द्वात्रिंशोऽध्यायः अथातः स्वभावविप्रतिपत्तिमध्यायं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥१॥
Now we shall discourse on the Chapter which treats of the prognosis based on the perversion of the external appearances of the body (Svabhava-vipratipatti-adhyaya). 1
स्वभावप्रसिद्धानां शरीरैकदेशानामन्यभावित्वं मरणाय । तद्यथा; – शुक्लानां कृष्णता, कृष्णानां शुक्लता, रक्तानामन्यवर्णत्वम्, स्थिराणां मृदुत्वम्, मृदूनां स्थिरता, चलानामचलत्वमचलानां चलता, पृथूनां सङ्क्षिप्तत्वम्, सङ्किप्तानां पृथुता, दीर्घाणां ह्रस्वत्वम्, ह्रस्वानां दीर्घता, अपतनधर्म्मिणां पतनधर्म्मित्वम्, पतनधर्म्मिणामपतनधम्मित्वम्; अकस्माच्च शैत्यौष्ण्यस्नैग्ध्यरौक्ष्यप्रस्तम्भवैवर्ण्यावसदनञ्चाङ्गानाम् ।। २ ।।
A contrariety of the natural features of any part or member of the body should be looked upon as a fatal indication. The blackness of a limb or a part which is naturally white, or the whiteness of a black² part, or a naturally red’ part, or member, etc. assuming any other colour, or a hard + part becoming soft, and vice versa, or a movables part suddenly becoming fixed, and vice versa,’ or the contraction (flexion) of an extended part, or the extension or expansion of a contracted (flexible) part or a shorts part suddenly becoming and the cornea. 2. The iris. 3. The tongue and the palate, etc. 4. Bones,
1. The teeth teeth, etc. 5. Soft parns such as the flesh, fat, etc. 6. Joints, etc. 7. Nose, ears and flesh, etc. 8. Head and forehead, etc. elongated, and vice versa, or a sudden hanging down of a part or member of the body which does not naturally¹0 hang down, and vice versa¹¹, or a sudden increase or decrease of natural temperature of any part, member, or organ of the body, as well as its sudden glossiness, roughness, numbness, discolouration, weakness, or weariness, should be looked upon as fatal symptoms. 2
स्वेभ्य: स्थानेभ्यः शरीरैकदेशानामवस्रस्तोत्क्षिप्तभ्रान्तावक्षिप्तपतितविमुक्तनिर्गतान्तर्गतगुरुलघुत्वानि, प्रवालवर्णव्यङ्गप्रादुर्भावोऽप्यकस्मात् । शिराणाञ्च दर्शनं ललाटे, नासावंशे वा पिडकोत्पत्तिः । ललाटे प्रभातकाले वा स्वेदः । नेत्ररोगाद् विना वाश्रुप्रवृत्तिः । गोमयचूर्णप्रकाशस्य वा रजसो दर्शनमुत्तमाङ्गे निलयनं वा कपोतकङ्कप्रभृतीनाम् । मूत्रपुरीषवृद्धिरभुञ्जानानां तत्प्रणाशो भुञ्जानानाम् । स्तनमूलहृदयोरःसु च शूलोत्पत्तयः | मध्ये शूनत्वमन्तेषु परिम्लायित्वं विपर्य्ययो वा तथार्द्धाङ्गे श्वयथुः । शोषोऽङ्गपक्षयोर्वा, नष्टहीनविकलविकृतस्वरता वा विवर्णपुष्पप्रादुर्भावो वा दन्तमुखनखशरीरेषु || ३ ||
(Similarly) a limb or a part of the body, hanging down from its natural position, or becoming raised or twisted round, or cast obliquely from its natural seat, or dislocated, or protruded, or drawn inward, or suddenly becoming light or heavy without any definite or assignable cause, or a sudden eruption of a coral-coloured rash or Vyanga, should be regarded as indicating a speedy dissolution of the patient in whom they are exhibited.
Likewise, the appearance of veins in the region of the forehead, or an eruption of postules on the ridge of the nose, perspiration on the forehead in the morning, copious lachrymation without any ocular complaint, a sense of being dusted with dried and pulverised cowdung over the face, or the flying of pigeons, Kankas, etc., over one’s head, or excessive micturitions or motions of the bowels from an empty stomach, or a suppression of urine or feces even after a hearty meal or draught, is fatal. So also, pain and aching about the breast and the chest, emaciation of the extremities and an oedema of the middle part of the trunk, and vice versa; or an oedema of the upper trunk and emaciation of the lower part, and vice versa; or an oedema of the left
