Charaka Janapadoddhvamsaniyam Vimana: 3rd Chapter: Epidemic Diseases

The 3rd chapter of Charaka Samhitha Vimana sthana is Janapadoddhvamsaneeya Vimanam. It deals with the determination of the specific characteristics of epidemics. 

अथातो जनपदोद्ध्वंसनीयं विमानं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athāto janapadoddhvaṃsanīyaṃ vimānaṃ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātreyaḥ||2||
We shall explore the chapter on the “Determination of the specific Characteristic of Epidemic disorders”. Thus said Lord Atreya [1-2]

जनपद मण्डले पञ्चाल क्षेत्रे द्विजातिवराध्युषिते काम्पिल्य राजधान्यां भगवान् पुनर्वसुरात्रेयोऽन्तेवासिगणपरिवृतः पश्चिमे घर्ममासे गङ्गा तीरे वन विचारमनुविचरञ्छिष्यमग्निवेशमब्रवीत्||३||
Janapada maṇḍale pañcāla kṣetre dvijātivarādhyuṣite kāmpilya rājadhānyāṃ bhagavān punarvasurātreyo’ntevāsigaṇaparivṛtaḥ paścime gharmamāse gaṅgā tīre vana vicāramanuvicarañchiṣyamagniveśamabravīt||3||

In Kampilya (modern Kampil of Farokhabad District in Uttar Pradesh), the capital city of the country called Panchala, which was inhabited by the high class people, Atreya was residing with his disciples. He was taking a stroll in the woods near the bank of the Ganga during the month of Jyestha (approximately May -June). He then, started speaking to his disciple Agnivesha. [3]

Collection of herbs before the onset of epidemics:
दृश्यन्ते हि खलु सौम्य! नक्षत्र ग्रह गण चन्द्र सूर्यानिलानलानां दिशां चाप्रकृतिभूतानामृतुवैकारिका भावाः, अचिरादितो भूरपि च न यथावद्रसवीर्य विपाक प्रभावमोषधीनां प्रतिविधास्यति, तद्वियोगाच्चातङ्कप्रायता नियता|
तस्मात् प्रागुद्ध्वंसात् प्राक् च भूमेर्विरसीभावादुद्धरध्वं सौम्य! भैषज्यानि यावन्नोपहत रस वीर्य विपाक प्रभावाणि भवन्ति|
वयं चैषां रस वीर्य विपाक प्रभावानुपयोक्ष्यामहे ये चास्माननुकाङ्क्षन्ति, यांश्च वयमनुकाङ्क्षामः|
dṛśyante hi khalu saumya! nakṣatra graha gaṇa candra sūryānilānalānāṃ diśāṃ cāprakṛtibhūtānāmṛtuvaikārikā bhāvāḥ, acirādito bhūrapi ca na yathāvadrasavīrya vipāka prabhāvamoṣadhīnāṃ pratividhāsyati, tadviyogāccātaṅkaprāyatā niyatā|
tasmāt prāguddhvaṃsāt prāk ca bhūmervirasībhāvāduddharadhvaṃ saumya! bhaiṣajyāni yāvannopahata rasa vīrya vipāka prabhāvāṇi bhavanti| vayaṃ caiṣāṃ rasa vīrya vipāka prabhāvānupayokṣyāmahe ye cāsmānanukāṅkṣanti, yāṃśca vayamanukāṅkṣāmaḥ|

O! Agnivesha, some abnormalities are now appearing in the stars, planets, moon, sun, air, fire and Disha (directions). This forecasts abnormality in the coming seasons, very soon, the earth will cease to manifest proper tastes, Veerya, Vipaka and Prabhava. This is bound to result in the wide-spread manifestation of diseases”

Therefore, O! Agnivesha, all of you should collect herbs before the time of destruction and before the earth loses its fertility, leading to the impairments of Rasa, Veerya, Vipaka and Prabhava.

Administration of herbs during epidemic disease:
न हि सम्यगुद्धृतेषु सौम्य! भैषज्येषु सम्यग्विहितेषु सम्यक् चावचारितेषु जनपदोद्ध्वंसकराणां विकाराणां किञ्चित् प्रतीकारगौरवं भवति||४||
na hi samyaguddhṛteṣu saumya! bhaiṣajyeṣu samyagvihiteṣu samyak cāvacāriteṣu janapadoddhvaṃsakarāṇāṃ vikārāṇāṃ kiñcit pratīkāragauravaṃ bhavati||4||

We shall administer these herbs with proper taste, potency, vipaka, and Prabhava to treat diseases. It is not difficult to treat epidemic diseases, provided the herbs are collected, preserved and administered properly. [4]

Query about onset of epidemic disease:
एवंवादिनं भगवन्तमात्रेयमग्निवेश उवाच- उद्धृतानि खलु भगवन्! भैषज्यानि, सम्यग्विहितानि, सम्यगवचारितानि च; अपि तु खलु जनपदोद्ध्वंसनमेकेनैव व्याधिना युगपद समान प्रकृत्याहार देह बल सात्म्य सत्त्व वयसां मनुष्याणां कस्माद्भवतीति||५||
evaṃvādinaṃ bhagavantamātreyamagniveśa uvāca- uddhṛtāni khalu bhagavan! bhaiṣajyāni, samyagvihitāni, samyagavacāritāni ca; api tu khalu janapadoddhvaṃsanamekenaiva vyādhinā yugapada samāna prakṛtyāhāra deha bala sātmya sattva vayasāṃ manuṣyāṇāṃ kasmādbhavatīti||5||

Agnivesha asked Lord Atreya, “O! Lord, herbs will soon be collected, preserved and administered properly. How is it that people having dissimilar nature, diet, physical strength, congeniality, mental faculties and age, simultaneously get afflicted by the same epidemic disease? [5]

Factors responsible for epidemics: Janapadodhwamsakara Bhava: 
तमुवाच भगवानात्रेयः- एवमसामान्यावतामप्येभिरग्निवेश! प्रकृत्यादिभिर्भावैर्मनुष्याणां येऽन्ये भावाः सामान्यास्तद्वैगुण्यात् समानकालाः समानलिङ्गाश्च व्याधयोऽभिनिर्वर्तमाना जनपदमुद्ध्वंसयन्ति|
ते तु खल्विमे भावाः सामान्या जनपदेषु भवन्ति; तद्यथा- वायुः, उदकं, देशः, काल इति||६||
tamuvāca bhagavānātreyaḥ- evamasāmānyāvatāmapyebhiragniveśa! prakṛtyādibhirbhāvairmanuṣyāṇāṃ ye’nye bhāvāḥ sāmānyāstadvaiguṇyāt samānakālāḥ samānaliṅgāśca vyādhayo’bhinirvartamānā janapadamuddhvaṃsayanti|
te tu khalvime bhāvāḥ sāmānyā janapadeṣu bhavanti; tadyathā- vāyuḥ, udakaṃ, deśaḥ, kāla iti||6||

Lord Atreya replied, “Agnivesha! Though there is dissimilarity in the physical constitution of human beings, there are such factors as are common to all individuals. They are – air, water, location and seasons. (Vayu, Udaka, Desha and Kala). and vitiation of these factors leads to the simultaneous manifestations of diseases having the same set of symptoms leaving to the destruction of a country. [6]

Characteristics of pollution of air, water, land and time:
तत्र वातमेवंविधमनारोग्यकरं विद्यात्; तद्यथा-यथर्तुविषममति स्तिमितमतिचलमतिपरुषमतिशीतमत्युष्णमतिरूक्षमत्यभिष्यन्दिनमतिभैरवारावमतिप्रतिहत- परस्परगतिमतिकुण्डलिनमसात्म्यगन्धबाष्पसिकतापांशुधूमोपहतमिति (१);
tatra vātam evaṃ vidham anārogyakaraṃ vidyāt; tadyathā-yathartu viṣamam atistimitam aticalam atiparuṣam atiśītam atyuṣṇam atirūkṣam atyabhiṣyandinam atibhairavārāvamatipratihata- paraspara gatim atikuṇḍalinam asātmyagandha bāṣpasikatāpāṃśudhūmopahatamiti (1);

