चतुविंशोऽध्यायः
विधिशोणितीयमध्यायं व्याख्यास्यामः ॥ १ ॥ इति ह स्माह भगवानात्रेयः ॥ २ ॥ अथातो
We shall now expound the chapter on the “Blood Formation (Haemopoiesis) and the Regimen therefor”. Thus, said Lord Atreya. [1-2] The present chapter deals with a detailed description of lightening and nourishing therapies as applied for the cure of the various diseases due to the vitiation of blood.
Factors responsible for normal Haemopoiesis
विधिना शोणितं जातं शुद्धं भवति देहिनाम् । देशकालौकसात्म्यानां विधिर्यः संप्रकाशितः ॥ ३ ॥
By the administration of proper regimen, with due regard to the place, time and habit as described in the sixth chapter of this section, pure blood is formed in human beings. [3] Some commentators are of the view that even if the normally formed blood gets vitiated due to certain extraneous factors, it is again purified by taking recourse to proper regimen.
Function of normal blood
तद्विशुद्धं हि रुधिरं वलवर्णसुखायुषा । चुनक्ति प्राणिनं प्राणः शोणितं ह्यनुवर्तते ॥ ४ ॥
Living creatures are endowed with strength, complexion, happiness and longevity due to pure blood. Blood plays a vital role in the sustenance of elan vital. [ 4 ]
It is only the pure blood that helps promotion of strength, etc. where there is pure blood, the elan vital is well sustained and not otherwise. As it will be said, “There are ten factors which help in sustaining the elan vital, viz., temples, three vital organs ( heart, head and bladder), throat, ( purified) blood, semen, ojas and rectum”—c.f. Sutra 29 : 3. Causes vitiating the Blood:
प्रदुष्टवहुतीक्ष्णोष्णैर्मद्यैरन्यैश्च तथाऽतिलवणक्षारैरम्लैः कुलत्थमापनिष्पावतिलतैलनिषेवणैः कटुभिरेव तद्विधैः । च॥५॥ पिण्डालुमूलकादीनां हरितानां च सर्वशः ॥ ६ ॥जलजानूपबैलानां प्रसद्दानां च सेवनात् । दध्यम्लमस्तुसुक्तानां सुरासौवीरकस्य च ॥ ७ ॥ विरुद्धानामुपक्लिन्नपूतीनां भक्षणेन च । भुक्त्वा दिवा प्रस्वपतां द्रवस्निग्धगुरूणि च ॥ ८ ॥ अत्यादानं तथा क्रोधं भजतां चातपानलौ । छर्दिवेगप्रतीघातात् काले चानवसेचनात् ॥ ९ ॥ श्रमाभिघातसंता पैरजीर्णाध्यशनैस्तथा शरत्कालस्वभावाच्च शोणितं सन्प्रदुष्यति ॥ १० ॥
Blood gets vitiated by the intake of
(a) Unwholesome, hot and sharp wine and food in large quantity;
(b) exceedingly saline, alkaline, acidic and pungent food;
(c) kulattha ( Dolichos biflorus Linn. ), masa ( Phaseolus radiatus Linn.), nispava ( a type of simbi ) and til oil ; pindalu ( Dioscorea alata Linu. ),
(d ) all green eatables like radish, etc.;
(e) meat of aquatic, marshy and prasaha ( for details vide Sutra 27:53 ) types of animal and animals living in holes;
(f) curd, sour whey, vinegar, wine, and sauviraka type of liquor ;
(g) rotten, putrified food articles and those having mutu. ally contradictory qualities; and
(h ) any other type of food in excessive quantity. Blood also gets vitiated by the following :
(a) Sleeping during day time after taking liquid, unctuous and heavy food ;
(b) Excessive anger, excessive exposure to the sun and fire ;
(c ) Suppression of the urge for vomiting ;
( d ) Absence of blood-letting therapy ( in the autumn );
(e) Exertion, external injury, heat, taking food before the previous meal is digested;
(f) By the very nature of the autumn season. [ 5-10]
Diseases caused by vitiated Blood
ततः शोणितजा रोगाः प्रजायन्ते पृथग्विधाः । मुखपाकोऽक्षिरागश्च गुल्मोपकुशवीसर्परक्तपित्तप्रमीलकाः विद्रधी रक्तमेहश्च प्रदरो वातशोणितम् ॥ १२ ॥ पूतिघ्राणास्यगन्धिता ॥ ११ ॥ वैवर्ण्यमग्निसादश्च पिपासा गुरुगात्रता । संतापश्चातिदौर्बल्यमरुचिः शिरसश्च रुक् ॥ १३ ॥ विदाहश्चान्नपानस्य तिक्ताम्लोद्भिरणं क्लमः । क्रोधप्रचुरता बुद्धेः संमोहो लवणास्यता ॥ १४ ॥ स्वेदः शरीरदौर्गन्ध्यं मदः कम्पः स्वरक्षयः । तन्द्रानिद्रातियोगश्च तमसञ्चातिदर्शनम् ॥ १८ ॥ कण्ड्डूरुः कोठपिडकाकुष्ठचर्मदलादयः विकाराः सर्व पवैते विज्ञेयाः शोणिताश्रयाः ॥ १६ ॥ शीतोष्ण स्निग्धरूक्षाद्यैरुपक्रान्ताश्च ये गदाः । सम्यक् साध्या न सिध्यन्ति रक्तजस्तान् विभावयेत् ॥ १७ ॥ 1
