Vividhashitapitiya Adhyaya

Sutra Sthana Chapter 28. Sequential effects of food and beverages

Abstract

There are biological effects of food and beverages on the physiological systems of body. In a sequence of earlier chapter, this chapter describes principles of digestion and metabolism of consumed diet. The formation of tissue elements and metabolic products during this process are explained in detail. The food nourishes body tissues through various systemic channels named ‘srotasa’. Specific disease conditions due to vitiation of these body systems and their principles of management are highlighted in this chapter. Apart from food, factors like habitat, season, combination, potency and excess consumption affecting the status of immunity and disease in the body have also been discussed here. The chapter explains why some people are healthy even after consuming unwholesome food articles while others suffer from diseases even after following wholesome food habits. This chapter also talks of diseases caused due to vitiation of various tissue elements and factors responsible for the movement of dosha from koshtha (gut) to shakha(periphery). These factors are important for preservation of health and disease management. Being the last chapter of tetrad on food and beverages, the chapter summarizes importance of diet, its examination for wholesome benefits and adverse effects on improper consumption.

Keywords: Food, digestion, eatable, drinks, disorders of various systems, treatment, movement of dosha, koshtha, shakha.

Vividhashitapitiya Adhyaya

Section/Chapter	Sutra Sthana Chapter 28
Tetrad/Sub-section	Annapana Chatushka
Preceding Chapter	Annapanavidhi Adhyaya
Succeeding Chapter	Dashapranayataneeya Adhyaya
Other Sections	Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana

Introduction

The preceding chapter dealt with properties of various dietary articles and preparations, while this one explains digestion and metabolism processes in brief. Even though Vividhashitapitiyam means different kinds of eatables and drinks, the chapter gives a detailed explanation of assimilation of food and its transformation into body tissues and diseases caused due to an abnormality of dhatus along with their line of treatment. Some references to this are also available later in the Charak Samhita Chikitsa Sthana 15th chapter (Grahani Chikitsa).

Wholesome food is vital for the nourishment of human body, the creation of healthy tissues, maintenance of health, and for the prevention of disease. Not following a wholesome food regimen causes vitiation of doshas. These doshas then reside within dhatus(tissue elements), upadhatus(tissues formed from the essence of dhatu during transformation process), or malas (metabolic wastes). In certain situations, the vitiated doshas get aggravated to cause diseases. The entire process is explained with clinical features of association of vitiated dosha with the respective pathogen. The causative factors for movement of dosha from the periphery to the gut and vice versa are important to understand the disease and prescribe the appropriate purification process. Digestion and assimilation are the most important physiological process in the body. Any abnormality in this process results in the improper formation of the dhatu thus resulting in either deficiency or excessive formation of dhatus resulting in disorders. The causes for the movement of vitiated doshas from alimentary tract (koshtha) to the raktadi dhatu and skin (shakha) results in the occurrence of diseases. Moving the doshas back to alimentary tract (koshtha) and after that removing them eliminates diseases. The line of treatment of various diseases due to an abnormality in the dhatus is mentioned in this chapter. Thus, the chapter presents important aspects of food, digestion, metabolism, immunity, diseases of affected tissues, and guidelines for their treatment.

Sanskrit text, Transliteration and English Translation

अथातो विविधाशितपीतीयमध्यायं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātō vividhāśitapītīyamadhyāyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto vividhAshitapItIyamadhyAyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter dealing with "Different types of food and drinks." Thus, said Lord Atreya. [1]

Digestion process and its effects

विविधमशितं पीतं लीढं खादितं जन्तोर्हितमन्तरग्निसन्धुक्षितबलेन यथास्वेनोष्मणा सम्यग्विपच्यमानंकालवदनवस्थितसर्वधातुपाकमनुपहतसर्वधातूष्ममारुतस्रोतः केवलं शरीरमुपचयबलवर्णसुखायुषा योजयति शरीरधातूनूर्जयतिच| धातवो हि धात्वाहाराः प्रकृतिमनुवर्तन्ते||३||

vividhamaśitaṁ pītaṁ līḍhaṁ khāditaṁ jantōrhitamantaragnisandhukṣitabalēna yathāsvēnōṣmaṇāsamyagvipacyamānaṁ kālavadanavasthitasarvadhātupākamanupahatasarvadhātūṣmamārutasrōtaḥkēvalaṁ śarīramupacayabalavarṇasukhāyuṣā yōjayati śarīradhātūnūrjayati ca| dhātavō hi dhātvāhārāḥ prakr̥timanuvartantē||3||

vividhamashitaM pItaM lIDhaM khAditaM jantorhitamantaragnisandhukShitabalena yathAsvenoShmaNAsamyagvipacyamAnaM kAlavadanavasthitasarvadhAtupākamanupahatasarvaDhātushmamArutasrotaHkevalaM sharIramupacayabalavarNasukhAyuShA yojayati sharIradhAtUnUrjayati ca| dhAtavo hi dhAtvAhArAH prakRutimanuvartante||3||

Different types of wholesome foods ingested in the form of eatables, drinkables, lickables and masticables stimulate the antaragni (digestive process) and get properly digested by respective bhutagni (specific digestion as per basic constituent or element). Further in due course of time food gets transformed into different dhatus in presence of dhatvagni (tissue specific digestion and metabolism) and vata (vyana vayu) by the process of dhatvagnipaka or metabolism, nourishes the tissues through the channels of circulation without any interruption, and produces plumpness, strength, complexion, health and longevity. The tissues are sustained by getting fed by various nourishing factors (poshaka dhatus). [3]

Metabolism, excretion, and homeostasis

तत्राहारप्रसादाख्यो रसः किट्टं च मलाख्यमभिनिर्वर्तते| किट्टात् स्वेदमूत्रपुरीषवातपित्तश्लेष्माणः कर्णाक्षिनासिकास्यलोमकूपप्रजननमलाः केशश्मश्रुलोमनखादयश्चावयवाःपुष्यन्ति| पुष्यन्ति त्वाहाररसाद्रसरुधिरमांसमेदोस्थिमज्जशुक्रौजांसि पञ्चेन्द्रियद्रव्याणि धातुप्रसादसञ्ज्ञकानिशरीरसन्धिबन्धपिच्छादयश्चावयवाः| ते सर्व एव धातवो मलाख्याः प्रसादाख्याश्च रसमलाभ्यां पुष्यन्तः स्वं मानमनुवर्तन्ते यथावयःशरीरम्| एवं रसमलौ स्वप्रमाणावस्थितावाश्रयस्य समधातोर्धातुसाम्यमनुवर्तयतः| निमित्ततस्तु क्षीणवृद्धानां प्रसादाख्यानां धातूनां वृद्धिक्षयाभ्यामाहारमूलाभ्यां रसः साम्यमुत्पादयत्यारोग्याय, किट्टं चमलानामेवमेव| स्वमानातिरिक्ताः पुनरुत्सर्गिणः शीतोष्णपर्यायगुणैश्चोपचर्यमाणा मलाः शरीर धातुसाम्यकराः समुपलभ्यन्ते||४||

