Part 8 - Vāyu, Pitta and Kapha

The qualities of the body are briefly of two kinds, those which make the system foul, the mala, and those which sustain and purify the body, the prasāda. Thus in the pores of the body are formed many undesirable bodily growths which seek egress; some constituents of the body, such as blood, are often turned into pus; the vāyu (air), pitta (bile) and kapha (phlegm or lymph) may become less or more than their normal measure (prakupita), and there are other entities which, existing in the body, tend to weaken or destroy it; these are all called malas. Others which go towards the sustenance and the growth of the body are called prasāda^[1].

But vāyu, pitta and kapha are primarily responsible for all kinds of morbidities of the body, and they are therefore called doṣa. It must, however, be noted that the vāyu, pitta and kapha and all other malas, so long as they remain in their proper measure (svamāna), do not pollute or weaken the body or produce diseases. So even malas like vāyu, pitta and kapha, or sweat, urine, etc., are called dhātus, or body-constituents, so long as they do not exceed their proper measure, and thus instead of weakening the body they serve to sustain it. Both the mala-dhātus and the prasāda-dhātus in their proper measure co-operate together in sustaining the body^[2]. When various kinds of healthy food and drink are exposed in the stomach to the internal fire of the digestive organs, they become digested by heat. The essential part of the digested food is the chyle (rasa), and the impurities which are left out and cannot be assimilated into the body as its constituents are called kitta or mala.

From this kitta are produced sweat, urine, excreta, vāyu, pitta, śleṣman and the dirt of ear, eye, nose, mouth and of the holes of the hairs of the body, the hair, beard, hair of the body, nails, etc.^[3]

The impurity of food is excreta and urine, that of rasa is phlegm (kapha), that of flesh bile (pitta) and that of fat (medas) sweat^[4]. This view of vāyu, pitta and kapha seems to indicate that these are secretions, waste-products (kitta), like the other vVaste-products of the body. But the theory of waste-products is that, when they are in their proper measure, they serve to sustain the body and perform important functions, but, when they exceed the proper limit or become less than their proper measure, they pollute the body and may ultimately break it. But of all waste-products vāyu , pitta and kapha are regarded as being fundamentally the most important entities, and they sustain the work of the body by their mutual co-operation in proper measure, and destroy it by the disturbance of balance due to the rise or fall of one, two or all three of them.

As has already been said, the body is composed of certain constituents, such as rasa and rakta. The food and drink which we take go to nourish the different dhātus. Not all the food and drink that we take, however, can be absorbed into the system, and consequently certain waste-products are left^[5]. The question arises, what is it that sustains the system or breaks it? It has already been noticed that the due proportion of the dhātus is what constitutes the health of the body. This due proportion, however, must, as is easy to see, depend on the proper absorption of food and drink in such a way that each of the dhātus may have its due share and that only, neither less nor more. It is also necessary that there should be a due functioning of the causes of waste or accretion, working in a manner conducive to the preservation of the proper proportion of the constituents with reference to themselves and the entire system. Deficiency or excess of waste-products is therefore an invariable concomitant of all disturbances of the balance of dhātus , and hence the deficiency or excess of waste-products is regarded as the cause of all dhātu-vaiṣamya.

So long as the waste-products are not in deficiency or excess, they are the agents which constitute the main working of the system and may themselves be therefore regarded as dhātus. It is when there is excess or deficiency of one or more of them that they oppose in various ways the general process of that working of the system and are to be regarded as doṣas or polluting agents. There are various waste-products of the body; but of all these vāyu, pitta and kapha are regarded as the three most important, being at the root of all growth and decay of the body, its health and disease.

Thus Ātreya says in answer to Kāpyavaca’s remarks in the learned discussions of the assembly of the sages,

“In one sense you have all spoken correctly; but none of your judgments are absolutely true. Just as it is necessary that religious duties (dharma), wealth (artha) and desires (kāma) should all be equally attended to, or just as the three seasons of winter, summer and rains all go in a definite order, so all the three, vāta, pitta and śleṣman or kapha, when they are in their natural state of equilibrium, contribute to the efficiency of all the sense-organs, the strength, colour and health of the body, and endow a man with long life. But, when they are disturbed, they produce opposite results and ultimately break the whole balance of the system and destroy it^[6].”

There is one important point to which the notice of the reader should particularly be drawn. I have sometimes translated mala as “polluting agents or impurities” and sometimes as “waste-products,” and naturally this may cause confusion.

The term mala has reference to the production of diseases^[7].

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-dhātu

(nirbādha-karān malādīn prasāṃde samcakṣ-mahe)^[8].

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

(tatrāhāra-prasādākhya-rasaḥ kittaṃ ca malākhyam abhinirvartate),

and out of this kitta is produced sweat, urine, excreta, vāyu,pitta and śleṣman.

