A History of Indian Medical Literature v1.c11: Chapter 4

A History of Indian Medical Literature v1.c11

Language: English

Chapter 4 v1.c11.1

Chapter one,¹ called katidhāpuruṣīya, is of a philosophical nature. It is mainly concerned with Sāmkhya and Vaiśeṣika doctrines and their application to medical thought.

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The chapter begins with Agniveśa’s questions on the puruṣa (1.3–15), which are answered by Punarvasu.

The puruṣa (individual) is composed of the five mahābhūtas and cetanā (consciousness) as the sixth principle (dhātu);² cetanā alone is also called puruṣa (1.16). In addition, the puruṣa can be described as consisting of twenty-four principles (dhātu):³ manas (mind), the ten indriyas (the functions of the five senses and the five organs of action),⁴ the five objects of the senses (artha), and the prakṛti (matter), which has eight elements (dhātu) (1.17).⁵ Manas and buddhi are characterized (1.18–23),⁶ followed by the ten indriyas (1.24–26), the five mahābhūtas (1.27–31ab), the objects of the senses (1.31cd), buddhi (1.32–34),⁷ and para (= avyakta;⁸ 1.35).

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Sattva, rajas and tamas are mentioned with regard to the keeping together of the aggregate (rāśi)⁹ of twenty-four principles, which constitutes the puruṣa, and with regard to the dissolution of this aggregate, i.e., final emancipation (1.36).¹⁰

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The existence of the puruṣa (here identical with the ātman), distinct from the body and eternal, and different from the puruṣa as an aggregate, is defended against opponents (1.37–62).¹¹

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The eight evolutes of bhūtaprakṛti are the five mahābhūtas,¹² buddhi,¹³ avyakta and ahaṃkāra;¹⁴ the products (vikāra) are sixteen in number:¹⁵ five organs of sense, five organs of action, mind (manas) and the objects of the senses (1.63–64). This whole, the avyakta excepted, is known as the field (kṣetra),¹⁶ while the avyakta is the knower of the field (kṣetrajña) (1.65). The avyakta gives rise to buddhi, ahaṃkāra evolves from buddhi, the five mahābhūtas arise from ahaṃkāra (1.66–67ab). The cycles of evolution and dissolution are described (1.67cd–69).¹⁷

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The characteristics of the ātman (ātmaliṅga) are enumerated (1.70–72),¹⁸ which disappear at death (1.73–74). A discourse on the ātman and the manas follows (1.75–85).¹⁹ A characteristic attributed to the manas is kriyāvattva (activity), while the ātman is the kartar (agent); the manas is unconscious, while the ātman is endowed with consciousness (1.75–76).²⁰

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Verses on the duty of a physician to avert future suffering introduce (1.86–94ab)²¹ a more general discussion of upadhā (attachment to the objects of the senses);²² upadhā is the main cause of suffering, freedom from it eliminates all miseries (1.99cd–97).²³

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Causes of misery are dealt with in the next section: dhīvibhraṃśa²⁴ or buddhivibhraṃśa (impairment of functions of the intellect), dhṛtivibhraṃśa (impairment of the faculty of keeping one’s ground), smṛtivibhramśa (impairment of memory), samprāpti (the coming to fruition) of kāla (the factor of time), samprāpti of karman (past actions), and asātmyārthāgama (unsuitable contact with the objects of the senses) (1.98).25

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These subjects are more elaborately discussed. Dhī-, dhṛti- and smṛti vibhramśa are subsumed under the term prajñāparādha (errors in judgment) (1.99–109).26 Natural (svābhāvika) diseases, like old age and death, belong, together with all the other disorders influenced by the time factor, to those caused by kālasamprāpti (1.110–155). Karman is the same as daiva (fate); diseases caused by karman are not amenable to treatment and subside only after the effects of karman are exhausted (1.116–117).27 Unsuitable contact with the objects of the senses (asātmyārthasamyoga) is illustrated by means of examples (1.118–128).

