Physician as depicted in Manasollasa

by Sri B. S. Hebballi | 2001 | 75,801 words

This thesis critically evaluates the role of physicians in Ayurvedic literature, particularly in King Somesvara's Manasollasa. It explores the connection between mind and body health, emphasizing the influence of diet and actions....

3. The concept of Dravy and Tridosha

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Substances that are heavy, tough, hard, stable, non-slimy, dense, gross and abounding in the quality of smell are dominated by prthvi; they promote plumpness, compactness, heaviness and stability. Substances that are liquid, unctuous, cold, dull, soft, slimy and abounding in the qualities of taste are dominated by jala; they promote stickiness, like

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146 ointment, unctuousness, compactness, moistness, softness and happiness. Substances that are hot, sharp, subtle, light, ununctuous, non-slimy and abounding in the qualities of vision are dominated by tejas; they promote combustion, metabolism, lustre, radiance and colour. Substances that are light, cold, ununctuous, rough, non-slimy, subtle and abounding in the qualities of touch are dominated by vayu. They promote roughness, aversion, movement, non-slimness and lightness. Substances that are soft, light, subtle, smooth and dominated by the qualities of sound are dominated by akasa; they promote softness, porosity and lightness. Tridosa Concept: In the organic world, these correspond to the panca-bhutas as and when operated by the soul. To be more explicit, the panca-bhutas, prthivi, ap, tejas, vayu and akasa, make up the whole of our physical matter, and this, when operated by the soul, is spoken of as being made up of vata, pitta and kapha, which correspond respectively to rajas, satva and tamas, the trigunas, which constitute the primal and fundamental triplicity of nature prakrti characterising manifested existence of all grades. The origin of tridosas from the five elementary substances is represented as follows: tatra vayoratmaivatma pittamagneyam slesmasaumyah ambhahprthivibhyamslesma } - - vayuh pittam kaphah satva rajas satva + rajas satva + rajas tamas akasa vayuh tejas (agni ) ap prthivi vayuh pittam kaphah

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147 Susruta describes the tridoshas thus: vatapittaslesmana eva dehasambhavahetavah | taireva' vyapanneradhomadhyordhvasannivistaih sariramidam dharyate'garamivasthunabhistisubhiratasca tristhunamahureke | ta eva ca vyapannah pralayahetavah | tadebhireva sonitacaturthaih sambhavasthitipralayesvapyavirahitam sariram bhavati || - susrutasamhita - su . 21-3 I It is from vata, pitta and kapha that the human body takes its origin. They are respectively situated in the upper, middle and lower parts of the trunk and support the structure-body, just as three pillars support a building, and hence the name given to it by some Acaryas. When they are diseased, they lead to destruction. So, with the aid of these three supplemented by blood as the fourth, the body is maintained in a normal condition. Thus Susruta gives here an idea of (1) what tridosas are, (2) what their normal function is, (3) how they take part in pathological processes, and (4) how with blood as a medium, they conduct all processes, from birth to death. He further observes - visargadanaviksepaih somasuryanila yatha | dharayanti jagaddeham kaphapittanilastatha || - susrutasamhita - 21 Here Susruta compares the forces of nature with those of the human body. Just as the sun, the moon, and the air are heavenly forces in one sense and bodies in another, similarly, the tridosas which have d and * are complex bodies having both anatomical and physiological functions in the economy of life. In other words, the tridosas are perfect dravyas and as such fulfil the requirements of a dravya as defined by Caraka in yatrasritah karmagunah karanam samavayi yat tat dravyam | ( carakasamhita sutrasthana - 1 ) The substance, in which guna and karma are indissolubly united and which is a samavayi karana combinative cause, is a 'dravya'. -

