Consumption (rajayakshma)

The text calls consumption the seat of all bodily diseases, since breathlessness, cough and many others arise when it is present.

It is called kshaya because it wastes the tissues beginning with rasa, shosha because it dries them daily with its heat, and rajayakshma because it destroys even kings.

The commentary says kshaya, shosha and rajayakshma are meaningful names of tapedik.

Because one dosha predominates more or less, the disease is also called vata, pitta or kapha type, but since the features of all doshas appear together and the treatment is one, it is held to be sannipatic.

Causes named: suppressing stool and urine, excessive intercourse, injury, food lacking nourishing tastes such as sweet, and kapha obstructing the vessels that carry rasa, with all doshas aggravated.

Prodromes: much thick phlegm, breathlessness, slackness of all limbs, vomiting, dry throat, weak digestion, intoxication, whitish eyes, excessive sleep and rhinitis.

Dreams in which one is carried by parrots, peacocks, birds, mongooses, crows, vultures, monkeys or chameleons, or sees a dry stony river or smoke-filled dry trees burning in a forest fire, are also listed as prodromes.

Eleven features are named: from vata, change or loss of voice, sunken flanks and contracted shoulders; from pitta, fever, burning, bleeding and diarrhoea; from kapha, aversion to food, cough, a sore throat and heaviness of the head.

The consumptive is first made unctuous with ghee prepared with nourishing drugs, then cleansed with mild emetics, mild purgatives and mild head purgation.

The paste of stone flower and shilavalka, taken with boiled cow's milk, long pepper and sugar, is said to remove kshaya very quickly.

The chitraka rasayana taken always by rule is said to destroy even strong rajayakshma (kshaya).

Sweet rice, barley and wheat foods with ghee, jaggery, plenty of milk, mung soup, fruits and nourishing vegetables are recommended.

Food and drink should be quick to digest, kindle digestion, give relish, be aphrodisiac and nourishing, and be served with varied tastes and agreeable vegetables.

A footnote says that even a man as capable as a king, once afflicted by this disease, is not freed from it.

A physician who wants a good name should leave a consumptive patient who has all eleven features, or any five or six of them, since the disease has then become incurable.

A patient who keeps wasting while eating a great deal, with swelling of the feet, abdomen and genitals and with diarrhoea, is said to die soon.

A patient with wasting disease (kshaya) who dreams of a monkey as a friend, or of making friends with one, is said to surely die.

The text quotes, in order to reject it, Charaka's treatment of consumption (shosha), in which the meats of birds, snakes, earthworms, foxes, mongooses, cats, jackals and flesh-eating beasts are to be given to the consumptive disguised under the names of peacock, partridge, fish, hare and deer, so that they are eaten without disgust.

The translation quotes, in order to reject it, Charaka's treatment of consumption (shosha): for a consumptive whose life is in doubt, the flesh-increasing meat of meat-eating animals is to be given by rule, peacock and under that name vulture, owl and blue jay; partridge and under that name crow; varmi fish and under that name snakes; fish entrails and gandupada (a kind of insect); hare and under that name jackal, large mongoose, cat and jackal cubs; and lion, bear, taraksha, tiger and also elephant and rhinoceros, so that flesh grows; a patient unused to meat or disgusted by it is to be made fond of it by praise, and the meat given under other animals' names so that he does not refuse it or vomit it.