Vimana Sthana Chapter 3. Determination of specific characteristics of destruction of communities
|Section/Chapter||Vimana Sthana Chapter 3|
|Preceding Chapter||Trividhakukshiya Vimana|
|Succeeding Chapter||Trividha Roga Vishesha Vijnaniya Vimana|
|Other Sections||Sutra Sthana, Nidana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana|
|Translator and commentator||Nishteswar K.|
|Editors||Pol A., Deole Y.S., Basisht G.|
|Year of publication||2020|
|Publisher||Charak Samhita Research, Training and Skill Development Centre|
Janapadodhvansa literally means destruction or annihilation of communities or settlements. Epidemics and outbreaks of highly communicable diseases have blighted mankind since time immemorial. Ayurvedic scholars and exponents of antiquity like Sushruta and Charaka recorded these in their works on aupasargika roga and janapadodhvansa respectively, according special importance to the topic.
An astute observation of practitioners such as Charaka was that vitiated vayu (air), jala or udaka(water), desha (land) and kala (season) were key factors responsible for causing epidemics. Sushruta refers to the concept of janapadodhvansa while discussing ritucharya (seasonal regimen) under the title Maraka.[Su.Sa.Sutra Sthana 6/17] In Ashtangasangraha, the concept of janapadodhvansa was described under the chapter entitled Viruddhanna Vijnaniyam. The therapeutic modalities are incorporated in the disease prevention protocol in Ashtanga hridayam.
The causative factors of janapadodhvansa (epidemics), characteristics of vitiated factors and remedial measures to treat the conditions are described. It is strongly recommended collecting and stocking drugs potent in all attributes (like rasa, guna, veerya, and vipaka) necessary to tackle the catastrophic conditions associated with any epidemic. Agnivesha was inquisitive to know about common morbidity among the individuals with dissimilar constitution, dietetic habits, physical strength, suitability, mental faculties , etc.
Atreya began his discourse with a discussion on the environmental factors that are common to all inhabitants of a region, i.e., vayu, jala, desha, and kala. These four factors, when not polluted or contaminated, are vital not only for our survival, but for the survival of all life-forms. By nature, air, water, land and seasons are indispensable factors in their progressive order.
Seasons are the most indispensable ones of all factors, since its vitiation leads to diseases becoming highly virulent, taking epidemic proportions. With regard to communicable diseases in general, an interplay of agents, hosts and the environmental factors lead to a dynamic state of health and disease.
Adharma karma (sinful act) committed during an individual’s present life and the previous life, is responsible for the vitiation of these factors. Intellectual errors (prajnaparadha) is the cause for both these types of sins (i.e., sins in the present life as well as in the past).
Per vedic scriptures, large periods of time witness a slow degradation of dharma (spiritual duties) and guna (qualities) in the conducts and attributes of living beings. The scriptures divided these periods into four distinct phases, or yugas, with each yuga witnessing a significant degradation in dharma and guna than the preceding one. One such guna, longevity or life-span of individuals, depends upon the strength of both daiva (predetermined) and purushakara (human effort of present life). If the individuals of a specific locality might have collectively committed sinful acts like burning villages or other sinful acts etc., in their previous birth, they are likely to die at a time during epidemics. Similarly, persons who committed sinful acts separately in their previous lives gathered in a specific region may also die collectively of a common cause. Atreya opines that the individuals who do not share similarities in death (mrityu samanyata) or previous deeds (karma samanyata) could be treated with Panchakarma procedures (five evacuative therapies) and administration of rasayana measures (rejuvenative procedures) with previously collected drugs, along with sadvritta (observance of noble conducts) etc. He further recommended administering cold measures to cure diseases caused by hot things and vice versa. The principle of treatment should be administration of antagonistic therapies to their causes (vitiated dosha).
Remedial measures for treating pollution or vitiation of the four environmental factors separately is not suggested, but emphasis is given on the management of individuals affected in an epidemic. Sushruta suggested certain treatment modalities for eliminating the poison from the atmosphere as well as from the patient’s body. [Su.Sa.Kalpa Sthana 6] The drums, banners and gateways of the houses should be smeared with the medicament, or ksharaagada (formulation), that may be beneficial in the management of air pollution.
The analysis of the characteristics of the vitiated environmental factors, such as howling wind, water with altered smell-color-taste-touch, and land over-flooded or associated with frequent occurrence of meteorites, thunderbolts and earthquakes are some of the various calamitous acts of nature that result in significant death toll the world over. So the concept of janapadodhvansa cannot be totally interpreted as a study of epidemics or diseases. Environmental changes caused by man’s interference with the bio-ecology in which he lives, as well as pollution due to depletion of natural resources may be the cause for the destruction of communities, and could justify the attribution to karma given here as a cause of vitiation.
In this chapter Agnivesha asked Atreya the following five questions with regards to janapadodhvansa:
- How do all individuals having different physical constitution etc., suffer from the same diseases, due to the same set of causative factors?
- What is the factor underlying the vitiation of air etc., which destroys entire communities?
- Is the span of life of all individuals predetermined or not?
- If the life span of all human beings is not predetermined then how is it said that some people die in the predetermined time and the rest otherwise?
- Why do physicians advise hot water to patients suffering from fever in preference to cold water when the dosha involved in the pathogenesis of this disease (jwara) is amenable to cooling therapies?
And lord Atreya answered all the questions patiently.
Sanskrit Text, Transliteration and English Translation
अथातो जनपदोद्ध्वंसनीयं विमानं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athātō janapadōddhvaṁsanīyaṁ vimānaṁ vyākhyāsyāmaḥ||1|| iti ha smāha bhagavānātrēyaḥ||2||
athAto janapadoddhvaMsanIyaM vimAnaM vyAkhyAsyAmaH||1|| iti ha smAha bhagavAnAtreyaH||2||
Now we shall expound the chapter "Janapadodhvansaniya Vimana" (Determination of specific characteristics of destruction of communities). Thus said Lord Atreya. [1-2]
Note: The term janapadodhvansa is a generic term for natural and man-made calamities, also implying epidemics.
Location of the discussion
जनपदमण्डले पञ्चालक्षेत्रे द्विजातिवराध्युषिते काम्पिल्यराजधान्यां भगवान् पुनर्वसुरात्रेयोऽन्तेवासिगणपरिवृतः पश्चिमे घर्ममासे गङ्गातीरे वनविचारमनुविचरञ्छिष्यमग्निवेशमब्रवीत्||३||
janapadamaṇḍalē pañcālakṣētrē dvijātivarādhyuṣitē kāmpilyarājadhānyāṁ bhagavān punarvasurātrēyō'ntēvāsigaṇaparivr̥taḥ paścimēgharmamāsē gaṅgātīrē vanavicāramanuvicarañchiṣyamagnivēśamabravīt||3||
janapadamaNDale pa~jcAlakShetre dvijAtivarAdhyuShite kAmpilyarAjadhAnyAM bhagavAn punarvasurAtreyo~antevAsigaNaparivRutaH pashcimegharmamAse ga~ggAtIre vanavicAramanuvicara~jchiShyamagniveshamabravIt||3||
Lord Atreya, while taking a stroll in the latter month of a summer, surrounded by his disciples, in the forest area near the banks of Ganga at Kampilya, capital city of Panchala region, which was the residence of the dwija (elite of the twice born communities like brahmins who adopt wearing of sacred thread on their body), thus turned to his disciple Agnivesha and said. 
Importance of timely drug collection
दृश्यन्ते हि खलु सौम्य! नक्षत्रग्रहगणचन्द्रसूर्यानिलानलानां दिशां चाप्रकृतिभूतानामृतुवैकारिका भावाः, अचिरादितो भूरपि च न यथावद्रसवीर्यविपाकप्रभावमोषधीनां प्रतिविधास्यति, तद्वियोगाच्चातङ्कप्रायता नियता| तस्मात् प्रागुद्ध्वंसात् प्राक् च भूमेर्विरसीभावादुद्धरध्वं सौम्य! भैषज्यानि यावन्नोपहतरसवीर्यविपाकप्रभावाणि भवन्ति| वयं षांरसवीर्यविपाकप्रभावानुपयोक्ष्यामहे ये चास्माननुकाङ्क्षन्ति, यांश्च वयमनुकाङ्क्षामः| न हि सम्यगुद्धृतेषु सौम्य! भैषज्येषु सम्यग्विहितेषु सम्यक् चावचारितेषु जनपदोद्ध्वंसकराणां विकाराणां किञ्चित् प्रतीकारगौरवं भवति||४||
dr̥śyantē hi khalu saumya! nakṣatragrahagaṇacandrasūryānilānalānāṁ diśāṁcāprakr̥tibhūtānāmr̥tuvaikārikā  bhāvāḥ, acirāditō bhūrapi ca nayathāvadrasavīryavipākaprabhāvamōṣadhīnāṁ pratividhāsyati, tadviyōgāccātaṅkaprāyatā niyatā| tasmāt prāguddhvaṁsāt prāk ca bhūmērvirasībhāvāduddharadhvaṁ saumya! bhaiṣajyāniyāvannōpahatarasavīryavipākaprabhāvāṇi bhavanti| vayaṁ caiṣāṁ rasavīryavipākaprabhāvānupayōkṣyāmahē yē cāsmānanukāṅkṣanti, yāṁścavayamanukāṅkṣāmaḥ| na hi samyaguddhr̥tēṣu saumya! bhaiṣajyēṣu samyagvihitēṣu samyak cāvacāritēṣujanapadōddhvaṁsakarāṇāṁ vikārāṇāṁ kiñcit pratīkāragauravaṁ bhavati||4||
dRushyante hi khalu saumya! nakShatragrahagaNacandrasUryAnilAnalAnAM dishAMcAprakRutibhUtAnAmRutuvaikArikA bhAvAH, acirAdito bhUrapi ca nayathAvadrasavIryavipAkaprabhAvamoShadhInAM pratividhAsyati, tadviyogAccAta~gkaprAyatA niyatA| tasmAt prAguddhvaMsAt prAk ca bhUmervirasIbhAvAduddharadhvaM saumya! bhaiShajyAniyAvannopahatarasavIryavipAkaprabhAvANi bhavanti| vayaM caiShAM rasavIryavipAkaprabhAvAnupayokShyAmahe ye cAsmAnanukA~gkShanti, yAMshcavayamanukA~gkShAmaH| na hi samyaguddhRuteShu saumya! bhaiShajyeShu samyagvihiteShu samyak cAvacAriteShujanapadoddhvaMsakarANAM vikArANAM ki~jcit pratIkAragauravaM bhavati||4||
Gentle one (Agnivesha), the abnormal conditions of the stars, the planets, the Moon, the Sun, the wind, the fire and the directions seem to give us the ominous sign that there is going to be a derangement of seasons. As a result of this abnormality, the earth will fail to produce herbs possessing good qualities of rasa (taste), veerya (potency), vipaka (metabolism of diet and drugs), and prabhava (specific attribute). In consequence of these properties, spread of diseases is certain. Therefore, well before any calamities occur and well before the earth has lost its fertility, collect the medicinal herbs before they lose their rasa, veerya, vipaka and prabhava. We shall thus, when the occasion arises, make use of the drugs having optimum qualities for the benefit of those who seek us and also those whom we seek to help. There will not be any difficulty in counteracting any janapadodhvansa vyadhi (disease due to natural calamities or epidemics), if the drugs are properly collected well in advance, processed and administered. 
एवं वादिनं भगवन्तमात्रेयमग्निवेश उवाच-उद्धृतानि खलु भगवन्! भैषज्यानि, सम्यग्विहितानि, सम्यगवचारितानि च; अपि तु खलु जनपदोद्ध्वंसनमेकेनैव व्याधिना युगपदसमानप्रकृत्याहारदेहबलसात्म्यसत्त्ववयसां मनुष्याणां कस्माद्भवतीति||५||
ēvaṁvādinaṁ bhagavantamātrēyamagnivēśa uvāca- uddhr̥tāni khalu bhagavan! bhaiṣajyāni,samyagvihitāni, samyagavacāritāni  ca; api tu khalu janapadōddhvaṁsanamēkēnaiva vyādhināyugapadasamānaprakr̥tyāhāradēhabalasātmyasattvavayasāṁ manuṣyāṇāṁ kasmādbhavatīti||5||
evaMvAdinaM bhagavantamAtreyamagnivesha uvAca- uddhRutAni khalu bhagavan! bhaiShajyAni,samyagvihitAni, samyagavacAritAni  ca; api tu khalu janapadoddhvaMsanamekenaiva vyAdhinAyugapadasamAnaprakRutyAhAradehabalasAtmyasattvavayasAM manuShyANAM kasmAdbhavatIti||5||
Agnivesha humbly submitted to Lord Atreya that such medicinal herbs have already been properly collected, processed and administered according to his instructions. He then asked Lord Atreya, “How does the simultaneous destruction of communities take place by the incidence of one single disease, in spite of individuals who differ from one another in their constitution, diet, physique, vitality, habits, psychic make up, and age?” 
