Learn by asking

It was first published at Solapur in 1940 by the Sakhārām Nemchand Granthamālā; the second edition was issued in August 2014 by Dharmoday Sahitya Prakashan, Sagar, at the inspiration of Āryikā Gurumatī Mātājī.

The publisher's note says the work had become rare and unobtainable. In 2003 Āryikā Gurumatī Mātājī's group, staying briefly in Solapur, asked about it; the editor's grandson Dr. Mahāvīr Śāstrī said the family could not get it reprinted, and with his consent Śrī Mahāvīr Luhāḍe of Jalna took on the reprint, which appears unchanged in its original form, in 1100 copies. The first edition had been published by Govindjī Rāvjī Dośī in memory of his father, Seṭh Rāvjī Sakhārām Dośī, who had worked for the recovery of the work.

It has 25 chapters (pariccheda) and an appendix with the Riṣṭādhyāya, the Hitādhyāya and the Vanauṣadhiśabdādarśa, a glossary giving medicine names in Sanskrit, Hindi, Marathi and Kannada.

The introduction adds that for each disease the work treats the cause, prodromal signs, pathogenesis, treatment and curability together, sets out rasa, rasāyana and kalpa preparations in separate chapters, and has a section on fatal signs. Rai Bahadur Narasiṁhācārya, quoted by the editor, says the work opens by dividing medicine into prevention and cure and ends with a long Sanskrit prose discourse on the uselessness of a flesh diet.

Four: a copy of the palm-leaf manuscript in the Mysore Government Library, a palm-leaf manuscript in Kannada script from Shravanabelagola, a Mumbai copy that seems to be made from it, and an old, mostly correct paper manuscript from Raichur district.

The editor says the Mysore copy is handsomely written but incorrect and omits the Hitāhitādhyāya, while the Raichur manuscript resolved many difficulties; its colophon traces its copying from Bālacandra Bhaṭṭāraka (Śaka 1351). He collated the copies, noted variant readings in places, and printed the Hitāhitādhyāya, found in two copies, as it stood because it was too corrupt to correct.

Pt. Vardhamān Pārśvanāth Śāstrī edited and translated it; Pt. Anantarājendra Śāstrī of Mumbai and Pt. Bindumādhav Śāstrī of Ahmednagar revised it; Vaidya Pañcānana Pt. Gaṅgādhar Gopāl Guṇe Śāstrī wrote the introduction; and Seṭh Rāvjī Sakhārām Dośī inspired and supported the work.

The editor says Dośī had the first copy made at the Mysore Government Library, encouraged the translation, supported the founding of the Kalyāṇa press named after the work, and gathered materials and funds; he died before the book appeared, and his son Seṭh Govindjī Rāvjī completed the task and published it in his memory. The editor, who says he is not a physician, signed his statement at Solapur on 1-2-1940.

In the Jain canon the Prāṇāvāya is one of the fourteen Pūrvas of the twelfth aṅga, the scripture that sets out the eight-limbed Ayurveda; Ugrāditya says he composed the Kalyāṇakāraka in Sanskrit by condensing this Ardhamāgadhī scripture.

The editor says the Jain āgama is authoritative because the gaṇadharas arranged the Omniscient's divine voice into the twelve aṅgas, and that the Prāṇāvāya also deals with poisonous creatures and their treatment and the division of prāṇa and apāna; citing chapter 25, verse 54, he regards the Kalyāṇakāraka as part of that canon. The introduction's footnote, calling it the Prāṇavāda Pūrva, says all ācāryas composed their Ayurvedic works in accordance with it.

Medicine protects the health of the healthy and frees the sick from disease (chapter 1, verse 24). Health is ultimate (pāramārthika), the imperishable bliss of the soul, or practical (vyāvahārika), the balance of the dhātus, agni and doṣas with clear senses, a joyful mind and a disease-free body.

The editor says medicine is composed to benefit the world and that the work treats both purposes in brief. Ultimate health is said to come from destroying the eight karmas; the author names the karma that brings pain (asātāvedanīya) as the main cause of ill health and doṣa imbalance as its outer cause.

No formula in the work uses wine, meat or honey, because they arise from violence; and its last section, which Ugrāditya is said to have delivered at the court of Nṛpatuṅga Vallabha, sets out to prove that meat is of no use in medicine.

The introduction says giving them up upholds non-violence and that they are not indispensable in treatment. The editor reads Somanātha's Kannada verse as showing that Pūjyapāda's Kalyāṇakāraka also used no wine, meat or honey, and cites K. Śeṣaśāstrī, Kavirāj Gaṇanāth Sen and Kavirāj Yogīndranāth Sen as physicians who rejected wine and meat in medicine. He argues that plant medicines can remove even terrible diseases, citing Samantabhadra's bhasmaka disease.

He was a contemporary of the Rāṣṭrakūṭa king Amoghavarṣa I (Nṛpatuṅga), living in the 8th century of the Śaka era, the 9th century of the Vikrama and Christian eras.

The work cites earlier ācāryas presumed to be before the sixth century, and its closing sentence says Ugrāditya delivered its last section in the assembly of Nṛpatuṅga Vallabha; the editor identifies this king with Amoghavarṣa I, whose accession historians place in Śaka 736 (815 CE) and who was a disciple of Jinasena. He cites Prof. Saletore and Rai Bahadur Narasiṁhācārya, who calls Ugrāditya a contemporary of Amoghavarṣa I and of the Eastern Cālukya king Kali Viṣṇuvardhana V. The earlier introduction by Gaṅgādhar Guṇe Śāstrī infers only that the work is later than Vāgbhaṭa.

In the Jina temple on the Rāmagiri hill in Veṅgi, the chief place of the Trikaliṅga country; his guru was Śrīnandi Ācārya.

The editor says Ugrāditya's brief self-introduction in chapter 25 names Śrīnandi, whose feet a king called Śrī Viṣṇurāja Parameśvara worshipped. He explains Trikaliṅga as North Kaliṅga or Utkala (from the Gaṅgā to Kaṭaka), Middle Kaliṅga (from Kaṭaka to Mahendragiri) and South Kaliṅga (from Mahendragiri to the Godāvarī), and suggests the Rāmagiri may be the one where, according to the Padmapurāṇa, Rāmacandra had temples built.

Chiefly Pūjyapāda (a Kalyāṇakāraka, a Śālākyatantra and the Vaidyāmṛta), Samantabhadra (the Siddhānta Rasāyana Kalpa), the sages of the Puṣpāyurveda, Gummaṭadeva Muni (Merutantra) and Siddha Nāgārjuna (Nāgārjuna Kalpa, Nāgārjuna Kakṣapuṭa), as well as authors who wrote medical works in Kannada.

He notes that Ugrāditya cites the views of earlier ācāryas such as Pūjyapāda, Samantabhadra, Pātrasvāmī, Siddhasena, Daśarathaguru and Meghanātha, whose works are now lost. He says Samantabhadra's work had 18,000 verses, that the Puṣpāyurveda gives rasāyana preparations from 18,000 kinds of pollen-free flowers, and that Somanātha's Kannada translation of Pūjyapāda's Kalyāṇakāraka is the oldest medical work in Kannada, and he laments that such works are being lost to insects.

The Lord's divine voice answered by setting out, in brief, the four subjects of the whole science (the person, diseases, medicines and time) with their features, kinds and sub-kinds.

Bharata and others put the question in the assembly of Ṛṣabhanātha, explaining that in the present land of action many humans have lives that can be cut short and live in great fear from the aggravation of vāta, pitta and kapha (verses 4-6). After they fell silent, the divine voice went forth (verse 7) and first described the person, diseases, medicines and the distinctions of time, dividing the whole of Ayurveda into four subjects (verse 8). This teaching was received by the gaṇadharas and handed down through the sages (verses 9-10), and the book states the purpose of the science as protecting the health of the healthy and freeing the sick from disease (verse 24).

The physician, the patient, the medicine and the attendants; the wise physician is the chief.

Verse 28 says that what the sages call kriyā is treatment and that it rests on four components endowed with their qualities: the physician, the patient, the medicine and the attendants who serve the patient. The commentary adds that the wise physician is the chief, because without him the other three are useless.

'Veda', from the root vid (knowledge, reflection, gain), means what reveals the true nature of things, and joined with 'āyus' it names the science of life. Its purpose is to protect the health of the healthy and to free the sick from disease.