Air with following characteristics is injurious to health:
Atistimitam aticalam – Excessive calmness or violent blows
Atiparuṣam atiśītam atyuṣṇam atirūkṣam atyabhiṣyandinam – Excessive dryness, cold, hot air, roughness or humidity
Atibhairavārāvamatipratihata – excessive clashes among each other (wind blowing from one direction clashing with the one from the other)
Paraspara gatim atikuṇḍalinam – excessively cyclonic in nature and
Asātmyagandha bāṣpasikatāpāṃśudhūmopahatamiti – association with unwholesome smell, gases, sand, ashes and smoke

Water that can cause endemic diseases:
उदकं तु खल्वत्यर्थ विकृत गन्ध वर्ण रस स्पर्शं क्लेद बहुलमपक्रान्त जलचर विहङ्गमुपक्षीण जलेशयमप्रीतिकरमपगतगुणं विद्यात् (२);
udakaṃ tu khalvatyartha vikṛta gandha varṇa rasa sparśaṃ kleda bahulamapakrānta jalacara vihaṅgamupakṣīṇa jaleśayamaprītikaramapagataguṇaṃ vidyāt (2);

Water having the following characteristics is considered to devoid of its normal attributes
Vikṛta gandha varṇa rasa sparśaṃ – abnormal smell, color, taste and touch
Kleda – excessive stickiness
Bahulamapakrānta jalacara vihaṅgamupakṣīṇa – absence of aquatic birds
Jaleśayam aprītikaram apagataguṇaṃ vidyāt – reduction in the number of aquatic animals and
aprītikaram apagataguṇaṃ – unpleasantness.
polluted water

Land that can cause endemic diseases:
देशं पुनः प्रकृति विकृत वर्ण गन्ध रस स्पर्शं क्लेद बहुलमुपसृष्टं सरीसृपव्यालमशकशलभ मक्षिका मूषकोलूकश्माशानिकशकुनिजम्बूकादिभिस्तृणोलूपोपवनवन्तं प्रतानादिबहुलमपूर्ववदवपतितशुष्कनष्टशस्यं धूम्रपवनं प्रध्मातपतत्रिगणमुत्क्रुष्टश्वगणमुद्भ्रान्तव्यथित विविध मृग पक्षि सङ्घ मुत्सृष्ट नष्ट धर्म सत्य लज्जाचार शील गुण जनपदं शश्वत्क्षुभितोदीर्ण सलिलाशयं प्रततोल्कापातनिर्घात भूमि कम्पमतिभयारावरूपं रूक्ष ताम्रारुण सिताभ्रजालसंवृतार्कचन्द्र तारकमभीक्ष्णं ससम्भ्रमोद्वेगमिव सत्रासरुदितमिव सतमस्कमिव गुह्यकाचरितमिवाक्रन्दितशब्द बहुलं चाहितं विद्यात् (३);
deśaṃ punaḥ prakṛti vikṛta varṇa gandha rasa sparśaṃ kleda bahulamupasṛṣṭaṃ sarīsṛpavyālamaśakaśalabha makṣikā mūṣakolūkaśmāśānikaśakunijambūkādibhistṛṇolūpopavanavantaṃ pratānādibahulamapūrvavadavapatitaśuṣkanaṣṭaśasyaṃ dhūmrapavanaṃ pradhmātapatatrigaṇamutkruṣṭaśvagaṇamudbhrāntavyathitavividhamṛgapakṣisaṅghamutsṛṣṭanaṣṭadharmasatyalajjācāraśīlaguṇajanapadaṃ śaśvatkṣubhitodīrṇasalilāśayaṃ pratatolkāpātanirghātabhūmikampamatibhayārāvarūpaṃ rūkṣatāmrāruṇasitābhrajālasaṃvṛtārkacandratārakamabhīkṣṇaṃ sasambhramodvegamiva satrāsaruditamiva satamaskamiva guhyakācaritamivākranditaśabdabahulaṃ cāhitaṃ vidyāt (3);

Land having the following characteristics is considered to be harmful:
Prakṛti vikṛta varṇa gandha rasa sparśaṃ – Abnormal color, smell, taste and touch
Kleda bahulam – Excessive stickiness
Abundance of serpents, wild animals, mosquitoes, locusts, flies, rats, owls, vulture and jackal
Pratānādi bahulam – Having  excess of grass and weeds
Apūrvavadavapatita – Abundance of excessively branched creepers
Having a novel look
śuṣkanaṣṭaśasyaṃ – withered, dried
Dhūmrapavanaṃ – Abundance of smoke in the wind;
Presence of wild cries of birds and dogs
Bewilderment and pain in animals and birds.
polluted city

Time having following characteristics is considered to be harmful:
कालं तु खलु यथर्तुलिङ्गाद्विपरीतलिङ्गमतिलिङ्गं हीनलिङ्गं चाहितं व्यवस्येत् (४);
kālaṃ tu khalu yathartuliṅgādviparītaliṅgamatiliṅgaṃ hīnaliṅgaṃ cāhitaṃ vyavasyet (4);
Perversion or absence of religion, truth, modesty, manners, conducts and other qualities of the inhabitants of the land
Constant agitation and over-flow of water reservoirs
Frequent occurrence of meteorites, thunderbolts and earth quakes
Fierce look and cries in the nature
Appearances of roughness and coppery, red and white colored sun, moon and stars; their appearance as if they are covered with a net of clouds
Confusion, excitement; apprehension, lamentation and darkness and darkness in the atmosphere and
Presence of excessive crying noise as if the country is seized by demons
Manifestation of the characteristic features contrary to the normal conditions of the various seasons is considered to be harmful.

इमानेवन्दोषयुक्तांश्चतुरो भावाञ्जनपदोद्ध्वंसकरान् वदन्ति कुशलाः; अतोऽन्यथाभूतांस्तु हितानाचक्षते||७||
imānevandoṣayuktāṃścaturo bhāvāñjanapadoddhvaṃsakarān vadanti kuśalāḥ; ato’nyathābhūtāṃstu hitānācakṣate||7||
The above mentioned four factors along with their respective features of vitiation are considered by the wise to be responsible for the destruction by epidemic diseases. When these factors are having qualities opposite to above, they are useful for human beings.

Importance of treatment:
विगुणेष्वपि खल्वेतेषु जनपदोद्ध्वंसकरेषु भावेषु भेषजेनोपपाद्यमानानामभयं भवति रोगेभ्य इति||८||
viguṇeṣvapi khalveteṣu janapadoddhvaṃsakareṣu bhāveṣu bheṣajenopapādyamānānāmabhayaṃ bhavati rogebhya iti||8||
During the impairment of these Janapadodhwamsakara Bhavas (factors), if proper medicine administration is done, one need not be afraid of diseases.  [7-8]

Most dangerous factor – Janapadodhwamsa kara Bhava:
भवन्ति चात्र-
वैगुण्यमुपपन्नानां देशकालानिलाम्भसाम्|
गरीयस्त्वं विशेषेण हेतुमत् सम्प्रवक्ष्यते||९||
वाताज्जलं जलाद्देशं देशात् कालं स्वभावतः|
विद्याद्दुष्परिहार्यत्वाद्गरीयस्तरमर्थवित् ||१०||
वाय्वादिषु यथोक्तानां दोषाणां तु विशेषवित्|
प्रतीकारस्य सौकर्ये विद्याल्लाघवलक्षणम्||११||
bhavanti cātra-
vaiguṇyamupapannānāṃ deśakālānilāmbhasām|
garīyastvaṃ viśeṣeṇa hetumat sampravakṣyate||9||
vātājjalaṃ jalāddeśaṃ deśāt kālaṃ svabhāvataḥ|
vidyādduṣparihāryatvādgarīyastaramarthavit ||10||
vāyvādiṣu yathoktānāṃ doṣāṇāṃ tu viśeṣavit|
pratīkārasya saukarye vidyāllāghavalakṣaṇam||11||

Thus it is said: – We shall now explain the vitiation of land, season, air and water in the order of their importance.
Impairment of Vata, Jala, Desha and Kala are more lethal in their increasing order.  (Kala impairment is most dangerous).
A specialist should know that, it is easier to correct the vitiation of air, water and land, than those of Kala. [9-11]

Line of treatment of epidemic diseases:
चतुर्ष्वपि तु दुष्टेषु कालान्तेषु यदा नराः|
भेषजेनोपपाद्यन्ते न भवन्त्यातुरास्तदा||१२||
caturṣvapi tu duṣṭeṣu kālānteṣu yadā narāḥ|
bheṣajenopapādyante na bhavantyāturāstadā||12||
One does not suffer from these disease even while all these 4 vitiated factors (vitiated air, water, place and time) are at work if he is administered with medicines and treatment.

