Rajayakshma Nidana: Causes, Pathogenesis, Symptoms, and Prognosis
लिङ्गेष्वल्पेष्वतिक्षीणं व्याधौ षट्करणक्षयम् / वर्जयेत्साधयेदेव सर्वेष्वपि ततो ऽन्यथा
liṅgeṣvalpeṣvatikṣīṇaṃ vyādhau ṣaṭkaraṇakṣayam / varjayetsādhayedeva sarveṣvapi tato 'nyathā
若征象稀少而病者已极度枯槁,或病中出现六种机能(ṣaṭ-karaṇa)之衰败,则当避而不治;反之,若无此等情形,则应当在一切情况下确然施治。
Lord Vishnu (teaching Garuda/Vinata-putra in the Garuda Purana’s instructional dialogue)
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.
Primary Rasa: shanta
Secondary Rasa: karuna
Related Themes: Garuda Purana 1.152 (ariṣṭa-lakṣaṇa/prognostic signs; treatment eligibility)
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.
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.
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.