tatrāhāraprasādākhyō Rasaḥ kiṭṭaṁ ca malākhyamabhinirvartatē| kiṭṭāt svēdamūtrapurīṣavātaPittaślēṣmāṇaḥ karṇākṣināsikāsyalōmakūpaprajananamalāḥkēśaśmaśrulōmanakhādayaścāvayavāḥ puṣyanti| puṣyanti tvāhārarasādRasarudhiramāṁsamēdōsthiMajjāśukraujāṁsi pañcēndriyadravyāṇidhātuprasādasañjñakāni śarīRasandhibandhapicchādayaścāvayavāḥ| tē sarva ēva dhātavō malākhyāḥ prasādākhyāśca Rasamalābhyāṁ puṣyantaḥ svaṁ mānamanuvartantēyathāvayaḥśarīram| ēvaṁ Rasamalau svapramāṇāvasthitāvāśrayasya samadhātōrDhātusāmyamanuvartayataḥ| nimittatastu kṣīṇavr̥ddhānāṁ prasādākhyānāṁ dhātūnāṁ vr̥ddhikṣayābhyāmāhāramūlābhyāṁ Rasaḥsāmyamutpādayatyārōgyāya, kiṭṭaṁ ca malānāmēvamēva| svamānātiriktāḥ punarutsargiṇaḥ śītōṣṇaparyāyaguṇaiścōpacaryamāṇā malāḥ śarīra Dhātusāmyakarāḥsamupalabhyantē||4||

tatrAhArapRasadAkhyo RasaH kiTTaM ca malAkhyamabhinirvartate| kiTTAt svedamUtrapurIShaVātaPittashleShmANaH karNAkShinAsikAsyalomakUpaprajananamalAHkeshashmashrulomanakhAdayashcAvayavAH puShyanti| puShyanti tvAhAraRasadRasarudhiraMaṃsa medosthiMajjāŚukraujAMsi pa~jcendriyadravyANidhAtupRasadasa~jj~jakAni sharIRasandhibandhapicchAdayashcAvayavAH| te sarva eva dhAtavo malAkhyAH pRasadAkhyAshca RasamalAbhyAM puShyantaH svaM mAnamanuvartanteyathAvayaHsharIram| evaM Rasamalau svapramANAvasthitAvAshrayasya samadhAtorDhātusAmyamanuvartayataH| nimittatastu kShINavRuddhAnAM pRasadAkhyAnAM dhAtUnAM vRuddhikShayAbhyAmAhAramUlAbhyAMRasaH sAmyamutpAdayatyArogyAya, kiTTaM ca malAnAmevameva| svamAnAtiriktAH punarutsargiNaH shItoShNaparyAyaguNaishcopacaryamANA malAH sharIraDhātusAmyakarAH samupalabhyante||4||

The food gets transformed into two forms i.e. prasada or essence form (ahara rasa) and kitta (the waste form). The kitta part nourishes the mala or excretory products like sweat, urine, stool, vata, pitta, kapha, excreta of the ear, nose, mouth, hair follicle, genital organs, hair, beard, body hair, nails, etc. The essence part or ahara rasa nourishes rasa (body fluids), rakta (blood), mamsa (flesh), medas (fat), asthi (bone), majja (bone marrow), shukra (reproductive elements like semen and ovum), ojas (essence of the seven fundamental tissue elements, or the sapta dhatus), basic components of five sense organs, joints, ligaments, tendons and mucilage part in the body. All the malas (wastes) and dhatu (tissue elements) of the body are nourished by the waste part of food and essence of food or ahara rasa respectively. The rasadi dhatus and malas or waste products are nourished so that the quality is maintained according to size and age of the body. Thus, after digestion, the essence and waste of food in their normal quantity maintain the equilibrium of tissues. The tissue elements may increase or decrease due to some etiology, which can be normalized by the essence part of digested food in decreased or increased quantity. Similarly, malas can be transformed into the waste part of ahara rasa. The waste products, when in excess, can be excreted and the status of the body can be brought to an equilibrium through treatments with the therapies having opposite qualities like hot, cold, etc. [4]

Channels for the nourishment of tissues

तेषां तु मलप्रसादाख्यानां धातूनां स्रोतांस्ययनमुखानि| तानि यथाविभागेन यथास्वं धातूनापूरयन्ति| एवमिदं शरीरमशितपीतलीढखादितप्रभवम्| अशितपीतलीढखादितप्रभवाश्चास्मिञ् शरीरे व्याधयो भवन्ति| हिताहितोपयोगविशेषास्त्वत्र शुभाशुभविशेषकरा भवन्तीति||५||

tēṣāṁ tu malaprasādākhyānāṁ dhātūnāṁ srōtāṁsyayanamukhāni| tāni yathāvibhāgēna yathāsvaṁ dhātūnāpūrayanti| ēvamidaṁ śarīramaśitapītalīḍhakhāditaprabhavam| aśitapītalīḍhakhāditaprabhavāścāsmiñ śarīrē vyādhayō bhavanti| hitāhitōpayōgaviśēṣāstvatra śubhāśubhaviśēṣakarā bhavantīti||5||

teShAM tu malapRasadAkhyAnAM dhAtUnAM srotAMsyayanamukhAni| tAni yathAvibhAgena yathAsvaM dhAtUnApUrayanti| evamidaM sharIramashitapItalIDhakhAditaprabhavam| ashitapItalIDhakhAditaprabhavAshcAsmi~j sharIre vyAdhayo bhavanti| hitAhitopayogavisheShAstvatra shubhAshubhavisheShakarA bhavantIti||5||

The nourishing as well as excretory products enter different channels of circulation and nourish the respective dhatus. Thus, this body is maintained by the nourishment drawn from eatables, drinkables, linctuses and chewables. The diseases could also be caused by these sources (i.e., eatables, etc.). Intake of wholesome and unwholesome food results in positive health and diseases respectively. [5]

Query of Agnivesha

एवंवादिनं भगवन्तमात्रेयमग्निवेश उवाच-दृश्यन्ते हि भगवन्! हितसमाख्यातमप्याहारमुपयुञ्जाना व्याधिमन्तश्चागदाश्च,तथैवाहितसमाख्यातम्; एवं दुष्टे कथं हिताहितोपयोगविशेषात्मकं शुभाशुभविशेषमुपलभामह इति||६||

ēvaṁvādinaṁ bhagavantamātrēyamagnivēśa uvāca- dr̥śyantē hi bhagavan!hitasamākhyātamapyāhāramupayuñjānā vyādhimantaścāgadāśca, tathaivāhitasamākhyātam; ēvaṁ duṣṭēkathaṁ hitāhitōpayōgaviśēṣātmakaṁ śubhāśubhaviśēṣamupalabhāmaha iti||6||

evaMvAdinaM bhagavantamAtreyamagnivesha uvAca- dRushyante hi bhagavan!hitasamAkhyAtamapyAhAramupayu~jjAnA vyAdhimantashcAgadAshca, tathaivAhitasamAkhyAtam; evaMduShTe kathaM hitAhitopayogavisheShAtmakaM shubhAshubhavisheShamupalabhAmaha iti||6||

After hearing an explanation of Lord Atreya, Agnivesha said “Oh Lord, some individuals consuming wholesome food get afflicted with diseases, while some individuals consuming unwholesome food remain healthy. In this regard, how does one infer that health and disease are influenced by wholesome and unwholesome foods respectively?”. [6]

