sara'' (best quality of mind) =====
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स्मृतिमन्तोभक्तिमन्तःकृतज्ञाःप्राज्ञाःशुचयोमहोत्साहादक्षाधीराःसमरविक्रान्तयोधिनस्त्यक्तविषादाःसुव्यवस्थितगतिगम्भीरबुद्धिचेष्टाःकल्याणाभिनिवेशिनश्चसत्त्वसाराः| तेषांस्वलक्षणैरेवगुणाव्याख्याताः||११०||
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smr̥timantōbhaktimantaḥkr̥tajñāḥprājñāḥśucayōmahōtsāhādakṣādhīrāḥsamaravikrāntayōdhinastyaktaviṣādāḥsuvyavasthitagatigambhīrabuddhicēṣṭāḥkalyāṇābhinivēśinaścas<br>attvasārāḥ|tēṣāṁsvalakṣaṇairēvaguṇāvyākhyātāḥ||110||

smRutimanto bhaktimantaH kRutaj~jAH prAj~jAH shucayo mahotsAhA dakShA dhIrAHsamaravikrAntayodhinastyaktaviShAdAH suvyavasthitagatigambhIrabuddhiceShTAHkalyANAbhiniveshinashca sattvasArAH|
teShAM svalakShaNaireva guNA vyAkhyAtAH||110||
</div></div>

<div style="text-align:justify;">
The ''sattva sara'' persons are endowed with memory (''smriti''), devotion (''bhakti''), are grateful (''kritajna''), knowledgeable (''prajna''), cleanliness (''shuchi''), enthusiastic (''mahotsaha''), skillful (''daksha''), courageous (''dhira''), fighting in battle with valor, free from anxiety (''tyaktavishada''), having well-organized activities and highly intellectual abilities engaged in virtuous act.

Their characters are explained by their qualities mentioned above. [110]
</div>

===== Characteristics of ''sarva sara'' (best quality of all tissues) =====
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तत्रसर्वैःसारैरुपेताःपुरुषाभवन्त्यतिबलाःपरमसुखयुक्ताः] क्लेशसहाःसर्वारम्भेष्वात्मनिजातप्रत्ययाःकल्याणाभिनिवेशिनःस्थिरसमाहितशरीराःसुसमाहितगतयःसानुनादस्निग्धगम्भीरमहास्वराःसुखैश्वर्यवित्तोपभोगसम्मानभाजोमन्दजरसोमन्दविकाराः<br>प्रायस्तुल्यगुणविस्तीर्णापत्याश्चिरजीविनश्च||१११||
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tatrasarvaiḥsārairupētāḥpuruṣābhavantyatibalāḥ paramasukhayuktāḥklēśasahāḥsarvārambhēṣvātmanijātapratyayāḥkalyāṇābhinivēśinaḥsthirasamāhitaśarīrāḥsusamāhitagatayaḥsānunādasnigdhagambhī<br>ramahāsvarāḥsukhaiśvaryavittōpabhōgasammānabhājōmandajarasōmandavikārāḥprāyastulyaguṇavistīrṇāpatyāścirajīvinaśca||111||

tatra sarvaiH sArairupetAH puruShA bhavantyatibalAH paramasukhayuktAH [2] kleshasahAHsarvArambheShvAtmani jAtapratyayAH kalyANAbhiniveshinaH sthirasamAhitasharIrAHsusamAhitagatayaH sAnunAdasnigdhagambhIramahAsvarAH sukhaishvaryavittopabhogasammAnabhAjomandajaraso mandavikArAH prAyastulyaguNavistIrNApatyAshcirajIvinashca||111||
</div></div>

<div style="text-align:justify;">
The persons having all essences are very strong and happy, enduring, confident in all actions, inclined to benevolent acts, having firm and balanced body with balanced movements; resonant, melodious, deep and high voice; endowed with happiness supremacy, wealth, enjoyment and honor; with slow ageing and pathogenic process, mostly having similar and numerous offspring and which are long-lived.[111]
</div>

===== Characteristics of ''Asara'' (no/low quality of tissues) =====
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अतोविपरीतास्त्वसाराः||११२||
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atōviparītāstvasārāḥ||112||

ato viparItAstvasArAH||112||
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And those persons having no or less essence of tissues are contrary to these individual.[112]

===== Characteristics of ''madhya sara''(moderate quality of tissues) =====
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मध्यानांमध्यैःसारविशेषैर्गुणविशेषाव्याख्याताभवन्ति||११३||
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madhyānāṁmadhyaiḥsāraviśēṣairguṇaviśēṣāvyākhyātābhavanti||113||

madhyAnAM madhyaiHsAravisheShairguNavisheShA vyAkhyAtA bhavanti||113||
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Individual having moderate essence should be known by their respective qualities in moderate degrees. [113]
<div class="mw-collapsible mw-collapsed">

इतिसाराण्यष्टौपुरुषाणांबलप्रमाणविशेषज्ञानार्थमुपदिष्टानिभवन्ति||११४||
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itisārāṇyaṣṭaupuruṣāṇāṁbalapramāṇaviśēṣajñānārthamupadiṣṭānibhavanti||114||

iti sArANyaShTau puruShANAM balapramANavisheShaj~jAnArthamupadiShTAni bhavanti||114||
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Thus eight types of essence of persons have been described for the knowledge of the degree of strength. [114]
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कथंनुशरीरमात्रदर्शनादेवभिषङ्मुह्येदयमुपचितत्वाद्बलवान्, अयमल्पबलःकृशत्वात्, महाबलोऽयंमहाशरीरत्वात्, अयमल्पशरीरत्वादल्पबलइति; दृश्यन्तेह्यल्पशरीराःकृशाश्चैकेबलवन्तः; तत्रपिपीलिकाभारहरणवत्सिद्धिः| अतश्चसारतःपरीक्षेतेत्युक्तम्] ||११५||
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kathaṁ nu śarīramātradarśanādēva bhiṣaṅmuhyēdayamupacitatvādbalavān, ayamalpabalaḥ kr̥śatvāt, mahābalō'yaṁ mahāśarīratvāt, ayamalpaśarīratvādalpabala iti; dr̥śyantē hyalpaśarīrāḥ kr̥śāścaikē balavantaḥ; tatra pipīlikābhāraharaṇavat siddhiḥ| ataśca sārataḥ parīkṣētētyuktam ||115||

kathaM nu sharIramAtradarshanAdeva bhiSha~gmuhyedayamupacitatvAdbalavAn, ayamalpabalaHkRushatvAt, mahAbalo~ayaM mahAsharIratvAt, ayamalpasharIratvAdalpabala iti; dRushyantehyalpasharIrAH kRushAshcaike balavantaH; tatra pipIlikAbhAraharaNavat siddhiH|
atashca sArataH parIkShetetyuktam [3] ||115||
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Physician may sometimes take wrong decision only by looking at the patient such as the patient is strong because of being corpulent, he is weak because of leanness, he is very strong because of possessing big body and he is very weak because of possessing small body. But it is observed that some persons having small body and leanness are strong like the small ants carrying a big load. This is the reason why essence (''sarata'') of ''dhatus'' is to be examined before understanding the ''bala'' of a patient.[115]
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==== Assessment of ''samhanana'' (compactness) ====
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संहननतश्चेतिसंहननं, संहतिः], संयोजनमित्येकोऽर्थः| तत्रसमसुविभक्तास्थि, सुबद्धसन्धि, सुनिविष्टमांसशोणितं, सुसंहतंशरीरमित्युच्यते| तत्रसुसंहतशरीराःपुरुषाबलवन्तः, विपर्ययेणाल्पबलाः, मध्यत्वात्संहननस्यमध्यबलाभवन्ति||११६||
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saṁhananataścēti saṁhananaṁ, saṁhatiḥ , saṁyōjanamityēkō'rthaḥ| tatra samasuvibhaktāsthi, subaddhasandhi, suniviṣṭamāṁsaśōṇitaṁ, susaṁhataṁ śarīramityucyatē| tatra susaṁhataśarīrāḥ puruṣā balavantaḥ, viparyayēṇālpabalāḥ, madhyatvāt saṁhananasya madhyabalā bhavanti||116||

saMhananatashceti saMhananaM, saMhatiH [1] , saMyojanamityeko~arthaH|
tatra samasuvibhaktAsthi, subaddhasandhi, suniviShTamAMsashoNitaM, susaMhataM sharIramityucyate|
tatra susaMhatasharIrAH puruShA balavantaH, viparyayeNAlpabalAH, madhyatvAt saMhananasyamadhyabalA bhavanti||116||
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The patient should also be examined by ''samhanana'' (compactness). ''Samhanana, Samhati'' and ''Samyojana'' are synonymous. A well compact body is known by evenly well demarcated bones (''samasuvibhaktasthi''), well bound joints (''subaddhasandhi''), well formed muscles and blood (''sunivishtamamsashonitam''). Those having well compact body are strong, otherwise weak and those having moderate compactness have medium strength. [116]
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==== Assessment of ''pramana'' (proportion and measurements) ====
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प्रमाणतश्चेतिशरीरप्रमाणंपुनर्यथास्वेनाङ्गुलिप्रमाणेनोपदेक्ष्यतेउत्सेधविस्तारायामैर्यथाक्रमम्| तत्रपादौ] चत्वारिषट्चतुर्दशाङ्गुलानि, जङ्घेत्वष्टादशाङ्गुलेषोडशाङ्गुलपरिक्षेपेच, जानुनीचतुरङ्गुलेषोडशाङ्गुलपरिक्षेपे, त्रिंशदङ्गुलपरिक्षेपावष्टादशाङ्गुलावूरु, षडङ्गुलदीर्घौवृषणावष्टाङ्गुलपरिणाहौ, शेफःषडङ्गुलदीर्घंपञ्चाङ्गुलपरिणाहं, द्वादशाङ्गुलिपरिणाहोभगः, षोडशाङ्गुलविस्ताराकटी, दशाङ्गुलंबस्तिशिरः, दशाङ्गुलविस्तारंद्वादशाङ्गुलमुदरं, दशाङ्गुलविस्तीर्णेद्वादशाङ्गुलायामेपार्श्वे, द्वादशाङ्गुलंस्तनान्तरं, द्व्यङ्गुलंस्तनपर्यन्तं, चतुर्विशत्यङ्गुलविशालंद्वादशाङ्गुलोत्सेधमुरः, द्व्यङ्गुलं] हृदयम्, अष्टाङ्गुलौस्कन्धौ, षडङ्गुलावंसौ, षोडशाङ्गुलौप्रबाहू, पञ्चदशाङ्गुलौप्रपाणी, हस्तौद्वादशाङ्गुलौ] , कक्षावष्टाङ्गुलौ, त्रिकंद्वादशाङ्गुलोत्सेधम्, अष्टादशाङ्गुलोत्सेधंपृष्ठं, चतुरङ्गुलोत्सेधाद्वाविंशत्यङ्गुलपरिणाहाशिरोधरा, द्वादशाङ्गुलोत्सेधंचतुर्विंशत्यङ्गुलपरिणाहमाननं, पञ्चाङ्गुलमास्यं, चिबुकौष्ठकर्णाक्षिमध्यनासिकाललाटंचतुरङ्गुलं, षोडशाङ्गुलोत्सेधंद्वात्रिंशदङ्गुलपरिणाहंशिरः; इतिपृथक्त्वेनाङ्गावयवानांमानमुक्तम्| केवलंपुनःशरीरमङ्गुलिपर्वाणिचतुरशीतिः| तदायामविस्तारसमंसमुच्यते| तत्रायुर्बलमोजःसुखमैश्वर्यंवित्तमिष्टाश्चापरेभावाभवन्त्यायत्ताःप्रमाणवतिशरीरे; विपर्ययस्त्वतोहीनेऽधिकेवा||११७||
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pramāṇataścēti śarīrapramāṇaṁ punaryathāsvēnāṅgulipramāṇēnōpadēkṣyatē utsēdhavistārāyāmairyathākramam| tatra pādau catvāri ṣaṭ caturdaśāṅgulāni, jaṅghē tvaṣṭādaśāṅgulē ṣōḍaśāṅgulaparikṣēpē ca, jānunī caturaṅgulē ṣōḍaśāṅgulaparikṣēpē, triṁśadaṅgulaparikṣēpāvaṣṭādaśāṅgulāvūru, ṣaḍaṅguladīrghau vr̥ṣaṇāvaṣṭāṅgulapariṇāhau, śēphaḥ ṣaḍaṅguladīrghaṁ pañcāṅgulapariṇāhaṁ, dvādaśāṅgulipariṇāhō bhagaḥ, ṣōḍaśāṅgulavistārā kaṭī, daśāṅgulaṁ bastiśiraḥ, daśāṅgulavistāraṁ dvādaśāṅgulamudaraṁ, daśāṅgulavistīrṇē dvādaśāṅgulāyāmē pārśvē, dvādaśāṅgulaṁ stanāntaraṁ, dvyaṅgulaṁ stanaparyantaṁ, caturviśatyaṅgulaviśālaṁ dvādaśāṅgulōtsēdhamuraḥ, dvyaṅgulaṁ hr̥dayam, aṣṭāṅgulau skandhau, ṣaḍaṅgulāvaṁsau, ṣōḍaśāṅgulau prabāhū, pañcadaśāṅgulau prapāṇī, hastau dvādaśāṅgulau , kakṣāvaṣṭāṅgulau, trikaṁ dvādaśāṅgulōtsēdham, aṣṭādaśāṅgulōtsēdhaṁ pr̥ṣṭhaṁ, caturaṅgulōtsēdhā dvāviṁśatyaṅgulapariṇāhā śirōdharā, dvādaśāṅgulōtsēdhaṁ caturviṁśatyaṅgulapariṇāhamānanaṁ, pañcāṅgulamāsyaṁ, cibukauṣṭhakarṇākṣimadhyanāsikālalāṭaṁ caturaṅgulaṁ, ṣōḍaśāṅgulōtsēdhaṁ dvātriṁśadaṅgulapariṇāhaṁ śiraḥ; iti pr̥thaktvēnāṅgāvayavānāṁ mānamuktam| kēvalaṁ punaḥśarīramaṅguliparvāṇi caturaśītiḥ| tadāyāmavistārasamaṁ samucyatē| tatrāyurbalamōjaḥ sukhamaiśvaryaṁ vittamiṣṭāścāparē bhāvā bhavantyāyattāḥ pramāṇavati śarīrē; viparyayastvatō hīnē'dhikē vā||117||

pramANatashceti sharIrapramANaM punaryathAsvenA~ggulipramANenopadekShyateutsedhavistArAyAmairyathAkramam|
tatra pAdau [1] catvAri ShaT caturdashA~ggulAni, ja~gghe tvaShTAdashA~gguleShoDashA~ggulaparikShepe ca, jAnunI catura~ggule ShoDashA~ggulaparikShepe,triMshada~ggulaparikShepAvaShTAdashA~ggulAvUru, ShaDa~gguladIrghauvRuShaNAvaShTA~ggulapariNAhau, shephaH ShaDa~gguladIrghaM pa~jcA~ggulapariNAhaM,dvAdashA~ggulipariNAho bhagaH, ShoDashA~ggulavistArA kaTI, dashA~ggulaM bastishiraH,dashA~ggulavistAraM dvAdashA~ggulamudaraM, dashA~ggulavistIrNe dvAdashA~ggulAyAme pArshve,dvAdashA~ggulaM stanAntaraM, dvya~ggulaM stanaparyantaM, caturvishatya~ggulavishAlaMdvAdashA~ggulotsedhamuraH, dvya~ggulaM [2] hRudayam, aShTA~ggulau skandhau,ShaDa~ggulAvaMsau, ShoDashA~ggulau prabAhU, pa~jcadashA~ggulau prapANI, hastaudvAdashA~ggulau [3] , kakShAvaShTA~ggulau, trikaM dvAdashA~ggulotsedham,aShTAdashA~ggulotsedhaM pRuShThaM, catura~ggulotsedhA dvAviMshatya~ggulapariNAhA shirodharA,dvAdashA~ggulotsedhaM caturviMshatya~ggulapariNAhamAnanaM, pa~jcA~ggulamAsyaM,cibukauShThakarNAkShimadhyanAsikAlalATaM catura~ggulaM, ShoDashA~ggulotsedhaMdvAtriMshada~ggulapariNAhaM shiraH; iti pRuthaktvenA~ggAvayavAnAM mAnamuktam|
kevalaM punaHsharIrama~gguliparvANi caturashItiH|
tadAyAmavistArasamaM samucyate|
tatrAyurbalamojaH sukhamaishvaryaM vittamiShTAshcApare bhAvA bhavantyAyattAH pramANavatisharIre; viparyayastvato hIne~adhike vA||117||
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Examination regarding measurement of body is to be described by the measure of individual fingers in terms of height, breadth, and length respectively. It is dealt under anthropometry. Feet are four (H.) six (B.) and fourteen (L) fingers; Calf region are eighteen fingers long and with sixteen fingers circumference; knees four fingers long with sixteen fingers circumference; thighs eighteen fingers (long) with thirty finger circumference; testicles six fingers long with eight fingers circumference; penis six fingers long with five fingers circumference; vulva with twelve fingers circumference; waist sixteen fingers broad, ''bastishira'' ten fingers, abdomen ten fingers broad and twelve finger long; sides ten fingers broad and twelve fingers long; interval between the breasts twelve fingers, (apex of the) heart two fingers, blades six fingers, arms sixteen fingers (long) forearms fifteen fingers (long); hands twelve fingers (long), axillae eighth fingers, sacral region twelve fingers height, back eighteen fingers height, neck four fingers height with twenty two fingers circumference, face twelve finger high with twenty four fingers circumference; mouth five fingers; chin, lips, ears, middle of the eyes, nose and forehead four fingers; head sixteen fingers high with thirty two fingers circumference. Thus measurement of the body parts has been said separately. The entire body measures eighty four fingers in height and also in breadth such individuals possess longevity, strength, immunity, happiness, supremacy, wealth and other desired facilities. Those having body with less or more measurement have qualities contrary to these.[117]
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==== Assessment of [[satmya]] (suitability) ====
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सात्म्यतश्चेतिसात्म्यंनामतद्यत्सातत्येनोपसेव्यमानमुपशेते| तत्रयेघृतक्षीरतैलमांसरससात्म्याःसर्वरससात्म्याश्चतेबलवन्तःक्लेशसहाश्चिरजीविनश्चभवन्ति, रूक्षसात्म्याःपुनरेकरससात्म्याश्चयेतेप्रायेणाल्पबलाअल्पक्लेशसहाअल्पायुषोऽल्पसाधनाश्चभवन्ति, व्यामिश्रसात्म्यास्तुयेतेमध्यबलाःसात्म्यनिमित्ततोभवन्ति||११८||
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sātmyataścēti sātmyaṁ nāma tadyat sātatyēnōpasēvyamānamupaśētē| tatra yē ghr̥takṣīratailamāṁsarasasātmyāḥ sarvarasasātmyāśca tē balavantaḥ klēśasahāścirajīvinaśca bhavanti, rūkṣasātmyāḥ punarēkarasasātmyāśca yē tē prāyēṇālpabalā alpaklēśasahā alpāyuṣō'lpasādhanāśca bhavanti, vyāmiśrasātmyāstu yē tē madhyabalāḥ sātmyanimittatō bhavanti||118||

sAtmyatashceti sAtmyaM nAma tadyat sAtatyenopasevyamAnamupashete|
tatra ye ghRutakShIratailamAMsarasasAtmyAH sarvarasasAtmyAshca te balavantaHkleshasahAshcirajIvinashca bhavanti, rUkShasAtmyAH punarekarasasAtmyAshca ye te prAyeNAlpabalAalpakleshasahA alpAyuSho~alpasAdhanAshca bhavanti, vyAmishrasAtmyAstu ye te madhyabalAHsAtmyanimittato bhavanti||118||
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Examination in respect to suitability by practice (''satmya'') should also be done. Suitable is that, which being used constantly has wholesome effect, those suited to ghee, milk, oil and meat soup, and to all ''rasas'' are strong, enduring and long-lived. On the contrary, those suited to rough diet and single rasa are often weak, unenduring, and short-lived and are with little means. Those having mixed suitability have medium strength.[118]
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==== Assessment of ''Sattva'' (psyche/mental strength) ====
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सत्त्वतश्चेतिसत्त्वमुच्यतेमनः| तच्छरीरस्यतन्त्रकमात्मसंयोगात्| तत्त्रिविधंबलभेदेन- प्रवरं, मध्यम्, अवरंचेति; अतश्चप्रवरमध्यावरसत्त्वाःपुरुषाभवन्ति| तत्रप्रवरसत्त्वाःसत्त्वसारास्तेसारेषूपदिष्टाः, स्वल्पशरीराह्यपितेनिजागन्तुनिमित्तासुमहतीष्वपिपीडास्वव्यथा] दृश्यन्तेसत्त्वगुणवैशेष्यात्; मध्यसत्त्वास्त्वपरानात्मन्युपनिधाय] संस्तम्भयन्त्यात्मनाऽऽत्मानंपरैर्वाऽपिसंस्तभ्यन्ते; हीनसत्त्वास्तुनात्मनानापिपरैःसत्त्वबलंप्रतिशक्यन्तेउपस्तम्भयितुं, महाशरीराह्यपितेस्वल्पानामपिवेदनानामसहादृश्यन्ते, सन्निहितभयशोकलोभमोहमानारौद्रभैरवद्विष्टबीभत्सविकृतसङ्कथास्वपिचपशुपुरुषमांसशोणितानिचावेक्ष्यविषादवैवर्ण्यमूर्च्छोन्मादभ्रमप्रपतनानामन्यतममाप्नुवन्त्यथवामरणमिति||११९||
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sattvataścēti sattvamucyatē manaḥ| taccharīrasya tantrakamātmasaṁyōgāt| tat trividhaṁ balabhēdēna- pravaraṁ, madhyam, avaraṁ cēti; ataśca pravaramadhyāvarasattvāḥ puruṣā bhavanti| tatra pravarasattvāḥ sattvasārāstē sārēṣūpadiṣṭāḥ, svalpaśarīrā hyapi tē nijāgantunimittāsu mahatīṣvapi pīḍāsvavyathā dr̥śyantē sattvaguṇavaiśēṣyāt; madhyasattvāstvaparānātmanyupanidhāya saṁstambhayantyātmanā''tmānaṁ parairvā'pi saṁstabhyantē; hīnasattvāstu nātmanā nāpi paraiḥ sattvabalaṁ prati śakyantē upastambhayituṁ, mahāśarīrā hyapi tē svalpānāmapi vēdanānāmasahā dr̥śyantē, sannihitabhayaśōkalōbhamōhamānā raudrabhairavadviṣṭabībhatsavikr̥tasaṅkathāsvapi ca paśupuruṣamāṁsaśōṇitāni cāvēkṣya viṣādavaivarṇyamūrcchōnmādabhramaprapatanānāmanyatamamāpnuvantyathavā maraṇamiti||119||

sattvatashceti sattvamucyate manaH|
taccharIrasya tantrakamAtmasaMyogAt|
tat trividhaM balabhedena- pravaraM, madhyam, avaraM ceti; atashca pravaramadhyAvarasattvAHpuruShA bhavanti|
tatra pravarasattvAH sattvasArAste sAreShUpadiShTAH, svalpasharIrA hyapi te nijAgantunimittAsumahatIShvapi pIDAsvavyathA [1] dRushyante sattvaguNavaisheShyAt;madhyasattvAstvaparAnAtmanyupanidhAya [2] saMstambhayantyAtmanA~a~atmAnaM parairvA~apisaMstabhyante; hInasattvAstu nAtmanA nApi paraiH sattvabalaM prati shakyante upastambhayituM,mahAsharIrA hyapi te svalpAnAmapi vedanAnAmasahA dRushyante, sannihitabhayashokalobhamohamAnAraudrabhairavadviShTabIbhatsavikRutasa~gkathAsvapi ca pashupuruShamAMsashoNitAni cAvekShyaviShAdavaivarNyamUrcchonmAdabhramaprapatanAnAmanyatamamApnuvantyathavA maraNamiti||119||
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One should also be examined in respect of psyche/mental strength(''sattva''). ''Sattva'' is known as mind, which controls the body functions by conjunction with the self. It is of three types according to strength- superior, medium and inferior. Accordingly, the persons are also (of three types) having superior, medium and inferior psyche.

Amongst them, those having superior mental strength are, in fact, ''sattva sara'' (with ''sattva'' as essence) and have been described in context of ''sara''. They, though possessing small stature body are seen unmoved even in severe affections (innate or exogenous) due to predominance of ''sattva'' quality.

Those having medium quality of psyche sustain themselves at the instance of other or entirely by others.

But those having inferior mind can sustain neither by themselves nor by others, although having big stature, they are unable to endure even mild pain, they are associated with fear, grief, greed, confusion and conceit; and even during fierce, frightening, disliked, disgusting and ugly narratives or on seeing the animal or human flesh or blood get afflicted with anxiety, abnormal complexion, fainting, insanity, giddiness or falling on the ground or even succumb to death.[119]
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==== Assessment of ''aharashakti'' (power of assimilation) ====
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आहारशक्तितश्चेतिआहारशक्तिरभ्यवहरणशक्त्याजरणशक्तयाचपरीक्ष्या; बलायुषीह्याहारायत्ते||१२०||
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āhāraśaktitaścēti āhāraśaktirabhyavaharaṇaśaktyā jaraṇaśaktayā ca parīkṣyā; balāyuṣī hyāhārāyattē||120||

AhArashaktitashceti AhArashaktirabhyavaharaNashaktyA jaraNashaktayA ca parIkShyA; balAyuShIhyAhArAyatte||120||
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Examination regarding power for assimilation (''aharashakti'') is to be done in respect of power of ingestion as well as digestion. Strength and life depends on diet.[120]

==== Assessment of ''vyayamashakti'' (exercise capacity) ====
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व्यायामशक्तितश्चेतिव्यायामशक्तिरपिकर्मशक्त्यापरीक्ष्या| कर्मशक्त्याह्यनुमीयतेबलत्रैविध्यम् ||१२१||
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vyāyāmaśaktitaścēti vyāyāmaśaktirapi karmaśaktyā parīkṣyā| karmaśaktyā hyanumīyatē balatraividhyam ||121||

vyAyAmashaktitashceti vyAyAmashaktirapi karmashaktyA parIkShyA|
karmashaktyA hyanumIyate balatraividhyam [1] ||121||
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In respect of capacity of exercise (''vyayamashakti'') examination should be done by the capactiy for work. In accordance with capacity for work strength is inferred as of three types (poor, moderate and good). [121]

==== Assessment of ''vaya'' (age) ====
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वयस्तश्चेतिकालप्रमाणविशेषापेक्षिणीहिशरीरावस्थावयोऽभिधीयते| तद्वयोयथास्थूलभेदेनत्रिविधं- बालं, मध्यं, जीर्णमिति| तत्रबालमपरिपक्वधातुमजातव्यञ्जनंसुकुमारमक्लेशसहमसम्पूर्णबलंश्लेष्मधातुप्रायमाषोडशवर्षं, विवर्धमानधातुगुणंपुनःप्रायेणानवस्थितसत्त्वमात्रिंशद्वर्षमुपदिष्टं; मध्यंपुनःसमत्वागतबलवीर्यपौरुषपराक्रमग्रहणधारणस्मरणवचनविज्ञानसर्वधातुगुणंबलस्थितमवस्थितसत्त्वमविशीर्यमाणधातुगुणंपित्तधातुप्रायमाषष्टिवर्षमुपदिष्टम्; अतःपरं
हीयमानधात्विन्द्रियबलवीर्यपौरुषपराक्रमग्रहणधारणस्मरणवचनविज्ञानंभ्रश्यमानधातुगुणंवायुधातुप्रायंक्रमेणजीर्णमुच्यतेआवर्षशतम्| वर्षशतंखल्वायुषःप्रमाणमस्मिन्काले; सन्तिचपुनरधिकोनवर्षशतजीविनोऽपिमनुष्याः; तेषांविकृतिवर्ज्यैःप्रकृत्यादिबलविशेषैरायुषोलक्षणतश्चप्रमाणमुपलभ्यवयसस्त्रित्वंविभजेत्||१२२||
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vayastaścēti kālapramāṇaviśēṣāpēkṣiṇī hi śarīrāvasthā vayō'bhidhīyatē| tadvayō yathāsthūlabhēdēna trividhaṁ- bālaṁ, madhyaṁ, jīrṇamiti| tatra bālamaparipakvadhātumajātavyañjanaṁ sukumāramaklēśasahamasampūrṇabalaṁ ślēṣmadhātuprāyamāṣōḍaśavarṣaṁ, vivardhamānadhātuguṇaṁ punaḥ prāyēṇānavasthitasattvamātriṁśadvarṣamupadiṣṭaṁ; madhyaṁ punaḥ samatvāgatabalavīryapauruṣaparākramagrahaṇadhāraṇasmaraṇavacanavijñānasarvadhātuguṇaṁ balasthitamavasthitasattvamaviśīryamāṇadhātuguṇaṁ pittadhātuprāyamāṣaṣṭivarṣamupadiṣṭam; ataḥ paraṁ
hīyamānadhātvindriyabalavīryapauruṣaparākramagrahaṇadhāraṇasmaraṇavacanavijñānaṁ bhraśyamānadhātuguṇaṁ vāyudhātuprāyaṁ kramēṇa jīrṇamucyatē āvarṣaśatam| varṣaśataṁ khalvāyuṣaḥ pramāṇamasmin kālē; santi ca punaradhikōnavarṣaśatajīvinō'pi manuṣyāḥ; tēṣāṁ vikr̥tivarjyaiḥ prakr̥tyādibalaviśēṣairāyuṣō lakṣaṇataśca pramāṇamupalabhya vayasastritvaṁ vibhajēt||122||

vayastashceti kAlapramANavisheShApekShiNI hi sharIrAvasthA vayo~abhidhIyate|
tadvayo yathAsthUlabhedena [1] trividhaM- bAlaM, madhyaM, jIrNamiti|
tatra bAlamaparipakvadhAtumajAtavya~jjanaM sukumAramakleshasahamasampUrNabalaMshleShmadhAtuprAyamAShoDashavarShaM, vivardhamAnadhAtuguNaM punaHprAyeNAnavasthitasattvamAtriMshadvarShamupadiShTaM; madhyaM punaHsamatvAgatabalavIryapauruShaparAkramagrahaNadhAraNasmaraNavacanavij~jAnasarvadhAtuguNaMbalasthitamavasthitasattvamavishIryamANadhAtuguNaMpittadh<br>AtuprAyamAShaShTivarShamupadiShTam; ataH paraM
hIyamAnadhAtvindriyabalavIryapauruShaparAkramagrahaNadhAraNasmaraNavacanavij~jAnaMbhrashyamAnadhAtuguNaM vAyudhAtuprAyaM krameNa jIrNamucyate AvarShashatam|
varShashataM khalvAyuShaH pramANamasmin kAle; santi ca punaradhikonavarShashatajIvino~apimanuShyAH; teShAM vikRutivarjyaiH prakRutyAdibalavisheShairAyuSho lakShaNatashcapramANamupalabhya vayasastritvaM vibhajet||122||
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Examination of a person with respect to age should be done as the state of body corresponds to the length of time. Age is broadly divided into three stages viz. childhood, middle age and old age.

Childhood is determined upto the age of sixteen years when ''dhatus'' are immature, sexual characters are not manifested the body is delicate, unenduring with incomplete strength and predominance of ''kapha dhatu''.

This again is perceived in two subtypes viz. ''dhatus'' in developing stage up to sixteen years and fickle mind up to thirty years.

The middle age is characterized by strength, energy, virility, valor, acquisition, retention, recollection, speech, understanding and qualities of all ''dhatus'' having developed properly; with proper physical and mental strength, without degeneration in qualities of ''dhatus'', with predominance of ''pitta dhatu'' and is up to sixty years.

Later is the old age up to one hundred years. During this period ''dhatus'', sense organs, strength, energy, virility, prowess, acquisition, retention, recollection, speech and understanding generally or gradually degenerate, this phase is predominated by ''vayu''. During this stage the measure of life span is one hundred years.

There are persons who lived longer or shorter than that, in such cases, one should determine the three divisions of age on the basis of strength of the factors like ''prakriti'' etc. except ''vikriti'' and also by the features of different periods of life span.[122]
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एवंप्रकृत्यादीनांविकृतिवर्ज्यानांभावानांप्रवरमध्यावरविभागेनबलविशेषंविभजेत्| विकृतिबलत्रैविध्येनतुदोषबलंत्रिविधमनुमीयते| ततोभैषज्यस्यतीक्ष्णमृदुमध्यविभागेनत्रैविध्यंविभज्ययथादोषंभैषज्यमवचारयेदिति||१२३||
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ēvaṁ prakr̥tyādīnāṁ vikr̥tivarjyānāṁ bhāvānāṁ pravaramadhyāvaravibhāgēna balaviśēṣaṁ vibhajēt| vikr̥tibalatraividhyēna tu dōṣabalaṁ trividhamanumīyatē| tatō bhaiṣajyasya tīkṣṇamr̥dumadhyavibhāgēna traividhyaṁ vibhajya yathādōṣaṁ bhaiṣajyamavacārayēditi||123||

evaM prakRutyAdInAM vikRutivarjyAnAM bhAvAnAM pravaramadhyAvaravibhAgena balavisheShaMvibhajet|
vikRutibalatraividhyena tu doShabalaM trividhamanumIyate|
tato bhaiShajyasya tIkShNamRudumadhyavibhAgena traividhyaM vibhajya yathAdoShaMbhaiShajyamavacArayediti||123||
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Thus, the strength of the entities like ''prakriti'', etc. barring ''vikriti'' should be determined in three divisions – superior, medium and inferior. According to severity of morbidity (''vikriti'') the three degrees of strength of ''dosha'' are inferred. In accordance with the medicaments should also be divided into three degrees i.e. strong, mild and moderate in regard to ''dosha''.[123]
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===== Knowledge of lifespan =====
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आयुषःप्रमाणज्ञानहेतोःपुनरिन्द्रियेषु] जातिसूत्रीयेचलक्षणान्युपदेक्ष्यन्ते||१२४||
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āyuṣaḥ pramāṇajñānahētōḥ punarindriyēṣu jātisūtrīyē ca lakṣaṇānyupadēkṣyantē||124||

AyuShaH pramANaj~jAnahetoH punarindriyeShu [1] jAtisUtrIye ca lakShaNAnyupadekShyante||124||
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In regard to knowledge of measure of life span, there is description of symptoms in Indriya sthana and Jatisutriya adhyaya (eighth chapter of sharira sthana).[124]

==== Assessment of ''Kala'' (time or stage or season) ====
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कालःपुनःसंवत्सरश्चातुरावस्थाच| तत्रसंवत्सरोद्विधात्रिधाषोढाद्वादशधाभूयश्चाप्यतःप्रविभज्यतेतत्तत्कार्यमभिसमीक्ष्य| अत्रखलुतावत्षोढाप्रविभज्यकार्यमुपदेक्ष्यते- हेमन्तोग्रीष्मोवर्षाश्चेतिशीतोष्णवर्षलक्षणास्त्रयऋतवोभवन्ति, तेषामन्तरेष्वितरेसाधारणलक्षणास्त्रयऋतवः- प्रावृट्शरद्वसन्ताइति| प्रावृडितिप्रथमःप्रवृष्टःकालः, तस्यानुबन्धोहिवर्षाः| एवमेतेसंशोधनमधिकृत्यषट्विभज्यन्तेऋतवः||१२५||
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kālaḥ punaḥ saṁvatsaraścāturāvasthā ca| tatra saṁvatsarō dvidhā tridhā ṣōḍhā dvādaśadhā bhūyaścāpyataḥ pravibhajyatē tattatkāryamabhisamīkṣya| atra khalu tāvat ṣōḍhā pravibhajya kāryamupadēkṣyatē- hēmantō grīṣmō varṣāścēti śītōṣṇavarṣalakṣaṇāstraya r̥tavō bhavanti, tēṣāmantarēṣvitarē sādhāraṇalakṣaṇāstraya r̥tavaḥ- prāvr̥ṭśaradvasantā iti| prāvr̥ḍiti prathamaḥ pravr̥ṣṭaḥ kālaḥ, tasyānubandhō hi varṣāḥ| ēvamētē saṁśōdhanamadhikr̥tya ṣaṭ vibhajyantē r̥tavaḥ||125||

kAlaH punaH saMvatsarashcAturAvasthA ca|
tatra saMvatsaro dvidhA tridhA ShoDhA dvAdashadhA bhUyashcApyataH pravibhajyatetattatkAryamabhisamIkShya|
atra khalu tAvat ShoDhA pravibhajya kAryamupadekShyate- hemanto grIShmo varShAshcetishItoShNavarShalakShaNAstraya Rutavo bhavanti, teShAmantareShvitare sAdhAraNalakShaNAstrayaRutavaH- prAvRuTsharadvasantA iti|
prAvRuDiti prathamaH pravRuShTaH [1] kAlaH, tasyAnubandho hi varShAH|
evamete saMshodhanamadhikRutya ShaT vibhajyante RutavaH||125||
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''Kala'' (time) has been considered of two types viz. year aspect and status of the patient. The year has been divided into two, three, six, twelve or even more parts according to nature of action (to be taken). Now, dividing into six, the action will be said. ''Hemanta'' (early winter), ''grishma'' (summer) and ''varsha'' (rainy season) these are the three seasons characterised by cold, heat and rains. In between them, there are other three seasons having common characters as ''pravrit'' (early rain), ''sharada'' (autumn) and ''vasanta'' (spring). ''Pravrit'' denotes the early rain; ''varsha'' is the continuation of the same. Thus, these six divisions of the seasons have been made for the purpose of evacuative therapy.[125]

==== Appropriate season for purification therapies ====
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तत्रसाधारणलक्षणेष्वृतुषुवमनादीनांप्रवृत्तिर्विधीयते, निवृत्तिरितरेषु| साधारणलक्षणाहिमन्दशीतोष्णवर्षत्वात्सुखतमाश्चभवन्त्यविकल्पकाश्चशरीरौषधानाम्, इतरेपुनरत्यर्थशीतोष्णवर्षत्वाद्दुःखतमाश्च
भवन्तिविकल्पकाश्चशरीरौषधानाम्||१२६||
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tatra sādhāraṇalakṣaṇēṣvr̥tuṣu vamanādīnāṁ pravr̥ttirvidhīyatē, nivr̥ttiritarēṣu| sādhāraṇalakṣaṇā hi mandaśītōṣṇavarṣatvāt sukhatamāśca bhavantyavikalpakāśca śarīrauṣadhānām, itarē punaratyarthaśītōṣṇavarṣatvādduḥkhatamāśca bhavanti vikalpakāśca śarīrauṣadhānām||126||

tatra sAdhAraNalakShaNeShvRutuShu vamanAdInAM pravRuttirvidhIyate, nivRuttiritareShu|
sAdhAraNalakShaNA hi mandashItoShNavarShatvAt sukhatamAshca bhavantyavikalpakAshcasharIrauShadhAnAm, itare punaratyarthashItoShNavarShatvAdduHkhatamAshca bhavanti vikalpakAshcasharIrauShadhAnAm||126||
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Purification therapies such as emesis etc. are applied in seasons having similar characters(as of physiological vitiation of ''dosha'') and are stopped in other seasons. The seasons having similar characters are the most convenient ones and are not harmful to body and drugs because of moderate cold, heat and rains, while others, due to excessive cold, heat and rains are inconvenient ones and harmful to body and the drugs.[126]
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तत्रहेमन्तेह्यतिमात्रशीतोपहतत्वाच्छरीरमसुखोपपन्नंभवत्यतिशीतवाताध्मातमतिदारुणीभूतमवबद्धदोषंच, भेषजंपुनःसंशोधनार्थमुष्णस्वभावमतिशीतोपहतत्वान्मन्दवीर्यत्वमापद्यते, तस्मात्तयोःसंयोगेसंशोधनमयोगायोपपद्यतेशरीरमपिचवातोपद्रवाय| ग्रीष्मेपुनर्भृशोष्णोपहतत्वाच्छरीरमसुखोपपन्नंभवत्युष्णवातातपाध्मातमतिशिथिलमत्यर्थप्रविलीनदोषं, भेषजंपुनःसंशोधनार्थमुष्णस्वभावमुष्णानुगमनात्तीक्ष्णतरत्वमापद्यते, तस्मात्तयोःसंयोगेसंशोधनमतियोगायोपपद्यतेशरीरमपिपिपासोपद्रवाय| वर्षासुतुमेघजलावततेगूढार्कचन्द्रतारेधाराकुलेवियतिभूमौपङ्कजलपटलसंवृतायामत्यर्थोपक्लिन्नशरीरेषुभूतेषुविहतस्वभावेषुचकेवलेष्वौषधग्रामेषुतोयतोयदानुगतमारुतसंसर्गाद्गुरुप्रवृत्तीनिवमनादीनिभवन्ति, गुरुसमुत्थानानिचशरीराणि| तस्माद्वमनादीनांनिवृत्तिर्विधीयतेवर्षान्तेष्वृतुषु , नचेदात्ययिकंकर्म| आत्ययिकेपुनःकर्मणिकाममृतुंविकल्प्यकृत्रिमगुणोपधानेनयथर्तुगुणविपरीतेनभेषजंसंयोगसंस्कारप्रमाणविकल्पेनोपपाद्यप्रमाणवीर्यसमंकृत्वाततःप्रयोजयेदुत्तमेनयत्नेनावहितः||१२७||
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tatra hēmantē hyatimātraśītōpahatatvāccharīramasukhōpapannaṁ bhavatyatiśītavātādhmātamatidāruṇībhūtamavabaddhadōṣaṁ ca, bhēṣajaṁ punaḥ saṁśōdhanārthamuṣṇasvabhāvamatiśītōpahatatvānmandavīryatvamāpadyatē, tasmāttayōḥ saṁyōgē saṁśōdhanamayōgāyōpapadyatē śarīramapi ca vātōpadravāya| grīṣmē punarbhr̥śōṣṇōpahatatvāccharīramasukhōpapannaṁ bhavatyuṣṇavātātapādhmātamatiśithilamatyarthapravilīnadōṣaṁ, bhēṣajaṁ punaḥ saṁśōdhanārthamuṣṇasvabhāvamuṣṇānugamanāttīkṣṇataratvamāpadyatē, tasmāttayōḥ saṁyōgē saṁśōdhanamatiyōgāyōpapadyatē śarīramapi pipāsōpadravāya| varṣāsu tu mēghajalāvatatē gūḍhārkacandratārē dhārākulē viyati bhūmau paṅkajalapaṭalasaṁvr̥tāyāmatyarthōpaklinnaśarīrēṣu bhūtēṣu vihatasvabhāvēṣu ca kēvalēṣvauṣadhagrāmēṣu tōyatōyadānugatamārutasaṁsargād gurupravr̥ttīni vamanādīni bhavanti, gurusamutthānāni ca śarīrāṇi| tasmādvamanādīnāṁ nivr̥ttirvidhīyatē varṣāntēṣvr̥tuṣu , na cēdātyayikaṁ karma| ātyayikē punaḥ karmaṇi kāmamr̥tuṁ vikalpya kr̥trimaguṇōpadhānēna yathartuguṇaviparītēna bhēṣajaṁ saṁyōgasaṁskārapramāṇavikalpēnōpapādya pramāṇavīryasamaṁ kr̥tvā tataḥ prayōjayēduttamēna yatnēnāvahitaḥ||127||

tatra hemante hyatimAtrashItopahatatvAccharIramasukhopapannaMbhavatyatishItavAtAdhmAtamatidAruNIbhUtamavabaddhadoShaM ca, bheShajaM punaHsaMshodhanArthamuShNasvabhAvamatishItopahatatvAnmandavIryatvamApadyate, tasmAttayoHsaMyoge saMshodhanamayogAyopapadyate sharIramapi ca vAtopadravAya|
grIShme punarbhRushoShNopahatatvAccharIramasukhopapannaMbhavatyuShNavAtAtapAdhmAtamatishithilamatyarthapravilInadoShaM, bheShajaM punaHsaMshodhanArthamuShNasvabhAvamuShNAnugamanAttIkShNataratvamApadyate, tasmAttayoH saMyogesaMshodhanamatiyogAyopapadyate sharIramapi pipAsopadravAya|
varShAsu tu meghajalAvatate gUDhArkacandratAre dhArAkule viyati bhUmaupa~gkajalapaTalasaMvRutAyAmatyarthopaklinnasharIreShu bhUteShu vihatasvabhAveShu cakevaleShvauShadhagrAmeShu toyatoyadAnugatamArutasaMsargAd gurupravRuttIni vamanAdIni bhavanti,gurusamutthAnAni ca sharIrANi|
tasmAdvamanAdInAM nivRuttirvidhIyate varShAnteShvRutuShu [1] , na cedAtyayikaM karma|
Atyayike punaH karmaNi kAmamRutuM vikalpya kRutrimaguNopadhAnena yathartuguNaviparItenabheShajaM saMyogasaMskArapramANavikalpenopapAdya pramANavIryasamaM kRutvA tataHprayojayeduttamena yatnenAvahitaH||127||
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During ''hemanta'' (early winter) the body is affected by excessive cold and as such is distressed, exposed to excessively cold wind, is too much roughed and dry, and with ''doshas'' adhered; on the other hand, the drugs administered for evacuation are hot by nature which become mild in potency due to exposure to excessively cold wind. Hence in conjunction of both these, the evacuative therapy becomes ineffective and the body is inflicted with the ''vatika'' complication.

During summer season the body afflicted by excessive heat becomes distressed exposed to excessively hot winds too much lax and with excessively lignified ''doshas''; the drugs, on the other hand, administered for evacuation being hot in nature become more intense because of exposure to heat; hence in conjunction of both these, the evacuative therapy produces effects in excess and the body also gets complication like thirst etc.

During rainy season, when the sky is pervaded with cloud and water the sun, the moon and the stars are hidden and there are torrential rains. The earth is covered with mud and water; the body of living beings is moistened and the entire herbal wealth is damaged in nature, the evacuative measures become dull in action and the human bodies sluggish in recovery due to exposure to wind associated with moisture and clouds.

