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The physician is the keystone in the healthcare ecosystem because of his specific knowledge, alertness to attend patients, and administrative capabilities. For example, a potter’s role in making pots is critical, and not that of soil, stick, wheel, thread etc.The qualities of a royal physician, a life saviour, and a quack are also described in the chapter. The ideal attitude of a good physician in treating a patient and important aspects about good clinical practice are described.
 
The physician is the keystone in the healthcare ecosystem because of his specific knowledge, alertness to attend patients, and administrative capabilities. For example, a potter’s role in making pots is critical, and not that of soil, stick, wheel, thread etc.The qualities of a royal physician, a life saviour, and a quack are also described in the chapter. The ideal attitude of a good physician in treating a patient and important aspects about good clinical practice are described.
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===Sanskrit text, transliteration and english translation===
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===Sanskrit text, Transliteration and English Translation===
 
   
 
   
 
अथातः खुड्डाकचतुष्पादमध्यायं व्याख्यास्यामः||१||  
 
अथातः खुड्डाकचतुष्पादमध्यायं व्याख्यास्यामः||१||  
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iti ha smAha bhagavAnAtreyaH||2||  
 
iti ha smAha bhagavAnAtreyaH||2||  
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Now (I) shall expound the Khuḍḍakacatuṣpada (chapter on four components of healthcare in brief) as propounded by Lord Atreya.[1-2]
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Now (I) shall expound the ''Khuddakachatushpada'' (chapter on four components of healthcare in brief) as propounded by Lord Atreya.[1-2]
    
==== Four components of Healthcare ====
 
==== Four components of Healthcare ====
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sukhasa~jj~jakamArogyaM, vikAro duHkhameva ca||4||  
 
sukhasa~jj~jakamArogyaM, vikAro duHkhameva ca||4||  
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Disequilibrium of dhātus is disease and their equilibrium is health. Health is termed as happiness, while disorder as unhappiness. [4]
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Disequilibrium of ''dhatus'' is disease and their equilibrium is health. Health is termed as happiness, while disorder as unhappiness. [4]
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==== Definition of chikitsa [therapeutics/management of disease] ====
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==== Definition of ''chikitsa'' (therapeutics/management of disease) ====
    
चतुर्णां भिषगादीनां शस्तानां धातुवैकृते|  
 
चतुर्णां भिषगादीनां शस्तानां धातुवैकृते|  
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pravRuttirdhAtusAmyArthA cikitsetyabhidhIyate||5||  
 
pravRuttirdhAtusAmyArthA cikitsetyabhidhIyate||5||  
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Employment of all the excellent four – physician etc. – in case of disorder of dhātu with the objective of (re-establishing) their equilibrium is called “Therapeutics”. [5]
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Employment of all the excellent four – physician etc. – in case of disorder of ''dhatu'' with the objective of (re-establishing) their equilibrium is called “Therapeutics”. [5]
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==== Qualities of the best vaidya [knowledgeable physician] ====
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==== Qualities of the best ''vaidya'' (knowledgeable physician) ====
 
   
 
   
 
श्रुते पर्यवदातत्वं बहुशो दृष्टकर्मता|  
 
श्रुते पर्यवदातत्वं बहुशो दृष्टकर्मता|  
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dAkShyaM shaucamiti j~jeyaM vaidye guNacatuShTayam||6||  
 
dAkShyaM shaucamiti j~jeyaM vaidye guNacatuShTayam||6||  
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A vaidya should possess the qualities such as proficiency in theoretical knowledge [that is learnt], extensive practical experience, dexterity and purity (of body and mind). [6]
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A ''vaidya'' should possess the qualities such as proficiency in theoretical knowledge (that is learnt), extensive practical experience, dexterity and purity (of body and mind). [6]
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==== Qualities of dravya [medicine] ====
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==== Qualities of ''dravya'' (medicine) ====
    
