The short version
Chapter 27 of the Uttara Tantra of the Sushruta Samhita names nine Bala Grahas — Skanda, Skandapasmara, Shakuni, Revati, Putana, Andha-Putana, Shita-Putana, Mukha-mandika and Naigamesha — and describes what each one looks like in an infant. The names are the names of spirits. The descriptions are something else entirely: fists, rolling eyes, foaming, green stool, net-like veins across the abdomen, and — six times over — a distinct smell. This article reads that chapter verse by verse, together with the tail of chapter 26 that finishes Shiro-roga Pratishedha and closes the Shalakya Tantra with a census of every disease above the collarbone.
📖 24 min read · Classical source: Sushruta Samhita, Uttara Tantra, chapters XXVI (Shiro-roga Pratishedha, verses 9–19) and XXVII (Nava-Graha-Kriti-Vijnaniya) · pages 169–176 of the Kaviraj Kunja Lal Bhishagratna English edition
What's in this article
- A Seam in the Text: One Tantra Ends, Another Begins
- The Source: Sushruta Samhita, Uttara Tantra 26–27
- Finishing Shiro-roga Pratishedha: Tridoshaja and Kshayaja (XXVI.9–10)
- Krimija Shiro-roga: the Strangest Prescription in the Chapter (XXVI.11)
- The Avapida Nasya Shelf: Suryavarta, Ardhavabhedaka, Anantavata, Shankhaka (XXVI.12–16)
- One Universal Rule, and the Two Diseases Exempted From It (XXVI.17–18)
- The Closing Census: 76 + 28 + 31 + 11 + 65, and the Books Sushruta Says He Abridged (XXVI.19)
- Nava Graha: the Nine Named Grahas of Infancy (XXVII.1–3)
- Why the Chapter Says They Come: Conduct, Cleanliness and a Frightened Child (XXVII.4)
- Skanda-graha and Skandapasmara: the Convulsive Pair (XXVII.5–6)
- Shakuni and Revati: Vesicles, Green Stool and the Rubbed Nose (XXVII.7–8)
- Putana and Andha-Putana: the Name Every Indian Reader Already Knows (XXVII.9–10)
- Shita-Putana, Mukha-mandika, Naigamesha: the Last Three (XXVII.11–13)
- Sushruta's Prognosis: the Three Signs That Close the Door (XXVII.14)
- Reading the Chapter Sideways: Nine Grahas, Six Smells
- The Rules of the Chamber: Mustard, a Lamp, Ghrita and the Fire (XXVII.15)
- Reading the Nine Grahas With Modern Eyes
- What This Article Is Not
- Daily Care in a Classical Spirit
- More to Read on This Topic
- Frequently Asked Questions
A Seam in the Text: One Tantra Ends, Another Begins
Most chapters of a classical Samhita begin and end quietly. Today's pages do not. Midway down page 172 of Bhishagratna's English edition, the Sushruta Samhita finishes its account of the aching head, prints a summary of everything it has said about the region above the collarbone, and then writes a single line: Here ends the Shalakya Tantra. One page later a new chapter opens on a subject with nothing to do with eyes, ears, noses or teeth. It opens on infants.
That seam is what makes these eight pages worth reading together. The Shalakya Tantra — the branch dealing with the urdhvajatru, the parts above the clavicle — has occupied the Uttara Tantra since its first chapter, and chapter 26 finishes it. Then chapter 27 begins Kaumarabhritya, the care of children, through its strangest door: a list of nine Grahas, malignant influences, each said to seize an infant and leave a recognisable mark.
The modern reader arrives at that door with an obvious reaction, and it is worth naming it straight away rather than pretending it is not there. A chapter that attributes childhood illness to demons looks, at first glance, like the part of the tradition one quietly skips. But read the verses rather than the headings and something odd happens. The causes are supernatural. The observations are not. What Sushruta actually records under each demon's name is a tight cluster of signs — how the child sleeps, whether it takes the breast, what the stool looks like, how the limbs move, what the skin does, and, over and over, how the child smells. Strip the nine names out and what remains is a differential list.
This article reads both halves in order: first the tail of Shiro-roga Pratishedha, whose opening verses we covered separately, then the closing census, then all fifteen verses of the Nava-Graha-Kriti-Vijnaniya.

Uttara Tantra 26 and 27: the last chapter of the Shalakya Tantra and the first of Kaumarabhritya.
The Source: Sushruta Samhita, Uttara Tantra 26–27
The Sushruta Samhita is one of the three texts of the Brihat Trayi, the great triad, alongside the Charaka Samhita and the Ashtanga Hridaya. Its last of six sections is the Uttara Tantra, the "later" or supplementary book, and it is where the text handles the subjects its five earlier sections left aside: the diseases of the eye, ear, nose, head and mouth, then the diseases of childhood, then the fevers and the internal disorders.
