English
Thus, according to Kumaragiras and Saunaka the - head appears first, because it is the seat of the senses; according to Kankayana, the physician of Balhika, and Krtavirya the heart appears first, because according to Krtavirya (as reported in Susruta) this is the seat of consciousness (cetana) and of buddhi and manas; according to Bhadrakapya (as reported by Caraka) the navel comes first, since this is the place where food is stored, and according to Parasara (as reported in Susgruta), because the whole body grows from there. According to Bhadra Saunaka (as re- ported by Caraka) the smaller intestine and the larger intestine (pakvasaya) appear first, since this is the seat of air (marutadhi- sthanatvat) ; according to Badiga (as reported by Caraka) the hands and feet come out first, because these are the principal organs, and according to Markandeya (as reported by Susruta), because they are the main roots of all efforts (tan-miilatudc cestayah) ; ac- cording to Vaideha Janaka (as reported by Caraka) the senses appear first, for they are the seats of understanding (buddhy-adhis- thana); according to Marici (as reported by Caraka) it is not possible to say which part of the body develops first, because it cannot be seen by anyone (paroksatvad acintyam); according to Subhiiti Gautama (as reported by Susruta) the middle part of the body (madhya-Sarira) appears first, since the development of other parts of the body is dependent on it (tan-nibaddhatvat sarva-gatra- sambhavasya); according to Dhanvantari (as reported by both Caraka and Susruta) all the parts of the body begin to develop together (yugapat sarvangabhinirvrtti), though on account of their fineness and more or less undifferentiated character such develop- ment may not be properly noticed, as with the parts of a growing bamboo-shootor amango fruit (garbhasyasiksmatvan nopalabhyante vamsankuravat ciita-phalavac ca)'. Just as the juicy parts and the stone, which are undifferentiated in a green mango at its early stages, are all found clearly developed and differentiated when it 1 Susruta-samhitd, 111. 3. 32 and Caraka-samhitd, 1v. 6. 21. XIII] Foetal Development 317 is ripe, so, when the human foetus is even in the early stages of development, all its undifferentiated parts are already developing there pari passu, though on account of their fineness of structure and growth they cannot then be distinguished. Referring to the early process of the growth of the foetus, Susruta says that, as the semen and blood undergo chemical changes through heat, seven different layers of skin (kala) are successively produced, like the creamy layers (santanika) formed in milk. The first layer, one-eighteenth of a paddy seed (dhanya) in thickness, is called avabhasini; the second, one-sixteenth of a paddy seed, lohita; the third, one-twelfth of a paddy seed, sveta; the fourth, one-eighth, is called tamra; the fifth, one-fifth, vedini; the sixth, of the size of a paddy seed, rohini; the seventh, of the size of two paddy seeds, mamsa-dhara. All these seven layers of skin come to about six paddy seeds, or roughly one inch. This is said to hold good only in those places of the body which are fleshy. Apart from these seven kalas of skin there are also seven kalas between the different dhatus. A dhatu (from the root dha, to hold) is that which supports or sustains the body, such as chyle (rasa), blood (rakta), flesh (mamsa), fat (medas), bone (asthi), marrow (majja), semen (sukra) and the last vital fluid (ojas). Lymph (kapha), bile (pitta) and excreta (purisa) have also to be counted as dhatus. These kalas, however, are not visible; their existence is inferred from the fact that the different dhatus must have separate places allotted to them, and the kalas are supposed to divide the layer of one dhatu from another and are covered with lymph and tissues (sma@yu)!. In the first kala, known as the mamsa-dhara, the veins, tissues, etc. of the flesh are found; in the second, the rakta-dhara, is found the blood inside the flesh; in the third, called the medo-dhara, there is the fat which is found in the abdomen and also between the smaller bones?. The fourth kala is the slesma-dhara, which exists in the joints; the fifth is the purisa-dhard, which exists in the intestine (pakvasaya) and separates the excreta; the sixth and the seventh are the pitta-dhara and the sukra-dhara. Susruta thinks that the liver and spleen are produced from 1 The kald is defined by Vrddha-Vagbhata as yas tu dhdtv asayantaresu kledo *vatisthate yathasvam usmabhir vipakvah snayu-slesma-jarayu-cchannah kdsthaiva saro dhatu-sara-sesol *patvat kald-samjnah (Astanga-samgraha, Sarira, v). 