Metrical Text

The man, whose complexion suddenly assumes a brown, red, blue or yellow shade, should be regarded as already gathered to his rest. The man, who has lost all sense of modesty or propriety, and whose complexion, and whose strength (ojah) and memory have suddenly undergone discolouration or extreme deterioration, should be counted with the dead. Little chance there is of the life of a patient whose lower lip hangs down while the upper one is drawn or turned up, and both of them have assumed a black colour like that of a jamboline fruit. The patient, whose teeth fall out or which have assumed a reddish or a dark brown colour, or a colour like that of a Khanjana bird (dark blue), should be reckoned as already gathered to his fathers.

* Physicians of the Ayurvedic School, however, observe a distinction between Chhaya (shade of complexion), Prabha (healthful glow of the complexion), and Varna (natural colour of the complexion) itself. The Chhaya or the shade of one's complexion may be easily distinguished as clear, rough or cool, etc. and can be detected only on a close view. The Prabha, on the other hand, is visible from a distance and admits of of being divided into seven different types, such as red, yellow, while, brown, greenish, pale, and black. The Varna or the natural colour of the complexion of a man is found to be either fair, black, dusky leaning towards the fair, according to his race and habitation. The term also includes natural modesty, look and ease.

The patient, whose tongue has become furred, swollen, or inert, or is of a black colour, should be considered as already at the gate of death. The patient, whose nose has sunk or become bent, cracked, dried, or who when breathing makes a gurgling sound through the nostrils, should be given up as lost. A patient is certainly quitting this life whose eyes appear to be contracted, or unequal, oblique, or inert, insensitive to light or touch, sunk in their sockets, or bloody, or marked by a copious lachrymation. The patient whose hair appears to have been glued to his head whose eyebrows are contracted and hang down, and whose eyelashes are listless should be considered as about to leave his mortal frame.

The patient, who is incapable of swallowing any food or of holding up his head, and who looks with a kind of fixed stare, with all memories of life fully obliterated, should be deemed as dying on that very day. A wise or prudent physician should give up the medical treatment of a patient, no matter whether strong or weak, who is found to be fainting away every time he is lifted up or seated. The patient, who constantly extends or draws up his lower extremities, or keeps them in a gathered up posture, should be looked upon as rapidly succumbing. A wise physician should abandon a patient, characterised by the coldness of his breath and extremities and a hurried and intermittent respiration, or who is found breathing with his mouth open, or lips separated.

Similarly, a patient affected with a kind of stupor or insomnia and remaining drowsy, all day long, or fainting at the least attempt of speaking, should be counted with the dead. The patient, who licks his upper lip, or is troubled with eructations, or holds conversations with the departed, should be deemed as already entered into the region of the dead. A man, spontaneously bleeding through the roots of his hairs (pores of the skin) otherwise than in a case of poisoning, should be deemed as dying on that day.

A patient, affected with an up-coursing pain about the cardiac region, like the one which distinguishes a case of Vatashtila (appearance of a stone-like lump rising or seated within the thorax and ascribed to the action of the deranged Vayu), accompanied by an aversion to food, etc., should be already reckoned among the dead.

An idiopathic swelling (Shopha) first occurring in either of the lower extremities in a male patient not as a complication of any other disease *, as well as a similar swelling first appearing at the face, or about the region of the anus in a male or a female patient, is sure to have a fatal termination.

* Such as Chlorosis, Ascites, Hoemorrhoids.

A patient, suffering from cough or asthma attended with dysentery, fever, hic-cough, vomiting and swelling of the penis and the scrotum, should be given up as lost. Excessive perspiration, burning, hic-cough, dyspnoea and hyperpyrexia with a burning sensation of the body, are undoubtedly capable of extinguishing the vital spark even in a strong patient. Similarly, a patient, with a black coated tongue and the left eye sunk in its socket and a foul smell from the mouth, should be given up as lost.

The mouth of a man, who is on his way to the mansions of the god of death, becomes filled with tears, the legs are wet with perspiration, and the pupils of the eyes roll about or become listless.

The patient, whose limbs become all of a sudden abnormally light or heavy, is sure to go to the region of the son of the day-god (Yama.) The patient, whose body emits a fishy, dirty or a fragrant smell, or smells like fat, oil, or clarified-butter, is on the way to the mansions of Death.

The patient on whose forehead lice freely move about, or whose offerings the crows do not eat, or who does not find comfort in any position or place, goes to the mansions of the god of death. A patient, who has become emaciated and enfeebled, or has been suffering from a complication of such diseases as fever, dysentery, oedema, etc., one supervening another pre-existing malady, should be deemed as beyond the pale of medicine. A ravenous hunger or an unquenchable thirst in a weak patient, who refuses to be appeased or satisfied with sweet, wholesome and palatable food or drink, should be regarded as a fatal indication. A patient exhibiting such symptoms as diarrhoea, an excruciating headache, colic in the intestines, thirst and gradual failing of strength, stands in danger of imminent death. Death is due to the transitory character of life, or it may be attributed to irregular conduct, or to the deeds of one's previous existence transformed into the dynamics of fate.

Ghosts, evil spirits, Pishachas and monsters of various shapes and denomination, constantly lead men to death. These evil spirits, owing to their natural killing propensities, nullify the efficacies of medicines; and hence it is futile to take in hand the medical treatment of a man who exhibits any of the abovesaid fatal symptoms, and thereby testifies that he has fallen into the clutches of such evil spirits.

Thus ends the Thirty-first Chapter of the Sutrasthanam in the Sushruta-Samhita which deals with prognosis from perverted features.