Sushruta Samhita Chapter 3 Adhyayana Sampradaya

This article explains Sushruta Samhita Sutrasthana Chapter 3 “Adhyayana Sampradaya” – Facilitating the study.

Sushruta performing surgery pic

Adhyayana Sampradaya

We shall now expound the chapter-adhyayana sampradaya-facilitating the study (of the treatise); as revealed by the Venerable Dhanvantari.

Contents of the chapter

Sanskrit Verses

Contents and sections of the chapter
s was stated earlier (ch.1/39) this treatise (Sushruta Samhita) consists of one hundred and twenty Adhyayas (chapters). These chapters are arranged in five sthanas (sections). The division is as mentioned below –

  • Sutra Sthana (section of doctrines) – In this section there are forty-six chapters
  • Nidana Sthana (section on diagnosis of diseases) – In this section there are sixteen chapters
  • Sharira Sthana (section on cosmology, human anatomy and physiology) – In this section there are ten chapters
  • Chikitsa Sthana (section on therapeutics) – In this section there are forty chapters
  • Kalpa Sthana (section on toxicology) – In this section there are eight chapters

Uttara Tantra (section on other diseases) – Apart from the above said one hundred and twenty chapters, there are sixty-six chapters in Utttara Tantra section which deals with other diseases not mentioned in the above-mentioned sections.
Read – Acharya Sushruta: Work, Samhita, Legacy, Amazing Facts

  1. Chapters of Sutra Sthana (section on basic principles):- 
Sl NoName of the chapterMeaning
1VedotpattiOrigin of Ayurveda
2Shishyanaya / ShishyopanayanaInitiation of the students
3Adhyayana DanikaFacilitating the study, arrangement of the text
4PrabhashaniyaNeed of interpretations
5Agrya Sangrahaniya / Agropaharaniyacollection of materials for surgical operation
6RutucharyaSeasonal Regimen
7Yantra VidhiBlunt instruments and their usage
8ShastravacharaniyaSharp instruments and their usage
9YogyasutriyaPractical training
10VishikanupraveshaniyaEntry into the profession
11Kshara Kalpana (Ksharapaka Vidhi)Preparation and usage of caustic alkalis
12Agnikarma VidhiThermal / fire cauterization
13Jalaukavacharaniya / Jalauka VidhiUse of leeches
14Raktavarnanam / ShonitavarnaniyaDiscrimination of blood
15Dosha Dhatu Mala (Kshaya Vrddhi) VijnaniyaKnowledge of Doshas, Dhatu (tissues) and Mala (excreta)
16Karna Vyadhi VidhiPuncturing the earlobe
17AmapakvaishaniyaRecognition of unripe and ripe stages of swellings
18Vranalepanabandha VidhiDressing and bandaging the wounds
19VranitopasaniyaCare of wounded persons
20HitahitiyaSuitable and unsuitable things for the patients
21Vrana prasnaKnowledge of wounds
22Vranasrava vijnaniyaKnowledge of discharges
23Krityakritya VidhiPrognosis of wounds
24Vyadhi SamuddeshiyaClassification of diseases
25Shastra Karma VidhiSurgical techniques
26Pranasta Shalya VijnaniyaRecognizing foreign bodies
27ShalyapanayaniyaRemoval of foreign bodies
28Viparitaviparita Vrana VijnaniyaGood and bad prognosis of wounds
29Viparitaviparita Duta Shakuna Svapna Nidarshaniya VijnaniyaKnowledge of good and bad messenger, omen, dreams etc
30Panchendriyartha VipratipattiFatal signs of sensory perceptions
31Chaya VipratipattiFatal signs of shadows and reflections
32Svabhava VipratipattiFatal signs in constitution
33AvaraniyaIncurable diseases, complications etc
34YuktasheniyaDuties of army physician
35AturopakramaniyaExamination of the patient
36Bhumipravibhaga VijnaniyaClassification of land regions
37Mishraka AdhyayaProperties of drugs
38Dravya SangrahaniyaGroups of drugs
39Samshodhana SamshamaniyaPurifactory and palliative drug groups
40Dravya Rasa Gunadi VijnaniyaKnowledge of properties of drugs
41Dravya Vishesa VijnaniyaClassification of drugs
42Rasa Visesa VijnaniyaProperties of tastes
43Vamana Dravya Vikalpa VijnaniyaAdministration of emetic drugs
44Virechana Dravya VikalpaAdministration of purgative drugs
45Drava Dravya VidhiKnowledge of liquid substances
46Annapana VidhiKnowledge of articles of food and drinks

