Ashtanga Hrudaya Sutra Sthana Chapter 1: Ayushkamiyam Adhyayam (Basic Principles of Ayurveda)

The 1st chapter of Sutra Sthanam of Ashtanga Hridayam is named as Ayushkamiyam Adhyaya. This chapter deals with the Basic Principles of Ayurveda).

Prayer

रागादिरोगान् सततानुषक्तानशेषकायप्रसृतानशेषान् |
औत्सुक्यमोहारतिदाञ्जघान योऽपूर्ववैद्याय नमोस्तु तस्मै |१|
Salutations to the unique Physician, who has destroyed, without any residue all the diseases like Raga (lust, anger, greed, arrogance, jealousy, selfishness, ego), which are constantly associated with the body, which is spread all over the body, giving rise to disease, delusion and restlessness.
This salutation is done to Lord Dhanwantari.

Pledge by the author(s)

अथात आयुष्कामीयमध्यायं व्याख्यास्यामः| (गद्यसूत्रम्)||१||
इति ह स्माहुरात्रेयादयो महर्षयः| (गद्यसूत्रम्)|२|
Maharshi Atreya and the other sages pledge that henceforth they will explain the chapter named Ayushkameeyam.
The word meaning of Ayu is life; kameeyam means the quest for. Hence Ayushkameeyam means the quest for life.

Purpose of life

आयुःकामायमानेन धर्मार्थसुखसाधनम्|
आयुर्वेदोपदेशेषु विधेयः परमादरः||२||
Only if one has long life, can he achieve the below objectives of life – –
1. Dharma – righteousness,
2. Artha – earning livelihood in a legal, ethical way,
3. Kama – fulfilling our desires,
4. Moksha – achieving salvation.
To achieve the above objectives by living longer, Ayurveda is helpful. To learn the science of Ayurveda, which explains how to achieve these purposes, ‘obedience’ (Vidheya) is the most important quality.

Origin of Ayurveda

ब्रह्मा स्मृत्वाऽऽयुषो वेदं प्रजापतिमजिग्रहत्।
सोऽश्विनौ तौ सहस्राक्षं सोऽत्रिपुत्रादिकान्मुनीन्॥३॥
तेऽग्निवेशादिकांस्ते तु पृथक् तन्त्राणि तेनिरे।
Lord Brahma, remembering Ayurveda, taught it to Daksha Prajapathi. He in turn taught it to Ashwini Kumaras (Nasatya and Dasra). They taught it to Sahasraksha (Lord Indra), he taught it to Atri’s son (Atreya Punarvasu) and other sages, they taught it to Agnivesha and others and they (Agnivesa and other disciples) composed treatises, each one separately.

Ashtanga Hridaya – a concise textbook

तेभ्योऽतिविप्रकीर्णेभ्यः प्रायः सारतरोच्चयः||४||
क्रियतेऽष्टाङ्गहृदयं नातिसंक्षेपविस्तरम्|
From Ayurvedic text books that are too elaborate and hence very difficult to study, only the essence is collected and presented in Ashtanga Hridaya, which is neither too short nor too elaborate.

Ashtanga Ayurveda – Eight branches of Ayurveda

कायबालग्रहोर्ध्वाङ्गशल्यदंष्ट्राजरावृषान्||५||
अष्टावङ्गानि तस्याहुश्चिकित्सा येषु संश्रिता|
1. Kaya Chikitsa – General medicine
2. Bala Chikitsa – Paediatrics
3. Graha Chikitsa – Psychiatry
4. Urdhvanga Chikitsa – Diseases and treatment of ear, nose, throat, eyes and head (neck and above region)
5. Shalya Chikitsa – Surgery
6. Damshrta Chikitsa – Toxicology
7. Jara Chikitsa – Geriatrics
8. VrushyaChikitsa – Aphrodisiac therapy – These are the eight branches of Ayurveda.

Tridosha and their distribution

वायुः पित्तं कफश्चेति त्रयो दोषाः समासतः||६||
विकृताविकृता देहं घ्नन्ति ते वर्तयन्ति च||
ते व्यापिनोऽपि हृन्नाभ्योरधोमध्योर्ध्वसंश्रयाः||७||
Vata, Pitta and Kapha are the three Doshas of the body.
A perfect balance of three Doshas leads to health and their imbalance leads to diseases.
The Tridosha are present all over the body, but their presence is especially seen in particular parts.
If you divide the body into three parts,
The upper part up to the chest is dominated by Kapha Dosha,
The middle part between the chest and umbilicus is dominated by Pitta,
The part below the umbilicus is dominated by Vata.