Therefore, the measures like emesis etc. are stopped in the seasons ending with the rains (early winter, summer and rainy seasons) except in case of emergency. In emergency too, one should administer the therapy with great care after modifying the seasonal effects sufficiently by artificial means producing qualities contrary to the seasons and by making the measure appropriate in standard potency with variation in combination, processing and quantity. [127]

==== Stage of disease ====
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आतुरावस्थास्वपितुकार्याकार्यंप्रतिकालाकालसञ्ज्ञा; तद्यथा- अस्यामवस्थायामस्यभेषजस्याकालः, कालःपुनरन्यस्येति; एतदपिहिभवत्यवस्थाविशेषेण; तस्मादातुरावस्थास्वपिहिकालाकालसञ्ज्ञा| तस्यपरीक्षा- मुहुर्मुहुरातुरस्यसर्वावस्थाविशेषावेक्षणंयथावद्भेषजप्रयोगार्थम्| नह्यतिपतितकालमप्राप्तकालंवाभेषजमुपयुज्यमानंयौगिकंभवति; कालोहिभैषज्यप्रयोगपर्याप्तिमभिनिर्वर्तयति||१२८||
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āturāvasthāsvapi tu kāryākāryaṁ prati kālākālasañjñā; tadyathā- asyāmavasthāyāmasya bhēṣajasyākālaḥ , kālaḥ punaranyasyēti; ētadapi hi bhavatyavasthāviśēṣēṇa; tasmādāturāvasthāsvapi hi kālākālasañjñā| tasya parīkṣā- muhurmuhurāturasya sarvāvasthāviśēṣāvēkṣaṇaṁ yathāvadbhēṣajaprayōgārtham| na hyatipatitakālamaprāptakālaṁ vā bhēṣajamupayujyamānaṁ yaugikaṁ bhavati; kālō hi bhaiṣajyaprayōgaparyāptimabhinirvartayati||128||

AturAvasthAsvapi tu kAryAkAryaM prati kAlAkAlasa~jj~jA; tadyathA- asyAmavasthAyAmasyabheShajasyAkAlaH [1] , kAlaH punaranyasyeti; etadapi hi bhavatyavasthAvisheSheNa;tasmAdAturAvasthAsvapi hi kAlAkAlasa~jj~jA|
tasya parIkShA- muhurmuhurAturasya sarvAvasthAvisheShAvekShaNaM yathAvadbheShajaprayogArtham|
na hyatipatitakAlamaprAptakAlaM vA bheShajamupayujyamAnaM yaugikaM bhavati; kAlo hibhaiShajyaprayogaparyAptimabhinirvartayati||128||
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The status of the patient is also called as timely or untimely in relation the act being performed or not. Such as, in a certain condition one drug is untimely, and the other one is timely. This is also due to specific condition, hence the nomenclature of ''kala'' (timely) and ''akala'' (untimely) is given to the conditions of the patients. This is examined like this- the physician should observe all the conditions of the patient again and again in order to administer the correct therapy. The therapy administered after or before the (opportune) time is not effective because time determines the sufficiency to the administration of therapy.[128]

==== ''Pravritti'' (inclination or action) ====
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प्रवृत्तिस्तुप्रतिकर्मसमारम्भः| तस्यलक्षणंभिषगौषधातुरपरिचारकाणांक्रियासमायोगः||१२९||
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pravr̥ttistu pratikarmasamārambhaḥ| tasya lakṣaṇaṁ bhiṣagauṣadhāturaparicārakāṇāṁ kriyāsamāyōgaḥ||129||

pravRuttistu pratikarmasamArambhaH|
tasya lakShaNaM bhiShagauShadhAturaparicArakANAM kriyAsamAyogaH||129||
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''Pravritti'' (inclination or action) is the initiation of the therapy which is characterized by the combination of physician, drug, patient and attendant in treatment. [129]

==== ''Upaya'' (management) ====
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उपायःपुनर्भिषगादीनांसौष्ठवमभिविधानंचसम्यक्| तस्यलक्षणं- भिषगादीनांयथोक्तगुणसम्पत्देशकालप्रमाणसात्म्यक्रियादिभिश्चसिद्धिकारणैःसम्यगुपपादितस्यौषधस्यावचारणमिति||१३०||
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upāyaḥ punarbhiṣagādīnāṁ sauṣṭhavamabhividhānaṁ ca samyak| tasya lakṣaṇaṁ- bhiṣagādīnāṁ yathōktaguṇasampat dēśakālapramāṇasātmyakriyādibhiśca siddhikāraṇaiḥ samyagupapāditasyauṣadhasyāvacāraṇamiti||130||

upAyaH punarbhiShagAdInAM sauShThavamabhividhAnaM [1] ca samyak|
tasya lakShaNaM- bhiShagAdInAM yathoktaguNasampat deshakAlapramANasAtmyakriyAdibhishcasiddhikAraNaiH samyagupapAditasyauShadhasyAvacAraNamiti||130||
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Regarding ''upaya'' it is excellence of physician etc. and their proper arrangement which is characterized by the physician etc. endowed with their respective qualities and proper application of therapy along with the consideration of place, time, quantitative measurement, suitability, processing etc. which are the factors which when considered and administered with specific medicine leads to success.[130]
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एवमेतेदशपरीक्ष्यविशेषाःपृथक्पृथक्परीक्षितव्याभवन्ति||१३१||
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ēvamētē daśa parīkṣyaviśēṣāḥ pr̥thak pr̥thak parīkṣitavyā bhavanti||131||

evamete dasha parIkShyavisheShAH pRuthak pRuthak parIkShitavyA bhavanti||131||
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Thus these mentioned ten entities should be examined separately and sincerely.[131]

==== Objective of examination ====
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परीक्षायास्तुखलुप्रयोजनंप्रतिपत्तिज्ञानम्प्रतिपत्तिर्नामयोविकारोयथाप्रतिपत्तव्यस्तस्यतथाऽनुष्ठानज्ञानम्||१३२||
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parīkṣāyāstu khalu prayōjanaṁ pratipattijñānam| pratipattirnāma yō vikārō yathā pratipattavyastasya tathā'nuṣṭhānajñānam||132||

parIkShAyAstu khalu prayojanaM pratipattij~jAnam|
pratipattirnAma yo vikAro yathA pratipattavyastasya tathA~anuShThAnaj~jAnam||132||
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''Pratipatti'' is the object of examination. In other words, it is the decision regarding course of action. More over ''pratipatti'' is the knowledge of treatment, with which the disorder is to be treated. [132]
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यत्रतुखलुवमनादीनांप्रवृत्तिः, यत्रचनिवृत्तिः, तद्व्यासतःसिद्धिषूत्तरमुपदेक्ष्यामः||१३३||
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yatra tu khalu vamanādīnāṁ pravr̥ttiḥ, yatra ca nivr̥ttiḥ, tadvyāsataḥ siddhiṣūttaramupadēkṣyāmaḥ||133||

yatra tu khalu vamanAdInAM pravRuttiH, yatra ca nivRuttiH, tadvyAsataHsiddhiShUttaramupadekShyAmaH||133||
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The conditions where emesis etc. are indicated or contraindicated will be described in detail in [[Siddhi Sthana]]. [133]
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प्रवृत्तिनिवृत्तिलक्षणसंयोगेतुगुरुलाघवंसम्प्रधार्यसम्यगध्यवस्येदन्यतरनिष्ठायाम्सन्तिहिव्याधयःशास्त्रेषूत्सर्गापवादैरुपक्रमंप्रतिनिर्दिष्टाः| तस्माद्गुरुलाघवंसम्प्रधार्यसम्यगध्यवस्येदित्युक्तम्||१३४||
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pravr̥ttinivr̥ttilakṣaṇasaṁyōgē tu gurulāghavaṁ sampradhārya samyagadhyavasyēdanyataraniṣṭhāyām| santi hi vyādhayaḥ śāstrēṣūtsargāpavādairupakramaṁ prati nirdiṣṭāḥ| tasmādgurulāghavaṁ sampradhārya samyagadhyavasyēdityuktam||134||

pravRuttinivRuttilakShaNasaMyoge tu gurulAghavaM sampradhAryasamyagadhyavasyedanyataraniShThAyAm|
santi hi vyAdhayaH shAstreShUtsargApavAdairupakramaM prati nirdiShTAH|
tasmAdgurulAghavaM sampradhArya samyagadhyavasyedityuktam||134||
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In situation where symptoms of both indication and contraindication conjoined, one should decide (the treatment protocol) after proper examination of dominant or recessive condition of ''dosha''. The diseases mentioned in treatises are in respect of their treatment as general rule or exception. Hence it is said that one should take action after considering the dominant or recessive condition of ''dosha''. [134]

==== List of medicines used in therapeutic emesis ====
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यानितुखलुवमनादिषुभेषजद्रव्याण्युपयोगंगच्छन्तितान्यनुव्याख्यास्यामः| तद्यथा- फलजीमूतकेक्ष्वाकुधामार्गवकुटजकृतवेधनफलानि, फलजीमूतकेक्ष्वाकुधामार्गवपत्रपुष्पाणिआरग्वधवृक्षकमदनस्वादुकण्टकपाठापाटलाशार्ङ्गेष्टामूर्वासप्तपर्णनक्तमालपिचुमर्दपटोलसुषवीगुडूची- चित्रकसोमवल्कशतावरीद्वीपीशिग्रुमूलकषायैः, मधुकमधूककोविदारकर्वुदारनीपविदुलबिम्बीशणपुष्पीसदापुष्पाप्रत्यक्पुष्पाकषायैश्च, एलाहरेणुप्रियङ्गुपृथ्वीकाकुस्तुम्बुरुतगरनलदह्रीवेरतालीशोशीरकषायैश्च , इक्षुकाण्डेक्ष्विक्षुवालिकादर्भपोटगलकालङ्कृ(ङ्क)तकषायैश्च,
सुमनासौमनस्यायनीहरिद्रादारुहरिद्रावृश्चीरपुनर्नवामहासहाक्षुद्रसहाकषायैश्च, शाल्मलिशाल्मलिकभद्रपर्ण्येलापर्ण्युपोदिकोद्दालकधन्वनराजादनोपचित्रागोपीशृङ्गाटिकाकषायैश्च, पिप्पलीपिप्पलीमूलचव्यचित्रकशृङ्गवेरसर्षपफाणितक्षीरक्षारलवणोदकैश्च, यथालाभंयथेष्टंवाऽप्युपसंस्कृत्यवर्तिक्रियाचूर्णावलेहस्नेहकषायमांसरसयवागूयूषकाम्बलिकक्षीरोपधेयान्मोदकानन्यांश्चभक्ष्यप्रकारान्विविधाननुविधाययथार्हंवमनार्हायदद्याद्विधिवद्वमनम्| इतिकल्पसङ्ग्रहोवमनद्रव्याणाम्| कल्पमेषांविस्तारेणोत्तरकालमुपदेक्ष्यामः||१३५||
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yāni tu khalu vamanādiṣu bhēṣajadravyāṇyupayōgaṁ gacchanti tānyanuvyākhyāsyāmaḥ| tadyathā- phalajīmūtakēkṣvākudhāmārgavakuṭajakr̥tavēdhanaphalāni, phalajīmūtakēkṣvākudhāmārgavapatrapuṣpāṇi āragvadhavr̥kṣakamadanasvādukaṇṭakapāṭhāpāṭalāśārṅgēṣṭāmūrvāsaptaparṇanaktamālapicumardapa<br>ṭōlasuṣavīguḍūcī- citrakasōmavalkaśatāvarīdvīpīśigrumūlakaṣāyaiḥ, madhukamadhūkakōvidārakarvudāranīpavidulabimbīśaṇapuṣpīsadāpuṣpāpratyakpuṣpākaṣāyaiśca, ēlāharēṇupriyaṅgupr̥thvīkākustumburutagaranaladahrīvēratālīśōśīrakaṣāyaiśca , ikṣukāṇḍēkṣvikṣuvālikādarbhapōṭagalakālaṅkr̥(ṅka)takaṣāyaiśca, sumanāsaumanasyāyanīharidrādāruharidrāvr̥ścīrapunarnavāmahāsahākṣudrasahākaṣāyaiśc, śālmaliśālmalikabhadraparṇyēlāparṇyupōdikōddālakadhanvan<br>arājādanōpacitrāgōpīśr̥ṅgāṭiākaṣāyaiśca, pippalīpippalīmūlacavyacitrakaśr̥ṅgavērasarṣapaphāṇitakṣīrakṣāralavaṇōdakaiśca, yathālābhaṁ yathēṣṭaṁ vā'pyupasaṁskr̥tya vartikriyācūrṇāvalēhasnēhakaṣāyamāṁsarasayavāgūyūṣakāmbalikakṣīrōpadhēyānmōdakānanyāṁśca bhakṣyaprakārān vividhānanuvidhāya yathārhaṁ vamanārhāya dadyādvidhivadvamanam| iti kalpasaṅgrahō vamanadravyāṇām| kalpamēṣāṁ vistārēṇōttarakālamupadēkṣyāmaḥ||135||

yAni tu khalu vamanAdiShu bheShajadravyANyupayogaM gacchanti tAnyanuvyAkhyAsyAmaH|
tadyathA- phalajImUtakekShvAkudhAmArgavakuTajakRutavedhanaphalAni, phalajImUtakekShvAkudhAmArgavapatrapuShpANiAragvadhavRukShakamadanasvAdukaNTakapAThApATalAshAr~ggeShTAmUrvAsaptaparNanaktamAlapic<br>umardapaTolasuShavIguDUcI-citrakasomavalkashatAvarIdvIpIshigrumUlakaShAyaiH,madhukamadhUkakovidArakarvudAranIpavidulabimbIshaNapuShpIsadApuShpApratyakpuShpAkaShAyaishca,elAha<br>reNupriya~ggupRuthvIkAkustumburutagaranaladahrIveratAlIshoshIrakaShAyaishca [1] ,ikShukANDekShvikShuvAlikAdarbhapoTagalakAla~gkRu(~gka)takaShAyaishca,
sumanAsaumanasyAyanIharidrAdAruharidrAvRushcIrapunarnavAmahAsahAkShudrasahAkaShAyaishca,shAlmalishAlmalikabhadraparNyelAparNyupodikoddAlakadhanva<br>narAjAdanopacitrAgopIshRu~ggATikAkaShAyaishca,pippalIpippalImUlacavyacitrakashRu~ggaverasarShapaphANitakShIrakShAralavaNodakaishca, yathAlAbhaM yatheShTaMvA~apyupasaMskRutya vartikriyAcUrNAvalehasnehakaShAyamAMsarasayavAgUyUShakAmbalikakShIropadheyAnmodakAnanyAMshcabhakShyaprakArAn vividhAnanuvidhAya yathArhaM vamanArhAya dadyAdvidhivadvamanam|
iti kalpasa~ggraho vamanadravyANAm|
kalpameShAM vistAreNottarakAlamupadekShyAmaH||135||
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In this concern the drugs which are mentioned for therapeutic emesis etc. are being mentioned henceforth. They are as follows:
*Fruits of ''madanaphala, jimutaka, ikshvaku, dhamargava, kutaja, kritavedhana'' ;
*Leaves and flowers of ''madanaphala, jimutaka, ikshvaku, dhamargava'';
*Decoctions of the roots of ''aragvadha, vrikshaka (kutaja), madana, svadukanṭaka, paṭha, patala, sharangeshta, murva, saptaparna, naktamala, pichumarda (nimba), patola, sushavi, guduchi- chitraka, somavalka, shatavari, dvipi, shigrumula'';
*Decoction of ''madhuka, madhooka, kovidara, karvudara, nipa, vidula, bimbi, shaṇapushpi, sadapushpa (arka)'' and ''pratyakpushpa(apamarga)'';
*Decoction of ''ela, harenu, priyangu, prithvika, kustumburu, tagara, nalada, hrivera, talis, ushira,''
*Decoction of ''ikshu, kandekshu, ikshuvalika, darbha, potagala, kalankri(nka)ta'';
*Decoction of ''sumana, saumanasyayani, haridra, daruharidra, vrishchirq, punarnava, mahasaha, kshudrasaha;''
*Decoction of ''sumana, saumanasyayani'';
*Decoction of ''shalmali, shalmalika, bhadraparni, elaparni, upodika, uddalaka, dhanvana, rajadana, upachitra, gopi (sariva), shringataka; pippali, pippalimula, chavya, chitraka, shringavera, sarshapa, phanita, kshira, kshara,'' salt with water and made into bolus and other eatables added with ''vartti kriya'' (suppository), powder, linctus, processed in lipids, extract, meat soup, gruel, (vegetable) soup, ''kambalika'' and milk should be administered to the patient requiring emesis according to prescribed procedure. These are, in brief, the pharmaceutical forms of emetic drugs, which are described in detail latter on in [[Kalpa Sthana]].[135]

==== List of medicines used in therapeutic purgation ====
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विरेचनद्रव्याणितुश्यामात्रिवृच्चतुरङ्गुलतिल्वकमहावृक्षसप्तलाशङ्खिनीदन्तीद्रवन्तीनांक्षीरमूलत्वक्पत्रपुष्पफलानियथायोगंतैस्तैःक्षीरमूलत्वक्पत्रपुष्पफलैर्विक्लिप्ताविक्लिप्तैः , अजगन्धाश्वगन्धाजशृङ्गीक्षीरिणीनीलिनीक्लीतककषायैश्च, प्रकीर्योदकीर्यामसूरविदलाकम्पिल्लकविडङ्गगवाक्षीकषायैश्च, पीलुप्रियालमृद्वीकाकाश्मर्यपरूषकबदरदाडिमामलकहरीतकीबिभीतकवृश्चीरपुनर्नवाविदारिगन्धादिकषायैश्च,सीधुसुरासौवीरकतुषोदकमैरेयमेदकमदिरामधुमधूलकधान्याम्लकुवलबदरखर्जूरकर्कन्धुभिश्च, दधिदधिमण्डोदश्विद्भिश्च, गोमहिष्यजावीनांचक्षीरमूत्रैर्यथालाभंयथेष्टंवाऽप्युपसंस्कृत्यवर्तिक्रियाचूर्णासवलेहस्नेहकषायमांसरसयूषकाम्बलिकयवागूक्षीरोपधेयान्मोदकानन्यांश्चभक्ष्यप्र(वि)कारान्विविधांश्चयोगाननुविधाययथार्हंविरेच<br>नार्हायदद्याद्विरेचनम्| इतिकल्पसङ्ग्रहोविरेचनद्रव्याणाम्| कल्पमेषांविस्तरेणयथावदुत्तरकालमुपदेक्ष्यामः||१३६||
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virēcanadravyāṇi tu
śyāmātrivr̥ccaturaṅgulatilvakamahāvr̥kṣasaptalāśaṅkhinīdantīdravantīnāṁ kṣīramūlatvakpatrapuṣpaphalāni yathāyōgaṁ taistaiḥ kṣīramūlatvakpatrapuṣpaphalairvikliptāvikliptaiḥ , ajagandhāśvagandhājaśr̥ṅgīkṣīriṇīnīlinīklītakakaṣāyaiśca, prakīryōdakīryāmasūravidalākampillakaviḍaṅgagavākṣīkaṣāyaiśca, pīlupriyālamr̥dvīkākāśmaryaparūṣakabadaradāḍimāmalakaharītakībibhītakavr̥ścīrapunarnavāvidārigandhādikaṣāyaiśca, sīdhusurāsauvīrakatuṣōdakamairēyamēdakamadirāmadhumadhūlakadhānyāmlakuvalabadarakharjūrakarkandhubhiśca, dadhidadhimaṇḍōdaśvidbhiśca, gōmahiṣyajāvīnāṁ ca kṣīramūtrairyathālābhaṁ yathēṣṭaṁ vā'pyupasaṁskr̥tya vartikriyācūrṇāsavalēhasnēhakaṣāyamāṁsarasayūṣakāmbalikayavāgūkṣīrōpadhēyān mōdakānanyāṁśca bhakṣyapra(vi)kārān vividhāṁśca yōgānanuvidhāya yathārhaṁ virēcanārhāya dadyādvirēcanam| iti kalpasaṅgrahō virēcanadravyāṇām| kalpamēṣāṁ vistarēṇa yathāvaduttarakālamupadēkṣyāmaḥ||136||

virecanadravyANi tu shyAmAtrivRuccatura~ggulatilvakamahAvRukShasaptalAsha~gkhinIdantIdravantInAMkShIramUlatvakpatrapuShpaphalAni yathAyogaM taistaiH kShIramUlatvakpatrapuShpaphalairvikliptAvikliptaiH ,ajagandhAshvagandhAjashRu~ggIkShIriNInIlinIklItakakaShAyaishca,prakIryodakIryAmasUravidalAkampillakaviDa~ggagavAkShIkaShAyaishca,pIlupriyAlamRudvIkAkAsh<br>maryaparUShakabadaradADimAmalakaharItakIbibhItakavRushcIrapunarnavAvidArigandhAdikaShAyaishca,sIdhusurAsauvIrakatuShodakamaireyamedakamadirAmadhum<br>adhUlakadhAnyAmlakuvalabadarakharjUrakarkandhubhishca,dadhidadhimaNDodashvidbhishca, gomahiShyajAvInAM ca kShIramUtrairyathAlAbhaM yatheShTaM vA~apyupasaMskRutyavartikriyAcUrNAsavalehasnehakaShAyamAMsarasayUShakAmbalikayavAgUkShIropadheyAn modakAnanyAMshcabhakShyapra(vi)kArAn vividhAMshca [1] yogAnanuvidhAya yathArhaM virecanArhAya dadyAdvirecanam|
iti kalpasa~ggraho virecanadravyANAm|
kalpameShAM vistareNa yathAvaduttarakAlamupadekShyAmaH||136||
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Purgative drugs in parts of latex, root, bark, leaf, flower and fruit wholly or individually of ''shyama, trivrit, chaturangula'' (''aragvadha''), ''tilvaka, mahavriksha, saptala, shankhini, danti'' and ''dravanti'' are to be used according to requirement. They should be processed, according to need or availability with the following:
*decoction of ''ajagandha, ashvagandha, ajashringi, kshirini, nilini'' and ''klitaka'';
*''prakirya, udakirya, masuravidala, kampillaka, vidanga,'' and ''gavakshi'';
*''pilu, priyala, mrudvika, kashmarya, parushaka, badara, dadima, amalaki, haritaki, bibhitaki, vrushchira, punarnava'' and the drugs of ''vidarigandhadi gana'';
*''sidhu, sura, sauviraka, tushodaka, maireya, medaka, madira, madhu, madhulaka, dhanyamla, kuvala, badara, kharjura, karkandhu, dadhi, dadhimanda'' (curdwater), ''udashvid'' (buttermilk) and;
*milk and urine of cow, buffalo, goat and sheep;
*made into bolus and other eatables added with ''vartikriya'' (suppository), ''churna'' (powder), ''asava, leha'' (linctus), ''sneha'' (medicated fatty preparation), ''kashaya'' (decoction), ''mamsarasa'' (meat-soup), ''yusha'' (vegetable soup), ''kambalika'' (a kind of soup prepared from whey and green gram), ''yavagu'' (gruel), ''kshiropadheyan'' (milk administered), ''modaka'' (comparatively big tablet for high dose), and other forms of food preparation are to be used in patient requiring purgation. These are in brief the pharmaceutical preparation of purgative drugs, which will be further described in detail.[136]

==== List of medicines used in therapeutic non-unctuous enema ====
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आस्थापनेषुतुभूयिष्ठकल्पानिद्रव्याणियानियोगमुपयान्तितेषुतेष्ववस्थान्तरेष्वातुराणां, तानिद्रव्याणिनामतोविस्तरेणोपदिश्यमानान्यपरिसङ्ख्येयानिस्युरतिबहुत्वात्; इष्टश्चानतिसङ्क्षेपविस्तरोपदेशस्तन्त्रे, इष्टंचकेवलंज्ञानं, तस्माद्रसतएवतान्यत्रव्याख्यास्यामः| ससंसर्गविकल्पविस्तरोह्येषामपरिसङ्ख्येयः, समवेतानांरसानामंशांशबलविकल्पातिबहुत्वात्| तस्माद्द्रव्याणांचैकदेशमुदाहरणार्थंरसेष्वनुविभज्यरसैकैकश्येनचनामलक्षणार्थंषडास्थापनस्कन्धारसतोऽनुविभज्यव्याख्यास्तन्ते||१३७||
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āsthāpanēṣu tu bhūyiṣṭhakalpāni dravyāṇi yāni yōgamupayānti tēṣu tēṣvavasthāntarēṣvāturāṇāṁ, tāni dravyāṇi nāmatō vistarēṇōpadiśyamānānyaparisaṅkhyēyāni syuratibahutvāt; iṣṭaścānatisaṅkṣēpavistarōpadēśastantrē, iṣṭaṁ ca kēvalaṁ jñānaṁ, tasmādrasata ēva tānyatra vyākhyāsyāmaḥ| rasasaṁsargavikalpavistarō hyēṣāmaparisaṅkhyēyaḥ, samavētānāṁ rasānāmaṁśāṁśabalavikalpātibahutvāt| tasmāddravyāṇāṁ caikadēśamudāharaṇārthaṁ rasēṣvanuvibhajya rasaikaikaśyēna ca nāmalakṣaṇārthaṁ ṣaḍāsthāpanaskandhā rasatō'nuvibhajya vyākhyāstantē||137||

AsthApaneShu tu bhUyiShThakalpAni dravyANi yAni yogamupayAnti teShuteShvavasthAntareShvAturANAM, tAni dravyANi nAmato vistareNopadishyamAnAnyaparisa~gkhyeyAnisyuratibahutvAt; iShTashcAnatisa~gkShepavistaropadeshastantre, iShTaM ca kevalaM j~jAnaM,tasmAdrasata eva tAnyatra vyAkhyAsyAmaH|
rasasaMsargavikalpavistaro [1] hyeShAmaparisa~gkhyeyaH, samavetAnAMrasAnAmaMshAMshabalavikalpAtibahutvAt|
tasmAddravyANAM caikadeshamudAharaNArthaM raseShvanuvibhajya rasaikaikashyena canAmalakShaNArthaM ShaDAsthApanaskandhA rasato~anuvibhajya vyAkhyAstante||137||
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The drugs which are mostly used in non-unctuous enema in different conditions of patients may become innumerable if they are described in detail by individual names, but as the dealing of the subject in the treatise is desired, they are mentioned here only according to ''rasas''. In respect of these, the details of the variations in combination of ''rasas'' are immeasurable because of the excessive numerousness of the proportional variations in combined ''rasas''. Hence for illustration, a part of drugs having been grouped in ''rasas'', six groups of (drugs used in) non-unctuous enema are mentioned here according to ''rasas'' for characterization according to name on the basis of individual ''rasa''. [137]
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यत्तुषड्विधमास्थापनमेकरसमित्याचक्षतेभिषजः, तद्दुर्लभतमंसंसृष्टरसभूयिष्ठत्वाद्द्रव्याणाम्| तस्मान्मधुराणिमधुरप्रायाणिमधुरविपाकानिमधुरप्रभावाणिचमधुरस्कन्धेमधुराण्येवकृत्वोपदेक्ष्यन्ते, तथेतराणिद्रव्याण्यपि||१३८||
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yattu ṣaḍvidhamāsthāpanamēkarasamityācakṣatē bhiṣajaḥ, taddurlabhatamaṁ saṁsr̥ṣṭarasabhūyiṣṭhatvāddravyāṇām| tasmānmadhurāṇi madhuraprāyāṇi madhuravipākāni madhuraprabhāvāṇi ca madhuraskandhē madhurāṇyēva kr̥tvōpadēkṣyantē, tathētarāṇi dravyāṇyapi||138||

yattu ShaDvidhamAsthApanamekarasamityAcakShate bhiShajaH, taddurlabhatamaMsaMsRuShTarasabhUyiShThatvAddravyANAm|
tasmAnmadhurANi madhuraprAyANi madhuravipAkAni madhuraprabhAvANi ca madhuraskandhemadhurANyeva kRutvopadekShyante, tathetarANi dravyANyapi||138||
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That non-unctuous enema is of six types having single rasa as said by physician. Drugs possess mostly the combined ''rasa'' therefore grouping them in single group is not possible, hence the drugs included in ''madhura'' group mean those which are sweet, predominantly sweet, and sweet in ''vipaka'' or having effects similar to sweet drugs. This is same for other drugs also.[138]

==== ''Madhura skandha'' (group of sweet drugs) ====
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तद्यथा-

जीवकर्षभकौजीवन्तीवीरातामलकीकाकोलीक्षीरकाकोलीमुद्गपर्णीमाषपर्णीशालपर्णीपृश्निपर्ण्यसनपर्णीमधुपर्णीमेदामहामेदाकर्कटशृङ्गीशृङ्गाटिकाछिन्नरुहाच्छत्राऽतिच्छत्राश्रावणीमहाश्रावणीसहदेवाविश्वदे<br>वाशुक्लाक्षीरशुक्लाबलाऽतिबलाविदारीक्षीरविदारीक्षुद्रसहामहासहाऋष्यगन्धाऽश्वगन्धावृश्चीरःपुनर्नवाबृहतीकण्टकारिकोरुबूकोमोरटःश्वदंष्ट्रासंहर्षाशतावरीशतपुष्पामधूकपुष्पीयष्टीमधुमधूलिकामृद्वीकाखर्जू<br>रंपरूषकमात्मगुप्तापुष्करबीजंकशेरुकंराजकशेरुकंराजादनंकतकंकाश्मर्यंशीतपाक्योदनपाकीतालखर्जूरमस्तकमिक्षुरिक्षुवालिकादर्भःकुशःकाशःशालिर्गुन्द्रेत्कटकःशरमूलंराजक्षवकःऋष्यप्रोक्ताद्वारदाभारद्वाजी<br>वनत्रपुष्यभीरुपत्रीहंसपादीकाकनासिकाकुलिङ्गाक्षीक्षीरवल्लीकपोलवल्लीकपोतवल्लीसोमवल्लीगोपवल्लीमधुवल्लीचेति; एषामेवंविधानामन्येषांचमधुरवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वाप्रक्षाल्यपानीयेनसुप्रक्षालितायांस्थाल्यांसमावाप्यपयसाऽर्धोदकेनाभ्यासिच्यसाधयेद्दर्व्यासत<br>तमवघट्टयन्;तदुपयुक्तभूयिष्ठेऽम्भसिगतरसेष्वौषधेषुपयसिचानुपदग्धेस्थालीमुपहृत्यसुपरिपूतंपयःसुखोष्णंघृततैलवसामज्जलवणफाणितोपहितंबस्तिंवातविकारिणेविधिज्ञोविधिवद्दद्यात्; शीतंतुमधुसर्पिर्भ्यामुपसंसृज्यपित्तविकारिणेविधिवद्दद्यात्| इतिमधुरस्कन्धः||१३९||
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tadyathā-

jīvakarṣabhakau jīvantī vīrā tāmalakī kākōlī kṣīrakākōlī mudgaparṇī māṣaparṇī śālaparṇī pr̥śniparṇyasanaparṇī madhuparṇī mēdā mahāmēdā karkaṭaśr̥ṅgī śr̥ṅgāṭikā chinnaruhā cchatrā'ticchatrā śrāvaṇī mahāśrāvaṇī sahadēvā viśvadēvā śuklā kṣīraśuklā balā'tibalā vidārī kṣīravidārī kṣudrasahā mahāsahā r̥ṣyagandhā'śvagandhā vr̥ścīraḥ punarnavā br̥hatī kaṇṭakārikōrubūkō mōraṭaḥ śvadaṁṣṭrā saṁharṣā śatāvarī śatapuṣpā madhūkapuṣpī yaṣṭīmadhu madhūlikā mr̥dvīkā kharjūraṁ parūṣakamātmaguptā puṣkarabījaṁ kaśērukaṁ rājakaśērukaṁ rājādanaṁ katakaṁ kāśmaryaṁ śītapākyōdanapākī tālakharjūramastakamikṣurikṣuvālikā darbhaḥ kuśaḥ kāśaḥ śālirgundrētkaṭakaḥ śaramūlaṁ rājakṣavakaḥ r̥ṣyaprōktā dvāradā bhāradvājī vanatrapuṣyabhīrupatrī haṁsapādī kākanāsikā kuliṅgākṣī kṣīravallī kapōlavallī kapōtavallī sōmavallī gōpavallī madhuvallī cēti; ēṣāmēvaṁvidhānāmanyēṣāṁ ca madhuravargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā prakṣālya pānīyēna suprakṣālitāyāṁ sthālyāṁ samāvāpya payasā'rdhōdakēnābhyāsicya sādhayēddarvyā satatamavaghaṭṭayan; tadupayuktabhūyiṣṭhē'mbhasi gatarasēṣvauṣadhēṣu payasi cānupadagdhē sthālīmupahr̥tya suparipūtaṁ payaḥ sukhōṣṇaṁ ghr̥tatailavasāmajjalavaṇaphāṇitōpahitaṁ bastiṁ vātavikāriṇē vidhijñō vidhivaddadyāt; śītaṁ tu madhusarpirbhyāmupasaṁsr̥jya pittavikāriṇē vidhivaddadyāt| iti madhuraskandhaḥ||139||

tadyathA-

jIvakarShabhakau jIvantI vIrA tAmalakI kAkolI kShIrakAkolI mudgaparNI mAShaparNIshAlaparNI pRushniparNyasanaparNI [1] madhuparNI medA mahAmedA karkaTashRu~ggI shRu~ggATikAchinnaruhA cchatrA~aticchatrA shrAvaNI mahAshrAvaNI sahadevA vishvadevA shuklA kShIrashuklAbalA~atibalA vidArI kShIravidArI kShudrasahA mahAsahA RuShyagandhA~ashvagandhA vRushcIraHpunarnavA bRuhatI kaNTakArikorubUko moraTaH shvadaMShTrA saMharShA shatAvarI shatapuShpAmadhUkapuShpI yaShTImadhu madhUlikA mRudvIkA kharjUraM parUShakamAtmaguptA puShkarabIjaMkasherukaM rAjakasherukaM rAjAdanaM katakaM kAshmaryaM shItapAkyodanapAkItAlakharjUramastakamikShurikShuvAlikA darbhaH kushaH kAshaH shAlirgundretkaTakaH sharamUlaMrAjakShavakaH RuShyaproktA dvAradA bhAradvAjI vanatrapuShyabhIrupatrI haMsapAdI kAkanAsikAkuli~ggAkShI kShIravallI kapolavallI kapotavallI somavallI gopavallI madhuvallI ceti;eShAmevaMvidhAnAmanyeShAM ca madhuravargaparisa~gkhyAtAnAmauShadhadravyANAM chedyAnikhaNDashashchedayitvA bhedyAni cANusho bhedayitvA prakShAlya pAnIyena suprakShAlitAyAM sthAlyAMsamAvApya payasA~ardhodakenAbhyAsicya sAdhayeddarvyA satatamavaghaTTayan;tadupayuktabhUyiShThe~ambhasi gataraseShvauShadheShu payasi cAnupadagdhe sthAlImupahRutyasuparipUtaM [2] payaH sukhoShNaM ghRutatailavasAmajjalavaNaphANitopahitaM bastiM vAtavikAriNevidhij~jo vidhivaddadyAt; shItaM tu madhusarpirbhyAmupasaMsRujya pittavikAriNe vidhivaddadyAt|
iti madhuraskandhaH||139||
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The drugs mentioned in sweet group (''madhura skandha'') are ''jivaka, rushabhaka, jivanti, vira, amalaki, kakoli, kshirakakoli, mudgaparni, mashaparṇi, shalaparni, prushniparni, mashaparni, shalaparni, meda, mahameda, karkatashringi, shringataka, chinnaruha, cchatra, aticchatra, shravani, mahashravavani, sahadeva, vishvadeva, shukla, kshirashukla, bala, atibala, vidari, kshiravidari, kshudrasaha, mahasaha, rishyagandha, ashvagandha, vrishchira, punarnava, brihati, kantakari, korubuka, moraṭa, shwadamshtra, samharsha, shatavari, shaatapushpa, madhukapushpi, yashtimadhu, madhulika, mrudvika, kharjura, parushaka, atmagupta, pushkarabija, kasheruka, rajakasheruka, rajadana, kataka, kashmarya, shita, pakya, danapaki tala, kharjura, mastakam, ikshu, ikshuvalika, darbha, kusha, kasha, shali, gundrrtkataka, shaaramula, rajakshavaka, rushyaprokta, dvarada, bharadvaj, vanatrapushya, bhirupatri hamsapadi, kakanasa, kulinga, kshiravalli, kapolavalli, kapotavalli, somavalli'' and ''gopavalli''. These and such other drugs of sweet group should be taken. After cutting and breaking them into small pieces and washing with water properly, should be kept in a vessel. Adding to it milk diluted with half water should be cooked stirring till its major portion of water is absorbed, drugs are extracted and milk is not charred. The vessel should be brought down and the milk should be taken out of it and filtered well. This lukewarm milk added with ghee, oil, fat, marrow, salt and ''phanita'' should be used properly for enema by expert in ''vatika'' disorders. In ''paittika'' disorders, the same should be given cold and combined with honey and ghee. Thus, ends the sweet group of drugs. [139]

==== ''Amla skandha'' (group of sour drugs) ====
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आम्राम्रातकलकुचकरमर्दवृक्षाम्लाम्लवेतसकुवलबदरदाडिममातुलुङ्गगण्डीरामलकनन्दीतकशीतक- तिन्तिण्डीकदन्तशठैरावतककोशाम्रधन्वनानांफलानि, पत्राणिचाम्रातकाश्मन्तकचाङ्गेरीणांचतुर्विधानांचाम्लिकानांद्वयोश्चकोलयोश्चामशुष्कयोर्द्वयोश्चैवशुष्काम्लिकयोर्ग्राम्यारण्ययोः, आसवद्रव्याणिचसुरासौवीरकतुषोदकमैरेयमेदकमदिरामधुशुक्तशीधुदधिदधिमण्डोदश्विद्धान्याम्लादीनिच, एषामेवंविधानामन्येषांचाम्लवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वाद्रवैःस्थाल्यामभ्यासिच्यसाधयित्वोपसंस्कृत्ययथावत्तैलवसामज्जलवणफाणितोपहितंसु<br>खोष्णंबस्तिंवातविकारिणेविधिज्ञोविधिवद्दद्यात्| इत्यम्लस्कन्धः||१४०||
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Āmrāmrātakalakucakaramardavr̥kṣāmlāmlavētasakuvalabadaradāḍimamātuluṅgagaṇḍīrāmalakanandītakaśītaka- tintiṇḍīkadantaśaṭhairāvatakakōśāmradhanvanānāṁ phalāni, patrāṇi cāmrātakāśmantakacāṅgērīṇāṁ caturvidhānāṁ cāmlikānāṁ dvayōśca kōlayōścāmaśuṣkayōrdvayōścaiva śuṣkāmlikayōrgrāmyāraṇyayōḥ, āsavadravyāṇi ca surāsauvīrakatuṣōdakamairēyamēdakamadirāmadhuśuktaśīdhudadhidadhimaṇḍōdaśviddhānyāmlādīni ca, ēṣāmēvaṁvidhānāmanyēṣāṁ cāmlavargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā dravaiḥ sthālyāmabhyāsicya sādhayitvōpasaṁskr̥tya yathāvattailavasāmajjalavaṇaphāṇitōpahitaṁ sukhōṣṇaṁ bastiṁ vātavikāriṇē vidhijñō vidhivaddadyāt| ityamlaskandhaḥ||140||

AmrAmrAtakalakucakaramardavRukShAmlAmlavetasakuvalabadaradADimamAtulu~ggagaNDIrAmalakanandItakashItaka-tintiNDIkadantashaThairAvatakakoshAmradhanvanAnAM phalAni, patrANi cAmrAtakAshmantakacA~ggerINAMcaturvidhAnAM cAmlikAnAM dvayoshca kolayoshcAmashuShkayordvayoshcaiva shuShkAmlikayorgrAmyAraNyayoH,AsavadravyANi casurAsauvIrakatuShodakamaireyamedakamadirAmadhushuktashIdhudadhidadhimaNDodashviddhAnyAmlAdIni ca,eShAmevaMvidhAnAmanyeShAM cAmlavargaparisa~gkhyAtAnAmauShadhadravyANAM chedyAnikhaNDashashchedayitvA bhedyAni cANusho bhedayitvA dravaiH sthAlyAmabhyAsicya sAdhayitvopasaMskRutyayathAvattailavasAmajjalavaNaphANitopahitaM sukhoShNaM bastiM vAtavikAriNe vidhij~jo vidhivaddadyAt|
ityamlaskandhaH||140||
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The sour group (drugs of ''amlaskandha'') includes fruits of ''amra, amrataka, lakucha, karamarda, vrukshamla, amlavetasa, kuvala, badara, dadima, matulunga, gandira, amalaka, nanditaka, shitaka, tintindika, dantashath, airavataka, koshamra, dhanvan'';

*Leaves of ''amrataka, ashmantaka, changeri,'' four types of ''amlika'', two types of ''kola''- unripe and dried, two types of dried tamarind wild and cultivated, substances used in preparation of ''asava, sura, sauviraka, tushodaka, maireya, medaka, madira, madhu, shukta, sidhu, dadhimanda,'' buttermilk, ''dhanyamla'' etc.

These and such other drugs of the sour group should be taken and after cutting and breaking into small pieces should be placed in a vessel along with liquids and be cooked. The lukewarm product added properly with oil, fat, ''majja'', salt and ''phanita'' should be used for enema in ''vatika'' disorders according to procedure by the expert physician. Thus, ends the sour group. [140]

==== ''Lavana skandha'' (group of salty drugs) ====
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सैन्धवसौवर्चलकालविडपाक्यानूपकूप्यवालुकैलमौलकसामुद्ररोमकौद्भिदौषरपाटेयकपांशुजान्येवम्प्रकाराणिचान्यानिलवणवर्गपरिसङ्ख्यातानि, एतान्यम्लोपहितान्युष्णोदकोपहितानिवास्नेहवन्तिसुखोष्णंबस्तिंवातविकारिणेविधिज्ञोविधिवद्दद्यात्| इतिलवणस्कन्धः||१४१||
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saindhavasauvarcalakālaviḍapākyānūpakūpyavālukailamaulakasāmudrarōmakaudbhidauṣarapāṭēyakapāṁśujānyēvamprakārāṇi cānyāni lavaṇavargaparisaṅkhyātāni, ētānyamlōpahitānyuṣṇōdakōpahitāni vā snēhavanti sukhōṣṇaṁ bastiṁ vātavikāriṇē vidhijñō vidhivaddadyāt| iti lavaṇaskandhaḥ||141||

saindhavasauvarcalakAlaviDapAkyAnUpakUpyavAlukailamaulakasAmudraromakaudbhidauSharapATeyakapAMshujAnyevamprakArANicAnyAni lavaNavargaparisa~gkhyAtAni, etAnyamlopahitAnyuShNodakopahitAni vA snehavanti sukhoShNaM bastiM vAtavikAriNevidhij~jo vidhivaddadyAt|
iti lavaNaskandhaH||141||
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In the salty group (''lavana skandha''), the drugs mentioned are – ''saindhava, sauvarchala, kala, vida, pakya, anupa, valukaila, maulaka, samudra, romaka, audbhida, aushara, pateyaka, pamshuja'' and others. These drugs added with sour or warm water along with fatty substance in lukewarm condition should be used for enema in ''vatika'' disorders according to procedure by the expert. This concludes the salty group of drugs. [141]

==== ''Katu skandha'' (group of pungent drugs) ====
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पिप्पलीपिप्पलीमूलहस्तिपिप्पलीचव्यचित्रकशृङ्गवेरमरिचाजमोदार्द्रकविडङ्गकुस्तुम्बुरुपीलुतेजवत्येलाकुष्ठभल्लातकास्थिहिङ्गुनिर्यासकिलिममूलकसर्षपलशुनकरञ्जशिग्रुकमधुशिग्रुकखरपुष्प<br>भूस्तृणसुमखसुरसकुठेरकार्जक- गण्डीरकालमालकपर्णासक्षवकफणिज्झकक्षारमूत्रपित्तानीति; एषामेवंविधानांचान्येषांकटुकवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वागोमूत्रेणसहसाधयित्वोपसंस्कृत्ययथावन्मधुतैललवणोपहितंसुखोष्णंबस्तिंश्लेष्मविकारि<br>णेविधिज्ञोविधिवद्दद्यात्| इतिकटुकस्कन्धः||१४२||
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pippalīpippalīmūlahastipippalīcavyacitrakaśr̥ṅgavēramaricājamōdārdrakaviḍaṅgakustumburupīlutējōvatyēlākuṣṭhabhallātakāsthihiṅguniryāsakilimamūlakasarṣapalaśunakar<br>añjaśigrukamadhuśigrukakharapupabhūstr̥ṇasumukhasurasakuṭhērakārjaka- gaṇḍīrakālamālakaparṇāsakṣavakaphaṇijjhakakṣāramūtrapittānīti; ēṣāmēvaṁvidhānāṁ cānyēṣāṁ kaṭukavargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā gōmūtrēṇa saha sādhayitvōpasaṁskr̥tya yathāvanmadhutailalavaṇōpahitaṁ sukhōṣṇaṁ bastiṁ ślēṣmavikāriṇē vidhijñō vidhivaddadyāt| iti kaṭukaskandhaḥ||142||

pippalIpippalImUlahastipippalIcavyacitrakashRu~ggaveramaricAjamodArdrakaviDa~ggakustumburupIlutejovatyelAkuShTha-bhallAtakAsthihi~gguniryAsakilimamUlakasarShapalashunakara~jjashigrukamadhushigrukakharapuShpabhUstRuNasumukhasurasakuTherakArjaka-gaNDIrakAlamAlakaparNAsakShavakaphaNijjhakakShAramUtrapittAnIti; eShAmevaMvidhAnAM cAnyeShAMkaTukavargaparisa~gkhyAtAnAmauShadhadravyANAM chedyAni khaNDashashchedayitvA bhedyAni cANusho bhedayitvA gomUtreNa sahasAdhayitvopasaMskRutya yathAvanmadhutailalavaNopahitaM sukhoShNaM bastiM shleShmavikAriNe vidhij~jo vidhivaddadyAt|
iti kaTukaskandhaH||142||
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In pungent group (''katuka skandha'') the drugs included are – ''pippali, pippalimula, gajapippali, chavya, chitraka, shunţhi, maricha, ajamoda, ardraka, vidanga, dhanyaka, pilu, tejavati, ela, kushtha, bhallatakasthi, hinguniryasa, devadaru, mulaka, sarshapa, lashuna, karanja, shigru, madhu shigru, kharapushpa, bhustruna sumukha, surasa, kutheraka, arjaka, gandira, kalamalaka, parnasa, kshavaka, phanijjhaka,'' alkali, urines, and biles. These along with other similar drugs of group (pungent) should be taken and after cutting and breaking into pieces should be cooked with cow’s urine. This while lukewarm added with honey oil and salt should be used for enema in ''shlaishmika'' disorders according to procedure by experts. Thus ends the pungent group.[142]

==== ''Tikta skandha'' (group of bitter drugs) ====
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चन्दननलदकृतमालनक्तमालनिम्बतुम्बुरुकुटजहरिद्रादारुहरिद्रामुस्तमूर्वाकिराततिक्तककटुकरोहिणीत्रायमाणाकारवेल्लिकाकरीरकरवीरकेबुककठिल्लकवृषमण्डूकपर्णीकर्कोटकवार्ताकुकर्कशकाकमाचीकाको<br>दुम्बरिकासुषव्यतिविषापटोलकुलकपाठागुडूचीवेत्राग्रवेतसविकङ्कतबकुलसोमवल्कसप्तपर्णसुमनार्कावल्गुजवचातगरागुरुवालकोशीराणीति , एषामेवंविधानांचान्येषांतिक्तवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वाप्रक्षाल्यपानीयेनाभ्यासिच्यसाधयित्वोपसंस्कृत्ययथावन्मधुतैललवणोपहितंसुखोष्णंबस्तिं<br>श्लेष्मविकारिणेविधिज्ञोविधिवद्दद्यात्, शीतंतुमधुसर्पिर्भ्यामपसंसृज्यपित्तविकारिणेविधिज्ञोविधिवद्दद्यात्| इतितिक्तस्कन्धः||१४३||
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candananaladakr̥tamālanaktamālanimbatumburukuṭajaharidrādāruharidrāmustamūrvākirātatiktakakaṭukarōhiṇītrāyamāṇā- kāravēllikākarīrakaravīrakēbukakaṭhillakavr̥ṣamaṇḍūkaparṇīkarkōṭakavārtākukarkaśakākamācīkākōdumbarikāsuṣavyativiṣā- paṭōlakulakapāṭhāguḍūcīvētrāgravētasavikaṅkatabakulasōmavalkasaptaparṇasumanārkāvalgujavacātagarāguruvālakōśīrāṇīti , ēṣāmēvaṁvidhānāṁ cānyēṣāṁ tiktavargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā prakṣālya pānīyēnābhyāsicya sādhayitvōpasaṁskr̥tya yathāvanmadhutailalavaṇōpahitaṁ sukhōṣṇaṁ bastiṁ ślēṣmavikāriṇē vidhijñō vidhivaddadyāt, śītaṁ tu madhusarpirbhyāmapasaṁsr̥jya pittavikāriṇē vidhijñō vidhivaddadyāt| iti tiktaskandhaḥ||143||

candananaladakRutamAlanaktamAlanimbatumburukuTajaharidrAdAruharidrAmustamUrvAkirAtatiktakakaTukarohiNItrAyamANA-kAravellikAkarIrakaravIrakebukakaThillakavRuShamaNDUkaparNIkarkoTakavArtAkukarkashakAkamAcIkAkodumbarikAsuShavyativiShA-paTolakulakapAThAguDUcIvetrAgravetasavika~gkatabakulasomavalkasaptaparNasumanArkAvalgujavacAtagarAguruvAlakoshIrANIti [1] ,eShAmevaMvidhAnAM cAnyeShAM tiktavargaparisa~gkhyAtAnAmauShadhadravyANAM chedyAni khaNDashashchedayitvA bhedyAnicANusho bhedayitvA prakShAlya pAnIyenAbhyAsicya sAdhayitvopasaMskRutya yathAvanmadhutailalavaNopahitaM sukhoShNaM bastiMshleShmavikAriNe vidhij~jo vidhivaddadyAt, shItaM tu madhusarpirbhyAmapasaMsRujya pittavikAriNe vidhij~jo vidhivaddadyAt|
iti tiktaskandhaH||143||
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The drugs mentioned in bitter group (''tikta skandha'') are – ''Chandana, nalada, aragvadha, naktamala, nimba, tumburu, kutaja, haridra, daruharidra, musta, murva, kiratatikta, katurohini, trayamana, karvellika, karira, karavira, kebuka, kathillaka, vrusha, mandukaparni, karkotaka, vartaku, karkasha, kakamachi, kakodumbarika, sushavi, ativisha, patola, kulaka, patha, guduchi, tip of vetra, vetasa, vikankata, bakula, somavalka, saptaparna, sumana, arka, avalguja, vacha, tagara, agaru, balaka'' and ''ushira'', along with other similar drugs of the bitter group should be taken and after cutting and breaking them into pieces and washing properly be cooked with water. The product when lukewarm should be added with honey, oil and salt to be used in enema for ''kaphaja'' disorders according to procedure by the expert. In ''paittika'' disorders the same should be used while cold and added with honey and ghee. This ends the bitter group.[143]

==== ''Kashaya skandha'' (group of astringent drugs) ====
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प्रियङ्ग्वनन्ताम्रास्थ्यम्बष्ठकीकट्वङ्गलोध्रमोचरससमङ्गाधातकीपुष्पपद्मापद्मकेशरजम्ब्वाम्रप्लक्षवटकपीतनोदुम्बराश्वत्थभल्लातकास्थ्यश्मन्तकशिरीषशिंशपासोमवल्कतिन्दुकप्रियालबदरखदिरसप्तप<br>र्णाश्वकर्णस्यन्दनार्जुनारिमेदैलवालुकपरिपेलवकदम्बशल्लकीजिङ्गिनीकाशकशेरुकराजकशेरुकट्फलवंशपद्मकाशोकशालधवसर्जभूर्जशणखरपुष्पापुरशमीमाचीकवरकतुङ्गाजकर्णस्फूर्जकबिभीतककम्भीपु<br>ष्करबीज- बिसमृणालतालखर्जूरतरुणानीति , एषामेवंविधानांचान्येषांकषायवर्गपरिसङ्ख्यातानामौषधद्रव्याणांछेद्यानिखण्डशश्छेदयित्वाभेद्यानिचाणुशोभेदयित्वाप्रक्षाल्यपानीयेनाभ्यासिच्यसाधयित्वोपसंस्कृत्ययथावन्मधुतैललवणोपहितंसुखोष्णंब<br>स्तिंश्लेष्मविकारिणेविधिज्ञोविधिवद्दद्यात्, शीतंतुमधुसर्पिर्भ्यामुपसंसृज्यपित्तविकारिणेदद्यात्| इतिकषायस्कन्धः||१४४||
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priyaṅgvanantāmrāsthyambaṣṭhakīkaṭvaṅgalōdhramōcarasasamaṅgādhātakīpuṣpapadmāpadmakēśarajambvāmraplakṣavaṭa- kapītanōdumbarāśvatthabhallātakāsthyaśmantakaśirīṣaśiṁśapāsōmavalkatindukapriyālabadarakhadira- saptaparṇāśvakarṇasyandanārjunārimēdailavālukaparipēlavakadambaśallakījiṅginīkāśakaśērukarājakaśērukaṭphalavaṁśa- padmakāśōkaśāladhavasarjabhūrjaśaṇakharapuṣpāpuraśamīmācīkavarakatuṅgājakarṇasphūrjakabibhītakakumbhīpuṣkarabīja- bisamr̥ṇālatālakharjūrataruṇānīti , ēṣāmēvaṁvidhānāṁ cānyēṣāṁ kaṣāyavargaparisaṅkhyātānāmauṣadhadravyāṇāṁ chēdyāni khaṇḍaśaśchēdayitvā bhēdyāni cāṇuśō bhēdayitvā prakṣālya pānīyēnābhyāsicya sādhayitvōpasaṁskr̥tya yathāvanmadhutailalavaṇōpahitaṁ sukhōṣṇaṁ bastiṁ ślēṣmavikāriṇē vidhijñō vidhivaddadyāt, śītaṁ tu madhusarpirbhyāmupasaṁsr̥jya pittavikāriṇē dadyāt| iti kaṣāyaskandhaḥ||144||

priya~ggvanantAmrAsthyambaShThakIkaTva~ggalodhramocarasasama~ggAdhAtakIpuShpapadmApadmakesharajambvAmraplakShavaTa-kapItanodumbarAshvatthabhallAtakAsthyashmantakashirIShashiMshapAsomavalkatindukapriyAlabadarakhadira-saptaparNAshvakarNasyandanArjunArimedailavAlukaparipelavakadambashallakIji~gginIkAshakasherukarAjakasherukaTphalavaMsha-padmakAshokashAladhavasarjabhUrjashaNakharapuShpApurashamImAcIkavarakatu~ggAjakarNasphUrjakabibhItakakumbhIpuShkarabIja-bisamRuNAlatAlakharjUrataruNAnIti [1] , eShAmevaMvidhAnAM cAnyeShAM kaShAyavargaparisa~gkhyAtAnAmauShadhadravyANAMchedyAni khaNDashashchedayitvA bhedyAni cANusho bhedayitvA prakShAlya pAnIyenAbhyAsicya sAdhayitvopasaMskRutyayathAvanmadhutailalavaNopahitaM sukhoShNaM bastiM shleShmavikAriNe vidhij~jo vidhivaddadyAt, shItaM tumadhusarpirbhyAmupasaMsRujya pittavikAriNe dadyAt|
iti kaShAyaskandhaH||144||
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The drugs of ''Kashaya skandha'' (astringent group) are – ''priyangu, ananta, amrasthi, ambashthaki, katvanga, lodhra, mocharasa, samanga, dhataki flowers, padma, padmakeshara, jambu, amra, plaksha, vata, kapitana, udumbara, ashwattha, bhallatakasthi, ashmantaka, shirisha, shimshapa, somavalka, tinduka, priyala, badara, khadira, saptaparna, ashwakarna, syandana, arjuna, arimeda, elavaluka, paripelava, kadamba, shallaki, jingini, kasha, kasheruka, rajakasheruka, katphala, vamsha, padmaka, ashoka, shala, dhava, sarja, bhuja, sana, kharapushpa, guggulu, shami, machika, varaka, tunga, ajakarna, sphurjaka, bibhitaka, kumbhi, pushkarabija,'' lotus stem, lotus stalk, tender, parts of ''tala'', and ''kharjura'', along with other similar drugs of astringent group should be taken and after cutting and breaking them into small pieces and washing be cooked with water. The lukewarm product being added with honey, oil and salt be used for enema in disorders of ''kapha'' according to procedure by expert. In ''paittika'' disorders the same should be used while cold and added with honey and ghee.
This is the astringent group. [144]
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तत्रश्लोकाः-

