Sannipātas (fevers due to Vāta, Pitta and Kapha)

At the orders of Pāṇḍu, Galagaṇḍa brings in the army-chiefs led by Sannipātas to meet the prince.

Sannipātas^[1] are fevers caused by aggravation of Vāta, Pitta and Kapha. They pave way for undermining the health of the body. As they gain power they develop into various types of diseases such as Kuṣhṭas, Plīhas, Gulmas, Unmādas, Vraṇās, Arśas, Pramehas, Kṛcchra, Aśmarya and Atisāra (II.13):

āṣṭau kuṣṭhā daśa ca balinaḥ plīhagulmāstathāṣṭau
  ṣaṭ conmādā vasati daśakaṃ paṣcakaṃ ca vraṇānām |
ārśobhedāḥ ṣaḍatigatayo viṃśatiśca pramehāḥ
  kṛcchrāśmaryo daśa daśa punaḥ santi saptātisārāḥ ||

Their special features and how they would attack the body are presented through their dialogues–

(i) Aṣṭādaśa-kuṣṭhāḥ–

Eighteen types of Kuṣṭha-rogas (seven major and eleven minor)^[2] –Kuṣṭha is very powerful since it results from the faults of different dhātus^[3].

The Kuṣṭhas would enter into the body and will make it so unfit even to look at or even to move with by others (II.14cd):

śatroḥ praviśya puramīkṣitumapyayogyaṃ kurmo vayaṃ tanubhṛtāmatikutsanīyam ||

(ii) Plīharogā–

Four types as Vātaja-plīha, Pittaja-plīha, Kaphaja-phlīha and Raktaja-phlīha^[4].

(iii) Gulmarogā–

Also are of four types–Vātaja-gulma, Pittaja-gulma, Kaphaja-gulma and Sannipātaja-gulma.^[5]

Gulma and Plīha make the body suffer with unbearable pain (II.23ab):

āsmāsu praviśatsu śātravapuraṃ pīḍākareṣu drutaṃ
  kāryākāryaviveka eva na bhavedalpo'pi tasmin kṣaṇe |

(iv) Unmādā–

Either one doṣa or all the doṣas put together cause unmāda. Five types of unmādas are caused by mental illness; the sixth arises on being attacked by poison, says Mādhavanidāna^[6].

None can withstand the attack of Unmādas either physically or mentally; they pounce upon the target without anyone’s knowledge (II.15cd):

pāṭhīnān kamaṭhaiḥ samaṃ viluṭhataḥ sarve'nukurvantu te
  śārdūlā iva śambarān sarabhasaṃ yānadya gṛhṇīmahe ||

(v) Vraṇāḥ–

Fifteen types: arise out of the faults of rakta, kṣata and tridoṣas^[7]. Vraṇas would at first attack the body vehemently and burn it with fever (II.16 cd):

āraṇyamiva khāṇḍavaṃ ghanasaraṇyatītadrumavrajaṃ dahanahetayaḥ puramarerdahāmo vayam ||

(vi) Arśā–

Six types occur.^[8] Arśas would help Vraṇas by tightly sealing the exit gate of the body, that is the anus, thereby make the body completely under this control; the people affected by Arśas can not stand or walk or talk; they would not eat or drink or even sleep.

They make the minds ever filled with only unbearable painful sufferings (II.17):

gṛhṇīyāma vyathayitumarestatpuraṃ yena sarve
  vyāghrākṛṣṭā iva hi paśavaḥ prāṇino'smadgṛhītāḥ |
sthatuṃ gantuṃ śayitumaśituṃ pātumābhāṣituṃ vā
  nāpekṣante manasi dadhato duḥkhamātrānubhūtim ||

(vii) Prameha–

Twenty types that happen due to tridoṣas, and defects of medas.^[9]

Pramehas would completely make this city (body) which has secretions of blood, flesh, fat, bones and fluids of bone marrows go dry (II.18ab):

prasrāvākhyāṃ pariṇatimasṛṅmāṃsamedo'sthimajjāsvātanvanto vayamanudinaṃ tatpuraṃ śoṣayāmaḥ |

(viii) Kṛcchra–

Sixteen types; they create urinary problems. Generally it is caused by the defects of kṣata, puriśa, aśmarī and śukra. According to Suśruta, the mūtraghāta varieties of Kṛcchras are twelve in number, thus totalling to sixteen^[10].