Answer by Atreya about causative factors of disease and immunity

तमुवाच भगवानात्रेयः- न हिताहारोपयोगिनामग्निवेश! तन्निमित्ता व्याधयो जायन्ते, न च केवलं हिताहारोपयोगादेवसर्वव्याधिभयमतिक्रान्तं भवति, सन्ति ह्यृतेऽप्यहिताहारोपयोगादन्या रोगप्रकृतयः, तद्यथा- कालविपर्ययः, प्रज्ञापराधः,शब्दस्पर्शरूपरसगन्धाश्चासात्म्या इति| ताश्च रोगप्रकृतयो रसान् सम्यगुपयुञ्जानमपि पुरुषमशुभेनोपपादयन्ति; तस्माद्धिताहारोपयोगिनोऽपि दृश्यन्तेव्याधिमन्तः| अहिताहारोपयोगिनां पुनः कारणतो न सद्यो दोषवान् भवत्यपचारः| न हि सर्वाण्यपथ्यानि तुल्यदोषाणि, न च सर्वे दोषास्तुल्यबलाः, न च सर्वाणि शरीराणि व्याधिक्षमत्वे समर्थानि भवन्ति| तदेव ह्यपथ्यं देशकालसंयोगवीर्यप्रमाणातियोगाद्भूयस्तरमपथ्यं सम्पद्यते| स एव दोषः संसृष्टयोनिर्विरुद्धोपक्रमो गम्भीरानुगतश्चिरस्थितः प्राणायतनसमुत्थो मर्मोपघाती कष्टतमः क्षिप्रकारितमश्चसम्पद्यते| शरीराणि चातिस्थूलान्यतिकृशान्यनिविष्टमांसशोणितास्थीनि दुर्बलान्यसात्म्याहारोपचितान्यल्पाहाराण्यल्पसत्त्वानि चभवन्त्यव्याधिसहानि, विपरीतानि पुनर्व्याधिसहानि| एभ्यश्चैवापथ्याहारदोषशरीरविशेषेभ्यो व्याधयो मृदवो दारुणाः क्षिप्रसमुत्थाश्चिरकारिणश्च भवन्ति| त एव वातपित्तश्लेष्माणः स्थानविशेषे प्रकुपिता व्याधिविशेषानभिनिर्वर्तयन्त्यग्निवेश!||७||

tamuvāca bhagavānātrēyaḥ- na hitāhārōpayōgināmagnivēśa! tannimittā vyādhayō jāyantē, na ca kēvalaṁhitāhārōpayōgādēva sarvavyādhibhayamatikrāntaṁ bhavati, santi hyr̥tē'pyahitāhārōpayōgādanyārōgaprakr̥tayaḥ, tadyathā- kālaviparyayaḥ, prajñāparādhaḥ, śabdasparśarūpaRasagandhāścāsātmyā iti| tāśca rōgaprakr̥tayō rasān samyagupayuñjānamapi puruṣamaśubhēnōpapādayanti;tasmāddhitāhārōpayōginō'pi dr̥śyantē vyādhimantaḥ| ahitāhārōpayōgināṁ punaḥ kāraṇatō na sadyō dōṣavān bhavatyapacāraḥ| na hi sarvāṇyapathyāni tulyadōṣāṇi, na ca sarvē dōṣāstulyabalāḥ, na ca sarvāṇi śarīrāṇi vyādhikṣamatvēsamarthāni bhavanti| tadēva hyapathyaṁ dēśakālasaṁyōgavīryapramāṇātiyōgādbhūyastaramapathyaṁ sampadyatē| sa ēva dōṣaḥ saṁsr̥ṣṭayōnirviruddhōpakramō gambhīrānugataścirasthitaḥ prāṇāyatanasamutthōmarmōpaghātī kaṣṭatamaḥ kṣiprakāritamaśca sampadyatē| śarīrāṇi cātisthūlānyatikr̥śānyaniviṣṭamāṁsaśōṇitāsthīnidurbalānyasātmyāhārōpacitānyalpāhārāṇyalpasattvāni ca bhavantyavyādhisahāni, viparītānipunarvyādhisahāni| ēbhyaścaivāpathyāhāradōṣaśarīraviśēṣēbhyō vyādhayō mr̥davō dāruṇāḥ kṣipRasamutthāścirakāriṇaścabhavanti| ta ēva vātaPittaślēṣmāṇaḥ sthānaviśēṣē prakupitā vyādhiviśēṣānabhinirvartayantyagnivēśa!||7||

tamuvAca bhagavAnAtreyaH- na hitAhAropayoginAmagnivesha! tannimittA vyAdhayo jAyante, na cakevalaM hitAhAropayogAdeva sarvavyAdhibhayamatikrAntaM bhavati, santihyRute~apyahitAhAropayogAdanyA rogaprakRutayaH, tadyathA- kAlaviparyayaH, praj~jAparAdhaH,shabdasparsharUpaRasagandhAshcAsAtmyA iti| tAshca rogaprakRutayo Rasan samyagupayu~jjAnamapi puruShamashubhenopapAdayanti;tasmAddhitAhAropayogino~api dRushyante vyAdhimantaH| ahitAhAropayoginAM punaH kAraNato na sadyo doShavAn bhavatyapacAraH| na hi sarvANyapathyAni tulyadoShANi, na ca sarve DoṣastulyabalAH, na ca sarvANi sharIrANivyAdhikShamatve samarthAni bhavanti| tadeva hyapathyaM deshakAlasaMyogavIryapramANAtiyogAdbhUyastaramapathyaM sampadyate| sa eva doShaH saMsRuShTayonirviruddhopakramo gambhIrAnugatashcirasthitaH PrāṇayatanasamutthomarmopaghAtI kaShTatamaH kShiprakAritamashca sampadyate| sharIrANi cAtisthUlAnyatikRushAnyaniviShTaMaṃsa shoNitAsthInidurbalAnyasAtmyAhAropacitAnyalpAhArANyalpasattvAni ca bhavantyavyAdhisahAni, viparItAnipunarvyAdhisahAni| ebhyashcaivApathyAhAraDoṣasharIravisheShebhyo vyAdhayo mRudavo dAruNAHkShipRasamutthAshcirakAriNashca bhavanti| ta eva VātaPittashleShmANaH sthānavisheShe prakupitAvyAdhivisheShAnabhinirvartayantyagnivesha!||7||

Lord Atreya replied, "An individual consuming wholesome food will not get afflicted with disease due to the food. Intake of wholesome food alone is not the causative factor for a disease or can it prevent diseases. Apart from unwholesome food, there are many other etiological factors that lead to a disease, such as changes in season, intellectual errors, unwholesome contacts, excessive, wrong and overutilization of senses of sound, touch, vision, taste and smell. These etiological factors can cause diseases in an individual despite wholesome intake of rasa and diet. Hence, an individual taking wholesome food has also been observed to have taken ill. Similarly, consuming unwholesome diet does not immediately produce untoward effects. All unwholesome food articles are not equally harmful, all the doshas are not of equal strength, and all the bodies are not capable of preventing disease. Unwholesome food can be more harmful depending upon the habitat, season, combination, potency, and intake in excessive quantity. The doshas become acute and extremely difficult to manage when they get associated with multiple factors, treated with wrong therapies, become deep rooted, chronic, get vitiated in one of the ten seats of prana, and when they afflict vital centers within the body known as marma. Individuals, who are excessively obese, emaciated, whose muscles, blood, bones are depleted, who are very weak physically, who are habituated to consuming unwholesome food, who take in inadequate quantities of food, and who have very weak mind cannot withstand diseases. Contrary to this, individuals having opposite qualities to the ones mentioned above are capable of resisting diseases. Thus, unwholesome diet, doshas, and body constitution factors produce diseases of mild, severe, acute and chronic nature. [7]

Description of diseases affecting various dhatu (tissue)

