Abstracts - Sutra Sthana

The abstracts of all thirty chapters of Sutra Sthana are presented here for introductory knowledge about its chapters. For more knowledge, the readers can go to the individual chapters.

Chapter 1. Fundamental principles for Longevity – Deerghanjiviteeya Adhyaya

The title of Charak Samhita’s very first chapter, Deerghanjiviteeya Adhyaya, literally means the chapter on longevity. This is symbolic, because it implies that Ayurveda is not merely the science of life, but also a science of longevity. This chapter deliberates on the purpose of long life and health as the means of achieving the four primary instincts of human beings - virtue, wealth, gratification and emancipation (purushartha chatushtaya) – by way of explaining some of the basic tenets of Ayurveda and defining its scope. The chapter introduces fundamental principles of Ayurveda, including its definition, objective, concept of three bodily (sharira) dosha and their qualities, and two mental (manasa) dosha and their treatment. The Samanya Vishesha Theory, pharmaco-therapeutic aspects, classification of drugs, list of herbs and other animal products useful in purification and pacification therapies are highlighted. Through these deliberations, this chapter essentially lays the foundation for building the body of knowledge on life sciences and healthcare that Charak Samhita is known for.

Chapter 2. Dehusked Seeds of Apamarga and other medicines – Apamarga Tanduliya Adhyaya

The second chapter within Bheshaja Chatushka (tetrad constituting four chapters on medicinal treatment) deals with list of herbs used in Panchakarma (bio-purification processes). The liberty to execute this treatment based upon dose and time of administration is given through logical reasoning (Yukti pramana). Specific diet preparations like gruels (Yavagu) are enlisted with their benefits and indications to be used in preservation of health and treatment of diseases. The chapter denotes importance of body purification and diet in healthcare system.

Chapter 3. Aragvadha(cassia) and other medicines –Aragvadhiya Adhyaya

While the preceding chapter (Apamarga Tanduliya) dealt with internal application of therapies in the form of Panchakarma, this chapter deals with the external application of medications. Thirty two types of external applications are enlisted in this chapter. The important indication is Kushtha (Skin diseases). These are systemic disorders considered as major disease (maharoga). They require internal cleansing and purification treatments prior to external treatments – and hence, the sequence of the chapters. Without prior internal treatment, local treatments have limited efficacy.

Chapter 4. The Classification of Six Hundred Types of Evacuatives – Shadvirechanashatashritiya Adhyaya

This chapter provides comprehensive information about herbs and their classification by their specific activity and utility, medicinal preparations for evacuation (or evacuatives), and specific therapeutic regimen such as cleansing regimen (samshodhana) and pacification regimen (samshamana). Ayurveda emphasizes upon removing body impurities, like metabolic waste products, toxins, and undigested foods from various tissues and organs before treating any disease or applying measures for preservation, protection, and rejuvenation of health. There are six hundred preparations used for cleansing the body by therapeutic emesis (vamana) and therapeutic purgation (virechana), five hundred herbs, and fifty groups of herbs with similar activity profile (mahakashaya) used in their preparations. A physician should have complete knowledge of special/selective actions of various preparations meant for removal of impurities from the body. Each of the fifty mahakashaya comprises ten herbs. This chapter also describes six types of plant-based evacuatives (virechana ashraya), their basic sources as per taste (five kashaya yoni), and five medicinal forms like juice, paste, decoction, cold effusion and hot effusion.

Chapter 5. The proper quantity of food and daily regimen for preserving health –Matrashiteeya Adhyaya

Swastha chatushka, the tetrad of chapters on health, deals with the preservation of health and prevention of diseases. The first chapter of this tetrad, entitled Matrashiteeya Adhyaya, covers two topics viz. various aspects of the proper quantity and quality of diet and various daily regimens that should be followed by a person for healthy living. The tenets of personal hygiene, oral hygiene and hygiene of sense organs are described in this chapter. The routine procedures to preserve health like abhyanga (massage), nasya (nasal errhines), kavala (mouth wash), gandusha (gargling), karnapurana (applying oil in ears), anjana (collyrium) etc. are described in this chapter with their methods of administration and positive health benefits.