तमुवाच भगवानात्रेयः- एवमसामान्यावतामप्येभिरग्निवेश! प्रकृत्यादिभिर्भावैर्मनुष्याणां येऽन्ये वाः सामान्यास्तद्वैगुण्यात् समानकालाः समानलिङ्गाश्च व्याधयोऽभिनिर्वर्तमाना जनपदमुद्ध्वंसयन्ति| ते तु खल्विमे भावाः सामान्या जनपदेषु भवन्ति; तद्यथा- वायुः, उदकं, देशः,काल इति||६||
tamuvāca bhagavānātrēyaḥ- ēvamasāmānyāvatāmapyēbhiragnivēśa! prakr̥tyādibhirbhāvairmanuṣyāṇāṁyē'nyē bhāvāḥ sāmānyāstadvaiguṇyāt samānakālāḥ samānaliṅgāśca vyādhayō'bhinirvartamānājanapadamuddhvaṁsayanti| tē tu khalvimē bhāvāḥ sāmānyā janapadēṣu bhavanti; tadyathā- vāyuḥ, udakaṁ, dēśaḥ, kāla iti||6||
tamuvAca bhagavAnAtreyaH- evamasAmAnyAvatAmapyebhiragnivesha!prakRutyAdibhirbhAvairmanuShyANAM ye~anye bhAvAH sAmAnyAstadvaiguNyAt samAnakAlAHsamAnali~ggAshca vyAdhayo~abhinirvartamAnA janapadamuddhvaMsayanti| te tu khalvime bhAvAH sAmAnyA janapadeShu bhavanti; tadyathA- vAyuH, udakaM, deshaH, kAla iti||6||
Lord Atreya replied “Agnivesha! Though a community may be dissimilar with respect to the constitution and other characteristics of its individuals, there are other common factors which often get adversely affected, resulting in simultaneous outbreak of diseases having similar symptoms that destroy communities. The common factors which affect mass population are vayu (air), jala (water), desha (land) and kala (season). 
Characteristics of polluted air
तत्र वातमेवंविधमनारोग्यकरं विद्यात्; तद्यथा यथर्तुविषममतिस्तिमितमतिचलमतिपरुषमतिशीतमत्युष्णमतिरूक्षमत्यभिष्यन्दिनमतिभैरवारावमतिप्रतिहत- परस्परगतिमतिकुण्डलिनमसात्म्यगन्धबाष्पसिकतापांशुधूमोपहतमिति (१);
tatra vātamēvaṁvidhamanārōgyakaraṁ vidyāt; tadyathā-yathartuviṣamamatistimitamaticalamatiparuṣamatiśītamatyuṣṇamatirūkṣamatyabhiṣyandinamatibhairavārāvamatipratihata-parasparagatimatikuṇḍalinamasātmyagandhabāṣpasikatāpāṁśudhūmōpahatamiti (1);
tatra vAtamevaMvidhamanArogyakaraM vidyAt; tadyathA-yathartuviShamamatistimitamaticalamatiparuShamatishItamatyuShNamatirUkShamatyabhiShyandinamatibhairavArAvamatipratihata-parasparagatimatikuNDalinamasAtmyagandhabAShpasikatApAMshudhUmopahatamiti (1);
The characteristic features of air that is known to cause widespread diseases include air that is not in conformity with the season, totally calm or violently blowing, exceedingly rough, intensely cold, intensely hot, excessively dry, excessively humid, terribly clamorous, blowing from contrary directions and clashing with each other (winds blowing in opposite direction), violently spinning (whirlwind) and associated with unwholesome odour, moisture, sand, dust and smoke. [6.1]
Characteristics of polluted water
उदकं तु खल्वत्यर्थविकृतगन्धवर्णरसस्पर्शंक्लेदबहुलमपक्रान्तजलचरविहङ्गमुपक्षीणजलेशयमप्रीतिकरमपगतगुणं विद्यात् (२);
udakaṁ tu khalvatyarthavikr̥tagandhavarṇarasasparśaṁklēdabahulamapakrāntajalacaravihaṅgamupakṣīṇajalēśayamaprītikaramapagataguṇaṁ vidyāt (2);
udakaM tu khalvatyarthavikRutagandhavarNarasasparshaM kledabahulamapakrAntajalacaraviha~ggamupakShINajaleshayamaprItikaramapagataguNaM vidyAt (2);
Water that does not seem normal in smell, colour, taste and touch, has excessive stickiness, is from a source devoid of aquatic animals and birds or from a drying up water reservoir without pleasantness and is basically devoid of normal attributes indicates polluted water. [6.2]
Characteristics of polluted land
देशं पुनः प्रकृतिविकृतवर्णगन्धरसस्पर्शं क्लेदबहुलमुपसृष्टं सरीसृपव्यालमशकशलभमक्षिकामूषकोलूकश्माशानिकशकुनिजम्बूकादिभिस्तृणोलूपोपवनवन्तं प्रतानादिबहुलमपूर्ववदवपतितशुष्कनष्टशस्यंधूम्रपवनं प्रध्मातपतत्रिगणमुत्क्रुष्टश्वगणमुद्भ्रान्तव्यथितविविधमृगपक्षिसङ्घमुत्सृष्टनष्टधर्मसत्यलज्जाचाशीलगुणजनपदं शश्वत्क्षुभितोदीर्णसलिलाशयं प्रततोल्कापातनिर्घातभूमिकम्पमतिभयारावरूपं रूक्षताम्रारुणसिताभ्रजालसंवृतार्कचन्द्रतारकमभीक्ष्णं ससम्भ्रमोद्वेगमिव सत्रासरुदितमिव सतमस्कमिव गुह्यकाचरितमिवाक्रन्दितशब्दबहुलं चाहितं विद्यात् (३);
dēśaṁ punaḥ prakr̥tivikr̥tavarṇagandharasasparśaṁ klēdabahulamupasr̥ṣṭaṁsarīsr̥pavyālamaśakaśalabhamakṣikāmūṣakōlūkaśmāśānikaśakunijambūkādibhistr̥ṇōlūpōpavanavantaṁpratānādibahulamapūrvavadavapatitaśuṣkanaṣṭaśasyaṁ dhūmrapavanaṁpradhmātapatatrigaṇamutkruṣṭaśvagaṇamudbhrāntavyathitavividhamr̥gapakṣisaṅghamutsr̥ṣṭanaṣṭadharmasatyalajjācāraśīlaguṇajanapadaṁśaśvatkṣubhitōdīrṇasalilāśayaṁ pratatōlkāpātanirghātabhūmikampamatibhayārāvarūpaṁ rūkṣatāmrāruṇasitābhrajālasaṁvr̥tārkacandratārakamabhīkṣṇaṁ sasambhramōdvēgamiva satrāsaruditamiva satamaskamivaguhyakācaritamivākranditaśabdabahulaṁ cāhitaṁ vidyāt (3);
deshaM punaH prakRutivikRutavarNagandharasasparshaM kledabahulamupasRuShTaMsarIsRupavyAlamashakashalabhamakShikAmUShakolUkashmAshAnikashakunijambUkAdibhistRuNolUpopavanavantaMpratAnAdibahulamapUrvavadavapatitashuShkanaShTashasyaM dhUmrapavanaMpradhmAtapatatrigaNamutkruShTashvagaNamudbhrAntavyathitavividhamRugapakShisa~gghamutsRuShTanaShTadharmasatyalajjAcArashIlaguNajanapadaMshashvatkShubhitodIrNasalilAshayaM pratatolkApAtanirghAtabhUmikampamatibhayArAvarUpaM rUkShatAmrAruNasitAbhrajAlasaMvRutArkacandratArakamabhIkShNaM sasambhramodvegamiva satrAsaruditamiva satamaskamivaguhyakAcaritamivAkranditashabdabahulaM cAhitaM vidyAt (3);
Any land having abnormal colour, odour, taste and touch, that which is excessively damp and has an abundance of serpents, beasts, mosquitoes, locusts, flies, mice, owls, birds and animals such as jackal, and jungles of ulupa grass and weeds, is abounding in creepers, where crops have fallen, withered or have been destroyed in an unprecedented manner, where the wind is smoky, where (unusual) cries of birds and dogs are heard, where herds of animals and flocks of birds of various kinds are always in a state of panic and pain, where the people’s virtues like religion, truth, modesty, custom, character have either declined or been given up, where the water reservoirs always alter and are over-flowing, where there is frequent exposure to meteorites, thunderbolts and earthquakes, where nature is full of menacing sound and sights, where the sun, the moon and the stars are frequently covered by dry, coppery, ruddy and grey clouds and the general atmosphere is of constant confusion, excitement and lamentation, crying, fright and darkness as if seized by guhyaka (ghosts and ghouls). [6.3]
Characteristics of polluted time/season
कालं तु खलु यथर्तुलिङ्गाद्विपरीतलिङ्गमतिलिङ्गं हीनलिङ्गं चाहितं व्यवस्येत् (४); इमानेवन्दोषयुक्तांश्चतुरो भावाञ्जनपदोद्ध्वंसकरान् वदन्ति कुशलाः; अतोऽन्यथाभूतांस्तु हितानाचक्षते||७||
kālaṁ tu khalu yathartuliṅgādviparītaliṅgamatiliṅgaṁ hīnaliṅgaṁ cāhitaṁ vyavasyēt (4); imānēvandōṣayuktāṁścaturō bhāvāñjanapadōddhvaṁsakarān vadanti kuśalāḥ; atō'nyathābhūtāṁstu hitānācakṣatē||7||
kAlaM tu khalu yathartuli~ggAdviparItali~ggamatili~ggaM hInali~ggaM cAhitaM vyavasyet (4); imAnevandoShayuktAMshcaturo bhAvA~jjanapadoddhvaMsakarAn vadanti kushalAH; ato~anyathAbhUtAMstu hitAnAcakShate||7||
A time is said to be unwholesome if it exhibits characteristics that are opposite to normal or exhibit excessive or deficient characteristics (e.g. early rains, too little rain, excessively hot summers or cold winters, etc) These four environmental factors, affected in the aforesaid way, can be considered the type that cause epidemics, and those having features contrary to these could be considered wholesome. 
General measures for the management
विगुणेष्वपि खल्वेतेषु जनपदोद्ध्वंसकरेषु भावेषु भेषजेनोपपाद्यमानानामभयं भवति रोगेभ्य इति||८||
वैगुण्यमुपपन्नानां देशकालानिलाम्भसाम्।गरीयस्त्वं विशेषेण हेतुमत् संप्रवक्ष्यते ॥९॥
वाताज्जलं जलाद्देशं देशात् कालं स्वभावतः| विद्याद्दुष्परिहार्यत्वाद्गरीयस्तरमर्थवित् "||१०||
वाय्वादिषु यथोक्तानां दोषाणां तु विशेषवित्| प्रतीकारस्य सौकर्ये विद्याल्लाघवलक्षणम्||११||
viguṇēṣvapi khalvētēṣu janapadōddhvaṁsakarēṣu bhāvēṣu bhēṣajēnōpapādyamānānāmabhayaṁ bhavati rōgēbhya iti||8||
bhavanti cātra- vaiguṇyamupapannānāṁ dēśakālānilāmbhasām| garīyastvaṁ viśēṣēṇa hētumat sampravakṣyatē||9||
vātājjalaṁ jalāddēśaṁ dēśāt kālaṁ svabhāvataḥ| vidyādduṣparihāryatvādgarīyastaramarthavit ||10||
vāyvādiṣu yathōktānāṁ dōṣāṇāṁ tu viśēṣavit| pratīkārasya saukaryē vidyāllāghavalakṣaṇam||11||
viguNeShvapi khalveteShu janapadoddhvaMsakareShu bhAveShu bheShajenopapAdyamAnAnAmabhayaM bhavati rogebhya iti||8||
bhavanti cAtra- vaiguNyamupapannAnAM deshakAlAnilAmbhasAm| garIyastvaM visheSheNa hetumat sampravakShyate||9||
vAtAjjalaM jalAddeshaM deshAt kAlaM svabhAvataH| vidyAdduShparihAryatvAdgarIyastaramarthavit ||10||
vAyvAdiShu yathoktAnAM doShANAM tu visheShavit| pratIkArasya saukarye vidyAllAghavalakShaNam||11||
In spite of these inauspicious factors, there is no fear of diseases to those persons who possess medicines that have been obtained well in advance.
We shall now indicate, with a proper reasoning, the relative significance of each of the four factors of air, water, place and time that have deranged. These four are important in progressive order because of the degree of their indispensability.
The wise man knows that water is more important than air, and land is more important than water and season is yet more important than land by virtue of their degree of indispensability.