Dosha predominance in the body according to Age, Time of the day and Stage of digestion

वयोहोरात्रिभुक्तानां तेऽन्तमध्यादिगाः क्रमात्|
In a person’s lifespan,
Early part is dominated by Kapha,
Middle part is dominated by Pitta,
Old age is dominated by Vata.
During the day and night (separately),
First part is dominated by Kapha,
Second part is dominated by Pitta and
Third part is dominated by Vata.
While eating and during digestion,
First part (gastric phase) is dominated by Kapha,
Second part (intestinal phase) is dominated by Pitta and
Third part (colonic phase) is dominated by Vata.

Agni Bheda – Types of Digestive fire

तैर्भवेद्विषमस्तीक्ष्णो मन्दश्चाग्निः समैः समः||८||
There are four types of Digestive fires (Agni)
1. Vishama Agni – A person with Vishama Agni will sometimes have high appetite, and sometimes, low appetite.
2. Teekshna Agni – A person with Teeksna Agni will have high digestion strength and appetite.
3. Manda Agni – A person with Manda Agni will have low digestion power and appetite.
4. Sama Agni – A person with Sama Agni will have proper appetite and digestion power. Here, digestion occurs at an appropriate time.

Koshta Bheda – Types of bowel / digestive tract

कोष्ठः क्रूरो मृदुर्मध्यो मध्यः स्यात्तैः समैरपि|
There are three types of bowels (Koshta)
1. Kroora Koshta – hard bowels
2. Mrudu Koshta – soft bowels
3. Madhyama Koshta –normal bowels.

Deha Prakriti – Body type

शुक्रार्तवस्थैर्जन्मादौ विषेणेव विषक्रिमेः||९||
तैश्च तिस्रः प्रकृतयो हीनमध्योत्तमाः पृथक्|
समधातुः समस्तासु श्रेष्ठा निन्द्या द्विदोषजाः||१०||
Like the Visha (poison) is natural and inherent to poisonous insects, similarly, the Prakruti (body type) is inherent to humans. The body type is inherited during conception, based on qualities of shukra (sperm) and arthava (ovum).
Vata prakruti – Vata body type is considered as low quality
Pitta Prakruti – Pitta body type is considered as moderate quality
Kapha Prakruti – Kapha body type is considered good quality.
Tridosha Prakruti – Body type influenced equally by Vata, Pitta and Kapha is considered the best quality.
Dual Dosha Prakritis, like Vata-Pitta, Pitta-Kapha, Vata-Kapha body types are not considered good.

Vata Dosha Lakshana – Characteristics of Vata Dosha

तत्र रूक्षो लघुः शीतः खरः सूक्ष्मश्चलोऽनिलः|
Rooksha – dryness,
Laghu – lightness,
Sheeta – coldness,
Khara – roughness,
Sookshma – minuteness,
Chala – movement are the qualities of Vata Dosha.

Pitta Dosha Lakshana – Characteristics of Pitta Dosha

पित्तं सस्नेहतीक्ष्णोष्णं लघु विस्रं सरं द्रवम्||११||
Sasneha – slightly oily, unctuous,
Teekshna – piercing, entering into deep tissues,
Ushna – hotness,
Laghu – lightness,
Visram – bad smell,
Sara – fluidity, movement,
Drava – liquidity are the qualities of Pitta Dosha.

Kapha Dosha Lakshana – Characteristics of Kapha Dosha

स्निग्धः शीतो गुरुर्मन्दः श्लक्ष्णो मृत्स्नः स्थिरः कफः|
Snigdha – oily, unctuous,
Sheeta – cold,
Guru – heavy,
Manda – mild, viscous,
Shlakshna – smooth, clear,
Mrutsna – slimy, jelly-like,
Sthira – stability, immobility are the qualities of Kapha Dosha.

Samsarga and Sannipata

संसर्गः सन्निपातश्च तद्द्वित्रिक्षयकोपतः||१२||
The imbalance (increase/decrease) of two Doshas together is called Samsarga. Imbalance of all the three Doshas together is called Sannipata.

Dhatu and Mala – Body tissues and excretory products

रसासृङ्मांसमेदोऽस्थिमज्जशुक्राणि धातवः|
सप्त दूष्याः मला मूत्रशकृत्स्वेदादयोऽपि च||१३||
Body tissues and waste products are called Dushyas (Those that are influenced and affected by Doshas).