Chapter XXVI is titled Shiro-roga Pratishedha — pratishedha meaning the warding off, the counter-measure, the therapeutics. It answers the previous chapter, XXV, which had named and described eleven diseases of the head. Verses 1 to 8 of chapter XXVI deal with the Vataja, Pittaja, Raktaja and Kaphaja types; those we have read already. Today's pages pick up at verse 9 and run to verse 19, where the chapter and the whole Shalakya Tantra close together.
Chapter XXVII carries the title Nava-Graha-Kriti-Vijnaniyam. The compound unpacks as nava, nine; graha, seizer; kriti, the form or the doing; vijnaniya, that which is to be known or discerned. "The chapter on discerning the forms of the nine seizers." The word graha is worth pausing on, because it is the same word used for a planet — the thing that seizes, takes hold, grips. In this chapter it means neither a planet nor a natural cause of illness, but an agency that takes hold of a child.
The word Bala Graha
Bala means a child. Graha means one who seizes. Bala Graha — the seizers of children — became the standing name for this entire body of material, and later texts organise it as a subject in its own right. It is one half of the classical branch Kaumarabhritya, the rearing of the young, which sits in the eight branches of Ayurveda between Kaya Chikitsa and Shalakya. The other half is everything practical: feeding, weaning, the milk of the mother and the nurse.
A word on the edition. All verse numbers here follow Kaviraj Kunja Lal Bhishagratna's English translation, first published from Calcutta between 1907 and 1916 — the edition these pages are read from. Bhishagratna translates Graha as "malignant star" and sometimes "demon", and where he inserts a guess in brackets we have left the guess in his brackets and named it as his.
Finishing Shiro-roga Pratishedha: Tridoshaja and Kshayaja (XXVI.9–10)
Chapter XXVI's remaining verses run through the head diseases that verses 1 to 8 had not covered. The first is the Tridoshaja type — the head disease marked by the concerted action of all three Doshas. Sushruta's instruction here is procedurally interesting rather than pharmacologically interesting: the measures that are severally remedial to each of the three deranged Doshas should be employed together. There is no separate Tridoshaja shelf. You combine.
To that he adds one specific: draughts of old and matured clarified butter — purana ghrita — are said to be especially efficacious in such instances. Aged ghee appears repeatedly across the Samhitas as a distinct material from fresh ghee, valued precisely for its age, and it will appear again in today's second chapter.
The second is Kshayaja Shiro-roga, the type attributed to waste or atrophy of the local fat. Here the register changes completely. Where most of chapter XXVI empties the head — errhines, purgatives, blood-letting — the Kshayaja verse fills it. Vrimhana measures are recommended: the nourishing, bulk-giving class. Clarified butter cooked with the drugs of the Vayu-subduing group and the Madhura (sweet) group is to be given both as a drink and as an errhine.
Then verse 10 does something a modern textbook would never do: it cross-references by outcome rather than by ingredient. Any medicated ghrita which acts as a remedy in cases of consumptive cough, it says, would be found most efficacious in this Kshayaja type. In other words — whatever works for the wasting cough, use that here. The logic is that both are conditions of depletion, so the same restorative shelf applies. Bhishagratna adds a footnote recording that the commentator Videha read the preparation differently: the ghee should be cooked with the decoction of the Vayu-subduing drugs and with the Kalka, the paste, of the Madhura drugs. Two commentators, two readings of one line, both preserved.
Krimija Shiro-roga: the Strangest Prescription in the Chapter (XXVI.11)
Verse 11 is the one readers remember. Krimija Shiro-roga is the head disease attributed to krimi — worms or parasites — germinating in the head. Sushruta's answer is not a drug. It is a lure.
The patient is to be made to snuff in a quantity of animal blood. The worms, drawn by the smell of the blood, come down into the passages of the nostrils, where they are then carefully extracted with tongs. Bait, migration, extraction. It is a mechanical procedure described in one sentence, and it belongs to the surgical temperament that runs through the whole of the Sushruta Samhita — the text that would rather reach in and take a thing out than wait for it to resolve.
Only after the extraction does the pharmacy appear. Head-purgatives — shiro-virechana — are composed of the pulverised seeds of small Shigru mixed with Kamsya, which Bhishagratna glosses as dead brass, and Nili, indigo, pounded together. Alternatively any vermifuge drug — Vidanga is the one named — pasted with the urine of a cow, stuffed into the nostrils in the manner of an Avapida Nasya. Then fumigation into the nostrils with the fumes of burnt sordid fishes, and vermifuge food and drink of various kinds.
A note on reading verses like this one. The instinct is to ask whether it worked. The more useful question for a reader of classical texts is what the verse tells us about how its author thought. Verse 11 tells us Sushruta held that some head disease had a physical, mobile, extractable cause, that this cause could be induced to move by a stimulus, and that the nostril was the route. That is a model, and it is a testable one, which is more than most first-millennium aetiology offers.

