Charaka Samhita and Sushruta Samhita
by Nayana Sharma | 2015 | 139,725 words
This page relates ‘Disease in the classical Samhitas’ of the study on the Charaka Samhita and the Sushruta Samhita, both important and authentic Sanskrit texts belonging to Ayurveda: the ancient Indian science of medicine and nature. The text anaylsis its medical and social aspects, and various topics such as diseases and health-care, the physician, their training and specialisation, interaction with society, educational training, etc.
Disease in the classical Saṃhitās
A clearer notion of disease is offered by the classical medical authors based on an understanding of the physiological functioning of the body. The concept of disease is related to the notion of health and there is antipodal distinction between the two. The term ārogyam implies freedom from roga or disease. Health signifies happiness and disease denotes pain (sukhasaṃjñakam ārogyaṃ ḥkhameva ca).[1] The absence of disease enables an individual to accomplish the four objectives of life: virtuous acts (dharma), acquisition of wealth (artha), gratification of desire (kāma) and final emancipation (mokṣa).[2] The obstacle in the realization of these objectives is condition of disease that threatens the individual’s wellbeing and his very survival.[3] Here, we are reminded of the sages who were impelled to learn Āyurveda when diseases became the impediment to long life, sacred studies and their religious observances.[4] It is in this sense that health is the state of happiness and disease one of pain. Suśruta also defines disease as duḥkha, that is, a painful condition (tadduḥkhasaṃyogā vyādhaya uccayante).[5] Duḥkha is the prakritised form for duḥs tha, meaning uneasy, uncomfortable, unpleasant or difficult.[6]
In physiological terms, well-being is dependent on the constituent elements of the body, that is, the dhātus. The condition of health (prakṛti) is the state of equilibrium of the dhātus; any alteration of this equilibrium that causes discomfort and suffering is the condition of disease (vikāro dhātuvaiṣamyaṃ,sāmyaṃ prakṛtirucyate).[7] Hence, one of the synonyms of disease is vikāra which implies a change of bodily or mental condition (for the worse). Dhātus consist of the three doṣas, i.e., vāta (wind), pitta (bile), kapha (phlegm); the seven types of tissues, i.e., rasa (chyle), rakta (blood), māṃsa (muscle tissue), medas (fat tissue), asthi (bone), majj ukra (semen); and the upadhātus.[8] Suśruta gives a more detailed definition: a person is said to be svastha or healthy when the doṣas (humors) and the metabolic state (agni) are in equilibrium, when the functional activities of the dhātus (tissues) and the malas (excretory products) are in balance, and the soul (ātmā), the senses (indriya) and the mind (mana) feel well.[9] Health is a question of both physical and mental well-being.[10]
Other than roga, there are several terms that signify disease in our classical Saṃhitās: vyādhi,[11] āmaya,[12] gada,[13] ātaṅka,[14] yakṣmā,[15] jvara,[16] vikāra,[17] and roga.[18] These terms are synonymous,[19] though each of these words has specific connotation and is indicative of disease in its various aspects. The term “vyādhi” indicates that disease is associated with pain of various types. The term “āmaya’ bears reference to āma[20] that is invariably present in the pathogenesis of disease. Gada also implies poisons, and is one of the names of the divine twin physicians the Aśvins.[21] “Ātaṅka” is a pointer to the fact that the suffering individual leads a miserable life. “Yakṣmā” indicates that like yakṣmāroga (consumption/tuberculosis), disorders are symptom complexes associated with many disease entities. The word “jvara’ is indicative of both psychic and somatic afflictions. “Vikāra” points to the changes brought about in the body and the mind by disease. “Roga” is an indicator of the painfulness of diseases.[22]
Disease is conceptualized as an altered condition of the body and/or the mind that is associated with pain and misery. The perception of fear is also associated with conditions of disorder as we recall the words of Bharadvāja when he approached Indra with the prayer for learning the science of life: “The diseases terrifying to all creatures have manifested themselves…” (vyādho hi samutpannāḥ sarvaprāṇibhayaṅkarāḥ).[23]
Caraka refers to two allegorical narratives relating to the origin of fever and tuberculosis. The wrath of Śiva afflicts men with fever;[24] and that of Dakṣa afflicted Candra with consumption.[25] In both situations, anger is personified as malevolent force that begets suffering in humans as disease. Thus, anger/krodha, yakṣmā, jvara and roga are synonymous in medical parlance and all they connote duḥkha or misery (krodho yakṣmā jvaro roga ekārtho duḥkhasaṃjñak).[26]
Footnotes and references:
[1]:
[3]:
Caraka Saṃhitā Sūtrasthāna 1.22.
[4]:
Caraka Saṃhitā Sūtrasthāna 1.6.
[5]:
Suśruta Saṃhitā Sūtrasthāna 1.16.
[6]:
Monier-Williams, p.483.
[7]:
Caraka Saṃhitā Sūtrasthāna 9.4.
[8]:
Cakrapāṇidatta’s commentary on Caraka Saṃhitā Sūtrasthāna 9.4.
[9]:
Suśruta Saṃhitā Sūtrasthāna 15.41.
[10]:
Caraka Saṃhitā Sūtrasthāna 1.55.
[11]:
Eg. Caraka Saṃhitā Śārīrasthāna 1.108; Suśruta Saṃhitā Sūtrasthāna 21.33.
[12]:
Eg. Caraka Saṃhitā Sūtrasthāna 6.50.
[13]:
Eg. Caraka Saṃhitā Śārīrasthāna 1.114; Suśruta Saṃhitā Sūtrasthāna 33.5/1.
[14]:
Eg. Suśruta Saṃhitā Sūtrasthāna 10.5.
[15]:
Caraka Saṃhitā Nidāna-sthāna 1.5.
[17]:
Eg. Suśruta Saṃhitā Sūtrasthāna 21.29.
[18]:
Eg. Caraka Saṃhitā Śārīrasthāna 1.115; Suśruta Saṃhitā Sūtrasthāna 12.9.
[19]:
Caraka Saṃhitā Nidāna-sthāna 1.5.
[20]:
Āma implies undigested matter.
[21]:
Monier-Williams, p.134.
[22]:
Cakrapāṇidatta’s commentary to Caraka Saṃhitā Nidāna-sthāna 1.5.
[23]:
Caraka Saṃhitā Sūtrasthāna 1.22.
[24]:
Caraka Saṃhitā Cikitsāsthāna 3.23-24.
[25]:
Caraka Saṃhitā Cikitsāsthāna 8.5.
[26]:
Caraka Saṃhitā Cikitsāsthāna 8.11.