षड्वर्गाःपरिसङ्ख्यातायएतेरसभेदतः| आस्थापनमभिप्रेत्यतान्विद्यात्सार्वयौगिकान्||१४५||

सर्वशोहिप्रणिहिताःसर्वरोगेषुजानता| सर्वान्रोगान्नियच्छन्तियेभ्यआस्थापनंहितम्||१४६||
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tatra ślōkāḥ-

ṣaḍvargāḥ parisaṅkhyātā ya ētē rasabhēdataḥ| āsthāpanamabhiprētya tānvidyātsārvayaugikān||145||

sarvaśō hi praṇihitāḥ sarvarōgēṣu jānatā| sarvānrōgānniyacchanti yēbhya āsthāpanaṁ hitam||146||

tatra shlokAH-

ShaDvargAH parisa~gkhyAtA ya ete rasabhedataH|
AsthApanamabhipretya tAnvidyAtsArvayaugikAn||145||

sarvasho hi praNihitAH sarvarogeShu jAnatA|
sarvAnrogAnniyacchanti yebhya AsthApanaM hitam||146||
</div></div>

Amongst two verses the six groups enumerated are according to ''rasa'' and should be known as applicable in all disorders being used in form of non- unctuous enema, which being employed in diseases according to the respective procedures by the learned expert physician controls all the diseases. [145-146]
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येषांयेषांप्रशान्त्यर्थंयेयेनपरिकीर्तिताः| द्रव्यवर्गाविकाराणांतेषांतेपरिकोपकाः||१४७||

इत्येतेषडास्थापनस्कन्धारसतोऽनुविभज्यव्याख्याताः||१४८||
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yēṣāṁ yēṣāṁ praśāntyarthaṁ yē yē na parikīrtitāḥ| dravyavargā vikārāṇāṁ tēṣāṁ tē parikōpakāḥ||147||

ityētē ṣaḍāsthāpanaskandhā rasatō'nuvibhajya vyākhyātāḥ||148||

yeShAM yeShAM prashAntyarthaM ye ye na parikIrtitAH|
dravyavargA vikArANAM teShAM te parikopakAH||147||

ityete ShaDAsthApanaskandhA rasato~anuvibhajya vyAkhyAtAH||148||
</div></div>

And the groups of drugs which are not advocated in certain disorders should be considered as those aggravating the same. Thus, these six groups of non-unctuous enema are described dividing them according to ''rasa''. [147-148]

==== Guidelines for inclusion or exclusion of drugs ====
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तेभ्योभिषग्बुद्धिमान्परिसङ्ख्यातमपियद्यद्द्रव्यमयौगिकंमन्येत, तत्तदपकर्षयेत्; यद्यच्चानुक्तमपियौगिकंमन्येत, तत्तद्विदध्यात्; वर्गमपिवर्गेणोपसंसृजेदेकमेकेनानेकेनवायुक्तिंप्रमाणीकृत्य| प्रचरणमिवभिक्षुकस्यबीजमिवकर्षकस्यसूत्रंबुद्धिमतामल्पमप्यनल्पज्ञानायभवति; तस्माद्बुद्धिमतामूहापोहवितर्काः, मन्दबुद्धेस्तुयथोक्तानुगमनमेवश्रेयः| यथोक्तंहिमार्गमनुगच्छन्भिषक्संसाधयतिकार्यमनतिमहत्त्वाद्वाविनिपातयत्यनतिह्रस्वत्वादुदाहरणस्येति||१४९||
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tēbhyō bhiṣagbuddhimān parisaṅkhyātamapi yadyaddravyamayaugikaṁ manyēta, tattadapakarṣayēt; yadyaccānuktamapi yaugikaṁ manyēta, tattadvidadhyāt; vargamapi vargēṇōpasaṁsr̥jēdēkamēkēnānēkēna vā yuktiṁ pramāṇīkr̥tya| pracaraṇamiva bhikṣukasya bījamiva karṣakasya sūtraṁ buddhimatāmalpamapyanalpajñānāya bhavati; tasmādbuddhimatāmūhāpōhavitarkāḥ, mandabuddhēstu yathōktānugamanamēva śrēyaḥ| yathōktaṁ hi mārgamanugacchan bhiṣak saṁsādhayati kāryamanatimahattvādvā vinipātayatyanatihrasvatvādudāharaṇasyēti||149||

tebhyo bhiShagbuddhimAn parisa~gkhyAtamapi yadyaddravyamayaugikaM manyeta, tattadapakarShayet;yadyaccAnuktamapi yaugikaM manyeta, tattadvidadhyAt; vargamapivargeNopasaMsRujedekamekenAnekena vA yuktiM pramANIkRutya|
pracaraNamiva bhikShukasya bIjamiva karShakasya sUtraM buddhimatAmalpamapyanalpaj~jAnAyabhavati; tasmAdbuddhimatAmUhApohavitarkAH, mandabuddhestu yathoktAnugamanameva shreyaH|
yathoktaM hi mArgamanugacchan bhiShak saMsAdhayati kAryamanatimahattvAdvA [1]vinipAtayatyanatihrasvatvAdudAharaNasyeti||149||
</div></div>

The wise physician should eliminate or exclude the drugs if it is not appropriate even if enumerated under the group and should add the appropriate one even if un-enumerated. In situation needed a group of drugs may be combined with other or several other groups based on the reasoning. The aphorism, though small, is able to provide wide knowledge to the wise like alms of a mendicant or seed of a farmer. The aphorism for the wise, gives rise to critical analysis and reasoning while on the other hand for the dull, it is better to follow the saying exactly. The physician following the said course succeeds in his endeavor or causes little risk because of the illustration being not too brief.[149]

==== List of drugs for unctuous enema ====
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अतःपरमनुवासनद्रव्याण्यनुव्याख्यास्यामः| अनुवासनंतुस्नेहएव| स्नेहस्तुद्विविधः- स्थावरात्मकः, जङ्गमात्मकश्च| तत्रस्थावरात्मकःस्नेहस्तैलमतैलंच| तद्द्वयंतैलमेवकृत्वोपदेक्ष्यामः, सर्वतस्तैलप्राधान्यात्| जङ्गमात्मकस्तुवसा, मज्जा, सर्पिरिति| तेषांतैलवसामज्जसर्पिषांयथापूर्वंश्रेष्ठंवातश्लेष्मविकारेष्वनुवासनीयेषु, यथोत्तरंतुपित्तविकारेषु, सर्वएववासर्वविकारेष्वपियोगमुपयान्तिसंस्कारविधिविशेषादिति||१५०||
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ataḥ paramanuvāsanadravyāṇyanuvyākhyāsyāmaḥ|
anuvāsanaṁ tu snēha ēva|
snēhastu dvividhaḥ- sthāvarātmakaḥ, jaṅgamātmakaśca|
tatra sthāvarātmakaḥ snēhastailamatailaṁ ca|
taddvayaṁ tailamēva kr̥tvōpadēkṣyāmaḥ, sarvatastailaprādhānyāt|
jaṅgamātmakastu vasā, majjā, sarpiriti|
tēṣāṁ tailavasāmajjasarpiṣāṁ yathāpūrvaṁ śrēṣṭhaṁ vātaślēṣmavikārēṣvanuvāsanīyēṣu, yathōttaraṁ tupittavikārēṣu, sarva ēva vā sarvavikārēṣvapi yōgamupayānti saṁskāravidhiviśēṣāditi||150||

ataH paramanuvAsanadravyANyanuvyAkhyAsyAmaH|
anuvAsanaM tu sneha eva|
snehastu dvividhaH- sthAvarAtmakaH, ja~ggamAtmakashca|
tatra sthAvarAtmakaH snehastailamatailaM ca|
taddvayaM tailameva kRutvopadekShyAmaH, sarvatastailaprAdhAnyAt|
ja~ggamAtmakastu vasA, majjA, sarpiriti|
teShAM tailavasAmajjasarpiShAM yathApUrvaM shreShThaM vAtashleShmavikAreShvanuvAsanIyeShu,yathottaraM tu pittavikAreShu, sarva eva vA sarvavikAreShvapi yogamupayAntisaMskAravidhivisheShAditi||150||
</div></div>

Now the drugs used for unctuous enema are mentioned. ''Anuvasana'' (unctuous enema) is, in fact composed of unctuous substances, which are of two types – Vegetable products and animal products. The vegetable products are either ''taila'' (oil derived from ''tila'' – sesamum seeds) or ''ataila'' (other than the above) but both of them are described here as ''taila'' because of overall predominance of ''tila'' oil.

Animal products are fat, marrow and ghee. Out of the oil, fat, marrow and ghee, excellence of applicability as unctuous enema in disorders of ''vata'' and ''kapha'', is determined in regressive order and progressive order in ''paittika'' disorders, so all are applicable in all disorders according to particular procedure and processing. [150]

==== List of drugs for nasal errhines ====
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शिरोविरेचनद्रव्याणिपुनरपामार्गपिप्पलीमरिचविडङ्गशिग्रुशिरीषतुम्बुरुपिल्वजाज्यमोदावार्ताकीपृथ्वीकैलाहरेणुकाफलानि
च,सुमुखसुरसकुठेरकगण्डीरकालमालकपर्णासक्षवकफणिज्झकहरिद्राशृङ्गवेरमूलकलशुनतर्कारीसर्षपपत्राणिच,अर्कालर्ककुष्ठनागदन्तीवचापामार्गश्वेताज्योतिष्मतीगवाक्षीगण्डीरपुष्प्यवाक्पुष्पीवृश्चिकाली<br>वयस्थातिविषामूलानिच, हरिद्राशृङ्गवेरमूलकलशुनकन्दाश्च, लोध्रमदनसप्तपर्णनिम्बार्कपुष्पाणिच, देवदार्वगुरुसरलशल्लकीजिङ्गिन्यसनहिङ्गुनिर्यासाश्च, तेजोवतीवराङ्गेङ्गुदीशोभाञ्जनकबृहतीकण्टकारिकात्वचश्चेति| शिरोविरेचनंसप्तविधं, फल-पत्र-मूल-कन्द-पुष्प-निर्यास-त्वगाश्रयभेदात्| लवणकटुतिक्तकषायाणिचेन्द्रियोपशयानितथाऽपराण्यनुक्तान्यपिद्रव्याणियथायोगविहितानिशिरोविरेचनार्थमुपदिश्यन्तइति||१५१||
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śirōvirēcanadravyāṇipunarapāmārgapippalīmaricaviḍaṅgaśigruśirīṣatumburupilvajājyamōdāvārtākīpr̥thvīkailāharēṇukāphalāni ca,sumukhasurasakuṭhērakagaṇḍīrakālamālakaparṇāsakṣavakaphaṇijjhakaharidrāśr̥ṅgavēramūlakalaśunatarkārīsarṣapapatrāṇica, arkālarkakuṣṭhanāgadantīvacāpāmārgaśvētājyōtiṣmatīgavākṣīgaṇḍīrapuṣpyavākpuṣpīvr̥ścikālīvayasthātiviṣāmūlāni ca,haridrāśr̥ṅgavēramūlakalaśunakandāśca, lōdhramadanasaptaparṇanimbārkapuṣpāṇi ca,dēvadārvagurusaralaśallakījiṅginyasanahiṅguniryāsāśca, tējōvatīvarāṅgēṅgudīśōbhāñjanakabr̥hatīkaṇṭakārikātvacaścēti|
śirōvirēcanaṁ saptavidhaṁ, phala-patra-mūla-kanda-puṣpa-niryāsa-tvagāśrayabhēdāt|
lavaṇakaṭutiktakaṣāyāṇi cēndriyōpaśayāni tathā'parāṇyanuktānyapi dravyāṇi yathāyōgavihitāniśirōvirēcanārthamupadiśyanta iti||151||

shirovirecanadravyANipunarapAmArgapippalImaricaviDa~ggashigrushirIShatumburupilvajAjyamodAvArtAkIpRuthvIkailAhareNukAphalAni ca,sumukhasurasakuTherakagaNDIrakAlamAlakaparNAsakShavakaphaNijjhakaharidrAshRu~ggaveramUlakalashunatarkArIsarShapapatrANica, arkAlarkakuShThanAgadantIvacApAmArgashvetAjyotiShmatIgavAkShIgaNDIrapuShpyavAkpuShpIvRushcikAlIvayasthAtiviShAmUlAnica, haridrAshRu~ggaveramUlakalashunakandAshca, lodhramadanasaptaparNanimbArkapuShpANi ca,devadArvagurusaralashallakIji~gginyasanahi~gguniryAsAshca,tejovatIvarA~gge~ggudIshobhA~jjanakabRuhatIkaNTakArikAtvacashceti|
shirovirecanaM saptavidhaM, phala-patra-mUla-kanda-puShpa-niryAsa-tvagAshrayabhedAt|
lavaNakaTutiktakaShAyANi cendriyopashayAni tathA~aparANyanuktAnyapi dravyANi yathAyogavihitAni shirovirecanArthamupadishyantaiti||151||
</div></div>

The drugs mentioned for use in head- evacuation are as follows:

*Fruits of ''apamarga, pippali, maricha, vidanga, shigru, shirisha, tumburu, pilu, ajaji, ajamoda, vartaki, prithvika, ela,'' and ''harenuka'';
*Leaves of ''sumukha, surasa, kutheraka, gandira, kalmalaka, parnasa, kshavaka, phannijhaka, haridra, shunţhi, mulaka, lashuna, tarkari'' and ''sarshapa'' ;
*Roots of ''arka, alarka, kushtha, naga-danti, vacha, apamarga, jyotishmati, gavakshi, gandirapushpi, avakpushpi, vrushchikali, vayastha'' and ''ativisha'';
*Tuberous rhizomes or roots of ''haridra, shunthi, mulaka and lashuna'';
*Flowers of ''lodhra, madana, saptaparna, nimba'' and ''arka'';
*Exudations of ''devadaru, aguru, sarala, shallaki, jingini, asana'',and '' hingu'';
*Bark of ''tejovati, varanga, ingudi, shobhanjana, bruhati'' and ''kantakarika.'' In this way according to substrate (of action) the nasal errhines is of seven types such as fruit, leaf, root, tuber, flower, exudation and bark; other saline, pungent bitter and astringent drugs which are wholesome to the sense organs and other unmentioned drugs may be used, according to condition needed for nasal errhines.[151]

=== Summary ===
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तत्रश्लोकाः

लक्षणाचार्यशिष्याणांपरीक्षाकारणंचयत्| अध्येयाध्यापनविधीसम्भाषाविधिरेवच||१५२||

षड्भिरूनानिपञ्चाशद्वादमार्गपदानिच| पदानिदशचान्यानिकारणादीनितत्त्वतः||१५३||

सम्प्रश्नश्चपरीक्षादेर्नवकोवमनादिषु| भिषग्जितीयेरोगाणांविमानेसम्प्रकाशितः||१५४||
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tatra ślōkāḥ-

lakṣaṇācāryaśiṣyāṇāṁ parīkṣā kāraṇaṁ ca yat|
adhyēyādhyāpanavidhī sambhāṣāvidhirēva ca||152||

ṣaḍbhirūnāni pañcāśadvādamārgapadāni ca|
padāni daśa cānyāni kāraṇādīni tattvataḥ||153||

sampraśnaśca parīkṣādērnavakō vamanādiṣu|
bhiṣagjitīyē rōgāṇāṁ vimānē samprakāśitaḥ||154||

tatra shlokAH-

lakShaNAcAryashiShyANAM parIkShA kAraNaM ca yat|
adhyeyAdhyApanavidhI sambhAShAvidhireva ca||152||

ShaDbhirUnAni pa~jcAshadvAdamArgapadAni ca|
padAni dasha cAnyAni kAraNAdIni tattvataH||153||

samprashnashca parIkShAdernavako vamanAdiShu|
bhiShagjitIye rogANAM vimAne samprakAshitaH||154||
</div></div>

Summing the chapter regarding specific features of discussion of therapeutics of diseases, it has been mentioned that – examination of treatise, preceptor and disciple with reasons, method of study and teaching, method of discussion, forty four terms related to the course of discussion, ten other terms with application, nine questions related to examination etc. in emesis etc. has been described in the chapter. [152-154]
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बहुविधमिदमुक्तमर्थजातंबहुविधवाक्यविचित्रमर्थकान्तम्| बहुविधशुभशब्दसन्धियुक्तंबहुविधवादनिसूदनंपरेषाम्||१५५||

इमांमतिंबहुविधहेतुसंश्रयांविजज्ञिवान्परमतवादसूदनीम्| नसज्जतेपरवचनावमर्दनैर्नशक्यतेपरवचनैश्चमर्दितुम्||१५६||

दोषादीनांतुभावानांसर्वेषामेवहेतुमत्| मानात्सम्यग्विमानानिनिरुक्तानिविभागशः||१५७||
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bahuvidhamidamuktamarthajātaṁ bahuvidhavākyavicitramarthakāntam|
bahuvidhaśubhaśabdasandhiyuktaṁ bahuvidhavādanisūdanaṁ parēṣām||155||

imāṁ matiṁ bahuvidhahētusaṁśrayāṁ vijajñivān paramatavādasūdanīm|
na [1] sajjatē paravacanāvamardanairna śakyatē paravacanaiśca marditum||156||

dōṣādīnāṁ tu bhāvānāṁ sarvēṣāmēva hētumat|
mānāt samyagvimānāni niruktāni vibhāgaśaḥ||157||

bahuvidhamidamuktamarthajAtaM bahuvidhavAkyavicitramarthakAntam|
bahuvidhashubhashabdasandhiyuktaM bahuvidhavAdanisUdanaM pareShAm||155||

imAM matiM bahuvidhahetusaMshrayAM vijaj~jivAn paramatavAdasUdanIm|
na [1] sajjate paravacanAvamardanairna shakyate paravacanaishca marditum||156||

doShAdInAM tu bhAvAnAM sarveShAmeva hetumat|
mAnAt samyagvimAnAni niruktAni vibhAgashaH||157||
</div></div>

This chapter containing various ideas, variegated with various sentences, pleasing with meanings, possessed with various auspicious words and their unions and capable of defeating opponents in various debates, it has been said; one who has acquired this knowledge based on various reasons and refuting the opponent’s view in debates does not get fastened by the pressure of opponents arguments nor does he get subdued by their arguments.

Etymologically ''vimana'' is termed because of providing proper and correct knowledge of the specific features of entities like ''dosha'' etc. with reasoning and classification. [155-157]
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इत्यग्निवेशकृतेतन्त्रेचरकप्रतिसंस्कृतेविमानस्थाने
रोगभिषग्जितीयविमानंनामाष्टमोऽध्यायः||८||

(अग्निवेशकृतेतन्त्रेचरकप्रतिसंस्कृते| अनेनावधिनास्थानंविमानानांसमर्थितम्|)|
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ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē vimānasthānē
rōgabhiṣagjitīyavimānaṁ nāmāṣṭamō'dhyāyaḥ||8||

(agnivēśakr̥tē tantrē carakapratisaṁskr̥tē|
anēnāvadhinā sthānaṁ vimānānāṁ samarthitam|)|
ityagniveshakRute tantre carakapratisaMskRute vimAnasthAne
rogabhiShagjitIyavimAnaM nAmAShTamo~adhyAyaH||8||

(agniveshakRute tantre carakapratisaMskRute|
anenAvadhinA sthAnaM vimAnAnAM samarthitam|)|
</div></div>

Thus, gets end of eighth chapter on specific features of therapeutics of diseases in [[Vimana Sthana]] in the treatise composed by Agnivesha and redacted by Charak. With this, [[Vimana Sthana]] (section on specific features) also comes to an end.

== Tattva Vimarsha (Fundamental Principles) ==

*The ideal preceptor, ideal medical treatise and ideal student are considered as basic pillars for proper propagation of medical knowledge.
*In a conference, the discussion to improve one’s capabilities should be properly initiated according to the abilities of opponents and participants, topics for discussion, one’s own strength and weakness.
*A good Ayurvedic physician needs to have four qualifications:
**Knowledge of health science from appropriate ''Shastra'',
**Experience of practical knowledge and skill from excellent teachers,
**Character, mental & physical capability, and strong desire to be one.
**Participation in dialogue, discussion by participating in conferences,seminars and symposiums.

How to develop these qualities are described at length in this chapter.

*''Vakyaprashamsa'' (syntactical excellence) is achieved by a statement free from deficiency (''anyunama'') and superfluity (''anadhikama''), meaningfulness (''arthavata''), devoid of deprivation of meaning (''anaparthaka''), incongruity (''aviruddham'') and comprehensible (''adhigatapadartham'').
*For the physician to improve his medical knowledge ''karana'', (reasoning/doer), ''karana'' (knowledge of means), ''karyayoni'' (objective), ''karya'' (action), ''karyaphala'' (attainment of objective and happiness), ''anubandha'' (after effect), ''desha'' (land/patient), ''kala'' (year and phase of disease), ''pravritti'' (initiation of therapy) and ''upaya'' (proper management) are necessary.
*The signs of regaining health are equilibrium of ''dhatus'' and its feature is absence of disease.
*Assessment of regaining health is based on following criteria: alleviation of the disorder, normalcy of voice and complexion, nourishment of body, increase in strength, desire for food, relish at meal time, proper and timely digestion of the food taken, timely sleep, non-appearance of abnormal dreams, easy awakening, easy elimination of urine, faeces and semen, overall normalcy of mind, intellect and sense organs and associated with no other unhealthy features.
*The result of the act (''karyaphala'') is attainment of happiness. It is featured as satisfaction of mind, intellect, sense organs and the body pleasure.
*The dose and potency of drugs shall be decided after due consideration of patient’s place of living, his strength, and morbidity. If it is not considered, then the medicine may harm the patient and adverse reaction of drugs may occur.
*Complete knowledge of patient’s condition is required before starting the treatment, which is done by tenfold examination. These ten entities are:
#''Desha'' (place) which is of two types – habitat and patient’s body;
#Examination of ''prakriti'' and ''vikriti'' according to ''dosha'',
#Description of eight type of ''sara'' (essence of body tissues),
#Compactness, structure and body mass,
#Measurement of body parts,
#Specific suitability of a person,
#''Sattva'' (mental strength),
#Power of digestion and assimilation,
#Exercise endurance and
#Age.
*Knowledge of seven types of ''prakriti'' and their features are necessary to understand normal state of body.
*The factors such as constitution of sperm and ovum, the time (of conception) and status of health of uterus, diet and lifestyle of mother (during pregnancy), and interaction of ''mahabhutas'' determine the basic constitution (''prakriti'') of fetus (''garbha''). The genetic map of an individual is determined by these factors.
*''Shleshma'' is naturally unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), sweet (''madhura''), essence (''sara''), dense (''sandra''), slow acting (''manda''), stable (''stimita''), heavy (''guru''), cold (''sheeta''), slimy (''vijjala'') and clear (''acchah'').
*''Pitta'' is naturally hot (''ushna''), sharply/acutely acting (''tikshna''), liquid (''drava''), of fleshy smell (''visram''), sour (''amla'') and pungent (''katu'').
*''Vata'' is naturally rough (''ruksha''), light (''laghu''), mobile (''chala''), abundant (''bahu''), swift (''shighra''), cold (''sheeta''), coarse (''parusha'') and non-slimy (''vishada'').
*Pathological condition (''vikriti'') needs to be evaluated to be able to provide effective treatment. The disorder should be examined in terms of the strength of the cause (''hetu''), ''dosha'' (vitiating intermediary factors), ''dushya'' (vitiated factors), constitution (''prakriti''), place (''desha''), time (''kala'') and the symptoms. These factors determine the severity of disease.
*Eight types of ''sara'' (best quality of body tissues) determine the strength of body tissues. Indeed, innate immunity of body tissues depends upon ''sara'', and it can be examined by the given features.
*Assessment of ''samhanana'' (compactness) is important to examine the differentiation and organization of muscle, fat, bones. These determine the strength of person.
*Analyzing the compactness (''samhanana''), proportionate relation of different parts (''pramana''), suitability (''satmya''), mental state (''sattva''), intake and digestive capacity (''ahara''), exercise tolerance (''vyayama'') and age (''vaya'') helps the physician to classify the strength of the patient into three categories viz. superior (''pravara''), medium (''madhya'') and inferior (''avara''). It is on this basis that physician decides to give strong (''tikshna''), mild (''mridu'') and moderate (''madhya'') medicaments.
*The basic unit to measure the body parts is height, breadth and circumference of one’s own finger (''anguli''). This is used in personified medicine to determine one’s own standard proportion of body parts. There cannot be a single standard for overall population.
*Assessment of ''satmya'' (suitability) determines the overall diet and lifestyle of an individual and this affects lifespan of the person.
*The mental strength is important to assess the behavioral response of patient to disease. It is essential to assess mental strength in every disease, because, a person having big stature may pretend a mild disease as like a critical condition and physician may be misled to incorrect diagnosis.
*The physiological and psychological functions depend upon age of a person. Similarly, there is dominance of a specific ''dosha'' according to ''dosha''. ''Kapha'' is dominant is childhood, ''pitta'' in adulthood and ''vata'' in old age. If there is pathological dominance of a particular ''dosha'' in a certain age, then there will be changes according to respective ''dosha''. Thus, the lifespan will differ as per ''dosha'' dominance in respect to age.
*The severity of morbidity depends upon degree of ''dosha'' aggravation. Medicaments shall be prescribed considering severity of morbidity and strength of patient.
*Purificatory therapies need to be performed at appropriate time of the year (''kala'') which is divided into six ''ritus'', namely ''hemant'' (early winter), ''grishma'' (summer) and ''varsha'' (rainy season) these are the three season characterized by cold, heat and rains. In between them there are other three seasons having common characters as ''pravrita'' (early rain), ''sharad'' (autumn) and ''vasanta'' (spring). Last three are termed as ''sadharan ritu'' during which purificatory (''shodhana'') treatment can be done.

Similarly, medicine should be given at appropriate time to the patient (''kala'') and when not to be given (''akala'').

*Purification therapies shall be performed as per the seasonal vitiation of respective ''dosha''. The medicines shall be administered considering stage of disease and appropriate time as per the morbidity.

== Vidhi Vimarsha (Applied Inferences) ==

The text of [[Charak Samhita]] is several thousand years old. It provides holistic solutions for the people and society. World has changed since, with change in thinking, lifestyle and technological advancements but, many of the guiding principles are still applicable Following should be applicable now.

=== Selection of medical treatise ===

In the last century, there has been significant change in how medical education is imparted, specially Ayurvedic education. Since olden times, Ayurvedic teacher would select a student and provide both theoretical and practical training by a process called ''Guru''/''shishya'' (student/teacher) relationship. Student was also guided how to select the medical treatise, criteria for which is described in the text above. These days, books are recommended by the faculty of medical schools according to the syllabus. Guidelines given in the text are still useful in selecting any worth reading book on a particular subject.

=== Ideal presentation of text ===

Treatise should be such that is understood by all students with different levels of intelligence. Repetition of the same principles which only increases the exercise of studying should not be present. It should include a concise and accurate statement of fact or concept followed by explanation with supportive examples using common language words. The words used should not be difficult for hearing, spelling, remembering and use of infamous words should be avoided. The sentence used for explanation should give complete and correct meaning and sequencing should be in a way to achieve clear stepwise and comprehensive understanding of the topic. The chapter or subject should be well placed and related topic should follow in order. The content in the book should be very effective, attractive and giving complete knowledge without repetition. Various graphs, flow charts, diagrams pictures and color plates which generates interest within the readers should be included.

The conclusions of explanation should be perfect and unalterable. The principles mentioned in text should be the same from beginning to the end.

In present context, the guidelines for writing a research paper or an article or a monograph include all the points mentioned in the text. The principles to write considering reader’s psyche are important and shall be followed for making a good treatise. [[Charak Samhita]] follows the same principles of presentation.

=== Qualities of a teacher ===

Teacher influences the life of a student. A teacher should have complete theoretical and practical knowledge of [[Ayurveda]]. The qualities of an ideal teacher are described in the text. Furthermore, keeping the competency of medical education in mind, the teacher should have knowledge of contemporary sciences and should behave with care and unbiased to the students. Teacher should not be egoistic and jealous. He should enjoy his teaching and not feel burden of teaching even if he needs to repeat. He should understand the lifestyle, psychiatric and body constitution of his patients and convey the same to his students. Significance of each symptom and sign seen in patient should be noted with help of sense organs and the same clinical methods should be explained to the students.

A good teacher plays significant role in making life of a student. Even today, in Ayurvedic practice, ''guru-shishya parampara'' (traditional learning through students staying with teachers) exists, that is the most effective method of learning practical applications of principles of [[Ayurveda]].

=== Qualities of an ideal student ===

Today, with the increasing demand of education for all, the students are taught in the classrooms in a group. However, the best teacher develops a one-to-one interaction with each student to make him inform about the knowledge. The student must possess some qualities and develop learning skills to receive the information and follow instructions given by teacher. Student should be physically and mentally able to perform his duties as a future physician, surgeon, teacher, and/or researcher.

He should follow ''sadvritta'' and should be respectful to teacher so as to gain more and more knowledge in each aspect of life. He should engage in frequent academic dialogue with fellow students and teachers. His mind should be focused on his goal. He should have fixed aim of attaining the knowledge about the topic. Student should concentrate on acquiring good qualities and should participate in extra curricular activities like sports and debate etc. Retaining power of the student should be good.

Inference made after discussion and considering both the positive and negative points, student should have such qualities of understanding what and which are the positive and negative effects of each and every action he does. Secondly, he should have sharp memory, broad minded and he should be forgiving and should help others.

=== Medical ethics and social behaviors of a doctor ===

Manners and social behavior of doctor is very important. The doctor has prime importance in the society owing to his health-care responsibilities. Also, the medico-legal aspect while treating patient in emergency medical care, and treating patient of opposite gender must be kept in mind to avoid legal issues. The ethical code of conduct of the society or country where he/she lives shall be followed.

=== Conferences (acquiring cumulative wisdom) ===

In seminars and conferences, research papers and case reports are presented which help in acquiring knowledge to provide better care to the patients. Healthy discussion brings about growth in knowledge, increases enlightenment and is helpful in preparation for competition. Sharpness and clarity of knowledge is increased. Vocabulary is increased and also interpretation power is increased.

The guidelines to be followed while participating in a discussion to make it more beneficial are described in the text. The points that should be considered while preparing a paper for presentation are applicable for effective communication.

=== Examination of patient ===

It is important to assess physical and mental state of the patient and the nature of medicine for treatment.

=== ''Prakriti'' examination ===

The ''prakriti'' or basic constitution is very important to be investigated to know overall health status of a person. The place of birth, place of living, place of work is important for identifying the ethnic habits, suitability, and external causes of a disease. Accordingly, the do’s and don’ts in terms of diet and lifestyle are prescribed, that is the integral part of Ayurvedic prescription. Currently, concept of ''prakriti'' is being investigated further in personalized medicine to know the genotype and phenotype of an individual and predicting certain disorders in view of prevention.

=== ''Sara'' examination ===

To evaluate immunity or bodie’s resistance to disease, ''sara'' or ‘or the best qualities of tissues needs to be examined. The constitutional essence helps to understand the immunity of the person. More the ''sarata'' of ''dhatu'', more is the immunological strength of the person. Analogue of ant helps to understand the significance of essence of ''dhatus''. And although small and lean in size is able to lift more than its weight due to ''asthisarata'' present in it. In [[Vividhashitpitiya Adhyaya]] of [[Sutra Sthana]] (chapter 28), special importance is given to ''mamsa'' (muscle), ''shonita'' (blood) and ''asthi dhatu'' (bone) in ''Vyadhikshamatva'' (immunity) which needs to be researched more.

=== [[Satmya]] (suitability) ===

The effect of a drug depends upon its interaction with the body tissues. If it is not suitable to the body tissues, then adverse reaction may occur or drug may not be effective. Drug resistance also needs to be considered under the heading of ''satmya'' because it is observed that to a person who has developed resistance to certain antibiotics does not offer response to such medicament thus not attaining successful result in the person. Nowadays culture study is used to understand the usefulness of antibiotics in the patient. Therefore the suitability of the patient must be considered before prescribing a medicine.

=== The ideal time for purification procedures ===

If in emergency ''shodhana'' has to be done in unsuitable weather, then the surroundings of the patient should be made such that it resembles the ''sadharan kala'', for example, if it is very cold then room should be adjusted with warmness and if it is very hot as in ''grishma'', then the temperature in the room should be reduced. Also a physician must use ''yukti'' and accordingly use or make the necessary ''dravyas'' ''sheeta'' or ''ushna'' by appropriate ''samyoga'' (combination), ''samskara'' (processing) and ''pramana'' (dose).

=== Examination of stage of disease ===

''Aturavastha'' or the phase of disease in patient also matters in treatment as seen in context of ''jwara'' wherein in ''kashaya'' (decoction) should not be administered for seven days or till amapachana does not take place. This interprets that the body of patient shall be able to metabolize the drugs. In case of ''jwara'', the ''doshas'' are too vitiated with the poor status of ''agni'', therefore the body is unable to metabolize even the drugs also. Therefore ''langhana'' (fasting) is the first treatment in ''jwara''. In nutshell, the medicines shall be prescribed considering the phase of disease and status of the patient.

Nowadays, various software and decision support systems are available to help physicians regarding the diagnosis. Various subjective assessment scales to examine ''sara'' and questionnaires to assess ''prakriti'' are available to know the status of patient.

=== Examination of psyche of patient ===

''Mana''/''satva'' (mind) is said to be ''tantraka'' (technical operator) as the one who is ''preraka'' (inspirer) or ''dharaka'' (owner). ''Mana'' is the initiator of all activity but it can carry out its action in conjunction with ''atma'' only. If ''mana'' is weak it is unable to tolerate the symptoms of disease and he/she exaggerates those. If the doctor makes the mistake of considering the inferior mental strength of patient with severe disease depending on presentation of symptoms and gives strong medicine then he may end up with complication.

Symptoms of severely diseased and mildly diseased are mentioned in seventh chapter of [[Vimana Sthana]].

The mental status examination has a special importance in today’s medical practice. The physician has to modulate interaction with the patient, dose of medicine, potency of medicine considering the psychology of the patient. The physician who communicates better with the patient helps to heal disease naturally.

=== Assessment of ''ahara shakti'' (intake capacity) ===

''Aharashakti'' is not only the quantity of food intake, but also its digestive capacity. Quantity of food taken and digestive capacity of the person is to be considered. The assessment of ''agni'' is based upon the food intake capacity of the person. The proporation of body tissue depends upon intake of food and its assimilation inside body. This directly affects the health status. Hence, ''ahara shakti'' is important to be assessed.

Further, if the patient is not responding to oral administration of drugs, then the parenteral or any other route of drug administration is to be chosen.

=== Assessment of ''vyayama shakti'' (exercise endurance capacity) ===

''Vyayamashakti'' is described as ''bharvahanshakti'' i.e. capacity to work. People doing strenuous work or exercise have more forebearance and are strong. The capacity to exercise is directly related with the cardio-vascular, pulmonary, muscular and mental status of the patient, and hence it is linked with healthy lifespan. Nowadays, various stress tests are done for evaluation of these functions and are useful to determine the prognosis of disease to give guidance for necessary intervention.

=== Reference books for further reading ===

1. Charak Samhita by Agnivesha Edited By Yadavji Trikamji Acharya-Munshiram Manoharlal Publishers Pvt. Ltd. 4th Edition.

2. Sushruta Samhita of Sushruta Edited By Yadavji Trikamji Acharya- Chaukhamba Orientalia, Varanasi- 6th Edition.

3. Astanga Hrudaya By Vagbhat-Chaukhamba Publication

4. Caraka Samhita (Text With English Translation & Critical Exposition Based On Cakrapani Datta Ayurved Dipika) By R K Sharma And Bhagwan Dash, Chowkhamba Sanskrit Series Office, Varanasi.

5. Basic Principles Of [[Ayurveda]], Padarth Vijnana By Prof. Yogesh Chandra Mishra- Chaukhamba Sanskrit Bhawan, Varanasi.

6. Padarth Vigyan By Dr Krishnamurthy- Chaukhamba Sanskrit Bhawan, Varanasi.

7. Tarka Sangraha- Chaukhamba Sanskrit Bhawan, Varanasi.
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Ashtauninditiya Adhyaya

2020-09-16T06:38:19Z

Vidyadhishkashikar: /* Eight inherent sequelae of obesity */

{{#seo:
|title=Ashtauninditiya Adhyaya
|titlemode=append
|keywords=Atisthaulya, Atikarshya, Morbid obesity, Hereditary and genetic Disorders, Endocrine Disorders, Sleep(Nidra), Insomnia(Anidra), sleep disorders,charak samhita, Ayurveda,Indian system of medicine.
|description=Sutra Sthana Chapter 21. Eight Undesirable Physical Constitutions
|image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg
|image_alt=carak samhita
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<big>'''Sutra Sthana Chapter 21. Eight Undesirable Physical Constitutions '''</big>
{{Infobox
|title = Ashtauninditiya Adhyaya
|label1 = Section/Chapter
|data1 = [[Sutra Sthana]] Chapter 21
|label2 = Tetrad/Sub-section
|data2 = ''Yojana Chatushka''
|label3 = Preceding Chapter
|data3 = [[Maharoga Adhyaya]]

|label4 = Succeeding Chapter
|data4 = [[Langhanabrimhaniya Adhyaya]]

|label5 = Other Sections
|data5 = [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|data6 = Pandey A.
|label7 = Reviewer
|data7 = Byadgi P.S.
|label8 = Editor
|data8 = Dwivedi R.B.
|label9 = Date of publication
|data9 = December 17, 2018
|label10 = DOI
|data10 =

}}

<big>'''Abstract'''</big>
<div style="text-align:justify;">This is the first chapter of tetrad on guidelines on management of diseases. After enlisting eight undesirable physical appearances based on the criteria like body height, body mass, complexion and presence of hair. The extreme presence or absence of these parameters leads to undesirable physical appearances. The most commonly observed conditions in the society like morbid obesity and extreme emaciation are described in details with their causative factors, signs and symptoms, and ways of effective management. In etio-pathogenesis of these disorders, sleep is the second most important cause after diet. Therefore a special emphasis is given on the merits of sleep, qualities or characteristics that define a “good sleep” and the demerits of sleep related disorders. </div>

'''Keywords''': ''Atisthaulya, Atikarshya,'' Morbid obesity, Hereditary and genetic Disorders, Endocrine Disorders, Sleep(''Nidra''), Insomnia(''Anidra'')

== Introduction ==
<div style="text-align:justify;">
Charak has laid down the foundation of genetic/hereditary and endocrinal disorders in relation to four pairs of opposing (and undesirable) physical characteristics- height (too tall, too short), body hair (too hairy, hairless), complexion (too dark, too light), and body mass (too obese, too lean). Among these, ''atisthula'' (morbid obesity) is the most undesirable characteristic because it is associated with several life-threatening complications including diabetes, hypertension, coronary artery diseases, joint disorders, skin disorders, anorectal problems, etc. This chapter focuses on the features of a healthy physical constitution of a person, definitions of sleep, as well as key concepts associated with disease management such as etiopathogenesis, clinical presentation, prognosis, and management of ''atisthula''. Some key etiological factors of ''atisthula'' include dietary and lifestyle indicators (e.g., sedentary habit and high-calorie diet), and genetic and hereditary factors. This chapter also describes the pathogenesis of ''atisthula'' in detail, involving ''rasa'' (plasma) and ''meda'' (adipose tissue) as important ''dushyas'' (affected tissues). Modern medicine has acknowledged the role of ''meda'' (adipose tissue) as a principal ''dushya'', with obesity and dyslipidemia regarded as the main components of the basic matrix of this disease and its related disorders<ref name=ref1>Pandey A. K and Singh R. H.: “A Study of the Immune status in patients of diabetes mellitus and their Management with certain NaimittikaRasayana drugs”, JRAS. Vol. XXIV. No. 3-4, 2003; 48-61. </ref> <ref name=ref2>Pandey A.K and Singh R.H. (2012): A Clinical Study on Certain Diabetic Complications under the Influence of Naimittika Rasayana Therapy w.s.r. to Nishamalaki and Shilajatu), PhD. Thesis, Department of Kayachikitsa,, IMS, BHU, Varanasi. </ref> <ref name=ref3>Jaspreet Singh & A. K. Pandey: Clinical Evaluation of Pushkaramula (Inula racemosa) Capsule in the patients of Metabolic syndrome”, International Journal of Medicine and Pharmaceutical Sciences (IJMPS), ISSN(P): 2250-0049; ISSN(E): 2321-0095, Vol. 4, Issue 2, Apr 2014, 9-20. </ref>. The recent concept of “metabolic syndrome” was already recognized in [[Ayurveda]]. Biomedical science points that overweight individuals experience greatly elevated morbidity and mortality from various ailments including cardiovascular diseases<ref>National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Bethesda, Md: National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases; 1998. </ref> <ref>Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001;321: 225–236.</ref>

Obesity research is focused on preventive measures and management of complications like prediabetes, diabetes, metabolic syndrome, hypertension, stroke, coronary artery disease, congestive heart failure, cardiomyopathy, and arrhythmia/sudden death<ref>Singh Jaspreet & Pandey A.K. (2012): Clinical Evaluation of Pushkarmula churna in the patients of metabolic syndrome w.s.r, to Ojas and Agni MD (Ay) Department of Kayachikitsa, IMS, BHU, Varanasi. </ref>. In the modern world, obesity has emerged as a serious health issue in both developed and developing nations and is recognized as one of the most serious public health problems of the 21st century. In 2008 the WHO estimated that globally, at least 500 million adults (or approximately 1 in 10 adults) are obese, with higher rates among women than men. Obesity is the reason for about 80% of type 2 diabetes, about 70% of cardiovascular diseases, and 42% of breast and colon cancers today. In the past two decades, the number of overweight children and adolescents has doubled<ref>Lau D.C. et al (April 2007). "2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]", CMAJ , 176 (8): S1–13. </ref>. The rate of obesity also increases with age at least up to 50 or 60 years old. Once considered a problem specific to only high-income countries, obesity has acquired pandemic proportions and is affecting people globally<ref>World Health Organization (WHO) (2000). Obesity: Preventing and Managing the Global Epidemic. Report on a WHO Consultation. Geneva. (WHO technical report series 894). </ref> <ref>P.J.English, M.A.Ghatei, I.A.Malik, S. R. Bloom and J. P. H. Wilding ( June-1, 2002): Food fails to suppress ghrelin levels in obese humans, The Journal of Clinical Endocrinology & Metabolism, 87(6):2984–2987. </ref>, <ref>Pandey, A. K. (2015): </ref>

Any course of treatment for obesity suggested by modern medical practitioners primarily includes dietary changes and physical exercise followed by anti-obesity drugs that help reduce appetite or inhibit fat absorption. In severe cases, various invasive and non-invasive surgical procedures could be prescribed - such as partial gastrectomy, gastric bypass, banding, gastric balloons, etc<ref>Puhl R, Brownell KD (December 2001): "Bias, discrimination, and obesity". Obes. Res.9 (12): 788–805. doi:10.1038/oby.2001.108. PMID 11743063. </ref>. However, [[Ayurveda]]’s approach to weight management is very different. Instead, [[Ayurveda]] advocates dietary restrictions according to the ''prakriti'' (predisposition or temperament of the patient), moderate exercise, practice of ''yogasanas'' and ''pranayama'', besides certain ayurvedic medications and bio-purificatory measures for its management<ref>Pandey A.K. (2013-2014): Conceptual background on obesity (sthaulya/medoroga) & an approach for its management through ayurveda, chapter published in a book ‘Integrative approach to metabolic syndrome’ published by Mahima research foundation and social welfare, Varanasi, UP, India, 2013-2014, p.no.-47-59. </ref>.

