Ashtanga Hridayam Shareerasthanam Chapter 5:  Vikritivijnaniya Shareeram Adhyaya (Knowledge of abnormalities and bad prognostics)    

The 5th chapter of Sarirasthanam of Ashtanga Hridayam is named as Vikritivijnaniya sharira Adhyayah. This chapter deals with the explanation of abnormalities and bad prognostics.

The topics covered in this chapter include –

–        Definition of rishta – the fatal signs
–        Importance of treating the patient having longevity of life and reasons for its failure in those having deficit life
–        Relationship of death with rishta signs
–        Kinds of fatal signs
–        Rista bhavah – Factors under fatal signs
–        Fatal signs connected with appearance
–        Signs of residual life of one year, only six months, one month, six or three days, fifteen days
–        Signs of death from increased pitta,
–        Fatal signs connected with sense organs, fingers, sounds, respiration, smell of the body, unpleasant and unnatural tastes developed in the body, abnormal temperature variations, contrasting sensations of cold and heat, contrasting and abnormal sensory perceptions, premonitory symptoms of diseases, gain and loss of virtues,
–        Seeing contrasting, abnormal and fearful forms which point towards impending death
–        Fatal signs concerned with voice, shades, complexion and shadow,
–        Kinds of complexion and fatal signs associated with them
–        Fatal signs associated with activities,
–        Fatal signs based on abnormalities in the nature of gunas and doshas
–        Fatal signs observed in eyes, hands and feet
–        Fatal signs associated with disease symptoms, in diseases like fever, bleeding disorders, cough and dyspnoea, tuberculosis, vomiting, thirst, alcoholic intoxication, piles, diarrhea, urinary stones, diabetes, abdominal tumors, abdominal disorders, anemia, dropsy, herpes, leprosy, vata and vata disorders, gout, all diseases, enlargement of prostate, chicken pox, small pox, jaundice, skin abrasions, ulcers etc
–        Diseases to be rejected in a weak person in spite of presence of feeble symptoms
–        Sudden appearance of some symptoms which indicate impending death of the person
–        Fatal signs based on the sudden appearance of black moles etc
–        Fatal signs based on non-availability of medicines
–        Fatal signs based on failure of medicines and treatments
–        Fatal signs based on sudden changes occurring in the medicines and foods for no obvious reasons
–        Fatal signs based on untoward events happening in the patient’s home
–        Fatal signs based on sudden disappearance of diseases in a weak patient
–        Fatal signs based on sudden destruction of potency of the medicines
–        Importance of having the knowledge of rista i.e. fatal signs, for a physician
–        Fatal signs based on expiry of period of life and effort of benevolent deeds

Pledge by the author(s)

अथातो विकृतिविज्ञानीयं शारीरं व्याख्यास्यामः।

इति ह स्माहुरात्रेयादयो महर्षयः।।गद्यसूत्रे॥२॥

After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of abnormalities and bad prognostics. Thus say (pledge) atreya and other sages.

Rista Niruki – definition of fatal signs

पुष्पं फलस्य धूमो ऽग्नेर्वर्षस्य जलदोदयः ।

यथा भविष्यतो लिङ्गं रिष्टं मृत्योस्तथा ध्रुवम् ॥ १ ॥

Just as the flower, smoke and appearance (and collection) of clouds are the signs of future occurrence of the fruit, fire and rain respectively, rista are the definite signs of oncoming death (fatal signs)

Importance of treating the patient having longevity of life and reasons for its failure in those having deficit life

आयुष्मति क्रियाः सर्वाः सफलाः सम्प्रयोजिताः ।

भवन्ति भिषजां भूत्यै कृतज्ञ इव भूभुजि ॥ १+(१) ॥

क्षीणायुषि कृतं कर्म व्यर्थं कृतमिवाधमे ।

अयशो देहसन्देहं स्वार्थहानिं च यच्चति ॥ १+(२) ॥

तर्हीदानीं गतासूनां लक्षणं सम्प्रचक्षते ।

विकृतिः प्रकृतेः प्राज्ञैः प्रदिष्टा रिष्टसञ्ज्ञया ॥ १+(३) ॥

All the treatment properly administered by the physician to the person who has long life become successful just like the grateful person (becomes faithful) to the king. Treatment administrated to the person whose life is waning (short) become a waste, just as the help done to a mean person. By that, the physician gets bad reputation, doubt of life and loss of own desires (possessions). Hence, herein are described, the signs of the person who is losing his life. Abnormal changes of the prakrti, normal features of the body and mind) are called, by the learned, as rista (fatal signs)

Relationship of death with rishta signs

अरिष्टं नास्ति मरणं दृष्टरिष्टं च जीवितम् ।

अरिष्टे रिष्टविज्ञानं न च रिष्टेऽप्यनैपुणात् ॥ २ ॥

There is no death without rista (without the appearance of fatal signs) and no life when rista (fatal signs) are seen. Understanding nonfatal fatal signs as fatal signs, and understanding fatal signs as nonfatal, happen due to inexperience (of the physician)

Rista Bhedha – kinds of fatal signs

केचित्तु तद्द्विधेत्याहुः स्थाय्यस्थायिविभेदतः ।

दोषाणामपि बाहुल्याद्रिष्टाभासः समुद्भवेत् ॥ ३ ॥

स दोषाणां शमे शाम्येत्स्थाय्यवश्यं तु मृत्यवे ।

Some opine that these (fatal signs) are of two kinds, viz, sthayi (permanent, non changing) and asthayi (temporary, changing), ristabhasa (sings resembling fatal signs), manifest even due to great increase of the dosas; they subside (disappear) with mitigation of the dosas, while the sthayi rista (permanent fatal signs) are sure to cause death

Rista bhavah – factors under fatal signs

रूपेन्द्रियस्वरच्चायाप्रतिच्चायाक्रियादिषु ॥ ४ ॥

अन्येष्वपि च भावेषु प्राकृतेष्वनिमित्ततः ।

विकृतिर्या समासेन रिष्टं तदिति लक्षयेत् ॥ ५ ॥

Rupa (appearance, size, shape, colour etc),  indriya (sense organs), svara (voice / speech), chaya (shade, complexion), pratichaya (image), kriya (activities, functions) and many other factors undergoing change from their normalcy (becoming abnormal) without any cause (apparent reason) are all to be considered as rista (fatal signs).