The Avapida Nasya shelf of XXVI.12-16 - pressed pastes and plasters for the four named head diseases.
The Avapida Nasya Shelf: Suryavarta, Ardhavabhedaka, Anantavata, Shankhaka (XXVI.12–16)
Four of the eleven head diseases carry proper names rather than dosha labels, and verses 12 to 16 treat them as a group. Suryavarta is the one that turns with the sun. Ardhavabhedaka is the splitting of half the head, the Sanskrit ancestor of the sense behind the word migraine. Anantavata is the endless one, beginning at the nape. Shankhaka attacks the temples. We described all four in detail when we read chapter XXV; here we are only interested in what chapter XXVI does about them.
For Suryavarta the answer is errhines, and Bhishagratna's bracket extends that to plasters and gargles. The diet should consist principally of boiled rice and milk with clarified butter, and the essence or extract of the meat of jangala animals — the arid-land creatures whose flesh the Samhitas class as light. The same measures are to be employed for Ardhavabhedaka.
Then the chapter lists the Avapida Nasya options — the pressed-paste errhine, where a paste is squeezed and the expressed juice instilled into the nostril. Six alternatives are given, and they read like a shelf rather than a formula:
| Avapida option (XXVI.12–14) | Sanskrit materials named |
|---|---|
| Seeds, paired | Shirisha and Mulaka seeds |
| Root with a cooling aromatic | Bamboo roots with Karpura (camphor) |
| Two pungent roots | Vacha and Magadhi |
| Sweet root with honey | Yashti-madhu and madhu |
| Mineral with honey | Manahshila pasted with madhu |
| Single aromatic wood | Chandana, pasted |
Bhishagratna's footnote on the first line is a small lesson in textual transmission: Sripati Datta, commenting on Vrinda, prescribes the bark of Shirisha, while Shivadasa Sen, commenting on Chakradutta, prescribes the seeds. The verse survived; the part of the plant did not.
After the Avapida, the patient is made to snuff medicated clarified butter cooked with the drugs of the Madhura group — the Kakolyadi — in both cases. And plasters of Sariva, Utpala, Kushtha and Yashti-madhu, pasted with Kanjika (acid gruel) and surcharged with oil and clarified butter, are applied to the affected region. Sushruta adds that these plasters serve equally in the Kaphaja type of Shiro-roga — and Bhishagratna footnotes a dispute even here, noting that some manuscripts read Kshayaja in place of Kaphaja, that Jejjata does not accept that reading, and that others read Anilatmake, the Vataja type.
Anantavata is to be treated like Suryavarta, with two additions. Blood-letting should be effected by opening a local vein. And the diet should subdue both Vayu and Pitta, consisting of Madhu-Mastaka, Sanghyava and Ghrita-pura — which Bhishagratna glosses as different kinds of confectionery made of wheat, sugar, milk and clarified butter. A prescription of sweets, written down, in a medical text, in the first millennium.
Shankhaka gets clarified butter churned from milk, given as a drink and used as an errhine, with the same rice-ghee-jangala diet. Its plasters are the cooling shelf: Shatavari, black sesamum, Yashti-madhu, Nilotpala, Durva and Punarnava pasted together; or Maha-sugandha; or Palindi pasted with Kanjika. Cooling washes and plasters, and the Avapida Nasyas already prescribed for Suryavarta, are to be used here too. For readers who want the wider procedure, we have a separate guide to Nasya and its five classical types.
One Universal Rule, and the Two Diseases Exempted From It (XXVI.17–18)
Verses 17 and 18 close the therapeutic half with a general rule, and the rule is more interesting for what it excludes than for what it commands.
Strong head-purgatives composed of oil and honey, Sushruta says, should be administered first in cases of Shiro-roga. Then the patient should be made to snuff in drops of mustard oil. And where the preceding measures fail to produce relief, the patient should be treated with Sneha and Sveda — oleation and sudation — and bleeding should then be effected by opening a local vein.
That is a three-stage escalation: clear the head, then oil it, then if neither answers, soften and sweat the patient and open a vein. But the sentence carries an exception clause, and it names exactly two of the eleven diseases: with the exception of the Krimija and the Kshayaja types.
Why those two, and no others
Look at what the exempted pair have in common. Krimija has a cause the text believes is physically present in the head and must be drawn out, not driven out — a purgative would move the wrong thing. Kshayaja is defined by depletion; every measure in the standard escalation subtracts, and subtracting from a depleted head is the one thing the chapter has already warned against. The exception is not arbitrary. It is the chapter checking its own general rule against the two aetiologies that contradict it.
It is a small piece of internal consistency, and easy to walk past. A text that had simply accumulated remedies would not have bothered to carve out the two entries where its own universal instruction fails.

XXVI.19 sums the section: 76 ocular, 28 of the ear, 31 nasal, 11 of the head, 65 of the mouth.
