Medicines (g): Decoctions/Astringent Medicines (Kasāva/Kaṣāya)

The Pāli term kasāva/kasāya (or the Sanskrit equivalent kaṣāya) carries with it several meanings. Of these, two relate to medicine: decoction and astringent taste

(Pali-English Dictionary, s.v. “kasāya”; A Sanskrit-English Dictionary, s.v. “kaṣāya”). Horner (2000) translated this term in the Theravāda Bhesajjakkhandhaka as “astringent decoction,” perhaps with the intention to include both meanings. But this may not be the most suitable translation because decoctions can be of different taste (Caraka Saṃhitā Sūtrasthāna 4. 6). In the English translations of the Āyurvedic treatises, the term is generally translated as decoction when dealing with drugs, and as astringent when talking about taste. Here in this section, the term will be rendered as decoction when translating from Pāli and Sanskrit sources. It is because in these sources the term is compounded with a plant’s name, suggesting that it should refer to the “decoction” of a certain plant (a drug), rather than to the taste of a drug. In the Chinese sources, however, this group of medicines are termed differently as decoction, astringent medicine, bitter medicine, or even just the phonetic transcription of the term kaṣāya. Translation of these Chinese terms to English will be in accord with the terms given in the texts.

The passages concerning this group of drugs are:

Theravāda:—“… the decoction medicines [are]: decoction of neem tree, decoction of Tellicherry bark, decoction of pakkava, decoction of Indian beech, or whatever other decoction-medicines there are; neither they serve as hard food among the hard food, nor as soft food among the soft food. Having accepted them, [one has] to take care of [them] for the duration of one's life, [and] to use [them] when there is a reason.”^[1]

Dharmaguptaka:—“At that time there was a sick monk. The physician instructed [him] to consume decoction-medicine. The Buddha said: ‘A sick monk with a reason is allowed to use [it] for the duration of one’s life. Herein, decoction is the decoction of root, stem, leaf, flower, [or] fruit.’”^[2] “… decoction of root; decoction of stem, leaf, flower, [or] fruit …”^[3]

Sarvāstivāda:—“The elder monk Upāli asked the Buddha: ‘What are the bitter medicines?’^[4] The Buddha said: ‘Tellicherry bark, gouboluo-tree 拘波羅樹 (camphor tree, or box myrtle, or South Indian redwood?), guozhenlita-tree 拘真利他樹 (mountain ebony or Indian trumpet flower?), shiluo-tree 師羅樹 (siris tree?), boqieluo-tree 波伽羅樹 (bullet wood or trumpet flower?), boniwuqiluntuo-tree 波尼無祇倫陀樹 (?).’”^[5]

“Five kinds of decoction: decoction of root, decoction of stem, decoction of leaf, decoction of flower, [and] decoction of fruit. [They are] for the duration of one’s life, [and one can] stay with them in the same room overnight.”^[6]

Mūlasarvāstivāda (Sanskrit):—“What are the five decoctions? [They are] decoction of mango tree, decoction of neem tree, decoction of black plum tree,^[7] decoction of siris tree, and decoction of neem tree in Kośambī^[8] (?).”^[9]

Mūlasarvāstivāda (Chinese):—“What are the five kinds of astringent medicines? [They] are: mango wood, neem wood, black plum wood, siris wood, [and] Kośambī’s neem wood (?)”^[10]

Certain plants have been named for use as decoction-medicines/astringent medicines in the Chapters on Medicine. Some can be identified while some not. Only limited explanations about these drugs are found in the commentaries. In the Samantapāsādikā (V. 1090), brief notes concerning two plants are: “Paggava is a kind of creeper. Nattamāla is [synonymous with] karañja” (paggavan ti latājāti. nattamālan ti karañjaṃ). The exact plants for most of the bitter medicines given in the Sarvāstivāda Bhaiṣajyadharmaka are not known. In addition, extra information relating to the use of bitter medicines is mentioned in this text: The Buddha also gave permissions and instructions on the use of tools such as mortar, pestle, and sieve, as well as on the method of application of these medicines (Taishō Tripiṭaka 1435. 185a2-6).