The following diseases occur due to the vitiation of blood: stomatitis, conjunctivitis, rhinitis, foul odour from mouth, abdominal tumour, upakusa type of mouth diseases, visarpa (a skin disease characterised by an acute spread), raktapitta ( a disease characterized by bleeding from different parts of the body), pramilaka (drowsiness), abscess, hematuria, menorrhagia, gout, palor, suppression of the power of digestion, thirst, heaviness of the body, burning sensation, excessive weakness, anorexia, headache, bitter sour eructation specially of the diet and drink that are not properly digested, excessive anger, bewilderment, saline taste in mouth, excessive sweating, foul smell of the body, intoxication, shivering, aphonia, drowsiness, excessive sleep, frequent attack of fainting, pruritus, eruption, urticaria, pimples, obstinate skin diseases including leprosy, dermatoses, etc.
If the curable diseases do not get cured by cold, hot, unctuous, drying and such other therapies, they are to be taken as diseases due to the vitiation of blood.
Upakusa is a disease of the mouth-vide Susruta: Nidana 16:22. Even though the disease carmadala (dermatosis) is a type of kustha, it is separately mentioned for the sake of clarity. It may be noted that unlike the doshas which are capable of producing diseases independently the blood does not have the capacity to produce diseases in itself; it only represents a secondary factor for the causation of diseases.
Apart from the diseases enumerated in verses 11 to 16 above, there are many other verses which are not described here. The main criteria for diagnosing such diseases are described in verse no. 17 as follows: The diseases which are apparently curable by the administration of drugs having cold, hot, unctuous, dry and such other properties but are not actually cured in spite of the administration of such a therapy it should be understood that such diseases are caused mainly due to the vitiation of rakta. The idea underlying such a diagnosis is that the above mentioned therapy, if properly administered is sure to cure the diseases caused by the vitiation of doshas; but such of the diseases as are caused by the aggravation of rakta cannot be cured simply by the therapy meant for alleviating the diseases due to the vitiation of doshas.
Principles of treatment for the diseases of blood
कुर्याच्छोणितरोगेषु रक्तपित्तहरीं क्रियाम् । विरेकमुपवासं च स्रावणं शोणितस्य च ॥ १८ ॥
Therapies like purgation, fasting and blood-letting indicated for the treatment of raktapitta (a disease characterized by bleeding from different parts of the body) are also useful for curing diseases due to the vitiation of blood.
The above mentioned therapies in their entirety are not to be administered in all diseases. They are to be selected with due regard to the nature of the disease caused by the vitiation of blood. Caution for Blood-letting :
बलदोषप्रमाणाद्वा विशुद्धया रुधिरस्य वा ।
रुधिरं स्रावयेजन्तोराशयं प्रसमीक्ष्य वा ॥ १९ ॥
Blood-letting is to be done, with due regard to the strength of the patient and nature as well as seriousness of the disease. The quantity of blood that is to be taken out should be commensurate with the purification of blood. [ 19 ]
There are three important points to be taken into account in connction with blood-letting. Firstly this therapy is to be administered, with due regard to the strength of the patient and the extent of the manifestation of the concerned disease. If the patient is strong enough and the disease is of a very serious nature, more blood may by taken out. Secondly, it is to be seen that the blood-letting corresponds to the extent of purification of blood, that is to say, the blood may be taken out until the remaining blood is purified. Thirdly even for the patients suffering from the same type of diseases, the blood-letting is to be regulated according to the seriousness of the disease. For example, in the case of patients suffering from minor skin diseases, blood-letting is to be done in small quantity with the help of a scraper whereas in the case of major skin diseases, a large quantity of blood is to be taken out by venesetion c. f. Chikitsa 7:40.