General treatment in epidemics
कालान्तेषु यदा नराः| भेषजेनोपपाद्यन्ते न भवन्त्यातुरास्तदा||१२||
येषां न मृत्युसामान्यं सामान्यं न च कर्मणाम्| कर्म पञ्चविधं तेषां भेषजं परमुच्यते||१३||
रसायनानां विधिवच्चोपयोगः शस्यते| शस्यते देहवृत्तिश्च भेषजैः पूर्वमुद्धृतैः||१४||
सत्यं भूते दया दानं बलयो देवतार्चनम्| सद्धृत्तस्यानुवृत्तिश्च प्रशमो गुप्तिरात्मनः||१५||
हितं जनपदानां च शिवानामुपसेवनम्| सेवनं ब्रह्मचर्यस्य तथैव ब्रह्मचारिणाम्||१६||
सङ्कथा धर्मशास्त्राणां महर्षीणां जितात्मनाम्| धार्मिकैः सात्त्विकैर्नित्यं सहास्या वृद्धसम्मतैः||१७||
त्येतद्भेषजं प्रोक्तमायुषः परिपालनम्| येषामनियतो मृत्युस्तस्मिन् काले सुदारुणे||१८||
caturṣvapi tu duṣṭēṣu kālāntēṣu yadā narāḥ| bhēṣajēnōpapādyantē na bhavantyāturāstadā||12||
yēṣāṁ na mr̥tyusāmānyaṁ sāmānyaṁ na ca karmaṇām| karma pañcavidhaṁ tēṣāṁ bhēṣajaṁ paramucyatē||13||
rasāyanānāṁ vidhivaccōpayōgaḥ praśasyatē| śasyatē dēhavr̥ttiśca bhēṣajaiḥ pūrvamuddhr̥taiḥ||14||
satyaṁ bhūtē dayā dānaṁ balayō dēvatārcanam| saddhr̥ttasyānuvr̥ttiśca praśamō guptirātmanaḥ||15||
hitaṁ janapadānāṁ ca śivānāmupasēvanam| sēvanaṁ brahmacaryasya tathaiva brahmacāriṇām||16||
saṅkathā dharmaśāstrāṇāṁ maharṣīṇāṁ jitātmanām| dhārmikaiḥ sāttvikairnityaṁ sahāsyā vr̥ddhasammataiḥ||17||
ityētadbhēṣajaṁ prōktamāyuṣaḥ paripālanam| yēṣāmaniyatō mr̥tyustasmin kālē sudāruṇē||18||
caturShvapi tu duShTeShu kAlAnteShu yadA narAH| bheShajenopapAdyante na bhavantyAturAstadA||12||
yeShAM na mRutyusAmAnyaM sAmAnyaM na ca karmaNAm| karma pa~jcavidhaM teShAM bheShajaM paramucyate||13||
rasAyanAnAM vidhivaccopayogaH prashasyate| shasyate dehavRuttishca bheShajaiH pUrvamuddhRutaiH||14||
satyaM bhUte dayA dAnaM balayo devatArcanam| saddhRuttasyAnuvRuttishca prashamo guptirAtmanaH||15||
hitaM janapadAnAM ca shivAnAmupasevanam| sevanaM brahmacaryasya tathaiva brahmacAriNAm||16||
sa~gkathA dharmashAstrANAM maharShINAM jitAtmanAm| dhArmikaiH sAttvikairnityaM sahAsyA vRuddhasammataiH||17||
ityetadbheShajaM proktamAyuShaH paripAlanam| yeShAmaniyato mRutyustasmin kAle sudAruNe||18||
In spite of vitiation of the four factors ending with vitiation of time (season), one need not suffer from diseases provided they are assured of proper medicaments which are already collected and processed.
Those who did not engage in identical acts in their prior lives and those who are not destined to die during calamities, for their cure, five elimination therapies (viz., emesis, purgation, enema- niruha and anuvasana types and errhines) are considered the best. For them, the proper use of rasayana chikitsa (rejuvenation treatment) is recommended and maintenance of the body by means of medicinal herbs collected before the onset of epidemics is recommended.
Truthfulness, compassion for living beings, charity, sacrifices, worship of god, observance of right conduct, tranquility, prophylactic protection of oneself and seeking one’s own good, residing in a wholesome country, service to those observing brahmacharya (celibacy) and following it, discussion of religious scriptures, constant association with the righteous, the well disposed and those who are approved by the elders- all this with a view to protecting life has been termed ‘medicine’ to those who are not destined to die in that critical time. [12-18]
Causes for the vitiation of janapadodhwansa factors
इति श्रुत्वा जनपदोद्ध्वंसने कारणानि पुनरपि भगवन्तमात्रेयमग्निवेश उवाच- अथ खलु भगवन्! कुतोमूलमेषां वाय्वादीनांवैगुण्यमुत्पद्यते? येनोपपन्ना जनपदमुद्ध्वंसयन्तीति||१९||
तमुवाच भगवानात्रेयः- सर्वेषामप्यग्निवेश! वाय्वादीनां यद्वैगुण्यमुत्पद्यते तस्य मूलमधर्मः, तन्मूलं वाऽसत्कर्म पूर्वकृतं; तयोर्योनिः प्रज्ञापराध एव| तद्यथा- यदा वै देशनगरनिगमजनपदप्रधाना धर्ममुत्क्रम्याधर्मेण प्रजां वर्तयन्ति, तदाश्रितोपाश्रिताः रजनपदा व्यवहारोपजीविनश्च तमधर्ममभिवर्धयन्ति, ततः सोऽधर्मः प्रसभं धर्ममन्तर्धत्ते, तस्तेऽन्तर्हितधर्माणो देवताभिरपि त्यज्यन्ते; तेषां थाऽन्तर्हितधर्मणामधर्मप्रधानानामपक्रान्तदेवतानामृतवो व्यापद्यन्ते; तेन नापो यथाकालं देवो र्षति न वा वर्षति विकृतं वा वर्षति, वाता न सम्यगभिवान्ति, तिर्व्यापद्यते, लिलान्युपशुष्यन्ति, ओषधयः स्वभावं परिहायापद्यन्ते विकृतिं; तत उद्ध्वंसन्ते जनपदाः श्याभ्यवहार्यदोषात् ||२०||
iti śrutvā janapadōddhvaṁsanē kāraṇāni punarapi bhagavantamātrēyamagnivēśa uvāca- atha khalubhagavan! kutōmūlamēṣāṁ vāyvādīnāṁ vaiguṇyamutpadyatē? yēnōpapannājanapadamuddhvaṁsayantīti||19||
tamuvāca bhagavānātrēyaḥ- sarvēṣāmapyagnivēśa! vāyvādīnāṁ yadvaiguṇyamutpadyatē tasyamūlamadharmaḥ, tanmūlaṁ vā'satkarma pūrvakr̥taṁ; tayōryōniḥ prajñāparādha ēva| tadyathā- yadā vai dēśanagaranigamajanapadapradhānā dharmamutkramyādharmēṇa prajāṁvartayanti, tadāśritōpāśritāḥ paurajanapadā vyavahārōpajīvinaśca tamadharmamabhivardhayanti, tataḥsō'dharmaḥ prasabhaṁ dharmamantardhattē, tatastē'ntarhitadharmāṇō dēvatābhirapi tyajyantē; tēṣāṁtathā'ntarhitadharmaṇāmadharmapradhānānāmapakrāntadēvatānāmr̥tavō vyāpadyantē; tēna nāpōyathākālaṁ dēvō varṣati na vā varṣati vikr̥taṁ vā varṣati, vātā na samyagabhivānti, kṣitirvyāpadyatē,salilānyupaśuṣyanti, ōṣadhayaḥ svabhāvaṁ parihāyāpadyantē vikr̥tiṁ; tata uddhvaṁsantē janapadāḥspr̥śyābhyavahāryadōṣāt ||20||
iti shrutvA janapadoddhvaMsane kAraNAni punarapi bhagavantamAtreyamagnivesha uvAca- atha khalubhagavan! kutomUlameShAM vAyvAdInAM vaiguNyamutpadyate? yenopapannAjanapadamuddhvaMsayantIti||19||
tamuvAca bhagavAnAtreyaH- sarveShAmapyagnivesha! vAyvAdInAM yadvaiguNyamutpadyate tasyamUlamadharmaH, tanmUlaM vA~asatkarma pUrvakRutaM; tayoryoniH praj~jAparAdha eva| tadyathA- yadA vai deshanagaranigamajanapadapradhAnA dharmamutkramyAdharmeNa prajAMvartayanti, tadAshritopAshritAH paurajanapadA vyavahAropajIvinashca tamadharmamabhivardhayanti,tataH so~adharmaH prasabhaM dharmamantardhatte, tataste~antarhitadharmANo devatAbhirapityajyante; teShAM tathA~antarhitadharmaNAmadharmapradhAnAnAmapakrAntadevatAnAmRutavovyApadyante; tena nApo yathAkAlaM devo varShati na vA varShati vikRutaM vA varShati, vAtA nasamyagabhivAnti, kShitirvyApadyate, salilAnyupashuShyanti, oShadhayaH svabhAvaM parihAyApadyantevikRutiM; tata uddhvaMsante janapadAH spRushyAbhyavahAryadoShAt ||20||
After listening to Lord Atreya, Agnivesha asked once again, ‘Now tell us, Lord! What makes the air etc. vitiated which tends to destroy whole people?’ Lord Atreya replied that the root cause of vitiation of these factors is adharma (unrighteousness). Sins of the present life or the misdeeds of the past life also are at the root of vitiation of all these factors and the source of this is intellectual error (prajnaparadha). Thus when the reigning heads of countries, cities, trade guilds etc. govern the people irresponsibly by transgressing the virtuous path, then their officers, sub-ordinates and under- subordinates, people of the city and community and traders deviate from their duties as well and propagate such unrighteous acts further. Their sinful acts perforce causes the righteous acts to disappear. Because of the disappearance of righteous acts, even the Gods desert the people living in such places. This causes seasons to get impaired in these places. There is no rain in time, or never at all, or abnormal rain occurs; the air does not blow properly; the land is afflicted, the water reservoirs dry up, and herbs lose their true properties and suffer deterioration. As a consequence, the people perish as the result of infectious contact or ingestion of polluted food and water.[19-20]
Sinful acts- the cause of war and destruction
तथा शस्त्रप्रभवस्यापि जनपदोद्ध्वंसस्याधर्म एव हेतुर्भवति| येऽतिप्रवृद्धलोभक्रोधमोहमानास्ते दुर्बलानवमत्यात्मस्वजनपरोपघाताय शस्त्रेण परस्परमभिक्रामन्ति, परान् वाऽभिक्रामन्ति, परैर्वाऽभिक्राम्यन्ते||२१||
tathā śastraprabhavasyāpi janapadōddhvaṁsasyādharma ēva hēturbhavati| yē'tipravr̥ddhalōbhakrōdhamōhamānāstē durbalānavamatyātmasvajanaparōpaghātāya śastrēṇaparasparamabhikrāmanti, parān vā'bhikrāmanti, parairvā'bhikrāmyantē||21||
tathA shastraprabhavasyApi janapadoddhvaMsasyAdharma eva heturbhavati| ye~atipravRuddhalobhakrodhamohamAnAste durbalAnavamatyAtmasvajanaparopaghAtAya shastreNaparasparamabhikrAmanti, parAn vA~abhikrAmanti, parairvA~abhikrAmyante||21||
In the same manner, it is unrighteous act alone that is the cause of the destruction of peoples by weapons. Those who suffer from excessive lobha (greed), krodha (anger), moha (attachment), and disregard the weak may start fighting among themselves with weapons and attack either the enemies or get attacked by enemies. 
Sinful acts leading to affliction by demons and curse of sages
रक्षोगणादिभिर्वा विधै र्भूतसङ्घै स्तमधर्ममन्यद्वाऽप्य पचारान्तरम उपलभ्याभिहन्यन्ते||२२||
तथाऽभिशापप्रभवस्याप्यधर्म एव हेतुर्भवति| ये लुप्तधर्माणो र्मादपेतास्ते रुवृद्धसिद्धर्षिपूज्यानवमत्याहितान्याचरन्ति; ततस्ताः प्रजा गुर्वादिभिरभिशप्ता भस्मतामुपयान्ति प्रागेवानेकपुरुषकुलविनाशाय, नियतप्रत्ययोपलम्भादनियताश्चापरे ||२३||
tathā'bhiśāpaprabhavasyāpyadharma ēva hēturbhavati| yē luptadharmāṇō dharmādapētāstē guruvr̥ddhasiddharṣipūjyānavamatyāhitānyācaranti; tatastāḥ prajāgurvādibhirabhiśaptā bhasmatāmupayānti prāgēvānēkapuruṣakulavināśāya,niyatapratyayōpalambhādaniyatāścāparē ||23||
tathA~abhishApaprabhavasyApyadharma eva heturbhavati| ye luptadharmANo dharmAdapetAste guruvRuddhasiddharShipUjyAnavamatyAhitAnyAcaranti; tatastAHprajA gurvAdibhirabhishaptA bhasmatAmupayAnti prAgevAnekapuruShakulavinAshAya,niyatapratyayopalambhAdaniyatAshcApare  ||23||
People also get destroyed by rakshasa (demons) or other creatures due to unrighteous or other deviant acts. Adharma (unrighteousness) is also the cause of diseases caused as a result of curses. Those who get by without performing religious duties or who shirk from their religious duties tend to behave irresponsibly or are disrespectful to the preceptors, elders, the wise, sages and the nobility. Consequently, such people often get cursed by preceptors etc. Such wraths could destroy individuals or communities immediately or at a pre-determined time. 