Panchakarma:
येषां न मृत्युसामान्यं सामान्यं न च कर्मणाम्|
कर्म पञ्चविधं तेषां भेषजं परमुच्यते||१३||
yeṣāṃ na mṛtyusāmānyaṃ sāmānyaṃ na ca karmaṇām|
karma pañcavidhaṃ teṣāṃ bheṣajaṃ paramucyate||13||
For those who are afflicted with these 4 factors, Panchakarma is the best treatment for them.

Rasayana therapy:
रसायनानां विधिवच्चोपयोगः प्रशस्यते|
शस्यते देहवृत्तिश्च भेषजैः पूर्वमुद्धृतैः||१४||
rasāyanānāṃ vidhivaccopayogaḥ praśasyate|
śasyate dehavṛttiśca bheṣajaiḥ pūrvamuddhṛtaiḥ||14||
Proper Rasayana therapy done with medicines that are collected before onset of epidemic disease restores physical health.

सत्यं भूते दया दानं बलयो देवतार्चनम्|
सद्धृत्तस्यानुवृत्तिश्च प्रशमो गुप्तिरात्मनः||१५||
satyaṃ bhūte dayā dānaṃ balayo devatārcanam|
saddhṛttasyānuvṛttiśca praśamo guptirātmanaḥ||15||
Truthfulness,
Bhoote Daya – compassion for living beings,
Dana – donation, charity,
Bali – scarifies,
Devatarchana – prayer to the gods,
Sadvrutta – good deeds,
adoption of preventive measures, tranquility, protection of the self by Mantra etc are very effective.

हितं जनपदानां च शिवानामुपसेवनम्|
सेवनं ब्रह्मचर्यस्य तथैव ब्रह्मचारिणाम्||१६||
hitaṃ janapadānāṃ ca śivānāmupasevanam|
sevanaṃ brahmacaryasya tathaiva brahmacāriṇām||16||
Devotion towards God, residence in auspicious localities, observance of Brahmacharya, service to those observing Brahmacharya is told as a remedy.
Read more about Brahmacharya – Celibacy

सङ्कथा धर्मशास्त्राणां महर्षीणां जितात्मनाम्|
धार्मिकैः सात्त्विकैर्नित्यं सहास्या वृद्धसम्मतैः||१७||
saṅkathā dharmaśāstrāṇāṃ maharṣīṇāṃ jitātmanām|
dhārmikaiḥ sāttvikairnityaṃ sahāsyā vṛddhasammataiḥ||17||
Discussion on religious scriptures, befriending great sages, who have self- control, who follow religion, who are Satvika and who are learned people.

इत्येतद्भेषजं प्रोक्तमायुषः परिपालनम्|
येषामनियतो मृत्युस्तस्मिन् काले सुदारुणे||१८||
ityetadbheṣajaṃ proktamāyuṣaḥ paripālanam|
yeṣāmaniyato mṛtyustasmin kāle sudāruṇe||18||
These therapies, which when adopted during epidemic disorders, can easily save lives of individuals provided the epidemics can easily save the lives of individuals provided the death of a particular individual is not pre-determined (by destiny)  [12-18]

Reasons for pollution of water etc leading to epidemics:
इति श्रुत्वा जनपदोद्ध्वंसने कारणानि पुनरपि भगवन्तमात्रेयमग्निवेश उवाच- अथ खलु भगवन्! कुतोमूलमेषां वाय्वादीनां वैगुण्यमुत्पद्यते? येनोपपन्ना जनपदमुद्ध्वंसयन्तीति||१९||
iti śrutvā janapadoddhvaṃsane kāraṇāni punarapi bhagavantamātreyamagniveśa uvāca- atha khalu bhagavan! kutomūlameṣāṃ vāyvādīnāṃ vaiguṇyamutpadyate? yenopapannā janapadamuddhvaṃsayantīti||19||
Having heard the causes of epidemics leading to the destruction of countries, Agnivesha again inquired from Lord Atreya, Sir! What is the factor underlying the vitiation of air etc., which destroy the entire country?

तमुवाच भगवानात्रेयः- सर्वेषामप्यग्निवेश! वाय्वादीनां यद्वैगुण्यमुत्पद्यते तस्य मूलमधर्मः, तन्मूलं वाऽसत्कर्म पूर्वकृतं; तयोर्योनिः प्रज्ञापराध एव |
tamuvāca bhagavānātreyaḥ- sarveṣāmapyagniveśa! vāyvādīnāṃ yadvaiguṇyamutpadyate tasya mūlamadharmaḥ, tanmūlaṃ vā’satkarma pūrvakṛtaṃ; tayoryoniḥ prajñāparādha eva|

Lord Atreya replied “Sins of the present life or the misdeeds of the past life are at the root of the vitiation of all these factors. Intellectual blasphemy  (Prajnaparadha) constitutes the origin of both the types of sins.

Causes – Sins:
तद्यथा- यदा वै देशनगरनिगमजनपदप्रधाना धर्ममुत्क्रम्याधर्मेण प्रजां वर्तयन्ति, तदाश्रितोपाश्रिताः पौरजनपदा व्यवहारोपजीविनश्च तमधर्ममभिवर्धयन्ति, ततः सोऽधर्मः प्रसभं धर्ममन्तर्धत्ते, ततस्तेऽन्तर्हितधर्माणो देवताभिरपि त्यज्यन्ते;
tadyathā- yadā vai deśanagaranigamajanapadapradhānā dharmamutkramyādharmeṇa prajāṃ vartayanti, tadāśritopāśritāḥ paurajanapadā vyavahāropajīvinaśca tamadharmamabhivardhayanti, tataḥ so’dharmaḥ prasabhaṃ dharmamantardhatte, tataste’ntarhitadharmāṇo devatābhirapi tyajyante;

For example, when the rulers of states, towns, cities and countries do not follow the righteous path and take up to sins, then their subordinates and common people of villages and cities, and merchants add further to this sinful situation.

तेषां तथाऽन्तर्हितधर्मणामधर्मप्रधानानामपक्रान्तदेवतानामृतवो व्यापद्यन्ते; तेन नापो यथाकालं देवो वर्षति न वा वर्षति विकृतं वा वर्षति, वाता न सम्यगभिवान्ति, क्षितिर्व्यापद्यते, सलिलान्युपशुष्यन्ति, ओषधयः स्वभावं परिहायापद्यन्ते विकृतिं; तत उद्ध्वंसन्ते जनपदाः स्पृश्याभ्यवहार्यदोषात् ||२०||
teṣāṃ tathā’ntarhitadharmaṇāmadharmapradhānānāmapakrāntadevatānāmṛtavo vyāpadyante; tena nāpo yathākālaṃ devo varṣati na vā varṣati vikṛtaṃ vā varṣati, vātā na samyagabhivānti, kṣitirvyāpadyate, salilānyupaśuṣyanti, oṣadhayaḥ svabhāvaṃ parihāyāpadyante vikṛtiṃ; tata uddhvaṃsante janapadāḥ spṛśyābhyavahāryadoṣāt ||20||

Sinful acts make the righteous acts to disappear. Because of the disappearance of Dharma, the god’s desert the people living in these places. Such are the places where seasons get impaired. Consequently, there will not be rainfall, wind does not blow properly; there is abnormality in the earth, water dries up, drugs lose their qualities and get impaired. Then there is impairment of the country because of the impairment of food and drinks. [19-20]

Sinful act leading to war:
तथा शस्त्रप्रभवस्यापि जनपदोद्ध्वंसस्याधर्म एव हेतुर्भवति|
येऽतिप्रवृद्धलोभक्रोधमोहमानास्ते दुर्बलानवमत्यात्मस्वजनपरोपघाताय शस्त्रेण परस्परमभिक्रामन्ति, परान् वाऽभिक्रामन्ति, परैर्वाऽभिक्राम्यन्ते||२१||
tathā śastraprabhavasyāpi janapadoddhvaṃsasyādharma eva heturbhavati|
ye’tipravṛddhalobhakrodhamohamānāste durbalānavamatyātmasvajanaparopaghātāya śastreṇa parasparamabhikrāmanti, parān vā’bhikrāmanti, parairvā’bhikrāmyante||21||