Chapter 6. Seasonal Regimen or Qualitative Dietetics – Tasyashiteeya Adhyaya

This chapter describes seasonal regimen for preservation of health. The year (kala) is divided into seasons (ritu) based upon the changes in environmental conditions, changes in temperature, change in day-night cycle and circadian rhythm. Being an integral unit of the nature, these seasonal changes in nature affect human physiology too. Therefore, one must follow the specific regimen for maintaining the equilibrium of body components in harmony with nature. The seasonal regimen is designed on the basis of changes in the dosha, physical strength, and digestive power. This chapter continues the study of dietary regimen from the preceding chapters by adding the dimension of time and seasonal variations to it.

Chapter 7. Non-suppressible and suppressible natural urges and other factors for health – Naveganadharaniya Adhyaya

This chapter describes preventive measures for endogenous and exogenous diseases. The auto-regulated system of body cleanses out metabolic waste products through various channels and maintains equilibrium in the body. This systematic natural mechanism is termed as ‘Vega’ (Natural urges). Non-suppression of these natural urges is utmost important to keep body clean and preserve health. This chapter includes thirteen types of natural urges, disorders due to their long term suppression and their treatment. It also emphasizes on observation of proper dietary regimen and timely exercise as per the individual’s unique body constitution. Means for maintaining psychological and social well-being for prevention of psycho-spiritual disorders are described in detail. The methods of prevention of diseases by improving strength, by knowing one’s own body constitution, maintaining psycho-spiritual balance and following an ideal dietary and lifestyle regimen suited to one’s unique constitution have been provided here.

Chapter 8.The Disciplinary Protocol for Sense and Motor Organs – Indriyopakramaniya Adhyaya

This chapter describes how humans perceive the world surroundings by means of five senses (Hear, see, smell, taste, and touch), how a system of five senses called Indriya Pancha-Panchaka works and communicates with mind to perceive the surroundings and how a person can maintain health by using his/her senses properly (and therefore leading a tempered, ethical life) or suffer from disease by not using their senses properly. It also explains the role of mind, intellect and soul in the entire process of perception. This chapter describes the qualities of the mind based on the predominance of the three fundamental qualities, the triguna (sattva, rajas and tamas), including the illusions created by the mind that makes a common observer perceive through his/her senses, say, multiple minds instead of one. It further describes the spiritual elements (Adhyatma dravya guna sangraha) & their action. The principles of psycho-pathogenesis based on the excessive, deficient and perverted association of five senses with their objects along with the principles of preventing psychic disturbances and preserving the physical, mental and socio-spiritual health in the form of the principles of sadvritta has been elaborately described. This involves a broad range of ethical observances & moral practices for preventing psychosomatic disturbances. Broadly, the practices regarding code of general ethics, diet, natural urges, relationship with women, study, regarding self-control & related to worship have been elaborately described. General ethical practices related to individual, inter- personal & about maintenance of social relations have been included, which are extremely valuable for personal & social health.

Chapter 9.The four fundamental components of Healthcare- Khuddakachatushpada Adhyaya

After completing the Swastha chatushka(tetrad on health), the components of Healthcare Management are described in Nirdesh Chatushka (tetrad on guidelines of healthcare management). The present chapter deals with four components necessary for providing optimum quality healthcare. These components are: Physician, Medicine, Attendant and the Patient. Further, standard qualities of these components are described. Definitions of disorder, health, treatment etc, along with different types of physicians are also elaborated in relation with the healthcare management.

Chapter 10. The four important components of Therapeutics –Mahachatushpada Adhyaya

In the preceding chapter, four important aspects of healthcare including the standard qualities of physician, nursing staff, medicine and the patient were described. This chapter deals with guidelines for therapeutic management based on four types of prognosis of diseases. It is important to determine prognosis of a disease before starting the treatment to decide the quality of life of patient, and whether it will be diseased or disease free. Therefore, as the title suggests, the chapter is about four important components of therapeutic management of diseases.