Verse 19 and its commentary say the science is called Ayurveda because it sets out wholesome and unwholesome, happy and unhappy life, the signs and measure of life span and the substances good or bad for life. Verse 24 says the science exists to benefit the world and has two aims: protecting the health of the healthy and releasing the sick from disease.

The patient's span of life, learnt through questions, portents, omens, scripture, astrology, dreams and the words of those with divine knowledge.

Verse 30 tells the physician to learn the measure of the patient's life through questions, portents, omens, scripture, astrology (ascendant and lunar conjunctions), dreams and divine statements before making efforts at treatment. Verse 31 adds that no one dies without death signs (riṣṭa), which must be searched for carefully, and verses 33-37 describe the messenger's signs and the omens met on the way that point to the patient's death.

Ultimate (pāramārthika) health, the bliss of liberation, which is primary, and practical (vyavahāra) health, which is secondary; practical health means balanced digestive fire and tissues, undisturbed doshas, proper elimination of wastes and a clear self, senses and mind.

Verse 2 says the Jinas declared health to be of two kinds, the first and chief being ultimate health and the other arising from worldly practice. Verse 3 describes ultimate health as the wondrous, final, unequalled bliss beyond the senses born of the destruction of all karmas. Verse 4 lists the marks of practical health: balanced fire and tissues, absence of dosha disturbance, proper excretion and constant clarity of self, senses and mind; a footnote quotes Vāgbhaṭa's similar definition. Verse 7 adds simply that one whose body is free of disease is called healthy.

Balanced fire digests a proper meal properly; irregular fire (from vāta) sometimes digests it and sometimes not; sharp fire (from pitta) digests even an excessive meal; weak fire (from kapha) cannot digest even a small one. The text pairs enema therapy, purgation, and emesis with nasal therapy with the vāta, pitta and kapha types in that order.

Verse 11 asks the physician to judge whether a person's fire is balanced, irregular or weak; verse 12 says disordered fire is threefold, irregular from vāta, sharp from pitta and weak from kapha, and its footnotes give the definitions. Verse 13 pairs enema, purgation and emesis with nasal therapy with these in order, and verse 14 says balanced fire is protected by seasonal food and by enemas, purgation and emesis suited to the three periods; a footnote defines balanced fire. These are purification procedures that the text assigns to the physician.

Dry land (jāṅgala), with thin, rough-bodied people, mostly has vāta disorders and calls for vāta-pacifying treatment; marshy land (ānūpa), with stout, kapha-predominant people, has vāta disorders with much kapha and calls for treating kapha and vāta; ordinary land (sādhāraṇa) has balanced conditions, no dosha disturbance and is the best.

Verse 19 names the three lands and calls the ordinary one chief. Verses 20-24 describe dry land by its rough vegetation, hard hills, scarce deep wells and thin people with prominent veins, who suffer mostly from vāta. Verses 25-34 describe marshy land by its cold water, mud, lush trees, lakes and rich milk-and-jaggery diet, whose stout people suffer vāta disorders with much kapha. Verses 35-38 describe ordinary land as free of extremes, where seasonal food and balanced fire keep the doshas undisturbed so that disease does not arise.

It becomes kalala in ten days, turbid in ten more and firm in ten more, then bubble-like and solid in the following months; flesh grows in the fifth month, limbs in the sixth, skin, nails and hair in the seventh, and the head's opening pulsates in the eighth; birth comes in the ninth or tenth month. Until the seventh month it absorbs juices from the mother's food all around; after that it feeds through a navel cord.

Verse 48 says the semen mixes with the woman's blood in the womb and the soul enters by its karma; verses 51-52 say the joined mass gains the six capacities within an antarmuhūrta and takes bodily form. Verses 53-54 give the timeline, adding that if the child is not born within ten months a disorder is to be understood. Verses 55-57 say the child lies wrapped in the jarāyu between stomach, intestine and rectum, drinks the pitta- and kapha-rich juices formed from the mother's food like a corpse in a water pot, and after seven months receives nourishment through a lotus-stalk-like navel cord that the commentary connects to the mother's heart; birth may go well or end in the death of the child or even the mother.

300 bones, 300 joints, 900 sinews, 700 veins, 500 muscles, 24 vessels (dhamanī) and 107 vital points. The footnote says the joint count cannot equal the bone count, notes Suśruta's 300 bones and 210 joints, and calls the reading a scribal error.

Verse 2 counts 300 bones, 300 joints, 900 sinews, 700 veins and 500 muscles; the footnote argues that two bones meet at one joint, so joints must be fewer, cites Suśruta (300 bones, 210 joints) and, although all three manuscripts read the same, judges the reading corrupt. Verse 3 counts 24 dhamanīs from the navel (ten up, ten down, four crosswise), 16 kaṇḍarās and 6 kūrcas. Verse 4 adds 2 muscle cords, 7 skin layers, 8 channels, one liver, one spleen and 16 rows of large intestine. Verse 5 gives 107 vital points, 9 openings and eighty lakh hair pores, and verse 6 gives 32 teeth and 20 nails.

Constitution is formed by the dosha that predominates when the soul enters the mixed semen and blood in the womb, and it is balanced if all three are equal. The vāta type is described as thin and rough, with dry sparse hair and cracked feet, restless and wakeful; the pitta type as quick-tempered, sharp-witted, sweating and warm-bodied, ageing and balding early; the kapha type as stout, steady, patient and fond of sweets, with a deep voice.

Verse 17 and its commentary say the dominant dosha at the moment the soul enters the mixed semen and blood decides the constitution: a pitta-dominant mass gives a pitta constitution, and so on, with equal doshas giving a balanced one. Verses 18-20 describe the vāta type as disliking cold, wakeful and talkative, unsteady and friendless, thin and rough with cracked feet and visible vessels, dreaming of mountain peaks and the sky. Verses 21-24 describe the pitta type as angry, intelligent, eloquent and skilled, with red lips and palate and a warm, loose body, ageing early, balding, always hungry and dreaming of gold, fire and red flowers. Verses 25-27 describe the kapha type as intelligent, stout and cheerful, grateful, prosperous, with a voice like a drum or lion, tolerant of pleasure and pain, slow to learn but accomplished, dreaming of lotus pools and rivers.

Cow, goat, buffalo, horse, donkey, camel, elephant and ram; all are said to kill worms, to be pungent, bitter, hot, dry and light, and to remove kapha and vata.

Verse 35 opens the group of urines (mūtravarga) with eight kinds of urine and gives them one shared set of properties: they destroy worms, are pungent, bitter and hot, dry and light, and remove kapha and vata.

Kushtha, tumours, nodules, kilāsa, painful urination, piles, corrupted wounds and all worm diseases; by its fiery power it burns the body.

Verse 36 says alkali always shares the properties of urine. The commentary lists the conditions it conquers and adds that its fiery (āgneya) power burns the body. The text gives no preparation or dose here.

Warm water, drunk after the meal.

Verse 39 calls warm water drunk afterwards the one medicine for all food in general. The same verse names sauvīra for bitter foods and sour buttermilk for salty foods, and the commentary adds that taking kāñjī with the meal is good.

A sweet after-drink with astringent fruits and tuber and leaf vegetables, and a pungent one with plainly sweet foods.

Verse 40 calls a sweet after-drink wholesome with astringent fruits and tuber and leaf vegetables, and an after-drink of pungent substances best with foods that are plainly sweet. A footnote glosses katu as covering both pungent and bitter.

A salty after-drink for sour foods and a bitter and astringent one for pungent foods; milk is wholesome with every taste.

Verse 41 gives the salty after-drink for sour foods, bitter and astringent after-drinks for pungent foods, and calls milk a wholesome after-drink with all tastes.

By giving whatever the person craves, is wholesome for them and suits their constitution.

Verse 42 notes that cravings shift: heavy use of sour can bring a longing for sweet, and overuse of another taste a longing for sour. The physician should therefore apply, by the rule of after-drinks, whatever is wholesome, appetizing and suitable for each person.

Wash the hands, rub them together, touch the eyes with the wet hands and rub the face lightly; this is said to help the eyes and make the face radiant.

Verse 43 says the eyes gain brightness and various eye diseases go away, and that the face, rubbed this way every day, becomes radiant like a lotus while facial vyanga, tilakālaka, nīlī and other conditions are removed.

