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A History of Indian Medical Literature v1.c8: Chapter 1

A History of Indian Medical Literature v1.c8

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English

Chapter 1

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Chapter one,² called dīrghamjīvitīya, is the most heterogeneous of the whole saṃhitā in its composition.

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Verses 3–40 describe the descent of the divine āyurveda to earth. The āyurveda was transmitted by Brahmā³ to Prajāpati,⁴ by Prajāpati to the Aśvins, by the Aśvins to Indra.⁵

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A large group of sages,⁶ assembled on the slopes of the foothills of the Himālayas, sends Bharadvāja as their delegate to the abode of Indra,⁷ in order to ask this god for help, because diseases had cropped up among the living beings, creating thus obstacles to a religious life.⁸ Bharadvāja receives the āyurveda and passes his knowledge on to the other sages, among whom is Ātreya Punarvasu, who teaches the science in his turn to his six disciples. These six pupils, Agniveśa, Bhela, Jatūkarṇa, Parāśara, Hārīta and Kṣārapāṇi, put Ātreya’s teaching down in writing. Agniveśa is mentioned as the one who was the first to compose a medical treatise based on Ātreya’s exposition.⁹

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Stories about the transmission of the āyurveda from divinities to human sages, similar to those found in the Carakasaṃhitā or of a more or less different character, occur in the Suśrutasaṃhitā, the works attributed to Vāgbhaṭa, the Kāśyapa-saṃhitā, Hārī-tasaṃhitā, Ugrāditya’s Kalyāṇakāraka, Bhāvamiśra’s Bhāvaprakāśa, and the Bṛhannighaṇṭuratnākara.¹⁰ An independent tradition regarding the origin of āyurveda is presented by the Brahmavaivartapurāṇa.¹¹

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The Tibetan medical tradition developed its own version of the divine origin of the science.¹²

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The large assembly of sages is a characteristic feature of the Carakasaṃhitā,¹³ although not unique. A similar group met at the court of king Romapāda in order to be instructed in hastyāyurveda.¹⁴ Part I of the Bower MS tells about a group of sages in the Himālayas who are interested in medicinal plants.

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Parallels occur in non-medical treatises.¹⁵ A long list, with partly the same names as those of the Carakasaṃhitā, is found in the Bhāratīyanāṭyaśāstra.¹⁶ Meetings of numerous sages are also described in the Mahābhārata,¹⁷ Rāmāyaṇa¹⁸ and Bhāgavatapurāṇa.¹⁹

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The sheer length of the list of sages (ṛṣi)²⁰ in the Carakasaṃhitā made Cakrapāṇidatta comment that it serves to remove sins (pāpakṣaya) and to show that the āyurveda is worthy of being honoured by great minds (mahāpuruṣa). The motley character of the group was noticed by Cakra; he divides the sages into yāyāvaras, śālīnas²¹ and ayonijas (not born from a womb),²² and into four categories: ṛṣika, ṛṣiputra, devarṣi and maharṣi. 23 Later scholars also expressed their opinion on the remarkable heterogeneity of the assembled sages, who, in the Indian tradition, belong to different yugas, which precludes their meeting together. 24

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In my opinion, Caraka's list of sages, many of whom are known from Vedic literature, may have been inserted in order to stress the connection between āyurveda and the Vedic tradition, the orthodoxy of its teachings, and its association with the brāhmaṇas.

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Chapter one continues, after this introductory part, with the actual subject-matter of the treatise, in discussing the terms āyus 25 and āyurveda (1.41–43). 26

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The next series of verses, 44–52, deal with Vaiśeṣika concepts and their application in āyurveda, 27 a subject not discussed in the Bhelasaṃhitā, Suśrutasaṃhitā and the works ascribed to Vāgbhaṭa.