 Why is this section called Sutra Sthana?
Since these forty-six chapters briefly point out the principles of the science (Ayurveda) and are arranged in a cogent / aphoristic manner so as to give a clear meaning, this section is  named as Sutra Sthana (section of Aphorisms).
Read – Understanding The Principles of Ayurveda

2. Chapters of Nidana Sthana – Section on diagnosis of diseases

Sl NoName of the chapterMeaning
1Vata Vyadhi nidanaDiagnosis of diseases produced by Vata (nervous diseases)
2Arshas NidanaDiagnosis of piles
3Ashmari NidanaDiagnosis of urinary calculus
4Bhagandara Nidana (fistula in-ano)Diagnosis of fistula-in-ano
5Kustha NidanamDiagnosis of leprosy and other skin diseases
6Prameha NidanaDiagnosis of diabetes
7Udara NidanaDiagnosis of enlargement of the abdomen
8Mudhagarbha NidanaDiagnosis of obstructed foetus
9Vidradhi NidanaDiagnosis of abscess
10Visarpadi NidanaDiagnosis of erysipelas etc
11Granthyadi NidanaDiagnosis of tumours etc
12Vriddhi NidanaDiagnosis of hernia etc
13Kshudra Roga NidanaDiagnosis of minor diseases
14Shuka Roga NidanaDiagnosis of diseases of the penis
15Bhagna nidanaDiagnosis of fractures
16Mukha Roga NidanaDiseases of the mouth (oral cavity)

Since these sixteen chapters describe the etiological factors (causes) and symptoms etc of the diseases, this section comprising these chapters is named as Nidana Sthana (Section of diagnosis / Nosology).
Read – Relationship Of Doshas With Nidana Panchakas

3. Chapters of Sharira Sthana – section on anatomy etc

Sl NoName of the chapter
1Sarvabhutachinta ShariraCosmology
2ShukrashonitashuddhiCleansing of sperm and ovum / Good and bad reproductive elements
4Garbha VyakaranaAnatomy
5Sharira Shankhya VyakaranaNumbers of structures of the body
6Marma NirdeshaDescription of vital spots / points of the body
7Shira VibhaktiDescription of veins
8Shira Vyadha VidhiProcedure of venesection (vein puncture)
9Dhamani   VyakaranaDescription of arteries / nerves
10Garbhini VyakaranaRegimen of pregnant women

These ten chapters describing the features of the human body have been included in this Sharira sthana by the sages (Lord Dhanvantari), for better understanding of the body by the physicians, as well as by yogis (who practice control of the mind for attaining salvation).