Rinse the mouth, take astringent, bitter and pungent things or a pleasant smoke to clear kapha, sit at ease, walk a hundred steps, lie briefly on the left side, avoid exercise and sit a while taking liquids.

The commentary names areca nut, catechu, clove, musk and betel as the astringent, bitter and pungent things, and explains that kapha increases as soon as one eats. A footnote adds: after eating, sit like a king.

Because it is the one benefactor of the world.

Verse 45 likens the work to a drop drawn from the ocean of scripture that came from the mouth of the Jina, whose waves are all substances and principles and whose two shores are the means to the aims of this world and the next; the commentary concludes that it is therefore named Kalyāṇakāraka.

Mixed in one kudava of breast milk (16 tola in the commentary), drunk in the morning.

Verse 58 says to take a kudava of breast milk and drink it in the morning; the commentary says the person sits alone in the inner chamber of the specially built house, away from relatives and attendants, mixes the chandramrita into 16 tola of breast milk and drinks it with a steady mind.

They grow daily in the bright fortnight and are full at full moon, then decline in the dark fortnight and all fall on the new-moon day.

The text says the plant waxes and wanes with its leaves like the moon. The commentary adds that it is very hard to find and grows in lakes, deep rivers and mountain regions, and that its potency, name and form are one and many like the Jain syadvada, that is, beyond conception.

A very solid house with three walls and three storeys that is entered only after three circumambulations; the user stays alone in its central chamber.

Verse 58 and its commentary describe the house and say the user sits in its inner chamber (garbhagriha), separated from relatives and attendants, to drink the chandramrita.

At first only milk, fragrant and boiled then cooled; once strength appears, shali rice with ghee and milk once a day, along with massage, bath and anointing.

Verses 59-60 say that the person who has been properly vomited and purged, lying on the ground and hungry, is given only milk by the attendants, daily and very cool; after the strength born of the nectar is seen, bath, massage and anointing follow, and a meal of shali rice with milk and ghee is given once a day.

Wearing shoes, socks, a warm coat and a turban and accompanied by family, he goes out at night and gets used to fire, wind, cold, heat and drinking water, then returns to the house, daily.

Verse 61 says that after a month, with feet covered, body wrapped and head covered, protected and surrounded by attendants, he leaves his dwelling night after night, practises exposure to fire, wind, cold, sun and water, and again lives in the house in the same way.

To the sinful, timid, careless, those without family or wealth, those who disrespect medicine, lack aspiration or enthusiasm, are given to vices or unrestrained, the angry, those hostile to the Jina's teaching and wicked people.

Verse 65 describes these medicines as the source of prosperity and happiness and lists the people who must be excluded from receiving them.

Because of fate, ignorance, lack of money, unavailability of the drug, an unsteady mind, lack of steady effort, their nature, lack of a suitable house, contact with unfriendly relatives and friends, or unbelief.

Verse 66 says that even the generous and wealthy do not obtain these great medicines, though they are most beneficial to them, for these reasons.

The stool is white, thick and very cold and comes slowly and in large amount; the patient feels chilled and the body heavy and cold.

Verse 86 and its commentary attribute these signs to an excess of kapha and call the disease shleshmatisara. The following verse adds the signs of sannipata, ama and pakva diarrhoea.

Stool that sinks in water and smells foul marks ama diarrhoea; the opposite signs mark pakva diarrhoea.

Verse 87 gives this test. Verse 90 asks the physician to judge the ama and pakva states before treating; the commentary explains digestion (pachana) for ama and binding (stambhana) for pakva.

The very young, the very old, the emaciated, the weak and the consumptive, and those whose stool looks like ghee, spleen, fat, liver, oil, water, milk, curd or buttermilk.

Verse 89 gives this list. Verse 88 adds that diarrhoea from excessive grief, with very bloody hot stool, bloating, colic, complications such as thirst, swelling, fever, breathlessness and cough, loss of appetite and a weakened voice, is said to destroy the patient.

Warm water mixed with a paste of madanaphala, rock salt and long pepper is drunk to induce vomiting; nothing is eaten that day, and the next day a little warm vilepi or yusha cooked with binding drugs is given.

Verse 90 prescribes the emesis and verse 91 the after-care, given once intoxication, burning and the doshas have settled. Both records are marked as requiring professional supervision.

For diarrhoea in the pakva stage; it is drunk with whey.

Verse 95 lists mango seed kernel, lodhra, liquorice, sesame, padmaka, dhataki flowers, silk-cotton gum, bael pulp, priyangu, kutaja bark, ativisha and manjishtha, powdered together.

Barks of cinnamon, aralu, kutaja, mango, kadamba and jambu are ground with thick rice water, wrapped in banana leaves, cooked by putapaka and squeezed; the cooled red juice is drunk with liquorice paste.

Verses 96-97 say the juice is fragrant and red and overcomes diarrhoea very quickly. As an alternative, ambashthika, pomegranate and tinduka cooked in buttermilk are drunk.

A decoction of jambu, mango, neem, musta, aragvadha and dhataki flowers is reduced to one eighth, strained and cooked until it coats the ladle; the thick preparation is licked.

Verse 98 says licking it overcomes diarrhoea soon; the commentary calls the product an avaleha.

Long-standing diarrhoea, chronic fever, insanity, epilepsy, urinary stone, gulma, abdominal enlargement, liver disorder, vata, breathlessness and cough, spleen enlargement, ashthila, urinary gravel, asrigdara, burning, vertigo, depleted semen and fainting.

Verse 101 names cow's milk taken lukewarm and adds that milk prepared with medicines suited to each disease is better still.

Buttermilk with rock salt and dry ginger; mung soup with cumin tempered with ghee, salt and black pepper; and milk prepared with ajamoda and rock salt.

Verse 102 lists these three as wholesome food for people with chronic diarrhoea and chronic fever.

Cure the curable with medicines, keep the manageable in check with skilled procedures, and declare the incurable as incurable and give them up.

Verse 27 says curable (sadhya) diseases are to be cured with medicines and other measures, manageable (yapya) diseases are to be sustained with various procedures, and diseases that are hard to understand and hard to treat are incurable; the physician should say so and abandon them.

Treat with half of them, or half of that, or with as many as are available.

Verse 26 calls the medicine groups unique and unfailing and says that if the whole group is not available, using half, half of that, or finally whatever can be obtained still makes the diseases subside.

The dosha that caused the disease, which dosha is strong or weak, the merits and faults of the medicines, and the signs of the major diseases.

Verse 25 describes the learned physician as one who considers which dosha produced the disease and which is strong or weak, understands the good and bad qualities of excellent medicines, knows the signs of the major diseases, and then conquers diseases with suitable medicines.

Substances and their tastes, potencies, post-digestive effects and specific actions are countless and cannot all be told in a short treatise.

In verse 24 the author says many more medicines with greater and wonderful qualities exist beyond those described; even all-knowing physicians leave the account of substances incomplete, so someone like himself cannot complete it.

Sitopaladi churna.

Footnote 1 on PDF 227, attached to the heading of the Tvagadi powder (verse 22), says that in practice it is called Sitopaladi churna.

As a drop from the ocean of scripture that came from the Jina's mouth; the commentary says it is the one benefactor of the world, hence the name.

Verse 28 pictures an ocean whose waves are all substances and whose two banks are the means for this world and the next; the treatise is a drop from it. The commentary adds in brackets that because it is the sole benefactor of the world it is named Kalyanakaraka.

Their types, sub-types, mixed forms, and greater or lesser predominance.

After the causes, signs and remedies of the three doshas have been told in brief, the physician is to pacify diseases by applying fitting medicines with attention to the types, sub-types, combinations and predominance of the doshas.

One's own karma done before; all other causes are secondary.

Verse 11 says every disorder has a cause, to be sorted into primary and secondary: the primary cause is one's own past karma and the rest are its instrumental qualifiers. Verse 13 adds that diseases arise not from the anger of the elements, aggravation of the doshas, a bad year or the planets, but from the rise and udīraṇā of karma, while verse 10 names the aggravation and calming of the doshas as the instrumental causes through which sin and merit bear fruit.

Internal treatment, which is dharma, and external treatment, which is only an auxiliary cause; external treatment means oleation, sudation, emesis, purgation and, where suitable, excision and incision, chosen according to substance, place, time and condition.