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S. Dasgupta claimed 28 that there are important differences between some concepts as defined in the Carakasamhitā and the corresponding ones in Vaiśeṣika texts. In his view, the terms sāmānya and viśeṣa in the Carakasamhitā have a significance quite different from what they have in the Vaiśeṣikasūtras; he asserted that, in the Carakasamhitā, the word sāmānya, which denotes a class in the Vaiśeṣika system, 29 means concrete things which have similar constituents or characteristics, while viśeṣa, denoting ultimate particulars in the Vaiśeṣika system, means concrete things which have dissimilar constituents or characteristics. This judgment has been refuted by A. Comba, 30 who argues that the use of the words sāmānya and viśeṣa in their literal meaning is not foreign to the Vaiśeṣika tradition at all.

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The most important passages of the Carakasamhitā on the universals (sāmānya) and particulars (viśeṣa) are: Sū.1.28cd–29ab, which lists the six categories of Vaiśeṣika in the following order: sāmānya, viśeṣa, guṇa, dravya, karman, and samavāya; 1.44, which describes the causality of sāmānya and viśeṣa; 1.45, which defines these concepts through characteristics useful in medicine.

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The first of these passages enumerates the categories in an unusual order; sāmānya and viśeṣa are the fourth, respectively fifth category in Vaiśeṣika texts; both terms are used in their technical, not their literal, meaning on this occasion. The other passages employ the term sāmānya in its technical sense, i.e., it denotes the category, whereas the term viśeṣa does not denote the category of this name, the ultimate particular, but the universal-particular (sāmānyaviśeṣa) in its differentiating aspect; the ultimate particulars (antyaviśeṣa) are regarded as useless in medical theory. 31

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A. Comba concluded in her study that the Carakasamhitā defines the universals and particulars differently from the Vaiśeṣikasūtras. By means of metonymies and ellipses, the Carakasamhitā points out the gnoseological function, at once unifying and differentiating, of the universal-particulars, rather than deducing their existence.

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This led her to think that the Carakasamhitā takes for granted the demonstration of the universals in Kaṇāda's Vaiśeṣikasūtras, which implies that the latter are not dependent on speculations developed in medical circles, contrary to the opinions on this issue put forward by D. Chattopadhyaya. 32

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S. Dasgupta 33 remarked that the Carakasamhitā seems to take its start from the Vaiśeṣika. He expressed as his view 34 that Caraka's definition of sāmānya and viśeṣa shows that they were then not yet counted as separate categories, as in the later Vaiśeṣika; Caraka’s sūtras were in his opinion probably written at a time when the Vaiśeṣika doctrines were undergoing changes, and compendia were beginning to appear; he supposed that a compendia like the Bhāṣāpariccheda might have been available to the author. 35

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Verses 46–47 describe the puṃs (= puruṣa), who is the subject (adhikaraṇa) of the science of life, as a combination (saṃyoga) of three constituents (tridaṇḍa): sattva (= manas), ātman and body (śarīra). 36

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Verse 48 is concerned with the category dravya (substance); 37 in agreement with Vaiśeṣika doctrine, the substances are nine in number: the five mahābhūtas, 38 ātman, manas, time (kāla) and space (diś); this enumeration of what are called the kāraṇadravyas is followed by an ardhaśloka on the kāryadravyas, divided into sentient (cetana) and insentient (acetana). 39

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The categories guṇa and karman are dealt with in verse 49. The guṇas, forty-one in number, are divided into three groups by Cakrapāṇidatta in his commentary: vaiśeṣika-, sāmānya- and ātmaguṇas. The vaiśeṣikaguṇas are the objects (artha) of the senses (smell, taste, etc.); this agrees with Vaiśeṣika thought. 40 The qualities referred to as gurvādayaḥ in Ca.Sū.1.49 are sāmānyaguṇas; they consist of ten pairs of opposites, listed at Ca.Sū.25.36 and Śā.6.10, and by Cakra ad Ca.Sū.1.49: guru (heavy) and light (laghu), śīta (cold) and uṣṇa (hot), snigdha (oleaginous) and rūkṣa (dry), manda (sluggish) and tīkṣṇa (sharp), sthira (solid) and sara (flowing), mṛdu (soft) and kaṭhina (hard), viśada (clear) and picchila (mucilaginous), ślakṣṇa (smooth) and khara (rough), sthūla (gross) and sūkṣma 41 (subtle), sāndra (viscid) and drava (liquid); 42 a similar list is not known from Vaiśeṣika literature. Buddhi and the list ending with prayatna, referred to in Ca.Sū.1.49, constitute the ātmaguṇas, a subject discussed in Śārīrasthāna 1. 43 A second series of sāmānyaguṇas is alluded to as parādayaḥ; the items of this list are enumerated at Ca.Sū.26.29–30ab. 44 Karman is defined as movement (ceṣṭita), of the nature of effort, etc. (prayatnādi).

