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Thus Caraka says, as has already been mentioned, that from the time of the formation of the foetus the vata, pitta and kapha are working, but in more or less diverse ways and in diverse systems, with equal vayu, pitta, mala and kapha (sama-pittanila- kapha) or different degrees of predominance of them as vétala, pittala and slesmala®. Men of the slesmala type are generally healthy, whereas vatala and pittala persons are always of indifferent health. Later on, when there is a disease with the predominance of that dosa which is predominant in man’s constitution from his birth, the newly collected dosa produces morbidity on the lines on which the predominating dosa of his constitution is working ; but this newly collected dosa does not augment the corresponding original dosa. The original dosa is never increased, and, whatever may be the predominance of a dosa due to any disease, the constitutional condition of the dosas remains the same. Thus a vata-prakrti person does not become Slesma-prakrti or pitia-prakrti, and vice- versa. The dosas which are constitutional always remain as the prakrtim tha narandm bhautikim kecid Ghuh pavana-dahana-toyath kirtitds tas tu tisrah. Susruta, 111. 4. 80. 2 Caraka refers to a view that there are none who may be regarded as sama-vata-pitta-slesman (or having equal vata, pitta and slesman). Since all men take various kinds of diet (visamahdropayogitvat), they must be either vdta- prakrtt, pitta-prakrti, or slesma-prakrtt. Against this Caraka says that sama-vdata- pttta-slesman is the same thing as health or freedom from disease (aroga). All medicines are applied for attaining this end, and there cannot be any doubt that such a state exists. Again, the terms vata-prakrti, pitta-prakrti and slesma- prakrti are incorrect; for prakrti means health. What they mean by vata-prakrti is that vata is quantitatively predominant (adhikya-bhdavat sa dosa-prakrtir ucyate), and quantitative predominance is the same as vikdra; so the proper terms are vatala, pittala, etc. When a vatala person takes things which increase vata, his v@ta increases at once; but when he takes things which increase pitta or $lesman, these do not increase in him as rapidly as vata does. So in the case of a pittala person pitta increases rapidly when articles which increase pitta are taken, and so with regard to slesman (Caraka-samhita, 111. 6. 14-18). XIII] Vayu, Pitta and Kapha 335 constant part engaged in their physiological operations. The later accretion of the dosas or their deficiency has a separate course of action in producing diseases, and there is no interchange between these later collections of dosas or their deficiency and the con- stitutional constant parts of the dosas known as prakrti!. The only sense (as Cakrapani says) in which a dosa is related to a consti- tutional (prakriz) dosa is that a dosa grows strong in a system in which a corresponding dosa is constitutionally predominant, and it grows weaker when the opposite is the case?. It is not out of place in this connection to say that, though the dosas are mutually op- posed to one another, they do not always neutralize one another, and it is possible for them to grow simultaneously violent in a system. In the six seasons of rains (varsa), autumn (Sarat), late autumn (hemanta), winter (sita), spring (vasanta) and summer (grisma) there is an alternate collection (caya), disturbance (prakopa) and lowering down (prasama) of the three dosas, pitta, slesman and vayu respectively. Thus, for example, in the rains (vars@) there is collection of pitta, in the autumn (Sarat) there is dis- turbance of pitta, in the harvesting season (hemanta) there is lowering of pitta and collection of slesman, in the summer there is collection of vata, and so forth’. Contrasting the functions of the dosas in the normal (prakrti) and abnormal (vikrti) states, Caraka says that in the normal state the heat of 1 [bid.i.7.38-41. The passage prakrti-stham yada pittam marutah slesmanah ksaye (1. 17. 45) is often referred to in support of the view that the new accretions of dosas affect the prakrti-dosas. But Cakrapani explains it differently. He says that a disease may be caused by a dosa which is not in excess of the constant constitutional quantity (prakrti-mdna) by virtue of the fact that it may be carried from one part of the body to another and thereby may produce a local accretion or excess, though the total quantity of dosa may not be in excess. 2 samanam hi prakrtim prapya dosah pravrddha-balo bhavati, asamanam tu prapya tatha balavan na syat (Cakrapani on Caraka-samhitd, 1. 17. 62). 8 Jbid.1. 17.112. See also Cakrapani’s comments on these. Dalhana, in com- menting on Susruta-samhitd, 1. 