Verse 30 calls dharma the internal cause of calming disease and external treatment an auxiliary cause, which is what the book describes. Verse 31 says that by following dravya, kṣetra, kāla and bhāva and applying oleation, sudation, emesis and purgation, or excision and incision in diseases that need them, the sick person becomes well. Earlier, verse 14 says the wise call the practice that calms karma, such as worship and meditation, the real treatment.

By means (upāyapāka), through medicines that remove the unripe state of the disease, and by time (kālapāka), on their own without medicine.

Verse 16 compares the doshas to fruit, which ripens on the tree by itself or is ripened by skilled people. Verse 17 defines ripening by means as ripening the doshas with medicines that remove āma, and ripening by time as their ripening within their own period without medicine, which is seen in animals, birds and the destitute. The same two ways of ripening are described for karma in verses 14-15.

He must know both the texts and the practice, and be truthful, steady, forgiving, light-handed, healthy, experienced and careful; one who knows only theory or only practice is not fit.

Verse 38 lists the physician's qualities: truthful, steady, forgiving, light-handed, accomplished and healthy, having seen great treatments, having learned the whole science from a teacher, and free of carelessness. Verses 46-48 add that he must study under a teacher and also gain practical experience; two half-physicians together are as useless as two one-legged men tied together, and only one skilled in both, who knows medicines, instruments, surgical instruments and texts, may treat the people with the king's permission. Verses 49-51 say an ignorant physician kills, should be stopped by kings, and turns even good medicines into dangers.

Physician, patient, medicine and attendant; the attendant should be strong, forgiving, steady, devoted to helping others, tolerant, affectionate and skilful.

Verse 42 says that physician, patient, medicine and attendant, each with its qualities, are the four unequalled limbs of treatment, and together they destroy disease quickly, as a king defeats enemies with his fourfold army. The patient should be wealthy, long-lived, intelligent, well supported by family and servants, strong, self-controlled and wish for his own good (verse 39); the medicine should come from a good region, be gathered in season, small in dose, pleasant, of good appearance, taste and smell and work as soon as taken (verse 40); and the attendant has the qualities of verse 41. Verse 43 adds that the physician, helped by the other three, brings quick relief.

By seeing, touching and questioning; touch shows whether the body is hot or cold, hard or soft, unctuous or dry, light, heavy or clear, and whether this is natural or deranged.

Verses 52-53 tell the physician to learn the strength of the disease and whether it is curable by seeing, touching and questioning before treating. By touch (verse 54) he judges heat, cold, hardness, softness, oiliness, dryness, lightness, heaviness and clarity of the body affected by the doshas, the commentary adding the movement of the pulse. By questions (verse 55) he learns the patient's region, family, natural state, digestive fire, the force of the disease, strength, desired food, stool and urine and what suits him. By sight (verse 56) he reads shade, form, marks, signs and temperament to judge whether life span is declining or growing.

Into curable and incurable; the curable are hard to cure or easy to cure, the incurable are manageable (yāpya) or untreatable (anupakrama), four kinds in all.

Verse 58, which names Samantabhadra as its source, divides diseases into curable and incurable, each in two kinds. Hard-to-cure diseases yield only to great effort, arrangements and formulations, easy ones to little effort, short time and few medicines (verse 60). Manageable diseases are held down by suitable medicine and diet but kill in time, while untreatable ones take life at once; before treating such incurable states the physician should say so clearly, or he earns disrepute (verse 59). Verse 61 sums these up as four kinds.

Each disease slides one class worse: easy becomes hard, hard becomes manageable, manageable becomes untreatable, and the untreatable kills at once.

Verse 62, which the commentary attributes to Ācārya Pūjyapāda, says that without prompt treatment by the method of the texts, curable diseases become hard to cure, hard ones manageable, manageable ones untreatable, and untreatable ones destroy life immediately. Diseases destroy precious life as quickly as fire or a snake, so they should always be set right promptly with proper treatment. Verse 57 similarly warns that a great disease may look slight and a slight one incurable, so the physician should weigh everything by reasoning and scripture and treat quickly.

Because if the soul were wholly permanent no treatment would be needed, and if wholly momentary there would be no one to treat.

Verses 3-6 describe the soul as knower and seer, bound to a body made by its own karma, the doer and enjoyer of its karma, the size of its body, and permanent yet changing through birth, old age and death. Verses 7-8 say only a physician whose doctrine holds this view can give treatment that brings happiness, because absolute permanence or absolute momentariness would rule treatment out; so the syādvāda (anekānta) view must be adopted. Verse 9 extends this to the person, disease, medicine and time, which are to be held valid only in a relative sense.

The house should be in an auspicious place, protected, clean, guarded and stocked with medicines; the bed new, wide and curtained, with the patient lying head to the east or south.

Verses 18-21 describe the house first because it matters most: built in an auspicious direction and place, protected by mantra, yantra and tantra rites, always swept, lit, scented with incense and hung with flowers, guarded and entered only by tested men and women, not draughty or full of holes or defects, and stocked with equipment and good medicines. Verses 22-23 give a good cot with new, wide, pleasing bedding, curtains all round and a canopy above; steady, alert and calm friends and relatives watch over the patient, who lies with the head to the east or south.

Prameha, kushtha, udara, vatavyadhi, mudhagarbha, haemorrhoids, urinary stone and fistula-in-ano.

Verse 4 of chapter 11 says the omniscient ones call these the major diseases. The chapter then undertakes to describe each with its signs, fatal signs, curability, chief causes, prevention and treatment, and begins with prameha.

Too much heavy, liquid, unctuous and cold food, much day sleep, lack of exertion and idleness; the prodromes are burning in the hands, feet and body, thirst, an unctuous sticky body, sweetness in the mouth and overeating.

Verse 6 gives the causes and verse 7 the prodromes. Verse 8 explains that the aggravated doshas with fat reach the bladder and ripen there, so that turbid urine flows copiously and often, which the commentary calls the chief sign of prameha.

It turns in time into madhumeha; the patient is then called madhumehi and develops prameha boils.

The commentary on verse 10 adds this to the definition of prameha (passing much urine with the prodromes present). Verse 43 says that when the patient is not treated with the diet, conduct and medicines described, the boils appear especially on the lower body, and verse 44 notes that the madhumeha patient is hard to purge.

Sharavika, sarshapika, jalini, putrini, kacchapika, masurika, vidarika, vidradhika, alaji and vinata; they are treated with leeches and strong purgation, ripening applications, incision, cleansing and healing.

Verse 11 names nine and calls them ten; the commentary adds vinata, which verses 19-20 describe. Each is named after its form, for example sharavika after a shallow earthen dish and masurika after a lentil, and all arise from the three doshas. Verses 44-46 give leech bloodletting and strong purgation, then pressing, plastering and bandaging with mustard, radish seed, rock salt, drumstick and the three pungents until the boils ripen, then incision, cleansing and healing.

The thin are built up with nourishing medicines and the stout are made lean with reducing (karshana) measures.

Verse 29 says prameha patients are of these two kinds by birth or through unwholesome diet. The course that follows is a dry diet that avoids alcohol, milk, ghee, sour things, sweets, curd, sugarcane and meat; oleation with sesame, linseed and mustard oil and emesis with neem juice and madanaphala; purgation; a niruha enema with cow urine and sesame oil; and grains and pulses such as kodo millet, barley, wheat and green gram.

Constant exertion such as riding elephants and horses, weapon practice and running; a poor well-born patient is sent on pilgrimage on foot, and a poor patient of low birth digs wells and tanks and tends cattle.

Verse 40 calls for constant practice of exertion to remove prameha. Verse 41 sends a well-born but poor patient whose disease is hard to cure on pilgrimage on foot, and verse 42 tells a poor patient of low birth to dig wells, tanks and step-wells, tend cows, eat once a day what he gets by begging and drink water of the kind cows drink.

The wound is cleansed with cleansing drugs, filled with a healing paste, covered with leaves and wrapped in fine cloth; the next day the bandage is opened, the pus pressed out, the wound washed with decoction water, dressed and bandaged again.

Verses 47-48 list the cleansing drugs (karanja, turmeric, neem, kutki and others) and the healing drugs (sesame, lodhra, liquorice, arjuna bark, manjishtha and others). Verses 51-53 describe the bandage and say that bandaging cleanses the wound, heals it and makes it soft and painless, so it is the right course in all wounds. A clean wound is stable, without pus, painless, pigeon-coloured and fleshy; a healed one is level with the skin and of the same colour (verse 55).