Rupa rista – fatal signs connected with appearance

केशरोमनिरभ्यङ्गं यस्याभ्यक्तमिवेक्ष्यते ।

यस्यात्यर्थं चले नेत्रे स्तब्धान्तर्गतनिर्गते ॥ ६ ॥

जिह्मे विस्तृतसङ्क्षिप्ते सङ्क्षिप्तविनतभ्रुणी ।

उद्भ्रान्तदर्शने हीनदर्शने नकुलोपमे ॥ ७ ॥

कपोताभे अलाताभे स्रुते लुलितपक्ष्मणी ।

नासिकात्यर्थविवृता संवृता पिटिकाचिता ॥ ८ ॥

उच्चूना स्फुटिता म्लाना यस्यौष्ठो यात्यधोऽधरः ।

ऊर्ध्वं द्वितीयः स्यातां वा पक्वजम्बूनिभावुभौ ॥ ९ ॥

दन्ताः सशर्कराः श्यावास्ताम्राः पुष्पितपङ्किताः ।

सहसैव पतेयुर्वा जिह्वा जिह्मा विसर्पिणी ॥ १० ॥

शूना शुष्का गुरुः श्यावा लिप्ता सुप्ता सकण्टका ।

शिरः शिरोधरा वोढुं पृष्ठं वा भारमात्मनः ॥ ११ ॥

हनू वा पिण्डमास्यस्थं शक्नुवन्ति न यस्य च ।

यस्यानिमित्तमङ्गानि गुरूण्यतिलघूनि वा ॥ १२ ॥

विषदोषाद्विनायस्य खेभ्यो रक्तं प्रवर्तते ।

उत्सिक्तं मेहनं यस्य वृषणावतिनिःसृतौ ॥ १३ ॥

अतोऽन्यथा वा यस्य स्यात् सर्वे ते कालचोदिताः ।

He, whose hair on the head and on the body appearing as though smeared with oil, though not actually smeared whose eyes are highly unsteady or having no movement at all; which have (appear) gone deep inside or protruding out, become irregular (asymmetrical) either expanded or contracted; eye brows are contracted or bent down; sight either increases, decreased or becomes like that of a mongoose, pigeon and burning coal; tears flowing profusely, the eye lashes getting twisted whose nose, is very greatly dilated or contacted; having eruptions, having serve swelling at the top, cracked and lustreless whose upper lip, droops down (very greatly) and lower lip moves upwards greatly; both lips having colour of a ripe jambuphala (dark blue in colour) whose teeth, are full of tarter, black or coppery, have flowers (spots of different shapes) coated with dirt, and which fall off suddenly whose tongue is irregular, having more of movement, swollen, dry, heavy (thick), blue in colour, coated, sleeping / numb (having no sensation) and having thorn like eruptions whose neck is unable to bear the weight of its head and the back is unable to bear the weight of its own body whose lower jaw is unable to hold the bolus of food put into the mouth whose body and body parts, become either very heavy or every light without any cause from whose orifices (eyes, ears, nose, mouth, urethra, and anus) blood flows out, without the effect of poison whose penis, has moved upward greatly and testes (scrotum) moved downward greatly or both of them are in the opposite (penis, moved downward and scrotum moved upward greatly) all such persons are nearing death.

Fatal signs indicated by formation of vein like lines

यस्यापूर्वाः सिरालेखा बालेन्द्वाकृतयोऽपि वा ॥ १४ ॥

ललाटे वस्तिशीर्षे वा षण्मासान्न स जीवति ।

He, on whose forehead, urinary bladder or head, lines of veins or patches resembling the young moon appear afresh (which were not present before) does not live even for six months

Signs of residual life of only six months

पद्मिनीपत्त्रवत्तोयं शरीरे यस्य देहिनः ॥ १५ ॥

प्लवते प्लवमानस्य षण्मासास्तस्य जीवितम् ।

He, on whose body, after taking bath, water floats like floating on the lotus leaf, (without moistening it), his life is for six months only

Signs of death from increased pitta

हरिताभाः सिरा यस्य रोमकूपाश्च संवृताः ॥ १६ ॥

सोऽम्लाभिलाषी पुरुषः पित्तान्मरणमश्नुते ।

He, whose veins are greenish (or yellowish), hair follicles are contracted, who desires sours (things of sour taste in food), attains death from (increase of) pitta

Signs of ‘death within a month’

यस्य गोमयचूर्णाभं चूर्णं मूर्ध्नि मुखेऽपि वा ॥ १७ ॥

सस्नेहं मूर्ध्नि धूमो वा मासान्तं तस्य जीवितम् ।

He, whose head or face become covered with unctuous (greasy) powder like the powder of cowdung, or whose head becomes smoky (emitting the small of smoke) his life ends within a month

Signs of ‘impending death within six or three days’

मूर्ध्नि भ्रुवोर्वा कुर्वन्ति सीमन्तावर्तका नवाः ॥ १८ ॥

मृत्युं स्वस्थस्य षड्रात्रात्त्रिरात्रादातुरस्य तु ।

Bifurcating lines and patches appearing afresh on the head or the brows produce death within six days in a healthy man and within three days in a sick man.

Impending signs of death which are pointers to reject a patient

जिह्वा श्यावा मुखं पूति सव्यमक्षि निमज्जति ॥ १९ ॥

खगा वा मूर्ध्नि लीयन्ते यस्य तं परिवर्जयेत् ।

He, whose tongue becomes blue; mouth becomes foul smelling; left eye goes deep inside; on whose head birds alight, should be rejected (as dead).

Signs of impending death within 15 days

यस्य स्नातानुलिप्तस्य पूर्वंशुष्यत्युरो भृशम् ॥ २० ॥

आर्द्रेषु सर्वगात्रेषु सोऽर्धमासं न जीवति |

He, in whom the chest dries up very soon, after the person has bathed and smeared with unguents, while the other parts of the body remain moist does not live for even half of a month

Indriya Rista – fatal signs connected with sense organs

अकस्माद्युगपद्गात्रे वर्णौ प्राकृतवैकृतौ ॥ २१ ॥

तथैवोपचयग्लानिरौक्ष्यस्नेहादि मृत्यवे ।

Sudden appearance without any other reason, of normal and abnormal colours together, in the body (causes death). Likewise, increase of strength or debility, dryness or moistness etc. appearing suddenly lead to death

Fatal signs observed in fingers, sounds and respiration

यस्य स्फुटेयुरङ्गुल्यो नाकृष्टा न स जीवति ॥ २२ ॥

क्षवकासादिषु तथा यस्यापूर्वो ध्वनिर्भवेत् ।

ह्रस्वो दीर्घोऽति वोच्च्वासः पूतिः सुरभिरेव वा ॥ २३ ॥

He, whose fingers do not produce sound (knukles) when pulled, does not live; unusual sound which were not present before, appearing in sneezing coughing etc (belching, fart etc.) The respiration becoming either very short or very  long, and having either foul smell or sweet smell (does not live)

Fatal signs observed in the smell emitted from the body

आप्लुतानाप्लुते काये यस्य गन्धोऽतिमानुषः ।

मलवस्त्रव्रणादौ वा वर्षान्तं तस्य जीवितम् ॥ २४ ॥

He who, emits nonhuman smell from his body with or without bathing, in the waste products (of his body), dress, wounds etc., his life is only till the end of one year

Fatal signs observed on the basis of unpleasant and unnatural tastes developed in the body

भजन्तेऽत्यङ्गसौरस्याद्यं यूकामक्षिकादयः ।

त्यजन्ति वातिवैरस्यात्सोऽपि वर्षं न जीवति ॥ २५ ॥

He, whose body becomes very sweet attracting lice, flies etc., or becomes very unpleasant in taste, making the insects to depart from the body; even he does not live for one year

Fatal signs observed on the basis of abnormal temperature variations (feel of cold and heat)

सततोष्मसु गात्रेषु शैत्यं यस्योपलक्ष्यते ।

शीतेषु भृशमौष्ण्यं वा स्वेदः स्तम्भोऽप्यहेतुकः ॥ २६ ॥

He, who has the appearance of cold suddenly and without any cause, on the parts of the body which are warm always and appearance of warmth on the parts which are cold always; severe perspiration or rigidity (loss of movement) does not live for one year)

Fatal signs observed on the basis of contrasting feel of cold and heat sensations

यो जातशीतपिटिकः शीताङ्गो वा विदह्यते ।

उष्णद्वेषी च शितार्तः स प्रेताधिपगोचरः ॥ २७ ॥

He, who has cold eruptions (eruptions caused by increases of kapha) and whose body is cold, but yet experiences severe burning sensation; he who is suffering from cold but yet hates warmth, are being seen by the lord of the dead.