9. Pupils, etc. 10. Hair, nails, etc. 11. Perspiration, urine and feces etc.
half of the body and emaciation of the right, and vice versa; or hoarseness, huskiness, or loss of voice, discolouring of the teeth, nails or of the skin, eruption of white patches on the chest, etc., of the body, should be deemed as signs which forebode the approaching dissolution of an individual. 3
यस्य वाऽप्सु कफपुरीषरेतांसि निमज्जन्ति । यस्य वा दृष्टिमण्डले भिन्नविकृतानि रूपाण्यालोक्यन्ते । स्नेहाभ्यक्तकेशाङ्ग इव यो भाति । यक्ष दुर्बलो भक्तद्वेषातिसाराभ्यां पीडचते कासमानश्च तृष्णाभिभूतः । क्षीणश्छर्द्दिभक्तद्वेषयुक्तः सफेनपूयरुधिरोद्वामी हतस्वरः शूलाभिपन्नच मनुष्यः । शूनकरचरणवदनः क्षीणोऽन्नद्वेषी प्रस्तपिण्डिकांसपाणिपादो ज्वरकासाभिभूतः । यस्तु पूर्व्वाहे भुक्तमपराह्ने च्छर्द्दयत्यविदग्धमतिसार्य्यते वा ज्वरकासाभिभूतः स श्वासात् प्रियते ॥४॥
Moreover the patient, whose semen or expectorated or fecal matter does not float on water, or who sees the distorted or bifurcated images of objects, or whose hair shines with a gloss as if anointed with oil, finds his relief in death. A weak dysentery patient with a complete aversion to food, or one who is tormented with thirst even when suffering from a cough, or a man suffering from chronic catarrh with a complete loathing for food, or from gastritis (Sula) with aphonia, and vomiting frothy blood and pus, should be regarded as past all cure. A patient, enfeebled and emaciated through fever, cough and an oedematous swelling of the face and the extremities, and showing the greatest aversion to food, and the muscles of whose calves, shoulders and thighs have grown loose and flabby, should be considered as awaiting the call of death. A patient, suffering from fever, cough, and vomiting, or passing with the stool, in the evening, undigested food matter eaten in the morning, would die of asthma. 4
बस्तवद् विलपन् यक्ष भूमौ पतति सस्तमुष्कः स्तब्धमेद्रो भग्नग्रीवः प्रनष्टमेहनच मनुष्यः । प्राग्विशुष्यमाणहृदय आर्द्रशरीरः । यक्ष लोष्टं लोष्टेणाभिहन्ति काष्ठं काष्ठेन तृणानि वा च्छिनत्ति । अधरोष्ठं दशत्युत्तरोष्ठं वा लेढि । आलुञ्चति वा कर्णी केशांश्च । देवद्विजगुरुसुहृद्वैद्यांश्चद्वेष्टि। यस्य वक्रानुवक्रगा ग्रहा गर्हितस्थानगताः पीडयन्ति। जन्मर्क्ष वा यस्योल्काशनिभ्यामभिहन्यते होरा वा । गृहदारशयनासनयानवाहन-मणि-रत्नोपकरणगर्हितलक्षणनिमित्तप्रादुर्भावो वेति ॥५॥
The patient, who falls to the ground bleating like a goat, and exhibits such symptoms as a rupture of the testes, numbness of the penis, drooping of the neck and introsusception of the penis, should be considered as past all cure. The patient, whose heart is first felt dry followed by becoming covered with a slimy moisture of the whole body, as well as one who strikes a stone with a stone, or a piece of wood with a piece of wood, or who cleaves in two blades of dried grass, or one who bites his lower lip and licks the upper one, or draws his ears and tears his hair, or dishonours the gods and the Brahmanas, as well as his own physician, friends and relations, should be regarded as beyond the pale of medicine.
Similarly, a disease, due to the influence of a malignant planet occupying either through its retrogade or zigzag movement, an inauspicious position in relation to the natal asterism of the patients, is sure to terminate in death. A man, struck by lightning or a falling meteor, baffles all medicinal skill. Similarly, a disease due to the fact of one’s own house, wife, bed, seat, conveyance, or riding-animal assuming any ill-omened features, or a disease originated through the use of gems, utensils, garments, etc. of forbidden or inauspicious character usually ends in death (Arista). 5
भवन्ति चात्र
चिकित्स्यमानः सम्यक् च विकारो योऽभिवर्द्धते । प्रक्षीणबलमांसस्य लक्षणं तद्गतायुषः ।। ६ ।।
Authoritative verses on the Subject: A disease, appearing in an enfeebled and emaciated subject and refusing to yield to a course of proper medicinal treatment, and which becomes rather aggravated by the administration of proper medicinal remedies or antidotes, necessarily portends the death of the patient. 6
निवर्त्तते महाव्याधिः सहसा यस्य देहिनः । न चाहारफलं यस्य दृश्यते स विनश्यति ।।७।।
एतान्यरिष्टरूपाणि सम्यग् बुध्येत यो भिषक् । साध्यासाध्यपरीक्षायां स राज्ञः सम्मतो भवेत् ॥८॥
A Mahavyadhi¹ (lit:- a deep seated disease) suddenly abating in a person in whom nourishment fails to produce any perceptible effect forebodes a fatal termination. The physician, who can detect and fully interpret these fatal indications, is honoured by the king for determining the curable or incurable nature of a disease. 7-8
1. Any deep seated disease, which seriously affects the vital principles of a man, is called Mahavyadhi. Diseases such as Prameha, Vatavyadhi, Sosa, etc. have also been included within the category in the Chapter on Kaya-chikitsa. A general amelioration or recovery in these cases being natural, on account of their deepseated character, a sudded abatement is usually fraught with fatal consequences. (Arista).
इति सुश्रुतसंहितायां सूत्रस्थाने स्वभावविप्रतिपत्तिर्नाम द्वात्रिंशोऽध्यायः ॥३२॥
Thus ends the thirty second Chapter of Sutrasthana in the Susruta-Samhita which deals with the prognosis based on perversion of the natural appearances of the body.