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The next subjects are sukha (happiness) and duḥkha (suffering), arising from the contact with the sense of touch (sparśa)28 and mind (manas), which leads to attachments (tṛṣṇā) in the form of desire (icchā) and aversion (dveṣa) (1.129–136). Mokṣa (final emancipation), in which all sensations (vedanā) have ceased, is reached by means of yoga (1.137–139).29

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The eight wonderful powers (aiśvara bala) of yogins are enumerated: āveśa (entering another’s body), cetaso jñānam (knowing another’s mind), arthānāṃ chandataḥ kriyā (doing things at will), dṛṣṭi (extraordinary power of vision), śrotra (extraordinary power of hearing), smṛti (extraordinary power of memory), kānti (extraordinary beauty) and iṣṭato ’darśanam (invisibility at pleasure) (1.140–141).30

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The way leading to mokṣa (final emancipation) and this state itself are described (1.142–155).31

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Chapter two is called atulyagotrīya.32 This title refers to the rule that marriages33 between members of the same gotra should not be contracted (2.3).34

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This chapter contains Ātreya’s answers to thirty-six questions35 of Agniveśa which deal with conception, embryology, and a number of more diverse subjects.36

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The male semen (śukra) is said to be composed of four mahābhūtas and to originate from (food containing) the six tastes (2.4).37 The causes of normal conception, foetal development and delivery of the child are mentioned, followed by the causes of abnormalities in these processes (2.6–7).38

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A type of pseudo-pregnancy is described, caused by vāyu which obstructs (the flow of) the menstrual blood.39 When this blood is at last discharged, some people say that because only blood is seen and no trace of a foetus, the latter has been destroyed by an evil spirit (bhūta);40 this view is rejected for the reason that these evil spirits, who roam about during the night, are fond of ojas and would have caused fatal damage to the mother’s body too, if they actually had succeeded in gaining access to her body (2.8–10).41

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Predominance of rakta42 at conception produces a female, predominance of śukra (semen) a male child.43 The genesis of twins44 and multiple births45 is explained, followed by the causes of delayed parturition and the differences in twins (2.11–16).

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A number of abnormalities of the offspring are accounted for. A child called dviretas46 is born when the male and female contributions to the bīja47 are equal48 or when there is damage to the bīja.49 A pavanendriya is conceived when vāyu harms the seat of śukra of the embryo,50 a saṃskāravāha when anila (= vāta) injures the opening (dvāra) of the receptacle of sperm.51 The two (male and female) types of klība52 are born from parents whose procreatory fluids (bīja) are sluggish or deficient, who are weak or do not experience sexual pleasure (harṣa). A vakrin53 is the result of pratigha54 of the female during intercourse and weakness of the male. An īrṣyārati55 is born from spiteful partners who do not enjoy the act fully.56 A vātasaṇḍaka’s testicles are seriously damaged by an abnormal condition (doṣa) of vāyu and agni (2.17–21).57

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The signs indicating conception are described, followed by signs pointing to the sex of the child;58 it will resemble the kind of being or person with whom the mother is preoccupied during conception (2.22–25).59

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A foetus is composed of four mahābhūtas,60 each of which derives from father, mother, the mother’s food and the ātman;61 the appearance and other characteristics62 of the child are determined by its own karman and that of its parents (2.26–27).63 The causes of abnormalities in the newborn child are discussed (2.29–30).

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Transmigration is the next subject discussed. The ātman is described, the entities accompanying it during the cycle of rebirths,64 the factors determining one’s physical appearance and mental characteristics, etc. (2.31–38).65

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The causes of happiness and sorrow (harṣa and śoka) are dealt with again. All diseases are brought about by errors in judgment (prajñāparādha), unsuitable (contact with the) objects (of the senses) and transformations caused by time. Fate (daiva) and personal efforts (pauruṣa) are decisive factors in health and disease (2.39–47).66

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Chapter three, called khuḍḍikā garbhāvakrāntiḥ,67 is concerned with the descent (avakrānti) of the transmigrating self (jīva)68 into the embryo. The chapter is composed in the form of a dialogue between Ātreya and Bharadvāja.69

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Ātreya proposes that the child in the womb is an aggregate (samudāya) of six factors (bhāva) derived from the mother, father, ātman, suitability (sātmya), the nutrient fluid (of the mother) (rasa), and sattva (= manas).70 This proposition is rejected by Bharadvāja, who gives his arguments, which are refuted by Ātreya (3.3–5).

