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Roganika Vimana

2017-12-28T08:45:50Z

Vinay Exafluence: /* Vidhi Vimarsha */

{{Infobox
|title = Roganika Vimana
|label1 = Section/Chapter
|data1 = [[Vimana Sthana]] Chapter 6
|label2 = Preceding Chapter
|data2 = [[Sroto Vimana]]

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

|header3 =

}}
== [[Vimana Sthana]] Chapter 6: [[Roganika Vimana]] ==
(Groups of diseases)

=== Abstract ===
<div style="text-align:justify;">
This chapter describes criteria for classification and enumeration of diseases, ''agni'' and patients. Because of variable symptoms and pathogenesis, the diseases are innumerable and they are rearranged in groups in this chapter. The purpose of grouping is to find common modalities for treatment and diagnosis and it is essential to know the disease pathology at micro level. The source components of all the physical and mental disorders are ''tridosha'' (three morbid factors). There are three basic causes, viz. injudicious use of senses, intellectual errors and ignoring the bio clock. All diseases have common origin and pathway up to some level which serves as criteria for grouping of ailments. The common criteria for the enumeration of diseases include prognosis, severity, location, nature of causative factors and site of origin. Classification of ''agni'' on the basis of strength is described in this chapter. ''Prakriti'' as the parameter for the stratifying and clustering various types of patients and concept of psychosomatic diseases is highlighted in this chapter. Primary and secondary diseases on the basis of priority of vitiation of ''doshas'' are explained for successful management of the disease.

'''Keywords''': ''Agni, Prakriti,'' Psychosomatic diseases, Primary and secondary diseases.
</div>
=== Introduction ===
<div style="text-align:justify;">
This chapter is introducing the ten groups in five pairs of diseases, which are explained in earlier two chapters (19th and 20th chapters) of [[Sutra Sthana]]. The principal behind this grouping is the same as the billions of persons are clubbed only in three groups according to predominance of three ''dosha'' in their constitution and personality traits. Similarly, on the basis of curable/incurable, severity (mild/severe), origin (mental/physical), causative factors (endogenous/exogenous), and pathological sites of diseases (''amashaya samuththa/pakwashaya samuththa'', diseases can also be clubbed in five pairs of ten major groups.

The term ''roga'' may be applicable to both the ''doshas'' and diseases but there is difference between the two, in as much as ''doshas'' are numerable and diseases are innumerable. One ''dosha'' may be responsible for the causation of many diseases. As it is impossible to describe all the diseases in view of their innumerability, only ten groups will be explained here as are discovered by ancient sages.

After grouping of diseases, this chapter deals with grouping of other two aspects i.e. ''agni'' and patient. ''Agni'' (digestive ability) is of four types, ''tikshna agni'' (severe), ''mandaagni'' (low), ''vishamagni'' (irregular) and ''samaagni'' (balanced). Patients are of four types with the predominance of ''dosha'' - ''vatika, paittika, kaphaja'' and ''samaprakriti''.

At the end of the chapter describes qualities of an expert physician who is perfect in diagnosis, skilled in treatment and has good knowledge of drugs.
</div>
=== Sanskrit Text, Transliteration and English Translation ===

अथातो रोगानीकं विमानं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||

athātō rōgānīkaṁ vimānaṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||

athAto rogAnIkaM vimAnaM vyAkhyAsyAmaH||1||
iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter on the “restructuring the groups of diseases” Thus said Lord Atreya. [1-2]

==== Types of diseases ====

द्वे रोगानीके भवतः प्रभावभेदेन- साध्यम्, असाध्यं च; द्वे रोगानीके बलभेदेन- मृदु, दारुणं च; द्वे रोगानीके अधिष्ठानभेदेन- मनोऽधिष्ठानं, शरीराधिष्ठानं च; द्वे रोगानीके निमित्तभेदेन- स्वधातुवैषम्यनिमित्तम्, आगन्तुनिमित्तं च; द्वे रोगानीके आशयभेदेन- आमाशयसमुत्थं, पक्वाशयसमुत्थं चेति| एवमेतत् प्रभावबलाधिष्ठाननिमित्ताशयभेदाद्द्वैधं सद्भेदप्रकृत्यन्तरेण भिद्यमानमथवाऽपि सन्धीयमानं स्यादेकत्वं बहुत्वं वा| एकत्वं तावदेकमेव रोगानीकं, दुःखसामान्यात्; बहुत्वं तु दश रोगानीकानि प्रभावभेदादिना भवन्ति; बहुत्वमपि सङ्ख्येयं स्यादसङ्ख्येयं वा| तत्र सङ्ख्येयं तावद्यथोक्तमष्टोदरीये, अपरिसङ्ख्येयं पुनर्यथा- महारोगाध्याये रुग्वर्णसमुत्थानादीनामसङ्ख्येयत्वात्||३||

dvē rōgānīkē bhavataḥ prabhāvabhēdēna- sādhyam, asādhyaṁ ca; dvē rōgānīkē balabhēdēna- mr̥du,dāruṇaṁ ca; dvē rōgānīkē adhiṣṭhānabhēdēna- manō'dhiṣṭhānaṁ, śarīrādhiṣṭhānaṁ ca; dvē rōgānīkēnimittabhēdēna- svadhātuvaiṣamyanimittam, āgantunimittaṁ ca; dvē rōgānīkē āśayabhēdēna-āmāśayasamutthaṁ, pakvāśayasamutthaṁ cēti|
ēvamētat prabhāvabalādhiṣṭhānanimittāśayabhēdāddvaidhaṁ sadbhēdaprakr̥tyantarēṇabhidyamānamathavā'pi sandhīyamānaṁ syādēkatvaṁ bahutvaṁ vā|
ēkatvaṁ tāvadēkamēva rōgānīkaṁ, duḥkhasāmānyāt [1] ; bahutvaṁ tu daśa rōgānīkāniprabhāvabhēdādinā bhavanti; bahutvamapi saṅkhyēyaṁ syādasaṅkhyēyaṁ vā|
tatra saṅkhyēyaṁ tāvadyathōktamaṣṭōdarīyē, aparisaṅkhyēyaṁ punaryathā- mahārōgādhyāyērugvarṇasamutthānādīnāmasaṅkhyēyatvāt||3||

Dve rogAnIke bhaVataH prabhAvabhedena- sAdhyam, asAdhyaM ca; dve rogAnIke balabhedena- mRudu, dAruNaM ca; dve rogAnIke adhiShThAnabhedena- mano~adhiShThAnaM, sharIrAdhiShThAnaM ca;dve rogAnIke nimittabhedena- svadhAtuvaiShamyanimittam, AgantunimittaM ca; dve rogAnIke Ashayabhedena- AmAshayasamutthaM, pakvAshayasamutthaM ceti| evametat prabhAvabalAdhiShThAnanimittAshayabhedAddvaidhaM
sadbhedaprakRutyantareNa bhidyamAnamathavA~api sandhIyamAnaM syAdekatvaM bahutvaM vA| ekatvaM tAvadekameva rogAnIkaM, duHkhasAmAnyAt;
bahutvaM tu dasha rogAnIkAni prabhAvabhedAdinA bhavanti; bahutvamapi sa~gkhyeyaM
syAdasa~gkhyeyaM vA| tatra sa~gkhyeyaM tAvadyathoktamaShTodarIye, aparisa~gkhyeyaM punaryathA- mahArogAdhyAye rugvarNasamutthAnAdInAmasa~gkhyeyatvAt||3||
<div style="text-align:justify;">
Following are the two categories of diseases:

1. On the basis of Prognosis – i. Curables ii. Incurables
2. On the basis of Intensity - i. Mild ii. Severe
3.On the basis of Location - i. Physical ii. Mental
4.On the basis of Causes - i. Endogenous ii. Exogenous
5.On the basis of Origin - i. Digestive origin(Amashaya) ii. Excretory(pakwashaya) origin

Thus there are two categories of diseases based upon prognosis, intensity, location, cause and origin. There might be only one type of disease or many types of diseases based upon the classification (permutation and combination). Only one type of disease is based on similarity in causing pain and multiple types based upon ten categories and criteria mentioned above prognosis etc. That may be numerable or innumerable. Numerable as mentioned in the chapter [[Ashtodariya]] and innumerable as described in [[Maharoga Adhyaya]] owing to innumerability of nature of pain, change in colour, variation in origin etc. factors. [3]
</div>
==== Justification for different types of classification ====

न च सङ्ख्येयाग्रेषु भेदप्रकृत्यन्तरीयेषु विगीतिरित्यतो दोषवती स्यादत्र काचित् प्रतिज्ञा, न चाविगीतिरित्यतः स्याददोषवती| भेत्ता हि भेद्यमन्यथाभिनत्ति, अन्यथा पुरस्ताद्भिन्नं भेदप्रकृत्यन्तरेण भिन्दन् भेदसङ्ख्याविशेषमापादयत्यनेकधा, न च पूर्वं भेदाग्रमुपहन्ति| समानायामपि खलु भेदप्रकृतौ प्रकृतानुप्रयोगान्तरमपेक्ष्यम्[१] |सन्ति ह्यर्थान्तराणि समानशब्दाभिहितानि, सन्ति चानर्थान्तराणि पर्यायशब्दाभिहितानि| समानो हि रोगशब्दो दोषेषु च व्याधिषु च; दोषा ह्यपि रोगशब्दमातङ्कशब्दं यक्ष्मशब्दं दोषप्रकृतिशब्दं विकारशब्दं च लभन्ते, व्याधयश्च रोगशब्दमातङ्कशब्दं यक्ष्मशब्दं दोषप्रकृतिशब्दं विकारशब्दं च लभन्ते| तत्र दोषेषु चैव व्याधिषु च रोगशब्दः समानः, शेषेषु तु विशेषवान्||४||

na ca saṅkhyēyāgrēṣu bhēdaprakr̥tyantarīyēṣu vigītirityatō dōṣavatī syādatra kācit pratijñā, nacāvigītirityataḥ syādadōṣavatī|
bhēttā hi bhēdyamanyathābhinatti, anyathā purastādbhinnaṁ bhēdaprakr̥tyantarēṇa bhindanbhēdasaṅkhyāviśēṣamāpādayatyanēkadhā, na ca pūrvaṁ bhēdāgramupahanti|
samānāyāmapi khalu bhēdaprakr̥tau prakr̥tānuprayōgāntaramapēkṣyam [1] |
santi hyarthāntarāṇi samānaśabdābhihitāni, santi cānarthāntarāṇi paryāyaśabdābhihitāni|
samānō hi rōgaśabdō dōṣēṣu ca vyādhiṣu ca; dōṣā hyapi rōgaśabdamātaṅkaśabdaṁ yakṣmaśabdaṁdōṣaprakr̥tiśabdaṁ vikāraśabdaṁ ca labhantē, vyādhayaśca rōgaśabdamātaṅkaśabdaṁ yakṣmaśabdaṁdōṣaprakr̥tiśabdaṁ vikāraśabdaṁ ca labhantē|
tatra dōṣēṣu caiva vyādhiṣu ca rōgaśabdaḥ samānaḥ, śēṣēṣu tu viśēṣavān||4||

Na ca sa~gkhyeyAgreShu bhedaprakRutyantarIyeShu vigItirityato doShavatI syAdatra kAcit
pratij~jA, na cAvigItirityataH syAdadoShavatI| bhettA hi bhedyamanyathAbhinatti, anyathA
purastAdbhinnaM bhedaprakRutyantareNa bhindan bhedasa~gkhyAvisheShamApAdayatyanekadhA, na ca pUrvaM bhedAgramupahanti| samAnAyAmapi khalu bhedaprakRutau prakRutAnuprayogAntaramapekShyam|
santi hyarthAntarANi samAnashabdAbhihitAni, santi cAnarthAntarANi
paryAyashabdAbhihitAni| samAno hi rogashabdo doSheShu ca vyAdhiShu ca; doShA
hyapi rogashabdamAta~gkashabdaM yakShmashabdaM doShaprakRutishabdaM vikArashabdaM ca labhante, vyAdhayashca rogashabdamAta~gkashabdaM yakShmashabdaM
doShaprakRutishabdaM vikArashabdaM ca labhante| tatra doSheShu caiva vyAdhiShu
ca rogashabdaH samAnaH, sheSheShu tu visheShavAn||4||

If something, already classified in a particular manner, is reclassified in another way following different criteria, there may be change in the number of groups, and such a charge should not render the statement suggesting such a classification incorrect.
<div style="text-align:justify;">
An individual has the liberty to classify things as he likes. If something is already classified into some groups in a particular manner, he may reclassify it on the basis of different criteria which may result in changes in the number of groups in different ways. This does not invalidate the number of groups according to some other mode of classification. In some cases the criterion of classification may appear to be the same as the previous one but the specific features of each of these criteria should be observed in deciding about the validity of this classification. The same term may carry different meanings e.g. the word ''roga, antanka, yakshman, doshaprakriti'' and ''vikara'' (morbidity – these terms carry the meaning of or are synonymous with both ''dosha'' and ''vyadhi'' (disease). Thus the term ''roga'' is synonymous with both the ''dosha'' and ''vyadhi''. For the rest like ''hetu'' (etiology) etc., this term, viz. ''roga'' carries a different meaning. [4]
</div>
==== Physical and psychic ''doshas'' and their vitiators ====

तत्र व्याधयोऽपरिसङ्ख्येया भवन्ति, अतिबहुत्वात्| दोषास्तु खलु परिसङ्ख्येया भवन्ति, अनतिबहुत्वात्| तस्माद्यथाचित्रं विकारानुदाहरणार्थम्, अनवशेषेण च दोषान् व्याख्यास्यामः| रजस्तमश्च मानसौ दोषौ| तयोर्विकाराः कामक्रोधलोभमोहेर्ष्यामानमदशोकचित्तो(न्तो)द्वेगभयहर्षादयः|
वातपित्तश्लेष्माणस्तु खलु शारीरा दोषाः| तेषामपि च विकारा ज्वरातीसारशोफशोषश्वासमेहकुष्ठादयः| इति दोषाः केवला व्याख्याता विकारैकदेशश्च||५||
तत्र खल्वेषां द्वयानामपि दोषाणां त्रिविधं प्रकोपणं; तद्यथा- असात्म्येन्द्रियार्थसंयोगः, प्रज्ञापराधः परिणामश्चेति||६||

tatra vyādhayō'parisaṅkhyēyā bhavanti, atibahutvāt|
dōṣāstu khalu parisaṅkhyēyā bhavanti, anatibahutvāt|
tasmādyathācitraṁ vikārānudāharaṇārtham, anavaśēṣēṇa ca dōṣān vyākhyāsyāmaḥ|
rajastamaśca mānasau dōṣau|
tayōrvikārāḥ kāmakrōdhalōbhamōhērṣyāmānamadaśōkacittō(ntō)dvēgabhayaharṣādayaḥ|
vātapittaślēṣmāṇastu khalu śārīrā dōṣāḥ|
tēṣāmapi ca vikārā jvarātīsāraśōphaśōṣaśvāsamēhakuṣṭhādayaḥ|
iti dōṣāḥ kēvalā vyākhyātā vikāraikadēśaśca||5||

tatra khalvēṣāṁ dvayānāmapi dōṣāṇāṁ trividhaṁ prakōpaṇaṁ; tadyathā- asātmyēndriyārthasaṁyōgaḥ,prajñāparādhaḥ, pariṇāmaścēti||6||
Tatra vyAdhayo~aparisa~gkhyeyA bhavanti, atibahutvAt| Doshastu khalu parisa~gkhyeyA
bhavanti, anatibahutvAt| tasmAdyathAcitraM vikArAnudAharaNArtham, anavasheSheNa ca
doShAn vyAkhyAsyAmaH| rajastamashca mAnasau doShau| tayorvikArAH kAmakrodhalobhamoherShyAmAnamadashokacitto(nto)dvegabhayaharShAdayaH| VataPittashleShmANastu khalu shArIrA doShAH| teShAmapi ca vikArA jvarAtIsArashophashoShashvAsamehakuShThAdayaH| iti doShAH kevalA vyAkhyAtA
vikAraikadeshashca||5||

tatra khalveShAM dvayAnAmapi doShANAM trividhaM prakopaNaM;
tadyathA- asAtmyendriyArthasaMyogaH, praj~jAparAdhaH, pariNAmashceti||6||
<div style="text-align:justify;">
Because of their multitudinous nature, diseases are innumerable. On the other hand, ''doshas'' are numerable because of their limited number. So only some of the diseases will be explained by way of illustrations whereas ''doshas'' will be explained in their entirety.
''Rajas'' and ''tamas'' are the ''doshas'' pertaining to the mind and the types of morbidity caused by them are ''kama'' (passion), anger, greed, attachment, envy, ego, pride grief, worry, anxiety, fear, excitement etc. ''Vata, pitta and kapha''- these three are the ''doshas'' pertaining to the body. Diseases caused by them are fever, diarrhea, edema, consumption, dyspnoea, ''meha'' (obstinate urinary disorder including diabetes), ''kushtha'' (obstinate skin disease including leprosy) etc. Thus ''doshas'' in their entirety and diseases in parts are explained.

Both of these types of ''doshas'' have three types of etiological factors, viz.
#unwholesome contact with the object of senses,
#intellectual errors, and
#seasonal vagaries. [5-6]
</div>
==== Factors responsible for manifestation of innumerable diseases ====

प्रकुपितास्तु खलु ते प्रकोपणविशेषाद्दूष्यविशेषाच्च विकारविशेषानभिनिर्वर्तयन्त्यपरिसङ्ख्येयान्||७||

prakupitāstu khalu tē prakōpaṇaviśēṣāddūṣyaviśēṣācca vikāraviśēṣānabhinirvartayantyaparisaṅkhyēyān||7||

prakupitAstu khalu te prakopaNavisheShAddUShyavisheShAcca
vikAravisheShAnabhinirvartayantyaparisa~gkhyeyAn||7||

Depending upon the specific nature of the causative factors and also the specificity of the tissue elements afflicted, ''doshas'' when aggravated manifest innumerable types of diseases. [7]

==== Psycho-somatic diseases ====

ते च विकाराः परस्परमनुवर्तमानाः कदाचिदनुबध्नन्ति कामादयो ज्वरादयश्च||८||

tē ca vikārāḥ parasparamanuvartamānāḥ kadācidanubadhnanti kāmādayō jvarādayaśca||8||

te ca vikArAH parasparamanuvartamAnAH kadAcidanubadhnanti kAmAdayo jvarAdayashca||8||

When allowed to persist for long, these psychic diseases viz. ''kama'' (passion) etc., and somatic diseases viz. fever etc., at times get combined with each other. [8]

==== Psychic doshas- their eternal union ====

नियतस्त्वनुबन्धो रजस्तमसोः परस्परं, न ह्यरजस्कं तमः प्रवर्तते ||९||

niyatastvanubandhō rajastamasōḥ parasparaṁ, na hyarajaskaṁ tamaḥ pravartatē ||9||

niyatastvanubandho rajastamasoH parasparaM, na hyarajaskaM tamaH pravartate ||9||

There is an eternal union between the two ''doshas'' pertaining to mind, viz. ''rajas'' and ''tamas''. ''Tamas'' cannot manifest its actions without ''rajas''. [9]

==== Combination of physical ''doshas'' ====

(प्रायः) शारीरदोषाणामेकाधिष्ठानीयानां सन्निपातः संसर्गो वा समानगुणत्वात्; दोषा हि दूषणैः समानाः||१०||

(prāyaḥ) śārīradōṣāṇāmēkādhiṣṭhānīyānāṁ sannipātaḥ saṁsargō vā samānaguṇatvāt; dōṣā hi dūṣaṇaiḥsamānāḥ||10||

(prAyaH) shArIradoShANAmekAdhiShThAnIyAnAM sannipAtaH saMsargo vA samAnaguNatvAt; doShA hi dUShaNaiH samAnAH||10||
<div style="text-align:justify;">
The three somatic ''doshas'' located at the same place and having identical attributes mostly combine with one another (''samsarga'') or with all taken together (''sannipata''). Attributes of ''doshas'' resemble those of the factors which vitiate those ''doshas''. [10]
</div>
==== Primary and Secondary diseases ====

तत्रानुबन्ध्यानुबन्धकृतो विशेषः- स्वतन्त्रो व्यक्तलिङ्गो यथोक्तसमुत्थानप्रशमो भवत्यनुबन्ध्यः, तद्विपरीतलक्षणस्त्वनुबन्धः| अनुबन्ध्यलक्षणसमन्वितास्तत्र
यदि दोषा भवन्ति तत्त्रिकं सन्निपातमाचक्षते, द्वयं वा संसर्गम्| अनुबन्ध्यानुबन्धविशेषकृतस्तु बहुविधो दोषभेदः| एवमेष सञ्ज्ञाप्रकृतो भिषजां दोषेषु व्याधिषु च नानाप्रकृतिविशेषव्यूहः ||११||

tatrānubandhyānubandhakr̥tō viśēṣaḥ- svatantrō vyaktaliṅgō yathōktasamutthānapraśamōbhavatyanubandhyaḥ, tadviparītalakṣaṇastvanubandhaḥ|
anubandhyalakṣaṇasamanvitāstatra yadi dōṣā bhavanti tattrikaṁ sannipātamācakṣatē, dvayaṁ vāsaṁsargam|
anubandhyānubandhaviśēṣakr̥tastu bahuvidhō dōṣabhēdaḥ|
ēvamēṣa sañjñāprakr̥tō bhiṣajāṁ dōṣēṣu vyādhiṣu ca nānāprakr̥tiviśēṣavyūhaḥ ||11||

tatrAnubandhyAnubandhakRuto visheShaH- sVatantro vyaktali~ggo yathoktasamutthAnaprashamo bhavatyanubandhyaH, tadviparItalakShaNastvanubandhaH|
anubandhyalakShaNasamanvitAstatra yadi doShA bhavanti tattrikaM sannipAtamAcakShate,
dvayaM vA saMsargam| anubandhyAnubandhavisheShakRutastu bahuvidho doShabhedaH|
evameSha sa~jj~jAprakRuto bhiShajAM doSheShu vyAdhiShu ca nAnAprakRutivisheShavyUhaH||11||

Characteristic features of primary and secondary (subordinate) diseases are as follows:
<div style="text-align:justify;">
The primary disease manifests its own symptoms independently; this morbid condition is caused by factors specific to the manifestation of the disease. This can be cured by the therapies prescribed for that particular disease. The subordinate disease is characterized by opposite features. If all the three ''doshas'' are primarily vitiated at a time, the condition is known as ''sannipata''. If only two of the ''doshas'' are vitiated, it is called ''samsarga''. Depending upon the primary and subordinate nature of ''doshas'', they are of many types. Considering such characteristic features, physicians attribute various names (like ''jwara'' or fever and ''atisara'' or diarrhea) to different conditions caused by ''doshas'' and diseases. [11]
</div>
==== Four types of ''Agni'' ====

अग्निषु तु शारीरेषु चतुर्विधो विशेषो बलभेदेन भवति| तद्यथा- तीक्ष्णो, मन्दः, समो, विषमश्चेति| तत्र तीक्ष्णोऽग्निः सर्वापचारसहः, तद्विपरीतलक्षणस्तु मन्दः, समस्तु खल्वपचारतो विकृतिमापद्यतेऽनपचारतस्तु प्रकृताववतिष्ठते,
समलक्षणविपरीतलक्षणस्तु विषम इति| एते चतुर्विधा भवन्त्यग्नयश्चतुर्विधानामेव पुरुषाणाम्| तत्र समवातपित्तश्लेष्मणां प्रकृतिस्थानां समा भवन्त्यग्नयः, वातलानां तु वाताभिभूतेऽग्न्यधिष्ठाने विषमा भवन्त्यग्नयः, पित्तलानां तु पित्ताभिभूते ह्यग्न्यधिष्ठाने तीक्ष्णा भवन्त्यग्नयः, श्लेष्मलानां तु श्लेष्माभिभूतेऽग्न्यधिष्ठाने मन्दा भवन्त्यग्नयः||१२||

agniṣu tu śārīrēṣu caturvidhō viśēṣō balabhēdēna bhavati|
tadyathā- tīkṣṇō, mandaḥ, samō, viṣamaścēti|
tatra tīkṣṇō'gniḥ sarvāpacārasahaḥ, tadviparītalakṣaṇastu mandaḥ, samastu khalvapacāratōvikr̥timāpadyatē'napacāratastu prakr̥tāvavatiṣṭhatē, samalakṣaṇaviparītalakṣaṇastu viṣama iti|
ētē caturvidhā bhavantyagnayaścaturvidhānāmēva puruṣāṇām|
tatra samavātapittaślēṣmaṇāṁ prakr̥tisthānāṁ samā bhavantyagnayaḥ, vātalānāṁ tuvātābhibhūtē'gnyadhiṣṭhānē viṣamā bhavantyagnayaḥ, pittalānāṁ tu pittābhibhūtē hyagnyadhiṣṭhānē tīkṣṇābhavantyagnayaḥ, ślēṣmalānāṁ tu ślēṣmābhibhūtē'gnyadhiṣṭhānē mandā bhavantyagnayaḥ||12||

AgniShu tu shArIreShu caturvidho visheSho balabhedena bhavati| tadyathA- tIkShNo, mandaH, samo, viShamashceti| tatra tIkShNo~AgniH sarvApacArasahaH, tadviparItalakShaNastu mandaH, samastu khalvapacArato
vikRutimApadyate~anapacAratastu prakRutAvavatiShThate,
samalakShaNaviparItalakShaNastu viShama iti| ete caturvidhA bhavantyagnayashcaturvidhAnAmeva puruShANAm| tatra
samaVataPittashleShmaNAM prakRutisthAnAM samA bhavantyagnayaH, VatalAnAM tu VatabhibhUte~agnyadhiShThAne viShamA bhavantyagnayaH, PittalAnAM Tu PittabhibhUte hyagnyadhiShThAne tIkShNA bhavantyagnayaH,
shleShmalAnAM tu shleShmAbhibhUte~agnyadhiShThAne
mandA bhavantyagnayaH||12||
<div style="text-align:justify;">
Depending upon their intensity, ''agnis'' (factors responsible for digestion and metabolism) located in the body of human beings can be classified under four categories, viz. ''tikshna'' (severe), ''manda'' (low), ''sama'' (normal) and ''vishama'' (irregular). The ''tikshna'' type is capable of tolerating all types of irregularities whereas the ''manda'' type is of opposite nature, i.e. even a small irregularity will impair its functioning. The ''sama'' or balanced type of ''agni'' gets impaired even by minor irregularities; it maintains its normalcy so long as there is no irregularity. The irregular type of ''agni'', as opposed to ''sama'' or balanced type, sometimes gets impaired and sometime it does not get impaired by irregularities.

These four types of ''agni'' occur in the four types of individuals. In individuals having ''vata, pitta'' and ''kapha'' in their balanced and normal state, the ''agnis'' are regular or balanced. In the case of individuals having the dominance of ''vata'' constitution, due to the affliction of the site of ''agni'' by ''vata,'' their ''agnis'' are irregular. In the case of individuals having the dominance of ''pitta'', the ''agnis'' are sharp. Similarly, in the case of individuals having the dominance of ''kapha'' in the constitution, the ''agnis'' are mild due to the affliction of the site of ''agni'' by ''kapha''. [12]
</div>
==== Physical constitution ====

तत्र केचिदाहुः- न समवातपित्तश्लेष्माणो जन्तवः सन्ति, विषमाहारोपयोगित्वान्मनुष्याणां; तस्माच्च वातप्रकृतयः केचित्, केचित् पित्तप्रकृतयः, केचित् पुनः श्लेष्मप्रकृतयो भवन्तीति| तच्चानुपपन्नं, कस्मात् कारणात्? समवातपित्तश्लेष्माणं ह्यरोगमिच्छन्ति भिषजः, यतः प्रकृतिश्चारोग्यम्, आरोग्यार्था च भेषजप्रवृत्तिः, सा चेष्टरूपा, तस्मात् सन्ति समवातपित्तश्लेष्माणः; न खलु सन्ति वातप्रकृतयः पित्तप्रकृतयः श्लेष्मप्रकृतयो वा|
तस्य तस्य किल दोषस्याधिक्यात् सा सा दोषप्रकृतिरुच्यते मनुष्याणां, न च विकृतेषु
दोषेषु प्रकृतिस्थत्वमुपपद्यते, तस्मान्नैताः प्रकृतयः सन्ति; सन्ति तु खलु वातलाः
पित्तलाः श्लेष्मलाश्च, अप्रकृतिस्थास्तु ते ज्ञेयाः||१३||

tatra kēcidāhuḥ- na samavātapittaślēṣmāṇō jantavaḥ santi, viṣamāhārōpayōgitvānmanuṣyāṇāṁ; tasmāccavātaprakr̥tayaḥ kēcit, kēcit pittaprakr̥tayaḥ, kēcit punaḥ ślēṣmaprakr̥tayō bhavantīti|
taccānupapannaṁ, kasmāt kāraṇāt? samavātapittaślēṣmāṇaṁ hyarōgamicchanti bhiṣajaḥ, yataḥ prakr̥tiścārōgyam, ārōgyārthā ca bhēṣajapravr̥ttiḥ, sā cēṣṭarūpā, tasmāt santi samavātapittaślēṣmāṇaḥ; nakhalu santi vātaprakr̥tayaḥ pittaprakr̥tayaḥ ślēṣmaprakr̥tayō vā|
tasya tasya kila dōṣasyādhikyāt sā sā dōṣaprakr̥tirucyatē manuṣyāṇāṁ, na ca vikr̥tēṣu dōṣēṣuprakr̥tisthatvamupapadyatē, tasmānnaitāḥ prakr̥tayaḥ santi; santi tu khalu vātalāḥ pittalāḥ ślēṣmalāśca,aprakr̥tisthāstu tē jñēyāḥ||13||

tatra kecidAhuH- na samaVataPittashleShmANo jantavaH santi, viShamAhAropayogitvAnmanuShyANAM;tasmAcca
VataprakRutayaH kecit,kecit PittaprakRutayaH, kecit punaH
shleShmaprakRutayo bhavantIti|taccAnupapannaM, kasmAt
kAraNAt? samaVataPittashleShmANaM hyarogamicchanti
bhiShajaH,yataH prakRutishcArogyam,ArogyArthA ca bheShajapravRuttiH,
sA ceShTarUpA, tasmAt santi samaVataPittashleShmANaH;na khalu
santi VataprakRutayaH PittaprakRutayaH shleShmaprakRutayo vA|
tasya tasya kila DoshasyAdhikyAt sA sA doShaprakRutirucyate manuShyANAM, na ca vikRuteShu doSheShu prakRutisthatvamupapadyate,tasmAnnaitAH prakRutayaH santi; santi tu khalu VatalAH PittalAH shleShmalAshca, aprakRutisthAstu te j~jeyAH||13||
<div style="text-align:justify;">
Some scholars hold the view that living beings cannot have a balanced state of ''vata, pitta'' and ''kapha'' in their body because they are accustomed to the intake of diets which are seldom balanced. Therefore, according to them some individuals have ''vata prakriti'' (''vatika'' constitution), some have ''pitta prakriti'' (''pattika'' constitution) and the rest have ''kapha prakriti'' (''shlaishmika'' constitution). This is not correct because physicians take an individual to be healthy only when ''vata, pitta'' and ''kapha'' in his body are in a state of equilibrium and health represents the natural state of the body. It is with a view to maintaining good health that all types of treatments are prescribed. That state of the body is the most cherished one. Therefore, there are individuals having the balanced state of ''vata, pitta'' and ''kapha'' in their body.

The use of terms like ''vataprakriti, pittaprakriti'' and ''kaphaprakriti'' is not correct because in these types of constitutions, there is always a dominance of ''doshas'' in the bodies of individuals. ''Prakriti'' means a normal or natural state and there should not be any dominance of ''doshas'' in the bodies of such individuals. So such individuals as are having the dominance of one or the other ''doshas'' cannot be described to have the normal state of their body. Thus to use the correct term, they are ''vatala'' (having the dominance of ''vata''), ''pittala'' (having the dominance of ''pitta'') and ''shlesmala'' (having the dominance of ''kapha''), and these do not indicate the normal state of their body. [13]
</div>
==== Management of persons having different types of physical constitution ====

तेषां तु खलु चतुर्विधानां पुरुषाणां चत्वार्यनुप्रणिधानानि
श्रेयस्कराणि भवन्ति| तत्र समसर्वधातूनां सर्वाकारसमम्, अधिकदोषाणां तु त्रयाणां यथास्वं दोषाधिक्यमभिसमीक्ष्य दोषप्रतिकूलयोगीनि त्रीण्यनु(न्न)प्रणिधानानि श्रेयस्कराणि भवन्ति यावदग्नेः समीभावात्, समे तु सममेव कार्यम्; एवं चेष्टा भेषजप्रयोगाश्चापरे| तान् विस्तरेणानुव्याख्यास्यामः||१४||

tēṣāṁ tu khalu caturvidhānāṁ puruṣāṇāṁ catvāryanupraṇidhānāni śrēyaskarāṇi bhavanti|
tatra samasarvadhātūnāṁ sarvākārasamam, adhikadōṣāṇāṁ tu trayāṇāṁ yathāsvaṁdōṣādhikyamabhisamīkṣya dōṣapratikūlayōgīni trīṇyanu(nna)praṇidhānāni śrēyaskarāṇi bhavanti yāvadagnēḥsamībhāvāt, samē tu samamēva kāryam; ēvaṁ cēṣṭā bhēṣajaprayōgāścāparē|
tān vistarēṇānuvyākhyāsyāmaḥ||14||

doShe pravRuddhe pratikUlatayA yogIni doShapratikUlayogIni| trINi VataPittashleShmapratikUlAni|same tviti samatAM gate vahnau, yathocitavidhAnena (VataprakRutyAdInAM) samamevAnupraNidhAnaM
kartavyam|evamityanena prakAreNa ceShTAbheShajayorapi prayogA VatadInAM bhavanti; ye tu,evamityanena caturvidhenoktena prakAreNeti vadanti, te samaprakRutInAM ca samavyAyAmAdiceShTA bheShajaM
ca RutucaryAvidheyaM vamanAdikArakaM sUcyate~aneneti
vyAkhyAnayanti||14||
<div style="text-align:justify;">
Four types of regimens are prescribed for the benefit of these four categories of individuals. For an individual having the balance state of all ''doshas'', all the regimens to be adopted by him should be of balanced type. When there is predominance of ''doshas'', depending upon the nature of the ''doshas'' involved, it is useful to adopt such three regimens as would be in contradiction with these three predominating ''doshas'' till there is normalcy of ''agni''. It is only after the normalcy of the ''agni'' is attained, balanced regimens should be adopted. Similarly, various therapies and other regimens should be administered to these four categories of individuals. We shall now explain them in detail. [14]
</div>
==== Characteristic of constitutions and management of ''vata'' dominance ====

त्रयस्तु पुरुषा भवन्त्यातुराः, ते त्वनातुरास्तन्त्रान्तरीयाणां भिषजाम्| तद्यथा- वातलः,पित्तलः, श्लेष्मलश्चेति| तेषामिदं विशेषविज्ञानं- वातलस्य वातनिमित्ताः, पित्तलस्य पित्तनिमित्ताः, श्लेष्मलस्य श्लेष्मनिमित्ता व्याधयः प्रायेण बलवन्तश्च भवन्ति||१५||
तत्र वातलस्य वातप्रकोपणान्यासेवमानस्य क्षिप्रं वातः प्रकोपमापद्यते, न तथेतरौ दोषौ; स तस्य प्रकोपमापन्नो यथोक्तैर्विकारैः शरीरमुपतपति बलवर्णसुखायुषामुपघाताय| तस्यावजयनं- स्नेहस्वेदौ विधियुक्तौ, मृदूनि च संशोधनानि स्नेहोष्णमधुराम्ललवणयुक्तानि, तद्वदभ्यवहार्याणि, अभ्यङ्गोपनाहनोद्वेष्टनोन्मर्दनपरिषेकावगाहनसंवाहनावपीडनवित्रासनविस्मापनविस्मारणानि, सुरासवविधानं, स्नेहाश्चानेकयोनयो दीपनीयपाचनीयवातहरविरेचनीयोपहितास्तथा शतपाकाः
सहस्रपाकाः सर्वशश्च प्रयोगार्थाः, बस्तयः, बस्तिनियमः सुखशीलता चेति||१६||

trayastu puruṣā bhavantyāturāḥ, tē tvanāturāstantrāntarīyāṇāṁ bhiṣajām|
tadyathā- vātalaḥ, pittalaḥ, ślēṣmalaścēti|
tēṣāmidaṁ viśēṣavijñānaṁ- vātalasya vātanimittāḥ, pittalasya pittanimittāḥ, ślēṣmalasya ślēṣmanimittāvyādhayaḥ prāyēṇa balavantaśca bhavanti||15||

tatra vātalasya vātaprakōpaṇānyāsēvamānasya [16] kṣipraṁ vātaḥ prakōpamāpadyatē, na tathētarau dōṣau; satasya prakōpamāpannō yathōktairvikāraiḥ śarīramupatapati balavarṇasukhāyuṣāmupaghātāya|
tasyāvajayanaṁ- snēhasvēdau vidhiyuktau, mr̥dūni ca saṁśōdhanāni snēhōṣṇamadhurāmlalavaṇayuktāni,tadvadabhyavahāryāṇi,abhyaṅgōpanāhanōdvēṣṭanōnmardanapari
ṣēkāvagāhanasaṁvāhanāvapīḍanavitrāsanavismāpanavismāraṇāni,surāsavavidhānaṁ, snēhāścānēkayōnayō dīpanīyapācanīyavātaharavirēcanīyōpahitāstathā śatapākāḥsahasrapākāḥ sarvaśaśca prayōgārthāḥ, bastayaḥ, bastiniyamaḥ sukhaśīlatā cēti||16||

Trayastu puruShA bhavantyAturAH,te tvanAturAstantrAntarIyANAM bhiShajAm|tadyathA-VatalaH,PittalaH,shleShmalashceti|teShAmidaM
visheShavij~jAnaM-Vatalasya VatanimittAH,Pittalasya PittanimittAH,
shleShmalasya shleShmanimittA vyAdhayaH prAyeNa balavantashca
bhavanti||15||

tatra Vatalasya VataprakopaNAnyAsevamAnasya
kShipraM VataH prakopamApadyate,na tathetarau doShau; sa tasya
prakopamApanno yathoktairvikAraiH sharIramupatapati balavarNasukhAyuShAmupaghAtAya| tasyAvajayanaM-snehasvedau
vidhiyuktau,mRudUni ca saMshodhanAni snehoShNamadhurAmlalavaNayuktAni,tadvadabhyavahAryANi,
abhya~ggopanAhanodveShTanonmardanapariShekAvagAhanasaMvAhanAvapIDanavitrAsanavismApanavismAraNAni, surAsavavidhAnaM, snehAshcAnekayonayo dIpanIyapAcanIyaVataharavirecanIyopahitAstathA
shatapAkAH sahasrapAkAH sarvashashca prayogArthAH, bastayaH, bastiniyamaH sukhashIlatA ceti||16||
<div style="text-align:justify;">
''Vatala'' (dominance of ''vata''), ''pittala'' (dominance of ''pitta'') and ''shleshmala'' (dominance of ''kapha'')- these three are the morbid state in individuals, even though, according to another school of thought they represent the natural states of the body. Their characteristic features are as given below: - ''vatala, pittala'' and ''shleshmala'' types of individuals are more susceptible to ''vatika, pittika'' and ''shlaishmika'' diseases respectively and such diseases in the respective types of individual become very severe.

If ''vatala'' type of individual resorts to such things which are aggravators of ''vata, vata'' in his body gets aggravated immediately. This does not happen in case of remaining two ''doshas''. The aggravated ''vata'' afflicts individuals by the manifestation of disease already described, resulting in the impairment of strength, complexion, happiness and longevity. The following therapies alleviate this ''dosha'':

#Proper administration of oleation and fomentation;
#Mild purgative prepared by the addition of fat, hot things and substances having sweet, sour and saline tastes;
#Food having the ingredients of the above mentioned properties.
#Massage, poultices, bandages, kneading, effusion, bath, ''samvahana'' (pressing and massaging by hand), pressing, using means of terrifying, methods of surprising and making oneself to forget (bad memories)
#Use of wine and ''asavas'' (fermented drinks)
#Fats from different sources mixed with drugs having digestive, stimulant, carminative, ''vata'' alleviating and purgative properties- they may be boiled hundred and thousand times and be used for being administered in different ways, viz. internal use, massage, enema, etc., and
#Observance of enema regimens, its regulations and adopting comfort (in behavior and lifestyle) [15-16]
</div>
==== Characteristics of ''pittala'' constitution and its management ====

पित्तलस्यापि पित्तप्रकोपणान्यासेवमानस्य क्षिप्रं
पित्तं प्रकोपमापद्यते, न तथेतरौ दोषौ; तदस्य प्रकोपमापन्नं यथोक्तैर्विकारैः शरीरमुपतपति
बलवर्णसुखायुषामुपघाताय| तस्यावजयनं- सर्पिष्पानं, सर्पिषा च स्नेहनम्, अधश्च दोषहरणं,
मधुरतिक्तकषायशीतानां चौषधाभ्यवहार्याणामुपयोगः, मृदुमधुरसुरभिशीतहृद्यानां गन्धानां चोपसेवा,
मुक्तामणिहारावलीनां च परमशिशिरवारिसंस्थितानां धारणमुरसा, क्षणे क्षणेऽग्र्यचन्दनप्रियङ्गुकालीयमृणालशीतवातवारिभिरुत्पलकुमुदकोकनदसौगन्धिकपद्मानुगतैश्च वारिभिरभिप्रोक्षणं, श्रुतिसुखमृदुमधुरमनोऽनुगानां
च गीतवादित्राणां श्रवणं, श्रवणं चाभ्युदयानां, सुहृद्भिः संयोगः, संयोगश्चेष्टाभिः स्त्रीभिः शीतोपहितांशुकस्रग्धारिणीभिः, निशाकरांशुशीतलप्रवातहर्म्यवासः, शैलान्तरपुलिनशिशिरसदनवसनव्यजनपवनसेवनं, रम्याणां चोपवनानां सुखशिशिरसुरभिमारुतोपहितानामुपसेवनं, सेवनं चपद्मोत्पलनलिनकुमुदसौगन्धिकपुण्डरीकशतपत्रहस्तानां , सौम्यानां च सर्वभावानामिति||१७||

pittalasyāpi pittaprakōpaṇānyāsēvamānasya [17] kṣipraṁ pittaṁ prakōpamāpadyatē, na tathētarau dōṣau;tadasya prakōpamāpannaṁ yathōktairvikāraiḥ śarīramupatapati balavarṇasukhāyuṣāmupaghātāya|
tasyāvajayanaṁ- sarpiṣpānaṁ, sarpiṣā ca snēhanam, adhaśca dōṣaharaṇaṁ, madhuratiktakaṣāyaśītānāṁcauṣadhābhyavahāryāṇāmupayōgaḥ, mr̥dumadhurasurabhiśītahr̥dyānāṁ gandhānāṁ cōpasēvā,muktāmaṇihārāvalīnāṁ ca paramaśiśiravārisaṁsthitānāṁ dhāraṇamurasā, kṣaṇēkṣaṇē'gryacandanapriyaṅgukālīyamr̥ṇālaśītavātavāribhirutpalakumudakōkanadasaugandhikapadmānugataiścavāribhirabhiprōkṣaṇaṁ, śrutisukhamr̥dumadhuramanō'nugānāṁ ca gītavāditrāṇāṁ śravaṇaṁ, śravaṇaṁcābhyudayānāṁ, suhr̥dbhiḥ saṁyōgaḥ, saṁyōgaścēṣṭābhiḥ strībhiḥ śītōpahitāṁśukasragdhāriṇībhiḥ,niśākarāṁśuśītalapravātaharmyavāsaḥ, śailāntarapulinaśiśirasadanavasanavyajanapavanasēvanaṁ,ramyāṇāṁ cōpavanānāṁ sukhaśiśirasurabhimārutōpahitānāmupasēvanaṁ, sēvanaṁ capadmōtpalanalinakumudasaugandhikapuṇḍarīkaśatapatrahastānāṁ [18] , saumyānāṁ casarvabhāvānāmiti||17||

PittalasyApi PittaprakopaNAnyAsevamAnasya kShipraM PittaM
prakopamApadyate, na tathetarau doShau;tadasya prakopamApannaM
yathoktairvikAraiH sharIramupatapati balavarNasukhAyuShAmupaghAtAya| tasyAvajayanaM-
sarpiShpAnaM,sarpiShA ca snehanam, adhashca doShaharaNaM, madhuratiktakaShAyashItAnAM cauShadhAbhyavahAryANAmupayogaH,mRudumadhurasurabhishItahRudyAnAM gandhAnAM
copasevA, muktAmaNihArAvalInAM ca paramashishiravArisaMsthitAnAM dhAraNamurasA,
kShaNekShaNe~agryacandanapriya~ggukAlIyamRuNAlashItaVatavAribhirutpalakumudakokanadasaugandhikapadmAnugataishca vAribhirabhiprokShaNaM,shrutisukhamRudumadhuramano~anugAnAM
ca gItavAditrANAM shravaNaM,shravaNaM cAbhyudayAnAM, suhRudbhiH saMyogaH,saMyogashceShTAbhiH strIbhiH shItopahitAMshukasragdhAriNIbhiH,nishAkarAMshushItalapraVataharmyavAsaH, shailAntarapulinashishirasadanavasanavyajanapavanasevanaM,
ramyANAM copavanAnAM sukhashishirasurabhimArutopahitAnAmupasevanaM,sevanaM ca
padmotpalanalinakumudasaugandhikapuNDarIkashatapatrahastAnAM,
saumyAnAM ca sarvabhAvAnAmiti||17||
<div style="text-align:justify;">
If a ''pittaja'' individual resorts to such things as are aggravators of ''pitta, pitta'' in his body gets aggravated immediately. This does not happen in the case of remaining two ''doshas''. The aggravated ''pitta'' afflicts the individual by the manifestation of diseases already described resulting in the impairment of strength, complexion, happiness and longevity. The following therapies alleviate this ''dosha'':

#Consumption of ghee;
#Oleation by ghee;
#Purgation;
#Use of drugs and diets having sweet, bitter and astringent tastes; and cooling property;
#Use of scents which are mild, sweet, fragrant, cooling and cordial;
#Use in the chest of pearls, jewels and garlands which are kept in excessively cold water;
#Frequent sprinkling of cold water and cold air of ''agryachandana'' (Santalum album Linn.), ''priyangu'' (Callicarpa macrophylla), ''kaliya'' (yellow variety of ''chandana'') and ''mrinala'' (lotus stalk) mixed with ''utpala'' (Nymphaea alba Linn.), ''kumuda'' (a variety of ''utpala''), ''kokanada'' (a variety of ''utpala'' red in color), ''saugandhika'' (a variety of ''utpala'') and ''padma'' (Nelumbo nucifera Gaertn.)
#Hearing of songs and music which are pleasing to ears, mild, sweet and agreeable;
#Hearing the information regarding prosperity;
#Keeping company of friends;
#Company of agreeable ladies wearing cooling garments and garlands;
#Residence in buildings which is cooled by the moon rays and exposed to the breezes from all sides;
#Residence in cold places in mountains and river banks, use of cold apparel and exposure to the cold winds of fans;
#Visiting beautiful garden having pleasing, cold and fragrant wind;
#Use of flower of ''padma'' (Nelumbo ncifera Gaertn.), ''utpala'' (Nymphaea alba linn.), ''nalina'' (a type of lotus), ''kumuda'' (a variety of ''utpala''), ''saugandhika'' (a variety of ''utpala''), ''pundarika''( Nymphaea lotus Linn.) and ''satapatra'' ( a variety of lotus); and
#Adoption of such other regimens as are of soothing nature. [17]
</div>
==== Characteristics of ''slaishmala'' constitution and its management ====

श्लेष्मलस्यापि श्लेष्मप्रकोपणान्यासेवमानस्य [१] क्षिप्रं श्लेष्मा प्रकोपमापद्यते, न तथेतरौ दोषौ; स तस्य प्रकोपमापन्नोयथोक्तैर्विकारैः शरीरमुपतपति बलवर्णसुखायुषामुपघाताय|
तस्यावजयनं- विधियुक्तानि तीक्ष्णोष्णानि संशोधनानि, रूक्षप्रायाणि चाभ्यवहार्याणि कटुकतिक्तकषायोपहितानि, तथैवधावनलङ्घनप्लवनपरिसरणजागरणनियुद्धव्यवायव्यायामोन्मर्दनस्नानोत्सादनानि, विशेषतस्तीक्ष्णानां दीर्घकालस्थितानां चमद्यानामुपयोगः, सधूमपानः सर्वशश्चोपवासः, तथोष्णं वासः, सुखप्रतिषेधश्च सुखार्थमेवेति||१८||

ślēṣmalasyāpi ślēṣmaprakōpaṇānyāsēvamānasya [19] kṣipraṁ ślēṣmā prakōpamāpadyatē, na tathētarau dōṣau;sa tasya prakōpamāpannō yathōktairvikāraiḥ śarīramupatapati balavarṇasukhāyuṣāmupaghātāya|
tasyāvajayanaṁ- vidhiyuktāni tīkṣṇōṣṇāni saṁśōdhanāni, rūkṣaprāyāṇi cābhyavahāryāṇikaṭukatiktakaṣāyōpahitāni, tathaivadhāvanalaṅghanaplavanaparisaraṇajāgaraṇaniyuddhavyavāyavyāyāmōnmardanasnānōtsādanāni,viśēṣatastīkṣṇānāṁ dīrghakālasthitānāṁ ca madyānāmupayōgaḥ, sadhūmapānaḥ sarvaśaścōpavāsaḥ,tathōṣṇaṁ vāsaḥ, sukhapratiṣēdhaśca sukhārthamēvēti||18||

shleShmalasyApi shleShmaprakopaNAnyAsevamAnasya kShipraM shleShmA prakopamApadyate,na tathetarau doShau; sa tasya prakopamApanno yathoktairvikAraiH sharIramupatapati balavarNasukhAyuShAmupaghAtAya|tasyAvajayanaM-
vidhiyuktAni tIkShNoShNAni saMshodhanAni,rUkShaprAyANi
cAbhyavahAryANi kaTukatiktakaShAyopahitAni, tathaiva
dhAvanala~gghanaplavanaparisaraNajAgaraNaniyuddhavyavAyavyAyAmonmardanasnAnotsAdanAni,visheShatastIkShNAnAM dIrghakAlasthitAnAM ca madyAnAmupayogaH, sadhUmapAnaHsarvashashcopavAsaH,tathoShNaM vAsaH,
sukhapratiShedhashca sukhArthameveti||18||
<div style="text-align:justify;">
If ''shlaishmala'' types of individual resorts to such things as are aggravators of ''kapha'', then ''kapha'' in his body gets aggravated immediately; this does not happen to the remaining two ''doshas''. The aggravated ''kapha'' afflicts the individual by the manifestation of diseases already described, resulting in the impairment of strength, complexion, happiness and longevity. The following therapies alleviate this ''dosha'':

#Proper administration of strong and hot elimination therapies;
#Intake of diet which is mostly ununctuous and is composed of ingredients having pungent, bitter and astringent tastes;
#Running, jumping, swimming, whirling, keeping awake during night, fighting, sexual intercourse, exercise, unction, bath and oil massage;
#Intake of strong wines preserved for a long time;
#All lightening therapies along with herbal smoking;
#Use of warm apparel; and
#Giving up comforts of life with a view to enjoying happiness ultimately. [18]
</div>
==== Characteristics of royal physician ====

भवति चात्र- सर्वरोगविशेषज्ञः सर्वकार्यविशेषवित्| सर्वभेषजतत्त्वज्ञो राज्ञः प्राणपतिर्भवेदिति||१९||

bhavati cātra-
sarvarōgaviśēṣajñaḥ sarvakāryaviśēṣavit| sarvabhēṣajatattvajñō rājñaḥ prāṇapatirbhavēditi||19||

bhavati cAtra- sarvarogavisheShaj~jaH sarvakAryavisheShavit| sarvabheShajatattvaj~jo rAj~jaH prANapatirbhavediti||19||

Thus it is said:-
A man well versed with the specific features of all diseases, principles of their treatment and properties of all medicaments is entitled to be a royal physician. [19]

==== Summary ====

तत्र श्लोकाः- प्रकृत्यन्तरभेदेन रोगानीकविकल्पनम्| परस्पराविरोधश्च सामान्यं रोगदोषयोः||२०|| दोषसङ्ख्या विकाराणामेकदेशः प्रकोपणम्| जरणं प्रति चिन्ता च कायाग्नेर्धुक्षणानि च||२१|| नराणां वातलादीनां प्रकृतिस्थापनानि च| रोगानीके विमानेऽस्मिन् व्याहृतानि महर्षिणा||२२||

tatra ślōkāḥ-
prakr̥tyantarabhēdēna rōgānīkavikalpanam| parasparāvirōdhaśca sāmānyaṁ rōgadōṣayōḥ||20||

dōṣasaṅkhyā vikārāṇāmēkadēśaḥ prakōpaṇam|
jaraṇaṁ prati cintā ca kāyāgnērdhukṣaṇāni ca||21||

narāṇāṁ vātalādīnāṁ prakr̥tisthāpanāni ca|
rōgānīkē vimānē'smin vyāhr̥tāni maharṣiṇā||22||

shlokAH-prakRutyantarabhedena rogAnIkavikalpanam|parasparAvirodhashca sAmAnyaM rogadoShayoH||20||Doshasa~gkhyA vikArANAmekadeshaH prakopaNam|jaraNaM prati cintA ca kAyAgnerdhukShaNAni ca||21||

narANAM VatalAdInAM prakRutisthApanAni ca| rogAnIke vimAne~asmin vyAhRutAni maharShiNA||22||
<div style="text-align:justify;">
To sum up, in this chapter, groups of diseases based upon ''vata'' etc. ''prakriti'' types, non-contradiction of classified categories of diseases, similarity in ''dosha'' and ''roga'', numbers of ''doshas'', diseases with one type, causes of vitiation of ''dosha'', description of ''agni'', and means to stimulate it’s functions, ''vata'' etc. dominant types of persons and their management to maintain normalcy of ''dosha'' are described in details by sage Atreya. [20-22]

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

#The grouping of diseases, patients and ''agni'' is framed for development of common modalities for diagnosis and treatment.
#Understanding the disease, the ''agni'' (digestive capacity) and ''prakriti'' (constitution) of a person is of prime importance for a physician to provide effective treatment.
#Comprehensive knowledge of a disease includes its prognosis(curable or incurable), severity(mild or severe), location(soma or psyche),causes(endogenous or exogenous) and site of origin (stomach/digestive or large intestine/excretory).
#If a person has predominant ''dosha'' and indulges in activities or food increasing that ''dosha'' then he will have abrupt onset of disease caused by aggravation of that ''dosha''.
#A disease with known etiology, clinical features pointing to a diagnosis and indicated effective treatment is called ''anubandhya'', on the other hand a disease with unknown etiology, variable clinical features and not effective treatment is called ''anubandh''.
#Mental and physical disorders may start as such but later influence each other.
#Passion, anger, greed, attachment, envy, ego, worry, anxiety, fear, excitement etc. are due to psychic ''dosha, raja'' and ''tamas''.
#''Rajas'' is the initiator of all actions. ''Tamas'' cannot act without ''rajas''.
#''Agni''( digestive processes) of a person shall be diagnosed as ''tikshna''(severe), ''manda''(low), ''sama''(balanced) and ''vishama''(irregular). The selection of diet and dose of medicine depends upon ''agni''.

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

''Vimana'' literally means measurement, so this section gives the physical as well pathological parameters for the measurement of various entities like ''dosha, dhatu, agni, srotasa'' etc. In the present chapter method of classification of diseases is given on the basis of prognosis, severity, site of origin, cause and location. Physicians are directed to diagnose the disease as primary or secondary one on the basis of vitiated ''doshas'' and treatment given. Primary ''doshas'' manifest their respective diseases when they are aggravated. On the other hand, the sub-ordinate ''dosha'' manifests their respective symptoms only when they are stimulated by the primary ''dosha''. In other words, in view of their un-manifested symptoms, subordinate ''dosha'', do not get aggravated by the factor responsible for their aggravation as mentioned in the texts nor do they get alleviated by the therapy prescribed specially for them. They get alleviated only when the therapy prescribed for primary ''dosha'' is administered. That is to say the aggravation and alleviation of subordinate ''doshas'' are affected by the causative factors and therapies, other than their own. This is because they share the attributes of the ''dosha'', of primary nature to some extent. For example, in the autumn season ''pitta'' is vitiated primarily and ''kapha'' secondarily due to sour ''vipaka'' of water etc. This is because sour taste is responsible for the vitiation of both. For the treatment of primary ''doshas'', viz. ''pitta'', ghee boiled with bitter drugs is employed; bitter taste, by nature, alleviates the subordinate ''dosha'', viz. ''kapha'' also. ''Anubandhya'' and, ''anubandha'' are the technical terms for primary and secondary diseases respectively known to scholar adapt in the medical science.

After the description of the classification of diseases, ''agni'' is described which is essential for the maintenance of the body. The term ''sharireshu'' indicates that ''agni'' (factors or enzymes responsible for digestion and metabolism) residing all over the body. However, in subsequent elaboration, ''agni'' residing in the gastrointestinal tract is described because this ''agni'' regulates the aggravation or abatement of all the other ''agnis'' (Chikitsa 15:39). ''Agnis'' belonging to regular or balanced category are the most beneficial for a healthy living; still ''agnis'' belonging to the sharp category are given priority in the order of description because of their importance in as much as they are capable of tolerating all types of irregularities. Balanced (''sama'') condition of ''vata, pitta,'' and ''kapha'' during their natural states and when they are aggravated, accompanies regular or balanced ''agnis''. The term ''prakriti'' (meaning natural state) has different other meaning as well. Because of these two factors and with a view to specifying the intention, Acharya has used the term ''prakritisthanam'' along with ''vatapittashleshmana''. In the case of an individual having the dominance of ''vata'' in his constitution, ''agni'' becomes irregular only when the sites of ''agnis'' in his body are afflicted by ''vata'' and not otherwise. Similar is the explanation for the changes in the ''agnis'' in individuals having the dominance of ''pitta'' and ''kapha'' in their constitution. The concept of ''prakriti'' is also described in the chapter in the context of disease. It is worth mentioning that the ''prakriti'' described in this chapter is in reference to the diseased state i.e. ''vikrita avastha''. [1-2]

''Doshas'' pertaining to mind are given priority in the order of their description because they are comparatively smaller in number. [5-6]

Classification of various diseases on five parameters is described and then gives a generalized method for classification of disease on the basis of grief as a universal symptom. Here it is important to note that he uses the term grief instead of pain to identify the disease. The word grief (''dukha'') signifies both mental as well as physical trouble. Thus more emphasis is given on the fact that both the component of a disease i.e. somatic and psychic should be equally treated for successful management. Description of the causative ''doshas'' for mental diseases and their relation with physical ''doshas'' is given. In the same context the psychosomatic diseases are described. Chronic somatic diseases cause psychological diseases and chronic psychological diseases leads to somatic diseases i.e. both are intermingled and have cause and effect relationship.

Modern scientific research supports this age-old tenet of medical wisdom. Walter Cannon in 1920, documented the physiological changes in body as a response to stressors through hormones called catecholamines. This was further researched by Hans Selye to pioneer the field of stress research. He described the close relation between body and mind with various articles on stress affecting humans biologically. Biofeedback is found effective in treatment of various psycho-somatic disorders. Dean Ornish and his colleagues also worked upon the concept to integrate ''yoga'', meditation for designing protocol for stress management in a medical center<ref> Sourced from http://www.bravewell.org/integrative_medicine/philosophical_foundation/mind_and_body_connection/ accessed on 18/06/2017 </ref>.

International classification of diseases and related health problems is a system that classifies disease on the basis of interpretation and comparison of mortality and morbidity data across globe<ref> Sourced from http://www.who.int/classifications/icd/revision/en/ accessed on 26/06/2017 </ref>.

The relation between ''agni'' and disease process is essential to be understood. Impairment of ''agni'' is a cause of accumulation of various toxic products inside body leading to disease. ''Agni'' includes all processes of digestion and metabolism taking at gross level, tissue level, micro-cellular level. Hence it needs a special emphasis while treating a disease. Diagnosis of ''agni'' of a person is one of key factor in understanding disease. The following charts 1,2 and 3 shows various types of ''agni'' and its related processes in ayurvedic perspective.
</div>
[[File:Chart 1.png]]

==== Chart 1: Different types of ''Agni''====

[[File:Chart 2.png]]

==== Chart 2: Factors involved in ''Agni'' process ====

[[File:Chart 3.png]]

==== Chart 3: Diagrammatic representation of importance of ''Agni'' ====
<div style="text-align:justify;">
Determination of psychosomatic constitution as well as disease susceptibility of an individual in population through genetic trait is known as ''prakriti''. ''Prakriti'' is a broad term encompasses all the three genotype, phenotype as well as endophenotype. The concept of prakriti in[https://en.wikipedia.org/wiki/Ayurveda Ayurveda] is related to the bio-characteristic of an individual in healthy state and its vulnerability for particular diseases. According to [https://en.wikipedia.org/wiki/Ayurveda Ayurveda], ''prakriti'' of an individual once determined at the time of fertilization remains unchanged throughout life though it is well influenced by environment. Role of environment in determination of ''prakriti'' during prenatal period is as important as postnatal period. Reviewing the human embryology, it can be postulated that the three primitive germinal layers namely ectoderm, mesoderm and endoderm can be correlated with ''vatika, paittika'' and ''kaphaja'' trait. According to [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] at the time of fertilization the ''doshika prakriti'' is determined by the ''doshika'' predominance of ''shukra'' (sperm) and ''shonita'' (ovum) that represent the fastidious genetic alignment of chromosomes in sperm and ovum and decide the genetic trait of zygote. Robust research is being conducted to study the link between ''prakriti'' and genes.

In [[Nidana Sthana]] Chapter 4 ([[Prameha Nidana]]), Acharya says that the development of disease is multifactorial and it depends upon both the virulence of pathogens (''nidana'') as well as host response (''dushya''). Response of the host can be quantified by using ''prakriti'' as a parameter. [13]

=== Applied aspect for future research ===

#Scientific validation of term ''prakriti'' and standardization of ''doshika'' and ''manasa prakriti''.
#Preparation of protocol for the classification of diseases on the basis of ''vata, pitta'' and ''kapha''.
#Standardization of Parameters for the characterization of ''agni'' into ''manda, tikshana'' and ''vishama''.
#Classification of disease, patient as well as management on the basis of ''prakriti'' and its scientific validation.

=== Future Scope for Research ===

#Searching genetic trait for different ''prakriti'' and disease susceptibility accordingly.
#Standardization of ''Jathragni, Bhutagni'' and ''Dhatvagni''.

=== Further reading ===

#Kajaria Divya, Tripathi J.S, Tiwari S.K. Clinical Application of Concept of Agni. Asian Journal of Pharmaceutical Research. 2014; 4(1):1-5.
#Kajaria Divya, Tripathi J.S, Tiwari S.K. Exploring Novel Concept of Agni and its Clinical Relevance. Alternative & Intregrative Medicine.2013; 2(8):1-5.
#Patwardhan, B., and Mashelkar, R. A. (2009) Traditional medicine-inspired approaches to drug discovery: can Ayurveda show the way forward? Drug Discovery Today 14 (15-16), 804–11.
#Bhushan, P., Kalpana, J., and Arvind, C. (2005) Classification of human population based on HLA gene polymorphism and the concept of Prakriti in Ayurveda. J. Altern. Complement. Med. 11 (2), 349–53.
#Prasher, B., Negi, S., Aggarwal, S., Mandal, A. K., Sethi, T. P.,Deshmukh, S. R., Purohit, S. G., Sengupta, S., Khanna, S., Mohammad, F., Garg, G., Brahmachari, S. K., Indian Genome Variation Consortium, Mukerji, M. (2008) Whole genome expression and biochemical correlates of extreme constitutional types de!ned in Ayurveda. J. Transl. Med.6, 48.
#Aggarwal, S., Negi, S., Jha, P., Singh, P. K., Stobdan, T., Pasha,M. A., Ghosh, S., Agrawal, A., Prasher, B., and Mukerji, M. (2010) EGLN1 involvement in high-altitude adaptation revealed through genetic analysis of extreme constitution types de!ned in Ayurveda. Proc.Natl. Acad. Sci. U.S.A. 107 (44), 18961–6.
#Peng, Y., Yang, Z., Zhang, H., Cui, C., Qi, X., Luo, X., Tao, X.,Wu, T., Ouzhuluobu, B., Ciwangsangbu, D., Chen, H., Shi, H., and Su, B. (2011) Genetic variations in Tibetan populations and high-altitude adaptation at the Himalayas. Mol. Biol. Evol. 28 (2), 1075–81.
#Xu, S., Li, S., Yang, Y., Tan, J., Lou, H., Jin, W., Yang, L., Pan, X.,Wang, J., Shen, Y., Wu, B., Wang, H., and Jin, L. (2011) A genome-wide search for signals of high-altitude adaptation in Tibetans. Mol. Biol. Evol.28 (2), 1003–11.
#Bigham, A., Bauchet, M., Pinto, D., Mao, X., Akey, J. M., Mei, R.,Scherer, S. W., Julian, C. G., Wilson, M. J., L!opez Herr!aez, D., Brutsaert, T., Parra, E. J., Moore, L. G., and Shriver, M. D. (2010) Identifying signatures of natural selection in Tibetan and Andean populations using dense genome scan data. PLoS Genet. 6 (9), e1001116.
#Storz, J. F. (2010) Evolution. Genes for high altitudes. Science 329 (5987), 40–1.
#Huerta-Yepez, S, Baay-Guzman, G. J., Bebenek, I. G., Hernandez-Pando, R, Vega, M. I., Chi, L, Riedl, M, Diaz-Sanchez, D, Kleerup, E, Tashkin, D. P., Gonzalez, F. J., Bonavida, B, Zeidler, M, and Hankinson,O. (2011) Hypoxia Inducible Factor promotes murine allergic airway inflammation and is increased in asthma and rhinitis. Allergy66 (7),909–18.
</div>
=== Glossary of Technical Terms ===

#प्रभाव Prabhava - Prognosis
#साध्यम् Sadhyam – Curable
#असाध्यं Asadhyam- Incurable
#मनोऽधिष्ठानं Mano~adhiShThAnaM - Psychological
#शरीराधिष्ठानं sharIrAdhiShThAnaM - Systemic
#निमित्त Nimitta- Etiology
#प्रज्ञापराधः praj~jAparAdhaH – Mental abuse
#परिणाम pariNAma – Environmental causes of disease
#अनुबन्ध्य Anubandhya- Primary Disease
#अनुबन्ध Anubandh- Secondary Disease
#अग्नि Agni – Biological process of energy liberation and conversion
#प्रकृति prakRuti - Prakriti is a broad term encompasses all the three Genotype, Phenotype as well as Endophenotype .
#रुजा rüjä – Uncomfortable feelings. The term signifies any kind of uncomfortable feelings like pain etc.

=== References ===
<references/>

Anujyoti

2017-12-26T14:48:26Z

Vinay Exafluence: /* Indriya Sthana, Chapter 11 */

{{Infobox
|title = Anujyoti
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 11
|label2 = Preceding Chapter
|data2 = [[Sadyomarneeya]]

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

|header3 =

}}
== [[Indriya Sthana]], Chapter 11 ==

=== Abstract ===
<div style="text-align:justify;">
[[Anujyoti]] explicates the signs and symptoms of imminent death due to diminution of ''Agni'' (factor responsible for digestion and metabolism). The components of life like lifespan, strength, complexion, enthusiasm, health, growth, luster, and immunity are dependent upon the status of ''agni''. Diminution of its power causes generalized symptoms indicative of imminent death. Declaration of the estimated time for death might be based on experience of many experts of that time, which can now be reestablished in light of present scientific developments. The clinical signs and symptoms given in this chapter are useful as an additional information for assessment of prognosis.

'''Keywords''': ''Anujyoti, Arista, Bali'', digestion.
</div>
=== Introduction ===
<div style="text-align:justify;">
The present chapter, ''Anujyotiyamindriyam'' , or [[Anujyoti]], deals with near death signs that arise due to decrease in digestive capacity of a person i.e. ''jatharagni''. The chapter indicates importance of digestive and metabolic functions of ''agni''. The ingested food is helpful and nutritive to body only if, it passes through various digestive and metabolic processes successfully. This food nourishes the body at cellular level and it reflects in the form of good complexion, strength, good health, enthusiasm, and nourishment to formation of ''ojas''. Some part of food digested with the help of ''agni'' nourishes sensory organs along with ''mana'' (mind) too. Ayurveda has emphasized the importance of quality and quantity of Agni for metabolic activity of the body, that if the ''agni'' works well, the person lives long and if it ceases; the person is going to die.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 4. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512 </ref>

Some signs seen in diseased or in healthy person, with or without any significant/visible pathology leading to death, are mentioned. These signs occurs due to initiation of some life threatening disease with poor prognosis even in initial stage.

It is emphasized that any extreme alternation in body physiology or psychology, person’s own behavior, mental functions, etc. without any significant reason; is also one of the sign for death.

Mind supremacy is also highlighted, as the mental strength of a person declines due to advancement of disease; then the person is likely to die. Composition of physical body (''sharira''), sensoria (''indriya''), mind (''sattva'') and soul (''atma'') is called life (''ayu''). With advanced stage of disease, physical body gets damaged, sensoria may also get affected and soul becomes ready to leave the diseased body; in such situation only strong mind power can sustain life as physical body follows mind and vice versa.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 1, Ver. 155. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 298 </ref>

It is elucidated that if person’s life span has ended; even good quality of physician, medicine or care taker are helpless. In a nutshell person’s life span is fixed and when it is gets finished, some signs are manifested called ''arishta''.

Further, status of dying person is described briefly that, he may develop aversion to all loving and respectful persons, friends, food (and other basic essentials for surviving) etc. as his soul is almost in position to detach this body and preparing self to travel to other world. The chapter defines ''arishta'' with a new dimension. The concomitant aggravation of ''dosha'' (either qualitative or quantitative) with life-threatening diminution of ''dhatu'' is significant in the prediction of death.
</div>
===Sanskrit text, Transliteration and English Translation===

अणुज्योतीयेन्द्रियोपक्रमः
अथातोऽणुज्योतीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō'ṇujyōtīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto~aNujyotIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter on signs and symptoms of ‘Imminent Death due to diminution of ''Agni'' (Factor responsible for digestion and metabolism) as said by Lord Atreya. [1-2]

==== Signs of near-death and declining lifespan ====

अणुज्योतिरनेकाग्रो दुश्छायो दुर्मनाः सदा|
रतिं न लभते याति परलोकं समान्तरम्||३||

aṇujyōtiranēkāgrō duśchāyō durmanāḥ sadā|
ratiṁ na labhatē yāti paralōkaṁ samāntaram||3||

aNujyotiranekAgro dushchAyo durmanAH sadA|
ratiM na labhate yAti [1] paralokaM samAntaram||3||

The person always (suffering from) with poor digestion, unstable or agitated mind, diminished luster, weak mental strength and restlessness goes to other world [dies] within a year. [3]

बलिं बलिभृतो यस्य प्रणीतं नोपभुञ्जते|
लोकान्तरगतः पिण्डं भुङ्क्ते संवत्सरेण सः||४||

सप्तर्षीणां समीपस्थां यो न पश्यत्यरुन्धतीम्|
संवत्सरान्ते जन्तुः स सम्पश्यति महत्तमः||५||

विकृत्या विनिमित्तं यः शोभामुपचयं धनम्|
प्राप्नोत्यतो वा विभ्रंशं समान्तं तस्य जीवितम्||६||

baliṁ balibhr̥tō yasya praṇītaṁ nōpabhuñjatē|
lōkāntaragataḥ piṇḍaṁ bhuṅktē saṁvatsarēṇa saḥ||4||

saptarṣīṇāṁ samīpasthāṁ yō na paśyatyarundhatīm|
saṁvatsarāntē jantuḥ sa sampaśyati mahattamaḥ||5||

vikr̥tyā vinimittaṁ yaḥ śōbhāmupacayaṁ dhanam|
prāpnōtyatō vā vibhraṁśaṁ samāntaṁ tasya jīvitam||6||

baliM balibhRuto yasya praNItaM nopabhu~jjate|
lokAntaragataH piNDaM bhu~gkte saMvatsareNa saH||4||

saptarShINAM samIpasthAM yo na pashyatyarundhatIm|
saMvatsarAnte jantuH sa sampashyati mahattamaH||5||

vikRutyA vinimittaM yaH shobhAmupacayaM dhanam|
prApnotyato vA vibhraMshaM samAntaM tasya jIvitam||6||
<div style="text-align:justify;">
When a person offers ''bali'' (an offering a piece of daily meal) to crow and it does not accept it this indicates of death within a year for the offering person.

If a person is not able to see the star ''Arundhati'' situated adjacent to the constellation of ''Saptarshi'' (The Great Bear), he succumbs to death one year thereafter. [5]

Sudden gain or loss of luster, body weight, or wealth without any reasons indicates death of the person within one year thereafter. [6]
</div>
भक्तिः शीलं स्मृतिस्त्यागो बुद्धिर्बलमहेतुकम्|
षडेतानि निवर्तन्ते षड्भिर्मासैर्मरिष्यतः||७||

bhaktiḥ śīlaṁ smr̥tistyāgō buddhirbalamahētukam|
ṣaḍētāni nivartantē ṣaḍbhirmāsairmariṣyataḥ||7||

bhaktiH shIlaM smRutistyAgo buddhirbalamahetukam|
ShaDetAni nivartante ShaDbhirmAsairmariShyataH||7||

Sudden changes in likings, gentleness, memory, sacrifices, intellect and strength these six attributes in a person indicate the death within a time of six months. [7]

धमनीनामपूर्वाणां जालमत्यर्थशोभनम्|
ललाटे दृश्यते यस्य षण्मासान्न स जीवति||८||

लेखाभिश्चन्द्रवक्राभिर्ललाटमुपचीयते|
यस्य तस्यायुषः षड्भिर्मासैरन्तं समादिशेत्||९||

dhamanīnāmapūrvāṇāṁ jālamatyarthaśōbhanam|
lalāṭē dr̥śyatē yasya ṣaṇmāsānna sa jīvati||8||

lēkhābhiścandravakrābhirlalāṭamupacīyatē|
yasya tasyāyuṣaḥ ṣaḍbhirmāsairantaṁ samādiśēt||9||

dhamanInAmapUrvANAM jAlamatyarthashobhanam|
lalATe dRushyate yasya ShaNmAsAnna sa jIvati||8||

lekhAbhishcandravakrAbhirlalATamupacIyate|
yasya tasyAyuShaH ShaDbhirmAsairantaM samAdishet||9||

Sudden appearance of extremely shiny and prominent vasculature on fore head of an individual indicates that maximum life span of less than six month. [8]

A person, on whose forehead crescent shaped grooves develop, is supposed to die after six months [9]

शरीरकम्पः सम्मोहो गतिर्वचनमेव च|
मत्तस्येवोपलभ्यन्ते यस्य मासं न जीवति||१०||

रेतोमूत्रपुरीषाणि यस्य मज्जन्ति चाम्भसि|
स मासात् स्वजनद्वेष्टा मृत्युवारिणि मज्जति||११||

śarīrakampaḥ sammōhō gatirvacanamēva ca|
mattasyēvōpalabhyantē yasya māsaṁ na jīvati||10||

rētōmūtrapurīṣāṇi yasya majjanti cāmbhasi|
sa māsāt svajanadvēṣṭā mr̥tyuvāriṇi majjati||11||

sharIrakampaH sammoho gatirvacanameva ca|
mattasyevopalabhyante yasya mAsaM na jIvati||10||

retomUtrapurIShANi yasya majjanti cAmbhasi|
sa mAsAt svajanadveShTA mRutyuvAriNi majjati||11||

Sudden appearance of tremors on body, drowsiness along with altered gait and speech resembling of an insane person cannot survive even for a month. [10]

If semen, urine and feces of an individual sink in water as well as have aversion from own relatives, will sink in the water of death within one month. [11]

हस्तपादं मुखं चोभे विशेषाद्यस्य शुष्यतः|
शूयेते वा विना देहात् स च मासं न जीवति||१२||

ललाटे मूर्ध्नि बस्तौ वा नीला यस्य प्रकाशते|
राजी बालेन्दुकुटिला न स जीवितुमर्हति||१३||

प्रवालगुटिकाभासा यस्य गात्रे मसूरिकाः|
उत्पद्याशु विनश्यन्ति न चिरात् स विनश्यति||१४||

ग्रीवावमर्दो बलवाञ्जिह्वाश्वयथुरेव च|
ब्रध्नास्यगलपाकश्च यस्य पक्वं तमादिशेत्||१५||

सम्भ्रमोऽतिप्रलापोऽतिभेदोऽस्थ्नामतिदारुणः |
कालपाशपरीतस्य त्रयमेतत् प्रवर्तते||१६||

प्रमुह्य लुञ्चयेत् केशान् परिगृह्णात्यतीव च|
नरः स्वस्थवदाहारमबलः कालचोदितः||१७||

hastapādaṁ mukhaṁ cōbhē viśēṣādyasya śuṣyataḥ|
śūyētē vā vinā dēhāt sa ca māsaṁ na jīvati||12||

lalāṭē mūrdhni bastau vā nīlā yasya prakāśatē|
rājī bālēndukuṭilā na sa jīvitumarhati||13||

pravālaguṭikābhāsā yasya gātrē masūrikāḥ|
utpadyāśu vinaśyanti na cirāt sa vinaśyati||14||

grīvāvamardō balavāñjihvāśvayathurēva ca|
bradhnāsyagalapākaśca yasya pakvaṁ tamādiśēt||15||

sambhramō'tipralāpō'tibhēdō'sthnāmatidāruṇaḥ |
kālapāśaparītasya trayamētat pravartatē||16||

pramuhya luñcayēt kēśān parigr̥hṇātyatīva ca|
naraḥ svasthavadāhāramabalaḥ kālacōditaḥ||17||

hastapAdaM mukhaM cobhe visheShAdyasya shuShyataH|
shUyete vA vinA dehAt sa ca mAsaM [1] na jIvati||12||

lalATe mUrdhni bastau vA nIlA yasya prakAshate|
rAjI bAlendukuTilA na sa jIvitumarhati||13||

pravAlaguTikAbhAsA yasya gAtre masUrikAH|
utpadyAshu vinashyanti [2] na cirAt sa vinashyati||14||

grIvAvamardo balavA~jjihvAshvayathureva ca|
bradhnAsyagalapAkashca yasya pakvaM tamAdishet||15||

sambhramo~atipralApo~atibhedo~asthnAmatidAruNaH [3] |
kAlapAshaparItasya trayametat pravartate||16||

pramuhya lu~jcayet keshAn parigRuhNAtyatIva [4] ca|
naraH svasthavadAhAramabalaH [5] kAlacoditaH||17||
<div style="text-align:justify;">
If there is noticeable emaciation or swelling of hands and feet along with face and without body (trunk) involvement, he will not survive for more than a month.[12]

Appearance of crescent shaped blue lines on fore head, face and pelvic region indicates that the person will not survive. [13]

If eruption of ''masurika'' (small pox like lesions) on body, having appearance of coral beds (bright red), subsides immediately after its manifestation, the person will die immediately. [14]

A person having acute and severe squeezing type of pain in neck, swelling of tongue along with inflammation of scrotum, throat and mouth should be considered as ripen (for death). [15]

Excessive giddiness, extreme delirium and severe piercing type of pain in bones, manifestation of these three symptoms together indicates that the person is captured by death. [16]

A person, who pulls out his hair in fainting state, eats food like healthy person and still remains weak should be considered as captured by death. [17]
</div>
समीपे चक्षुषोः कृत्वा मृगयेताङ्गुलीकरम्|
स्मयतेऽपि च कालान्ध ऊर्ध्वगानिमिषेक्षणः ||१८||

शयनादासनादङ्गात् काष्ठात् कुड्यादथापि वा|
असन्मृगयते किञ्चित् स मुह्यन् कालचोदितः||१९||

samīpē cakṣuṣōḥ kr̥tvā mr̥gayētāṅgulīkaram|
smayatē'pi ca kālāndha ūrdhvagānimiṣēkṣaṇaḥ ||18||

śayanādāsanādaṅgāt kāṣṭhāt kuḍyādathāpi vā|
asanmr̥gayatē kiñcit sa muhyan kālacōditaḥ||19||

samIpe cakShuShoH kRutvA mRugayetA~ggulIkaram|
smayate~api ca kAlAndha UrdhvagAnimiShekShaNaH [1] ||18||

shayanAdAsanAda~ggAt kAShThAt kuDyAdathApi vA|
asanmRugayate ki~jcit sa muhyan kAlacoditaH||19||
<div style="text-align:justify;">
The person who searches for his own fingers and hands putting them before his eyes and smiles with upward gaze and unblinking should be considered as blinded by death, [18]

A person who is lying on his bed but is searching for his bed continuously, sitting on chair and searching his own seat, searching his own organs, walking with the stick and searching the same, and searching the walls of his own room, or while working with something and searching the same, are the symptoms of the imminent death of that person. [19]
</div>
अहास्यहासी सम्मुह्यन् प्रलेढि दशनच्छदौ|
शीतपादकरोच्छ्वासो यो नरो न स जीवति||२०||

आह्वयंस्तं समीपस्थं स्वजनं जनमेव वा|
महामोहावृतमनाः पश्यन्नपि न पश्यति||२१||

ahāsyahāsī sammuhyan pralēḍhi daśanacchadau|
śītapādakarōcchvāsō yō narō na sa jīvati||20||

āhvayaṁstaṁ samīpasthaṁ svajanaṁ janamēva vā|
mahāmōhāvr̥tamanāḥ paśyannapi na paśyati||21||

ahAsyahAsI sammuhyan praleDhi [1] dashanacchadau|
shItapAdakarocchvAso yo naro na sa jIvati||20||

AhvayaMstaM samIpasthaM svajanaM janameva vA|
mahAmohAvRutamanAH pashyannapi na pashyati||21||

Person who laughs without any reason, acts stupid, teeth and gums are covered with dirt, biting his lips and whose feet, arms are too cold and disappointingly takes long breaths will not survive for long. [20]

Loud shout to call relatives and other people sitting nearby, severe visual hallucinations for non-existing things, observed in the person whose mind is covered by severe delusion [of death].[21]

अयोगमतियोगं वा शरीरे मतिमान् भिषक्|
खादीनां युगपद्दृष्ट्वा भेषजं नावचारयेत्||२२||

ayōgamatiyōgaṁ vā śarīrē matimān bhiṣak|
khādīnāṁ yugapaddr̥ṣṭvā bhēṣajaṁ nāvacārayēt||22||

ayogamatiyogaM vA sharIre matimAn bhiShak|
khAdInAM yugapaddRuShTvA bheShajaM nAvacArayet||22||

A wise physician should abstain from treating a patient on observing that the patient’s body is simultaneously responding both excessively and deficiently to sensory stimuli. [22]

==== Signs of death ====

अतिप्रवृद्ध्या रोगाणां मनसश्च बलक्षयात्|
वासमुत्सृजति क्षिप्रं शरीरी देहसञ्ज्ञकम्||२३||

वर्णस्वरावग्निबलं वागिन्द्रियमनोबलम्|
हीयतेऽसुक्षये निद्रा नित्या भवति वा न वा||२४||

atipravr̥ddhyā rōgāṇāṁ manasaśca balakṣayāt|
vāsamutsr̥jati kṣipraṁ śarīrī dēhasañjñakam||23||

varṇasvarāvAgnibalaṁ vāgindriyamanōbalam|
hīyatē'sukṣayē nidrā nityā bhavati vā na vā||24||

atipravRuddhyA rogANAM manasashca balakShayAt|
vAsamutsRujati kShipraM sharIrI dehasa~jj~jakam||23||

varNasvarAvagnibalaM vAgindriyamanobalam|
hIyate~asukShaye nidrA nityA bhavati vA na vA||24||

In case of extreme advancement of the disease and weaker psychological strength, the soul immediately leaves the body. [23]
Near the end of life there is general decline in complexion, voice,''agni'', speech and state of mind, as well as sleep pattern alters. [24]

भिषग्भेषजपानान्नगुरुमित्रद्विषश्च ये|
वशगाः सर्व एवैते बोद्धव्याः समवर्तिनः||२५||

एतेषु रोगः क्रमते भेषजं प्रतिहन्यते|
नैषामन्नानि भुञ्जीत न चोदकमपि स्पृशेत्||२६||

bhiṣagbhēṣajapānānnagurumitradviṣaśca yē|
vaśagāḥ sarva ēvaitē bōddhavyāḥ samavartinaḥ||25||

ētēṣu rōgaḥ kramatē bhēṣajaṁ pratihanyatē|
naiṣāmannāni bhuñjīta na cōdakamapi spr̥śēt||26||

bhiShagbheShajapAnAnnagurumitradviShashca ye|
vashagAH sarva evaite boddhavyAH samavartinaH||25||

eteShu rogaH kramate bheShajaM pratihanyate|
naiShAmannAni bhu~jjIta na codakamapi spRushet||26||

Those who hate physician, medicine, food (and drink), teacher (spiritual teacher), and friends; are considered to be already under the grip of God of death. [25]

In such people, the disease progress occurs unrestricted and the medicine remains ineffective. The wise physician should not take his offerings in any form, even in form of food and drinks. [26]

पादाः समेताश्चत्वारः सम्पन्नाः साधकैर्गुणैः|
व्यर्था गतायुषो द्रव्यं विना नास्ति गुणोदयः||२७||

pādāḥ samētāścatvāraḥ sampannāḥ sādhakairguṇaiḥ|
vyarthā gatāyuṣō dravyaṁ vinā nāsti guṇōdayaḥ||27||

pAdAH sametAshcatvAraH sampannAH sAdhakairguNaiH|
vyarthA gatAyuSho dravyaM vinA nAsti guNodayaH||27||

Availability of all four basic components of treatment i.e. doctor, medicament, care taker and patient with their desirable quality are of no value in regard to the person who is at the end of his life and there is no response to treatment.[27]

परीक्ष्यमायुर्भिषजा नीरुजस्यातुरस्य च|
आयुर्ज्ञानफलं कृत्स्नमायुर्ज्ञे ह्यनुवर्तते||२८||

parīkṣyamāyurbhiṣajā nīrujasyāturasya ca|
āyurjñānaphalaṁ kr̥tsnamāyurjñē hyanuvartatē||28||

parIkShyamAyurbhiShajA nIrujasyAturasya ca|
Ayurj~jAnaphalaM kRutsnamAyurj~je hyanuvartate||28||

The physician should always assess the prognostic signs of life in diseased as well as in healthy person. Because the knowledge of prognostic signs of life and diseases helps to decide remaining lifespan and hence treatment can be planned accordingly. [28]

==== Summary ====

तत्र श्लोकः-
क्रियापथमतिक्रान्ताः केवलं देहमाप्लुताः|
चिह्नं कुर्वन्ति यद्दोषास्तदरिष्टं निरुच्यते||२९||

tatra ślōkaḥ-
kriyāpathamatikrāntāḥ kēvalaṁ dēhamāplutāḥ|
cihnaṁ kurvanti yaddōṣāstadariṣṭaṁ nirucyatē||29||

tatra shlokaH-
kriyApathamatikrAntAH kevalaM dehamAplutAH|
cihnaM kurvanti yaddoShAstadariShTaM nirucyate||29||

Here is the re capitulatory verse: The signs originated due to extensively vitiated and pervaded ''dosha'' throughout the body, and already transcended the stage of the treatment are called ''arishta'' (signs of death). [29]

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*Optimum quality and quantity of ''agni'' is necessary for sustenance of life.
*Stable mental status, complexion and mental strength are markers to predict lifespan of patient.
*Sudden changes in likings, gentleness, memory, sacrifices, intellect and strength in a person are pre-indications of death.
*Altered sensorium and psychological status leading to various delusions and hallucinations are pre-indicators of death.
*Near the end of life there is general decline in complexion, voice, ''agni'', speech and state of mind, as well as sleep pattern alters.
*The prognostic signs of life in diseased as well as in healthy person shall always be assessed. This helps to decide remaining lifespan and planning treatment.
*The signs originated due to extensively vitiated and pervaded ''dosha'' throughout the body, and already transcended the stage of the treatment are called ''arishta'' (signs of death).

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

Metabolic process and thermoregulatory center situated in hypothalamus play key role to generate and maintain body temperature respectively. Reduced temperature shows slow metabolic process and gradually it ceases completely, causing death.
With the help of healthy digestive power and proper metabolic activity; food nourishes the body and provide macro and micronutrients to the body.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 3. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512 </ref>

In any manner, hampered blood or oxygen supply to the brain leads to lack of concentration, weakness of mental functions or agitation. Deposition of any toxic substance or progressive degenerative changes of mind also leads to such symptoms. Ageing and death are considered as natural process with passage of time.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 4, Ver. 36. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 323 </ref> With declining phase of life, ageing symptoms start to appear, as new cell production is almost stops and older cell destruction continues. With the passage of senescence; weakness, decreasing appetite, muscular wasting, decreased fluid intake, neurological dysfunctions, decreasing level of consciousness etc. are common symptoms manifest and gradually leads to cessation of life.<ref>httpendlink.lurie.northwestern.edulast_hours_of_livingpart_one.pdf </ref>

Every individual has good appetite and capability of digesting foods he regularly ingests. ''Ksheerada''(only on milk), ''ksheera-anna''(milk and rice products), ''annada'' (staple foods), are three basic stages of life. During ageing process, gradual reduction in both qualitative consumption and digestive abilities are observed. This in turn influences the individual’s physical and mental wellbeing leading to reduction in life span ending in death.[3]

As per the principle of ''Yatha Brahmande Tatha Pinde'', whatever is there in the universe, is there in the human body. Hence there should be some connections between human body and the universe. When the soul is preparing for detachment from the body to start its journey to other world, there should be some indications from the universe as indicator of impending death. As per Indian tradition, offerings of food to birds specially to crow and non-acceptance of offering by crow may indicate the preparation of soul for detachment from living body. Inability to see ''Arundhati'' in the sky is another indication of the same. [4 – 5]

Acute loss or gain of luster or body weight can be the result of carcinogenic condition or severe catabolic changes taking place in the body that can be fatal for the person. [6]

Brain regulates multiple functions related to sensory, motor and autonomous nervous system like emotions, intellect and many other activities. Amygdala, and physiological functioning of limbic system of brain, are responsible for proper emotions and its expression. If these are deviated grossly, it shows involvement of higher center in pathogenesis and poor prognosis.

Gradual cessation of the functions is a clear indication of either degenerative changes or space occupying lesion (SOL) in the specific area. Acute toxicity of brain also leads to acute degeneration of brain cells or infarction that leads to hampering of function. [7]
Sudden appearance of crescent shaped streaks or blood vessel network on forehead may relate with Amyloidosis. It is a rare disease that occurs when a protein (albumoid) substance gets deposited in person’s organ. This abnormal protein is usually produced in bone marrow and can be deposited in any tissue or organ. The prognosis is poor. [8-9]<ref>the description is based on https://en.wikipedia.org/wiki/Amyloidosis, accessed on 15/10/2015 </ref>

If person having combination of dual type of activity of mind i.e. exaggerated (in form of tremor), and diminished activity (in form of stupor), simultaneously; is supposed to die within a month. These dual types of signs may indicate increased intracranial pressure (ICP) due to localized mass like hematoma, neoplasm, abscess, edema, infarction, obstruction in CSF circulation, diffuse brain edema (like encephalitis, meningitis, or diffuse head injury), thrombosis, or idiopathic intracranial hypertension.

Symptoms of raised ICP are altered mental state, lethargy, irritability, slow decision making and abnormal social behavior. Ultimate result of the patho-physiology of such condition is stupor, coma and death. Rapidly rising ICP leads to syncope, seizures. These neurologic changes seen in increased ICP are mostly due to hypoxia and hyper apnea. [10]

If fecal matter or other excreta are mixed with ''ama'', it sinks straight in water due to its heaviness. Same concept is applied to other body discharge or ''dhatus'' too. Fecal matter is the end product of digestion. Hence, if it sinks in water it shows incomplete or improper digestion of food. ''Shukra'' is the last ''dhatu'' and hence all ''dhatvagni'' contribute (directly or indirectly) in its formation. To sink ''shukra'' in water is indicative that the ''dhatu'' is in ''sama'' stage. To get dipped all the three i.e. feces, urine and semen shows impairment of ''jatharagni'' along with ''dhatvagni'' functions leading to qualitative mal-formation of all ''dhatus''. Such situation has been considered as fatal. [11]

Muscular wasting of hands and feet is a type of neurogenic muscular atrophy with poor prognosis.

Swelling over both extremities along with face is an indication of damage of two vital organ simultaneously i.e. heart and kidney and hence survival of patient is difficult.[12]

Appearance of blue lines occurs in various conditions. This may be indication of venous congestion due to heart, lungs and liver diseases, requiring attention while scaling the span of life. [13]

Immediate disappearance of manifested small pox subsequently develops acute toxemia and hence leads to death. [14]

Combined manifestation of stiff neck along with inflamed throat and scrotum and swollen tongue is the condition of tertiary stage of syphilis when the person develops syphilitic meningitis (complication of untreated syphilis), is a life threatening condition. [15]

Visual (or even other sensorial) hallucinations are often part of the dying experience. Person may unknowingly involve in such activities with such illusions. This is the phase when the soul is getting ready to detach from the body and to travel for another world. The dying may turn their focus to “another world”, and thus may see (or feel other sensorial hallucination of) some unusual things, he may see or talk to such people who are already died. [18-19]

Various kinds of hallucinations are indications of altered psychological state of dying person, and to have laughter without any specific cause is also result of such hallucinations. To lick own lips is the sign of dehydration and coldness of breath and extremity are the indication of almost reducing function of heart and hence, stoppage of blood flow to concerned area. [20] Delusions along with altered sensorial organ is the sign of death. [21]

Days or hours before death, the dying person becomes less and less responsive to voice and touch and may not awaken. (Sometimes, quite unexpectedly, the person may appear well and even look as if he/she is going to recover. The person may be alert and talkative. But it does not mean that he is getting well; of course the time may be used as a “window of opportunity” to say what you need to say and have closure).<ref>httpkokuamau.orgresourceslast-stages-life </ref> [8] These all of sudden recovery changes are also signs of near death. [25]

As per ancient classical texts, life span of everyone is fixed and pre-ordained. No one can add years to the life only quality of life can be improved with medications. The same thing is meant here when it is said that death is the destiny of patient and that desirable quality of medicine, human resource and all other things cannot make the person outlive his destined lifespan.[27]
</div>
=== Glossary ===

#Agni – Digestive and metabolic power of body
#Ojas – extract / essence of all seven Dhatu
#Mana - Thought
#Indriya – sensory organs
#Sattva - Mind
#Atma -Soul
#Arishta – the symptom that show definite death of person
#Dosha – basic components / energy which govern the body
#Ksheerapa- dependent on milk only
#Ksheerannada – taking milk and grains both (as principal food)
#Annada – taking grains as staple food
#Bali – the food or other thing that offered to creatures or God
#Arundhati – a star that situated adjacent to the constellation of the great bear

=== References ===

<references/>

Anujyoti

2017-12-26T14:45:48Z

Vinay Exafluence: /* References */

{{Infobox
|title = Anujyoti
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 11
|label2 = Preceding Chapter
|data2 = [[Sadyomarneeya]]

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

|header3 =

}}
== [[Indriya Sthana]], Chapter 11 ==

=== Abstract ===

[[Anujyoti]] explicates the signs and symptoms of imminent death due to diminution of ''Agni'' (factor responsible for digestion and metabolism). The components of life like lifespan, strength, complexion, enthusiasm, health, growth, luster, and immunity are dependent upon the status of ''agni''. Diminution of its power causes generalized symptoms indicative of imminent death. Declaration of the estimated time for death might be based on experience of many experts of that time, which can now be reestablished in light of present scientific developments. The clinical signs and symptoms given in this chapter are useful as an additional information for assessment of prognosis.

'''Keywords''': ''Anujyoti, Arista, Bali'', digestion.

=== Introduction ===

The present chapter, ''Anujyotiyamindriyam'' , or [[Anujyoti]], deals with near death signs that arise due to decrease in digestive capacity of a person i.e. ''jatharagni''. The chapter indicates importance of digestive and metabolic functions of ''agni''. The ingested food is helpful and nutritive to body only if, it passes through various digestive and metabolic processes successfully. This food nourishes the body at cellular level and it reflects in the form of good complexion, strength, good health, enthusiasm, and nourishment to formation of ''ojas''. Some part of food digested with the help of ''agni'' nourishes sensory organs along with ''mana'' (mind) too. Ayurveda has emphasized the importance of quality and quantity of Agni for metabolic activity of the body, that if the ''agni'' works well, the person lives long and if it ceases; the person is going to die.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 4. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512 </ref>

Some signs seen in diseased or in healthy person, with or without any significant/visible pathology leading to death, are mentioned. These signs occurs due to initiation of some life threatening disease with poor prognosis even in initial stage.

It is emphasized that any extreme alternation in body physiology or psychology, person’s own behavior, mental functions, etc. without any significant reason; is also one of the sign for death.

Mind supremacy is also highlighted, as the mental strength of a person declines due to advancement of disease; then the person is likely to die. Composition of physical body (''sharira''), sensoria (''indriya''), mind (''sattva'') and soul (''atma'') is called life (''ayu''). With advanced stage of disease, physical body gets damaged, sensoria may also get affected and soul becomes ready to leave the diseased body; in such situation only strong mind power can sustain life as physical body follows mind and vice versa.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 1, Ver. 155. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 298 </ref>

It is elucidated that if person’s life span has ended; even good quality of physician, medicine or care taker are helpless. In a nutshell person’s life span is fixed and when it is gets finished, some signs are manifested called ''arishta''.

Further, status of dying person is described briefly that, he may develop aversion to all loving and respectful persons, friends, food (and other basic essentials for surviving) etc. as his soul is almost in position to detach this body and preparing self to travel to other world. The chapter defines ''arishta'' with a new dimension. The concomitant aggravation of ''dosha'' (either qualitative or quantitative) with life-threatening diminution of ''dhatu'' is significant in the prediction of death.

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

अणुज्योतीयेन्द्रियोपक्रमः
अथातोऽणुज्योतीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō'ṇujyōtīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto~aNujyotIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter on signs and symptoms of ‘Imminent Death due to diminution of ''Agni'' (Factor responsible for digestion and metabolism) as said by Lord Atreya. [1-2]

==== Signs of near-death and declining lifespan ====

अणुज्योतिरनेकाग्रो दुश्छायो दुर्मनाः सदा|
रतिं न लभते याति परलोकं समान्तरम्||३||

aṇujyōtiranēkāgrō duśchāyō durmanāḥ sadā|
ratiṁ na labhatē yāti paralōkaṁ samāntaram||3||

aNujyotiranekAgro dushchAyo durmanAH sadA|
ratiM na labhate yAti [1] paralokaM samAntaram||3||

The person always (suffering from) with poor digestion, unstable or agitated mind, diminished luster, weak mental strength and restlessness goes to other world [dies] within a year. [3]

बलिं बलिभृतो यस्य प्रणीतं नोपभुञ्जते|
लोकान्तरगतः पिण्डं भुङ्क्ते संवत्सरेण सः||४||

सप्तर्षीणां समीपस्थां यो न पश्यत्यरुन्धतीम्|
संवत्सरान्ते जन्तुः स सम्पश्यति महत्तमः||५||

विकृत्या विनिमित्तं यः शोभामुपचयं धनम्|
प्राप्नोत्यतो वा विभ्रंशं समान्तं तस्य जीवितम्||६||

baliṁ balibhr̥tō yasya praṇītaṁ nōpabhuñjatē|
lōkāntaragataḥ piṇḍaṁ bhuṅktē saṁvatsarēṇa saḥ||4||

saptarṣīṇāṁ samīpasthāṁ yō na paśyatyarundhatīm|
saṁvatsarāntē jantuḥ sa sampaśyati mahattamaḥ||5||

vikr̥tyā vinimittaṁ yaḥ śōbhāmupacayaṁ dhanam|
prāpnōtyatō vā vibhraṁśaṁ samāntaṁ tasya jīvitam||6||

baliM balibhRuto yasya praNItaM nopabhu~jjate|
lokAntaragataH piNDaM bhu~gkte saMvatsareNa saH||4||

saptarShINAM samIpasthAM yo na pashyatyarundhatIm|
saMvatsarAnte jantuH sa sampashyati mahattamaH||5||

vikRutyA vinimittaM yaH shobhAmupacayaM dhanam|
prApnotyato vA vibhraMshaM samAntaM tasya jIvitam||6||

When a person offers ''bali'' (an offering a piece of daily meal) to crow and it does not accept it this indicates of death within a year for the offering person.

If a person is not able to see the star ''Arundhati'' situated adjacent to the constellation of ''Saptarshi'' (The Great Bear), he succumbs to death one year thereafter. [5]

Sudden gain or loss of luster, body weight, or wealth without any reasons indicates death of the person within one year thereafter. [6]

भक्तिः शीलं स्मृतिस्त्यागो बुद्धिर्बलमहेतुकम्|
षडेतानि निवर्तन्ते षड्भिर्मासैर्मरिष्यतः||७||

bhaktiḥ śīlaṁ smr̥tistyāgō buddhirbalamahētukam|
ṣaḍētāni nivartantē ṣaḍbhirmāsairmariṣyataḥ||7||

bhaktiH shIlaM smRutistyAgo buddhirbalamahetukam|
ShaDetAni nivartante ShaDbhirmAsairmariShyataH||7||

Sudden changes in likings, gentleness, memory, sacrifices, intellect and strength these six attributes in a person indicate the death within a time of six months. [7]

धमनीनामपूर्वाणां जालमत्यर्थशोभनम्|
ललाटे दृश्यते यस्य षण्मासान्न स जीवति||८||

लेखाभिश्चन्द्रवक्राभिर्ललाटमुपचीयते|
यस्य तस्यायुषः षड्भिर्मासैरन्तं समादिशेत्||९||

dhamanīnāmapūrvāṇāṁ jālamatyarthaśōbhanam|
lalāṭē dr̥śyatē yasya ṣaṇmāsānna sa jīvati||8||

lēkhābhiścandravakrābhirlalāṭamupacīyatē|
yasya tasyāyuṣaḥ ṣaḍbhirmāsairantaṁ samādiśēt||9||

dhamanInAmapUrvANAM jAlamatyarthashobhanam|
lalATe dRushyate yasya ShaNmAsAnna sa jIvati||8||

lekhAbhishcandravakrAbhirlalATamupacIyate|
yasya tasyAyuShaH ShaDbhirmAsairantaM samAdishet||9||

Sudden appearance of extremely shiny and prominent vasculature on fore head of an individual indicates that maximum life span of less than six month. [8]

A person, on whose forehead crescent shaped grooves develop, is supposed to die after six months [9]

शरीरकम्पः सम्मोहो गतिर्वचनमेव च|
मत्तस्येवोपलभ्यन्ते यस्य मासं न जीवति||१०||

रेतोमूत्रपुरीषाणि यस्य मज्जन्ति चाम्भसि|
स मासात् स्वजनद्वेष्टा मृत्युवारिणि मज्जति||११||

śarīrakampaḥ sammōhō gatirvacanamēva ca|
mattasyēvōpalabhyantē yasya māsaṁ na jīvati||10||

rētōmūtrapurīṣāṇi yasya majjanti cāmbhasi|
sa māsāt svajanadvēṣṭā mr̥tyuvāriṇi majjati||11||

sharIrakampaH sammoho gatirvacanameva ca|
mattasyevopalabhyante yasya mAsaM na jIvati||10||

retomUtrapurIShANi yasya majjanti cAmbhasi|
sa mAsAt svajanadveShTA mRutyuvAriNi majjati||11||

Sudden appearance of tremors on body, drowsiness along with altered gait and speech resembling of an insane person cannot survive even for a month. [10]

If semen, urine and feces of an individual sink in water as well as have aversion from own relatives, will sink in the water of death within one month. [11]

हस्तपादं मुखं चोभे विशेषाद्यस्य शुष्यतः|
शूयेते वा विना देहात् स च मासं न जीवति||१२||

ललाटे मूर्ध्नि बस्तौ वा नीला यस्य प्रकाशते|
राजी बालेन्दुकुटिला न स जीवितुमर्हति||१३||

प्रवालगुटिकाभासा यस्य गात्रे मसूरिकाः|
उत्पद्याशु विनश्यन्ति न चिरात् स विनश्यति||१४||

ग्रीवावमर्दो बलवाञ्जिह्वाश्वयथुरेव च|
ब्रध्नास्यगलपाकश्च यस्य पक्वं तमादिशेत्||१५||

सम्भ्रमोऽतिप्रलापोऽतिभेदोऽस्थ्नामतिदारुणः |
कालपाशपरीतस्य त्रयमेतत् प्रवर्तते||१६||

प्रमुह्य लुञ्चयेत् केशान् परिगृह्णात्यतीव च|
नरः स्वस्थवदाहारमबलः कालचोदितः||१७||

hastapādaṁ mukhaṁ cōbhē viśēṣādyasya śuṣyataḥ|
śūyētē vā vinā dēhāt sa ca māsaṁ na jīvati||12||

lalāṭē mūrdhni bastau vā nīlā yasya prakāśatē|
rājī bālēndukuṭilā na sa jīvitumarhati||13||

pravālaguṭikābhāsā yasya gātrē masūrikāḥ|
utpadyāśu vinaśyanti na cirāt sa vinaśyati||14||

grīvāvamardō balavāñjihvāśvayathurēva ca|
bradhnāsyagalapākaśca yasya pakvaṁ tamādiśēt||15||

sambhramō'tipralāpō'tibhēdō'sthnāmatidāruṇaḥ |
kālapāśaparītasya trayamētat pravartatē||16||

pramuhya luñcayēt kēśān parigr̥hṇātyatīva ca|
naraḥ svasthavadāhāramabalaḥ kālacōditaḥ||17||

hastapAdaM mukhaM cobhe visheShAdyasya shuShyataH|
shUyete vA vinA dehAt sa ca mAsaM [1] na jIvati||12||

lalATe mUrdhni bastau vA nIlA yasya prakAshate|
rAjI bAlendukuTilA na sa jIvitumarhati||13||

pravAlaguTikAbhAsA yasya gAtre masUrikAH|
utpadyAshu vinashyanti [2] na cirAt sa vinashyati||14||

grIvAvamardo balavA~jjihvAshvayathureva ca|
bradhnAsyagalapAkashca yasya pakvaM tamAdishet||15||

sambhramo~atipralApo~atibhedo~asthnAmatidAruNaH [3] |
kAlapAshaparItasya trayametat pravartate||16||

pramuhya lu~jcayet keshAn parigRuhNAtyatIva [4] ca|
naraH svasthavadAhAramabalaH [5] kAlacoditaH||17||

If there is noticeable emaciation or swelling of hands and feet along with face and without body (trunk) involvement, he will not survive for more than a month.[12]

Appearance of crescent shaped blue lines on fore head, face and pelvic region indicates that the person will not survive. [13]

If eruption of ''masurika'' (small pox like lesions) on body, having appearance of coral beds (bright red), subsides immediately after its manifestation, the person will die immediately. [14]

A person having acute and severe squeezing type of pain in neck, swelling of tongue along with inflammation of scrotum, throat and mouth should be considered as ripen (for death). [15]

Excessive giddiness, extreme delirium and severe piercing type of pain in bones, manifestation of these three symptoms together indicates that the person is captured by death. [16]

A person, who pulls out his hair in fainting state, eats food like healthy person and still remains weak should be considered as captured by death. [17]

समीपे चक्षुषोः कृत्वा मृगयेताङ्गुलीकरम्|
स्मयतेऽपि च कालान्ध ऊर्ध्वगानिमिषेक्षणः ||१८||

शयनादासनादङ्गात् काष्ठात् कुड्यादथापि वा|
असन्मृगयते किञ्चित् स मुह्यन् कालचोदितः||१९||

samīpē cakṣuṣōḥ kr̥tvā mr̥gayētāṅgulīkaram|
smayatē'pi ca kālāndha ūrdhvagānimiṣēkṣaṇaḥ ||18||

śayanādāsanādaṅgāt kāṣṭhāt kuḍyādathāpi vā|
asanmr̥gayatē kiñcit sa muhyan kālacōditaḥ||19||

samIpe cakShuShoH kRutvA mRugayetA~ggulIkaram|
smayate~api ca kAlAndha UrdhvagAnimiShekShaNaH [1] ||18||

shayanAdAsanAda~ggAt kAShThAt kuDyAdathApi vA|
asanmRugayate ki~jcit sa muhyan kAlacoditaH||19||

The person who searches for his own fingers and hands putting them before his eyes and smiles with upward gaze and unblinking should be considered as blinded by death, [18]

A person who is lying on his bed but is searching for his bed continuously, sitting on chair and searching his own seat, searching his own organs, walking with the stick and searching the same, and searching the walls of his own room, or while working with something and searching the same, are the symptoms of the imminent death of that person. [19]

अहास्यहासी सम्मुह्यन् प्रलेढि दशनच्छदौ|
शीतपादकरोच्छ्वासो यो नरो न स जीवति||२०||

आह्वयंस्तं समीपस्थं स्वजनं जनमेव वा|
महामोहावृतमनाः पश्यन्नपि न पश्यति||२१||

ahāsyahāsī sammuhyan pralēḍhi daśanacchadau|
śītapādakarōcchvāsō yō narō na sa jīvati||20||

āhvayaṁstaṁ samīpasthaṁ svajanaṁ janamēva vā|
mahāmōhāvr̥tamanāḥ paśyannapi na paśyati||21||

ahAsyahAsI sammuhyan praleDhi [1] dashanacchadau|
shItapAdakarocchvAso yo naro na sa jIvati||20||

AhvayaMstaM samIpasthaM svajanaM janameva vA|
mahAmohAvRutamanAH pashyannapi na pashyati||21||

Person who laughs without any reason, acts stupid, teeth and gums are covered with dirt, biting his lips and whose feet, arms are too cold and disappointingly takes long breaths will not survive for long. [20]

Loud shout to call relatives and other people sitting nearby, severe visual hallucinations for non-existing things, observed in the person whose mind is covered by severe delusion [of death].[21]

अयोगमतियोगं वा शरीरे मतिमान् भिषक्|
खादीनां युगपद्दृष्ट्वा भेषजं नावचारयेत्||२२||

ayōgamatiyōgaṁ vā śarīrē matimān bhiṣak|
khādīnāṁ yugapaddr̥ṣṭvā bhēṣajaṁ nāvacārayēt||22||

ayogamatiyogaM vA sharIre matimAn bhiShak|
khAdInAM yugapaddRuShTvA bheShajaM nAvacArayet||22||

A wise physician should abstain from treating a patient on observing that the patient’s body is simultaneously responding both excessively and deficiently to sensory stimuli. [22]

==== Signs of death ====

अतिप्रवृद्ध्या रोगाणां मनसश्च बलक्षयात्|
वासमुत्सृजति क्षिप्रं शरीरी देहसञ्ज्ञकम्||२३||

वर्णस्वरावग्निबलं वागिन्द्रियमनोबलम्|
हीयतेऽसुक्षये निद्रा नित्या भवति वा न वा||२४||

atipravr̥ddhyā rōgāṇāṁ manasaśca balakṣayāt|
vāsamutsr̥jati kṣipraṁ śarīrī dēhasañjñakam||23||

varṇasvarāvAgnibalaṁ vāgindriyamanōbalam|
hīyatē'sukṣayē nidrā nityā bhavati vā na vā||24||

atipravRuddhyA rogANAM manasashca balakShayAt|
vAsamutsRujati kShipraM sharIrI dehasa~jj~jakam||23||

varNasvarAvagnibalaM vAgindriyamanobalam|
hIyate~asukShaye nidrA nityA bhavati vA na vA||24||

In case of extreme advancement of the disease and weaker psychological strength, the soul immediately leaves the body. [23]
Near the end of life there is general decline in complexion, voice,''agni'', speech and state of mind, as well as sleep pattern alters. [24]

भिषग्भेषजपानान्नगुरुमित्रद्विषश्च ये|
वशगाः सर्व एवैते बोद्धव्याः समवर्तिनः||२५||

एतेषु रोगः क्रमते भेषजं प्रतिहन्यते|
नैषामन्नानि भुञ्जीत न चोदकमपि स्पृशेत्||२६||

bhiṣagbhēṣajapānānnagurumitradviṣaśca yē|
vaśagāḥ sarva ēvaitē bōddhavyāḥ samavartinaḥ||25||

ētēṣu rōgaḥ kramatē bhēṣajaṁ pratihanyatē|
naiṣāmannāni bhuñjīta na cōdakamapi spr̥śēt||26||

bhiShagbheShajapAnAnnagurumitradviShashca ye|
vashagAH sarva evaite boddhavyAH samavartinaH||25||

eteShu rogaH kramate bheShajaM pratihanyate|
naiShAmannAni bhu~jjIta na codakamapi spRushet||26||

Those who hate physician, medicine, food (and drink), teacher (spiritual teacher), and friends; are considered to be already under the grip of God of death. [25]

In such people, the disease progress occurs unrestricted and the medicine remains ineffective. The wise physician should not take his offerings in any form, even in form of food and drinks. [26]

पादाः समेताश्चत्वारः सम्पन्नाः साधकैर्गुणैः|
व्यर्था गतायुषो द्रव्यं विना नास्ति गुणोदयः||२७||

pādāḥ samētāścatvāraḥ sampannāḥ sādhakairguṇaiḥ|
vyarthā gatāyuṣō dravyaṁ vinā nāsti guṇōdayaḥ||27||

pAdAH sametAshcatvAraH sampannAH sAdhakairguNaiH|
vyarthA gatAyuSho dravyaM vinA nAsti guNodayaH||27||

Availability of all four basic components of treatment i.e. doctor, medicament, care taker and patient with their desirable quality are of no value in regard to the person who is at the end of his life and there is no response to treatment.[27]

परीक्ष्यमायुर्भिषजा नीरुजस्यातुरस्य च|
आयुर्ज्ञानफलं कृत्स्नमायुर्ज्ञे ह्यनुवर्तते||२८||

parīkṣyamāyurbhiṣajā nīrujasyāturasya ca|
āyurjñānaphalaṁ kr̥tsnamāyurjñē hyanuvartatē||28||

parIkShyamAyurbhiShajA nIrujasyAturasya ca|
Ayurj~jAnaphalaM kRutsnamAyurj~je hyanuvartate||28||

The physician should always assess the prognostic signs of life in diseased as well as in healthy person. Because the knowledge of prognostic signs of life and diseases helps to decide remaining lifespan and hence treatment can be planned accordingly. [28]

==== Summary ====

तत्र श्लोकः-
क्रियापथमतिक्रान्ताः केवलं देहमाप्लुताः|
चिह्नं कुर्वन्ति यद्दोषास्तदरिष्टं निरुच्यते||२९||

tatra ślōkaḥ-
kriyāpathamatikrāntāḥ kēvalaṁ dēhamāplutāḥ|
cihnaṁ kurvanti yaddōṣāstadariṣṭaṁ nirucyatē||29||

tatra shlokaH-
kriyApathamatikrAntAH kevalaM dehamAplutAH|
cihnaM kurvanti yaddoShAstadariShTaM nirucyate||29||

Here is the re capitulatory verse: The signs originated due to extensively vitiated and pervaded ''dosha'' throughout the body, and already transcended the stage of the treatment are called ''arishta'' (signs of death). [29]

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

*Optimum quality and quantity of ''agni'' is necessary for sustenance of life.
*Stable mental status, complexion and mental strength are markers to predict lifespan of patient.
*Sudden changes in likings, gentleness, memory, sacrifices, intellect and strength in a person are pre-indications of death.
*Altered sensorium and psychological status leading to various delusions and hallucinations are pre-indicators of death.
*Near the end of life there is general decline in complexion, voice, ''agni'', speech and state of mind, as well as sleep pattern alters.
*The prognostic signs of life in diseased as well as in healthy person shall always be assessed. This helps to decide remaining lifespan and planning treatment.
*The signs originated due to extensively vitiated and pervaded ''dosha'' throughout the body, and already transcended the stage of the treatment are called ''arishta'' (signs of death).

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

Metabolic process and thermoregulatory center situated in hypothalamus play key role to generate and maintain body temperature respectively. Reduced temperature shows slow metabolic process and gradually it ceases completely, causing death.
With the help of healthy digestive power and proper metabolic activity; food nourishes the body and provide macro and micronutrients to the body.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 3. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512 </ref>

In any manner, hampered blood or oxygen supply to the brain leads to lack of concentration, weakness of mental functions or agitation. Deposition of any toxic substance or progressive degenerative changes of mind also leads to such symptoms. Ageing and death are considered as natural process with passage of time.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 4, Ver. 36. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 323 </ref> With declining phase of life, ageing symptoms start to appear, as new cell production is almost stops and older cell destruction continues. With the passage of senescence; weakness, decreasing appetite, muscular wasting, decreased fluid intake, neurological dysfunctions, decreasing level of consciousness etc. are common symptoms manifest and gradually leads to cessation of life.<ref>httpendlink.lurie.northwestern.edulast_hours_of_livingpart_one.pdf </ref>

Every individual has good appetite and capability of digesting foods he regularly ingests. ''Ksheerada''(only on milk), ''ksheera-anna''(milk and rice products), ''annada'' (staple foods), are three basic stages of life. During ageing process, gradual reduction in both qualitative consumption and digestive abilities are observed. This in turn influences the individual’s physical and mental wellbeing leading to reduction in life span ending in death.[3]

As per the principle of ''Yatha Brahmande Tatha Pinde'', whatever is there in the universe, is there in the human body. Hence there should be some connections between human body and the universe. When the soul is preparing for detachment from the body to start its journey to other world, there should be some indications from the universe as indicator of impending death. As per Indian tradition, offerings of food to birds specially to crow and non-acceptance of offering by crow may indicate the preparation of soul for detachment from living body. Inability to see ''Arundhati'' in the sky is another indication of the same. [4 – 5]

Acute loss or gain of luster or body weight can be the result of carcinogenic condition or severe catabolic changes taking place in the body that can be fatal for the person. [6]

Brain regulates multiple functions related to sensory, motor and autonomous nervous system like emotions, intellect and many other activities. Amygdala, and physiological functioning of limbic system of brain, are responsible for proper emotions and its expression. If these are deviated grossly, it shows involvement of higher center in pathogenesis and poor prognosis.

Gradual cessation of the functions is a clear indication of either degenerative changes or space occupying lesion (SOL) in the specific area. Acute toxicity of brain also leads to acute degeneration of brain cells or infarction that leads to hampering of function. [7]
Sudden appearance of crescent shaped streaks or blood vessel network on forehead may relate with Amyloidosis. It is a rare disease that occurs when a protein (albumoid) substance gets deposited in person’s organ. This abnormal protein is usually produced in bone marrow and can be deposited in any tissue or organ. The prognosis is poor. [8-9]<ref>the description is based on https://en.wikipedia.org/wiki/Amyloidosis, accessed on 15/10/2015 </ref>

If person having combination of dual type of activity of mind i.e. exaggerated (in form of tremor), and diminished activity (in form of stupor), simultaneously; is supposed to die within a month. These dual types of signs may indicate increased intracranial pressure (ICP) due to localized mass like hematoma, neoplasm, abscess, edema, infarction, obstruction in CSF circulation, diffuse brain edema (like encephalitis, meningitis, or diffuse head injury), thrombosis, or idiopathic intracranial hypertension.

Symptoms of raised ICP are altered mental state, lethargy, irritability, slow decision making and abnormal social behavior. Ultimate result of the patho-physiology of such condition is stupor, coma and death. Rapidly rising ICP leads to syncope, seizures. These neurologic changes seen in increased ICP are mostly due to hypoxia and hyper apnea. [10]

If fecal matter or other excreta are mixed with ''ama'', it sinks straight in water due to its heaviness. Same concept is applied to other body discharge or ''dhatus'' too. Fecal matter is the end product of digestion. Hence, if it sinks in water it shows incomplete or improper digestion of food. ''Shukra'' is the last ''dhatu'' and hence all ''dhatvagni'' contribute (directly or indirectly) in its formation. To sink ''shukra'' in water is indicative that the ''dhatu'' is in ''sama'' stage. To get dipped all the three i.e. feces, urine and semen shows impairment of ''jatharagni'' along with ''dhatvagni'' functions leading to qualitative mal-formation of all ''dhatus''. Such situation has been considered as fatal. [11]

Muscular wasting of hands and feet is a type of neurogenic muscular atrophy with poor prognosis.

Swelling over both extremities along with face is an indication of damage of two vital organ simultaneously i.e. heart and kidney and hence survival of patient is difficult.[12]

Appearance of blue lines occurs in various conditions. This may be indication of venous congestion due to heart, lungs and liver diseases, requiring attention while scaling the span of life. [13]

Immediate disappearance of manifested small pox subsequently develops acute toxemia and hence leads to death. [14]

Combined manifestation of stiff neck along with inflamed throat and scrotum and swollen tongue is the condition of tertiary stage of syphilis when the person develops syphilitic meningitis (complication of untreated syphilis), is a life threatening condition. [15]

Visual (or even other sensorial) hallucinations are often part of the dying experience. Person may unknowingly involve in such activities with such illusions. This is the phase when the soul is getting ready to detach from the body and to travel for another world. The dying may turn their focus to “another world”, and thus may see (or feel other sensorial hallucination of) some unusual things, he may see or talk to such people who are already died. [18-19]

Various kinds of hallucinations are indications of altered psychological state of dying person, and to have laughter without any specific cause is also result of such hallucinations. To lick own lips is the sign of dehydration and coldness of breath and extremity are the indication of almost reducing function of heart and hence, stoppage of blood flow to concerned area. [20] Delusions along with altered sensorial organ is the sign of death. [21]

Days or hours before death, the dying person becomes less and less responsive to voice and touch and may not awaken. (Sometimes, quite unexpectedly, the person may appear well and even look as if he/she is going to recover. The person may be alert and talkative. But it does not mean that he is getting well; of course the time may be used as a “window of opportunity” to say what you need to say and have closure).<ref>httpkokuamau.orgresourceslast-stages-life </ref> [8] These all of sudden recovery changes are also signs of near death. [25]

As per ancient classical texts, life span of everyone is fixed and pre-ordained. No one can add years to the life only quality of life can be improved with medications. The same thing is meant here when it is said that death is the destiny of patient and that desirable quality of medicine, human resource and all other things cannot make the person outlive his destined lifespan.[27]

=== Glossary ===

#Agni – Digestive and metabolic power of body
#Ojas – extract / essence of all seven Dhatu
#Mana - Thought
#Indriya – sensory organs
#Sattva - Mind
#Atma -Soul
#Arishta – the symptom that show definite death of person
#Dosha – basic components / energy which govern the body
#Ksheerapa- dependent on milk only
#Ksheerannada – taking milk and grains both (as principal food)
#Annada – taking grains as staple food
#Bali – the food or other thing that offered to creatures or God
#Arundhati – a star that situated adjacent to the constellation of the great bear

=== References ===

<references/>

Anujyoti

2017-12-26T14:44:32Z

Vinay Exafluence: /* Vidhi Vimarsha */

{{Infobox
|title = Anujyoti
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 11
|label2 = Preceding Chapter
|data2 = [[Sadyomarneeya]]

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

|header3 =

}}
== [[Indriya Sthana]], Chapter 11 ==

=== Abstract ===

[[Anujyoti]] explicates the signs and symptoms of imminent death due to diminution of ''Agni'' (factor responsible for digestion and metabolism). The components of life like lifespan, strength, complexion, enthusiasm, health, growth, luster, and immunity are dependent upon the status of ''agni''. Diminution of its power causes generalized symptoms indicative of imminent death. Declaration of the estimated time for death might be based on experience of many experts of that time, which can now be reestablished in light of present scientific developments. The clinical signs and symptoms given in this chapter are useful as an additional information for assessment of prognosis.

'''Keywords''': ''Anujyoti, Arista, Bali'', digestion.

=== Introduction ===

The present chapter, ''Anujyotiyamindriyam'' , or [[Anujyoti]], deals with near death signs that arise due to decrease in digestive capacity of a person i.e. ''jatharagni''. The chapter indicates importance of digestive and metabolic functions of ''agni''. The ingested food is helpful and nutritive to body only if, it passes through various digestive and metabolic processes successfully. This food nourishes the body at cellular level and it reflects in the form of good complexion, strength, good health, enthusiasm, and nourishment to formation of ''ojas''. Some part of food digested with the help of ''agni'' nourishes sensory organs along with ''mana'' (mind) too. Ayurveda has emphasized the importance of quality and quantity of Agni for metabolic activity of the body, that if the ''agni'' works well, the person lives long and if it ceases; the person is going to die.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 4. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512 </ref>

Some signs seen in diseased or in healthy person, with or without any significant/visible pathology leading to death, are mentioned. These signs occurs due to initiation of some life threatening disease with poor prognosis even in initial stage.

It is emphasized that any extreme alternation in body physiology or psychology, person’s own behavior, mental functions, etc. without any significant reason; is also one of the sign for death.

Mind supremacy is also highlighted, as the mental strength of a person declines due to advancement of disease; then the person is likely to die. Composition of physical body (''sharira''), sensoria (''indriya''), mind (''sattva'') and soul (''atma'') is called life (''ayu''). With advanced stage of disease, physical body gets damaged, sensoria may also get affected and soul becomes ready to leave the diseased body; in such situation only strong mind power can sustain life as physical body follows mind and vice versa.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 1, Ver. 155. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 298 </ref>

It is elucidated that if person’s life span has ended; even good quality of physician, medicine or care taker are helpless. In a nutshell person’s life span is fixed and when it is gets finished, some signs are manifested called ''arishta''.

Further, status of dying person is described briefly that, he may develop aversion to all loving and respectful persons, friends, food (and other basic essentials for surviving) etc. as his soul is almost in position to detach this body and preparing self to travel to other world. The chapter defines ''arishta'' with a new dimension. The concomitant aggravation of ''dosha'' (either qualitative or quantitative) with life-threatening diminution of ''dhatu'' is significant in the prediction of death.

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

अणुज्योतीयेन्द्रियोपक्रमः
अथातोऽणुज्योतीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō'ṇujyōtīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto~aNujyotIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter on signs and symptoms of ‘Imminent Death due to diminution of ''Agni'' (Factor responsible for digestion and metabolism) as said by Lord Atreya. [1-2]

==== Signs of near-death and declining lifespan ====

अणुज्योतिरनेकाग्रो दुश्छायो दुर्मनाः सदा|
रतिं न लभते याति परलोकं समान्तरम्||३||

aṇujyōtiranēkāgrō duśchāyō durmanāḥ sadā|
ratiṁ na labhatē yāti paralōkaṁ samāntaram||3||

aNujyotiranekAgro dushchAyo durmanAH sadA|
ratiM na labhate yAti [1] paralokaM samAntaram||3||

The person always (suffering from) with poor digestion, unstable or agitated mind, diminished luster, weak mental strength and restlessness goes to other world [dies] within a year. [3]

बलिं बलिभृतो यस्य प्रणीतं नोपभुञ्जते|
लोकान्तरगतः पिण्डं भुङ्क्ते संवत्सरेण सः||४||

सप्तर्षीणां समीपस्थां यो न पश्यत्यरुन्धतीम्|
संवत्सरान्ते जन्तुः स सम्पश्यति महत्तमः||५||

विकृत्या विनिमित्तं यः शोभामुपचयं धनम्|
प्राप्नोत्यतो वा विभ्रंशं समान्तं तस्य जीवितम्||६||

baliṁ balibhr̥tō yasya praṇītaṁ nōpabhuñjatē|
lōkāntaragataḥ piṇḍaṁ bhuṅktē saṁvatsarēṇa saḥ||4||

saptarṣīṇāṁ samīpasthāṁ yō na paśyatyarundhatīm|
saṁvatsarāntē jantuḥ sa sampaśyati mahattamaḥ||5||

vikr̥tyā vinimittaṁ yaḥ śōbhāmupacayaṁ dhanam|
prāpnōtyatō vā vibhraṁśaṁ samāntaṁ tasya jīvitam||6||

baliM balibhRuto yasya praNItaM nopabhu~jjate|
lokAntaragataH piNDaM bhu~gkte saMvatsareNa saH||4||

saptarShINAM samIpasthAM yo na pashyatyarundhatIm|
saMvatsarAnte jantuH sa sampashyati mahattamaH||5||

vikRutyA vinimittaM yaH shobhAmupacayaM dhanam|
prApnotyato vA vibhraMshaM samAntaM tasya jIvitam||6||

When a person offers ''bali'' (an offering a piece of daily meal) to crow and it does not accept it this indicates of death within a year for the offering person.

If a person is not able to see the star ''Arundhati'' situated adjacent to the constellation of ''Saptarshi'' (The Great Bear), he succumbs to death one year thereafter. [5]

Sudden gain or loss of luster, body weight, or wealth without any reasons indicates death of the person within one year thereafter. [6]

भक्तिः शीलं स्मृतिस्त्यागो बुद्धिर्बलमहेतुकम्|
षडेतानि निवर्तन्ते षड्भिर्मासैर्मरिष्यतः||७||

bhaktiḥ śīlaṁ smr̥tistyāgō buddhirbalamahētukam|
ṣaḍētāni nivartantē ṣaḍbhirmāsairmariṣyataḥ||7||

bhaktiH shIlaM smRutistyAgo buddhirbalamahetukam|
ShaDetAni nivartante ShaDbhirmAsairmariShyataH||7||

Sudden changes in likings, gentleness, memory, sacrifices, intellect and strength these six attributes in a person indicate the death within a time of six months. [7]

धमनीनामपूर्वाणां जालमत्यर्थशोभनम्|
ललाटे दृश्यते यस्य षण्मासान्न स जीवति||८||

लेखाभिश्चन्द्रवक्राभिर्ललाटमुपचीयते|
यस्य तस्यायुषः षड्भिर्मासैरन्तं समादिशेत्||९||

dhamanīnāmapūrvāṇāṁ jālamatyarthaśōbhanam|
lalāṭē dr̥śyatē yasya ṣaṇmāsānna sa jīvati||8||

lēkhābhiścandravakrābhirlalāṭamupacīyatē|
yasya tasyāyuṣaḥ ṣaḍbhirmāsairantaṁ samādiśēt||9||

dhamanInAmapUrvANAM jAlamatyarthashobhanam|
lalATe dRushyate yasya ShaNmAsAnna sa jIvati||8||

lekhAbhishcandravakrAbhirlalATamupacIyate|
yasya tasyAyuShaH ShaDbhirmAsairantaM samAdishet||9||

Sudden appearance of extremely shiny and prominent vasculature on fore head of an individual indicates that maximum life span of less than six month. [8]

A person, on whose forehead crescent shaped grooves develop, is supposed to die after six months [9]

शरीरकम्पः सम्मोहो गतिर्वचनमेव च|
मत्तस्येवोपलभ्यन्ते यस्य मासं न जीवति||१०||

रेतोमूत्रपुरीषाणि यस्य मज्जन्ति चाम्भसि|
स मासात् स्वजनद्वेष्टा मृत्युवारिणि मज्जति||११||

śarīrakampaḥ sammōhō gatirvacanamēva ca|
mattasyēvōpalabhyantē yasya māsaṁ na jīvati||10||

rētōmūtrapurīṣāṇi yasya majjanti cāmbhasi|
sa māsāt svajanadvēṣṭā mr̥tyuvāriṇi majjati||11||

sharIrakampaH sammoho gatirvacanameva ca|
mattasyevopalabhyante yasya mAsaM na jIvati||10||

retomUtrapurIShANi yasya majjanti cAmbhasi|
sa mAsAt svajanadveShTA mRutyuvAriNi majjati||11||

Sudden appearance of tremors on body, drowsiness along with altered gait and speech resembling of an insane person cannot survive even for a month. [10]

If semen, urine and feces of an individual sink in water as well as have aversion from own relatives, will sink in the water of death within one month. [11]

हस्तपादं मुखं चोभे विशेषाद्यस्य शुष्यतः|
शूयेते वा विना देहात् स च मासं न जीवति||१२||

ललाटे मूर्ध्नि बस्तौ वा नीला यस्य प्रकाशते|
राजी बालेन्दुकुटिला न स जीवितुमर्हति||१३||

प्रवालगुटिकाभासा यस्य गात्रे मसूरिकाः|
उत्पद्याशु विनश्यन्ति न चिरात् स विनश्यति||१४||

ग्रीवावमर्दो बलवाञ्जिह्वाश्वयथुरेव च|
ब्रध्नास्यगलपाकश्च यस्य पक्वं तमादिशेत्||१५||

सम्भ्रमोऽतिप्रलापोऽतिभेदोऽस्थ्नामतिदारुणः |
कालपाशपरीतस्य त्रयमेतत् प्रवर्तते||१६||

प्रमुह्य लुञ्चयेत् केशान् परिगृह्णात्यतीव च|
नरः स्वस्थवदाहारमबलः कालचोदितः||१७||

hastapādaṁ mukhaṁ cōbhē viśēṣādyasya śuṣyataḥ|
śūyētē vā vinā dēhāt sa ca māsaṁ na jīvati||12||

lalāṭē mūrdhni bastau vā nīlā yasya prakāśatē|
rājī bālēndukuṭilā na sa jīvitumarhati||13||

pravālaguṭikābhāsā yasya gātrē masūrikāḥ|
utpadyāśu vinaśyanti na cirāt sa vinaśyati||14||

grīvāvamardō balavāñjihvāśvayathurēva ca|
bradhnāsyagalapākaśca yasya pakvaṁ tamādiśēt||15||

sambhramō'tipralāpō'tibhēdō'sthnāmatidāruṇaḥ |
kālapāśaparītasya trayamētat pravartatē||16||

pramuhya luñcayēt kēśān parigr̥hṇātyatīva ca|
naraḥ svasthavadāhāramabalaḥ kālacōditaḥ||17||

hastapAdaM mukhaM cobhe visheShAdyasya shuShyataH|
shUyete vA vinA dehAt sa ca mAsaM [1] na jIvati||12||

lalATe mUrdhni bastau vA nIlA yasya prakAshate|
rAjI bAlendukuTilA na sa jIvitumarhati||13||

pravAlaguTikAbhAsA yasya gAtre masUrikAH|
utpadyAshu vinashyanti [2] na cirAt sa vinashyati||14||

grIvAvamardo balavA~jjihvAshvayathureva ca|
bradhnAsyagalapAkashca yasya pakvaM tamAdishet||15||

sambhramo~atipralApo~atibhedo~asthnAmatidAruNaH [3] |
kAlapAshaparItasya trayametat pravartate||16||

pramuhya lu~jcayet keshAn parigRuhNAtyatIva [4] ca|
naraH svasthavadAhAramabalaH [5] kAlacoditaH||17||

If there is noticeable emaciation or swelling of hands and feet along with face and without body (trunk) involvement, he will not survive for more than a month.[12]

Appearance of crescent shaped blue lines on fore head, face and pelvic region indicates that the person will not survive. [13]

If eruption of ''masurika'' (small pox like lesions) on body, having appearance of coral beds (bright red), subsides immediately after its manifestation, the person will die immediately. [14]

A person having acute and severe squeezing type of pain in neck, swelling of tongue along with inflammation of scrotum, throat and mouth should be considered as ripen (for death). [15]

Excessive giddiness, extreme delirium and severe piercing type of pain in bones, manifestation of these three symptoms together indicates that the person is captured by death. [16]

A person, who pulls out his hair in fainting state, eats food like healthy person and still remains weak should be considered as captured by death. [17]

समीपे चक्षुषोः कृत्वा मृगयेताङ्गुलीकरम्|
स्मयतेऽपि च कालान्ध ऊर्ध्वगानिमिषेक्षणः ||१८||

शयनादासनादङ्गात् काष्ठात् कुड्यादथापि वा|
असन्मृगयते किञ्चित् स मुह्यन् कालचोदितः||१९||

samīpē cakṣuṣōḥ kr̥tvā mr̥gayētāṅgulīkaram|
smayatē'pi ca kālāndha ūrdhvagānimiṣēkṣaṇaḥ ||18||

śayanādāsanādaṅgāt kāṣṭhāt kuḍyādathāpi vā|
asanmr̥gayatē kiñcit sa muhyan kālacōditaḥ||19||

samIpe cakShuShoH kRutvA mRugayetA~ggulIkaram|
smayate~api ca kAlAndha UrdhvagAnimiShekShaNaH [1] ||18||

shayanAdAsanAda~ggAt kAShThAt kuDyAdathApi vA|
asanmRugayate ki~jcit sa muhyan kAlacoditaH||19||

The person who searches for his own fingers and hands putting them before his eyes and smiles with upward gaze and unblinking should be considered as blinded by death, [18]

A person who is lying on his bed but is searching for his bed continuously, sitting on chair and searching his own seat, searching his own organs, walking with the stick and searching the same, and searching the walls of his own room, or while working with something and searching the same, are the symptoms of the imminent death of that person. [19]

अहास्यहासी सम्मुह्यन् प्रलेढि दशनच्छदौ|
शीतपादकरोच्छ्वासो यो नरो न स जीवति||२०||

आह्वयंस्तं समीपस्थं स्वजनं जनमेव वा|
महामोहावृतमनाः पश्यन्नपि न पश्यति||२१||

ahāsyahāsī sammuhyan pralēḍhi daśanacchadau|
śītapādakarōcchvāsō yō narō na sa jīvati||20||

āhvayaṁstaṁ samīpasthaṁ svajanaṁ janamēva vā|
mahāmōhāvr̥tamanāḥ paśyannapi na paśyati||21||

ahAsyahAsI sammuhyan praleDhi [1] dashanacchadau|
shItapAdakarocchvAso yo naro na sa jIvati||20||

AhvayaMstaM samIpasthaM svajanaM janameva vA|
mahAmohAvRutamanAH pashyannapi na pashyati||21||

Person who laughs without any reason, acts stupid, teeth and gums are covered with dirt, biting his lips and whose feet, arms are too cold and disappointingly takes long breaths will not survive for long. [20]

Loud shout to call relatives and other people sitting nearby, severe visual hallucinations for non-existing things, observed in the person whose mind is covered by severe delusion [of death].[21]

अयोगमतियोगं वा शरीरे मतिमान् भिषक्|
खादीनां युगपद्दृष्ट्वा भेषजं नावचारयेत्||२२||

ayōgamatiyōgaṁ vā śarīrē matimān bhiṣak|
khādīnāṁ yugapaddr̥ṣṭvā bhēṣajaṁ nāvacārayēt||22||

ayogamatiyogaM vA sharIre matimAn bhiShak|
khAdInAM yugapaddRuShTvA bheShajaM nAvacArayet||22||

A wise physician should abstain from treating a patient on observing that the patient’s body is simultaneously responding both excessively and deficiently to sensory stimuli. [22]

==== Signs of death ====

अतिप्रवृद्ध्या रोगाणां मनसश्च बलक्षयात्|
वासमुत्सृजति क्षिप्रं शरीरी देहसञ्ज्ञकम्||२३||

वर्णस्वरावग्निबलं वागिन्द्रियमनोबलम्|
हीयतेऽसुक्षये निद्रा नित्या भवति वा न वा||२४||

atipravr̥ddhyā rōgāṇāṁ manasaśca balakṣayāt|
vāsamutsr̥jati kṣipraṁ śarīrī dēhasañjñakam||23||

varṇasvarāvAgnibalaṁ vāgindriyamanōbalam|
hīyatē'sukṣayē nidrā nityā bhavati vā na vā||24||

atipravRuddhyA rogANAM manasashca balakShayAt|
vAsamutsRujati kShipraM sharIrI dehasa~jj~jakam||23||

varNasvarAvagnibalaM vAgindriyamanobalam|
hIyate~asukShaye nidrA nityA bhavati vA na vA||24||

In case of extreme advancement of the disease and weaker psychological strength, the soul immediately leaves the body. [23]
Near the end of life there is general decline in complexion, voice,''agni'', speech and state of mind, as well as sleep pattern alters. [24]

भिषग्भेषजपानान्नगुरुमित्रद्विषश्च ये|
वशगाः सर्व एवैते बोद्धव्याः समवर्तिनः||२५||

एतेषु रोगः क्रमते भेषजं प्रतिहन्यते|
नैषामन्नानि भुञ्जीत न चोदकमपि स्पृशेत्||२६||

bhiṣagbhēṣajapānānnagurumitradviṣaśca yē|
vaśagāḥ sarva ēvaitē bōddhavyāḥ samavartinaḥ||25||

ētēṣu rōgaḥ kramatē bhēṣajaṁ pratihanyatē|
naiṣāmannāni bhuñjīta na cōdakamapi spr̥śēt||26||

bhiShagbheShajapAnAnnagurumitradviShashca ye|
vashagAH sarva evaite boddhavyAH samavartinaH||25||

eteShu rogaH kramate bheShajaM pratihanyate|
naiShAmannAni bhu~jjIta na codakamapi spRushet||26||

Those who hate physician, medicine, food (and drink), teacher (spiritual teacher), and friends; are considered to be already under the grip of God of death. [25]

In such people, the disease progress occurs unrestricted and the medicine remains ineffective. The wise physician should not take his offerings in any form, even in form of food and drinks. [26]

पादाः समेताश्चत्वारः सम्पन्नाः साधकैर्गुणैः|
व्यर्था गतायुषो द्रव्यं विना नास्ति गुणोदयः||२७||

pādāḥ samētāścatvāraḥ sampannāḥ sādhakairguṇaiḥ|
vyarthā gatāyuṣō dravyaṁ vinā nāsti guṇōdayaḥ||27||

pAdAH sametAshcatvAraH sampannAH sAdhakairguNaiH|
vyarthA gatAyuSho dravyaM vinA nAsti guNodayaH||27||

Availability of all four basic components of treatment i.e. doctor, medicament, care taker and patient with their desirable quality are of no value in regard to the person who is at the end of his life and there is no response to treatment.[27]

परीक्ष्यमायुर्भिषजा नीरुजस्यातुरस्य च|
आयुर्ज्ञानफलं कृत्स्नमायुर्ज्ञे ह्यनुवर्तते||२८||

parīkṣyamāyurbhiṣajā nīrujasyāturasya ca|
āyurjñānaphalaṁ kr̥tsnamāyurjñē hyanuvartatē||28||

parIkShyamAyurbhiShajA nIrujasyAturasya ca|
Ayurj~jAnaphalaM kRutsnamAyurj~je hyanuvartate||28||

The physician should always assess the prognostic signs of life in diseased as well as in healthy person. Because the knowledge of prognostic signs of life and diseases helps to decide remaining lifespan and hence treatment can be planned accordingly. [28]

==== Summary ====

तत्र श्लोकः-
क्रियापथमतिक्रान्ताः केवलं देहमाप्लुताः|
चिह्नं कुर्वन्ति यद्दोषास्तदरिष्टं निरुच्यते||२९||

tatra ślōkaḥ-
kriyāpathamatikrāntāḥ kēvalaṁ dēhamāplutāḥ|
cihnaṁ kurvanti yaddōṣāstadariṣṭaṁ nirucyatē||29||

tatra shlokaH-
kriyApathamatikrAntAH kevalaM dehamAplutAH|
cihnaM kurvanti yaddoShAstadariShTaM nirucyate||29||

Here is the re capitulatory verse: The signs originated due to extensively vitiated and pervaded ''dosha'' throughout the body, and already transcended the stage of the treatment are called ''arishta'' (signs of death). [29]

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

*Optimum quality and quantity of ''agni'' is necessary for sustenance of life.
*Stable mental status, complexion and mental strength are markers to predict lifespan of patient.
*Sudden changes in likings, gentleness, memory, sacrifices, intellect and strength in a person are pre-indications of death.
*Altered sensorium and psychological status leading to various delusions and hallucinations are pre-indicators of death.
*Near the end of life there is general decline in complexion, voice, ''agni'', speech and state of mind, as well as sleep pattern alters.
*The prognostic signs of life in diseased as well as in healthy person shall always be assessed. This helps to decide remaining lifespan and planning treatment.
*The signs originated due to extensively vitiated and pervaded ''dosha'' throughout the body, and already transcended the stage of the treatment are called ''arishta'' (signs of death).

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

Metabolic process and thermoregulatory center situated in hypothalamus play key role to generate and maintain body temperature respectively. Reduced temperature shows slow metabolic process and gradually it ceases completely, causing death.
With the help of healthy digestive power and proper metabolic activity; food nourishes the body and provide macro and micronutrients to the body.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 3. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512 </ref>

In any manner, hampered blood or oxygen supply to the brain leads to lack of concentration, weakness of mental functions or agitation. Deposition of any toxic substance or progressive degenerative changes of mind also leads to such symptoms. Ageing and death are considered as natural process with passage of time.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 4, Ver. 36. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 323 </ref> With declining phase of life, ageing symptoms start to appear, as new cell production is almost stops and older cell destruction continues. With the passage of senescence; weakness, decreasing appetite, muscular wasting, decreased fluid intake, neurological dysfunctions, decreasing level of consciousness etc. are common symptoms manifest and gradually leads to cessation of life.<ref>httpendlink.lurie.northwestern.edulast_hours_of_livingpart_one.pdf </ref>

Every individual has good appetite and capability of digesting foods he regularly ingests. ''Ksheerada''(only on milk), ''ksheera-anna''(milk and rice products), ''annada'' (staple foods), are three basic stages of life. During ageing process, gradual reduction in both qualitative consumption and digestive abilities are observed. This in turn influences the individual’s physical and mental wellbeing leading to reduction in life span ending in death.[3]

As per the principle of ''Yatha Brahmande Tatha Pinde'', whatever is there in the universe, is there in the human body. Hence there should be some connections between human body and the universe. When the soul is preparing for detachment from the body to start its journey to other world, there should be some indications from the universe as indicator of impending death. As per Indian tradition, offerings of food to birds specially to crow and non-acceptance of offering by crow may indicate the preparation of soul for detachment from living body. Inability to see ''Arundhati'' in the sky is another indication of the same. [4 – 5]

Acute loss or gain of luster or body weight can be the result of carcinogenic condition or severe catabolic changes taking place in the body that can be fatal for the person. [6]

Brain regulates multiple functions related to sensory, motor and autonomous nervous system like emotions, intellect and many other activities. Amygdala, and physiological functioning of limbic system of brain, are responsible for proper emotions and its expression. If these are deviated grossly, it shows involvement of higher center in pathogenesis and poor prognosis.

Gradual cessation of the functions is a clear indication of either degenerative changes or space occupying lesion (SOL) in the specific area. Acute toxicity of brain also leads to acute degeneration of brain cells or infarction that leads to hampering of function. [7]
Sudden appearance of crescent shaped streaks or blood vessel network on forehead may relate with Amyloidosis. It is a rare disease that occurs when a protein (albumoid) substance gets deposited in person’s organ. This abnormal protein is usually produced in bone marrow and can be deposited in any tissue or organ. The prognosis is poor. [8-9]<ref>the description is based on https://en.wikipedia.org/wiki/Amyloidosis, accessed on 15/10/2015 </ref>

If person having combination of dual type of activity of mind i.e. exaggerated (in form of tremor), and diminished activity (in form of stupor), simultaneously; is supposed to die within a month. These dual types of signs may indicate increased intracranial pressure (ICP) due to localized mass like hematoma, neoplasm, abscess, edema, infarction, obstruction in CSF circulation, diffuse brain edema (like encephalitis, meningitis, or diffuse head injury), thrombosis, or idiopathic intracranial hypertension.

Symptoms of raised ICP are altered mental state, lethargy, irritability, slow decision making and abnormal social behavior. Ultimate result of the patho-physiology of such condition is stupor, coma and death. Rapidly rising ICP leads to syncope, seizures. These neurologic changes seen in increased ICP are mostly due to hypoxia and hyper apnea. [10]

If fecal matter or other excreta are mixed with ''ama'', it sinks straight in water due to its heaviness. Same concept is applied to other body discharge or ''dhatus'' too. Fecal matter is the end product of digestion. Hence, if it sinks in water it shows incomplete or improper digestion of food. ''Shukra'' is the last ''dhatu'' and hence all ''dhatvagni'' contribute (directly or indirectly) in its formation. To sink ''shukra'' in water is indicative that the ''dhatu'' is in ''sama'' stage. To get dipped all the three i.e. feces, urine and semen shows impairment of ''jatharagni'' along with ''dhatvagni'' functions leading to qualitative mal-formation of all ''dhatus''. Such situation has been considered as fatal. [11]

Muscular wasting of hands and feet is a type of neurogenic muscular atrophy with poor prognosis.

Swelling over both extremities along with face is an indication of damage of two vital organ simultaneously i.e. heart and kidney and hence survival of patient is difficult.[12]

Appearance of blue lines occurs in various conditions. This may be indication of venous congestion due to heart, lungs and liver diseases, requiring attention while scaling the span of life. [13]

Immediate disappearance of manifested small pox subsequently develops acute toxemia and hence leads to death. [14]

Combined manifestation of stiff neck along with inflamed throat and scrotum and swollen tongue is the condition of tertiary stage of syphilis when the person develops syphilitic meningitis (complication of untreated syphilis), is a life threatening condition. [15]

Visual (or even other sensorial) hallucinations are often part of the dying experience. Person may unknowingly involve in such activities with such illusions. This is the phase when the soul is getting ready to detach from the body and to travel for another world. The dying may turn their focus to “another world”, and thus may see (or feel other sensorial hallucination of) some unusual things, he may see or talk to such people who are already died. [18-19]

Various kinds of hallucinations are indications of altered psychological state of dying person, and to have laughter without any specific cause is also result of such hallucinations. To lick own lips is the sign of dehydration and coldness of breath and extremity are the indication of almost reducing function of heart and hence, stoppage of blood flow to concerned area. [20] Delusions along with altered sensorial organ is the sign of death. [21]

Days or hours before death, the dying person becomes less and less responsive to voice and touch and may not awaken. (Sometimes, quite unexpectedly, the person may appear well and even look as if he/she is going to recover. The person may be alert and talkative. But it does not mean that he is getting well; of course the time may be used as a “window of opportunity” to say what you need to say and have closure).<ref>httpkokuamau.orgresourceslast-stages-life </ref> [8] These all of sudden recovery changes are also signs of near death. [25]

As per ancient classical texts, life span of everyone is fixed and pre-ordained. No one can add years to the life only quality of life can be improved with medications. The same thing is meant here when it is said that death is the destiny of patient and that desirable quality of medicine, human resource and all other things cannot make the person outlive his destined lifespan.[27]

=== Glossary ===

#Agni – Digestive and metabolic power of body
#Ojas – extract / essence of all seven Dhatu
#Mana - Thought
#Indriya – sensory organs
#Sattva - Mind
#Atma -Soul
#Arishta – the symptom that show definite death of person
#Dosha – basic components / energy which govern the body
#Ksheerapa- dependent on milk only
#Ksheerannada – taking milk and grains both (as principal food)
#Annada – taking grains as staple food
#Bali – the food or other thing that offered to creatures or God
#Arundhati – a star that situated adjacent to the constellation of the great bear

=== References ===

#Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 4. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512
#Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 1, Ver. 155. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 298
#Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 3. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512
#Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 4, Ver. 36. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 323
#httpendlink.lurie.northwestern.edulast_hours_of_livingpart_one.pdf
#the description is based on https://en.wikipedia.org/wiki/Amyloidosis, accessed on 15/10/2015
#httpkokuamau.orgresourceslast-stages-life
#Acharya JT, editor. Charak Samhita of Agnivesha, Vimanasthana 4th ed. Ch. 8, Ver. 94. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 276

Anujyoti

2017-12-26T14:38:08Z

Vinay Exafluence: /* Introduction */

{{Infobox
|title = Anujyoti
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 11
|label2 = Preceding Chapter
|data2 = [[Sadyomarneeya]]

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

|header3 =

}}
== [[Indriya Sthana]], Chapter 11 ==

=== Abstract ===

[[Anujyoti]] explicates the signs and symptoms of imminent death due to diminution of ''Agni'' (factor responsible for digestion and metabolism). The components of life like lifespan, strength, complexion, enthusiasm, health, growth, luster, and immunity are dependent upon the status of ''agni''. Diminution of its power causes generalized symptoms indicative of imminent death. Declaration of the estimated time for death might be based on experience of many experts of that time, which can now be reestablished in light of present scientific developments. The clinical signs and symptoms given in this chapter are useful as an additional information for assessment of prognosis.

'''Keywords''': ''Anujyoti, Arista, Bali'', digestion.

=== Introduction ===

The present chapter, ''Anujyotiyamindriyam'' , or [[Anujyoti]], deals with near death signs that arise due to decrease in digestive capacity of a person i.e. ''jatharagni''. The chapter indicates importance of digestive and metabolic functions of ''agni''. The ingested food is helpful and nutritive to body only if, it passes through various digestive and metabolic processes successfully. This food nourishes the body at cellular level and it reflects in the form of good complexion, strength, good health, enthusiasm, and nourishment to formation of ''ojas''. Some part of food digested with the help of ''agni'' nourishes sensory organs along with ''mana'' (mind) too. Ayurveda has emphasized the importance of quality and quantity of Agni for metabolic activity of the body, that if the ''agni'' works well, the person lives long and if it ceases; the person is going to die.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 4. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512 </ref>

Some signs seen in diseased or in healthy person, with or without any significant/visible pathology leading to death, are mentioned. These signs occurs due to initiation of some life threatening disease with poor prognosis even in initial stage.

It is emphasized that any extreme alternation in body physiology or psychology, person’s own behavior, mental functions, etc. without any significant reason; is also one of the sign for death.

Mind supremacy is also highlighted, as the mental strength of a person declines due to advancement of disease; then the person is likely to die. Composition of physical body (''sharira''), sensoria (''indriya''), mind (''sattva'') and soul (''atma'') is called life (''ayu''). With advanced stage of disease, physical body gets damaged, sensoria may also get affected and soul becomes ready to leave the diseased body; in such situation only strong mind power can sustain life as physical body follows mind and vice versa.<ref>Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 1, Ver. 155. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 298 </ref>

It is elucidated that if person’s life span has ended; even good quality of physician, medicine or care taker are helpless. In a nutshell person’s life span is fixed and when it is gets finished, some signs are manifested called ''arishta''.

Further, status of dying person is described briefly that, he may develop aversion to all loving and respectful persons, friends, food (and other basic essentials for surviving) etc. as his soul is almost in position to detach this body and preparing self to travel to other world. The chapter defines ''arishta'' with a new dimension. The concomitant aggravation of ''dosha'' (either qualitative or quantitative) with life-threatening diminution of ''dhatu'' is significant in the prediction of death.

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

अणुज्योतीयेन्द्रियोपक्रमः
अथातोऽणुज्योतीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō'ṇujyōtīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto~aNujyotIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter on signs and symptoms of ‘Imminent Death due to diminution of ''Agni'' (Factor responsible for digestion and metabolism) as said by Lord Atreya. [1-2]

==== Signs of near-death and declining lifespan ====

अणुज्योतिरनेकाग्रो दुश्छायो दुर्मनाः सदा|
रतिं न लभते याति परलोकं समान्तरम्||३||

aṇujyōtiranēkāgrō duśchāyō durmanāḥ sadā|
ratiṁ na labhatē yāti paralōkaṁ samāntaram||3||

aNujyotiranekAgro dushchAyo durmanAH sadA|
ratiM na labhate yAti [1] paralokaM samAntaram||3||

The person always (suffering from) with poor digestion, unstable or agitated mind, diminished luster, weak mental strength and restlessness goes to other world [dies] within a year. [3]

बलिं बलिभृतो यस्य प्रणीतं नोपभुञ्जते|
लोकान्तरगतः पिण्डं भुङ्क्ते संवत्सरेण सः||४||

सप्तर्षीणां समीपस्थां यो न पश्यत्यरुन्धतीम्|
संवत्सरान्ते जन्तुः स सम्पश्यति महत्तमः||५||

विकृत्या विनिमित्तं यः शोभामुपचयं धनम्|
प्राप्नोत्यतो वा विभ्रंशं समान्तं तस्य जीवितम्||६||

baliṁ balibhr̥tō yasya praṇītaṁ nōpabhuñjatē|
lōkāntaragataḥ piṇḍaṁ bhuṅktē saṁvatsarēṇa saḥ||4||

saptarṣīṇāṁ samīpasthāṁ yō na paśyatyarundhatīm|
saṁvatsarāntē jantuḥ sa sampaśyati mahattamaḥ||5||

vikr̥tyā vinimittaṁ yaḥ śōbhāmupacayaṁ dhanam|
prāpnōtyatō vā vibhraṁśaṁ samāntaṁ tasya jīvitam||6||

baliM balibhRuto yasya praNItaM nopabhu~jjate|
lokAntaragataH piNDaM bhu~gkte saMvatsareNa saH||4||

saptarShINAM samIpasthAM yo na pashyatyarundhatIm|
saMvatsarAnte jantuH sa sampashyati mahattamaH||5||

vikRutyA vinimittaM yaH shobhAmupacayaM dhanam|
prApnotyato vA vibhraMshaM samAntaM tasya jIvitam||6||

When a person offers ''bali'' (an offering a piece of daily meal) to crow and it does not accept it this indicates of death within a year for the offering person.

If a person is not able to see the star ''Arundhati'' situated adjacent to the constellation of ''Saptarshi'' (The Great Bear), he succumbs to death one year thereafter. [5]

Sudden gain or loss of luster, body weight, or wealth without any reasons indicates death of the person within one year thereafter. [6]

भक्तिः शीलं स्मृतिस्त्यागो बुद्धिर्बलमहेतुकम्|
षडेतानि निवर्तन्ते षड्भिर्मासैर्मरिष्यतः||७||

bhaktiḥ śīlaṁ smr̥tistyāgō buddhirbalamahētukam|
ṣaḍētāni nivartantē ṣaḍbhirmāsairmariṣyataḥ||7||

bhaktiH shIlaM smRutistyAgo buddhirbalamahetukam|
ShaDetAni nivartante ShaDbhirmAsairmariShyataH||7||

Sudden changes in likings, gentleness, memory, sacrifices, intellect and strength these six attributes in a person indicate the death within a time of six months. [7]

धमनीनामपूर्वाणां जालमत्यर्थशोभनम्|
ललाटे दृश्यते यस्य षण्मासान्न स जीवति||८||

लेखाभिश्चन्द्रवक्राभिर्ललाटमुपचीयते|
यस्य तस्यायुषः षड्भिर्मासैरन्तं समादिशेत्||९||

dhamanīnāmapūrvāṇāṁ jālamatyarthaśōbhanam|
lalāṭē dr̥śyatē yasya ṣaṇmāsānna sa jīvati||8||

lēkhābhiścandravakrābhirlalāṭamupacīyatē|
yasya tasyāyuṣaḥ ṣaḍbhirmāsairantaṁ samādiśēt||9||

dhamanInAmapUrvANAM jAlamatyarthashobhanam|
lalATe dRushyate yasya ShaNmAsAnna sa jIvati||8||

lekhAbhishcandravakrAbhirlalATamupacIyate|
yasya tasyAyuShaH ShaDbhirmAsairantaM samAdishet||9||

Sudden appearance of extremely shiny and prominent vasculature on fore head of an individual indicates that maximum life span of less than six month. [8]

A person, on whose forehead crescent shaped grooves develop, is supposed to die after six months [9]

शरीरकम्पः सम्मोहो गतिर्वचनमेव च|
मत्तस्येवोपलभ्यन्ते यस्य मासं न जीवति||१०||

रेतोमूत्रपुरीषाणि यस्य मज्जन्ति चाम्भसि|
स मासात् स्वजनद्वेष्टा मृत्युवारिणि मज्जति||११||

śarīrakampaḥ sammōhō gatirvacanamēva ca|
mattasyēvōpalabhyantē yasya māsaṁ na jīvati||10||

rētōmūtrapurīṣāṇi yasya majjanti cāmbhasi|
sa māsāt svajanadvēṣṭā mr̥tyuvāriṇi majjati||11||

sharIrakampaH sammoho gatirvacanameva ca|
mattasyevopalabhyante yasya mAsaM na jIvati||10||

retomUtrapurIShANi yasya majjanti cAmbhasi|
sa mAsAt svajanadveShTA mRutyuvAriNi majjati||11||

Sudden appearance of tremors on body, drowsiness along with altered gait and speech resembling of an insane person cannot survive even for a month. [10]

If semen, urine and feces of an individual sink in water as well as have aversion from own relatives, will sink in the water of death within one month. [11]

हस्तपादं मुखं चोभे विशेषाद्यस्य शुष्यतः|
शूयेते वा विना देहात् स च मासं न जीवति||१२||

ललाटे मूर्ध्नि बस्तौ वा नीला यस्य प्रकाशते|
राजी बालेन्दुकुटिला न स जीवितुमर्हति||१३||

प्रवालगुटिकाभासा यस्य गात्रे मसूरिकाः|
उत्पद्याशु विनश्यन्ति न चिरात् स विनश्यति||१४||

ग्रीवावमर्दो बलवाञ्जिह्वाश्वयथुरेव च|
ब्रध्नास्यगलपाकश्च यस्य पक्वं तमादिशेत्||१५||

सम्भ्रमोऽतिप्रलापोऽतिभेदोऽस्थ्नामतिदारुणः |
कालपाशपरीतस्य त्रयमेतत् प्रवर्तते||१६||

प्रमुह्य लुञ्चयेत् केशान् परिगृह्णात्यतीव च|
नरः स्वस्थवदाहारमबलः कालचोदितः||१७||

hastapādaṁ mukhaṁ cōbhē viśēṣādyasya śuṣyataḥ|
śūyētē vā vinā dēhāt sa ca māsaṁ na jīvati||12||

lalāṭē mūrdhni bastau vā nīlā yasya prakāśatē|
rājī bālēndukuṭilā na sa jīvitumarhati||13||

pravālaguṭikābhāsā yasya gātrē masūrikāḥ|
utpadyāśu vinaśyanti na cirāt sa vinaśyati||14||

grīvāvamardō balavāñjihvāśvayathurēva ca|
bradhnāsyagalapākaśca yasya pakvaṁ tamādiśēt||15||

sambhramō'tipralāpō'tibhēdō'sthnāmatidāruṇaḥ |
kālapāśaparītasya trayamētat pravartatē||16||

pramuhya luñcayēt kēśān parigr̥hṇātyatīva ca|
naraḥ svasthavadāhāramabalaḥ kālacōditaḥ||17||

hastapAdaM mukhaM cobhe visheShAdyasya shuShyataH|
shUyete vA vinA dehAt sa ca mAsaM [1] na jIvati||12||

lalATe mUrdhni bastau vA nIlA yasya prakAshate|
rAjI bAlendukuTilA na sa jIvitumarhati||13||

pravAlaguTikAbhAsA yasya gAtre masUrikAH|
utpadyAshu vinashyanti [2] na cirAt sa vinashyati||14||

grIvAvamardo balavA~jjihvAshvayathureva ca|
bradhnAsyagalapAkashca yasya pakvaM tamAdishet||15||

sambhramo~atipralApo~atibhedo~asthnAmatidAruNaH [3] |
kAlapAshaparItasya trayametat pravartate||16||

pramuhya lu~jcayet keshAn parigRuhNAtyatIva [4] ca|
naraH svasthavadAhAramabalaH [5] kAlacoditaH||17||

If there is noticeable emaciation or swelling of hands and feet along with face and without body (trunk) involvement, he will not survive for more than a month.[12]

Appearance of crescent shaped blue lines on fore head, face and pelvic region indicates that the person will not survive. [13]

If eruption of ''masurika'' (small pox like lesions) on body, having appearance of coral beds (bright red), subsides immediately after its manifestation, the person will die immediately. [14]

A person having acute and severe squeezing type of pain in neck, swelling of tongue along with inflammation of scrotum, throat and mouth should be considered as ripen (for death). [15]

Excessive giddiness, extreme delirium and severe piercing type of pain in bones, manifestation of these three symptoms together indicates that the person is captured by death. [16]

A person, who pulls out his hair in fainting state, eats food like healthy person and still remains weak should be considered as captured by death. [17]

समीपे चक्षुषोः कृत्वा मृगयेताङ्गुलीकरम्|
स्मयतेऽपि च कालान्ध ऊर्ध्वगानिमिषेक्षणः ||१८||

शयनादासनादङ्गात् काष्ठात् कुड्यादथापि वा|
असन्मृगयते किञ्चित् स मुह्यन् कालचोदितः||१९||

samīpē cakṣuṣōḥ kr̥tvā mr̥gayētāṅgulīkaram|
smayatē'pi ca kālāndha ūrdhvagānimiṣēkṣaṇaḥ ||18||

śayanādāsanādaṅgāt kāṣṭhāt kuḍyādathāpi vā|
asanmr̥gayatē kiñcit sa muhyan kālacōditaḥ||19||

samIpe cakShuShoH kRutvA mRugayetA~ggulIkaram|
smayate~api ca kAlAndha UrdhvagAnimiShekShaNaH [1] ||18||

shayanAdAsanAda~ggAt kAShThAt kuDyAdathApi vA|
asanmRugayate ki~jcit sa muhyan kAlacoditaH||19||

The person who searches for his own fingers and hands putting them before his eyes and smiles with upward gaze and unblinking should be considered as blinded by death, [18]

A person who is lying on his bed but is searching for his bed continuously, sitting on chair and searching his own seat, searching his own organs, walking with the stick and searching the same, and searching the walls of his own room, or while working with something and searching the same, are the symptoms of the imminent death of that person. [19]

अहास्यहासी सम्मुह्यन् प्रलेढि दशनच्छदौ|
शीतपादकरोच्छ्वासो यो नरो न स जीवति||२०||

आह्वयंस्तं समीपस्थं स्वजनं जनमेव वा|
महामोहावृतमनाः पश्यन्नपि न पश्यति||२१||

ahāsyahāsī sammuhyan pralēḍhi daśanacchadau|
śītapādakarōcchvāsō yō narō na sa jīvati||20||

āhvayaṁstaṁ samīpasthaṁ svajanaṁ janamēva vā|
mahāmōhāvr̥tamanāḥ paśyannapi na paśyati||21||

ahAsyahAsI sammuhyan praleDhi [1] dashanacchadau|
shItapAdakarocchvAso yo naro na sa jIvati||20||

AhvayaMstaM samIpasthaM svajanaM janameva vA|
mahAmohAvRutamanAH pashyannapi na pashyati||21||

Person who laughs without any reason, acts stupid, teeth and gums are covered with dirt, biting his lips and whose feet, arms are too cold and disappointingly takes long breaths will not survive for long. [20]

Loud shout to call relatives and other people sitting nearby, severe visual hallucinations for non-existing things, observed in the person whose mind is covered by severe delusion [of death].[21]

अयोगमतियोगं वा शरीरे मतिमान् भिषक्|
खादीनां युगपद्दृष्ट्वा भेषजं नावचारयेत्||२२||

ayōgamatiyōgaṁ vā śarīrē matimān bhiṣak|
khādīnāṁ yugapaddr̥ṣṭvā bhēṣajaṁ nāvacārayēt||22||

ayogamatiyogaM vA sharIre matimAn bhiShak|
khAdInAM yugapaddRuShTvA bheShajaM nAvacArayet||22||

A wise physician should abstain from treating a patient on observing that the patient’s body is simultaneously responding both excessively and deficiently to sensory stimuli. [22]

==== Signs of death ====

अतिप्रवृद्ध्या रोगाणां मनसश्च बलक्षयात्|
वासमुत्सृजति क्षिप्रं शरीरी देहसञ्ज्ञकम्||२३||

वर्णस्वरावग्निबलं वागिन्द्रियमनोबलम्|
हीयतेऽसुक्षये निद्रा नित्या भवति वा न वा||२४||

atipravr̥ddhyā rōgāṇāṁ manasaśca balakṣayāt|
vāsamutsr̥jati kṣipraṁ śarīrī dēhasañjñakam||23||

varṇasvarāvAgnibalaṁ vāgindriyamanōbalam|
hīyatē'sukṣayē nidrā nityā bhavati vā na vā||24||

atipravRuddhyA rogANAM manasashca balakShayAt|
vAsamutsRujati kShipraM sharIrI dehasa~jj~jakam||23||

varNasvarAvagnibalaM vAgindriyamanobalam|
hIyate~asukShaye nidrA nityA bhavati vA na vA||24||

In case of extreme advancement of the disease and weaker psychological strength, the soul immediately leaves the body. [23]
Near the end of life there is general decline in complexion, voice,''agni'', speech and state of mind, as well as sleep pattern alters. [24]

भिषग्भेषजपानान्नगुरुमित्रद्विषश्च ये|
वशगाः सर्व एवैते बोद्धव्याः समवर्तिनः||२५||

एतेषु रोगः क्रमते भेषजं प्रतिहन्यते|
नैषामन्नानि भुञ्जीत न चोदकमपि स्पृशेत्||२६||

bhiṣagbhēṣajapānānnagurumitradviṣaśca yē|
vaśagāḥ sarva ēvaitē bōddhavyāḥ samavartinaḥ||25||

ētēṣu rōgaḥ kramatē bhēṣajaṁ pratihanyatē|
naiṣāmannāni bhuñjīta na cōdakamapi spr̥śēt||26||

bhiShagbheShajapAnAnnagurumitradviShashca ye|
vashagAH sarva evaite boddhavyAH samavartinaH||25||

eteShu rogaH kramate bheShajaM pratihanyate|
naiShAmannAni bhu~jjIta na codakamapi spRushet||26||

Those who hate physician, medicine, food (and drink), teacher (spiritual teacher), and friends; are considered to be already under the grip of God of death. [25]

In such people, the disease progress occurs unrestricted and the medicine remains ineffective. The wise physician should not take his offerings in any form, even in form of food and drinks. [26]

पादाः समेताश्चत्वारः सम्पन्नाः साधकैर्गुणैः|
व्यर्था गतायुषो द्रव्यं विना नास्ति गुणोदयः||२७||

pādāḥ samētāścatvāraḥ sampannāḥ sādhakairguṇaiḥ|
vyarthā gatāyuṣō dravyaṁ vinā nāsti guṇōdayaḥ||27||

pAdAH sametAshcatvAraH sampannAH sAdhakairguNaiH|
vyarthA gatAyuSho dravyaM vinA nAsti guNodayaH||27||

Availability of all four basic components of treatment i.e. doctor, medicament, care taker and patient with their desirable quality are of no value in regard to the person who is at the end of his life and there is no response to treatment.[27]

परीक्ष्यमायुर्भिषजा नीरुजस्यातुरस्य च|
आयुर्ज्ञानफलं कृत्स्नमायुर्ज्ञे ह्यनुवर्तते||२८||

parīkṣyamāyurbhiṣajā nīrujasyāturasya ca|
āyurjñānaphalaṁ kr̥tsnamāyurjñē hyanuvartatē||28||

parIkShyamAyurbhiShajA nIrujasyAturasya ca|
Ayurj~jAnaphalaM kRutsnamAyurj~je hyanuvartate||28||

The physician should always assess the prognostic signs of life in diseased as well as in healthy person. Because the knowledge of prognostic signs of life and diseases helps to decide remaining lifespan and hence treatment can be planned accordingly. [28]

==== Summary ====

तत्र श्लोकः-
क्रियापथमतिक्रान्ताः केवलं देहमाप्लुताः|
चिह्नं कुर्वन्ति यद्दोषास्तदरिष्टं निरुच्यते||२९||

tatra ślōkaḥ-
kriyāpathamatikrāntāḥ kēvalaṁ dēhamāplutāḥ|
cihnaṁ kurvanti yaddōṣāstadariṣṭaṁ nirucyatē||29||

tatra shlokaH-
kriyApathamatikrAntAH kevalaM dehamAplutAH|
cihnaM kurvanti yaddoShAstadariShTaM nirucyate||29||

Here is the re capitulatory verse: The signs originated due to extensively vitiated and pervaded ''dosha'' throughout the body, and already transcended the stage of the treatment are called ''arishta'' (signs of death). [29]

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

*Optimum quality and quantity of ''agni'' is necessary for sustenance of life.
*Stable mental status, complexion and mental strength are markers to predict lifespan of patient.
*Sudden changes in likings, gentleness, memory, sacrifices, intellect and strength in a person are pre-indications of death.
*Altered sensorium and psychological status leading to various delusions and hallucinations are pre-indicators of death.
*Near the end of life there is general decline in complexion, voice, ''agni'', speech and state of mind, as well as sleep pattern alters.
*The prognostic signs of life in diseased as well as in healthy person shall always be assessed. This helps to decide remaining lifespan and planning treatment.
*The signs originated due to extensively vitiated and pervaded ''dosha'' throughout the body, and already transcended the stage of the treatment are called ''arishta'' (signs of death).

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

Metabolic process and thermoregulatory center situated in hypothalamus play key role to generate and maintain body temperature respectively. Reduced temperature shows slow metabolic process and gradually it ceases completely, causing death.
With the help of healthy digestive power and proper metabolic activity; food nourishes the body and provide macro and micronutrients to the body. [3]

In any manner, hampered blood or oxygen supply to the brain leads to lack of concentration, weakness of mental functions or agitation. Deposition of any toxic substance or progressive degenerative changes of mind also leads to such symptoms. Ageing and death are considered as natural process with passage of time.[4] With declining phase of life, ageing symptoms start to appear, as new cell production is almost stops and older cell destruction continues. With the passage of senescence; weakness, decreasing appetite, muscular wasting, decreased fluid intake, neurological dysfunctions, decreasing level of consciousness etc. are common symptoms manifest and gradually leads to cessation of life. [5]

Every individual has good appetite and capability of digesting foods he regularly ingests. ''Ksheerada''(only on milk), ''ksheera-anna''(milk and rice products), ''annada'' (staple foods), are three basic stages of life. During ageing process, gradual reduction in both qualitative consumption and digestive abilities are observed. This in turn influences the individual’s physical and mental wellbeing leading to reduction in life span ending in death.[3]

As per the principle of ''Yatha Brahmande Tatha Pinde'', whatever is there in the universe, is there in the human body. Hence there should be some connections between human body and the universe. When the soul is preparing for detachment from the body to start its journey to other world, there should be some indications from the universe as indicator of impending death. As per Indian tradition, offerings of food to birds specially to crow and non-acceptance of offering by crow may indicate the preparation of soul for detachment from living body. Inability to see ''Arundhati'' in the sky is another indication of the same. [4 – 5]

Acute loss or gain of luster or body weight can be the result of carcinogenic condition or severe catabolic changes taking place in the body that can be fatal for the person. [6]

Brain regulates multiple functions related to sensory, motor and autonomous nervous system like emotions, intellect and many other activities. Amygdala, and physiological functioning of limbic system of brain, are responsible for proper emotions and its expression. If these are deviated grossly, it shows involvement of higher center in pathogenesis and poor prognosis.

Gradual cessation of the functions is a clear indication of either degenerative changes or space occupying lesion (SOL) in the specific area. Acute toxicity of brain also leads to acute degeneration of brain cells or infarction that leads to hampering of function. [7]
Sudden appearance of crescent shaped streaks or blood vessel network on forehead may relate with Amyloidosis. It is a rare disease that occurs when a protein (albumoid) substance gets deposited in person’s organ. This abnormal protein is usually produced in bone marrow and can be deposited in any tissue or organ. The prognosis is poor. [8-9][6]

If person having combination of dual type of activity of mind i.e. exaggerated (in form of tremor), and diminished activity (in form of stupor), simultaneously; is supposed to die within a month. These dual types of signs may indicate increased intracranial pressure (ICP) due to localized mass like hematoma, neoplasm, abscess, edema, infarction, obstruction in CSF circulation, diffuse brain edema (like encephalitis, meningitis, or diffuse head injury), thrombosis, or idiopathic intracranial hypertension.

Symptoms of raised ICP are altered mental state, lethargy, irritability, slow decision making and abnormal social behavior. Ultimate result of the patho-physiology of such condition is stupor, coma and death. Rapidly rising ICP leads to syncope, seizures. These neurologic changes seen in increased ICP are mostly due to hypoxia and hyper apnea. [10]

If fecal matter or other excreta are mixed with ''ama'', it sinks straight in water due to its heaviness. Same concept is applied to other body discharge or ''dhatus'' too. Fecal matter is the end product of digestion. Hence, if it sinks in water it shows incomplete or improper digestion of food. ''Shukra'' is the last ''dhatu'' and hence all ''dhatvagni'' contribute (directly or indirectly) in its formation. To sink ''shukra'' in water is indicative that the ''dhatu'' is in ''sama'' stage. To get dipped all the three i.e. feces, urine and semen shows impairment of ''jatharagni'' along with ''dhatvagni'' functions leading to qualitative mal-formation of all ''dhatus''. Such situation has been considered as fatal. [11]

Muscular wasting of hands and feet is a type of neurogenic muscular atrophy with poor prognosis.

Swelling over both extremities along with face is an indication of damage of two vital organ simultaneously i.e. heart and kidney and hence survival of patient is difficult.[12]

Appearance of blue lines occurs in various conditions. This may be indication of venous congestion due to heart, lungs and liver diseases, requiring attention while scaling the span of life. [13]

Immediate disappearance of manifested small pox subsequently develops acute toxemia and hence leads to death. [14]

Combined manifestation of stiff neck along with inflamed throat and scrotum and swollen tongue is the condition of tertiary stage of syphilis when the person develops syphilitic meningitis (complication of untreated syphilis), is a life threatening condition. [15]

Visual (or even other sensorial) hallucinations are often part of the dying experience. Person may unknowingly involve in such activities with such illusions. This is the phase when the soul is getting ready to detach from the body and to travel for another world. The dying may turn their focus to “another world”, and thus may see (or feel other sensorial hallucination of) some unusual things, he may see or talk to such people who are already died. [18-19]

Various kinds of hallucinations are indications of altered psychological state of dying person, and to have laughter without any specific cause is also result of such hallucinations. To lick own lips is the sign of dehydration and coldness of breath and extremity are the indication of almost reducing function of heart and hence, stoppage of blood flow to concerned area. [20] Delusions along with altered sensorial organ is the sign of death. [21]

Days or hours before death, the dying person becomes less and less responsive to voice and touch and may not awaken. (Sometimes, quite unexpectedly, the person may appear well and even look as if he/she is going to recover. The person may be alert and talkative. But it does not mean that he is getting well; of course the time may be used as a “window of opportunity” to say what you need to say and have closure). [8] These all of sudden recovery changes are also signs of near death. [25]

As per ancient classical texts, life span of everyone is fixed and pre-ordained. No one can add years to the life only quality of life can be improved with medications. The same thing is meant here when it is said that death is the destiny of patient and that desirable quality of medicine, human resource and all other things cannot make the person outlive his destined lifespan.[27]

=== Glossary ===

#Agni – Digestive and metabolic power of body
#Ojas – extract / essence of all seven Dhatu
#Mana - Thought
#Indriya – sensory organs
#Sattva - Mind
#Atma -Soul
#Arishta – the symptom that show definite death of person
#Dosha – basic components / energy which govern the body
#Ksheerapa- dependent on milk only
#Ksheerannada – taking milk and grains both (as principal food)
#Annada – taking grains as staple food
#Bali – the food or other thing that offered to creatures or God
#Arundhati – a star that situated adjacent to the constellation of the great bear

=== References ===

#Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 4. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512
#Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 1, Ver. 155. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 298
#Acharya JT, editor. Charak Samhita of Agnivesha, Chikitsasthana 4th ed. Ch. 15, Ver. 3. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 512
#Acharya JT, editor. Charak Samhita of Agnivesha, Sharirasthana 4th ed. Ch. 4, Ver. 36. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 323
#httpendlink.lurie.northwestern.edulast_hours_of_livingpart_one.pdf
#the description is based on https://en.wikipedia.org/wiki/Amyloidosis, accessed on 15/10/2015
#httpkokuamau.orgresourceslast-stages-life
#Acharya JT, editor. Charak Samhita of Agnivesha, Vimanasthana 4th ed. Ch. 8, Ver. 94. Varanasi: Chaukhambha Surabharati Prakashana; 1994. p. 276

Yasyashyavanimitta

2017-12-26T13:44:27Z

Vinay Exafluence: /* Indriya Sthana Chapter 9 */

{{Infobox
|title = Yasyashyavanimitta
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 9
|label2 = Preceding Chapter
|data2 = [[Avakshirsheeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 9 ==

=== Abstract ===
<div style="text-align:justify;">
This chapter, ([[Yasyashyavanimitta]]), includes various signs and symptoms related to imminent death that start with changes in color of eyes and identified in a patient as well as in healthy individuals. It has been emphasized that physician should have knowledge of all ''Arishta Lakshana'' (near death signs) described in this chapter. Clinically only few of them manifest at a stage in an individual and hence the person must be examined properly. Certain features related with imminent death are described which when associated with any disease indicate grave prognosis. Complications which indicate the incurability of a disease are scientific and are seen till date. Description of eight grave diseases and symptoms of approaching death are other two important topics which add value to this chapter. These signs are important in palliative care. Therefore, knowledge of such predictive signs and symptoms is an integral part of medical science.

Keywords: ''Arishta, Vikara, Bala, Marana, Jivita,'' change in eye color, grave diseases, death.
</div>
=== Introduction ===
<div style="text-align:justify;">
[[Yasyashyavanimitta]] refers to color changes in eyes. In the first four chapters of [[Indriya Sthana]], conditions related to ''Indriya'' or five sense organs have been described. In those chapters, derangements in functional aspects of ''indriyas'' have been given importance and Atreya told to examine them by the help of ''Anumana Pramana''. In this chapter certain anatomical changes or changes which can be examined by ''Pratyaksha Pramana''(direct observation) are mentioned which are equally important indicators of life span.
Nowadays, importance is given to the identification of approaching death. Educational and training programs are organized to educate family members/relatives/attendants so that patient care is not neglected near death and this specialized field is commonly known as Palliative care. The World Health Organization (WHO) defines palliative care as 'an approach that improves the quality of life of individuals and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual'.<ref> Available from: http://www.who.int/hiv/topics/palliative/PalliativeCare/en/ </ref>
The aging of the population, with the numerous chronic debilitating and malignant conditions associated with growing older, has focused attention on palliative care. The terminal state is an integral process and a time to reconcile differences so that patient and family may accept death with a minimum of physical, spiritual, and psychosocial anguish.<ref> Rousseau P., Hospice and palliative care, Dis Mon. 1995 Dec;41(12):779-842. </ref> Hospice care is a specialized philosophy and system of care for the terminally ill patient that accepts death in an affirmative way and provides palliative care and emotional support to dying patients and their families.<ref> Plumb JD, Ogle KS., Hospice care, Prim Care. 1992 Dec;19(4):807-20. </ref> Hospice and palliative care philosophy lays emphasis on relieving suffering and improving quality of life at the end of life in order to permit experiences that will have positive meaning. The role of the physician is central in providing this care.<ref> Sethi S. Hospice: an underutilized resource, J Okla State Med Assoc. 2001 Mar;94(3):79-84. </ref> When recovery is uncertain it is better to discuss this rather than giving false hope to the patient and family. This is generally perceived as a strength in the doctor-patient relationship and helps to build trust.<ref> John Ellershaw, Care of the dying patient: the last hours or days of life, BMJ. 2003 January 4; 326(7379): 30–34. </ref> Charaka also supports this view and states that those near death should not be treated. Thus it becomes important that physician should be well trained in identifying features of impending death.

In order to care for dying patients it is essential to “identify dying”. This aim can be attained by applying the knowledge given in this chapter. Presently to predict prognostic value few tools have been designed. Most widely-used prognostic tools is the Palliative Performance Scale (PPS) which has been studied primarily in inpatient settings and in patients with cancer. Few researches are on going to develop tools for prognosis in other diseases also.<ref> Harrold J, Rickerson E, Carroll JT, McGrath J, Morales K, Kapo J, Casarett D., Is the palliative performance scale a useful predictor of mortality in a heterogeneous hospice population?, J Palliat Med. 2005 Jun;8(3):503-9. </ref> Research can be done to develop a scale based on parameters described in Ayurvedic ''Arishta Vigyana'' and this chapter can also contribute a lot in making such kind of tool.
</div>
===Sanskrit text, Transliteration and English Translation===

यस्यश्यावनिमित्तेन्द्रियोपक्रमः
अथातो यस्यश्यावनिमित्तीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō yasyaśyāvanimittīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto yasyashyAvanimittIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter entitled ‘The sensorial prognosis from the observation of the dark brown color of the eye of a man’. Thus said Lord Atreya. [1-2]

==== Signs of death due to ''Pitta'' disorders ====

यस्य श्यावे परिध्वस्ते हरिते चापि दर्शने|
आपन्नो व्याधिरन्ताय ज्ञेयस्तस्य विजानता||३||

निःसञ्ज्ञः परिशुष्कास्यः समृद्धो व्याधिभिश्च यः|
उपरुद्धायुषं ज्ञात्वा तं धीरः परिवर्जयेत्||४||

हरिताश्च सिरा यस्य लोमकूपाश्च संवृताः|
सोऽम्लाभिलाषी पुरुषः पित्तान्मरणमश्नुते||५||

yasya śyāvē paridhvastē haritē cāpi darśanē|
āpannō vyādhirantāya jñēyastasya vijānatā||3||

niḥsañjñaḥ pariśuṣkāsyaḥ samr̥ddhō vyādhibhiśca yaḥ|
uparuddhāyuṣaṁ jñātvā taṁ dhīraḥ parivarjayēt||4||

haritāśca sirā yasya lōmakūpāśca saṁvr̥tāḥ|
sō'mlābhilāṣī puruṣaḥ pittānmaraṇamaśnutē||5||

yasya shyAve paridhvaste harite cApi darshane|
Apanno vyAdhirantAya j~jeyastasya vijAnatA||3||

niHsa~jj~jaH parishuShkAsyaH samRuddho vyAdhibhishca yaH|
uparuddhAyuShaM j~jAtvA taM dhIraH parivarjayet||4||

haritAshca sirA yasya lomakUpAshca saMvRutAH|
so~amlAbhilAShI puruShaH pittAnmaraNamashnute||5||
<div style="text-align:justify;">
If patient eyes are brownish/blackish, distorted or displaced or greenish in color, then such condition indicates impending death.
The patient who is unconscious, having dry mouth and is suffering from various diseases should be considered as having short life span and such patient should be discarded by the wise physician.

The man whose veins are green and whose hair follicles are closed and who craves for sour things succumb to death due to ''pitta'' disorders. [3-5]
</div>
==== Signs of death due to ''Rajayakshma'' and ''Shosha'' ====

शरीरान्ताश्च शोभन्ते शरीरं चोपशुष्यति|
बलं च हीयते यस्य राजयक्ष्मा हिनस्ति तम्||६||

अंसाभितापो हिक्का च छर्दनं शोणितस्य च|
आनाहः पार्श्वशूलं च भवत्यन्ताय शोषिणः||७||

śarīrāntāśca śōbhantē śarīraṁ cōpaśuṣyati|
balaṁ ca hīyatē yasya rājayakṣmā hinasti tam||6||

aṁsābhitāpō hikkā ca chardanaṁ śōṇitasya ca|
ānāhaḥ pārśvaśūlaṁ ca bhavatyantāya śōṣiṇaḥ||7||

sharIrAntAshca shobhante sharIraM copashuShyati|
balaM ca hIyate yasya rAjayakShmA hinasti tam||6||

aMsAbhitApo hikkA ca chardanaM shoNitasya ca|
AnAhaH pArshvashUlaM ca bhavatyantAya shoShiNaH||7||

In a patient of ''rajyayakshma'', waning strength, shining extremities and emaciated body parts denotes that patient will succumb to death soon.