तत्र रसादिषु स्थानेषु प्रकुपितानां दोषाणां यस्मिन् स्थाने ये ये व्याधयः सम्भवन्ति तांस्तान् यथावदनुव्याख्यास्यामः||८||

tatra rasādiṣu sthānēṣu prakupitānāṁ dōṣāṇāṁ yasmin sthānē yē yē vyādhayaḥ sambhavanti tāṁstānyathāvadanuvyākhyāsyāmaḥ||8||

tatra RasadiShu sthAneShu prakupitAnAM doShANAM yasmin sthAne ye ye vyAdhayaH sambhavantitAMstAn yathAvadanuvyAkhyAsyAmaH||8||

The specific diseases caused due to vitiated doshas in the seats of rasa, rakta, etc. dhatus will be explained further. [8]

Diseases due to vitiation of rasa

अश्रद्धा चारुचिश्चास्यवैरस्यमरसज्ञता| हृल्लासो गौरवं तन्द्रा साङ्गमर्दो ज्वरस्तमः ||९||

पाण्डुत्वं स्रोतसां रोधः क्लैब्यं सादः कृशाङ्गता| नाशोऽग्नेरयथाकालं वलयः पलितानि च||१०||

रसप्रदोषजा रोगा,...|११|

aśraddhā cāruciścāsyavairasyamaRasajñatā| hr̥llāsō gauravaṁ tandrā sāṅgamardō jvarastamaḥ ||9||

pāṇḍutvaṁ srōtasāṁ rōdhaḥ klaibyaṁ sādaḥ kr̥śāṅgatā| nāśō'gnērayathākālaṁ valayaḥ palitāni ca||10||

Rasapradōṣajā rōgā,...|11|

ashraddhA cArucishcAsyavairasyamaRasaj~jatA| hRullAso gauravaM tandrA sA~ggamardo jvarastamaH ||9||

pANDutvaM srotasAM rodhaH klaibyaM sAdaH kRushA~ggatA| nAsho~agnerayathAkAlaM valayaH palitAni ca||10||

RasapradoShajA rogA,...|11|

Aversion towards food, anorexia, altered sense of taste, inability to identify tastes, nausea, heaviness in the body, drowsiness, body ache, fever, blackouts, anemia, obstruction of channels, impotence, tiredness (angavasada), emaciation, diminished agni, and premature aging (wrinkling of skin and graying of hair) are some of the disorders caused due to vitiation of rasa. [9-11]

Diseases due to vitiation of rakta

...वक्ष्यन्ते रक्तदोषजाः| कुष्ठवीसर्पपिडका रक्तपित्तमसृग्दरः||११||

गुदमेढ्रास्यपाकश्च प्लीहा गुल्मोऽथ विद्रधिः| नीलिका कामला व्यङ्गः पिप्प्लवस्तिलकालकाः||१२||

दद्रुश्चर्मदलं श्वित्रं पामा कोठास्रमण्डलम्| रक्तप्रदोषाज्जायन्ते,...|१3|

...vakṣyantē Rakta dōṣajāḥ| kuṣṭhavīsarpapiḍakā Rakta Pittamasr̥gdaraḥ||11||

gudamēḍhrāsyapākaśca plīhā gulmō'tha vidradhiḥ| nīlikā kāmalā vyaṅgaḥ pipplavastilakālakāḥ||12||

dadruścarmadalaṁ śvitraṁ pāmā kōṭhāsramaṇḍalam| Rakta pradōṣājjāyantē,...|13|

...vakShyante Rakta doShajAH| KuṣṭhavIsarpapiDakA Rakta PittamasRugdaraH||11||

gudameDhrAsyapākashca plIhA gulmo~atha vidradhiH| nIlikA kAmalA vya~ggaH pipplavastilakAlakAH||12||

dadrushcarmadalaM shvitraM pAmA koThAsramaNDalam| Rakta pradoShAjjAyante,...|13|

The following diseases are caused due to vitiation of rakta: Skin disorders including kushtha, erysipelas (visarpa), furuncles (pidaka), raktapitta (a kind of bleeding disorder), menorrhagia (asrugdara), inflammation of anus, penis, oral cavity, splenic disorders (pliha), abdominal lump (gulma), abscess (vidradhi), blue mole (nilika), jaundice (kamala), freckles/blemish (vyanga), portwine mark (piplu), black mole of the size of sesame seed (tilakalaka), ringworm (dadru), dermatitis (charmadala), leucoderma (svitra), scabies (pama), urticaria (kotha), and circular erythema (asra mandala). [11-13]

Diseases due to vitiation of mamsa

...शृणु मांसप्रदोषजान्||१३||

अधिमांसार्बुदं कीलं गलशालूकशुण्डिके| पूतिमांसालजीगण्डगण्डमालोपजिह्विकाः||१४||

विद्यान्मांसाश्रयान्,...|१५|

...śr̥ṇu māṁsapradōṣajān||13||

adhimāṁsārbudaṁ kīlaṁ galaśālūkaśuṇḍikē| pūtimāṁsālajīgaṇḍagaṇḍamālōpajihvikāḥ||14||

vidyānmāṁsāśrayān,...|15|

...shRuNu Maṃsa pradoShajAn||13||

adhiMaṃsa rbudaM kIlaM galashAlUkashuNDike| pUtiMaṃsa lajIgaNDagaNDamAlopajihvikAH||14||

vidyAnMaṃsa shrayAn,...|15|

Following diseases are caused due to vitiation of mamsadhatu: adhimamsa (granuloma), arbuda (myoma), kila (piles), galashaluka (uvulitis), galashundika (tonsillitis), putimamsa (gangrene), alaji (boils), ganda (goiter), gandamala (cervical lymphadenitis) and upajihvika (inflammation of epiglottis). [13-15]

Diseases due to vitiation of meda

.. मेदःसंश्रयांस्तु प्रचक्ष्महे| निन्दितानि प्रमेहाणां पूर्वरूपाणि यानि च||१५||

.. mēdaḥsaṁśrayāṁstu pracakṣmahē| ninditāni pramēhāṇāṁ pūrvarūpāṇi yāni ca||15||

... medaHsaMshrayAMstu pracakShmahe| ninditAni pramehANAM pUrvarUpANi yAni ca||15||

Premonitory symptoms of persistent urinary disorders including diabetes mellitus and eight undesirable types of physical constitutions, which are not appreciable in the society (to be avoided, described earlier in chapter 21 of ashta nindita) are produced due to vitiation of medas. [15]

Diseases due to vitiation of asthi

अध्यस्थिदन्तौ दन्तास्थिभेदशूलं विवर्णता| केशलोमनखश्मश्रुदोषाश्चास्थिप्रदोषजाः||१६||

adhyasthidantau dantāsthibhēdaśūlaṁ vivarṇatā| kēśalōmanakhaśmaśrudōṣāścāsthipradōṣajāḥ||16||

adhyasthidantau dantAsthibhedashUlaM vivarNatA| keshalomanakhashmashruDoṣashcAsthipradoShajAH||16||

Hypertrophy of bones and teeth, splitting and severe pain in teeth and bone, discoloration, abnormality of body hair, nail and beard are the diseases caused due to vitiation of asthi. [16]

Diseases due to vitiation of majja

रुक् पर्वणां भ्रमो मूर्च्छा दर्शनं तमसस्तथा| अरुषां स्थूलमूलानां पर्वजानां च दर्शनम्||१७||

मज्जप्रदोषात्, ...|१८|

ruk parvaṇāṁ bhramō mūrcchā darśanaṁ tamasastathā| aruṣāṁ sthūlamūlānāṁ parvajānāṁ ca darśanam||17||

