Chapter 6. Roganika Vimana adhyaya (Chapter on Classification of Diseases)

Chapter 6. Roganika Vimana adhyaya (Chapter on Classification of Diseases)

अथातो रोगानीकं विमानं व्याख्यास्यामः||१|| 

इति ह स्माह भगवानात्रेयः||२||

We shall now expound the chapter on the “restructuring the groups of diseases” Thus said Lord Atreya. [1-2]

Types of diseases

Following are the two categories of diseases:

द्वे रोगानीके भवतः प्रभावभेदेन- साध्यम्, असाध्यं च;  

1. On the basis of Prognosis / PRABHAVA– 

i. Curables / SADHYA

ii. Incurables / ASADHYA

द्वे रोगानीके बलभेदेन- मृदु, दारुणं च;

2. On the basis of Intensity - / BALA

i. Mild / MRDU

ii. Severe / DARUNA

द्वे रोगानीके अधिष्ठानभेदेन- मनोऽधिष्ठानं, शरीराधिष्ठानं च;

3.On the basis of Location - ADHISHTANA

i. Physical / SARIRA

ii. Mental /MANA

 द्वे रोगानीके निमित्तभेदेन- स्वधातुवैषम्यनिमित्तम्, आगन्तुनिमित्तं च;  

4.On the basis of Causes - NIMITTA

i. Endogenous / स्वधातुवैषम्यनिमित्तम्

ii. Exogenous / आगन्तुनिमित्तं 

द्वे रोगानीके आशयभेदेन- आमाशयसमुत्थं, पक्वाशयसमुत्थं चेति|

5.On the basis of Origin -  ASAYA

i. Digestive origin(Amashaya) 

ii. Excretory(pakwashaya) origin

एवमेतत् प्रभावबलाधिष्ठाननिमित्ताशयभेदाद्द्वैधं सद्भेद

 

Thus there are two categories of diseases based upon 

• prognosis/ PRABHAVA, 
• intensity/ BALA, 
• location/ ADHISHTANA, 
• cause / NIMITTAand 
• origin / ASAYA. 

प्रकृत्यन्तरेण भिद्यमानमथवाऽपि सन्धीयमानं स्यादेकत्वं बहुत्वं वा|

There might be 

• only one type of disease or 
• many types of diseases 

 - based upon the classification (permutation and combination). 

एकत्वं तावदेकमेव रोगानीकं, दुःखसामान्यात्; 

• Only one type of disease is based on similarity in causing pain and 

बहुत्वं तु दश रोगानीकानि प्रभावभेदादिना भवन्ति; 

• multiple types based upon ten categories and criteria mentioned above prognosis etc. 

 बहुत्वमपि सङ्ख्येयं स्यादसङ्ख्येयं वा| 

तत्र सङ्ख्येयं तावद्यथोक्तमष्टोदरीये, अपरिसङ्ख्येयं पुनर्यथा- महारोगाध्याये रुग्वर्णसमुत्थानादीनामसङ्ख्येयत्वात्||३||

- That may be numerable or innumerable. 

• Numerable as mentioned in the chapter Ashtodariya and 
• innumerable as described in Maharoga Adhyaya owing to innumerability of nature of pain, change in colour, variation in origin etc. factors. [3]

Justification for different types of classification

न च सङ्ख्येयाग्रेषु भेदप्रकृत्यन्तरीयेषु विगीतिरित्यतो दोषवती स्यादत्र काचित् प्रतिज्ञा, न चाविगीतिरित्यतः स्याददोषवती| भेत्ता हि भेद्यमन्यथाभिनत्ति, अन्यथा पुरस्ताद्भिन्नं भेदप्रकृत्यन्तरेण भिन्दन् भेदसङ्ख्याविशेषमापादयत्यनेकधा, न च पूर्वं भेदाग्रमुपहन्ति| समानायामपि खलु भेदप्रकृतौ प्रकृतानुप्रयोगान्तरमपेक्ष्यम्[१] |सन्ति ह्यर्थान्तराणि समानशब्दाभिहितानि, सन्ति चानर्थान्तराणि पर्यायशब्दाभिहितानि| 

If something, already classified in a particular manner, is reclassified in another way following different criteria, there may be change in the number of groups, and such a charge should not render the statement suggesting such a classification incorrect.