The burning pain in the shoulder region, hiccup, hematemesis, distension of the stomach and pain in the flanks in patient of consumption will end the life of patient. [6-7]

==== Eight grave diseases leading to death ====

वातव्याधिरपस्मारी कुष्ठी शोफी तथोदरी|
गुल्मी च मधुमेही च राजयक्ष्मी च यो नरः||८||

अचिकित्स्या भवन्त्येते बलमांसक्षये सति|
अन्येष्वपि विकारेषु तान् भिषक् परिवर्जयेत्||९||

vātavyādhirapasmārī kuṣṭhī śōphī tathōdarī|
gulmī ca madhumēhī ca rājayakṣmī ca yō naraḥ||8||

acikitsyā bhavantyētē balamāṁsakṣayē sati|
anyēṣvapi vikārēṣu tān bhiṣak parivarjayēt||9||

vAtavyAdhirapasmArI kuShThI shophI tathodarI|
gulmI ca madhumehI ca rAjayakShmI ca yo naraH||8||

acikitsyA bhavantyete balamAMsakShaye sati|
anyeShvapi vikAreShu tAn bhiShak parivarjayet||9||
<div style="text-align:justify;">
When diseases like ''Vatavyadhi'' (diseases due to ''vata''), ''Apasmara'' (Epilepsy), ''Kushtha'' (Skin diseases), ''Shopha'' (Swellings), ''Udara'' (abdominal diseases including ascitis), ''Gulma'' (lumps and tumors), ''Madhumeha'' (urinary disorders including Diabetes) and ''Rajayakshama'' (Tuberculosis) are associated with loss of strength and muscle wasting then such patient should be discarded by the physician as patient will not recover and will succumb to death.

Patients suffering from other diseases too having above features should be avoided by the physician. [8-9]
</div>
==== Death signs after ''Virechana'' (purgation) ====

विरेचनहृतानाहो यस्तृष्णानुगतो नरः|
विरिक्तः पुनराध्माति यथा प्रेतस्तथैव सः||१०||

virēcanahr̥tānāhō yastr̥ṣṇānugatō naraḥ|
viriktaḥ punarādhmāti yathā prētastathaiva saḥ||10||

virecanahRutAnAho yastRuShNAnugato naraH|
viriktaH punarAdhmAti yathA pretastathaiva saH||10||

If abdominal distension of a patient is relieved by purgation for short time and then patient develops thirst, distension of abdomen and severe pain again, then such patient should be considered as a ghost i.e. the patients will surely die soon. [10]

==== Dryness as death sign ====

पेयं पातुं न शक्नोति कण्ठस्य च मुखस्य च|
उरसश्च विशुष्कत्वाद्यो नरो न स जीवति ||११||

pēyaṁ pātuṁ na śaknōti kaṇṭhasya ca mukhasya ca|
urasaśca viśuṣkatvādyō narō na sa jīvati ||11||

peyaM pAtuM na shaknoti kaNThasya ca mukhasya ca|
urasashca vishuShkatvAdyo naro na sa jIvati ||11||

One who, because of excessive dryness of throat, mouth and chest, is unable to drink anything does not survive.

==== Feeble voice as death sign ====

स्वरस्य दुर्बलीभावं हानिं च बलवर्णयोः|
रोगवृद्धिमयुक्त्या च दृष्ट्वा मरणमादिशेत्||१२||

ऊर्ध्वश्वासं गतोष्माणं शूलोपहतवङ्क्षणम्|
शर्म चानधिगच्छन्तं बुद्धिमान् परिवर्जयेत्||१३||

svarasya durbalībhāvaṁ hāniṁ ca balavarṇayōḥ|
rōgavr̥ddhimayuktyā ca dr̥ṣṭvā maraṇamādiśēt||12||

ūrdhvaśvāsaṁ gatōṣmāṇaṁ śūlōpahatavaṅkṣaṇam|
śarma cānadhigacchantaṁ buddhimān parivarjayēt||13||

svarasya durbalIbhAvaM hAniM ca balavarNayoH|
rogavRuddhimayuktyA ca dRuShTvA maraNamAdishet||12||

UrdhvashvAsaM gatoShmANaM shUlopahatava~gkShaNam|
sharma cAnadhigacchantaM buddhimAn parivarjayet||13||

If a patient develops weakness of voice, diminution of strength and complexion, and aggravation of disease without an apparent cause then such patient will die soon.

The person/ individual whose breathing has been shallow, has subnormal temperature and who feels piercing pains in the groins without experiencing a moment of comfort, should be discarded by the wise physician.[12-13]

==== Signs of death ====

अपस्वरं भाषमाणं प्राप्तं मरणमात्मनः|
श्रोतारं चाप्यशब्दस्य दूरतः परिवर्जयेत्||१४||

यं नरं सहसा रोगो दुर्बलं परिमुञ्चति|
संशयप्राप्तमात्रेयो जीवितं तस्य मन्यते||१५||

अथ चेज्ज्ञातयस्तस्य याचेरन् प्रणिपाततः|
रसेनाद्यादिति ब्रूयान्नास्मै दद्याद्विशोधनम्||१६||

मासेन चेन्न दृश्येत विशेषस्तस्य शोभनः|
रसैश्चान्यैर्बहुविधैर्दुर्लभं तस्य जीवितम्||१७||

apasvaraṁ bhāṣamāṇaṁ prāptaṁ maraṇamātmanaḥ|
śrōtāraṁ cāpyaśabdasya dūrataḥ parivarjayēt||14||

yaṁ naraṁ sahasā rōgō durbalaṁ parimuñcati|
saṁśayaprāptamātrēyō jīvitaṁ tasya manyatē||15||

atha cējjñātayastasya yācēran praṇipātataḥ|
rasēnādyāditi brūyānnāsmai dadyādviśōdhanam||16||

māsēna cēnna dr̥śyēta viśēṣastasya śōbhanaḥ|
rasaiścānyairbahuvidhairdurlabhaṁ tasya jīvitam||17||

apasvaraM bhAShamANaM prAptaM maraNamAtmanaH|
shrotAraM cApyashabdasya dUrataH parivarjayet||14||

yaM naraM sahasA rogo durbalaM parimu~jcati|
saMshayaprAptamAtreyo jIvitaM tasya manyate||15||

atha cejj~jAtayastasya yAceran praNipAtataH|
rasenAdyAditi brUyAnnAsmai dadyAdvishodhanam||16||

mAsena cenna dRushyeta visheShastasya shobhanaH|
rasaishcAnyairbahuvidhairdurlabhaM tasya jIvitam||17||
<div style="text-align:justify;">
The man speaking irrelevantly about death or patient suffering from auditory hallucinations should not be treated.
If in any disease, patient deteriorates all of a sudden, his survival is doubtful as told by Atreya. If the relatives of the patient request the physician begging for his life, the physician should prescribe the diet of soup prepared out of meat; but no ''Shodhana'' (purificatory therapy) should be done in such patient as it will further deteriorate the condition.

If after one month, no signs of improvement as the result of soup prepared out of meat and varied other nutritive agents are seen, then the patient’s survival is rare. [14-17]
</div>
==== Various assessment parameters for lifespan and death ====

निष्ठ्यूतं च पुरीषं च रेतश्चाम्भसि मज्जति|
यस्य तस्यायुषः प्राप्तमन्तमाहुर्मनीषिणः||१८||

निष्ठ्यूते यस्य दृश्यन्ते वर्णा बहुविधाः पृथक्|
तच्च सीदत्यपः प्राप्य न स जीवितुमर्हति ||१९||

पित्तमूष्मानुगं यस्य शङ्खौ प्राप्य विमूर्च्छति |
स रोगः शङ्खको नाम्ना त्रिरात्राद्धन्ति जीवितम्||२०||

सफेनं रुधिरं यस्य मुहुरास्यात् प्रसिच्यते|
शूलैश्च तुद्यते कुक्षिः प्रत्याख्येयस्तथाविधः||२१||

बलमांसक्षयस्तीव्रो रोगवृद्धिररोचकः|
यस्यातुरस्य लक्ष्यन्ते त्रीन् पक्षान्न स जीवति||२२||

niṣṭhyūtaṁ ca purīṣaṁ ca rētaścāmbhasi majjati|
yasya tasyāyuṣaḥ prāptamantamāhurmanīṣiṇaḥ||18||

niṣṭhyūtē yasya dr̥śyantē varṇā bahuvidhāḥ pr̥thak|
tacca sīdatyapaḥ prāpya na sa jīvitumarhati ||19||

pittamūṣmānugaṁ yasya śaṅkhau prāpya vimūrcchati |
sa rōgaḥ śaṅkhakō nāmnā trirātrāddhanti jīvitam||20||

saphēnaṁ rudhiraṁ yasya muhurāsyāt prasicyatē|
śūlaiśca tudyatē kukṣiḥ pratyākhyēyastathāvidhaḥ||21||

balamāṁsakṣayastīvrō rōgavr̥ddhirarōcakaḥ|
yasyāturasya lakṣyantē trīn pakṣānna sa jīvati||22||

niShThyUtaM ca purIShaM ca retashcAmbhasi majjati|
yasya tasyAyuShaH prAptamantamAhurmanIShiNaH||18||

niShThyUte yasya dRushyante varNA bahuvidhAH pRuthak|
tacca sIdatyapaH prApya na sa jIvitumarhati ||19||

pittamUShmAnugaM yasya sha~gkhau prApya vimUrcchati |
sa rogaH sha~gkhako nAmnA trirAtrAddhanti jIvitam||20||

saphenaM rudhiraM yasya muhurAsyAt prasicyate|
shUlaishca tudyate kukShiH pratyAkhyeyastathAvidhaH||21||

balamAMsakShayastIvro rogavRuddhirarocakaH|
yasyAturasya lakShyante trIn pakShAnna sa jIvati||22||
<div style="text-align:justify;">
If a man’s sputum, feces and semen sink into water, the wise physicians say that he has come to the end of his life.
If the sputum has various color and sinks in water, the patient does not survive.

The morbid condition in which the ''pitta'', reaches up to temporal area and accumulates there, is known by the name of ''Shankhaka''. It kills the patient in three nights.

The man frequently spitting frothy blood and suffering from piercing pains in the stomach, should be refused for the treatment by the physician.

The patient, who suffers from rapid loss of strength and muscle wasting, aggravation of disease symptoms and anorexia, does not survive more than three fortnights. [18-22]
</div>
==== Summary ====

तत्र श्लोकौ-
विज्ञानानि मनुष्याणां मरणे प्रत्युपस्थिते|
भवन्त्येतानि सम्पश्येदन्यान्येवंविधानि च||२३||

तानि सर्वाणि लक्ष्यन्ते न तु सर्वाणि मानवम्|
विशन्ति विनशिष्यन्तं तस्माद्बोध्यानि सर्वतः||२४||

tatra ślōkau-
vijñānāni manuṣyāṇāṁ maraṇē pratyupasthitē|
bhavantyētāni sampaśyēdanyānyēvaṁvidhāni ca||23||

tāni sarvāṇi lakṣyantē na tu sarvāṇi mānavam|
viśanti vinaśiṣyantaṁ tasmādbōdhyāni sarvataḥ||24||

tatra shlokau-
vij~jAnAni manuShyANAM maraNe pratyupasthite|
bhavantyetAni sampashyedanyAnyevaMvidhAni ca||23||

tAni sarvANi lakShyante na tu sarvANi mAnavam|
vishanti vinashiShyantaM tasmAdbodhyAni sarvataH||24||

These features in human beings denote impending death.

The physician should observe these and other similar features.

It is not necessarily that one founds them collectively in one person who is approaching death. Only few of them may appear in one person.
Hence,the physician should know with all the signs and symptoms, prognosticative of death. [23-24]

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
Various biomarkers have been developed since the time of Charaka and many diseases which were incurable can be controlled. Patient should be evaluated using these biomarkers, before communicating to the patient and family about remaining lifespan of patient.

The ''bala'' (strength and immunity) and ''mamsa'' (muscle mass) are important markers for assessment of health and death. Depletion of these two markers indicates near death signs. [8-9]

Change in eye color, voice, sputum, feces and semen are markers of near death.

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

General examination is important for assessing life span of any individual. Treatment should be planned after complete examination of disease and patient including the biomarkers.

Cravings for substances which increases vitiation of causative Dosha reflects grave prognosis of the disease. [Verse No. 3-5]

Patient with poor strength will die with consumption, as the patient will not be able to fight disease and will succumb to death. [Verse No. 6-7]

''Ashta Mahagada'' , or eight grave diseases, are difficult to treat. They should not be treated if they are associated with loss of strength with muscle wasting.[8-9]

If patient suffers from an incurable disease and shows ''arishta'' signs, he should not be treated and physician should inform the relatives about the exact condition of the patient and suggest care to keep the patient comfortable. If the legal guardian of the patient requests the physician for treatment then only he should treat the patient. [Verse No. 14-17]

=== Glossary ===

#(apasmAra,अपस्मार) - Seizures A neurological condition comprising episodes of fearful paroxysmal movements of the body which are produced by perversion of memory, intelligence and other mental functions along with loss of memory during the episode.
#ādhmāna (AdhmAna, आध्मान) The term signifies distention or inflation of a body part caused due to stagnation of the substances inside it; but generally is taken for distention of the abdomen associated with pain due to various reasons like obstruction to the urine and feces, accumulation of blood in abdomen etc.
#Ānāha आनाह Obstruction, Constipation Obstruction of the feces in the intestine is to be termed as constipation. The term also signifies obstruction to the flow or normal movements of any substance in any part of the body.
#chardi (chardi,छर्दि) - Vomiting A disease in which vomiting is the main symptom.
#gulma (gulma,गुल्म) - Lump in abdomen. A lump like formation occurring in the abdomen either mobile or static in nature, circular in shape and constantly increasing and decreasing in size.
#hikkā (hikkA,हिक्का) – Hiccoughs. A disease characterized by production of peculiar sound like hic-hic by mouth.
#jwara ( jvara,ज्वर) - Pyrexia / fever A sense of non well being in senses, mind and body along with raised body temperature and associated by obstruction to the skin.
#kushtha (kuShTha , कुष्ठ) - Multiple dermatological manifestation Chronic Dermatological diseases characterized by disfiguring and discoloration chronic non- suppurative skin disorders.
#lohitapitta (lohitapittaM,लोहितपित्त) - Hemorrhagic disorder A hemorrhagic disorder in which bleeding occurs through orifices of the body without any direct injury to the body tissues.
#madhumeha (madhumeha, मधुमेह) Diabetes mellitus. A stage of diabetes mellitus where in the urine and blood gets sweetened like honey.
#prameha (prameha,प्रमेह) Diabetes, The disease characterized by symptoms of frequent excessive and turbid urination.
#rajayakshma (rAjayakShmA- राजयक्ष्मा)- means “Roga” (disease) as well as a particular disease i.e. -Disease characterized by generalized wasting of the body tissues caused due to malnourishment as a result of obstruction in the channels.
#shankhak (sha~gkhak, शङ्खक) Intracranial growth, Saggital sinus thrombosis A fatal disease of head characterized by severe pain and swelling in the temporal area.
#shonita (shoNitA-शोणित)- 1. Synonym of Rakta. 2. Synonym of Ārtava
#shosha (shoSha,शोष) - A disease characterized by generalized emaciation.
#trishna (tRuShNA,तृष्णा) - Polydypsia The condition resembles to morbid thirst in which the person even after continuous water intake fails to quench his thirst.
#udara (udara, उदर) - Generalized abdominal enlargement.
#urdhvashvasa (UrdhvashvAsa, ऊर्ध्वश्वास) Stertorous breathing or failing respiration. Characterized by obstructed inspiration due to blockage of respiratory channels
#vatavyadhi(vAtavyAdhi, वातव्याधि) – Special category of diseases caused by vitiation of Vata Dosha
#virechana (virecanA- विरेचन) -Therapeutic purgation.
</div>
=== References ===

<references/>

Yasyashyavanimitta

2017-12-26T13:40:10Z

Vinay Exafluence: /* References */

{{Infobox
|title = Yasyashyavanimitta
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 9
|label2 = Preceding Chapter
|data2 = [[Avakshirsheeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 9 ==

=== Abstract ===

This chapter, ([[Yasyashyavanimitta]]), includes various signs and symptoms related to imminent death that start with changes in color of eyes and identified in a patient as well as in healthy individuals. It has been emphasized that physician should have knowledge of all ''Arishta Lakshana'' (near death signs) described in this chapter. Clinically only few of them manifest at a stage in an individual and hence the person must be examined properly. Certain features related with imminent death are described which when associated with any disease indicate grave prognosis. Complications which indicate the incurability of a disease are scientific and are seen till date. Description of eight grave diseases and symptoms of approaching death are other two important topics which add value to this chapter. These signs are important in palliative care. Therefore, knowledge of such predictive signs and symptoms is an integral part of medical science.

Keywords: ''Arishta, Vikara, Bala, Marana, Jivita,'' change in eye color, grave diseases, death.

=== Introduction ===

[[Yasyashyavanimitta]] refers to color changes in eyes. In the first four chapters of [[Indriya Sthana]], conditions related to ''Indriya'' or five sense organs have been described. In those chapters, derangements in functional aspects of ''indriyas'' have been given importance and Atreya told to examine them by the help of ''Anumana Pramana''. In this chapter certain anatomical changes or changes which can be examined by ''Pratyaksha Pramana''(direct observation) are mentioned which are equally important indicators of life span.
Nowadays, importance is given to the identification of approaching death. Educational and training programs are organized to educate family members/relatives/attendants so that patient care is not neglected near death and this specialized field is commonly known as Palliative care. The World Health Organization (WHO) defines palliative care as 'an approach that improves the quality of life of individuals and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual'.<ref> Available from: http://www.who.int/hiv/topics/palliative/PalliativeCare/en/ </ref>
The aging of the population, with the numerous chronic debilitating and malignant conditions associated with growing older, has focused attention on palliative care. The terminal state is an integral process and a time to reconcile differences so that patient and family may accept death with a minimum of physical, spiritual, and psychosocial anguish.<ref> Rousseau P., Hospice and palliative care, Dis Mon. 1995 Dec;41(12):779-842. </ref> Hospice care is a specialized philosophy and system of care for the terminally ill patient that accepts death in an affirmative way and provides palliative care and emotional support to dying patients and their families.<ref> Plumb JD, Ogle KS., Hospice care, Prim Care. 1992 Dec;19(4):807-20. </ref> Hospice and palliative care philosophy lays emphasis on relieving suffering and improving quality of life at the end of life in order to permit experiences that will have positive meaning. The role of the physician is central in providing this care.<ref> Sethi S. Hospice: an underutilized resource, J Okla State Med Assoc. 2001 Mar;94(3):79-84. </ref> When recovery is uncertain it is better to discuss this rather than giving false hope to the patient and family. This is generally perceived as a strength in the doctor-patient relationship and helps to build trust.<ref> John Ellershaw, Care of the dying patient: the last hours or days of life, BMJ. 2003 January 4; 326(7379): 30–34. </ref> Charaka also supports this view and states that those near death should not be treated. Thus it becomes important that physician should be well trained in identifying features of impending death.

In order to care for dying patients it is essential to “identify dying”. This aim can be attained by applying the knowledge given in this chapter. Presently to predict prognostic value few tools have been designed. Most widely-used prognostic tools is the Palliative Performance Scale (PPS) which has been studied primarily in inpatient settings and in patients with cancer. Few researches are on going to develop tools for prognosis in other diseases also.<ref> Harrold J, Rickerson E, Carroll JT, McGrath J, Morales K, Kapo J, Casarett D., Is the palliative performance scale a useful predictor of mortality in a heterogeneous hospice population?, J Palliat Med. 2005 Jun;8(3):503-9. </ref> Research can be done to develop a scale based on parameters described in Ayurvedic ''Arishta Vigyana'' and this chapter can also contribute a lot in making such kind of tool.

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

यस्यश्यावनिमित्तेन्द्रियोपक्रमः
अथातो यस्यश्यावनिमित्तीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō yasyaśyāvanimittīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto yasyashyAvanimittIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter entitled ‘The sensorial prognosis from the observation of the dark brown color of the eye of a man’. Thus said Lord Atreya. [1-2]

==== Signs of death due to ''Pitta'' disorders ====

यस्य श्यावे परिध्वस्ते हरिते चापि दर्शने|
आपन्नो व्याधिरन्ताय ज्ञेयस्तस्य विजानता||३||

निःसञ्ज्ञः परिशुष्कास्यः समृद्धो व्याधिभिश्च यः|
उपरुद्धायुषं ज्ञात्वा तं धीरः परिवर्जयेत्||४||

हरिताश्च सिरा यस्य लोमकूपाश्च संवृताः|
सोऽम्लाभिलाषी पुरुषः पित्तान्मरणमश्नुते||५||

yasya śyāvē paridhvastē haritē cāpi darśanē|
āpannō vyādhirantāya jñēyastasya vijānatā||3||

niḥsañjñaḥ pariśuṣkāsyaḥ samr̥ddhō vyādhibhiśca yaḥ|
uparuddhāyuṣaṁ jñātvā taṁ dhīraḥ parivarjayēt||4||

haritāśca sirā yasya lōmakūpāśca saṁvr̥tāḥ|
sō'mlābhilāṣī puruṣaḥ pittānmaraṇamaśnutē||5||

yasya shyAve paridhvaste harite cApi darshane|
Apanno vyAdhirantAya j~jeyastasya vijAnatA||3||

niHsa~jj~jaH parishuShkAsyaH samRuddho vyAdhibhishca yaH|
uparuddhAyuShaM j~jAtvA taM dhIraH parivarjayet||4||

haritAshca sirA yasya lomakUpAshca saMvRutAH|
so~amlAbhilAShI puruShaH pittAnmaraNamashnute||5||

If patient eyes are brownish/blackish, distorted or displaced or greenish in color, then such condition indicates impending death.
The patient who is unconscious, having dry mouth and is suffering from various diseases should be considered as having short life span and such patient should be discarded by the wise physician.

The man whose veins are green and whose hair follicles are closed and who craves for sour things succumb to death due to ''pitta'' disorders. [3-5]

==== Signs of death due to ''Rajayakshma'' and ''Shosha'' ====

शरीरान्ताश्च शोभन्ते शरीरं चोपशुष्यति|
बलं च हीयते यस्य राजयक्ष्मा हिनस्ति तम्||६||

अंसाभितापो हिक्का च छर्दनं शोणितस्य च|
आनाहः पार्श्वशूलं च भवत्यन्ताय शोषिणः||७||

śarīrāntāśca śōbhantē śarīraṁ cōpaśuṣyati|
balaṁ ca hīyatē yasya rājayakṣmā hinasti tam||6||

aṁsābhitāpō hikkā ca chardanaṁ śōṇitasya ca|
ānāhaḥ pārśvaśūlaṁ ca bhavatyantāya śōṣiṇaḥ||7||

sharIrAntAshca shobhante sharIraM copashuShyati|
balaM ca hIyate yasya rAjayakShmA hinasti tam||6||

aMsAbhitApo hikkA ca chardanaM shoNitasya ca|
AnAhaH pArshvashUlaM ca bhavatyantAya shoShiNaH||7||

In a patient of ''rajyayakshma'', waning strength, shining extremities and emaciated body parts denotes that patient will succumb to death soon.

The burning pain in the shoulder region, hiccup, hematemesis, distension of the stomach and pain in the flanks in patient of consumption will end the life of patient. [6-7]

==== Eight grave diseases leading to death ====

वातव्याधिरपस्मारी कुष्ठी शोफी तथोदरी|
गुल्मी च मधुमेही च राजयक्ष्मी च यो नरः||८||

अचिकित्स्या भवन्त्येते बलमांसक्षये सति|
अन्येष्वपि विकारेषु तान् भिषक् परिवर्जयेत्||९||

vātavyādhirapasmārī kuṣṭhī śōphī tathōdarī|
gulmī ca madhumēhī ca rājayakṣmī ca yō naraḥ||8||

acikitsyā bhavantyētē balamāṁsakṣayē sati|
anyēṣvapi vikārēṣu tān bhiṣak parivarjayēt||9||

vAtavyAdhirapasmArI kuShThI shophI tathodarI|
gulmI ca madhumehI ca rAjayakShmI ca yo naraH||8||

acikitsyA bhavantyete balamAMsakShaye sati|
anyeShvapi vikAreShu tAn bhiShak parivarjayet||9||

When diseases like ''Vatavyadhi'' (diseases due to ''vata''), ''Apasmara'' (Epilepsy), ''Kushtha'' (Skin diseases), ''Shopha'' (Swellings), ''Udara'' (abdominal diseases including ascitis), ''Gulma'' (lumps and tumors), ''Madhumeha'' (urinary disorders including Diabetes) and ''Rajayakshama'' (Tuberculosis) are associated with loss of strength and muscle wasting then such patient should be discarded by the physician as patient will not recover and will succumb to death.

Patients suffering from other diseases too having above features should be avoided by the physician. [8-9]

==== Death signs after ''Virechana'' (purgation) ====

विरेचनहृतानाहो यस्तृष्णानुगतो नरः|
विरिक्तः पुनराध्माति यथा प्रेतस्तथैव सः||१०||

virēcanahr̥tānāhō yastr̥ṣṇānugatō naraḥ|
viriktaḥ punarādhmāti yathā prētastathaiva saḥ||10||

virecanahRutAnAho yastRuShNAnugato naraH|
viriktaH punarAdhmAti yathA pretastathaiva saH||10||

If abdominal distension of a patient is relieved by purgation for short time and then patient develops thirst, distension of abdomen and severe pain again, then such patient should be considered as a ghost i.e. the patients will surely die soon. [10]

==== Dryness as death sign ====

पेयं पातुं न शक्नोति कण्ठस्य च मुखस्य च|
उरसश्च विशुष्कत्वाद्यो नरो न स जीवति ||११||

pēyaṁ pātuṁ na śaknōti kaṇṭhasya ca mukhasya ca|
urasaśca viśuṣkatvādyō narō na sa jīvati ||11||

peyaM pAtuM na shaknoti kaNThasya ca mukhasya ca|
urasashca vishuShkatvAdyo naro na sa jIvati ||11||

One who, because of excessive dryness of throat, mouth and chest, is unable to drink anything does not survive.

==== Feeble voice as death sign ====

स्वरस्य दुर्बलीभावं हानिं च बलवर्णयोः|
रोगवृद्धिमयुक्त्या च दृष्ट्वा मरणमादिशेत्||१२||

ऊर्ध्वश्वासं गतोष्माणं शूलोपहतवङ्क्षणम्|
शर्म चानधिगच्छन्तं बुद्धिमान् परिवर्जयेत्||१३||

svarasya durbalībhāvaṁ hāniṁ ca balavarṇayōḥ|
rōgavr̥ddhimayuktyā ca dr̥ṣṭvā maraṇamādiśēt||12||

ūrdhvaśvāsaṁ gatōṣmāṇaṁ śūlōpahatavaṅkṣaṇam|
śarma cānadhigacchantaṁ buddhimān parivarjayēt||13||

svarasya durbalIbhAvaM hAniM ca balavarNayoH|
rogavRuddhimayuktyA ca dRuShTvA maraNamAdishet||12||

UrdhvashvAsaM gatoShmANaM shUlopahatava~gkShaNam|
sharma cAnadhigacchantaM buddhimAn parivarjayet||13||

If a patient develops weakness of voice, diminution of strength and complexion, and aggravation of disease without an apparent cause then such patient will die soon.

The person/ individual whose breathing has been shallow, has subnormal temperature and who feels piercing pains in the groins without experiencing a moment of comfort, should be discarded by the wise physician.[12-13]

==== Signs of death ====

अपस्वरं भाषमाणं प्राप्तं मरणमात्मनः|
श्रोतारं चाप्यशब्दस्य दूरतः परिवर्जयेत्||१४||

यं नरं सहसा रोगो दुर्बलं परिमुञ्चति|
संशयप्राप्तमात्रेयो जीवितं तस्य मन्यते||१५||

अथ चेज्ज्ञातयस्तस्य याचेरन् प्रणिपाततः|
रसेनाद्यादिति ब्रूयान्नास्मै दद्याद्विशोधनम्||१६||

मासेन चेन्न दृश्येत विशेषस्तस्य शोभनः|
रसैश्चान्यैर्बहुविधैर्दुर्लभं तस्य जीवितम्||१७||

apasvaraṁ bhāṣamāṇaṁ prāptaṁ maraṇamātmanaḥ|
śrōtāraṁ cāpyaśabdasya dūrataḥ parivarjayēt||14||

yaṁ naraṁ sahasā rōgō durbalaṁ parimuñcati|
saṁśayaprāptamātrēyō jīvitaṁ tasya manyatē||15||

atha cējjñātayastasya yācēran praṇipātataḥ|
rasēnādyāditi brūyānnāsmai dadyādviśōdhanam||16||

māsēna cēnna dr̥śyēta viśēṣastasya śōbhanaḥ|
rasaiścānyairbahuvidhairdurlabhaṁ tasya jīvitam||17||

apasvaraM bhAShamANaM prAptaM maraNamAtmanaH|
shrotAraM cApyashabdasya dUrataH parivarjayet||14||

yaM naraM sahasA rogo durbalaM parimu~jcati|
saMshayaprAptamAtreyo jIvitaM tasya manyate||15||

atha cejj~jAtayastasya yAceran praNipAtataH|
rasenAdyAditi brUyAnnAsmai dadyAdvishodhanam||16||

mAsena cenna dRushyeta visheShastasya shobhanaH|
rasaishcAnyairbahuvidhairdurlabhaM tasya jIvitam||17||

The man speaking irrelevantly about death or patient suffering from auditory hallucinations should not be treated.
If in any disease, patient deteriorates all of a sudden, his survival is doubtful as told by Atreya. If the relatives of the patient request the physician begging for his life, the physician should prescribe the diet of soup prepared out of meat; but no ''Shodhana'' (purificatory therapy) should be done in such patient as it will further deteriorate the condition.

If after one month, no signs of improvement as the result of soup prepared out of meat and varied other nutritive agents are seen, then the patient’s survival is rare. [14-17]

==== Various assessment parameters for lifespan and death ====

निष्ठ्यूतं च पुरीषं च रेतश्चाम्भसि मज्जति|
यस्य तस्यायुषः प्राप्तमन्तमाहुर्मनीषिणः||१८||

निष्ठ्यूते यस्य दृश्यन्ते वर्णा बहुविधाः पृथक्|
तच्च सीदत्यपः प्राप्य न स जीवितुमर्हति ||१९||

पित्तमूष्मानुगं यस्य शङ्खौ प्राप्य विमूर्च्छति |
स रोगः शङ्खको नाम्ना त्रिरात्राद्धन्ति जीवितम्||२०||

सफेनं रुधिरं यस्य मुहुरास्यात् प्रसिच्यते|
शूलैश्च तुद्यते कुक्षिः प्रत्याख्येयस्तथाविधः||२१||

बलमांसक्षयस्तीव्रो रोगवृद्धिररोचकः|
यस्यातुरस्य लक्ष्यन्ते त्रीन् पक्षान्न स जीवति||२२||

niṣṭhyūtaṁ ca purīṣaṁ ca rētaścāmbhasi majjati|
yasya tasyāyuṣaḥ prāptamantamāhurmanīṣiṇaḥ||18||

niṣṭhyūtē yasya dr̥śyantē varṇā bahuvidhāḥ pr̥thak|
tacca sīdatyapaḥ prāpya na sa jīvitumarhati ||19||

pittamūṣmānugaṁ yasya śaṅkhau prāpya vimūrcchati |
sa rōgaḥ śaṅkhakō nāmnā trirātrāddhanti jīvitam||20||

saphēnaṁ rudhiraṁ yasya muhurāsyāt prasicyatē|
śūlaiśca tudyatē kukṣiḥ pratyākhyēyastathāvidhaḥ||21||

balamāṁsakṣayastīvrō rōgavr̥ddhirarōcakaḥ|
yasyāturasya lakṣyantē trīn pakṣānna sa jīvati||22||

niShThyUtaM ca purIShaM ca retashcAmbhasi majjati|
yasya tasyAyuShaH prAptamantamAhurmanIShiNaH||18||

niShThyUte yasya dRushyante varNA bahuvidhAH pRuthak|
tacca sIdatyapaH prApya na sa jIvitumarhati ||19||

pittamUShmAnugaM yasya sha~gkhau prApya vimUrcchati |
sa rogaH sha~gkhako nAmnA trirAtrAddhanti jIvitam||20||

saphenaM rudhiraM yasya muhurAsyAt prasicyate|
shUlaishca tudyate kukShiH pratyAkhyeyastathAvidhaH||21||

balamAMsakShayastIvro rogavRuddhirarocakaH|
yasyAturasya lakShyante trIn pakShAnna sa jIvati||22||

If a man’s sputum, feces and semen sink into water, the wise physicians say that he has come to the end of his life.
If the sputum has various color and sinks in water, the patient does not survive.

The morbid condition in which the ''pitta'', reaches up to temporal area and accumulates there, is known by the name of ''Shankhaka''. It kills the patient in three nights.

The man frequently spitting frothy blood and suffering from piercing pains in the stomach, should be refused for the treatment by the physician.

The patient, who suffers from rapid loss of strength and muscle wasting, aggravation of disease symptoms and anorexia, does not survive more than three fortnights. [18-22]

==== Summary ====

तत्र श्लोकौ-
विज्ञानानि मनुष्याणां मरणे प्रत्युपस्थिते|
भवन्त्येतानि सम्पश्येदन्यान्येवंविधानि च||२३||

तानि सर्वाणि लक्ष्यन्ते न तु सर्वाणि मानवम्|
विशन्ति विनशिष्यन्तं तस्माद्बोध्यानि सर्वतः||२४||

tatra ślōkau-
vijñānāni manuṣyāṇāṁ maraṇē pratyupasthitē|
bhavantyētāni sampaśyēdanyānyēvaṁvidhāni ca||23||

tāni sarvāṇi lakṣyantē na tu sarvāṇi mānavam|
viśanti vinaśiṣyantaṁ tasmādbōdhyāni sarvataḥ||24||

tatra shlokau-
vij~jAnAni manuShyANAM maraNe pratyupasthite|
bhavantyetAni sampashyedanyAnyevaMvidhAni ca||23||

tAni sarvANi lakShyante na tu sarvANi mAnavam|
vishanti vinashiShyantaM tasmAdbodhyAni sarvataH||24||

These features in human beings denote impending death.

The physician should observe these and other similar features.

It is not necessarily that one founds them collectively in one person who is approaching death. Only few of them may appear in one person.
Hence,the physician should know with all the signs and symptoms, prognosticative of death. [23-24]

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

Various biomarkers have been developed since the time of Charaka and many diseases which were incurable can be controlled. Patient should be evaluated using these biomarkers, before communicating to the patient and family about remaining lifespan of patient.

The ''bala'' (strength and immunity) and ''mamsa'' (muscle mass) are important markers for assessment of health and death. Depletion of these two markers indicates near death signs. [8-9]

Change in eye color, voice, sputum, feces and semen are markers of near death.

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

General examination is important for assessing life span of any individual. Treatment should be planned after complete examination of disease and patient including the biomarkers.

Cravings for substances which increases vitiation of causative Dosha reflects grave prognosis of the disease. [Verse No. 3-5]

Patient with poor strength will die with consumption, as the patient will not be able to fight disease and will succumb to death. [Verse No. 6-7]

''Ashta Mahagada'' , or eight grave diseases, are difficult to treat. They should not be treated if they are associated with loss of strength with muscle wasting.[8-9]

If patient suffers from an incurable disease and shows ''arishta'' signs, he should not be treated and physician should inform the relatives about the exact condition of the patient and suggest care to keep the patient comfortable. If the legal guardian of the patient requests the physician for treatment then only he should treat the patient. [Verse No. 14-17]

=== Glossary ===

#(apasmAra,अपस्मार) - Seizures A neurological condition comprising episodes of fearful paroxysmal movements of the body which are produced by perversion of memory, intelligence and other mental functions along with loss of memory during the episode.
#ādhmāna (AdhmAna, आध्मान) The term signifies distention or inflation of a body part caused due to stagnation of the substances inside it; but generally is taken for distention of the abdomen associated with pain due to various reasons like obstruction to the urine and feces, accumulation of blood in abdomen etc.
#Ānāha आनाह Obstruction, Constipation Obstruction of the feces in the intestine is to be termed as constipation. The term also signifies obstruction to the flow or normal movements of any substance in any part of the body.
#chardi (chardi,छर्दि) - Vomiting A disease in which vomiting is the main symptom.
#gulma (gulma,गुल्म) - Lump in abdomen. A lump like formation occurring in the abdomen either mobile or static in nature, circular in shape and constantly increasing and decreasing in size.
#hikkā (hikkA,हिक्का) – Hiccoughs. A disease characterized by production of peculiar sound like hic-hic by mouth.
#jwara ( jvara,ज्वर) - Pyrexia / fever A sense of non well being in senses, mind and body along with raised body temperature and associated by obstruction to the skin.
#kushtha (kuShTha , कुष्ठ) - Multiple dermatological manifestation Chronic Dermatological diseases characterized by disfiguring and discoloration chronic non- suppurative skin disorders.
#lohitapitta (lohitapittaM,लोहितपित्त) - Hemorrhagic disorder A hemorrhagic disorder in which bleeding occurs through orifices of the body without any direct injury to the body tissues.
#madhumeha (madhumeha, मधुमेह) Diabetes mellitus. A stage of diabetes mellitus where in the urine and blood gets sweetened like honey.
#prameha (prameha,प्रमेह) Diabetes, The disease characterized by symptoms of frequent excessive and turbid urination.
#rajayakshma (rAjayakShmA- राजयक्ष्मा)- means “Roga” (disease) as well as a particular disease i.e. -Disease characterized by generalized wasting of the body tissues caused due to malnourishment as a result of obstruction in the channels.
#shankhak (sha~gkhak, शङ्खक) Intracranial growth, Saggital sinus thrombosis A fatal disease of head characterized by severe pain and swelling in the temporal area.
#shonita (shoNitA-शोणित)- 1. Synonym of Rakta. 2. Synonym of Ārtava
#shosha (shoSha,शोष) - A disease characterized by generalized emaciation.
#trishna (tRuShNA,तृष्णा) - Polydypsia The condition resembles to morbid thirst in which the person even after continuous water intake fails to quench his thirst.
#udara (udara, उदर) - Generalized abdominal enlargement.
#urdhvashvasa (UrdhvashvAsa, ऊर्ध्वश्वास) Stertorous breathing or failing respiration. Characterized by obstructed inspiration due to blockage of respiratory channels
#vatavyadhi(vAtavyAdhi, वातव्याधि) – Special category of diseases caused by vitiation of Vata Dosha
#virechana (virecanA- विरेचन) -Therapeutic purgation.

=== References ===

<references/>

Yasyashyavanimitta

2017-12-26T13:39:35Z

Vinay Exafluence: /* Introduction */

{{Infobox
|title = Yasyashyavanimitta
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 9
|label2 = Preceding Chapter
|data2 = [[Avakshirsheeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 9 ==

=== Abstract ===

This chapter, ([[Yasyashyavanimitta]]), includes various signs and symptoms related to imminent death that start with changes in color of eyes and identified in a patient as well as in healthy individuals. It has been emphasized that physician should have knowledge of all ''Arishta Lakshana'' (near death signs) described in this chapter. Clinically only few of them manifest at a stage in an individual and hence the person must be examined properly. Certain features related with imminent death are described which when associated with any disease indicate grave prognosis. Complications which indicate the incurability of a disease are scientific and are seen till date. Description of eight grave diseases and symptoms of approaching death are other two important topics which add value to this chapter. These signs are important in palliative care. Therefore, knowledge of such predictive signs and symptoms is an integral part of medical science.

Keywords: ''Arishta, Vikara, Bala, Marana, Jivita,'' change in eye color, grave diseases, death.

=== Introduction ===

[[Yasyashyavanimitta]] refers to color changes in eyes. In the first four chapters of [[Indriya Sthana]], conditions related to ''Indriya'' or five sense organs have been described. In those chapters, derangements in functional aspects of ''indriyas'' have been given importance and Atreya told to examine them by the help of ''Anumana Pramana''. In this chapter certain anatomical changes or changes which can be examined by ''Pratyaksha Pramana''(direct observation) are mentioned which are equally important indicators of life span.
Nowadays, importance is given to the identification of approaching death. Educational and training programs are organized to educate family members/relatives/attendants so that patient care is not neglected near death and this specialized field is commonly known as Palliative care. The World Health Organization (WHO) defines palliative care as 'an approach that improves the quality of life of individuals and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual'.<ref> Available from: http://www.who.int/hiv/topics/palliative/PalliativeCare/en/ </ref>
The aging of the population, with the numerous chronic debilitating and malignant conditions associated with growing older, has focused attention on palliative care. The terminal state is an integral process and a time to reconcile differences so that patient and family may accept death with a minimum of physical, spiritual, and psychosocial anguish.<ref> Rousseau P., Hospice and palliative care, Dis Mon. 1995 Dec;41(12):779-842. </ref> Hospice care is a specialized philosophy and system of care for the terminally ill patient that accepts death in an affirmative way and provides palliative care and emotional support to dying patients and their families.<ref> Plumb JD, Ogle KS., Hospice care, Prim Care. 1992 Dec;19(4):807-20. </ref> Hospice and palliative care philosophy lays emphasis on relieving suffering and improving quality of life at the end of life in order to permit experiences that will have positive meaning. The role of the physician is central in providing this care.<ref> Sethi S. Hospice: an underutilized resource, J Okla State Med Assoc. 2001 Mar;94(3):79-84. </ref> When recovery is uncertain it is better to discuss this rather than giving false hope to the patient and family. This is generally perceived as a strength in the doctor-patient relationship and helps to build trust.<ref> John Ellershaw, Care of the dying patient: the last hours or days of life, BMJ. 2003 January 4; 326(7379): 30–34. </ref> Charaka also supports this view and states that those near death should not be treated. Thus it becomes important that physician should be well trained in identifying features of impending death.

In order to care for dying patients it is essential to “identify dying”. This aim can be attained by applying the knowledge given in this chapter. Presently to predict prognostic value few tools have been designed. Most widely-used prognostic tools is the Palliative Performance Scale (PPS) which has been studied primarily in inpatient settings and in patients with cancer. Few researches are on going to develop tools for prognosis in other diseases also.<ref> Harrold J, Rickerson E, Carroll JT, McGrath J, Morales K, Kapo J, Casarett D., Is the palliative performance scale a useful predictor of mortality in a heterogeneous hospice population?, J Palliat Med. 2005 Jun;8(3):503-9. </ref> Research can be done to develop a scale based on parameters described in Ayurvedic ''Arishta Vigyana'' and this chapter can also contribute a lot in making such kind of tool.

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

यस्यश्यावनिमित्तेन्द्रियोपक्रमः
अथातो यस्यश्यावनिमित्तीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō yasyaśyāvanimittīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto yasyashyAvanimittIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter entitled ‘The sensorial prognosis from the observation of the dark brown color of the eye of a man’. Thus said Lord Atreya. [1-2]

==== Signs of death due to ''Pitta'' disorders ====

यस्य श्यावे परिध्वस्ते हरिते चापि दर्शने|
आपन्नो व्याधिरन्ताय ज्ञेयस्तस्य विजानता||३||

निःसञ्ज्ञः परिशुष्कास्यः समृद्धो व्याधिभिश्च यः|
उपरुद्धायुषं ज्ञात्वा तं धीरः परिवर्जयेत्||४||

हरिताश्च सिरा यस्य लोमकूपाश्च संवृताः|
सोऽम्लाभिलाषी पुरुषः पित्तान्मरणमश्नुते||५||

yasya śyāvē paridhvastē haritē cāpi darśanē|
āpannō vyādhirantāya jñēyastasya vijānatā||3||

niḥsañjñaḥ pariśuṣkāsyaḥ samr̥ddhō vyādhibhiśca yaḥ|
uparuddhāyuṣaṁ jñātvā taṁ dhīraḥ parivarjayēt||4||

haritāśca sirā yasya lōmakūpāśca saṁvr̥tāḥ|
sō'mlābhilāṣī puruṣaḥ pittānmaraṇamaśnutē||5||

yasya shyAve paridhvaste harite cApi darshane|
Apanno vyAdhirantAya j~jeyastasya vijAnatA||3||

niHsa~jj~jaH parishuShkAsyaH samRuddho vyAdhibhishca yaH|
uparuddhAyuShaM j~jAtvA taM dhIraH parivarjayet||4||

haritAshca sirA yasya lomakUpAshca saMvRutAH|
so~amlAbhilAShI puruShaH pittAnmaraNamashnute||5||

If patient eyes are brownish/blackish, distorted or displaced or greenish in color, then such condition indicates impending death.
The patient who is unconscious, having dry mouth and is suffering from various diseases should be considered as having short life span and such patient should be discarded by the wise physician.

The man whose veins are green and whose hair follicles are closed and who craves for sour things succumb to death due to ''pitta'' disorders. [3-5]

==== Signs of death due to ''Rajayakshma'' and ''Shosha'' ====

शरीरान्ताश्च शोभन्ते शरीरं चोपशुष्यति|
बलं च हीयते यस्य राजयक्ष्मा हिनस्ति तम्||६||

अंसाभितापो हिक्का च छर्दनं शोणितस्य च|
आनाहः पार्श्वशूलं च भवत्यन्ताय शोषिणः||७||

śarīrāntāśca śōbhantē śarīraṁ cōpaśuṣyati|
balaṁ ca hīyatē yasya rājayakṣmā hinasti tam||6||

aṁsābhitāpō hikkā ca chardanaṁ śōṇitasya ca|
ānāhaḥ pārśvaśūlaṁ ca bhavatyantāya śōṣiṇaḥ||7||

sharIrAntAshca shobhante sharIraM copashuShyati|
balaM ca hIyate yasya rAjayakShmA hinasti tam||6||

aMsAbhitApo hikkA ca chardanaM shoNitasya ca|
AnAhaH pArshvashUlaM ca bhavatyantAya shoShiNaH||7||

In a patient of ''rajyayakshma'', waning strength, shining extremities and emaciated body parts denotes that patient will succumb to death soon.

The burning pain in the shoulder region, hiccup, hematemesis, distension of the stomach and pain in the flanks in patient of consumption will end the life of patient. [6-7]

==== Eight grave diseases leading to death ====

वातव्याधिरपस्मारी कुष्ठी शोफी तथोदरी|
गुल्मी च मधुमेही च राजयक्ष्मी च यो नरः||८||

अचिकित्स्या भवन्त्येते बलमांसक्षये सति|
अन्येष्वपि विकारेषु तान् भिषक् परिवर्जयेत्||९||

vātavyādhirapasmārī kuṣṭhī śōphī tathōdarī|
gulmī ca madhumēhī ca rājayakṣmī ca yō naraḥ||8||

acikitsyā bhavantyētē balamāṁsakṣayē sati|
anyēṣvapi vikārēṣu tān bhiṣak parivarjayēt||9||

vAtavyAdhirapasmArI kuShThI shophI tathodarI|
gulmI ca madhumehI ca rAjayakShmI ca yo naraH||8||

acikitsyA bhavantyete balamAMsakShaye sati|
anyeShvapi vikAreShu tAn bhiShak parivarjayet||9||

When diseases like ''Vatavyadhi'' (diseases due to ''vata''), ''Apasmara'' (Epilepsy), ''Kushtha'' (Skin diseases), ''Shopha'' (Swellings), ''Udara'' (abdominal diseases including ascitis), ''Gulma'' (lumps and tumors), ''Madhumeha'' (urinary disorders including Diabetes) and ''Rajayakshama'' (Tuberculosis) are associated with loss of strength and muscle wasting then such patient should be discarded by the physician as patient will not recover and will succumb to death.

Patients suffering from other diseases too having above features should be avoided by the physician. [8-9]

==== Death signs after ''Virechana'' (purgation) ====

विरेचनहृतानाहो यस्तृष्णानुगतो नरः|
विरिक्तः पुनराध्माति यथा प्रेतस्तथैव सः||१०||

virēcanahr̥tānāhō yastr̥ṣṇānugatō naraḥ|
viriktaḥ punarādhmāti yathā prētastathaiva saḥ||10||

virecanahRutAnAho yastRuShNAnugato naraH|
viriktaH punarAdhmAti yathA pretastathaiva saH||10||

If abdominal distension of a patient is relieved by purgation for short time and then patient develops thirst, distension of abdomen and severe pain again, then such patient should be considered as a ghost i.e. the patients will surely die soon. [10]

==== Dryness as death sign ====

पेयं पातुं न शक्नोति कण्ठस्य च मुखस्य च|
उरसश्च विशुष्कत्वाद्यो नरो न स जीवति ||११||

pēyaṁ pātuṁ na śaknōti kaṇṭhasya ca mukhasya ca|
urasaśca viśuṣkatvādyō narō na sa jīvati ||11||

peyaM pAtuM na shaknoti kaNThasya ca mukhasya ca|
urasashca vishuShkatvAdyo naro na sa jIvati ||11||

One who, because of excessive dryness of throat, mouth and chest, is unable to drink anything does not survive.

==== Feeble voice as death sign ====

स्वरस्य दुर्बलीभावं हानिं च बलवर्णयोः|
रोगवृद्धिमयुक्त्या च दृष्ट्वा मरणमादिशेत्||१२||

ऊर्ध्वश्वासं गतोष्माणं शूलोपहतवङ्क्षणम्|
शर्म चानधिगच्छन्तं बुद्धिमान् परिवर्जयेत्||१३||

svarasya durbalībhāvaṁ hāniṁ ca balavarṇayōḥ|
rōgavr̥ddhimayuktyā ca dr̥ṣṭvā maraṇamādiśēt||12||

ūrdhvaśvāsaṁ gatōṣmāṇaṁ śūlōpahatavaṅkṣaṇam|
śarma cānadhigacchantaṁ buddhimān parivarjayēt||13||

svarasya durbalIbhAvaM hAniM ca balavarNayoH|
rogavRuddhimayuktyA ca dRuShTvA maraNamAdishet||12||

UrdhvashvAsaM gatoShmANaM shUlopahatava~gkShaNam|
sharma cAnadhigacchantaM buddhimAn parivarjayet||13||

If a patient develops weakness of voice, diminution of strength and complexion, and aggravation of disease without an apparent cause then such patient will die soon.

The person/ individual whose breathing has been shallow, has subnormal temperature and who feels piercing pains in the groins without experiencing a moment of comfort, should be discarded by the wise physician.[12-13]

==== Signs of death ====

अपस्वरं भाषमाणं प्राप्तं मरणमात्मनः|
श्रोतारं चाप्यशब्दस्य दूरतः परिवर्जयेत्||१४||

यं नरं सहसा रोगो दुर्बलं परिमुञ्चति|
संशयप्राप्तमात्रेयो जीवितं तस्य मन्यते||१५||

अथ चेज्ज्ञातयस्तस्य याचेरन् प्रणिपाततः|
रसेनाद्यादिति ब्रूयान्नास्मै दद्याद्विशोधनम्||१६||

मासेन चेन्न दृश्येत विशेषस्तस्य शोभनः|
रसैश्चान्यैर्बहुविधैर्दुर्लभं तस्य जीवितम्||१७||

apasvaraṁ bhāṣamāṇaṁ prāptaṁ maraṇamātmanaḥ|
śrōtāraṁ cāpyaśabdasya dūrataḥ parivarjayēt||14||

yaṁ naraṁ sahasā rōgō durbalaṁ parimuñcati|
saṁśayaprāptamātrēyō jīvitaṁ tasya manyatē||15||

atha cējjñātayastasya yācēran praṇipātataḥ|
rasēnādyāditi brūyānnāsmai dadyādviśōdhanam||16||

māsēna cēnna dr̥śyēta viśēṣastasya śōbhanaḥ|
rasaiścānyairbahuvidhairdurlabhaṁ tasya jīvitam||17||

apasvaraM bhAShamANaM prAptaM maraNamAtmanaH|
shrotAraM cApyashabdasya dUrataH parivarjayet||14||

yaM naraM sahasA rogo durbalaM parimu~jcati|
saMshayaprAptamAtreyo jIvitaM tasya manyate||15||

atha cejj~jAtayastasya yAceran praNipAtataH|
rasenAdyAditi brUyAnnAsmai dadyAdvishodhanam||16||

mAsena cenna dRushyeta visheShastasya shobhanaH|
rasaishcAnyairbahuvidhairdurlabhaM tasya jIvitam||17||

The man speaking irrelevantly about death or patient suffering from auditory hallucinations should not be treated.
If in any disease, patient deteriorates all of a sudden, his survival is doubtful as told by Atreya. If the relatives of the patient request the physician begging for his life, the physician should prescribe the diet of soup prepared out of meat; but no ''Shodhana'' (purificatory therapy) should be done in such patient as it will further deteriorate the condition.

If after one month, no signs of improvement as the result of soup prepared out of meat and varied other nutritive agents are seen, then the patient’s survival is rare. [14-17]

==== Various assessment parameters for lifespan and death ====

निष्ठ्यूतं च पुरीषं च रेतश्चाम्भसि मज्जति|
यस्य तस्यायुषः प्राप्तमन्तमाहुर्मनीषिणः||१८||

निष्ठ्यूते यस्य दृश्यन्ते वर्णा बहुविधाः पृथक्|
तच्च सीदत्यपः प्राप्य न स जीवितुमर्हति ||१९||

पित्तमूष्मानुगं यस्य शङ्खौ प्राप्य विमूर्च्छति |
स रोगः शङ्खको नाम्ना त्रिरात्राद्धन्ति जीवितम्||२०||

सफेनं रुधिरं यस्य मुहुरास्यात् प्रसिच्यते|
शूलैश्च तुद्यते कुक्षिः प्रत्याख्येयस्तथाविधः||२१||

बलमांसक्षयस्तीव्रो रोगवृद्धिररोचकः|
यस्यातुरस्य लक्ष्यन्ते त्रीन् पक्षान्न स जीवति||२२||

niṣṭhyūtaṁ ca purīṣaṁ ca rētaścāmbhasi majjati|
yasya tasyāyuṣaḥ prāptamantamāhurmanīṣiṇaḥ||18||

niṣṭhyūtē yasya dr̥śyantē varṇā bahuvidhāḥ pr̥thak|
tacca sīdatyapaḥ prāpya na sa jīvitumarhati ||19||

pittamūṣmānugaṁ yasya śaṅkhau prāpya vimūrcchati |
sa rōgaḥ śaṅkhakō nāmnā trirātrāddhanti jīvitam||20||

saphēnaṁ rudhiraṁ yasya muhurāsyāt prasicyatē|
śūlaiśca tudyatē kukṣiḥ pratyākhyēyastathāvidhaḥ||21||

balamāṁsakṣayastīvrō rōgavr̥ddhirarōcakaḥ|
yasyāturasya lakṣyantē trīn pakṣānna sa jīvati||22||

niShThyUtaM ca purIShaM ca retashcAmbhasi majjati|
yasya tasyAyuShaH prAptamantamAhurmanIShiNaH||18||

niShThyUte yasya dRushyante varNA bahuvidhAH pRuthak|
tacca sIdatyapaH prApya na sa jIvitumarhati ||19||

pittamUShmAnugaM yasya sha~gkhau prApya vimUrcchati |
sa rogaH sha~gkhako nAmnA trirAtrAddhanti jIvitam||20||

saphenaM rudhiraM yasya muhurAsyAt prasicyate|
shUlaishca tudyate kukShiH pratyAkhyeyastathAvidhaH||21||

balamAMsakShayastIvro rogavRuddhirarocakaH|
yasyAturasya lakShyante trIn pakShAnna sa jIvati||22||

If a man’s sputum, feces and semen sink into water, the wise physicians say that he has come to the end of his life.
If the sputum has various color and sinks in water, the patient does not survive.

The morbid condition in which the ''pitta'', reaches up to temporal area and accumulates there, is known by the name of ''Shankhaka''. It kills the patient in three nights.

The man frequently spitting frothy blood and suffering from piercing pains in the stomach, should be refused for the treatment by the physician.

The patient, who suffers from rapid loss of strength and muscle wasting, aggravation of disease symptoms and anorexia, does not survive more than three fortnights. [18-22]

==== Summary ====

तत्र श्लोकौ-
विज्ञानानि मनुष्याणां मरणे प्रत्युपस्थिते|
भवन्त्येतानि सम्पश्येदन्यान्येवंविधानि च||२३||

तानि सर्वाणि लक्ष्यन्ते न तु सर्वाणि मानवम्|
विशन्ति विनशिष्यन्तं तस्माद्बोध्यानि सर्वतः||२४||

tatra ślōkau-
vijñānāni manuṣyāṇāṁ maraṇē pratyupasthitē|
bhavantyētāni sampaśyēdanyānyēvaṁvidhāni ca||23||

tāni sarvāṇi lakṣyantē na tu sarvāṇi mānavam|
viśanti vinaśiṣyantaṁ tasmādbōdhyāni sarvataḥ||24||

tatra shlokau-
vij~jAnAni manuShyANAM maraNe pratyupasthite|
bhavantyetAni sampashyedanyAnyevaMvidhAni ca||23||

tAni sarvANi lakShyante na tu sarvANi mAnavam|
vishanti vinashiShyantaM tasmAdbodhyAni sarvataH||24||

These features in human beings denote impending death.

The physician should observe these and other similar features.

It is not necessarily that one founds them collectively in one person who is approaching death. Only few of them may appear in one person.
Hence,the physician should know with all the signs and symptoms, prognosticative of death. [23-24]

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

Various biomarkers have been developed since the time of Charaka and many diseases which were incurable can be controlled. Patient should be evaluated using these biomarkers, before communicating to the patient and family about remaining lifespan of patient.

The ''bala'' (strength and immunity) and ''mamsa'' (muscle mass) are important markers for assessment of health and death. Depletion of these two markers indicates near death signs. [8-9]

Change in eye color, voice, sputum, feces and semen are markers of near death.

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

General examination is important for assessing life span of any individual. Treatment should be planned after complete examination of disease and patient including the biomarkers.

Cravings for substances which increases vitiation of causative Dosha reflects grave prognosis of the disease. [Verse No. 3-5]

Patient with poor strength will die with consumption, as the patient will not be able to fight disease and will succumb to death. [Verse No. 6-7]

''Ashta Mahagada'' , or eight grave diseases, are difficult to treat. They should not be treated if they are associated with loss of strength with muscle wasting.[8-9]

If patient suffers from an incurable disease and shows ''arishta'' signs, he should not be treated and physician should inform the relatives about the exact condition of the patient and suggest care to keep the patient comfortable. If the legal guardian of the patient requests the physician for treatment then only he should treat the patient. [Verse No. 14-17]

=== Glossary ===

#(apasmAra,अपस्मार) - Seizures A neurological condition comprising episodes of fearful paroxysmal movements of the body which are produced by perversion of memory, intelligence and other mental functions along with loss of memory during the episode.
#ādhmāna (AdhmAna, आध्मान) The term signifies distention or inflation of a body part caused due to stagnation of the substances inside it; but generally is taken for distention of the abdomen associated with pain due to various reasons like obstruction to the urine and feces, accumulation of blood in abdomen etc.
#Ānāha आनाह Obstruction, Constipation Obstruction of the feces in the intestine is to be termed as constipation. The term also signifies obstruction to the flow or normal movements of any substance in any part of the body.
#chardi (chardi,छर्दि) - Vomiting A disease in which vomiting is the main symptom.
#gulma (gulma,गुल्म) - Lump in abdomen. A lump like formation occurring in the abdomen either mobile or static in nature, circular in shape and constantly increasing and decreasing in size.
#hikkā (hikkA,हिक्का) – Hiccoughs. A disease characterized by production of peculiar sound like hic-hic by mouth.
#jwara ( jvara,ज्वर) - Pyrexia / fever A sense of non well being in senses, mind and body along with raised body temperature and associated by obstruction to the skin.
#kushtha (kuShTha , कुष्ठ) - Multiple dermatological manifestation Chronic Dermatological diseases characterized by disfiguring and discoloration chronic non- suppurative skin disorders.
#lohitapitta (lohitapittaM,लोहितपित्त) - Hemorrhagic disorder A hemorrhagic disorder in which bleeding occurs through orifices of the body without any direct injury to the body tissues.
#madhumeha (madhumeha, मधुमेह) Diabetes mellitus. A stage of diabetes mellitus where in the urine and blood gets sweetened like honey.
#prameha (prameha,प्रमेह) Diabetes, The disease characterized by symptoms of frequent excessive and turbid urination.
#rajayakshma (rAjayakShmA- राजयक्ष्मा)- means “Roga” (disease) as well as a particular disease i.e. -Disease characterized by generalized wasting of the body tissues caused due to malnourishment as a result of obstruction in the channels.
#shankhak (sha~gkhak, शङ्खक) Intracranial growth, Saggital sinus thrombosis A fatal disease of head characterized by severe pain and swelling in the temporal area.
#shonita (shoNitA-शोणित)- 1. Synonym of Rakta. 2. Synonym of Ārtava
#shosha (shoSha,शोष) - A disease characterized by generalized emaciation.
#trishna (tRuShNA,तृष्णा) - Polydypsia The condition resembles to morbid thirst in which the person even after continuous water intake fails to quench his thirst.
#udara (udara, उदर) - Generalized abdominal enlargement.
#urdhvashvasa (UrdhvashvAsa, ऊर्ध्वश्वास) Stertorous breathing or failing respiration. Characterized by obstructed inspiration due to blockage of respiratory channels
#vatavyadhi(vAtavyAdhi, वातव्याधि) – Special category of diseases caused by vitiation of Vata Dosha
#virechana (virecanA- विरेचन) -Therapeutic purgation.

=== References ===

Pannarupiya

2017-12-26T13:12:33Z

Vinay Exafluence: /* Indriya Sthana Chapter 7 */

{{Infobox
|title = Pannarupiya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 7
|label2 = Preceding Chapter
|data2 = [[Kathamanasharireeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 7 ==

=== Abstract ===
<div style="text-align:justify;">
The seventh chapter [[Pannarupiya]] deals with the loss of shadow image in eyes, changes in complexion and luster indicative of imminent death. Difference between shadow and luster is also explained in this chapter with characteristic features of shadows pertaining to each of ''pancha mahabhuta''. The chapter focuses on fatal prognostic features related to complexion and luster.

Keywords: shadow image, complexion, luster, ''chhaya, varna, prabha''.

=== Introduction ===

If there is any distortion in the image of the examiner reflected as a shadow in the pupil of the patient, should be considered as a sign of imminent death of the patient. ''Nimittanurupa vikriti'' (image pertaining to death) will serve as a yard stick to measure the span of life.
</div>
===Sanskrit text, Transliteration and English Translation===

पन्नरूपीयेन्द्रियोपक्रमः
अथातः पन्नरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pannarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pannarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter on the signs of imminent death as indicated by the distortion of the image reflected in the pupil.[1-2]

==== Loss of shadow image in eyes ====

दृष्ट्यां यस्य विजानीयात् पन्नरूपां कुमारिकाम्|
प्रतिच्छायामयीमक्ष्णोर्नैनमिच्छेच्चिकित्सितुम्||३||

dr̥ṣṭyāṁ yasya vijānīyāt pannarūpāṁ kumārikām|
praticchāyāmayīmakṣṇōrnainamicchēccikitsitum||3||

dRuShTyAM yasya vijAnIyAt pannarUpAM kumArikAm|
praticchAyAmayImakShNornainamiccheccikitsitum||3||

The condition in which loss of shadow image is observed in the pupil (eyes) of the patient, should be discarded for treatment.[3]

==== Features of fatal prognosis as per shadows ====

ज्योत्स्नायामातपे दीपे सलिलादर्शयोरपि|
अङ्गेषु विकृता यस्य च्छाया प्रेतस्तथैव सः||४||

jyōtsnāyāmātapē dīpē salilādarśayōrapi|
aṅgēṣu vikr̥tā yasya cchāyā prētastathaiva saḥ||4||

jyotsnAyAmAtape dIpe salilAdarshayorapi|
a~ggeShu vikRutA yasya cchAyA pretastathaiva saH||4||

If any sorts of deformity observed in body parts in the shadow of the person in moonlight, sunlight, light of a lamp, water or mirror. He should be considered as dead. [4]

छिन्ना भिन्नाऽऽकुला च्छाया हीना वाऽप्यधिकाऽपि वा|
नष्टा तन्वी द्विधा च्छिन्ना विकृता विशिरा च या||५||

एताश्चान्याश्च याः काश्चित् प्रतिच्छाया विगर्हिताः|
सर्वा मुमूर्षतां ज्ञेया न चेल्लक्ष्यनिमित्तजाः||६||

chinnā bhinnā''kulā cchāyā hīnā vā'pyadhikā'pi vā|
naṣṭā tanvī dvidhā cchinnā vikr̥tā viśirā ca yā||5||

ētāścānyāśca yāḥ kāścit praticchāyā vigarhitāḥ|
sarvā mumūrṣatāṁ jñēyā na cēllakṣyanimittajāḥ||6||

chinnA bhinnA~a~akulA cchAyA hInA vA~apyadhikA~api vA|
naShTA tanvI dvidhA cchinnA vikRutA vishirA ca yA||5||

etAshcAnyAshca yAH kAshcit praticchAyA vigarhitAH|
sarvA mumUrShatAM j~jeyA na cellakShyanimittajAH||6||
<div style="text-align:justify;">
Observation of shadow of a patient as broken, torn, hazy, devoid of certain organs, seeing excess organs, not conspicuous, bifurcated, deformed and without head, such other similar abnormal shadows if develops without any apparent cause it is considered as severe morbidity.[5-6]
</div>
संस्थानेन प्रमाणेन वर्णेन प्रभया तथा|
छाया विवर्तते यस्य स्वस्थोऽपि प्रेत एव सः||७||

saṁsthānēna pramāṇēna varṇēna prabhayā tathā|
chāyā vivartatē yasya svasthō'pi prēta ēva saḥ||7||

saMsthAnena pramANena varNena prabhayA tathA|
chAyA vivartate yasya svastho~api preta eva saH||7||

Distortion of shadow in respect of changes in shape, measurement, colour and lustre should be considered as ominous sign even in healthy individual.[7]

संस्थानमाकृतिर्ज्ञेया सुषमा विषमा च सा|
मध्यमल्पं महच्चोक्तं प्रमाणं त्रिविधं नृणाम्||८||

प्रतिप्रमाणसंस्थाना जलादर्शातपादिषु|
छाया या सा प्रतिच्छाया च्छाया वर्णप्रभाश्रया||९||

saṁsthānamākr̥tirjñēyā suṣamā viṣamā ca sā|
madhyamalpaṁ mahaccōktaṁ pramāṇaṁ trividhaṁ nr̥ṇām||8||

pratipramāṇasaṁsthānā jalādarśātapādiṣu|
chāyā yā sā praticchāyā cchāyā varṇaprabhāśrayā||9||

saMsthAnamAkRutirj~jeyA suShamA viShamA ca sA|
madhyamalpaM mahaccoktaMpramANaM trividhaM nRuNAm||8||

pratipramANasaMsthAnA jalAdarshAtapAdiShu|
chAyA yA sA praticchAyA cchAyA varNaprabhAshrayA||9||
<div style="text-align:justify;">
The term ''sansthana'' means shape which may be symmetrical or asymmetrical.
Measurement is of three kinds namely short, medium, and large The image reflected in water, mirror, etc., corresponding to the measurement and shape of the body of the individual is known as ''praticchhaya'' which is nothing but reflected shadow based on the color and luster of the individual.[8-9]
</div>
==== Features of Shadow of ''Pancha-Mahabhuta'' ====

खादीनां पञ्च पञ्चानां छाया विविधलक्षणाः|
नाभसी निर्मला नीला सस्नेहा सप्रभेव च||१०||

रूक्षा श्यावारुणा या तु वायवी सा हतप्रभा|
विशुद्धरक्ता त्वाग्नेयी दीप्ताभा दर्शनप्रिया||११||

शुद्धवैदूर्यविमला सुस्निग्धा चाम्भसी मता|
स्थिरा स्निग्धा घना श्लक्ष्णा श्यामा श्वेता च पार्थिवी||१२||

वायवी गर्हिता त्वासां चतस्रः स्युः सुखोदयाः |
वायवी तु विनाशाय क्लेशाय महतेऽपि वा||१३||

khādīnāṁ pañca pañcānāṁ chāyā vividhalakṣaṇāḥ|
nābhasī nirmalā nīlā sasnēhā saprabhēva ca||10||

rūkṣā śyāvāruṇā yā tu vāyavī sā hataprabhā|
viśuddharaktā tvāgnēyī dīptābhā darśanapriyā||11||

śuddhavaidūryavimalā susnigdhā cāmbhasī matā|
sthirā snigdhā ghanā ślakṣṇā śyāmā śvētā ca pārthivī||12||

vāyavī garhitā tvāsāṁ catasraḥ syuḥ sukhōdayāḥ |
vāyavī tu vināśāya klēśāya mahatē'pi vā||13||

khAdInAM pa~jca pa~jcAnAM chAyA vividhalakShaNAH|
nAbhasI nirmalA nIlA sasnehA saprabheva ca||10||

rUkShA shyAvAruNA yA tu vAyavI sA hataprabhA|
vishuddharaktA tvAgneyI dIptAbhA darshanapriyA||11||

shuddhavaidUryavimalA susnigdhA cAmbhasI matA|
sthirA snigdhAghanA shlakShNA shyAmA shvetA ca pArthivI||12||

vAyavI garhitA tvAsAM catasraH syuH sukhodayAH |
vAyavI tu vinAshAya kleshAya mahate~api vA||13||

The following are the distinctive characteristic features of shadows pertaining to each of the five great elements.
====Table 1: Shadows of Pancha-Mahabhuta:====
{| class="wikitable"
! rowspan="1"| S.No
! rowspan="1"| Mahabhuta
! rowspan="1"| Distinctive characteristic features of shadows
|-
| 1 || Akash Bhoota || Clear , blue, unctuous and lustrous shadow
|-
| 2.|| Vayu Bhoota || Dry, brown, and reddish
|-
| 3.|| Agni Bhoota || Bright red, brilliant and pleasing to the eyes
|-
| 4.|| Jala Bhoota || Clear like cat’s eye, and excessive unctuous
|-
| 5.|| Prithvi Bhoota || Stable, unctuous, compact, smooth, black and white
|-
|}

The shadow pertaining to ''vayu bhuta'' is of inferior in nature whereas the remaining four are indicative of pleasure and happiness. ''Vayu bhuta'' shadows indicative of great calamities and miseries.[10-13]

स्यात्तैजसी प्रभा सर्वा सा तु सप्तविधा स्मृता|
रक्ता पीता सिता श्यावा हरिता पाण्डुराऽसिता||१४||

तासां याः स्युर्विकासिन्यः स्निग्धाश्च विपुलाश्च याः|
ताः शुभा रूक्षमलिनाः सङ्क्षिप्ताश्चाशुभोदयाः ||१५||

syāttaijasī prabhā sarvā sā tu saptavidhā smr̥tā|
raktā pītā sitā śyāvā haritā pāṇḍurā'sitā||14||

tāsāṁ yāḥ syurvikāsinyaḥ snigdhāśca vipulāśca yāḥ|
tāḥ śubhā rūkṣamalināḥ saṅkṣiptāścāśubhōdayāḥ ||15||

syAttaijasI prabhA sarvA sA tu saptavidhA smRutA|
raktA pItA sitA shyAvA haritA pANDurA~asitA||14||

tAsAM yAH syurvikAsinyaH snigdhAshca vipulAshca yAH|
tAH shubhA rUkShamalinAH sa~gkShiptAshcAshubhodayAH||15||
<div style="text-align:justify;">
All varieties of luster are constituted of ''tejas bhuta''. They are classified as seven type’s namely red, yellow, white, brown, green, pale yellowish and black. Of them which are emanative, unctuous, and dense are auspicious and those others which are dry, dirty and thin are inauspicious.[14-15]
</div>
==== Difference between ''Chhaya'' (shadow) and ''Prabha''(lustre) ====

वर्णमाक्रामति च्छाया भास्तु वर्णप्रकाशिनी|
आसन्ना लक्ष्यते च्छाया भाः प्रकृष्टा प्रकाशते||१६||

नाच्छायो नाप्रभः कश्चिद्विशेषाश्चिह्नयन्ति तु|
नृणां शुभाशुभोत्पत्तिं काले छायाप्रभाश्रयाः||१७||

varṇamākrāmati cchāyā bhāstu varṇaprakāśinī|
āsannā lakṣyatē cchāyā bhāḥ prakr̥ṣṭā prakāśatē||16||

nācchāyō nāprabhaḥ kaścidviśēṣāścihnayanti tu|
nr̥ṇāṁ śubhāśubhōtpattiṁ kālē chāyāprabhāśrayāḥ||17||

varNamAkrAmati cchAyA bhAstu varNaprakAshinI|
AsannA lakShyate cchAyA bhAH prakRuShTA prakAshate||16||

nAcchAyo nAprabhaH kashcidvisheShAshcihnayanti tu|
nRuNAM shubhAshubhotpattiM kAle chAyAprabhAshrayAH||17||
<div style="text-align:justify;">
The shadow decreases the complexion of the body whereas the lustre illuminates. The shadow can be observed from nearby whereas lustre illuminates from a distance. There is nothing devoid of lustre or shadow. Certain distinctive features of the shadow and the lustre when mature indicates emergence of inauspicious or auspicious results in relation to human beings. [16-17]
</div>
==== Fatal signs ====

कामलाऽक्ष्णोर्मुखं पूर्णं शङ्खयोर्मुक्तमांसता|
सन्त्रासश्चोष्णगात्रत्वं यस्य तं परिवर्जयेत्||१८||

उत्थाप्यमानः शयनात् प्रमोहं याति यो नरः|
मुहुर्मुहुर्न सप्ताहं स जीवति विकत्थनः ||१९||

संसृष्टा व्याधयो यस्य प्रतिलोमानुलोमगाः|
व्यापन्ना ग्रहणी प्रायः सोऽर्धमासं न जीवति||२०||

kāmalā'kṣṇōrmukhaṁ pūrṇaṁ śaṅkhayōrmuktamāṁsatā|
santrāsaścōṣṇagātratvaṁ yasya taṁ parivarjayēt||18||

utthāpyamānaḥ śayanāt pramōhaṁ yāti yō naraḥ|
muhurmuhurna saptāhaṁ sa jīvati vikatthanaḥ ||19||

saṁsr̥ṣṭā vyādhayō yasya pratilōmānulōmagāḥ|
vyāpannā grahaṇī prāyaḥ sō'rdhamāsaṁ na jīvati||20||

kAmalA~akShNormukhaM pUrNaM sha~gkhayormuktamAMsatA|
santrAsashcoShNagAtratvaM yasya taM parivarjayet||18||

utthApyamAnaH shayanAt pramohaM yAti yo naraH|
muhurmuhurna saptAhaM sa jIvati vikatthanaH ||19||

saMsRuShTA vyAdhayo yasya pratilomAnulomagAH|
vyApannA grahaNI prAyaH so~ardhamAsaM na jIvati||20||
<div style="text-align:justify;">
Patient who is suffering from ''kamala'', swelling of face, wasting in temples and terrifying appearance with high fever such patient should be discarded for management.

Patient who faints again and again while being lifted from bed cannot survive for a week.
The patient afflicted with multiple ''doshas'' having movements in upward, downward both directions along with disordered ''grahani''(Duodenum and Small intestine) cannot survive for longer than for a fortnight.[18-20]
</div>
उपरुद्धस्य रोगेण कर्शितस्याल्पमश्नतः|
बहु मूत्रपुरीषं स्याद्यस्य तं परिवर्जयेत्||२१||

दुर्बलो बहु भुङ्क्ते यः प्राग्भुक्तादन्नमातुरः |
अल्पमूत्रपुरीषश्च यथा प्रेतस्तथैव सः||२२||

इष्टं च गुणसम्पन्नमन्नमश्नाति यो नरः|
शश्वच्च बलवर्णाभ्यां हीयते न स जीवति||२३||

प्रकूजति प्रश्वसिति शिथिलं चातिसार्यते|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२४||

ह्रस्वं च यः प्रश्वसिति व्याविद्धं स्पन्दते च यः|
मृतमेव तमात्रेयो व्याचचक्षे पुनर्वसुः||२५||

ऊर्ध्वं च यः प्रश्वसिति श्लेष्मणा चाभिभूयते|
हीनवर्णबलाहारो यो नरो न स जीवति||२६||

uparuddhasya rōgēṇa karśitasyālpamaśnataḥ|
bahu mūtrapurīṣaṁ syādyasya taṁ parivarjayēt||21||

durbalō bahu bhuṅktē yaḥ prāgbhuktādannamāturaḥ |
alpamūtrapurīṣaśca yathā prētastathaiva saḥ||22||

iṣṭaṁ ca guṇasampannamannamaśnāti yō naraḥ|
śaśvacca balavarṇābhyāṁ hīyatē na sa jīvati||23||

prakūjati praśvasiti śithilaṁ cātisāryatē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||24||

hrasvaṁ ca yaḥ praśvasiti vyāviddhaṁ spandatē ca yaḥ|
mr̥tamēva tamātrēyō vyācacakṣē punarvasuḥ||25||

ūrdhvaṁ ca yaḥ praśvasiti ślēṣmaṇā cābhibhūyatē|
hīnavarṇabalāhārō yō narō na sa jīvati||26||

uparuddhasya rogeNa karshitasyAlpamashnataH|
bahu mUtrapurIShaM syAdyasya taM parivarjayet||21||

durbalo bahu bhu~gkte yaH prAgbhuktAdannamAturaH |
alpamUtrapurIShashca yathA pretastathaiva saH||22||

iShTaM ca guNasampannamannamashnAti yo naraH|
shashvacca balavarNAbhyAM hIyate na sa jIvati||23||

prakUjati prashvasiti shithilaM cAtisAryate|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||24||

hrasvaM ca yaH prashvasiti vyAviddhaM spandate ca yaH|
mRutameva tamAtreyo vyAcacakShe punarvasuH||25||

UrdhvaM ca yaH prashvasiti shleShmaNA cAbhibhUyate|
hInavarNabalAhAro yo naro na sa jIvati||26||
<div style="text-align:justify;">
Consumption of little quantity of food by emaciated person but excretes large amount of urine and stool should be discarded for management.

Consumption of excess quantity of food by weak patient but passes scanty urine and stool should be considered as ghost or almost dead.
In spite of taking suitable diet if person constantly loose strength and complexion indicates bad prognosis.
If a person who is weak, thirsty and having dryness of mouth, if suffers from groaning, dyspnea and diarrhea, then it should not be treated because he will not survive.

If patient is suffering from shallow respiration with irregular twitching in the body is said to be severe fatal condition like almost dead.
Person who is suffering from respiratory distress with abundance of ''kapha'' along with diminution of complexion, strength and less intake of food will not survive for longer.[21-26]
</div>
ऊर्ध्वाग्रे नयने यस्य मन्ये चारतकम्पने|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२७||

यस्य गण्डावुपचितौ ज्वरकासौ च दारुणौ|
शूली प्रद्वेष्टि चाप्यन्नं तस्मिन् कर्म न सिध्यति||२८||

व्यावृत्तमूर्धजिह्वास्यो भ्रुवौ यस्य च विच्युते|
कण्टकैश्चाचिता जिह्वा यथा प्रेतस्तथैव सः||२९||

शेफश्चात्यर्थमुत्सिक्तं निःसृतौ वृषणौ भृशम्|
अतश्चैव विपर्यासो विकृत्या प्रेतलक्षणम्||३०||

निचितं यस्य मांसं स्यात्त्वगस्थिष्वेव दृश्यते|
क्षीणस्यानश्नतस्तस्य मासमायुः परं भवेत्||३१||

ūrdhvāgrē nayanē yasya manyē cāratakampanē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||27||

yasya gaṇḍāvupacitau jvarakāsau ca dāruṇau|
śūlī pradvēṣṭi cāpyannaṁ tasmin karma na sidhyati||28||

vyāvr̥ttamūrdhajihvāsyō bhruvau yasya ca vicyutē|
kaṇṭakaiścācitā jihvā yathā prētastathaiva saḥ||29||

śēphaścātyarthamutsiktaṁ niḥsr̥tau vr̥ṣaṇau bhr̥śam|
ataścaiva viparyāsō vikr̥tyā prētalakṣaṇam||30||

nicitaṁ yasya māṁsaṁ syāttvagasthiṣvēva dr̥śyatē|
kṣīṇasyānaśnatastasya māsamāyuḥ paraṁ bhavēt||31||

UrdhvAgre nayane yasya manye cAratakampane|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||27||

yasya gaNDAvupacitau jvarakAsau ca dAruNau|
shUlI pradveShTi cApyannaM tasmin karma na sidhyati||28||

vyAvRuttamUrdhajihvAsyo bhruvau yasya ca vicyute|
kaNTakaishcAcitA jihvA yathA pretastathaiva saH||29||

shephashcAtyarthamutsiktaM niHsRutau vRuShaNau bhRusham|
atashcaiva viparyAso vikRutyA pretalakShaNam||30||

nicitaM yasya mAMsaM syAttvagasthiShveva dRushyate|
kShINasyAnashnatastasya mAsamAyuH paraM bhavet||31||
<div style="text-align:justify;">
A weak, thirsty and dryness of mouth suffers from rigid and upward look of the eyes and persistent throbbing of the carotid region of the neck, will not survive for long.

If an emaciated person having prominent cheeks along with high fever, severe cough, colic and dislike for food will not cure from his ailments because no treatment suits him.

If there is a distortion of the head, tongue and face, drooping of eye brows and appearance of thorny coat over tongue, don’t treat such patients due to its ominous nature.

Whose penis is excessively long along with pendulous testicles or vice versa, such signs are indicative of death of a patient immediately.
In emaciated individual whose muscles are excessively undergone wasting with remnants of skin and bone does not survive more than one month.[27-31]
</div>
==== Summary ====

तत्र श्लोकः-
इदं लिङ्गमरिष्टाख्यमनेकमभिजज्ञिवान्|
आयुर्वेदविदित्याख्यां लभते कुशलो जनः||३२||

tatra ślōkaḥ-
idaṁ liṅgamariṣṭākhyamanēkamabhijajñivān|
āyurvēdavidityākhyāṁ labhatē kuśalō janaḥ||32||

tatra shlokaH-
idaM li~ggamariShTAkhyamanekamabhijaj~jivAn|
AyurvedavidityAkhyAM labhate kushalo janaH||32||

To summarize:

Who is well versed with the observation of above signs and symptoms which indicates imminent death, is entitled to be known as intelligent physician. [32]

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

*Shadow image in pupils, changes in complexion and luster should be examined to assess prognosis.
*Perception of distorted images of body parts or their absence are ominous signs.

=== ''Vidhi Vimarsha'' ===
<div style="text-align:justify;">
==== Role of ''Pancha-mahabhuta'' in complexion and luster ====
Following cross references are important to be re-visited to assess the role of ''pancha-mahabhuta'', especially ''tejas mahabhuta'' in complexion and luster.
*''Tejas mahabhuta'' promote luster complexion, strength, energy, power, digestive fire, and vitality. It also alleviates all ''vatika'' diseases and sustains youthful age. (Su.Chi.38/50)
*The normal watery rasa converted to reddish color by ''pitta'' is ''rakta'' and its equilibrium brings health. (Su.Su.14/5)
*Qualities of ''Pancha-mahabhuta'' are:
**Qualities of ''Akasha'' are- sound, auditory organ, all orifices and distinctness.
**Qualities of ''Vayu'' are – touch tactile organ, all activities, movements in all body parts and lightness.
**Qualities of ''Tejas'' are – vision, visual organ, complexion, heat, splendor, digestion, intolerance, sharpness and valor.
**Qualities of ''Apa'' are- taste, gustatory organ, all liquidity, heaviness, coldness, unctuousness and semen and
**Qualities of ''Parthiva'' (i.e., those that have qualities of the ''prithvi'' element) are- smell, olfactory organ, hardness and heaviness.(Su.Sha.1/19)
*''Tejas'' element is the causative factor of complexion when at the time of conception, it is predominantly associated with ''apa'' element, it makes the fetus fair- complexioned, predominance in ''parthivi'' elements causes black one. That in ''parthivi'' and ''akasha'' elements gives to black- sky complexion while predominance in ''apa'' and ''akasha'' elements makes fair-sky complexion of fetus. If ''tejas'' does not reach the visual organ, it makes the fetus born blind, the same associated with blood makes red eyed, that associated with ''pitta'' and ''kapha'' makes yellow- eyed and white-eyed respectively, if associated with ''vata'' it causes deformity in eyes.
*''Jatharagni'' is the primary factor for sustenance of life, color, strength, health, enthusiasm, plumpness, complexion, ''ojas, tejas,'' ''agni'' and ''prana''.
*To seethings devoid of their real characteristics - e.g., bright things looking dull and lusterless - indicates impending death of the patient.
*''Pannarupi'' implies something whose form or aspect has disappeared. ''Pannarupam'' , the word, has been derived from ''apannarupam,'' implies ill-formed or confused in respect of shape.
*Any alterations in ''chhaya'' (complexion) and ''prabha'' (luster) denotes the ominous sign for the patient.
*The process of dying usually begins well before death actually occurs. Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination. As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality. The journey ultimately leads to the physical departure from the body.

==== Sign of Imminent Death ====

#Patient who is suffering from ''kamala'', swelling in face, wasting in temples, and terrifying appearance with high fever has grave prognosis.
#Patient who faints again and again while being lifted from bed may not survive for a week. This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, such as fearing hidden enemies or feeling invincible. The dying person may also experience hallucinations, sometimes seeing or speaking to people that are not there or died in the past. Some may see this as the veil being lifted between this life and the next. The person may pick at their sheets and clothing in a state of agitation. Movements and actions may seem aimless and make no sense to others. They are moving further away from life to this earth.
#At the end of life, patients often lose interest in eating and drinking because the body is conserving its energy and no longer requires the same level of nourishment. It is important to let each individual decide how much, even if it is little or nothing, that he or she wishes to eat or drink. Family members should not force food or drink, as it will only make their loved one feel uncomfortable or upset. Near the end of life, patients no longer feel hunger pangs and forcing them to eat may actually cause nausea and abdominal pain. Eventually, the patient may become entirely unable to swallow food and fluids. Frequent mouth care will be given to help prevent dry mouth.
#When the body prepares to die, a decrease in urine production and loss of bladder and bowel control are noted. The urine may appear dark because the patient is not as hydrated and there is less circulation in the kidneys.
#Fluids may collect in a dying person’s throat and lungs. Because he or she is unable to swallow or cough up this fluid, he or she may make a gurgling noise. The noise may be worrisome to family members, but it is common and rarely uncomfortable for the patient. Elevating and repositioning the head may help to relieve some of the congestion.
#As cardiac output and intravascular volume decrease at the end of life, there will be evidence of diminished peripheral blood perfusion. Tachycardia, hypotension, peripheral cooling, peripheral and central cyanosis, and mottling of the skin (livedo reticularis) are expected. Venous blood may pool along dependent skin surfaces. Urine output falls as perfusion of the kidneys diminishes.

In parapsychology and many forms of spiritual practice, an aura is a field of subtle, luminous radiation surrounding a person or object (like the halo oraureola in religious art). <ref>Aura (paranormal); From Wikipedia, the free encyclopedia; available at http://en.wikipedia.org/wiki/Aura_(paranormal)</ref>,
<ref>How to see and READ the AURA: Part 1; available at http://www.thiaoouba.com/seeau.htm</ref>
</div>
=== Glossary ===
{| class="wikitable"
|-
| पन्नरूपीय || Destruction/loss of images
|-
| च्छाया || Complexion
|-
| प्रतिच्छाया || Shadow
|-
| प्रभाl || ustre
|-
| कुमारिका || Pupil
|-
| वर्णप्रकाशिनी || illuminates complexion
|-
| सलिलादर्शयोरपि || Moon light
|-
| छिन्ना भिन्ना || Broken, Torn
|-
| विकृता विशिरा || Bifurcated, deformed
|-
| कर्शित || Emaciated
|-
| प्रेत || Ghost
|-
| मुमूर्षतां || Morbidity
|-
| प्रकूजति प्रश्वसिति || Dyspnoea
|-
| प्राणवर्धनम् || Vitality
|-
| सुषमा || Symmetrical
|-
| विषमा || Asymmetrical
|-
| मध्य || Medium
|-
| मल्पं || Short
|-
| महच्चोक्तं || large
|-
| सप्रभेव || lustrous shadow
|-
| दर्शनप्रिया || Pleasing to the eyes
|-
| विनाशाय || Great calamities
|-
| क्लेशाय || Miseries
|-
| स्युर्विकासिन्यः || Emanative
|-
| स्निग्धाश्च || Unctuous
|-
| विपुलाश्च || Auspicious
|-
| र्मुखं पूर्णं || Swelling in face
|-
| शङ्खयोर्मुक्तमांसता || Wasting in temples
|-
| सन्त्रास || Terrifying in appearance
|-
| उत्थाप्यमानः || Lifted from bed
|-
| ल्पमश्नतः || Consumption of little quantity of food
|-
| बहु मूत्रपुरीषं || Excretes large amount of stool and urine
|-
| प्रकूजति प्रश्वसिति || Shallow respiration
|-
| व्याविद्धं स्पन्दते || Irregular twitching
|-
| मन्ये चारतकम्पने || Throbbing of the carotid region
|-
| निःसृतौ वृषणौ || Pendulous testicles
|-
| मरिष्टा || Imminent death
|-
| वर्ण || Complexion
|-
| बलोत्साह || Strength, energy
|-
| वयःस्थापनमुत्तमम् || Sustains youthful age
|-
| शब्दः || Sound
|-
| शब्देन्द्रियं || Auditory organ
|-
| सर्वच्छिद्रसमूहो || All orifices
|-
| विविक्तता || Distinctness
|-
| स्पर्शः || Touch
|-
| स्पर्शेन्द्रियं || Tactile organ
|-
| सर्वचेष्टासमूहः || All activities
|-
| सर्वशरीरस्पन्दनं || Movement in all body parts
|-
| लघुता || lightness
|-
| रूपं || Vision
|-
| रूपेन्द्रियं || Visual organ
|-
| भ्राजिष्णुता || Splendour
|-
| मर्ष || Intolerance
|-
| शौर्यं || Valour
|-
| रसनेन्द्रियं || Gustatory organ
|-
| सर्वद्रवसमूहो || All liquidity
|-
| गुरुता || Heaviness
|-
| स्नेहो || Unctuousnes
|-
| रेतश्च || Semen
|-
| गन्धेन्द्रियं || Olfactory organ
|-
| सर्वमूर्तसमूहो || Hardness
|-
|}

=== References ===

<references/>

Pannarupiya

2017-12-26T13:09:38Z

Vinay Exafluence: /* References */

{{Infobox
|title = Pannarupiya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 7
|label2 = Preceding Chapter
|data2 = [[Kathamanasharireeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 7 ==

=== Abstract ===

The seventh chapter [[Pannarupiya]] deals with the loss of shadow image in eyes, changes in complexion and luster indicative of imminent death. Difference between shadow and luster is also explained in this chapter with characteristic features of shadows pertaining to each of ''pancha mahabhuta''. The chapter focuses on fatal prognostic features related to complexion and luster.

Keywords: shadow image, complexion, luster, ''chhaya, varna, prabha''.

=== Introduction ===

If there is any distortion in the image of the examiner reflected as a shadow in the pupil of the patient, should be considered as a sign of imminent death of the patient. ''Nimittanurupa vikriti'' (image pertaining to death) will serve as a yard stick to measure the span of life.

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

पन्नरूपीयेन्द्रियोपक्रमः
अथातः पन्नरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pannarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pannarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter on the signs of imminent death as indicated by the distortion of the image reflected in the pupil.[1-2]

==== Loss of shadow image in eyes ====

दृष्ट्यां यस्य विजानीयात् पन्नरूपां कुमारिकाम्|
प्रतिच्छायामयीमक्ष्णोर्नैनमिच्छेच्चिकित्सितुम्||३||

dr̥ṣṭyāṁ yasya vijānīyāt pannarūpāṁ kumārikām|
praticchāyāmayīmakṣṇōrnainamicchēccikitsitum||3||

dRuShTyAM yasya vijAnIyAt pannarUpAM kumArikAm|
praticchAyAmayImakShNornainamiccheccikitsitum||3||

The condition in which loss of shadow image is observed in the pupil (eyes) of the patient, should be discarded for treatment.[3]

==== Features of fatal prognosis as per shadows ====

ज्योत्स्नायामातपे दीपे सलिलादर्शयोरपि|
अङ्गेषु विकृता यस्य च्छाया प्रेतस्तथैव सः||४||

jyōtsnāyāmātapē dīpē salilādarśayōrapi|
aṅgēṣu vikr̥tā yasya cchāyā prētastathaiva saḥ||4||

jyotsnAyAmAtape dIpe salilAdarshayorapi|
a~ggeShu vikRutA yasya cchAyA pretastathaiva saH||4||

If any sorts of deformity observed in body parts in the shadow of the person in moonlight, sunlight, light of a lamp, water or mirror. He should be considered as dead. [4]

छिन्ना भिन्नाऽऽकुला च्छाया हीना वाऽप्यधिकाऽपि वा|
नष्टा तन्वी द्विधा च्छिन्ना विकृता विशिरा च या||५||

एताश्चान्याश्च याः काश्चित् प्रतिच्छाया विगर्हिताः|
सर्वा मुमूर्षतां ज्ञेया न चेल्लक्ष्यनिमित्तजाः||६||

chinnā bhinnā''kulā cchāyā hīnā vā'pyadhikā'pi vā|
naṣṭā tanvī dvidhā cchinnā vikr̥tā viśirā ca yā||5||

ētāścānyāśca yāḥ kāścit praticchāyā vigarhitāḥ|
sarvā mumūrṣatāṁ jñēyā na cēllakṣyanimittajāḥ||6||

chinnA bhinnA~a~akulA cchAyA hInA vA~apyadhikA~api vA|
naShTA tanvI dvidhA cchinnA vikRutA vishirA ca yA||5||

etAshcAnyAshca yAH kAshcit praticchAyA vigarhitAH|
sarvA mumUrShatAM j~jeyA na cellakShyanimittajAH||6||

Observation of shadow of a patient as broken, torn, hazy, devoid of certain organs, seeing excess organs, not conspicuous, bifurcated, deformed and without head, such other similar abnormal shadows if develops without any apparent cause it is considered as severe morbidity.[5-6]

संस्थानेन प्रमाणेन वर्णेन प्रभया तथा|
छाया विवर्तते यस्य स्वस्थोऽपि प्रेत एव सः||७||

saṁsthānēna pramāṇēna varṇēna prabhayā tathā|
chāyā vivartatē yasya svasthō'pi prēta ēva saḥ||7||

saMsthAnena pramANena varNena prabhayA tathA|
chAyA vivartate yasya svastho~api preta eva saH||7||

Distortion of shadow in respect of changes in shape, measurement, colour and lustre should be considered as ominous sign even in healthy individual.[7]

संस्थानमाकृतिर्ज्ञेया सुषमा विषमा च सा|
मध्यमल्पं महच्चोक्तं प्रमाणं त्रिविधं नृणाम्||८||

प्रतिप्रमाणसंस्थाना जलादर्शातपादिषु|
छाया या सा प्रतिच्छाया च्छाया वर्णप्रभाश्रया||९||

saṁsthānamākr̥tirjñēyā suṣamā viṣamā ca sā|
madhyamalpaṁ mahaccōktaṁ pramāṇaṁ trividhaṁ nr̥ṇām||8||

pratipramāṇasaṁsthānā jalādarśātapādiṣu|
chāyā yā sā praticchāyā cchāyā varṇaprabhāśrayā||9||

saMsthAnamAkRutirj~jeyA suShamA viShamA ca sA|
madhyamalpaM mahaccoktaMpramANaM trividhaM nRuNAm||8||

pratipramANasaMsthAnA jalAdarshAtapAdiShu|
chAyA yA sA praticchAyA cchAyA varNaprabhAshrayA||9||

The term ''sansthana'' means shape which may be symmetrical or asymmetrical.
Measurement is of three kinds namely short, medium, and large The image reflected in water, mirror, etc., corresponding to the measurement and shape of the body of the individual is known as ''praticchhaya'' which is nothing but reflected shadow based on the color and luster of the individual.[8-9]

==== Features of Shadow of ''Pancha-Mahabhuta'' ====

खादीनां पञ्च पञ्चानां छाया विविधलक्षणाः|
नाभसी निर्मला नीला सस्नेहा सप्रभेव च||१०||

रूक्षा श्यावारुणा या तु वायवी सा हतप्रभा|
विशुद्धरक्ता त्वाग्नेयी दीप्ताभा दर्शनप्रिया||११||

शुद्धवैदूर्यविमला सुस्निग्धा चाम्भसी मता|
स्थिरा स्निग्धा घना श्लक्ष्णा श्यामा श्वेता च पार्थिवी||१२||

वायवी गर्हिता त्वासां चतस्रः स्युः सुखोदयाः |
वायवी तु विनाशाय क्लेशाय महतेऽपि वा||१३||

khādīnāṁ pañca pañcānāṁ chāyā vividhalakṣaṇāḥ|
nābhasī nirmalā nīlā sasnēhā saprabhēva ca||10||

rūkṣā śyāvāruṇā yā tu vāyavī sā hataprabhā|
viśuddharaktā tvāgnēyī dīptābhā darśanapriyā||11||

śuddhavaidūryavimalā susnigdhā cāmbhasī matā|
sthirā snigdhā ghanā ślakṣṇā śyāmā śvētā ca pārthivī||12||

vāyavī garhitā tvāsāṁ catasraḥ syuḥ sukhōdayāḥ |
vāyavī tu vināśāya klēśāya mahatē'pi vā||13||

khAdInAM pa~jca pa~jcAnAM chAyA vividhalakShaNAH|
nAbhasI nirmalA nIlA sasnehA saprabheva ca||10||

rUkShA shyAvAruNA yA tu vAyavI sA hataprabhA|
vishuddharaktA tvAgneyI dIptAbhA darshanapriyA||11||

shuddhavaidUryavimalA susnigdhA cAmbhasI matA|
sthirA snigdhAghanA shlakShNA shyAmA shvetA ca pArthivI||12||

vAyavI garhitA tvAsAM catasraH syuH sukhodayAH |
vAyavI tu vinAshAya kleshAya mahate~api vA||13||

The following are the distinctive characteristic features of shadows pertaining to each of the five great elements.
====Table 1: Shadows of Pancha-Mahabhuta:====
{| class="wikitable"
! rowspan="1"| S.No
! rowspan="1"| Mahabhuta
! rowspan="1"| Distinctive characteristic features of shadows
|-
| 1 || Akash Bhoota || Clear , blue, unctuous and lustrous shadow
|-
| 2.|| Vayu Bhoota || Dry, brown, and reddish
|-
| 3.|| Agni Bhoota || Bright red, brilliant and pleasing to the eyes
|-
| 4.|| Jala Bhoota || Clear like cat’s eye, and excessive unctuous
|-
| 5.|| Prithvi Bhoota || Stable, unctuous, compact, smooth, black and white
|-
|}

The shadow pertaining to ''vayu bhuta'' is of inferior in nature whereas the remaining four are indicative of pleasure and happiness. ''Vayu bhuta'' shadows indicative of great calamities and miseries.[10-13]

स्यात्तैजसी प्रभा सर्वा सा तु सप्तविधा स्मृता|
रक्ता पीता सिता श्यावा हरिता पाण्डुराऽसिता||१४||

तासां याः स्युर्विकासिन्यः स्निग्धाश्च विपुलाश्च याः|
ताः शुभा रूक्षमलिनाः सङ्क्षिप्ताश्चाशुभोदयाः ||१५||

syāttaijasī prabhā sarvā sā tu saptavidhā smr̥tā|
raktā pītā sitā śyāvā haritā pāṇḍurā'sitā||14||

tāsāṁ yāḥ syurvikāsinyaḥ snigdhāśca vipulāśca yāḥ|
tāḥ śubhā rūkṣamalināḥ saṅkṣiptāścāśubhōdayāḥ ||15||

syAttaijasI prabhA sarvA sA tu saptavidhA smRutA|
raktA pItA sitA shyAvA haritA pANDurA~asitA||14||

tAsAM yAH syurvikAsinyaH snigdhAshca vipulAshca yAH|
tAH shubhA rUkShamalinAH sa~gkShiptAshcAshubhodayAH||15||

All varieties of luster are constituted of ''tejas bhuta''. They are classified as seven type’s namely red, yellow, white, brown, green, pale yellowish and black. Of them which are emanative, unctuous, and dense are auspicious and those others which are dry, dirty and thin are inauspicious.[14-15]

==== Difference between ''Chhaya'' (shadow) and ''Prabha''(lustre) ====

वर्णमाक्रामति च्छाया भास्तु वर्णप्रकाशिनी|
आसन्ना लक्ष्यते च्छाया भाः प्रकृष्टा प्रकाशते||१६||

नाच्छायो नाप्रभः कश्चिद्विशेषाश्चिह्नयन्ति तु|
नृणां शुभाशुभोत्पत्तिं काले छायाप्रभाश्रयाः||१७||

varṇamākrāmati cchāyā bhāstu varṇaprakāśinī|
āsannā lakṣyatē cchāyā bhāḥ prakr̥ṣṭā prakāśatē||16||

nācchāyō nāprabhaḥ kaścidviśēṣāścihnayanti tu|
nr̥ṇāṁ śubhāśubhōtpattiṁ kālē chāyāprabhāśrayāḥ||17||

varNamAkrAmati cchAyA bhAstu varNaprakAshinI|
AsannA lakShyate cchAyA bhAH prakRuShTA prakAshate||16||

nAcchAyo nAprabhaH kashcidvisheShAshcihnayanti tu|
nRuNAM shubhAshubhotpattiM kAle chAyAprabhAshrayAH||17||

The shadow decreases the complexion of the body whereas the lustre illuminates. The shadow can be observed from nearby whereas lustre illuminates from a distance. There is nothing devoid of lustre or shadow. Certain distinctive features of the shadow and the lustre when mature indicates emergence of inauspicious or auspicious results in relation to human beings. [16-17]

==== Fatal signs ====

कामलाऽक्ष्णोर्मुखं पूर्णं शङ्खयोर्मुक्तमांसता|
सन्त्रासश्चोष्णगात्रत्वं यस्य तं परिवर्जयेत्||१८||

उत्थाप्यमानः शयनात् प्रमोहं याति यो नरः|
मुहुर्मुहुर्न सप्ताहं स जीवति विकत्थनः ||१९||

संसृष्टा व्याधयो यस्य प्रतिलोमानुलोमगाः|
व्यापन्ना ग्रहणी प्रायः सोऽर्धमासं न जीवति||२०||

kāmalā'kṣṇōrmukhaṁ pūrṇaṁ śaṅkhayōrmuktamāṁsatā|
santrāsaścōṣṇagātratvaṁ yasya taṁ parivarjayēt||18||

utthāpyamānaḥ śayanāt pramōhaṁ yāti yō naraḥ|
muhurmuhurna saptāhaṁ sa jīvati vikatthanaḥ ||19||

saṁsr̥ṣṭā vyādhayō yasya pratilōmānulōmagāḥ|
vyāpannā grahaṇī prāyaḥ sō'rdhamāsaṁ na jīvati||20||

kAmalA~akShNormukhaM pUrNaM sha~gkhayormuktamAMsatA|
santrAsashcoShNagAtratvaM yasya taM parivarjayet||18||

utthApyamAnaH shayanAt pramohaM yAti yo naraH|
muhurmuhurna saptAhaM sa jIvati vikatthanaH ||19||

saMsRuShTA vyAdhayo yasya pratilomAnulomagAH|
vyApannA grahaNI prAyaH so~ardhamAsaM na jIvati||20||

Patient who is suffering from ''kamala'', swelling of face, wasting in temples and terrifying appearance with high fever such patient should be discarded for management.

Patient who faints again and again while being lifted from bed cannot survive for a week.
The patient afflicted with multiple ''doshas'' having movements in upward, downward both directions along with disordered ''grahani''(Duodenum and Small intestine) cannot survive for longer than for a fortnight.[18-20]

उपरुद्धस्य रोगेण कर्शितस्याल्पमश्नतः|
बहु मूत्रपुरीषं स्याद्यस्य तं परिवर्जयेत्||२१||

दुर्बलो बहु भुङ्क्ते यः प्राग्भुक्तादन्नमातुरः |
अल्पमूत्रपुरीषश्च यथा प्रेतस्तथैव सः||२२||

इष्टं च गुणसम्पन्नमन्नमश्नाति यो नरः|
शश्वच्च बलवर्णाभ्यां हीयते न स जीवति||२३||

प्रकूजति प्रश्वसिति शिथिलं चातिसार्यते|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२४||

ह्रस्वं च यः प्रश्वसिति व्याविद्धं स्पन्दते च यः|
मृतमेव तमात्रेयो व्याचचक्षे पुनर्वसुः||२५||

ऊर्ध्वं च यः प्रश्वसिति श्लेष्मणा चाभिभूयते|
हीनवर्णबलाहारो यो नरो न स जीवति||२६||

uparuddhasya rōgēṇa karśitasyālpamaśnataḥ|
bahu mūtrapurīṣaṁ syādyasya taṁ parivarjayēt||21||

durbalō bahu bhuṅktē yaḥ prāgbhuktādannamāturaḥ |
alpamūtrapurīṣaśca yathā prētastathaiva saḥ||22||

iṣṭaṁ ca guṇasampannamannamaśnāti yō naraḥ|
śaśvacca balavarṇābhyāṁ hīyatē na sa jīvati||23||

prakūjati praśvasiti śithilaṁ cātisāryatē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||24||

hrasvaṁ ca yaḥ praśvasiti vyāviddhaṁ spandatē ca yaḥ|
mr̥tamēva tamātrēyō vyācacakṣē punarvasuḥ||25||

ūrdhvaṁ ca yaḥ praśvasiti ślēṣmaṇā cābhibhūyatē|
hīnavarṇabalāhārō yō narō na sa jīvati||26||

uparuddhasya rogeNa karshitasyAlpamashnataH|
bahu mUtrapurIShaM syAdyasya taM parivarjayet||21||

durbalo bahu bhu~gkte yaH prAgbhuktAdannamAturaH |
alpamUtrapurIShashca yathA pretastathaiva saH||22||

iShTaM ca guNasampannamannamashnAti yo naraH|
shashvacca balavarNAbhyAM hIyate na sa jIvati||23||

prakUjati prashvasiti shithilaM cAtisAryate|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||24||

hrasvaM ca yaH prashvasiti vyAviddhaM spandate ca yaH|
mRutameva tamAtreyo vyAcacakShe punarvasuH||25||

UrdhvaM ca yaH prashvasiti shleShmaNA cAbhibhUyate|
hInavarNabalAhAro yo naro na sa jIvati||26||

Consumption of little quantity of food by emaciated person but excretes large amount of urine and stool should be discarded for management.

Consumption of excess quantity of food by weak patient but passes scanty urine and stool should be considered as ghost or almost dead.
In spite of taking suitable diet if person constantly loose strength and complexion indicates bad prognosis.
If a person who is weak, thirsty and having dryness of mouth, if suffers from groaning, dyspnea and diarrhea, then it should not be treated because he will not survive.

If patient is suffering from shallow respiration with irregular twitching in the body is said to be severe fatal condition like almost dead.
Person who is suffering from respiratory distress with abundance of ''kapha'' along with diminution of complexion, strength and less intake of food will not survive for longer.[21-26]

ऊर्ध्वाग्रे नयने यस्य मन्ये चारतकम्पने|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२७||

यस्य गण्डावुपचितौ ज्वरकासौ च दारुणौ|
शूली प्रद्वेष्टि चाप्यन्नं तस्मिन् कर्म न सिध्यति||२८||

व्यावृत्तमूर्धजिह्वास्यो भ्रुवौ यस्य च विच्युते|
कण्टकैश्चाचिता जिह्वा यथा प्रेतस्तथैव सः||२९||

शेफश्चात्यर्थमुत्सिक्तं निःसृतौ वृषणौ भृशम्|
अतश्चैव विपर्यासो विकृत्या प्रेतलक्षणम्||३०||

निचितं यस्य मांसं स्यात्त्वगस्थिष्वेव दृश्यते|
क्षीणस्यानश्नतस्तस्य मासमायुः परं भवेत्||३१||

ūrdhvāgrē nayanē yasya manyē cāratakampanē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||27||

yasya gaṇḍāvupacitau jvarakāsau ca dāruṇau|
śūlī pradvēṣṭi cāpyannaṁ tasmin karma na sidhyati||28||

vyāvr̥ttamūrdhajihvāsyō bhruvau yasya ca vicyutē|
kaṇṭakaiścācitā jihvā yathā prētastathaiva saḥ||29||

śēphaścātyarthamutsiktaṁ niḥsr̥tau vr̥ṣaṇau bhr̥śam|
ataścaiva viparyāsō vikr̥tyā prētalakṣaṇam||30||

nicitaṁ yasya māṁsaṁ syāttvagasthiṣvēva dr̥śyatē|
kṣīṇasyānaśnatastasya māsamāyuḥ paraṁ bhavēt||31||

UrdhvAgre nayane yasya manye cAratakampane|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||27||

yasya gaNDAvupacitau jvarakAsau ca dAruNau|
shUlI pradveShTi cApyannaM tasmin karma na sidhyati||28||

vyAvRuttamUrdhajihvAsyo bhruvau yasya ca vicyute|
kaNTakaishcAcitA jihvA yathA pretastathaiva saH||29||

shephashcAtyarthamutsiktaM niHsRutau vRuShaNau bhRusham|
atashcaiva viparyAso vikRutyA pretalakShaNam||30||

nicitaM yasya mAMsaM syAttvagasthiShveva dRushyate|
kShINasyAnashnatastasya mAsamAyuH paraM bhavet||31||

A weak, thirsty and dryness of mouth suffers from rigid and upward look of the eyes and persistent throbbing of the carotid region of the neck, will not survive for long.

If an emaciated person having prominent cheeks along with high fever, severe cough, colic and dislike for food will not cure from his ailments because no treatment suits him.

If there is a distortion of the head, tongue and face, drooping of eye brows and appearance of thorny coat over tongue, don’t treat such patients due to its ominous nature.

Whose penis is excessively long along with pendulous testicles or vice versa, such signs are indicative of death of a patient immediately.
In emaciated individual whose muscles are excessively undergone wasting with remnants of skin and bone does not survive more than one month.[27-31]

==== Summary ====

तत्र श्लोकः-
इदं लिङ्गमरिष्टाख्यमनेकमभिजज्ञिवान्|
आयुर्वेदविदित्याख्यां लभते कुशलो जनः||३२||

tatra ślōkaḥ-
idaṁ liṅgamariṣṭākhyamanēkamabhijajñivān|
āyurvēdavidityākhyāṁ labhatē kuśalō janaḥ||32||

tatra shlokaH-
idaM li~ggamariShTAkhyamanekamabhijaj~jivAn|
AyurvedavidityAkhyAM labhate kushalo janaH||32||

To summarize:

Who is well versed with the observation of above signs and symptoms which indicates imminent death, is entitled to be known as intelligent physician. [32]

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

*Shadow image in pupils, changes in complexion and luster should be examined to assess prognosis.
*Perception of distorted images of body parts or their absence are ominous signs.

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

==== Role of ''Pancha-mahabhuta'' in complexion and luster ====
Following cross references are important to be re-visited to assess the role of ''pancha-mahabhuta'', especially ''tejas mahabhuta'' in complexion and luster.
*''Tejas mahabhuta'' promote luster complexion, strength, energy, power, digestive fire, and vitality. It also alleviates all ''vatika'' diseases and sustains youthful age. (Su.Chi.38/50)
*The normal watery rasa converted to reddish color by ''pitta'' is ''rakta'' and its equilibrium brings health. (Su.Su.14/5)
*Qualities of ''Pancha-mahabhuta'' are:
**Qualities of ''Akasha'' are- sound, auditory organ, all orifices and distinctness.
**Qualities of ''Vayu'' are – touch tactile organ, all activities, movements in all body parts and lightness.
**Qualities of ''Tejas'' are – vision, visual organ, complexion, heat, splendor, digestion, intolerance, sharpness and valor.
**Qualities of ''Apa'' are- taste, gustatory organ, all liquidity, heaviness, coldness, unctuousness and semen and
**Qualities of ''Parthiva'' (i.e., those that have qualities of the ''prithvi'' element) are- smell, olfactory organ, hardness and heaviness.(Su.Sha.1/19)
*''Tejas'' element is the causative factor of complexion when at the time of conception, it is predominantly associated with ''apa'' element, it makes the fetus fair- complexioned, predominance in ''parthivi'' elements causes black one. That in ''parthivi'' and ''akasha'' elements gives to black- sky complexion while predominance in ''apa'' and ''akasha'' elements makes fair-sky complexion of fetus. If ''tejas'' does not reach the visual organ, it makes the fetus born blind, the same associated with blood makes red eyed, that associated with ''pitta'' and ''kapha'' makes yellow- eyed and white-eyed respectively, if associated with ''vata'' it causes deformity in eyes.
*''Jatharagni'' is the primary factor for sustenance of life, color, strength, health, enthusiasm, plumpness, complexion, ''ojas, tejas,'' ''agni'' and ''prana''.
*To seethings devoid of their real characteristics - e.g., bright things looking dull and lusterless - indicates impending death of the patient.
*''Pannarupi'' implies something whose form or aspect has disappeared. ''Pannarupam'' , the word, has been derived from ''apannarupam,'' implies ill-formed or confused in respect of shape.
*Any alterations in ''chhaya'' (complexion) and ''prabha'' (luster) denotes the ominous sign for the patient.
*The process of dying usually begins well before death actually occurs. Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination. As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality. The journey ultimately leads to the physical departure from the body.

==== Sign of Imminent Death ====

#Patient who is suffering from ''kamala'', swelling in face, wasting in temples, and terrifying appearance with high fever has grave prognosis.
#Patient who faints again and again while being lifted from bed may not survive for a week. This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, such as fearing hidden enemies or feeling invincible. The dying person may also experience hallucinations, sometimes seeing or speaking to people that are not there or died in the past. Some may see this as the veil being lifted between this life and the next. The person may pick at their sheets and clothing in a state of agitation. Movements and actions may seem aimless and make no sense to others. They are moving further away from life to this earth.
#At the end of life, patients often lose interest in eating and drinking because the body is conserving its energy and no longer requires the same level of nourishment. It is important to let each individual decide how much, even if it is little or nothing, that he or she wishes to eat or drink. Family members should not force food or drink, as it will only make their loved one feel uncomfortable or upset. Near the end of life, patients no longer feel hunger pangs and forcing them to eat may actually cause nausea and abdominal pain. Eventually, the patient may become entirely unable to swallow food and fluids. Frequent mouth care will be given to help prevent dry mouth.
#When the body prepares to die, a decrease in urine production and loss of bladder and bowel control are noted. The urine may appear dark because the patient is not as hydrated and there is less circulation in the kidneys.
#Fluids may collect in a dying person’s throat and lungs. Because he or she is unable to swallow or cough up this fluid, he or she may make a gurgling noise. The noise may be worrisome to family members, but it is common and rarely uncomfortable for the patient. Elevating and repositioning the head may help to relieve some of the congestion.
#As cardiac output and intravascular volume decrease at the end of life, there will be evidence of diminished peripheral blood perfusion. Tachycardia, hypotension, peripheral cooling, peripheral and central cyanosis, and mottling of the skin (livedo reticularis) are expected. Venous blood may pool along dependent skin surfaces. Urine output falls as perfusion of the kidneys diminishes.

In parapsychology and many forms of spiritual practice, an aura is a field of subtle, luminous radiation surrounding a person or object (like the halo oraureola in religious art). <ref>Aura (paranormal); From Wikipedia, the free encyclopedia; available at http://en.wikipedia.org/wiki/Aura_(paranormal)</ref>,
<ref>How to see and READ the AURA: Part 1; available at http://www.thiaoouba.com/seeau.htm</ref>

=== Glossary ===
{| class="wikitable"
|-
| पन्नरूपीय || Destruction/loss of images
|-
| च्छाया || Complexion
|-
| प्रतिच्छाया || Shadow
|-
| प्रभाl || ustre
|-
| कुमारिका || Pupil
|-
| वर्णप्रकाशिनी || illuminates complexion
|-
| सलिलादर्शयोरपि || Moon light
|-
| छिन्ना भिन्ना || Broken, Torn
|-
| विकृता विशिरा || Bifurcated, deformed
|-
| कर्शित || Emaciated
|-
| प्रेत || Ghost
|-
| मुमूर्षतां || Morbidity
|-
| प्रकूजति प्रश्वसिति || Dyspnoea
|-
| प्राणवर्धनम् || Vitality
|-
| सुषमा || Symmetrical
|-
| विषमा || Asymmetrical
|-
| मध्य || Medium
|-
| मल्पं || Short
|-
| महच्चोक्तं || large
|-
| सप्रभेव || lustrous shadow
|-
| दर्शनप्रिया || Pleasing to the eyes
|-
| विनाशाय || Great calamities
|-
| क्लेशाय || Miseries
|-
| स्युर्विकासिन्यः || Emanative
|-
| स्निग्धाश्च || Unctuous
|-
| विपुलाश्च || Auspicious
|-
| र्मुखं पूर्णं || Swelling in face
|-
| शङ्खयोर्मुक्तमांसता || Wasting in temples
|-
| सन्त्रास || Terrifying in appearance
|-
| उत्थाप्यमानः || Lifted from bed
|-
| ल्पमश्नतः || Consumption of little quantity of food
|-
| बहु मूत्रपुरीषं || Excretes large amount of stool and urine
|-
| प्रकूजति प्रश्वसिति || Shallow respiration
|-
| व्याविद्धं स्पन्दते || Irregular twitching
|-
| मन्ये चारतकम्पने || Throbbing of the carotid region
|-
| निःसृतौ वृषणौ || Pendulous testicles
|-
| मरिष्टा || Imminent death
|-
| वर्ण || Complexion
|-
| बलोत्साह || Strength, energy
|-
| वयःस्थापनमुत्तमम् || Sustains youthful age
|-
| शब्दः || Sound
|-
| शब्देन्द्रियं || Auditory organ
|-
| सर्वच्छिद्रसमूहो || All orifices
|-
| विविक्तता || Distinctness
|-
| स्पर्शः || Touch
|-
| स्पर्शेन्द्रियं || Tactile organ
|-
| सर्वचेष्टासमूहः || All activities
|-
| सर्वशरीरस्पन्दनं || Movement in all body parts
|-
| लघुता || lightness
|-
| रूपं || Vision
|-
| रूपेन्द्रियं || Visual organ
|-
| भ्राजिष्णुता || Splendour
|-
| मर्ष || Intolerance
|-
| शौर्यं || Valour
|-
| रसनेन्द्रियं || Gustatory organ
|-
| सर्वद्रवसमूहो || All liquidity
|-
| गुरुता || Heaviness
|-
| स्नेहो || Unctuousnes
|-
| रेतश्च || Semen
|-
| गन्धेन्द्रियं || Olfactory organ
|-
| सर्वमूर्तसमूहो || Hardness
|-
|}

=== References ===

<references/>

Pannarupiya

2017-12-26T13:08:53Z

Vinay Exafluence: /* Sign of Imminent Death */

{{Infobox
|title = Pannarupiya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 7
|label2 = Preceding Chapter
|data2 = [[Kathamanasharireeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 7 ==

=== Abstract ===

The seventh chapter [[Pannarupiya]] deals with the loss of shadow image in eyes, changes in complexion and luster indicative of imminent death. Difference between shadow and luster is also explained in this chapter with characteristic features of shadows pertaining to each of ''pancha mahabhuta''. The chapter focuses on fatal prognostic features related to complexion and luster.

Keywords: shadow image, complexion, luster, ''chhaya, varna, prabha''.

=== Introduction ===

If there is any distortion in the image of the examiner reflected as a shadow in the pupil of the patient, should be considered as a sign of imminent death of the patient. ''Nimittanurupa vikriti'' (image pertaining to death) will serve as a yard stick to measure the span of life.

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

पन्नरूपीयेन्द्रियोपक्रमः
अथातः पन्नरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pannarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pannarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter on the signs of imminent death as indicated by the distortion of the image reflected in the pupil.[1-2]

==== Loss of shadow image in eyes ====

दृष्ट्यां यस्य विजानीयात् पन्नरूपां कुमारिकाम्|
प्रतिच्छायामयीमक्ष्णोर्नैनमिच्छेच्चिकित्सितुम्||३||

dr̥ṣṭyāṁ yasya vijānīyāt pannarūpāṁ kumārikām|
praticchāyāmayīmakṣṇōrnainamicchēccikitsitum||3||

dRuShTyAM yasya vijAnIyAt pannarUpAM kumArikAm|
praticchAyAmayImakShNornainamiccheccikitsitum||3||

The condition in which loss of shadow image is observed in the pupil (eyes) of the patient, should be discarded for treatment.[3]

==== Features of fatal prognosis as per shadows ====

ज्योत्स्नायामातपे दीपे सलिलादर्शयोरपि|
अङ्गेषु विकृता यस्य च्छाया प्रेतस्तथैव सः||४||

jyōtsnāyāmātapē dīpē salilādarśayōrapi|
aṅgēṣu vikr̥tā yasya cchāyā prētastathaiva saḥ||4||

jyotsnAyAmAtape dIpe salilAdarshayorapi|
a~ggeShu vikRutA yasya cchAyA pretastathaiva saH||4||

If any sorts of deformity observed in body parts in the shadow of the person in moonlight, sunlight, light of a lamp, water or mirror. He should be considered as dead. [4]

छिन्ना भिन्नाऽऽकुला च्छाया हीना वाऽप्यधिकाऽपि वा|
नष्टा तन्वी द्विधा च्छिन्ना विकृता विशिरा च या||५||

एताश्चान्याश्च याः काश्चित् प्रतिच्छाया विगर्हिताः|
सर्वा मुमूर्षतां ज्ञेया न चेल्लक्ष्यनिमित्तजाः||६||

chinnā bhinnā''kulā cchāyā hīnā vā'pyadhikā'pi vā|
naṣṭā tanvī dvidhā cchinnā vikr̥tā viśirā ca yā||5||

ētāścānyāśca yāḥ kāścit praticchāyā vigarhitāḥ|
sarvā mumūrṣatāṁ jñēyā na cēllakṣyanimittajāḥ||6||

chinnA bhinnA~a~akulA cchAyA hInA vA~apyadhikA~api vA|
naShTA tanvI dvidhA cchinnA vikRutA vishirA ca yA||5||

etAshcAnyAshca yAH kAshcit praticchAyA vigarhitAH|
sarvA mumUrShatAM j~jeyA na cellakShyanimittajAH||6||

Observation of shadow of a patient as broken, torn, hazy, devoid of certain organs, seeing excess organs, not conspicuous, bifurcated, deformed and without head, such other similar abnormal shadows if develops without any apparent cause it is considered as severe morbidity.[5-6]

संस्थानेन प्रमाणेन वर्णेन प्रभया तथा|
छाया विवर्तते यस्य स्वस्थोऽपि प्रेत एव सः||७||

saṁsthānēna pramāṇēna varṇēna prabhayā tathā|
chāyā vivartatē yasya svasthō'pi prēta ēva saḥ||7||

saMsthAnena pramANena varNena prabhayA tathA|
chAyA vivartate yasya svastho~api preta eva saH||7||

Distortion of shadow in respect of changes in shape, measurement, colour and lustre should be considered as ominous sign even in healthy individual.[7]

संस्थानमाकृतिर्ज्ञेया सुषमा विषमा च सा|
मध्यमल्पं महच्चोक्तं प्रमाणं त्रिविधं नृणाम्||८||

प्रतिप्रमाणसंस्थाना जलादर्शातपादिषु|
छाया या सा प्रतिच्छाया च्छाया वर्णप्रभाश्रया||९||

saṁsthānamākr̥tirjñēyā suṣamā viṣamā ca sā|
madhyamalpaṁ mahaccōktaṁ pramāṇaṁ trividhaṁ nr̥ṇām||8||

pratipramāṇasaṁsthānā jalādarśātapādiṣu|
chāyā yā sā praticchāyā cchāyā varṇaprabhāśrayā||9||

saMsthAnamAkRutirj~jeyA suShamA viShamA ca sA|
madhyamalpaM mahaccoktaMpramANaM trividhaM nRuNAm||8||

pratipramANasaMsthAnA jalAdarshAtapAdiShu|
chAyA yA sA praticchAyA cchAyA varNaprabhAshrayA||9||

The term ''sansthana'' means shape which may be symmetrical or asymmetrical.
Measurement is of three kinds namely short, medium, and large The image reflected in water, mirror, etc., corresponding to the measurement and shape of the body of the individual is known as ''praticchhaya'' which is nothing but reflected shadow based on the color and luster of the individual.[8-9]

==== Features of Shadow of ''Pancha-Mahabhuta'' ====

खादीनां पञ्च पञ्चानां छाया विविधलक्षणाः|
नाभसी निर्मला नीला सस्नेहा सप्रभेव च||१०||

रूक्षा श्यावारुणा या तु वायवी सा हतप्रभा|
विशुद्धरक्ता त्वाग्नेयी दीप्ताभा दर्शनप्रिया||११||

शुद्धवैदूर्यविमला सुस्निग्धा चाम्भसी मता|
स्थिरा स्निग्धा घना श्लक्ष्णा श्यामा श्वेता च पार्थिवी||१२||

वायवी गर्हिता त्वासां चतस्रः स्युः सुखोदयाः |
वायवी तु विनाशाय क्लेशाय महतेऽपि वा||१३||

khādīnāṁ pañca pañcānāṁ chāyā vividhalakṣaṇāḥ|
nābhasī nirmalā nīlā sasnēhā saprabhēva ca||10||

rūkṣā śyāvāruṇā yā tu vāyavī sā hataprabhā|
viśuddharaktā tvāgnēyī dīptābhā darśanapriyā||11||

śuddhavaidūryavimalā susnigdhā cāmbhasī matā|
sthirā snigdhā ghanā ślakṣṇā śyāmā śvētā ca pārthivī||12||

vāyavī garhitā tvāsāṁ catasraḥ syuḥ sukhōdayāḥ |
vāyavī tu vināśāya klēśāya mahatē'pi vā||13||

khAdInAM pa~jca pa~jcAnAM chAyA vividhalakShaNAH|
nAbhasI nirmalA nIlA sasnehA saprabheva ca||10||

rUkShA shyAvAruNA yA tu vAyavI sA hataprabhA|
vishuddharaktA tvAgneyI dIptAbhA darshanapriyA||11||

shuddhavaidUryavimalA susnigdhA cAmbhasI matA|
sthirA snigdhAghanA shlakShNA shyAmA shvetA ca pArthivI||12||

vAyavI garhitA tvAsAM catasraH syuH sukhodayAH |
vAyavI tu vinAshAya kleshAya mahate~api vA||13||

The following are the distinctive characteristic features of shadows pertaining to each of the five great elements.
====Table 1: Shadows of Pancha-Mahabhuta:====
{| class="wikitable"
! rowspan="1"| S.No
! rowspan="1"| Mahabhuta
! rowspan="1"| Distinctive characteristic features of shadows
|-
| 1 || Akash Bhoota || Clear , blue, unctuous and lustrous shadow
|-
| 2.|| Vayu Bhoota || Dry, brown, and reddish
|-
| 3.|| Agni Bhoota || Bright red, brilliant and pleasing to the eyes
|-
| 4.|| Jala Bhoota || Clear like cat’s eye, and excessive unctuous
|-
| 5.|| Prithvi Bhoota || Stable, unctuous, compact, smooth, black and white
|-
|}

The shadow pertaining to ''vayu bhuta'' is of inferior in nature whereas the remaining four are indicative of pleasure and happiness. ''Vayu bhuta'' shadows indicative of great calamities and miseries.[10-13]

स्यात्तैजसी प्रभा सर्वा सा तु सप्तविधा स्मृता|
रक्ता पीता सिता श्यावा हरिता पाण्डुराऽसिता||१४||

तासां याः स्युर्विकासिन्यः स्निग्धाश्च विपुलाश्च याः|
ताः शुभा रूक्षमलिनाः सङ्क्षिप्ताश्चाशुभोदयाः ||१५||

syāttaijasī prabhā sarvā sā tu saptavidhā smr̥tā|
raktā pītā sitā śyāvā haritā pāṇḍurā'sitā||14||

tāsāṁ yāḥ syurvikāsinyaḥ snigdhāśca vipulāśca yāḥ|
tāḥ śubhā rūkṣamalināḥ saṅkṣiptāścāśubhōdayāḥ ||15||

syAttaijasI prabhA sarvA sA tu saptavidhA smRutA|
raktA pItA sitA shyAvA haritA pANDurA~asitA||14||

tAsAM yAH syurvikAsinyaH snigdhAshca vipulAshca yAH|
tAH shubhA rUkShamalinAH sa~gkShiptAshcAshubhodayAH||15||

All varieties of luster are constituted of ''tejas bhuta''. They are classified as seven type’s namely red, yellow, white, brown, green, pale yellowish and black. Of them which are emanative, unctuous, and dense are auspicious and those others which are dry, dirty and thin are inauspicious.[14-15]

==== Difference between ''Chhaya'' (shadow) and ''Prabha''(lustre) ====

वर्णमाक्रामति च्छाया भास्तु वर्णप्रकाशिनी|
आसन्ना लक्ष्यते च्छाया भाः प्रकृष्टा प्रकाशते||१६||

नाच्छायो नाप्रभः कश्चिद्विशेषाश्चिह्नयन्ति तु|
नृणां शुभाशुभोत्पत्तिं काले छायाप्रभाश्रयाः||१७||

varṇamākrāmati cchāyā bhāstu varṇaprakāśinī|
āsannā lakṣyatē cchāyā bhāḥ prakr̥ṣṭā prakāśatē||16||

nācchāyō nāprabhaḥ kaścidviśēṣāścihnayanti tu|
nr̥ṇāṁ śubhāśubhōtpattiṁ kālē chāyāprabhāśrayāḥ||17||

varNamAkrAmati cchAyA bhAstu varNaprakAshinI|
AsannA lakShyate cchAyA bhAH prakRuShTA prakAshate||16||

nAcchAyo nAprabhaH kashcidvisheShAshcihnayanti tu|
nRuNAM shubhAshubhotpattiM kAle chAyAprabhAshrayAH||17||

The shadow decreases the complexion of the body whereas the lustre illuminates. The shadow can be observed from nearby whereas lustre illuminates from a distance. There is nothing devoid of lustre or shadow. Certain distinctive features of the shadow and the lustre when mature indicates emergence of inauspicious or auspicious results in relation to human beings. [16-17]

==== Fatal signs ====

कामलाऽक्ष्णोर्मुखं पूर्णं शङ्खयोर्मुक्तमांसता|
सन्त्रासश्चोष्णगात्रत्वं यस्य तं परिवर्जयेत्||१८||

उत्थाप्यमानः शयनात् प्रमोहं याति यो नरः|
मुहुर्मुहुर्न सप्ताहं स जीवति विकत्थनः ||१९||

संसृष्टा व्याधयो यस्य प्रतिलोमानुलोमगाः|
व्यापन्ना ग्रहणी प्रायः सोऽर्धमासं न जीवति||२०||

kāmalā'kṣṇōrmukhaṁ pūrṇaṁ śaṅkhayōrmuktamāṁsatā|
santrāsaścōṣṇagātratvaṁ yasya taṁ parivarjayēt||18||

utthāpyamānaḥ śayanāt pramōhaṁ yāti yō naraḥ|
muhurmuhurna saptāhaṁ sa jīvati vikatthanaḥ ||19||

saṁsr̥ṣṭā vyādhayō yasya pratilōmānulōmagāḥ|
vyāpannā grahaṇī prāyaḥ sō'rdhamāsaṁ na jīvati||20||

kAmalA~akShNormukhaM pUrNaM sha~gkhayormuktamAMsatA|
santrAsashcoShNagAtratvaM yasya taM parivarjayet||18||

utthApyamAnaH shayanAt pramohaM yAti yo naraH|
muhurmuhurna saptAhaM sa jIvati vikatthanaH ||19||

saMsRuShTA vyAdhayo yasya pratilomAnulomagAH|
vyApannA grahaNI prAyaH so~ardhamAsaM na jIvati||20||

Patient who is suffering from ''kamala'', swelling of face, wasting in temples and terrifying appearance with high fever such patient should be discarded for management.

Patient who faints again and again while being lifted from bed cannot survive for a week.
The patient afflicted with multiple ''doshas'' having movements in upward, downward both directions along with disordered ''grahani''(Duodenum and Small intestine) cannot survive for longer than for a fortnight.[18-20]

उपरुद्धस्य रोगेण कर्शितस्याल्पमश्नतः|
बहु मूत्रपुरीषं स्याद्यस्य तं परिवर्जयेत्||२१||

दुर्बलो बहु भुङ्क्ते यः प्राग्भुक्तादन्नमातुरः |
अल्पमूत्रपुरीषश्च यथा प्रेतस्तथैव सः||२२||

इष्टं च गुणसम्पन्नमन्नमश्नाति यो नरः|
शश्वच्च बलवर्णाभ्यां हीयते न स जीवति||२३||

प्रकूजति प्रश्वसिति शिथिलं चातिसार्यते|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२४||

ह्रस्वं च यः प्रश्वसिति व्याविद्धं स्पन्दते च यः|
मृतमेव तमात्रेयो व्याचचक्षे पुनर्वसुः||२५||

ऊर्ध्वं च यः प्रश्वसिति श्लेष्मणा चाभिभूयते|
हीनवर्णबलाहारो यो नरो न स जीवति||२६||

uparuddhasya rōgēṇa karśitasyālpamaśnataḥ|
bahu mūtrapurīṣaṁ syādyasya taṁ parivarjayēt||21||

durbalō bahu bhuṅktē yaḥ prāgbhuktādannamāturaḥ |
alpamūtrapurīṣaśca yathā prētastathaiva saḥ||22||

iṣṭaṁ ca guṇasampannamannamaśnāti yō naraḥ|
śaśvacca balavarṇābhyāṁ hīyatē na sa jīvati||23||

prakūjati praśvasiti śithilaṁ cātisāryatē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||24||

hrasvaṁ ca yaḥ praśvasiti vyāviddhaṁ spandatē ca yaḥ|
mr̥tamēva tamātrēyō vyācacakṣē punarvasuḥ||25||

ūrdhvaṁ ca yaḥ praśvasiti ślēṣmaṇā cābhibhūyatē|
hīnavarṇabalāhārō yō narō na sa jīvati||26||

uparuddhasya rogeNa karshitasyAlpamashnataH|
bahu mUtrapurIShaM syAdyasya taM parivarjayet||21||

durbalo bahu bhu~gkte yaH prAgbhuktAdannamAturaH |
alpamUtrapurIShashca yathA pretastathaiva saH||22||

iShTaM ca guNasampannamannamashnAti yo naraH|
shashvacca balavarNAbhyAM hIyate na sa jIvati||23||

prakUjati prashvasiti shithilaM cAtisAryate|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||24||

hrasvaM ca yaH prashvasiti vyAviddhaM spandate ca yaH|
mRutameva tamAtreyo vyAcacakShe punarvasuH||25||

UrdhvaM ca yaH prashvasiti shleShmaNA cAbhibhUyate|
hInavarNabalAhAro yo naro na sa jIvati||26||

Consumption of little quantity of food by emaciated person but excretes large amount of urine and stool should be discarded for management.

Consumption of excess quantity of food by weak patient but passes scanty urine and stool should be considered as ghost or almost dead.
In spite of taking suitable diet if person constantly loose strength and complexion indicates bad prognosis.
If a person who is weak, thirsty and having dryness of mouth, if suffers from groaning, dyspnea and diarrhea, then it should not be treated because he will not survive.

If patient is suffering from shallow respiration with irregular twitching in the body is said to be severe fatal condition like almost dead.
Person who is suffering from respiratory distress with abundance of ''kapha'' along with diminution of complexion, strength and less intake of food will not survive for longer.[21-26]

ऊर्ध्वाग्रे नयने यस्य मन्ये चारतकम्पने|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२७||

यस्य गण्डावुपचितौ ज्वरकासौ च दारुणौ|
शूली प्रद्वेष्टि चाप्यन्नं तस्मिन् कर्म न सिध्यति||२८||

व्यावृत्तमूर्धजिह्वास्यो भ्रुवौ यस्य च विच्युते|
कण्टकैश्चाचिता जिह्वा यथा प्रेतस्तथैव सः||२९||

शेफश्चात्यर्थमुत्सिक्तं निःसृतौ वृषणौ भृशम्|
अतश्चैव विपर्यासो विकृत्या प्रेतलक्षणम्||३०||

निचितं यस्य मांसं स्यात्त्वगस्थिष्वेव दृश्यते|
क्षीणस्यानश्नतस्तस्य मासमायुः परं भवेत्||३१||

ūrdhvāgrē nayanē yasya manyē cāratakampanē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||27||

yasya gaṇḍāvupacitau jvarakāsau ca dāruṇau|
śūlī pradvēṣṭi cāpyannaṁ tasmin karma na sidhyati||28||

vyāvr̥ttamūrdhajihvāsyō bhruvau yasya ca vicyutē|
kaṇṭakaiścācitā jihvā yathā prētastathaiva saḥ||29||

śēphaścātyarthamutsiktaṁ niḥsr̥tau vr̥ṣaṇau bhr̥śam|
ataścaiva viparyāsō vikr̥tyā prētalakṣaṇam||30||

nicitaṁ yasya māṁsaṁ syāttvagasthiṣvēva dr̥śyatē|
kṣīṇasyānaśnatastasya māsamāyuḥ paraṁ bhavēt||31||

UrdhvAgre nayane yasya manye cAratakampane|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||27||

yasya gaNDAvupacitau jvarakAsau ca dAruNau|
shUlI pradveShTi cApyannaM tasmin karma na sidhyati||28||

vyAvRuttamUrdhajihvAsyo bhruvau yasya ca vicyute|
kaNTakaishcAcitA jihvA yathA pretastathaiva saH||29||

shephashcAtyarthamutsiktaM niHsRutau vRuShaNau bhRusham|
atashcaiva viparyAso vikRutyA pretalakShaNam||30||

nicitaM yasya mAMsaM syAttvagasthiShveva dRushyate|
kShINasyAnashnatastasya mAsamAyuH paraM bhavet||31||

A weak, thirsty and dryness of mouth suffers from rigid and upward look of the eyes and persistent throbbing of the carotid region of the neck, will not survive for long.

If an emaciated person having prominent cheeks along with high fever, severe cough, colic and dislike for food will not cure from his ailments because no treatment suits him.

If there is a distortion of the head, tongue and face, drooping of eye brows and appearance of thorny coat over tongue, don’t treat such patients due to its ominous nature.

Whose penis is excessively long along with pendulous testicles or vice versa, such signs are indicative of death of a patient immediately.
In emaciated individual whose muscles are excessively undergone wasting with remnants of skin and bone does not survive more than one month.[27-31]

==== Summary ====

तत्र श्लोकः-
इदं लिङ्गमरिष्टाख्यमनेकमभिजज्ञिवान्|
आयुर्वेदविदित्याख्यां लभते कुशलो जनः||३२||

tatra ślōkaḥ-
idaṁ liṅgamariṣṭākhyamanēkamabhijajñivān|
āyurvēdavidityākhyāṁ labhatē kuśalō janaḥ||32||

tatra shlokaH-
idaM li~ggamariShTAkhyamanekamabhijaj~jivAn|
AyurvedavidityAkhyAM labhate kushalo janaH||32||

To summarize:

Who is well versed with the observation of above signs and symptoms which indicates imminent death, is entitled to be known as intelligent physician. [32]

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

*Shadow image in pupils, changes in complexion and luster should be examined to assess prognosis.
*Perception of distorted images of body parts or their absence are ominous signs.

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

==== Role of ''Pancha-mahabhuta'' in complexion and luster ====
Following cross references are important to be re-visited to assess the role of ''pancha-mahabhuta'', especially ''tejas mahabhuta'' in complexion and luster.
*''Tejas mahabhuta'' promote luster complexion, strength, energy, power, digestive fire, and vitality. It also alleviates all ''vatika'' diseases and sustains youthful age. (Su.Chi.38/50)
*The normal watery rasa converted to reddish color by ''pitta'' is ''rakta'' and its equilibrium brings health. (Su.Su.14/5)
*Qualities of ''Pancha-mahabhuta'' are:
**Qualities of ''Akasha'' are- sound, auditory organ, all orifices and distinctness.
**Qualities of ''Vayu'' are – touch tactile organ, all activities, movements in all body parts and lightness.
**Qualities of ''Tejas'' are – vision, visual organ, complexion, heat, splendor, digestion, intolerance, sharpness and valor.
**Qualities of ''Apa'' are- taste, gustatory organ, all liquidity, heaviness, coldness, unctuousness and semen and
**Qualities of ''Parthiva'' (i.e., those that have qualities of the ''prithvi'' element) are- smell, olfactory organ, hardness and heaviness.(Su.Sha.1/19)
*''Tejas'' element is the causative factor of complexion when at the time of conception, it is predominantly associated with ''apa'' element, it makes the fetus fair- complexioned, predominance in ''parthivi'' elements causes black one. That in ''parthivi'' and ''akasha'' elements gives to black- sky complexion while predominance in ''apa'' and ''akasha'' elements makes fair-sky complexion of fetus. If ''tejas'' does not reach the visual organ, it makes the fetus born blind, the same associated with blood makes red eyed, that associated with ''pitta'' and ''kapha'' makes yellow- eyed and white-eyed respectively, if associated with ''vata'' it causes deformity in eyes.
*''Jatharagni'' is the primary factor for sustenance of life, color, strength, health, enthusiasm, plumpness, complexion, ''ojas, tejas,'' ''agni'' and ''prana''.
*To seethings devoid of their real characteristics - e.g., bright things looking dull and lusterless - indicates impending death of the patient.
*''Pannarupi'' implies something whose form or aspect has disappeared. ''Pannarupam'' , the word, has been derived from ''apannarupam,'' implies ill-formed or confused in respect of shape.
*Any alterations in ''chhaya'' (complexion) and ''prabha'' (luster) denotes the ominous sign for the patient.
*The process of dying usually begins well before death actually occurs. Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination. As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality. The journey ultimately leads to the physical departure from the body.

==== Sign of Imminent Death ====

#Patient who is suffering from ''kamala'', swelling in face, wasting in temples, and terrifying appearance with high fever has grave prognosis.
#Patient who faints again and again while being lifted from bed may not survive for a week. This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, such as fearing hidden enemies or feeling invincible. The dying person may also experience hallucinations, sometimes seeing or speaking to people that are not there or died in the past. Some may see this as the veil being lifted between this life and the next. The person may pick at their sheets and clothing in a state of agitation. Movements and actions may seem aimless and make no sense to others. They are moving further away from life to this earth.
#At the end of life, patients often lose interest in eating and drinking because the body is conserving its energy and no longer requires the same level of nourishment. It is important to let each individual decide how much, even if it is little or nothing, that he or she wishes to eat or drink. Family members should not force food or drink, as it will only make their loved one feel uncomfortable or upset. Near the end of life, patients no longer feel hunger pangs and forcing them to eat may actually cause nausea and abdominal pain. Eventually, the patient may become entirely unable to swallow food and fluids. Frequent mouth care will be given to help prevent dry mouth.
#When the body prepares to die, a decrease in urine production and loss of bladder and bowel control are noted. The urine may appear dark because the patient is not as hydrated and there is less circulation in the kidneys.
#Fluids may collect in a dying person’s throat and lungs. Because he or she is unable to swallow or cough up this fluid, he or she may make a gurgling noise. The noise may be worrisome to family members, but it is common and rarely uncomfortable for the patient. Elevating and repositioning the head may help to relieve some of the congestion.
#As cardiac output and intravascular volume decrease at the end of life, there will be evidence of diminished peripheral blood perfusion. Tachycardia, hypotension, peripheral cooling, peripheral and central cyanosis, and mottling of the skin (livedo reticularis) are expected. Venous blood may pool along dependent skin surfaces. Urine output falls as perfusion of the kidneys diminishes.

In parapsychology and many forms of spiritual practice, an aura is a field of subtle, luminous radiation surrounding a person or object (like the halo oraureola in religious art). <ref>Aura (paranormal); From Wikipedia, the free encyclopedia; available at http://en.wikipedia.org/wiki/Aura_(paranormal)</ref>,
<ref>How to see and READ the AURA: Part 1; available at http://www.thiaoouba.com/seeau.htm</ref>

=== Glossary ===
{| class="wikitable"
|-
| पन्नरूपीय || Destruction/loss of images
|-
| च्छाया || Complexion
|-
| प्रतिच्छाया || Shadow
|-
| प्रभाl || ustre
|-
| कुमारिका || Pupil
|-
| वर्णप्रकाशिनी || illuminates complexion
|-
| सलिलादर्शयोरपि || Moon light
|-
| छिन्ना भिन्ना || Broken, Torn
|-
| विकृता विशिरा || Bifurcated, deformed
|-
| कर्शित || Emaciated
|-
| प्रेत || Ghost
|-
| मुमूर्षतां || Morbidity
|-
| प्रकूजति प्रश्वसिति || Dyspnoea
|-
| प्राणवर्धनम् || Vitality
|-
| सुषमा || Symmetrical
|-
| विषमा || Asymmetrical
|-
| मध्य || Medium
|-
| मल्पं || Short
|-
| महच्चोक्तं || large
|-
| सप्रभेव || lustrous shadow
|-
| दर्शनप्रिया || Pleasing to the eyes
|-
| विनाशाय || Great calamities
|-
| क्लेशाय || Miseries
|-
| स्युर्विकासिन्यः || Emanative
|-
| स्निग्धाश्च || Unctuous
|-
| विपुलाश्च || Auspicious
|-
| र्मुखं पूर्णं || Swelling in face
|-
| शङ्खयोर्मुक्तमांसता || Wasting in temples
|-
| सन्त्रास || Terrifying in appearance
|-
| उत्थाप्यमानः || Lifted from bed
|-
| ल्पमश्नतः || Consumption of little quantity of food
|-
| बहु मूत्रपुरीषं || Excretes large amount of stool and urine
|-
| प्रकूजति प्रश्वसिति || Shallow respiration
|-
| व्याविद्धं स्पन्दते || Irregular twitching
|-
| मन्ये चारतकम्पने || Throbbing of the carotid region
|-
| निःसृतौ वृषणौ || Pendulous testicles
|-
| मरिष्टा || Imminent death
|-
| वर्ण || Complexion
|-
| बलोत्साह || Strength, energy
|-
| वयःस्थापनमुत्तमम् || Sustains youthful age
|-
| शब्दः || Sound
|-
| शब्देन्द्रियं || Auditory organ
|-
| सर्वच्छिद्रसमूहो || All orifices
|-
| विविक्तता || Distinctness
|-
| स्पर्शः || Touch
|-
| स्पर्शेन्द्रियं || Tactile organ
|-
| सर्वचेष्टासमूहः || All activities
|-
| सर्वशरीरस्पन्दनं || Movement in all body parts
|-
| लघुता || lightness
|-
| रूपं || Vision
|-
| रूपेन्द्रियं || Visual organ
|-
| भ्राजिष्णुता || Splendour
|-
| मर्ष || Intolerance
|-
| शौर्यं || Valour
|-
| रसनेन्द्रियं || Gustatory organ
|-
| सर्वद्रवसमूहो || All liquidity
|-
| गुरुता || Heaviness
|-
| स्नेहो || Unctuousnes
|-
| रेतश्च || Semen
|-
| गन्धेन्द्रियं || Olfactory organ
|-
| सर्वमूर्तसमूहो || Hardness
|-
|}

=== References ===

Pannarupiya

2017-12-26T13:05:39Z

Vinay Exafluence: /* Glossary */

{{Infobox
|title = Pannarupiya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 7
|label2 = Preceding Chapter
|data2 = [[Kathamanasharireeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 7 ==

=== Abstract ===

The seventh chapter [[Pannarupiya]] deals with the loss of shadow image in eyes, changes in complexion and luster indicative of imminent death. Difference between shadow and luster is also explained in this chapter with characteristic features of shadows pertaining to each of ''pancha mahabhuta''. The chapter focuses on fatal prognostic features related to complexion and luster.

Keywords: shadow image, complexion, luster, ''chhaya, varna, prabha''.

=== Introduction ===

If there is any distortion in the image of the examiner reflected as a shadow in the pupil of the patient, should be considered as a sign of imminent death of the patient. ''Nimittanurupa vikriti'' (image pertaining to death) will serve as a yard stick to measure the span of life.

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

पन्नरूपीयेन्द्रियोपक्रमः
अथातः पन्नरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pannarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pannarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter on the signs of imminent death as indicated by the distortion of the image reflected in the pupil.[1-2]

==== Loss of shadow image in eyes ====

दृष्ट्यां यस्य विजानीयात् पन्नरूपां कुमारिकाम्|
प्रतिच्छायामयीमक्ष्णोर्नैनमिच्छेच्चिकित्सितुम्||३||

dr̥ṣṭyāṁ yasya vijānīyāt pannarūpāṁ kumārikām|
praticchāyāmayīmakṣṇōrnainamicchēccikitsitum||3||

dRuShTyAM yasya vijAnIyAt pannarUpAM kumArikAm|
praticchAyAmayImakShNornainamiccheccikitsitum||3||

The condition in which loss of shadow image is observed in the pupil (eyes) of the patient, should be discarded for treatment.[3]

==== Features of fatal prognosis as per shadows ====

ज्योत्स्नायामातपे दीपे सलिलादर्शयोरपि|
अङ्गेषु विकृता यस्य च्छाया प्रेतस्तथैव सः||४||

jyōtsnāyāmātapē dīpē salilādarśayōrapi|
aṅgēṣu vikr̥tā yasya cchāyā prētastathaiva saḥ||4||

jyotsnAyAmAtape dIpe salilAdarshayorapi|
a~ggeShu vikRutA yasya cchAyA pretastathaiva saH||4||

If any sorts of deformity observed in body parts in the shadow of the person in moonlight, sunlight, light of a lamp, water or mirror. He should be considered as dead. [4]

छिन्ना भिन्नाऽऽकुला च्छाया हीना वाऽप्यधिकाऽपि वा|
नष्टा तन्वी द्विधा च्छिन्ना विकृता विशिरा च या||५||

एताश्चान्याश्च याः काश्चित् प्रतिच्छाया विगर्हिताः|
सर्वा मुमूर्षतां ज्ञेया न चेल्लक्ष्यनिमित्तजाः||६||

chinnā bhinnā''kulā cchāyā hīnā vā'pyadhikā'pi vā|
naṣṭā tanvī dvidhā cchinnā vikr̥tā viśirā ca yā||5||

ētāścānyāśca yāḥ kāścit praticchāyā vigarhitāḥ|
sarvā mumūrṣatāṁ jñēyā na cēllakṣyanimittajāḥ||6||

chinnA bhinnA~a~akulA cchAyA hInA vA~apyadhikA~api vA|
naShTA tanvI dvidhA cchinnA vikRutA vishirA ca yA||5||

etAshcAnyAshca yAH kAshcit praticchAyA vigarhitAH|
sarvA mumUrShatAM j~jeyA na cellakShyanimittajAH||6||

Observation of shadow of a patient as broken, torn, hazy, devoid of certain organs, seeing excess organs, not conspicuous, bifurcated, deformed and without head, such other similar abnormal shadows if develops without any apparent cause it is considered as severe morbidity.[5-6]

संस्थानेन प्रमाणेन वर्णेन प्रभया तथा|
छाया विवर्तते यस्य स्वस्थोऽपि प्रेत एव सः||७||

saṁsthānēna pramāṇēna varṇēna prabhayā tathā|
chāyā vivartatē yasya svasthō'pi prēta ēva saḥ||7||

saMsthAnena pramANena varNena prabhayA tathA|
chAyA vivartate yasya svastho~api preta eva saH||7||

Distortion of shadow in respect of changes in shape, measurement, colour and lustre should be considered as ominous sign even in healthy individual.[7]

संस्थानमाकृतिर्ज्ञेया सुषमा विषमा च सा|
मध्यमल्पं महच्चोक्तं प्रमाणं त्रिविधं नृणाम्||८||

प्रतिप्रमाणसंस्थाना जलादर्शातपादिषु|
छाया या सा प्रतिच्छाया च्छाया वर्णप्रभाश्रया||९||

saṁsthānamākr̥tirjñēyā suṣamā viṣamā ca sā|
madhyamalpaṁ mahaccōktaṁ pramāṇaṁ trividhaṁ nr̥ṇām||8||

pratipramāṇasaṁsthānā jalādarśātapādiṣu|
chāyā yā sā praticchāyā cchāyā varṇaprabhāśrayā||9||

saMsthAnamAkRutirj~jeyA suShamA viShamA ca sA|
madhyamalpaM mahaccoktaMpramANaM trividhaM nRuNAm||8||

pratipramANasaMsthAnA jalAdarshAtapAdiShu|
chAyA yA sA praticchAyA cchAyA varNaprabhAshrayA||9||

The term ''sansthana'' means shape which may be symmetrical or asymmetrical.
Measurement is of three kinds namely short, medium, and large The image reflected in water, mirror, etc., corresponding to the measurement and shape of the body of the individual is known as ''praticchhaya'' which is nothing but reflected shadow based on the color and luster of the individual.[8-9]

==== Features of Shadow of ''Pancha-Mahabhuta'' ====

खादीनां पञ्च पञ्चानां छाया विविधलक्षणाः|
नाभसी निर्मला नीला सस्नेहा सप्रभेव च||१०||

रूक्षा श्यावारुणा या तु वायवी सा हतप्रभा|
विशुद्धरक्ता त्वाग्नेयी दीप्ताभा दर्शनप्रिया||११||

शुद्धवैदूर्यविमला सुस्निग्धा चाम्भसी मता|
स्थिरा स्निग्धा घना श्लक्ष्णा श्यामा श्वेता च पार्थिवी||१२||

वायवी गर्हिता त्वासां चतस्रः स्युः सुखोदयाः |
वायवी तु विनाशाय क्लेशाय महतेऽपि वा||१३||

khādīnāṁ pañca pañcānāṁ chāyā vividhalakṣaṇāḥ|
nābhasī nirmalā nīlā sasnēhā saprabhēva ca||10||

rūkṣā śyāvāruṇā yā tu vāyavī sā hataprabhā|
viśuddharaktā tvāgnēyī dīptābhā darśanapriyā||11||

śuddhavaidūryavimalā susnigdhā cāmbhasī matā|
sthirā snigdhā ghanā ślakṣṇā śyāmā śvētā ca pārthivī||12||

vāyavī garhitā tvāsāṁ catasraḥ syuḥ sukhōdayāḥ |
vāyavī tu vināśāya klēśāya mahatē'pi vā||13||

khAdInAM pa~jca pa~jcAnAM chAyA vividhalakShaNAH|
nAbhasI nirmalA nIlA sasnehA saprabheva ca||10||

rUkShA shyAvAruNA yA tu vAyavI sA hataprabhA|
vishuddharaktA tvAgneyI dIptAbhA darshanapriyA||11||

shuddhavaidUryavimalA susnigdhA cAmbhasI matA|
sthirA snigdhAghanA shlakShNA shyAmA shvetA ca pArthivI||12||

vAyavI garhitA tvAsAM catasraH syuH sukhodayAH |
vAyavI tu vinAshAya kleshAya mahate~api vA||13||

The following are the distinctive characteristic features of shadows pertaining to each of the five great elements.
====Table 1: Shadows of Pancha-Mahabhuta:====
{| class="wikitable"
! rowspan="1"| S.No
! rowspan="1"| Mahabhuta
! rowspan="1"| Distinctive characteristic features of shadows
|-
| 1 || Akash Bhoota || Clear , blue, unctuous and lustrous shadow
|-
| 2.|| Vayu Bhoota || Dry, brown, and reddish
|-
| 3.|| Agni Bhoota || Bright red, brilliant and pleasing to the eyes
|-
| 4.|| Jala Bhoota || Clear like cat’s eye, and excessive unctuous
|-
| 5.|| Prithvi Bhoota || Stable, unctuous, compact, smooth, black and white
|-
|}

The shadow pertaining to ''vayu bhuta'' is of inferior in nature whereas the remaining four are indicative of pleasure and happiness. ''Vayu bhuta'' shadows indicative of great calamities and miseries.[10-13]

स्यात्तैजसी प्रभा सर्वा सा तु सप्तविधा स्मृता|
रक्ता पीता सिता श्यावा हरिता पाण्डुराऽसिता||१४||

तासां याः स्युर्विकासिन्यः स्निग्धाश्च विपुलाश्च याः|
ताः शुभा रूक्षमलिनाः सङ्क्षिप्ताश्चाशुभोदयाः ||१५||

syāttaijasī prabhā sarvā sā tu saptavidhā smr̥tā|
raktā pītā sitā śyāvā haritā pāṇḍurā'sitā||14||

tāsāṁ yāḥ syurvikāsinyaḥ snigdhāśca vipulāśca yāḥ|
tāḥ śubhā rūkṣamalināḥ saṅkṣiptāścāśubhōdayāḥ ||15||

syAttaijasI prabhA sarvA sA tu saptavidhA smRutA|
raktA pItA sitA shyAvA haritA pANDurA~asitA||14||

tAsAM yAH syurvikAsinyaH snigdhAshca vipulAshca yAH|
tAH shubhA rUkShamalinAH sa~gkShiptAshcAshubhodayAH||15||

All varieties of luster are constituted of ''tejas bhuta''. They are classified as seven type’s namely red, yellow, white, brown, green, pale yellowish and black. Of them which are emanative, unctuous, and dense are auspicious and those others which are dry, dirty and thin are inauspicious.[14-15]

==== Difference between ''Chhaya'' (shadow) and ''Prabha''(lustre) ====

वर्णमाक्रामति च्छाया भास्तु वर्णप्रकाशिनी|
आसन्ना लक्ष्यते च्छाया भाः प्रकृष्टा प्रकाशते||१६||

नाच्छायो नाप्रभः कश्चिद्विशेषाश्चिह्नयन्ति तु|
नृणां शुभाशुभोत्पत्तिं काले छायाप्रभाश्रयाः||१७||

varṇamākrāmati cchāyā bhāstu varṇaprakāśinī|
āsannā lakṣyatē cchāyā bhāḥ prakr̥ṣṭā prakāśatē||16||

nācchāyō nāprabhaḥ kaścidviśēṣāścihnayanti tu|
nr̥ṇāṁ śubhāśubhōtpattiṁ kālē chāyāprabhāśrayāḥ||17||

varNamAkrAmati cchAyA bhAstu varNaprakAshinI|
AsannA lakShyate cchAyA bhAH prakRuShTA prakAshate||16||

nAcchAyo nAprabhaH kashcidvisheShAshcihnayanti tu|
nRuNAM shubhAshubhotpattiM kAle chAyAprabhAshrayAH||17||

The shadow decreases the complexion of the body whereas the lustre illuminates. The shadow can be observed from nearby whereas lustre illuminates from a distance. There is nothing devoid of lustre or shadow. Certain distinctive features of the shadow and the lustre when mature indicates emergence of inauspicious or auspicious results in relation to human beings. [16-17]

==== Fatal signs ====

कामलाऽक्ष्णोर्मुखं पूर्णं शङ्खयोर्मुक्तमांसता|
सन्त्रासश्चोष्णगात्रत्वं यस्य तं परिवर्जयेत्||१८||

उत्थाप्यमानः शयनात् प्रमोहं याति यो नरः|
मुहुर्मुहुर्न सप्ताहं स जीवति विकत्थनः ||१९||

संसृष्टा व्याधयो यस्य प्रतिलोमानुलोमगाः|
व्यापन्ना ग्रहणी प्रायः सोऽर्धमासं न जीवति||२०||

kāmalā'kṣṇōrmukhaṁ pūrṇaṁ śaṅkhayōrmuktamāṁsatā|
santrāsaścōṣṇagātratvaṁ yasya taṁ parivarjayēt||18||

utthāpyamānaḥ śayanāt pramōhaṁ yāti yō naraḥ|
muhurmuhurna saptāhaṁ sa jīvati vikatthanaḥ ||19||

saṁsr̥ṣṭā vyādhayō yasya pratilōmānulōmagāḥ|
vyāpannā grahaṇī prāyaḥ sō'rdhamāsaṁ na jīvati||20||

kAmalA~akShNormukhaM pUrNaM sha~gkhayormuktamAMsatA|
santrAsashcoShNagAtratvaM yasya taM parivarjayet||18||

utthApyamAnaH shayanAt pramohaM yAti yo naraH|
muhurmuhurna saptAhaM sa jIvati vikatthanaH ||19||

saMsRuShTA vyAdhayo yasya pratilomAnulomagAH|
vyApannA grahaNI prAyaH so~ardhamAsaM na jIvati||20||

Patient who is suffering from ''kamala'', swelling of face, wasting in temples and terrifying appearance with high fever such patient should be discarded for management.

Patient who faints again and again while being lifted from bed cannot survive for a week.
The patient afflicted with multiple ''doshas'' having movements in upward, downward both directions along with disordered ''grahani''(Duodenum and Small intestine) cannot survive for longer than for a fortnight.[18-20]

उपरुद्धस्य रोगेण कर्शितस्याल्पमश्नतः|
बहु मूत्रपुरीषं स्याद्यस्य तं परिवर्जयेत्||२१||

दुर्बलो बहु भुङ्क्ते यः प्राग्भुक्तादन्नमातुरः |
अल्पमूत्रपुरीषश्च यथा प्रेतस्तथैव सः||२२||

इष्टं च गुणसम्पन्नमन्नमश्नाति यो नरः|
शश्वच्च बलवर्णाभ्यां हीयते न स जीवति||२३||

प्रकूजति प्रश्वसिति शिथिलं चातिसार्यते|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२४||

ह्रस्वं च यः प्रश्वसिति व्याविद्धं स्पन्दते च यः|
मृतमेव तमात्रेयो व्याचचक्षे पुनर्वसुः||२५||

ऊर्ध्वं च यः प्रश्वसिति श्लेष्मणा चाभिभूयते|
हीनवर्णबलाहारो यो नरो न स जीवति||२६||

uparuddhasya rōgēṇa karśitasyālpamaśnataḥ|
bahu mūtrapurīṣaṁ syādyasya taṁ parivarjayēt||21||

durbalō bahu bhuṅktē yaḥ prāgbhuktādannamāturaḥ |
alpamūtrapurīṣaśca yathā prētastathaiva saḥ||22||

iṣṭaṁ ca guṇasampannamannamaśnāti yō naraḥ|
śaśvacca balavarṇābhyāṁ hīyatē na sa jīvati||23||

prakūjati praśvasiti śithilaṁ cātisāryatē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||24||

hrasvaṁ ca yaḥ praśvasiti vyāviddhaṁ spandatē ca yaḥ|
mr̥tamēva tamātrēyō vyācacakṣē punarvasuḥ||25||

ūrdhvaṁ ca yaḥ praśvasiti ślēṣmaṇā cābhibhūyatē|
hīnavarṇabalāhārō yō narō na sa jīvati||26||

uparuddhasya rogeNa karshitasyAlpamashnataH|
bahu mUtrapurIShaM syAdyasya taM parivarjayet||21||

durbalo bahu bhu~gkte yaH prAgbhuktAdannamAturaH |
alpamUtrapurIShashca yathA pretastathaiva saH||22||

iShTaM ca guNasampannamannamashnAti yo naraH|
shashvacca balavarNAbhyAM hIyate na sa jIvati||23||

prakUjati prashvasiti shithilaM cAtisAryate|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||24||

hrasvaM ca yaH prashvasiti vyAviddhaM spandate ca yaH|
mRutameva tamAtreyo vyAcacakShe punarvasuH||25||

UrdhvaM ca yaH prashvasiti shleShmaNA cAbhibhUyate|
hInavarNabalAhAro yo naro na sa jIvati||26||

Consumption of little quantity of food by emaciated person but excretes large amount of urine and stool should be discarded for management.

Consumption of excess quantity of food by weak patient but passes scanty urine and stool should be considered as ghost or almost dead.
In spite of taking suitable diet if person constantly loose strength and complexion indicates bad prognosis.
If a person who is weak, thirsty and having dryness of mouth, if suffers from groaning, dyspnea and diarrhea, then it should not be treated because he will not survive.

If patient is suffering from shallow respiration with irregular twitching in the body is said to be severe fatal condition like almost dead.
Person who is suffering from respiratory distress with abundance of ''kapha'' along with diminution of complexion, strength and less intake of food will not survive for longer.[21-26]

ऊर्ध्वाग्रे नयने यस्य मन्ये चारतकम्पने|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२७||

यस्य गण्डावुपचितौ ज्वरकासौ च दारुणौ|
शूली प्रद्वेष्टि चाप्यन्नं तस्मिन् कर्म न सिध्यति||२८||

व्यावृत्तमूर्धजिह्वास्यो भ्रुवौ यस्य च विच्युते|
कण्टकैश्चाचिता जिह्वा यथा प्रेतस्तथैव सः||२९||

शेफश्चात्यर्थमुत्सिक्तं निःसृतौ वृषणौ भृशम्|
अतश्चैव विपर्यासो विकृत्या प्रेतलक्षणम्||३०||

निचितं यस्य मांसं स्यात्त्वगस्थिष्वेव दृश्यते|
क्षीणस्यानश्नतस्तस्य मासमायुः परं भवेत्||३१||

ūrdhvāgrē nayanē yasya manyē cāratakampanē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||27||

yasya gaṇḍāvupacitau jvarakāsau ca dāruṇau|
śūlī pradvēṣṭi cāpyannaṁ tasmin karma na sidhyati||28||

vyāvr̥ttamūrdhajihvāsyō bhruvau yasya ca vicyutē|
kaṇṭakaiścācitā jihvā yathā prētastathaiva saḥ||29||

śēphaścātyarthamutsiktaṁ niḥsr̥tau vr̥ṣaṇau bhr̥śam|
ataścaiva viparyāsō vikr̥tyā prētalakṣaṇam||30||

nicitaṁ yasya māṁsaṁ syāttvagasthiṣvēva dr̥śyatē|
kṣīṇasyānaśnatastasya māsamāyuḥ paraṁ bhavēt||31||

UrdhvAgre nayane yasya manye cAratakampane|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||27||

yasya gaNDAvupacitau jvarakAsau ca dAruNau|
shUlI pradveShTi cApyannaM tasmin karma na sidhyati||28||

vyAvRuttamUrdhajihvAsyo bhruvau yasya ca vicyute|
kaNTakaishcAcitA jihvA yathA pretastathaiva saH||29||

shephashcAtyarthamutsiktaM niHsRutau vRuShaNau bhRusham|
atashcaiva viparyAso vikRutyA pretalakShaNam||30||

nicitaM yasya mAMsaM syAttvagasthiShveva dRushyate|
kShINasyAnashnatastasya mAsamAyuH paraM bhavet||31||

A weak, thirsty and dryness of mouth suffers from rigid and upward look of the eyes and persistent throbbing of the carotid region of the neck, will not survive for long.

If an emaciated person having prominent cheeks along with high fever, severe cough, colic and dislike for food will not cure from his ailments because no treatment suits him.

If there is a distortion of the head, tongue and face, drooping of eye brows and appearance of thorny coat over tongue, don’t treat such patients due to its ominous nature.

Whose penis is excessively long along with pendulous testicles or vice versa, such signs are indicative of death of a patient immediately.
In emaciated individual whose muscles are excessively undergone wasting with remnants of skin and bone does not survive more than one month.[27-31]

==== Summary ====

तत्र श्लोकः-
इदं लिङ्गमरिष्टाख्यमनेकमभिजज्ञिवान्|
आयुर्वेदविदित्याख्यां लभते कुशलो जनः||३२||

tatra ślōkaḥ-
idaṁ liṅgamariṣṭākhyamanēkamabhijajñivān|
āyurvēdavidityākhyāṁ labhatē kuśalō janaḥ||32||

tatra shlokaH-
idaM li~ggamariShTAkhyamanekamabhijaj~jivAn|
AyurvedavidityAkhyAM labhate kushalo janaH||32||

To summarize:

Who is well versed with the observation of above signs and symptoms which indicates imminent death, is entitled to be known as intelligent physician. [32]

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

*Shadow image in pupils, changes in complexion and luster should be examined to assess prognosis.
*Perception of distorted images of body parts or their absence are ominous signs.

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

==== Role of ''Pancha-mahabhuta'' in complexion and luster ====
Following cross references are important to be re-visited to assess the role of ''pancha-mahabhuta'', especially ''tejas mahabhuta'' in complexion and luster.
*''Tejas mahabhuta'' promote luster complexion, strength, energy, power, digestive fire, and vitality. It also alleviates all ''vatika'' diseases and sustains youthful age. (Su.Chi.38/50)
*The normal watery rasa converted to reddish color by ''pitta'' is ''rakta'' and its equilibrium brings health. (Su.Su.14/5)
*Qualities of ''Pancha-mahabhuta'' are:
**Qualities of ''Akasha'' are- sound, auditory organ, all orifices and distinctness.
**Qualities of ''Vayu'' are – touch tactile organ, all activities, movements in all body parts and lightness.
**Qualities of ''Tejas'' are – vision, visual organ, complexion, heat, splendor, digestion, intolerance, sharpness and valor.
**Qualities of ''Apa'' are- taste, gustatory organ, all liquidity, heaviness, coldness, unctuousness and semen and
**Qualities of ''Parthiva'' (i.e., those that have qualities of the ''prithvi'' element) are- smell, olfactory organ, hardness and heaviness.(Su.Sha.1/19)
*''Tejas'' element is the causative factor of complexion when at the time of conception, it is predominantly associated with ''apa'' element, it makes the fetus fair- complexioned, predominance in ''parthivi'' elements causes black one. That in ''parthivi'' and ''akasha'' elements gives to black- sky complexion while predominance in ''apa'' and ''akasha'' elements makes fair-sky complexion of fetus. If ''tejas'' does not reach the visual organ, it makes the fetus born blind, the same associated with blood makes red eyed, that associated with ''pitta'' and ''kapha'' makes yellow- eyed and white-eyed respectively, if associated with ''vata'' it causes deformity in eyes.
*''Jatharagni'' is the primary factor for sustenance of life, color, strength, health, enthusiasm, plumpness, complexion, ''ojas, tejas,'' ''agni'' and ''prana''.
*To seethings devoid of their real characteristics - e.g., bright things looking dull and lusterless - indicates impending death of the patient.
*''Pannarupi'' implies something whose form or aspect has disappeared. ''Pannarupam'' , the word, has been derived from ''apannarupam,'' implies ill-formed or confused in respect of shape.
*Any alterations in ''chhaya'' (complexion) and ''prabha'' (luster) denotes the ominous sign for the patient.
*The process of dying usually begins well before death actually occurs. Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination. As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality. The journey ultimately leads to the physical departure from the body.

==== Sign of Imminent Death ====

#Patient who is suffering from ''kamala'', swelling in face, wasting in temples, and terrifying appearance with high fever has grave prognosis.
#Patient who faints again and again while being lifted from bed may not survive for a week. This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, such as fearing hidden enemies or feeling invincible. The dying person may also experience hallucinations, sometimes seeing or speaking to people that are not there or died in the past. Some may see this as the veil being lifted between this life and the next. The person may pick at their sheets and clothing in a state of agitation. Movements and actions may seem aimless and make no sense to others. They are moving further away from life to this earth.
#At the end of life, patients often lose interest in eating and drinking because the body is conserving its energy and no longer requires the same level of nourishment. It is important to let each individual decide how much, even if it is little or nothing, that he or she wishes to eat or drink. Family members should not force food or drink, as it will only make their loved one feel uncomfortable or upset. Near the end of life, patients no longer feel hunger pangs and forcing them to eat may actually cause nausea and abdominal pain. Eventually, the patient may become entirely unable to swallow food and fluids. Frequent mouth care will be given to help prevent dry mouth.
#When the body prepares to die, a decrease in urine production and loss of bladder and bowel control are noted. The urine may appear dark because the patient is not as hydrated and there is less circulation in the kidneys.
#Fluids may collect in a dying person’s throat and lungs. Because he or she is unable to swallow or cough up this fluid, he or she may make a gurgling noise. The noise may be worrisome to family members, but it is common and rarely uncomfortable for the patient. Elevating and repositioning the head may help to relieve some of the congestion.
#As cardiac output and intravascular volume decrease at the end of life, there will be evidence of diminished peripheral blood perfusion. Tachycardia, hypotension, peripheral cooling, peripheral and central cyanosis, and mottling of the skin (livedo reticularis) are expected. Venous blood may pool along dependent skin surfaces. Urine output falls as perfusion of the kidneys diminishes.

In parapsychology and many forms of spiritual practice, an aura is a field of subtle, luminous radiation surrounding a person or object (like the halo oraureola in religious art).

=== Glossary ===
{| class="wikitable"
|-
| पन्नरूपीय || Destruction/loss of images
|-
| च्छाया || Complexion
|-
| प्रतिच्छाया || Shadow
|-
| प्रभाl || ustre
|-
| कुमारिका || Pupil
|-
| वर्णप्रकाशिनी || illuminates complexion
|-
| सलिलादर्शयोरपि || Moon light
|-
| छिन्ना भिन्ना || Broken, Torn
|-
| विकृता विशिरा || Bifurcated, deformed
|-
| कर्शित || Emaciated
|-
| प्रेत || Ghost
|-
| मुमूर्षतां || Morbidity
|-
| प्रकूजति प्रश्वसिति || Dyspnoea
|-
| प्राणवर्धनम् || Vitality
|-
| सुषमा || Symmetrical
|-
| विषमा || Asymmetrical
|-
| मध्य || Medium
|-
| मल्पं || Short
|-
| महच्चोक्तं || large
|-
| सप्रभेव || lustrous shadow
|-
| दर्शनप्रिया || Pleasing to the eyes
|-
| विनाशाय || Great calamities
|-
| क्लेशाय || Miseries
|-
| स्युर्विकासिन्यः || Emanative
|-
| स्निग्धाश्च || Unctuous
|-
| विपुलाश्च || Auspicious
|-
| र्मुखं पूर्णं || Swelling in face
|-
| शङ्खयोर्मुक्तमांसता || Wasting in temples
|-
| सन्त्रास || Terrifying in appearance
|-
| उत्थाप्यमानः || Lifted from bed
|-
| ल्पमश्नतः || Consumption of little quantity of food
|-
| बहु मूत्रपुरीषं || Excretes large amount of stool and urine
|-
| प्रकूजति प्रश्वसिति || Shallow respiration
|-
| व्याविद्धं स्पन्दते || Irregular twitching
|-
| मन्ये चारतकम्पने || Throbbing of the carotid region
|-
| निःसृतौ वृषणौ || Pendulous testicles
|-
| मरिष्टा || Imminent death
|-
| वर्ण || Complexion
|-
| बलोत्साह || Strength, energy
|-
| वयःस्थापनमुत्तमम् || Sustains youthful age
|-
| शब्दः || Sound
|-
| शब्देन्द्रियं || Auditory organ
|-
| सर्वच्छिद्रसमूहो || All orifices
|-
| विविक्तता || Distinctness
|-
| स्पर्शः || Touch
|-
| स्पर्शेन्द्रियं || Tactile organ
|-
| सर्वचेष्टासमूहः || All activities
|-
| सर्वशरीरस्पन्दनं || Movement in all body parts
|-
| लघुता || lightness
|-
| रूपं || Vision
|-
| रूपेन्द्रियं || Visual organ
|-
| भ्राजिष्णुता || Splendour
|-
| मर्ष || Intolerance
|-
| शौर्यं || Valour
|-
| रसनेन्द्रियं || Gustatory organ
|-
| सर्वद्रवसमूहो || All liquidity
|-
| गुरुता || Heaviness
|-
| स्नेहो || Unctuousnes
|-
| रेतश्च || Semen
|-
| गन्धेन्द्रियं || Olfactory organ
|-
| सर्वमूर्तसमूहो || Hardness
|-
|}

=== References ===

Pannarupiya

2017-12-26T12:40:44Z

Vinay Exafluence: /* Features of Shadow of Pancha-Mahabhuta */

{{Infobox
|title = Pannarupiya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 7
|label2 = Preceding Chapter
|data2 = [[Kathamanasharireeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 7 ==

=== Abstract ===

The seventh chapter [[Pannarupiya]] deals with the loss of shadow image in eyes, changes in complexion and luster indicative of imminent death. Difference between shadow and luster is also explained in this chapter with characteristic features of shadows pertaining to each of ''pancha mahabhuta''. The chapter focuses on fatal prognostic features related to complexion and luster.

Keywords: shadow image, complexion, luster, ''chhaya, varna, prabha''.

=== Introduction ===

If there is any distortion in the image of the examiner reflected as a shadow in the pupil of the patient, should be considered as a sign of imminent death of the patient. ''Nimittanurupa vikriti'' (image pertaining to death) will serve as a yard stick to measure the span of life.

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

पन्नरूपीयेन्द्रियोपक्रमः
अथातः पन्नरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pannarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pannarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter on the signs of imminent death as indicated by the distortion of the image reflected in the pupil.[1-2]

==== Loss of shadow image in eyes ====

दृष्ट्यां यस्य विजानीयात् पन्नरूपां कुमारिकाम्|
प्रतिच्छायामयीमक्ष्णोर्नैनमिच्छेच्चिकित्सितुम्||३||

dr̥ṣṭyāṁ yasya vijānīyāt pannarūpāṁ kumārikām|
praticchāyāmayīmakṣṇōrnainamicchēccikitsitum||3||

dRuShTyAM yasya vijAnIyAt pannarUpAM kumArikAm|
praticchAyAmayImakShNornainamiccheccikitsitum||3||

The condition in which loss of shadow image is observed in the pupil (eyes) of the patient, should be discarded for treatment.[3]

==== Features of fatal prognosis as per shadows ====

ज्योत्स्नायामातपे दीपे सलिलादर्शयोरपि|
अङ्गेषु विकृता यस्य च्छाया प्रेतस्तथैव सः||४||

jyōtsnāyāmātapē dīpē salilādarśayōrapi|
aṅgēṣu vikr̥tā yasya cchāyā prētastathaiva saḥ||4||

jyotsnAyAmAtape dIpe salilAdarshayorapi|
a~ggeShu vikRutA yasya cchAyA pretastathaiva saH||4||

If any sorts of deformity observed in body parts in the shadow of the person in moonlight, sunlight, light of a lamp, water or mirror. He should be considered as dead. [4]

छिन्ना भिन्नाऽऽकुला च्छाया हीना वाऽप्यधिकाऽपि वा|
नष्टा तन्वी द्विधा च्छिन्ना विकृता विशिरा च या||५||

एताश्चान्याश्च याः काश्चित् प्रतिच्छाया विगर्हिताः|
सर्वा मुमूर्षतां ज्ञेया न चेल्लक्ष्यनिमित्तजाः||६||

chinnā bhinnā''kulā cchāyā hīnā vā'pyadhikā'pi vā|
naṣṭā tanvī dvidhā cchinnā vikr̥tā viśirā ca yā||5||

ētāścānyāśca yāḥ kāścit praticchāyā vigarhitāḥ|
sarvā mumūrṣatāṁ jñēyā na cēllakṣyanimittajāḥ||6||

chinnA bhinnA~a~akulA cchAyA hInA vA~apyadhikA~api vA|
naShTA tanvI dvidhA cchinnA vikRutA vishirA ca yA||5||

etAshcAnyAshca yAH kAshcit praticchAyA vigarhitAH|
sarvA mumUrShatAM j~jeyA na cellakShyanimittajAH||6||

Observation of shadow of a patient as broken, torn, hazy, devoid of certain organs, seeing excess organs, not conspicuous, bifurcated, deformed and without head, such other similar abnormal shadows if develops without any apparent cause it is considered as severe morbidity.[5-6]

संस्थानेन प्रमाणेन वर्णेन प्रभया तथा|
छाया विवर्तते यस्य स्वस्थोऽपि प्रेत एव सः||७||

saṁsthānēna pramāṇēna varṇēna prabhayā tathā|
chāyā vivartatē yasya svasthō'pi prēta ēva saḥ||7||

saMsthAnena pramANena varNena prabhayA tathA|
chAyA vivartate yasya svastho~api preta eva saH||7||

Distortion of shadow in respect of changes in shape, measurement, colour and lustre should be considered as ominous sign even in healthy individual.[7]

संस्थानमाकृतिर्ज्ञेया सुषमा विषमा च सा|
मध्यमल्पं महच्चोक्तं प्रमाणं त्रिविधं नृणाम्||८||

प्रतिप्रमाणसंस्थाना जलादर्शातपादिषु|
छाया या सा प्रतिच्छाया च्छाया वर्णप्रभाश्रया||९||

saṁsthānamākr̥tirjñēyā suṣamā viṣamā ca sā|
madhyamalpaṁ mahaccōktaṁ pramāṇaṁ trividhaṁ nr̥ṇām||8||

pratipramāṇasaṁsthānā jalādarśātapādiṣu|
chāyā yā sā praticchāyā cchāyā varṇaprabhāśrayā||9||

saMsthAnamAkRutirj~jeyA suShamA viShamA ca sA|
madhyamalpaM mahaccoktaMpramANaM trividhaM nRuNAm||8||

pratipramANasaMsthAnA jalAdarshAtapAdiShu|
chAyA yA sA praticchAyA cchAyA varNaprabhAshrayA||9||

The term ''sansthana'' means shape which may be symmetrical or asymmetrical.
Measurement is of three kinds namely short, medium, and large The image reflected in water, mirror, etc., corresponding to the measurement and shape of the body of the individual is known as ''praticchhaya'' which is nothing but reflected shadow based on the color and luster of the individual.[8-9]

==== Features of Shadow of ''Pancha-Mahabhuta'' ====

खादीनां पञ्च पञ्चानां छाया विविधलक्षणाः|
नाभसी निर्मला नीला सस्नेहा सप्रभेव च||१०||

रूक्षा श्यावारुणा या तु वायवी सा हतप्रभा|
विशुद्धरक्ता त्वाग्नेयी दीप्ताभा दर्शनप्रिया||११||

शुद्धवैदूर्यविमला सुस्निग्धा चाम्भसी मता|
स्थिरा स्निग्धा घना श्लक्ष्णा श्यामा श्वेता च पार्थिवी||१२||

वायवी गर्हिता त्वासां चतस्रः स्युः सुखोदयाः |
वायवी तु विनाशाय क्लेशाय महतेऽपि वा||१३||

khādīnāṁ pañca pañcānāṁ chāyā vividhalakṣaṇāḥ|
nābhasī nirmalā nīlā sasnēhā saprabhēva ca||10||

rūkṣā śyāvāruṇā yā tu vāyavī sā hataprabhā|
viśuddharaktā tvāgnēyī dīptābhā darśanapriyā||11||

śuddhavaidūryavimalā susnigdhā cāmbhasī matā|
sthirā snigdhā ghanā ślakṣṇā śyāmā śvētā ca pārthivī||12||

vāyavī garhitā tvāsāṁ catasraḥ syuḥ sukhōdayāḥ |
vāyavī tu vināśāya klēśāya mahatē'pi vā||13||

khAdInAM pa~jca pa~jcAnAM chAyA vividhalakShaNAH|
nAbhasI nirmalA nIlA sasnehA saprabheva ca||10||

rUkShA shyAvAruNA yA tu vAyavI sA hataprabhA|
vishuddharaktA tvAgneyI dIptAbhA darshanapriyA||11||

shuddhavaidUryavimalA susnigdhA cAmbhasI matA|
sthirA snigdhAghanA shlakShNA shyAmA shvetA ca pArthivI||12||

vAyavI garhitA tvAsAM catasraH syuH sukhodayAH |
vAyavI tu vinAshAya kleshAya mahate~api vA||13||

The following are the distinctive characteristic features of shadows pertaining to each of the five great elements.
====Table 1: Shadows of Pancha-Mahabhuta:====
{| class="wikitable"
! rowspan="1"| S.No
! rowspan="1"| Mahabhuta
! rowspan="1"| Distinctive characteristic features of shadows
|-
| 1 || Akash Bhoota || Clear , blue, unctuous and lustrous shadow
|-
| 2.|| Vayu Bhoota || Dry, brown, and reddish
|-
| 3.|| Agni Bhoota || Bright red, brilliant and pleasing to the eyes
|-
| 4.|| Jala Bhoota || Clear like cat’s eye, and excessive unctuous
|-
| 5.|| Prithvi Bhoota || Stable, unctuous, compact, smooth, black and white
|-
|}

The shadow pertaining to ''vayu bhuta'' is of inferior in nature whereas the remaining four are indicative of pleasure and happiness. ''Vayu bhuta'' shadows indicative of great calamities and miseries.[10-13]

स्यात्तैजसी प्रभा सर्वा सा तु सप्तविधा स्मृता|
रक्ता पीता सिता श्यावा हरिता पाण्डुराऽसिता||१४||

तासां याः स्युर्विकासिन्यः स्निग्धाश्च विपुलाश्च याः|
ताः शुभा रूक्षमलिनाः सङ्क्षिप्ताश्चाशुभोदयाः ||१५||

syāttaijasī prabhā sarvā sā tu saptavidhā smr̥tā|
raktā pītā sitā śyāvā haritā pāṇḍurā'sitā||14||

tāsāṁ yāḥ syurvikāsinyaḥ snigdhāśca vipulāśca yāḥ|
tāḥ śubhā rūkṣamalināḥ saṅkṣiptāścāśubhōdayāḥ ||15||

syAttaijasI prabhA sarvA sA tu saptavidhA smRutA|
raktA pItA sitA shyAvA haritA pANDurA~asitA||14||

tAsAM yAH syurvikAsinyaH snigdhAshca vipulAshca yAH|
tAH shubhA rUkShamalinAH sa~gkShiptAshcAshubhodayAH||15||

All varieties of luster are constituted of ''tejas bhuta''. They are classified as seven type’s namely red, yellow, white, brown, green, pale yellowish and black. Of them which are emanative, unctuous, and dense are auspicious and those others which are dry, dirty and thin are inauspicious.[14-15]

==== Difference between ''Chhaya'' (shadow) and ''Prabha''(lustre) ====

वर्णमाक्रामति च्छाया भास्तु वर्णप्रकाशिनी|
आसन्ना लक्ष्यते च्छाया भाः प्रकृष्टा प्रकाशते||१६||

नाच्छायो नाप्रभः कश्चिद्विशेषाश्चिह्नयन्ति तु|
नृणां शुभाशुभोत्पत्तिं काले छायाप्रभाश्रयाः||१७||

varṇamākrāmati cchāyā bhāstu varṇaprakāśinī|
āsannā lakṣyatē cchāyā bhāḥ prakr̥ṣṭā prakāśatē||16||

nācchāyō nāprabhaḥ kaścidviśēṣāścihnayanti tu|
nr̥ṇāṁ śubhāśubhōtpattiṁ kālē chāyāprabhāśrayāḥ||17||

varNamAkrAmati cchAyA bhAstu varNaprakAshinI|
AsannA lakShyate cchAyA bhAH prakRuShTA prakAshate||16||

nAcchAyo nAprabhaH kashcidvisheShAshcihnayanti tu|
nRuNAM shubhAshubhotpattiM kAle chAyAprabhAshrayAH||17||

The shadow decreases the complexion of the body whereas the lustre illuminates. The shadow can be observed from nearby whereas lustre illuminates from a distance. There is nothing devoid of lustre or shadow. Certain distinctive features of the shadow and the lustre when mature indicates emergence of inauspicious or auspicious results in relation to human beings. [16-17]

==== Fatal signs ====

कामलाऽक्ष्णोर्मुखं पूर्णं शङ्खयोर्मुक्तमांसता|
सन्त्रासश्चोष्णगात्रत्वं यस्य तं परिवर्जयेत्||१८||

उत्थाप्यमानः शयनात् प्रमोहं याति यो नरः|
मुहुर्मुहुर्न सप्ताहं स जीवति विकत्थनः ||१९||

संसृष्टा व्याधयो यस्य प्रतिलोमानुलोमगाः|
व्यापन्ना ग्रहणी प्रायः सोऽर्धमासं न जीवति||२०||

kāmalā'kṣṇōrmukhaṁ pūrṇaṁ śaṅkhayōrmuktamāṁsatā|
santrāsaścōṣṇagātratvaṁ yasya taṁ parivarjayēt||18||

utthāpyamānaḥ śayanāt pramōhaṁ yāti yō naraḥ|
muhurmuhurna saptāhaṁ sa jīvati vikatthanaḥ ||19||

saṁsr̥ṣṭā vyādhayō yasya pratilōmānulōmagāḥ|
vyāpannā grahaṇī prāyaḥ sō'rdhamāsaṁ na jīvati||20||

kAmalA~akShNormukhaM pUrNaM sha~gkhayormuktamAMsatA|
santrAsashcoShNagAtratvaM yasya taM parivarjayet||18||

utthApyamAnaH shayanAt pramohaM yAti yo naraH|
muhurmuhurna saptAhaM sa jIvati vikatthanaH ||19||

saMsRuShTA vyAdhayo yasya pratilomAnulomagAH|
vyApannA grahaNI prAyaH so~ardhamAsaM na jIvati||20||

Patient who is suffering from ''kamala'', swelling of face, wasting in temples and terrifying appearance with high fever such patient should be discarded for management.

