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and sometimes as “‘waste-products,” and naturally this may cause confusion. The term mala has reference to the production of diseases*. Kitta means waste-products or secretions, and these may be called mala when they are in such proportions as to cause diseases. When, however, a mala is in such proportions that it does not produce any disease, it is not a mala proper but a mala-dhatu (nirbadha-karan maladin prasimde samcaks- mahe)*?. In another passage of Caraka (1. 28. 3), which has been referred to above, it is said that out of the digested food and drink there are produced rasa and kitta (secretion) called mala (tatrahara- prasadakhya-rasah kittam ca malakhyam abhinirvartate), and out of this kitta is produced sweat, urine, excreta, vayu, pitta and slesman. These malas are also dhatus, inasmuch as they sustain the body as much as the other dhatus, rasa or rakta, etc. do, so long as they are in their proper proportions and balance (te sarva eva dhatavo malakhyah prasadakhyas ca)*. Vagbhata, however, takes a different view of this subject. He separates the dosa, dhatu and mala and speaks of them as being the roots of the body. Thus he says that vayu sustains the body, contributing energy (utsaha), exhalation (ucchvasa), inspiration (nihsvasa), mental and bodily movement (cesta), ejective forces (vega-pravartana) ; pitta helps the body by 1 Caraka-samhitd, 1. 12. 13. 2 tatra mala-bhitas te ye Sarirasya badhakarah syuh. Caraka-samhitd, 1v.6.17. 3 Cakrapani on Caraka-samhita. Compare Sarngadhara, 1.8: vayuh pittam kapho dosa dhatavas ca mala matah, i.e. vayu, pitta and kapha are known as dosa, dhatu and mala. 4 Also evam rasa-malau sva-pramanavasthitav asrayasya sama-dhator dhatu- samyam anuvartayatah (Caraka-samhitd, 1. 28. 3). 328 Speculations in the Medical Schools [cH. digestive function, heat, the function of sight, imagination (medha), power of understanding (dhi), courage (s‘aurya), softness of the body; and slesman, by steadiness, smoothness, by serving to unite the joints, etc. The functions of the seven dhatus, beginning with rasa, are said to be the giving of satisfaction through the proper functioning of the senses (prinana or rasa), the contribution of vitality (jivana), the production of oiliness (sneha), the supporting of the burden (dharana) of the bones (asthi), the filling up of bone cavities (piirana or majja) and productivity (garbhotpada of sukra) ; of males it is said that the excreta has the power of holding the body, while urine ejects the surplus water and sweat holds it back?. The elder Vagbhata distinguishes the dhatus from vayu, pitta and kapha by calling the latter dosa (polluting agents) and the former disya (the constituents which are polluted). He further definitely denies that the malas of dhatus could be the cause of disease. He thus tries to explain away this view (that of Caraka as referred to above) as being aupacarika, i.e. a metaphorical statement?. The body, according to him, is a joint product of dosa, dhatu and mala’. Indu, the commentator on the Astanga-samgraha, however, emphasizes one important characteristic of the dosas when he says that the dynamic which sets the dha&tus in motion (dosebhya eva dhatiinam pravrttih) is derived from the dosas, and the circulation chemical activities, oiliness, hardness, etc. of the chyle (rasa) are derived from them*. Owing to the predominance of one or other of the dosas from the earliest period, when the foetus begins to develop, the child is said to possess the special features of one or other of the dosas and is accordingly called vata-prakrti, pitta- prakrti or slesma-prakrti. Vagbhata further says that disease is not dhatu-vaisamya, but dosa-vaisamya, and the equilibrium of dosas or dosa-samya is health. A disease, on this view, is the disturbance of dosas, and, as dosas are entities independent of the dhatus, the disturbance of dosas may not necessarily mean the dis- turbance of dhatus®. In another passage the elder Vagbhata says 1 Astanga-hrdaya, 1. 11. 1-5. E tayjan ity-upacarena tan ahur ghrta-dahavat rasadisthesu dosesu vyadhayas sambhavanti ye. Astdnga-samgraha, t. i. * Indu, the commentator on the Astanga-samgraha, puts it as sariram ca dosa- dhatu-mala-samudayah (1. 