He is free when he passes urine that is clear, very bitter, dry, alkaline, slightly warm and not turbid, only now and then and in small amounts.

Verse 56 gives these signs of recovery. In contrast, verses 25-27 describe as incurable the patient whose urine flows like fat, ghee, honey or an elephant's rut fluid, who has the complications, boils on vital places, dreams of swimming in or drinking from rivers and seas, and a wasted body; treating such a patient is called futile.

Aruna from vata; kapala, rishyajihva, audumbara and kakanaka from pitta; dadru and pundarika from kapha.

Verses 61-62 say these are called great because they penetrate the tissues and are mostly incurable. Minor kushtha has thousands of varieties through kapha and blood (verse 63); the text goes on to describe sidhma, rakasha, mahakushtha, eka, vicharchi, vipadika, parisarpa, visarpana, kitibha, charmadala, pama and kacchu, and verse 58 says kushtha takes eighteen forms.

Kushtha in the skin, blood and flesh is curable with medicines; in the fat it is only manageable; the rest, in bone, marrow and semen, does not heal even with panchakarma.

Verses 76 and 84 give this scheme. Also incurable are kilasa, tridoshic kushtha, non-discharging pale kushtha in the skin and congenital kushtha (verse 70), pundarika like a white lotus and kakanaka coloured like the bandhuka flower, gold or the bimba fruit (verse 77), and a badly affected child of parents with kushtha (verse 78). Severe eye disease, loss of voice and pus flowing from the sores are the fatal signs (verse 78).

Emesis every fifteen days, strong purgation every month, bloodletting every six days and head purgation every three days.

Verse 99 says kushtha patients must be purified upward and downward and bled freely, because remaining dosha makes the kushtha return. Verses 100-101 then give the schedule and call it the course of treatment for all kushtha, to be carried out by a careful physician.

The bhallataka-seed paste (verse 97) and the bhallatakadi paste (verse 98), both made with burnt drugs in sesame oil.

Verse 96 says the kushtha pastes also apply to shvitra and announces colour-restoring pastes. The first uses bhallataka seed, chitraka, bilva pulp, bhringaraja, arka latex, orpiment and realgar, or the hides of leopard, tiger, elephant or deer; the second burns bhallataka, the three myrobalans, arka latex, sesame, the three pungents, vidanga, apamarga, kanjira, bitter gourds and neem seed.

A ghee pot is heated in fire, leaves of jambu, kapittha, tulasi, mango and citron are boiled in it, it is washed with fragrant water, smeared inside with pepper and pippali in sugar water, perfumed with flowers and bound outside with cords.

After the medicine, jaggery and khadira decoction are put in, the mouth is sealed and the pot is buried in a pit filled with grain. The text says every such nectar-like preparation (every arishta, in the commentary) is made this way; the danti and iron preparation is taken out after seven days, fifteen days or a month, and the ash-water preparation after a month.

Food free of salt and sour things, and one tula in all (5 ser in the commentary); one who does so is said to live a hundred years free of disease.

Verses 119-121 describe making the ash with sixteen heatings and taking it with ghee and sugar after judging strength, saying it removes kushtha, spleen disease, piles and pandu and gives strength, youthfulness and comfort. Verse 122 adds the diet and the one-tula course, and the commentary concludes that it is a rasayana.

Musta, vidanga, triphala, chitraka and the three pungents with an equal amount of iron, taken with sugar and ghee; it is said to relieve pandu, prameha, piles, severe kushtha, sinuses and worm disease.

Verse 123 has the nine drug parts powdered with iron equal to them; the commentary says nine parts of iron bhasma and leaves out triphala. Verse 124 calls it the well-known navayasa and lists the diseases it relieves when used by the proper method.

Vatodara, pittodara, kaphodara, sannipatodara (dushyodara), yakrit-plihodara, baddhagudodara, kshatodara (parisravi udara) and dakodara.

Verse 127 says terrible mahodaras arise from the doshas singly or together, liver and spleen disorders, water, poisoning, and obstruction or foreign bodies. The commentary explains these causes, including drinking water during oleation and similar procedures and a foreign body lodged in the intestine, and derives the eight kinds from them.

Baddhagudodara arises when hair, small stones or grass in food lodge in the intestine; sravi udara when a thorn or sharp object swallowed unknowingly pierces the intestine.

In baddhagudodara faeces accumulate in the intestine and pass with great difficulty, with a foul faecal smell (verse 134). In sravi udara much watery fluid oozes from the pierced intestine and passes through the anus, with pricking pain (verse 135).

The first four (vata, pitta, kapha and combined) by medicines and the other four by surgery, with both needed after a long time; udaras that have ended as jalodara, and patients who refill quickly after purgation with anorexia, broken-feeling flanks and swelling, are to be left as incurable.

Verse 139 says that at the final stage all udaras become jalodara and incurable (in old age, the commentary says) and adds baddhodara and sravi udara to those the physician should avoid; verse 140 (printed 141) calls the rest difficult to cure with daily skilled care; verse 141 divides the eight between medicine and surgery; verse 142 gives the signs of incurability.

Cow milk four times the snuhi latex is boiled with it, set into curd with buttermilk and churned; the butter is cooked again with snuhi latex. It is drunk for half a month or a month.

Verses 158-159 call it the best of ghees and the means against the great diseases; the commentary says it works through purgation and is the one excellent means against kushtha, udara and similar great diseases, and that ghees made with decoctions of purgative drugs also help. Verses 160-161 cook it again with more purgative drugs to make mahanaracha ghee.

Because draining it all at once may bring on severe thirst, intense fainting, fever and burning; the fluid is let out from the left side over fifteen days, with the waist cloth tightened as it drains.

Verse 174 prepares the patient with oil, a lukewarm bath and a waist cloth and punctures the stated place with an edgeless instrument; verses 176-177 drain the fluid through a two-mouthed tube a little at a time; verse 178 then keeps the patient on food taken with lukewarm milk for six months.

Heat (tapa), binding (upanaha), steam (ushma) and liquid (drava); heat, binding and steam sudation suit vata joined with kapha.

Verse 6 lists the four kinds. Vata joined with kapha is sweated with heat, binding and steam, while vata joined with blood and pitta is given liquid sudation with milk, water, ghee and kanji. The commentary describes each: heated sand bundles or bricks, a thick poultice bound with leaves, steam from heated iron, a decoction pot with a tube or an ember pit, and immersion in or affusion with warm decoction.

A leather sleeve open at both ends is fixed on the head, sealed with black gram paste, filled with vata-reducing oil and held for a thousand kshana.

For vata in the head, the cap-like sleeve of leather or thick leather-like cloth is set on the head, its join sealed with black gram paste and filled with vata-reducing oil; the head is kept still for a thousand kshana until discharge begins from the nose, mouth and eyes, and the sleeve is then removed.

A swollen and numb body, distension, a bent and trembling body, excessive vata, absence of pain and wasted limbs.

Verse 33 says a hemiplegia patient with these signs, gripped by excessive vata and without pain, is to be regarded as incurable and given up.

As the time taken to circle the knee once with the hand and snap the fingers.

Verse 44 has the ear filled with medicated oil or with goat urine, garlic and arka juice and held for a hundred, five hundred or a thousand matra; the footnote explains that one matra is the time of one circle of the hand round the knee and a snap of the fingers.

Garbhasrava is the loss of the fetus in the first four months; garbhapata is its loss in the fifth or sixth month.

Verse 46 gives the causes of a fallen pregnancy (riding, much walking, slipping, intercourse, falls and blows) and verse 47 describes the young fetus up to four months, when excited vata causes distension, pain, retention of urine and heavy bleeding; the footnotes on PDF 275 fix the two terms by month.

Explain the difficulty to the king and the relatives, cut his nails, smear the hand with slippery drugs and ghee, and take care not to harm mother or fetus.

Verses 54-56 call the extraction very hard. The physician informs the king and the woman's relatives, inserts a nail-trimmed hand smeared with slippery drugs and ghee, and draws the fetus out compassionately by pulling it as it lies, turning it, sliding it or pulling at once as its position requires; the verse adds that mantras are recited.