Sapta Dhatu – Seven body tissues

Rasa – Lymph or plasma
Rakta -Blood
Mamsa – Muscle
Meda – Fat tissue
Asthi – Bones and cartilages
Majja – Bone marrow
Shukra – Semen / Ovum or entire male and female reproductive tract and its secretions

Tri Mala – Three waste products of the body

Shakrut / Pureesha (faeces),
Sweda (sweat) and
Mootra (urine) constitute the Tri Mala (three waste products of the body).

Status of Tridosha and health

वृद्धिः समानैः सर्वेषां विपरीतैर्विपर्ययः|
Samana means similar or equal; Viparita means opposite.
Equal qualities lead to increase, and opposing qualities lead to decrease.

Shad Rasa – Six Tastes

रसाः स्वाद्वम्ललवणतिक्तोषणकषायकाः||१४||
षड् द्रव्यमाश्रितास्ते च यथापूर्वंबलावहाः|
There are 6 types of tastes (Rasa).
Svadu / Madhura – sweet,
Amla – Sour,
Lavana – Salt,
Tikta – Bitter,
Ushna / Katu – Pungent,
Kashaya – Astringent.
They are successively lower in energy. It means sweet taste imparts maximum energy to the body and astringent, the least.

Alleviation of Dosha According to Taste

तत्राद्या मारुतं घ्नन्ति त्रयस्तिक्तादयः कफम्||१५||
कषायतिक्तमधुराः पित्तमन्ये तु कुर्वते|
शमनं कोपनं स्वस्थहितं द्रव्यमिति त्रिधा||१६||
In the list of tastes, the first three, i.e., Madhura (sweet), Amla (sour) and Lavana (salt) mitigate Vata and increase Kapha.
The last three, i.e., Tikta (bitter), Katu (pungent) and Kashaya (astringent) tastes mitigate Kapha and increase Vata.
Kashaya (astringent), Tikta (bitter) and Madhura (sweet) tastes mitigate Pitta.
Amla (sour), Lavana (salt) and Katu (pungent) tastes increase Pitta.

Dravya Bheda – Types of Substance:
Shamana – that which allays –A substance that brings down the increased Dosha to normalcy
Kopana – that which aggravates -A substance that aggravates Dosha, dhatu (tissues) or mala (waste products)
Swasthahita – A substance that maintains the normalcy of Tridosha and health.

Two types of Virya (Potency)

उष्णशीतगुणोत्कर्षात्तत्र वीर्यं द्विधा स्मृतम्|
Ushna veerya – Hot potency
Sheeta veerya – Cold potency

Three types of Vipaka (Taste conversion after digestion)

त्रिधा विपाको द्रव्यस्य स्वाद्वम्लकटुकात्मकः||१७||
Swadu (Madhura) Vipaka – Sweet taste conversion after digestion
Amla Vipaka– Sour taste conversion after digestion
Katu Vipaka – Pungent taste conversion after digestion.

Gurvadi Guna – Attributes or Qualities

गुरुमन्दहिमस्निग्धश्लक्ष्णसान्द्रमृदुस्थिराः|
गुणाः ससूक्ष्मविशदा विंशतिः सविपर्ययाः||१८||

The twenty types of gunas (qualities) –
Guru (heavy) X laghu (light)
Manda (slow) X tiksna (sharp, deep penetrating)
Hima (cold) X ushna (hot)
Snigdha (unctuous) X ruksa (dry)
Slaksna (smooth) X khara (rough)
Sandra (solid) X drava (liquid)
Mrdu (soft) X kathina (hard)
Sthira (stable) X cala (moving, unstable)
Suksma (minute, small) X sthula (big)
Vishada (clarity, non slimy) X picchila (slimy, sticky, coating)

Roga Arogya Karana – Cause of Disease and Health

कालार्थकर्मणां योगो हीनमिथ्यातिमात्रकः|
सम्यग्योगश्च विज्ञेयो रोगारोग्यैककारणम्||१९||
Hina (less), ati (more) or mithya (wrong) unison of Kala (time), Artha (senses) and Karma (functions) is the reason for diseases and the right unison of these three factors is the reason for health.

Disease and health

रोगास्तु दोषवैषम्यं, दोषसाम्यमरोगता|
Imbalance in Tridosha leads to Roga (disease).
Samya (perfect balance) of Dosha is health.