2 The fat inside the smaller bones is called medas, whereas that inside the larger ones is called majjd, or marrow, and the fat of pure flesh only is called vapda, or fat. 318 Speculations in the Medical Schools [cH. blood, pupphusa (lungs) from the froth of blood, and unduka (a gland in the colon?) from the dirt of blood (Sonita-kitta-prabhava). The best parts (prasada) of blood and lymph are acted upon by bile, and va@yu works in association therewith; by this process the entrails, rectum and bladder are produced; and, when the heating process goes on in the abdomen, the tongue is produced, as the essence of lymph, blood and flesh. The air, being associated with heat, enters the flesh and changes the currents, the muscles (pes?) are differentiated, and by the oily part of fat the va@yu produces the veins (si7@) and tissues (sn@yu). From the essential part of blood and fat the kidneys (vrkka) are produced, from the essential part of flesh, blood, lymph and fat the testicles, and from the essence of blood and lymph the heart, which is the centre of the dhamanis through which flows the current of life (pra@na-vah@). Underneath the heart on the left side there are the spleen and the pupphusa, and on the right side the liver and the kloma (right lung?), and this is particularly the place of consciousness. At the time of sleep, when it is covered with slesman having a super- abundance of tamas, the heart remains contracted. The foetus grows through the chyle of the mother and also through the inflation of the body of the foetus by air’. The navel of the body is the heating centre (jyotzh-sthana), and the air, starting from here, continues to inflate the body. It must be borne in mind that a foetus is the product of several causes operating jointly. A defect of any particular limb at birth is due to some defect in that part of one or more of the operating causes through the influence of which that particular limb was produced. The cause of foetal development is not a question of organs or limbs which were absolutely non-existent: they already existed, in the potential form, in the causes operating jointly. The joint causes did not produce something absolutely new, but their joint operation helped to actualize all that was already inherent in them. Of all the joint causes the self remains unchanged in all changes of the body. The changes of pleasure and pain or such other characteristics as are considered to be due to the soul are really due either to sattva or manas, or to the body?. Cakrapani, commenting on this, says that the fact that a soul may 1 Susruta-samhita, 11. 4. 57. * nir-vikarah paras tv atma sarva-bhitanam nirvisesa-sativa-Sarirayos tu visesad visesopalabdhith. Caraka-samhitd, iv. 4. 34. XII] Growth and Disease 319 take its birth as this or that animal does not imply that the soul is liable to change (paramatma-vikara na bhavanti) ; for such a change is due to the excessive preponderance of sattva, rajas or tamas, which are in reality due to virtue and vice, which in themselves are but the characteristics of mind (sattva-rajas-tamah-prabalata- riipa-vikaraja-manojanya-dharmadharma-janyany eva). There are three kinds of morbid elements (dosa) of the body, viz. vata, pitta and slesman, and two morbid elements which affect the mind (sativa), viz. rajas and tamas. By the disorder of the first three the body becomes diseased, and by that of the second two the mind becomes affected. These, however, will be dealt with more fully later on. Growth and Disease. The three elements, v@yu, pitta and kapha, are counted both as constituents (dhatus) and as dosas, or morbid elements. Dhatus are those elements which uphold the body. The body is the con- glomeration (samudaya) of the modification of five bhitas, or elements, and it works properly so long as these elements are in proper proportions (sama-yoga-vahin) in the body”. The modifica- tions of the five elements which co-operate together to uphold the body are called dhatus. When one or more of the dhdatus fall off or exceed the proper quantity (dhatu-vaisamya), one or more dhdtus may be in excess or deficient either in partial ten- dencies or in entirety (akartsnyena prakrtya ca). It has to be noted that, as Cakrapani explains, not every kind of excess or deficiency of dhadtus produces dhatu-vaisamya, or disturbance of the equilibrium of the dhatus: it is only when such deficiency or excess produces affections of the body that it is called dhatu-vaisamya,. That amount of excess or deficiency which does not produce trouble or affection of the body is called the normal measure of the dhatus (prakrta-mana)*. It is indeed obvious that such a definition of prakrta-mana and dhatu-vaisamya involves a vicious circle, since the normal measure or prakrta-mdana of dhatus is said to be that which exists when there is no trouble or affection, and dhatu-vatsamya is that which exists when there is trouble 1 Cakrapani’s commentary, Caraka, Iv. 4. 2 Caraka-samhita, 1v.6.4. Cakrapani, in commenting on the word sama-yoga- vahin, explains sama as meaning ucita-pramdana (proper quantity).