Patient who faints again and again while being lifted from bed cannot survive for a week.
The patient afflicted with multiple ''doshas'' having movements in upward, downward both directions along with disordered ''grahani''(Duodenum and Small intestine) cannot survive for longer than for a fortnight.[18-20]

उपरुद्धस्य रोगेण कर्शितस्याल्पमश्नतः|
बहु मूत्रपुरीषं स्याद्यस्य तं परिवर्जयेत्||२१||

दुर्बलो बहु भुङ्क्ते यः प्राग्भुक्तादन्नमातुरः |
अल्पमूत्रपुरीषश्च यथा प्रेतस्तथैव सः||२२||

इष्टं च गुणसम्पन्नमन्नमश्नाति यो नरः|
शश्वच्च बलवर्णाभ्यां हीयते न स जीवति||२३||

प्रकूजति प्रश्वसिति शिथिलं चातिसार्यते|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२४||

ह्रस्वं च यः प्रश्वसिति व्याविद्धं स्पन्दते च यः|
मृतमेव तमात्रेयो व्याचचक्षे पुनर्वसुः||२५||

ऊर्ध्वं च यः प्रश्वसिति श्लेष्मणा चाभिभूयते|
हीनवर्णबलाहारो यो नरो न स जीवति||२६||

uparuddhasya rōgēṇa karśitasyālpamaśnataḥ|
bahu mūtrapurīṣaṁ syādyasya taṁ parivarjayēt||21||

durbalō bahu bhuṅktē yaḥ prāgbhuktādannamāturaḥ |
alpamūtrapurīṣaśca yathā prētastathaiva saḥ||22||

iṣṭaṁ ca guṇasampannamannamaśnāti yō naraḥ|
śaśvacca balavarṇābhyāṁ hīyatē na sa jīvati||23||

prakūjati praśvasiti śithilaṁ cātisāryatē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||24||

hrasvaṁ ca yaḥ praśvasiti vyāviddhaṁ spandatē ca yaḥ|
mr̥tamēva tamātrēyō vyācacakṣē punarvasuḥ||25||

ūrdhvaṁ ca yaḥ praśvasiti ślēṣmaṇā cābhibhūyatē|
hīnavarṇabalāhārō yō narō na sa jīvati||26||

uparuddhasya rogeNa karshitasyAlpamashnataH|
bahu mUtrapurIShaM syAdyasya taM parivarjayet||21||

durbalo bahu bhu~gkte yaH prAgbhuktAdannamAturaH |
alpamUtrapurIShashca yathA pretastathaiva saH||22||

iShTaM ca guNasampannamannamashnAti yo naraH|
shashvacca balavarNAbhyAM hIyate na sa jIvati||23||

prakUjati prashvasiti shithilaM cAtisAryate|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||24||

hrasvaM ca yaH prashvasiti vyAviddhaM spandate ca yaH|
mRutameva tamAtreyo vyAcacakShe punarvasuH||25||

UrdhvaM ca yaH prashvasiti shleShmaNA cAbhibhUyate|
hInavarNabalAhAro yo naro na sa jIvati||26||

Consumption of little quantity of food by emaciated person but excretes large amount of urine and stool should be discarded for management.

Consumption of excess quantity of food by weak patient but passes scanty urine and stool should be considered as ghost or almost dead.
In spite of taking suitable diet if person constantly loose strength and complexion indicates bad prognosis.
If a person who is weak, thirsty and having dryness of mouth, if suffers from groaning, dyspnea and diarrhea, then it should not be treated because he will not survive.

If patient is suffering from shallow respiration with irregular twitching in the body is said to be severe fatal condition like almost dead.
Person who is suffering from respiratory distress with abundance of ''kapha'' along with diminution of complexion, strength and less intake of food will not survive for longer.[21-26]

ऊर्ध्वाग्रे नयने यस्य मन्ये चारतकम्पने|
बलहीनः पिपासार्तः शुष्कास्यो न स जीवति||२७||

यस्य गण्डावुपचितौ ज्वरकासौ च दारुणौ|
शूली प्रद्वेष्टि चाप्यन्नं तस्मिन् कर्म न सिध्यति||२८||

व्यावृत्तमूर्धजिह्वास्यो भ्रुवौ यस्य च विच्युते|
कण्टकैश्चाचिता जिह्वा यथा प्रेतस्तथैव सः||२९||

शेफश्चात्यर्थमुत्सिक्तं निःसृतौ वृषणौ भृशम्|
अतश्चैव विपर्यासो विकृत्या प्रेतलक्षणम्||३०||

निचितं यस्य मांसं स्यात्त्वगस्थिष्वेव दृश्यते|
क्षीणस्यानश्नतस्तस्य मासमायुः परं भवेत्||३१||

ūrdhvāgrē nayanē yasya manyē cāratakampanē|
balahīnaḥ pipāsārtaḥ śuṣkāsyō na sa jīvati||27||

yasya gaṇḍāvupacitau jvarakāsau ca dāruṇau|
śūlī pradvēṣṭi cāpyannaṁ tasmin karma na sidhyati||28||

vyāvr̥ttamūrdhajihvāsyō bhruvau yasya ca vicyutē|
kaṇṭakaiścācitā jihvā yathā prētastathaiva saḥ||29||

śēphaścātyarthamutsiktaṁ niḥsr̥tau vr̥ṣaṇau bhr̥śam|
ataścaiva viparyāsō vikr̥tyā prētalakṣaṇam||30||

nicitaṁ yasya māṁsaṁ syāttvagasthiṣvēva dr̥śyatē|
kṣīṇasyānaśnatastasya māsamāyuḥ paraṁ bhavēt||31||

UrdhvAgre nayane yasya manye cAratakampane|
balahInaH pipAsArtaH shuShkAsyo na sa jIvati||27||

yasya gaNDAvupacitau jvarakAsau ca dAruNau|
shUlI pradveShTi cApyannaM tasmin karma na sidhyati||28||

vyAvRuttamUrdhajihvAsyo bhruvau yasya ca vicyute|
kaNTakaishcAcitA jihvA yathA pretastathaiva saH||29||

shephashcAtyarthamutsiktaM niHsRutau vRuShaNau bhRusham|
atashcaiva viparyAso vikRutyA pretalakShaNam||30||

nicitaM yasya mAMsaM syAttvagasthiShveva dRushyate|
kShINasyAnashnatastasya mAsamAyuH paraM bhavet||31||

A weak, thirsty and dryness of mouth suffers from rigid and upward look of the eyes and persistent throbbing of the carotid region of the neck, will not survive for long.

If an emaciated person having prominent cheeks along with high fever, severe cough, colic and dislike for food will not cure from his ailments because no treatment suits him.

If there is a distortion of the head, tongue and face, drooping of eye brows and appearance of thorny coat over tongue, don’t treat such patients due to its ominous nature.

Whose penis is excessively long along with pendulous testicles or vice versa, such signs are indicative of death of a patient immediately.
In emaciated individual whose muscles are excessively undergone wasting with remnants of skin and bone does not survive more than one month.[27-31]

==== Summary ====

तत्र श्लोकः-
इदं लिङ्गमरिष्टाख्यमनेकमभिजज्ञिवान्|
आयुर्वेदविदित्याख्यां लभते कुशलो जनः||३२||

tatra ślōkaḥ-
idaṁ liṅgamariṣṭākhyamanēkamabhijajñivān|
āyurvēdavidityākhyāṁ labhatē kuśalō janaḥ||32||

tatra shlokaH-
idaM li~ggamariShTAkhyamanekamabhijaj~jivAn|
AyurvedavidityAkhyAM labhate kushalo janaH||32||

To summarize:

Who is well versed with the observation of above signs and symptoms which indicates imminent death, is entitled to be known as intelligent physician. [32]

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

*Shadow image in pupils, changes in complexion and luster should be examined to assess prognosis.
*Perception of distorted images of body parts or their absence are ominous signs.

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

==== Role of ''Pancha-mahabhuta'' in complexion and luster ====
Following cross references are important to be re-visited to assess the role of ''pancha-mahabhuta'', especially ''tejas mahabhuta'' in complexion and luster.
*''Tejas mahabhuta'' promote luster complexion, strength, energy, power, digestive fire, and vitality. It also alleviates all ''vatika'' diseases and sustains youthful age. (Su.Chi.38/50)
*The normal watery rasa converted to reddish color by ''pitta'' is ''rakta'' and its equilibrium brings health. (Su.Su.14/5)
*Qualities of ''Pancha-mahabhuta'' are:
**Qualities of ''Akasha'' are- sound, auditory organ, all orifices and distinctness.
**Qualities of ''Vayu'' are – touch tactile organ, all activities, movements in all body parts and lightness.
**Qualities of ''Tejas'' are – vision, visual organ, complexion, heat, splendor, digestion, intolerance, sharpness and valor.
**Qualities of ''Apa'' are- taste, gustatory organ, all liquidity, heaviness, coldness, unctuousness and semen and
**Qualities of ''Parthiva'' (i.e., those that have qualities of the ''prithvi'' element) are- smell, olfactory organ, hardness and heaviness.(Su.Sha.1/19)
*''Tejas'' element is the causative factor of complexion when at the time of conception, it is predominantly associated with ''apa'' element, it makes the fetus fair- complexioned, predominance in ''parthivi'' elements causes black one. That in ''parthivi'' and ''akasha'' elements gives to black- sky complexion while predominance in ''apa'' and ''akasha'' elements makes fair-sky complexion of fetus. If ''tejas'' does not reach the visual organ, it makes the fetus born blind, the same associated with blood makes red eyed, that associated with ''pitta'' and ''kapha'' makes yellow- eyed and white-eyed respectively, if associated with ''vata'' it causes deformity in eyes.
*''Jatharagni'' is the primary factor for sustenance of life, color, strength, health, enthusiasm, plumpness, complexion, ''ojas, tejas,'' ''agni'' and ''prana''.
*To seethings devoid of their real characteristics - e.g., bright things looking dull and lusterless - indicates impending death of the patient.
*''Pannarupi'' implies something whose form or aspect has disappeared. ''Pannarupam'' , the word, has been derived from ''apannarupam,'' implies ill-formed or confused in respect of shape.
*Any alterations in ''chhaya'' (complexion) and ''prabha'' (luster) denotes the ominous sign for the patient.
*The process of dying usually begins well before death actually occurs. Death is a personal journey that each individual approaches in their own unique way. Nothing is concrete, nothing is set in stone. There are many paths one can take on this journey but all lead to the same destination. As one comes close to death, a process begins; a journey from the known life of this world to the unknown of what lies ahead. As that process begins, a person starts on a mental path of discovery, comprehending that death will indeed occur and believing in their own mortality. The journey ultimately leads to the physical departure from the body.

==== Sign of Imminent Death ====

#Patient who is suffering from ''kamala'', swelling in face, wasting in temples, and terrifying appearance with high fever has grave prognosis.
#Patient who faints again and again while being lifted from bed may not survive for a week. This is the time during the journey that one begins to sleep most of the time. Disorientation is common and altered senses of perception can be expected. One may experience delusions, such as fearing hidden enemies or feeling invincible. The dying person may also experience hallucinations, sometimes seeing or speaking to people that are not there or died in the past. Some may see this as the veil being lifted between this life and the next. The person may pick at their sheets and clothing in a state of agitation. Movements and actions may seem aimless and make no sense to others. They are moving further away from life to this earth.
#At the end of life, patients often lose interest in eating and drinking because the body is conserving its energy and no longer requires the same level of nourishment. It is important to let each individual decide how much, even if it is little or nothing, that he or she wishes to eat or drink. Family members should not force food or drink, as it will only make their loved one feel uncomfortable or upset. Near the end of life, patients no longer feel hunger pangs and forcing them to eat may actually cause nausea and abdominal pain. Eventually, the patient may become entirely unable to swallow food and fluids. Frequent mouth care will be given to help prevent dry mouth.
#When the body prepares to die, a decrease in urine production and loss of bladder and bowel control are noted. The urine may appear dark because the patient is not as hydrated and there is less circulation in the kidneys.
#Fluids may collect in a dying person’s throat and lungs. Because he or she is unable to swallow or cough up this fluid, he or she may make a gurgling noise. The noise may be worrisome to family members, but it is common and rarely uncomfortable for the patient. Elevating and repositioning the head may help to relieve some of the congestion.
#As cardiac output and intravascular volume decrease at the end of life, there will be evidence of diminished peripheral blood perfusion. Tachycardia, hypotension, peripheral cooling, peripheral and central cyanosis, and mottling of the skin (livedo reticularis) are expected. Venous blood may pool along dependent skin surfaces. Urine output falls as perfusion of the kidneys diminishes.

In parapsychology and many forms of spiritual practice, an aura is a field of subtle, luminous radiation surrounding a person or object (like the halo oraureola in religious art).

=== Glossary ===
पन्नरूपीय Destruction/loss of images च्छाया Complexion
प्रतिच्छाया Shadow
प्रभा lustre
कुमारिका Pupil
वर्णप्रकाशिनी illuminates complexion
सलिलादर्शयोरपि Moon light
छिन्ना भिन्ना Broken, Torn
विकृता विशिरा Bifurcated, deformed
कर्शित Emaciated
प्रेत Ghost
मुमूर्षतां Morbidity
प्रकूजति प्रश्वसिति Dyspnoea
प्राणवर्धनम् Vitality
सुषमा Symmetrical
विषमा Asymmetrical
मध्य Medium
मल्पं Short
महच्चोक्तं large
सप्रभेव lustrous shadow
दर्शनप्रिया Pleasing to the eyes
विनाशाय Great calamities
क्लेशाय Miseries
स्युर्विकासिन्यः Emanative
स्निग्धाश्च Unctuous
विपुलाश्च Auspicious
र्मुखं पूर्णं Swelling in face
शङ्खयोर्मुक्तमांसता Wasting in temples
सन्त्रास Terrifying in appearance
उत्थाप्यमानः Lifted from bed
ल्पमश्नतः Consumption of little quantity of food
बहु मूत्रपुरीषं Excretes large amount of stool and urine
प्रकूजति प्रश्वसिति Shallow respiration
व्याविद्धं स्पन्दते Irregular twitching
मन्ये चारतकम्पने Throbbing of the carotid region
निःसृतौ वृषणौ Pendulous testicles
मरिष्टा Imminent death
वर्ण Complexion
बलोत्साह Strength, energy
वयःस्थापनमुत्तमम् Sustains youthful age
शब्दः Sound
शब्देन्द्रियं Auditory organ
सर्वच्छिद्रसमूहो All orifices
विविक्तता Distinctness
स्पर्शः Touch
स्पर्शेन्द्रियं Tactile organ
सर्वचेष्टासमूहः All activities
सर्वशरीरस्पन्दनं Movement in all body parts
लघुता lightness
रूपं Vision
रूपेन्द्रियं Visual organ
भ्राजिष्णुता Splendour
मर्ष Intolerance
शौर्यं Valour
रसनेन्द्रियं Gustatory organ
सर्वद्रवसमूहो All liquidity
गुरुता Heaviness
स्नेहो Unctuousnes
रेतश्च Semen
गन्धेन्द्रियं Olfactory organ
सर्वमूर्तसमूहो Hardness

=== References ===

Kathamanasharireeya

2017-12-26T06:26:38Z

Vinay Exafluence: /* Indriya Sthana Chapter 6 */

{{Infobox
|title = Kathamanasharireeya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 6
|label2 = Preceding Chapter
|data2 = [[Indriyaneeka]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 6 ==

=== Abstract ===
<div style="text-align:justify;">
This chapter, [[Kathamanasharireeya]], explains some specific clinical features that are different than sensory perceptions and prodromal symptoms. Most of the time they indicate serious complications and are indicative of imminent death.

'''Keywords''': Death features, Bad prognostic features.
</div>
=== Introduction ===
<div style="text-align:justify;">
Previous chapter ([[Purvarupeeya]]) dealt with the types of premonitory symptoms which indicate imminent death. The present chapter focuses on the characteristic signs and symptoms of diseases in individuals which results in imminent death. The chapter signifies the importance of observation of patient in assessing prognosis of disease. The word ''kathamani sharireeyam'' implies types of presentations of diseases in body leading to immediate death.

This chapter is a random compilation of bad prognostic features of diseases that are mentioned in [[Nidana Sthana]] and [[Chikitsa Sthana]]. An experienced clinician can identify bad prognosis of disease well in time and shall intervene as per the condition of patient.
</div>
===Sanskrit text, Transliteration and English Translation===

अथातःकतमानिशरीरीयमिन्द्रियंव्याख्यास्यामः||१||

इतिहस्माहभगवानात्रेयः||२||

athātaḥkatamāniśarīrīyamindriyaṁvyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH katamAnisharIrIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Lord Atreya said, “Now we shall explain the chapter ''Katmani sharireeyam indriyam''". [1-2]

==== Query of Agnivesha ====

कतमानिशरीराणिव्याधिमन्तिमहामुने!|यानिवैद्यःपरिहरेद्येषुकर्मनसिद्ध्यति||३||

इत्यात्रेयोऽग्निवेशेनप्रश्नंपृष्टःसुदुर्वचम्|आचचक्षेयथातस्मैभगवांस्तन्निबोधत||४||

यस्य वै भाषमाणस्य रुजत्यूर्ध्वमुरो भृशम्| अन्नं च च्यवते भुक्तं स्थितं चापि न जीर्यति||५||

बलं च हीयते शीघ्रं तृष्णा चातिप्रवर्धते| जायते हृदि शूलं च तं भिषक् परिवर्जयेत्||६||

katamāni śarīrāṇi vyādhimanti mahāmunē!| yāni vaidyaḥ pariharēdyēṣu karma na siddhyati||3||

ityātrēyō'gnivēśēnapraśnaṁpr̥ṣṭaḥsudurvacam|ācacakṣēyathātasmaibhagavāṁstannibōdhata||4||

yasyavaibhāṣamāṇasyarujatyūrdhvamurōbhr̥śam|annaṁcacyavatēbhuktaṁsthitaṁcāpinajīryati||5||

balaṁ ca hīyatē śīghraṁ tr̥ṣṇā cātipravardhatē| jāyatē hr̥di śūlaṁ ca taṁ bhiṣak parivarjayēt||6||

katamAni sharIrANi vyAdhimanti mahAmune!|
yAni vaidyaH pariharedyeShu karma na siddhyati||3||

ityAtreyo~agniveshena prashnaM pRuShTaH sudurvacam|
AcacakShe yathA tasmai bhagavAMstannibodhata||4||

yasya vai bhAShamANasya rujatyUrdhvamuro bhRusham|
annaM ca cyavate bhuktaM sthitaM cApi na jIryati||5||

balaM ca hIyate shIghraM tRuShNA cAtipravardhate|
jAyate hRudi shUlaM ca taM bhiShak parivarjayet||6||
<div style="text-align:justify;">
Agnivesha asks Atreya that how many such symptoms are seen in a diseased individual for which treatment become ineffective. Hearing this, the great scholar explained him thus:

One, who has severe pain in the upper part of chest while talking, vomits the ingested food, cannot digest the food ingested; one, whose ''bala'' (strength) is depleting suddenly and who has morbid thirst; one who has pain in the region of ''hridaya'' (heart) are incurable.[3-6]
</div>
==== Poor prognosis in ''Hikka, Anaha, Atisara'' and ''Jwara'' ====

हिक्का गम्भीरजा यस्य शोणितं चातिसार्यते| न तस्मै भेषजं दद्यात् स्मरन्नात्रेयशासनम्||७||

आनाहश्चातिसारश्च यमेतौ दुर्बलं नरम्| व्याधितं विशतो रोगौ दुर्लभं तस्य जीवितम्||८||

आनाहश्चातितृष्णा च यमेतौ दुर्बलं नरम्| विशतो विजहत्येनं प्राणा नातिचिरान्नरम्||९||

ज्वरः पौर्वाह्णिको यस्य शुष्ककासश्च दारुणः| बलमांसविहीनस्य यथा प्रेतस्तथैव सः||१०||

hikkā gambhīrajā yasya śōṇitaṁ cātisāryatē| na tasmai bhēṣajaṁ dadyāt smarannātrēyaśāsanam||7||

ānāhaścātisāraśca yamētau durbalaṁ naram| vyādhitaṁ viśatō rōgau durlabhaṁ tasya jīvitam||8||

ānāhaścātitr̥ṣṇā ca yamētau durbalaṁ naram| viśatō vijahatyēnaṁ prāṇā nāticirānnaram||9||

jvaraḥ paurvāhṇikō yasya śuṣkakāsaśca dāruṇaḥ| balamāṁsavihīnasya yathā prētastathaiva saḥ||10||

hikkA gambhIrajA yasya shoNitaM cAtisAryate|
na tasmai bheShajaM dadyAt smarannAtreyashAsanam||7||

AnAhashcAtisArashca yametau durbalaM naram|
vyAdhitaM vishato rogau durlabhaM tasya jIvitam||8||

AnAhashcAtitRuShNA ca yametau durbalaM naram|
vishato vijahatyenaM prANA nAticirAnnaram||9||

jvaraH paurvAhNiko yasya shuShkakAsashca dAruNaH|
balamAMsavihInasya yathA pretastathaiva saH||10||
<div style="text-align:justify;">
''Gambheera hikka'', or hiccups with deeper pathology, when accompanied with bleeding diarrhea, is a serious condition. In such a case, medication should not be given since the condition is not manageable by stream of Atreya school of medicine. (Note: It may be managed by Dhanwantari school of surgery).

Further, when ''gambheera hikka'' (hiccups with deeper pathology) is associated with ''anaha'' (distended abdomen) and ''atisara'' (diarrhea), both in a weak person is most difficult to treat and the person’s life is in danger.

Further this same is associated with ''anaha'' (distended abdomen) and ''trishna'' (excessive thirst) in a weak person, has poor prognosis and he will die soon.

Again this hiccups associated with ''poorvanhika jwara'' (fever in forenoon) and ''shushka kasa'' (dry cough) in a person with wasting of muscles and depleted strength as like as dead body .[7-10]
</div>
==== Poor prognosis in ''Shotha'' ====

यस्य मूत्रं पुरीषं च ग्रथितं सम्प्रवर्तते| निरूष्मणो जठरिणः श्वसनो न स जीवति||११||

श्वयथुर्यस्य कुक्षिस्थो हस्तपादं विसर्पति| ज्ञातिसङ्घं स सङ्क्लेश्य तेन रोगेण हन्यते||१२||

श्वयथुर्यस्य पादस्थस्तथा स्रस्ते च पिण्डिके| सीदतश्चाप्युभे जङ्घे तं भिषक् परिवर्जयेत्||१३||

शूनहस्तं शूनपादं शूनगुह्योदरं नरम्| हीनवर्णबलाहारमौषधैर्नोपपादयेत्||१४||

yasya mūtraṁ purīṣaṁ ca grathitaṁ sampravartatē| nirūṣmaṇō jaṭhariṇaḥ śvasanō na sa jīvati||11||

śvayathuryasya kukṣisthō hastapādaṁ visarpati| jñātisaṅghaṁ sa saṅklēśya tēna rōgēṇa hanyatē||12||

śvayathuryasya pādasthastathā srastē ca piṇḍikē| sīdataścāpyubhē jaṅghē taṁ bhiṣak parivarjayēt||13||

śūnahastaṁ śūnapādaṁ śūnaguhyōdaraṁ naram| hīnavarṇabalāhāramauṣadhairnōpapādayēt||14||

yasya mUtraM purIShaM ca grathitaM sampravartate|
nirUShmaNo jaThariNaH shvasano na sa jIvati||11||

shvayathuryasya kukShistho hastapAdaM visarpati|
j~jAtisa~gghaM sa sa~gkleshya tena rogeNa hanyate||12||

shvayathuryasya pAdasthastathA sraste ca piNDike|
sIdatashcApyubhe ja~gghe taM bhiShak parivarjayet||13||

shUnahastaM shUnapAdaM shUnaguhyodaraM naram|
hInavarNabalAhAramauShadhairnopapAdayet||14||
<div style="text-align:justify;">
In a person with abdominal disease, who passes hard stool and condensed urine, whose body temperature is subnormal, and has dyspnea, is unable to survive.

A person whose abdominal edema spreads towards upper and lower both extremities will cause great distress to his relatives (due to disease) and dies with same disease.

A person having pedal edema, with flaccid calf muscles and pain in both thighs shall be avoided by physician (due to poor prognosis).

A person having edema on hands, feet pelvic region, abdomen and diminution of color complexion, strength, and aversion of food should not be administered medicine [due to poor prognosis, medicines are of no use]. [11-14]
</div>
==== Poor prognosis in respiratory disorders ====

उरोयुक्तो बहुश्लेष्मा नीलः पीतः सलोहितः| सततं च्यवते यस्य दूरात्तं परिवर्जयेत्||१५||

हृष्टरोमा सान्द्रमूत्रः शूनः कासज्वरार्दितः | क्षीणमांसो नरो दूराद्वर्ज्यो वैद्येन जानता||१६||

त्रयः प्रकुपिता यस्य दोषाः कष्टाभिलक्षिताः | कृशस्य बलहीनस्य नास्ति तस्य चिकित्सितम्||१७||

ज्वरातिसारौ शोफान्ते श्वयथुर्वा तयोः क्षये| दुर्बलस्य विशेषेण नरस्यान्ताय जायते||१८||

पाण्डुरश्च कृशोऽत्यर्थं तृष्णयाऽभिपरिप्लुतः| डम्बरी कुपितोच्छ्वासः प्रत्याख्येयो विजानता||१९||

urōyuktō bahuślēṣmā nīlaḥ pītaḥ salōhitaḥ| satataṁ cyavatē yasya dūrāttaṁ parivarjayēt||15||

hr̥ṣṭarōmā sāndramūtraḥ śūnaḥ kāsajvarārditaḥ | kṣīṇamāṁsō narō dūrādvarjyō vaidyēna jānatā||16||

trayaḥ prakupitā yasya dōṣāḥ kaṣṭābhilakṣitāḥ | kr̥śasya balahīnasya nāsti tasya cikitsitam||17||

jvarātisārau śōphāntē śvayathurvā tayōḥ kṣayē| durbalasya viśēṣēṇa narasyāntāya jāyatē||18||

pāṇḍuraśca kr̥śō'tyarthaṁ tr̥ṣṇayā'bhipariplutaḥ| ḍambarī kupitōcchvāsaḥ pratyākhyēyō vijānatā||19||

uroyukto bahushleShmA nIlaH pItaH salohitaH|
satataM cyavate yasya dUrAttaM parivarjayet||15||

hRuShTaromA sAndramUtraH shUnaH kAsajvarArditaH |
kShINamAMso naro dUrAdvarjyo vaidyena jAnatA||16||

trayaH prakupitA yasya doShAH kaShTAbhilakShitAH |
kRushasya balahInasya nAsti tasya cikitsitam||17||

jvarAtisArau shophAnte shvayathurvA tayoH kShaye|
durbalasya visheSheNa narasyAntAya jAyate||18||

pANDurashca kRusho~atyarthaM tRuShNayA~abhipariplutaH|
DambarI kupitocchvAsaH pratyAkhyeyo vijAnatA||19||
<div style="text-align:justify;">
One whose chest is full of phlegm, and constantly expectorates the blue, yellow, and blood mixed sputum, a wise physician should avoid to treat such patients even from distance.

A patient who is having thin stature, wasting of muscles, with Horripilation, colloidal or thick urine, with edema, cough, and fever, should be avoided by physician.

A person whose all the three doshas are vitiated, emaciated, having no strength, is untreatable.

If, in an emaciated patient with fever and diarrhea as sequel of edema or edema as sequel of these two, dies soon. A patient who is pale, excessively emaciated, having excessive thirst, eyes are fixed on one object, and with painful breath is better to declare untreatable. [15-19]
</div>
हनुमन्याग्रहस्तृष्णा बलह्रासोऽतिमात्रया| प्राणाश्चोरसि वर्तन्ते यस्य तं परिवर्जयेत्||२०||

hanumanyāgrahastr̥ṣṇā balahrāsō'timātrayā| prāṇāścōrasi vartantē yasya taṁ parivarjayēt||20||

hanumanyAgrahastRuShNA balahrAso~atimAtrayA|
prANAshcorasi vartante yasya taM parivarjayet||20||

If a person having lock jaw and rigid neck suffers from thirst, diminished strength, and the signs of life(breath) are only confined to chest, such patient should be discarded for treatment purpose. [20]

==== Markers of imminent death ====

ताम्यत्यायच्छते शर्म न किञ्चिदपि विन्दति| क्षीणमांसबलाहारो मुमूर्षुरचिरान्नरः||२१||

विरुद्धयोनयो यस्य विरुद्धोपक्रमा भृशम्| वर्धन्ते दारुणा रोगाः शीघ्रं शीघ्रं स हन्यते||२२||

बलं विज्ञानमारोग्यं ग्रहणी मांसशोणितम् | एतानि यस्य क्षीयन्ते क्षिप्रं क्षिप्रं स हन्यते||२३||

आरोग्यं हीयते यस्य प्रकृतिः परिहीयते| सहसा सहसा तस्य मृत्युर्हरति जीवितम्||२४||

tāmyatyāyacchatē śarma na kiñcidapi vindati| kṣīṇamāṁsabalāhārō mumūrṣuracirānnaraḥ||21||

viruddhayōnayō yasya viruddhōpakramā bhr̥śam| vardhantē dāruṇā rōgāḥ śīghraṁ śīghraṁ sa hanyatē||22||

balaṁ vijñānamārōgyaṁ grahaṇī māṁsaśōṇitam | ētāni yasya kṣīyantē kṣipraṁ kṣipraṁ sa hanyatē||23||

ārōgyaṁ hīyatē yasya prakr̥tiḥ parihīyatē| sahasā sahasā tasya mr̥tyurharati jīvitam||24||

tAmyatyAyacchate sharma na ki~jcidapi vindati|
kShINamAMsabalAhAro mumUrShuracirAnnaraH||21||

viruddhayonayo yasya viruddhopakramA bhRusham|
vardhantedAruNA rogAH shIghraM shIghraM sa hanyate||22||

balaM vij~jAnamArogyaM grahaNI mAMsashoNitam |
etAni yasya kShIyante kShipraM kShipraM sa hanyate||23||

ArogyaM hIyate yasya prakRutiH parihIyate|
sahasA sahasA tasya mRutyurharati jIvitam||24||
<div style="text-align:justify;">
If an emaciated person with diminished strength presenting lack of digestive power, faints repeatedly, with violent movements of the body and restlessness in any situation, he succumbs to death immediately.

In a person suffering from more than one disease, and if their etiological factors are mutually contradictory and the line of treatments are also contradictory this is indicative of fatal prognosis. If they appear suddenly, the sudden death of the patient is also certain.

Strength against disease is knowledge of Health and health is based on digestive power and power or muscles, and purity of blood. Where all these diminished there is no hope for long life and thus succumb for death.

If there is sudden deterioration of health is extended to the change in basic constitution (''prakriti'') of a patient then he succumbs for sudden death. [21-24]
</div>
==== Summary ====

तत्रश्लोकः-
इत्येतानि शरीराणि व्याधिमन्ति विवर्जयेत्| न ह्येषु धीराः पश्यन्ति सिद्धिं काञ्चिदुपक्रमात्||२५||

tatraślōkaḥ-
ityētāni śarīrāṇi vyādhimanti vivarjayēt| na hyēṣu dhīrāḥ paśyanti siddhiṁ kāñcidupakramāt||25||

tatra shlokaH-
ityetAni sharIrANi vyAdhimanti vivarjayet|
na hyeShu dhIrAH pashyanti siddhiM kA~jcidupakramAt||25||

Patients with above mentioned diseases should not be taken for treatment. The wise physician should not anticipate success of his treatment in such cases.[25]

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*Strength against disease is knowledge of health.
*Health is based on digestive power, power of muscles and purity of blood. Significant decrease of these are the markers of terminal illness.
*Sudden deterioration of health and change in basic constitution (''prakriti'') of a patient, is fatal sign.
*In a person suffering from more than one disease, and if their etiological factors are mutually contradictory and the line of treatments are also contradictory, the condition worsens with bad prognosis leading to death. If they appear suddenly, the sudden death of the patient is also certain. [21-24]

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

*The conditions related with respiratory disease pathologies are pleural effusion, pneumothorax and pleural tumors and secondary to pulmonary diseases like pneumonias, pulmonary infarction and bronchogenic carcinoma.
*''Anna'' (food) is considered as ''prana'' (vital force). Difficulty to intake the food interferes with nutrition and leads to severe disability. It also interferes with the intake of medicines. Dysphagia may be due to mechanical causes or neurological causes seen associated with other serious pathologies. Lack of digestion indicates impairment of digestive system and thus lack of absorption of nutrients and medicines. ''Prakrita kapha'' imparts ''bala'' (strength) to the body. Sudden depletion of ''bala'' indicates impairment of ''Ojus''. ''Bala'' is essential for both treatment and for prevention of further progression of disease. Severe ''kapha kshaya'' (depletion of ''kapha'') and ''vata-pitta'' vitiation is explained as the cause behind the pathogenesis of ''trishna''. ''Trishna'' indicates not merely thirst, but severe depletion of water and electrolytes from the body which may lead to pathology even at the cellular level. [verse 5-6]
*''Gambheera Hikka'' (severe hiccups) is included as one among the terminal illness in Ayurveda. The word ''gambheera'' indicates either ''hikka'' originating from deep pathology. ''Gambheera hikka'' is mentioned as ''pranantiki'' (Life ending) by Charaka in the [[Chikitsa Sthana]]. Persistent hiccups are seen in many pathologies both mechanical and neurological like central nervous system lesions and tumors. Individuals who are very weak due to any illness get afflicted with abdominal distension (''anaha'') and diarrhea simultaneously, it will be very much difficult to prolong his life. Likewise, a debilitated or weak person when afflicted with morbid thirst (''trishna'') and abdominal distension (''anaha'') will soon die.
*The word ''durbala'' signifies decreased strength in terms of immune deficiency, decreased quality of ''dhatus'', diminished ability to withstand the strength of medicine and disease itself and decreased ability to recover. Such a person, who is weakened by illness when afflicted by any disease or any super imposed infection, there are less chances of survival.
The conditions related to gastrointestinal pathologies include, E.coli infections, Irritable Bowel Syndrome, colitis, lactose intolerance, intestinal obstructions, cystic fibrosis, colon cancer.
*Agni is considered the principal factor responsible for health and disease. When a condition is mentioned as ''nirishmana'' (decrease in temperature/warmth), it ascertains to the fact that the dissociative and associative functions that usually happens physiologically in an individual is subnormal. The physiological levels of ''agni'' in succeeding hierarchy such as the ''dhatwagni'' and ''bhutagni'' will naturally get deranged. Such an individual does not respond to medication and the ''dhatus'' formed will be either ''saama'' or there will be ''dhatu sarahinatha'', which by itself forms abasement for ensuing diseases to be strong and with serious complications.
*The condition presented with edema as feature are Congestive cardiac failure, end stage renal failure, Good Pasteur’s syndrome, Hemolytic uremic syndrome, Cardiomyopathy, Ascites, Thrombophlebitis.

Few diseased conditions mentioned here in this chapter may be in quite manageable stage with the present modern management facilities but to the time of Charaka those were definitely fatal. For example, many of hypo-volemic and dehydrated conditions are well treated now. But still it is a challenge to save life in toxic dehydrations. Many such clinical challenges are narrated where patient should not be neglected, rather aggressive care should be provided with informed consent to the relatives about possible fatal outcome.
</div>

Purvarupeeya

2017-12-26T06:21:32Z

Vinay Exafluence: /* Indriya Sthana Chapter 5 */

{{Infobox
|title = Purvarupeeya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 5
|label2 = Preceding Chapter
|data2 = [[Indriyaneeka]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 5 ==

===Abstract===
<div style="text-align:justify;">
[[Purvarupeeya]] has been devoted to predict prognosis of diseases by prodromal symptoms. This chapter suggests that knowledge and examination of prodromal symptoms was important in ancient times and emphasis was given that physician should carefully recognize disease in early stage and predict course of disease. With the help of eight diseases of [[Nidana Sthana]] important principles related to prognosis have been laid down which are also applicable to all other diseases and are valid till now. Various aspects of dreams including physiology, types, interpretation and prognostic importance have also been described. Various dreams along with physical and mental features have been incorporated in prodromal symptoms which signify that dreams should also be analyzed and properly investigated before predicting prognosis of any disease. Even with restricted technological tools, par excellence observation and principles described regarding ''Arishta Lakshana'' are valid till now.

'''Keywords''': Prodromal symptoms, dream, prognosis, disease, death.
</div>
=== Introduction ===
<div style="text-align:justify;">
In this chapter prodromal symptoms and dreams related to poor prognosis of diseases- fatality are described. In the first verse, Charaka has emphasized that he will describe both common and special prodromal symptoms. This indicates that while there may be some prodromata which result out of normal pathogenesis, some are unusual and unexpected. In the next verse it has been said that if all prodromal symptoms are manifesting and are severe in nature then such a condition will be fatal. This principle is applicable to all other diseases also. Prodromal symptoms of ''kushta'' and ''prameha'' suggest that complications manifest before cardinal symptoms of the disease appear. If body metabolism in any disease is altered severely during latent phase of disease and complications are appearing before manifestation of full-fledged disease then such condition will be difficult to cure. Example of ''gulma'' suggests that there are certain diseases which are incurable in nature and prodromal symptoms related to such clinical conditions will always be precursors of imminent death. It is commonly seen that any person who is emaciated and have low immunity and strength, when affected by disease, has fatal consequences due to less resistance. This fact is explained with the example of ''shosha''. Another important aspect regarding disease prognosis is that, if a person is continuously partaking causative factors or is in constant exposure to the causative factors, body will be unable to fight disease properly and thus there will be less chances of recovery from the disease. This point is also mentioned while describing prognosis of ''shosha''.

From the above discussion it is clear that prodromal symptoms can be useful in predicting diagnosis of any disease. But now question arises whether it is practically possible to predict prognosis with prodromal symptoms? We should admit that it is very difficult and one will need years of experience to attain such competence. Another important fact is that the prediction of prognosis can be done from ''purvarupa'' only after disease manifestation. Charaka states that ''purvarupa'' converting into a particular disease in future can be termed a prognostic sign. This indicates that we cannot predict by only prodromal symptoms. We have to look into whether disease was produced after ''purvarupa'' or not. For example, delirium in ''raktapitta'' is indicator of poor prognosis. If delirium is seen in any patient but he is not developing ''raktapitta'' we cannot predict poor prognosis. In this condition, after manifestation of ''raktapitta'' we need to ask the patient whether he suffered from delirium before disease manifestation or not. It is a retrospective inquiry about ''purvarupa'' based on which a prospective prediction may be made. We will have to follow detailed retro-prospective approach and will need proper patient history comprising of each and every detail from prodromal symptoms to disease manifestation. Thus practically, prodromal symptoms are helpful only after disease manifestation as they are not independent. Since accompanying symptoms may also lead to predictions, they can also be regarded as tools of predictive prognosis. This might be the reason that Sushruta and Vagbhata have not described dreams in reference of ''purvarupa'' but have described in ''rupavastha'' (stage of disease manifestation).

Biomarkers are recent advancements can be the answer to above problem as we do not need to wait for disease manifestation and can predict prognosis by seeing values of biomarkers related to that disease. In 2001, a consensus panel at the National Institutes of Health defined the term biomarker as ‘a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention or other health care intervention’.<ref>Torres-Bugarín O, Zavala-Cerna MG, Nava A, Flores-García A, Ramos-Ibarra ML. Potential Uses, Limitations, and Basic Procedures of Micronuclei and Nuclear Abnormalities in Buccal Cells. Disease Markers. 2014;2014:956835. </ref> Biomarker defined as alteration in the constituents of tissues or body fluids provide a powerful approach to understanding the spectrum of chronic disease with application in at least 5 areas like screening, diagnosis, prognostics, prediction of disease recurrence and therapeutic monitoring.<ref>Pradeep Sahu et al, Biomarkers: An Emerging Tool for Diagnosis of a Disease and Drug Development, Asian J. Res. Pharm. Sci. 2011; Vol. 1: Issue 1, Pg 09-16 </ref> The biomarker is either produced by the diseased organ (e.g., tumor) or by the body in response to disease. Before diagnosis, markers could be used for screening and risk assessment. Tumor classification, stage and sometimes grade are generally used to assess prognosis. Researches in the field of biomarkers may give us chance to know prognosis of disease in early stage.

Another important aspect mentioned in this chapter is concept of dreams. The descriptions related to dreams are found abundantly in the ancient oriental classics, specifically the Atharvaveda, Upanishadas, Puranas, Darshanas and [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. The description of the ''doshika'' dreams of the Atharvaveda is similar to that in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. Dreams are mentioned while describing ''purvarupa'', ''rupa'' and ''arishta lakshanas''.<ref>Sonali S. Tendulkar and R. R. Dwivedi, ‘Swapna’ in the Indian classics: Mythology or science?,Ayu. 2010 Apr-Jun; 31(2): 170–174. </ref> Sushruta states that sex of the unborn child can be predicted and Vagbhata says that ''doshika prakriti'' can be known by the help of dreams.

Subject of dreams is dealt in very scientific manner. According to Charaka, dreams occur when person is in relatively wakeful state. This has been proved now by the researches that dreams mainly occur in the rapid-eye movement (REM) stage of sleep—when brain activity is high and resembles that of being awake. In the late 19th century, psychotherapist Sigmund Freud developed a theory that the content of dreams is driven by unconscious wish fulfillment. Freud called dreams the "royal road to the unconscious”.<ref>Jeannette Y. Wick; Guido R. Zann, Drugs and Dreams, J Am Pharm Assoc (2003) 2002;42:385-390. </ref> To Freud, no dream was of entertainment value, they all held important meanings. Dreams reflect the dreamer’s mental, emotional, and physical state. This fact is well established in this chapter while describing classification of dreams. Dreams are based on our day to day interactions and so are classified as dreams seen, heard, felt etc. Two of the seven types, one which predict prognosis and one which is due to vitiation of ''doshas'' are said to have fatal consequences.

Research studies are needed to prove that dreams can be used as markers of prognosis. Some studies have been conducted in this regard but we cannot make strong conclusion on basis of their results. In a few studies it has been shown that hormone levels affect dreams. One of the studies states that cortisol plays an important role in controlling the state of memory systems during sleep. High levels of cortisol, as are observed late at night and, typically in the context of REM sleep, disrupt normal hippocampal → neocortical communication, thereby interfering with forms of memory consolidation dependent upon this communication. At the same time, the content of dreams is also affected.<ref>Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678. </ref> In neurological and psychological diseases dream disturbances are often seen but few other diseases have also been found to affect dreams. Patients with sleep apnea are reported to have intense nightmares.<ref>J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73. </ref> Abnormal dreams have also been reported in diseases like Relapsing fever,<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165. </ref> Cardiac ischemia<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28. </ref> etc. Certain drugs also affect dreams e.g. Anti malarial drug has shown to alter dream types.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203. </ref> This proves that at times diseases certainly affect dreams but intense research studies are needed to actually establish this fact on scientific grounds.
</div>
===Sanskrit text, Transliteration and English Translation===

अथातः पूर्वरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pūrvarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pUrvarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter of premonitory symptoms related to signs of death.
Thus spoke lord Atreya.[1-2]

==== Incurable prodromal signs of ''Jwara'' leading to death ====

पूर्वरूपाण्यसाध्यानां विकाराणां पृथक् पृथक्|
भिन्नाभिन्नानि वक्ष्यामो भिषजां ज्ञानवृद्धये||३||

पूर्वरूपाणि सर्वाणि ज्वरोक्तान्यतिमात्रया|
यं विशन्ति विशत्येनं मृत्युर्ज्वरपुरःसरः||४||

अन्यस्यापि च रोगस्य पूर्वरूपाणि यं नरम्|
विशन्त्यनेन कल्पेन तस्यापि मरणं ध्रुवम्||५||

pūrvarūpāṇyasādhyānāṁ vikārāṇāṁ pr̥thak pr̥thak|
bhinnābhinnāni vakṣyāmō bhiṣajāṁ jñānavr̥ddhayē||3||

pūrvarūpāṇi sarvāṇi jvarōktānyatimātrayā|
yaṁ viśanti viśatyēnaṁ mr̥tyurjvarapuraḥsaraḥ||4||

anyasyāpi ca rōgasya pūrvarūpāṇi yaṁ naram|
viśantyanēna kalpēna tasyāpi maraṇaṁ dhruvam||5||

pUrvarUpANyasAdhyAnAM vikArANAM pRuthak pRuthak|
bhinnAbhinnAni vakShyAmo bhiShajAM j~jAnavRuddhaye||3||

pUrvarUpANi sarvANi jvaroktAnyatimAtrayA|
yaM vishanti vishatyenaM mRutyurjvarapuraHsaraH||4||

anyasyApi ca rogasya pUrvarUpANi yaM naram|
vishantyanena kalpena tasyApi maraNaM dhruvam||5||
<div style="text-align:justify;">
For enhancing the knowledge of physicians, we will distinctly explain the general and fatal prodromal symptoms of diseases.
If all prodromal symptoms of ''jwara'' manifests in severe degree, the person will die. If prodromal symptoms of any other disease also appear in the same way as described above, death of the patient is certain. [3-5]
</div>
==== Incurable prodromal signs of ''Rajayakshma'' leading to death ====

पूर्वरूपैकदेशांस्तु वक्ष्यामोऽन्यान् सुदारुणान्|
ये रोगाननुबध्नन्ति मृत्युर्यैरनुबध्यते [१] ||६||

बलं च हीयते यस्य प्रतिश्यायश्च वर्धते|
तस्य नारीप्रसक्तस्य शोषोऽन्तायोपजायते||७||

श्वभिरुष्ट्रैः खरैर्वाऽपि याति यो दक्षिणां दिशम्|
स्वप्ने यक्ष्माणमासाद्य जीवितं स विमुञ्चति||८||

प्रेतैः सह पिबेन्मद्यं स्वप्ने यः कृष्यते शुना|
सुघोरं ज्वरमासाद्य जीवितं स विमुञ्चति||९||

pūrvarūpaikadēśāṁstu vakṣyāmō'nyān sudāruṇān|
yē rōgānanubadhnanti mr̥tyuryairanubadhyatē ||6||

balaṁ ca hīyatē yasya pratiśyāyaśca vardhatē|
tasya nārīprasaktasya śōṣō'ntāyōpajāyatē||7||

śvabhiruṣṭraiḥ kharairvā'pi yāti yō dakṣiṇāṁ diśam|
svapnē yakṣmāṇamāsādya jīvitaṁ sa vimuñcati||8||

prētaiḥ saha pibēnmadyaṁ svapnē yaḥ kr̥ṣyatē śunā|
sughōraṁ jvaramāsādya jīvitaṁ sa vimuñcati||9||

pUrvarUpaikadeshAMstu vakShyAmo~anyAn sudAruNAn|
ye rogAnanubadhnanti mRutyuryairanubadhyate ||6||

balaM ca hIyate yasya pratishyAyashca vardhate|
tasya nArIprasaktasya shoSho~antAyopajAyate||7||

shvabhiruShTraiH kharairvA~api yAti yo dakShiNAM disham|
svapne yakShmANamAsAdya jIvitaM sa vimu~jcati||8||

pretaiH saha pibenmadyaM svapne yaH kRuShyate shunA|
sughoraM jvaramAsAdya jIvitaM sa vimu~jcati||9||
<div style="text-align:justify;">
Now we shall discuss certain severe premonitory symptoms which are associated with certain diseases.
The consumption which is associated with continuously decreasing strength, worsening rhinitis and over indulgence in sex in prodromal stage will turn out to be incurable.

A man, who in his dreams, is dragged by dog, camel or a donkey towards south, leaves his life as by consumption.
A person who in his dreams takes alcohol with demons and who is dragged by a dog leaves his life getting affected with severe fever. [6-9]
</div>
==== Incurable prodromal signs of ''Raktapitta'' leading to death ====

लाक्षारक्ताम्बराभं यः पश्यत्यम्बरमन्तिकात्|
स रक्तपित्तमासाद्य तेनैवान्ताय नीयते||१०||

रक्तस्रग्रक्तसर्वाङ्गो रक्तवासा मुहुर्हसन्|
यः स्वप्ने ह्रियते नार्या स रक्तं प्राप्य सीदति||११||

lākṣāraktāmbarābhaṁ yaḥ paśyatyambaramantikāt|
sa raktapittamāsādya tēnaivāntāya nīyatē||10||

raktasragraktasarvāṅgō raktavāsā muhurhasan|
yaḥ svapnē hriyatē nāryā sa raktaṁ prāpya sīdati||11||

lAkShAraktAmbarAbhaM yaH pashyatyambaramantikAt|
sa raktapittamAsAdya tenaivAntAya nIyate||10||

raktasragraktasarvA~ggo raktavAsA muhurhasan|
yaH svapne hriyate nAryA sa raktaM prApya sIdati||11||
<div style="text-align:justify;">
He who sees clothes as if dyed with red lac, leaves his life if he gets affected with severe bleeding disorders.
In his dream, the man who sees himself adorned with red garlands, clad in red clothes, anointed with red dye and dragged by a continuously laughing woman will succumb to severe bleeding disorders. [10-11]
</div>
==== Incurable prodromal signs of ''Gulma'' leading to death ====

शूलाटोपान्त्रकूजाश्च दौर्बल्यं चातिमात्रया|
नखादिषु च वैवर्ण्यं गुल्मेनान्तकरो ग्रहः||१२||

लता कण्टकिनी यस्य दारुणा हृदि जायते|
स्वप्ने गुल्मस्तमन्ताय क्रूरो विशति मानवम्||१३||

śūlāṭōpāntrakūjāśca daurbalyaṁ cātimātrayā|
nakhādiṣu ca vaivarṇyaṁ gulmēnāntakarō grahaḥ||12||

latā kaṇṭakinī yasya dāruṇā hr̥di jāyatē|
svapnē gulmastamantāya krūrō viśati mānavam||13||

shUlATopAntrakUjAshca daurbalyaM cAtimAtrayA|
nakhAdiShu ca vaivarNyaM gulmenAntakaro grahaH||12||

latA kaNTakinI yasya dAruNA hRudi jAyate|
svapne gulmastamantAya krUro vishati mAnavam||13||
<div style="text-align:justify;">
A man who experiences severe pain, gurgling sounds in abdomen, intestinal peristalsis, excessive debility, discoloration of nails and other body parts is going to die if he is affected with ''gulma''.

A person, who in his dreams sees hard and thorny creepers grown on his chest and then gets afflicted by ''gulma'', is surely going to die soon. [12-13]
</div>
==== Incurable prodromal signs of ''Kushtha'' leading to death ====

कायेऽल्पमपि संस्पृष्टं सुभृशं यस्य दीर्यते|
क्षतानि च न रोहन्ति कुष्ठैर्मृत्युर्हिनस्ति तम्||१४||

नग्नस्याज्यावसिक्तस्य जुह्वतोऽग्निमनर्चिषम्|
पद्मान्युरसि जायन्ते स्वप्ने कुष्ठैर्मरिष्यतः||१५||

kāyē'lpamapi saṁspr̥ṣṭaṁ subhr̥śaṁ yasya dīryatē|
kṣatāni ca na rōhanti kuṣṭhairmr̥tyurhinasti tam||14||

nagnasyājyāvasiktasya juhvatō'gnimanarciṣam|
padmānyurasi jāyantē svapnē kuṣṭhairmariṣyataḥ||15||

kAye~alpamapi saMspRuShTaM subhRushaM yasya dIryate|
kShatAni ca na rohanti kuShThairmRutyurhinasti tam||14||

nagnasyAjyAvasiktasya juhvato~agnimanarciSham|
padmAnyurasi jAyante svapne kuShThairmariShyataH||15||
<div style="text-align:justify;">
A person whose body even if touched gently leads to deep cuts and whose injuries never heal will be killed by severe skin diseases.
In his dream, a man who sees himself naked, anointed with ghee, offering the oblations without the fire being lit, who has lotuses grown on his chest, will be taken away by death as afflicted by skin diseases.[14-15]
</div>
==== Incurable prodromal signs of ''Prameha'' leading to death ====

स्नातानुलिप्तगात्रेऽपि यस्मिन् गृध्नन्ति मक्षिकाः|
स प्रमेहेण संस्पर्शं प्राप्य तेनैव हन्यते||१६||

स्नेहं बहुविधं स्वप्ने चण्डालैः सह यः पिबेत्|
बध्यते स प्रमेहेण स्पृश्यतेऽन्ताय मानवः||१७||

snātānuliptagātrē'pi yasmin gr̥dhnanti makṣikāḥ|
sa pramēhēṇa saṁsparśaṁ prāpya tēnaiva hanyatē||16||

snēhaṁ bahuvidhaṁ svapnē caṇḍālaiḥ saha yaḥ pibēt|
badhyatē sa pramēhēṇa spr̥śyatē'ntāya mānavaḥ||17||

snAtAnuliptagAtre~api yasmin gRudhnanti makShikAH|
sa prameheNa saMsparshaM prApya tenaiva hanyate||16||

snehaM bahuvidhaM svapne caNDAlaiH saha yaH pibet|
badhyate sa prameheNa spRushyate~antAya mAnavaH||17||

Even after taking bath and getting anointed with scents, flies are attracted towards person, he will certainly die, if affected with ''prameha''.

One who sees in his dreams, drinking various kinds of oily substances with Chandalas becomes affected by ''prameha'' and will die. [16-17]

==== Incurable prodromal signs of ''Unmada'' and ''Apasmara'' leading to death ====

ध्यानायासौ तथोद्वेगौ मोहश्चास्थानसम्भवः|
अरतिर्बलहानिश्च मृत्युरुन्मादपूर्वकः||१८||

आहारद्वेषिणं पश्यन् लुप्तचित्तमुदर्दितम्|
विद्याद्धीरो मुमूर्षुं तमुन्मादेनातिपातिना||१९||

क्रोधनं त्रासबहुलं सकृत्प्रहसिताननम्|
मूर्च्छापिपासाबहुलं हन्त्युन्मादः शरीरिणम्||२०||

नृत्यन् रक्षोगणैः साकं यः स्वप्नेऽम्भसि सीदति |
स प्राप्य भृशमुन्मादं याति लोकमतः परम्||२१||

असत्तमः पश्यति यः शृणोत्यप्यसतः स्वनान्|
बहून् बहुविधान् जाग्रत् सोऽपस्मारेण बध्यते||२२||

मत्तं नृत्यन्तमाविध्य प्रेतो हरति यं नरम्|
स्वप्ने हरति तं मृत्युरपस्मारपुरःसरः||२३||

dhyānāyāsau tathōdvēgau mōhaścāsthānasambhavaḥ|
aratirbalahāniśca mr̥tyurunmādapūrvakaḥ||18||

āhāradvēṣiṇaṁ paśyan luptacittamudarditam|
vidyāddhīrō mumūrṣuṁ tamunmādēnātipātinā||19||

krōdhanaṁ trāsabahulaṁ sakr̥tprahasitānanam|
mūrcchāpipāsābahulaṁ hantyunmādaḥ śarīriṇam||20||

nr̥tyan rakṣōgaṇaiḥ sākaṁ yaḥ svapnē'mbhasi sīdati |
sa prāpya bhr̥śamunmādaṁ yāti lōkamataḥ param||21||

asattamaḥ paśyati yaḥ śr̥ṇōtyapyasataḥ svanān|
bahūn bahuvidhān jāgrat sō'pasmārēṇa badhyatē||22||

mattaṁ nr̥tyantamāvidhya prētō harati yaṁ naram|
svapnē harati taṁ mr̥tyurapasmārapuraḥsaraḥ||23||

dhyAnAyAsau tathodvegau mohashcAsthAnasambhavaH|
aratirbalahAnishca mRutyurunmAdapUrvakaH||18||

AhAradveShiNaM pashyan luptacittamudarditam|
vidyAddhIro mumUrShuM tamunmAdenAtipAtinA||19||

krodhanaM trAsabahulaM sakRutprahasitAnanam|
mUrcchApipAsAbahulaM hantyunmAdaH sharIriNam||20||

nRutyan rakShogaNaiH sAkaM yaH svapne~ambhasi sIdati |
sa prApya bhRushamunmAdaM yAti lokamataH param||21||

asattamaH pashyati yaH shRuNotyapyasataH svanAn|
bahUn bahuvidhAn jAgrat so~apasmAreNa badhyate||22||

mattaM nRutyantamAvidhya preto harati yaM naram|
svapne harati taM mRutyurapasmArapuraHsaraH||23||
<div style="text-align:justify;">
He who is affected with disturbing thoughts, anxiety, stupefaction without any specific cause, restlessness, loss of strength will succumb to death as affected with insanity.

The person who feels excess anger, fear, always smiles and who is suffering from severe stupor and thirst will be certainly killed by insanity.

The man who in his dreams dances with evil spirits and sinks in water leaves the world.
He who sees darkness even when he is awake and hears sounds when there is no real sound, will be killed by epilepsy.
In dream, a person who sees himself dancing with ghosts while in intoxication with his head upside down, will be taken away by death getting affected with epilepsy. [18-23]
</div>
स्तभ्येते प्रतिबुद्धस्य हनू मन्ये तथाऽक्षिणी|
यस्य तं बहिरायामो गृहीत्वा हन्त्यसंशयम्||२४||

शष्कुलीर्वाऽप्यपूपान् वा स्वप्ने खादति यो नरः|
स चेत्तादृक् छर्दयति प्रतिबुद्धो न जीवति||२५||

stabhyētē pratibuddhasya hanū manyē tathā'kṣiṇī|
yasya taṁ bahirāyāmō gr̥hītvā hantyasaṁśayam||24||

śaṣkulīrvā'pyapūpān vā svapnē khādati yō naraḥ|
sa cēttādr̥k chardayati pratibuddhō na jīvati||25||

stabhyete pratibuddhasya hanU manye tathA~akShiNI|
yasya taM bahirAyAmo gRuhItvA hantyasaMshayam||24||

shaShkulIrvA~apyapUpAn vA svapne khAdati yo naraH|
sa cettAdRuk chardayati pratibuddho na jIvati||25||
<div style="text-align:justify;">
If individual is found with ''bahirayama'' ( a disease with feature of opisthotonus or bending of body backwards) soon after awaking from sleep along with lock jaw, neck stiffness, stale eyes and paralysis is going to lose life soon.

Such an individual in his dream sees himself taking cakes of sesame seeds and ''apupa'' ( a dietary item) and vomits the same when he is awake.[24-25]
</div>
एतानि पूर्वरूपाणि यः सम्यगवबुध्यते|
स एषामनुबन्धं च फलं च ज्ञातुमर्हति||२६||

ētāni pūrvarūpāṇi yaḥ samyagavabudhyatē|
sa ēṣāmanubandhaṁ ca phalaṁ ca jñātumarhati||26||

etAni pUrvarUpANi yaH samyagavabudhyate|
sa eShAmanubandhaM ca phalaM ca j~jAtumarhati||26||

One who (physician) understands these premonitory symptoms thoroughly, also deserves the knowledge of associated diseases and their result i.e. death.[26]

इमांश्चाप्यपरान् स्वप्नान् दारुणानुपलक्षयेत्|
व्याधितानां विनाशाय क्लेशाय महतेऽपि वा||२७||

यस्योत्तमाङ्गे जायन्ते वंशगुल्मलतादयः|
वयांसि च विलीयन्ते स्वप्ने मौण्ड्यमियाच्च यः||२८||

गृध्रोलूकश्वकाकाद्यैः स्वप्ने यः परिवार्यते|
रक्षःप्रेतपिशाचस्त्रीचण्डालद्रविडान्ध्रकैः ||२९||

वंशवेत्रलतापाशतृणकण्टकसङ्कटे|
संसज्जति हि यः स्वप्ने यो गच्छन् प्रपतत्यपि||३०||

भूमौ पांशूपधानायां वल्मीके वाऽथ भस्मनि|
श्मशानायतने श्वभ्रे स्वप्ने यः प्रपतत्यपि ||३१||

कलुषेऽम्भसि पङ्के वा कूपे वा तमसाऽऽवृते|
स्वप्ने मज्जति शीघ्रेण स्रोतसा ह्रियते च यः||३२||

स्नेहपानं तथाऽभ्यङ्गः प्रच्छर्दनविरेचने|
हिरण्यलाभः कलहः स्वप्ने बन्धपराजयौ||३३||

उपानद्युगनाशश्च प्रपातः पादचर्मणोः|
हर्षः स्वप्ने प्रकुपितैः पितृभिश्चावभर्त्सनम्||३४||

दन्तचन्द्रार्कनक्षत्रदेवतादीपचक्षुषाम् |
पतनं वा विनाशो वा स्वप्ने भेदो नगस्य वा||३५||

रक्तपुष्पं वनं भूमिं पापकर्मालयं चिताम्|
गुहान्धकारसम्बाधं स्वप्ने यः प्रविशत्यपि||३६||

रक्तमाली हसन्नुच्चैर्दिग्वासा दक्षिणां दिशम्|
दारुणामटवीं स्वप्ने कपियुक्तेन याति वा||३७||

काषायिणामसौम्यानां नग्नानां दण्डधारिणाम्|
कृष्णानां रक्तनेत्राणां स्वप्ने नेच्छन्ति दर्शनम्||३८||

कृष्णा पापा निराचारा दीर्घकेशनखस्तनी|
विरागमाल्यवसना स्वप्ने कालनिशा मता||३९||

इत्येते दारुणाः स्वप्ना रोगी यैर्याति पञ्चताम्|
अरोगः संशयं गत्वा कश्चिदेव प्रमुच्यते||४०||

imāṁścāpyaparān svapnān dāruṇānupalakṣayēt|
vyādhitānāṁ vināśāya klēśāya mahatē'pi vā||27||

yasyōttamāṅgē jāyantē vaṁśagulmalatādayaḥ|
vayāṁsi ca vilīyantē svapnē mauṇḍyamiyācca yaḥ||28||

gr̥dhrōlūkaśvakākādyaiḥ svapnē yaḥ parivāryatē|
rakṣaḥprētapiśācastrīcaṇḍāladraviḍāndhrakaiḥ ||29||

vaṁśavētralatāpāśatr̥ṇakaṇṭakasaṅkaṭē|
saṁsajjati hi yaḥ svapnē yō gacchan prapatatyapi||30||

bhūmau pāṁśūpadhānāyāṁ valmīkē vā'tha bhasmani|
śmaśānāyatanē śvabhrē svapnē yaḥ prapatatyapi ||31||

kaluṣē'mbhasi paṅkē vā kūpē vā tamasā''vr̥tē|
svapnē majjati śīghrēṇa srōtasā hriyatē ca yaḥ||32||

snēhapānaṁ tathā'bhyaṅgaḥ pracchardanavirēcanē|
hiraṇyalābhaḥ kalahaḥ svapnē bandhaparājayau||33||

upānadyuganāśaśca prapātaḥ pādacarmaṇōḥ|
harṣaḥ svapnē prakupitaiḥ pitr̥bhiścāvabhartsanam||34||

dantacandrārkanakṣatradēvatādīpacakṣuṣām |
patanaṁ vā vināśō vā svapnē bhēdō nagasya vā||35||

raktapuṣpaṁ vanaṁ bhūmiṁ pāpakarmālayaṁ citām|
guhāndhakārasambādhaṁ svapnē yaḥ praviśatyapi||36||

raktamālī hasannuccairdigvāsā dakṣiṇāṁ diśam|
dāruṇāmaṭavīṁ svapnē kapiyuktēna yāti vā||37||

kāṣāyiṇāmasaumyānāṁ nagnānāṁ daṇḍadhāriṇām|
kr̥ṣṇānāṁ raktanētrāṇāṁ svapnē nēcchanti darśanam||38||

kr̥ṣṇā pāpā nirācārā dīrghakēśanakhastanī|
virāgamālyavasanā svapnē kālaniśā matā||39||

ityētē dāruṇāḥ svapnā rōgī yairyāti pañcatām|
arōgaḥ saṁśayaṁ gatvā kaścidēva pramucyatē||40||

imAMshcApyaparAn svapnAn dAruNAnupalakShayet|
vyAdhitAnAM vinAshAya kleshAya mahate~api vA||27||

yasyottamA~gge jAyante vaMshagulmalatAdayaH|
vayAMsi ca vilIyante svapne mauNDyamiyAcca yaH||28||

gRudhrolUkashvakAkAdyaiH svapne yaH parivAryate|
rakShaHpretapishAcastrIcaNDAladraviDAndhrakaiH ||29||

vaMshavetralatApAshatRuNakaNTakasa~gkaTe|
saMsajjati hi yaH svapne yo gacchan prapatatyapi||30||

bhUmau pAMshUpadhAnAyAM valmIke vA~atha bhasmani|
shmashAnAyatane shvabhre svapne yaH prapatatyapi ||31||

kaluShe~ambhasi pa~gke vA kUpe vA tamasA~a~avRute|
svapne majjati shIghreNa srotasA hriyate ca yaH||32||

snehapAnaM tathA~abhya~ggaH pracchardanavirecane|
hiraNyalAbhaH kalahaH svapne bandhaparAjayau||33||

upAnadyuganAshashca prapAtaH pAdacarmaNoH|
harShaH svapne prakupitaiH pitRubhishcAvabhartsanam||34||

dantacandrArkanakShatradevatAdIpacakShuShAm |
patanaM vA vinAsho vA svapne bhedo nagasya vA||35||

raktapuShpaM vanaM bhUmiM pApakarmAlayaM citAm|
guhAndhakArasambAdhaM svapne yaH pravishatyapi||36||

raktamAlI hasannuccairdigvAsA dakShiNAM disham|
dAruNAmaTavIM svapne kapiyuktena yAti vA||37||

kAShAyiNAmasaumyAnAM nagnAnAM daNDadhAriNAm|
kRuShNAnAM raktanetrANAM svapnenecchanti darshanam||38|

kRuShNA pApA nirAcArA dIrghakeshanakhastanI|
virAgamAlyavasanA svapne kAlanishA matA||39||

ityete dAruNAH svapnA rogI yairyAti pa~jcatAm|
arogaH saMshayaM gatvA kashcideva pramucyate||40||
<div style="text-align:justify;">
Certain other dreams which are fierce should also be analyzed as they indicate the approaching death of the diseased and grave sufferings for those who are going to be affected.

He, who in his dreams sees bamboos, shrubs and creepers etc. growing in his head, birds coming to them and his scalp been shaved.
Or who in his dreams sees himself surrounded by vultures, owls, dogs, crows and other birds or by Rakshasa, dead men, ''pishachas'', women, ''chandalas'', and inhabitants of Dravida and Andhra regions.

Or who in his dreams finds himself surrounded by pathless forests of bamboo, canes, creepers, grass and prickly plants and finds himself lost in the midst and falling down while trying to come out.

Or who in his dreams, falls down on the bare ground covered with dust or upon an anthill or upon ashes, or upon a crematorium or in to a hole.

Or who sinks in a ditch or pond of dirty water or into mire or in a dark well or who is carried away by a rapid current.
Or who in his dreams drinks oily substances or anoints his body with oil, vomits, defecates, or gets gold, engages in quarrel, gets defeated and captured.

Or who lose his sandals, has skin of feet peeling off or feels excited or who is rebuked by his angry ancestors.
Or who sees in his dreams the fall or destruction of his own tooth or the moon or the sun or the stars or the burning lamps or his own eyes or the cracking of a mountain.

Or who in his dreams, enters a forest of trees with red flowers or a place where sinful activities are done or a funeral place (crematorium), a dark cave.

Or who in his dreams sees himself proceeding towards south, finds himself adorned with garlands of red flowers, laughing aloud and naked.
The sight of a woman who is dark in complexion, who is sinful, who has long hair and nails, hanging breasts, or who is clad in garlands of red flowers and red garments is regarded to be as fatal as a fatal night.
These are severe dreams which indicate death of a patient.

If a healthy man sees such dreams, his life becomes doubtful, rarely does he escape. [27-40]
</div>
==== Dreams ====

मनोवहानां पूर्णत्वाद्दोषैरतिबलैस्त्रिभिः|
स्रोतसां दारुणान् स्वप्नान् काले पश्यति दारुणे||४१||

नातिप्रसुप्तः पुरुषः सफलानफलांस्तथा|
इन्द्रियेशेन मनसा स्वप्नान् पश्यत्यनेकधा||४२||

manōvahānāṁ pūrṇatvāddōṣairatibalaistribhiḥ|
srōtasāṁ dāruṇān svapnān kālē paśyati dāruṇē||41||

nātiprasuptaḥ puruṣaḥ saphalānaphalāṁstathā|
indriyēśēna manasā svapnān paśyatyanēkadhā||42||

manovahAnAM pUrNatvAddoShairatibalaistribhiH|
srotasAM dAruNAn svapnAn kAle pashyati dAruNe||41||

nAtiprasuptaH puruShaH saphalAnaphalAMstathA|
indriyeshena manasA svapnAn pashyatyanekadhA||42||
<div style="text-align:justify;">
When the channels associated with the mind are saturated by the excessively vitiated ''doshas'', such terrible dreams appear in his sleep. The person who is not in deep sleep (subconscious state), sees various fruitful (meaningful) or fruitless (meaningless) dreams in association with sense organs. [41-42]
</div>
दृष्टं श्रुतानुभूतं च प्रार्थितं कल्पितं तथा|
भाविकं दोषजं चैव स्वप्नं सप्तविधं विदुः||४३||

dr̥ṣṭaṁ śrutānubhūtaṁ ca prārthitaṁ kalpitaṁ tathā|
bhāvikaṁ dōṣajaṁ caiva svapnaṁ saptavidhaṁ viduḥ||43||

dRuShTaM shrutAnubhUtaM ca prArthitaM kalpitaM tathA|
bhAvikaM doShajaM caiva svapnaM saptavidhaM viduH||43||

It is known that there are seven kinds of dreams: seen, heard, felt, desired, imagined, prognosticating and faulty by nature. [43]
[[File:swapnabhead.png]]<br>
तत्र पञ्चविधं पूर्वमफलं भिषगादिशेत्|
दिवास्वप्नमतिह्रस्वमतिदीर्घं च बुद्धिमान्||४४||

दृष्टः प्रथमरात्रे यः स्वप्नः सोऽल्पफलो भवेत्|
न स्वपेद्यं पुनर्दृष्ट्वा स सद्यः स्यान्महाफलः||४५||

अकल्याणमपि स्वप्नं दृष्ट्वा तत्रैव यः पुनः|
पश्येत् सौम्यं शुभाकारं तस्य विद्याच्छुभं फलम्||४६||

tatra pañcavidhaṁ pūrvamaphalaṁ bhiṣagādiśēt|
divāsvapnamatihrasvamatidīrghaṁ ca buddhimān||44||

dr̥ṣṭaḥ prathamarātrē yaḥ svapnaḥ sō'lpaphalō bhavēt|
na svapēdyaṁ punardr̥ṣṭvā sa sadyaḥ syānmahāphalaḥ||45||

akalyāṇamapi svapnaṁ dr̥ṣṭvā tatraiva yaḥ punaḥ|
paśyēt saumyaṁ śubhākāraṁ tasya vidyācchubhaṁphalam|46||

tatra pa~jcavidhaM pUrvamaphalaM bhiShagAdishet|
divAsvapnamatihrasvamatidIrghaM ca buddhimAn||44||

dRuShTaH prathamarAtre yaH svapnaH so~alpaphalo bhavet|
na svapedyaM punardRuShTvA sa sadyaH syAnmahAphalaH||45||

akalyANamapi svapnaM dRuShTvA tatraiva yaH punaH|
pashyet saumyaM shubhAkAraM tasya vidyAcchubhaM phalam||46||

Amongst these the first five (viz.seen, heard, felt, desired and imagined) are fruitless (meaningless), and also those seen during daytime, and those which are too short or too long.

The dream that is seen during the first part of night is partially fruitful. He, however who having seen a dream does not sleep after it, will be realizing the dream completely.

It should be known that if a person having seen an inauspicious dream, sees without waking up another dream that is auspicious and of beneficial form just afterwards, he meets with good results. [44-46]

==== Summary ====

तत्र श्लोकः-
पूर्वरूपाण्यथ स्वप्नान् य इमान् वेत्ति दारुणान्|
न स मोहादसाध्येषु कर्माण्यारभते भिषक्||४७||

tatra ślōkaḥ-
pūrvarūpāṇyatha svapnān ya imān vētti dāruṇān|
na sa mōhādasādhyēṣu karmāṇyārabhatē bhiṣak||47||

tatra shlokaH-
pUrvarUpANyatha svapnAn ya imAn vetti dAruNAn|
na sa mohAdasAdhyeShu karmANyArabhate bhiShak||47||

A physician who is conversant with those premonitory symptoms which are associated with such terrible dreams never starts the treatment for incurable diseases out of his ignorance.[47]

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*Important principle regarding disease prognosis states that “if all premonitory symptoms of a disease are fully manifested in severe form then it indicates poor prognosis”. [Verse No.3-5]
*If any person is continuously exposed to etiological agents and complications appear earlier than such disease is going to have poor prognosis. It is also emphasized that any person who is severely debilitated will not recover from any disease easily. Interpretation based on dreams should also be considered while predicting course of the disease. One special note from this chapter is that they describe symptoms in combination than in solitary appearance which shows the complexity of disease causing and disease prognostic process leading to fatality. Perhaps this needs a specially designed research to study on relation between dreams and ''arishtas''. [Verse No.6-9]
*It has been emphasized that not only clinical presentations but personal experiences of the patient can play role in disease outcome and so should not be neglected. This analogy described here has a striking resemblance with astronomy and understanding of body components. They attribute special colors, precious stones in relation with ''dhatus'', zodiac signs and body components. Perhaps Jyothisha Shastra (astrology) and gemology can be referred for more explanation. [Verse No.10-11]
*It has been emphasized that even minor complaints of the patient should not be ignored as they can be indicator of forthcoming serious and grave conditions. [Verse No.12-13]
*Significance of dreams in prodromal symptoms and fatal consequences have been described which need further study and research. All the three ''doshas'' should be excessively vitiated and should involve ''Manovaha Srotas'', i.e. channels associated with mind for producing such kind of dreams.

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

*In present era we do not predict prognosis by prodromal symptoms except in few cases as prodromal symptoms are not exactly known in most of the diseases. Due to ambiguity, prodromal symptoms are not considered reliable and this might be the reason they are not given importance in disease diagnosis and prognosis. [Verse No.3-5]
*In the example of tuberculosis, if person is severely debilitated and then consumption is occurring then there are more chances that he will succumb to disease. Persistence of cause like sexual indulgence in such condition will further precipitate the possibility of fatality. Here one point is noticeable that rhinorrhea is not a symptom of tuberculosis. It can occur as complication of extra-pulmonary tuberculosis which may lead to bony erosion, out-pouching of the dura, CSF leak, and subsequent bacterial meningitis which is a fatal condition. This condition suggests that if severe complications are occurring earlier than manifestation of cardinal feature of the disease, it indicates poor prognosis of disease.<ref>Waqas Wahid Baig et al., Spontaneous Cerebrospinal Fluid Rhinorrhea with Pneumocephalus: An Unusual Manifestation of Nasal Tuberculosis, Korean J Intern Med. 2012 September; 27(3): 350–352 </ref> This rule applies to all other diseases: if prior health status of person is poor, he continues to partake etiological agents and complications are appearing in very early stage then disease produced in future will be fatal in nature.
*Horrible dreams in a person indicate the decreased mental strength of the person. ‘Mind’ is component of health and patient can combat diseases easily with strong mind and will power. Disease is always difficult to cure in a depressed person with low will power. This might be a reason why Charaka has mentioned importance of dreams while predicting prognosis of any disease. Lifestyle has changed since this text was composed, the type of dreams and their interpretation should also be changed, requiring research. We often give importance to ''sharira doshas'' and neglect the importance of ''manasa doshas'' in causation and continuation of disease process. Perhaps this chapter gives us a scope to view things from different dimension. For all dreams the role of ''manasa doshas'' are pivotal. This needs further research [Verse No.6-9]
*From above verse it can be inferred that delirium before bleeding disorders will be fatal for the patient. Important cause of delirium is old age and other risk factors are poor overall health, anemia, malnutrition, underlying medical or neurologic illness etc.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc,chapter 26 </ref> If we critically analyze these factors we can infer that each of these will deteriorate general condition of the patient and so even slight bleeding can produce fatal results in such persons. [Verse No.10-11]
*''Kushta'' literally means discoloration, disgrace, disfiguration of the normal skin texture. From above verse it can be inferred that here ''kushta'' wound refers to non healing ulcers of leprosy. Leprosy is a chronic infectious disease caused by Mycobacterium Leprae, the only pathogenic bacteria able to infect peripheral nerves. About 30% of people with leprosy develop nerve damage. Neural impairment results in a set of sensitive, motor and autonomic disturbances, with ulcers originating primarily on the hands and feet. Neuropathic ulcers are one of the most common squeal of leprosy, but little is known about their clinical and epidemiological aspects.<ref>Josafá G Barreto, Claudio G Salgado, Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial, BMC Infect Dis. 2010; 10: 237 </ref> If wounds are occurring before change in normal texture of skin it shows that wounds are occurring in prodromal stage and sensory loss has occurred till this stage and so slight injuries are resulting into wound formation. Such condition will lead to late diagnosis and hence chances of recovery will be minimal. [Verse No.14-15]
*Symptoms mentioned above in prodromal symptoms of ''unmada'' are negative symptoms and so there are chances of more suicidal tendency which is a major cause of death in ''unmada''. The presence and duration of prodromal symptoms may predict outcome in schizophrenia, that is, long duration of prodromal symptoms may be indicative of poor prognosis.<ref>Chapman, L.J.; Day, D.; and Burstein, A. The process-reactive distinction and prognosis in schizophrenia. Journal of Nervous and Mental Disease, 133:383-391, 1961. </ref>
*Aura are common in seizures of occipital or temporal lobe origin in patients with focal epileptic seizures.<ref>Christian G. Bien, Felix O. Benninger, Horst Urbach, Johannes Schramm, Martin Kurthen, Christian E. Elger, Localizing value of epileptic visual auras Brain (2000) 123 (2): 244-253. </ref> Patients with refractory temporal lobe epilepsy (TLE) have an increased risk of sudden death that is 50 times greater than that in the general population. So if hallucinations are present in epilepsy they indicate grave prognosis. [Verse No.18-23]
*As mentioned earlier dreams are replica of mind and such kinds of dream represents weak and feeble mental status which is not strong enough to fight diseases properly. So if such dreams are frequently seen by patients they will have poor rate of recovery as compared to patient with strong mind and will power. [Verse No.27-40]
*In modern era, during late 19th century, psychotherapist Sigmund Freud gave emphasis on dream connection with mind in his famous book ‘The interpretation of dreams’. He developed a theory that the content of dreams is driven by unconscious wish fulfillment.<ref>Stone MH,Dream analysis in the psychodynamic psychotherapy of borderline patients, Psychodyn Psychiatry. 2012 Jun;40(2):287-302. </ref> Presently dream is defined as successions of images, ideas, emotions, and sensations that occur involuntarily in the mind during certain stages of sleep.<ref>Dream, The American Heritage Dictionary of the English Language, Fourth Edition. 2000. Retrieved May 7, 2009. </ref> Description of ''manovaha srotas'' in pathogenesis of dream shows that role of mind in producing dreams was known in ancient times.
*Various studies have established link between REM sleep and dreaming.<ref>Klemm WR. Why Does Rem Sleep Occur? A Wake-Up Hypothesis. Frontiers in Systems Neuroscience. 2011;5:73. </ref> Poly somnograms show brainwave patterns in REM to be similar to that recorded during wakefulness. Intense dreaming occurs during REM sleep as a result of heightened brain activity. This proves that observations noted by ancient Ayurvedic seers related to pathogenesis of dream are minute and correct. [Verse No.41-42]
*As mentioned above dreams more or less depict unconsciousness state. Freud called dreams the "royal road to the unconscious”. They are related to activities which we have seen, listened, wished, thought etc. Based on this fact seven types of dream have been classified here. Five of them are mild as they are more near to events which we encounter in day to day life. Last two have fatal consequences as they are due to disease or ''dosha'' involvement. [Verse No.43]
*It is difficult to predict dream consequences on the basis of time or order in which they were seen. Researches are needed to scientifically prove the validity of such dream prediction. [Verse No.44-46]
</div>
=== References ===

<references/>

Purvarupeeya

2017-12-26T06:17:37Z

Vinay Exafluence: /* References */

{{Infobox
|title = Purvarupeeya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 5
|label2 = Preceding Chapter
|data2 = [[Indriyaneeka]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 5 ==

===Abstract===

[[Purvarupeeya]] has been devoted to predict prognosis of diseases by prodromal symptoms. This chapter suggests that knowledge and examination of prodromal symptoms was important in ancient times and emphasis was given that physician should carefully recognize disease in early stage and predict course of disease. With the help of eight diseases of [[Nidana Sthana]] important principles related to prognosis have been laid down which are also applicable to all other diseases and are valid till now. Various aspects of dreams including physiology, types, interpretation and prognostic importance have also been described. Various dreams along with physical and mental features have been incorporated in prodromal symptoms which signify that dreams should also be analyzed and properly investigated before predicting prognosis of any disease. Even with restricted technological tools, par excellence observation and principles described regarding ''Arishta Lakshana'' are valid till now.

'''Keywords''': Prodromal symptoms, dream, prognosis, disease, death.

=== Introduction ===

In this chapter prodromal symptoms and dreams related to poor prognosis of diseases- fatality are described. In the first verse, Charaka has emphasized that he will describe both common and special prodromal symptoms. This indicates that while there may be some prodromata which result out of normal pathogenesis, some are unusual and unexpected. In the next verse it has been said that if all prodromal symptoms are manifesting and are severe in nature then such a condition will be fatal. This principle is applicable to all other diseases also. Prodromal symptoms of ''kushta'' and ''prameha'' suggest that complications manifest before cardinal symptoms of the disease appear. If body metabolism in any disease is altered severely during latent phase of disease and complications are appearing before manifestation of full-fledged disease then such condition will be difficult to cure. Example of ''gulma'' suggests that there are certain diseases which are incurable in nature and prodromal symptoms related to such clinical conditions will always be precursors of imminent death. It is commonly seen that any person who is emaciated and have low immunity and strength, when affected by disease, has fatal consequences due to less resistance. This fact is explained with the example of ''shosha''. Another important aspect regarding disease prognosis is that, if a person is continuously partaking causative factors or is in constant exposure to the causative factors, body will be unable to fight disease properly and thus there will be less chances of recovery from the disease. This point is also mentioned while describing prognosis of ''shosha''.

From the above discussion it is clear that prodromal symptoms can be useful in predicting diagnosis of any disease. But now question arises whether it is practically possible to predict prognosis with prodromal symptoms? We should admit that it is very difficult and one will need years of experience to attain such competence. Another important fact is that the prediction of prognosis can be done from ''purvarupa'' only after disease manifestation. Charaka states that ''purvarupa'' converting into a particular disease in future can be termed a prognostic sign. This indicates that we cannot predict by only prodromal symptoms. We have to look into whether disease was produced after ''purvarupa'' or not. For example, delirium in ''raktapitta'' is indicator of poor prognosis. If delirium is seen in any patient but he is not developing ''raktapitta'' we cannot predict poor prognosis. In this condition, after manifestation of ''raktapitta'' we need to ask the patient whether he suffered from delirium before disease manifestation or not. It is a retrospective inquiry about ''purvarupa'' based on which a prospective prediction may be made. We will have to follow detailed retro-prospective approach and will need proper patient history comprising of each and every detail from prodromal symptoms to disease manifestation. Thus practically, prodromal symptoms are helpful only after disease manifestation as they are not independent. Since accompanying symptoms may also lead to predictions, they can also be regarded as tools of predictive prognosis. This might be the reason that Sushruta and Vagbhata have not described dreams in reference of ''purvarupa'' but have described in ''rupavastha'' (stage of disease manifestation).

Biomarkers are recent advancements can be the answer to above problem as we do not need to wait for disease manifestation and can predict prognosis by seeing values of biomarkers related to that disease. In 2001, a consensus panel at the National Institutes of Health defined the term biomarker as ‘a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention or other health care intervention’.<ref>Torres-Bugarín O, Zavala-Cerna MG, Nava A, Flores-García A, Ramos-Ibarra ML. Potential Uses, Limitations, and Basic Procedures of Micronuclei and Nuclear Abnormalities in Buccal Cells. Disease Markers. 2014;2014:956835. </ref> Biomarker defined as alteration in the constituents of tissues or body fluids provide a powerful approach to understanding the spectrum of chronic disease with application in at least 5 areas like screening, diagnosis, prognostics, prediction of disease recurrence and therapeutic monitoring.<ref>Pradeep Sahu et al, Biomarkers: An Emerging Tool for Diagnosis of a Disease and Drug Development, Asian J. Res. Pharm. Sci. 2011; Vol. 1: Issue 1, Pg 09-16 </ref> The biomarker is either produced by the diseased organ (e.g., tumor) or by the body in response to disease. Before diagnosis, markers could be used for screening and risk assessment. Tumor classification, stage and sometimes grade are generally used to assess prognosis. Researches in the field of biomarkers may give us chance to know prognosis of disease in early stage.

Another important aspect mentioned in this chapter is concept of dreams. The descriptions related to dreams are found abundantly in the ancient oriental classics, specifically the Atharvaveda, Upanishadas, Puranas, Darshanas and [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. The description of the ''doshika'' dreams of the Atharvaveda is similar to that in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. Dreams are mentioned while describing ''purvarupa'', ''rupa'' and ''arishta lakshanas''.<ref>Sonali S. Tendulkar and R. R. Dwivedi, ‘Swapna’ in the Indian classics: Mythology or science?,Ayu. 2010 Apr-Jun; 31(2): 170–174. </ref> Sushruta states that sex of the unborn child can be predicted and Vagbhata says that ''doshika prakriti'' can be known by the help of dreams.

Subject of dreams is dealt in very scientific manner. According to Charaka, dreams occur when person is in relatively wakeful state. This has been proved now by the researches that dreams mainly occur in the rapid-eye movement (REM) stage of sleep—when brain activity is high and resembles that of being awake. In the late 19th century, psychotherapist Sigmund Freud developed a theory that the content of dreams is driven by unconscious wish fulfillment. Freud called dreams the "royal road to the unconscious”.<ref>Jeannette Y. Wick; Guido R. Zann, Drugs and Dreams, J Am Pharm Assoc (2003) 2002;42:385-390. </ref> To Freud, no dream was of entertainment value, they all held important meanings. Dreams reflect the dreamer’s mental, emotional, and physical state. This fact is well established in this chapter while describing classification of dreams. Dreams are based on our day to day interactions and so are classified as dreams seen, heard, felt etc. Two of the seven types, one which predict prognosis and one which is due to vitiation of ''doshas'' are said to have fatal consequences.

Research studies are needed to prove that dreams can be used as markers of prognosis. Some studies have been conducted in this regard but we cannot make strong conclusion on basis of their results. In a few studies it has been shown that hormone levels affect dreams. One of the studies states that cortisol plays an important role in controlling the state of memory systems during sleep. High levels of cortisol, as are observed late at night and, typically in the context of REM sleep, disrupt normal hippocampal → neocortical communication, thereby interfering with forms of memory consolidation dependent upon this communication. At the same time, the content of dreams is also affected.<ref>Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678. </ref> In neurological and psychological diseases dream disturbances are often seen but few other diseases have also been found to affect dreams. Patients with sleep apnea are reported to have intense nightmares.<ref>J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73. </ref> Abnormal dreams have also been reported in diseases like Relapsing fever,<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165. </ref> Cardiac ischemia<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28. </ref> etc. Certain drugs also affect dreams e.g. Anti malarial drug has shown to alter dream types.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203. </ref> This proves that at times diseases certainly affect dreams but intense research studies are needed to actually establish this fact on scientific grounds.

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

अथातः पूर्वरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pūrvarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pUrvarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter of premonitory symptoms related to signs of death.
Thus spoke lord Atreya.[1-2]

==== Incurable prodromal signs of ''Jwara'' leading to death ====

पूर्वरूपाण्यसाध्यानां विकाराणां पृथक् पृथक्|
भिन्नाभिन्नानि वक्ष्यामो भिषजां ज्ञानवृद्धये||३||

पूर्वरूपाणि सर्वाणि ज्वरोक्तान्यतिमात्रया|
यं विशन्ति विशत्येनं मृत्युर्ज्वरपुरःसरः||४||

अन्यस्यापि च रोगस्य पूर्वरूपाणि यं नरम्|
विशन्त्यनेन कल्पेन तस्यापि मरणं ध्रुवम्||५||

pūrvarūpāṇyasādhyānāṁ vikārāṇāṁ pr̥thak pr̥thak|
bhinnābhinnāni vakṣyāmō bhiṣajāṁ jñānavr̥ddhayē||3||

pūrvarūpāṇi sarvāṇi jvarōktānyatimātrayā|
yaṁ viśanti viśatyēnaṁ mr̥tyurjvarapuraḥsaraḥ||4||

anyasyāpi ca rōgasya pūrvarūpāṇi yaṁ naram|
viśantyanēna kalpēna tasyāpi maraṇaṁ dhruvam||5||

pUrvarUpANyasAdhyAnAM vikArANAM pRuthak pRuthak|
bhinnAbhinnAni vakShyAmo bhiShajAM j~jAnavRuddhaye||3||

pUrvarUpANi sarvANi jvaroktAnyatimAtrayA|
yaM vishanti vishatyenaM mRutyurjvarapuraHsaraH||4||

anyasyApi ca rogasya pUrvarUpANi yaM naram|
vishantyanena kalpena tasyApi maraNaM dhruvam||5||

For enhancing the knowledge of physicians, we will distinctly explain the general and fatal prodromal symptoms of diseases.
If all prodromal symptoms of ''jwara'' manifests in severe degree, the person will die. If prodromal symptoms of any other disease also appear in the same way as described above, death of the patient is certain. [3-5]

==== Incurable prodromal signs of ''Rajayakshma'' leading to death ====

पूर्वरूपैकदेशांस्तु वक्ष्यामोऽन्यान् सुदारुणान्|
ये रोगाननुबध्नन्ति मृत्युर्यैरनुबध्यते [१] ||६||

बलं च हीयते यस्य प्रतिश्यायश्च वर्धते|
तस्य नारीप्रसक्तस्य शोषोऽन्तायोपजायते||७||

श्वभिरुष्ट्रैः खरैर्वाऽपि याति यो दक्षिणां दिशम्|
स्वप्ने यक्ष्माणमासाद्य जीवितं स विमुञ्चति||८||

प्रेतैः सह पिबेन्मद्यं स्वप्ने यः कृष्यते शुना|
सुघोरं ज्वरमासाद्य जीवितं स विमुञ्चति||९||

pūrvarūpaikadēśāṁstu vakṣyāmō'nyān sudāruṇān|
yē rōgānanubadhnanti mr̥tyuryairanubadhyatē ||6||

balaṁ ca hīyatē yasya pratiśyāyaśca vardhatē|
tasya nārīprasaktasya śōṣō'ntāyōpajāyatē||7||

śvabhiruṣṭraiḥ kharairvā'pi yāti yō dakṣiṇāṁ diśam|
svapnē yakṣmāṇamāsādya jīvitaṁ sa vimuñcati||8||

prētaiḥ saha pibēnmadyaṁ svapnē yaḥ kr̥ṣyatē śunā|
sughōraṁ jvaramāsādya jīvitaṁ sa vimuñcati||9||

pUrvarUpaikadeshAMstu vakShyAmo~anyAn sudAruNAn|
ye rogAnanubadhnanti mRutyuryairanubadhyate ||6||

balaM ca hIyate yasya pratishyAyashca vardhate|
tasya nArIprasaktasya shoSho~antAyopajAyate||7||

shvabhiruShTraiH kharairvA~api yAti yo dakShiNAM disham|
svapne yakShmANamAsAdya jIvitaM sa vimu~jcati||8||

pretaiH saha pibenmadyaM svapne yaH kRuShyate shunA|
sughoraM jvaramAsAdya jIvitaM sa vimu~jcati||9||

Now we shall discuss certain severe premonitory symptoms which are associated with certain diseases.
The consumption which is associated with continuously decreasing strength, worsening rhinitis and over indulgence in sex in prodromal stage will turn out to be incurable.

A man, who in his dreams, is dragged by dog, camel or a donkey towards south, leaves his life as by consumption.
A person who in his dreams takes alcohol with demons and who is dragged by a dog leaves his life getting affected with severe fever. [6-9]

==== Incurable prodromal signs of ''Raktapitta'' leading to death ====

लाक्षारक्ताम्बराभं यः पश्यत्यम्बरमन्तिकात्|
स रक्तपित्तमासाद्य तेनैवान्ताय नीयते||१०||

रक्तस्रग्रक्तसर्वाङ्गो रक्तवासा मुहुर्हसन्|
यः स्वप्ने ह्रियते नार्या स रक्तं प्राप्य सीदति||११||

lākṣāraktāmbarābhaṁ yaḥ paśyatyambaramantikāt|
sa raktapittamāsādya tēnaivāntāya nīyatē||10||

raktasragraktasarvāṅgō raktavāsā muhurhasan|
yaḥ svapnē hriyatē nāryā sa raktaṁ prāpya sīdati||11||

lAkShAraktAmbarAbhaM yaH pashyatyambaramantikAt|
sa raktapittamAsAdya tenaivAntAya nIyate||10||

raktasragraktasarvA~ggo raktavAsA muhurhasan|
yaH svapne hriyate nAryA sa raktaM prApya sIdati||11||

He who sees clothes as if dyed with red lac, leaves his life if he gets affected with severe bleeding disorders.
In his dream, the man who sees himself adorned with red garlands, clad in red clothes, anointed with red dye and dragged by a continuously laughing woman will succumb to severe bleeding disorders. [10-11]

==== Incurable prodromal signs of ''Gulma'' leading to death ====

शूलाटोपान्त्रकूजाश्च दौर्बल्यं चातिमात्रया|
नखादिषु च वैवर्ण्यं गुल्मेनान्तकरो ग्रहः||१२||

लता कण्टकिनी यस्य दारुणा हृदि जायते|
स्वप्ने गुल्मस्तमन्ताय क्रूरो विशति मानवम्||१३||

śūlāṭōpāntrakūjāśca daurbalyaṁ cātimātrayā|
nakhādiṣu ca vaivarṇyaṁ gulmēnāntakarō grahaḥ||12||

latā kaṇṭakinī yasya dāruṇā hr̥di jāyatē|
svapnē gulmastamantāya krūrō viśati mānavam||13||

shUlATopAntrakUjAshca daurbalyaM cAtimAtrayA|
nakhAdiShu ca vaivarNyaM gulmenAntakaro grahaH||12||

latA kaNTakinI yasya dAruNA hRudi jAyate|
svapne gulmastamantAya krUro vishati mAnavam||13||

A man who experiences severe pain, gurgling sounds in abdomen, intestinal peristalsis, excessive debility, discoloration of nails and other body parts is going to die if he is affected with ''gulma''.

A person, who in his dreams sees hard and thorny creepers grown on his chest and then gets afflicted by ''gulma'', is surely going to die soon. [12-13]

==== Incurable prodromal signs of ''Kushtha'' leading to death ====

कायेऽल्पमपि संस्पृष्टं सुभृशं यस्य दीर्यते|
क्षतानि च न रोहन्ति कुष्ठैर्मृत्युर्हिनस्ति तम्||१४||

नग्नस्याज्यावसिक्तस्य जुह्वतोऽग्निमनर्चिषम्|
पद्मान्युरसि जायन्ते स्वप्ने कुष्ठैर्मरिष्यतः||१५||

kāyē'lpamapi saṁspr̥ṣṭaṁ subhr̥śaṁ yasya dīryatē|
kṣatāni ca na rōhanti kuṣṭhairmr̥tyurhinasti tam||14||

nagnasyājyāvasiktasya juhvatō'gnimanarciṣam|
padmānyurasi jāyantē svapnē kuṣṭhairmariṣyataḥ||15||

kAye~alpamapi saMspRuShTaM subhRushaM yasya dIryate|
kShatAni ca na rohanti kuShThairmRutyurhinasti tam||14||

nagnasyAjyAvasiktasya juhvato~agnimanarciSham|
padmAnyurasi jAyante svapne kuShThairmariShyataH||15||

A person whose body even if touched gently leads to deep cuts and whose injuries never heal will be killed by severe skin diseases.
In his dream, a man who sees himself naked, anointed with ghee, offering the oblations without the fire being lit, who has lotuses grown on his chest, will be taken away by death as afflicted by skin diseases.[14-15]

==== Incurable prodromal signs of ''Prameha'' leading to death ====

स्नातानुलिप्तगात्रेऽपि यस्मिन् गृध्नन्ति मक्षिकाः|
स प्रमेहेण संस्पर्शं प्राप्य तेनैव हन्यते||१६||

स्नेहं बहुविधं स्वप्ने चण्डालैः सह यः पिबेत्|
बध्यते स प्रमेहेण स्पृश्यतेऽन्ताय मानवः||१७||

snātānuliptagātrē'pi yasmin gr̥dhnanti makṣikāḥ|
sa pramēhēṇa saṁsparśaṁ prāpya tēnaiva hanyatē||16||

snēhaṁ bahuvidhaṁ svapnē caṇḍālaiḥ saha yaḥ pibēt|
badhyatē sa pramēhēṇa spr̥śyatē'ntāya mānavaḥ||17||

snAtAnuliptagAtre~api yasmin gRudhnanti makShikAH|
sa prameheNa saMsparshaM prApya tenaiva hanyate||16||

snehaM bahuvidhaM svapne caNDAlaiH saha yaH pibet|
badhyate sa prameheNa spRushyate~antAya mAnavaH||17||

Even after taking bath and getting anointed with scents, flies are attracted towards person, he will certainly die, if affected with ''prameha''.

One who sees in his dreams, drinking various kinds of oily substances with Chandalas becomes affected by ''prameha'' and will die. [16-17]

==== Incurable prodromal signs of ''Unmada'' and ''Apasmara'' leading to death ====

ध्यानायासौ तथोद्वेगौ मोहश्चास्थानसम्भवः|
अरतिर्बलहानिश्च मृत्युरुन्मादपूर्वकः||१८||

आहारद्वेषिणं पश्यन् लुप्तचित्तमुदर्दितम्|
विद्याद्धीरो मुमूर्षुं तमुन्मादेनातिपातिना||१९||

क्रोधनं त्रासबहुलं सकृत्प्रहसिताननम्|
मूर्च्छापिपासाबहुलं हन्त्युन्मादः शरीरिणम्||२०||

नृत्यन् रक्षोगणैः साकं यः स्वप्नेऽम्भसि सीदति |
स प्राप्य भृशमुन्मादं याति लोकमतः परम्||२१||

असत्तमः पश्यति यः शृणोत्यप्यसतः स्वनान्|
बहून् बहुविधान् जाग्रत् सोऽपस्मारेण बध्यते||२२||

मत्तं नृत्यन्तमाविध्य प्रेतो हरति यं नरम्|
स्वप्ने हरति तं मृत्युरपस्मारपुरःसरः||२३||

dhyānāyāsau tathōdvēgau mōhaścāsthānasambhavaḥ|
aratirbalahāniśca mr̥tyurunmādapūrvakaḥ||18||

āhāradvēṣiṇaṁ paśyan luptacittamudarditam|
vidyāddhīrō mumūrṣuṁ tamunmādēnātipātinā||19||

krōdhanaṁ trāsabahulaṁ sakr̥tprahasitānanam|
mūrcchāpipāsābahulaṁ hantyunmādaḥ śarīriṇam||20||

nr̥tyan rakṣōgaṇaiḥ sākaṁ yaḥ svapnē'mbhasi sīdati |
sa prāpya bhr̥śamunmādaṁ yāti lōkamataḥ param||21||

asattamaḥ paśyati yaḥ śr̥ṇōtyapyasataḥ svanān|
bahūn bahuvidhān jāgrat sō'pasmārēṇa badhyatē||22||

mattaṁ nr̥tyantamāvidhya prētō harati yaṁ naram|
svapnē harati taṁ mr̥tyurapasmārapuraḥsaraḥ||23||

dhyAnAyAsau tathodvegau mohashcAsthAnasambhavaH|
aratirbalahAnishca mRutyurunmAdapUrvakaH||18||

AhAradveShiNaM pashyan luptacittamudarditam|
vidyAddhIro mumUrShuM tamunmAdenAtipAtinA||19||

krodhanaM trAsabahulaM sakRutprahasitAnanam|
mUrcchApipAsAbahulaM hantyunmAdaH sharIriNam||20||

nRutyan rakShogaNaiH sAkaM yaH svapne~ambhasi sIdati |
sa prApya bhRushamunmAdaM yAti lokamataH param||21||

asattamaH pashyati yaH shRuNotyapyasataH svanAn|
bahUn bahuvidhAn jAgrat so~apasmAreNa badhyate||22||

mattaM nRutyantamAvidhya preto harati yaM naram|
svapne harati taM mRutyurapasmArapuraHsaraH||23||

He who is affected with disturbing thoughts, anxiety, stupefaction without any specific cause, restlessness, loss of strength will succumb to death as affected with insanity.

The person who feels excess anger, fear, always smiles and who is suffering from severe stupor and thirst will be certainly killed by insanity.

The man who in his dreams dances with evil spirits and sinks in water leaves the world.
He who sees darkness even when he is awake and hears sounds when there is no real sound, will be killed by epilepsy.
In dream, a person who sees himself dancing with ghosts while in intoxication with his head upside down, will be taken away by death getting affected with epilepsy. [18-23]

स्तभ्येते प्रतिबुद्धस्य हनू मन्ये तथाऽक्षिणी|
यस्य तं बहिरायामो गृहीत्वा हन्त्यसंशयम्||२४||

शष्कुलीर्वाऽप्यपूपान् वा स्वप्ने खादति यो नरः|
स चेत्तादृक् छर्दयति प्रतिबुद्धो न जीवति||२५||

stabhyētē pratibuddhasya hanū manyē tathā'kṣiṇī|
yasya taṁ bahirāyāmō gr̥hītvā hantyasaṁśayam||24||

śaṣkulīrvā'pyapūpān vā svapnē khādati yō naraḥ|
sa cēttādr̥k chardayati pratibuddhō na jīvati||25||

stabhyete pratibuddhasya hanU manye tathA~akShiNI|
yasya taM bahirAyAmo gRuhItvA hantyasaMshayam||24||

shaShkulIrvA~apyapUpAn vA svapne khAdati yo naraH|
sa cettAdRuk chardayati pratibuddho na jIvati||25||

If individual is found with ''bahirayama'' ( a disease with feature of opisthotonus or bending of body backwards) soon after awaking from sleep along with lock jaw, neck stiffness, stale eyes and paralysis is going to lose life soon.

Such an individual in his dream sees himself taking cakes of sesame seeds and ''apupa'' ( a dietary item) and vomits the same when he is awake.[24-25]

एतानि पूर्वरूपाणि यः सम्यगवबुध्यते|
स एषामनुबन्धं च फलं च ज्ञातुमर्हति||२६||

ētāni pūrvarūpāṇi yaḥ samyagavabudhyatē|
sa ēṣāmanubandhaṁ ca phalaṁ ca jñātumarhati||26||

etAni pUrvarUpANi yaH samyagavabudhyate|
sa eShAmanubandhaM ca phalaM ca j~jAtumarhati||26||

One who (physician) understands these premonitory symptoms thoroughly, also deserves the knowledge of associated diseases and their result i.e. death.[26]

इमांश्चाप्यपरान् स्वप्नान् दारुणानुपलक्षयेत्|
व्याधितानां विनाशाय क्लेशाय महतेऽपि वा||२७||

यस्योत्तमाङ्गे जायन्ते वंशगुल्मलतादयः|
वयांसि च विलीयन्ते स्वप्ने मौण्ड्यमियाच्च यः||२८||

गृध्रोलूकश्वकाकाद्यैः स्वप्ने यः परिवार्यते|
रक्षःप्रेतपिशाचस्त्रीचण्डालद्रविडान्ध्रकैः ||२९||

वंशवेत्रलतापाशतृणकण्टकसङ्कटे|
संसज्जति हि यः स्वप्ने यो गच्छन् प्रपतत्यपि||३०||

भूमौ पांशूपधानायां वल्मीके वाऽथ भस्मनि|
श्मशानायतने श्वभ्रे स्वप्ने यः प्रपतत्यपि ||३१||

कलुषेऽम्भसि पङ्के वा कूपे वा तमसाऽऽवृते|
स्वप्ने मज्जति शीघ्रेण स्रोतसा ह्रियते च यः||३२||

स्नेहपानं तथाऽभ्यङ्गः प्रच्छर्दनविरेचने|
हिरण्यलाभः कलहः स्वप्ने बन्धपराजयौ||३३||

उपानद्युगनाशश्च प्रपातः पादचर्मणोः|
हर्षः स्वप्ने प्रकुपितैः पितृभिश्चावभर्त्सनम्||३४||

दन्तचन्द्रार्कनक्षत्रदेवतादीपचक्षुषाम् |
पतनं वा विनाशो वा स्वप्ने भेदो नगस्य वा||३५||

रक्तपुष्पं वनं भूमिं पापकर्मालयं चिताम्|
गुहान्धकारसम्बाधं स्वप्ने यः प्रविशत्यपि||३६||

रक्तमाली हसन्नुच्चैर्दिग्वासा दक्षिणां दिशम्|
दारुणामटवीं स्वप्ने कपियुक्तेन याति वा||३७||

काषायिणामसौम्यानां नग्नानां दण्डधारिणाम्|
कृष्णानां रक्तनेत्राणां स्वप्ने नेच्छन्ति दर्शनम्||३८||

कृष्णा पापा निराचारा दीर्घकेशनखस्तनी|
विरागमाल्यवसना स्वप्ने कालनिशा मता||३९||

इत्येते दारुणाः स्वप्ना रोगी यैर्याति पञ्चताम्|
अरोगः संशयं गत्वा कश्चिदेव प्रमुच्यते||४०||

imāṁścāpyaparān svapnān dāruṇānupalakṣayēt|
vyādhitānāṁ vināśāya klēśāya mahatē'pi vā||27||

yasyōttamāṅgē jāyantē vaṁśagulmalatādayaḥ|
vayāṁsi ca vilīyantē svapnē mauṇḍyamiyācca yaḥ||28||

gr̥dhrōlūkaśvakākādyaiḥ svapnē yaḥ parivāryatē|
rakṣaḥprētapiśācastrīcaṇḍāladraviḍāndhrakaiḥ ||29||

vaṁśavētralatāpāśatr̥ṇakaṇṭakasaṅkaṭē|
saṁsajjati hi yaḥ svapnē yō gacchan prapatatyapi||30||

bhūmau pāṁśūpadhānāyāṁ valmīkē vā'tha bhasmani|
śmaśānāyatanē śvabhrē svapnē yaḥ prapatatyapi ||31||

kaluṣē'mbhasi paṅkē vā kūpē vā tamasā''vr̥tē|
svapnē majjati śīghrēṇa srōtasā hriyatē ca yaḥ||32||

snēhapānaṁ tathā'bhyaṅgaḥ pracchardanavirēcanē|
hiraṇyalābhaḥ kalahaḥ svapnē bandhaparājayau||33||

upānadyuganāśaśca prapātaḥ pādacarmaṇōḥ|
harṣaḥ svapnē prakupitaiḥ pitr̥bhiścāvabhartsanam||34||

dantacandrārkanakṣatradēvatādīpacakṣuṣām |
patanaṁ vā vināśō vā svapnē bhēdō nagasya vā||35||

raktapuṣpaṁ vanaṁ bhūmiṁ pāpakarmālayaṁ citām|
guhāndhakārasambādhaṁ svapnē yaḥ praviśatyapi||36||

raktamālī hasannuccairdigvāsā dakṣiṇāṁ diśam|
dāruṇāmaṭavīṁ svapnē kapiyuktēna yāti vā||37||

kāṣāyiṇāmasaumyānāṁ nagnānāṁ daṇḍadhāriṇām|
kr̥ṣṇānāṁ raktanētrāṇāṁ svapnē nēcchanti darśanam||38||

kr̥ṣṇā pāpā nirācārā dīrghakēśanakhastanī|
virāgamālyavasanā svapnē kālaniśā matā||39||

ityētē dāruṇāḥ svapnā rōgī yairyāti pañcatām|
arōgaḥ saṁśayaṁ gatvā kaścidēva pramucyatē||40||

imAMshcApyaparAn svapnAn dAruNAnupalakShayet|
vyAdhitAnAM vinAshAya kleshAya mahate~api vA||27||

yasyottamA~gge jAyante vaMshagulmalatAdayaH|
vayAMsi ca vilIyante svapne mauNDyamiyAcca yaH||28||

gRudhrolUkashvakAkAdyaiH svapne yaH parivAryate|
rakShaHpretapishAcastrIcaNDAladraviDAndhrakaiH ||29||

vaMshavetralatApAshatRuNakaNTakasa~gkaTe|
saMsajjati hi yaH svapne yo gacchan prapatatyapi||30||

bhUmau pAMshUpadhAnAyAM valmIke vA~atha bhasmani|
shmashAnAyatane shvabhre svapne yaH prapatatyapi ||31||

kaluShe~ambhasi pa~gke vA kUpe vA tamasA~a~avRute|
svapne majjati shIghreNa srotasA hriyate ca yaH||32||

snehapAnaM tathA~abhya~ggaH pracchardanavirecane|
hiraNyalAbhaH kalahaH svapne bandhaparAjayau||33||

upAnadyuganAshashca prapAtaH pAdacarmaNoH|
harShaH svapne prakupitaiH pitRubhishcAvabhartsanam||34||

dantacandrArkanakShatradevatAdIpacakShuShAm |
patanaM vA vinAsho vA svapne bhedo nagasya vA||35||

raktapuShpaM vanaM bhUmiM pApakarmAlayaM citAm|
guhAndhakArasambAdhaM svapne yaH pravishatyapi||36||

raktamAlI hasannuccairdigvAsA dakShiNAM disham|
dAruNAmaTavIM svapne kapiyuktena yAti vA||37||

kAShAyiNAmasaumyAnAM nagnAnAM daNDadhAriNAm|
kRuShNAnAM raktanetrANAM svapnenecchanti darshanam||38|

kRuShNA pApA nirAcArA dIrghakeshanakhastanI|
virAgamAlyavasanA svapne kAlanishA matA||39||

ityete dAruNAH svapnA rogI yairyAti pa~jcatAm|
arogaH saMshayaM gatvA kashcideva pramucyate||40||

Certain other dreams which are fierce should also be analyzed as they indicate the approaching death of the diseased and grave sufferings for those who are going to be affected.

He, who in his dreams sees bamboos, shrubs and creepers etc. growing in his head, birds coming to them and his scalp been shaved.
Or who in his dreams sees himself surrounded by vultures, owls, dogs, crows and other birds or by Rakshasa, dead men, ''pishachas'', women, ''chandalas'', and inhabitants of Dravida and Andhra regions.

Or who in his dreams finds himself surrounded by pathless forests of bamboo, canes, creepers, grass and prickly plants and finds himself lost in the midst and falling down while trying to come out.

Or who in his dreams, falls down on the bare ground covered with dust or upon an anthill or upon ashes, or upon a crematorium or in to a hole.

Or who sinks in a ditch or pond of dirty water or into mire or in a dark well or who is carried away by a rapid current.
Or who in his dreams drinks oily substances or anoints his body with oil, vomits, defecates, or gets gold, engages in quarrel, gets defeated and captured.

Or who lose his sandals, has skin of feet peeling off or feels excited or who is rebuked by his angry ancestors.
Or who sees in his dreams the fall or destruction of his own tooth or the moon or the sun or the stars or the burning lamps or his own eyes or the cracking of a mountain.

Or who in his dreams, enters a forest of trees with red flowers or a place where sinful activities are done or a funeral place (crematorium), a dark cave.

Or who in his dreams sees himself proceeding towards south, finds himself adorned with garlands of red flowers, laughing aloud and naked.
The sight of a woman who is dark in complexion, who is sinful, who has long hair and nails, hanging breasts, or who is clad in garlands of red flowers and red garments is regarded to be as fatal as a fatal night.
These are severe dreams which indicate death of a patient.

If a healthy man sees such dreams, his life becomes doubtful, rarely does he escape. [27-40]

==== Dreams ====

मनोवहानां पूर्णत्वाद्दोषैरतिबलैस्त्रिभिः|
स्रोतसां दारुणान् स्वप्नान् काले पश्यति दारुणे||४१||

नातिप्रसुप्तः पुरुषः सफलानफलांस्तथा|
इन्द्रियेशेन मनसा स्वप्नान् पश्यत्यनेकधा||४२||

manōvahānāṁ pūrṇatvāddōṣairatibalaistribhiḥ|
srōtasāṁ dāruṇān svapnān kālē paśyati dāruṇē||41||

nātiprasuptaḥ puruṣaḥ saphalānaphalāṁstathā|
indriyēśēna manasā svapnān paśyatyanēkadhā||42||

manovahAnAM pUrNatvAddoShairatibalaistribhiH|
srotasAM dAruNAn svapnAn kAle pashyati dAruNe||41||

nAtiprasuptaH puruShaH saphalAnaphalAMstathA|
indriyeshena manasA svapnAn pashyatyanekadhA||42||

When the channels associated with the mind are saturated by the excessively vitiated ''doshas'', such terrible dreams appear in his sleep. The person who is not in deep sleep (subconscious state), sees various fruitful (meaningful) or fruitless (meaningless) dreams in association with sense organs. [41-42]

दृष्टं श्रुतानुभूतं च प्रार्थितं कल्पितं तथा|
भाविकं दोषजं चैव स्वप्नं सप्तविधं विदुः||४३||

dr̥ṣṭaṁ śrutānubhūtaṁ ca prārthitaṁ kalpitaṁ tathā|
bhāvikaṁ dōṣajaṁ caiva svapnaṁ saptavidhaṁ viduḥ||43||

dRuShTaM shrutAnubhUtaM ca prArthitaM kalpitaM tathA|
bhAvikaM doShajaM caiva svapnaM saptavidhaM viduH||43||

It is known that there are seven kinds of dreams: seen, heard, felt, desired, imagined, prognosticating and faulty by nature. [43]
[[File:swapnabhead.png]]<br>
तत्र पञ्चविधं पूर्वमफलं भिषगादिशेत्|
दिवास्वप्नमतिह्रस्वमतिदीर्घं च बुद्धिमान्||४४||

दृष्टः प्रथमरात्रे यः स्वप्नः सोऽल्पफलो भवेत्|
न स्वपेद्यं पुनर्दृष्ट्वा स सद्यः स्यान्महाफलः||४५||

अकल्याणमपि स्वप्नं दृष्ट्वा तत्रैव यः पुनः|
पश्येत् सौम्यं शुभाकारं तस्य विद्याच्छुभं फलम्||४६||

tatra pañcavidhaṁ pūrvamaphalaṁ bhiṣagādiśēt|
divāsvapnamatihrasvamatidīrghaṁ ca buddhimān||44||

dr̥ṣṭaḥ prathamarātrē yaḥ svapnaḥ sō'lpaphalō bhavēt|
na svapēdyaṁ punardr̥ṣṭvā sa sadyaḥ syānmahāphalaḥ||45||

akalyāṇamapi svapnaṁ dr̥ṣṭvā tatraiva yaḥ punaḥ|
paśyēt saumyaṁ śubhākāraṁ tasya vidyācchubhaṁphalam|46||

tatra pa~jcavidhaM pUrvamaphalaM bhiShagAdishet|
divAsvapnamatihrasvamatidIrghaM ca buddhimAn||44||

dRuShTaH prathamarAtre yaH svapnaH so~alpaphalo bhavet|
na svapedyaM punardRuShTvA sa sadyaH syAnmahAphalaH||45||

akalyANamapi svapnaM dRuShTvA tatraiva yaH punaH|
pashyet saumyaM shubhAkAraM tasya vidyAcchubhaM phalam||46||

Amongst these the first five (viz.seen, heard, felt, desired and imagined) are fruitless (meaningless), and also those seen during daytime, and those which are too short or too long.

The dream that is seen during the first part of night is partially fruitful. He, however who having seen a dream does not sleep after it, will be realizing the dream completely.

It should be known that if a person having seen an inauspicious dream, sees without waking up another dream that is auspicious and of beneficial form just afterwards, he meets with good results. [44-46]

==== Summary ====

तत्र श्लोकः-
पूर्वरूपाण्यथ स्वप्नान् य इमान् वेत्ति दारुणान्|
न स मोहादसाध्येषु कर्माण्यारभते भिषक्||४७||

tatra ślōkaḥ-
pūrvarūpāṇyatha svapnān ya imān vētti dāruṇān|
na sa mōhādasādhyēṣu karmāṇyārabhatē bhiṣak||47||

tatra shlokaH-
pUrvarUpANyatha svapnAn ya imAn vetti dAruNAn|
na sa mohAdasAdhyeShu karmANyArabhate bhiShak||47||

A physician who is conversant with those premonitory symptoms which are associated with such terrible dreams never starts the treatment for incurable diseases out of his ignorance.[47]

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

*Important principle regarding disease prognosis states that “if all premonitory symptoms of a disease are fully manifested in severe form then it indicates poor prognosis”. [Verse No.3-5]
*If any person is continuously exposed to etiological agents and complications appear earlier than such disease is going to have poor prognosis. It is also emphasized that any person who is severely debilitated will not recover from any disease easily. Interpretation based on dreams should also be considered while predicting course of the disease. One special note from this chapter is that they describe symptoms in combination than in solitary appearance which shows the complexity of disease causing and disease prognostic process leading to fatality. Perhaps this needs a specially designed research to study on relation between dreams and ''arishtas''. [Verse No.6-9]
*It has been emphasized that not only clinical presentations but personal experiences of the patient can play role in disease outcome and so should not be neglected. This analogy described here has a striking resemblance with astronomy and understanding of body components. They attribute special colors, precious stones in relation with ''dhatus'', zodiac signs and body components. Perhaps Jyothisha Shastra (astrology) and gemology can be referred for more explanation. [Verse No.10-11]
*It has been emphasized that even minor complaints of the patient should not be ignored as they can be indicator of forthcoming serious and grave conditions. [Verse No.12-13]
*Significance of dreams in prodromal symptoms and fatal consequences have been described which need further study and research. All the three ''doshas'' should be excessively vitiated and should involve ''Manovaha Srotas'', i.e. channels associated with mind for producing such kind of dreams.

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

*In present era we do not predict prognosis by prodromal symptoms except in few cases as prodromal symptoms are not exactly known in most of the diseases. Due to ambiguity, prodromal symptoms are not considered reliable and this might be the reason they are not given importance in disease diagnosis and prognosis. [Verse No.3-5]
*In the example of tuberculosis, if person is severely debilitated and then consumption is occurring then there are more chances that he will succumb to disease. Persistence of cause like sexual indulgence in such condition will further precipitate the possibility of fatality. Here one point is noticeable that rhinorrhea is not a symptom of tuberculosis. It can occur as complication of extra-pulmonary tuberculosis which may lead to bony erosion, out-pouching of the dura, CSF leak, and subsequent bacterial meningitis which is a fatal condition. This condition suggests that if severe complications are occurring earlier than manifestation of cardinal feature of the disease, it indicates poor prognosis of disease.<ref>Waqas Wahid Baig et al., Spontaneous Cerebrospinal Fluid Rhinorrhea with Pneumocephalus: An Unusual Manifestation of Nasal Tuberculosis, Korean J Intern Med. 2012 September; 27(3): 350–352 </ref> This rule applies to all other diseases: if prior health status of person is poor, he continues to partake etiological agents and complications are appearing in very early stage then disease produced in future will be fatal in nature.
*Horrible dreams in a person indicate the decreased mental strength of the person. ‘Mind’ is component of health and patient can combat diseases easily with strong mind and will power. Disease is always difficult to cure in a depressed person with low will power. This might be a reason why Charaka has mentioned importance of dreams while predicting prognosis of any disease. Lifestyle has changed since this text was composed, the type of dreams and their interpretation should also be changed, requiring research. We often give importance to ''sharira doshas'' and neglect the importance of ''manasa doshas'' in causation and continuation of disease process. Perhaps this chapter gives us a scope to view things from different dimension. For all dreams the role of ''manasa doshas'' are pivotal. This needs further research [Verse No.6-9]
*From above verse it can be inferred that delirium before bleeding disorders will be fatal for the patient. Important cause of delirium is old age and other risk factors are poor overall health, anemia, malnutrition, underlying medical or neurologic illness etc.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc,chapter 26 </ref> If we critically analyze these factors we can infer that each of these will deteriorate general condition of the patient and so even slight bleeding can produce fatal results in such persons. [Verse No.10-11]
*''Kushta'' literally means discoloration, disgrace, disfiguration of the normal skin texture. From above verse it can be inferred that here ''kushta'' wound refers to non healing ulcers of leprosy. Leprosy is a chronic infectious disease caused by Mycobacterium Leprae, the only pathogenic bacteria able to infect peripheral nerves. About 30% of people with leprosy develop nerve damage. Neural impairment results in a set of sensitive, motor and autonomic disturbances, with ulcers originating primarily on the hands and feet. Neuropathic ulcers are one of the most common squeal of leprosy, but little is known about their clinical and epidemiological aspects.<ref>Josafá G Barreto, Claudio G Salgado, Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial, BMC Infect Dis. 2010; 10: 237 </ref> If wounds are occurring before change in normal texture of skin it shows that wounds are occurring in prodromal stage and sensory loss has occurred till this stage and so slight injuries are resulting into wound formation. Such condition will lead to late diagnosis and hence chances of recovery will be minimal. [Verse No.14-15]
*Symptoms mentioned above in prodromal symptoms of ''unmada'' are negative symptoms and so there are chances of more suicidal tendency which is a major cause of death in ''unmada''. The presence and duration of prodromal symptoms may predict outcome in schizophrenia, that is, long duration of prodromal symptoms may be indicative of poor prognosis.<ref>Chapman, L.J.; Day, D.; and Burstein, A. The process-reactive distinction and prognosis in schizophrenia. Journal of Nervous and Mental Disease, 133:383-391, 1961. </ref>
*Aura are common in seizures of occipital or temporal lobe origin in patients with focal epileptic seizures.<ref>Christian G. Bien, Felix O. Benninger, Horst Urbach, Johannes Schramm, Martin Kurthen, Christian E. Elger, Localizing value of epileptic visual auras Brain (2000) 123 (2): 244-253. </ref> Patients with refractory temporal lobe epilepsy (TLE) have an increased risk of sudden death that is 50 times greater than that in the general population. So if hallucinations are present in epilepsy they indicate grave prognosis. [Verse No.18-23]
*As mentioned earlier dreams are replica of mind and such kinds of dream represents weak and feeble mental status which is not strong enough to fight diseases properly. So if such dreams are frequently seen by patients they will have poor rate of recovery as compared to patient with strong mind and will power. [Verse No.27-40]
*In modern era, during late 19th century, psychotherapist Sigmund Freud gave emphasis on dream connection with mind in his famous book ‘The interpretation of dreams’. He developed a theory that the content of dreams is driven by unconscious wish fulfillment.<ref>Stone MH,Dream analysis in the psychodynamic psychotherapy of borderline patients, Psychodyn Psychiatry. 2012 Jun;40(2):287-302. </ref> Presently dream is defined as successions of images, ideas, emotions, and sensations that occur involuntarily in the mind during certain stages of sleep.<ref>Dream, The American Heritage Dictionary of the English Language, Fourth Edition. 2000. Retrieved May 7, 2009. </ref> Description of ''manovaha srotas'' in pathogenesis of dream shows that role of mind in producing dreams was known in ancient times.
*Various studies have established link between REM sleep and dreaming.<ref>Klemm WR. Why Does Rem Sleep Occur? A Wake-Up Hypothesis. Frontiers in Systems Neuroscience. 2011;5:73. </ref> Poly somnograms show brainwave patterns in REM to be similar to that recorded during wakefulness. Intense dreaming occurs during REM sleep as a result of heightened brain activity. This proves that observations noted by ancient Ayurvedic seers related to pathogenesis of dream are minute and correct. [Verse No.41-42]
*As mentioned above dreams more or less depict unconsciousness state. Freud called dreams the "royal road to the unconscious”. They are related to activities which we have seen, listened, wished, thought etc. Based on this fact seven types of dream have been classified here. Five of them are mild as they are more near to events which we encounter in day to day life. Last two have fatal consequences as they are due to disease or ''dosha'' involvement. [Verse No.43]
*It is difficult to predict dream consequences on the basis of time or order in which they were seen. Researches are needed to scientifically prove the validity of such dream prediction. [Verse No.44-46]

=== References ===

<references/>

Purvarupeeya

2017-12-26T06:16:05Z

Vinay Exafluence: /* Vidhi Vimarsha */

{{Infobox
|title = Purvarupeeya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 5
|label2 = Preceding Chapter
|data2 = [[Indriyaneeka]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 5 ==

===Abstract===

[[Purvarupeeya]] has been devoted to predict prognosis of diseases by prodromal symptoms. This chapter suggests that knowledge and examination of prodromal symptoms was important in ancient times and emphasis was given that physician should carefully recognize disease in early stage and predict course of disease. With the help of eight diseases of [[Nidana Sthana]] important principles related to prognosis have been laid down which are also applicable to all other diseases and are valid till now. Various aspects of dreams including physiology, types, interpretation and prognostic importance have also been described. Various dreams along with physical and mental features have been incorporated in prodromal symptoms which signify that dreams should also be analyzed and properly investigated before predicting prognosis of any disease. Even with restricted technological tools, par excellence observation and principles described regarding ''Arishta Lakshana'' are valid till now.

'''Keywords''': Prodromal symptoms, dream, prognosis, disease, death.

=== Introduction ===

In this chapter prodromal symptoms and dreams related to poor prognosis of diseases- fatality are described. In the first verse, Charaka has emphasized that he will describe both common and special prodromal symptoms. This indicates that while there may be some prodromata which result out of normal pathogenesis, some are unusual and unexpected. In the next verse it has been said that if all prodromal symptoms are manifesting and are severe in nature then such a condition will be fatal. This principle is applicable to all other diseases also. Prodromal symptoms of ''kushta'' and ''prameha'' suggest that complications manifest before cardinal symptoms of the disease appear. If body metabolism in any disease is altered severely during latent phase of disease and complications are appearing before manifestation of full-fledged disease then such condition will be difficult to cure. Example of ''gulma'' suggests that there are certain diseases which are incurable in nature and prodromal symptoms related to such clinical conditions will always be precursors of imminent death. It is commonly seen that any person who is emaciated and have low immunity and strength, when affected by disease, has fatal consequences due to less resistance. This fact is explained with the example of ''shosha''. Another important aspect regarding disease prognosis is that, if a person is continuously partaking causative factors or is in constant exposure to the causative factors, body will be unable to fight disease properly and thus there will be less chances of recovery from the disease. This point is also mentioned while describing prognosis of ''shosha''.

From the above discussion it is clear that prodromal symptoms can be useful in predicting diagnosis of any disease. But now question arises whether it is practically possible to predict prognosis with prodromal symptoms? We should admit that it is very difficult and one will need years of experience to attain such competence. Another important fact is that the prediction of prognosis can be done from ''purvarupa'' only after disease manifestation. Charaka states that ''purvarupa'' converting into a particular disease in future can be termed a prognostic sign. This indicates that we cannot predict by only prodromal symptoms. We have to look into whether disease was produced after ''purvarupa'' or not. For example, delirium in ''raktapitta'' is indicator of poor prognosis. If delirium is seen in any patient but he is not developing ''raktapitta'' we cannot predict poor prognosis. In this condition, after manifestation of ''raktapitta'' we need to ask the patient whether he suffered from delirium before disease manifestation or not. It is a retrospective inquiry about ''purvarupa'' based on which a prospective prediction may be made. We will have to follow detailed retro-prospective approach and will need proper patient history comprising of each and every detail from prodromal symptoms to disease manifestation. Thus practically, prodromal symptoms are helpful only after disease manifestation as they are not independent. Since accompanying symptoms may also lead to predictions, they can also be regarded as tools of predictive prognosis. This might be the reason that Sushruta and Vagbhata have not described dreams in reference of ''purvarupa'' but have described in ''rupavastha'' (stage of disease manifestation).

Biomarkers are recent advancements can be the answer to above problem as we do not need to wait for disease manifestation and can predict prognosis by seeing values of biomarkers related to that disease. In 2001, a consensus panel at the National Institutes of Health defined the term biomarker as ‘a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention or other health care intervention’.<ref>Torres-Bugarín O, Zavala-Cerna MG, Nava A, Flores-García A, Ramos-Ibarra ML. Potential Uses, Limitations, and Basic Procedures of Micronuclei and Nuclear Abnormalities in Buccal Cells. Disease Markers. 2014;2014:956835. </ref> Biomarker defined as alteration in the constituents of tissues or body fluids provide a powerful approach to understanding the spectrum of chronic disease with application in at least 5 areas like screening, diagnosis, prognostics, prediction of disease recurrence and therapeutic monitoring.<ref>Pradeep Sahu et al, Biomarkers: An Emerging Tool for Diagnosis of a Disease and Drug Development, Asian J. Res. Pharm. Sci. 2011; Vol. 1: Issue 1, Pg 09-16 </ref> The biomarker is either produced by the diseased organ (e.g., tumor) or by the body in response to disease. Before diagnosis, markers could be used for screening and risk assessment. Tumor classification, stage and sometimes grade are generally used to assess prognosis. Researches in the field of biomarkers may give us chance to know prognosis of disease in early stage.

Another important aspect mentioned in this chapter is concept of dreams. The descriptions related to dreams are found abundantly in the ancient oriental classics, specifically the Atharvaveda, Upanishadas, Puranas, Darshanas and [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. The description of the ''doshika'' dreams of the Atharvaveda is similar to that in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. Dreams are mentioned while describing ''purvarupa'', ''rupa'' and ''arishta lakshanas''.<ref>Sonali S. Tendulkar and R. R. Dwivedi, ‘Swapna’ in the Indian classics: Mythology or science?,Ayu. 2010 Apr-Jun; 31(2): 170–174. </ref> Sushruta states that sex of the unborn child can be predicted and Vagbhata says that ''doshika prakriti'' can be known by the help of dreams.

Subject of dreams is dealt in very scientific manner. According to Charaka, dreams occur when person is in relatively wakeful state. This has been proved now by the researches that dreams mainly occur in the rapid-eye movement (REM) stage of sleep—when brain activity is high and resembles that of being awake. In the late 19th century, psychotherapist Sigmund Freud developed a theory that the content of dreams is driven by unconscious wish fulfillment. Freud called dreams the "royal road to the unconscious”.<ref>Jeannette Y. Wick; Guido R. Zann, Drugs and Dreams, J Am Pharm Assoc (2003) 2002;42:385-390. </ref> To Freud, no dream was of entertainment value, they all held important meanings. Dreams reflect the dreamer’s mental, emotional, and physical state. This fact is well established in this chapter while describing classification of dreams. Dreams are based on our day to day interactions and so are classified as dreams seen, heard, felt etc. Two of the seven types, one which predict prognosis and one which is due to vitiation of ''doshas'' are said to have fatal consequences.

Research studies are needed to prove that dreams can be used as markers of prognosis. Some studies have been conducted in this regard but we cannot make strong conclusion on basis of their results. In a few studies it has been shown that hormone levels affect dreams. One of the studies states that cortisol plays an important role in controlling the state of memory systems during sleep. High levels of cortisol, as are observed late at night and, typically in the context of REM sleep, disrupt normal hippocampal → neocortical communication, thereby interfering with forms of memory consolidation dependent upon this communication. At the same time, the content of dreams is also affected.<ref>Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678. </ref> In neurological and psychological diseases dream disturbances are often seen but few other diseases have also been found to affect dreams. Patients with sleep apnea are reported to have intense nightmares.<ref>J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73. </ref> Abnormal dreams have also been reported in diseases like Relapsing fever,<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165. </ref> Cardiac ischemia<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28. </ref> etc. Certain drugs also affect dreams e.g. Anti malarial drug has shown to alter dream types.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203. </ref> This proves that at times diseases certainly affect dreams but intense research studies are needed to actually establish this fact on scientific grounds.

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

अथातः पूर्वरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pūrvarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pUrvarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter of premonitory symptoms related to signs of death.
Thus spoke lord Atreya.[1-2]

==== Incurable prodromal signs of ''Jwara'' leading to death ====

पूर्वरूपाण्यसाध्यानां विकाराणां पृथक् पृथक्|
भिन्नाभिन्नानि वक्ष्यामो भिषजां ज्ञानवृद्धये||३||

पूर्वरूपाणि सर्वाणि ज्वरोक्तान्यतिमात्रया|
यं विशन्ति विशत्येनं मृत्युर्ज्वरपुरःसरः||४||

अन्यस्यापि च रोगस्य पूर्वरूपाणि यं नरम्|
विशन्त्यनेन कल्पेन तस्यापि मरणं ध्रुवम्||५||

pūrvarūpāṇyasādhyānāṁ vikārāṇāṁ pr̥thak pr̥thak|
bhinnābhinnāni vakṣyāmō bhiṣajāṁ jñānavr̥ddhayē||3||

pūrvarūpāṇi sarvāṇi jvarōktānyatimātrayā|
yaṁ viśanti viśatyēnaṁ mr̥tyurjvarapuraḥsaraḥ||4||

anyasyāpi ca rōgasya pūrvarūpāṇi yaṁ naram|
viśantyanēna kalpēna tasyāpi maraṇaṁ dhruvam||5||

pUrvarUpANyasAdhyAnAM vikArANAM pRuthak pRuthak|
bhinnAbhinnAni vakShyAmo bhiShajAM j~jAnavRuddhaye||3||

pUrvarUpANi sarvANi jvaroktAnyatimAtrayA|
yaM vishanti vishatyenaM mRutyurjvarapuraHsaraH||4||

anyasyApi ca rogasya pUrvarUpANi yaM naram|
vishantyanena kalpena tasyApi maraNaM dhruvam||5||

For enhancing the knowledge of physicians, we will distinctly explain the general and fatal prodromal symptoms of diseases.
If all prodromal symptoms of ''jwara'' manifests in severe degree, the person will die. If prodromal symptoms of any other disease also appear in the same way as described above, death of the patient is certain. [3-5]

==== Incurable prodromal signs of ''Rajayakshma'' leading to death ====

पूर्वरूपैकदेशांस्तु वक्ष्यामोऽन्यान् सुदारुणान्|
ये रोगाननुबध्नन्ति मृत्युर्यैरनुबध्यते [१] ||६||

बलं च हीयते यस्य प्रतिश्यायश्च वर्धते|
तस्य नारीप्रसक्तस्य शोषोऽन्तायोपजायते||७||

श्वभिरुष्ट्रैः खरैर्वाऽपि याति यो दक्षिणां दिशम्|
स्वप्ने यक्ष्माणमासाद्य जीवितं स विमुञ्चति||८||

प्रेतैः सह पिबेन्मद्यं स्वप्ने यः कृष्यते शुना|
सुघोरं ज्वरमासाद्य जीवितं स विमुञ्चति||९||

pūrvarūpaikadēśāṁstu vakṣyāmō'nyān sudāruṇān|
yē rōgānanubadhnanti mr̥tyuryairanubadhyatē ||6||

balaṁ ca hīyatē yasya pratiśyāyaśca vardhatē|
tasya nārīprasaktasya śōṣō'ntāyōpajāyatē||7||

śvabhiruṣṭraiḥ kharairvā'pi yāti yō dakṣiṇāṁ diśam|
svapnē yakṣmāṇamāsādya jīvitaṁ sa vimuñcati||8||

prētaiḥ saha pibēnmadyaṁ svapnē yaḥ kr̥ṣyatē śunā|
sughōraṁ jvaramāsādya jīvitaṁ sa vimuñcati||9||

pUrvarUpaikadeshAMstu vakShyAmo~anyAn sudAruNAn|
ye rogAnanubadhnanti mRutyuryairanubadhyate ||6||

balaM ca hIyate yasya pratishyAyashca vardhate|
tasya nArIprasaktasya shoSho~antAyopajAyate||7||

shvabhiruShTraiH kharairvA~api yAti yo dakShiNAM disham|
svapne yakShmANamAsAdya jIvitaM sa vimu~jcati||8||

pretaiH saha pibenmadyaM svapne yaH kRuShyate shunA|
sughoraM jvaramAsAdya jIvitaM sa vimu~jcati||9||

Now we shall discuss certain severe premonitory symptoms which are associated with certain diseases.
The consumption which is associated with continuously decreasing strength, worsening rhinitis and over indulgence in sex in prodromal stage will turn out to be incurable.

A man, who in his dreams, is dragged by dog, camel or a donkey towards south, leaves his life as by consumption.
A person who in his dreams takes alcohol with demons and who is dragged by a dog leaves his life getting affected with severe fever. [6-9]

==== Incurable prodromal signs of ''Raktapitta'' leading to death ====

लाक्षारक्ताम्बराभं यः पश्यत्यम्बरमन्तिकात्|
स रक्तपित्तमासाद्य तेनैवान्ताय नीयते||१०||

रक्तस्रग्रक्तसर्वाङ्गो रक्तवासा मुहुर्हसन्|
यः स्वप्ने ह्रियते नार्या स रक्तं प्राप्य सीदति||११||

lākṣāraktāmbarābhaṁ yaḥ paśyatyambaramantikāt|
sa raktapittamāsādya tēnaivāntāya nīyatē||10||

raktasragraktasarvāṅgō raktavāsā muhurhasan|
yaḥ svapnē hriyatē nāryā sa raktaṁ prāpya sīdati||11||

lAkShAraktAmbarAbhaM yaH pashyatyambaramantikAt|
sa raktapittamAsAdya tenaivAntAya nIyate||10||

raktasragraktasarvA~ggo raktavAsA muhurhasan|
yaH svapne hriyate nAryA sa raktaM prApya sIdati||11||

He who sees clothes as if dyed with red lac, leaves his life if he gets affected with severe bleeding disorders.
In his dream, the man who sees himself adorned with red garlands, clad in red clothes, anointed with red dye and dragged by a continuously laughing woman will succumb to severe bleeding disorders. [10-11]

==== Incurable prodromal signs of ''Gulma'' leading to death ====

शूलाटोपान्त्रकूजाश्च दौर्बल्यं चातिमात्रया|
नखादिषु च वैवर्ण्यं गुल्मेनान्तकरो ग्रहः||१२||

लता कण्टकिनी यस्य दारुणा हृदि जायते|
स्वप्ने गुल्मस्तमन्ताय क्रूरो विशति मानवम्||१३||

śūlāṭōpāntrakūjāśca daurbalyaṁ cātimātrayā|
nakhādiṣu ca vaivarṇyaṁ gulmēnāntakarō grahaḥ||12||

latā kaṇṭakinī yasya dāruṇā hr̥di jāyatē|
svapnē gulmastamantāya krūrō viśati mānavam||13||

shUlATopAntrakUjAshca daurbalyaM cAtimAtrayA|
nakhAdiShu ca vaivarNyaM gulmenAntakaro grahaH||12||

latA kaNTakinI yasya dAruNA hRudi jAyate|
svapne gulmastamantAya krUro vishati mAnavam||13||

A man who experiences severe pain, gurgling sounds in abdomen, intestinal peristalsis, excessive debility, discoloration of nails and other body parts is going to die if he is affected with ''gulma''.

A person, who in his dreams sees hard and thorny creepers grown on his chest and then gets afflicted by ''gulma'', is surely going to die soon. [12-13]

==== Incurable prodromal signs of ''Kushtha'' leading to death ====

कायेऽल्पमपि संस्पृष्टं सुभृशं यस्य दीर्यते|
क्षतानि च न रोहन्ति कुष्ठैर्मृत्युर्हिनस्ति तम्||१४||

नग्नस्याज्यावसिक्तस्य जुह्वतोऽग्निमनर्चिषम्|
पद्मान्युरसि जायन्ते स्वप्ने कुष्ठैर्मरिष्यतः||१५||

kāyē'lpamapi saṁspr̥ṣṭaṁ subhr̥śaṁ yasya dīryatē|
kṣatāni ca na rōhanti kuṣṭhairmr̥tyurhinasti tam||14||

nagnasyājyāvasiktasya juhvatō'gnimanarciṣam|
padmānyurasi jāyantē svapnē kuṣṭhairmariṣyataḥ||15||

kAye~alpamapi saMspRuShTaM subhRushaM yasya dIryate|
kShatAni ca na rohanti kuShThairmRutyurhinasti tam||14||

nagnasyAjyAvasiktasya juhvato~agnimanarciSham|
padmAnyurasi jAyante svapne kuShThairmariShyataH||15||

A person whose body even if touched gently leads to deep cuts and whose injuries never heal will be killed by severe skin diseases.
In his dream, a man who sees himself naked, anointed with ghee, offering the oblations without the fire being lit, who has lotuses grown on his chest, will be taken away by death as afflicted by skin diseases.[14-15]

==== Incurable prodromal signs of ''Prameha'' leading to death ====

स्नातानुलिप्तगात्रेऽपि यस्मिन् गृध्नन्ति मक्षिकाः|
स प्रमेहेण संस्पर्शं प्राप्य तेनैव हन्यते||१६||

स्नेहं बहुविधं स्वप्ने चण्डालैः सह यः पिबेत्|
बध्यते स प्रमेहेण स्पृश्यतेऽन्ताय मानवः||१७||

snātānuliptagātrē'pi yasmin gr̥dhnanti makṣikāḥ|
sa pramēhēṇa saṁsparśaṁ prāpya tēnaiva hanyatē||16||

snēhaṁ bahuvidhaṁ svapnē caṇḍālaiḥ saha yaḥ pibēt|
badhyatē sa pramēhēṇa spr̥śyatē'ntāya mānavaḥ||17||

snAtAnuliptagAtre~api yasmin gRudhnanti makShikAH|
sa prameheNa saMsparshaM prApya tenaiva hanyate||16||

snehaM bahuvidhaM svapne caNDAlaiH saha yaH pibet|
badhyate sa prameheNa spRushyate~antAya mAnavaH||17||

Even after taking bath and getting anointed with scents, flies are attracted towards person, he will certainly die, if affected with ''prameha''.

One who sees in his dreams, drinking various kinds of oily substances with Chandalas becomes affected by ''prameha'' and will die. [16-17]

==== Incurable prodromal signs of ''Unmada'' and ''Apasmara'' leading to death ====

ध्यानायासौ तथोद्वेगौ मोहश्चास्थानसम्भवः|
अरतिर्बलहानिश्च मृत्युरुन्मादपूर्वकः||१८||

आहारद्वेषिणं पश्यन् लुप्तचित्तमुदर्दितम्|
विद्याद्धीरो मुमूर्षुं तमुन्मादेनातिपातिना||१९||

क्रोधनं त्रासबहुलं सकृत्प्रहसिताननम्|
मूर्च्छापिपासाबहुलं हन्त्युन्मादः शरीरिणम्||२०||

नृत्यन् रक्षोगणैः साकं यः स्वप्नेऽम्भसि सीदति |
स प्राप्य भृशमुन्मादं याति लोकमतः परम्||२१||

असत्तमः पश्यति यः शृणोत्यप्यसतः स्वनान्|
बहून् बहुविधान् जाग्रत् सोऽपस्मारेण बध्यते||२२||

मत्तं नृत्यन्तमाविध्य प्रेतो हरति यं नरम्|
स्वप्ने हरति तं मृत्युरपस्मारपुरःसरः||२३||

dhyānāyāsau tathōdvēgau mōhaścāsthānasambhavaḥ|
aratirbalahāniśca mr̥tyurunmādapūrvakaḥ||18||

āhāradvēṣiṇaṁ paśyan luptacittamudarditam|
vidyāddhīrō mumūrṣuṁ tamunmādēnātipātinā||19||

krōdhanaṁ trāsabahulaṁ sakr̥tprahasitānanam|
mūrcchāpipāsābahulaṁ hantyunmādaḥ śarīriṇam||20||

nr̥tyan rakṣōgaṇaiḥ sākaṁ yaḥ svapnē'mbhasi sīdati |
sa prāpya bhr̥śamunmādaṁ yāti lōkamataḥ param||21||

asattamaḥ paśyati yaḥ śr̥ṇōtyapyasataḥ svanān|
bahūn bahuvidhān jāgrat sō'pasmārēṇa badhyatē||22||

mattaṁ nr̥tyantamāvidhya prētō harati yaṁ naram|
svapnē harati taṁ mr̥tyurapasmārapuraḥsaraḥ||23||

dhyAnAyAsau tathodvegau mohashcAsthAnasambhavaH|
aratirbalahAnishca mRutyurunmAdapUrvakaH||18||

AhAradveShiNaM pashyan luptacittamudarditam|
vidyAddhIro mumUrShuM tamunmAdenAtipAtinA||19||

krodhanaM trAsabahulaM sakRutprahasitAnanam|
mUrcchApipAsAbahulaM hantyunmAdaH sharIriNam||20||

nRutyan rakShogaNaiH sAkaM yaH svapne~ambhasi sIdati |
sa prApya bhRushamunmAdaM yAti lokamataH param||21||

asattamaH pashyati yaH shRuNotyapyasataH svanAn|
bahUn bahuvidhAn jAgrat so~apasmAreNa badhyate||22||

mattaM nRutyantamAvidhya preto harati yaM naram|
svapne harati taM mRutyurapasmArapuraHsaraH||23||

He who is affected with disturbing thoughts, anxiety, stupefaction without any specific cause, restlessness, loss of strength will succumb to death as affected with insanity.

The person who feels excess anger, fear, always smiles and who is suffering from severe stupor and thirst will be certainly killed by insanity.

The man who in his dreams dances with evil spirits and sinks in water leaves the world.
He who sees darkness even when he is awake and hears sounds when there is no real sound, will be killed by epilepsy.
In dream, a person who sees himself dancing with ghosts while in intoxication with his head upside down, will be taken away by death getting affected with epilepsy. [18-23]

स्तभ्येते प्रतिबुद्धस्य हनू मन्ये तथाऽक्षिणी|
यस्य तं बहिरायामो गृहीत्वा हन्त्यसंशयम्||२४||

शष्कुलीर्वाऽप्यपूपान् वा स्वप्ने खादति यो नरः|
स चेत्तादृक् छर्दयति प्रतिबुद्धो न जीवति||२५||

stabhyētē pratibuddhasya hanū manyē tathā'kṣiṇī|
yasya taṁ bahirāyāmō gr̥hītvā hantyasaṁśayam||24||

śaṣkulīrvā'pyapūpān vā svapnē khādati yō naraḥ|
sa cēttādr̥k chardayati pratibuddhō na jīvati||25||

stabhyete pratibuddhasya hanU manye tathA~akShiNI|
yasya taM bahirAyAmo gRuhItvA hantyasaMshayam||24||

shaShkulIrvA~apyapUpAn vA svapne khAdati yo naraH|
sa cettAdRuk chardayati pratibuddho na jIvati||25||

If individual is found with ''bahirayama'' ( a disease with feature of opisthotonus or bending of body backwards) soon after awaking from sleep along with lock jaw, neck stiffness, stale eyes and paralysis is going to lose life soon.

Such an individual in his dream sees himself taking cakes of sesame seeds and ''apupa'' ( a dietary item) and vomits the same when he is awake.[24-25]

एतानि पूर्वरूपाणि यः सम्यगवबुध्यते|
स एषामनुबन्धं च फलं च ज्ञातुमर्हति||२६||

ētāni pūrvarūpāṇi yaḥ samyagavabudhyatē|
sa ēṣāmanubandhaṁ ca phalaṁ ca jñātumarhati||26||

etAni pUrvarUpANi yaH samyagavabudhyate|
sa eShAmanubandhaM ca phalaM ca j~jAtumarhati||26||

One who (physician) understands these premonitory symptoms thoroughly, also deserves the knowledge of associated diseases and their result i.e. death.[26]

इमांश्चाप्यपरान् स्वप्नान् दारुणानुपलक्षयेत्|
व्याधितानां विनाशाय क्लेशाय महतेऽपि वा||२७||

यस्योत्तमाङ्गे जायन्ते वंशगुल्मलतादयः|
वयांसि च विलीयन्ते स्वप्ने मौण्ड्यमियाच्च यः||२८||

गृध्रोलूकश्वकाकाद्यैः स्वप्ने यः परिवार्यते|
रक्षःप्रेतपिशाचस्त्रीचण्डालद्रविडान्ध्रकैः ||२९||

वंशवेत्रलतापाशतृणकण्टकसङ्कटे|
संसज्जति हि यः स्वप्ने यो गच्छन् प्रपतत्यपि||३०||

भूमौ पांशूपधानायां वल्मीके वाऽथ भस्मनि|
श्मशानायतने श्वभ्रे स्वप्ने यः प्रपतत्यपि ||३१||

कलुषेऽम्भसि पङ्के वा कूपे वा तमसाऽऽवृते|
स्वप्ने मज्जति शीघ्रेण स्रोतसा ह्रियते च यः||३२||

स्नेहपानं तथाऽभ्यङ्गः प्रच्छर्दनविरेचने|
हिरण्यलाभः कलहः स्वप्ने बन्धपराजयौ||३३||

उपानद्युगनाशश्च प्रपातः पादचर्मणोः|
हर्षः स्वप्ने प्रकुपितैः पितृभिश्चावभर्त्सनम्||३४||

दन्तचन्द्रार्कनक्षत्रदेवतादीपचक्षुषाम् |
पतनं वा विनाशो वा स्वप्ने भेदो नगस्य वा||३५||

रक्तपुष्पं वनं भूमिं पापकर्मालयं चिताम्|
गुहान्धकारसम्बाधं स्वप्ने यः प्रविशत्यपि||३६||

रक्तमाली हसन्नुच्चैर्दिग्वासा दक्षिणां दिशम्|
दारुणामटवीं स्वप्ने कपियुक्तेन याति वा||३७||

काषायिणामसौम्यानां नग्नानां दण्डधारिणाम्|
कृष्णानां रक्तनेत्राणां स्वप्ने नेच्छन्ति दर्शनम्||३८||

कृष्णा पापा निराचारा दीर्घकेशनखस्तनी|
विरागमाल्यवसना स्वप्ने कालनिशा मता||३९||

इत्येते दारुणाः स्वप्ना रोगी यैर्याति पञ्चताम्|
अरोगः संशयं गत्वा कश्चिदेव प्रमुच्यते||४०||

imāṁścāpyaparān svapnān dāruṇānupalakṣayēt|
vyādhitānāṁ vināśāya klēśāya mahatē'pi vā||27||

yasyōttamāṅgē jāyantē vaṁśagulmalatādayaḥ|
vayāṁsi ca vilīyantē svapnē mauṇḍyamiyācca yaḥ||28||

gr̥dhrōlūkaśvakākādyaiḥ svapnē yaḥ parivāryatē|
rakṣaḥprētapiśācastrīcaṇḍāladraviḍāndhrakaiḥ ||29||

vaṁśavētralatāpāśatr̥ṇakaṇṭakasaṅkaṭē|
saṁsajjati hi yaḥ svapnē yō gacchan prapatatyapi||30||

bhūmau pāṁśūpadhānāyāṁ valmīkē vā'tha bhasmani|
śmaśānāyatanē śvabhrē svapnē yaḥ prapatatyapi ||31||

kaluṣē'mbhasi paṅkē vā kūpē vā tamasā''vr̥tē|
svapnē majjati śīghrēṇa srōtasā hriyatē ca yaḥ||32||

snēhapānaṁ tathā'bhyaṅgaḥ pracchardanavirēcanē|
hiraṇyalābhaḥ kalahaḥ svapnē bandhaparājayau||33||

upānadyuganāśaśca prapātaḥ pādacarmaṇōḥ|
harṣaḥ svapnē prakupitaiḥ pitr̥bhiścāvabhartsanam||34||

dantacandrārkanakṣatradēvatādīpacakṣuṣām |
patanaṁ vā vināśō vā svapnē bhēdō nagasya vā||35||

raktapuṣpaṁ vanaṁ bhūmiṁ pāpakarmālayaṁ citām|
guhāndhakārasambādhaṁ svapnē yaḥ praviśatyapi||36||

raktamālī hasannuccairdigvāsā dakṣiṇāṁ diśam|
dāruṇāmaṭavīṁ svapnē kapiyuktēna yāti vā||37||

kāṣāyiṇāmasaumyānāṁ nagnānāṁ daṇḍadhāriṇām|
kr̥ṣṇānāṁ raktanētrāṇāṁ svapnē nēcchanti darśanam||38||

kr̥ṣṇā pāpā nirācārā dīrghakēśanakhastanī|
virāgamālyavasanā svapnē kālaniśā matā||39||

ityētē dāruṇāḥ svapnā rōgī yairyāti pañcatām|
arōgaḥ saṁśayaṁ gatvā kaścidēva pramucyatē||40||

imAMshcApyaparAn svapnAn dAruNAnupalakShayet|
vyAdhitAnAM vinAshAya kleshAya mahate~api vA||27||

yasyottamA~gge jAyante vaMshagulmalatAdayaH|
vayAMsi ca vilIyante svapne mauNDyamiyAcca yaH||28||

gRudhrolUkashvakAkAdyaiH svapne yaH parivAryate|
rakShaHpretapishAcastrIcaNDAladraviDAndhrakaiH ||29||

vaMshavetralatApAshatRuNakaNTakasa~gkaTe|
saMsajjati hi yaH svapne yo gacchan prapatatyapi||30||

bhUmau pAMshUpadhAnAyAM valmIke vA~atha bhasmani|
shmashAnAyatane shvabhre svapne yaH prapatatyapi ||31||

kaluShe~ambhasi pa~gke vA kUpe vA tamasA~a~avRute|
svapne majjati shIghreNa srotasA hriyate ca yaH||32||

snehapAnaM tathA~abhya~ggaH pracchardanavirecane|
hiraNyalAbhaH kalahaH svapne bandhaparAjayau||33||

upAnadyuganAshashca prapAtaH pAdacarmaNoH|
harShaH svapne prakupitaiH pitRubhishcAvabhartsanam||34||

dantacandrArkanakShatradevatAdIpacakShuShAm |
patanaM vA vinAsho vA svapne bhedo nagasya vA||35||

raktapuShpaM vanaM bhUmiM pApakarmAlayaM citAm|
guhAndhakArasambAdhaM svapne yaH pravishatyapi||36||

raktamAlI hasannuccairdigvAsA dakShiNAM disham|
dAruNAmaTavIM svapne kapiyuktena yAti vA||37||

kAShAyiNAmasaumyAnAM nagnAnAM daNDadhAriNAm|
kRuShNAnAM raktanetrANAM svapnenecchanti darshanam||38|

kRuShNA pApA nirAcArA dIrghakeshanakhastanI|
virAgamAlyavasanA svapne kAlanishA matA||39||

ityete dAruNAH svapnA rogI yairyAti pa~jcatAm|
arogaH saMshayaM gatvA kashcideva pramucyate||40||

Certain other dreams which are fierce should also be analyzed as they indicate the approaching death of the diseased and grave sufferings for those who are going to be affected.

He, who in his dreams sees bamboos, shrubs and creepers etc. growing in his head, birds coming to them and his scalp been shaved.
Or who in his dreams sees himself surrounded by vultures, owls, dogs, crows and other birds or by Rakshasa, dead men, ''pishachas'', women, ''chandalas'', and inhabitants of Dravida and Andhra regions.

Or who in his dreams finds himself surrounded by pathless forests of bamboo, canes, creepers, grass and prickly plants and finds himself lost in the midst and falling down while trying to come out.

Or who in his dreams, falls down on the bare ground covered with dust or upon an anthill or upon ashes, or upon a crematorium or in to a hole.

Or who sinks in a ditch or pond of dirty water or into mire or in a dark well or who is carried away by a rapid current.
Or who in his dreams drinks oily substances or anoints his body with oil, vomits, defecates, or gets gold, engages in quarrel, gets defeated and captured.

Or who lose his sandals, has skin of feet peeling off or feels excited or who is rebuked by his angry ancestors.
Or who sees in his dreams the fall or destruction of his own tooth or the moon or the sun or the stars or the burning lamps or his own eyes or the cracking of a mountain.

Or who in his dreams, enters a forest of trees with red flowers or a place where sinful activities are done or a funeral place (crematorium), a dark cave.

Or who in his dreams sees himself proceeding towards south, finds himself adorned with garlands of red flowers, laughing aloud and naked.
The sight of a woman who is dark in complexion, who is sinful, who has long hair and nails, hanging breasts, or who is clad in garlands of red flowers and red garments is regarded to be as fatal as a fatal night.
These are severe dreams which indicate death of a patient.

If a healthy man sees such dreams, his life becomes doubtful, rarely does he escape. [27-40]

==== Dreams ====

मनोवहानां पूर्णत्वाद्दोषैरतिबलैस्त्रिभिः|
स्रोतसां दारुणान् स्वप्नान् काले पश्यति दारुणे||४१||

नातिप्रसुप्तः पुरुषः सफलानफलांस्तथा|
इन्द्रियेशेन मनसा स्वप्नान् पश्यत्यनेकधा||४२||

manōvahānāṁ pūrṇatvāddōṣairatibalaistribhiḥ|
srōtasāṁ dāruṇān svapnān kālē paśyati dāruṇē||41||

nātiprasuptaḥ puruṣaḥ saphalānaphalāṁstathā|
indriyēśēna manasā svapnān paśyatyanēkadhā||42||

manovahAnAM pUrNatvAddoShairatibalaistribhiH|
srotasAM dAruNAn svapnAn kAle pashyati dAruNe||41||

nAtiprasuptaH puruShaH saphalAnaphalAMstathA|
indriyeshena manasA svapnAn pashyatyanekadhA||42||

When the channels associated with the mind are saturated by the excessively vitiated ''doshas'', such terrible dreams appear in his sleep. The person who is not in deep sleep (subconscious state), sees various fruitful (meaningful) or fruitless (meaningless) dreams in association with sense organs. [41-42]

दृष्टं श्रुतानुभूतं च प्रार्थितं कल्पितं तथा|
भाविकं दोषजं चैव स्वप्नं सप्तविधं विदुः||४३||

dr̥ṣṭaṁ śrutānubhūtaṁ ca prārthitaṁ kalpitaṁ tathā|
bhāvikaṁ dōṣajaṁ caiva svapnaṁ saptavidhaṁ viduḥ||43||

dRuShTaM shrutAnubhUtaM ca prArthitaM kalpitaM tathA|
bhAvikaM doShajaM caiva svapnaM saptavidhaM viduH||43||

It is known that there are seven kinds of dreams: seen, heard, felt, desired, imagined, prognosticating and faulty by nature. [43]
[[File:swapnabhead.png]]<br>
तत्र पञ्चविधं पूर्वमफलं भिषगादिशेत्|
दिवास्वप्नमतिह्रस्वमतिदीर्घं च बुद्धिमान्||४४||

दृष्टः प्रथमरात्रे यः स्वप्नः सोऽल्पफलो भवेत्|
न स्वपेद्यं पुनर्दृष्ट्वा स सद्यः स्यान्महाफलः||४५||

अकल्याणमपि स्वप्नं दृष्ट्वा तत्रैव यः पुनः|
पश्येत् सौम्यं शुभाकारं तस्य विद्याच्छुभं फलम्||४६||

tatra pañcavidhaṁ pūrvamaphalaṁ bhiṣagādiśēt|
divāsvapnamatihrasvamatidīrghaṁ ca buddhimān||44||

dr̥ṣṭaḥ prathamarātrē yaḥ svapnaḥ sō'lpaphalō bhavēt|
na svapēdyaṁ punardr̥ṣṭvā sa sadyaḥ syānmahāphalaḥ||45||

akalyāṇamapi svapnaṁ dr̥ṣṭvā tatraiva yaḥ punaḥ|
paśyēt saumyaṁ śubhākāraṁ tasya vidyācchubhaṁphalam|46||

tatra pa~jcavidhaM pUrvamaphalaM bhiShagAdishet|
divAsvapnamatihrasvamatidIrghaM ca buddhimAn||44||

dRuShTaH prathamarAtre yaH svapnaH so~alpaphalo bhavet|
na svapedyaM punardRuShTvA sa sadyaH syAnmahAphalaH||45||

akalyANamapi svapnaM dRuShTvA tatraiva yaH punaH|
pashyet saumyaM shubhAkAraM tasya vidyAcchubhaM phalam||46||

Amongst these the first five (viz.seen, heard, felt, desired and imagined) are fruitless (meaningless), and also those seen during daytime, and those which are too short or too long.

The dream that is seen during the first part of night is partially fruitful. He, however who having seen a dream does not sleep after it, will be realizing the dream completely.

It should be known that if a person having seen an inauspicious dream, sees without waking up another dream that is auspicious and of beneficial form just afterwards, he meets with good results. [44-46]

==== Summary ====

तत्र श्लोकः-
पूर्वरूपाण्यथ स्वप्नान् य इमान् वेत्ति दारुणान्|
न स मोहादसाध्येषु कर्माण्यारभते भिषक्||४७||

tatra ślōkaḥ-
pūrvarūpāṇyatha svapnān ya imān vētti dāruṇān|
na sa mōhādasādhyēṣu karmāṇyārabhatē bhiṣak||47||

tatra shlokaH-
pUrvarUpANyatha svapnAn ya imAn vetti dAruNAn|
na sa mohAdasAdhyeShu karmANyArabhate bhiShak||47||

A physician who is conversant with those premonitory symptoms which are associated with such terrible dreams never starts the treatment for incurable diseases out of his ignorance.[47]

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

*Important principle regarding disease prognosis states that “if all premonitory symptoms of a disease are fully manifested in severe form then it indicates poor prognosis”. [Verse No.3-5]
*If any person is continuously exposed to etiological agents and complications appear earlier than such disease is going to have poor prognosis. It is also emphasized that any person who is severely debilitated will not recover from any disease easily. Interpretation based on dreams should also be considered while predicting course of the disease. One special note from this chapter is that they describe symptoms in combination than in solitary appearance which shows the complexity of disease causing and disease prognostic process leading to fatality. Perhaps this needs a specially designed research to study on relation between dreams and ''arishtas''. [Verse No.6-9]
*It has been emphasized that not only clinical presentations but personal experiences of the patient can play role in disease outcome and so should not be neglected. This analogy described here has a striking resemblance with astronomy and understanding of body components. They attribute special colors, precious stones in relation with ''dhatus'', zodiac signs and body components. Perhaps Jyothisha Shastra (astrology) and gemology can be referred for more explanation. [Verse No.10-11]
*It has been emphasized that even minor complaints of the patient should not be ignored as they can be indicator of forthcoming serious and grave conditions. [Verse No.12-13]
*Significance of dreams in prodromal symptoms and fatal consequences have been described which need further study and research. All the three ''doshas'' should be excessively vitiated and should involve ''Manovaha Srotas'', i.e. channels associated with mind for producing such kind of dreams.

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

*In present era we do not predict prognosis by prodromal symptoms except in few cases as prodromal symptoms are not exactly known in most of the diseases. Due to ambiguity, prodromal symptoms are not considered reliable and this might be the reason they are not given importance in disease diagnosis and prognosis. [Verse No.3-5]
*In the example of tuberculosis, if person is severely debilitated and then consumption is occurring then there are more chances that he will succumb to disease. Persistence of cause like sexual indulgence in such condition will further precipitate the possibility of fatality. Here one point is noticeable that rhinorrhea is not a symptom of tuberculosis. It can occur as complication of extra-pulmonary tuberculosis which may lead to bony erosion, out-pouching of the dura, CSF leak, and subsequent bacterial meningitis which is a fatal condition. This condition suggests that if severe complications are occurring earlier than manifestation of cardinal feature of the disease, it indicates poor prognosis of disease.<ref>Waqas Wahid Baig et al., Spontaneous Cerebrospinal Fluid Rhinorrhea with Pneumocephalus: An Unusual Manifestation of Nasal Tuberculosis, Korean J Intern Med. 2012 September; 27(3): 350–352 </ref> This rule applies to all other diseases: if prior health status of person is poor, he continues to partake etiological agents and complications are appearing in very early stage then disease produced in future will be fatal in nature.
*Horrible dreams in a person indicate the decreased mental strength of the person. ‘Mind’ is component of health and patient can combat diseases easily with strong mind and will power. Disease is always difficult to cure in a depressed person with low will power. This might be a reason why Charaka has mentioned importance of dreams while predicting prognosis of any disease. Lifestyle has changed since this text was composed, the type of dreams and their interpretation should also be changed, requiring research. We often give importance to ''sharira doshas'' and neglect the importance of ''manasa doshas'' in causation and continuation of disease process. Perhaps this chapter gives us a scope to view things from different dimension. For all dreams the role of ''manasa doshas'' are pivotal. This needs further research [Verse No.6-9]
*From above verse it can be inferred that delirium before bleeding disorders will be fatal for the patient. Important cause of delirium is old age and other risk factors are poor overall health, anemia, malnutrition, underlying medical or neurologic illness etc.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc,chapter 26 </ref> If we critically analyze these factors we can infer that each of these will deteriorate general condition of the patient and so even slight bleeding can produce fatal results in such persons. [Verse No.10-11]
*''Kushta'' literally means discoloration, disgrace, disfiguration of the normal skin texture. From above verse it can be inferred that here ''kushta'' wound refers to non healing ulcers of leprosy. Leprosy is a chronic infectious disease caused by Mycobacterium Leprae, the only pathogenic bacteria able to infect peripheral nerves. About 30% of people with leprosy develop nerve damage. Neural impairment results in a set of sensitive, motor and autonomic disturbances, with ulcers originating primarily on the hands and feet. Neuropathic ulcers are one of the most common squeal of leprosy, but little is known about their clinical and epidemiological aspects.<ref>Josafá G Barreto, Claudio G Salgado, Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial, BMC Infect Dis. 2010; 10: 237 </ref> If wounds are occurring before change in normal texture of skin it shows that wounds are occurring in prodromal stage and sensory loss has occurred till this stage and so slight injuries are resulting into wound formation. Such condition will lead to late diagnosis and hence chances of recovery will be minimal. [Verse No.14-15]
*Symptoms mentioned above in prodromal symptoms of ''unmada'' are negative symptoms and so there are chances of more suicidal tendency which is a major cause of death in ''unmada''. The presence and duration of prodromal symptoms may predict outcome in schizophrenia, that is, long duration of prodromal symptoms may be indicative of poor prognosis.<ref>Chapman, L.J.; Day, D.; and Burstein, A. The process-reactive distinction and prognosis in schizophrenia. Journal of Nervous and Mental Disease, 133:383-391, 1961. </ref>
*Aura are common in seizures of occipital or temporal lobe origin in patients with focal epileptic seizures.<ref>Christian G. Bien, Felix O. Benninger, Horst Urbach, Johannes Schramm, Martin Kurthen, Christian E. Elger, Localizing value of epileptic visual auras Brain (2000) 123 (2): 244-253. </ref> Patients with refractory temporal lobe epilepsy (TLE) have an increased risk of sudden death that is 50 times greater than that in the general population. So if hallucinations are present in epilepsy they indicate grave prognosis. [Verse No.18-23]
*As mentioned earlier dreams are replica of mind and such kinds of dream represents weak and feeble mental status which is not strong enough to fight diseases properly. So if such dreams are frequently seen by patients they will have poor rate of recovery as compared to patient with strong mind and will power. [Verse No.27-40]
*In modern era, during late 19th century, psychotherapist Sigmund Freud gave emphasis on dream connection with mind in his famous book ‘The interpretation of dreams’. He developed a theory that the content of dreams is driven by unconscious wish fulfillment.<ref>Stone MH,Dream analysis in the psychodynamic psychotherapy of borderline patients, Psychodyn Psychiatry. 2012 Jun;40(2):287-302. </ref> Presently dream is defined as successions of images, ideas, emotions, and sensations that occur involuntarily in the mind during certain stages of sleep.<ref>Dream, The American Heritage Dictionary of the English Language, Fourth Edition. 2000. Retrieved May 7, 2009. </ref> Description of ''manovaha srotas'' in pathogenesis of dream shows that role of mind in producing dreams was known in ancient times.
*Various studies have established link between REM sleep and dreaming.<ref>Klemm WR. Why Does Rem Sleep Occur? A Wake-Up Hypothesis. Frontiers in Systems Neuroscience. 2011;5:73. </ref> Poly somnograms show brainwave patterns in REM to be similar to that recorded during wakefulness. Intense dreaming occurs during REM sleep as a result of heightened brain activity. This proves that observations noted by ancient Ayurvedic seers related to pathogenesis of dream are minute and correct. [Verse No.41-42]
*As mentioned above dreams more or less depict unconsciousness state. Freud called dreams the "royal road to the unconscious”. They are related to activities which we have seen, listened, wished, thought etc. Based on this fact seven types of dream have been classified here. Five of them are mild as they are more near to events which we encounter in day to day life. Last two have fatal consequences as they are due to disease or ''dosha'' involvement. [Verse No.43]
*It is difficult to predict dream consequences on the basis of time or order in which they were seen. Researches are needed to scientifically prove the validity of such dream prediction. [Verse No.44-46]

=== References ===

#Torres-Bugarín O, Zavala-Cerna MG, Nava A, Flores-García A, Ramos-Ibarra ML. Potential Uses, Limitations, and Basic Procedures of Micronuclei and Nuclear Abnormalities in Buccal Cells. Disease Markers. 2014;2014:956835.
#Pradeep Sahu et al, Biomarkers: An Emerging Tool for Diagnosis of a Disease and Drug Development, Asian J. Res. Pharm. Sci. 2011; Vol. 1: Issue 1, Pg 09-16
#Sonali S. Tendulkar and R. R. Dwivedi, ‘Swapna’ in the Indian classics: Mythology or science?,Ayu. 2010 Apr-Jun; 31(2): 170–174.
#Jeannette Y. Wick; Guido R. Zann, Drugs and Dreams, J Am Pharm Assoc (2003) 2002;42:385-390.
#Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678.
#J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203.
#Waqas Wahid Baig et al., Spontaneous Cerebrospinal Fluid Rhinorrhea with Pneumocephalus: An Unusual Manifestation of Nasal Tuberculosis, Korean J Intern Med. 2012 September; 27(3): 350–352
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc,chapter 26
#Josafá G Barreto, Claudio G Salgado, Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial, BMC Infect Dis. 2010; 10: 237
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Diabetes mellitus Chapter 338.
#Chapman, L.J.; Day, D.; and Burstein, A. The process-reactive distinction and prognosis in schizophrenia. Journal of Nervous and Mental Disease, 133:383-391, 1961.
#Christian G. Bien, Felix O. Benninger, Horst Urbach, Johannes Schramm, Martin Kurthen, Christian E. Elger, Localizing value of epileptic visual auras Brain (2000) 123 (2): 244-253.
#Stone MH,Dream analysis in the psychodynamic psychotherapy of borderline patients, Psychodyn Psychiatry. 2012 Jun;40(2):287-302.
#Dream, The American Heritage Dictionary of the English Language, Fourth Edition. 2000. Retrieved May 7, 2009.
#Klemm WR. Why Does Rem Sleep Occur? A Wake-Up Hypothesis. Frontiers in Systems Neuroscience. 2011;5:73.

Purvarupeeya

2017-12-26T06:09:53Z

Vinay Exafluence: /* Introduction */

{{Infobox
|title = Purvarupeeya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 5
|label2 = Preceding Chapter
|data2 = [[Indriyaneeka]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 5 ==

===Abstract===

[[Purvarupeeya]] has been devoted to predict prognosis of diseases by prodromal symptoms. This chapter suggests that knowledge and examination of prodromal symptoms was important in ancient times and emphasis was given that physician should carefully recognize disease in early stage and predict course of disease. With the help of eight diseases of [[Nidana Sthana]] important principles related to prognosis have been laid down which are also applicable to all other diseases and are valid till now. Various aspects of dreams including physiology, types, interpretation and prognostic importance have also been described. Various dreams along with physical and mental features have been incorporated in prodromal symptoms which signify that dreams should also be analyzed and properly investigated before predicting prognosis of any disease. Even with restricted technological tools, par excellence observation and principles described regarding ''Arishta Lakshana'' are valid till now.

'''Keywords''': Prodromal symptoms, dream, prognosis, disease, death.

=== Introduction ===

In this chapter prodromal symptoms and dreams related to poor prognosis of diseases- fatality are described. In the first verse, Charaka has emphasized that he will describe both common and special prodromal symptoms. This indicates that while there may be some prodromata which result out of normal pathogenesis, some are unusual and unexpected. In the next verse it has been said that if all prodromal symptoms are manifesting and are severe in nature then such a condition will be fatal. This principle is applicable to all other diseases also. Prodromal symptoms of ''kushta'' and ''prameha'' suggest that complications manifest before cardinal symptoms of the disease appear. If body metabolism in any disease is altered severely during latent phase of disease and complications are appearing before manifestation of full-fledged disease then such condition will be difficult to cure. Example of ''gulma'' suggests that there are certain diseases which are incurable in nature and prodromal symptoms related to such clinical conditions will always be precursors of imminent death. It is commonly seen that any person who is emaciated and have low immunity and strength, when affected by disease, has fatal consequences due to less resistance. This fact is explained with the example of ''shosha''. Another important aspect regarding disease prognosis is that, if a person is continuously partaking causative factors or is in constant exposure to the causative factors, body will be unable to fight disease properly and thus there will be less chances of recovery from the disease. This point is also mentioned while describing prognosis of ''shosha''.

From the above discussion it is clear that prodromal symptoms can be useful in predicting diagnosis of any disease. But now question arises whether it is practically possible to predict prognosis with prodromal symptoms? We should admit that it is very difficult and one will need years of experience to attain such competence. Another important fact is that the prediction of prognosis can be done from ''purvarupa'' only after disease manifestation. Charaka states that ''purvarupa'' converting into a particular disease in future can be termed a prognostic sign. This indicates that we cannot predict by only prodromal symptoms. We have to look into whether disease was produced after ''purvarupa'' or not. For example, delirium in ''raktapitta'' is indicator of poor prognosis. If delirium is seen in any patient but he is not developing ''raktapitta'' we cannot predict poor prognosis. In this condition, after manifestation of ''raktapitta'' we need to ask the patient whether he suffered from delirium before disease manifestation or not. It is a retrospective inquiry about ''purvarupa'' based on which a prospective prediction may be made. We will have to follow detailed retro-prospective approach and will need proper patient history comprising of each and every detail from prodromal symptoms to disease manifestation. Thus practically, prodromal symptoms are helpful only after disease manifestation as they are not independent. Since accompanying symptoms may also lead to predictions, they can also be regarded as tools of predictive prognosis. This might be the reason that Sushruta and Vagbhata have not described dreams in reference of ''purvarupa'' but have described in ''rupavastha'' (stage of disease manifestation).

Biomarkers are recent advancements can be the answer to above problem as we do not need to wait for disease manifestation and can predict prognosis by seeing values of biomarkers related to that disease. In 2001, a consensus panel at the National Institutes of Health defined the term biomarker as ‘a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention or other health care intervention’.<ref>Torres-Bugarín O, Zavala-Cerna MG, Nava A, Flores-García A, Ramos-Ibarra ML. Potential Uses, Limitations, and Basic Procedures of Micronuclei and Nuclear Abnormalities in Buccal Cells. Disease Markers. 2014;2014:956835. </ref> Biomarker defined as alteration in the constituents of tissues or body fluids provide a powerful approach to understanding the spectrum of chronic disease with application in at least 5 areas like screening, diagnosis, prognostics, prediction of disease recurrence and therapeutic monitoring.<ref>Pradeep Sahu et al, Biomarkers: An Emerging Tool for Diagnosis of a Disease and Drug Development, Asian J. Res. Pharm. Sci. 2011; Vol. 1: Issue 1, Pg 09-16 </ref> The biomarker is either produced by the diseased organ (e.g., tumor) or by the body in response to disease. Before diagnosis, markers could be used for screening and risk assessment. Tumor classification, stage and sometimes grade are generally used to assess prognosis. Researches in the field of biomarkers may give us chance to know prognosis of disease in early stage.

Another important aspect mentioned in this chapter is concept of dreams. The descriptions related to dreams are found abundantly in the ancient oriental classics, specifically the Atharvaveda, Upanishadas, Puranas, Darshanas and [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. The description of the ''doshika'' dreams of the Atharvaveda is similar to that in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. Dreams are mentioned while describing ''purvarupa'', ''rupa'' and ''arishta lakshanas''.<ref>Sonali S. Tendulkar and R. R. Dwivedi, ‘Swapna’ in the Indian classics: Mythology or science?,Ayu. 2010 Apr-Jun; 31(2): 170–174. </ref> Sushruta states that sex of the unborn child can be predicted and Vagbhata says that ''doshika prakriti'' can be known by the help of dreams.

Subject of dreams is dealt in very scientific manner. According to Charaka, dreams occur when person is in relatively wakeful state. This has been proved now by the researches that dreams mainly occur in the rapid-eye movement (REM) stage of sleep—when brain activity is high and resembles that of being awake. In the late 19th century, psychotherapist Sigmund Freud developed a theory that the content of dreams is driven by unconscious wish fulfillment. Freud called dreams the "royal road to the unconscious”.<ref>Jeannette Y. Wick; Guido R. Zann, Drugs and Dreams, J Am Pharm Assoc (2003) 2002;42:385-390. </ref> To Freud, no dream was of entertainment value, they all held important meanings. Dreams reflect the dreamer’s mental, emotional, and physical state. This fact is well established in this chapter while describing classification of dreams. Dreams are based on our day to day interactions and so are classified as dreams seen, heard, felt etc. Two of the seven types, one which predict prognosis and one which is due to vitiation of ''doshas'' are said to have fatal consequences.

Research studies are needed to prove that dreams can be used as markers of prognosis. Some studies have been conducted in this regard but we cannot make strong conclusion on basis of their results. In a few studies it has been shown that hormone levels affect dreams. One of the studies states that cortisol plays an important role in controlling the state of memory systems during sleep. High levels of cortisol, as are observed late at night and, typically in the context of REM sleep, disrupt normal hippocampal → neocortical communication, thereby interfering with forms of memory consolidation dependent upon this communication. At the same time, the content of dreams is also affected.<ref>Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678. </ref> In neurological and psychological diseases dream disturbances are often seen but few other diseases have also been found to affect dreams. Patients with sleep apnea are reported to have intense nightmares.<ref>J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73. </ref> Abnormal dreams have also been reported in diseases like Relapsing fever,<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165. </ref> Cardiac ischemia<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28. </ref> etc. Certain drugs also affect dreams e.g. Anti malarial drug has shown to alter dream types.<ref>Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203. </ref> This proves that at times diseases certainly affect dreams but intense research studies are needed to actually establish this fact on scientific grounds.

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

अथातः पूर्वरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pūrvarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pUrvarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter of premonitory symptoms related to signs of death.
Thus spoke lord Atreya.[1-2]

==== Incurable prodromal signs of ''Jwara'' leading to death ====

पूर्वरूपाण्यसाध्यानां विकाराणां पृथक् पृथक्|
भिन्नाभिन्नानि वक्ष्यामो भिषजां ज्ञानवृद्धये||३||

पूर्वरूपाणि सर्वाणि ज्वरोक्तान्यतिमात्रया|
यं विशन्ति विशत्येनं मृत्युर्ज्वरपुरःसरः||४||

अन्यस्यापि च रोगस्य पूर्वरूपाणि यं नरम्|
विशन्त्यनेन कल्पेन तस्यापि मरणं ध्रुवम्||५||

pūrvarūpāṇyasādhyānāṁ vikārāṇāṁ pr̥thak pr̥thak|
bhinnābhinnāni vakṣyāmō bhiṣajāṁ jñānavr̥ddhayē||3||

pūrvarūpāṇi sarvāṇi jvarōktānyatimātrayā|
yaṁ viśanti viśatyēnaṁ mr̥tyurjvarapuraḥsaraḥ||4||

anyasyāpi ca rōgasya pūrvarūpāṇi yaṁ naram|
viśantyanēna kalpēna tasyāpi maraṇaṁ dhruvam||5||

pUrvarUpANyasAdhyAnAM vikArANAM pRuthak pRuthak|
bhinnAbhinnAni vakShyAmo bhiShajAM j~jAnavRuddhaye||3||

pUrvarUpANi sarvANi jvaroktAnyatimAtrayA|
yaM vishanti vishatyenaM mRutyurjvarapuraHsaraH||4||

anyasyApi ca rogasya pUrvarUpANi yaM naram|
vishantyanena kalpena tasyApi maraNaM dhruvam||5||

For enhancing the knowledge of physicians, we will distinctly explain the general and fatal prodromal symptoms of diseases.
If all prodromal symptoms of ''jwara'' manifests in severe degree, the person will die. If prodromal symptoms of any other disease also appear in the same way as described above, death of the patient is certain. [3-5]

==== Incurable prodromal signs of ''Rajayakshma'' leading to death ====

पूर्वरूपैकदेशांस्तु वक्ष्यामोऽन्यान् सुदारुणान्|
ये रोगाननुबध्नन्ति मृत्युर्यैरनुबध्यते [१] ||६||

बलं च हीयते यस्य प्रतिश्यायश्च वर्धते|
तस्य नारीप्रसक्तस्य शोषोऽन्तायोपजायते||७||

श्वभिरुष्ट्रैः खरैर्वाऽपि याति यो दक्षिणां दिशम्|
स्वप्ने यक्ष्माणमासाद्य जीवितं स विमुञ्चति||८||

प्रेतैः सह पिबेन्मद्यं स्वप्ने यः कृष्यते शुना|
सुघोरं ज्वरमासाद्य जीवितं स विमुञ्चति||९||

pūrvarūpaikadēśāṁstu vakṣyāmō'nyān sudāruṇān|
yē rōgānanubadhnanti mr̥tyuryairanubadhyatē ||6||

balaṁ ca hīyatē yasya pratiśyāyaśca vardhatē|
tasya nārīprasaktasya śōṣō'ntāyōpajāyatē||7||

śvabhiruṣṭraiḥ kharairvā'pi yāti yō dakṣiṇāṁ diśam|
svapnē yakṣmāṇamāsādya jīvitaṁ sa vimuñcati||8||

prētaiḥ saha pibēnmadyaṁ svapnē yaḥ kr̥ṣyatē śunā|
sughōraṁ jvaramāsādya jīvitaṁ sa vimuñcati||9||

pUrvarUpaikadeshAMstu vakShyAmo~anyAn sudAruNAn|
ye rogAnanubadhnanti mRutyuryairanubadhyate ||6||

balaM ca hIyate yasya pratishyAyashca vardhate|
tasya nArIprasaktasya shoSho~antAyopajAyate||7||

shvabhiruShTraiH kharairvA~api yAti yo dakShiNAM disham|
svapne yakShmANamAsAdya jIvitaM sa vimu~jcati||8||

pretaiH saha pibenmadyaM svapne yaH kRuShyate shunA|
sughoraM jvaramAsAdya jIvitaM sa vimu~jcati||9||

Now we shall discuss certain severe premonitory symptoms which are associated with certain diseases.
The consumption which is associated with continuously decreasing strength, worsening rhinitis and over indulgence in sex in prodromal stage will turn out to be incurable.

A man, who in his dreams, is dragged by dog, camel or a donkey towards south, leaves his life as by consumption.
A person who in his dreams takes alcohol with demons and who is dragged by a dog leaves his life getting affected with severe fever. [6-9]

==== Incurable prodromal signs of ''Raktapitta'' leading to death ====

लाक्षारक्ताम्बराभं यः पश्यत्यम्बरमन्तिकात्|
स रक्तपित्तमासाद्य तेनैवान्ताय नीयते||१०||

रक्तस्रग्रक्तसर्वाङ्गो रक्तवासा मुहुर्हसन्|
यः स्वप्ने ह्रियते नार्या स रक्तं प्राप्य सीदति||११||

lākṣāraktāmbarābhaṁ yaḥ paśyatyambaramantikāt|
sa raktapittamāsādya tēnaivāntāya nīyatē||10||

raktasragraktasarvāṅgō raktavāsā muhurhasan|
yaḥ svapnē hriyatē nāryā sa raktaṁ prāpya sīdati||11||

lAkShAraktAmbarAbhaM yaH pashyatyambaramantikAt|
sa raktapittamAsAdya tenaivAntAya nIyate||10||

raktasragraktasarvA~ggo raktavAsA muhurhasan|
yaH svapne hriyate nAryA sa raktaM prApya sIdati||11||

He who sees clothes as if dyed with red lac, leaves his life if he gets affected with severe bleeding disorders.
In his dream, the man who sees himself adorned with red garlands, clad in red clothes, anointed with red dye and dragged by a continuously laughing woman will succumb to severe bleeding disorders. [10-11]

==== Incurable prodromal signs of ''Gulma'' leading to death ====

शूलाटोपान्त्रकूजाश्च दौर्बल्यं चातिमात्रया|
नखादिषु च वैवर्ण्यं गुल्मेनान्तकरो ग्रहः||१२||

लता कण्टकिनी यस्य दारुणा हृदि जायते|
स्वप्ने गुल्मस्तमन्ताय क्रूरो विशति मानवम्||१३||

śūlāṭōpāntrakūjāśca daurbalyaṁ cātimātrayā|
nakhādiṣu ca vaivarṇyaṁ gulmēnāntakarō grahaḥ||12||

latā kaṇṭakinī yasya dāruṇā hr̥di jāyatē|
svapnē gulmastamantāya krūrō viśati mānavam||13||

shUlATopAntrakUjAshca daurbalyaM cAtimAtrayA|
nakhAdiShu ca vaivarNyaM gulmenAntakaro grahaH||12||

latA kaNTakinI yasya dAruNA hRudi jAyate|
svapne gulmastamantAya krUro vishati mAnavam||13||

A man who experiences severe pain, gurgling sounds in abdomen, intestinal peristalsis, excessive debility, discoloration of nails and other body parts is going to die if he is affected with ''gulma''.