The etiology, pathogenesis, clinical features and consequences of extreme leanness (''atikrisha''), as an outcome of ''rasakshaya'' (decrease of ''rasa''), ''medokshaya'' (decrease of ''fat'') and ''mamsakshaya'' (decrease of ''muscles'') have also been described in this chapter. The two basic approaches for management of ''atikrisha'' and ''atisthula'' are augmentation (''brimhana'') and depletion (''karshana'') of body tissues respectively. Various drug and non-drug modalities have been suggested for the replenishment of ''dhatus'' and their nourishment to attain good health. In this regard, ''Rasayana'' drugs help balance hormones, promote essential nutrition and enhance immunity to ''atisthula'' and ''atikrisha'' respectively. As mentioned earlier, this chapter also emphasizes the role of good ''nidra'' (sleep) in maintaining a healthy life. In fact, as per [[Ayurveda]], after ''ahara'' (diet), ''nidra'' is one of the three sub-pillars of life (''trayopastambha'') and has a significant place in preventive medicine because normal sleep helps prevent diseases and unwholesome sleep may lead to fatal diseases. In [[Ayurveda]], ''nidra'' is considered a ''brimhana'' (nourishing) agent that promotes physical and mental health and enhances immunity<ref>Vd. H.S.KHushvaha (2009). Agniveshakrita Charak Samhita, Sutrasthana-11, Varanasi, Chaukhambha Orientalia, 2009. </ref>.
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==Sanskrit text, transliteration and english translation==
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अथातोऽष्टौनिन्दितीयमध्यायं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||
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athātō'ṣṭauninditīyamadhyāyaṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||

athAto~aShTauninditIyamadhyAyaM vyAkhyAsyAmaH||1||
iti ha smAha bhagavAnAtreyaH||2||
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Now we shall expound the chapter "Ashtauninditiya" (Eight undesirable physical appearances). Thus said Lord Atreya [1-2]

=== Eight undesirable physical appearances ===
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इह खलु शरीरमधिकृत्याष्टौ पुरुषा निन्दिता भवन्ति; तद्यथा- अतिदीर्घश्च, अतिह्रस्वश्च, अतिलोमा च, अलोमा च, अतिकृष्णश्च, अतिगौरश्च, अतिस्थूलश्च, अतिकृशश्चेति||३||
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iha khalu śarīramadhikr̥tyāṣṭau puruṣā ninditā bhavanti; tadyathā- atidīrghaśca, atihrasvaśca, atilōmā ca,alōmā ca, atikr̥ṣṇaśca, atigauraśca, atisthūlaśca, atikr̥śaścēti||3||

iha khalu sharIramadhikRutyAShTau puruShA ninditA bhavanti; tadyathA- atidIrghashca, atihrasvashca, atilomA ca, alomA ca [1] , atikRuShNashca, atigaurashca,atisthUlashca, atikRushashceti||3||
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In the context of the body (structure and appearance), the following eight types of persons are considered undesirable - too tall, too short, too hairy, hairless, too dark, too light (complexioned), too obese and too lean [3]

=== Obesity and leanness ===

==== Eight inherent sequelae of obesity ====
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तत्रातिस्थूलकृशयोर्भूय एवापरे निन्दितविशेषा भवन्ति |
अतिस्थूलस्य तावदायुषो ह्रासो जवोपरोधः कृच्छ्रव्यवायता दौर्बल्यं दौर्गन्ध्यं स्वेदाबाधः क्षुदतिमात्रं पिपासातियोगश्चेति भवन्त्यष्टौ दोषाः|
तदतिस्थौल्यमतिसम्पूरणाद्गुरुमधुरशीतस्निग्धोपयोगादव्यायामादव्यवायाद्दिवास्वप्नाद्धर्षनित्यत्वाद-चिन्तनाद्बीजस्वभावाच्चोपजायते|
तस्य ह्यतिमात्रमेदस्विनो मेद एवोपचीयते न तथेतरे धातवः, तस्मादस्यायुषो ह्रासः; शैथिल्यात् सौकुमार्याद्गुरुत्वाच्चमेदसो जवोपरोधः, शुक्राबहुत्वान्मेदसाऽऽवृतमार्गत्वाच्च कृच्छ्रव्यवायता, दौर्बल्यमसमत्वाद्धातूनां, दौर्गन्ध्यं मेदोदोषान्मेदसः स्वभावात् स्वेदनत्वाच्च, मेदसः श्लेष्मसंसर्गाद्विष्यन्दित्वाद्बहुत्वाद्गुरुत्वाद्व्यायामासहत्वाच्च स्वेदाबाधः, तीक्ष्णाग्नित्वात् प्रभूतकोष्ठवायुत्वाच्च क्षुदतिमात्रं पिपासातियोगश्चेति ||४||
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tatrātisthūlakr̥śayōrbhūya ēvāparē ninditaviśēṣā bhavanti|
atisthūlasya tāvadāyuṣō hrāsō javōparōdhaḥ kr̥cchravyavāyatā daurbalyaṁ daurgandhyaṁ svēdābādhaḥkṣudatimātraṁ pipāsātiyōgaścēti bhavantyaṣṭau dōṣāḥ|
tadatisthaulyamatisampūraṇādgurumadhuraśītasnigdhōpayōgādavyāyāmādavyavāyāddivāsvapnāddharṣanityatvāda-cintanādbījasvabhāvāccōpajāyatē| tasya hyatimātramēdasvinō mēda ēvōpacīyatē na tathētarē dhātavaḥ, tasmādasyāyuṣō hrāsaḥ; śaithilyātsaukumāryādgurutvācca mēdasō javōparōdhaḥ, Śukrābahutvānmēdasā'' vr̥tamārgatvācca kr̥cchravyavāyatā,daurbalyamasamatvāddhātūnāṁ, daurgandhyaṁ mēdōdōṣānmēdasaḥ svabhāvāt svēdanatvācca, Mēdasaḥślēṣmasaṁsargādviṣyanditvādbahutvādgurutvādvyāyāmāsahatvācca svēdābādhaḥ, tīkṣṇāgnitvātprabhūtakōṣṭhavāyutvācca kṣudatimātraṁ pipāsātiyōgaścēti||4||

tatrAtisthUlakRushayorbhUya evApare ninditavisheShA bhavanti|
atisthUlasya tAvadAyuSho hrAso javoparodhaH kRucchravyavAyatA daurbalyaM daurgandhyaM svedAbAdhaH kShudatimAtraM pipAsAtiyogashcetibhavantyaShTau doShAH|
tadatisthaulyamatisampUraNAdgurumadhurashItasnigdhopayogAdavyAyAmAdavyavAyAddivAsvapnAddharShanityatvAda- cintanAdbIjasvabhAvAccopajAyate|
tasya hyatimAtramedasvino meda evopacIyate na tathetare dhAtavaH, tasmAdasyAyuSho hrAsaH; shaithilyAt saukumAryAdgurutvAcca medaso javoparodhaH ,shukrAbahutvAnmedasA~a~avRutamArgatvAcca kRucchravyavAyatA, daurbalyamasamatvAddhAtUnAM, daurgandhyaM medodoShAnmedasaH svabhAvAtsvedanatvAcca, medasaH shleShmasaMsargAdviShyanditvAdbahutvAdgurutvAdvyAyAmAsahatvAcca svedAbAdhaH, tIkShNAgnitvAt prabhUtakoShThavAyutvAccakShudatimAtraM pipAsAtiyogashceti||4||
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<div style="text-align:justify;">
Amongst these, the too obese and too lean physical appearances are considered the most undesirable ones. The excessively obese have eight inherent defects in them: reduced lifespan, constricted or limited movement (hampered due to loose, tender and heavy fats), reduced sexual activities or impotence (due to small quantity of semen produced and obstruction of the channel of semen by ''medas''), debility (due to ''dhatu'' imbalance), emit bad smell (due to the inherent nature of fatty tissues as well as excessive sweating), profuse sweating (since ''medas'' and ''kapha'' are vitiated), and excessive hunger and thirst (due to excessive digestive ''agni'' and ''vayu'' in the body). Excessive obesity is caused due to over-nourishment as a consequence of the intake of heavy, sweet, cold and fatty diet, lack of physical exercise, abstinence from sexual intercourse, sleeping during the day, uninterrupted cheerfulness, lack of mental activities and hereditary/genetic defects. These consequences may lead to an excess of fat (with further accumulation of only fat) and consequent depletion of dhatus. [4]
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==== Pathophysiology of Obesity ====
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भवन्ति चात्र-
मेदसाऽऽवृतमार्गत्वाद्वायुः कोष्ठे विशेषतः|
चरन् सन्धुक्षयत्यग्निमाहारं शोषयत्यपि||५||

तस्मात् स शीघ्रं जरयत्याहारं चातिकाङ्क्षति|
विकारांश्चाश्नुते घोरान् कांश्चित्कालव्यतिक्रमात्||६||

एतावुपद्रवकरौ विशेषादग्निमारुतौ|
एतौ हि दहतः स्थूलं वनदावो वनं यथा||७||

मेदस्यतीव संवृद्धे सहसैवानिलादयः|
विकारान् दारुणान् कृत्वा नाशयन्त्याशु जीवितम्||८||

मेदोमांसातिवृद्धत्वाच्चलस्फिगुदरस्तनः|
अयथोपचयोत्साहो नरोऽतिस्थूल उच्यते||९||

इति मेदस्विनो दोषा हेतवो रूपमेव च|
निर्दिष्टं, ....|१०|
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bhavanti cātra-
mēdasā''vr̥tamārgatvādvāyuḥ kōṣṭhē viśēṣataḥ|
caran sandhukṣayatyagnimāhāraṁ śōṣayatyapi||5||

tasmāt sa śīghraṁ jarayatyāhāraṁ cātikāṅkṣati|
vikārāṁścāśnutē ghōrān kāṁścitkālavyatikramāt||6||

ētāvupadravakarau viśēṣādagnimārutau|
ētau hi dahataḥ sthūlaṁ vanadāvō vanaṁ yathā||7||

mēdasyatīva saṁvr̥ddhē sahasaivānilādayaḥ|
vikārān dāruṇān kr̥tvā nāśayantyāśu jīvitam||8||

mēdōmāṁsātivr̥ddhatvāccalasphigudarastanaḥ|
ayathōpacayōtsāhō narō'tisthūla ucyatē||9||

iti mēdasvinō dōṣā hētavō rūpamēva ca|
nirdiṣṭaṁ, ....|10|

bhavanti cAtra-
medasA~a~avRutamArgatvAdvAyuH koShThe visheShataH|
caran sandhukShayatyagnimAhAraM shoShayatyapi||5||

tasmAt sa shIghraM jarayatyAhAraM cAtikA~gkShati|
vikArAMshcAshnute ghorAn kAMshcitkAlavyatikramAt||6||

etAvupadravakarau visheShAdagnimArutau|
etau hi dahataH sthUlaM vanadAvo vanaM yathA||7||

medasyatIva saMvRuddhe sahasaivAnilAdayaH|
vikArAn dAruNAn [1] kRutvA nAshayantyAshu jIvitam||8||

medomAMsAtivRuddhatvAccalasphigudarastanaH|
ayathopacayotsAho [2] naro~atisthUla ucyate||9||

iti medasvino doShA hetavo rUpameva ca|
nirdiShTaM, ....|10|
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<div style="text-align:justify;">
Due to the obstruction of body channels by ''medas'', the movement of ''vata'' is specially confined to ''koshtha'' (abdominal viscera) resulting in the stimulation of digestive power and absorption of food. Hence,the person digests food quickly and becomes a voracious eater. By not following rules of taking meals at specific times during the day, he is afflicted by dreadful diseases. ''Agni'' (''pitta'' component responsible for digestion) and ''vata'' are the two most troublesome factors from the standpoint of obesity. These factors blight an obese person as wildfire destroys a forest. As the body gains excessive fat, vitiated ''doshas'' suddenly cause severe diseases resulting in rapid deterioration of life. The person is considered too obese when there is an excessive increase in fat and muscle tissue in the regions of buttocks, abdomen, and breasts, which become pendulous and suffer from deficient metabolism and energy. These are the causes, signs, and symptoms of an obese person [5-10]
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==== Features of an excessively lean person ====
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... वक्ष्यते वाच्यमतिकार्श्ये त्वतः परम्||१०||

सेवा रूक्षान्नपानानां लङ्घनं प्रमिताशनम्|
क्रियातियोगः शोकश्च वेगनिद्राविनिग्रहः||११||

रूक्षस्योद्वर्तनं स्नानस्याभ्यासः प्रकृतिर्जरा|
विकारानुशयः क्रोधः कुर्वन्त्यतिकृशं नरम्||१२||

व्यायाममतिसौहित्यं क्षुत्पिपासामयौषधम् |
कृशो न सहते तद्वदतिशीतोष्णमैथुनम्||१३||

प्लीहा कासः क्षयः श्वासो गुल्मोऽर्शांस्युदराणि च|
कृशं प्रायोऽभिधावन्ति रोगाश्च ग्रहणीगताः||१४||

शुष्कस्फिगुदरग्रीवो धमनीजालसन्ततः|
त्वगस्थिशेषोऽतिकृशः स्थूलपर्वा नरो मतः||१५||
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... vakṣyatē vācyamatikārśyē tvataḥ param||10||

sēvā rūkṣānnapānānāṁ laṅghanaṁ pramitāśanam|
kriyātiyōgaḥ śōkaśca vēganidrāvinigrahaḥ||11||

rūkṣasyōdvartanaṁ snānasyābhyāsaḥ prakr̥tirjarā|
vikārānuśayaḥ krōdhaḥ kurvantyatikr̥śaṁ naram||12||

vyāyāmamatisauhityaṁ kṣutpipāsāmayauṣadham |
kr̥śō na sahatē tadvadatiśītōṣṇamaithunam||13||

plīhā kāsaḥ kṣayaḥ śvāsō gulmō'rśāṁsyudarāṇi ca|
kr̥śaṁ prāyō'bhidhāvanti rōgāśca grahaṇīgatāḥ||14||

śuṣkasphigudaragrīvō dhamanījālasantataḥ|
tvagasthiśēṣō'tikr̥śaḥ sthūlaparvā narō mataḥ||15||

... vakShyate vAcyamatikArshye tvataH param||10||

sevA rUkShAnnapAnAnAM la~gghanaM pramitAshanam|
kriyAtiyogaH shokashca veganidrAvinigrahaH||11||

rUkShasyodvartanaM snAnasyAbhyAsaH prakRutirjarA|
vikArAnushayaH krodhaH kurvantyatikRushaM naram||12||

vyAyAmamatisauhityaM kShutpipAsAmayauShadham [1] |
kRusho na sahate tadvadatishItoShNamaithunam||13||

plIhA kAsaH kShayaH shvAso gulmo~arshAMsyudarANi ca|
kRushaM prAyo~abhidhAvanti [2] rogAshca grahaNIgatAH||14||

shuShkasphigudaragrIvo dhamanIjAlasantataH|
tvagasthisheSho~atikRushaH sthUlaparvA naro mataH||15||
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<div style="text-align:justify;">
Hereafter, the features of an excessively lean person will be explained by etiology, signs, symptoms and defects. Indulgence in the intake of dry (non-unctuous) diets and drinks, fasting, intake of food in inadequate quantity, overuse of therapeutic purificatory measures, grief, suppression of natural urges, inadequate sleep or sleep deprivation, dry powder massage, indulgence in baths, heredity, old age, continued illness and anger make a person too lean.

The excessively lean person does not tolerate physical exercise, intake of food in large quantities, hunger, thirst, diseases, and drugs. They also cannot tolerate too much cold, heat and sexual intercourse. Such a person is often associated with splenic diseases, cough, wasting, dyspnoea, gulma (abdominal tumor), piles, abdominal disorders and disorders of grahanі. The excessively lean person has dried up buttocks, abdomen and neck, the prominent vascular network is mostly “skin and bones” with thickened nodes [10-15]
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सततं व्याधितावेतावतिस्थूलकृशौ नरौ|
सततं चोपचर्यौ हि कर्शनैर्बृंहणैरपि||१६||

स्थौल्यकार्श्ये वरं कार्श्यं समोपकरणौ हि तौ|
यद्युभौ व्याधिरागच्छेत् स्थूलमेवातिपीडयेत्||१७||
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satataṁ vyādhitāvētāvatisthūlakr̥śau narau|
satataṁ cōpacaryau hi karśanairbr̥ṁhaṇairapi||16||

sthaulyakārśyē varaṁ kārśyaṁ samōpakaraṇau hi tau|
yadyubhau vyādhirāgacchēt sthūlamēvātipīḍayēt||17||

satataM vyAdhitAvetAvatisthUlakRushau narau|
satataM copacaryau hi karshanairbRuMhaNairapi||16||

sthaulyakArshye varaM kArshyaM samopakaraNau hi tau|
yadyubhau vyAdhirAgacchet sthUlamevAtipIDayet||17||
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<div style="text-align:justify;">
Both these undesirable types of people (too obese and too lean) always suffer from some disease or the other and need to be constantly managed by bulk-reducing and bulk-promoting therapies respectively. Of the two, lean is less harmful than obese, and the physical and mental sufferings in the case of an obese person are far greater in comparison to a lean person [16-17]
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==== The importance of ideal body proportion ====
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सममांसप्रमाणस्तु समसंहननो नरः|
दृढेन्द्रियो विकाराणां न बलेनाभिभूयते||१८||

क्षुत्पिपासातपसहः शीतव्यायामसंसहः|
समपक्ता समजरः सममांसचयो मतः||१९||
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samamāṁsapramāṇastu samasaṁhananō naraḥ|
dr̥ḍhēndriyō vikārāṇāṁ na balēnābhibhūyatē||18||

kṣutpipāsātapasahaḥ śītavyāyāmasaṁsahaḥ|
samapaktā samajaraḥ samamāṁsacayō mataḥ||19||

samamAMsapramANastu samasaMhanano naraH|
dRuDhendriyo vikArANAM na balenAbhibhUyate||18||

kShutpipAsAtapasahaH shItavyAyAmasaMsahaH|
samapaktA samajaraH samamAMsacayo mataH||19||
</div></div>

<div style="text-align:justify;">
A person with a balanced proportion of muscles and compactness of the body and firmness in sense organs is not overcome by the onslaught of disorders. Such people can tolerate hunger, thirst, the heat of the sun, cold and physical exercise. Their digestion, assimilation of food and muscle metabolism is in a state of equilibrium. [18-19]
</div>
==== The best diet for obese and lean persons ====
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गुरु चातर्पणं चेष्टं स्थूलानां कर्शनं प्रति|
कृशानां बृंहणार्थं च लघु सन्तर्पणं च यत्||२०||
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guru cātarpaṇaṁ cēṣṭaṁ sthūlānāṁ karśanaṁ prati|
kr̥śānāṁ br̥ṁhaṇārthaṁ ca laghu santarpaṇaṁ ca yat||20||

guru cAtarpaNaM ceShTaM sthUlAnAM karshanaM prati|
kRushAnAM bRuMhaNArthaM ca laghu santarpaNaM ca yat||20||
</div></div>

Heavy and non-nourishing (diet) therapy are prescribed for slimming in the case of the too obese, while for promoting the bulk of the too lean light and nourishing therapy is prescribed [20]

==== Management of obesity ====
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वातघ्नान्यन्नपानानि श्लेष्ममेदोहराणि च|
रूक्षोष्णा बस्तयस्तीक्ष्णा रूक्षाण्युद्वर्तनानि च||२१||

गुडूचीभद्रमुस्तानां प्रयोगस्त्रैफलस्तथा|
तक्रारिष्टप्रयोगश्च प्रयोगो माक्षिकस्य च||२२||

विडङ्गं नागरं क्षारः काललोहरजो मधु|
यवामलकचूर्णं च प्रयोगः श्रेष्ठ उच्यते||२३||

बिल्वादिपञ्चमूलस्य प्रयोगः क्षौद्रसंयुतः|
शिलाजतुप्रयोगश्च साग्निमन्थरसः परः||२४||

प्रशातिका प्रियङ्गुश्च श्यामाका यवका यवाः|
जूर्णाह्वाः कोद्रवा मुद्गाः कुलत्थाश्चक्रमुद्गकाः ||२५||

आढकीनां च बीजानि पटोलामलकैः सह|
भोजनार्थं प्रयोज्यानि पानं चानु मधूदकम्||२६||

अरिष्टांश्चानुपानार्थे मेदोमांसकफापहान्|
अतिस्थौल्यविनाशाय संविभज्य प्रयोजयेत्||२७||

प्रजागरं व्यवायं च व्यायामं चिन्तनानि च|
स्थौल्यमिच्छन् परित्यक्तुं क्रमेणाभिप्रवर्धयेत्||२८||
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vātaghnānyannapānāni ślēṣmamēdōharāṇi ca|
rūkṣōṣṇā bastayastīkṣṇā rūkṣāṇyudvartanāni ca||21||

guḍūcībhadramustānāṁ prayōgastraiphalastathā|
takrāriṣṭaprayōgaśca prayōgō mākṣikasya ca||22||

viḍaṅgaṁ nāgaraṁ kṣāraḥ kālalōharajō madhu|
yavāmalakacūrṇaṁ ca prayōgaḥ śrēṣṭha ucyatē||23||

bilvādipañcamūlasya prayōgaḥ kṣaudrasaṁyutaḥ|
śilājatuprayōgaśca sāgnimantharasaḥ paraḥ||24||

praśātikā priyaṅguśca śyāmākā yavakā yavāḥ|
jūrṇāhvāḥ kōdravā mudgāḥ kulatthāścakramudgakāḥ ||25||

āḍhakīnāṁ ca bījāni paṭōlāmalakaiḥ saha|
bhōjanārthaṁ prayōjyāni pānaṁ cānu madhūdakam||26||

ariṣṭāṁścānupānārthē mēdōmāṁsakaphāpahān|
atisthaulyavināśāya saṁvibhajya prayōjayēt||27||

prajāgaraṁ vyavāyaṁ ca vyāyāmaṁ cintanāni ca|
sthaulyamicchan parityaktuṁ kramēṇābhipravardhayēt||28||

vAtaghnAnyannapAnAni shleShmamedoharANi ca|
rUkShoShNA bastayastIkShNA rUkShANyudvartanAni ca||21||

guDUcIbhadramustAnAM prayogastraiphalastathA|
takrAriShTaprayogashca prayogo mAkShikasya ca||22||

viDa~ggaM nAgaraM kShAraH kAlaloharajo madhu|
yavAmalakacUrNaM ca prayogaH shreShTha ucyate||23||

bilvAdipa~jcamUlasya prayogaH kShaudrasaMyutaH|
shilAjatuprayogashca sAgnimantharasaH paraH||24||

prashAtikA priya~ggushca shyAmAkA yavakA yavAH|
jUrNAhvAH kodravA mudgAH kulatthAshcakramudgakAH [1] ||25||

ADhakInAM ca bIjAni paTolAmalakaiH saha|
bhojanArthaM prayojyAni pAnaM cAnu madhUdakam||26||

ariShTAMshcAnupAnArthe medomAMsakaphApahAn|
atisthaulyavinAshAya saMvibhajya prayojayet||27||

prajAgaraM [2] vyavAyaM ca vyAyAmaM cintanAni ca|
sthaulyamicchan parityaktuM krameNAbhipravardhayet||28||
</div></div>

<div style="text-align:justify;">
Food and drinks that alleviate vata and reduce ''kapha'' and ''meda'' (fat), enema with sharp, ununctuous and hot drugs, therapeutic powder massage, use of ''guduchi'' (Tinospora cordifolia Miers), ''musta'' (Cyperus rotundus Linn), ''triphala'' (haritaki-Terminalia chebula Linn, ''bibhitaka''(Terminalia belerica Roxb) and ''amalaka'' (Emblica officinalis Gaertn), ''takrarishta'' (a fermented medicinal preparation of buttermilk) and honey are recommended for the management of obesity. A formulation prepared from ''vidanga'' (Embelia ribes Burm f.), ''nagara'' (Zingiber officinale Rose), ''yavakshara'' (alkali preparation of barley), ash powder of black iron along with honey, powder of ''yava'' (Hordeum vulgarae Linn) and ''amalaka'' (Emblica officinalis Gaertn) is also an excellent weight-loss drug. Similarly, ''Bilvadi panchamula'' (five major roots) mixed with honey and shilajatu along with the juice of ''agnimantha'' (Clerodendrum phlomidis Linn.f.) are also very effective preparations for weight-loss.

A diet consisting of ''prashatika'' (Setaria italic Beauv.), ''priyangu'' (Aglaia roxburghiana Mig.), ''shyamaka'' (Echinochloa frumentaea Linn.), ''yavaka'' (small variety of Hordeum vulgarae Linn), ''yava'' (Hordeum vulgarae Linn), ''jurnahva'' (Sorghum vulgare Linn), ''kodrava'' (papalum scrobiculatum Linn.), ''mudga'' (Phaseolus mungo Linn.), ''kulattha'' (Dolichos biflorus Linn.), ''chakramudgaka'', ''adhaki'' (Cajanus cajan Millsp.) along with ''patola'' (Trichosanthes cucumerina Linn) and ''amalaka'' (Emblica officinalis Gaertn) is very effective in tackling obesity and maintaining good health. Honey water and alcoholic preparations may be taken as postprandial drinks that help in reducing excessive fat and muscle tissues, while also alleviating ''kapha dosha''.
</div>
One desirous of reducing obesity should indulge more and more in vigil, sexual activities, as well as physical and mental exercises [21-28]

==== Management of leanness ====
<div class="mw-collapsible mw-collapsed">

स्वप्नो हर्षः सुखा शय्या मनसो निर्वृतिः शमः|
चिन्ताव्यवायव्यायामविरामः प्रियदर्शनम्||२९||

नवान्नानि नवं मद्यं ग्राम्यानूपौदका रसाः|
संस्कृतानि च मांसानि दधि सर्पिः पयांसि च||३०||

इक्षवः शालयो माषा गोधूमा गुडवैकृतम्|
बस्तयः स्निग्धमधुरास्तैलाभ्यङ्गश्च सर्वदा||३१||

स्निग्धमुद्वर्तनं स्नानं गन्धमाल्यनिषेवणम्|
शुक्लं वासो यथाकालं दोषाणामवसेचनम्||३२||

रसायनानां वृष्याणां योगानामुपसेवनम्|
हत्वाऽतिकार्श्यमाधत्ते नृणामुपचयं परम्||३३||

अचिन्तनाच्च कार्याणां ध्रुवं सन्तर्पणेन च|
स्वप्नप्रसङ्गाच्च नरो वराह इव पुष्यति||३४||
<div class="mw-collapsible-content">

svapnō harṣaḥ sukhā śayyā manasō nirvr̥tiḥ śamaḥ|
cintāvyavāyavyāyāmavirāmaḥ priyadarśanam||29||

navānnāni navaṁ madyaṁ grāmyānūpaudakā rasāḥ|
saṁskr̥tāni ca māṁsāni dadhi sarpiḥ payāṁsi ca||30||

ikṣavaḥ śālayō māṣā gōdhūmā guḍavaikr̥tam|
bastayaḥ snigdhamadhurāstailābhyaṅgaśca sarvadā||31||

snigdhamudvartanaṁ snānaṁ gandhamālyaniṣēvaṇam|
śuklaṁ vāsō yathākālaṁ dōṣāṇāmavasēcanam||32||

rasāyanānāṁ vr̥ṣyāṇāṁ yōgānāmupasēvanam|
hatvā'tikārśyamādhattē nr̥ṇāmupacayaṁ param||33||

acintanācca kāryāṇāṁ dhruvaṁ santarpaṇēna ca|
svapnaprasaṅgācca narō varāha iva puṣyati||34||

svapno harShaH sukhA shayyA manaso nirvRutiH shamaH|
cintAvyavAyavyAyAmavirAmaH priyadarshanam||29||

navAnnAni navaM madyaM grAmyAnUpaudakA rasAH|
saMskRutAni ca mAMsAni dadhi sarpiH payAMsi ca||30||

ikShavaH shAlayo mAShA godhUmA guDavaikRutam|
bastayaH snigdhamadhurAstailAbhya~ggashca sarvadA||31||

snigdhamudvartanaM snAnaM gandhamAlyaniShevaNam|
shuklaM vAso yathAkAlaM doShANAmavasecanam||32||

rasAyanAnAM vRuShyANAM yogAnAmupasevanam|
hatvA~atikArshyamAdhatte nRuNAmupacayaM param||33||

acintanAcca kAryANAM dhruvaM santarpaNena ca|
svapnaprasa~ggAcca naro varAha iva puShyati||34||
</div></div>

<div style="text-align:justify;">
Sleep, exhilaration, comfortable bed, contentment, relaxed mind, abstinence from anxiety, sexual act and physical exercise, cheerfulness, newly harvested cereals, fresh wine, meat soup of animals residing in domestic, marshy and aquatic areas, well-cooked and prepared meat, curd, ghee, milk, sugarcane, ''shali'' rice, ''masha'' (Phaseolus radiates Linn.), wheat and its products, jaggery and its products, enema consisting of unctuous and sweet drugs, regular oil massage, unctuous bath, use of fragrance and garlands, use of white dress, elimination of ''doshas'' in due time and regular use of rejuvenating and aphrodisiac formulations to reduce excessive leanness and nourish the body.
Besides, freedom from anxiety about any work, intake of nourishing diet and adequate sleep makes the man too obese like a pig [29-34]
</div>
=== Concept of Nidra (sleep) ===
==== Physiological mechanism of sleep ====
<div class="mw-collapsible mw-collapsed">

यदा तु मनसि क्लान्ते कर्मात्मानः क्लमान्विताः |
विषयेभ्यो निवर्तन्ते तदा स्वपिति मानवः||३५||
<div class="mw-collapsible-content">

yadā tu manasi klāntē karmātmānaḥ klamānvitāḥ |
viṣayēbhyō nivartantē tadā svapiti mānavaḥ||35||

yadA tu manasi klAnte karmAtmAnaH klamAnvitAH |
viShayebhyo nivartante tadA svapiti mAnavaH||35||
</div></div>

An individual falls asleep when his mind including the sensory and motor organs get exhausted, and they dissociate themselves from their objects. [35]

==== Benefits of sleep ====
<div class="mw-collapsible mw-collapsed">

निद्रायत्तं सुखं दुःखं पुष्टिः कार्श्यं बलाबलम्|
वृषता क्लीबता ज्ञानमज्ञानं जीवितं न च||३६||

अकालेऽतिप्रसङ्गाच्च न च निद्रा निषेविता|
सुखायुषी पराकुर्यात् कालरात्रिरिवापरा||३७||

सैव युक्ता पुनर्युङ्क्ते निद्रा देहं सुखायुषा|
पुरुषं योगिनं सिद्ध्या सत्या बुद्धिरिवागता||३८||
<div class="mw-collapsible-content">

nidrāyattaṁ sukhaṁ duḥkhaṁ puṣṭiḥ kārśyaṁ balābalam|
vr̥ṣatā klībatā jñānamajñānaṁ jīvitaṁ na ca||36||

akālē'tiprasaṅgācca na ca nidrā niṣēvitā|
sukhāyuṣī parākuryāt kālarātririvāparā||37||

saiva yuktā punaryuṅktē nidrā dēhaṁ sukhāyuṣā|
puruṣaṁ yōginaṁ siddhyā satyā buddhirivāgatā||38||

nidrAyattaM sukhaM duHkhaM puShTiH kArshyaM balAbalam|
vRuShatA klIbatA j~jAnamaj~jAnaM jIvitaM na ca||36||

akAle~atiprasa~ggAcca na ca nidrA niShevitA|
sukhAyuShI parAkuryAt [1] kAlarAtririvAparA||37||

saiva yuktA punaryu~gkte nidrA dehaM sukhAyuShA|
puruShaM yoginaM siddhyA satyA buddhirivAgatA||38||
</div></div>

<div style="text-align:justify;">
In human beings, happiness and misery, nourishment and emaciation, strength and weakness, fertility and infertility, knowledge and ignorance, and life and death depend upon proper (and improper sleep). Untimely, excessive sleep and sleep deprivation take away both happiness and longevity from a person. Similarly, proper sleep brings about happiness and longevity in human beings just as real knowledge brings about spiritual power in yogis [36-38]
</div>
==== Indications of daytime sleep ====
<div class="mw-collapsible mw-collapsed">

गीताध्ययनमद्यस्त्रीकर्मभाराध्वकर्शिताः|
अजीर्णिनः क्षताः क्षीणा वृद्धा बालास्तथाऽबलाः||३९||

तृष्णातीसारशूलार्ताः श्वासिनो हिक्किनः कृशाः|
पतिताभिहतोन्मत्ताः क्लान्ता यानप्रजागरैः||४०||

क्रोधशोकभयक्लान्ता दिवास्वप्नोचिताश्च ये|
सर्व एते दिवास्वप्नं सेवेरन् सार्वकालिकम्||४१||

धातुसाम्यं तथा ह्येषां बलं चाप्युपजायते|
श्लेष्मा पुष्णाति चाङ्गानि स्थैर्यं भवति चायुषः||४२||

ग्रीष्मे त्वादानरूक्षाणां वर्धमाने च मारुते|
रात्रीणां चातिसङ्क्षेपाद्दिवास्वप्नः प्रशस्यते||४३||
<div class="mw-collapsible-content">

gītādhyayanamadyastrīkarmabhārādhvakarśitāḥ|
ajīrṇinaḥ kṣatāḥ kṣīṇā vr̥ddhā bālāstathā'balāḥ||39||

tr̥ṣṇātīsāraśūlārtāḥ śvāsinō hikkinaḥ kr̥śāḥ|
patitābhihatōnmattāḥ klāntā yānaprajāgaraiḥ||40||

krōdhaśōkabhayaklāntā divāsvapnōcitāśca yē|
sarva ētē divāsvapnaṁ sēvēran sārvakālikam||41||

dhātusāmyaṁ tathā hyēṣāṁ balaṁ cāpyupajāyatē|
ślēṣmā puṣṇāti cāṅgāni sthairyaṁ bhavati cāyuṣaḥ||42||

grīṣmē tvādānarūkṣāṇāṁ vardhamānē ca mārutē|
rātrīṇāṁ cātisaṅkṣēpāddivāsvapnaḥ praśasyatē||43||

gItAdhyayanamadyastrIkarmabhArAdhvakarshitAH|
ajIrNinaH kShatAH kShINA vRuddhA bAlAstathA~abalAH||39||

tRuShNAtIsArashUlArtAH shvAsino hikkinaH kRushAH|
patitAbhihatonmattAH klAntA yAnaprajAgaraiH||40||

krodhashokabhayaklAntA divAsvapnocitAshca ye|
sarva ete divAsvapnaM severan sArvakAlikam||41||

dhAtusAmyaM tathA hyeShAM balaM cApyupajAyate|
shleShmA puShNAti cA~ggAni sthairyaM bhavati cAyuShaH||42||

grIShme tvAdAnarUkShANAM vardhamAne ca mArute|
rAtrINAM cAtisa~gkShepAddivAsvapnaH prashasyate||43||
</div></div>

<div style="text-align:justify;">
Sleeping during the day is advocated for those who are exhausted on account of singing, reading, alcoholic drinking, sexual intercourse, elimination therapy, carrying heavy weight, walking long distances, suffering from phthisis, wasting, thirst, diarrhea, colic pain, dyspnea, hiccup, insanity, or are too old, too young, weak and emaciated. It is also recommended for those who are injured by fall and assault or exhausted by travel-related stress, vigil, anger, grief, and fear. By this, equilibrium of ''dhatus'' and strength is maintained, and ''kapha'' nourishes the body parts and ensures longevity. In the summer season, nights become shorter, and ''vata'' gets provoked in the body in ''adanakala'' (seasons of low body strength, such as summer and rains) due to absorption of fluid. Therefore, during this period daytime sleeping is advocated for all [39-43]
</div>
==== Consequences of improper daytime sleep ====
<div class="mw-collapsible mw-collapsed">

ग्रीष्मवर्ज्येषु कालेषु दिवास्वप्नात् प्रकुप्यतः|
श्लेष्मपित्ते दिवास्वप्नस्तस्मात्तेषु न शस्यते||४४||

मेदस्विनः स्नेहनित्याः श्लेष्मलाः श्लेष्मरोगिणः|
दूषीविषार्ताश्च दिवा न शयीरन् कदाचन||४५||

हलीमकः शिरःशूलं स्तैमित्यं गुरुगात्रता|
अङ्गमर्दोऽग्निनाशश्च प्रलेपो हृदयस्य च||४६||

शोफारोचकहृल्लासपीनसार्धावभेदकाः|
कोठारुःपिडकाः कण्डूस्तन्द्रा कासो गलामयाः||४७||

स्मृतिबुद्धिप्रमोहश्च संरोधः स्रोतसां ज्वरः|
इन्द्रियाणामसामर्थ्यं विषवेगप्रवर्त(र्ध)नम्||४८||

भवेन्नृणां दिवास्वप्नस्याहितस्य निषेवणात्|
तस्माद्धिताहितं स्वप्नं बुद्ध्वा स्वप्यात् सुखं बुधः||४९||
<div class="mw-collapsible-content">

grīṣmavarjyēṣu kālēṣu divāsvapnāt prakupyataḥ|
ślēṣmapittē divāsvapnastasmāttēṣu na śasyatē||44||

mēdasvinaḥ snēhanityāḥ ślēṣmalāḥ ślēṣmarōgiṇaḥ|
dūṣīviṣārtāśca divā na śayīran kadācana||45||

halīmakaḥ śiraḥśūlaṁ staimityaṁ gurugātratā|
aṅgamardō'gnināśaśca pralēpō hr̥dayasya ca||46||

śōphārōcakahr̥llāsapīnasārdhāvabhēdakāḥ|
kōṭhāruḥpiḍakāḥ kaṇḍūstandrā kāsō galāmayāḥ||47||

smr̥tibuddhipramōhaśca saṁrōdhaḥ srōtasāṁ jvaraḥ|
indriyāṇāmasāmarthyaṁ viṣavēgapravarta(rdha)nam||48||

bhavēnnr̥ṇāṁ divāsvapnasyāhitasya niṣēvaṇāt|
tasmāddhitāhitaṁ svapnaṁ buddhvā svapyāt sukhaṁ budhaḥ||49||

grIShmavarjyeShu kAleShu divAsvapnAt prakupyataH|
shleShmapitte divAsvapnastasmAtteShu na shasyate||44||

medasvinaH snehanityAH shleShmalAH shleShmarogiNaH|
dUShIviShArtAshca divA na shayIran kadAcana||45||

halImakaH shiraHshUlaM staimityaM gurugAtratA|
a~ggamardo~agninAshashca pralepo hRudayasya ca||46||

shophArocakahRullAsapInasArdhAvabhedakAH|
koThAruHpiDakAH kaNDUstandrA kAso galAmayAH||47||

smRutibuddhipramohashca saMrodhaH srotasAM jvaraH|
indriyANAmasAmarthyaM viShavegapravarta(rdha)nam||48||

bhavennRuNAM divAsvapnasyAhitasya niShevaNAt|
tasmAddhitAhitaM svapnaM buddhvA svapyAt sukhaM budhaH||49||
</div></div>

<div style="text-align:justify;">
Sleeping during daytime is contraindicated in the seasons other than summer because it causes vitiation of ''kapha'' and ''pitta''. Persons having excessive fat, those who are addicted to fatty substances, having plenty of ''kapha'', suffering from vitiated ''kapha'' related disorders, and those afflicted by latent poisons should never sleep during daytime. If one violated the given advice of sleeping during the day, he would subject himself to ''halimaka'' (advance stage of jaundice), headache, cold, heaviness of body parts, malaise, loss of digestive power, ''hridyopalepa'' (a feeling as if phlegm adhered to the heart), edema, anorexia, nausea, rhinitis, hemicranias, urticarial patches, pustules, boils, itching, drowsiness, coughing, disorders of the throat, impairment of memory and intelligence, obstruction of the body channels, fever, incapability of sensory and motor systems and enhancement of the toxic effects of poisons. So, one should keep in view the merits and demerits of sleep in various seasons and situations to stay happy and live long [44-49]
</div>
==== Qualities of day and night sleep ====
<div class="mw-collapsible mw-collapsed">

रात्रौ जागरणं रूक्षं स्निग्धं प्रस्वपनं दिवा|
अरूक्षमनभिष्यन्दि त्वासीनप्रचलायितम्||५०||
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rātrau jāgaraṇaṁ rūkṣaṁ snigdhaṁ prasvapanaṁ divā|
arūkṣamanabhiṣyandi tvāsīnapracalāyitam||50||

rAtrau jAgaraNaM rUkShaM snigdhaM prasvapanaM divA|
arUkShamanabhiShyandi tvAsInapracalAyitam||50||
</div></div>

Insomnia or staying up late at night causes roughness in the body and sleeping during the day causes ''snigdhata'' (unctuousness). However, napping in sitting posture does not cause either roughness nor unctuousness [50]

==== The importance of diet and sleep among the obese and the (excessively) lean ====
<div class="mw-collapsible mw-collapsed">

देहवृत्तौ यथाऽऽहारस्तथा स्वप्नः सुखो मतः|
स्वप्नाहारसमुत्थे च स्थौल्यकार्श्ये विशेषतः||५१||
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dēhavr̥ttau yathā''hārastathā svapnaḥ sukhō mataḥ|
svapnāhārasamutthē ca sthaulyakārśyē viśēṣataḥ||51||

dehavRuttau yathA~a~ahArastathA svapnaH sukho mataH|
svapnAhArasamutthe ca sthaulyakArshye visheShataH||51||
</div></div>

As wholesome diet is essential for the maintenance of the body, sleep is essential for happiness. Therefore, obesity and leanness are specifically caused by improper sleep and diet. [51]

==== Sleep-promoting measures ====
<div class="mw-collapsible mw-collapsed">

अभ्यङ्गोत्सादनं स्नानं ग्राम्यानूपौदका रसाः|
शाल्यन्नं सदधि क्षीरं स्नेहो मद्यं मनःसुखम्||५२||

मनसोऽनुगुणा गन्धाः शब्दाः संवाहनानि च|
चक्षुषोस्तर्पणं लेपः शिरसो वदनस्य च||५३||

स्वास्तीर्णं शयनं वेश्म सुखं कालस्तथोचितः|
आनयन्त्यचिरान्निद्रां प्रनष्टा या निमित्ततः||५४||
<div class="mw-collapsible-content">

abhyaṅgōtsādanaṁ snānaṁ grāmyānūpaudakā rasāḥ|
śālyannaṁ sadadhi kṣīraṁ snēhō madyaṁ manaḥsukham||52||

manasō'nuguṇā gandhāḥ śabdāḥ saṁvāhanāni ca|
cakṣuṣōstarpaṇaṁ lēpaḥ śirasō vadanasya ca||53||

svāstīrṇaṁ śayanaṁ vēśma sukhaṁ kālastathōcitaḥ|
ānayantyacirānnidrāṁ pranaṣṭā yā nimittataḥ||54||

abhya~ggotsAdanaM snAnaM grAmyAnUpaudakA rasAH|
shAlyannaM sadadhi kShIraM sneho madyaM manaHsukham||52||

manaso~anuguNA gandhAH shabdAH saMvAhanAni ca|
cakShuShostarpaNaM lepaH shiraso vadanasya ca||53||

svAstIrNaM shayanaM veshma sukhaM kAlastathocitaH|
AnayantyacirAnnidrAM pranaShTA yA nimittataH||54||
</div></div>

<div style="text-align:justify;">
If for some reason one suffers from sleeplessness, he can be cured by applying measures such as- body massages, unction, bath, (intake of) soup made up of meat of domestic, marshy and/or aquatic animals, ''shali'' rice with curd, milk, fat, wine, mental pleasure, pleasant smell and sound, application of soothing ointment to eyes, head and face, comfortable bed and home, and getting habituated to sleeping at a particular time. [52-54]
</div>
==== Causes of insomnia ====
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कायस्य शिरसश्चैव विरेकश्छर्दनं भयम्|
चिन्ता क्रोधस्तथा धूमो व्यायामो रक्तमोक्षणम्||५५||

उपवासोऽसुखा शय्या सत्त्वौदार्यं तमोजयः|
निद्राप्रसङ्गमहितं वारयन्ति समुत्थितम्||५६||

एत एव च विज्ञेया निद्रानाशस्य हेतवः|
कार्यं कालो विकारश्च प्रकृतिर्वायुरेव च||५७||
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kāyasya śirasaścaiva virēkaśchardanaṁ bhayam|
cintā krōdhastathā dhūmō vyāyāmō raktamōkṣaṇam||55||

upavāsō'sukhā śayyā sattvaudāryaṁ tamōjayaḥ|
nidrāprasaṅgamahitaṁ vārayanti samutthitam||56||

ēta ēva ca vijñēyā nidrānāśasya hētavaḥ|
kāryaṁ kālō vikāraśca prakr̥tirvāyurēva ca||57||

kAyasya shirasashcaiva virekashchardanaM bhayam|
cintA krodhastathA dhUmo vyAyAmo [1] raktamokShaNam||55||

upavAso~asukhA shayyA sattvaudAryaM tamojayaH|
nidrAprasa~ggamahitaM vArayanti samutthitam||56||

eta eva ca vij~jeyA nidrAnAshasya [2] hetavaH|
kAryaM kAlo vikArashca prakRutirvAyureva ca||57||
</div></div>

<div style="text-align:justify;">
Elimination of ''doshas'' from the body and the head through purgation and emesis, predominance of ''sattva'' and suppression of ''tamas'', emotions such as fear, anxiety, and anger, habits and activities such as smoking, physical exercise, bloodletting, fasting, and environmental settings such as uncomfortable bed go a long way in overcoming excessive sleepiness/hypersomnolence.
The above-mentioned factors, along with overwork, old age, ''vatika'' diseases, ''vatika'' constitution and aggravation of ''vata'' itself, are known to cause sleeplessness even in a normal individual. Some are insomniac even by nature. [55-57]
</div>
==== Origins and types of sleep ====
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तमोभवा श्लेष्मसमुद्भवा च मनःशरीरश्रमसम्भवा च|
आगन्तुकी व्याध्यनुवर्तिनी च रात्रिस्वभावप्रभवा च निद्रा||५८||
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tamōbhavā ślēṣmasamudbhavā ca manaḥśarīraśramasambhavā ca|
āgantukī vyādhyanuvartinī ca rātrisvabhāvaprabhavā ca nidrā||58||

tamobhavA shleShmasamudbhavA ca manaHsharIrashramasambhavA ca|
AgantukI vyAdhyanuvartinI ca rAtrisvabhAvaprabhavA ca nidrA||58||
</div></div>

Sleep is of seven types, categorized by its cause: ''Tamas'', vitiated ''kapha'', mental exertion, physical exertion, exogenous factors, diseases, and normal (nighttime). [58]
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रात्रिस्वभावप्रभवा मता या तां भूतधात्रीं प्रवदन्ति तज्ज्ञाः|
तमोभवामाहुरघस्य मूलं शेषाः पुनर्व्याधिषु निर्दिशन्ति||५९||
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rātrisvabhāvaprabhavā matā yā tāṁ bhūtadhātrīṁ pravadanti tajjñāḥ|
tamōbhavāmāhuraghasya mūlaṁ śēṣāḥ punarvyādhiṣu nirdiśanti||59||

rAtrisvabhAvaprabhavA matA yA tAM bhUtadhAtrIM pravadanti tajj~jAH|
tamobhavAmAhuraghasya mUlaM sheShAH punarvyAdhiShu nirdishanti||59||
</div></div>

<div style="text-align:justify;">
Natural sleep (sleeping at night) is the best form of sleep. This is also known as ''Bhutadhatri'', or “that which nurses all the living beings." The form of sleep that is caused by ''tamas'' is the cause of all sinful acts while the remaining types are observed in specific situations and ailments [59]
</div>
=== Summary ===
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तत्र श्लोकाः-

निन्दिताः पुरुषास्तेषां यौ विशेषेण निन्दितौ|
निन्दिते कारणं दोषास्तयोर्निन्दितभेषजम्||६०||

येभ्यो यदा हिता निद्रा येभ्यश्चाप्यहिता यदा|
अतिनिद्रायानिद्राय भेषजं यद्भवा च सा||६१||

या या यथाप्रभावा च निद्रा तत् सर्वमत्रिजः|
अष्टौनिन्दितसङ्ख्याते व्याजहार पुनर्वसुः||६२||
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tatra ślōkāḥ-
ninditāḥ puruṣāstēṣāṁ yau viśēṣēṇa ninditau|
ninditē kāraṇaṁ dōṣāstayōrninditabhēṣajam||60||

yēbhyō yadā hitā nidrā yēbhyaścāpyahitā yadā|
atinidrāyānidrāya bhēṣajaṁ yadbhavā ca sā||61||

yā yā yathāprabhāvā ca nidrā tat sarvamatrijaḥ|
aṣṭauninditasaṅkhyātē vyājahāra punarvasuḥ||62||

tatra shlokAH-
ninditAH puruShAsteShAM yau visheSheNa ninditau|
nindite kAraNaM doShAstayorninditabheShajam||60||

yebhyo yadA hitA nidrA yebhyashcApyahitA yadA|
atinidrAyAnidrAya [1] bheShajaM yadbhavA ca sA||61||

yA yA yathAprabhAvA ca nidrA tat sarvamatrijaH|
aShTauninditasa~gkhyAte vyAjahAra punarvasuH||62||
</div></div>

Now, the summing up verses – Acharya Punarvasu (Lord Atreya), the son of Atri, has explained the contents in the chapter on “eight types of undesirable constitutions” as given below:

*Enumeration of undesirable constitutions.
*Two most undesirable types of persons.
*The causes of undesirability.
*Demerits of undesirable persons.
*Treatment of undesirable persons.
*Indications and contra-indications of sleep depend upon the nature of the individual and time.
*Causes and treatment of over-sleep and sleeplessness.
*Factors those are responsible for inducing good sleep.
*Types and effects of sleep [60-62]

== Tattva Vimarsha (Fundamental Principles) ==
<div style="text-align:justify;">
*Eight types of the undesirable appearance of humans are: too tall, too short, too hairy, hairless, too dark, too light (complexioned), too obese and too lean. Too obese and too lean are the most undesirable of human appearances that are also more prone to various diseases. [3]
*Excessive obesity has eight inherent defects viz. decrease in longevity, hampered mobility, difficulty in sexual intercourse, debility, bad body odor, profuse sweating, excessive hunger, and excessive thirst. [4]
*Excessive obesity is caused by over-nourishment due to the intake of heavy, sweet, cold and fatty diet, lack of physical exercise, abstinence from sexual intercourse, indulgence in the day sleeping, uninterrupted cheerfulness, lack of mental activities and hereditary/genetic defects. [4]
*Obesity is a result of obstruction of channels by excess accumulated ''medas'' (fat). This deranges the movement of ''vata'' is specially confined to ''koshtha'' (abdominal viscera) resulting in the stimulation and hastening of the digestive process through abnormally increased ''agni'' (''pitta''). This leads to excessive hunger and thirst and the person eats more food to gain weight. An excessive increase in adipose tissue and vitiation of ''tridosha'' causes severe diseases in obese people. [5-8]
*Disproportionate increase of fat occurs mainly around buttocks, abdomen, and breasts, which become pendulous and the person suffers from improper metabolism and energy. [9]
*Indulgence in dry (non-unctuous) diets and drinks, fasting, inadequate diet, overuse of therapeutic purificatory measures, grief, suppression of natural urges, sleep deprivation, dry powder massage, indulgence in baths, heredity, old age, continued illness and anger make a person too lean. [11-12]
*Too lean and too obese persons are prone to suffering from various diseases and need constant treatment. [16]
*Being lean is better than being obese because the lean person responds well to nourishing treatment and balancing of the causative ''dosha'' (''vata'' and ''pitta''). On the contrary, reducing therapy and drugs used in the treatment of obesity can cause an increase in ''agni'', which may cause increased appetite and thirst.Hence, the obese suffer more than the lean. [17]
*A person possessing a balanced constitution of muscles and compactness of the body, and stable sense organs does not fall prey to diseases. He can tolerate hunger, thirst, heat and cold, and physical strain better. His digestion, assimilation of food and muscle metabolism are in a state of equilibrium. [18-19]
*The food that is heavy to digest but not having any fattening (such as high fiber diet) is prescribed for the obese. In lean persons, food that is light to digest and has high nourishing value is prescribed. [20]
*Food and drinks that alleviate ''vata'' and reduce ''kapha'' and ''medas'', as well as therapies such as enema (administered with drugs of sharply acting, dry and hot properties) and therapeutic powder massages are important treatments for obesity. [21-22]
*To enhance body mass of the excessively lean, an easy-to-digest and nourishing diet therapy, proper sleep, mind relaxing activities, ''rasayanas'' and aphrodisiacs, a diet with unctuous food and newly harvested food, and measures that eliminate vitiated ''doshas'' are prescribed. [29-34]
*Tiredness, inactivity of mind, and detachment from sense organs are certain situations and conditions that help in falling asleep. [35]
*Normal sleep is necessary for the normal functioning of human body and excessive or inadequate sleep results in many diseases. Happiness and misery, nourishment and emaciation, strength and weakness, fertility and infertility, knowledge and ignorance and life and death depend on proper and improper sleep. [36]
*Sleeping during the day is indicated for restoring any damage to the physical constitution or depletion of body tissues. In a normal person, sleeping during the day is contraindicated in seasons other than summer because it causes vitiation of ''kapha'' and ''pitta''. Daytime sleep causes serious health problems. While insomnia causes roughness in the body, daytime sleep causes ''snigdhata'' (unctuousness) in the body. [39-50]
*Obesity and leanness are caused by improper diet and sleep. [51]

== Vidhi Vimarsha(Applied Inferences) ==

In biomedical science, the above-described eight types of undesirable persons are comparable to a variety of genetic and neuroendocrine disorders. Out of these eight types, the last two (''atisthula'' and ''atikrisha'') need therapeutic interventions and deserve special attention. According to Chakrapanі, physical deformities such as ''kubja'' (hunchback) and ''pangu'' (limp gait) may also be taken as undesirable.

=== Morbid obesity ===

In the context of ''atisthula'' and ''atikrisha'', Charak has explored these conditions from the standpoint of their diathesis, clinical presentation, and management, which is comparable to approaches taken today to the study of obesity and leanness. Suśruta has considered ''rasa dhatu'' as the main culprit for both obesity and emaciation (''rasa nimittameva sthaulyam karshyam ca'')<ref>Acharya, J.T. (translator) (1915). Sushrut Sanhita of Sushrut, Nirnay Sagar Press, Mumbai, India, p. 65, Su.Su-15/39. </ref>.

Lipid precursors are acted upon by fat-specific energy (''medhodhatvagni'') for their conversion into adipose tissue (''medodhatu'')<ref>Mishra, L.C. (2003). Scientific Basis of Ayurvedic therapy, Chapter 9 Obesity (Medoroga) in [[Ayurveda]]; eBook, published by CRC press, Taylor & Francis Group. </ref>. Vitiation of ''kapha dosha'' and excessive accumulation of fat-specific energy and waste products of adipose tissues (''kleda'') lead to dysfunction of adipose tissues. Adipose channels have two origins - kidney, adrenal and fat around them and other are visceral and omental fat (''vapavahana'')<ref>Shastri, P.K (1983), (translater), Caraka samhita, Part I, 2nd ed., Chaukhambha Sanskrit Sansthan, Varanasi, India, p. 595. </ref>. These channels draw nutrition, including lipid from the antecedent flesh and transient lipid and then convert them into a stored form of lipid. As per biomedical science, obesity is associated with increased adipose stores in the subcutaneous tissues, skeletal muscles and internal organs such as kidney, heart, liver and omentum. Adipose tissues (''medodhatu'') form a crucial link to the concept of tissue metabolism. Low levels of fat-specific energy (''medodhatvagni''), despite a normal food intake, can lead to a steady accumulation of fat and the outcome is obesity<ref>Bleich S, Cutler D, Murray C, Adams A (2008). "Why is the developed world obese?". Annu Rev Public Health29: 273–95. doi:10.1146/annurev.publhealth.29.020907.090954. PMID 18173389. </ref> <ref>Drewnowski A, Specter SE (January 2004). "Poverty and obesity: the role of energy density and energy costs". Am. J. Clin. Nutr.79 (1): 6–16. </ref>. The conventional system of medicine has given due consideration to certain factors such as insufficient sleep, genetic predisposition, later age pregnancy, certain medications and other epigenetic factors in the etiopathogenesis of obesity and its related disorders<ref>Keith SW, Redden DT, Katzmarzyk PT et al. (2006). "Putative contributors to the secular increase in obesity: Exploring the roads less traveled". Int J Obes (Lond)30 (11): 1585–94. doi:10.1038/sj.ijo.0803326. PMID 16801930. </ref>.(Verse 3-4)

=== Increased desire to eat among the obese ===

Charak correlated an increased desire to eat with increased ''agni'' in the morbidly obese. Recent evidence suggests that leptin and ghrelin had shown their influence on appetite. In this context, ghrelin is produced from the stomach, and leptin is produced by the adipose tissue of fat storage reserves in the body, which is responsible for short-term and long-term appetite control respectively in the body<ref>Hamann A, Matthaei S (1996). "Regulation of energy balance by leptin". Exp. Clin. Endocrinol. Diabetes104 (4): 293–300. doi:10.1055/s-0029-1211457. PMID 8886745. </ref>. In the brain melanocortin pathway has drawn the attention of research scholars that this pathway has a specific role in stimulating appetite, which is located in the area of the lateral and ventromedial hypothalamus and arcuate nucleus. These areas are directly related to the feeding and satiety centers<ref name=ref30>Rao CR, Sen PK, Flier JS (2012). Handbook of Statistics: Bioinformatics in Human Health and Heredity; Published by North Holland; 1 edition, Kindle Edition, 1 edition. </ref> .

