The Compendium of Caraka 3.6: ṣaṣṭho 'adhyāyaḥ/

Now we shall expound the specific determination of the host of diseases.

Thus spoke the venerable Ātreya.

There are two hosts of diseases according to the division of prognosis: curable and incurable; two hosts of diseases according to the division of strength: mild and severe; two hosts of diseases according to the division of site: seated in the mind and seated in the body; two hosts of diseases according to the division of cause: caused by imbalance of one's own bodily constituents and caused by exogenous factors; two hosts of diseases according to the division of receptacle: arising from the stomach and arising from the intestines.

Thus, this being two-fold according to the division of prognosis, strength, site, cause, and receptacle, it may become singular or plural when divided by another principle of division, or when combined.

Singularity, first, is just a single host of diseases because of the common factor of suffering; plurality, however, is ten hosts of diseases by division of prognosis and the like; plurality also may be numerable or innumerable. Among these, the numerable is as stated in the 'Eightfold Stomachs' chapter, while the innumerable is as stated in the 'Great Diseases' chapter, because pain, color, etiology, and the like are innumerable.

And there is no contradiction among the primary enumerations based on other principles of division; therefore, no proposition here is faulty, nor is it free of fault merely because it lacks contradiction.

For an analyzer divides what is to be divided in one way, and then dividing what has been divided in another way according to another principle of division, he produces specific numbers of divisions in many ways, and does not undermine the previous enumeration of divisions.

Even when the principle of division is the same, indeed, the subsequent contextual application must be taken into account.

For there are different meanings expressed by the same word, and there are identical meanings expressed by synonymous words.

For the word 'roga' is common to both doshas and diseases; for doshas also receive the word 'roga', the word 'ātaṅka', the word 'yakṣman', the word 'doṣaprakṛti', and the word 'vikāra', and diseases also receive the word 'roga', the word 'ātaṅka', the word 'yakṣman', the word 'doṣaprakṛti', and the word 'vikāra'.

Among them, the word 'roga' is common to both doshas and diseases, but with the others it has distinctions.

Among them, diseases are innumerable because of their great multitude; doshas, however, are numerable because they are not excessively multitudinous.

Therefore, we shall expound the disorders variously for the purpose of illustration, and the doshas in their entirety.

Rajas and tamas are the mental doshas.

Their disorders are desire, anger, greed, delusion, envy, pride, intoxication, grief, mental agitation, fear, exhilaration, and so forth.

Vāta, pitta, and kapha, however, are the bodily doshas.

And their disorders are fever, diarrhea, swelling, wasting, dyspnoea, urinary disorders, skin diseases, and so forth.

Thus the doshas have been explained completely, and the disorders in part.

Now, among them, there is a threefold aggravation of both kinds of doshas; namely: unwholesome contact of the sense faculties with their objects, intellectual blasphemy, and the transformation [of time].

When aggravated, they indeed produce innumerable varieties of disorders on account of differences in provoking causes and differences in tissues affected.

And these disorders, accompanying one another, sometimes become associated—such as desire and the rest, and fever and the rest.

The association of rajas and tamas with each other, however, is constant, for tamas never operates without rajas.

Usually, bodily doshas residing in the same site undergo combination of three or combination of two, because of their shared qualities; for doshas are identical in that they vitiate.

In that context, the distinction made by primary and secondary is: that which is independent, with manifest symptoms, whose onset and alleviation are as described, is primary; while that which has the opposite characteristics is secondary.

If the doshas there are endowed with primary characteristics, they call the triad a combination of three, or the pair a combination of two.

The division of doshas produced by the distinction of primary and secondary, however, is of many kinds.

In this way, this array of diverse fundamental distinctions is established by designations among physicians regarding doshas and diseases.

As for the fires within the body, there is a fourfold distinction according to differences in strength.

Namely: sharp, dull, balanced, and irregular.

Among them, the sharp fire tolerates all dietary indiscretions; the dull has opposite characteristics; the balanced undergoes abnormality through indiscretion, but remains in its normal state when free from indiscretion; and the irregular has characteristics opposite to the balanced.

These four kinds of fires belong to four kinds of persons.

Among them, those whose vāta, pitta, and kapha are in balance and stay in their normal state have balanced fires; in those prone to vāta, when the site of fire is dominated by vāta, the fires are irregular; in those prone to pitta, when the site of fire is dominated by pitta, the fires are sharp; and in those prone to kapha, when the site of fire is dominated by kapha, the fires are dull.

Here, some say: 'There are no living beings whose vāta, pitta, and kapha are in balance, because humans use irregular diets; therefore, some have a vāta constitution, some a pitta constitution, and some a kapha constitution.'

That is incorrect. For what reason? For physicians regard one whose vāta, pitta, and kapha are in balance as free from disease; since normal constitution is health, and the application of medicine is for the sake of health, and that [health] is the desired state, therefore people with balanced vāta, pitta, and kapha do exist; there are indeed no vāta constitutions, pitta constitutions, or kapha constitutions.