These malas are also dhātus, inasmuch as they sustain the body as much as the other dhātus, rasa or rakta, etc. do, so long as they are in their proper proportions and balance

(te sarva eva dhātavo malākhyāḥ prasādākhyāś ca)^[9].

Vāgbhata, however, takes a different view of this subject. He separates the doṣa, dhātu and mala and speaks of them as being the roots of the body.

Thus he says that vāyu sustains

• the body,
• contributing energy (utsāha),
• exhalation (ucchvāsa),
• inspiration (niḥśvāsa),
• mental and bodily movement (ceṣṭā),
• ejective forces (vega-pravartana);

pitta helps the body by

• digestive function,
• heat,
• the function of sight,
• imagination (medhā),
• power of understanding (dhī),
• courage (śaurya),
• softness of the body;

and śleṣman, by steadiness, smoothness, by serving to unite the joints, etc.

The functions of the seven dhātus, beginning with rasa, are said to be the giving of satisfaction through the proper functioning of

• the senses (prīṇana or rasa),
• the contribution of vitality (jīvana),
• the production of oiliness (sneha),
• the supporting of the burden (dhāraṇa) of the bones (asthi),
• the filling up of bone cavities (pūraṇa or majjā)
• and productivity (garbhotpāda of śukra) ;

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^[10]. The elder Vāgbhata distinguishes the dhātus from vāyu, pitta and kapha by calling the latter doṣa (polluting agents) and the former dūṣya (the constituents which are polluted). He further definitely denies that the malas of dhātus could be the cause of disease. He thus tries to explain away this view (that of Caraka as referred to above) as being aupacārika, i.e. a metaphorical statement^[11].

The body, according to him, is a joint product of doṣa, dhātu and mala^[12]. Indu, the commentator on the Aṣṭāṅga-saṃgraha, however, emphasizes one important characteristic of the doṣas when he says that the dynamic which sets the dhātus in motion (doṣebhya eva dhātūnāṃ pravṛttiḥ) is derived from the doṣas, and the circulation chemical activities, oiliness, hardness, etc. of the chyle (rasa) are derived from them^[13].

Owing to the predominance of one or other of the doṣas 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 doṣas and is accordingly called vāta-prakṛti, pitta-prakṛti or śleṣma-prakṛti. Vāgbhata further says that disease is not dhātu-vaiṣamya, but doṣa-vaiṣamya, and the equilibrium of doṣas or doṣa-sāmya is health. A disease, on this view, is the disturbance of doṣas, and, as doṣas are entities independent of the dhātus, the disturbance of doṣas may not necessarily mean the disturbance of dhātus^[14].

In another passage the elder Vāgbhata says that, as the manifold universe is nothing but a modification of the guṇas, so all diseases are but modifications of the three doṣas, 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 doṣas^[15]. The elder Vāgbhata uses also in another place the simile of the three guṇas with reference to the three doṣas.

Thus he says,

“As the three guṇas 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 doṣas also co-operate together, in spite of natural opposition, for the production of the diverse diseases^[16].”

In the treatment of the bone system the present writer agrees with Dr Hoernle that Vāgbhata always attempted to bring about a reconciliation between Caraka and Suśruta 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 (aupacārikī) the expressed views of Caraka that the dhātu-malas are the doṣas. On the other hand, he followed the statements of the Uttar a- tantra that the three doṣas, the dhātus, excreta and urine sustain a man’s body. He further follows the Uttara-tantra in holding that the three doṣas are the three guṇas (bhinnā doṣās trayo guṇāḥ). Ḍalhaṇa identifies vāyu with rajas, pitta with sattva and kapha with tamas^[17].

In the Sūtra-sthāna Suśruta mentions blood (śoṇita) as having the same status as vāyu, pitta and kapha and holds that the body depends on food and drink as well as on the various combinations of vāyu,pitta, kapha and śoṇita in health and disease. Ḍalhaṇa, in commenting on this, says that, Suśruta’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^[18]. Suśruta further speaks of vāta, pitta and śleṣman as the causes of the formation of the body (deha-sambhava-hetavaḥ). The vāta, 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. Ḍalhaṇa remarks that vāta, pitta and kapha are concomitant causes, working in cooperation with semen and blood^[19].

Suśruta further derives vāta from the root vā, to move, pitta from tap, to heat, and śleṣman from śliṣ, to connect together. The Sūtra-sthāna of Suśruta compares kapha, pitta and vāyu with the moon (soma), the sun (sūrya) and air (anila) but not with the three guṇas, 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 Suśruta, is situated between the stomach (āmāśaya) and the smaller intestines (pakvāśaya), 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 (ātma-śaktyā) it works in other pitta centres of the body and by its heating work (agni-karma) sets up the proper activities at those places. In its function of cooking it is called pācaka, in its function in the liver and spleen, as supplying the colouring matter of blood, it is called “colouring” (rañjaka), in its function in the heart it serves intellectual purposes (sādhaka), in its function in the eyes it is called “perceiving,” or locaka, in its function of giving a glossy appearance to the skin it is called bhrājaka. It is hot, liquid and blue or yellow, possesses bad smell, and after passing through unhealthy digestive actions tastes sour. Coming to śleṣman, Suśruta says that the stomach is its natural place; being watery, it flows downwards and neutralizes the bile-heat, which otherwise would have destroyed the whole body by its excessive heat. Being in āmāśaya, it w^rorks in the other centres of śleṣman, such as the heart, the tongue, the throat, the head and in all the joints of the body.