Fatal signs observed on the basis of contrasting temperatures in chest and abdomen

उरस्यूष्मा भवेद्यस्य जठरे चातिशीतता ।

भिन्नं पुरीषं तृष्णा च यथा प्रेतस्तथैव सः ॥ २८ ॥

He, whose chest is very warm and abdomen (inside) very cold, which has severe diarrhoea and thirst is just like a cadaver

Other fatal signs indicating impending death within one month

मूत्रं पुरीषं निष्ठ्यूतं शुक्रं वाप्सु निमज्जति ।

निष्ठ्यूतं बहुवर्णं वा यस्य मासात्स नश्यति ॥ २९ ॥

He, whose urine, feaces, sputum or semen, sink in water; the sputum being of many colours, dies within a month

Seeing contrasting, abnormal and fearful forms which point towards impending death

घनीभूतमिवाकाशमाकाशमिव यो घनम् ।

अमूर्तमिव मूर्तं च मूर्तं चामूर्तवत्स्थितम् ॥ ३० ॥

तेजस्व्यतेजस्तद्वच्च शुक्लं कृष्णमसच्च सत् ।

अनेत्ररोगश्चन्द्रं च बहुरूपमलाञ्चनम् ॥ ३१ ॥

जाग्रद्रक्षांसि गन्धर्वान् प्रेतानन्यांश्च तद्विधान् ।

रूपं व्याकृति तत्तच्च यः पश्यति स नश्यति ॥ ३२ ॥

He, who sees the sky (surrounding empty space) as a solid body and solid substances (bodies) as the sky (empty space), those (objects) which have form (size, shape etc), as formless, and the formless ones as having form; similarly the  luminescent as nonluminiscent, white as black and nonexistent as existing; who even without diseases of the eyes, sees the moon having many shapes (and number) and covered with dust; who even when awake, sees Raksasa, Gandharva, Preta and such others (non human being) and those forms which are terrifying to look at; is going to perish.

Fatal signs indicating ensuing death within one year

सप्तर्षीणां समीपस्थां यो न पश्यत्यरुन्धतीम् ।

ध्रुवमाकाशगङ्गां वा स न पश्यति तां समाम् ॥ ३३ ॥

He, who does not see the star Arundhati, which is near by to the Saptarsi (group of seven stars), who does not see the Dhruva (pole star) or Akasaganga  (river of the sky/ stellar galaxy), does not live for a year

Fatal signs based on contrasting and abnormal sensory perceptions

मेघतोयौघनिर्घोषवीणापणववेणुजान् ।

शृणोत्यन्यांश्च यः शब्दानसतो न सतोऽपि वा ॥ ३४ ॥

निष्पीड्य कर्णौ शृणुयान्न यो धुकधुकास्वनम् ।

तद्वद्गन्धरसस्पर्शान् मन्यते यो विपर्ययात् ॥ ३५ ॥

सर्वशो वा न यो यश्च दीपगन्धं न जिघ्रति ।

विधिना यस्य दोषाय स्वास्थ्यायाविधिना रसाः ॥ ३६ ॥

यः पांसुनेव कीर्णाङ्गो योऽङ्गे घातं न वेत्ति वा ।

अन्तरेण तपस्तीव्रं योगं वा विधिपूर्वकम् ॥ ३७ ॥

जानात्यतीन्द्रियं यश्च तेषां मरणमादिशेत् ।

He, who hears the sounds of the cloud, sea waves, the vina, panava and venu (flute) all (musical instruments) or such others even though it (sound) is not present; or does not hear the sound which is actually present;

यो शृणुयन्न धुकधुका स्वनम् कर्णौ निष्पीड्य – yo śṛṇuyanna dhukadhukā svanam karṇau niṣpīḍya –  who does not hear the dhukdhuk sound when he blocks his ears with his fingers

तद्वत्गन्ध रस स्पर्शान्मन्यते यो विपर्ययात् सर्वशो वा न यो यः च – tadvat gandha rasa sparśān manyate yo viparyayāt sarvaśo vā na yo yaḥ ca – similarly with regard to smell, taste and touch; he who understands these in the opposite manner either fully or partially;

न जिघ्रति दीपगन्धं – na jighrati dīpa gandhaṃ – he who does not understand the smell of the lamp wick (which is extinguished just then),

यस्य रसाः विधिना दोषाय स्वास्थ्याय अविधिना – yasya rasāḥ vidhinā doṣāya svāsthyāya avidhinā – who does not recognise the particular tastes (of drugs) which have been administered in accordance to the dosa (to mitigate them) and those tastes which are consumed during health without observing the rules;

यः इवकीर्णाङ्गो पांसुन् यो न वेत्ति घातं अङ्गे वा – yaḥ iva kīrṇāṅgo pāṃsun yo na vetti ghātaṃ aṅge vā – he whose body gets coated with sand (dirty powder) who does not understand injury (cut , blow and such others) of his body,

यः अन्तरेण तीव्रं तपः योगं वा विधि पूर्वकम् – yaḥ antareṇa tīvraṃ tapaḥ yogaṃ vā vidhi pūrvakam – who without doing severe penance or yoga as per proper procedure,

जानाति अतीन्द्रियं च तेषां मरणं आदिशेत् – jānāti atīndriyaṃ ca teṣāṃ maraṇaṃ ādiśet – beings to experience of extra sensory knowledge – in all of them death is sure (all are going to die)

AH Sa 5.38b-41a

Svara Rista – fatal signs concerned with the voice

श्रोतारं चास्य शब्दस्य दूरतः परिवर्जयेत् ।

हीनो दीनः स्वरोऽव्यक्तो यस्य स्याद्गद्गदोऽपि वा ॥ ३८ ॥

सहसा यो विमुह्येद्वा विवक्षुर्न स जीवति ।

स्वरस्य दुर्बलीभावं हानिं च बलवर्णयोः ॥ ३९ ॥

रोगवृद्धिमयुक्त्या च दृष्ट्वा मरणमादिशेत् ।

अपस्वरं भाषमाणं प्राप्तं मरणमात्मनः ॥ ४० ॥

श्रोतारं च अस्य शब्दस्य दूरतः परिवर्जयेत् ।

He, whose voice becomes low (feeble), peevish, inaudible, stammering or who is anxious to speak but loses his voice suddenly, does not survive voice becoming feeble, along with loss of strength and colour (of the body), increase in the severity of the disease, these happening without any known cause, should be noted as (the signs) of the death. He, who in an unusual voice proclaims his own death repeatedly or he who hears such a sound (talk by others that  he is going to die) should be avoided at a distance (the physician should refuse treatment to such persons since they are going to die)

Chaya pratichaya rista – fatal signs connected with shades and shadow

संस्थानेन प्रमाणेन वर्णेन प्रभयापि वा ॥ ४१ ॥

चाया विवर्तते यस्य स्वप्नेऽपि प्रेत एव सः ।

He, whose chaya (shade) undergoes change (abnormal) in its features (shape), size, colour, or brilliance even in dreams (more so at other times) is a dead man.

Meaning of pratichaya & chaya

आतपादर्शतोयादौ या संस्थानप्रमाणतः ॥ ४२ ॥

चायाङ्गात्सम्भवत्युक्ता प्रतिच्चायेति सा पुनः ।

वर्णप्रभाश्रया या तु सा चायैव शरीरगा ॥ ४३ ॥

The form emanating from by the body (or its parts) having the (natural) features and size, through the medium of sunlight (rays), mirror, water etc, is called pratichaya (shadow image) (it is not connected with colour and radiance) that which is connected to these colour and radiance are related to the body only and they are called as chaya.