A person, who in his dreams sees hard and thorny creepers grown on his chest and then gets afflicted by ''gulma'', is surely going to die soon. [12-13]

==== Incurable prodromal signs of ''Kushtha'' leading to death ====

कायेऽल्पमपि संस्पृष्टं सुभृशं यस्य दीर्यते|
क्षतानि च न रोहन्ति कुष्ठैर्मृत्युर्हिनस्ति तम्||१४||

नग्नस्याज्यावसिक्तस्य जुह्वतोऽग्निमनर्चिषम्|
पद्मान्युरसि जायन्ते स्वप्ने कुष्ठैर्मरिष्यतः||१५||

kāyē'lpamapi saṁspr̥ṣṭaṁ subhr̥śaṁ yasya dīryatē|
kṣatāni ca na rōhanti kuṣṭhairmr̥tyurhinasti tam||14||

nagnasyājyāvasiktasya juhvatō'gnimanarciṣam|
padmānyurasi jāyantē svapnē kuṣṭhairmariṣyataḥ||15||

kAye~alpamapi saMspRuShTaM subhRushaM yasya dIryate|
kShatAni ca na rohanti kuShThairmRutyurhinasti tam||14||

nagnasyAjyAvasiktasya juhvato~agnimanarciSham|
padmAnyurasi jAyante svapne kuShThairmariShyataH||15||

A person whose body even if touched gently leads to deep cuts and whose injuries never heal will be killed by severe skin diseases.
In his dream, a man who sees himself naked, anointed with ghee, offering the oblations without the fire being lit, who has lotuses grown on his chest, will be taken away by death as afflicted by skin diseases.[14-15]

==== Incurable prodromal signs of ''Prameha'' leading to death ====

स्नातानुलिप्तगात्रेऽपि यस्मिन् गृध्नन्ति मक्षिकाः|
स प्रमेहेण संस्पर्शं प्राप्य तेनैव हन्यते||१६||

स्नेहं बहुविधं स्वप्ने चण्डालैः सह यः पिबेत्|
बध्यते स प्रमेहेण स्पृश्यतेऽन्ताय मानवः||१७||

snātānuliptagātrē'pi yasmin gr̥dhnanti makṣikāḥ|
sa pramēhēṇa saṁsparśaṁ prāpya tēnaiva hanyatē||16||

snēhaṁ bahuvidhaṁ svapnē caṇḍālaiḥ saha yaḥ pibēt|
badhyatē sa pramēhēṇa spr̥śyatē'ntāya mānavaḥ||17||

snAtAnuliptagAtre~api yasmin gRudhnanti makShikAH|
sa prameheNa saMsparshaM prApya tenaiva hanyate||16||

snehaM bahuvidhaM svapne caNDAlaiH saha yaH pibet|
badhyate sa prameheNa spRushyate~antAya mAnavaH||17||

Even after taking bath and getting anointed with scents, flies are attracted towards person, he will certainly die, if affected with ''prameha''.

One who sees in his dreams, drinking various kinds of oily substances with Chandalas becomes affected by ''prameha'' and will die. [16-17]

==== Incurable prodromal signs of ''Unmada'' and ''Apasmara'' leading to death ====

ध्यानायासौ तथोद्वेगौ मोहश्चास्थानसम्भवः|
अरतिर्बलहानिश्च मृत्युरुन्मादपूर्वकः||१८||

आहारद्वेषिणं पश्यन् लुप्तचित्तमुदर्दितम्|
विद्याद्धीरो मुमूर्षुं तमुन्मादेनातिपातिना||१९||

क्रोधनं त्रासबहुलं सकृत्प्रहसिताननम्|
मूर्च्छापिपासाबहुलं हन्त्युन्मादः शरीरिणम्||२०||

नृत्यन् रक्षोगणैः साकं यः स्वप्नेऽम्भसि सीदति |
स प्राप्य भृशमुन्मादं याति लोकमतः परम्||२१||

असत्तमः पश्यति यः शृणोत्यप्यसतः स्वनान्|
बहून् बहुविधान् जाग्रत् सोऽपस्मारेण बध्यते||२२||

मत्तं नृत्यन्तमाविध्य प्रेतो हरति यं नरम्|
स्वप्ने हरति तं मृत्युरपस्मारपुरःसरः||२३||

dhyānāyāsau tathōdvēgau mōhaścāsthānasambhavaḥ|
aratirbalahāniśca mr̥tyurunmādapūrvakaḥ||18||

āhāradvēṣiṇaṁ paśyan luptacittamudarditam|
vidyāddhīrō mumūrṣuṁ tamunmādēnātipātinā||19||

krōdhanaṁ trāsabahulaṁ sakr̥tprahasitānanam|
mūrcchāpipāsābahulaṁ hantyunmādaḥ śarīriṇam||20||

nr̥tyan rakṣōgaṇaiḥ sākaṁ yaḥ svapnē'mbhasi sīdati |
sa prāpya bhr̥śamunmādaṁ yāti lōkamataḥ param||21||

asattamaḥ paśyati yaḥ śr̥ṇōtyapyasataḥ svanān|
bahūn bahuvidhān jāgrat sō'pasmārēṇa badhyatē||22||

mattaṁ nr̥tyantamāvidhya prētō harati yaṁ naram|
svapnē harati taṁ mr̥tyurapasmārapuraḥsaraḥ||23||

dhyAnAyAsau tathodvegau mohashcAsthAnasambhavaH|
aratirbalahAnishca mRutyurunmAdapUrvakaH||18||

AhAradveShiNaM pashyan luptacittamudarditam|
vidyAddhIro mumUrShuM tamunmAdenAtipAtinA||19||

krodhanaM trAsabahulaM sakRutprahasitAnanam|
mUrcchApipAsAbahulaM hantyunmAdaH sharIriNam||20||

nRutyan rakShogaNaiH sAkaM yaH svapne~ambhasi sIdati |
sa prApya bhRushamunmAdaM yAti lokamataH param||21||

asattamaH pashyati yaH shRuNotyapyasataH svanAn|
bahUn bahuvidhAn jAgrat so~apasmAreNa badhyate||22||

mattaM nRutyantamAvidhya preto harati yaM naram|
svapne harati taM mRutyurapasmArapuraHsaraH||23||

He who is affected with disturbing thoughts, anxiety, stupefaction without any specific cause, restlessness, loss of strength will succumb to death as affected with insanity.

The person who feels excess anger, fear, always smiles and who is suffering from severe stupor and thirst will be certainly killed by insanity.

The man who in his dreams dances with evil spirits and sinks in water leaves the world.
He who sees darkness even when he is awake and hears sounds when there is no real sound, will be killed by epilepsy.
In dream, a person who sees himself dancing with ghosts while in intoxication with his head upside down, will be taken away by death getting affected with epilepsy. [18-23]

स्तभ्येते प्रतिबुद्धस्य हनू मन्ये तथाऽक्षिणी|
यस्य तं बहिरायामो गृहीत्वा हन्त्यसंशयम्||२४||

शष्कुलीर्वाऽप्यपूपान् वा स्वप्ने खादति यो नरः|
स चेत्तादृक् छर्दयति प्रतिबुद्धो न जीवति||२५||

stabhyētē pratibuddhasya hanū manyē tathā'kṣiṇī|
yasya taṁ bahirāyāmō gr̥hītvā hantyasaṁśayam||24||

śaṣkulīrvā'pyapūpān vā svapnē khādati yō naraḥ|
sa cēttādr̥k chardayati pratibuddhō na jīvati||25||

stabhyete pratibuddhasya hanU manye tathA~akShiNI|
yasya taM bahirAyAmo gRuhItvA hantyasaMshayam||24||

shaShkulIrvA~apyapUpAn vA svapne khAdati yo naraH|
sa cettAdRuk chardayati pratibuddho na jIvati||25||

If individual is found with ''bahirayama'' ( a disease with feature of opisthotonus or bending of body backwards) soon after awaking from sleep along with lock jaw, neck stiffness, stale eyes and paralysis is going to lose life soon.

Such an individual in his dream sees himself taking cakes of sesame seeds and ''apupa'' ( a dietary item) and vomits the same when he is awake.[24-25]

एतानि पूर्वरूपाणि यः सम्यगवबुध्यते|
स एषामनुबन्धं च फलं च ज्ञातुमर्हति||२६||

ētāni pūrvarūpāṇi yaḥ samyagavabudhyatē|
sa ēṣāmanubandhaṁ ca phalaṁ ca jñātumarhati||26||

etAni pUrvarUpANi yaH samyagavabudhyate|
sa eShAmanubandhaM ca phalaM ca j~jAtumarhati||26||

One who (physician) understands these premonitory symptoms thoroughly, also deserves the knowledge of associated diseases and their result i.e. death.[26]

इमांश्चाप्यपरान् स्वप्नान् दारुणानुपलक्षयेत्|
व्याधितानां विनाशाय क्लेशाय महतेऽपि वा||२७||

यस्योत्तमाङ्गे जायन्ते वंशगुल्मलतादयः|
वयांसि च विलीयन्ते स्वप्ने मौण्ड्यमियाच्च यः||२८||

गृध्रोलूकश्वकाकाद्यैः स्वप्ने यः परिवार्यते|
रक्षःप्रेतपिशाचस्त्रीचण्डालद्रविडान्ध्रकैः ||२९||

वंशवेत्रलतापाशतृणकण्टकसङ्कटे|
संसज्जति हि यः स्वप्ने यो गच्छन् प्रपतत्यपि||३०||

भूमौ पांशूपधानायां वल्मीके वाऽथ भस्मनि|
श्मशानायतने श्वभ्रे स्वप्ने यः प्रपतत्यपि ||३१||

कलुषेऽम्भसि पङ्के वा कूपे वा तमसाऽऽवृते|
स्वप्ने मज्जति शीघ्रेण स्रोतसा ह्रियते च यः||३२||

स्नेहपानं तथाऽभ्यङ्गः प्रच्छर्दनविरेचने|
हिरण्यलाभः कलहः स्वप्ने बन्धपराजयौ||३३||

उपानद्युगनाशश्च प्रपातः पादचर्मणोः|
हर्षः स्वप्ने प्रकुपितैः पितृभिश्चावभर्त्सनम्||३४||

दन्तचन्द्रार्कनक्षत्रदेवतादीपचक्षुषाम् |
पतनं वा विनाशो वा स्वप्ने भेदो नगस्य वा||३५||

रक्तपुष्पं वनं भूमिं पापकर्मालयं चिताम्|
गुहान्धकारसम्बाधं स्वप्ने यः प्रविशत्यपि||३६||

रक्तमाली हसन्नुच्चैर्दिग्वासा दक्षिणां दिशम्|
दारुणामटवीं स्वप्ने कपियुक्तेन याति वा||३७||

काषायिणामसौम्यानां नग्नानां दण्डधारिणाम्|
कृष्णानां रक्तनेत्राणां स्वप्ने नेच्छन्ति दर्शनम्||३८||

कृष्णा पापा निराचारा दीर्घकेशनखस्तनी|
विरागमाल्यवसना स्वप्ने कालनिशा मता||३९||

इत्येते दारुणाः स्वप्ना रोगी यैर्याति पञ्चताम्|
अरोगः संशयं गत्वा कश्चिदेव प्रमुच्यते||४०||

imāṁścāpyaparān svapnān dāruṇānupalakṣayēt|
vyādhitānāṁ vināśāya klēśāya mahatē'pi vā||27||

yasyōttamāṅgē jāyantē vaṁśagulmalatādayaḥ|
vayāṁsi ca vilīyantē svapnē mauṇḍyamiyācca yaḥ||28||

gr̥dhrōlūkaśvakākādyaiḥ svapnē yaḥ parivāryatē|
rakṣaḥprētapiśācastrīcaṇḍāladraviḍāndhrakaiḥ ||29||

vaṁśavētralatāpāśatr̥ṇakaṇṭakasaṅkaṭē|
saṁsajjati hi yaḥ svapnē yō gacchan prapatatyapi||30||

bhūmau pāṁśūpadhānāyāṁ valmīkē vā'tha bhasmani|
śmaśānāyatanē śvabhrē svapnē yaḥ prapatatyapi ||31||

kaluṣē'mbhasi paṅkē vā kūpē vā tamasā''vr̥tē|
svapnē majjati śīghrēṇa srōtasā hriyatē ca yaḥ||32||

snēhapānaṁ tathā'bhyaṅgaḥ pracchardanavirēcanē|
hiraṇyalābhaḥ kalahaḥ svapnē bandhaparājayau||33||

upānadyuganāśaśca prapātaḥ pādacarmaṇōḥ|
harṣaḥ svapnē prakupitaiḥ pitr̥bhiścāvabhartsanam||34||

dantacandrārkanakṣatradēvatādīpacakṣuṣām |
patanaṁ vā vināśō vā svapnē bhēdō nagasya vā||35||

raktapuṣpaṁ vanaṁ bhūmiṁ pāpakarmālayaṁ citām|
guhāndhakārasambādhaṁ svapnē yaḥ praviśatyapi||36||

raktamālī hasannuccairdigvāsā dakṣiṇāṁ diśam|
dāruṇāmaṭavīṁ svapnē kapiyuktēna yāti vā||37||

kāṣāyiṇāmasaumyānāṁ nagnānāṁ daṇḍadhāriṇām|
kr̥ṣṇānāṁ raktanētrāṇāṁ svapnē nēcchanti darśanam||38||

kr̥ṣṇā pāpā nirācārā dīrghakēśanakhastanī|
virāgamālyavasanā svapnē kālaniśā matā||39||

ityētē dāruṇāḥ svapnā rōgī yairyāti pañcatām|
arōgaḥ saṁśayaṁ gatvā kaścidēva pramucyatē||40||

imAMshcApyaparAn svapnAn dAruNAnupalakShayet|
vyAdhitAnAM vinAshAya kleshAya mahate~api vA||27||

yasyottamA~gge jAyante vaMshagulmalatAdayaH|
vayAMsi ca vilIyante svapne mauNDyamiyAcca yaH||28||

gRudhrolUkashvakAkAdyaiH svapne yaH parivAryate|
rakShaHpretapishAcastrIcaNDAladraviDAndhrakaiH ||29||

vaMshavetralatApAshatRuNakaNTakasa~gkaTe|
saMsajjati hi yaH svapne yo gacchan prapatatyapi||30||

bhUmau pAMshUpadhAnAyAM valmIke vA~atha bhasmani|
shmashAnAyatane shvabhre svapne yaH prapatatyapi ||31||

kaluShe~ambhasi pa~gke vA kUpe vA tamasA~a~avRute|
svapne majjati shIghreNa srotasA hriyate ca yaH||32||

snehapAnaM tathA~abhya~ggaH pracchardanavirecane|
hiraNyalAbhaH kalahaH svapne bandhaparAjayau||33||

upAnadyuganAshashca prapAtaH pAdacarmaNoH|
harShaH svapne prakupitaiH pitRubhishcAvabhartsanam||34||

dantacandrArkanakShatradevatAdIpacakShuShAm |
patanaM vA vinAsho vA svapne bhedo nagasya vA||35||

raktapuShpaM vanaM bhUmiM pApakarmAlayaM citAm|
guhAndhakArasambAdhaM svapne yaH pravishatyapi||36||

raktamAlI hasannuccairdigvAsA dakShiNAM disham|
dAruNAmaTavIM svapne kapiyuktena yAti vA||37||

kAShAyiNAmasaumyAnAM nagnAnAM daNDadhAriNAm|
kRuShNAnAM raktanetrANAM svapnenecchanti darshanam||38|

kRuShNA pApA nirAcArA dIrghakeshanakhastanI|
virAgamAlyavasanA svapne kAlanishA matA||39||

ityete dAruNAH svapnA rogI yairyAti pa~jcatAm|
arogaH saMshayaM gatvA kashcideva pramucyate||40||

Certain other dreams which are fierce should also be analyzed as they indicate the approaching death of the diseased and grave sufferings for those who are going to be affected.

He, who in his dreams sees bamboos, shrubs and creepers etc. growing in his head, birds coming to them and his scalp been shaved.
Or who in his dreams sees himself surrounded by vultures, owls, dogs, crows and other birds or by Rakshasa, dead men, ''pishachas'', women, ''chandalas'', and inhabitants of Dravida and Andhra regions.

Or who in his dreams finds himself surrounded by pathless forests of bamboo, canes, creepers, grass and prickly plants and finds himself lost in the midst and falling down while trying to come out.

Or who in his dreams, falls down on the bare ground covered with dust or upon an anthill or upon ashes, or upon a crematorium or in to a hole.

Or who sinks in a ditch or pond of dirty water or into mire or in a dark well or who is carried away by a rapid current.
Or who in his dreams drinks oily substances or anoints his body with oil, vomits, defecates, or gets gold, engages in quarrel, gets defeated and captured.

Or who lose his sandals, has skin of feet peeling off or feels excited or who is rebuked by his angry ancestors.
Or who sees in his dreams the fall or destruction of his own tooth or the moon or the sun or the stars or the burning lamps or his own eyes or the cracking of a mountain.

Or who in his dreams, enters a forest of trees with red flowers or a place where sinful activities are done or a funeral place (crematorium), a dark cave.

Or who in his dreams sees himself proceeding towards south, finds himself adorned with garlands of red flowers, laughing aloud and naked.
The sight of a woman who is dark in complexion, who is sinful, who has long hair and nails, hanging breasts, or who is clad in garlands of red flowers and red garments is regarded to be as fatal as a fatal night.
These are severe dreams which indicate death of a patient.

If a healthy man sees such dreams, his life becomes doubtful, rarely does he escape. [27-40]

==== Dreams ====

मनोवहानां पूर्णत्वाद्दोषैरतिबलैस्त्रिभिः|
स्रोतसां दारुणान् स्वप्नान् काले पश्यति दारुणे||४१||

नातिप्रसुप्तः पुरुषः सफलानफलांस्तथा|
इन्द्रियेशेन मनसा स्वप्नान् पश्यत्यनेकधा||४२||

manōvahānāṁ pūrṇatvāddōṣairatibalaistribhiḥ|
srōtasāṁ dāruṇān svapnān kālē paśyati dāruṇē||41||

nātiprasuptaḥ puruṣaḥ saphalānaphalāṁstathā|
indriyēśēna manasā svapnān paśyatyanēkadhā||42||

manovahAnAM pUrNatvAddoShairatibalaistribhiH|
srotasAM dAruNAn svapnAn kAle pashyati dAruNe||41||

nAtiprasuptaH puruShaH saphalAnaphalAMstathA|
indriyeshena manasA svapnAn pashyatyanekadhA||42||

When the channels associated with the mind are saturated by the excessively vitiated ''doshas'', such terrible dreams appear in his sleep. The person who is not in deep sleep (subconscious state), sees various fruitful (meaningful) or fruitless (meaningless) dreams in association with sense organs. [41-42]

दृष्टं श्रुतानुभूतं च प्रार्थितं कल्पितं तथा|
भाविकं दोषजं चैव स्वप्नं सप्तविधं विदुः||४३||

dr̥ṣṭaṁ śrutānubhūtaṁ ca prārthitaṁ kalpitaṁ tathā|
bhāvikaṁ dōṣajaṁ caiva svapnaṁ saptavidhaṁ viduḥ||43||

dRuShTaM shrutAnubhUtaM ca prArthitaM kalpitaM tathA|
bhAvikaM doShajaM caiva svapnaM saptavidhaM viduH||43||

It is known that there are seven kinds of dreams: seen, heard, felt, desired, imagined, prognosticating and faulty by nature. [43]
[[File:swapnabhead.png]]<br>
तत्र पञ्चविधं पूर्वमफलं भिषगादिशेत्|
दिवास्वप्नमतिह्रस्वमतिदीर्घं च बुद्धिमान्||४४||

दृष्टः प्रथमरात्रे यः स्वप्नः सोऽल्पफलो भवेत्|
न स्वपेद्यं पुनर्दृष्ट्वा स सद्यः स्यान्महाफलः||४५||

अकल्याणमपि स्वप्नं दृष्ट्वा तत्रैव यः पुनः|
पश्येत् सौम्यं शुभाकारं तस्य विद्याच्छुभं फलम्||४६||

tatra pañcavidhaṁ pūrvamaphalaṁ bhiṣagādiśēt|
divāsvapnamatihrasvamatidīrghaṁ ca buddhimān||44||

dr̥ṣṭaḥ prathamarātrē yaḥ svapnaḥ sō'lpaphalō bhavēt|
na svapēdyaṁ punardr̥ṣṭvā sa sadyaḥ syānmahāphalaḥ||45||

akalyāṇamapi svapnaṁ dr̥ṣṭvā tatraiva yaḥ punaḥ|
paśyēt saumyaṁ śubhākāraṁ tasya vidyācchubhaṁphalam|46||

tatra pa~jcavidhaM pUrvamaphalaM bhiShagAdishet|
divAsvapnamatihrasvamatidIrghaM ca buddhimAn||44||

dRuShTaH prathamarAtre yaH svapnaH so~alpaphalo bhavet|
na svapedyaM punardRuShTvA sa sadyaH syAnmahAphalaH||45||

akalyANamapi svapnaM dRuShTvA tatraiva yaH punaH|
pashyet saumyaM shubhAkAraM tasya vidyAcchubhaM phalam||46||

Amongst these the first five (viz.seen, heard, felt, desired and imagined) are fruitless (meaningless), and also those seen during daytime, and those which are too short or too long.

The dream that is seen during the first part of night is partially fruitful. He, however who having seen a dream does not sleep after it, will be realizing the dream completely.

It should be known that if a person having seen an inauspicious dream, sees without waking up another dream that is auspicious and of beneficial form just afterwards, he meets with good results. [44-46]

==== Summary ====

तत्र श्लोकः-
पूर्वरूपाण्यथ स्वप्नान् य इमान् वेत्ति दारुणान्|
न स मोहादसाध्येषु कर्माण्यारभते भिषक्||४७||

tatra ślōkaḥ-
pūrvarūpāṇyatha svapnān ya imān vētti dāruṇān|
na sa mōhādasādhyēṣu karmāṇyārabhatē bhiṣak||47||

tatra shlokaH-
pUrvarUpANyatha svapnAn ya imAn vetti dAruNAn|
na sa mohAdasAdhyeShu karmANyArabhate bhiShak||47||

A physician who is conversant with those premonitory symptoms which are associated with such terrible dreams never starts the treatment for incurable diseases out of his ignorance.[47]

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

*Important principle regarding disease prognosis states that “if all premonitory symptoms of a disease are fully manifested in severe form then it indicates poor prognosis”. [Verse No.3-5]
*If any person is continuously exposed to etiological agents and complications appear earlier than such disease is going to have poor prognosis. It is also emphasized that any person who is severely debilitated will not recover from any disease easily. Interpretation based on dreams should also be considered while predicting course of the disease. One special note from this chapter is that they describe symptoms in combination than in solitary appearance which shows the complexity of disease causing and disease prognostic process leading to fatality. Perhaps this needs a specially designed research to study on relation between dreams and ''arishtas''. [Verse No.6-9]
*It has been emphasized that not only clinical presentations but personal experiences of the patient can play role in disease outcome and so should not be neglected. This analogy described here has a striking resemblance with astronomy and understanding of body components. They attribute special colors, precious stones in relation with ''dhatus'', zodiac signs and body components. Perhaps Jyothisha Shastra (astrology) and gemology can be referred for more explanation. [Verse No.10-11]
*It has been emphasized that even minor complaints of the patient should not be ignored as they can be indicator of forthcoming serious and grave conditions. [Verse No.12-13]
*Significance of dreams in prodromal symptoms and fatal consequences have been described which need further study and research. All the three ''doshas'' should be excessively vitiated and should involve ''Manovaha Srotas'', i.e. channels associated with mind for producing such kind of dreams.

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

*In present era we do not predict prognosis by prodromal symptoms except in few cases as prodromal symptoms are not exactly known in most of the diseases. Due to ambiguity, prodromal symptoms are not considered reliable and this might be the reason they are not given importance in disease diagnosis and prognosis. [Verse No.3-5]
*In the example of tuberculosis, if person is severely debilitated and then consumption is occurring then there are more chances that he will succumb to disease. Persistence of cause like sexual indulgence in such condition will further precipitate the possibility of fatality. Here one point is noticeable that rhinorrhea is not a symptom of tuberculosis. It can occur as complication of extra-pulmonary tuberculosis which may lead to bony erosion, out-pouching of the dura, CSF leak, and subsequent bacterial meningitis which is a fatal condition. This condition suggests that if severe complications are occurring earlier than manifestation of cardinal feature of the disease, it indicates poor prognosis of disease.[10] This rule applies to all other diseases: if prior health status of person is poor, he continues to partake etiological agents and complications are appearing in very early stage then disease produced in future will be fatal in nature.
*Horrible dreams in a person indicate the decreased mental strength of the person. ‘Mind’ is component of health and patient can combat diseases easily with strong mind and will power. Disease is always difficult to cure in a depressed person with low will power. This might be a reason why Charaka has mentioned importance of dreams while predicting prognosis of any disease. Lifestyle has changed since this text was composed, the type of dreams and their interpretation should also be changed, requiring research. We often give importance to ''sharira doshas'' and neglect the importance of ''manasa doshas'' in causation and continuation of disease process. Perhaps this chapter gives us a scope to view things from different dimension. For all dreams the role of ''manasa doshas'' are pivotal. This needs further research [Verse No.6-9]
*From above verse it can be inferred that delirium before bleeding disorders will be fatal for the patient. Important cause of delirium is old age and other risk factors are poor overall health, anemia, malnutrition, underlying medical or neurologic illness etc. [11] If we critically analyze these factors we can infer that each of these will deteriorate general condition of the patient and so even slight bleeding can produce fatal results in such persons. [Verse No.10-11]
*''Kushta'' literally means discoloration, disgrace, disfiguration of the normal skin texture. From above verse it can be inferred that here ''kushta'' wound refers to non healing ulcers of leprosy. Leprosy is a chronic infectious disease caused by Mycobacterium Leprae, the only pathogenic bacteria able to infect peripheral nerves. About 30% of people with leprosy develop nerve damage. Neural impairment results in a set of sensitive, motor and autonomic disturbances, with ulcers originating primarily on the hands and feet. Neuropathic ulcers are one of the most common squeal of leprosy, but little is known about their clinical and epidemiological aspects. [12] If wounds are occurring before change in normal texture of skin it shows that wounds are occurring in prodromal stage and sensory loss has occurred till this stage and so slight injuries are resulting into wound formation. Such condition will lead to late diagnosis and hence chances of recovery will be minimal. [Verse No.14-15]
*Symptoms mentioned above in prodromal symptoms of ''unmada'' are negative symptoms and so there are chances of more suicidal tendency which is a major cause of death in ''unmada''. The presence and duration of prodromal symptoms may predict outcome in schizophrenia, that is, long duration of prodromal symptoms may be indicative of poor prognosis. [14]
*Aura are common in seizures of occipital or temporal lobe origin in patients with focal epileptic seizures. [15] Patients with refractory temporal lobe epilepsy (TLE) have an increased risk of sudden death that is 50 times greater than that in the general population. So if hallucinations are present in epilepsy they indicate grave prognosis. [Verse No.18-23]
*As mentioned earlier dreams are replica of mind and such kinds of dream represents weak and feeble mental status which is not strong enough to fight diseases properly. So if such dreams are frequently seen by patients they will have poor rate of recovery as compared to patient with strong mind and will power. [Verse No.27-40]
*In modern era, during late 19th century, psychotherapist Sigmund Freud gave emphasis on dream connection with mind in his famous book ‘The interpretation of dreams’. He developed a theory that the content of dreams is driven by unconscious wish fulfillment. [16] Presently dream is defined as successions of images, ideas, emotions, and sensations that occur involuntarily in the mind during certain stages of sleep. [17] Description of ''manovaha srotas'' in pathogenesis of dream shows that role of mind in producing dreams was known in ancient times.
*Various studies have established link between REM sleep and dreaming. [18] Poly somnograms show brainwave patterns in REM to be similar to that recorded during wakefulness. Intense dreaming occurs during REM sleep as a result of heightened brain activity. This proves that observations noted by ancient Ayurvedic seers related to pathogenesis of dream are minute and correct. [Verse No.41-42]
*As mentioned above dreams more or less depict unconsciousness state. Freud called dreams the "royal road to the unconscious”. They are related to activities which we have seen, listened, wished, thought etc. Based on this fact seven types of dream have been classified here. Five of them are mild as they are more near to events which we encounter in day to day life. Last two have fatal consequences as they are due to disease or ''dosha'' involvement. [Verse No.43]
*It is difficult to predict dream consequences on the basis of time or order in which they were seen. Researches are needed to scientifically prove the validity of such dream prediction. [Verse No.44-46]

=== References ===

#Torres-Bugarín O, Zavala-Cerna MG, Nava A, Flores-García A, Ramos-Ibarra ML. Potential Uses, Limitations, and Basic Procedures of Micronuclei and Nuclear Abnormalities in Buccal Cells. Disease Markers. 2014;2014:956835.
#Pradeep Sahu et al, Biomarkers: An Emerging Tool for Diagnosis of a Disease and Drug Development, Asian J. Res. Pharm. Sci. 2011; Vol. 1: Issue 1, Pg 09-16
#Sonali S. Tendulkar and R. R. Dwivedi, ‘Swapna’ in the Indian classics: Mythology or science?,Ayu. 2010 Apr-Jun; 31(2): 170–174.
#Jeannette Y. Wick; Guido R. Zann, Drugs and Dreams, J Am Pharm Assoc (2003) 2002;42:385-390.
#Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678.
#J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203.
#Waqas Wahid Baig et al., Spontaneous Cerebrospinal Fluid Rhinorrhea with Pneumocephalus: An Unusual Manifestation of Nasal Tuberculosis, Korean J Intern Med. 2012 September; 27(3): 350–352
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc,chapter 26
#Josafá G Barreto, Claudio G Salgado, Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial, BMC Infect Dis. 2010; 10: 237
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Diabetes mellitus Chapter 338.
#Chapman, L.J.; Day, D.; and Burstein, A. The process-reactive distinction and prognosis in schizophrenia. Journal of Nervous and Mental Disease, 133:383-391, 1961.
#Christian G. Bien, Felix O. Benninger, Horst Urbach, Johannes Schramm, Martin Kurthen, Christian E. Elger, Localizing value of epileptic visual auras Brain (2000) 123 (2): 244-253.
#Stone MH,Dream analysis in the psychodynamic psychotherapy of borderline patients, Psychodyn Psychiatry. 2012 Jun;40(2):287-302.
#Dream, The American Heritage Dictionary of the English Language, Fourth Edition. 2000. Retrieved May 7, 2009.
#Klemm WR. Why Does Rem Sleep Occur? A Wake-Up Hypothesis. Frontiers in Systems Neuroscience. 2011;5:73.

Purvarupeeya

2017-12-26T05:59:16Z

Vinay Exafluence: /* Dreams */

{{Infobox
|title = Purvarupeeya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 5
|label2 = Preceding Chapter
|data2 = [[Indriyaneeka]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 5 ==

===Abstract===

[[Purvarupeeya]] has been devoted to predict prognosis of diseases by prodromal symptoms. This chapter suggests that knowledge and examination of prodromal symptoms was important in ancient times and emphasis was given that physician should carefully recognize disease in early stage and predict course of disease. With the help of eight diseases of [[Nidana Sthana]] important principles related to prognosis have been laid down which are also applicable to all other diseases and are valid till now. Various aspects of dreams including physiology, types, interpretation and prognostic importance have also been described. Various dreams along with physical and mental features have been incorporated in prodromal symptoms which signify that dreams should also be analyzed and properly investigated before predicting prognosis of any disease. Even with restricted technological tools, par excellence observation and principles described regarding ''Arishta Lakshana'' are valid till now.

'''Keywords''': Prodromal symptoms, dream, prognosis, disease, death.

=== Introduction ===

In this chapter prodromal symptoms and dreams related to poor prognosis of diseases- fatality are described. In the first verse, Charaka has emphasized that he will describe both common and special prodromal symptoms. This indicates that while there may be some prodromata which result out of normal pathogenesis, some are unusual and unexpected. In the next verse it has been said that if all prodromal symptoms are manifesting and are severe in nature then such a condition will be fatal. This principle is applicable to all other diseases also. Prodromal symptoms of ''kushta'' and ''prameha'' suggest that complications manifest before cardinal symptoms of the disease appear. If body metabolism in any disease is altered severely during latent phase of disease and complications are appearing before manifestation of full-fledged disease then such condition will be difficult to cure. Example of ''gulma'' suggests that there are certain diseases which are incurable in nature and prodromal symptoms related to such clinical conditions will always be precursors of imminent death. It is commonly seen that any person who is emaciated and have low immunity and strength, when affected by disease, has fatal consequences due to less resistance. This fact is explained with the example of ''shosha''. Another important aspect regarding disease prognosis is that, if a person is continuously partaking causative factors or is in constant exposure to the causative factors, body will be unable to fight disease properly and thus there will be less chances of recovery from the disease. This point is also mentioned while describing prognosis of ''shosha''.

From the above discussion it is clear that prodromal symptoms can be useful in predicting diagnosis of any disease. But now question arises whether it is practically possible to predict prognosis with prodromal symptoms? We should admit that it is very difficult and one will need years of experience to attain such competence. Another important fact is that the prediction of prognosis can be done from ''purvarupa'' only after disease manifestation. Charaka states that ''purvarupa'' converting into a particular disease in future can be termed a prognostic sign. This indicates that we cannot predict by only prodromal symptoms. We have to look into whether disease was produced after ''purvarupa'' or not. For example, delirium in ''raktapitta'' is indicator of poor prognosis. If delirium is seen in any patient but he is not developing ''raktapitta'' we cannot predict poor prognosis. In this condition, after manifestation of ''raktapitta'' we need to ask the patient whether he suffered from delirium before disease manifestation or not. It is a retrospective inquiry about ''purvarupa'' based on which a prospective prediction may be made. We will have to follow detailed retro-prospective approach and will need proper patient history comprising of each and every detail from prodromal symptoms to disease manifestation. Thus practically, prodromal symptoms are helpful only after disease manifestation as they are not independent. Since accompanying symptoms may also lead to predictions, they can also be regarded as tools of predictive prognosis. This might be the reason that Sushruta and Vagbhata have not described dreams in reference of ''purvarupa'' but have described in ''rupavastha'' (stage of disease manifestation).

Biomarkers are recent advancements can be the answer to above problem as we do not need to wait for disease manifestation and can predict prognosis by seeing values of biomarkers related to that disease. In 2001, a consensus panel at the National Institutes of Health defined the term biomarker as ‘a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention or other health care intervention’.[1] Biomarker defined as alteration in the constituents of tissues or body fluids provide a powerful approach to understanding the spectrum of chronic disease with application in at least 5 areas like screening, diagnosis, prognostics, prediction of disease recurrence and therapeutic monitoring.[2] The biomarker is either produced by the diseased organ (e.g., tumor) or by the body in response to disease. Before diagnosis, markers could be used for screening and risk assessment. Tumor classification, stage and sometimes grade are generally used to assess prognosis. Researches in the field of biomarkers may give us chance to know prognosis of disease in early stage.

Another important aspect mentioned in this chapter is concept of dreams. The descriptions related to dreams are found abundantly in the ancient oriental classics, specifically the Atharvaveda, Upanishadas, Puranas, Darshanas and [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. The description of the ''doshika'' dreams of the Atharvaveda is similar to that in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. Dreams are mentioned while describing ''purvarupa'', ''rupa'' and ''arishta lakshanas''.[3] Sushruta states that sex of the unborn child can be predicted and Vagbhata says that ''doshika prakriti'' can be known by the help of dreams.

Subject of dreams is dealt in very scientific manner. According to Charaka, dreams occur when person is in relatively wakeful state. This has been proved now by the researches that dreams mainly occur in the rapid-eye movement (REM) stage of sleep—when brain activity is high and resembles that of being awake. In the late 19th century, psychotherapist Sigmund Freud developed a theory that the content of dreams is driven by unconscious wish fulfillment. Freud called dreams the "royal road to the unconscious”. [4] To Freud, no dream was of entertainment value, they all held important meanings. Dreams reflect the dreamer’s mental, emotional, and physical state. This fact is well established in this chapter while describing classification of dreams. Dreams are based on our day to day interactions and so are classified as dreams seen, heard, felt etc. Two of the seven types, one which predict prognosis and one which is due to vitiation of ''doshas'' are said to have fatal consequences.

Research studies are needed to prove that dreams can be used as markers of prognosis. Some studies have been conducted in this regard but we cannot make strong conclusion on basis of their results. In a few studies it has been shown that hormone levels affect dreams. One of the studies states that cortisol plays an important role in controlling the state of memory systems during sleep. High levels of cortisol, as are observed late at night and, typically in the context of REM sleep, disrupt normal hippocampal → neocortical communication, thereby interfering with forms of memory consolidation dependent upon this communication. At the same time, the content of dreams is also affected.[5] In neurological and psychological diseases dream disturbances are often seen but few other diseases have also been found to affect dreams. Patients with sleep apnea are reported to have intense nightmares. [6] Abnormal dreams have also been reported in diseases like Relapsing fever,[7] Cardiac ischemia[8] etc. Certain drugs also affect dreams e.g. Anti malarial drug has shown to alter dream types.[9] This proves that at times diseases certainly affect dreams but intense research studies are needed to actually establish this fact on scientific grounds.

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

अथातः पूर्वरूपीयमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ pūrvarūpīyamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pUrvarUpIyamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

We shall now expound the chapter of premonitory symptoms related to signs of death.
Thus spoke lord Atreya.[1-2]

==== Incurable prodromal signs of ''Jwara'' leading to death ====

पूर्वरूपाण्यसाध्यानां विकाराणां पृथक् पृथक्|
भिन्नाभिन्नानि वक्ष्यामो भिषजां ज्ञानवृद्धये||३||

पूर्वरूपाणि सर्वाणि ज्वरोक्तान्यतिमात्रया|
यं विशन्ति विशत्येनं मृत्युर्ज्वरपुरःसरः||४||

अन्यस्यापि च रोगस्य पूर्वरूपाणि यं नरम्|
विशन्त्यनेन कल्पेन तस्यापि मरणं ध्रुवम्||५||

pūrvarūpāṇyasādhyānāṁ vikārāṇāṁ pr̥thak pr̥thak|
bhinnābhinnāni vakṣyāmō bhiṣajāṁ jñānavr̥ddhayē||3||

pūrvarūpāṇi sarvāṇi jvarōktānyatimātrayā|
yaṁ viśanti viśatyēnaṁ mr̥tyurjvarapuraḥsaraḥ||4||

anyasyāpi ca rōgasya pūrvarūpāṇi yaṁ naram|
viśantyanēna kalpēna tasyāpi maraṇaṁ dhruvam||5||

pUrvarUpANyasAdhyAnAM vikArANAM pRuthak pRuthak|
bhinnAbhinnAni vakShyAmo bhiShajAM j~jAnavRuddhaye||3||

pUrvarUpANi sarvANi jvaroktAnyatimAtrayA|
yaM vishanti vishatyenaM mRutyurjvarapuraHsaraH||4||

anyasyApi ca rogasya pUrvarUpANi yaM naram|
vishantyanena kalpena tasyApi maraNaM dhruvam||5||

For enhancing the knowledge of physicians, we will distinctly explain the general and fatal prodromal symptoms of diseases.
If all prodromal symptoms of ''jwara'' manifests in severe degree, the person will die. If prodromal symptoms of any other disease also appear in the same way as described above, death of the patient is certain. [3-5]

==== Incurable prodromal signs of ''Rajayakshma'' leading to death ====

पूर्वरूपैकदेशांस्तु वक्ष्यामोऽन्यान् सुदारुणान्|
ये रोगाननुबध्नन्ति मृत्युर्यैरनुबध्यते [१] ||६||

बलं च हीयते यस्य प्रतिश्यायश्च वर्धते|
तस्य नारीप्रसक्तस्य शोषोऽन्तायोपजायते||७||

श्वभिरुष्ट्रैः खरैर्वाऽपि याति यो दक्षिणां दिशम्|
स्वप्ने यक्ष्माणमासाद्य जीवितं स विमुञ्चति||८||

प्रेतैः सह पिबेन्मद्यं स्वप्ने यः कृष्यते शुना|
सुघोरं ज्वरमासाद्य जीवितं स विमुञ्चति||९||

pūrvarūpaikadēśāṁstu vakṣyāmō'nyān sudāruṇān|
yē rōgānanubadhnanti mr̥tyuryairanubadhyatē ||6||

balaṁ ca hīyatē yasya pratiśyāyaśca vardhatē|
tasya nārīprasaktasya śōṣō'ntāyōpajāyatē||7||

śvabhiruṣṭraiḥ kharairvā'pi yāti yō dakṣiṇāṁ diśam|
svapnē yakṣmāṇamāsādya jīvitaṁ sa vimuñcati||8||

prētaiḥ saha pibēnmadyaṁ svapnē yaḥ kr̥ṣyatē śunā|
sughōraṁ jvaramāsādya jīvitaṁ sa vimuñcati||9||

pUrvarUpaikadeshAMstu vakShyAmo~anyAn sudAruNAn|
ye rogAnanubadhnanti mRutyuryairanubadhyate ||6||

balaM ca hIyate yasya pratishyAyashca vardhate|
tasya nArIprasaktasya shoSho~antAyopajAyate||7||

shvabhiruShTraiH kharairvA~api yAti yo dakShiNAM disham|
svapne yakShmANamAsAdya jIvitaM sa vimu~jcati||8||

pretaiH saha pibenmadyaM svapne yaH kRuShyate shunA|
sughoraM jvaramAsAdya jIvitaM sa vimu~jcati||9||

Now we shall discuss certain severe premonitory symptoms which are associated with certain diseases.
The consumption which is associated with continuously decreasing strength, worsening rhinitis and over indulgence in sex in prodromal stage will turn out to be incurable.

A man, who in his dreams, is dragged by dog, camel or a donkey towards south, leaves his life as by consumption.
A person who in his dreams takes alcohol with demons and who is dragged by a dog leaves his life getting affected with severe fever. [6-9]

==== Incurable prodromal signs of ''Raktapitta'' leading to death ====

लाक्षारक्ताम्बराभं यः पश्यत्यम्बरमन्तिकात्|
स रक्तपित्तमासाद्य तेनैवान्ताय नीयते||१०||

रक्तस्रग्रक्तसर्वाङ्गो रक्तवासा मुहुर्हसन्|
यः स्वप्ने ह्रियते नार्या स रक्तं प्राप्य सीदति||११||

lākṣāraktāmbarābhaṁ yaḥ paśyatyambaramantikāt|
sa raktapittamāsādya tēnaivāntāya nīyatē||10||

raktasragraktasarvāṅgō raktavāsā muhurhasan|
yaḥ svapnē hriyatē nāryā sa raktaṁ prāpya sīdati||11||

lAkShAraktAmbarAbhaM yaH pashyatyambaramantikAt|
sa raktapittamAsAdya tenaivAntAya nIyate||10||

raktasragraktasarvA~ggo raktavAsA muhurhasan|
yaH svapne hriyate nAryA sa raktaM prApya sIdati||11||

He who sees clothes as if dyed with red lac, leaves his life if he gets affected with severe bleeding disorders.
In his dream, the man who sees himself adorned with red garlands, clad in red clothes, anointed with red dye and dragged by a continuously laughing woman will succumb to severe bleeding disorders. [10-11]

==== Incurable prodromal signs of ''Gulma'' leading to death ====

शूलाटोपान्त्रकूजाश्च दौर्बल्यं चातिमात्रया|
नखादिषु च वैवर्ण्यं गुल्मेनान्तकरो ग्रहः||१२||

लता कण्टकिनी यस्य दारुणा हृदि जायते|
स्वप्ने गुल्मस्तमन्ताय क्रूरो विशति मानवम्||१३||

śūlāṭōpāntrakūjāśca daurbalyaṁ cātimātrayā|
nakhādiṣu ca vaivarṇyaṁ gulmēnāntakarō grahaḥ||12||

latā kaṇṭakinī yasya dāruṇā hr̥di jāyatē|
svapnē gulmastamantāya krūrō viśati mānavam||13||

shUlATopAntrakUjAshca daurbalyaM cAtimAtrayA|
nakhAdiShu ca vaivarNyaM gulmenAntakaro grahaH||12||

latA kaNTakinI yasya dAruNA hRudi jAyate|
svapne gulmastamantAya krUro vishati mAnavam||13||

A man who experiences severe pain, gurgling sounds in abdomen, intestinal peristalsis, excessive debility, discoloration of nails and other body parts is going to die if he is affected with ''gulma''.

A person, who in his dreams sees hard and thorny creepers grown on his chest and then gets afflicted by ''gulma'', is surely going to die soon. [12-13]

==== Incurable prodromal signs of ''Kushtha'' leading to death ====

कायेऽल्पमपि संस्पृष्टं सुभृशं यस्य दीर्यते|
क्षतानि च न रोहन्ति कुष्ठैर्मृत्युर्हिनस्ति तम्||१४||

नग्नस्याज्यावसिक्तस्य जुह्वतोऽग्निमनर्चिषम्|
पद्मान्युरसि जायन्ते स्वप्ने कुष्ठैर्मरिष्यतः||१५||

kāyē'lpamapi saṁspr̥ṣṭaṁ subhr̥śaṁ yasya dīryatē|
kṣatāni ca na rōhanti kuṣṭhairmr̥tyurhinasti tam||14||

nagnasyājyāvasiktasya juhvatō'gnimanarciṣam|
padmānyurasi jāyantē svapnē kuṣṭhairmariṣyataḥ||15||

kAye~alpamapi saMspRuShTaM subhRushaM yasya dIryate|
kShatAni ca na rohanti kuShThairmRutyurhinasti tam||14||

nagnasyAjyAvasiktasya juhvato~agnimanarciSham|
padmAnyurasi jAyante svapne kuShThairmariShyataH||15||

A person whose body even if touched gently leads to deep cuts and whose injuries never heal will be killed by severe skin diseases.
In his dream, a man who sees himself naked, anointed with ghee, offering the oblations without the fire being lit, who has lotuses grown on his chest, will be taken away by death as afflicted by skin diseases.[14-15]

==== Incurable prodromal signs of ''Prameha'' leading to death ====

स्नातानुलिप्तगात्रेऽपि यस्मिन् गृध्नन्ति मक्षिकाः|
स प्रमेहेण संस्पर्शं प्राप्य तेनैव हन्यते||१६||

स्नेहं बहुविधं स्वप्ने चण्डालैः सह यः पिबेत्|
बध्यते स प्रमेहेण स्पृश्यतेऽन्ताय मानवः||१७||

snātānuliptagātrē'pi yasmin gr̥dhnanti makṣikāḥ|
sa pramēhēṇa saṁsparśaṁ prāpya tēnaiva hanyatē||16||

snēhaṁ bahuvidhaṁ svapnē caṇḍālaiḥ saha yaḥ pibēt|
badhyatē sa pramēhēṇa spr̥śyatē'ntāya mānavaḥ||17||

snAtAnuliptagAtre~api yasmin gRudhnanti makShikAH|
sa prameheNa saMsparshaM prApya tenaiva hanyate||16||

snehaM bahuvidhaM svapne caNDAlaiH saha yaH pibet|
badhyate sa prameheNa spRushyate~antAya mAnavaH||17||

Even after taking bath and getting anointed with scents, flies are attracted towards person, he will certainly die, if affected with ''prameha''.

One who sees in his dreams, drinking various kinds of oily substances with Chandalas becomes affected by ''prameha'' and will die. [16-17]

==== Incurable prodromal signs of ''Unmada'' and ''Apasmara'' leading to death ====

ध्यानायासौ तथोद्वेगौ मोहश्चास्थानसम्भवः|
अरतिर्बलहानिश्च मृत्युरुन्मादपूर्वकः||१८||

आहारद्वेषिणं पश्यन् लुप्तचित्तमुदर्दितम्|
विद्याद्धीरो मुमूर्षुं तमुन्मादेनातिपातिना||१९||

क्रोधनं त्रासबहुलं सकृत्प्रहसिताननम्|
मूर्च्छापिपासाबहुलं हन्त्युन्मादः शरीरिणम्||२०||

नृत्यन् रक्षोगणैः साकं यः स्वप्नेऽम्भसि सीदति |
स प्राप्य भृशमुन्मादं याति लोकमतः परम्||२१||

असत्तमः पश्यति यः शृणोत्यप्यसतः स्वनान्|
बहून् बहुविधान् जाग्रत् सोऽपस्मारेण बध्यते||२२||

मत्तं नृत्यन्तमाविध्य प्रेतो हरति यं नरम्|
स्वप्ने हरति तं मृत्युरपस्मारपुरःसरः||२३||

dhyānāyāsau tathōdvēgau mōhaścāsthānasambhavaḥ|
aratirbalahāniśca mr̥tyurunmādapūrvakaḥ||18||

āhāradvēṣiṇaṁ paśyan luptacittamudarditam|
vidyāddhīrō mumūrṣuṁ tamunmādēnātipātinā||19||

krōdhanaṁ trāsabahulaṁ sakr̥tprahasitānanam|
mūrcchāpipāsābahulaṁ hantyunmādaḥ śarīriṇam||20||

nr̥tyan rakṣōgaṇaiḥ sākaṁ yaḥ svapnē'mbhasi sīdati |
sa prāpya bhr̥śamunmādaṁ yāti lōkamataḥ param||21||

asattamaḥ paśyati yaḥ śr̥ṇōtyapyasataḥ svanān|
bahūn bahuvidhān jāgrat sō'pasmārēṇa badhyatē||22||

mattaṁ nr̥tyantamāvidhya prētō harati yaṁ naram|
svapnē harati taṁ mr̥tyurapasmārapuraḥsaraḥ||23||

dhyAnAyAsau tathodvegau mohashcAsthAnasambhavaH|
aratirbalahAnishca mRutyurunmAdapUrvakaH||18||

AhAradveShiNaM pashyan luptacittamudarditam|
vidyAddhIro mumUrShuM tamunmAdenAtipAtinA||19||

krodhanaM trAsabahulaM sakRutprahasitAnanam|
mUrcchApipAsAbahulaM hantyunmAdaH sharIriNam||20||

nRutyan rakShogaNaiH sAkaM yaH svapne~ambhasi sIdati |
sa prApya bhRushamunmAdaM yAti lokamataH param||21||

asattamaH pashyati yaH shRuNotyapyasataH svanAn|
bahUn bahuvidhAn jAgrat so~apasmAreNa badhyate||22||

mattaM nRutyantamAvidhya preto harati yaM naram|
svapne harati taM mRutyurapasmArapuraHsaraH||23||

He who is affected with disturbing thoughts, anxiety, stupefaction without any specific cause, restlessness, loss of strength will succumb to death as affected with insanity.

The person who feels excess anger, fear, always smiles and who is suffering from severe stupor and thirst will be certainly killed by insanity.

The man who in his dreams dances with evil spirits and sinks in water leaves the world.
He who sees darkness even when he is awake and hears sounds when there is no real sound, will be killed by epilepsy.
In dream, a person who sees himself dancing with ghosts while in intoxication with his head upside down, will be taken away by death getting affected with epilepsy. [18-23]

स्तभ्येते प्रतिबुद्धस्य हनू मन्ये तथाऽक्षिणी|
यस्य तं बहिरायामो गृहीत्वा हन्त्यसंशयम्||२४||

शष्कुलीर्वाऽप्यपूपान् वा स्वप्ने खादति यो नरः|
स चेत्तादृक् छर्दयति प्रतिबुद्धो न जीवति||२५||

stabhyētē pratibuddhasya hanū manyē tathā'kṣiṇī|
yasya taṁ bahirāyāmō gr̥hītvā hantyasaṁśayam||24||

śaṣkulīrvā'pyapūpān vā svapnē khādati yō naraḥ|
sa cēttādr̥k chardayati pratibuddhō na jīvati||25||

stabhyete pratibuddhasya hanU manye tathA~akShiNI|
yasya taM bahirAyAmo gRuhItvA hantyasaMshayam||24||

shaShkulIrvA~apyapUpAn vA svapne khAdati yo naraH|
sa cettAdRuk chardayati pratibuddho na jIvati||25||

If individual is found with ''bahirayama'' ( a disease with feature of opisthotonus or bending of body backwards) soon after awaking from sleep along with lock jaw, neck stiffness, stale eyes and paralysis is going to lose life soon.

Such an individual in his dream sees himself taking cakes of sesame seeds and ''apupa'' ( a dietary item) and vomits the same when he is awake.[24-25]

एतानि पूर्वरूपाणि यः सम्यगवबुध्यते|
स एषामनुबन्धं च फलं च ज्ञातुमर्हति||२६||

ētāni pūrvarūpāṇi yaḥ samyagavabudhyatē|
sa ēṣāmanubandhaṁ ca phalaṁ ca jñātumarhati||26||

etAni pUrvarUpANi yaH samyagavabudhyate|
sa eShAmanubandhaM ca phalaM ca j~jAtumarhati||26||

One who (physician) understands these premonitory symptoms thoroughly, also deserves the knowledge of associated diseases and their result i.e. death.[26]

इमांश्चाप्यपरान् स्वप्नान् दारुणानुपलक्षयेत्|
व्याधितानां विनाशाय क्लेशाय महतेऽपि वा||२७||

यस्योत्तमाङ्गे जायन्ते वंशगुल्मलतादयः|
वयांसि च विलीयन्ते स्वप्ने मौण्ड्यमियाच्च यः||२८||

गृध्रोलूकश्वकाकाद्यैः स्वप्ने यः परिवार्यते|
रक्षःप्रेतपिशाचस्त्रीचण्डालद्रविडान्ध्रकैः ||२९||

वंशवेत्रलतापाशतृणकण्टकसङ्कटे|
संसज्जति हि यः स्वप्ने यो गच्छन् प्रपतत्यपि||३०||

भूमौ पांशूपधानायां वल्मीके वाऽथ भस्मनि|
श्मशानायतने श्वभ्रे स्वप्ने यः प्रपतत्यपि ||३१||

कलुषेऽम्भसि पङ्के वा कूपे वा तमसाऽऽवृते|
स्वप्ने मज्जति शीघ्रेण स्रोतसा ह्रियते च यः||३२||

स्नेहपानं तथाऽभ्यङ्गः प्रच्छर्दनविरेचने|
हिरण्यलाभः कलहः स्वप्ने बन्धपराजयौ||३३||

उपानद्युगनाशश्च प्रपातः पादचर्मणोः|
हर्षः स्वप्ने प्रकुपितैः पितृभिश्चावभर्त्सनम्||३४||

दन्तचन्द्रार्कनक्षत्रदेवतादीपचक्षुषाम् |
पतनं वा विनाशो वा स्वप्ने भेदो नगस्य वा||३५||

रक्तपुष्पं वनं भूमिं पापकर्मालयं चिताम्|
गुहान्धकारसम्बाधं स्वप्ने यः प्रविशत्यपि||३६||

रक्तमाली हसन्नुच्चैर्दिग्वासा दक्षिणां दिशम्|
दारुणामटवीं स्वप्ने कपियुक्तेन याति वा||३७||

काषायिणामसौम्यानां नग्नानां दण्डधारिणाम्|
कृष्णानां रक्तनेत्राणां स्वप्ने नेच्छन्ति दर्शनम्||३८||

कृष्णा पापा निराचारा दीर्घकेशनखस्तनी|
विरागमाल्यवसना स्वप्ने कालनिशा मता||३९||

इत्येते दारुणाः स्वप्ना रोगी यैर्याति पञ्चताम्|
अरोगः संशयं गत्वा कश्चिदेव प्रमुच्यते||४०||

imāṁścāpyaparān svapnān dāruṇānupalakṣayēt|
vyādhitānāṁ vināśāya klēśāya mahatē'pi vā||27||

yasyōttamāṅgē jāyantē vaṁśagulmalatādayaḥ|
vayāṁsi ca vilīyantē svapnē mauṇḍyamiyācca yaḥ||28||

gr̥dhrōlūkaśvakākādyaiḥ svapnē yaḥ parivāryatē|
rakṣaḥprētapiśācastrīcaṇḍāladraviḍāndhrakaiḥ ||29||

vaṁśavētralatāpāśatr̥ṇakaṇṭakasaṅkaṭē|
saṁsajjati hi yaḥ svapnē yō gacchan prapatatyapi||30||

bhūmau pāṁśūpadhānāyāṁ valmīkē vā'tha bhasmani|
śmaśānāyatanē śvabhrē svapnē yaḥ prapatatyapi ||31||

kaluṣē'mbhasi paṅkē vā kūpē vā tamasā''vr̥tē|
svapnē majjati śīghrēṇa srōtasā hriyatē ca yaḥ||32||

snēhapānaṁ tathā'bhyaṅgaḥ pracchardanavirēcanē|
hiraṇyalābhaḥ kalahaḥ svapnē bandhaparājayau||33||

upānadyuganāśaśca prapātaḥ pādacarmaṇōḥ|
harṣaḥ svapnē prakupitaiḥ pitr̥bhiścāvabhartsanam||34||

dantacandrārkanakṣatradēvatādīpacakṣuṣām |
patanaṁ vā vināśō vā svapnē bhēdō nagasya vā||35||

raktapuṣpaṁ vanaṁ bhūmiṁ pāpakarmālayaṁ citām|
guhāndhakārasambādhaṁ svapnē yaḥ praviśatyapi||36||

raktamālī hasannuccairdigvāsā dakṣiṇāṁ diśam|
dāruṇāmaṭavīṁ svapnē kapiyuktēna yāti vā||37||

kāṣāyiṇāmasaumyānāṁ nagnānāṁ daṇḍadhāriṇām|
kr̥ṣṇānāṁ raktanētrāṇāṁ svapnē nēcchanti darśanam||38||

kr̥ṣṇā pāpā nirācārā dīrghakēśanakhastanī|
virāgamālyavasanā svapnē kālaniśā matā||39||

ityētē dāruṇāḥ svapnā rōgī yairyāti pañcatām|
arōgaḥ saṁśayaṁ gatvā kaścidēva pramucyatē||40||

imAMshcApyaparAn svapnAn dAruNAnupalakShayet|
vyAdhitAnAM vinAshAya kleshAya mahate~api vA||27||

yasyottamA~gge jAyante vaMshagulmalatAdayaH|
vayAMsi ca vilIyante svapne mauNDyamiyAcca yaH||28||

gRudhrolUkashvakAkAdyaiH svapne yaH parivAryate|
rakShaHpretapishAcastrIcaNDAladraviDAndhrakaiH ||29||

vaMshavetralatApAshatRuNakaNTakasa~gkaTe|
saMsajjati hi yaH svapne yo gacchan prapatatyapi||30||

bhUmau pAMshUpadhAnAyAM valmIke vA~atha bhasmani|
shmashAnAyatane shvabhre svapne yaH prapatatyapi ||31||

kaluShe~ambhasi pa~gke vA kUpe vA tamasA~a~avRute|
svapne majjati shIghreNa srotasA hriyate ca yaH||32||

snehapAnaM tathA~abhya~ggaH pracchardanavirecane|
hiraNyalAbhaH kalahaH svapne bandhaparAjayau||33||

upAnadyuganAshashca prapAtaH pAdacarmaNoH|
harShaH svapne prakupitaiH pitRubhishcAvabhartsanam||34||

dantacandrArkanakShatradevatAdIpacakShuShAm |
patanaM vA vinAsho vA svapne bhedo nagasya vA||35||

raktapuShpaM vanaM bhUmiM pApakarmAlayaM citAm|
guhAndhakArasambAdhaM svapne yaH pravishatyapi||36||

raktamAlI hasannuccairdigvAsA dakShiNAM disham|
dAruNAmaTavIM svapne kapiyuktena yAti vA||37||

kAShAyiNAmasaumyAnAM nagnAnAM daNDadhAriNAm|
kRuShNAnAM raktanetrANAM svapnenecchanti darshanam||38|

kRuShNA pApA nirAcArA dIrghakeshanakhastanI|
virAgamAlyavasanA svapne kAlanishA matA||39||

ityete dAruNAH svapnA rogI yairyAti pa~jcatAm|
arogaH saMshayaM gatvA kashcideva pramucyate||40||

Certain other dreams which are fierce should also be analyzed as they indicate the approaching death of the diseased and grave sufferings for those who are going to be affected.

He, who in his dreams sees bamboos, shrubs and creepers etc. growing in his head, birds coming to them and his scalp been shaved.
Or who in his dreams sees himself surrounded by vultures, owls, dogs, crows and other birds or by Rakshasa, dead men, ''pishachas'', women, ''chandalas'', and inhabitants of Dravida and Andhra regions.

Or who in his dreams finds himself surrounded by pathless forests of bamboo, canes, creepers, grass and prickly plants and finds himself lost in the midst and falling down while trying to come out.

Or who in his dreams, falls down on the bare ground covered with dust or upon an anthill or upon ashes, or upon a crematorium or in to a hole.

Or who sinks in a ditch or pond of dirty water or into mire or in a dark well or who is carried away by a rapid current.
Or who in his dreams drinks oily substances or anoints his body with oil, vomits, defecates, or gets gold, engages in quarrel, gets defeated and captured.

Or who lose his sandals, has skin of feet peeling off or feels excited or who is rebuked by his angry ancestors.
Or who sees in his dreams the fall or destruction of his own tooth or the moon or the sun or the stars or the burning lamps or his own eyes or the cracking of a mountain.

Or who in his dreams, enters a forest of trees with red flowers or a place where sinful activities are done or a funeral place (crematorium), a dark cave.

Or who in his dreams sees himself proceeding towards south, finds himself adorned with garlands of red flowers, laughing aloud and naked.
The sight of a woman who is dark in complexion, who is sinful, who has long hair and nails, hanging breasts, or who is clad in garlands of red flowers and red garments is regarded to be as fatal as a fatal night.
These are severe dreams which indicate death of a patient.

If a healthy man sees such dreams, his life becomes doubtful, rarely does he escape. [27-40]

==== Dreams ====

मनोवहानां पूर्णत्वाद्दोषैरतिबलैस्त्रिभिः|
स्रोतसां दारुणान् स्वप्नान् काले पश्यति दारुणे||४१||

नातिप्रसुप्तः पुरुषः सफलानफलांस्तथा|
इन्द्रियेशेन मनसा स्वप्नान् पश्यत्यनेकधा||४२||

manōvahānāṁ pūrṇatvāddōṣairatibalaistribhiḥ|
srōtasāṁ dāruṇān svapnān kālē paśyati dāruṇē||41||

nātiprasuptaḥ puruṣaḥ saphalānaphalāṁstathā|
indriyēśēna manasā svapnān paśyatyanēkadhā||42||

manovahAnAM pUrNatvAddoShairatibalaistribhiH|
srotasAM dAruNAn svapnAn kAle pashyati dAruNe||41||

nAtiprasuptaH puruShaH saphalAnaphalAMstathA|
indriyeshena manasA svapnAn pashyatyanekadhA||42||

When the channels associated with the mind are saturated by the excessively vitiated ''doshas'', such terrible dreams appear in his sleep. The person who is not in deep sleep (subconscious state), sees various fruitful (meaningful) or fruitless (meaningless) dreams in association with sense organs. [41-42]

दृष्टं श्रुतानुभूतं च प्रार्थितं कल्पितं तथा|
भाविकं दोषजं चैव स्वप्नं सप्तविधं विदुः||४३||

dr̥ṣṭaṁ śrutānubhūtaṁ ca prārthitaṁ kalpitaṁ tathā|
bhāvikaṁ dōṣajaṁ caiva svapnaṁ saptavidhaṁ viduḥ||43||

dRuShTaM shrutAnubhUtaM ca prArthitaM kalpitaM tathA|
bhAvikaM doShajaM caiva svapnaM saptavidhaM viduH||43||

It is known that there are seven kinds of dreams: seen, heard, felt, desired, imagined, prognosticating and faulty by nature. [43]
[[File:swapnabhead.png]]<br>
तत्र पञ्चविधं पूर्वमफलं भिषगादिशेत्|
दिवास्वप्नमतिह्रस्वमतिदीर्घं च बुद्धिमान्||४४||

दृष्टः प्रथमरात्रे यः स्वप्नः सोऽल्पफलो भवेत्|
न स्वपेद्यं पुनर्दृष्ट्वा स सद्यः स्यान्महाफलः||४५||

अकल्याणमपि स्वप्नं दृष्ट्वा तत्रैव यः पुनः|
पश्येत् सौम्यं शुभाकारं तस्य विद्याच्छुभं फलम्||४६||

tatra pañcavidhaṁ pūrvamaphalaṁ bhiṣagādiśēt|
divāsvapnamatihrasvamatidīrghaṁ ca buddhimān||44||

dr̥ṣṭaḥ prathamarātrē yaḥ svapnaḥ sō'lpaphalō bhavēt|
na svapēdyaṁ punardr̥ṣṭvā sa sadyaḥ syānmahāphalaḥ||45||

akalyāṇamapi svapnaṁ dr̥ṣṭvā tatraiva yaḥ punaḥ|
paśyēt saumyaṁ śubhākāraṁ tasya vidyācchubhaṁphalam|46||

tatra pa~jcavidhaM pUrvamaphalaM bhiShagAdishet|
divAsvapnamatihrasvamatidIrghaM ca buddhimAn||44||

dRuShTaH prathamarAtre yaH svapnaH so~alpaphalo bhavet|
na svapedyaM punardRuShTvA sa sadyaH syAnmahAphalaH||45||

akalyANamapi svapnaM dRuShTvA tatraiva yaH punaH|
pashyet saumyaM shubhAkAraM tasya vidyAcchubhaM phalam||46||

Amongst these the first five (viz.seen, heard, felt, desired and imagined) are fruitless (meaningless), and also those seen during daytime, and those which are too short or too long.

The dream that is seen during the first part of night is partially fruitful. He, however who having seen a dream does not sleep after it, will be realizing the dream completely.

It should be known that if a person having seen an inauspicious dream, sees without waking up another dream that is auspicious and of beneficial form just afterwards, he meets with good results. [44-46]

==== Summary ====

तत्र श्लोकः-
पूर्वरूपाण्यथ स्वप्नान् य इमान् वेत्ति दारुणान्|
न स मोहादसाध्येषु कर्माण्यारभते भिषक्||४७||

tatra ślōkaḥ-
pūrvarūpāṇyatha svapnān ya imān vētti dāruṇān|
na sa mōhādasādhyēṣu karmāṇyārabhatē bhiṣak||47||

tatra shlokaH-
pUrvarUpANyatha svapnAn ya imAn vetti dAruNAn|
na sa mohAdasAdhyeShu karmANyArabhate bhiShak||47||

A physician who is conversant with those premonitory symptoms which are associated with such terrible dreams never starts the treatment for incurable diseases out of his ignorance.[47]

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

*Important principle regarding disease prognosis states that “if all premonitory symptoms of a disease are fully manifested in severe form then it indicates poor prognosis”. [Verse No.3-5]
*If any person is continuously exposed to etiological agents and complications appear earlier than such disease is going to have poor prognosis. It is also emphasized that any person who is severely debilitated will not recover from any disease easily. Interpretation based on dreams should also be considered while predicting course of the disease. One special note from this chapter is that they describe symptoms in combination than in solitary appearance which shows the complexity of disease causing and disease prognostic process leading to fatality. Perhaps this needs a specially designed research to study on relation between dreams and ''arishtas''. [Verse No.6-9]
*It has been emphasized that not only clinical presentations but personal experiences of the patient can play role in disease outcome and so should not be neglected. This analogy described here has a striking resemblance with astronomy and understanding of body components. They attribute special colors, precious stones in relation with ''dhatus'', zodiac signs and body components. Perhaps Jyothisha Shastra (astrology) and gemology can be referred for more explanation. [Verse No.10-11]
*It has been emphasized that even minor complaints of the patient should not be ignored as they can be indicator of forthcoming serious and grave conditions. [Verse No.12-13]
*Significance of dreams in prodromal symptoms and fatal consequences have been described which need further study and research. All the three ''doshas'' should be excessively vitiated and should involve ''Manovaha Srotas'', i.e. channels associated with mind for producing such kind of dreams.

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

*In present era we do not predict prognosis by prodromal symptoms except in few cases as prodromal symptoms are not exactly known in most of the diseases. Due to ambiguity, prodromal symptoms are not considered reliable and this might be the reason they are not given importance in disease diagnosis and prognosis. [Verse No.3-5]
*In the example of tuberculosis, if person is severely debilitated and then consumption is occurring then there are more chances that he will succumb to disease. Persistence of cause like sexual indulgence in such condition will further precipitate the possibility of fatality. Here one point is noticeable that rhinorrhea is not a symptom of tuberculosis. It can occur as complication of extra-pulmonary tuberculosis which may lead to bony erosion, out-pouching of the dura, CSF leak, and subsequent bacterial meningitis which is a fatal condition. This condition suggests that if severe complications are occurring earlier than manifestation of cardinal feature of the disease, it indicates poor prognosis of disease.[10] This rule applies to all other diseases: if prior health status of person is poor, he continues to partake etiological agents and complications are appearing in very early stage then disease produced in future will be fatal in nature.
*Horrible dreams in a person indicate the decreased mental strength of the person. ‘Mind’ is component of health and patient can combat diseases easily with strong mind and will power. Disease is always difficult to cure in a depressed person with low will power. This might be a reason why Charaka has mentioned importance of dreams while predicting prognosis of any disease. Lifestyle has changed since this text was composed, the type of dreams and their interpretation should also be changed, requiring research. We often give importance to ''sharira doshas'' and neglect the importance of ''manasa doshas'' in causation and continuation of disease process. Perhaps this chapter gives us a scope to view things from different dimension. For all dreams the role of ''manasa doshas'' are pivotal. This needs further research [Verse No.6-9]
*From above verse it can be inferred that delirium before bleeding disorders will be fatal for the patient. Important cause of delirium is old age and other risk factors are poor overall health, anemia, malnutrition, underlying medical or neurologic illness etc. [11] If we critically analyze these factors we can infer that each of these will deteriorate general condition of the patient and so even slight bleeding can produce fatal results in such persons. [Verse No.10-11]
*''Kushta'' literally means discoloration, disgrace, disfiguration of the normal skin texture. From above verse it can be inferred that here ''kushta'' wound refers to non healing ulcers of leprosy. Leprosy is a chronic infectious disease caused by Mycobacterium Leprae, the only pathogenic bacteria able to infect peripheral nerves. About 30% of people with leprosy develop nerve damage. Neural impairment results in a set of sensitive, motor and autonomic disturbances, with ulcers originating primarily on the hands and feet. Neuropathic ulcers are one of the most common squeal of leprosy, but little is known about their clinical and epidemiological aspects. [12] If wounds are occurring before change in normal texture of skin it shows that wounds are occurring in prodromal stage and sensory loss has occurred till this stage and so slight injuries are resulting into wound formation. Such condition will lead to late diagnosis and hence chances of recovery will be minimal. [Verse No.14-15]
*Symptoms mentioned above in prodromal symptoms of ''unmada'' are negative symptoms and so there are chances of more suicidal tendency which is a major cause of death in ''unmada''. The presence and duration of prodromal symptoms may predict outcome in schizophrenia, that is, long duration of prodromal symptoms may be indicative of poor prognosis. [14]
*Aura are common in seizures of occipital or temporal lobe origin in patients with focal epileptic seizures. [15] Patients with refractory temporal lobe epilepsy (TLE) have an increased risk of sudden death that is 50 times greater than that in the general population. So if hallucinations are present in epilepsy they indicate grave prognosis. [Verse No.18-23]
*As mentioned earlier dreams are replica of mind and such kinds of dream represents weak and feeble mental status which is not strong enough to fight diseases properly. So if such dreams are frequently seen by patients they will have poor rate of recovery as compared to patient with strong mind and will power. [Verse No.27-40]
*In modern era, during late 19th century, psychotherapist Sigmund Freud gave emphasis on dream connection with mind in his famous book ‘The interpretation of dreams’. He developed a theory that the content of dreams is driven by unconscious wish fulfillment. [16] Presently dream is defined as successions of images, ideas, emotions, and sensations that occur involuntarily in the mind during certain stages of sleep. [17] Description of ''manovaha srotas'' in pathogenesis of dream shows that role of mind in producing dreams was known in ancient times.
*Various studies have established link between REM sleep and dreaming. [18] Poly somnograms show brainwave patterns in REM to be similar to that recorded during wakefulness. Intense dreaming occurs during REM sleep as a result of heightened brain activity. This proves that observations noted by ancient Ayurvedic seers related to pathogenesis of dream are minute and correct. [Verse No.41-42]
*As mentioned above dreams more or less depict unconsciousness state. Freud called dreams the "royal road to the unconscious”. They are related to activities which we have seen, listened, wished, thought etc. Based on this fact seven types of dream have been classified here. Five of them are mild as they are more near to events which we encounter in day to day life. Last two have fatal consequences as they are due to disease or ''dosha'' involvement. [Verse No.43]
*It is difficult to predict dream consequences on the basis of time or order in which they were seen. Researches are needed to scientifically prove the validity of such dream prediction. [Verse No.44-46]

=== References ===

#Torres-Bugarín O, Zavala-Cerna MG, Nava A, Flores-García A, Ramos-Ibarra ML. Potential Uses, Limitations, and Basic Procedures of Micronuclei and Nuclear Abnormalities in Buccal Cells. Disease Markers. 2014;2014:956835.
#Pradeep Sahu et al, Biomarkers: An Emerging Tool for Diagnosis of a Disease and Drug Development, Asian J. Res. Pharm. Sci. 2011; Vol. 1: Issue 1, Pg 09-16
#Sonali S. Tendulkar and R. R. Dwivedi, ‘Swapna’ in the Indian classics: Mythology or science?,Ayu. 2010 Apr-Jun; 31(2): 170–174.
#Jeannette Y. Wick; Guido R. Zann, Drugs and Dreams, J Am Pharm Assoc (2003) 2002;42:385-390.
#Jessica D. Payne, Lynn Nadel, Sleep, dreams, and memory consolidation: The role of the stress hormone cortisol, Learning Memory 2004 November; 11(6): 671–678.
#J. F. Pagel, Carol Kwiatkowski, The Nightmares of Sleep Apnea: Nightmare Frequency Declines with Increasing Apnea Hypopnea Index, J Clin Sleep Med. 2010 February 15; 6(1): 69–73.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 165.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 28.
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Chapter 203.
#Waqas Wahid Baig et al., Spontaneous Cerebrospinal Fluid Rhinorrhea with Pneumocephalus: An Unusual Manifestation of Nasal Tuberculosis, Korean J Intern Med. 2012 September; 27(3): 350–352
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc,chapter 26
#Josafá G Barreto, Claudio G Salgado, Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial, BMC Infect Dis. 2010; 10: 237
#Harrison’s-Principles of Internal Medicine-17th edition, The McGraw-Hill Companies, Inc, , Diabetes mellitus Chapter 338.
#Chapman, L.J.; Day, D.; and Burstein, A. The process-reactive distinction and prognosis in schizophrenia. Journal of Nervous and Mental Disease, 133:383-391, 1961.
#Christian G. Bien, Felix O. Benninger, Horst Urbach, Johannes Schramm, Martin Kurthen, Christian E. Elger, Localizing value of epileptic visual auras Brain (2000) 123 (2): 244-253.
#Stone MH,Dream analysis in the psychodynamic psychotherapy of borderline patients, Psychodyn Psychiatry. 2012 Jun;40(2):287-302.
#Dream, The American Heritage Dictionary of the English Language, Fourth Edition. 2000. Retrieved May 7, 2009.
#Klemm WR. Why Does Rem Sleep Occur? A Wake-Up Hypothesis. Frontiers in Systems Neuroscience. 2011;5:73.

File:Swapnabhead.png

2017-12-26T05:55:29Z

Vinay Exafluence: swapnabhead

swapnabhead

Indriyaneeka

2017-12-26T05:46:51Z

Vinay Exafluence: /* Introduction/ Vishayanupravesha */

{{Infobox
|title = Indriyaneeka
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 4
|label2 = Preceding Chapter
|data2 = [[Parimarshaneeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 4 ==

=== Abstract ===
<div style="text-align:justify;">
This chapter explicates about the alterations in the perception of the five sense organs which reveal impending death of an individual. The previous three chapters described ''arishta lakshanas'' as perceived by senses vision, sound, taste and touch. This chapter describes ''arishta lakshanas'' as perceived by all five ''Indriya'' or senses. ''Indriya'' and ''aneekam'' indicate the group of all five sense organs. There is a good synchrony between all sense organs for conversion of information into the knowledge.

'''Keywords''': Perceptions, alterations, fatal signs of senses.
</div>
=== Introduction/ ''Vishayanupravesha'' ===
<div style="text-align:justify;">
The perception by the sense organs has been described in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] to be a function of the conjunction of ''mana'' (mind) with the ''atman'' (soul), the sense organs (''indriya'') and its subject (''indriyartha'') (Figure 1.)<br>
[[File:organs as per Ayurveda.png]]<br>
Fig. 1 – Showing the chart of perception by the sense organs as per [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]

The correct perception has been described to be the function of ''mana'' and ''vata''. ''Vata'' is the entity which joins the ''mana'' and the above stated three other components. The functions of ''mana'' and ''vata'' account for in the modern medical sciences to that of the nervous system and its components.

Perception by the sense organs occurs through conduction by the peripheral nerves to the brain. Some of the sensory ''arishta'' perceptions described in this chapter are now also described in the modern medical science. The conditions due to defect in the nervous system and peripheral nerves such as Dysosmia (Distorted identification of smell), Parosmia (Altered perception of smell in the presence of an odor, usually unpleasant), Phantosmia (detection of smells which are not present), Ageusia (Inability to taste), Dysgeusia (Distorted ability to taste), paraesthesias (altered tactile perception) etc.. Some of these are described in this chapter as an indicator of forthcoming death.
</div>

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

इन्द्रियानीकेन्द्रियोपक्रमः
अथात इन्द्रियानीकमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athāta indriyānīkamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAta indriyAnIkamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we will explicate the chapter highlighting the features of imminent death by faulty perceptions of sense organs of a person.[1-2]

इन्द्रियाणि यथा जन्तोः परीक्षेत विशेषवित्|
ज्ञातुमिच्छन् भिषङ्मानमायुषस्तन्निबोधत ||३||

अनुमानात् परीक्षेत दर्शनादीनि तत्त्वतः|
अद्धा हि विदितं ज्ञानमिन्द्रियाणामतीन्द्रियम्||४||

indriyāṇi yathā jantōḥ parīkṣēta viśēṣavit|
jñātumicchan bhiṣaṅmānamāyuṣastannibōdhata ||3||

anumānāt parīkṣēta darśanādīni tattvataḥ|
addhā hi viditaṁ jñānamindriyāṇāmatīndriyam||4||

indriyANi yathA jantoH parIkSheta visheShavit|
j~jAtumicchan bhiSha~gmAnamAyuShastannibodhata ||3||

anumAnAt parIkSheta darshanAdIni tattvataH|
addhA hi viditaM j~jAnamindriyANAmatIndriyam||4||
<div style="text-align:justify;">
We will now explain how an expert physician who is desirous to know the life span of the person. He should go with keen observations of the sensory perceptions by a patient. Some of the observations may be based on the inference on questioning, where the physician cannot apply his senses such as taste and visual alterations. [3-4]
</div>
स्वस्थेभ्यो विकृतं यस्य ज्ञानमिन्द्रियसंश्रयम् |
आलक्ष्येतानिमित्तेन लक्षणं मरणस्य तत्||५||

इत्युक्तं लक्षणं सम्यगिन्द्रियेष्वशुभोदयम्|
तदेव तु पुनर्भूयो विस्तरेण निबोधत||६||

svasthēbhyō vikr̥taṁ yasya jñānamindriyasaṁśrayam |
ālakṣyētānimittēna lakṣaṇaṁ maraṇasya tat||5||

ityuktaṁ lakṣaṇaṁ samyagindriyēṣvaśubhōdayam|
tadēva tu punarbhūyō vistarēṇa nibōdhata||6||

svasthebhyo vikRutaM yasya j~jAnamindriyasaMshrayam [1] |
AlakShyetAnimittena lakShaNaM maraNasya tat||5||

ityuktaM lakShaNaM samyagindriyeShvashubhodayam|
tadeva tu punarbhUyo vistareNa nibodhata||6||

In case where patient’s sense organs are healthy and even they perceive the altered sense without any apparent cause, denote the cause of imminent death. Other general and specific altered sensory perceptions will be dealt in detail in subsequent paragraphs.[5-6]

घनीभूतमिवाकाशमाकाशमिव मेदिनीम्|
विगीतमुभयं ह्येतत् पश्यन् मरणमृच्छति||७||

ghanībhūtamivākāśamākāśamiva mēdinīm|
vigītamubhayaṁ hyētat paśyan maraṇamr̥cchati||7||

ghanIbhUtamivAkAshamAkAshamiva medinIm|
vigItamubhayaM hyetat pashyan maraNamRucchati||7||

A person who views the sky as something solid (like the earth) and the earth like something void (like the sky), he is sure to die soon as both the above signs are inauspicious. [7]

यस्य दर्शनमायाति मारुतोऽम्बरगोचरः|
अग्निर्नायाति चादीप्तस्तस्यायुःक्षयमादिशेत्||८||

yasya darśanamāyāti mārutō'mbaragōcaraḥ|
agnirnāyāti cādīptastasyāyuḥkṣayamādiśēt||8||

yasya darshanamAyAti mAruto~ambaragocaraH|
agnirnAyAti cAdIptastasyAyuHkShayamAdishet||8||

One who visualizes the wind in the sky in a physical form but does not see the flame of a kindled fire, should be considered as a moribund person. [8]

जले सुविमले जालमजालावतते नरः|
स्थिते गच्छति वा दृष्ट्वा जीवितात् परिमुच्यते||९||

jalē suvimalē jālamajālāvatatē naraḥ|
sthitē gacchati vā dr̥ṣṭvā jīvitāt parimucyatē||9||

jale suvimale jAlamajAlAvatate naraH|
sthite gacchati vA dRuShTvA jIvitAt parimucyate||9|

A person if visualises net like appearance in clean water either stagnant or moving one, when actually there is no such net, then it constitutes the premonitory symptom of forthcoming death. [9]

जाग्रत् पश्यति यः प्रेतान् रक्षांसि विविधानि च|
अन्यद्वाऽप्यद्भुतं किञ्चिन्न स जीवितुमर्हति||१०||

jāgrat paśyati yaḥ prētān rakṣāṁsi vividhāni ca|
anyadvā'pyadbhutaṁ kiñcinna sa jīvitumarhati||10||

jAgrat pashyati yaH pretAn rakShAMsi vividhAni ca|
anyadvA~apyadbhutaM ki~jcinna sa jIvitumarhati||10||

If a person when awake, perceives various kinds of ''pretas'' (ghosts) and ''rakshasas'' (demons) or any other supernatural creatures he will not survive for long. [10]

योऽग्निं प्रकृतिवर्णस्थं नीलं पश्यति निष्प्रभम्|
कृष्णं वा यदि वा शुक्लं निशां व्रजति सप्तमीम्||११||

yō'gniṁ prakr̥tivarṇasthaṁ nīlaṁ paśyati niṣprabham|
kr̥ṣṇaṁ vā yadi vā śuklaṁ niśāṁ vrajati saptamīm||11||

yo~agniM prakRutivarNasthaM nIlaM pashyati niShprabham|
kRuShNaM vA yadi vA shuklaM nishAM vrajati saptamIm||11||

If a person perceives fire burning in its natural color but is lusterless, bluish, black or white, it is indicative of death of the patient after seven nights.[11]

मरीचीनसतो मेघान्मेघान् वाऽप्यसतोऽम्बरे|
विद्युतो वा विना मेघैः पश्यन् मरणमृच्छति||१२||

marīcīnasatō mēghānmēghān vā'pyasatō'mbarē|
vidyutō vā vinā mēghaiḥ paśyan maraṇamr̥cchati||12||

marIcInasato meghAnmeghAn vA~apyasato~ambare|
vidyuto vA vinA meghaiH pashyan maraNamRucchati||12||

If a person visualizes ''marῑchi'' (cloud light) or cloud or lightening when there is such no cloud or lightening present in the sky, it is indicative of imminent death of the person. [12]

मृन्मयीमिव यः पात्रीं कृष्णाम्बरसमावृताम्|
आदित्यमीक्षते शुद्धं चन्द्रं वा न स जीवति||१३||

अपर्वणि यदा पश्येत् सूर्याचन्द्रमसोर्ग्रहम्|
अव्याधितो व्याधितो वा तदन्तं तस्य जीवितम्||१४||

नक्तं सूर्यमहश्चन्द्रमनग्नौ धूममुत्थितम्|
अग्निं वा निष्प्रभं रात्रौ दृष्ट्वा मरणमृच्छति||१५||

प्रभावतः प्रभाहीनान्निष्प्रभांश्च प्रभावतः|
नरा विलिङ्गान् पश्यन्ति भावान् भावाञ्जिहासवः [३] ||१६||

व्याकृतीनि विवर्णानि विसङ्ख्योपगतानि च|
विनिमित्तानि पश्यन्ति रूपाण्यायुःक्षये नराः||१७||

यश्च पश्यत्यदृश्यान् वै दृश्यान् यश्च न पश्यति|
तावुभौ पश्यतः क्षिप्रं यमक्षयमसंशयम्||१८||

mr̥nmayīmiva yaḥ pātrīṁ kr̥ṣṇāmbarasamāvr̥tām|
ādityamīkṣatē śuddhaṁ candraṁ vā na sa jīvati||13||

aparvaṇi yadā paśyēt sūryācandramasōrgraham|
avyādhitō vyādhitō vā tadantaṁ tasya jīvitam||14||

naktaṁ sūryamahaścandramanagnau dhūmamutthitam|
agniṁ vā niṣprabhaṁ rātrau dr̥ṣṭvā maraṇamr̥cchati||15||

prabhāvataḥ prabhāhīnānniṣprabhāṁśca prabhāvataḥ|
narā viliṅgān paśyanti bhāvān bhāvāñjihāsavaḥ ||16||

vyākr̥tīni vivarṇāni visaṅkhyōpagatāni ca|
vinimittāni paśyanti rūpāṇyāyuḥkṣayē narāḥ||17||

yaśca paśyatyadr̥śyān vai dr̥śyān yaśca na paśyati|
tāvubhau paśyataḥ kṣipraṁ yamakṣayamasaṁśayam||18||

mRunmayImiva yaH pAtrIM kRuShNAmbarasamAvRutAm|
AdityamIkShate shuddhaM candraM vA na sa jIvati||13||

aparvaNi yadA pashyet sUryAcandramasorgraham|
avyAdhito vyAdhito vA tadantaM tasya jIvitam||14||

naktaM sUryamahashcandramanagnau dhUmamutthitam|
agniMvA niShprabhaM rAtrau dRuShTvA maraNamRucchati|15||

prabhAvataH prabhAhInAnniShprabhAMshca prabhAvataH|
narA vili~ggAn pashyanti bhAvAn bhAvA~jjihAsavaH ||16||

vyAkRutIni vivarNAni visa~gkhyopagatAni ca|
vinimittAni pashyanti rUpANyAyuHkShaye narAH||17||

yashca pashyatyadRushyAn vai dRushyAn yashca na pashyati|
tAvubhau pashyataH kShipraM yamakShayamasaMshayam||18||
<div style="text-align:justify;">
Here in these verses are further described some symptoms which when present indicate imminent death of the person –
*To see the sun or the moon painted or fixed on an earthen plate covered with a black cloth;
*To see solar or lunar eclipse when there is no such occasion.
*To see the sun at night, moon in the day, the smoke when there is no fire or to perceive fire without flame at night
*Appearance of bright things without luster and the ones having no luster as bright i.e. unable to view real or actual characteristics.
*To have visual perception of things in a distorted manner i.e. to visualize things as having multiple forms, devoid of complexion and in inaccurate numbers without any reason and
*To visualize the invisible ones and not to visualize the visible ones.[13-18]
</div>
अशब्दस्य च यः श्रोता शब्दान् यश्च न बुध्यते|
द्वावप्येतौ यथा प्रेतौ तथा ज्ञेयौ विजानता ||१९||

संवृत्याङ्गुलिभिः कर्णौ ज्वालाशब्दं य आतुरः|
न शृणोति गतासुं तं बुद्धिमान् परिवर्जयेत्||२०||

aśabdasya ca yaḥ śrōtā śabdān yaśca na budhyatē|
dvāvapyētau yathā prētau tathā jñēyau vijānatā ||19||

saṁvr̥tyāṅgulibhiḥ karṇau jvālāśabdaṁ ya āturaḥ|
na śr̥ṇōti gatāsuṁ taṁ buddhimān parivarjayēt||20||

ashabdasya ca yaH shrotA shabdAn yashca na budhyate|
dvAvapyetau yathA pretau tathA j~jeyau vijAnatA ||19||

saMvRutyA~ggulibhiH karNau jvAlAshabdaM ya AturaH|
na shRuNoti gatAsuM taM buddhimAn parivarjayet||20||

A person who hears the inaudible sounds and doesn’t hear the audible ones; and the one who is unable to hear the internal (stellar) sound after closing the ear with fingers is sure to die hence a knowledgeable physician should not engage in treating him.[19-20]

विपर्ययेण यो विद्याद्गन्धानां साध्वसाधुताम्|
न वा तान् सर्वशो विद्यात्तं विद्याद्विगतायुषम्||२१||

viparyayēṇa yō vidyādgandhānāṁ sādhvasādhutām|
na vā tān sarvaśō vidyāttaṁ vidyādvigatāyuṣam||21||

viparyayeNa yo vidyAdgandhAnAM sAdhvasAdhutAm|
na vA tAn sarvasho vidyAttaM vidyAdvigatAyuSham||21||

If a person fails to distinguish between good and bad smells or is not responsive to any smells at all, he is to be considered as a moribund person.[21]

यो रसान्न विजानाति न वा जानाति तत्त्वतः|
मुखपाकादृते पक्वं तमाहुः कुशला नरम्||२२||

yō rasānna vijānāti na vā jānāti tattvataḥ|
mukhapākādr̥tē pakvaṁ tamāhuḥ kuśalā naram||22||

yo rasAnna vijAnAti na vA jAnAti tattvataH|
mukhapAkAdRute pakvaM tamAhuH kushalA naram||22||

A person who is not able to detect the various gustatory sensations at all or has altered gustatory perception despite having no mouth ulcers or inflammation in the mouth; should also be considered ripe for death. [22]

उष्णाञ्छीतान् खराञ्छ्लक्ष्णान्मृदूनपि च दारुणान्|
स्पृश्यान् स्पृष्ट्वा ततोऽन्यत्वं मुमूर्षुस्तेषु मन्यते||२३||

uṣṇāñchītān kharāñchlakṣṇānmr̥dūnapi ca dāruṇān|
spr̥śyān spr̥ṣṭvā tatō'nyatvaṁ mumūrṣustēṣu manyatē||23||

uShNA~jchItAn kharA~jchlakShNAnmRudUnapi ca dAruNAn|
spRushyAn spRuShTvA tato~anyatvaM mumUrShusteShumanyate||23||

If a person perceives hot things as cold, coarseness as smoothness, softness as hardness and vice- versa by touch, he should also be considered as moribund person.[23]

अन्तरेण तपस्तीव्रं योगं वा विधिपूर्वकम्|
इन्द्रियैरधिकं पश्यन् पञ्चत्वमधिगच्छति||२४||

इन्द्रियाणामृते दृष्टेरिन्द्रियार्थानदोषजान्|
नरः पश्यति यः कश्चिदिन्द्रियैर्न स जीवति||२५||

antarēṇa tapastīvraṁ yōgaṁ vā vidhipūrvakam|
indriyairadhikaṁ paśyan पञ्चत्वमpañcatvamadhigacchati||24||

indriyāṇāmr̥tē dr̥ṣṭērindriyārthānadōṣajān|
naraḥ paśyati yaḥ kaścidindriyairna sa jīvati||25||

antareNa tapastIvraM yogaM vA vidhipUrvakam|
indriyairadhikaM pashyan pa~jcatvamadhigacchati||24||

indriyANAmRute dRuShTerindriyArthAnadoShajAn|
naraH pashyati yaH kashcidindriyairna sa jIvati||25||

If a person starts having the perception of supernatural things without being preceded by severe ascetic practices or penance or by means of ''yogic'' practices, it is indicative of imminent death. [25]

aस्वस्थाः प्रज्ञाविपर्यासैरिन्द्रियार्थेषु वैकृतम्|
पश्यन्ति येऽसद्बहुशस्तेषां [१] मरणमादिशेत्||२६||

asvasthāḥ prajñāviparyāsairindriyārthēṣu vaikr̥tam|
paśyanti yē'sadbahuśastēṣāṁ [1] maraṇamādiśēt||26||

svasthAH praj~jAviparyAsairindriyArtheShu vaikRutam|
pashyanti ye~asadbahushasteShAM [1] maraNamAdishet||26||

If an otherwise healthy person starts perceiving things wrongly in contradiction to the normal relationship between the sense organs and their subjects as a result of mental perversion is sure to die soon. [26]

तत्र श्लोकः-
एतदिन्द्रियविज्ञानं यः पश्यति यथातथम्|
मरणं जीवितं चैव स भिषक् ज्ञातुमर्हति||२७||

tatra ślōkaḥ-
ētadindriyavijñānaṁ yaḥ paśyati yathātatham|
maraṇaṁ jīvitaṁ caiva sa bhiṣak jñātumarhati||27||

tatra shlokaH-
etadindriyavij~jAnaM yaH pashyati yathAtatham|
maraNaM jIvitaM caiva sa bhiShak j~jAtumarhati||27||
<div style="text-align:justify;">
To conclude, it can be said that a physician who knows the science of premonition of death as indicated by the characteristic features of the sense organs can very easily distinguish between life and death.[27]

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

''Indriya'' (sense organs) and their connection with mind to perceive the right object is important for health. If this is severely altered, then ''arishta'' (near death signs) are observed as wrong perceptions.

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

Normally all senses are specific for a special purpose. One cannot be a replaced by another. Usually there is a good synchrony seen during functioning of sensory organs.

''Achara rasayana'' (Code and conduct of society): A child and his ''indriya'' start getting trained according to codes and conducts of the society soon after birth and grow in that society normally and there is continued training throughout life. ''Pragyaparadha'' (intellectual errors) leads to altered behavior by false and uncontrolled perception by ''indriya'' or senses, this can also occur because of alcohol, substance abuse or mental illness etc. If there is no known cause for the altered behavior then it can be called ''arishta'' and has been considered as a sign of fatality.

This chapter deals about the various perversions of the perception of the sensory organs. All these symptoms resemble the manifestations also seen in psychiatric conditions. It is important to keep in mind that ''arishta lakshana'' should be considered after excluding known conditions causing such symptoms, then only they should be valued as a tool to gauge span of life.

=== Glossary ===

#''Ateendriya'' (atIndriya; अतीन्द्रिय): beyond the boundary of perception by sense organs
#''Ghanibhuta'' (ghanIbhUta; घनीभूत): solid in nature
#''Panchatvam'' (pañcatvama; पञ्चत्वम): to dissociate into the five ''mahabhutas'' as happens after death, the body decomposes/ to die
#''Medinim'' (mēdinīm; मेदिनीम्): the earth
#''Marichi'' (marIcI; मरीची): cloud light
#''Mrin mayeem'' (mRunmayIm; मृन्मयीम); earthern pot
</div>

File:Organs as per Ayurveda.png

2017-12-26T05:44:59Z

Vinay Exafluence: organs as per Ayurveda

organs as per Ayurveda

Indriyaneeka

2017-12-26T05:29:43Z

Vinay Exafluence: /* Indriya Sthana Chapter 4 */

{{Infobox
|title = Indriyaneeka
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 4
|label2 = Preceding Chapter
|data2 = [[Parimarshaneeya]]

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 4 ==

=== Abstract ===
<div style="text-align:justify;">
This chapter explicates about the alterations in the perception of the five sense organs which reveal impending death of an individual. The previous three chapters described ''arishta lakshanas'' as perceived by senses vision, sound, taste and touch. This chapter describes ''arishta lakshanas'' as perceived by all five ''Indriya'' or senses. ''Indriya'' and ''aneekam'' indicate the group of all five sense organs. There is a good synchrony between all sense organs for conversion of information into the knowledge.

'''Keywords''': Perceptions, alterations, fatal signs of senses.
</div>
=== Introduction/ ''Vishayanupravesha'' ===
<div style="text-align:justify;">
The perception by the sense organs has been described in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] to be a function of the conjunction of ''mana'' (mind) with the ''atman'' (soul), the sense organs (''indriya'') and its subject (''indriyartha'') (Figure 1.)

Fig. 1 – Showing the chart of perception by the sense organs as per [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]

The correct perception has been described to be the function of ''mana'' and ''vata''. ''Vata'' is the entity which joins the ''mana'' and the above stated three other components. The functions of ''mana'' and ''vata'' account for in the modern medical sciences to that of the nervous system and its components.

Perception by the sense organs occurs through conduction by the peripheral nerves to the brain. Some of the sensory ''arishta'' perceptions described in this chapter are now also described in the modern medical science. The conditions due to defect in the nervous system and peripheral nerves such as Dysosmia (Distorted identification of smell), Parosmia (Altered perception of smell in the presence of an odor, usually unpleasant), Phantosmia (detection of smells which are not present), Ageusia (Inability to taste), Dysgeusia (Distorted ability to taste), paraesthesias (altered tactile perception) etc.. Some of these are described in this chapter as an indicator of forthcoming death.
</div>
===Sanskrit text, Transliteration and English Translation===

इन्द्रियानीकेन्द्रियोपक्रमः
अथात इन्द्रियानीकमिन्द्रियं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athāta indriyānīkamindriyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAta indriyAnIkamindriyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we will explicate the chapter highlighting the features of imminent death by faulty perceptions of sense organs of a person.[1-2]

इन्द्रियाणि यथा जन्तोः परीक्षेत विशेषवित्|
ज्ञातुमिच्छन् भिषङ्मानमायुषस्तन्निबोधत ||३||

अनुमानात् परीक्षेत दर्शनादीनि तत्त्वतः|
अद्धा हि विदितं ज्ञानमिन्द्रियाणामतीन्द्रियम्||४||

indriyāṇi yathā jantōḥ parīkṣēta viśēṣavit|
jñātumicchan bhiṣaṅmānamāyuṣastannibōdhata ||3||

anumānāt parīkṣēta darśanādīni tattvataḥ|
addhā hi viditaṁ jñānamindriyāṇāmatīndriyam||4||

indriyANi yathA jantoH parIkSheta visheShavit|
j~jAtumicchan bhiSha~gmAnamAyuShastannibodhata ||3||

anumAnAt parIkSheta darshanAdIni tattvataH|
addhA hi viditaM j~jAnamindriyANAmatIndriyam||4||
<div style="text-align:justify;">
We will now explain how an expert physician who is desirous to know the life span of the person. He should go with keen observations of the sensory perceptions by a patient. Some of the observations may be based on the inference on questioning, where the physician cannot apply his senses such as taste and visual alterations. [3-4]
</div>
स्वस्थेभ्यो विकृतं यस्य ज्ञानमिन्द्रियसंश्रयम् |
आलक्ष्येतानिमित्तेन लक्षणं मरणस्य तत्||५||

इत्युक्तं लक्षणं सम्यगिन्द्रियेष्वशुभोदयम्|
तदेव तु पुनर्भूयो विस्तरेण निबोधत||६||

svasthēbhyō vikr̥taṁ yasya jñānamindriyasaṁśrayam |
ālakṣyētānimittēna lakṣaṇaṁ maraṇasya tat||5||

ityuktaṁ lakṣaṇaṁ samyagindriyēṣvaśubhōdayam|
tadēva tu punarbhūyō vistarēṇa nibōdhata||6||

svasthebhyo vikRutaM yasya j~jAnamindriyasaMshrayam [1] |
AlakShyetAnimittena lakShaNaM maraNasya tat||5||

ityuktaM lakShaNaM samyagindriyeShvashubhodayam|
tadeva tu punarbhUyo vistareNa nibodhata||6||

In case where patient’s sense organs are healthy and even they perceive the altered sense without any apparent cause, denote the cause of imminent death. Other general and specific altered sensory perceptions will be dealt in detail in subsequent paragraphs.[5-6]

घनीभूतमिवाकाशमाकाशमिव मेदिनीम्|
विगीतमुभयं ह्येतत् पश्यन् मरणमृच्छति||७||

ghanībhūtamivākāśamākāśamiva mēdinīm|
vigītamubhayaṁ hyētat paśyan maraṇamr̥cchati||7||

ghanIbhUtamivAkAshamAkAshamiva medinIm|
vigItamubhayaM hyetat pashyan maraNamRucchati||7||

A person who views the sky as something solid (like the earth) and the earth like something void (like the sky), he is sure to die soon as both the above signs are inauspicious. [7]

यस्य दर्शनमायाति मारुतोऽम्बरगोचरः|
अग्निर्नायाति चादीप्तस्तस्यायुःक्षयमादिशेत्||८||

yasya darśanamāyāti mārutō'mbaragōcaraḥ|
agnirnāyāti cādīptastasyāyuḥkṣayamādiśēt||8||

yasya darshanamAyAti mAruto~ambaragocaraH|
agnirnAyAti cAdIptastasyAyuHkShayamAdishet||8||

One who visualizes the wind in the sky in a physical form but does not see the flame of a kindled fire, should be considered as a moribund person. [8]

जले सुविमले जालमजालावतते नरः|
स्थिते गच्छति वा दृष्ट्वा जीवितात् परिमुच्यते||९||

jalē suvimalē jālamajālāvatatē naraḥ|
sthitē gacchati vā dr̥ṣṭvā jīvitāt parimucyatē||9||

jale suvimale jAlamajAlAvatate naraH|
sthite gacchati vA dRuShTvA jIvitAt parimucyate||9|

A person if visualises net like appearance in clean water either stagnant or moving one, when actually there is no such net, then it constitutes the premonitory symptom of forthcoming death. [9]

जाग्रत् पश्यति यः प्रेतान् रक्षांसि विविधानि च|
अन्यद्वाऽप्यद्भुतं किञ्चिन्न स जीवितुमर्हति||१०||

jāgrat paśyati yaḥ prētān rakṣāṁsi vividhāni ca|
anyadvā'pyadbhutaṁ kiñcinna sa jīvitumarhati||10||

jAgrat pashyati yaH pretAn rakShAMsi vividhAni ca|
anyadvA~apyadbhutaM ki~jcinna sa jIvitumarhati||10||

If a person when awake, perceives various kinds of ''pretas'' (ghosts) and ''rakshasas'' (demons) or any other supernatural creatures he will not survive for long. [10]

योऽग्निं प्रकृतिवर्णस्थं नीलं पश्यति निष्प्रभम्|
कृष्णं वा यदि वा शुक्लं निशां व्रजति सप्तमीम्||११||

yō'gniṁ prakr̥tivarṇasthaṁ nīlaṁ paśyati niṣprabham|
kr̥ṣṇaṁ vā yadi vā śuklaṁ niśāṁ vrajati saptamīm||11||

yo~agniM prakRutivarNasthaM nIlaM pashyati niShprabham|
kRuShNaM vA yadi vA shuklaM nishAM vrajati saptamIm||11||

If a person perceives fire burning in its natural color but is lusterless, bluish, black or white, it is indicative of death of the patient after seven nights.[11]

मरीचीनसतो मेघान्मेघान् वाऽप्यसतोऽम्बरे|
विद्युतो वा विना मेघैः पश्यन् मरणमृच्छति||१२||

marīcīnasatō mēghānmēghān vā'pyasatō'mbarē|
vidyutō vā vinā mēghaiḥ paśyan maraṇamr̥cchati||12||

marIcInasato meghAnmeghAn vA~apyasato~ambare|
vidyuto vA vinA meghaiH pashyan maraNamRucchati||12||

If a person visualizes ''marῑchi'' (cloud light) or cloud or lightening when there is such no cloud or lightening present in the sky, it is indicative of imminent death of the person. [12]

मृन्मयीमिव यः पात्रीं कृष्णाम्बरसमावृताम्|
आदित्यमीक्षते शुद्धं चन्द्रं वा न स जीवति||१३||

अपर्वणि यदा पश्येत् सूर्याचन्द्रमसोर्ग्रहम्|
अव्याधितो व्याधितो वा तदन्तं तस्य जीवितम्||१४||

नक्तं सूर्यमहश्चन्द्रमनग्नौ धूममुत्थितम्|
अग्निं वा निष्प्रभं रात्रौ दृष्ट्वा मरणमृच्छति||१५||

प्रभावतः प्रभाहीनान्निष्प्रभांश्च प्रभावतः|
नरा विलिङ्गान् पश्यन्ति भावान् भावाञ्जिहासवः [३] ||१६||

व्याकृतीनि विवर्णानि विसङ्ख्योपगतानि च|
विनिमित्तानि पश्यन्ति रूपाण्यायुःक्षये नराः||१७||

यश्च पश्यत्यदृश्यान् वै दृश्यान् यश्च न पश्यति|
तावुभौ पश्यतः क्षिप्रं यमक्षयमसंशयम्||१८||

mr̥nmayīmiva yaḥ pātrīṁ kr̥ṣṇāmbarasamāvr̥tām|
ādityamīkṣatē śuddhaṁ candraṁ vā na sa jīvati||13||

aparvaṇi yadā paśyēt sūryācandramasōrgraham|
avyādhitō vyādhitō vā tadantaṁ tasya jīvitam||14||

naktaṁ sūryamahaścandramanagnau dhūmamutthitam|
agniṁ vā niṣprabhaṁ rātrau dr̥ṣṭvā maraṇamr̥cchati||15||

prabhāvataḥ prabhāhīnānniṣprabhāṁśca prabhāvataḥ|
narā viliṅgān paśyanti bhāvān bhāvāñjihāsavaḥ ||16||

vyākr̥tīni vivarṇāni visaṅkhyōpagatāni ca|
vinimittāni paśyanti rūpāṇyāyuḥkṣayē narāḥ||17||

yaśca paśyatyadr̥śyān vai dr̥śyān yaśca na paśyati|
tāvubhau paśyataḥ kṣipraṁ yamakṣayamasaṁśayam||18||

mRunmayImiva yaH pAtrIM kRuShNAmbarasamAvRutAm|
AdityamIkShate shuddhaM candraM vA na sa jIvati||13||

aparvaNi yadA pashyet sUryAcandramasorgraham|
avyAdhito vyAdhito vA tadantaM tasya jIvitam||14||

naktaM sUryamahashcandramanagnau dhUmamutthitam|
agniMvA niShprabhaM rAtrau dRuShTvA maraNamRucchati|15||

prabhAvataH prabhAhInAnniShprabhAMshca prabhAvataH|
narA vili~ggAn pashyanti bhAvAn bhAvA~jjihAsavaH ||16||

vyAkRutIni vivarNAni visa~gkhyopagatAni ca|
vinimittAni pashyanti rUpANyAyuHkShaye narAH||17||

yashca pashyatyadRushyAn vai dRushyAn yashca na pashyati|
tAvubhau pashyataH kShipraM yamakShayamasaMshayam||18||
<div style="text-align:justify;">
Here in these verses are further described some symptoms which when present indicate imminent death of the person –
*To see the sun or the moon painted or fixed on an earthen plate covered with a black cloth;
*To see solar or lunar eclipse when there is no such occasion.
*To see the sun at night, moon in the day, the smoke when there is no fire or to perceive fire without flame at night
*Appearance of bright things without luster and the ones having no luster as bright i.e. unable to view real or actual characteristics.
*To have visual perception of things in a distorted manner i.e. to visualize things as having multiple forms, devoid of complexion and in inaccurate numbers without any reason and
*To visualize the invisible ones and not to visualize the visible ones.[13-18]
</div>
अशब्दस्य च यः श्रोता शब्दान् यश्च न बुध्यते|
द्वावप्येतौ यथा प्रेतौ तथा ज्ञेयौ विजानता ||१९||

संवृत्याङ्गुलिभिः कर्णौ ज्वालाशब्दं य आतुरः|
न शृणोति गतासुं तं बुद्धिमान् परिवर्जयेत्||२०||

aśabdasya ca yaḥ śrōtā śabdān yaśca na budhyatē|
dvāvapyētau yathā prētau tathā jñēyau vijānatā ||19||

saṁvr̥tyāṅgulibhiḥ karṇau jvālāśabdaṁ ya āturaḥ|
na śr̥ṇōti gatāsuṁ taṁ buddhimān parivarjayēt||20||

ashabdasya ca yaH shrotA shabdAn yashca na budhyate|
dvAvapyetau yathA pretau tathA j~jeyau vijAnatA ||19||

saMvRutyA~ggulibhiH karNau jvAlAshabdaM ya AturaH|
na shRuNoti gatAsuM taM buddhimAn parivarjayet||20||

A person who hears the inaudible sounds and doesn’t hear the audible ones; and the one who is unable to hear the internal (stellar) sound after closing the ear with fingers is sure to die hence a knowledgeable physician should not engage in treating him.[19-20]

विपर्ययेण यो विद्याद्गन्धानां साध्वसाधुताम्|
न वा तान् सर्वशो विद्यात्तं विद्याद्विगतायुषम्||२१||

viparyayēṇa yō vidyādgandhānāṁ sādhvasādhutām|
na vā tān sarvaśō vidyāttaṁ vidyādvigatāyuṣam||21||

viparyayeNa yo vidyAdgandhAnAM sAdhvasAdhutAm|
na vA tAn sarvasho vidyAttaM vidyAdvigatAyuSham||21||

If a person fails to distinguish between good and bad smells or is not responsive to any smells at all, he is to be considered as a moribund person.[21]

यो रसान्न विजानाति न वा जानाति तत्त्वतः|
मुखपाकादृते पक्वं तमाहुः कुशला नरम्||२२||

yō rasānna vijānāti na vā jānāti tattvataḥ|
mukhapākādr̥tē pakvaṁ tamāhuḥ kuśalā naram||22||

yo rasAnna vijAnAti na vA jAnAti tattvataH|
mukhapAkAdRute pakvaM tamAhuH kushalA naram||22||

A person who is not able to detect the various gustatory sensations at all or has altered gustatory perception despite having no mouth ulcers or inflammation in the mouth; should also be considered ripe for death. [22]

उष्णाञ्छीतान् खराञ्छ्लक्ष्णान्मृदूनपि च दारुणान्|
स्पृश्यान् स्पृष्ट्वा ततोऽन्यत्वं मुमूर्षुस्तेषु मन्यते||२३||

uṣṇāñchītān kharāñchlakṣṇānmr̥dūnapi ca dāruṇān|
spr̥śyān spr̥ṣṭvā tatō'nyatvaṁ mumūrṣustēṣu manyatē||23||

uShNA~jchItAn kharA~jchlakShNAnmRudUnapi ca dAruNAn|
spRushyAn spRuShTvA tato~anyatvaM mumUrShusteShumanyate||23||

If a person perceives hot things as cold, coarseness as smoothness, softness as hardness and vice- versa by touch, he should also be considered as moribund person.[23]

अन्तरेण तपस्तीव्रं योगं वा विधिपूर्वकम्|
इन्द्रियैरधिकं पश्यन् पञ्चत्वमधिगच्छति||२४||

इन्द्रियाणामृते दृष्टेरिन्द्रियार्थानदोषजान्|
नरः पश्यति यः कश्चिदिन्द्रियैर्न स जीवति||२५||

antarēṇa tapastīvraṁ yōgaṁ vā vidhipūrvakam|
indriyairadhikaṁ paśyan पञ्चत्वमpañcatvamadhigacchati||24||

indriyāṇāmr̥tē dr̥ṣṭērindriyārthānadōṣajān|
naraḥ paśyati yaḥ kaścidindriyairna sa jīvati||25||

antareNa tapastIvraM yogaM vA vidhipUrvakam|
indriyairadhikaM pashyan pa~jcatvamadhigacchati||24||

indriyANAmRute dRuShTerindriyArthAnadoShajAn|
naraH pashyati yaH kashcidindriyairna sa jIvati||25||

If a person starts having the perception of supernatural things without being preceded by severe ascetic practices or penance or by means of ''yogic'' practices, it is indicative of imminent death. [25]

aस्वस्थाः प्रज्ञाविपर्यासैरिन्द्रियार्थेषु वैकृतम्|
पश्यन्ति येऽसद्बहुशस्तेषां [१] मरणमादिशेत्||२६||

asvasthāḥ prajñāviparyāsairindriyārthēṣu vaikr̥tam|
paśyanti yē'sadbahuśastēṣāṁ [1] maraṇamādiśēt||26||

svasthAH praj~jAviparyAsairindriyArtheShu vaikRutam|
pashyanti ye~asadbahushasteShAM [1] maraNamAdishet||26||

If an otherwise healthy person starts perceiving things wrongly in contradiction to the normal relationship between the sense organs and their subjects as a result of mental perversion is sure to die soon. [26]

तत्र श्लोकः-
एतदिन्द्रियविज्ञानं यः पश्यति यथातथम्|
मरणं जीवितं चैव स भिषक् ज्ञातुमर्हति||२७||

tatra ślōkaḥ-
ētadindriyavijñānaṁ yaḥ paśyati yathātatham|
maraṇaṁ jīvitaṁ caiva sa bhiṣak jñātumarhati||27||

tatra shlokaH-
etadindriyavij~jAnaM yaH pashyati yathAtatham|
maraNaM jIvitaM caiva sa bhiShak j~jAtumarhati||27||
<div style="text-align:justify;">
To conclude, it can be said that a physician who knows the science of premonition of death as indicated by the characteristic features of the sense organs can very easily distinguish between life and death.[27]

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

''Indriya'' (sense organs) and their connection with mind to perceive the right object is important for health. If this is severely altered, then ''arishta'' (near death signs) are observed as wrong perceptions.

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

Normally all senses are specific for a special purpose. One cannot be a replaced by another. Usually there is a good synchrony seen during functioning of sensory organs.

''Achara rasayana'' (Code and conduct of society): A child and his ''indriya'' start getting trained according to codes and conducts of the society soon after birth and grow in that society normally and there is continued training throughout life. ''Pragyaparadha'' (intellectual errors) leads to altered behavior by false and uncontrolled perception by ''indriya'' or senses, this can also occur because of alcohol, substance abuse or mental illness etc. If there is no known cause for the altered behavior then it can be called ''arishta'' and has been considered as a sign of fatality.

This chapter deals about the various perversions of the perception of the sensory organs. All these symptoms resemble the manifestations also seen in psychiatric conditions. It is important to keep in mind that ''arishta lakshana'' should be considered after excluding known conditions causing such symptoms, then only they should be valued as a tool to gauge span of life.

=== Glossary ===

#''Ateendriya'' (atIndriya; अतीन्द्रिय): beyond the boundary of perception by sense organs
#''Ghanibhuta'' (ghanIbhUta; घनीभूत): solid in nature
#''Panchatvam'' (pañcatvama; पञ्चत्वम): to dissociate into the five ''mahabhutas'' as happens after death, the body decomposes/ to die
#''Medinim'' (mēdinīm; मेदिनीम्): the earth
#''Marichi'' (marIcI; मरीची): cloud light
#''Mrin mayeem'' (mRunmayIm; मृन्मयीम); earthern pot
</div>

Varnasvariyamindriyam Adhyaya

2017-12-26T05:06:13Z

Vinay Exafluence: /* Indriya Sthana Chapter 1 (Chapter on Arishta Lakshana, or Near Death Signs) */

{{Infobox
|title = Varnasvariyamindriyam Adhyaya
|label1 = Section/Chapter
|data1 = [[Indriya Sthana]] Chapter 1
|label2 = Preceding Chapter
|data2 = None

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

|header3 =

}}
== [[Indriya Sthana]] Chapter 1 (Chapter on ''Arishta Lakshana'', or Near Death Signs) ==

===Abstract ===
<div style="text-align:justify;">
The chapter [[Varnasvariyamindriyam Adhyaya]] is about ''arishta lakshana'' (near death signs) perceived by auditory and visual senses. ''Swara'' (Voice) is an audible feature, whereas color and complexion are visual features. Sudden change in frequency, rhythm, resonance, tone, the pitch of voice and complexion of the body is indicative of serious pathology of the body. The characteristic features of ''arishtas'' are described in the chapter.

'''Keywords''': Near death signs, change in voice, change in complexion.
</div>
===Introduction ===
<div style="text-align:justify;">
Charaka has placed [[Indriya Sthana]] (section about near death signs) before [[Chikitsa Sthana]] (section about the treatment of diseases) possibly, to guide physician when not to treat a patient. In this first chapter of [[Indriya Sthana]], [[Varnasvariyamindriyam Adhyaya]], Charaka mentions near death signs and symptoms that can be directly observed by visual and other faculties. This chapter also describes ''prakriti'', the natural disposition of an individual, and ''vikriti'', or abnormalities , since such knowledge helps in discerning any sign of ''vikriti'' in a "healthy" individual. Three types of morbid conditions are observed namely, ''lakshana nimitta'', caused by bodily marks, ''lakshya nimitta'', caused by etiological factors which disturb the health, and ''nimitta anuroopa vikriti'', a break down for no apparent reason resembling with etiological factors. The chapter describes various near death signs with changes in color, the complexion of body parts and voice.
</div>
===Sanskrit text, Transliteration and English Translation===

वर्णस्वरीयेन्द्रियोपक्रमः
अथातोवर्णस्वरीयमिन्द्रियंव्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||

athātōvarṇasvarīyamindriyaṁvyākhyāsyāmaḥ||1||
itihasmāhabhagavānātrēyaḥ||2||

athAto varNasvarIyamindriyaM vyAkhyAsyAmaH||1||
iti ha smAha bhagavAnAtreyaH||2||

Lord Athreya says, "Now we shall expound the normal and abnormal color, complexion and voice in a person which especially relies on two ''indriyas'' –visual and auditory faculty".[1-2]

==== Factors for assessment of residual span of life ====

इह खलु वर्णश्च स्वरश्च गन्धश्च रसश्च स्पर्शश्च चक्षुश्च श्रोत्रं च घ्राणं च रसनं च स्पर्शनं च सत्त्वं च भक्तिश्च शौचं च शीलंचाचारश्च स्मृतिश्चाकृतिश्च प्रकृतिश्च विकृतिश्च बलं च ग्लानिश्च मेधा च हर्षश्च रौक्ष्यं च स्नेहश्च तन्द्रा चारम्भश्च गौरवं चलाघवं च गुणाश्चाहारश्च विहारश्चाहारपरिणामश्चोपायश्चापायश्च व्याधिश्च व्याधिपूर्वरूपं च वेदनाश्चोपद्रवाश्च च्छाया चप्रतिच्छाया च स्वप्नदर्शनं च दूताधिकारश्च पथि चौत्पातिकं चातुरकुले भावावस्थान्तराणि च भेषजसंवृत्तिश्च भेषजविकारयुक्तिश्चेति परीक्ष्याणि प्रत्यक्षानुमानोपदेशैरायुषः प्रमाणावशेषं जिज्ञासमानेन भिषजा||३||

iha khalu varṇaśca svaraśca gandhaśca rasaśca sparśaśca cakṣuśca śrōtraṁ ca ghrāṇaṁ ca rasanaṁ casparśanaṁ ca sattvaṁ ca bhaktiśca śaucaṁ ca śīlaṁ cācāraśca smr̥tiścākr̥tiśca prakr̥tiśca vikr̥tiśca balaṁ caglāniśca mēdhā ca harṣaśca raukṣyaṁ ca snēhaśca tandrā cārambhaśca gauravaṁ ca lāghavaṁ caguṇāścāhāraśca vihāraścāhārapariṇāmaścōpāyaścāpāyaśca vyādhiśca vyādhipūrvarūpaṁ cavēdanāścōpadravāśca cchāyā ca praticchāyā ca svapnadarśanaṁ ca dūtādhikāraśca pathi cautpātikaṁcāturakulē bhāvāvasthāntarāṇi ca bhēṣajasaṁvr̥ttiśca bhēṣajavikārayuktiścēti parīkṣyāṇipratyakṣānumānōpadēśairāyuṣaḥ pramāṇāvaśēṣaṁ jijñāsamānēna bhiṣajā||3||

iha khalu varNashca svarashca gandhashca rasashca sparshashca cakShushca shrotraM ca ghrANaM carasanaM ca sparshanaM ca sattvaM ca bhaktishca shaucaM ca shIlaM cAcArashca smRutishcAkRutishcaprakRutishca vikRutishca balaM ca glAnishca medhA ca harShashca raukShyaM ca snehashca tandrAcArambhashca gauravaM ca lAghavaM ca guNAshcAhArashcavihArashcAhArapariNAmashcopAyashcApAyashca vyAdhishca vyAdhipUrvarUpaM cavedanAshcopadravAshca cchAyA ca praticchAyA ca svapnadarshanaM ca dUtAdhikArashca pathicautpAtikaM cAturakule bhAvAvasthAntarANi ca bheShajasaMvRuttishca bheShajavikArayuktishcetiparIkShyANi pratyakShAnumAnopadeshairAyuShaH pramANAvasheShaM jij~jAsamAnena bhiShajA||3||
<div style="text-align:justify;">
The following entities should be examined by the physician desiring to assess the residual span of life of the patient using direct observation, and inference such as:
*Physical appearance (complexion, appearance of eyes, ears, nose, tongue, skin), including attributes perceived by the senses (voice, smell, taste, touch, etc.)
*Behavioral traits (mood, upkeep, conduct, etc.)
*Dietary habits and lifestyle (regimens, ability to digest, etc.)
*Existing health conditions (signs of diseases, symptoms, complications, drug use, effect of medicines on illness and on the patient)

Bad omens perceived by the physician on his way to patient's house, changed conditions of the patient's residence, signs and symptoms indicating the residual span of life may be evident on these factors. Hence physician should pay careful attention to each one of them and interpretation should be made based on his observations, knowledge and scriptural advice. [3]
</div>
तत्र तु खल्वेषां परीक्ष्याणां कानिचित् पुरुषमनाश्रितानि, कानिचिच्च पुरुषसंश्रयाणि|
तत्र यानि पुरुषमनाश्रितानि तान्युपदेशतो युक्तितश्च परीक्षेत, पुरुषसंश्रयाणि पुनः प्रकृतितोविकृतितश्च||४||

tatra tu khalvēṣāṁ parīkṣyāṇāṁ kānicit puruṣamanāśritāni, kānicicca puruṣasaṁśrayāṇi| tatra yāni puruṣamanāśritāni tānyupadēśatō yuktitaśca parīkṣēta, puruṣasaṁśrayāṇipunaḥprakr̥titōvikr̥titaśca||4||

tatra tu khalveShAM parIkShyANAM kAnicit puruShamanAshritAni, kAnicicca puruShasaMshrayANi|
tatra yAni puruShamanAshritAni tAnyupadeshato yuktitashca parIkSheta, puruShasaMshrayANi punaHprakRutito vikRutitashca||4||
<div style="text-align:justify;">
Out of these entities, some are not seated in a patient but are about patients. Those who are not seated in patients are required to be examined with logic based on scriptural instructions and inference. Those which can be seen in patients are examined by observing their constitution and morbid conditions. The factors not seated in patients are often circumstantial like an informer who comes with news of patient and the good/bad omens seen by the physician. But all these factors should be assessed wisely in the quest for the life of the patient. [4]
</div>
==== Factors responsible for natural constitution ====

तत्रप्रकृतिर्जातिप्रसक्ताच,कुलप्रसक्ताच,देशानुपातिनीच, कालानुपातिनी च वयोऽनुपातिनीच,प्रत्यात्मनियताचेति| जातिकुलदेशकालवयःप्रत्यात्मनियता हि तेषां तेषां पुरुषाणां ते ते भावविशेषाभवन्ति||५||

tatraprakr̥tirjātiprasaktāca,kulaprasaktāca,dēśānupātinīca, kālānupātinī ca vayō'nupātinīca,pratyātmaniyatācēti| jātikuladēśakālavayaḥpratyātmaniyatā hi tēṣāṁ tēṣāṁ puruṣāṇāṁtētēbhāvaviśēṣābhavanti||5||

tatra prakRutirjAtiprasaktA ca, kulaprasaktA ca, deshAnupAtinI ca, kAlAnupAtinI ca vayo~anupAtinI ca, pratyAtmaniyatA ceti|
jAtikuladeshakAlavayaHpratyAtmaniyatA hi teShAM teShAM puruShANAM te te bhAvavisheShAbhavanti||5||
<div style="text-align:justify;">
The natural constitution of a person depends upon ''Jati'' (caste), ''Kula'' (race), ''Desha'' (place), ''Kala'' (time and season), ''Vaya'' (age), ''Pratyatmaniyata'' (individual habits and habitat). The different variations seen in persons are based upon their caste, race, place of living, season, age and individual habits.[5]
</div>
==== Types of pathological abnormalities ====

विकृतिःपुनर्लक्षणनिमित्ताच,लक्ष्यनिमित्ताच,निमित्तानुरूपाच||६||

vikr̥tiḥpunarlakṣaṇanimittāca,lakṣyanimittāca,nimittānurūpāca||6||

vikRutiH punarlakShaNanimittA ca, lakShyanimittA ca, nimittAnurUpA ca||6||

The pathological conditions are classified as:
*''Lakshana nimitta'': pathological appearance based on symptoms
*''Lakshya nimitta'' : Diseases based upon etiological factors
*''Nimittanurupa'': This type of pathology is based on signs resembling with etiological factors. [6]

तत्र लक्षणनिमित्ता नाम सा यस्याः शरीरे लक्षणान्येव हेतुभूतानि भवन्ति दैवात्; लक्षणानि हि कानिचिच्छरीरोपनिबद्धानि भवन्ति, यानि हि तस्मिंस्तस्मिन् काले तत्राधिष्ठानमासाद्य तां तां विकृतिमुत्पादयन्ति|७|

tatra lakṣaṇanimittā nāma sā yasyāḥ śarīrē lakṣaṇānyēva hētubhūtāni bhavanti daivāt; lakṣaṇāni hi kāniciccharīrōpanibaddhāni bhavanti, yāni hi tasmiṁstasmin kālētatrādhiṣṭhānamāsādya tāṁ tāṁ vikr̥timutpādayanti|7|

tatra lakShaNanimittA nAma sA yasyAH sharIre lakShaNAnyeva hetubhUtAni bhavanti daivAt; lakShaNAni hi kAniciccharIropanibaddhAni bhavanti, yAni hitasmiMstasmin kAle tatrAdhiShThAnamAsAdya tAM tAM vikRutimutpAdayanti|7|
<div style="text-align:justify;">
The pathological conditions based on symptoms are those, whose causative factors are pre-determined by destiny in the form of physiognomic signs. Some of these signs may be latent in the body, and appear at particular time in particular parts of body giving rise to particular related morbid conditions. [7[1]]
</div>
लक्ष्यनिमित्ता तु सा यस्या उपलभ्यते निमित्तं यथोक्तं निदानेषु|७|

lakṣyanimittā tu sā yasyā upalabhyatē nimittaṁ yathōktaṁ [1] nidānēṣu|7|

lakShyanimittA tu sA yasyA upalabhyate nimittaM yathoktaM [1] nidAneShu|7|

The pathological conditions based on etiological factors is that which appear as per the etiopathogenesis described (in [[Nidana Sthana]]section). [7[2]]

निमित्तानुरूपा तु निमित्तार्थानुकारिणी या, तामनिमित्तां निमित्तमायुषः प्रमाणज्ञानस्येच्छन्ति भिषजो भूयश्चायुषः क्षयनिमित्तां प्रेतेलिङ्गानुरूपां, यामायुषोऽन्तर्गतस्य [१] ज्ञानार्थमुपदिशन्ति धीराः|
यां चाधिकृत्य पुरुषसंश्रयाणि मुमूर्षतां लक्षणान्युपदेक्ष्यामः|
इत्युद्देशः|
तं विस्तरेणानुव्याख्यास्यामः||७||

nimittānurūpā tu nimittārthānukāriṇī yā, tāmanimittāṁ nimittamāyuṣaḥ pramāṇajñānasyēcchanti bhiṣajō bhūyaścāyuṣaḥ kṣayanimittāṁ prētēliṅgānurūpāṁ,yāmāyuṣō'ntargatasya [1] jñānārthamupadiśanti dhīrāḥ|
yāṁ cādhikr̥tya puruṣasaṁśrayāṇi mumūrṣatāṁ lakṣaṇānyupadēkṣyāmaḥ|
ityuddēśaḥ|
taṁ vistarēṇānuvyākhyāsyāmaḥ||7||

nimittAnurUpA tu nimittArthAnukAriNI yA, tAmanimittAM nimittamAyuShaH pramANaj~jAnasyecchanti bhiShajo bhUyashcAyuShaH kShayanimittAMpreteli~ggAnurUpAM, yAmAyuSho~antargatasya [1] j~jAnArthamupadishanti dhIrAH|
yAM cAdhikRutya puruShasaMshrayANi mumUrShatAM lakShaNAnyupadekShyAmaH|
ityuddeshaH|
taM vistareNAnuvyAkhyAsyAmaH||7||
<div style="text-align:justify;">
The pathological conditions based upon the factors that appear to behave like etiological factors is that which resembles the conditions brought about by etiological factors. It is the undetermined pathological condition which the physicians regard as the determination in the ascertainment of the remaining lifespan. It is furthermore the pathological condition resulting from exhaustion of life-measure and resembling a corpse-like appearance, that the wise delineate for the purpose of ascertaining the remaining portion of life-span. It is the reference to this condition that we shall set out the signs and symptoms observed in the body of the patient who is fated to die. This is the summary. We shall explain in detail. [7[3]]
</div>
==== Normal complexion ====

तत्रादितएववर्णाधिकारः|
तद्यथा- कृष्णः, श्यामः, श्यामावदातः, अवदातश्चेति प्रकृतिवर्णाः शरीरस्य भवन्ति; यांश्चापरानुपेक्षमाणो विद्यादनूकतोऽन्यथा वाऽपि निर्दिश्यमानांस्तज्ज्ञैः||८||

tatrāditaēvavarṇādhikāraḥ|
tadyathā- kr̥ṣṇaḥ, śyāmaḥ , śyāmāvadātaḥ, avadātaścēti prakr̥tivarṇāḥ śarīrasya bhavanti;yāṁścāparānupēkṣamāṇō vidyādanūkatō'nyathā vā'pi nirdiśyamānāṁstajjñaiḥ||8||

tatrAdita eva varNAdhikAraH|
tadyathA- kRuShNaH, shyAmaH [1] , shyAmAvadAtaH, avadAtashceti prakRutivarNAH sharIrasya bhavanti; yAMshcAparAnupekShamANo [2] vidyAdanUkato~anyathAvA~api nirdishyamAnAMstajj~jaiH||8||

There are four types of natural complexion – black, dark (blue or brown), dark-fair (blue or brown), fair white, There may some more complexions with combinations of such colors.[8]

==== Abnormal complexion ====

नीलश्यावताम्रहरितशुक्लाश्च वर्णाः शरीरस्य वैकारिका भवन्ति; यांश्चापरानुपेक्षमाणो विद्यात्प्राग्विकृतानभूत्वोत्पन्नान् | इति प्रकृतिविकृतिवर्णा भवन्त्युक्ताः शरीरस्य|
तत्र प्रकृतिवर्णमर्धशरीरे विकृतिवर्णमर्धशरीरे, द्वावपि वर्णौ मर्यादाविभक्तौ दृष्ट्वा; यद्येवं सव्यदक्षिणविभागेन, यद्येवंपूर्वपश्चिमविभागेन, यद्युत्तराधरविभागेन, यद्यन्तर्बहिर्विभागेन, आतुरस्यारिष्टमिति विद्यात्; एवमेव वर्णभेदोमुखेऽप्यन्यत्र वर्तमानो मरणाय भवति||९||

nīlaśyāvatāmraharitaśuklāśca varṇāḥ śarīrasya vaikārikā bhavanti; yāṁścāparānupēkṣamāṇōvidyātprāgvikr̥tānabhūtvōtpannān | iti prakr̥tivikr̥tivarṇā bhavantyuktāḥ śarīrasya| tatra prakr̥tivarṇamardhaśarīrē vikr̥tivarṇamardhaśarīrē, dvāvapi varṇau maryādāvibhaktau dr̥ṣṭvā;yadyēvaṁ savyadakṣiṇavibhāgēna, yadyēvaṁ pūrvapaścimavibhāgēna, yadyuttarādharavibhāgēna,yadyantarbahirvibhāgēna, āturasyāriṣṭamiti vidyāt; ēvamēva varṇabhēdō mukhē'pyanyatra vartamānōmaraṇāya bhavati||9||

nIlashyAvatAmraharitashuklAshca varNAH sharIrasya vaikArikA bhavanti; yAMshcAparAnupekShamANo [1] vidyAt prAgvikRutAnabhUtvotpannAn [2] |
iti prakRutivikRutivarNA bhavantyuktAH sharIrasya|
tatra prakRutivarNamardhasharIre vikRutivarNamardhasharIre, dvAvapi varNau maryAdAvibhaktau dRuShTvA; yadyevaM savyadakShiNavibhAgena, yadyevaMpUrvapashcimavibhAgena, yadyuttarAdharavibhAgena, yadyantarbahirvibhAgena, AturasyAriShTamiti vidyAt; evameva varNabhedo mukhe~apyanyatra [3] vartamAnomaraNAya bhavati||9||
<div style="text-align:justify;">
The unnatural or pathological complexions include blue, blackish, coppery, green and snow white. Similarly, there are some other unnatural types of complexion which appear suddenly for unknown reason. These are the normal and abnormal complexions of body.
Normal complexion in one half of the body and abnormal complexion in the other half and both are demarcated clearly by a line, same abnormality on left and right side of body, front and back side of body, upper and lower or internal and external parts of the body is considered ''arishta'' (near to death signs). Such demarcation abnormality on face and other parts too indicates death. [9]
</div>
वर्णभेदेन ग्लानिहर्षरौक्ष्यस्नेहा व्याख्याताः||१०||

varṇabhēdēnaglāniharṣaraukṣyasnēhāvyākhyātāḥ||10||

varNabhedena glAniharSharaukShyasnehA vyAkhyAtAH||10||

On the same line of differentiation of complexion, malaise and cheerfulness, roughness and unctuousness are described. [10]

तथा पिप्लुव्यङ्गतिलकालकपिडकानामन्यतमस्यानने जन्मातुरस्यैवमेवाप्रशस्तं विद्यात्||११||

tathā pipluvyaṅgatilakālakapiḍakānāmanyatamasyānanē janmāturasyaivamēvāpraśastaṁ vidyāt||11||

tathA pipluvya~ggatilakAlakapiDakAnAmanyatamasyAnane janmAturasyaivamevAprashastaM vidyAt||11||

Similarly, sudden appearance of ''piplu'' (Acne), ''vyanga'' (Pigmented skin), ''tilakalaka'' (Mole) and ''pidaka'' (Boil) on the face of the patient is inauspicious. [11]

नखनयनवदनमूत्रपुरीषहस्तपादौष्ठादिष्वपि च वैकारिकोक्तानां वर्णानामन्यतमस्य प्रादुर्भावो हीनबलवर्णेन्द्रियेषुलक्षणमायुषः क्षयस्य भवति||१२||

यच्चान्यदपि किञ्चिद्वर्णवैकृतमभूतपूर्वं सहसोत्पद्येतानिमित्तमेव हीयमानस्यातुरस्य शश्वत्, तदरिष्टमिति विद्यात्|
इति वर्णाधिकारः||१३||

nakhanayanavadanamūtrapurīṣahastapādauṣṭhādiṣvapi ca vaikārikōktānāṁ varṇānāmanyatamasyaprādurbhāvō hīnabalavarṇēndriyēṣu lakṣaṇamāyuṣaḥ kṣayasya bhavati||12||

yaccānyadapi kiñcidvarṇavaikr̥tamabhūtapūrvaṁ sahasōtpadyētānimittamēva hīyamānasyāturasyaśaśvat,tadariṣṭamitividyāt|itivarṇādhikāraḥ||13||

nakhanayanavadanamUtrapurIShahastapAdauShThAdiShvapi ca vaikArikoktAnAM varNAnAmanyatamasya prAdurbhAvo hInabalavarNendriyeShu lakShaNamAyuShaHkShayasya bhavati||12||

yaccAnyadapi ki~jcidvarNavaikRutamabhUtapUrvaM sahasotpadyetAnimittameva hIyamAnasyAturasya shashvat, tadariShTamiti vidyAt|
iti varNAdhikAraH||13||
<div style="text-align:justify;">
Sudden appearance of any one of the abnormal colors in nails, eyes, face, urine, stool, hands, legs and lips together with diminished strength, complexion and senses indicate imminent death. Such other abnormal complexions too that appear suddenly for the first time without any apparent cause in the patient with constant deterioration of health are the signs of death. [12-13]
</div>
==== Normal and abnormal voice ====

स्वराधिकारस्तु- हंसक्रौञ्चनेमिदुन्दुभिकलविङ्ककाककपोतजर्जरानुकाराः प्रकृतिस्वरा भवन्ति; यांश्चापरानुपेक्षमाणोऽपि विद्यादनूकतोऽन्यथा वाऽपि निर्दिश्यमानांस्तज्ज्ञैः|
एडककलग्रस्ताव्यक्तगद्गदक्षामदीनानुकीर्णास्त्वातुराणां स्वरा वैकारिका भवन्ति; यांश्चापरानुपेक्षमाणोऽपि विद्यात्प्राग्विकृतानभूत्वोत्पन्नान् | इति प्रकृतिविकृतिस्वरा व्याख्याता भवन्ति||१४||

svarādhikārastu- haṁsakrauñcanēmidundubhikalaviṅkakākakapōtajarjarānukārāḥ prakr̥tisvarā bhavanti;yāṁścāparānupēkṣamāṇō'pi vidyādanūkatō'nyathā vā'pi nirdiśyamānāṁstajjñaiḥ| ēḍakakalagrastāvyaktagadgadakṣāmadīnānukīrṇāstvāturāṇāṁ svarā vaikārikā bhavanti;yāṁścāparānupēkṣamāṇō'pi vidyāt prāgvikr̥tānabhūtvōtpannānitiprakr̥tivikr̥tisvarāvyākhyātābhavanti||14||

svarAdhikArastu- haMsakrau~jcanemidundubhikalavi~gkakAkakapotajarjarAnukArAH prakRutisvarA bhavanti; yAMshcAparAnupekShamANo~api [1]vidyAdanUkato~anyathA vA~api nirdishyamAnAMstajj~jaiH|
eDakakalagrastAvyaktagadgadakShAmadInAnukIrNAstvAturANAM [2] svarA vaikArikA bhavanti; yAMshcAparAnupekShamANo~api [3] vidyAtprAgvikRutAnabhUtvotpannAn [4] |
iti prakRutivikRutisvarA vyAkhyAtA bhavanti||14||
<div style="text-align:justify;">
The normal human voice resembles the voice of ''hamsa'' (swan), ''krauncha'' (demoiselle crane), ''nemi'' (wheel), ''dundubhi'' (kettle drum), ''kalavinka'' (house sparrow), ''kaka'' (crow), ''kapota'' (dove) and jarjara (a type of drum).
The voice of person with disease resembles that of sheep and is feeble, inaudible, indistinct, choked, hoarse, painful and stammering. Thus normal and abnormal voices are described. [14]
</div>
तत्र प्रकृतिवैकारिकाणां स्वराणामाश्वभिनिर्वृत्तिः स्वरानेकत्वमेकस्य चानेकत्वमप्रशस्तम्| इतिस्वराधिकारः||१५||

इति वर्णस्वराधिकारौ यथावदुक्तौ मुमूर्षतां लक्षणज्ञानार्थमिति||१६||

tatra prakr̥tivaikārikāṇāṁ svarāṇāmāśvabhinirvr̥ttiḥ svarānēkatvamēkasya cānēkatvamapraśastam|itisvarādhikāraḥ||15||

iti varṇasvarādhikārau yathāvaduktau mumūrṣatāṁ lakṣaṇajñānārthamiti||16||

If the abnormal and inauspicious voices occur suddenly, or rhythm, tone, pitch, resonance and frequency of voice changes on sudden onset, it is inauspicious (there is a grave indication of imminent death).[15]

==== Summary ====

भवन्तिचात्र-
यस्यवैकारिकोवर्णःशरीरउपपद्यते| अर्धे वा यदि वा कृत्स्ने निमित्तं न च नास्ति सः||१७||

नीलंवायदिवाश्यावंताम्रंवायदिवाऽरुणम्| मुखार्धमन्यथा वर्णो मुखार्धेऽरिष्टमुच्यते||१८||

स्नेहोमुखार्धेसुव्यक्तोरौक्ष्यमर्धमुखेभृशम्| ग्लानिरर्धे तथा हर्षो मुखार्धे प्रेतलक्षणम्||१९||

तिलकाःपिप्लवोव्यङ्गाराजयश्चपृथग्विधाः| आतुरस्याशुजायन्तेमुखे प्राणान् मुमुक्षतः||२०||

पुष्पाणिनखदन्तेषुपङ्कोवादन्तसंश्रितः| चूर्णको वाऽपि दन्तेषु लक्षणं मरणस्य तत्||२१||

ओष्ठयोःपादयोःपाण्योरक्ष्णोर्मूत्रपुरीषयोः| नखेष्वपिचवैवर्ण्यमेतत्क्षीणबलेऽन्तकृत्||२२||

यस्यनीलावुभावोष्ठौपक्वजाम्बवसन्निभौ| मुमूर्षुरिति तं विद्यान्नरो धीरो गतायुषम्||२३||

एकोवायदिवाऽनेकोयस्यवैकारिकःस्वरः| सहसोत्पद्यते जन्तोर्हीयमानस्नास्ति सः||२४||

यच्चान्यदपिकिञ्चित्स्याद्वैकृतंस्वरवर्णयोः| बलमांसविहीनस्यतत्सर्वं मरणोदयम् ||२५||

bhavanti cātra-
yasya vaikārikō varṇaḥ śarīra upapadyatē|
ardhē vā yadi vā kr̥tsnē nimittaṁ na ca nāsti saḥ||17||

nīlaṁ vā yadi vā śyāvaṁ tāmraṁ vā yadi vā'ruṇam|
mukhārdhamanyathā varṇō mukhārdhē'riṣṭamucyatē||18||

snēhō mukhārdhē suvyaktō raukṣyamardhamukhē [1] bhr̥śam|
glānirardhē tathā harṣō mukhārdhē prētalakṣaṇam||19||

tilakāḥ piplavō vyaṅgā rājayaśca pr̥thagvidhāḥ|
āturasyāśu jāyantē mukhē prāṇān mumukṣataḥ||20||

puṣpāṇi nakhadantēṣu paṅkō vā dantasaṁśritaḥ|
cūrṇakō vā'pi dantēṣu lakṣaṇaṁ maraṇasya [2] tat||21||

ōṣṭhayōḥ pādayōḥ pāṇyōrakṣṇōrmūtrapurīṣayōḥ|
nakhēṣvapi ca vaivarṇyamētat kṣīṇabalē'ntakr̥t||22||

yasya nīlāvubhāvōṣṭhau pakvajāmbavasannibhau|
mumūrṣuriti taṁ vidyānnarō dhīrō gatāyuṣam||23||

ēkō vā yadi vā'nēkō yasya vaikārikaḥ svaraḥ|
sahasōtpadyatē jantōrhīyamānasya nāsti saḥ||24||

yaccānyadapi kiñcit syādvaikr̥taṁ svaravarṇayōḥ|
balamāṁsavihīnasya tat sarvaṁ maraṇōdayam [3] ||25||

tatra ślōkaḥ-
iti varṇasvarāvuktau lakṣaṇārthaṁ mumūrṣatām|
yastau [4] samyagvijānāti nāyurjñānē sa muhyati||26||

bhavanticAtra-
yasyavaikArikovarNaHsharIraupapadyate|
ardhe vA yadi vA kRutsne nimittaM na canAstisaH||17||

nIlaM vA yadi vA shyAvaM tAmraM vA yadi vA~aruNam|
mukhArdhamanyathA varNo mukhArdhe~ariShTamucyate||18||

sneho mukhArdhe suvyakto raukShyamardhamukhe bhRusham|
glAnirardhe tathA harSho mukhArdhe pretalakShaNam||19||

tilakAH piplavo vya~ggA rAjayashca pRuthagvidhAH|
AturasyAshu jAyante mukhe prANAn mumukShataH||20||

puShpANi nakhadanteShu pa~gko vA dantasaMshritaH|
cUrNako vA~api danteShu lakShaNaM maraNasya tat||21||

oShThayoH pAdayoH pANyorakShNormUtrapurIShayoH|
nakheShvapi ca vaivarNyametat kShINabale~antakRut||22||

yasya nIlAvubhAvoShThau pakvajAmbavasannibhau|
mumUrShuriti taM vidyAnnaro dhIro gatAyuSham||23||

eko vA yadi vA~aneko yasya vaikArikaH svaraH|
sahasotpadyate jantorhIyamAnasya nAsti saH||24||

yaccAnyadapi ki~jcit syAdvaikRutaM svaravarNayoH|
balamAMsavihInasya tat sarvaM maraNodayam ||25||
<div style="text-align:justify;">
If half of the face there is blue, blackish, coppery or tawny color and the color of the remaining half is otherwise. Manifestation of unctuousness in one half of the face and roughness in the other half is inauspicious.

The appearance of swelling in one-half of the face and emaciation in the other half. Spontaneous appearance of various types of ''tila'' (black mole), ''piplu'' (port wine mark),''vyanga'' (freckles), and ''raji'' (spots like mustard) in the face of the patient.

The appearance of flowers like spots in nails and teeth and sticky and powdery substance over the teeth is an indicator of death. Discoloration of lips, legs, heels, eyes, urine, stool and nails of the patient are indicators of diminished strength.

When both the lips become bluish like ripe fruits of ''jambu'', this is a clear indication of death.

In a patient who is very much weak, due to ''Ojokshaya'' (immune depletion) along with any changes occur in voice either as single problem or multiple issues, that indicates death.

In chronic immune deficient person, there is all possibilities of ''dhatusaraheenatha'' (Severe wasting of tissues) can lead to abnormal voice.

Such other abnormalities in voice and complexion of an individual who is devoid of strength and flesh also indicate imminent death.[17-25]
</div>
तत्रश्लोकः-
इतिवर्णस्वरावुक्तौलक्षणार्थंमुमूर्षताम्|यस्तौसम्यग्विजानाति नायुर्ज्ञाने स मुह्यति||२६||

tatraślōkaḥ-
itivarṇasvarāvuktaulakṣaṇārthaṁmumūrṣatām|
yastau samyagvijānāti nāyurjñānē sa muhyati||26||

tatra shlokaH-
iti varNasvarAvuktau lakShaNArthaM mumUrShatAm|
yastau [4] samyagvijAnAti nAyurj~jAne sa muhyati||26||

Thus the fatal signs related with complexion and voice are described. One who knows the details of these facts will not be confused in knowing lifespan of patient.

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*The prognosis of disease leading to death can be predicted by keen observation of complexion, color of body parts and voice. [3]
*The natural constitution of a person depends upon ''Jati'' (caste), ''Kula'' (race), ''Desha'' (place), ''Kala'' (time and season), ''Vaya'' (age), ''Pratyatmaniyata'' (individual habits and habitat). The different variations seen in persons are based upon their caste, race, palce of living, season, age and individual habits. [5]
*The complexion is a tool to assess malaise, cheerfulness, dryness and unctuousness in body i.e. the circulatory and metabolic state of body. [9]

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

*Sudden change in following factors indicate near death signs:
Complexion, voice, smell, taste, touch, eyes, ears, nose, tongue, skin, psyche, desire, cleanliness, conduct, behavior, memory, shape, nature, morbidity, strength, malaise, intellect, exhilaration, dryness, unctuousness, drowsiness, initiation, heaviness, lightness, qualities, diet, regimens, digestion of food, manifestation of disease, disappearance of disease, characters of disease, premonitory signs of the disease, symptoms, complications, administration of proper medicine, and effect of medicine on disease, luster, shadow, dream, state of informer about the patient. Bad omens perceived by the physician on his way to patient’s house, changed conditions of the patient’s residence, signs and symptoms indicating the residual span of life may be evident in these factors. Hence physician should pay careful attention to each one of them and interpretation should be made based on his observations, knowledge and scriptural advice.
*The examination of complexion does not just mean the color only. It also includes objects of visual perception like coarseness, glossiness etc. Abnormal ''swara'' (voice) include fluctuations in the normal quality of sounds produced (hoarseness of voice, dysphonia), absence of the normal physiological sounds like absence of peristalsis in peritonitis, presence of abnormal sounds like crepitus in joints & crepitations, rhonchi etc. in lungs. Abnormalities in touch include tactile perception of abnormal hardness, softness, warmth etc.
*The morbid conditions are of three types. Such as those indicated by bodily marks, those caused by etiological factors and those resemble etiological factors.
*''Lakshana nimitta'' include visible end stage manifestations.
*The abnormal color produced can be considered as ''ojokshaya lakshana'' (depletion of quality of tissue). In ''Raktarshas'' (bleeding piles), when there is excessive bleeding, it may lead to poor complexion, strength, enthusiasm and depleted ''Ojas''. If proper measure is not taken the condition may become fatal. The unnatural colors formed can be compared with the cyanotic conditions, discoloration seen in the fatal hepatic and renal pathologies etc. Appearance of white spots, white nails and loss of pigmentation can be seen in chronic liver failure.
*In chronic kidney disease, the conjunctival deposition of calcium leads to redness and gritty feeling in the eye called uremic red eye. Also deposition of calcium as a band in the lamina proprea of cornea leads to band keratopathy.
*In chronic hepatic failure, erythematous patches may appear over many parts of the body, especially over the chest wall and supraclavicular regions.
*Appearance of abnormal complexion in the entire or half of the body of the individual without any significant reason is due to abnormal peripheral circulation. Oxygenation can affect the complexion. Serious vascular insufficiencies will also result in impaired skin complexion. In deep vein thrombosis DVT alteration in pigmentation is well appreciated.
*When both the lips become bluish like ripe fruits of ''jambu'', this is a clear indication of death. As per modern science this condition is similar to central cyanosis. It is directly due to ''Vata Pratilomata'' (reverse direction of ''Vata'') in different organs. The main ''Srotas'' involved are ''Rasavaha srotas'' and ''Raktavaha Srotas.''
*Abnormal voices:
**In ''sannipatha jwara'' - ''swarasada'' (low pitched voice) is a ''lakshana''.
**In ''kshathaja kasa'' - ''paravatha ivaakoojan'' (cooing sound like that of a pigeon comes out of the throat)
**In ''Apatantraka –kapota iva koojan'' ( make sound like a pigeon).
**In Tetanus -sudden death occurs due to laryngeal spasm .
**Dysphonia—Disturbance of phonation due to disturbance in vocal cords. Strained, harsh, low pitched voice, nasal voice.
**In laryngeal tumors like supra glottic cancer and glottis cancer hoarseness of voice is a late symptom.
In fact the abnormal changes in color and voice of the patient reflect serious changes in the physiology. Deep seated pathologies of cardio vascular system, Respiratory system, endocrine system often presents with color changes. Central and peripheral cyanosis represents certain death causing conditions. Similarly lesions in the central nervous system can lead to changes in the voice. Dysarthria, Dysphasia and Dysphonia shows underlining pathologies which may become fatal. In short this chapter highlights the events related with major systems in the body which can cause death.
</div>

Jatisutriya Sharira

2017-12-25T04:56:56Z

Vinay Exafluence: /* References */

{{Infobox
|title = Jatisutriya Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 8
|label2 = Preceding Chapter
|data2 = [[Samkhya Sharira]]

|label3= Succeeding Chapter
|data3 = None
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}
== [[Sharira Sthana]] Chapter 8 Jatisutriya Shariram ==

=== Abstract ===
<div style="text-align:justify;">
The eighth chapter of [[Sharira Sthana]], [[Jatisutriya Sharira]], continues from where Chapter Two ends, and deals not just with obstetrics and midwifery, but also prescribes measures for good parental health and effective neonatal care. It also describes pioneering concepts such as construction of a maternity home, attending wet nurses (and the concept of a milk bank), and well-furnished nurseries. ''Jati'' means birth, hence this chapter deals with the method of procreation in short.

'''Keywords''':''Jatisutriya, Dhatri''
</div>
=== Introduction ===
<div style="text-align:justify;">
The [[Sharira Sthana]] and [[Chikitsa Sthana]] provide valuable insights into obstretics, midwifery and gynaecology in the Vedic ages. Since Ayurveda is holistic in its treatment of various aspects of life sciences, these sections go beyond in their treatment of these branches of medicine, prescribing ground rules for effective neonatology and improved parental health. This chapter starts with certain guidelines for purification of the parents, including spiritual practices and appropriate rules for coitus, to improve the odds of giving birth to a healthy and desired offspring. For purification, therapies such as [[Panchakarma]] are advocated. A very specific - and contentious - spiritual procedure called ''putreshti yajna'' is also explained here, with an aim towards giving birth to a son (or a child of desired gender) with all excellent qualities.

Next, the chapter talks of fertilization and its features, and confirmation of conception. At this stage, sound parental health is also important. Couples are advised to follow various dietary measures as well as rules to engage in physical and mental activities, etc.
The subsequent part of the chapter deals with obstetrics and midwifery –detailing the development of the embryo to fetus and the milestones of intrauterine growth and development are explained. Certain sections of this chapter are controversial and could attract legal attention today, such as the practice of ''pumsavana'' (ways to get the offspring of a desired gender). Also, with our current understanding of genetics, it is not possible to change the gender after fertilization. The role of learned ''brahmins, vaidya'' and experienced old ladies in midwifery is given a lot of importance in this chapter.

Toys and playtime are essential for normal growth and development of a child, and the final section of this chapter describes the ideal characteristics of toys, play area, clothes and the child nursery.

Summarizing the eighth chapter, it deals with Obstetrics and Neonatology while also touching upon parental health and early child care, introducing certain concepts that are now considered modern best practices in the field,
</div>
===Sanskrit text, Transliteration and English Translation===

अथातो जातिसूत्रीयं शारीरं व्याख्यास्यामः||१||

athātō jātisūtrīyaṁ śārīraṁ vyākhyāsyāmaḥ||1||

athAto jAtisUtrIyaM shArIraM vyAkhyAsyAmaH||1||

“Now I shall expound the chapter dealing with continuation of one’s own lineage, in this discourse on Sharira.” [1]

Note: ''Jati'' means birth and ''Sutra'' is which is described in short. ''Jatisutriya'' is description of different methods and procedures of birth in short.

इति ह स्माह भगवानात्रेयः||२||

iti ha smāha bhagavānātrēyaḥ||2||

iti ha smAha bhagavAnAtreyaH||2||

Thus said Lord Atreya [2]

स्त्रीपुंसयोरव्यापन्नशुक्रशोणितगर्भाशययोः श्रेयसीं प्रजामिच्छतोस्तदर्थाभिनिर्वृत्तिकरं [१] कर्मोपदेक्ष्यामः||३||

strīpuṁsayōravyāpannaśukraśōṇitagarbhāśayayōḥ śrēyasīṁ prajāmicchatōstadarthābhinirvr̥ttikaraṁ [1]karmōpadēkṣyāmaḥ||3||

strIpuMsayoravyApannashukrashoNitagarbhAshayayoH shreyasIMprajAmicchatostadarthAbhinirvRuttikaraM [1] karmopadekShyAmaH||3||

Now we shall explain the procedures required for begetting a progeny of excellent qualities, to be practiced by man and woman of unaltered (pure, undamaged) sperm, ovum and uterus. [3]

अथाप्येतौ स्त्रीपुंसौ स्नेहस्वेदाभ्यामुपपाद्य, वमनविरेचनाभ्यां संशोध्य, क्रमेण प्रकृतिमापादयेत्|
संशुद्धौ चास्थापनानुवासनाभ्यामुपाचरेत्; उपाचरेच्च मधुरौषधसंस्कृताभ्यां घृतक्षीराभ्यां पुरुषं, स्त्रियं तु तैलमाषाभ्याम्||४||

athāpyētau strīpuṁsau snēhasvēdābhyāmupapādya, vamanavirēcanābhyāṁ saṁśōdhya, kramēṇaprakr̥timāpādayēt|
saṁśuddhau cāsthāpanānuvāsanābhyāmupācarēt; upācarēcca madhurauṣadhasaṁskr̥tābhyāṁghr̥takṣīrābhyāṁ puruṣaṁ, striyaṁ tu tailamāṣābhyām||4||

athApyetau strIpuMsau snehasvedAbhyAmupapAdya, vamanavirecanAbhyAM saMshodhya, krameNaprakRutimApAdayet|
saMshuddhau cAsthApanAnuvAsanAbhyAmupAcaret; upAcarecca madhurauShadhasaMskRutAbhyAMghRutakShIrAbhyAM puruShaM, striyaM tu tailamAShAbhyAm||4||
<div style="text-align:justify;">
Such a couple (desiring good progeny) should first undergo purification therapies described earlier in this treatise - unction and sudation procedures followed by emesis and purgation - and gradually get back to normalcy. Once purified, the couple should undergo non-unctuous and unctuous enema. Then, the man should be administered with sweet-tasting drugs processed with ghee and milk while the woman should take sesame oil and black gram. [4]
</div>
==== Abstinence from coitus during menstruation ====

ततः पुष्पात् प्रभृति त्रिरात्रमासीत ब्रह्मचारिण्यधःशायिनी, पाणिभ्यामन्नमजर्जरपात्राद्भुञ्जाना [१] , न चकाञ्चिन्मृजामापद्येत|
ततश्चतुर्थेऽहन्येनामुत्साद्य सशिरस्कं स्नापयित्वा शुक्लानि वासांस्याच्छादयेत् पुरुषं च|
ततः शुक्लवाससौ स्रग्विणौ सुमनसावन्योन्यमभिकामौ संवसेयातां स्नानात् प्रभृति युग्मेष्वहःसु पुत्रकामौ, अयुग्मेषुदुहितृकामौ||५||

tataḥ puṣpāt prabhr̥ti trirātramāsīta brahmacāriṇyadhaḥśāyinī, pāṇibhyāmannamajarjarapātrādbhuñjānā[1] , na ca kāñcinmr̥jāmāpadyēta|
tataścaturthē'hanyēnāmutsādya saśiraskaṁ snāpayitvā śuklāni vāsāṁsyācchādayēt puruṣaṁ ca|
tataḥ śuklavāsasau sragviṇau sumanasāvanyōnyamabhikāmau saṁvasēyātāṁ snānāt prabhr̥tiyugmēṣvahaḥsu putrakāmau, ayugmēṣu duhitr̥kāmau||5||

tataH puShpAt prabhRuti trirAtramAsIta brahmacAriNyadhaHshAyinI,pANibhyAmannamajarjarapAtrAdbhu~jjAnA [1] , na ca kA~jcinmRujAmApadyeta|
tatashcaturthe~ahanyenAmutsAdya sashiraskaM snApayitvA shuklAni vAsAMsyAcchAdayet puruShaM ca|
tataH shuklavAsasau sragviNau sumanasAvanyonyamabhikAmau saMvaseyAtAM snAnAt prabhRutiyugmeShvahaHsu putrakAmau, ayugmeShu duhitRukAmau||5||
<div style="text-align:justify;">
While menstruating, the woman should abstain from coitus for three nights, sleep on the ground, consume food with her hand from unbroken utensils, and should not clean her body by any means. On the fourth day, she should be anointed well with oil and should be given a good head bath, cleansed well, and then made to wear white coloured apparel. The man should follow similar rituals as the woman on her fourth day of menstruation. Then onwards, the two, wearing white apparels and garlands, with pleasant disposition, loving each other, should enter into acts of cohabitation - on even days if desirous of a male child, and on odd days for a female child. [5]
</div>
==== Postures and circumstances to be avoided for coitus ====

न च न्युब्जां पार्श्वगतां वा संसेवेत|
न्युब्जाया वातो बलवान् स योनिं पीडयति, पार्श्वगताया दक्षिणे पार्श्वे श्लेष्मा स च्युतः पिदधाति गर्भाशयं, वामे पार्श्वे पित्तंतदस्याः पीडितं विदहति रक्तं शुक्रं च, तस्मादुत्ताना बीजं गृह्णीयात्; तथाहि यथास्थानमवतिष्ठन्ते दोषाः|
पर्याप्ते चैनां शीतोदकेन परिषिञ्चेत्|
तत्रात्यशिता क्षुधिता पिपासिता भीता विमनाः शोकार्ता क्रुद्धाऽन्यं च पुमांसमिच्छन्ती मैथुने चातिकामा वा न गर्भं धत्ते,विगुणां वा प्रजां जनयति|
अतिबालामतिवृद्धां दीर्घरोगिणीमन्येन वा विकारेणोपसृष्टां वर्जयेत्|
पुरुषेऽप्येत एव दोषाः|
अतः सर्वदोषवर्जितौ स्त्रीपुरुषौ संसृज्येयाताम्||६||

na ca nyubjāṁ pārśvagatāṁ vā saṁsēvēta|
nyubjāyā vātō balavān sa yōniṁ pīḍayati, pārśvagatāyā dakṣiṇē pārśvē ślēṣmā sa cyutaḥ pidadhātigarbhāśayaṁ, vāmē pārśvē pittaṁ tadasyāḥ pīḍitaṁ vidahati raktaṁ śukraṁ ca, tasmāduttānā bījaṁgr̥hṇīyāt; tathāhi yathāsthānamavatiṣṭhantē dōṣāḥ|
paryāptē caināṁ śītōdakēna pariṣiñcēt|
tatrātyaśitā kṣudhitā pipāsitā bhītā vimanāḥ śōkārtā kruddhā'nyaṁ ca pumāṁsamicchantī maithunēcātikāmā vā na garbhaṁ dhattē, viguṇāṁ vā prajāṁ janayati|
atibālāmativr̥ddhāṁ dīrgharōgiṇīmanyēna vā vikārēṇōpasr̥ṣṭāṁ varjayēt|
puruṣē'pyēta ēva dōṣāḥ|
ataḥ sarvadōṣavarjitau strīpuruṣau saṁsr̥jyēyātām||6||

na ca nyubjAM pArshvagatAM vA saMseveta|
nyubjAyA vAto balavAn sa yoniM pIDayati, pArshvagatAyA dakShiNe pArshve shleShmA sa cyutaHpidadhAti garbhAshayaM, vAme pArshve pittaM tadasyAH pIDitaM vidahati raktaM shukraM ca,tasmAduttAnA bIjaM gRuhNIyAt; tathAhi yathAsthAnamavatiShThante doShAH|
paryApte cainAM shItodakena pariShi~jcet|
tatrAtyashitA kShudhitA pipAsitA bhItA vimanAH shokArtA kruddhA~anyaM ca pumAMsamicchantImaithune cAtikAmA vA na garbhaM dhatte, viguNAM vA prajAM janayati|
atibAlAmativRuddhAM dIrgharogiNImanyena vA vikAreNopasRuShTAM varjayet|
puruShe~apyeta eva doShAH|
ataH sarvadoShavarjitau strIpuruShau saMsRujyeyAtAm||6||
<div style="text-align:justify;">
During sexual intercourse, the woman should not be in prone posture, or lie on her sides. In the former case, ''vata dosha'' becomes stronger and inflicts the genital tract and in the latter case, lying on her right side, displaces ''kapha dosha'' into the mouth of the uterus and creates obstruction, while if she is on her left side, ''pitta dosha'' afflicts the ovum and sperm by its heat. Therefore, the woman should receive the sperm lying on her back, in this position; the doshas are in their states of normalcy. After coitus, vagina should be sprinkled with cold water.

The woman who has overeaten, thirsty, frightened, dejected, in grief, anger or in love with a man other than her husband, or who is overpassionate (during the coital act) will fail to conceive or if conceived, will give birth to a child with some defects.

A very young (sexually immature) girl or a very old woman, woman suffering from chronic illness or suffering with any other disorders should not procreate. This condition applies for a male partner too. Hence only a man and a woman who are free from all defects, and are of suitable age should engage in coitus. [6]
</div>
==== Preparations before coitus ====

सञ्जातहर्षौ मैथुने चानुकूलाविष्टगन्धं स्वास्तीर्णं सुखं शयनमुपकल्प्य मनोज्ञं हितमशनमशित्वा नात्यशितौ दक्षिणपादेनपुमानारोहेत् वामपादेन स्त्री||७||

sañjātaharṣau maithunē cānukūlāviṣṭagandhaṁ svāstīrṇaṁ sukhaṁ śayanamupakalpya manōjñaṁhitamaśanamaśitvā nātyaśitau dakṣiṇapādēna pumānārōhēt vāmapādēna strī||7||

sa~jjAtaharShau maithune cAnukUlAviShTagandhaM svAstIrNaM sukhaM shayanamupakalpya manoj~jaMhitamashanamashitvA nAtyashitau dakShiNapAdena pumAnArohet vAmapAdena strI||7||
<div style="text-align:justify;">
The couple that is sufficiently aroused and fully engrossed in the sexual act, after having their favorite food (wholesome, not overeaten), should lie on bed which is well adorned with pleasant perfumes and bedecked with comfortable mattresses of one’s choice for the sexual act, man placing his right foot first and woman her left. [7]
</div>
==== ''Mantra'' before the sexual act ====

तत्र मन्त्रं प्रयुञ्जीत- “अहिरसि आयुरसि सर्वतः प्रतिष्ठाऽसि धाता त्वा ददतु विधाता त्वा दधातु ब्रह्मवर्चसा भव” इति|
“ब्रह्मा बृहस्पतिर्विष्णुःसोमःसूर्यस्तथाऽश्विनौ|
भगोऽथ मित्रावरुणौ वीरं [२] ददतु मे सुतम्”
इत्युक्त्वा संवसेयाताम्||८||

tatra mantraṁ prayuñjīta- “ahirasi āyurasi sarvataḥ pratiṣṭhā'si dhātā tvā dadatu vidhātā tvā dadhātubrahmavarcasā bhava” iti|
“brahmā br̥haspatirviṣṇuḥsōmaḥsūryastathā'śvinau|
bhagō'tha mitrāvaruṇau vīraṁ [2] dadatu mē sutam”
ityuktvā saṁvasēyātām||8||

tatra mantraM prayu~jjIta- “ahirasi Ayurasi sarvataH pratiShThA~asi dhAtA tvA dadatu vidhAtA tvAdadhAtu brahmavarcasA bhava” iti|
“brahmA bRuhaspatirviShNuHsomaHsUryastathA~ashvinau|
bhago~atha mitrAvaruNau vIraM [2] dadatu me sutam”
ityuktvA saMvaseyAtAm||8||
<div style="text-align:justify;">
Then, they should recite the ''mantra'' meaning: ‘Thou art the day; Thou art the life; Thou art well established from all sides. May the supporter endow Thee; may the dispenser dispense to Thee: be Thou born with ''Brahmic'' splendor’. May Brahma, Brhaspati, Visnu, Soma, Surya and the two Ashwins, as also Bhaga, Mitra and Varuna, bless me with a heroic son.’ Having uttered this, the couple should commence the sexual act. [8]
</div>
==== Daily rituals to be followed a week before coitus by a woman desirous of a healthy male child ====

सा चेदेवमाशासीत-बृहन्तमवदातं हर्यक्षमोजस्विनं शुचिं सत्त्वसम्पन्नं पुत्रमिच्छेयमिति, शुद्धस्नानात् प्रभृत्यस्यैमन्थमवदातयवानां मधुसर्पिर्भ्यां संसृज्य श्वेताया गोः सरूपवत्सायाः पयसाऽऽलोड्य राजते कांस्ये वा पात्रे काले काले सप्ताहंसततं प्रयच्छेत् पानाय|
प्रातश्च शालियवान्नविकारान् दधिमधुसर्पिर्भिः पयोभिर्वा संसृज्य भुञ्जीत, तथा सायमवदातशरणशयनासनपानवसनभूषणाच स्यात्|
सायं प्रातश्च शश्वच्छ्वेतं महान्तं वृषभमाजानेयं वा हरिचन्दनाङ्गदं पश्येत्|
सौम्याभिश्चैनां कथाभिर्मनोनुकूलाभिरुपासीत|
सौम्याकृतिवचनोपचारचेष्टांश्च स्त्रीपुरुषानितरानपि चेन्द्रियार्थानवदातान् पश्येत्|
सहचर्यश्चैनां प्रियहिताभ्यां सततमुपचरेयुस्तथा भर्ता|
न च मिश्रीभावमापद्येयातामिति|
अनेन विधिना सप्तरात्रं स्थित्वाऽष्टमेऽहन्याप्लुत्याद्भिः सशिरस्कं सह भर्त्रा अहतानि वस्त्राण्याच्छादयेदवदातानि,अवदाताश्च स्रजो भूषणानि च बिभृयात्||९||

sā cēdēvamāśāsīta- br̥hantamavadātaṁ haryakṣamōjasvinaṁ śuciṁ sattvasampannaṁ putramicchēyamiti,śuddhasnānāt prabhr̥tyasyai manthamavadātayavānāṁ madhusarpirbhyāṁ saṁsr̥jya śvētāyā gōḥsarūpavatsāyāḥ payasā''lōḍya rājatē kāṁsyē vā pātrē kālē kālē saptāhaṁ satataṁ prayacchēt pānāya|
prātaśca śāliyavānnavikārān dadhimadhusarpirbhiḥ payōbhirvā saṁsr̥jya bhuñjīta, tathāsāyamavadātaśaraṇaśayanāsanapānavasanabhūṣaṇā ca syāt|
sāyaṁ prātaśca śaśvacchvētaṁ mahāntaṁ vr̥ṣabhamājānēyaṁ vā haricandanāṅgadaṁ paśyēt|
saumyābhiścaināṁ kathābhirmanōnukūlābhirupāsīta|
saumyākr̥tivacanōpacāracēṣṭāṁśca strīpuruṣānitarānapi cēndriyārthānavadātān paśyēt|
sahacaryaścaināṁ priyahitābhyāṁ satatamupacarēyustathā bhartā|
na ca miśrībhāvamāpadyēyātāmiti|
anēna vidhinā saptarātraṁ sthitvā'ṣṭamē'hanyāplutyādbhiḥ saśiraskaṁ saha bhartrā ahatānivastrāṇyācchādayēdavadātāni, avadātāśca srajō bhūṣaṇāni ca bibhr̥yāt||9||

sA cedevamAshAsIta- bRuhantamavadAtaM haryakShamojasvinaM shuciM sattvasampannaMputramiccheyamiti, shuddhasnAnAt prabhRutyasyai manthamavadAtayavAnAM madhusarpirbhyAMsaMsRujya shvetAyA goH sarUpavatsAyAH payasA~a~aloDya rAjate kAMsye vA pAtre kAle kAle saptAhaMsatataM prayacchet pAnAya|
prAtashca shAliyavAnnavikArAn dadhimadhusarpirbhiH payobhirvA saMsRujya bhu~jjIta, tathAsAyamavadAtasharaNashayanAsanapAnavasanabhUShaNA ca syAt|
sAyaM prAtashca shashvacchvetaM mahAntaM vRuShabhamAjAneyaM vA haricandanA~ggadaM pashyet|
saumyAbhishcainAM kathAbhirmanonukUlAbhirupAsIta|
saumyAkRutivacanopacAraceShTAMshca strIpuruShAnitarAnapi cendriyArthAnavadAtAn pashyet|
sahacaryashcainAM priyahitAbhyAM satatamupacareyustathA bhartA|
na ca mishrIbhAvamApadyeyAtAmiti|
anena vidhinA saptarAtraM sthitvA~aShTame~ahanyAplutyAdbhiH sashiraskaM saha bhartrA ahatAnivastrANyAcchAdayedavadAtAni, avadAtAshca srajo bhUShaNAni ca bibhRuyAt||9||
<div style="text-align:justify;">
A woman desirous of having a male child with large limbs, fair complexion, with eyes like those of a lion (full of vigor), pure, and with good mental disposition should, after her menstrual period, first take a purificatory bath, then be given a light porridge of well cleaned white barley grains duly sweetened by adding honey and ghee, diluted in the milk of a white cow having a white calf, in a utensil made of silver or bronze, regularly in the morning and evening for a week.

During mornings and evenings, she should eat a diet prepared with sali rice and/or barley mixed with curd, honey, ghee or with milk. Her room, bed, seat, drink, dress and ornaments etc. all should be of white color. In the evenings and mornings, she should look at a white majestic bull / stallion duly smeared with white sandal paste without fail. She should also be entertained with pleasant tales of her interest, acceptable to her mood. She should also look at men and women having good personality, speech, behaviour and manners, as well as visuals and objects that are white in color.

Her companions and husband should also entertain her with things, discussion topics, and activities that are pleasant to her, and not stressful. The couple, should, however avoid sexual contact during this period. Following this regimen for a week, on the eighth day she, along with her husband, after taking a head bath with pure (consecrated – ''abhimantritam'') water, get prepared for coitus by adorning themselves with new white apparel, garlands and ornaments. [9]
</div>
==== Rituals at the end of the week ====

तत ऋत्विक् प्रागुत्तरस्यां दिश्यगारस्य प्राग्प्रवणमुदक्प्रवणं वा प्रदेशमभिसमीक्ष्य, गोमयोदकाभ्यां स्थण्डिलमुपलिप्य, प्रोक्ष्यचोदकेन, वेदीमस्मिन् स्थापयेत्|
तां पश्चिमेनाहतवस्त्रसञ्चये श्वेतार्षभे वाऽप्यजिन उपविशेद् ब्राह्मणप्रयुक्तः, राजन्यप्रयुक्तस्तु वैयाघ्रे चर्मण्यानडुहे वा,वैश्यप्रयुक्तस्तु रौरवे बास्ते वा|
तत्रोपविष्टः पालाशीभिरैङ्गुदीभिरौदुम्बरीभिर्माधूकीभिर्वा समिद्भिरग्निमुपसमाधाय, कुशैः परिस्तीर्य, परिधिभिश्च परिधाय,लाजैः शुक्लाभिश्च गन्धवतीभिः सुमनोभिरुपकिरेत्|
तत्र प्रणीयोदपात्रं पवित्रपूतमुपसंस्कृत्य सर्पिराज्यार्थं यथोक्तवर्णानाजानेयादीन् समन्ततः स्थापयेत्||१०||

tata r̥tvik prāguttarasyāṁ diśyagārasya prāgpravaṇamudakpravaṇaṁ vā pradēśamabhisamīkṣya,gōmayōdakābhyāṁ sthaṇḍilamupalipya, prōkṣya cōdakēna, vēdīmasmin sthāpayēt|
tāṁ paścimēnāhatavastrasañcayē śvētārṣabhē vā'pyajina upaviśēd brāhmaṇaprayuktaḥ,rājanyaprayuktastu vaiyāghrē carmaṇyānaḍuhē vā, vaiśyaprayuktastu rauravē bāstē vā|
tatrōpaviṣṭaḥ pālāśībhiraiṅgudībhiraudumbarībhirmādhūkībhirvā samidbhiragnimupasamādhāya, kuśaiḥparistīrya, paridhibhiśca paridhāya, lājaiḥ śuklābhiśca gandhavatībhiḥ sumanōbhirupakirēt|
tatra praṇīyōdapātraṁ pavitrapūtamupasaṁskr̥tya sarpirājyārthaṁ yathōktavarṇānājānēyādīn samantataḥsthāpayēt||10||

tata Rutvik prAguttarasyAM dishyagArasya prAgpravaNamudakpravaNaM vA pradeshamabhisamIkShya,gomayodakAbhyAM sthaNDilamupalipya, prokShya codakena, vedImasmin sthApayet|
tAM pashcimenAhatavastrasa~jcaye shvetArShabhe vA~apyajina upavished brAhmaNaprayuktaH,rAjanyaprayuktastu vaiyAghre carmaNyAnaDuhe vA, vaishyaprayuktastu raurave bAste vA|
tatropaviShTaH pAlAshIbhirai~ggudIbhiraudumbarIbhirmAdhUkIbhirvA samidbhiragnimupasamAdhAya,kushaiH paristIrya, paridhibhishca paridhAya, lAjaiH shuklAbhishca gandhavatIbhiH sumanobhirupakiret|
tatra praNIyodapAtraM pavitrapUtamupasaMskRutya sarpirAjyArthaM yathoktavarNAnAjAneyAdInsamantataH sthApayet||10||
<div style="text-align:justify;">
At the end of one week, a priest should select a place on the north side of the house, having a downward slope towards the east or the north. The selected place/ground should be duly smeared with cowdung and water. After sprinkling the place with water, he should prepare and fix the altar.

On the west of the altar, the priest should take his seat on an undamaged cotton cushion or on the skin of a white bull, if he is officiating on behalf of a ''brahmana'' patron, on the skin of a tiger or bull if ''kshatriya'', and on the skin of a deer or a ram, in case of a ''vaisya''.

Thus seated, he should kindle the scared fire with the twigs of ''palasha'' (Butea monosperma Kuntze), ''ingudi'' (Balanites aegyptica Delile), ''udumbara'' (Ficus racemosa Linn) or ''madhuka'' (Madhuka indica J.F.Gmel), spread the ''kusha'' (Desmostachya bipinnata Stapf.) grass around, and fix the enclosure of fire with big stalks of ''palasha'' (Butea monospermakuntze) on all four sides, and then spread the altar with parched/roasted paddy and white coloured flowers having sweet fragrance. Then, he should prepare a water pot, clean and sanctified by ''mantras'', make available adequate amount of ghee for offerings, and place auspicious objects (such as bulls or stallions) of said qualities and colors, etc. in and around the place of offering as mentioned earlier. [10]
</div>
==== Additional rituals before cohabiting ====

ततः पुत्रकामा पश्चिमतोऽग्निं दक्षिणतो ब्राह्मणमुपविश्यान्वालभेत सह भर्त्रा यथेष्टं पुत्रमाशासाना| ततस्तस्या आशासानाया ऋत्विक् प्रजापतिमभिनिर्दिश्य योनौ तस्याः कामपरिपूरणार्थं काम्यामिष्टिं निर्वर्तयेद् ‘विष्णुर्योनिंकल्पयतु’ इत्यनयर्चा|
ततश्चैवाज्येन स्थालीपाकमभिघार्य त्रिर्जुहुयाद्यथाम्नायम्|
मन्त्रोपमन्त्रितमुदपात्रं तस्यै दद्यात् सर्वोदकार्थान् कुरुष्वेति|
ततः समाप्ते कर्मणि पूर्वं दक्षिणपादमभिहरन्ती प्रदक्षिणमग्निमनुपरिक्रामेत् सह भर्त्रा|
ततो [१] ब्राह्मणान् स्वस्ति वाचयित्वाऽऽज्यशेषं [२] प्राश्नीयात् पूर्वं पुमान्, पश्चात् स्त्री; न चोच्छिष्टमवशेषयेत्|
ततस्तौ सह संवसेयातामष्टरात्रं, तथाविधपरिच्छदावेव च स्यातां [३] , तथेष्टपुत्रं जनयेताम्||११||

tataḥ putrakāmā paścimatō'gniṁ dakṣiṇatō brāhmaṇamupaviśyānvālabhēta saha bhartrā yathēṣṭaṁputramāśāsānā|
tatastasyā āśāsānāyā r̥tvik prajāpatimabhinirdiśya yōnau tasyāḥ kāmaparipūraṇārthaṁ kāmyāmiṣṭiṁnirvartayēd ‘viṣṇuryōniṁ kalpayatu’ ityanayarcā|
tataścaivājyēna sthālīpākamabhighārya trirjuhuyādyathāmnāyam|
mantrōpamantritamudapātraṁ tasyai dadyāt sarvōdakārthān kuruṣvēti|
tataḥ samāptē karmaṇi pūrvaṁ dakṣiṇapādamabhiharantī pradakṣiṇamagnimanuparikrāmēt saha bhartrā|
tatō [1] brāhmaṇān svasti vācayitvā''jyaśēṣaṁ [2] prāśnīyāt pūrvaṁ pumān, paścāt strī; nacōcchiṣṭamavaśēṣayēt|
tatastau saha saṁvasēyātāmaṣṭarātraṁ, tathāvidhaparicchadāvēva ca syātāṁ [3] , tathēṣṭaputraṁjanayētām||11||

tataH putrakAmA pashcimato~agniM dakShiNato brAhmaNamupavishyAnvAlabheta saha bhartrAyatheShTaM putramAshAsAnA|
tatastasyA AshAsAnAyA Rutvik prajApatimabhinirdishya yonau tasyAH kAmaparipUraNArthaMkAmyAmiShTiM nirvartayed ‘viShNuryoniM kalpayatu’ ityanayarcA|
tatashcaivAjyena sthAlIpAkamabhighArya trirjuhuyAdyathAmnAyam|
mantropamantritamudapAtraM tasyai dadyAt sarvodakArthAn kuruShveti|
tataH samApte karmaNi pUrvaM dakShiNapAdamabhiharantI pradakShiNamagnimanuparikrAmet sahabhartrA|
tato [1] brAhmaNAn svasti vAcayitvA~a~ajyasheShaM [2] prAshnIyAt pUrvaM pumAn, pashcAt strI; nacocchiShTamavasheShayet|
tatastau saha saMvaseyAtAmaShTarAtraM, tathAvidhaparicchadAveva ca syAtAM [3] , tatheShTaputraMjanayetAm||11||
<div style="text-align:justify;">
Thereafter the woman, desirous of progeny, should sit with her husband on the west side of the altar, while the priest should sit to the south, and together they should perform the holy oblation to fire expressing their longing for a progeny. Then, the priest, addressing the God of procreation (Prajapati) for the fulfilment of her desire in her womb, should perform the ‘boon bestowing rite’, by chanting the said hymn ‘May Visnu bless the womb and make it fertile’. Then, the priest should prepare a bolus of cooked rice in an earthen pot by mixing the oblation with ghee, offering it to the holy fire thrice according to the prescribed methods. He should then give the sanctified pot of water to the woman to be used for all her purposes.

On the completion of the rite, she should, placing her right foot first, walk around the fire keeping to her right and accompanied by her husband. Then, after taking the the blessing of the ''brahmanas'', the couple should consume the remains of the sacrificial ghee - first the husband and then the wife - taking care not to leave any leftovers. On completion of this ritual, they shall cohabit for a period of eight nights, wearing the dress etc., as prescribed earlier. In this manner they will be able to beget a progeny, as desired. [11]
</div>
या तु स्त्री श्यामं लोहिताक्षं व्यूढोरस्कं महाबाहुं च पुत्रमाशासीत, या वा कृष्णं कृष्णमृदुदीर्घकेशं शुक्लाक्षं शुक्लदन्तंतेजस्विनमात्मवन्तम्; एष एवानयोरपि होमविधिः|
किन्तु परिबर्हो वर्णवर्जं स्यात्|
पुत्रवर्णानुरूपस्तु यथाशीरेव तयोः परिबर्होऽन्यः कार्यः स्यात्||१२||

yā tu strī śyāmaṁ lōhitākṣaṁ vyūḍhōraskaṁ mahābāhuṁ ca putramāśāsīta, yā vā kr̥ṣṇaṁkr̥ṣṇamr̥dudīrghakēśaṁ śuklākṣaṁ śukladantaṁ tējasvinamātmavantam; ēṣa ēvānayōrapi hōmavidhiḥ|
kintu paribarhō varṇavarjaṁ syāt|
putravarṇānurūpastu yathāśīrēva tayōḥ paribarhō'nyaḥ kāryaḥ syāt||12||

yA tu strI shyAmaM lohitAkShaM vyUDhoraskaM mahAbAhuM ca putramAshAsIta, yA vA kRuShNaMkRuShNamRududIrghakeshaM shuklAkShaM shukladantaM tejasvinamAtmavantam; eSha evAnayorapihomavidhiH|
kintu paribarho varNavarjaM syAt|
putravarNAnurUpastu yathAshIreva tayoH paribarho~anyaH kAryaH syAt||12||
<div style="text-align:justify;">
As regards the woman desirous of a child with sky blue complexion, red eye, broad chest and long limbs, or a woman who seeks off spring with black complexion, with black, soft and long hair, glittering white eye and teeth, radiant and self-restrained, the rituals to be followed are the same as described above. The preparations and materials required will not be of the same color but it should be made, in either case, to match the desired complexion of the child to be born, agreeable to the mother’s desire. [12]
</div>
==== Rituals for those belonging to the "shudra" lineage ====

शूद्रा तु नमस्कारमेव कुर्यात् (देवाग्निद्विजगुरुतपस्विसिद्धेभ्यः [४] )||१३||

śūdrā tu namaskāramēva kuryāt (dēvāgnidvijagurutapasvisiddhēbhyaḥ [4] )||13||

shUdrA tu namaskArameva kuryAt (devAgnidvijagurutapasvisiddhebhyaH [4] )||13||

Those belonging to ''shudra'' lineage, the mere act of salutation/pray (to the God, holy fire, ''brahmanas'', teachers/elders/preceptors, and saints and seers) should suffice. [13]

==== Advice for the mother desiring certain traits in her offspring ====

या या च यथाविधं पुत्रमाशासीत तस्यास्तस्यास्तां तां पुत्राशिषमनुनिशम्य तांस्ताञ्जनपदान्मनसाऽनुपरिक्रामयेत्|
ततो [५] या या येषां येषां जनपदानां मनुष्याणामनुरूपं पुत्रमाशासीत सा सा तेषां तेषां जनपदानांमनुष्याणामाहारविहारोपचारपरिच्छदाननुविधत्स्वेति वाच्या स्यात्|
इत्येतत् सर्वं पुत्राशिषां समृद्धिकरं कर्म व्याख्यातं भवति||१४||

yā yā ca yathāvidhaṁ putramāśāsīta tasyāstasyāstāṁ tāṁ putrāśiṣamanuniśamyatāṁstāñjanapadānmanasā'nuparikrāmayēt|
tatō [5] yā yā yēṣāṁ yēṣāṁ janapadānāṁ manuṣyāṇāmanurūpaṁ putramāśāsīta sā sā tēṣāṁ tēṣāṁjanapadānāṁ manuṣyāṇāmāhāravihārōpacāraparicchadānanuvidhatsvēti vācyā syāt|
ityētat sarvaṁ putrāśiṣāṁ samr̥ddhikaraṁ karma vyākhyātaṁ bhavati||14||

yA yA ca yathAvidhaM putramAshAsIta tasyAstasyAstAM tAM putrAshiShamanunishamyatAMstA~jjanapadAnmanasA~anuparikrAmayet|
tato [5] yA yA yeShAM yeShAM janapadAnAM manuShyANAmanurUpaM putramAshAsIta sA sA teShAMteShAM janapadAnAM manuShyANAmAhAravihAropacAraparicchadAnanuvidhatsveti vAcyA syAt|
ityetat sarvaM putrAshiShAM samRuddhikaraM karma vyAkhyAtaM bhavati||14||
<div style="text-align:justify;">
By knowing about the kind of child she desires, the woman should be advised to mentally travel to such places where people having similar dispositions live. Also, she should be advised to take diet, assume behavior, and engage in activities, attire, and social/cultural behooving such places and people.

