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3 etad eva dhatiinam prakrta-manam yad avikara-kari, Cakrapani’s comment on Caraka-samhita, 1. 6. 4. 320 Speculations in the Medical Schools [cH. in the body; the trouble or affection of the body has thus to be defined in terms of dhatu-vaisamya. The only escape from this charge is that dhatu-vaisamya and disease are synonymous, and the prakyta- mana of dhatus is the same as health. When the dhatus are in their normal measure, there cannot be any vaisamya, except of a local nature, as when, for example, the pitta existing in its own proper measure is somehow carried by vayu to a part of the body and there is consequently a local excess. Whatever leads to the increase of any particular dha@tu automatically leads also to the decrease of other dhatus which are opposed to it. Things having the same sort of composition as a particular bodily dhatu increase it, and things having a different composition decrease it (samanyam ekatva-karam visesas tu prthaktva-krt)'. The normal health of a man is but another name for his dha@tu-samya; a man is said to be unhealthy, or to be in a state of dhatu-vaisamya, when symptoms of disease (vik@ra) are seen. Slight variations of the due proportion of dhatu do not entitle us to call them instances of dhatu-vaisamya unless there is vikara or symptoms of it externally expressed. The daily course of a healthy man ought to be such that the equilibrium of dhatus may be properly maintained. The sole aim of Ayur-veda is to advise diet, medicines, and a course of behaviour, such that, if they are properly followed, a normally healthy person may maintain the balance of his dha@tus and a man who has lost the equilibrium of his dhatus may regain it. The aim of Ayur-veda is thus to advise men how to secure dhatu-samya (dhatu-samya-kriya cokta tantrasyasya prayojanam)?. If a normally healthy man wishes to keep his health at its normal level, he has to take things of different tastes, so that there may not be an excess of any particular kind of substance in the body. Diseases are caused through the excessive, deficient, and wrongful administration of sense-objects, the climatic charac- teristics of heat and cold, and the misuse of intelligence?. Thus the sight of objects with powerful light, the hearing of loud sounds like the roaring of thunder, the smelling of very strong odours, too much eating, the touching of too much cold or heat or too much bathing or massage are examples of atiyoga, or excessive association with sense-objects. Not to see, hear, smell, taste or 1 Caraka-samhitd, 1. 1. 44. *rlbtds.T. 1 52. MS kdla-buddhindriyarthandm yogo mithyda na cati ca dvayasrayanam vyadhindm tri-vidho hetu-samgrahah. Ibid. 1. 1. 53. XIII] Growth and Disease 321 touch at all would be ayoga, or deficient association with sense- objects. To see objects very near the eye, at a very great distance, or to see frightful, hideous, unpleasant and disturbing sights, would be examples cf the improper use (mithya-yoga) of the visual sense. To hear grating and unpleasant sounds would be examples of the improper use of the ear; to smell bad and nauseating odours would be examples of mithyad-yoga of the nose; to eat together different kinds of things, which in their combination are so opposed as to be unhealthy, is an example of the improper use of the tongue; to be exposed to sudden heat and cold are examples of the im- proper use of touch!. Similarly, all activities of speech, mind and body, when they are performed to an excessive degree, or not performed at all, or performed in an undesirable or unhealthy manner, are to be considered respectively as examples of atzyoga, ayoga and mithyd-yoga of the effort of speech, mind and body (van-manah-sarira-pravrtti)*. But these are all due to the misuse of intelligence (prajfiaparadha). When a particular season manifests its special characteristics of heat, cold or rains to an excessive degree or to a very deficient degree or in a very irregular or unnatural manner, we have what are called atiyoga, ayoga and mithya-yoga of time (kala)®. But the misuse of intelligence, or prajnaparadha, is at the root of all excessive, deficient or wrongful association with sense-objects*; for, when proper things are not taken at the proper time or proper things are not done at the proper time, it is all misuse of intelligence and is therefore included under prajiaparadha. When certain sinful deeds are performed by prajnaparadha, and, by the sins (adharma) associated with those deeds, which become efficient only after a certain lapse of time, illness is produced, the real cause of the illness is primarily adharma or its root cause, prajiaparadha; kala, or time, however, may still be regarded in some sense as the cause through which the adharma is matured and becomes productive. The principle of growth and decay is involved in the maxim 1 Caraka-samhitd, 1. 