Similarly a sinful act is at the root of destruction of a country by armaments. Because of increased greed, anger, ego, some people may start fighting among themselves with killer intention or the enemy looking down- upon them as weak persons. They may attack the enemy or may get attacked by them. [21]

Sinful act leading to affliction by Rakshasas:
रक्षोगणादिभिर्वा विविधैर्भूतसङ्घैस्तमधर्ममन्यद्वाऽप्यपचारान्तरमुपलभ्याभिहन्यन्ते||२२||
rakṣogaṇādibhirvā vividhairbhūtasaṅghaistamadharmamanyadvā’pyapacārāntaramupalabhyābhihanyante||22||
People also get destroyed by Rakshasas (demons or germs) and varieties of other creatures due to sins. [22]

Sinful act leading to curse:
तथाऽभिशापप्रभवस्याप्यधर्म एव हेतुर्भवति|
ये लुप्तधर्माणो धर्मादपेतास्ते गुरु वृद्ध सिद्धर्षिपूज्यानवमत्याहितान्याचरन्ति; ततस्ताः प्रजा गुर्वादिभिरभिशप्ता भस्मतामुपयान्ति प्रागेवानेकपुरुषकुलविनाशाय, नियतप्रत्ययोपलम्भादनियताश्चापरे ||२३||
tathā’bhiśāpaprabhavasyāpyadharma eva heturbhavati|
ye luptadharmāṇo dharmādapetāste guru vṛddha siddharṣipūjyānavamatyāhitānyācaranti; tatastāḥ prajā gurvādibhirabhiśaptā bhasmatāmupayānti prāgevānekapuruṣakulavināśāya, niyatapratyayopalambhādaniyatāścāpare ||23||

Similarly the sinful act causes destruction of population by curse. Those who get on without religious duties, they wrongly behave by showing disrespect to respectable ones. Many such families get immediately destroyed by curse. Even if they do not stay together, they get simultaneously destroyed because of the predetermined effect of the curse on them. [23]

Attributes in different Yugas:
प्रागपि चाधर्मादृते नाशुभोत्पत्तिरन्यतोऽभूत्|
prāgapi cādharmādṛte nāśubhotpattiranyato’bhūt|
From the beginning of creation, manifestation of inauspiciousness has been preceded by sinful acts.

During Satyuga / Krutayuga:
आदिकाले ह्यदितिसुतसमौजसोऽतिविमल विपुल प्रभावाः प्रत्यक्ष देव देवर्षि धर्म यज्ञ विधि विधानाः शैल सार संहत स्थिर शरीराः प्रसन्नवर्णेन्द्रियाः पवन सम बल जव पराक्रमाश्चारुस्फिचोऽभिरूप प्रमाणाकृति प्रसादोपचयवन्तः सत्यार्जवानृशंस्यदानदमनियमतपोपवास ब्रह्मचर्य व्रतपरा व्यपगत भय राग द्वेष मोह लोभ क्रोध शोक मानरोग निद्रा तन्द्रा श्रम क्लमालस्य परिग्रहाश्च पुरुषा बभूवुरमितायुषः|
ādikāle hyaditisutasamaujaso’tivimala vipula prabhāvāḥ pratyakṣa deva devarṣi dharma yajña vidhi vidhānāḥ śaila sāra saṃhata sthira śarīrāḥ prasannavarṇendriyāḥ pavana sama bala javaparākramāścārusphico’bhirūpa pramāṇākṛti prasādopacayavantaḥ satyārjavānṛśaṃsyadānadamaniyamatapopavāsabrahmacaryavrataparā vyapagata bhaya rāga dveṣa moha lobha krodha śoka mānaroga nidrā tandrā śrama klamālasya parigrahāśca puruṣā babhūvuramitāyuṣaḥ|

During Satyuga, people were energetic like the sun; They were gods, divine saints, following Dharma, Yajna as per rules, Their bodies were firm like mountains; compact and stable; they had clear complexion and senses; they had strength, motion and valor like those of the wind;
They were endowed with the good shaped organs, features, proper body measurements, happiness and nourishment ;
They were endowed with truthfulness, simplicity, non-violence, charity, self-control, observance of rules, medication, fasting, Brahmacharya and religious rites, and they were devoid of fear, attachment, envy, delicious, greed, anger, grief, mental diseases, abnormal sleep, drowsiness, fatigue, exhaustion, laziness and tendency to collect things.

तेषामुदार सत्त्वगुण कर्मणामचिन्त्य रस वीर्य विपाक प्रभाव गुण समुदितानि प्रादुर्बभूवुः शस्यानि सर्वगुण समुदितत्वात् पृथिव्यादीनां कृतयुगस्यादौ|
teṣāmudāra sattvaguṇa karmaṇāmacintya rasa vīrya vipāka prabhāva guṇa samuditāni prādurbabhūvuḥ śasyāni sarvaguṇa samuditatvāt pṛthivyādīnāṃ kṛtayugasyādau|
Because of these factors they were endowed with an unlimited span of life in the beginning of the Satyuga.
Because of the noble mind, qualities and actions of the people, the earth etc., got endowed with all the good qualities as a result of which excellent tastes, potencies, Vipaka and specific actions were manifested in food grains.

At the end of Satyuga / Krutayuga: 
भ्रश्यति तु कृतयुगे केषाञ्चिदत्यादानात् साम्पन्निकानां सत्त्वानां शरीरगौरवमासीत्, शरीरगौरवाच्छ्रमः, श्रमादालस्यम्, आलस्यात् सञ्चयः, सञ्चयात् परिग्रहः, परिग्रहाल्लोभः प्रादुरासीत् कृते|
bhraśyati tu kṛtayuge keṣāñcidatyādānāt sāmpannikānāṃ sattvānāṃ śarīragauravamāsīt, śarīragauravācchramaḥ, śramādālasyam, ālasyāt sañcayaḥ, sañcayāt parigrahaḥ, parigrahāllobhaḥ prādurāsīt kṛte|
At the end of the satyayuga, some rich people got heaviness in their bodies due to over- indulgence. They suffered from fatigue because of the heaviness of the body. Fatigue gave rise to laziness; laziness made them to accumulate things; accumulation led to the attachment for these things and attachment resulted in greed.

During Tretayuga: 
ततस्त्रेतायां लोभादभिद्रोहः, अभिद्रोहानृतवचनम्, अनृतवचनात् काम क्रोध मानद्वेष पारुष्याभिघातभयताप शोक चिन्तोद्वेगादयः प्रवृत्ताः|
ततस्त्रेतायां धर्मपादोऽन्तर्धानमगमत्|
tatastretāyāṃ lobhādabhidrohaḥ, abhidrohānṛtavacanam, anṛtavacanāt kāma krodha mānadveṣa pāruṣyābhighātabhayatāpa śoka cintodvegādayaḥ pravṛttāḥ| tatastretāyāṃ dharmapādo’ntardhānamagamat|

During Tretayuga greed gave rise to malice; malice gave rise to false statements, arose passion, anger, vanity, hatred, cruelty, infliction of injury, fear, sorrow, grief, worry, anxiety etc. therefore, during Tretayuga, a quarter of Dharma(religious duties) disappeared.

तस्यान्तर्धानात् युगवर्ष प्रमाणस्य पादह्रासः, पृथिव्यादेश्च गुणपादप्रणाशोऽभूत्| तत्प्रणाशकृतश्च शस्यानां स्नेहवैमल्य रस वीर्य विपाक प्रभाव गुणपादभ्रांशः|
tasyāntardhānāt yugavarṣa pramāṇasya pādahrāsaḥ, pṛthivyādeśca guṇapādapraṇāśo’bhūt| tatpraṇāśakṛtaśca śasyānāṃ snehavaimalya rasa vīrya vipāka prabhāva guṇapādabhrāṃśaḥ|
Because of this, the lifespan of human beings  reduced by a quarter. Similarly, there was reduction in the attributes of earth etc, by one quarter. Because of the reduction of these attributes there was diminution by one quarter of the unctuousness, purity, tastes, potency, Vipakas, specific actions and qualities of grains.