The decrease of virtue and life span by a quarter in each Yuga (time period)
प्रागपि चाधर्मादृते नाशुभोत्पत्तिरन्यतोऽभूत्| आदिकाले ह्यदितिसुतसमौजसोऽतिविमलविपुलप्रभावाः प्रत्यक्षदेवदेवर्षिधर्मयज्ञविधिविधानाः शैलसारसंहतस्थिरशरीराः प्रसन्नवर्णेन्द्रियाः पवनसमबल जवपराक्रमाश्चारुस्फिचोऽभिरूपप्रमाणाकृतिप्रसादोपचयवन्तःसत्यार्जवानृशंस्यदानदमनियमतपोपवासब्रह्मचर्यव्रतपरा व्यपगतभयरागद्वेषमोहलोभक्रोधशोकमानरोगनिद्रातन्द्राश्रमक्लमालस्यपरिग्रहाश्च पुरुषा बभूवुरमितायुषः| तेषामुदारसत्त्वगुणकर्मणामचिन्त्यरसवीर्यविपाकप्रभावगुणसमुदितानि प्रादुर्बभूवुः शस्यानि सर्वगुणसमुदितत्वात् पृथिव्यादीनां कृतयुगस्यादौ| भ्रश्यति तु कृतयुगे केषाञ्चिदत्यादानात् साम्पन्निकानां सत्त्वानां शरीरगौरवमासीत्, शरीरगौरवाच्छ्रमः, श्रमादालस्यम्, आलस्यात् सञ्चयः, सञ्चयात् परिग्रहः, परिग्रहाल्लोभः प्रादुरासीत् कृते| ततस्त्रेतायां लोभादभिद्रोहः, अभिद्रोहानृतवचनम्, अनृतवचनात् कामक्रोधमानद्वेषपारुष्याभिघातभयतापशोकचिन्तोद्वेगादयः प्रवृत्ताः| ततस्त्रेतायां धर्मपादोऽन्तर्धानमगमत्| तस्यान्तर्धानात् युगवर्षप्रमाणस्य पादह्रासः, पृथिव्यादेश्च गुणपादप्रणाशोऽभूत्| तत्प्रणाशकृतश्च शस्यानां स्नेहवैमल्यरसवीर्यविपाकप्रभावगुणपादभ्रांशः| ततस्तानि प्रजाशरीराणि हीयमानगुणपादै राहारविहारैरयथापूर्वमुपष्टभ्यमानान्यग्निमारुतपरीतानि प्राग्व्याधिभिर्ज्वरादिभिराक्रान्तानि| अतः प्राणिनो ह्रासमवापुरायुषः क्रमश इति||२४||
भवतश्चात्र- युगे युगे धर्मपादः क्रमेणानेन हीयते| गुणपादश्च भूतानामेवं लोकः प्रलीयते||२५||
संवत्सरशते पूर्णे याति संवत्सरः क्षयम्| देहिनामायुषः काले यत्र यन्मानमिष्यते||२६||
इति विकाराणां प्रागुत्पत्तिहेतुरुक्तो भवति||२७||
एवंवादिनं भगवन्तमग्निवेश उवाच- किन्नु खलु भगवन्! नियतकालप्रमाणमायुः सर्वं न ति||२८||
prāgapi cādharmādr̥tē nāśubhōtpattiranyatō'bhūt| ādikālē hyaditisutasamaujasō'tivimalavipulaprabhāvāḥ pratyakṣadēvadēvarṣidharmayajñavidhividhānāḥśailasārasaṁhatasthiraśarīrāḥ prasannavarṇēndriyāḥpavanasamabalajavaparākramāścārusphicō'bhirūpapramāṇākr̥tiprasādōpacayavantaḥsatyārjavānr̥śaṁsyadānadamaniyamatapōpavāsabrahmacaryavrataparāvyapagatabhayarāgadvēṣamōhalōbhakrōdhaśōkamānarōganidrātandrāśramaklamālasyaparigrahāścapuruṣā babhūvuramitāyuṣaḥ| tēṣāmudārasattvaguṇakarmaṇāmacintyarasavīryavipākaprabhāvaguṇasamuditāni  prādurbabhūvuḥśasyāni sarvaguṇasamuditatvāt pr̥thivyādīnāṁ kr̥tayugasyādau| bhraśyati tu kr̥tayugē kēṣāñcidatyādānāt sāmpannikānāṁ sattvānāṁ śarīragauravamāsīt,śarīragauravācchramaḥ, śramādālasyam, ālasyāt sañcayaḥ, sañcayāt parigrahaḥ, parigrahāllōbhaḥprādurāsīt kr̥tē| tatastrētāyāṁ lōbhādabhidrōhaḥ, abhidrōhānr̥tavacanam, anr̥tavacanātkāmakrōdhamānadvēṣapāruṣyābhighātabhayatāpaśōkacintōdvēgādayaḥ pravr̥ttāḥ| tatastrētāyāṁ dharmapādō'ntardhānamagamat| tasyāntardhānāt yugavarṣapramāṇasya pādahrāsaḥ, pr̥thivyādēśca guṇapādapraṇāśō'bhūt| tatpraṇāśakr̥taśca śasyānāṁ snēhavaimalyarasavīryavipākaprabhāvaguṇapādabhrāṁśaḥ| tatastāni prajāśarīrāṇihīyamānaguṇapādairāhāravihārairayathāpūrvamupaṣṭabhyamānānyagnimārutaparītāni prāgvyādhibhirjvarādibhirākrāntāni| ataḥ prāṇinō hrāsamavāpurāyuṣaḥ kramaśa iti||24||
bhavataścātra- yugē yugē dharmapādaḥ kramēṇānēna hīyatē| guṇapādaśca bhūtānāmēvaṁ lōkaḥ pralīyatē||25||
saṁvatsaraśatē pūrṇē yāti saṁvatsaraḥ kṣayam| dēhināmāyuṣaḥ kālē yatra yanmānamiṣyatē||26||
iti vikārāṇāṁ prāgutpattihēturuktō bhavati||27||
ēvaṁvādinaṁ bhagavantamagnivēśa uvāca- kinnu khalu bhagavan! niyatakālapramāṇamāyuḥ sarvaṁ navēti||28||
prAgapi cAdharmAdRute nAshubhotpattiranyato~abhUt| AdikAle hyaditisutasamaujaso~ativimalavipulaprabhAvAHpratyakShadevadevarShidharmayaj~javidhividhAnAH shailasArasaMhatasthirasharIrAHprasannavarNendriyAHpavanasamabalajavaparAkramAshcArusphico~abhirUpapramANAkRutiprasAdopacayavantaHsatyArjavAnRushaMsyadAnadamaniyamatapopavAsabrahmacaryavrataparAvyapagatabhayarAgadveShamohalobhakrodhashokamAnaroganidrAtandrAshramaklamAlasyaparigrahAshcapuruShA babhUvuramitAyuShaH| teShAmudArasattvaguNakarmaNAmacintyarasavIryavipAkaprabhAvaguNasamuditAni  prAdurbabhUvuHshasyAni sarvaguNasamuditatvAt pRuthivyAdInAM kRutayugasyAdau| bhrashyati tu kRutayuge keShA~jcidatyAdAnAt sAmpannikAnAM sattvAnAM sharIragauravamAsIt,sharIragauravAcchramaH, shramAdAlasyam, AlasyAt sa~jcayaH, sa~jcayAt parigrahaH, parigrahAllobhaHprAdurAsIt kRute| tatastretAyAM lobhAdabhidrohaH, abhidrohAnRutavacanam, anRutavacanAtkAmakrodhamAnadveShapAruShyAbhighAtabhayatApashokacintodvegAdayaH pravRuttAH| tatastretAyAM dharmapAdo~antardhAnamagamat| tasyAntardhAnAt yugavarShapramANasya pAdahrAsaH, pRuthivyAdeshca guNapAdapraNAsho~abhUt| tatpraNAshakRutashca shasyAnAM snehavaimalyarasavIryavipAkaprabhAvaguNapAdabhrAMshaH| tatastAni prajAsharIrANihIyamAnaguNapAdairAhAravihArairayathApUrvamupaShTabhyamAnAnyagnimArutaparItAni prAgvyAdhibhirjvarAdibhirAkrAntAni| ataH prANino hrAsamavApurAyuShaH kramasha iti||24||
bhavatashcAtra- yuge yuge dharmapAdaH krameNAnena hIyate| guNapAdashca bhUtAnAmevaM lokaH pralIyate||25||
saMvatsarashate pUrNe yAti saMvatsaraH kShayam| dehinAmAyuShaH kAle yatra yanmAnamiShyate||26||
iti vikArANAM prAgutpattiheturukto bhavati||27||
evaMvAdinaM bhagavantamagnivesha uvAca- kinnu khalu bhagavan! niyatakAlapramANamAyuH sarvaMna veti||28||
Even in the earliest of times, calamities never resulted from any factor other than adharma (unrighteousness).
In the first yuga (kritayuga or satyayuga), people were gifted with vitality equal to those of the sons of Aditi (i.e., devas or Gods) – they were exceedingly pure and unhampered in their powers to perceive the Supreme, the God-like sages, the Divine Law, the religious sacrifices, and the sacrificial rituals. Their bodies were firm like the essence of mountains - compact and stable; they had clear senses and complexions. They had movement, strength and valor like those of the wind; they were with well-formed buttocks, endowed with handsomeness, body-size, cheerfulness and corpulence. They were devoted to truth, honest behavior, compassion, charity, self-restraint, moral discipline, spiritual endeavor, fasting, continence, and religious vows. They were free from fear, desire, aversion, infatuation, greed, anger, despondency, pride, disease, sleep, indolence, fatigue, languor, sloth and spirit of acquisition; and lastly they were bestowed with longevity. For the benefit of these people of noble minds, qualities and deeds, the crops grew with inconceivable rasa, veerya, vipaka, and prabhava, and the virtue of the earth during the dawn of this golden age was charged fully with all excellent qualities.
At the end of the satyayuga, however, some affluent people started gaining heaviness in their bodies due to over-indulgence in food. They started suffering from fatigue in lieu of this. Fatigue gave rise to laziness, and laziness made them to accumulate things; accumulation led to the attachment for these things and attachment resulted in greed.
With the onset of the tretayuga, greed gave rise to malice in its wake, malice led to falsehood, and falsehood led to passion, anger, vanity, hatred, cruelty, aggression, fear, grief, anxiety, distress and the like. Symbolically, during tretayuga, one-fourth of dharma (religious duties) disappeared, resulting in reduction of the life-span of human beings by a quarter. Similarly, there was reduction in the attributes of earth etc., by a quarter. Because of the reduction of these attributes there was diminution by one quarter of the unctuousness, purity, tastes (rasa), potency (veerya), post digestive effects (vipaka), prabhava and qualities of grains. In effect, this degradation impacted all aspects of living beings that were described to have existed in the satyayuga. There was an unusual change in the maintenance of equilibrium of tissue elements and there was vitiation of agni (pitta) and maruta (vata) by which, first of all, bodies of living beings got afflicted with diseases viz. jwara (fever) etc. Therefore the life-span of living beings underwent gradual diminution.
The concluding verse:
With the passage of each yuga, righteousness or dharma gets reduced by a quarter, with similar reduction in the qualities of living beings, finally leading to dissolution of the universe. After completion of one hundred years in each yuga there is loss of one year in life span of living beings in respective age. Thus the initial origin of disorders is described.