Chapter 11.The Three Desires of Life and important triads – Tistraishaniya Adhyaya

Having or expressing desires is a human trait, and only human beings aspire to fulfil them. This chapter explains three basic desires in human beings- longevity, wealth (or materialistic comforts), and a blissful afterlife. The guidelines to fulfil them during one’s life leading to a healthy and righteous life are also given in this chapter, hence it comes under the tetrad of guidelines of healthcare management. It also guides to treat a patient with physical and/or mental disease and describes eight triads. The theories of reincarnation and creation of universe are discussed and explained. Four means for getting absolute knowledge (pariksha viz.examination, pratyaksha (clearly perceivable), anumana (Inference based on evidence) and yukti (logical management) and their role in establishing the theory of reincarnation are described in detail. A physician can use these methods to know about disease (roga) and patient (rogi) completely and can choose appropriate courses of treatment, with suitable drugs.

Chapter 12.The merits and demerits of Vata – Vatakalakaliya Adhyaya

This last chapter of the Nirdesha Chatushka is based on the findings of an assembly of expert practitioners of Ayurveda, headed by Atreya, that analyzed the normal and abnormal functions of tridosha. Among the three doshas, the vata dosha is discussed in more detail, considering its supremacy as the initiator of all functions in the body. In the environment, Vata is also responsible for many weather conditions like extreme heat, extreme rain or extreme cold. The important normal and abnormal functions of Vata in environment are also mentioned in this chapter. Consequently, brief descriptions of pitta and kapha dosha’s normal and abnormal functions have been provided.

Chapter 13. Oleation therapies – Snehadhyaya

Kalpana chatushka (tetrad on applications of medicine) starts with the chapter on oleation therapy. This chapter describes details of oleation therapy including the sources of lipids, types, properties, administration method, time, dose, alternative methods of administration in the form of recipe (vicharana), indications, contraindications, symptoms of proper, inadequate and excess oleation. Adipose tissue in the form of fat is essential components of body it provides lubrication to all viscera and other interstitial spaces due to its unctuous property. Lipids are integral part of cell membrane that allows entry of lipid soluble substances/drugs into the cells. The selection of lipids for oleation therapy depends upon the specific integrity of gut, severity of the disease, and specific indications of lipids. Lipids processed with medicines can be prescribed in diabetes or skin diseases where natural fact is contra-indicated. Apt oleation therapy results in normal functions of vata, increase in digestive power, softening of (hard) faeces, and making the body supple and soft. Improper implementation of methods or violation of guidelines results in complications such as skin diseases, itching, haemorrhoids, ascitis, fainting, indigestion etc. Oleation and sudation are pre-requisites or pre-treatment procedures for purification (shodhana) therapies to aid in moving vitiated dosha to gut (for an eventual expelling out of the body and achieve purification). The present chapter can be considered as a first step in purification therapies described.

Chapter 14. Sudation Therapies – Swedadhyaya

This chapter deals with sudation (Swedana) therapy, essentially followed after oleation therapy. Swedana (sudation) is a process in which the individual is subjected to therapeutic sweating. It is considered an essential prerequisite to Panchakarma (purification therapy involving five procedures) in Ayurveda. Swedana is intended to remove excessive vata and kapha dosha and is contraindicated in pitta disorders. The extent and intensity of swedana depends upon various factors such as physical strength, severity of dosha, season, site, age etc. There are specific indications and contraindications for swedana karma and the optimal signs should be strictly followed for the procedure. There are many agents to induce sweating which can be broadly divided into sagni sweda (sweating induced with the help of fire) and niragni sweda (induced without using fire). Bolus fomentation, steam fomentation, tub fomentation and poultice fomentation are some of the very common types of swedana procedures. There are thirteen varieties of fomentations (prevalent in the olden days) that involve direct usage of heat derived from fire, and ten methods without fire. Swedana is an effective therapeutic method in Ayurveda and is the focus of study in this chapter.