11. 37. 2 Ibid. 1. 11. 39, 40. Cakrapani says that this includes sinful deeds which produce illness and unhappiness, sarira-mdanasika-vdcanika-karma-mithya-yo- genaiva-dharmotpadavantara-vydparenaivadharma-janyanam vikaranam kriya- manatvat. 3 "Three seasons only are mentioned, Sitosma-varsa-laksanah punar heman- (bart pale Ibid. 1. 11. 42. 4 Thus Cakrapani, commenting on this, says, “*buddhy-aparadhasyaiva indri- yarthatiyogadi-hetutvat.” Ibid. 1. 1. 53. DiI 2i 322 Speculations in the Medical Schools [cH. that the different constituents of the body grow when articles of food having similar constituents are taken, and that they decay when articles of food having opposite qualities are taken (evam eva sarva-dhatu-gunanam samanya-yogad vrddhir vipar- yayadd hrasah)'. Thus, flesh increases by the intake of flesh, so does blood by taking blood, fat by fat, bones by cartilages, marrow by marrow, semen by semen and a foetus by eggs?. But the prin- ciple applies not only to the same kind of substances as taken in the above example, but also to substances having largely similar qualities, just as the seminal fluid may be increased by taking milk and butter (samdna-guna-bhiyisthanam anyaprakrtinam apy-ahara- vikaranam upayogah)*. The ordinary conditions of growth always hold good, namely, proper age of growth, nature, proper diet and absence of those circumstances that retard growth. The assimila- tion of food is effected by heat which digests, air which collects together all things for the action of heat, water which softens, fat which makes the food smooth, and time which helps the process of digestion*. As any particular food is digested and changed, it becomes assimilated into the body. The hard parts of the food form the hard parts of the body and the liquid parts form the liquid parts such as blood and the like; and unhealthy food, i.e. food which has qualities opposed to the natural qualities of the body, has a disintegrating influence on the body. As regards the growth of the body through the essence of the food-juice, there are two different views summed up by Cakrapani (1. 28. 3). Some say that the chyle is transformed into blood, and the blood into flesh, and so forth. As regards the method of this transformation, some say that, just as the whole milk is changed into curd, so the whole chyle is transformed into blood, while others say that this transformation is somewhat like the circula- tion in irrigation (kedari-kulyad-nyaya). The rasa (chyle) produced as a result of the digestive process, coming into association with rasa as the body-constituent (dhatu-riipa-rasa), increases it to a certain extent; another part of the rasa, having the same colour and smell as blood, goes to blood and increases it, and another part similarly goes to flesh and increases it; and the same process takes place with reference to its increasing fat, etc. Here the whole circula- 1 Caraka-samhita, 1. 1. 43 and 44, also Iv 6. 9 and particularly tv. 6. 10. * Ibid. 1v. 6. 10. Cakrapani explains @ma-garbha as anda. 3 Tbid. 1v. 6. 116 4 Ibid. 1. 6. 14 and 15. XIII] Growth and Disease 323 tion begins by the entrance of the entire chyle into the constituent rasa (rasa-dhatu) ; in passing through some part remains in the rasa and increases it, the unabsorbed part passes into blood, and what is unabsorbed there passes into flesh and so on to the other higher constituents of bones, marrow and semen!. But others think that, just as in a farm-house pigeons of different descriptions sit together (khale kapota-nyaya), so not all the digested food-juice passes through the channel of the rasa-dhatu, but different parts of it pass through different channels from the very first stage. That part of it which nourishes rasa enters into the channel of its circulation, that part of it which nourishes the blood goes directly into that, and so on. But there is generally this time limitation, that the part which nourishes the blood enters into it only when the part which nourishes rasa-dhatu has been absorbed in it; so again the part which enters into flesh can only do so when the part which nourishes blood has been absorbed in it. Thus the circulatory system is different from the very beginning; and yet the nourish- ment of blood takes place later than that of vasa, the nourishment of flesh later than that of blood, and so on (rasad raktam tato mamsam ityader ayam arthah yad rasa-pusti-kalad uttara-kalam raktam jayate, etc.). The upholders of the last view maintain that the other theory cannot properly explain how a nourishing diet (vrsya), such as milk, can immediately increase the seminal fluid, and that, if it had to follow the lengthy process of passing through all the circulatory systems, it could not do its part so quickly; but on the second theory, milk through its special quality (prabhava) can be immediately associated with the seminal fluid and there- by increase it?.