After lord Atreya’s talk, Agnivesha raised a query- Lord! Is the life span of all individuals predetermined or is it not? [24-28]
Factors determining the life span
तं भगवानुवाच- इहाग्निवेश! भूतानामायुर्युक्तिमपेक्षते| दैवे पुरुषकारे च स्थितं ह्यस्य बलाबलम्||२९||
दैवमात्मकृतं विद्यात् कर्म यत् पौर्वदैहिकम्| स्मृतः पुरुषकारस्तु क्रियते यदिहापरम्||३०||
बलाबलविशेषोऽस्ति तयोरपि च कर्मणोः| दृष्टं हि त्रिविधं कर्म हीनं मध्यममुत्तमम्||३१||
तयोरुदारयोर्युक्तिर्दीर्घस्य च सुखस्य च| नियतस्यायुषो हेतुर्विपरीतस्य चेतरा||३२||
मध्यमा मध्यमस्येष्टा कारणं शृणु चापरम्|३३| दैवं पुरुषकारेण दुर्बलं ह्युपहन्यते||३३||
दैवेन चेतरत् कर्म विशिष्टेनोपहन्यते| दृष्ट्वा यदेके मन्यन्ते नियतं मानमायुषः||३४||
कर्म किञ्चित् क्वचित् काले विपाके नियतं महत्| किञ्चित्त्वकालनियतं प्रत्ययैः प्रतिबोध्यते||३५||
taṁ bhagavānuvāca- ihāgnivēśa! bhūtānāmāyuryuktimapēkṣatē| daivē puruṣakārē ca sthitaṁ hyasya balābalam||29||
daivamātmakr̥taṁ vidyāt karma yat paurvadaihikam| smr̥taḥ puruṣakārastu kriyatē yadihāparam||30||
balābalaviśēṣō'sti tayōrapi ca karmaṇōḥ| dr̥ṣṭaṁ hi trividhaṁ karma hīnaṁ madhyamamuttamam||31||
tayōrudārayōryuktirdīrghasya ca sukhasya ca| niyatasyāyuṣō hēturviparītasya cētarā||32||
madhyamā madhyamasyēṣṭā kāraṇaṁ śr̥ṇu cāparam| daivaṁ puruṣakārēṇa durbalaṁ hyupahanyatē||33||
daivēna cētarat karma viśiṣṭēnōpahanyatē| dr̥ṣṭvā yadēkē manyantē niyataṁ mānamāyuṣaḥ||34||
karma kiñcit kvacit kālē vipākē niyataṁ mahat| kiñcittvakālaniyataṁ pratyayaiḥ pratibōdhyatē||35||
taM bhagavAnuvAca- ihAgnivesha! bhUtAnAmAyuryuktimapekShate| daive puruShakAre ca sthitaM hyasya balAbalam||29||
daivamAtmakRutaM vidyAt karma yat paurvadaihikam| smRutaH puruShakArastu kriyate yadihAparam||30||
balAbalavisheSho~asti tayorapi ca karmaNoH| dRuShTaM hi trividhaM karma hInaM madhyamamuttamam||31||
tayorudArayoryuktirdIrghasya ca sukhasya ca| niyatasyAyuSho heturviparItasya cetarA||32||
madhyamA madhyamasyeShTA kAraNaM shRuNu cAparam| daivaM puruShakAreNa durbalaM hyupahanyate||33||
daivena cetarat karma vishiShTenopahanyate| dRuShTvA yadeke manyante niyataM mAnamAyuShaH||34||
karma ki~jcit kvacit kAle vipAke niyataM mahat| ki~jcittvakAlaniyataM pratyayaiH pratibodhyate||35||
Lord Atreya replied, “Agnivesha! The life span of all living beings depends on the proper coordination of two factors, namely, daiva (divine/pre-determined) and purushakara (human effort). Daiva means one’s own deeds in the previous life while purushakara stands for one’s actions (deeds) in this life”.
These two factors are gauged by means of various degrees of strength and weakness, which can be further classified into three kinds- inferior, medium, superior. When both types of action (destiny and efforts) are of the best characters then they make for long, happy and determined life, and if they are of the inferior type, the result is just the opposite (short, unhappy and undetermined life span). When these are medium, then the life-span and its quality are also said to be mediocre (though not entirely unhappy).
Now listen to the other cause of the pre-determination, or of the life-span. A weak daiva gets subdued by a strong purushakara. Similarly a strong daiva overshadows one’s purushakara and because of this, some scholars hold the view that the span of life is invariably predetermined. There are some powerful actions whose implementation takes place at a predetermined time, but there is another kind of action whose implementation is not predetermined and gets manifested in an appropriate atmosphere. [29-35]
The proof of the indeterminateness of the life span
तस्मादुभयदृष्टत्वादेकान्तग्रहणमसाधु| निदर्शनमपि चात्रोदाहरिष्यमः- यदि हि नियतकालप्रमाणमायुः सर्वं स्यात्, तदाऽऽयुष्कामाणां न मन्त्रौषधिमणिमङ्गलबल्युपहारहोमनियमप्रायश्चित्तोपवासस्वस्त्ययनप्रणिपातगमनाद्याः या इष्टयश्च प्रयोज्येरन्; नोद्भ्रान्तचण्डचपलगोजोष्ट्रखरतुरगमहिषादयः पवनादयश्च दुष्टाः परिहार्याः स्युः, न प्रपातगिरिविषमदुर्गाम्बुवेगाः, तथा न प्रमत्तोन्मत्तोद्भान्तचण्डचपलमोहलोभाकुलमतयः, नारयः, न प्रवृद्धोऽग्निः, च विविधविषाश्रयाः रीसृपोरगादयः, न साहसं, नादेशकालचर्या, न नरेन्द्रप्रकोप ति; एवमादयो हि भावा नाभावकराः स्युः, आयुषः सर्वस्य नियतकालप्रमाणत्वात्|न चानभ्यस्ताकालमरणभयनिवारकाणामकालमरणभयमागच्छेत् प्रणिनां, व्यर्थाश्चारम्भकथाप्रयोगबुद्धयः स्युर्महर्षीणां रसायनाधिकारे, नापीन्द्रो नियतायुषं शत्रुं वज्रेणाभिहन्यात्, नाश्विनावार्तं भेषजेनोपपादयेतां , न महर्षयो यथेष्टमायुस्तपसा प्राप्नुयुः, न च विदितवेदितव्या महर्षयः ससुरेशाः सम्यक् पश्येयुरुपदिशेयुराचरेयुर्वा| अपि च सर्वचक्षुषामेतत् परं यदैन्द्रं चक्षुः , इदं चाप्यस्माकं तेन प्रत्यक्षं; यथा- पुरुषसहस्राणामुत्थायोत्थायाहवं कुर्वतामकुर्वतां चातुल्यायुष्ट्वं, तथा जातमात्राणामप्रतीकारात् प्रतीकाराच्च, अविषविषप्राशिनां चाप्यतुल्यायुष्ट्वमेव, न च तुल्यो योगक्षेम उदपानघटानां चित्रघटानां चोत्सीदतां; तस्माद्धितोपचारमूलं जीवितम्, अतो विपर्ययान्मृत्युः| अपि च देशकालात्मगुणविपरीतानां कर्मणामाहारविकाराणां च क्रमोपयोगः सम्यक्, त्यागः सर्वस्य चातियोगायोगमिथ्यायोगानां, सर्वातियोगसन्धारणम् , असन्धारणमुदीर्णानां च गतिमतां, साहसानां च वर्जनम्, आरोग्यानुवृत्तौ हेतुमुपलभामहे सम्यगुपदिशामः सम्यक् पश्यामश्चेति||३६||
tasmādubhayadr̥ṣṭatvādēkāntagrahaṇamasādhu| nidarśanamapi cātrōdāhariṣyamaḥ- yadi hi niyatakālapramāṇamāyuḥ sarvaṁ syāt, tadā yuṣkāmāṇāṁ namantrauṣadhimaṇimaṅgalabalyupahārahōmaniyamaprāyaścittōpavāsasvastyayanapraṇipātagamanādyāḥkriyā iṣṭayaśca prayōjyēran; nōdbhrāntacaṇḍacapalagōjōṣṭrakharaturagamahiṣādayaḥ pavanādayaścaduṣṭāḥ parihāryāḥ syuḥ, na prapātagiriviṣamadurgāmbuvēgāḥ, tathā napramattōnmattōdbhāntacaṇḍacapalamōhalōbhākulamatayaḥ, nārayaḥ, na pravr̥ddhō'gniḥ, cavividhaviṣāśrayāḥ sarīsr̥pōragādayaḥ, na sāhasaṁ, nādēśakālacaryā, na narēndraprakōpa iti; ēvamādayō hibhāvā nābhāvakarāḥ syuḥ, āyuṣaḥ sarvasya niyatakālapramāṇatvāt| na cānabhyastākālamaraṇabhayanivārakāṇāmakālamaraṇabhayamāgacchēt praṇināṁ,vyarthāścārambhakathāprayōgabuddhayaḥ syurmaharṣīṇāṁ rasāyanādhikārē, nāpīndrō niyatāyuṣaṁśatruṁ vajrēṇābhihanyāt, nāśvināvārtaṁ bhēṣajēnōpapādayētāṁ , na maharṣayō yathēṣṭamāyustapasāprāpnuyuḥ, na ca viditavēditavyā maharṣayaḥ sasurēśāḥ samyak paśyēyurupadiśēyurācarēyurvā| api ca sarvacakṣuṣāmētat paraṁ yadaindraṁ cakṣuḥ, idaṁ cāpyasmākaṁ tēna pratyakṣaṁ; yathā-puruṣasahasrāṇāmutthāyōtthāyāhavaṁ kurvatāmakurvatāṁ cātulyāyuṣṭvaṁ, tathājātamātrāṇāmapratīkārāt pratīkārācca, aviṣaviṣaprāśināṁ cāpyatulyāyuṣṭvamēva, na ca tulyō yōgakṣēmaudapānaghaṭānāṁ citraghaṭānāṁ cōtsīdatāṁ; tasmāddhitōpacāramūlaṁ jīvitam, atō viparyayānmr̥tyuḥ| api ca dēśakālātmaguṇaviparītānāṁ karmaṇāmāhāravikārāṇāṁ ca kramōpayōgaḥ samyak, tyāgaḥsarvasya cātiyōgāyōgamithyāyōgānāṁ, sarvātiyōgasandhāraṇam , asandhāraṇamudīrṇānāṁ cagatimatāṁ, sāhasānāṁ ca varjanam, ārōgyānuvr̥ttau hētumupalabhāmahē samyagupadiśāmaḥ samyakpaśyāmaścēti||36||
tasmAdubhayadRuShTatvAdekAntagrahaNamasAdhu| nidarshanamapi cAtrodAhariShyamaH- yadi hi niyatakAlapramANamAyuH sarvaM syAt,tadA~a~ayuShkAmANAM namantrauShadhimaNima~ggalabalyupahArahomaniyamaprAyashcittopavAsasvastyayanapraNipAtagamanAdyAHkriyA iShTayashca prayojyeran; nodbhrAntacaNDacapalagojoShTrakharaturagamahiShAdayaH pavanAdayashcaduShTAH parihAryAH syuH, na prapAtagiriviShamadurgAmbuvegAH, tathA napramattonmattodbhAntacaNDacapalamohalobhAkulamatayaH, nArayaH, na pravRuddho~agniH, cavividhaviShAshrayAH sarIsRuporagAdayaH, na sAhasaM, nAdeshakAlacaryA, na narendraprakopa iti;evamAdayo hi bhAvA nAbhAvakarAH syuH, AyuShaH sarvasya niyatakAlapramANatvAt| na cAnabhyastAkAlamaraNabhayanivArakANAmakAlamaraNabhayamAgacchet praNinAM,vyarthAshcArambhakathAprayogabuddhayaH syurmaharShINAM rasAyanAdhikAre, nApIndro niyatAyuShaMshatruM vajreNAbhihanyAt, nAshvinAvArtaM bheShajenopapAdayetAM  , na maharShayoyatheShTamAyustapasA prApnuyuH, na ca viditaveditavyA maharShayaH sasureshAH samyakpashyeyurupadisheyurAcareyurvA| api ca sarvacakShuShAmetat paraM yadaindraM cakShuH, idaM cApyasmAkaM tena pratyakShaM; yathA-puruShasahasrANAmutthAyotthAyAhavaM kurvatAmakurvatAM cAtulyAyuShTvaM, tathAjAtamAtrANAmapratIkArAt pratIkArAcca, aviShaviShaprAshinAM cApyatulyAyuShTvameva, na ca tulyoyogakShema udapAnaghaTAnAM citraghaTAnAM cotsIdatAM; tasmAddhitopacAramUlaM jIvitam, atoviparyayAnmRutyuH| api ca deshakAlAtmaguNaviparItAnAM karmaNAmAhAravikArANAM ca kramopayogaH samyak, tyAgaHsarvasya cAtiyogAyogamithyAyogAnAM, sarvAtiyogasandhAraNam, asandhAraNamudIrNAnAM cagatimatAM, sAhasAnAM ca varjanam, ArogyAnuvRuttau hetumupalabhAmahe samyagupadishAmaH samyakpashyAmashceti||36||
Since, as explained in the preceding verse, life is of two kinds (daiva and purushakara) and they play their roles in the determination of the span of life, it is not desirable to debate which of these is responsible for janapadodhvansa, when a calamity occurs. We wish to explain this point with the following illustration. If the life-span in every case were predetermined, then none would be found to seek longevity by means of acts such as incantation (chanting mantra), wearing amulets, propitiation, sacrifices, offerings, oblations, regimen, atonement (prayaschitta), fasting and other purgative therapies, benedictory rites, genuflexion (the act of bending the knee in worship), pilgrimages and sacrificial rites. People would not feel the need to avoid getting excited, or anxious or protect themselves from running cows, marauding hordes of elephants, camels, donkeys, horses, buffalos, tornados and hurricanes, cataracts (large waterfall), mountains, uneven and difficult places, and strong water currents. One would not abstain from the company of men who are drunk and insane, or in fierce and unstable states or those inflicted by infatuation and greed, enemies, or raging fire. One would not be afraid of various kind of venomous reptiles and serpents, or shirk from committing rash acts, behavior that is not suited to the place and time, and acts that cause displeasure to king and the state. In short, no one would be afraid of anything if all life forms were to be of predetermined duration. Though predetermined death causes fear to those who have not made use of prophylactic measures which ward off such fear. Introductory propositions, stories, recipes and theories propounded by sages become meaningless in situations where death is predetermined. Not even Indra would have been able to kill his enemies with the help of his formidable vajra if everyone were to have pre-determined life span, and neither could the Ashwins have healed anyone with their medicines.