The Closing Census: 76 + 28 + 31 + 11 + 65, and the Books Sushruta Says He Abridged (XXVI.19)
Verse 19 is the last verse of the Shalakya Tantra, and it is a summary. The causes, symptoms and therapeutics, it says, of:
| Region | Count given at XXVI.19 | Where the Samhita covers it |
|---|---|---|
| Netra — ocular affections | seventy-six | Chapters I–XIX |
| Karna — diseases of the ear | twenty-eight | Chapters XX–XXI |
| Nasa — nasal diseases | thirty-one | Chapters XXII–XXIV |
| Shiras — diseases of the head | eleven | Chapters XXV–XXVI |
| Mukha — affections of the mouth | sixty-seven, glossed sixty-five | Nidana Sthana XVI |
The mouth figure carries a visible wobble. Bhishagratna prints "sixty-seven (sixty-five)", preserving both the number in his manuscript and the number the tradition settled on — and sixty-five is the count the Mukha Roga chapter itself announces when it opens. Taking the settled figure, the Shalakya census totals 211 named conditions above the collarbone. Taking the manuscript figure, 213. We have read the eye census, the seventy-six netra rogas, and the mouth census on this blog in their own articles.
Then comes the line that historians of the text find most valuable, and it is an admission. These diseases, Sushruta says, "have been described in detail in other treatises" — Bhishagratna's bracket names those of Videha and others, "dealing with this special subject, the diseases of the over-clavicular region". The number, symptoms and therapeutics are here briefly described in accordance therewith.
Read that carefully. The Uttara Tantra is not claiming to be the source. It is telling you it is a summary of a specialist literature that already existed, written by named authorities, of which this is the abridgement. Twenty-six chapters, more than two hundred named conditions, and the text closes by saying the full version is elsewhere. That elsewhere has not survived. What we have is the abstract.
Nava Graha: the Nine Named Grahas of Infancy (XXVII.1–3)
Chapter XXVII opens with the formula the Samhita uses for every new subject: "Now we shall discourse on the chapter which deals with the specific features of the nine diseases of infant life, which are attributed to the influences of the nine malignant Grahas." The teacher then addresses the pupil by name — Attentively hear me describe, Sushruta — a reminder that in this text's own framing the speaker is Divodasa Dhanvantari and Sushruta is the student taking it down.
What he promises to describe is fourfold: the origin, the cause, the medical treatment, and the characteristic symptoms by which each can be accurately diagnosed. Then verse 3 gives the list. Nine, in the order the text gives them:
| # | Graha | Sense of the name |
|---|---|---|
| 1 | Skanda-graha | Skanda, the war-god, son of Agni and the Krittikas |
| 2 | Skandapasmara | Skanda + apasmara, the falling or forgetting one |
| 3 | Shakuni | From shakuni, a bird |
| 4 | Revati | Revati, a nakshatra and a goddess-name |
| 5 | Putana | From puta; the stinking or foul one |
| 6 | Andha-Putana | The blind Putana |
| 7 | Shita-Putana | The cold Putana |
| 8 | Mukha-mandika | From mukha, face; the one that rings or marks the face |
| 9 | Naigamesha, also Pitri-graha | The goat-faced one; alternatively, the ancestral seizer |
Two things are already visible in the list alone. First, three of the nine are Putanas — a base name with two qualified variants, which is how the Samhitas typically subdivide a category they consider large. Second, the ninth carries two names, and the alternative — Pitri-graha, the seizer of the ancestors or fathers — points at a different explanatory frame entirely: not a demon of the wild but the neglected dead.
Why the Chapter Says They Come: Conduct, Cleanliness and a Frightened Child (XXVII.4)
Verse 4 gives the aetiology, and it is worth quoting closely because it is the verse that determines how the whole chapter should be read. The Grahas affect the person of a child, it says, in the cases where:
- the directions laid down before, in the Sharira Sthana, regarding the conduct of the mother or the nurse during the period the child is brought up on the breast, are not followed;
- and consequently where proper benedictory rites are not performed;
- and where the child is allowed to remain in an unclean state;
- or where the child, becoming uneasy somehow, gets frightened, is rebuked, or begins to cry.
Three of those four are not supernatural at all. The conduct of the nursing mother, the cleanliness of the child, and the child's distress are conditions any observer can check. Only the second — the unperformed rite — belongs to the ritual register, and even it is framed as a consequence of the first.
The verse then explains why the chapter has to proceed by symptom. The Grahas "make their appearance for the purpose of getting proper respect and worship", and, being omnipotent and omnipresent, "are not capable of being seen by man when they enter the person of a child". Because the agent is invisible, the text says, I shall discourse on the symptoms of their presence, as derived from the authority of the sages of yore.
The methodological move hiding in verse 4
An invisible cause forces a visible method. Because no one can observe a Graha, the entire chapter must be built out of what can be observed in the child — and that is precisely what the next nine verses are. The supernatural premise, oddly, produces a rigorously observational text. Whatever one makes of the demons, verse 4 is the reason chapter XXVII contains almost no theory and almost nothing but signs.