Changes in blood due to vitiation of different doshas
फेनिलं तनु । अरुणाभं भवेद्वाताद्विशदं पित्तात् पीतासितं रक्तं स्त्यायत्यौ॰ण्याच्चिरेण च ॥ २० ॥
ईषत्पाण्डु कफादुष्टं पिञ्छिलं तन्तुमद्धनम् । संसृष्टलिङ्गं संसर्गान्त्रिलिङ्गं सान्निपातिकम् ॥ २१ ॥
The rakta, vitiated by vata becomes reddish, non-slimy, foamy and thin; the one vitiated by pitta is yellow and black, and it takes a longer time to coagulate bacause of the inherent heat (of pitta); the one vitiated by kapha is slightly pale in colour, slimy, thready and thick; the one due to vitiation by more than one dasa shares the characteristics of the respective symptoms of all the vitiated doshas. [21-22] Features of pure blood:
तपनीयेन्द्रगोपाभं पद्मालक्तकसन्निभम् ।
गुञ्जाफलसवर्ण च विशुद्धं विद्धि शोणितम् ॥ २२ ॥ Pure blood can be likened to gold ( purified with fire), fire fly (indragopa), red lotus, lac, fruit of gunja (Abrus precatorius Linn.) in colour (depending upon the individual constitution). [22]
Dietetic management after blood-letting
नात्युष्णशीतं लघु दीपनीयं रक्तेऽपनीते हितमन्नपानम् । तदा शरीरं धनवस्थितासृगग्निर्विशेषेण च रक्षितव्यः ॥ २३ ॥ After blood-letting, intake of food and drink which are neither very hot nor very cold, and are light and stimulants of digestion are recommended. At this stage, because of the instability of the body, the power of digestion and metabolism is specially required to be maintained. [ 23 ]
If food and drink are exceedingly cold, they will suppress the power of digestion and metabolism; if too hot, they will add to the instability of the blood. So the intake of food and drink which are not very hot nor very cold are recommended. Light and easily digestible food may also be given with a view to stimulating the power of digestion.
Features of men having normal blood
प्रसन्नवर्णेन्द्रियमिन्द्रियार्थानिच्छन्तमव्याहतपक्तृवेगम् ।
सुखान्वितं तु (पु) टिषलोपपनं विशुद्धरक्तं पुरुषं वदन्ति ॥ २४ ॥
The signs and symptoms of persons endowed with pure blood are clarity in complexion, normal functioning of sense organs, natural urge for the objects of sense organs, unobstructed digestion and motion, happiness, contentment (nourishment) and strength. [ 24 ]
Even without examining the blood as such, one can determine its purity by external signs and symptoms of individuals as indicated in this verse.
Aetiopathology of cerebro-vascular accidents and cerebral symptoms
यदा तु रक्तवाहीनि रससंज्ञावहानि च । पृथक्पृथक् समस्ता वा स्त्रोतांसि कुपिता मलाः ॥ २५ ॥ मलिनाहारशीलस्य रजोमोहावृतात्मनः । प्रतिहत्यावतिष्ठन्ते जायन्ते व्याधयस्तदा ॥ २६ ॥ विद्याद्विचक्षणः । मदमूर्च्छायसंन्यासास्तेषां यथोत्तरं बलाधिक्यं हेतुलिङ्गोपशान्तिषु ॥ २७ ॥ दुर्बलं चेतसः स्थानं यदा वायुः प्रपद्यते । मनो बिक्षोभयञ्जन्तोः संज्ञां संमोहयेत्तदा ॥ २८ ॥ पित्तमेवं कफश्चैवं मनो विक्षोभयन्त्रणाम् । संज्ञां नयत्याकुलतां विशेषश्चात्र वक्ष्यते ॥ २९ ॥
In the cases of individuals with habitual intake of unwholesome food and with their mind covered with rajas and tamas, the doshas get vitiated jointly or severally and then they obstruct the channels like arteries including viens, lymphatics including lacteals and nerves resulting in the manifestation of diseases like intoxication, fainting and syncope.
