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इत्युक्तं त्रिविधोदर्कं रक्तं मार्गविशेषतः। एभ्यस्तु खलु हेतुभ्यः किञ्चित्साध्यं न सिध्यति ॥२१॥
[Factors affecting prognosis] Some curable diseases do not get treated successfully (and lead to incurability) because of following factors: 1. Not following proper treatment protocol
english translation
प्रेष्योपकरणाभावाद्दौरात्म्याद्वैद्यदोषतः। अकर्मतश्च साध्यत्वं कश्चिद्रोगोऽतिवर्तते ॥२२॥
2 lack of attendants and equipment 3 Mischievousness and fault of the physician.
english translation
तत्रासाध्यत्वमेकं स्यात् साध्ययाप्यपरिक्रमात्। रक्तपित्तस्य विज्ञानमिदं तस्योपदिश्यते ॥२३॥
If the disease is not treated, then it proceeds to incurability. If treated well, sometimes the incurable disease may become curable or palliable. [Signs of incurable raktapitta] Now described are types of raktapitta, identified (by their physical appearance).
english translation
यत् कृष्णमथवा नीलं यद्वा शक्रधनुष्प्रभम्। रक्तपित्तमसाध्यं तद्वाससो रञ्जनं च यत् ॥२४॥
Raktapitta is incurable if the blood is black, blue or of rainbow color and stains clothes. Bleeding with excessively fetid smell, in large quantities,
english translation
भृशं पूत्यतिमात्रं च सर्वोपद्रववच्च यत्। बलमांसक्षये यच्च तच्च रक्तमसिद्धिमत् ॥२५॥
and associated with all the complications, particularly in weak and emaciated patients is incurable.
english translation