Cautery, purgation, caustic alkali, surgery, emesis and the like; mild measures are used instead.

Verse 82 says children's diseases are not to be treated with these harsh measures and that curable diseases are treated with suitably mild ones; verse 81 adds that children receive the same medicines as adults by dosha, with the dose fitted to age, strength and dosha.

Vataja, pittaja, kaphaja, raktaja, sannipataja and sahaja (congenital).

Verse 85 lists the six. Vataja piles are hard with pain, distension and retention of flatus and stool; pittaja and raktaja are soft and bleed very hot blood; kaphaja are very hard, large and itchy; sannipataja show all signs together; sahaja are very minute with the signs of sannipataja, and all are called hard to cure.

Recent, mild, internal piles with medicine; soft, spread, thick, raised ones with alkali; rough, firm, raised, hard ones with cautery; thin-based, hanging, moist ones with the knife.

After the procedure for removing piles, the commentary on PDF 287 sorts piles by their character to choose the treatment; verses 112-113 add that vata and kapha piles take alkali and cautery, blood and pitta piles alkali, thick-based hard large piles excision and cautery, and soft piles in a strong patient pastes and drug combinations.

Because they give rise to many other diseases, being their root cause.

Verse 90 says piles produce nodules, gulma, liver enlargement, ashthila, abdominal disease, loss of strength and colic; because they are the root of so many diseases they are called mularoga or mulavyadhi.

Kapha entering the bladder with urine settles like mud in a new pot, is dried hard by heat and is broken by vata into sand-like grains.

Verse 3 compares it to mud forming by itself at the bottom of a new pot of clear water. Verse 4 adds that strong vata breaks the dried kapha into two, three or many pieces, which lodge in the urinary passage and cause severe pain in the waist, groin, bladder and penis; a footnote says a stone broken up by vata is called sharkara.

Kaphaja, pittaja, vataja and shukraja (from semen); kapha predominates in every stone.

Verse 6 names the four by primary and secondary factor. A footnote explains that even a pitta stone has kapha at its root, because a dense stone-like mass cannot form from the other doshas without kapha.

Because the child's body and bladder are small, its flesh is scant and an instrument can be applied easily.

Verse 13 says stones are especially common in children, from much day sleep, a very narrow urinary passage, rich sweet food and naturally abundant kapha; verse 14 then explains why removal is easy.

A soft stone is cured by medicines; a hard, grown stone is broken open with care and removed, that is, by surgery.

Verse 19 likens ashmari to thunderbolt, poison, fire and a snake. Verse 17 calls a stone with terrible pain, bloody urine passed with difficulty and ulcers incurable or hard to cure, and verse 18 says a patient with swollen navel and scrotum, blocked urine and extreme pain is to be given up.

Eight, four and two finger-breadths, measured by the patient's own finger.

The men's nozzle is round, smooth, made of silver or another metal, with a collar at its base and shaped like a jasmine stalk; the women's has a large collar and the girls' a collar too. All are fitted to a bag, and the fluid given is at most one prasrita.

Shatayonaka (vata), ushtragala (pitta), parisravi (kapha), kambukavarta (all three doshas) and unmargi (foreign body); the all-dosha and foreign-body kinds are incurable.

Verse 49 says all kinds are by nature very hard to cure and that the sannipata and shalyaja kinds should be left alone. A footnote defines bhagandara as a very painful boil within two finger-breadths of the anus that bursts there.

Through a large wound faeces, urine and semen escape and the tract worsens; the anus can be torn, and wind escaping from it causes colic and distension.

Verses 56-59 also say that joined tracts are cut at once and separate ones in turn after each heals, and that the incision is shaped like a half-plough (ardhalangala) or a cow's trail (gotirtha).

For two months: sexual intercourse, long journeys, much riding, wrestling and other causes of injury, and food that makes the stool hard.

Verse 70 and its commentary also ask the patient to keep a proper regimen of food and evacuation during these two months.

Seven, from vata, pitta, kapha, blood, fat, urine and intestine; the intestinal kind (antravriddhi) is to be declared incurable before treatment.

For the urine type the scrotum is pierced with the vrihimukha instrument and drained through a tube as in jalodara; for the fat type it is opened avoiding the sevani and the fat removed; for antravriddhi, once declared incurable, bala oil or castor oil with rock salt is given with vata-reducing care.

With the dosha-based treatment sequence given earlier for the kinds of scrotal enlargement.

Verse 2 applies the scrotal-enlargement treatments to upadamsha according to the dosha and to all other severe swellings; a tooth-caused case gets cold ghee, milk and very cooling pastes (verse 6).

Rubbing the penis with rough, uneven leaves to enlarge it, masturbation and intercourse with a narrow vagina.

These produce many eruptions on the penis; the text prescribes ghee affusion and sudation, and a footnote says the disease has eighteen kinds.

Trikatu, garlic, asafoetida, vacha, ingudi and langali, applied daily as a paste with warm leaves bound over it.

The text says this calms aggravated shlipada, but a shlipada that has grown excessively is to be regarded as incurable.

Fat accumulates (upachaya) at the jaw, throat, eyes and joints and forms small hard swellings, so it is called apachi.

Its nodules may burst and discharge, subside by themselves or keep appearing anew; treatment aims at kapha and fat with emesis, strong nasal medication and purgation.

Unripe is hard; ripening has fever, much burning and warmth; ripe has lost its severe pain and changed colour.

A hot-group poultice comes first, which makes an unripe swelling subside or ripen quickly; a ripe swelling is cleansed by incision with a sharp knife.

Excision, incision, scraping, puncturing, probing, extraction, draining and suturing.

The verse likens them to the eight kinds of karma of embodied beings, and names the heron-beak instrument (kankavaktra) for extracting foreign bodies; footnotes define each act.

Pus coming out upward, with breathlessness, cough, hiccup and other vata signs, is fatal; pus draining downward is curable.

Verse 26 adds that a vidradhi ripened in the anus, heart, liver, navel, spleen or bladder is not curable.

Since no disease arises without the doshas, decide from the signs which dosha is primary and which secondary and treat with suitable pacifying drugs.

The text adds that describing them again would be grinding what is already ground (pishtapeshana).

An auspicious jatumani is left untreated; an inauspicious one is removed with drugs and other means.

Jatumani is described as a round, red, painless mark present from birth, from kapha and blood, called lahsan in the vernacular.

It is to be left untreated; the patient lives fifteen days at most.

The verse says it ends within a fortnight; it arises from all doshas at the trika, neck, hands, flanks and feet with burning like a forest fire.

Those from vata, pitta, kapha, blood and all doshas together, plus suryavarta, ardhavabhedaka, shankhaka, the worm-caused type and the depletion type.

Verse 3 names head diseases from vata, kapha, blood, pitta and all doshas together, and suryavarta, ardhavabhedaka and shankhaka; verse 4 adds the worm-caused and depletion types, and verse 10 closes the section by counting ten. Verse 8 directs treatment by the dominant dosha with venesection, head purgation, heating, binding, mouthfuls and plasters.

Suryavarta pain rises from morning to midday with the sun and wanes as the sun goes down; ardhavabhedaka is severe pain in exactly one half of the head.

Both are described in verse 5. Verse 7 adds that head pain from blood and pitta is worse by day, and pain from vata and kapha worse at night.

It adds severe burning and swelling at the temple and a choking of the throat as under the force of poison, and says the disease kills within three days.

Verse 6 describes shankhaka as vata, alone or with kapha, pitta and blood, causing pain especially at the temples on cold, windy and cloudy days; the footnote on the same page gives the further signs and the three-day course.

A stick of bilva, shyonaka, patala, gambhari or agnimantha (one or all five) is wrapped in cloth over three parts, soaked in oil and lit like a wick held tip down; the oil dripping into a vessel below is dipika oil.

The footnote gives the stick as eighteen angula long and says oil can be drawn the same way from devadaru, kushtha and sarala wood. Verse 24 has the ear washed with a decoction of trivrit, turmeric, aragvadha and kutaja and then filled with dipika oil, which is said to destroy worms and severe pain.

If the patient is strong, a physician skilled in suction carefully draws it out with an applied gourd or horn, or removes it with a probe; an insect that has entered the ear is removed the same way.

This is verse 25 with its commentary; the text stresses the patient's strength, the physician's skill in suction and great care.

