Shloka 23

Rajayakshma Nidana: Causes, Pathogenesis, Symptoms, and Prognosis

Devanagari script

लिङ्गेष्वल्पेष्वतिक्षीणं व्याधौ षट्करणक्षयम् / वर्जयेत्साधयेदेव सर्वेष्वपि ततो ऽन्यथा

Transliteration

liṅgeṣvalpeṣvatikṣīṇaṃ vyādhau ṣaṭkaraṇakṣayam / varjayetsādhayedeva sarveṣvapi tato 'nyathā

Translation

When the signs are few and the patient is exceedingly wasted, or when a disease brings decline of the six faculties (ṣaṭ-karaṇa), one should refrain from undertaking treatment. Otherwise—when these are absent—one should indeed treat in all cases.

Word by Word

• liṅgeṣu: in the signs/symptoms
• liṅgeṣu: Adhikarana (Locative/अधिकरण)
• Type: Noun
• Root: liṅga (प्रातिपदिक)
• Form: नपुंसकलिङ्ग, सप्तमी (7th), बहुवचन

• alpeṣu: slight / few
• alpeṣu: Visheshana (Qualifier/विशेषण)
• Type: Adjective
• Root: alpa (प्रातिपदिक)
• Form: नपुंसकलिङ्ग, सप्तमी (7th), बहुवचन; विशेषण (qualifying liṅgeṣu)

• ati-kṣīṇam: one excessively emaciated
• ati-kṣīṇam: Karma (Object/कर्म)
• Type: Adjective
• Root: ati (अव्यय) + kṣīṇa (कृदन्त/प्रातिपदिक)
• Form: नपुंसकलिङ्ग, द्वितीया (2nd), एकवचन; अव्ययीभाव: ati + kṣīṇa = excessively emaciated; कर्मपद (object of varjayet/sādhayet)

• vyādhau: in disease/illness
• vyādhau: Adhikarana (Locative/अधिकरण)
• Type: Noun
• Root: vyādhi (प्रातिपदिक)
• Form: पुंलिङ्ग, सप्तमी (7th), एकवचन

• ṣaṭ-karaṇa-kṣayam: wasting of the six faculties
• ṣaṭ-karaṇa-kṣayam: Karma (Object/कर्म)
• Type: Noun
• Root: ṣaṭ (संख्या) + karaṇa (प्रातिपदिक) + kṣaya (प्रातिपदिक)
• Form: पुंलिङ्ग, द्वितीया (2nd), एकवचन; (dvigu/tatpurusha sense) 'wasting of the six instruments/faculties'

• varjayet: should avoid
• varjayet: Kriya (Action/क्रिया)
• Type: Verb
• Root: vṛj (धातु)
• Form: विधिलिङ् (Optative), प्रथमपुरुष (3rd), एकवचन; परस्मैपद

• sādhayet: should treat / accomplish
• sādhayet: Kriya (Action/क्रिया)
• Type: Verb
• Root: sādh (धातु)
• Form: विधिलिङ् (Optative), प्रथमपुरुष (3rd), एकवचन; परस्मैपद

• eva: indeed / only
• eva: Sambandha (Particle/निपात)
• Type: Indeclinable
• Root: eva (अव्यय)
• Form: अवधारणार्थक अव्यय

• sarveṣu: in all (cases)
• sarveṣu: Adhikarana (Locative/अधिकरण)
• Type: Adjective
• Root: sarva (प्रातिपदिक)
• Form: नपुंसकलिङ्ग, सप्तमी (7th), बहुवचन; विशेषण (elliptic: 'in all (cases/signs)')

• api: also / even
• api: Sambandha (Particle/निपात)
• Type: Indeclinable
• Root: api (अव्यय)
• Form: समुच्चय/अपि-कारक अव्यय (also/even)

• tataḥ: thereafter / therefore
• tataḥ: Sambandha (Adverbial/क्रियाविशेषण)
• Type: Indeclinable
• Root: tataḥ (अव्यय)
• Form: अव्यय (adverb: 'thereafter/therefore')

• anyathā: otherwise
• anyathā: Sambandha (Adverbial/क्रियाविशेषण)
• Type: Indeclinable
• Root: anyathā (अव्यय)
• Form: अव्यय (adverb: 'otherwise')

Speaker

Lord Vishnu (teaching Garuda/Vinata-putra in the Garuda Purana’s instructional dialogue)

Philosophical Teaching

Concept: Yukta-vyavahāra: act with discernment; avoid futile action when signs indicate terminal decline; otherwise fulfill the duty to treat.

Vedantic Theme: Karma-yoga prudence: right action aligned with reality; acceptance of mortality (mṛtyu-dharma).

Application: Use prognostic markers (few signs yet extreme wasting; ṣaṭ-karaṇa-kṣaya) to decide on intensity/appropriateness of treatment; shift to comfort care when needed.

Verse Rasa

Primary Rasa: shanta

Secondary Rasa: karuna

Cross References

Related Themes: Garuda Purana 1.152 (ariṣṭa-lakṣaṇa/prognostic signs; treatment eligibility)

Characters & Entities

• Vishnu
• Garuda

FAQs

What is the importance of prognosis (lakṣaṇa-based assessment) in the Garuda Purana?

This verse stresses ethical discernment: when fatal indicators appear—extreme wasting and decline of core faculties—treatment should be avoided; when such signs are absent, one should proceed with therapy.

How does this verse relate to Garuda Purana’s broader teachings on dharma?

It frames medical action as dharmic responsibility: do not pursue futile intervention in clearly terminal conditions, but do not neglect treatment when recovery is reasonably possible.

Practical application of this wisdom today?

Use careful assessment and honesty in care decisions—seek timely treatment when strength and functions remain, and prioritize compassionate, realistic care when severe systemic decline is evident.