Thus, the section detailing rituals that couples desirous of a healthy progeny – of the attributes of their liking – has been explained. [14]
</div>
==== Role of ''mahabhutas'' in contributing to the complexion of the offspring ====

न खलु केवलमेतदेव कर्म वर्णवैशेष्यकरं भवति|
अपि तु तेजोधातुरप्युदकान्तरिक्षधातुप्रायोऽवदातवर्णकरो भवति, पृथिवीवायुधातुप्रायः कृष्णवर्णकरः, समसर्वधातुप्रायःश्यामवर्णकरः||१५||

na khalu kēvalamētadēva karma varṇavaiśēṣyakaraṁ bhavati|
api tu tējōdhāturapyudakāntarikṣadhātuprāyō'vadātavarṇakarō bhavati, pr̥thivīvāyudhātuprāyaḥkr̥ṣṇavarṇakaraḥ, samasarvadhātuprāyaḥ śyāmavarṇakaraḥ||15||

na khalu kevalametadeva karma varNavaisheShyakaraM bhavati|
api tu tejodhAturapyudakAntarikShadhAtuprAyo~avadAtavarNakaro bhavati, pRuthivIvAyudhAtuprAyaHkRuShNavarNakaraH, samasarvadhAtuprAyaH shyAmavarNakaraH||15||
<div style="text-align:justify;">
Apart from the procedures mentioned above, ''mahabhutas'' also contribute in colour and complexion of skin. It is important to note that the ''teja'' (aura) associated with ''apa'' and ''akasha mahabuta'' are responsible for fair complexion, ''prithvi'' and ''vayu'' are responsible for black, and an equilibrium of all the five ''mahabhutas'' result in ''shyamavarna'' i.e. sky-like bluish complexion. [15]
</div>
==== Factors determining the psychological disposition of the progeny ====

सत्त्ववैशेष्यकराणि पुनस्तेषां तेषां प्राणिनां मातापितृसत्त्वान्यन्तर्वत्न्याः श्रुतयश्चाभीक्ष्णं स्वोचितं च कर्मसत्त्वविशेषाभ्यासश्चेति||१६||

sattvavaiśēṣyakarāṇi punastēṣāṁ tēṣāṁ prāṇināṁ mātāpitr̥sattvānyantarvatnyāḥ śrutayaścābhīkṣṇaṁsvōcitaṁ ca karma sattvaviśēṣābhyāsaścēti||16||

sattvavaisheShyakarANi punasteShAM teShAM prANinAM mAtApitRusattvAnyantarvatnyAHshrutayashcAbhIkShNaM svocitaM ca karma sattvavisheShAbhyAsashceti||16||
<div style="text-align:justify;">
The factors that determine the psychological disposition of the progeny depends upon the various mental traits of the parents, the impressions received by the pregnant woman, and the influence of past deeds (especially, the psychological makeup of the person in his/her past life). [16]
</div>
यथोक्तेन विधिनोपसंस्कृतशरीरयोः स्त्रीपुरुषयोर्मिश्रीभावमापन्नयोः शुक्रं शोणितेन सह संयोगं समेत्याव्यापन्नमव्यापन्नेनयोनावनुपहतायामप्रदुष्टे गर्भाशये गर्भमभिनिर्वर्तयत्येकान्तेन|
यथा-निर्मले वाससि सुपरिकल्पिते रञ्जनं समुदितगुणमुपनिपातादेव रागमभिनिर्वर्तयति, तद्वत्; यथा वाक्षीरंदध्नाऽभिषुतमभिषवणाद्विहाय स्वभावमापद्यते दधिभावं, शुक्रं तद्वत्||१७||

yathōktēna vidhinōpasaṁskr̥taśarīrayōḥ strīpuruṣayōrmiśrībhāvamāpannayōḥ śukraṁ śōṇitēna sahasaṁyōgaṁ samētyāvyāpannamavyāpannēna yōnāvanupahatāyāmapraduṣṭē garbhāśayēgarbhamabhinirvartayatyēkāntēna|
yathā- nirmalē vāsasi suparikalpitē rañjanaṁ samuditaguṇamupanipātādēva rāgamabhinirvartayati,tadvat; yathā vā kṣīraṁ dadhnā'bhiṣutamabhiṣavaṇādvihāya svabhāvamāpadyatē dadhibhāvaṁ, śukraṁtadvat||17||

yathoktena vidhinopasaMskRutasharIrayoH strIpuruShayormishrIbhAvamApannayoH shukraM shoNitenasaha saMyogaM sametyAvyApannamavyApannena yonAvanupahatAyAmapraduShTe garbhAshayegarbhamabhinirvartayatyekAntena|
yathA- nirmale vAsasi suparikalpite ra~jjanaM samuditaguNamupanipAtAdeva rAgamabhinirvartayati,tadvat; yathA vA kShIraM dadhnA~abhiShutamabhiShavaNAdvihAya svabhAvamApadyate dadhibhAvaM,shukraM tadvat||17||
<div style="text-align:justify;">
When a couple, whose body and mind are purified by above mentioned methods, engages in sexual intercourse, the undamaged sperm unites with the healthy ovum in a clean genital tract and the healthy uterus is home to an embryo with all the desired characters. Just as a well-washed cloth catches the colour of good dye instantly or milk, when mixed with drops of curd, transforms into curd leaving its original characters, the seeds acquire the positive attributes of the parents and the environment. [17]
</div>
एवमभिनिर्वर्तमानस्य गर्भस्य स्त्रीपुरुषत्वे हेतुः पूर्वमुक्तः|
यथा हि बीजमनुपतप्तमुप्तं स्वां स्वां प्रकृतिमनुविधीयते व्रीहिर्वा व्रीहित्वं यवो वा यवत्वं तथा स्त्रीपुरुषावपि यथोक्तंहेतुविभागमनुविधीयेते||१८||

ēvamabhinirvartamānasya garbhasya strīpuruṣatvē hētuḥ pūrvamuktaḥ|
yathā hi bījamanupataptamuptaṁ svāṁ svāṁ prakr̥timanuvidhīyatē vrīhirvā vrīhitvaṁ yavō vā yavatvaṁtathā strīpuruṣāvapi yathōktaṁ hētuvibhāgamanuvidhīyētē||18||
evamabhinirvartamAnasya garbhasya strIpuruShatve hetuH pUrvamuktaH|
yathA hi bIjamanupataptamuptaM svAM svAM prakRutimanuvidhIyate vrIhirvA vrIhitvaM yavo vA yavatvaMtathA strIpuruShAvapi yathoktaM hetuvibhAgamanuvidhIyete||18||
<div style="text-align:justify;">
Factors determining the sex of an embryo have already been explained. Just as an undamaged seed when sown reproduces its own kind, such as the paddy seed germinates into paddy and the barley seed produces barley, so too men and women beget children possessing the natural characteristics of their parents. [18]
</div>
==== Factors that can change the progeny's sex before birth ====

तयोः कर्मणा वेदोक्तेन विवर्तनमुपदिश्यते [१] प्राग्व्यक्तीभावात् प्रयुक्तेन सम्यक्|
कर्मणां हि देशकालसम्पदुपेतानां नियतमिष्टफलत्वं, तथेतरेषामितरत्वम्|
तस्मादापन्नगर्भां स्त्रियमभिसमीक्ष्य प्राग्व्यक्तीभावाद्गर्भस्य पुंसवनमस्यै दद्यात्|
गोष्ठे जातस्य न्यग्रोधस्य प्रागुत्तराभ्यां शाखाभ्यां शुङ्गे अनुपहते आदाय द्वाभ्यां धान्यमाषाभ्यां सम्पदुपेताभ्यांगौरसर्षपाभ्यां वा सह दध्नि प्रक्षिप्य पुष्येण पिबेत्, तथैवापराञ्जीवकर्षभकापामार्गसहचरकल्कांश्च युगपदेकैकशो यथेष्टंवाऽप्युपसंस्कृत्य पयसा, कुड्यकीटकं मत्स्यकं वोदकाञ्जलौ प्रक्षिप्य पुष्येण पिबेत्, तथा कनकमयान् राजतानायसांश्चपुरुषकानग्निवर्णानणुप्रमाणान् दध्नि पयस्युदकाञ्जलौ वा प्रक्षिप्य पिबेदनवशेषतः पुष्येण, पुष्येणैव च शालिपिष्टस्यपच्यमानस्योष्माणमुपाघ्राय तस्यैव च पिष्टस्योदकसंसृष्टस्य रसं देहल्यामुपनिधाय [२] दक्षिणे नासापुटे स्वयमासिञ्चेत्पिचुना|
यच्चान्यदपि ब्राह्मणा ब्रूयुराप्ता वा स्त्रियः पुंसवनमिष्टं तच्चानुष्ठेयम्|
इति पुंसवनानि||१९||

tayōḥ karmaṇā vēdōktēna vivartanamupadiśyatē [1] prāgvyaktībhāvāt prayuktēna samyak|
karmaṇāṁ hi dēśakālasampadupētānāṁ niyatamiṣṭaphalatvaṁ, tathētarēṣāmitaratvam|
tasmādāpannagarbhāṁ striyamabhisamīkṣya prāgvyaktībhāvādgarbhasya puṁsavanamasyai dadyāt|
gōṣṭhē jātasya nyagrōdhasya prāguttarābhyāṁ śākhābhyāṁ śuṅgē anupahatē ādāya dvābhyāṁdhānyamāṣābhyāṁ sampadupētābhyāṁ gaurasarṣapābhyāṁ vā saha dadhni prakṣipya puṣyēṇa pibēt,tathaivāparāñjīvakarṣabhakāpāmārgasahacarakalkāṁśca yugapadēkaikaśō yathēṣṭaṁvā'pyupasaṁskr̥tya payasā, kuḍyakīṭakaṁ matsyakaṁ vōdakāñjalau prakṣipya puṣyēṇa pibēt, tathākanakamayān rājatānāyasāṁśca puruṣakānagnivarṇānaṇupramāṇān dadhni payasyudakāñjalau vāprakṣipya pibēdanavaśēṣataḥ puṣyēṇa, puṣyēṇaiva ca śālipiṣṭasya pacyamānasyōṣmāṇamupāghrāyatasyaiva ca piṣṭasyōdakasaṁsr̥ṣṭasya rasaṁ dēhalyāmupanidhāya [2] dakṣiṇē nāsāpuṭē svayamāsiñcētpicunā|
yaccānyadapi brāhmaṇā brūyurāptā vā striyaḥ puṁsavanamiṣṭaṁ taccānuṣṭhēyam|
iti puṁsavanāni||19||

tayoH karmaNA vedoktena vivartanamupadishyate [1] prAgvyaktIbhAvAt prayuktena samyak|
karmaNAM hi deshakAlasampadupetAnAM niyatamiShTaphalatvaM, tathetareShAmitaratvam|
tasmAdApannagarbhAM striyamabhisamIkShya prAgvyaktIbhAvAdgarbhasya puMsavanamasyai dadyAt|
goShThe jAtasya nyagrodhasya prAguttarAbhyAM shAkhAbhyAM shu~gge anupahate AdAya dvAbhyAMdhAnyamAShAbhyAM sampadupetAbhyAM gaurasarShapAbhyAM vA saha dadhni prakShipya puShyeNapibet, tathaivAparA~jjIvakarShabhakApAmArgasahacarakalkAMshca yugapadekaikasho yatheShTaMvA~apyupasaMskRutya payasA, kuDyakITakaM matsyakaM vodakA~jjalau prakShipya puShyeNa pibet,tathA kanakamayAn rAjatAnAyasAMshca puruShakAnagnivarNAnaNupramANAn dadhnipayasyudakA~jjalau vA prakShipya pibedanavasheShataH puShyeNa, puShyeNaiva ca shAlipiShTasyapacyamAnasyoShmANamupAghrAya tasyaiva ca piShTasyodakasaMsRuShTasya rasaMdehalyAmupanidhAya [2] dakShiNe nAsApuTe svayamAsi~jcet picunA|
yaccAnyadapi brAhmaNA brUyurAptA vA striyaH puMsavanamiShTaM taccAnuShTheyam|
iti puMsavanAni||19||
<div style="text-align:justify;">
This verse lays down procedures mentioned in Vedic scriptures that, if administered correctly, could change the sex of an offspring even before its birth. When applied in the best of places and time, these procedures bear the desired fruit invariably always. Therefore, after examining the woman who has conceived recently, before the signs of gestation become apparent, (the physician) should administer ''pumsavana'' (procedures to beget a male offspring) on her.

On the day of the appearance of the auspicious ''pushyanakshatra'', one should collect two fresh leaf-buds from a banyan tree (Ficusreligiosa Linn), growing in a cow-pen (typically, an open ground or range where cows are kept), from its eastern or northern side branches. Then those leaf-buds should be added to curd and blended with either two good grains of ''masha'' (Phaseolus radiatus Linn - black gram) or white mustard seeds, and then given to the expectant mother to drink. Or, she may be given milk to drink that has been processed with the paste of ''jivaka, rishabhaka, apamarga'' (Achyranthesaspera Linn), and ''saireyaka'' (synonym of ''Sahachara''–Barleriacristata Linn) -either all mixed into a paste together or separately, as required. Or else she should be given a handful of water with ''kudyakitaka'' (a type of insect) or ''matsyaka'' (a type of small fish) on the occasion of ''pushyanakshatra''.
Similarly, on the event of ''pushyanakshatra'', she should drink handful of curd milk or water, without leaving any leftover, duly immersed with red hot miniature male statuettes made of gold, silver or and iron. Similarly, on the occasion of ''pushyanakshatra'', she should be made to inhale the steam emanating from steaming dish of powdered ''shali'' rice (while it is being cooked) and she herself should daub into her right nostril, using a cotton swab, drops of water from that same cooking pot, by placing (her head) on the ''daheli'' (door-sill).

In addition to these rituals, any other measures suggested by ''brahmanas'' or well versed (experienced and well-favoring) women as ''pumsavana'', should also be applied.

This concludes the verse on ''pumsavana''. [19]
</div>
==== Measures for the preservation of the embryo ====

अत ऊर्ध्वं गर्भस्थापनानि व्याख्यास्यामः
ऐन्द्री ब्राह्मी शतवीर्या सहस्रवीर्याऽमोघाऽव्यथा शिवाऽरिष्टा वाट्यपुष्पीविष्वक्सेनकान्ता चेत्यासामोषधीनां शिरसा दक्षिणेन वा पाणिना धारणं, एताभिश्चैव सिद्धस्य पयसः सर्पिषो वा पानम्,एताभिश्चैव पुष्ये पुष्ये स्नानं, सदा च ताः [१] समालभेत|
तथा सर्वासां जीवनीयोक्तानामोषधीनां सदोपयोगस्तैस्तैरुपयोगविधिभिः|
इति गर्भस्थापनानि व्याख्यातानि भवन्ति||२०||

ata ūrdhvaṁ garbhasthāpanāni vyākhyāsyāmaḥ- aindrī brāhmī śatavīryā sahasravīryā'mōghā'vyathāśivā'riṣṭā vāṭyapuṣpī viṣvaksēnakāntā cētyāsāmōṣadhīnāṁ śirasā dakṣiṇēna vā pāṇinā dhāraṇaṁ,ētābhiścaiva siddhasya payasaḥ sarpiṣō vā pānam, ētābhiścaiva puṣyē puṣyē snānaṁ, sadā ca tāḥ [1]samālabhēta|
tathā sarvāsāṁ jīvanīyōktānāmōṣadhīnāṁ sadōpayōgastaistairupayōgavidhibhiḥ|
iti garbhasthāpanāni vyākhyātāni bhavanti||20||

ata UrdhvaM garbhasthApanAni vyAkhyAsyAmaH- aindrI brAhmI shatavIryAsahasravIryA~amoghA~avyathA shivA~ariShTA vATyapuShpI viShvaksenakAntA cetyAsAmoShadhInAMshirasA dakShiNena vA pANinA dhAraNaM, etAbhishcaiva siddhasya payasaH sarpiSho vA pAnam,etAbhishcaiva puShye puShye snAnaM, sadA ca tAH [1] samAlabheta|
tathA sarvAsAM jIvanIyoktAnAmoShadhInAM sadopayogastaistairupayogavidhibhiH|
iti garbhasthApanAni vyAkhyAtAni bhavanti||20||
<div style="text-align:justify;">
From this verse onwards, measures for the preservation of embryo (''garbha'') have been explained. Some of these rituals or practices require the pregnant woman to wear herbs, such as ''aindri'' (Citrulluscolocynthis Schrad – Gorakshakarkati), ''brahmi'' (Bacopamonnieri Pennel), ''satavirya'' (Cynodon doctylon Pers), ''sahasravirya'' (a variety of ''durva'' - cynodon species, also known as ''durvadwaya''), ''amogha'' (''patala'' – Stereospermumsuaveolens DC), ''avyatha'' (''guduchi'' – Tinospora cordifolia Miers), ''shiva''(''haritaki'' – Terminaliachebula Linn), ''arishta'' (katukarohini – Piccrorhizakurroa Royle ex Benth), ''vatyapushpi'' (Pitabala – Sidacordifolia Linn), and ''vishwaksenakanta'' (''priyangu'' – Callicarpa macrophylla Vahl.),on her head or her right hand. Or she may drink milk or ghee processed with the above mentioned herbs, or bathe at every occasion of ''pushyanakshatra'' with water boiled using these herbs, and she should keep these herbs readily available always. Similarly, the regular use of all of the ''jivaniya'' class of herbs (life promoter group of herbs) in the (above) prescribed manner is also beneficial. Thus, the procedures for stabilization of embryo (''garbha'') have been described in this verse. [20]
</div>
==== Factors that could damage or destroy the embryo ====

गर्भोपघातकरास्त्विमे भावा भवन्ति; तद्यथा
उत्कटविषमकठिनासनसेविन्या [१] वातमूत्रपुरीषवेगानुपरुन्धत्यादारुणानुचितव्यायामसेविन्यास्तीक्ष्णोष्णातिमात्रसेविन्याः प्रमिताशनसेविन्या गर्भो म्रियतेऽन्तः कुक्षेः, अकाले वा स्रंसते,शोषी वा भवति; तथाऽभिघातप्रपीडनैः श्वभ्रकूपप्रपातदेशावलोकनैर्वाऽभीक्ष्णं मातुः प्रपतत्यकालेगर्भः,तथाऽतिमात्रसङ्क्षोभिभिर्यानैर्यानेन, अप्रियातिमात्रश्रवणैर्वा|
प्रततोत्तानशायिन्याः पुनर्गर्भस्य नाभ्याश्रया नाडी कण्ठमनुवेष्टयति, विवृतशायिनी नक्तञ्चारिणी चोन्मत्तं जनयति,अपस्मारिणं पुनः कलिकलहशीला, व्यवायशीला दुर्वपुषमह्रीकं स्त्रैणं वा, शोकनित्या भीतमपचितमल्पायुषं वा, अभिध्यात्री [२]परोपतापिनमीर्ष्युं स्त्रैणं वा, स्तेना त्वायासबहुलमतिद्रोहिणमकर्मशीलं वा, अमर्षिणी चण्डमौपधिकमसूयकं वा स्वप्ननित्यातन्द्रालुमबुधमल्पाग्निं वा, मद्यनित्या पिपासालुमल्पस्मृतिमनवस्थितचित्तं वा, गोधामांसप्राया [३] शार्करिणमश्मरिणंशनैर्मेहिणं वा, वराहमांसप्राया रक्ताक्षं क्रथनमतिपरुषरोमाणं वा, मत्स्यमांसनित्या चिरनिमेषं स्तब्धाक्षं वा, मधुरनित्याप्रमेहिणं मूकमतिस्थूलं वा, अम्लनित्या रक्तपित्तिनं त्वगक्षिरोगिणं वा, लवणनित्या शीघ्रवलीपलितं खालित्यरोगिणं वा,कटुकनित्या दुर्बलमल्पशुक्रमनपत्यं वा, तिक्तनित्या शोषिणमबलमनुपचितं वा, कषायनित्या श्यावमानाहिनमुदावर्तिनं वा,यद्यच्च यस्य यस्य व्याधेर्निदानमुक्तं तत्तदासेवमानाऽन्तर्वत्नी तन्निमित्तविकारबहुलमपत्यं जनयति|
पितृजास्तु शुक्रदोषा मातृजैरपचारैर्व्याख्याताः|
इति गर्भोपघातकरा भावा भवन्त्युक्ताः [४] |
तस्मादहितानाहारविहारान् प्रजासम्पदमिच्छन्ती स्त्री विशेषेण वर्जयेत्|
साध्वाचारा चात्मानमुपचरेद्धिताभ्यामाहारविहाराभ्यामिति||२१||

garbhōpaghātakarāstvimē bhāvā bhavanti; tadyathā- utkaṭaviṣamakaṭhināsanasēvinyā [1]vātamūtrapurīṣavēgānuparundhatyā dāruṇānucitavyāyāmasēvinyāstīkṣṇōṣṇātimātrasēvinyāḥpramitāśanasēvinyā garbhō mriyatē'ntaḥ kukṣēḥ, akālē vā sraṁsatē, śōṣī vā bhavati;tathā'bhighātaprapīḍanaiḥ śvabhrakūpaprapātadēśāvalōkanairvā'bhīkṣṇaṁ mātuḥprapatatyakālēgarbhaḥ, tathā'timātrasaṅkṣōbhibhiryānairyānēna, apriyātimātraśravaṇairvā|
pratatōttānaśāyinyāḥ punargarbhasya nābhyāśrayā nāḍī kaṇṭhamanuvēṣṭayati, vivr̥taśāyinī naktañcāriṇīcōnmattaṁ janayati, apasmāriṇaṁ punaḥ kalikalahaśīlā, vyavāyaśīlā durvapuṣamahrīkaṁ straiṇaṁ vā,śōkanityā bhītamapacitamalpāyuṣaṁ vā, abhidhyātrī [2] parōpatāpinamīrṣyuṁ straiṇaṁ vā, stēnātvāyāsabahulamatidrōhiṇamakarmaśīlaṁ vā, amarṣiṇī caṇḍamaupadhikamasūyakaṁ vā svapnanityātandrālumabudhamalpāgniṁ vā, madyanityā pipāsālumalpasmr̥timanavasthitacittaṁ vā,gōdhāmāṁsaprāyā [3] śārkariṇamaśmariṇaṁ śanairmēhiṇaṁ vā, varāhamāṁsaprāyā raktākṣaṁkrathanamatiparuṣarōmāṇaṁ vā, matsyamāṁsanityā ciranimēṣaṁ stabdhākṣaṁ vā, madhuranityāpramēhiṇaṁ mūkamatisthūlaṁ vā, amlanityā raktapittinaṁ tvagakṣirōgiṇaṁ vā, lavaṇanityāśīghravalīpalitaṁ khālityarōgiṇaṁ vā, kaṭukanityā durbalamalpaśukramanapatyaṁ vā, tiktanityāśōṣiṇamabalamanupacitaṁ vā, kaṣāyanityā śyāvamānāhinamudāvartinaṁ vā, yadyacca yasya yasyavyādhērnidānamuktaṁ tattadāsēvamānā'ntarvatnī tannimittavikārabahulamapatyaṁ janayati|
pitr̥jāstu śukradōṣā mātr̥jairapacārairvyākhyātāḥ|
iti garbhōpaghātakarā bhāvā bhavantyuktāḥ [4] |
tasmādahitānāhāravihārān prajāsampadamicchantī strī viśēṣēṇa varjayēt|
sādhvācārā cātmānamupacarēddhitābhyāmāhāravihārābhyāmiti||21||

garbhopaghAtakarAstvime bhAvA bhavanti; tadyathA- utkaTaviShamakaThinAsanasevinyA [1]vAtamUtrapurIShavegAnuparundhatyA dAruNAnucitavyAyAmasevinyAstIkShNoShNAtimAtrasevinyAHpramitAshanasevinyA garbho mriyate~antaH kukSheH, akAle vA sraMsate, shoShI vA bhavati;tathA~abhighAtaprapIDanaiH shvabhrakUpaprapAtadeshAvalokanairvA~abhIkShNaM mAtuHprapatatyakAlegarbhaH, tathA~atimAtrasa~gkShobhibhiryAnairyAnena, apriyAtimAtrashravaNairvA|
pratatottAnashAyinyAH punargarbhasya nAbhyAshrayA nADI kaNThamanuveShTayati, vivRutashAyinInakta~jcAriNI conmattaM janayati, apasmAriNaM punaH kalikalahashIlA, vyavAyashIlAdurvapuShamahrIkaM straiNaM vA, shokanityA bhItamapacitamalpAyuShaM vA, abhidhyAtrI [2]paropatApinamIrShyuM straiNaM vA, stenA tvAyAsabahulamatidrohiNamakarmashIlaM vA, amarShiNIcaNDamaupadhikamasUyakaM vA svapnanityA tandrAlumabudhamalpAgniM vA, madyanityApipAsAlumalpasmRutimanavasthitacittaM vA, godhAmAMsaprAyA [3] shArkariNamashmariNaMshanairmehiNaM vA, varAhamAMsaprAyA raktAkShaM krathanamatiparuSharomANaM vA,matsyamAMsanityA ciranimeShaM stabdhAkShaM vA, madhuranityA pramehiNaM mUkamatisthUlaM vA,amlanityA raktapittinaM tvagakShirogiNaM vA, lavaNanityA shIghravalIpalitaM khAlityarogiNaM vA,kaTukanityA durbalamalpashukramanapatyaM vA, tiktanityA shoShiNamabalamanupacitaM vA,kaShAyanityA shyAvamAnAhinamudAvartinaM vA, yadyacca yasya yasya vyAdhernidAnamuktaMtattadAsevamAnA~antarvatnI tannimittavikArabahulamapatyaM janayati|
pitRujAstu shukradoShA mAtRujairapacArairvyAkhyAtAH|
iti garbhopaghAtakarA bhAvA bhavantyuktAH [4] |
tasmAdahitAnAhAravihArAn prajAsampadamicchantI strI visheSheNa varjayet|
sAdhvAcArA cAtmAnamupacareddhitAbhyAmAhAravihArAbhyAmiti||21||
<div style="text-align:justify;">
The following factors may damage or destroy the embryo/fetus: a woman who sits in awkward positions, on uneven and hard seats, or suppresses the urge to pass flatulence, urine and bowel movement, or indulges in intensive or extreme forms of physical activities, or is excessively addicted to consuming pungent and hot things, or eats very sparingly. In such scenarios, her fetus could dry up in the womb or get delivered prematurely, or atrophy.

Similarly, by suffering repeated trauma or similar injuries, or on looking down from heights (e.g., from mountain-tops or cliffs, deep wells, etc.), the expectant mother is liable to miscarry. Similarly, she is liable to miscarry if she travels long distances in excessively jerky carriages, or is exposed to, for prolonged periods of time, loud and unpleasant noise.

By constantly resting or sleeping on her back, the umbilical cord attached to the fetus winds itself round the throat of the fetus, thus tending to strangulate it (so pregnant woman should avoid such posture). Similarly, a woman who sleeps in open air or is used to walking at night is prone to giving birth to a mentally-challenged child. If the woman indulges in too much of quarrels and fights, the child could become epileptic. A woman who indulges in sexual practice excessively (or a nymphomaniac) will give birth to truant with a passion for women. A woman under constant grief would give birth to a timid, or under-developed or short-lived child. A woman who always thinks ill of others will give birth to a delinquent or an anti-social. A woman who is a thief will give birth to a lazy child who is wicked and inept, while an intolerant woman would give birth to a child who is of fierce, deceitful and jealous nature. A woman who sleeps for long hours would give birth to a dull and unwise child with poor digestive powers, while a woman addicted to wines to a child who is ever-thirsty and fickle minded. A woman who consumes flesh and meat of ''godha'' (iguana) would give birth to a child afflicted with stones or ''shanairmeha'' (a type of urinary disorder where dribbling is seen), while a woman used to consume pork frequently would give birth to a child with red eyes, rough body-hair, and prone to suffering from severe respiratory disorders. A woman used to consume fish excessively would give birth to a child with lagophthalmos and related eye disorders, while a woman used to eating a lot of sweets is prone to giving birth to a dumb or excessively obese child or a child afflicted with diabetes. A woman fond of sour things is prone to giving birth to an offspring suffering from bleeding disorders or diseases of skin and eyes, while a woman addicted to salt or salty food articles may give birth to a child with early onset of wrinkles, grey hair or baldness. A woman used to pungent substances in excess may give birth to a weak child, deficient in semen and impotent, while a woman using bitter substances in excess may give birth to a child with emaciated, weak or undeveloped body. A woman habituated to excessive use of astringents may give birth to a child with blackish complexion, suffering from constipation and ''udavarta'' (misperistalsis).

In summary, a pregnant woman indulging in unhealthy dietary and lifestyle activities that could cause certain diseases would increase the risk of her off spring getting afflicted with similar (or more virulent) disorders. From the father’s side, defects in semen could occur due to above mentioned factors for mother. Hence, a woman desirous of a child with excellent qualities should abstain from all forms of addictions as well as unhealthy dietary and lifestyle activities. [21]
</div>
==== Treating pregnant women afflicted with ailments ====

व्याधींश्चास्या मृदुमधुरशिशिरसुखसुकुमारप्रायैरौषधाहारोपचारैरुपचरेत्, न चास्या वमनविरेचनशिरोविरेचनानि प्रयोजयेत्, नरक्तमवसेचयेत्, सर्वकालं च नास्थापनमनुवासनं वा कुर्यादन्यत्रात्ययिकाद्व्याधेः|
अष्टमं मासमुपादाय वमनादिसाध्येषु पुनर्विकारेष्वात्ययिकेषु मृदुभिर्वमनादिभिस्तदर्थकारिभिर्वोपचारः स्यात्|
पूर्णमिव तैलपात्रमसङ्क्षोभयताऽन्तर्वत्नी [१] भवत्युपचर्या||२२||

vyādhīṁścāsyā mr̥dumadhuraśiśirasukhasukumāraprāyairauṣadhāhārōpacārairupacarēt, na cāsyāvamanavirēcanaśirōvirēcanāni prayōjayēt, na raktamavasēcayēt, sarvakālaṁ ca nāsthāpanamanuvāsanaṁ vākuryādanyatrātyayikādvyādhēḥ|
aṣṭamaṁ māsamupādāya vamanādisādhyēṣu punarvikārēṣvātyayikēṣumr̥dubhirvamanādibhistadarthakāribhirvōpacāraḥ syāt|
pūrṇamiva tailapātramasaṅkṣōbhayatā'ntarvatnī [1] bhavatyupacaryā||22||

vyAdhIMshcAsyA mRudumadhurashishirasukhasukumAraprAyairauShadhAhAropacArairupacaret, na cAsyAvamanavirecanashirovirecanAni prayojayet, na raktamavasecayet, sarvakAlaM ca nAsthApanamanuvAsanaM vAkuryAdanyatrAtyayikAdvyAdheH|
aShTamaM mAsamupAdAya vamanAdisAdhyeShu punarvikAreShvAtyayikeShumRudubhirvamanAdibhistadarthakAribhirvopacAraH syAt|
pUrNamiva tailapAtramasa~gkShobhayatA~antarvatnI [1] bhavatyupacaryA||22||
<div style="text-align:justify;">
Any ailment or disease afflicting a pregnant woman should be treated very delicately, by means of medicaments and diet that are mainly soft, palatable, cooling, pleasant and mild. She should not be subjected to emetics, purgatives, or ''nasya'' (errhines), or to practices such as bloodletting. She should not be, at any time, administered corrective and unctuous enema, except in very serious emergency situations. In her final trimester, the pregnant woman, if in emergency conditions wherein emesis is urgently required, should only be treated by means of very mild emetics etc., or by its substitutes. A pregnant woman should be handled like a pot brimful of oil, which can spill on irritation i.e., very delicately. [22]
</div>
==== Occurrences of bleeding during pregnancy ====

सा चेदपचाराद् द्वयोस्त्रिषु वा मासेषु पुष्पं पश्येन्नास्या गर्भः स्थास्यतीति विद्यात्; अजातसारो हि तस्मिन् काले भवतिगर्भः||२३||
sā cēdapacārād dvayōstriṣu vā māsēṣu puṣpaṁ paśyēnnāsyā garbhaḥ sthāsyatīti vidyāt; ajātasārō hi tasmin kālēbhavati garbhaḥ||23||
sA cedapacArAd dvayostriShu vA mAseShu puShpaM pashyennAsyA garbhaH sthAsyatIti vidyAt; ajAtasAro hi tasmin kAle bhavatigarbhaH||23||

If, as the result of wrongful behavior, bleeding occurs in a pregnant woman either in the second or third month, one should conclude that the conception will not be sustainable, as the embryo during this period is still immature. [23]

सा चेच्चतुष्प्रभृतिषु मासेषुक्रोधशोकासूयेर्ष्याभयत्रासव्यवायव्यायामसङ्क्षोभसन्धारणविषमाशनशयनस्थानक्षुत्पिपासातियोगात् कदाहाराद्वा पुष्पंपश्येत्, तस्या गर्भस्थापनविधिमुपदेक्ष्यामः|
पुष्पदर्शनादेवैनां ब्रूयात्- शयनं तावन्मृदुसुखशिशिरास्तरणसंस्तीर्णमीषदवनतशिरस्कं प्रतिपद्यस्वेति|
ततो यष्टीमधुकसर्पिर्भ्यां परमशिशिरवारिणी संस्थिताभ्यां पिचुमाप्लाव्योपस्थसमीपे स्थापयेत्तस्याः, तथाशतधौतसहस्रधौताभ्यां सर्पिर्भ्यामधोनाभेः सर्वतः प्रदिह्यात्, सर्वतश्च गव्येन चैनां पयसा सुशीतेन मधुकाम्बुना वान्यग्रोधादिकषायेण वा परिषेचयेदधो नाभेः, उदकं वा सुशीतमवगाहयेत्, क्षीरिणां कषायद्रुमाणां च स्वरसपरिपीतानि चेलानि [२]ग्राहयेत्, न्यग्रोधादिशुङ्गासिद्धयोर्वाक्षीरसर्पिषोः पिचुं ग्राहयेत्, अतश्चैवाक्षमात्रं प्राशयेत्, प्राशयेद्वा केवलं क्षीरसर्पिः,पद्मोत्पलकुमुदकिञ्जल्कांश्चास्यै समधुशर्करान् लेहार्थं दद्यात्, शृङ्गाटकपुष्करबीजकशेरुकान् भक्ष्णार्थं,गन्धप्रियङ्ग्वसितोत्पलशालूकोदुम्बरशलाटुन्यग्रोधशुङ्गानि वा पाययेदेनामाजेन पयसा, पयसा चैनांबलातिबलाशालिषष्टिकेक्षुमूलकाकोलीशृतेन समधुशर्करं रक्तशालीनामोदनं मृदुसुरभिशीतलं भोजयेत्,लावकपिञ्जलकुरङ्गशम्बरशशहरिणैणकालपुच्छकरसेन वा घृतसुसंस्कृतेन सुखशिशिरोपवातदेशस्थां भोजयेत्,क्रोधशोकायासव्यवायव्यायामेभ्यश्चाभिरक्षेत्, सौम्याभिश्चैनां कथाभिर्मनोनुकूलाभिरुपासीत; तथाऽस्या गर्भस्तिष्ठति||२४||

sā cēccatuṣprabhr̥tiṣu māsēṣukrōdhaśōkāsūyērṣyābhayatrāsavyavāyavyāyāmasaṅkṣōbhasandhāraṇaviṣamāśanaśayanasthānakṣutpipāsātiyōgātkadāhārādvā puṣpaṁ paśyēt, tasyā garbhasthāpanavidhimupadēkṣyāmaḥ|
puṣpadarśanādēvaināṁ brūyāt- śayanaṁ tāvanmr̥dusukhaśiśirāstaraṇasaṁstīrṇamīṣadavanataśiraskaṁpratipadyasvēti|
tatō yaṣṭīmadhukasarpirbhyāṁ paramaśiśiravāriṇī saṁsthitābhyāṁ picumāplāvyōpasthasamīpē sthāpayēttasyāḥ,tathā śatadhautasahasradhautābhyāṁ sarpirbhyāmadhōnābhēḥ sarvataḥ pradihyāt, sarvataśca gavyēna caināṁpayasā suśītēna madhukāmbunā vā nyagrōdhādikaṣāyēṇa vā pariṣēcayēdadhō nābhēḥ, udakaṁ vāsuśītamavagāhayēt, kṣīriṇāṁ kaṣāyadrumāṇāṁ ca svarasaparipītāni cēlāni [2] grāhayēt,nyagrōdhādiśuṅgāsiddhayōrvākṣīrasarpiṣōḥ picuṁ grāhayēt, ataścaivākṣamātraṁ prāśayēt, prāśayēdvā kēvalaṁkṣīrasarpiḥ, padmōtpalakumudakiñjalkāṁścāsyai samadhuśarkarān lēhārthaṁ dadyāt,śr̥ṅgāṭakapuṣkarabījakaśērukān bhakṣṇārthaṁ, gandhapriyaṅgvasitōtpalaśālūkōdumbaraśalāṭunyagrōdhaśuṅgānivā pāyayēdēnāmājēna payasā, payasā caināṁ balātibalāśāliṣaṣṭikēkṣumūlakākōlīśr̥tēna samadhuśarkaraṁraktaśālīnāmōdanaṁ mr̥dusurabhiśītalaṁ bhōjayēt,lāvakapiñjalakuraṅgaśambaraśaśahariṇaiṇakālapucchakarasēna vā ghr̥tasusaṁskr̥tēnasukhaśiśirōpavātadēśasthāṁ bhōjayēt, krōdhaśōkāyāsavyavāyavyāyāmēbhyaścābhirakṣēt, saumyābhiścaināṁkathābhirmanōnukūlābhirupāsīta; tathā'syā garbhastiṣṭhati||24||

sA ceccatuShprabhRutiShu mAseShukrodhashokAsUyerShyAbhayatrAsavyavAyavyAyAmasa~gkShobhasandhAraNaviShamAshanashayanasthAnakShutpipAsAtiyogAtkadAhArAdvA puShpaM pashyet, tasyA garbhasthApanavidhimupadekShyAmaH|
puShpadarshanAdevainAM brUyAt- shayanaM tAvanmRudusukhashishirAstaraNasaMstIrNamIShadavanatashiraskaMpratipadyasveti|
tato yaShTImadhukasarpirbhyAM paramashishiravAriNI saMsthitAbhyAM picumAplAvyopasthasamIpe sthApayettasyAH, tathAshatadhautasahasradhautAbhyAM sarpirbhyAmadhonAbheH sarvataH pradihyAt, sarvatashca gavyena cainAM payasA sushItenamadhukAmbunA vA nyagrodhAdikaShAyeNa vA pariShecayedadho nAbheH, udakaM vA sushItamavagAhayet, kShIriNAMkaShAyadrumANAM ca svarasaparipItAni celAni [2] grAhayet, nyagrodhAdishu~ggAsiddhayorvAkShIrasarpiShoH picuM grAhayet,atashcaivAkShamAtraM prAshayet, prAshayedvA kevalaM kShIrasarpiH, padmotpalakumudaki~jjalkAMshcAsyaisamadhusharkarAn lehArthaM dadyAt, shRu~ggATakapuShkarabIjakasherukAn bhakShNArthaM,gandhapriya~ggvasitotpalashAlUkodumbarashalATunyagrodhashu~ggAni vA pAyayedenAmAjena payasA, payasA cainAMbalAtibalAshAliShaShTikekShumUlakAkolIshRutena samadhusharkaraM raktashAlInAmodanaM mRudusurabhishItalaM bhojayet,lAvakapi~jjalakura~ggashambarashashahariNaiNakAlapucchakarasena vA ghRutasusaMskRutenasukhashishiropavAtadeshasthAM bhojayet, krodhashokAyAsavyavAyavyAyAmebhyashcAbhirakShet, saumyAbhishcainAMkathAbhirmanonukUlAbhirupAsIta; tathA~asyA garbhastiShThati||24||
<div style="text-align:justify;">
If the pregnant woman, in her second trimester or later, as a consequence of excessive anger, grief, intolerance, envy, fear, sex, exercise, agitation, suppression of body urges, faulty eating, faulty lying down and standing habits, excessive hunger and thirst or as the result of malnutrition, starts to bleed, then the following course of treatment should be adopted to safeguard the conception from any mishap:
• As soon as the blood discharge is noticed, the patient should be instructed to lie down on a soft and comfortable couch with her head placed slightly lower than the rest of herbody.
• The physician should then place a cotton swab, immersed in medicated ghee prepared with yashtimadhu (Glycyrrhiza glabraLinn) and then kept in cold water, near or in the vaginal passage. She should also be annointed with shatadhautaor sahasradhauta ghrita (ghee washed a hundred or a thousand times with water or medicated decoctions) on or below the navel region. Similarly, she could also be sprinkled with cold milk or decoction of madhuka and nyagrodhadi class of (Ficusbengalensis Linn) herbs on or below her navel region, or she should take bath in tub of cold water. Cloth pieces soaked in the juice of ksheerivriksha (latex-yielding trees) class of herbs, or a cotton swab soaked in milk and ghee processed with leaf-buds of nyagrodhadi (Ficusbengalensis Linn) class of drugs should be inserted into her vagina. She should also consume ghee made up of milk in a quantity of aksha (about 10-12 ml) and treated with the same drugs as mentioned above. She should be offered a concoction made up of stamens of kamala (Nelumbo nucifera Gaertn.), utpala (Nymphaea alba Linn), and kumuda (a variety of Nymphaea species), mixed with honey and sugar linctus. She should eat singhataka (Trapabispinosa Roxb. – chestnut), pushkarabeeja (lotus seeds –Nelumbonucifera Gaertn.) and kasheruka (Scirpusgrossus Linn. f.). She may be given goat’s milk boiled with gandhapriyangu (Callicarpamacrophylla Vahl.), nilotpala (blue variety of Nymphaeaalba Linn), shaluka (rhizome of lotus), fruits of udumbara (Ficusracemosa Linn.) and leaf-buds of nyagrodha (Ficusbengalensis Linn). She should eat soft, fragrant and cooked shali rice of red variety (Orizasativa Linn.), added with honey and sugar along with milk boiled with roots of bala (Sidacordifolia Linn.), atibala (Abutilonindicum Linn.), shali, sashtika (both varieties of Orizasativa Linn.) ikshu (sugarcane- Saccharumofficinarum Linn.), and kakoli. Or she should eat the above rice along with the soup made of meat that is well-seasoned with ghee, of lava (Common Quail), kapinjala (Grey Partridge), kuranga (Roe deer), sambara (Indian Sambar), shasha (Rabbit), harina (Black Buck), ena (Antelope) orkalapuchchaka (Black tailed Deer), while sitting comfortably in a cool and well ventilated place. She should be protected from anger, grief, overexertion, activities that are sexual or intensely physical in nature, and should be entertained with pleasing and comforting stories. By following these methods, the embryo (garbha) is saved from abortion. [24]
</div>
यस्याः पुनरामान्वयात् पुष्पदर्शनं स्यात्, प्रायस्तस्यास्तद्गर्भोपघातकरं भवति,
विरुद्धोपक्रमत्वात्तयोः||२५||

yasyāḥ punarāmānvayāt puṣpadarśanaṁ syāt, prāyastasyāstadgarbhōpaghātakaraṁ bhavati,
viruddhōpakramatvāttayōḥ||25||

yasyAH punarAmAnvayAt puShpadarshanaM syAt, prAyastasyAstadgarbhopaghAtakaraM bhavati,
viruddhopakramatvAttayoH||25||

If vaginal bleeding occurs as the result of ama (indigestion), there is a very high probability of miscarriage and abortion of the foetus and it may not be avoidable, because the two disorders (vaginal bleeding and indigestion) require mutually opposite treatments. [25]

यस्याः पुनरुष्णतीक्ष्णोपयोगाद्गर्भिण्या महति सञ्जातसारे गर्भे पुष्पदर्शनं स्यादन्यो वा योनिस्रावस्तस्या गर्भो वृद्धिं नप्राप्नोति निःस्रुतत्वात्; स कालमवतिष्ठतेऽतिमात्रं, तमुपविष्टकमित्याचक्षते केचित्|
उपवासव्रतकर्मपरायाः पुनः कदाहारायाः स्नेहद्वेषिण्या वातप्रकोपणोक्तान्यासेवमानाया गर्भो वृद्धिं न प्राप्नोतिपरिशुष्कत्वात्; स चापि कालमवतिष्ठतेऽतिमात्रम् [१] , अस्पन्दनश्च भवति, तं तु नागोदरमित्याचक्षते||२६||

yasyāḥ punaruṣṇatīkṣṇōpayōgādgarbhiṇyā mahati sañjātasārē garbhē puṣpadarśanaṁ syādanyō vāyōnisrāvastasyā garbhō vr̥ddhiṁ na prāpnōti niḥsrutatvāt; sa kālamavatiṣṭhatē'timātraṁ,tamupaviṣṭakamityācakṣatē kēcit|
upavāsavratakarmaparāyāḥ punaḥ kadāhārāyāḥ snēhadvēṣiṇyā vātaprakōpaṇōktānyāsēvamānāyāgarbhō vr̥ddhiṁ na prāpnōti pariśuṣkatvāt; sa cāpi kālamavatiṣṭhatē'timātram [1] , aspandanaśca bhavati,taṁ tu nāgōdaramityācakṣatē||26||

yasyAH punaruShNatIkShNopayogAdgarbhiNyA mahati sa~jjAtasAre garbhe puShpadarshanaM syAdanyovA yonisrAvastasyA garbho vRuddhiM na prApnoti niHsrutatvAt; sa kAlamavatiShThate~atimAtraM,tamupaviShTakamityAcakShate kecit|
upavAsavratakarmaparAyAH punaH kadAhArAyAH snehadveShiNyA vAtaprakopaNoktAnyAsevamAnAyAgarbho vRuddhiM na prApnoti parishuShkatvAt; sa cApi kAlamavatiShThate~atimAtram [1] , aspandanashcabhavati, taM tu nAgodaramityAcakShate||26||
<div style="text-align:justify;">
If a pregnant woman with a large and well-formed foetus starts experiencing bleeding or other forms of uterine discharge as aresult of indulgence in hot and pungent food articles, the foetus will cease growing. Such a foetus will stay for a long time in the mother’s womb and this condition is referred to as Upavistaka (or prolonged gestation).
Similarly, in a pregnant woman who suffers from malnutrition due to overindulgence in rituals requiring fasting, or who avoids unctuous articles and indulges in vata-provoking dietary or lifestyle activities, foetus will not develop due to it getting weaned away from nutrition, and such foetus will remain in the womb for a long period of time without developing. This condition is called Nagodara (elephantine gestation). [26]
</div>
==== Specific Therapeutic courses for the management of Intrauterine Growth Retardation ====

नार्योस्तयोरुभयोरपि चिकित्सितविशेषमुपदेक्ष्यामः- भौतिकजीवनीयबृंहणीयमधुरवातहरसिद्धानां सर्पिषां पयसामामगर्भाणांचोपयोगो गर्भवृद्धिकरः; तथा सम्भोजनमेतैरेव सिद्धैश्च घृतादिभिः सुभिक्षायाः [१] , अभीक्ष्णंयानवाहनापमार्जनावजृम्भणैरुपपादनमिति||२७||

nāryōstayōrubhayōrapi cikitsitaviśēṣamupadēkṣyāmaḥ-bhautikajīvanīyabr̥ṁhaṇīyamadhuravātaharasiddhānāṁ sarpiṣāṁ payasāmāmagarbhāṇāṁ cōpayōgōgarbhavr̥ddhikaraḥ; tathā sambhōjanamētairēva siddhaiśca ghr̥tādibhiḥ subhikṣāyāḥ [1] , abhīkṣṇaṁyānavāhanāpamārjanāvajr̥mbhaṇairupapādanamiti||27|
nAryostayorubhayorapi cikitsitavisheShamupadekShyAmaH-bhautikajIvanIyabRuMhaNIyamadhuravAtaharasiddhAnAM sarpiShAM payasAmAmagarbhANAM copayogogarbhavRuddhikaraH; tathA sambhojanametaireva siddhaishca ghRutAdibhiH subhikShAyAH [1] ,abhIkShNaM yAnavAhanApamArjanAvajRumbhaNairupapAdanamiti||27||
<div style="text-align:justify;">
Now (we) shall expound the specific therapeutic courses of treatment recommended for the management of ''upavistaka'' (intrauterine growth retardation because of decreased nutrient transfer) and nagodara (IUGR because of malnourishment). Ghee and milk which have been medicated with ''bhautika'' (drugs having anti-evil spirits / germs action), ''jivaniya'' (life-promoting), ''brimhaniya'' (bulk promoting), ''madhura'' (sweet) and ''vatahara'' (''vata'' alleviating) drugs help stimulate the development of the fetus. Immature or undeveloped fetus (i.e. poultry eggs) with milk also acts as an effective growth stimulant for the fetus. Ample use of medicated ghee also serves to nourish the mother and her fetus. These therapeutic courses should be supplemented with walking, moving in carriages (that do not jerk a lot), physical cleansing and engaging in mild exercises and other forms of physical activities. [27]
</div>
यस्याः पुनर्गर्भः प्रसुप्तो न स्पन्दते तां श्येनमत्स्यगवयशिखिताम्रचूडतित्तिरीणामन्यतमस्य सर्पिष्मता रसेन माषयूषेण वाप्रभूतसर्पिषा मूलकयूषेण वा रक्तशालीनामोदनं मृदुमधुरशीतलं भोजयेत्|
तैलाभ्यङ्गेन चास्या अभीक्ष्णमुदरबस्तिवङ्क्षणोरुकटीपार्श्वपृष्ठप्रदेशानीषदुष्णेनोपचरेत्||२८||

yasyāḥ punargarbhaḥ prasuptō na spandatē tāṁśyēnamatsyagavayaśikhitāmracūḍatittirīṇāmanyatamasya sarpiṣmatā rasēna māṣayūṣēṇa vāprabhūtasarpiṣā mūlakayūṣēṇa vā raktaśālīnāmōdanaṁ mr̥dumadhuraśītalaṁ bhōjayēt|
tailābhyaṅgēna cāsyā abhīkṣṇamudarabastivaṅkṣaṇōrukaṭīpārśvapr̥ṣṭhapradēśānīṣaduṣṇēnōpacarēt||28||

yasyAH punargarbhaH prasupto na spandate tAMshyenamatsyagavayashikhitAmracUDatittirINAmanyatamasya sarpiShmatA rasena mAShayUSheNa vAprabhUtasarpiShA mUlakayUSheNa vA raktashAlInAmodanaM mRudumadhurashItalaM bhojayet|
tailAbhya~ggena cAsyAabhIkShNamudarabastiva~gkShaNorukaTIpArshvapRuShThapradeshAnIShaduShNenopacaret||28||
<div style="text-align:justify;">
If the fetal development has stalled or is slowed (for various reasons), then the pregnant woman should be advised to take ''shali'' rice (cooked Oriza sativa Linn.) which is soft, sweet and cool, with meat juices (seasoned with ghee), of one or more of the following animals- the hawk, fish, ''gayal'', peacock, rooster, or partridge - or with gruel of ''masha'' (Phaseolusradiates Linn - black gram) or with the soup of radish, with plenty of ghee. She also should be massaged with lukewarm oil (''tila taila''-gingilly oil) over her abdomen, pelvic region, groin, thigh, waist, sides and back. [28]
</div>
==== Constipation during Final Trimester ====

यस्याः पुनरुदावर्तविबन्धः स्यादष्टमे मासे न चानुवासनसाध्यं मन्येत ततस्तस्यास्तद्विकारप्रशमनमुपकल्पयेन्निरूहम्|
उदावर्तो ह्युपेक्षितः सहसा सगर्भां [२] गर्भिणीं गर्भमथवाऽतिपातयेत्|

तत्र वीरणशालिषष्टिककुशकाशेक्षुवालिकावेतसपरिव्याधमूलानां भूतीकानन्ताकाश्मर्यपरूषकमधुकमृद्वीकानां चपयसाऽर्धोदकेनोद्गमय्य रसं प्रियालबिभीतकमज्जतिलकल्कसम्प्रयुक्तमीषल्लवणमनत्युष्णं च निरूहं दद्यात्|
व्यपगतविबन्धां चैनां सुखसलिलपरिषिक्ताङ्गीं स्थैर्यकरमविदाहिनमाहारं भुक्तवतीं सायं मधुरकसिद्धेन तैलेनानुवासयेत्|
न्युब्जां त्वेनामास्थापनानुवासनाभ्यामुपचरेत्||२९||

yasyāḥ punarudāvartavibandhaḥ syādaṣṭamē māsē na cānuvāsanasādhyaṁ manyētatatastasyāstadvikārapraśamanamupakalpayēnnirūham|
udāvartō hyupēkṣitaḥ sahasā sagarbhāṁ [2] garbhiṇīṁ garbhamathavā'tipātayēt|
tatra vīraṇaśāliṣaṣṭikakuśakāśēkṣuvālikāvētasaparivyādhamūlānāṁbhūtīkānantākāśmaryaparūṣakamadhukamr̥dvīkānāṁ ca payasā'rdhōdakēnōdgamayya rasaṁpriyālabibhītakamajjatilakalkasamprayuktamīṣallavaṇamanatyuṣṇaṁ ca nirūhaṁ dadyāt|
vyapagatavibandhāṁ caināṁ sukhasalilapariṣiktāṅgīṁ sthairyakaramavidāhinamāhāraṁ bhuktavatīṁsāyaṁ madhurakasiddhēna tailēnānuvāsayēt|
nyubjāṁ tvēnāmāsthāpanānuvāsanābhyāmupacarēt||29||

yasyAH punarudAvartavibandhaH syAdaShTame mAse na cAnuvAsanasAdhyaM manyetatatastasyAstadvikAraprashamanamupakalpayennirUham|
udAvarto hyupekShitaH sahasA sagarbhAM [2] garbhiNIM garbhamathavA~atipAtayet|
tatra vIraNashAliShaShTikakushakAshekShuvAlikAvetasaparivyAdhamUlAnAMbhUtIkAnantAkAshmaryaparUShakamadhukamRudvIkAnAM ca payasA~ardhodakenodgamayya rasaMpriyAlabibhItakamajjatilakalkasamprayuktamIShallavaNamanatyuShNaM ca nirUhaM dadyAt|
vyapagatavibandhAM cainAM sukhasalilapariShiktA~ggIM sthairyakaramavidAhinamAhAraM bhuktavatIMsAyaM madhurakasiddhena tailenAnuvAsayet|
nyubjAM tvenAmAsthApanAnuvAsanAbhyAmupacaret||29||
<div style="text-align:justify;">
In case the pregnant woman develops constipation due to ''udavarta'' (misperistalsis) in the eighth month and if it cannot be treated with unctuous enema, then the physician should treat her with non-unctuous enema that may relieve her condition. If the disorder of misperistalsis is neglected, it may abruptly turn fatal for both the mother and the fetus or for the fetus alone. In such conditions, a decoction prepared with the roots of ''virana'' (Veriveriazizanoides Nash), ''shali'' (Oryzasativa Linn), ''sashtika'' (a variety of Oryza species), ''kusha'' (Desmostachya bipinnata Staf), ''kasha'' (Saccharum spontaneum Linn.), ''ikshuvalika'' (Asteracanthalongifolia Nees), ''vetasa'' (Salixcaprea Linn.), ''parivyadha'' (type of Vetasa, Salix species) ''bhutika'' (Trachyspermumammi Sprague), ''ananta'' (Hemidesmus indicusR. B.), ''kashmarya'' (Gmelinaarborea Linn.), ''parushaka'' (Grewiaasiatica Linn.), ''madhuka'' (Glycyrrhizaglabra Linn) and ''mridwika'' (Vitisvinifera Linn.), prepared with milk and mixed with half that volume of water containing paste of ''priyala'' (Buchananialanzan Spreng), ''bibhitakamajja'' (the seed pulp of Terminaliabelerica Roxb.), ''tila'' (Sesamumindicum Linn.) and salt (''Saindhava'' – rock salt) should be used for non-unctuous enema. Once the constipation is relieved, she should be sprinkled with lukewarm water and then given food having stabilizing properties and which will not cause any burning sensation.

In the evening, she should be treated with unctuous enema of oil prepared with sweet drugs. The enema should be administered to her in a bent-down position (fetal, knee-to-the-chest position). [29]
</div>
==== Symptoms of death of fetus in the womb ====

यस्याः पुनरतिमात्रदोषोपचयाद्वा तीक्ष्णोष्णातिमात्रसेवनाद्वा वातमूत्रपुरीषवेगविधारणैर्वा विषमाश(स)नशयनस्थानसम्पीडनाभिघातैर्वा क्रोधशोकेर्ष्याभयत्रासादिभिर्वा साहसैर्वाऽपरैः कर्मभिरन्तःकुक्षेर्गर्भो [१] म्रियते, तस्याःस्तिमितं स्तब्धमुदरमाततं शीतमश्मान्तर्गतमिव भवत्यस्पन्दनो गर्भः, शूलमधिकमुपजायते, न चाव्यः प्रादुर्भवन्ति, योनिर्नप्रस्रवति, अक्षिणी चास्याः स्रस्ते भवतः, ताम्यति, व्यथते, भ्रमते, श्वसिति, अरतिबहुला च भवति, न चास्या वेगप्रादुर्भावोयथावदुपलभ्यते; इत्येवंलक्षणां स्त्रियं मृतगर्भेयमिति विद्यात्||३०||

yasyāḥ punaratimātradōṣōpacayādvā tīkṣṇōṣṇātimātrasēvanādvā vātamūtrapurīṣavēgavidhāraṇairvāviṣamāśa(sa)naśayanasthānasampīḍanābhighātairvā krōdhaśōkērṣyābhayatrāsādibhirvāsāhasairvā'paraiḥ karmabhirantaḥkukṣērgarbhō [1] mriyatē, tasyāḥ stimitaṁ stabdhamudaramātataṁśītamaśmāntargatamiva bhavatyaspandanō garbhaḥ, śūlamadhikamupajāyatē, na cāvyaḥ prādurbhavanti,yōnirna prasravati, akṣiṇī cāsyāḥ srastē bhavataḥ, tāmyati, vyathatē, bhramatē, śvasiti, aratibahulā cabhavati, na cāsyā vēgaprādurbhāvō yathāvadupalabhyatē; ityēvaṁlakṣaṇāṁ striyaṁ mr̥tagarbhēyamitividyāt||30||

yasyAH punaratimAtradoShopacayAdvA tIkShNoShNAtimAtrasevanAdvAvAtamUtrapurIShavegavidhAraNairvA viShamAsha(sa)nashayanasthAnasampIDanAbhighAtairvAkrodhashokerShyAbhayatrAsAdibhirvA sAhasairvA~aparaiH karmabhirantaHkukShergarbho [1] mriyate,tasyAH stimitaM stabdhamudaramAtataM shItamashmAntargatamiva bhavatyaspandano garbhaH,shUlamadhikamupajAyate, na cAvyaH prAdurbhavanti, yonirna prasravati, akShiNI cAsyAH srastebhavataH, tAmyati, vyathate, bhramate, shvasiti, aratibahulA ca bhavati, na cAsyA vegaprAdurbhAvoyathAvadupalabhyate; ityevaMlakShaNAM striyaM mRutagarbheyamiti vidyAt||30||
<div style="text-align:justify;">
If the fetus dies in the womb as a result of excessive increase of ''doshas'' caused due to over-indulgence in pungent and hot things, or due to suppression of urges to pass flatulence, urine and bowel movement, or due to faulty eating, faulty sitting, lying down or standing or due to compression (of the womb) and injuries, or passion, grief, envy, horror, fear etc., or due to intensive/extreme physical activities, then the stomach will be still, rigid, bloated up, cold and stony-hard. This condition would be accompanied by severe pain in the stomach, but the labor pains do not set in and there is no discharge. The woman’s eyes will droop and she may feel nauseous, pain, is in agony, giddiness, and breathlessness with intense restlessness. The natural urges also will not be proper as routine. If these features are seen in a pregnant woman, then it should be construed that the fetus is dead. [30]
</div>
==== Treatment of dead fetus in the womb ====

तस्य गर्भशल्यस्य जरायुप्रपातनं कर्म संशमनमित्याहुरेके, मन्त्रादिकमथर्ववेदविहितमित्येके, परिदृष्टकर्मणा शल्यहर्त्राहरणमित्येके|
व्यपगतगर्भशल्यां तु स्त्रियमामगर्भां सुरासीध्वरिष्टमधुमदिरासवानामन्यतममग्रे सामर्थ्यतःपाययेद्गर्भकोष्ठशुद्ध्यर्थमर्तिविस्मरणार्थं प्रहर्षणार्थं च, अतः परं सम्प्रीणनैर्बलानुरक्षिभिरस्नेहसम्प्रयुक्तैर्यवाग्वादिभिर्वा [१]तत्कालयोगिभिराहारैरुपचरेद्दोषधातुक्लेदविशोषणमात्रं कालम्|
अतः परं स्नेहपानैर्बस्तिभिराहारविधिभिश्च दीपनीयजीवनीयबृंहणीयमधुरवातहरसमाख्यातैरुपचरेत्| परिपक्वगर्भशल्यायाः पुनर्विमुक्तगर्भशल्यायास्तदहरेव स्नेहोपचारः स्यात्||३१||

tasya garbhaśalyasya jarāyuprapātanaṁ karma saṁśamanamityāhurēkē,mantrādikamatharvavēdavihitamityēkē, paridr̥ṣṭakarmaṇā śalyahartrā haraṇamityēkē|
vyapagatagarbhaśalyāṁ tu striyamāmagarbhāṁ surāsīdhvariṣṭamadhumadirāsavānāmanyatamamagrēsāmarthyataḥ pāyayēdgarbhakōṣṭhaśuddhyarthamartivismaraṇārthaṁ praharṣaṇārthaṁ ca, ataḥ paraṁsamprīṇanairbalānurakṣibhirasnēhasamprayuktairyavāgvādibhirvā [1]tatkālayōgibhirāhārairupacarēddōṣadhātuklēdaviśōṣaṇamātraṁ kālam|
ataḥ paraṁ snēhapānairbastibhirāhāravidhibhiścadīpanīyajīvanīyabr̥ṁhaṇīyamadhuravātaharasamākhyātairupacarēt|
paripakvagarbhaśalyāyāḥ punarvimuktagarbhaśalyāyāstadaharēva snēhōpacāraḥ syāt||31||

tasya garbhashalyasya jarAyuprapAtanaM karma saMshamanamityAhureke,mantrAdikamatharvavedavihitamityeke, paridRuShTakarmaNA shalyahartrA haraNamityeke|
vyapagatagarbhashalyAM tu striyamAmagarbhAMsurAsIdhvariShTamadhumadirAsavAnAmanyatamamagre sAmarthyataHpAyayedgarbhakoShThashuddhyarthamartivismaraNArthaM praharShaNArthaM ca, ataH paraMsamprINanairbalAnurakShibhirasnehasamprayuktairyavAgvAdibhirvA [1]tatkAlayogibhirAhArairupacareddoShadhAtukledavishoShaNamAtraM kAlam|
ataH paraM snehapAnairbastibhirAhAravidhibhishcadIpanIyajIvanIyabRuMhaNIyamadhuravAtaharasamAkhyAtairupacaret|
paripakvagarbhashalyAyAH punarvimuktagarbhashalyAyAstadahareva snehopacAraH syAt||31||
<div style="text-align:justify;">
According to some scholars, the treatment of dead fetus (which acts like a foreign body within the womb) consists of administering medicines which are used to expel the placenta. Others suggest using mantras, prayers and spiritual offerings as explained in the Atharva Veda. Yet others believe that it should be removed by surgical means by an expert surgeon.

If the dead fetus is immature (i.e., in its early stages of development), then once the dead fetus is extracted, the woman should drink, to her fill, alcoholic drinks such ''assura, sidhu, arishta, madhu, madira'' and ''asava'' in order to cleanse her uterus, relieve herself from pain and also to become euphoric (i.e., overcome her grief). Then she should be given food articles that are nourishing and strength-enhancing but without fat or oil in them, such as gruels that are suitable for that moment till the excess moisture of the ''dosha'' and ''dhatus'' are absorbed. Then she should be treated with ''snehapana'' (administration of unctuous substances), enema and diets processed with medications possessing appetizing, vitalizing, bulk-promoting, sweet and ''vata''-alleviating properties. If the dead fetus is a mature one, once the dead fetus is removed, that day itself she should be treated with unction measures. [31]
</div>
==== Monthly regimen to be adopted during normal pregnancy ====

परमतो निर्विकारमाप्याय्यमानस्य गर्भस्य मासे मासे कर्मोपदेक्ष्यामः|
प्रथमे मासे शङ्किता चेद्गर्भमापन्ना क्षीरमनुपस्कृतं मात्रावच्छीतं काले काले पिबेत्, सात्म्यमेव च भोजनं सायं प्रातश्चभुञ्जीत; द्वितीये मासे क्षीरमेव च मधुरौषधसिद्धं; तृतीये मासे क्षीरं मधुसर्पिर्भ्यामुपसंसृज्य; चतुर्थे मासेक्षीरनवनीतमक्षमात्रमश्नीयात्; पञ्चमे मासे क्षीरसर्पिः; षष्ठे मासे क्षीरसर्पिर्मधुरौषधसिद्धं; तदेव सप्तमे मासे|
तत्र गर्भस्य केशा जायमाना मातुर्विदाहं जनयन्तीति स्त्रियो भाषन्ते; तन्नेति भगवानात्रेयः, किन्तुगर्भोत्पीडनाद्वातपित्तश्लेष्माण उरः प्राप्य विदाहं जनयन्ति, ततः कण्डूरुपजायते, कण्डूमूला च किक्किसावाप्तिर्भवति|
तत्र कोलोदकेन नवनीतस्य मधुरौषधसिद्धस्य पाणितलमात्रं काले कालेऽस्यै पानार्थं दद्यात्, चन्दनमृणालकल्कैश्चास्याःस्तनोदरं विमृद्गीयात्, शिरीषधातकीसर्षपमधुकचूर्णैर्वा, कुटजार्जकबीजमुस्तहरिद्राकल्कैर्वा,निम्बकोलसुरसमञ्जिष्ठाकल्कैर्वा, पृषतहरिणशशरुधिरयुतया त्रिफलया वा; करवीरपत्रसिद्धेन तैलेनाभ्यङ्गः; परिषेकःपुनर्मालतीमधुकसिद्धेनाम्भसा; जातकण्डूश्च कण्डूयनं वर्जयेत्त्वग्भेदवैरूप्यपरिहारार्थम्, असह्यायां तुकण्ड्वामुन्मर्दनोद्धर्षणाभ्यां परिहारः स्यात्; मधुरमाहारजातं वातहरमल्पमस्नेहलवणमल्पोदकानुपानं च भुञ्जीत|
अष्टमे तु मासे क्षीरयवागूं सर्पिष्मतीं काले काले पिबेत्; तन्नेति भद्रकाप्यः, पैङ्गल्याबाधो ह्यस्या गर्भमागच्छेदिति; अस्त्वत्रपैङ्गल्याबाध इत्याह भगवान् पुनर्वसुरात्रेयः, न त्वेवैतन्न कार्यम्; एवं कुर्वती ह्यरोगाऽऽरोग्यबलवर्णस्वरसंहननसम्पदुपेतंज्ञातीनामपि श्रेष्ठमपत्यं जनयति|
नवमे तु खल्वेनां मासे मधुरौषधसिद्धेन तैलेनानुवासयेत्|
अतश्चैवास्यास्तैलात् पिचुं योनौ प्रणयेद्गर्भस्थानमार्गस्नेहनार्थम्|
यदिदं कर्म प्रथमं मासं समुपादायोपदिष्टमानवमान्मासात्तेन गर्भिण्या गर्भसमये गर्भधारिणीकुक्षिकटीपार्श्वपृष्ठं [१] मृदूभवति,वातश्चानुलोमः सम्पद्यते, मूत्रपुरीषे च प्रकृतिभूते सुखेन मार्गमनुपद्येते, चर्मनखानि च मार्दवमुपयान्ति, बलवर्णौचोपचीयेते; पुत्रं चेष्टं सम्पदुपेतं सुखिनं सुखेनैषा काले प्रजायत इति||३२||

paramatō nirvikāramāpyāyyamānasya garbhasya māsē māsē karmōpadēkṣyāmaḥ|
prathamē māsē śaṅkitā cēdgarbhamāpannā kṣīramanupaskr̥taṁ mātrāvacchītaṁ kālē kālē pibēt,sātmyamēva ca bhōjanaṁ sāyaṁ prātaśca bhuñjīta; dvitīyē māsē kṣīramēva ca madhurauṣadhasiddhaṁ;tr̥tīyē māsē kṣīraṁ madhusarpirbhyāmupasaṁsr̥jya; caturthē māsē kṣīranavanītamakṣamātramaśnīyāt;pañcamē māsē kṣīrasarpiḥ; ṣaṣṭhē māsē kṣīrasarpirmadhurauṣadhasiddhaṁ; tadēva saptamē māsē|
tatra garbhasya kēśā jāyamānā māturvidāhaṁ janayantīti striyō bhāṣantē; tannēti bhagavānātrēyaḥ, kintugarbhōtpīḍanādvātapittaślēṣmāṇa uraḥ prāpya vidāhaṁ janayanti, tataḥ kaṇḍūrupajāyatē, kaṇḍūmūlā cakikkisāvāptirbhavati|
tatra kōlōdakēna navanītasya madhurauṣadhasiddhasya pāṇitalamātraṁ kālē kālē'syai pānārthaṁ dadyāt,candanamr̥ṇālakalkaiścāsyāḥ stanōdaraṁ vimr̥dgīyāt, śirīṣadhātakīsarṣapamadhukacūrṇairvā,kuṭajārjakabījamustaharidrākalkairvā, nimbakōlasurasamañjiṣṭhākalkairvā,pr̥ṣatahariṇaśaśarudhirayutayā triphalayā vā; karavīrapatrasiddhēna tailēnābhyaṅgaḥ; pariṣēkaḥpunarmālatīmadhukasiddhēnāmbhasā; jātakaṇḍūśca kaṇḍūyanaṁvarjayēttvagbhēdavairūpyaparihārārtham, asahyāyāṁ tu kaṇḍvāmunmardanōddharṣaṇābhyāṁ parihāraḥsyāt; madhuramāhārajātaṁ vātaharamalpamasnēhalavaṇamalpōdakānupānaṁ ca bhuñjīta|
aṣṭamē tu māsē kṣīrayavāgūṁ sarpiṣmatīṁ kālē kālē pibēt; tannēti bhadrakāpyaḥ, paiṅgalyābādhō hyasyāgarbhamāgacchēditi; astvatra paiṅgalyābādha ityāha bhagavān punarvasurātrēyaḥ, na tvēvaitannakāryam; ēvaṁ kurvatī hyarōgā''rōgyabalavarṇasvarasaṁhananasampadupētaṁ jñātīnāmapiśrēṣṭhamapatyaṁ janayati|
navamē tu khalvēnāṁ māsē madhurauṣadhasiddhēna tailēnānuvāsayēt|
ataścaivāsyāstailāt picuṁ yōnau praṇayēdgarbhasthānamārgasnēhanārtham|
yadidaṁ karma prathamaṁ māsaṁ samupādāyōpadiṣṭamānavamānmāsāttēna garbhiṇyā garbhasamayēgarbhadhāriṇīkukṣikaṭīpārśvapr̥ṣṭhaṁ [1] mr̥dūbhavati, vātaścānulōmaḥ sampadyatē, mūtrapurīṣē caprakr̥tibhūtē sukhēna mārgamanupadyētē, carmanakhāni ca mārdavamupayānti, balavarṇau cōpacīyētē;putraṁ cēṣṭaṁ sampadupētaṁ sukhinaṁ sukhēnaiṣā kālē prajāyata iti||32||

paramato nirvikAramApyAyyamAnasya garbhasya mAse mAse karmopadekShyAmaH|
prathame mAse sha~gkitA cedgarbhamApannA kShIramanupaskRutaM mAtrAvacchItaM kAle kAle pibet,sAtmyameva ca bhojanaM sAyaM prAtashca bhu~jjIta; dvitIye mAse kShIrameva camadhurauShadhasiddhaM; tRutIye mAse kShIraM madhusarpirbhyAmupasaMsRujya; caturthe mAsekShIranavanItamakShamAtramashnIyAt; pa~jcame mAse kShIrasarpiH; ShaShThe mAsekShIrasarpirmadhurauShadhasiddhaM; tadeva saptame mAse|
tatra garbhasya keshA jAyamAnA mAturvidAhaM janayantIti striyo bhAShante; tanneti bhagavAnAtreyaH,kintu garbhotpIDanAdvAtapittashleShmANa uraH prApya vidAhaM janayanti, tataH kaNDUrupajAyate,kaNDUmUlA ca kikkisAvAptirbhavati|
tatra kolodakena navanItasya madhurauShadhasiddhasya pANitalamAtraM kAle kAle~asyai pAnArthaMdadyAt, candanamRuNAlakalkaishcAsyAH stanodaraM vimRudgIyAt,shirIShadhAtakIsarShapamadhukacUrNairvA, kuTajArjakabIjamustaharidrAkalkairvA,nimbakolasurasama~jjiShThAkalkairvA, pRuShatahariNashasharudhirayutayA triphalayA vA;karavIrapatrasiddhena tailenAbhya~ggaH; pariShekaH punarmAlatImadhukasiddhenAmbhasA;jAtakaNDUshca kaNDUyanaM varjayettvagbhedavairUpyaparihArArtham, asahyAyAM tukaNDvAmunmardanoddharShaNAbhyAM parihAraH syAt; madhuramAhArajAtaMvAtaharamalpamasnehalavaNamalpodakAnupAnaM ca bhu~jjIta|
aShTame tu mAse kShIrayavAgUM sarpiShmatIM kAle kAle pibet; tanneti bhadrakApyaH, pai~ggalyAbAdhohyasyA garbhamAgacchediti; astvatra pai~ggalyAbAdha ityAha bhagavAn punarvasurAtreyaH, natvevaitanna kAryam; evaM kurvatI hyarogA~a~arogyabalavarNasvarasaMhananasampadupetaMj~jAtInAmapi shreShThamapatyaM janayati|
navame tu khalvenAM mAse madhurauShadhasiddhena tailenAnuvAsayet|
atashcaivAsyAstailAt picuM yonau praNayedgarbhasthAnamArgasnehanArtham|
yadidaM karma prathamaM mAsaM samupAdAyopadiShTamAnavamAnmAsAttena garbhiNyAgarbhasamaye garbhadhAriNIkukShikaTIpArshvapRuShThaM [1] mRudUbhavati, vAtashcAnulomaHsampadyate, mUtrapurIShe ca prakRutibhUte sukhena mArgamanupadyete, carmanakhAni camArdavamupayAnti, balavarNau copacIyete; putraM ceShTaM sampadupetaM sukhinaM sukhenaiShA kAleprajAyata iti||32||
<div style="text-align:justify;">
In this verse, we shall explain the monthly regimen to be adopted in a steadily developing, normal pregnancy:
*In the first month when pregnancy is suspected, cold and unmedicated milk (that has not been processed with any drug) should be taken in adequate quantity at regular intervals, and nourishing food should be eaten twice a day.
*In the second month of pregnancy, milk processed with sweet-tasting drugs should be taken, as needed.
*In the third month of pregnancy, milk along with honey and ghee should be given to drink.
*In the fourth month of pregnancy, milk along with one ''aksha'' (10 – 12 g) butter should be consumed.
*In the fifth month of pregnancy, milk along with ghee should be given.
*In the sixth month of pregnancy, milk with ghee processed with sweet-tasting drugs should be given to drink.
*In the seventh month of pregnancy, she should be given the same regimen as prescribed in the sixth month. Experienced women are of the opinion that during this period, the fetus develops scalp hair and it causes burning sensation in the mother. But this view is negated by Lord Atreya, who says that due to the pressure created by the fetus, the three ''doshas'' of the mother reach the chest region and cause burning sensation in her, causing itching which, in turn, causes ''kikkisa'' (stretch-marks or striae gravidarum -linea albicantes – the white abdominal lines seen during and after pregnancy on the abdomen). To manage this condition, she should regularly be given butter medicated with sweet-tasting drugs, the quantity of which she can hold in her single palm, along with a decoction of ''kola'' (Zizyphus jujube Lam). Her breasts and abdomen should be massaged with a paste of ''chandana'' (Santalumalbum Linn.), ''mrinala'' (stalk of lotus) or powder of ''shirisha'' (Albizia lebbeck Benth), ''dhataki'' (Woodfordiafruticosa Kurz), ''sarshapa'' (Mustard – Brassicanigra Koch), and ''madhuka'' (Glycyrrhizaglabra Linn.) or paste of ''kutaja'' (Holarrhenaantidysenterica Wall.), seed of ''arjaka'' (Ocimumgratissimum Linn.), ''musta'' (Cyperusrotundus Linn.), ''haridra'' (Curcumalonga Linn.) or paste of ''nimba'' (Azadirachtaindica A. Juss), ''kola'' (Zizyphusjujuba Lam.), ''surasa'' (Ocimumsanctum Linn.) and ''manjishta'' (Rubiacordifolia Linn.) or ''triphala'' (three pungent fruits – Terminaliachebula Linn., Terminaliabelerica Roxb. and Emblicaofficinalis Gaertn.) mixed with the blood of ''prishta'' (spotted deer), massage with oil prepared with leaf of ''karavira'' (Neriumindicum Mill.) and sprinkling with water processed with ''jati'' (''Malati'' – Aganosma dichotoma K. Schum.) and ''madhuka'' (Glycyrrhizaglabra Linn.) plant. Thus, itching should be avoided to prevent stretch-mark on skin (and therefore, avoiding disfiguring the skin). If itching is too severe to tolerate then it should be overcome by an application of ''unmardana'' (anointing) and ''udgharshana'' (rubbing with pastes) procedures. During this period, she should eat sweet-tasting food that is ''vata'' alleviating in nature and is light on oil, fat and salt, and should drink less water immediately after the food.
*In the eighth month, she should take gruel prepared with milk and mixed with ghee in all her meals in their appropriate times. Bhadrakapya has opposing views on this and believes that it causes ''paingalya'' (tawny discoloration of the eyes of fetus) in the fetus, and hence should not be practiced. On this point, Lord Atreya believes that while the risk of paingalya may be there, it does not indicate in any way that the above regimen should not be applied. The woman following this regimen remains free from all disorders and gives birth to a child endowed with excellent health, strength, complexion, voice and compactness of body.
*Finally, in the ninth month of pregnancy, she should be treated with unctuous enema prepared with sweet-tasting drugs. A cotton swab soaked in the same oil should be kept in her genital tract in order to lubricate the passage of the fetus.

If the specific dietary regimen and therapeutic measures mentioned above are followed right from the first month of pregnancy to the ninth month, the entire child-bearing region of the woman’s body – including her womb, waist, sides of pelvis, and her back - become soft at the time of delivery, ''vata'' functions in a normal way, urine and bowel movement pass smoothly, skin and nails become soft, her strength and complexion are improved and the woman delivers the child effortlessly. [32]
</div>
==== Attributes of the maternity home ====

प्राक् चैवास्या नवमान्मासात् सूतिकागारं कारयेदपहृतास्थिशर्कराकपाले देशे प्रशस्तरूपरसगन्धायां भूमौ प्राग्द्वारमुदग्द्वारं वाबैल्वानां काष्ठानां तैन्दुकैङ्गुदकानां भाल्लातकानां वार(रु)णानां खादिराणां वा; यानि चान्यान्यपि ब्राह्मणाःशंसेयुरथर्ववेदविदस्तेषां; वसनालेपनाच्छादनापिधानसम्पदुपेतंवास्तुविद्याहृदययोगाग्निसलिलोदूखलवर्चःस्थानस्नानभूमिमहानसमृतुसुखं च||३३||

prāk caivāsyā navamānmāsāt sūtikāgāraṁ kārayēdapahr̥tāsthiśarkarākapālē dēśēpraśastarūparasagandhāyāṁ bhūmau prāgdvāramudagdvāraṁ vā bailvānāṁ kāṣṭhānāṁtaindukaiṅgudakānāṁ bhāllātakānāṁ vāra(ru)ṇānāṁ khādirāṇāṁ vā; yāni cānyānyapi brāhmaṇāḥśaṁsēyuratharvavēdavidastēṣāṁ; vasanālēpanācchādanāpidhānasampadupētaṁvāstuvidyāhr̥dayayōgāgnisalilōdūkhalavarcaḥsthānasnānabhūmimahānasamr̥tusukhaṁ ca||33||

prAk caivAsyA navamAnmAsAt sUtikAgAraM kArayedapahRutAsthisharkarAkapAle desheprashastarUparasagandhAyAM bhUmau prAgdvAramudagdvAraM vA bailvAnAM kAShThAnAMtaindukai~ggudakAnAM bhAllAtakAnAM vAra(ru)NAnAM khAdirANAM vA; yAni cAnyAnyapi brAhmaNAHshaMseyuratharvavedavidasteShAM; vasanAlepanAcchAdanApidhAnasampadupetaMvAstuvidyAhRudayayogAgnisalilodUkhalavarcaHsthAnasnAnabhUmimahAnasamRutusukhaM ca||33||
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Well before the ninth month of pregnancy, a maternity home should be constructed in a place that is free from bones, gravels and broken pieces of baked earthen utensils, the soil of which should have excellent color, taste and odour, the door of which should be facing the east or north and made of ''bilwa'' wood (Aeglemarmelos Corr.) or ''tinduka'' (Diospyrosperegrine Gurke), ''ingudi'' (Balanitesaegyptica Delile.), ''bhallataka'' (Semecarpusanacardium Linn.), ''varuna'' (Creteva religiosa) or ''khadira'' (Acaciacatechu willd.), or those woods recommended by ''brahmins'' who are well versed in Atharva Veda. The maternity home should be well built, spacious, well painted, have adequate doors and windows, well furnished with appliances, furnishings, water storage, lavatories, toiletries, etc. - built in accordance with the principles of ''Vastuvidya'' (science of architecture). The house should be comfortable for all seasons. [33]
</div>
==== Items to be made available in the maternity home ====

तत्र सर्पिस्तैलमधुसैन्धवसौवर्चलकालविड्लवणविडङ्गकुष्ठकिलिमनागर-पिप्पलीपिप्पलीमूलहस्तिपिप्पलीमण्डूकपर्ण्येलालाङ्गलीवचाचव्यचित्रकचिरबिल्व-हिङ्गुसर्षपलशुनकतककणकणिकानीपातसीबल्वजभूर्जकुलत्थमैरेयसुरासवाः सन्निहिताः स्युः; तथाऽश्मानौ द्वौ, द्वे कु(च)ण्डमुसले, द्वे उदूखले, खरवृषभश्च [१] , द्वौ च तीक्ष्णौ सूचीपिप्पलकौ सौवर्णराजतौ, शस्त्राणि च तीक्ष्णायसानि, द्वौ चबिल्वमयौ पर्यङ्कौ, तैन्दुकैङ्गुदानि च काष्ठान्यग्निसन्धुक्षणानि, स्त्रियश्च बह्व्यो बहुशः प्रजाताः सौहार्दयुक्ताःसततमनुरक्ताः प्रदक्षिणाचाराः प्रतिपत्तिकुशलाः प्रकृतिवत्सलास्त्यक्तविषादाः क्लेशसहिन्योऽभिमताः,ब्राह्मणाश्चाथर्ववेदविदः; यच्चान्यदपि तत्र समर्थं मन्येत, यच्चान्यच्च ब्राह्मणा ब्रूयुः स्त्रियश्च वृद्धास्तत् कार्यम्||३४||

tatra sarpistailamadhusaindhavasauvarcalakālaviḍlavaṇaviḍaṅgakuṣṭhakilimanāgara-pippalīpippalīmūlahastipippalīmaṇḍūkaparṇyēlālāṅgalīvacācavyacitrakacirabilva-hiṅgusarṣapalaśunakatakakaṇakaṇikānīpātasībalvajabhūrjakulatthamairēyasurāsavāḥ sannihitāḥ syuḥ;tathā'śmānau dvau, dvē ku(ca)ṇḍamusalē, dvē udūkhalē, kharavr̥ṣabhaśca [1] , dvau ca tīkṣṇausūcīpippalakau sauvarṇarājatau, śastrāṇi ca tīkṣṇāyasāni, dvau ca bilvamayau paryaṅkau,taindukaiṅgudāni ca kāṣṭhānyagnisandhukṣaṇāni, striyaśca bahvyō bahuśaḥ prajātāḥ sauhārdayuktāḥsatatamanuraktāḥ pradakṣiṇācārāḥ pratipattikuśalāḥ prakr̥tivatsalāstyaktaviṣādāḥ klēśasahinyō'bhimatāḥ,brāhmaṇāścātharvavēdavidaḥ; yaccānyadapi tatra samarthaṁ manyēta, yaccānyacca brāhmaṇā brūyuḥstriyaśca vr̥ddhāstat kāryam||34||

tatra sarpistailamadhusaindhavasauvarcalakAlaviDlavaNaviDa~ggakuShThakilimanAgara-pippalIpippalImUlahastipippalImaNDUkaparNyelAlA~ggalIvacAcavyacitrakacirabilva-hi~ggusarShapalashunakatakakaNakaNikAnIpAtasIbalvajabhUrjakulatthamaireyasurAsavAH sannihitAHsyuH; tathA~ashmAnau dvau, dve ku(ca)NDamusale, dve udUkhale, kharavRuShabhashca [1] , dvau catIkShNau sUcIpippalakau sauvarNarAjatau, shastrANi ca tIkShNAyasAni, dvau ca bilvamayau parya~gkau,taindukai~ggudAni ca kAShThAnyagnisandhukShaNAni, striyashca bahvyo bahushaH prajAtAHsauhArdayuktAH satatamanuraktAH pradakShiNAcArAH pratipattikushalAHprakRutivatsalAstyaktaviShAdAH kleshasahinyo~abhimatAH, brAhmaNAshcAtharvavedavidaH;yaccAnyadapi tatra samarthaM manyeta, yaccAnyacca brAhmaNA brUyuH striyashca vRuddhAstatkAryam||34||
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The following items should be made available in that maternity home: Ghee, honey, ''saindhava'' (rock salt), ''sauvarchala, kala, bida'' salts, ''vidanga'' (Emblelia ribes Burm. f.), ''kushta'' (Saussurea lappaC. B. Clarke.), ''kilima'' (Cedrus deodara Loud.), ''nagara'' (Zingiber officinale Rosc.), ''pippali'' (Piper longum Linn), ''pippali moola'' (root of Piper longum Linn.), ''hasti pippali'' (Scindapsus officinalis Schott), ''mandukaparni'' (Centella asiatica urban.), ''ela'' (Elettaria cadamomum Maton.), ''langali'' (Gloriosa superba Linn.), ''vacha'' (Acorus calamus Linn.), ''chavya'' (Piper cheba Hunter.), ''chitraka'' (Plumbago zeylanica Linn.), ''chirabilva'' (Pongamia pinnata Merr.), ''hingu'' (Ferula narthex Boiss.), ''sarshapa'' (Brassica nigra Koch.), ''lashuna'' (Alium sativum Linn.), ''kataka'' (Strychnos potatorum Linn. f.), ''kana'' (Pippali – piper longum Linn), ''kundaka, kanika'' (a variety of ''kana'' with bigger grains), ''neepa'' (Anthocephalus indicus A. Rich.), ''atasi'' (Linum usitatissumum Linn.), ''balvaja'' (--), ''bhurja'' (Betula utilis D. Don.), ''kulatha'' (Dolichos biflorus Linn.), ''maireya'', and alcoholic beverages (''sura'', and ''asava''). In addition to the above, the following items too should be kept available there – two grinding stones, two small pestles, two mortars, one untamed bull, two gold and silver cases for keeping needles, various surgical instruments that are sharp and prepared of metals, two bedsteads made of ''bilva'' (Aeglemarmelos Corr.), wood of ''tinduka'' (Diospyrosperegrine Gurke) and ''ingudi'' (Balanitesaegyptica Delile.) as fire wood, good number of female attendants who are multiskilled, who are affectionate and attached to the lady, well mannered, resourceful, pleasant to talk to, free from grief, tolerant of hardship and agreeable, and brahmins well versed in the Atharva Veda.

Above all, whatever prescribed by brahmins and experienced old ladies and found necessary are to be kept handy in this maternity home. [34]
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==== Rituals for the expecting woman before entering the maternity home ====

ततः प्रवृत्ते नवमे मासे पुण्येऽहनि प्रशस्तनक्षत्रयोगमुपगते प्रशस्ते भगवति शशिनि कल्याणे कल्याणे च करणे मैत्रे मुहूर्ते शान्तिंहुत्वा गोब्राह्मणमग्निमुदकं चादौ प्रवेश्य गोभ्यस्तृणोदकं मधुलाजांश्च प्रदाय ब्राह्मणेभ्योऽक्षतान् सुमनसो नान्दीमुखानि चफलानीष्टानि दत्त्वोदकपूर्वमासनस्थेभ्योऽभिवाद्य पुनराचम्य स्वस्ति वाचयेत्|
ततः पुण्याहशब्देन गोब्राह्मणं समनुवर्तमाना [१] प्रदक्षिणं प्रविशेत् सूतिकागारम्|
तत्रस्था च प्रसवकालं प्रतीक्षेत||३५||

tataḥ pravr̥ttē navamē māsē puṇyē'hani praśastanakṣatrayōgamupagatē praśastē bhagavati śaśini kalyāṇēkalyāṇē ca karaṇē maitrē muhūrtē śāntiṁ hutvā gōbrāhmaṇamagnimudakaṁ cādau pravēśyagōbhyastr̥ṇōdakaṁ madhulājāṁśca pradāya brāhmaṇēbhyō'kṣatān sumanasō nāndīmukhāni caphalānīṣṭāni dattvōdakapūrvamāsanasthēbhyō'bhivādya punarācamya svasti vācayēt|
tataḥ puṇyāhaśabdēna gōbrāhmaṇaṁ samanuvartamānā [1] pradakṣiṇaṁ praviśēt sūtikāgāram|
tatrasthā ca prasavakālaṁ pratīkṣēta||35||

tataH pravRutte navame mAse puNye~ahani prashastanakShatrayogamupagate prashaste bhagavatishashini kalyANe kalyANe ca karaNe maitre muhUrte shAntiM hutvA gobrAhmaNamagnimudakaM cAdaupraveshya gobhyastRuNodakaM madhulAjAMshca pradAya brAhmaNebhyo~akShatAn sumanasonAndImukhAni ca phalAnIShTAni dattvodakapUrvamAsanasthebhyo~abhivAdya punarAcamya svastivAcayet|
tataH puNyAhashabdena gobrAhmaNaM samanuvartamAnA [1] pradakShiNaM pravishet sUtikAgAram|
tatrasthA ca prasavakAlaM pratIkSheta||35||
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After furnishing the maternity home, in the beginning of the ninth month, on an auspicious day, when moon is in the auspicious ''nakshatra'' (constellation), with an auspicious ''karana'' and at an auspicious ''muhurta'' (astrological unit of time), with priests offering oblations and rites to holy fire, first of all the cow, the ''brahmana'', fire and water should be made to enter the maternity home. Then grass, water, honey and ''laja'' (parched rice) should be offered to the cows, and ''akshata'' (rice grains prepared exclusively for worship), fragrant flowers and sweet fruits (such as ''khajura'', date), which are indicative of good fortune, should be offered to the ''brahmanas''. Blessings should then be sought from the ''brahmanas'', after taking sips of water (''achamana'' is taking sips of water after chanting ''mantra''). With auspicious mantras being chanted by the priests, the expecting woman should enter the maternity home, following the cow and the ''brahmanas'' to her right side. Then she should stay there until she delivers her child. [35]
</div>
==== Premonitory signs and symptoms of labor ====

तस्यास्तु खल्विमानि लिङ्गानि प्रजननकालमभितो भवन्ति; तद्यथा- क्लमो गात्राणां, ग्लानिराननस्य, अक्ष्णोः शैथिल्यं,विमुक्तबन्धनत्वमिव [१] वक्षसः, कुक्षेरवस्रंसनम्, अधोगुरुत्वं, वङ्क्षणबस्तिकटीकुक्षिपार्श्वपृष्ठनिस्तोदः, योनेः प्रस्रवणम्,अनन्नाभिलाषश्चेति; ततोऽनन्तरमावीनां प्रादुर्भावः, प्रसेकश्च गर्भोदकस्य||३६||

tasyāstu khalvimāni liṅgāni prajananakālamabhitō bhavanti; tadyathā- klamō gātrāṇāṁ, glānirānanasya,akṣṇōḥ śaithilyaṁ, vimuktabandhanatvamiva [1] vakṣasaḥ, kukṣēravasraṁsanam, adhōgurutvaṁ,vaṅkṣaṇabastikaṭīkukṣipārśvapr̥ṣṭhanistōdaḥ, yōnēḥ prasravaṇam, anannābhilāṣaścēti;tatō'nantaramāvīnāṁ prādurbhāvaḥ, prasēkaśca garbhōdakasya||36||
tasyAstu khalvimAni li~ggAni prajananakAlamabhito bhavanti; tadyathA- klamo gAtrANAM,glAnirAnanasya, akShNoH shaithilyaM, vimuktabandhanatvamiva [1] vakShasaH, kukSheravasraMsanam,adhogurutvaM, va~gkShaNabastikaTIkukShipArshvapRuShThanistodaH, yoneH prasravaNam,anannAbhilAShashceti; tato~anantaramAvInAM prAdurbhAvaH, prasekashca garbhodakasya||36||
<div style="text-align:justify;">
The premonitory signs and symptoms of labor include tiredness, pallor, laxity of eyes (drooping of eyelids), feeling of getting freed from constrictions around the chest, bearing down pressure sensation in pelvis because of fetus, heaviness of lower abdomen, and pain in the groin, bladder area perineum, pelvis, belly, sides and the back, discharge from the vagina, lack of desire for food. These are typically followed by the appearance of ''garbhodaka'' (amniotic fluid) and initiation of ''aavee'' (labor pain). [36]
</div>
==== Commencement of ''aavee'' (labor) ====

आवीप्रादुर्भावे तु भूमौ शयनं विदध्यान्मृद्वास्तरणोपपन्नम्|
तदध्यासीत [२] सा|
तां ततः समन्ततः परिवार्य यथोक्तगुणाः स्त्रियः पर्युपासीरन्नाश्वासयन्त्यो वाग्भिर्ग्राहिणीयाभिः [३] सान्त्वनीयाभिश्च||३७||

āvīprādurbhāvē tu bhūmau śayanaṁ vidadhyānmr̥dvāstaraṇōpapannam|
tadadhyāsīta [2] sā|
tāṁ tataḥ samantataḥ parivārya yathōktaguṇāḥ striyaḥ paryupāsīrannāśvāsayantyō vāgbhirgrāhiṇīyābhiḥ[3] sāntvanīyābhiśca||37||

AvIprAdurbhAve tu bhUmau shayanaM vidadhyAnmRudvAstaraNopapannam|
tadadhyAsIta [2] sA|
tAM tataH samantataH parivArya yathoktaguNAH striyaH paryupAsIrannAshvAsayantyovAgbhirgrAhiNIyAbhiH [3] sAntvanIyAbhishca||37||
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With the commencement of ''aavee'', the parturient woman should be made to sit on a bed prepared with soft materials spread over the ground. Then, the female attendants with qualities mentioned in the preceding verses should surround her from all sides and encourage her by comforting words and touch. [37]
</div>
==== Issues with delivery despite labor pains ====

सा चेदावीभिः सङ्क्लिश्यमाना न प्रजायेताथैनां ब्रूयात्-उत्तिष्ठ, मुसलमन्यतरं गृहीष्व, अनेनैतदुलूखलं धान्यपूर्णंमुहुर्मुहुरभिजहि मुहुर्मुहुरवजृम्भस्व चङ्क्रमस्व चान्तराऽन्तरेति; एवमुपदिशन्त्येके|
तन्नेत्याह भगवानात्रेयः|
दारुणव्यायामवर्जनं हि गर्भिण्याः सततमुपदिश्यते, विशेषतश्च प्रजननकाले प्रचलितसर्वधातुदोषायाःसुकुमार्या नार्यामुसलव्यायामसमीरितो वायुरन्तरं लब्ध्वा प्राणान् हिंस्यात्, दुष्प्रतीकारतमा हि तस्मिन् काले विशेषेण भवति गर्भिणी;तस्मान्मुसलग्रहणं परिहार्यमृषयो मन्यन्ते, जृम्भणं चङ्क्रमणं च पुनरनुष्ठेयमिति|
अथास्यै दद्यात् कुष्ठैलालाङ्गलिकीवचाचित्रकचिरबिल्वचव्यचूर्णमुपघ्रातुं, सा तन्मुहुर्मुहुरुपजिघ्रेत्, तथा भूर्जपत्रधूमंशिंशपासारधूमं वा|
तस्याश्चान्तराऽन्तरा कटीपार्श्वपृष्ठसक्थिदेशानीषदुष्णेन तैलेनाभ्यज्यानुसुखमवमृद्नीयात् [४] |
अनेन कर्मणा गर्भोऽवाक् [५] प्रतिपद्यते||३८||

sā cēdāvībhiḥ saṅkliśyamānā na prajāyētāthaināṁ brūyāt- uttiṣṭha, musalamanyataraṁ gr̥hīṣva,anēnaitadulūkhalaṁ dhānyapūrṇaṁ muhurmuhurabhijahi muhurmuhuravajr̥mbhasva caṅkramasvacāntarā'ntarēti; ēvamupadiśantyēkē|
tannētyāha bhagavānātrēyaḥ|
dāruṇavyāyāmavarjanaṁ hi garbhiṇyāḥ satatamupadiśyatē, viśēṣataśca prajananakālēpracalitasarvadhātudōṣāyāḥ sukumāryā nāryā musalavyāyāmasamīritō vāyurantaraṁ labdhvā prāṇānhiṁsyāt, duṣpratīkāratamā hi tasmin kālē viśēṣēṇa bhavati garbhiṇī; tasmānmusalagrahaṇaṁparihāryamr̥ṣayō manyantē, jr̥mbhaṇaṁ caṅkramaṇaṁ ca punaranuṣṭhēyamiti|
athāsyai dadyāt kuṣṭhailālāṅgalikīvacācitrakacirabilvacavyacūrṇamupaghrātuṁ, sātanmuhurmuhurupajighrēt, tathā bhūrjapatradhūmaṁ śiṁśapāsāradhūmaṁ vā|
tasyāścāntarā'ntarā kaṭīpārśvapr̥ṣṭhasakthidēśānīṣaduṣṇēna tailēnābhyajyānusukhamavamr̥dnīyāt [4] |
anēna karmaṇā garbhō'vāk [5] pratipadyatē||38||

sA cedAvIbhiH sa~gklishyamAnA na prajAyetAthainAM brUyAt- uttiShTha, musalamanyataraM gRuhIShva,anenaitadulUkhalaM dhAnyapUrNaM muhurmuhurabhijahi muhurmuhuravajRumbhasva ca~gkramasvacAntarA~antareti; evamupadishantyeke|
tannetyAha bhagavAnAtreyaH|
dAruNavyAyAmavarjanaM hi garbhiNyAH satatamupadishyate, visheShatashca prajananakAlepracalitasarvadhAtudoShAyAH sukumAryA nAryA musalavyAyAmasamIrito vAyurantaraM labdhvA prANAnhiMsyAt, duShpratIkAratamA hi tasmin kAle visheSheNa bhavati garbhiNI; tasmAnmusalagrahaNaMparihAryamRuShayo manyante, jRumbhaNaM ca~gkramaNaM ca punaranuShTheyamiti|
athAsyai dadyAt kuShThailAlA~ggalikIvacAcitrakacirabilvacavyacUrNamupaghrAtuM, sAtanmuhurmuhurupajighret, tathA bhUrjapatradhUmaM shiMshapAsAradhUmaM vA|
tasyAshcAntarA~antarA kaTIpArshvapRuShThasakthideshAnIShaduShNenatailenAbhyajyAnusukhamavamRudnIyAt [4] |
anena karmaNA garbho~avAk [5] pratipadyate||38||
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If in spite of acute labor pains, she is not able to deliver, some advise that the woman must be instructed to get up, hold a pestle and pound grains repeatedly, taking breaks and deep breaths, and moving about periodically. Lord Atreya, however, does not consider it right. According to him, a pregnant woman should always be advised to avoid strenuous exercises and particularly during parturition, since all the body elements and humors are in a state of commotion, ''vata'', aggravated by the strain involved in the exercise of pounding, could even be fatal to the pregnant woman. Woman during this situation will be difficult to cure. Other sages advise against the pounding exercises but advocating deep breathing and moving about.

The woman should be made to inhale the powders of ''kushta'' (Saussurea lappa C.B.Clarke.), ''ela'' (Elettaria cardamomum Maton), ''langalaki'' (Gloriosa superb Linn.), ''vacha'' (Acorus calamus Linn.), ''chitraka'' (Plumbago zeylanica Linn.), ''chirbilva'' (Pongamia pinnata Mirr.) and ''chavya'' (Piper chaba Hunter), which can be administered frequently . Similarly the fumigation done with leaves of ''bhurja'' (Betula utilis D. Don.) or pith of ''shimsapa'' (Dalbergia sissoo Roxb.) could be used for inhalation. During this period, she should be given a light massage over her waist, sides, back and legs with lukewarm oil followed by a kneading massage. With these measures the fetus descends down. [38]
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==== Mantra to be recited when labor pain increases ====

स यदा जानीयाद्विमुच्य हृदयमुदरमस्यास्त्वाविशति, बस्तिशिरोऽवगृह्णाति, त्वरयन्त्येनामाव्यः, परिवर्ततेऽधो [६] गर्भइति; अस्यामवस्थायां पर्यङ्कमेनामारोप्य प्रवाहयितुमुपक्रमेत|
कर्णे चास्या मन्त्रमिममनुकूला स्त्री जपेत्-
‘क्षितिर्जलं वियत्तेजो वायुर्विष्णुः [७] प्रजापतिः|
सगर्भां त्वां सदा पान्तु वैशल्यं च दिशन्तु ते|
प्रसूष्व त्वमविक्लिष्टमविक्लिष्टा शुभानने!|
कार्तिकेयद्युतिं पुत्रं कार्तिकेयाभिरक्षितम्’ इति||३९||

sa yadā jānīyādvimucya hr̥dayamudaramasyāstvāviśati, bastiśirō'vagr̥hṇāti, tvarayantyēnāmāvyaḥ,parivartatē'dhō [6] garbha iti; asyāmavasthāyāṁ paryaṅkamēnāmārōpya pravāhayitumupakramēta|
karṇē cāsyā mantramimamanukūlā strī japēt-
‘kṣitirjalaṁ viyattējō vāyurviṣṇuḥ [7] prajāpatiḥ|
sagarbhāṁ tvāṁ sadā pāntu vaiśalyaṁ ca diśantu tē|
prasūṣva tvamavikliṣṭamavikliṣṭā śubhānanē!|
kārtikēyadyutiṁ putraṁ kārtikēyābhirakṣitam’ iti||39||

sa yadA jAnIyAdvimucya hRudayamudaramasyAstvAvishati, bastishiro~avagRuhNAti,tvarayantyenAmAvyaH, parivartate~adho [6] garbha iti; asyAmavasthAyAM parya~gkamenAmAropyapravAhayitumupakrameta|
karNe cAsyA mantramimamanukUlA strI japet-
‘kShitirjalaM viyattejo vAyurviShNuH [7] prajApatiH|
sagarbhAM tvAM sadA pAntu vaishalyaM ca dishantu te|
prasUShva tvamavikliShTamavikliShTA shubhAnane!|
kArtikeyadyutiM putraM kArtikeyAbhirakShitam’ iti||39||
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When the feeling of fetus descending into the lower abdomen getting separated from heart (upper part) is felt by mother, and fetal head has turned which gets caught in the pelvic cavity, also the labour pain becomes more frequent. At this stage she should be made to lie down on the delivery cot and urged to bear down. One of her favourite lady attendants should recite the following ''mantra'' in her ears “May the Earth, the water, the heaven, the light, the wind, Visnu and Prajapati ever protect you and the child and may they guide the delivery. O, auspicious faced one! Bring forth, without distress to yourself or to him, a son who will possess the lustre of Kartikeya and will have the protection of Kartikeya.’’ [39]
</div>
ताश्चैनां यथोक्तगुणाः स्त्रियोऽनुशिष्युः-अनागतावीर्मा प्रवाहिष्ठाः; या ह्यनागतावीः [८] प्रवाहते व्यर्थमेवास्यास्तत् कर्मभवति, प्रजा चास्या विकृता विकृतिमापन्ना च, श्वासकासशोषप्लीहप्रसक्ता वा भवति|
यथा हि क्षवथूद्गारवातमूत्रपुरीषवेगान् प्रयतमानोऽप्यप्राप्तकालान्न लभते कृच्छ्रेण वाऽप्यवाप्नोति [९] ,तथाऽनागतकालंगर्भमपि प्रवाहमाणा; यथा चैषामेव क्षवथ्वादीनां सन्धारणमुपघातायोपपद्यते, तथा प्राप्तकालस्य गर्भस्याप्रवाहणमिति|
सा यथानिर्देशं कुरुष्वेति वक्तव्या स्यात्|
तथा च कुर्वती शनैः पूर्वं प्रवाहेत, ततोऽनन्तरं बलवत्तरम्|
तस्यां च प्रवाहमाणायां स्त्रियः शब्दं कुर्युः- ‘प्रजाता प्रजाता धन्यं धन्यं पुत्रम्’ इति|
तथाऽस्या हर्षेणाप्याय्यन्ते प्राणाः||४०||

tāścaināṁ yathōktaguṇāḥ striyō'nuśiṣyuḥ- anāgatāvīrmā pravāhiṣṭhāḥ; yā hyanāgatāvīḥ [8] pravāhatēvyarthamēvāsyāstat karma bhavati, prajā cāsyā vikr̥tā vikr̥timāpannā ca, śvāsakāsaśōṣaplīhaprasaktā vābhavati|
yathā hi kṣavathūdgāravātamūtrapurīṣavēgān prayatamānō'pyaprāptakālānna labhatē kr̥cchrēṇavā'pyavāpnōti [9] , tathā'nāgatakālaṁ garbhamapi pravāhamāṇā; yathā caiṣāmēva kṣavathvādīnāṁsandhāraṇamupaghātāyōpapadyatē, tathā prāptakālasya garbhasyāpravāhaṇamiti|
sā yathānirdēśaṁ kuruṣvēti vaktavyā syāt|
tathā ca kurvatī śanaiḥ pūrvaṁ pravāhēta, tatō'nantaraṁ balavattaram|
tasyāṁ ca pravāhamāṇāyāṁ striyaḥ śabdaṁ kuryuḥ- ‘prajātā prajātā dhanyaṁ dhanyaṁ putram’ iti|
tathā'syā harṣēṇāpyāyyantē prāṇāḥ||40||

tAshcainAM yathoktaguNAH striyo~anushiShyuH- anAgatAvIrmA pravAhiShThAH; yA hyanAgatAvIH [8]pravAhate vyarthamevAsyAstat karma bhavati, prajA cAsyA vikRutA vikRutimApannA ca,shvAsakAsashoShaplIhaprasaktA vA bhavati|
yathA hi kShavathUdgAravAtamUtrapurIShavegAn prayatamAno~apyaprAptakAlAnna labhate kRucchreNavA~apyavApnoti [9] , tathA~anAgatakAlaM garbhamapi pravAhamANA; yathA caiShAmevakShavathvAdInAM sandhAraNamupaghAtAyopapadyate, tathA prAptakAlasya garbhasyApravAhaNamiti|
sA yathAnirdeshaM kuruShveti vaktavyA syAt|
tathA ca kurvatI shanaiH pUrvaM pravAheta, tato~anantaraM balavattaram|
tasyAM ca pravAhamANAyAM striyaH shabdaM kuryuH- ‘prajAtA prajAtA dhanyaM dhanyaM putram’ iti|
tathA~asyA harSheNApyAyyante prANAH||40||
<div style="text-align:justify;">
The attending women should instruct her thus, “Don’t strain (bear down) when there is no labor pain, because if you do, the efforts may go in vain, and moreover the off spring may be born with deformities or afflicted with diseases like ''shwasa'' (dyspnoea), ''kasa'' (cough), ''shosha'' (emaciation) or ''pleeha'' (spleenic disorders). As when there is no natural urge to sneeze, or pass flatulence, urine or bowel movements, they will not appear or if appear will be with a lot of effort, similarly if the woman strains when there is no labour pain, the foetus will not come out or if at all it comes out, it will be with great difficulty. On the other hand, just as when there is a strong urge to pass bodily wastes, one should not suppress them, not straining when there is acute labor pain will lead to difficult labour. The woman should be advised to follow the following instructions - Initially she should strain (bear down) with mild force, gradually with stronger efforts. While she is bearing down hard, the attendants should keep repeating words such as ‘She has just delivered a worthy son, fortunate son’.Such words make the woman feel happy and motivate her to continue pushing the baby out. [40]
</div>
==== Procedure to remove placenta post-delivery ====

यदा च प्रजाता स्यात्तदैवैनामवेक्षेत- काचिदस्या अपरा प्रपन्ना न वेति|
तस्याश्चेदपरा न प्रपन्ना स्यादथैनामन्यतमा स्त्री दक्षिणेन पाणिना नाभेरुपरिष्टाद्बलवन्निपीड्य सव्येन पाणिना पृष्ठतउपसङ्गृह्य तां सुनिर्धूतं निर्धुनुयात्|
अथास्याः पार्ष्ण्या श्रोणीमाकोटयेत्|
अस्याः स्फिचावुपसङ्गृह्य सुपीडितं पीडयेत्|
अथास्या बालवेण्या कण्ठतालु परिमृशेत्|
भूर्जपत्रकाचमणिसर्पनिर्मोकैश्चास्या योनिं धूपयेत्|
कुष्ठतालीसकल्कं बल्वजयूषे [१] मैरेयसुरामण्डे तीक्ष्णे कौलत्थे व यूषे मण्डूकपर्णीपिप्पलीसम्पाके वा सम्प्लाव्य पाययेदेनाम्|
तथा सूक्ष्मैलाकिलिमकुष्ठनागर विडङ्गपिप्पलीकालागुरुचव्यचित्रकोपकुञ्चिकाकल्कं खरवृषभस्य वा जीवतो [२] दक्षिणंकर्णमुत्कृत्य दृषदि जर्जरीकृत्य बल्वजक्वाथादीनामाप्लावनानामन्यतमे [३] प्रक्षिप्याप्लाव्य मुहूर्तस्थितमुद्धृत्य तदाप्लावनंपाययेदेनाम्|
शतपुष्पाकुष्ठमदनहिङ्गुसिद्धस्य चैनां तैलस्य पिचुं ग्राहयेत्|
अतश्चैवानुवासयेत्|
एतैरेव चाप्लावनैः फलजीमूतेक्ष्वाकुधामार्गवकुटजकृतवेधनहस्तिपिप्पल्युपहितैरास्थापयेत्|
तदास्थापनमस्याः सह वातमूत्रपुरीषैर्निर्हरत्यपरामासक्तां वायोरेवाप्रतिलोमगत्वात् [४] |
अपरां हि वातमूत्रपुरीषाण्यन्यानि चान्तर्बहिर्मार्गाणि [५] सज्जन्ति||४१||

yadā ca prajātā syāttadaivaināmavēkṣēta- kācidasyā aparā prapannā na vēti|
tasyāścēdaparā na prapannā syādathaināmanyatamā strī dakṣiṇēna pāṇinānābhērupariṣṭādbalavannipīḍya savyēna pāṇinā pr̥ṣṭhata upasaṅgr̥hya tāṁ sunirdhūtaṁ nirdhunuyāt|
athāsyāḥ pārṣṇyā śrōṇīmākōṭayēt|
asyāḥ sphicāvupasaṅgr̥hya supīḍitaṁ pīḍayēt|
athāsyā bālavēṇyā kaṇṭhatālu parimr̥śēt|
bhūrjapatrakācamaṇisarpanirmōkaiścāsyā yōniṁ dhūpayēt|
kuṣṭhatālīsakalkaṁ balvajayūṣē [1] mairēyasurāmaṇḍē tīkṣṇē kaulatthē va yūṣēmaṇḍūkaparṇīpippalīsampākē vā samplāvya pāyayēdēnām|
tathā sūkṣmailākilimakuṣṭhanāgara viḍaṅgapippalīkālāgurucavyacitrakōpakuñcikākalkaṁ kharavr̥ṣabhasyavā jīvatō [2] dakṣiṇaṁ karṇamutkr̥tya dr̥ṣadi jarjarīkr̥tya balvajakvāthādīnāmāplāvanānāmanyatamē [3]prakṣipyāplāvya muhūrtasthitamuddhr̥tya tadāplāvanaṁ pāyayēdēnām|
śatapuṣpākuṣṭhamadanahiṅgusiddhasya caināṁ tailasya picuṁ grāhayēt|
ataścaivānuvāsayēt|
ētairēva cāplāvanaiḥ phalajīmūtēkṣvākudhāmārgavakuṭajakr̥tavēdhanahastipippalyupahitairāsthāpayēt|
tadāsthāpanamasyāḥ saha vātamūtrapurīṣairnirharatyaparāmāsaktāṁ vāyōrēvāpratilōmagatvāt [4] |
aparāṁ hi vātamūtrapurīṣāṇyanyāni cāntarbahirmārgāṇi [5] sajjanti||41||

yadA ca prajAtA syAttadaivainAmavekSheta- kAcidasyA aparA prapannA na veti|
tasyAshcedaparA na prapannA syAdathainAmanyatamA strI dakShiNena pANinAnAbherupariShTAdbalavannipIDya savyena pANinA pRuShThata upasa~ggRuhya tAM sunirdhUtaMnirdhunuyAt|
athAsyAH pArShNyA shroNImAkoTayet|
asyAH sphicAvupasa~ggRuhya supIDitaM pIDayet|
athAsyA bAlaveNyA kaNThatAlu parimRushet|
bhUrjapatrakAcamaNisarpanirmokaishcAsyA yoniM dhUpayet|
kuShThatAlIsakalkaM balvajayUShe [1] maireyasurAmaNDe tIkShNe kaulatthe va yUShemaNDUkaparNIpippalIsampAke vA samplAvya pAyayedenAm|
tathA sUkShmailAkilimakuShThanAgara viDa~ggapippalIkAlAgurucavyacitrakopaku~jcikAkalkaMkharavRuShabhasya vA jIvato [2] dakShiNaM karNamutkRutya dRuShadi jarjarIkRutyabalvajakvAthAdInAmAplAvanAnAmanyatame [3] prakShipyAplAvya muhUrtasthitamuddhRutyatadAplAvanaM pAyayedenAm|
shatapuShpAkuShThamadanahi~ggusiddhasya cainAM tailasya picuM grAhayet|
atashcaivAnuvAsayet|
etaireva cAplAvanaiHphalajImUtekShvAkudhAmArgavakuTajakRutavedhanahastipippalyupahitairAsthApayet|
tadAsthApanamasyAH saha vAtamUtrapurIShairnirharatyaparAmAsaktAM vAyorevApratilomagatvAt [4] |
aparAM hi vAtamUtrapurIShANyanyAni cAntarbahirmArgANi [5] sajjanti||41||
<div style="text-align:justify;">
Immediately after the delivery of the child, one should confirm whether the placenta has been expelled out or not. If it is not expelled, then one of the female attendants should forcefully press her abdomen from above the navel region with her right hand and holding her back with left, should give a good shake to the body of the patient. The hip region of the patient should be pressed with the heels and her buttocks should be taken by hand and strongly pressed by the attendant. Her throat should be rubbed with the braid of her hair. The genital tract should be fumigated with the leaves of ''bhurja'' (Betula utilis D. Don.), ''kachamani'' (quartz) and ''sarpanirmoka'' (slough of serpent). She should be given paste of ''kushta'' (Saussurea lappa C. B. Clarke) and ''talisa'' (Abies webbiana Lindl.) mixed with the soup of ''balwaja'' (a hemp-like plant) or strong liquor of ''maireya'' and ''sura''-like beverages for drinking, or the soup of ''kulaththa'' (Dolichos biflorus Linn. - horse gram) or decoctions of ''mandukaparni'' (Centella asiatica Urban.) and ''pippali'' (Piper longum Linn.). The paste of ''laghu ela'' (Elettaria cardamomum Moton.), ''kilima'' (Devadaru – Cedrus deodara Loud.), ''kushta'' (Saussurea lappa C.B. Clarke), ''shunthi'' (Zingiber officinale Rosc.), ''vidanga'' (Embeliaribes Burm f.), ''pippali'' (Piper longum Linn.), ''kalagaru'' (Aquilaria agallocha Roxb. – black variety), ''chavya'' (Piper chaba Junter.), ''chitraka'' (Plumbago zeylanica Roxb.) and ''upakunjika'' (Nigella sativa Linn.)and crushed pieces of the right ear of a living untamed bull, pounding it on grinding stone and keeping it for some time in one of the decoctions of ''Balwaja'' (-?-) etc.;The liquid portion of this decoction should be administered to the patient as a drink. A cotton swab soaked in the oil prepared with ''shatapushpa'' (Foeniculum vulgare Mill.), ''kushta'' (Saussurea lappa C. B. Clarke), ''Madana'' (Randia dumetorum Lam.) and ''hingu'' (Ferula narthex Boiss.) should be inserted into her vaginal passage, and with the same oil, ''anuvasana basti'' (unctuous enema) should be administered to her. The decoction of ''Balwaja''(-?-) should be mixed with apaste of ''madanaphala''(Randia duemtorum Lam.), ''devadali'' (Luffaechinata Roxb.),''ikshvaku'' (Legenaria siceraria Standl.), ''dhamargava'' (Luffa cylindrica M. Roem.), ''kutaja'' (Holarrhena antidysenterica Wall.), ''kritavedhana'' (Luffa acutangula Roxb.) and ''gajapippali'' (Scindapsus officilanlis Schott.) and administered in the form of ''asthapana basti'' (non-unctuous enema).This non-unctuous enema will lead to the expulsion of the retained placenta while passing flatulence, urine and bowel movementsby the downward movement of ''vayu''. Bodily wastes have a tendency to come out of the body naturally, but may get obstructed inside the abdomen, obstructing the ejection of the placenta too. [41]

तस्यास्तु खल्वपरायाः प्रपतनार्थे कर्मणि क्रियमाणे जातमात्रस्यैव कुमारस्य कार्याण्येतानि कर्माणि भवन्ति; तद्यथा-अश्मनोः सङ्घट्टनं कर्णयोर्मूले, शीतोदकेनोष्णोदकेन वा मुखपरिषेकः [१] , तथा स क्लेशविहतान् प्राणान् पुनर्लभेत|
कृष्णकपालिकाशूर्पेण चैनमभिनिष्पुणीयुर्यद्यचेष्टः स्याद् यावत् प्राणानां प्रत्यागमनम् (तत्तत् [२] सर्वमेव कार्यम्)|
ततः प्रत्यागतप्राणं प्रकृतिभूतमभिसमीक्ष्य स्नानोदकग्रहणाभ्यामुपपादयेत्||४२||

tasyāstu khalvaparāyāḥ prapatanārthē karmaṇi kriyamāṇē jātamātrasyaiva kumārasya kāryāṇyētānikarmāṇi bhavanti; tadyathā- aśmanōḥ saṅghaṭṭanaṁ karṇayōrmūlē, śītōdakēnōṣṇōdakēna vāmukhapariṣēkaḥ [1] , tathā sa klēśavihatān prāṇān punarlabhēta|
kr̥ṣṇakapālikāśūrpēṇa cainamabhiniṣpuṇīyuryadyacēṣṭaḥ syād yāvat prāṇānāṁ pratyāgamanam (tattat [2]sarvamēva kāryam)|
tataḥ pratyāgataprāṇaṁ prakr̥tibhūtamabhisamīkṣya snānōdakagrahaṇābhyāmupapādayēt||42||

tasyAstu khalvaparAyAH prapatanArthe karmaNi kriyamANe jAtamAtrasyaiva kumArasya kAryANyetAnikarmANi bhavanti; tadyathA- ashmanoH sa~gghaTTanaM karNayormUle, shItodakenoShNodakena vAmukhapariShekaH [1] , tathA sa kleshavihatAn prANAn punarlabheta|
kRuShNakapAlikAshUrpeNa cainamabhiniShpuNIyuryadyaceShTaH syAd yAvat prANAnAMpratyAgamanam (tattat [2] sarvameva kAryam)|
tataH pratyAgataprANaM prakRutibhUtamabhisamIkShya snAnodakagrahaNAbhyAmupapAdayet||42||

While administering the various procedures described in the preceding verse to remove the placenta from the mother’s body, certain measures should also be performed on the newly born child, such as gently striking the stones near the root of the ear, and sprinkling of cold or hot water over its face, to rejuvenate its vital breath that might have stopped due to distress. If the child is not movingor does not revive, it should then be fanned with a winnowing basket made of bamboo etc. till it regains consciousness (the procedures to be continued till consciousness is established). Once respiration is established and gets normalized, then he should be given a good bath and cleansed thoroughly. [42]
</div>
==== Procedure for cleaning the baby after birth ====

अथास्य ताल्वोष्ठकण्ठजिह्वाप्रमार्जनमारभेताङ्गुल्या सुपरिलिखितनखया सुप्रक्षालितोपधानकार्पाससपिचुमत्या|
प्रथमं प्रमार्जितास्यस्य चास्य शिरस्तालु कार्पासपिचुना स्नेहगर्भेण प्रतिसञ्छादयेत्|
ततोऽस्यानन्तरं सैन्धवोपहितेन सर्पिषा कार्यं प्रच्छर्दनम्||४३||

athāsya tālvōṣṭhakaṇṭhajihvāpramārjanamārabhētāṅgulyā suparilikhitanakhayāsuprakṣālitōpadhānakārpāsasapicumatyā|
prathamaṁ pramārjitāsyasya cāsya śirastālu kārpāsapicunā snēhagarbhēṇa pratisañchādayēt|
tatō'syānantaraṁ saindhavōpahitēna sarpiṣā kāryaṁ pracchardanam||43||

athAsya tAlvoShThakaNThajihvApramArjanamArabhetA~ggulyA suparilikhitanakhayAsuprakShAlitopadhAnakArpAsasapicumatyA|
prathamaM pramArjitAsyasya cAsya shirastAlu kArpAsapicunA snehagarbheNa pratisa~jchAdayet|
tato~asyAnantaraM saindhavopahitena sarpiShA kAryaM pracchardanam||43||
<div style="text-align:justify;">
Thereafter, the palate, lips, throat and tongue of the child should be cleaned with a clean cotton swab using a finger of the attendant, whose nails have been well manicured. After cleaning the mouth, a cotton swab well soaked in oil should be placed over the ''shirastalu'' (anterior fontanel) and then a procedure to provoke vomiting should be administered using ghee with ''saindhava'' (rock salt). [43]
</div>
==== Measuring the umbilical cord ====

ततः कल्पनं नाड्याः|
अतस्तस्याः कल्पनविधिमुपदेक्ष्यामः-नाभिबन्धनात् प्रभृत्यष्टाङ्गुलमभिज्ञानं कृत्वा छेदनावकाशस्य द्वयोरन्तरयोःशनैर्गृहीत्वा तीक्ष्णेन रौक्मराजतायसानां छेदनानामन्यतमेनार्धधारेण [१] छेदयेत्|
तामग्रे सूत्रेणोपनिबध्य कण्ठेऽस्य शिथिलमवसृजेत्|
तस्य चेन्नाभिः पच्येत, तां लोध्रमधुकप्रियङ्गुसुरदारुहरिद्राकल्कसिद्धेन तैलेनाभ्यज्यात्, एषामेव तैलौषधानांचूर्णेनावचूर्णयेत्|
इति नाडीकल्पनविधिरुक्तः सम्यक्||४४||

tataḥ kalpanaṁ nāḍyāḥ|
atastasyāḥ kalpanavidhimupadēkṣyāmaḥ- nābhibandhanāt prabhr̥tyaṣṭāṅgulamabhijñānaṁ kr̥tvāchēdanāvakāśasya dvayōrantarayōḥ śanairgr̥hītvā tīkṣṇēna raukmarājatāyasānāṁchēdanānāmanyatamēnārdhadhārēṇa [1] chēdayēt|
tāmagrē sūtrēṇōpanibadhya kaṇṭhē'sya śithilamavasr̥jēt|
tasya cēnnābhiḥ pacyēta, tāṁ lōdhramadhukapriyaṅgusuradāruharidrākalkasiddhēna tailēnābhyajyāt,ēṣāmēva tailauṣadhānāṁ cūrṇēnāvacūrṇayēt|
iti nāḍīkalpanavidhiruktaḥ samyak||44||

tataH kalpanaM nADyAH|
atastasyAH kalpanavidhimupadekShyAmaH- nAbhibandhanAt prabhRutyaShTA~ggulamabhij~jAnaMkRutvA chedanAvakAshasya dvayorantarayoH shanairgRuhItvA tIkShNena raukmarAjatAyasAnAMchedanAnAmanyatamenArdhadhAreNa [1] chedayet|
tAmagre sUtreNopanibadhya kaNThe~asya shithilamavasRujet|
tasya cennAbhiH pacyeta, tAM lodhramadhukapriya~ggusuradAruharidrAkalkasiddhena tailenAbhyajyAt,eShAmeva tailauShadhAnAM cUrNenAvacUrNayet|
iti nADIkalpanavidhiruktaH samyak||44||
<div style="text-align:justify;">
Thereafter, the umbilical cord is measured. The cord should be marked at a distance of eight angula (thumb-length) from its base where it is attached at the navel of the child, and then holding the cord gently and firmly on both the ends, it should be cut with a sharp half-edged instrument made of gold, silver or iron (steel). The portion of the cord at the navel side should be tied with a thread and then loosely tied to the neck of the child. If the umbilicus end gets suppurated, then it should be anointed with oil prepared with paste of ''lodhra'' (Symplocos racemosa Roxb.), ''madhuka'' (Glycyrrhiza glabra Linn.), ''priyangu'' (Callicarpa macrophylla Vahl.), ''devadaru'' (Cedrus deodara Loud.) and ''haridra'' (Curcuma longa Linn.), and the powder of the same drugs should be sprinkled over the cut surface.
This concludes the verse on the “measurement of the cord”. [44]
</div>
==== Complications arising due to improper cutting of the umbilical cord ====

असम्यक्कल्पने हि नाड्या आयामव्यायामोत्तुण्डिता-पिण्डलिका-विनामिका-विजृम्भिकाबाधेभ्यो भयम्|
तत्राविदाहिभिर्वातपित्तप्रशमनैरभ्यङ्गोत्सादनपरिषेकैः सर्पिर्भिश्चोपक्रमेत गुरुलाघवमभिसमीक्ष्य||४५||

asamyakkalpanē hi nāḍyā āyāmavyāyāmōttuṇḍitā-piṇḍalikā-vināmikā-vijr̥mbhikābādhēbhyō bhayam|
tatrāvidāhibhirvātapittapraśamanairabhyaṅgōtsādanapariṣēkaiḥ sarpirbhiścōpakramētagurulāghavamabhisamīkṣya||45||

asamyakkalpane hi nADyA AyAmavyAyAmottuNDitA-piNDalikA-vinAmikA-vijRumbhikAbAdhebhyo bhayam|
tatrAvidAhibhirvAtapittaprashamanairabhya~ggotsAdanapariShekaiH sarpirbhishcopakrametagurulAghavamabhisamIkShya||45||
<div style="text-align:justify;">
Improper cutting of the umbilical cord and administering of measures explained in the preceding verse could lead to complications such as ''ayamottundita'' (vertical swelling), ''vyayamottundita'' (horizontal swelling), ''pindalika'' (lumpy swellings or formation of a circular ring around the umblicus), ''vinamika'' (swelling in the margins with depression at centre), and ''vijrumbhika'' (swelling with constant increase in size as in umblical hernia). In case of these complications, by carefully observing the severity of the condition (mild to severe involvement of the ''doshas''), it should be treated using massages, unction, and sprinkling of ghee prepared with drugs that are non-irritants and ''vata'' and ''pitta'' pacifying. [45]
</div>
==== Birth-rites per Vedic rituals ====

अतोऽनन्तरं जातकर्म कुमारस्य कार्यम्|
तद्यथा- मधुसर्पिषी मन्त्रोपमन्त्रिते यथाम्नायं प्रथमं प्राशितुं दद्यात्|
स्तनमत ऊर्ध्वमेतेनैव विधिना दक्षिणं पातुं पुरस्तात् प्रयच्छेत्|
अथातः [१] शीर्षतः स्थापयेदुदकुम्भं मन्त्रोपमन्त्रितम्||४६||

atō'nantaraṁ jātakarma kumārasya kāryam|
tadyathā- madhusarpiṣī mantrōpamantritē yathāmnāyaṁ prathamaṁ prāśituṁ dadyāt|
stanamata ūrdhvamētēnaiva vidhinā dakṣiṇaṁ pātuṁ purastāt prayacchēt|
athātaḥ [1] śīrṣataḥ sthāpayēdudakumbhaṁ mantrōpamantritam||46||

ato~anantaraM jAtakarma kumArasya kAryam|
tadyathA- madhusarpiShI mantropamantrite yathAmnAyaM prathamaM prAshituM dadyAt|
stanamata Urdhvametenaiva vidhinA dakShiNaM pAtuM purastAt prayacchet|
athAtaH [1] shIrShataH sthApayedudakumbhaM mantropamantritam||46||
<div style="text-align:justify;">
Thereafter, birth-rites of the child should be performed per vedic rituals, which are as follows: first of all, honey and ghee duly “consecrated” with vedic mantras (chanted by brahmanas or priests) should be anointed to the child. Breast milk should first be fed from the right breast, and should be done so after performing the rituals mentioned above. An earthen pot filled with water should be consecrated with mantras and kept near the head of the child. [46]
</div>
==== Measures to protect the newborn ====

अथास्य रक्षां विदध्यात्- आदानीखदिरकर्कन्धुपीलुपरूषकशाखाभिरस्या गृहं समन्ततः परिवारयेत्|
सर्वतश्च सूतिकागारस्य सर्षपातसीतण्डुलकणकणिकाः प्रकिरेयुः|
तथा तण्डुलबलिहोमः सततमुभयकालं [१] क्रियेतानामकर्मणः [२] |
द्वारे च मुसलं देहलीमनु तिरश्चीनं न्यसेत्|
वचाकुष्ठक्षौमकहिङ्गुसर्षपातसीलशुनकणकणिकानां रक्षोघ्नसमाख्यातानां चौषधीनां पोट्टलिकां बद्ध्वासूतिकागारस्योत्तरदेहल्यामवसृजेत्, तथा सूतिकायाः कण्ठे सपुत्रायाः, स्थाल्युदककुम्भपर्यङ्केष्वपि, तथैव चद्वयोर्द्वारपक्षयोः|
कणककण्टकेन्धनवानग्निस्तिन्दुककाष्ठेन्धनश्चाग्निः सूतिकागारस्याभ्यन्तरतो नित्यं स्यात्|
स्त्रियश्चैनां यथोक्तगुणाः सुहृदश्चानुश्चानुजागृयुर्दशाहं द्वादशाहं वा|
अनुपरतप्रदानमङ्गलाशीःस्तुतिगीतवादित्रमन्नपानविशदमनुरक्तप्रहृष्टजनसम्पूर्णं च तद्वेश्म कार्यम्|
ब्राह्मणश्चाथर्ववेदवित् सततमुभयकालं शान्तिं जुहुयात् स्वस्त्ययनार्थं कुमारस्य तथा सूतिकायाः|
इत्येतद्रक्षाविधानमुक्तम्||४७||

athāsya rakṣāṁ vidadhyāt- ādānīkhadirakarkandhupīluparūṣakaśākhābhirasyā gr̥haṁ samantataḥparivārayēt|
sarvataśca sūtikāgārasya sarṣapātasītaṇḍulakaṇakaṇikāḥ prakirēyuḥ|
tathā taṇḍulabalihōmaḥ satatamubhayakālaṁ [1] kriyētānāmakarmaṇaḥ [2] |
dvārē ca musalaṁ dēhalīmanu tiraścīnaṁ nyasēt|
vacākuṣṭhakṣaumakahiṅgusarṣapātasīlaśunakaṇakaṇikānāṁ rakṣōghnasamākhyātānāṁ cauṣadhīnāṁpōṭṭalikāṁ baddhvā sūtikāgārasyōttaradēhalyāmavasr̥jēt, tathā sūtikāyāḥ kaṇṭhē saputrāyāḥ,sthālyudakakumbhaparyaṅkēṣvapi, tathaiva ca dvayōrdvārapakṣayōḥ|
kaṇakakaṇṭakēndhanavānagnistindukakāṣṭhēndhanaścāgniḥ sūtikāgārasyābhyantaratō nityaṁ syāt|
striyaścaināṁ yathōktaguṇāḥ suhr̥daścānuścānujāgr̥yurdaśāhaṁ dvādaśāhaṁ vā|
anuparatapradānamaṅgalāśīḥstutigītavāditramannapānaviśadamanuraktaprahr̥ṣṭajanasampūrṇaṁ catadvēśma kāryam|
brāhmaṇaścātharvavēdavit satatamubhayakālaṁ śāntiṁ juhuyāt svastyayanārthaṁ kumārasya tathāsūtikāyāḥ|
ityētadrakṣāvidhānamuktam||47||

athAsya rakShAM vidadhyAt- AdAnIkhadirakarkandhupIluparUShakashAkhAbhirasyA gRuhaM samantataHparivArayet|
sarvatashca sUtikAgArasya sarShapAtasItaNDulakaNakaNikAH prakireyuH|
tathA taNDulabalihomaH satatamubhayakAlaM [1] kriyetAnAmakarmaNaH [2] |
dvAre ca musalaM dehalImanu tirashcInaM nyaset|
vacAkuShThakShaumakahi~ggusarShapAtasIlashunakaNakaNikAnAM rakShoghnasamAkhyAtAnAMcauShadhInAM poTTalikAM baddhvA sUtikAgArasyottaradehalyAmavasRujet, tathA sUtikAyAH kaNThesaputrAyAH, sthAlyudakakumbhaparya~gkeShvapi, tathaiva ca dvayordvArapakShayoH|
kaNakakaNTakendhanavAnagnistindukakAShThendhanashcAgniH sUtikAgArasyAbhyantarato nityaM syAt|
striyashcainAM yathoktaguNAH suhRudashcAnushcAnujAgRuyurdashAhaM dvAdashAhaM vA|
anuparatapradAnama~ggalAshIHstutigItavAditramannapAnavishadamanuraktaprahRuShTajanasampUrNaMca tadveshma kAryam|
brAhmaNashcAtharvavedavit satatamubhayakAlaM shAntiM juhuyAt svastyayanArthaM kumArasya tathAsUtikAyAH|
ityetadrakShAvidhAnamuktam||47||
<div style="text-align:justify;">
This verse describes measures to protect the newborn. To start with, the maternity home should be surrounded by the branches of ''adani'' (-?-),''khadira'' (Acacia catechu Willd.), ''karkandhu'' (Zyzyphus nummularia W.&A.), ''pilu'' (Salvadora persica Linn.), and ''parushaka'' (Grewiaasiatica Linn.).''Sarshapa'' (Brassica nigra Linn - mustard seeds), ''atasi'' (Linum ustatissimum Linn.), and ''tandula kanakanika'' (pieces of broken rice) should be spread all over the floors in the maternity home. The sacrificial ritual of offering rice to fire should be performed every morning and evening till the naming ceremony for the child is complete. At the door-sill, a wooden pestle should be kept obliquely. A ''potli'' (bag) containing ''vacha'' (Acorus calamus Linn.), ''kushtha'' (Saussurea lappa C.B. Clarke.), ''choraka'' (Ksaumaka -?-), ''hingu'' (Ferula narthex Boiss.), ''sarshapa'' (Brassica nigra Koch.), ''atasi'' (Linum usitatissimum Linn.), ''lashuna'' (Alium sativum Linn.), ''kanakanika'' (-?-) and other drugs known to be repellents of evil spirits should be tied to the door-sill, and to the necks of the mother and the child , and should also be put into cooking utensils, water jars, bed, and on either side of the door panels. There should be a fire lighted constantly with the fire woods of ''kanakanika'' (-?-), and ''tinduka'' (Diospyros peregrine Gurke.) at the fireplace within the maternity home. The attending women (of the qualities mentioned earlier) should keep vigilance of the maternity home for ten to twelve days. The whole house should be kept busy with people who are pious, affectionate and happy, and kept engaged with gifts, encouraging blessings, praise, song, music food and drinks. In order to bestow auspicious blessings on the mother and the child, ''brahmins'' well versed in Atharva Veda should perform ritual sacrifices in the sacred fire two times a day. These are, rituals and measures that need to be put in place to protect the mother and the child. [47]
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==== Post-partum care of the mother ====

सूतिकां तु खलु बुभुक्षितां विदित्वा स्नेहं पाययेत परमया शक्त्या सर्पिस्तैलं वसां मज्जानं वा सात्म्यीभावमभिसमीक्ष्यपिप्पलीपिप्पलीमूलचव्यचित्रकशृङ्गवेरचूर्णसहितम्|
स्नेहं पीतवत्याश्च सर्पिस्तैलाभ्यामभ्यज्य वेष्टयेदुदरं महताऽच्छेन वाससा; तथा तस्या न वायुरुदरेविकृतिमुत्पादयत्यनवकाशत्वात्|
जीर्णे तु स्नेहे पिप्पल्यादिभिरेव सिद्धां यवागूं सुस्निग्धां द्रवां मात्रशः [१] पाययेत्|
उभयतःकालं चोष्णोदकेन च परिषेचयेत् प्राक् स्नेहयवागूपानाभ्याम्|
एवं पञ्चरात्रं सप्तरात्रं वाऽनुपाल्य क्रमेणाप्याययेत्|
स्वस्थवृत्तमेतावत् सूतिकायाः||४८||

sūtikāṁ tu khalu bubhukṣitāṁ viditvā snēhaṁ pāyayēta paramayā śaktyā sarpistailaṁ vasāṁ majjānaṁ vāsātmyībhāvamabhisamīkṣya pippalīpippalīmūlacavyacitrakaśr̥ṅgavēracūrṇasahitam|
snēhaṁ pītavatyāśca sarpistailābhyāmabhyajya vēṣṭayēdudaraṁ mahatā'cchēna vāsasā; tathā tasyā navāyurudarē vikr̥timutpādayatyanavakāśatvāt|
jīrṇē tu snēhē pippalyādibhirēva siddhāṁ yavāgūṁ susnigdhāṁ dravāṁ mātraśaḥ [1] pāyayēt|
ubhayataḥkālaṁ cōṣṇōdakēna ca pariṣēcayēt prāk snēhayavāgūpānābhyām|
ēvaṁ pañcarātraṁ saptarātraṁ vā'nupālya kramēṇāpyāyayēt|
svasthavr̥ttamētāvat sūtikāyāḥ||48||

sUtikAM tu khalu bubhukShitAM viditvA snehaM pAyayeta paramayA shaktyA sarpistailaM vasAM majjAnaMvA sAtmyIbhAvamabhisamIkShya pippalIpippalImUlacavyacitrakashRu~ggaveracUrNasahitam|
snehaM pItavatyAshca sarpistailAbhyAmabhyajya veShTayedudaraM mahatA~acchena vAsasA; tathAtasyA na vAyurudare vikRutimutpAdayatyanavakAshatvAt|
jIrNe tu snehe pippalyAdibhireva siddhAM yavAgUM susnigdhAM dravAM mAtrashaH [1] pAyayet|
ubhayataHkAlaM coShNodakena ca pariShecayet prAk snehayavAgUpAnAbhyAm|
evaM pa~jcarAtraM saptarAtraM vA~anupAlya krameNApyAyayet|
svasthavRuttametAvat sUtikAyAH||48||
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After the delivery (i.e., in the post-partum period) when the new mother feels hungry and needs nourishment, suitable fatty substances like ghee, oil, and majja (muscle fat or marrow), duly mixed with the powders of pippali (Piper longum Linn.), pippalimula (root of Piper longum Linn.), chavya (Piper chaba Hunter.), chitraka (Plumbagozeylanica Linn.) and shrungabera (Zingiberofficinale Rocs.) should be given to her, according to her status of appetitie. Once she has eaten, she should be given a good massage on her abdomen with ghee and oil and then a big clean cloth should be wrapped around her abdomen so that vayu may not find a place to cause any ailment. Once the food eaten is digested, she should take liquid gruel prepared with pippali (Piper longum Linn.) etc., mixed with unctuous substances in copious amounts. She should take a warm water bath before taking meals, though. This regimen should be continued for five to seven nights. [48]
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तस्यास्तु खलु यो व्याधिरुत्पद्यते स कृच्छ्रसाध्यो भवत्यसाध्यो वा, गर्भवृद्धिक्षयितशिथिलसर्वधातुत्वात्,प्रवाहणवेदनाक्लेदनरक्तनिःस्रुतिविशेषशून्यशरीरत्वाच्च; तस्मात्तां यथोक्तेन विधिनोपचरेत्;भौतिकजीवनीयबृंहणीयमधुरवातहरसिद्धैरभ्यङ्गोत्सादनपरिषेकावगाहनान्नपानविधिभिर्विशेषतश्चोपचरेत्; विशेषतो हिशून्यशरीराः स्त्रियः प्रजाता भवन्ति||४९||

tasyāstu khalu yō vyādhirutpadyatē sa kr̥cchrasādhyō bhavatyasādhyō vā, garbhavr̥ddhikṣayitaśithilasarvadhātutvāt,pravāhaṇavēdanāklēdanaraktaniḥsrutiviśēṣaśūnyaśarīratvācca; tasmāttāṁ yathōktēna vidhinōpacarēt;bhautikajīvanīyabr̥ṁhaṇīyamadhuravātaharasiddhairabhyaṅgōtsādanapariṣēkāvagāhanānnapānavidhibhirviśēṣataścōpacarēt;viśēṣatō hi śūnyaśarīrāḥ striyaḥ prajātā bhavanti||49||

tasyAstu khalu yo vyAdhirutpadyate sa kRucchrasAdhyo bhavatyasAdhyo vA, garbhavRuddhikShayitashithilasarvadhAtutvAt,pravAhaNavedanAkledanaraktaniHsrutivisheShashUnyasharIratvAcca; tasmAttAM yathoktena vidhinopacaret;bhautikajIvanIyabRuMhaNIyamadhuravAtaharasiddhairabhya~ggotsAdanapariShekAvagAhanAnnapAnavidhibhirvisheShatashcopacaret;visheShato hi shUnyasharIrAH striyaH prajAtA bhavanti||49||
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If the mother is afflicted with any disease at this puerperal stage, then the condition becomes either difficult to cure or incurable because her body has suffered throughout pregnancy and parturition; because of providing nourishment for growth and development of fetus as well as discharges of blood and kleda during parturition she is vulnerable to doshic afflictions and various diseases.It is therefore important for a weak mother, or a mother afflicted with sickness to be specifically treated with massages, oil anointments, warm baths, food and drink prepared with drugs that are bhautika (alleviators of evil spirits), and of jivaniya, brimhaniya, madhura and vatahar classes of medications. [49]
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दशमे त्वहनि [१] सपुत्रा स्त्री सर्वगन्धौषधैर्गौरसर्षपलोध्रैश्च स्नाता लघ्वहतशुचिवस्त्रं परिधाय [२] पवित्रेष्टलघुविचित्रभूषणवतीच संस्पृश्य मङ्गलान्युचितामर्चयित्वा च देवतां शिखिनः शुक्लवाससोऽव्यङ्गांश्च ब्राह्मणान् स्वस्ति वाचयित्वाकुमारमहतानां [३] च वाससां सञ्चये प्राक्शिरसमुदक्शिरसं वा संवेश्य देवतापूर्वं द्विजातिभ्यः प्रणमतीत्युक्त्वा कुमारस्य पिताद्वे नामनी कारयेन्नाक्षत्रिकं नामाभिप्रायिकं च|
तत्राभिप्रायिकं घोषवदाद्यन्तस्थान्तमूष्मान्तं वाऽवृद्धं [४] त्रिपुरुषानूकमनवप्रतिष्ठितं, नाक्षात्रिकं तु नक्षत्रदेवतासमानाख्यं [५]द्व्यक्षरं चतुरक्षरं वा||५०||
daśamē tvaha
ni [1] saputrā strī sarvagandhauṣadhairgaurasarṣapalōdhraiśca snātā laghvahataśucivastraṁparidhāya [2] pavitrēṣṭalaghuvicitrabhūṣaṇavatī ca saṁspr̥śya maṅgalānyucitāmarcayitvā ca dēvatāṁśikhinaḥ śuklavāsasō'vyaṅgāṁśca brāhmaṇān svasti vācayitvā kumāramahatānāṁ [3] ca vāsasāṁ sañcayēprākśirasamudakśirasaṁ vā saṁvēśya dēvatāpūrvaṁ dvijātibhyaḥ praṇamatītyuktvā kumārasya pitā dvēnāmanī kārayēnnākṣatrikaṁ nāmābhiprāyikaṁ ca|
tatrābhiprāyikaṁ ghōṣavadādyantasthāntamūṣmāntaṁ vā'vr̥ddhaṁ [4] tripuruṣānūkamanavapratiṣṭhitaṁ,nākṣātrikaṁ tu nakṣatradēvatāsamānākhyaṁ [5] dvyakṣaraṁ caturakṣaraṁ vā||50||

dashame tvahani [1] saputrA strI sarvagandhauShadhairgaurasarShapalodhraishca snAtAlaghvahatashucivastraM paridhAya [2] pavitreShTalaghuvicitrabhUShaNavatI ca saMspRushyama~ggalAnyucitAmarcayitvA ca devatAM shikhinaH shuklavAsaso~avya~ggAMshca brAhmaNAn svastivAcayitvA kumAramahatAnAM [3] ca vAsasAM sa~jcaye prAkshirasamudakshirasaM vA saMveshyadevatApUrvaM dvijAtibhyaH praNamatItyuktvA kumArasya pitA dve nAmanI kArayennAkShatrikaMnAmAbhiprAyikaM ca|
tatrAbhiprAyikaM ghoShavadAdyantasthAntamUShmAntaM vA~avRuddhaM [4]tripuruShAnUkamanavapratiShThitaM, nAkShAtrikaM tu nakShatradevatAsamAnAkhyaM [5] dvyakSharaMcaturakSharaM vA||50||
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On the tenth day of delivery, the woman, along with her child, should take bath in water treated with fragrant herbs, shveta sarshapa (white variety of mustard – Brassica nigra Koch.) and lodhra (Symplocos recemosa Roxb.). They should be dressed in light, new and clean garments, while the woman should also be adorned in pure, light and variegated ornaments. The garments and ornaments should have been consecrated using Vedic rituals, and blessed by priests wearing white garments and without any physical deformities. Then the child, having been wrapped in a new garment, should be placed with his head facing the east or the north. The father of the child should pay obeisance to the Gods and Brahmins on behalf of the child and then give it two names: one denoting the nakshatra under which it was born and the other intended for social interactions. The name for social purpose should have a Ghosha (sonant) for its first letter and for its last a Antastha (semi-vowel) or usman (sibilants and aspirate), should be free of Vriddhi(diphthongs), indicative of one of the three ancestors (father, grandfather and great grandfather) and not a new created The constellar name should be identical to that of the diety of the nakshatra and should be made up of two or four (Sanskrit) syllables. [50]
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==== Assessment of life-span of the baby ====

वृत्ते [१] च नामकर्मणि कुमारं परीक्षितुमुपक्रमेतायुषः प्रमाणज्ञानहेतोः|
तत्रेमान्यायुष्मतां कुमाराणां लक्षणानि भवन्ति|
तद्यथा- एकैकजा मृदवोऽल्पाः स्निग्धाः सुबद्धमूलाः कृष्णाः केशाः प्रशस्यन्ते, स्थिरा बहला त्वक्,प्रकृत्याऽतिसम्पन्नमीषत्प्रमाणातिवृत्तमनुरूपमातपत्रोपमं [२] शिरः, व्यूढं दृढं समंसुश्लिष्टशङ्खसन्ध्यूर्ध्वव्यञ्जनसम्पन्नमुपचितं वलिभमर्धचन्द्राकृति ललाटं, बहलौ विपुलसमपीठौ समौ नीचैर्वृद्धौपृष्ठतोऽवनतौ सुश्लिष्टकर्णपुत्रकौ महाच्छिद्रौ कर्णौ, ईषत्प्रलम्बिन्यावसङ्गते समे संहते महत्यौ भ्रुवौ, समे समाहितदर्शनेव्यक्तभागविभागे बलवती तेजसोपपन्ने स्वङ्गापाङ्गे चक्षुषी, ऋज्वी महोच्छ्वासा वंशसम्पन्नेषदवनताग्रा नासिका,महदृजुसुनिविष्टदन्तमास्यम्, आयामविस्तारोपपन्ना श्लक्ष्णा तन्वी प्रकृतिवर्णयुक्ता [३] जिह्वा, श्लक्ष्णंयुक्तोपचयमूष्मोपपन्नं रक्तं तालु, महानदीनः स्निग्धोऽनुनादी गम्भीरसमुत्थो धीरः स्वरः, नातिस्थूलौ नातिकृशौविस्तारोपपन्नावास्यप्रच्छादनौ रक्तावोष्ठौ, महत्यौ हनू, वृत्ता नातिमहती ग्रीवा, व्यूढमुपचितमुरः, गूढं जत्रु पृष्ठवंशश्च,विप्रकृष्टान्तरौ स्तनौ, असम्पातिनी स्थिरे पार्श्वे, वृत्तपरिपूर्णायतौ बाहू सक्थिनी अङ्गुलयश्च, महदुपचितं पाणिपादं, स्थिरावृत्ताः स्निग्धास्ताम्रास्तुङ्गाः कूर्माकाराः करजाः, प्रदक्षिणावर्ता सोत्सङ्गा च नाभिः, उरस्त्रिभागहीना समा समुपचितमांसाकटी, वृत्तौ स्थिरोपचितमांसौ नात्युन्नतौ नात्यवनतौ स्फिचौ, अनुपूर्वं वृत्तावुपचययुक्तावूरू, नात्युपचिते नात्यपचिते एणीपदेप्रगूढसिरास्थिसन्धी जङ्घे, नात्युपचितौ नात्यपचितौ गुल्फौ, पूर्वोपदिष्टगुणौ पादौ कूर्माकारौ, प्रकृतियुक्तानिवातमूत्रपुरीषगुह्यानि तथा स्वप्रजागरणायासस्मितरुदितस्तनग्रहणानि, यच्च किञ्चिदन्यदप्यनुक्तमस्ति तदपि सर्वंप्रकृतिसम्पन्नमिष्टं, विपरीतं पुनरनिष्टम्|
इति दीर्घायुर्लक्षणानि||५१||

vr̥ttē [1] ca nāmakarmaṇi kumāraṁ parīkṣitumupakramētāyuṣaḥ pramāṇajñānahētōḥ|
tatrēmānyāyuṣmatāṁ kumārāṇāṁ lakṣaṇāni bhavanti|
tadyathā- ēkaikajā mr̥davō'lpāḥ snigdhāḥ subaddhamūlāḥ kr̥ṣṇāḥ kēśāḥ praśasyantē, sthirā bahalā tvak,prakr̥tyā'tisampannamīṣatpramāṇātivr̥ttamanurūpamātapatrōpamaṁ [2] śiraḥ, vyūḍhaṁ dr̥ḍhaṁ samaṁsuśliṣṭaśaṅkhasandhyūrdhvavyañjanasampannamupacitaṁ valibhamardhacandrākr̥ti lalāṭaṁ, bahalauvipulasamapīṭhau samau nīcairvr̥ddhau pr̥ṣṭhatō'vanatau suśliṣṭakarṇaputrakau mahācchidrau karṇau,īṣatpralambinyāvasaṅgatē samē saṁhatē mahatyau bhruvau, samē samāhitadarśanē vyaktabhāgavibhāgēbalavatī tējasōpapannē svaṅgāpāṅgē cakṣuṣī, r̥jvī mahōcchvāsā vaṁśasampannēṣadavanatāgrā nāsikā,mahadr̥jusuniviṣṭadantamāsyam, āyāmavistārōpapannā ślakṣṇā tanvī prakr̥tivarṇayuktā [3] jihvā, ślakṣṇaṁyuktōpacayamūṣmōpapannaṁ raktaṁ tālu, mahānadīnaḥ snigdhō'nunādī gambhīrasamutthō dhīraḥsvaraḥ, nātisthūlau nātikr̥śau vistārōpapannāvāsyapracchādanau raktāvōṣṭhau, mahatyau hanū, vr̥ttānātimahatī grīvā, vyūḍhamupacitamuraḥ, gūḍhaṁ jatru pr̥ṣṭhavaṁśaśca, viprakr̥ṣṭāntarau stanau,asampātinī sthirē pārśvē, vr̥ttaparipūrṇāyatau bāhū sakthinī aṅgulayaśca, mahadupacitaṁ pāṇipādaṁ,sthirā vr̥ttāḥ snigdhāstāmrāstuṅgāḥ kūrmākārāḥ karajāḥ, pradakṣiṇāvartā sōtsaṅgā ca nābhiḥ,urastribhāgahīnā samā samupacitamāṁsā kaṭī, vr̥ttau sthirōpacitamāṁsau nātyunnatau nātyavanatausphicau, anupūrvaṁ vr̥ttāvupacayayuktāvūrū, nātyupacitē nātyapacitē ēṇīpadē pragūḍhasirāsthisandhījaṅghē, nātyupacitau nātyapacitau gulphau, pūrvōpadiṣṭaguṇau pādau kūrmākārau, prakr̥tiyuktānivātamūtrapurīṣaguhyāni tathā svaprajāgaraṇāyāsasmitaruditastanagrahaṇāni, yaccakiñcidanyadapyanuktamasti tadapi sarvaṁ prakr̥tisampannamiṣṭaṁ, viparītaṁ punaraniṣṭam|
iti dīrghāyurlakṣaṇāni||51||

vRutte [1] ca nAmakarmaNi kumAraM parIkShitumupakrametAyuShaH pramANaj~jAnahetoH|
tatremAnyAyuShmatAM kumArANAM lakShaNAni bhavanti|
tadyathA- ekaikajA mRudavo~alpAH snigdhAH subaddhamUlAH kRuShNAH keshAH prashasyante, sthirAbahalA tvak, prakRutyA~atisampannamIShatpramANAtivRuttamanurUpamAtapatropamaM [2] shiraH,vyUDhaM dRuDhaM samaM sushliShTasha~gkhasandhyUrdhvavya~jjanasampannamupacitaMvalibhamardhacandrAkRuti lalATaM, bahalau vipulasamapIThau samau nIcairvRuddhaupRuShThato~avanatau sushliShTakarNaputrakau mahAcchidrau karNau, IShatpralambinyAvasa~ggatesame saMhate mahatyau bhruvau, same samAhitadarshane vyaktabhAgavibhAge balavatI tejasopapannesva~ggApA~gge cakShuShI, RujvI mahocchvAsA vaMshasampanneShadavanatAgrA nAsikA,mahadRujusuniviShTadantamAsyam, AyAmavistAropapannA shlakShNA tanvI prakRutivarNayuktA [3] jihvA,shlakShNaM yuktopacayamUShmopapannaM raktaM tAlu, mahAnadInaH snigdho~anunAdIgambhIrasamuttho dhIraH svaraH, nAtisthUlau nAtikRushau vistAropapannAvAsyapracchAdanauraktAvoShThau, mahatyau hanU, vRuttA nAtimahatI grIvA, vyUDhamupacitamuraH, gUDhaM jatrupRuShThavaMshashca, viprakRuShTAntarau stanau, asampAtinI sthire pArshve, vRuttaparipUrNAyataubAhU sakthinI a~ggulayashca, mahadupacitaM pANipAdaM, sthirA vRuttAH snigdhAstAmrAstu~ggAHkUrmAkArAH karajAH, pradakShiNAvartA sotsa~ggA ca nAbhiH, urastribhAgahInA samAsamupacitamAMsA kaTI, vRuttau sthiropacitamAMsau nAtyunnatau nAtyavanatau sphicau, anupUrvaMvRuttAvupacayayuktAvUrU, nAtyupacite nAtyapacite eNIpade pragUDhasirAsthisandhI ja~gghe,nAtyupacitau nAtyapacitau gulphau, pUrvopadiShTaguNau pAdau kUrmAkArau, prakRutiyuktAnivAtamUtrapurIShaguhyAni tathA svaprajAgaraNAyAsasmitaruditastanagrahaNAni, yaccaki~jcidanyadapyanuktamasti tadapi sarvaM prakRutisampannamiShTaM, viparItaM punaraniShTam|
iti dIrghAyurlakShaNAni||51||
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Once the naming ceremony is over, the life-span of the child is assessed by the priests. The children that live long, according to this verse, have discrete, soft, sparse, oily, firm-rooted and black hair, firm and thick skin, naturally well-endowed, slightly bigger in size, umbrella-like head; broad, firm, even, united well with the temporal bone, endowed with three transverse lines, plump, having wrinkles and half moon-shaped forehead; thick, large, symmetrical ears with even flaps, equal elongated and downwardly depressed at the back, having compact tragus and big meatus; eyebrows that are slightly hanging downwards, disjoined (i.e., separate brows and not a uni-brow), even, compact and large; symmetrical eyes that have sharp vision, have beautiful shape (when viewed from the front and the sides); straight nose, with large nostrils, well ridged and slightly depressed at the tip; mouth big and straight, with good gums (and when the child grows up, a healthy set of teeth); tongue of sufficient length and breadth, smooth in texture and of normal colour; palate smooth, well developed, hot and red; voice sweet, echoing, and tempered; reddish lips that are neither too thick nor thin; large jaws; round, but not very long (or craning) or thick neck; broad and well developed chest; hidden xiphisternum and vertebral column; unbending and stable sides; arms, legs and fingers that are round, developed and long; hands and feet that are big and developed; unafflicted nails, round, unctuous, coppery, high and tortoise shaped; navel that is whirled clockwise and deep; waist 1/3rd less than chest (in breadth), even, having well developed muscles; buttocks round, not too elevated, with firm and developed muscles; thighs tapering downwards, round and well developed; shanks neither too stout nor too thin, but resembling that of deer’s foot, with hidden blood vessels, bones and joints; ankles neither too broad nor too thin; feet possessing the above features and tortoise shaped; and normal functions associated with passing bodily wastes, sexual organs, sleep, abilities to express emotions by smiling, weeping, and appetite through suckling. Other aspects of the child’s body or bodily functions, if with normal features, are desirable.
This sums up the verse on physical features used to assess the longevity of the newborn. [51]
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==== Qualities of the wet-nurse attending the newborn ====

अतो धात्रीपरीक्षामुपदेक्ष्यामः|
अथ ब्रूयात्-धात्रीमानय समानवर्णां यौवनस्थां निभृतामनातुरामव्यङ्गामव्यसनामविरूपामजुगुप्सितां [१]देशजातीयामक्षुद्रामक्षुद्रकर्मिणीं कुले जातां वत्सलामरोगां जीवद्वत्सां पुंवत्सांदोग्ध्रीमप्रमत्तामनुच्चारशायिनीमनन्त्यावसायिनीं कुशलोपचारां शुचिमशुचिद्वेषिणीं स्तनस्तन्यसम्पदुपेतामिति||५२||

atō dhātrīparīkṣāmupadēkṣyāmaḥ|
atha brūyāt- dhātrīmānaya samānavarṇāṁ yauvanasthāṁnibhr̥tāmanāturāmavyaṅgāmavyasanāmavirūpāmajugupsitāṁ [1] dēśajātīyāmakṣudrāmakṣudrakarmiṇīṁkulē jātāṁ vatsalāmarōgāṁ jīvadvatsāṁ puṁvatsāṁdōgdhrīmapramattāmanuccāraśāyinīmanantyāvasāyinīṁ kuśalōpacārāṁ śucimaśucidvēṣiṇīṁstanastanyasampadupētāmiti||52||

ato dhAtrIparIkShAmupadekShyAmaH|
atha brUyAtdhAtrImAnaya samAnavarNAM yauvanasthAMnibhRutAmanAturAmavya~ggAmavyasanAmavirUpAmajugupsitAM [1]deshajAtIyAmakShudrAmakShudrakarmiNIM kule jAtAM vatsalAmarogAM jIvadvatsAM puMvatsAMdogdhrImapramattAmanuccArashAyinImanantyAvasAyinIM kushalopacArAM shucimashucidveShiNIMstanastanyasampadupetAmiti||52||
<div style="text-align:justify;">
This verse describes the qualities of the wet nurse attending the baby. The attending physician should ask of the parents to hire a wet nurse who belongs to the same caste as the child’s mother, who is in her youth, is submissive, free from diseases, not deficient in any limb, not given to unwholesome pursuits, not ugly, not ill- disposed, is native to the country, is not mean or does not indulge in mean acts, affectionate towards children, whose children have not died, who is a mother to a male child, who is never careless, not sleeping in beds soiled with excrement, not married to man of lower caste, skillful in attendance, hygienic and is endowed with plenty of milk in her breasts. [52]
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==== Qualities of an ideal breast ====

तत्रेयं स्तनसम्पत्- नात्यूर्ध्वौ नातिलम्बावनतिकृशावनतिपीनौ युक्तपिप्पलकौ सुखप्रपानौ चेति (स्तनसम्पत्)||५३||
tatrēyaṁ stanasampat- nātyūrdhvau nātilambāvanatikr̥śāvanatipīnau yuktapippalakau sukhaprapānau cēti(stanasampat)||53||

tatreyaM stanasampat- nAtyUrdhvau nAtilambAvanatikRushAvanatipInau yuktapippalakau sukhaprapAnauceti (stanasampat)||53||

These are the features of ideal breasts: they should be neither be very high nor very loose and sagging, neither very lean nor massive. They should have proportionate nipples and be easy to suck. [53]

==== Qualities of the ideal breastmilk ====

स्तन्यसम्पत्तु प्रकृतिवर्णगन्धरसस्पर्शम्, उदपात्रे च दुह्यमानमुदकं व्येति प्रकृतिभूतत्वात्; तत् पुष्टिकरमारोग्यकरं चेति(स्तन्यसम्पत्)||५४||
stanyasampattu prakr̥tivarṇagandharasasparśam, udapātrē ca duhyamānamudakaṁ vyētiprakr̥tibhūtatvāt; tat puṣṭikaramārōgyakaraṁ cēti (stanyasampat)||54||

stanyasampattu prakRutivarNagandharasasparsham, udapAtre ca duhyamAnamudakaM vyetiprakRutibhUtatvAt; tat puShTikaramArogyakaraM ceti (stanyasampat)||54||

Ideal breast milk for the baby has properties such as natural color, smell, taste and touch and when poured into a pot of water, it should mix at once perfectly with the water. Such milk is nourishing and health giving to the child. [54]

अतोऽन्यथा व्यापन्नं ज्ञेयम्|
तस्य विशेषाः श्यावारुणवर्णं कषायानुरसं विशदमनालक्ष्यगन्धं रूक्षं द्रवं फेनिलं लघ्वतृप्तिकरं कर्शनं वातविकाराणां कर्तृवातोपसृष्टं क्षीरमभिज्ञेयं [१] ; कृष्णनीलपीतताम्रावभासं तिक्ताम्लकटुकानुरसं कुणपरुधिरगन्धि भृशोष्णं पित्तविकाराणां कर्तृच पित्तोपसृष्टं क्षीरमभिज्ञेयम्, अत्यर्थशुक्लमतिमाधुर्योपपन्नं लवणानुरसं घृततैलवसामज्जगन्धि पिच्छिलंतन्तुमदुकपात्रेऽवसीदछ्लेष्मविकाराणां कर्तृ श्लेष्मोपसृष्टं क्षीरमभिज्ञेयम्||५५||

atō'nyathā vyāpannaṁ jñēyam|
tasya viśēṣāḥ- śyāvāruṇavarṇaṁ kaṣāyānurasaṁ viśadamanālakṣyagandhaṁ rūkṣaṁ dravaṁ phēnilaṁlaghvatr̥ptikaraṁ karśanaṁ vātavikārāṇāṁ kartr̥ vātōpasr̥ṣṭaṁ kṣīramabhijñēyaṁ [1] ;kr̥ṣṇanīlapītatāmrāvabhāsaṁ tiktāmlakaṭukānurasaṁ kuṇaparudhiragandhi bhr̥śōṣṇaṁ pittavikārāṇāṁkartr̥ ca pittōpasr̥ṣṭaṁ kṣīramabhijñēyam, atyarthaśuklamatimādhuryōpapannaṁ lavaṇānurasaṁghr̥tatailavasāmajjagandhi picchilaṁ tantumadukapātrē'vasīdachlēṣmavikārāṇāṁ kartr̥ ślēṣmōpasr̥ṣṭaṁkṣīramabhijñēyam||55||

ato~anyathA vyApannaM j~jeyam|
tasya visheShAH- shyAvAruNavarNaM kaShAyAnurasaM vishadamanAlakShyagandhaM rUkShaM dravaMphenilaM laghvatRuptikaraM karshanaM vAtavikArANAM kartRu vAtopasRuShTaM kShIramabhij~jeyaM [1] ;kRuShNanIlapItatAmrAvabhAsaM tiktAmlakaTukAnurasaM kuNaparudhiragandhi bhRushoShNaMpittavikArANAM kartRu ca pittopasRuShTaM kShIramabhij~jeyam, atyarthashuklamatimAdhuryopapannaMlavaNAnurasaM ghRutatailavasAmajjagandhi picchilaM tantumadukapAtre~avasIdachleShmavikArANAMkartRu shleShmopasRuShTaM kShIramabhij~jeyam||55||
<div style="text-align:justify;">
The breast milk which does not fit the above description is to considered vitiated and unfit for the child’s consumption. Milk that assumes a darkish or reddish hue, astringent in after-taste, clear, of no marked smell, dry, watery, frothy and light in texture or form, and is not satisfying causes emaciation, gives rise to vatika disorders, and thus, should be considered vata-vitiated. Milk that looks blackish, bluish, yellow, or coppery, has an after-taste which is sour or pungent, which smells like a corpse or like blood, and which is very warm is pitta-vitiated and could cause pittaja disorders. Finally, the milk that is very white, very sweet with a saltish after-taste, that has odour like ghee, oil, flesh-marrow or bone-marrow, is viscid, thready and sinks in water without mixing, gives rise to disorders of kapha and should be considered as kapha-vitiated milk. [55]
</div>
तेषां तु त्रयाणामपि क्षीरदोषाणां प्रतिविशेषमभिसमीक्ष्य यथास्वं यथादोषं च वमनविरेचनास्थापनानुवासनानि विभज्य कृतानिप्रशमनाय भवन्ति|
पानाशनविधिस्तु दुष्टक्षीराया यवगोधूमशालिषष्टिकमुद्गहरेणुककुलत्थसुरासौवीरकमैरेयमेदकलशुनकरञ्जप्रायः स्यात्|
क्षीरदोषविशेषांश्चावेक्ष्यावेक्ष्य तत्तद्विधानं कार्यं स्यात्|
पाठामहौषधसुरदारुमुस्तमूर्वागुडूचीवत्सकफलकिराततिक्तककटुकरोहिणीसारिवाकषायाणां च पानं प्रशस्यते, तथाऽन्येषांतिक्तकषायकटुकमधुराणां [१] द्रव्याणां प्रयोगः क्षीरविकारविशेषानभिसमीक्ष्य मात्रां कालं च|
इति क्षीरविशोधनानि||५६||

tēṣāṁ tu trayāṇāmapi kṣīradōṣāṇāṁ prativiśēṣamabhisamīkṣya yathāsvaṁ yathādōṣaṁ cavamanavirēcanāsthāpanānuvāsanāni vibhajya kr̥tāni praśamanāya bhavanti|
pānāśanavidhistu duṣṭakṣīrāyāyavagōdhūmaśāliṣaṣṭikamudgaharēṇukakulatthasurāsauvīrakamairēyamēdakalaśunakarañjaprāyaḥ syāt|
kṣīradōṣaviśēṣāṁścāvēkṣyāvēkṣya tattadvidhānaṁ kāryaṁ syāt|
pāṭhāmahauṣadhasuradārumustamūrvāguḍūcīvatsakaphalakirātatiktakakaṭukarōhiṇīsārivākaṣāyāṇāṁ capānaṁ praśasyatē, tathā'nyēṣāṁ tiktakaṣāyakaṭukamadhurāṇāṁ [1] dravyāṇāṁ prayōgaḥkṣīravikāraviśēṣānabhisamīkṣya mātrāṁ kālaṁ ca|
iti kṣīraviśōdhanāni||56||

teShAM tu trayANAmapi kShIradoShANAM prativisheShamabhisamIkShya yathAsvaM yathAdoShaM cavamanavirecanAsthApanAnuvAsanAni vibhajya kRutAni prashamanAya bhavanti|
pAnAshanavidhistu duShTakShIrAyAyavagodhUmashAliShaShTikamudgahareNukakulatthasurAsauvIrakamaireyamedakalashunakara~jjaprAyaHsyAt|
kShIradoShavisheShAMshcAvekShyAvekShya tattadvidhAnaM kAryaM syAt|
pAThAmahauShadhasuradArumustamUrvAguDUcIvatsakaphalakirAtatiktakakaTukarohiNIsArivAkaShAyANAMca pAnaM prashasyate, tathA~anyeShAM tiktakaShAyakaTukamadhurANAM [1] dravyANAM prayogaHkShIravikAravisheShAnabhisamIkShya mAtrAM kAlaM ca|
iti kShIravishodhanAni||56||
<div style="text-align:justify;">
If any of the three varieties of vitiated milks described in the preceding verse is in advertently consumed by the child, after ascertaining the specific features of the milk or the symptoms that are associated with a dosha affliction, emetics, purgatives and unctuous and non-unctuous enema specific to that afflicted dosha should be administered. The dietetic guidelines to a woman with vitiated milk are as follows: her food and drink should consist mainly of barley, wheat, sali and shashtika rice, mudga (Phaseolus mungo Linn. - green gram), harenuka (Lathyrus ashaca Linn.), sura, sauviraka, maireya and medaka varieties of wines, lashuna (Alium sativum Linn.) and karanja (Pongamia pinnata Merr.). The milk should be examined at frequent intervals for specific features and the appropriate corrective measures should be adopted. The decoctions of patha (Cissmpelos pareira Linn.), shunthi (Zingiberofficinale Rosc.), devadaru (Cedrusdeodara Loud.), musta (Cyperusrotundus Linn.), murva (Clemaistrilobaheyne ex Roth), guduchi (Tinosporacordifolia Miers.), indrayava (Holarrhenaantidysentrica wall.), kiratatikta (SwertiachirataBuch. -Ham.), katukarohini (Picrorhizakurroa Royle ex Benth.) and sariva (Hemidesmusindicus R. B.) are said to be beneficial. Similarly, other drugs with bitter, astringent, pungent and sweet tastes could also be administered, depending upon the nature of the disorder, dosage and season. [56]
</div>
==== Lactation-stimulants (or galactogogues) ====

क्षीरजननानि तु मद्यानि सीधुवर्ज्यानि, ग्राम्यानूपौदकानि च शाकधान्यमांसानि, द्रवमधुराम्ललवणभूयिष्ठाश्चाहाराः,क्षीरिण्यश्चौषधयः, क्षीरपानमनायासश्च, वीरणषष्टिकशालीक्षुवालिकादर्भकुशकाशगुन्द्रेत्कटमूलकषायाणां च पानमिति(क्षीरजननानि)||५७||

kṣīrajananāni tu madyāni sīdhuvarjyāni, grāmyānūpaudakāni ca śākadhānyamāṁsāni,dravamadhurāmlalavaṇabhūyiṣṭhāścāhārāḥ, kṣīriṇyaścauṣadhayaḥ, kṣīrapānamanāyāsaśca,vīraṇaṣaṣṭikaśālīkṣuvālikādarbhakuśakāśagundrētkaṭamūlakaṣāyāṇāṁ ca pānamiti (kṣīrajananāni)||57||

kShIrajananAni tu madyAni sIdhuvarjyAni, grAmyAnUpaudakAni ca shAkadhAnyamAMsAni,dravamadhurAmlalavaNabhUyiShThAshcAhArAH, kShIriNyashcauShadhayaH, kShIrapAnamanAyAsashca,vIraNaShaShTikashAlIkShuvAlikAdarbhakushakAshagundretkaTamUlakaShAyANAM ca pAnamiti(kShIrajananAni)||57||
<div style="text-align:justify;">
Galactogogues (lactation-stimulants) include the following food articles and habits: all wines with the exception of sidhu, vegetables, cereals and meat of domestic, marshy and aquatic origins; food articles and liquids that have predominantly sweet, sour or salty taste; herbs containing milky juices; cow’s milk; avoidance of laborious tasks, and; drinking of the decoctions of roots of virana (Vetiveria zizanoides Nash.), shashtika (a variety of shali – Oryza sativa Linn.), shali (Oryza sativa Linn.), ikshuvalika (Astercantha longifolia Nees.), darbha (Desmostachya bipinnata Stapf), kusha (Desmostachya bipinnata Stapf), kasha (Saccharum spontaneum Linn.), gundra (Saccharum sara)and Itkata (-?-)(are galactogogues). [57]
</div>
====Procedure to be followed by the wet-nurse in order to feed the baby ====

धात्री तु यदा स्वादुबहुलशुद्धदुग्धा स्यात्तदास्नातानुलिप्ता शुक्लवस्त्रं परिधायैन्द्रीं ब्राह्मीं शतवीर्यां सहस्रवीर्याममोघामव्यथांशिवामरिष्टां वाट्यपुष्पीं विष्वक्सेनकान्तां [१] वा बिभ्रत्योषधिं कुमारं प्राङ्मुखंप्रथमं दक्षिणं स्तनं पाययेत्|
इति धात्रीकर्म||५८||

dhātrī tu yadā svādubahulaśuddhadugdhā syāttadāsnātānuliptā śuklavastraṁ paridhāyaindrīṁ brāhmīṁśatavīryāṁ sahasravīryāmamōghāmavyathāṁ śivāmariṣṭāṁ vāṭyapuṣpīṁ viṣvaksēnakāntāṁ [1] vābibhratyōṣadhiṁ kumāraṁ prāṅmukhaṁ prathamaṁ dakṣiṇaṁ stanaṁ pāyayēt|
iti dhātrīkarma||58||

dhAtrI tu yadA svAdubahulashuddhadugdhA syAttadAsnAtAnuliptA shuklavastraM paridhAyaindrIMbrAhmIM shatavIryAM sahasravIryAmamoghAmavyathAM shivAmariShTAM vATyapuShpIMviShvaksenakAntAM [1] vA bibhratyoShadhiM kumAraM prA~gmukhaM prathamaM dakShiNaM stanaMpAyayet|
iti dhAtrIkarma||58||
<div style="text-align:justify;">
When the wet nurse, having sweet, copious and pure milk, has bathed and anointed herself with fragrant pastes, dressed in white garments and adorned with herbs such as aindri (Citrullus colocynthis Schrad), brahmi (Bacopa monnieri Pennel), shatavirya (Cynodon dactylon Pers.), sahasravirya (a type of Shatavirya), amogha (Emblica officinalis Gaertn.), avyatha (Tinospora cordifolia Miers.)shiva (Terminalia chebula Linn.), vatyapushpi (Sida rhombifolia Linn.) and viswaksenakanta (Callicarpa macrophyla Vahl.), then she should take hold of the baby and, while facing east , feed the baby from the right breast first. These are prescribed duties of dhatri, or the wet nurse attending the baby. [58]
</div>
==== Procedure of construction of nursery ====

अतोऽनन्तरं कुमारागारविधिमनुव्याख्यास्यामः-वास्तुविद्याकुशलः प्रशस्तं रम्यमतमस्कं निवातं प्रवातैकदेशंदृढमपगतश्वापदपशुदंष्ट्रिमूषिकपतङ्गं सुविभक्तसलिलोलूखलमूत्रवर्चःस्थानस्नानभूमिमहानसमृतुसुखंयथर्तुशयनासनास्तरणसम्पन्नं कुर्यात्; तथा सुविहितरक्षाविधानबलिमङ्गलहोमप्रायश्चित्तंशुचिवृद्धवैद्यानुरक्तजनसम्पूर्णम्|
इति कुमारागारविधिः||५९||

atō'nantaraṁ kumārāgāravidhimanuvyākhyāsyāmaḥ- vāstuvidyākuśalaḥ praśastaṁ ramyamatamaskaṁnivātaṁ pravātaikadēśaṁ dr̥ḍhamapagataśvāpadapaśudaṁṣṭrimūṣikapataṅgaṁsuvibhaktasalilōlūkhalamūtravarcaḥsthānasnānabhūmimahānasamr̥tusukhaṁyathartuśayanāsanāstaraṇasampannaṁ kuryāt;tathā suvihitarakṣāvidhānabalimaṅgalahōmaprāyaścittaṁśucivr̥ddhavaidyānuraktajanasampūrṇam|
iti kumārāgāravidhiḥ||59||

ato~anantaraM kumArAgAravidhimanuvyAkhyAsyAmaH- vAstuvidyAkushalaH prashastaMramyamatamaskaM nivAtaM pravAtaikadeshaMdRuDhamapagatashvApadapashudaMShTrimUShikapata~ggaMsuvibhaktasalilolUkhalamUtravarcaHsthAnasnAnabhUmimahAnasamRutusukhaMya<br>thartushayanAsanAstaraNasampannaM kuryAt; tathAsuvihitarakShAvidhAnabalima~ggalahomaprAyashcittaM shucivRuddhavaidyAnuraktajanasampUrNam|
iti kumArAgAravidhiH||59||
<div style="text-align:justify;">
This verse describes the procedure of construction of the nursery. It should be built by a skillful architect and should be sturdy, beautiful, well lighted, protected from draught, well ventilated (with air-entry from only one direction), free from pests, animals, fanged creatures, mice and moths. It should be well accessible to places of water storage, grinding, lavatory, bath and cooking, should be comfortable during all seasons, and furnished with beds, seats and spreads suited to each season. Moreover, protective measures, holy offerings, auspicious rites, and oblations should be performed and the facility should be provided with clean and experienced physicians and with a compassionate and caring staff. Thus, the metod of construction of a child care nursery has been described. [59]
</div>
शयनासनास्तरणप्रावरणानि कुमारस्य मृदुलघुशुचिसुगन्धीनि स्युः; स्वेदमलजन्तुमन्ति मूत्रपुरीषोपसृष्टानि च वर्ज्यानि स्युः;असति सम्भवेऽन्येषां तान्येव च सुप्रक्षालितोपधानानि सुधूपितानि शुद्धशुष्काण्युपयोगं गच्छेयुः||६०||

śayanāsanāstaraṇaprāvaraṇāni kumārasya mr̥dulaghuśucisugandhīni syuḥ; svēdamalajantumantimūtrapurīṣōpasr̥ṣṭāni ca varjyāni syuḥ; asati sambhavē'nyēṣāṁ tānyēva ca suprakṣālitōpadhānānisudhūpitāni śuddhaśuṣkāṇyupayōgaṁ gacchēyuḥ||60||

shayanAsanAstaraNaprAvaraNAni kumArasya mRudulaghushucisugandhIni syuH; svedamalajantumantimUtrapurIShopasRuShTAni ca varjyAni syuH; asati sambhave~anyeShAM tAnyeva casuprakShAlitopadhAnAni sudhUpitAni shuddhashuShkANyupayogaM gaccheyuH||60||
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The bed, seats, spreads and covers meant for the child should be soft, light, clean and perfumed. Sweat and/or excrement-stained or pestilence-infested articles should be disposed off immediately, and if fresh ones are not available the same may be used again only after they have been washed and fumigated thoroughly and rendered perfectly clean and dry. [60]
</div>
धूपनानि पुनर्वाससां शयनास्तरणप्रावरणानां चयवसर्षपातसीहिङ्गुगुग्गुलुवचाचोरकवयःस्थागोलोमीजटिलापलङ्कषाशोकरोहिणीसर्पनिर्मोकाणि घृतयुक्तानि स्युः||६१||

dhūpanāni punarvāsasāṁ śayanāstaraṇaprāvaraṇānāṁ cayavasarṣapātasīhiṅgugugguluvacācōrakavayaḥsthāgōlōmījaṭilāpalaṅkaṣāśōkarōhiṇīsarpanirmōkāṇighr̥tayuktāni syuḥ||61||

dhUpanAni punarvAsasAM shayanAstaraNaprAvaraNAnAM cayavasarShapAtasIhi~ggugugguluvacAcorakavayaHsthAgolomIjaTilApala~gkaShAshokarohiNIsarpanirmokANighRutayuktAni syuH||61||
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For fumigation of the garments, bed, and furnishings the following articles smeared with ghee may be used- barley, mustard, atasi (Linumusitaissimum Linn.), hingu (Ferulanarthex Boiss.), guggulu (Commiforamukul Engl.), vacha (Acoruscalamus Linn.), choraka (Angelicaglauca Edgw), vayahstha (Bacopamonnieri Pennel.), golomi (type of Vacha), jatila (Nardostachysjatamansi D. C.), palankasha (type of Guggulu), ashoka (Saracaindica Linn.), rohini (Picrorhizakurroa royle ex Benth.)and sarpa nirmoka(sloughs of snakes). [61]
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==== Measures for ensuring the child's well-being ====

मणयश्च धारणीयाः कुमारस्य खड्गरुरुगवयवृषभाणां जीवतामेव दक्षिणेभ्यो विषाणेभ्योऽग्राणि गृहीतानि स्युः;ऐन्द्र्याद्याश्चौषधयो जीवकर्षभकौ च, यानि चान्यान्यपि ब्राह्मणाः प्रशंसेयुरथर्ववेदविदः||६२||

maṇayaśca dhāraṇīyāḥ kumārasya khaḍgarurugavayavr̥ṣabhāṇāṁ jīvatāmēva dakṣiṇēbhyōviṣāṇēbhyō'grāṇi gr̥hītāni syuḥ; aindryādyāścauṣadhayō jīvakarṣabhakau ca, yāni cānyānyapi brāhmaṇāḥpraśaṁsēyuratharvavēdavidaḥ||62||

maNayashca dhAraNIyAH kumArasya khaDgarurugavayavRuShabhANAM jIvatAmeva dakShiNebhyoviShANebhyo~agrANi gRuhItAni syuH; aindryAdyAshcauShadhayo jIvakarShabhakau ca, yAni cAnyAnyapibrAhmaNAH prashaMseyuratharvavedavidaH||62||

The following articles should be worn as talismans or amulets by the child: gems, tip of the right horn of a live rhinoceros, deer, gayal or a bull; herbs like aindri, jivaka, rusabhaka, etc., and also all such articles as the brahmins well versed in Atharva Veda may recommend. [62]

क्रीडनकानि खलु कुमारस्य विचित्राणि घोषवन्त्यभिरामाणि चागुरूणि चातीक्ष्णाग्राणि चानास्य प्रवेशीनि चाप्राणहराणिचावित्रासनानि स्युः||६३||

krīḍanakāni khalu kumārasya vicitrāṇi ghōṣavantyabhirāmāṇi cāgurūṇi cātīkṣṇāgrāṇi cānāsya pravēśīnicāprāṇaharāṇi cāvitrāsanāni syuḥ||63||
krIDanakAni khalu kumArasya vicitrANi ghoShavantyabhirAmANi cAgurUNi cAtIkShNAgrANi cAnAsyapraveshIni cAprANaharANi cAvitrAsanAni syuH||63||

The toys of the child should be multicolored, attractive, light, without sharp edges, and incapable of being swallowed. These should make pleasing sounds (i.e., should not be making screechy, loud or disturbing sounds), and should not be fatal to life or disturbing. [63]

न ह्यस्य वित्रासनं साधु|
तस्मात्तस्मिन् रुदत्यभुञ्जाने वाऽन्यत्र विधेयतामगच्छति राक्षसपिशाचपूतनाद्यानां नामान्याह्वयता कुमारस्य वित्रासनार्थंनामग्रहणं न कार्यं स्यात्||६४||

na hyasya vitrāsanaṁ sādhu|
tasmāttasmin rudatyabhuñjānē vā'nyatra vidhēyatāmagacchati rākṣasapiśācapūtanādyānāṁnāmānyāhvayatā kumārasya vitrāsanārthaṁ nāmagrahaṇaṁ na kāryaṁ syāt||64||

na hyasya vitrAsanaM sAdhu|
tasmAttasmin rudatyabhu~jjAne vA~anyatra vidheyatAmagacchati rAkShasapishAcapUtanAdyAnAMnAmAnyAhvayatA kumArasya vitrAsanArthaM nAmagrahaNaM na kAryaM syAt||64||

It is never good to frighten a child. So, if he is found weeping, refusing to eat his meals, or in any other way becoming disobedient, it is not good to take the name of rakshasas (goblins), pishacha (ghost) or putana (harpy) with a purpose of scaring him further. [64]

यदि त्वातुर्यं किञ्चित् कुमारमागच्छेत् तत् प्रकृतिनिमित्तपूर्वरूपलिङ्गोपशयविशेषैस्तत्त्वतोऽनुबुध्यसर्वविशेषानातुरौषधदेशकालाश्रयानवेक्षमाणश्चिकित्सितुमारभेतैनं मधुरमृदुलघुसुरभिशीतशङ्करं कर्म प्रवर्तयन्|
एवंसात्म्या हि कुमारा भवन्ति|
तथा ते शर्म लभन्ते चिराय|
अरोगे त्वरोगवृत्तमातिष्ठेद्देशकालात्मगुणविपर्ययेण वर्तमानः, क्रमेणासात्म्यानि परिवर्त्योपयुञ्जानः सर्वाण्यहितानिवर्जयेत्|
तथा बलवर्णशरीरायुषां सम्पदमवाप्नोतीति||६५||

yadi tvāturyaṁ kiñcit kumāramāgacchēt tat prakr̥tinimittapūrvarūpaliṅgōpaśayaviśēṣaistattvatō'nubudhyasarvaviśēṣānāturauṣadhadēśakālāśrayānavēkṣamāṇaścikitsitumārabhētainaṁmadhu<br>ramr̥dulaghusurabhiśītaś<br>aṅkaraṁ karma pravartayan|
ēvaṁsātmyā hi kumārā bhavanti|
tathā tē śarma labhantē cirāya|
arōgē tvarōgavr̥ttamātiṣṭhēddēśakālātmaguṇaviparyayēṇa vartamānaḥ, kramēṇāsātmyāniparivartyōpayuñjānaḥ sarvāṇyahitāni varjayēt|
tathā balavarṇaśarīrāyuṣāṁ sampadamavāpnōtīti||65||

yadi tvAturyaM ki~jcit kumAramAgacchet tatprakRutinimittapUrvarUpali~ggopashayavisheShaistattvato~anubudhyasarvavisheShAnAturauShadhadeshakAlAshrayAnavekShamANashcikitsitumArabhetainaMmadhu<br>ramRudulaghusurabhishItasha~gkaraM karma pravartayan|
evaMsAtmyA hi kumArA bhavanti|
tathA te sharma labhante cirAya|
aroge tvarogavRuttamAtiShTheddeshakAlAtmaguNaviparyayeNa vartamAnaH, krameNAsAtmyAniparivartyopayu~jjAnaH sarvANyahitAni varjayet|
tathA balavarNasharIrAyuShAM sampadamavApnotIti||65||
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If some illness affects the child, then the physician, after cautiously examining the child, should thoroughly analyze his constitution, etiological factors, premonitory signs and symptoms, and all other factors concerned such as time and place, and then should proceed to treat him by medication that is sweet in taste and smell, soft, light, cold and pleasant. Such measures suit the palate of the children and make the administering of drugs that much easier. As regards a healthy child, the regimen prescribed for regular consumption is the same as that mentioned as code of conduct for the healthy. Following these ensures that the child attains the excellence of strength, healthy complexion, bodily growth and longevity. [65]
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एवमेनं कुमारमायौवनप्राप्तेर्धर्मार्थकौशलागमनाच्चानुपालयेत्||६६||

ēvamēnaṁ kumāramāyauvanaprāptērdharmārthakauśalāgamanāccānupālayēt||66||

evamenaM kumAramAyauvanaprApterdharmArthakaushalAgamanAccAnupAlayet||66||

In this manner the child should be nurtured, from his childhood to his youth, i.e., till he acquires the knowledge and skills necessary for conducting religious activities and leading his livelihood. [66]

इति पुत्राशिषां समृद्धिकरं कर्म व्याख्यातम्|
तदाचरन् यथोक्तैर्विधिभिः पूजां यथेष्टं लभतेऽनसूयक इति||६७||

iti putrāśiṣāṁ samr̥ddhikaraṁ karma vyākhyātam|
tadācaran yathōktairvidhibhiḥ pūjāṁ yathēṣṭaṁ labhatē'nasūyaka iti||67||

iti putrAshiShAM samRuddhikaraM karma vyAkhyAtam|
tadAcaran yathoktairvidhibhiH pUjAM yatheShTaM labhate~anasUyaka iti||67||

Thus all measures that promote the life of one’s progeny have been described for those who aspire to have children. By adopting these measures in the prescribed manner, one who is free from envy and ill-will attains his wishes with regard and honour. [67]

==== Summary ====

तत्र श्लोकौ-
पुत्राशिषां कर्म समृद्धिकारकं यदुक्तमेतन्महदर्थसंहितम्|
तदाचरन् ज्ञो विधिभिर्यथातथं पूजां यथेष्टं लभतेऽनसूयकः||६८||

tatra ślōkau-
putrāśiṣāṁ karma samr̥ddhikārakaṁ yaduktamētanmahadarthasaṁhitam|
tadācaran jñō vidhibhiryathātathaṁ pūjāṁ yathēṣṭaṁ labhatē'nasūyakaḥ||68||

tatra shlokau-
putrAshiShAM karma samRuddhikArakaM yaduktametanmahadarthasaMhitam|
tadAcaran j~jo vidhibhiryathAtathaM pUjAM yatheShTaM labhate~anasUyakaH||68||

Thus, to sum up this chapter, measures described here will fulfill the longing of the individual of desirred progeny and these are of great importance. By taking recourse to these measures in the manner prescribed, a wise man, free from envy or ill-will, is blessed (with a child) according to his wishes. [68]

शरीरं चिन्त्यते सर्वं दैवमानुषसम्पदा|
सर्वभावैर्यतस्तस्माच्छारीरं स्थानमुच्यते||६९||

śarīraṁ cintyatē sarvaṁ daivamānuṣasampadā|
sarvabhāvairyatastasmācchārīraṁ sthānamucyatē||69||

sharIraM cintyate sarvaM daivamAnuShasampadA|
sarvabhAvairyatastasmAcchArIraM sthAnamucyate||69||

This section is known as [[Sharira Sthana]] because it consists of a body of knowledge consisting of all the godly and human aspects of the various phenomena taking place in an individual’s body.