Twenty-eight of the ear, thirty-one of the nose, eight of the teeth, fifteen of the tooth roots (gums) and seventeen of the throat; five tongue diseases and nine palate diseases are also announced.

The counts come from verse 27 (ear), verse 43 (nose), verse 50 (teeth), the commentary on verse 65 (gums), the commentary on verse 79 (throat), the commentary on verse 59 (tongue) and the heading before verse 95 (palate). The mouth is said to have seven sites of disease (verse 44).

The wise physician should extract it quickly; the commentary adds that drugs cannot cure it.

Krimidanta is described as a tooth with black holes, very loose, discharging pus without special cause and always aching (verse 51). Verse 79 refers back to the krimidanta measures for khalavardhana, where the extra tooth is extracted and its root burnt.

Rohini of the combined, kapha and blood types (in the commentary), adhijihvika once suppurated, valaya, mahalasa, vrinda and shataghni are to be given up; galavidradhi and mamsatana are also described as deadly.

Curable rohini is treated with bloodletting, mouthfuls, smoking, emesis, licks, head purgation and rubbing, while kanthashaluka, ekavrinda and gilayu are incised; throat diseases in general are treated with emesis, nasal drops, plasters and gargles (verse 94).

Meals of ghee, milk, rice pudding (payasa) and moistening foods, together with nasal medication and drugs chosen for the strongest dosha.

Verse 40 gives this regimen; verse 41 adds head purgation, head saturation, medicated smoke, gargles, licks and khala cooked with pungent, hot and alkaline substances for all nasal diseases.

Vichari and the vata, pitta and kapha types of sarvasara; sarvasara is so called because it spreads to seven places of the mouth.

Verse 103 names one separate disease, vichari, and sarvasara arising from the three doshas. A footnote explains that sarvasara spreads to the mouth, tongue, throat, lips, gums, teeth and palate. Vichari, a pitta swelling with burning, foul smell and high fever, is later listed among the incurable diseases.

Sixty-six mouth diseases are described, of which nineteen are to be abandoned.

The nineteen are three lip diseases (from the three doshas, flesh and blood), two of the tooth roots, three of the teeth, alasa of the tongue, arbuda of the palate, eight of the throat (svaraghna, valaya, vrinda, mahalasa, mamsachaya, rohini, galaugha, shataghni) and vichari of the whole mouth.

Bhringaraja juice, amalaki juice and sesame oil, one prastha each, four prastha of cow's milk and a pala of liquorice paste; it is given as nasal drops for many mouth diseases.

The commentary gives one prastha as 64 tola and the liquorice as 16 tola, used as paste. All are combined and the oil is cooked until done; the text says its nasya destroys many diseases of the mouth.

Five circles (mandala), six junctions (sandhi) and six layers (patala).

The circles are lashes, lids, white, black and sight; four junctions lie between them, with the fifth at the inner corner and the sixth at the outer corner. Two layers are in the lids and four in the eyeball, and timira arises in those four layers.

Tarpana is holding eye-beneficial juices or ghee in the eyes of the patient lying on his back; putapaka is juice squeezed from a leaf-wrapped, clay-coated ball of drugs roasted in a cow-dung fire and put into the eyes like tarpana.

The note follows verse 133 on vata-type abhishyanda. It names mango and similar leaves for wrapping and says the clay and leaves are removed before the ball is squeezed.

It turns into adhimantha of the same dosha; untreated, the kapha type destroys sight in seven days, the vata type in six, the blood type in five or three, and the pitta type at once.

Adhimantha is marked by tearing, churning eye pain and severe pain in half the head. The text urges quick treatment with suitable medicines and those of abhishyanda, and says neglected vata-type adhimantha becomes the incurable hatadhimantha.

Parvani, alaji, puyalasa, kaphopanaha, four kinds of discharge (kapha, pitta, blood and pus) and krimigranthi.

The footnote to verse 171 equates the pus discharge with the sannipata type. Alaji is a hard, black, painful knot from kapha; when it ripens and discharges pus it is puyalasa; krimigranthi is a very itchy knot made by worms at the junction of lid and white.

Gruel cooked in milk with ghee and sugar, green gram soup, rice pudding with ghee or rice with green gram soup, cooling vegetables, and scented water in measured amounts.

The vegetables are cooked and of astringent, bitter and sweet taste with cooling potency. For thirst the water is made pleasant with sandalwood scent and perfumed with fragrant flowers and camphor.

Seventy-six: ten from vata, ten from pitta, thirteen from kapha, sixteen from blood, twenty-five from all three doshas and two from external causes.

Verse 230 gives ten diseases for each dosha with three more for kapha, sixteen for blood, twenty-five for the combination of all three doshas and two external ones, and verse 231 totals them as seventy-six. The following verses sort each group into curable, palliable and incurable diseases.

As a round, lentil-sized part suited to coolness, arising where the karma that veils the eye-sense is subsided and destroyed; it perishes quickly and must be protected with great care.

Verse 209 and its commentary describe drishti in Jain terms as arising where the karma that covers the faculty of sight is partly destroyed and partly subsided (kshayopashama). It is round like a lentil, favours coolness and is the part through which forms are seen. Because it is easily destroyed, it is to be guarded with great effort.

In the first layer things are seen indistinctly; in the second even a needle's eye cannot be seen; in the third things below are not seen and objects look like hair, mosquitoes or flies; in the fourth, timira blocks sight completely and is called linganasha.

Verses 211 to 215 describe these stages. A small amount of kapha lodged in the first three layers is said to cause night blindness (naktandhya), while timira reaching the fourth layer is linganasha, which has six kinds.

Eleven: the five kinds of arma, sirajapidaka, sirajala, arbuda, shushkarsha, arsho vartma and parvani.

Verse 245 divides the seventy-six eye diseases by treatment: eleven to be excised, five incised, nine scraped, fifteen punctured, twelve treated with medicines only, seven palliable and fifteen to be given up. Verse 246 names the eleven to be excised. The text presents these as procedures for a trained physician.

After the kapha type is recognised by pressing, the patient looks at his nose and the physician slowly pierces the natural opening in the white of the eye with a smooth copper yavavaktra probe, makes him sneeze to expel kapha, withdraws the probe once objects are seen, and then gives nasya.

Verses 279 to 281 say that a linganasha which disperses on pressing is born of intense kapha. The patient is asked to look towards his own nose; the physician considers the white region and pierces the natural opening gradually with the very smooth copper probe called yavavaktra, makes the patient sneeze to bring out the kapha, and withdraws the probe slowly when objects in front become visible. The patient then lies on his back and is given nasya with pungent, dry, kapha-removing drugs. The text presents this as an operation by a physician.

With sesame oil in the vata type, with ghee in the kapha type, and with white sugar in the pitta and blood types.

Verse 284 and its commentary say that triphala powder taken in this way gives the eyes clarity, nourishment and excellence. The verse speaks of timira in the kapha case, and the commentary calls all of them linganasha.

Eye drops of palasha gum with milk and sugar, and a triphala decoction with ghee to drink; the triphala remedy is said not to be beneficial in shukti.

Verses 258 and 259 first say that all pitta-born eye diseases are treated with cooling measures. The palasha gum drops are said to remove the pitta eye diseases and amladhyushita quickly, and the triphala decoction mixed with ghee is drunk for amladhyushita, with the remark that it does not suit shukti.

To refrain from constantly reading tiny letters and from gazing at bright lamps and intense light.

Verse 291 calls this restraint the protection of one's sight, which is perishable by nature. The preceding verse names other famous measures for the eyes: foot massage taught by Pujyapada, cold nasya and collyrium of Siddhasena, and tarpana of the eyes and head of Jatacharya.

If the eye has not left its place, ghee is smeared and a bandage bound; if it is ruptured and hanging, it is separated and treated by the wound procedure, with sudation, plasters, smoking, nasya and nourishing therapy.

Verses 253 and 254 distinguish an injured eye that stays in place from one that is ruptured. The second case refers back to the wound treatment described earlier in the book and is work for a trained practitioner.

Maha, urdhva, chhinna, tamaka and kshudra; kshudra and tamaka are curable, the rest are to be abandoned.

Kshudra shvasa arises on slight exertion and settles on rest; tamaka comes in a weak person with kapha and cough and worsens on eating. Tamaka is very hard to cure in a very weak person, and the sages say the other three kinds should be abandoned.