1). * tathad ca dhdatu-posdya rasasya vahana-paka-sneha-kathinyadi dosa- prasdda-labhyam eva (ibid.). s Ayur-veda is closely associated with the Samkhya and Nyaya-Vaiéesika, which alone deal with some sort of physics in Indian philosophy. It is pointed XII] Vayu, Pitta and Kapha 329 that, as the manifold universe is nothing but a modification of the gunas, so all diseases are but modifications of the three dosas, or, as in the ocean waves, billows and foam are seen which are in reality the same as the ocean, so all the different diseases are nothing but the three dosas!. The elder Vagbhata uses also in another place the simile of the three gunas with reference to the three dosas. Thus he says, ‘‘ As the three gumas co-operate together for the production of the world in all its diversity, in spite of the mutual opposition that exists among themselves, so the three dosas also co-operate together, in spite of natural opposition, for the pro- duction of the diverse diseases?.” In the treatment of the bone system the present writer agrees with Dr Hoernle that Vagbhata always attempted to bring about a reconciliation between Caraka and Susruta by explaining away the unadjustable views of one or the other. Here also the same tendency is seen. Thus, on the one hand, he explained away as being metaphorical (aupacariki) the expressed views of Caraka that the dhdtu-malas are the dosas. On the other hand, he followed the statements of the Uttara-tantra that the three dosas, the dhatus, excreta and urine sustain a man’s body. He further follows the Uttara-tantra in holding that the three dosas are the three gunas (bhinna dosas trayo gunah). Dalhana identifies vayu with rajas, pitta with sattva and kapha with tamas®. In the Sitra-sthana Susruta mentions blood (sonita) as having the same status as vayu, pitta and kapha and holds that the body out by Narasimha Kaviraja (a writer from the south) in his Vivarana-siddhdanta- cintamani (the only manuscript of which is in possession of the present writer) that according to Samkhya it is the dosa transforming itself from a state of equilibrium to a state of unbalanced preponderance of any of them that is to be called a disease (vaisamya-samydavastha-bhinnavastha-visesavad dosatvam rogatvam). The Naiyayikas, however, hold that disease is a separate entity or substance, which is produced by dosa, but which is not itself a dosa (dravyatve sati dosa-bhinna-dosa-janyaivam rogatvam). So a disease is different from its symptoms or effects. Narasimha further holds that, since Caraka speaks of diseases as being fiery (@gneya) and aerial (vdyavya), he tacitly accepts the diseases as separate substances. That Caraka sometimes describes a disease as being dhdtu-vaisamya is to be explained as due to the fact that, since dhatu-vaisamyas produce diseases, they are themselves also called diseases in a remote sense (yat tu Carakena dhatu-vaisamyasya rogatvam uktam tat tesam tatha- vidha-duhkha-kartrtvad aupacarikam. Vivarana-siddhanta-cintamamni, MS. p. 3). 1 Astanga-samgraha, 1. 22. = aGrambhakam virodhe ’pi mitho yad yad guna-trayam visvasya drstam yugapad vyadher dosa-trayam tatha (ibid. 1. 21). 3 rajo-bhuyistho marutah, rajo hi pravartakam sarva-bhavanam pittam sattvot- katam laghu-prakdsakatvat,rajo-yuktam va ity eke kaphas tamo-bahulah, guru-pra- varanatmakatvad ity ahur bhisajah. Yady evam tat katham kapha-prakrtike pumsi . sattva-gunopapannata pathita, ucyate, guna-dvitayam api kaphe jfiatavyam sattva- tamo-bahula apa (Dalhana on Susruta, Uttara-tantra, 66. 9). 330 Speculations in the Medical Schools [cH. depends on food and drink as well as on the various combinations of vayu, pitta, kapha and sonita in health and disease. Dalhana, in commenting on this, says that, Susruta’s work being principally a treatise on surgery, its author holds that blood with all its impurities plays an important part in producing disturbances in all wounds’. Susruta further speaks of vata, pitta and slesman as the causes of the formation of the body (deha-sambhava-hetavah).'The vata, pitta and kapha, situated in the lower, middle and upper parts of the body, are like three pillars which support the body, and blood also co-operates with them in the same work. Dalhana remarks that vata, pitta and kapha are concomitant causes, working in co- operation with semen and blood?. Susruta further derives vata from the root va, to move, pitta from tap, to heat, and slesman from slis, to connect together. The Sétra-sthana of Susruta com- pares kapha, pitta and vayu with the moon (soma), the sun (sirya) and air (anila) but not-with the three gunas, as is found in the supplementary book, called the Uttara-tantra. In discussing the nature of pitta, he says that pitta is the fire in the body and there is no other fire but pitta in the body. Pitta has all the qualities of fire, and so, when it diminishes, articles of food with fiery qualities serve to increase it, and, when it increases, articles of food with cooling properties serve to diminish it. Pitta, according to Susruta, is situated between the stomach (@md@saya) and the smaller intestines (pakvasaya), and it cooks all food and drink and separates the chyle on the one hand, and the excreta, urine, etc. on the other. Being situated in the above place, between the stomach and the smaller intestines (tatra-stham eva), by its own power (a@tma-saktya) it works in other pitta centres of the body and by its heating work (agni-karma) sets up the proper activities at those places.