The place of vāyu is the pelvic regions and the rectum (śroṇi-guda-saṃśraya) ; the main place of the blood, which is counted as doṣa by Suśruta, is regarded as being the liver and the spleen^[20]. I have noticed above, that in the Atharva-Veda mention is found of three kinds of diseases, the airy (vātaja), the dry (śuṣma) and the wet (abhraja)^[21]. In the Caraka-samhitā vāta, pitta and kapha are regarded as being produced from kitta, or secretions. They are thus regarded here as being of the nature of internal waste-products of unassimilated food-juice at the different stages of its assimilation, as chyle, flesh, etc., which have important physiological functions to perform for the preservation of the process of the growth of the body, when they are in due proportions, and they break up the body when they are in undue proportions.

What exactly kitta means is difficult to determine. It may mean merely the part of the food-juice unassimilated as chyle, or the part of it unassimilated as blood, and so forth; or it may mean such unassimilated products, together with the secretions from the respective dhātus, which absorb the substantial part of the food-juice and throw off some of its impurities into the unabsorbed material; this at least is what kitta ought to mean, if it is interpreted as dhātu-mala, or impurities of dhātus .

These secretions and waste-products form the source of most of the constructive and destructive forces of the body. The watery character of kapha and the fiery character of pitta are not ignored; but their essence or substance is considered to be secretive, or of the nature of waste-product. Suśruta, however, does not seem to refer to this secretive aspect, but he seems to have grasped the essential physiological activity of the body as being of the nature of digestive operation and the distribution of the heat and the products of digestion; and the analogy of cooking, as requiring fire, water and air, seems to have been well before his mind.

Suśruta also seems to have leant more towards the view of the physiological operations of the body as being due to elemental activities, the food-juice taking the place of earth and the other three principles being fire (pitta), water (śleṣman) and air (vāta). The reason why the principles of the body are here regarded as being transformations of fire, water and air is not explained by Suśruta. The supplementary Uttara-tantra , however, thinks that they are the three guṇas. Vāgbhata, always fond of taking a middle course in his endeavour to reconcile the different attempts to grasp the principles under discussion, holds that they are comparable to the three guṇas , because, though opposed to one another, they also co-operate together; and, because diseases are but modifications of the doṣas, he further thinks that doṣas, dhātus and dhātu-malas are quite different entities; but he is unable to give any definite idea as to what these doṣas are.

The person who seems to have had the most definite conception of the doṣas was Caraka. In the Uttara-tantra and by Vāgbhata the Sāṃkhya analogy of the guṇas seems to have had a very distracting influence, and, instead of trying to find out the true physiological position of the doṣas , these writers explain away the difficulty by a vague reference to the Sāṃkhya guṇas.

Let us now return to Caraka. By him vāyu is described as being dry (rukṣa), cold (śīta), light (laghu), subtle (sūkṣma), moving (cala), scattering everything else in different directions (viśada) and rough (khara)^[22]. It is neutralized in the body by those things which have opposite qualities.

In the healthy constructive process the vāyu is said to perform physiological functions as follows:

• it sustains the machinery of the body (tantra-yantra-dharaḥ), it manifests itself as prāna, udāna, samāna and apāna and is the generator of diverse kinds of efforts;
• it is the force which controls (niyantā) the mind from all undesirables and directs (praṇetā) it to all that is desirable,
• is the cause of the employment of the sense-organs,
• is the carrier of the stimulation of sense-objects, collects together the dhātus of the body, harmonizes the functions of the body as one whole,
• is the mover of speech, is the cause of touch and sounds, as also of the corresponding sense-organs,
• the root of joy and mental energy,
• the air for the digestive fire, the healer of morbidities,
• the ejecter of extraneous dirts,
• the operating agent for all kinds of circulation,
• the framer of the shape of the foetus,
• and is, in short, identical with the continuity of life (āyuṣo ’nuvṛtti-pratyaya-bhūta).

When it is in undue proportions, it brings about all sorts of troubles, weakens the strength, colour, happiness and life, makes the mind sad, weakens the functions of the sense-organs, causes malformations of the foetus, produces diseases and all emotions of fear, grief, delirium, etc., and arrests the functions of the prāṇas.