Fatal signs related to shadow / image of a person

भवेद्यस्य प्रतिच्चाया चिन्नाभिन्नाधिकाकुला ।

विशिरा द्विशिरा जिह्मा विकृता यदि वान्यथा ॥ ४४ ॥

तं समाप्तायुषं विद्यान्न चेल्लक्ष्यनिमित्तजा ।

प्रतिच्चायामयी यस्य न चाक्ष्णीक्ष्येत कन्यका ॥ ४५ ॥

He, whose shadow / image is found to be cut, torn, more in number, unsteady, headless, double headed, irregular, distorted or any other (unnatural) form, should be considered as completing his life, if these are not due to known causes (intentional creation). He, whose image is not seen in the eyes of others i.e. image on the pupil / cornea of another man’s eye (should be taken as completing his life)

Chaya rista – fatal signs in different kinds of shade/ complexion

खादीनां पञ्च पञ्चानां चाया विविधलक्षणाः ।

नाभसी निर्मलानीला सस्नेहा सप्रभेव च ॥ ४६ ॥

वाताद्रजोऽरुणा श्यावा भस्मरूक्षा हतप्रभा ।

विशुद्धरक्ता त्वाग्नेयी दीप्ताभा दर्शनप्रिया ॥ ४७ ॥

शुद्धवैडूर्यविमला सुस्निग्धा तोयजा सुखा ।

स्थिरा स्निग्धा घना शुद्धा श्यामा श्वेता च पार्थिवी ॥ ४८ ॥

वायवी रोगमरणक्लेशायान्याः सुखोदयाः ।

The five chaya (shade, complextion) related to the mahabhutas such as kha (akasa) etc. are each of different features; nabhasi (related to akasa bhuta) is transparent, blue, unctuous and radiant, vataja (related to vayu bhuta) is  dirty, crimson, blue, ashlike, dry and nonradiant; agneyi (related to tejas bhutas) is bright red, glistening and pleasing to look at; toyaja (related to a jala bhuta) is like the pure vaidurya, transparent, slightly unctuous and good; parthivi (related to prathvi bhuta) is stable, unctuous, thick, transparent, black or white. Among these vayu chaya produces diseases, death or misery, while the others are for producing happiness (health)

Seven kinds of prabha i.e. complexion and fatal signs associated with them

प्रभोक्ता तैजसी सर्वा सा तु सप्तविधा स्मृता ॥ ४९ ॥

रक्ता पीता सिता श्यावा हरिता पाण्डुराऽसिता ।

तासां याः स्युर्विकासिन्यः स्निग्धाश्च विमलाश्च याः ॥ ५० ॥

ताः शुभा मलिना रूक्षाः सङ्क्षिप्ताश्चाशुभोदयाः ।

Prabha (complexion) is of seven kinds viz, red, yellow, white, blue, green, yellowish white and black. All these are described as related to tejobhhuta. Among them, those which are spreading / radiating, unctuous and transparent are benevolent (doing good) and those dirty, dry, and brief (constricted, nonradiating) are malevolent (doing harm)

Differences between chaya and prabha and their relevance in prognosis

वर्णमाक्रामति च्चाया प्रभा वर्णप्रकाशिनी ॥ ५१ ॥

आसन्ने लक्ष्यते चाया विकृष्टे भा प्रकाशते ।

नाच्चायो नाप्रभः कश्चिद्विशेषाश्चिह्नयन्ति तु ॥ ५२ ॥

नृणां शुभाशुभोत्पत्तिं काले चायासमाश्रयाः ।

Chaya (shade), engulfs (masks), the varna (colour) while prabha (complexion) brightens the colour. Chaya is noticeable (understood) from near (close by) whereas prabha is noticeable even from a distance. Neither, chaya nor prabha indicate at any time the special features of man, that is his attaining good or bad (health or ill health). But at that time (of death) they do so getting associated with chaya 

Kriya rista – fatal signs connected with activities

निकषन्निव यः पादौ च्युतांसः परिसर्पति ॥ ५३ ॥

हीयते बलतः शश्वद्योऽन्नमश्नन् हितं बहु ।

योऽल्पाशी बहुविण्मूत्रो बह्वाशी चाल्पमूत्रविट् ॥ ५४ ॥

यो वाल्पाशी कफेनार्तो दीर्घं श्वसिति चेष्टते ।

दीर्घमुच्च्वस्य यो ह्रस्वं निःश्वस्य परिताम्यति ॥ ५५ ॥

ह्रस्वं च यः प्रश्वसिति व्याविद्धं स्पन्दते भृशम् ।

शिरो विक्षिपते कृच्च्राद्योऽञ्चयित्वा प्रपाणिकौ ॥ ५६ ॥

यो ललाटा स्रुतस्वेदः श्लथसन्धानबन्धनः ।

उत्थाप्यमानः सम्मुह्येद्यो बली दुर्बलोऽपि वा ॥ ५७ ॥

उत्तान एव स्वपिति यः पादौ विकरोति च ।

शयनासनकुड्यादेर्योऽसदेव जिघृक्षति ॥ ५८ ॥

अहास्यहासी सम्मुह्यन् यो लेढि दशनच्चदौ ।

उत्तरौष्ठं परिलिहन् फूत्कारांश्च करोति यः ॥ ५९ ॥

यमभिद्रवति च्चाया कृष्णा पीतारुणापि वा ।

भिषग्भेषजपानान्नगुरुमित्रद्विषश्च ये ॥ ६० ॥

वशगाः सर्व एवैते विज्ञेयाः समवर्तिनः ।

He who walks by dragging his feet on the ground (scratching the ground) as though his feet have dropped off; who suddenly loses his strength though  consuming good food in large quantity; he who was eats very less but excretes large quantities of faces and urine; who eats more but excretes less quantities of feaces and urine; he who eats less but suffer from (increase of) Kapha, breathes out deep (long expiration) and rolls on the bed;

Who takes long expiration but has very short inspiration and becomes unconscious; he whose; respirations are short (shallow), chest is throbbing, and pulsations are frequent. Who rolls his head with difficulty, holds out his forehands contracting them; who discharges sweat from his forehead, has looseness of joints and tendons; he who becomes unconscious by standing up, whether he is strong or weak; he who sleeps with his face kept upward (supine) and moving his legs awkwardly; he who tries to hold the bed, chair, wall etc. which are actually not present; who laughs at things which do not evoke  laughter or which are not  to be laughed at; who  faints and licks the lips, who licks the upper lip and produces whistling sound; he to whom either black, yellow or crimson shades run quick (manifest suddenly), who develops hatredress towards the physician, medicine, drinks, food, preceptors and friends all these are to be considered as conquered by samavarti the god of death.

Fatal signs based on temperature variations and premonitory symptoms

ग्रीवाललाटहृदयं यस्य स्विद्यति शीतलम् ॥ ६१ ॥

उष्णोऽपरः प्रदेशश्च शरणं तस्य देवताः ।

पूर्वरूपाणि सर्वाणि ज्वरादिष्वतिमात्रया ।

यं विशन्ति विशत्येनं मृत्युर्ज्वरपुरःसरः ॥ ६२१+(१) ॥

He, whose neck, forehead and (region of) the heart are sweating and cold, while the other parts are hot, is to be protected by the Gods only. He, who develops all the prodromal symptoms, in abundance, in diseases  such as Jvara (fever) etc. will succumb to death followed by fever.