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Samavāya is defined in verse 50 as the relation of inseparable inherence (apṛthagbhāva), as in the case of earth and other substances and their qualities; this relation is said to be eternal (nitya). Cakra describes it, in agreement with Praśastapāda’s commentary on the Vaiśeṣikasūtras, as the invariable co-existence (ayutasiddhi) of substrate (ādhāra) and that which exists in it (ādhārya). 45

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Verse 51 defines dravya (substance) as that in which inhere karman and guṇa and which is a samavāyikāraṇa (inherent cause). This definition is qualified by Cakrapāṇi, because karman does not inhere in the mahābhūtas. 46 The same verse defines guṇa as being inherent (samavāyin) in a substance), devoid of action (niśceṣṭa), 47 and causative (kāraṇa). 48

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Verse 52 describes karman, in conformity with Vaiśeṣika views, as inherent in substance, causative of conjunction (saṃyoga) and disjunction (vibhāga), and independent of other factors (nānyad apekṣate). 49

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Chapter one then turns to concepts which are important in medical theory. Equilibrium of the dhātus (constituent elements of the body) is the object of the medical science, to be achieved by appropriate measures (kriyā) (1.53).

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The threefold cause of bodily and mental disorders is the improper (mithyāyoga), 50 deficient (ayoga) and excessive (atiyoga) contact with time, buddhi and the objects of the senses (1.54), a subject more thoroughly discussed in Ca.Sū.11.

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The body and the sattva 51 are the seats of both diseased and healthy states of man; a proper contact (samayoga) with the aforesaid factors is the cause of well-being (1.55).

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Verse 56 characterizes the ātman.

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Verse 57 enumerates the three bodily doṣas: 52 vāyu, pitta and kapha, and the two mental (mānasa) doṣas: rajas and tamas. 53 Verse 58 declares that the bodily doṣas are appeased by remedial measures (auṣadha), 54 which are of two types: daivavyapāśraya and yuktivyapāśraya; 55 the mental doṣas are pacified by means of jñāna, vijñāna, 56 dhairya, smṛti and samādhi.

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The qualities of the doṣas and, by implication, the qualities of medicinal substances alleviating excited doṣas, are dealt with in verses 59–61. 57

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The general principle on which the treatment of curable diseases is based is sketched in verses 62–63. Verses 64–66 are about the tastes, their relationships with the mahābhūtas and those with the doṣas.

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Verse 67 divides medicinal substances into three groups: doṣapraśamana, dhātupradūṣaṇa and svasthavṛtti(kara). 58 Verses 68–74ab 59 divide drugs, according to their source, into jāṅgama, bhauma (or pārthiva) and audbhida, i.e., of animal, inorganic and vegetable origin; 60 many substances and clusters of substances belonging to these groups are enumerated. 61

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Verses 74cd–119 describe sixteen plants with useful roots (mūlinī; 1.77–80), nineteen plants with useful fruits (phalinī; 1.81–86ab), 62 four fatty substances (mahāsneha; 1.86cd–88ab), five salts (1.88cd–92ab), 63 eight kinds of urine 64 and milk (1.92cd–113), 65 and six trees 66 used in evacuation (śodhana; 1.114–118). 67

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Verses 120–135 state that a good physician should not only be acquainted with the names and characteristics of drugs, but in particular with their proper administration, on which therapeutic success depends.

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Verses 136–140 summarize the contents of the chapter. 68

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Chapter two, called apāmārgataṇḍulīya, 69 deals with drugs useful in vamana (emesis) and virecana (purgation) (2.1–16); both treatments, which, taken together, are identical with the śodhana (evacuation) of Sū.1.76, form part of the complex procedure called pañcakarman, elaborately described in the Siddhisthāna. 70

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Many of the substances of this part of chapter two are already mentioned in Ca.Sū.1.74cd–119.

