एकत्रिंशोऽध्यायः अथातश्छायाविप्रतिपत्तिमध्यायं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the Chapter which deals with the prognosis to be gathered from the altered condition of features (Chaya-Vipratipatti-adhyaya). 1
श्यावा लोहितिका नीला पीतिका वापि मानवम्। अभिद्रवन्ति यं छाया: स परासुरसंशयम् ।। २ ।।
हीरपक्रमते यस्य प्रभास्मृतिधृतिश्रियः । अकस्माद् यं भजन्ते वा स परासुरसंशयम् ॥ ३ ॥
यस्याधरौष्ठः पतितः क्षिप्तचोर्ध्वं तथोत्तरः । उभौ वा जाम्बवाभासौ दुर्लभं तस्य जीवितम् ॥ ४ ॥
1. Physicians of the Ayurvedic School, however, observe a distinction between Chaya (shade of complexion) Prabha (healthful glow of the complexion), and Varma (natural colour of the complexion ) itself. The Chaya or the shade of one’s complexion may be easily distinguished as clear, rough or cool, etc. and can be detected only on a close view. The Prabha, on the other hand, is visible from a distance and admits of being divided into seven different types, such as red, yellow, white, brown, greenish, pale, and black. The Varma or the natural colour of the complexion of a man is found to be either fair, black, dusky learning towards the fair, according to his race and habitation. The term also includes natural modesty, look and ease.
आरक्ता दशना यस्य श्यावा वा स्युः पतन्ति च । खञ्जनप्रतिमा वापि तं गतायुषमादिशेत् ॥ ५ ॥
Metrical Text: The man, whose complexion suddenly assumes a brown, red, blue or yellow shade, should be regarded as already gathered to his rest. The man, who has lost all sense of modesty or propriety, and whose complexion, and whose strength (ojah) and memory have suddenly undergone discolouration or extreme deterioration, should be counted with the dead. Little chance there is of the life of a patient whose lower lip hangs down while the upper one is drawn or turned up, and both of them have assumed a black colour like that of a jamboline fruit. The patient, whose teeth fall out or which have assumed a reddish or a dark brown colour, or a colour like that of a Khanjana bird (dark blue), should be reckoned as already gathered to his fathers. 2-5
कृष्णा स्तब्धावलिप्ता वा जिह्वा शूना च यस्य वै । कर्कशा वा भवेद् यस्य सोऽचिराद् विजहात्यसून् ।।६।।
कुटिला स्फुटिता वापि शुष्का वा यस्य नासिका। अवस्फूर्ज्जति मग्ना वा न स जीवति मानवः ॥७॥
सङ्क्षिप्ते विषमे स्तब्धे रक्ते सस्ते च लोचने । स्यातां वा प्रसुते यस्य स गतायुर्नरो ध्रुवम् ।।८।।
केशा: सीमन्तिनो यस्य सङ्क्षिप्ते विनते ध्रुवौ । लुण्डन्ति चाक्षिपक्ष्माणि सोऽचिराद् याति मृत्यवे ।।९।।
The patient, whose tongue has become furred, swollen, or inert, or is of a black colour, should be considered as already at the gate of death. The patient, whose nose has sunk or become bent, cracked, dried, or who when breathing makes a gurgling sound through the nostrils, should be given up as lost. A patient is certainly quitting this life whose eyes appear to be contracted, or unequal, oblique, or inert, insensitive to light or touch, sunk in their sockets, or bloody, or marked by a copious lachrymation. The patient whose hair appears to have been glued to his head, whose eyebrows are contracted and hang down, and whose eyelashes are listless should be considered as about to leave his mortal frame. 6-9
नाहरत्यन्नमास्यस्थं न धारयति यः शिरः । एकाग्रदृष्टिर्मूढ़ात्मा सद्यः प्राणान् जहाति सः ।। १० ।।
बलवान् दुर्बलो वापि सम्मोहं योऽधिगच्छति। उत्थाप्यमानो बहुशस्तं पक्वं भिषगादिशेत् ||११ ।।