There are two distinct groups of neurons in the arcuate nucleus viz- The first group contains neuropeptide Y (NPY) and agouti-related peptide (AgRP) and the second group contains Pro-opiomelanocortin (POMC) and cocaine and amphetamine regulated transcript (CART). The first group of neuron i.e. NPY/AgRP exerts stimulatory inputs to the LH while inhibitory inputs to the VMH, which stimulate feeding and inhibit satiety respectively. Both groups of arcuate nucleus neurons are the under the regulation of leptin, which inhibits the NPY/AgRP group of neurons and stimulating the POMC/CART group of neurons. Hence, the leptin deficiency or leptin resistance leads to develop overfeeding tendency, which is caused by some genetic and acquired forms of obesity<ref name=ref30/>Rao CR, Sen PK, Flier JS (2012). Handbook of Statistics: Bioinformatics in Human Health and Heredity; Published by North Holland; 1 edition, Kindle Edition, 1 edition. </ref> <ref>Raina GS (2011). Obesity being the major health burden needed to be chased: A systemic review. J Appl Pharm Sci. 2011;1:238–45. </ref>. These findings suggest the genetic inputs in overweight and obesity, which is quite comparable to the Ayurvedic lexicons.(verse 4)

=== Consequences of obesity ===

Serious diseases (''daruna vikara'') are the outcome of excessive obesity due obstruction of body channels by the ''medas''. This indicates ancient wisdom of [[Ayurveda]] ''acharyas'', which is comparable to the impact of obesity on health perspectives of biomedical science<ref>Mishra, L.C. (2003). Scientific Basis of Ayurvedic therapy, Chapter 9 Obesity (Medoroga) in [[Ayurveda]]; eBook, published by CRC press, Taylor & Francis Group. </ref>. We have yet to understand what they had foreseen in reference to fat accumulation around the kidneys. Decreased life span (''ayukshaya'') is stated to be an important consequence of obesity in [[Ayurveda]]. According to contemporary science, metabolic and psychological pathologies are often present together and are associated with dysregulation of the hypothalamic-pituitary-adrenal axis<ref>Boulpaep, Emile L.; Boron, Walter F. (2003). Medical physiologya: A cellular and molecular approach. Philadelphia: Saunders. p. 1227. ISBN 0-7216-3256-4 </ref>. Affect disorders are also reported among obese binge eaters. The National Institute of Health, USA has issued an alert labeling obesity a "Killer disease" due to its health-related consequences such as coronary disease, diabetes mellitus, hypertension, hyperlipidemia, kidney disorders, gallbladder disorders, cancer of colon, pancreas, breast, uterus, kidney and gallbladder, osteoarthritis, menstrual irregularities in females, cryptogenic cirrhosis of the liver and hepatocellular carcinoma, insulin resistance, and physiological hyperinsulinemia. Some of the social consequences of obesity could include divorces, due in part to reduce sexual activities between partners. Besides there, transitional physiological phases such as weight gain during adolescence in boys and girls, post-natal weight gain in women, and peri-post menopausal obesity are frequently noted in clinical settings that warrant special care and management<ref> Kuniko Takagi, Romain Legrand, Akihiro Asakawa, Haruka Amitani, Marie François, Naouel Tennoune, Moïse Coëffier, Sophie Claeyssens, Jean-Claude do Rego, Pierre Déchelotte, Akio Inui, Sergueï O. Fetissov. Anti-ghrelin immunoglobulins modulate ghrelin stability and its orexigenic effect in obese mice and humans. Nature Communications, 2013; 4 DOI: 10.1038/ncomms3685, site on 08/02/2014. </ref> <ref>Grundy SM (2004). "Obesity, metabolic syndrome, and cardiovascular disease". J. Clin. Endocrinol. Metab.89 (6): 2595–600. doi:10.1210/jc.2004-0372. PMID 15181029. </ref> <ref>Foster, W.R. and Burton, B.T.(1985). Health implication of obesity, Ann. Intern.Med., 103, 1024. </ref> <ref>Grunstein, R.R. and Widcox, I. (1994). Sleep-disordered breathing and obesity, Clin.Endocrinol.Metab. Baillier’s, 8, 601. </ref> <ref>Daugero, K.D. (2001). A new perspective on glucorticoid feedback: relation to stress, carbohydrate feeding and feeding behavior, J. Neuroendocrinol., 13, 1088. </ref> <ref>Larsson, B. et al (1984), Abdominal adipose distribution, obesity and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913, Br. Med. J., 288, 1401. </ref> <ref>Esposito K. et al (2004). "Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial". JAMA, 291 (24): 2978–84. </ref>.(verse 5-8)

=== Etiology, features, and consequences of ''atikrisha'' (emaciation) ===

The etiological factors for ''atikrisha'' may be divided into two groups - excessive expenditure of calories and fewer intakes of calories. Either of these conditions leads to under-nutrition which ultimately results in ''atikrisha''. In the pathogenesis of ''krishata'', ''vayu'' plays an important role. Most of the etiological factors observed in the case of ''krisha'' and ''atikrisha'' provoke ''vata'' vitiation. Thus, vitiated ''vata'' may be considered the most important factor in the pathogenesis of ''krisha''. In ''sthaulya'' there is excessive formation and under-utilization (due to sedentary habit) of the ''rasa dhatu''. On the other hand, in ''krishata'' there is less formation of ''rasa'' due to diseases or due to undernourishment. Further, Charak and Sushruta both have categorized ''krishata'' as a ''rasa pradoshaja vyadhi'' (C.Su.28:10, Su.Su.15:37,24:8). In this way, ''rasa dhatu dushti'' mainly in the form of ''kshaya'' is found in extremely lean or emaciated people. The other ''dhatu'' involved in the pathogenesis of obesity as well as ''atikrisha'' is ''meda'' since it is mentioned that ''medokshaya'' (or the deficiency of ''meda'') cause ''krisanga'' (A.H.Su.11:18)<ref>Munshi, V.D. (translator) (1952). Ashtang Hridaya,Sastum Sahityavardhak Mudranalaya, Ahmedabad, India, p. 135, Sutrasthana-24/5, 11/18. </ref>.

In biomedical terms, emaciation is the outcome of loss of the fatty contents or loss of adipose tissue component of subcutaneous fat, which is lying beneath the outer covering of the body<ref>Gray D.S., Fujioka K. (1991). "Use of relative weight and Body Mass Index for the determination of adiposity". J Clin Epidemiol, 44 (6): 545–50. </ref>. It is also known as extreme weight loss, leanness, or thinness. In general term, it is also known as wasting, which is caused by hampered nutritional requirement at the tissue level and excessive starvation. Wasting or leanness is an important symptom of improper nourishment, which is commonly seen in various clinical conditions such as poverty, a variety of gastrointestinal disorders, various eating disorders, prolonged fever, malignant diseases, endocrine disorders, chronic infections, autoimmune disorders as well as parasitic infections. The malnourished person faced a lot of problems related to cardiovascular, integumentary and urogenital systems. Disturbances in blood circulation, serum electrolyte, and serum protein are commonly observed in emaciated person. Such type individuals are more to suffer from infections due to deranged immune power and swelling in general<ref>"Emaciation". Medical-Dictionary.TheFreeDictionary.com. Retrieved February 19, 2014. </ref>.
Obesity and leanness can manifest themselves in very severe and excessive forms than discussed here and those cases could make the management of such disorders - and any disease it could lead to – very challenging. While the principles of treatment remain unchanged, the therapeutic measures should be suitably intensified to counter the numerous disorders that arise because of excessive obesity and leanness (C.Su. 23/3-34). The patients of ''atikrisha'' and ''sthaulya'' perpetually suffer from diseases but the standpoint of treatment, the former is significantly more manageable because ''sthula'' (or the obese) suffers more in comparison to ''atikrisha'' (the emaciated) (Su.Su. 15:42). Further, it is mentioned that ''atikṛisha'' is a grave disease, but is considered better than ''atisthula'' from treatment aspect because there is no treatment for ''sthaulya''. For proper treatment of ''sthulya'' the drugs must have ''medohara, agnihara'' and ''vatahara'' action at the same time, which is neither possible from ''karshaṇa'' nor ''brimhana''. Recent evidence also suggests that Charak had associated extreme weight-loss/undernourishment with high rates of morbidity and mortality, although to a lesser extent than obesity<ref>Bose, Bholanoth (1877, 2009). A new system of medicine, entitled recognizant medicine; or, The state of the sick. London: J. & A. Churchill. pp. 192–199. Retrieved February 19, 2014. </ref> <ref>Lusky A, Barell V, Lubin F, Kaplan G, Layani V, Shohat Z, et al. Relationship between morbidity and extreme values of body mass index in adolescents. Int J Epidemiol 1996;25(4):829-834. </ref> <ref>Lake JK, Power C, Cole TJ. Women's reproductive health: the role of body mass index in early and adult life. Int J Obes Relat Metab Disord 1997;21(6):432-438. </ref> <ref> Kopp W, Blum WF, von Prittwitz S, Ziegler A, Lubbert H, Emons G, et al. Low leptin levels predict amenorrhea in underweight and eating disordered females. Mol Psychiatry 1997;2(4):335-340. </ref> <ref> He Q, Karlberg J. BMI in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res 2001;49(2):244-251. </ref>.

=== Management of the Morbidly Obese ===

In the conventional system of medicine, the main treatment for obesity consists of diet and physical exercise for short-term weight control. Maintaining the weight by short-term dietary control is very difficult to an obese person, and it required guided exercise and low calory diet in their daily regimens. Because lack of physical exercise is the key factor and imparts a role in the diathesis of obesity. 61 The lack of physical activities also plays an important role in obesity-associated with the involvement of brain and abdominal. Regarding physical exercise, it not only reduces body weight but also counteract metabolic adaptation but regulating nutritional balance set point.64 It is presumed that physical inactivity contributes to both visceral adiposity and cerebellar brain changes because in the area of cerebellar cortex and hippocampal dentate gyrus of brain show enhanced synaptogenesis and neurogenesis in response to physical exercise training.<ref>Matthias Raschpichler et al (2013). Abdominal fat distribution and its relationship to brain changes: the differential effects of age on cerebellar structure and function: a cross-sectional, exploratory study. BMJ Open. 2013; 3(1): e001915.Published online 2013 Jan 24. doi: 10.1136/bmjopen-2012-001915 </ref> <ref>McCarthyHD, EllisSM, ColeTJ. (2003): Central overweight and obesity in British youth aged 11–16 years: cross sectional surveys of waist circumference. BMJ, 326:624. </ref> <ref>GollischKS, BrandauerJ, JessenN, et al. (2009):Effects of exercise training on subcutaneous and visceral adipose tissue in normal- and high-fat diet-fed rats, Am J Physiol Endocrinol Metab; 297:E495–504. </ref>

In this context, [[Ayurveda]] has laid down a strong emphasis on drugs, dietary and lifestyle interventions for the management of atisthaulya. Therefore, factors such as ''madhura, sheeta, snigdha, guru, picchila'' and lifestyle errors are to be avoided in such cases. ''Ruksha udvartanas'' are advocated obese patients as an external purificatory measure, while ''vamana, virechana,'' and ''asthapana basti'' as internal bio-purificatory measures. If an ''atisthula'' person possesses good stamina and strength, they should be treated with ''vamana'' and ''virechana karma''. Non-unctuous, warm and strong enema are advocated such type of patients.<ref>Singh R.H.(1998). The holistic principles of Ayurvedic Medicine. Chaukhambha Publications, Varanasi. </ref> <ref>Singh R.H. (2002) . Panchakarma therapy (2nd Ed). Chaukhambha Sanskrit Sereis office, Varanasi. </ref> <ref>Paranjpe, P., Patki, P., and Patwardhan, P., (1990). Ayurvedic treatment of obesity: a randomized double blind, placebo-controlled clinical trial, J. Ethnopharmacol., 29, 1–11. </ref> <ref>Kasture, H.S. (translator) (1985). Ayurvediya Panchakarma Vignyana (3rd ed.). Shri Baidyanath Ayurved Bhavan Pvt. Ltd., Kolkata, India, p. 247. </ref>''Yogic'' practices have a significant impact on the physical, mental, emotional and spiritual health of the individual. It is reported that a significant improvement in the levels of BP, LDL cholesterol, and BMI can be noted after three months of residential therapy consisting of vegetarian diet and ''kriya yoga''. A randomized controlled study reveals that practicing ''yoga'' for a year brought about significant improvement in body weight and body density. Regular practice of ''yoga'' has shown to improve the serum lipid profile in patients (with known IHD) as well as in healthy subjects. A regular regimen of ''praṇayama'' reduces stress hormone and levels of endorphin and enkephalin, consequently increasing the level of HDL while decreasing the level of LDL, VLDL and TGs.<ref>Schmidt, T et al (1997): Changes in cardiovascular risk factors and hormones during a comprehensive residential three month kriyayoga training and vegetarian nutrition, Acta Physiol.Scand Suppl. 640:158:160. </ref> <ref>Bera, T.K., Rajapurkar, M.V. (1993): Body composition, cardiovascular edurance and anaerobic power of yogic practitioner, Indian J. Physiol. Pharmacol, 37:225-228. </ref> <ref>Mahajan, A.S., Reddy, K.S., Sachdeva, U. (1999): Lipid profiles of coronary risk subjects following yogic lifestyle intervention, Indian Heart J, 51:37040. </ref> <ref>Manachanda, S.C. et al.(2000): Retardation of coronary atherosclerosis with yoga lifestyle intervention, J Assoc.Physicians India, 48 (7): 687-694. </ref>

Recent evidence suggests that some ''ayurvedic'' herbal drugs are found to be very effective in normalizing deranged lipid profiles, reducing BMI and slowing down the risk heart diseases. Ayurvedic drugs such as ''rasona'' (Allium cepa), ''guggulu'' (Commiphora mukul), ''puṣhkaramula'' (Inula racemosa), ''arjuna'' (Terminalia Arjuna), ''dhānyaka'' (Coriandrum sativum), ''nishamalaki churṇa'' (powder of Emblica officinalis and Curcuma longa),''haritaki'' (Terminalia chebula), ''haridra'' (Curcuma longa), ''bilva'' (Aegle marmelos), ''tejapatra'' (Cinnamomum tamala), ''vrikshamla'' (Garcinia cambogia) and Ayurvedic formulations such as- ''triphala guggulu'', ''medohara guggulu'', ''amṛitadi guggulu'', ''arogyavardhani vaṭi'' etc. are also found to be effective in weight reduction as well as relief in other signs and symptoms. <ref name=ref1/> <ref name=ref2/> <ref name=ref3/><ref>Banerjee, S.K., Maulik, S.K. (2002): Effect of garlic on cardiovascular disorders: a review, Nutr.J, 1:4.</ref> <ref>Satyavati, G.V., Dwarakanath, C., and Tripathi, S.N. (1950 & 1969). Experimental studies on the hypocholesterolemic effect of Commiphora mukul (Guggulu), Indian J. Med. Res., 57, 1950, 1969. </ref> <ref>Karthikeyan, K. et al. (2003): Cardioprotective effect of the alcoholic extract of Terminalia arjuna bark in an invitro model of myocardial ischemic reperfusion injury, Iife Scince, 10, 73 (21):2727:39. </ref> <ref>Verghese, J. (2001): Coriander, Indian Spices, 38 (1):8. </ref> <ref>Kannan, V et al. (2012): Anti-diabetic activity on ethanolic extracts of fruits of terminalia chebula in Alloxan induced diabetic rats, American J. of Drug Discovery and Development, 2:135-142. </ref> <ref>Despande, U.R. (1966): Effect of Turmeric extract on lipid profile (1-22), Int.Seminar on free radicals medicated disease, 2-4. </ref> <ref>Kesari, A.N. et al. (2006): Hypoglycemic and anti-hyperglycemic activity of Aegle mormelas seed extract in normal and diabetic rats, J. Ethnopharmacol, 103 (3): 374-79. </ref> <ref>Sharma, S.R., Dwivedi, S.K., Swarup, D (1996): Hypoglycemic and hypolipidaemic effects of Cinnamomum tamala Nees leaves, Indian J Exp Biol, 34 (2): 216-220. </ref> <ref>Kohsuke Hayamizu, MS, Yuri Ishii, et al.( SE P T EMB E R / O C T O B E R 2003):Effects of Garcinia cambogia (Hydroxycitric Acid) on Visceral Fat Accumulation: A Double-Blind, Randomized, Placebo-Controlled Trial, current therapeutic research,VO L UME 64, No. 8, 551-567. </ref> <ref>Bhagwat, B.K. (1995). Triphala-guggul in Sthoulya in [[Ayurveda]] Research Papers III, Kulkarni, P.H., Ed., Ayurved Rasashala, Pune, India, p. 215 </ref> <ref>Vaidya, A.B. et al. (1980). A double-blind clinical trial of Arogyawardhini — an Ayurvedic drug- in acute viral hepatitis, Ind. J. Med. Res., 72, 588. </ref>( verse 20-28)

=== Management of the emaciated/too lean ===

Too lean patients are brought to good health through renourishment or reintroducing nourishing liquids and food to the body and check the process of catabolism. It starts with a glass of water followed by mixed with lemon and table salt and finally reach to juices, which is made up of vegetable, pulses, rice mixed with pepper, lemon juice and table salt. Later on, it is replaced with cow milk, soups of pulses and vegetable mixed with butter and salt. If the emaciated status is improved, try to introduced small amount of solid food in meals at the frequent interval and try to avoid a large amount of solid food at a time. The dietary regimen is to be focused on proteins, fats, carbohydrates, multi-vitamin and mineral for the management of the emaciated person. It is always kept in mind at the time of management of the too lean person, excessive fatty foods items and excess fiber dominated grains and vegetable are to be avoided because they are deficient in energy and consume too much time for digestion. Treatment of emaciation also includes prescribing a lot of sleep, rest, relaxation, and counseling. In the present context, ''rasa'' means body fluid which is responsible for the nourishment of entire body and mind. Impairment of circulation of body fluid results in diseases and decay. ''Rasa'' should be available in adequate quantity and quality for it to circulate through the cells of the body, providing the requisite nourishment they need for proper functioning.(verse 29-34)

=== Concept of Sleep ===

The age-old concepts of sleep (''nidra'') and its different stages such as ''jagrata'', ''swapana'' and ''sushupti'' are comparable to the current concept of sleep and its stages. The problems and pattern of sleep are assessed by observing the activity of brain through Electroencephalogram (EEG) pattern.<ref>Dement, William; Kleitman, Nathaniel (1 November 1957). "Cyclic variations in EEG during sleep and their relation to eye movements, body motility, and dreaming". Electroencephalography and Clinical Neurophysiology9 (4): 673–690. doi:10.1016/0013-4694(57)90088-3. PMID 13480240. </ref> It is pointed out that wakefulness and stages of sleep have a specific EEG pattern. The wakefulness is associated with Beta and Gama waves frequencies in EEG pattern, which depends on pleasurable or painful stressors of surrounding environment. Stage 1 non-rapid eye movement (NREM) sleep is characterized by slowing down of Beta and Gama wave frequencies, reached to slow down the Alpha wave, and finally reached to Theta wave frequencies in EEG pattern. At a higher stage of NREM and REM, these brain wave frequencies in EEG pattern gradually decreases, and the person falls into sleep. By observing overall brain activity in EEG pattern, we can say that frequencies of sleep waves are low in wakefulness and it is gradual increases in different stages of sleep. Sleep spindles and K-complexes appeared in EEG pattern in Stage 2 of sleep, while more sleep spindles are observed in Stage 3 of sleep. The slow wave sleep is also known as high amplitude Delta wave, which is commonly observed in Stages 3 and 4 of sleep in EEG pattern. Low amplitude, mixed frequency waves- a sawtooth wave in EEG pattern observed at REM stage of sleep.<ref> 71. BARKER, W; BURGWIN, S (1948 Nov-Dec). "Brain wave patterns accompanying changes in sleep and wakefulness during hypnosis." Psychosomatic Medicine10 (6): 317–26. PMID 18106841. </ref> <ref>Jankel, WR; Niedermeyer, E (January 1985). "Sleep spindles.". Journal of clinical neurophysiology: official publication of the American Electroencephalographic Society2 (1): 1–35. PMID 3932462. </ref> <ref>Loomis, A. L.; Harvey, E. N.; Hobart, G. A (1938). "Distribution of disturbance-patterns in the human electroencephalogram with special reference to sleep". Journal of Neurophysiology1: 413–430. </ref>(verse 35)

==== Sleep regulation ====

It is presumed that the sleep physiology is controlled by the hypothalamus and the suprachiasmatic nucleus (SCN) in the brain, which regulates mechanism of homeostatic and circadian rhythm respectively of the body. The actual mechanism of the physiology of sleep is still evolving in biomedical sciences. The sleep is initiated and begins by projections from the SCN to the brain stem. Borbely called projections as Process S (homeostatic) and Process C (Circadian) respectively, who first proposed these two process models in 1982. He pointed out that maximum sleep is the outcome of significant differences between homeostatic and circadian rhythm.<ref name=ref74>Saper, Clifford B.; Scammell, Thomas E.; Lu, (Jun (27 October 2005)): "Hypothalamic regulation of sleep and circadian rhythms". Nature437 (7063): 1257–1263. doi:10.1038/nature04284. PMID 16251950.</ref>(verse 39-43)

==== Effects of sleep ====

Recent conventional evidence suggests that seasonal variation can have an impact on sleep/wake cycle, which is quite interesting and proven the age-old concept of [[Ayurveda]]. Recent evidence shows that core temperature of body and secretion of melatonin hormone levels are slightly greater in the month of summer due to prolong the length of light exposure, which imparts significant role in daytime sleep in summer. This is the reason people go to bed early at night and wake up early in the morning in the month of summer. Sunlight exposure in the morning hours may affect internal biological clock, shifting the timing of the sleep window. The need and function of sleep are the most lacking areas of sleep research in biomedical sciences. Some of the important ones are- restoration and recovery of body systems, energy conservation, memory consolidation, protection from predation, brain development, and discharge of emotions.<ref name=ref74/> <ref>Krueger, James M.; Obál, Ferenc; Fang, Jidong. "Why we sleep: a theoretical view of sleep function". Sleep Medicine Reviews3 (2): 119–129. doi:10.1016/S1087-0792(99)90019-9. </ref> <ref>KRUEGER, JAMES M.; OBÄL, FERENC (1 June 1993). "A neuronal group theory of sleep function". Journal of Sleep Research2 (2): 63–69. doi:10.1111/j.1365-2869.1993.tb00064.x. </ref> <ref>Friborg, O., Bjorvatn, B., Amponsah, B., Pallesen, S. (2012). Associations between seasonal variations in day length (photoperiod), sleep timing, sleep quality and mood: a comparison between Ghana (5°) and Norway (69°). Journal of Sleep Research, 21(2), 176-184.) </ref>(verse 36-38 and 44-49)

==== Sleep about ''atisthula'' and ''atikrisha'' ====

Recent evidence suggests that a good sleep plays an important role in the regulation of neuroendocrine, hormonal and metabolic function in the body. Since last few decades, the timing and quality of sleep is gradually hampered due to the affliction of modernization in many ways. At present, the adult and children progressively reduce bedtimes and increases times for other activities, which affect the metabolic functions in many ways. The ''atisthula'' and ''atikrisha'' are also the outcome of excessive sleep and lack of sleep and vice-versa. Evidence shows that sleep loss for prolong period may provoke the risk of weight gain and morbid obesity. Further, sleep reduction in young adults affects metabolic and endocrine functions in various ways such as- insulin resistance, hyperglycemia, elevated sympathovagal activity, an elevated level of serum glucocorticoid hormone, increased levels of ghrelin, and decreased the level of leptin. Due to improper and lack of good quality of sleep in adolescents may be important factors to consider in the prevention of childhood obesity.<ref>Neeraj K. Gupta,William H. Mueller,Wenyaw Chan, Janet C. Meininger (2002).: Is obesity associated with poor sleep quality in adolescents?. Am. J. Hum. Biol.; 14:762–768, 2002. </ref> Probably this is the reason that sleep is mentioned in ''ashṭoninditiya'' chapter by Charak about ''atisthula'' and ''atikrisha'' like other dietary and lifestyle intervention.(verse 51)

==== Insomnia or sleeplessness ====

''Anidra'' of [[Ayurveda]] is closely related to Insomnia, or sleeplessness of biomedical sciences. It is a disorder of sleep in which a person is unable to fall in sleep. Nowadays, insomnia is an important area of clinical practice to seek the attention of the physician because a large number of patients come to the hospital suffering from insomnia as secondary conditions. It is sometimes a functional impairment during awake, which may occur at any age, but it is particularly common in the elderly. Insomnia is either short-term lasting up to 3 hours, or it may be long term lasting for > 3 hours. It may lead to developing dementia, lack of concentration, depression, mental irritation and increases the risk of cardio-vascular accidents along with increases the chances of a roadside accident. <ref>Roth, T. (2007). "Insomnia: Definition, prevalence, etiology, and consequences". Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine3 (5 Suppl): S7–10. </ref> <ref>Wilson, Jennifer F. (2008). "Insomnia". Annals of Internal Medicine148: ITC1. doi:10.7326/0003-4819-148-1-200801010-01001 </ref> Regarding its management some drug such as valerian extract has undergone multiple studies and appears to be moderately effective. Similarly, L-Arginine L-aspartate, S-adenosyl-L-homocysteine, and delta sleep inducing peptide (DSIP) appear to be significantly effective in the cases of insomnias.<ref>Morin, C. M.; Koetter, U.; Bastien, C.; Ware, J. C.; Wooten, V. (2005). "Valerian-hops combination and diphenhydramine for treating insomnia: A randomized placebo-controlled clinical trial". Sleep28 (11): 1465–1471. </ref> <ref>Meolie, A. L.; Rosen, C. et al.: Clinical Practice Review Committee; American Academy of Sleep Medicine (2005). "Oral nonprescription treatment for insomnia: An evaluation of products with limited evidence". Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine1 (2): 173–187. PMID 17561634. </ref>

Improper sleep has a harmful impact on carbohydrate metabolism and endocrine function. Besides, it also reduces the metabolic activity in the brain with prolonging lack of sleep. The effects are similar to those seen in normal aging and, therefore, sleep debt may increase the severity of age-related chronic disorders. <ref name=ref85>Van Dongen, HP; Maislin, G; Mullington, JM; Dinges, DF (2003-03-15). "The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation.". Sleep26 (2): 117–26.</ref> Lack of sleep for prolonged period has been shown to affect cognitive functions of people involved in versatile activities along with interfering in mood and emotion. This is one of reason to increased tendency to fear, depression, and rage in the people having a deficiency in sleep. The mechanism and effects of sleep deficit are still evolving in the pathophysiology of sleep deficit.<ref>Karine Spiegel, Rachel Leproult, BS, Eve Van Cauter.: Impact of sleep debt on metabolic and endocrine function. The lancet, Volume 354, Issue 9188, 23 October 1999, Pages 1435–1439. </ref> <ref name=ref85/> <ref>Chee, MW; Chuah, LY (August 2008). "Functional neuroimaging insights into how sleep and sleep deprivation affect memory and cognition.". Current Opinion in Neurology21 (4): 417–23. </ref>

The concept of ''Nidra'' in [[Ayurveda]] is quite comparable to the sleep of biomedical sciences. The ''nidra'' is so important for the maintenance of health and sustaining the life. This is true in the light of contemporary scientific knowledge too. According to [[Ayurveda]], ''kapha'' and ''tamas'' are responsible for ''nidra'' even as modern studies attribute the occurrence of sleep to many factors including stimulation of certain areas of the brain. [[Ayurveda]] classifies the ''nidra'' based on the mode of origin while modern classification of sleep based on physiological variations seen in association with the different types of sleep. Some factors like food, activities, external stimuli, etc. affect ''nidra'' or sleep. Any variation in the normal sleep pattern is not at all desirable, and they may cause serious health problems that demand proper medical attention.(verse 52-54)

=== Conclusion ===

The present chapter reveals that the clinical entity, consequences, and management of too obese, too lean, insomnia, along with categorization of good built, information and mechanism of sleep and measures to induce good sleep was fairly well known even in the classical period of [[Ayurveda]], which is comparable to the latest development in this field. The Ayurvedic classics vividly describe the etiological factors, pathogenesis, clinical presentation, complications and its categories and treatment modalities of too obese, which has a striking resemblance to the latest development in this field. The ''samprapti'' (pathogenesis) of this disease is based on the specific ''dosha-dushya'' pattern. Besides, the special emphasis placed on vitiation of ''medas''. The age-old ideas are now getting strong scientific support for the emerging concept of prediabetes, insulin resistance, and metabolic syndrome, signifying the role of lipid disorders in the pathogenesis, hypometabolic state (''ama'' state) and immunodeficiency in these disorders. Numbers of complications have been described in this context including ''prameha'', GI problems, skin disorders, etc. It is presumed that in the diathesis of complications, impaired status of ''agni, ojas'' and ''medas'' play an important role6.

On The overall assessment, the concept of overweight and obesity, emaciation, sleep and its type, indications, and contraindications of day sleep, the role of sleep in obesity, causes of insomnia and features of good and bad sleep along with features of good body built was a well-known entity since antiquity. The available descriptions appear very contemporary and scientific. Certain therapeutic modalities have close resemblance with several non-drug approaches of modern medicine. These modalities can be combined judiciously for individualized prevention and cure of too obese, too lean and insomnia. The current approaches and management of too obese and too lean along with insomnia are still not satisfactory in the conventional system of medicine; this chapter provides a new outlook to scholars and researchers of [[Ayurveda]], which is based on current publications and reports.
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==References==
<references/>

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Sutra Sthana

2020-09-14T11:35:52Z

Vidyadhishkashikar:

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{{Infobox
|title = [[Charak Samhita]] Sutra Sthana-Preamble
|label1 = Section/Chapter
|data1 = [[Sutra Sthana]] Section 1/ Preamble
|label2 = Preceding section
|data2 = None
|label3 = Succeeding section
|data3 = [[Nidana Sthana]]
|label4 = Other Sections
|data4 = [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label5 = Author
|data5 = Dwivedi R.B.
|label6 = Reviewer
|data6 = Basisht G.
|label7 = Editor
|data7 = Deole Y. S.
|label8 = Date of publication
|data8 = December 17, 2018
|label9 = DOI
|data9 = --
|label10 = Chapters
|data10 = [[Deerghanjiviteeya Adhyaya]], [[Apamarga Tanduliya Adhyaya]], [[Aragvadhiya Adhyaya]],[[Shadvirechanashatashritiya Adhyaya]],[[Matrashiteeya Adhyaya]],[[Tasyashiteeya Adhyaya]],[[Naveganadharaniya Adhyaya]],[[Indriyopakramaniya Adhyaya]],[[Khuddakachatushpada Adhyaya]],[[Mahachatushpada Adhyaya]],[[Tistraishaniya Adhyaya]],[[Vatakalakaliya Adhyaya]],[[Snehadhyaya]]
[[Swedadhyaya]],[[Upakalpaniya Adhyaya]],[[Chikitsaprabhritiya Adhyaya]],[[Kiyanta Shiraseeya Adhyaya]],[[Trishothiya Adhyaya]],[[Ashtodariya Adhyaya]],[[Maharoga Adhyaya]],[[Ashtauninditiya Adhyaya]],[[Langhanabrimhaniya Adhyaya]],[[Santarpaniya Adhyaya]],[[Vidhishonitiya Adhyaya]],[[Yajjah Purushiya Adhyaya]],[[Atreyabhadrakapyiya Adhyaya]],[[Annapanavidhi Adhyaya]],[[Vividhashitapitiya Adhyaya]],[[Dashapranayataneeya Adhyaya]],[[Arthedashmahamooliya Adhyaya]]
}}

'''<big>Preamble of Sutra Sthana (Section on Fundamental Principles)</big>'''

<div style="text-align:justify;">Sutra Sthana is the first section dealing with fundamental principles of [[Ayurveda]].The [[Sutra Sthana]] (Section on fundamental principles) deserves the same place as the head deserves in the human body.[Cha. Chi. 30/45] This important section lays the foundation for the whole Samhita by describing the basic principles. The word ''Sutra'' literally means a short sentence which has deep meaning. The name of section suggests that it is a chain of important principles in concise form. Besides the fundamental principles, this section also establishes various technical terms that are used in subsequent sections of the samhita. This helps in providing a base to not just [[Ayurveda]] practitioners, but also to teachers, researchers, and scholars.

From the standpoint of its structure, the Sutra Sthana consists of thirty chapters, grouped into eight logical contexts. The first seven ''Chatushkas'' (or tetrads, i.e., groups of four), while the last one is a a group of two chapters (sangrahadvaya).

===Bheshaja Chatushka (four chapters on medicines)===

The first tetrad is also known as ''Bheshaja'' or the ''Aushadha''(medicine) ''Chatushka''. This tetrad deals with various medicines to be used in various forms either externally or internally.
* The first chapter [[Deerghanjiviteeya Adhyaya]], explains important concepts such as [[Deerghanjiviteeya Adhyaya#Three Sharira Dosha and two Manas Dosha|''Tridosha'' (''Vata, Pitta and Kapha'')]], [[Deerghanjiviteeya Adhyaya#Rasa (taste sensations)|''Rasa''(taste)]], [[Deerghanjiviteeya Adhyaya#Six Basic Principles for direct knowledge|''Shad padartha siddhanta'' (six basic principles)]], etc. which are integral to [[Ayurveda]] and used extensively throughout [[Charak Samhita]]. Besides these technical terms, the first chapter describes various medicines, like ''Phalini Dravya'' (therapeutically useful fruits as drugs), ''Moolini Dravya''(therapeutically useful roots as drugs), ''Mahasneha'' (four kinds of fats), ''Lavana''(salts), various types of ''mutra''(urine) and ''ksheera''(milk). The chapter emphasizes on the rational use of medications, since indiscriminate use of even good medicines can cause more harm than good. The chapter then goes on to explain the important concept of ''Trisutra'' (three principles of [[Ayurveda]]) i.e. ''hetu'' (causes), ''linga''(signs and symptoms) and ''aushadha'' (medicine).
* The second chapter ([[Apamarga Tanduliya Adhyaya]]) deals specifically with herbs and medicines to be used during and after [[Panchakarma]] (five methods of bio-purification). Thus, the first two chapters of this tetrad describe various medicines to be used internally.
* The third chapter ([[Aragvadhiya Adhyaya]]) advocates the use of topical medications, or medicines to be applied externally, i.e.,''lepa'' etc.
* The fourth chapter ([[Shadvirechanashatashritiya Adhyaya]]) provides details of fifty ''Mahakashaya''(or five classes of groups of ten medicines, and six hundred evacuatives) to be used in various diseases. Overall, this ''Chatushka'' provides a list of drugs to be used in various forms in a variety of diseases.

===Swastha Chatushka (four chapters on preservation of health)===

The second tetrad is the ''Swastha Chatushka'' that deals with important guidelines to be followed by healthy individuals to maintain their health.
* The first chapter of this tetrad, [[Matrashiteeya]], deals with the daily regimen to be followed by healthy individuals to maintain their health.
* The second chapter, [[Tasyashiteeya]], recommends changes one should make in his/her daily habits and lifestyle i.e. clothing, food habits, exercise etc., depending upon the season, to stay healthy.
* The third chapter, [[Naveganadharaniya]], explains the importance of suppressible and non-suppressible urges in the human body, diseases due to non-suppressible urges and their treatment.
* [[Indriyopakramaniya]], the last chapter, deals with ''sadvritta'' (general code of conduct). Besides maintaining his own health, ''sadvritta'' also helps the individual in maintaining healthy relations with other individuals, thus helping maintain harmony in the society at large.

===Nirdesha Chatushka (four chapters on guidelines for healthcare management)===

The third tetrad, ''Nirdesha Chatushka'', is about instructions to health care providers.
* The first chapter [[Khuddakachatushpada]], deals with four aspects of therapeutics) - ''vaidya'' (physician), ''dravya'' (medicine), ''upasthata'' (nurse) and ''rogi''(patient). Four qualities of each of these aspects and prime importance of the physician among all of them.
* The next chapter, [[Mahachatushpada]], explains the classification of diseases on the basis of prognosis. It is recommended in this chapter that the treatment should only be initiated after thorough diagnosis and identification of the disease, and the physician should refrain himself from treating the incurable diseases.
* The third chapter, ([[Tistraishaniya]]) deals with topics such as the three types of desires, strength, causes of diseases, diseases themselves, paths, physicians, and therapies.
* The last chapter , ([[Vatakalakaliya]]) deals with the good and bad qualities/functions of ''vata'', ''pitta'', and ''kapha''. A physician should have a thorough knowledge of the guidelines provided in this tetrad to succeed in his field.

===Kalpana Chatushka (four chapters on therapeutic purification procedures)===

The next tetrad, ''Kalpanachatushka'', deals with the application of medicines in the form of various therapeutic purification procedures either in healthy or in diseased individuals. ''Shodhana'' (bio-purification procedures) is an important concept of [[Ayurveda]] prescribed for removal of toxic wastes from the body. To prepare the patient for bio-purification, he has to go through specific pre-shodhana procedures, such as ''snehana''(internal application of ''sneha'' (fat)) and ''swedana''(sweating), to mobilize toxic wastes within the body and excrete them out of the body.
* The first chapter, [[Snehadhyaya]], provides the guidelines for proper use of ''sneha''(lipids) either for ''shodhana'' or for ''shamana'' (to appease/palliation) purposes. A patient who has successfully completed the ''snehana'' procedure is now subjected to ''swedana'' procedure.
* The next chapter, [[Swedadhyaya]], explains the various types of ''swedana''(fomentation) recommended for various diseases. ''Snehana'' and ''swedana'' help the toxins to move towards the gut from where they will be expelled out of the body either through ''vamana''(therapeutic emesis) or ''virechana''(therapeutic purgation).
* The next chapter, [[Upakalpaniya]], emphasizes on how a physician should be well equipped before administering any ''shodhana'' procedure to any of the patients. This chapter provides the outline for a fully equipped hospital and standard ''vamana'' and ''virechana'' procedures.
* The last chapter of this tetrad, [[Chikitsaprabhritiya]], depicts the importance of ''shodhana'' over ''shamana'' therapy. The details of properly / improperly administered ''shodhana'' procedures are discussed here. Important concepts like ''shuddha chikitsa'' (pure form of treatment)and ''svabhavoparamavada''(theory of natural destruction) etc. have also been described in this chapter.

===Roga Chatushka (four chapters on classification of diseases)===

The fifth ''Chatushka'' is about ''roga'' (disease). As the name suggests, this tetrad provides a (brief) list of diseases that are extensively mentioned throughout Charak Samhita.
* The first chapter [[Kiyanta Shiraseeya]], provides the details of diseases like ''shiroroga''(diseases of the head), ''hridroga''(cardiac diseases), eighteen types of ''kshaya''(loss of body tissues), ''vidradhi'' (abscess) and ''madhumeha''(a clinical condition similar to diabetes mellitus).
* The next chapter, [[Trishothiya]], elucidates various types of edema.
*The third chapter, [[Ashtodariya]], reveals the types of about 48 diseases that are caused by a combination of ''doshas''.
*The last chapter, [[Maharoga]], is exclusively dedicated to the diseases caused by single ''doshas''(''vata'', ''pitta'', or ''kapha'').

===Yojana Chatushka (four chapters on guidelines for management of diseases)===

The sixth ''Chatushka'', ''Yojanachatushka'', deals with aspects of treatment of various diseases.
* The first chapter of this tetrad, [[Ashtauninditiya]], describes eight types of people who are marginalized (or ridiculed) in the society due to their physical features. Out of these eight, only two i.e. ''atisthoola'' (morbidly obese) and ''atikrisha'' (emaciated) are described in detail because of their clinical significance along with their symptomatology and treatment.
* The next chapter, [[Langhanabrimhaniya]], describes six types of treatment i.e. ''langhana''(fasting), ''brimhana''(nourishing therapy), ''snehana'', ''svedana'', ''rukshana''(medical treatment for reducing fat) and ''stambhana''(astringent therapy) – primarily for managing ''atisthoola'' or ''atikrisha'' conditions, but also indicated for various other conditions described later in the Samhita. Out of these six, mainly two therapies i.e. ''langhana'' and ''brimhana'' have been described in greater detail.
* The third chapter, [[Santarpaniya]], deals with diseases caused due to over-nourishment or under-nourishment along with their treatment.
* The last chapter of this ''Chatushka'', [[Vidhishonitiya]], deals with diseases that are not cured by any of the above-mentioned therapies and termed as diseases due to vitiation of ''rakta'' (blood). Such diseases, along with their etiology, symptomatology and treatment have been described in this chapter. Overall this tetrad deals with all types of treatment modalities that find extensive reference across the Samhita.

===Annapana Chatushka (four chapters on food and beverages)===

The last ''Chatushka'' is ''Annapana Chatushka''.
* The first chapter, [[Yajjah Purushiya]], brings forth the important perspective of the origin of human beings and the origin of diseases. This chapter also describes 155 entities (''Agrya'',or entities considered best in their category of drugs, food articles, bio-purification procedures, etc.)that are important for healthy as well as diseased individuals.
* The next chapter [[Atreyabhadrakapyiya]], describes in detail the concept of Ayurvedic pharmacology in the form of ''rasa'' (taste), ''veerya''(drug potency), and ''vipaka''(final conversion of food/drug after the action of ''jatharagni''(digestive power) and ''prabhava''(specific action of a drug). This chapter also throws light on the important concept of ''viruddha ahara''(incompatible diet) which seems to be the primary cause of many diseases even today.
* The third chapter, [[Annapanavidhi Adhyaya]], provides details of Ayurvedic dietetics. This chapter details a wide variety of food and beverages, along with their medicinal values.
* The last chapter, [[Vividhashitapitiya]], deals with important concepts such as formation of body tissues from the diet consumed, immunity and immune-compromised individuals, diseases originated from various body tissues, and migration of ''dosha'' from ''shakha''(periphery or the tissue elements) to ''koshtha''(central part of the body or alimentary tract)and vice versa.

===Sangraha Adhyaya(two chapters on brief summary)===

The last two chapters are termed as ''Sangrahadvaya''.

* The first of these two chapters, [[Dashapranayataneeya]], deals with the ten locations in the human body where ''Prana''(life) resides. Besides this important concept, the chapter also details the attributes of a ''pranabhisaravaidya''(a physician who protects the life) and a ''rogabhisaravaidya'' (a physician who aggravates the disease and takes away the life of the patient).
* The last chapter, [[Arthedashmahamooliya]], deals with a variety of subjects such as the importance of ''Arth'' (hridaya-heart), ten major blood vessels or channels from the heart, the definition of ''ayu'' (combination of four entities i.e. body, mind, soul and senses) and its four types, [[Ayurveda]], the aim of Ayurvedic science,and its method of study etc.

===Logical format of section===

The name of each chapter of Sutra Sthana has its own significance. It either describes the main content of the chapter, the first topic described in that chapter, or the first word of that chapter. All the chapters are written in the same prose and poetry format. Each chapter ends with a summarizing verse or ''Tatrashloka''(chapter summary). In some places, the prose is followed by poetry describing the same topic, such as ''Bhavati Cha Atra''(the topic first described in prose is then described in poetry format). Various parameters have been used while constructing the ''shlokas'', denoting the command of the author over Sanskrit. The chapters are written in various styles, including as a dialogue (or a question-answer session) between the sage Atreya and his disciple, Agnivesha, or discussions among an assembly of sages. In fact, on reading the Charak Samhita, one can find four type of ''sutras'' - ''Guru sutras'' (by the sage Atreya), ''Shishyasutras'' (by Agnivesha, the disciple or ''shishya'' of Atreya), ''Pratisankartu sutras'' (by Charak), and ''Ekiyasutras''(anonymous).

Like in most sections, the [[Sutra Sthana]] also reads as a free-flow text, with each chapter linked logically with the preceding and succeeding chapters in some way.

===Researches===

Following research theses are conducted on Sutra Sthana in general and other topics in particular.

'''Researches on Chatushka in Sutra Sthana:'''

#Madhumati Dhamale, The study of Yojana Catuska of Caraka and Yojana for the management of Raktasrita Vyadhi (Hypertension). 2001. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Dandavate B.D., A comparative study of the sutrasthanam of Caraka Samhita. Ph.D. Thesis. Pune
#Mallika K.J. Critical study of Svastha-Chatushka of Charaka w.s.r. to biophysical and biochemical changes in Ritu Sandhi. 2002. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Hiten Vaja. Study of Roga-Chatushka of Charaka w.s.r. to “Trividha Bodhya Sangraha”.2002. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Meera Bhojani. Study of Nirdesha-Chatushka of Charaka and applied aspect of Trayo-Roga Marga. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Anuradha Agarwal. Study of Kalpana-Chatushka and its applied aspect of Aushadha Matra in relation to Aturabala. 2004. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Sangeeta More.Conceptual and critical study of Bheshaja Catushka w.s.r. to Agnidipana. 2009. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Santosh Mane.Study on Sangraha Dwaya of Charaka and assessment of the effect of Hridya Aushadhi on Oja-Kshaya.2004. M.D. Thesis. I.P.G.T.R.A., Jamnagar

'''Researches on Specific concepts in Sutra Sthana:'''

# Mayur Kulkarni. Concept of Dhatu-Pradoshaja Vikaras in Brihattrayee with the principle of management in Rakta-Pradoshaja Vikaras.2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Parvani Indrakumar.A conceptual and applied study of Viruddha Ahara with particular reference to Eka-Kushtha. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Bhavna Pandya.Charaka Samhita Ke Ashtau Ninditiya Adhyay Ka Saidhantika Va Samikshanatmak Adhyayan Evam Atikrisha Mein Brimhanopaya. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Ami Rajani.Critical study of “Vividhasitapitiya Adhyaya” w.s.r. to principle of Management in Rasapradosaja Vikar. 2009. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#S.M. Angadi. Rogamarga Ka Nidana Cikitsatmaka Adhyayana (Madhyama Roga Marga Vimarsa).1967.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#B.S. Venkataram. Rogamarga Tatha Sodhana Purve Snehana. 1968.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Patel T.C. Bahya Rogamarga Vimarsa. 1969.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#D.N. Shukla. Madhyama Rogamarga Me Basti Cikitsa. 1971. M.D. Thesis. I.P.G.T.R.A., Jamnagar

=== All abstracts ===

The new learners of Sutra sthana can read all abstracts of chapters of this section on [[Abstracts – Sutra Sthana]] page.

</div>

Sutra Sthana

2020-09-14T11:34:42Z

Vidyadhishkashikar:

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{{Infobox
|title = [[Charak Samhita]] Sutra Sthana-Preamble
|label1 = Section/Chapter
|data1 = [[Sutra Sthana]] Section 1/ Preamble
|label2 = Preceding section
|data2 = None
|label3 = Succeeding section
|data3 = [[Nidana Sthana]]
|label4 = Other Sections
|data4 = [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label5 = Author
|data5 = Dwivedi R.B.
|label6 = Reviewer
|data6 = Basisht G.
|label7 = Editor
|data7 = Deole Y. S.
|label8 = Date of publication
|data8 = December 17, 2018
|label9 = DOI
|data9 = --
|header10 = Chapters
|label10 =
|data10 = [[Deerghanjiviteeya Adhyaya]], [[Apamarga Tanduliya Adhyaya]], [[Aragvadhiya Adhyaya]],[[Shadvirechanashatashritiya Adhyaya]],[[Matrashiteeya Adhyaya]],[[Tasyashiteeya Adhyaya]],[[Naveganadharaniya Adhyaya]],[[Indriyopakramaniya Adhyaya]],[[Khuddakachatushpada Adhyaya]],[[Mahachatushpada Adhyaya]],[[Tistraishaniya Adhyaya]],[[Vatakalakaliya Adhyaya]],[[Snehadhyaya]]
[[Swedadhyaya]],[[Upakalpaniya Adhyaya]],[[Chikitsaprabhritiya Adhyaya]],[[Kiyanta Shiraseeya Adhyaya]],[[Trishothiya Adhyaya]],[[Ashtodariya Adhyaya]],[[Maharoga Adhyaya]],[[Ashtauninditiya Adhyaya]],[[Langhanabrimhaniya Adhyaya]],[[Santarpaniya Adhyaya]],[[Vidhishonitiya Adhyaya]],[[Yajjah Purushiya Adhyaya]],[[Atreyabhadrakapyiya Adhyaya]],[[Annapanavidhi Adhyaya]],[[Vividhashitapitiya Adhyaya]],[[Dashapranayataneeya Adhyaya]],[[Arthedashmahamooliya Adhyaya]]
}}

'''<big>Preamble of Sutra Sthana (Section on Fundamental Principles)</big>'''

<div style="text-align:justify;">Sutra Sthana is the first section dealing with fundamental principles of [[Ayurveda]].The [[Sutra Sthana]] (Section on fundamental principles) deserves the same place as the head deserves in the human body.[Cha. Chi. 30/45] This important section lays the foundation for the whole Samhita by describing the basic principles. The word ''Sutra'' literally means a short sentence which has deep meaning. The name of section suggests that it is a chain of important principles in concise form. Besides the fundamental principles, this section also establishes various technical terms that are used in subsequent sections of the samhita. This helps in providing a base to not just [[Ayurveda]] practitioners, but also to teachers, researchers, and scholars.

From the standpoint of its structure, the Sutra Sthana consists of thirty chapters, grouped into eight logical contexts. The first seven ''Chatushkas'' (or tetrads, i.e., groups of four), while the last one is a a group of two chapters (sangrahadvaya).