The strong patient first gets emesis and then oil enema and other purifications; the weak patient gets pacifying medicines only.

Verse 9 says purification is planned for strong patients, beginning with emesis followed by oil enema and other cleansing; for weak patients only pacifying medicines are used. Remedies that follow include Pippalyadi ghee, Bharangyadi powder, Bhringaraja oil and Tvagadi powder.

Vataja, pittaja, kaphaja, kshataja and kshayaja; kshayaja cough is tridoshic and hard to treat.

Kshataja cough follows chest injury from exertion such as study and brings thick bloody discharge. Kshayaja cough comes in a person weakened by tissue loss who spits blood-red sputum. For injury and wasting cough the text gives a powder of amalaki, gokshura, dates, priyala, liquorice, blue lotus, bharangi and long pepper with ghee and sugar on a milk diet.

Because the text says thirst cannot arise without pitta.

Verse 34 says ama thirst, counted among the dosha kinds, is treated with the whole course for pitta thirst. A footnote describes it as thirst from indigestion of food with heart pain, salivation and malaise, and explains that including it under the dosha kinds keeps the count of five.

Vomit mixed with blood, pus and kapha, constant complications and repeated fainting.

Verse 41 says a physician who knows the matter should leave such a patient as incurable. For curable vomiting with strong doshas, verse 42 calls for emesis and purgation with dosha-destroying drugs.

Six (vata, pitta, kapha, tridoshic, fat and blood); the tridoshic and blood kinds are called incurable.

Causes named include loud recitation, grief, poison, a blow to the throat and loud speaking. Fat-born hoarseness is treated like the kapha kind, and the incurable kinds are attempted only after careful thought. Daily ghee after meals is given for the vata kind, milk with ghee and jaggery for pitta, and alkaline water with the three pungents and three fruits for kapha.

Those who want a long life should never hold back an urge; doing so causes udavarta.

Holding back urges makes provoked apana rise into udana. The text names seven kinds by the urge held back (flatus, urine, faeces, semen, vomiting, tears, sneezing), each with its own effects, and says all are treated with the treatment for vata disorders; neglected udavarta is said to kill quickly.

Annaja, yamika, kshudrika, mahapralaya and gambhirika, produced by the vayu called prana provoked with kapha.

Annaja follows excess sharp and pungent food; yamika comes in pairs shaking head and throat; kshudrika comes slowly from the root of the collarbone; mahapralaya shakes the whole body and afflicts the vital points; gambhirika rises from the navel with a deep sound and complications such as fever.

New, unripe coryza is calmed with ghee prepared by dosha; ripened coryza with thick phlegm is drained by nasal medication.

To bring it to ripeness the text uses sudation, massage, gargles with the three pungents and emesis, and ripening foods such as warm dry-ginger water, milk with red shigru and fresh ginger, pulse soups and a sour horse-gram gruel with pepper. Vitiated coryza gets ghee with alkaline and pungent drugs, strong nasal drops, warm affusion, smoking and plasters.

Pitta type: emesis with drugs mixed with ghee, jaggery and milk, then purgation. Kapha type: emesis with warm water containing trikatu, then purgation with trivrit, sour fruit, rock salt and dry ginger.

Verse 7 adds that the pitta treatment described earlier may also be used, and verse 9 adds enemas with drugs suited to the dosha.

Curd, jaggery, sugarcane juice, fruits such as mango, all kinds of milk, meat, sweet tastes and food or drink containing leafy vegetables.

Verse 22 lists these as unwholesome; verse 20 adds that meals of pungent and bitter items are very beneficial for worm patients.

Ama ajirna (food stays raw and sweet) from kapha, vidagdha (food turns sour) from pitta, and vishtabdha (severe pain, distension, retained stool) from vata.

Verse 24 adds that constant eating of many foods, like a cow, causes ajirna, from which alasaka, vilambika and vishuchika arise; verse 29 calls fasting the best measure.

In vatabasti, vata aggravated by suppressing urine closes the bladder outlet, so urine is retained with pain in the bladder and lower abdomen; in mutratita, urine that was held back will not come when wanted, or comes only a little at a time with straining and pain.

Both belong to the urinary obstruction (mutraghata) group of verses 39 to 52, several of which are traced to holding back the urge to urinate.

Twenty: five each from vata, pitta, kapha and all three doshas.

The note gives the causes as wrong diet and conduct, vitiated menstrual blood, semen defects and fate; verse 75 says the type caused by all three doshas is to be given up as incurable.

Both show the signs of pregnancy, but the limbs of a foetus move without pain, while the gulma throbs as a lump with pain.

The blood gulma occurs only in women, shows pitta signs and is treated like pitta gulma; a footnote says it becomes easily curable when old and is treated after ten months.

Taking much sour and other unwholesome food and conduct soon after fever, burning or pandu have subsided, which aggravates pitta.

The aggravated pitta whitens (or yellows) the body and causes great swelling; the treatment given for swelling is said to help, with a decoction of jaggery, haritaki, cow urine and iron ash and meals of barley and shali rice.

It says apasmara comes from quickly moving doshas, so it arrives suddenly and passes quickly; ignorant people take this for a graha's work, but it is born of the doshas.

Verses 112 and 113 describe the attack (falling, gnashing teeth, vomiting phlegm, upturned eyes, loud cries) with vata predominant, and verse 117 treats it with the drugs for insanity and strong nasya.

By the nature of the diseases, as sown seeds sprout early or late, and by karma from past actions, as ocean waves come one by one or many together.

Verses 115 and 116 make both points; verse 99 adds that no effect arises without internal and external causes.

Each numbered entry gives a Sanskrit headword with its gender, then Hindi, Marathi and Kannada equivalents in columns.

The column heads read संस्कृत, हिंदी, मराठी and कन्नड. The entries are arranged by initial letter (अ, आ, इ, उ, ऊ, ए, ऐ, क, ख and ग in this part) and the numbering starts again at 1 in each letter section; some entries only refer to another headword with देखो (Hindi) and पहा (Marathi).

सोंठ (dry ginger), मिरच (black pepper) and पीपल (long pepper), together called त्रिकटु.

Entry क 3 glosses कटुत्रिक as त्रिकटु and numbers its members 1 सोंठ, 2 मिरच, 3 पीपल; the Marathi column gives सोंठ, मिरी and पिंपळ. Entry क 2, कटुक, also begins with त्रिकटु, सोंठ, मिरच, पीपल.

अक्ष (karsha, 2 tolas), कोल (one tola), कुडव (32 tolas), कुची (eight handfuls) and गुंजा (one ratti).

Besides plant names, some headwords are glossed as measures: अक्ष as कर्षपरिमाण, '2 तोले का प्रमाण' (अ 56); कोल as 'एक तोला' (क 86); कुडव as '32 तोला प्रमाण' (क 103); कुची as 'अष्टमुष्टिप्रमाण' (क 59); and गुंजा as '1 रत्तिप्रमाण' (ग 29).

काकोली, क्षीरकाकोली, जीवक, ऋषभक, ऋद्धि, वृद्धि, मेदा, महामेदा, गुडूची, मुद्गपर्णी, माषपर्णी, पद्मक, वंशलोचन, शृंगी, प्रपौण्डरीक, जीवन्ती, मधुयष्टि and द्राक्षा.

Entry क 43 gives no Hindi or Marathi equivalents; instead it quotes a Sanskrit verse that ends by saying this group is called काकोल्यादि by name.

The gum of the गुग्गुल tree.

Under गुग्गुल (ग 8) the Hindi column says 'गुग्गुल का पेड, इसका गोन्द गूगल है' and also gives शिलाजित and the red सैजिना as senses; the Marathi column lists महिषाक्ष, आरक्तवर्ण, महानील and कुमुद.

Hindi वासक वृक्ष, अडूसा वृक्ष and बसौंटा; Marathi अडूळसा.

Entry अ 22 gives these names; आटरूष (आ 4) repeats अडूसा with the Marathi अडूलसा, and आमलक (आ 8) also lists बांसा, अडूसा and बसौंटा.

It glosses it as the flowers of कुसुम, with whose colour cloth is dyed.

Entry क 76 (printed कुसंभ, neuter) gives the Hindi 'कुसूम के फूल [जिस के रंग से वस्त्र रंगा जाता है]' and the Marathi कुर्डईचे फूल.