Part 7 - Growth and Disease

The three elements, vāyu, pitta and kapha , are counted both as constituents (dhātus) and as doṣas , or morbid elements. Dhātus are those elements which uphold the body. The body is the conglomeration (samudāya) of the modification of five bhūtas, or elements, and it works properly so long as these elements are in proper proportions (sama-yoga-vāhin) in the body^[1]. The modifications of the five elements which co-operate together to uphold the body are called dhātus. When one or more of the dhātus fall off or exceed the proper quantity (dhātu-vaiṣamya), one or more dhātus may be in excess or deficient either in partial tendencies or in entirety (akārtsnyena prakṛtyā ca). It has to be noted that, as Cakrapāṇi explains, not every kind of excess or deficiency of dhātus produces dhātu-vaiṣamya, or disturbance of the equilibrium of the dhātus: it is only when such deficiency or excess produces affections of the body that it is called dhātu-vaiṣamya. That amount of excess or deficiency which does not produce trouble or affection of the body is called the normal measure of the dhātus (prākṛta-māna)^[2]. It is indeed obvious that such a definition of prākṛta-māna and dhātu-vaiṣamya involves a vicious circle, since the normal measure or prākṛta-māna of dhātus is said to be that which exists when there is no trouble or affection, and dhātu-vaiṣamya is that which exists when there is trouble in the body; the trouble or affection of the body has thus to be defined in terms of dhātu-vaiṣamya.

The only escape from this charge is that dhātu-vaiṣamya and disease are synonymous, and the prākṛta-māna of dhātus is the same as health. When the dhātus are in their normal measure, there cannot be any vaiṣamya, except of a local nature, as when, for example, the pitta existing in its own proper measure is somehow carried by vāyu to a part of the body and there is consequently a local excess. Whatever leads to the increase of any particular dhātu automatically leads also to the decrease of other dhātus which are opposed to it. Things having the same sort of composition as a particular bodily dhātu increase it, and things having a different composition decrease it (sāmānyam ekatva-karaṃ viśeṣas tu pṛthaktva-kṛt)^[3].

The normal health of a man is but another name for his dhātu-sāmya ; a man is said to be unhealthy, or to be in a state of dhātu-vaiṣamya , when symptoms of disease (vikāra) are seen. Slight variations of the due proportion of dhātu do not entitle us to call them instances of dhātu-vaiṣamya unless there is vikāra or symptoms of it externally expressed. The daily course of a healthy man ought to be such that the equilibrium of dhātus may be properly maintained. The sole aim of Āyurveda 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 dhātus and a man who has lost the equilibrium of his dhātus may regain it. The aim of Āyurveda is thus to advise men how to secure dhātu-sāmya (dhātu-sāmya-kriyā coktā tantrasyāsya prayojanam)^[4].

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 characteristics of heat and cold, and the misuse of intelligence^[5]. 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 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 of the improper use (mithyā-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 mithyā-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 improper use of touch^[6].

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 atiyoga , ayoga and mithyā-yoga of the effort of speech, mind and body (vāñ-manaḥ-śarvra-pravṛtti)^[7]. But these are all due to the misuse of intelligence (prajñāparādha).

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 mithyā-yoga of time (kāla)^[8]. But the misuse of intelligence, or prajñāparādha , is at the root of all excessive, deficient or wrongful association with sense-objects^[9]; 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 prajñāparādha. When certain sinful deeds are performed by prajñāparādha , 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, prajñāparādha ; kāla, 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 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-dhātu-guṇānāṃ sāmānya-yogād vṛddhir vipar-yayādd hrāsaḥ)^[10].

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^[11]. But the principle 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

(samāna-guṇa-bhūyiṣṭhānām anyaprahrtīnām apy-āhāra-vikārāṇām upayogaḥ)^[12].

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 assimilation 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^[13]. 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 Cakrapāṇi (i. 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 circulation in irrigation (kedarī-kulyā-nyāya). The rasa (chyle) produced as a result of the digestive process, coming into association with rasa as the body-constituent (dhātu-rūpa-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 circulation begins by the entrance of the entire chyle into the constituent rasa (rasa-dhātu); 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^[14]. But others think that, just as in a farm-house pigeons of different descriptions sit together (khale kapota-nyāya), so not all the digested food-juice passes through the channel of the rasa-dhātu , 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-dhātu 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 nourishment of blood takes place later than that of rasa , the nourishment of flesh later than that of blood, and so on (rasād raktaṃ tato māṃsam ityāder ayam arthaḥ yad rasa-puṣṭi-kālād uttora-kālaṃ raktaṃ jāyate, etc.). The upholders of the last view maintain that the other theory cannot properly explain how a nourishing diet (vṛṣya), 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 (prabhāva) can be immediately associated with the seminal fluid and thereby increase it^[15]. But Cakrapāṇi remarks that the earlier theory (kedārī-kulyā) is as good as the later one.

