Introduction and Cause of diseases

All the five senses are the transformed state of Pañca Mahābhūta. The predominant Mahābhūta in each sense organ are as follows-Eyes belong to Tejas, Tongue belongs to Ap, Ears belongs to Ākāśa, Nose belongs to Pṛthvī and Skin belongs to Vāyu. Most of the diseases are caused by non-unions, excessive or abnormal unification of the sense organs and intellect. Insolence of Vāta, Pitta and Kapha results the birth of all diseases. Head is regarded as the seat of life force and sense organs.

There are three causes of any disease, namely, unhealthy consumption, fault of intellect and time. These three factors cause both physical and mental disorders. Body and mind are the basis of disorders. Proper co-ordination of time, intellect and senses are the basis of good health. Vayu, pitta and kapha are called physical defects. The fault of the mind is Sattva, Raja and Tamaḥ. If it is distorted, it becomes a disease and it is called Doṣa. Physical doṣa is eradicated by the co-ordination of Daiva and reason. And the doṣa of the mind is calmed by wisdom, science, patience and samadhi. The physical-air is dry, cold, light, beyond perception, fast, non-slithery. The things that are opposite to air in nature, like cool, warm, heavy, thick, slow, slippery and plain calm the mind. The thing that executes the work of the senses and the mechanisms of the body is called Vāyu. Pitta is slightly tender, warm, flammable, sharp, liquid, acid, saturated and bitter. Pitta or bile is neutralized with the things that are opposite in quality like harsh, cool, blunt, indissoluble, acidic, neutral and sweet in quality. The word Pitta refers to bile and the warmth of the body. Mucus is guru, cool, gentle, smooth, sweet, still and slippery. Kapha is neutralized with the things that are opposite in quality. These elements calm the mucus. The watery part of the body is called mucus. Possible diseases are cured by all the opposite quality medicines and all these medicines must be applied by understanding the time and place of the country. For example, fever is relieved by antipyretic medicine. There is no cure for incurable diseases or age-related diseases. There are four steps of treatment, i.e., physician, medicine, attendant and patient^[1]. When these Catuṣpāda have proper qualities, the disease becomes neutralized. Inequality of vāyu, pitta, and kapha is called disease and equality is called health. The name of healing is happiness and the name of disease is sorrow. When the poisonous nature is fourfold in nature, they are introduced or moved to perform the equilibrium of the distorted doṣas. This is called treatment. Four qualities of the Vaidya. namely-scriptural proficiency, versatility, skill and purity.

A person who has gained knowledge in scriptures, understood the functionalities of medicines and has witnessed the activities of physicians, is called a life-giver. There are six qualities of a royal physician, i.e., knowledge, logic, science, memory, readiness and care^[2]. Again, Knowledge, memory, experience, practice, attainment and resort^[3]. Those who possess these six qualities are never subject to any failure and fault. He who treats with the combination of scripture and intellect is never found guilty.

Patient, attendant, and medicines are under the control of the physician. Therefore, the doctor will try to improve the self-qualities. The four duties of a physician are intimacy with the patient, compassion, and encouragement, treating patients with enthusiasm and care, and abstaining from applying medicines to healthy people.

According to the doctors, herbs with four qualities are medicine. Treatable diseases do not get cured without treatment. Again, not all herbs in the world are enough for the incurable disease. Experienced doctors cannot cure the dying patient. The patients are treated with scriptural medicines and the weak are treated with strengthening medicines. In addition, the nature of the disorder is established by treating the disease with the opposite medicine. There are two types of disease-curable and incurable. The doctor who knowingly attempts the work on time will surely cure the disease. The doctor who attempts to treat the incurable disease suffers loss of self-interest, loss of education, loss of reputation, condemnation and incompetence of business. Possible diseases are of two types-easy and difficult. There are three types of possible diseases. Less, medium and more. Incurable diseases are also of two types, i.e., Yāpya and  incurable. There are three types of attempts, namely-Prāṇaiṣaṇā, Dhanaiṣaṇā and Paralaukaiṣaṇā.

A healthy person should follow healthy habits. The suffering person should have peace of mind. Longevity can be gained by obeying the soul. It is obligatory to seek wealth after life. Absence of wealth means there is sin and hence, there is no longevity. Then he will imitate the third eṣaṇā, that is, the afterlife^[4]. Service to the Guru, study, vows, hospitality, charity, no greed for the other’s wealth, religious austerities, envy, bodily verbal, mental and somatic deeds will bring him peace with the senses, etc. By doing so, one attains fame in this world and glory in the afterlife.