ततस्तानि प्रजाशरीराणि हीयमानगुणपादैराहारविहारैरयथापूर्वमुपष्टभ्यमानान्यग्निमारुतपरीतानि प्राग्व्याधिभिर्ज्वरादिभिराक्रान्तानि|
अतः प्राणिनो ह्रासमवापुरायुषः क्रमश इति||२४||
tatastāni prajāśarīrāṇi hīyamānaguṇapādairāhāravihārairayathāpūrvamupaṣṭabhyamānānyagnimārutaparītāni prāgvyādhibhirjvarādibhirākrāntāni|
ataḥ prāṇino hrāsamavāpurāyuṣaḥ kramaśa iti||24||

Because of the reduction by a quarter of the attributes of diets and regimens there was an unusual change in the maintenance of equilibrium of Dhatus and there was vitiation of Agni (pitta) and Maruta (vata) by which, first of all, bodies of living being got afflicted with diseases like fever. Therefore the lifespan of living beings underwent gradual diminution. [24]

Gradual decrease in lifespan:
भवतश्चात्र-
युगे युगे धर्मपादः क्रमेणानेन हीयते|
गुणपादश्च भूतानामेवं लोकः प्रलीयते||२५||
संवत्सरशते पूर्णे याति संवत्सरः क्षयम्|
देहिनामायुषः काले यत्र यन्मानमिष्यते||२६||
इति विकाराणां प्रागुत्पत्तिहेतुरुक्तो भवति||२७||
bhavataścātra-
yuge yuge dharmapādaḥ krameṇānena hīyate|
guṇapādaśca bhūtānāmevaṃ lokaḥ pralīyate||25||
saṃvatsaraśate pūrṇe yāti saṃvatsaraḥ kṣayam|
dehināmāyuṣaḥ kāle yatra yanmānamiṣyate||26||
iti vikārāṇāṃ prāgutpattiheturukto bhavati||27||

Thus it is said: – Religious duties and qualities of living beings got reduced in quarters gradually by the passage of each Yuga. This is how the entire universe has to face dissolution. After the passage of 1/ 100th of the Yuga, the life span of living beings got reduced by one year the actual span of life specific to that age. Thus the origin of diseases in ancient times is described. [25-27]

Query about span of life:
एवंवादिनं भगवन्तमग्निवेश उवाच- किन्नु खलु भगवन्! नियतकालप्रमाणमायुः सर्वं न वेति||२८||
evaṃvādinaṃ bhagavantamagniveśa uvāca- kinnu khalu bhagavan! niyatakālapramāṇamāyuḥ sarvaṃ na veti||28||
Agnivesha enquired from lord Atreya, “O! Lord, is the span of life of all individuals predetermined or not?[28]

Daiva and purusakara:
तं भगवानुवाच-
इहाग्निवेश! भूतानामायुर्युक्तिमपेक्षते|
दैवे पुरुषकारे च स्थितं ह्यस्य बलाबलम्||२९||
taṃ bhagavānuvāca-
ihāgniveśa! bhūtānāmāyuryuktimapekṣate|
daive puruṣakāre ca sthitaṃ hyasya balābalam||29||
Lord Atreya replied, O! Agnivesha, the lifespan of individuals depends upon the strength or weakness of both the Daiva (pre-determined) and Purusha (human effort).

Daiva and Purusha Kaara:
दैवमात्मकृतं विद्यात् कर्म यत् पौर्वदैहिकम्|
स्मृतः पुरुषकारस्तु क्रियते यदिहापरम्||३०||
daivamātmakṛtaṃ vidyāt karma yat paurvadaihikam|
smṛtaḥ puruṣakārastu kriyate yadihāparam||30||
What is done during the past life is known as Daiva where the effect is predetermined and what is done during the existing life is known as Purusakaara- where the effect is based upon the human effort.

बलाबलविशेषोऽस्ति तयोरपि च कर्मणोः|
दृष्टं हि त्रिविधं कर्म हीनं मध्यममुत्तमम्||३१||
balābalaviśeṣo’sti tayorapi ca karmaṇoḥ|
dṛṣṭaṃ hi trividhaṃ karma hīnaṃ madhyamamuttamam||31||

Depending upon the strength or weakness, both the types of actions described above are classified into three categories, viz, mild, moderate and strong.

तयोरुदारयोर्युक्तिर्दीर्घस्य च सुखस्य च|
नियतस्यायुषो हेतुर्विपरीतस्य चेतरा||३२||
tayorudārayoryuktirdīrghasya ca sukhasya ca|
niyatasyāyuṣo heturviparītasya cetarā||32||
Association with the effects of both these types of actions belonging to the strong category results in the long and happy life with a predetermined span.

मध्यमा मध्यमस्येष्टा कारणं शृणु चापरम्|३३|
madhyamā madhyamasyeṣṭā kāraṇaṃ śṛṇu cāparam|33|
In case of their mildness, the result is opposite and in the case of their mediocrity, the result is moderate. Hear the other cause of the predetermination or otherwise of the life-span [29-32]

Daiva and Purusakaara dominance of one over the other:
दैवं पुरुषकारेण दुर्बलं ह्युपहन्यते||३३||
daivaṃ puruṣakāreṇa durbalaṃ hyupahanyate||33||
A weak Daiva (actions during the past life) get subdued by a strong Puruhsakara (action during the present life).

दैवेन चेतरत् कर्म विशिष्टेनोपहन्यते|
दृष्ट्वा यदेके मन्यन्ते नियतं मानमायुषः||३४||
daivena cetarat karma viśiṣṭenopahanyate|
dṛṣṭvā yadeke manyante niyataṃ mānamāyuṣaḥ||34||

Similarly a strong Daiva subdues Purushakaara and because of this, some scholars hold the view that the span of life is invariably pre-determined.

कर्म किञ्चित् क्वचित् काले विपाके नियतं महत्|
किञ्चित्त्वकालनियतं प्रत्ययैः प्रतिबोध्यते||३५||
karma kiñcit kvacit kāle vipāke niyataṃ mahat|
kiñcittvakālaniyataṃ pratyayaiḥ pratibodhyate||35||

Effects of a strong Daiva (actions of the previous life) are invariably manifested. The time of this manifestation is conditioned by the availability of a congenial atmosphere. [33-35]

Daiva and purusakara their role in the determination of span of life:
तस्मादुभयदृष्टत्वादेकान्तग्रहणमसाधु|
tasmādubhayadṛṣṭatvādekāntagrahaṇamasādhu|
Since the Daiva (actions during the previous life) and Purusakara (actions of the present life) both play their roles in the determination of the span of life, it is not correct to hold one sided view that one or the other is responsible for this.