बहुता तत्रयोग्यत्वमनेकविधकल्पना|  
 
बहुता तत्रयोग्यत्वमनेकविधकल्पना|  
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sampacceti catuShko~ayaM dravyANAM guNa ucyate||7||  
 
sampacceti catuShko~ayaM dravyANAM guNa ucyate||7||  
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Abundance [in availability], efficacy [with good pharmacological properties], various pharmaceutical forms and intact qualities of drugs – these are four qualities of the ideal medicine. [7]
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Abundance (in availability), efficacy (with good pharmacological properties), various pharmaceutical forms and intact qualities of drugs – these are four qualities of the ideal medicine. [7]
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==== Qualities of best attendant [care taker/nursing staff] ====
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==== Qualities of best attendant (caretaker/nursing staff) ====
 
   
 
   
 
उपचारज्ञता दाक्ष्यमनुरागश्च भर्तरि|  
 
उपचारज्ञता दाक्ष्यमनुरागश्च भर्तरि|  
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shaucaM ceti catuShko~ayaM guNaH paricare jane||8||  
 
shaucaM ceti catuShko~ayaM guNaH paricare jane||8||  
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Knowledge of taking care of patient (nursing) as well as preparation, dispensing and administration of medicines and healthy recipes, dexterity, affectionate towards patient and purity of body and mind – these are four qualities of attendant. [8]
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Knowledge of taking care of patient (nursing) as well as preparation, dispensing and administration of medicines and healthy recipes, dexterity, affectionate towards patient and purity of body and mind – these are four qualities of attendant. [8]
    
==== Qualities of best patient ====
 
==== Qualities of best patient ====
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j~jApakatvaM ca rogANAmAturasya guNAH smRutAH||9||
 
j~jApakatvaM ca rogANAmAturasya guNAH smRutAH||9||
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Good memory [to remember treatment guidelines], obedience [to follow given instructions], fearlessness [courage to face adversities of disease] and ability to provide all information about the disease – these are the qualities of patient. [9]
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Good memory (to remember treatment guidelines), obedience (to follow given instructions), fearlessness (courage to face adversities of disease) and ability to provide all information about the disease – these are the qualities of patient. [9]
    
==== Importance and role of physician ====
 
==== Importance and role of physician ====
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nAvahanti guNaM vaidyAdRute pAdatrayaM tathA||13||  
 
nAvahanti guNaM vaidyAdRute pAdatrayaM tathA||13||  
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As the soil, stick, wheel, thread etc. don’t serve the purpose (of making pot) without the potter, the other three components are in the same position without the physician. [13]
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As the soil, stick, wheel, thread etc. do not serve the purpose (of making pot) without the potter, the other three components are in the same position without the physician. [13]
    
गन्धर्वपुरवन्नाशं यद्विकाराः सुदारुणाः|  
 
गन्धर्वपुरवन्नाशं यद्विकाराः सुदारुणाः|  
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sati pAdatraye j~jAj~jau bhiShajAvatra kAraNam|15|  
 
sati pAdatraye j~jAj~jau bhiShajAvatra kAraNam|15|  
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Very severe disorders vanish like the (imaginary) city of gandharvas (magician) while even the simplest of disorders aggravated, in spite of the other three components of treatment i.e.  drugs, nurse, patient (with all their qualities). Learned and ignorant physicians are responsible for the above two consequences respectively. [14-14½]
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Very severe disorders vanish like the (imaginary) city of ''gandharvas'' (magician) while even the simplest of disorders aggravated, in spite of the other three components of treatment i.e.  drugs, nurse, patient (with all their qualities). Learned and ignorant physicians are responsible for the above two consequences respectively. [14-14½]
    
वरमात्मा हुतोऽज्ञेन न चिकित्सा प्रवर्तिता||१५||  
 
वरमात्मा हुतोऽज्ञेन न चिकित्सा प्रवर्तिता||१५||  
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It is better to self-immolate than be treated by a quack, as a blind man moves groping with the help of the movement of his hand with fear, as a boat without sailors comes under the storm. The physician who has no knowledge of his area of medicine or science proceeds in the realm of therapeutic management with too much fear and lack of confidence.
 