An individual has the liberty to classify things as he likes. 

If something is already classified into some groups in a particular manner, he may reclassify it on the basis of different criteria which may result in changes in the number of groups in different ways. This does not invalidate the number of groups according to some other mode of classification. 

In some cases the criterion of classification may appear to be the same as the previous one but the specific features of each of these criteria should be observed in deciding about the validity of this classification. 

समानो हि रोगशब्दो दोषेषु च व्याधिषु च; दोषा ह्यपि रोगशब्दमातङ्कशब्दं यक्ष्मशब्दं दोषप्रकृतिशब्दं विकारशब्दं च लभन्ते, व्याधयश्च रोगशब्दमातङ्कशब्दं यक्ष्मशब्दं दोषप्रकृतिशब्दं विकारशब्दं च लभन्ते| तत्र दोषेषु चैव व्याधिषु च रोगशब्दः समानः, शेषेषु तु विशेषवान्||४||

The same term may carry different meanings e.g. the word roga, antanka, yakshman, doshaprakriti and vikara (morbidity – these terms carry the meaning of or are synonymous with both dosha and vyadhi (disease). 

Thus the term roga is synonymous with both the doshaand vyadhi. For the rest like hetu (etiology) etc., this term, viz. roga carries a different meaning. [4]

Physical and psychic doshas and their vitiators

तत्र व्याधयोऽपरिसङ्ख्येया भवन्ति, अतिबहुत्वात्| दोषास्तु खलु परिसङ्ख्येया भवन्ति, अनतिबहुत्वात्| तस्माद्यथाचित्रं विकारानुदाहरणार्थम्, अनवशेषेण च दोषान् व्याख्यास्यामः|  

• Because of their multitudinous nature, diseases are innumerable. 
• On the other hand, doshas are numerable because of their limited number. 

 So only some of the diseases will be explained by way of illustrations whereas doshas will be explained in their entirety. 

रजस्तमश्च मानसौ दोषौ| तयोर्विकाराः कामक्रोधलोभमोहेर्ष्यामानमदशोकचित्तो(न्तो)द्वेगभयहर्षादयः|

• Rajas and tamas are the doshas pertaining to the mind and 

      -    the types of morbidity caused by them are

• kama (passion), 
• anger, 
• greed, 
• attachment, 
• envy, 
• ego, 
• pride 
• grief, 
• worry, 
• anxiety, 
• fear, 
• excitement etc. 
• 
  

वातपित्तश्लेष्माणस्तु खलु शारीरा दोषाः| तेषामपि च विकारा ज्वरातीसारशोफशोषश्वासमेहकुष्ठादयः| इति दोषाः केवला व्याख्याता विकारैकदेशश्च||५|| 

Vata, pitta and kapha- these three are the doshas pertaining to the body. 

Diseases caused by them are 

• fever, 
• diarrhea, 
• edema, 
• consumption, 
• dyspnoea, 
• meha (obstinate urinary disorder including diabetes), 
• kushtha (obstinate skin disease including leprosy) etc. 

          - Thus doshas in their entirety and diseases in parts are explained.

तत्र खल्वेषां द्वयानामपि दोषाणां त्रिविधं प्रकोपणं; तद्यथा- असात्म्येन्द्रियार्थसंयोगः, प्रज्ञापराधः परिणामश्चेति||६||

Both of these types of doshas have three types of etiological factors, viz.