Fatal signs based on gain and loss of virtues

योऽणुज्योतिरनेकाग्रो दुश्चायो दुर्मनाः सदा ॥ ६२ ॥

बलिं बलिभृतो यस्य प्रणीतं नोपभुञ्जते ।

निर्निमित्तं च यो मेधां शोभामुपचयं श्रियम् ॥ ६३ ॥

प्राप्नोत्यतो वा विभ्रंशं स प्राप्नोति यमक्षयम् ।

He, who has an anujyothi (very little of consciousness), who has many worries (subjects of worry), who has bad complexion and a bad mind always; he for whose sake (desiring good) offering of eatables are prepared but is not partaken by those birds, animals etc. which are offered; he who without any cause, attains great intelligence, radiance, development of the body and wealth, suddenly or losses all these suddenly, goes to the residence of yama (lord of death)

Fatal signs based on abnormalities in the nature of gunas and doshas

गुणदोषमयी यस्य स्वस्थस्य व्याधितस्य वा ॥ ६४ ॥

यात्यन्यथात्वं प्रकृतिः षण्मासान् न स जीवति ।

Prakrti (natural features), related to the guna (satva, rajas and tamas) or to the dosas (vata, pitta and kapha), whether of a healthy person or a sick person, if becomes abnormal, he shall not live for a month.

Factors which abandon a dying person

भक्तिः शीलं स्मृतिस्त्यागो बुद्धिर्बलमहेतुकम् ॥ ६५ ॥

षडेतानि निवर्तन्ते षड्भिर्मासैर्मरिष्यतः ।

Faith, good conduct, memory, charitable nature, intelligence and strength these six qualities abandon without any reason, the person who is going to die in six months.

Features of a person who is going to die in a month time

मत्तवद्गतिवाक्कम्पमोहा मासान्मरिष्यतः ॥ ६६ ॥

Gait, speech, tremors (movements of the body parts) and unconsciousness resembling those of an intoxicated person are the features of the person going to die within a month.

Features of a person who is going to die in six days time

नश्यत्यजानन् षडहात्केशलुञ्चनवेदनाम् ।

न याति यस्य चाहारः कण्ठं कण्ठामयादृते ॥ ६७ ॥

He, who does not understand the pain when his hair are plucked; he in whom the food does not pass through the throat even though he is not suffering from any diseases of the throat is going to die within six days.

Fatal signs of a person who doesn’t survive

प्रेष्याः प्रतीपतां यान्ति प्रेताकृतिरुदीर्यते ।

यस्य निद्रा भवेन्नित्या नैव वा न स जीवति ॥ ६८ ॥

He, whose attendants turn against him, in whom features of a cadaver appear, who sleeps always or does not sleep at all (even for a moment) does not survive.

Fatal signs observed in eyes, hands and feet

वक्त्रमापूर्यतेऽश्रूणां स्विद्यतश्चरणौ भृशम् ।

चक्षुश्चाकुलतां याति यमराज्यं गमिष्यतः ॥ ६९ ॥

Orifices of tears getting filled up by tears (because obstructed leading to absence of tears), palms and soles sweating profusely; eyes becoming unsteady are the features of the person going to the kingdom of yama (death).

Other signs of impending death

यैः पुरा रमते भावैररतिस्तैर्न जीवति ।

He, who does not relish things (food, activities etc) which he used to relish previously does not survive

Vyadhilaksana Rista – fatal signs in symptoms of diseases

सहसा जायते यस्य विकारः सर्वलक्षणः ॥ ७० ॥

निवर्तते वा सहसा सहसा स विनश्यति ।

He, in whom all the signs and symptoms of the oncoming disease manifest suddenly or disappear suddenly – he dies soon.

Jwaragata Rista – fatal signs in fever

ज्वरो निहन्ति बलवान् गम्भीरो दैर्घरात्रिकः ॥ ७१ ॥

सप्रलापभ्रमश्वासः क्षीणं शूनं हतानलम् ।

अक्षामं सक्तवचनं रक्ताक्षं हृदि शूलिनम् ॥ ७२ ॥

सशुष्ककासः पूर्वाह्णे योऽपराह्णेऽपि वा भवेत् ।

बलमांसविहीनस्य श्लेष्मकाससमन्वितः ॥ ७३ ॥

Jvara (fever) which is powerful, deep seated (vitiated many tissues and organs), persistent (long standing, chronic), accompanied with delirium, giddiness and dyspnoea; emaciation or swelling (oedema) and loss of digestive capacity; in him who is not too emaciated but has obstruction of speech, redness of the eyes, pain in the heart; sa śuṣka kāsaḥ pūrvāhṇe yo aparāhṇe api vā bhavet – in him who has dry cough either in the morning or the evening and is deprived of strength , muscles and suffering from cough born of slesma (kapha) cough with expectoration) kills the patient

Raktapitta gata Rista – fatal signs in bleeding disorders

रक्तपित्तं भृशं रक्तं कृष्णमिन्द्रधनुष्प्रभम् ।

ताम्रहारिद्रहरितं रूपं रक्तं प्रदर्शयेत् ॥ ७४ ॥

रोमकूपप्रविसृतं कण्ठास्यहृदये सजत् ।

वाससोऽरञ्जनं पूति वेगवच्चाति भूरि च ॥ ७५ ॥

वृद्धं पाण्डुज्वरच्चर्दिकासशोफातिसारिणम् ।

Raktapitta (bleeding diseases) in which the blood coming out has colour such as bright red, black, like those of the rainbow, coppery, yellow (turmeric color) or green, blood coming out from hair follicles; blood accumulating in the throat, mouth and (region of) the heart; blood not staining the cloth, emitting foul smell, coming out in bouts and in large quantity. In old persons and in those having anaemia, fever vomiting, cough, swelling(dropsy) and diarrhoea is going to kill.

Kasa-Svasa gata Rista – fatal signs in cough and breathing disorders / dyspnea

कासश्वासौ ज्वरच्छर्दि तृष्णातीसारशोफिनम्॥७६॥

Kasa (cough) and svasa (dyspnoea) are fatal in person having fever, vomiting, thirst, diarrhoea and swelling (dropsy).

Yakshma gata Rista – fatal signs in tuberculosis

यक्ष्मा पार्श्वरुजानाहरक्तच्चर्द्यंसतापिनम् ।

Yaksma (pulmonary tuberculosis) is fatal, in persons who are having pain in the flanks, flatulence, vomiting of blood and burning sensation at the back of the shoulders.

Chardi gata Rista – fatal signs in vomiting 

छर्दिर्वेगवती मूत्रशकृद्गन्धिः सचन्द्रिका ॥ ७७ ॥

सास्रविट्पूयरुक्कासश्वासवत्यनुषङ्गिणी ।

Chardi (vomiting) is fatal, which has powerful bouts, the vomited material having the smell of urine and feaces; glistening particles, feces and pus; associated with pain, cough, dyspnoea, and which is persisting for long duration.

Trsna gata Rista – fatal signs in thirst

तृष्णान्यरोगक्षपितं बहिर्जिह्वं विचेतनम् ॥ ७८ ॥

Trishna (thirst) is fatal, in persons who are debilitated by other diseases, in whom the tongue is protruding and who are unconscious.

Madatyaya gata Rista – fatal signs in alcoholic intoxication

मदात्ययोऽतिशीतार्तं क्षीणं तैलप्रभाननम् ।

madātyayo’tiśītārtaṃ kṣīṇaṃ tailaprabhānanam |

Madatyaya (alcoholic intoxication) is fatal, in persons who are suffering from severe cold feeling, emaciation and whose face appears to be smeared with oil.

Arshas gata Rista – fatal signs in piles

अर्शांसि पाणिपन्नाभिगुदमुष्कास्यशोफिनम् ॥ ७९ ॥

हृत्पार्श्वाङ्गरुजाच्छर्दिपायुपाकज्वरातुरम् ।

Arshas (haemorrhoids), piles) is fatal, in persons who has oedema in the hands, feet umbilicus, rectum, scrotum and of face; pain in the region of the heart, flanks and other parts of the body, vomiting, ulcerations of the rectum and fever.