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148 Now let us see what dravyas are. The history of evolution tells us that (1) the tanmatras, which are rudimentary principles and nonspecific bodies, are karana-dravyas (bhavarupa ) karanadravya s, and ( 2 ) the specific bodies, which are the outcome-evolutes of the tanmatras, are karyadravyas, karyadravya s and become organic or inorganic according as they are semdriya or All bodies, in this way, are naturally Pancabhautika in their origin and constitution, but in the process of development where 3 D✓✓ is the chief working agent are marked off by changes in the qualifies of the constituents. As the qualities change, the results of the actions change. - → The dravyas according to nyaya, vaisesika and ayurveda are nine in number : 1. prithive - 2. ap - 3, 3. tejas - No 4. vayu a, - p, 5. akasa vayu, 3]TTT, 6. kala - #l, 7. dik - fad, 8. atman atman and 9. manas - manas . Of these, the first five are, .e., capable of being perceived by the senses, while the last four are not so, i.e., they are. All physical matter is pancabhautika and composed of the five elementary dravyas mixed up in various proportions. The paramanus of these dravyas are electrified particles belonging to these five elements, thus giving rise to the physical objects which we see around us. Dravyas are 34 vayavya, agneya, apya and parthiva . At this point of discussion, it is to be noted that the dravyas do not by themselves explain the whole universe. They tentatively serve as their framework; it must be remembered that they are gunavat, karmavat and samavayikarana s. As compared with guna and karma, they are nitya . We have, therefore, now to consider the categories (padartas-cs) other than dravya. By the term 'category' we have to understand, with the exception of one, the several groups or classes into which objects can be divided and not mere modes of predication. They are guna - guna, karma - karma, samanya samanya, f¶¶-visesa, ¶¶¶¶-samavaya, and 3/4-abhava; and together with dravya, they constitute the seven padarthas of the Nyaya school. Of these, dravya, guna and karma have real objective existence with them

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149 and therefore we are more concerned with them here. Abhava is rejected by the Ayurvedists and Vaisesikas. The remaining are budhyapeksa, i.e., relative to understanding. We have already spoken about dravya, and we shall now say a few words about each of the remaining six: (a) Gunat : Guna by itself is niscesta ie, inactive. It becomes a Karana when it gets associated with dravya for the purpose of producing action. So, whenever we use the term dravya, we mean it, for all practical purposes, to be a combination of dravya and guna. Gunas are described by Caraka as "satha gurvadayo buddhih prayatnamtah paradayah . These belong to both cetana-cetana and acetana - acetana dravyas. arthah gurvadayah buddhih prayatnamtah paradayah sabda, sparsa, rupa, rasa, gamdha, Residing in pamcamahabhuta s guru-laghu ; sita-usna ; snigdha- ruksah ; mamda - tiksna ; sthira - cara ; mrdu- kathina ; visada - picchala ; slaksna - khara ; suksma - sthula ; samdra - drava ; dhi, dhrtih, smrtih, ahamkarah iccha, dvesa, sukha, duhkha, prayatna paraparataya yuktisca samkhya samyoga eva ca | vibhagasca prthaktvam ca parimanamathapi ca | samskaro'bhyasa ityete guna jneyah paradayah || --- carakasamhita - sutrasthana 26.27 (b) Karma : Karma is defined by Caraka as samyoge ca vibhage ca karanam dravyamasritam | kartavyasya kriya karma karma nanyadapeksate || carakasamhita - sutrasthana 1.52 " - 4. Guna is defined as samavayi tu niscestah karanam gunah || carakasamhita - sutrasthana 1-51

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N.B. -Shows the general relation between the pamcabhautikasuksmadravya and the dhatu s. 150 Prevailing Prevailing Prevailing tanmatra type of dravya dosa Prevailing saptadhatu in dravya s Physical & PharmacologiPhysiological Chemical properties cal properties properties gandha parthiva kapha mamsa sthula, samdra, mamda, madhura mainly sthairyasamghatopacayakaram sthira, guru, kathina . rasa apya kapha rasa, medas, sita, stimita, snigdha madhura mainly majjan, sukra manda, guru, sara, samdra, mrdu, picchala . kasaya, amla and kasaya secondarily | visesatah adhogatisvabhavam snehana- pralhadana - kledana bandhana-visyandanakaram lavana secondarily rupa taijasa pitta rakta usna, tiksna, suksma, ruksa khara, laghu, visada . katuka mainly amla, lavana dahana - pacana- daruna-tapana prakasana-prabhavarnakaram secondarily sparsa vayaviya vayu asthin suksma, ruksa, sara, kasaya mainly vaisadyalaghavaglapana sisira, laghu, visada tikta secondarily viruksanavicaranakaram sabda akasiya vayu akasiya common to all slaksna, suksma, mrdu, avyaktarasa mardavasosiryalaghavakaram vyavayi, vivikta . dravya s