Chapter 15. Guidelines for Hospital Management and Purification Treatment- Upakalpaniya Adhyaya

This chapter focuses on the pre-requisites for construction of a well-equipped hospital facility suitable for administration of Panchakarma therapies in continuation with the discussion on purification procedures (samshodhana karmas) from the preceding chapters. Pre-procedure, main procedure and post-procedure guidelines have been described in detail in this chapter. The descriptions of dosages of drugs for vamana (therapeutic emesis) and virechana (therapeutic purgation) with assessment of inadequate, proper and excess purification are detailed. Afflictions of dosha, complications, dietetic regimen during the therapy and after the therapy (samsarjana karma or graduated diet) have also been clearly elaborated.

Chapter 16. Assessment and care in Panchakarma therapies – Chikitsaprabhritiya Adhyaya

Meaning of title of this chapter describes its subject about approaching the conditions arise during therapies. The assessment of correct and incorrect administration of therapeutic procedures, along with its treatment interventions are described in this chapter. It also enlists indications for therapeutic intervention and their benefits with details of post therapeutic dietary management. The applicability of svabhavoparamvada (i.e. theory of natural destruction of causative factors of disease) is discussed in this chapter, that emphasizes need of therapeutic interventions for fast recovery to health.

Chapter 17. Diseases of three vital organs including Head and other conditions – Kiyanta Shiraseeya Adhyaya

This is the first chapter of Roga Chatushka (tetrad on classification of diseases) dealing with description of diseases of the vital organs the head and the heart. Diseases are caused due to disequilibrium of dosha in body. The signs and symptoms of various permutations and combinations of dosha imbalances are enlisted in this chapter. It also enlists and describes signs of depletion of dhatu and mala. The disorders of oja are narrated, which continues with description of madhumeha (diabetes mellitus), and carbuncles produced as its complications. Various types of dosha gati (movements) are mentioned in this chapter. The comprehensive information about principles of basic Ayurvedic pathology is included in the chapter.

Chapter 18.Three Types of Swellings and other conditions – Trishothiya Adhyaya

The preceding chapter enlisted swellings in the form of carbuncles. This chapter provides further details about causative factors for endogenous and exogenous swellings/distensions, signs of dosha dominant swellings, their locations in the body and principles of treatment. Further, the guidelines to diagnose a new disease and criteria for classification are narrated. Specific normal functions of dosha are described in this chapter. These functions, if disturbed, are aptly inferred as clinical signs of early changes in the body. These are used for diagnosis of a disease at an early stage or predictions for future disease.

Chapter 19. Numerical Classification of Diseases – Ashtodariya Adhyaya

In continuation of the previous chapter, this chapter delves into classifications of diseases. Diseases have been broadly classified here into two groups – one comprising of diseases manifesting as a result of involvement of two or more doshas (Samanyaja Vyadhi), while the other focusing on diseases caused due to a single dosha (Nanatmaja Vyadhi). Forty-eight diseases have been enlisted with their types from diagnostic perspective in this chapter. The role of dosha in etiopathogenesis of the diseases, difference between the exogenous and endogenous diseases and their coexistence is also described. One to one correlation of these disease entities with those in conventional medicine has limited scope. Some diseases described in this chapter can be exactly correlated with diseases of conventional medicine whereas some cannot be.

Chapter 20. Dosha specific classification of diseases – Maharoga Adhyaya

This chapter further extends description of classification of diseases according to criteria viz. endogenous-exogenous causes, basic nature, site of origin, clinical presentations. The specific causes of endogenous and exogenous diseases are described. The chapter further enlists diseases caused due to only one dosha with their sites of origin. This elaborates the concept distinct one-dosha categories of diseases. There are as many as eighty variants due to a vitiated vata only, forty due to pitta, and twenty due to kapha. Any effective diagnosis or treatment of these diseases would need a detailed study of the dosha, their locations and characteristics. This knowledge is provided to substantiate the importance of knowing disease before initiating the treatment in clinical medicine. The chapter recapitulates principles of knowledge of disease described in the tetrad.