Decoction is a significant group of medicines in Āyurveda, with abundant information available. In the Caraka Saṃhitā, it is described that there are five kinds of decoctions, each with the taste of sweet, sour, pungent, bitter, and astringent (Sūtrasthāna 4. 6); there are five ways for preparing decoctions: extracting juice (svarasa), forming paste (kalka), boiling the drug (śṛta), cold infusion (śīta), and hot infusion (phāṇṭa) (Sūtrasthāna 4. 7); then there enumerates various decoctions of drugs which are divided into fifty groups (Sūtrasthāna 4. 8-19). The decoction-medicines recorded in the Chapters on Medicine are all found in use in Āyurveda (perhaps except the two, pakkava and kośambaka, which are unidentifiable or uncertain). The huge amount of decoctions employed in Āyurveda indicates that this category of medicines had been well advanced in the classical Āyurvedic phase of Indian medical history.

Modern herbal medicine has some forms of medicines resembling the decoctions that were processed in ancient India. The present forms are described by van Wyk and Wink (2004, 18):

“Extracts are liquids, powdered or viscous crude mixtures of chemical compounds, extracted from plant material using water or organic solvents such as alcohol (ethanol). As a result, the extract contains only the soluble fractions of the plant material … and the non-soluble (fibrous) residues … are discarded. … Decoction refers to a preparation that is made by adding cold water to the required amount of drug. It is then heated to boiling and allowed to simmer for five to ten minutes, after which it is strained. Infusion refers to a preparation that is made by adding boiling water to the required amount of drug, which is allowed to steep for five to ten minutes before it is strained. … Maceration refers to a preparation made by adding cold water to the required amount of drug, which is allowed to soak at room temperature for six to eight hours before it is strained. Juice is prepared by crushing freshly harvested plant parts in water and then expressing the juice.”

The following table enumerates the decoction-medicines or astringent medicines that have been mentioned in the Chapters on Medicine.

	Original name	English name	Botanical name
Theravāda	nimbakasāva	decoction of neem tree	Azadirachta indica
	kuṭajakasāva	d. of Tellicherry bark	Holarrhena antidysenterica
	pakkavakasāva	?	?
	nattamālakasāva	d. of Indian beech	Pongamia pinnata
Dharmaguptaka	根莖葉花果罽沙 (or 根莖葉華果湯)	decoction of root, stem, leaf, flower, or fruit	—-
Sarvāstivāda	拘賴闍樹	Tellicherry bark	Holarrhena antidysenterica
	拘波羅樹	camphor tree or box myrtle or South Indian redwood[11] (?)	Cinnamomum camphora or Myrica nagi or Dalbergia sissoo (?)
	拘真利他樹	mountain ebony or Indian trumpet flower (?)	Bauhinia variegata or Oroxylum indicum (?)
	師羅樹	siris tree (?)	Albizia lebbeck (?)
	波伽羅樹	bullet wood or trumpet flower (?)	Mimusops elengi or Stereospermum suaveolens (?)
	波尼無祇倫陀樹	?	?
Mūlasarvāstivāda (Sanskrit)	āmrakaṣāya	decoction of mango tree	Mangifera indica
	nimbakaṣāya	d. of neem tree	Azadirachta indica
	jambukaṣāya	d. of black plum tree	Syzygium cuminii
	śirīṣakaṣāya	d. of siris tree	Albizia lebbeck
	kośambakaṣāya	d. of Kośambī’s neem (?)	Azadirachta indica (?)
Mūlasarvāstivāda (Chinese)	阿摩羅木	mango wood	Mangifera indica
	楝木	neem wood	Azadirachta indica
	贍部木	black plum wood	Syzygium cuminii
	尸利沙木	siris wood	Albizia lebbeck
	高苫薄迦木	Kośambī’s neem wood (?)	Azadirachta indica