===Bheshaja Chatushka (four chapters on medicines)===

The first tetrad is also known as ''Bheshaja'' or the ''Aushadha''(medicine) ''Chatushka''. This tetrad deals with various medicines to be used in various forms either externally or internally.
* The first chapter [[Deerghanjiviteeya Adhyaya]], explains important concepts such as [[Deerghanjiviteeya Adhyaya#Three Sharira Dosha and two Manas Dosha|''Tridosha'' (''Vata, Pitta and Kapha'')]], [[Deerghanjiviteeya Adhyaya#Rasa (taste sensations)|''Rasa''(taste)]], [[Deerghanjiviteeya Adhyaya#Six Basic Principles for direct knowledge|''Shad padartha siddhanta'' (six basic principles)]], etc. which are integral to [[Ayurveda]] and used extensively throughout [[Charak Samhita]]. Besides these technical terms, the first chapter describes various medicines, like ''Phalini Dravya'' (therapeutically useful fruits as drugs), ''Moolini Dravya''(therapeutically useful roots as drugs), ''Mahasneha'' (four kinds of fats), ''Lavana''(salts), various types of ''mutra''(urine) and ''ksheera''(milk). The chapter emphasizes on the rational use of medications, since indiscriminate use of even good medicines can cause more harm than good. The chapter then goes on to explain the important concept of ''Trisutra'' (three principles of [[Ayurveda]]) i.e. ''hetu'' (causes), ''linga''(signs and symptoms) and ''aushadha'' (medicine).
* The second chapter ([[Apamarga Tanduliya Adhyaya]]) deals specifically with herbs and medicines to be used during and after [[Panchakarma]] (five methods of bio-purification). Thus, the first two chapters of this tetrad describe various medicines to be used internally.
* The third chapter ([[Aragvadhiya Adhyaya]]) advocates the use of topical medications, or medicines to be applied externally, i.e.,''lepa'' etc.
* The fourth chapter ([[Shadvirechanashatashritiya Adhyaya]]) provides details of fifty ''Mahakashaya''(or five classes of groups of ten medicines, and six hundred evacuatives) to be used in various diseases. Overall, this ''Chatushka'' provides a list of drugs to be used in various forms in a variety of diseases.

===Swastha Chatushka (four chapters on preservation of health)===

The second tetrad is the ''Swastha Chatushka'' that deals with important guidelines to be followed by healthy individuals to maintain their health.
* The first chapter of this tetrad, [[Matrashiteeya]], deals with the daily regimen to be followed by healthy individuals to maintain their health.
* The second chapter, [[Tasyashiteeya]], recommends changes one should make in his/her daily habits and lifestyle i.e. clothing, food habits, exercise etc., depending upon the season, to stay healthy.
* The third chapter, [[Naveganadharaniya]], explains the importance of suppressible and non-suppressible urges in the human body, diseases due to non-suppressible urges and their treatment.
* [[Indriyopakramaniya]], the last chapter, deals with ''sadvritta'' (general code of conduct). Besides maintaining his own health, ''sadvritta'' also helps the individual in maintaining healthy relations with other individuals, thus helping maintain harmony in the society at large.

===Nirdesha Chatushka (four chapters on guidelines for healthcare management)===

The third tetrad, ''Nirdesha Chatushka'', is about instructions to health care providers.
* The first chapter [[Khuddakachatushpada]], deals with four aspects of therapeutics) - ''vaidya'' (physician), ''dravya'' (medicine), ''upasthata'' (nurse) and ''rogi''(patient). Four qualities of each of these aspects and prime importance of the physician among all of them.
* The next chapter, [[Mahachatushpada]], explains the classification of diseases on the basis of prognosis. It is recommended in this chapter that the treatment should only be initiated after thorough diagnosis and identification of the disease, and the physician should refrain himself from treating the incurable diseases.
* The third chapter, ([[Tistraishaniya]]) deals with topics such as the three types of desires, strength, causes of diseases, diseases themselves, paths, physicians, and therapies.
* The last chapter , ([[Vatakalakaliya]]) deals with the good and bad qualities/functions of ''vata'', ''pitta'', and ''kapha''. A physician should have a thorough knowledge of the guidelines provided in this tetrad to succeed in his field.

===Kalpana Chatushka (four chapters on therapeutic purification procedures)===

The next tetrad, ''Kalpanachatushka'', deals with the application of medicines in the form of various therapeutic purification procedures either in healthy or in diseased individuals. ''Shodhana'' (bio-purification procedures) is an important concept of [[Ayurveda]] prescribed for removal of toxic wastes from the body. To prepare the patient for bio-purification, he has to go through specific pre-shodhana procedures, such as ''snehana''(internal application of ''sneha'' (fat)) and ''swedana''(sweating), to mobilize toxic wastes within the body and excrete them out of the body.
* The first chapter, [[Snehadhyaya]], provides the guidelines for proper use of ''sneha''(lipids) either for ''shodhana'' or for ''shamana'' (to appease/palliation) purposes. A patient who has successfully completed the ''snehana'' procedure is now subjected to ''swedana'' procedure.
* The next chapter, [[Swedadhyaya]], explains the various types of ''swedana''(fomentation) recommended for various diseases. ''Snehana'' and ''swedana'' help the toxins to move towards the gut from where they will be expelled out of the body either through ''vamana''(therapeutic emesis) or ''virechana''(therapeutic purgation).
* The next chapter, [[Upakalpaniya]], emphasizes on how a physician should be well equipped before administering any ''shodhana'' procedure to any of the patients. This chapter provides the outline for a fully equipped hospital and standard ''vamana'' and ''virechana'' procedures.
* The last chapter of this tetrad, [[Chikitsaprabhritiya]], depicts the importance of ''shodhana'' over ''shamana'' therapy. The details of properly / improperly administered ''shodhana'' procedures are discussed here. Important concepts like ''shuddha chikitsa'' (pure form of treatment)and ''svabhavoparamavada''(theory of natural destruction) etc. have also been described in this chapter.

===Roga Chatushka (four chapters on classification of diseases)===

The fifth ''Chatushka'' is about ''roga'' (disease). As the name suggests, this tetrad provides a (brief) list of diseases that are extensively mentioned throughout Charak Samhita.
* The first chapter [[Kiyanta Shiraseeya]], provides the details of diseases like ''shiroroga''(diseases of the head), ''hridroga''(cardiac diseases), eighteen types of ''kshaya''(loss of body tissues), ''vidradhi'' (abscess) and ''madhumeha''(a clinical condition similar to diabetes mellitus).
* The next chapter, [[Trishothiya]], elucidates various types of edema.
*The third chapter, [[Ashtodariya]], reveals the types of about 48 diseases that are caused by a combination of ''doshas''.
*The last chapter, [[Maharoga]], is exclusively dedicated to the diseases caused by single ''doshas''(''vata'', ''pitta'', or ''kapha'').

===Yojana Chatushka (four chapters on guidelines for management of diseases)===

The sixth ''Chatushka'', ''Yojanachatushka'', deals with aspects of treatment of various diseases.
* The first chapter of this tetrad, [[Ashtauninditiya]], describes eight types of people who are marginalized (or ridiculed) in the society due to their physical features. Out of these eight, only two i.e. ''atisthoola'' (morbidly obese) and ''atikrisha'' (emaciated) are described in detail because of their clinical significance along with their symptomatology and treatment.
* The next chapter, [[Langhanabrimhaniya]], describes six types of treatment i.e. ''langhana''(fasting), ''brimhana''(nourishing therapy), ''snehana'', ''svedana'', ''rukshana''(medical treatment for reducing fat) and ''stambhana''(astringent therapy) – primarily for managing ''atisthoola'' or ''atikrisha'' conditions, but also indicated for various other conditions described later in the Samhita. Out of these six, mainly two therapies i.e. ''langhana'' and ''brimhana'' have been described in greater detail.
* The third chapter, [[Santarpaniya]], deals with diseases caused due to over-nourishment or under-nourishment along with their treatment.
* The last chapter of this ''Chatushka'', [[Vidhishonitiya]], deals with diseases that are not cured by any of the above-mentioned therapies and termed as diseases due to vitiation of ''rakta'' (blood). Such diseases, along with their etiology, symptomatology and treatment have been described in this chapter. Overall this tetrad deals with all types of treatment modalities that find extensive reference across the Samhita.

===Annapana Chatushka (four chapters on food and beverages)===

The last ''Chatushka'' is ''Annapana Chatushka''.
* The first chapter, [[Yajjah Purushiya]], brings forth the important perspective of the origin of human beings and the origin of diseases. This chapter also describes 155 entities (''Agrya'',or entities considered best in their category of drugs, food articles, bio-purification procedures, etc.)that are important for healthy as well as diseased individuals.
* The next chapter [[Atreyabhadrakapyiya]], describes in detail the concept of Ayurvedic pharmacology in the form of ''rasa'' (taste), ''veerya''(drug potency), and ''vipaka''(final conversion of food/drug after the action of ''jatharagni''(digestive power) and ''prabhava''(specific action of a drug). This chapter also throws light on the important concept of ''viruddha ahara''(incompatible diet) which seems to be the primary cause of many diseases even today.
* The third chapter, [[Annapanavidhi Adhyaya]], provides details of Ayurvedic dietetics. This chapter details a wide variety of food and beverages, along with their medicinal values.
* The last chapter, [[Vividhashitapitiya]], deals with important concepts such as formation of body tissues from the diet consumed, immunity and immune-compromised individuals, diseases originated from various body tissues, and migration of ''dosha'' from ''shakha''(periphery or the tissue elements) to ''koshtha''(central part of the body or alimentary tract)and vice versa.

===Sangraha Adhyaya(two chapters on brief summary)===

The last two chapters are termed as ''Sangrahadvaya''.

* The first of these two chapters, [[Dashapranayataneeya]], deals with the ten locations in the human body where ''Prana''(life) resides. Besides this important concept, the chapter also details the attributes of a ''pranabhisaravaidya''(a physician who protects the life) and a ''rogabhisaravaidya'' (a physician who aggravates the disease and takes away the life of the patient).
* The last chapter, [[Arthedashmahamooliya]], deals with a variety of subjects such as the importance of ''Arth'' (hridaya-heart), ten major blood vessels or channels from the heart, the definition of ''ayu'' (combination of four entities i.e. body, mind, soul and senses) and its four types, [[Ayurveda]], the aim of Ayurvedic science,and its method of study etc.

===Logical format of section===

The name of each chapter of Sutra Sthana has its own significance. It either describes the main content of the chapter, the first topic described in that chapter, or the first word of that chapter. All the chapters are written in the same prose and poetry format. Each chapter ends with a summarizing verse or ''Tatrashloka''(chapter summary). In some places, the prose is followed by poetry describing the same topic, such as ''Bhavati Cha Atra''(the topic first described in prose is then described in poetry format). Various parameters have been used while constructing the ''shlokas'', denoting the command of the author over Sanskrit. The chapters are written in various styles, including as a dialogue (or a question-answer session) between the sage Atreya and his disciple, Agnivesha, or discussions among an assembly of sages. In fact, on reading the Charak Samhita, one can find four type of ''sutras'' - ''Guru sutras'' (by the sage Atreya), ''Shishyasutras'' (by Agnivesha, the disciple or ''shishya'' of Atreya), ''Pratisankartu sutras'' (by Charak), and ''Ekiyasutras''(anonymous).

Like in most sections, the [[Sutra Sthana]] also reads as a free-flow text, with each chapter linked logically with the preceding and succeeding chapters in some way.

===Researches===

Following research theses are conducted on Sutra Sthana in general and other topics in particular.

'''Researches on Chatushka in Sutra Sthana:'''

#Madhumati Dhamale, The study of Yojana Catuska of Caraka and Yojana for the management of Raktasrita Vyadhi (Hypertension). 2001. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Dandavate B.D., A comparative study of the sutrasthanam of Caraka Samhita. Ph.D. Thesis. Pune
#Mallika K.J. Critical study of Svastha-Chatushka of Charaka w.s.r. to biophysical and biochemical changes in Ritu Sandhi. 2002. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Hiten Vaja. Study of Roga-Chatushka of Charaka w.s.r. to “Trividha Bodhya Sangraha”.2002. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Meera Bhojani. Study of Nirdesha-Chatushka of Charaka and applied aspect of Trayo-Roga Marga. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Anuradha Agarwal. Study of Kalpana-Chatushka and its applied aspect of Aushadha Matra in relation to Aturabala. 2004. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Sangeeta More.Conceptual and critical study of Bheshaja Catushka w.s.r. to Agnidipana. 2009. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Santosh Mane.Study on Sangraha Dwaya of Charaka and assessment of the effect of Hridya Aushadhi on Oja-Kshaya.2004. M.D. Thesis. I.P.G.T.R.A., Jamnagar

'''Researches on Specific concepts in Sutra Sthana:'''

# Mayur Kulkarni. Concept of Dhatu-Pradoshaja Vikaras in Brihattrayee with the principle of management in Rakta-Pradoshaja Vikaras.2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Parvani Indrakumar.A conceptual and applied study of Viruddha Ahara with particular reference to Eka-Kushtha. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Bhavna Pandya.Charaka Samhita Ke Ashtau Ninditiya Adhyay Ka Saidhantika Va Samikshanatmak Adhyayan Evam Atikrisha Mein Brimhanopaya. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Ami Rajani.Critical study of “Vividhasitapitiya Adhyaya” w.s.r. to principle of Management in Rasapradosaja Vikar. 2009. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#S.M. Angadi. Rogamarga Ka Nidana Cikitsatmaka Adhyayana (Madhyama Roga Marga Vimarsa).1967.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#B.S. Venkataram. Rogamarga Tatha Sodhana Purve Snehana. 1968.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Patel T.C. Bahya Rogamarga Vimarsa. 1969.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#D.N. Shukla. Madhyama Rogamarga Me Basti Cikitsa. 1971. M.D. Thesis. I.P.G.T.R.A., Jamnagar

=== All abstracts ===

The new learners of Sutra sthana can read all abstracts of chapters of this section on [[Abstracts – Sutra Sthana]] page.

</div>

Sutra Sthana

2020-09-14T11:33:51Z

Vidyadhishkashikar:

{{#seo:
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|description=Sutra Sthana is the first section dealing with fundamental principles of Ayurveda.
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{{Infobox
|title = [[Charak Samhita]] Sutra Sthana-Preamble
|label1 = Section/Chapter
|data1 = [[Sutra Sthana]] Section 1/ Preamble
|label2 = Preceding section
|data2 = None
|label3 = Succeeding section
|data3 = [[Nidana Sthana]]
|label4 = Other Sections
|data4 = [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label5 = Author
|data5 = Dwivedi R.B.
|label6 = Reviewer
|data6 = Basisht G.
|label7 = Editor
|data7 = Deole Y. S.
|label8 = Date of publication
|data8 = December 17, 2018
|label9 = DOI
|data9 = --
|header10 = Chapters

|label10 =
|data10 = [[Deerghanjiviteeya Adhyaya]], [[Apamarga Tanduliya Adhyaya]], [[Aragvadhiya Adhyaya]],[[Shadvirechanashatashritiya Adhyaya]],[[Matrashiteeya Adhyaya]],[[Tasyashiteeya Adhyaya]],[[Naveganadharaniya Adhyaya]],[[Indriyopakramaniya Adhyaya]],[[Khuddakachatushpada Adhyaya]],[[Mahachatushpada Adhyaya]],[[Tistraishaniya Adhyaya]],[[Vatakalakaliya Adhyaya]],[[Snehadhyaya]]
[[Swedadhyaya]],[[Upakalpaniya Adhyaya]],[[Chikitsaprabhritiya Adhyaya]],[[Kiyanta Shiraseeya Adhyaya]],[[Trishothiya Adhyaya]],[[Ashtodariya Adhyaya]],[[Maharoga Adhyaya]],[[Ashtauninditiya Adhyaya]],[[Langhanabrimhaniya Adhyaya]],[[Santarpaniya Adhyaya]],[[Vidhishonitiya Adhyaya]],[[Yajjah Purushiya Adhyaya]],[[Atreyabhadrakapyiya Adhyaya]],[[Annapanavidhi Adhyaya]],[[Vividhashitapitiya Adhyaya]],[[Dashapranayataneeya Adhyaya]],[[Arthedashmahamooliya Adhyaya]]
}}

'''<big>Preamble of Sutra Sthana (Section on Fundamental Principles)</big>'''

<div style="text-align:justify;">Sutra Sthana is the first section dealing with fundamental principles of [[Ayurveda]].The [[Sutra Sthana]] (Section on fundamental principles) deserves the same place as the head deserves in the human body.[Cha. Chi. 30/45] This important section lays the foundation for the whole Samhita by describing the basic principles. The word ''Sutra'' literally means a short sentence which has deep meaning. The name of section suggests that it is a chain of important principles in concise form. Besides the fundamental principles, this section also establishes various technical terms that are used in subsequent sections of the samhita. This helps in providing a base to not just [[Ayurveda]] practitioners, but also to teachers, researchers, and scholars.

From the standpoint of its structure, the Sutra Sthana consists of thirty chapters, grouped into eight logical contexts. The first seven ''Chatushkas'' (or tetrads, i.e., groups of four), while the last one is a a group of two chapters (sangrahadvaya).

===Bheshaja Chatushka (four chapters on medicines)===

The first tetrad is also known as ''Bheshaja'' or the ''Aushadha''(medicine) ''Chatushka''. This tetrad deals with various medicines to be used in various forms either externally or internally.
* The first chapter [[Deerghanjiviteeya Adhyaya]], explains important concepts such as [[Deerghanjiviteeya Adhyaya#Three Sharira Dosha and two Manas Dosha|''Tridosha'' (''Vata, Pitta and Kapha'')]], [[Deerghanjiviteeya Adhyaya#Rasa (taste sensations)|''Rasa''(taste)]], [[Deerghanjiviteeya Adhyaya#Six Basic Principles for direct knowledge|''Shad padartha siddhanta'' (six basic principles)]], etc. which are integral to [[Ayurveda]] and used extensively throughout [[Charak Samhita]]. Besides these technical terms, the first chapter describes various medicines, like ''Phalini Dravya'' (therapeutically useful fruits as drugs), ''Moolini Dravya''(therapeutically useful roots as drugs), ''Mahasneha'' (four kinds of fats), ''Lavana''(salts), various types of ''mutra''(urine) and ''ksheera''(milk). The chapter emphasizes on the rational use of medications, since indiscriminate use of even good medicines can cause more harm than good. The chapter then goes on to explain the important concept of ''Trisutra'' (three principles of [[Ayurveda]]) i.e. ''hetu'' (causes), ''linga''(signs and symptoms) and ''aushadha'' (medicine).
* The second chapter ([[Apamarga Tanduliya Adhyaya]]) deals specifically with herbs and medicines to be used during and after [[Panchakarma]] (five methods of bio-purification). Thus, the first two chapters of this tetrad describe various medicines to be used internally.
* The third chapter ([[Aragvadhiya Adhyaya]]) advocates the use of topical medications, or medicines to be applied externally, i.e.,''lepa'' etc.
* The fourth chapter ([[Shadvirechanashatashritiya Adhyaya]]) provides details of fifty ''Mahakashaya''(or five classes of groups of ten medicines, and six hundred evacuatives) to be used in various diseases. Overall, this ''Chatushka'' provides a list of drugs to be used in various forms in a variety of diseases.

===Swastha Chatushka (four chapters on preservation of health)===

The second tetrad is the ''Swastha Chatushka'' that deals with important guidelines to be followed by healthy individuals to maintain their health.
* The first chapter of this tetrad, [[Matrashiteeya]], deals with the daily regimen to be followed by healthy individuals to maintain their health.
* The second chapter, [[Tasyashiteeya]], recommends changes one should make in his/her daily habits and lifestyle i.e. clothing, food habits, exercise etc., depending upon the season, to stay healthy.
* The third chapter, [[Naveganadharaniya]], explains the importance of suppressible and non-suppressible urges in the human body, diseases due to non-suppressible urges and their treatment.
* [[Indriyopakramaniya]], the last chapter, deals with ''sadvritta'' (general code of conduct). Besides maintaining his own health, ''sadvritta'' also helps the individual in maintaining healthy relations with other individuals, thus helping maintain harmony in the society at large.

===Nirdesha Chatushka (four chapters on guidelines for healthcare management)===

The third tetrad, ''Nirdesha Chatushka'', is about instructions to health care providers.
* The first chapter [[Khuddakachatushpada]], deals with four aspects of therapeutics) - ''vaidya'' (physician), ''dravya'' (medicine), ''upasthata'' (nurse) and ''rogi''(patient). Four qualities of each of these aspects and prime importance of the physician among all of them.
* The next chapter, [[Mahachatushpada]], explains the classification of diseases on the basis of prognosis. It is recommended in this chapter that the treatment should only be initiated after thorough diagnosis and identification of the disease, and the physician should refrain himself from treating the incurable diseases.
* The third chapter, ([[Tistraishaniya]]) deals with topics such as the three types of desires, strength, causes of diseases, diseases themselves, paths, physicians, and therapies.
* The last chapter , ([[Vatakalakaliya]]) deals with the good and bad qualities/functions of ''vata'', ''pitta'', and ''kapha''. A physician should have a thorough knowledge of the guidelines provided in this tetrad to succeed in his field.

===Kalpana Chatushka (four chapters on therapeutic purification procedures)===

The next tetrad, ''Kalpanachatushka'', deals with the application of medicines in the form of various therapeutic purification procedures either in healthy or in diseased individuals. ''Shodhana'' (bio-purification procedures) is an important concept of [[Ayurveda]] prescribed for removal of toxic wastes from the body. To prepare the patient for bio-purification, he has to go through specific pre-shodhana procedures, such as ''snehana''(internal application of ''sneha'' (fat)) and ''swedana''(sweating), to mobilize toxic wastes within the body and excrete them out of the body.
* The first chapter, [[Snehadhyaya]], provides the guidelines for proper use of ''sneha''(lipids) either for ''shodhana'' or for ''shamana'' (to appease/palliation) purposes. A patient who has successfully completed the ''snehana'' procedure is now subjected to ''swedana'' procedure.
* The next chapter, [[Swedadhyaya]], explains the various types of ''swedana''(fomentation) recommended for various diseases. ''Snehana'' and ''swedana'' help the toxins to move towards the gut from where they will be expelled out of the body either through ''vamana''(therapeutic emesis) or ''virechana''(therapeutic purgation).
* The next chapter, [[Upakalpaniya]], emphasizes on how a physician should be well equipped before administering any ''shodhana'' procedure to any of the patients. This chapter provides the outline for a fully equipped hospital and standard ''vamana'' and ''virechana'' procedures.
* The last chapter of this tetrad, [[Chikitsaprabhritiya]], depicts the importance of ''shodhana'' over ''shamana'' therapy. The details of properly / improperly administered ''shodhana'' procedures are discussed here. Important concepts like ''shuddha chikitsa'' (pure form of treatment)and ''svabhavoparamavada''(theory of natural destruction) etc. have also been described in this chapter.

===Roga Chatushka (four chapters on classification of diseases)===

The fifth ''Chatushka'' is about ''roga'' (disease). As the name suggests, this tetrad provides a (brief) list of diseases that are extensively mentioned throughout Charak Samhita.
* The first chapter [[Kiyanta Shiraseeya]], provides the details of diseases like ''shiroroga''(diseases of the head), ''hridroga''(cardiac diseases), eighteen types of ''kshaya''(loss of body tissues), ''vidradhi'' (abscess) and ''madhumeha''(a clinical condition similar to diabetes mellitus).
* The next chapter, [[Trishothiya]], elucidates various types of edema.
*The third chapter, [[Ashtodariya]], reveals the types of about 48 diseases that are caused by a combination of ''doshas''.
*The last chapter, [[Maharoga]], is exclusively dedicated to the diseases caused by single ''doshas''(''vata'', ''pitta'', or ''kapha'').

===Yojana Chatushka (four chapters on guidelines for management of diseases)===

The sixth ''Chatushka'', ''Yojanachatushka'', deals with aspects of treatment of various diseases.
* The first chapter of this tetrad, [[Ashtauninditiya]], describes eight types of people who are marginalized (or ridiculed) in the society due to their physical features. Out of these eight, only two i.e. ''atisthoola'' (morbidly obese) and ''atikrisha'' (emaciated) are described in detail because of their clinical significance along with their symptomatology and treatment.
* The next chapter, [[Langhanabrimhaniya]], describes six types of treatment i.e. ''langhana''(fasting), ''brimhana''(nourishing therapy), ''snehana'', ''svedana'', ''rukshana''(medical treatment for reducing fat) and ''stambhana''(astringent therapy) – primarily for managing ''atisthoola'' or ''atikrisha'' conditions, but also indicated for various other conditions described later in the Samhita. Out of these six, mainly two therapies i.e. ''langhana'' and ''brimhana'' have been described in greater detail.
* The third chapter, [[Santarpaniya]], deals with diseases caused due to over-nourishment or under-nourishment along with their treatment.
* The last chapter of this ''Chatushka'', [[Vidhishonitiya]], deals with diseases that are not cured by any of the above-mentioned therapies and termed as diseases due to vitiation of ''rakta'' (blood). Such diseases, along with their etiology, symptomatology and treatment have been described in this chapter. Overall this tetrad deals with all types of treatment modalities that find extensive reference across the Samhita.

===Annapana Chatushka (four chapters on food and beverages)===

The last ''Chatushka'' is ''Annapana Chatushka''.
* The first chapter, [[Yajjah Purushiya]], brings forth the important perspective of the origin of human beings and the origin of diseases. This chapter also describes 155 entities (''Agrya'',or entities considered best in their category of drugs, food articles, bio-purification procedures, etc.)that are important for healthy as well as diseased individuals.
* The next chapter [[Atreyabhadrakapyiya]], describes in detail the concept of Ayurvedic pharmacology in the form of ''rasa'' (taste), ''veerya''(drug potency), and ''vipaka''(final conversion of food/drug after the action of ''jatharagni''(digestive power) and ''prabhava''(specific action of a drug). This chapter also throws light on the important concept of ''viruddha ahara''(incompatible diet) which seems to be the primary cause of many diseases even today.
* The third chapter, [[Annapanavidhi Adhyaya]], provides details of Ayurvedic dietetics. This chapter details a wide variety of food and beverages, along with their medicinal values.
* The last chapter, [[Vividhashitapitiya]], deals with important concepts such as formation of body tissues from the diet consumed, immunity and immune-compromised individuals, diseases originated from various body tissues, and migration of ''dosha'' from ''shakha''(periphery or the tissue elements) to ''koshtha''(central part of the body or alimentary tract)and vice versa.

===Sangraha Adhyaya(two chapters on brief summary)===

The last two chapters are termed as ''Sangrahadvaya''.

* The first of these two chapters, [[Dashapranayataneeya]], deals with the ten locations in the human body where ''Prana''(life) resides. Besides this important concept, the chapter also details the attributes of a ''pranabhisaravaidya''(a physician who protects the life) and a ''rogabhisaravaidya'' (a physician who aggravates the disease and takes away the life of the patient).
* The last chapter, [[Arthedashmahamooliya]], deals with a variety of subjects such as the importance of ''Arth'' (hridaya-heart), ten major blood vessels or channels from the heart, the definition of ''ayu'' (combination of four entities i.e. body, mind, soul and senses) and its four types, [[Ayurveda]], the aim of Ayurvedic science,and its method of study etc.

===Logical format of section===

The name of each chapter of Sutra Sthana has its own significance. It either describes the main content of the chapter, the first topic described in that chapter, or the first word of that chapter. All the chapters are written in the same prose and poetry format. Each chapter ends with a summarizing verse or ''Tatrashloka''(chapter summary). In some places, the prose is followed by poetry describing the same topic, such as ''Bhavati Cha Atra''(the topic first described in prose is then described in poetry format). Various parameters have been used while constructing the ''shlokas'', denoting the command of the author over Sanskrit. The chapters are written in various styles, including as a dialogue (or a question-answer session) between the sage Atreya and his disciple, Agnivesha, or discussions among an assembly of sages. In fact, on reading the Charak Samhita, one can find four type of ''sutras'' - ''Guru sutras'' (by the sage Atreya), ''Shishyasutras'' (by Agnivesha, the disciple or ''shishya'' of Atreya), ''Pratisankartu sutras'' (by Charak), and ''Ekiyasutras''(anonymous).

Like in most sections, the [[Sutra Sthana]] also reads as a free-flow text, with each chapter linked logically with the preceding and succeeding chapters in some way.

===Researches===

Following research theses are conducted on Sutra Sthana in general and other topics in particular.

'''Researches on Chatushka in Sutra Sthana:'''

#Madhumati Dhamale, The study of Yojana Catuska of Caraka and Yojana for the management of Raktasrita Vyadhi (Hypertension). 2001. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Dandavate B.D., A comparative study of the sutrasthanam of Caraka Samhita. Ph.D. Thesis. Pune
#Mallika K.J. Critical study of Svastha-Chatushka of Charaka w.s.r. to biophysical and biochemical changes in Ritu Sandhi. 2002. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Hiten Vaja. Study of Roga-Chatushka of Charaka w.s.r. to “Trividha Bodhya Sangraha”.2002. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Meera Bhojani. Study of Nirdesha-Chatushka of Charaka and applied aspect of Trayo-Roga Marga. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Anuradha Agarwal. Study of Kalpana-Chatushka and its applied aspect of Aushadha Matra in relation to Aturabala. 2004. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Sangeeta More.Conceptual and critical study of Bheshaja Catushka w.s.r. to Agnidipana. 2009. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Santosh Mane.Study on Sangraha Dwaya of Charaka and assessment of the effect of Hridya Aushadhi on Oja-Kshaya.2004. M.D. Thesis. I.P.G.T.R.A., Jamnagar

'''Researches on Specific concepts in Sutra Sthana:'''

# Mayur Kulkarni. Concept of Dhatu-Pradoshaja Vikaras in Brihattrayee with the principle of management in Rakta-Pradoshaja Vikaras.2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Parvani Indrakumar.A conceptual and applied study of Viruddha Ahara with particular reference to Eka-Kushtha. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Bhavna Pandya.Charaka Samhita Ke Ashtau Ninditiya Adhyay Ka Saidhantika Va Samikshanatmak Adhyayan Evam Atikrisha Mein Brimhanopaya. 2003. M.D. Thesis. I.P.G.T.R.A., Jamnagar
# Ami Rajani.Critical study of “Vividhasitapitiya Adhyaya” w.s.r. to principle of Management in Rasapradosaja Vikar. 2009. M.D. Thesis. I.P.G.T.R.A., Jamnagar
#S.M. Angadi. Rogamarga Ka Nidana Cikitsatmaka Adhyayana (Madhyama Roga Marga Vimarsa).1967.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#B.S. Venkataram. Rogamarga Tatha Sodhana Purve Snehana. 1968.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#Patel T.C. Bahya Rogamarga Vimarsa. 1969.M.D. Thesis. I.P.G.T.R.A., Jamnagar
#D.N. Shukla. Madhyama Rogamarga Me Basti Cikitsa. 1971. M.D. Thesis. I.P.G.T.R.A., Jamnagar

=== All abstracts ===

The new learners of Sutra sthana can read all abstracts of chapters of this section on [[Abstracts – Sutra Sthana]] page.

</div>

Shvayathu Chikitsa

2020-09-14T10:27:31Z

Vidyadhishkashikar:

{{#seo:
|title=Shvayathu Chikitsa
|titlemode=append
|keywords=Shvayathu, shotha, shopha, edema, swelling, langhana, amapachana, shodhana, Ayurveda, charak samhita, Indian system of medicine.
|description=Chikitsa Sthana Chapter 12. Management of Shvayathu (Various types of Swellings)
|image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|type=article
}}

<big>'''[[Chikitsa Sthana]] Chapter 12. Management of Shvayathu (Various types of Swellings) </big>'''
{{Infobox
|title = Shvayathu Chikitsa
|label1 = Section/Chapter
|data1 = [[Chikitsa Sthana]] Chapter 12
|label2 = Preceding Chapter
|data2 = [[Kshatakshina Chikitsa]]

|label3= Succeeding Chapter
|data3 = [[Udara Chikitsa]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|data6 = Goyal M.
|label7 = Reviewer
|data7 = Singh G.
|label8 = Editor
|data8 = Singh G., Goyal M.
|label9 = Date of publication
|data9 = December 17, 2018
|label10 = DOI
|data10 =
|header3 =

}}
<big>'''Abstract</big>'''
<div style="text-align:justify;">
This chapter deals with the treatment of various types of swellings like generalized edema and local eruptions including pustules, nodules and tumors. The etiological factors for these swellings can be endogenous (''nija'') or exogenous (''agantuja''). In all types of swellings, three ''doshas'' are involved but it is named according to the dominance of the ''dosha''. After describing general symptoms and signs of the swelling, specific symptoms and signs of ''vata, pitta'' and ''kapha'' as well as of incurable and curable swellings are explained.

Line of treatment depends upon type of swelling as well as involved parts of the body; wholesome and unwholesome diet and lifestyle for the benefit of the patient is explained. Detailed treatments along with drug preparations, internal and external therapeutic measures are discussed according to ''vata, pitta'' and ''kapha'' types of swelling.

Local swellings occurring in the various parts of the body in the form of papules, pustules, nodules, tumors etc are described in the last part of the chapter. It includes ''shaluka'' (quinsy), ''Bidalika'' (Ludwig’s angina), ''Taluvidradhi'' (palatal abscess), ''Upajihivika'' (superficial glossitis), ''Upakusha'' (gingivitis) and ''Danta-Vidradhi'' (dental abscess) which occurs in buccal cavity and generally included in Śālākya specialty. ''Galaganda'' is goiter and ''gandamala'' and ''granthi'' are mainly related with various types of swellings of lymph nodes. ''Arbuda'' (tumor), ''alaji'' (inflammation of eye), ''akshata'' (whitlow), ''vidarika'' (lymphadenitis), ''visphotaka'' (eruption), ''kaksha'' (herpes zoster), ''romantika'' (measles), ''masurika'' (chickenpox), ''bradhna'' (hernia), ''bhagandara'' (fistula-in-ano), ''shleepada'' (elephantiasis), ''jalakagardabha'' (acute sprading inflammation), ''abhighataja'' (traumatic) and ''vishaja'' (poisonous) swellings along with their medical treatment and wherever necessary surgical measures are also described. Difference and similarity between ''granthi'' and ''arbuda'' are also mentioned.

'''Keywords''': ''Shvayathu, shotha, shopha,'' edema, swelling, ''langhana, amapachana, shodhana''. </div>

== Introduction ==
<div style="text-align:justify;">
This chapter on [[Shvayathu Chikitsa]] (treatment of swelling) follows the chapter on ''kshata-kshina'' because in both the diseases vital organs are involved. ''Charaka'' defines ''shvayathu'' as bulging (''utsedha'') from the skin and this chapter mainly deals with the management of various types of general swellings and local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), large swellings like [[galaganda]] (goiter), tumor etc are also described.

Chapter 18th of [[Sutra Sthana]] deals with diagnostic aspects of swelling under the name of ''[[trishothiya]]''. Therein the word ''shopha'' is frequently used for shotha. Thus, the words ''shvayathu, shotha'' and ''shopha'' are used as synonyms and all denote edema or swelling. For inflammatory swelling Sushruta has used the word ''vrana-shotha''.

In the [[Sutra Sthana]], Charaka classified ''shotha'' in many ways but in this chapter which is mainly on the treatment, only those classifications are given which are important from treatment point of view, such as three types according to ''dosha'' viz, ''vata, pitta'' and ''kapha''; two types viz. ''nija'' (endogenous) and ''agantuja'' (exogenous) as well as ''ekanga'' (local) and ''sarvanga'' (generalized ) types.

== Sanskrit text, Transliteration and English Translation ==
<div class="mw-collapsible mw-collapsed">

अथातः श्वयथुचिकित्सितं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||
<div class="mw-collapsible-content">

athātaḥ śvayathucikitsitaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH shvayathucikitsitaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||
</div></div>

Now we shall expound the chapter "Shvayathu chikitsa" (Management of different types of swelling). Thus said Lord Atreya. [1-2]
<div class="mw-collapsible mw-collapsed">

भिषग्वरिष्ठं सुरसिद्धजुष्टं मुनीन्द्रमत्र्यात्मजमग्निवेशः| <br />
महागदस्य श्वयथोर्यथावत् प्रकोपरूपप्रशमानपृच्छत्||३|| <br />
<div class="mw-collapsible-content">

bhiṣagvariṣṭhaṁ surasiddhajuṣṭaṁ munīndramatryātmajamagnivēśaḥ| <br />
mahāgadasya śvayathōryathāvat prakōparūpapraśamānapr̥cchat||3||<br />

bhiShagvariShThaM surasiddhajuShTaM munIndramatryAtmajamagniveshaH| <br />
mahAgadasya shvayathoryathAvat prakoparUpaprashamAnapRucchat||3||<br />
</div></div>

Agnivesha approached the best physician and great sage, the son of Atri sitting midst of gods and saints and requested him to elaborate on the etiology, signs and symptoms and treatment of the major disease- ''shvayathu'' [3]
<div class="mw-collapsible mw-collapsed">

तस्मै जगादागदवेदसिन्धुप्रवर्तनाद्रिप्रवरोऽत्रिजस्तान्| <br />
वातादिभेदात्त्रिविधस्य सम्यङ्निजानिजैकाङ्गजसर्वजस्य||४|| <br />
<div class="mw-collapsible-content">

tasmai jagādāgadavēdasindhupravartanādripravarō'trijastān| <br />
vātādibhēdāttrividhasya samyaṅnijānijaikāṅgajasarvajasya||4||<br />

tasmai jagAdAgadavedasindhupravartanAdripravaro~atrijastAn| <br />
vAtAdibhedAttrividhasya samya~gnijAnijaikA~ggajasarvajasya||4||<br />
</div></div>

Sage Atreya who is like Himalaya from which flows out the Indus of the science of healing, fully expounded the subject of swellings of three types based on ''tridosha, nija'' and ''agantuja'' based on etiology and ''ekanga'' and ''sarvanga'' type according to location [4]

=== Causative factors of ''nija'' (endogenous) swelling/edema ===
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शुद्ध्यामयाभक्तकृशाबलानां क्षाराम्लतीक्ष्णोष्णगुरूपसेवा| <br />
दध्याममृच्छाकविरोधिदुष्टगरोपसृष्टान्ननिषेवणं च||५|| <br />

अर्शांस्यचेष्टा न च देहशुद्धिर्मर्मोपघातो विषमा प्रसूतिः| <br />
मिथ्योपचारः प्रतिकर्मणां च निजस्य हेतुः श्वयथोः प्रदिष्टः||६||<br />
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śuddhyāmayābhaktakr̥śābalānāṁ kṣārāmlatīkṣṇōṣṇagurūpasēvā| <br />
dadhyāmamr̥cchākavirōdhiduṣṭagarōpasr̥ṣṭānnaniṣēvaṇaṁ ca||5|| <br />

arśāṁsyacēṣṭā na ca dēhaśuddhirmarmōpaghātō viṣamā prasūtiḥ| <br />
mithyōpacāraḥ pratikarmaṇāṁ ca nijasya hētuḥ śvayathōḥ pradiṣṭaḥ||6||<br />

shuddhyAmayAbhaktakRushAbalAnAM kShArAmlatIkShNoShNagurUpasevA| <br />
dadhyAmamRucchAkavirodhiduShTagaropasRuShTAnnaniShevaNaM ca||5|| <br />

arshAMsyaceShTA na ca dehashuddhirmarmopaghAto viShamA prasUtiH| <br />
mithyopacAraH pratikarmaNAM ca nijasya hetuH shvayathoH pradiShTaH||6||<br />
</div></div>

Excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''shodhana'', fasting or disease.

Excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''shodhana'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment [5-6]

=== Causative factors of ''agantuka'' (exogenous) swelling ===
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बाह्यास्त्वचो दूषयिताऽभिघातः काष्ठाश्मशस्त्राग्निविषायसाद्यैः [१] |

आगन्तुहेतुःत्रिविधो निजश्च सर्वार्धगात्रावयवाश्रितत्वात्||७||
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bāhyāstvacō dūṣayitā'bhighātaḥ kāṣṭhāśmaśastrāgniviṣāyasādyaiḥ [1] |

āgantuhētuḥ trividhō nijaśca sarvārdhagātrāvayavāśritatvāt||7||

bAhyAstvaco dUShayitA~abhighAtaH kAShThAshmashastrAgniviShAyasAdyaiH |

AgantuhetuH trividho nijashca sarvArdhagAtrAvayavAshritatvAt||7||
</div></div>

External causative factors of swelling are trauma to skin with wood, stone, weapon, fire, poison etc.

Endogenous swelling is of three types i.e. of whole body, half body or limited to one part or organ [7]

=== Pathogenesis of swelling ===
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बाह्याः सिराः प्राप्य यदा कफासृक्पित्तानि सन्दूषयतीह वायुः| <br />
तैर्बद्धमार्गः स तदा विसर्पन्नुत्सेधलिङ्गं श्वयथुं करोति||८|| <br />

उरःस्थितैरूर्ध्वमधस्तु [१] वायोः स्थानस्थितैर्मध्यगतैस्तु मध्ये| <br />
सर्वाङ्गगः सर्वगतैः क्वचित्स्थैर्दोषैः क्वचित् स्याच्छ्वयथुस्तदाख्यः||९||<br />
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bāhyāḥ sirāḥ prāpya yadā kaphāsr̥kpittāni sandūṣayatīha vāyuḥ| <br />
tairbaddhamārgaḥ sa tadā visarpannutsēdhaliṅgaṁ śvayathuṁ karōti||8|| <br />

uraḥsthitairūrdhvamadhastu [1] vāyōḥ sthānasthitairmadhyagataistu madhyē| <br />
sarvāṅgagaḥ sarvagataiḥ kvacitsthairdōṣaiḥ kvacit syācchvayathustadākhyaḥ||9||<br />

bAhyAH sirAH prApya yadA kaphAsRukpittAni sandUShayatIha vAyuH| <br />
tairbaddhamArgaH sa tadA visarpannutsedhali~ggaM shvayathuM karoti||8||<br />

uraHsthitairUrdhvamadhastu [1] vAyoH sthAnasthitairmadhyagataistu madhye| <br />
sarvA~ggagaH sarvagataiH kvacitsthairdoShaiH kvacit syAcchvayathustadAkhyaH||9||<br />
</div></div>

Morbid ''vata'' is obstructed by vitiated ''kapha, rakta'' and ''pitta'' aggravated at the site of peripheral superficial vessels. This vitiated ''vata'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.

If the ''vata'' lodges in the chest, then it causes edema of upper parts of the body; if it lodges in its own place i.e. lower parts then it causes edema of lower parts and if it lodges in middle then it causes edema of middle parts.

If ''vata'' spreads in the entire body then it causes edema all over the body but if it lodges in one place then it causes local swelling of that part or organ. These swellings are named after the particular region that it affects [8-9]

=== Prodromal symptoms of edema ===
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ऊष्मा तथा स्याद्दवथुः सिराणामायाम इत्येव च पूर्वरूपम्|
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ūṣmā tathā syāddavathuḥ sirāṇāmāyāma ityēva ca pūrvarūpam|

UShmA tathA syAddavathuH sirANAmAyAma ityeva ca pUrvarUpam|
</div></div>

Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling [9½]

=== ''Tridoshaja'' nature of all swellings ===
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सर्वस्त्रिदोषोऽधिकदोषलिङ्गैस्तच्छब्दमभ्येति भिषग्जितं च||१०||
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sarvastridōṣō'dhikadōṣaliṅgaistacchabdamabhyēti bhiṣagjitaṁ ca||10||

sarvastridoSho~adhikadoShali~ggaistacchabdamabhyeti bhiShagjitaM ca||10||
</div></div>

All types of swelling are produced by involvement of all the three ''dosha'' but they are named based on the predominance of that particular ''dosha''. The line of treatment is also according to the dominant ''dosha'' [10]

=== General symptoms of swelling ===
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सगौरवं स्यादनवस्थितत्वं सोत्सेधमुष्माऽथ सिरातनुत्वम्| <br />
सलोमहर्षाऽङ्गविवर्णता च सामान्यलिङ्गं श्वयथोः प्रदिष्टम्||११|| <br />
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sagauravaṁ syādanavasthitatvaṁ sōtsēdhamuṣmā'tha sirātanutvam| <br />
salōmaharṣā'ṅgavivarṇatā ca sāmānyaliṅgaṁ śvayathōḥ pradiṣṭam||11||<br />

sagauravaM syAdanavasthitatvaM sotsedhamuShmA~atha sirAtanutvam| <br />
salomaharShA~a~ggavivarNatA ca sAmAnyali~ggaM shvayathoH pradiShTam||11||<br />
</div></div>

Heaviness, movability, bulging, heat, thinning of the vessels, horripilation and discoloration of the affected skin are the general signs and symptoms of edema [11]

=== Symptoms of ''vataja'' dominant edema/swelling ===
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चलस्तनुत्वक्परुषोऽरुणोऽसितः प्रसुप्तिहर्षार्तियुतोऽनिमित्ततः| <br />
प्रशाम्यति प्रोन्नमति प्रपीडितो दिवाबली च श्वयथुः समीरणात्||१२|| <br />
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calastanutvakparuṣō'ruṇō'sitaḥ prasuptiharṣārtiyutō'nimittataḥ| <br />
praśāmyati prōnnamati prapīḍitō divābalī ca śvayathuḥ samīraṇāt||12||<br />

calastanutvakparuSho~aruNo~asitaH prasuptiharShArtiyuto~animittataH| <br />
prashAmyati pronnamati prapIDito divAbalI ca shvayathuH samIraNAt||12||<br />
</div></div>

Skin of the effected part in ''vata'' dominant swelling becomes thin and rough and dry (''parusha''), dusky-brown colored with horripilation and feeling of numbness and discomfort. The swelling is moveable and pitting on pressure but it attains normal position immediately, increases during the day time and often subsides without appreciable reason [12]

=== Symptoms of ''pitta'' dominant swelling (inflammation) ===
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मृदुः सगन्धोऽसितपीतरागवान् भ्रमज्वरस्वेदतृषामदान्वितः| <br />
य उष्यते स्पर्शरुगक्षिरागकृत् [१] स पित्तशोथो भृशदाहपाकवान्||१३|| <br />
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mr̥duḥ sagandhō'sitapītarāgavān bhramajvarasvēdatr̥ṣāmadānvitaḥ| <br />
ya uṣyatē sparśarugakṣirāgakr̥t [1] sa pittaśōthō bhr̥śadāhapākavān||13||<br />

mRuduH sagandho~asitapItarAgavAn bhramajvarasvedatRuShAmadAnvitaH| <br />
ya uShyate sparsharugakShirAgakRut [1] sa pittashotho bhRushadAhapAkavAn||13||<br />
</div></div>

The ''pitta''-dominant swelling is soft, painful to touch, with specific odor and blackish, yellow or red colored skin and has tendency of turning to abscess. It is accompanied with excessive burning sensation, fever, perspiration, giddiness, thirst, redness in eyes and intoxication [13]

=== Symptoms of ''kapha''-dominant edema ===
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गुरुः स्थिरः पाण्डुररोचकान्वितः प्रसेकनिद्रावमिवह्निमान्द्यकृत्| <br />
स कृच्छ्रजन्मप्रशमो निपीडितो न चोन्नमेद्रात्रिबली कफात्मकः||१४|| <br />
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guruḥ sthiraḥ pāṇḍurarōcakānvitaḥ prasēkanidrāvamivahnimāndyakr̥t| <br />
sa kr̥cchrajanmapraśamō nipīḍitō na cōnnamēdrātribalī kaphātmakaḥ||14||<br />

guruH sthiraH pANDurarocakAnvitaH prasekanidrAvamivahnimAndyakRut| <br />
sa kRucchrajanmaprashamo nipIDito na connamedrAtribalI kaphAtmakaH||14||<br />
</div></div>

''Kapha''-dominant swelling is heavy and firm/immovable. It is associated with anemia, anorexia, low digestion, water-brash, vomiting and sleepiness. It appears and disappears very slowly and on pressing it takes long time to attain its normal position and increases at the night time [14]

=== Symptoms of bad prognostic of edema ===
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कृशस्य रोगैरबलस्य यो भवेदुपद्रवैर्वा वमिपूर्वकैर्युतः| <br />
स हन्ति मर्मानुगतोऽथ राजिमान् परिस्रवेद्धीनबलस्य सर्वगः||१५|| <br />
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kr̥śasya rōgairabalasya yō bhavēdupadravairvā vamipūrvakairyutaḥ| <br />
sa hanti marmānugatō'tha rājimān parisravēddhīnabalasya sarvagaḥ||15||<br />

kRushasya rogairabalasya yo bhavedupadravairvA vamipUrvakairyutaH| <br />
sa hanti marmAnugato~atha rAjimAn parisraveddhInabalasya sarvagaH||15||<br />
</div></div>

The edema/swelling of the patient, whose body is emaciated and weakened by a disease or is debilitated, or having complications or associated with vomiting, involving vital organs or whole body or spread with prominent vessels or in which profuse discharge oozes out, leads to death [15]

=== Symptoms of easily curable swelling ===
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अहीनमांसस्य य एकदोषजो नवो बलस्थस्य सुखः स साधने| <br />
निदानदोषर्तुविपर्ययक्रमैरुपाचरेत्तं बलदोषकालवित्||१६|| <br />
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ahīnamāṁsasya ya ēkadōṣajō navō balasthasya sukhaḥ sa sādhanē|<br />
nidānadōṣartuviparyayakramairupācarēttaṁ baladōṣakālavit||16||<br />

ahInamAMsasya ya ekadoShajo navo balasthasya sukhaH sa sAdhane|<br />
nidAnadoShartuviparyayakramairupAcarettaM baladoShakAlavit||16||<br />
</div></div>

The swelling of a patient who is neither emaciated nor weak; that involved single ''dosha'' or is of recent origin is easily curable.
The physician expert in the knowledge of strength, ''dosha'' and proper time of treatment should treat the curable patients by prescribing such measures which are opposite to cause, ''dosha'' and season [16]

=== Principles of treatment of edema/swelling ===
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अथामजं लङ्घनपाचनक्रमैर्विशोधनैरुल्बणदोषमादितः| <br />
शिरोगतं शीर्षविरेचनैरधो [४] विरेचनैरूर्ध्वहरैस्तथोर्ध्वजम्||१७|| <br />

उपाचरेत् स्नेहभवं विरूक्षणैः प्रकल्पयेत् स्नेहविधिं च रूक्षजे| <br />
विबद्धविट्केऽनिलजे निरूहणं घृतं तु पित्तानिलजे सतिक्तकम्||१८|| <br />

पयश्च मूर्च्छारतिदाहतर्षिते विशोधनीये तु समूत्रमिष्यते| <br />
कफोत्थितं क्षारकटूष्णसंयुतैः समूत्रतक्रासवयुक्तिभिर्जयेत्||१९|| <br />
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athāmajaṁ laṅghanapācanakramairviśōdhanairulbaṇadōṣamāditaḥ| <br />
śirōgataṁ śīrṣavirēcanairadhō [4] virēcanairūrdhvaharaistathōrdhvajam||17|| <br />

upācarēt snēhabhavaṁ virūkṣaṇaiḥ prakalpayēt snēhavidhiṁ ca rūkṣajē| <br />
vibaddhaviṭkē'nilajē nirūhaṇaṁ ghr̥taṁ tu pittānilajē satiktakam||18|| <br />

payaśca mūrcchāratidāhatarṣitē viśōdhanīyē tu samūtramiṣyatē| <br />
kaphōtthitaṁ kṣārakaṭūṣṇasaṁyutaiḥ samūtratakrāsavayuktibhirjayēt||19||<br />

athAmajaM la~gghanapAcanakramairvishodhanairulbaNadoShamAditaH| <br />
shirogataM shIrShavirecanairadho [4] virecanairUrdhvaharaistathordhvajam||17|| <br />

upAcaret snehabhavaM virUkShaNaiH prakalpayet snehavidhiM ca rUkShaje| <br />
vibaddhaviTke~anilaje nirUhaNaM ghRutaM tu pittAnilaje satiktakam||18|| <br />

payashca mUrcchAratidAhatarShite vishodhanIye tu samUtramiShyate| <br />
kaphotthitaM kShArakaTUShNasaMyutaiH samUtratakrAsavayuktibhirjayet||19||<br />
</div></div>