Roga Bheda – Types of Disease

निजागन्तुविभागेन तत्र रोगा द्विधा स्मृताः||२०||
The two types of diseases:
Nija roga – Disease caused due to imbalance in internal factors.
Agantu Roga – Disease caused due to external factors.

Roga Bheda According to Adhishtana(Disease classification according to location)

तेषां कायमनोभेदादधिष्ठानमपि द्विधा|
Based on Adhishtana (location), the doshas are of two types i.e.,
Kaya / sharirika dosha (Vata, Pitta and Kapha)
Mano dosha (psychic doshas)

Types of Mano (psychic) Doshas

रजस्तमश्च मनसो द्वौ च दोषावुदाहृतौ||२१||
There are two types of Mano Doshas –
Rajas – quality of mind that drives us to actions and attractions
Tamas – that leads to inaction, darkness, and lethargy.

Rogi and Roga Pariksha

दर्शनस्पर्शनप्रश्नैः परीक्षेत च रोगिणम्|
रोगं निदानप्राग्रूपलक्षणोपशयाप्तिभिः||२२||
Methods of Rogi Pariksha (Examination of patient) –
Darshana – by inspection, observation
Sparshana – by touching, percussion, palpation,
Prashna – by interrogation

Methods of Roga Pariksha (Examination of the disease) –
Disease should be examined by its –
Nidana – causes, etiology
Pragrupa – Purvarupa – prodromal symptoms, premonitory symptoms
Lakshana – specific signs and symptoms, clinical features
Upashaya – pacifying and aggravating factors of symptoms
Apti – Samprapti – pathogenesis of the disease.

Desha Bheda – Types of Habitat

भूमिदेहप्रभेदेन देशमाहुरिह द्विधा|
जाङ्गलं वातभूयिष्ठमनूपं तु कफोल्बणम्||२३||
साधारणं सममलं त्रिधा भूदेशमादिशेत्|
In the context of medicine, Desha is said to be of two kinds –
Bhumi desha – region of land and
Deha desha – the body.
Bhumi desha (region) is of three kinds –
Jangala (arid or desert-like land) – which is predominant of Vata
Anupa (marshy land) – which is predominant of Kapha
Sadharana (land with moderate water, vegetation, sunlight) – which has all Tridosha in balance.

Kala Bheda – Types of time

क्षणादिर्व्याध्यवस्था च कालो भेषजयोगकृत्||२४||
Two kinds are considered –
Kshanadi kala – Normal time, beginning with seconds (Kshana).
Vyadhi Avastha Kala – Stages of disease.

Aushadha Bheda – Classification of Medicine

शोधनं शमनं चेति समासादौषधं द्विधा |
There are two types of medicines –
Shamana – Palliative treatment – which brings the Dosha to normalcy (useful in initial stages of diseases)
Shodhana – Purification treatment – which expels imbalanced Dosha out of body (useful in aggravated stages of the disease.

Main therapies and ingredient for Doshas

शरीरजानां दोषाणां क्रमेण परमौषधम्||२५||
बस्तिर्विरेको वमनं तथा तैलं घृतं मधु|
For diseases of the body, under Shodhana (purification) regimen,
For Vata – Basti (enema)
For Pitta – Virechana (purgation)
For Kapha – Vamana (emesis).
For diseases of the body, under Shamana (palliative) regimen,
For Vata – Taila (oil)
For Pitta – Ghrita (ghee)
For Kapha – Madhu (honey).

Treatment for Mano Dosha (Dosha pertaining to the psyche)

धीधैर्यात्मादिविज्ञानं मनोदोषौषधं परम्||२६||
Dhee – improving intelligence
Dhairya – improving courage and
Atmavijnana – Self realization – are the means to treat mental imbalance.

Chikitsa Chatushpada – Four limbs / pillars of treatment

भिषक् द्रव्याण्युपस्थाता रोगी पादचतुष्टयम्|
चिकित्सितस्य निर्दिष्टं, प्रत्येकं तच्चतुर्गुणम्||२७||
Bhishak (Doctor), Dravya (Medicine), Upasthata (Nurse) and Rogi (Patient) are the four factors in treatment. Each of these has four qualities.