1. unwholesome contact with the object of senses / ASATMYA INDRIYARDHA SAMYOGA
2. intellectual errors/ PRAJNAPARADHA and
3. seasonal vagaries / KALA [5-6]

Factors responsible for manifestation of innumerable diseases

प्रकुपितास्तु खलु ते प्रकोपणविशेषाद्दूष्यविशेषाच्च विकारविशेषानभिनिर्वर्तयन्त्यपरिसङ्ख्येयान्||७||
 
Depending upon the specific nature of the causative factors and also the specificity of the tissue elements afflicted, doshas when aggravated manifest innumerable types of diseases. [7]

Psycho-somatic diseases

ते च विकाराः परस्परमनुवर्तमानाः कदाचिदनुबध्नन्ति कामादयो ज्वरादयश्च||८||
When allowed to persist for long, these psychic diseases viz. kama (passion) etc., and somatic diseases viz. fever etc., at times get combined with each other. [8]

Psychic doshas- their eternal union

नियतस्त्वनुबन्धो रजस्तमसोः परस्परं, न ह्यरजस्कं तमः प्रवर्तते ||९||

There is an eternal union between the two doshas pertaining to mind, viz. rajas and tamas. Tamas cannot manifest its actions without rajas. [9]

Combination of physical doshas

(प्रायः) शारीरदोषाणामेकाधिष्ठानीयानां सन्निपातः संसर्गो वा समानगुणत्वात्; दोषा हि दूषणैः समानाः||१०||

The three somatic doshas located at the same place and having identical attributes mostly 

• combine with one another (samsarga) or 
• with all taken together (sannipata). 

Attributes of doshas resemble those of the factors which vitiate those doshas. [10]

Primary and Secondary diseases

तत्रानुबन्ध्यानुबन्धकृतो विशेषः- स्वतन्त्रो व्यक्तलिङ्गो यथोक्तसमुत्थानप्रशमो भवत्यनुबन्ध्यः, तद्विपरीतलक्षणस्त्वनुबन्धः| अनुबन्ध्यलक्षणसमन्वितास्तत्र यदि दोषा भवन्ति तत्त्रिकं सन्निपातमाचक्षते, द्वयं वा संसर्गम्| अनुबन्ध्यानुबन्धविशेषकृतस्तु बहुविधो दोषभेदः| एवमेष सञ्ज्ञाप्रकृतो भिषजां दोषेषु व्याधिषु च नानाप्रकृतिविशेषव्यूहः ||११||


Characteristic features of primary and secondary (subordinate) diseases are as follows:

• The primary disease manifests its own symptoms independently; 
• this morbid condition is caused by factors specific to the manifestation of the disease. 
• This can be cured by the therapies prescribed for that particular disease. 
• The subordinate disease is characterized by opposite features. 
• If all the three doshas are primarily vitiated at a time, the condition is known as sannipata. 
• If only two of the doshas are vitiated, it is called samsarga. 

Depending upon the primary and subordinate nature of doshas, they are of many types. 

Considering such characteristic features, physicians attribute various names (like jwara or fever and atisara or diarrhea) to different conditions caused by doshas and diseases. [11]

Four types of Agni

अग्निषु तु शारीरेषु चतुर्विधो विशेषो बलभेदेन भवति| 

तद्यथा- तीक्ष्णो, मन्दः, समो, विषमश्चेति|

Depending upon their intensity, agnis (factors responsible for digestion and metabolism) located in the body of human beings can be classified under four categories, viz. 

1. tikshna (severe), 

2. manda (low), 

3. sama (normal) and 

4. vishama (irregular).

 तत्र तीक्ष्णोऽग्निः सर्वापचारसहः, 

1. The tikshna type is capable of tolerating all types of irregularities 

तद्विपरीतलक्षणस्तु मन्दः,

2. whereas the manda type is of opposite nature, i.e. even a small irregularity will impair its functioning. 

 

समस्तु खल्वपचारतो विकृतिमापद्यतेऽनपचारतस्तु प्रकृताववतिष्ठते,

3. The sama or balanced type of agni gets impaired even by minor irregularities; it maintains its normalcy so long as there is no irregularity. 

 

समलक्षणविपरीतलक्षणस्तु विषम इति| 

4. The irregular type of agni, as opposed to sama or balanced type, sometimes gets impaired and sometime it does not get impaired by irregularities.

