Ayushkamiya Sutrasthana- Ashtanga Hridyam part 4

Hello learner, Welcome to Sanskrit Gurukul. In this post, we will cover the last part of Ayushkamiya Chapter of Ashtanga Hridyam, written by Acharya Vagbhata.

Chikitsa Chatushpada (four limbs of treatment)

In this shloka of the Ayushkamiya Chapter of Ashtanga Hridyam, Acharya Vagbhata explains about the 4 important pillar of treatment in Ayurveda or in general.

भिषग् द्रव्याण्युपस्थाता रोगी पादचतुष्टयम् ।
चिकित्सितस्य निर्दिष्टं, प्रत्येकं तच्चतुर्गुणम् ॥२७৷৷

The four limbs od treatment are Bhishag (Doctor), Dravya (medicine), upastha (nurse), and rogi (Patient). Each of them have further four qualities.
Note: The hope of complete success in treatment rests on these four . These four have further four qualities – in this way this treatment has sixteen qualities. Vaidya is the main one among these four, because without him these three stages are meaningless, and if he is capable then he can extract the work from these meaningless stages.

Qualities of a doctor

दक्षस्तीर्थात्तशास्त्रार्थो दृष्टकर्मा शुचिर्भिषक् ।

• Daksha- Apart from being an expert in public behavior, it is necessary for a Vaidya to be clever in his work also; That is, one with excellent intelligence.
• Teerthattashastrartha – Understand the meaning of the scriptures well from a well-read Acharya,
• Drushtakarma – must have witnessed the therapies (gained practical experience)
• Shuchi- should be pure, free from defects in body, mind and speech, that is, pure inside and out.
  The patient remains suspicious of his relatives. But having faith in the doctor, he hands over his life to him. Therefore, a physician should always be ready to enhance his qualities.

Qualities of Medicine

बहुकल्पं बहुगुणं सम्पन्नं योग्यमौषधम् ।।2 8 ।।

• Bahukalpam – Drug should be useful to formulate various pharmaceutical preparations like swarasa (fresh juice of leaves), kalka (paste), cūrņa (powder), kwatha (decoction) etc. according to the choice of the patient and the need of the hour.
• Bahugunam – Drug also should contain highest number of qualities (gurvadi guņas). So that the same drug can be utilised in a number of disease conditions by altering anupāna.
• Sampannam – Drugs should be potent and free from infection and moisture.
• Yogyam –  And also suitable to the patient and diseases according to the region and season.

Qualities of Nurse

अनुरक्तः शुचिर्दक्षो बुद्धिमान् परिचारकः ।

• Anurakta:  Attendant should have utmost affection and service motto towards the patient.
• shuci: Purity or sanctity in all aspects means physical as well as psychological. Attendant should have the devotion and dedication towards the profession and should not consider any evil thoughts.
• Dakshata: Attendant must be perfectly trained and should have skill and the knowledge of nursing.
• Buddhiman:  And also must have intelligence.

Qualities of a Ideal patient

आढ्यो रोगी भिषग्वश्यो ज्ञापकः सत्त्ववानपि ।।2 9 ॥

• Adhya (Wealthy): Patient must be wealthy. Then only he is able to purchase the equipment and drugs required for the treatment.
• Bhisagvaśya (Obedient to the physician): Patient must be obedient and should follow the instructions of the physician.
• Jñāpaka (Memory): Patient should have memory to narrate the sequence of historical events pertaining to his ailments, which is essential for proper diagnosis and treatment.
• Sattvawan (Strong will): Sattva means manas or mind. Sattvawān means having strong will power. Patients who are having strong will power can tolerate miserable situations also.

Types of Diseases

In the following shloka of the Ayushkamiya Chapter of Ashtanga Hridyam, Acharya Vagbhata explains the types of diseases and features of curability and incurability.

साध्यो असाध्य इति व्याधि‌द्विधा तौ तु पुन‌विद्वधासुसाध्यः कृच्छ्रसाध्यश्च, याप्यो यश्चानुपक्रमः

Disease are of 4 major type:

• Disease
  • Sadhya (Curable)
    • Susadhya (Easily Curable)
    • Kruccha Sadhya (Curable with Difficulty)
  • Asadhay
    • Yapya (palliable)
    • Anupakrama (Absolutly Irreversable)

सर्वोषधक्षमे देहे यूनः पुंसो जितात्मनः अमर्मगो अल्पहेत्वग्र रूपरूपो

अनुपद्रवः अतुल्यदूष्यदेशर्तुप्रकृतिः पादसम्पदिग्रहेष्वनुगुनेष्वेकदोषमार्गो नवः सुखः