Qualities of Bhishak (doctor)

दक्षस्तीर्थात्तशास्त्रार्थो दृष्टकर्मा शुचिर्भिषक्|
Daksha – Alert, disciplined, able
Tirthatthashastrartha – Having detailed knowledge of science (about diseases and treatment)
Drushtakarma – Having practical experience
Shuchi – Cleanliness

Qualities of Dravya / Aushada (medicine)

बहुकल्पं बहुगुणं सम्पन्नं योग्यमौषधम्||२८||
Bahukalpa – Ability to formulate into different dosage forms, like decoction, powder, herbal oil etc.
Bahuguna – Having enormous qualities
Sampanna – Endowed with virtues
Yogya – Suitable and appropriate for specific diseases.

Qualities of Upasthata / Paricharaka (nurse)

अनुरक्तः शुचिर्दक्षो बुद्धिमान् परिचारकः|
Anurakta – Compassion towards patients
Shuchi – Cleanliness
Daksha – Alert, active
Buddhiman – Intelligence

Qualities of Rogi (patient)

आढ्यो रोगी भिषग्वश्यो ज्ञापकः सत्त्ववानपि||२९||
Adhya – Rich
Bhishagvashya – Obedience towards doctor
Jnapaka – Having good memory
Satvavaan – Having good strength to tolerate disease and treatment.

Vyadhi Bheda based on Sadhyasadhyata (Disease classification based on prognosis)

साध्योऽसाध्य इति व्याधिर्द्विधा, तौ तु पुनर्द्विधा|
सुसाध्यः कृच्छ्रसाध्यश्च, याप्यो यश्चानुपक्रमः॥२९+(१)॥
There are two types of diseases, which are further divided into two each –
1.Sadhya – Thatwhich can be cured.
It is of two types –
ⅰ. Sukha Sadhya (Easily curable),
ⅱ. Krichra Sadhya (Cured with difficulty)
2.Asadhya – That which cannot be cured.
It is of two types –
ⅰ. Yapya (which cannot be cured but can be managed),
ⅱ. Anupakrama (Incurable).

Qualities of Sukha Sadhya Vyadhi – easily curable disease

सर्वौषधक्षमे देहे यूनः पुंसो जितात्मनः|
अमर्मगोऽल्पहेत्वग्ररूपरूपोऽनुपद्रवः||३०||
अतुल्यदूष्यदेशर्तुप्रकृतिः पादसम्पदि|
ग्रहेष्वनुगुणेऽष्वेकदोषमार्गो नवः सुखः||३१||

Qualities of Sukha Sadhya Vyadhi – easily curable disease:
Sarvaushadhakshame dehe – The body of the patient is able to tolerate all types of medicines
Yunaha – Young patient
Pumsa – Male patient
Jitatmanaha – Patient having good control over sense organs, who follows abstinence
Amarmaga – If the disease has not affected sensitive areas like brain, heart, kidney
Alpahetu – If the cause for disease is mild
Alparoopa – Mild symptoms
Anupadrava – no complications
Atulya dushya desha rutu prakruti – If the Dosha and Dhatu (body tissue) involved, Desha (place), Rutu (season) and Prakruti (body type) are not influenced by one particular Dosha,
Pada sampadi – If all the sixteen qualities of the doctor, patient etc. explained above are present
Graha anuguna – If astrology is in favour of the patient
Eka Doshaja – Disease due to only one Dosha
Eka Marga – If only one body channel is affected
Nava – Disease of recent origin / onset.

Qualities of Krichra Sadhya Vyadhi – Diseases which are cured with difficulty

शस्त्रादिसाधनः कृच्छ्रः सङ्करे च ततो गदः|
Diseases which require the use of surgical instruments etc. in treatment and also those which have a mixture of factors enumerated in previous verses are krichra sadhya (curable with difficulty).

Qualities of Yapya Vyadhi – Diseases which are manageable

शेषत्वादायुषो याप्यः पथ्याभ्यासाद्विपर्यये||३२||
A disease is Yapya (manageable) if, although its presentation is opposite to Sukha Sadhya lakshanas, the patient can be managed with Pathya – diet, activities and medicine.

Qualities of Anupakrama Vyadhi – Diseases which are not curable

अनुपक्रम एव स्यात्स्थितोऽत्यन्तविपर्यये|
औत्सुक्यमोहारतिकृद् दृष्टरिष्टोऽक्षनाशनः||३३||
Diseases which have features entirely opposite to those of curable diseases, which have stayed for long periods of time, involving all the important tissues and vital organs, which have produced anxiety (fear of death), delusion and restlessness; which are presenting with fatal signs and which causes damage to sense organs are impossible to cure.

