Precautionary measures for good health and Prophylactic Measures

The ancient medical practitioners have given considerable thought to the prevention of illnesses, which indisputably, was more important than treatment. The Atharvavedic hymns, such as VI.3 and XIX.2, invoke several deities for protection against disease and malevolence. They include Indra, Puṣana, Aditi, Viṣnu, Soma, Sarasvati, Agni, Varuṇa, the Aśvins among others. The twin physicians are appealed “to keep malignites afar” in hymn XX.139 followed by further invocations in hymns XX.140-143. Prayers, charms and amulets were the main defence against disease and misfortune. As we have noted above, Caraka advocates wearing of good herbs (oṣaddhīḥ praśastā dhārayet) for well-being.^[1] This reminds us of the prolific use of amulets (maṇi) in the Atharvaveda which, in fact, was the mainstay of early therapeutics. The Atharvan amulet is made to bestow on the wearer long life, safety from diseases and demons and protection from every kind of danger.^[2] The amulet of jaṇgiḍa is said to be one of thousand powers,^[3] while there is another with the power of a hundred physicians and a thousand healing herbs.^[4]

References to amulets are minimal in the two Saṃhitās. The principal prophylactic measures advocated for the preservation of health and promotion of longevity are physical exercise (vyāyāma), qualitative dietetics, and the elimination and rejuvenation therapies. All the three are combined in a holistic form in the seasonal regimen referred to as svasthavṛttam.^[5]

Vyāyāma implies physical activities by which the entire body is exercised. It reduces obesity, enhances strength and agility, nourishes the body, prevents premature senility and muscular degradation, improves digestion, preserves youthfulness, etc., which are some of its benefits. If one exercises till the body perspires, he is unlikely to be afflicted by diseases.^[6] However, Suśruta cautions that one should exercise keeping his age, strength, physique, locale, season and diet in consideration.^[7] By physical exercise, even faulty diet and activities cannot lead to vāta-rakta because the pathogenic factor is neutralized or is rendered less potent.^[8]

Kings and princes are known to have undertaken regular exercise. Palaces had designated space for this purpose fitted with the necessary equipment as is known from the Kādambari (samucitavyāyāmopakaranaṃ vyāyāmabhūmi).^[9]

The essence of good health, as we have noted in an earlier chapter, is the maintenance of the equilibrium of the doṣas, the dhātus and the malas. The issue of body weight is also important in this regard and Suśruta lays emphasis on the maintaining a moderate body build. Both obesity and emaciation bring a host of diseases. Obesity causes shortness of breath on effort, thirst, polyphagia, excessive sleep, undue perspiration, bad body odour, snoring, a sense of depression in the body and blurred speech. Excluding the adipose tissue, all the other tissues do not receive adequate nourishment causing physical weakness and hence, the obese are incapacitated in all their activities.^[10] On the other hand, underweight individuals are unable to tolerate hunger, thirst, cold, heat and rains, or carry weights. They frequently suffer from nervous disorders, weakness and complications, such as asthma, cough, consumption, splenomegaly, hypoactivity of digestive mechanisms, abdominal gaseous tumours and haemorrhagic diseases.^[11]

Diseases in overweight individuals assume seriousness due to obstructions in the metabolic passages. It is, therefore, imperative to avoid all the causative factors of obesity, such as ślesman promoting diets, eating before digesting the previous meal, lack of physical exercise and indulging in sleep during the day.^[12] Physical exercise gives lightness (lāghavaṃ)^[13] to the body among other benefits (as noted above) but must be done correctly. Perspiration, enhanced respiration, lightness of the body, inhibition of the heart and other organs are the signs of exercising correctly. On the other hand, excessive work out can cause exertion, exhaustion, consumption, thirst, bleeding from different parts of the body (raktapitta), pratāmaka (a type of dyspnoea), cough, fever and vomiting.^[14] Hence, the teachers advise caution while exercising. It is contraindicated for those who are emaciated from excessive sexual activity, weight-lifting and by travelling on foot; for those who are angry, grieving, fearful and exhausted; for children and the aged; those having a dominantly vātika constitution and who have to speak much. Exercise is avoidable when one is starving and dehydrated.^[15]

The ancient physicians recognise that diseases can be prevented by taking timely recourse to appropriate therapies, that is, before the occurrence of disease or while it in the primary stage.^[16] The months of Caitra (March-April), Śrāvaṇa (July-August) and Mārgaśīrṣa (November-December) are suitable for undergoing elimination (śodhana) therapies, that is, when the conditions are moderate. The body is first prepared by administering oleation (snehana) and fomentation (svedana). This is followed by the administration of emetics and purgation, and again by enema and inhalation therapies.^[17] Thereafter, one may undergo rasāyana for rejuvenation of the body and enhancement of virility. These procedures are claimed to have two long–term positive effects: first, the tissue elements remain in a state of equilibrium and illnesses are averted; and second, the growth of tissue elements implies that process of ageing is slows down.^[18]

The third kind of prophylactic measure recommended in our texts is a regimen appropriate to the season so as to counteract its effects on the doṣas. We have already noted the effects of the period of atmospheric hydration and the period of dehydration, corresponding to uttarāyana (northern solstice) and dakṣināyana (southern solstice), on the rasas and consequently on the human body. Consequently, Āyurveda advocates that diet should contain those rasas that can pacify the aggravated doṣa. Besides, clothing and activities of daily life have to be suited to neutralize the seasonal effects.

Thus, Suśruta says:

yasmin yasminṛtau ye ye doṣāḥ kupyanti dehinām.
teṣu teṣu pradātavyā rasāste te vijānatā.^[19]

Footnotes and references:

[1]:

Caraka Saṃhitā Sūtrasthāna 8.18.

[2]:

V.W. Karambelkar, The Atharva-Veda and the Āyur-Veda, p.120.

[3]:

Atharvaveda II.4.2.

[4]:

Atharvaveda II.9.3.

[5]:

Suśruta Saṃhitā Uttaratantra 64.

[6]:

Suśruta Saṃhitā Cikitsāsthāna 24.30-45.

[7]:

Suśruta Saṃhitā Cikitsāsthāna 24.48.

[8]:

Ḍalhaṇa’s commentary to Suśruta Saṃhitā Cikitsāsthāna 5.5.

[9]:

P.V.Sharma, Medicine in the Classical Age, p.47.

[10]:

Suśruta Saṃhitā Sūtrasthāna 15.32.

[11]:

Suśruta Saṃhitā Sūtrasthāna 15.33.

[12]:

Suśruta Saṃhitā Sūtrasthāna 15.32.

[13]:

Caraka Saṃhitā Sūtrasthāna 7.32.

[14]:

Caraka Saṃhitā Sūtrasthāna 7.33

[15]:

Caraka Saṃhitā Sūtrasthāna 7.35 (1-2).

[16]:

Caraka Saṃhitā Sūtrasthāna 11.63.

[17]:

Caraka Saṃhitā Sūtrasthāna 7.46-47.

[18]:

Caraka Saṃhitā Sūtrasthāna 7.49.

[19]:

Suśruta Saṃhitā Uttaratantra 64.5.