निदर्शनमपि चात्रोदाहरिष्यमः- यदि हि नियत काल प्रमाणमायुः सर्वं स्यात्, तदाऽऽयुष्कामाणां न मन्त्रौषधि मणि मङ्गल बल्युपहार होम नियम प्रायश्चित्तोपवासस्वस्त्ययनप्रणिपातगमनाद्याः क्रिया इष्टयश्च प्रयोज्येरन्; नोद्भ्रान्तचण्डचपलगोजोष्ट्रखरतुरगमहिषादयः पवनादयश्च दुष्टाः परिहार्याः स्युः, न प्रपात गिरि विषमदुर्गाम्बुवेगाः, तथा न प्रमत्तोन्मत्तोद्भान्तचण्डचपलमोहलोभाकुलमतयः, नारयः, न प्रवृद्धोऽग्निः, च विविधविषाश्रयाः सरीसृपोरगादयः, न साहसं, नादेशकालचर्या, न नरेन्द्रप्रकोप इति; एवमादयो हि भावा नाभावकराः स्युः, आयुषः सर्वस्य नियतकालप्रमाणत्वात्|
न चानभ्यस्ताकालमरणभयनिवारकाणामकालमरणभयमागच्छेत् प्रणिनां, व्यर्थाश्चारम्भकथाप्रयोगबुद्धयः स्युर्महर्षीणां रसायनाधिकारे, नापीन्द्रो नियतायुषं शत्रुं वज्रेणाभिहन्यात्, नाश्विनावार्तं भेषजेनोपपादयेतां, न महर्षयो यथेष्टमायुस्तपसा प्राप्नुयुः, न च विदितवेदितव्या महर्षयः ससुरेशाः सम्यक् पश्येयुरुपदिशेयुराचरेयुर्वा|
nidarśanamapi cātrodāhariṣyamaḥ- yadi hi niyata kāla pramāṇamāyuḥ sarvaṃ syāt, tadā”yuṣkāmāṇāṃ na mantrauṣadhi maṇi maṅgala balyupahāra homa niyama prāyaścittopavāsasvastyayanapraṇipātagamanādyāḥ kriyā iṣṭayaśca prayojyeran; nodbhrāntacaṇḍacapalagojoṣṭrakharaturagamahiṣādayaḥ pavanādayaśca duṣṭāḥ parihāryāḥ syuḥ, na prapāta giri viṣamadurgāmbuvegāḥ, tathā na pramattonmattodbhāntacaṇḍacapalamohalobhākulamatayaḥ, nārayaḥ, na pravṛddho’gniḥ, ca vividhaviṣāśrayāḥ sarīsṛporagādayaḥ, na sāhasaṃ, nādeśakālacaryā, na narendraprakopa iti; evamādayo hi bhāvā nābhāvakarāḥ syuḥ, āyuṣaḥ sarvasya niyatakālapramāṇatvāt|
na cānabhyastākālamaraṇabhayanivārakāṇāmakālamaraṇabhayamāgacchet praṇināṃ, vyarthāścārambhakathāprayogabuddhayaḥ syurmaharṣīṇāṃ rasāyanādhikāre, nāpīndro niyatāyuṣaṃ śatruṃ vajreṇābhihanyāt, nāśvināvārtaṃ bheṣajenopapādayetāṃ, na maharṣayo yatheṣṭamāyustapasā prāpnuyuḥ, na ca viditaveditavyā maharṣayaḥ sasureśāḥ samyak paśyeyurupadiśeyurācareyurvā|

If the lifespan is totally predetermined, then why there is need to do mantras (incantations) Aushadi (auspicious substances), Mani (wearing gems), Mangala Bali – auspicious rites, Upahara -offering, oblations, observance of religious rules (niyama), aPrayashcitta – reconciliation, Upavasa fasting,  benedictory rites, paying obeisance, pilgrimage etc?

If the lifespan is totally predetermined, One may not be afraid of fierce and excited bulls, elephants, camels, donkeys, horses, buffaloes, harmful winds, waterfalls, rivers passing through mountains and having dangerous currents which are difficult to cross; rough fierce people and whose minds are afflicted with confusion and greed, enemies, highly inflamed fire, various poisonous animals like reptiles, over straining, regimens which are not conducive to the locality and seasons and such deeds as would enrage the king of the land.

अपि च सर्वचक्षुषामेतत् परं यदैन्द्रं चक्षुः, इदं चाप्यस्माकं तेन प्रत्यक्षं; यथा- पुरुष सहस्राणामुत्थायोत्थायाहवं कुर्वतामकुर्वतां चातुल्यायुष्ट्वं, तथा जातमात्राणामप्रतीकारात् प्रतीकाराच्च, अविषविषप्राशिनां चाप्यतुल्यायुष्ट्वमेव, न च तुल्यो योगक्षेम उदपानघटानां चित्रघटानां चोत्सीदतां; तस्माद्धितोपचारमूलं जीवितम्, अतो विपर्ययान्मृत्युः|
api ca sarvacakṣuṣāmetat paraṃ yadaindraṃ cakṣuḥ, idaṃ cāpyasmākaṃ tena pratyakṣaṃ; yathā- puruṣa sahasrāṇāmutthāyotthāyāhavaṃ kurvatāmakurvatāṃ cātulyāyuṣṭvaṃ, tathā jātamātrāṇāmapratīkārāt pratīkārācca, aviṣaviṣaprāśināṃ cāpyatulyāyuṣṭvameva, na ca tulyo yogakṣema udapānaghaṭānāṃ citraghaṭānāṃ cotsīdatāṃ; tasmāddhitopacāramūlaṃ jīvitam, ato viparyayānmṛtyuḥ|

If lifespan is totally predetermined, then those who have not taken steps to prevent untimely death, is not be afraid of it;
The instructions for initiation and discussions about the administration of Rasayana therapies would all be meaningless;
If lifespan is totally predetermined, even Lord Indra cannot kill his enemy by his Vajra (thunderbolt), even great sages cannot live as long as they like by means of meditation.

Why pre-determined lifespan theory is hoax?
अपि च देशकालात्मगुणविपरीतानां कर्मणामाहारविकाराणां च क्रमोपयोगः सम्यक्, त्यागः सर्वस्य चातियोगायोगमिथ्यायोगानां, सर्वातियोगसन्धारणम्, असन्धारणमुदीर्णानां च गतिमतां, साहसानां च वर्जनम्, आरोग्यानुवृत्तौ हेतुमुपलभामहे सम्यगुपदिशामः सम्यक् पश्यामश्चेति||३६||
api ca deśakālātmaguṇaviparītānāṃ karmaṇāmāhāravikārāṇāṃ ca kramopayogaḥ samyak, tyāgaḥ sarvasya cātiyogāyogamithyāyogānāṃ, sarvātiyogasandhāraṇam, asandhāraṇamudīrṇānāṃ ca gatimatāṃ, sāhasānāṃ ca varjanam, ārogyānuvṛttau hetumupalabhāmahe samyagupadiśāmaḥ samyak paśyāmaśceti||36||

The futility of the theory of predetermined lifespan can be observed even with the naked eyes. For example, thousands of people who go in for a battle and those who do not, have dissimilar spans of life.

Similarly, people whose diseases are treated immediately after their manifestation and those whose diseases are not treated in time or those who take poison and those who do not, have dissimilar spans of life. Earthen jars used as ornamental vases differ in respect of their durability.

Therefore, wholesome regimens lead to longevity, unwholesome ones to death. One should gradually resort to such actions and diets that are having qualities opposite to those of the locality, seasons and one’s own body.

He should avoid the over utilization, non- utilization and wrong- utilization of all regimens (Heena, Mithya and Atiyoga). One should give up all types of over indulgences; he is not supreme the manifested urges and he should avoid over straining. We know, we properly advise and we properly observe the above mentioned factors for the maintenance of health. [36]

Agnivesha’s query about time of death:
अतः परमग्निवेश उवाच- एवं सत्य नियत कालप्रमाणायुषां भगवन्! कथं काल मृत्युरकालमृत्युर्वाभवतीति||३७||
ataḥ paramagniveśa uvāca- evaṃ satya niyata kālapramāṇāyuṣāṃ bhagavan! kathaṃ kāla mṛtyurakālamṛtyurvābhavatīti||37||

Agnivesha enquired, “O! Lord, if the span of living being is not predetermined then how is it said that some people die in the predetermined time and the rest otherwise?” [37]