It is because of the excess of this or that dosha, it is said, that this or that dosha-constitution of humans is spoken of; but when the doshas are abnormal, state of normal constitution is not possible; therefore these are not constitutions; rather, there are people prone to vāta, prone to pitta, and prone to kapha, but they are to be known as not in their normal constitution.

For those four kinds of persons, indeed, four regimens are beneficial.

Among them, for those whose bodily constituents are all in balance, [a regimen] balanced in every aspect [is beneficial]; but for the three with excess doshas, having observed the excess of their respective doshas, three regimens antagonistic to the doshas are beneficial until the fire becomes balanced; once it is balanced, only a balanced [regimen] should be adopted; and likewise for activities and other medical treatments.

We shall explain these in detail.

Three persons are patients; but they are not patients according to physicians of other treatises.

Namely: the person predominantly of vāta, the person predominantly of pitta, and the person predominantly of kapha.

Their specific diagnosis is this: for the person predominantly of vāta, diseases caused by vāta usually arise and are severe; for the person predominantly of pitta, diseases caused by pitta; and for the person predominantly of kapha, diseases caused by kapha.

In that regard, when a person predominantly of vāta indulges in things that provoke vāta, vāta quickly becomes aggravated, but not so the other two doshas; once aggravated in him, it afflicts the body with the aforesaid disorders, leading to the destruction of strength, complexion, happiness, and lifespan.

Its subjugation is: properly administered oleation and fomentation, mild evacuative therapies combined with unctuous, hot, sweet, sour, and salty [substances], food and drinks of the same kind, massage, poultices, wraps, deep pressure massage, affusion, immersion baths, gentle massage, nasal pressing, frightening, astonishing, and making [the patient] forget, the administration of surā and āsava wines, oils of multiple sources prepared with appetizing, digestive-maturing, vāta-alleviating, and purgative herbs as well as those boiled a hundred or a thousand times for all manner of applications, enemas, regular regimen of enemas, and living comfortably.

Likewise, when a person predominantly of pitta indulges in things that provoke pitta, pitta quickly becomes aggravated, but not so the other two doshas; once aggravated in him, it afflicts the body with the aforesaid disorders, leading to the destruction of strength, complexion, happiness, and lifespan.

Its subjugation is: drinking ghee, oleation with ghee, downward evacuation of doshas, use of sweet, bitter, astringent, and cooling medicines and foods, resort to mild, sweet, fragrant, cool, and heart-pleasing scents, wearing strings of pearls and jewels kept in extremely cool water upon the chest, frequent sprinkling with the best sandal, priyaṅgu, kālīya, and lotus stalks along with cool wind and water, and with waters infused with blue water-lily, white water-lily, red lotus, saugandhika, and lotus, listening to vocal and instrumental music that is pleasant to the ear, soft, sweet, and engaging to the mind, hearing news of auspicious events, association with dear friends, intimacy with desirable women wearing cool garments and garlands, dwelling in mansions cooled by moonlight and breezy with drafts, enjoying the shelter of mountains, sandbars, cool residences, fabrics, and breezes from fans, visiting delightful groves filled with comfortable, cool, and fragrant breezes, keeping in hand lotus, blue water-lily, nalina, white water-lily, saugandhika, puṇḍarīka, and hundred-petaled lotus, and resorting to all gentle and soothing things.

Likewise, when a person predominantly of kapha indulges in things that provoke kapha, kapha quickly becomes aggravated, but not so the other two doshas; once aggravated in him, it afflicts the body with the aforesaid disorders, leading to the destruction of strength, complexion, happiness, and lifespan.

Its subjugation is: properly administered sharp and hot evacuative therapies, foods that are predominantly dry and prepared with pungent, bitter, and astringent tastes, likewise running, jumping, swimming, pacing, keeping awake at night, wrestling, sexual intercourse, physical exercise, deep pressure massage, bathing, and unction, especially the use of sharp and long-matured alcoholic drinks, total fasting accompanied by medicinal smoking, likewise warm clothing, and the renunciation of comfort entirely for the sake of true well-being.

And on this point there is [a verse]:

One who knows the specific distinctions of all diseases, understands the distinctions of all treatments,
and knows the true nature of all medicines, may become the king's chief physician.

Here are the summary verses:

The classification of the host of diseases according to differences in constitutional predisposition,
their mutual non-contradiction, and the commonality between disease and doshas;

The enumeration of doshas, a partial account of disorders, their provoking factors,
deliberation regarding digestion, and the rekindling agents for the bodily fire;

And the restorative measures for the constitutions of men predominantly of vāta and so forth—
these have been declared by the great sage in this specific determination of the host of diseases.

Thus ends the sixth chapter, entitled "Specific Determination of the Host of Diseases," in the Section on Specific Determination of the treatise composed by Agniveśa and redacted by Caraka.