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The medicinal plant apāmārga is the first one appearing in chapter two because it is the main drug used in evacuation of the head. 71 Madana (2.7) is the main drug among the emetics, 72 trivṛtā (2.9) among the purgatives. 73

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The second part of chapter two describes twenty-eight medicinal gruels (yavāgū; 2.17–34), 74 employed in the dietetic regimen after a course of pañcakarman, especially if improperly carried out. 75

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Chapter three, called āragvadhīya, 76 describes thirty-two 77 preparations called cū- rṇapradeha,⁷⁸ to be used for the purpose of external purification after proper evacuation of the patient.⁸⁰

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Cūrṇapradeha is a powdered drug (cūrṇa), sprinkled over a spot already smeared with an oil, and rubbed for some time.⁸¹

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Chapter four, called ṣaḍvirecanaśatāśritīya,⁸² discusses evacuative (virecana) preparations.⁸³

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Six hundred of these preparations will be dealt with briefly in this chapter, to be described more fully later, in the Kalpopaniṣad (= Kalpasthāna).⁸⁴ The numbers of the preparations to be described in the twelve chapters of the Kalpasthāna are announced.

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The milky sap (kṣīra), roots, bark, leaves, flowers and fruits of plants are employed (4.5) in the preparations, which are henceforth referred to as kaṣāyas in this chapter. The salt taste is unsuitable, the other five tastes are suitable in a kaṣāya (4.6).

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Five types of kaṣāya are distinguished, arranged according to their decrease in strength: svarasa (freshly expressed juice), kalka (paste), śṛta (decoction), śīta (cold infusion), and phāṇṭa (hot infusion).⁸⁵ The definitions of these types are given in some interpolated verses.⁸⁶

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Ten large groups (varga) of mahākaṣāyas are distinguished, subdivided into fifty smaller groups with specific actions;⁸⁷ each of these smaller groups comprises ten items, consisting of plants or plant products.⁸⁸ One and the same plant may be found in more than one of these groups of ten.⁸⁹

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The groups begin with medicinal substances which are jīvanīya (vitalizing) and end with those which are vayaḥsthāpana (preserving youthful vigour), thus stressing the rasāyana aspect of āyurveda. The arrangement, names and actions of the fifty groups are remarkable in several respects and suggest that Sū.4 may represent an old part of the Carakasaṃhitā.

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Substances called virecana in a broad sense are said to be the subject of the chapter, but, actually, a very small part of the groups of ten drugs belongs to this category.⁹⁰ Many groups consist of specifics against particular disorders,⁹¹ drugs acting on particular regions of the body⁹² or particular bodily constituents,⁹³ drugs with particular general effects,⁹⁴ etc. Some groups are specifically active against disorders not described as distinct diseases in the Carakasaṃhitā.⁹⁵

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Chapter five, called mātrāśitīya,⁹⁶ is concerned with daily regimen.⁹⁷

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The subjects are: the suitable quantities of light and heavy articles of food, which are dependent on the power of one’s digestion (agnibala) (5.3–13);⁹⁸ the application of collyria (añjana) (5.14–20ab);⁹⁹ smoking (dhūmapāna) as a daily routine¹⁰⁰ and for therapeutic purposes (5.20cd–56ab);¹⁰¹ the preparation of aṇutaila and its use as a snuff (5.56cd–71ab);¹⁰² teeth-cleaning (dantapavana; 5.71cd–74ab);¹⁰³ tongue-scraping (jihvānirlekhana; 5.74cd–76ab);¹⁰⁴ keeping fragrant substances in the mouth (5.76cd–77);¹⁰⁵ the use of gargles (gaṇḍūsa; 5.78–80);¹⁰⁶ rubbing the head with oil (mūrdhatailaniṣevaṇa; 5.81–83);¹⁰⁷ the use of eardrops (karṇatarpaṇa; 5.84);¹⁰⁸ massage of the body and the feet with oil (snehābhyaṅga; 5.85–92);¹⁰⁹ rubbing the body all over (śarīraparimārjana; 5.93); bathing (snāna; 5.94);¹¹⁰ wearing clean clothes (5.95); the uses of fragrant substances, garlands, gems and ornaments (5.96–97); 111 hygiene of feet and excretory orifices (5.98); 112 hair- and nail-cutting (5.99); 113 the use of footwear, 114 umbrella, 115 and stick (5.100–102). 116