Why should the great sages try to obtain a pre-determined life-span? It would also not be necessary for the great sages, along with the lord of Gods (Indra), who already know all that is worth knowing, to see, to instruct and to behave properly.
Now of all type of evidences that we observe with, the eye is the best means of perception and the following is founded on visual observation. By surveying thousands of cases, we find that the length of life enjoyed by those who repeatedly engage in fighting and those who keep away is not the same. Similarly, the life-span of those whose disorders are rectified as soon as they manifest themselves and those whose disorders are not so treated the length of life enjoyed is not the same; similarly with those who take poison, and those who do not. For instance, the assurance of safety enjoyed by an earthen water pot which is subjected to wear and tear and an ornamental vase is not the same. Hence wholesome regimen is the basis of life and contrary is that of death.
One should abstain from excessive, negative and perverted use of time, actions, and senses. It is important to control emotions, not suppress natural urges (to pass bodily wastes), and avoid over-exertion. One should resort to the right and gradual habituation (and not a rapid or quick adoption) to behavior and dietetic articles which are antagonistic to the prevailing region, season and one’s own constitution. We know, and therefore we properly advise and observe the above mentioned factors for the maintenance of health. 
Timely and untimely death
परमग्निवेश उवाच- एवं सत्यनियतकालप्रमाणायुषां भगवन्! कथं कालमृत्युरकालमृत्युर्वाभवतीति||३७||
श्रूयतामग्निवेश! यथा यानसमायुक्तोऽक्षः प्रकृत्यैवाक्षगुणैरुपेतः स च सर्वगुणोपपन्नो वाह्यमानो यथाकालं स्वप्रमाणक्षयादेवावसानं गच्छेत्, तथाऽऽयुः शरीरोपगतं बलवत्प्रकृत्या यथावदुपचर्यमाणं स्वप्रमाणक्षयादेवावसानं गच्छति; स मृत्युः काले| यथा च स एवाक्षोऽतिभाराधिष्ठितत्वाद्विषमपथादपथादक्षचक्रभङ्गाद्वाह्यवाहकदोषादणिमोक्षादनुपाङ्गात् पर्यसनाच्चान्तराऽवसानमापद्यते, तथाऽऽयुरप्ययथाबलमारम्भादयथाग्न्यभ्यवहरणाद्विषमाभ्यावहरणाद्विषमशरीरन्यासादतिमैथुनासत्संश्रयादुदीर्ण- वेगविनिग्रहाद्विधार्यवेगाविधारणाद्भूतविषवाय्वग्न्युपतापादभिघातादाहारप्रतीकारविवर्जनाच्चान्तराऽसानमापद्यते, स मृत्युरकाले; तथा ज्वरादीनप्यातङ्कान्मिथ्योपचरितानकालमृत्यून् पश्याम इति||३८||
ataḥ paramagnivēśa uvāca- ēvaṁ satyaniyatakālapramāṇāyuṣāṁ bhagavan! kathaṁ kālamr̥tyurakālamr̥tyurvābhavatīti||37||
śrūyatāmagnivēśa! yathā yānasamāyuktō'kṣaḥ prakr̥tyaivākṣaguṇairupētaḥ sa ca sarvaguṇōpapannōvāhyamānō yathākālaṁ svapramāṇakṣayādēvāvasānaṁ gacchēt, tathāyuḥ śarīrōpagataṁ balavatprakr̥tyā yathāvadupacaryamāṇaṁsvapramāṇakṣayādēvāvasānaṁ gacchati; sa mr̥tyuḥ kālē| yathā ca sa ēvākṣō'tibhārādhiṣṭhitatvādviṣamapathādapathādakṣacakrabhaṅgādvāhyavāhakadōṣādaṇimōkṣādanupāṅgātparyasanāccāntarā'vasānamāpadyatē,tathāyurapyayathābalamārambhādayathāgnyabhyavaharaṇādviṣamābhyāvaharaṇādviṣamaśarīranyāsādatimaithunādasatsaṁśrayādudīrṇa-vēgavinigrahādvidhāryavēgāvidhāraṇādbhūtaviṣavāyvagnyupatāpādabhighātādāhārapratīkāravivarjanāccāntarā'vasānamāpadyatē, samr̥tyurakālē; tathā jvarādīnapyātaṅkānmithyōpacaritānakālamr̥tyūn paśyāma iti||38||
ataH paramagnivesha uvAca- evaM satyaniyatakAlapramANAyuShAM bhagavan! kathaM kAlamRutyurakAlamRutyurvAbhavatIti||37||
shrUyatAmagnivesha! yathA yAnasamAyukto~akShaH prakRutyaivAkShaguNairupetaH sa ca sarvaguNopapanno vAhyamAnoyathAkAlaM svapramANakShayAdevAvasAnaM gacchet, tathA~a~ayuH sharIropagataM balavatprakRutyA yathAvadupacaryamANaMsvapramANakShayAdevAvasAnaM gacchati; sa mRutyuH kAle| yathA ca sa evAkSho~atibhArAdhiShThitatvAdviShamapathAdapathAdakShacakrabha~ggAdvAhyavAhakadoShAdaNimokShAdanupA~ggAtparyasanAccAntarA~avasAnamApadyate,tathA~a~ayurapyayathAbalamArambhAdayathAgnyabhyavaharaNAdviShamAbhyAvaharaNAdviShamasharIranyAsAdatimaithunAdasatsaMshrayAdudIrNa-vegavinigrahAdvidhAryavegAvidhAraNAdbhUtaviShavAyvagnyupatApAdabhighAtAdAhArapratIkAravivarjanAccAntarA~avasAnamApadyate, samRutyurakAle; tathA jvarAdInapyAta~gkAnmithyopacaritAnakAlamRutyUn pashyAma iti||38||
On hearing this, Agnivesha asked, “Lord! If this is so, that the lives of men are of un-predetermined duration, then what makes for death in due time and death before time (prematurely)?”
The Lord Atreya said to him, “Listen, Agnivesha! Just as a vehicle with an axle endowed with all good qualities and driven on a good road gets destroyed only after the expiry of its normal life, similarly the life inside the body of an individual endowed with strong physique and wholesome regimen will come to an end only at the end of its normal span (according to the yuga). This is called kalamrityu (timely death). The same vehicle along with its axle may subject itself to premature destruction in the event of a heavy load, uneven road, driving in places where there is no road, breakage of the wheel, defects in the vehicle or the driver, separation of the locking hook, lack of grease or a mishap. Similarly, in the event of overstrain, eating in excess of one’s own agni(digestive power), irregular meals, irregular posture of the body, excessive indulgence in sex, company of evil or wicked, suppression of manifested natural urges, non-suppression of urges which should be controlled, affliction with evil spirits (germs), poison, wind and fire, exposure to injuries and avoidance of food and medicines, or if afflicted with diseases but not treated properly, the life of a human being comes to a premature end. This is called akala mrityu (premature death). [37-38]
The role of hot water in jwara
अथाग्निवेशः पप्रच्छ- किन्नु खलु भगवन्! ज्वरितेभ्यः पानीयमुष्णं प्रयच्छन्ति भिषजो भूयिष्ठं न तथा शीतम्, अस्ति च शीतसाध्योऽपि धातुर्ज्वरकर इति||३९||
तमुवाच भगवानात्रेयः- ज्वरितस्य कायसमुत्थानदेशकालानभिसमीक्ष्य पाचनार्थं पानीयमुष्णं प्रयच्छन्ति भिषजः| ज्वरो ह्यामाशयसमुत्थः, प्रायो भेषजानि चामाशयसमुत्थानां विकाराणां पाचनवमनापतर्पणसमर्थानि भवन्ति; पाचनार्थं च पानीयमुष्णं, तस्मादेतज्ज्वरितेभ्यः प्रयच्छन्ति भिषजो भूयिष्ठम्| तद्धि तेषां पीतं वातमनुलोमयति, अग्निं चोदर्यमुदीरयति, क्षिप्रं जरां गच्छति, श्लेष्माणं परिशोषयति, स्वल्पमपि च पीतं तृष्णाप्रशमनायोपकल्पते; तथायुक्तमपि चैतन्नात्यर्थोत्सन्नपित्ते ज्वरे सदाहभ्रमप्रलापातिसारे वा प्रदेयम्, उष्णेन हि दाहभ्रमप्रलापातिसारा भूयोऽभिवर्धन्ते, शीतेन चोपशाम्यन्तीति||४०||
athāgnivēśaḥ papraccha- kinnu khalu bhagavan! jvaritēbhyaḥ pānīyamuṣṇaṁ prayacchanti bhiṣajōbhūyiṣṭhaṁ na tathā śītam, asti ca śītasādhyō'pi dhāturjvarakara iti||39||
tamuvāca bhagavānātrēyaḥ- jvaritasya kāyasamutthānadēśakālānabhisamīkṣya pācanārthaṁpānīyamuṣṇaṁ prayacchanti bhiṣajaḥ| jvarō hyāmāśayasamutthaḥ, prāyō bhēṣajāni cāmāśayasamutthānāṁ vikārāṇāṁpācanavamanāpatarpaṇasamarthāni bhavanti; pācanārthaṁ ca pānīyamuṣṇaṁ, tasmādētajjvaritēbhyaḥprayacchanti bhiṣajō bhūyiṣṭham| taddhi tēṣāṁ pītaṁ vātamanulōmayati, agniṁ cōdaryamudīrayati, kṣipraṁ jarāṁ gacchati, ślēṣmāṇaṁpariśōṣayati, svalpamapi ca pītaṁ tr̥ṣṇāpraśamanāyōpakalpatē; tathāyuktamapicaitannātyarthōtsannapittē jvarē sadāhabhramapralāpātisārē vā pradēyam, uṣṇēna hidāhabhramapralāpātisārā bhūyō'bhivardhantē, śītēna cōpaśāmyantīti||40||
athAgniveshaH papraccha- kinnu khalu bhagavan! jvaritebhyaH pAnIyamuShNaM prayacchanti bhiShajobhUyiShThaM na tathA shItam, asti ca shItasAdhyo~api dhAturjvarakara iti||39||
tamuvAca bhagavAnAtreyaH- jvaritasya kAyasamutthAnadeshakAlAnabhisamIkShya pAcanArthaMpAnIyamuShNaM prayacchanti bhiShajaH| jvaro hyAmAshayasamutthaH, prAyo bheShajAni cAmAshayasamutthAnAM vikArANAMpAcanavamanApatarpaNasamarthAni bhavanti; pAcanArthaM ca pAnIyamuShNaM,tasmAdetajjvaritebhyaH prayacchanti bhiShajo bhUyiShTham| taddhi teShAM pItaM vAtamanulomayati, agniM codaryamudIrayati, kShipraM jarAM gacchati,shleShmANaM parishoShayati, svalpamapi ca pItaM tRuShNAprashamanAyopakalpate; tathAyuktamapicaitannAtyarthotsannapitte jvare sadAhabhramapralApAtisAre vA pradeyam, uShNena hidAhabhramapralApAtisArA bhUyo~abhivardhante, shItena copashAmyantIti||40||
Agnivesha then questioned Atreya, “Lord! Why do physicians prescribe hot water to the patients suffering from fever in preference to cold water, although one knows that the dosha (humor) which causes fevers is relieved by sheetala-dravya (cold articles)’ Lord Atreya replied, “Physicians, after assessing the patient’s constitution, etiology of the disease, place and time advise hot beverages to the patient with a view to help them with their digestion. Moreover, fever arises from amashaya (stomach) and the remedies usually used for disorders arise from the stomach with digestive, emetic and depletive properties. As hot beverages promote digestion, the physician generally prescribes them to patients suffering from fever.
Ingestion of hot beverages helps expel gas, stimulates digestive power, digests (the ingested beverage) quickly, dries up the mucus, and relieves thirst when taken even in a smaller quantity.