(ix) Aśmarī–

Four types^[11]. Asmarīs could easily curb the body’s growth (II.19):

vardhiṣyate na yāvat sahitaḥ sarvairbhaṭairnijairvairī |
tāvannigrahaṇīyaḥ śreyaskāmena puruṣeṇa ||

(x) Atisāra–

Seven types;^[12] they achieve the death of the living beings as they would make the eye balls to fix down, make the face shrink, and make the flesh dry; thereby the rib bones become easily countable; they destroy both the mental and physical strength (II.21):

netne majjayituṃ mukhaṃ glapayituṃ jatrudvayaṃ vyaṣjituṃ
  pārśvāsthnāṃ gaṇanīyatāṃ gamayituṃ tattvaṃ bhṛśaṃ luṇṭhitum |
saptatve'pi nije sthite ghaṭayituṃ paṣcatvamevāṅgināṃ
  śaktānnaḥ prahiṇoṣi yatra tarasā tat sādhayāmo vayam ||

Besides, even though medicines made of Rasa and Gandhaka may be ready to withstand the attacks of the diseases, by unsafe

Footnotes and references:

[1]:

The commentary enumerates the thirteen Sannipātas thus (p.83):
visphāraka [visphārakaḥ], āśukārī, kampana [kampanaḥ], babhru [babhruḥ], viddhākhya [viddhākhyaḥ], phalgu [phalguḥ], kūṭapālaka [kūṭapālakaḥ], saṃmohaka [saṃmohakaḥ], pākala [pākalaḥ], yāmya [yāmyaḥ], krakaca [krakacaḥ], karkoṭaka [karkoṭakaḥ], vaidārika [vaidārikaḥ]—iti nāmataśca trayodaśavidhān sannipātaviśeṣān |

The commentary also adds that Bhāvaprakāśa gives different names (p.85):
bhāvaprakāśādiṣu dṛśyamānāni nāmāntarāṇyapi yathā—kumbhīpāka [kumbhīpākaḥ], prorṇunābha [prorṇunābhaḥ], pralāpī, āntardāha [āntardāhaḥ], daṇḍupāta [daṇḍupātaḥ], āntaka [āntakaḥ], eṇīdāha [eṇīdāhaḥ], hāridra [hāridraḥ], ājaghoṣa [ājaghoṣaḥ], bhūtahāsa [bhūtahāsaḥ], yantrapīḍa [yantrapīḍaḥ], sanyāsa [sanyāsaḥ], saṃśoṣī ceti |

[2]:

Mādhavanidāna, 53.6-7ab:
vātādayastrayo duṣṭāstvagraktaṃ māṃsamambu ca |
dūṣayanti sa kuṣṭhāni saptako dravyasaṃgrahaḥ || ātaḥ kuṣṭhāni jāyante sapta caikādaśaiva tu |

[3]:

Caraka Samhita, V.4:
na ca kiṣcidasti kuṣṭhamekadoṣaprakopanimittam |
... sa saptavidho āṣṭādaśavidho'parisaṃkhyeyavidho vā bhavati |

[4]:

See com.p.87:
vāta-pitta-kaphaistrayo raktena caika iti plīhāmayaṃ bhāvamiśrādayaścaturdhā vibhajanti |

[5]:

Loc.cit: gulmasya tu vātaja-pittaja-kaphaja-sannipātajabhedena prādhānyena caturvidhatvaṃ saṃpadyate raktajasya nātra parigaṇaneti āṣṭau iti saṃkhyāsūcanayā jṣāyate |

[6]:

Mādhavanidāna, 21.2-3 ab:
ekaikaśaḥ sarvaśaśca doṣairatyarthamūrcchitaiḥ |
mānasena ca duḥkhena sa ca paṣcavidhaḥ smṛtaḥ ||
viṣādbhavati ṣaṣṭhaśca yathāsvaṃ tatra bheṣajam |

[7]:

Śarṅgadhara Paddhati, Pūrvabhāgha, 7.71:
raktāt kṣatāt tridoṣaiśca vraṇāḥ paṣcadaśoditāḥ |

[8]:

Mādhavanidāna, 5.1:
pṛthagdoṣaiḥ samastaiśca śoṇitātsahajāni ca |
ārśāṃsi ṣaṭprakārāṇi vidyādgudavalitraye ||

[9]:

ibid., 31.4:
kaphaḥ sapittaḥ pavanaśca doṣā medo'sraśukāmbuvasālasīkāḥ |
majjārasaujaḥpiśitaṃ ca dūṣyāḥ pramehiṇāṃ viṃśatireva mehāḥ ||

[10]:

See com. p.88:
ātra kṛcchraśabdena na kevalaṃ mūtra kṛcchrarogaḥ kintu mūtrāghātaśca sūcyate |
kṣataja-purīṣajāśmarīja-śukrajamedāt kṛcchrāṇi catvāri | suśrutoktarītya mūtrāghātā dvādaśa |

[11]:

Suśruta Saṃhitā, Nidāna, 3.3:
catastro'śmaryo bhavanti śleṣmādhiṣṭhānāḥ tadyathā-śleṣmaṇā vātena pittena śukreṇa ceti ||

[12]:

trabraravragādahārāsāmahatibra, VII .7:
pṛthak tridoṣaiḥ sarvaiśca śokādāmādbhayādapi | ātīsāraḥ saptadhā syāt ... ||

[13]:

JN (II.31):
sādhito'pi sa kiṃ kuryādrasaḥ pathyakramaṃ vinā |
jihvācāpalamudbhāvya sa eva dhvaṃsayiṣyate ||

[14]:

JN (II.39):
yaccaṣcalaṃ prakṛtya viṣayeṣu mano nisargadurdāntam |
tatkāmādibhiretairbhedayituṃ śakyate śanakaiḥ ||