From the point of view of aetiology, symptomatology and cure, syncope is more serious than fainting and the latter is more serious than intoxication.
When the vata attacks the site of mind which has become weak, it disturbs the mind and brings about unconsciousness thereby. Similarly pitta and kapha as well disturb the mind, resulting in the unconsciousness of the individual. The special features of these conditions will be described later. [ 25-29]
In the above verses, the cause and pathogenesis of the various mental diseases are described. As usual, the root cause of mental diseases is the vitiation of the three doshas jointly or severally. Mental diseases like intoxication, fainting and syncope occur when these vitiated doshas affect inter alia the nerves which are in fact the carriers of consciousness. The degree of unconsciousness progressively increases intoxication, fainting and syncope.
Signs and symptoms of Mada Roga
चलस्खलितचेष्टितम् । रूक्षश्यावारुणाकृतिम् ॥ ३० ॥ संप्रहारकलिप्रियम् । विद्यात् पित्तमदाविष्टं रक्तपीतासिताकृतिम् ॥ ३१ ॥ स्वल्पासंबद्धवचनं तन्द्रालस्यसमन्वितम् । विद्यात् कफमदाविष्टं पाण्डुं प्रध्यानतत्परम् ॥ ३२ ॥ सक्तानल्पद्रुताभाष विद्याद्वातमदाविष्टं सक्रोधपरुषाभाष सर्वाण्येतानि रूपाणि सन्निपातकृते मदे ।
Signs and symptoms of vatika type of intoxication (mada ) are : making incoherent, excessive and fast speeches, instability and incoordination in action, dryness, blackishness and redness in complexion; those of the paittika type of intoxication are: angry and harsh speeches, liking for assaults and quarrels, and redness, yellowness and blackness in complexion; those of the Slaismika type of intoxication are, feeble incoherent speeches, drowsiness, laziness, paleness and wandering. The sannipatika type of intoxication shares all the above mentioned signs and symptoms. [ 30-32]
Treatment of mada roga
जायते शाम्यति क्षिप्रं मदो मद्यमदाकृतिः ॥ ३३ ॥ This intoxication which can be likened to the one caused by alcoholic drinks is manifested and cured immediately. [ 33 ]
Intoxications and dosha
यश्च मद्यकृतः प्रोक्तो विषजो रौधिरश्च यः ।
सर्व एते मदा नर्ते वातपित्तकफत्रयात् ॥ ३४ ॥
Intoxication of all types produced either by alcoholic drinks or by the intake of poison or by the vitiation of blood are, on an ultimate analysis, caused by nothing but the vitiation of vata, pitta and or kapha (and so all varieties of intoxication are of four types, viz., vatika paittika, slaismika and sannipatika ). [ 34 ]
Signs and symptoms of Murcha
नीलं वा यदि वा कृष्णमाकाशमथवाऽरुणम् । पश्यंस्तमः प्रविशति शीघ्रं च प्रतिबुध्यते ॥ ३५ ॥ वेपथुश्चाङ्गमर्दश्च प्रपीडा हृदयस्य च । कार्य घ्यावारुणा च्छाया सूर्च्छाये वातसंभवे ॥ ३६ ॥ रक्तं हरितवर्ण वा वियत् पीतमथापि वा । पश्यंस्तमः प्रविशति सस्वेदः प्रतिबुध्यते ॥ ३७ ॥ सपिपासः ससंतापो रक्तपीताकुलेक्षणः । संभिन्नवर्चाः पीताभो मूर्च्छाये पित्तसंभवे ॥ ३८ ॥ मेघसङ्काशमाकाशमावृतं वा तमोघनैः । पश्यंस्तमः प्रविशति चिराज्य प्रतिबुध्यते ॥ ३९ ॥ ।। गुरुभिः प्रावृतैरङ्गैर्यथैवात्रे॑ण चर्मणा । सप्रसेकः सहल्लासो मूर्च्छाये कफसंभवे ।। ४० ॥ सर्वाकृतिः सन्निपातादपस्मार इवागतः । स जन्तुं पातयत्याशु विना बीभत्सचेष्टितैः ॥ ४१ ॥
To an individual suffering from vatika type of fainting the sky appears as blue, black or red and thereafter he becomes unconscious but soon he recovers; there is trembling, malaise, cardiac pain, emaciation and blackish brown or red complexion. To an individual suffering from paittika type of fainting, the sky appears as red, green or yellow, thereafter he becomes unconscious and recovers with sweating; there is feeling of thirst, heat, there are redness and yellowness in eyes, diarrhoea and yellow complexion.