एते चतुर्विधा भवन्त्यग्नयश्चतुर्विधानामेव पुरुषाणाम्| 

These four types of agni occur in the four types of individuals.

तत्र समवातपित्तश्लेष्मणां प्रकृतिस्थानां समा भवन्त्यग्नयः, 

 1. In individuals having vata, pitta and kapha in their balanced and normal state, the agnis are regular or balanced. 

वातलानां तु वाताभिभूतेऽग्न्यधिष्ठाने विषमा भवन्त्यग्नयः, 

2. In the case of individuals having the dominance of vata constitution, due to the affliction of the site of agni by vata, their agnis are irregular. 

पित्तलानां तु पित्ताभिभूते ह्यग्न्यधिष्ठाने तीक्ष्णा भवन्त्यग्नयः, 

3. In the case of individuals having the dominance of pitta, the agnis are sharp. 

श्लेष्मलानां तु श्लेष्माभिभूतेऽग्न्यधिष्ठाने मन्दा भवन्त्यग्नयः||१२||

4. Similarly, in the case of individuals having the dominance of kapha in the constitution, the agnis are mild due to the affliction of the site of agni by kapha. [12]

Physical constitution

तत्र केचिदाहुः- न समवातपित्तश्लेष्माणो जन्तवः सन्ति, विषमाहारोपयोगित्वान्मनुष्याणां; तस्माच्च वातप्रकृतयः केचित्, केचित् पित्तप्रकृतयः, केचित् पुनः श्लेष्मप्रकृतयो भवन्तीति| 

Some scholars hold the view that living beings cannot have a balanced state of vata, pitta and kapha in their body because they are accustomed to the intake of diets which are seldom balanced. 

Therefore, according to them some individuals have 

1. vata prakriti (vatika constitution), 
2. some have pitta prakriti (pattika constitution) and 
3. the rest have kapha prakriti (shlaishmika constitution). 

तच्चानुपपन्नं, कस्मात् कारणात्?

समवातपित्तश्लेष्माणं ह्यरोगमिच्छन्ति भिषजः, यतः प्रकृतिश्चारोग्यम्,

 - This is not correct because physicians take an individual to be healthy only when vata, pitta and kapha in his body are in a state of equilibrium and health represents the natural state of the body. 

  

आरोग्यार्था च भेषजप्रवृत्तिः,  

It is with a view to maintaining good health that all types of treatments are prescribed. 

सा चेष्टरूपा, तस्मात् सन्ति समवातपित्तश्लेष्माणः;

That state of the body is the most cherished one. Therefore, there are individuals having the balanced state of vata, pitta and kapha in their body.

न खलु सन्ति वातप्रकृतयः पित्तप्रकृतयः श्लेष्मप्रकृतयो वा| तस्य तस्य 

किल दोषस्याधिक्यात् सा 

The use of terms like vataprakriti, pittaprakriti and kaphaprakriti is not correct because in these types of constitutions, there is always a dominance of doshas in the bodies of individuals. 

सा दोषप्रकृतिरुच्यते मनुष्याणां, न च विकृतेषु दोषेषु प्रकृतिस्थत्वमुपपद्यते, तस्मान्नैताः प्रकृतयः सन्ति; 

Prakriti means a normal or natural state and there should not be any dominance of doshas in the bodies of such individuals. So such individuals as are having the dominance of one or the other doshas cannot be described to have the normal state of their body. 

सन्ति तु खलु वातलाः पित्तलाः श्लेष्मलाश्च, अप्रकृतिस्थास्तु ते ज्ञेयाः||१३||

Thus to use the correct term, 

• they are vatala(having the dominance of vata), 
• pittala (having the dominance of pitta) and 
• shlesmala (having the dominance of kapha), and 

 - these do not indicate the normal state of their body. [13]

Management of persons having different types of physical constitution

तेषां तु खलु चतुर्विधानां पुरुषाणां चत्वार्यनुप्रणिधानानि श्रेयस्कराणि भवन्ति| तत्र समसर्वधातूनां सर्वाकारसमम्, 

Four types of regimens are prescribed for the benefit of these four categories of individuals. 