Factors influencing Susadhya (Easily Curable) prognosis:

• Body is capable of withstanding all types of treatments.
• If the patient is young (Diseases can be painful for pregnant women, children and the elderly.) and male (diseases are incurable or difficult-to-cure in female or eunuch. That is why it is prescribed to heal a woman in a gentle form.).
• Having control over sense organs.
• Not striking the vital organs.
• Causes, premonitary symptoms, other signs and symptoms are mild and devoid of complications.
• Dosha, dushya, desha, kala and prakṛti are all dissimilar.
• Fourfold therapeutic measures are available along with beneficial planetary constellations.
• Only one dosa is involved in the pathogenesis of the diseases and manifested in one path way.
• Recent onset etc. are the factors influencing the good prognosis.

शस्त्रादिसाधनः कृच्छुः सङ्करे च तती गदः ।
शेवत्वादायुषो याप्यः पथ्याभ्यासाद्विपर्यये ॥३२।।
अनुपक्रम एव स्यात्स्थितोऽत्यन्तविपर्यये ।
औत्सुक्यमोहारतिकृद् दुष्टरिष्टोऽक्षनाशनः ॥३३॥

Factors responsible for Kruccha Sadhya (bad prognosis).

• Diseases which require more than one difficult methods of treatment like medicine, surgery, applications of alkalines and cauterization.
• Long duration (chronicity).
• Having incurable symptoms.

Palliable Diseases:

• Yapya roga are possessing opposite features of easily curable diseases.
• In this condition, the individual is surviving only due to the length of his life still exists and also taking wholesome diet regularly.

Factors determining the incurablility of diseases:

• Possessing entire opposite characters of easily curable diseases.
• Causing complications like excitement, restlessness and unconsciousness.
• Bad prognostic signs and affect of sense organs will be seen.
• In which all treatments fail to be rejected.

Varjaniya rogi lakşaņa (Features of the patients to be discarded for treatment)

In the following shloka of the Ayushkamiya Chapter of Ashtanga Hridyam, Acharya Vagbhata explains the types of patienthose ts worth rejecting even those having curable diseases.

ततः त्यजेदार्त भिषग्भूपैद्विष्टं तेषां द्विषं द्विषम् ।
हीनोपकरणं व्यग्रमविधेयं गतायुषम् ॥३४॥
चण्डं शोकातुरं भीरुं कृतघ्नं वैद्यमानिनम् ।

• Who hates as well as hated by the physician and the king.
• Who are not having sufficient equipment and instruments for proper treatment.
• Who are busily engaged with other activities and not paid attention towards treatment.
• Who are disobedient towards physician.
• Having short span of life.
• Those who are violent, grief, fearful, ungrateful and who feels himself, as a doctor and not following the instructions given by the physician etc. should not be treated.

तन्त्रस्यास्य पर चातो वक्ष्यतेऽध्यायसङ्ग्रहः ॥३५॥

Chapters in Ashtang Hridayam

For easy understanding the treatise, chapters pertaining to the text Ashtanga Hridayam is enumerated here as under:

आयुष्कामदिनींहारोगानुत्पादनद्रवाः ।

अन्नज्ञानानसंरक्षामात्राद्रव्यरसाश्रयाः ॥३६॥ 

दोषादिज्ञानतङ्गेदतच्चिकित्साद्वयुपक्रमाः । 

शुद्ध्यादिस्नेहनस्वेद्रेकास्थापननावनम् ॥३७॥ 

धूमगण्डूपटक्‌सेकतृप्तियन्त्रकशखकम् ।

शिराविधिः शल्यविधिः शखक्षाराग्निकर्मिको ॥३८॥

Sutrasthana

There are eight places in this book; The first of these is the Sutrasthana of thirty chapters, namely,

• Ayushkamiya,
• Dinachararya,
• Ritucharya,
• Roganutpadaniya,
• Dravadravya-vijnaniyah
• Annasvaroopa-vijnaniyah
• Annaraksharaksha,
• Matrashitiya,
• Dravyadi-vijnaniyah,
• Rasabhediya,
• Doshadi-vijnaniya,
• Doshabhediya,
• Doshadi-vijnaniya,
• Dvividhopakramaniya,
• Shodhanadi-samgraha;
• Sneha vidhi
• swedavidhi
• vamana- virecana vidhi
• basti- vidhi
• nasya vidhi (nasal method),
• dhūma pāna vidhi (smoking method),
• gandushadi vidhi (mouth gargle and such other therapies)
• Ascyotana-anjana vidhi adhyaya
• ointment method,
• Tarpana-putapaka vidhi
• Yantra vidhi
• Sastra vidhi
• Siravyadha vidhi
• Salyaharana vidhi
• Sastrakarma vidhi
• Ksaragnikarma vidhi