Skanda-graha and Skandapasmara: the Convulsive Pair (XXVII.5–6)
Skanda-graha is described first, and the description is dense. The indications are swelling of the eyes, distorted features of the face, and an aversion to the breast-milk. The body of the child emits a bloody smell. One of the eyelids becomes fixed or motionless. The child looks frightened, closes his fists — Bhishagratna adds the bracket "as in a fit of convulsion" — and moans a little. The eyes become highly rolling, and the stool becomes hard.
Nine signs in two sentences, spanning five channels of observation: the face, the smell, the eyelid, the posture of the hands, the stool. Note especially the closed fists and the fixed eyelid — not the kind of detail one invents, but the kind one notices.
Skandapasmara-graha follows immediately, and its name carries the clue: apasmara is the classical term for the falling disorder, treated at length elsewhere in the Samhitas. Its characteristic features are alternate fits of fainting and consciousness; convulsive jerks of the legs and hands "like those in dancing"; foaming at the mouth; yawning; and the passing of stool and urine together with the passage of wind.
The simile is the detail to keep. Like those in dancing — the text reaches for a comparison from ordinary life to fix the quality of the movement, exactly as the Nidana Sthana reaches for crabs and horses' ears to fix the shape of a fracture. Classical Ayurvedic description leans on simile wherever precision matters, because a simile survives copying better than an adjective does.

XXVII.15: a clean chamber, mustard seeds strewn on the floor, and a lamp kept perpetually burning.
Shakuni and Revati: Vesicles, Green Stool and the Rubbed Nose (XXVII.7–8)
Shakuni Graha is marked by looseness of the limbs, which emit a peculiar bird-like smell. Bhishagratna footnotes the word: by shakuni, literally a bird, is here meant meat-eating aquatic birds. The child in such a case starts up in terror, and its body is covered with a large number of secreting ulcers — Vrana — or with eruptions of vesicles attended with a burning sensation, subsequently suppurating and bursting of themselves.
That is a full description of a skin eruption with a defined course: appearance, sensation, suppuration, rupture. The text is not merely listing that the skin is affected; it is describing a sequence in time.
Revati Graha is a different picture altogether, and the most colour-heavy entry in the chapter. The face assumes a blood-red hue. The stool, and the urine with it, becomes green. The body of the child looks as if of deep yellow or dark brown colour. Fever ensues, with an inflammation of the mouth. A bruised pain is felt all over the body. And — the last sign, and the most human — the child frequently rubs its nose and ears.
Why the last sign matters. Rubbing the nose and ears is a behavioural sign, not a physical one. It is the sort of thing recorded only by someone who has spent time watching an unwell infant rather than examining one. Several of the nine entries carry a sign of this kind — startling up, crying unceasingly, lying always on the face — and together they suggest the chapter's material came from sustained observation of children at close range.
Putana and Andha-Putana: the Name Every Indian Reader Already Knows (XXVII.9–10)
Of the nine names in this chapter, one is famous far outside medicine. Putana is the demoness of the Bhagavata Purana who comes to the infant Krishna in the form of a beautiful nurse, offering her breast, and is destroyed in the attempt. The story is told across the Puranic literature and painted and performed everywhere in India.
The relationship between the two Putanas is not one of borrowing in either direction — the figure belongs to a shared stock of names that the epic, Puranic and medical literatures all draw on. But the overlap in subject is striking and worth stating plainly: in the narrative literature, Putana is a threat that comes to an infant disguised as a wet-nurse. In the medical literature, Putana is a category of infant illness whose sibling entry, Andha-Putana, is defined partly by the child's refusal of the breast. Both traditions place the same name at the same point of vulnerability — the nursing infant.
Putana Graha itself, in Sushruta's account, presents as: looseness of the limbs; disturbed sleep, whether by day or by night; loose stools; emission of a crow-like smell from the body; vomiting; the appearance of goose-flesh on the skin; and thirst.
Andha-Putana — the blind Putana — is the heaviest entry in the chapter, with eight signs: dislike for the breast-milk; an attack of Atisara, the classical term for the flux; cough; hiccough; vomiting; fever; discolouring of the complexion; swelling in the skin; and an inclination to lie always on the face.
The prone-lying detail closes the entry, and like the rubbed nose it is behavioural. A child who will not take the breast, who has the flux and a cough and a fever, and who turns face-down and stays there, is a picture rather than a list.
Shita-Putana, Mukha-mandika, Naigamesha: the Last Three (XXVII.11–13)
Shita-Putana, the cold Putana, is characterised by constant and frightened startling up; excessive shivering; comatose sleep; constant diarrhoeic stools; and a bloody smell of the limbs. The child in this case cries almost unceasingly, and a rumbling sound is heard in the intestines. Shivering and comatose sleep in the same entry is a strange pairing, and the text does not soften it.