Atisara gata Rista – fatal signs in diarrhea

अतीसारो यकृत्पिण्डमांसधावनमेचकैः ॥ ८० ॥

तुल्यस्तैलघृतक्षीरदधिमज्जवसासवैः ।

मस्तुलुङ्गमषीपूयवेसवाराम्बुमाक्षिकैः ॥ ८१ ॥

अतिरक्तासितस्निग्धपूत्यच्चघनवेदनः ।

कर्बुरः प्रस्रवन् धातून् निष्पुरीषोऽथवातिविट् ॥ ८२ ॥

तन्तुमान् मक्षिकाक्रान्तो राजीमांश्चन्द्रकैर्युतः ।

शीर्णपायुवलिं मुक्तनालं पर्वास्थिशूलिनम् ॥ ८३ ॥

स्रस्तपायुं बलक्षीणमन्नमेवोपवेशयन् ।

सतृट्श्वासज्वरच्चर्दिदाहानाहप्रवाहिकः ॥ ८४ ॥

Atisara (diarrohea) is fatal, when the faecal matter resembles (has colours like that of) piece of liver, mutton wash, peacocks feather, oil, ghee, curds, bone marrow, muscle fat, fermented infusion, brain matter, soot, pus, fluid of vesavara and honey. Either very red, very black, very unctuous, with very foul smell, very thin / clear (like water); eliminated with severe pain, and with many colours; tissues expelled either without faecal matter or with large quantity of faecal matter; feaces containing thread (like bodies), invaded (surrounded) by flies, broken by dividing lines, containing glistening particles; who has protrusion of the rectal folds, anal orifice always remaining open (excessively dilated), pain in the joints and bones; prolapsed of the rectum, loss of strength, eliminating food (undigested) itself, accompanied with thirst,, dyspnoea, fever, vomiting burning sensation, flatulence/dissention of the abdomen and dysentery.

Ashmari-meha gata Rista – fatal signs in urinary stones and diabetes

अश्मरी शूनवृषणं बद्धमूत्रं रुजार्दितम् ।

मेहस्तृड्दाहपिटिकामांसकोथातिसारिणम् ॥ ८५ ॥

पिटिका मर्महृत्पृष्ठस्तनांसगुदमूर्धगाः ।

पर्वपादकरस्था वा मन्दोत्साहं प्रमेहिणम् ॥ ८६ ॥

सर्वं च मांससङ्कोथदाहतृष्णामदज्वरैः ।

विसर्पमर्मसंरोधहिध्माश्वासभ्रमक्लमैः ॥ ८७ ॥

Ashmari (urinary calulus) kills, the person who has swelling of the scrotum, obstruction of urine and pain. Meha (diabetes, polyurea) is fatal, in him who has thirst, burning sensation, eruptions(carbuncles), putrefaction of muscles (gangrene) and diarrohea; pitaka (carbuncle) which are situated on vital spots, region of the heart, back, breasts shoulders, rectum, head, joints, feet and hands, in him, who has no enthusiasm (for physical activities), and in all persons who have putrefaction of the muscles, burning sensation, thirst, toxicity, fever, visarpa (herpes), obstruction of vital organs, hiccup, dyspnoea, giddiness and exhaustion

Gulma gata Rista – fatal signs in abdominal tumors

गुल्मः पृथुपरीणाहो घनः कूर्म इवोन्नतः ।

सिरानद्धो ज्वरच्चर्दिहिध्माध्मानरुजान्वितः ॥ ८८ ॥

कासपीनसहृल्लासश्वासातीसारशोफवान् ।

Gulma(abdominal tumour) is fatal; when it is of large size, hard (stony), elevated like the tortoise shell, studded with prominent veins, accompanied with  fever, vomiting, hiccup, tympanitis, pain (in the abdomen), cough, nasal catarrh, oppression in the region of the heart, dyspnoea, diarrhoea and swelling (dropsy)

Jathara gata Rista – fatal signs in abdominal disorders

विण्मूत्रसङ्ग्रहश्वासशोफहिध्माज्वरभ्रमैः ॥ ८९ ॥

मूर्चाचर्द्यतिसारैश्च जठरं हन्ति दुर्बलम् ।

शूनाक्षं कुटिलोपस्थमुपक्लिन्नतनुत्वचम् ॥ ९० ॥

विरेचनहृतानाहमानह्यन्तं पुनः पुनः ।

Jathara (enlargemet of the abdomen) kills a debilitated person when associated with suppression of urine and feaces, dyspnoea; edema, hiccough, fever, giddiness, vomiting, diarrhea, whose eyes are swollen, penis is curved, dampness of body and skin even after purgation, flatulence which occur again and again (repeatedly).

Panduroga gata Rista – fatal signs in anemia

पाण्डुरोगः श्वयथुमान् पीताक्षिनखदर्शनम् ॥ ९१ ॥

Panduroga (anaemia) is fatal in the person who has oedema, yellowishness of eyes, nails and vision

Sopha gata Rista – fatal signs in dropsy

तन्द्रादाहारुचिच्छर्दिमूर्चाध्मानातिसारवान् ।

अनेकोपद्रवयुतः पादाभ्यां प्रसृतो नरम् ॥ ९२ ॥

नारीं शोफो मुखाद्धन्ति कुक्षिगुह्यादुभावपि ।

राजीचितः स्रवंश्चर्दिज्वरश्वासातिसारिणम् ॥ ९३ ॥

Shopha (dropsy) is fatal, to the person who has drowsiness, burning sensation, anorexia, vomiting, fainting, flatulence, diarrohea and many complications / other secondary diseases occur. Oedema spreading from the leg (upwards) in man and from the face (downwards) in woman, from the abdomen and genitals in both kills them; swelling having radial lines (striae), exudations, vomiting, fever, dyspnoea and diarrhoea (kill)

Sopha gata Rista – fatal signs in dropsy

ज्वरातीसारौ शोफान्ते श्वयथुर्वा तयोः क्षये ।

दुर्बलस्य विशेषेण जायन्तेऽन्ताय देहिनः ॥ ९४ ॥

श्वयथुर्यस्य पादस्थः परिस्रस्ते च पिण्डिके ।

सीदतः सक्थिनी चैव तं भिषक् परिवर्जयेत् ॥ ९५ ॥

आननं हस्तपादं च विशेषाद्यस्य शुष्यतः ।

शूयेते वा विना देहात्स मासाद्याति पञ्चताम् ॥ ९६ ॥

Fever and diarrhoea at the end of dropsy and dropsy at their end, specifically in a weak person is going to kill him the physician should reject him who has swelling (dropsy) of the feet, drooping of the calves and thighs getting exhausted yasya ānanaṃ hasta pādaṃ ca viśeṣāt śuṣyataḥ – he whose face, hands and feet especially getting dried, or these getting swollen without the other parts of the body is going to die within a month.

Visarpa gata Rista – fatal signs in herpes 

विसर्पः कासवैवर्ण्यज्वरमूर्चाङ्गभङ्गवान् ।

भ्रमास्यशोफहृल्लासदेहसादातिसारवान् ॥ ९७ ॥

Visarpa (herpes) kills, the person who has cough, discolouration, fever, fainting, cutting pain in the body, giddiness, swelling of the face, oppression in the (region of the) heart, debility of the body and diarrhoea

Kushta gata Rista – fatal signs in leprosy  

कुष्ठं विशीर्यमाणाङ्गं रक्तनेत्रं हतस्वरम् ।

मन्दाग्निं जन्तुभिर्जुष्टं हन्ति तृष्णातिसारिणम् ॥ ९८ ॥

Kushtha (leprosy) kills, the person whose body parts are falling off, eyes are red; has loss of voice, loss of digestive power, wounds vitiated by worms, thirst and diarrhoea.