It is interesting to note how Vāyorvida describes the cosmic functions of air as the upholding of the earth, causing the burning of fire, the uniform motion of the planets and stars, the production of clouds, the showering of rains, the flow of rivers, the shaping of flowers and fruits, the shooting out of plants, the formation of the seasons, the formation of the strata of minerals, the production of the power of seeds to produce shoots, the growing up of crops, etc.^[23] In the same discussion Mārīci considers fire to be contained in the pitta and productive of all good and bad qualities, digestion and indigestion, vision and blindness, courage and fear, anger, joy, ignorance, etc., according as it is in equilibrium or is disturbed. Kāpya maintains that soma, contained in śleṣman , produces all good and bad qualities, such as firmness and looseness of the body, fatness, leanness, energy and idleness, virility and impotence, knowledge and ignorance, etc.^[24]

These discussions seem to indicate that before Atreya’s treatise was written attempts were made to explain the physiological functions of the body in health and disease by referring them to the operation of one operative principle. The Chāndogya Upaniṣad speaks of earth, water and fire as being world-principles of construction : the different vāyus were known as early as the Atharva-Veda , and vāyu is regarded in many of the Upaniṣads as the principle of life. It seems fairly certain that the theory of vāta, pitta and kapha is a later development of the view which regarded air (pavana), fire (dahana) and water (toya) as the fundamental constitutive principles of the body.

Thus Suśruta refers to this view in hi. 4.80:

“Some say that the constitution (prakrti) of the human body is elemental (bhautikī), the three constitutive elements being air, fire and water^[25].”

The advance of the medical schools of thought over these speculations and over others which consider the body to be a product of one bhūta or of many bhūtas is to be sought in this, that, besides allowing the material causes (upādāna) of the body to be the dhātus , they emphasized the necessity of admitting one or more inherent dynamic principles for the development and decay of the body. This explains how vāta , pitta and kapha are regarded both as dhātu and as doṣa , as prakṛti and as vikṛti.

Thus Caraka says, as has already been mentioned, that from the time of the formation of the foetus the vāta, pitta and kapha are working, but in more or less diverse ways and in diverse systems, with equal

• vāyu,
• pitta,
• mala
• and kapha (sama-pittānila-kapha)

or different degrees of predominance of them as

• vātala,
• pittala
• and śleṣmala^[26].

Men of the śleṣmala type are generally healthy, whereas vātala and pittala persons are always of indifferent health. Later on, when there is a disease with the predominance of that doṣa which is predominant in man’s constitution from his birth, the newly collected doṣa produces morbidity on the lines on which the predominating doṣa of his constitution is working; but this newly collected doṣa does not augment the corresponding original doṣa.

The original doṣa is never increased, and, whatever may be the predominance of a doṣa due to any disease, the constitutional condition of the doṣas remains the same. Thus a vāta-prakṛti person does not become śleṣma-prakṛti or pitta-prakṛti, and vice-versa.

The doṣas which are constitutional always remain as the constant part engaged in their physiological operations. The later accretion of the doṣas or their deficiency has a separate course of action in producing diseases, and there is no interchange between these later collections of doṣas or their deficiency and the constitutional constant parts of the doṣas known as prakṛti^[27]. The only sense (as Cakrapāṇi says) in which a doṣa is related to a constitutional (prakṛti) doṣa is that a doṣa grows strong in a system in which a corresponding doṣa is constitutionally predominant, and it grows weaker when the opposite is the case^[28]. It is not out of place in this connection to say that, though the doṣas are mutually opposed 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 (varṣā),
• autumn (śarat),
• late autumn (hemanta),
• winter (śīta),
• spring (vasanta)
• and summer (grīṣma)

there is an alternate

1. collection (caya),
2. disturbance (prakopa)
3. and lowering down (praśama)

of the three doṣas, pitta, śleṣman and vāyu respectively.

Thus, for example,

• in the rains (varṣā) there is collection of pitta,
• in the autumn (śarat) there is disturbance of pitta,
• in the harvesting season (hemanta) there is lowering of pitta and collection of śleṣman,
• in the summer there is collection of vāta, and so forth^[29].

Contrasting the functions of the doṣas in the normal (prakṛti) and abnormal (vikṛti) states, Caraka says that in the normal state the heat of pitta occasions digestion; śleṣman is strength and vitality, and vāyu is the source of all activities and the life of all living beings; but in the abnormal state pitta produces many diseases; śleṣman is the dirt of the system and the cause of many troubles, and vāta also produces many diseases and ultimately death. The places (sthānāni) at which the affections of vāta, pitta and kapha are mostly found are thus described by Caraka: of vāta the bladder, rectum, waist and the bones of the leg, but the smaller intestine (pakvāśaya) is its particular place of affection; of pitta sweat, blood and the stomach, of which the last is the most important; of śleṣman the chest, head, neck, the joints, stomach and fat, of which the chest is the most important.

