Adhyaya 146

Verse 1

नाम पञ्चचत्वारिंशदुत्तरशततमो ऽध्यायः धन्वन्तरिरुवाच / सर्वरोगनिदानञ्च वक्ष्ये सुश्रुत तत्त्वतः / आत्रेयाद्यैर्मुनिवरैर्यथा पूर्वमुदीरितम्

This is called the one hundred and forty-sixth chapter (of this section). Dhanvantari said: “O Suśruta, I shall truthfully expound the causes and diagnostic foundations of all diseases, just as Atreya and other eminent sages taught in former times.”

Verse 2

रोगः पाप्मा ज्वरो व्याधिर्विकारो दुष्ट आमयः / यक्ष्मातङ्कगदा बाधाः शब्दाः पर्यायवाचिनः

“Disease” is also called pāpmā (a corrupting affliction), jvara (fever), vyādhi (illness), vikāra (disorder), duṣṭa āmaya (malignant ailment), yakṣmā (consumption), aṅka (distress), gadā (sickness), and bādhā (obstruction or torment)—these are used as synonyms.

Verse 3

निदानं पूर्वरूपाणि रूपाण्युपशयस्तथा / संप्राप्तिश्चैति विज्ञानं रोगाणां पञ्चधा स्मृतम्

The science of understanding diseases is remembered as fivefold: nidāna (cause), pūrvarūpa (premonitory signs), rūpa (manifest symptoms), upaśaya (relieving or aggravating factors), and saṃprāpti (the course of pathogenesis).

Verse 4

निमित्तहेत्वायतनप्रत्ययोत्थानकारणैः / निदानमाहुः पर्यायैः प्राग्रूपं येन लक्ष्यते

By the terms nimitta (occasion), hetu (cause), āyatana (seat), pratyaya (condition), utthāna (origin), and kāraṇa (instrumental cause), the sages describe what is called nidāna—namely, that by which a condition is recognized through its prāgrūpa (prodromal sign).

Verse 5

उत्पित्सुरामयो दोषविशेषेणानधिष्ठितः / लिङ्गमव्यक्तमल्पत्वाद्व्याधीनां तद्यथायथम्

When a disease is just beginning to arise and has not yet become firmly established through a specific aggravation of the doṣas, its signs remain indistinct—because they are slight—varying according to each illness.

Verse 6

तदेव व्यक्ततां यातं रूपमित्यभिधीयते / संस्थानां व्यञ्जनं लिङ्गं लक्षणं चिह्नमाकृतिः

That very entity, when it becomes manifest, is called “form” (rūpa). Its configuration is the outward expression—mark, characteristic, sign, and shape.

Verse 7

हेतुव्याधिविपर्यस्तविपर्यस्तार्थकारिणाम् / औषधान्नविहाराणामुपयोगं सुखावहम्

For those whose bodily causes and diseases have become deranged, so that things act with reversed (harmful) effects, the proper use of medicines, food, and a regimen of living becomes a source of comfort and well-being.

Verse 8

विद्यादुपशयं व्याधेः स हि सात्म्यमिति स्मृतः / विपरीतो ऽनुपशयो व्याध्यसात्म्येतिसंज्ञितः

That which is understood to bring relief in a disease is remembered as “wholesomeness” (sātmya). Its opposite—what brings no relief—is termed “unwholesomeness” (asātmya) with respect to that disease.

Verse 9

यथा दुष्टेन दोषेण यथा चानुविसर्पता / निर्वृत्तिरामयस्यासौ संप्राप्तिरभिधीयते

Just as a corrupted doṣa spreads through the system, and just as a disease accordingly arises and runs its course—so is this process described as saṃprāpti.

Verse 10

संख्याविकल्पप्राधान्यबलकालविशेषतः / सा भिद्यते यथात्रैव वक्ष्यन्ते ऽष्टौ ज्वरा इति

Owing to distinctions in number, variation, predominance, strength, and the particularity of time, that condition becomes differentiated; thus, here itself, the eight kinds of fever (jvara) will be described.

Verse 11

दोषाणां समवेतानां विकल्पोशांशकल्पना / स्वातन्त्र्यपारतन्त्र्याभ्यां व्याधेः प्राधान्यमादिशेत्

When the bodily doṣas unite, one should discern their possible variations and proportional shares; and, by judging which doṣa acts independently and which depends upon another, one should declare the doṣa that predominates in the disease.

Verse 12

हेत्वादिकार्त्स्न्यावयवैर्बलाबलविशेषषणम् / नक्तन्दिनार्धभुक्तांशैर्व्याधिकालो यथामलम्

By weighing the causes and the full array of factors and bodily components, one should determine the distinct signs of strength and weakness. Likewise, from patterns such as eating at night, eating by day, and eating only in half-measures, one should understand the disease’s course in time, in accord with the underlying impurity (mala) and humoral disturbance.