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151 * is a cause both in conjunction and disjunction, and it rests in a manner embodied in . Its function lies in doing that which is required of it to be done. It does not require any other condition. In other words, of is action pure and simple, and it manifests only when in combination with and . Gangadhara, the commentator on Caraka Samhita, says : nahi nirgunam dravyamasti na ca adravyam karmasti | tatah sahakari karanam dravyakarmanorapi gunah | carakasamhita - sutrasthana 1-32 Regarding kartavyasya kriya karma etc., he further says 5 : "karma is independent of any other action alien to its purpose (svabhinna ) during conjunction and disjunction of. It restricts itself to the same dravyas, brings about and by association and disassociation, changes the nature and properties of the dravyas, and eventually having undergone alteration, manifests itself in the form of an ordinary or extraordinary action, for the accomplishment of an act". Karma is both a karanasamanya and karyasamanya, because samyogadin hi janayati karma | karma ca samyogodibhyah jayate | It must be remembered in the first place that Ayurveda is a practical science based upon realities in the working processes of the living human body. It cannot stand merely on abstract ideas. Therefore, Caraka, having stated in general the nature of dravya, guna, and karma, goes on to explain in the very next verse, what the line of action, i.e., medical treatment should be, as follows 5. ityuktam karanam karyam dhatusamyamihocyate | dhatusamyam kriya cokta tamtrasthasyamprayojanam || carakasamhita - sutrasthana 1-40 svasrayadravyanam samyogavibhagesu nanyatkamapeिksate, tattadravyamivasritya samyogavibhagau punah punah krtva tani dravyani tatsthamscagunan parinamayat svayam svayam ca parinamat ekibhuya cimtyacimtya visista karmarupena jayamanam samavaititi karyasya tatkarma | carakasamhita - sutrasthana - 1

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152 He clearly states that dravya, guna and karma are karana s and dhatu samyakriya is their karya . He has already stated elsewhere that samanya visesa and samavaya are also karana s. But considered from a physical point of view dravya, guna and karma are inseparable; some sort of T and some type of of must accompany dravya . On the other hand, samanya and visesa are the causes of vrddhi and hrasa in dravya ; they change the guna and karma in dravya . So, dravya is nitya in one sense, and guna and karma (compared with dravya ) are anitya . All the dravya s are not nitya . They are of two kinds, viz., prakrtidravya s and karyadravya s. The prakrtidravya s are the Pancamahabhutas and the karyadravya s are either semdriya or nirimdraya . Instances of semdriyadravya s are sarira, imdriya and visaya . It is thus clear that the karyadravya s are mahabhutavikaradravya s, and not pamcamahabhuta s which are only original states of matter. Hence, we read the following words in Caraka "sariram nama cetanadhisthanabhutam pamcabhutavikara samudayatmakam || " Now samavaya indicates only a relationship between dravya, guna and karma . From a strictly logical point of view, it is a perpetual union, i.e., a condition of existence in which two things which are in a combined state, never had any separate existence. But samavayitva changes with the karana s, i.e., guna and karma so far as the form and function of karya (saririka ) dravya s are concerned. So, though samavaya by itself cannot be varying, the samavayikarana s are varying. We thus, see the difference between purusa and prakrti, prakrti and vikrti, avisesa and visesa, suksma and sthula and sthula and sthula . This view of the Sankhyakarika corresponds with that of Ayurvedists and the Naiyaikas ( naiyayika ). The soul varies according to the bhavakhya and limgakhyasarga and constitutions vary according to triguna s (samkhyakarika ). Following the same line of thought it can be said that tridosa s are the products of pamcabhautikadravya s invested with qualities (guna ) and the power of action (karma ). Thus, spamdana and utksepana are karma s being the results of the action of vayu residing in the rajoguna in a dravya . (c) samanya and visesa .

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153 (i) sarvada sarvabhavanam samanyam vrddhikaranam | hrasaheturvisesasca pravrttirubhayasya tu || (ii) samanyamekatvakaram visesastu prthaktvakrt | tulyarthata hi samanyam visesastu viparyayah || (i) samanya, the common factor existing in dravyas, adds to their strength; but gives rise to a concept of their peculiarity consisting in separateness, as a factor leading to deterioration. Both these factors are simultaneously working, when in relation to the body economy. "prakrtirubhayasyatu " may be compared with" prakrtya ca virodhina dhatunam vrddhihrasau bhavatah | (ca.sa . a. 6) (ii) "samanya brings about oneness or likeness, and visesa difference, unlikeness or separateness. H indicates the fitness to accomplish a common object and visesa indicates contrariety (apacaya )." Gangadhara, the commentator, explains (i) samanya and (ii) visesa in the following words : (i) samananam dravyagunakarmanam vrddhau prayojakam samanyam | (ii) visistanam dravyagunakarmanam hrase prayojako visesah | So, samanyam vrddhikaranalaksanam, or ekatvakaram or tulyarthata | (yena samanam yat tasya tenasaha tulyarthatvam- samanyam ) visesah : asamanatvam or viparitatvam (apacaya ) or prthaktvakrt or hrasahetutvam It must be noted here that the interpretation of samanya and visesa in Ayurvedic literature is different from that adopted by the physicians of samanya and visesa in the sense of genus and species.