There are eighty affections of vāta, forty of pitta and twenty of śleṣman^[30]. But in each of these various affections of vāta , pitta and śleṣman the special features and characteristics of the corresponding dośas are found. Thus Caraka in 1. 20. 12-23 describes certain symptoms as leading to a diagnosis of the disease as being due to the disturbance of vāta , pitta or kapha. But a question may arise as to what may consistently with this view be considered to be the nature of vāyu,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 doṣas, 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 vāyu ; wherever there is another set of symptoms, there is disturbance of pitta, and so forth.

But there are serious objections against such an interpretation. For, as we have shown above, there are many passages where these doṣas 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. Moreover, there are many passages which describe pitta and kapha as entities having a particular colour and material consistency, and it is also said that there are particular places in the body where they collect, and this would be impossible upon the interpretation that they are not real entities, but hypothetical, having only a methodological value as being no more than convenient symbols for a collective grasp of different symptoms^[31].

The attribution of a certain number of specific qualities to the doṣas is due to a belief that the qualities of effects are due to the qualities of causes. So, from the diverse qualities of our bodies considered as effects, the causes were also considered as having those qualities from which those of the effects were derived. Thus, in connection with the description of the qualities of vāta, Caraka says that on account of the qualities of raukṣya the bodies of those having congenital vāta tendency are rough, lean and small, and the voices of such people are rough, weak, grating, slow and broken, and they cannot sleep well (jāgarūka); again, on account of the quality of lightness of vāyu, the movements of a man with congenital vāta tendency would be light and quick, and so would be all his efforts, eating, speech, and so forth. It is easy to see that the resemblance of the qualities of vāyu to the qualities of the body is remote; yet, since the special features and characteristics of one’s body were considered as being due to one or the other of the body-building agents, these characteristics of the body were through remote similarity referred to them.

There is another point to be noted in connection with the enumeration of the qualities of the doṣas. The disturbance of a doṣa does not necessarily mean that all its qualities have been exhibited in full strength; it is possible that one or more of the qualities of a doṣa may run to excess, leaving others intact.

Thus vāyu is said to possess the qualities of

• rūkṣa,
• laghu,
• cala,
• bahu,
• śīghra,
• śīta, etc.,

and it is possible that in any particular case the śīta quality may run to excess, leaving others undisturbed, or so may śīta and rūkṣa, or śīta, rūkṣa and laghu, and so forth. Hence it is the business of the physician not only to discover which doṣa has run to excess, but also to examine which qualities of which doṣa have run to excess. The qualities of doṣas are variable, i.e. it is possible that a doṣa in its state of disturbance will remain a doṣa, and yet have some of its qualities increased and others decreased.

The nature of the disturbance of a doṣa is determined by the nature of the disturbance of the qualities involved (aṃśāmśa-vikalpa)^[32]. The natural inference from such a theory is that, since the entities having this or that quality are but component parts of a doṣa, a doṣa cannot be regarded as a whole homogeneous in all its parts. On this view a doṣa appears to be a particular kind of secretion which is a mixture of a number of different secretions having different qualities, but which operate together on the same lines. When a particular doṣa is in a healthy order, its component entities are in certain definite proportions both with regard to themselves and to the total doṣa. But, when it is disturbed, some of the component secretions may increase i-i undue proportions, while others may remain in the normal state; of course, the quantity of the whole doṣa may also increase or decrease.

A doṣa such as kapha or pitta should therefore be regarded as a name for a collection of secretions rather than one secretion of a homogeneous character. It will be easily seen that, on taking into consideration the comparative strengths of the different components of a doṣa and the relative strengths of the other components of other doṣas and the relative strengths and proportions of each of the doṣas amongst themselves, the number of combinations is innumerable, and the diseases proceeding from such combinations are also innumerable. The whole system of Caraka’s treatment depends upon the ascertainment of the nature of these affections; the names of diseases are intended to be mere collective appellations of a number of affections of a particular type^[33].

One further point which ought to be noted with regard to the constructive and destructive operations of vāyu, pitta and kapha is that they are independent agents which work in unison with a man’s karma and also in unison with a man’s mind. The operations of the mind and the operations of the body, as performed by vāyu, pitta and kapha on the materials of the dhātus, rasa, rakta, etc., run parallel to each other; for both follow the order of human karma, but neither of them is determined by the other, though they correspond to each other closely. This psycho-physical parallelism is suggested throughout Caraka’s system.

Caraka, in trying to formulate it, says:

‘‘ śārīram api satvam anuvidhīyate satvaṃ ca śārīram ”

(the mind corresponds to the body and the body to the mind).

It may be remembered in this connection that the ultimate cause of all dhātu-vaiṣamya or abhighāta (bodily injuries through accidents, a fall and the like) is foolish action (prajñāparādha).