उत्तानः सर्व्वदा शेते पादौ विकुरुते च यः । विप्रसारणशीलो वा न स जीवति मानवः ।। १२ ।।
शीतपादकरोच्छ्वास-च्छिन्नश्वासश्च यो भवेत् । काकोच्छ्वासच यो मर्त्यस्तं धीरः परिवर्ज्जयेत् । । १३ ।।
The patient, who is incapable of swallowing any food or of holding up his head, and who looks with a kind of fixed stare, with all memories of life fully obliterated, should be deemed as dying on that very day. A wise or prudent physician should give up the medical treatment of a patient, no matter whether strong or weak, who is found to be fainting away every time he is lifted up or seated. The patient, who constantly extends or draws up his lower extremities, or keeps them in a gathered up posture, should be looked upon as rapidly succumbing. A wise physician should abandon a patient, characterised by the coldness of his breath and extremities and a hurried and intermittent respiration, or who is found breathing with his mouth open, or lips separated. 10-13
निद्रा न च्छिद्यते यस्य यो वा जागर्त्ति सर्व्वदा । मुह्येद् वा वक्तुकामस्तु प्रत्याख्येयः स जानता ।।१४ ।।
उत्तरौष्ठञ्च यो लिह्यादुत्कारांश्च करोति यः । प्रेतैर्वा भाषते सार्द्धं प्रेतरूपं तमादिशेत् ।। १५ ।।
खेभ्य: सरोमकूपेभ्यो यस्य रक्तं पुरुषस्याविषार्त्तस्य सद्यो जह्यात् स प्रवर्त्तते । जीवितम् ।। १६ ।।
Similarly, a patient affected with a kind of stupor or insomnia and remaining drowsy, all day long, or fainting at the least attempt of speaking, should be counted with the dead. The patient, who licks his upper lip, or is troubled with eructations, or holds conversations with the departed, should be deemed as already entered into the region of the dead. A man, spontaneously bleeding through the roots of his hair (pores of the skin) otherwise than in a case of poisoning, should be deemed as dying on that day. 14-16
वाताष्ठीला तु हृदये यस्योर्ध्वमनुयायिनी । रुजान्नविद्वेषकरी स परासुरसंशयम् ।।१७।।
A patient, affected with an up-coursing pain about the cardiac region, like the one which distinguishes a case of Vatasthila (appearance of a stone-like lump rising or seated within the thorax and ascribed to the action of the deranged Vayu), accompanied by an aversion to food, etc., should be already reckoned among the dead. 17
अनन्योपद्रवकृतः शोफः पादसमुत्थितः । पुरुषं हन्ति नारीन्तु मुखजो गुह्यजो द्वयम् ॥ १८ ॥
An idiopathic swelling (Sopha) first occurring in either of the lower extremities in a male patient not as a complication of any other disease¹, as well as a similar swelling first appearing at the face, or about the region of the anus in a male or a female patient, is sure to have a fatal termination, 18
अतिसारो ज्वरो हिक्काच्छर्द्दिः शूनाण्डमेठ्रता । श्वासिनः कासिनो वापि यस्य तं क्षीणमादिशेत् ।।१९।।
स्वेदो दाहश्च बलवान् हिक्का श्वासश्च मानवम्। बलवन्तमपि प्राणैर्वियुञ्जन्ति न संशयः ।।२०।।
श्यावा जिह्वा भवेद् यस्य सव्यञ्चाक्षि निमज्जति । मुखञ्च जायते पूति यस्य तं परिवर्ज्जयेत् ॥ २१ ॥
A patient, suffering from cough or asthma attended with dysentery, fever, hic-cough, vomiting and swelling of the penis and the scrotum, should be given up as lost. Excessive perspiration, burning, hiccough, dyspnoea and hyperpyrexia with a burning sensation of the body, are undoubtedly capable of extinguishing the vital spark even in a strong patient. Similarly a patient, with a black coated tongue and the left eye sunk in its socket and a foul smell from the mouth, should be given up as lost. 19-21