21. 18, says that sancaya of dosas means aggre- gation or accumulation in general (dehe ’tirupavyddhis cayah); prakopa of dosas means that the accumulated dosas are spread through the system (vilayana-riipa vrddhih prakopah). The external signs of the caya of vdta are fullness of the stomach and want of motions; of pitta yellowish appearance and reduction of heat (mandosnata) ; of kapha heaviness of the limbs and feeling of laziness. In all cases of caya there is a feeling of aversion to causes which increase the particular dosa of which there has been caya (caya-karana-vidvesaés ca). The stage of caya is the first stage of operation in the growth and prevention of diseases. If the dosas can be removed or neutralized at this stage, there is no further disease. The usual indication of the disturbance (prakopa) of vdyu is disorders of the stomach; of pitta, acidity, thirst and burning; of kapha, aversion to food, palpitation (hrdayotkleda), etc. The prakopa of blood (Sonita) is always due to the prakopa of vata, pitta or kapha. This is the second stage of the progress of diseases. The 336 Speculations in the Medical Schools [cH. pitta occasions digestion; slesman is strength and vitality, and vayu is the source of all activities and the life of all living beings; but in the abnormal state pitta produces many diseases; slesman is the dirt of the system and the cause of many troubles, and vata also produces many diseases and ultimately death. The places (sthanani) at which the affections of vata, pitta and kapha are mostly found are thus described by Caraka: of vata the bladder, rectum, waist and the bones of the leg, but the smaller intestine (pakvasaya) is its particular place of affection; of pitta sweat, blood and the stomach, of which the last is the most important; of Slesman the chest, head, neck, the joints, stomach and fat, of which the chest is the most important. There are eighty affections of vata, forty of pitta and twenty of slesman}. But in each of these various affections of vata, pitta and slesman the special features and characteristics of the corresponding dosas are found. Thus Caraka in I. 20. 12-23 describes certain symptoms as leading to a diagnosis of the disease as being due to the disturbance of vata, pitta or kapha. But a question may arise as to what may con- sistently with this view be considered to be the nature of vayu, pitta and kapha. Are they only hypothetical entities, standing as symbols of a number of symptoms without any real existence? In such an interpretation reality would belong to the symptoms, and the agents of morbidity, or the dosas, would only be convenient symbols for collecting certain groups of these symptoms under one name. Wherever there is one particular set of symptoms, it is to be considered that there is disturbance of vayu; wherever there is another set of symptoms, there is disturbance of pitta, and so third stage is called prasara. At this stage there is something like a fermentation of the dosas (paryusita-kinvodaka-pista-samavaya iva). This is moved about by vayu, which though inanimate, is the cause of all motor activities. When a large quantity of water accumulates at any place, it breaks the embankment and flows down and joins on its way with other streams and flows on all sides; so the dosas also flow, sometimes alone, sometimes two conjointly, and sometimes all together. In the whole body, in the half of it, or in whatever part the fer- mented dosas spread, there the symptoms of diseases are showered down, as it were, like water from the clouds (doso vikaram nabhasi meghavat tatra varsati). When one dosa, e.g. vdyu, spreads itself in the natural place of another dosa, e.g. pitta, the remedy of the latter will remove the former (vdyoh pitta-sthadna- gatasya pittavat pratikdrah). The difference between prakopa and prasdra is thus described by Dalhana: just as when butter is first stirred up, it moves a little; this slight movement is like prakopa; but, when it is continuously and violently stirred to flow out, in froths and foams, it may then be called prasdra (Susruta-samhita, 1. 21. 18-32). The fourth stage is when the parva-ripa is seen, and the fifth stage is the stage of riipa or vyadhi (disease) (ibid. 38, 39). 1 Caraka-samhita, 1. 20. 11. XIII] Vayu, Pitta and Kapha 337 forth. But there are serious objections against such an inter- pretation. For, as we have shown above, there are many passages where these dosas are described as secretions and waste-products, which in their normal proportions sustain and build the body and in undue proportions produce diseases and may ultimately break up the system. These passages could not be satisfactorily explained upon the above interpretation.