Vayu gata Rista – fatal signs caused by vitiated vayu   

वायुः सुप्तत्वचं भुग्नं कम्पशोफरुजातुरम् ।

Vayu (diseases caused by increase of vata, nervous, disorders) kills the patient, whose skin has lost the sensation, whose body is bent(curved/contracted) and having tremors, swelling and pain.

Vatasra gata Rista – fatal signs in gout   

वातास्रं मोहमूर्चायमदास्वप्नज्वरान्वितम् ॥ ९९ ॥

शिरोग्रहारुचिश्वास सङ्कोचस्फोटकोथवत् ।

Vatasra (gout) kills the person, who has delusion, fainting, toxicity, sleep(too much), fever, catching pain in the head, anorexia, dyspnoea, contractions, cracking noise and putrefaction (of the toes, fingers etc.)

Sarvamaya gata Rista – fatal signs in all diseases   

शिरोरोगारुचिश्वासमोहविड्भेदतृड्भ्रमैः ॥ १०० ॥

घ्नन्ति सर्वामयाः क्षीणस्वरधातुबलानलम् ।

All diseases are going to kill the person, who has disease of the head (headache), anorexia, dyspnoea, delusion, diarrhoea, thirst, giddiness, feeble voice, depletion of tissues, loss of strength and digestive power.

Diseases to be rejected in a weak person in spite of presence of feeble symptoms

वातव्याधिरपस्मारी कुष्ठी रक्त्युदरी क्षयी ॥ १०१ ॥

गुल्मी मेही च तान् क्षीणान् विकारेऽल्पेऽपि वर्जयेत् ।

Persons suffering from vata vyadhi (nervous diseases) apasmara (epilepsy), kustha (leprosy), raktapitta (bleeding diseases), udara (enlargement of the abdomen), ksaya (tuberculosis), gulma (abdominal tumor), meha (diabetes) and who are weak, even though they have very few, mild abnormal symptoms, should be rejected.

Vital signs indicating impending death within three weeks

बलमांसक्षयस्तीव्रो रोगवृद्धिररोचकः ॥ १०२ ॥

यस्यातुरस्य लक्ष्यन्ते त्रीन् पक्षान्न स जीवति ।

Profound loss of strength and depletion of tissues, exacerbation of the diseases and anorexia, seen in the patient, such a person will not survive for three fortnights.

Vital signs in vatashtila – enlargement of prostate

वाताष्ठीलातिसंवृद्धा तिष्ठन्ती दारुणा हृदि ॥ १०३ ॥

तृष्णयानुपरीतस्य सद्यो मुष्णाति जीवितम् ।

Vatasthila (enlargement of the prostate caused by increased vata) which is very big, and stands in the heart (abdomen to be more correct) causing severe pain and the patient troubled with severe thirst, takes away his life immediately.

Vital signs related to abnormalities of vata

शैथिल्यं पिण्डिके वायुर्नीत्वा नासां च जिह्मताम् ॥ १०४ ॥

क्षीणस्यायम्य मन्ये वा सद्यो मुष्णाति जीवितम् ।

नाभिगुदान्तरं गत्वा वङ्क्षणौ वा समाश्रयन् ॥ १०५ ॥

गृहीत्वा पायुहृदये क्षीणदेहस्य वा बली ।

मलान् वस्तिशिरो नाभिं विबध्य जनयन् रुजम् ॥ १०६ ॥

कुर्वन् वङ्क्षणयोः शूलं तृष्णां भिन्नपुरीषताम् ।

श्वासं वा जनयन् वायुर्गृहीत्वा गुदवङ्क्षणम् ॥ १०७ ॥

Vata producing looseness of the calf muscles, irregularity of the nose, or bending of the neck in an emaciated person is going to take away the life immediately vata getting localised in between the umbilicus and the rectum or located in the groin, or localized in between rectum and region of the heart, in a weak person (is going to kill him immediately). Vata causing suppression of the waste products, obstructing the head of the urinary bladder and the umbilicus, produces pain in the groins, or produces dyspnoea, catching pain of the rectum and groins (is going to kill him immediately).

Vital signs related to abnormalities of vata

वितत्य पर्शुकाग्राणि गृहीत्वोरश्च मारुतः ।

स्तिमितस्यातताक्षस्य सद्यो मुष्णाति जीवितम् ॥ १०८ ॥

Maruta (vata) causing expansion of the tips of the ribs, catching pain in the chest, loss of movement of the chest and wide opened eyes is going to kill him immediately.

Sudden appearance of some symptoms which indicate impending death of the person

सहसा ज्वरसन्तापस्तृष्णा मूर्च्छा बलक्षयः ।

विश्लेषणं च सन्धीनां मुमूर्षोरुपजायते ॥ १०९ ॥

Sudden increase of fever, thirst, fainting (loss of consciousness), loss of strength, and looseness of body joints appear in the person who is going to die soon

More symptoms pointing towards end of life

गोसर्गे वदनाद्यस्य स्वेदः प्रच्यवते भृशम् ।

लेपज्वरोपतप्तस्य दुर्लभं तस्य जीवितम् ॥ ११० ॥

Severe perspiration of the face and other parts at the time of letting out the cows (in the morning) and the person suffering from fever, coating (enveloping) of the body and fever the life of such a man is definitely unobtainable.

Fatal signs related to Masurika (chicken pox)

प्रवालगुटिकाभासा यस्य गात्रे मसूरिकाः ।

उत्पद्याशु विनश्यन्ति न चिरात्स विनश्यति ॥ १११ ॥

He, on whose body, masurika (chiken pox) appear resembling beads of pearls / corols and disappear suddenly, dies soon.

Fatal signs related to visphotaka – small pox

मसूरविदलप्रख्यास्तथा विद्रुमसन्निभाः ।

अन्तर्वक्त्राः किणाभाःच विस्फोटा देहनाशनाः ॥ ११२ ॥

Visphota (small pox) erupting resembling the cotyledon of masura (tentil) or bead of coral, having their mouth inwards and roducing sound (on touch), is going to destroy the body.

Fatal signs related to jaundice and other signs

कामलाक्ष्णोर्मुखं पूर्णं शङ्खयोर्मुक्तमांसता ।

सन्त्रासश्चोष्णताङ्गे च यस्य तं परिवर्जयेत् ॥ ११३ ॥

He, whose eyes have kamala (jaundice, deep yellow colour) and face full (with that colour or swollen), loss of muscles in the temples, serve debility and (great) warmth in the body should be rejected.

Fatal signs related sudden appearance of skin abrasions

अकस्मादनुधावच्च विघृष्टं त्वक्समाश्रयम् ।

So also, the person, whom vighrusta (abrasion, wound) invades the skin suddenly (without any cause)

Fatal signs related to vranas (ulcers).

चन्दनोशीरमदिराकुणपध्वाङ्क्षगन्धयः ।

शैवालकुक्कुटशिखाकुङ्कुमालमषीप्रभाः ॥ ११४१+(१) ॥

अन्तर्दाहा निरूष्मणः प्राणनाशकरा व्रणाः ॥ ११४१+(२)अब् ॥

यो वातजो न शूलाय स्यान्न दाहाय पित्तजः ॥ ११४ ॥

कफजो न च पूयाय मर्मजश्च रुजे न यः ।

अचूर्णश्चूर्णकीर्णाभो यत्राकस्माच्च दृश्यते ॥ ११५ ॥

रूपं शक्तिध्वजादीनांसर्वांस्तान्वर्जयेद्व्रणान् ।

विण्मूत्रमारुतवहं कृमिणं च भगन्दरम् ॥ ११६ ॥

Vrana (ulcers) while emit odours like that of candana (Santalum album), usira (Vetiveria zizanioides), madira (wine), kanapa (cadaver) and dhvanksa (crow); colours like saivala (algae), kukkuta sikha (cocks comb), kumkuma (saffron), ala, and masi (soot) producing burning sensation inside but not hot to touch, and which is life threatening, that which is caused by vata but not painful, that caused by pitta but not having burning sensation, that caused by kapha but not having pus, that situated on vital spots but not causing pain, that which is not fissured but appears as having fissures or powdery material is visible suddenly (without any reason), that resembling a sakti (a kind of weapon), dhavaja (flag) etc. (without any reason) all these ulcers should be rejected. Bhagandara (fistula-in-ano) through which faceal matter, urine and flatus is coming out and in which worms (bacteria) are present (should be rejected).

