168 - Diseases

The chapter describes the three humours, their disruption as the cause of diseases, the seven ingredients of the body, the three humours with their characteristics.

Dhanvantari said: 

1. O Sushruta, I shall succinctly explain the recipes of medicinal compounds removing all ailments for the sake of longevity of all living beings. 

2-3. By the intake of astringent, pungent, bitter, acid or parchifying foodstuffs, anxiety, inordinate sexual intercourse, physical fatigue, fright, grief, keeping awake at night, loud talking, carrying heavy loads, undue exertions and pulling hard, Vayu gets aggravated during the rainy season, when the food is digested or at the close of the day. 

4-5. By the intake of hot acid, saline, alkaline and pungent foodstuffs, by taking food before perfect digestion, exposure to sunshine, warmth of fire, drinking of spirituous liquors and anger, Pitta gets aggravated. When the food is in the process of digestion, in the midday, after the rainy season, in summer and at midnight. 

6-7. By the intake of sweet, acid, saline, fatty, heavy and very cold articles of food, by taking in newly harvested rice, flesh of animals living in marshy places and lubricious stuffs, want of sufficient exercise, sleep during the day, and luxurious easy-going habits, Kapha gets aggravated immediately after food, or at dusk or in the spring season. 

8-9. "The symptoms of aggravation of Vayu are these: -- Roughness of the body, contraction of limbs, aching pain, obstruction to the passage of waste matter, insensibility, horripilation, rigidity, emaciation, a dark brown complexion, loose ness of limbs, increase in exertion, etc. Hence ailments in which these symptoms are seen are those produced by Vayu aggravation. 

10. Burning sensation, heat, wetness of feet, anger without reason, lustfulness, exhaustion, pungent and acid (eructation), foul smell in the sweat like that of a dead body, fainting, excessive thirst, vertig, yellow and green colour--these are the symptoms of Pitta affliction in men. 

11-12. Glossiness of the body, sweet taste in the mouth, delayed execution of things, obstruction, paralysed numbness, satiation, amassedness, anasarcha, chillness, heaviness, itching sensation, and overwhelming attack of sleep are the symptoms of Kapha aggravation, Ailments caused by two doshas in combination must be known by the combination of symptoms. 

13. A Sannipataja ailment exhibits all the symptoms as it is caused by all the doshas in combination. The body is the receptacle and base for all the doshas, dhatus (fundamental constituents of the body) and waste matter. 

14. Equilibrium of doshas indicates normal health; if any of them increases or decreases it indicates sickness. Fat, blood, flesh, suet, bones, marrow and semen are the seven Dhatus. 

15. Vayu, Pitta, and Kapha are the three doshas. Faeces, urine etc. are called Malas (Waste matter). Vayu is cool, light, subtle, cause of loss of voice, strong and unsteady. 

16. Pitta is acid, pungent, hot; unripeness, undigestedness is the cause of sickness. Kapha is sweet, saline, glossy, heavy and lubricious. 

17. Vayu is seated in rectum and buttocks; Pitta is located in the digestive cavity; Kapha is located in the abdomen, throat and joints of the cranium. 

18. Things of pungent, bitter and stringent taste aggravate Vayu; things pungent, acid and saline in taste aggravate Pitta; Things sweet, hot and saline aggravate Kapha. 

19. These are administered in reverse order to quell the aggravated doshas. Doshas coming back to their normal seats quell the ailment and bring relief. 

20. Sweet taste improves the power of vision and increases lymph secretions and the Dhatus. An acid taste at the end is relishing, appetising and digestant. 

21. A bitter taste is appetising, curative of fever, remover of thirst, laxative and cause of emaciation. An astringent taste excites pitta, is scraping, rigidifier and absorbant. 

22. A drug is good if it is the receptacle of tastes, potency and relieving after-effects. A drug consistent in taste and after-effects has all properties. 

23. The poteney of a drug is twofold: Shita (cooling) Ushna (Heating). The Paka or digestive transformation of the tastes is twofold sweet and pungent. 

24. Physician, Medicine, Patient and plenty of nurses these four are the important constituents in the process of treatment. Any deficiency in them renders the process unfruitful. 

25. A physician shall start his work after thoroughly understanding the habitation, season, age (of the patient), digestive power, physical temperament, nature of his constitution, drug, physical strength and the ailment. 

26. That country is called Sadharana (common or ordinary) which has both the characteristics [of Jangala (hilly forest) and Anupa (marshy lands)]. A patient is a Bala (child) till the sixteenth year, till the seventieth year Madhya (middle aged) and Vruddha (old) thereafter.

27. Kapha, Pitta and Vayu respectively predominate in the three stages of life. All modes of treatment except those involving alkaline, surgical and fire operations are to be followed in a debilitated or aged person. 

28. A lean person must be given Bramhana (treatment making one stout) and to a corpulent man the treatment is Karshanam (reducing bulk). A body of medium structure should be maintained as it is. Thus, three kinds of bodies shall be known. 