Again vāta, pitta and kapha are found to perform not only physical operations, but also intellectual operations of various kinds. But all intellectual operations belong properly to mind. What is meant by attributing intellectual functions to vāyu, pitta and kapha seems to be a sort of psycho-physical parallelism, mind corresponding to body, body corresponding to mind, and both corresponding to karma.

Footnotes and references:

[1]:

Caraka-saṃhitā, iv. 6. 17.

[2]:

evaṃ rasa-malau sva-pramāṇāvasthitav āśrayasya sama-dhātor dhātu-sām-yam anuvartayataḥ (ibid. 1. 28. 3).

[3]:

Ibid. 1. 28. 3.

[4]:

Ibid. vi. 15. 30.

[5]:

Śārṅgadhara (iv. 5) counts seven visible waste-products which are different from the three malas referred to here as vāyu, pitta and kapḥa.

These are

1. the watery secretions from tongue, eyes and cheeks,
2. the colouring pitta,
3. the dirt of ears, tongue, teeth, armpits and penis,
4. the nails,
5. the dirt of the eyes,
6. the glossy appearance of the face,
7. the eruptions which come out in youth, and beards.

Rāḍhamalla, in commenting on this, refers to Caraka-saṃhitā

[6]:

Caraka-saṃḥitā, I. 12. 13.

[7]:

tatra mala-bḥūtās te ye śtirīrasya bādhakarāḥ syuḥ. Caraka-saṃḥitā, IV. 6. 17.

[8]:

Cakrapāṇi on Caraka-saṃhitā. Compare Śārñgadhara, iv. 8: vāyuḥ pittaṃ kapho doṣā dhātavaś ca malā matāḥ, i.e. vāyu, pitta and kapha are known as doṣa, dhātu and mala.

[9]:

Also evaṃ rasa-malau sva-pramāṇāvasthitav āśrayasya sama-dhātor dhātu-sāmyam anuvartayataḥ (Caraka-saṃhitā, 1. 28. 3).

, vi. 15. 29-30, in support of the above passage of Śārñgadhara. Most of the malas are chidra-malas, or impurities of the openings.

[10]:

Aṣṭāṅga-hṛdaya, 1. 11. 1-5.

[11]:

tajjān ity-upacāreṇa tān āhur ghṛta-dāhavat
rasādistheṣu doṣeṣu vyādhnycis sombhavanti ye.
      Aṣṭāṅga-saṃgraha, 1. 1.

[12]:

Indu, the commentator on the Aṣṭāṅga-saṃgraha, puts it as śarīraṃ ca doṣa-dhātu-mala-samudāyaḥ (1. 1).

[13]:

tathā ca dhātu-poṣāya rasasya vahana-pāka-sneha-kāṭhinyādi doṣa-prasāda-labhyam eva
      (ibid.).

[14]:

Āyurveda is closely associated with the Sāṃkhya and Nyāya-Vaiśesika, which alone deal with some sort of physics in Indian philosophy. It is pointed out by Narasimha Kavirāja (a writer from the south) in his Vivaraṇa-siddhānta-cititāmaṇi (the only manuscript of which is in possession of the present writer) that according to Sāṃkhya it is the doṣa transforming itself from a state of equilibrium to a state of unbalanced preponderance of any of them that is to be called a disease

(vaiṣamya-sāmyāvasthā-bhinnāvasthā-viśeṣavad doṣatvaṃ rogatvam).

The Naiyāyikas, however, hold that disease is a separate entity or substance, which is produced by doṣa, but which is not itself a doṣa

(dravyatve sati doṣa-bhinna-doṣa-janyatvaṃ rogatvam).

So a disease is different from its symptoms or effects. Narasimha further holds that, since Caraka speaks of diseases as being fiery (āgneya) and aerial (vāyavya), he tacitly accepts the diseases as separate substances. That Caraka sometimes describes a disease as being dhātu-vaiṣamya is to be explained as due to the fact that, since dhātu-vaiṣamyas produce diseases, they are themselves also called diseases in a remote sense

(yat tu Carakena dhātu-vaiṣamyasya rogatvam uktaṃ tat teṣāṃ tathā-vidha-duḥkha-kartṛtvād aupacārikam.
      Vivaraṇa-siddhānta-cintāmaṇi, MS. p. 3).

[15]:

Aṣṭāṅga-saṃgraha, 1. 22.

[16]:

ārambhakaṃ virodhe 'pi mitho yad yadguṇa-trayam

viśvasya dṛṣṭaṃ yugapad vyādher doṣa-trayaṃ tathā (ibid. 1. 21).