4. Chapters of Chikitsa Sthana – section on therapeutics:-

Sl NoName of the chapterMeaning
1Divraniya ChikitsitaTreatment of two kinds of wounds
2Sadyovrana ChikitsitaTreatment of traumatic wounds
3Bhagna ChikitsitaTreatment of fractures
4Vata Vyadhi ChikitsitaTreatment of diseases of Nervous System
5Maha Vyadhi Chikitsa  Treatment of great diseases
6Arsas ChikitsaTreatment of Haemorrhoids
7Ashmari ChikitsaTreatment of urinary calculus
8Bhagandara ChikitsitaTreatment of rectal fistula / fistula-in-ano
9Kustha ChikitsitaTreatment of leprosy and some other skin diseases
10Mahakushta CikitsitaTreatment of major leprosy / major skin diseases
11Prameha ChikitsaTreatment of diabetes
12Prameha Pidaka ChikitsaTreatment of diabetic eruptions / carbuncles
13Madhumeha ChikitsaTreatment of diabetes mellitus
14Udara CikitsitaTreatment of abdominal enlargement
15Mudha Garbha ChikitsaTreatment of obstructed foetus
16Vidradhi ChikitsaTreatment of abscess
17Visarpa ChikitsaTreatment of erysipelas
18Granthi ChikitsaTreatment of cystic swellings / tumour
19Vrddhi-Upadamsa ChikitsaTreatment of hernia, scrotal enlargement etc
20Kshudra Roga ChikitsaTreatment of minor disorders
21Sukadosa ChikitsaTreatment of diseases of the penis
22Mukha roga ChikitsaTreatment of diseases of the mouth
23Sophia ChikitsitaTreatment of dropsy
24Anagatabadha ChikitsaTreatment of non-manifested diseases (prevention of diseases)
25Misraka ChikitsitaTreatment of miscellaneous diseases
26Kshinabaliya VajikaranaAphrodisiac therapy for those who have lost their strength
27Sarvopaghata Shamaniya RasayanaRejuvenation therapy for pacifying (curing) all diseases
28Medhayushkamiya RasayanaRejuvenation therapy for those in need of mind wellness and strength (rejuvenation of mind)
29Svabhava vyadhi pratishedhaTreatment of natural diseases
30Nivrutta Santapiya RasayanaRejuvenation therapy for getting rid of diseases and misery
31SnehopayogikaOleation therapy
32SvedavacharaniyaSweating / Sudation therapy
33Vamana Virechana VidhiEmesis and Purgation therapies
34Vamana Virechana Vyapat  ChikitsitaManagement of complications of emesis and purgation therapies
35Basti vidhiRectal enema therapy
36Basti Vyapad  ChikitsitaManagement of complications of enema therapy
37Anuvasana Uttara Basti VidhiOil enema and urethral enema therapy
38Niruha Basti KarmaDecoction enema therapy
39Aturopadrava ChikitsaManagement of complications of purifactory therapies
40Dhuma Nasyadi VidhiInhalation of smoke and nasal medication (errhines) therapies

Prayascita, Prashamana, Cikitsa and Shanti karma are synonyms of each other and all these share common meanings also. They are also used interchangeably. Since these are defined in the chapters of this section, this section is named as ‘Cikitsa Sthana’.
Read – Ways To Improve Knowledge, Intelligence As Per Sushruta

5. Chapter of Kalpa sthana( section on toxicology)

Sl NoName of the chapterMeaning
1Annaraksha KalpaProtection of foods from poisons
2Sthvara Visha VijnaniyaKnowledge of vegetable poisons
3Jangama Visha VijnanaKnowledge of animal poisons
4Sarpa Dasta VijnaniyaKnowledge of snake bite
5Sarpa Dasta ChikitsaTreatment of snake bite
6Dundubhisvaniya KalpaMethod of detoxification of poisons
7Mushika KalpaRat bite poison
8Kita KalpaInsect bites etc

Since these (eight) chapters deal with treatment of poisons, this section is called Kalpa sthana. Thus, are described one hundred and twenty chapters.
Read – Rhinoplasty and Congenital Megacolon By Acharya Sushrutha

6. Chapters of Uttara Sthana-Last section
Further on will be described the Uttara Tantra in its own name. Since it deals mainly with upadrava (complications or secondary diseases) it (the first chapter) is also called as Aupadravika Tantra.

