Chaya Vipratipatti Adhyaya (Abnormal Complexion Changes And Fatal Signs) – 31st Chapter of Sushruta Samhita

Introduction

Chaya Vipratipatti Adhyaya is the thirty-first chapter of the Sutrasthana of the Sushruta Samhita. This chapter briefly describes abnormal changes in complexion, physical appearance, behaviour, and bodily functions that Ayurveda considers important in assessing the severity and prognosis of diseases. Sushruta explains various signs and symptoms that may indicate a critical health condition and an unfavourable outcome. The chapter highlights the importance of observational changes in the patient’s overall appearance and general condition to understand the possible course of illness. It also discusses the limitations of treatment in conditions traditionally considered incurable. Overall, Chaya Vipratipatti Adhyaya provides an overview of Ayurvedic prognostic principles and emphasises the importance of careful observation and clinical judgement in understanding the patient’s condition.

Introduction To Chaya Vipratipatti Adhyaya

 अथातश्छायाविप्रतिपत्तिमध्यायं व्याख्यास्यामः , यथोवाच भगवान् धन्वन्तरिः ||

In this verse, the author introduces the chapter Chaya Vipratipatti Adhyaya of the Sushruta Samhita. Lord Dhanvantari, the revered teacher of Ayurveda, explains the changes in complexion and their significance in assessing a person’s health and identifying signs that may indicate a serious or  fatal condition.

Abnormal Complexion Changes As Signs Of Approaching Death

श्यावा लोहितिका नीला पीतिका वाऽपि मानवम् |
अभिद्रवन्ति यं छायाः स परासुरसंशयम् ||

When a person’s complexion develops unusual shades of brown , reddish, bluish, or yellowish discoloration, and these changes become distinctly apparent, they are described in Ayurveda as ominous signs that may indicate impending death.

Sudden Loss Of Vital Qualities As A Fatal Prognostic Sign

ह्रीरपक्रमते यस्य प्रभास्मृतिधृतिश्रियः। अकस्माद्यं भजन्ते वा स परासुरसंशयम्॥

When a person suddenly loses their sense of modesty, natural glow, memory, mental firmness, and prosperity, or these qualities unexpectedly abandon them, consider this a serious ominous sign associated with the approach of death.

Distinctive Lip Changes As An Ominous Prognostic Sign

यस्याधरौष्ठः पतितः क्षिप्तश्चोर्ध्वं तथोत्तरः |
उभौ वा जाम्बवाभासौ दुर्लभं तस्य जीवितम् ||

When a person’s lower lip hangs abnormally downward and the upper lip turns upward, or when both lips acquire a dark brown color like that of a jamboline fruit , the verse describes this as a grave sign indicating that survival is unlikely.

Abnormal Tooth Colour And Loosening As Signs Of A Poor Prognosis

आरक्ता दशना यस्य श्यावा वा स्युः पतन्ति च  |
खञ्जनप्रतिमा वाऽपि तं गतायुषमादिशेत् ||

If a person’s teeth become unusually red or dark, begin to fall out, or develop an appearance resembling the eyes of a wagtail bird, Ayurveda describes these changes as ominous indicators associated with the nearing end of life.

Abnormal Changes In The Tongue As A Fatal Prognostic Sign

कृष्णा स्तब्धाऽवलिप्ता वा जिह्वा शूना च यस्य वै |
कर्कशा वा भवेद्यस्य सोऽचिराद्विजहात्यसून् ||

A tongue that becomes black, rigid, coated, swollen, or unusually rough is described in this verse as a grave warning sign associated with the imminent loss of life.

Distortion And Loss Of Normal Shape Of The Nose

कुटिला स्फुटिता वाऽपि शुष्का वा यस्य नासिका |
अवस्फूर्जति मग्ना वा न स जीवति मानवः ||

If a person’s nose becomes crooked, bent ,cracked, dry, sunken, or unusually flattened, or when breathing makes a gurgling sound through nostrils ,we  consider these severe physical changes ominous signs indicating that life may soon come to an end.

Abnormal Eye Appearance As An Indicator Of Approaching Death

सङ्क्षिप्ते विषमे स्तब्धे रक्ते स्रस्ते च लोचने |
स्यातां वा प्रस्रुते यस्य स गतायुर्नरो ध्रुवम् ||

Eyes that become shrunken, unequal , rigid, blood-red, or drooping, or that continuously discharge fluid, are described as serious prognostic signs associated with impending death.

Changes In Hair, Eyebrows, And Eyelashes As Ominous Signs

केशाः सीमन्तिनो यस्य सङ्क्षिप्ते विनते भ्रुवौ |
लुण्डन्ति चाक्षिपक्ष्माणि सोऽचिराद्याति मृत्यवे ||

When a person’s hair appears to have been glued to his head , the eyebrows become contracted and droop, and the eyelashes begin to fall out, these unusual physical changes are regarded in the verse as signs of approaching death.