ShariraSthana

शारीरमुच्यतेगर्भावक्रान्तितद्व्यापद‌ङ्गमर्माविभागिकम्विकृतिर्दूतजं षष्ठम्

• Garbhavakranti sarira (embryology).
• Garbhavyapad sarira (disorders of pregnancy).
• Anga vibhaga sarira (different parts of the body).
• Marma vibhaga sarira (classification of vital spots).
• Vikrti vijnaniya sarira (knowledge of bad prognosis).
• Dutadi vijnaniya sarira (knowledge of messenger etc.).

NIDANA STHANA (DIAGNOSIS OF DISEASES):

निदानं सार्वरोगिकम्ज्वरासृक्श्वासयक्ष्मादिमदाद्यर्शोतिसारिणाम्मूत्राघातप्रमेहाणां विद्रद्द्याद्युदरस्य चपाण्डुकुष्ठानिलार्तानां वातास्रस्य च षोडशा

• Sarvroga nidanam (diagnosis of diseases in general).
• Jvara nidanam (diagnosis of fever).
• Raktapitta, Kasa nidanam (disease and cough).
• Svasa-Hidhma nidanam (diagnosis of bleeding disease and cough).
• Rajayaksmadi nidanam (diagnosis of pulmonary tuberculosis etc.).
• Madatyaya nidanam (diagnosis of alcoholic intoxication).
• Arsas nidanam (diagnosis of haemorrhoids).
• Atisara-Grahani nidanam (diagnosis of diarrhoea and duodenal disorders).
• Mutraghata nidanam (diagnosis of retention of urine).
• Prameha nidanam (diagnosis of diabetes).
• Vidradhi-Vrddhi-Gulma nidanam (diagnosis of abscess, enlargement of the scrotum and abdominal tumour).
• Udara nidanam (diagnosis of enlargement of the abdomen).
• Panduroga-sopha-visarpa nidanam (diagnosis of anaemia, dropsy and herpes).
• Kustha-svitra-krimi nidanam (diagnosis of leprosy, leucoderma and parasites).
• Vata vyadhi nidanam (diagnosis of diseases of the nervous system).
• Vatasonita nidanam (diagnosis of gout).

CIKITSITA STHANA (THERAPEUTICS):

चिकित्सितं ज्वरे रक्ते श्वासे कासे च यक्ष्मणिवामौ मदात्यये अर्थःसु, विशि द्वौ, द्वौ च मूत्रितेविद्रधौ गुल्मजठरपाण्डुशोफविसर्पिषुकुष्ठश्वित्रानिलव्याधिवातास्रेषु चिकित्सितम्वाविंशतिरिमेअध्यायाः

• Jvara cikitsita (treatment of fevers).
• Raktapitta cikitsita (treatment of bleeding disease).
• Kasa cikitsita (treatment of cough).
• Svasa-Hidhma cikitsita (treatment of dyspnoea and hiccup).
• Rajayaksmadi cikitsita (treatment of pul. tuberculosis, etc.).
• Chardi-Hrdroga-Trsna cikitsita (treatment of vomiting, heart disease and thirst).
• Madatyaya cikitsita (treatment of alcoholic intoxication).
• Arsas cikitsita (treatment of haemorrhoids).
• Atisara cikitsita (treatment of diarrhoea).
• Grahani dosa cikitsita (treatment of duodenal disorder).
• Mutraghata cikitsita (treatment of retention of urine).
• Prameha cikitsita (treatment of diabetes).
• Vidradhi-vrddhi cikitsita (treatment of abscess, enlargement of the scrotum).
• Gulma cikitsita (treatment of abdominal tumour).
• Udara cikitsita (treatment of enlargement of the abdomen).
• Pandu roga cikitsita (treatment of anaemia).
• Svayathu (sopha) cikitsita (treatment of dropsy).
• Visarpa cikitsita (treatment of herpes).
• Kustha cikitsita (treatment of leprosy).
• Svitra-krimi cikitsita (treatment of leucoderma and parasites).
• Vata vyadhi cikitsita (treatment of diseases of the nervous system).
• Vatasonita cikitsita (treatment of gout).