Nevertheless, hot drinks should not be administered in fevers which are due to exacerbation of pitta-dominant symptoms such as fevers accompanied with excessive burning sensations, giddiness, delirium, and diarrhea, since these disorders are greatly aggravated by hot measures. Such ailments require cold fomentation or cold treatments. [39-40]
भवति चात्र- शीतेनोष्णकृतान् रोगाञ्छमयन्ति भिषग्विदः| ये तु शीतकृता रोगास्तेषामुष्णं भिषग्जितम्||४१||
एवमितरेषामपि व्याधीनां निदानविपरीतं भेषजं भवति; यथा- अपतर्पणनिमित्तानां व्याधीनां नान्तरेण पूरणमस्ति शान्तिः, तथा पूरणनिमित्तानां व्याधीनां नान्तरेणापतर्पणम्||४२||
bhavati cātra- śītēnōṣṇakr̥tān rōgāñchamayanti bhiṣagvidaḥ| yē tu śītakr̥tā rōgāstēṣāmuṣṇaṁ bhiṣagjitam||41||
ēvamitarēṣāmapi vyādhīnāṁ nidānaviparītaṁ bhēṣajaṁ bhavati; yathā- apatarpaṇanimittānāṁ vyādhīnāṁnāntarēṇa pūraṇamasti śāntiḥ, tathā pūraṇanimittānāṁ vyādhīnāṁ nāntarēṇāpatarpaṇam||42||
bhavati cAtra- shItenoShNakRutAn rogA~jchamayanti bhiShagvidaH| ye tu shItakRutA rogAsteShAmuShNaM bhiShagjitam||41||
evamitareShAmapi vyAdhInAM nidAnaviparItaM bheShajaM bhavati; yathA- apatarpaNanimittAnAMvyAdhInAM nAntareNa pUraNamasti shAntiH, tathA pUraNanimittAnAM vyAdhInAMnAntareNApatarpaNam||42||
The intelligent physician treats disorders originating from heat (or hot sources) with cold measures and the disorders born of cold using hot measures. Thus, the treatment of other diseases is planned with antagonistic measures of etiological factors since there is no alleviation of the disorders caused by apatarpana without santarpana, and of those caused by santarpana without apatarpana. [41-42]
Apatarpana Chikitsa (depletion measures)
अपतर्पणमपि च त्रिविधं- लङ्घनं, लङ्घनपाचनं, दोषावसेचनं चेति||४३||
तत्र लङ्घनमल्पबलदोषाणां , लङ्घनेन ह्यग्निमारुतवृद्ध्या वातातपपरीतमिवाल्पमुदकमल्पो दोषः प्रशोषमापद्यते; लङ्घनपाचने तु मध्यबलदोषाणां, लङ्घनपाचनाभ्यां हि सूर्यसन्तापमारुताभ्यां पांशुभस्मावकिरणैरिव चानतिबहूदकं मध्यबलो दोषः प्रशोषमापद्यते; बहुदोषाणां पुनर्दोषावसेचनमेव कार्यं, न ह्यभिन्ने केदारसेतौ पल्वलाप्रसेकोऽस्ति, तद्वद्दोषावसेचनम्||४४||
दोषावसेचनमन्यद्वा भेषजं प्राप्तकालमप्यातुरस्य नैवंविधस्य कुर्यात्| तद्यथा- अनपवादप्रतीकारस्याधनस्यापरिचारकस्य वैद्यमानिनश्चण्डस्यासूयकस्य तीव्राधर्मारुचेरतिक्षीणबलमांसशोणितस्यासाध्यरोगोपहतस्य मुमूर्षुलिङ्गान्वितस्य चेति| एवंविधं ह्यातुरमुपचरन् भिषक् पापीयसाऽयशसा योगमृच्छतीति||४५||
apatarpaṇamapi ca trividhaṁ- laṅghanaṁ, laṅghanapācanaṁ, dōṣāvasēcanaṁ cēti||43||
tatra laṅghanamalpabaladōṣāṇāṁ , laṅghanēna hyagnimārutavr̥ddhyāvātātapaparītamivālpamudakamalpō dōṣaḥ praśōṣamāpadyatē; laṅghanapācanē  tumadhyabaladōṣāṇāṁ, laṅghanapācanābhyāṁ hi sūryasantāpamārutābhyāṁ pāṁśubhasmāvakiraṇairivacānatibahūdakaṁ madhyabalō dōṣaḥ praśōṣamāpadyatē; bahudōṣāṇāṁ punardōṣāvasēcanamēva kāryaṁ,na hyabhinnē kēdārasētau palvalāprasēkō'sti, tadvaddōṣāvasēcanam||44||
dōṣāvasēcanamanyadvā bhēṣajaṁ prāptakālamapyāturasya naivaṁvidhasya kuryāt| tadyathā- anapavādapratīkārasyādhanasyāparicārakasya vaidyamāninaścaṇḍasyāsūyakasyatīvrādharmārucēratikṣīṇabalamāṁsaśōṇitasyāsādhyarōgōpahatasya mumūrṣuliṅgānvitasya cēti| ēvaṁvidhaṁ hyāturamupacaran bhiṣak pāpīyasā'yaśasā yōgamr̥cchatīti||45||
apatarpaNamapi ca trividhaM- la~gghanaM, la~gghanapAcanaM, doShAvasecanaM ceti||43||
tatra la~gghanamalpabaladoShANAM  , la~gghanena hyagnimArutavRuddhyAvAtAtapaparItamivAlpamudakamalpo doShaH prashoShamApadyate; la~gghanapAcane  tumadhyabaladoShANAM, la~gghanapAcanAbhyAM hi sUryasantApamArutAbhyAMpAMshubhasmAvakiraNairiva cAnatibahUdakaM madhyabalo doShaH prashoShamApadyate;bahudoShANAM punardoShAvasecanameva kAryaM, na hyabhinne kedArasetau palvalApraseko~asti,tadvaddoShAvasecanam||44||
doShAvasecanamanyadvA bheShajaM prAptakAlamapyAturasya naivaMvidhasya kuryAt| tadyathA- anapavAdapratIkArasyAdhanasyAparicArakasya  vaidyamAninashcaNDasyAsUyakasyatIvrAdharmAruceratikShINabalamAMsashoNitasyAsAdhyarogopahatasya mumUrShuli~ggAnvitasya ceti| evaMvidhaM hyAturamupacaran bhiShak pApIyasA~ayashasA yogamRucchatIti||45||
Apatarpana (depletion) is of three kinds viz, langhana (reducing therapy), langhana pachana (reducing therapy along with therapies for digestion of ama dosha) and doshavasechana (elimination of vitiated dosha from the body). (A detailed treatment of this topic has already been provided in the Sutra Sthana section of the Charaka Samhita.)
Langhana is indicated in disorders of mild morbidity. Through this procedure, digestive fire and vata is stimulated that helps reduce alpa dosha (mild vitiation of dosha) like a small quantity of water exposed to the sun and wind dries up.
Langhana pachana is indicated in disorders of moderate morbidity. Through this combined therapy involving langhana and stimulated digestion, disorders of moderate morbidity are dried up “like a sink that is acted upon by the sun and wind on the one hand, and by a sprinkling of dust and ashes on the other”.
In disorders of severe morbidity, there is only one course available, which is the elimination of toxic dosha. There is no remedy for overflowing of a pool except for creating a breach in its field barrier.
Individuals naturally unfit for treatment
Once the state of a disease is assessed, the physician should remember that even if elimination therapies could be felt as necessary or required, other forms of depletion therapies and nourishing therapies should not be administered to such patients as those who have not been absolved of allegations against them, those who are without wealth or attendants, those who do not follow their doctors’ instructions, those who are violent, those who are jealous, those who take keen pleasure in vicious acts, those whose strength, muscle bulk, and blood have been excessively depleted, those who are suffering from incurable diseases, and those who exhibit fatal prognostic signs. By treating such patients, the physician commits sin and attracts defamation and ignominy. [43-45]
Types of land
भवति चात्र- तदात्वे चानुबन्धे वा यस्य स्यादशुभं फलम्| कर्मणस्तन्न कर्तव्यमेतद्बुद्धिमतां मतम्||४६||
(अल्पोदकद्रुमो यस्तु प्रवातः प्रचुरातपः| ज्ञेयः स जाङ्गलो देशः स्वल्परोगतमोऽपि च||४७||
प्रचुरोदकवृक्षो यो निवातो दुर्लभातपः| अनूपो बहुदोषश्च, समः साधारणो मतः)||४८||
bhavati cātra- tadātvē cānubandhē vā yasya syādaśubhaṁ phalam| karmaṇastanna kartavyamētadbuddhimatāṁ matam||46||
(alpōdakadrumō yastu pravātaḥ pracurātapaḥ| jñēyaḥ sa jāṅgalō dēśaḥ svalparōgatamō'pi ca||47||
pracurōdakavr̥kṣō yō nivātō durlabhātapaḥ| anūpō bahudōṣaśca, samaḥ sādhāraṇō mataḥ)||48||
bhavati cAtra- tadAtve cAnubandhe vA yasya syAdashubhaM phalam| karmaNastanna kartavyametadbuddhimatAM matam||46||
(alpodakadrumo yastu pravAtaH pracurAtapaH| j~jeyaH sa jA~ggalo deshaH svalparogatamo~api ca||47||
pracurodakavRukSho yo nivAto durlabhAtapaH| anUpo bahudoShashca, samaH sAdhAraNo mataH)||48||
According to the wise, one should not to resort to an action which either immediately or later results in evil or undesirable consequences. A region that sees scanty rainfall and desert vegetation is called jangala desha (arid land), and such a land is swept by high winds and abundant sunshine. It causes minimum number of diseases. That region which has abundant rainfall and luxuriant vegetation, scarcity of air and sunshine is known as anupa desha (wet land). The climate in such lands causes many dosha (bodily disorders). If the characteristics of these two varieties of desha are in balance in a land, such a place is known as sadharana desha (normal land). [47-48]
तत्र श्लोकाः- पूर्वरूपाणि सामान्या हेतवः सस्वलक्षणाः| देशोद्ध्वंसस्य भैषज्यं हेतूनां मूलमेव च||४९||
प्राग्विकारसमुत्पत्तिरायुषश्च क्षयक्रमः| मरणं प्रति भूतानां कालाकालविनिश्चयः||५०||
यथा चाकालमरणं यथायुक्तं च भेषजम्| सिद्धिं यात्यौषधं येषां न कुर्याद्येन हेतुना||५१||
तदात्रेयोऽग्निवेशाय निखिलं सर्वमुक्तवान्| देशोद्ध्वंसनिमित्तीये विमाने मुनिसत्तमः||५२||
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते विमानस्थाने जनपदोद्ध्वंसनीयविमानं नाम तृतीयोऽध्यायः||३||
tatra ślōkāḥ- pūrvarūpāṇi sāmānyā hētavaḥ sasvalakṣaṇāḥ| dēśōddhvaṁsasya bhaiṣajyaṁ hētūnāṁ mūlamēva ca||49||
prāgvikārasamutpattirāyuṣaśca kṣayakramaḥ| maraṇaṁ prati bhūtānāṁ kālākālaviniścayaḥ||50||
yathā cākālamaraṇaṁ yathāyuktaṁ ca bhēṣajam| siddhiṁ yātyauṣadhaṁ yēṣāṁ na kuryādyēna hētunā||51||
tadātrēyō'gnivēśāya nikhilaṁ sarvamuktavān| dēśōddhvaṁsanimittīyē vimānē munisattamaḥ||52||
tatra shlokAH- pUrvarUpANi sAmAnyA hetavaH sasvalakShaNAH| deshoddhvaMsasya bhaiShajyaM hetUnAM mUlameva ca||49||
prAgvikArasamutpattirAyuShashca kShayakramaH| maraNaM prati bhUtAnAM kAlAkAlavinishcayaH||50||
yathA cAkAlamaraNaM yathAyuktaM ca bheShajam| siddhiM yAtyauShadhaM yeShAM na kuryAdyena hetunA||51||
tadAtreyo~agniveshAya nikhilaM sarvamuktavAn| deshoddhvaMsanimittIye vimAne munisattamaH||52||
To sum up, premonitory signs and symptoms that precede destruction of communities, environmental factors that cause such calamities (along with their individual characteristics), remedial measures , sources of the destructive causes, origin of diseases in ancient period, the order of gradual diminution in the life-span, the determination of timely and untimely death, cause of premature death, selection of treatment to achieve success, and the reason for not treating a particular patient - all these aspects have been expounded in the form of a dialogue between Lord Atreya and Agnivesha in this chapter on janapadodhwansa (destruction of communities). Thus ends the third chapter on janapadodhwansa of the vimana section , composed by Agnivesha and redacted by Charaka. [49-52]
Tattva Vimarsha (Fundamental Principles)
- Janapadodhvansa (destruction of human settlements or communities by means of natural and man-made calamities including epidemics) occurs when collective action of communities/towns/ countries do not follow their dharma (eternal duty) in the present and/or past lives and commit acts that are unrighteous or even harmful.
- Janapadodhvansa is caused by the vitiation of four environmental factors :vayu (air), jala (water) , desha(location) and kala (season, time).