29. The strength of a patient should be understood from his steadiness, exercises, and gaiety of mind. An enthusiastic adventuresome man does not show signs of decline or decay. 

30. Drink and diet though opposed to his temperament yet giving him relief and pleasure are termed his Satmya or second nature. 

31. If the pregnant woman takes Kapha-generating foodstuffs the child will be Kapha prakruti (Kapha-temperamented). The same is the case with Vayu generating and Pitta generating foodstuffs. If a balanced diet is maintained the child shall be Samadhatu (having all fundamental constituents in proper proportion). 

32. A Vata temperamented person is lean, harsh and volatile. He has few hair and he prattle in dream. 

33. A pitta-temperamented person is irritable, scholarly and perspiring too much. His hair turns prematurely grey. He dreams of fiery blazing things. 

34. A Kapha temperamented person is of steady mind, subtle in speech and of gay disposition. He has glossy hair. In dreams he sees water and rocks. 

35. If a person exhibits the traits peculiar to two or three doshas he must be considered mixed-temperamented. The predominant traits will be those of the predominant dosha. 

36. The digestive power is sluggish, sharp, irregular or normal if Kapha or Pitta or Vayu predominates or remains in equilibrium. 

37. The normal one should be preserved; the irregular one is to be remedied by curbing Vayu; the sharp one by antidotes to Pitta and the sluggish one by eliminating Kapha. 

38. The root cause of all ailments is indigestion resulting in the annihilation of the gastric fire; Indigestion is of four types-Ama, Amla, Rasa and Vishtambha. 

39. The Ama sort of indigestion causes cholera, sluggish ness of the heart, etc. The antidote for this is the administration of an emetic with the washings of the drug Vaca¹ with salt.

1. Acorus calamus.

40. Due to Amla (acidity) the disorders, non-secretion of semen, vertigo, fainting fits and excessive thirst are observed. The remedy there, is drinking of unboiled cold water and inhaling chill air.

41. In the Rasa type of indigestion (affecting lymph secretion) the symptoms are breaking pain in the limbs, sluggishness of the head and repugnance for food. The remedy in this case is complete abstention from food and drink and sleep during the day. 

42. The two symptoms of acute pain and enlarged spleen indicate the Vishtambha form of indigestion marked by suppression of faeces and urine. Diaphoretic measures and salt water for drinking are the antidote in this case. 

43-44. The types of indigestion Ama, Amia, and Vishtambha are respectively caused by Kapha, Pitta and Vayu. A sensible man (suffering from any of these) shall plaster his stomach with a paste of Hingu,² Tryusana,³ and Salt and take a nap in the day time. All sorts of indigestion will be dispelled. Hosts of illness result from unwholesome articles and hence one should forsake all unwholesome articles.

2. Asfoetida. 

3. Also called Trikatu. It is a combination of Black Pepper, long Pepper and dry Ginger.

45. Hot water taken after honey is a good digestant. Milk is incompatible with bamboo shoots, curd and fish. 

46. The big five root drugs (Mahat Panchamula) are Bilva,⁴ Shona,⁵ Gambhari,⁶ Patala,⁷ and Ganikarika⁸. They are appetising and they dispel excess of Kapha and Vayu. 

4. Aegle Marmelos.

5. Bignonia indica.

6. Gmelina arborea.

7. Bignonia suaveoleoffs

8. Premna spinosa.

47. The small Panchamūla drugs are Shalaparni¹, Přuśhniparni², two types of Bruhati³, and Gokşhura⁴ and they dispel excess of Vayu and Pitta. They are aphrodisiac in character. 

            1. Desmodium Gangeticum or Hedysärum G.

 2. Flemionitis cordifolia. 

3. Solanum Indicum. 

4. Tribulus Lanuginosus.

48. Both these two groups together are called Dašhamūla⁵ drugs. They cure all fevers of Sannipätaja type. They are very good in cough, asthma, somnolence and pain in the sides. 

            5. Ten roots. 

49-50. Madicinal oils, ghees and pastes prepared with these are very good in Alakā ailments (Sannipätaja). Drugs with four times water shall be boiled and reduced to one fourth. Add four times of butter or oil to this with equal quantity of milk. The Kalka or residue will be one fourth of the oil or butter. This medicated butter of good påka (proper cooking) is a good clyster in troubles with urinary bladder. The hard kalka can be applied over the body and the soft dust can be used as an errhine. 

51. The gross body and the sense organs must be well thought of. If they are in their proper function that is called normalcy of health. A person destined for longevity must be properly attended to. 

52. A person whose activities of the sense organs are perverted hasten towards death's door. A person who hates the physician friends and elders and he who loves enemies too follows suit. 

53. He whose heel bones, knees, forehead, jaw bones, cheek bones suffer from prolapsus, dies ere long. 

54. Left eye sinking in the socket; dark tongue, deranged nose, black lips dislodged from their seats, and a face turned black-all these indicate death and hence those patients must be given up.