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The constituents of the body deriving from the mother are enumerated: tvac (the layers of the skin),71 lohita (blood), māṃsa (muscular tissue), medas (fatty tissue), nabhi (the navel), hṛdaya (heart), kloman, yakṛt (liver), plīhan (spleen), vṛkkas (kidneys), basti (bladder), pūrīṣādhāna (receptacle of faeces), āmāśaya, pakvāśaya, uttaraguda (rectum), adharaguda (anal region), kṣudrāntra (small intestine), sthūlāntra (large intestine),72 vapā, and vapāvahana (omentum).73 Derived from the father are: keśa (the hairs of the head), śmaśru (the beard hair), nakha (nails), loman (body hair), danta (the teeth), asthi (the bones), sirā (veins), snāyu (the cords, i.e., ligaments, etc.), and dhamanī (arteries).74

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Derived from the ātman75 are: birth in various successive wombs, āyus (the life span), ātmajñāna (knowledge of the self), manas, indriya (the senses), prāṇa, apāna, preraṇa (setting in motion), dhāraṇa (sustenance), ākṛti (personal appearance),76 svara (voice), varṇa (complexion), sukha (happiness), duḥkha (misery), icchā (desire), dveṣa (aversion), cetanā (consciousness), dhṛti (power of restraint), smṛti (memory), ahaṃkāra (the ego), and prayatna (effort).77

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Derived from sātmya are: ārogya (health), anālasya (diligence), alolupatva (absence of greed), indriyaprasāda (clarity of the senses), saṃpad (excellence) of svara (voice), varṇa (complexion) and bīja (reproductive factors), and praharṣabhūyastva (abundance of orgastic pleasure).78

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Derived from rasa are: abhinirvṛtti (development) and abhivṛddhi (growth) of the body, prāṇānubandha (maintenance of the link with the vital breaths), tṛpti (satisfaction), puṣṭi (a well-nourished bodily appearance), and utsāha (perseverance).79

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Derived from sattva are: bhakti (inclination), śīla (conduct), śauca (purity), dveṣa (enmity), smṛti (memory), moha (attachment), tyāga (detachment), mātsarya (envy), śaurya (valour), bhaya (fear), krodha (anger), tandrā (drowsiness), utsāha (perseverance), taikṣṇya (harshness), mārdava (mildness), gāmbhīrya (seriousness), anavasthitatva (instability), and other features to be described in the context of the sattva typology (3.6–13).80

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After listening to this exposition by Ātreya, Bharadvāja asks a second set of questions, to which Ātreya replies again. The latter explains why living beings, man included, generate offspring of the same species as the parents,81 and why intellectual deficiency is not always of a hereditary character. He also clarifies the connections between the ātman and the senses (3.14–25).82

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Chapter four, called mahatī garbhāvakrāntiḥ, deals with embryology.83 The subjects discussed in the chapter are enumerated (4.3). The five factors (bhāva) at the origin of the aggregate called garbha (embryo, foetus) are referred to (4.4).

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The combination of śukra, śoṇita and jīva is called garbha (4.5). The garbha is a product of the five mahābhūtas and the seat of consciousness (cetanā), which is regarded as the sixth dhātu (4.6).84

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Conception is described (4.7) and the processes in its wake. First of all, the cetanādhātu (principle on which potential consciousness is based),85 accompanied by the sattva as its instrument, becomes active in appropriating the qualities (guṇa),86 beginning with (those of) ākāśa, gradually followed by (those of) the other four mahābhūtas; this process requires very little time (4.8).87

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In the first month of its development the embryo is a jelly-like (kheṭa) mixture of all its constituents;88 in the second month it becomes a firm mass (ghana), which is like a bolus (piṇḍa),89 like a muscle (peśī), or like a tumour(arbuda),90 thus indicating that its sex is male, female, or neither male nor female (napuṃsaka).91 All the sense organs, the main parts of the body (aṅga) and the smaller parts, develop in the third month.92