Chapter 21. Eight Undesirable Physical Constitutions – Ashtauninditiya Adhyaya

This is the first chapter of tetrad on guidelines on management of diseases. After enlisting eight undesirable physical appearances based on the criteria like body height, body mass, complexion and presence of hairs. The extreme presence or absence of these parameters leads to undesirable physical appearances. The most commonly observed conditions in the society like morbid obesity and extreme emaciation are described in details with their causative factors, signs and symptoms, and ways of effective management. In etio-pathogenesis of these disorders, sleep is the second most important cause after diet. Therefore a special emphasis is given on the merits of sleep, qualities or characteristics that define a “good sleep” and the demerits of sleep related disorders.

Chapter 22. Reduction and nourishing therapies – Langhanabrimhaniya Adhyaya

In continuation with the earlier chapter, the main courses of treatment for the morbidly obese and the extremely thin/skinny/emaciated persons are described in this chapter. Ayurvedic therapeutics are categorized broadly under two categories like reducing (Apatarpana) or nourishing (Santarpana); It is further classified into six types: Langhana (Fasting, reducing), Brimhana (nourishing), Rukshana (drying), Stambhana (astringent/styptic), Snehana (oleation), and Swedana (sudation). Besides providing insights into these therapeutic measures, this chapter also describes specific advantages of these therapeutic procedures, pharmacological actions of properties and their indications in detail. The features of optimally administered techniques while understanding the consequences of their over and under-application are also narrated.

Chapter 23. Over-nutrition, under-nutrition and its disorders – Santarpaniya Adhyaya

Diseases are caused due to over nutrition and under nutrition. This chapter enlists the causative factors affecting nutritional status leading to two categories of diseases viz. Santarpana (over-nutrition) and apatarpana (under nutrition). The dietary and lifestyle management of these two disease categories is also elaborated. Nutraceutical preparations, weight reducing recipes, therapeutic procedures like panchakarma and other associated procedures are described with medicaments. The chapter also contains a comprehensive list of commonly available herbs used in treatment of these diseases.

Chapter 24. Characteristics of Shonita (Blood), its vitiation and disorders – Vidhishonitiya Adhyaya

Blood is important for maintaining vitality of individual. It is also the most influential factor in patho-physiology of any disease as it carries vitiated dosha leading to disease. This chapter focuses on rakta dhatu (blood tissue), delineating the characteristic features of pure blood as well as the factors influencing the formation of blood. Pure blood (Shuddha rakta) is formed by following proper dietary habits as described in Ayurveda. Therefore, characteristics of pure blood, the causative factors for vitiation of blood, dosha specific features of vitiated blood, their treatment and procedure of bloodletting are described in this chapter. Since blood plays an important role in the treatment of cerebrovascular diseases, a description of ailments such as mada (intoxication/confusion), murchha (syncope), and sanyasa (coma), their pathology and courses of treatment, and mind’s role in the pathogenesis of some of these diseases have also been provided.

Chapter 25. Origin of Human Beings and the best things for life – Yajjah Purushiya Adhyaya

This chapter, the first within the annapana chatushka (tetrad of guidelines on food and beverages), is based on the findings of a congregation of ancient Ayurveda practitioners and sages, assembled to understand the origin of Purusha (conscious/sentient being) and causes of diseases that afflict the purusha. Different theories to understand various aspects that influence the purusha are postulated, such as those of atma (spirit), mana (mind), rasa (nutrient fluid), shad dhatu (six elements), matru-pitru(parents), karma (past deeds), swabhava (nature), Prajapati (creator), and Kala (time). After considering all these postulations, it is concluded that the same factors that are responsible for the origin of humans are responsible for diseases too. The wholesome diet is responsible for proper growth and development of holistic human being, while the unwholesome diet for diseases. The most commonly applicable wholesome (and unwholesome) diet is discussed with examples. A specific collection called agrya samgraha (collection of definitive and first choice of medication or treatment) is introduced. In all, one hundred fifty-six drugs and therapies have been enumerated in this chapter. Also ingredients used in 84 naturally fermented preparations named ‘asava’ that help in strengthening the patient’s mind, body and digestive power (agni) are listed.