• For an individual having the balance state of all doshas, all the regimens to be adopted by him should be of balanced type. 

अधिकदोषाणां तु त्रयाणां यथास्वं दोषाधिक्यमभिसमीक्ष्य दोषप्रतिकूलयोगीनि त्रीण्यनु(न्न)प्रणिधानानि श्रेयस्कराणि भवन्ति 

• When there is predominance of doshas, depending upon the nature of the doshas involved, it is useful to adopt such three regimens as would be in contradiction with these three predominating doshas till there is normalcy of agni. 

यावदग्नेः समीभावात्, समे तु सममेव कार्यम्; एवं चेष्टा भेषजप्रयोगाश्चापरे|  

• It is only after the normalcy of the agni is attained, balanced regimens should be adopted. 
• Similarly, various therapies and other regimens should be administered to these four categories of individuals. 

तान् विस्तरेणानुव्याख्यास्यामः||१४||

We shall now explain them in detail. [14]

Characteristic of constitutions and management of vata dominance

त्रयस्तु पुरुषा भवन्त्यातुराः, ते त्वनातुरास्तन्त्रान्तरीयाणां भिषजाम्| तद्यथा- वातलः,पित्तलः, श्लेष्मलश्चेति| तेषामिदं विशेषविज्ञानं- वातलस्य वातनिमित्ताः, पित्तलस्य पित्तनिमित्ताः, श्लेष्मलस्य श्लेष्मनिमित्ता व्याधयः प्रायेण बलवन्तश्च भवन्ति||१५|| 

Vatala (dominance of vata), pittala (dominance of pitta) and shleshmala (dominance of kapha)- these three are the morbid state in individuals, even though, according to another school of thought they represent the natural states of the body.

 Their characteristic features are as given below: 

       - vatala, pittala and shleshmala types of individuals are more susceptible to vatika, pittika and shlaishmika diseases respectively and such diseases in the respective types of individual become very severe.

तत्र वातलस्य वातप्रकोपणान्यासेवमानस्य क्षिप्रं वातः प्रकोपमापद्यते, न तथेतरौ दोषौ; स तस्य प्रकोपमापन्नो यथोक्तैर्विकारैः शरीरमुपतपति बलवर्णसुखायुषामुपघाताय|

If vatala type of individual resorts to such things which are aggravators of vata, vata in his body gets aggravated immediately. 

- This does not happen in case of remaining two doshas. The aggravated vata afflicts individuals by the manifestation of disease already described, 

• resulting in the impairment of strength, 
• complexion, 
• happiness and 
• longevity. 

 

तस्यावजयनं-     

The following therapies alleviate this dosha:

स्नेहस्वेदौ विधियुक्तौ,

1. Proper administration of oleation / SNEHA and fomentation/ SWEDA ;

मृदूनि च संशोधनानि

स्नेहोष्णमधुराम्ललवणयुक्तानि,

2. Mild purgative prepared by the addition of fat, hot things and substances having sweet, sour and saline tastes

तद्वदभ्यवहार्याणि, 

3. Food having the ingredients of the above mentioned properties.

अभ्यङ्गोपनाहनोद्वेष्टनोन्मर्दनपरिषेकावगाहनसंवाहनावपीडनवित्रासनविस्मापनविस्मारणानि,

4. Massage, poultices, bandages, kneading, effusion, bath, samvahana (pressing and massaging by hand), pressing, using means of terrifying, methods of surprising and making oneself to forget (bad memories)

सुरासवविधानं,  

5. Use of wine and asavas (fermented drinks)

स्नेहाश्चानेकयोनयो

दीपनीयपाचनीयवातहरविरेचनीयोपहितास्तथा शतपाकाः सहस्रपाकाः सर्वशश्च प्रयोगार्थाः, बस्तयः, 