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Derived from ākāśa are śabda (sound), śrotra (the sense of hearing), lāghava (lightness),93 saukṣmya (subtlety) and viveka (separation); derived from vāyu are sparśa (touch), sparśana (the tactile sense), raukṣya (dryness), preraṇa (setting in motion),94 dhātuvyūhana (disposition and displacement of the dhātus), and ceṣṭāḥ śārīryaḥ (bodily movements); derived from agni (fire) are rūpa (vision), darśana (the sense of seeing), prakāśa (clarity), pakti (digestion and related processes), and auṣṇya (heat); derived from ap (water) are rasa (taste), rasana (the gustatory sense), śaitya (coldness), mārdava (softness), sneha (unctuousness), and kleda (moisture); derived from pṛthvī (earth) are gandha (smell), ghrāṇa (the olfactory sense), gaurava (heaviness), sthairya (solidity), and mūrti (corporeality) (4.9–12).95

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The parallelism of macrocosm and microcosm is stressed (4.13).

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The organs of sense, and the major and minor parts of the body, appear thus simultaneously, apart from those which develop later in life (4.14). Sensations (vedanā) arise in the same period. The foetus begins to quicken (spandate) and to long for whatever was experienced in its previous life. This state is called dvaiḥṛdayya, because the foetus, being connected with the mother’s heart through nutritive vessels, goes through the same desires as its mother.96 For that reason the mother’s desires should be duly taken into consideration and satisfied, unless harmful to the child (4.15, 17, 19).97

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The signs of pregnancy are described (4.16),98 followed by rules concerning the mother’s diet and behaviour (4.18).99

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During the fourth month the mass of the foetus increases, which makes the gravida feel heavy.100 The muscular tissue and blood develop in the fifth month in particular, which leads to leanness in the mother. The sixth month is characterized by the development of strength and complexion, which results in loss of strength and complexion in the mother. The foetus grows in every respect during the eighth month, which makes the expectant mother exhausted; this month is dangerous because ojas is exchanged between mother and child, leading to fluctuations of mood in both (4.19–24).101

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The ninth and tenth months are the period of parturition.102 Factors influencing normal development of the foetus and normal delivery are dealt with (4.25–29).103

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Disorders of the foetus on account of damage to the female procreatory fluid (śoṇita) and the uterus are discussed: affections of parts of the body derived from the mother, sterility (vandhyātva), premature death,104 and the condition of being a vārttā.105 The same disorders arise from damage to particular parts of the male seed, with this difference that not a vārttā, but a tṛṇaputrika may be born106 (4.30–31).

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The last section of the chapter is devoted to a character typology. Human beings are of three main character types (sattva): śuddha, rājasa and tāmasa.107 Though the variations in character are innumerable, a number of types are described in more detail.

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The seven śuddha types are: brāhma,108 ārṣa, aindra, yāmya, vāruṇa, kaubera, and gāndharva; the six tāmasa types are: āsura, rākṣasa,109 paiśāca,110 sārpa, praita, and śākuna; the three tāmasa types are: pāśava,111 mātsya and vānaspatya (4.36–40).112

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Chapter five, called puruṣavicaya, is concerned with the parallelism between macrocosm and microcosm and with the way leading to final emancipation (mokṣa).

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The parallels between the cosmos (loka) and the person (puruṣa) are discussed first. The cosmos is an aggregate of six dhātus: the five mahābhūtas and the unmanifest (avyakta) brahman. The puruṣa is similar to the cosmos in this respect (5.4).

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The parallelism is elucidated in more detail. The mahābhūtas (earth, etc.) and brahman are represented in the puruṣa by mūrti (corporeality), kleda (moisture), abhisantāpa (heat), prāṇa, suṣiratva (hollowness), and the antarātman. The vibhūti113 of brahman is represented by Prajāpati,114 the vibhūti of the antarātman by sattva (= manas). Indra corresponds to the ahaṃkāra,115 Āditya116 to ādāna (absorption),117

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Rudra to roṣa (anger), Soma to prasāda (serenity), the Vasus¹¹⁸ to sukha (happiness), the Aśvins to kānti (beauty), Marut to utsāha (perseverance), the Viśvedevāḥ¹¹⁹ to the sense organs and their objects;¹²⁰ darkness (tamas) corresponds to ignorance (moha), light to (spiritual) knowlege (jñāna). The four ages (yuga) of the world correspond to childhood, adulthood, old age and disease (5.5).