Footnotes and references:

[1]:

Theravāda Vinaya Piṭaka I. 201: “... kasāvāni bhesajjāni nimbakasāvaṃ kuṭajakasāvaṃ pakkavakasāvaṃ nattamālakasāvaṃ yāni vā pan’ aññāni pi atthi kasāvabhesajjāni, n’ eva khādaniye khādaniyattaṃ pharanti, na bhojaniye bhojaniyattaṃ pharanti, tāni paṭiggahetvā yāvajīvaṃ pariharituṃ, sati paccaye paribhuñjituṃ.”

[2]:

Taishō Tripiṭaka 1428. 867a24-26: “爾時有病比丘，醫教服罽沙藥，佛言：「病比丘有因緣盡形壽聽服。是中罽沙者，根莖葉花菓罽沙。」” 罽沙 should be kaṣāya.

[3]:

Taishō Tripiṭaka 1428. 877a22: “...根湯、莖葉華菓湯...” 湯, which means soup, can also refer to decoction.

[4]:

苦藥 literally means bitter medicine. Since kaṣāya can mean astringent, which in turn means “(of taste or smell) sharp or bitter” (Oxford Dictionary: Language Matters, s.v. “astringent” [accessed January 26, 2015, http://www.oxforddictionaries.com/definition/english/astringent?searchDictCode=all]). So the bitter medicines are likely relating to the decoctions/astringent medicines.

[5]:

Taishō Tripiṭaka 1435. 184c28-185a2: “長老優波離問佛：「何等苦藥？」佛言：「拘賴闍樹、拘波羅樹、拘真利他樹、師羅樹、波伽羅樹、波尼無祇倫陀樹。」” 拘波羅樹 may be one of the

followings: karpūra (camphor tree), kaṭphala (box myrtle), or kapilā (South Indian redwood). 拘真利他樹 may be kañchanaka (mountain ebony) or kuṭannaṭa (Indian trumpet flower). 師羅樹 may be śirīṣa (siris tree). 波伽羅樹 may be bakula (bullet wood) or pāṭalā (trumpet flower). 波尼無祇倫陀樹 is unidentifiable.

[6]:

Taishō Tripiṭaka 1435. 194a14-15: “五種湯：根湯、莖湯、葉湯、華湯、果湯，盡形壽共房宿。” See footnote 100 above. This piece of information on decoction is consistent with those in the Dharmaguptaka Bhaiṣajyaskandhaka.

[7]:

Pāli and Sanskrit dictionaries such as Pali-English Dictionary and A Sanskrit-English Dictionary rendered jambŭ as rose apple or rose apple tree. But Āyurvedic texts identify it as black plum. Wujastyk (2004) has written an essay justifying that it should be black plum.

[8]:

The term kośamba-kaṣāya should be kośambaka-kaṣāya by comparing with the Chinese parallel. The name of this plant kośambaka is not found in Āyurvedic texts or books on Indian medicinal plants. But in the Dictionary of Pāli Proper Names, it is stated that numerous margosa trees (i.e. neem trees) were grown in and around the city Kosambī (Malalasekera 1998, 694). Kośambaka, which means “belonging or relating to Kośambī”, may thus refer to the neem trees in this city.

[9]:

Gilgit Manuscripts III. 1.iv: “pañca kaṣāyāḥ katame| āmrakaṣāyo nimbakaṣāyo jambukaṣāyaḥ [śirīṣakaṣāyaḥ] kośambakaṣāyaśca|”

[10]:

Taishō Tripiṭaka 1448. 1b28-29: “云何五種澁藥？謂阿摩羅木、楝木、贍部木、尸利沙木、高苫薄迦木。”

[11]:

The information on kapilā (South Indian redwood) is based on A Sanskrit-English Dictionary (s.v. “kapilā”) and Dash (2008, 263).