Atreya’s reply: 
तमुवाच भगवानात्रेयः- श्रूयतामग्निवेश! यथा यानसमायुक्तोऽक्षः प्रकृत्यैवाक्षगुणैरुपेतः स च सर्वगुणोपपन्नो वाह्यमानो यथाकालं स्वप्रमाणक्षयादेवावसानं गच्छेत्, तथाऽऽयुः शरीरोपगतं बलवत्प्रकृत्या यथावदुपचर्यमाणं स्वप्रमाणक्षयादेवावसानं गच्छति; स मृत्युः काले|
यथा च स एवाक्षोऽतिभाराधिष्ठितत्वाद्विषमपथादपथादक्षचक्रभङ्गाद्वाह्यवाहकदोषादणिमोक्षादनुपाङ्गात् पर्यसनाच्चान्तराऽवसानमापद्यते, तथाऽऽयुरप्ययथाबलमारम्भादयथाग्न्यभ्यवहरणाद्विषमाभ्यावहरणाद्विषमशरीरन्यासादतिमैथुनादसत्संश्रयादुदीर्ण- वेगविनिग्रहाद्विधार्यवेगाविधारणाद्भूतविषवाय्वग्न्युपतापादभिघातादाहारप्रतीकारविवर्जनाच्चान्तराऽवसानमापद्यते, स मृत्युरकाले; तथा ज्वरादीनप्यातङ्कान्मिथ्योपचरितानकालमृत्यून् पश्याम इति||३८||
tamuvāca bhagavānātreyaḥ- śrūyatāmagniveśa! yathā yānasamāyukto’kṣaḥ prakṛtyaivākṣaguṇairupetaḥ sa ca sarvaguṇopapanno vāhyamāno yathākālaṃ svapramāṇakṣayādevāvasānaṃ gacchet, tathā”yuḥ śarīropagataṃ balavatprakṛtyā yathāvadupacaryamāṇaṃ svapramāṇakṣayādevāvasānaṃ gacchati; sa mṛtyuḥ kāle|
yathā ca sa evākṣo’tibhārādhiṣṭhitatvādviṣamapathādapathādakṣacakrabhaṅgādvāhyavāhakadoṣādaṇimokṣādanupāṅgāt paryasanāccāntarā’vasānamāpadyate, tathā”yurapyayathābalamārambhādayathāgnyabhyavaharaṇādviṣamābhyāvaharaṇādviṣamaśarīranyāsādatimaithunādasatsaṃśrayādudīrṇa- vegavinigrahādvidhāryavegāvidhāraṇādbhūtaviṣavāyvagnyupatāpādabhighātādāhārapratīkāravivarjanāccāntarā’vasānamāpadyate, sa mṛtyurakāle; tathā jvarādīnapyātaṅkānmithyopacaritānakālamṛtyūn paśyāma iti||38||

Lord Atreya replied, “O! Agnivesha, as a vehicle with an axle endowed with all good qualities and driven on a good road gets destroyed only after the expiry of its normal life, similarly the life inside the body of an individual endowed with strong physique and wholesome regimen will come to an end only at the end of its normal span (according to the Yuga).

This is called “timely death”, the same vehicle along with its axle may subject itself to premature destruction in the event of a heavy load, uneven road, driving in places where there is no road, breakage of the wheel, defects in the vehicle or the driver, separation of the locking hook, lack of grease or an accident.

Similarly, in the event of excess strain, eating in excess, irregular meals, irregular body postures, excessive sex, association of urges which should be suppressed, affliction with evil spirits (germs), poison, wind and fire, exposure to injury and the avoidance of food and medicines, the life of an individual may soon come to an end. This is called “premature death”; when diseases like fever etc are not properly treated, they also lead to premature death. [38]

Query about prescription of hot water to patients suffering from fever:
अथाग्निवेशः पप्रच्छ- किन्नु खलु भगवन्! ज्वरितेभ्यः पानीयमुष्णं प्रयच्छन्ति भिषजो भूयिष्ठं न तथा शीतम्, अस्ति च शीतसाध्योऽपि धातुर्ज्वरकर इति||३९||
athāgniveśaḥ papraccha- kinnu khalu bhagavan! jvaritebhyaḥ pānīyamuṣṇaṃ prayacchanti bhiṣajo bhūyiṣṭhaṃ na tathā śītam, asti ca śītasādhyo’pi dhāturjvarakara iti||39||

Agnivesha enquired, O! Lord, why do physicians advise patients suffering from fever to take hot water in preference to cold water when the Dosha involved in the pathogenesis of this disease is is ideal for cooling therapies? [39]

Rationale behind administering hot water:
तमुवाच भगवानात्रेयः- ज्वरितस्य काय समुत्थान देश कालानभि समीक्ष्य पाचनार्थं पानीयमुष्णं प्रयच्छन्ति भिषजः|
ज्वरो ह्यामाशयसमुत्थः, प्रायो भेषजानि चामाशय समुत्थानां विकाराणां पाचन वमनापतर्पण समर्थानि भवन्ति; पाचनार्थं च पानीयमुष्णं, तस्मादेतज्ज्वरितेभ्यः प्रयच्छन्ति भिषजो भूयिष्ठम्|
तद्धि तेषां पीतं वातमनुलोमयति, अग्निं चोदर्यमुदीरयति, क्षिप्रं जरां गच्छति, श्लेष्माणं परिशोषयति, स्वल्पमपि च पीतं तृष्णाप्रशमनायोपकल्पते; तथायुक्तमपि चैतन्नात्यर्थोत्सन्नपित्ते ज्वरे सदाहभ्रमप्रलापातिसारे वा प्रदेयम्, उष्णेन हि दाहभ्रमप्रलापातिसारा भूयोऽभिवर्धन्ते, शीतेन चोपशाम्यन्तीति||४०||
tamuvāca bhagavānātreyaḥ- jvaritasya kāya samutthāna deśa kālānabhi samīkṣya pācanārthaṃ pānīyamuṣṇaṃ prayacchanti bhiṣajaḥ|
jvaro hyāmāśayasamutthaḥ, prāyo bheṣajāni cāmāśaya samutthānāṃ vikārāṇāṃ pācana vamanāpatarpaṇa samarthāni bhavanti; pācanārthaṃ ca pānīyamuṣṇaṃ, tasmādetajjvaritebhyaḥ prayacchanti bhiṣajo bhūyiṣṭham|
taddhi teṣāṃ pītaṃ vātamanulomayati, agniṃ codaryamudīrayati, kṣipraṃ jarāṃ gacchati, śleṣmāṇaṃ pariśoṣayati, svalpamapi ca pītaṃ tṛṣṇāpraśamanāyopakalpate; tathāyuktamapi caitannātyarthotsannapitte jvare sadāhabhramapralāpātisāre vā pradeyam, uṣṇena hi dāhabhramapralāpātisārā bhūyo’bhivardhante, śītena copaśāmyantīti||40||

Rationale behind administering hot water:
Lord Atreya replied, “Keeping in view physical advise the patient suffering from fever to take hot water so that the immaturely formed Doshas which are responsible for the disease may get matured. The site of origin of fever is Amashaya (stomach).

For the treatment of disease originated from the stomach, usually Pachaka (digestive), as well as emetic (Vamana) and Apatarpana (depleting) drugs are administered. It is because of this that the physician advises the patient suffering from fever to take hot water.

If hot water is taken, this results in a downward movement of Vata (flatus), stimulation of Agni (digestive enzymes), easy digestion (the hot water itself gets easily digested) and drying up of Kapha. Even then, hot water is not given to those patients with excessive vitiation of Pitta or if there is burning sensation, dizziness, delirium and diarrhea. Hot things, lead to the burning sensation, giddiness, delirium and diarrhea. Only cold food and drinks are helpful in this situation . [40]
Read more hot water benefits as per Ayurveda

भवति चात्र-
शीतेनोष्णकृतान् रोगाञ्छमयन्ति भिषग्विदः|
ये तु शीतकृता रोगास्तेषामुष्णं भिषग्जितम्||४१||
bhavati cātra-
śītenoṣṇakṛtān rogāñchamayanti bhiṣagvidaḥ|
ye tu śītakṛtā rogāsteṣāmuṣṇaṃ bhiṣagjitam||41||

Thus it is said:- enlightened physicians administer cold things to cure diseases caused by hot things. For diseases caused by cold things , hot drugs are useful. [41]

Nourishing and depletion therapies: Santarpana and Apatarpana: 
एवमितरेषामपि व्याधीनां निदान विपरीतं भेषजं भवति; यथा- अपतर्पणनिमित्तानां व्याधीनां नान्तरेण पूरणमस्ति शान्तिः, तथा पूरण निमित्तानां व्याधीनां नान्तरेणापतर्पणम्||४२||
अपतर्पणमपि च त्रिविधं- लङ्घनं, लङ्घनपाचनं, दोषावसेचनं चेति||४३||
तत्र लङ्घनमल्पबलदोषाणां, लङ्घनेन ह्यग्निमारुतवृद्ध्या वातातपपरीतमिवाल्पमुदकमल्पो दोषः प्रशोषमापद्यते; लङ्घनपाचने तु मध्यबलदोषाणां, लङ्घनपाचनाभ्यां हि सूर्यसन्तापमारुताभ्यां पांशु भस्मावकिरणैरिव चानतिबहूदकं मध्यबलो दोषः प्रशोषमापद्यते; बहुदोषाणां पुनर्दोषावसेचनमेव कार्यं, न ह्यभिन्ने केदारसेतौ पल्वलाप्रसेकोऽस्ति, तद्वद्दोषावसेचनम्||४४||
evamitareṣāmapi vyādhīnāṃ nidāna viparītaṃ bheṣajaṃ bhavati; yathā- apatarpaṇanimittānāṃ vyādhīnāṃ nāntareṇa pūraṇamasti śāntiḥ, tathā pūraṇa nimittānāṃ vyādhīnāṃ nāntareṇāpatarpaṇam||42||
apatarpaṇamapi ca trividhaṃ- laṅghanaṃ, laṅghanapācanaṃ, doṣāvasecanaṃ ceti||43||
tatra laṅghanamalpabaladoṣāṇāṃ, laṅghanena hyagnimārutavṛddhyā vātātapaparītamivālpamudakamalpo doṣaḥ praśoṣamāpadyate; laṅghanapācane tu madhyabaladoṣāṇāṃ, laṅghanapācanābhyāṃ hi sūryasantāpamārutābhyāṃ pāṃśu bhasmāvakiraṇairiva cānatibahūdakaṃ madhyabalo doṣaḥ praśoṣamāpadyate; bahudoṣāṇāṃ punardoṣāvasecanameva kāryaṃ, na hyabhinne kedārasetau palvalāpraseko’sti, tadvaddoṣāvasecanam||44||