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The purpose of this exposition on the parallels between loka¹²¹ and puruṣa is that it leads to true knowledge (satyā buddhiḥ), consisting of the realization that cosmos and self are identical¹²² (5.7). Attachment (pravṛtti) is the main cause of all kinds of affliction (upaplava), while detachment (nivṛtti) leads to their cessation (uparama).¹²³ This true knowledge is based on the insight that loka and puruṣa are identical (5.8).

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The sources of attachment are dealt with: moha (ignorance), icchā (desire), dveṣa (aversion) and karman (action). Attachment gives rise to ahaṃkāra (experiencing the own ego as a glorious entity), saṅga (actions not leading to emancipation), saṃśaya (doubt), abhisamplava (considering the self to be identical with the body), abhyavapāta (self-based attachment), vipratyaya (considering something wholesome as unwholesome, etc., and the other way round), aviśeṣa (lack of discrimination), and anupāya (employment of unsuitable means) (5.10).¹²⁴ Detachment is apavarga (emancipation), mokṣa (freedom from bondage), etc. (5.11).

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The means to be employed for the ascent (udayana) leading to mokṣa (5.12) and the achievement of the aim (5.13–24) are described.

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Chapter six, called śārīravicaya, deals with a number of subjects.

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Its first part is concerned with imbalance of the dhātus (= doṣas) and restoration of their equilibrium. A dhātu increases by the use of substances with properties similar to those of the dhātu, while it is subject to decrease through the use of substances with contrary properties. Treatment of imbalances of the dhātus is based on this principle (6.3–11). The twenty properties (guṇa) of the dhātus are enumerated in this section (6.10).¹²⁵

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Factors leading to bodily growth, increase of strength and transformation of the food are dealt with (6.12–16). The constituents of the body are divided into two groups: mala and prasāda. The malas (waste products) are the various secretions (upadeha) which come out of the orifices of the body,¹²⁶ bodily elements (dhātu) which have been subject to excessive pāka (paripakva),¹²⁷ excited (prakupita) doṣas,¹²⁸ and other substances harmful to the body. The entities called prasāda are the (normal) seven bodily elements¹²⁹ (6.17).

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The three doṣas, when corrupted (duṣṭa), are the agents causing corruption of all the constituents mentioned, because it is in their nature (svabhāva) to do so (6.18).

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The second part is devoted to questions pertaining to embryology. On the important problem as to which part of the embryo arises first, conflicting views have been expressed by sages who composed (medical) treatises (sūtrakṛt). Kumāraśiras Bharadvāja is of the opinion that the head arises first; it is the heart according to Kāṅkāyana, the physician from Bāhlīka, the navel according to Bhadrakāpya, the pakvāśaya and guda (rectum and anus)¹³⁰ according to Bhadraśaunaka, hands and feet according to Baḍiśa, the organs of sense according to Janaka from Videha; the question cannot be answered, because observation is impossible, according to Mārīci Kaśyapa; all the organs appear at the same time, according to Dhanvantari. Atreya agrees with Dhanvantari, but not without drawing attention to the importance of the heart as the root (mūla) of all the parts of the body and the seat (adhiṣṭāna) of some other constituents (bhāva)¹³¹ (6.21).¹³²

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The foetus lies in the womb (kukṣi) with its face towards the mother's back, its head upwards and limbs folded.¹³³

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In the early stage of its development, the foetus is entirely dependent for its maintenance on upasneha (transudation)¹³⁴ and upasveda (conduction of heat)¹³⁵ from the mother's body. Later, upasneha is effected partly through the pores of the hairs (romakūpa) and partly through the vessels in the umbilical cord (nābhināḍyayana). This cord is attached to the navel at one end, to the placenta (aparā)¹³⁶ at the other end, and the placenta is connected with the mother's heart, which fills it with nourishment (6.23).¹³⁷

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Normally, the child turns its head downwards when the time of delivery is approaching (6.24).

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Disorders of the newly-born child which are not brought about by the doṣas find their origin in the wrath of the gods and of other beings (6.27).

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The last section of the chapter is concerned with timely and untimely death (kālākalāmṛtyu).¹³⁸ The normal life span in the present age is said to be one hundred years (6.28–29).

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Chapter seven, called śarīrasamkhyā,¹³⁹ deals with the parts of the body and their respective numbers.