- For those who survive epidemics, the treatment includes purification therapies, drugs with effects opposite to the cause, rasayana drugs, hot water, balanced diet, fasting, etc.
- Over indulgence in food causes heaviness in body. It leads to fatigue. Fatigue gives rise to laziness, and laziness makes to accumulate things; accumulation leads to the attachment for these things and attachment results in greed. Greed gives rise to malice in its wake, malice leads to falsehood, and falsehood led to passion, anger, vanity, hatred, cruelty, aggression, fear, grief, anxiety, distress and the likely psychological disorders.
- The life span of all living beings depends on the proper coordination of two factors, namely, daiva (divine/pre-determined) and purushakara (human effort). Daiva means one’s own deeds in the previous life while purushakara stands for one’s actions (deeds) in this life”.
- Apatarpana (depletion) is of three kinds viz,langhana (reducing therapy),langhana pachana (reducing therapy along with therapies for digestion of ama dosha) and doshavasechana (elimination of vitiated dosha from the body).
- Langhana (reducing therapy) is done for mildly vitiated dosha. Langhana pachana (reducing therapy along with therapies for digestion of ama dosha) is done in moderately vitiated dosha. Doshavasechana (elimination of vitiated dosha from the body) is done in severely vitiated dosha.
Vidhi Vimarsha (Applied Inferences)
The janapadas (Sanskrit: जनपद) were the major realms, republics or kingdoms of vedic (Iron Age) India. By the 6th century BC, they were divided into sixteen classical mahajanapadas. The term janapada is a compound (or tatpurusha) term, comprising of jana (people or subjects) and pada (foot). From its earliest attestations, the word has multiple meanings, and depending upon the context, could mean a community, a realm, or a population. Janapadas could also mean gathering places of men, merchants, artisans and craftsmen akin to a marketplace or town surrounded by hamlets and villages. A janapadin is the ruler of a janapada.
Diseases in nature may manifest in the form of epidemic, endemic and pandemic. Epidemics defined as an occurrence of disease that is temporary of high prevalence or a widespread occurrence of an infectious disease in a community at a particular time. An epidemic occurring over a wide geographical area (e.g., worldwide) is called pandemic. Endemic is a state of disease or condition regularly found among particular people or in a certain area.,
Over the centuries, many epidemic diseases have wiped out huge portions of populations. From cholera and small pox to the plague (Black Death) and influenza, the wide and rapid spread of diseases has decimated population many times over the ages. [Verse 1-2]
Chakrapani interpreted the latter part of summer in the opening verses as the month of Jyeshtha , but it should be the month of Ashadha according to an analysis of the season made by Sushruta and Vagbhata.
The appearance of stars, planets, sun and moon are not similar in every season. The changes in the features of these planetary bodies characterise the impairment of seasons. For e.g., stars normally appear clear in the summer season. But if they appear as if covered with a layer of dews, then it should be taken as an indication of abnormality leading to the spread of epidemics. The statement of Lord Atreya “that the patient who desires to be treated by him and whom he desires to treat” should not be misconstrued to mean that he is prejudiced while treating his patients. The physician, however, can treat the curable conditions only. [Verse 4]
The author of Ashtangasangraha opines that characteristics of contaminated air also contain sand (dust), vapour (smoke) and poison. [6/1] He also quotes that contaminated water will be abnormal in its taste, colour etc., is deserted by birds and comes out of bad places and dried out reservoirs. [6/2] Next, according to him, a contaminated land is one that is blighted with lots of flies, rats, reptiles, and frequent natural calamities, is full of unhealthy foods, and is devoid of righteousness (people of right conduct) and potent herbs. [6/3] Finally, he concludes that vayu, jala, desha, and kala are difficult to avoid and are progressively severe and unpredictable in that order (i.e., vitiated udaka is more severe than vitiated vayu, etc). Chakrapani opines that “One can be protected from polluted air by residing in a closed chamber. Similarly, caution can be exercised while drinking polluted water. One can migrate to another land for protection from the effects of land/soil/place pollution. But one cannot guard himself against the ill effects of polluted seasons. Thus the seasons are the most important ones of the four factors, vitiation of which leads to manifestation of epidemic diseases.” [ Verse 11]
Chakrapani interprets that no medicine will be of any help to individuals whose death is predestined. People who engage in identical sinful acts (e.g., engaging themselves in burning villages) or individuals who have committed separately sinful acts if living together cannot avoid death during epidemics. The author of Ashtangasangraha furnished a 13-point formula for (or increasing the odds of) saving one’s life in janapadodhwansas- 1) celibacy, 2) forgiveness, 3) charity, 4) good conduct, 5) self-control, 6) acts of righteousness, 7) reading moral stories, 8) worship of God, sages and disciplined men, 9) living in healthy places, 10) company of good people, 11) activities which are prescribed to obtain the grace of God, 12) Panchakarma therapy and 13) Rasayana therapy. As Lord Atreya mentioned, these are all “medicines” that one takes pre-emptively to avoid suffering the consequences of a calamity. In the case of seasons with unusual features, prescribed regimen for seasons commencing with hemanta should be followed even though out of season otherwise there is a risk of being affected by the features of both cold and heat. The regimen prescribed for seasons of cold, heat and rain should also be similarly planned. In terms of following regimens, both hemanta and shishira are the same. Three kinds of climatic changes may take place unusually at certain period viz., (a) atiyoga- increase of the normal features than the usual b) ayoga- decrease of the normal features than the usual and (c) mithyayoga- appearance of features not usual for that season (features of any other season showing up). All these three are abnormal. A doubt arises here as to how are the seasonal regimen to be followed? Here, it is necessary to understand that the intensity or rigor in following a regimen depends on the degree of aberrations in the season. If there is an increase in the usual features in the season, the regimen prescribed for that season itself should be followed more intensively and in case of decrease of the usual feature it is enough to follow the same regimen mildly. In case of appearance of unusual features, it is necessary to follow the regimen of the “invading” season. For example, if the features of shishira ritu appears in grishma ritu, the regimen should be that of shishira ritu though it is actually grishma. [Verse 12-18]
When an epidemic breaks out in a region, it affects a large number of people in the community who are not similar in all respects. Such diseases are very powerful, their mode of spread is very quick and their source common. People in antiquity had recognised that such epidemics are due to use of contaminated air, water, land and season which are common to all in a community. Vagbhata opines that such abnormalities of air etc. are due to abnormal movement of planets, calamities which occur naturally in the earth, atmosphere and the sky. The cause for such natural abnormalities of air etc. is due to the (sinful) acts of the community. [ Verse 19-20]
Death occurs due to a fight with weapons. In such a fighting people of their own as well as their enemies - both succumb to death. [ Verse 21-22]
Per the verses, death occurs – in calamities –by any of the following means: (1) vyadhiprabhava (due to diseases) (2) shastraprabhava (due to weapons) (3) bhutaprabhava(due to demons/germs) (4) abhishapaprabhava (due to the curse) [ Verse 23]
Sage Vyasa described that the life span of people in satyayuga was 400 years. During kaliyuga the span of human life is one hundred years. After the passage of 1/100th time of yuga the life span of human beings is reduced by 1 year and becomes 99 years only(Chakrapani). The duration of satyayuga equals 4,800 years of the years of the demigods, tretayuga equals 3,600 years, dvaparayuga equals 2,400 years, and finally, kaliyuga is of 1,200 years of the deva (demigods). One year of the demigods is equal to 360 years of human beings. The duration of the satyayuga is therefore 4,800 x 360 or 1,728,000 years. The duration of the tretayuga is 3,600 x 360, or 1,296,000 years. The duration of the dvaparayuga is 2,400 x 360, or 864,000 years. And the last, the kaliyuga, is 1,200 x 360, or 432,000 years in total. (Srimad Bhagavatam 3.11.19)
Worldwide, the average life expectancy at birth was 67.88 years (65.71 years for males and 70.14 years for females) over the period 2005–2010 according to United Nations (World population prospects 2010 revision), and 66.57 years (64.52 years for males and 68.76 years for females) for 2009 according to The World Fact book. The average life expectancy of an Indian is 65 years according to World Health Organization (2011). [Verse 24-28]
The Ashtangasangraha, while discussing timely and untimely deaths furnished two examples i.e. chariot and lamp which are if properly maintained undergo decay in a usual way and if not well maintained meet the decay prematurely. Proper use of chariot means looking after it carefully, by repairing the broken parts immediately, putting lubricating oil to the axles, running it on good and even roads, not loading heavily etc., by improper use the chariot becomes mutilated, breaks up into pieces and become unstable, far earlier to its expected period of life. Likewise the life of a person who maintains it properly continues to exit till the prescribed period whereas the life of that person, who does not need to maintain it, becomes extinct in the middle. A lamp continues to burn till the presence of oil, wick and absence of disturbance by insects, etc., whereas it gets extinguished in the middle if the oil or wick is absent or if it is disturbed by wind or insects. So also life continues to exist for the full period in the body of the person who protects it with healthy foods and from disturbing diseases while the life of the person who spoils it with unhealthy foods and frequent diseases, ends up prematurely.
Indu, a commentator on the Charaka Samhita, states that akalamrityu or untimely death is due to actions which ripen without any fixed period of time and kalamrityu- timely death - is due to actions which ripen after certain determined period. It is only after ripening, the actions produce their effect. The time required for ripening being variable, certain things can be done during this period to alter the effects, though the effects cannot be fully removed. It is therefore important for the individual concerned about his death to adopt certain good or prescribed things while discontinuing any harmful or bad habits (ahita, unsuitable). [Verse 37-38]
The principles prescribed for the treatment of jwara (fever) is also applicable to other diseases. [Verse 42]
Diseases caused by santarpana (over nourishment) and apatarpana (depletion therapy) should be treated using antagonistic measures similar to the line of treatment of diseases caused by ushna (hot) and sheeta (cold) etiological factors. All the therapies i.e. shadupakrama (six measures) broadly divided into two categories i.e. santarpana and apatarpana. Apatarpana therapy is further subdivided into- langhana, langhana pachana and doshavasechana. Langhana and pachana are combined in the second group because pachana therapy accentuates the effect of langhana. During pachanakala, if brimhana therapy is adopted, it may lead to antagonistic effect on agni (causing agnimandhya) and prevents pachana activity. According to Chakarpani pachana therapy invariably produces the effect of langhana. Tarpana (Nourishing therapy) suppress the power of digestion and will not help in pachana of dosha.
Sinful acts committed by the patient acts as an obstruction in the way of the cure of the patient. The word vaidyamani was interpreted as the patient who is egoistic not following the instructions of the physician. While describing the chikitsa-chatuhspada (quadruplets of therapy), the qualities of the patients are described such as adhya (one who is rich), bhishag-vashyo (follower of physician’s instructions), jnapaka (possessing good memory) and satvavan (possessing good mental strength). Atreya followed these criteria for rendering treatment of any disease. [Verse 43-44-45]
Savants of India in the past observed that living beings were suffering from fatal diseases, despite practising yoga and performing all kinds of religious rites. This observation prompted them to depute sage Bhardwaja with a mission to bring Ayurveda to the planet of life. Ayurveda focuses not only on prevention of diseases, but also on providing cure of the patient’s suffering. In this system the essential aspects for supporting life are identified under three factors namely ahara (food), nidra (sleep) and brahmacharya (celibacy) often referred as trayupastambha (three supportive pillars). These factors usually play a key role in preventing the individuals from succumbing to death. Atreya propounded the concept of janpadodhvansha (destruction of communities), and forwarded his view by projecting adharmaas the main etiological factor for natural calamities and outbreak of epidemics. He also observed that sinful acts of past life as well as present life contribute for the calamities resulting in heavy death toll. Among the remedial measures three types of chikitsa (therapies) i.e yuktivyapashraya chikitsa (rational therapy) which includes shodhana therapy (purificatory measures) and rasayana; Daivavyapashraya chikitsa (divine measures like offering sacrifices and chanting mantras, wearing gems) and satwavajaya (psychotherapy) are suggested in the management of diseases of janapadodhvansavyadhi (diseases during natural calamities & epidemics). One of the important doctrines of Hindu philosophy is the belief in past, present and future lives for every living being. The actions of every life are not going to end with that life alone. Good actions give good effects, bad ones produce bad effects and both mixed together will give mixed effect. In the language of Indian philosophy the (karma) actions of past life are known as adrihsta (unseen) daiva (providential, divine) purvakrita (done previously) and prarabdha (obtained from the past). The effects of these past actions are known as vasana (covering, adherents) as these adhere to the atma (soul) and travel with him from the previous life to the next (succeeding) life.
Actions of the existing life may be classified into two categories namely daiva and purushakara. Righteous offerings and auspicious acts constitute the first category and their effect cannot be rationally explained. Administration of medicaments belongs to the second category and they produce their effects by promoting the excellence of rasa dhatu(plasma), rakta(blood) etc. The rasayana therapy would be helpful only to those persons whose span of life is not determined. For an individual having a determined span of life, such therapies are of not beneficial. [Verse 29-35]
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