If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''langhana'') and digestive drugs and only then ''shodhana'' therapy should be undertaken according to dominant ''dosha''. General lines of treatment of ''doshaja'' swelling are as follows:

*If it involves head then ''shiro-virechana'' is prescribed;
*If it involves lower parts of the body then ''virechana'' (therapeutic purgation) is prescribed;
*If it involves upper parts of the body then ''vamana'' (therapeutic emesis)is prescribed;
*If it is caused by unctuous then ''rukshana'' (drying) therapy is done;
*If it is caused by un-unctuous (''ruksha'') then unctuous (''snehana'') therapy is done;
*If ''vata'' swelling is associated with constipation then it should be treated with ''niruha basti'';
*If it is caused by ''vata-pitta'' then it should be treated with ghee prepared with bitter drugs;
*If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;
*If the patient is suffering from swelling where ''shodhana'' is required then milk mixed with cow’s urine should be given.
*If the patient is suffering from ''kapha'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given [17-19]

=== ''Apathya'' (unwholesome) for swelling/edema ===
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ग्राम्याब्जानूपं पिशितमबलं शुष्कशाकं नवान्नं <br />
गौडं पिष्टान्नं दधि तिलकृतं [५] विज्जलं [६] मद्यमम्लम्| <br />
धाना वल्लूरं समशनमथो गुर्वसात्म्यं विदाहि <br />
स्वप्नं चारात्रौ श्वयथुगदवान् वर्जयेन्मैथुनं च||२०|| <br />
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grāmyābjānūpaṁ piśitamabalaṁ śuṣkaśākaṁ navānnaṁ <br />
gauḍaṁ piṣṭānnaṁ dadhi tilakr̥taṁ [5] vijjalaṁ [6] madyamamlam| <br />
dhānā vallūraṁ samaśanamathō gurvasātmyaṁ vidāhi <br />
svapnaṁ cārātrau śvayathugadavān varjayēnmaithunaṁ ca||20||<br />

grAmyAbjAnUpaM pishitamabalaM shuShkashAkaM navAnnaM <br />
gauDaM piShTAnnaM dadhi tilakRutaM [5] vijjalaM [6] madyamamlam| <br />
dhAnA vallUraM samashanamatho gurvasAtmyaM vidAhi <br />
svapnaM cArAtrau shvayathugadavAn varjayenmaithunaM ca||20||<br />
</div></div>

Meat of domestic, aquatic and wet-land animals or weak animals; dry vegetables, fresh grains, molasses, fine flour products, curd, products of sesame, slimy and sour food articles, wine, roasted barley, dried meat, ''samashana'' (taking of mixture of wholesome and unwholesome food), taking of unwholesome, heavy and irritant diet articles, day sleep and sexual acts should be avoided by the patient of edema/swelling [20]

=== ''Vyoshadi churna'' for ''kapha'' swelling/edema ===
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व्योषं त्रिवृत्तिक्तकरोहिणी च सायोरजस्का त्रिफलारसेन| <br />
पीतं कफोत्थं शमयेत्तु शोफं गव्येन मूत्रेण हरीतकी च||२१|| <br />
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vyōṣaṁ trivr̥ttiktakarōhiṇī ca sāyōrajaskā triphalārasēna| <br />
pītaṁ kaphōtthaṁ śamayēttu śōphaṁ gavyēna mūtrēṇa harītakī ca||21|| <br />

vyoShaM trivRuttiktakarohiNI ca sAyorajaskA triphalArasena| <br />
pItaM kaphotthaM shamayettu shophaM gavyena mUtreNa harItakI ca||21|| <br />
</div></div>

Mixture of powders of ''trikatu, trivrit, katuka'' and ''lauha-bhasma'' taken with juice of ''triphala''; or ''haritaki'' powder taken by mixing with cow’s urine relieves ''kapha'' edema/swelling [21]

=== Remedy for ''tridoshaja'' edema ===
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हरीतकीनागरदेवदारु सुखाम्बुयुक्तं सपुनर्नवं वा| <br />
सर्वं पिबेत्त्रिष्वपि मूत्रयुक्तं स्नातश्च जीर्णे पयसाऽन्नमद्यात्||२२|| <br />
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harītakīnāgaradēvadāru sukhāmbuyuktaṁ sapunarnavaṁ vā| <br />
sarvaṁ pibēttriṣvapi mūtrayuktaṁ snātaśca jīrṇē payasā'nnamadyāt||22||<br />

harItakInAgaradevadAru sukhAmbuyuktaM sapunarnavaM vA| <br />
sarvaM pibettriShvapi mUtrayuktaM snAtashca jIrNe payasA~annamadyAt||22||<br />
</div></div>

Mixture of ''haritaki'', dried ginger and ''devadaru'' taken with lukewarm water, or ''punarnava'' mixed with all the above drugs taken with cow‘s urine relieves swelling produced by all the three ''dosha''. On digestion of the drug and after taking bath, the patient should take food with milk [22]

=== Remedy for ''vata'' edema/swelling ===
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पुनर्नवानागरमुस्तकल्कान् प्रस्थेन धीरः पयसाऽक्षमात्रान्| <br />
मयूरकं मागधिकां समूलां सनागरां वा प्रपिबेत् सवाते||२३|| <br />
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punarnavānāgaramustakalkān prasthēna dhīraḥ payasā'kṣamātrān| <br />
mayūrakaṁ māgadhikāṁ samūlāṁ sanāgarāṁ vā prapibēt savātē||23|| <br />

punarnavAnAgaramustakalkAn prasthena dhIraH payasA~akShamAtrAn| <br />
mayUrakaM mAgadhikAM samUlAM sanAgarAM vA prapibet savAte||23|| <br />
</div></div>

The 500 ml of milk prepared with paste of 10 gm each ''punarnava'', dried ginger and ''mustaka''; or milk prepared with ''mayuraka, pippalimula'' and dried ginger taken orally relieves swelling due to ''vata'' [23]

=== Remedy for ''vata-pitta'' swelling/edema ===
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दन्तीत्रिवृत्त्र्यूषणचित्रकैर्वा पयः शृतं दोषहरं पिबेन्ना| <br />
द्विप्रस्थमात्रं तु पलार्धिकैस्तैरर्धावशिष्टं पवने सपित्ते||२४|| <br />
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dantītrivr̥ttryūṣaṇacitrakairvā payaḥ śr̥taṁ dōṣaharaṁ pibēnnā| <br />
dviprasthamātraṁ tu palārdhikaistairardhāvaśiṣṭaṁ pavanē sapittē||24|| <br />

dantItrivRuttryUShaNacitrakairvA payaH shRutaM doShaharaM pibennA| <br />
dviprasthamAtraM tu palArdhikaistairardhAvashiShTaM pavane sapitte||24|| <br />
</div></div>

One liter of milk prepared with 20 gm each of ''danti, trivrit, trikatu'' and ''chitraka'' added with one liter of water reduced to half, taken orally relieves edema caused by combination of ''vata'' and ''pitta'' [24]

=== General remedies for edema ===
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सशुण्ठिपीतद्रुरसं प्रयोज्यं श्यामोरुबूकोषणसाधितं वा| <br />
त्वग्दारुवर्षाभुमहौषधैर्वा गुडूचिकानागरदन्तिभिर्वा||२५|| <br />
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saśuṇṭhipītadrurasaṁ prayōjyaṁ śyāmōrubūkōṣaṇasādhitaṁ vā| <br />
tvagdāruvarṣābhumahauṣadhairvā guḍūcikānāgaradantibhirvā||25|| <br />

sashuNThipItadrurasaM prayojyaM shyAmorubUkoShaNasAdhitaM vA| <br />
tvagdAruvarShAbhumahauShadhairvA guDUcikAnAgaradantibhirvA||25|| <br />
</div></div>

Milk prepared with dry ginger and ''daruharidra'' or prepared with ''shyama'', castor root and black pepper, or prepared with cinnamon, ''devadaru, punarnava'' and dry ginger; or prepared with ''guduchi'', dry ginger and ''danti''; taken orally relieves edema [25]
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सप्ताहमौष्ट्रं त्वथवाऽपि मासं पयः पिबेद्भोजनवारिवर्जी| <br />
गव्यं समूत्रं महिषीपयो वा क्षीराशनो मूत्रमथो गवां वा||२६|| <br />
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saptāhamauṣṭraṁ tvathavā'pi māsaṁ payaḥ pibēdbhōjanavārivarjī| <br />
gavyaṁ samūtraṁ mahiṣīpayō vā kṣīrāśanō mūtramathō gavāṁ vā||26|| <br />

saptAhamauShTraM tvathavA~api mAsaM payaH pibedbhojanavArivarjI| <br />
gavyaM samUtraM mahiShIpayo vA kShIrAshano mUtramatho gavAM vA||26|| <br />
</div></div>

The patient by avoiding all other food and drinks if remains only on camel’s milk for a week or month or similarly remains on cow’s milk mixed with equal quantity of cow’s urine or on buffalo’s milk mixed with an equal quantity of cow’s urine or other milk with cow’s urine, then edema is cured [26]
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तक्रं पिबेद्वा गुरुभिन्नवर्चाः सव्योषसौवर्चलमाक्षिकं च| <br />
गुडाभयां वा गुडनागरं वा सदोषभिन्नामविबद्धवर्चाः||२७|| <br />
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takraṁ pibēdvā gurubhinnavarcāḥ savyōṣasauvarcalamākṣikaṁ ca| <br />
guḍābhayāṁ vā guḍanāgaraṁ vā sadōṣabhinnāmavibaddhavarcāḥ||27|| <br />

takraM pibedvA gurubhinnavarcAH savyoShasauvarcalamAkShikaM ca| <br />
guDAbhayAM vA guDanAgaraM vA sadoShabhinnAmavibaddhavarcAH||27|| <br />
</div></div>

Patient of edema if passes heavy (with mucous) and loose stools may drink butter milk mixed with ''trikatu, sauvarchala''-salt and honey; or if the stool is morbid, loose, with ''ama'' or hard stool, then jaggery and ''haritaki'' or jaggery with dry ginger are given [27]
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विड्वातसङ्गे पयसा रसैर्वा प्राग्भक्तमद्यादुरुबूकतैलम् [७] |

स्रोतोविबन्धेऽग्निरुचिप्रणाशे मद्यान्यरिष्टांश्च पिबेत् सुजातान्||२८||
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viḍvātasaṅgē payasā rasairvā prāgbhaktamadyādurubūkatailam [7] |

srōtōvibandhē'gnirucipraṇāśē madyānyariṣṭāṁśca pibēt sujātān||28||

viDvAtasa~gge payasA rasairvA prAgbhaktamadyAdurubUkatailam [7] |

srotovibandhe~agnirucipraNAshe madyAnyariShTAMshca pibet sujAtAn||28||
</div></div>

If there is retention of feces and flatus, the patient may be given castor oil with milk or with meat-soup before meal; and if there is occlusion of channels or loss of digestion power and appetite, then the patient may be given simple or medicated wines [28]

=== ''Gandeeradyarishta'' ===
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गण्डीरभल्लातकचित्रकांश्च व्योषं विडङ्गं बृहतीद्वयं च| <br />
द्विप्रस्थिकं गोमयपावकेन द्रोणे पचेत् कूर्चिकमस्तुनस्तु [८] ||२९|| <br />

त्रिभागशेषं च सुपूतशीतं द्रोणेन तत् प्राकृतमस्तुना च| <br />
सितोपलायाश्च शतेन युक्तं लिप्ते घटे चित्रकपिप्पलीनाम्||३०|| <br />

वैहायसे स्थापितमादशाहात् प्रयोजयंस्तद्विनिहन्ति शोफान्| <br />
भगन्दरार्शःक्रिमिकुष्ठमेहान् वैवर्ण्यकार्श्यानिलहिक्कनं च||३१|| <br />

इति गण्डीराद्यरिष्टः <br />
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gaṇḍīrabhallātakacitrakāṁśca vyōṣaṁ viḍaṅgaṁ br̥hatīdvayaṁ ca| <br />
dviprasthikaṁ gōmayapāvakēna drōṇē pacēt kūrcikamastunastu [8] ||29|| <br />

tribhāgaśēṣaṁ ca supūtaśītaṁ drōṇēna tat prākr̥tamastunā ca| <br />
sitōpalāyāśca śatēna yuktaṁ liptē ghaṭē citrakapippalīnām||30|| <br />

vaihāyasē sthāpitamādaśāhāt prayōjayaṁstadvinihanti śōphān| <br />
bhagandarārśaḥkrimikuṣṭhamēhān vaivarṇyakārśyānilahikkanaṁ ca||31|| <br />

iti gaṇḍīrādyariṣṭaḥ <br />

gaNDIrabhallAtakacitrakAMshca vyoShaM viDa~ggaM bRuhatIdvayaM ca| <br />
dviprasthikaM gomayapAvakena droNe pacet kUrcikamastunastu [8] ||29|| <br />

tribhAgasheShaM ca supUtashItaM droNena tat prAkRutamastunA ca| <br />
sitopalAyAshca shatena yuktaM lipte ghaTe citrakapippalInAm||30|| <br />

vaihAyase sthApitamAdashAhAt prayojayaMstadvinihanti shophAn| <br />
bhagandarArshaHkrimikuShThamehAn vaivarNyakArshyAnilahikkanaM ca||31|| <br />

iti gaNDIrAdyariShTaH <br />
</div></div>

Take 1.280 Kg of ''gandeera, bhallataka, chitraka, trikatu, vidnaga, kantakari'' and ''brihati'' and add 1.024 Kg of ''kurchika-mastu'' (prepared by adding hot water in curd) and boil on cow-dung fire till one-third remains and then filter. On cooling add to it 1.024 Kg natural-''mastu'' (prepared by adding water in curd), 4 kg of sugar-candy and put in a pitcher lined with paste of ''chitraka'' and ''pippali'' and leave this pot at a high-open place for 10 days for fermentation to prepare ''arishta''.

Oral administration of ''gandeeradyarishtha'' cures edema, fistula-in-ano, piles, helminthiasis, ''kushtha''(obstinate skin diseases), polyuria, discoloration, emaciation and hiccup due to ''vata''. Thus ''gandeeradyarishtha'' is described [29-31]

=== ''Ashtashato arishta'' ===
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काश्मर्यधात्रीमरिचाभयाक्षद्राक्षाफलानां [९] च सपिप्पलीनाम्| <br />
शतं शतं जीर्णगुडात्तुलां [१०] च सङ्क्षुद्य कुम्भे मधुना प्रलिप्ते||३२|| <br />

सप्ताहमुष्णे द्विगुणं तु शीते स्थितं जलद्रोणयुतं पिबेन्ना| <br />
शोफान् विबन्धान् कफवातजांश्च निहन्त्यरिष्टोऽष्टशतोऽग्निकृच्च||३३|| <br />

इत्यष्टशतोऽरिष्टः <br />
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kāśmaryadhātrīmaricābhayākṣadrākṣāphalānāṁ [9] ca sapippalīnām| <br />
śataṁ śataṁ jīrṇaguḍāttulāṁ [10] ca saṅkṣudya kumbhē madhunā praliptē||32|| <br />

saptāhamuṣṇē dviguṇaṁ tu śītē sthitaṁ jaladrōṇayutaṁ pibēnnā| <br />
śōphān vibandhān kaphavātajāṁśca nihantyariṣṭō'ṣṭaśatō'gnikr̥cca||33|| <br />

ityaṣṭaśatō'riṣṭaḥ <br />

kAshmaryadhAtrImaricAbhayAkShadrAkShAphalAnAM [9] ca sapippalInAm| <br />
shataM shataM jIrNaguDAttulAM [10] ca sa~gkShudya kumbhe madhunA pralipte||32|| <br />

saptAhamuShNe dviguNaM tu shIte sthitaM jaladroNayutaM pibennA| <br />
shophAn vibandhAn kaphavAtajAMshca nihantyariShTo~aShTashato~agnikRucca||33|| <br />

ityaShTashato~ariShTaH <br />
</div></div>

Take 100 ''pala'' each of ''kashmarya, amalaki,'' black pepper, ''haritaki, vibhitaki, pippali'' and grapes, add to it 100 ''pala'' of old jaggery and two ''drona'' of water, then put the mixture in a vessel lined with honey for 7 days in summer or for 14 days in winter for fermentation. Thus fermented ''asava'' is known as ''ashtashato-arishtha''. Its oral administration cures edema and constipation due to ''kapha'' and ''vata'' and stimulates digestion and metabolism (''agni''). Thus ''ashthato-arishta'' is described [32-33]

=== ''Punarnavadi arishta'' ===
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पुनर्नवे द्वे च बले सपाठे दन्तीं [११] गुडूचीमथ चित्रकं च| <br />
निदिग्धिकां च त्रिपलानि पक्त्वा द्रोणावशेषे सलिले ततस्तम्||३४|| <br />

पूत्वा रसं द्वे च गुडात् पुराणात्तुले मधुप्रस्थयुतं सुशीतम्| <br />
मासं निदध्याद्घृतभाजनस्थं पल्ले यवानां परतस्तु मासात्||३५|| <br />

चूर्णीकृतैरर्धपलांशिकैस्तं पत्रत्वगेलामरिचाम्बुलोहैः [१२] | <br />
गन्धान्वितं क्षौद्रघृतप्रदिग्धे जीर्णे पिबेद् व्याधिबलं समीक्ष्य||३६|| <br />

हृत्पाण्डुरोगं श्वयथुं प्रवृद्धं प्लीहज्वरारोचकमेहगुल्मान्| <br />
भगन्दरं षड्जठराणि कासं श्वासं ग्रहण्यामयकुष्ठकण्डूः||३७|| <br />

शाखानिलं बद्धपुरीषतां च हिक्कां किलासं च हलीमकं च| <br />
क्षिप्रं जयेद्वर्णबलायुरोजस्तेजोन्वितो मांसरसान्नभोजी||३८|| <br />

इति पुनर्नवाद्यरिष्टः <br />
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punarnavē dvē ca balē sapāṭhē dantīṁ [11] guḍūcīmatha citrakaṁ ca|<br />
nidigdhikāṁ ca tripalāni paktvā drōṇāvaśēṣē salilē tatastam||34|| <br />

pūtvā rasaṁ dvē ca guḍāt purāṇāttulē madhuprasthayutaṁ suśītam| <br />
māsaṁ nidadhyādghr̥tabhājanasthaṁ pallē yavānāṁ paratastu māsāt||35||<br />

cūrṇīkr̥tairardhapalāṁśikaistaṁ patratvagēlāmaricāmbulōhaiḥ [12] | <br />
gandhānvitaṁ kṣaudraghr̥tapradigdhē jīrṇē pibēd vyādhibalaṁ samīkṣya||36|| <br />

hr̥tpāṇḍurōgaṁ śvayathuṁ pravr̥ddhaṁ plīhajvarārōcakamēhagulmān| <br />
bhagandaraṁ ṣaḍjaṭharāṇi kāsaṁ śvāsaṁ grahaṇyāmayakuṣṭhakaṇḍūḥ||37|| <br />

śākhānilaṁ baddhapurīṣatāṁ ca hikkāṁ kilāsaṁ ca halīmakaṁ ca| <br />
kṣipraṁ jayēdvarṇabalāyurōjastējōnvitō māṁsarasānnabhōjī||38|| <br />

iti punarnavādyariṣṭaḥ <br />

punarnave dve ca bale sapAThe dantIM [11] guDUcImatha citrakaM ca| <br />
nidigdhikAM ca tripalAni paktvA droNAvasheShe salile tatastam||34||<br />

pUtvA rasaM dve ca guDAt purANAttule madhuprasthayutaM sushItam| <br />
mAsaM nidadhyAdghRutabhAjanasthaM palle yavAnAM paratastu mAsAt||35|| <br />

cUrNIkRutairardhapalAMshikaistaM patratvagelAmaricAmbulohaiH [12] | <br />
gandhAnvitaM kShaudraghRutapradigdhe jIrNe pibed vyAdhibalaM samIkShya ||36|| <br />

hRutpANDurogaM shvayathuM pravRuddhaM plIhajvarArocakamehagulmAn| <br />
bhagandaraM ShaDjaTharANi kAsaM shvAsaM grahaNyAmayakuShThakaNDUH ||37|| <br />

shAkhAnilaM baddhapurIShatAM ca hikkAM kilAsaM ca halImakaM ca| <br />
kShipraM jayedvarNabalAyurojastejonvito mAMsarasAnnabhojI||38||<br />

iti punarnavAdyariShTaH <br />
</div></div>

Make a decoction of 120 gm each of two types of ''punarnavā, balā, pāṭhā, dantī, guḍūchī, chitraka, kantakāri'' and ''triphalā'' by adding water (about 4.1 liters) and reducing it to 1.024 liter. Add to this decoction 8 kg of jaggery and 640 gm of honey and keep it in a vessel lined with ghee and place it in a heap of barley for a month. Thereafter to make it fragrant, add 20 gm powders each of ''tejapatra'', cinnamon, cardamom, black pepper, couscous and iron ''bhasma'' and store in a pot lined with honey and ghee. It is to be taken after the digestion of the meal in a dose according to the strength of the disease. In diet, food with meat soup may be given.

It provides quick cure in heart disease, anemia, severe edema, splenic disorders, fever, anorexia, polyuria, ''gulma'', fistula-in-ano, six types of ''udararoga'', cough, dyspnea, assimilation disorders (''grahani''), dermatosis (''kushtha''), pruritis, ''vata'' disorders of limbs, constipation, hiccup, leukoderma and ''halimaka'' (greenish coloration of skin). It also improves complexion, strength, oja and vitality. Thus ''punarnavadi arishta'' is described [34-38]

=== ''Triphaladyarishta'' ===
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फलत्रिकं दीप्यकचित्रकौ च सपिप्पलीलोहरजो विडङ्गम्| <br />
चूर्णीकृतं कौडविकं द्विरंशं क्षौद्रं पुराणस्य तुलां गुडस्य||३९|| <br />

मासं निदध्याद्घृतभाजनस्थं यवेषु तानेव निहन्ति रोगान्| <br />
ये चार्शसां पाण्डुविकारिणां च प्रोक्ता हिताः शोफिषु तेऽप्यरिष्टाः||४०|| <br />

इति त्रिफलाद्यरिष्टः <br />
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phalatrikaṁ dīpyakacitrakau ca sapippalīlōharajō viḍaṅgam| <br />
cūrṇīkr̥taṁ kauḍavikaṁ dviraṁśaṁ kṣaudraṁ purāṇasya tulāṁ guḍasya||39|| <br />

māsaṁ nidadhyādghr̥tabhājanasthaṁ yavēṣu tānēva nihanti rōgān| <br />
yē cārśasāṁ pāṇḍuvikāriṇāṁ ca prōktā hitāḥ śōphiṣu tē'pyariṣṭāḥ||40|| <br />

iti triphalādyariṣṭaḥ <br />

phalatrikaM dIpyakacitrakau ca sapippalIloharajo viDa~ggam| <br />
cUrNIkRutaM kauDavikaM dviraMshaM kShaudraM purANasya tulAM guDasya||39|| <br />

mAsaM nidadhyAdghRutabhAjanasthaM yaveShu tAneva nihanti rogAn| <br />
ye cArshasAM pANDuvikAriNAM ca proktA hitAH shophiShu te~apyariShTAH||40|| <br />

iti triphalAdyariShTaH <br />
</div></div>

Make decoction from the coarse powder of 160 gm each of ''triphala, ajawan, chitraka, pippali,'' iron bhasma and ''vidanga''. To this decoction add 320 ml of honey and 4 kg of jaggery and put it in a vessel lined with ghee and place in a heap of barley for a month. Its oral administration cures all the diseases mentioned above. Thus ''triphaladyarishtha'' is described.

The ''asava'' and ''arishtha'' mentioned for the treatment of piles and anemia are also beneficial for relieving the edema [39-40]

=== Powder preparations for edema ===
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कृष्णा सपाठा गजपिप्पली च निदिग्धिका चित्रकनागरे च| <br />
सपिप्पलीमूलरजन्यजाजीमुस्तं च चूर्णं सुखतोयपीतम्||४१|| <br />

हन्यात्त्रिदोषं चिरजं च शोफं कल्कश्च भूनिम्बमहौषधस्य| <br />
अयोरजस्त्र्यूषणयावशूकचूर्णं च पीतं त्रिफलारसेन||४२|| <br />
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kr̥ṣṇā sapāṭhā gajapippalī ca nidigdhikā citrakanāgarē ca| <br />
sapippalīmūlarajanyajājīmustaṁ ca cūrṇaṁ sukhatōyapītam||41|| <br />

hanyāttridōṣaṁ cirajaṁ ca śōphaṁ kalkaśca bhūnimbamahauṣadhasya| <br />
ayōrajastryūṣaṇayāvaśūkacūrṇaṁ ca pītaṁ triphalārasēna||42||<br />

kRuShNA sapAThA gajapippalI ca nidigdhikA citrakanAgare ca| <br />
sapippalImUlarajanyajAjImustaM ca cUrNaM sukhatoyapItam||41|| <br />

hanyAttridoShaM cirajaM ca shophaM kalkashca bhUnimbamahauShadhasya| <br />
ayorajastryUShaNayAvashUkacUrNaM ca pItaM triphalArasena||42||<br />
</div></div>

Use of any one of the following powder preparations cures chronic edema caused by all the three ''dosha'':

The mixture of the powders of ''pippali, pippalimula, pāthā, gajapippali,'' cumin, ''kantakāri, chitraka,'' dried ginger, turmeric, cumin and ''mustaka'' taken with lukewarm water, or paste of ''bhumyāmalaki'' and dried ginger taken with lukewarm water or
''bhasma'' of iron, ''trikatu'' and ''yavakshara'' taken with decoction of ''triphala'' [41-42]

=== ''Ksharagudika'' ===
<div class="mw-collapsible mw-collapsed">

क्षारद्वयं स्याल्लवणानि चत्वार्ययोरजो व्योषफलत्रिके च| <br />
सपिप्पलीमूलविडङ्गसारं मुस्ताजमोदामरदारुबिल्वम्||४३|| <br />

कलिङ्गकाश्चित्रकमूलपाठे यष्ट्याह्वयं सातिविषं पलांशम्| <br />
सहिङ्गुकर्षं त्वणुशुष्कचूर्णं द्रोणं तथा मूलकशुण्ठकानाम्||४४|| <br />

स्याद्भस्मनस्तत् सलिलेन साध्यमालोड्य यावद्घनमप्रदग्धम्| <br />
स्त्यानं ततः कोलसमां तु मात्रां कृत्वा सुशुष्कां विधिनोपयुञ्ज्यात्||४५|| <br />

प्लीहोदरश्वित्रहलीमकार्शःपाण्ड्वामयारोचकशोषशोफान्| <br />
विसूचिकागुल्मगराश्मरीश्च सश्वासकासाः प्रणुदेत् सकुष्ठाः||४६|| <br />

इति क्षारगुडिका <br />
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kṣāradvayaṁ syāllavaṇāni catvāryayōrajō vyōṣaphalatrikē ca| <br />
sapippalīmūlaviḍaṅgasāraṁ mustājamōdāmaradārubilvam||43|| <br />

kaliṅgakāścitrakamūlapāṭhē yaṣṭyāhvayaṁ sātiviṣaṁ palāṁśam| <br />
sahiṅgukarṣaṁ tvaṇuśuṣkacūrṇaṁ drōṇaṁ tathā mūlakaśuṇṭhakānām||44|| <br />

syādbhasmanastat salilēna sādhyamālōḍya yāvadghanamapradagdham| <br />
styānaṁ tataḥ kōlasamāṁ tu mātrāṁ kr̥tvā suśuṣkāṁ vidhinōpayuñjyāt||45||<br />

plīhōdaraśvitrahalīmakārśaḥpāṇḍvāmayārōcakaśōṣaśōphān| <br />
visūcikāgulmagarāśmarīśca saśvāsakāsāḥ praṇudēt sakuṣṭhāḥ||46|| <br />

iti kṣāraguḍikā || <br />

kShAradvayaM syAllavaNAni catvAryayorajo vyoShaphalatrike ca| <br />
sapippalImUlaviDa~ggasAraM mustAjamodAmaradArubilvam||43|| <br />

kali~ggakAshcitrakamUlapAThe yaShTyAhvayaM sAtiviShaM palAMsham| <br />
sahi~ggukarShaM tvaNushuShkacUrNaM droNaM tathA mUlakashuNThakAnAm||44|| <br />

syAdbhasmanastat salilena sAdhyamAloDya yAvadghanamapradagdham| <br />
styAnaM tataH kolasamAM tu mAtrAM kRutvA sushuShkAM vidhinopayu~jjyAt||45|| <br />

plIhodarashvitrahalImakArshaHpANDvAmayArocakashoShashophAn| <br />
visUcikAgulmagarAshmarIshca sashvAsakAsAH praNudet sakuShThAH||46|| <br />

iti kShAraguDikA <br />
</div></div>

Take 40 gm fine powder each of ''svarajjikā'' and ''yava-kshara'', four varieties of salt, iron ''bhasma, trikatu, triphala, pippalimula,'' pealed seeds of ''vidanga, mustaka, ajamodā, devadāru, bilva, indrayava,'' root of ''chitraka, pāthā, ativishā'' and liquorice; 10 gm of asafetida and 1.024 Kg of dried radish and dried ginger. Add water to it and heat the mixture till it becomes thick taking care that it should not seared and from it make pills of 5 gm each and dry them.

Properly administered pills cure splenomegaly, leukoderma, ''halimaka'' (greenish coloration of the skin), piles, anemia, anorexia, emaciation, edema, gastroenteritis, ''gulma'', synthetic poisoning, lithiasis, dyspnea, cough and dermatosis. Thus ''ksharagudika'' is described [43-46]

=== Course of ''gud-adraka'' ===
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प्रयोजयेदार्द्रकनागरं वा तुल्यं गुडेनार्धपलाभिवृद्ध्या| <br />
मात्रा परं पञ्चपलानि मासं जीर्णे पयो यूषरसाश्च भक्तम्||४७||<br />

गुल्मोदरार्शःश्वयथुप्रमेहाञ् श्वासप्रतिश्यालसकाविपाकान्| <br />
सकामलाशोषमनोविकारान् कासं कफं चैव जयेत् प्रयोगः||४८|| <br />
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prayōjayēdārdrakanāgaraṁ vā tulyaṁ guḍēnārdhapalābhivr̥ddhyā| <br />
mātrā paraṁ pañcapalāni māsaṁ jīrṇē payō yūṣarasāśca bhaktam||47|| <br />

gulmōdarārśaḥśvayathupramēhāñ śvāsapratiśyālasakāvipākān| <br />
sakāmalāśōṣamanōvikārān kāsaṁ kaphaṁ caiva jayēt prayōgaḥ||48||<br />

prayojayedArdrakanAgaraM vA tulyaM guDenArdhapalAbhivRuddhyA| <br />
mAtrA paraM pa~jcapalAni mAsaM jIrNe payo yUSharasAshca bhaktam||47|| <br />

gulmodarArshaHshvayathupramehA~j shvAsapratishyAlasakAvipAkAn| <br />
sakAmalAshoShamanovikArAn kAsaM kaphaM caiva jayet prayogaH||48||<br />
</div></div>

Mix equal quantity of jaggery and ginger and take it in 20 gm dose initially and then increase its dose by 20 gm daily till the dose becomes 200 gm per day. Then this dose is to be continued for the remaining days of the month. During this treatment, on digestion of the drug, rice gruel and milk or meat soup should be given to eat.

The one month course cures ''gulma, udararoga,'' piles, edema, polyuria, dyspnea, coryza, cough, ''alasaka,'' indigestion, jaundice, consumption, mental disorders and kapha disorders [47-48]

=== Course of ''shilajatu'' ===
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रसस्तथैवार्द्रकनागरस्य पेयोऽथ जीर्णे पयसाऽन्नमद्यात्| <br />
जत्वश्मजं [१३] च त्रिफलारसेन हन्यात्त्रिदोषं श्वयथुं प्रसह्य||४९|| <br />

इति शिलाजतुप्रयोगः <br />
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rasastathaivārdrakanāgarasya pēyō'tha jīrṇē payasā'nnamadyāt| <br />
jatvaśmajaṁ [13] ca triphalārasēna hanyāttridōṣaṁ śvayathuṁ prasahya||49|| <br />

iti śilājatuprayōgaḥ <br />

rasastathaivArdrakanAgarasya peyo~atha jIrNe payasA~annamadyAt| <br />
jatvashmajaM [13] ca triphalArasena hanyAttridoShaM shvayathuM prasahya||49|| <br />

iti shilAjatuprayogaH <br />
</div></div>

Similarly juice of ginger may be taken with ''shilajatu'' for one month in the doses and manner mentioned above. On getting the hunger food should be taken with milk.

A month’s course of ''shilājatu'' with juice of ''triphalā'' will completely cure the edema/swelling caused by all the three ''dosha''. Thus course of ''shilājatu'' is described [49]

=== ''Kamsa haritaki'' ===
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द्विपञ्चमूलस्य पचेत् कषाये कंसेऽभयानां च शतं गुडस्य| <br />
लेहे सुसिद्धेऽथ विनीय चूर्णं व्योषं त्रिसौगन्ध्यमुषास्थिते च||५०|| <br />

प्रस्थार्धमात्रं मधुनः सुशीते किञ्चिच्च चूर्णादपि यावशूकात्| <br />
एकाभयां प्राश्य ततश्च लेहाच्छुक्तिं निहन्ति श्वयथुं प्रवृद्धम्||५१|| <br />

श्वासज्वरारोचकमेहगुल्मप्लीहत्रिदोषोदरपाण्डुरोगान्| <br />
कार्श्यामवातावसृगम्लपित्तवैवर्ण्यमूत्रानिलशुक्रदोषान्||५२|| <br />

इति कंसहरीतकी <br />
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dvipañcamūlasya pacēt kaṣāyē kaṁsē'bhayānāṁ ca śataṁ guḍasya| <br />
lēhē susiddhē'tha vinīya cūrṇaṁ vyōṣaṁ trisaugandhyamuṣāsthitē ca||50|| <br />

prasthārdhamātraṁ madhunaḥ suśītē kiñcicca cūrṇādapi yāvaśūkāt| <br />
ēkābhayāṁ prāśya tataśca lēhācchuktiṁ nihanti śvayathuṁ pravr̥ddham||51|| <br />

śvāsajvarārōcakamēhagulmaplīhatridōṣōdarapāṇḍurōgān| <br />
kārśyāmavātāvasr̥gamlapittavaivarṇyamūtrānilaśukradōṣān||52|| <br />

iti kaṁsaharītakī <br />

dvipa~jcamUlasya pacet kaShAye kaMse~abhayAnAM ca shataM guDasya| <br />
lehe susiddhe~atha vinIya cUrNaM vyoShaM trisaugandhyamuShAsthite ca||50|| <br />

prasthArdhamAtraM madhunaH sushIte ki~jcicca cUrNAdapi yAvashUkAt| <br />
ekAbhayAM prAshya tatashca lehAcchuktiM nihanti shvayathuM pravRuddham||51|| <br />

shvAsajvarArocakamehagulmaplIhatridoShodarapANDurogAn| <br />
kArshyAmavAtAvasRugamlapittavaivarNyamUtrAnilashukradoShAn||52|| <br />

iti kaMsaharItakI <br />
</div></div>

Make 2.56 liter decoction of ''dashamula'' and add to it ''haritaki'' 100 in number and 4.0 kg of jaggery and powder of ''trikatu'' and ''trijata'' (three aromatics- leaves and bark of cinnamon and cardamom). Leave it overnight and next morning on cooling adds 320 gm of honey and little quantity of ''yavakshara''.

Take it in the dose of 10 gm along with one ''haritaki''. It will cure severe edema and also dyspnea, fever, anorexia, polyuria, ''gulma'', splenic-disorders, ''sannipātika-udararoga,'' anemia, emaciation, rheumatoid arthritis, bleeding disorders, hyperchlorhydria, discoloration of skin and ''vāta'' disorders of urine and semen. Thus ''kaṁsaharītakī'' is described [50-52]

=== Patoladi kashaya ===
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पटोलमूलामरदारुदन्तीत्रायन्तिपिप्पल्यभयाविशालाः| <br />
यष्ट्याह्वयं तिक्तकरोहिणी च सचन्दना स्यान्निचुलानि दार्वी||५३|| <br />

कर्षोन्मितैस्तैः क्वथितः कषायो घृतेन पेयः कुडवेन युक्तः| <br />
वीसर्पदाहज्वरसन्निपाततृष्णाविषाणि श्वयथुं च हन्ति||५४|| <br />
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paṭōlamūlāmaradārudantītrāyantipippalyabhayāviśālāḥ| <br />
yaṣṭyāhvayaṁ tiktakarōhiṇī ca sacandanā syānniculāni dārvī||53|| <br />

karṣōnmitaistaiḥ kvathitaḥ kaṣāyō ghr̥tēna pēyaḥ kuḍavēna yuktaḥ| <br />
vīsarpadāhajvarasannipātatr̥ṣṇāviṣāṇi śvayathuṁ ca hanti||54||<br />

paTolamUlAmaradArudantItrAyantipippalyabhayAvishAlAH| <br />
yaShTyAhvayaM tiktakarohiNI ca sacandanA syAnniculAni dArvI||53|| <br />

karShonmitaistaiH kvathitaH kaShAyo ghRutena peyaH kuDavena yuktaH| <br />
vIsarpadAhajvarasannipAtatRuShNAviShANi shvayathuM ca hanti||54||<br />
</div></div>

Make decoction of 10 gm each of roots of ''patola, devadāru, danti, trāyamānā, pippali, haritaki, indrāyana,'' liquorices, sandal wood, ''katukā, dāruhridrā'' and ''samudraphala''. This decoction should be taken with 160 gm of ghee. It cures ''visarpa'' (erysipelas), burning sensation, fever, ''sannipāta'' thirst, poisoning and edema [53-54]

=== ''Chitraka ghrita'' ===
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सचित्रकं [१४] धान्ययवान्यजाजीसौवर्चलं त्र्यूषणवेतसाम्लम्| <br />
बिल्वात् फलं दाडिमयावशूकौ सपिप्पलीमूलमथापि चव्यम्||५५|| <br />

पिष्ट्वाऽक्षमात्राणि जलाढकेन पक्त्वा घृतप्रस्थमथ प्रयुञ्ज्यात्| <br />
अर्शांसि गुल्मं श्वयथुं कृच्छ्रं निहन्ति वह्निं च करोति दीप्तम्||५६|| <br />
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sacitrakaṁ [14] dhānyayavānyajājīsauvarcalaṁ tryūṣaṇavētasāmlam| <br />
b0ilvāt phalaṁ dāḍimayāvaśūkau sapippalīmūlamathāpi cavyam||55|| <br />

piṣṭvā'kṣamātrāṇi jalāḍhakēna paktvā ghr̥taprasthamatha prayuñjyāt| <br />
arśāṁsi gulmaṁ śvayathuṁ ca kr̥cchraṁ nihanti vahniṁ ca karōti dīptam||56|| <br />

sacitrakaM [14] dhAnyayavAnyajAjIsauvarcalaM tryUShaNavetasAmlam| <br />
bilvAt phalaM dADimayAvashUkau sapippalImUlamathApi cavyam||55|| <br />

piShTvA~akShamAtrANi jalADhakena paktvA ghRutaprasthamatha prayu~jjyAt|<br />
arshAMsi gulmaM shvayathuM ca kRucchraM nihanti vahniM ca karoti dIptam||56||<br />
</div></div>

Make paste of 10 gm each of ''chitraka,'' coriander, ajawan, cumin, ''sauvarchala''-salt, ''trikatu, amlavetasa, bilva,'' pomegranate, ''yavakṣāra, pippalimula'' and ''chavya''; add to it 640 gm of ghee and 2.56 liter of water. Prepare ''ghrita'' as per ''sneha pāka'' method.

Oral administration of ''chitraka'' ghee cures edema/swelling even if it is difficult to cure as well as piles and ''gulma'' and stimulate the digestion and metabolism (''agni''). [55-56]
<div class="mw-collapsible mw-collapsed">

पिबेद्घृतं वाऽष्टगुणाम्बुसिद्धं सचित्रकक्षारमुदारवीर्यम्| <br />
कल्याणकं वाऽपि सपञ्चगव्यं तिक्तं महद्वाऽप्यथ तिक्तकं वा||५७|| <br />
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pibēdghr̥taṁ vā'ṣṭaguṇāmbusiddhaṁ sacitrakakṣāramudāravīryam| <br />
kalyāṇakaṁ vā'pi sapañcagavyaṁ tiktaṁ mahadvā'pyatha tiktakaṁ vā||57||<br />

pibedghRutaM vA~aShTaguNAmbusiddhaM sacitrakakShAramudAravIryam| <br />
kalyANakaM vA~api sapa~jcagavyaM tiktaM mahadvA~apyatha tiktakaM vA||57||<br />
</div></div>

Prepare a ''ghrita'' with eight times of water with paste of ''chitraka'' and ''yavakshara''. It has great potency. The patient may also take the ''kalyānaka ghrita'' or ''panchagavya ghrita'' or ''mahātikta ghrita'' or ''tikta ghrita'' [57]
<div class="mw-collapsible mw-collapsed">

क्षीरं घटे चित्रककल्कलिप्ते दध्यागतं साधु विमथ्य तेन| <br />
तज्जं घृतं चित्रकमूलगर्भं तक्रेण सिद्धं श्वयथुघ्नमग्र्यम्||५८|| <br />

अर्शोऽतिसारानिलगुल्ममेहांश्चैतन्निहन्त्यग्निबलप्रदं [१५] च| <br />
तक्रेण चाद्यात् सघृतेन तेन भोज्यानि सिद्धामथवा यवागूम्||५९|| <br />

इति चित्रकघृतम् <br />
<div class="mw-collapsible-content">

kṣīraṁ ghaṭē citrakakalkaliptē dadhyāgataṁ sādhu vimathya tēna| <br />
tajjaṁ ghr̥taṁ citrakamūlagarbhaṁ takrēṇa siddhaṁ śvayathughnamagryam||58|| <br />

arśō'tisārānilagulmamēhāṁścaitannihantyagnibalapradaṁ [15] ca| <br />
takrēṇa cādyāt saghr̥tēna tēna bhōjyāni siddhāmathavā yavāgūm||59|| <br />

iti citrakaghr̥tam <br />

kShIraM ghaTe citrakakalkalipte dadhyAgataM sAdhu vimathya tena| <br />
tajjaM ghRutaM citrakamUlagarbhaM takreNa siddhaM shvayathughnamagryam||58|| <br />

arsho~atisArAnilagulmamehAMshcaitannihantyagnibalapradaM [15] ca| <br />
takreNa cAdyAt saghRutena tena bhojyAni siddhAmathavA yavAgUm||59|| <br />

iti citrakaghRutam <br />
</div></div>

Put milk in a pot coated with paste of ''chitraka'' and curdle it. Churn this curd well to get butter which is heated to ghee. Add to the ghee all the buttermilk (which contains mixed ''chitraka'' also) from the pot and prepare the medicated ''ghrita''. It is best to cure edema. It also provides relief in piles, diarrhea, ''vāta-gulma'', polyuria and stimulates digestion and metabolism (''agni'').

During the treatment the diet should be taken with buttermilk prepared as above with ''chitraka'' along with ghee prepared from the above butter or gruels prepared with this butter milk and ghee. Thus ''chitraka ghrita'' is described [58-59]

=== Yavagu preparations ===
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जीवन्त्यजाजीशटिपुष्कराह्वैः सकारवीचित्रकबिल्वमध्यैः| <br />
सयावशूकैर्बदरप्रमाणैर्वृक्षाम्लयुक्ता घृततैलभृष्टा||६०|| <br />

अर्शोऽतिसारानिलगुल्मशोफहृद्रोगमन्दाग्निहिता यवागूः| <br />
या पञ्चकोलैर्विधिनैव [१६] तेन सिद्धा भवेत् सा च समा तयैव||६१|| <br />
<div class="mw-collapsible-content">

jīvantyajājīśaṭipuṣkarāhvaiḥ sakāravīcitrakabilvamadhyaiḥ| <br />
sayāvaśūkairbadarapramāṇairvr̥kṣāmlayuktā ghr̥tatailabhr̥ṣṭā||60|| <br />

arśō'tisārānilagulmaśōphahr̥drōgamandāgnihitā yavāgūḥ| <br />
yā pañcakōlairvidhinaiva [16] tēna siddhā bhavēt sā ca samā tayaiva||61|| <br />

jIvantyajAjIshaTipuShkarAhvaiH sakAravIcitrakabilvamadhyaiH| <br />
sayAvashUkairbadarapramANairvRukShAmlayuktA ghRutatailabhRuShTA||60|| <br />

arsho~atisArAnilagulmashophahRudrogamandAgnihitA yavAgUH| <br />
yA pa~jcakolairvidhinaiva [16] tena siddhA bhavet sA ca samA tayaiva||61|| <br />
</div></div>

Take 5 gm each of ''jivanti,'' cumin, ''saṭi, pushkarmula, karvi'' (celery), ''chitraka, bilva'' and ''yavakashara,'' make a medicated gruel (''yavāgu'') and then fry it in ghee and oil. This gruel taken by adding ''vrikshamla'' cures piles, diarrhea, ''vāta gulma'', edema, heart disease and low digestion.

The medicated ''yavāgu'' (gruel) similarly prepared with ''panchakola'' also gives the same relief as mentioned above (60-61).

=== ''Pathya'' (wholesome food) for ''shotha'' ===
<div class="mw-collapsible mw-collapsed">

कुलत्थयूषश्च सपिप्पलीको मौद्गश्च सत्र्यूषणयावशूकः| <br />
रसस्तथा विष्किरजाङ्गलानां सकूर्मगोधाशिखिशल्लकानाम्||६२|| <br />

सुवर्चला गृञ्जनकं पटोलं सवायसीमूलकवेत्रनिम्बम्| <br />
शाकार्थिनां शाकमिति प्रशस्तं भोज्ये पुराणश्च यवः सशालिः||६३|| <br />
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kulatthayūṣaśca sapippalīkō maudgaśca satryūṣaṇayāvaśūkaḥ| <br />
rasastathā viṣkirajāṅgalānāṁ sakūrmagōdhāśikhiśallakānām||62|| <br />

suvarcalā gr̥ñjanakaṁ paṭōlaṁ savāyasīmūlakavētranimbam| <br />
śākārthināṁ śākamiti praśastaṁ bhōjyē purāṇaśca yavaḥ saśāliḥ||63||<br />

kulatthayUShashca sapippalIko maudgashca satryUShaNayAvashUkaH| <br />
rasastathA viShkirajA~ggalAnAM sakUrmagodhAshikhishallakAnAm||62|| <br />

suvarcalA gRu~jjanakaM paTolaM savAyasImUlakavetranimbam| <br />
shAkArthinAM shAkamiti prashastaM bhojye purANashca yavaH sashAliH||63||<br />
</div></div>

Followings diet articles are wholesome for the patient of edema/swelling:
*Soup of ''kulattha'' mixed with long piper
*Soup of ''munga'' mixed with ''trikatu'' and ''yavakshara''
*Meat soup of gallinaceous and wild creatures,
*Meat soup of tortoise, iguana, peacock and pangolin,
*Vegetables such as heliotrope, turnip, ''makoya'' (wild snake gourd), radish, ''vetra, neem'' and ''patola''
*Old ''shali rice'' and old barley [62-63]

=== External applications ===
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आभ्यन्तरं भेषजमुक्तमेतद्बर्हिर्हितं यच्छृणु तद्यथावत्| <br />
स्नेहान् प्रदेहान् परिषेचनानि स्वेदांश्च वातप्रबलस्य कुर्यात्||६४|| <br />
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ābhyantaraṁ bhēṣajamuktamētadbarhirhitaṁ yacchr̥ṇu tadyathāvat| <br />
snēhān pradēhān pariṣēcanāni svēdāṁśca vātaprabalasya kuryāt||64|| <br />

AbhyantaraM bheShajamuktametadbarhirhitaM yacchRuNu tadyathAvat| <br />
snehAn pradehAn pariShecanAni svedAMshca vAtaprabalasya kuryAt||64|| <br />
</div></div>

Thus internal preparations have been described. Now external preparations beneficial for the patient of swelling will be described. ''Snehana, swedana,'' smearing with pastes and effusions should be done in a patient having dominance of ''vata'' swelling [64]

=== ''Shaileyadi taila'' ===
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शैलेयकुष्ठागुरुदारुकौन्तीत्वक्पद्मकैलाम्बुपलाशमुस्तैः| <br />
प्रियङ्गुथौणेयकहेममांसीतालीशपत्रप्लवपत्रधान्यैः||६५|| <br />

श्रीवेष्टकध्यामकपिप्पलीभिः स्पृक्कानखैश्चैव यथोपलाभम्| <br />
वातान्वितेऽभ्यङ्गमुशन्ति तैलं सिद्धं सुपिष्टैरपि च प्रदेहम्||६६|| <br />
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śailēyakuṣṭhāgurudārukauntītvakpadmakailāmbupalāśamustaiḥ| <br />
priyaṅguthauṇēyakahēmamāṁsītālīśapatraplavapatradhānyaiḥ||65|| <br />

śrīvēṣṭakadhyāmakapippalībhiḥ spr̥kkānakhaiścaiva yathōpalābham| <br />
vātānvitē'bhyaṅgamuśanti tailaṁ siddhaṁ supiṣṭairapi ca pradēham||66|| <br />

shaileyakuShThAgurudArukauntItvakpadmakailAmbupalAshamustaiH| <br />
priya~gguthauNeyakahemamAMsItAlIshapatraplavapatradhAnyaiH||65|| <br />

shrIveShTakadhyAmakapippalIbhiH spRukkAnakhaishcaiva yathopalAbham| <br />
vAtAnvite~abhya~ggamushanti tailaM siddhaM supiShTairapi ca pradeham||66||<br />
</div></div>

Take ''kuṣṭha, aguru, devadāru, kaunti,'' cinnamon, ''padmaka,'' cardamom, ''sugandhabālā, palāśa, mustaka, priyangu, thauneyaka, nāgakeśara, jatāmāmsi, tālisapatra, plava, tejapatra,'' coriander, ''sriveshtaka, dhyāmaka,'' piper longum, ''sprikkā'' and ''nakha''. Make paste of all or as much as drugs available and prepare medicated oil from it. In ''vāta'' edema, do massage with this oil. Alternatively make paste of the entire drugs and apply on the body of the patient as smear [65-66]

=== Medicated water for bath ===
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जलैश्च वासार्ककरञ्जशिग्रुकाश्मर्यपत्रार्जकजैश्च सिद्धैः| <br />
स्विन्नो मृदूष्णै रवितप्ततोयैः स्नातश्च गन्धैरनुलेपनीयः||६७|| <br />
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jalaiśca vāsārkakarañjaśigrukāśmaryapatrārjakajaiśca siddhaiḥ| <br />
svinnō mr̥dūṣṇai ravitaptatōyaiḥ snātaśca gandhairanulēpanīyaḥ||67||<br />

jalaishca vAsArkakara~jjashigrukAshmaryapatrArjakajaishca [17] siddhaiH| <br />
svinno mRudUShNai [18] ravitaptatoyaiH snAtashca gandhairanulepanIyaH||67||<br />
</div></div>

Add leaves of ''vāsā, arka, karanja, sigru, kashmarya'' and holy basil in hot water and take sudation with this tolerably hot water. Then the patient should take bath with water heated in sun and apply aromatics on the body [67]

=== External application in ''pitta'' dominance ===
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सवेतसाः क्षीरवतां द्रुमाणां त्वचः समञ्जिष्ठलतामृणालाः| <br />
सचन्दनाः पद्मकवालकौ च पैत्ते प्रदेहस्तु सतैलपाकः||६८|| <br />

आक्तस्य तेनाम्बु रविप्रतप्तं सचन्दनं साभयपद्मकं च| <br />
स्नाने हितं क्षीरवतां कषायः क्षीरोदकं चन्दनलेपनं च||६९|| <br />
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savētasāḥ kṣīravatāṁ drumāṇāṁ tvacaḥ samañjiṣṭhalatāmr̥ṇālāḥ| <br />
sacandanāḥ padmakavālakau ca paittē pradēhastu satailapākaḥ||68|| <br />

āktasya tēnāmbu raviprataptaṁ sacandanaṁ sābhayapadmakaṁ ca| <br />
snānē hitaṁ kṣīravatāṁ kaṣāyaḥ kṣīrōdakaṁ candanalēpanaṁ ca||69||<br />

savetasAH kShIravatAM drumANAM tvacaH sama~jjiShThalatAmRuNAlAH| <br />
sacandanAH padmakavAlakau ca paitte pradehastu satailapAkaH||68|| <br />

Aktasya tenAmbu raviprataptaM sacandanaM sAbhayapadmakaM ca| <br />
snAne hitaM kShIravatAM kaShAyaH kShIrodakaM candanalepanaM ca||69||<br />
</div></div>

Prepare medicated oil from ''vetasa, manjiṣhthā, mrināla,'' sandal, ''padmaka'' and ''khasha'' and bark of latex-exuding plants. Apply this oil on the body to relieve ''pitta'' swelling. Thereafter, bathing with medicated water prepared with sandal, ''khaśa'' and ''padmaka'' and heated by sun rays or with water prepared with latex-exuding plants or water mixed with milk is beneficial. Smearing with paste of sandalwood is also beneficial [68-69]

=== External application in ''kapha'' dominance ===
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कफे तु कृष्णासिकतापुराणपिण्याकशिग्रुत्वगुमाप्रलेपः| <br />
कुलत्थशुण्ठीजलमूत्रसेकश्चण्डागुरुभ्यामनुलेपनं च||७०|| <br />
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kaphē tu kr̥ṣṇāsikatāpurāṇapiṇyākaśigrutvagumāpralēpaḥ| <br />
kulatthaśuṇṭhījalamūtrasēkaścaṇḍāgurubhyāmanulēpanaṁ ca||70|| <br />

kaphe tu kRuShNAsikatApurANapiNyAkashigrutvagumApralepaH| <br />
kulatthashuNThIjalamUtrasekashcaNDAgurubhyAmanulepanaM ca||70|| <br />
</div></div>

In ''kapha'' dominant edema, application of paste of long pepper, sand, old oil-cake, bark of drum-stick and linseed is advised.
Effusion with decoction of ''kulattha'' (hoarse gram), dry ginger and cow’s urine followed by anointing of the body with paste of sandal and ''aguru'' is also beneficial (70).