Other signs of impending death

घट्टयन् जानुना जानु पादावुद्यम्य पातयन् ।

योऽपास्यति मुहुर्वक्त्रमातुरो न स जीवति ॥ ११७ ॥

The patient who beats one knee joint with the other, raises the feet and drops it down, turns his face away (without any apprant reason) does not survive.

Signs of impending death based on activities done by the patient

दन्तैश्चिन्दन्नखाग्राणि तैश्च केशांस्तृणानि च ।

भूमि काष्ठेन विलिखन् लोष्टं लोष्टेन ताडयन् ॥ ११८ ॥

हृष्टरोमा सान्द्रमूत्रः शुष्ककासी ज्वरी च यः ।

मुहुर्हसन् मुहुः क्ष्वेडन् शय्यां पादेन हन्ति यः ॥ ११९॥

मुहुश्चिद्राणि विमृशन्नातुरो न स जीवति ।

He, who bites the tips of his nails, hairs, grass etc., with his teeth, who scratches the ground with a stick; beating one stone with another one, who has horripilations, thick urine, dry cough and fever; who laughs for a while and weeps the next moment, who kicks the bed with his legs, the patient who intently examines the orifices (such as ears, nose, anus, urethra, mouth etc) doest not survive.

Fatal signs based on the sudden appearance of black moles etc.

मृत्यवे सहसार्तस्य तिलकव्यङ्गविप्लवः ॥ १२० ॥

मुखे दन्तनखे पुष्पं जठरे विविधाः सिराः ।

Sudden appearance of tila (black moles), vyanga (black patches), piplu (discoloured rashes) on the face, flower like spots on the teeth and nails, raised veins of different kinds (colours) on the abdomen are for causing death of the patient soon.

Other fatal signs indicating impending death

ऊर्ध्वश्वासं गतोष्माणं शूलोपहतवङ्क्षणम् ॥ १२१ ॥

शर्म चानधिगच्चन्तं बुद्धिमान् परिवर्जयेत् ।

विकारा यस्य वर्धन्ते प्रकृतिः परिहीयते ॥ १२२ ॥

सहसा सहसा तस्य मृत्युर्हरति जीवितम् ।

Profound expiration, loss of body temperature, and severe pain in the groins not subsiding (with any treatment) should be rejected by the wise physician. He, in whom abnormalities undergo sudden increase; the normalcy (natural constitutional characteristics) become destroyed suddenly, his life will soon be taken away by death.

Fatal signs based on non-availability of medicines

यमुद्दिश्यातुरं वैद्यः सम्पादयितुमौषधम् ॥ १२३ ॥

यतमानो न शक्नोति दुर्लभं तस्य जीवितम् ।

He, for whose sake (patient), the physician tries to obtain the medicines. But does not succeed in getting them, the life of such a person is definitely hard to retain.

Fatal signs based on failure of medicines and treatments

विज्ञातं बहुशः सिद्धं विधिवच्चावचारितम् ॥ १२४ ॥

न सिध्यत्यौषधं यस्य नास्ति तस्य चिकित्सितम् ।

He, in whom the medicine which is well known, found effective many times and administered according to proper procedures still does not prove effective, there is no other treatment for him.

Fatal signs based on sudden changes occurring in the medicines and foods for no obvious reasons

भवेद्यस्यौषधेऽन्ने वा कल्प्यमाने विपर्ययः ॥ १२५ ॥

अकस्माद्वर्णगन्धादेः स्वस्थोऽपि न स जीवति ।

Either the medicine or food, prepared for a person, under going change into the opposite, in their colour, smell etc suddenly (without any reason), such a person does not survive even is if he is healthy man.

Fatal signs based on untoward events happening in the patient’s home

निवाते सेन्धनं यस्य ज्योतिश्चाप्युपशाम्यति ॥ १२६ ॥

आतुरस्य गृहे यस्य भिद्यन्ते वा पतन्ति वा ।

अतिमात्रममत्राणि दुर्लभं तस्य जीवितम् ॥ १२७ ॥

If in the patient’s house, the fire gets extinguished even though there is no breeze, and presence of sufficient fuel; things (such as vessels, furniture etc) break or fall down in great bounds the life of such a patient is difficult to be retained.

Fatal signs based on sudden disappearance of diseases in a weak patient

यं नरं सहसा रोगो दुर्बलं परिमुञ्चति ।

संशयप्राप्तमात्रेयो जीवितं तस्य मन्यते ॥ १२८ ॥

He, who is very debilitated and whose diseases disappear suddenly, such a person’s life is surely uncertain considers Atreya.

The physician should not inform the details of the death of the patient to the patient’s family and friends

कथयेन्न च पृष्टोऽपि दुःश्रवं मरणं भिषक् ।

गतासोर्बन्धुमित्राणां न चेच्चेत्तं चिकित्सितुम् ॥ १२९ ॥

The physician, though questioned, should not inform the details of the death of the patient to the relatives and friends of the patient whose life span has diminished (who are liable to become grief stricken get shocked by the news) and also should not desire to treat them (patients whose life span has been completed).

Fatal signs based on sudden destruction of potency of the medicines

यमदूतपिशाचाद्यैर्यत्परासुर् उपास्यते ।

घ्नद्भिरौषधवीर्याणि तस्मात्तं परिवर्जयेत् ॥ १३० ॥

In a patient who is going to die soon, the attendants of Yama (lord of death), the pisacas (Goblins) etc. destroy the potency of the medicines consumed (by the patient); hence such a patient should be rejected.

Importance of having the knowledge of rista i.e. fatal signs, for a physician

आयुर्वेदफलं कृत्स्नं यदायुर्ज्ञे प्रतिष्ठितम् ।

रिष्टज्ञानादृतस्तस्मात्सर्वदैव भवेद्भिषक् ॥ १३१ ॥

In the physician who understands the knowledge of life, the entire effects of Ayurveda is treasured; without the knowledge of Rista (fatal signs) it is incomplete; hence the physician should always be well conversant with it.

Fatal signs based on expiry of period of life and effort of benevolent deeds

मरणं प्राणिनां दृष्टमायुःपुण्योभयक्षयात् ।

तयोरप्यक्षयाद्दृष्टं विषमापरिहारिणाम् ॥ १३२ ॥

Death is sure to be seen in living beings at the expiry of the period of life and effort of benevolent deeds even without expiry of these two (period of life and effect of benevolent acts) deaths may ensure by unavoidable irregularities (incidents which occurs accidentally).

इति श्रीवैद्यपतिसिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां द्वितीये शारीरस्थाने विकृतिविज्ञानीयो नाम पञ्चमोऽध्यायः॥५॥

Thus ends the chapter named Vikrti Vijnaniya knowledge of fatal signs fifth in Sarira sthana of asthanga Hrdaya samhita, composed of sirmad vagbhata, son of Sri Vaidyapati Simhagupta.