[17]:

rajo-bhuyiṣṭho mārutaḥ, rajo hi pravartakaṃ sarva-bhāvānāṃ pittaṃ sattvot-kaṭaṃ laghu-prakāśakatvāt,rajo-yuktaṃ vā ity eke kaphas tamo-bahulaḥ,guru-prā-varaṇātmakatvād ity āhur bhiṣajaḥ. Yady evam tat kathaṃ kapha-prakṛtike puṃsi sattva-guṇopapannatā paṭhitā, ucyate, guṇa-dvitayam api kaphe jñātavyaṃ sattva-tamo-bahulā āpa
      (Ḍalhaṇa on Suśruta, Uttara-tantra, 66. 9).

[18]:

etad dhi śalya-tantram, ialya-tantre ca vraṇaḥ pradhāna-bhūtaḥ vraṇe ca dūṣyeṣu madhye raktasya prādhānyam iti śoṇitopādānam
      (ibid.).

Suśruta also uses the word doṣa to mean pus (pūya) (i. 5. 12).

[19]:

Suśruta, 1.21. 3 and 4. Ḍalhaṇa, commenting on this, writes:

“śukrārtavādi sahakāritayā deha-janakā abhipretāḥ”

[20]:

Suśruta-saṃhitā, I. u. 8-16.

[21]:

Ye abhrajā vātajā yaś ca śuṣmo
      (Atharva- Veḍa, I. 12.3);

again, agner ivāsya dahata eti śuṣmiṇaḥ
      (ibid. vi. 20. 4).

[22]:

Caraka-saṃhitā, 1.1 .58. Cakrapāṇi, in commenting on this,says that, though vāyu is described as neither hot nor cold according to the Vaiśesika philosophy, yet, since it is found to increase by cold and decrease by heat, it is regarded as cold. Of course, when connected with pitta it is found to be hot, but that is on account of its association with the heat of pitta (yoga-vāhitvāt). In the Vāta-kalā-kalīya chapter (1. 12. 4), six qualities of vāta are mentioned; sūkṣma is not mentioned, however, and, in place of cala, dāruṇa is mentioned. Cakrapāṇi says that dāruṇa means the same as cala. In the same chapter (1. 12. 7) vāyu is qualified as śuṣira-kara, i.e. that which makes holes.

[23]:

Caraka-saṃhitā, 1. 12. 8.

[24]:

Ibid. I. 12 and 12.

[25]:

prakṛtim iha narāṇām bhautiklṃ kecid āhuh
pavana-dahana-toyaiḥ kīrtitās tās tu tisraḥ.
      Śuśruta, ill. 4. 80.

[26]:

Caraka refers to a view that there are none who may be regarded as sama-vāta-pitta-śleṣman (or having equal vāta , pitta and śleṣman). Since all men take various kinds of diet (viṣamāhāropayogitvāt), they must be either vāta-prakṛti, pitta-prakṛti, or śleṣma-prakṛti. Against this Caraka says that sama-vāta-pitta-śleṣman 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 vāta-prakṛti, pitta-prakṛti and śleṣma-prakṛti are incorrect; for prakṛti means health. What they mean by vāta-prakṛti is that vāta is quantitatively predominant (ādhikya-bhāvāt sā doṣa-prakṛtir ucyate), and quantitative predominance is the same as vikāra ; so the proper terms are vātala, pittala, etc. When a vātala person takes things which increase vāta, his vāta increases at once; but when he takes things which increase pitta or śleṣman, these do not increase in him as rapidly as vāta does. So in the case of a pittala person pitta increases rapidly when articles which increase pitta are taken, and so with regard to śleṣman (Caraka-saṃhitā , ill. 6. 14-18).

[27]:

Ibid. 1.7. 38-41. The passage prakṛti-sthaṃ yadā pittaṃ mārutaḥ śleṣmaṇaḥ kṣaye (1. 17. 45) is often referred to in support of the view that the new accretions of doṣas affect the prakṛti-doṣas. But Cakrapāṇi explains it differently. He says that a disease may be caused by a doṣa which is not in excess of the constant constitutional quantity (prakṛti-māna) 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 doṣa may not be in excess.

[28]:

samānāṃ hi prakṛtiṃ prāpya doṣaḥ pravṛddha-balo bhavati, asamānāṃ tu prāpya tathā balavān na syāt (Cakrapāṇi on Caraka-saṃhitā, 1. 17. 62).

[29]:

Ibid. 1.17.112. See also Cakrapāṇi’s comments on these. Ḍalhaṇa, in commenting on Suśruta-saṃhitā, I. 21. 18, says that saṅcaya of doṣas means aggregation or accumulation in general

(dehe ’tirupāvṛddhiś cayaḥ);

prakopa of doṣas means that the accumulateḍ doṣas are spread through the system

(vilayana-rūpā vṛddhiḥ prakopaḥ).

The external signs of the caya of vāta are fullness of the stomach and want of motions; of pitta yellowish appearance and reduction of heat (mandoṣṇatā); of kapha heaviness of the limbs aṇḍ feeling of laziness. In all cases of caya there is a feeling of aversion to causes which increase the particular doṣa of which there has been caya

(caya-kāraṇa-vidveṣaś ca).