6. Fats from different sources mixed with drugs having 

• digestive, 
• stimulant, 
• carminative, 
• vata alleviating and 
• purgative properties

- they may be boiled hundred and thousand times and be used for being administered in different ways, viz. internal use, massage, enema, etc., and

बस्तिनियमः सुखशीलता चेति||१६||

7. Observance of enema regimens, its regulations and adopting comfort (in behavior and lifestyle) [15-16]

Characteristics of pittala constitution and its management

पित्तलस्यापि पित्तप्रकोपणान्यासेवमानस्य क्षिप्रं पित्तं प्रकोपमापद्यते, न तथेतरौ दोषौ; तदस्य प्रकोपमापन्नं यथोक्तैर्विकारैः शरीरमुपतपति बलवर्णसुखायुषामुपघाताय|

If a pittaja individual resorts to such things as are aggravators of pitta, pitta in his body gets aggravated immediately. This does not happen in the case of remaining two doshas. 

The aggravated pitta afflicts the individual by the manifestation of diseases already described resulting in the impairment of strength, complexion, happiness and longevity. 

The following therapies alleviate this dosha:

तस्यावजयनं-    मधुरतिक्तकषायशीतानां चौषधाभ्यवहार्याणामुपयोगः, मृदुमधुरसुरभिशीतहृद्यानां गन्धानां चोपसेवा, 

सर्पिष्पानं, 

1. Consumption of ghee;

सर्पिषा च स्नेहनम्,

2. Oleation by ghee;

अधश्च दोषहरणं,

3. Purgation;

मधुरतिक्तकषायशीतानां चौषधाभ्यवहार्याणामुपयोगः, 

1. Use of drugs and diets having sweet, bitter and astringent tastes; and cooling property;

मृदुमधुरसुरभिशीतहृद्यानां गन्धानां चोपसेवा, 

1. Use of scents which are mild, sweet, fragrant, cooling and cordial;
2. 
   

मुक्तामणिहारावलीनां च परमशिशिरवारिसंस्थितानां धारणमुरसा,

1. Use in the chest of pearls, jewels and garlands which are kept in excessively cold water;

 क्षणे क्षणेऽग्र्यचन्दनप्रियङ्गुकालीयमृणालशीतवातवारिभिरुत्पलकुमुदकोकनदसौगन्धिकपद्मानुगतैश्च वारिभिरभिप्रोक्षणं, 

1. Frequent sprinkling of cold water and cold air of agryachandana (Santalum album Linn.), priyangu (Callicarpa macrophylla), kaliya (yellow variety of chandana) and mrinala (lotus stalk) mixed with utpala (Nymphaea alba Linn.), kumuda (a variety of utpala), kokanada (a variety of utpala red in color), saugandhika (a variety of utpala) and padma (Nelumbo nucifera Gaertn.)

श्रुतिसुखमृदुमधुरमनोऽनुगानां च गीतवादित्राणां श्रवणं, 

1. Hearing of songs and music which are pleasing to ears, mild, sweet and agreeable;

श्रवणं चाभ्युदयानां,

1. Hearing the information regarding prosperity;

सुहृद्भिः संयोगः,

1. Keeping company of friends;

  संयोगश्चेष्टाभिः स्त्रीभिः शीतोपहितांशुकस्रग्धारिणीभिः,  

1. Company of agreeable ladies wearing cooling garments and garlands;

निशाकरांशुशीतलप्रवातहर्म्यवासः,

1. Residence in buildings which is cooled by the moon rays and exposed to the breezes from all sides;

शैलान्तरपुलिनशिशिरसदनवसनव्यजनपवनसेवनं, 

1. Residence in cold places in mountains and river banks, use of cold apparel and exposure to the cold winds of fans;

रम्याणां चोपवनानां सुखशिशिरसुरभिमारुतोपहितानामुपसेवनं, 

1. Visiting beautiful garden having pleasing, cold and fragrant wind;

सेवनं चपद्मोत्पलनलिनकुमुदसौगन्धिकपुण्डरीकशतपत्रहस्तानां , 

1. Use of flower of padma (Nelumbo ncifera Gaertn.), utpala (Nymphaea alba linn.), nalina (a type of lotus), kumuda (a variety of utpala), saugandhika (a variety of utpala), pundarika( Nymphaea lotus Linn.) and satapatra ( a variety of lotus); and