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Six layers of skin (tvac) are distinguished:¹⁴⁰ udakadharā;¹⁴¹ asṛgdharā;¹⁴² the third layer, in which sidhma¹⁴³ and kilāsa¹⁴⁴ have their origin;¹⁴⁵ the fourth layer, from which dadru and kuṣṭha¹⁴⁶ originate;¹⁴⁷ the fifth layer, which is the seat of alajī and vidradhi;¹⁴⁸ the sixth layer, which, when cut, causes fainting,¹⁴⁹ is the seat of a type of blackish red boils (arūṃṣi)¹⁵⁰ (7.4).¹⁵¹

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The body is composed of six main parts: the two arms (bāhu), the two legs (sakthi), head and neck, and trunk (antarādhi) (7.5).¹⁵²

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The bones, together with the sockets (ulūkhala) of the teeth and the nails, are three hundred and sixty in number (7.6).¹⁵³

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These bones consist of: thirty-two teeth, thirty-two sockets of the teeth (dantolūkhala),¹⁵⁴ twenty nails, sixty phalanxes in fingers and toes (pāṇipādāngulyasthi),¹⁵⁵ twenty metacarpal and metatarsal bones (pāṇipādaśalākā),¹⁵⁶ four bases of the metacarpal and metatarsal bones (pāṇipādaśalākādhiṣṭhāna),¹⁵⁷ two bones in the heels (pārṣṇi),¹⁵⁸ four bones in the ankles (gulpha),¹⁵⁹ two wrist-bones (maṇika),¹⁶⁰ four bones in the forearms (aratni), four bones in the lower legs (jaṅghā),¹⁶¹ two bones in the knees (jānu),¹⁶² two kneecaps (jānukapālikā),¹⁶³ two long bones in the thighs (ūrunalaka), two long bones in the upper arms (bāhunalaka), two bones in the shoulders (aṃsa),¹⁶⁴ two shoulder blades (aṃsaphalaka),¹⁶⁵ two clavicles (akṣaka),¹⁶⁶ one breastbone (jatru),¹⁶⁷ two bones in the palate (tālukā),¹⁶⁸ two flat pelvic bones (śroṇiphalaka),¹⁶⁹ one pubic bone (bhagāsthi),¹⁷⁰ forty-five bones in the back (pṛṣṭhagatāsthi), 171 fifteen bones in the neck (grīvā), 172 fourteen bones in the front part of the chest (uras), 173 twenty-four ribs (parśuka), 174 twenty-four sockets (sthālaka) of the ribs, 175 twenty-four tubercles (arbuda) for the sthālakas, 176 one jaw bone (hanvasthi), two connecting bones at the roots of the jaw (hanumūlabandhana), 177 one bone constituting the nose (nāsikā), the prominent parts of the cheeks (gaṇḍakūṭa), and the forehead (lalāṭa), 178 two bones in the temples (śaṅkha), 179 and four flat skull bones (śiraḥkapāla). 180

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There are five seats of the senses: skin, tongue, nose, eyes and ears; five senses (buddhīndriya): the tactile, gustatory, olfactory, visual and auditory sense; five motor organs (karmendriya): hands, feet, anus (pāyu), genitals (upastha) and tongue (7.7). There is one heart, which is the seat of consciousness (cetanādhātu) (7.8). 181

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There are ten seats (āyatana) of the prāṇas: head, throat, heart, navel, anal region, bladder, ojas, semen, blood and muscular tissue (7.9). 182

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The viscera (koṣṭhāṅgāni) are fifteen in number: navel (nābhi), heart (hṛdaya), kloman, 183 liver (yakṛt), 184 spleen (plīhan), the two kidneys (vṛkka), 185 urinary bladder (basti), receptacle of the faeces (purīṣādhāra), 186 receptacle of undigested food (āmāśaya), 187 receptacle of digested food (pakvāśaya), 188 the upper part of the rectum (uttaraguda), the lower part of the rectum (adharaguda), 189 small intestine (kṣudrāntra), large intestine (sthūlāntra), 190 and omentum (vapāvahana) 191 (7.10). 192