Patient worth rejection

त्यजेदार्तं भिषग्भूपैर्द्विष्टं तेषां द्विषं द्विषम्|
हीनोपकरणं व्यग्रमविधेयं गतायुषम्||३४||
चण्डं शोकातुरं भीरुं कृतघ्नं वैद्यमानिनम्|
The physician should reject the patient –
who is hated by the physician and the king and who hates them;
who hates himself (dejected in life), who is not having the equipments and other facilities required for treatment,
who is busy with other activities,
who is not having the required attention etc. towards the treatment,
who is disobedient (to the physician),
whose life is coming to an end,
who has an evil mindset (violent, destructive),
who is afflicted with great grief,
who is full of fear,
who is ungrateful and
who thinks himself to be a physician (in respect of deciding drugs, therapies, food, activities etc.)

Adhyaya Sangraha – List of Chapters

तन्त्रस्यास्य परं चातो वक्ष्यतेऽध्यायसङ्ग्रहः||३५||
The list of other Adhyayas (chapters) explained in Ashtanga Hridaya are

Sutra Sthana

आयुष्कामदिनर्त्वीहारोगानुत्पादनद्रवाः|
अन्नज्ञानान्नसंरक्षामात्राद्रव्यरसाश्रयाः||३६||
दोषादिज्ञानतद्भेदतच्चिकित्साद्युपक्रमाः|
शुद्ध्यादिस्नेहनस्वेदरेकास्थापननावनम्||३७||
धूमगण्डूषदृक्सेकतृप्तियन्त्रकशस्त्रकम्|
शिराविधिः शल्यविधिः शस्त्रक्षाराग्निकर्मिकौ||३८||
सूत्रस्थानमिमेऽध्यायास्त्रिंशत्शारीरमुच्यते|
The list of chapters explained in Sutra Sthana –
1. Ayuskamiyaadhyaya (desire for long life). 2. Dinacaryaadhyaya (daily regimen).
3. Rtucaryaadhyaya (seasonal regimen). 4. Roganutpadaniyaadhyaya (prevention of diseases).
5. Dravadravyavijnaniyaadhyaya (knowledge of liquid materials).
6. Annasvarupavijnaniyaadhyaya (nature of food materials).
7. Annaraksadhyaya (Protection of foods). 8. Matrasitiyadhyaya (Proper quantity of food).
9. Dravyadivijnaniyaadhyaya (Knowledge of substances etc.).
10. Rasabhediyaadhyaya (classification of tastes).
11. Dosadivijnaniyaadhyaya (Knowledge of dosas etc.).
12. Dosabhediyaadhyaya (classification of dosas).
13. Dosopakramaniyaadhyaya (treatment of the dosas).
14. Dvividhopakramaniyaadhyaya (two kinds of treatments).
15. Sodhanadiganasangrahaadhyaya (groups of drugs for purificatory therapies etc.).
16. Sneha vidhiadhyaya (oleation therapy). 17. Svedavidhiadhyaya (sudation therapy).
18. Vamana virecanavidhiadhyaya (emesis and purgation therapies).
19. Basti vidhiadhyaya (enema therapy). 20. Nasya vidhiadhyaya (nasal medication).
21. Dhumapanavidhiadhyaya (inhalation of smoke therapy).
22. Gandusadividhiadhyaya (mouth gargles and other therapies).
23. Ascyotana-anjanavidhiadhyaya (eye drops, collyrium therapies).
24. Tarpana-putapakavidhiadhyaya (satiating the eye and other therapies).
25. Yantra vidhiadhyaya (use of blunt instruments).
26. Sastra vidhiadhyaya (use of sharp instruments).
27. Siravyadhavidhiadhyaya (venesection).
28. Salyaharanavidhiadhyaya (removal of foreign bodies).
29. Sastrakarmavidhiadhyaya (surgical operation).
30. Ksaragnikarmavidhiadhyaya (alkaline and thermal cautery)

Sharira Sthana

गर्भावक्रान्तितद्व्यापदङ्गमर्मविभागिकम्||३९||
विकृतिर्दूतजं षष्ठम्
The list of chapters explained in Sharira Sthana –
1. Garbhavakrantisarira (embryology). 2. Garbhavyapadsarira (disorders of pregnancy).
3. Anga vibhaga sarira (different parts of the body). 4. Marma vibhaga sarira (classification of vital spots). 5. Vikruti vijnaniyasarira (knowledge of bad prognosis).
6. Dutadivijnaniyasarira (knowledge of messenger etc.)

