English
e, if there is hunger, thirst or premature senility, when thei*e is no reason for it, they are proper subjects for treat¬ ment ), but not so when they are timely.” Siisrtita 1, 24. 5-7‘ ®. “In addition to { parasitic ) animalcules (that cause disease), there are twenty kinds of microbes ( krimi ) divided into four classes.” Charaka III. 7. 6"^ ‘‘The origin of the microbes of the blood¬ vessels ( veins ), is like that of leprosy. Their 46. t ; tsfti ^irCiTT *TT*i€r5 i V3 iin 53T5nf^3T^ i ik ^fra^ItfTlT 3 s|taH3T33'(Tiajf3p{fWfir. I oinHJcn*fti g*ra ftft'n; i ^WFra^niFfiT'. '5<ifvqre{5ro^(gf*T?TV^{|’.; ^t?i- fictr^ I cT3 qftt^SKrr; i vw I 3F3 \m\ x^, a."?* i 47. Rstiirfw: f5R*{*i; {re^Ki; ;% vfifi{fvrr^si*{T*n^gf%^r *{^ i 'TOra’ftcrr, ft*TT*n?iT*T*(, "Sj <• 100 ANCIENT HINDU MEDICINE habitat is the hlood-vessels. They are very minute, globular and without feet. Many of them are so minute that they are invisible.” Charaka III. 7. 7*®. Pathology or the science of disease, has up to the last century, been rather vague, owing to the complexity of reaction of the pathogenic agents upon the living matter. Bacteriology is entirely a modern science. A few years ago it was not even suspected that infectious diseases are due to the intervention of morbific microbic agents. Their very existence was not even known. Microscopy and chemical reagents have hut recently revealed the most interesting teeming world of animalcules, which though invisible to the naked eye, are no less potent adversaries of the living beings, and there is a constant struggle between life and these invisible foes, to which it ultimately succumbs, and in spite of the relentless war of science for the last generation, it has not been able, but partially, to conquer and to control them. Even the diseases that we call organic, as the cardiac 48. lit; i FfiTvmra I i fwi' ^TT^, -0 ( PATHOLOGY 101 affection, or metabolical as gout, may be tlie manifestations of the accumulated reactions of pathogenic germs, which have disappeard long ago, as pneumococci and gonococci respectively. This is clearly seen in tabes dorsalis, as a sequel of syphilis, after twenty or thirty years of infec¬ tion. The ancient conception of disease was based more or less on humoral pathology, i. e. disease originated fz’om the derangement of the humors and it was the function of the diet and medicine and proper living, to bring them back to their normalcy and equilibrium. According to the Hindu schools of medicine, there were three fun¬ damental humors {payu, pitta^ kapha), according to the Greek, four (blood, phlegm, bile and water by some, yellow and black biles by others) in the human body. 'Vayu' is the active principle like the wind, which brings hot and cold weaves ‘pitta’ is the heat principle like the sun ; and the ‘kapha’ is the cold principle like the moon, wTiose beams were reputed to exercise a very soothing and beneficial influence on plant life, in contradistinction of the sun’s rays which were supposed to have a scorching effect, as it usually happens in an arid tropical climate. {Snsruta 1. 21. 8 ). As for the luxuriant vegetable life and 102 ANCIENT HINDU MEDICINE growtli, all these three elements in their right proportion are necessary, and excess of either, heat, cold or wind, is injurious to the plant, as in the animal kingdom. However fanciful and grotesque this appears at the first glance to the moderner, it is not really so when it is seen with clear perspective and sharp analysis. It is true that concrete facts and statements appeal more to reason than vague generalization and abstract philosophy. But by close observation it will he easily observed that their ‘-cayu, pitta, kapha’ correspond, to what is expressed in vulgar terminology, as ‘nervous, sanguine and phlegmatic temperaments and which can he translated into medical nomencla¬ ture as ‘hypermetabolism, normal metabolis^n and hypometaholism’ The following citations tend to lead to the aforesaid conclusion :— ‘‘The bodily oxidation ( agnx) is classified into four kinds according to its activities as follows :— hyper-( t'iksna ), hypo-( manda ), normal {samd) and ah normal ( visama ). Of them ( one of ) hypermetabolism is able to bear all abuses ( i. e possesses a great resisting power against infection ) ; hypometaholism has its opposite qualities ; normal metabolism becomes ( easily ) upset by abuse, hut without abuse, remains PATHOLOGY 103 \ natural ; abnormal metabolism has the opposite qualities of the normal,.” Charaka III. 6. 