For on that view also it might be held that by milk its special quality (prabhāva) passed quickly through the various stages and became associated with the seminal fluid. Nor can it be said that according to the first theory every case of impurity of rasa (rasa-duṣṭi) is also a case of impurity of blood (rakta-duṣṭi), as is argued; for not the whole of rasa is transformed into blood, but only a part of it. So the rasa part may be impure, but still the part that goes to form blood may be pure; thus both theories are equally strong, and nothing can be said in favour of either. In Caraka-saṃhitā , vi. 15. 14 and 15, it is said that from rasa there is rakta (blood), from rakta flesh, from flesh fat, from fat bones, from bones marrow, from marrow semen. The two theories above referred to deal with the supposed ways in which such transformations occur.

In addition to the seven dhātus, or body-constituents, spoken of above there are ten upa-dhātus , which are counted by Bhoja as śirā, snāyu, ovarial blood and the seven layers of skin^[16]. Caraka says in vi. 15. 15 that from rasa is also produced milk, and from milk ovarial blood; again, the thick tissues or ligaments (kaṇḍarā) and śirās are produced from blood, and from flesh are produced fat (vasā) and the six layers of skin, and from fat (medas) are produced the five tissues. The chyle, or rasa, becomes tinged with red by the heat of bile. The blood, again, being worked upon by vāyu and heat, becomes steady and white, and is called fat (medas). The bones are a conglomeration of earth, heat and air and therefore, though produced from flesh and fat, are hard. They are made porous by vāyu running through them, and the pores are filled in by fat, which is called marrow. From the oily parts of marrow, again, semen is produced. Just as water percolates through the pores of a new earthen jug, the semen percolates through the pores of the bones, and there is also a flow of this seminal fluid through the body by way of its own ducts. By the rousing of desires and sex joy and by the heat of the sex act the semen oozes out and collects in the testes, from which it is ultimately liberated through its proper channel^[17].

Footnotes and references:

[1]:

Caraka-saṃhitā, iv.6.4. Cakrapāṇi, in commenting on the word sama-yoga-vāhin, explains sama as meaning ucita-pramāṇa (proper quantity).

[2]:

etad eva dhātūnāṃ prākṛta-mānaṃ yad avikāra-kāri.
      Cakrapāṇi’s comment on Caraka-saṃhitā, iv. 6. 4.

[3]:

Caraka-saṃhitā, i. i. 44.

[4]:

Ibid. 1. 1. 52.

[5]:

kāla-buddhīndriyārthānānt yogo mithyā na cāti ca
ḍvayāśrayāṇāṃ vyāḍhīnāṃ tri-viḍho hetu-saṃgrahaḥ.
      Ibid. I. 1. 53.

[6]:

Carako-saṃḥitā, 1. 11. 37.

[7]:

Ibid. 1. 11. 39, 40. Cakrapāṇi says that this includes sinful deeds which produce illness and unhappiness,

śārīra-mānasika-vācanika-karma-mithyā-yo-genaivā-dharmotpādāvāntara-vyāpāreṇaivūdharma-janyānāṃ vikārāṇām kriya-mānatvāt.

[8]:

Three seasons only are mentioned, Śītoṣma-varṣa-lakṣaṇāḥ punar heman-ta-grīṣma-varṣāḥ. Ibid. 1. 11. 42.

[9]:

Thus Cakrapāṇi, commenting on this, says,

“buddhy-aparādhasyaiva indri-yārthātiyogādi-hetutvāt.”
      Ibid. 1. 1. 53.

[10]:

Caraka-saṃhitā, 1. 1. 43 and 44, also IV 6. 9 and particularly iv. 6. 10.

[11]:

Ibid. iv. 6. 10. Cakrapāṇi explains āma-garbha as aṇḍa.

[12]:

Ibid. iv. 6. 11.

[13]:

Ibid. iv. 6. 14 and 15.

[14]:

There are two kinds of rasa, called dhātu-rasa and poṣaka-rasa. See Cakrapāṇi’s comment on Caraka-saṃhitā, vi. 15. 14 and 15.

[15]:

pariṇāma-pakṣe, vṛṣya-prayogasya raktādi-rūpāpatti-krameṇāticireṇa śukraṃ bhavatīti; kṣīrādayaś ca sadya eva vṛṣyā dṛsyante, khale-kapota-pakṣe tu vṛṣyotpanno rasaḥ prabhāvāc chīghram eva śukreṇa saṃbaddhaḥ san tat-puṣṭim karotiti yuktam
      (Cakrapāṇi on Caraka-saṃhitā, 1. 28. 3).

Elsewhere (ibid. vi. 15. 32) it is said that those articles of food which stimulate semen (vṛṣyā) are, according to some authorities, changed into semen in six days and nights, whereas in the ordinary course, as is said in Suśruta, it takes a month for the transformation of ordinary articles of food into semen. But Caraka does not favour any time limitation and urges that, just as the movement of a wheel depends upon the energy spent on it, so the time that a particular food takes for getting itself transformed into semen or into any other dhātu depends upon the nature of the food and the powers of digestion.

[16]:

Cakrapāṇi on Caraka-saṃḥitā, vi. 15. 14 and 15, a quotation from Bhoja. Ojas is counted as an upa-dhātu.

[17]:

Caraka-saṃhitā, vi. 15. 22-29.