At the outset of the great war, Bhishma stood as the commander of Duryodhana’s vast army, while Shikhandi led the forces of the Pandavas. For ten days, a fierce and terrible battle raged between them, weapons clashing and arrows flying in unending torrents. On the tenth day, Bhishma, pierced by hundreds of arrows from both Shikhandi and Arjuna, saw the sun begin its northward journey. Realizing his time had come, he turned his mind inward and meditated upon the divine wielder of the mace. Having spoken at length about many kinds of dharma and having satisfied the spirits of his ancestors, Bhishma merged peacefully into a pure, blissful, and sinless state. After Bhishma’s fall, the mighty Drona took up command and engaged in battle with Dhrishtadyumna. For five days, their fight was exceedingly fierce. Many kings of the earth met their end in that clash, struck down by Arjuna’s hand. Overwhelmed by grief and loss, Drona too departed from this world and attained heaven. Next, Karna, renowned for his valor, challenged Arjuna. For two days, their duel thundered across the battlefield, until Karna, overwhelmed by the storm of Arjuna’s weapons, fell and reached the radiant realm of the sun. After him, Shalya went forth to face the wise Dharmaraja, Yudhishthira. In but half a day, Shalya was brought down by arrows that blazed like fire. At last, Duryodhana, filled with vigor, seized his heavy mace and rushed forward like Death itself at the world’s end. But the heroic Bhima struck him down with his own mace. In the darkness of night, Ashvatthama, Drona’s son, entered the camp of the sleeping Pandava army. Remembering his father’s death, he slew Dhrishtadyumna and the sons of Draupadi with his powerful arms. Draupadi wept in despair, but Arjuna, conquering Ashvatthama with the missile of reeds, took from him his priceless jewel. Yudhishthira then comforted the women, who were overwhelmed by grief, and after bathing, offered sacred oblations to the gods, ancestors, and departed forefathers. Reassured by Bhishma’s words, Yudhishthira established a great kingdom. He worshipped Vishnu with a grand Ashvamedha sacrifice, performed according to sacred rule and with generous gifts. He installed Parikshit on the throne. Later, upon hearing of the destruction of the Yadavas in the Mausala episode, Yudhishthira recited the thousand names of Vishnu. In time, Yudhishthira, accompanied by Bhima and his brothers, journeyed to Vishnu’s heaven. Vasudeva, too, was born again, taking the form of Buddha to bewilder the enemies of the gods. In the future, Vishnu will appear once more as Kalki in the village of Shambhala, riding a horse and reducing the worlds to ashes. For the protection of the gods and all beings, to remove unrighteousness, and to destroy the wicked, Vishnu takes incarnation again and again. Just as Dhanvantari was born from the churning of the milk ocean and taught Ayurveda for the well-being of gods and others, so too do divine descents bring benefit to the world. By hearing the stories of Viśvāmitra’s son, the great-souled Suśruta, and of the descents of the Bhāratas, a person attains heaven. Now, Dhanvantari spoke to Suśruta: “I shall explain in detail the causes of all diseases, as the sages beginning with Ātreya have declared. Disease, evil, fever, affliction, disorder, corrupted ailment, consumption, suffering, and pain—these are all different words expressing the same idea. The knowledge of diseases is considered fivefold: their cause, prodromal signs, symptoms, alleviation, and progression. The cause is described by many names—sign, reason, locus, condition, and origin—while the prodrome is that which allows a disease to be recognized beforehand. When a disease is about to arise but not yet established, due to disturbance in the humors, its signs are faint and slight, varying according to the disease. When these signs become manifest, they are called symptoms, and are also known as form, indication, sign, mark, and appearance. Relief and comfort are brought about by the proper use of medicines, food, and regimen that counteract or reverse the cause and the disease. Alleviation is called suitability; the opposite, which aggravates disease, is unsuitability. The progression of a disease is the process by which, through a corrupted humor or its spread, the disease reaches fruition. This progression has many distinctions—by number, variation, predominance, strength, time, and other specifics, such as the eight types of fever. The variation and combination of humors, their estimation, and whether they act independently or dependently, indicate the predominance of a disease. The timing of disease is determined by the completeness or partial presence of causes and other factors, by strength and weakness, and by the portions of day, night, or after eating. Thus, the meaning of cause has been explained; Vyāsa will further instruct on this. The root of all diseases is the aggravation of the bodily humors. The various improper usages that provoke their aggravation have already been described, including the threefold improper conjunctions of the three humors. By excessive use of bitter, pungent, astringent, sour, dry, or insufficient foods; by running, excitement, staying awake at night, or speaking too loudly; by overexertion in action, fear, grief, anxiety, exercise, or sexual activity; and by eating at the end of summer days and nights—wind (vāta) is aggravated. Bile (pitta) is aggravated by pungent, salty, sharp, hot, spicy foods; by anger; by burning sensations; and during autumn, midday, and midnight. Phlegm (kapha) is aggravated by foods that are sweet, sour, salty, unctuous, heavy, cooling, pleasurable to the mouth, sleep-inducing, hard to digest, and nourishing when eaten during the day or before sleep. Improper practices, such as forced vomiting after meals, especially when food is undigested, particularly in the morning and early night, also cause disorders of phlegm. When all these factors are mixed together, combined disorders arise. Similarly, consuming incompatible, poorly digested, irregular, or mutually antagonistic foods leads to disease. Eating spoiled wine, water, dried vegetables, roots, oil-cakes, rotten meat, putrid, dried, or emaciated fish—these too are causes of illness. Thus did Dhanvantari begin to teach the causes and nature of disease, as passed down by the sages, for the welfare of all beings.