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154 In its highest degree (samanya ), expresses only existence (satta ), a property common to all bhavas. visesa abides in the nine dravyas (prthivyadi ), which are eternal substances. Out of these nine dravyas atma, manas, kala, dik, akasa are infinite ; and the paramanu s of the remaining four, viz., prthivi, ap, tejas and vayu are indivisible. They (amtyavisesah ) have reached the uttermost point, and they are what they are by their indivisible nature. Its theory or doctrine is that all substances are composed of countless minute indivisible particles, from the combinations of which all forms of substances, physical and mental, arise, and from the operation of which all phenomena take place. These combinations are subject to change or destruction, but the indivisible particles cannot be destroyed or altered. This visesa is the distinguishing feature of the vaisesika philosophy. (e) SAMAVAYA : INSEPARABLE INHERENCE. 6 In this connection Caraka says," Samavaya is the perpetual intimate relation between an object and its qualities; in other words, it is the communion ( fellowship) of two things, whereof one, so long as it exists, continues united with the other, e.g., this relation exists between prthivi and its guna s. (f) ABHAVA : NEGATION or NON-EXISTENCE. It is of four kinds : - (1) pragabhava Antecedent non-existence, as in the case of a pot before it is produced. - (2) pradhvamsabhava Subsequent non existence, as in the case of a pot after it is destroyed. 6. samavayo'prthagbhavo bhumyadinam gunairmatah | sam nityo, yatra hi dravyam na tatraniyato gunah || B carakasamhita - sutrasthana 1-49 sa nityo yatrahi dravyam = sa samavayah nityah yatra hi dravyam nityam ] na tatraniyato gunah tatra = tatra nityedravye gunah na vinasi |

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155 (3) anyonyabhava Mutual non-existence, which finds expression in judgments like "The pot is not cloth.' (4) atyamtabhava Absolute non-existence; this variety we have when there is the bare ground with no pot on it. In medical science dravya is to be understood as Karyadravya, as it counts predominantly in the treatment of diseases. Dravya is, therefore, represented as samavayikarana, i.e., combinative cause wherein actions (karma) and attributes (guna) exist. According to Vaisesikas even soul (purusa) is a dravya, i.e., a substance, for, though it is devoid of action, i.e., change, still it appears to possess action by its contact with mind and the internal organs, in the state of phenomenal existence. The human body, according to Ayurveda, is composed of three fundamental elements called dosas, dhatus and malas. The dosas govern the physico-chemical and physiological activities of the body, while dhatus enter into the formation of the basic structure of a body cell, thereby performing some specific actions. The malas are substances which are partly utilised in the body and partly excreted in a modified form after performing their physiological functions. These three elements are said to be in a dynamic equilibrium with each other for the maintenance of health. Any imbalance of their relative preponderance in the body results in disease and decay. As has been stated bofore, inside the body, there are three dosas which govern the physico-chemical and physiological activities. These three dosas are vayu, pitta and kapha. These dosas are composed of mahabhutas. All the dosas have all the five mahabhutas in their composition. However, the vayu dosa is dominated by akasa mahabhuta and vayu-mahabhuta. In pitta, agni-mahabhuta is predominant, and kapha is primarily constituted of jala and prthvi-mahabhutas.