Mukha-mandika is, to a modern reader, the most legible of the nine, and its signs cohere unusually tightly. Paleness — Bhishagratna glosses it emaciation — of the body and trunk. A glossy line, which he glosses as swelling, of the face and the extremities, attended with frightfulness. A voracious appetite. The appearance of net-like veins on the abdomen. And the emission of a urine-like smell from the body.
The net-like veins
Of every sign in chapter XXVII, this is the one that reads most like direct observation and least like inherited formula. A wasted trunk with a swollen face and extremities, veins standing out visibly across the abdomen, and hunger that does not stop — those four signs are recorded together, in one entry, as a single presentation. The text offers no mechanism for why they should co-occur. It simply reports that they do.
Naigamesha, also called Pitri-graha, closes the list: frothy vomits; bending of the middle of the trunk; an anxious appearance; loud crying; upward gaze of the eyes; constant emaciation — Bhishagratna notes a variant reading, fever, marked D.R. for different reading; a fatty smell in the body; and unconsciousness.
Naigamesha is the one figure of the nine with a substantial life in Indian art. He appears in Mathura sculpture from the Kushana period as a goat-headed male figure, sometimes shown with children, and he is a well-known figure in Jain narrative, where Harinegamesin transfers the embryo of Mahavira. The iconography and the medical entry are separate traditions around one name — but the association of that name with infants runs through both.
Sushruta's Prognosis: the Three Signs That Close the Door (XXVII.14)
Verse 14 is short and it is the gravest verse in the chapter. A stupefied state of the child, it says, attended with an aversion to breast-milk and constant fits of fainting, as well as the full development of all the specific symptoms, show the imminent fatal termination of the disease. Otherwise it may prove amenable to treatment, if it is not a case of long standing.
Three signs, then, mark the grave case: stupefaction, refusal of the breast, and repeated fainting. Plus a fourth criterion that is not a sign but a pattern — the full development of all the specific symptoms of whichever Graha is in question. And one qualifier that is neither: duration. A case of long standing is treated as a worse case regardless of its signs.
This is the classical sadhya-asadhya distinction — the curable and the incurable — which the Samhitas apply to almost every disease they name, and which we have met before in the Kaya Chikitsa survey. Its purpose is not fatalism but triage — and also professional protection: a physician who could name in advance the cases that would not turn was a physician whose reputation survived them.
Note too what the refusal of the breast is doing here. It appeared under Skanda-graha, again under Andha-Putana, and now a third time as one of the three markers of a grave case — the same sign recorded three times in three roles.
Reading the Chapter Sideways: Nine Grahas, Six Smells
Read the chapter down the page and it is nine portraits. Read it across the page — the same column for every entry — and something else appears. Six of the nine Grahas are given a characteristic smell.
| Graha | Odour recorded | Verse |
|---|---|---|
| Skanda-graha | a bloody smell from the body | XXVII.5 |
| Shakuni | a bird-like smell from the limbs | XXVII.7 |
| Putana | a crow-like smell from the body | XXVII.9 |
| Shita-Putana | a bloody smell of the limbs | XXVII.11 |
| Mukha-mandika | a urine-like smell from the body | XXVII.12 |
| Naigamesha | a fatty smell in the body | XXVII.13 |
That is two-thirds of the chapter's entries carrying an olfactory sign, and the smells are not decorative adjectives — they are differentiating. Bloody, bird-like, crow-like, urine-like, fatty. Two entries share "bloody", and those two, Skanda and Shita-Putana, are separated by other means entirely: fixed eyelid and hard stool in one, shivering and unceasing crying in the other.
Smell as a diagnostic channel is not unique to this chapter — the Samhitas examine the patient by darshana (looking), sparshana (touching) and prashna (questioning), and bodily odour runs through the diagnostic literature. But nowhere else in the Uttara Tantra is odour used this systematically, entry after entry, to tell adjacent conditions apart.
Set the smells aside and the remaining columns organise the same way. Every entry records how the child sleeps — disturbed by day or night, comatose, startling up. Most record the stool — hard, loose, green, diarrhoeic. Several record whether the child takes the breast. A chapter with a supernatural frame turns out to have a fixed observational schema underneath it: sleep, feeding, stool, skin, movement, smell.

The homa of XXVII.15 - ghrita, flowers and sandal paste offered with Sarva-gandha materials.
The Rules of the Chamber: Mustard, a Lamp, Ghrita and the Fire (XXVII.15)
The chapter's final verse is titled "Rules to be observed", and it describes the room rather than the child. Four instructions, then a fifth that is a rite.
The child should be kept in a clean and purified chamber. Its body should be rubbed or anointed with old and matured clarified butter — purana ghrita again, the same material named back at XXVI.9. Mustard seeds should be strewn all over the floor, and the text specifies who does the strewing: a person in a clean state. And a lamp of mustard oil should be kept perpetually burning in the room.