Nourishing and depletion therapies: Santarpana and Apatarpana: 
Similarly, the treatment of other disease involve the administration of therapies as are antagonistic to their causes. For example, diseases caused by the depletion of Dhatus cannot get cured without nourishing therapy; similarly diseases caused by over-nourishment cannot be cured without depletion therapy.

Apatarpana – Depletion therapy is of three types, viz,
Langhana (fasting),
Langhana-pachana (fasting and administration of such medicaments as would help I burning out the maturity of doshas) and
Doshavasecahna (elimination of Doshas).

Langhana (fasting) is suitable when the vitiation of Doshas is mild. By fasting, there is aggravation of Agni (power of digestion) and Vata, as a small quantity of water gets absorbed by heat and wind similarly Doshas get subsided by the aggravation of Agni and Vata due to fasting. Read more about benefits of Langhana therapy

Langhana Pachana (fasting and administration of such medicaments as would help in bringing out the maturity (paka) of Doshas) is suitable when the vitiation of Doshas is moderate. As exposure to sun rays, wind and sprinkling of ashes and dust dry up water in moderately vitiated. If the aggravation of Doshas is very strong, then it is necessary to eliminate them. Without breaking the boundary wall, it will not be eliminate to dry up a pond. Similar is the case when the doshas are exceedingly vitiated. [42]

Patients unsuitable for treatment: 
दोषावसेचनमन्यद्वा भेषजं प्राप्तकालमप्यातुरस्य नैवंविधस्य कुर्यात्|
तद्यथा- अनपवादप्रतीकारस्याधनस्यापरिचारकस्य वैद्यमानिनश्चण्डस्यासूयकस्य तीव्राधर्मारुचेरतिक्षीणबलमांसशोणितस्यासाध्यरोगोपहतस्य मुमूर्षुलिङ्गान्वितस्य चेति|
एवंविधं ह्यातुरमुपचरन् भिषक् पापीयसाऽयशसा योगमृच्छतीति||४५||
doṣāvasecanamanyadvā bheṣajaṃ prāptakālamapyāturasya naivaṃvidhasya kuryāt|
tadyathā- anapavādapratīkārasyādhanasyāparicārakasya vaidyamāninaścaṇḍasyāsūyakasya tīvrādharmāruceratikṣīṇabalamāṃsaśoṇitasyāsādhyarogopahatasya mumūrṣuliṅgānvitasya ceti|
evaṃvidhaṃ hyāturamupacaran bhiṣak pāpīyasā’yaśasā yogamṛcchatīti||45||

Even though required, as per state of the disease, elimination therapies, other forms of depletion therapies and nourishing therapy is not be administered to such patients who are
Anapavada Pratikara – have not been absolved of the allegations against them, those who are incapable of meeting their expenditure, those who pose themselves as physicians, those who are given to violent behavior and envy, those who draw pleasure from vicious acts, those whose strength, flesh and blood have undergone excessive diminution, these who are suffering from incurable diseases and those who are having symptoms of imminent death. If the physician takes such patients under his treatment, then he is defamed because of sinful acts. [ 45]

Thus it is said:-
भवति चात्र-
तदात्वे चानुबन्धे वा यस्य स्यादशुभं फलम्|
कर्मणस्तन्न कर्तव्यमेतद्बुद्धिमतां मतम्||४६||
bhavati cātra-
tadātve cānubandhe vā yasya syādaśubhaṃ phalam|
karmaṇastanna kartavyametadbuddhimatāṃ matam||46||

If an action produces inauspicious results immediately or in the long run, then according to wise persons, one should not resort to such type of work.

Different kinds of places:
(अल्पोदकद्रुमो यस्तु प्रवातः प्रचुरातपः|
ज्ञेयः स जाङ्गलो देशः स्वल्परोगतमोऽपि च||४७||
प्रचुरोदकवृक्षो यो निवातो दुर्लभातपः|
अनूपो बहुदोषश्च, समः साधारणो मतः)||४८||
(alpodakadrumo yastu pravātaḥ pracurātapaḥ|
jñeyaḥ sa jāṅgalo deśaḥ svalparogatamo’pi ca||47||
pracurodakavṛkṣo yo nivāto durlabhātapaḥ|
anūpo bahudoṣaśca, samaḥ sādhāraṇo mataḥ)||48||

Jangala or arid type of country is characterized by scarcity of water and trees, and plentiful of air and sunshine. It causes minimum number of diseases.
Anupa or marshy land is characterized by abundance of water and trees and scarcity of air and sunshine. It causes many diseases.
Sama or moderate type of country is characterized by moderation in the above mentioned factors. [46-48]

To sum up:-
तत्र श्लोकाः-
पूर्वरूपाणि सामान्या हेतवः सस्वलक्षणाः|
देशोद्ध्वंसस्य भैषज्यं हेतूनां मूलमेव च||४९||
प्राग्विकारसमुत्पत्तिरायुषश्च क्षयक्रमः|
मरणं प्रति भूतानां कालाकालविनिश्चयः||५०||
यथा चाकालमरणं यथायुक्तं च भेषजम्|
सिद्धिं यात्यौषधं येषां न कुर्याद्येन हेतुना||५१||
तदात्रेयोऽग्निवेशाय निखिलं सर्वमुक्तवान्|
देशोद्ध्वंसनिमित्तीये विमाने मुनिसत्तमः||५२||
tatra ślokāḥ-
pūrvarūpāṇi sāmānyā hetavaḥ sasvalakṣaṇāḥ|
deśoddhvaṃsasya bhaiṣajyaṃ hetūnāṃ mūlameva ca||49||
prāgvikārasamutpattirāyuṣaśca kṣayakramaḥ|
maraṇaṃ prati bhūtānāṃ kālākālaviniścayaḥ||50||
yathā cākālamaraṇaṃ yathāyuktaṃ ca bheṣajam|
siddhiṃ yātyauṣadhaṃ yeṣāṃ na kuryādyena hetunā||51||
tadātreyo’gniveśāya nikhilaṃ sarvamuktavān|
deśoddhvaṃsanimittīye vimāne munisattamaḥ||52||

Premonitory signs , causative factors in general, characteristic features and management of epidemics which destroy countries, source of the causative factors, origin of diseases in ancient times, process of the reduction in the span on life, determination of the timely and premature death of living beings, cause of premature death, appropriate medicine, selection of therapy for success, reasons for which a particular patient is not be treated- all these topics are described by lord Atreya to Agnivesha in this chapter on “ Janapadodhwamsa.” [49-52]

इत्यग्निवेशकृते तन्त्रे चरक प्रतिसंस्कृते विमान स्थाने जनपदोद्ध्वंसनीय विमानं नाम तृतीयोऽध्यायः||३||
ityagniveśakṛte tantre caraka pratisaṃskṛte vimāna sthāne janapadoddhvaṃsanīya vimānaṃ nāma tṛtīyo’dhyāyaḥ||3||
Thus ends the third chapter on the Determination of the Specific Characteristics of epidemics of the Vimana section of Agnivesha’s work as redacted by Charaka. [3]


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