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Table Showing the relation between tridosas and age, part of the body, Meal, Day, Night and Season. Part of Constitution Age Meal Day Night Body (kostha ) Season 156 vata Old age Lower Part ante After-noon Last portion grisme sacaya of night varsasu prakopa saradi upasama pitta Youth Middle part madhye Mid day Mid night varsasu samcaya saradi prakopa hemamte upasama kapha Infancy and Upper part adau Morning First part sisire samcaya child hood of night vasamte prakopa grisme upasama

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157 The doctrine of the dosas plays an important part in Ayurveda inasmuch as it forms the basis for the maintenance of positive health and diagnosis, as well as treatment of diseases. A correct appreciation of this doctrine is, therefore, essential for proper comprehension and appreciation of the theory and practice of Ayurveda. When they are in their normal state, they sustain the body and any disturbance in their equilibrium results in disease and decay. These three dosas pervade all over the body. There are, however, some elements or organs of the body in which they are primarily located. For example, the urinary bladder, the intestines, the pelvic region, the two thighs, the two legs and the bones are the primary seats of vayu. The seats of pitta are the sweat, the lymph, the blood and the stomach. Similarly, the seats of kapha are the thorax, the head, the neck, the joints, the upper portion of the stomach and the fat tissues of the body. Each of these three dosas are again divided into five types. These five divisions represent only five different aspects of the same dosa and they are not five different entities in the body. Locations and functions of these divisions of vayu, pitta and kapha are given below: During different seasons of the year, these dosas undergo certain changes. For example, vayu gets aggravated during June-August, i.e., at the end of the summer. Pitta gets aggravated between October and December, i.e., during autumn, and kapha gets aggravated between February-April, i.e., during spring. If certain precautionary measures are not taken during these seasons, the person would expose himself to certain diseases caused by these dosas. The precautions to be taken in these seasons will be described later. In the classical Ayurvedic texts, it is suggested that to promote positive health and prevent the occurrence of diseases, one should take medicated enema by the end of summer season, purgation during autumn and emesis during spring.

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158 Factors Responsible for Aggravation of Dosas: Vata gets aggravated by the suppression of manifested natural urges taking food before the previous meal is digested, remaining awake for long hours at night, speaking with a loud voice, physical exercise in excess of one's capacity, exposure to jerks because of travelling in a vehicle for a long time, intake of ingredients having pungent, bitter and astringent tastes, intake of dry fruit, excessive worry, sexual indulgence, fear, fasting, cold and grief. It also gets normally aggravated during the onset of rainy season. Pitta gets aggravated by the excessive intake of pungent and sour things, alcoholic preparations, saline, hot, vidahi (things which cause burning sensation) and sharp things. Other factors which are responsible for the aggravation of pitta are anger, excessive exposure to sun and fire, fear, fatigue, intake of dry vegetables and alkalies. Indigestion and irregularity in taking food also aggravates pitta. Pitta normally gets aggravated during autumn season. Kapha becomes aggravated by sleep during the day time, by the intake of sweet things, cold things, fish, meat, heavy, sour and slimy things, preparations of sesamum, sugarcane and milk, unctuous things, intake of food even after satisfaction, and intake of diet and drinks containing salt and water in excess during the spring season. Aggravation of vayu causes roughness, contraction, punching pain, colic pain, discolouration of the skin, malaise, abnormal movements in limbs, fracture, numbness, coldness, dryness and emaciation. Aggravated pitta causes fatigue, sweating, burning sensation, colouration of the skin, foul smell, stickiness, anger, incoherent speech, fainting and giddiness. It is specially responsible for yellow colouration of the body.

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159 Whiteness (paleness), coldness, heaviness, itching, unctuousness, upadeha (sticking of excreta in different orifices of the body), stimitatva (a subjective feeling as if covered with a wet cloth), lepa (a subjective feeling as if some extraneous material is adhering to the body), swelling, excessive exudation and cirakriya (delay in action or response) are the manifestations of aggravated kapha. Treatment of ailments caused by Aggravation of Dosas : Drinks, diet, regimens and medicines which are unctuous, hot, stable, aphrodisiac, strength promoting, saline, sweet, sour, oils, exposure to sun, bath, massage, enema, inhalation therapy, sleep, taking rest, application of hot ointments etc., alleviate vata. Drinks, diet regimens and medicines which are bitter, sweet and astringent, cold wind, shade, night, water, moon rays, underground residence, fountain, lotus, embracing the body of females, ghee, milk, purgation, sprinkling of water, blood letting, anointment, etc. alleviate pitta. Drinks, diet, regimens and medicines which are rough, alkaline, astringent, bitter and pungent, exercise, spitting therapy, sexual indulgence, walking, fighting, remaining awake, aquatic games, padaghata (putting pressure of different parts of the body through feet), exposure to heat and sun-rays, emetic therapy, fomentation, upanaha (application of hot ointments), etc. alleviate the aggravated kapha.

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