Thus, ends the eight chapter of the [[Sharira Sthana]] of Agnivesha’s work as redacted by Charaka, and also marks the end of the [[Sharira Sthana]] itself. [69]

=== ''Tattva Vimarsha'' ===
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*Posture plays an important role in facilitating the union of the sperm and the ovum. Improper posture may lead to dosha prakopa, or dosha vitiation. Also, physical and mental wellbeing of both partners is essential for successful coitus and furthering one’s lineage. [6]
*Sexual intercourse, when done with happy and joyous mood results in good progeny. Entering the bed by placing the right and left leg first by male and female partners respectively needs scientific exploration. It may merely be auspicious as per rituals. [7] Healthy progeny and succession of lineage, amply supported by recitations of mantra (to invoke the Gods and bless the progeny), was the sole purpose of sexual intercourse. Pleasure and eroticism were not the prime purpose of sexual acts, per the vedic rituals documented. [8]
*For the husband to practice celibacy for the period of one week following his wife’s menstrual period is advised to ensure healthy sperm, in turn helping beget a healthy offspring. During this period specific dietetic, behavioural and psychological regimen are advised to be followed by both the partners for attaining physical and psychological well-being, which will further support conception. [9]
*The ideal time for performing the Putreshti procedure is mentioned as a week or so of cessation of menstrual flow of the female partner, so that ovulation starts. After this they may cohabit for eight nights. [11]
*Predominance of a particular mahabhuta at the time of conception plays an important role in begetting a progeny of desired physique and complexion. [15]
*Psyche of the child to be born is decided by the deeds of the previous life of the individual as well as the mental disposition of the parents at the time of conception and the mental status of the mother during her pregnancy. [16]
*To beget a good progeny, healthy male and female reproductive systems, proper ovulatory cycles and potent seeds are essential. [17]
*Even if all factors and conditions for obtaining a desired progeny are met, the influence of the child’s past (due to the deeds in his previous life) are said to play a critical role in deciding the final outcome. [18] Pumsavana is a measure of begetting a child of desired sex, literally meaning a male child. However, some authors refer to this as a procedure not only for sex selection but for proper implantation, intra uterine growth and development of the foetus as well. [19]
*The herbs indicated for the Pumsavana karma will provide nutritional support to the pregnant woman and thus benefit the mother as well as her growing foetus. [20]
*The principle behind do’s and don’ts advocated during pregnancy is to lead an unaltered normal life with adequate rest, care and good nutrition to attain a healthy progeny. [21]
*Chances of survival of the fetus are less and even if it survives, chances of congenital anomaly are more if bleeding appears during the second or third month. [23]
*Upavishtaka and Nagodara, both suggestive of intrauterine growth retardation (IUGR) result due to improper nutrition to the growing foetus. [26] Proper nutrition will help correct the same. [27] Santarpana chikitsa which are vatahara are to be adopted. [28]
*Garbhini udavarta, a condition caused due to reverse movement of apana vata can have implications during child birth. [29]
*In children, the dosha, dushya etc. causing the disease are the same as that in adults, the only difference being drug dosage. [65]

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

==== Ritukala – Ideal period in menstrual cycle for conception ====

For conception, the period after stoppage of menstruation,i.e., from the 4th day onwards to 12 days corresponding to the 16th day of the menstrual cycle is considered to be the ideal period for impregnation. During the first half of the menstrual cycle, i.e., from 1st day to 14th day, estrogen hormone is dominant, and under its influence, the cervical mucus becomes watery with a high concentration of sodium chloride. This consistency is ideal for spermatozoa to travel through the cervical canal. After ovulation on the 14th day, the formation of corpus luteum leads to the dominance of progesterone hormone, and this leads to change in a characteristic of cervical mucus from watery to viscous because of increased protein content and decrease in sodium chloride. This hampers the migration of sperm in the cervical canal. Hence the ritukala of 12 days in the first half of the cycle is justified.
[[File:gtypemucus.png]] [[File:ltypemucus.png]]
Under effect of progesterone preventing sperm penetration Cervical mucus under estrogenic effect <br>
Source : http://www.naturalfamilyplanning.ie/mucus/gls-p-mucus/<br>

The possible mechanism of sex selection can be understood by knowing the swimming behavior of spermatozoa bearing X and Y chromosome in the female genital tract, as well as evidence suggesting selective penetration of spermatozoa in cervical mucus. The factors affecting the motility of sperms in genital tract are pH, temperature, viscosity, osmolarity, elements and ions. All these evidence suggest that the sex selection may depend on the female genital environment which changes throughout the cycle and hence the specific days of coitus mentioned in text may contribute to the selection of the desired offspring. The concentration of sperm in semen increases if the coitus is performed during alternate days. More the number of Y-bearing spermatozoa, more probability of procuring a male progeny<ref> Skandhan KP, Japee Jasmine: Hypothesis: Who is responsible for the sex of the offspring, Trends in Medical Research; 2011 </ref>.

==== Selection of Suitable partner for conception ====

In Ayurveda classics, the preparation of procuring healthy progeny begins with the selection of a partner. For a healthy progeny with longevity and desired traits, both partners should be of reproductive age without any physical or mental disease or chronic illness. Conception in older age is associated with genetic abnormalities like Down’s syndrome and rare chromosomal abnormalities like Patau's syndrome and Edward's syndrome in the offspring. Increased maternal age may also lead to the poor outcome of pregnancy. Conception during illness may result in congenital anomalies or growth retarded fetus. Research has shown risks of low birth weight, premature labor, anemia, and pre-eclampsia are related to the biological age<ref> CM Gibbs et al, The Impact of Early Age at First Childbirth on Maternal and Infant Health, 2012, PMID:22742615 </ref>.

Ideal position for coitus and factors affecting conception:
In the prone position, pressure on abdomen affects the natural movement of vata dosha, while the left-lateral position stimulates the enzyme secretions in the gut and leads to pitta prakopa. Therefore, a comfortable, supine position is recommended for coitus for conception, as all body humors are in their proper positions. A sprinkling of cold water or cold compresses of vulva after coitus is useful to prevent the reverse flow of semen from the female genital tract. Mental comfort, urge for sex and willingness for sex with the same partner are very important factors for the conception and formation of a healthy fetus. As neuro-endocrinal harmony is essential during the act of coitus, one should be free of urges or thoughts of hunger, thirst, passing flatulence, urination or bowel movements, and should be free from emotions like stress, anger, anxiety while having sexual intercourse.

==== Ambiance for coitus ====

The importance of ambiance in stimulating desire in a couple to perform sex, and thus, conceive a healthy child, is expressly mentioned in this chapter. Articles or experiences pleasant to the sensory organs (such as using fragrant objects, pleasing or arousing music or sound, articles pleasant in taste or touch) in a stimulating environment play a very important role in arousal and act as aphrodisiacs, per Ayurvedic texts.

==== Effect of chanting mantras ====

Keeping the body and its doshas in harmony with its environment are essential to good conception, as it is with staying healthy, per Ayurvedic texts. This is consistent with the vedic concept of Yatha Pinde Tatha Brahmande (As the Body, so the Universe) – that problems occur when there is disequilibrium between the body and its surroundings.

Chanting and reciting mantras have an effect on neuro-endocrinal homeostasis<ref> Claire Braboszcz, Stephanie Hahusseau, Arnaud Delorme Meditation and Neuroscience: From Basic Research to Clinical Practice, 2010, Springer Publishing </ref>. Hence chanting or reciting mantras or shlokas is recommended for maintenance of a psychosomatic balance of the body. In Vedic rituals, shloka (sacred hymns) to be chanted are said to invoke Lord Brahma, the creator of the universe and the progenitor of all the activities of the universe, Lord Brihaspati, the power behind every activity, Lord Vishnu, the preserver of the universe, Soma and Agni, the prime principles in all living beings, Ashvinau, the symbol of health and well-being in every creature, and Mitra and Varuna, the forces necessary to sustain life in the universe. Therefore, vedic scriptures, including Ayurvedic texts, emphasize on paying one’s obeisance to deities and forces of the universe, in the form of Gods, if one desires a healthy offspring.

Chanting of mantras is known to have physical, mental and spiritual benefits. Mantra chanting form the basis of yogic meditation practices to help calm one’s mind and ease anxieties, which could have adverse effects on one’s progeny. Ayurveda science also mentions the role of the atma, along with the union of sperm and ovum, as a prerequisite, in the formation of the garbha. For the atma (of the newborn) to be of best satva and good prior karma, the ambiance and environment of the area should be spiritual, and chanting helps in creating such an environment.

==== Do’s and Dont’s before coitus ====

This chapter provides a detailed list of Do’s and Don’ts that could help a couple conceive a healthy child. These rules or guidelines address various aspects of the couple’s lifestyle – including their diet, their environment – and their health. Traditional rituals and guidelines such as staying pious (and not indulging in immoral thoughts or actions) and being in the company of spiritual or virtuous individuals have been adviced, especially for the expecting mother.

==== Preparation for putreshthi yajna and its benefits ====

Cultures around the world, especially in the eastern countries, practice various rituals to get a healthy offspring. While these rituals and customs are considered essential, their validity from the standpoint of scientific studies have not yet been established. Cultural traditions, however, do provide some much-needed assurance during this period of anxiety and should be continued according to tradition. The physical, psychological, social and spiritual wellbeing of the couple desirous of having progeny is very important - and this is facilitated through rituals. All the regimen and rituals also favor a planned pregnancy instead of an accidental pregnancy. A planned pregnancy ensures a proper physical, psychological, financial and social status.

==== Regimens and factors affecting desired progeny ====

For getting the desired result (i.e., a healthy progeny of the desired traits), one has to apply the factors either in the form of the same element (dravya samanya) or the elements having similar constitution and properties (guna samanya) or similar the effort (karma samanya), giving the similar to get similar output. All the above mentioned dietary, ritualistic practices, and do's and don'ts need to be of the desired dravya, guna and karma samanya to get the desired result, i.e., healthy and long living progeny with good complexion and intelligence. Whatever the mother sees, tastes, touches, feels, thinks and the way she behaves or thinks socially or spiritually has a deep impact on the future temperament and behavior of the child. A popular example of this ‘karma based garbha samskara’ is the mythological story of Abhimanyu, the warrior son of Arjuna, in the Mahabharata. Abhimanyu, even when he was a fetus in his mother (Subhadra)’s womb, learned the technique of entering the Chakravyuha (a special type of battle formation) from his maternal uncle Lord Krishna. If the mother takes dravya having predominant jala mahabhuta dravya, there will be an increase in the kapha dhatu of the fetus, giving it a fair complexion. Similarly, other mahabhuta-dominant dravyas contribute to other types of complexions in the baby.
In Korea, for prenatal development, expectant mothers are advised to do certain practices called ‘Taegyo.<ref> Lee, Yuna, Lee, Jiyoung, Korean Traditional Taegyo Prenatal Education based on Sajudang Lee’s “Taegyo Singi”, 2016, International Journal of Childbirth Education, Pg 34-37 </ref>' Expectant mothers are advised to stay calm, avoid evil thoughts, listening to soft music, reading inspiring stories aloud, staying vigilant of surroundings and prudent in speech and action. Following these practices provides a safe and healthy environment for the fetal development.
Research in Pre-natal education

Researchers have been studying the effect of external sensory experiences on the brain activities of infants. In one instance, researchers found enhanced brain activity in infants exposed to “novel word sounds” played everyday during the third trimester.<ref> Partanen, Eino et al, Prenatal Music Exposure Induces Long-Term Neural Effects, 2013, PLoS One, doi: 10.1371/journal.pone.0078946 </ref>

==== Effects of karma of the progeny’s prior birth ====

As explained in this chapter, with the effect of karma samanya there is garbha sanskara on the fetus inside the mother’s womb. Therefore, the birth of an individual in any race depends on the karma of the parents and the karma from the child’s previous life. According to Charaka, an individual goes through the cycle of birth and death according to Karma Siddhanta. In fact, the birth of an individual has multiple facets like poorvakarma, matrija karma, pitrija karma, garbhadhana, garbhini paricharya and much more. One should not forget the effect of, i.e., karma on the fetus, the mother, and the father. Therefore, in spite of following of all do’s and don’ts strictly, there can be bad progeny because of it's (and the parent's) karma.

==== Factors for healthy progeny ====

As explained earlier, according to yukti pramana, the formation of garbha is multidimensional and requires normalcy of all components i.e. fertile period, healthy uterus, sufficient and healthy nutrients, and most importantly, healthy gametes.

==== Maintenance of products of conception ====

Stha or tishthati means to stay or remain in position. For sustaining a pregnancy, proper nourishment with adequate hormone status is essential. As mentioned in verse 20 of this chapter, herbs such as aindra, brahmi, satavirya, etc. help nourish the fetus, while Jivaniya herbs used regularly by the mother help achieve a healthy outcome of pregnancy.

==== Factors causing harm to the embryo ====

Numerous factors that may hamper sustaining the pregnancy or cause abnormalities in the progeny have been described in this chapter. These factors can be classified as dietary, lifestyle, traumatic, psychological and spiritual factors. Observance of these avoidable factors leads to growth retardation, the death of the fetus, premature birth, illness or congenital malformations to the offspring. Research seems to indicate that emotional stress to the mother can lead to prenatal or postnatal complications of various types<ref> Stephen Maret, Introduction to Prenatal Psychology, 2011, Church Gate Books ISBN: 9780578089980 </ref> . Dietary habits and lifestyle may lead to neurohormonal changes which affect pregnancy and its outcome<ref> Calvin Hobel, Jennifer Culhane, Role of Pyschosocial and Nutritional Stress on Poor Pregnancy Outcome, 2003, J.Nutr., vol 133 no. 5 1709S-1717S </ref> . Similar faulty habits by the father can also cause abnormalities of spermatozoa which in turn leads to congenital anomalies in offspring.

==== Precaution for the treatment of disorders in pregnant females ====

As explained by Charaka, a pregnant woman is like a vessel full of oil and should be treated with care, meaning that all doshas, dhatu, mala and ojas of the pregnant woman are at such a critical physiological stage that if one does not attend to her in a timely and proper way it may lead to damage to the foetus or the mother or both. Hence the disorders which may occur during pregnancy are to be treated with special care. For the antenatal mother, the diet or medications which should be used for curing any ailment should be mild and effective. Panchakarma treatment, because of its use of invasive and strong medicines, is to be avoided. Basti and abhyanga to kati are advocated in the eighth month of pregnancy, and these are comparatively safer procedures and may also help in a normal labor. During the eighth month, the fetus is sufficiently developed and viable, and even if the mother gets labor pain while undergoing treatment (mild to aggressive courses, as the need may be), the fetus can be preserved, and there are fewer chances of compromising fetal life.
The effects of drug use during pregnancy on the fetus has been researched and documented. The mother as well the fetus, if subjected to certain drugs /treatment, can lead to side-effects on either or both. FDA has specified a certain list of drugs (X category) which are contraindicated during pregnancy <ref> https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/labeling/ucm093307.htm
Ix Gawade T, Ghorpade M, Effect of bala siddha taila anuvasana basti on labour pains; Ayurlog: National journal of Research in Ayurveda science’ Vol 3, Feb 2015
</ref>. In Ayurveda, the principles of antenatal treatment are given for shamana as well as shodhana, other drugs and treatment are contraindicated. In practice, for any ailments occurring during pregnancy, herbal medicines are preferred over herbo mineral medicines.

==== Disorders of the fetus and its treatment ====

Following are the common disorder of fetus, abortion, followed by intrauterine growth retardation and intrauterine death:

===== Factors responsible for abortion and its treatment =====

First-trimester abortion is seen in about 80% of total abortions. Any bleeding during the first trimester (up to 12 weeks) may either end in inevitable abortion, preterm labor and in rare cases may proceed to full term. Emotional factors like severe anger, stress, jealousy all are suspected to cause the high release of CRH (Corticotropin-releasing hormone) which may trigger uterine contractions.
Uterine bleeding from implantation site or deciduas may be triggered because of coitus, trauma, exercise and faulty regimen. Bleeding may further release prostaglandins which could trigger uterine contractions and hence abortion.
Management of such condition is aimed at relieving uterine contractions and bleeding. Since there are vata and shonita dushti in abortion, treatment should follow the principle of vatarakta chikitsa viz. sheeta and snigdha lepa, and brimhana, vatahara, raktavardhaka diet, and drugs. Sura (alcohol-containing preparations) is mainly advised to relieve the pain and to increase the hemopoiesis.

As explained earlier, garbhapata (abortion) due to ama dosha (during the first trimester) is very critical to treat. Treatment of ama dosha is apatarpana while that of garbha and garbhini needs santarpana, which are antagonistic and hence very tedious to treat. In practice, Madhura varga dravyas such as shatavari (Asparagus racemosus) and medicated ghee phalaghrita are used in case of threatened abortion. These promote proper nourishment and growth and stop bleeding.

===== Growth retardation of fetus and its treatment =====

Intrauterine growth retardation of the fetus occurs due to malnourishment of mother as well as pregnancy disorders which cause vaginal discharge and bleeding. According to severity, they are categorized as garbhashosha (mentioned in Charaka Sharirsthana 2nd chapter) upavishtaka, nagodara, lina garbha (not directly mentioned but clinical features with the absence of movements of fetus suggest this condition). These conditions occur either because of improper nourishment of mother with vata and pitta dominant diet or because of decreased transfer of nutrients from mother to fetus as a consequence of fetal metabolic disorder or placental abnormality. The treatment principle applicable here is brimhana supplying nourishment to mother and fetus.
All the dietary articles mentioned in the management have vatahara and dhatupushtikara properties, as there are vataprakopa and dhatukshya in these conditions. In the case of lina garbha, there is the absence of fetal movements, to expel such fetus, treatments which increase uterine contractions and induce labor are indicated because such fetus resembles fetus papyraceous or mummified fetus.
Practically the herbs used in fetal growth restriction are yashtimadhu, shatavari, gambhari and preparations like phalghrita, laghumalinivasanta. These herbs and preparations are rasayana and improve dhatvagni and rasa dhatu nirmana. They also help in clearing any obstruction in the channels (srotas) which are supplying nourishment to the fetus through the mother. As mentioned in classics, ksheer basti given to the mother in severe IUGR conditions stimulates fetal growth.

===== Garbhini Udavarta and its management =====

As a result of progesterone hormone which relaxes all the smooth muscles, there is decreased bowel and intestinal movements. Especially during the later months of pregnancy, along with progesterone, the pressure of the uterus on intestines and rectum leads to decreased peristalsis. This is observed most commonly during the 8th month. Garbhini udavarta is a similar condition with constipation and gaseous distention. This condition is to be relieved as straining for defecation may lead to hemorrhoids, bleeding hemorrhoids and leaking of membranes. Medicated enema of decoction is to be administered to clear the bowel as oral medications may aggravate uterine contractions. Enema with oil should be administered afterward for oleation of the tract, and this may further help in the formation of canal/pathway for parturition.

The position in pregnancy to administer basti is nyubja sthithi – hunchback /flexed posture. Conventionally, the left-lateral position is used. In nyubja sthithi, the fetus moves in a ventral position relieving the pressure on colon and rectum, making it easy for basti to be administered and reach descending colon easily.

===== Mrita garbha (intrauterine death) and its management =====

All the factors which are contraindicated during pregnancy and are known to cause harm to the fetus, if continued by the mother can cause upavishtaka, nagodara, garbhashosa. If left untreated, excessive accumulation of doshas with maternal illness may lead to placental insufficiency and fetal disorders where it fails to metabolize nutrients and causes fetal death. The symptoms of mritagarbha (fetal death) also signify causes as antepartum hemorrhage, hypovolemia and its complications in the mother. [30]

To expel the dead fetus, the treatments to be administered are to initiate uterine contractions and induce labor. If necessary surgical treatment for removal of a dead fetus is also believed to save the mother from serious complications like DIC (disseminated intravascular coagulopathy) may occur if fetal fibrin is absorbed in maternal circulation. After the removal of the dead fetus, the physician should administer sura varga (alcoholic preparations) for the relief of pain and purification of the gut and genito-urinary system and also for the sense of exhilaration. Loss of fetus in such a later stage can be very stressful for mother and anxiety, depression and other psychotic complications may arise if proper care is not taken. Once there is complete shuddhi of koshtha and garbhashaya, one should give brimhana treatment to promote tissue bulk and nutrition. As there is the removal of the kleda from all dhatus during the management and shuddhi, santarpana is very essential.

==== Monthly regimen during pregnancy ====

Regular intake of recommended diet and daily routine is essential for fetal growth as well as maternal well-being. Daily use of milk and milk products is an important aspect of garbhini paricharya. Milk can nourish all body tissues and is considered a wholesome diet, fulfilling the requirement of fetal as well as maternal growth. Milk is sheeta, snigdha, and madhura and increases the ojas in the body. Ojas is said to be the essence of all body tissues and revitalizes to produce new body elements. The regimen is rich in proteins as well as carbohydrates which are essential for fetal growth and development. Due care is taken while prescribing the regimen to prevent vata prakopa. Disturbance in vata balance may cause many diseases of the fetus as well as the mother. From the eighth month onwards, the preparation of birth canal for pariturition begins and also there is the descent of fetal presenting part in the pelvis. To relieve the symptoms of this pressure on pelvis and augment the formation of lower segment, to prepare cervix to become ripe and easily dilatable, basti and pichu (vaginal tampon) of oil are advised<ref> Meharban Singh – Care Of the New Born, 7thed. New Delhi. Sagar Publications, 2010. </ref>. ix Basti keeps vata dosha balanced & its gati in anulom (downward) direction, preventing the obstruction in the path of vata dosha to help the process of labor, natural and in ease.

Antenatal patients are prescribed Ayurvedic regimen throughout pregnancy with proper diet advice. The medicines given are shatavari, phalghrita especially during the first trimester.

Use of a herbomineral preparation Garbhapala rasa because of its lead content is under controversy. Appropriate preparation of this herbominearal compound following Ayurvedic Formulary of India ensures proper development of the fetus and prevents bleeding and threatened abortion during the first trimester. Along with the physical development of the fetus, the spiritual and psychological development is also taken care of. Given this, the do's and don't's includes visiting scenic and places of interest, associating with likable people, eating prescribed diet, reading and listening to interesting stories are advised.

The lifestyle, diet, exercise, synthetic drugs, food additives like artificial colors, preservatives, the onslaught of electromagnetic radiations have become an integral part of the day today life (ref:https://infoayushdarpan.wordpress.com/2017/01/18/the-role-of-masanumasik-formulations/). This affects the growth and development of the fetus. Decoctions made in the form of Ghana vati as mentioned by Ashtanga and Sushruta are used as a monthly treatment for all antenatal patients which facilitate proper nourishment and hence the growth of fetus preventing any illness. Research has shown that application of matra basti and yoni pichu of Bala tssail given from the first day of 9th month results in normal labor without prolongation with spontaneous onset Ref. Also, it reduces postpartum complications like a backache, lower abdominal pain, and abdominal distention.

Kikkisa (striae gravidarum) which occurs on abdominal and breast area due to itching is to be treated with local application of drugs which relieves itching and burning sensation. Also, certain herbs are varnya in nature i.e. to improve color and complexion of skin. Ointments, oil, and lepa are prepared from these formulations and prescribed to mother to apply on abdominal area, thighs, and breast from the second month itself to prevent kikkisa.

Care during 9th month of pregnancy: Instead of suitiikagara, what special care of pregnant lady is advised by Ayurvedic obstretian at home before she goes into labor should be described. What instructions are given when labor pain starts?

==== Management of Labor ====

Instead of moving the mother after the labor pain starts, she is shifted to the delivery abode (sutikagara) at the onset of the ninth month. The entry is a ritual and done on auspicious day and timing to ensure the successful and uneventful outcome of pregnancy and parturition without any untoward complications. Symptoms and signs which signify formation of the lower segment with uterine contractions and cervical dilation indicate the onset of labor. As soon as the onset of labor is determined, the counseling and observation of mother are to be with while she is lying down.

To ensure proper progress of labor or when the uterine contractions are not strong, to favor descent of presenting part of the fetus, the mother is advised to walk around. She is also given herbs which are known to have the property of enhancing uterine contractions, in inhalation or fumigation form for quick absorption. Application of lepa made of pippali and vacha churna on abdominal area enhances the intensity of contractions. They are also helpful in prolonged labor caused by weak contractions. Langali, though not abundantly available, tying its roots or applying its lepa also gives such desired effects.

The intensity of increased labor pain and the onset of gripping pain in lower pelvis signifies further descent of fetus and full dilatation of the cervix. The bearing down efforts is encouraged in lying down position. Chanting also encourages the mother to bear down properly.

The proper timing of bearing down is full dilatation and presence of intense pain (uterine contractions). The two forces, voluntary (which are maternal bearing down effort) and involuntary (uterine contractions), when combined, lead to further descent and expulsion of a fetus with birth passage properly formed after full dilatation of the cervix. Expulsion of the fetus is controlled by apana vayu located in shroni (pelvis). If there is no movement of apana vayu and the mother bears down, it causes vata prakopa and leads to vikata navajata (baby born with deformities). Secondly, whenever there is an appropriate movement of apana vayu, but the woman suppresses that urge to bear down, that too leads to vata prakopa and causes deformities in the baby, the formation of caput succedaneum and fetal distress, both occur as a result of premature bearing down efforts and absence of bearing down respectively. The consequence of premature bearing down has increased the incidence of remote complication like vaginal and uterine prolapse.

After the birth of a baby, in the case of retained placenta, the therapies administered are to increase uterine contractions and increase intra-abdominal pressure for placental detachment and descent in the vagina. All these measures, along with basti, are vatahara and are vata shamaka measures for the restoration of prakrita gati of vata dosha to expel out the placenta along with stool and urine.

==== Care of the Newborn ====

Resuscitation of a newborn is the initial step and is called Pranapratyagaman Vidhi. There is a prescribed sequence for the clearing of mucous secretions from the oral cavity. First the palate, then the inner aspect of lips, kantha (pharynx), and the Jivha (tongue) should be cleaned. Once the secretion is cleared from the palate, it facilitates the air entry in the pharynx easily. Clearing of pharynx clears the air passage and finally clearing of tongue removes the amniotic fluid and mucous which sticks to the tongue. Nowadays, a neonatal care practice is to clear up the secretion with a suction apparatus first from the mouth and then through the nose. The reason for removing secretions from the mouth first is to prevent the aspiration of more copious oral secretions than nasal secretions. Emesis with ghee and rock salt prescribed in the past is not done. Modern practice is to do gastric suction.
Once the baby is breathing well next step is to cut the umbilical cord under aseptic conditions to prevent serious complication of stump infection. This is followed by application of oil and dry powders with antiseptic and drying property. All these measures are to prevent infection in the umbilical stump, early fall of the umbilical cord, healthy healing of the wound after the fall of the cord stump and for prevention of complications like omphalocele, etc. Lodhra, madhuka, priyamgu, suradaru, and Haridra, etc. are drugs that have kashaya and astringent properties to remove excessive moisture and prevent infection, since dry conditions favor the early separation of stump. Oil made up of the same drugs has antimicrobial and wound healing properties and prevents moisture and microbes. The wrong method of cutting of cord and improper care of the cord leads to complications.

==== Samskara After birth ====

Ayurveda Acharyas follow some medicinal practices in combination with ritualistic customs. The very first feed to the baby should be applied in a ritualistic and hygienic way. Therefore, in jatakarmasamskara, the father has to take a bath before holding the baby, followed by reciting mantras softly in the ear of the baby, followed by making the baby lick gold with honey and ghee. Licking initiates swallowing movement in the newly born baby, and once such sucking and swallowing movements start, it is safe to initiate breastfeeding. Breastfeeding is recommended immediately after birth since breastmilk provides colostrum (stanya piyusha) which gives the baby ample amount of protein, cholesterol, and immunoglobins. Colostrum is said to be essential for the growth of brain and memory of the baby. Cholesterols in the colostrum have essential linoleic fatty acids and various species-specific properties that are essential for nervine and enhancement of immunity. According to the recent practice of neonatal care, breastfeeding should be initiated within 15 minutes after birth, in the case of normal labor, and within 2 hours of birth in case of cesarean section. Precautions should be taken to prevent neonatal sepsis. Are ther any special ayurvedic ways being used now?

==== Prescribed post-partum measures for women ====

Parturition and postpartum phase cause significant changes physiologically, psychologically and anatomically especially, in her hormones and the neuro-endocrinal axis. All dhatus of the mother are at a low ebb (kshaya) during labor, and therefore there is vata prakopa and agnimandya. Therefore, in the postpartum phase, a physician should administer vatahara, deepana, and brimhana upakrama and should help restore the woman’s body tissues in a systematic manner, taking care of her digestive capacity. To regain homeostasis, the regimen of diet for first ten days postpartum are prescribed.
The measures prescribed in these texts are for the woman after delivery to transition from the effects of labor into a state of normalcy and good health smoothly. These measures help in the involution of the uterus and pelvic cavity, contraction of the distended abdomen, and help in restoring digestion. Immediate care will help in easing the fatigue of labor too. Experienced practitioners endorse these measures clinically.

Within ten days of childbirth, the uterus returns to its normal size and shape, the lochia (serous and water discharge from uterine bed through the vagina) becomes minimum or nil, and the physiology of the woman is restored to her normal stage. The mother also lactates in this phase. However, since she is still weak and vulnerable to diseases, while her body (and life) returns to a state of normalcy, she should be kept under strict vigil and care.

Orally decoction of dashmoola for garbhashaya shodhana as well as relieving backache is given, trikatu churna, vasa churna, bharangi churna, pippali churna, parsik yavani churna in combination with honey or warm water is administered for sufficient uterine contractions ensuring proper drainage of lochia, for agnideepana and for relieving pain. Shatavari churna with milk (Kshirpaka) for proper lactation, tablet triphala guggulu as the antiseptic measure is also given to the mother. At many Ayurveda hospitals, the mother is massaged with bala oil followed by steam; yonidhupana is done by sitting on a chair with herbs for fumigation kept below. (fig) A blanket is wrapped around the body covering legs after mother sits on it. The abdomen is wrapped with a big cloth to prevent distention and ensure proper involution.
[[File:Chair_for_yonidhupana.png|thumb|center|upright=1.35|alt=A Chair for yoni dhupana.]]

Fig: Chair for yoni dhupana<br>
Source: http://www.jennsutkowski.com/blog-du-moment/steam-that-yonisteam-that-yoni-for-me-or-i-mean-you

==== Naming Ceremony ====

The naming ceremony is also advised to be done on the tenth day of childbirth. Although the family is free to keep a name of their choosing, guidelines for selection of the name are given here - one that is auspicious and derived through rituals, and the other for social identity.

Naming the baby is a very important event. A person’s name always leaves a very deep impact on his/her personality and behavior. Psychologically, what one hears and reacts is very important for the mental wellbeing of the person. Therefore, one should be given a good name having an auspicious meaning and that which instills confidence in the individual. Vedic cultures have formal naming ceremonies, as do some other cultures around the world. [50]

==== Examination of Newborn ====

All the morphological features of the newborn should be examined thoroughly to rule out any features of congenital anomalies and life-threatening conditions as early as possible. With the help of such findings, one can prevent further complications and consequences of these congenital issues. Therefore, on the tenth day of the child’s delivery, the physician should examine the baby thoroughly. The newborn is grossly examined at birth, but thorough examination is recommended on the tenth day because many minute observations might get missed just after birth and will become obvious by the tenth day.

Currently, wet nurse for feeding the baby is not used unless the mother dies and close relative is available..

Characteristics of Breast milk, the effect of a mother's diet on breast milk and its management: Shuddha stanya (pure breast milk) is necessary for the newborn. According to Ayurveda whenever the pakva ahara rasa enters the stana (breast), its madhura rasa get converted into stanya (breast milk). Therefore, whatever the mother eats converts into stanya. If the mother takes a diet that causes dosha prakopa, then such a vitiated dosha vitiates the stanya and the vitiated stanya causes disease in the newborn baby. Therefore, the mother should take balanced and healthy diet which does not vitiate doshas.

Some of the properties of stanya afflicted with vitiated doshas are as follows: vitiated vata dosha has tikta, kashya rasa and therefore, the stanya afflicted with vitiated vata dosha becomes tikata and kashya (bitter). Similar samprapti (etiology) is applicable in cases of pitta and kapha dosha prakopa as well.

As explained earlier, stanya produced from the adya ahara rasa dhatu (from the first dhatu..) is afflicted with vitiated kapha/shleshma dosha. Shodhana treatment is key for treating stanya dushti vikara (i.e. breastmilk infections). Shodhana should be followed by the administration of tikta, katu, and kashaya rasa drugs like vachaharidradi gana or charakokta patha mahaushadi suradarvadi stanya shodhana mahakashya (Cha. Sutra Sthana).

All the above-mentioned drugs and diet have been investigated and found useful with many evidence-based types of research, and are prescribed as galactagogues ref.

According to today's obstetrics and neonatology practice, the mother should feed the baby with the comfort of both mother and baby, keeping both in proper positions and with positive and loving thoughts for the baby.
The concept of examination of breast milk is not practically applied in today's era. The diet, lifestyle, and psyche of the mother affect the quality and quantity of breast milk. The characteristic and quantity of breast milk affects the growth and development of the newborn.

==== Designing and care of the child’s room ====

The kumaragara (or day care facility) should be prepared in such a manner as to prevent accidents and to protect the child from agantuja vyadhi (diseases due to external/extrinsic factors). In such healthy, emotionally stable and protected environment, children grow very healthy. Antimicrobial properties of all these drugs have been proven in different researches, and hence their use in newborn care and the neonatal nursery is quite evident. Till date, there is no evidence-based scientific explanation available for wearing stones and animal-based jewelry or ornaments. Most of these practices have passed down as customs or rituals since time immemorial.

==== Toys for children ====

Toys are very fundamental constituents for the proper growth and development of creative and logical thoughts in babies. Toys play a crucial role as sensory stimuli. Acharya Charaka was well aware of this aspect of child development and therefore described toys in detail. All societies and cultures have toys, and their role in child development is universally accepted.

==== The upbringing of the child ====

According to Artha Shastra of Chanakya (Vishnugupta), a child till the age of five years needs a lot of care and affection, while the next ten years require inculcating him/her with discipline and education and once he/she reaches 16 years of age, he/she should be treated as a friend. Children of 16 years of age are mature, physically and sexually, and by then are ready to acquire skills of work for earning.
</div>

=== References ===

<references/>

Jatisutriya Sharira

2017-12-25T04:55:23Z

Vinay Exafluence: /* Prescribed post-partum measures for women */

Jatisutriya Sharira

2017-12-25T04:52:43Z

Vinay Exafluence: /* Prescribed post-partum measures for women */

Jatisutriya Sharira

2017-12-25T04:52:09Z

Vinay Exafluence: /* Monthly regimen during pregnancy */

{{Infobox
|title = Jatisutriya Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 8
|label2 = Preceding Chapter
|data2 = [[Samkhya Sharira]]

|label3= Succeeding Chapter
|data3 = None
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}
== [[Sharira Sthana]] Chapter 8 Jatisutriya Shariram ==

=== Abstract ===
<div style="text-align:justify;">
The eighth chapter of [[Sharira Sthana]], [[Jatisutriya Sharira]], continues from where Chapter Two ends, and deals not just with obstetrics and midwifery, but also prescribes measures for good parental health and effective neonatal care. It also describes pioneering concepts such as construction of a maternity home, attending wet nurses (and the concept of a milk bank), and well-furnished nurseries. ''Jati'' means birth, hence this chapter deals with the method of procreation in short.

'''Keywords''':''Jatisutriya, Dhatri''
</div>
=== Introduction ===
<div style="text-align:justify;">
The [[Sharira Sthana]] and [[Chikitsa Sthana]] provide valuable insights into obstretics, midwifery and gynaecology in the Vedic ages. Since Ayurveda is holistic in its treatment of various aspects of life sciences, these sections go beyond in their treatment of these branches of medicine, prescribing ground rules for effective neonatology and improved parental health. This chapter starts with certain guidelines for purification of the parents, including spiritual practices and appropriate rules for coitus, to improve the odds of giving birth to a healthy and desired offspring. For purification, therapies such as [[Panchakarma]] are advocated. A very specific - and contentious - spiritual procedure called ''putreshti yajna'' is also explained here, with an aim towards giving birth to a son (or a child of desired gender) with all excellent qualities.

Next, the chapter talks of fertilization and its features, and confirmation of conception. At this stage, sound parental health is also important. Couples are advised to follow various dietary measures as well as rules to engage in physical and mental activities, etc.
The subsequent part of the chapter deals with obstetrics and midwifery –detailing the development of the embryo to fetus and the milestones of intrauterine growth and development are explained. Certain sections of this chapter are controversial and could attract legal attention today, such as the practice of ''pumsavana'' (ways to get the offspring of a desired gender). Also, with our current understanding of genetics, it is not possible to change the gender after fertilization. The role of learned ''brahmins, vaidya'' and experienced old ladies in midwifery is given a lot of importance in this chapter.

Toys and playtime are essential for normal growth and development of a child, and the final section of this chapter describes the ideal characteristics of toys, play area, clothes and the child nursery.

Summarizing the eighth chapter, it deals with Obstetrics and Neonatology while also touching upon parental health and early child care, introducing certain concepts that are now considered modern best practices in the field,
</div>
===Sanskrit text, Transliteration and English Translation===

अथातो जातिसूत्रीयं शारीरं व्याख्यास्यामः||१||

athātō jātisūtrīyaṁ śārīraṁ vyākhyāsyāmaḥ||1||

athAto jAtisUtrIyaM shArIraM vyAkhyAsyAmaH||1||

“Now I shall expound the chapter dealing with continuation of one’s own lineage, in this discourse on Sharira.” [1]

Note: ''Jati'' means birth and ''Sutra'' is which is described in short. ''Jatisutriya'' is description of different methods and procedures of birth in short.

इति ह स्माह भगवानात्रेयः||२||

iti ha smāha bhagavānātrēyaḥ||2||

iti ha smAha bhagavAnAtreyaH||2||

Thus said Lord Atreya [2]

स्त्रीपुंसयोरव्यापन्नशुक्रशोणितगर्भाशययोः श्रेयसीं प्रजामिच्छतोस्तदर्थाभिनिर्वृत्तिकरं [१] कर्मोपदेक्ष्यामः||३||

strīpuṁsayōravyāpannaśukraśōṇitagarbhāśayayōḥ śrēyasīṁ prajāmicchatōstadarthābhinirvr̥ttikaraṁ [1]karmōpadēkṣyāmaḥ||3||

strIpuMsayoravyApannashukrashoNitagarbhAshayayoH shreyasIMprajAmicchatostadarthAbhinirvRuttikaraM [1] karmopadekShyAmaH||3||

Now we shall explain the procedures required for begetting a progeny of excellent qualities, to be practiced by man and woman of unaltered (pure, undamaged) sperm, ovum and uterus. [3]

अथाप्येतौ स्त्रीपुंसौ स्नेहस्वेदाभ्यामुपपाद्य, वमनविरेचनाभ्यां संशोध्य, क्रमेण प्रकृतिमापादयेत्|
संशुद्धौ चास्थापनानुवासनाभ्यामुपाचरेत्; उपाचरेच्च मधुरौषधसंस्कृताभ्यां घृतक्षीराभ्यां पुरुषं, स्त्रियं तु तैलमाषाभ्याम्||४||

athāpyētau strīpuṁsau snēhasvēdābhyāmupapādya, vamanavirēcanābhyāṁ saṁśōdhya, kramēṇaprakr̥timāpādayēt|
saṁśuddhau cāsthāpanānuvāsanābhyāmupācarēt; upācarēcca madhurauṣadhasaṁskr̥tābhyāṁghr̥takṣīrābhyāṁ puruṣaṁ, striyaṁ tu tailamāṣābhyām||4||

athApyetau strIpuMsau snehasvedAbhyAmupapAdya, vamanavirecanAbhyAM saMshodhya, krameNaprakRutimApAdayet|
saMshuddhau cAsthApanAnuvAsanAbhyAmupAcaret; upAcarecca madhurauShadhasaMskRutAbhyAMghRutakShIrAbhyAM puruShaM, striyaM tu tailamAShAbhyAm||4||
<div style="text-align:justify;">
Such a couple (desiring good progeny) should first undergo purification therapies described earlier in this treatise - unction and sudation procedures followed by emesis and purgation - and gradually get back to normalcy. Once purified, the couple should undergo non-unctuous and unctuous enema. Then, the man should be administered with sweet-tasting drugs processed with ghee and milk while the woman should take sesame oil and black gram. [4]
</div>
==== Abstinence from coitus during menstruation ====

ततः पुष्पात् प्रभृति त्रिरात्रमासीत ब्रह्मचारिण्यधःशायिनी, पाणिभ्यामन्नमजर्जरपात्राद्भुञ्जाना [१] , न चकाञ्चिन्मृजामापद्येत|
ततश्चतुर्थेऽहन्येनामुत्साद्य सशिरस्कं स्नापयित्वा शुक्लानि वासांस्याच्छादयेत् पुरुषं च|
ततः शुक्लवाससौ स्रग्विणौ सुमनसावन्योन्यमभिकामौ संवसेयातां स्नानात् प्रभृति युग्मेष्वहःसु पुत्रकामौ, अयुग्मेषुदुहितृकामौ||५||

tataḥ puṣpāt prabhr̥ti trirātramāsīta brahmacāriṇyadhaḥśāyinī, pāṇibhyāmannamajarjarapātrādbhuñjānā[1] , na ca kāñcinmr̥jāmāpadyēta|
tataścaturthē'hanyēnāmutsādya saśiraskaṁ snāpayitvā śuklāni vāsāṁsyācchādayēt puruṣaṁ ca|
tataḥ śuklavāsasau sragviṇau sumanasāvanyōnyamabhikāmau saṁvasēyātāṁ snānāt prabhr̥tiyugmēṣvahaḥsu putrakāmau, ayugmēṣu duhitr̥kāmau||5||

tataH puShpAt prabhRuti trirAtramAsIta brahmacAriNyadhaHshAyinI,pANibhyAmannamajarjarapAtrAdbhu~jjAnA [1] , na ca kA~jcinmRujAmApadyeta|
tatashcaturthe~ahanyenAmutsAdya sashiraskaM snApayitvA shuklAni vAsAMsyAcchAdayet puruShaM ca|
tataH shuklavAsasau sragviNau sumanasAvanyonyamabhikAmau saMvaseyAtAM snAnAt prabhRutiyugmeShvahaHsu putrakAmau, ayugmeShu duhitRukAmau||5||
<div style="text-align:justify;">
While menstruating, the woman should abstain from coitus for three nights, sleep on the ground, consume food with her hand from unbroken utensils, and should not clean her body by any means. On the fourth day, she should be anointed well with oil and should be given a good head bath, cleansed well, and then made to wear white coloured apparel. The man should follow similar rituals as the woman on her fourth day of menstruation. Then onwards, the two, wearing white apparels and garlands, with pleasant disposition, loving each other, should enter into acts of cohabitation - on even days if desirous of a male child, and on odd days for a female child. [5]
</div>
==== Postures and circumstances to be avoided for coitus ====

न च न्युब्जां पार्श्वगतां वा संसेवेत|
न्युब्जाया वातो बलवान् स योनिं पीडयति, पार्श्वगताया दक्षिणे पार्श्वे श्लेष्मा स च्युतः पिदधाति गर्भाशयं, वामे पार्श्वे पित्तंतदस्याः पीडितं विदहति रक्तं शुक्रं च, तस्मादुत्ताना बीजं गृह्णीयात्; तथाहि यथास्थानमवतिष्ठन्ते दोषाः|
पर्याप्ते चैनां शीतोदकेन परिषिञ्चेत्|
तत्रात्यशिता क्षुधिता पिपासिता भीता विमनाः शोकार्ता क्रुद्धाऽन्यं च पुमांसमिच्छन्ती मैथुने चातिकामा वा न गर्भं धत्ते,विगुणां वा प्रजां जनयति|
अतिबालामतिवृद्धां दीर्घरोगिणीमन्येन वा विकारेणोपसृष्टां वर्जयेत्|
पुरुषेऽप्येत एव दोषाः|
अतः सर्वदोषवर्जितौ स्त्रीपुरुषौ संसृज्येयाताम्||६||

na ca nyubjāṁ pārśvagatāṁ vā saṁsēvēta|
nyubjāyā vātō balavān sa yōniṁ pīḍayati, pārśvagatāyā dakṣiṇē pārśvē ślēṣmā sa cyutaḥ pidadhātigarbhāśayaṁ, vāmē pārśvē pittaṁ tadasyāḥ pīḍitaṁ vidahati raktaṁ śukraṁ ca, tasmāduttānā bījaṁgr̥hṇīyāt; tathāhi yathāsthānamavatiṣṭhantē dōṣāḥ|
paryāptē caināṁ śītōdakēna pariṣiñcēt|
tatrātyaśitā kṣudhitā pipāsitā bhītā vimanāḥ śōkārtā kruddhā'nyaṁ ca pumāṁsamicchantī maithunēcātikāmā vā na garbhaṁ dhattē, viguṇāṁ vā prajāṁ janayati|
atibālāmativr̥ddhāṁ dīrgharōgiṇīmanyēna vā vikārēṇōpasr̥ṣṭāṁ varjayēt|
puruṣē'pyēta ēva dōṣāḥ|
ataḥ sarvadōṣavarjitau strīpuruṣau saṁsr̥jyēyātām||6||

na ca nyubjAM pArshvagatAM vA saMseveta|
nyubjAyA vAto balavAn sa yoniM pIDayati, pArshvagatAyA dakShiNe pArshve shleShmA sa cyutaHpidadhAti garbhAshayaM, vAme pArshve pittaM tadasyAH pIDitaM vidahati raktaM shukraM ca,tasmAduttAnA bIjaM gRuhNIyAt; tathAhi yathAsthAnamavatiShThante doShAH|
paryApte cainAM shItodakena pariShi~jcet|
tatrAtyashitA kShudhitA pipAsitA bhItA vimanAH shokArtA kruddhA~anyaM ca pumAMsamicchantImaithune cAtikAmA vA na garbhaM dhatte, viguNAM vA prajAM janayati|
atibAlAmativRuddhAM dIrgharogiNImanyena vA vikAreNopasRuShTAM varjayet|
puruShe~apyeta eva doShAH|
ataH sarvadoShavarjitau strIpuruShau saMsRujyeyAtAm||6||
<div style="text-align:justify;">
During sexual intercourse, the woman should not be in prone posture, or lie on her sides. In the former case, ''vata dosha'' becomes stronger and inflicts the genital tract and in the latter case, lying on her right side, displaces ''kapha dosha'' into the mouth of the uterus and creates obstruction, while if she is on her left side, ''pitta dosha'' afflicts the ovum and sperm by its heat. Therefore, the woman should receive the sperm lying on her back, in this position; the doshas are in their states of normalcy. After coitus, vagina should be sprinkled with cold water.

The woman who has overeaten, thirsty, frightened, dejected, in grief, anger or in love with a man other than her husband, or who is overpassionate (during the coital act) will fail to conceive or if conceived, will give birth to a child with some defects.

A very young (sexually immature) girl or a very old woman, woman suffering from chronic illness or suffering with any other disorders should not procreate. This condition applies for a male partner too. Hence only a man and a woman who are free from all defects, and are of suitable age should engage in coitus. [6]
</div>
==== Preparations before coitus ====

सञ्जातहर्षौ मैथुने चानुकूलाविष्टगन्धं स्वास्तीर्णं सुखं शयनमुपकल्प्य मनोज्ञं हितमशनमशित्वा नात्यशितौ दक्षिणपादेनपुमानारोहेत् वामपादेन स्त्री||७||

sañjātaharṣau maithunē cānukūlāviṣṭagandhaṁ svāstīrṇaṁ sukhaṁ śayanamupakalpya manōjñaṁhitamaśanamaśitvā nātyaśitau dakṣiṇapādēna pumānārōhēt vāmapādēna strī||7||

sa~jjAtaharShau maithune cAnukUlAviShTagandhaM svAstIrNaM sukhaM shayanamupakalpya manoj~jaMhitamashanamashitvA nAtyashitau dakShiNapAdena pumAnArohet vAmapAdena strI||7||
<div style="text-align:justify;">
The couple that is sufficiently aroused and fully engrossed in the sexual act, after having their favorite food (wholesome, not overeaten), should lie on bed which is well adorned with pleasant perfumes and bedecked with comfortable mattresses of one’s choice for the sexual act, man placing his right foot first and woman her left. [7]
</div>
==== ''Mantra'' before the sexual act ====

तत्र मन्त्रं प्रयुञ्जीत- “अहिरसि आयुरसि सर्वतः प्रतिष्ठाऽसि धाता त्वा ददतु विधाता त्वा दधातु ब्रह्मवर्चसा भव” इति|
“ब्रह्मा बृहस्पतिर्विष्णुःसोमःसूर्यस्तथाऽश्विनौ|
भगोऽथ मित्रावरुणौ वीरं [२] ददतु मे सुतम्”
इत्युक्त्वा संवसेयाताम्||८||

tatra mantraṁ prayuñjīta- “ahirasi āyurasi sarvataḥ pratiṣṭhā'si dhātā tvā dadatu vidhātā tvā dadhātubrahmavarcasā bhava” iti|
“brahmā br̥haspatirviṣṇuḥsōmaḥsūryastathā'śvinau|
bhagō'tha mitrāvaruṇau vīraṁ [2] dadatu mē sutam”
ityuktvā saṁvasēyātām||8||

tatra mantraM prayu~jjIta- “ahirasi Ayurasi sarvataH pratiShThA~asi dhAtA tvA dadatu vidhAtA tvAdadhAtu brahmavarcasA bhava” iti|
“brahmA bRuhaspatirviShNuHsomaHsUryastathA~ashvinau|
bhago~atha mitrAvaruNau vIraM [2] dadatu me sutam”
ityuktvA saMvaseyAtAm||8||
<div style="text-align:justify;">
Then, they should recite the ''mantra'' meaning: ‘Thou art the day; Thou art the life; Thou art well established from all sides. May the supporter endow Thee; may the dispenser dispense to Thee: be Thou born with ''Brahmic'' splendor’. May Brahma, Brhaspati, Visnu, Soma, Surya and the two Ashwins, as also Bhaga, Mitra and Varuna, bless me with a heroic son.’ Having uttered this, the couple should commence the sexual act. [8]
</div>
==== Daily rituals to be followed a week before coitus by a woman desirous of a healthy male child ====

सा चेदेवमाशासीत-बृहन्तमवदातं हर्यक्षमोजस्विनं शुचिं सत्त्वसम्पन्नं पुत्रमिच्छेयमिति, शुद्धस्नानात् प्रभृत्यस्यैमन्थमवदातयवानां मधुसर्पिर्भ्यां संसृज्य श्वेताया गोः सरूपवत्सायाः पयसाऽऽलोड्य राजते कांस्ये वा पात्रे काले काले सप्ताहंसततं प्रयच्छेत् पानाय|
प्रातश्च शालियवान्नविकारान् दधिमधुसर्पिर्भिः पयोभिर्वा संसृज्य भुञ्जीत, तथा सायमवदातशरणशयनासनपानवसनभूषणाच स्यात्|
सायं प्रातश्च शश्वच्छ्वेतं महान्तं वृषभमाजानेयं वा हरिचन्दनाङ्गदं पश्येत्|
सौम्याभिश्चैनां कथाभिर्मनोनुकूलाभिरुपासीत|
सौम्याकृतिवचनोपचारचेष्टांश्च स्त्रीपुरुषानितरानपि चेन्द्रियार्थानवदातान् पश्येत्|
सहचर्यश्चैनां प्रियहिताभ्यां सततमुपचरेयुस्तथा भर्ता|
न च मिश्रीभावमापद्येयातामिति|
अनेन विधिना सप्तरात्रं स्थित्वाऽष्टमेऽहन्याप्लुत्याद्भिः सशिरस्कं सह भर्त्रा अहतानि वस्त्राण्याच्छादयेदवदातानि,अवदाताश्च स्रजो भूषणानि च बिभृयात्||९||

sā cēdēvamāśāsīta- br̥hantamavadātaṁ haryakṣamōjasvinaṁ śuciṁ sattvasampannaṁ putramicchēyamiti,śuddhasnānāt prabhr̥tyasyai manthamavadātayavānāṁ madhusarpirbhyāṁ saṁsr̥jya śvētāyā gōḥsarūpavatsāyāḥ payasā''lōḍya rājatē kāṁsyē vā pātrē kālē kālē saptāhaṁ satataṁ prayacchēt pānāya|
prātaśca śāliyavānnavikārān dadhimadhusarpirbhiḥ payōbhirvā saṁsr̥jya bhuñjīta, tathāsāyamavadātaśaraṇaśayanāsanapānavasanabhūṣaṇā ca syāt|
sāyaṁ prātaśca śaśvacchvētaṁ mahāntaṁ vr̥ṣabhamājānēyaṁ vā haricandanāṅgadaṁ paśyēt|
saumyābhiścaināṁ kathābhirmanōnukūlābhirupāsīta|
saumyākr̥tivacanōpacāracēṣṭāṁśca strīpuruṣānitarānapi cēndriyārthānavadātān paśyēt|
sahacaryaścaināṁ priyahitābhyāṁ satatamupacarēyustathā bhartā|
na ca miśrībhāvamāpadyēyātāmiti|
anēna vidhinā saptarātraṁ sthitvā'ṣṭamē'hanyāplutyādbhiḥ saśiraskaṁ saha bhartrā ahatānivastrāṇyācchādayēdavadātāni, avadātāśca srajō bhūṣaṇāni ca bibhr̥yāt||9||

sA cedevamAshAsIta- bRuhantamavadAtaM haryakShamojasvinaM shuciM sattvasampannaMputramiccheyamiti, shuddhasnAnAt prabhRutyasyai manthamavadAtayavAnAM madhusarpirbhyAMsaMsRujya shvetAyA goH sarUpavatsAyAH payasA~a~aloDya rAjate kAMsye vA pAtre kAle kAle saptAhaMsatataM prayacchet pAnAya|
prAtashca shAliyavAnnavikArAn dadhimadhusarpirbhiH payobhirvA saMsRujya bhu~jjIta, tathAsAyamavadAtasharaNashayanAsanapAnavasanabhUShaNA ca syAt|
sAyaM prAtashca shashvacchvetaM mahAntaM vRuShabhamAjAneyaM vA haricandanA~ggadaM pashyet|
saumyAbhishcainAM kathAbhirmanonukUlAbhirupAsIta|
saumyAkRutivacanopacAraceShTAMshca strIpuruShAnitarAnapi cendriyArthAnavadAtAn pashyet|
sahacaryashcainAM priyahitAbhyAM satatamupacareyustathA bhartA|
na ca mishrIbhAvamApadyeyAtAmiti|
anena vidhinA saptarAtraM sthitvA~aShTame~ahanyAplutyAdbhiH sashiraskaM saha bhartrA ahatAnivastrANyAcchAdayedavadAtAni, avadAtAshca srajo bhUShaNAni ca bibhRuyAt||9||
<div style="text-align:justify;">
A woman desirous of having a male child with large limbs, fair complexion, with eyes like those of a lion (full of vigor), pure, and with good mental disposition should, after her menstrual period, first take a purificatory bath, then be given a light porridge of well cleaned white barley grains duly sweetened by adding honey and ghee, diluted in the milk of a white cow having a white calf, in a utensil made of silver or bronze, regularly in the morning and evening for a week.

During mornings and evenings, she should eat a diet prepared with sali rice and/or barley mixed with curd, honey, ghee or with milk. Her room, bed, seat, drink, dress and ornaments etc. all should be of white color. In the evenings and mornings, she should look at a white majestic bull / stallion duly smeared with white sandal paste without fail. She should also be entertained with pleasant tales of her interest, acceptable to her mood. She should also look at men and women having good personality, speech, behaviour and manners, as well as visuals and objects that are white in color.

Her companions and husband should also entertain her with things, discussion topics, and activities that are pleasant to her, and not stressful. The couple, should, however avoid sexual contact during this period. Following this regimen for a week, on the eighth day she, along with her husband, after taking a head bath with pure (consecrated – ''abhimantritam'') water, get prepared for coitus by adorning themselves with new white apparel, garlands and ornaments. [9]
</div>
==== Rituals at the end of the week ====

तत ऋत्विक् प्रागुत्तरस्यां दिश्यगारस्य प्राग्प्रवणमुदक्प्रवणं वा प्रदेशमभिसमीक्ष्य, गोमयोदकाभ्यां स्थण्डिलमुपलिप्य, प्रोक्ष्यचोदकेन, वेदीमस्मिन् स्थापयेत्|
तां पश्चिमेनाहतवस्त्रसञ्चये श्वेतार्षभे वाऽप्यजिन उपविशेद् ब्राह्मणप्रयुक्तः, राजन्यप्रयुक्तस्तु वैयाघ्रे चर्मण्यानडुहे वा,वैश्यप्रयुक्तस्तु रौरवे बास्ते वा|
तत्रोपविष्टः पालाशीभिरैङ्गुदीभिरौदुम्बरीभिर्माधूकीभिर्वा समिद्भिरग्निमुपसमाधाय, कुशैः परिस्तीर्य, परिधिभिश्च परिधाय,लाजैः शुक्लाभिश्च गन्धवतीभिः सुमनोभिरुपकिरेत्|
तत्र प्रणीयोदपात्रं पवित्रपूतमुपसंस्कृत्य सर्पिराज्यार्थं यथोक्तवर्णानाजानेयादीन् समन्ततः स्थापयेत्||१०||

tata r̥tvik prāguttarasyāṁ diśyagārasya prāgpravaṇamudakpravaṇaṁ vā pradēśamabhisamīkṣya,gōmayōdakābhyāṁ sthaṇḍilamupalipya, prōkṣya cōdakēna, vēdīmasmin sthāpayēt|
tāṁ paścimēnāhatavastrasañcayē śvētārṣabhē vā'pyajina upaviśēd brāhmaṇaprayuktaḥ,rājanyaprayuktastu vaiyāghrē carmaṇyānaḍuhē vā, vaiśyaprayuktastu rauravē bāstē vā|
tatrōpaviṣṭaḥ pālāśībhiraiṅgudībhiraudumbarībhirmādhūkībhirvā samidbhiragnimupasamādhāya, kuśaiḥparistīrya, paridhibhiśca paridhāya, lājaiḥ śuklābhiśca gandhavatībhiḥ sumanōbhirupakirēt|
tatra praṇīyōdapātraṁ pavitrapūtamupasaṁskr̥tya sarpirājyārthaṁ yathōktavarṇānājānēyādīn samantataḥsthāpayēt||10||

tata Rutvik prAguttarasyAM dishyagArasya prAgpravaNamudakpravaNaM vA pradeshamabhisamIkShya,gomayodakAbhyAM sthaNDilamupalipya, prokShya codakena, vedImasmin sthApayet|
tAM pashcimenAhatavastrasa~jcaye shvetArShabhe vA~apyajina upavished brAhmaNaprayuktaH,rAjanyaprayuktastu vaiyAghre carmaNyAnaDuhe vA, vaishyaprayuktastu raurave bAste vA|
tatropaviShTaH pAlAshIbhirai~ggudIbhiraudumbarIbhirmAdhUkIbhirvA samidbhiragnimupasamAdhAya,kushaiH paristIrya, paridhibhishca paridhAya, lAjaiH shuklAbhishca gandhavatIbhiH sumanobhirupakiret|
tatra praNIyodapAtraM pavitrapUtamupasaMskRutya sarpirAjyArthaM yathoktavarNAnAjAneyAdInsamantataH sthApayet||10||
<div style="text-align:justify;">
At the end of one week, a priest should select a place on the north side of the house, having a downward slope towards the east or the north. The selected place/ground should be duly smeared with cowdung and water. After sprinkling the place with water, he should prepare and fix the altar.

On the west of the altar, the priest should take his seat on an undamaged cotton cushion or on the skin of a white bull, if he is officiating on behalf of a ''brahmana'' patron, on the skin of a tiger or bull if ''kshatriya'', and on the skin of a deer or a ram, in case of a ''vaisya''.

Thus seated, he should kindle the scared fire with the twigs of ''palasha'' (Butea monosperma Kuntze), ''ingudi'' (Balanites aegyptica Delile), ''udumbara'' (Ficus racemosa Linn) or ''madhuka'' (Madhuka indica J.F.Gmel), spread the ''kusha'' (Desmostachya bipinnata Stapf.) grass around, and fix the enclosure of fire with big stalks of ''palasha'' (Butea monospermakuntze) on all four sides, and then spread the altar with parched/roasted paddy and white coloured flowers having sweet fragrance. Then, he should prepare a water pot, clean and sanctified by ''mantras'', make available adequate amount of ghee for offerings, and place auspicious objects (such as bulls or stallions) of said qualities and colors, etc. in and around the place of offering as mentioned earlier. [10]
</div>
==== Additional rituals before cohabiting ====

ततः पुत्रकामा पश्चिमतोऽग्निं दक्षिणतो ब्राह्मणमुपविश्यान्वालभेत सह भर्त्रा यथेष्टं पुत्रमाशासाना| ततस्तस्या आशासानाया ऋत्विक् प्रजापतिमभिनिर्दिश्य योनौ तस्याः कामपरिपूरणार्थं काम्यामिष्टिं निर्वर्तयेद् ‘विष्णुर्योनिंकल्पयतु’ इत्यनयर्चा|
ततश्चैवाज्येन स्थालीपाकमभिघार्य त्रिर्जुहुयाद्यथाम्नायम्|
मन्त्रोपमन्त्रितमुदपात्रं तस्यै दद्यात् सर्वोदकार्थान् कुरुष्वेति|
ततः समाप्ते कर्मणि पूर्वं दक्षिणपादमभिहरन्ती प्रदक्षिणमग्निमनुपरिक्रामेत् सह भर्त्रा|
ततो [१] ब्राह्मणान् स्वस्ति वाचयित्वाऽऽज्यशेषं [२] प्राश्नीयात् पूर्वं पुमान्, पश्चात् स्त्री; न चोच्छिष्टमवशेषयेत्|
ततस्तौ सह संवसेयातामष्टरात्रं, तथाविधपरिच्छदावेव च स्यातां [३] , तथेष्टपुत्रं जनयेताम्||११||

tataḥ putrakāmā paścimatō'gniṁ dakṣiṇatō brāhmaṇamupaviśyānvālabhēta saha bhartrā yathēṣṭaṁputramāśāsānā|
tatastasyā āśāsānāyā r̥tvik prajāpatimabhinirdiśya yōnau tasyāḥ kāmaparipūraṇārthaṁ kāmyāmiṣṭiṁnirvartayēd ‘viṣṇuryōniṁ kalpayatu’ ityanayarcā|
tataścaivājyēna sthālīpākamabhighārya trirjuhuyādyathāmnāyam|
mantrōpamantritamudapātraṁ tasyai dadyāt sarvōdakārthān kuruṣvēti|
tataḥ samāptē karmaṇi pūrvaṁ dakṣiṇapādamabhiharantī pradakṣiṇamagnimanuparikrāmēt saha bhartrā|
tatō [1] brāhmaṇān svasti vācayitvā''jyaśēṣaṁ [2] prāśnīyāt pūrvaṁ pumān, paścāt strī; nacōcchiṣṭamavaśēṣayēt|
tatastau saha saṁvasēyātāmaṣṭarātraṁ, tathāvidhaparicchadāvēva ca syātāṁ [3] , tathēṣṭaputraṁjanayētām||11||

tataH putrakAmA pashcimato~agniM dakShiNato brAhmaNamupavishyAnvAlabheta saha bhartrAyatheShTaM putramAshAsAnA|
tatastasyA AshAsAnAyA Rutvik prajApatimabhinirdishya yonau tasyAH kAmaparipUraNArthaMkAmyAmiShTiM nirvartayed ‘viShNuryoniM kalpayatu’ ityanayarcA|
tatashcaivAjyena sthAlIpAkamabhighArya trirjuhuyAdyathAmnAyam|
mantropamantritamudapAtraM tasyai dadyAt sarvodakArthAn kuruShveti|
tataH samApte karmaNi pUrvaM dakShiNapAdamabhiharantI pradakShiNamagnimanuparikrAmet sahabhartrA|
tato [1] brAhmaNAn svasti vAcayitvA~a~ajyasheShaM [2] prAshnIyAt pUrvaM pumAn, pashcAt strI; nacocchiShTamavasheShayet|
tatastau saha saMvaseyAtAmaShTarAtraM, tathAvidhaparicchadAveva ca syAtAM [3] , tatheShTaputraMjanayetAm||11||
<div style="text-align:justify;">
Thereafter the woman, desirous of progeny, should sit with her husband on the west side of the altar, while the priest should sit to the south, and together they should perform the holy oblation to fire expressing their longing for a progeny. Then, the priest, addressing the God of procreation (Prajapati) for the fulfilment of her desire in her womb, should perform the ‘boon bestowing rite’, by chanting the said hymn ‘May Visnu bless the womb and make it fertile’. Then, the priest should prepare a bolus of cooked rice in an earthen pot by mixing the oblation with ghee, offering it to the holy fire thrice according to the prescribed methods. He should then give the sanctified pot of water to the woman to be used for all her purposes.

On the completion of the rite, she should, placing her right foot first, walk around the fire keeping to her right and accompanied by her husband. Then, after taking the the blessing of the ''brahmanas'', the couple should consume the remains of the sacrificial ghee - first the husband and then the wife - taking care not to leave any leftovers. On completion of this ritual, they shall cohabit for a period of eight nights, wearing the dress etc., as prescribed earlier. In this manner they will be able to beget a progeny, as desired. [11]
</div>
या तु स्त्री श्यामं लोहिताक्षं व्यूढोरस्कं महाबाहुं च पुत्रमाशासीत, या वा कृष्णं कृष्णमृदुदीर्घकेशं शुक्लाक्षं शुक्लदन्तंतेजस्विनमात्मवन्तम्; एष एवानयोरपि होमविधिः|
किन्तु परिबर्हो वर्णवर्जं स्यात्|
पुत्रवर्णानुरूपस्तु यथाशीरेव तयोः परिबर्होऽन्यः कार्यः स्यात्||१२||

yā tu strī śyāmaṁ lōhitākṣaṁ vyūḍhōraskaṁ mahābāhuṁ ca putramāśāsīta, yā vā kr̥ṣṇaṁkr̥ṣṇamr̥dudīrghakēśaṁ śuklākṣaṁ śukladantaṁ tējasvinamātmavantam; ēṣa ēvānayōrapi hōmavidhiḥ|
kintu paribarhō varṇavarjaṁ syāt|
putravarṇānurūpastu yathāśīrēva tayōḥ paribarhō'nyaḥ kāryaḥ syāt||12||

yA tu strI shyAmaM lohitAkShaM vyUDhoraskaM mahAbAhuM ca putramAshAsIta, yA vA kRuShNaMkRuShNamRududIrghakeshaM shuklAkShaM shukladantaM tejasvinamAtmavantam; eSha evAnayorapihomavidhiH|
kintu paribarho varNavarjaM syAt|
putravarNAnurUpastu yathAshIreva tayoH paribarho~anyaH kAryaH syAt||12||
<div style="text-align:justify;">
As regards the woman desirous of a child with sky blue complexion, red eye, broad chest and long limbs, or a woman who seeks off spring with black complexion, with black, soft and long hair, glittering white eye and teeth, radiant and self-restrained, the rituals to be followed are the same as described above. The preparations and materials required will not be of the same color but it should be made, in either case, to match the desired complexion of the child to be born, agreeable to the mother’s desire. [12]
</div>
==== Rituals for those belonging to the "shudra" lineage ====

शूद्रा तु नमस्कारमेव कुर्यात् (देवाग्निद्विजगुरुतपस्विसिद्धेभ्यः [४] )||१३||

śūdrā tu namaskāramēva kuryāt (dēvāgnidvijagurutapasvisiddhēbhyaḥ [4] )||13||

shUdrA tu namaskArameva kuryAt (devAgnidvijagurutapasvisiddhebhyaH [4] )||13||

Those belonging to ''shudra'' lineage, the mere act of salutation/pray (to the God, holy fire, ''brahmanas'', teachers/elders/preceptors, and saints and seers) should suffice. [13]

==== Advice for the mother desiring certain traits in her offspring ====

या या च यथाविधं पुत्रमाशासीत तस्यास्तस्यास्तां तां पुत्राशिषमनुनिशम्य तांस्ताञ्जनपदान्मनसाऽनुपरिक्रामयेत्|
ततो [५] या या येषां येषां जनपदानां मनुष्याणामनुरूपं पुत्रमाशासीत सा सा तेषां तेषां जनपदानांमनुष्याणामाहारविहारोपचारपरिच्छदाननुविधत्स्वेति वाच्या स्यात्|
इत्येतत् सर्वं पुत्राशिषां समृद्धिकरं कर्म व्याख्यातं भवति||१४||

yā yā ca yathāvidhaṁ putramāśāsīta tasyāstasyāstāṁ tāṁ putrāśiṣamanuniśamyatāṁstāñjanapadānmanasā'nuparikrāmayēt|
tatō [5] yā yā yēṣāṁ yēṣāṁ janapadānāṁ manuṣyāṇāmanurūpaṁ putramāśāsīta sā sā tēṣāṁ tēṣāṁjanapadānāṁ manuṣyāṇāmāhāravihārōpacāraparicchadānanuvidhatsvēti vācyā syāt|
ityētat sarvaṁ putrāśiṣāṁ samr̥ddhikaraṁ karma vyākhyātaṁ bhavati||14||

yA yA ca yathAvidhaM putramAshAsIta tasyAstasyAstAM tAM putrAshiShamanunishamyatAMstA~jjanapadAnmanasA~anuparikrAmayet|
tato [5] yA yA yeShAM yeShAM janapadAnAM manuShyANAmanurUpaM putramAshAsIta sA sA teShAMteShAM janapadAnAM manuShyANAmAhAravihAropacAraparicchadAnanuvidhatsveti vAcyA syAt|
ityetat sarvaM putrAshiShAM samRuddhikaraM karma vyAkhyAtaM bhavati||14||
<div style="text-align:justify;">
By knowing about the kind of child she desires, the woman should be advised to mentally travel to such places where people having similar dispositions live. Also, she should be advised to take diet, assume behavior, and engage in activities, attire, and social/cultural behooving such places and people.

Thus, the section detailing rituals that couples desirous of a healthy progeny – of the attributes of their liking – has been explained. [14]
</div>
==== Role of ''mahabhutas'' in contributing to the complexion of the offspring ====

न खलु केवलमेतदेव कर्म वर्णवैशेष्यकरं भवति|
अपि तु तेजोधातुरप्युदकान्तरिक्षधातुप्रायोऽवदातवर्णकरो भवति, पृथिवीवायुधातुप्रायः कृष्णवर्णकरः, समसर्वधातुप्रायःश्यामवर्णकरः||१५||

na khalu kēvalamētadēva karma varṇavaiśēṣyakaraṁ bhavati|
api tu tējōdhāturapyudakāntarikṣadhātuprāyō'vadātavarṇakarō bhavati, pr̥thivīvāyudhātuprāyaḥkr̥ṣṇavarṇakaraḥ, samasarvadhātuprāyaḥ śyāmavarṇakaraḥ||15||

na khalu kevalametadeva karma varNavaisheShyakaraM bhavati|
api tu tejodhAturapyudakAntarikShadhAtuprAyo~avadAtavarNakaro bhavati, pRuthivIvAyudhAtuprAyaHkRuShNavarNakaraH, samasarvadhAtuprAyaH shyAmavarNakaraH||15||
<div style="text-align:justify;">
Apart from the procedures mentioned above, ''mahabhutas'' also contribute in colour and complexion of skin. It is important to note that the ''teja'' (aura) associated with ''apa'' and ''akasha mahabuta'' are responsible for fair complexion, ''prithvi'' and ''vayu'' are responsible for black, and an equilibrium of all the five ''mahabhutas'' result in ''shyamavarna'' i.e. sky-like bluish complexion. [15]
</div>
==== Factors determining the psychological disposition of the progeny ====

सत्त्ववैशेष्यकराणि पुनस्तेषां तेषां प्राणिनां मातापितृसत्त्वान्यन्तर्वत्न्याः श्रुतयश्चाभीक्ष्णं स्वोचितं च कर्मसत्त्वविशेषाभ्यासश्चेति||१६||

sattvavaiśēṣyakarāṇi punastēṣāṁ tēṣāṁ prāṇināṁ mātāpitr̥sattvānyantarvatnyāḥ śrutayaścābhīkṣṇaṁsvōcitaṁ ca karma sattvaviśēṣābhyāsaścēti||16||

sattvavaisheShyakarANi punasteShAM teShAM prANinAM mAtApitRusattvAnyantarvatnyAHshrutayashcAbhIkShNaM svocitaM ca karma sattvavisheShAbhyAsashceti||16||
<div style="text-align:justify;">
The factors that determine the psychological disposition of the progeny depends upon the various mental traits of the parents, the impressions received by the pregnant woman, and the influence of past deeds (especially, the psychological makeup of the person in his/her past life). [16]
</div>
यथोक्तेन विधिनोपसंस्कृतशरीरयोः स्त्रीपुरुषयोर्मिश्रीभावमापन्नयोः शुक्रं शोणितेन सह संयोगं समेत्याव्यापन्नमव्यापन्नेनयोनावनुपहतायामप्रदुष्टे गर्भाशये गर्भमभिनिर्वर्तयत्येकान्तेन|
यथा-निर्मले वाससि सुपरिकल्पिते रञ्जनं समुदितगुणमुपनिपातादेव रागमभिनिर्वर्तयति, तद्वत्; यथा वाक्षीरंदध्नाऽभिषुतमभिषवणाद्विहाय स्वभावमापद्यते दधिभावं, शुक्रं तद्वत्||१७||

yathōktēna vidhinōpasaṁskr̥taśarīrayōḥ strīpuruṣayōrmiśrībhāvamāpannayōḥ śukraṁ śōṇitēna sahasaṁyōgaṁ samētyāvyāpannamavyāpannēna yōnāvanupahatāyāmapraduṣṭē garbhāśayēgarbhamabhinirvartayatyēkāntēna|
yathā- nirmalē vāsasi suparikalpitē rañjanaṁ samuditaguṇamupanipātādēva rāgamabhinirvartayati,tadvat; yathā vā kṣīraṁ dadhnā'bhiṣutamabhiṣavaṇādvihāya svabhāvamāpadyatē dadhibhāvaṁ, śukraṁtadvat||17||

yathoktena vidhinopasaMskRutasharIrayoH strIpuruShayormishrIbhAvamApannayoH shukraM shoNitenasaha saMyogaM sametyAvyApannamavyApannena yonAvanupahatAyAmapraduShTe garbhAshayegarbhamabhinirvartayatyekAntena|
yathA- nirmale vAsasi suparikalpite ra~jjanaM samuditaguNamupanipAtAdeva rAgamabhinirvartayati,tadvat; yathA vA kShIraM dadhnA~abhiShutamabhiShavaNAdvihAya svabhAvamApadyate dadhibhAvaM,shukraM tadvat||17||
<div style="text-align:justify;">
When a couple, whose body and mind are purified by above mentioned methods, engages in sexual intercourse, the undamaged sperm unites with the healthy ovum in a clean genital tract and the healthy uterus is home to an embryo with all the desired characters. Just as a well-washed cloth catches the colour of good dye instantly or milk, when mixed with drops of curd, transforms into curd leaving its original characters, the seeds acquire the positive attributes of the parents and the environment. [17]
</div>
एवमभिनिर्वर्तमानस्य गर्भस्य स्त्रीपुरुषत्वे हेतुः पूर्वमुक्तः|
यथा हि बीजमनुपतप्तमुप्तं स्वां स्वां प्रकृतिमनुविधीयते व्रीहिर्वा व्रीहित्वं यवो वा यवत्वं तथा स्त्रीपुरुषावपि यथोक्तंहेतुविभागमनुविधीयेते||१८||

ēvamabhinirvartamānasya garbhasya strīpuruṣatvē hētuḥ pūrvamuktaḥ|
yathā hi bījamanupataptamuptaṁ svāṁ svāṁ prakr̥timanuvidhīyatē vrīhirvā vrīhitvaṁ yavō vā yavatvaṁtathā strīpuruṣāvapi yathōktaṁ hētuvibhāgamanuvidhīyētē||18||
evamabhinirvartamAnasya garbhasya strIpuruShatve hetuH pUrvamuktaH|
yathA hi bIjamanupataptamuptaM svAM svAM prakRutimanuvidhIyate vrIhirvA vrIhitvaM yavo vA yavatvaMtathA strIpuruShAvapi yathoktaM hetuvibhAgamanuvidhIyete||18||
<div style="text-align:justify;">
Factors determining the sex of an embryo have already been explained. Just as an undamaged seed when sown reproduces its own kind, such as the paddy seed germinates into paddy and the barley seed produces barley, so too men and women beget children possessing the natural characteristics of their parents. [18]
</div>
==== Factors that can change the progeny's sex before birth ====

तयोः कर्मणा वेदोक्तेन विवर्तनमुपदिश्यते [१] प्राग्व्यक्तीभावात् प्रयुक्तेन सम्यक्|
कर्मणां हि देशकालसम्पदुपेतानां नियतमिष्टफलत्वं, तथेतरेषामितरत्वम्|
तस्मादापन्नगर्भां स्त्रियमभिसमीक्ष्य प्राग्व्यक्तीभावाद्गर्भस्य पुंसवनमस्यै दद्यात्|
गोष्ठे जातस्य न्यग्रोधस्य प्रागुत्तराभ्यां शाखाभ्यां शुङ्गे अनुपहते आदाय द्वाभ्यां धान्यमाषाभ्यां सम्पदुपेताभ्यांगौरसर्षपाभ्यां वा सह दध्नि प्रक्षिप्य पुष्येण पिबेत्, तथैवापराञ्जीवकर्षभकापामार्गसहचरकल्कांश्च युगपदेकैकशो यथेष्टंवाऽप्युपसंस्कृत्य पयसा, कुड्यकीटकं मत्स्यकं वोदकाञ्जलौ प्रक्षिप्य पुष्येण पिबेत्, तथा कनकमयान् राजतानायसांश्चपुरुषकानग्निवर्णानणुप्रमाणान् दध्नि पयस्युदकाञ्जलौ वा प्रक्षिप्य पिबेदनवशेषतः पुष्येण, पुष्येणैव च शालिपिष्टस्यपच्यमानस्योष्माणमुपाघ्राय तस्यैव च पिष्टस्योदकसंसृष्टस्य रसं देहल्यामुपनिधाय [२] दक्षिणे नासापुटे स्वयमासिञ्चेत्पिचुना|
यच्चान्यदपि ब्राह्मणा ब्रूयुराप्ता वा स्त्रियः पुंसवनमिष्टं तच्चानुष्ठेयम्|
इति पुंसवनानि||१९||

tayōḥ karmaṇā vēdōktēna vivartanamupadiśyatē [1] prāgvyaktībhāvāt prayuktēna samyak|
karmaṇāṁ hi dēśakālasampadupētānāṁ niyatamiṣṭaphalatvaṁ, tathētarēṣāmitaratvam|
tasmādāpannagarbhāṁ striyamabhisamīkṣya prāgvyaktībhāvādgarbhasya puṁsavanamasyai dadyāt|
gōṣṭhē jātasya nyagrōdhasya prāguttarābhyāṁ śākhābhyāṁ śuṅgē anupahatē ādāya dvābhyāṁdhānyamāṣābhyāṁ sampadupētābhyāṁ gaurasarṣapābhyāṁ vā saha dadhni prakṣipya puṣyēṇa pibēt,tathaivāparāñjīvakarṣabhakāpāmārgasahacarakalkāṁśca yugapadēkaikaśō yathēṣṭaṁvā'pyupasaṁskr̥tya payasā, kuḍyakīṭakaṁ matsyakaṁ vōdakāñjalau prakṣipya puṣyēṇa pibēt, tathākanakamayān rājatānāyasāṁśca puruṣakānagnivarṇānaṇupramāṇān dadhni payasyudakāñjalau vāprakṣipya pibēdanavaśēṣataḥ puṣyēṇa, puṣyēṇaiva ca śālipiṣṭasya pacyamānasyōṣmāṇamupāghrāyatasyaiva ca piṣṭasyōdakasaṁsr̥ṣṭasya rasaṁ dēhalyāmupanidhāya [2] dakṣiṇē nāsāpuṭē svayamāsiñcētpicunā|
yaccānyadapi brāhmaṇā brūyurāptā vā striyaḥ puṁsavanamiṣṭaṁ taccānuṣṭhēyam|
iti puṁsavanāni||19||

tayoH karmaNA vedoktena vivartanamupadishyate [1] prAgvyaktIbhAvAt prayuktena samyak|
karmaNAM hi deshakAlasampadupetAnAM niyatamiShTaphalatvaM, tathetareShAmitaratvam|
tasmAdApannagarbhAM striyamabhisamIkShya prAgvyaktIbhAvAdgarbhasya puMsavanamasyai dadyAt|
goShThe jAtasya nyagrodhasya prAguttarAbhyAM shAkhAbhyAM shu~gge anupahate AdAya dvAbhyAMdhAnyamAShAbhyAM sampadupetAbhyAM gaurasarShapAbhyAM vA saha dadhni prakShipya puShyeNapibet, tathaivAparA~jjIvakarShabhakApAmArgasahacarakalkAMshca yugapadekaikasho yatheShTaMvA~apyupasaMskRutya payasA, kuDyakITakaM matsyakaM vodakA~jjalau prakShipya puShyeNa pibet,tathA kanakamayAn rAjatAnAyasAMshca puruShakAnagnivarNAnaNupramANAn dadhnipayasyudakA~jjalau vA prakShipya pibedanavasheShataH puShyeNa, puShyeNaiva ca shAlipiShTasyapacyamAnasyoShmANamupAghrAya tasyaiva ca piShTasyodakasaMsRuShTasya rasaMdehalyAmupanidhAya [2] dakShiNe nAsApuTe svayamAsi~jcet picunA|
yaccAnyadapi brAhmaNA brUyurAptA vA striyaH puMsavanamiShTaM taccAnuShTheyam|
iti puMsavanAni||19||
<div style="text-align:justify;">
This verse lays down procedures mentioned in Vedic scriptures that, if administered correctly, could change the sex of an offspring even before its birth. When applied in the best of places and time, these procedures bear the desired fruit invariably always. Therefore, after examining the woman who has conceived recently, before the signs of gestation become apparent, (the physician) should administer ''pumsavana'' (procedures to beget a male offspring) on her.

On the day of the appearance of the auspicious ''pushyanakshatra'', one should collect two fresh leaf-buds from a banyan tree (Ficusreligiosa Linn), growing in a cow-pen (typically, an open ground or range where cows are kept), from its eastern or northern side branches. Then those leaf-buds should be added to curd and blended with either two good grains of ''masha'' (Phaseolus radiatus Linn - black gram) or white mustard seeds, and then given to the expectant mother to drink. Or, she may be given milk to drink that has been processed with the paste of ''jivaka, rishabhaka, apamarga'' (Achyranthesaspera Linn), and ''saireyaka'' (synonym of ''Sahachara''–Barleriacristata Linn) -either all mixed into a paste together or separately, as required. Or else she should be given a handful of water with ''kudyakitaka'' (a type of insect) or ''matsyaka'' (a type of small fish) on the occasion of ''pushyanakshatra''.
Similarly, on the event of ''pushyanakshatra'', she should drink handful of curd milk or water, without leaving any leftover, duly immersed with red hot miniature male statuettes made of gold, silver or and iron. Similarly, on the occasion of ''pushyanakshatra'', she should be made to inhale the steam emanating from steaming dish of powdered ''shali'' rice (while it is being cooked) and she herself should daub into her right nostril, using a cotton swab, drops of water from that same cooking pot, by placing (her head) on the ''daheli'' (door-sill).

In addition to these rituals, any other measures suggested by ''brahmanas'' or well versed (experienced and well-favoring) women as ''pumsavana'', should also be applied.

This concludes the verse on ''pumsavana''. [19]
</div>
==== Measures for the preservation of the embryo ====

अत ऊर्ध्वं गर्भस्थापनानि व्याख्यास्यामः
ऐन्द्री ब्राह्मी शतवीर्या सहस्रवीर्याऽमोघाऽव्यथा शिवाऽरिष्टा वाट्यपुष्पीविष्वक्सेनकान्ता चेत्यासामोषधीनां शिरसा दक्षिणेन वा पाणिना धारणं, एताभिश्चैव सिद्धस्य पयसः सर्पिषो वा पानम्,एताभिश्चैव पुष्ये पुष्ये स्नानं, सदा च ताः [१] समालभेत|
तथा सर्वासां जीवनीयोक्तानामोषधीनां सदोपयोगस्तैस्तैरुपयोगविधिभिः|
इति गर्भस्थापनानि व्याख्यातानि भवन्ति||२०||

ata ūrdhvaṁ garbhasthāpanāni vyākhyāsyāmaḥ- aindrī brāhmī śatavīryā sahasravīryā'mōghā'vyathāśivā'riṣṭā vāṭyapuṣpī viṣvaksēnakāntā cētyāsāmōṣadhīnāṁ śirasā dakṣiṇēna vā pāṇinā dhāraṇaṁ,ētābhiścaiva siddhasya payasaḥ sarpiṣō vā pānam, ētābhiścaiva puṣyē puṣyē snānaṁ, sadā ca tāḥ [1]samālabhēta|
tathā sarvāsāṁ jīvanīyōktānāmōṣadhīnāṁ sadōpayōgastaistairupayōgavidhibhiḥ|
iti garbhasthāpanāni vyākhyātāni bhavanti||20||

ata UrdhvaM garbhasthApanAni vyAkhyAsyAmaH- aindrI brAhmI shatavIryAsahasravIryA~amoghA~avyathA shivA~ariShTA vATyapuShpI viShvaksenakAntA cetyAsAmoShadhInAMshirasA dakShiNena vA pANinA dhAraNaM, etAbhishcaiva siddhasya payasaH sarpiSho vA pAnam,etAbhishcaiva puShye puShye snAnaM, sadA ca tAH [1] samAlabheta|
tathA sarvAsAM jIvanIyoktAnAmoShadhInAM sadopayogastaistairupayogavidhibhiH|
iti garbhasthApanAni vyAkhyAtAni bhavanti||20||
<div style="text-align:justify;">
From this verse onwards, measures for the preservation of embryo (''garbha'') have been explained. Some of these rituals or practices require the pregnant woman to wear herbs, such as ''aindri'' (Citrulluscolocynthis Schrad – Gorakshakarkati), ''brahmi'' (Bacopamonnieri Pennel), ''satavirya'' (Cynodon doctylon Pers), ''sahasravirya'' (a variety of ''durva'' - cynodon species, also known as ''durvadwaya''), ''amogha'' (''patala'' – Stereospermumsuaveolens DC), ''avyatha'' (''guduchi'' – Tinospora cordifolia Miers), ''shiva''(''haritaki'' – Terminaliachebula Linn), ''arishta'' (katukarohini – Piccrorhizakurroa Royle ex Benth), ''vatyapushpi'' (Pitabala – Sidacordifolia Linn), and ''vishwaksenakanta'' (''priyangu'' – Callicarpa macrophylla Vahl.),on her head or her right hand. Or she may drink milk or ghee processed with the above mentioned herbs, or bathe at every occasion of ''pushyanakshatra'' with water boiled using these herbs, and she should keep these herbs readily available always. Similarly, the regular use of all of the ''jivaniya'' class of herbs (life promoter group of herbs) in the (above) prescribed manner is also beneficial. Thus, the procedures for stabilization of embryo (''garbha'') have been described in this verse. [20]
</div>
==== Factors that could damage or destroy the embryo ====

गर्भोपघातकरास्त्विमे भावा भवन्ति; तद्यथा
उत्कटविषमकठिनासनसेविन्या [१] वातमूत्रपुरीषवेगानुपरुन्धत्यादारुणानुचितव्यायामसेविन्यास्तीक्ष्णोष्णातिमात्रसेविन्याः प्रमिताशनसेविन्या गर्भो म्रियतेऽन्तः कुक्षेः, अकाले वा स्रंसते,शोषी वा भवति; तथाऽभिघातप्रपीडनैः श्वभ्रकूपप्रपातदेशावलोकनैर्वाऽभीक्ष्णं मातुः प्रपतत्यकालेगर्भः,तथाऽतिमात्रसङ्क्षोभिभिर्यानैर्यानेन, अप्रियातिमात्रश्रवणैर्वा|
प्रततोत्तानशायिन्याः पुनर्गर्भस्य नाभ्याश्रया नाडी कण्ठमनुवेष्टयति, विवृतशायिनी नक्तञ्चारिणी चोन्मत्तं जनयति,अपस्मारिणं पुनः कलिकलहशीला, व्यवायशीला दुर्वपुषमह्रीकं स्त्रैणं वा, शोकनित्या भीतमपचितमल्पायुषं वा, अभिध्यात्री [२]परोपतापिनमीर्ष्युं स्त्रैणं वा, स्तेना त्वायासबहुलमतिद्रोहिणमकर्मशीलं वा, अमर्षिणी चण्डमौपधिकमसूयकं वा स्वप्ननित्यातन्द्रालुमबुधमल्पाग्निं वा, मद्यनित्या पिपासालुमल्पस्मृतिमनवस्थितचित्तं वा, गोधामांसप्राया [३] शार्करिणमश्मरिणंशनैर्मेहिणं वा, वराहमांसप्राया रक्ताक्षं क्रथनमतिपरुषरोमाणं वा, मत्स्यमांसनित्या चिरनिमेषं स्तब्धाक्षं वा, मधुरनित्याप्रमेहिणं मूकमतिस्थूलं वा, अम्लनित्या रक्तपित्तिनं त्वगक्षिरोगिणं वा, लवणनित्या शीघ्रवलीपलितं खालित्यरोगिणं वा,कटुकनित्या दुर्बलमल्पशुक्रमनपत्यं वा, तिक्तनित्या शोषिणमबलमनुपचितं वा, कषायनित्या श्यावमानाहिनमुदावर्तिनं वा,यद्यच्च यस्य यस्य व्याधेर्निदानमुक्तं तत्तदासेवमानाऽन्तर्वत्नी तन्निमित्तविकारबहुलमपत्यं जनयति|
पितृजास्तु शुक्रदोषा मातृजैरपचारैर्व्याख्याताः|
इति गर्भोपघातकरा भावा भवन्त्युक्ताः [४] |
तस्मादहितानाहारविहारान् प्रजासम्पदमिच्छन्ती स्त्री विशेषेण वर्जयेत्|
साध्वाचारा चात्मानमुपचरेद्धिताभ्यामाहारविहाराभ्यामिति||२१||

garbhōpaghātakarāstvimē bhāvā bhavanti; tadyathā- utkaṭaviṣamakaṭhināsanasēvinyā [1]vātamūtrapurīṣavēgānuparundhatyā dāruṇānucitavyāyāmasēvinyāstīkṣṇōṣṇātimātrasēvinyāḥpramitāśanasēvinyā garbhō mriyatē'ntaḥ kukṣēḥ, akālē vā sraṁsatē, śōṣī vā bhavati;tathā'bhighātaprapīḍanaiḥ śvabhrakūpaprapātadēśāvalōkanairvā'bhīkṣṇaṁ mātuḥprapatatyakālēgarbhaḥ, tathā'timātrasaṅkṣōbhibhiryānairyānēna, apriyātimātraśravaṇairvā|
pratatōttānaśāyinyāḥ punargarbhasya nābhyāśrayā nāḍī kaṇṭhamanuvēṣṭayati, vivr̥taśāyinī naktañcāriṇīcōnmattaṁ janayati, apasmāriṇaṁ punaḥ kalikalahaśīlā, vyavāyaśīlā durvapuṣamahrīkaṁ straiṇaṁ vā,śōkanityā bhītamapacitamalpāyuṣaṁ vā, abhidhyātrī [2] parōpatāpinamīrṣyuṁ straiṇaṁ vā, stēnātvāyāsabahulamatidrōhiṇamakarmaśīlaṁ vā, amarṣiṇī caṇḍamaupadhikamasūyakaṁ vā svapnanityātandrālumabudhamalpāgniṁ vā, madyanityā pipāsālumalpasmr̥timanavasthitacittaṁ vā,gōdhāmāṁsaprāyā [3] śārkariṇamaśmariṇaṁ śanairmēhiṇaṁ vā, varāhamāṁsaprāyā raktākṣaṁkrathanamatiparuṣarōmāṇaṁ vā, matsyamāṁsanityā ciranimēṣaṁ stabdhākṣaṁ vā, madhuranityāpramēhiṇaṁ mūkamatisthūlaṁ vā, amlanityā raktapittinaṁ tvagakṣirōgiṇaṁ vā, lavaṇanityāśīghravalīpalitaṁ khālityarōgiṇaṁ vā, kaṭukanityā durbalamalpaśukramanapatyaṁ vā, tiktanityāśōṣiṇamabalamanupacitaṁ vā, kaṣāyanityā śyāvamānāhinamudāvartinaṁ vā, yadyacca yasya yasyavyādhērnidānamuktaṁ tattadāsēvamānā'ntarvatnī tannimittavikārabahulamapatyaṁ janayati|
pitr̥jāstu śukradōṣā mātr̥jairapacārairvyākhyātāḥ|
iti garbhōpaghātakarā bhāvā bhavantyuktāḥ [4] |
tasmādahitānāhāravihārān prajāsampadamicchantī strī viśēṣēṇa varjayēt|
sādhvācārā cātmānamupacarēddhitābhyāmāhāravihārābhyāmiti||21||

garbhopaghAtakarAstvime bhAvA bhavanti; tadyathA- utkaTaviShamakaThinAsanasevinyA [1]vAtamUtrapurIShavegAnuparundhatyA dAruNAnucitavyAyAmasevinyAstIkShNoShNAtimAtrasevinyAHpramitAshanasevinyA garbho mriyate~antaH kukSheH, akAle vA sraMsate, shoShI vA bhavati;tathA~abhighAtaprapIDanaiH shvabhrakUpaprapAtadeshAvalokanairvA~abhIkShNaM mAtuHprapatatyakAlegarbhaH, tathA~atimAtrasa~gkShobhibhiryAnairyAnena, apriyAtimAtrashravaNairvA|
pratatottAnashAyinyAH punargarbhasya nAbhyAshrayA nADI kaNThamanuveShTayati, vivRutashAyinInakta~jcAriNI conmattaM janayati, apasmAriNaM punaH kalikalahashIlA, vyavAyashIlAdurvapuShamahrIkaM straiNaM vA, shokanityA bhItamapacitamalpAyuShaM vA, abhidhyAtrI [2]paropatApinamIrShyuM straiNaM vA, stenA tvAyAsabahulamatidrohiNamakarmashIlaM vA, amarShiNIcaNDamaupadhikamasUyakaM vA svapnanityA tandrAlumabudhamalpAgniM vA, madyanityApipAsAlumalpasmRutimanavasthitacittaM vA, godhAmAMsaprAyA [3] shArkariNamashmariNaMshanairmehiNaM vA, varAhamAMsaprAyA raktAkShaM krathanamatiparuSharomANaM vA,matsyamAMsanityA ciranimeShaM stabdhAkShaM vA, madhuranityA pramehiNaM mUkamatisthUlaM vA,amlanityA raktapittinaM tvagakShirogiNaM vA, lavaNanityA shIghravalIpalitaM khAlityarogiNaM vA,kaTukanityA durbalamalpashukramanapatyaM vA, tiktanityA shoShiNamabalamanupacitaM vA,kaShAyanityA shyAvamAnAhinamudAvartinaM vA, yadyacca yasya yasya vyAdhernidAnamuktaMtattadAsevamAnA~antarvatnI tannimittavikArabahulamapatyaM janayati|
pitRujAstu shukradoShA mAtRujairapacArairvyAkhyAtAH|
iti garbhopaghAtakarA bhAvA bhavantyuktAH [4] |
tasmAdahitAnAhAravihArAn prajAsampadamicchantI strI visheSheNa varjayet|
sAdhvAcArA cAtmAnamupacareddhitAbhyAmAhAravihArAbhyAmiti||21||
<div style="text-align:justify;">
The following factors may damage or destroy the embryo/fetus: a woman who sits in awkward positions, on uneven and hard seats, or suppresses the urge to pass flatulence, urine and bowel movement, or indulges in intensive or extreme forms of physical activities, or is excessively addicted to consuming pungent and hot things, or eats very sparingly. In such scenarios, her fetus could dry up in the womb or get delivered prematurely, or atrophy.

Similarly, by suffering repeated trauma or similar injuries, or on looking down from heights (e.g., from mountain-tops or cliffs, deep wells, etc.), the expectant mother is liable to miscarry. Similarly, she is liable to miscarry if she travels long distances in excessively jerky carriages, or is exposed to, for prolonged periods of time, loud and unpleasant noise.

By constantly resting or sleeping on her back, the umbilical cord attached to the fetus winds itself round the throat of the fetus, thus tending to strangulate it (so pregnant woman should avoid such posture). Similarly, a woman who sleeps in open air or is used to walking at night is prone to giving birth to a mentally-challenged child. If the woman indulges in too much of quarrels and fights, the child could become epileptic. A woman who indulges in sexual practice excessively (or a nymphomaniac) will give birth to truant with a passion for women. A woman under constant grief would give birth to a timid, or under-developed or short-lived child. A woman who always thinks ill of others will give birth to a delinquent or an anti-social. A woman who is a thief will give birth to a lazy child who is wicked and inept, while an intolerant woman would give birth to a child who is of fierce, deceitful and jealous nature. A woman who sleeps for long hours would give birth to a dull and unwise child with poor digestive powers, while a woman addicted to wines to a child who is ever-thirsty and fickle minded. A woman who consumes flesh and meat of ''godha'' (iguana) would give birth to a child afflicted with stones or ''shanairmeha'' (a type of urinary disorder where dribbling is seen), while a woman used to consume pork frequently would give birth to a child with red eyes, rough body-hair, and prone to suffering from severe respiratory disorders. A woman used to consume fish excessively would give birth to a child with lagophthalmos and related eye disorders, while a woman used to eating a lot of sweets is prone to giving birth to a dumb or excessively obese child or a child afflicted with diabetes. A woman fond of sour things is prone to giving birth to an offspring suffering from bleeding disorders or diseases of skin and eyes, while a woman addicted to salt or salty food articles may give birth to a child with early onset of wrinkles, grey hair or baldness. A woman used to pungent substances in excess may give birth to a weak child, deficient in semen and impotent, while a woman using bitter substances in excess may give birth to a child with emaciated, weak or undeveloped body. A woman habituated to excessive use of astringents may give birth to a child with blackish complexion, suffering from constipation and ''udavarta'' (misperistalsis).

In summary, a pregnant woman indulging in unhealthy dietary and lifestyle activities that could cause certain diseases would increase the risk of her off spring getting afflicted with similar (or more virulent) disorders. From the father’s side, defects in semen could occur due to above mentioned factors for mother. Hence, a woman desirous of a child with excellent qualities should abstain from all forms of addictions as well as unhealthy dietary and lifestyle activities. [21]
</div>
==== Treating pregnant women afflicted with ailments ====

व्याधींश्चास्या मृदुमधुरशिशिरसुखसुकुमारप्रायैरौषधाहारोपचारैरुपचरेत्, न चास्या वमनविरेचनशिरोविरेचनानि प्रयोजयेत्, नरक्तमवसेचयेत्, सर्वकालं च नास्थापनमनुवासनं वा कुर्यादन्यत्रात्ययिकाद्व्याधेः|
अष्टमं मासमुपादाय वमनादिसाध्येषु पुनर्विकारेष्वात्ययिकेषु मृदुभिर्वमनादिभिस्तदर्थकारिभिर्वोपचारः स्यात्|
पूर्णमिव तैलपात्रमसङ्क्षोभयताऽन्तर्वत्नी [१] भवत्युपचर्या||२२||

vyādhīṁścāsyā mr̥dumadhuraśiśirasukhasukumāraprāyairauṣadhāhārōpacārairupacarēt, na cāsyāvamanavirēcanaśirōvirēcanāni prayōjayēt, na raktamavasēcayēt, sarvakālaṁ ca nāsthāpanamanuvāsanaṁ vākuryādanyatrātyayikādvyādhēḥ|
aṣṭamaṁ māsamupādāya vamanādisādhyēṣu punarvikārēṣvātyayikēṣumr̥dubhirvamanādibhistadarthakāribhirvōpacāraḥ syāt|
pūrṇamiva tailapātramasaṅkṣōbhayatā'ntarvatnī [1] bhavatyupacaryā||22||

vyAdhIMshcAsyA mRudumadhurashishirasukhasukumAraprAyairauShadhAhAropacArairupacaret, na cAsyAvamanavirecanashirovirecanAni prayojayet, na raktamavasecayet, sarvakAlaM ca nAsthApanamanuvAsanaM vAkuryAdanyatrAtyayikAdvyAdheH|
aShTamaM mAsamupAdAya vamanAdisAdhyeShu punarvikAreShvAtyayikeShumRudubhirvamanAdibhistadarthakAribhirvopacAraH syAt|
pUrNamiva tailapAtramasa~gkShobhayatA~antarvatnI [1] bhavatyupacaryA||22||
<div style="text-align:justify;">
Any ailment or disease afflicting a pregnant woman should be treated very delicately, by means of medicaments and diet that are mainly soft, palatable, cooling, pleasant and mild. She should not be subjected to emetics, purgatives, or ''nasya'' (errhines), or to practices such as bloodletting. She should not be, at any time, administered corrective and unctuous enema, except in very serious emergency situations. In her final trimester, the pregnant woman, if in emergency conditions wherein emesis is urgently required, should only be treated by means of very mild emetics etc., or by its substitutes. A pregnant woman should be handled like a pot brimful of oil, which can spill on irritation i.e., very delicately. [22]
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==== Occurrences of bleeding during pregnancy ====

सा चेदपचाराद् द्वयोस्त्रिषु वा मासेषु पुष्पं पश्येन्नास्या गर्भः स्थास्यतीति विद्यात्; अजातसारो हि तस्मिन् काले भवतिगर्भः||२३||
sā cēdapacārād dvayōstriṣu vā māsēṣu puṣpaṁ paśyēnnāsyā garbhaḥ sthāsyatīti vidyāt; ajātasārō hi tasmin kālēbhavati garbhaḥ||23||
sA cedapacArAd dvayostriShu vA mAseShu puShpaM pashyennAsyA garbhaH sthAsyatIti vidyAt; ajAtasAro hi tasmin kAle bhavatigarbhaH||23||

If, as the result of wrongful behavior, bleeding occurs in a pregnant woman either in the second or third month, one should conclude that the conception will not be sustainable, as the embryo during this period is still immature. [23]

सा चेच्चतुष्प्रभृतिषु मासेषुक्रोधशोकासूयेर्ष्याभयत्रासव्यवायव्यायामसङ्क्षोभसन्धारणविषमाशनशयनस्थानक्षुत्पिपासातियोगात् कदाहाराद्वा पुष्पंपश्येत्, तस्या गर्भस्थापनविधिमुपदेक्ष्यामः|
पुष्पदर्शनादेवैनां ब्रूयात्- शयनं तावन्मृदुसुखशिशिरास्तरणसंस्तीर्णमीषदवनतशिरस्कं प्रतिपद्यस्वेति|
ततो यष्टीमधुकसर्पिर्भ्यां परमशिशिरवारिणी संस्थिताभ्यां पिचुमाप्लाव्योपस्थसमीपे स्थापयेत्तस्याः, तथाशतधौतसहस्रधौताभ्यां सर्पिर्भ्यामधोनाभेः सर्वतः प्रदिह्यात्, सर्वतश्च गव्येन चैनां पयसा सुशीतेन मधुकाम्बुना वान्यग्रोधादिकषायेण वा परिषेचयेदधो नाभेः, उदकं वा सुशीतमवगाहयेत्, क्षीरिणां कषायद्रुमाणां च स्वरसपरिपीतानि चेलानि [२]ग्राहयेत्, न्यग्रोधादिशुङ्गासिद्धयोर्वाक्षीरसर्पिषोः पिचुं ग्राहयेत्, अतश्चैवाक्षमात्रं प्राशयेत्, प्राशयेद्वा केवलं क्षीरसर्पिः,पद्मोत्पलकुमुदकिञ्जल्कांश्चास्यै समधुशर्करान् लेहार्थं दद्यात्, शृङ्गाटकपुष्करबीजकशेरुकान् भक्ष्णार्थं,गन्धप्रियङ्ग्वसितोत्पलशालूकोदुम्बरशलाटुन्यग्रोधशुङ्गानि वा पाययेदेनामाजेन पयसा, पयसा चैनांबलातिबलाशालिषष्टिकेक्षुमूलकाकोलीशृतेन समधुशर्करं रक्तशालीनामोदनं मृदुसुरभिशीतलं भोजयेत्,लावकपिञ्जलकुरङ्गशम्बरशशहरिणैणकालपुच्छकरसेन वा घृतसुसंस्कृतेन सुखशिशिरोपवातदेशस्थां भोजयेत्,क्रोधशोकायासव्यवायव्यायामेभ्यश्चाभिरक्षेत्, सौम्याभिश्चैनां कथाभिर्मनोनुकूलाभिरुपासीत; तथाऽस्या गर्भस्तिष्ठति||२४||

sā cēccatuṣprabhr̥tiṣu māsēṣukrōdhaśōkāsūyērṣyābhayatrāsavyavāyavyāyāmasaṅkṣōbhasandhāraṇaviṣamāśanaśayanasthānakṣutpipāsātiyōgātkadāhārādvā puṣpaṁ paśyēt, tasyā garbhasthāpanavidhimupadēkṣyāmaḥ|
puṣpadarśanādēvaināṁ brūyāt- śayanaṁ tāvanmr̥dusukhaśiśirāstaraṇasaṁstīrṇamīṣadavanataśiraskaṁpratipadyasvēti|
tatō yaṣṭīmadhukasarpirbhyāṁ paramaśiśiravāriṇī saṁsthitābhyāṁ picumāplāvyōpasthasamīpē sthāpayēttasyāḥ,tathā śatadhautasahasradhautābhyāṁ sarpirbhyāmadhōnābhēḥ sarvataḥ pradihyāt, sarvataśca gavyēna caināṁpayasā suśītēna madhukāmbunā vā nyagrōdhādikaṣāyēṇa vā pariṣēcayēdadhō nābhēḥ, udakaṁ vāsuśītamavagāhayēt, kṣīriṇāṁ kaṣāyadrumāṇāṁ ca svarasaparipītāni cēlāni [2] grāhayēt,nyagrōdhādiśuṅgāsiddhayōrvākṣīrasarpiṣōḥ picuṁ grāhayēt, ataścaivākṣamātraṁ prāśayēt, prāśayēdvā kēvalaṁkṣīrasarpiḥ, padmōtpalakumudakiñjalkāṁścāsyai samadhuśarkarān lēhārthaṁ dadyāt,śr̥ṅgāṭakapuṣkarabījakaśērukān bhakṣṇārthaṁ, gandhapriyaṅgvasitōtpalaśālūkōdumbaraśalāṭunyagrōdhaśuṅgānivā pāyayēdēnāmājēna payasā, payasā caināṁ balātibalāśāliṣaṣṭikēkṣumūlakākōlīśr̥tēna samadhuśarkaraṁraktaśālīnāmōdanaṁ mr̥dusurabhiśītalaṁ bhōjayēt,lāvakapiñjalakuraṅgaśambaraśaśahariṇaiṇakālapucchakarasēna vā ghr̥tasusaṁskr̥tēnasukhaśiśirōpavātadēśasthāṁ bhōjayēt, krōdhaśōkāyāsavyavāyavyāyāmēbhyaścābhirakṣēt, saumyābhiścaināṁkathābhirmanōnukūlābhirupāsīta; tathā'syā garbhastiṣṭhati||24||

sA ceccatuShprabhRutiShu mAseShukrodhashokAsUyerShyAbhayatrAsavyavAyavyAyAmasa~gkShobhasandhAraNaviShamAshanashayanasthAnakShutpipAsAtiyogAtkadAhArAdvA puShpaM pashyet, tasyA garbhasthApanavidhimupadekShyAmaH|
puShpadarshanAdevainAM brUyAt- shayanaM tAvanmRudusukhashishirAstaraNasaMstIrNamIShadavanatashiraskaMpratipadyasveti|
tato yaShTImadhukasarpirbhyAM paramashishiravAriNI saMsthitAbhyAM picumAplAvyopasthasamIpe sthApayettasyAH, tathAshatadhautasahasradhautAbhyAM sarpirbhyAmadhonAbheH sarvataH pradihyAt, sarvatashca gavyena cainAM payasA sushItenamadhukAmbunA vA nyagrodhAdikaShAyeNa vA pariShecayedadho nAbheH, udakaM vA sushItamavagAhayet, kShIriNAMkaShAyadrumANAM ca svarasaparipItAni celAni [2] grAhayet, nyagrodhAdishu~ggAsiddhayorvAkShIrasarpiShoH picuM grAhayet,atashcaivAkShamAtraM prAshayet, prAshayedvA kevalaM kShIrasarpiH, padmotpalakumudaki~jjalkAMshcAsyaisamadhusharkarAn lehArthaM dadyAt, shRu~ggATakapuShkarabIjakasherukAn bhakShNArthaM,gandhapriya~ggvasitotpalashAlUkodumbarashalATunyagrodhashu~ggAni vA pAyayedenAmAjena payasA, payasA cainAMbalAtibalAshAliShaShTikekShumUlakAkolIshRutena samadhusharkaraM raktashAlInAmodanaM mRudusurabhishItalaM bhojayet,lAvakapi~jjalakura~ggashambarashashahariNaiNakAlapucchakarasena vA ghRutasusaMskRutenasukhashishiropavAtadeshasthAM bhojayet, krodhashokAyAsavyavAyavyAyAmebhyashcAbhirakShet, saumyAbhishcainAMkathAbhirmanonukUlAbhirupAsIta; tathA~asyA garbhastiShThati||24||
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If the pregnant woman, in her second trimester or later, as a consequence of excessive anger, grief, intolerance, envy, fear, sex, exercise, agitation, suppression of body urges, faulty eating, faulty lying down and standing habits, excessive hunger and thirst or as the result of malnutrition, starts to bleed, then the following course of treatment should be adopted to safeguard the conception from any mishap:
• As soon as the blood discharge is noticed, the patient should be instructed to lie down on a soft and comfortable couch with her head placed slightly lower than the rest of herbody.
• The physician should then place a cotton swab, immersed in medicated ghee prepared with yashtimadhu (Glycyrrhiza glabraLinn) and then kept in cold water, near or in the vaginal passage. She should also be annointed with shatadhautaor sahasradhauta ghrita (ghee washed a hundred or a thousand times with water or medicated decoctions) on or below the navel region. Similarly, she could also be sprinkled with cold milk or decoction of madhuka and nyagrodhadi class of (Ficusbengalensis Linn) herbs on or below her navel region, or she should take bath in tub of cold water. Cloth pieces soaked in the juice of ksheerivriksha (latex-yielding trees) class of herbs, or a cotton swab soaked in milk and ghee processed with leaf-buds of nyagrodhadi (Ficusbengalensis Linn) class of drugs should be inserted into her vagina. She should also consume ghee made up of milk in a quantity of aksha (about 10-12 ml) and treated with the same drugs as mentioned above. She should be offered a concoction made up of stamens of kamala (Nelumbo nucifera Gaertn.), utpala (Nymphaea alba Linn), and kumuda (a variety of Nymphaea species), mixed with honey and sugar linctus. She should eat singhataka (Trapabispinosa Roxb. – chestnut), pushkarabeeja (lotus seeds –Nelumbonucifera Gaertn.) and kasheruka (Scirpusgrossus Linn. f.). She may be given goat’s milk boiled with gandhapriyangu (Callicarpamacrophylla Vahl.), nilotpala (blue variety of Nymphaeaalba Linn), shaluka (rhizome of lotus), fruits of udumbara (Ficusracemosa Linn.) and leaf-buds of nyagrodha (Ficusbengalensis Linn). She should eat soft, fragrant and cooked shali rice of red variety (Orizasativa Linn.), added with honey and sugar along with milk boiled with roots of bala (Sidacordifolia Linn.), atibala (Abutilonindicum Linn.), shali, sashtika (both varieties of Orizasativa Linn.) ikshu (sugarcane- Saccharumofficinarum Linn.), and kakoli. Or she should eat the above rice along with the soup made of meat that is well-seasoned with ghee, of lava (Common Quail), kapinjala (Grey Partridge), kuranga (Roe deer), sambara (Indian Sambar), shasha (Rabbit), harina (Black Buck), ena (Antelope) orkalapuchchaka (Black tailed Deer), while sitting comfortably in a cool and well ventilated place. She should be protected from anger, grief, overexertion, activities that are sexual or intensely physical in nature, and should be entertained with pleasing and comforting stories. By following these methods, the embryo (garbha) is saved from abortion. [24]
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यस्याः पुनरामान्वयात् पुष्पदर्शनं स्यात्, प्रायस्तस्यास्तद्गर्भोपघातकरं भवति,
विरुद्धोपक्रमत्वात्तयोः||२५||

yasyāḥ punarāmānvayāt puṣpadarśanaṁ syāt, prāyastasyāstadgarbhōpaghātakaraṁ bhavati,
viruddhōpakramatvāttayōḥ||25||

yasyAH punarAmAnvayAt puShpadarshanaM syAt, prAyastasyAstadgarbhopaghAtakaraM bhavati,
viruddhopakramatvAttayoH||25||

If vaginal bleeding occurs as the result of ama (indigestion), there is a very high probability of miscarriage and abortion of the foetus and it may not be avoidable, because the two disorders (vaginal bleeding and indigestion) require mutually opposite treatments. [25]

यस्याः पुनरुष्णतीक्ष्णोपयोगाद्गर्भिण्या महति सञ्जातसारे गर्भे पुष्पदर्शनं स्यादन्यो वा योनिस्रावस्तस्या गर्भो वृद्धिं नप्राप्नोति निःस्रुतत्वात्; स कालमवतिष्ठतेऽतिमात्रं, तमुपविष्टकमित्याचक्षते केचित्|
उपवासव्रतकर्मपरायाः पुनः कदाहारायाः स्नेहद्वेषिण्या वातप्रकोपणोक्तान्यासेवमानाया गर्भो वृद्धिं न प्राप्नोतिपरिशुष्कत्वात्; स चापि कालमवतिष्ठतेऽतिमात्रम् [१] , अस्पन्दनश्च भवति, तं तु नागोदरमित्याचक्षते||२६||

yasyāḥ punaruṣṇatīkṣṇōpayōgādgarbhiṇyā mahati sañjātasārē garbhē puṣpadarśanaṁ syādanyō vāyōnisrāvastasyā garbhō vr̥ddhiṁ na prāpnōti niḥsrutatvāt; sa kālamavatiṣṭhatē'timātraṁ,tamupaviṣṭakamityācakṣatē kēcit|
upavāsavratakarmaparāyāḥ punaḥ kadāhārāyāḥ snēhadvēṣiṇyā vātaprakōpaṇōktānyāsēvamānāyāgarbhō vr̥ddhiṁ na prāpnōti pariśuṣkatvāt; sa cāpi kālamavatiṣṭhatē'timātram [1] , aspandanaśca bhavati,taṁ tu nāgōdaramityācakṣatē||26||

yasyAH punaruShNatIkShNopayogAdgarbhiNyA mahati sa~jjAtasAre garbhe puShpadarshanaM syAdanyovA yonisrAvastasyA garbho vRuddhiM na prApnoti niHsrutatvAt; sa kAlamavatiShThate~atimAtraM,tamupaviShTakamityAcakShate kecit|
upavAsavratakarmaparAyAH punaH kadAhArAyAH snehadveShiNyA vAtaprakopaNoktAnyAsevamAnAyAgarbho vRuddhiM na prApnoti parishuShkatvAt; sa cApi kAlamavatiShThate~atimAtram [1] , aspandanashcabhavati, taM tu nAgodaramityAcakShate||26||
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If a pregnant woman with a large and well-formed foetus starts experiencing bleeding or other forms of uterine discharge as aresult of indulgence in hot and pungent food articles, the foetus will cease growing. Such a foetus will stay for a long time in the mother’s womb and this condition is referred to as Upavistaka (or prolonged gestation).
Similarly, in a pregnant woman who suffers from malnutrition due to overindulgence in rituals requiring fasting, or who avoids unctuous articles and indulges in vata-provoking dietary or lifestyle activities, foetus will not develop due to it getting weaned away from nutrition, and such foetus will remain in the womb for a long period of time without developing. This condition is called Nagodara (elephantine gestation). [26]
</div>
==== Specific Therapeutic courses for the management of Intrauterine Growth Retardation ====

नार्योस्तयोरुभयोरपि चिकित्सितविशेषमुपदेक्ष्यामः- भौतिकजीवनीयबृंहणीयमधुरवातहरसिद्धानां सर्पिषां पयसामामगर्भाणांचोपयोगो गर्भवृद्धिकरः; तथा सम्भोजनमेतैरेव सिद्धैश्च घृतादिभिः सुभिक्षायाः [१] , अभीक्ष्णंयानवाहनापमार्जनावजृम्भणैरुपपादनमिति||२७||

nāryōstayōrubhayōrapi cikitsitaviśēṣamupadēkṣyāmaḥ-bhautikajīvanīyabr̥ṁhaṇīyamadhuravātaharasiddhānāṁ sarpiṣāṁ payasāmāmagarbhāṇāṁ cōpayōgōgarbhavr̥ddhikaraḥ; tathā sambhōjanamētairēva siddhaiśca ghr̥tādibhiḥ subhikṣāyāḥ [1] , abhīkṣṇaṁyānavāhanāpamārjanāvajr̥mbhaṇairupapādanamiti||27|
nAryostayorubhayorapi cikitsitavisheShamupadekShyAmaH-bhautikajIvanIyabRuMhaNIyamadhuravAtaharasiddhAnAM sarpiShAM payasAmAmagarbhANAM copayogogarbhavRuddhikaraH; tathA sambhojanametaireva siddhaishca ghRutAdibhiH subhikShAyAH [1] ,abhIkShNaM yAnavAhanApamArjanAvajRumbhaNairupapAdanamiti||27||
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Now (we) shall expound the specific therapeutic courses of treatment recommended for the management of ''upavistaka'' (intrauterine growth retardation because of decreased nutrient transfer) and nagodara (IUGR because of malnourishment). Ghee and milk which have been medicated with ''bhautika'' (drugs having anti-evil spirits / germs action), ''jivaniya'' (life-promoting), ''brimhaniya'' (bulk promoting), ''madhura'' (sweet) and ''vatahara'' (''vata'' alleviating) drugs help stimulate the development of the fetus. Immature or undeveloped fetus (i.e. poultry eggs) with milk also acts as an effective growth stimulant for the fetus. Ample use of medicated ghee also serves to nourish the mother and her fetus. These therapeutic courses should be supplemented with walking, moving in carriages (that do not jerk a lot), physical cleansing and engaging in mild exercises and other forms of physical activities. [27]
</div>
यस्याः पुनर्गर्भः प्रसुप्तो न स्पन्दते तां श्येनमत्स्यगवयशिखिताम्रचूडतित्तिरीणामन्यतमस्य सर्पिष्मता रसेन माषयूषेण वाप्रभूतसर्पिषा मूलकयूषेण वा रक्तशालीनामोदनं मृदुमधुरशीतलं भोजयेत्|
तैलाभ्यङ्गेन चास्या अभीक्ष्णमुदरबस्तिवङ्क्षणोरुकटीपार्श्वपृष्ठप्रदेशानीषदुष्णेनोपचरेत्||२८||

yasyāḥ punargarbhaḥ prasuptō na spandatē tāṁśyēnamatsyagavayaśikhitāmracūḍatittirīṇāmanyatamasya sarpiṣmatā rasēna māṣayūṣēṇa vāprabhūtasarpiṣā mūlakayūṣēṇa vā raktaśālīnāmōdanaṁ mr̥dumadhuraśītalaṁ bhōjayēt|
tailābhyaṅgēna cāsyā abhīkṣṇamudarabastivaṅkṣaṇōrukaṭīpārśvapr̥ṣṭhapradēśānīṣaduṣṇēnōpacarēt||28||

yasyAH punargarbhaH prasupto na spandate tAMshyenamatsyagavayashikhitAmracUDatittirINAmanyatamasya sarpiShmatA rasena mAShayUSheNa vAprabhUtasarpiShA mUlakayUSheNa vA raktashAlInAmodanaM mRudumadhurashItalaM bhojayet|
tailAbhya~ggena cAsyAabhIkShNamudarabastiva~gkShaNorukaTIpArshvapRuShThapradeshAnIShaduShNenopacaret||28||
<div style="text-align:justify;">
If the fetal development has stalled or is slowed (for various reasons), then the pregnant woman should be advised to take ''shali'' rice (cooked Oriza sativa Linn.) which is soft, sweet and cool, with meat juices (seasoned with ghee), of one or more of the following animals- the hawk, fish, ''gayal'', peacock, rooster, or partridge - or with gruel of ''masha'' (Phaseolusradiates Linn - black gram) or with the soup of radish, with plenty of ghee. She also should be massaged with lukewarm oil (''tila taila''-gingilly oil) over her abdomen, pelvic region, groin, thigh, waist, sides and back. [28]
</div>
==== Constipation during Final Trimester ====

यस्याः पुनरुदावर्तविबन्धः स्यादष्टमे मासे न चानुवासनसाध्यं मन्येत ततस्तस्यास्तद्विकारप्रशमनमुपकल्पयेन्निरूहम्|
उदावर्तो ह्युपेक्षितः सहसा सगर्भां [२] गर्भिणीं गर्भमथवाऽतिपातयेत्|

तत्र वीरणशालिषष्टिककुशकाशेक्षुवालिकावेतसपरिव्याधमूलानां भूतीकानन्ताकाश्मर्यपरूषकमधुकमृद्वीकानां चपयसाऽर्धोदकेनोद्गमय्य रसं प्रियालबिभीतकमज्जतिलकल्कसम्प्रयुक्तमीषल्लवणमनत्युष्णं च निरूहं दद्यात्|
व्यपगतविबन्धां चैनां सुखसलिलपरिषिक्ताङ्गीं स्थैर्यकरमविदाहिनमाहारं भुक्तवतीं सायं मधुरकसिद्धेन तैलेनानुवासयेत्|
न्युब्जां त्वेनामास्थापनानुवासनाभ्यामुपचरेत्||२९||

yasyāḥ punarudāvartavibandhaḥ syādaṣṭamē māsē na cānuvāsanasādhyaṁ manyētatatastasyāstadvikārapraśamanamupakalpayēnnirūham|
udāvartō hyupēkṣitaḥ sahasā sagarbhāṁ [2] garbhiṇīṁ garbhamathavā'tipātayēt|
tatra vīraṇaśāliṣaṣṭikakuśakāśēkṣuvālikāvētasaparivyādhamūlānāṁbhūtīkānantākāśmaryaparūṣakamadhukamr̥dvīkānāṁ ca payasā'rdhōdakēnōdgamayya rasaṁpriyālabibhītakamajjatilakalkasamprayuktamīṣallavaṇamanatyuṣṇaṁ ca nirūhaṁ dadyāt|
vyapagatavibandhāṁ caināṁ sukhasalilapariṣiktāṅgīṁ sthairyakaramavidāhinamāhāraṁ bhuktavatīṁsāyaṁ madhurakasiddhēna tailēnānuvāsayēt|
nyubjāṁ tvēnāmāsthāpanānuvāsanābhyāmupacarēt||29||

yasyAH punarudAvartavibandhaH syAdaShTame mAse na cAnuvAsanasAdhyaM manyetatatastasyAstadvikAraprashamanamupakalpayennirUham|
udAvarto hyupekShitaH sahasA sagarbhAM [2] garbhiNIM garbhamathavA~atipAtayet|
tatra vIraNashAliShaShTikakushakAshekShuvAlikAvetasaparivyAdhamUlAnAMbhUtIkAnantAkAshmaryaparUShakamadhukamRudvIkAnAM ca payasA~ardhodakenodgamayya rasaMpriyAlabibhItakamajjatilakalkasamprayuktamIShallavaNamanatyuShNaM ca nirUhaM dadyAt|
vyapagatavibandhAM cainAM sukhasalilapariShiktA~ggIM sthairyakaramavidAhinamAhAraM bhuktavatIMsAyaM madhurakasiddhena tailenAnuvAsayet|
nyubjAM tvenAmAsthApanAnuvAsanAbhyAmupacaret||29||
<div style="text-align:justify;">
In case the pregnant woman develops constipation due to ''udavarta'' (misperistalsis) in the eighth month and if it cannot be treated with unctuous enema, then the physician should treat her with non-unctuous enema that may relieve her condition. If the disorder of misperistalsis is neglected, it may abruptly turn fatal for both the mother and the fetus or for the fetus alone. In such conditions, a decoction prepared with the roots of ''virana'' (Veriveriazizanoides Nash), ''shali'' (Oryzasativa Linn), ''sashtika'' (a variety of Oryza species), ''kusha'' (Desmostachya bipinnata Staf), ''kasha'' (Saccharum spontaneum Linn.), ''ikshuvalika'' (Asteracanthalongifolia Nees), ''vetasa'' (Salixcaprea Linn.), ''parivyadha'' (type of Vetasa, Salix species) ''bhutika'' (Trachyspermumammi Sprague), ''ananta'' (Hemidesmus indicusR. B.), ''kashmarya'' (Gmelinaarborea Linn.), ''parushaka'' (Grewiaasiatica Linn.), ''madhuka'' (Glycyrrhizaglabra Linn) and ''mridwika'' (Vitisvinifera Linn.), prepared with milk and mixed with half that volume of water containing paste of ''priyala'' (Buchananialanzan Spreng), ''bibhitakamajja'' (the seed pulp of Terminaliabelerica Roxb.), ''tila'' (Sesamumindicum Linn.) and salt (''Saindhava'' – rock salt) should be used for non-unctuous enema. Once the constipation is relieved, she should be sprinkled with lukewarm water and then given food having stabilizing properties and which will not cause any burning sensation.

In the evening, she should be treated with unctuous enema of oil prepared with sweet drugs. The enema should be administered to her in a bent-down position (fetal, knee-to-the-chest position). [29]
</div>
==== Symptoms of death of fetus in the womb ====

यस्याः पुनरतिमात्रदोषोपचयाद्वा तीक्ष्णोष्णातिमात्रसेवनाद्वा वातमूत्रपुरीषवेगविधारणैर्वा विषमाश(स)नशयनस्थानसम्पीडनाभिघातैर्वा क्रोधशोकेर्ष्याभयत्रासादिभिर्वा साहसैर्वाऽपरैः कर्मभिरन्तःकुक्षेर्गर्भो [१] म्रियते, तस्याःस्तिमितं स्तब्धमुदरमाततं शीतमश्मान्तर्गतमिव भवत्यस्पन्दनो गर्भः, शूलमधिकमुपजायते, न चाव्यः प्रादुर्भवन्ति, योनिर्नप्रस्रवति, अक्षिणी चास्याः स्रस्ते भवतः, ताम्यति, व्यथते, भ्रमते, श्वसिति, अरतिबहुला च भवति, न चास्या वेगप्रादुर्भावोयथावदुपलभ्यते; इत्येवंलक्षणां स्त्रियं मृतगर्भेयमिति विद्यात्||३०||

yasyāḥ punaratimātradōṣōpacayādvā tīkṣṇōṣṇātimātrasēvanādvā vātamūtrapurīṣavēgavidhāraṇairvāviṣamāśa(sa)naśayanasthānasampīḍanābhighātairvā krōdhaśōkērṣyābhayatrāsādibhirvāsāhasairvā'paraiḥ karmabhirantaḥkukṣērgarbhō [1] mriyatē, tasyāḥ stimitaṁ stabdhamudaramātataṁśītamaśmāntargatamiva bhavatyaspandanō garbhaḥ, śūlamadhikamupajāyatē, na cāvyaḥ prādurbhavanti,yōnirna prasravati, akṣiṇī cāsyāḥ srastē bhavataḥ, tāmyati, vyathatē, bhramatē, śvasiti, aratibahulā cabhavati, na cāsyā vēgaprādurbhāvō yathāvadupalabhyatē; ityēvaṁlakṣaṇāṁ striyaṁ mr̥tagarbhēyamitividyāt||30||

yasyAH punaratimAtradoShopacayAdvA tIkShNoShNAtimAtrasevanAdvAvAtamUtrapurIShavegavidhAraNairvA viShamAsha(sa)nashayanasthAnasampIDanAbhighAtairvAkrodhashokerShyAbhayatrAsAdibhirvA sAhasairvA~aparaiH karmabhirantaHkukShergarbho [1] mriyate,tasyAH stimitaM stabdhamudaramAtataM shItamashmAntargatamiva bhavatyaspandano garbhaH,shUlamadhikamupajAyate, na cAvyaH prAdurbhavanti, yonirna prasravati, akShiNI cAsyAH srastebhavataH, tAmyati, vyathate, bhramate, shvasiti, aratibahulA ca bhavati, na cAsyA vegaprAdurbhAvoyathAvadupalabhyate; ityevaMlakShaNAM striyaM mRutagarbheyamiti vidyAt||30||
<div style="text-align:justify;">
If the fetus dies in the womb as a result of excessive increase of ''doshas'' caused due to over-indulgence in pungent and hot things, or due to suppression of urges to pass flatulence, urine and bowel movement, or due to faulty eating, faulty sitting, lying down or standing or due to compression (of the womb) and injuries, or passion, grief, envy, horror, fear etc., or due to intensive/extreme physical activities, then the stomach will be still, rigid, bloated up, cold and stony-hard. This condition would be accompanied by severe pain in the stomach, but the labor pains do not set in and there is no discharge. The woman’s eyes will droop and she may feel nauseous, pain, is in agony, giddiness, and breathlessness with intense restlessness. The natural urges also will not be proper as routine. If these features are seen in a pregnant woman, then it should be construed that the fetus is dead. [30]
</div>
==== Treatment of dead fetus in the womb ====

तस्य गर्भशल्यस्य जरायुप्रपातनं कर्म संशमनमित्याहुरेके, मन्त्रादिकमथर्ववेदविहितमित्येके, परिदृष्टकर्मणा शल्यहर्त्राहरणमित्येके|
व्यपगतगर्भशल्यां तु स्त्रियमामगर्भां सुरासीध्वरिष्टमधुमदिरासवानामन्यतममग्रे सामर्थ्यतःपाययेद्गर्भकोष्ठशुद्ध्यर्थमर्तिविस्मरणार्थं प्रहर्षणार्थं च, अतः परं सम्प्रीणनैर्बलानुरक्षिभिरस्नेहसम्प्रयुक्तैर्यवाग्वादिभिर्वा [१]तत्कालयोगिभिराहारैरुपचरेद्दोषधातुक्लेदविशोषणमात्रं कालम्|
अतः परं स्नेहपानैर्बस्तिभिराहारविधिभिश्च दीपनीयजीवनीयबृंहणीयमधुरवातहरसमाख्यातैरुपचरेत्| परिपक्वगर्भशल्यायाः पुनर्विमुक्तगर्भशल्यायास्तदहरेव स्नेहोपचारः स्यात्||३१||

tasya garbhaśalyasya jarāyuprapātanaṁ karma saṁśamanamityāhurēkē,mantrādikamatharvavēdavihitamityēkē, paridr̥ṣṭakarmaṇā śalyahartrā haraṇamityēkē|
vyapagatagarbhaśalyāṁ tu striyamāmagarbhāṁ surāsīdhvariṣṭamadhumadirāsavānāmanyatamamagrēsāmarthyataḥ pāyayēdgarbhakōṣṭhaśuddhyarthamartivismaraṇārthaṁ praharṣaṇārthaṁ ca, ataḥ paraṁsamprīṇanairbalānurakṣibhirasnēhasamprayuktairyavāgvādibhirvā [1]tatkālayōgibhirāhārairupacarēddōṣadhātuklēdaviśōṣaṇamātraṁ kālam|
ataḥ paraṁ snēhapānairbastibhirāhāravidhibhiścadīpanīyajīvanīyabr̥ṁhaṇīyamadhuravātaharasamākhyātairupacarēt|
paripakvagarbhaśalyāyāḥ punarvimuktagarbhaśalyāyāstadaharēva snēhōpacāraḥ syāt||31||

tasya garbhashalyasya jarAyuprapAtanaM karma saMshamanamityAhureke,mantrAdikamatharvavedavihitamityeke, paridRuShTakarmaNA shalyahartrA haraNamityeke|
vyapagatagarbhashalyAM tu striyamAmagarbhAMsurAsIdhvariShTamadhumadirAsavAnAmanyatamamagre sAmarthyataHpAyayedgarbhakoShThashuddhyarthamartivismaraNArthaM praharShaNArthaM ca, ataH paraMsamprINanairbalAnurakShibhirasnehasamprayuktairyavAgvAdibhirvA [1]tatkAlayogibhirAhArairupacareddoShadhAtukledavishoShaNamAtraM kAlam|
ataH paraM snehapAnairbastibhirAhAravidhibhishcadIpanIyajIvanIyabRuMhaNIyamadhuravAtaharasamAkhyAtairupacaret|
paripakvagarbhashalyAyAH punarvimuktagarbhashalyAyAstadahareva snehopacAraH syAt||31||
<div style="text-align:justify;">
According to some scholars, the treatment of dead fetus (which acts like a foreign body within the womb) consists of administering medicines which are used to expel the placenta. Others suggest using mantras, prayers and spiritual offerings as explained in the Atharva Veda. Yet others believe that it should be removed by surgical means by an expert surgeon.

If the dead fetus is immature (i.e., in its early stages of development), then once the dead fetus is extracted, the woman should drink, to her fill, alcoholic drinks such ''assura, sidhu, arishta, madhu, madira'' and ''asava'' in order to cleanse her uterus, relieve herself from pain and also to become euphoric (i.e., overcome her grief). Then she should be given food articles that are nourishing and strength-enhancing but without fat or oil in them, such as gruels that are suitable for that moment till the excess moisture of the ''dosha'' and ''dhatus'' are absorbed. Then she should be treated with ''snehapana'' (administration of unctuous substances), enema and diets processed with medications possessing appetizing, vitalizing, bulk-promoting, sweet and ''vata''-alleviating properties. If the dead fetus is a mature one, once the dead fetus is removed, that day itself she should be treated with unction measures. [31]
</div>
==== Monthly regimen to be adopted during normal pregnancy ====

परमतो निर्विकारमाप्याय्यमानस्य गर्भस्य मासे मासे कर्मोपदेक्ष्यामः|
प्रथमे मासे शङ्किता चेद्गर्भमापन्ना क्षीरमनुपस्कृतं मात्रावच्छीतं काले काले पिबेत्, सात्म्यमेव च भोजनं सायं प्रातश्चभुञ्जीत; द्वितीये मासे क्षीरमेव च मधुरौषधसिद्धं; तृतीये मासे क्षीरं मधुसर्पिर्भ्यामुपसंसृज्य; चतुर्थे मासेक्षीरनवनीतमक्षमात्रमश्नीयात्; पञ्चमे मासे क्षीरसर्पिः; षष्ठे मासे क्षीरसर्पिर्मधुरौषधसिद्धं; तदेव सप्तमे मासे|
तत्र गर्भस्य केशा जायमाना मातुर्विदाहं जनयन्तीति स्त्रियो भाषन्ते; तन्नेति भगवानात्रेयः, किन्तुगर्भोत्पीडनाद्वातपित्तश्लेष्माण उरः प्राप्य विदाहं जनयन्ति, ततः कण्डूरुपजायते, कण्डूमूला च किक्किसावाप्तिर्भवति|
तत्र कोलोदकेन नवनीतस्य मधुरौषधसिद्धस्य पाणितलमात्रं काले कालेऽस्यै पानार्थं दद्यात्, चन्दनमृणालकल्कैश्चास्याःस्तनोदरं विमृद्गीयात्, शिरीषधातकीसर्षपमधुकचूर्णैर्वा, कुटजार्जकबीजमुस्तहरिद्राकल्कैर्वा,निम्बकोलसुरसमञ्जिष्ठाकल्कैर्वा, पृषतहरिणशशरुधिरयुतया त्रिफलया वा; करवीरपत्रसिद्धेन तैलेनाभ्यङ्गः; परिषेकःपुनर्मालतीमधुकसिद्धेनाम्भसा; जातकण्डूश्च कण्डूयनं वर्जयेत्त्वग्भेदवैरूप्यपरिहारार्थम्, असह्यायां तुकण्ड्वामुन्मर्दनोद्धर्षणाभ्यां परिहारः स्यात्; मधुरमाहारजातं वातहरमल्पमस्नेहलवणमल्पोदकानुपानं च भुञ्जीत|
अष्टमे तु मासे क्षीरयवागूं सर्पिष्मतीं काले काले पिबेत्; तन्नेति भद्रकाप्यः, पैङ्गल्याबाधो ह्यस्या गर्भमागच्छेदिति; अस्त्वत्रपैङ्गल्याबाध इत्याह भगवान् पुनर्वसुरात्रेयः, न त्वेवैतन्न कार्यम्; एवं कुर्वती ह्यरोगाऽऽरोग्यबलवर्णस्वरसंहननसम्पदुपेतंज्ञातीनामपि श्रेष्ठमपत्यं जनयति|
नवमे तु खल्वेनां मासे मधुरौषधसिद्धेन तैलेनानुवासयेत्|
अतश्चैवास्यास्तैलात् पिचुं योनौ प्रणयेद्गर्भस्थानमार्गस्नेहनार्थम्|
यदिदं कर्म प्रथमं मासं समुपादायोपदिष्टमानवमान्मासात्तेन गर्भिण्या गर्भसमये गर्भधारिणीकुक्षिकटीपार्श्वपृष्ठं [१] मृदूभवति,वातश्चानुलोमः सम्पद्यते, मूत्रपुरीषे च प्रकृतिभूते सुखेन मार्गमनुपद्येते, चर्मनखानि च मार्दवमुपयान्ति, बलवर्णौचोपचीयेते; पुत्रं चेष्टं सम्पदुपेतं सुखिनं सुखेनैषा काले प्रजायत इति||३२||

paramatō nirvikāramāpyāyyamānasya garbhasya māsē māsē karmōpadēkṣyāmaḥ|
prathamē māsē śaṅkitā cēdgarbhamāpannā kṣīramanupaskr̥taṁ mātrāvacchītaṁ kālē kālē pibēt,sātmyamēva ca bhōjanaṁ sāyaṁ prātaśca bhuñjīta; dvitīyē māsē kṣīramēva ca madhurauṣadhasiddhaṁ;tr̥tīyē māsē kṣīraṁ madhusarpirbhyāmupasaṁsr̥jya; caturthē māsē kṣīranavanītamakṣamātramaśnīyāt;pañcamē māsē kṣīrasarpiḥ; ṣaṣṭhē māsē kṣīrasarpirmadhurauṣadhasiddhaṁ; tadēva saptamē māsē|
tatra garbhasya kēśā jāyamānā māturvidāhaṁ janayantīti striyō bhāṣantē; tannēti bhagavānātrēyaḥ, kintugarbhōtpīḍanādvātapittaślēṣmāṇa uraḥ prāpya vidāhaṁ janayanti, tataḥ kaṇḍūrupajāyatē, kaṇḍūmūlā cakikkisāvāptirbhavati|
tatra kōlōdakēna navanītasya madhurauṣadhasiddhasya pāṇitalamātraṁ kālē kālē'syai pānārthaṁ dadyāt,candanamr̥ṇālakalkaiścāsyāḥ stanōdaraṁ vimr̥dgīyāt, śirīṣadhātakīsarṣapamadhukacūrṇairvā,kuṭajārjakabījamustaharidrākalkairvā, nimbakōlasurasamañjiṣṭhākalkairvā,pr̥ṣatahariṇaśaśarudhirayutayā triphalayā vā; karavīrapatrasiddhēna tailēnābhyaṅgaḥ; pariṣēkaḥpunarmālatīmadhukasiddhēnāmbhasā; jātakaṇḍūśca kaṇḍūyanaṁvarjayēttvagbhēdavairūpyaparihārārtham, asahyāyāṁ tu kaṇḍvāmunmardanōddharṣaṇābhyāṁ parihāraḥsyāt; madhuramāhārajātaṁ vātaharamalpamasnēhalavaṇamalpōdakānupānaṁ ca bhuñjīta|
aṣṭamē tu māsē kṣīrayavāgūṁ sarpiṣmatīṁ kālē kālē pibēt; tannēti bhadrakāpyaḥ, paiṅgalyābādhō hyasyāgarbhamāgacchēditi; astvatra paiṅgalyābādha ityāha bhagavān punarvasurātrēyaḥ, na tvēvaitannakāryam; ēvaṁ kurvatī hyarōgā''rōgyabalavarṇasvarasaṁhananasampadupētaṁ jñātīnāmapiśrēṣṭhamapatyaṁ janayati|
navamē tu khalvēnāṁ māsē madhurauṣadhasiddhēna tailēnānuvāsayēt|
ataścaivāsyāstailāt picuṁ yōnau praṇayēdgarbhasthānamārgasnēhanārtham|
yadidaṁ karma prathamaṁ māsaṁ samupādāyōpadiṣṭamānavamānmāsāttēna garbhiṇyā garbhasamayēgarbhadhāriṇīkukṣikaṭīpārśvapr̥ṣṭhaṁ [1] mr̥dūbhavati, vātaścānulōmaḥ sampadyatē, mūtrapurīṣē caprakr̥tibhūtē sukhēna mārgamanupadyētē, carmanakhāni ca mārdavamupayānti, balavarṇau cōpacīyētē;putraṁ cēṣṭaṁ sampadupētaṁ sukhinaṁ sukhēnaiṣā kālē prajāyata iti||32||

paramato nirvikAramApyAyyamAnasya garbhasya mAse mAse karmopadekShyAmaH|
prathame mAse sha~gkitA cedgarbhamApannA kShIramanupaskRutaM mAtrAvacchItaM kAle kAle pibet,sAtmyameva ca bhojanaM sAyaM prAtashca bhu~jjIta; dvitIye mAse kShIrameva camadhurauShadhasiddhaM; tRutIye mAse kShIraM madhusarpirbhyAmupasaMsRujya; caturthe mAsekShIranavanItamakShamAtramashnIyAt; pa~jcame mAse kShIrasarpiH; ShaShThe mAsekShIrasarpirmadhurauShadhasiddhaM; tadeva saptame mAse|
tatra garbhasya keshA jAyamAnA mAturvidAhaM janayantIti striyo bhAShante; tanneti bhagavAnAtreyaH,kintu garbhotpIDanAdvAtapittashleShmANa uraH prApya vidAhaM janayanti, tataH kaNDUrupajAyate,kaNDUmUlA ca kikkisAvAptirbhavati|
tatra kolodakena navanItasya madhurauShadhasiddhasya pANitalamAtraM kAle kAle~asyai pAnArthaMdadyAt, candanamRuNAlakalkaishcAsyAH stanodaraM vimRudgIyAt,shirIShadhAtakIsarShapamadhukacUrNairvA, kuTajArjakabIjamustaharidrAkalkairvA,nimbakolasurasama~jjiShThAkalkairvA, pRuShatahariNashasharudhirayutayA triphalayA vA;karavIrapatrasiddhena tailenAbhya~ggaH; pariShekaH punarmAlatImadhukasiddhenAmbhasA;jAtakaNDUshca kaNDUyanaM varjayettvagbhedavairUpyaparihArArtham, asahyAyAM tukaNDvAmunmardanoddharShaNAbhyAM parihAraH syAt; madhuramAhArajAtaMvAtaharamalpamasnehalavaNamalpodakAnupAnaM ca bhu~jjIta|
aShTame tu mAse kShIrayavAgUM sarpiShmatIM kAle kAle pibet; tanneti bhadrakApyaH, pai~ggalyAbAdhohyasyA garbhamAgacchediti; astvatra pai~ggalyAbAdha ityAha bhagavAn punarvasurAtreyaH, natvevaitanna kAryam; evaM kurvatI hyarogA~a~arogyabalavarNasvarasaMhananasampadupetaMj~jAtInAmapi shreShThamapatyaM janayati|
navame tu khalvenAM mAse madhurauShadhasiddhena tailenAnuvAsayet|
atashcaivAsyAstailAt picuM yonau praNayedgarbhasthAnamArgasnehanArtham|
yadidaM karma prathamaM mAsaM samupAdAyopadiShTamAnavamAnmAsAttena garbhiNyAgarbhasamaye garbhadhAriNIkukShikaTIpArshvapRuShThaM [1] mRudUbhavati, vAtashcAnulomaHsampadyate, mUtrapurIShe ca prakRutibhUte sukhena mArgamanupadyete, carmanakhAni camArdavamupayAnti, balavarNau copacIyete; putraM ceShTaM sampadupetaM sukhinaM sukhenaiShA kAleprajAyata iti||32||
<div style="text-align:justify;">
In this verse, we shall explain the monthly regimen to be adopted in a steadily developing, normal pregnancy:
*In the first month when pregnancy is suspected, cold and unmedicated milk (that has not been processed with any drug) should be taken in adequate quantity at regular intervals, and nourishing food should be eaten twice a day.
*In the second month of pregnancy, milk processed with sweet-tasting drugs should be taken, as needed.
*In the third month of pregnancy, milk along with honey and ghee should be given to drink.
*In the fourth month of pregnancy, milk along with one ''aksha'' (10 – 12 g) butter should be consumed.
*In the fifth month of pregnancy, milk along with ghee should be given.
*In the sixth month of pregnancy, milk with ghee processed with sweet-tasting drugs should be given to drink.
*In the seventh month of pregnancy, she should be given the same regimen as prescribed in the sixth month. Experienced women are of the opinion that during this period, the fetus develops scalp hair and it causes burning sensation in the mother. But this view is negated by Lord Atreya, who says that due to the pressure created by the fetus, the three ''doshas'' of the mother reach the chest region and cause burning sensation in her, causing itching which, in turn, causes ''kikkisa'' (stretch-marks or striae gravidarum -linea albicantes – the white abdominal lines seen during and after pregnancy on the abdomen). To manage this condition, she should regularly be given butter medicated with sweet-tasting drugs, the quantity of which she can hold in her single palm, along with a decoction of ''kola'' (Zizyphus jujube Lam). Her breasts and abdomen should be massaged with a paste of ''chandana'' (Santalumalbum Linn.), ''mrinala'' (stalk of lotus) or powder of ''shirisha'' (Albizia lebbeck Benth), ''dhataki'' (Woodfordiafruticosa Kurz), ''sarshapa'' (Mustard – Brassicanigra Koch), and ''madhuka'' (Glycyrrhizaglabra Linn.) or paste of ''kutaja'' (Holarrhenaantidysenterica Wall.), seed of ''arjaka'' (Ocimumgratissimum Linn.), ''musta'' (Cyperusrotundus Linn.), ''haridra'' (Curcumalonga Linn.) or paste of ''nimba'' (Azadirachtaindica A. Juss), ''kola'' (Zizyphusjujuba Lam.), ''surasa'' (Ocimumsanctum Linn.) and ''manjishta'' (Rubiacordifolia Linn.) or ''triphala'' (three pungent fruits – Terminaliachebula Linn., Terminaliabelerica Roxb. and Emblicaofficinalis Gaertn.) mixed with the blood of ''prishta'' (spotted deer), massage with oil prepared with leaf of ''karavira'' (Neriumindicum Mill.) and sprinkling with water processed with ''jati'' (''Malati'' – Aganosma dichotoma K. Schum.) and ''madhuka'' (Glycyrrhizaglabra Linn.) plant. Thus, itching should be avoided to prevent stretch-mark on skin (and therefore, avoiding disfiguring the skin). If itching is too severe to tolerate then it should be overcome by an application of ''unmardana'' (anointing) and ''udgharshana'' (rubbing with pastes) procedures. During this period, she should eat sweet-tasting food that is ''vata'' alleviating in nature and is light on oil, fat and salt, and should drink less water immediately after the food.
*In the eighth month, she should take gruel prepared with milk and mixed with ghee in all her meals in their appropriate times. Bhadrakapya has opposing views on this and believes that it causes ''paingalya'' (tawny discoloration of the eyes of fetus) in the fetus, and hence should not be practiced. On this point, Lord Atreya believes that while the risk of paingalya may be there, it does not indicate in any way that the above regimen should not be applied. The woman following this regimen remains free from all disorders and gives birth to a child endowed with excellent health, strength, complexion, voice and compactness of body.
*Finally, in the ninth month of pregnancy, she should be treated with unctuous enema prepared with sweet-tasting drugs. A cotton swab soaked in the same oil should be kept in her genital tract in order to lubricate the passage of the fetus.

If the specific dietary regimen and therapeutic measures mentioned above are followed right from the first month of pregnancy to the ninth month, the entire child-bearing region of the woman’s body – including her womb, waist, sides of pelvis, and her back - become soft at the time of delivery, ''vata'' functions in a normal way, urine and bowel movement pass smoothly, skin and nails become soft, her strength and complexion are improved and the woman delivers the child effortlessly. [32]
</div>
==== Attributes of the maternity home ====

प्राक् चैवास्या नवमान्मासात् सूतिकागारं कारयेदपहृतास्थिशर्कराकपाले देशे प्रशस्तरूपरसगन्धायां भूमौ प्राग्द्वारमुदग्द्वारं वाबैल्वानां काष्ठानां तैन्दुकैङ्गुदकानां भाल्लातकानां वार(रु)णानां खादिराणां वा; यानि चान्यान्यपि ब्राह्मणाःशंसेयुरथर्ववेदविदस्तेषां; वसनालेपनाच्छादनापिधानसम्पदुपेतंवास्तुविद्याहृदययोगाग्निसलिलोदूखलवर्चःस्थानस्नानभूमिमहानसमृतुसुखं च||३३||

prāk caivāsyā navamānmāsāt sūtikāgāraṁ kārayēdapahr̥tāsthiśarkarākapālē dēśēpraśastarūparasagandhāyāṁ bhūmau prāgdvāramudagdvāraṁ vā bailvānāṁ kāṣṭhānāṁtaindukaiṅgudakānāṁ bhāllātakānāṁ vāra(ru)ṇānāṁ khādirāṇāṁ vā; yāni cānyānyapi brāhmaṇāḥśaṁsēyuratharvavēdavidastēṣāṁ; vasanālēpanācchādanāpidhānasampadupētaṁvāstuvidyāhr̥dayayōgāgnisalilōdūkhalavarcaḥsthānasnānabhūmimahānasamr̥tusukhaṁ ca||33||

prAk caivAsyA navamAnmAsAt sUtikAgAraM kArayedapahRutAsthisharkarAkapAle desheprashastarUparasagandhAyAM bhUmau prAgdvAramudagdvAraM vA bailvAnAM kAShThAnAMtaindukai~ggudakAnAM bhAllAtakAnAM vAra(ru)NAnAM khAdirANAM vA; yAni cAnyAnyapi brAhmaNAHshaMseyuratharvavedavidasteShAM; vasanAlepanAcchAdanApidhAnasampadupetaMvAstuvidyAhRudayayogAgnisalilodUkhalavarcaHsthAnasnAnabhUmimahAnasamRutusukhaM ca||33||
<div style="text-align:justify;">
Well before the ninth month of pregnancy, a maternity home should be constructed in a place that is free from bones, gravels and broken pieces of baked earthen utensils, the soil of which should have excellent color, taste and odour, the door of which should be facing the east or north and made of ''bilwa'' wood (Aeglemarmelos Corr.) or ''tinduka'' (Diospyrosperegrine Gurke), ''ingudi'' (Balanitesaegyptica Delile.), ''bhallataka'' (Semecarpusanacardium Linn.), ''varuna'' (Creteva religiosa) or ''khadira'' (Acaciacatechu willd.), or those woods recommended by ''brahmins'' who are well versed in Atharva Veda. The maternity home should be well built, spacious, well painted, have adequate doors and windows, well furnished with appliances, furnishings, water storage, lavatories, toiletries, etc. - built in accordance with the principles of ''Vastuvidya'' (science of architecture). The house should be comfortable for all seasons. [33]
</div>
==== Items to be made available in the maternity home ====

तत्र सर्पिस्तैलमधुसैन्धवसौवर्चलकालविड्लवणविडङ्गकुष्ठकिलिमनागर-पिप्पलीपिप्पलीमूलहस्तिपिप्पलीमण्डूकपर्ण्येलालाङ्गलीवचाचव्यचित्रकचिरबिल्व-हिङ्गुसर्षपलशुनकतककणकणिकानीपातसीबल्वजभूर्जकुलत्थमैरेयसुरासवाः सन्निहिताः स्युः; तथाऽश्मानौ द्वौ, द्वे कु(च)ण्डमुसले, द्वे उदूखले, खरवृषभश्च [१] , द्वौ च तीक्ष्णौ सूचीपिप्पलकौ सौवर्णराजतौ, शस्त्राणि च तीक्ष्णायसानि, द्वौ चबिल्वमयौ पर्यङ्कौ, तैन्दुकैङ्गुदानि च काष्ठान्यग्निसन्धुक्षणानि, स्त्रियश्च बह्व्यो बहुशः प्रजाताः सौहार्दयुक्ताःसततमनुरक्ताः प्रदक्षिणाचाराः प्रतिपत्तिकुशलाः प्रकृतिवत्सलास्त्यक्तविषादाः क्लेशसहिन्योऽभिमताः,ब्राह्मणाश्चाथर्ववेदविदः; यच्चान्यदपि तत्र समर्थं मन्येत, यच्चान्यच्च ब्राह्मणा ब्रूयुः स्त्रियश्च वृद्धास्तत् कार्यम्||३४||

tatra sarpistailamadhusaindhavasauvarcalakālaviḍlavaṇaviḍaṅgakuṣṭhakilimanāgara-pippalīpippalīmūlahastipippalīmaṇḍūkaparṇyēlālāṅgalīvacācavyacitrakacirabilva-hiṅgusarṣapalaśunakatakakaṇakaṇikānīpātasībalvajabhūrjakulatthamairēyasurāsavāḥ sannihitāḥ syuḥ;tathā'śmānau dvau, dvē ku(ca)ṇḍamusalē, dvē udūkhalē, kharavr̥ṣabhaśca [1] , dvau ca tīkṣṇausūcīpippalakau sauvarṇarājatau, śastrāṇi ca tīkṣṇāyasāni, dvau ca bilvamayau paryaṅkau,taindukaiṅgudāni ca kāṣṭhānyagnisandhukṣaṇāni, striyaśca bahvyō bahuśaḥ prajātāḥ sauhārdayuktāḥsatatamanuraktāḥ pradakṣiṇācārāḥ pratipattikuśalāḥ prakr̥tivatsalāstyaktaviṣādāḥ klēśasahinyō'bhimatāḥ,brāhmaṇāścātharvavēdavidaḥ; yaccānyadapi tatra samarthaṁ manyēta, yaccānyacca brāhmaṇā brūyuḥstriyaśca vr̥ddhāstat kāryam||34||

tatra sarpistailamadhusaindhavasauvarcalakAlaviDlavaNaviDa~ggakuShThakilimanAgara-pippalIpippalImUlahastipippalImaNDUkaparNyelAlA~ggalIvacAcavyacitrakacirabilva-hi~ggusarShapalashunakatakakaNakaNikAnIpAtasIbalvajabhUrjakulatthamaireyasurAsavAH sannihitAHsyuH; tathA~ashmAnau dvau, dve ku(ca)NDamusale, dve udUkhale, kharavRuShabhashca [1] , dvau catIkShNau sUcIpippalakau sauvarNarAjatau, shastrANi ca tIkShNAyasAni, dvau ca bilvamayau parya~gkau,taindukai~ggudAni ca kAShThAnyagnisandhukShaNAni, striyashca bahvyo bahushaH prajAtAHsauhArdayuktAH satatamanuraktAH pradakShiNAcArAH pratipattikushalAHprakRutivatsalAstyaktaviShAdAH kleshasahinyo~abhimatAH, brAhmaNAshcAtharvavedavidaH;yaccAnyadapi tatra samarthaM manyeta, yaccAnyacca brAhmaNA brUyuH striyashca vRuddhAstatkAryam||34||
<div style="text-align:justify;">
The following items should be made available in that maternity home: Ghee, honey, ''saindhava'' (rock salt), ''sauvarchala, kala, bida'' salts, ''vidanga'' (Emblelia ribes Burm. f.), ''kushta'' (Saussurea lappaC. B. Clarke.), ''kilima'' (Cedrus deodara Loud.), ''nagara'' (Zingiber officinale Rosc.), ''pippali'' (Piper longum Linn), ''pippali moola'' (root of Piper longum Linn.), ''hasti pippali'' (Scindapsus officinalis Schott), ''mandukaparni'' (Centella asiatica urban.), ''ela'' (Elettaria cadamomum Maton.), ''langali'' (Gloriosa superba Linn.), ''vacha'' (Acorus calamus Linn.), ''chavya'' (Piper cheba Hunter.), ''chitraka'' (Plumbago zeylanica Linn.), ''chirabilva'' (Pongamia pinnata Merr.), ''hingu'' (Ferula narthex Boiss.), ''sarshapa'' (Brassica nigra Koch.), ''lashuna'' (Alium sativum Linn.), ''kataka'' (Strychnos potatorum Linn. f.), ''kana'' (Pippali – piper longum Linn), ''kundaka, kanika'' (a variety of ''kana'' with bigger grains), ''neepa'' (Anthocephalus indicus A. Rich.), ''atasi'' (Linum usitatissumum Linn.), ''balvaja'' (--), ''bhurja'' (Betula utilis D. Don.), ''kulatha'' (Dolichos biflorus Linn.), ''maireya'', and alcoholic beverages (''sura'', and ''asava''). In addition to the above, the following items too should be kept available there – two grinding stones, two small pestles, two mortars, one untamed bull, two gold and silver cases for keeping needles, various surgical instruments that are sharp and prepared of metals, two bedsteads made of ''bilva'' (Aeglemarmelos Corr.), wood of ''tinduka'' (Diospyrosperegrine Gurke) and ''ingudi'' (Balanitesaegyptica Delile.) as fire wood, good number of female attendants who are multiskilled, who are affectionate and attached to the lady, well mannered, resourceful, pleasant to talk to, free from grief, tolerant of hardship and agreeable, and brahmins well versed in the Atharva Veda.

Above all, whatever prescribed by brahmins and experienced old ladies and found necessary are to be kept handy in this maternity home. [34]
</div>
==== Rituals for the expecting woman before entering the maternity home ====

ततः प्रवृत्ते नवमे मासे पुण्येऽहनि प्रशस्तनक्षत्रयोगमुपगते प्रशस्ते भगवति शशिनि कल्याणे कल्याणे च करणे मैत्रे मुहूर्ते शान्तिंहुत्वा गोब्राह्मणमग्निमुदकं चादौ प्रवेश्य गोभ्यस्तृणोदकं मधुलाजांश्च प्रदाय ब्राह्मणेभ्योऽक्षतान् सुमनसो नान्दीमुखानि चफलानीष्टानि दत्त्वोदकपूर्वमासनस्थेभ्योऽभिवाद्य पुनराचम्य स्वस्ति वाचयेत्|
ततः पुण्याहशब्देन गोब्राह्मणं समनुवर्तमाना [१] प्रदक्षिणं प्रविशेत् सूतिकागारम्|
तत्रस्था च प्रसवकालं प्रतीक्षेत||३५||

tataḥ pravr̥ttē navamē māsē puṇyē'hani praśastanakṣatrayōgamupagatē praśastē bhagavati śaśini kalyāṇēkalyāṇē ca karaṇē maitrē muhūrtē śāntiṁ hutvā gōbrāhmaṇamagnimudakaṁ cādau pravēśyagōbhyastr̥ṇōdakaṁ madhulājāṁśca pradāya brāhmaṇēbhyō'kṣatān sumanasō nāndīmukhāni caphalānīṣṭāni dattvōdakapūrvamāsanasthēbhyō'bhivādya punarācamya svasti vācayēt|
tataḥ puṇyāhaśabdēna gōbrāhmaṇaṁ samanuvartamānā [1] pradakṣiṇaṁ praviśēt sūtikāgāram|
tatrasthā ca prasavakālaṁ pratīkṣēta||35||

tataH pravRutte navame mAse puNye~ahani prashastanakShatrayogamupagate prashaste bhagavatishashini kalyANe kalyANe ca karaNe maitre muhUrte shAntiM hutvA gobrAhmaNamagnimudakaM cAdaupraveshya gobhyastRuNodakaM madhulAjAMshca pradAya brAhmaNebhyo~akShatAn sumanasonAndImukhAni ca phalAnIShTAni dattvodakapUrvamAsanasthebhyo~abhivAdya punarAcamya svastivAcayet|
tataH puNyAhashabdena gobrAhmaNaM samanuvartamAnA [1] pradakShiNaM pravishet sUtikAgAram|
tatrasthA ca prasavakAlaM pratIkSheta||35||
<div style="text-align:justify;">
After furnishing the maternity home, in the beginning of the ninth month, on an auspicious day, when moon is in the auspicious ''nakshatra'' (constellation), with an auspicious ''karana'' and at an auspicious ''muhurta'' (astrological unit of time), with priests offering oblations and rites to holy fire, first of all the cow, the ''brahmana'', fire and water should be made to enter the maternity home. Then grass, water, honey and ''laja'' (parched rice) should be offered to the cows, and ''akshata'' (rice grains prepared exclusively for worship), fragrant flowers and sweet fruits (such as ''khajura'', date), which are indicative of good fortune, should be offered to the ''brahmanas''. Blessings should then be sought from the ''brahmanas'', after taking sips of water (''achamana'' is taking sips of water after chanting ''mantra''). With auspicious mantras being chanted by the priests, the expecting woman should enter the maternity home, following the cow and the ''brahmanas'' to her right side. Then she should stay there until she delivers her child. [35]
</div>
==== Premonitory signs and symptoms of labor ====

तस्यास्तु खल्विमानि लिङ्गानि प्रजननकालमभितो भवन्ति; तद्यथा- क्लमो गात्राणां, ग्लानिराननस्य, अक्ष्णोः शैथिल्यं,विमुक्तबन्धनत्वमिव [१] वक्षसः, कुक्षेरवस्रंसनम्, अधोगुरुत्वं, वङ्क्षणबस्तिकटीकुक्षिपार्श्वपृष्ठनिस्तोदः, योनेः प्रस्रवणम्,अनन्नाभिलाषश्चेति; ततोऽनन्तरमावीनां प्रादुर्भावः, प्रसेकश्च गर्भोदकस्य||३६||

tasyāstu khalvimāni liṅgāni prajananakālamabhitō bhavanti; tadyathā- klamō gātrāṇāṁ, glānirānanasya,akṣṇōḥ śaithilyaṁ, vimuktabandhanatvamiva [1] vakṣasaḥ, kukṣēravasraṁsanam, adhōgurutvaṁ,vaṅkṣaṇabastikaṭīkukṣipārśvapr̥ṣṭhanistōdaḥ, yōnēḥ prasravaṇam, anannābhilāṣaścēti;tatō'nantaramāvīnāṁ prādurbhāvaḥ, prasēkaśca garbhōdakasya||36||
tasyAstu khalvimAni li~ggAni prajananakAlamabhito bhavanti; tadyathA- klamo gAtrANAM,glAnirAnanasya, akShNoH shaithilyaM, vimuktabandhanatvamiva [1] vakShasaH, kukSheravasraMsanam,adhogurutvaM, va~gkShaNabastikaTIkukShipArshvapRuShThanistodaH, yoneH prasravaNam,anannAbhilAShashceti; tato~anantaramAvInAM prAdurbhAvaH, prasekashca garbhodakasya||36||
<div style="text-align:justify;">
The premonitory signs and symptoms of labor include tiredness, pallor, laxity of eyes (drooping of eyelids), feeling of getting freed from constrictions around the chest, bearing down pressure sensation in pelvis because of fetus, heaviness of lower abdomen, and pain in the groin, bladder area perineum, pelvis, belly, sides and the back, discharge from the vagina, lack of desire for food. These are typically followed by the appearance of ''garbhodaka'' (amniotic fluid) and initiation of ''aavee'' (labor pain). [36]
</div>
==== Commencement of ''aavee'' (labor) ====

आवीप्रादुर्भावे तु भूमौ शयनं विदध्यान्मृद्वास्तरणोपपन्नम्|
तदध्यासीत [२] सा|
तां ततः समन्ततः परिवार्य यथोक्तगुणाः स्त्रियः पर्युपासीरन्नाश्वासयन्त्यो वाग्भिर्ग्राहिणीयाभिः [३] सान्त्वनीयाभिश्च||३७||

āvīprādurbhāvē tu bhūmau śayanaṁ vidadhyānmr̥dvāstaraṇōpapannam|
tadadhyāsīta [2] sā|
tāṁ tataḥ samantataḥ parivārya yathōktaguṇāḥ striyaḥ paryupāsīrannāśvāsayantyō vāgbhirgrāhiṇīyābhiḥ[3] sāntvanīyābhiśca||37||

AvIprAdurbhAve tu bhUmau shayanaM vidadhyAnmRudvAstaraNopapannam|
tadadhyAsIta [2] sA|
tAM tataH samantataH parivArya yathoktaguNAH striyaH paryupAsIrannAshvAsayantyovAgbhirgrAhiNIyAbhiH [3] sAntvanIyAbhishca||37||
<div style="text-align:justify;">
With the commencement of ''aavee'', the parturient woman should be made to sit on a bed prepared with soft materials spread over the ground. Then, the female attendants with qualities mentioned in the preceding verses should surround her from all sides and encourage her by comforting words and touch. [37]
</div>
==== Issues with delivery despite labor pains ====

सा चेदावीभिः सङ्क्लिश्यमाना न प्रजायेताथैनां ब्रूयात्-उत्तिष्ठ, मुसलमन्यतरं गृहीष्व, अनेनैतदुलूखलं धान्यपूर्णंमुहुर्मुहुरभिजहि मुहुर्मुहुरवजृम्भस्व चङ्क्रमस्व चान्तराऽन्तरेति; एवमुपदिशन्त्येके|
तन्नेत्याह भगवानात्रेयः|
दारुणव्यायामवर्जनं हि गर्भिण्याः सततमुपदिश्यते, विशेषतश्च प्रजननकाले प्रचलितसर्वधातुदोषायाःसुकुमार्या नार्यामुसलव्यायामसमीरितो वायुरन्तरं लब्ध्वा प्राणान् हिंस्यात्, दुष्प्रतीकारतमा हि तस्मिन् काले विशेषेण भवति गर्भिणी;तस्मान्मुसलग्रहणं परिहार्यमृषयो मन्यन्ते, जृम्भणं चङ्क्रमणं च पुनरनुष्ठेयमिति|
अथास्यै दद्यात् कुष्ठैलालाङ्गलिकीवचाचित्रकचिरबिल्वचव्यचूर्णमुपघ्रातुं, सा तन्मुहुर्मुहुरुपजिघ्रेत्, तथा भूर्जपत्रधूमंशिंशपासारधूमं वा|
तस्याश्चान्तराऽन्तरा कटीपार्श्वपृष्ठसक्थिदेशानीषदुष्णेन तैलेनाभ्यज्यानुसुखमवमृद्नीयात् [४] |
अनेन कर्मणा गर्भोऽवाक् [५] प्रतिपद्यते||३८||

sā cēdāvībhiḥ saṅkliśyamānā na prajāyētāthaināṁ brūyāt- uttiṣṭha, musalamanyataraṁ gr̥hīṣva,anēnaitadulūkhalaṁ dhānyapūrṇaṁ muhurmuhurabhijahi muhurmuhuravajr̥mbhasva caṅkramasvacāntarā'ntarēti; ēvamupadiśantyēkē|
tannētyāha bhagavānātrēyaḥ|
dāruṇavyāyāmavarjanaṁ hi garbhiṇyāḥ satatamupadiśyatē, viśēṣataśca prajananakālēpracalitasarvadhātudōṣāyāḥ sukumāryā nāryā musalavyāyāmasamīritō vāyurantaraṁ labdhvā prāṇānhiṁsyāt, duṣpratīkāratamā hi tasmin kālē viśēṣēṇa bhavati garbhiṇī; tasmānmusalagrahaṇaṁparihāryamr̥ṣayō manyantē, jr̥mbhaṇaṁ caṅkramaṇaṁ ca punaranuṣṭhēyamiti|
athāsyai dadyāt kuṣṭhailālāṅgalikīvacācitrakacirabilvacavyacūrṇamupaghrātuṁ, sātanmuhurmuhurupajighrēt, tathā bhūrjapatradhūmaṁ śiṁśapāsāradhūmaṁ vā|
tasyāścāntarā'ntarā kaṭīpārśvapr̥ṣṭhasakthidēśānīṣaduṣṇēna tailēnābhyajyānusukhamavamr̥dnīyāt [4] |
anēna karmaṇā garbhō'vāk [5] pratipadyatē||38||

sA cedAvIbhiH sa~gklishyamAnA na prajAyetAthainAM brUyAt- uttiShTha, musalamanyataraM gRuhIShva,anenaitadulUkhalaM dhAnyapUrNaM muhurmuhurabhijahi muhurmuhuravajRumbhasva ca~gkramasvacAntarA~antareti; evamupadishantyeke|
tannetyAha bhagavAnAtreyaH|
dAruNavyAyAmavarjanaM hi garbhiNyAH satatamupadishyate, visheShatashca prajananakAlepracalitasarvadhAtudoShAyAH sukumAryA nAryA musalavyAyAmasamIrito vAyurantaraM labdhvA prANAnhiMsyAt, duShpratIkAratamA hi tasmin kAle visheSheNa bhavati garbhiNI; tasmAnmusalagrahaNaMparihAryamRuShayo manyante, jRumbhaNaM ca~gkramaNaM ca punaranuShTheyamiti|
athAsyai dadyAt kuShThailAlA~ggalikIvacAcitrakacirabilvacavyacUrNamupaghrAtuM, sAtanmuhurmuhurupajighret, tathA bhUrjapatradhUmaM shiMshapAsAradhUmaM vA|
tasyAshcAntarA~antarA kaTIpArshvapRuShThasakthideshAnIShaduShNenatailenAbhyajyAnusukhamavamRudnIyAt [4] |
anena karmaNA garbho~avAk [5] pratipadyate||38||
<div style="text-align:justify;">
If in spite of acute labor pains, she is not able to deliver, some advise that the woman must be instructed to get up, hold a pestle and pound grains repeatedly, taking breaks and deep breaths, and moving about periodically. Lord Atreya, however, does not consider it right. According to him, a pregnant woman should always be advised to avoid strenuous exercises and particularly during parturition, since all the body elements and humors are in a state of commotion, ''vata'', aggravated by the strain involved in the exercise of pounding, could even be fatal to the pregnant woman. Woman during this situation will be difficult to cure. Other sages advise against the pounding exercises but advocating deep breathing and moving about.