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Chapter six, called tasyāśitīya, discusses physiological changes during the seasons and the recommended seasonal regimen (ṛtucaryā). 117

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The subjects are: the importance of seasonal regimen (6.3); the year is divided into six seasons; the period in which the sun courses northwards (udagayana), known as ādāna, consists of the seasons beginning with śiśira (the cool season) and ending with grīṣma (summer); the period in which the sun courses southwards, called visarga, consists of the seasons beginning with varṣāḥ (the rainy season) and ending with hemanta (winter) (6.4); 118 the main characteristics of visarga and ādāna 119 (6.5–8); the characteristics of hemanta and the regimen to be observed (6.9–18); the characteristics and regimen pertaining to śiśira (6.19–21), vasanta (spring) (6.22–26), grīṣma (6.27–32), varṣāḥ (6.33–40), and śarad (autumn) (6.41–48); the definition of okasātmya (one’s adjustment as to diet and behaviour to the region of residence) (6.49–50).

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Chapter seven, called navegāndhāraṇīya, 120 is concerned with the unwholesome effects of the suppression of natural urges (vegadhāraṇa) 121 and other subjects.

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The thirteen urges not to be suppressed are those relating to urination, defecation, ejaculation, passing flatus, vomiting, sneezing, eructation, yawing, hunger, thirst, shedding tears, sleep, and heavy breathing caused by exercise. The symptoms resulting from suppression and the treatment of these syndromes are described (7.3–25). 122

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The next series of verses enumerate urges that should be suppressed as being morally condemnable (7.26–30). 123

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Some verses are devoted to the proper use of physical exercise (vyāyāma; 7.31–33). 124 Excessive indulgence in physical exercise, laughing, talking, travelling, sexual intercourse and waking by night is warned against (7.34–35). Those who should avoid physical exercise are described (two additional verses). 125 The proper way to get out of bad habits is described (7.36–38). 126

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The remaining subjects dealt with are: the constitutions (prakṛti; 7.39–41); 127 bodily orifices and channels obstructed by excreta and secretions (7.42–43); general causes of endogenous (nija) and exogenous (āgantu) diseases and their treatment (7.44–55); 128 persons with whom one should not associate and persons whose company is to be recommended (7.56–59); rules about the intake of thick sour milk (dadhi; 7.61–62).

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Chapter eight, called indriyopakramaṇīya, 129 gives an account of the five sensory faculties 130 and mind 131 (8.3–17), 132 followed by rules of conduct, which refer to numerous Hindu practices (8.18–29). 133

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Among the persons to be shunned (8.19) is a bhrūṇahan, explained by Cakra as a garbhaghātaka, i.e., someone who kills an embryo or foetus, thus inducing an abortion. 134 A Vedic mantra is quoted (8.28). 135 Friendship (maitrī) and compassion (kāruṇya) are among the recommended virtues (8.29). 136

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Chapter nine, called khuḍḍākacatuṣpāda, forms the short exposition on the four ‘pillars of treatment’: the physician, the drug, the attendant and the patient. 137

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Chapter ten, called mahācatuṣpāda, 138 is, to a certain extent, a continuation of chapter nine.

