The four qualities of a Bhishak (Ayurvedic practitioner)

This sutra enumerates the four qualities of a Bhishak (practitioner of treatment) that are clearly expected. The first is professional competence, i.e., he treats patients without any doubts, he is confident, knowledgeable in his field, he is a master. His skills have been properly handed down to him from his professional teacher and have been properly checked. His treatment is definitely not an experiment, on the contrary: A Bhishak treats with 100% certainty. The Ayurvedic practitioner should be an expert in practice, i.e., he knows how to use medications and remedies. (The sutra also certainly means the art of surgery, which is currently excluded from Ayurvedic practice in Europe.) The most important quality is Shuchi, which means that the Ayurvedic practitioner should have professional skills in clinical psychology in order to gain the respect and trust of the patient and be seen by the patient as an authority. All four qualities mentioned are the essential identity of the Ayurvedic practitioner. Anybody can know about Ayurveda in theory, but it is something else to practice it.

The Bhishak has four "legs" of his own, therefore, each of which must function in order for him to work properly. The first leg, Daksha, means being a perfectionist, somebody who can see something through to the end in all of its details, and whose storehouse of knowledge is absolutely full and well-organized, accessible. There is nothing lacking or missing. Whatever is not known can become known so there is nothing missing. This includes tírthátta, which means an aim - this must be established for the treatment, the practitioner knows exactly what the point is of what he does. The second leg is Shastartha, to be equipped with a grasp of the Vedic literature and its principles. Drushtakarma (practical experience) is the third leg. The fourth leg, Shuchi, means there is clarity of vision, the practitioner has no doubt about what has to be done and what is happening. 

Daksha tírthátta means there is perfect understanding of the aim to be achieved by the treatment. Shastra means to master all of the principles of how things work from the literature (doshas, etc.), to have them available for use, as tools in the treatment, as artha, the necessary prerequisites. Drushtakarma means practical experience in using such tools - there is something to be learned from any environment, from any circumstance, there is always something available to the practitioner that can be involved in practical application to treatment. This cannot be acquired any other way than by doing it, like cooking, riding a bicycle, or swimming - we cannot just read about these things and know how to do them on that basis alone. The fourth leg, Shuchi, means there is clarity of vision, both physical and mental.