The woman should be made to inhale the powders of ''kushta'' (Saussurea lappa C.B.Clarke.), ''ela'' (Elettaria cardamomum Maton), ''langalaki'' (Gloriosa superb Linn.), ''vacha'' (Acorus calamus Linn.), ''chitraka'' (Plumbago zeylanica Linn.), ''chirbilva'' (Pongamia pinnata Mirr.) and ''chavya'' (Piper chaba Hunter), which can be administered frequently . Similarly the fumigation done with leaves of ''bhurja'' (Betula utilis D. Don.) or pith of ''shimsapa'' (Dalbergia sissoo Roxb.) could be used for inhalation. During this period, she should be given a light massage over her waist, sides, back and legs with lukewarm oil followed by a kneading massage. With these measures the fetus descends down. [38]
</div>
==== Mantra to be recited when labor pain increases ====

स यदा जानीयाद्विमुच्य हृदयमुदरमस्यास्त्वाविशति, बस्तिशिरोऽवगृह्णाति, त्वरयन्त्येनामाव्यः, परिवर्ततेऽधो [६] गर्भइति; अस्यामवस्थायां पर्यङ्कमेनामारोप्य प्रवाहयितुमुपक्रमेत|
कर्णे चास्या मन्त्रमिममनुकूला स्त्री जपेत्-
‘क्षितिर्जलं वियत्तेजो वायुर्विष्णुः [७] प्रजापतिः|
सगर्भां त्वां सदा पान्तु वैशल्यं च दिशन्तु ते|
प्रसूष्व त्वमविक्लिष्टमविक्लिष्टा शुभानने!|
कार्तिकेयद्युतिं पुत्रं कार्तिकेयाभिरक्षितम्’ इति||३९||

sa yadā jānīyādvimucya hr̥dayamudaramasyāstvāviśati, bastiśirō'vagr̥hṇāti, tvarayantyēnāmāvyaḥ,parivartatē'dhō [6] garbha iti; asyāmavasthāyāṁ paryaṅkamēnāmārōpya pravāhayitumupakramēta|
karṇē cāsyā mantramimamanukūlā strī japēt-
‘kṣitirjalaṁ viyattējō vāyurviṣṇuḥ [7] prajāpatiḥ|
sagarbhāṁ tvāṁ sadā pāntu vaiśalyaṁ ca diśantu tē|
prasūṣva tvamavikliṣṭamavikliṣṭā śubhānanē!|
kārtikēyadyutiṁ putraṁ kārtikēyābhirakṣitam’ iti||39||

sa yadA jAnIyAdvimucya hRudayamudaramasyAstvAvishati, bastishiro~avagRuhNAti,tvarayantyenAmAvyaH, parivartate~adho [6] garbha iti; asyAmavasthAyAM parya~gkamenAmAropyapravAhayitumupakrameta|
karNe cAsyA mantramimamanukUlA strI japet-
‘kShitirjalaM viyattejo vAyurviShNuH [7] prajApatiH|
sagarbhAM tvAM sadA pAntu vaishalyaM ca dishantu te|
prasUShva tvamavikliShTamavikliShTA shubhAnane!|
kArtikeyadyutiM putraM kArtikeyAbhirakShitam’ iti||39||
<div style="text-align:justify;">
When the feeling of fetus descending into the lower abdomen getting separated from heart (upper part) is felt by mother, and fetal head has turned which gets caught in the pelvic cavity, also the labour pain becomes more frequent. At this stage she should be made to lie down on the delivery cot and urged to bear down. One of her favourite lady attendants should recite the following ''mantra'' in her ears “May the Earth, the water, the heaven, the light, the wind, Visnu and Prajapati ever protect you and the child and may they guide the delivery. O, auspicious faced one! Bring forth, without distress to yourself or to him, a son who will possess the lustre of Kartikeya and will have the protection of Kartikeya.’’ [39]
</div>
ताश्चैनां यथोक्तगुणाः स्त्रियोऽनुशिष्युः-अनागतावीर्मा प्रवाहिष्ठाः; या ह्यनागतावीः [८] प्रवाहते व्यर्थमेवास्यास्तत् कर्मभवति, प्रजा चास्या विकृता विकृतिमापन्ना च, श्वासकासशोषप्लीहप्रसक्ता वा भवति|
यथा हि क्षवथूद्गारवातमूत्रपुरीषवेगान् प्रयतमानोऽप्यप्राप्तकालान्न लभते कृच्छ्रेण वाऽप्यवाप्नोति [९] ,तथाऽनागतकालंगर्भमपि प्रवाहमाणा; यथा चैषामेव क्षवथ्वादीनां सन्धारणमुपघातायोपपद्यते, तथा प्राप्तकालस्य गर्भस्याप्रवाहणमिति|
सा यथानिर्देशं कुरुष्वेति वक्तव्या स्यात्|
तथा च कुर्वती शनैः पूर्वं प्रवाहेत, ततोऽनन्तरं बलवत्तरम्|
तस्यां च प्रवाहमाणायां स्त्रियः शब्दं कुर्युः- ‘प्रजाता प्रजाता धन्यं धन्यं पुत्रम्’ इति|
तथाऽस्या हर्षेणाप्याय्यन्ते प्राणाः||४०||

tāścaināṁ yathōktaguṇāḥ striyō'nuśiṣyuḥ- anāgatāvīrmā pravāhiṣṭhāḥ; yā hyanāgatāvīḥ [8] pravāhatēvyarthamēvāsyāstat karma bhavati, prajā cāsyā vikr̥tā vikr̥timāpannā ca, śvāsakāsaśōṣaplīhaprasaktā vābhavati|
yathā hi kṣavathūdgāravātamūtrapurīṣavēgān prayatamānō'pyaprāptakālānna labhatē kr̥cchrēṇavā'pyavāpnōti [9] , tathā'nāgatakālaṁ garbhamapi pravāhamāṇā; yathā caiṣāmēva kṣavathvādīnāṁsandhāraṇamupaghātāyōpapadyatē, tathā prāptakālasya garbhasyāpravāhaṇamiti|
sā yathānirdēśaṁ kuruṣvēti vaktavyā syāt|
tathā ca kurvatī śanaiḥ pūrvaṁ pravāhēta, tatō'nantaraṁ balavattaram|
tasyāṁ ca pravāhamāṇāyāṁ striyaḥ śabdaṁ kuryuḥ- ‘prajātā prajātā dhanyaṁ dhanyaṁ putram’ iti|
tathā'syā harṣēṇāpyāyyantē prāṇāḥ||40||

tAshcainAM yathoktaguNAH striyo~anushiShyuH- anAgatAvIrmA pravAhiShThAH; yA hyanAgatAvIH [8]pravAhate vyarthamevAsyAstat karma bhavati, prajA cAsyA vikRutA vikRutimApannA ca,shvAsakAsashoShaplIhaprasaktA vA bhavati|
yathA hi kShavathUdgAravAtamUtrapurIShavegAn prayatamAno~apyaprAptakAlAnna labhate kRucchreNavA~apyavApnoti [9] , tathA~anAgatakAlaM garbhamapi pravAhamANA; yathA caiShAmevakShavathvAdInAM sandhAraNamupaghAtAyopapadyate, tathA prAptakAlasya garbhasyApravAhaNamiti|
sA yathAnirdeshaM kuruShveti vaktavyA syAt|
tathA ca kurvatI shanaiH pUrvaM pravAheta, tato~anantaraM balavattaram|
tasyAM ca pravAhamANAyAM striyaH shabdaM kuryuH- ‘prajAtA prajAtA dhanyaM dhanyaM putram’ iti|
tathA~asyA harSheNApyAyyante prANAH||40||
<div style="text-align:justify;">
The attending women should instruct her thus, “Don’t strain (bear down) when there is no labor pain, because if you do, the efforts may go in vain, and moreover the off spring may be born with deformities or afflicted with diseases like ''shwasa'' (dyspnoea), ''kasa'' (cough), ''shosha'' (emaciation) or ''pleeha'' (spleenic disorders). As when there is no natural urge to sneeze, or pass flatulence, urine or bowel movements, they will not appear or if appear will be with a lot of effort, similarly if the woman strains when there is no labour pain, the foetus will not come out or if at all it comes out, it will be with great difficulty. On the other hand, just as when there is a strong urge to pass bodily wastes, one should not suppress them, not straining when there is acute labor pain will lead to difficult labour. The woman should be advised to follow the following instructions - Initially she should strain (bear down) with mild force, gradually with stronger efforts. While she is bearing down hard, the attendants should keep repeating words such as ‘She has just delivered a worthy son, fortunate son’.Such words make the woman feel happy and motivate her to continue pushing the baby out. [40]
</div>
==== Procedure to remove placenta post-delivery ====

यदा च प्रजाता स्यात्तदैवैनामवेक्षेत- काचिदस्या अपरा प्रपन्ना न वेति|
तस्याश्चेदपरा न प्रपन्ना स्यादथैनामन्यतमा स्त्री दक्षिणेन पाणिना नाभेरुपरिष्टाद्बलवन्निपीड्य सव्येन पाणिना पृष्ठतउपसङ्गृह्य तां सुनिर्धूतं निर्धुनुयात्|
अथास्याः पार्ष्ण्या श्रोणीमाकोटयेत्|
अस्याः स्फिचावुपसङ्गृह्य सुपीडितं पीडयेत्|
अथास्या बालवेण्या कण्ठतालु परिमृशेत्|
भूर्जपत्रकाचमणिसर्पनिर्मोकैश्चास्या योनिं धूपयेत्|
कुष्ठतालीसकल्कं बल्वजयूषे [१] मैरेयसुरामण्डे तीक्ष्णे कौलत्थे व यूषे मण्डूकपर्णीपिप्पलीसम्पाके वा सम्प्लाव्य पाययेदेनाम्|
तथा सूक्ष्मैलाकिलिमकुष्ठनागर विडङ्गपिप्पलीकालागुरुचव्यचित्रकोपकुञ्चिकाकल्कं खरवृषभस्य वा जीवतो [२] दक्षिणंकर्णमुत्कृत्य दृषदि जर्जरीकृत्य बल्वजक्वाथादीनामाप्लावनानामन्यतमे [३] प्रक्षिप्याप्लाव्य मुहूर्तस्थितमुद्धृत्य तदाप्लावनंपाययेदेनाम्|
शतपुष्पाकुष्ठमदनहिङ्गुसिद्धस्य चैनां तैलस्य पिचुं ग्राहयेत्|
अतश्चैवानुवासयेत्|
एतैरेव चाप्लावनैः फलजीमूतेक्ष्वाकुधामार्गवकुटजकृतवेधनहस्तिपिप्पल्युपहितैरास्थापयेत्|
तदास्थापनमस्याः सह वातमूत्रपुरीषैर्निर्हरत्यपरामासक्तां वायोरेवाप्रतिलोमगत्वात् [४] |
अपरां हि वातमूत्रपुरीषाण्यन्यानि चान्तर्बहिर्मार्गाणि [५] सज्जन्ति||४१||

yadā ca prajātā syāttadaivaināmavēkṣēta- kācidasyā aparā prapannā na vēti|
tasyāścēdaparā na prapannā syādathaināmanyatamā strī dakṣiṇēna pāṇinānābhērupariṣṭādbalavannipīḍya savyēna pāṇinā pr̥ṣṭhata upasaṅgr̥hya tāṁ sunirdhūtaṁ nirdhunuyāt|
athāsyāḥ pārṣṇyā śrōṇīmākōṭayēt|
asyāḥ sphicāvupasaṅgr̥hya supīḍitaṁ pīḍayēt|
athāsyā bālavēṇyā kaṇṭhatālu parimr̥śēt|
bhūrjapatrakācamaṇisarpanirmōkaiścāsyā yōniṁ dhūpayēt|
kuṣṭhatālīsakalkaṁ balvajayūṣē [1] mairēyasurāmaṇḍē tīkṣṇē kaulatthē va yūṣēmaṇḍūkaparṇīpippalīsampākē vā samplāvya pāyayēdēnām|
tathā sūkṣmailākilimakuṣṭhanāgara viḍaṅgapippalīkālāgurucavyacitrakōpakuñcikākalkaṁ kharavr̥ṣabhasyavā jīvatō [2] dakṣiṇaṁ karṇamutkr̥tya dr̥ṣadi jarjarīkr̥tya balvajakvāthādīnāmāplāvanānāmanyatamē [3]prakṣipyāplāvya muhūrtasthitamuddhr̥tya tadāplāvanaṁ pāyayēdēnām|
śatapuṣpākuṣṭhamadanahiṅgusiddhasya caināṁ tailasya picuṁ grāhayēt|
ataścaivānuvāsayēt|
ētairēva cāplāvanaiḥ phalajīmūtēkṣvākudhāmārgavakuṭajakr̥tavēdhanahastipippalyupahitairāsthāpayēt|
tadāsthāpanamasyāḥ saha vātamūtrapurīṣairnirharatyaparāmāsaktāṁ vāyōrēvāpratilōmagatvāt [4] |
aparāṁ hi vātamūtrapurīṣāṇyanyāni cāntarbahirmārgāṇi [5] sajjanti||41||

yadA ca prajAtA syAttadaivainAmavekSheta- kAcidasyA aparA prapannA na veti|
tasyAshcedaparA na prapannA syAdathainAmanyatamA strI dakShiNena pANinAnAbherupariShTAdbalavannipIDya savyena pANinA pRuShThata upasa~ggRuhya tAM sunirdhUtaMnirdhunuyAt|
athAsyAH pArShNyA shroNImAkoTayet|
asyAH sphicAvupasa~ggRuhya supIDitaM pIDayet|
athAsyA bAlaveNyA kaNThatAlu parimRushet|
bhUrjapatrakAcamaNisarpanirmokaishcAsyA yoniM dhUpayet|
kuShThatAlIsakalkaM balvajayUShe [1] maireyasurAmaNDe tIkShNe kaulatthe va yUShemaNDUkaparNIpippalIsampAke vA samplAvya pAyayedenAm|
tathA sUkShmailAkilimakuShThanAgara viDa~ggapippalIkAlAgurucavyacitrakopaku~jcikAkalkaMkharavRuShabhasya vA jIvato [2] dakShiNaM karNamutkRutya dRuShadi jarjarIkRutyabalvajakvAthAdInAmAplAvanAnAmanyatame [3] prakShipyAplAvya muhUrtasthitamuddhRutyatadAplAvanaM pAyayedenAm|
shatapuShpAkuShThamadanahi~ggusiddhasya cainAM tailasya picuM grAhayet|
atashcaivAnuvAsayet|
etaireva cAplAvanaiHphalajImUtekShvAkudhAmArgavakuTajakRutavedhanahastipippalyupahitairAsthApayet|
tadAsthApanamasyAH saha vAtamUtrapurIShairnirharatyaparAmAsaktAM vAyorevApratilomagatvAt [4] |
aparAM hi vAtamUtrapurIShANyanyAni cAntarbahirmArgANi [5] sajjanti||41||
<div style="text-align:justify;">
Immediately after the delivery of the child, one should confirm whether the placenta has been expelled out or not. If it is not expelled, then one of the female attendants should forcefully press her abdomen from above the navel region with her right hand and holding her back with left, should give a good shake to the body of the patient. The hip region of the patient should be pressed with the heels and her buttocks should be taken by hand and strongly pressed by the attendant. Her throat should be rubbed with the braid of her hair. The genital tract should be fumigated with the leaves of ''bhurja'' (Betula utilis D. Don.), ''kachamani'' (quartz) and ''sarpanirmoka'' (slough of serpent). She should be given paste of ''kushta'' (Saussurea lappa C. B. Clarke) and ''talisa'' (Abies webbiana Lindl.) mixed with the soup of ''balwaja'' (a hemp-like plant) or strong liquor of ''maireya'' and ''sura''-like beverages for drinking, or the soup of ''kulaththa'' (Dolichos biflorus Linn. - horse gram) or decoctions of ''mandukaparni'' (Centella asiatica Urban.) and ''pippali'' (Piper longum Linn.). The paste of ''laghu ela'' (Elettaria cardamomum Moton.), ''kilima'' (Devadaru – Cedrus deodara Loud.), ''kushta'' (Saussurea lappa C.B. Clarke), ''shunthi'' (Zingiber officinale Rosc.), ''vidanga'' (Embeliaribes Burm f.), ''pippali'' (Piper longum Linn.), ''kalagaru'' (Aquilaria agallocha Roxb. – black variety), ''chavya'' (Piper chaba Junter.), ''chitraka'' (Plumbago zeylanica Roxb.) and ''upakunjika'' (Nigella sativa Linn.)and crushed pieces of the right ear of a living untamed bull, pounding it on grinding stone and keeping it for some time in one of the decoctions of ''Balwaja'' (-?-) etc.;The liquid portion of this decoction should be administered to the patient as a drink. A cotton swab soaked in the oil prepared with ''shatapushpa'' (Foeniculum vulgare Mill.), ''kushta'' (Saussurea lappa C. B. Clarke), ''Madana'' (Randia dumetorum Lam.) and ''hingu'' (Ferula narthex Boiss.) should be inserted into her vaginal passage, and with the same oil, ''anuvasana basti'' (unctuous enema) should be administered to her. The decoction of ''Balwaja''(-?-) should be mixed with apaste of ''madanaphala''(Randia duemtorum Lam.), ''devadali'' (Luffaechinata Roxb.),''ikshvaku'' (Legenaria siceraria Standl.), ''dhamargava'' (Luffa cylindrica M. Roem.), ''kutaja'' (Holarrhena antidysenterica Wall.), ''kritavedhana'' (Luffa acutangula Roxb.) and ''gajapippali'' (Scindapsus officilanlis Schott.) and administered in the form of ''asthapana basti'' (non-unctuous enema).This non-unctuous enema will lead to the expulsion of the retained placenta while passing flatulence, urine and bowel movementsby the downward movement of ''vayu''. Bodily wastes have a tendency to come out of the body naturally, but may get obstructed inside the abdomen, obstructing the ejection of the placenta too. [41]

तस्यास्तु खल्वपरायाः प्रपतनार्थे कर्मणि क्रियमाणे जातमात्रस्यैव कुमारस्य कार्याण्येतानि कर्माणि भवन्ति; तद्यथा-अश्मनोः सङ्घट्टनं कर्णयोर्मूले, शीतोदकेनोष्णोदकेन वा मुखपरिषेकः [१] , तथा स क्लेशविहतान् प्राणान् पुनर्लभेत|
कृष्णकपालिकाशूर्पेण चैनमभिनिष्पुणीयुर्यद्यचेष्टः स्याद् यावत् प्राणानां प्रत्यागमनम् (तत्तत् [२] सर्वमेव कार्यम्)|
ततः प्रत्यागतप्राणं प्रकृतिभूतमभिसमीक्ष्य स्नानोदकग्रहणाभ्यामुपपादयेत्||४२||

tasyāstu khalvaparāyāḥ prapatanārthē karmaṇi kriyamāṇē jātamātrasyaiva kumārasya kāryāṇyētānikarmāṇi bhavanti; tadyathā- aśmanōḥ saṅghaṭṭanaṁ karṇayōrmūlē, śītōdakēnōṣṇōdakēna vāmukhapariṣēkaḥ [1] , tathā sa klēśavihatān prāṇān punarlabhēta|
kr̥ṣṇakapālikāśūrpēṇa cainamabhiniṣpuṇīyuryadyacēṣṭaḥ syād yāvat prāṇānāṁ pratyāgamanam (tattat [2]sarvamēva kāryam)|
tataḥ pratyāgataprāṇaṁ prakr̥tibhūtamabhisamīkṣya snānōdakagrahaṇābhyāmupapādayēt||42||

tasyAstu khalvaparAyAH prapatanArthe karmaNi kriyamANe jAtamAtrasyaiva kumArasya kAryANyetAnikarmANi bhavanti; tadyathA- ashmanoH sa~gghaTTanaM karNayormUle, shItodakenoShNodakena vAmukhapariShekaH [1] , tathA sa kleshavihatAn prANAn punarlabheta|
kRuShNakapAlikAshUrpeNa cainamabhiniShpuNIyuryadyaceShTaH syAd yAvat prANAnAMpratyAgamanam (tattat [2] sarvameva kAryam)|
tataH pratyAgataprANaM prakRutibhUtamabhisamIkShya snAnodakagrahaNAbhyAmupapAdayet||42||

While administering the various procedures described in the preceding verse to remove the placenta from the mother’s body, certain measures should also be performed on the newly born child, such as gently striking the stones near the root of the ear, and sprinkling of cold or hot water over its face, to rejuvenate its vital breath that might have stopped due to distress. If the child is not movingor does not revive, it should then be fanned with a winnowing basket made of bamboo etc. till it regains consciousness (the procedures to be continued till consciousness is established). Once respiration is established and gets normalized, then he should be given a good bath and cleansed thoroughly. [42]
</div>
==== Procedure for cleaning the baby after birth ====

अथास्य ताल्वोष्ठकण्ठजिह्वाप्रमार्जनमारभेताङ्गुल्या सुपरिलिखितनखया सुप्रक्षालितोपधानकार्पाससपिचुमत्या|
प्रथमं प्रमार्जितास्यस्य चास्य शिरस्तालु कार्पासपिचुना स्नेहगर्भेण प्रतिसञ्छादयेत्|
ततोऽस्यानन्तरं सैन्धवोपहितेन सर्पिषा कार्यं प्रच्छर्दनम्||४३||

athāsya tālvōṣṭhakaṇṭhajihvāpramārjanamārabhētāṅgulyā suparilikhitanakhayāsuprakṣālitōpadhānakārpāsasapicumatyā|
prathamaṁ pramārjitāsyasya cāsya śirastālu kārpāsapicunā snēhagarbhēṇa pratisañchādayēt|
tatō'syānantaraṁ saindhavōpahitēna sarpiṣā kāryaṁ pracchardanam||43||

athAsya tAlvoShThakaNThajihvApramArjanamArabhetA~ggulyA suparilikhitanakhayAsuprakShAlitopadhAnakArpAsasapicumatyA|
prathamaM pramArjitAsyasya cAsya shirastAlu kArpAsapicunA snehagarbheNa pratisa~jchAdayet|
tato~asyAnantaraM saindhavopahitena sarpiShA kAryaM pracchardanam||43||
<div style="text-align:justify;">
Thereafter, the palate, lips, throat and tongue of the child should be cleaned with a clean cotton swab using a finger of the attendant, whose nails have been well manicured. After cleaning the mouth, a cotton swab well soaked in oil should be placed over the ''shirastalu'' (anterior fontanel) and then a procedure to provoke vomiting should be administered using ghee with ''saindhava'' (rock salt). [43]
</div>
==== Measuring the umbilical cord ====

ततः कल्पनं नाड्याः|
अतस्तस्याः कल्पनविधिमुपदेक्ष्यामः-नाभिबन्धनात् प्रभृत्यष्टाङ्गुलमभिज्ञानं कृत्वा छेदनावकाशस्य द्वयोरन्तरयोःशनैर्गृहीत्वा तीक्ष्णेन रौक्मराजतायसानां छेदनानामन्यतमेनार्धधारेण [१] छेदयेत्|
तामग्रे सूत्रेणोपनिबध्य कण्ठेऽस्य शिथिलमवसृजेत्|
तस्य चेन्नाभिः पच्येत, तां लोध्रमधुकप्रियङ्गुसुरदारुहरिद्राकल्कसिद्धेन तैलेनाभ्यज्यात्, एषामेव तैलौषधानांचूर्णेनावचूर्णयेत्|
इति नाडीकल्पनविधिरुक्तः सम्यक्||४४||

tataḥ kalpanaṁ nāḍyāḥ|
atastasyāḥ kalpanavidhimupadēkṣyāmaḥ- nābhibandhanāt prabhr̥tyaṣṭāṅgulamabhijñānaṁ kr̥tvāchēdanāvakāśasya dvayōrantarayōḥ śanairgr̥hītvā tīkṣṇēna raukmarājatāyasānāṁchēdanānāmanyatamēnārdhadhārēṇa [1] chēdayēt|
tāmagrē sūtrēṇōpanibadhya kaṇṭhē'sya śithilamavasr̥jēt|
tasya cēnnābhiḥ pacyēta, tāṁ lōdhramadhukapriyaṅgusuradāruharidrākalkasiddhēna tailēnābhyajyāt,ēṣāmēva tailauṣadhānāṁ cūrṇēnāvacūrṇayēt|
iti nāḍīkalpanavidhiruktaḥ samyak||44||

tataH kalpanaM nADyAH|
atastasyAH kalpanavidhimupadekShyAmaH- nAbhibandhanAt prabhRutyaShTA~ggulamabhij~jAnaMkRutvA chedanAvakAshasya dvayorantarayoH shanairgRuhItvA tIkShNena raukmarAjatAyasAnAMchedanAnAmanyatamenArdhadhAreNa [1] chedayet|
tAmagre sUtreNopanibadhya kaNThe~asya shithilamavasRujet|
tasya cennAbhiH pacyeta, tAM lodhramadhukapriya~ggusuradAruharidrAkalkasiddhena tailenAbhyajyAt,eShAmeva tailauShadhAnAM cUrNenAvacUrNayet|
iti nADIkalpanavidhiruktaH samyak||44||
<div style="text-align:justify;">
Thereafter, the umbilical cord is measured. The cord should be marked at a distance of eight angula (thumb-length) from its base where it is attached at the navel of the child, and then holding the cord gently and firmly on both the ends, it should be cut with a sharp half-edged instrument made of gold, silver or iron (steel). The portion of the cord at the navel side should be tied with a thread and then loosely tied to the neck of the child. If the umbilicus end gets suppurated, then it should be anointed with oil prepared with paste of ''lodhra'' (Symplocos racemosa Roxb.), ''madhuka'' (Glycyrrhiza glabra Linn.), ''priyangu'' (Callicarpa macrophylla Vahl.), ''devadaru'' (Cedrus deodara Loud.) and ''haridra'' (Curcuma longa Linn.), and the powder of the same drugs should be sprinkled over the cut surface.
This concludes the verse on the “measurement of the cord”. [44]
</div>
==== Complications arising due to improper cutting of the umbilical cord ====

असम्यक्कल्पने हि नाड्या आयामव्यायामोत्तुण्डिता-पिण्डलिका-विनामिका-विजृम्भिकाबाधेभ्यो भयम्|
तत्राविदाहिभिर्वातपित्तप्रशमनैरभ्यङ्गोत्सादनपरिषेकैः सर्पिर्भिश्चोपक्रमेत गुरुलाघवमभिसमीक्ष्य||४५||

asamyakkalpanē hi nāḍyā āyāmavyāyāmōttuṇḍitā-piṇḍalikā-vināmikā-vijr̥mbhikābādhēbhyō bhayam|
tatrāvidāhibhirvātapittapraśamanairabhyaṅgōtsādanapariṣēkaiḥ sarpirbhiścōpakramētagurulāghavamabhisamīkṣya||45||

asamyakkalpane hi nADyA AyAmavyAyAmottuNDitA-piNDalikA-vinAmikA-vijRumbhikAbAdhebhyo bhayam|
tatrAvidAhibhirvAtapittaprashamanairabhya~ggotsAdanapariShekaiH sarpirbhishcopakrametagurulAghavamabhisamIkShya||45||
<div style="text-align:justify;">
Improper cutting of the umbilical cord and administering of measures explained in the preceding verse could lead to complications such as ''ayamottundita'' (vertical swelling), ''vyayamottundita'' (horizontal swelling), ''pindalika'' (lumpy swellings or formation of a circular ring around the umblicus), ''vinamika'' (swelling in the margins with depression at centre), and ''vijrumbhika'' (swelling with constant increase in size as in umblical hernia). In case of these complications, by carefully observing the severity of the condition (mild to severe involvement of the ''doshas''), it should be treated using massages, unction, and sprinkling of ghee prepared with drugs that are non-irritants and ''vata'' and ''pitta'' pacifying. [45]
</div>
==== Birth-rites per Vedic rituals ====

अतोऽनन्तरं जातकर्म कुमारस्य कार्यम्|
तद्यथा- मधुसर्पिषी मन्त्रोपमन्त्रिते यथाम्नायं प्रथमं प्राशितुं दद्यात्|
स्तनमत ऊर्ध्वमेतेनैव विधिना दक्षिणं पातुं पुरस्तात् प्रयच्छेत्|
अथातः [१] शीर्षतः स्थापयेदुदकुम्भं मन्त्रोपमन्त्रितम्||४६||

atō'nantaraṁ jātakarma kumārasya kāryam|
tadyathā- madhusarpiṣī mantrōpamantritē yathāmnāyaṁ prathamaṁ prāśituṁ dadyāt|
stanamata ūrdhvamētēnaiva vidhinā dakṣiṇaṁ pātuṁ purastāt prayacchēt|
athātaḥ [1] śīrṣataḥ sthāpayēdudakumbhaṁ mantrōpamantritam||46||

ato~anantaraM jAtakarma kumArasya kAryam|
tadyathA- madhusarpiShI mantropamantrite yathAmnAyaM prathamaM prAshituM dadyAt|
stanamata Urdhvametenaiva vidhinA dakShiNaM pAtuM purastAt prayacchet|
athAtaH [1] shIrShataH sthApayedudakumbhaM mantropamantritam||46||
<div style="text-align:justify;">
Thereafter, birth-rites of the child should be performed per vedic rituals, which are as follows: first of all, honey and ghee duly “consecrated” with vedic mantras (chanted by brahmanas or priests) should be anointed to the child. Breast milk should first be fed from the right breast, and should be done so after performing the rituals mentioned above. An earthen pot filled with water should be consecrated with mantras and kept near the head of the child. [46]
</div>
==== Measures to protect the newborn ====

अथास्य रक्षां विदध्यात्- आदानीखदिरकर्कन्धुपीलुपरूषकशाखाभिरस्या गृहं समन्ततः परिवारयेत्|
सर्वतश्च सूतिकागारस्य सर्षपातसीतण्डुलकणकणिकाः प्रकिरेयुः|
तथा तण्डुलबलिहोमः सततमुभयकालं [१] क्रियेतानामकर्मणः [२] |
द्वारे च मुसलं देहलीमनु तिरश्चीनं न्यसेत्|
वचाकुष्ठक्षौमकहिङ्गुसर्षपातसीलशुनकणकणिकानां रक्षोघ्नसमाख्यातानां चौषधीनां पोट्टलिकां बद्ध्वासूतिकागारस्योत्तरदेहल्यामवसृजेत्, तथा सूतिकायाः कण्ठे सपुत्रायाः, स्थाल्युदककुम्भपर्यङ्केष्वपि, तथैव चद्वयोर्द्वारपक्षयोः|
कणककण्टकेन्धनवानग्निस्तिन्दुककाष्ठेन्धनश्चाग्निः सूतिकागारस्याभ्यन्तरतो नित्यं स्यात्|
स्त्रियश्चैनां यथोक्तगुणाः सुहृदश्चानुश्चानुजागृयुर्दशाहं द्वादशाहं वा|
अनुपरतप्रदानमङ्गलाशीःस्तुतिगीतवादित्रमन्नपानविशदमनुरक्तप्रहृष्टजनसम्पूर्णं च तद्वेश्म कार्यम्|
ब्राह्मणश्चाथर्ववेदवित् सततमुभयकालं शान्तिं जुहुयात् स्वस्त्ययनार्थं कुमारस्य तथा सूतिकायाः|
इत्येतद्रक्षाविधानमुक्तम्||४७||

athāsya rakṣāṁ vidadhyāt- ādānīkhadirakarkandhupīluparūṣakaśākhābhirasyā gr̥haṁ samantataḥparivārayēt|
sarvataśca sūtikāgārasya sarṣapātasītaṇḍulakaṇakaṇikāḥ prakirēyuḥ|
tathā taṇḍulabalihōmaḥ satatamubhayakālaṁ [1] kriyētānāmakarmaṇaḥ [2] |
dvārē ca musalaṁ dēhalīmanu tiraścīnaṁ nyasēt|
vacākuṣṭhakṣaumakahiṅgusarṣapātasīlaśunakaṇakaṇikānāṁ rakṣōghnasamākhyātānāṁ cauṣadhīnāṁpōṭṭalikāṁ baddhvā sūtikāgārasyōttaradēhalyāmavasr̥jēt, tathā sūtikāyāḥ kaṇṭhē saputrāyāḥ,sthālyudakakumbhaparyaṅkēṣvapi, tathaiva ca dvayōrdvārapakṣayōḥ|
kaṇakakaṇṭakēndhanavānagnistindukakāṣṭhēndhanaścāgniḥ sūtikāgārasyābhyantaratō nityaṁ syāt|
striyaścaināṁ yathōktaguṇāḥ suhr̥daścānuścānujāgr̥yurdaśāhaṁ dvādaśāhaṁ vā|
anuparatapradānamaṅgalāśīḥstutigītavāditramannapānaviśadamanuraktaprahr̥ṣṭajanasampūrṇaṁ catadvēśma kāryam|
brāhmaṇaścātharvavēdavit satatamubhayakālaṁ śāntiṁ juhuyāt svastyayanārthaṁ kumārasya tathāsūtikāyāḥ|
ityētadrakṣāvidhānamuktam||47||

athAsya rakShAM vidadhyAt- AdAnIkhadirakarkandhupIluparUShakashAkhAbhirasyA gRuhaM samantataHparivArayet|
sarvatashca sUtikAgArasya sarShapAtasItaNDulakaNakaNikAH prakireyuH|
tathA taNDulabalihomaH satatamubhayakAlaM [1] kriyetAnAmakarmaNaH [2] |
dvAre ca musalaM dehalImanu tirashcInaM nyaset|
vacAkuShThakShaumakahi~ggusarShapAtasIlashunakaNakaNikAnAM rakShoghnasamAkhyAtAnAMcauShadhInAM poTTalikAM baddhvA sUtikAgArasyottaradehalyAmavasRujet, tathA sUtikAyAH kaNThesaputrAyAH, sthAlyudakakumbhaparya~gkeShvapi, tathaiva ca dvayordvArapakShayoH|
kaNakakaNTakendhanavAnagnistindukakAShThendhanashcAgniH sUtikAgArasyAbhyantarato nityaM syAt|
striyashcainAM yathoktaguNAH suhRudashcAnushcAnujAgRuyurdashAhaM dvAdashAhaM vA|
anuparatapradAnama~ggalAshIHstutigItavAditramannapAnavishadamanuraktaprahRuShTajanasampUrNaMca tadveshma kAryam|
brAhmaNashcAtharvavedavit satatamubhayakAlaM shAntiM juhuyAt svastyayanArthaM kumArasya tathAsUtikAyAH|
ityetadrakShAvidhAnamuktam||47||
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This verse describes measures to protect the newborn. To start with, the maternity home should be surrounded by the branches of ''adani'' (-?-),''khadira'' (Acacia catechu Willd.), ''karkandhu'' (Zyzyphus nummularia W.&A.), ''pilu'' (Salvadora persica Linn.), and ''parushaka'' (Grewiaasiatica Linn.).''Sarshapa'' (Brassica nigra Linn - mustard seeds), ''atasi'' (Linum ustatissimum Linn.), and ''tandula kanakanika'' (pieces of broken rice) should be spread all over the floors in the maternity home. The sacrificial ritual of offering rice to fire should be performed every morning and evening till the naming ceremony for the child is complete. At the door-sill, a wooden pestle should be kept obliquely. A ''potli'' (bag) containing ''vacha'' (Acorus calamus Linn.), ''kushtha'' (Saussurea lappa C.B. Clarke.), ''choraka'' (Ksaumaka -?-), ''hingu'' (Ferula narthex Boiss.), ''sarshapa'' (Brassica nigra Koch.), ''atasi'' (Linum usitatissimum Linn.), ''lashuna'' (Alium sativum Linn.), ''kanakanika'' (-?-) and other drugs known to be repellents of evil spirits should be tied to the door-sill, and to the necks of the mother and the child , and should also be put into cooking utensils, water jars, bed, and on either side of the door panels. There should be a fire lighted constantly with the fire woods of ''kanakanika'' (-?-), and ''tinduka'' (Diospyros peregrine Gurke.) at the fireplace within the maternity home. The attending women (of the qualities mentioned earlier) should keep vigilance of the maternity home for ten to twelve days. The whole house should be kept busy with people who are pious, affectionate and happy, and kept engaged with gifts, encouraging blessings, praise, song, music food and drinks. In order to bestow auspicious blessings on the mother and the child, ''brahmins'' well versed in Atharva Veda should perform ritual sacrifices in the sacred fire two times a day. These are, rituals and measures that need to be put in place to protect the mother and the child. [47]
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==== Post-partum care of the mother ====

सूतिकां तु खलु बुभुक्षितां विदित्वा स्नेहं पाययेत परमया शक्त्या सर्पिस्तैलं वसां मज्जानं वा सात्म्यीभावमभिसमीक्ष्यपिप्पलीपिप्पलीमूलचव्यचित्रकशृङ्गवेरचूर्णसहितम्|
स्नेहं पीतवत्याश्च सर्पिस्तैलाभ्यामभ्यज्य वेष्टयेदुदरं महताऽच्छेन वाससा; तथा तस्या न वायुरुदरेविकृतिमुत्पादयत्यनवकाशत्वात्|
जीर्णे तु स्नेहे पिप्पल्यादिभिरेव सिद्धां यवागूं सुस्निग्धां द्रवां मात्रशः [१] पाययेत्|
उभयतःकालं चोष्णोदकेन च परिषेचयेत् प्राक् स्नेहयवागूपानाभ्याम्|
एवं पञ्चरात्रं सप्तरात्रं वाऽनुपाल्य क्रमेणाप्याययेत्|
स्वस्थवृत्तमेतावत् सूतिकायाः||४८||

sūtikāṁ tu khalu bubhukṣitāṁ viditvā snēhaṁ pāyayēta paramayā śaktyā sarpistailaṁ vasāṁ majjānaṁ vāsātmyībhāvamabhisamīkṣya pippalīpippalīmūlacavyacitrakaśr̥ṅgavēracūrṇasahitam|
snēhaṁ pītavatyāśca sarpistailābhyāmabhyajya vēṣṭayēdudaraṁ mahatā'cchēna vāsasā; tathā tasyā navāyurudarē vikr̥timutpādayatyanavakāśatvāt|
jīrṇē tu snēhē pippalyādibhirēva siddhāṁ yavāgūṁ susnigdhāṁ dravāṁ mātraśaḥ [1] pāyayēt|
ubhayataḥkālaṁ cōṣṇōdakēna ca pariṣēcayēt prāk snēhayavāgūpānābhyām|
ēvaṁ pañcarātraṁ saptarātraṁ vā'nupālya kramēṇāpyāyayēt|
svasthavr̥ttamētāvat sūtikāyāḥ||48||

sUtikAM tu khalu bubhukShitAM viditvA snehaM pAyayeta paramayA shaktyA sarpistailaM vasAM majjAnaMvA sAtmyIbhAvamabhisamIkShya pippalIpippalImUlacavyacitrakashRu~ggaveracUrNasahitam|
snehaM pItavatyAshca sarpistailAbhyAmabhyajya veShTayedudaraM mahatA~acchena vAsasA; tathAtasyA na vAyurudare vikRutimutpAdayatyanavakAshatvAt|
jIrNe tu snehe pippalyAdibhireva siddhAM yavAgUM susnigdhAM dravAM mAtrashaH [1] pAyayet|
ubhayataHkAlaM coShNodakena ca pariShecayet prAk snehayavAgUpAnAbhyAm|
evaM pa~jcarAtraM saptarAtraM vA~anupAlya krameNApyAyayet|
svasthavRuttametAvat sUtikAyAH||48||
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After the delivery (i.e., in the post-partum period) when the new mother feels hungry and needs nourishment, suitable fatty substances like ghee, oil, and majja (muscle fat or marrow), duly mixed with the powders of pippali (Piper longum Linn.), pippalimula (root of Piper longum Linn.), chavya (Piper chaba Hunter.), chitraka (Plumbagozeylanica Linn.) and shrungabera (Zingiberofficinale Rocs.) should be given to her, according to her status of appetitie. Once she has eaten, she should be given a good massage on her abdomen with ghee and oil and then a big clean cloth should be wrapped around her abdomen so that vayu may not find a place to cause any ailment. Once the food eaten is digested, she should take liquid gruel prepared with pippali (Piper longum Linn.) etc., mixed with unctuous substances in copious amounts. She should take a warm water bath before taking meals, though. This regimen should be continued for five to seven nights. [48]
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तस्यास्तु खलु यो व्याधिरुत्पद्यते स कृच्छ्रसाध्यो भवत्यसाध्यो वा, गर्भवृद्धिक्षयितशिथिलसर्वधातुत्वात्,प्रवाहणवेदनाक्लेदनरक्तनिःस्रुतिविशेषशून्यशरीरत्वाच्च; तस्मात्तां यथोक्तेन विधिनोपचरेत्;भौतिकजीवनीयबृंहणीयमधुरवातहरसिद्धैरभ्यङ्गोत्सादनपरिषेकावगाहनान्नपानविधिभिर्विशेषतश्चोपचरेत्; विशेषतो हिशून्यशरीराः स्त्रियः प्रजाता भवन्ति||४९||

tasyāstu khalu yō vyādhirutpadyatē sa kr̥cchrasādhyō bhavatyasādhyō vā, garbhavr̥ddhikṣayitaśithilasarvadhātutvāt,pravāhaṇavēdanāklēdanaraktaniḥsrutiviśēṣaśūnyaśarīratvācca; tasmāttāṁ yathōktēna vidhinōpacarēt;bhautikajīvanīyabr̥ṁhaṇīyamadhuravātaharasiddhairabhyaṅgōtsādanapariṣēkāvagāhanānnapānavidhibhirviśēṣataścōpacarēt;viśēṣatō hi śūnyaśarīrāḥ striyaḥ prajātā bhavanti||49||

tasyAstu khalu yo vyAdhirutpadyate sa kRucchrasAdhyo bhavatyasAdhyo vA, garbhavRuddhikShayitashithilasarvadhAtutvAt,pravAhaNavedanAkledanaraktaniHsrutivisheShashUnyasharIratvAcca; tasmAttAM yathoktena vidhinopacaret;bhautikajIvanIyabRuMhaNIyamadhuravAtaharasiddhairabhya~ggotsAdanapariShekAvagAhanAnnapAnavidhibhirvisheShatashcopacaret;visheShato hi shUnyasharIrAH striyaH prajAtA bhavanti||49||
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If the mother is afflicted with any disease at this puerperal stage, then the condition becomes either difficult to cure or incurable because her body has suffered throughout pregnancy and parturition; because of providing nourishment for growth and development of fetus as well as discharges of blood and kleda during parturition she is vulnerable to doshic afflictions and various diseases.It is therefore important for a weak mother, or a mother afflicted with sickness to be specifically treated with massages, oil anointments, warm baths, food and drink prepared with drugs that are bhautika (alleviators of evil spirits), and of jivaniya, brimhaniya, madhura and vatahar classes of medications. [49]
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दशमे त्वहनि [१] सपुत्रा स्त्री सर्वगन्धौषधैर्गौरसर्षपलोध्रैश्च स्नाता लघ्वहतशुचिवस्त्रं परिधाय [२] पवित्रेष्टलघुविचित्रभूषणवतीच संस्पृश्य मङ्गलान्युचितामर्चयित्वा च देवतां शिखिनः शुक्लवाससोऽव्यङ्गांश्च ब्राह्मणान् स्वस्ति वाचयित्वाकुमारमहतानां [३] च वाससां सञ्चये प्राक्शिरसमुदक्शिरसं वा संवेश्य देवतापूर्वं द्विजातिभ्यः प्रणमतीत्युक्त्वा कुमारस्य पिताद्वे नामनी कारयेन्नाक्षत्रिकं नामाभिप्रायिकं च|
तत्राभिप्रायिकं घोषवदाद्यन्तस्थान्तमूष्मान्तं वाऽवृद्धं [४] त्रिपुरुषानूकमनवप्रतिष्ठितं, नाक्षात्रिकं तु नक्षत्रदेवतासमानाख्यं [५]द्व्यक्षरं चतुरक्षरं वा||५०||
daśamē tvaha
ni [1] saputrā strī sarvagandhauṣadhairgaurasarṣapalōdhraiśca snātā laghvahataśucivastraṁparidhāya [2] pavitrēṣṭalaghuvicitrabhūṣaṇavatī ca saṁspr̥śya maṅgalānyucitāmarcayitvā ca dēvatāṁśikhinaḥ śuklavāsasō'vyaṅgāṁśca brāhmaṇān svasti vācayitvā kumāramahatānāṁ [3] ca vāsasāṁ sañcayēprākśirasamudakśirasaṁ vā saṁvēśya dēvatāpūrvaṁ dvijātibhyaḥ praṇamatītyuktvā kumārasya pitā dvēnāmanī kārayēnnākṣatrikaṁ nāmābhiprāyikaṁ ca|
tatrābhiprāyikaṁ ghōṣavadādyantasthāntamūṣmāntaṁ vā'vr̥ddhaṁ [4] tripuruṣānūkamanavapratiṣṭhitaṁ,nākṣātrikaṁ tu nakṣatradēvatāsamānākhyaṁ [5] dvyakṣaraṁ caturakṣaraṁ vā||50||

dashame tvahani [1] saputrA strI sarvagandhauShadhairgaurasarShapalodhraishca snAtAlaghvahatashucivastraM paridhAya [2] pavitreShTalaghuvicitrabhUShaNavatI ca saMspRushyama~ggalAnyucitAmarcayitvA ca devatAM shikhinaH shuklavAsaso~avya~ggAMshca brAhmaNAn svastivAcayitvA kumAramahatAnAM [3] ca vAsasAM sa~jcaye prAkshirasamudakshirasaM vA saMveshyadevatApUrvaM dvijAtibhyaH praNamatItyuktvA kumArasya pitA dve nAmanI kArayennAkShatrikaMnAmAbhiprAyikaM ca|
tatrAbhiprAyikaM ghoShavadAdyantasthAntamUShmAntaM vA~avRuddhaM [4]tripuruShAnUkamanavapratiShThitaM, nAkShAtrikaM tu nakShatradevatAsamAnAkhyaM [5] dvyakSharaMcaturakSharaM vA||50||
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On the tenth day of delivery, the woman, along with her child, should take bath in water treated with fragrant herbs, shveta sarshapa (white variety of mustard – Brassica nigra Koch.) and lodhra (Symplocos recemosa Roxb.). They should be dressed in light, new and clean garments, while the woman should also be adorned in pure, light and variegated ornaments. The garments and ornaments should have been consecrated using Vedic rituals, and blessed by priests wearing white garments and without any physical deformities. Then the child, having been wrapped in a new garment, should be placed with his head facing the east or the north. The father of the child should pay obeisance to the Gods and Brahmins on behalf of the child and then give it two names: one denoting the nakshatra under which it was born and the other intended for social interactions. The name for social purpose should have a Ghosha (sonant) for its first letter and for its last a Antastha (semi-vowel) or usman (sibilants and aspirate), should be free of Vriddhi(diphthongs), indicative of one of the three ancestors (father, grandfather and great grandfather) and not a new created The constellar name should be identical to that of the diety of the nakshatra and should be made up of two or four (Sanskrit) syllables. [50]
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==== Assessment of life-span of the baby ====

वृत्ते [१] च नामकर्मणि कुमारं परीक्षितुमुपक्रमेतायुषः प्रमाणज्ञानहेतोः|
तत्रेमान्यायुष्मतां कुमाराणां लक्षणानि भवन्ति|
तद्यथा- एकैकजा मृदवोऽल्पाः स्निग्धाः सुबद्धमूलाः कृष्णाः केशाः प्रशस्यन्ते, स्थिरा बहला त्वक्,प्रकृत्याऽतिसम्पन्नमीषत्प्रमाणातिवृत्तमनुरूपमातपत्रोपमं [२] शिरः, व्यूढं दृढं समंसुश्लिष्टशङ्खसन्ध्यूर्ध्वव्यञ्जनसम्पन्नमुपचितं वलिभमर्धचन्द्राकृति ललाटं, बहलौ विपुलसमपीठौ समौ नीचैर्वृद्धौपृष्ठतोऽवनतौ सुश्लिष्टकर्णपुत्रकौ महाच्छिद्रौ कर्णौ, ईषत्प्रलम्बिन्यावसङ्गते समे संहते महत्यौ भ्रुवौ, समे समाहितदर्शनेव्यक्तभागविभागे बलवती तेजसोपपन्ने स्वङ्गापाङ्गे चक्षुषी, ऋज्वी महोच्छ्वासा वंशसम्पन्नेषदवनताग्रा नासिका,महदृजुसुनिविष्टदन्तमास्यम्, आयामविस्तारोपपन्ना श्लक्ष्णा तन्वी प्रकृतिवर्णयुक्ता [३] जिह्वा, श्लक्ष्णंयुक्तोपचयमूष्मोपपन्नं रक्तं तालु, महानदीनः स्निग्धोऽनुनादी गम्भीरसमुत्थो धीरः स्वरः, नातिस्थूलौ नातिकृशौविस्तारोपपन्नावास्यप्रच्छादनौ रक्तावोष्ठौ, महत्यौ हनू, वृत्ता नातिमहती ग्रीवा, व्यूढमुपचितमुरः, गूढं जत्रु पृष्ठवंशश्च,विप्रकृष्टान्तरौ स्तनौ, असम्पातिनी स्थिरे पार्श्वे, वृत्तपरिपूर्णायतौ बाहू सक्थिनी अङ्गुलयश्च, महदुपचितं पाणिपादं, स्थिरावृत्ताः स्निग्धास्ताम्रास्तुङ्गाः कूर्माकाराः करजाः, प्रदक्षिणावर्ता सोत्सङ्गा च नाभिः, उरस्त्रिभागहीना समा समुपचितमांसाकटी, वृत्तौ स्थिरोपचितमांसौ नात्युन्नतौ नात्यवनतौ स्फिचौ, अनुपूर्वं वृत्तावुपचययुक्तावूरू, नात्युपचिते नात्यपचिते एणीपदेप्रगूढसिरास्थिसन्धी जङ्घे, नात्युपचितौ नात्यपचितौ गुल्फौ, पूर्वोपदिष्टगुणौ पादौ कूर्माकारौ, प्रकृतियुक्तानिवातमूत्रपुरीषगुह्यानि तथा स्वप्रजागरणायासस्मितरुदितस्तनग्रहणानि, यच्च किञ्चिदन्यदप्यनुक्तमस्ति तदपि सर्वंप्रकृतिसम्पन्नमिष्टं, विपरीतं पुनरनिष्टम्|
इति दीर्घायुर्लक्षणानि||५१||

vr̥ttē [1] ca nāmakarmaṇi kumāraṁ parīkṣitumupakramētāyuṣaḥ pramāṇajñānahētōḥ|
tatrēmānyāyuṣmatāṁ kumārāṇāṁ lakṣaṇāni bhavanti|
tadyathā- ēkaikajā mr̥davō'lpāḥ snigdhāḥ subaddhamūlāḥ kr̥ṣṇāḥ kēśāḥ praśasyantē, sthirā bahalā tvak,prakr̥tyā'tisampannamīṣatpramāṇātivr̥ttamanurūpamātapatrōpamaṁ [2] śiraḥ, vyūḍhaṁ dr̥ḍhaṁ samaṁsuśliṣṭaśaṅkhasandhyūrdhvavyañjanasampannamupacitaṁ valibhamardhacandrākr̥ti lalāṭaṁ, bahalauvipulasamapīṭhau samau nīcairvr̥ddhau pr̥ṣṭhatō'vanatau suśliṣṭakarṇaputrakau mahācchidrau karṇau,īṣatpralambinyāvasaṅgatē samē saṁhatē mahatyau bhruvau, samē samāhitadarśanē vyaktabhāgavibhāgēbalavatī tējasōpapannē svaṅgāpāṅgē cakṣuṣī, r̥jvī mahōcchvāsā vaṁśasampannēṣadavanatāgrā nāsikā,mahadr̥jusuniviṣṭadantamāsyam, āyāmavistārōpapannā ślakṣṇā tanvī prakr̥tivarṇayuktā [3] jihvā, ślakṣṇaṁyuktōpacayamūṣmōpapannaṁ raktaṁ tālu, mahānadīnaḥ snigdhō'nunādī gambhīrasamutthō dhīraḥsvaraḥ, nātisthūlau nātikr̥śau vistārōpapannāvāsyapracchādanau raktāvōṣṭhau, mahatyau hanū, vr̥ttānātimahatī grīvā, vyūḍhamupacitamuraḥ, gūḍhaṁ jatru pr̥ṣṭhavaṁśaśca, viprakr̥ṣṭāntarau stanau,asampātinī sthirē pārśvē, vr̥ttaparipūrṇāyatau bāhū sakthinī aṅgulayaśca, mahadupacitaṁ pāṇipādaṁ,sthirā vr̥ttāḥ snigdhāstāmrāstuṅgāḥ kūrmākārāḥ karajāḥ, pradakṣiṇāvartā sōtsaṅgā ca nābhiḥ,urastribhāgahīnā samā samupacitamāṁsā kaṭī, vr̥ttau sthirōpacitamāṁsau nātyunnatau nātyavanatausphicau, anupūrvaṁ vr̥ttāvupacayayuktāvūrū, nātyupacitē nātyapacitē ēṇīpadē pragūḍhasirāsthisandhījaṅghē, nātyupacitau nātyapacitau gulphau, pūrvōpadiṣṭaguṇau pādau kūrmākārau, prakr̥tiyuktānivātamūtrapurīṣaguhyāni tathā svaprajāgaraṇāyāsasmitaruditastanagrahaṇāni, yaccakiñcidanyadapyanuktamasti tadapi sarvaṁ prakr̥tisampannamiṣṭaṁ, viparītaṁ punaraniṣṭam|
iti dīrghāyurlakṣaṇāni||51||

vRutte [1] ca nAmakarmaNi kumAraM parIkShitumupakrametAyuShaH pramANaj~jAnahetoH|
tatremAnyAyuShmatAM kumArANAM lakShaNAni bhavanti|
tadyathA- ekaikajA mRudavo~alpAH snigdhAH subaddhamUlAH kRuShNAH keshAH prashasyante, sthirAbahalA tvak, prakRutyA~atisampannamIShatpramANAtivRuttamanurUpamAtapatropamaM [2] shiraH,vyUDhaM dRuDhaM samaM sushliShTasha~gkhasandhyUrdhvavya~jjanasampannamupacitaMvalibhamardhacandrAkRuti lalATaM, bahalau vipulasamapIThau samau nIcairvRuddhaupRuShThato~avanatau sushliShTakarNaputrakau mahAcchidrau karNau, IShatpralambinyAvasa~ggatesame saMhate mahatyau bhruvau, same samAhitadarshane vyaktabhAgavibhAge balavatI tejasopapannesva~ggApA~gge cakShuShI, RujvI mahocchvAsA vaMshasampanneShadavanatAgrA nAsikA,mahadRujusuniviShTadantamAsyam, AyAmavistAropapannA shlakShNA tanvI prakRutivarNayuktA [3] jihvA,shlakShNaM yuktopacayamUShmopapannaM raktaM tAlu, mahAnadInaH snigdho~anunAdIgambhIrasamuttho dhIraH svaraH, nAtisthUlau nAtikRushau vistAropapannAvAsyapracchAdanauraktAvoShThau, mahatyau hanU, vRuttA nAtimahatI grIvA, vyUDhamupacitamuraH, gUDhaM jatrupRuShThavaMshashca, viprakRuShTAntarau stanau, asampAtinI sthire pArshve, vRuttaparipUrNAyataubAhU sakthinI a~ggulayashca, mahadupacitaM pANipAdaM, sthirA vRuttAH snigdhAstAmrAstu~ggAHkUrmAkArAH karajAH, pradakShiNAvartA sotsa~ggA ca nAbhiH, urastribhAgahInA samAsamupacitamAMsA kaTI, vRuttau sthiropacitamAMsau nAtyunnatau nAtyavanatau sphicau, anupUrvaMvRuttAvupacayayuktAvUrU, nAtyupacite nAtyapacite eNIpade pragUDhasirAsthisandhI ja~gghe,nAtyupacitau nAtyapacitau gulphau, pUrvopadiShTaguNau pAdau kUrmAkArau, prakRutiyuktAnivAtamUtrapurIShaguhyAni tathA svaprajAgaraNAyAsasmitaruditastanagrahaNAni, yaccaki~jcidanyadapyanuktamasti tadapi sarvaM prakRutisampannamiShTaM, viparItaM punaraniShTam|
iti dIrghAyurlakShaNAni||51||
<div style="text-align:justify;">
Once the naming ceremony is over, the life-span of the child is assessed by the priests. The children that live long, according to this verse, have discrete, soft, sparse, oily, firm-rooted and black hair, firm and thick skin, naturally well-endowed, slightly bigger in size, umbrella-like head; broad, firm, even, united well with the temporal bone, endowed with three transverse lines, plump, having wrinkles and half moon-shaped forehead; thick, large, symmetrical ears with even flaps, equal elongated and downwardly depressed at the back, having compact tragus and big meatus; eyebrows that are slightly hanging downwards, disjoined (i.e., separate brows and not a uni-brow), even, compact and large; symmetrical eyes that have sharp vision, have beautiful shape (when viewed from the front and the sides); straight nose, with large nostrils, well ridged and slightly depressed at the tip; mouth big and straight, with good gums (and when the child grows up, a healthy set of teeth); tongue of sufficient length and breadth, smooth in texture and of normal colour; palate smooth, well developed, hot and red; voice sweet, echoing, and tempered; reddish lips that are neither too thick nor thin; large jaws; round, but not very long (or craning) or thick neck; broad and well developed chest; hidden xiphisternum and vertebral column; unbending and stable sides; arms, legs and fingers that are round, developed and long; hands and feet that are big and developed; unafflicted nails, round, unctuous, coppery, high and tortoise shaped; navel that is whirled clockwise and deep; waist 1/3rd less than chest (in breadth), even, having well developed muscles; buttocks round, not too elevated, with firm and developed muscles; thighs tapering downwards, round and well developed; shanks neither too stout nor too thin, but resembling that of deer’s foot, with hidden blood vessels, bones and joints; ankles neither too broad nor too thin; feet possessing the above features and tortoise shaped; and normal functions associated with passing bodily wastes, sexual organs, sleep, abilities to express emotions by smiling, weeping, and appetite through suckling. Other aspects of the child’s body or bodily functions, if with normal features, are desirable.
This sums up the verse on physical features used to assess the longevity of the newborn. [51]
</div>
==== Qualities of the wet-nurse attending the newborn ====

अतो धात्रीपरीक्षामुपदेक्ष्यामः|
अथ ब्रूयात्-धात्रीमानय समानवर्णां यौवनस्थां निभृतामनातुरामव्यङ्गामव्यसनामविरूपामजुगुप्सितां [१]देशजातीयामक्षुद्रामक्षुद्रकर्मिणीं कुले जातां वत्सलामरोगां जीवद्वत्सां पुंवत्सांदोग्ध्रीमप्रमत्तामनुच्चारशायिनीमनन्त्यावसायिनीं कुशलोपचारां शुचिमशुचिद्वेषिणीं स्तनस्तन्यसम्पदुपेतामिति||५२||

atō dhātrīparīkṣāmupadēkṣyāmaḥ|
atha brūyāt- dhātrīmānaya samānavarṇāṁ yauvanasthāṁnibhr̥tāmanāturāmavyaṅgāmavyasanāmavirūpāmajugupsitāṁ [1] dēśajātīyāmakṣudrāmakṣudrakarmiṇīṁkulē jātāṁ vatsalāmarōgāṁ jīvadvatsāṁ puṁvatsāṁdōgdhrīmapramattāmanuccāraśāyinīmanantyāvasāyinīṁ kuśalōpacārāṁ śucimaśucidvēṣiṇīṁstanastanyasampadupētāmiti||52||

ato dhAtrIparIkShAmupadekShyAmaH|
atha brUyAtdhAtrImAnaya samAnavarNAM yauvanasthAMnibhRutAmanAturAmavya~ggAmavyasanAmavirUpAmajugupsitAM [1]deshajAtIyAmakShudrAmakShudrakarmiNIM kule jAtAM vatsalAmarogAM jIvadvatsAM puMvatsAMdogdhrImapramattAmanuccArashAyinImanantyAvasAyinIM kushalopacArAM shucimashucidveShiNIMstanastanyasampadupetAmiti||52||
<div style="text-align:justify;">
This verse describes the qualities of the wet nurse attending the baby. The attending physician should ask of the parents to hire a wet nurse who belongs to the same caste as the child’s mother, who is in her youth, is submissive, free from diseases, not deficient in any limb, not given to unwholesome pursuits, not ugly, not ill- disposed, is native to the country, is not mean or does not indulge in mean acts, affectionate towards children, whose children have not died, who is a mother to a male child, who is never careless, not sleeping in beds soiled with excrement, not married to man of lower caste, skillful in attendance, hygienic and is endowed with plenty of milk in her breasts. [52]
</div>
==== Qualities of an ideal breast ====

तत्रेयं स्तनसम्पत्- नात्यूर्ध्वौ नातिलम्बावनतिकृशावनतिपीनौ युक्तपिप्पलकौ सुखप्रपानौ चेति (स्तनसम्पत्)||५३||
tatrēyaṁ stanasampat- nātyūrdhvau nātilambāvanatikr̥śāvanatipīnau yuktapippalakau sukhaprapānau cēti(stanasampat)||53||

tatreyaM stanasampat- nAtyUrdhvau nAtilambAvanatikRushAvanatipInau yuktapippalakau sukhaprapAnauceti (stanasampat)||53||

These are the features of ideal breasts: they should be neither be very high nor very loose and sagging, neither very lean nor massive. They should have proportionate nipples and be easy to suck. [53]

==== Qualities of the ideal breastmilk ====

स्तन्यसम्पत्तु प्रकृतिवर्णगन्धरसस्पर्शम्, उदपात्रे च दुह्यमानमुदकं व्येति प्रकृतिभूतत्वात्; तत् पुष्टिकरमारोग्यकरं चेति(स्तन्यसम्पत्)||५४||
stanyasampattu prakr̥tivarṇagandharasasparśam, udapātrē ca duhyamānamudakaṁ vyētiprakr̥tibhūtatvāt; tat puṣṭikaramārōgyakaraṁ cēti (stanyasampat)||54||

stanyasampattu prakRutivarNagandharasasparsham, udapAtre ca duhyamAnamudakaM vyetiprakRutibhUtatvAt; tat puShTikaramArogyakaraM ceti (stanyasampat)||54||

Ideal breast milk for the baby has properties such as natural color, smell, taste and touch and when poured into a pot of water, it should mix at once perfectly with the water. Such milk is nourishing and health giving to the child. [54]

अतोऽन्यथा व्यापन्नं ज्ञेयम्|
तस्य विशेषाः श्यावारुणवर्णं कषायानुरसं विशदमनालक्ष्यगन्धं रूक्षं द्रवं फेनिलं लघ्वतृप्तिकरं कर्शनं वातविकाराणां कर्तृवातोपसृष्टं क्षीरमभिज्ञेयं [१] ; कृष्णनीलपीतताम्रावभासं तिक्ताम्लकटुकानुरसं कुणपरुधिरगन्धि भृशोष्णं पित्तविकाराणां कर्तृच पित्तोपसृष्टं क्षीरमभिज्ञेयम्, अत्यर्थशुक्लमतिमाधुर्योपपन्नं लवणानुरसं घृततैलवसामज्जगन्धि पिच्छिलंतन्तुमदुकपात्रेऽवसीदछ्लेष्मविकाराणां कर्तृ श्लेष्मोपसृष्टं क्षीरमभिज्ञेयम्||५५||

atō'nyathā vyāpannaṁ jñēyam|
tasya viśēṣāḥ- śyāvāruṇavarṇaṁ kaṣāyānurasaṁ viśadamanālakṣyagandhaṁ rūkṣaṁ dravaṁ phēnilaṁlaghvatr̥ptikaraṁ karśanaṁ vātavikārāṇāṁ kartr̥ vātōpasr̥ṣṭaṁ kṣīramabhijñēyaṁ [1] ;kr̥ṣṇanīlapītatāmrāvabhāsaṁ tiktāmlakaṭukānurasaṁ kuṇaparudhiragandhi bhr̥śōṣṇaṁ pittavikārāṇāṁkartr̥ ca pittōpasr̥ṣṭaṁ kṣīramabhijñēyam, atyarthaśuklamatimādhuryōpapannaṁ lavaṇānurasaṁghr̥tatailavasāmajjagandhi picchilaṁ tantumadukapātrē'vasīdachlēṣmavikārāṇāṁ kartr̥ ślēṣmōpasr̥ṣṭaṁkṣīramabhijñēyam||55||

ato~anyathA vyApannaM j~jeyam|
tasya visheShAH- shyAvAruNavarNaM kaShAyAnurasaM vishadamanAlakShyagandhaM rUkShaM dravaMphenilaM laghvatRuptikaraM karshanaM vAtavikArANAM kartRu vAtopasRuShTaM kShIramabhij~jeyaM [1] ;kRuShNanIlapItatAmrAvabhAsaM tiktAmlakaTukAnurasaM kuNaparudhiragandhi bhRushoShNaMpittavikArANAM kartRu ca pittopasRuShTaM kShIramabhij~jeyam, atyarthashuklamatimAdhuryopapannaMlavaNAnurasaM ghRutatailavasAmajjagandhi picchilaM tantumadukapAtre~avasIdachleShmavikArANAMkartRu shleShmopasRuShTaM kShIramabhij~jeyam||55||
<div style="text-align:justify;">
The breast milk which does not fit the above description is to considered vitiated and unfit for the child’s consumption. Milk that assumes a darkish or reddish hue, astringent in after-taste, clear, of no marked smell, dry, watery, frothy and light in texture or form, and is not satisfying causes emaciation, gives rise to vatika disorders, and thus, should be considered vata-vitiated. Milk that looks blackish, bluish, yellow, or coppery, has an after-taste which is sour or pungent, which smells like a corpse or like blood, and which is very warm is pitta-vitiated and could cause pittaja disorders. Finally, the milk that is very white, very sweet with a saltish after-taste, that has odour like ghee, oil, flesh-marrow or bone-marrow, is viscid, thready and sinks in water without mixing, gives rise to disorders of kapha and should be considered as kapha-vitiated milk. [55]
</div>
तेषां तु त्रयाणामपि क्षीरदोषाणां प्रतिविशेषमभिसमीक्ष्य यथास्वं यथादोषं च वमनविरेचनास्थापनानुवासनानि विभज्य कृतानिप्रशमनाय भवन्ति|
पानाशनविधिस्तु दुष्टक्षीराया यवगोधूमशालिषष्टिकमुद्गहरेणुककुलत्थसुरासौवीरकमैरेयमेदकलशुनकरञ्जप्रायः स्यात्|
क्षीरदोषविशेषांश्चावेक्ष्यावेक्ष्य तत्तद्विधानं कार्यं स्यात्|
पाठामहौषधसुरदारुमुस्तमूर्वागुडूचीवत्सकफलकिराततिक्तककटुकरोहिणीसारिवाकषायाणां च पानं प्रशस्यते, तथाऽन्येषांतिक्तकषायकटुकमधुराणां [१] द्रव्याणां प्रयोगः क्षीरविकारविशेषानभिसमीक्ष्य मात्रां कालं च|
इति क्षीरविशोधनानि||५६||

tēṣāṁ tu trayāṇāmapi kṣīradōṣāṇāṁ prativiśēṣamabhisamīkṣya yathāsvaṁ yathādōṣaṁ cavamanavirēcanāsthāpanānuvāsanāni vibhajya kr̥tāni praśamanāya bhavanti|
pānāśanavidhistu duṣṭakṣīrāyāyavagōdhūmaśāliṣaṣṭikamudgaharēṇukakulatthasurāsauvīrakamairēyamēdakalaśunakarañjaprāyaḥ syāt|
kṣīradōṣaviśēṣāṁścāvēkṣyāvēkṣya tattadvidhānaṁ kāryaṁ syāt|
pāṭhāmahauṣadhasuradārumustamūrvāguḍūcīvatsakaphalakirātatiktakakaṭukarōhiṇīsārivākaṣāyāṇāṁ capānaṁ praśasyatē, tathā'nyēṣāṁ tiktakaṣāyakaṭukamadhurāṇāṁ [1] dravyāṇāṁ prayōgaḥkṣīravikāraviśēṣānabhisamīkṣya mātrāṁ kālaṁ ca|
iti kṣīraviśōdhanāni||56||

teShAM tu trayANAmapi kShIradoShANAM prativisheShamabhisamIkShya yathAsvaM yathAdoShaM cavamanavirecanAsthApanAnuvAsanAni vibhajya kRutAni prashamanAya bhavanti|
pAnAshanavidhistu duShTakShIrAyAyavagodhUmashAliShaShTikamudgahareNukakulatthasurAsauvIrakamaireyamedakalashunakara~jjaprAyaHsyAt|
kShIradoShavisheShAMshcAvekShyAvekShya tattadvidhAnaM kAryaM syAt|
pAThAmahauShadhasuradArumustamUrvAguDUcIvatsakaphalakirAtatiktakakaTukarohiNIsArivAkaShAyANAMca pAnaM prashasyate, tathA~anyeShAM tiktakaShAyakaTukamadhurANAM [1] dravyANAM prayogaHkShIravikAravisheShAnabhisamIkShya mAtrAM kAlaM ca|
iti kShIravishodhanAni||56||
<div style="text-align:justify;">
If any of the three varieties of vitiated milks described in the preceding verse is in advertently consumed by the child, after ascertaining the specific features of the milk or the symptoms that are associated with a dosha affliction, emetics, purgatives and unctuous and non-unctuous enema specific to that afflicted dosha should be administered. The dietetic guidelines to a woman with vitiated milk are as follows: her food and drink should consist mainly of barley, wheat, sali and shashtika rice, mudga (Phaseolus mungo Linn. - green gram), harenuka (Lathyrus ashaca Linn.), sura, sauviraka, maireya and medaka varieties of wines, lashuna (Alium sativum Linn.) and karanja (Pongamia pinnata Merr.). The milk should be examined at frequent intervals for specific features and the appropriate corrective measures should be adopted. The decoctions of patha (Cissmpelos pareira Linn.), shunthi (Zingiberofficinale Rosc.), devadaru (Cedrusdeodara Loud.), musta (Cyperusrotundus Linn.), murva (Clemaistrilobaheyne ex Roth), guduchi (Tinosporacordifolia Miers.), indrayava (Holarrhenaantidysentrica wall.), kiratatikta (SwertiachirataBuch. -Ham.), katukarohini (Picrorhizakurroa Royle ex Benth.) and sariva (Hemidesmusindicus R. B.) are said to be beneficial. Similarly, other drugs with bitter, astringent, pungent and sweet tastes could also be administered, depending upon the nature of the disorder, dosage and season. [56]
</div>
==== Lactation-stimulants (or galactogogues) ====

क्षीरजननानि तु मद्यानि सीधुवर्ज्यानि, ग्राम्यानूपौदकानि च शाकधान्यमांसानि, द्रवमधुराम्ललवणभूयिष्ठाश्चाहाराः,क्षीरिण्यश्चौषधयः, क्षीरपानमनायासश्च, वीरणषष्टिकशालीक्षुवालिकादर्भकुशकाशगुन्द्रेत्कटमूलकषायाणां च पानमिति(क्षीरजननानि)||५७||

kṣīrajananāni tu madyāni sīdhuvarjyāni, grāmyānūpaudakāni ca śākadhānyamāṁsāni,dravamadhurāmlalavaṇabhūyiṣṭhāścāhārāḥ, kṣīriṇyaścauṣadhayaḥ, kṣīrapānamanāyāsaśca,vīraṇaṣaṣṭikaśālīkṣuvālikādarbhakuśakāśagundrētkaṭamūlakaṣāyāṇāṁ ca pānamiti (kṣīrajananāni)||57||

kShIrajananAni tu madyAni sIdhuvarjyAni, grAmyAnUpaudakAni ca shAkadhAnyamAMsAni,dravamadhurAmlalavaNabhUyiShThAshcAhArAH, kShIriNyashcauShadhayaH, kShIrapAnamanAyAsashca,vIraNaShaShTikashAlIkShuvAlikAdarbhakushakAshagundretkaTamUlakaShAyANAM ca pAnamiti(kShIrajananAni)||57||
<div style="text-align:justify;">
Galactogogues (lactation-stimulants) include the following food articles and habits: all wines with the exception of sidhu, vegetables, cereals and meat of domestic, marshy and aquatic origins; food articles and liquids that have predominantly sweet, sour or salty taste; herbs containing milky juices; cow’s milk; avoidance of laborious tasks, and; drinking of the decoctions of roots of virana (Vetiveria zizanoides Nash.), shashtika (a variety of shali – Oryza sativa Linn.), shali (Oryza sativa Linn.), ikshuvalika (Astercantha longifolia Nees.), darbha (Desmostachya bipinnata Stapf), kusha (Desmostachya bipinnata Stapf), kasha (Saccharum spontaneum Linn.), gundra (Saccharum sara)and Itkata (-?-)(are galactogogues). [57]
</div>
====Procedure to be followed by the wet-nurse in order to feed the baby ====

धात्री तु यदा स्वादुबहुलशुद्धदुग्धा स्यात्तदास्नातानुलिप्ता शुक्लवस्त्रं परिधायैन्द्रीं ब्राह्मीं शतवीर्यां सहस्रवीर्याममोघामव्यथांशिवामरिष्टां वाट्यपुष्पीं विष्वक्सेनकान्तां [१] वा बिभ्रत्योषधिं कुमारं प्राङ्मुखंप्रथमं दक्षिणं स्तनं पाययेत्|
इति धात्रीकर्म||५८||

dhātrī tu yadā svādubahulaśuddhadugdhā syāttadāsnātānuliptā śuklavastraṁ paridhāyaindrīṁ brāhmīṁśatavīryāṁ sahasravīryāmamōghāmavyathāṁ śivāmariṣṭāṁ vāṭyapuṣpīṁ viṣvaksēnakāntāṁ [1] vābibhratyōṣadhiṁ kumāraṁ prāṅmukhaṁ prathamaṁ dakṣiṇaṁ stanaṁ pāyayēt|
iti dhātrīkarma||58||

dhAtrI tu yadA svAdubahulashuddhadugdhA syAttadAsnAtAnuliptA shuklavastraM paridhAyaindrIMbrAhmIM shatavIryAM sahasravIryAmamoghAmavyathAM shivAmariShTAM vATyapuShpIMviShvaksenakAntAM [1] vA bibhratyoShadhiM kumAraM prA~gmukhaM prathamaM dakShiNaM stanaMpAyayet|
iti dhAtrIkarma||58||
<div style="text-align:justify;">
When the wet nurse, having sweet, copious and pure milk, has bathed and anointed herself with fragrant pastes, dressed in white garments and adorned with herbs such as aindri (Citrullus colocynthis Schrad), brahmi (Bacopa monnieri Pennel), shatavirya (Cynodon dactylon Pers.), sahasravirya (a type of Shatavirya), amogha (Emblica officinalis Gaertn.), avyatha (Tinospora cordifolia Miers.)shiva (Terminalia chebula Linn.), vatyapushpi (Sida rhombifolia Linn.) and viswaksenakanta (Callicarpa macrophyla Vahl.), then she should take hold of the baby and, while facing east , feed the baby from the right breast first. These are prescribed duties of dhatri, or the wet nurse attending the baby. [58]
</div>
==== Procedure of construction of nursery ====

अतोऽनन्तरं कुमारागारविधिमनुव्याख्यास्यामः-वास्तुविद्याकुशलः प्रशस्तं रम्यमतमस्कं निवातं प्रवातैकदेशंदृढमपगतश्वापदपशुदंष्ट्रिमूषिकपतङ्गं सुविभक्तसलिलोलूखलमूत्रवर्चःस्थानस्नानभूमिमहानसमृतुसुखंयथर्तुशयनासनास्तरणसम्पन्नं कुर्यात्; तथा सुविहितरक्षाविधानबलिमङ्गलहोमप्रायश्चित्तंशुचिवृद्धवैद्यानुरक्तजनसम्पूर्णम्|
इति कुमारागारविधिः||५९||

atō'nantaraṁ kumārāgāravidhimanuvyākhyāsyāmaḥ- vāstuvidyākuśalaḥ praśastaṁ ramyamatamaskaṁnivātaṁ pravātaikadēśaṁ dr̥ḍhamapagataśvāpadapaśudaṁṣṭrimūṣikapataṅgaṁsuvibhaktasalilōlūkhalamūtravarcaḥsthānasnānabhūmimahānasamr̥tusukhaṁyathartuśayanāsanāstaraṇasampannaṁ kuryāt;tathā suvihitarakṣāvidhānabalimaṅgalahōmaprāyaścittaṁśucivr̥ddhavaidyānuraktajanasampūrṇam|
iti kumārāgāravidhiḥ||59||

ato~anantaraM kumArAgAravidhimanuvyAkhyAsyAmaH- vAstuvidyAkushalaH prashastaMramyamatamaskaM nivAtaM pravAtaikadeshaMdRuDhamapagatashvApadapashudaMShTrimUShikapata~ggaMsuvibhaktasalilolUkhalamUtravarcaHsthAnasnAnabhUmimahAnasamRutusukhaMya<br>thartushayanAsanAstaraNasampannaM kuryAt; tathAsuvihitarakShAvidhAnabalima~ggalahomaprAyashcittaM shucivRuddhavaidyAnuraktajanasampUrNam|
iti kumArAgAravidhiH||59||
<div style="text-align:justify;">
This verse describes the procedure of construction of the nursery. It should be built by a skillful architect and should be sturdy, beautiful, well lighted, protected from draught, well ventilated (with air-entry from only one direction), free from pests, animals, fanged creatures, mice and moths. It should be well accessible to places of water storage, grinding, lavatory, bath and cooking, should be comfortable during all seasons, and furnished with beds, seats and spreads suited to each season. Moreover, protective measures, holy offerings, auspicious rites, and oblations should be performed and the facility should be provided with clean and experienced physicians and with a compassionate and caring staff. Thus, the metod of construction of a child care nursery has been described. [59]
</div>
शयनासनास्तरणप्रावरणानि कुमारस्य मृदुलघुशुचिसुगन्धीनि स्युः; स्वेदमलजन्तुमन्ति मूत्रपुरीषोपसृष्टानि च वर्ज्यानि स्युः;असति सम्भवेऽन्येषां तान्येव च सुप्रक्षालितोपधानानि सुधूपितानि शुद्धशुष्काण्युपयोगं गच्छेयुः||६०||

śayanāsanāstaraṇaprāvaraṇāni kumārasya mr̥dulaghuśucisugandhīni syuḥ; svēdamalajantumantimūtrapurīṣōpasr̥ṣṭāni ca varjyāni syuḥ; asati sambhavē'nyēṣāṁ tānyēva ca suprakṣālitōpadhānānisudhūpitāni śuddhaśuṣkāṇyupayōgaṁ gacchēyuḥ||60||

shayanAsanAstaraNaprAvaraNAni kumArasya mRudulaghushucisugandhIni syuH; svedamalajantumantimUtrapurIShopasRuShTAni ca varjyAni syuH; asati sambhave~anyeShAM tAnyeva casuprakShAlitopadhAnAni sudhUpitAni shuddhashuShkANyupayogaM gaccheyuH||60||
<div style="text-align:justify;">
The bed, seats, spreads and covers meant for the child should be soft, light, clean and perfumed. Sweat and/or excrement-stained or pestilence-infested articles should be disposed off immediately, and if fresh ones are not available the same may be used again only after they have been washed and fumigated thoroughly and rendered perfectly clean and dry. [60]
</div>
धूपनानि पुनर्वाससां शयनास्तरणप्रावरणानां चयवसर्षपातसीहिङ्गुगुग्गुलुवचाचोरकवयःस्थागोलोमीजटिलापलङ्कषाशोकरोहिणीसर्पनिर्मोकाणि घृतयुक्तानि स्युः||६१||

dhūpanāni punarvāsasāṁ śayanāstaraṇaprāvaraṇānāṁ cayavasarṣapātasīhiṅgugugguluvacācōrakavayaḥsthāgōlōmījaṭilāpalaṅkaṣāśōkarōhiṇīsarpanirmōkāṇighr̥tayuktāni syuḥ||61||

dhUpanAni punarvAsasAM shayanAstaraNaprAvaraNAnAM cayavasarShapAtasIhi~ggugugguluvacAcorakavayaHsthAgolomIjaTilApala~gkaShAshokarohiNIsarpanirmokANighRutayuktAni syuH||61||
<div style="text-align:justify;">
For fumigation of the garments, bed, and furnishings the following articles smeared with ghee may be used- barley, mustard, atasi (Linumusitaissimum Linn.), hingu (Ferulanarthex Boiss.), guggulu (Commiforamukul Engl.), vacha (Acoruscalamus Linn.), choraka (Angelicaglauca Edgw), vayahstha (Bacopamonnieri Pennel.), golomi (type of Vacha), jatila (Nardostachysjatamansi D. C.), palankasha (type of Guggulu), ashoka (Saracaindica Linn.), rohini (Picrorhizakurroa royle ex Benth.)and sarpa nirmoka(sloughs of snakes). [61]
</div>

==== Measures for ensuring the child's well-being ====

मणयश्च धारणीयाः कुमारस्य खड्गरुरुगवयवृषभाणां जीवतामेव दक्षिणेभ्यो विषाणेभ्योऽग्राणि गृहीतानि स्युः;ऐन्द्र्याद्याश्चौषधयो जीवकर्षभकौ च, यानि चान्यान्यपि ब्राह्मणाः प्रशंसेयुरथर्ववेदविदः||६२||

maṇayaśca dhāraṇīyāḥ kumārasya khaḍgarurugavayavr̥ṣabhāṇāṁ jīvatāmēva dakṣiṇēbhyōviṣāṇēbhyō'grāṇi gr̥hītāni syuḥ; aindryādyāścauṣadhayō jīvakarṣabhakau ca, yāni cānyānyapi brāhmaṇāḥpraśaṁsēyuratharvavēdavidaḥ||62||

maNayashca dhAraNIyAH kumArasya khaDgarurugavayavRuShabhANAM jIvatAmeva dakShiNebhyoviShANebhyo~agrANi gRuhItAni syuH; aindryAdyAshcauShadhayo jIvakarShabhakau ca, yAni cAnyAnyapibrAhmaNAH prashaMseyuratharvavedavidaH||62||

The following articles should be worn as talismans or amulets by the child: gems, tip of the right horn of a live rhinoceros, deer, gayal or a bull; herbs like aindri, jivaka, rusabhaka, etc., and also all such articles as the brahmins well versed in Atharva Veda may recommend. [62]

क्रीडनकानि खलु कुमारस्य विचित्राणि घोषवन्त्यभिरामाणि चागुरूणि चातीक्ष्णाग्राणि चानास्य प्रवेशीनि चाप्राणहराणिचावित्रासनानि स्युः||६३||

krīḍanakāni khalu kumārasya vicitrāṇi ghōṣavantyabhirāmāṇi cāgurūṇi cātīkṣṇāgrāṇi cānāsya pravēśīnicāprāṇaharāṇi cāvitrāsanāni syuḥ||63||
krIDanakAni khalu kumArasya vicitrANi ghoShavantyabhirAmANi cAgurUNi cAtIkShNAgrANi cAnAsyapraveshIni cAprANaharANi cAvitrAsanAni syuH||63||

The toys of the child should be multicolored, attractive, light, without sharp edges, and incapable of being swallowed. These should make pleasing sounds (i.e., should not be making screechy, loud or disturbing sounds), and should not be fatal to life or disturbing. [63]

न ह्यस्य वित्रासनं साधु|
तस्मात्तस्मिन् रुदत्यभुञ्जाने वाऽन्यत्र विधेयतामगच्छति राक्षसपिशाचपूतनाद्यानां नामान्याह्वयता कुमारस्य वित्रासनार्थंनामग्रहणं न कार्यं स्यात्||६४||

na hyasya vitrāsanaṁ sādhu|
tasmāttasmin rudatyabhuñjānē vā'nyatra vidhēyatāmagacchati rākṣasapiśācapūtanādyānāṁnāmānyāhvayatā kumārasya vitrāsanārthaṁ nāmagrahaṇaṁ na kāryaṁ syāt||64||

na hyasya vitrAsanaM sAdhu|
tasmAttasmin rudatyabhu~jjAne vA~anyatra vidheyatAmagacchati rAkShasapishAcapUtanAdyAnAMnAmAnyAhvayatA kumArasya vitrAsanArthaM nAmagrahaNaM na kAryaM syAt||64||

It is never good to frighten a child. So, if he is found weeping, refusing to eat his meals, or in any other way becoming disobedient, it is not good to take the name of rakshasas (goblins), pishacha (ghost) or putana (harpy) with a purpose of scaring him further. [64]

यदि त्वातुर्यं किञ्चित् कुमारमागच्छेत् तत् प्रकृतिनिमित्तपूर्वरूपलिङ्गोपशयविशेषैस्तत्त्वतोऽनुबुध्यसर्वविशेषानातुरौषधदेशकालाश्रयानवेक्षमाणश्चिकित्सितुमारभेतैनं मधुरमृदुलघुसुरभिशीतशङ्करं कर्म प्रवर्तयन्|
एवंसात्म्या हि कुमारा भवन्ति|
तथा ते शर्म लभन्ते चिराय|
अरोगे त्वरोगवृत्तमातिष्ठेद्देशकालात्मगुणविपर्ययेण वर्तमानः, क्रमेणासात्म्यानि परिवर्त्योपयुञ्जानः सर्वाण्यहितानिवर्जयेत्|
तथा बलवर्णशरीरायुषां सम्पदमवाप्नोतीति||६५||

yadi tvāturyaṁ kiñcit kumāramāgacchēt tat prakr̥tinimittapūrvarūpaliṅgōpaśayaviśēṣaistattvatō'nubudhyasarvaviśēṣānāturauṣadhadēśakālāśrayānavēkṣamāṇaścikitsitumārabhētainaṁmadhu<br>ramr̥dulaghusurabhiśītaś<br>aṅkaraṁ karma pravartayan|
ēvaṁsātmyā hi kumārā bhavanti|
tathā tē śarma labhantē cirāya|
arōgē tvarōgavr̥ttamātiṣṭhēddēśakālātmaguṇaviparyayēṇa vartamānaḥ, kramēṇāsātmyāniparivartyōpayuñjānaḥ sarvāṇyahitāni varjayēt|
tathā balavarṇaśarīrāyuṣāṁ sampadamavāpnōtīti||65||

yadi tvAturyaM ki~jcit kumAramAgacchet tatprakRutinimittapUrvarUpali~ggopashayavisheShaistattvato~anubudhyasarvavisheShAnAturauShadhadeshakAlAshrayAnavekShamANashcikitsitumArabhetainaMmadhu<br>ramRudulaghusurabhishItasha~gkaraM karma pravartayan|
evaMsAtmyA hi kumArA bhavanti|
tathA te sharma labhante cirAya|
aroge tvarogavRuttamAtiShTheddeshakAlAtmaguNaviparyayeNa vartamAnaH, krameNAsAtmyAniparivartyopayu~jjAnaH sarvANyahitAni varjayet|
tathA balavarNasharIrAyuShAM sampadamavApnotIti||65||
<div style="text-align:justify;">
If some illness affects the child, then the physician, after cautiously examining the child, should thoroughly analyze his constitution, etiological factors, premonitory signs and symptoms, and all other factors concerned such as time and place, and then should proceed to treat him by medication that is sweet in taste and smell, soft, light, cold and pleasant. Such measures suit the palate of the children and make the administering of drugs that much easier. As regards a healthy child, the regimen prescribed for regular consumption is the same as that mentioned as code of conduct for the healthy. Following these ensures that the child attains the excellence of strength, healthy complexion, bodily growth and longevity. [65]
</div>
एवमेनं कुमारमायौवनप्राप्तेर्धर्मार्थकौशलागमनाच्चानुपालयेत्||६६||

ēvamēnaṁ kumāramāyauvanaprāptērdharmārthakauśalāgamanāccānupālayēt||66||

evamenaM kumAramAyauvanaprApterdharmArthakaushalAgamanAccAnupAlayet||66||

In this manner the child should be nurtured, from his childhood to his youth, i.e., till he acquires the knowledge and skills necessary for conducting religious activities and leading his livelihood. [66]

इति पुत्राशिषां समृद्धिकरं कर्म व्याख्यातम्|
तदाचरन् यथोक्तैर्विधिभिः पूजां यथेष्टं लभतेऽनसूयक इति||६७||

iti putrāśiṣāṁ samr̥ddhikaraṁ karma vyākhyātam|
tadācaran yathōktairvidhibhiḥ pūjāṁ yathēṣṭaṁ labhatē'nasūyaka iti||67||

iti putrAshiShAM samRuddhikaraM karma vyAkhyAtam|
tadAcaran yathoktairvidhibhiH pUjAM yatheShTaM labhate~anasUyaka iti||67||

Thus all measures that promote the life of one’s progeny have been described for those who aspire to have children. By adopting these measures in the prescribed manner, one who is free from envy and ill-will attains his wishes with regard and honour. [67]

==== Summary ====

तत्र श्लोकौ-
पुत्राशिषां कर्म समृद्धिकारकं यदुक्तमेतन्महदर्थसंहितम्|
तदाचरन् ज्ञो विधिभिर्यथातथं पूजां यथेष्टं लभतेऽनसूयकः||६८||

tatra ślōkau-
putrāśiṣāṁ karma samr̥ddhikārakaṁ yaduktamētanmahadarthasaṁhitam|
tadācaran jñō vidhibhiryathātathaṁ pūjāṁ yathēṣṭaṁ labhatē'nasūyakaḥ||68||

tatra shlokau-
putrAshiShAM karma samRuddhikArakaM yaduktametanmahadarthasaMhitam|
tadAcaran j~jo vidhibhiryathAtathaM pUjAM yatheShTaM labhate~anasUyakaH||68||

Thus, to sum up this chapter, measures described here will fulfill the longing of the individual of desirred progeny and these are of great importance. By taking recourse to these measures in the manner prescribed, a wise man, free from envy or ill-will, is blessed (with a child) according to his wishes. [68]

शरीरं चिन्त्यते सर्वं दैवमानुषसम्पदा|
सर्वभावैर्यतस्तस्माच्छारीरं स्थानमुच्यते||६९||

śarīraṁ cintyatē sarvaṁ daivamānuṣasampadā|
sarvabhāvairyatastasmācchārīraṁ sthānamucyatē||69||

sharIraM cintyate sarvaM daivamAnuShasampadA|
sarvabhAvairyatastasmAcchArIraM sthAnamucyate||69||

This section is known as [[Sharira Sthana]] because it consists of a body of knowledge consisting of all the godly and human aspects of the various phenomena taking place in an individual’s body.

Thus, ends the eight chapter of the [[Sharira Sthana]] of Agnivesha’s work as redacted by Charaka, and also marks the end of the [[Sharira Sthana]] itself. [69]

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*Posture plays an important role in facilitating the union of the sperm and the ovum. Improper posture may lead to dosha prakopa, or dosha vitiation. Also, physical and mental wellbeing of both partners is essential for successful coitus and furthering one’s lineage. [6]
*Sexual intercourse, when done with happy and joyous mood results in good progeny. Entering the bed by placing the right and left leg first by male and female partners respectively needs scientific exploration. It may merely be auspicious as per rituals. [7] Healthy progeny and succession of lineage, amply supported by recitations of mantra (to invoke the Gods and bless the progeny), was the sole purpose of sexual intercourse. Pleasure and eroticism were not the prime purpose of sexual acts, per the vedic rituals documented. [8]
*For the husband to practice celibacy for the period of one week following his wife’s menstrual period is advised to ensure healthy sperm, in turn helping beget a healthy offspring. During this period specific dietetic, behavioural and psychological regimen are advised to be followed by both the partners for attaining physical and psychological well-being, which will further support conception. [9]
*The ideal time for performing the Putreshti procedure is mentioned as a week or so of cessation of menstrual flow of the female partner, so that ovulation starts. After this they may cohabit for eight nights. [11]
*Predominance of a particular mahabhuta at the time of conception plays an important role in begetting a progeny of desired physique and complexion. [15]
*Psyche of the child to be born is decided by the deeds of the previous life of the individual as well as the mental disposition of the parents at the time of conception and the mental status of the mother during her pregnancy. [16]
*To beget a good progeny, healthy male and female reproductive systems, proper ovulatory cycles and potent seeds are essential. [17]
*Even if all factors and conditions for obtaining a desired progeny are met, the influence of the child’s past (due to the deeds in his previous life) are said to play a critical role in deciding the final outcome. [18] Pumsavana is a measure of begetting a child of desired sex, literally meaning a male child. However, some authors refer to this as a procedure not only for sex selection but for proper implantation, intra uterine growth and development of the foetus as well. [19]
*The herbs indicated for the Pumsavana karma will provide nutritional support to the pregnant woman and thus benefit the mother as well as her growing foetus. [20]
*The principle behind do’s and don’ts advocated during pregnancy is to lead an unaltered normal life with adequate rest, care and good nutrition to attain a healthy progeny. [21]
*Chances of survival of the fetus are less and even if it survives, chances of congenital anomaly are more if bleeding appears during the second or third month. [23]
*Upavishtaka and Nagodara, both suggestive of intrauterine growth retardation (IUGR) result due to improper nutrition to the growing foetus. [26] Proper nutrition will help correct the same. [27] Santarpana chikitsa which are vatahara are to be adopted. [28]
*Garbhini udavarta, a condition caused due to reverse movement of apana vata can have implications during child birth. [29]
*In children, the dosha, dushya etc. causing the disease are the same as that in adults, the only difference being drug dosage. [65]

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

==== Ritukala – Ideal period in menstrual cycle for conception ====

For conception, the period after stoppage of menstruation,i.e., from the 4th day onwards to 12 days corresponding to the 16th day of the menstrual cycle is considered to be the ideal period for impregnation. During the first half of the menstrual cycle, i.e., from 1st day to 14th day, estrogen hormone is dominant, and under its influence, the cervical mucus becomes watery with a high concentration of sodium chloride. This consistency is ideal for spermatozoa to travel through the cervical canal. After ovulation on the 14th day, the formation of corpus luteum leads to the dominance of progesterone hormone, and this leads to change in a characteristic of cervical mucus from watery to viscous because of increased protein content and decrease in sodium chloride. This hampers the migration of sperm in the cervical canal. Hence the ritukala of 12 days in the first half of the cycle is justified.
[[File:gtypemucus.png]] [[File:ltypemucus.png]]
Under effect of progesterone preventing sperm penetration Cervical mucus under estrogenic effect <br>
Source : http://www.naturalfamilyplanning.ie/mucus/gls-p-mucus/<br>

The possible mechanism of sex selection can be understood by knowing the swimming behavior of spermatozoa bearing X and Y chromosome in the female genital tract, as well as evidence suggesting selective penetration of spermatozoa in cervical mucus. The factors affecting the motility of sperms in genital tract are pH, temperature, viscosity, osmolarity, elements and ions. All these evidence suggest that the sex selection may depend on the female genital environment which changes throughout the cycle and hence the specific days of coitus mentioned in text may contribute to the selection of the desired offspring. The concentration of sperm in semen increases if the coitus is performed during alternate days. More the number of Y-bearing spermatozoa, more probability of procuring a male progeny<ref> Skandhan KP, Japee Jasmine: Hypothesis: Who is responsible for the sex of the offspring, Trends in Medical Research; 2011 </ref>.

==== Selection of Suitable partner for conception ====

In Ayurveda classics, the preparation of procuring healthy progeny begins with the selection of a partner. For a healthy progeny with longevity and desired traits, both partners should be of reproductive age without any physical or mental disease or chronic illness. Conception in older age is associated with genetic abnormalities like Down’s syndrome and rare chromosomal abnormalities like Patau's syndrome and Edward's syndrome in the offspring. Increased maternal age may also lead to the poor outcome of pregnancy. Conception during illness may result in congenital anomalies or growth retarded fetus. Research has shown risks of low birth weight, premature labor, anemia, and pre-eclampsia are related to the biological age<ref> CM Gibbs et al, The Impact of Early Age at First Childbirth on Maternal and Infant Health, 2012, PMID:22742615 </ref>.

Ideal position for coitus and factors affecting conception:
In the prone position, pressure on abdomen affects the natural movement of vata dosha, while the left-lateral position stimulates the enzyme secretions in the gut and leads to pitta prakopa. Therefore, a comfortable, supine position is recommended for coitus for conception, as all body humors are in their proper positions. A sprinkling of cold water or cold compresses of vulva after coitus is useful to prevent the reverse flow of semen from the female genital tract. Mental comfort, urge for sex and willingness for sex with the same partner are very important factors for the conception and formation of a healthy fetus. As neuro-endocrinal harmony is essential during the act of coitus, one should be free of urges or thoughts of hunger, thirst, passing flatulence, urination or bowel movements, and should be free from emotions like stress, anger, anxiety while having sexual intercourse.

==== Ambiance for coitus ====

The importance of ambiance in stimulating desire in a couple to perform sex, and thus, conceive a healthy child, is expressly mentioned in this chapter. Articles or experiences pleasant to the sensory organs (such as using fragrant objects, pleasing or arousing music or sound, articles pleasant in taste or touch) in a stimulating environment play a very important role in arousal and act as aphrodisiacs, per Ayurvedic texts.

==== Effect of chanting mantras ====

Keeping the body and its doshas in harmony with its environment are essential to good conception, as it is with staying healthy, per Ayurvedic texts. This is consistent with the vedic concept of Yatha Pinde Tatha Brahmande (As the Body, so the Universe) – that problems occur when there is disequilibrium between the body and its surroundings.

Chanting and reciting mantras have an effect on neuro-endocrinal homeostasis<ref> Claire Braboszcz, Stephanie Hahusseau, Arnaud Delorme Meditation and Neuroscience: From Basic Research to Clinical Practice, 2010, Springer Publishing </ref>. Hence chanting or reciting mantras or shlokas is recommended for maintenance of a psychosomatic balance of the body. In Vedic rituals, shloka (sacred hymns) to be chanted are said to invoke Lord Brahma, the creator of the universe and the progenitor of all the activities of the universe, Lord Brihaspati, the power behind every activity, Lord Vishnu, the preserver of the universe, Soma and Agni, the prime principles in all living beings, Ashvinau, the symbol of health and well-being in every creature, and Mitra and Varuna, the forces necessary to sustain life in the universe. Therefore, vedic scriptures, including Ayurvedic texts, emphasize on paying one’s obeisance to deities and forces of the universe, in the form of Gods, if one desires a healthy offspring.

Chanting of mantras is known to have physical, mental and spiritual benefits. Mantra chanting form the basis of yogic meditation practices to help calm one’s mind and ease anxieties, which could have adverse effects on one’s progeny. Ayurveda science also mentions the role of the atma, along with the union of sperm and ovum, as a prerequisite, in the formation of the garbha. For the atma (of the newborn) to be of best satva and good prior karma, the ambiance and environment of the area should be spiritual, and chanting helps in creating such an environment.

==== Do’s and Dont’s before coitus ====

This chapter provides a detailed list of Do’s and Don’ts that could help a couple conceive a healthy child. These rules or guidelines address various aspects of the couple’s lifestyle – including their diet, their environment – and their health. Traditional rituals and guidelines such as staying pious (and not indulging in immoral thoughts or actions) and being in the company of spiritual or virtuous individuals have been adviced, especially for the expecting mother.

==== Preparation for putreshthi yajna and its benefits ====

Cultures around the world, especially in the eastern countries, practice various rituals to get a healthy offspring. While these rituals and customs are considered essential, their validity from the standpoint of scientific studies have not yet been established. Cultural traditions, however, do provide some much-needed assurance during this period of anxiety and should be continued according to tradition. The physical, psychological, social and spiritual wellbeing of the couple desirous of having progeny is very important - and this is facilitated through rituals. All the regimen and rituals also favor a planned pregnancy instead of an accidental pregnancy. A planned pregnancy ensures a proper physical, psychological, financial and social status.

==== Regimens and factors affecting desired progeny ====

For getting the desired result (i.e., a healthy progeny of the desired traits), one has to apply the factors either in the form of the same element (dravya samanya) or the elements having similar constitution and properties (guna samanya) or similar the effort (karma samanya), giving the similar to get similar output. All the above mentioned dietary, ritualistic practices, and do's and don'ts need to be of the desired dravya, guna and karma samanya to get the desired result, i.e., healthy and long living progeny with good complexion and intelligence. Whatever the mother sees, tastes, touches, feels, thinks and the way she behaves or thinks socially or spiritually has a deep impact on the future temperament and behavior of the child. A popular example of this ‘karma based garbha samskara’ is the mythological story of Abhimanyu, the warrior son of Arjuna, in the Mahabharata. Abhimanyu, even when he was a fetus in his mother (Subhadra)’s womb, learned the technique of entering the Chakravyuha (a special type of battle formation) from his maternal uncle Lord Krishna. If the mother takes dravya having predominant jala mahabhuta dravya, there will be an increase in the kapha dhatu of the fetus, giving it a fair complexion. Similarly, other mahabhuta-dominant dravyas contribute to other types of complexions in the baby.
In Korea, for prenatal development, expectant mothers are advised to do certain practices called ‘Taegyo.<ref> Lee, Yuna, Lee, Jiyoung, Korean Traditional Taegyo Prenatal Education based on Sajudang Lee’s “Taegyo Singi”, 2016, International Journal of Childbirth Education, Pg 34-37 </ref>' Expectant mothers are advised to stay calm, avoid evil thoughts, listening to soft music, reading inspiring stories aloud, staying vigilant of surroundings and prudent in speech and action. Following these practices provides a safe and healthy environment for the fetal development.
Research in Pre-natal education

Researchers have been studying the effect of external sensory experiences on the brain activities of infants. In one instance, researchers found enhanced brain activity in infants exposed to “novel word sounds” played everyday during the third trimester.<ref> Partanen, Eino et al, Prenatal Music Exposure Induces Long-Term Neural Effects, 2013, PLoS One, doi: 10.1371/journal.pone.0078946 </ref>

==== Effects of karma of the progeny’s prior birth ====

As explained in this chapter, with the effect of karma samanya there is garbha sanskara on the fetus inside the mother’s womb. Therefore, the birth of an individual in any race depends on the karma of the parents and the karma from the child’s previous life. According to Charaka, an individual goes through the cycle of birth and death according to Karma Siddhanta. In fact, the birth of an individual has multiple facets like poorvakarma, matrija karma, pitrija karma, garbhadhana, garbhini paricharya and much more. One should not forget the effect of, i.e., karma on the fetus, the mother, and the father. Therefore, in spite of following of all do’s and don’ts strictly, there can be bad progeny because of it's (and the parent's) karma.

==== Factors for healthy progeny ====

As explained earlier, according to yukti pramana, the formation of garbha is multidimensional and requires normalcy of all components i.e. fertile period, healthy uterus, sufficient and healthy nutrients, and most importantly, healthy gametes.

==== Maintenance of products of conception ====

Stha or tishthati means to stay or remain in position. For sustaining a pregnancy, proper nourishment with adequate hormone status is essential. As mentioned in verse 20 of this chapter, herbs such as aindra, brahmi, satavirya, etc. help nourish the fetus, while Jivaniya herbs used regularly by the mother help achieve a healthy outcome of pregnancy.

==== Factors causing harm to the embryo ====

Numerous factors that may hamper sustaining the pregnancy or cause abnormalities in the progeny have been described in this chapter. These factors can be classified as dietary, lifestyle, traumatic, psychological and spiritual factors. Observance of these avoidable factors leads to growth retardation, the death of the fetus, premature birth, illness or congenital malformations to the offspring. Research seems to indicate that emotional stress to the mother can lead to prenatal or postnatal complications of various types<ref> Stephen Maret, Introduction to Prenatal Psychology, 2011, Church Gate Books ISBN: 9780578089980 </ref> . Dietary habits and lifestyle may lead to neurohormonal changes which affect pregnancy and its outcome<ref> Calvin Hobel, Jennifer Culhane, Role of Pyschosocial and Nutritional Stress on Poor Pregnancy Outcome, 2003, J.Nutr., vol 133 no. 5 1709S-1717S </ref> . Similar faulty habits by the father can also cause abnormalities of spermatozoa which in turn leads to congenital anomalies in offspring.

==== Precaution for the treatment of disorders in pregnant females ====

As explained by Charaka, a pregnant woman is like a vessel full of oil and should be treated with care, meaning that all doshas, dhatu, mala and ojas of the pregnant woman are at such a critical physiological stage that if one does not attend to her in a timely and proper way it may lead to damage to the foetus or the mother or both. Hence the disorders which may occur during pregnancy are to be treated with special care. For the antenatal mother, the diet or medications which should be used for curing any ailment should be mild and effective. Panchakarma treatment, because of its use of invasive and strong medicines, is to be avoided. Basti and abhyanga to kati are advocated in the eighth month of pregnancy, and these are comparatively safer procedures and may also help in a normal labor. During the eighth month, the fetus is sufficiently developed and viable, and even if the mother gets labor pain while undergoing treatment (mild to aggressive courses, as the need may be), the fetus can be preserved, and there are fewer chances of compromising fetal life.
The effects of drug use during pregnancy on the fetus has been researched and documented. The mother as well the fetus, if subjected to certain drugs /treatment, can lead to side-effects on either or both. FDA has specified a certain list of drugs (X category) which are contraindicated during pregnancy <ref> https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/labeling/ucm093307.htm
Ix Gawade T, Ghorpade M, Effect of bala siddha taila anuvasana basti on labour pains; Ayurlog: National journal of Research in Ayurveda science’ Vol 3, Feb 2015
</ref>. In Ayurveda, the principles of antenatal treatment are given for shamana as well as shodhana, other drugs and treatment are contraindicated. In practice, for any ailments occurring during pregnancy, herbal medicines are preferred over herbo mineral medicines.

==== Disorders of the fetus and its treatment ====

Following are the common disorder of fetus, abortion, followed by intrauterine growth retardation and intrauterine death:

===== Factors responsible for abortion and its treatment =====

First-trimester abortion is seen in about 80% of total abortions. Any bleeding during the first trimester (up to 12 weeks) may either end in inevitable abortion, preterm labor and in rare cases may proceed to full term. Emotional factors like severe anger, stress, jealousy all are suspected to cause the high release of CRH (Corticotropin-releasing hormone) which may trigger uterine contractions.
Uterine bleeding from implantation site or deciduas may be triggered because of coitus, trauma, exercise and faulty regimen. Bleeding may further release prostaglandins which could trigger uterine contractions and hence abortion.
Management of such condition is aimed at relieving uterine contractions and bleeding. Since there are vata and shonita dushti in abortion, treatment should follow the principle of vatarakta chikitsa viz. sheeta and snigdha lepa, and brimhana, vatahara, raktavardhaka diet, and drugs. Sura (alcohol-containing preparations) is mainly advised to relieve the pain and to increase the hemopoiesis.

As explained earlier, garbhapata (abortion) due to ama dosha (during the first trimester) is very critical to treat. Treatment of ama dosha is apatarpana while that of garbha and garbhini needs santarpana, which are antagonistic and hence very tedious to treat. In practice, Madhura varga dravyas such as shatavari (Asparagus racemosus) and medicated ghee phalaghrita are used in case of threatened abortion. These promote proper nourishment and growth and stop bleeding.

===== Growth retardation of fetus and its treatment =====

Intrauterine growth retardation of the fetus occurs due to malnourishment of mother as well as pregnancy disorders which cause vaginal discharge and bleeding. According to severity, they are categorized as garbhashosha (mentioned in Charaka Sharirsthana 2nd chapter) upavishtaka, nagodara, lina garbha (not directly mentioned but clinical features with the absence of movements of fetus suggest this condition). These conditions occur either because of improper nourishment of mother with vata and pitta dominant diet or because of decreased transfer of nutrients from mother to fetus as a consequence of fetal metabolic disorder or placental abnormality. The treatment principle applicable here is brimhana supplying nourishment to mother and fetus.
All the dietary articles mentioned in the management have vatahara and dhatupushtikara properties, as there are vataprakopa and dhatukshya in these conditions. In the case of lina garbha, there is the absence of fetal movements, to expel such fetus, treatments which increase uterine contractions and induce labor are indicated because such fetus resembles fetus papyraceous or mummified fetus.
Practically the herbs used in fetal growth restriction are yashtimadhu, shatavari, gambhari and preparations like phalghrita, laghumalinivasanta. These herbs and preparations are rasayana and improve dhatvagni and rasa dhatu nirmana. They also help in clearing any obstruction in the channels (srotas) which are supplying nourishment to the fetus through the mother. As mentioned in classics, ksheer basti given to the mother in severe IUGR conditions stimulates fetal growth.

===== Garbhini Udavarta and its management =====

As a result of progesterone hormone which relaxes all the smooth muscles, there is decreased bowel and intestinal movements. Especially during the later months of pregnancy, along with progesterone, the pressure of the uterus on intestines and rectum leads to decreased peristalsis. This is observed most commonly during the 8th month. Garbhini udavarta is a similar condition with constipation and gaseous distention. This condition is to be relieved as straining for defecation may lead to hemorrhoids, bleeding hemorrhoids and leaking of membranes. Medicated enema of decoction is to be administered to clear the bowel as oral medications may aggravate uterine contractions. Enema with oil should be administered afterward for oleation of the tract, and this may further help in the formation of canal/pathway for parturition.

The position in pregnancy to administer basti is nyubja sthithi – hunchback /flexed posture. Conventionally, the left-lateral position is used. In nyubja sthithi, the fetus moves in a ventral position relieving the pressure on colon and rectum, making it easy for basti to be administered and reach descending colon easily.

===== Mrita garbha (intrauterine death) and its management =====

All the factors which are contraindicated during pregnancy and are known to cause harm to the fetus, if continued by the mother can cause upavishtaka, nagodara, garbhashosa. If left untreated, excessive accumulation of doshas with maternal illness may lead to placental insufficiency and fetal disorders where it fails to metabolize nutrients and causes fetal death. The symptoms of mritagarbha (fetal death) also signify causes as antepartum hemorrhage, hypovolemia and its complications in the mother. [30]

To expel the dead fetus, the treatments to be administered are to initiate uterine contractions and induce labor. If necessary surgical treatment for removal of a dead fetus is also believed to save the mother from serious complications like DIC (disseminated intravascular coagulopathy) may occur if fetal fibrin is absorbed in maternal circulation. After the removal of the dead fetus, the physician should administer sura varga (alcoholic preparations) for the relief of pain and purification of the gut and genito-urinary system and also for the sense of exhilaration. Loss of fetus in such a later stage can be very stressful for mother and anxiety, depression and other psychotic complications may arise if proper care is not taken. Once there is complete shuddhi of koshtha and garbhashaya, one should give brimhana treatment to promote tissue bulk and nutrition. As there is the removal of the kleda from all dhatus during the management and shuddhi, santarpana is very essential.

==== Monthly regimen during pregnancy ====

Regular intake of recommended diet and daily routine is essential for fetal growth as well as maternal well-being. Daily use of milk and milk products is an important aspect of garbhini paricharya. Milk can nourish all body tissues and is considered a wholesome diet, fulfilling the requirement of fetal as well as maternal growth. Milk is sheeta, snigdha, and madhura and increases the ojas in the body. Ojas is said to be the essence of all body tissues and revitalizes to produce new body elements. The regimen is rich in proteins as well as carbohydrates which are essential for fetal growth and development. Due care is taken while prescribing the regimen to prevent vata prakopa. Disturbance in vata balance may cause many diseases of the fetus as well as the mother. From the eighth month onwards, the preparation of birth canal for pariturition begins and also there is the descent of fetal presenting part in the pelvis. To relieve the symptoms of this pressure on pelvis and augment the formation of lower segment, to prepare cervix to become ripe and easily dilatable, basti and pichu (vaginal tampon) of oil are advised<ref> Meharban Singh – Care Of the New Born, 7thed. New Delhi. Sagar Publications, 2010. </ref>. ix Basti keeps vata dosha balanced & its gati in anulom (downward) direction, preventing the obstruction in the path of vata dosha to help the process of labor, natural and in ease.

Antenatal patients are prescribed Ayurvedic regimen throughout pregnancy with proper diet advice. The medicines given are shatavari, phalghrita especially during the first trimester.

Use of a herbomineral preparation Garbhapala rasa because of its lead content is under controversy. Appropriate preparation of this herbominearal compound following Ayurvedic Formulary of India ensures proper development of the fetus and prevents bleeding and threatened abortion during the first trimester. Along with the physical development of the fetus, the spiritual and psychological development is also taken care of. Given this, the do's and don't's includes visiting scenic and places of interest, associating with likable people, eating prescribed diet, reading and listening to interesting stories are advised.

The lifestyle, diet, exercise, synthetic drugs, food additives like artificial colors, preservatives, the onslaught of electromagnetic radiations have become an integral part of the day today life (ref:https://infoayushdarpan.wordpress.com/2017/01/18/the-role-of-masanumasik-formulations/). This affects the growth and development of the fetus. Decoctions made in the form of Ghana vati as mentioned by Ashtanga and Sushruta are used as a monthly treatment for all antenatal patients which facilitate proper nourishment and hence the growth of fetus preventing any illness. Research has shown that application of matra basti and yoni pichu of Bala tssail given from the first day of 9th month results in normal labor without prolongation with spontaneous onset Ref. Also, it reduces postpartum complications like a backache, lower abdominal pain, and abdominal distention.

Kikkisa (striae gravidarum) which occurs on abdominal and breast area due to itching is to be treated with local application of drugs which relieves itching and burning sensation. Also, certain herbs are varnya in nature i.e. to improve color and complexion of skin. Ointments, oil, and lepa are prepared from these formulations and prescribed to mother to apply on abdominal area, thighs, and breast from the second month itself to prevent kikkisa.

Care during 9th month of pregnancy: Instead of suitiikagara, what special care of pregnant lady is advised by Ayurvedic obstretian at home before she goes into labor should be described. What instructions are given when labor pain starts?

==== Management of Labor ====

Instead of moving the mother after the labor pain starts, she is shifted to the delivery abode (sutikagara) at the onset of the ninth month. The entry is a ritual and done on auspicious day and timing to ensure the successful and uneventful outcome of pregnancy and parturition without any untoward complications. Symptoms and signs which signify formation of the lower segment with uterine contractions and cervical dilation indicate the onset of labor. As soon as the onset of labor is determined, the counseling and observation of mother are to be with while she is lying down.

To ensure proper progress of labor or when the uterine contractions are not strong, to favor descent of presenting part of the fetus, the mother is advised to walk around. She is also given herbs which are known to have the property of enhancing uterine contractions, in inhalation or fumigation form for quick absorption. Application of lepa made of pippali and vacha churna on abdominal area enhances the intensity of contractions. They are also helpful in prolonged labor caused by weak contractions. Langali, though not abundantly available, tying its roots or applying its lepa also gives such desired effects.

The intensity of increased labor pain and the onset of gripping pain in lower pelvis signifies further descent of fetus and full dilatation of the cervix. The bearing down efforts is encouraged in lying down position. Chanting also encourages the mother to bear down properly.

The proper timing of bearing down is full dilatation and presence of intense pain (uterine contractions). The two forces, voluntary (which are maternal bearing down effort) and involuntary (uterine contractions), when combined, lead to further descent and expulsion of a fetus with birth passage properly formed after full dilatation of the cervix. Expulsion of the fetus is controlled by apana vayu located in shroni (pelvis). If there is no movement of apana vayu and the mother bears down, it causes vata prakopa and leads to vikata navajata (baby born with deformities). Secondly, whenever there is an appropriate movement of apana vayu, but the woman suppresses that urge to bear down, that too leads to vata prakopa and causes deformities in the baby, the formation of caput succedaneum and fetal distress, both occur as a result of premature bearing down efforts and absence of bearing down respectively. The consequence of premature bearing down has increased the incidence of remote complication like vaginal and uterine prolapse.

After the birth of a baby, in the case of retained placenta, the therapies administered are to increase uterine contractions and increase intra-abdominal pressure for placental detachment and descent in the vagina. All these measures, along with basti, are vatahara and are vata shamaka measures for the restoration of prakrita gati of vata dosha to expel out the placenta along with stool and urine.

==== Care of the Newborn ====

Resuscitation of a newborn is the initial step and is called Pranapratyagaman Vidhi. There is a prescribed sequence for the clearing of mucous secretions from the oral cavity. First the palate, then the inner aspect of lips, kantha (pharynx), and the Jivha (tongue) should be cleaned. Once the secretion is cleared from the palate, it facilitates the air entry in the pharynx easily. Clearing of pharynx clears the air passage and finally clearing of tongue removes the amniotic fluid and mucous which sticks to the tongue. Nowadays, a neonatal care practice is to clear up the secretion with a suction apparatus first from the mouth and then through the nose. The reason for removing secretions from the mouth first is to prevent the aspiration of more copious oral secretions than nasal secretions. Emesis with ghee and rock salt prescribed in the past is not done. Modern practice is to do gastric suction.
Once the baby is breathing well next step is to cut the umbilical cord under aseptic conditions to prevent serious complication of stump infection. This is followed by application of oil and dry powders with antiseptic and drying property. All these measures are to prevent infection in the umbilical stump, early fall of the umbilical cord, healthy healing of the wound after the fall of the cord stump and for prevention of complications like omphalocele, etc. Lodhra, madhuka, priyamgu, suradaru, and Haridra, etc. are drugs that have kashaya and astringent properties to remove excessive moisture and prevent infection, since dry conditions favor the early separation of stump. Oil made up of the same drugs has antimicrobial and wound healing properties and prevents moisture and microbes. The wrong method of cutting of cord and improper care of the cord leads to complications.

==== Samskara After birth ====

Ayurveda Acharyas follow some medicinal practices in combination with ritualistic customs. The very first feed to the baby should be applied in a ritualistic and hygienic way. Therefore, in jatakarmasamskara, the father has to take a bath before holding the baby, followed by reciting mantras softly in the ear of the baby, followed by making the baby lick gold with honey and ghee. Licking initiates swallowing movement in the newly born baby, and once such sucking and swallowing movements start, it is safe to initiate breastfeeding. Breastfeeding is recommended immediately after birth since breastmilk provides colostrum (stanya piyusha) which gives the baby ample amount of protein, cholesterol, and immunoglobins. Colostrum is said to be essential for the growth of brain and memory of the baby. Cholesterols in the colostrum have essential linoleic fatty acids and various species-specific properties that are essential for nervine and enhancement of immunity. According to the recent practice of neonatal care, breastfeeding should be initiated within 15 minutes after birth, in the case of normal labor, and within 2 hours of birth in case of cesarean section. Precautions should be taken to prevent neonatal sepsis. Are ther any special ayurvedic ways being used now?

==== Prescribed post-partum measures for women ====

Parturition and postpartum phase cause significant changes physiologically, psychologically and anatomically especially, in her hormones and the neuro-endocrinal axis. All dhatus of the mother are at a low ebb (kshaya) during labor, and therefore there is vata prakopa and agnimandya. Therefore, in the postpartum phase, a physician should administer vatahara, deepana, and brimhana upakrama and should help restore the woman’s body tissues in a systematic manner, taking care of her digestive capacity. To regain homeostasis, the regimen of diet for first ten days postpartum are prescribed.
The measures prescribed in these texts are for the woman after delivery to transition from the effects of labor into a state of normalcy and good health smoothly. These measures help in the involution of the uterus and pelvic cavity, contraction of the distended abdomen, and help in restoring digestion. Immediate care will help in easing the fatigue of labor too. Experienced practitioners endorse these measures clinically.

Within ten days of childbirth, the uterus returns to its normal size and shape, the lochia (serous and water discharge from uterine bed through the vagina) becomes minimum or nil, and the physiology of the woman is restored to her normal stage. The mother also lactates in this phase. However, since she is still weak and vulnerable to diseases, while her body (and life) returns to a state of normalcy, she should be kept under strict vigil and care.

Orally decoction of dashmoola for garbhashaya shodhana as well as relieving backache is given, trikatu churna, vasa churna, bharangi churna, pippali churna, parsik yavani churna in combination with honey or warm water is administered for sufficient uterine contractions ensuring proper drainage of lochia, for agnideepana and for relieving pain. Shatavari churna with milk (Kshirpaka) for proper lactation, tablet triphala guggulu as the antiseptic measure is also given to the mother. At many Ayurveda hospitals, the mother is massaged with bala oil followed by steam; yonidhupana is done by sitting on a chair with herbs for fumigation kept below. (fig) A blanket is wrapped around the body covering legs after mother sits on it. The abdomen is wrapped with a big cloth to prevent distention and ensure proper involution.
[[File:Chair_for_yonidhupana.png|thumb|center|upright=1.35|alt=A Chair for yoni dhupana.]]

Fig: Chair for yoni dhupana
Source: http://www.jennsutkowski.com/blog-du-moment/steam-that-yonisteam-that-yoni-for-me-or-i-mean-you

==== Naming Ceremony ====

The naming ceremony is also advised to be done on the tenth day of childbirth. Although the family is free to keep a name of their choosing, guidelines for selection of the name are given here - one that is auspicious and derived through rituals, and the other for social identity.

Naming the baby is a very important event. A person’s name always leaves a very deep impact on his/her personality and behavior. Psychologically, what one hears and reacts is very important for the mental wellbeing of the person. Therefore, one should be given a good name having an auspicious meaning and that which instills confidence in the individual. Vedic cultures have formal naming ceremonies, as do some other cultures around the world. [50]

==== Examination of Newborn ====

All the morphological features of the newborn should be examined thoroughly to rule out any features of congenital anomalies and life-threatening conditions as early as possible. With the help of such findings, one can prevent further complications and consequences of these congenital issues. Therefore, on the tenth day of the child’s delivery, the physician should examine the baby thoroughly. The newborn is grossly examined at birth, but thorough examination is recommended on the tenth day because many minute observations might get missed just after birth and will become obvious by the tenth day.

Currently, wet nurse for feeding the baby is not used unless the mother dies and close relative is available..

Characteristics of Breast milk, the effect of a mother's diet on breast milk and its management: Shuddha stanya (pure breast milk) is necessary for the newborn. According to Ayurveda whenever the pakva ahara rasa enters the stana (breast), its madhura rasa get converted into stanya (breast milk). Therefore, whatever the mother eats converts into stanya. If the mother takes a diet that causes dosha prakopa, then such a vitiated dosha vitiates the stanya and the vitiated stanya causes disease in the newborn baby. Therefore, the mother should take balanced and healthy diet which does not vitiate doshas.

Some of the properties of stanya afflicted with vitiated doshas are as follows: vitiated vata dosha has tikta, kashya rasa and therefore, the stanya afflicted with vitiated vata dosha becomes tikata and kashya (bitter). Similar samprapti (etiology) is applicable in cases of pitta and kapha dosha prakopa as well.

As explained earlier, stanya produced from the adya ahara rasa dhatu (from the first dhatu..) is afflicted with vitiated kapha/shleshma dosha. Shodhana treatment is key for treating stanya dushti vikara (i.e. breastmilk infections). Shodhana should be followed by the administration of tikta, katu, and kashaya rasa drugs like vachaharidradi gana or charakokta patha mahaushadi suradarvadi stanya shodhana mahakashya (Cha. Sutra Sthana).

All the above-mentioned drugs and diet have been investigated and found useful with many evidence-based types of research, and are prescribed as galactagogues ref.

According to today's obstetrics and neonatology practice, the mother should feed the baby with the comfort of both mother and baby, keeping both in proper positions and with positive and loving thoughts for the baby.
The concept of examination of breast milk is not practically applied in today's era. The diet, lifestyle, and psyche of the mother affect the quality and quantity of breast milk. The characteristic and quantity of breast milk affects the growth and development of the newborn.

==== Designing and care of the child’s room ====

The kumaragara (or day care facility) should be prepared in such a manner as to prevent accidents and to protect the child from agantuja vyadhi (diseases due to external/extrinsic factors). In such healthy, emotionally stable and protected environment, children grow very healthy. Antimicrobial properties of all these drugs have been proven in different researches, and hence their use in newborn care and the neonatal nursery is quite evident. Till date, there is no evidence-based scientific explanation available for wearing stones and animal-based jewelry or ornaments. Most of these practices have passed down as customs or rituals since time immemorial.

==== Toys for children ====

Toys are very fundamental constituents for the proper growth and development of creative and logical thoughts in babies. Toys play a crucial role as sensory stimuli. Acharya Charaka was well aware of this aspect of child development and therefore described toys in detail. All societies and cultures have toys, and their role in child development is universally accepted.

==== The upbringing of the child ====

According to Artha Shastra of Chanakya (Vishnugupta), a child till the age of five years needs a lot of care and affection, while the next ten years require inculcating him/her with discipline and education and once he/she reaches 16 years of age, he/she should be treated as a friend. Children of 16 years of age are mature, physically and sexually, and by then are ready to acquire skills of work for earning.
</div>

=== References ===

<references/>
#Agnivesha, Charaka Samhita, Chakrapani commentary, Yadavji trivikramji Acharya, Chaukhambha Sanskrit Sansthan, Varanasi, reprint 2009.
#Baghel M. S., Researches In Ayurveda, Mridu Ayurvedic Publication & Sales, Jamnagar, 1997.
#Bhavamishra, Bhavaprakasha with Vidyotini Hindi Comm., Chowkhamba Samskrita Series, Varanasi, 1980.
#Bhela Samhita – Chowkhambha Vidyabhavan, Varanasi, 1961.
#Ghai OP. Normal Growth and its Disorders. In OP Ghai, Vinod KP, Arvinb B (Editors) GHAI Essential Pediatrics, Seventh Ed. New Delhi, CBS Publishers, and Distributors, 2009.
#Govinda Das Sen, Bhaishjya Ratnavali, commented by Ambikadatta Shastri, Rajeshwara Datta Shastri, Varanasi: Chaukhambha Prakashan, 2010.
#Harita Samhita, Tritiya sthana, Kasanidana Chikitsa Adhyaya (12th ch). E-book, pdf Maharishi University of Management, Vedic Literature Collection.
#Madhavakara, Madhava Nidana, Vijayarakshita commentary (Madhukosha), Brahmananda Tripathi (ed). Varanasi: Chaukhambha Surabharati Prakashan, 2008.
#Meharban Singh – Care Of the New Born, 7thed. New Delhi. Sagar Publications, 2010.
#Moneir M. Williams – Sanskrita English Dictionary, Munshi Monoharlal Publ. Delhi.
#P. V. Tiwari – Prasuti Tantra & Stri Roga, Chowkhambha Orientalia, Varanasi, 1987.
#Sharangadhara, Sharangadhara Samhita, commented by Adamalla (Deepika), Pandit Parashurama Shastri, Varanasi: Chaukhambha Orientalia Publications; 2008.
#Sharma PV, Dravyaguna Vijyana Vol II, Varanasi, Chaukhambha Bharati Acadamy; 2006.
#Stedman’s Medical Dictionary.
#Sushruta, Sushruta Samhita, Dalhanacommentary, Ed by Vd. Jadhavji Trikamji Acharya, , Varanasi:Chaukhambha Sanskrit Sansthan, reprint 2009.
#Vagbhata, Asthanga Hridaya, Arunadatta and Hemadri commentary.,Harishastri Paradakara Vaidya(ed.), Varanasi: Chaukhambha Orientalia Publications; 2005.
#Vagbhata, Astanga Sangraha, commentary by Kaviraja Atridava Gupta, Varanasi, Chaukamba Krishnadas Prakashan, 2005.
#Vridhhajeevaka, Kashyapa Samhita. Pandit Hemaraja Sharma(ed.), commented by Satyapala Bhishgacharya, Varanasi, Chaukhambha Sanskrit Sansthan, 2009.
#Yoga Ratnakara – Vidyotini Hindi Comm.., 1st Ed. Chowkhsmbha Sanskrita Series, Varanasi, 1973.

Jatisutriya Sharira

2017-12-25T04:48:21Z

Vinay Exafluence: /* References */

{{Infobox
|title = Jatisutriya Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 8
|label2 = Preceding Chapter
|data2 = [[Samkhya Sharira]]

|label3= Succeeding Chapter
|data3 = None
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]

|header3 =

}}
== [[Sharira Sthana]] Chapter 8 Jatisutriya Shariram ==

=== Abstract ===
<div style="text-align:justify;">
The eighth chapter of [[Sharira Sthana]], [[Jatisutriya Sharira]], continues from where Chapter Two ends, and deals not just with obstetrics and midwifery, but also prescribes measures for good parental health and effective neonatal care. It also describes pioneering concepts such as construction of a maternity home, attending wet nurses (and the concept of a milk bank), and well-furnished nurseries. ''Jati'' means birth, hence this chapter deals with the method of procreation in short.

'''Keywords''':''Jatisutriya, Dhatri''
</div>
=== Introduction ===
<div style="text-align:justify;">
The [[Sharira Sthana]] and [[Chikitsa Sthana]] provide valuable insights into obstretics, midwifery and gynaecology in the Vedic ages. Since Ayurveda is holistic in its treatment of various aspects of life sciences, these sections go beyond in their treatment of these branches of medicine, prescribing ground rules for effective neonatology and improved parental health. This chapter starts with certain guidelines for purification of the parents, including spiritual practices and appropriate rules for coitus, to improve the odds of giving birth to a healthy and desired offspring. For purification, therapies such as [[Panchakarma]] are advocated. A very specific - and contentious - spiritual procedure called ''putreshti yajna'' is also explained here, with an aim towards giving birth to a son (or a child of desired gender) with all excellent qualities.

Next, the chapter talks of fertilization and its features, and confirmation of conception. At this stage, sound parental health is also important. Couples are advised to follow various dietary measures as well as rules to engage in physical and mental activities, etc.
The subsequent part of the chapter deals with obstetrics and midwifery –detailing the development of the embryo to fetus and the milestones of intrauterine growth and development are explained. Certain sections of this chapter are controversial and could attract legal attention today, such as the practice of ''pumsavana'' (ways to get the offspring of a desired gender). Also, with our current understanding of genetics, it is not possible to change the gender after fertilization. The role of learned ''brahmins, vaidya'' and experienced old ladies in midwifery is given a lot of importance in this chapter.

Toys and playtime are essential for normal growth and development of a child, and the final section of this chapter describes the ideal characteristics of toys, play area, clothes and the child nursery.

Summarizing the eighth chapter, it deals with Obstetrics and Neonatology while also touching upon parental health and early child care, introducing certain concepts that are now considered modern best practices in the field,
</div>
===Sanskrit text, Transliteration and English Translation===

अथातो जातिसूत्रीयं शारीरं व्याख्यास्यामः||१||

athātō jātisūtrīyaṁ śārīraṁ vyākhyāsyāmaḥ||1||

athAto jAtisUtrIyaM shArIraM vyAkhyAsyAmaH||1||

“Now I shall expound the chapter dealing with continuation of one’s own lineage, in this discourse on Sharira.” [1]

Note: ''Jati'' means birth and ''Sutra'' is which is described in short. ''Jatisutriya'' is description of different methods and procedures of birth in short.

इति ह स्माह भगवानात्रेयः||२||

iti ha smāha bhagavānātrēyaḥ||2||

iti ha smAha bhagavAnAtreyaH||2||

Thus said Lord Atreya [2]

स्त्रीपुंसयोरव्यापन्नशुक्रशोणितगर्भाशययोः श्रेयसीं प्रजामिच्छतोस्तदर्थाभिनिर्वृत्तिकरं [१] कर्मोपदेक्ष्यामः||३||

strīpuṁsayōravyāpannaśukraśōṇitagarbhāśayayōḥ śrēyasīṁ prajāmicchatōstadarthābhinirvr̥ttikaraṁ [1]karmōpadēkṣyāmaḥ||3||

strIpuMsayoravyApannashukrashoNitagarbhAshayayoH shreyasIMprajAmicchatostadarthAbhinirvRuttikaraM [1] karmopadekShyAmaH||3||

Now we shall explain the procedures required for begetting a progeny of excellent qualities, to be practiced by man and woman of unaltered (pure, undamaged) sperm, ovum and uterus. [3]

अथाप्येतौ स्त्रीपुंसौ स्नेहस्वेदाभ्यामुपपाद्य, वमनविरेचनाभ्यां संशोध्य, क्रमेण प्रकृतिमापादयेत्|
संशुद्धौ चास्थापनानुवासनाभ्यामुपाचरेत्; उपाचरेच्च मधुरौषधसंस्कृताभ्यां घृतक्षीराभ्यां पुरुषं, स्त्रियं तु तैलमाषाभ्याम्||४||

athāpyētau strīpuṁsau snēhasvēdābhyāmupapādya, vamanavirēcanābhyāṁ saṁśōdhya, kramēṇaprakr̥timāpādayēt|
saṁśuddhau cāsthāpanānuvāsanābhyāmupācarēt; upācarēcca madhurauṣadhasaṁskr̥tābhyāṁghr̥takṣīrābhyāṁ puruṣaṁ, striyaṁ tu tailamāṣābhyām||4||

athApyetau strIpuMsau snehasvedAbhyAmupapAdya, vamanavirecanAbhyAM saMshodhya, krameNaprakRutimApAdayet|
saMshuddhau cAsthApanAnuvAsanAbhyAmupAcaret; upAcarecca madhurauShadhasaMskRutAbhyAMghRutakShIrAbhyAM puruShaM, striyaM tu tailamAShAbhyAm||4||
<div style="text-align:justify;">
Such a couple (desiring good progeny) should first undergo purification therapies described earlier in this treatise - unction and sudation procedures followed by emesis and purgation - and gradually get back to normalcy. Once purified, the couple should undergo non-unctuous and unctuous enema. Then, the man should be administered with sweet-tasting drugs processed with ghee and milk while the woman should take sesame oil and black gram. [4]
</div>
==== Abstinence from coitus during menstruation ====

ततः पुष्पात् प्रभृति त्रिरात्रमासीत ब्रह्मचारिण्यधःशायिनी, पाणिभ्यामन्नमजर्जरपात्राद्भुञ्जाना [१] , न चकाञ्चिन्मृजामापद्येत|
ततश्चतुर्थेऽहन्येनामुत्साद्य सशिरस्कं स्नापयित्वा शुक्लानि वासांस्याच्छादयेत् पुरुषं च|
ततः शुक्लवाससौ स्रग्विणौ सुमनसावन्योन्यमभिकामौ संवसेयातां स्नानात् प्रभृति युग्मेष्वहःसु पुत्रकामौ, अयुग्मेषुदुहितृकामौ||५||

tataḥ puṣpāt prabhr̥ti trirātramāsīta brahmacāriṇyadhaḥśāyinī, pāṇibhyāmannamajarjarapātrādbhuñjānā[1] , na ca kāñcinmr̥jāmāpadyēta|
tataścaturthē'hanyēnāmutsādya saśiraskaṁ snāpayitvā śuklāni vāsāṁsyācchādayēt puruṣaṁ ca|
tataḥ śuklavāsasau sragviṇau sumanasāvanyōnyamabhikāmau saṁvasēyātāṁ snānāt prabhr̥tiyugmēṣvahaḥsu putrakāmau, ayugmēṣu duhitr̥kāmau||5||

tataH puShpAt prabhRuti trirAtramAsIta brahmacAriNyadhaHshAyinI,pANibhyAmannamajarjarapAtrAdbhu~jjAnA [1] , na ca kA~jcinmRujAmApadyeta|
tatashcaturthe~ahanyenAmutsAdya sashiraskaM snApayitvA shuklAni vAsAMsyAcchAdayet puruShaM ca|
tataH shuklavAsasau sragviNau sumanasAvanyonyamabhikAmau saMvaseyAtAM snAnAt prabhRutiyugmeShvahaHsu putrakAmau, ayugmeShu duhitRukAmau||5||
<div style="text-align:justify;">
While menstruating, the woman should abstain from coitus for three nights, sleep on the ground, consume food with her hand from unbroken utensils, and should not clean her body by any means. On the fourth day, she should be anointed well with oil and should be given a good head bath, cleansed well, and then made to wear white coloured apparel. The man should follow similar rituals as the woman on her fourth day of menstruation. Then onwards, the two, wearing white apparels and garlands, with pleasant disposition, loving each other, should enter into acts of cohabitation - on even days if desirous of a male child, and on odd days for a female child. [5]
</div>
==== Postures and circumstances to be avoided for coitus ====

न च न्युब्जां पार्श्वगतां वा संसेवेत|
न्युब्जाया वातो बलवान् स योनिं पीडयति, पार्श्वगताया दक्षिणे पार्श्वे श्लेष्मा स च्युतः पिदधाति गर्भाशयं, वामे पार्श्वे पित्तंतदस्याः पीडितं विदहति रक्तं शुक्रं च, तस्मादुत्ताना बीजं गृह्णीयात्; तथाहि यथास्थानमवतिष्ठन्ते दोषाः|
पर्याप्ते चैनां शीतोदकेन परिषिञ्चेत्|
तत्रात्यशिता क्षुधिता पिपासिता भीता विमनाः शोकार्ता क्रुद्धाऽन्यं च पुमांसमिच्छन्ती मैथुने चातिकामा वा न गर्भं धत्ते,विगुणां वा प्रजां जनयति|
अतिबालामतिवृद्धां दीर्घरोगिणीमन्येन वा विकारेणोपसृष्टां वर्जयेत्|
पुरुषेऽप्येत एव दोषाः|
अतः सर्वदोषवर्जितौ स्त्रीपुरुषौ संसृज्येयाताम्||६||

na ca nyubjāṁ pārśvagatāṁ vā saṁsēvēta|
nyubjāyā vātō balavān sa yōniṁ pīḍayati, pārśvagatāyā dakṣiṇē pārśvē ślēṣmā sa cyutaḥ pidadhātigarbhāśayaṁ, vāmē pārśvē pittaṁ tadasyāḥ pīḍitaṁ vidahati raktaṁ śukraṁ ca, tasmāduttānā bījaṁgr̥hṇīyāt; tathāhi yathāsthānamavatiṣṭhantē dōṣāḥ|
paryāptē caināṁ śītōdakēna pariṣiñcēt|
tatrātyaśitā kṣudhitā pipāsitā bhītā vimanāḥ śōkārtā kruddhā'nyaṁ ca pumāṁsamicchantī maithunēcātikāmā vā na garbhaṁ dhattē, viguṇāṁ vā prajāṁ janayati|
atibālāmativr̥ddhāṁ dīrgharōgiṇīmanyēna vā vikārēṇōpasr̥ṣṭāṁ varjayēt|
puruṣē'pyēta ēva dōṣāḥ|
ataḥ sarvadōṣavarjitau strīpuruṣau saṁsr̥jyēyātām||6||

na ca nyubjAM pArshvagatAM vA saMseveta|
nyubjAyA vAto balavAn sa yoniM pIDayati, pArshvagatAyA dakShiNe pArshve shleShmA sa cyutaHpidadhAti garbhAshayaM, vAme pArshve pittaM tadasyAH pIDitaM vidahati raktaM shukraM ca,tasmAduttAnA bIjaM gRuhNIyAt; tathAhi yathAsthAnamavatiShThante doShAH|
paryApte cainAM shItodakena pariShi~jcet|
tatrAtyashitA kShudhitA pipAsitA bhItA vimanAH shokArtA kruddhA~anyaM ca pumAMsamicchantImaithune cAtikAmA vA na garbhaM dhatte, viguNAM vA prajAM janayati|
atibAlAmativRuddhAM dIrgharogiNImanyena vA vikAreNopasRuShTAM varjayet|
puruShe~apyeta eva doShAH|
ataH sarvadoShavarjitau strIpuruShau saMsRujyeyAtAm||6||
<div style="text-align:justify;">
During sexual intercourse, the woman should not be in prone posture, or lie on her sides. In the former case, ''vata dosha'' becomes stronger and inflicts the genital tract and in the latter case, lying on her right side, displaces ''kapha dosha'' into the mouth of the uterus and creates obstruction, while if she is on her left side, ''pitta dosha'' afflicts the ovum and sperm by its heat. Therefore, the woman should receive the sperm lying on her back, in this position; the doshas are in their states of normalcy. After coitus, vagina should be sprinkled with cold water.

The woman who has overeaten, thirsty, frightened, dejected, in grief, anger or in love with a man other than her husband, or who is overpassionate (during the coital act) will fail to conceive or if conceived, will give birth to a child with some defects.

A very young (sexually immature) girl or a very old woman, woman suffering from chronic illness or suffering with any other disorders should not procreate. This condition applies for a male partner too. Hence only a man and a woman who are free from all defects, and are of suitable age should engage in coitus. [6]
</div>
==== Preparations before coitus ====

सञ्जातहर्षौ मैथुने चानुकूलाविष्टगन्धं स्वास्तीर्णं सुखं शयनमुपकल्प्य मनोज्ञं हितमशनमशित्वा नात्यशितौ दक्षिणपादेनपुमानारोहेत् वामपादेन स्त्री||७||

sañjātaharṣau maithunē cānukūlāviṣṭagandhaṁ svāstīrṇaṁ sukhaṁ śayanamupakalpya manōjñaṁhitamaśanamaśitvā nātyaśitau dakṣiṇapādēna pumānārōhēt vāmapādēna strī||7||

sa~jjAtaharShau maithune cAnukUlAviShTagandhaM svAstIrNaM sukhaM shayanamupakalpya manoj~jaMhitamashanamashitvA nAtyashitau dakShiNapAdena pumAnArohet vAmapAdena strI||7||
<div style="text-align:justify;">
The couple that is sufficiently aroused and fully engrossed in the sexual act, after having their favorite food (wholesome, not overeaten), should lie on bed which is well adorned with pleasant perfumes and bedecked with comfortable mattresses of one’s choice for the sexual act, man placing his right foot first and woman her left. [7]
</div>
==== ''Mantra'' before the sexual act ====

तत्र मन्त्रं प्रयुञ्जीत- “अहिरसि आयुरसि सर्वतः प्रतिष्ठाऽसि धाता त्वा ददतु विधाता त्वा दधातु ब्रह्मवर्चसा भव” इति|
“ब्रह्मा बृहस्पतिर्विष्णुःसोमःसूर्यस्तथाऽश्विनौ|
भगोऽथ मित्रावरुणौ वीरं [२] ददतु मे सुतम्”
इत्युक्त्वा संवसेयाताम्||८||

tatra mantraṁ prayuñjīta- “ahirasi āyurasi sarvataḥ pratiṣṭhā'si dhātā tvā dadatu vidhātā tvā dadhātubrahmavarcasā bhava” iti|
“brahmā br̥haspatirviṣṇuḥsōmaḥsūryastathā'śvinau|
bhagō'tha mitrāvaruṇau vīraṁ [2] dadatu mē sutam”
ityuktvā saṁvasēyātām||8||

tatra mantraM prayu~jjIta- “ahirasi Ayurasi sarvataH pratiShThA~asi dhAtA tvA dadatu vidhAtA tvAdadhAtu brahmavarcasA bhava” iti|
“brahmA bRuhaspatirviShNuHsomaHsUryastathA~ashvinau|
bhago~atha mitrAvaruNau vIraM [2] dadatu me sutam”
ityuktvA saMvaseyAtAm||8||
<div style="text-align:justify;">
Then, they should recite the ''mantra'' meaning: ‘Thou art the day; Thou art the life; Thou art well established from all sides. May the supporter endow Thee; may the dispenser dispense to Thee: be Thou born with ''Brahmic'' splendor’. May Brahma, Brhaspati, Visnu, Soma, Surya and the two Ashwins, as also Bhaga, Mitra and Varuna, bless me with a heroic son.’ Having uttered this, the couple should commence the sexual act. [8]
</div>
==== Daily rituals to be followed a week before coitus by a woman desirous of a healthy male child ====

सा चेदेवमाशासीत-बृहन्तमवदातं हर्यक्षमोजस्विनं शुचिं सत्त्वसम्पन्नं पुत्रमिच्छेयमिति, शुद्धस्नानात् प्रभृत्यस्यैमन्थमवदातयवानां मधुसर्पिर्भ्यां संसृज्य श्वेताया गोः सरूपवत्सायाः पयसाऽऽलोड्य राजते कांस्ये वा पात्रे काले काले सप्ताहंसततं प्रयच्छेत् पानाय|
प्रातश्च शालियवान्नविकारान् दधिमधुसर्पिर्भिः पयोभिर्वा संसृज्य भुञ्जीत, तथा सायमवदातशरणशयनासनपानवसनभूषणाच स्यात्|
सायं प्रातश्च शश्वच्छ्वेतं महान्तं वृषभमाजानेयं वा हरिचन्दनाङ्गदं पश्येत्|
सौम्याभिश्चैनां कथाभिर्मनोनुकूलाभिरुपासीत|
सौम्याकृतिवचनोपचारचेष्टांश्च स्त्रीपुरुषानितरानपि चेन्द्रियार्थानवदातान् पश्येत्|
सहचर्यश्चैनां प्रियहिताभ्यां सततमुपचरेयुस्तथा भर्ता|
न च मिश्रीभावमापद्येयातामिति|
अनेन विधिना सप्तरात्रं स्थित्वाऽष्टमेऽहन्याप्लुत्याद्भिः सशिरस्कं सह भर्त्रा अहतानि वस्त्राण्याच्छादयेदवदातानि,अवदाताश्च स्रजो भूषणानि च बिभृयात्||९||

sā cēdēvamāśāsīta- br̥hantamavadātaṁ haryakṣamōjasvinaṁ śuciṁ sattvasampannaṁ putramicchēyamiti,śuddhasnānāt prabhr̥tyasyai manthamavadātayavānāṁ madhusarpirbhyāṁ saṁsr̥jya śvētāyā gōḥsarūpavatsāyāḥ payasā''lōḍya rājatē kāṁsyē vā pātrē kālē kālē saptāhaṁ satataṁ prayacchēt pānāya|
prātaśca śāliyavānnavikārān dadhimadhusarpirbhiḥ payōbhirvā saṁsr̥jya bhuñjīta, tathāsāyamavadātaśaraṇaśayanāsanapānavasanabhūṣaṇā ca syāt|
sāyaṁ prātaśca śaśvacchvētaṁ mahāntaṁ vr̥ṣabhamājānēyaṁ vā haricandanāṅgadaṁ paśyēt|
saumyābhiścaināṁ kathābhirmanōnukūlābhirupāsīta|
saumyākr̥tivacanōpacāracēṣṭāṁśca strīpuruṣānitarānapi cēndriyārthānavadātān paśyēt|
sahacaryaścaināṁ priyahitābhyāṁ satatamupacarēyustathā bhartā|
na ca miśrībhāvamāpadyēyātāmiti|
anēna vidhinā saptarātraṁ sthitvā'ṣṭamē'hanyāplutyādbhiḥ saśiraskaṁ saha bhartrā ahatānivastrāṇyācchādayēdavadātāni, avadātāśca srajō bhūṣaṇāni ca bibhr̥yāt||9||

sA cedevamAshAsIta- bRuhantamavadAtaM haryakShamojasvinaM shuciM sattvasampannaMputramiccheyamiti, shuddhasnAnAt prabhRutyasyai manthamavadAtayavAnAM madhusarpirbhyAMsaMsRujya shvetAyA goH sarUpavatsAyAH payasA~a~aloDya rAjate kAMsye vA pAtre kAle kAle saptAhaMsatataM prayacchet pAnAya|
prAtashca shAliyavAnnavikArAn dadhimadhusarpirbhiH payobhirvA saMsRujya bhu~jjIta, tathAsAyamavadAtasharaNashayanAsanapAnavasanabhUShaNA ca syAt|
sAyaM prAtashca shashvacchvetaM mahAntaM vRuShabhamAjAneyaM vA haricandanA~ggadaM pashyet|
saumyAbhishcainAM kathAbhirmanonukUlAbhirupAsIta|
saumyAkRutivacanopacAraceShTAMshca strIpuruShAnitarAnapi cendriyArthAnavadAtAn pashyet|
sahacaryashcainAM priyahitAbhyAM satatamupacareyustathA bhartA|
na ca mishrIbhAvamApadyeyAtAmiti|
anena vidhinA saptarAtraM sthitvA~aShTame~ahanyAplutyAdbhiH sashiraskaM saha bhartrA ahatAnivastrANyAcchAdayedavadAtAni, avadAtAshca srajo bhUShaNAni ca bibhRuyAt||9||
<div style="text-align:justify;">
A woman desirous of having a male child with large limbs, fair complexion, with eyes like those of a lion (full of vigor), pure, and with good mental disposition should, after her menstrual period, first take a purificatory bath, then be given a light porridge of well cleaned white barley grains duly sweetened by adding honey and ghee, diluted in the milk of a white cow having a white calf, in a utensil made of silver or bronze, regularly in the morning and evening for a week.

During mornings and evenings, she should eat a diet prepared with sali rice and/or barley mixed with curd, honey, ghee or with milk. Her room, bed, seat, drink, dress and ornaments etc. all should be of white color. In the evenings and mornings, she should look at a white majestic bull / stallion duly smeared with white sandal paste without fail. She should also be entertained with pleasant tales of her interest, acceptable to her mood. She should also look at men and women having good personality, speech, behaviour and manners, as well as visuals and objects that are white in color.

Her companions and husband should also entertain her with things, discussion topics, and activities that are pleasant to her, and not stressful. The couple, should, however avoid sexual contact during this period. Following this regimen for a week, on the eighth day she, along with her husband, after taking a head bath with pure (consecrated – ''abhimantritam'') water, get prepared for coitus by adorning themselves with new white apparel, garlands and ornaments. [9]
</div>
==== Rituals at the end of the week ====

तत ऋत्विक् प्रागुत्तरस्यां दिश्यगारस्य प्राग्प्रवणमुदक्प्रवणं वा प्रदेशमभिसमीक्ष्य, गोमयोदकाभ्यां स्थण्डिलमुपलिप्य, प्रोक्ष्यचोदकेन, वेदीमस्मिन् स्थापयेत्|
तां पश्चिमेनाहतवस्त्रसञ्चये श्वेतार्षभे वाऽप्यजिन उपविशेद् ब्राह्मणप्रयुक्तः, राजन्यप्रयुक्तस्तु वैयाघ्रे चर्मण्यानडुहे वा,वैश्यप्रयुक्तस्तु रौरवे बास्ते वा|
तत्रोपविष्टः पालाशीभिरैङ्गुदीभिरौदुम्बरीभिर्माधूकीभिर्वा समिद्भिरग्निमुपसमाधाय, कुशैः परिस्तीर्य, परिधिभिश्च परिधाय,लाजैः शुक्लाभिश्च गन्धवतीभिः सुमनोभिरुपकिरेत्|
तत्र प्रणीयोदपात्रं पवित्रपूतमुपसंस्कृत्य सर्पिराज्यार्थं यथोक्तवर्णानाजानेयादीन् समन्ततः स्थापयेत्||१०||

tata r̥tvik prāguttarasyāṁ diśyagārasya prāgpravaṇamudakpravaṇaṁ vā pradēśamabhisamīkṣya,gōmayōdakābhyāṁ sthaṇḍilamupalipya, prōkṣya cōdakēna, vēdīmasmin sthāpayēt|
tāṁ paścimēnāhatavastrasañcayē śvētārṣabhē vā'pyajina upaviśēd brāhmaṇaprayuktaḥ,rājanyaprayuktastu vaiyāghrē carmaṇyānaḍuhē vā, vaiśyaprayuktastu rauravē bāstē vā|
tatrōpaviṣṭaḥ pālāśībhiraiṅgudībhiraudumbarībhirmādhūkībhirvā samidbhiragnimupasamādhāya, kuśaiḥparistīrya, paridhibhiśca paridhāya, lājaiḥ śuklābhiśca gandhavatībhiḥ sumanōbhirupakirēt|
tatra praṇīyōdapātraṁ pavitrapūtamupasaṁskr̥tya sarpirājyārthaṁ yathōktavarṇānājānēyādīn samantataḥsthāpayēt||10||

tata Rutvik prAguttarasyAM dishyagArasya prAgpravaNamudakpravaNaM vA pradeshamabhisamIkShya,gomayodakAbhyAM sthaNDilamupalipya, prokShya codakena, vedImasmin sthApayet|
tAM pashcimenAhatavastrasa~jcaye shvetArShabhe vA~apyajina upavished brAhmaNaprayuktaH,rAjanyaprayuktastu vaiyAghre carmaNyAnaDuhe vA, vaishyaprayuktastu raurave bAste vA|
tatropaviShTaH pAlAshIbhirai~ggudIbhiraudumbarIbhirmAdhUkIbhirvA samidbhiragnimupasamAdhAya,kushaiH paristIrya, paridhibhishca paridhAya, lAjaiH shuklAbhishca gandhavatIbhiH sumanobhirupakiret|
tatra praNIyodapAtraM pavitrapUtamupasaMskRutya sarpirAjyArthaM yathoktavarNAnAjAneyAdInsamantataH sthApayet||10||
<div style="text-align:justify;">
At the end of one week, a priest should select a place on the north side of the house, having a downward slope towards the east or the north. The selected place/ground should be duly smeared with cowdung and water. After sprinkling the place with water, he should prepare and fix the altar.

On the west of the altar, the priest should take his seat on an undamaged cotton cushion or on the skin of a white bull, if he is officiating on behalf of a ''brahmana'' patron, on the skin of a tiger or bull if ''kshatriya'', and on the skin of a deer or a ram, in case of a ''vaisya''.

Thus seated, he should kindle the scared fire with the twigs of ''palasha'' (Butea monosperma Kuntze), ''ingudi'' (Balanites aegyptica Delile), ''udumbara'' (Ficus racemosa Linn) or ''madhuka'' (Madhuka indica J.F.Gmel), spread the ''kusha'' (Desmostachya bipinnata Stapf.) grass around, and fix the enclosure of fire with big stalks of ''palasha'' (Butea monospermakuntze) on all four sides, and then spread the altar with parched/roasted paddy and white coloured flowers having sweet fragrance. Then, he should prepare a water pot, clean and sanctified by ''mantras'', make available adequate amount of ghee for offerings, and place auspicious objects (such as bulls or stallions) of said qualities and colors, etc. in and around the place of offering as mentioned earlier. [10]
</div>
==== Additional rituals before cohabiting ====

ततः पुत्रकामा पश्चिमतोऽग्निं दक्षिणतो ब्राह्मणमुपविश्यान्वालभेत सह भर्त्रा यथेष्टं पुत्रमाशासाना| ततस्तस्या आशासानाया ऋत्विक् प्रजापतिमभिनिर्दिश्य योनौ तस्याः कामपरिपूरणार्थं काम्यामिष्टिं निर्वर्तयेद् ‘विष्णुर्योनिंकल्पयतु’ इत्यनयर्चा|
ततश्चैवाज्येन स्थालीपाकमभिघार्य त्रिर्जुहुयाद्यथाम्नायम्|
मन्त्रोपमन्त्रितमुदपात्रं तस्यै दद्यात् सर्वोदकार्थान् कुरुष्वेति|
ततः समाप्ते कर्मणि पूर्वं दक्षिणपादमभिहरन्ती प्रदक्षिणमग्निमनुपरिक्रामेत् सह भर्त्रा|
ततो [१] ब्राह्मणान् स्वस्ति वाचयित्वाऽऽज्यशेषं [२] प्राश्नीयात् पूर्वं पुमान्, पश्चात् स्त्री; न चोच्छिष्टमवशेषयेत्|
ततस्तौ सह संवसेयातामष्टरात्रं, तथाविधपरिच्छदावेव च स्यातां [३] , तथेष्टपुत्रं जनयेताम्||११||

tataḥ putrakāmā paścimatō'gniṁ dakṣiṇatō brāhmaṇamupaviśyānvālabhēta saha bhartrā yathēṣṭaṁputramāśāsānā|
tatastasyā āśāsānāyā r̥tvik prajāpatimabhinirdiśya yōnau tasyāḥ kāmaparipūraṇārthaṁ kāmyāmiṣṭiṁnirvartayēd ‘viṣṇuryōniṁ kalpayatu’ ityanayarcā|
tataścaivājyēna sthālīpākamabhighārya trirjuhuyādyathāmnāyam|
mantrōpamantritamudapātraṁ tasyai dadyāt sarvōdakārthān kuruṣvēti|
tataḥ samāptē karmaṇi pūrvaṁ dakṣiṇapādamabhiharantī pradakṣiṇamagnimanuparikrāmēt saha bhartrā|
tatō [1] brāhmaṇān svasti vācayitvā''jyaśēṣaṁ [2] prāśnīyāt pūrvaṁ pumān, paścāt strī; nacōcchiṣṭamavaśēṣayēt|
tatastau saha saṁvasēyātāmaṣṭarātraṁ, tathāvidhaparicchadāvēva ca syātāṁ [3] , tathēṣṭaputraṁjanayētām||11||

tataH putrakAmA pashcimato~agniM dakShiNato brAhmaNamupavishyAnvAlabheta saha bhartrAyatheShTaM putramAshAsAnA|
tatastasyA AshAsAnAyA Rutvik prajApatimabhinirdishya yonau tasyAH kAmaparipUraNArthaMkAmyAmiShTiM nirvartayed ‘viShNuryoniM kalpayatu’ ityanayarcA|
tatashcaivAjyena sthAlIpAkamabhighArya trirjuhuyAdyathAmnAyam|
mantropamantritamudapAtraM tasyai dadyAt sarvodakArthAn kuruShveti|
tataH samApte karmaNi pUrvaM dakShiNapAdamabhiharantI pradakShiNamagnimanuparikrAmet sahabhartrA|
tato [1] brAhmaNAn svasti vAcayitvA~a~ajyasheShaM [2] prAshnIyAt pUrvaM pumAn, pashcAt strI; nacocchiShTamavasheShayet|
tatastau saha saMvaseyAtAmaShTarAtraM, tathAvidhaparicchadAveva ca syAtAM [3] , tatheShTaputraMjanayetAm||11||
<div style="text-align:justify;">
Thereafter the woman, desirous of progeny, should sit with her husband on the west side of the altar, while the priest should sit to the south, and together they should perform the holy oblation to fire expressing their longing for a progeny. Then, the priest, addressing the God of procreation (Prajapati) for the fulfilment of her desire in her womb, should perform the ‘boon bestowing rite’, by chanting the said hymn ‘May Visnu bless the womb and make it fertile’. Then, the priest should prepare a bolus of cooked rice in an earthen pot by mixing the oblation with ghee, offering it to the holy fire thrice according to the prescribed methods. He should then give the sanctified pot of water to the woman to be used for all her purposes.

On the completion of the rite, she should, placing her right foot first, walk around the fire keeping to her right and accompanied by her husband. Then, after taking the the blessing of the ''brahmanas'', the couple should consume the remains of the sacrificial ghee - first the husband and then the wife - taking care not to leave any leftovers. On completion of this ritual, they shall cohabit for a period of eight nights, wearing the dress etc., as prescribed earlier. In this manner they will be able to beget a progeny, as desired. [11]
</div>
या तु स्त्री श्यामं लोहिताक्षं व्यूढोरस्कं महाबाहुं च पुत्रमाशासीत, या वा कृष्णं कृष्णमृदुदीर्घकेशं शुक्लाक्षं शुक्लदन्तंतेजस्विनमात्मवन्तम्; एष एवानयोरपि होमविधिः|
किन्तु परिबर्हो वर्णवर्जं स्यात्|
पुत्रवर्णानुरूपस्तु यथाशीरेव तयोः परिबर्होऽन्यः कार्यः स्यात्||१२||

yā tu strī śyāmaṁ lōhitākṣaṁ vyūḍhōraskaṁ mahābāhuṁ ca putramāśāsīta, yā vā kr̥ṣṇaṁkr̥ṣṇamr̥dudīrghakēśaṁ śuklākṣaṁ śukladantaṁ tējasvinamātmavantam; ēṣa ēvānayōrapi hōmavidhiḥ|
kintu paribarhō varṇavarjaṁ syāt|
putravarṇānurūpastu yathāśīrēva tayōḥ paribarhō'nyaḥ kāryaḥ syāt||12||

yA tu strI shyAmaM lohitAkShaM vyUDhoraskaM mahAbAhuM ca putramAshAsIta, yA vA kRuShNaMkRuShNamRududIrghakeshaM shuklAkShaM shukladantaM tejasvinamAtmavantam; eSha evAnayorapihomavidhiH|
kintu paribarho varNavarjaM syAt|
putravarNAnurUpastu yathAshIreva tayoH paribarho~anyaH kAryaH syAt||12||
<div style="text-align:justify;">
As regards the woman desirous of a child with sky blue complexion, red eye, broad chest and long limbs, or a woman who seeks off spring with black complexion, with black, soft and long hair, glittering white eye and teeth, radiant and self-restrained, the rituals to be followed are the same as described above. The preparations and materials required will not be of the same color but it should be made, in either case, to match the desired complexion of the child to be born, agreeable to the mother’s desire. [12]
</div>
==== Rituals for those belonging to the "shudra" lineage ====

शूद्रा तु नमस्कारमेव कुर्यात् (देवाग्निद्विजगुरुतपस्विसिद्धेभ्यः [४] )||१३||

śūdrā tu namaskāramēva kuryāt (dēvāgnidvijagurutapasvisiddhēbhyaḥ [4] )||13||

shUdrA tu namaskArameva kuryAt (devAgnidvijagurutapasvisiddhebhyaH [4] )||13||

Those belonging to ''shudra'' lineage, the mere act of salutation/pray (to the God, holy fire, ''brahmanas'', teachers/elders/preceptors, and saints and seers) should suffice. [13]

==== Advice for the mother desiring certain traits in her offspring ====

या या च यथाविधं पुत्रमाशासीत तस्यास्तस्यास्तां तां पुत्राशिषमनुनिशम्य तांस्ताञ्जनपदान्मनसाऽनुपरिक्रामयेत्|
ततो [५] या या येषां येषां जनपदानां मनुष्याणामनुरूपं पुत्रमाशासीत सा सा तेषां तेषां जनपदानांमनुष्याणामाहारविहारोपचारपरिच्छदाननुविधत्स्वेति वाच्या स्यात्|
इत्येतत् सर्वं पुत्राशिषां समृद्धिकरं कर्म व्याख्यातं भवति||१४||

yā yā ca yathāvidhaṁ putramāśāsīta tasyāstasyāstāṁ tāṁ putrāśiṣamanuniśamyatāṁstāñjanapadānmanasā'nuparikrāmayēt|
tatō [5] yā yā yēṣāṁ yēṣāṁ janapadānāṁ manuṣyāṇāmanurūpaṁ putramāśāsīta sā sā tēṣāṁ tēṣāṁjanapadānāṁ manuṣyāṇāmāhāravihārōpacāraparicchadānanuvidhatsvēti vācyā syāt|
ityētat sarvaṁ putrāśiṣāṁ samr̥ddhikaraṁ karma vyākhyātaṁ bhavati||14||

yA yA ca yathAvidhaM putramAshAsIta tasyAstasyAstAM tAM putrAshiShamanunishamyatAMstA~jjanapadAnmanasA~anuparikrAmayet|
tato [5] yA yA yeShAM yeShAM janapadAnAM manuShyANAmanurUpaM putramAshAsIta sA sA teShAMteShAM janapadAnAM manuShyANAmAhAravihAropacAraparicchadAnanuvidhatsveti vAcyA syAt|
ityetat sarvaM putrAshiShAM samRuddhikaraM karma vyAkhyAtaM bhavati||14||
<div style="text-align:justify;">
By knowing about the kind of child she desires, the woman should be advised to mentally travel to such places where people having similar dispositions live. Also, she should be advised to take diet, assume behavior, and engage in activities, attire, and social/cultural behooving such places and people.

Thus, the section detailing rituals that couples desirous of a healthy progeny – of the attributes of their liking – has been explained. [14]
</div>
==== Role of ''mahabhutas'' in contributing to the complexion of the offspring ====

न खलु केवलमेतदेव कर्म वर्णवैशेष्यकरं भवति|
अपि तु तेजोधातुरप्युदकान्तरिक्षधातुप्रायोऽवदातवर्णकरो भवति, पृथिवीवायुधातुप्रायः कृष्णवर्णकरः, समसर्वधातुप्रायःश्यामवर्णकरः||१५||

na khalu kēvalamētadēva karma varṇavaiśēṣyakaraṁ bhavati|
api tu tējōdhāturapyudakāntarikṣadhātuprāyō'vadātavarṇakarō bhavati, pr̥thivīvāyudhātuprāyaḥkr̥ṣṇavarṇakaraḥ, samasarvadhātuprāyaḥ śyāmavarṇakaraḥ||15||

na khalu kevalametadeva karma varNavaisheShyakaraM bhavati|
api tu tejodhAturapyudakAntarikShadhAtuprAyo~avadAtavarNakaro bhavati, pRuthivIvAyudhAtuprAyaHkRuShNavarNakaraH, samasarvadhAtuprAyaH shyAmavarNakaraH||15||
<div style="text-align:justify;">
Apart from the procedures mentioned above, ''mahabhutas'' also contribute in colour and complexion of skin. It is important to note that the ''teja'' (aura) associated with ''apa'' and ''akasha mahabuta'' are responsible for fair complexion, ''prithvi'' and ''vayu'' are responsible for black, and an equilibrium of all the five ''mahabhutas'' result in ''shyamavarna'' i.e. sky-like bluish complexion. [15]
</div>
==== Factors determining the psychological disposition of the progeny ====

सत्त्ववैशेष्यकराणि पुनस्तेषां तेषां प्राणिनां मातापितृसत्त्वान्यन्तर्वत्न्याः श्रुतयश्चाभीक्ष्णं स्वोचितं च कर्मसत्त्वविशेषाभ्यासश्चेति||१६||

sattvavaiśēṣyakarāṇi punastēṣāṁ tēṣāṁ prāṇināṁ mātāpitr̥sattvānyantarvatnyāḥ śrutayaścābhīkṣṇaṁsvōcitaṁ ca karma sattvaviśēṣābhyāsaścēti||16||

sattvavaisheShyakarANi punasteShAM teShAM prANinAM mAtApitRusattvAnyantarvatnyAHshrutayashcAbhIkShNaM svocitaM ca karma sattvavisheShAbhyAsashceti||16||
<div style="text-align:justify;">
The factors that determine the psychological disposition of the progeny depends upon the various mental traits of the parents, the impressions received by the pregnant woman, and the influence of past deeds (especially, the psychological makeup of the person in his/her past life). [16]
</div>
यथोक्तेन विधिनोपसंस्कृतशरीरयोः स्त्रीपुरुषयोर्मिश्रीभावमापन्नयोः शुक्रं शोणितेन सह संयोगं समेत्याव्यापन्नमव्यापन्नेनयोनावनुपहतायामप्रदुष्टे गर्भाशये गर्भमभिनिर्वर्तयत्येकान्तेन|
यथा-निर्मले वाससि सुपरिकल्पिते रञ्जनं समुदितगुणमुपनिपातादेव रागमभिनिर्वर्तयति, तद्वत्; यथा वाक्षीरंदध्नाऽभिषुतमभिषवणाद्विहाय स्वभावमापद्यते दधिभावं, शुक्रं तद्वत्||१७||

yathōktēna vidhinōpasaṁskr̥taśarīrayōḥ strīpuruṣayōrmiśrībhāvamāpannayōḥ śukraṁ śōṇitēna sahasaṁyōgaṁ samētyāvyāpannamavyāpannēna yōnāvanupahatāyāmapraduṣṭē garbhāśayēgarbhamabhinirvartayatyēkāntēna|
yathā- nirmalē vāsasi suparikalpitē rañjanaṁ samuditaguṇamupanipātādēva rāgamabhinirvartayati,tadvat; yathā vā kṣīraṁ dadhnā'bhiṣutamabhiṣavaṇādvihāya svabhāvamāpadyatē dadhibhāvaṁ, śukraṁtadvat||17||

yathoktena vidhinopasaMskRutasharIrayoH strIpuruShayormishrIbhAvamApannayoH shukraM shoNitenasaha saMyogaM sametyAvyApannamavyApannena yonAvanupahatAyAmapraduShTe garbhAshayegarbhamabhinirvartayatyekAntena|
yathA- nirmale vAsasi suparikalpite ra~jjanaM samuditaguNamupanipAtAdeva rAgamabhinirvartayati,tadvat; yathA vA kShIraM dadhnA~abhiShutamabhiShavaNAdvihAya svabhAvamApadyate dadhibhAvaM,shukraM tadvat||17||
<div style="text-align:justify;">
When a couple, whose body and mind are purified by above mentioned methods, engages in sexual intercourse, the undamaged sperm unites with the healthy ovum in a clean genital tract and the healthy uterus is home to an embryo with all the desired characters. Just as a well-washed cloth catches the colour of good dye instantly or milk, when mixed with drops of curd, transforms into curd leaving its original characters, the seeds acquire the positive attributes of the parents and the environment. [17]
</div>
एवमभिनिर्वर्तमानस्य गर्भस्य स्त्रीपुरुषत्वे हेतुः पूर्वमुक्तः|
यथा हि बीजमनुपतप्तमुप्तं स्वां स्वां प्रकृतिमनुविधीयते व्रीहिर्वा व्रीहित्वं यवो वा यवत्वं तथा स्त्रीपुरुषावपि यथोक्तंहेतुविभागमनुविधीयेते||१८||

ēvamabhinirvartamānasya garbhasya strīpuruṣatvē hētuḥ pūrvamuktaḥ|
yathā hi bījamanupataptamuptaṁ svāṁ svāṁ prakr̥timanuvidhīyatē vrīhirvā vrīhitvaṁ yavō vā yavatvaṁtathā strīpuruṣāvapi yathōktaṁ hētuvibhāgamanuvidhīyētē||18||
evamabhinirvartamAnasya garbhasya strIpuruShatve hetuH pUrvamuktaH|
yathA hi bIjamanupataptamuptaM svAM svAM prakRutimanuvidhIyate vrIhirvA vrIhitvaM yavo vA yavatvaMtathA strIpuruShAvapi yathoktaM hetuvibhAgamanuvidhIyete||18||
<div style="text-align:justify;">
Factors determining the sex of an embryo have already been explained. Just as an undamaged seed when sown reproduces its own kind, such as the paddy seed germinates into paddy and the barley seed produces barley, so too men and women beget children possessing the natural characteristics of their parents. [18]
</div>
==== Factors that can change the progeny's sex before birth ====

तयोः कर्मणा वेदोक्तेन विवर्तनमुपदिश्यते [१] प्राग्व्यक्तीभावात् प्रयुक्तेन सम्यक्|
कर्मणां हि देशकालसम्पदुपेतानां नियतमिष्टफलत्वं, तथेतरेषामितरत्वम्|
तस्मादापन्नगर्भां स्त्रियमभिसमीक्ष्य प्राग्व्यक्तीभावाद्गर्भस्य पुंसवनमस्यै दद्यात्|
गोष्ठे जातस्य न्यग्रोधस्य प्रागुत्तराभ्यां शाखाभ्यां शुङ्गे अनुपहते आदाय द्वाभ्यां धान्यमाषाभ्यां सम्पदुपेताभ्यांगौरसर्षपाभ्यां वा सह दध्नि प्रक्षिप्य पुष्येण पिबेत्, तथैवापराञ्जीवकर्षभकापामार्गसहचरकल्कांश्च युगपदेकैकशो यथेष्टंवाऽप्युपसंस्कृत्य पयसा, कुड्यकीटकं मत्स्यकं वोदकाञ्जलौ प्रक्षिप्य पुष्येण पिबेत्, तथा कनकमयान् राजतानायसांश्चपुरुषकानग्निवर्णानणुप्रमाणान् दध्नि पयस्युदकाञ्जलौ वा प्रक्षिप्य पिबेदनवशेषतः पुष्येण, पुष्येणैव च शालिपिष्टस्यपच्यमानस्योष्माणमुपाघ्राय तस्यैव च पिष्टस्योदकसंसृष्टस्य रसं देहल्यामुपनिधाय [२] दक्षिणे नासापुटे स्वयमासिञ्चेत्पिचुना|
यच्चान्यदपि ब्राह्मणा ब्रूयुराप्ता वा स्त्रियः पुंसवनमिष्टं तच्चानुष्ठेयम्|
इति पुंसवनानि||१९||

tayōḥ karmaṇā vēdōktēna vivartanamupadiśyatē [1] prāgvyaktībhāvāt prayuktēna samyak|
karmaṇāṁ hi dēśakālasampadupētānāṁ niyatamiṣṭaphalatvaṁ, tathētarēṣāmitaratvam|
tasmādāpannagarbhāṁ striyamabhisamīkṣya prāgvyaktībhāvādgarbhasya puṁsavanamasyai dadyāt|
gōṣṭhē jātasya nyagrōdhasya prāguttarābhyāṁ śākhābhyāṁ śuṅgē anupahatē ādāya dvābhyāṁdhānyamāṣābhyāṁ sampadupētābhyāṁ gaurasarṣapābhyāṁ vā saha dadhni prakṣipya puṣyēṇa pibēt,tathaivāparāñjīvakarṣabhakāpāmārgasahacarakalkāṁśca yugapadēkaikaśō yathēṣṭaṁvā'pyupasaṁskr̥tya payasā, kuḍyakīṭakaṁ matsyakaṁ vōdakāñjalau prakṣipya puṣyēṇa pibēt, tathākanakamayān rājatānāyasāṁśca puruṣakānagnivarṇānaṇupramāṇān dadhni payasyudakāñjalau vāprakṣipya pibēdanavaśēṣataḥ puṣyēṇa, puṣyēṇaiva ca śālipiṣṭasya pacyamānasyōṣmāṇamupāghrāyatasyaiva ca piṣṭasyōdakasaṁsr̥ṣṭasya rasaṁ dēhalyāmupanidhāya [2] dakṣiṇē nāsāpuṭē svayamāsiñcētpicunā|
yaccānyadapi brāhmaṇā brūyurāptā vā striyaḥ puṁsavanamiṣṭaṁ taccānuṣṭhēyam|
iti puṁsavanāni||19||

tayoH karmaNA vedoktena vivartanamupadishyate [1] prAgvyaktIbhAvAt prayuktena samyak|
karmaNAM hi deshakAlasampadupetAnAM niyatamiShTaphalatvaM, tathetareShAmitaratvam|
tasmAdApannagarbhAM striyamabhisamIkShya prAgvyaktIbhAvAdgarbhasya puMsavanamasyai dadyAt|
goShThe jAtasya nyagrodhasya prAguttarAbhyAM shAkhAbhyAM shu~gge anupahate AdAya dvAbhyAMdhAnyamAShAbhyAM sampadupetAbhyAM gaurasarShapAbhyAM vA saha dadhni prakShipya puShyeNapibet, tathaivAparA~jjIvakarShabhakApAmArgasahacarakalkAMshca yugapadekaikasho yatheShTaMvA~apyupasaMskRutya payasA, kuDyakITakaM matsyakaM vodakA~jjalau prakShipya puShyeNa pibet,tathA kanakamayAn rAjatAnAyasAMshca puruShakAnagnivarNAnaNupramANAn dadhnipayasyudakA~jjalau vA prakShipya pibedanavasheShataH puShyeNa, puShyeNaiva ca shAlipiShTasyapacyamAnasyoShmANamupAghrAya tasyaiva ca piShTasyodakasaMsRuShTasya rasaMdehalyAmupanidhAya [2] dakShiNe nAsApuTe svayamAsi~jcet picunA|
yaccAnyadapi brAhmaNA brUyurAptA vA striyaH puMsavanamiShTaM taccAnuShTheyam|
iti puMsavanAni||19||
<div style="text-align:justify;">
This verse lays down procedures mentioned in Vedic scriptures that, if administered correctly, could change the sex of an offspring even before its birth. When applied in the best of places and time, these procedures bear the desired fruit invariably always. Therefore, after examining the woman who has conceived recently, before the signs of gestation become apparent, (the physician) should administer ''pumsavana'' (procedures to beget a male offspring) on her.

On the day of the appearance of the auspicious ''pushyanakshatra'', one should collect two fresh leaf-buds from a banyan tree (Ficusreligiosa Linn), growing in a cow-pen (typically, an open ground or range where cows are kept), from its eastern or northern side branches. Then those leaf-buds should be added to curd and blended with either two good grains of ''masha'' (Phaseolus radiatus Linn - black gram) or white mustard seeds, and then given to the expectant mother to drink. Or, she may be given milk to drink that has been processed with the paste of ''jivaka, rishabhaka, apamarga'' (Achyranthesaspera Linn), and ''saireyaka'' (synonym of ''Sahachara''–Barleriacristata Linn) -either all mixed into a paste together or separately, as required. Or else she should be given a handful of water with ''kudyakitaka'' (a type of insect) or ''matsyaka'' (a type of small fish) on the occasion of ''pushyanakshatra''.
Similarly, on the event of ''pushyanakshatra'', she should drink handful of curd milk or water, without leaving any leftover, duly immersed with red hot miniature male statuettes made of gold, silver or and iron. Similarly, on the occasion of ''pushyanakshatra'', she should be made to inhale the steam emanating from steaming dish of powdered ''shali'' rice (while it is being cooked) and she herself should daub into her right nostril, using a cotton swab, drops of water from that same cooking pot, by placing (her head) on the ''daheli'' (door-sill).

In addition to these rituals, any other measures suggested by ''brahmanas'' or well versed (experienced and well-favoring) women as ''pumsavana'', should also be applied.

This concludes the verse on ''pumsavana''. [19]
</div>
==== Measures for the preservation of the embryo ====

अत ऊर्ध्वं गर्भस्थापनानि व्याख्यास्यामः
ऐन्द्री ब्राह्मी शतवीर्या सहस्रवीर्याऽमोघाऽव्यथा शिवाऽरिष्टा वाट्यपुष्पीविष्वक्सेनकान्ता चेत्यासामोषधीनां शिरसा दक्षिणेन वा पाणिना धारणं, एताभिश्चैव सिद्धस्य पयसः सर्पिषो वा पानम्,एताभिश्चैव पुष्ये पुष्ये स्नानं, सदा च ताः [१] समालभेत|
तथा सर्वासां जीवनीयोक्तानामोषधीनां सदोपयोगस्तैस्तैरुपयोगविधिभिः|
इति गर्भस्थापनानि व्याख्यातानि भवन्ति||२०||

ata ūrdhvaṁ garbhasthāpanāni vyākhyāsyāmaḥ- aindrī brāhmī śatavīryā sahasravīryā'mōghā'vyathāśivā'riṣṭā vāṭyapuṣpī viṣvaksēnakāntā cētyāsāmōṣadhīnāṁ śirasā dakṣiṇēna vā pāṇinā dhāraṇaṁ,ētābhiścaiva siddhasya payasaḥ sarpiṣō vā pānam, ētābhiścaiva puṣyē puṣyē snānaṁ, sadā ca tāḥ [1]samālabhēta|
tathā sarvāsāṁ jīvanīyōktānāmōṣadhīnāṁ sadōpayōgastaistairupayōgavidhibhiḥ|
iti garbhasthāpanāni vyākhyātāni bhavanti||20||

ata UrdhvaM garbhasthApanAni vyAkhyAsyAmaH- aindrI brAhmI shatavIryAsahasravIryA~amoghA~avyathA shivA~ariShTA vATyapuShpI viShvaksenakAntA cetyAsAmoShadhInAMshirasA dakShiNena vA pANinA dhAraNaM, etAbhishcaiva siddhasya payasaH sarpiSho vA pAnam,etAbhishcaiva puShye puShye snAnaM, sadA ca tAH [1] samAlabheta|
tathA sarvAsAM jIvanIyoktAnAmoShadhInAM sadopayogastaistairupayogavidhibhiH|
iti garbhasthApanAni vyAkhyAtAni bhavanti||20||
<div style="text-align:justify;">
From this verse onwards, measures for the preservation of embryo (''garbha'') have been explained. Some of these rituals or practices require the pregnant woman to wear herbs, such as ''aindri'' (Citrulluscolocynthis Schrad – Gorakshakarkati), ''brahmi'' (Bacopamonnieri Pennel), ''satavirya'' (Cynodon doctylon Pers), ''sahasravirya'' (a variety of ''durva'' - cynodon species, also known as ''durvadwaya''), ''amogha'' (''patala'' – Stereospermumsuaveolens DC), ''avyatha'' (''guduchi'' – Tinospora cordifolia Miers), ''shiva''(''haritaki'' – Terminaliachebula Linn), ''arishta'' (katukarohini – Piccrorhizakurroa Royle ex Benth), ''vatyapushpi'' (Pitabala – Sidacordifolia Linn), and ''vishwaksenakanta'' (''priyangu'' – Callicarpa macrophylla Vahl.),on her head or her right hand. Or she may drink milk or ghee processed with the above mentioned herbs, or bathe at every occasion of ''pushyanakshatra'' with water boiled using these herbs, and she should keep these herbs readily available always. Similarly, the regular use of all of the ''jivaniya'' class of herbs (life promoter group of herbs) in the (above) prescribed manner is also beneficial. Thus, the procedures for stabilization of embryo (''garbha'') have been described in this verse. [20]
</div>
==== Factors that could damage or destroy the embryo ====

गर्भोपघातकरास्त्विमे भावा भवन्ति; तद्यथा
उत्कटविषमकठिनासनसेविन्या [१] वातमूत्रपुरीषवेगानुपरुन्धत्यादारुणानुचितव्यायामसेविन्यास्तीक्ष्णोष्णातिमात्रसेविन्याः प्रमिताशनसेविन्या गर्भो म्रियतेऽन्तः कुक्षेः, अकाले वा स्रंसते,शोषी वा भवति; तथाऽभिघातप्रपीडनैः श्वभ्रकूपप्रपातदेशावलोकनैर्वाऽभीक्ष्णं मातुः प्रपतत्यकालेगर्भः,तथाऽतिमात्रसङ्क्षोभिभिर्यानैर्यानेन, अप्रियातिमात्रश्रवणैर्वा|
प्रततोत्तानशायिन्याः पुनर्गर्भस्य नाभ्याश्रया नाडी कण्ठमनुवेष्टयति, विवृतशायिनी नक्तञ्चारिणी चोन्मत्तं जनयति,अपस्मारिणं पुनः कलिकलहशीला, व्यवायशीला दुर्वपुषमह्रीकं स्त्रैणं वा, शोकनित्या भीतमपचितमल्पायुषं वा, अभिध्यात्री [२]परोपतापिनमीर्ष्युं स्त्रैणं वा, स्तेना त्वायासबहुलमतिद्रोहिणमकर्मशीलं वा, अमर्षिणी चण्डमौपधिकमसूयकं वा स्वप्ननित्यातन्द्रालुमबुधमल्पाग्निं वा, मद्यनित्या पिपासालुमल्पस्मृतिमनवस्थितचित्तं वा, गोधामांसप्राया [३] शार्करिणमश्मरिणंशनैर्मेहिणं वा, वराहमांसप्राया रक्ताक्षं क्रथनमतिपरुषरोमाणं वा, मत्स्यमांसनित्या चिरनिमेषं स्तब्धाक्षं वा, मधुरनित्याप्रमेहिणं मूकमतिस्थूलं वा, अम्लनित्या रक्तपित्तिनं त्वगक्षिरोगिणं वा, लवणनित्या शीघ्रवलीपलितं खालित्यरोगिणं वा,कटुकनित्या दुर्बलमल्पशुक्रमनपत्यं वा, तिक्तनित्या शोषिणमबलमनुपचितं वा, कषायनित्या श्यावमानाहिनमुदावर्तिनं वा,यद्यच्च यस्य यस्य व्याधेर्निदानमुक्तं तत्तदासेवमानाऽन्तर्वत्नी तन्निमित्तविकारबहुलमपत्यं जनयति|
पितृजास्तु शुक्रदोषा मातृजैरपचारैर्व्याख्याताः|
इति गर्भोपघातकरा भावा भवन्त्युक्ताः [४] |
तस्मादहितानाहारविहारान् प्रजासम्पदमिच्छन्ती स्त्री विशेषेण वर्जयेत्|
साध्वाचारा चात्मानमुपचरेद्धिताभ्यामाहारविहाराभ्यामिति||२१||

garbhōpaghātakarāstvimē bhāvā bhavanti; tadyathā- utkaṭaviṣamakaṭhināsanasēvinyā [1]vātamūtrapurīṣavēgānuparundhatyā dāruṇānucitavyāyāmasēvinyāstīkṣṇōṣṇātimātrasēvinyāḥpramitāśanasēvinyā garbhō mriyatē'ntaḥ kukṣēḥ, akālē vā sraṁsatē, śōṣī vā bhavati;tathā'bhighātaprapīḍanaiḥ śvabhrakūpaprapātadēśāvalōkanairvā'bhīkṣṇaṁ mātuḥprapatatyakālēgarbhaḥ, tathā'timātrasaṅkṣōbhibhiryānairyānēna, apriyātimātraśravaṇairvā|
pratatōttānaśāyinyāḥ punargarbhasya nābhyāśrayā nāḍī kaṇṭhamanuvēṣṭayati, vivr̥taśāyinī naktañcāriṇīcōnmattaṁ janayati, apasmāriṇaṁ punaḥ kalikalahaśīlā, vyavāyaśīlā durvapuṣamahrīkaṁ straiṇaṁ vā,śōkanityā bhītamapacitamalpāyuṣaṁ vā, abhidhyātrī [2] parōpatāpinamīrṣyuṁ straiṇaṁ vā, stēnātvāyāsabahulamatidrōhiṇamakarmaśīlaṁ vā, amarṣiṇī caṇḍamaupadhikamasūyakaṁ vā svapnanityātandrālumabudhamalpāgniṁ vā, madyanityā pipāsālumalpasmr̥timanavasthitacittaṁ vā,gōdhāmāṁsaprāyā [3] śārkariṇamaśmariṇaṁ śanairmēhiṇaṁ vā, varāhamāṁsaprāyā raktākṣaṁkrathanamatiparuṣarōmāṇaṁ vā, matsyamāṁsanityā ciranimēṣaṁ stabdhākṣaṁ vā, madhuranityāpramēhiṇaṁ mūkamatisthūlaṁ vā, amlanityā raktapittinaṁ tvagakṣirōgiṇaṁ vā, lavaṇanityāśīghravalīpalitaṁ khālityarōgiṇaṁ vā, kaṭukanityā durbalamalpaśukramanapatyaṁ vā, tiktanityāśōṣiṇamabalamanupacitaṁ vā, kaṣāyanityā śyāvamānāhinamudāvartinaṁ vā, yadyacca yasya yasyavyādhērnidānamuktaṁ tattadāsēvamānā'ntarvatnī tannimittavikārabahulamapatyaṁ janayati|
pitr̥jāstu śukradōṣā mātr̥jairapacārairvyākhyātāḥ|
iti garbhōpaghātakarā bhāvā bhavantyuktāḥ [4] |
tasmādahitānāhāravihārān prajāsampadamicchantī strī viśēṣēṇa varjayēt|
sādhvācārā cātmānamupacarēddhitābhyāmāhāravihārābhyāmiti||21||

garbhopaghAtakarAstvime bhAvA bhavanti; tadyathA- utkaTaviShamakaThinAsanasevinyA [1]vAtamUtrapurIShavegAnuparundhatyA dAruNAnucitavyAyAmasevinyAstIkShNoShNAtimAtrasevinyAHpramitAshanasevinyA garbho mriyate~antaH kukSheH, akAle vA sraMsate, shoShI vA bhavati;tathA~abhighAtaprapIDanaiH shvabhrakUpaprapAtadeshAvalokanairvA~abhIkShNaM mAtuHprapatatyakAlegarbhaH, tathA~atimAtrasa~gkShobhibhiryAnairyAnena, apriyAtimAtrashravaNairvA|
pratatottAnashAyinyAH punargarbhasya nAbhyAshrayA nADI kaNThamanuveShTayati, vivRutashAyinInakta~jcAriNI conmattaM janayati, apasmAriNaM punaH kalikalahashIlA, vyavAyashIlAdurvapuShamahrIkaM straiNaM vA, shokanityA bhItamapacitamalpAyuShaM vA, abhidhyAtrI [2]paropatApinamIrShyuM straiNaM vA, stenA tvAyAsabahulamatidrohiNamakarmashIlaM vA, amarShiNIcaNDamaupadhikamasUyakaM vA svapnanityA tandrAlumabudhamalpAgniM vA, madyanityApipAsAlumalpasmRutimanavasthitacittaM vA, godhAmAMsaprAyA [3] shArkariNamashmariNaMshanairmehiNaM vA, varAhamAMsaprAyA raktAkShaM krathanamatiparuSharomANaM vA,matsyamAMsanityA ciranimeShaM stabdhAkShaM vA, madhuranityA pramehiNaM mUkamatisthUlaM vA,amlanityA raktapittinaM tvagakShirogiNaM vA, lavaNanityA shIghravalIpalitaM khAlityarogiNaM vA,kaTukanityA durbalamalpashukramanapatyaM vA, tiktanityA shoShiNamabalamanupacitaM vA,kaShAyanityA shyAvamAnAhinamudAvartinaM vA, yadyacca yasya yasya vyAdhernidAnamuktaMtattadAsevamAnA~antarvatnI tannimittavikArabahulamapatyaM janayati|
pitRujAstu shukradoShA mAtRujairapacArairvyAkhyAtAH|
iti garbhopaghAtakarA bhAvA bhavantyuktAH [4] |
tasmAdahitAnAhAravihArAn prajAsampadamicchantI strI visheSheNa varjayet|
sAdhvAcArA cAtmAnamupacareddhitAbhyAmAhAravihArAbhyAmiti||21||
<div style="text-align:justify;">
The following factors may damage or destroy the embryo/fetus: a woman who sits in awkward positions, on uneven and hard seats, or suppresses the urge to pass flatulence, urine and bowel movement, or indulges in intensive or extreme forms of physical activities, or is excessively addicted to consuming pungent and hot things, or eats very sparingly. In such scenarios, her fetus could dry up in the womb or get delivered prematurely, or atrophy.

Similarly, by suffering repeated trauma or similar injuries, or on looking down from heights (e.g., from mountain-tops or cliffs, deep wells, etc.), the expectant mother is liable to miscarry. Similarly, she is liable to miscarry if she travels long distances in excessively jerky carriages, or is exposed to, for prolonged periods of time, loud and unpleasant noise.

By constantly resting or sleeping on her back, the umbilical cord attached to the fetus winds itself round the throat of the fetus, thus tending to strangulate it (so pregnant woman should avoid such posture). Similarly, a woman who sleeps in open air or is used to walking at night is prone to giving birth to a mentally-challenged child. If the woman indulges in too much of quarrels and fights, the child could become epileptic. A woman who indulges in sexual practice excessively (or a nymphomaniac) will give birth to truant with a passion for women. A woman under constant grief would give birth to a timid, or under-developed or short-lived child. A woman who always thinks ill of others will give birth to a delinquent or an anti-social. A woman who is a thief will give birth to a lazy child who is wicked and inept, while an intolerant woman would give birth to a child who is of fierce, deceitful and jealous nature. A woman who sleeps for long hours would give birth to a dull and unwise child with poor digestive powers, while a woman addicted to wines to a child who is ever-thirsty and fickle minded. A woman who consumes flesh and meat of ''godha'' (iguana) would give birth to a child afflicted with stones or ''shanairmeha'' (a type of urinary disorder where dribbling is seen), while a woman used to consume pork frequently would give birth to a child with red eyes, rough body-hair, and prone to suffering from severe respiratory disorders. A woman used to consume fish excessively would give birth to a child with lagophthalmos and related eye disorders, while a woman used to eating a lot of sweets is prone to giving birth to a dumb or excessively obese child or a child afflicted with diabetes. A woman fond of sour things is prone to giving birth to an offspring suffering from bleeding disorders or diseases of skin and eyes, while a woman addicted to salt or salty food articles may give birth to a child with early onset of wrinkles, grey hair or baldness. A woman used to pungent substances in excess may give birth to a weak child, deficient in semen and impotent, while a woman using bitter substances in excess may give birth to a child with emaciated, weak or undeveloped body. A woman habituated to excessive use of astringents may give birth to a child with blackish complexion, suffering from constipation and ''udavarta'' (misperistalsis).