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The ‘four pillars’ are referred to at the beginning of the chapter. Punarvasu Ātreya is reported to declare that rational (yuktiyukta) treatment leads to freedom from disease. He is contradicted by Maitreya, who states that people recover or die from disease, irrespective of treatment. 139 Ātreya replies that successful treatment depends on correct knowledge concerning curable (sādhya) and incurable (asādhya) diseases (10.3–8). 140

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Curable diseases are divided into two categories: easily curable (sukhasādhya) and curable with difficulty (kṛcchrasādhya). Curable diseases are also of three grades (alpa, madhya, utkṛṣṭa). Incurable diseases are either amenable to palliative treatment (yāpya) or intractable (anupakrama); grades are not distinguished. These categories are characterized (10.9–20). 141

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Chapter eleven, called tisraiṣaṇīya, 142 discusses the three desires (eṣaṇā): 143 the desire for a long life (prāṇaiṣaṇā), for wealth (dhanaiṣaṇā) and for the other world (paralokaiṣaṇā). 144

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The existence of the other world and of rebirth (punarbhava) 145 is defended against the views of opponents 146 and established through the four means of examination (parīkṣā): 147 āptopadeśa (authoritative statement), pratyakṣa (perception), anumāna (inference) 148 and yukti (reasoning).

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The fourfold examination is described and applied to the problem whether or not rebirth is a reality. The result of this investigation is positive, which justifies the desire for the other world (11.3–33). 149

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The remaining part of the chapter is devoted to threefold classifications: the three subordinate supports (of life) (upastambha), consisting of diet (āhāra), sleep (svapna) and celibacy (brahmacarya); 150 the three types of strength (bala): dependent on one’s constitution (sahaja), on time (kālaja) and one’s way of life (yuktikṛta); the three basic causes (āyatana) of diseases: unsuitable contact of the senses with their objects (asātmendriyārthasaṃyoga), behaviour based on errors in judgment (prajñāparādha), 151 and abnormal seasonal variations (pariṇāma); the three categories of diseases: endogenous (nija), exogenous (āgantu) 152 and mental (mānasa); the three pathways (mārga) of diseases: 153 the branches (śākhā), the vulnerable points (marman) together with the joints, and the viscera (koṣṭha), also called the peripheral (bāhya), middlemost (madhyama) and central (ābhyantara) pathway; 154 the three types of physicians: fraudulent ones (chadmacara), those imitating a physician’s behaviour (siddhasādhita, pratirūpaka), and the genuine ones; the three types of treatment: spiritual (daivavyapāśraya), rational (yuktivyapāśraya) and psychological (sattvāvajaya); 155 the three types of somatic therapy: internal purification (antaḥparimārjana), external purification (bahihparimārjana) 156 and surgical intervention (śastrapranidhāna) 157 (11.34–55).

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Surgical interventions mentioned are: chedana (excision), bhedana (incision), vyadhana (puncturing), dāraṇa (rupturing), lekhana (scraping), utpāṭana, 158 pracchana (scarification), sīvana (suturing), eṣaṇa (probing), kṣāra (the application of caustics), and jalaukas (the application of leeches) (11.55). 159

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Chapter twelve, called vātakālakalīya, 160 is in the form of a conversation among a group of sages 161 on the merits and demerits of vāta as a cosmical element 162 and a constituent of the body. 163

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The questions to be discussed by the sages are: the qualities of vāta, the factors leading to its excitement and its pacification, the way in which these factors affect the incorporeal (asaṃghātavant) and unsteady (anavasthita) 164 vāta, and the actions of vāta outside and inside the body.

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Kuśa Sāṃkṛtyāyana enumerates the six qualities of vāta. 165 Kumāraśiras Bharadvāja agrees and adds that vāta is excited by substances and actions with similar qualities. Kāṅkāyana, the physician from Bāhlīka, explains that pacification of excited vāta is brought about by factors with opposite qualities. Baḍiśa Dhāmārgava discusses the way in which vāta is affected by these aggravating and alleviating factors. Vāryovida talks about the normal functions of vāta, the afflictions it brings about in the human organism when excited, and the normal and abnormal actions of vāta in the external world, adding observations on Vāyu as a deity, who is identical with Yama, Prajāpati, Aditi, Viśvakarman and Viṣṇu. Marīci asks Vāryovida how this knowledge can be applied to medical practice. Vāryovida replies that a correct understanding of the normal and abnormal actions of vāyu enables a physician to give sound advice to his patients. Marīci objects that pitta is the main agent in health and disease. Kāpya brings forward that kapha is mainly responsible for normal and abnormal states of the human organism.