Majjāpradōṣāt, ...|18|

ruk parvaNAM bhramo mUrcchA darshanaM tamasastathA| aruShAM sthUlamUlAnAM parvajAnAM ca darshanam||17||

MajjāpradoShAt, ...|18|

Pain in the joints, giddiness, unconsciousness, blackouts and deep rooted abscess in joints are caused due to vitiation of majja. [17-18]

Diseases due to vitiation of shukra

...शुक्रस्य दोषात् क्लैब्यमहर्षणम्| रोगि वा क्लीबमल्पायुर्विरूपं वा प्रजायते||१८||

न चास्य जायते गर्भः पतति प्रस्रवत्यपि| शुक्रं हि दुष्टं सापत्यं सदारं बाधते नरम्||१९||

...śukrasya dōṣāt klaibyamaharṣaṇam| rōgi vā klībamalpāyurvirūpaṁ vā prajāyatē||18||

na cāsya jāyatē garbhaḥ patati prasravatyapi| śukraṁ hi duṣṭaṁ sāpatyaṁ sadāraṁ bādhatē naram||19||

...Śukrasya doShAt klaibyamaharShaNam| rogi vA klIbamalpAyurvirUpaM vA prajAyate||18||

na cAsya jAyate garbhaH patati prasravatyapi| ŚukraM hi duShTaM sApatyaM sadAraM bAdhate naram||19||

Due to vitiation of shukra, the person becomes sexually impotent, suffers from aharshana (inability to penetrate despite erection), and may have sick, impotent, and short-lived children with congenital abnormalities. There could be cases of no conception, or there will be spontaneous abortion. Thus, abnormalities of shukra result in misery for the individual as well as his family. [18-19]

Disease of sense organs

इन्द्रियाणि समाश्रित्य प्रकुप्यन्ति यदा मलाः| उपघातोपतापाभ्यां योजयन्तीन्द्रियाणि ते||२०||

indriyāṇi samāśritya prakupyanti yadā malāḥ| upaghātōpatāpābhyāṁ yōjayantīndriyāṇi tē||20||

indriyANi samAshritya prakupyanti yadA malAH| upaghAtopatApAbhyAM yojayantIndriyANi te||20||

When the doshas get vitiated in sense organs, they either cause impairment or deformity of the respective sense organ. [20]

Diseases of ligaments, vessels, and tendons

स्नायौ सिराकण्डराभ्यो दुष्टाः क्लिश्नन्ति मानवम्| स्तम्भसङ्कोचखल्लीभिर्ग्रन्थिस्फुरणसुप्तिभिः||२१||

snāyau sirākaṇḍarābhyō duṣṭāḥ kliśnanti mānavam| stambhasaṅkōcakhallībhirgranthisphuraṇasuptibhiḥ||21||

snAyau sirAkaNDarAbhyo duShTAH klishnanti mAnavam| stambhasa~gkocakhallIbhirgranthisphuraNasuptibhiH||21||

Stiffness, contraction, and neuralgia of upper and lower extremities, tumor, throbbing sensation and numbness are produced by the vitiated doshas in ligaments, blood vessels and tendons. [21]

Vitiation of mala by dosha

मलानाश्रित्य कुपिता भेदशोषप्रदूषणम्| दोषा मलानां कुर्वन्ति सङ्गोत्सर्गावतीव च||२२||

malānāśritya kupitā bhēdaśōṣapradūṣaṇam| dōṣā malānāṁ kurvanti saṅgōtsargāvatīva ca||22||

malAnAshritya kupitA bhedashoShapradUShaNam| doShA malAnAM kurvanti sa~ggotsargAvatIva ca||22||

The aggravation of doshas in the malas of the body causes excess discharge (bheda) of mala (as in diarrhea), decrease or dryness of mala, and abnormalities on normal color, smell, etc. leading to their retention or excessive elimination. [22]

Management principles

विविधादशितात् पीतादहिताल्लीढखादितात्| भवन्त्येते मनुष्याणां विकारा य उदाहृताः||२३||

तेषामिच्छन्ननुत्पत्तिं सेवेत मतिमान् सदा| हितान्येवाशितादीनि न स्युस्तज्जास्तथाऽऽमयाः||२४||

रसजानां विकाराणां सर्वं लङ्घनमौषधम्| विधिशोणितिकेऽध्याये रक्तजानां भिषग्जितम्||२५||

मांसजानां तु संशुद्धिः शस्त्रक्षाराग्निकर्म च| अष्टौनिन्दितिकेऽध्याये मेदोजानां चिकित्सितम्||२६||

अस्थ्याश्रयाणां व्याधीनां पञ्चकर्माणि भेषजम्| बस्त्यः क्षीरसर्पींषि तिक्तकोपहितानि च||२७||

मज्जशुक्रसमुत्थानामौषधं स्वादुतिक्तकम्| अन्नं व्यवायव्यायामौ शुद्धिः काले च मात्रया||२८||

शान्तिरिन्द्रियजानां तु त्रिमर्मीये प्रवक्ष्यते| स्नाय्वादिजानां प्रशमो वक्ष्यते वातरोगिके||२९||

नवेगान्धारणेऽध्याये चिकित्सासङ्ग्रहः कृतः| मलजानां विकाराणां सिद्धिश्चोक्ता क्वचित्क्वचित्||३०||

vividhādaśitāt pītādahitāllīḍhakhāditāt| bhavantyētē manuṣyāṇāṁ vikārā ya udāhr̥tāḥ||23||

tēṣāmicchannanutpattiṁ sēvēta matimān sadā| hitānyēvāśitādīni na syustajjāstathāmayāḥ||24||

Rasajānāṁ vikārāṇāṁ sarvaṁ laṅghanamauṣadham| vidhiśōṇitikē'dhyāyē Rakta jānāṁ bhiṣagjitam||25||

māṁsajānāṁ tu saṁśuddhiḥ śastrakṣārāgnikarma ca| aṣṭauninditikē'dhyāyē mēdōjānāṁ cikitsitam||26||

asthyāśrayāṇāṁ vyādhīnāṁ pañcakarmāṇi bhēṣajam| bastyaḥ kṣīRasarpīṁṣi tiktakōpahitāni ca||27||

MajjāśukRasamutthānāmauṣadhaṁ svādutiktakam| annaṁ vyavāyavyāyāmau śuddhiḥ kālē ca mātrayā||28||

śāntirindriyajānāṁ tu trimarmīyē pravakṣyatē| snāyvādijānāṁ praśamō vakṣyatē vātarōgikē||29||

navēgāndhāraṇē'dhyāyē cikitsāsaṅgrahaḥ kr̥taḥ| malajānāṁ vikārāṇāṁ siddhiścōktā kvacitkvacit||30||

vividhAdashitAt pItAdahitAllIDhakhAditAt| bhavantyete manuShyANAM vikArA ya udAhRutAH||23||

teShAmicchannanutpattiM seveta matimAn sadA| hitAnyevAshitAdIni na syustajjAstathA~a~amayAH||24||

RasajAnAM vikArANAM sarvaM la~gghanamauShadham| vidhishoNitike~adhyAye Rakta jAnAM bhiShagjitam||25||

Maṃsa jAnAM tu saMshuddhiH shastrakShArAgnikarma ca| aShTauninditike~adhyAye medojAnAM cikitsitam||26||

asthyAshrayANAM vyAdhInAM pa~jcakarmANi bheShajam| bastyaH kShIRasarpIMShi tiktakopahitAni ca||27||

MajjāŚukRasamutthAnAmauShadhaM svAdutiktakam| annaM vyavAyavyAyAmau shuddhiH kAle ca mAtrayA||28||

shAntirindriyajAnAM tu trimarmIye pravakShyate| snAyvAdijAnAM prashamo vakShyate Vātarogike||29||

navegAndhAraNe~adhyAye cikitsAsa~ggrahaH kRutaH| malajAnAM vikArANAM siddhishcoktA kvacitkvacit||30||

Various diseases produced due to the intake of unwholesome eatables, drinkables, linctuses, and chewables have been illustrated.