Nidana Sthana

निदानं सार्वरोगिकम्|
ज्वरासृक्श्वासयक्ष्मादिमदाद्यर्शोतिसारिणाम्||४०||
मूत्राघातप्रमेहाणां विद्रध्याद्युदरस्य च|
पाण्डुकुष्ठानिलार्तानां वातास्रस्य च षोडश||४१||
The list of chapters explained in Nidana Sthana–
1. Sarvroganidanam (diagnosis of diseases in general).
2. Jvaranidanam (diagnosis of fever).
3. Raktapitta, Kasa nidanam (diagnosis of bleeding disease and cough).
4. Svasa-Hidhmanidanam (diagnosis of dyspnoea and hiccup).
5. Rajayaksmadinidanam (diagnosis of pulmonary tuberculosis etc.).
6. Madatyayanidanam (diagnosis of alcoholic intoxication).
7. Arsasnidanam (diagnosis of haemorrhoids).
8. Atisara-Grahani nidanam (diagnosis of diarrhoea and duodenal disorders).
9. Mutraghatanidanam (diagnosis of retention of urine).
10. Prameha nidanam (diagnosis of diabetes).
11. Vidradhi-Vrddhi-Gulma nidanam (diagnosis of abscess, enlargement of the scrotum and abdominal
tumour).
12. Udara nidanam (diagnosis of enlargement of the abdomen).
13. Panduroga-sopha-visarpa nidanam (diagnosis of anaemia, dropsy and herpes).
14. Kustha-svitra-kriminidanam (diagnosis of leprosy, leucoderma and parasites).
15. Vata vyadhi nidanam (diagnosis of diseases of the nervous system).
16. Vatasonitanidanam (diagnosis of gout).

Chikitsa Sthana

चिकित्सितं ज्वरे रक्ते कासे श्वासे च यक्ष्मणि|
वमौ मदात्ययेऽर्शःसु, विशि द्वौ, द्वौ च मूत्रिते||४२||
विद्रधौ गुल्मजठरपाण्डुशोफविसर्पिषु|
कुष्ठश्वित्रानिलव्याधिवातास्रेषु चिकित्सितम्||४३||
द्वाविंशतिरिमेऽध्यायाः
The list of chapters explained in Chikitsa Sthana –
1. Jvara cikitsita (treatment of fevers). 2. Raktapitta cikitsita (treatment of bleeding disease).
3. Kasa cikitsita (treatment of cough). 4. Svasa-Hidhma cikitsita (treatment of dyspnoea and hiccup).
5. Rajayaksmadi cikitsita (treatment of pulmonary tuberculosis, etc.).
6. Chardi-Hrdroga-Trsna cikitsita (treatment of vomiting, heart disease and thirst).
7. Madatyaya cikitsita (treatment of alcoholic intoxication). 8. Arsascikitsita (treatment of haemorrhoids). 9. Atisara cikitsita (treatment of diarrhoea).
10. Grahani dosa cikitsita (treatment of duodenal disorder). 11. Mutraghata cikitsita (treatment of retention of urine). 12. Prameha cikitsita (treatment of diabetes). 13. Vidradhi-vrddhi cikitsita (treatment of abscess, enlargement of the scrotum). 14. Gulma cikitsita (treatment of abdominal tumour). 15. Udara cikitsita (treatment of enlargement of the abdomen). 16. Pandu roga cikitsita (treatment of anaemia). 17. Svayathu (sopha) cikitsita (treatment of dropsy). 18. Visarpa cikitsita (treatment of herpes). 19. Kustha cikitsita (treatment of leprosy). 20. Svitra-krimicikitsita (treatment of leucoderma and parasites). 21. Vata vyadhi cikitsita (treatment of diseases of the nervous system). 22. Vatasonita cikitsita (treatment of gout).

KalpaSiddhi Sthana

कल्पसिद्धिरतः परम्|
कल्पो वमेर्विरेकस्य तत्सिद्धिर्बस्तिकल्पना||४४||
सिद्धिर्बस्त्यापदां षष्ठो द्रव्यकल्पोऽत|
The list of chapters explained in Kalpa – Siddhi Sthana –
1. Vamana kalpa (emetic recipes). 2. Virecanakalpa (purgative recipes).
3. Vamana virecana vyapat siddhi (management of complications of emesis and purgation therapies). 4. Basti kalpa (enema recipes). 5. Basti vyapat siddhi (management of complications of enema therapy). 6. Dravya-kalpa (pharmaceutics).