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At the end of this discussion, Punarvasu Ātreya declares that all three dhātus, vāyu, pitta and kapha, should duly be taken into consideration in the assessment of health and disease.

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Chapter thirteen, on sneha, 166 is devoted to Punarvasu’s answers to Agniveśa’s queries about oleation therapy (sneha), 167 a type of treatment related to pañcakarman, 168 and especially important in counteracting disturbances of vāta.

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Punarvasu states that the fatty substances (sneha) used in medicine are of vegetable and animal origin. He gives a list of these substances, explains their properties and actions, the proper time of their administration, and mentions the anupānas to be taken (13.9–22). 169

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Twenty-four varieties of preparations containing a sneha (pravicāraṇā) are enumerated (13.23–25). The total number of fatty preparations is sixty-four (13.27–28). 170 Patients who require a high, medium or low dose of a sneha are mentioned (13.29–40). 171 Patients preferentially to be treated with ghee, oil, muscle fat or bone-marrow are discussed (13.41–50). 172

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The next subjects are: the maximum and minimum duration of a treatment with sneha (13.51); 173 patients suitable and unsuitable to sneha (13.52–56); 174 signs of defective, proper and excessive treatment (13.57–59); 175 preparatory measures (13.60–61); rules to be observed during treatment (13.62–64); 176 differences in the course of treatment between persons with soft (mṛdukoṣṭha) and hard bowels (krūrakoṣṭha) (13.65–69); 177 complications (vyāpatti; 13.70–79); 178 after-treatment (13.80–81); fatty preparations for patients to whom the usual ones are not suitable (13.82–95); 179 the absorption of a sneha (13.96–97); addition of salt to a sneha enhances its action (13.98). 180

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Sudation (sveda) should follow the treatment with a sneha; the next step consists of purification (saṃśodhana) (13.99). 181

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Chapter fourteen is concerned with sudation (sveda), 182 useful in disorders caused by vāta and kapha.

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General rules are dealt with first (14.3–12), 183 followed by the signs of proper treatment and over-sudation (14.13–15). 184 Indications and contra-indications are discussed (14.16–24). 185

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The materials used in piṇḍasveda (bolus sudation) 186 are enumerated; they can also be employed in prastarasveda (14.25–27). 187 The next verses are about the materials for jeṇṭākasveda (14.28), 188 nāḍīsveda (14.29–33), sudation in a tub (koṣṭha; 14.34), 189 and upanāhasveda (14.35–37). 190

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Thirteen types of sudation which require heating by fire 191 are described: saṃkara- (bolus sudation; 192 14.41), 193 prastara- (sudation on a layer of suitable material; 14.42), 194 nāḍī- (sudation by means of a tube; 14.43), 195 pariṣeka- (sudation by means of showers; 14.44), 196 avagāha(na) (sudation in a bath; 14.45), 197 jeṇṭāka- (sudation in a specially constructed room, resembling a sauna; 14.46), 198 aśmaghana- (sudation on a heated stone-slab; 14.47–50a), 199 karṣū- (sudation over a trench; 14.50b–51), kuṭī- (sudation in a cottage constructed for the purpose; 14.52–54), 200 bhū- (sudation of the same type as aśmaghana, but the patient lies on a heated layer of earth; 14.55), kumbhī- (sudation by means of a half-buried pitcher, filled with heated iron balls or stones; 14.56–58), kūpa- (sudation over a pit filled with heated dung; 14.59–60), and holākasveda (sudation over a dhītīkā, i.e., a heap of heated dung; 14.61–63). 201

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The ten types of sudation without the application of fire consist of physical exercise (vyāyāma), uṣṇasadana (residing in a non-heated warm room), warm clothing (guruprāvaraṇa), hunger, drinking of large quantities of water, fear, anger, poultices (upanāha), wrestling (āhava), and exposure to the sun (ātapa) (14.64–65ab). 202

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Sudation is of six general types: involving the application of fire or not involving it, applied to the whole body or part of it, oleaginous (against vāta disorders) or dry (against kapha disorders) (14.65cd–66). 203 The chapter ends with rules for after-treatment (14.67). 204

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Chapter fifteen, called upakalpanīya, on the equipment of a physician, describes a kind of infirmary, 205 with its personnel 206 and equipment, 207 suitable to the treatment of persons of high social status 208 with a full course of pañcakarman. Vamana (emesis) and virecana (purgation) 209 are dealt with in detail. 210

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Chapter sixteen, called cikitsāprabhṛtīya, 211 about the functions of a physician fully equipped for treatment (cikitsāprabhṛta), is a continuation of chapter fifteen.