Sl NoName of the chapterMeaning
1Aupadravika AdhyayaKnowledge of complications Knowledge of the eye???
2Sandhigata Roga VijnanaDiseases of the joints of the eyes
3Vartma Roga VijnanaDiseases of eyelids
4Shuklagata Roga VijnanaDiseases of the sclera
5Krsnagata Roga VijnanaDiseases of the cornea
6Sarvanga Roga VijnanaDiseases of  the whole eye
7Drustigata RogaDiseases of the pupil-lens
8Chikitsita Pravibhaga VijnaniyaTreatment of eye diseases
9Vatabhishyanda PratisedhaTreatment of ophthalmia / conjunctivitis of vata origin
10Pittabhishyanda PradisedhaTreatment of ophthalmia / conjunctivitis of pitta origin
11Sleshmabhishyanda PratisedhaConjunctivitis of Kapha origin
12Raktabhisyhanda PratisedhaConjunctivitis of Rakta (blood) origin
13Lekhya Roga PratishedhaTreatment of diseases needing scarification
14Bhedya Roga PratishedhaDiseases needing puncturing
15Chedya Roga PratishedhaDiseases needing incision
16Paksma Kopa PratishedhaTreatment of diseases of eyelashes
17Drstigata Roga PratishedhaTreatment of diseases of pupil / lens
18Kriya KalpaEye therapies
19Nayanabhighata PratishedhaTreatment of injuries of the eyes
20Karnagata Roga VijnaniyaKnowledge of the diseases of the ears
21Karnagata Roga PratishedhaTreatment of diseases of the ears
22Nasagata / Ghranagata Roga VijnaniyaKnowledge of the diseases of the nose
23Nasagata / Ghranagata Roga PratishedhaTreatment of diseases of the nose
24Pratisyaya PratishedhaTreatment of Nasal Catarrh
25Siro Roga VijnaniyaKnowledge of the diseases of the head
26Siro Roga PratishedhaTreatment of the diseases of the head

These twenty-six chapters constitute Shalakya Tantra (diseases of the eyes, ears, nose, mouth and head).
Read – Eye Diseases Causes, Pathogenesis, Symptoms, Treatment, Herbs

Sl NoName of the chapterMeaning
27Navagrahakruti VijnanaKnowledge of demons / evil spirits
28Skanda Graha PratishedhaTreatment of Skanda Graha 
29Skanda Apasmara Graha PratishedhaTreatment of Skanda Apasmara Graha
30Sakuni Graha PratishedhaTreatment of Sakuni Graha
31Revati Graha PratishedhaTreatment of Revatigraha
32Putana Graha PratishedhaTreatment of Putana Graha
33Andhaputana Graha PratishedhaTreatment of Andhaputana Graha
34Sitaputana PratishedhaTreatment of Sitaputana Graha
35Mukhamandika Graha PratishedhaTreatment of Mukha Mandika Graha
36Naigamesa Graha PratishedhaTreatment of Naigamesa Graha
37GrahotpattiOrigin of demons, evil spirits
38Yoni Vyapat PratishedhaTreatment of diseases of Vagina

These twelve chapters together with those described in Sarira Sthana (the first three chapters) constitute Kumara Tantra (diseases of Children / paediatrics).

Sl NoName of the chapterMeaning
39Jvara PratishedhaTreatment of fevers
40Atisara PratishedhaTreatment of diarrhoea
41Sosa PratishedhaTreatment of consumption
42Gulma PratishedhaTreatment of abdominal tumours
43Hridroga PratishedhaTreatment of Heart Diseases
44Pandu Roga PratishedhaTreatment of Anaemia
45Raktapitta PratishedhaTreatment of bleeding disorders
46Murcha PratishedhaTreatment of fainting
47Panatyaya PratishedhaTreatment of alcoholism
48Trsna PratishedhaTreatment of thirst disease
49Chardi PratishedhaTreatment of vomiting
50Hikka PratishedhaTreatment of Hiccup
51Swasa PratishedhaTreatment of dyspnoea / breathlessness
52Kasa PratishedhaTreatment of cough
53Svarabheda PratishedhaTreatment of hoarseness of voice
54Krimi Roga PratishedhaTreatment of parasites (parasitic infestation, infections)
55Udavarta PratishedhaTreatment of reverse peristalsis
56Visucika PratishedhaTreatment of gastroenteritis
57Arocaka PratishedhaTreatment of anorexia
58Mutraghata PratishedhaTreatment of retention of urine
59Mutrakrchchra PratishedhaTreatment of dysuria

 These twenty-one chapters constitute Kaya Cikitsa (inner medicine).
Read – Shuddha Chikitsa Meaning, Importance In Clinical Practice