Uttara Sthana

उत्तरम्| बालोपचारे तद्व्याधौ तद्ग्रहे, द्वौ च भूतगे||४५||
जन्मादेऽथ स्मृतिभ्रंशे, द्वौ द्वौ वर्त्मसु सन्धिषु|
दृक्तमोलिङ्गनाशेषु त्रयो, द्वौ द्वौ च सर्वगे||४६||
कर्णनासामुखशिरोव्रणे, भङ्गे भगन्दरे|
ग्रन्थ्यादौ क्षुद्ररोगेषु गुह्यरोगे पृथग्द्वयम्||४७||
विषे भुजङ्गे कीटेषु मूषकेषु रसायने|
चत्वारिंशोऽनपत्यानामध्यायो बीजपोषणः||४८||
The list of chapters explained in Uttara Sthana –
1. Balopacaraniyaadhyaya (care of the new born baby). 2. Balamayapratisedha (treatment of diseases of children). 3. Balagrahapratisedha (treatment of evil spirits). 4. Bhuta vijnaniya (knowledge of demons). 5. Bhuta pratisedha (treatment of demons). 6. Unmada pratisedha (treatment of insanity).
7. Apasmara pratisedha (treatment of epilepsy). 8. Vartma roga vijnaniya (knowledge of diseases of eyelids). 9. Vartma roga pratsedha (treatment of diseases of eyelids). 10. Sandhisitasita roga vijnaniya (knowledge of diseases of fornices, sclera and cornea). 11. Sandhisitasita roga pratisedha (treatment of diseases of fornices, sclera and cornea). 12. Drsti roga vijnaniya (knowledge of diseases of vision). 13. Timira pratisedha (treatment of blindness). 14. Linganasa pratisedha (treatment of blindness). 15. Sarvaksi roga vijnaniya (knowledge of diseases of the whole eye).
16. Sarvaksi roga pratisedha (treatment of diseases of the whole eye). 17. Karna roga vijnaniya (knowledge of diseases of the ear). 18. Karna roga pratisedha (treatment of diseases of the ear).
19. Nasa roga vijnaniya (knowledge of diseases of the nose). 20. Nasa roga pratisedha (treatment of diseases of the nose). 21. Mukha roga vijnaniya (knowledge of the diseases of the mouth). 22. Mukha roga pratisedha (treatment of diseases of the mouth). 23. Siro roga vijnaniya (knowledge of the diseases of the head). 24. Siro roga pratisedha (treatment of diseases of the head). 25. Vrana pratisedha (treatment of ulcers). 26. Sadyovrana pratisedha (treatment of traumatic wounds). 27. Bhanga pratisedha (treatment of fractures). 28. Bhagandara pratisedha (treatment of rectal fistula).
29. Granthi-arbuda-slipada-apaci-nadi vijnaniya (knowledge of tumours, cancers, filariasis, scrofula and sinus ulcer). 30. Granthyadipratisedha (treatment of tumours etc.). 31. Kshudra roga vijnaniya (knowledge of minor diseases). 32. Kshudra roga pratisedha (treatment of minor diseases). 33. Guhya roga vijnaniya (knowledge of diseases of genital organs). 34. Guhya roga pratisedha (treatment of diseases of genital organs). 35. Visa pratisedha (treatment of poisoning). 36. Sarpa visa pratisedha (treatment of snake bite poison). 37. Kitalutadi visa pratisedha (treatment of poison of insects, spiders etc.). 38. Musika-alarka visa pratisedha (treatment of mouse poison, rabid dog etc.). 39. Rasayana vidhi (rejuvenation therapy). 40. Vajikarana vidhi (aphrodisiac therapy).

इत्यध्यायशतं विंशं षड्भिः स्थानैरुदीरितम् ॥४८॥
Thus enlisted are the 120 chapters under 6 titles.

इति श्रीवैद्यपतिसिंहगुप्तसूनुवाग्भटविरचितायामष्टाङ्गहृदयसंहितायां सूत्रस्थाने आयुष्कामीयो नाम प्रथमोऽध्यायः||१||
Thus ends the chapter called Ayushkamiyam, the first in Sutrasthana of Astanga Hrudaya composed by SrimadVaghata, son of Sri Vaidyapati Simhagupta.