सौम्यानां च सर्वभावानामिति||१७||

1. Adoption of such other regimens as are of soothing nature. [17]

Characteristics of shlaishmala constitution and its management

श्लेष्मलस्यापि श्लेष्मप्रकोपणान्यासेवमानस्य [१] क्षिप्रं श्लेष्मा प्रकोपमापद्यते, न तथेतरौ दोषौ; स तस्य प्रकोपमापन्नोयथोक्तैर्विकारैः शरीरमुपतपति बलवर्णसुखायुषामुपघाताय| 

If shlaishmala types of individual resorts to such things as are aggravators of kapha, then kapha in his body gets aggravated immediately; this does not happen to the remaining two doshas. The aggravated kapha afflicts the individual by the manifestation of diseases already described, resulting in the impairment of strength, complexion, happiness and longevity. 

तस्यावजयनं-   

The following therapies alleviate this dosha:

विधियुक्तानि तीक्ष्णोष्णानि संशोधनानि,

1. Proper administration of strong and hot elimination therapies;

रूक्षप्रायाणि चाभ्यवहार्याणि कटुकतिक्तकषायोपहितानि,

2. Intake of diet which is mostly ununctuous and is composed of ingredients having pungent, bitter and astringent tastes;

तथैवधावनलङ्घनप्लवनपरिसरणजागरणनियुद्धव्यवायव्यायामोन्मर्दनस्नानोत्सादनानि,  

3. Running, jumping, swimming, whirling, keeping awake during night, fighting, sexual intercourse, exercise, unction, bath and oil massage;

विशेषतस्तीक्ष्णानां दीर्घकालस्थितानां चमद्यानामुपयोगः, 

4. Intake of strong wines preserved for a long time;

सधूमपानः सर्वशश्चोपवासः,

5. All lightening therapies along with herbal smoking;

तथोष्णं वासः, 

6. Use of warm apparel; and

सुखप्रतिषेधश्च सुखार्थमेवेति||१८||

7. Giving up comforts of life with a view to enjoying happiness ultimately. [18]

Characteristics of royal physician

भवति चात्र- सर्वरोगविशेषज्ञः सर्वकार्यविशेषवित्| 

सर्वभेषजतत्त्वज्ञो राज्ञः प्राणपतिर्भवेदिति||१९||

Thus it is said:- 

1.  Sarvaroga visheshajna / A man well versed with the specific features of all diseases, 
2. Sarvakarya visheshajna / principles of their treatment and 
3. Sarvabheshaja tatvajna / properties of all medicaments 

 - is entitled to be a royal physician. [19]

Summary

तत्र श्लोकाः- प्रकृत्यन्तरभेदेन रोगानीकविकल्पनम्| परस्पराविरोधश्च सामान्यं रोगदोषयोः||२०|| दोषसङ्ख्या विकाराणामेकदेशः प्रकोपणम्| जरणं प्रति चिन्ता च कायाग्नेर्धुक्षणानि च||२१|| नराणां वातलादीनां प्रकृतिस्थापनानि च| रोगानीके विमानेऽस्मिन् व्याहृतानि महर्षिणा||२२||

To sum up, in this chapter, 

• groups of diseases based upon vata etc. prakriti types, 
• non-contradiction of classified categories of diseases, 
• similarity in dosha and roga, 
• numbers of doshas, 
• diseases with one type, 
• causes of vitiation of dosha, 
• description of agni, 
• and means to stimulate it’s functions, 
• vata etc. dominant types of persons 
• and their management to maintain normalcy of dosha 

 - are described in details by sage Atreya. [20-22]