To an individual suffering from slaismika type of fainting, the sky appears as if raining or as if covered by dark cloud (or darkness and cloud); thereafter he becomes unconscious; he recovers after a long time; he feels as if his body is covered with a heavy blanket, like a wet hide; he gets salivation and nausea.
In the case of sannipatika type of fainting all the above signs and symptoms are manifested and the individual is laid down like a patient suffering from epilepsy (apasmara); but unlike epilepsy there is no awkward behaviour such as biting teeth, throwing out limbs, etc. [ 35-41]
Some commentators are of the view that appearance of blackish complexion represents a bad prognostic sign beause such complexions are caused by vata. In Indriya section (chapter 7, verse 13 ) it has been clearly stated that appearance of such complexions is indicative of death or a great calamity. But this is not tenable here because appearance of such a complexion represents a bad prognostic sign only when it occurs without any morbid cause. In the present context appearance of such complexions is caused by vitiated vata. Eevn the reference to Indriya section cited above, is against treating such a complexion as bad prognostic sign in absolute terms because the other alternative indication of such a complexion relates to a great calamity that might befall the individual. If such a complexion were a sure sign of immediate death, there would be no room for calamity whatsoever.
Differential diagnosis and treatment of Coma
दोषेषु मदमूर्च्छायाः कृतवेगेषु देहिनाम् । स्वयमेवोपशाम्यन्ति संन्यासो नौषधैर्विना ॥ ४२ ॥ वाग्देहमनसां चेष्टामाक्षिप्यातिवला मलाः । संन्यस्यन्त्यवलं जन्तुं प्राणायतनसंश्रिताः ॥ ४२ ॥ सना संन्याससंन्यस्तः काष्ठीभूतो मृतोपमः । प्राणैर्वियुज्यते शीघ्रं मुक्त्वा सद्यः फलाः क्रियाः ॥ ४४ ॥ दुर्गेऽम्भसि यथा मजद्भाजनं त्वरया बुधः । गृह्णीयातलमप्राप्तं तथा संन्यासपीडितम् ॥ ४५ ॥ अञ्जनान्यवपीडाश्च धूमाः प्रधमनानि च । सूचीभिस्तोदनं शस्तं दाहः पीडा नखान्तरे ॥ ४६ ॥ लुशनं केशलोम्नां च दन्तैर्दशनमेव च । आत्मगुप्तावघर्षश्च हितं तस्यावबोधने ॥ ४७ ॥ संमूर्दिछतानि तीक्ष्णानि मद्यानि विविधानि च । प्रभूतकटुयुक्तानि तस्यास्ये गालयेन्मुहुः ॥ ४८ ॥ मातुलुङ्गरसं तद्वन्महौषधसमायुतम् । तद्वत्सौवर्चलं दद्याधुकं मद्याम्लकाञ्जिकैः ॥ ४९ ॥ हिङ्गुषणसमायुक्तं यावत् संशाप्रबोधनम् । प्रवुद्धसंशमनैश्च लघुभिस्तमुपाचरेत् । ५० ।। विस्मापनैः स्मारणैश्च प्रियश्रुतिभिरेव च । पटुभिर्गोतवादित्रशब्दैश्चित्रैश्च दर्शनैः ॥ ५१ ॥ संसनोल्लेख नैर्धूमैरअनैः कवलप्रहैः । शोणितस्यावसेकैश्च व्यायामोद्धर्षणैस्तथा ॥ ५२ ॥ प्रबुद्धसंशं मतिमाननुबन्धमुपक्रमेत् । तस्य संरक्षितव्यं हि मनः प्रलयहेतुतः ॥ ५३ ।।
As regards intoxication and fainting, they are cured automatically soon after the manifestation of the attack by the aggravated doshas. The syncope, however, does not subside without the administration of proper medicines.