6**. “These four kinds of oxidation pertain to man. Those who have vayu, pitta, kapha, in propotion ( equal), enjoy normal oxidation. In the case of those who have predominance of vata ( nervous temperament), oxidation beomes abnormal by association with vayu. In those who have predominance of pitta ( sanguine temperament), oxidation becomes accentuated by its association (hyper-oxidation). In those who have predominance of ‘ slesma' ( phlegmatic tempera¬ ment ), their oxidation becomes lowered by its association ( hypo-oxidation ).” Charaka III. 6. 7 '“. ‘‘The dominant qualities at the time of union of 49. g vrafit \ 60. gw’HGi i 0 ftw I PreRtPir=g ftTnSr^it i vrajfii^ra: i i., i. I 104 ANCIENT HINDU MEDICINE I the sperm with ovum, are inborn (with the baby), as te'mperament {prahrti). Stisrtda III. 4, 48'*. “The man of nervous ( vata ) temperament,, is sleepless ( jmjaruha ), sensitive to cold, ill- tempered, exclusive ( = thievish ), haughty, unmannerly (<?■ = un-arian), fond of music, songs, dance and arts ( ganclJiarvachitta ), whose hands and feet are long, whose beard, hair and nails are very dry, who is excitable {hrodhalu^ angry) and strike people with hand and nails. That person is impatient, whose friendship is unstable, ( who is ) ungrateful, thin, violent, whose veins show out throughout his body, (who is) garrulous, who walks fast, is fond of walking and is Bckle- minded.” Siismta III 4. 59®". “The man of sanguine temperament ( pitta ) perspires freely, smells come from his body (from volatile oil ), his body has the yellowish color 51 . ( ^ ^ ^ 3?^ II snflK- 8 , 1 ^ITV^’ftSfire^Jjrj^nslfia!: ^ II 5 ii PATHOLOGY 105 \ and is relaxed ; and his nails, eyes, forehead, tongue, cheeks, and palms of hands and soles of feet are copper-colored (indications of good circulation of blood ); he becomes repugnant when he gets wrinkled ( vali ), gray-haired ( palita ) and bald-headed ( Ichcilitya ) : he is a voracious eater, sensitive to heat and he becomes easily angry and easily satisfied; his strength and longevity are medium. A man of sangui¬ nary temperament is brainy {medhav'i), clever and is an authoritative speaker ; in combat he is brave and irresistible.” Susrnta III. 4. 61®®. “The complexion of a man of phlegmatic (sle^ct) temperament, is like the grass, blue lotus blossom or wet arista fsoap-tree), sharpen¬ ed sword or the shaft of an arrow (i. e. fat and bright.) He is pleasant to look at, fond of eating sweet things (it is well-known that in myxedema or cretinism there is a great fondness 5.3. f I snfir- 8, I 106 ANCIENT HINDU MEDICINE for sugar and high tolerance for carbohydrates), obliging, lazy, patient, without desires, heavy, indifferent and thick-bodied.” Susruta III. 4. 65®*. One can see here almost the true clinical picture of hyper-thyroidism in an advanced state, in the primary stage and hypo-thyroidism. Thyroid influences metabolism. With metabolsim is inter-locked the automatic bodily mechanism of self-defence against infection. It is well- known that our integuments and mucous mem¬ branes swarm with innumerable pathogenic germs which almost live a harmless, vegetative parasitic life, but if the organism is devitalized by overwork or malnutrition, if its immunizing resisting power is lowered, in other words, if its defensive mechanism has been weakened, then infection takes place. We inhale almost with every inspiration plenty of bacillus tuberculosis and they lodge in our nostrils and lungs, we harbour in our intestine enough of coli-group, but they can not do any harm as long as our metabolic activities have not been . lowered snrlKwnn, a, I PATHOLOGY 107 1 beyond the danger point. So far pathogenesis, vitality of the organism, is the important factor. This vitality classification, coefficient with metabolism and oxidation, is practically synony¬ mous with myu ( = air) as a conductor of hot and cold waves, = heat principle), kapha ( = cold principle), which we are justified to translate as the nervous {hypermetabolism), sanguine iyiormal metabolism) and phlegmatic {hypometa- bolism) temperaments, and on which the whole system of the Hindu medicine is based. If there are points in which the picture drawn by Charaka varies from modern clinical observation (as had smell and premature senility in sanguine temperament, and strength in phlegmatic type), it should not be forgotten that, there have been evolutive changes with time both in the patho¬ genic agents and our system, from the time of the ancients and consequently reactions have been partially modified. Moreover, it is good to remember that for the age in which Charaka and Susruta lived, their studies strike our ad¬ miration-from the comparative historical point of view, but for modern practical needs, they are nothing but crude and vague generalizations. 108 ANCIENT HINDU MEDICINE I. Constitutional Pathogenesis We can quite agree with Susruta (I. 120). that ‘whatever causes pain, is a disease’.