• An intelligent individual desirous of preventing such disease should take wholesome food.
• Langhana (lightening) is the line of treatment for all the rasaja disorders.
• Treatment of raktaja disorders is mentioned in Vidhishonitiya Adhyaya (Charak Samhita Sutra Sthana 24th chapter).
• The mamsaja disorders should be treated with purification, surgery, utilizing alkali and agnikarma (cauterization).
• The treatment of medoja disorders is mentioned in Ashtauninditiya Adhyaya (Charak Samhita, Sutra Sthana 21st chapter).

The asthigata disorders should be treated with Panchakarma, especially basti (enema) prepared with bitter drugs, milk, and ghee.

Majja and shukragata disorders should be treated with diet having sweet and bitter taste, coitus, exercise and timely purification as required.

The treatment of disorders of sense organs is mentioned in Trimarmiya Chikitsa (Charak Samhita, Chikitsa Sthana, 26th chapter).

The treatment of disorders of ligaments, blood vessels, and tendons is mentioned in Vatavyadhi Chikitsa (Charak Samhita, Chikitsa Sthana, 28th chapter).

The treatment of disorders of waste products is mentioned in Naveganadharaniya Adhyaya (Charak Samhita, Sutra Sthana, 7th chapter) and few aspects in other sections. [23-30]

Movement of dosha from koshtha (gut) to shakha (periphery)

व्यायामादूष्मणस्तैक्ष्ण्याद्धितस्यानवचारणात्| कोष्ठाच्छाखा मला यान्ति द्रुतत्वान्मारुतस्य च||३१||

तत्रस्थाश्च विलम्बन्ते कदाचिन्न समीरिताः| नादेशकाले कुप्यन्ति भूयो हेतुप्रतीक्षिणः||३२||

vyāyāmādūṣmaṇastaikṣṇyāddhitasyānavacāraṇāt| kōṣṭhācchākhā malā yānti drutatvānmārutasya ca||31||

tatrasthāśca vilambantē kadācinna samīritāḥ| nādēśakālē kupyanti bhūyō hētupratīkṣiṇaḥ||32||

vyAyAmAdUShmaNastaikShNyAddhitasyAnavacAraNAt| KoṣṭhacchAkhA malA yAnti drutatvAnmArutasya ca||31||

tatrasthAshca vilambante kadAcinna samIritAH| nAdeshakAle kupyanti bhUyo hetupratIkShiNaH||32||

As mentioned earlier, the vitiated doshas move from the alimentary tract region (koshtha) to the periphery (shakha) i.e. raktadi dhatu and skin - due to several reasons such as excessive exercise, excessive heat, intake of unwholesome diet and regimen, and an excess pressure of fast-moving vata. These vitiated doshas stay in the peripheral regions in a dormant state and do not cause any disease till the season or environment is conducive for them to act. The doshas wait for other favorable provocative factors in the form of the region, season, etc. to cause diseases. [31-32]

Movement of dosha from shakha to koshtha

वृद्ध्या विष्यन्दनात् पाकात् स्रोतोमुखविशोधनात्| शाखा मुक्त्वा मलाः कोष्ठं यान्ति वायोश्च निग्रहात्||३३||

vr̥ddhyā viṣyandanāt pākāt srōtōmukhaviśōdhanāt| śākhā muktvā malāḥ kōṣṭhaṁ yānti vāyōśca nigrahāt||33||

vRuddhyA viShyandanAt pākat srotomukhavishodhanAt| Shākhā muktvA malAH KoṣṭhaM yAnti vAyoshca nigrahAt||33||

The doshas leave the shakha (extremities or peripheral regions) and come to koshtha (alimentary tract) due to aggravation, liquefaction, suppuration, clearing of the obstacle at the opening of the channels, or pacification of vata. [33]

Prevention of diseases

अजातानामनुत्पत्तौ जातानां विनिवृत्तये| रोगाणां यो विधिर्दृष्टः सुखार्थी तं समाचरेत्||३४||

सुखार्थाः सर्वभूतानां मताः सर्वाः प्रवृत्तयः| ज्ञानाज्ञानविशेषात्तु मार्गामार्गप्रवृत्तयः||३५||

ajātānāmanutpattau jātānāṁ vinivr̥ttayē| rōgāṇāṁ yō vidhirdr̥ṣṭaḥ sukhārthī taṁ samācarēt||34||

sukhārthāḥ sarvabhūtānāṁ matāḥ sarvāḥ pravr̥ttayaḥ| jñānājñānaviśēṣāttu mārgāmārgapravr̥ttayaḥ||35||

ajAtAnAmanutpattau jAtAnAM vinivRuttaye| rogANAM yo vidhirdRuShTaH sukhArthI taM samAcaret||34||

sukhArthAH sarvabhUtAnAM matAH sarvAH pravRuttayaH| j~jAnAj~jAnavisheShAttu mArgAmArgapravRuttayaH||35||

An individual desirous of happiness should follow the regimen advocated in this scripture for prevention and management of the manifested diseases. All living beings strive in this direction to attain the goal of staying happy, and they follow the right and wrong path depending on their awareness and ignorance. [34-35]

Benefits and harms of observing and non-observance of regimen

हितमेवानुरुध्यन्ते प्रपरीक्ष्य परीक्षकाः| रजोमोहावृतात्मानः प्रियमेव तु लौकिकाः||३६||

श्रुतं बुद्धिः स्मृतिर्दाक्ष्यं धृतिर्हितनिषेवणम्| वाग्विशुद्धिः शमो धैर्यमाश्रयन्ति परीक्षकम्||३७||

लौकिकं नाश्रयन्त्येते गुणा मोहरजःश्रितम् | तन्मूला बहवो यन्ति रोगाः शारीरमानसाः||३८||

hitamēvānurudhyantē praparīkṣya parīkṣakāḥ| rajōmōhāvr̥tātmānaḥ priyamēva tu laukikāḥ||36||

śrutaṁ buddhiḥ smr̥tirdākṣyaṁ dhr̥tirhitaniṣēvaṇam| vāgviśuddhiḥ śamō dhairyamāśrayanti parīkṣakam||37||

laukikaṁ nāśrayantyētē guṇā mōharajaḥśritam | tanmūlā bahavō yanti rōgāḥ śārīramānasāḥ||38||

HitamevAnurudhyante praparIkShya parIkShakAH| rajomohAvRutAtmAnaH priyameva tu laukikAH||36||

shrutaM buddhiH smRutirdAkShyaM dhRutirhitaniShevaNam| vAgvishuddhiH shamo dhairyamAshrayanti parIkShakam||37||

laukikaM nAshrayantyete guNA moharajaHshritam | tanmUlA bahavo yanti rogAH shArIramAnasAH||38||