It is better to self-immolate than be treated by a quack, as a blind man moves groping with the help of the movement of his hand with fear, as a boat without sailors comes under the storm. The physician who has no knowledge of his area of medicine or science proceeds in the realm of therapeutic management with too much fear and lack of confidence.
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Therefore never take treatment from an unknowledgeable physician. [15-16]
 
Therefore never take treatment from an unknowledgeable physician. [15-16]
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Such a person regarding himself as a physician cures by chance a patient whose lifespan is certain (who was destined to survive) but kills hundreds having uncertain lifespan. [17]
 
Such a person regarding himself as a physician cures by chance a patient whose lifespan is certain (who was destined to survive) but kills hundreds having uncertain lifespan. [17]
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==== Qualities of pranabhisara [life saviour] physician ====
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==== Qualities of ''pranabhisara'' (life saviour) physician ====
    
तस्माच्छास्त्रेऽर्थविज्ञाने प्रवृत्तौ कर्मदर्शने|  
 
तस्माच्छास्त्रेऽर्थविज्ञाने प्रवृत्तौ कर्मदर्शने|  
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bhiShak catuShTaye yuktaH prANAbhisara ucyate||18||  
 
bhiShak catuShTaye yuktaH prANAbhisara ucyate||18||  
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Hence, a physician possessing four qualities -  indulgence in scientific knowledge, clear understanding, right application, and practical experience - is known as the one who promotes life i.e. “pranabhisara”. [18]
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Hence, a physician possessing four qualities -  indulgence in scientific knowledge, clear understanding, right application, and practical experience - is known as the one who promotes life i.e. ''pranabhisara''. [18]
    
==== Qualities of a royal physician ====
 
==== Qualities of a royal physician ====
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The physician, who possesses knowledge of etiology, symptomatology, therapeutics and prevention of diseases, is the best among physicians and is fit for becoming a  royal physician. [19]
 
The physician, who possesses knowledge of etiology, symptomatology, therapeutics and prevention of diseases, is the best among physicians and is fit for becoming a  royal physician. [19]
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==== Qualities of ideal Vaidya ====
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==== Qualities of ideal ''vaidya'' ====
    
शस्त्रं शास्त्राणि सलिलं गुणदोषप्रवृत्तये|  
 
शस्त्रं शास्त्राणि सलिलं गुणदोषप्रवृत्तये|  
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sa vaidyashabdaM sadbhUtamarhan  prANisukhapradaH||23||  
 
sa vaidyashabdaM sadbhUtamarhan  prANisukhapradaH||23||  
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The merits [good effect] and demerits [bad effects] of weapons, scriptures and water depend on their user. So, physician should purify his intellect [to remove the lacunae] before treating.
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The merits (good effect) and demerits (bad effects) of weapons, scriptures and water depend on their user. So, physician should purify his intellect (to remove the lacunae) before treating.
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Learning, rationality or capacity for innovative thinking, specific scientific knowledge, memory, devotion to performing timely duties and action [clinical practice] – one who possesses these six qualities, nothing remains unachievable for him.
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Learning, rationality or capacity for innovative thinking, specific scientific knowledge, memory, devotion to performing timely duties and action (clinical practice) – one who possesses these six qualities, nothing remains unachievable for him.
Learning, wisdom, practical knowledge, experience, accomplishments, and continual guidance from eminent mentors – of these, even one quality is sufficient to add significance to the degree of ‘vaidya’. The one, who possesses all the auspicious qualities like learning etc., deserves to hold the honourable degree of ‘vaidya’ who showers happiness on all living beings. [20-23]
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Learning, wisdom, practical knowledge, experience, accomplishments, and continual guidance from eminent mentors – of these, even one quality is sufficient to add significance to the degree of ''vaidya''. The one, who possesses all the auspicious qualities like learning etc., deserves to hold the honourable degree of ''vaidya'' who showers happiness on all living beings. [20-23]
    
==== Importance of scientific studies ====
 
==== Importance of scientific studies ====