There are two types of matter, honest and dishonest. Their test or knowledge is of four kinds-admonition (Āptopadeśa), direct, conjecture and reasoning^[5]. Those who are free from Raja and Tamaḥ Guṇas with knowledge and meditation, those who are Trikālajña, those whose pure knowledge flows continuously are called Āpta, gentle and wise. When the soul, the senses, the mind and matter of the senses are on the same plane, the sense knowledge is complete. It is called direct knowledge. There are three types of perception: past, present and future. Inference is preceded by perception. There are three types of inference, namely, the inference of the cause from the effect, inference of the effect from the cause, and inference in general. For example, scholars assume fire is inferred from the smoke. The sign of reasoning or Yukti is that the intellect is able to see multiple outcomes from multiple causes which are valid for the past, present and future. This helps in the fulfilment of the three objects of human life, i.e., virtue, wealth, and desire. These four types are called tests. There is no other test than this. Such a test establishes the theory of rebirth.

There are three factors supporting life, three-fold strength, three types of causes, three types of diseases, three systems for the diseases, three types of physicians and three types of therapeutics. Unwholesome conjunction of the sense organs with their objects, intellectual blasphemy, and transformation-these are the threefold causes of diseases and if applied in their equivalence, it causes health. There are three types of diseases-endogenous (Nija), exogenous (Āgantu) and psychic (Mānasika). Endogenous diseases are caused by vāyu, pitta and phlegm. And all the diseases that arise from ghosts, poisons, wind, fire are called exogenous diseases. And psychic disease arises from the non-availability of the beloved and the gain of the unpleasant. If the intelligent person is mentally ill, then he should be careful to avoid harmful religious deeds and follow beneficial religious deeds. Religious work is the cure for mental illness. There are three types of pathogens. Namely-Śākhā i.e., the peripheral system includes tissue elements like blood, etc., and skin, Marmāsthisandhi or vital organs and joints of bones, and Koṣṭha or central system. External diseases are: goitre, pimple, boil, scrofula, wart, granuloma, moles, leprosy, and freckles etc.

Diseases according to the Śākhā are: visarpa or skin diseases characterised by an acute spread, oedema, gulma or abdominal tumour, piles, vidradhi or abscess etc.^[6] Diseases of the middle path way are: Pakṣaghāta or hemiplegia, Pakṣāgraha or tonic convulsion, Apatānaka or clonic convulsion, Ardita or facial paralysis, Śoṣa or consumption, tuberculosis, Asthisandhiśūla or pain in the bone joints, Gudabhraṃśa or prolapse rectum and anal fractures, and the disease of the head, heart and bladder. Diseases belong to the central system are: fever, diarrhoea, vomiting, Alasaka or intestinal torper, Visūcīkā or choleric diarrhoea, cough, dyspnoea, hiccough, Ānāha or constipation, Udara or disease of the abdomen and Plīhā or splenic disorders and the internal variety of Visarpa, Śvayathu or oedema, Gulma or abdominal tumour, Arśas or piles and Vidradhi or internal abscess.

Footnotes and references:

[1]:

bhiṣagdravyāṇyupasthatārogīpādacatuṣṭayam |
guṇavatkāraṇaṃjñeyaṃvikāravyupaśāntaye || (C. Sū. –IX.3); Rajneesh V. Giri and Smith Rajneesh, Synopsis on Caraka Saṃhitā, Varanasi, Chaukhambha Orientalia, 2019, p. 20.

[2]:

hetau liṅgepraśamane rogānāmapunarbhave |
jñānaṃ caturvidhaṃ yasya sa rājārho bhiṣaktamaḥ || (CS. -Sūtrasthāna–IX.19); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. I, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 189.

[3]:

śastraṃ śāstrāṇi salilaṃ guṇadoṣapravṛttaye |
pātrāpekṣīṇyataḥ prajñāṃ cikitsārthaṃ viśodhayet | (CS. -Sūtrasthāna–IX.20); Caraka Saṃhitā Vol. I with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 198.

[4]:

atha tṛtīyāṃ paralokaiṣaṇāmāpadyate | (CS. -Sūtrasthāna–XI.4); Baidyacharya Kalikinkar Sensarma & Ayurbedacharya Satyasekhar Bhattacharya (eds.), Caraka-Samhita–Vol. I, trans. Kabiraj Jasodanandan Sirkar, Kolkata, Deepayan Publication, 2013, p. 81.

[5]:

tasya caturvidhā parīkṣā -āptopadeśaḥ, pratya m, anumānaṃ, yuktiśceti || (CS. -Sūtrasthāna–XI.17); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. I, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 210.

[6]:

trayo rogamārgā iti-śākhā, marmāsthisandhayaḥ, koṣṭhaśca |
visarpaśvayathugulmārśovidradhyādayaḥ śākhānusāriṇo bhavanti rogaḥ | (CS. -Sūtrasthāna–XI.45-47); Baidyacharya Kalikinkar Sensarma &Ayurbedacharya Satyasekhar Bhattacharya (eds.), Caraka-Samhita–Vol. I, trans. Kabiraj Jasodanandan Sirkar, Kolkata, Deepayan Publication, 2013, pp. 90-91.