An intelligent individual follows an effective regimen after a thorough evaluation of the disease and its etiological factors as well as his prakriti. An individual dominated by Rajas and Tamas mental faculty, on the other hand, follows a regimen that could be pleasant to his senses, without any consideration or evaluation of his condition, the treatment, and his constitution. An intelligent person possesses the qualities of obedience, intelligence, memory, stable, able, purity of speech, tranquility, courage, and follows a wholesome regimen. Ignorant individuals do not possess these qualities as their mind is enveloped in moha (attachments to possessions) and rajas. Hence they suffer from various physical and mental disorders. [36-38]

प्रज्ञापराधाद्ध्यहितानर्थान् पञ्च निषेवते| सन्धारयति वेगांश्च सेवते साहसानि च||३९||

तदात्वसुखसञ्ज्ञेषु भावेष्वज्ञोऽनुरज्यते| रज्यते न तु विज्ञाता विज्ञाने ह्यमलीकृते||४०||

prajñāparādhāddhyahitānarthān pañca niṣēvatē| sandhārayati vēgāṁśca sēvatē sāhasāni ca||39||

tadātvasukhasañjñēṣu bhāvēṣvajñō'nurajyatē| rajyatē na tu vijñātā vijñānē hyamalīkr̥tē||40||

praj~jAparAdhAddhyahitAnarthAn pa~jca niShevate| sandhArayati vegAMshca sevate sAhasAni ca||39||

tadAtvasukhasa~jj~jeShu bhAveShvaj~jo~anurajyate| rajyate na tu vij~jAtA vij~jAne hyamalIkRute||40||

An ignorant individual, due to intellectual errors, indulges in unwholesome behavior with respect to the five sense organs, withholds the natural urges, and indulges in rash behavior which could be pleasant temporarily, but lead to misery in due course of time. A wise person due to his clarity of mind and awareness does not indulge in such activities and remains happy. [39-40]

The importance of food

न रागान्नाप्यविज्ञानादाहारानुपयोजयेत्| परीक्ष्य हितमश्नीयाद्देहो ह्याहारसम्भवः||४१||

na rāgānnāpyavijñānādāhārānupayōjayēt| parīkṣya hitamaśnīyāddēhō hyāhāRasambhavaḥ||41||

na rAgAnnApyavij~jAnAdAhArAnupayojayet| parIkShya hitamashnIyAddeho hyAhARasambhavaH||41||

One should not take food with greed and ignorance. One should consume wholesome food after evaluation as the body is formed from food. [41]

आहारस्य विधावष्टौ विशेषा हेतुसञ्ज्ञकाः| शुभाशुभसमुत्पत्तौ तान् परीक्ष्य प्रयोजयेत्||४२||

āhārasya vidhāvaṣṭau viśēṣā hētusañjñakāḥ| śubhāśubhasamutpattau tān parīkṣya prayōjayēt||42||

AhArasya vidhAvaShTau visheShA hetusa~jj~jakAH| shubhAshubhasamutpattau tAn parIkShya prayojayet||42||

Eight special factors are to be considered while consuming food. These factors should be evaluated before consuming food, as they are responsible for good and bad effects on the body. [43]

परिहार्याण्यपथ्यानि सदा परिहरन्नरः| भवत्यनृणतां प्राप्तः साधूनामिह पण्डितः||४३||

यत्तु रोगसमुत्थानमशक्यमिह केनचित्| परिहर्तुं न तत् प्राप्य शोचितव्यं मनीषिभिः||४४||

parihāryāṇyapathyāni sadā pariharannaraḥ| bhavatyanr̥ṇatāṁ prāptaḥ sādhūnāmiha paṇḍitaḥ||43||

yattu rōgasamutthānamaśakyamiha kēnacit| parihartuṁ na tat prāpya śōcitavyaṁ manīṣibhiḥ||44||

parihAryANyapathyAni sadA pariharannaraH| bhavatyanRuNatAM prAptaH sAdhUnAmiha paNDitaH||43||

yattu rogasamutthAnamashakyamiha kenacit| parihartuM na tat prApya shocitavyaM manIShibhiH||44||

One should always avoid unwholesome food. If one gets afflicted with a disease despite leading a healthy lifestyle, then he is not at fault as it could be the effect of previous birth. [43-44]

Summary

तत्र श्लोकाः- आहारसम्भवं वस्तु रोगाश्चाहारसम्भवाः| हिताहितविशेषाच्च विशेषः सुखदुःखयोः||४५||

सहत्वे चासहत्वे च दुःखानां देहसत्त्वयोः | विशेषो रोगसङ्घाश्च धातुजा ये पृथक्पृथक्||४६||

तेषां चैव प्रशमनं कोष्ठाच्छाखा उपेत्य च| दोषा यथा प्रकुप्यन्ति शाखाभ्यः कोष्ठमेत्य च||४७||

प्राज्ञाज्ञयोर्विशेषश्च स्वस्थातुरहितं च यत्| विविधाशितपीतीये तत् सर्वं सम्प्रकाशितम्||४८||

tatra ślōkāḥ- āhāRasambhavaṁ vastu rōgāścāhāRasambhavāḥ| hitāhitaviśēṣācca viśēṣaḥ sukhaduḥkhayōḥ||45||

sahatvē cāsahatvē ca duḥkhānāṁ dēhasattvayōḥ| viśēṣō rōgasaṅghāśca dhātujā yē pr̥thakpr̥thak||46||

tēṣāṁ caiva praśamanaṁ kōṣṭhācchākhā upētya ca| dōṣā yathā prakupyanti śākhābhyaḥ kōṣṭhamētya ca||47||

prājñājñayōrviśēṣaśca svasthāturahitaṁ ca yat| vividhāśitapītīyē tat sarvaṁ samprakāśitam||48||

tatra shlokAH- AhARasambhavaM vastu rogAshcAhARasambhavAH| hitAhitavisheShAcca visheShaH sukhaduHkhayoH||45||

sahatve cAsahatve ca duHkhAnAM dehasattvayoH | visheSho rogasa~gghAshca dhAtujA ye pRuthakpRuthak||46||

teShAM caiva prashamanaM KoṣṭhacchAkhA upetya ca| doShA yathA prakupyanti ShākhābhyaH Koṣṭhametya ca||47||

prAj~jAj~jayorvisheShashca svasthAturahitaM ca yat| vividhAshitapItIye tat sarvaM samprakAshitam||48||

The origin of life- and diseases - is food. Wholesome and unwholesome food articles are responsible for happiness and sorrow respectively. The body that can sustain and not sustain the diseases of body and mind, various diseases of individual dhatu, and their treatment, the mode of movement of doshas from alimentary tract (koshtha) to periphery, i.e, rakta etc. dhatus and skin (shakha) and vice versa, features of intelligent and ignorant individuals, wholesome regimens for healthy and patients are highlighted in Vividhashitapitiya Adhyaya. [45-48]