Chapter 26. Pharmacological principles of wholesome and unwholesome diet – Atreyabhadrakapyiya Adhyaya

The significance of wholesome (hita, pathya) and unwholesome (ahita, apathya) foods was dealt in the previous chapter Yajjah Purushiya. The present chapter named after Lord Atreya and a renowned sage Bhadrakapya, certain concepts and pharmacological principles explain the effects of beneficial (hita) and harmful food and substances (ahita ahara/dravyas). The discussion on "correlation between rasa (taste) and diet (ahara)" is documented here. Principles of Ayurvedic pharmacology like rasa (taste), veerya (potency), guna (quality), vipaka (metabolite) and prabhava (specific principle) are discussed to understand the mechanism of action of food and drugs. The effect can be perceived through minute observation of the physiological changes occurring after interaction in the body. Six perceived tastes, adverse effects of their excessive consumption are described. Certain food articles and their combination are incompatible to the body and lead to disease due to their antagonistic properties. These are categorized under viruddha (incompatible or antagonistic). This important concept is described to know about the possible food: drug::body interactions and their adverse effects.

Chapter 27. Classification and Regimen of food and beverages – Annapanavidhi Adhyaya

Since food is considered as the source of life as well as cause of diseases, this chapter is dedicated to a discussion on various dietary preparations, including post-prandial drinks, their properties and beneficial effects on the body. The edibles and beverages have been classified into twelve categories by type: cereals, pulses, meat, green vegetables, fruits, green herbs, alcoholic beverages, water, milk and milk products, sweet products including honey, prepared items, and ahara upayogi (useful foods). The description also includes use of diet in specific disease conditions indicating it therapeutic use. The chapter encompasses various principles of digestion of food and beverages according to its habitat, age, part used, processing method, its mixture. Agni (digestive capacity) of an individual is important for processing the food properly and achieving the desirable effects.

Chapter 28. Sequential effects of food and beverages – Vividhashitapitiya Adhyaya

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 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.

Chapter 29. The Ten Seats of Life Forces – Dashapranayataneeya Adhyaya

As the name suggests, the chapter provides a brief description of the ten vital sites of life forces. The characteristics to define and distinguish between the qualified physician and the quack are detailed further. The qualified physician is said to be a “companion of the life forces” (pranabhisara) that dwell in the body, especially in the ten seats specified above. On the other hand, the quack is said to be a companion of diseases (roganamabhisara). In the process of enumerating the characteristics of the qualified physician, this chapter also gives a succinct summary of the entire Sutra Sthana, implying that it represents the core subjects and skills a physician needs to acquire. The behavior of the quack is then portrayed vividly, and the chapter concludes with an express warning to the patients to never fall prey to the quack. It is also made clear that the responsibility of licensing the qualified physicians and censuring the quacks rests with the King and the State.

Chapter 30. The Ten great vessels arising from Heart and aspects of healthy life – Arthedashmahamooliya Adhyaya

The last chapter emphasizes some of the fundamental principles of life, health and disease. The chapter begins with a description of the heart and ten great vessels attached to it and talks about several aspects of vital importance such as shira, dhamani, srotas, ojas, etc. The salient features of good Ayurvedic practitioner, complete definition of Ayu and Ayurveda are provided in this chapter. The specific characteristics of quality of life are described in this chapter under the heading of hitayu(beneficial life). Further non-beneficial, happy and unhappy kinds of life have also been described in the chapter. The most important objective of Ayurveda about preservation of health of the healthy and pacification of diseases in the patients is highlighted in this chapter. The structure of treatise, its sections, means to study and understand are narrated. At last, a comprehensive list of all chapters in this entire treatise has been provided.