Then the rite. Libations of clarified butter with the drugs of the Sarva-gandha and Sarvaushadhi groups, and garlands of flowers, and sandal paste, should be cast into the fire and kept continually burning, while an incantation is recited. Bhishagratna footnotes the two groups: the drugs of the Eladi group are known as Sarva-gandha; the Sarvaushadhi drugs here are Vacha, Dhanyaka, Tila and others.
The incantation itself is given in full, and it is addressed to four powers in order: "Obeisance to thee, O fire-god, obeisance to thee, O goddess Krittika, obeisance to thee, O Skanda, obeisance to thee, O lord of the Grahas." Then the petition: with head down, in deep humility, the reciter asks for favour, asks that the offerings be accepted, and asks that the child be made hale and hearty again.
Four addressees, one lineage
Agni the fire-god; Krittika, the constellation that nursed Skanda; Skanda himself; and the lord of the Grahas. The sequence is a genealogy — fire, the nurses, the child of fire, and the power that commands the seizers. Skanda, the first-named Graha of verse 3, reappears in verse 15 as one of the powers addressed. In this chapter's world the same figure is both the danger and the recourse.
It is also worth noticing what the four practical instructions actually amount to, independent of the rite: a clean room, an anointed child, a swept and strewn floor, and a light kept burning through the night. Whatever the verse intends by them, that is a description of attentive nursing care. Readers interested in the fire ritual as a practice in its own right may want our separate piece on what a hawan involves.
Reading the Nine Grahas With Modern Eyes
There is a temptation, when reading a chapter like this, to play a matching game — to take each Graha and pin a modern label on it. That game is popular and it is mostly worthless, for a reason worth spelling out: the nine entries were never intended as nine distinct disease entities in the modern sense, so forcing them into modern categories produces confident answers to a question the text was not asking.
What survives translation into modern terms is not the nine names. It is the method. Consider what chapter XXVII actually does:
- It fixes a standard observational schema and applies it to every entry — sleep, feeding, stool, skin, movement, odour — so that entries can be compared column by column.
- It uses simile to preserve precision across copying: jerks "like those in dancing", a "bird-like" smell, "net-like" veins, "goose-flesh".
- It records behavioural signs alongside physical ones — the rubbed nose, the face-down posture, the unceasing cry — which is a habit modern paediatrics also depends on, because the patient cannot report anything.
- It states a prognosis rule separately from the descriptions, with named criteria and a duration qualifier.
- It preserves dissent: the D.R. variant at XXVII.13, and in the previous chapter Jejjata's refusal of a reading and the Shirisha bark-versus-seeds disagreement.
That last habit is the one most worth admiring. A text confident enough to record that its own commentators disagreed, and to print both readings, is behaving more like a scholarly apparatus than like a book of spells.
None of which requires us to accept the aetiology. Chapter XXVII pairs a supernatural explanation with a careful descriptive practice, and the two are separable — the descriptions do not depend on the demons being real, which is why they still read as observation a thousand-odd years later. We have written elsewhere about where the Sushruta Samhita's claims have and have not held up, and the same discipline applies here.
What This Article Is Not
This is a reading of two chapters of a first-millennium Sanskrit text. It is history and philology, not advice, and there are three things it is specifically not.
It is not guidance for a sick child. Nothing described above — not the anointing, not the chamber, not the lamp, not the fire offering, and certainly not any of the head-disease measures from chapter XXVI — is presented here as something to do for an unwell infant. If a child is unwell, the right step is a qualified paediatrician, promptly.
It is not a claim that the nine Grahas correspond to nine modern conditions. We have deliberately declined to make those identifications, and where Bhishagratna made a guess in brackets in 1911 we have left it in his brackets and named it as his.
It is not a product page. Ayurveda Hub sells daily-care items. None of them has anything to do with the subject matter of these chapters, and the short section below exists only because a classical fire ritual and the classical habit of anointing happen to be things we make objects for. Nothing on this site is a treatment, a cure or a preventive for any medical condition.
Daily Care in a Classical Spirit
Two habits appear in today's verses that survived into ordinary Indian domestic life: the homa, the offering of fragrant substances into a small fire, and the practice of anointing the body with an oil or a fat. Both are household routine rather than therapy, and that is the only sense in which we connect them to what we make.
Please read: Ayurveda Hub products are daily-care and personal-care items. They are not a treatment, a cure or a preventive for any medical condition, and nothing in this article should be read as suggesting otherwise. None of our products is intended for infants or young children. The classical material described above is presented for historical and educational interest only. If you or your child are unwell, consult a qualified healthcare professional.