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The minor parts (pratyaṅga) of the body, into which the main parts are subdivided, are fifty-six in number: 193 two jaṅghāpiṇḍikās (calves), 194 two ūrupiṇḍikās, 195 the two parts called sphic (buttock), 196 two vṛṣaṇas (testicles), 197 the śephas (penis), 198 two ukhās (armpits), 199 two vaṅkṣaṇas (groins), 200 two kukundaras, 201 one bastīśīrṣa, 202 one udara (abdomen), 203 two stanas (breasts), 204 two parts called śleṣmabhū, 205 two bāhupiṇḍikās, 206 one cibuka (chin), 207 two oṣṭhas (lips), 208 two sṛkkaṇīs (corners of the mouth), 209 two dantaveṣṭakas (the gums of the two halves of the mouth), 210 one tālu (palate), 211 one galaśuṇḍikā (uvula), 212 two upajihvikās, 213 one gojihvikā (tongue), 214 two gaṇḍas (cheeks), 215 two karṇaśaśkulikās, 216 two karṇaputrakas, 217 two akṣikūṭas, 218 four parts called akṣivartman (the eyelids), 219 two akṣikanīnikās, 220 two parts called bhrū (the eyebrow), 221 one avaṭu, 222 four hṛdayas of hands and feet (the palms and soles) 223 (7.11). 224

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The nine orifices (chidra) are nine in number: seven in the head and two below (7.12). 225

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The parts so far mentioned are visible; the remaining ones are invisible and their number has to be deduced by reasoning (7.13).

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The snāyus are nine hundred in number, 226 the sirās 227 seven hundred, 228 the dhamanīs 229 two hundred, 230 the peśīs (muscles) four hundred, 231 the marmans (vulnerable spots) one hundred and seven, 232 the sandhis (junctures) 233 two hundred. 234 The terminal openings (mukhāgra) of the minute branches of sirās and dhamanīs, as well as the hairs of scalp, and body are 29,956 in number (7.14). 235

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Bodily constituents, measurable in añjalis, 236 are dealt with next. The standard quantities are given; the figures are reached by reasoning (tarka). 237 Quantities mentioned are: ten añjali of watery fluid (udaka), 238 nine of rasa as a fluid resulting from the digestion of the food, eight of blood, seven of faeces, six of kapha, five of pitta, four of urine, three of vasā, two of medas, one of majjā; half an añjali of mastişka (brain tissue), 239 śukra (semen) and ślaismika ojas240 (7.15).

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Components and functions of the body which are regarded as mainly connected with one of the five mahābhūtas are enumerated (7.16).241

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Pṛthivī (earth) is predominantly present in parts which are sthūla (gross), sthira (firm), mūrtimant (endowed with a particular form), guru (heavy), khara (rough), and kaṭhina (hard); it also predominates in the nakhas (nails), asthis (bones), dantas (teeth), māṃsa (muscular tissue), carman (the outer layer of the skin), 242 varcas (faeces), keśa (hairs of the scalp), śmaśru (beard hair), loman (body hair), the kaṇḍarās, 243 gandha (smell) and ghrāṇa (the olfactory sense). Ap (water) predominates in parts which are drava (fluid), sara (mobile), manda (sluggish), snigdha (oleaginous), mṛdu (soft) and picchila (mucilaginous); it also predominates in rasa (nutrient fluid), rudhira (blood), vasā (muscle fat), kapha, pitta, mūtra (urine), sveda (sweat), rasa (taste), and rasana (the gustatory sense). Agni (fire) predominates in pitta, ūṣman (heat), bhās (lustre), rūpa (vision) and darśana (the visual sense). Vāyu (air) predominates in ucchvāsa (exspiration), praśvāsa (inspiration), unmeṣa (opening of the eyes), nimeṣa (closing of the eyes), ākuñcana (contraction), prasāraṇa (extension), gamana (locomotion), preraṇa (impelling), dhāraṇa (retention), sparśa (touch), and sparśana (the tactile sense). Antarikṣa (= ākāśa) predominates in vivikta parts (interstices), vāc (speech), large and minute vessels (srotas), śabda (sound), and śrotra (the auditory sense) (7.16).

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With respect to their division into atoms (paramāṇu), the component parts of the body are countless, because these atoms are present in very large numbers, of very minute size and imperceptible. Conjunction (saṃyoga) and disjunction (vibhāga) of the atoms is caused by vāyu and the own nature (svabhāva) of karman (movement) (7.17).