The stage of caya is the first stage of operation in the growth and prevention of diseases. If the doṣas can be removed or neutralized at this stage, there is no further disease. The usual indication of the disturbance (prakopa) of vāyu is disorders of the stomach; of pitta acidity, thirst and burning; of kapha, aversion to food, palpitation (hṛdayotkleda), etc. The prakopa of blood (śoṇita) is always due to the prakopa of vāta, pitta or kapha. This is the second stage of the progress of diseases. The third stage is called prasāra.

At this stage there is something like a fermentation of the doṣas

(paryuṣita-kiṇvodaka-piṣṭa-samavāya iva).

This is moved about by vāyu, 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 ḍown and joins on its way with other streams and flows on all sides; so the doṣas 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 fermented doṣas spread, there the symptoms of diseases are showered down, as it were, like water from the clouds

(doṣo mkāraṃ nabhasi meghavat tatra varṣati).

When one doṣa, e.g. vāyu, spreads itself in the natural place of another doṣa, e.g. pitta, the remedy of the latter will remove the former

(vāyoḥ pitta-sthāna-gatasya pittavat praṭīkāraḥ).

The difference between prakopa and prasāra is thus described by Ḍalhaṇa: just as when butter is first stirred up, it moves a little; this slight movement is lik e prakopa ; but, when it is continuously and violently stirred to flow out, in froths and foams, it may then be called prasāra (Suśruta-saṃhitā, 1. 21. 18-32).

The fourth stage is when the pūrva-rūpa is seen, and the fifth stage is the stage of rūpa or vyādhi (disease) (ibid. 38, 39).

[30]:

Caraka-saṃhitā, 1. 20. 11.

[31]:

The secretory character of these ḍoṣas is amply indicated by such passages as those which regard vāta , pitta and śleṣman as requiring some space in the stomach for digesting the food materials, e.g.

• ekaṃ punar vāta-pitta-śleṣmaṇām (ibid. in. 2. 3);
• śleṣma hi snigdha-ślakṣṇa-mṛdu-madhura-sāra-sāndra-manda-stimita-guru-ślta-vijjalācchaḥ
  (śleṣman is smooth, pleasing, soft, sweet, substantial, compact, inert, benumbed, heavy, cold, moist and transparent— ibid. in. 8. 14. 7.5);
• pittam uṣṇaṃ tīkṣṇaṃ dravaṃ visram amlaṃ kaṭukaṃ ca
  (pitta is hot, sharp and liquid, and possesses bad odour, and is acid and pungent and bitter— ibid. III. 8. 14. 7. 6) ;
• vātas tu rūkṣa-laghu-cala-bahu-śīghra-śita-paruṣa-viśadaḥ
  (vāta is rough, light, moving, manifold, quick, cold, coarse and scattering — ibid. III. 8. 14. 7. 7).

It must, however, be noted that the translation I have given of some of these words cannot be regarded as satisfactory; for in the translation I could only give one sense of a word, which in the original Sanskrit has been used in a variety of senses which the word has. Thus, for example, I have translated rūkṣa as “rough.” But it also means “slim,” “lean,” “having insomnia,” or (of a voice) “broken,” and so forth. There is no English synonym which would have so many senses. Mahāmahopādhyāya Kaviraj Gananātha Sen, of Calcutta, tries to divide the doṣas into two classes, invisible (sūkṣma) and visible (sthūla) — Siddhānta-nidāna, pp. 9-11. But though such a distinction can doubtless be made, it has not been so distinguished in the medical literature, as it is of little value from the medical point of view; it also does not help us to understand the real nature of the doṣas. The nature and the functions of the doṣas do not depend in the least on their visibility or invisibility, nor can the visible doṣa be regarded as always the product of the invisible one.

[32]:

Caraka-saṃḥitā, II. 1.10.4. Cakrapāṇi, in commenting on this, says:

“tatra doṣāṇām aṃśāmśa-vikalpoyathā—vāteprakūpite ’pi kadācid vātasya śītāṃśo balavān bhavati, kadācit laghv-aṃśaḥ, kadācid rūkṣāṃśaḥ kadācil laghu-rūkṣāṃśaḥ.”

The doṣa or doṣas which become prominently disturbed in a system are called anubandhya, and the doṣa or doṣas which at the time of diseases are not primarily disturbed are called anubandha. When three of the doṣas are jointly disturbed, it is called sannipāta, and when two are so disturbed it is called saṃsarga (ibid. 111. 6 . 11).

[33]:

yad vātārabdhatvādi-jñānam eva kāraṇam rogāṇāṃ cikitsāyām upakāri; nāma-jñānaṃ tu vyavahāra-mātra-prayojanārtham
      (Cakrapāṇi on Caraka-saṃḥitā, I. 18. 53).