In summary, a pregnant woman indulging in unhealthy dietary and lifestyle activities that could cause certain diseases would increase the risk of her off spring getting afflicted with similar (or more virulent) disorders. From the father’s side, defects in semen could occur due to above mentioned factors for mother. Hence, a woman desirous of a child with excellent qualities should abstain from all forms of addictions as well as unhealthy dietary and lifestyle activities. [21]
</div>
==== Treating pregnant women afflicted with ailments ====

व्याधींश्चास्या मृदुमधुरशिशिरसुखसुकुमारप्रायैरौषधाहारोपचारैरुपचरेत्, न चास्या वमनविरेचनशिरोविरेचनानि प्रयोजयेत्, नरक्तमवसेचयेत्, सर्वकालं च नास्थापनमनुवासनं वा कुर्यादन्यत्रात्ययिकाद्व्याधेः|
अष्टमं मासमुपादाय वमनादिसाध्येषु पुनर्विकारेष्वात्ययिकेषु मृदुभिर्वमनादिभिस्तदर्थकारिभिर्वोपचारः स्यात्|
पूर्णमिव तैलपात्रमसङ्क्षोभयताऽन्तर्वत्नी [१] भवत्युपचर्या||२२||

vyādhīṁścāsyā mr̥dumadhuraśiśirasukhasukumāraprāyairauṣadhāhārōpacārairupacarēt, na cāsyāvamanavirēcanaśirōvirēcanāni prayōjayēt, na raktamavasēcayēt, sarvakālaṁ ca nāsthāpanamanuvāsanaṁ vākuryādanyatrātyayikādvyādhēḥ|
aṣṭamaṁ māsamupādāya vamanādisādhyēṣu punarvikārēṣvātyayikēṣumr̥dubhirvamanādibhistadarthakāribhirvōpacāraḥ syāt|
pūrṇamiva tailapātramasaṅkṣōbhayatā'ntarvatnī [1] bhavatyupacaryā||22||

vyAdhIMshcAsyA mRudumadhurashishirasukhasukumAraprAyairauShadhAhAropacArairupacaret, na cAsyAvamanavirecanashirovirecanAni prayojayet, na raktamavasecayet, sarvakAlaM ca nAsthApanamanuvAsanaM vAkuryAdanyatrAtyayikAdvyAdheH|
aShTamaM mAsamupAdAya vamanAdisAdhyeShu punarvikAreShvAtyayikeShumRudubhirvamanAdibhistadarthakAribhirvopacAraH syAt|
pUrNamiva tailapAtramasa~gkShobhayatA~antarvatnI [1] bhavatyupacaryA||22||
<div style="text-align:justify;">
Any ailment or disease afflicting a pregnant woman should be treated very delicately, by means of medicaments and diet that are mainly soft, palatable, cooling, pleasant and mild. She should not be subjected to emetics, purgatives, or ''nasya'' (errhines), or to practices such as bloodletting. She should not be, at any time, administered corrective and unctuous enema, except in very serious emergency situations. In her final trimester, the pregnant woman, if in emergency conditions wherein emesis is urgently required, should only be treated by means of very mild emetics etc., or by its substitutes. A pregnant woman should be handled like a pot brimful of oil, which can spill on irritation i.e., very delicately. [22]
</div>
==== Occurrences of bleeding during pregnancy ====

सा चेदपचाराद् द्वयोस्त्रिषु वा मासेषु पुष्पं पश्येन्नास्या गर्भः स्थास्यतीति विद्यात्; अजातसारो हि तस्मिन् काले भवतिगर्भः||२३||
sā cēdapacārād dvayōstriṣu vā māsēṣu puṣpaṁ paśyēnnāsyā garbhaḥ sthāsyatīti vidyāt; ajātasārō hi tasmin kālēbhavati garbhaḥ||23||
sA cedapacArAd dvayostriShu vA mAseShu puShpaM pashyennAsyA garbhaH sthAsyatIti vidyAt; ajAtasAro hi tasmin kAle bhavatigarbhaH||23||

If, as the result of wrongful behavior, bleeding occurs in a pregnant woman either in the second or third month, one should conclude that the conception will not be sustainable, as the embryo during this period is still immature. [23]

सा चेच्चतुष्प्रभृतिषु मासेषुक्रोधशोकासूयेर्ष्याभयत्रासव्यवायव्यायामसङ्क्षोभसन्धारणविषमाशनशयनस्थानक्षुत्पिपासातियोगात् कदाहाराद्वा पुष्पंपश्येत्, तस्या गर्भस्थापनविधिमुपदेक्ष्यामः|
पुष्पदर्शनादेवैनां ब्रूयात्- शयनं तावन्मृदुसुखशिशिरास्तरणसंस्तीर्णमीषदवनतशिरस्कं प्रतिपद्यस्वेति|
ततो यष्टीमधुकसर्पिर्भ्यां परमशिशिरवारिणी संस्थिताभ्यां पिचुमाप्लाव्योपस्थसमीपे स्थापयेत्तस्याः, तथाशतधौतसहस्रधौताभ्यां सर्पिर्भ्यामधोनाभेः सर्वतः प्रदिह्यात्, सर्वतश्च गव्येन चैनां पयसा सुशीतेन मधुकाम्बुना वान्यग्रोधादिकषायेण वा परिषेचयेदधो नाभेः, उदकं वा सुशीतमवगाहयेत्, क्षीरिणां कषायद्रुमाणां च स्वरसपरिपीतानि चेलानि [२]ग्राहयेत्, न्यग्रोधादिशुङ्गासिद्धयोर्वाक्षीरसर्पिषोः पिचुं ग्राहयेत्, अतश्चैवाक्षमात्रं प्राशयेत्, प्राशयेद्वा केवलं क्षीरसर्पिः,पद्मोत्पलकुमुदकिञ्जल्कांश्चास्यै समधुशर्करान् लेहार्थं दद्यात्, शृङ्गाटकपुष्करबीजकशेरुकान् भक्ष्णार्थं,गन्धप्रियङ्ग्वसितोत्पलशालूकोदुम्बरशलाटुन्यग्रोधशुङ्गानि वा पाययेदेनामाजेन पयसा, पयसा चैनांबलातिबलाशालिषष्टिकेक्षुमूलकाकोलीशृतेन समधुशर्करं रक्तशालीनामोदनं मृदुसुरभिशीतलं भोजयेत्,लावकपिञ्जलकुरङ्गशम्बरशशहरिणैणकालपुच्छकरसेन वा घृतसुसंस्कृतेन सुखशिशिरोपवातदेशस्थां भोजयेत्,क्रोधशोकायासव्यवायव्यायामेभ्यश्चाभिरक्षेत्, सौम्याभिश्चैनां कथाभिर्मनोनुकूलाभिरुपासीत; तथाऽस्या गर्भस्तिष्ठति||२४||

sā cēccatuṣprabhr̥tiṣu māsēṣukrōdhaśōkāsūyērṣyābhayatrāsavyavāyavyāyāmasaṅkṣōbhasandhāraṇaviṣamāśanaśayanasthānakṣutpipāsātiyōgātkadāhārādvā puṣpaṁ paśyēt, tasyā garbhasthāpanavidhimupadēkṣyāmaḥ|
puṣpadarśanādēvaināṁ brūyāt- śayanaṁ tāvanmr̥dusukhaśiśirāstaraṇasaṁstīrṇamīṣadavanataśiraskaṁpratipadyasvēti|
tatō yaṣṭīmadhukasarpirbhyāṁ paramaśiśiravāriṇī saṁsthitābhyāṁ picumāplāvyōpasthasamīpē sthāpayēttasyāḥ,tathā śatadhautasahasradhautābhyāṁ sarpirbhyāmadhōnābhēḥ sarvataḥ pradihyāt, sarvataśca gavyēna caināṁpayasā suśītēna madhukāmbunā vā nyagrōdhādikaṣāyēṇa vā pariṣēcayēdadhō nābhēḥ, udakaṁ vāsuśītamavagāhayēt, kṣīriṇāṁ kaṣāyadrumāṇāṁ ca svarasaparipītāni cēlāni [2] grāhayēt,nyagrōdhādiśuṅgāsiddhayōrvākṣīrasarpiṣōḥ picuṁ grāhayēt, ataścaivākṣamātraṁ prāśayēt, prāśayēdvā kēvalaṁkṣīrasarpiḥ, padmōtpalakumudakiñjalkāṁścāsyai samadhuśarkarān lēhārthaṁ dadyāt,śr̥ṅgāṭakapuṣkarabījakaśērukān bhakṣṇārthaṁ, gandhapriyaṅgvasitōtpalaśālūkōdumbaraśalāṭunyagrōdhaśuṅgānivā pāyayēdēnāmājēna payasā, payasā caināṁ balātibalāśāliṣaṣṭikēkṣumūlakākōlīśr̥tēna samadhuśarkaraṁraktaśālīnāmōdanaṁ mr̥dusurabhiśītalaṁ bhōjayēt,lāvakapiñjalakuraṅgaśambaraśaśahariṇaiṇakālapucchakarasēna vā ghr̥tasusaṁskr̥tēnasukhaśiśirōpavātadēśasthāṁ bhōjayēt, krōdhaśōkāyāsavyavāyavyāyāmēbhyaścābhirakṣēt, saumyābhiścaināṁkathābhirmanōnukūlābhirupāsīta; tathā'syā garbhastiṣṭhati||24||

sA ceccatuShprabhRutiShu mAseShukrodhashokAsUyerShyAbhayatrAsavyavAyavyAyAmasa~gkShobhasandhAraNaviShamAshanashayanasthAnakShutpipAsAtiyogAtkadAhArAdvA puShpaM pashyet, tasyA garbhasthApanavidhimupadekShyAmaH|
puShpadarshanAdevainAM brUyAt- shayanaM tAvanmRudusukhashishirAstaraNasaMstIrNamIShadavanatashiraskaMpratipadyasveti|
tato yaShTImadhukasarpirbhyAM paramashishiravAriNI saMsthitAbhyAM picumAplAvyopasthasamIpe sthApayettasyAH, tathAshatadhautasahasradhautAbhyAM sarpirbhyAmadhonAbheH sarvataH pradihyAt, sarvatashca gavyena cainAM payasA sushItenamadhukAmbunA vA nyagrodhAdikaShAyeNa vA pariShecayedadho nAbheH, udakaM vA sushItamavagAhayet, kShIriNAMkaShAyadrumANAM ca svarasaparipItAni celAni [2] grAhayet, nyagrodhAdishu~ggAsiddhayorvAkShIrasarpiShoH picuM grAhayet,atashcaivAkShamAtraM prAshayet, prAshayedvA kevalaM kShIrasarpiH, padmotpalakumudaki~jjalkAMshcAsyaisamadhusharkarAn lehArthaM dadyAt, shRu~ggATakapuShkarabIjakasherukAn bhakShNArthaM,gandhapriya~ggvasitotpalashAlUkodumbarashalATunyagrodhashu~ggAni vA pAyayedenAmAjena payasA, payasA cainAMbalAtibalAshAliShaShTikekShumUlakAkolIshRutena samadhusharkaraM raktashAlInAmodanaM mRudusurabhishItalaM bhojayet,lAvakapi~jjalakura~ggashambarashashahariNaiNakAlapucchakarasena vA ghRutasusaMskRutenasukhashishiropavAtadeshasthAM bhojayet, krodhashokAyAsavyavAyavyAyAmebhyashcAbhirakShet, saumyAbhishcainAMkathAbhirmanonukUlAbhirupAsIta; tathA~asyA garbhastiShThati||24||
<div style="text-align:justify;">
If the pregnant woman, in her second trimester or later, as a consequence of excessive anger, grief, intolerance, envy, fear, sex, exercise, agitation, suppression of body urges, faulty eating, faulty lying down and standing habits, excessive hunger and thirst or as the result of malnutrition, starts to bleed, then the following course of treatment should be adopted to safeguard the conception from any mishap:
• As soon as the blood discharge is noticed, the patient should be instructed to lie down on a soft and comfortable couch with her head placed slightly lower than the rest of herbody.
• The physician should then place a cotton swab, immersed in medicated ghee prepared with yashtimadhu (Glycyrrhiza glabraLinn) and then kept in cold water, near or in the vaginal passage. She should also be annointed with shatadhautaor sahasradhauta ghrita (ghee washed a hundred or a thousand times with water or medicated decoctions) on or below the navel region. Similarly, she could also be sprinkled with cold milk or decoction of madhuka and nyagrodhadi class of (Ficusbengalensis Linn) herbs on or below her navel region, or she should take bath in tub of cold water. Cloth pieces soaked in the juice of ksheerivriksha (latex-yielding trees) class of herbs, or a cotton swab soaked in milk and ghee processed with leaf-buds of nyagrodhadi (Ficusbengalensis Linn) class of drugs should be inserted into her vagina. She should also consume ghee made up of milk in a quantity of aksha (about 10-12 ml) and treated with the same drugs as mentioned above. She should be offered a concoction made up of stamens of kamala (Nelumbo nucifera Gaertn.), utpala (Nymphaea alba Linn), and kumuda (a variety of Nymphaea species), mixed with honey and sugar linctus. She should eat singhataka (Trapabispinosa Roxb. – chestnut), pushkarabeeja (lotus seeds –Nelumbonucifera Gaertn.) and kasheruka (Scirpusgrossus Linn. f.). She may be given goat’s milk boiled with gandhapriyangu (Callicarpamacrophylla Vahl.), nilotpala (blue variety of Nymphaeaalba Linn), shaluka (rhizome of lotus), fruits of udumbara (Ficusracemosa Linn.) and leaf-buds of nyagrodha (Ficusbengalensis Linn). She should eat soft, fragrant and cooked shali rice of red variety (Orizasativa Linn.), added with honey and sugar along with milk boiled with roots of bala (Sidacordifolia Linn.), atibala (Abutilonindicum Linn.), shali, sashtika (both varieties of Orizasativa Linn.) ikshu (sugarcane- Saccharumofficinarum Linn.), and kakoli. Or she should eat the above rice along with the soup made of meat that is well-seasoned with ghee, of lava (Common Quail), kapinjala (Grey Partridge), kuranga (Roe deer), sambara (Indian Sambar), shasha (Rabbit), harina (Black Buck), ena (Antelope) orkalapuchchaka (Black tailed Deer), while sitting comfortably in a cool and well ventilated place. She should be protected from anger, grief, overexertion, activities that are sexual or intensely physical in nature, and should be entertained with pleasing and comforting stories. By following these methods, the embryo (garbha) is saved from abortion. [24]
</div>
यस्याः पुनरामान्वयात् पुष्पदर्शनं स्यात्, प्रायस्तस्यास्तद्गर्भोपघातकरं भवति,
विरुद्धोपक्रमत्वात्तयोः||२५||

yasyāḥ punarāmānvayāt puṣpadarśanaṁ syāt, prāyastasyāstadgarbhōpaghātakaraṁ bhavati,
viruddhōpakramatvāttayōḥ||25||

yasyAH punarAmAnvayAt puShpadarshanaM syAt, prAyastasyAstadgarbhopaghAtakaraM bhavati,
viruddhopakramatvAttayoH||25||

If vaginal bleeding occurs as the result of ama (indigestion), there is a very high probability of miscarriage and abortion of the foetus and it may not be avoidable, because the two disorders (vaginal bleeding and indigestion) require mutually opposite treatments. [25]

यस्याः पुनरुष्णतीक्ष्णोपयोगाद्गर्भिण्या महति सञ्जातसारे गर्भे पुष्पदर्शनं स्यादन्यो वा योनिस्रावस्तस्या गर्भो वृद्धिं नप्राप्नोति निःस्रुतत्वात्; स कालमवतिष्ठतेऽतिमात्रं, तमुपविष्टकमित्याचक्षते केचित्|
उपवासव्रतकर्मपरायाः पुनः कदाहारायाः स्नेहद्वेषिण्या वातप्रकोपणोक्तान्यासेवमानाया गर्भो वृद्धिं न प्राप्नोतिपरिशुष्कत्वात्; स चापि कालमवतिष्ठतेऽतिमात्रम् [१] , अस्पन्दनश्च भवति, तं तु नागोदरमित्याचक्षते||२६||

yasyāḥ punaruṣṇatīkṣṇōpayōgādgarbhiṇyā mahati sañjātasārē garbhē puṣpadarśanaṁ syādanyō vāyōnisrāvastasyā garbhō vr̥ddhiṁ na prāpnōti niḥsrutatvāt; sa kālamavatiṣṭhatē'timātraṁ,tamupaviṣṭakamityācakṣatē kēcit|
upavāsavratakarmaparāyāḥ punaḥ kadāhārāyāḥ snēhadvēṣiṇyā vātaprakōpaṇōktānyāsēvamānāyāgarbhō vr̥ddhiṁ na prāpnōti pariśuṣkatvāt; sa cāpi kālamavatiṣṭhatē'timātram [1] , aspandanaśca bhavati,taṁ tu nāgōdaramityācakṣatē||26||

yasyAH punaruShNatIkShNopayogAdgarbhiNyA mahati sa~jjAtasAre garbhe puShpadarshanaM syAdanyovA yonisrAvastasyA garbho vRuddhiM na prApnoti niHsrutatvAt; sa kAlamavatiShThate~atimAtraM,tamupaviShTakamityAcakShate kecit|
upavAsavratakarmaparAyAH punaH kadAhArAyAH snehadveShiNyA vAtaprakopaNoktAnyAsevamAnAyAgarbho vRuddhiM na prApnoti parishuShkatvAt; sa cApi kAlamavatiShThate~atimAtram [1] , aspandanashcabhavati, taM tu nAgodaramityAcakShate||26||
<div style="text-align:justify;">
If a pregnant woman with a large and well-formed foetus starts experiencing bleeding or other forms of uterine discharge as aresult of indulgence in hot and pungent food articles, the foetus will cease growing. Such a foetus will stay for a long time in the mother’s womb and this condition is referred to as Upavistaka (or prolonged gestation).
Similarly, in a pregnant woman who suffers from malnutrition due to overindulgence in rituals requiring fasting, or who avoids unctuous articles and indulges in vata-provoking dietary or lifestyle activities, foetus will not develop due to it getting weaned away from nutrition, and such foetus will remain in the womb for a long period of time without developing. This condition is called Nagodara (elephantine gestation). [26]
</div>
==== Specific Therapeutic courses for the management of Intrauterine Growth Retardation ====

नार्योस्तयोरुभयोरपि चिकित्सितविशेषमुपदेक्ष्यामः- भौतिकजीवनीयबृंहणीयमधुरवातहरसिद्धानां सर्पिषां पयसामामगर्भाणांचोपयोगो गर्भवृद्धिकरः; तथा सम्भोजनमेतैरेव सिद्धैश्च घृतादिभिः सुभिक्षायाः [१] , अभीक्ष्णंयानवाहनापमार्जनावजृम्भणैरुपपादनमिति||२७||

nāryōstayōrubhayōrapi cikitsitaviśēṣamupadēkṣyāmaḥ-bhautikajīvanīyabr̥ṁhaṇīyamadhuravātaharasiddhānāṁ sarpiṣāṁ payasāmāmagarbhāṇāṁ cōpayōgōgarbhavr̥ddhikaraḥ; tathā sambhōjanamētairēva siddhaiśca ghr̥tādibhiḥ subhikṣāyāḥ [1] , abhīkṣṇaṁyānavāhanāpamārjanāvajr̥mbhaṇairupapādanamiti||27|
nAryostayorubhayorapi cikitsitavisheShamupadekShyAmaH-bhautikajIvanIyabRuMhaNIyamadhuravAtaharasiddhAnAM sarpiShAM payasAmAmagarbhANAM copayogogarbhavRuddhikaraH; tathA sambhojanametaireva siddhaishca ghRutAdibhiH subhikShAyAH [1] ,abhIkShNaM yAnavAhanApamArjanAvajRumbhaNairupapAdanamiti||27||
<div style="text-align:justify;">
Now (we) shall expound the specific therapeutic courses of treatment recommended for the management of ''upavistaka'' (intrauterine growth retardation because of decreased nutrient transfer) and nagodara (IUGR because of malnourishment). Ghee and milk which have been medicated with ''bhautika'' (drugs having anti-evil spirits / germs action), ''jivaniya'' (life-promoting), ''brimhaniya'' (bulk promoting), ''madhura'' (sweet) and ''vatahara'' (''vata'' alleviating) drugs help stimulate the development of the fetus. Immature or undeveloped fetus (i.e. poultry eggs) with milk also acts as an effective growth stimulant for the fetus. Ample use of medicated ghee also serves to nourish the mother and her fetus. These therapeutic courses should be supplemented with walking, moving in carriages (that do not jerk a lot), physical cleansing and engaging in mild exercises and other forms of physical activities. [27]
</div>
यस्याः पुनर्गर्भः प्रसुप्तो न स्पन्दते तां श्येनमत्स्यगवयशिखिताम्रचूडतित्तिरीणामन्यतमस्य सर्पिष्मता रसेन माषयूषेण वाप्रभूतसर्पिषा मूलकयूषेण वा रक्तशालीनामोदनं मृदुमधुरशीतलं भोजयेत्|
तैलाभ्यङ्गेन चास्या अभीक्ष्णमुदरबस्तिवङ्क्षणोरुकटीपार्श्वपृष्ठप्रदेशानीषदुष्णेनोपचरेत्||२८||

yasyāḥ punargarbhaḥ prasuptō na spandatē tāṁśyēnamatsyagavayaśikhitāmracūḍatittirīṇāmanyatamasya sarpiṣmatā rasēna māṣayūṣēṇa vāprabhūtasarpiṣā mūlakayūṣēṇa vā raktaśālīnāmōdanaṁ mr̥dumadhuraśītalaṁ bhōjayēt|
tailābhyaṅgēna cāsyā abhīkṣṇamudarabastivaṅkṣaṇōrukaṭīpārśvapr̥ṣṭhapradēśānīṣaduṣṇēnōpacarēt||28||

yasyAH punargarbhaH prasupto na spandate tAMshyenamatsyagavayashikhitAmracUDatittirINAmanyatamasya sarpiShmatA rasena mAShayUSheNa vAprabhUtasarpiShA mUlakayUSheNa vA raktashAlInAmodanaM mRudumadhurashItalaM bhojayet|
tailAbhya~ggena cAsyAabhIkShNamudarabastiva~gkShaNorukaTIpArshvapRuShThapradeshAnIShaduShNenopacaret||28||
<div style="text-align:justify;">
If the fetal development has stalled or is slowed (for various reasons), then the pregnant woman should be advised to take ''shali'' rice (cooked Oriza sativa Linn.) which is soft, sweet and cool, with meat juices (seasoned with ghee), of one or more of the following animals- the hawk, fish, ''gayal'', peacock, rooster, or partridge - or with gruel of ''masha'' (Phaseolusradiates Linn - black gram) or with the soup of radish, with plenty of ghee. She also should be massaged with lukewarm oil (''tila taila''-gingilly oil) over her abdomen, pelvic region, groin, thigh, waist, sides and back. [28]
</div>
==== Constipation during Final Trimester ====

यस्याः पुनरुदावर्तविबन्धः स्यादष्टमे मासे न चानुवासनसाध्यं मन्येत ततस्तस्यास्तद्विकारप्रशमनमुपकल्पयेन्निरूहम्|
उदावर्तो ह्युपेक्षितः सहसा सगर्भां [२] गर्भिणीं गर्भमथवाऽतिपातयेत्|

तत्र वीरणशालिषष्टिककुशकाशेक्षुवालिकावेतसपरिव्याधमूलानां भूतीकानन्ताकाश्मर्यपरूषकमधुकमृद्वीकानां चपयसाऽर्धोदकेनोद्गमय्य रसं प्रियालबिभीतकमज्जतिलकल्कसम्प्रयुक्तमीषल्लवणमनत्युष्णं च निरूहं दद्यात्|
व्यपगतविबन्धां चैनां सुखसलिलपरिषिक्ताङ्गीं स्थैर्यकरमविदाहिनमाहारं भुक्तवतीं सायं मधुरकसिद्धेन तैलेनानुवासयेत्|
न्युब्जां त्वेनामास्थापनानुवासनाभ्यामुपचरेत्||२९||

yasyāḥ punarudāvartavibandhaḥ syādaṣṭamē māsē na cānuvāsanasādhyaṁ manyētatatastasyāstadvikārapraśamanamupakalpayēnnirūham|
udāvartō hyupēkṣitaḥ sahasā sagarbhāṁ [2] garbhiṇīṁ garbhamathavā'tipātayēt|
tatra vīraṇaśāliṣaṣṭikakuśakāśēkṣuvālikāvētasaparivyādhamūlānāṁbhūtīkānantākāśmaryaparūṣakamadhukamr̥dvīkānāṁ ca payasā'rdhōdakēnōdgamayya rasaṁpriyālabibhītakamajjatilakalkasamprayuktamīṣallavaṇamanatyuṣṇaṁ ca nirūhaṁ dadyāt|
vyapagatavibandhāṁ caināṁ sukhasalilapariṣiktāṅgīṁ sthairyakaramavidāhinamāhāraṁ bhuktavatīṁsāyaṁ madhurakasiddhēna tailēnānuvāsayēt|
nyubjāṁ tvēnāmāsthāpanānuvāsanābhyāmupacarēt||29||

yasyAH punarudAvartavibandhaH syAdaShTame mAse na cAnuvAsanasAdhyaM manyetatatastasyAstadvikAraprashamanamupakalpayennirUham|
udAvarto hyupekShitaH sahasA sagarbhAM [2] garbhiNIM garbhamathavA~atipAtayet|
tatra vIraNashAliShaShTikakushakAshekShuvAlikAvetasaparivyAdhamUlAnAMbhUtIkAnantAkAshmaryaparUShakamadhukamRudvIkAnAM ca payasA~ardhodakenodgamayya rasaMpriyAlabibhItakamajjatilakalkasamprayuktamIShallavaNamanatyuShNaM ca nirUhaM dadyAt|
vyapagatavibandhAM cainAM sukhasalilapariShiktA~ggIM sthairyakaramavidAhinamAhAraM bhuktavatIMsAyaM madhurakasiddhena tailenAnuvAsayet|
nyubjAM tvenAmAsthApanAnuvAsanAbhyAmupacaret||29||
<div style="text-align:justify;">
In case the pregnant woman develops constipation due to ''udavarta'' (misperistalsis) in the eighth month and if it cannot be treated with unctuous enema, then the physician should treat her with non-unctuous enema that may relieve her condition. If the disorder of misperistalsis is neglected, it may abruptly turn fatal for both the mother and the fetus or for the fetus alone. In such conditions, a decoction prepared with the roots of ''virana'' (Veriveriazizanoides Nash), ''shali'' (Oryzasativa Linn), ''sashtika'' (a variety of Oryza species), ''kusha'' (Desmostachya bipinnata Staf), ''kasha'' (Saccharum spontaneum Linn.), ''ikshuvalika'' (Asteracanthalongifolia Nees), ''vetasa'' (Salixcaprea Linn.), ''parivyadha'' (type of Vetasa, Salix species) ''bhutika'' (Trachyspermumammi Sprague), ''ananta'' (Hemidesmus indicusR. B.), ''kashmarya'' (Gmelinaarborea Linn.), ''parushaka'' (Grewiaasiatica Linn.), ''madhuka'' (Glycyrrhizaglabra Linn) and ''mridwika'' (Vitisvinifera Linn.), prepared with milk and mixed with half that volume of water containing paste of ''priyala'' (Buchananialanzan Spreng), ''bibhitakamajja'' (the seed pulp of Terminaliabelerica Roxb.), ''tila'' (Sesamumindicum Linn.) and salt (''Saindhava'' – rock salt) should be used for non-unctuous enema. Once the constipation is relieved, she should be sprinkled with lukewarm water and then given food having stabilizing properties and which will not cause any burning sensation.

In the evening, she should be treated with unctuous enema of oil prepared with sweet drugs. The enema should be administered to her in a bent-down position (fetal, knee-to-the-chest position). [29]
</div>
==== Symptoms of death of fetus in the womb ====

यस्याः पुनरतिमात्रदोषोपचयाद्वा तीक्ष्णोष्णातिमात्रसेवनाद्वा वातमूत्रपुरीषवेगविधारणैर्वा विषमाश(स)नशयनस्थानसम्पीडनाभिघातैर्वा क्रोधशोकेर्ष्याभयत्रासादिभिर्वा साहसैर्वाऽपरैः कर्मभिरन्तःकुक्षेर्गर्भो [१] म्रियते, तस्याःस्तिमितं स्तब्धमुदरमाततं शीतमश्मान्तर्गतमिव भवत्यस्पन्दनो गर्भः, शूलमधिकमुपजायते, न चाव्यः प्रादुर्भवन्ति, योनिर्नप्रस्रवति, अक्षिणी चास्याः स्रस्ते भवतः, ताम्यति, व्यथते, भ्रमते, श्वसिति, अरतिबहुला च भवति, न चास्या वेगप्रादुर्भावोयथावदुपलभ्यते; इत्येवंलक्षणां स्त्रियं मृतगर्भेयमिति विद्यात्||३०||

yasyāḥ punaratimātradōṣōpacayādvā tīkṣṇōṣṇātimātrasēvanādvā vātamūtrapurīṣavēgavidhāraṇairvāviṣamāśa(sa)naśayanasthānasampīḍanābhighātairvā krōdhaśōkērṣyābhayatrāsādibhirvāsāhasairvā'paraiḥ karmabhirantaḥkukṣērgarbhō [1] mriyatē, tasyāḥ stimitaṁ stabdhamudaramātataṁśītamaśmāntargatamiva bhavatyaspandanō garbhaḥ, śūlamadhikamupajāyatē, na cāvyaḥ prādurbhavanti,yōnirna prasravati, akṣiṇī cāsyāḥ srastē bhavataḥ, tāmyati, vyathatē, bhramatē, śvasiti, aratibahulā cabhavati, na cāsyā vēgaprādurbhāvō yathāvadupalabhyatē; ityēvaṁlakṣaṇāṁ striyaṁ mr̥tagarbhēyamitividyāt||30||

yasyAH punaratimAtradoShopacayAdvA tIkShNoShNAtimAtrasevanAdvAvAtamUtrapurIShavegavidhAraNairvA viShamAsha(sa)nashayanasthAnasampIDanAbhighAtairvAkrodhashokerShyAbhayatrAsAdibhirvA sAhasairvA~aparaiH karmabhirantaHkukShergarbho [1] mriyate,tasyAH stimitaM stabdhamudaramAtataM shItamashmAntargatamiva bhavatyaspandano garbhaH,shUlamadhikamupajAyate, na cAvyaH prAdurbhavanti, yonirna prasravati, akShiNI cAsyAH srastebhavataH, tAmyati, vyathate, bhramate, shvasiti, aratibahulA ca bhavati, na cAsyA vegaprAdurbhAvoyathAvadupalabhyate; ityevaMlakShaNAM striyaM mRutagarbheyamiti vidyAt||30||
<div style="text-align:justify;">
If the fetus dies in the womb as a result of excessive increase of ''doshas'' caused due to over-indulgence in pungent and hot things, or due to suppression of urges to pass flatulence, urine and bowel movement, or due to faulty eating, faulty sitting, lying down or standing or due to compression (of the womb) and injuries, or passion, grief, envy, horror, fear etc., or due to intensive/extreme physical activities, then the stomach will be still, rigid, bloated up, cold and stony-hard. This condition would be accompanied by severe pain in the stomach, but the labor pains do not set in and there is no discharge. The woman’s eyes will droop and she may feel nauseous, pain, is in agony, giddiness, and breathlessness with intense restlessness. The natural urges also will not be proper as routine. If these features are seen in a pregnant woman, then it should be construed that the fetus is dead. [30]
</div>
==== Treatment of dead fetus in the womb ====

तस्य गर्भशल्यस्य जरायुप्रपातनं कर्म संशमनमित्याहुरेके, मन्त्रादिकमथर्ववेदविहितमित्येके, परिदृष्टकर्मणा शल्यहर्त्राहरणमित्येके|
व्यपगतगर्भशल्यां तु स्त्रियमामगर्भां सुरासीध्वरिष्टमधुमदिरासवानामन्यतममग्रे सामर्थ्यतःपाययेद्गर्भकोष्ठशुद्ध्यर्थमर्तिविस्मरणार्थं प्रहर्षणार्थं च, अतः परं सम्प्रीणनैर्बलानुरक्षिभिरस्नेहसम्प्रयुक्तैर्यवाग्वादिभिर्वा [१]तत्कालयोगिभिराहारैरुपचरेद्दोषधातुक्लेदविशोषणमात्रं कालम्|
अतः परं स्नेहपानैर्बस्तिभिराहारविधिभिश्च दीपनीयजीवनीयबृंहणीयमधुरवातहरसमाख्यातैरुपचरेत्| परिपक्वगर्भशल्यायाः पुनर्विमुक्तगर्भशल्यायास्तदहरेव स्नेहोपचारः स्यात्||३१||

tasya garbhaśalyasya jarāyuprapātanaṁ karma saṁśamanamityāhurēkē,mantrādikamatharvavēdavihitamityēkē, paridr̥ṣṭakarmaṇā śalyahartrā haraṇamityēkē|
vyapagatagarbhaśalyāṁ tu striyamāmagarbhāṁ surāsīdhvariṣṭamadhumadirāsavānāmanyatamamagrēsāmarthyataḥ pāyayēdgarbhakōṣṭhaśuddhyarthamartivismaraṇārthaṁ praharṣaṇārthaṁ ca, ataḥ paraṁsamprīṇanairbalānurakṣibhirasnēhasamprayuktairyavāgvādibhirvā [1]tatkālayōgibhirāhārairupacarēddōṣadhātuklēdaviśōṣaṇamātraṁ kālam|
ataḥ paraṁ snēhapānairbastibhirāhāravidhibhiścadīpanīyajīvanīyabr̥ṁhaṇīyamadhuravātaharasamākhyātairupacarēt|
paripakvagarbhaśalyāyāḥ punarvimuktagarbhaśalyāyāstadaharēva snēhōpacāraḥ syāt||31||

tasya garbhashalyasya jarAyuprapAtanaM karma saMshamanamityAhureke,mantrAdikamatharvavedavihitamityeke, paridRuShTakarmaNA shalyahartrA haraNamityeke|
vyapagatagarbhashalyAM tu striyamAmagarbhAMsurAsIdhvariShTamadhumadirAsavAnAmanyatamamagre sAmarthyataHpAyayedgarbhakoShThashuddhyarthamartivismaraNArthaM praharShaNArthaM ca, ataH paraMsamprINanairbalAnurakShibhirasnehasamprayuktairyavAgvAdibhirvA [1]tatkAlayogibhirAhArairupacareddoShadhAtukledavishoShaNamAtraM kAlam|
ataH paraM snehapAnairbastibhirAhAravidhibhishcadIpanIyajIvanIyabRuMhaNIyamadhuravAtaharasamAkhyAtairupacaret|
paripakvagarbhashalyAyAH punarvimuktagarbhashalyAyAstadahareva snehopacAraH syAt||31||
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According to some scholars, the treatment of dead fetus (which acts like a foreign body within the womb) consists of administering medicines which are used to expel the placenta. Others suggest using mantras, prayers and spiritual offerings as explained in the Atharva Veda. Yet others believe that it should be removed by surgical means by an expert surgeon.

If the dead fetus is immature (i.e., in its early stages of development), then once the dead fetus is extracted, the woman should drink, to her fill, alcoholic drinks such ''assura, sidhu, arishta, madhu, madira'' and ''asava'' in order to cleanse her uterus, relieve herself from pain and also to become euphoric (i.e., overcome her grief). Then she should be given food articles that are nourishing and strength-enhancing but without fat or oil in them, such as gruels that are suitable for that moment till the excess moisture of the ''dosha'' and ''dhatus'' are absorbed. Then she should be treated with ''snehapana'' (administration of unctuous substances), enema and diets processed with medications possessing appetizing, vitalizing, bulk-promoting, sweet and ''vata''-alleviating properties. If the dead fetus is a mature one, once the dead fetus is removed, that day itself she should be treated with unction measures. [31]
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==== Monthly regimen to be adopted during normal pregnancy ====

परमतो निर्विकारमाप्याय्यमानस्य गर्भस्य मासे मासे कर्मोपदेक्ष्यामः|
प्रथमे मासे शङ्किता चेद्गर्भमापन्ना क्षीरमनुपस्कृतं मात्रावच्छीतं काले काले पिबेत्, सात्म्यमेव च भोजनं सायं प्रातश्चभुञ्जीत; द्वितीये मासे क्षीरमेव च मधुरौषधसिद्धं; तृतीये मासे क्षीरं मधुसर्पिर्भ्यामुपसंसृज्य; चतुर्थे मासेक्षीरनवनीतमक्षमात्रमश्नीयात्; पञ्चमे मासे क्षीरसर्पिः; षष्ठे मासे क्षीरसर्पिर्मधुरौषधसिद्धं; तदेव सप्तमे मासे|
तत्र गर्भस्य केशा जायमाना मातुर्विदाहं जनयन्तीति स्त्रियो भाषन्ते; तन्नेति भगवानात्रेयः, किन्तुगर्भोत्पीडनाद्वातपित्तश्लेष्माण उरः प्राप्य विदाहं जनयन्ति, ततः कण्डूरुपजायते, कण्डूमूला च किक्किसावाप्तिर्भवति|
तत्र कोलोदकेन नवनीतस्य मधुरौषधसिद्धस्य पाणितलमात्रं काले कालेऽस्यै पानार्थं दद्यात्, चन्दनमृणालकल्कैश्चास्याःस्तनोदरं विमृद्गीयात्, शिरीषधातकीसर्षपमधुकचूर्णैर्वा, कुटजार्जकबीजमुस्तहरिद्राकल्कैर्वा,निम्बकोलसुरसमञ्जिष्ठाकल्कैर्वा, पृषतहरिणशशरुधिरयुतया त्रिफलया वा; करवीरपत्रसिद्धेन तैलेनाभ्यङ्गः; परिषेकःपुनर्मालतीमधुकसिद्धेनाम्भसा; जातकण्डूश्च कण्डूयनं वर्जयेत्त्वग्भेदवैरूप्यपरिहारार्थम्, असह्यायां तुकण्ड्वामुन्मर्दनोद्धर्षणाभ्यां परिहारः स्यात्; मधुरमाहारजातं वातहरमल्पमस्नेहलवणमल्पोदकानुपानं च भुञ्जीत|
अष्टमे तु मासे क्षीरयवागूं सर्पिष्मतीं काले काले पिबेत्; तन्नेति भद्रकाप्यः, पैङ्गल्याबाधो ह्यस्या गर्भमागच्छेदिति; अस्त्वत्रपैङ्गल्याबाध इत्याह भगवान् पुनर्वसुरात्रेयः, न त्वेवैतन्न कार्यम्; एवं कुर्वती ह्यरोगाऽऽरोग्यबलवर्णस्वरसंहननसम्पदुपेतंज्ञातीनामपि श्रेष्ठमपत्यं जनयति|
नवमे तु खल्वेनां मासे मधुरौषधसिद्धेन तैलेनानुवासयेत्|
अतश्चैवास्यास्तैलात् पिचुं योनौ प्रणयेद्गर्भस्थानमार्गस्नेहनार्थम्|
यदिदं कर्म प्रथमं मासं समुपादायोपदिष्टमानवमान्मासात्तेन गर्भिण्या गर्भसमये गर्भधारिणीकुक्षिकटीपार्श्वपृष्ठं [१] मृदूभवति,वातश्चानुलोमः सम्पद्यते, मूत्रपुरीषे च प्रकृतिभूते सुखेन मार्गमनुपद्येते, चर्मनखानि च मार्दवमुपयान्ति, बलवर्णौचोपचीयेते; पुत्रं चेष्टं सम्पदुपेतं सुखिनं सुखेनैषा काले प्रजायत इति||३२||

paramatō nirvikāramāpyāyyamānasya garbhasya māsē māsē karmōpadēkṣyāmaḥ|
prathamē māsē śaṅkitā cēdgarbhamāpannā kṣīramanupaskr̥taṁ mātrāvacchītaṁ kālē kālē pibēt,sātmyamēva ca bhōjanaṁ sāyaṁ prātaśca bhuñjīta; dvitīyē māsē kṣīramēva ca madhurauṣadhasiddhaṁ;tr̥tīyē māsē kṣīraṁ madhusarpirbhyāmupasaṁsr̥jya; caturthē māsē kṣīranavanītamakṣamātramaśnīyāt;pañcamē māsē kṣīrasarpiḥ; ṣaṣṭhē māsē kṣīrasarpirmadhurauṣadhasiddhaṁ; tadēva saptamē māsē|
tatra garbhasya kēśā jāyamānā māturvidāhaṁ janayantīti striyō bhāṣantē; tannēti bhagavānātrēyaḥ, kintugarbhōtpīḍanādvātapittaślēṣmāṇa uraḥ prāpya vidāhaṁ janayanti, tataḥ kaṇḍūrupajāyatē, kaṇḍūmūlā cakikkisāvāptirbhavati|
tatra kōlōdakēna navanītasya madhurauṣadhasiddhasya pāṇitalamātraṁ kālē kālē'syai pānārthaṁ dadyāt,candanamr̥ṇālakalkaiścāsyāḥ stanōdaraṁ vimr̥dgīyāt, śirīṣadhātakīsarṣapamadhukacūrṇairvā,kuṭajārjakabījamustaharidrākalkairvā, nimbakōlasurasamañjiṣṭhākalkairvā,pr̥ṣatahariṇaśaśarudhirayutayā triphalayā vā; karavīrapatrasiddhēna tailēnābhyaṅgaḥ; pariṣēkaḥpunarmālatīmadhukasiddhēnāmbhasā; jātakaṇḍūśca kaṇḍūyanaṁvarjayēttvagbhēdavairūpyaparihārārtham, asahyāyāṁ tu kaṇḍvāmunmardanōddharṣaṇābhyāṁ parihāraḥsyāt; madhuramāhārajātaṁ vātaharamalpamasnēhalavaṇamalpōdakānupānaṁ ca bhuñjīta|
aṣṭamē tu māsē kṣīrayavāgūṁ sarpiṣmatīṁ kālē kālē pibēt; tannēti bhadrakāpyaḥ, paiṅgalyābādhō hyasyāgarbhamāgacchēditi; astvatra paiṅgalyābādha ityāha bhagavān punarvasurātrēyaḥ, na tvēvaitannakāryam; ēvaṁ kurvatī hyarōgā''rōgyabalavarṇasvarasaṁhananasampadupētaṁ jñātīnāmapiśrēṣṭhamapatyaṁ janayati|
navamē tu khalvēnāṁ māsē madhurauṣadhasiddhēna tailēnānuvāsayēt|
ataścaivāsyāstailāt picuṁ yōnau praṇayēdgarbhasthānamārgasnēhanārtham|
yadidaṁ karma prathamaṁ māsaṁ samupādāyōpadiṣṭamānavamānmāsāttēna garbhiṇyā garbhasamayēgarbhadhāriṇīkukṣikaṭīpārśvapr̥ṣṭhaṁ [1] mr̥dūbhavati, vātaścānulōmaḥ sampadyatē, mūtrapurīṣē caprakr̥tibhūtē sukhēna mārgamanupadyētē, carmanakhāni ca mārdavamupayānti, balavarṇau cōpacīyētē;putraṁ cēṣṭaṁ sampadupētaṁ sukhinaṁ sukhēnaiṣā kālē prajāyata iti||32||

paramato nirvikAramApyAyyamAnasya garbhasya mAse mAse karmopadekShyAmaH|
prathame mAse sha~gkitA cedgarbhamApannA kShIramanupaskRutaM mAtrAvacchItaM kAle kAle pibet,sAtmyameva ca bhojanaM sAyaM prAtashca bhu~jjIta; dvitIye mAse kShIrameva camadhurauShadhasiddhaM; tRutIye mAse kShIraM madhusarpirbhyAmupasaMsRujya; caturthe mAsekShIranavanItamakShamAtramashnIyAt; pa~jcame mAse kShIrasarpiH; ShaShThe mAsekShIrasarpirmadhurauShadhasiddhaM; tadeva saptame mAse|
tatra garbhasya keshA jAyamAnA mAturvidAhaM janayantIti striyo bhAShante; tanneti bhagavAnAtreyaH,kintu garbhotpIDanAdvAtapittashleShmANa uraH prApya vidAhaM janayanti, tataH kaNDUrupajAyate,kaNDUmUlA ca kikkisAvAptirbhavati|
tatra kolodakena navanItasya madhurauShadhasiddhasya pANitalamAtraM kAle kAle~asyai pAnArthaMdadyAt, candanamRuNAlakalkaishcAsyAH stanodaraM vimRudgIyAt,shirIShadhAtakIsarShapamadhukacUrNairvA, kuTajArjakabIjamustaharidrAkalkairvA,nimbakolasurasama~jjiShThAkalkairvA, pRuShatahariNashasharudhirayutayA triphalayA vA;karavIrapatrasiddhena tailenAbhya~ggaH; pariShekaH punarmAlatImadhukasiddhenAmbhasA;jAtakaNDUshca kaNDUyanaM varjayettvagbhedavairUpyaparihArArtham, asahyAyAM tukaNDvAmunmardanoddharShaNAbhyAM parihAraH syAt; madhuramAhArajAtaMvAtaharamalpamasnehalavaNamalpodakAnupAnaM ca bhu~jjIta|
aShTame tu mAse kShIrayavAgUM sarpiShmatIM kAle kAle pibet; tanneti bhadrakApyaH, pai~ggalyAbAdhohyasyA garbhamAgacchediti; astvatra pai~ggalyAbAdha ityAha bhagavAn punarvasurAtreyaH, natvevaitanna kAryam; evaM kurvatI hyarogA~a~arogyabalavarNasvarasaMhananasampadupetaMj~jAtInAmapi shreShThamapatyaM janayati|
navame tu khalvenAM mAse madhurauShadhasiddhena tailenAnuvAsayet|
atashcaivAsyAstailAt picuM yonau praNayedgarbhasthAnamArgasnehanArtham|
yadidaM karma prathamaM mAsaM samupAdAyopadiShTamAnavamAnmAsAttena garbhiNyAgarbhasamaye garbhadhAriNIkukShikaTIpArshvapRuShThaM [1] mRudUbhavati, vAtashcAnulomaHsampadyate, mUtrapurIShe ca prakRutibhUte sukhena mArgamanupadyete, carmanakhAni camArdavamupayAnti, balavarNau copacIyete; putraM ceShTaM sampadupetaM sukhinaM sukhenaiShA kAleprajAyata iti||32||
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In this verse, we shall explain the monthly regimen to be adopted in a steadily developing, normal pregnancy:
*In the first month when pregnancy is suspected, cold and unmedicated milk (that has not been processed with any drug) should be taken in adequate quantity at regular intervals, and nourishing food should be eaten twice a day.
*In the second month of pregnancy, milk processed with sweet-tasting drugs should be taken, as needed.
*In the third month of pregnancy, milk along with honey and ghee should be given to drink.
*In the fourth month of pregnancy, milk along with one ''aksha'' (10 – 12 g) butter should be consumed.
*In the fifth month of pregnancy, milk along with ghee should be given.
*In the sixth month of pregnancy, milk with ghee processed with sweet-tasting drugs should be given to drink.
*In the seventh month of pregnancy, she should be given the same regimen as prescribed in the sixth month. Experienced women are of the opinion that during this period, the fetus develops scalp hair and it causes burning sensation in the mother. But this view is negated by Lord Atreya, who says that due to the pressure created by the fetus, the three ''doshas'' of the mother reach the chest region and cause burning sensation in her, causing itching which, in turn, causes ''kikkisa'' (stretch-marks or striae gravidarum -linea albicantes – the white abdominal lines seen during and after pregnancy on the abdomen). To manage this condition, she should regularly be given butter medicated with sweet-tasting drugs, the quantity of which she can hold in her single palm, along with a decoction of ''kola'' (Zizyphus jujube Lam). Her breasts and abdomen should be massaged with a paste of ''chandana'' (Santalumalbum Linn.), ''mrinala'' (stalk of lotus) or powder of ''shirisha'' (Albizia lebbeck Benth), ''dhataki'' (Woodfordiafruticosa Kurz), ''sarshapa'' (Mustard – Brassicanigra Koch), and ''madhuka'' (Glycyrrhizaglabra Linn.) or paste of ''kutaja'' (Holarrhenaantidysenterica Wall.), seed of ''arjaka'' (Ocimumgratissimum Linn.), ''musta'' (Cyperusrotundus Linn.), ''haridra'' (Curcumalonga Linn.) or paste of ''nimba'' (Azadirachtaindica A. Juss), ''kola'' (Zizyphusjujuba Lam.), ''surasa'' (Ocimumsanctum Linn.) and ''manjishta'' (Rubiacordifolia Linn.) or ''triphala'' (three pungent fruits – Terminaliachebula Linn., Terminaliabelerica Roxb. and Emblicaofficinalis Gaertn.) mixed with the blood of ''prishta'' (spotted deer), massage with oil prepared with leaf of ''karavira'' (Neriumindicum Mill.) and sprinkling with water processed with ''jati'' (''Malati'' – Aganosma dichotoma K. Schum.) and ''madhuka'' (Glycyrrhizaglabra Linn.) plant. Thus, itching should be avoided to prevent stretch-mark on skin (and therefore, avoiding disfiguring the skin). If itching is too severe to tolerate then it should be overcome by an application of ''unmardana'' (anointing) and ''udgharshana'' (rubbing with pastes) procedures. During this period, she should eat sweet-tasting food that is ''vata'' alleviating in nature and is light on oil, fat and salt, and should drink less water immediately after the food.
*In the eighth month, she should take gruel prepared with milk and mixed with ghee in all her meals in their appropriate times. Bhadrakapya has opposing views on this and believes that it causes ''paingalya'' (tawny discoloration of the eyes of fetus) in the fetus, and hence should not be practiced. On this point, Lord Atreya believes that while the risk of paingalya may be there, it does not indicate in any way that the above regimen should not be applied. The woman following this regimen remains free from all disorders and gives birth to a child endowed with excellent health, strength, complexion, voice and compactness of body.
*Finally, in the ninth month of pregnancy, she should be treated with unctuous enema prepared with sweet-tasting drugs. A cotton swab soaked in the same oil should be kept in her genital tract in order to lubricate the passage of the fetus.

If the specific dietary regimen and therapeutic measures mentioned above are followed right from the first month of pregnancy to the ninth month, the entire child-bearing region of the woman’s body – including her womb, waist, sides of pelvis, and her back - become soft at the time of delivery, ''vata'' functions in a normal way, urine and bowel movement pass smoothly, skin and nails become soft, her strength and complexion are improved and the woman delivers the child effortlessly. [32]
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==== Attributes of the maternity home ====

प्राक् चैवास्या नवमान्मासात् सूतिकागारं कारयेदपहृतास्थिशर्कराकपाले देशे प्रशस्तरूपरसगन्धायां भूमौ प्राग्द्वारमुदग्द्वारं वाबैल्वानां काष्ठानां तैन्दुकैङ्गुदकानां भाल्लातकानां वार(रु)णानां खादिराणां वा; यानि चान्यान्यपि ब्राह्मणाःशंसेयुरथर्ववेदविदस्तेषां; वसनालेपनाच्छादनापिधानसम्पदुपेतंवास्तुविद्याहृदययोगाग्निसलिलोदूखलवर्चःस्थानस्नानभूमिमहानसमृतुसुखं च||३३||

prāk caivāsyā navamānmāsāt sūtikāgāraṁ kārayēdapahr̥tāsthiśarkarākapālē dēśēpraśastarūparasagandhāyāṁ bhūmau prāgdvāramudagdvāraṁ vā bailvānāṁ kāṣṭhānāṁtaindukaiṅgudakānāṁ bhāllātakānāṁ vāra(ru)ṇānāṁ khādirāṇāṁ vā; yāni cānyānyapi brāhmaṇāḥśaṁsēyuratharvavēdavidastēṣāṁ; vasanālēpanācchādanāpidhānasampadupētaṁvāstuvidyāhr̥dayayōgāgnisalilōdūkhalavarcaḥsthānasnānabhūmimahānasamr̥tusukhaṁ ca||33||

prAk caivAsyA navamAnmAsAt sUtikAgAraM kArayedapahRutAsthisharkarAkapAle desheprashastarUparasagandhAyAM bhUmau prAgdvAramudagdvAraM vA bailvAnAM kAShThAnAMtaindukai~ggudakAnAM bhAllAtakAnAM vAra(ru)NAnAM khAdirANAM vA; yAni cAnyAnyapi brAhmaNAHshaMseyuratharvavedavidasteShAM; vasanAlepanAcchAdanApidhAnasampadupetaMvAstuvidyAhRudayayogAgnisalilodUkhalavarcaHsthAnasnAnabhUmimahAnasamRutusukhaM ca||33||
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Well before the ninth month of pregnancy, a maternity home should be constructed in a place that is free from bones, gravels and broken pieces of baked earthen utensils, the soil of which should have excellent color, taste and odour, the door of which should be facing the east or north and made of ''bilwa'' wood (Aeglemarmelos Corr.) or ''tinduka'' (Diospyrosperegrine Gurke), ''ingudi'' (Balanitesaegyptica Delile.), ''bhallataka'' (Semecarpusanacardium Linn.), ''varuna'' (Creteva religiosa) or ''khadira'' (Acaciacatechu willd.), or those woods recommended by ''brahmins'' who are well versed in Atharva Veda. The maternity home should be well built, spacious, well painted, have adequate doors and windows, well furnished with appliances, furnishings, water storage, lavatories, toiletries, etc. - built in accordance with the principles of ''Vastuvidya'' (science of architecture). The house should be comfortable for all seasons. [33]
</div>
==== Items to be made available in the maternity home ====

तत्र सर्पिस्तैलमधुसैन्धवसौवर्चलकालविड्लवणविडङ्गकुष्ठकिलिमनागर-पिप्पलीपिप्पलीमूलहस्तिपिप्पलीमण्डूकपर्ण्येलालाङ्गलीवचाचव्यचित्रकचिरबिल्व-हिङ्गुसर्षपलशुनकतककणकणिकानीपातसीबल्वजभूर्जकुलत्थमैरेयसुरासवाः सन्निहिताः स्युः; तथाऽश्मानौ द्वौ, द्वे कु(च)ण्डमुसले, द्वे उदूखले, खरवृषभश्च [१] , द्वौ च तीक्ष्णौ सूचीपिप्पलकौ सौवर्णराजतौ, शस्त्राणि च तीक्ष्णायसानि, द्वौ चबिल्वमयौ पर्यङ्कौ, तैन्दुकैङ्गुदानि च काष्ठान्यग्निसन्धुक्षणानि, स्त्रियश्च बह्व्यो बहुशः प्रजाताः सौहार्दयुक्ताःसततमनुरक्ताः प्रदक्षिणाचाराः प्रतिपत्तिकुशलाः प्रकृतिवत्सलास्त्यक्तविषादाः क्लेशसहिन्योऽभिमताः,ब्राह्मणाश्चाथर्ववेदविदः; यच्चान्यदपि तत्र समर्थं मन्येत, यच्चान्यच्च ब्राह्मणा ब्रूयुः स्त्रियश्च वृद्धास्तत् कार्यम्||३४||

tatra sarpistailamadhusaindhavasauvarcalakālaviḍlavaṇaviḍaṅgakuṣṭhakilimanāgara-pippalīpippalīmūlahastipippalīmaṇḍūkaparṇyēlālāṅgalīvacācavyacitrakacirabilva-hiṅgusarṣapalaśunakatakakaṇakaṇikānīpātasībalvajabhūrjakulatthamairēyasurāsavāḥ sannihitāḥ syuḥ;tathā'śmānau dvau, dvē ku(ca)ṇḍamusalē, dvē udūkhalē, kharavr̥ṣabhaśca [1] , dvau ca tīkṣṇausūcīpippalakau sauvarṇarājatau, śastrāṇi ca tīkṣṇāyasāni, dvau ca bilvamayau paryaṅkau,taindukaiṅgudāni ca kāṣṭhānyagnisandhukṣaṇāni, striyaśca bahvyō bahuśaḥ prajātāḥ sauhārdayuktāḥsatatamanuraktāḥ pradakṣiṇācārāḥ pratipattikuśalāḥ prakr̥tivatsalāstyaktaviṣādāḥ klēśasahinyō'bhimatāḥ,brāhmaṇāścātharvavēdavidaḥ; yaccānyadapi tatra samarthaṁ manyēta, yaccānyacca brāhmaṇā brūyuḥstriyaśca vr̥ddhāstat kāryam||34||

tatra sarpistailamadhusaindhavasauvarcalakAlaviDlavaNaviDa~ggakuShThakilimanAgara-pippalIpippalImUlahastipippalImaNDUkaparNyelAlA~ggalIvacAcavyacitrakacirabilva-hi~ggusarShapalashunakatakakaNakaNikAnIpAtasIbalvajabhUrjakulatthamaireyasurAsavAH sannihitAHsyuH; tathA~ashmAnau dvau, dve ku(ca)NDamusale, dve udUkhale, kharavRuShabhashca [1] , dvau catIkShNau sUcIpippalakau sauvarNarAjatau, shastrANi ca tIkShNAyasAni, dvau ca bilvamayau parya~gkau,taindukai~ggudAni ca kAShThAnyagnisandhukShaNAni, striyashca bahvyo bahushaH prajAtAHsauhArdayuktAH satatamanuraktAH pradakShiNAcArAH pratipattikushalAHprakRutivatsalAstyaktaviShAdAH kleshasahinyo~abhimatAH, brAhmaNAshcAtharvavedavidaH;yaccAnyadapi tatra samarthaM manyeta, yaccAnyacca brAhmaNA brUyuH striyashca vRuddhAstatkAryam||34||
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The following items should be made available in that maternity home: Ghee, honey, ''saindhava'' (rock salt), ''sauvarchala, kala, bida'' salts, ''vidanga'' (Emblelia ribes Burm. f.), ''kushta'' (Saussurea lappaC. B. Clarke.), ''kilima'' (Cedrus deodara Loud.), ''nagara'' (Zingiber officinale Rosc.), ''pippali'' (Piper longum Linn), ''pippali moola'' (root of Piper longum Linn.), ''hasti pippali'' (Scindapsus officinalis Schott), ''mandukaparni'' (Centella asiatica urban.), ''ela'' (Elettaria cadamomum Maton.), ''langali'' (Gloriosa superba Linn.), ''vacha'' (Acorus calamus Linn.), ''chavya'' (Piper cheba Hunter.), ''chitraka'' (Plumbago zeylanica Linn.), ''chirabilva'' (Pongamia pinnata Merr.), ''hingu'' (Ferula narthex Boiss.), ''sarshapa'' (Brassica nigra Koch.), ''lashuna'' (Alium sativum Linn.), ''kataka'' (Strychnos potatorum Linn. f.), ''kana'' (Pippali – piper longum Linn), ''kundaka, kanika'' (a variety of ''kana'' with bigger grains), ''neepa'' (Anthocephalus indicus A. Rich.), ''atasi'' (Linum usitatissumum Linn.), ''balvaja'' (--), ''bhurja'' (Betula utilis D. Don.), ''kulatha'' (Dolichos biflorus Linn.), ''maireya'', and alcoholic beverages (''sura'', and ''asava''). In addition to the above, the following items too should be kept available there – two grinding stones, two small pestles, two mortars, one untamed bull, two gold and silver cases for keeping needles, various surgical instruments that are sharp and prepared of metals, two bedsteads made of ''bilva'' (Aeglemarmelos Corr.), wood of ''tinduka'' (Diospyrosperegrine Gurke) and ''ingudi'' (Balanitesaegyptica Delile.) as fire wood, good number of female attendants who are multiskilled, who are affectionate and attached to the lady, well mannered, resourceful, pleasant to talk to, free from grief, tolerant of hardship and agreeable, and brahmins well versed in the Atharva Veda.

Above all, whatever prescribed by brahmins and experienced old ladies and found necessary are to be kept handy in this maternity home. [34]
</div>
==== Rituals for the expecting woman before entering the maternity home ====

ततः प्रवृत्ते नवमे मासे पुण्येऽहनि प्रशस्तनक्षत्रयोगमुपगते प्रशस्ते भगवति शशिनि कल्याणे कल्याणे च करणे मैत्रे मुहूर्ते शान्तिंहुत्वा गोब्राह्मणमग्निमुदकं चादौ प्रवेश्य गोभ्यस्तृणोदकं मधुलाजांश्च प्रदाय ब्राह्मणेभ्योऽक्षतान् सुमनसो नान्दीमुखानि चफलानीष्टानि दत्त्वोदकपूर्वमासनस्थेभ्योऽभिवाद्य पुनराचम्य स्वस्ति वाचयेत्|
ततः पुण्याहशब्देन गोब्राह्मणं समनुवर्तमाना [१] प्रदक्षिणं प्रविशेत् सूतिकागारम्|
तत्रस्था च प्रसवकालं प्रतीक्षेत||३५||

tataḥ pravr̥ttē navamē māsē puṇyē'hani praśastanakṣatrayōgamupagatē praśastē bhagavati śaśini kalyāṇēkalyāṇē ca karaṇē maitrē muhūrtē śāntiṁ hutvā gōbrāhmaṇamagnimudakaṁ cādau pravēśyagōbhyastr̥ṇōdakaṁ madhulājāṁśca pradāya brāhmaṇēbhyō'kṣatān sumanasō nāndīmukhāni caphalānīṣṭāni dattvōdakapūrvamāsanasthēbhyō'bhivādya punarācamya svasti vācayēt|
tataḥ puṇyāhaśabdēna gōbrāhmaṇaṁ samanuvartamānā [1] pradakṣiṇaṁ praviśēt sūtikāgāram|
tatrasthā ca prasavakālaṁ pratīkṣēta||35||

tataH pravRutte navame mAse puNye~ahani prashastanakShatrayogamupagate prashaste bhagavatishashini kalyANe kalyANe ca karaNe maitre muhUrte shAntiM hutvA gobrAhmaNamagnimudakaM cAdaupraveshya gobhyastRuNodakaM madhulAjAMshca pradAya brAhmaNebhyo~akShatAn sumanasonAndImukhAni ca phalAnIShTAni dattvodakapUrvamAsanasthebhyo~abhivAdya punarAcamya svastivAcayet|
tataH puNyAhashabdena gobrAhmaNaM samanuvartamAnA [1] pradakShiNaM pravishet sUtikAgAram|
tatrasthA ca prasavakAlaM pratIkSheta||35||
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After furnishing the maternity home, in the beginning of the ninth month, on an auspicious day, when moon is in the auspicious ''nakshatra'' (constellation), with an auspicious ''karana'' and at an auspicious ''muhurta'' (astrological unit of time), with priests offering oblations and rites to holy fire, first of all the cow, the ''brahmana'', fire and water should be made to enter the maternity home. Then grass, water, honey and ''laja'' (parched rice) should be offered to the cows, and ''akshata'' (rice grains prepared exclusively for worship), fragrant flowers and sweet fruits (such as ''khajura'', date), which are indicative of good fortune, should be offered to the ''brahmanas''. Blessings should then be sought from the ''brahmanas'', after taking sips of water (''achamana'' is taking sips of water after chanting ''mantra''). With auspicious mantras being chanted by the priests, the expecting woman should enter the maternity home, following the cow and the ''brahmanas'' to her right side. Then she should stay there until she delivers her child. [35]
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==== Premonitory signs and symptoms of labor ====

तस्यास्तु खल्विमानि लिङ्गानि प्रजननकालमभितो भवन्ति; तद्यथा- क्लमो गात्राणां, ग्लानिराननस्य, अक्ष्णोः शैथिल्यं,विमुक्तबन्धनत्वमिव [१] वक्षसः, कुक्षेरवस्रंसनम्, अधोगुरुत्वं, वङ्क्षणबस्तिकटीकुक्षिपार्श्वपृष्ठनिस्तोदः, योनेः प्रस्रवणम्,अनन्नाभिलाषश्चेति; ततोऽनन्तरमावीनां प्रादुर्भावः, प्रसेकश्च गर्भोदकस्य||३६||

tasyāstu khalvimāni liṅgāni prajananakālamabhitō bhavanti; tadyathā- klamō gātrāṇāṁ, glānirānanasya,akṣṇōḥ śaithilyaṁ, vimuktabandhanatvamiva [1] vakṣasaḥ, kukṣēravasraṁsanam, adhōgurutvaṁ,vaṅkṣaṇabastikaṭīkukṣipārśvapr̥ṣṭhanistōdaḥ, yōnēḥ prasravaṇam, anannābhilāṣaścēti;tatō'nantaramāvīnāṁ prādurbhāvaḥ, prasēkaśca garbhōdakasya||36||
tasyAstu khalvimAni li~ggAni prajananakAlamabhito bhavanti; tadyathA- klamo gAtrANAM,glAnirAnanasya, akShNoH shaithilyaM, vimuktabandhanatvamiva [1] vakShasaH, kukSheravasraMsanam,adhogurutvaM, va~gkShaNabastikaTIkukShipArshvapRuShThanistodaH, yoneH prasravaNam,anannAbhilAShashceti; tato~anantaramAvInAM prAdurbhAvaH, prasekashca garbhodakasya||36||
<div style="text-align:justify;">
The premonitory signs and symptoms of labor include tiredness, pallor, laxity of eyes (drooping of eyelids), feeling of getting freed from constrictions around the chest, bearing down pressure sensation in pelvis because of fetus, heaviness of lower abdomen, and pain in the groin, bladder area perineum, pelvis, belly, sides and the back, discharge from the vagina, lack of desire for food. These are typically followed by the appearance of ''garbhodaka'' (amniotic fluid) and initiation of ''aavee'' (labor pain). [36]
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==== Commencement of ''aavee'' (labor) ====

आवीप्रादुर्भावे तु भूमौ शयनं विदध्यान्मृद्वास्तरणोपपन्नम्|
तदध्यासीत [२] सा|
तां ततः समन्ततः परिवार्य यथोक्तगुणाः स्त्रियः पर्युपासीरन्नाश्वासयन्त्यो वाग्भिर्ग्राहिणीयाभिः [३] सान्त्वनीयाभिश्च||३७||

āvīprādurbhāvē tu bhūmau śayanaṁ vidadhyānmr̥dvāstaraṇōpapannam|
tadadhyāsīta [2] sā|
tāṁ tataḥ samantataḥ parivārya yathōktaguṇāḥ striyaḥ paryupāsīrannāśvāsayantyō vāgbhirgrāhiṇīyābhiḥ[3] sāntvanīyābhiśca||37||

AvIprAdurbhAve tu bhUmau shayanaM vidadhyAnmRudvAstaraNopapannam|
tadadhyAsIta [2] sA|
tAM tataH samantataH parivArya yathoktaguNAH striyaH paryupAsIrannAshvAsayantyovAgbhirgrAhiNIyAbhiH [3] sAntvanIyAbhishca||37||
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With the commencement of ''aavee'', the parturient woman should be made to sit on a bed prepared with soft materials spread over the ground. Then, the female attendants with qualities mentioned in the preceding verses should surround her from all sides and encourage her by comforting words and touch. [37]
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==== Issues with delivery despite labor pains ====

सा चेदावीभिः सङ्क्लिश्यमाना न प्रजायेताथैनां ब्रूयात्-उत्तिष्ठ, मुसलमन्यतरं गृहीष्व, अनेनैतदुलूखलं धान्यपूर्णंमुहुर्मुहुरभिजहि मुहुर्मुहुरवजृम्भस्व चङ्क्रमस्व चान्तराऽन्तरेति; एवमुपदिशन्त्येके|
तन्नेत्याह भगवानात्रेयः|
दारुणव्यायामवर्जनं हि गर्भिण्याः सततमुपदिश्यते, विशेषतश्च प्रजननकाले प्रचलितसर्वधातुदोषायाःसुकुमार्या नार्यामुसलव्यायामसमीरितो वायुरन्तरं लब्ध्वा प्राणान् हिंस्यात्, दुष्प्रतीकारतमा हि तस्मिन् काले विशेषेण भवति गर्भिणी;तस्मान्मुसलग्रहणं परिहार्यमृषयो मन्यन्ते, जृम्भणं चङ्क्रमणं च पुनरनुष्ठेयमिति|
अथास्यै दद्यात् कुष्ठैलालाङ्गलिकीवचाचित्रकचिरबिल्वचव्यचूर्णमुपघ्रातुं, सा तन्मुहुर्मुहुरुपजिघ्रेत्, तथा भूर्जपत्रधूमंशिंशपासारधूमं वा|
तस्याश्चान्तराऽन्तरा कटीपार्श्वपृष्ठसक्थिदेशानीषदुष्णेन तैलेनाभ्यज्यानुसुखमवमृद्नीयात् [४] |
अनेन कर्मणा गर्भोऽवाक् [५] प्रतिपद्यते||३८||

sā cēdāvībhiḥ saṅkliśyamānā na prajāyētāthaināṁ brūyāt- uttiṣṭha, musalamanyataraṁ gr̥hīṣva,anēnaitadulūkhalaṁ dhānyapūrṇaṁ muhurmuhurabhijahi muhurmuhuravajr̥mbhasva caṅkramasvacāntarā'ntarēti; ēvamupadiśantyēkē|
tannētyāha bhagavānātrēyaḥ|
dāruṇavyāyāmavarjanaṁ hi garbhiṇyāḥ satatamupadiśyatē, viśēṣataśca prajananakālēpracalitasarvadhātudōṣāyāḥ sukumāryā nāryā musalavyāyāmasamīritō vāyurantaraṁ labdhvā prāṇānhiṁsyāt, duṣpratīkāratamā hi tasmin kālē viśēṣēṇa bhavati garbhiṇī; tasmānmusalagrahaṇaṁparihāryamr̥ṣayō manyantē, jr̥mbhaṇaṁ caṅkramaṇaṁ ca punaranuṣṭhēyamiti|
athāsyai dadyāt kuṣṭhailālāṅgalikīvacācitrakacirabilvacavyacūrṇamupaghrātuṁ, sātanmuhurmuhurupajighrēt, tathā bhūrjapatradhūmaṁ śiṁśapāsāradhūmaṁ vā|
tasyāścāntarā'ntarā kaṭīpārśvapr̥ṣṭhasakthidēśānīṣaduṣṇēna tailēnābhyajyānusukhamavamr̥dnīyāt [4] |
anēna karmaṇā garbhō'vāk [5] pratipadyatē||38||

sA cedAvIbhiH sa~gklishyamAnA na prajAyetAthainAM brUyAt- uttiShTha, musalamanyataraM gRuhIShva,anenaitadulUkhalaM dhAnyapUrNaM muhurmuhurabhijahi muhurmuhuravajRumbhasva ca~gkramasvacAntarA~antareti; evamupadishantyeke|
tannetyAha bhagavAnAtreyaH|
dAruNavyAyAmavarjanaM hi garbhiNyAH satatamupadishyate, visheShatashca prajananakAlepracalitasarvadhAtudoShAyAH sukumAryA nAryA musalavyAyAmasamIrito vAyurantaraM labdhvA prANAnhiMsyAt, duShpratIkAratamA hi tasmin kAle visheSheNa bhavati garbhiNI; tasmAnmusalagrahaNaMparihAryamRuShayo manyante, jRumbhaNaM ca~gkramaNaM ca punaranuShTheyamiti|
athAsyai dadyAt kuShThailAlA~ggalikIvacAcitrakacirabilvacavyacUrNamupaghrAtuM, sAtanmuhurmuhurupajighret, tathA bhUrjapatradhUmaM shiMshapAsAradhUmaM vA|
tasyAshcAntarA~antarA kaTIpArshvapRuShThasakthideshAnIShaduShNenatailenAbhyajyAnusukhamavamRudnIyAt [4] |
anena karmaNA garbho~avAk [5] pratipadyate||38||
<div style="text-align:justify;">
If in spite of acute labor pains, she is not able to deliver, some advise that the woman must be instructed to get up, hold a pestle and pound grains repeatedly, taking breaks and deep breaths, and moving about periodically. Lord Atreya, however, does not consider it right. According to him, a pregnant woman should always be advised to avoid strenuous exercises and particularly during parturition, since all the body elements and humors are in a state of commotion, ''vata'', aggravated by the strain involved in the exercise of pounding, could even be fatal to the pregnant woman. Woman during this situation will be difficult to cure. Other sages advise against the pounding exercises but advocating deep breathing and moving about.

The woman should be made to inhale the powders of ''kushta'' (Saussurea lappa C.B.Clarke.), ''ela'' (Elettaria cardamomum Maton), ''langalaki'' (Gloriosa superb Linn.), ''vacha'' (Acorus calamus Linn.), ''chitraka'' (Plumbago zeylanica Linn.), ''chirbilva'' (Pongamia pinnata Mirr.) and ''chavya'' (Piper chaba Hunter), which can be administered frequently . Similarly the fumigation done with leaves of ''bhurja'' (Betula utilis D. Don.) or pith of ''shimsapa'' (Dalbergia sissoo Roxb.) could be used for inhalation. During this period, she should be given a light massage over her waist, sides, back and legs with lukewarm oil followed by a kneading massage. With these measures the fetus descends down. [38]
</div>
==== Mantra to be recited when labor pain increases ====

स यदा जानीयाद्विमुच्य हृदयमुदरमस्यास्त्वाविशति, बस्तिशिरोऽवगृह्णाति, त्वरयन्त्येनामाव्यः, परिवर्ततेऽधो [६] गर्भइति; अस्यामवस्थायां पर्यङ्कमेनामारोप्य प्रवाहयितुमुपक्रमेत|
कर्णे चास्या मन्त्रमिममनुकूला स्त्री जपेत्-
‘क्षितिर्जलं वियत्तेजो वायुर्विष्णुः [७] प्रजापतिः|
सगर्भां त्वां सदा पान्तु वैशल्यं च दिशन्तु ते|
प्रसूष्व त्वमविक्लिष्टमविक्लिष्टा शुभानने!|
कार्तिकेयद्युतिं पुत्रं कार्तिकेयाभिरक्षितम्’ इति||३९||

sa yadā jānīyādvimucya hr̥dayamudaramasyāstvāviśati, bastiśirō'vagr̥hṇāti, tvarayantyēnāmāvyaḥ,parivartatē'dhō [6] garbha iti; asyāmavasthāyāṁ paryaṅkamēnāmārōpya pravāhayitumupakramēta|
karṇē cāsyā mantramimamanukūlā strī japēt-
‘kṣitirjalaṁ viyattējō vāyurviṣṇuḥ [7] prajāpatiḥ|
sagarbhāṁ tvāṁ sadā pāntu vaiśalyaṁ ca diśantu tē|
prasūṣva tvamavikliṣṭamavikliṣṭā śubhānanē!|
kārtikēyadyutiṁ putraṁ kārtikēyābhirakṣitam’ iti||39||

sa yadA jAnIyAdvimucya hRudayamudaramasyAstvAvishati, bastishiro~avagRuhNAti,tvarayantyenAmAvyaH, parivartate~adho [6] garbha iti; asyAmavasthAyAM parya~gkamenAmAropyapravAhayitumupakrameta|
karNe cAsyA mantramimamanukUlA strI japet-
‘kShitirjalaM viyattejo vAyurviShNuH [7] prajApatiH|
sagarbhAM tvAM sadA pAntu vaishalyaM ca dishantu te|
prasUShva tvamavikliShTamavikliShTA shubhAnane!|
kArtikeyadyutiM putraM kArtikeyAbhirakShitam’ iti||39||
<div style="text-align:justify;">
When the feeling of fetus descending into the lower abdomen getting separated from heart (upper part) is felt by mother, and fetal head has turned which gets caught in the pelvic cavity, also the labour pain becomes more frequent. At this stage she should be made to lie down on the delivery cot and urged to bear down. One of her favourite lady attendants should recite the following ''mantra'' in her ears “May the Earth, the water, the heaven, the light, the wind, Visnu and Prajapati ever protect you and the child and may they guide the delivery. O, auspicious faced one! Bring forth, without distress to yourself or to him, a son who will possess the lustre of Kartikeya and will have the protection of Kartikeya.’’ [39]
</div>
ताश्चैनां यथोक्तगुणाः स्त्रियोऽनुशिष्युः-अनागतावीर्मा प्रवाहिष्ठाः; या ह्यनागतावीः [८] प्रवाहते व्यर्थमेवास्यास्तत् कर्मभवति, प्रजा चास्या विकृता विकृतिमापन्ना च, श्वासकासशोषप्लीहप्रसक्ता वा भवति|
यथा हि क्षवथूद्गारवातमूत्रपुरीषवेगान् प्रयतमानोऽप्यप्राप्तकालान्न लभते कृच्छ्रेण वाऽप्यवाप्नोति [९] ,तथाऽनागतकालंगर्भमपि प्रवाहमाणा; यथा चैषामेव क्षवथ्वादीनां सन्धारणमुपघातायोपपद्यते, तथा प्राप्तकालस्य गर्भस्याप्रवाहणमिति|
सा यथानिर्देशं कुरुष्वेति वक्तव्या स्यात्|
तथा च कुर्वती शनैः पूर्वं प्रवाहेत, ततोऽनन्तरं बलवत्तरम्|
तस्यां च प्रवाहमाणायां स्त्रियः शब्दं कुर्युः- ‘प्रजाता प्रजाता धन्यं धन्यं पुत्रम्’ इति|
तथाऽस्या हर्षेणाप्याय्यन्ते प्राणाः||४०||

tāścaināṁ yathōktaguṇāḥ striyō'nuśiṣyuḥ- anāgatāvīrmā pravāhiṣṭhāḥ; yā hyanāgatāvīḥ [8] pravāhatēvyarthamēvāsyāstat karma bhavati, prajā cāsyā vikr̥tā vikr̥timāpannā ca, śvāsakāsaśōṣaplīhaprasaktā vābhavati|
yathā hi kṣavathūdgāravātamūtrapurīṣavēgān prayatamānō'pyaprāptakālānna labhatē kr̥cchrēṇavā'pyavāpnōti [9] , tathā'nāgatakālaṁ garbhamapi pravāhamāṇā; yathā caiṣāmēva kṣavathvādīnāṁsandhāraṇamupaghātāyōpapadyatē, tathā prāptakālasya garbhasyāpravāhaṇamiti|
sā yathānirdēśaṁ kuruṣvēti vaktavyā syāt|
tathā ca kurvatī śanaiḥ pūrvaṁ pravāhēta, tatō'nantaraṁ balavattaram|
tasyāṁ ca pravāhamāṇāyāṁ striyaḥ śabdaṁ kuryuḥ- ‘prajātā prajātā dhanyaṁ dhanyaṁ putram’ iti|
tathā'syā harṣēṇāpyāyyantē prāṇāḥ||40||

tAshcainAM yathoktaguNAH striyo~anushiShyuH- anAgatAvIrmA pravAhiShThAH; yA hyanAgatAvIH [8]pravAhate vyarthamevAsyAstat karma bhavati, prajA cAsyA vikRutA vikRutimApannA ca,shvAsakAsashoShaplIhaprasaktA vA bhavati|
yathA hi kShavathUdgAravAtamUtrapurIShavegAn prayatamAno~apyaprAptakAlAnna labhate kRucchreNavA~apyavApnoti [9] , tathA~anAgatakAlaM garbhamapi pravAhamANA; yathA caiShAmevakShavathvAdInAM sandhAraNamupaghAtAyopapadyate, tathA prAptakAlasya garbhasyApravAhaNamiti|
sA yathAnirdeshaM kuruShveti vaktavyA syAt|
tathA ca kurvatI shanaiH pUrvaM pravAheta, tato~anantaraM balavattaram|
tasyAM ca pravAhamANAyAM striyaH shabdaM kuryuH- ‘prajAtA prajAtA dhanyaM dhanyaM putram’ iti|
tathA~asyA harSheNApyAyyante prANAH||40||
<div style="text-align:justify;">
The attending women should instruct her thus, “Don’t strain (bear down) when there is no labor pain, because if you do, the efforts may go in vain, and moreover the off spring may be born with deformities or afflicted with diseases like ''shwasa'' (dyspnoea), ''kasa'' (cough), ''shosha'' (emaciation) or ''pleeha'' (spleenic disorders). As when there is no natural urge to sneeze, or pass flatulence, urine or bowel movements, they will not appear or if appear will be with a lot of effort, similarly if the woman strains when there is no labour pain, the foetus will not come out or if at all it comes out, it will be with great difficulty. On the other hand, just as when there is a strong urge to pass bodily wastes, one should not suppress them, not straining when there is acute labor pain will lead to difficult labour. The woman should be advised to follow the following instructions - Initially she should strain (bear down) with mild force, gradually with stronger efforts. While she is bearing down hard, the attendants should keep repeating words such as ‘She has just delivered a worthy son, fortunate son’.Such words make the woman feel happy and motivate her to continue pushing the baby out. [40]
</div>
==== Procedure to remove placenta post-delivery ====

यदा च प्रजाता स्यात्तदैवैनामवेक्षेत- काचिदस्या अपरा प्रपन्ना न वेति|
तस्याश्चेदपरा न प्रपन्ना स्यादथैनामन्यतमा स्त्री दक्षिणेन पाणिना नाभेरुपरिष्टाद्बलवन्निपीड्य सव्येन पाणिना पृष्ठतउपसङ्गृह्य तां सुनिर्धूतं निर्धुनुयात्|
अथास्याः पार्ष्ण्या श्रोणीमाकोटयेत्|
अस्याः स्फिचावुपसङ्गृह्य सुपीडितं पीडयेत्|
अथास्या बालवेण्या कण्ठतालु परिमृशेत्|
भूर्जपत्रकाचमणिसर्पनिर्मोकैश्चास्या योनिं धूपयेत्|
कुष्ठतालीसकल्कं बल्वजयूषे [१] मैरेयसुरामण्डे तीक्ष्णे कौलत्थे व यूषे मण्डूकपर्णीपिप्पलीसम्पाके वा सम्प्लाव्य पाययेदेनाम्|
तथा सूक्ष्मैलाकिलिमकुष्ठनागर विडङ्गपिप्पलीकालागुरुचव्यचित्रकोपकुञ्चिकाकल्कं खरवृषभस्य वा जीवतो [२] दक्षिणंकर्णमुत्कृत्य दृषदि जर्जरीकृत्य बल्वजक्वाथादीनामाप्लावनानामन्यतमे [३] प्रक्षिप्याप्लाव्य मुहूर्तस्थितमुद्धृत्य तदाप्लावनंपाययेदेनाम्|
शतपुष्पाकुष्ठमदनहिङ्गुसिद्धस्य चैनां तैलस्य पिचुं ग्राहयेत्|
अतश्चैवानुवासयेत्|
एतैरेव चाप्लावनैः फलजीमूतेक्ष्वाकुधामार्गवकुटजकृतवेधनहस्तिपिप्पल्युपहितैरास्थापयेत्|
तदास्थापनमस्याः सह वातमूत्रपुरीषैर्निर्हरत्यपरामासक्तां वायोरेवाप्रतिलोमगत्वात् [४] |
अपरां हि वातमूत्रपुरीषाण्यन्यानि चान्तर्बहिर्मार्गाणि [५] सज्जन्ति||४१||

yadā ca prajātā syāttadaivaināmavēkṣēta- kācidasyā aparā prapannā na vēti|
tasyāścēdaparā na prapannā syādathaināmanyatamā strī dakṣiṇēna pāṇinānābhērupariṣṭādbalavannipīḍya savyēna pāṇinā pr̥ṣṭhata upasaṅgr̥hya tāṁ sunirdhūtaṁ nirdhunuyāt|
athāsyāḥ pārṣṇyā śrōṇīmākōṭayēt|
asyāḥ sphicāvupasaṅgr̥hya supīḍitaṁ pīḍayēt|
athāsyā bālavēṇyā kaṇṭhatālu parimr̥śēt|
bhūrjapatrakācamaṇisarpanirmōkaiścāsyā yōniṁ dhūpayēt|
kuṣṭhatālīsakalkaṁ balvajayūṣē [1] mairēyasurāmaṇḍē tīkṣṇē kaulatthē va yūṣēmaṇḍūkaparṇīpippalīsampākē vā samplāvya pāyayēdēnām|
tathā sūkṣmailākilimakuṣṭhanāgara viḍaṅgapippalīkālāgurucavyacitrakōpakuñcikākalkaṁ kharavr̥ṣabhasyavā jīvatō [2] dakṣiṇaṁ karṇamutkr̥tya dr̥ṣadi jarjarīkr̥tya balvajakvāthādīnāmāplāvanānāmanyatamē [3]prakṣipyāplāvya muhūrtasthitamuddhr̥tya tadāplāvanaṁ pāyayēdēnām|
śatapuṣpākuṣṭhamadanahiṅgusiddhasya caināṁ tailasya picuṁ grāhayēt|
ataścaivānuvāsayēt|
ētairēva cāplāvanaiḥ phalajīmūtēkṣvākudhāmārgavakuṭajakr̥tavēdhanahastipippalyupahitairāsthāpayēt|
tadāsthāpanamasyāḥ saha vātamūtrapurīṣairnirharatyaparāmāsaktāṁ vāyōrēvāpratilōmagatvāt [4] |
aparāṁ hi vātamūtrapurīṣāṇyanyāni cāntarbahirmārgāṇi [5] sajjanti||41||

yadA ca prajAtA syAttadaivainAmavekSheta- kAcidasyA aparA prapannA na veti|
tasyAshcedaparA na prapannA syAdathainAmanyatamA strI dakShiNena pANinAnAbherupariShTAdbalavannipIDya savyena pANinA pRuShThata upasa~ggRuhya tAM sunirdhUtaMnirdhunuyAt|
athAsyAH pArShNyA shroNImAkoTayet|
asyAH sphicAvupasa~ggRuhya supIDitaM pIDayet|
athAsyA bAlaveNyA kaNThatAlu parimRushet|
bhUrjapatrakAcamaNisarpanirmokaishcAsyA yoniM dhUpayet|
kuShThatAlIsakalkaM balvajayUShe [1] maireyasurAmaNDe tIkShNe kaulatthe va yUShemaNDUkaparNIpippalIsampAke vA samplAvya pAyayedenAm|
tathA sUkShmailAkilimakuShThanAgara viDa~ggapippalIkAlAgurucavyacitrakopaku~jcikAkalkaMkharavRuShabhasya vA jIvato [2] dakShiNaM karNamutkRutya dRuShadi jarjarIkRutyabalvajakvAthAdInAmAplAvanAnAmanyatame [3] prakShipyAplAvya muhUrtasthitamuddhRutyatadAplAvanaM pAyayedenAm|
shatapuShpAkuShThamadanahi~ggusiddhasya cainAM tailasya picuM grAhayet|
atashcaivAnuvAsayet|
etaireva cAplAvanaiHphalajImUtekShvAkudhAmArgavakuTajakRutavedhanahastipippalyupahitairAsthApayet|
tadAsthApanamasyAH saha vAtamUtrapurIShairnirharatyaparAmAsaktAM vAyorevApratilomagatvAt [4] |
aparAM hi vAtamUtrapurIShANyanyAni cAntarbahirmArgANi [5] sajjanti||41||
<div style="text-align:justify;">
Immediately after the delivery of the child, one should confirm whether the placenta has been expelled out or not. If it is not expelled, then one of the female attendants should forcefully press her abdomen from above the navel region with her right hand and holding her back with left, should give a good shake to the body of the patient. The hip region of the patient should be pressed with the heels and her buttocks should be taken by hand and strongly pressed by the attendant. Her throat should be rubbed with the braid of her hair. The genital tract should be fumigated with the leaves of ''bhurja'' (Betula utilis D. Don.), ''kachamani'' (quartz) and ''sarpanirmoka'' (slough of serpent). She should be given paste of ''kushta'' (Saussurea lappa C. B. Clarke) and ''talisa'' (Abies webbiana Lindl.) mixed with the soup of ''balwaja'' (a hemp-like plant) or strong liquor of ''maireya'' and ''sura''-like beverages for drinking, or the soup of ''kulaththa'' (Dolichos biflorus Linn. - horse gram) or decoctions of ''mandukaparni'' (Centella asiatica Urban.) and ''pippali'' (Piper longum Linn.). The paste of ''laghu ela'' (Elettaria cardamomum Moton.), ''kilima'' (Devadaru – Cedrus deodara Loud.), ''kushta'' (Saussurea lappa C.B. Clarke), ''shunthi'' (Zingiber officinale Rosc.), ''vidanga'' (Embeliaribes Burm f.), ''pippali'' (Piper longum Linn.), ''kalagaru'' (Aquilaria agallocha Roxb. – black variety), ''chavya'' (Piper chaba Junter.), ''chitraka'' (Plumbago zeylanica Roxb.) and ''upakunjika'' (Nigella sativa Linn.)and crushed pieces of the right ear of a living untamed bull, pounding it on grinding stone and keeping it for some time in one of the decoctions of ''Balwaja'' (-?-) etc.;The liquid portion of this decoction should be administered to the patient as a drink. A cotton swab soaked in the oil prepared with ''shatapushpa'' (Foeniculum vulgare Mill.), ''kushta'' (Saussurea lappa C. B. Clarke), ''Madana'' (Randia dumetorum Lam.) and ''hingu'' (Ferula narthex Boiss.) should be inserted into her vaginal passage, and with the same oil, ''anuvasana basti'' (unctuous enema) should be administered to her. The decoction of ''Balwaja''(-?-) should be mixed with apaste of ''madanaphala''(Randia duemtorum Lam.), ''devadali'' (Luffaechinata Roxb.),''ikshvaku'' (Legenaria siceraria Standl.), ''dhamargava'' (Luffa cylindrica M. Roem.), ''kutaja'' (Holarrhena antidysenterica Wall.), ''kritavedhana'' (Luffa acutangula Roxb.) and ''gajapippali'' (Scindapsus officilanlis Schott.) and administered in the form of ''asthapana basti'' (non-unctuous enema).This non-unctuous enema will lead to the expulsion of the retained placenta while passing flatulence, urine and bowel movementsby the downward movement of ''vayu''. Bodily wastes have a tendency to come out of the body naturally, but may get obstructed inside the abdomen, obstructing the ejection of the placenta too. [41]

तस्यास्तु खल्वपरायाः प्रपतनार्थे कर्मणि क्रियमाणे जातमात्रस्यैव कुमारस्य कार्याण्येतानि कर्माणि भवन्ति; तद्यथा-अश्मनोः सङ्घट्टनं कर्णयोर्मूले, शीतोदकेनोष्णोदकेन वा मुखपरिषेकः [१] , तथा स क्लेशविहतान् प्राणान् पुनर्लभेत|
कृष्णकपालिकाशूर्पेण चैनमभिनिष्पुणीयुर्यद्यचेष्टः स्याद् यावत् प्राणानां प्रत्यागमनम् (तत्तत् [२] सर्वमेव कार्यम्)|
ततः प्रत्यागतप्राणं प्रकृतिभूतमभिसमीक्ष्य स्नानोदकग्रहणाभ्यामुपपादयेत्||४२||

tasyāstu khalvaparāyāḥ prapatanārthē karmaṇi kriyamāṇē jātamātrasyaiva kumārasya kāryāṇyētānikarmāṇi bhavanti; tadyathā- aśmanōḥ saṅghaṭṭanaṁ karṇayōrmūlē, śītōdakēnōṣṇōdakēna vāmukhapariṣēkaḥ [1] , tathā sa klēśavihatān prāṇān punarlabhēta|
kr̥ṣṇakapālikāśūrpēṇa cainamabhiniṣpuṇīyuryadyacēṣṭaḥ syād yāvat prāṇānāṁ pratyāgamanam (tattat [2]sarvamēva kāryam)|
tataḥ pratyāgataprāṇaṁ prakr̥tibhūtamabhisamīkṣya snānōdakagrahaṇābhyāmupapādayēt||42||

tasyAstu khalvaparAyAH prapatanArthe karmaNi kriyamANe jAtamAtrasyaiva kumArasya kAryANyetAnikarmANi bhavanti; tadyathA- ashmanoH sa~gghaTTanaM karNayormUle, shItodakenoShNodakena vAmukhapariShekaH [1] , tathA sa kleshavihatAn prANAn punarlabheta|
kRuShNakapAlikAshUrpeNa cainamabhiniShpuNIyuryadyaceShTaH syAd yAvat prANAnAMpratyAgamanam (tattat [2] sarvameva kAryam)|
tataH pratyAgataprANaM prakRutibhUtamabhisamIkShya snAnodakagrahaNAbhyAmupapAdayet||42||

While administering the various procedures described in the preceding verse to remove the placenta from the mother’s body, certain measures should also be performed on the newly born child, such as gently striking the stones near the root of the ear, and sprinkling of cold or hot water over its face, to rejuvenate its vital breath that might have stopped due to distress. If the child is not movingor does not revive, it should then be fanned with a winnowing basket made of bamboo etc. till it regains consciousness (the procedures to be continued till consciousness is established). Once respiration is established and gets normalized, then he should be given a good bath and cleansed thoroughly. [42]
</div>
==== Procedure for cleaning the baby after birth ====

अथास्य ताल्वोष्ठकण्ठजिह्वाप्रमार्जनमारभेताङ्गुल्या सुपरिलिखितनखया सुप्रक्षालितोपधानकार्पाससपिचुमत्या|
प्रथमं प्रमार्जितास्यस्य चास्य शिरस्तालु कार्पासपिचुना स्नेहगर्भेण प्रतिसञ्छादयेत्|
ततोऽस्यानन्तरं सैन्धवोपहितेन सर्पिषा कार्यं प्रच्छर्दनम्||४३||

athāsya tālvōṣṭhakaṇṭhajihvāpramārjanamārabhētāṅgulyā suparilikhitanakhayāsuprakṣālitōpadhānakārpāsasapicumatyā|
prathamaṁ pramārjitāsyasya cāsya śirastālu kārpāsapicunā snēhagarbhēṇa pratisañchādayēt|
tatō'syānantaraṁ saindhavōpahitēna sarpiṣā kāryaṁ pracchardanam||43||

athAsya tAlvoShThakaNThajihvApramArjanamArabhetA~ggulyA suparilikhitanakhayAsuprakShAlitopadhAnakArpAsasapicumatyA|
prathamaM pramArjitAsyasya cAsya shirastAlu kArpAsapicunA snehagarbheNa pratisa~jchAdayet|
tato~asyAnantaraM saindhavopahitena sarpiShA kAryaM pracchardanam||43||
<div style="text-align:justify;">
Thereafter, the palate, lips, throat and tongue of the child should be cleaned with a clean cotton swab using a finger of the attendant, whose nails have been well manicured. After cleaning the mouth, a cotton swab well soaked in oil should be placed over the ''shirastalu'' (anterior fontanel) and then a procedure to provoke vomiting should be administered using ghee with ''saindhava'' (rock salt). [43]
</div>
==== Measuring the umbilical cord ====

ततः कल्पनं नाड्याः|
अतस्तस्याः कल्पनविधिमुपदेक्ष्यामः-नाभिबन्धनात् प्रभृत्यष्टाङ्गुलमभिज्ञानं कृत्वा छेदनावकाशस्य द्वयोरन्तरयोःशनैर्गृहीत्वा तीक्ष्णेन रौक्मराजतायसानां छेदनानामन्यतमेनार्धधारेण [१] छेदयेत्|
तामग्रे सूत्रेणोपनिबध्य कण्ठेऽस्य शिथिलमवसृजेत्|
तस्य चेन्नाभिः पच्येत, तां लोध्रमधुकप्रियङ्गुसुरदारुहरिद्राकल्कसिद्धेन तैलेनाभ्यज्यात्, एषामेव तैलौषधानांचूर्णेनावचूर्णयेत्|
इति नाडीकल्पनविधिरुक्तः सम्यक्||४४||

tataḥ kalpanaṁ nāḍyāḥ|
atastasyāḥ kalpanavidhimupadēkṣyāmaḥ- nābhibandhanāt prabhr̥tyaṣṭāṅgulamabhijñānaṁ kr̥tvāchēdanāvakāśasya dvayōrantarayōḥ śanairgr̥hītvā tīkṣṇēna raukmarājatāyasānāṁchēdanānāmanyatamēnārdhadhārēṇa [1] chēdayēt|
tāmagrē sūtrēṇōpanibadhya kaṇṭhē'sya śithilamavasr̥jēt|
tasya cēnnābhiḥ pacyēta, tāṁ lōdhramadhukapriyaṅgusuradāruharidrākalkasiddhēna tailēnābhyajyāt,ēṣāmēva tailauṣadhānāṁ cūrṇēnāvacūrṇayēt|
iti nāḍīkalpanavidhiruktaḥ samyak||44||

tataH kalpanaM nADyAH|
atastasyAH kalpanavidhimupadekShyAmaH- nAbhibandhanAt prabhRutyaShTA~ggulamabhij~jAnaMkRutvA chedanAvakAshasya dvayorantarayoH shanairgRuhItvA tIkShNena raukmarAjatAyasAnAMchedanAnAmanyatamenArdhadhAreNa [1] chedayet|
tAmagre sUtreNopanibadhya kaNThe~asya shithilamavasRujet|
tasya cennAbhiH pacyeta, tAM lodhramadhukapriya~ggusuradAruharidrAkalkasiddhena tailenAbhyajyAt,eShAmeva tailauShadhAnAM cUrNenAvacUrNayet|
iti nADIkalpanavidhiruktaH samyak||44||
<div style="text-align:justify;">
Thereafter, the umbilical cord is measured. The cord should be marked at a distance of eight angula (thumb-length) from its base where it is attached at the navel of the child, and then holding the cord gently and firmly on both the ends, it should be cut with a sharp half-edged instrument made of gold, silver or iron (steel). The portion of the cord at the navel side should be tied with a thread and then loosely tied to the neck of the child. If the umbilicus end gets suppurated, then it should be anointed with oil prepared with paste of ''lodhra'' (Symplocos racemosa Roxb.), ''madhuka'' (Glycyrrhiza glabra Linn.), ''priyangu'' (Callicarpa macrophylla Vahl.), ''devadaru'' (Cedrus deodara Loud.) and ''haridra'' (Curcuma longa Linn.), and the powder of the same drugs should be sprinkled over the cut surface.
This concludes the verse on the “measurement of the cord”. [44]
</div>
==== Complications arising due to improper cutting of the umbilical cord ====

असम्यक्कल्पने हि नाड्या आयामव्यायामोत्तुण्डिता-पिण्डलिका-विनामिका-विजृम्भिकाबाधेभ्यो भयम्|
तत्राविदाहिभिर्वातपित्तप्रशमनैरभ्यङ्गोत्सादनपरिषेकैः सर्पिर्भिश्चोपक्रमेत गुरुलाघवमभिसमीक्ष्य||४५||

asamyakkalpanē hi nāḍyā āyāmavyāyāmōttuṇḍitā-piṇḍalikā-vināmikā-vijr̥mbhikābādhēbhyō bhayam|
tatrāvidāhibhirvātapittapraśamanairabhyaṅgōtsādanapariṣēkaiḥ sarpirbhiścōpakramētagurulāghavamabhisamīkṣya||45||

asamyakkalpane hi nADyA AyAmavyAyAmottuNDitA-piNDalikA-vinAmikA-vijRumbhikAbAdhebhyo bhayam|
tatrAvidAhibhirvAtapittaprashamanairabhya~ggotsAdanapariShekaiH sarpirbhishcopakrametagurulAghavamabhisamIkShya||45||
<div style="text-align:justify;">
Improper cutting of the umbilical cord and administering of measures explained in the preceding verse could lead to complications such as ''ayamottundita'' (vertical swelling), ''vyayamottundita'' (horizontal swelling), ''pindalika'' (lumpy swellings or formation of a circular ring around the umblicus), ''vinamika'' (swelling in the margins with depression at centre), and ''vijrumbhika'' (swelling with constant increase in size as in umblical hernia). In case of these complications, by carefully observing the severity of the condition (mild to severe involvement of the ''doshas''), it should be treated using massages, unction, and sprinkling of ghee prepared with drugs that are non-irritants and ''vata'' and ''pitta'' pacifying. [45]
</div>
==== Birth-rites per Vedic rituals ====

अतोऽनन्तरं जातकर्म कुमारस्य कार्यम्|
तद्यथा- मधुसर्पिषी मन्त्रोपमन्त्रिते यथाम्नायं प्रथमं प्राशितुं दद्यात्|
स्तनमत ऊर्ध्वमेतेनैव विधिना दक्षिणं पातुं पुरस्तात् प्रयच्छेत्|
अथातः [१] शीर्षतः स्थापयेदुदकुम्भं मन्त्रोपमन्त्रितम्||४६||

atō'nantaraṁ jātakarma kumārasya kāryam|
tadyathā- madhusarpiṣī mantrōpamantritē yathāmnāyaṁ prathamaṁ prāśituṁ dadyāt|
stanamata ūrdhvamētēnaiva vidhinā dakṣiṇaṁ pātuṁ purastāt prayacchēt|
athātaḥ [1] śīrṣataḥ sthāpayēdudakumbhaṁ mantrōpamantritam||46||

ato~anantaraM jAtakarma kumArasya kAryam|
tadyathA- madhusarpiShI mantropamantrite yathAmnAyaM prathamaM prAshituM dadyAt|
stanamata Urdhvametenaiva vidhinA dakShiNaM pAtuM purastAt prayacchet|
athAtaH [1] shIrShataH sthApayedudakumbhaM mantropamantritam||46||
<div style="text-align:justify;">
Thereafter, birth-rites of the child should be performed per vedic rituals, which are as follows: first of all, honey and ghee duly “consecrated” with vedic mantras (chanted by brahmanas or priests) should be anointed to the child. Breast milk should first be fed from the right breast, and should be done so after performing the rituals mentioned above. An earthen pot filled with water should be consecrated with mantras and kept near the head of the child. [46]
</div>
==== Measures to protect the newborn ====

अथास्य रक्षां विदध्यात्- आदानीखदिरकर्कन्धुपीलुपरूषकशाखाभिरस्या गृहं समन्ततः परिवारयेत्|
सर्वतश्च सूतिकागारस्य सर्षपातसीतण्डुलकणकणिकाः प्रकिरेयुः|
तथा तण्डुलबलिहोमः सततमुभयकालं [१] क्रियेतानामकर्मणः [२] |
द्वारे च मुसलं देहलीमनु तिरश्चीनं न्यसेत्|
वचाकुष्ठक्षौमकहिङ्गुसर्षपातसीलशुनकणकणिकानां रक्षोघ्नसमाख्यातानां चौषधीनां पोट्टलिकां बद्ध्वासूतिकागारस्योत्तरदेहल्यामवसृजेत्, तथा सूतिकायाः कण्ठे सपुत्रायाः, स्थाल्युदककुम्भपर्यङ्केष्वपि, तथैव चद्वयोर्द्वारपक्षयोः|
कणककण्टकेन्धनवानग्निस्तिन्दुककाष्ठेन्धनश्चाग्निः सूतिकागारस्याभ्यन्तरतो नित्यं स्यात्|
स्त्रियश्चैनां यथोक्तगुणाः सुहृदश्चानुश्चानुजागृयुर्दशाहं द्वादशाहं वा|
अनुपरतप्रदानमङ्गलाशीःस्तुतिगीतवादित्रमन्नपानविशदमनुरक्तप्रहृष्टजनसम्पूर्णं च तद्वेश्म कार्यम्|
ब्राह्मणश्चाथर्ववेदवित् सततमुभयकालं शान्तिं जुहुयात् स्वस्त्ययनार्थं कुमारस्य तथा सूतिकायाः|
इत्येतद्रक्षाविधानमुक्तम्||४७||

athāsya rakṣāṁ vidadhyāt- ādānīkhadirakarkandhupīluparūṣakaśākhābhirasyā gr̥haṁ samantataḥparivārayēt|
sarvataśca sūtikāgārasya sarṣapātasītaṇḍulakaṇakaṇikāḥ prakirēyuḥ|
tathā taṇḍulabalihōmaḥ satatamubhayakālaṁ [1] kriyētānāmakarmaṇaḥ [2] |
dvārē ca musalaṁ dēhalīmanu tiraścīnaṁ nyasēt|
vacākuṣṭhakṣaumakahiṅgusarṣapātasīlaśunakaṇakaṇikānāṁ rakṣōghnasamākhyātānāṁ cauṣadhīnāṁpōṭṭalikāṁ baddhvā sūtikāgārasyōttaradēhalyāmavasr̥jēt, tathā sūtikāyāḥ kaṇṭhē saputrāyāḥ,sthālyudakakumbhaparyaṅkēṣvapi, tathaiva ca dvayōrdvārapakṣayōḥ|
kaṇakakaṇṭakēndhanavānagnistindukakāṣṭhēndhanaścāgniḥ sūtikāgārasyābhyantaratō nityaṁ syāt|
striyaścaināṁ yathōktaguṇāḥ suhr̥daścānuścānujāgr̥yurdaśāhaṁ dvādaśāhaṁ vā|
anuparatapradānamaṅgalāśīḥstutigītavāditramannapānaviśadamanuraktaprahr̥ṣṭajanasampūrṇaṁ catadvēśma kāryam|
brāhmaṇaścātharvavēdavit satatamubhayakālaṁ śāntiṁ juhuyāt svastyayanārthaṁ kumārasya tathāsūtikāyāḥ|
ityētadrakṣāvidhānamuktam||47||

athAsya rakShAM vidadhyAt- AdAnIkhadirakarkandhupIluparUShakashAkhAbhirasyA gRuhaM samantataHparivArayet|
sarvatashca sUtikAgArasya sarShapAtasItaNDulakaNakaNikAH prakireyuH|
tathA taNDulabalihomaH satatamubhayakAlaM [1] kriyetAnAmakarmaNaH [2] |
dvAre ca musalaM dehalImanu tirashcInaM nyaset|
vacAkuShThakShaumakahi~ggusarShapAtasIlashunakaNakaNikAnAM rakShoghnasamAkhyAtAnAMcauShadhInAM poTTalikAM baddhvA sUtikAgArasyottaradehalyAmavasRujet, tathA sUtikAyAH kaNThesaputrAyAH, sthAlyudakakumbhaparya~gkeShvapi, tathaiva ca dvayordvArapakShayoH|
kaNakakaNTakendhanavAnagnistindukakAShThendhanashcAgniH sUtikAgArasyAbhyantarato nityaM syAt|
striyashcainAM yathoktaguNAH suhRudashcAnushcAnujAgRuyurdashAhaM dvAdashAhaM vA|
anuparatapradAnama~ggalAshIHstutigItavAditramannapAnavishadamanuraktaprahRuShTajanasampUrNaMca tadveshma kAryam|
brAhmaNashcAtharvavedavit satatamubhayakAlaM shAntiM juhuyAt svastyayanArthaM kumArasya tathAsUtikAyAH|
ityetadrakShAvidhAnamuktam||47||
<div style="text-align:justify;">
This verse describes measures to protect the newborn. To start with, the maternity home should be surrounded by the branches of ''adani'' (-?-),''khadira'' (Acacia catechu Willd.), ''karkandhu'' (Zyzyphus nummularia W.&A.), ''pilu'' (Salvadora persica Linn.), and ''parushaka'' (Grewiaasiatica Linn.).''Sarshapa'' (Brassica nigra Linn - mustard seeds), ''atasi'' (Linum ustatissimum Linn.), and ''tandula kanakanika'' (pieces of broken rice) should be spread all over the floors in the maternity home. The sacrificial ritual of offering rice to fire should be performed every morning and evening till the naming ceremony for the child is complete. At the door-sill, a wooden pestle should be kept obliquely. A ''potli'' (bag) containing ''vacha'' (Acorus calamus Linn.), ''kushtha'' (Saussurea lappa C.B. Clarke.), ''choraka'' (Ksaumaka -?-), ''hingu'' (Ferula narthex Boiss.), ''sarshapa'' (Brassica nigra Koch.), ''atasi'' (Linum usitatissimum Linn.), ''lashuna'' (Alium sativum Linn.), ''kanakanika'' (-?-) and other drugs known to be repellents of evil spirits should be tied to the door-sill, and to the necks of the mother and the child , and should also be put into cooking utensils, water jars, bed, and on either side of the door panels. There should be a fire lighted constantly with the fire woods of ''kanakanika'' (-?-), and ''tinduka'' (Diospyros peregrine Gurke.) at the fireplace within the maternity home. The attending women (of the qualities mentioned earlier) should keep vigilance of the maternity home for ten to twelve days. The whole house should be kept busy with people who are pious, affectionate and happy, and kept engaged with gifts, encouraging blessings, praise, song, music food and drinks. In order to bestow auspicious blessings on the mother and the child, ''brahmins'' well versed in Atharva Veda should perform ritual sacrifices in the sacred fire two times a day. These are, rituals and measures that need to be put in place to protect the mother and the child. [47]
</div>
==== Post-partum care of the mother ====

सूतिकां तु खलु बुभुक्षितां विदित्वा स्नेहं पाययेत परमया शक्त्या सर्पिस्तैलं वसां मज्जानं वा सात्म्यीभावमभिसमीक्ष्यपिप्पलीपिप्पलीमूलचव्यचित्रकशृङ्गवेरचूर्णसहितम्|
स्नेहं पीतवत्याश्च सर्पिस्तैलाभ्यामभ्यज्य वेष्टयेदुदरं महताऽच्छेन वाससा; तथा तस्या न वायुरुदरेविकृतिमुत्पादयत्यनवकाशत्वात्|
जीर्णे तु स्नेहे पिप्पल्यादिभिरेव सिद्धां यवागूं सुस्निग्धां द्रवां मात्रशः [१] पाययेत्|
उभयतःकालं चोष्णोदकेन च परिषेचयेत् प्राक् स्नेहयवागूपानाभ्याम्|
एवं पञ्चरात्रं सप्तरात्रं वाऽनुपाल्य क्रमेणाप्याययेत्|
स्वस्थवृत्तमेतावत् सूतिकायाः||४८||

sūtikāṁ tu khalu bubhukṣitāṁ viditvā snēhaṁ pāyayēta paramayā śaktyā sarpistailaṁ vasāṁ majjānaṁ vāsātmyībhāvamabhisamīkṣya pippalīpippalīmūlacavyacitrakaśr̥ṅgavēracūrṇasahitam|
snēhaṁ pītavatyāśca sarpistailābhyāmabhyajya vēṣṭayēdudaraṁ mahatā'cchēna vāsasā; tathā tasyā navāyurudarē vikr̥timutpādayatyanavakāśatvāt|
jīrṇē tu snēhē pippalyādibhirēva siddhāṁ yavāgūṁ susnigdhāṁ dravāṁ mātraśaḥ [1] pāyayēt|
ubhayataḥkālaṁ cōṣṇōdakēna ca pariṣēcayēt prāk snēhayavāgūpānābhyām|
ēvaṁ pañcarātraṁ saptarātraṁ vā'nupālya kramēṇāpyāyayēt|
svasthavr̥ttamētāvat sūtikāyāḥ||48||

sUtikAM tu khalu bubhukShitAM viditvA snehaM pAyayeta paramayA shaktyA sarpistailaM vasAM majjAnaMvA sAtmyIbhAvamabhisamIkShya pippalIpippalImUlacavyacitrakashRu~ggaveracUrNasahitam|
snehaM pItavatyAshca sarpistailAbhyAmabhyajya veShTayedudaraM mahatA~acchena vAsasA; tathAtasyA na vAyurudare vikRutimutpAdayatyanavakAshatvAt|
jIrNe tu snehe pippalyAdibhireva siddhAM yavAgUM susnigdhAM dravAM mAtrashaH [1] pAyayet|
ubhayataHkAlaM coShNodakena ca pariShecayet prAk snehayavAgUpAnAbhyAm|
evaM pa~jcarAtraM saptarAtraM vA~anupAlya krameNApyAyayet|
svasthavRuttametAvat sUtikAyAH||48||
<div style="text-align:justify;">
After the delivery (i.e., in the post-partum period) when the new mother feels hungry and needs nourishment, suitable fatty substances like ghee, oil, and majja (muscle fat or marrow), duly mixed with the powders of pippali (Piper longum Linn.), pippalimula (root of Piper longum Linn.), chavya (Piper chaba Hunter.), chitraka (Plumbagozeylanica Linn.) and shrungabera (Zingiberofficinale Rocs.) should be given to her, according to her status of appetitie. Once she has eaten, she should be given a good massage on her abdomen with ghee and oil and then a big clean cloth should be wrapped around her abdomen so that vayu may not find a place to cause any ailment. Once the food eaten is digested, she should take liquid gruel prepared with pippali (Piper longum Linn.) etc., mixed with unctuous substances in copious amounts. She should take a warm water bath before taking meals, though. This regimen should be continued for five to seven nights. [48]
</div>
तस्यास्तु खलु यो व्याधिरुत्पद्यते स कृच्छ्रसाध्यो भवत्यसाध्यो वा, गर्भवृद्धिक्षयितशिथिलसर्वधातुत्वात्,प्रवाहणवेदनाक्लेदनरक्तनिःस्रुतिविशेषशून्यशरीरत्वाच्च; तस्मात्तां यथोक्तेन विधिनोपचरेत्;भौतिकजीवनीयबृंहणीयमधुरवातहरसिद्धैरभ्यङ्गोत्सादनपरिषेकावगाहनान्नपानविधिभिर्विशेषतश्चोपचरेत्; विशेषतो हिशून्यशरीराः स्त्रियः प्रजाता भवन्ति||४९||

tasyāstu khalu yō vyādhirutpadyatē sa kr̥cchrasādhyō bhavatyasādhyō vā, garbhavr̥ddhikṣayitaśithilasarvadhātutvāt,pravāhaṇavēdanāklēdanaraktaniḥsrutiviśēṣaśūnyaśarīratvācca; tasmāttāṁ yathōktēna vidhinōpacarēt;bhautikajīvanīyabr̥ṁhaṇīyamadhuravātaharasiddhairabhyaṅgōtsādanapariṣēkāvagāhanānnapānavidhibhirviśēṣataścōpacarēt;viśēṣatō hi śūnyaśarīrāḥ striyaḥ prajātā bhavanti||49||

tasyAstu khalu yo vyAdhirutpadyate sa kRucchrasAdhyo bhavatyasAdhyo vA, garbhavRuddhikShayitashithilasarvadhAtutvAt,pravAhaNavedanAkledanaraktaniHsrutivisheShashUnyasharIratvAcca; tasmAttAM yathoktena vidhinopacaret;bhautikajIvanIyabRuMhaNIyamadhuravAtaharasiddhairabhya~ggotsAdanapariShekAvagAhanAnnapAnavidhibhirvisheShatashcopacaret;visheShato hi shUnyasharIrAH striyaH prajAtA bhavanti||49||
<div style="text-align:justify;">
If the mother is afflicted with any disease at this puerperal stage, then the condition becomes either difficult to cure or incurable because her body has suffered throughout pregnancy and parturition; because of providing nourishment for growth and development of fetus as well as discharges of blood and kleda during parturition she is vulnerable to doshic afflictions and various diseases.It is therefore important for a weak mother, or a mother afflicted with sickness to be specifically treated with massages, oil anointments, warm baths, food and drink prepared with drugs that are bhautika (alleviators of evil spirits), and of jivaniya, brimhaniya, madhura and vatahar classes of medications. [49]
</div>
दशमे त्वहनि [१] सपुत्रा स्त्री सर्वगन्धौषधैर्गौरसर्षपलोध्रैश्च स्नाता लघ्वहतशुचिवस्त्रं परिधाय [२] पवित्रेष्टलघुविचित्रभूषणवतीच संस्पृश्य मङ्गलान्युचितामर्चयित्वा च देवतां शिखिनः शुक्लवाससोऽव्यङ्गांश्च ब्राह्मणान् स्वस्ति वाचयित्वाकुमारमहतानां [३] च वाससां सञ्चये प्राक्शिरसमुदक्शिरसं वा संवेश्य देवतापूर्वं द्विजातिभ्यः प्रणमतीत्युक्त्वा कुमारस्य पिताद्वे नामनी कारयेन्नाक्षत्रिकं नामाभिप्रायिकं च|
तत्राभिप्रायिकं घोषवदाद्यन्तस्थान्तमूष्मान्तं वाऽवृद्धं [४] त्रिपुरुषानूकमनवप्रतिष्ठितं, नाक्षात्रिकं तु नक्षत्रदेवतासमानाख्यं [५]द्व्यक्षरं चतुरक्षरं वा||५०||
daśamē tvaha
ni [1] saputrā strī sarvagandhauṣadhairgaurasarṣapalōdhraiśca snātā laghvahataśucivastraṁparidhāya [2] pavitrēṣṭalaghuvicitrabhūṣaṇavatī ca saṁspr̥śya maṅgalānyucitāmarcayitvā ca dēvatāṁśikhinaḥ śuklavāsasō'vyaṅgāṁśca brāhmaṇān svasti vācayitvā kumāramahatānāṁ [3] ca vāsasāṁ sañcayēprākśirasamudakśirasaṁ vā saṁvēśya dēvatāpūrvaṁ dvijātibhyaḥ praṇamatītyuktvā kumārasya pitā dvēnāmanī kārayēnnākṣatrikaṁ nāmābhiprāyikaṁ ca|
tatrābhiprāyikaṁ ghōṣavadādyantasthāntamūṣmāntaṁ vā'vr̥ddhaṁ [4] tripuruṣānūkamanavapratiṣṭhitaṁ,nākṣātrikaṁ tu nakṣatradēvatāsamānākhyaṁ [5] dvyakṣaraṁ caturakṣaraṁ vā||50||

dashame tvahani [1] saputrA strI sarvagandhauShadhairgaurasarShapalodhraishca snAtAlaghvahatashucivastraM paridhAya [2] pavitreShTalaghuvicitrabhUShaNavatI ca saMspRushyama~ggalAnyucitAmarcayitvA ca devatAM shikhinaH shuklavAsaso~avya~ggAMshca brAhmaNAn svastivAcayitvA kumAramahatAnAM [3] ca vAsasAM sa~jcaye prAkshirasamudakshirasaM vA saMveshyadevatApUrvaM dvijAtibhyaH praNamatItyuktvA kumArasya pitA dve nAmanI kArayennAkShatrikaMnAmAbhiprAyikaM ca|
tatrAbhiprAyikaM ghoShavadAdyantasthAntamUShmAntaM vA~avRuddhaM [4]tripuruShAnUkamanavapratiShThitaM, nAkShAtrikaM tu nakShatradevatAsamAnAkhyaM [5] dvyakSharaMcaturakSharaM vA||50||
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On the tenth day of delivery, the woman, along with her child, should take bath in water treated with fragrant herbs, shveta sarshapa (white variety of mustard – Brassica nigra Koch.) and lodhra (Symplocos recemosa Roxb.). They should be dressed in light, new and clean garments, while the woman should also be adorned in pure, light and variegated ornaments. The garments and ornaments should have been consecrated using Vedic rituals, and blessed by priests wearing white garments and without any physical deformities. Then the child, having been wrapped in a new garment, should be placed with his head facing the east or the north. The father of the child should pay obeisance to the Gods and Brahmins on behalf of the child and then give it two names: one denoting the nakshatra under which it was born and the other intended for social interactions. The name for social purpose should have a Ghosha (sonant) for its first letter and for its last a Antastha (semi-vowel) or usman (sibilants and aspirate), should be free of Vriddhi(diphthongs), indicative of one of the three ancestors (father, grandfather and great grandfather) and not a new created The constellar name should be identical to that of the diety of the nakshatra and should be made up of two or four (Sanskrit) syllables. [50]
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==== Assessment of life-span of the baby ====

वृत्ते [१] च नामकर्मणि कुमारं परीक्षितुमुपक्रमेतायुषः प्रमाणज्ञानहेतोः|
तत्रेमान्यायुष्मतां कुमाराणां लक्षणानि भवन्ति|
तद्यथा- एकैकजा मृदवोऽल्पाः स्निग्धाः सुबद्धमूलाः कृष्णाः केशाः प्रशस्यन्ते, स्थिरा बहला त्वक्,प्रकृत्याऽतिसम्पन्नमीषत्प्रमाणातिवृत्तमनुरूपमातपत्रोपमं [२] शिरः, व्यूढं दृढं समंसुश्लिष्टशङ्खसन्ध्यूर्ध्वव्यञ्जनसम्पन्नमुपचितं वलिभमर्धचन्द्राकृति ललाटं, बहलौ विपुलसमपीठौ समौ नीचैर्वृद्धौपृष्ठतोऽवनतौ सुश्लिष्टकर्णपुत्रकौ महाच्छिद्रौ कर्णौ, ईषत्प्रलम्बिन्यावसङ्गते समे संहते महत्यौ भ्रुवौ, समे समाहितदर्शनेव्यक्तभागविभागे बलवती तेजसोपपन्ने स्वङ्गापाङ्गे चक्षुषी, ऋज्वी महोच्छ्वासा वंशसम्पन्नेषदवनताग्रा नासिका,महदृजुसुनिविष्टदन्तमास्यम्, आयामविस्तारोपपन्ना श्लक्ष्णा तन्वी प्रकृतिवर्णयुक्ता [३] जिह्वा, श्लक्ष्णंयुक्तोपचयमूष्मोपपन्नं रक्तं तालु, महानदीनः स्निग्धोऽनुनादी गम्भीरसमुत्थो धीरः स्वरः, नातिस्थूलौ नातिकृशौविस्तारोपपन्नावास्यप्रच्छादनौ रक्तावोष्ठौ, महत्यौ हनू, वृत्ता नातिमहती ग्रीवा, व्यूढमुपचितमुरः, गूढं जत्रु पृष्ठवंशश्च,विप्रकृष्टान्तरौ स्तनौ, असम्पातिनी स्थिरे पार्श्वे, वृत्तपरिपूर्णायतौ बाहू सक्थिनी अङ्गुलयश्च, महदुपचितं पाणिपादं, स्थिरावृत्ताः स्निग्धास्ताम्रास्तुङ्गाः कूर्माकाराः करजाः, प्रदक्षिणावर्ता सोत्सङ्गा च नाभिः, उरस्त्रिभागहीना समा समुपचितमांसाकटी, वृत्तौ स्थिरोपचितमांसौ नात्युन्नतौ नात्यवनतौ स्फिचौ, अनुपूर्वं वृत्तावुपचययुक्तावूरू, नात्युपचिते नात्यपचिते एणीपदेप्रगूढसिरास्थिसन्धी जङ्घे, नात्युपचितौ नात्यपचितौ गुल्फौ, पूर्वोपदिष्टगुणौ पादौ कूर्माकारौ, प्रकृतियुक्तानिवातमूत्रपुरीषगुह्यानि तथा स्वप्रजागरणायासस्मितरुदितस्तनग्रहणानि, यच्च किञ्चिदन्यदप्यनुक्तमस्ति तदपि सर्वंप्रकृतिसम्पन्नमिष्टं, विपरीतं पुनरनिष्टम्|
इति दीर्घायुर्लक्षणानि||५१||

vr̥ttē [1] ca nāmakarmaṇi kumāraṁ parīkṣitumupakramētāyuṣaḥ pramāṇajñānahētōḥ|
tatrēmānyāyuṣmatāṁ kumārāṇāṁ lakṣaṇāni bhavanti|
tadyathā- ēkaikajā mr̥davō'lpāḥ snigdhāḥ subaddhamūlāḥ kr̥ṣṇāḥ kēśāḥ praśasyantē, sthirā bahalā tvak,prakr̥tyā'tisampannamīṣatpramāṇātivr̥ttamanurūpamātapatrōpamaṁ [2] śiraḥ, vyūḍhaṁ dr̥ḍhaṁ samaṁsuśliṣṭaśaṅkhasandhyūrdhvavyañjanasampannamupacitaṁ valibhamardhacandrākr̥ti lalāṭaṁ, bahalauvipulasamapīṭhau samau nīcairvr̥ddhau pr̥ṣṭhatō'vanatau suśliṣṭakarṇaputrakau mahācchidrau karṇau,īṣatpralambinyāvasaṅgatē samē saṁhatē mahatyau bhruvau, samē samāhitadarśanē vyaktabhāgavibhāgēbalavatī tējasōpapannē svaṅgāpāṅgē cakṣuṣī, r̥jvī mahōcchvāsā vaṁśasampannēṣadavanatāgrā nāsikā,mahadr̥jusuniviṣṭadantamāsyam, āyāmavistārōpapannā ślakṣṇā tanvī prakr̥tivarṇayuktā [3] jihvā, ślakṣṇaṁyuktōpacayamūṣmōpapannaṁ raktaṁ tālu, mahānadīnaḥ snigdhō'nunādī gambhīrasamutthō dhīraḥsvaraḥ, nātisthūlau nātikr̥śau vistārōpapannāvāsyapracchādanau raktāvōṣṭhau, mahatyau hanū, vr̥ttānātimahatī grīvā, vyūḍhamupacitamuraḥ, gūḍhaṁ jatru pr̥ṣṭhavaṁśaśca, viprakr̥ṣṭāntarau stanau,asampātinī sthirē pārśvē, vr̥ttaparipūrṇāyatau bāhū sakthinī aṅgulayaśca, mahadupacitaṁ pāṇipādaṁ,sthirā vr̥ttāḥ snigdhāstāmrāstuṅgāḥ kūrmākārāḥ karajāḥ, pradakṣiṇāvartā sōtsaṅgā ca nābhiḥ,urastribhāgahīnā samā samupacitamāṁsā kaṭī, vr̥ttau sthirōpacitamāṁsau nātyunnatau nātyavanatausphicau, anupūrvaṁ vr̥ttāvupacayayuktāvūrū, nātyupacitē nātyapacitē ēṇīpadē pragūḍhasirāsthisandhījaṅghē, nātyupacitau nātyapacitau gulphau, pūrvōpadiṣṭaguṇau pādau kūrmākārau, prakr̥tiyuktānivātamūtrapurīṣaguhyāni tathā svaprajāgaraṇāyāsasmitaruditastanagrahaṇāni, yaccakiñcidanyadapyanuktamasti tadapi sarvaṁ prakr̥tisampannamiṣṭaṁ, viparītaṁ punaraniṣṭam|
iti dīrghāyurlakṣaṇāni||51||

vRutte [1] ca nAmakarmaNi kumAraM parIkShitumupakrametAyuShaH pramANaj~jAnahetoH|
tatremAnyAyuShmatAM kumArANAM lakShaNAni bhavanti|
tadyathA- ekaikajA mRudavo~alpAH snigdhAH subaddhamUlAH kRuShNAH keshAH prashasyante, sthirAbahalA tvak, prakRutyA~atisampannamIShatpramANAtivRuttamanurUpamAtapatropamaM [2] shiraH,vyUDhaM dRuDhaM samaM sushliShTasha~gkhasandhyUrdhvavya~jjanasampannamupacitaMvalibhamardhacandrAkRuti lalATaM, bahalau vipulasamapIThau samau nIcairvRuddhaupRuShThato~avanatau sushliShTakarNaputrakau mahAcchidrau karNau, IShatpralambinyAvasa~ggatesame saMhate mahatyau bhruvau, same samAhitadarshane vyaktabhAgavibhAge balavatI tejasopapannesva~ggApA~gge cakShuShI, RujvI mahocchvAsA vaMshasampanneShadavanatAgrA nAsikA,mahadRujusuniviShTadantamAsyam, AyAmavistAropapannA shlakShNA tanvI prakRutivarNayuktA [3] jihvA,shlakShNaM yuktopacayamUShmopapannaM raktaM tAlu, mahAnadInaH snigdho~anunAdIgambhIrasamuttho dhIraH svaraH, nAtisthUlau nAtikRushau vistAropapannAvAsyapracchAdanauraktAvoShThau, mahatyau hanU, vRuttA nAtimahatI grIvA, vyUDhamupacitamuraH, gUDhaM jatrupRuShThavaMshashca, viprakRuShTAntarau stanau, asampAtinI sthire pArshve, vRuttaparipUrNAyataubAhU sakthinI a~ggulayashca, mahadupacitaM pANipAdaM, sthirA vRuttAH snigdhAstAmrAstu~ggAHkUrmAkArAH karajAH, pradakShiNAvartA sotsa~ggA ca nAbhiH, urastribhAgahInA samAsamupacitamAMsA kaTI, vRuttau sthiropacitamAMsau nAtyunnatau nAtyavanatau sphicau, anupUrvaMvRuttAvupacayayuktAvUrU, nAtyupacite nAtyapacite eNIpade pragUDhasirAsthisandhI ja~gghe,nAtyupacitau nAtyapacitau gulphau, pUrvopadiShTaguNau pAdau kUrmAkArau, prakRutiyuktAnivAtamUtrapurIShaguhyAni tathA svaprajAgaraNAyAsasmitaruditastanagrahaNAni, yaccaki~jcidanyadapyanuktamasti tadapi sarvaM prakRutisampannamiShTaM, viparItaM punaraniShTam|
iti dIrghAyurlakShaNAni||51||
<div style="text-align:justify;">
Once the naming ceremony is over, the life-span of the child is assessed by the priests. The children that live long, according to this verse, have discrete, soft, sparse, oily, firm-rooted and black hair, firm and thick skin, naturally well-endowed, slightly bigger in size, umbrella-like head; broad, firm, even, united well with the temporal bone, endowed with three transverse lines, plump, having wrinkles and half moon-shaped forehead; thick, large, symmetrical ears with even flaps, equal elongated and downwardly depressed at the back, having compact tragus and big meatus; eyebrows that are slightly hanging downwards, disjoined (i.e., separate brows and not a uni-brow), even, compact and large; symmetrical eyes that have sharp vision, have beautiful shape (when viewed from the front and the sides); straight nose, with large nostrils, well ridged and slightly depressed at the tip; mouth big and straight, with good gums (and when the child grows up, a healthy set of teeth); tongue of sufficient length and breadth, smooth in texture and of normal colour; palate smooth, well developed, hot and red; voice sweet, echoing, and tempered; reddish lips that are neither too thick nor thin; large jaws; round, but not very long (or craning) or thick neck; broad and well developed chest; hidden xiphisternum and vertebral column; unbending and stable sides; arms, legs and fingers that are round, developed and long; hands and feet that are big and developed; unafflicted nails, round, unctuous, coppery, high and tortoise shaped; navel that is whirled clockwise and deep; waist 1/3rd less than chest (in breadth), even, having well developed muscles; buttocks round, not too elevated, with firm and developed muscles; thighs tapering downwards, round and well developed; shanks neither too stout nor too thin, but resembling that of deer’s foot, with hidden blood vessels, bones and joints; ankles neither too broad nor too thin; feet possessing the above features and tortoise shaped; and normal functions associated with passing bodily wastes, sexual organs, sleep, abilities to express emotions by smiling, weeping, and appetite through suckling. Other aspects of the child’s body or bodily functions, if with normal features, are desirable.
This sums up the verse on physical features used to assess the longevity of the newborn. [51]
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==== Qualities of the wet-nurse attending the newborn ====

अतो धात्रीपरीक्षामुपदेक्ष्यामः|
अथ ब्रूयात्-धात्रीमानय समानवर्णां यौवनस्थां निभृतामनातुरामव्यङ्गामव्यसनामविरूपामजुगुप्सितां [१]देशजातीयामक्षुद्रामक्षुद्रकर्मिणीं कुले जातां वत्सलामरोगां जीवद्वत्सां पुंवत्सांदोग्ध्रीमप्रमत्तामनुच्चारशायिनीमनन्त्यावसायिनीं कुशलोपचारां शुचिमशुचिद्वेषिणीं स्तनस्तन्यसम्पदुपेतामिति||५२||

atō dhātrīparīkṣāmupadēkṣyāmaḥ|
atha brūyāt- dhātrīmānaya samānavarṇāṁ yauvanasthāṁnibhr̥tāmanāturāmavyaṅgāmavyasanāmavirūpāmajugupsitāṁ [1] dēśajātīyāmakṣudrāmakṣudrakarmiṇīṁkulē jātāṁ vatsalāmarōgāṁ jīvadvatsāṁ puṁvatsāṁdōgdhrīmapramattāmanuccāraśāyinīmanantyāvasāyinīṁ kuśalōpacārāṁ śucimaśucidvēṣiṇīṁstanastanyasampadupētāmiti||52||

ato dhAtrIparIkShAmupadekShyAmaH|
atha brUyAtdhAtrImAnaya samAnavarNAM yauvanasthAMnibhRutAmanAturAmavya~ggAmavyasanAmavirUpAmajugupsitAM [1]deshajAtIyAmakShudrAmakShudrakarmiNIM kule jAtAM vatsalAmarogAM jIvadvatsAM puMvatsAMdogdhrImapramattAmanuccArashAyinImanantyAvasAyinIM kushalopacArAM shucimashucidveShiNIMstanastanyasampadupetAmiti||52||
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This verse describes the qualities of the wet nurse attending the baby. The attending physician should ask of the parents to hire a wet nurse who belongs to the same caste as the child’s mother, who is in her youth, is submissive, free from diseases, not deficient in any limb, not given to unwholesome pursuits, not ugly, not ill- disposed, is native to the country, is not mean or does not indulge in mean acts, affectionate towards children, whose children have not died, who is a mother to a male child, who is never careless, not sleeping in beds soiled with excrement, not married to man of lower caste, skillful in attendance, hygienic and is endowed with plenty of milk in her breasts. [52]
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==== Qualities of an ideal breast ====

तत्रेयं स्तनसम्पत्- नात्यूर्ध्वौ नातिलम्बावनतिकृशावनतिपीनौ युक्तपिप्पलकौ सुखप्रपानौ चेति (स्तनसम्पत्)||५३||
tatrēyaṁ stanasampat- nātyūrdhvau nātilambāvanatikr̥śāvanatipīnau yuktapippalakau sukhaprapānau cēti(stanasampat)||53||

tatreyaM stanasampat- nAtyUrdhvau nAtilambAvanatikRushAvanatipInau yuktapippalakau sukhaprapAnauceti (stanasampat)||53||

These are the features of ideal breasts: they should be neither be very high nor very loose and sagging, neither very lean nor massive. They should have proportionate nipples and be easy to suck. [53]

==== Qualities of the ideal breastmilk ====

स्तन्यसम्पत्तु प्रकृतिवर्णगन्धरसस्पर्शम्, उदपात्रे च दुह्यमानमुदकं व्येति प्रकृतिभूतत्वात्; तत् पुष्टिकरमारोग्यकरं चेति(स्तन्यसम्पत्)||५४||
stanyasampattu prakr̥tivarṇagandharasasparśam, udapātrē ca duhyamānamudakaṁ vyētiprakr̥tibhūtatvāt; tat puṣṭikaramārōgyakaraṁ cēti (stanyasampat)||54||

stanyasampattu prakRutivarNagandharasasparsham, udapAtre ca duhyamAnamudakaM vyetiprakRutibhUtatvAt; tat puShTikaramArogyakaraM ceti (stanyasampat)||54||

Ideal breast milk for the baby has properties such as natural color, smell, taste and touch and when poured into a pot of water, it should mix at once perfectly with the water. Such milk is nourishing and health giving to the child. [54]

अतोऽन्यथा व्यापन्नं ज्ञेयम्|
तस्य विशेषाः श्यावारुणवर्णं कषायानुरसं विशदमनालक्ष्यगन्धं रूक्षं द्रवं फेनिलं लघ्वतृप्तिकरं कर्शनं वातविकाराणां कर्तृवातोपसृष्टं क्षीरमभिज्ञेयं [१] ; कृष्णनीलपीतताम्रावभासं तिक्ताम्लकटुकानुरसं कुणपरुधिरगन्धि भृशोष्णं पित्तविकाराणां कर्तृच पित्तोपसृष्टं क्षीरमभिज्ञेयम्, अत्यर्थशुक्लमतिमाधुर्योपपन्नं लवणानुरसं घृततैलवसामज्जगन्धि पिच्छिलंतन्तुमदुकपात्रेऽवसीदछ्लेष्मविकाराणां कर्तृ श्लेष्मोपसृष्टं क्षीरमभिज्ञेयम्||५५||

atō'nyathā vyāpannaṁ jñēyam|
tasya viśēṣāḥ- śyāvāruṇavarṇaṁ kaṣāyānurasaṁ viśadamanālakṣyagandhaṁ rūkṣaṁ dravaṁ phēnilaṁlaghvatr̥ptikaraṁ karśanaṁ vātavikārāṇāṁ kartr̥ vātōpasr̥ṣṭaṁ kṣīramabhijñēyaṁ [1] ;kr̥ṣṇanīlapītatāmrāvabhāsaṁ tiktāmlakaṭukānurasaṁ kuṇaparudhiragandhi bhr̥śōṣṇaṁ pittavikārāṇāṁkartr̥ ca pittōpasr̥ṣṭaṁ kṣīramabhijñēyam, atyarthaśuklamatimādhuryōpapannaṁ lavaṇānurasaṁghr̥tatailavasāmajjagandhi picchilaṁ tantumadukapātrē'vasīdachlēṣmavikārāṇāṁ kartr̥ ślēṣmōpasr̥ṣṭaṁkṣīramabhijñēyam||55||

ato~anyathA vyApannaM j~jeyam|
tasya visheShAH- shyAvAruNavarNaM kaShAyAnurasaM vishadamanAlakShyagandhaM rUkShaM dravaMphenilaM laghvatRuptikaraM karshanaM vAtavikArANAM kartRu vAtopasRuShTaM kShIramabhij~jeyaM [1] ;kRuShNanIlapItatAmrAvabhAsaM tiktAmlakaTukAnurasaM kuNaparudhiragandhi bhRushoShNaMpittavikArANAM kartRu ca pittopasRuShTaM kShIramabhij~jeyam, atyarthashuklamatimAdhuryopapannaMlavaNAnurasaM ghRutatailavasAmajjagandhi picchilaM tantumadukapAtre~avasIdachleShmavikArANAMkartRu shleShmopasRuShTaM kShIramabhij~jeyam||55||
<div style="text-align:justify;">
The breast milk which does not fit the above description is to considered vitiated and unfit for the child’s consumption. Milk that assumes a darkish or reddish hue, astringent in after-taste, clear, of no marked smell, dry, watery, frothy and light in texture or form, and is not satisfying causes emaciation, gives rise to vatika disorders, and thus, should be considered vata-vitiated. Milk that looks blackish, bluish, yellow, or coppery, has an after-taste which is sour or pungent, which smells like a corpse or like blood, and which is very warm is pitta-vitiated and could cause pittaja disorders. Finally, the milk that is very white, very sweet with a saltish after-taste, that has odour like ghee, oil, flesh-marrow or bone-marrow, is viscid, thready and sinks in water without mixing, gives rise to disorders of kapha and should be considered as kapha-vitiated milk. [55]
</div>
तेषां तु त्रयाणामपि क्षीरदोषाणां प्रतिविशेषमभिसमीक्ष्य यथास्वं यथादोषं च वमनविरेचनास्थापनानुवासनानि विभज्य कृतानिप्रशमनाय भवन्ति|
पानाशनविधिस्तु दुष्टक्षीराया यवगोधूमशालिषष्टिकमुद्गहरेणुककुलत्थसुरासौवीरकमैरेयमेदकलशुनकरञ्जप्रायः स्यात्|
क्षीरदोषविशेषांश्चावेक्ष्यावेक्ष्य तत्तद्विधानं कार्यं स्यात्|
पाठामहौषधसुरदारुमुस्तमूर्वागुडूचीवत्सकफलकिराततिक्तककटुकरोहिणीसारिवाकषायाणां च पानं प्रशस्यते, तथाऽन्येषांतिक्तकषायकटुकमधुराणां [१] द्रव्याणां प्रयोगः क्षीरविकारविशेषानभिसमीक्ष्य मात्रां कालं च|
इति क्षीरविशोधनानि||५६||

tēṣāṁ tu trayāṇāmapi kṣīradōṣāṇāṁ prativiśēṣamabhisamīkṣya yathāsvaṁ yathādōṣaṁ cavamanavirēcanāsthāpanānuvāsanāni vibhajya kr̥tāni praśamanāya bhavanti|
pānāśanavidhistu duṣṭakṣīrāyāyavagōdhūmaśāliṣaṣṭikamudgaharēṇukakulatthasurāsauvīrakamairēyamēdakalaśunakarañjaprāyaḥ syāt|
kṣīradōṣaviśēṣāṁścāvēkṣyāvēkṣya tattadvidhānaṁ kāryaṁ syāt|
pāṭhāmahauṣadhasuradārumustamūrvāguḍūcīvatsakaphalakirātatiktakakaṭukarōhiṇīsārivākaṣāyāṇāṁ capānaṁ praśasyatē, tathā'nyēṣāṁ tiktakaṣāyakaṭukamadhurāṇāṁ [1] dravyāṇāṁ prayōgaḥkṣīravikāraviśēṣānabhisamīkṣya mātrāṁ kālaṁ ca|
iti kṣīraviśōdhanāni||56||

teShAM tu trayANAmapi kShIradoShANAM prativisheShamabhisamIkShya yathAsvaM yathAdoShaM cavamanavirecanAsthApanAnuvAsanAni vibhajya kRutAni prashamanAya bhavanti|
pAnAshanavidhistu duShTakShIrAyAyavagodhUmashAliShaShTikamudgahareNukakulatthasurAsauvIrakamaireyamedakalashunakara~jjaprAyaHsyAt|
kShIradoShavisheShAMshcAvekShyAvekShya tattadvidhAnaM kAryaM syAt|
pAThAmahauShadhasuradArumustamUrvAguDUcIvatsakaphalakirAtatiktakakaTukarohiNIsArivAkaShAyANAMca pAnaM prashasyate, tathA~anyeShAM tiktakaShAyakaTukamadhurANAM [1] dravyANAM prayogaHkShIravikAravisheShAnabhisamIkShya mAtrAM kAlaM ca|
iti kShIravishodhanAni||56||
<div style="text-align:justify;">
If any of the three varieties of vitiated milks described in the preceding verse is in advertently consumed by the child, after ascertaining the specific features of the milk or the symptoms that are associated with a dosha affliction, emetics, purgatives and unctuous and non-unctuous enema specific to that afflicted dosha should be administered. The dietetic guidelines to a woman with vitiated milk are as follows: her food and drink should consist mainly of barley, wheat, sali and shashtika rice, mudga (Phaseolus mungo Linn. - green gram), harenuka (Lathyrus ashaca Linn.), sura, sauviraka, maireya and medaka varieties of wines, lashuna (Alium sativum Linn.) and karanja (Pongamia pinnata Merr.). The milk should be examined at frequent intervals for specific features and the appropriate corrective measures should be adopted. The decoctions of patha (Cissmpelos pareira Linn.), shunthi (Zingiberofficinale Rosc.), devadaru (Cedrusdeodara Loud.), musta (Cyperusrotundus Linn.), murva (Clemaistrilobaheyne ex Roth), guduchi (Tinosporacordifolia Miers.), indrayava (Holarrhenaantidysentrica wall.), kiratatikta (SwertiachirataBuch. -Ham.), katukarohini (Picrorhizakurroa Royle ex Benth.) and sariva (Hemidesmusindicus R. B.) are said to be beneficial. Similarly, other drugs with bitter, astringent, pungent and sweet tastes could also be administered, depending upon the nature of the disorder, dosage and season. [56]
</div>
==== Lactation-stimulants (or galactogogues) ====

क्षीरजननानि तु मद्यानि सीधुवर्ज्यानि, ग्राम्यानूपौदकानि च शाकधान्यमांसानि, द्रवमधुराम्ललवणभूयिष्ठाश्चाहाराः,क्षीरिण्यश्चौषधयः, क्षीरपानमनायासश्च, वीरणषष्टिकशालीक्षुवालिकादर्भकुशकाशगुन्द्रेत्कटमूलकषायाणां च पानमिति(क्षीरजननानि)||५७||

kṣīrajananāni tu madyāni sīdhuvarjyāni, grāmyānūpaudakāni ca śākadhānyamāṁsāni,dravamadhurāmlalavaṇabhūyiṣṭhāścāhārāḥ, kṣīriṇyaścauṣadhayaḥ, kṣīrapānamanāyāsaśca,vīraṇaṣaṣṭikaśālīkṣuvālikādarbhakuśakāśagundrētkaṭamūlakaṣāyāṇāṁ ca pānamiti (kṣīrajananāni)||57||

kShIrajananAni tu madyAni sIdhuvarjyAni, grAmyAnUpaudakAni ca shAkadhAnyamAMsAni,dravamadhurAmlalavaNabhUyiShThAshcAhArAH, kShIriNyashcauShadhayaH, kShIrapAnamanAyAsashca,vIraNaShaShTikashAlIkShuvAlikAdarbhakushakAshagundretkaTamUlakaShAyANAM ca pAnamiti(kShIrajananAni)||57||
<div style="text-align:justify;">
Galactogogues (lactation-stimulants) include the following food articles and habits: all wines with the exception of sidhu, vegetables, cereals and meat of domestic, marshy and aquatic origins; food articles and liquids that have predominantly sweet, sour or salty taste; herbs containing milky juices; cow’s milk; avoidance of laborious tasks, and; drinking of the decoctions of roots of virana (Vetiveria zizanoides Nash.), shashtika (a variety of shali – Oryza sativa Linn.), shali (Oryza sativa Linn.), ikshuvalika (Astercantha longifolia Nees.), darbha (Desmostachya bipinnata Stapf), kusha (Desmostachya bipinnata Stapf), kasha (Saccharum spontaneum Linn.), gundra (Saccharum sara)and Itkata (-?-)(are galactogogues). [57]
</div>
====Procedure to be followed by the wet-nurse in order to feed the baby ====

धात्री तु यदा स्वादुबहुलशुद्धदुग्धा स्यात्तदास्नातानुलिप्ता शुक्लवस्त्रं परिधायैन्द्रीं ब्राह्मीं शतवीर्यां सहस्रवीर्याममोघामव्यथांशिवामरिष्टां वाट्यपुष्पीं विष्वक्सेनकान्तां [१] वा बिभ्रत्योषधिं कुमारं प्राङ्मुखंप्रथमं दक्षिणं स्तनं पाययेत्|
इति धात्रीकर्म||५८||

dhātrī tu yadā svādubahulaśuddhadugdhā syāttadāsnātānuliptā śuklavastraṁ paridhāyaindrīṁ brāhmīṁśatavīryāṁ sahasravīryāmamōghāmavyathāṁ śivāmariṣṭāṁ vāṭyapuṣpīṁ viṣvaksēnakāntāṁ [1] vābibhratyōṣadhiṁ kumāraṁ prāṅmukhaṁ prathamaṁ dakṣiṇaṁ stanaṁ pāyayēt|
iti dhātrīkarma||58||

dhAtrI tu yadA svAdubahulashuddhadugdhA syAttadAsnAtAnuliptA shuklavastraM paridhAyaindrIMbrAhmIM shatavIryAM sahasravIryAmamoghAmavyathAM shivAmariShTAM vATyapuShpIMviShvaksenakAntAM [1] vA bibhratyoShadhiM kumAraM prA~gmukhaM prathamaM dakShiNaM stanaMpAyayet|
iti dhAtrIkarma||58||
<div style="text-align:justify;">
When the wet nurse, having sweet, copious and pure milk, has bathed and anointed herself with fragrant pastes, dressed in white garments and adorned with herbs such as aindri (Citrullus colocynthis Schrad), brahmi (Bacopa monnieri Pennel), shatavirya (Cynodon dactylon Pers.), sahasravirya (a type of Shatavirya), amogha (Emblica officinalis Gaertn.), avyatha (Tinospora cordifolia Miers.)shiva (Terminalia chebula Linn.), vatyapushpi (Sida rhombifolia Linn.) and viswaksenakanta (Callicarpa macrophyla Vahl.), then she should take hold of the baby and, while facing east , feed the baby from the right breast first. These are prescribed duties of dhatri, or the wet nurse attending the baby. [58]
</div>
==== Procedure of construction of nursery ====

अतोऽनन्तरं कुमारागारविधिमनुव्याख्यास्यामः-वास्तुविद्याकुशलः प्रशस्तं रम्यमतमस्कं निवातं प्रवातैकदेशंदृढमपगतश्वापदपशुदंष्ट्रिमूषिकपतङ्गं सुविभक्तसलिलोलूखलमूत्रवर्चःस्थानस्नानभूमिमहानसमृतुसुखंयथर्तुशयनासनास्तरणसम्पन्नं कुर्यात्; तथा सुविहितरक्षाविधानबलिमङ्गलहोमप्रायश्चित्तंशुचिवृद्धवैद्यानुरक्तजनसम्पूर्णम्|
इति कुमारागारविधिः||५९||

atō'nantaraṁ kumārāgāravidhimanuvyākhyāsyāmaḥ- vāstuvidyākuśalaḥ praśastaṁ ramyamatamaskaṁnivātaṁ pravātaikadēśaṁ dr̥ḍhamapagataśvāpadapaśudaṁṣṭrimūṣikapataṅgaṁsuvibhaktasalilōlūkhalamūtravarcaḥsthānasnānabhūmimahānasamr̥tusukhaṁyathartuśayanāsanāstaraṇasampannaṁ kuryāt;tathā suvihitarakṣāvidhānabalimaṅgalahōmaprāyaścittaṁśucivr̥ddhavaidyānuraktajanasampūrṇam|
iti kumārāgāravidhiḥ||59||

ato~anantaraM kumArAgAravidhimanuvyAkhyAsyAmaH- vAstuvidyAkushalaH prashastaMramyamatamaskaM nivAtaM pravAtaikadeshaMdRuDhamapagatashvApadapashudaMShTrimUShikapata~ggaMsuvibhaktasalilolUkhalamUtravarcaHsthAnasnAnabhUmimahAnasamRutusukhaMya<br>thartushayanAsanAstaraNasampannaM kuryAt; tathAsuvihitarakShAvidhAnabalima~ggalahomaprAyashcittaM shucivRuddhavaidyAnuraktajanasampUrNam|
iti kumArAgAravidhiH||59||
<div style="text-align:justify;">
This verse describes the procedure of construction of the nursery. It should be built by a skillful architect and should be sturdy, beautiful, well lighted, protected from draught, well ventilated (with air-entry from only one direction), free from pests, animals, fanged creatures, mice and moths. It should be well accessible to places of water storage, grinding, lavatory, bath and cooking, should be comfortable during all seasons, and furnished with beds, seats and spreads suited to each season. Moreover, protective measures, holy offerings, auspicious rites, and oblations should be performed and the facility should be provided with clean and experienced physicians and with a compassionate and caring staff. Thus, the metod of construction of a child care nursery has been described. [59]
</div>
शयनासनास्तरणप्रावरणानि कुमारस्य मृदुलघुशुचिसुगन्धीनि स्युः; स्वेदमलजन्तुमन्ति मूत्रपुरीषोपसृष्टानि च वर्ज्यानि स्युः;असति सम्भवेऽन्येषां तान्येव च सुप्रक्षालितोपधानानि सुधूपितानि शुद्धशुष्काण्युपयोगं गच्छेयुः||६०||

śayanāsanāstaraṇaprāvaraṇāni kumārasya mr̥dulaghuśucisugandhīni syuḥ; svēdamalajantumantimūtrapurīṣōpasr̥ṣṭāni ca varjyāni syuḥ; asati sambhavē'nyēṣāṁ tānyēva ca suprakṣālitōpadhānānisudhūpitāni śuddhaśuṣkāṇyupayōgaṁ gacchēyuḥ||60||

shayanAsanAstaraNaprAvaraNAni kumArasya mRudulaghushucisugandhIni syuH; svedamalajantumantimUtrapurIShopasRuShTAni ca varjyAni syuH; asati sambhave~anyeShAM tAnyeva casuprakShAlitopadhAnAni sudhUpitAni shuddhashuShkANyupayogaM gaccheyuH||60||
<div style="text-align:justify;">
The bed, seats, spreads and covers meant for the child should be soft, light, clean and perfumed. Sweat and/or excrement-stained or pestilence-infested articles should be disposed off immediately, and if fresh ones are not available the same may be used again only after they have been washed and fumigated thoroughly and rendered perfectly clean and dry. [60]
</div>
धूपनानि पुनर्वाससां शयनास्तरणप्रावरणानां चयवसर्षपातसीहिङ्गुगुग्गुलुवचाचोरकवयःस्थागोलोमीजटिलापलङ्कषाशोकरोहिणीसर्पनिर्मोकाणि घृतयुक्तानि स्युः||६१||

dhūpanāni punarvāsasāṁ śayanāstaraṇaprāvaraṇānāṁ cayavasarṣapātasīhiṅgugugguluvacācōrakavayaḥsthāgōlōmījaṭilāpalaṅkaṣāśōkarōhiṇīsarpanirmōkāṇighr̥tayuktāni syuḥ||61||

dhUpanAni punarvAsasAM shayanAstaraNaprAvaraNAnAM cayavasarShapAtasIhi~ggugugguluvacAcorakavayaHsthAgolomIjaTilApala~gkaShAshokarohiNIsarpanirmokANighRutayuktAni syuH||61||
<div style="text-align:justify;">
For fumigation of the garments, bed, and furnishings the following articles smeared with ghee may be used- barley, mustard, atasi (Linumusitaissimum Linn.), hingu (Ferulanarthex Boiss.), guggulu (Commiforamukul Engl.), vacha (Acoruscalamus Linn.), choraka (Angelicaglauca Edgw), vayahstha (Bacopamonnieri Pennel.), golomi (type of Vacha), jatila (Nardostachysjatamansi D. C.), palankasha (type of Guggulu), ashoka (Saracaindica Linn.), rohini (Picrorhizakurroa royle ex Benth.)and sarpa nirmoka(sloughs of snakes). [61]
</div>

==== Measures for ensuring the child's well-being ====

मणयश्च धारणीयाः कुमारस्य खड्गरुरुगवयवृषभाणां जीवतामेव दक्षिणेभ्यो विषाणेभ्योऽग्राणि गृहीतानि स्युः;ऐन्द्र्याद्याश्चौषधयो जीवकर्षभकौ च, यानि चान्यान्यपि ब्राह्मणाः प्रशंसेयुरथर्ववेदविदः||६२||

maṇayaśca dhāraṇīyāḥ kumārasya khaḍgarurugavayavr̥ṣabhāṇāṁ jīvatāmēva dakṣiṇēbhyōviṣāṇēbhyō'grāṇi gr̥hītāni syuḥ; aindryādyāścauṣadhayō jīvakarṣabhakau ca, yāni cānyānyapi brāhmaṇāḥpraśaṁsēyuratharvavēdavidaḥ||62||

maNayashca dhAraNIyAH kumArasya khaDgarurugavayavRuShabhANAM jIvatAmeva dakShiNebhyoviShANebhyo~agrANi gRuhItAni syuH; aindryAdyAshcauShadhayo jIvakarShabhakau ca, yAni cAnyAnyapibrAhmaNAH prashaMseyuratharvavedavidaH||62||

The following articles should be worn as talismans or amulets by the child: gems, tip of the right horn of a live rhinoceros, deer, gayal or a bull; herbs like aindri, jivaka, rusabhaka, etc., and also all such articles as the brahmins well versed in Atharva Veda may recommend. [62]

क्रीडनकानि खलु कुमारस्य विचित्राणि घोषवन्त्यभिरामाणि चागुरूणि चातीक्ष्णाग्राणि चानास्य प्रवेशीनि चाप्राणहराणिचावित्रासनानि स्युः||६३||

krīḍanakāni khalu kumārasya vicitrāṇi ghōṣavantyabhirāmāṇi cāgurūṇi cātīkṣṇāgrāṇi cānāsya pravēśīnicāprāṇaharāṇi cāvitrāsanāni syuḥ||63||
krIDanakAni khalu kumArasya vicitrANi ghoShavantyabhirAmANi cAgurUNi cAtIkShNAgrANi cAnAsyapraveshIni cAprANaharANi cAvitrAsanAni syuH||63||

The toys of the child should be multicolored, attractive, light, without sharp edges, and incapable of being swallowed. These should make pleasing sounds (i.e., should not be making screechy, loud or disturbing sounds), and should not be fatal to life or disturbing. [63]

न ह्यस्य वित्रासनं साधु|
तस्मात्तस्मिन् रुदत्यभुञ्जाने वाऽन्यत्र विधेयतामगच्छति राक्षसपिशाचपूतनाद्यानां नामान्याह्वयता कुमारस्य वित्रासनार्थंनामग्रहणं न कार्यं स्यात्||६४||

na hyasya vitrāsanaṁ sādhu|
tasmāttasmin rudatyabhuñjānē vā'nyatra vidhēyatāmagacchati rākṣasapiśācapūtanādyānāṁnāmānyāhvayatā kumārasya vitrāsanārthaṁ nāmagrahaṇaṁ na kāryaṁ syāt||64||

na hyasya vitrAsanaM sAdhu|
tasmAttasmin rudatyabhu~jjAne vA~anyatra vidheyatAmagacchati rAkShasapishAcapUtanAdyAnAMnAmAnyAhvayatA kumArasya vitrAsanArthaM nAmagrahaNaM na kAryaM syAt||64||

It is never good to frighten a child. So, if he is found weeping, refusing to eat his meals, or in any other way becoming disobedient, it is not good to take the name of rakshasas (goblins), pishacha (ghost) or putana (harpy) with a purpose of scaring him further. [64]

यदि त्वातुर्यं किञ्चित् कुमारमागच्छेत् तत् प्रकृतिनिमित्तपूर्वरूपलिङ्गोपशयविशेषैस्तत्त्वतोऽनुबुध्यसर्वविशेषानातुरौषधदेशकालाश्रयानवेक्षमाणश्चिकित्सितुमारभेतैनं मधुरमृदुलघुसुरभिशीतशङ्करं कर्म प्रवर्तयन्|
एवंसात्म्या हि कुमारा भवन्ति|
तथा ते शर्म लभन्ते चिराय|
अरोगे त्वरोगवृत्तमातिष्ठेद्देशकालात्मगुणविपर्ययेण वर्तमानः, क्रमेणासात्म्यानि परिवर्त्योपयुञ्जानः सर्वाण्यहितानिवर्जयेत्|
तथा बलवर्णशरीरायुषां सम्पदमवाप्नोतीति||६५||

yadi tvāturyaṁ kiñcit kumāramāgacchēt tat prakr̥tinimittapūrvarūpaliṅgōpaśayaviśēṣaistattvatō'nubudhyasarvaviśēṣānāturauṣadhadēśakālāśrayānavēkṣamāṇaścikitsitumārabhētainaṁmadhu<br>ramr̥dulaghusurabhiśītaś<br>aṅkaraṁ karma pravartayan|
ēvaṁsātmyā hi kumārā bhavanti|
tathā tē śarma labhantē cirāya|
arōgē tvarōgavr̥ttamātiṣṭhēddēśakālātmaguṇaviparyayēṇa vartamānaḥ, kramēṇāsātmyāniparivartyōpayuñjānaḥ sarvāṇyahitāni varjayēt|
tathā balavarṇaśarīrāyuṣāṁ sampadamavāpnōtīti||65||

yadi tvAturyaM ki~jcit kumAramAgacchet tatprakRutinimittapUrvarUpali~ggopashayavisheShaistattvato~anubudhyasarvavisheShAnAturauShadhadeshakAlAshrayAnavekShamANashcikitsitumArabhetainaMmadhu<br>ramRudulaghusurabhishItasha~gkaraM karma pravartayan|
evaMsAtmyA hi kumArA bhavanti|
tathA te sharma labhante cirAya|
aroge tvarogavRuttamAtiShTheddeshakAlAtmaguNaviparyayeNa vartamAnaH, krameNAsAtmyAniparivartyopayu~jjAnaH sarvANyahitAni varjayet|
tathA balavarNasharIrAyuShAM sampadamavApnotIti||65||
<div style="text-align:justify;">
If some illness affects the child, then the physician, after cautiously examining the child, should thoroughly analyze his constitution, etiological factors, premonitory signs and symptoms, and all other factors concerned such as time and place, and then should proceed to treat him by medication that is sweet in taste and smell, soft, light, cold and pleasant. Such measures suit the palate of the children and make the administering of drugs that much easier. As regards a healthy child, the regimen prescribed for regular consumption is the same as that mentioned as code of conduct for the healthy. Following these ensures that the child attains the excellence of strength, healthy complexion, bodily growth and longevity. [65]
</div>
एवमेनं कुमारमायौवनप्राप्तेर्धर्मार्थकौशलागमनाच्चानुपालयेत्||६६||

ēvamēnaṁ kumāramāyauvanaprāptērdharmārthakauśalāgamanāccānupālayēt||66||

evamenaM kumAramAyauvanaprApterdharmArthakaushalAgamanAccAnupAlayet||66||

In this manner the child should be nurtured, from his childhood to his youth, i.e., till he acquires the knowledge and skills necessary for conducting religious activities and leading his livelihood. [66]

इति पुत्राशिषां समृद्धिकरं कर्म व्याख्यातम्|
तदाचरन् यथोक्तैर्विधिभिः पूजां यथेष्टं लभतेऽनसूयक इति||६७||

iti putrāśiṣāṁ samr̥ddhikaraṁ karma vyākhyātam|
tadācaran yathōktairvidhibhiḥ pūjāṁ yathēṣṭaṁ labhatē'nasūyaka iti||67||

iti putrAshiShAM samRuddhikaraM karma vyAkhyAtam|
tadAcaran yathoktairvidhibhiH pUjAM yatheShTaM labhate~anasUyaka iti||67||

Thus all measures that promote the life of one’s progeny have been described for those who aspire to have children. By adopting these measures in the prescribed manner, one who is free from envy and ill-will attains his wishes with regard and honour. [67]

==== Summary ====

तत्र श्लोकौ-
पुत्राशिषां कर्म समृद्धिकारकं यदुक्तमेतन्महदर्थसंहितम्|
तदाचरन् ज्ञो विधिभिर्यथातथं पूजां यथेष्टं लभतेऽनसूयकः||६८||

tatra ślōkau-
putrāśiṣāṁ karma samr̥ddhikārakaṁ yaduktamētanmahadarthasaṁhitam|
tadācaran jñō vidhibhiryathātathaṁ pūjāṁ yathēṣṭaṁ labhatē'nasūyakaḥ||68||

tatra shlokau-
putrAshiShAM karma samRuddhikArakaM yaduktametanmahadarthasaMhitam|
tadAcaran j~jo vidhibhiryathAtathaM pUjAM yatheShTaM labhate~anasUyakaH||68||

Thus, to sum up this chapter, measures described here will fulfill the longing of the individual of desirred progeny and these are of great importance. By taking recourse to these measures in the manner prescribed, a wise man, free from envy or ill-will, is blessed (with a child) according to his wishes. [68]

शरीरं चिन्त्यते सर्वं दैवमानुषसम्पदा|
सर्वभावैर्यतस्तस्माच्छारीरं स्थानमुच्यते||६९||

śarīraṁ cintyatē sarvaṁ daivamānuṣasampadā|
sarvabhāvairyatastasmācchārīraṁ sthānamucyatē||69||

sharIraM cintyate sarvaM daivamAnuShasampadA|
sarvabhAvairyatastasmAcchArIraM sthAnamucyate||69||

This section is known as [[Sharira Sthana]] because it consists of a body of knowledge consisting of all the godly and human aspects of the various phenomena taking place in an individual’s body.

Thus, ends the eight chapter of the [[Sharira Sthana]] of Agnivesha’s work as redacted by Charaka, and also marks the end of the [[Sharira Sthana]] itself. [69]

=== ''Tattva Vimarsha'' ===
<div style="text-align:justify;">
*Posture plays an important role in facilitating the union of the sperm and the ovum. Improper posture may lead to dosha prakopa, or dosha vitiation. Also, physical and mental wellbeing of both partners is essential for successful coitus and furthering one’s lineage. [6]
*Sexual intercourse, when done with happy and joyous mood results in good progeny. Entering the bed by placing the right and left leg first by male and female partners respectively needs scientific exploration. It may merely be auspicious as per rituals. [7] Healthy progeny and succession of lineage, amply supported by recitations of mantra (to invoke the Gods and bless the progeny), was the sole purpose of sexual intercourse. Pleasure and eroticism were not the prime purpose of sexual acts, per the vedic rituals documented. [8]
*For the husband to practice celibacy for the period of one week following his wife’s menstrual period is advised to ensure healthy sperm, in turn helping beget a healthy offspring. During this period specific dietetic, behavioural and psychological regimen are advised to be followed by both the partners for attaining physical and psychological well-being, which will further support conception. [9]
*The ideal time for performing the Putreshti procedure is mentioned as a week or so of cessation of menstrual flow of the female partner, so that ovulation starts. After this they may cohabit for eight nights. [11]
*Predominance of a particular mahabhuta at the time of conception plays an important role in begetting a progeny of desired physique and complexion. [15]
*Psyche of the child to be born is decided by the deeds of the previous life of the individual as well as the mental disposition of the parents at the time of conception and the mental status of the mother during her pregnancy. [16]
*To beget a good progeny, healthy male and female reproductive systems, proper ovulatory cycles and potent seeds are essential. [17]
*Even if all factors and conditions for obtaining a desired progeny are met, the influence of the child’s past (due to the deeds in his previous life) are said to play a critical role in deciding the final outcome. [18] Pumsavana is a measure of begetting a child of desired sex, literally meaning a male child. However, some authors refer to this as a procedure not only for sex selection but for proper implantation, intra uterine growth and development of the foetus as well. [19]
*The herbs indicated for the Pumsavana karma will provide nutritional support to the pregnant woman and thus benefit the mother as well as her growing foetus. [20]
*The principle behind do’s and don’ts advocated during pregnancy is to lead an unaltered normal life with adequate rest, care and good nutrition to attain a healthy progeny. [21]
*Chances of survival of the fetus are less and even if it survives, chances of congenital anomaly are more if bleeding appears during the second or third month. [23]
*Upavishtaka and Nagodara, both suggestive of intrauterine growth retardation (IUGR) result due to improper nutrition to the growing foetus. [26] Proper nutrition will help correct the same. [27] Santarpana chikitsa which are vatahara are to be adopted. [28]
*Garbhini udavarta, a condition caused due to reverse movement of apana vata can have implications during child birth. [29]
*In children, the dosha, dushya etc. causing the disease are the same as that in adults, the only difference being drug dosage. [65]

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

==== Ritukala – Ideal period in menstrual cycle for conception ====

For conception, the period after stoppage of menstruation,i.e., from the 4th day onwards to 12 days corresponding to the 16th day of the menstrual cycle is considered to be the ideal period for impregnation. During the first half of the menstrual cycle, i.e., from 1st day to 14th day, estrogen hormone is dominant, and under its influence, the cervical mucus becomes watery with a high concentration of sodium chloride. This consistency is ideal for spermatozoa to travel through the cervical canal. After ovulation on the 14th day, the formation of corpus luteum leads to the dominance of progesterone hormone, and this leads to change in a characteristic of cervical mucus from watery to viscous because of increased protein content and decrease in sodium chloride. This hampers the migration of sperm in the cervical canal. Hence the ritukala of 12 days in the first half of the cycle is justified.
[[File:gtypemucus.png]] [[File:ltypemucus.png]]
Under effect of progesterone preventing sperm penetration Cervical mucus under estrogenic effect <br>
Source : http://www.naturalfamilyplanning.ie/mucus/gls-p-mucus/<br>

The possible mechanism of sex selection can be understood by knowing the swimming behavior of spermatozoa bearing X and Y chromosome in the female genital tract, as well as evidence suggesting selective penetration of spermatozoa in cervical mucus. The factors affecting the motility of sperms in genital tract are pH, temperature, viscosity, osmolarity, elements and ions. All these evidence suggest that the sex selection may depend on the female genital environment which changes throughout the cycle and hence the specific days of coitus mentioned in text may contribute to the selection of the desired offspring. The concentration of sperm in semen increases if the coitus is performed during alternate days. More the number of Y-bearing spermatozoa, more probability of procuring a male progeny<ref> Skandhan KP, Japee Jasmine: Hypothesis: Who is responsible for the sex of the offspring, Trends in Medical Research; 2011 </ref>.

==== Selection of Suitable partner for conception ====

In Ayurveda classics, the preparation of procuring healthy progeny begins with the selection of a partner. For a healthy progeny with longevity and desired traits, both partners should be of reproductive age without any physical or mental disease or chronic illness. Conception in older age is associated with genetic abnormalities like Down’s syndrome and rare chromosomal abnormalities like Patau's syndrome and Edward's syndrome in the offspring. Increased maternal age may also lead to the poor outcome of pregnancy. Conception during illness may result in congenital anomalies or growth retarded fetus. Research has shown risks of low birth weight, premature labor, anemia, and pre-eclampsia are related to the biological age<ref> CM Gibbs et al, The Impact of Early Age at First Childbirth on Maternal and Infant Health, 2012, PMID:22742615 </ref>.

Ideal position for coitus and factors affecting conception:
In the prone position, pressure on abdomen affects the natural movement of vata dosha, while the left-lateral position stimulates the enzyme secretions in the gut and leads to pitta prakopa. Therefore, a comfortable, supine position is recommended for coitus for conception, as all body humors are in their proper positions. A sprinkling of cold water or cold compresses of vulva after coitus is useful to prevent the reverse flow of semen from the female genital tract. Mental comfort, urge for sex and willingness for sex with the same partner are very important factors for the conception and formation of a healthy fetus. As neuro-endocrinal harmony is essential during the act of coitus, one should be free of urges or thoughts of hunger, thirst, passing flatulence, urination or bowel movements, and should be free from emotions like stress, anger, anxiety while having sexual intercourse.

==== Ambiance for coitus ====

The importance of ambiance in stimulating desire in a couple to perform sex, and thus, conceive a healthy child, is expressly mentioned in this chapter. Articles or experiences pleasant to the sensory organs (such as using fragrant objects, pleasing or arousing music or sound, articles pleasant in taste or touch) in a stimulating environment play a very important role in arousal and act as aphrodisiacs, per Ayurvedic texts.

==== Effect of chanting mantras ====

Keeping the body and its doshas in harmony with its environment are essential to good conception, as it is with staying healthy, per Ayurvedic texts. This is consistent with the vedic concept of Yatha Pinde Tatha Brahmande (As the Body, so the Universe) – that problems occur when there is disequilibrium between the body and its surroundings.

Chanting and reciting mantras have an effect on neuro-endocrinal homeostasis<ref> Claire Braboszcz, Stephanie Hahusseau, Arnaud Delorme Meditation and Neuroscience: From Basic Research to Clinical Practice, 2010, Springer Publishing </ref>. Hence chanting or reciting mantras or shlokas is recommended for maintenance of a psychosomatic balance of the body. In Vedic rituals, shloka (sacred hymns) to be chanted are said to invoke Lord Brahma, the creator of the universe and the progenitor of all the activities of the universe, Lord Brihaspati, the power behind every activity, Lord Vishnu, the preserver of the universe, Soma and Agni, the prime principles in all living beings, Ashvinau, the symbol of health and well-being in every creature, and Mitra and Varuna, the forces necessary to sustain life in the universe. Therefore, vedic scriptures, including Ayurvedic texts, emphasize on paying one’s obeisance to deities and forces of the universe, in the form of Gods, if one desires a healthy offspring.

Chanting of mantras is known to have physical, mental and spiritual benefits. Mantra chanting form the basis of yogic meditation practices to help calm one’s mind and ease anxieties, which could have adverse effects on one’s progeny. Ayurveda science also mentions the role of the atma, along with the union of sperm and ovum, as a prerequisite, in the formation of the garbha. For the atma (of the newborn) to be of best satva and good prior karma, the ambiance and environment of the area should be spiritual, and chanting helps in creating such an environment.

==== Do’s and Dont’s before coitus ====

This chapter provides a detailed list of Do’s and Don’ts that could help a couple conceive a healthy child. These rules or guidelines address various aspects of the couple’s lifestyle – including their diet, their environment – and their health. Traditional rituals and guidelines such as staying pious (and not indulging in immoral thoughts or actions) and being in the company of spiritual or virtuous individuals have been adviced, especially for the expecting mother.

==== Preparation for putreshthi yajna and its benefits ====

Cultures around the world, especially in the eastern countries, practice various rituals to get a healthy offspring. While these rituals and customs are considered essential, their validity from the standpoint of scientific studies have not yet been established. Cultural traditions, however, do provide some much-needed assurance during this period of anxiety and should be continued according to tradition. The physical, psychological, social and spiritual wellbeing of the couple desirous of having progeny is very important - and this is facilitated through rituals. All the regimen and rituals also favor a planned pregnancy instead of an accidental pregnancy. A planned pregnancy ensures a proper physical, psychological, financial and social status.

==== Regimens and factors affecting desired progeny ====

For getting the desired result (i.e., a healthy progeny of the desired traits), one has to apply the factors either in the form of the same element (dravya samanya) or the elements having similar constitution and properties (guna samanya) or similar the effort (karma samanya), giving the similar to get similar output. All the above mentioned dietary, ritualistic practices, and do's and don'ts need to be of the desired dravya, guna and karma samanya to get the desired result, i.e., healthy and long living progeny with good complexion and intelligence. Whatever the mother sees, tastes, touches, feels, thinks and the way she behaves or thinks socially or spiritually has a deep impact on the future temperament and behavior of the child. A popular example of this ‘karma based garbha samskara’ is the mythological story of Abhimanyu, the warrior son of Arjuna, in the Mahabharata. Abhimanyu, even when he was a fetus in his mother (Subhadra)’s womb, learned the technique of entering the Chakravyuha (a special type of battle formation) from his maternal uncle Lord Krishna. If the mother takes dravya having predominant jala mahabhuta dravya, there will be an increase in the kapha dhatu of the fetus, giving it a fair complexion. Similarly, other mahabhuta-dominant dravyas contribute to other types of complexions in the baby.
In Korea, for prenatal development, expectant mothers are advised to do certain practices called ‘Taegyo.<ref> Lee, Yuna, Lee, Jiyoung, Korean Traditional Taegyo Prenatal Education based on Sajudang Lee’s “Taegyo Singi”, 2016, International Journal of Childbirth Education, Pg 34-37 </ref>' Expectant mothers are advised to stay calm, avoid evil thoughts, listening to soft music, reading inspiring stories aloud, staying vigilant of surroundings and prudent in speech and action. Following these practices provides a safe and healthy environment for the fetal development.
Research in Pre-natal education

Researchers have been studying the effect of external sensory experiences on the brain activities of infants. In one instance, researchers found enhanced brain activity in infants exposed to “novel word sounds” played everyday during the third trimester.<ref> Partanen, Eino et al, Prenatal Music Exposure Induces Long-Term Neural Effects, 2013, PLoS One, doi: 10.1371/journal.pone.0078946 </ref>

==== Effects of karma of the progeny’s prior birth ====

As explained in this chapter, with the effect of karma samanya there is garbha sanskara on the fetus inside the mother’s womb. Therefore, the birth of an individual in any race depends on the karma of the parents and the karma from the child’s previous life. According to Charaka, an individual goes through the cycle of birth and death according to Karma Siddhanta. In fact, the birth of an individual has multiple facets like poorvakarma, matrija karma, pitrija karma, garbhadhana, garbhini paricharya and much more. One should not forget the effect of, i.e., karma on the fetus, the mother, and the father. Therefore, in spite of following of all do’s and don’ts strictly, there can be bad progeny because of it's (and the parent's) karma.

==== Factors for healthy progeny ====

As explained earlier, according to yukti pramana, the formation of garbha is multidimensional and requires normalcy of all components i.e. fertile period, healthy uterus, sufficient and healthy nutrients, and most importantly, healthy gametes.

==== Maintenance of products of conception ====

Stha or tishthati means to stay or remain in position. For sustaining a pregnancy, proper nourishment with adequate hormone status is essential. As mentioned in verse 20 of this chapter, herbs such as aindra, brahmi, satavirya, etc. help nourish the fetus, while Jivaniya herbs used regularly by the mother help achieve a healthy outcome of pregnancy.

==== Factors causing harm to the embryo ====

Numerous factors that may hamper sustaining the pregnancy or cause abnormalities in the progeny have been described in this chapter. These factors can be classified as dietary, lifestyle, traumatic, psychological and spiritual factors. Observance of these avoidable factors leads to growth retardation, the death of the fetus, premature birth, illness or congenital malformations to the offspring. Research seems to indicate that emotional stress to the mother can lead to prenatal or postnatal complications of various types<ref> Stephen Maret, Introduction to Prenatal Psychology, 2011, Church Gate Books ISBN: 9780578089980 </ref> . Dietary habits and lifestyle may lead to neurohormonal changes which affect pregnancy and its outcome<ref> Calvin Hobel, Jennifer Culhane, Role of Pyschosocial and Nutritional Stress on Poor Pregnancy Outcome, 2003, J.Nutr., vol 133 no. 5 1709S-1717S </ref> . Similar faulty habits by the father can also cause abnormalities of spermatozoa which in turn leads to congenital anomalies in offspring.

==== Precaution for the treatment of disorders in pregnant females ====

As explained by Charaka, a pregnant woman is like a vessel full of oil and should be treated with care, meaning that all doshas, dhatu, mala and ojas of the pregnant woman are at such a critical physiological stage that if one does not attend to her in a timely and proper way it may lead to damage to the foetus or the mother or both. Hence the disorders which may occur during pregnancy are to be treated with special care. For the antenatal mother, the diet or medications which should be used for curing any ailment should be mild and effective. Panchakarma treatment, because of its use of invasive and strong medicines, is to be avoided. Basti and abhyanga to kati are advocated in the eighth month of pregnancy, and these are comparatively safer procedures and may also help in a normal labor. During the eighth month, the fetus is sufficiently developed and viable, and even if the mother gets labor pain while undergoing treatment (mild to aggressive courses, as the need may be), the fetus can be preserved, and there are fewer chances of compromising fetal life.
The effects of drug use during pregnancy on the fetus has been researched and documented. The mother as well the fetus, if subjected to certain drugs /treatment, can lead to side-effects on either or both. FDA has specified a certain list of drugs (X category) which are contraindicated during pregnancy <ref> https://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/labeling/ucm093307.htm
Ix Gawade T, Ghorpade M, Effect of bala siddha taila anuvasana basti on labour pains; Ayurlog: National journal of Research in Ayurveda science’ Vol 3, Feb 2015
</ref>. In Ayurveda, the principles of antenatal treatment are given for shamana as well as shodhana, other drugs and treatment are contraindicated. In practice, for any ailments occurring during pregnancy, herbal medicines are preferred over herbo mineral medicines.

==== Disorders of the fetus and its treatment ====

Following are the common disorder of fetus, abortion, followed by intrauterine growth retardation and intrauterine death:

===== Factors responsible for abortion and its treatment =====

First-trimester abortion is seen in about 80% of total abortions. Any bleeding during the first trimester (up to 12 weeks) may either end in inevitable abortion, preterm labor and in rare cases may proceed to full term. Emotional factors like severe anger, stress, jealousy all are suspected to cause the high release of CRH (Corticotropin-releasing hormone) which may trigger uterine contractions.
Uterine bleeding from implantation site or deciduas may be triggered because of coitus, trauma, exercise and faulty regimen. Bleeding may further release prostaglandins which could trigger uterine contractions and hence abortion.
Management of such condition is aimed at relieving uterine contractions and bleeding. Since there are vata and shonita dushti in abortion, treatment should follow the principle of vatarakta chikitsa viz. sheeta and snigdha lepa, and brimhana, vatahara, raktavardhaka diet, and drugs. Sura (alcohol-containing preparations) is mainly advised to relieve the pain and to increase the hemopoiesis.

As explained earlier, garbhapata (abortion) due to ama dosha (during the first trimester) is very critical to treat. Treatment of ama dosha is apatarpana while that of garbha and garbhini needs santarpana, which are antagonistic and hence very tedious to treat. In practice, Madhura varga dravyas such as shatavari (Asparagus racemosus) and medicated ghee phalaghrita are used in case of threatened abortion. These promote proper nourishment and growth and stop bleeding.

===== Growth retardation of fetus and its treatment =====

Intrauterine growth retardation of the fetus occurs due to malnourishment of mother as well as pregnancy disorders which cause vaginal discharge and bleeding. According to severity, they are categorized as garbhashosha (mentioned in Charaka Sharirsthana 2nd chapter) upavishtaka, nagodara, lina garbha (not directly mentioned but clinical features with the absence of movements of fetus suggest this condition). These conditions occur either because of improper nourishment of mother with vata and pitta dominant diet or because of decreased transfer of nutrients from mother to fetus as a consequence of fetal metabolic disorder or placental abnormality. The treatment principle applicable here is brimhana supplying nourishment to mother and fetus.
All the dietary articles mentioned in the management have vatahara and dhatupushtikara properties, as there are vataprakopa and dhatukshya in these conditions. In the case of lina garbha, there is the absence of fetal movements, to expel such fetus, treatments which increase uterine contractions and induce labor are indicated because such fetus resembles fetus papyraceous or mummified fetus.
Practically the herbs used in fetal growth restriction are yashtimadhu, shatavari, gambhari and preparations like phalghrita, laghumalinivasanta. These herbs and preparations are rasayana and improve dhatvagni and rasa dhatu nirmana. They also help in clearing any obstruction in the channels (srotas) which are supplying nourishment to the fetus through the mother. As mentioned in classics, ksheer basti given to the mother in severe IUGR conditions stimulates fetal growth.

===== Garbhini Udavarta and its management =====

As a result of progesterone hormone which relaxes all the smooth muscles, there is decreased bowel and intestinal movements. Especially during the later months of pregnancy, along with progesterone, the pressure of the uterus on intestines and rectum leads to decreased peristalsis. This is observed most commonly during the 8th month. Garbhini udavarta is a similar condition with constipation and gaseous distention. This condition is to be relieved as straining for defecation may lead to hemorrhoids, bleeding hemorrhoids and leaking of membranes. Medicated enema of decoction is to be administered to clear the bowel as oral medications may aggravate uterine contractions. Enema with oil should be administered afterward for oleation of the tract, and this may further help in the formation of canal/pathway for parturition.

The position in pregnancy to administer basti is nyubja sthithi – hunchback /flexed posture. Conventionally, the left-lateral position is used. In nyubja sthithi, the fetus moves in a ventral position relieving the pressure on colon and rectum, making it easy for basti to be administered and reach descending colon easily.

===== Mrita garbha (intrauterine death) and its management =====

All the factors which are contraindicated during pregnancy and are known to cause harm to the fetus, if continued by the mother can cause upavishtaka, nagodara, garbhashosa. If left untreated, excessive accumulation of doshas with maternal illness may lead to placental insufficiency and fetal disorders where it fails to metabolize nutrients and causes fetal death. The symptoms of mritagarbha (fetal death) also signify causes as antepartum hemorrhage, hypovolemia and its complications in the mother. [30]

To expel the dead fetus, the treatments to be administered are to initiate uterine contractions and induce labor. If necessary surgical treatment for removal of a dead fetus is also believed to save the mother from serious complications like DIC (disseminated intravascular coagulopathy) may occur if fetal fibrin is absorbed in maternal circulation. After the removal of the dead fetus, the physician should administer sura varga (alcoholic preparations) for the relief of pain and purification of the gut and genito-urinary system and also for the sense of exhilaration. Loss of fetus in such a later stage can be very stressful for mother and anxiety, depression and other psychotic complications may arise if proper care is not taken. Once there is complete shuddhi of koshtha and garbhashaya, one should give brimhana treatment to promote tissue bulk and nutrition. As there is the removal of the kleda from all dhatus during the management and shuddhi, santarpana is very essential.

==== Monthly regimen during pregnancy ====

Regular intake of recommended diet and daily routine is essential for fetal growth as well as maternal well-being. Daily use of milk and milk products is an important aspect of garbhini paricharya. Milk can nourish all body tissues and is considered a wholesome diet, fulfilling the requirement of fetal as well as maternal growth. Milk is sheeta, snigdha, and madhura and increases the ojas in the body. Ojas is said to be the essence of all body tissues and revitalizes to produce new body elements. The regimen is rich in proteins as well as carbohydrates which are essential for fetal growth and development. Due care is taken while prescribing the regimen to prevent vata prakopa. Disturbance in vata balance may cause many diseases of the fetus as well as the mother. From the eighth month onwards, the preparation of birth canal for pariturition begins and also there is the descent of fetal presenting part in the pelvis. To relieve the symptoms of this pressure on pelvis and augment the formation of lower segment, to prepare cervix to become ripe and easily dilatable, basti and pichu (vaginal tampon) of oil are advised. ix Basti keeps vata dosha balanced & its gati in anulom (downward) direction, preventing the obstruction in the path of vata dosha to help the process of labor, natural and in ease.

Antenatal patients are prescribed Ayurvedic regimen throughout pregnancy with proper diet advice. The medicines given are shatavari, phalghrita especially during the first trimester.

Use of a herbomineral preparation Garbhapala rasa because of its lead content is under controversy. Appropriate preparation of this herbominearal compound following Ayurvedic Formulary of India ensures proper development of the fetus and prevents bleeding and threatened abortion during the first trimester. Along with the physical development of the fetus, the spiritual and psychological development is also taken care of. Given this, the do's and don't's includes visiting scenic and places of interest, associating with likable people, eating prescribed diet, reading and listening to interesting stories are advised.

The lifestyle, diet, exercise, synthetic drugs, food additives like artificial colors, preservatives, the onslaught of electromagnetic radiations have become an integral part of the day today life (ref:https://infoayushdarpan.wordpress.com/2017/01/18/the-role-of-masanumasik-formulations/). This affects the growth and development of the fetus. Decoctions made in the form of Ghana vati as mentioned by Ashtanga and Sushruta are used as a monthly treatment for all antenatal patients which facilitate proper nourishment and hence the growth of fetus preventing any illness. Research has shown that application of matra basti and yoni pichu of Bala tssail given from the first day of 9th month results in normal labor without prolongation with spontaneous onset Ref. Also, it reduces postpartum complications like a backache, lower abdominal pain, and abdominal distention.

Kikkisa (striae gravidarum) which occurs on abdominal and breast area due to itching is to be treated with local application of drugs which relieves itching and burning sensation. Also, certain herbs are varnya in nature i.e. to improve color and complexion of skin. Ointments, oil, and lepa are prepared from these formulations and prescribed to mother to apply on abdominal area, thighs, and breast from the second month itself to prevent kikkisa.

Care during 9th month of pregnancy: Instead of suitiikagara, what special care of pregnant lady is advised by Ayurvedic obstretian at home before she goes into labor should be described. What instructions are given when labor pain starts?

==== Management of Labor ====

Instead of moving the mother after the labor pain starts, she is shifted to the delivery abode (sutikagara) at the onset of the ninth month. The entry is a ritual and done on auspicious day and timing to ensure the successful and uneventful outcome of pregnancy and parturition without any untoward complications. Symptoms and signs which signify formation of the lower segment with uterine contractions and cervical dilation indicate the onset of labor. As soon as the onset of labor is determined, the counseling and observation of mother are to be with while she is lying down.

To ensure proper progress of labor or when the uterine contractions are not strong, to favor descent of presenting part of the fetus, the mother is advised to walk around. She is also given herbs which are known to have the property of enhancing uterine contractions, in inhalation or fumigation form for quick absorption. Application of lepa made of pippali and vacha churna on abdominal area enhances the intensity of contractions. They are also helpful in prolonged labor caused by weak contractions. Langali, though not abundantly available, tying its roots or applying its lepa also gives such desired effects.

The intensity of increased labor pain and the onset of gripping pain in lower pelvis signifies further descent of fetus and full dilatation of the cervix. The bearing down efforts is encouraged in lying down position. Chanting also encourages the mother to bear down properly.

The proper timing of bearing down is full dilatation and presence of intense pain (uterine contractions). The two forces, voluntary (which are maternal bearing down effort) and involuntary (uterine contractions), when combined, lead to further descent and expulsion of a fetus with birth passage properly formed after full dilatation of the cervix. Expulsion of the fetus is controlled by apana vayu located in shroni (pelvis). If there is no movement of apana vayu and the mother bears down, it causes vata prakopa and leads to vikata navajata (baby born with deformities). Secondly, whenever there is an appropriate movement of apana vayu, but the woman suppresses that urge to bear down, that too leads to vata prakopa and causes deformities in the baby, the formation of caput succedaneum and fetal distress, both occur as a result of premature bearing down efforts and absence of bearing down respectively. The consequence of premature bearing down has increased the incidence of remote complication like vaginal and uterine prolapse.

After the birth of a baby, in the case of retained placenta, the therapies administered are to increase uterine contractions and increase intra-abdominal pressure for placental detachment and descent in the vagina. All these measures, along with basti, are vatahara and are vata shamaka measures for the restoration of prakrita gati of vata dosha to expel out the placenta along with stool and urine.

==== Care of the Newborn ====

Resuscitation of a newborn is the initial step and is called Pranapratyagaman Vidhi. There is a prescribed sequence for the clearing of mucous secretions from the oral cavity. First the palate, then the inner aspect of lips, kantha (pharynx), and the Jivha (tongue) should be cleaned. Once the secretion is cleared from the palate, it facilitates the air entry in the pharynx easily. Clearing of pharynx clears the air passage and finally clearing of tongue removes the amniotic fluid and mucous which sticks to the tongue. Nowadays, a neonatal care practice is to clear up the secretion with a suction apparatus first from the mouth and then through the nose. The reason for removing secretions from the mouth first is to prevent the aspiration of more copious oral secretions than nasal secretions. Emesis with ghee and rock salt prescribed in the past is not done. Modern practice is to do gastric suction.
Once the baby is breathing well next step is to cut the umbilical cord under aseptic conditions to prevent serious complication of stump infection. This is followed by application of oil and dry powders with antiseptic and drying property. All these measures are to prevent infection in the umbilical stump, early fall of the umbilical cord, healthy healing of the wound after the fall of the cord stump and for prevention of complications like omphalocele, etc. Lodhra, madhuka, priyamgu, suradaru, and Haridra, etc. are drugs that have kashaya and astringent properties to remove excessive moisture and prevent infection, since dry conditions favor the early separation of stump. Oil made up of the same drugs has antimicrobial and wound healing properties and prevents moisture and microbes. The wrong method of cutting of cord and improper care of the cord leads to complications.

==== Samskara After birth ====

Ayurveda Acharyas follow some medicinal practices in combination with ritualistic customs. The very first feed to the baby should be applied in a ritualistic and hygienic way. Therefore, in jatakarmasamskara, the father has to take a bath before holding the baby, followed by reciting mantras softly in the ear of the baby, followed by making the baby lick gold with honey and ghee. Licking initiates swallowing movement in the newly born baby, and once such sucking and swallowing movements start, it is safe to initiate breastfeeding. Breastfeeding is recommended immediately after birth since breastmilk provides colostrum (stanya piyusha) which gives the baby ample amount of protein, cholesterol, and immunoglobins. Colostrum is said to be essential for the growth of brain and memory of the baby. Cholesterols in the colostrum have essential linoleic fatty acids and various species-specific properties that are essential for nervine and enhancement of immunity. According to the recent practice of neonatal care, breastfeeding should be initiated within 15 minutes after birth, in the case of normal labor, and within 2 hours of birth in case of cesarean section. Precautions should be taken to prevent neonatal sepsis. Are ther any special ayurvedic ways being used now?

==== Prescribed post-partum measures for women ====

Parturition and postpartum phase cause significant changes physiologically, psychologically and anatomically especially, in her hormones and the neuro-endocrinal axis. All dhatus of the mother are at a low ebb (kshaya) during labor, and therefore there is vata prakopa and agnimandya. Therefore, in the postpartum phase, a physician should administer vatahara, deepana, and brimhana upakrama and should help restore the woman’s body tissues in a systematic manner, taking care of her digestive capacity. To regain homeostasis, the regimen of diet for first ten days postpartum are prescribed.
The measures prescribed in these texts are for the woman after delivery to transition from the effects of labor into a state of normalcy and good health smoothly. These measures help in the involution of the uterus and pelvic cavity, contraction of the distended abdomen, and help in restoring digestion. Immediate care will help in easing the fatigue of labor too. Experienced practitioners endorse these measures clinically.

Within ten days of childbirth, the uterus returns to its normal size and shape, the lochia (serous and water discharge from uterine bed through the vagina) becomes minimum or nil, and the physiology of the woman is restored to her normal stage. The mother also lactates in this phase. However, since she is still weak and vulnerable to diseases, while her body (and life) returns to a state of normalcy, she should be kept under strict vigil and care.

Orally decoction of dashmoola for garbhashaya shodhana as well as relieving backache is given, trikatu churna, vasa churna, bharangi churna, pippali churna, parsik yavani churna in combination with honey or warm water is administered for sufficient uterine contractions ensuring proper drainage of lochia, for agnideepana and for relieving pain. Shatavari churna with milk (Kshirpaka) for proper lactation, tablet triphala guggulu as the antiseptic measure is also given to the mother. At many Ayurveda hospitals, the mother is massaged with bala oil followed by steam; yonidhupana is done by sitting on a chair with herbs for fumigation kept below. (fig) A blanket is wrapped around the body covering legs after mother sits on it. The abdomen is wrapped with a big cloth to prevent distention and ensure proper involution.
[[File:Chair_for_yonidhupana.png|thumb|center|upright=1.35|alt=A Chair for yoni dhupana.]]

Fig: Chair for yoni dhupana
Source: http://www.jennsutkowski.com/blog-du-moment/steam-that-yonisteam-that-yoni-for-me-or-i-mean-you

==== Naming Ceremony ====

The naming ceremony is also advised to be done on the tenth day of childbirth. Although the family is free to keep a name of their choosing, guidelines for selection of the name are given here - one that is auspicious and derived through rituals, and the other for social identity.

Naming the baby is a very important event. A person’s name always leaves a very deep impact on his/her personality and behavior. Psychologically, what one hears and reacts is very important for the mental wellbeing of the person. Therefore, one should be given a good name having an auspicious meaning and that which instills confidence in the individual. Vedic cultures have formal naming ceremonies, as do some other cultures around the world. [50]

==== Examination of Newborn ====

All the morphological features of the newborn should be examined thoroughly to rule out any features of congenital anomalies and life-threatening conditions as early as possible. With the help of such findings, one can prevent further complications and consequences of these congenital issues. Therefore, on the tenth day of the child’s delivery, the physician should examine the baby thoroughly. The newborn is grossly examined at birth, but thorough examination is recommended on the tenth day because many minute observations might get missed just after birth and will become obvious by the tenth day.

Currently, wet nurse for feeding the baby is not used unless the mother dies and close relative is available..

Characteristics of Breast milk, the effect of a mother's diet on breast milk and its management: Shuddha stanya (pure breast milk) is necessary for the newborn. According to Ayurveda whenever the pakva ahara rasa enters the stana (breast), its madhura rasa get converted into stanya (breast milk). Therefore, whatever the mother eats converts into stanya. If the mother takes a diet that causes dosha prakopa, then such a vitiated dosha vitiates the stanya and the vitiated stanya causes disease in the newborn baby. Therefore, the mother should take balanced and healthy diet which does not vitiate doshas.

Some of the properties of stanya afflicted with vitiated doshas are as follows: vitiated vata dosha has tikta, kashya rasa and therefore, the stanya afflicted with vitiated vata dosha becomes tikata and kashya (bitter). Similar samprapti (etiology) is applicable in cases of pitta and kapha dosha prakopa as well.

As explained earlier, stanya produced from the adya ahara rasa dhatu (from the first dhatu..) is afflicted with vitiated kapha/shleshma dosha. Shodhana treatment is key for treating stanya dushti vikara (i.e. breastmilk infections). Shodhana should be followed by the administration of tikta, katu, and kashaya rasa drugs like vachaharidradi gana or charakokta patha mahaushadi suradarvadi stanya shodhana mahakashya (Cha. Sutra Sthana).

All the above-mentioned drugs and diet have been investigated and found useful with many evidence-based types of research, and are prescribed as galactagogues ref.

According to today's obstetrics and neonatology practice, the mother should feed the baby with the comfort of both mother and baby, keeping both in proper positions and with positive and loving thoughts for the baby.
The concept of examination of breast milk is not practically applied in today's era. The diet, lifestyle, and psyche of the mother affect the quality and quantity of breast milk. The characteristic and quantity of breast milk affects the growth and development of the newborn.

==== Designing and care of the child’s room ====

The kumaragara (or day care facility) should be prepared in such a manner as to prevent accidents and to protect the child from agantuja vyadhi (diseases due to external/extrinsic factors). In such healthy, emotionally stable and protected environment, children grow very healthy. Antimicrobial properties of all these drugs have been proven in different researches, and hence their use in newborn care and the neonatal nursery is quite evident. Till date, there is no evidence-based scientific explanation available for wearing stones and animal-based jewelry or ornaments. Most of these practices have passed down as customs or rituals since time immemorial.

==== Toys for children ====

Toys are very fundamental constituents for the proper growth and development of creative and logical thoughts in babies. Toys play a crucial role as sensory stimuli. Acharya Charaka was well aware of this aspect of child development and therefore described toys in detail. All societies and cultures have toys, and their role in child development is universally accepted.

==== The upbringing of the child ====

According to Artha Shastra of Chanakya (Vishnugupta), a child till the age of five years needs a lot of care and affection, while the next ten years require inculcating him/her with discipline and education and once he/she reaches 16 years of age, he/she should be treated as a friend. Children of 16 years of age are mature, physically and sexually, and by then are ready to acquire skills of work for earning.
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=== References ===

<references/>
#Agnivesha, Charaka Samhita, Chakrapani commentary, Yadavji trivikramji Acharya, Chaukhambha Sanskrit Sansthan, Varanasi, reprint 2009.
#Baghel M. S., Researches In Ayurveda, Mridu Ayurvedic Publication & Sales, Jamnagar, 1997.
#Bhavamishra, Bhavaprakasha with Vidyotini Hindi Comm., Chowkhamba Samskrita Series, Varanasi, 1980.
#Bhela Samhita – Chowkhambha Vidyabhavan, Varanasi, 1961.
#Ghai OP. Normal Growth and its Disorders. In OP Ghai, Vinod KP, Arvinb B (Editors) GHAI Essential Pediatrics, Seventh Ed. New Delhi, CBS Publishers, and Distributors, 2009.
#Govinda Das Sen, Bhaishjya Ratnavali, commented by Ambikadatta Shastri, Rajeshwara Datta Shastri, Varanasi: Chaukhambha Prakashan, 2010.
#Harita Samhita, Tritiya sthana, Kasanidana Chikitsa Adhyaya (12th ch). E-book, pdf Maharishi University of Management, Vedic Literature Collection.
#Madhavakara, Madhava Nidana, Vijayarakshita commentary (Madhukosha), Brahmananda Tripathi (ed). Varanasi: Chaukhambha Surabharati Prakashan, 2008.
#Meharban Singh – Care Of the New Born, 7thed. New Delhi. Sagar Publications, 2010.
#Moneir M. Williams – Sanskrita English Dictionary, Munshi Monoharlal Publ. Delhi.
#P. V. Tiwari – Prasuti Tantra & Stri Roga, Chowkhambha Orientalia, Varanasi, 1987.
#Sharangadhara, Sharangadhara Samhita, commented by Adamalla (Deepika), Pandit Parashurama Shastri, Varanasi: Chaukhambha Orientalia Publications; 2008.
#Sharma PV, Dravyaguna Vijyana Vol II, Varanasi, Chaukhambha Bharati Acadamy; 2006.
#Stedman’s Medical Dictionary.
#Sushruta, Sushruta Samhita, Dalhanacommentary, Ed by Vd. Jadhavji Trikamji Acharya, , Varanasi:Chaukhambha Sanskrit Sansthan, reprint 2009.
#Vagbhata, Asthanga Hridaya, Arunadatta and Hemadri commentary.,Harishastri Paradakara Vaidya(ed.), Varanasi: Chaukhambha Orientalia Publications; 2005.
#Vagbhata, Astanga Sangraha, commentary by Kaviraja Atridava Gupta, Varanasi, Chaukamba Krishnadas Prakashan, 2005.
#Vridhhajeevaka, Kashyapa Samhita. Pandit Hemaraja Sharma(ed.), commented by Satyapala Bhishgacharya, Varanasi, Chaukhambha Sanskrit Sansthan, 2009.
#Yoga Ratnakara – Vidyotini Hindi Comm.., 1st Ed. Chowkhsmbha Sanskrita Series, Varanasi, 1973.