KALPASIDDHI STHANA (PURIFICATORY RECIPES, PHARMACEUTICS):

कल्पसिद्धिरतः परम्कल्पो वमोविरेकस्य तत्सिद्धिर्बस्तिकल्पनासिद्धिर्बस्त्यापदां षष्ठो द्रव्यकल्पः

• Vamana kalpa (emetic recipes).
• Virecana kalpa (purgative recipes).
• Vamana virecana vyapat siddhi (management of complications of emesis and purgation therapies).
• Basti kalpa (enema recipes).
• Basti vyapat siddhi (management of complications of enema therapy).
• Dravya-kalpa (pharmaceutics).

UTTARASTHANA:

अत उत्तरम्बालोपचारे तद्रव्याधौ तद्ग्रहे, द्वौ च भूतगेउन्मादे अथ स्मृतिभ्रंशो, द्वौ द्वौ वर्मसु संधिषुदृक्तमोलिङ्गनाशेषु त्रयो, द्वौ द्वौ च सर्वगेकर्णनासामुखशिरोव्रणे, भङ्गे भगन्दरेग्रन्थ्यादौ क्षुद्ररोगेषु गुह्यरोगे पृथक्वयम्विषे भुजङ्गे कीटेषु मुष्केषु रसायनेचत्वारिंशो अनपत्यानामध्यायो बीजपोषणः

• Balopacaraniya adhyaya (care of the new born baby).
• Balamaya pratisedha (treatment of diseases of children).
• Balagraha pratisedha (treatment of evil spirits).
• Bhuta vijnaniya (knowledge of demons).
• Bhuta pratisedha (treatment of demons).
• Unmada pratisedha (treatment of insanity).
• Apasmara pratisedha (treatment of epilepsy).
• Vartma roga vijnaniya (knowledge of diseases of eyelids).
• Vartma roga pratsedha (treatment of diseases of eyelids).
• Sandhisitasita roga vijnaniya (knowledge of diseases of fornices, sclera and cornea).
• Sandhisitasita roga pratisedha (treatment of diseases of fornices, sclera and cornea).
• Drsti roga vijnaniya (knowledge of diseases of vision).
• Timira pratisedha (treatment of blindness).
• Linganasa pratisedha (treatment of blindness).
• Sarvaksi roga vijnaniya (knowledge of diseases of the whole eye).
• Sarvaksi roga pratisedha (treatment of diseases of the whole eye).
• Karna roga vijnaniya (knowledge of diseases of the ear).
• Karna roga pratisedha (treatment of diseases of the ear).
• Nasa roga vijnaniya (knowledge of the diseases of the nose).
• Nasa roga pratisedha (treatment of diseases of the nose).
• Mukha roga vijnaniya (knowledge of the diseases of the mouth).
• Mukha roga pratisedha (treatment of diseases of the mouth).
• Siro roga vijnaniya (knowledge of the diseases of head).
• Siro roga pratisedha (treatment of diseases of the head).
• Vrana pratisedha (treatment of ulcers).
• Sadyo vrana pratisedha (treatment of traumatic wounds).
• Bhanga pratisedha (treatment of fractures).
• Bhagandara pratisedha (treatment of rectal fistula)
• Granthi-arbuda-slipada-apaci-nadi vijnaniya (knowledge of tumours, cancers, filariasis, scrofula and sinus ulcer).
• Granthyadi pratisedha (treatment of tumours etc.).
• Ksudra roga vijnaniya (knowledge of minor diseases).
• Ksudra roga pratisedha (treatment of minor diseases).
• Guhya roga vijnaniya (knowledge of diseases of genital organs).
• Guhya roga pratisedha (treatment of diseases of genital organs).
• Visa pratisedha (treatment of poisoning).
• Sarpa visa pratisedha (treatment of snake bite poison).
• Kitalutadi visa pratisedha (treatment of poison of insects, spiders etc.).
• Musika-alarka visa pratisedha (treatment of poison of mouse, rabid, dog etc.).
• Rasayana vidhi (rejuvination therapy).
• Vajikarana vidhi (virilification therapy).

इत्यध्यायशतं विंशं ष‌ड्भिः स्थानैरुदीरितम्

End of first chapter of Sutrasthana of Ashtanga Hridayam.

With this, we have finished Ayushkamiya chapter of Sutrasthana- Ashtanga Hridyam by Acharya Vagbhata. In the next post we will cover the remaining shlokas. Dont forget to like, share and comment on the post. You can also follow us on Facebook, Pinterest, whatsapp, twitter and Instagram.

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