Verse 13

सर्वेषामेव रोगाणां निदानं कुपिता मलाः

For all diseases, the root cause is the bodily impurities—mala, the doṣas—when they become aggravated.

Verse 14

तत्प्रकोपस्य तु प्रोक्तं विविधाहितसेवनम् / अहितस्त्रिविधो योगस्त्रयाणां प्रागुदाहृतः

The cause of their aggravation is declared to be indulgence in diverse harmful practices. And the threefold conjunction of harmful factors for the three doṣas has been described earlier.

Verse 15

तिक्तोषणकषायाम्लरूक्षाप्रमितयोजनैः / धावनोदीरणनिशाजागरात्युच्चभाषणैः

By indulging in foods that are bitter, pungent and hot, astringent, sour, and excessively drying; by immoderate exertion and long journeys; and by habits such as restless running about, over-stimulating activity, keeping vigil at night, and speaking too loudly—one brings harm upon oneself.

Verse 16

क्रियाभियोगबीशोकचिन्ताव्यायाममैथुनैः / ग्रीष्माहोरात्रभुक्त्यन्ते प्रकुप्यति समीरणः

By excessive exertion in action—through fear, grief, worry, over-exercise, and indulgence in sex—and also by eating at the close of day and night in the summer, Vāyu, the bodily wind, becomes aggravated.

Verse 17

पित्तं कट्वालतीक्ष्णोष्णकटुक्रोधविदाहिभिः / शरन्मध्याह्नरात्र्यर्धविदाहसमयेषु च

Pitta is aggravated by pungent and sour tastes, by sharp and hot influences, by pungent habits, by anger, and by whatever causes burning; it also increases in autumn, at midday, at midnight, and in times marked by a burning sensation.

Verse 18

स्वाद्वम्ललवणस्निग्धगुर्वभिष्यन्दिशीतलैः / आस्यास्वप्नसुखाजीर्णदिवास्वप्नादिबृंहणैः

By indulging in sweet, sour, salty, oily, heavy, mucus-producing, and cold foods—and by habits such as idleness, excessive sleep, comfort-seeking, indigestion, sleeping by day, and other fattening regimens—(that bodily condition) arises and increases.

Verse 19

प्रिच्छर्दनाद्ययोगेन भुक्तान्नस्याप्यजीर्णके / पूर्वाह्ने पूर्वरात्रे च श्लेष्मा वक्ष्यामि सङ्करान्

When food that has been eaten remains undigested because vomiting and other eliminative measures are not properly applied, then—especially in the forenoon and in the first part of the night—Kapha, phlegm, becomes disturbed; now I shall describe its mixed and complicated manifestations.

Verse 20

मिश्रीभावात्समस्तानां सन्निपातस्तथा पुनः / संकीर्णाजीर्णविषमविरुद्धाद्यशनादिभिः

When all the doṣas become mingled together, there arises again sannipāta, the concurrence of the three doṣas; it is produced by improper eating—such as mixed and incompatible foods, undigested food, irregular (unwholesome) fare, and the like.

Verse 21

व्यापन्नमद्यपानीयशुष्कशाकाममूलकैः / पिण्याकमृत्यवसरपूतिशुष्ककृशमिषैः

They are made to subsist on spoiled liquor and foul water, on dried vegetables and raw roots, and on oil-cake; and at the time of death they are forced to eat stinking, dried, meagre scraps of flesh.

Verse 22

दोषत्रयकरैस्तैस्तैस्तथान्नपरिवर्ततः / धातोर्दुष्टात्पुरो वाताद्द्विग्रहावेशविप्लवात्

From various causes that generate the three doṣas, from improper changes in diet, from corruption of the body’s dhātus, from an adverse wind acting within, and from disturbances arising through possession or seizure by dual forces—disease arises.

Verse 23

दुष्टामान्नैरतिश्लैष्मग्रहैर्जन्मर्क्षपीडनात् / मिथ्यायोगाच्च विविधात्पापानाञ्च निषेवणात् / स्त्रीणां प्रसववैषम्यात्तथा मिथ्योपचारतः

From eating impure or harmful food, from disorders dominated by excessive phlegm (kapha), from afflictions due to the birth-asterism (nakṣatra), from improper unions of various kinds, from indulgence in diverse sins, from complications in women’s childbirth, and likewise from wrong or misguided treatment—these arise.

Verse 24

प्रतिरोगमिति क्रुद्धा रोगविध्यनुगामिनः / रसायनं प्रपद्याशु दोषा देहे विकुर्वते

Angered, the bodily doṣas that follow the course of disease—thinking, “We shall counter this remedy”—quickly take refuge in the rasāyana, and then produce further disturbances within the body.