Tattva Vimarsha / fundamental Principles

• Food is considered as prana or vital force, hence in this chapter, the process of transformation of this food into dhatus or body tissue into a fuel that sustains prana has been mentioned elaborately. [2]
• Panchabhutagnis are responsible for the digestion of specific components of food.
• If dhatavagni, dhatvahi strotas and dhatuposhakrasavahi vyana vayu (enzymes for tissue metabolism, specific channels, and specific nutrient transporters) are normal, then normal tissues are created. All tissues, throughout life, continuously help in the nourishment of other tissues.
• The metabolic process of ahara rasa (the end product of digestion) results in the formation of nourishing and waste products.
• The body is formed from food, and even diseases also originate from food. Wholesome and unwholesome foods are responsible for happiness and unhappiness respectively (Ch. Su. 28/45).
• Apart from unwholesome food, many other etiological factors for disease production are present, like a change of season, intellectual errors, unwholesome contacts (excessive, wrong and over-utilization) of senses of sound, touch, vision, taste and smell (Ch. Su. 28/7).
• All unwholesome food articles are not equally harmful, all the doshas are not of equal strength, and all the bodies are not capable of preventing disease (Ch. Su. 28/7).
• The doshas become acute and extremely difficult to manage when they get associated with multiple factors, get further aggravated or complicated when treated with a mutually contradictory therapy, become deep rooted, chronic, get vitiated in one of the ten seats of prana, and afflict vital centers of the body known as marma (Ch. Su. 28/7).
• Individuals, who are excessively obese, emaciated, whose muscles, blood and bone are depleted, who are very weak physically, who are habituated to unwholesome food, who consume inadequate quantities of food, and who possess weak mind cannot withstand diseases (Ch. Su. 28/7).
• The specific diseases (dhatu pradoshaja vikara) are caused due to an interplay between dosha and dushya and manifest as systemic disorders. (Ch. Su. 28/8).
• All living beings strive to attain the goal of happiness and follow the right and the wrong path depending on their awareness and ignorance (Ch. Su. 28/35).
• Multiple factors are responsible for health and disease – a healthy person can contract a disease despite following a very healthy lifestyle.

Vidhi Vimarsha / Applied Inferences

Kshira Dadhi Nyaya (milk-curd transformation phenomena/ analogy)

• The formation of dhatu involves the transformation of rasa into rakta, rakta into mamsa, etc., in the presence of respective dhatvagni in a similar manner as milk gets converted into curd, curds into butter and butter into ghee. According to Acharya Harita, within seven days rasa gets transformed into shukra. Even though this theory appears to be hypothetical, recent modern research has shown that this kind of transformation is possible. A team of Japanese and American scientists has managed to convert human skin cells into formed embryos by bathing them in weak citric acid for a duration of 30 minutes. Researchers at Stanford University transformed skin fibroblast cells from mice into working neurons by inserting genes that encode transcription factors. Researchers at Wake Forest University School of Medicine have successfully isolated stem cells from human skin, expanded them in the laboratory and coaxed them into becoming fat, muscle and bone cells . More recently, scientists have successfully made immature sperm cells from human bone marrow samples. Therefore, the formation of shukra from majja is proved by these scientific evidence .

Kedari Kulya Nyaya (vascular network)

• According to Kedari Kulya Nyaya innumerable microvascular channels transport nourishment to their respective sites in dhatus (tissues) in the body. The cells and tissues are bathed with nutrient plasma. But mere tissue perfusion is not enough to complete the process of nourishment. It needs the complementary play of two subsequent nyayas. (Ch. Su 28/4), (Ch Chi 15/36)
• Per modern science, vesicles transport nutrients to the target organs and get controlled by a set of genes (discovered by Randy Schekman). Further, James Rothman found out that protein machinery allows vesicles to fuse with their targets and permits transfer of nutrients to their target tissue. Thomas Sudhof revealed how signals instruct vesicles to release their cargo with precision. Through their discoveries, Rothman, Schekman and Sudhof have revealed the exquisitely precise control system for the transport and delivery of cellular cargo. Disturbances in this system have deleterious effects and contribute to conditions such as neurological diseases, diabetes, and immunological disorders.
• According to Khale Kapota Nyaya (distribution system), nutrients get directly absorbed by tissues selectively just as pigeons eat the grain of their choice. As per modern research, nutrients are transported to target tissues using vesicles and plasma binding/ transporter proteins when vesicles fuse with target membranes. Cells in those tissues have different organelles that produce various molecules like hormones, neurotransmitters, cytokines and enzymes etc. having specific functions that trigger at the right time and the target site.
• Rakta vibaddhamargatvan mamsa sinna prapadyate.: If a channel is obstructed, the sequential transformation of tissue is impaired.
• Langhana (reducing therapy) is the line of treatment for all the rasaja (body fluids) disorders (Ch. Su. 28/25).
• Treatment of raktaja (blood) disorders is mentioned in Vidhishonitiya Adhyaya (Charak Samhita Sutra Sthana 24th chapter). The treatment for raktaja vikara should be planned as per raktapitta, along with virechana, upavasa and raktamokshana (purgation, fasting, and bloodletting) (Ref. Cha. Su. 24/18). (Ch. Su. 28/25)
• The mamsaja disorders should be treated with purification, surgery, usage of alkali and agnikarma (cauterization) (Ch. Su. 28/26).
• The treatment of medoja disorders is mentioned in Ashtauninditiya Adhyaya (Charak Samhita, Sutra Sthana 21st chapter).

Guru Chatarpanam Dadhyat Sthulanam Karshanam Prati diet modification, exercise, purification, and drugs (Cha Su 21/20 (Ch. Su. 28/26):

• Asthigata disorders should be treated with Panchakarma, especially basti (enema) prepared from bitter drugs, milk and ghee should be administered (Ch. Su. 28/27).
• Majja and shukragata disorders should be treated with food and drugs having a sweet and bitter taste. Coitus, exercise and timely purification as required should be engaged in (Ch. Su. 28/28).
• The treatment of disorders of sense organs is mentioned in Trimarmiya Chikitsa (Charak Samhita, Chikitsa Sthana, 26th chapter) (Ch. Su. 28/29).
• The treatment of disorders of ligaments, blood vessels, and tendons is mentioned in Vatavyadhi Chikitsa (Charak Samhita, Chikitsa Sthana, 28th chapter) (Ch. Su. 28/30).
• The treatment of disorders of waste products is mentioned in Naveganadharaniya Adhyaya (Charak Samhita, Sutra Sthana, 7th chapter) and few aspects in other sections (Ch. Su. 28/30).

Glossary

1. Vividhāśitapītīya- Different kinds of eatable and drinkable food
2. Annapānavidhi - Dealing with properties of various dietary articles and preparations
3. Sāra- Essence of Dhātu
4. Kiṭṭa- Waste products resulting due to Ᾱhara and Dhātu pāka
5. Dhātvagni- The factor that helps in the formation of Dhātus from Ᾱhara Rasa
6. Jāṭharāni- Principle factor that helps in digestion of the food
7. Bhūtāgni- Factor that helps in digestion and assimilation of food predominant in specific Mahabhūta
8. Koṣṭha- Elementary tract
9. Śākhā- Raktādhātus and Tvak
10. Laṅghana- Therapy that helps to make the body light and helps in digestion of Ᾱma i.e. the morbid toxin responsible for causation of most of the diseases
11. Prāṇa- Vital force that is essential for sustenance of life
12. Marma- Vital points in the body
13. Aharṣaṇa- Erectile dysfunction
14. Rajas- Mental factor that leads to aggression and instability
15. Tamas- Ignorance
16. Moha¬- Attachment
17. Pośaka dhātu¬- The part of Dhātu that helps in nourishment of proceeding Dhātu
18. Aśita¬- Soft food that is eaten
19. Khādita- Hard food that is bitten and eaten
20. Pīta¬- liquids that are drinkable
21. Līḍha- Food that is licked
22. Pariṇāma- Consequence of an etiological factor
23. Agnikarma- Cauterization used for therapy
24. Paῆakarma¬¬-Five purificatory procedures to expel the accumulated morbid matter
25. Paῆcamahābhūta- Five principle elements from which our body and all substances in the universe are formed.