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The view that the composite body is one whole leads to attachment (saṅga), the insight that its parts are separate to final emancipation (apavarga).

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Chapter eight, called jātīsūtrīya, 244 deals with procreation, the management of pregnancy and delivery, 245 the care of the woman in childbed, 246 the care of the newborn child, etc.

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The topics disussed first are: rules for sexual intercourse (8.3–8); 247 rules and rituals ensuring desired characteristics 248 in the son to be conceived (8.9–14). 249 Apart from these behavioural rules and rituals, the complexion of a son will be determined by the relative preponderance of the mahābhūtas; tejas (fire), when associated with udaka (water) and antarikṣa (= ākāśa), furthers a fair (avadhūta) complexion, when associated with pṛthivī (earth) and vāyu (air) a dark (kṛṣṇa) complexion, while balance of the five gives rise to a śyāma250 colour of the skin (8.15). 251 Factors influencing the sattva of the child are added (8.16).

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The puṃsavana ritual, 252 aiming at the conception of a son, 253 is described 254 (8.19), 255 followed by measures promoting the maintenance of the pregnancy (garbhasthāpana; 8.20). Factors which are harmful to the unborn child (garbhopaghātakara) and may lead to its death, to abortion, particular defects, and diseases are discussed (8.21). 256

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Rules for the management of pregnancy are dealt with (8.22).

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The next section is concerned with disorders occurring during pregnancy and their treatment (8.23–31).257

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Disorders described are: bleeding (puṣpadarśana), bleeding associated with āma, upaviṣṭaka (prolongation of the gestation period), nāgodara (death of the child within the womb, followed by withering), udāvarta, vibandha (chronic obstipation), and death of the unborn child (mṛtagarbha); extraction (haraṇa) of a dead child (called a śalya) by a specialist (garbhahartar) is discussed.258

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The monthly regimen during pregnancy is dealt with.259 Ātreya rejects an opinion current among women and gives his view on the development of striae (kikkisa);260 he also refutes Bhadrakāpya’s thesis on the origin of tawniness (paiṅgalya) in the child (8.32).261

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The construction of the birth-chamber (sūtīkāgāra), its equipment, the way it should be occupied by the expectant mother (8.33–35),262 the signs heralding parturition, and the management of delivery263 are discussed (8.36–40),264 followed by the measures to be taken when the placenta (aparā) does not come out spontaneously265 (8.41).266

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The care for the child immediately after birth is described (8.42–43);267 the cutting of the umbilical cord (nāḍīkalpana);268 the treatment when it becomes inflamed; the disorders resulting from improper handling of the cord: āyāmottuṇḍikā (lengthwise swelling), vyāyāmottuṇḍitā (breadthwise swelling), piṇḍalikā (a circular swelling), vināmikā (swelling of the periphery and depression of the centre), and vijṛmbhikā (a gradual increase in size);269 the treatment of these disorders (8.42–45).270

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The birth-ceremony (jātakarman)271 should then be performed,272 the first feeding should take place (8.46),273 and measures should be taken which protect mother and child (8.47).274 The regimen of a woman who has recently given birth to a child is described; great care is necessary, since disorders arising in this period are grave, curable with difficulty or incurable (8.48–49).275

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The naming ceremony (nāmakaraṇa)276 is described (8.50).277 After this ceremony, the child should be examined with a view to determining its life span (āyus). A long list is given of characteristics indicating a long life (8.51).278

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The next subject is the wet-nurse (dhātrī): desirable qualities of a wet-nurse as a person, desirable characteristics of her breasts and breastmilk are dealt with (8:52–54).279 Disorders of the breastmilk (kṣīradoṣa) by vāta, pitta, kapha are described,280 followed by measures purifying the milk (kṣīraviśodhana) and promoting its production (kṣīrajanana) (8.55–57).281 The proper way of breastfeeding is described (8.58).282

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The chapter ends with prescriptions for the arrangement of the nursery (kumārāgāra), amulets (maṇi) to be worn by the child,283 toys (krīḍanaka),284 the behaviour of adults towards the child,285 and the general treatment of children’s diseases (8.59–66).

Linked texts (1)

Carakasaṃhitā — Agniveśa (Āyurveda) & Caraka, Sanskrit