Sl NoName of the chapterMeaning
60Amanusopasarga PratishedhaTreatment of possession by demons
61Apasmara PratishedhaTreatment of epilepsy
62Unmada PratishedhaTreatment of insanity

These three chapters are from Bhuta vidya (demonology).
Read – Apasmara Meaning And Understanding

Sl NoName of the chapterMeaning
63Rasabheda VikalpaCombination of tastes
64SwasthavrittaRegimen for maintenance of health
65TantrayuktiLiterary techniques
66Doshabheda VikalpaCombination of doshas

 These four chapters are from Tantrabhusana (merits of the treatise).
Read – Tantra Yukti: Tools For Composing And Understanding Treatises

Why is this section is called Uttara Tantra or Pascima Tantra?
Sages have named this section as ‘Uttara Tantra’ because this section is highly meritorious and is a compilation (collection) of meanings of many branches of Ayurveda. Pascima means ending. Since this section comes at the end (last section), it is called as Uttara Tantra or Pascima Tantra.

Inclusion of Ashtangas (eight sections / branches of Ayurveda) in Sushruta Samhita
Salakya Tantra, Kumara Tantra, Kaya Cikista and Bhuta Vidya are described (present, included) in this Uttara Tantra (sixth and last section of the treatise).
Vajikarana and Rasayana are described in Chikitsa Sthana.
Visatantra is included and explained in Kalpa sthana.
Salyatantra is included everywhere in the treatise.

Thus, the treatise consists of all the Astanga (eight branches) of Ayurveda) as propounded by the Adideva (Dhanvantari). He (the physician) who studies this treatise assiduously and puts into practice faithfully, becomes a best ‘giver and protector of life’ for the patients in the world.
Read – Ashtanga Ayurveda – The Eight Branches of Ayurveda

Sanskrit Verses
Sanskrit Verses

Qualities to become a Royal Physician

This treatise must be studied essentially. After studying, it should be practised diligently. He who does (study and practice) both shall become eligible to become a royal physician.

Some verses here:-
He who knows the science only (in theory) but is not skilled in practice becomes confused when approaching the patient just like a coward in a battlefield.
He who is skilled in practice through audacity and acts apart from the dictates of science, does not get respect from the wise and deserves killing by the king.
Both these kinds of persons (physicians) are unqualified and incapable of performing their duties (satisfactorily), science they possess half knowledge of the science, like a poison; hence such persons (physicians) should be avoided.
Medicine is like nectar, but when used by the ignorant, acts like a sharp weapon, fire or poison; hence such persons(physicians)should be avoided.

He who is not well versed in oleation etc (procedure of different therapies) and in acts such as excision etc (surgical techniques) kills the people by this greed; such Vaidya (quack physicians) thrive due to the inefficiency of the king.
He who possesses good knowledge of both (theory and practice) and is intelligent, such a person (physician) only capable of achieving the aims, just like a chariot of two wheels is capable of performing all its functions in the battlefield.

Method of study

So, dear son, listen attentively to the method of study which I am going to tell you now.
After the students have become clean (by performing  morning ablutions, bath etc). having put on an upper garment (in the customary fashion) having a steady mind and sit near, the  teacher should instruct them every word, part of a verse or  a full verse, according to their ability (of grasping) and make them repeat every word, part of the verse and the complete verse many times; each student made to act similarly, himself (teacher) repeating these  later; chanting should not be very fast, not very slow, not tiresome, not in the nasal voice, not making unnecessary movements of  brows, lips and hands, in a cultured way (Manner of speaking by educated and cultured people), neither very loud, nor very low; none should be allowed to move in between (the teacher and the taught) while they are engaged in study.
Read – Hoarse Voice Causes, Ayurvedic Treatment, Home Remedies

Some verses here:-
The student who is clean (in body and mind), devoted to the teacher, efficient, devoid of laziness and sleep and studies in this manner reaches the end of the science(gains deep and wide knowledge).
He who has completed the study should strive for achieving clarity of speech, correct understanding (of the implications of the teaching), boldness, efficiency in work, constant practice and success.
This ends the Third chapter, by the name Adhyayana Sampradaya in sutra Sthana of Sushruta Samhita.

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