1. Such as Chlorosis, Ascites, Hoemorrhoids.
वक्तमापूर्य्यतेऽश्रुणा स्विद्यतश्चरणावुभौ । चक्षुश्चाकुलतां याति यमराष्ट्रं गमिष्यतः ।।२२।।
The mouth of a man, who is on his way to the mansions of the god of death, becomes filled with tears, the legs are wet with perspiration, and the pupils of the eyes roll about or become listless. 22
अतिमात्रं लघूनि स्युर्गात्राणि गुरुकाणि च । यस्याकस्मात् स विज्ञेयो गन्ता वैवस्वतालयम् ॥ २३ ॥
ये नराः । पङ्कमत्स्यवसातैल-घृतगन्धाश्च मृष्टगन्थांश्च ये वान्ति गन्तारस्ते यमालयम् ॥ २४ ॥
The patient, whose limbs become all of a sudden abnormally light or heavy, is sure to go to the region of the son of the day-god (Yama). The patient, whose body emits a fishy, dirty or a fragrant smell, or smells like fat, oil, or clarified-butter, is on the way to the mansions of Death. 23-24
यूका ललाटमायान्ति बलिं नानन्ति वायसाः। येषां वापि रतिर्नास्ति यातारस्ते यमालयम् ॥ २५ ॥
ज्वरातिसारशोफाः स्युर्यस्यान्योन्यावसादिनः । प्रक्षीणबलमांसस्य नासौ शक्यश्चिकित्सितुम् ।। २६ ।।
क्षीणस्य यस्य क्षुत्तृष्णे हृदयर्मिष्टैर्हितैस्तथा । न शाम्यतोऽन्नपानैश्च तस्य मृत्युरुपस्थितः ।।२७।।
प्रवाहिका शिरःशूलं कोष्ठशूलञ्च दारुणम् । पिपासा बलहानिश्च तस्य मृत्युरुपस्थितः । ॥ २८ ॥
विषमेणोपचारेण कर्म्मभिश्च पुरा कृतैः | अनित्यत्वाच्च जन्तूनां जीवितं निधनं व्रजेत् ।। २९ ।।
The patient on whose forehead lice freely move about, or whose offerings the crows do not eat, or who does not find comfort in any position or place, goes to the mansions of the god of death. A patient, who has become emaciated and enfeebled, or has been suffering from a complication of such diseases as fever, dysentery, oedema, etc., one supervening another pre-existing malady, should be deemed as beyond the pale of medicine. A ravenous hunger or an unquenchable thirst in a weak patient, who refuses to be appeased or satisfied with sweet, whole-some and palatable food or drink, should be regarded as a fatal indication. A patient exhibiting such symptoms as diarrhoea, an excruciating headache, colic in the intestines, thirst and gradual failing of strength, stands in danger of imminent death. Death is due to the transitory character of life, or it may be attributed to irregular conduct, or to the deeds of one’s previous existence transformed into the dynamics of fate. 25-29
प्रेता भूताः पिशाचाश्च रक्षांसि विविधानि च । मरणाभिमुखं नित्यमुपसर्पन्ति मानवम् ।।३०।।
तानि भेषजवीर्य्याणि प्रतिघ्नन्ति जिघांसया । तस्मान्मोघाः क्रियाः सर्व्वा भवन्त्येव गतायुषः ।। ३१ ।।
Ghosts, evil spirits, Pisachas and monsters of various shapes and denomination, constantly lead men to death. These evil spirits, owing to their natural killing propensities, nullify the efficacies of medicines; and hence it is futile to take in hand the medical treatment of a man who exhibits any of the abovesaid fatal symptoms, and thereby testifies that he has fallen into the clutches of such evil spirits. 30-31
इति सुश्रुतसंहितायां सूत्रस्थाने च्छायाविप्रतिपत्तिर्नामैकत्रिंशोऽध्यायः ॥ ३१॥
Thus ends the Thirty-first Chapter of the Sutrasthana in the Susruta-Samhita which deals with prognosis from perverted features.