Doshas if acutely aggravated affect the action of speech, mind and body and after entering the site of elan vital, that is heart, weaken the individual and bring about absolute unconsciousness in him. Due to syncope, there is absolute loss of consciousness in the individual. A piece of wood or corpse as it were unless proper therapy having immediate action is administered, he would die instantaneously. If a physician comes across a patient suffering from syncope, he should hurry up in rescuing him from the impending calamity as a wise person takes out a pitcher sinking in very deep water much before it touches the bottom.
Application of collyrium, nasal drops, smoke, snuff, needling, burning, causing pain in the nail bed, plucking the hair from the head and body, biting with teeth and rubbing body with atmagupta (Mucuna prurita Hook.) are helpful in bringing about consciousness.
Various types of strong alcoholic drinks mixed together with other drugs of pungent taste should be carefully put in his mouth frequently. The physician should further administer the juice of matuluns;a ( Citrus decumana Linn. ), mahausadha (Zingiber officinale Rosc.), sonchal salt (mixed with wine), sour conjee added with hingu ( Ferula narthex Boiss. ) and marica ( Piper nigrum Linn. ) until the patient regains consciousness. After that he should be given light diet. Thereafter, his consciouenss should be maintained by various psychological and physical devices and his mind should be diverted from the aetiological factors of unconsciousness. He should be made to remember some surprising events, hear pleasing fine songs, music and other sounds and see wonderful sights. He should also be given purgation, emesis, smoke, collyrium, gargle, blood-letting physical exercise and rough_massage. [ 42-53]
When the doshas involved in the pathogenesis, manifest their actions during the attack phase of the disease, they become weak and the patient gets relief (temporarily). The patient in syncope should be given medicines that produce immediate effect, for example, strong irritant collyruim.
Management of Mada and Murcha
स्नेहस्वेदोपपन्नानां यथादोषं यथाबलम् । पश्च कर्माणि कुर्वीत मूर्च्छायेषु मदेषु च ॥ ५४ ॥ अष्टाविंशत्यौषधस्य तथा तिक्तस्य सर्पिषः । प्रयोगः शस्यते तद्वन्महतः षट्पलस्य वा ॥ ५५ ॥ त्रिफलायाः प्रयोगो वा सघृतक्षौद्रशर्करः । शिलाजतुप्रयोगो वा प्रयोगः पयसोऽपि वा ॥ ५६ ॥ पिप्पलीनां प्रयोगो वा पयसा चित्रकस्य वा । रसायनानां कौम्भस्य सर्पिषो वा प्रशस्यते ॥ ५७ ॥ रक्तावसेकाच्छात्राणां सतां सत्त्ववतामपि । सेवनान्मदमूर्च्छायाः प्रशाम्यन्ति शरीरिणाम् ॥ ५८ ॥
In the case of intoxication and fainting, the patient should be administered the five elimination therapies, after oleation and fomentation with due regard to the strength and the vitiation of the doshas of the individual. Besides the Kalyanaka ( contain. ing twenty eight drugs), Mahatiktaka and Satpala ghrita-vide Chikitsa 7 – may be given. Triphala alongwith ghee, honey and sugar, Silajatu (mineral pitch ), milk, pippali ( Piper longum Linn. ), chitraka ( Plumbago zeylanica Linn. ) with milk, ten year old ghee and such other elixirs may also be administered. Blood letting, study of ( religious ) books and devotion to spiritually enlightened good persons also cure intoxication and fainting. [ 54-58]
तत्र विशुद्धं चाविशुद्धं च शोणितं तस्य हेतवः । रक्तप्रदोषजा रोगास्तेषु रोगेषु चौषधम् ॥ ५९ ॥
मदमूर्च्छायसंन्यासहेतुलक्षणभेषजम् । विधिशोणित केऽध्याये सर्वमेतत् प्रकाशितम् ॥ ६० ॥
लोकौ –
To sum up :
Aetiology and signs of pure and impure blood, diseases due to impurity in blood, their treatment, aetiology, signs, symptoms and treatment of intoxication, fainting and syncope-all these are explained in the chapater on “Blood Formation and Regimen Therefor.” [ 59-60]
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते श्लोकस्थाने विधिशोणितीयो नाम चतुर्विंशोऽध्यायः ॥ २४ ॥
Thus ends the twenty fourth chapter on “Blood Formation and Regimen Therefor” of the Sutra section of Agnivesa’s work as redacted by Charaka. [ 24 ]
समाप्तो योजनाचतुष्कः ॥ ६ ॥
Thus ends the quadrate on “Inter-relationship of Diseses and Drugs.”
