A contrariety of the natural features of any part or member of the body should be looked upon as a fatal indication. The blackness of a limb or a part which is naturally white, * or the whiteness of a black † part, or a naturally red ‡ part, or member, etc. assuming any other colour, or a hard § part becoming soft, and vice versa\\, or a movable || || part suddenly becoming fixed, and vice versa ** or the contraction (flexion) of an extended part, or the extension or expansion of a contracted (flexible; part, or a short † † part suddenly becoming elongated ‡‡, and vice versa, or a sudden hanging down of a part or member of the body which does not naturally§§ hang down, and vice versa||||, or a sudden increase or decrease of natural temperature of any part, member, or organ of the body, as well as its sudden glossiness, roughness, numbness, discolouration, weakness, or weariness, should be looked upon as fatal symptoms.

* The teeth and the cornea, † The iris. ‡The tongue and the palate, etc. § Bones, teeth, etc. || Soft parts such as the flesh, fat, etc. || || Joints, etc. ** Nose, ears and flesh, etc † †Head and forehead, etc. ‡‡ Pupils, etc. §§ Hair, nails, etc. |||| Perspiration, urine and feces, etc.

(Similarly) a limb or a part of the body, hanging down from its natural position, or becoming raised or twisted round, or cast obliquely from its natural seat, or dislocated, or protruded, or drawn inward, or suddenly becoming light or heavy without any definite or assignable cause, or a sudden eruption of a coral-coloured rash or Vyanga, should be regarded as indicating a speedy dissolution of the patient in whom they are exhibited.

Likewise, the appearance of veins in the region of the forehead, or an eruption of postules on the ridge of the nose, perspiration on the forehead in the morning, copious lachrymation without any ocular complaint, a sense of being dusted with dried and pulverised cowdung over the face, or the flying of pigeons, Kankas, etc, over one's head, or excessive micturitions or motions of the bowels from an empty stomach, or a suppression of urine or feces even after a hearty meal or draught, is fatal. So also, pain and aching about the breast and the chest, emaciation of the extremities and an oedema of the middle part of the trunk, and vice versa; or an oedema of the upper trunk and emaciation of the lower part, and vice versa; or an oedema of the left half of the bod)' and emaciation of the right, and vice versa; or hoarseness, huskiness, or loss of voice, discolouring of the teeth, nails or of the skin, eruption of white patches on the chest, etc, of the body, should be deemed as signs which forebode the approaching dissolution of an individual.

Moreover the patient, whose semen, or expectorated or fecal matter does not float on water, or who sees the distorted or bifurcated images of objects, or whose hair shines with a gloss as if anointed with oil, finds his relief in death. A weak dysentery patient with a complete aversion to food, or one who is tormented with thirst even when suffering from a cough, or a man suffering from chronic catarrh with a complete loathing for food, or from gastritis (Sula) with aphonia, and vomiting frothy blood and pus, should be regarded as past all cure. A patient, enfeebled and emaciated through fever, cough and an cedematous swelling of the face and the extremities, and showing the greatest aversion to food, and the muscles of whose calves, shoulders and thighs have grown loose and flabby, should be considered as awaiting the call of death.

A patient, suffering from fever, cough, and vomiting, or passing with the stool, in the evening, undigested food matter eaten in the morning, would die of asthma. The patient, who falls to the ground bleating like a goat, and exhibits such symptoms as a rupture of the testes, numbness of the penis, drooping of the neck and introsusception of the penis, should be considered as past all cure. The patient, whose heart is first felt dry followed by becoming covered with a slimy moisture of the whole body, as well as one who strikes a stone with a stone, or a piece of wood with a piece of wood, or who cleaves in two blades of dried grass, or one who bites his lower lip and licks the upper one, or draws his ears and tears his hair, or dishonours the gods and the Brahmanas, as well as his own physician, friends and relations, should be regarded as beyond the pale of medicine.

Similarly, a disease, due to the influence of a malignant planet occupying, either through its retrogade or zigzag movement, an inauspicious position in relation to the natal asterism of the patients, is sure to terminate in death. A man, struck by lightning or a falling meteor, baffles all medicinal skill. Similarly, a disease due to the fact of one's own house, wife, bed, seat, conveyance, or riding-animal assuming any ill-omened features, or a disease originated through the use of gems, utensils, garments, etc. of forbidden or inauspicious character usually ends in death (Aristam).

Authoritative Verses On The Subject

A disease, appearing in an enfeebled and emaciated subject and refusing to yield to a course of proper medicinal treatment, and which becomes rather aggravated by the administration of proper medicinal remedies or antidotes, necessarily portends the death of the patient.

A Mahavyadhi * (Lita deep seated disease) suddenly abating in a person in whom nourishment fails to produce any perceptible effect forebodes a fatal termination. The physician, who can detect and fully interpret these fatal indications, is honoured by the king for determining the curable or incurable nature of a disease.

* Any deep seated disease, which seriously affects the vital principles of a man, is called Mahavyadhi. Diseases such as Prameha, Vatavyadhi, Shosha, etc. have also been included within the category in the Chapter on Kaya-chikitsha. A general amelioration or recovery in these cases being natural, on account of their deep-seated character, a sudden abatement is usually fraught with fatal consequences. (Arishtam.)

Thus ends the thirty-second Chapter of Sutrasthanam in the Sushruta-Samhita which deals with the prognosis based on perversion of the natural appearances of the body.