=== External application in burning sensation ===
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बिभीतकानां फलमध्यलेपः सर्वेषु दाहार्तिहरः प्रदिष्टः| <br />
यष्ट्याह्वमुस्तैः सकपित्थपत्रैः सचन्दनैस्तत्पिडकासु लेपः||७१|| <br />
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bibhītakānāṁ phalamadhyalēpaḥ sarvēṣu dāhārtiharaḥ pradiṣṭaḥ| <br />
yaṣṭyāhvamustaiḥ sakapitthapatraiḥ sacandanaistatpiḍakāsu lēpaḥ||71|| <br />

bibhItakAnAM phalamadhyalepaH sarveShu dAhArtiharaH pradiShTaH| <br />
yaShTyAhvamustaiH sakapitthapatraiH sacandanaistatpiDakAsu lepaH||71|| <br />
</div></div>

In all types of swelling, smearing with paste of fruit of ''vibhitaka'' is recommended to cure burning sensation and discomfort.
The topical application of paste of leaves of ''kapittha'' (wood apple), sandal, liquorices and ''mustaka'' provides relief in papules [71]
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रास्नावृषार्कत्रिफलाविडङ्गं शिग्रुत्वचो मूषिकपर्णिका च| <br />
निम्बार्जकौ व्याघ्रनखः सदूर्वा सुवर्चला तिक्तकरोहिणी च||७२|| <br />

सकाकमाची बृहती सकुष्ठा पुनर्नवा चित्रकनागरे च| <br />
उन्मर्दनं शोफिषु मूत्रपिष्टं शस्तस्तथा मूलकतोयसेकः||७३|| <br />
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rāsnāvr̥ṣārkatriphalāviḍaṅgaṁ śigrutvacō mūṣikaparṇikā ca| <br />
nimbārjakau vyāghranakhaḥ sadūrvā suvarcalā tiktakarōhiṇī ca||72|| <br />

sakākamācī br̥hatī sakuṣṭhā punarnavā citrakanāgarē ca| <br />
unmardanaṁ śōphiṣu mūtrapiṣṭaṁ śastastathā mūlakatōyasēkaḥ||73||<br />

rAsnAvRuShArkatriphalAviDa~ggaM shigrutvaco mUShikaparNikA ca| <br />
nimbArjakau vyAghranakhaH sadUrvA suvarcalA tiktakarohiNI ca||72|| <br />

sakAkamAcI bRuhatI sakuShThA punarnavA citrakanAgare ca| <br />
unmardanaM shophiShu mUtrapiShTaM shastastathA mUlakatoyasekaH||73||<br />
</div></div>

Take ''rāsnā, vāsā, arka, triphalā, vidanga,'' bark of ''sigru, mushakaparni, neem,'' holy basin, nails of ''vyāghra'' (shell), ''durvā'', sunflower, ''katukā, kākamāchi, brihati, kuṣtha, punarnavā, chitraka'' and dry ginger and make paste with cow’s urine. ''Unmardana'' type of massage with it is beneficial for swelling. Also effusion done with water boiled with above drugs is beneficial [72-73]

=== Various types of local swellings ===
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शोफास्तु गात्रावयवाश्रिता ये ते स्थानदूष्याकृतिनामभेदात्| <br />
अनेकसङ्ख्याः कतिचिच्च तेषां निदर्शनार्थं गदतो निबोध||७४|| <br />
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śōphāstu gātrāvayavāśritā yē tē sthānadūṣyākr̥tināmabhēdāt| <br />
anēkasaṅkhyāḥ katicicca tēṣāṁ nidarśanārthaṁ gadatō nibōdha||74||<br />

shophAstu gAtrAvayavAshritA ye te sthAnadUShyAkRutinAmabhedAt| <br />
anekasa~gkhyAH [19] katicicca teShAM nidarshanArthaM gadato nibodha||74||<br />
</div></div>

The swelling occurring in one limb or organ is of many types owing to their different classifications based on involved site, ''duṣhya,'' shape and name. Listen to the descriptions of some of them being given as illustration [74]

=== ''Shira Shopha'' (cellulitis of head) and ''Salūka'' (quinsy) ===
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दोषास्त्रयः स्वैः कुपिता निदानैः कुर्वन्ति शोफं शिरसः सुघोरम्|<br />
अन्तर्गले घुर्घुरिकान्वितं च शालूकमुच्छ्वासनिरोधकारि||७५|| <br />
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dōṣāstrayaḥ svaiḥ kupitā nidānaiḥ kurvanti śōphaṁ śirasaḥ sughōram|<br />
antargalē ghurghurikānvitaṁ ca śālūkamucchvāsanirōdhakāri||75||<br />

doShAstrayaH svaiH kupitA nidAnaiH kurvanti shophaM shirasaH sughoram|<br />
antargale ghurghurikAnvitaM ca shAlUkamucchvAsanirodhakAri||75||<br />
</div></div>

All the three dosha, provoked by indulging in their etiological factors produce severe inflammation of head.
When it affects inside of the throat, it produces sālūka, which is accompanied with stertorous breathing and obstruction to expiration [75]

=== ''Bidalika'' (Ludwig’s angina) ===
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गलस्य सन्धौ चिबुके गले च सदाहरागः श्वसनासु चोग्रः| <br />
शोफो भृशार्तिस्तु बिडालिका स्याद्धन्याद्गले चेद्वलयीकृता सा||७६|| <br />
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galasya sandhau cibukē galē ca sadāharāgaḥ śvasanāsu cōgraḥ| <br />
śōphō bhr̥śārtistu biḍālikā syāddhanyādgalē cēdvalayīkr̥tā sā||76||<br />

galasya sandhau cibuke gale ca sadAharAgaH shvasanAsu [20] cograH| <br />
shopho bhRushArtistu biDAlikA [21] syAddhanyAdgale cedvalayIkRutA sA||76||<br />
</div></div>

Acute swelling at the junction of throat behind the chin i.e. in trachea with redness and burning sensation in throat and causes obstruction to breathing with very much discomfort is known as ''biḍālikā''. It kills the patient if folds are formed in throat [76]

=== ''Talu-vidradhi'' (palatal abscess), ''upajihvika'' (superficial glossitis) and ''adhijihvikā'' (sub-lingual glossitis) ===
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स्यात्तालुविद्रध्यपि दाहरागपाकान्वितस्तालुनि सा त्रिदोषात्| <br />
जिह्वोपरिष्टादुपजिह्विका स्यात् कफादधस्तादधिजिह्विका च||७७|| <br />
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syāttāluvidradhyapi dāharāgapākānvitastāluni sā tridōṣāt| <br />
jihvōpariṣṭādupajihvikā syāt kaphādadhastādadhijihvikā ca||77|| <br />

syAttAluvidradhyapi dAharAgapAkAnvitastAluni sA tridoShAt| <br />
jihvopariShTAdupajihvikA syAt kaphAdadhastAdadhijihvikA ca||77|| <br />
</div></div>

Abscess in palate caused by ''tridosha'' with burning sensation, redness and pus formation is known as ''tālu-vidradhi''.

Swelling due to ''kapha'' occurring on the upper part of tongue is called ''upajihvikā'' (acute superficial glossitis) and which occurs sublingual part is called a''dhijihvikā'' (sub lingual glossitis) [77]

=== ''Upakusha'' (gingivitis) and ''danta-vidradhi'' (dental abscess) ===
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यो दन्तमांसेषु तु रक्तपित्तात् पाको भवेत् सोपकुशः प्रदिष्टः| <br />
स्याद्दन्तविद्रध्यपि दन्तमांसे शोफः कफाच्छोणितसञ्चयोत्थः||७८|| <br />
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yō dantamāṁsēṣu tu raktapittāt pākō bhavēt sōpakuśaḥ pradiṣṭaḥ| <br />
syāddantavidradhyapi dantamāṁsē śōphaḥ kaphācchōṇitasañcayōtthaḥ||78||<br />

yo dantamAMseShu tu raktapittAt pAko bhavet sopakushaH pradiShTaH| <br />
syAddantavidradhyapi dantamAMse shophaH kaphAcchoNitasa~jcayotthaH||78||<br />
</div></div>

Provoked ''rakta'' and ''pitta'' causes suppuration of the gums and it is called ''upakusha''. Accumulation of ''kapha'' and ''rakta'' produces elevated swelling in gums and it is known as ''danta-vidradhi'' [78]

=== ''Galaganḍa'' (goiter),''gandamala'' (cervical adenitis) and its management ===
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गलस्य पार्श्वे गलगण्ड एकः स्याद्गण्डमाला बहुभिस्तु गण्डैः| <br />
साध्याः स्मृताः पीनसपार्श्वशूलकासज्वरच्छर्दियुतास्त्वसाध्याः||७९|| <br />
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galasya pārśvē galagaṇḍa ēkaḥ syādgaṇḍamālā bahubhistu gaṇḍaiḥ| <br />
sādhyāḥ smr̥tāḥ pīnasapārśvaśūlakāsajvaracchardiyutāstvasādhyāḥ||79|| <br />

galasya pArshve galagaNDa ekaH syAdgaNDamAlA bahubhistu gaNDaiH| <br />
sAdhyAH smRutAH pInasapArshvashUlakAsajvaracchardiyutAstvasAdhyAH||79|| <br />
</div></div>

Single glandular swelling on the (middle) of neck is called ''galagaṇḍa'' (goiter) but if there are many nodular swellings making a chain like appearance, is known as ''gandamālā''. Generally they are curable but if accompanied with coryza, pain in side of the chest, cough, fever and vomiting then they are incurable [79]
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तेषां सिराकायशिरोविरेका धूमः पुराणस्य घृतस्य पानम्| <br />
स्याल्लङ्घनं वक्त्रभवेषु चापि प्रघर्षणं स्यात् कवलग्रहश्च||८०|| <br />
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tēṣāṁ sirākāyaśirōvirēkā dhūmaḥ purāṇasya ghr̥tasya pānam| <br />
syāllaṅghanaṁ vaktrabhavēṣu cāpi pragharṣaṇaṁ syāt kavalagrahaśca||80||<br />

teShAM sirAkAyashirovirekA dhUmaH purANasya ghRutasya pAnam| <br />
syAlla~gghanaM vaktrabhaveShu cApi pragharShaNaM syAt kavalagrahashca||80||<br />
</div></div>

In all the above mentioned conditions blood-letting, purgation, ''nasya, dhuma'' (medicated smoking therapy) and intake of old ghee is beneficial.

For the conditions specially affecting mouth, the line of treatment is ''langhana'' and rubbing with medicated powders and mouth washes (''kavala'') are beneficial [80]

=== ''Granthi'' (nodule) and its management ===
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अङ्गैकदेशेष्वनिलादिभिः स्यात् स्वरूपधारी स्फुरणः सिराभिः| <br />
ग्रन्थिर्महान्मांसभवस्त्वनर्तिर्मेदोभवः स्निग्धतमश्चलश्च||८१|| <br />
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aṅgaikadēśēṣvanilādibhiḥ syāt svarūpadhārī sphuraṇaḥ sirābhiḥ| <br />
granthirmahānmāṁsabhavastvanartirmēdōbhavaḥ snigdhatamaścalaśca||81|| <br />

a~ggaikadesheShvanilAdibhiH syAt svarUpadhArI sphuraNaH sirAbhiH| <br />
granthirmahAnmAMsabhavastvanartirmedobhavaH snigdhatamashcalashca||81|| <br />
</div></div>

Swelling occurring in one organ or region due to ''vata'' or other ''dosha'' may be diagnosed on the basis of their characteristic symptoms. The swelling occurring in vessels are pulsating in nature. The nodular swelling occurring in muscles is large in size. Swelling of the adipose tissues is excessively unctuous and movable [81]

=== Surgical management of ''granthi'' ===
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संशोधिते स्वेदितमश्मकाष्ठैः साङ्गुष्ठदण्डैर्विलयेदपक्वम्| <br />
विपाट्य चोद्धृत्य भिषक् सकोशं शस्त्रेण दग्ध्वा व्रणवच्चिकित्सेत्||८२|| <br />
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saṁśōdhitē svēditamaśmakāṣṭhaiḥ sāṅguṣṭhadaṇḍairvilayēdapakvam| <br />
vipāṭya cōddhr̥tya bhiṣak sakōśaṁ śastrēṇa dagdhvā vraṇavaccikitsēt||82||<br />

saMshodhite sveditamashmakAShThaiH sA~gguShThadaNDairvilayedapakvam| <br />
vipATya coddhRutya bhiShak sakoshaM shastreNa dagdhvA vraNavaccikitset||82|| <br />
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If the tumor is non-suppurative then after purification therapy, local sudation of the swelling should be done. Then the physician should try to dissolve the swelling by rubbing with stone or wooden apparatus or with manipulation of thumb or of a rod. Then it should be cut open and take out the tumor with its capsule. Then it should be cauterized and treatment of regular wound should be adopted [82]
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अदग्ध ईषत् परिशेषितश्च प्रयाति भूयोऽपि शनैर्विवृद्धिम्| <br />
तस्मादशेषः कुशलैः समन्ताच्छेद्यो भवेद्वीक्ष्य शरीरदेशान्||८३|| <br />

शेषे कृते पाकवशेन शीर्यात्ततः क्षतोत्थः प्रसरेद्विसर्पः| <br />
उपद्रवं तं प्रविचार्य तज्ज्ञस्तैर्भेषजैः पूर्वतरैर्यथोक्तैः||८४|| <br />

निवारयेदादित एव यत्नाद्विधानवित् स्वस्वविधिं विधाय| <br />
ततः क्रमेणास्य यथाविधानं व्रणं व्रणज्ञस्त्वरया चिकित्सेत्||८५|| <br />
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adagdha īṣat pariśēṣitaśca prayāti bhūyō'pi śanairvivr̥ddhim| <br />
tasmādaśēṣaḥ kuśalaiḥ samantācchēdyō bhavēdvīkṣya śarīradēśān||83|| <br />

śēṣē kr̥tē pākavaśēna śīryāttataḥ kṣatōtthaḥ prasarēdvisarpaḥ| <br />
upadravaṁ taṁ pravicārya tajjñastairbhēṣajaiḥ [22] pūrVātarairyathōktaiḥ||84|| <br />

nivārayēdādita [23] ēva yatnādvidhānavit svasvavidhiṁ vidhāya| <br />
tataḥ kramēṇāsya yathāvidhānaṁ vraṇaṁ vraṇajñastvarayā cikitsēt||85|| <br />

adagdha IShat parisheShitashca prayAti bhUyo~api shanairvivRuddhim| <br />
tasmAdasheShaH kushalaiH samantAcchedyo bhavedvIkShya sharIradeshAn||83|| <br />

sheShe kRute pAkavashena shIryAttataH kShatotthaH prasaredvisarpaH| <br />
upadravaM taM pravicArya tajj~jastairbheShajaiH [22] pUrvatarairyathoktaiH||84|| <br />

nivArayedAdita [23] eva yatnAdvidhAnavit svasvavidhiM vidhAya| <br />
tataH krameNAsya yathAvidhAnaM vraNaM vraNaj~jastvarayA cikitset||85|| <br />
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If the tumor is not properly cauterized or if some of its part is left out then it starts gradually increasing again. In that case it should be removed completely by opening from all sides by the skillful surgeon keeping in view the regional anatomy. If some portion is still left then it may suppurate and slough and may lead to complication of ''visarpa'' (erysipelas). The surgeon considering it as the severe complication first should try to treat it with great care by appropriate remedies described earlier. Therefore the wound specialist should quickly treat it in the prescribed manner following the appropriate line of treatment [83-85]
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विवर्जयेत् कुक्ष्युदराश्रितं च तथा गले मर्मणि संश्रितं च| <br />
स्थूलः खरश्चापि भवेद्विवर्ज्यो यश्चापि बालस्थविराबलानाम्||८६|| <br />
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vivarjayēt kukṣyudarāśritaṁ ca tathā galē marmaṇi saṁśritaṁ ca| <br />
sthūlaḥ kharaścāpi bhavēdvivarjyō yaścāpi bālasthavirābalānām||86||<br />

vivarjayet kukShyudarAshritaM ca tathA gale marmaNi saMshritaM ca| <br />
sthUlaH kharashcApi bhavedvivarjyo yashcApi bAlasthavirAbalAnAm||86||<br />
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The tumors occurring in flanks, abdomen, in the throat and in vital organs are incurable. Similarly tumors of big size and indurated which occurs in children, aged and weak are also incurable [86]

=== Differential diagnosis of ''arbuda'' (tumor) ===
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ग्रन्थ्यर्बुदानां च यतोऽविशेषः प्रदेशहेत्वाकृतिदोषदूष्यैः| <br />
ततश्चिकित्सेद्भिषगर्बुदानि विधानविद्ग्रन्थिचिकित्सितेन||८७|| <br />
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granthyarbudānāṁ ca yatō'viśēṣaḥ pradēśahētvākr̥tidōṣadūṣyaiḥ| <br />
tataścikitsēdbhiṣagarbudāni vidhānavidgranthicikitsitēna||87||<br />

granthyarbudAnAM ca yato~avisheShaH pradeshahetvAkRutidoShadUShyaiH| <br />
tatashcikitsedbhiShagarbudAni vidhAnavidgranthicikitsitena||87||<br />
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There is no much difference in nodules and tumors with regards to site, causative factors, shape, ''dosha'' morbidity and ''dushya'' (susceptible tissues). Therefore, tumor specialist should treat the tumor on the line of nodules described above [87]

=== ''Alaji'' and ''akshata'' (whitlow)===
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ताम्रा सशूला पिडका भवेद्या सा चालजी नाम परिस्रुताग्रा| <br />
शोफोऽक्षतश्चर्मनखान्तरे स्यान्मांसास्रदूषी भृशशीघ्रपाकः||८८|| <br />
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tāmrā saśūlā piḍakā bhavēdyā sā cālajī nāma parisrutāgrā| <br />
śōphō'kṣataścarmanakhāntarē syānmāṁsāsradūṣī bhr̥śaśīghrapākaḥ||88||<br />

tAmrA sashUlA [25] piDakA bhavedyA sA cAlajI nAma parisrutAgrA| <br />
shopho~akShatashcarmanakhAntare [26] syAnmAMsAsradUShI bhRushashIghrapAkaH||88|| <br />
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Appearing of copper colored papules with acute pain from which pus oozes out is known as alajī.
The severe inflammation occurring by vitiating flesh and blood in the skin adjoining nail which suppurates quickly is known as akṣata [88]

=== ''Vidarika'' (lymphadenitis) and its management ===
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ज्वरान्विता वङ्क्षणकक्षजा या वर्तिर्निरर्तिः कठिनायता च| <br />
विदारिका सा कफमारुताभ्यां तेषां यथादोषमुपक्रमः स्यात्||८९|| <br />

विस्रावणं पिण्डिकयोपनाहः पक्वेषु चैव व्रणवच्चिकित्सा| <br />
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jvarānvitā vaṅkṣaṇakakṣajā yā vartirnirartiḥ kaṭhināyatā ca| <br />
vidārikā sā kaphamārutābhyāṁ tēṣāṁ yathādōṣamupakramaḥ syāt||89|| <br />

visrāvaṇaṁ piṇḍikayōpanāhaḥ pakvēṣu caiva vraṇavaccikitsā|<br />

jvarAnvitA va~gkShaNakakShajA yA vartirnirartiH kaThinAyatA ca| <br />
vidArikA sA kaphamArutAbhyAM teShAM yathAdoShamupakramaH syAt||89|| <br />

visrAvaNaM piNDikayopanAhaH pakveShu caiva vraNavaccikitsA|<br />
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Painless cylindrical and hard swelling in the groin or axillary region accompanied with fever is known as ''vidārikā''. It occurs due to vitiation of ''kapha'' and ''vāta'' and should be managed according to the treatment of these ''dosha'', which include bloodletting, ''pinda sweda, upanāha'' and on suppuration it should be treated on the line of abscess [89]

=== ''Visphotaka'' (eruption) ===
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विस्फोटकाः सर्वशरीरगास्तु स्फोटाः [२७] सरागज्वरतर्षयुक्ताः||९०||
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visphōṭakāḥ sarvaśarīragāstu sphōṭāḥ [27] sarāgajvaratarṣayuktāḥ||90||

visphoTakAH sarvasharIragAstu sphoTAH [27] sarAgajvaratarShayuktAH||90||
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Red colored eruptions occurring all over the body along with fever and thirst are known as ''visphōṭaka'' (90).

=== ''Kaksha'' (herpes zoster) ===
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यज्ञोपवीतप्रतिमाः प्रभूताः पित्तानिलाभ्यां जनितास्तु कक्षाः [२८] |

याश्चापराः स्युः पिडकाः प्रकीर्णाः स्थूलाणुमध्या अपि पित्तजास्ताः||९१||
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yajñōpavītapratimāḥ prabhūtāḥ pittānilābhyāṁ janitāstu kakṣāḥ [28] |

yāścāparāḥ syuḥ piḍakāḥ prakīrṇāḥ sthūlāṇumadhyā api pittajāstāḥ||91||

yaj~jopavItapratimAH prabhUtAH pittAnilAbhyAM janitAstu kakShAH [28] |

yAshcAparAH syuH piDakAH prakIrNAH sthUlANumadhyA api pittajAstAH||91||
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Multiple eruptions occurring on the trunk due to ''pitta'' and ''vata'' where usually Hindu holy thread is worn, is known as ''kakṣā''.

Other such types of eruptions (''pidikā'') whether big, medium or small are also due to ''pitta'' [91]

=== ''Romantika'' (measles) ===
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क्षुद्रप्रमाणाः पिडकाः शरीरे सर्वाङ्गगाः सज्वरदाहतृष्णाः| <br />
कण्डूयुताः सारुचिसप्रसेका रोमान्तिकाः पित्तकफात् प्रदिष्टाः||९२|| <br />
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kṣudrapramāṇāḥ piḍakāḥ śarīrē sarvāṅgagāḥ sajvaradāhatr̥ṣṇāḥ| <br />
kaṇḍūyutāḥ sārucisaprasēkā rōmāntikāḥ pittakaphāt pradiṣṭāḥ||92|| <br />

kShudrapramANAH piDakAH sharIre sarvA~ggagAH sajvaradAhatRuShNAH| <br />
kaNDUyutAH sArucisaprasekA romAntikAH pittakaphAt pradiShTAH||92|| <br />
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Small sized eruption all over the body due to pitta and kapha along with fever, burning sensation, thirst, itching, anorexia and salivation are known as romāntikā (measles) [92]

=== Masurika (chickenpox) and its management ===
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याः सर्वगात्रेषु मसूरमात्रा मसूरिकाः पित्तकफात् प्रदिष्टाः| <br />
वीसर्पशान्त्यै विहिता क्रिया या तां तेषु कुष्ठे च हितां विदध्यात्||९३|| <br />
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yāḥ sarvagātrēṣu masūramātrā masūrikāḥ pittakaphāt pradiṣṭāḥ| <br />
vīsarpaśāntyai vihitā kriyā yā tāṁ tēṣu kuṣṭhē ca hitāṁ vidadhyāt||93||<br />

yAH sarvagAtreShu masUramAtrA masUrikAH pittakaphAt pradiShTAH| <br />
vIsarpashAntyai vihitA kriyA yA tAM teShu [29] kuShThe ca hitAM vidadhyAt||93||<br />
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Eruptions similar to size and shape of lentil (''masura'') occurring all over the body due to ''pitta'' and ''kapha'' is known as ''masurikā''; the treatment described for ''visarpa'' should is also adopted for it. For ''visphotaka'' etc., treatment described for ''kuṣtha'' should be adopted [93]

=== ''Bradhna'' (hernia) and its management ===
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ब्रध्नोऽनिलाद्यैर्वृषणे स्वलिङ्गैरन्त्रं निरेति प्रविशेन्मुहुश्च| <br />
मूत्रेण पूर्णं मृदु मेदसा चेत् स्निग्धं च विद्यात् कठिनं च शोथम्||९४|| <br />

विरेचनाभ्यङ्गनिरूहलेपाः पक्वेषु चैव व्रणवच्चिकित्सा| <br />
स्यान्मूत्रसेकः कफजं विपाट्य विशोध्य सीव्येद्व्रणवच्च पक्वम्||९५|| <br />
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bradhnō'nilādyairvr̥ṣaṇē svaliṅgairantraṁ nirēti praviśēnmuhuśca| <br />
mūtrēṇa pūrṇaṁ mr̥du mēdasā cēt snigdhaṁ ca vidyāt kaṭhinaṁ ca śōtham||94|| <br />

virēcanābhyaṅganirūhalēpāḥ pakvēṣu caiva vraṇavaccikitsā| <br />
syānmūtrasēkaḥ kaphajaṁ vipāṭya viśōdhya sīvyēdvraṇavacca pakvam||95||<br />

bradhno~anilAdyairvRuShaNe [30] svali~ggairantraM nireti pravishenmuhushca| <br />
mUtreNa pUrNaM mRudu medasA cet snigdhaM ca vidyAt kaThinaM ca shotham||94|| <br />

virecanAbhya~gganirUhalepAH pakveShu caiva vraNavaccikitsA| <br />
syAnmUtrasekaH [31] kaphajaM vipATya vishodhya sIvyedvraNavacca pakvam||95|| <br />
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Due to ''vata'' or other ''dosha'', the intestine frequently enters into scrotum and comes out and this condition is known as bradhna (hernia).

If liquid (''mutra'') accumulates in scrotum then the swelling is soft (hydrocele).

If fat accumulates in scrotum it is hard and unctuous.

Its treatment is ''virechana karma'', oil massage, ''niruha basti'' and smearing of paste. If it suppurates then treatment of ulcer (''vrana'') should be adopted.

If there is oozing of liquid (''mutra'') and the swelling is due to ''kapha,'' then it should be open up, cleaned and sutured as per line of treatment of ulcer [94-95]

=== Bhagandara (fistula-in-ano) and its management ===
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क्रिम्यस्थिसूक्ष्मक्षणनव्यवायप्रवाहणान्युत्कटकाश्वपृष्ठैः | <br />
गुदस्य पार्श्वे पिडका भृशार्तिः पक्वप्रभिन्ना तु भगन्दरः स्यात्||९६|| <br />

विरेचनं चैषणपाटनं च विशुद्धमार्गस्य च तैलदाहः| <br />
स्यात् क्षारसूत्रेण सुपाचितेन छिन्नस्य चास्य व्रणवच्चिकित्सा||९७|| <br />
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krimyasthisūkṣmakṣaṇanavyavāyapravāhaṇānyutkaṭakāśvapr̥ṣṭhaiḥ | <br />
gudasya pārśvē piḍakā bhr̥śārtiḥ pakvaprabhinnā tu bhagandaraḥ syāt||96|| <br />

virēcanaṁ caiṣaṇapāṭanaṁ ca viśuddhamārgasya ca tailadāhaḥ| <br />
syāt kṣārasūtrēṇa supācitēna chinnasya cāsya vraṇavaccikitsā||97||<br />

krimyasthisUkShmakShaNanavyavAyapravAhaNAnyutkaTakAshvapRuShThaiH [33] | <br />
gudasya pArshve piDakA bhRushArtiH pakvaprabhinnA tu bhagandaraH syAt||96|| <br />

virecanaM caiShaNapATanaM ca vishuddhamArgasya ca tailadAhaH| <br />
syAt kShArasUtreNa supAcitena [34] chinnasya cAsya vraNavaccikitsA||97||<br />
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On the lateral side of anus, a very painful pustule (''pidika'') occurs which suppurates and opens up; it is known as ''bhagandara'' (fistula-in-ano). It is caused by infection (''krimi''), injury with pointed object like bone leading to minute erosion, excessive sex, straining at defecation and friction due to sitting on hard seat of a horse or moving object.

Its treatment is ''virechana'', probing, cutting and after cleansing cauterization with hot oil. If surgery is contraindicated then ''kshara-sutra'' should be applied and during and after cutting the track, routine line of management of ulcer is adopted [96-97]

=== ''Shlipada'' (elephantiasis) and its management ===
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जङ्घासु पिण्डीप्रपदोपरिष्टात् [३५] स्याच्छ्लीपदं मांसकफास्रदोषात्| <br />
सिराकफघ्नश्च विधिः समग्रस्तत्रेष्यते सर्षपलेपनं च||९८|| <br />
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jaṅghāsu piṇḍīprapadōpariṣṭāt [35] syācchlīpadaṁ māṁsakaphāsradōṣāt| <br />
sirākaphaghnaśca vidhiḥ samagrastatrēṣyatē sarṣapalēpanaṁ ca||98||<br />

ja~gghAsu piNDIprapadopariShTAt [35] syAcchlIpadaM mAMsakaphAsradoShAt| <br />
sirAkaphaghnashca vidhiH samagrastatreShyate sarShapalepanaM ca||98||<br />
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The provoked ''kapha'' and ''rakta'' by involving flesh causes edema which begins from the upper part of the foot and spreads up to calf-muscle or shank; it is known as ''shlipada'' (elephantiasis). Its treatment is vene-section and local application of paste of mustard-seed as well as all other anti-''kapha'' treatment [98]

=== ''Jalakagardabha'' and its management ===
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मन्दास्तु पित्तप्रबलाः प्रदुष्टा दोषाः सुतीव्रं तनुरक्तपाकम्| <br />
कुर्वन्ति शोथं ज्वरतर्षयुक्तं विसर्पणं जालकगर्दभाख्यम्||९९|| <br />

विलङ्घनं रक्तविमोक्षणं च विरूक्षणं कायविशोधनं च| <br />
धात्रीप्रयोगाञ् शिशिरान् प्रदेहान् कुर्यात् सदा जालकगर्दभस्य||१००|| <br />
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mandāstu pittaprabalāḥ praduṣṭā dōṣāḥ sutīvraṁ tanuraktapākam| <br />
kurvanti śōthaṁ jvaratarṣayuktaṁ visarpaṇaṁ jālakagardabhākhyam||99|| <br />

vilaṅghanaṁ raktavimōkṣaṇaṁ ca virūkṣaṇaṁ kāyaviśōdhanaṁ ca| <br />
dhātrīprayōgāñ śiśirān pradēhān kuryāt sadā jālakagardabhasya||100||<br />

mandAstu pittaprabalAH praduShTA doShAH sutIvraM tanuraktapAkam| <br />
kurvanti shothaM jvaratarShayuktaM visarpaNaM jAlakagardabhAkhyam||99|| <br />

vila~gghanaM raktavimokShaNaM ca virUkShaNaM kAyavishodhanaM ca| <br />
dhAtrIprayogA~j shishirAn pradehAn kuryAt sadA jAlakagardabhasya||100||<br />
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Mildly provoked ''dosha'' with dominance of ''pitta'' causes very acute inflammation which slightly bleeds and suppurates, has a tendency of quick spreading and is accompanied by fever and thirst is known as ''jalakagardabha''.

Its treatment is ''langhana'' (lightening therapy), blood-letting, un-unctuous therapy, ''virechana'', use of ''amalaki'' and application of paste of drugs having cold potency [99-100]
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एवंविधांश्चाप्यपरान् परीक्ष्य शोथप्रकाराननिलादिलिङ्गैः| <br />
शान्तिं नयेद्दोषहरैर्यथास्वमालेपनच्छेदनभेददाहैः||१०१|| <br />
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ēvaṁvidhāṁścāpyaparān parīkṣya śōthaprakārānanilādiliṅgaiḥ| <br />
śāntiṁ nayēddōṣaharairyathāsvamālēpanacchēdanabhēdadāhaiḥ||101||<br />

evaMvidhAMshcApyaparAn parIkShya shothaprakArAnanilAdili~ggaiH| <br />
shAntiM nayeddoShaharairyathAsvamAlepanacchedanabhedadAhaiH||101||<br />
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Other types of inflammatory swellings may be diagnosed on the basis of the characteristic symptoms of the involved ''vata'' and other ''dosha''. It may also be managed by prescribing the treatment of involved ''dosha'' as well as by application of paste, incision and excision [101]

=== General guidelines of management ===
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प्रायोऽभिघातादनिलः सरक्तः शोथं सरागं प्रकरोति तत्र| <br />
वीसर्पनुन्मारुतरक्तनुच्च कार्यं विषघ्नं विषजे च कर्म||१०२|| <br />
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prāyō'bhighātādanilaḥ saraktaḥ śōthaṁ sarāgaṁ prakarōti tatra| <br />
vīsarpanunmārutaraktanucca kāryaṁ viṣaghnaṁ viṣajē ca karma||102||<br />

prAyo~abhighAtAdanilaH saraktaH shothaM sarAgaM prakaroti tatra| <br />
vIsarpanunmArutaraktanucca kAryaM viShaghnaM viShaje ca karma||102||<br />
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Generally external trauma causes reddish swelling due to provocation of ''vata'' and ''rakta''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''vata'' and ''rakta''.

If the swelling is caused by poisonous substances then it should be treated with anti-poison measures [102]

=== Summary ===
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तत्र श्लोकः-

त्रिविधस्य दोषभेदात् सर्वार्धावयवगात्रभेदाच्च| <br />
श्वयथोर्द्विविधस्य तथा लिङ्गानि चिकित्सितं चोक्तम्||१०३|| <br />
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tatra ślōkaḥ-

trividhasya dōṣabhēdāt sarvārdhāvayavagātrabhēdācca| <br />
śvayathōrdvividhasya tathā liṅgāni cikitsitaṁ cōktam||103|| <br />

tatra shlokaH-

trividhasya doShabhedAt sarvArdhAvayavagAtrabhedAcca| <br />
shvayathordvividhasya [36] tathA li~ggAni cikitsitaM coktam||103|| <br />
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Re-capitulatory verses-

Three types of swelling as per involvement of dosha; classification of swelling according to involvement whole or half body or one part; exogenous and endogenous swelling; their symptoms and treatment have been described [103]
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इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने
श्वयथुचिकित्सितं नाम द्वादशोऽध्यायः||१२||
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ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē
śvayathucikitsitaṁ nāma dvādaśō'dhyāyaḥ||12||

ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne
shvayathucikitsitaM nAma dvAdasho~adhyAyaH||12||
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Thus 12th chapter named [[Shvayathu Chikitsa]] in [[Chikitsa Sthana]] of treatise compiled by Agnivesha, revised by Charaka and unavailable part restored by Dridhabala is completed (12).

== Tattva Vimarsha (Fundamental Principles) ==

*''Shotha'' is caused by dietary causes like excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''shodhana'', fasting or disease; excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''shodhana'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment.
*Exogenous causes include trauma or injuries of various types and have acute pathogenesis.
*The pathogenesis of ''nija shotha'' includes obstruction of morbid vāta by vitiated ''kapha, rakta'' and ''pitta'' at the site of peripheral superficial vessels. This vitiated ''vata'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.
*Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling.
*All types of swelling are produced by involvement of all the three ''dosha'' but they are named based on the predominance of that particular ''dosha''. The line of treatment is also according to the dominant ''dosha''.
*The swelling in a patient who is neither emaciated nor weak; that involved single ''dosha'' or is of recent origin is easily curable.
*If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''langhana'') and digestive drugs. Only after that ''shodhana'' therapy should be undertaken according to dominant ''dosha''. General lines of treatment of ''doshaja'' swelling are as follows:
**If it involves head then ''shiro-virechana'' is prescribed;
**If it involves lower parts of the body then ''virechana'' (therapeutic purgation) is prescribed;
**If it involves upper parts of the body then ''vamana'' (therapeutic emesis)is prescribed;
**If it is caused by unctuous then ''rukshana'' (drying) therapy is done;
**If it is caused by un-unctuous (''ruksha'') then unctuous (''snehana'') therapy is done;
**If ''vata'' swelling is associated with constipation then it should be treated with ''niruha basti'';
**If it is caused by ''vata-pitta'' then it should be treated with ghee prepared with bitter drugs;
**If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;
**If the patient is suffering from swelling where ''shodhana'' is required then milk mixed with cow’s urine should be given;
**If the patient is suffering from ''kapha'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given.
**Generally external trauma causes reddish swelling due to provocation of ''vata'' and ''rakta''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''vata'' and ''rakta''. If the swelling is caused by poisonous substances then it should be treated with anti-poison measures (102).

== Vidhi Vimarsha (Applied Inferences ) ==

=== Derivation of term ===

The word ''Shvayathu'' is derived from root ''Tuoshchi-Gati-Vriddhyoh''. ''Tuo'' is converted to ''Shvi'' indicating to increase (''Vriddhi'') and by adding ''Athuc Pratyaya'' the word ''Shvayathu'' is derived which literally means increased (3).

=== Pathogenesis ===

In pathogenesis of ''shotha'' there is involvement of superficial veins (''Bahya shira''). Involvement of circulatory or lymphatic system is must in producing the ''shotha''.

=== Types of ''shotha'' ===

''Vata shotha'' is shifting in nature, pitting on pressure and increases in the day time and may vanish without visible cause. Further ''vata'' causes edema of the lower part of the body i. e feet and legs. All these characteristics of ''vata shotha'' are indicative cardiac edema.

In day time due to various activities and fatigue ''vata'' gets increased leading to increase in the edema. From modern point of view, cardiac edema increases in the evening which is ''vata kala'' due to the day activities. ''Vata shotha'' is pitting on pressure but on removing the pressure it immediately takes its original shape.

''Pitta sopha'' begins from middle parts of the body and then spreads to the other parts and has yellow-reddish color (Ashtangahridaya Nidana 13/33). Yellowish coloration indicates involvement of liver. Inflammatory swelling is related to ''pittaja shotha'' .

''Kapha Shotha'' slightly pits on pressure but takes long time to attain its original position after removing the pressure and increases at night. It develops slowly and also takes long time to subside. ''Kapha shotha'' occurs in upper part of the body and the treatment of edema occurring on the upper part is ''vamana'' i.e. of ''kapha''. On this basis it can be said that which mainly includes face. Renal edema occurs on the face in the morning (noticed on awakening though increased in the night). Other important sign is it is hard and the serous discharge comes out on scratching the skin (Ashtangahridaya Nidana 13/35-36). This indicates that hard non-pitting edema of elephantiasis may also be included under it. Other symptom mentioned for ''kaphaja shotha'' that the patient like warm touch indicates towards edema found in hypothyroidism (14).

=== Complications ===

Complications of ''shotha'' are vomiting, dyspnea, anorexia, thirst, fever, loose motions and weakness ([[Sutra Sthana]] chapter 18/18). Sushruta mentions two additional complications viz. cough and hiccups (Sushruta Chikitsa 23/8-9)(15)
Sushruta classify general edema in five types viz., ''vata, pitta, kapha, sannipata'' and ''vishaja'' (Sushruta Chikitsa 23/3) but does not consider local swelling as the part of ''shopha'' because while defining swelling it is clearly mentioned that which occurs in the large part under the skin and flesh etc but is other than nodules (''granthi''), abscess (''vidradhi''), ''alaji'' etc is known as ''shopha'' (Sushruta Sutra 17:3).

Ashtangahridaya describes ''shopha'' in the chapter on ''panduroga'' (anemia) because it is a main complication of anemia. Nine types of ''shopha'' described therein are three single ''dosha'' type, three ''samsarga'' types, one ''tridoshaja'' and one each due to trauma and poison. In addition three new types of ''shopha'' viz. ''prithu'' (extensive), ''unnata'' (elevated) and ''grathita'' (compact) are also mentioned (Ashtangahridaya Nidana 13/21-42).

Madhava Nidana followed Ashtangahridaya and describes nine types of ''shotha'' and does not describe localized ''shotha'' in this chapter on ''shotha'' (Madhava Nidana ''shothadhikara'').

''Charaka'' considers bulging (''utsedha'') from the skin as ''shvayathu'' therefore local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), ''galagandha'' (goiter), tumor etc are also described in this chapter. The probable modern equivalents are given in the bracket while describing these conditions in the text (74-100).

Sushruta defines ''arbuda'' as a round and immovable growth produced by vitiated ''dosha'' by afflicting ''mamsa'' with mild pain but having deep roots and located in extensive area at the expense of tissue and causes swelling of the ''mamsa'' extensively. This ''arbuda'' (tumor) grows slowly and does not suppurate (Sushruta Nidana 11/13-14). But Charaka being a clinician does not consider much difference in the management of ''arbuda'' and ''granthi'' as their site, causative factors, shape, ''dosha'' morbidity and ''dushya'' (susceptible tissues) are about the same. However, it is clearly mentioned that ''arbuda'' should be managed by the expert surgeon only (87).

Line of treatment, various procedures and preparations mentioned in this chapter for the management of various types of swellings are easy to administer and practical so should be practiced (16-73).

=== ''Shat-kriya-kala'' of ''shotha'' ===

#''Sanchaya'' (Accumulation): This is the first stage of the disease where due to indulgence into the causative factors accumulation of concerned ''dosha'' occurs. During this stage increase in the normal functions of the ''dosha'' is noticed.
#''Prakopa'' (Provocation): If the accumulated ''dosha'' are not properly taken care then they may go to the next stage of provocation. During this stage the ''prakopa'' symptoms of the involved ''dosha'' appear.
#''Prasara'' (Spreading): In the stage of ''prasara'' the ''dosha'' leaves their normal site and starts circulating all over the body.
#''Sthana-Smashrya'' (Localization): The circulating ''dosha'' interacts with such tissues which have some problem in their channels which may be anatomical, physiological or pathological. This phenomenon is ''dosha-dushya-samurchchana''. This localization of ''dosha'' leads to beginning of the pathogenesis of the disease and during this stage prodromal symptoms (''purva-rupa'') of the disease are produced. The prodromal symptoms of edema are heat, burning sensation and dilation of the vessels.
#''Vyakti'' (Manifestation): If the disease is not managed at the stage of localization then the disease manifest with its specific symptoms. The symptoms of various types of edema are mentioned in the verses from 11 to 16 of this chapter. All or few symptoms mentioned for the disease may appear but if all the symptoms appear then the disease may become incurable and if few then it is easily curable. Moderate appearance of the symptom indicates its moderate prognosis.
#''Bheda'' (Complications): If the disease is not properly treated even after it is fully manifestation then the complications may appear and the disease becomes difficult to cure or incurable. The seven complications of edema are vomiting, thirst, anorexia, dyspnea, fever, diarrhea and weakness ([[Sutra Sthana]] 18:18).

=== Differential Diagnosis of ''shotha'' ===

[[Ayurveda]] is a clinical science, therefore the classifications are also planned so that the disease can systematically be diagnosed on the basis of the symptoms. ''Shotha'' is a good example for it.

''Shotha'' has been defined as any abnormal elevation from the skin. First question to be asked to the patient whether there is any history of trauma, biting etc and if yes, then it is an ''agantuja shotha''. If there is a history of contact or taking poisonous substance then it is ''vishaja''.

Hereafter it is to be confirmed that whether the swelling is localized or all over the body. If ''shotha'' is localized in single organ or site then it can be diagnosed on the basis of nature of the lesion such as papules, pustules, nodules, tumor etc. It is further diagnosed on the basis of shape, site etc. For example ''gandhamala'' is garland like and ''galagandha'' is scrotum like swelling in neck. ''Romantika'' has minute papules while ''masurika'' has lentil like papules and so on. Associated general features such as fever, thirst etc also helps in differential diagnosis.

If ''shotha'' is generalized swelling then the point of its beginning is important e.g. ''pitta shopha'' starts from middle part of the abdomen, ''vata'' from the lower parts and ''kapha'' from upper parts of the body. The consideration of other characteristic features mentioned above will help in reaching the final diagnosis.

For example moving, pitting on pressure, increasing in the day time and sometime subsides without appreciable cause etc help in reaching the diagnosis for ''vata shopha''.

Swelling which is firm, slight pitting on pressure, increases in the night, takes long time to subside and is associated with low digestion, vomiting, anemia indicates towards ''kapha shotha''.

Swelling which is soft, tender on touch, associated with change to yellow color, fever etc is ''pitta shotha''.

Similarly causative factors can also be sorted out by asking whether it relates to food articles (curd, unripe fruits, spoiled, leafy vegetables) or its properties (excessive use of ''kshara'', sour, sharp, hot and heavy food articles), diet habit (fasting), sedentary life style, emaciation or weakness due to a disease or excessive ''shodhana'', contact to poisonous substances etc.

=== ''Chikitsa Sutra'' (Principles of treatment) ===

[[Ayurveda]] gives very importance to ''ama''. Therefore, if ''ama'' is associated with swelling then first it should be managed by prescribing lightening therapy (''langhana'') and digestive drugs. After getting the ''nirama'' symptoms, ''shodhana'' therapy can be done according to dominant ''dosha''. It is the general rule for all types of swellings.

''Shiro-virechana'' is the choice of therapy for ''dosha'' situated in head. Therefore if the swelling involves the head then first ''nasya'' should be done.

Chest and the upper parts are the main sites of ''kapha'' and for its removal, ''vamana'' therapy is best. Therefore if swelling is situated in upper parts or begins from upper parts and then spreads to other parts or it is ''kapha'' type then first of all ''vamana'' (emesis) therapy is prescribed. ''Kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are indicated after ''vamana'' therapy. If ''vamana'' therapy is not possible in the patient suffering from ''kapha'' swelling then these drugs may be given directly.

Generally ''basti'' is not preferred for the treatment of swelling, but if ''vata'' swelling is associated with constipation then it should be treated with ''niruha basti''. Otherwise ''virechana'' is indicated for the swelling of lower part as well as of ''vata''.
The local swellings with symptom of inflammation may be treated by following the general line of treatment as mentioned above and other measures mentioned while describing their treatment in this chapter. If it belongs to ''shalya'' or ''shalakya'' type specialties, then let it be treated by the experts of the specialty.

=== Clinical practices ===

{| class="wikitable"
|-
! scope="col"| Type
! scope="col"| Formulations
! scope="col"| Dosage
! scope="col"| Time
! scope="col"| ''Anupana''
|-
| ''Vata'' dominant
| ''Harina shringa'' mixture
| 60-120 mg
| In between two meals
| Honey + ''Dashamularishta'' + ''Punarnavasa''
|-
| ''Pitta'' dominant
| ''Aarogya'' Mixture
| 120-250 mg
| In between two meals
| Milk + ''saravadyasava'' + ''punarnavasava'' + ''vasakasava'
|-
| rowspan = "3"|''Kapha'' dominant
| ''Gomutra Haritaki''
| 1-3 grams
| In between two meals
| Cow urine, honey
|-
| ''Punarnava mandura''
| 250-500 mg
| In between two meals
| ''Punarnavasava''
|-
| ''Gudadraka Yoga''
| 120-250 mg
| In between two meals
| Honey
|}

=== Further reading ===

#Ashtanga Hridaya by Vagbhata with Sarvanga-Sundra commentry by Arunadatta, published by Chaukhamba Samskrit series office, Varanasi,
#Charaka: Charaka Samhita, Sutra Sthana chapter 18 and Ciktsa sthana chpter 12. Edited by Yadavaji T. Acharya. Niranaya sagar Press, Bombay.
#Madhava: Madhava Nidana; Śothadhikara. Published by Chaukhamba Samskrit series office, Varanasi,
#Sushruta: Sushruta Samhita. Sutra Sthana chapter 17 and Cikitsa sthana chapter 23. Edited by Yadavaji T. Acharya. Niranaya sagar Press, Bombay.
#Vagbhata: Ashtanga Hridaya with Sarvanga-Sundra commentry by Arunadatta, published by Chaukhamba Samskrit series office, Varanasi.

=== Related Chapter ===

* [[Trishothiya Adhyaya]]

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