Loss Of Swallowing Ability And Control Over The Head

नाहरत्यन्नमास्यस्थं न धारयति यः शिरः |
एकाग्रदृष्टिर्मूढात्मा सद्यः प्राणान् जहाति सः ||

A person who cannot swallow food already present in the mouth, struggles to keep the head upright, and remains with a fixed gaze and with confused mind is described in this verse as showing grave signs associated with the imminent end of life.

Persistent Unconsciousness As A Grave Prognostic Sign

बलवान् दुर्बलो वाऽपि सम्मोहं योऽधिगच्छति |
उत्थाप्यमानो बहुशस्तं पक्वं भिषगादिशेत् ||

Whether the person is  physically strong or weak, a person who enters a state of profound confusion and cannot regain normal awareness despite repeated attempts to awaken them is considered to have reached an advanced and critical stage of illness.

Persistent Body Posture And Involuntary Limb Movements

उत्तानः सर्वदा शेते पादौ विकुरुते च यः |
विप्रसारणशीलो वा न स जीवति मानवः ||

A person who constantly lies flat on the back, repeatedly moves the feet abnormally, and shows a continuous tendency to stretch  limbs is described in this verse as displaying ominous signs associated with the approaching end of life.

Cold Extremities And Abnormal Breathing Patterns

शीतपादकरोच्छ्वासश्छिन्नोच्छ्वासश्च यो भवेत् |
काकोच्छ्वासश्च यो मर्त्यस्तं धीरः परिवर्जयेत् ||

When a person’s hands ,  feet and breath  become cold and breathing turns interrupted, irregular, or resembles the gasping pattern attributed to a crow, the verse identifies these changes as grave signs that indicate a very poor prognosis.

Disturbances Of Sleep, Wakefulness, And Mental Awareness

निद्रा न छिद्यते यस्य यो वा जागर्ति सर्वदा |
मुह्येद्वा वक्तुकामश्च प्रत्याख्येयः स जानता ||

A person who remains trapped in unresponsive sleep, insomnia , experiences mental confusion, or struggles to express themselves despite wanting to speak is described as showing serious signs that warrant recognition of the limits of treatment.

Unusual Oral Movements And Perception Of The Departed 

उत्तरौष्ठं च यो लिह्यादुत्कारांश्च करोति यः |
प्रेतैर्वा भाषते सार्धं प्रेतरूपं तमादिशेत् ||

 Frequently licking the upper lip, producing unusual frothy secretions, or speaking as though communicating with deceased individuals are described in this verse as ominous manifestations associated with the nearing end of life.

Unexplained Bleeding From Body Openings And Skin Pores

खेभ्यः सरोमकूपेभ्यो यस्य रक्तं प्रवर्तते | पुरुषस्याविषार्तस्य सद्यो जह्यात् स जीवितम् ||

When a person who has not been affected by poison begins to bleed unexpectedly from the body’s natural openings or from the roots of   hair follicles, this is described as a grave sign associated with the imminent loss of life.

Upward-Moving Vata And Severe Pain In The Cardiac Region

वाताष्ठीला तु हृदये यस्योर्ध्वमनुयायिनी | रुजान्नविद्वेषकरी स परासुरसंशयम् ||

A person who develops a hard, stone-like swelling caused by Vata in cardiac region , which moves upward and produces pain along with an aversion to food, is described as showing an ominous sign indicating that life may soon come to an end.

Location Of Swelling And Its Serious Prognostic Significance

अनन्योपद्रवकृतः शोफः पादसमुत्थितः | पुरुषं हन्ति, नारीं तु मुखजो गुह्यजो द्वयम् ||

A swelling that develops in the lower extremities in man without any other associated complication is described as fatal in a man. In a woman, swelling arising in the face, or about the region of the anus in a male or a female patient , is considered an equally grave prognostic sign in this verse.

Combined Gastrointestinal And Respiratory Symptoms

अतिसारो ज्वरो हिक्का छर्दिः शूनाण्डमेढ्रता | श्वासिनः कासिनो वाऽपि यस्य तं क्षीणमादिशेत् ||

When a person suffering from breathlessness or persistent coughing also develops diarrhoea, fever, hiccups, vomiting, and swelling of the scrotum and penis , the verse describes the condition as a sign of profound physical decline and a poor prognosis.

Severe Sweating, Burning Sensation, Hiccups, And Breathlessness

स्वेदो दाहश्च बलवान् हिक्का श्वासश्च मानवम् | बलवन्तमपि प्राणैर्वियुञ्जन्ति न संशयः ||

Excessive  sweating,  severe burning sensation, persistent hiccups, and difficulty breathing can deprive a person of life, even when that person is physically strong. This verse emphasises the seriousness of these symptoms when they occur together.

Darkening Of The Tongue And Abnormal Changes In The Eye And Mouth

श्यावा जिह्वा भवेद्यस्य सव्यं चाक्षि निमज्जति | मुखं च जायते पूति यस्य तं  परिवर्जयेत्   ||

A person whose tongue becomes black or bluish, whose left eye appears to sink inward in the socket , and whose mouth develops a foul smell is described as displaying ominous physical changes associated with an approaching end of life.