Kesh Sanvardhan Tel and Cold Pressed Coconut Oil
The anointing comes first in verse XXVII.15, before the lamp and before the fire. The habit of putting oil on the head, and of anointing the body, is one of the oldest routines in the Indian household — the classical texts file it under the daily routine rather than under any therapy. Kesh Sanvardhan Tel is our herbal hair oil for that ordinary evening or pre-bath ritual, and our Cold Pressed Coconut Oil is single-ingredient coconut oil, cold pressed, for anyone who prefers a plain classical medium for hair and skin. Both are external-use daily-care items, for adults, and neither is a claim about effect.
★★★★★ "The product is overall good, and the best part is the pricing, as other brands were offering the same product at a higher price. However, I got this at a very decent price. Thank you, Ayurveda Hub!" — Nitin Thakur, verified buyer, Cold Pressed Coconut Oil (4.9★ from 9 reviews)
Sookshma Havan Kund
Verse XXVII.15 then describes libations of ghrita, along with flowers and sandal paste, cast into a fire kept continually burning, with materials from the Sarva-gandha and Sarvaushadhi groups — Bhishagratna names Vacha, Dhanyaka and Tila among the latter. The small square kund is the household vessel for exactly that kind of offering, and our Sookshma Havan Kund is made for the domestic version of it: a compact fire vessel for a short daily or occasional homa at home. It is an object for a ritual, nothing more.
More to Read on This Topic
More from our classical-text series

Bhishagratna's footnote names Vacha, Dhanyaka and Tila among the Sarvaushadhi drugs.
Shop All Ayurveda Hub Products →
Frequently Asked Questions
What does Bala Graha mean in Ayurveda? +
Bala means a child and graha means one who seizes or takes hold. Bala Graha is the classical name for a body of material dealing with disorders of infancy that the older texts attribute to nine malignant influences. The Sushruta Samhita treats it in Uttara Tantra chapter 27, the Nava-Graha-Kriti-Vijnaniya. It forms part of Kaumarabhritya, the classical branch concerned with the rearing of children.
Which chapter of the Sushruta Samhita Uttara Tantra covers the nine Grahas? +
Chapter XXVII (27), titled Nava-Graha-Kriti-Vijnaniyam. It runs to fifteen verses and follows immediately after chapter XXVI, which ends the Shalakya Tantra. In Kaviraj Kunja Lal Bhishagratna's English edition these are pages 173 to 176.
What are the names of the nine Grahas? +
In the order given at Uttara Tantra XXVII.3: Skanda-graha, Skandapasmara, Shakuni, Revati, Putana, Andha-Putana, Shita-Putana, Mukha-mandika, and Naigamesha — the last also called Pitri-graha.
Is the Putana of the Sushruta Samhita the same as the Putana in the Krishna story? +
They are the same name drawn from a shared stock of figures across Indian literature, not a case of one text citing the other. The Puranic Putana is a demoness who approaches the infant Krishna disguised as a nurse. Sushruta's Putana Graha is a category of infant disorder. Both traditions attach the name to the same point of vulnerability — the nursing infant — which is why the overlap is interesting even though neither text references the other.
Why does Sushruta describe smells so often in this chapter? +
Six of the nine entries record a characteristic bodily odour — bloody for Skanda-graha and Shita-Putana, bird-like for Shakuni, crow-like for Putana, urine-like for Mukha-mandika, and fatty for Naigamesha. Because the chapter's stated premise is that the cause cannot be seen, everything has to be built out of observable signs, and odour is one of the channels the classical diagnostic tradition uses alongside looking, touching and questioning.
What is Krimija Shiro-roga and how does chapter 26 handle it? +
Krimija Shiro-roga is the head disease the text attributes to krimi, worms or parasites. At Uttara Tantra XXVI.11 the described procedure is to have the patient snuff in animal blood so that the worms, drawn by the smell, descend into the nostril passages, where they are extracted with tongs — followed by head-purgatives and fumigation. It is one of only two head diseases exempted from the chapter's general rule about administering strong head-purgatives first.
How many diseases does the Shalakya Tantra count in total? +
Uttara Tantra XXVI.19 sums the section: seventy-six ocular affections, twenty-eight of the ear, thirty-one nasal, eleven of the head, and sixty-seven — glossed sixty-five — of the mouth. Using the settled figure of sixty-five, that is 211 named conditions above the collarbone; using the manuscript figure, 213.
Does the Sushruta Samhita claim to be the original source for these chapters? +
No, and it says so directly. At XXVI.19 the text states that these diseases "have been described in detail in other treatises" — Bhishagratna's bracket names Videha and others as specialists in the diseases of the region above the collarbone — and that what appears here is a brief description made in accordance with them. The Uttara Tantra presents this section as an abridgement of a specialist literature that has not survived.
Can any of this be used to treat a child today? +
No. This article is a historical and textual reading, not advice, and nothing in it should be applied to an unwell child. Ayurveda Hub products are daily-care items for adults, are not intended for infants or young children, and are not a treatment, a cure or a preventive for any medical condition. If a child is unwell, consult a qualified paediatrician.