Excessive Tearing, Sweating Of The Feet, And Disturbed Eye Movements

वक्त्रमापूर्यतेऽश्रूणां स्विद्यतश्चरणावुभौ | चक्षुश्चाकुलतां याति यमराष्ट्रं गमिष्यतः ||

When a person’s face becomes filled with tears, both legs are wet with sweating , and the eyes lose their normal steadiness or coordination, these changes are described as signs associated with the final stages of life.

Sudden Changes In The Weight And Feel Of The Body

अतिमात्रं लघूनि स्युर्गात्राणि गुरुकाणि वा | यस्याकस्मात् स विज्ञेयो गन्ता वैवस्वतालयम् ||

If a person’s limbs suddenly become excessively light or  heavy without any reason, this unexpected change is described as an ominous indication of an approaching end of life.

Unusual Body Odours And Altered Perception Of Smell

पङ्कमत्स्यवसातैलघृतगन्धांश्च ये नराः | मृष्टगन्धांश्च ये वान्ति गन्तारस्ते यमालयम् ||

People who emit unusual odours resembling mud, fish, animal fat, oil, or clarified butter , or who develop unusual changes in their body’s natural fragrance, are described as showing signs associated with an approaching end of life.

Unusual Behaviour Of Lice And Crows Alongside Loss Of Desire

यूका ललाटमायान्ति बलिं नाश्नन्ति वायसाः | येषां चापि रतिर्नास्ति यातारस्ते यमालयम् ||

When lice gather on a person’s forehead, crows refuse to eat food offerings, and the person ldoesnot find comfort in any position or place  the verse interprets these occurrences as ominous signs associated with approaching death.

Progressive Physical Decline With Fever, Diarrhoea, And Swelling

ज्वरातिसारशोफाः स्युर्यस्यान्योन्यावसादिनः | प्रक्षीणबलमांसस्य नासौ शक्यश्चिकित्सितम् ||

When fever, diarrhoea, and swelling aggravate one another in a person who is emaciated and enfeebled , this  condition is described as extremely difficult to treat and associated with a grave prognosis.

Persistent Hunger And Thirst Despite Nourishment

क्षीणस्य यस्य क्षुत्तृष्णे हृद्यैर्मिष्टैर्हितैस्तथा | न शाम्यतोऽन्नपानैश्च तस्य मृत्युरुपस्थितः ||

When a severely debilitated person continues to experience intense hunger and thirst despite consuming pleasant, nourishing, and palatable  food and drinks, the verse describes this persistence as an ominous sign indicating that death may be approaching.

Severe Abdominal Symptoms and Progressive Loss of Strength

प्रवाहिका शिरःशूलं कोष्ठशूलं च दारुणम् | पिपासा बलहानिश्च तस्य मृत्युरुपस्थितः ||

When a person develops  diarrhoea , headache, severe abdominal pain, excessive thirst, and profound weakness, these combined symptoms are described as signs associated with the approaching end of life.

The Role Of Improper Treatment, Past Deeds, And The Uncertainty Of Life

विषमेणोपचारेण कर्मभिश्च पुराकृतैः | अनित्यत्वाच्च जन्तूनां जीवितं निधनं व्रजेत् ||

Life may come to an end due to inappropriate treatment, the consequences of actions performed in the past, and the inherent uncertainty of human existence. This verse reminds us that life is impermanent and that several factors may contribute to its eventual end.

Supernatural Forces Described As Approaching The Dying

प्रेता भूताः पिशाचाश्च रक्षांसि विविधानि च | मरणाभिमुखं नित्यमुपसर्पन्ति मानवम् ||

According to the traditional beliefs described in this verse, Ghosts , evil spirits, departed beings, malevolent entities, and various supernatural forces are said to approach a person who is nearing death. This reflects the ancient Ayurvedic understanding of the unseen influences believed to surround a person during the final stages of life.

The Limitations of Treatment When Life Is Near Its End

तानि भेषजवीर्याणि प्रतिघ्नन्ति जिघांसया | तस्मान्मोघाः क्रियाः सर्वा भवन्त्येव गतायुषाम् ||

The verse explains that the potency of medicines is described as opposing these harmful forces that threaten  life. However, when a person’s lifespan is considered exhausted, therapeutic interventions are portrayed as unable to change the ultimate outcome.

Conclusion of Chaya Vipratipatti Adhyaya

इति सुश्रुतसंहितायां सूत्रस्थाने छायाविप्रतिपत्तिर्नामैकत्रिंशत्तमोऽध्यायः ||

This concludes the thirty-first chapter of the Sutrasthana of the Sushruta Samhita, entitled Chaya Vipratipatti Adhyaya, which discusses   changes in complexion and other ominous signs associated with an unfavourable prognosis.