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The signs of proper, inadequate and excessive treatment with emetics and purgatives are described (16.5–11), 212 followed by the symptoms of someone full of doṣas who is in need of evacuative therapy (16.13–16). The merits of evacuative measures are dealt with (16.17–21) 213 and the treatment of disorders due to their improper application (16.22–26). 214

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In reply to a question put by Agniveśa, Ātreya expounds that the function of a physician consists of the restoration of the equilibrium of the dhātus (16.29–38). 215

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Chapter seventeen, called kiyantaḥśirasīya, deals with a number of different subjects.

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The diseases of the head (śiroroga) are discussed first because the head is the chief part (uttamāṅga) of the body, being the place where the vital breaths (prāṇāḥ) and the senses are located (17.12). A long series of disorders affecting the head is enumerated (17.13–14). 216 The śirorogas in a restricted sense are five in number; they are caused by vāta, pitta, kapha, all the three doṣas together, and parasites (krimi) (17.15–29). 217 The same five types of heart disease (hṛdroga) are described (17.30–40). 218

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The total number of disturbances of the doṣas, with increase or decrease of one, two or three of them, and with combinations of increase and decrease, is sixty-two. These disturbances are classified into groups and their signs described (17.41–62). 219

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The signs of deficiency of the seven elements of the body (dhātu), 220 the seven impurities (mala) 221 and ojas 222 are listed; 223 ojas is characterized, followed by the causes of its decrease 224 (17.63–77). 225

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The causes of madhumeha are discussed; the seven kinds of boils (piḍakā), which arise when this disease is neglected, are described. 226 Their names are: śarāvikā, kac-chapikā, 227 jālinī, 228 sarṣapī, alajī, 229 vinatā and vidradhi (17.78–89). 230

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A more elaborate account of vidradhi (an abscess) follows. This disorder is of two types: external (bāhyā) and internal (ābhyantarī). 231 The causes of the internal type, the symptoms of its four doṣic varieties, the symptoms dependent on its location, and the curability or incurability of the varieties are dealt with (17.90–103). 232 The curability and incurability of all seven types of piḍakā is taken notice of (17.105–107). 233

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Other boils, independent of prameha, are also acknowledged (17.104 and 108–111). 234

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The movement (gati) of the doṣas is of three types: (1) decrease (kṣaya), constancy (sthāna) and increase (vṛddhi); (2) upward, downward and sideways movement; (3) location in the viscera, the branches of the body, and the vulnerable points, together with the joints (17.112–113). 235 A fourth type, dependent on the seasons, is added; it consists of accumulation (caya), excitement (prakopa) and pacification (praśama); 236 two varieties are distinguished: normal (prākṛtī) and abnormal (vaikṛtī) (17.114–118).

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Chapter eighteen, called triśothīya, gives an account of swellings (śotha). 237

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These disorders are caused by vāta, pitta and kapha; they are either endogenous (nija) or exogenous (āgantu) (18.3). The aetiology and symptomatology of these types are described (18.4–15). Varieties difficult to be cured are dealt with (18.16–17). The complications are enumerated (18.18). 238

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A long series of local swellings is described: upajihvikā (18.19), 239 galaśuṇḍikā (18.20), 240 galagaṇḍa (18.21), 241 galagraha (18.22), 242 visarpa (18.23), 243 piḍakā (18.24), 244 tilaka (18.25), 245 piplu (18.25), 246 vyaṅga (18.25), 247 nīlikā (18.25), 248 śaṅkhaka (18.26), 249 karṇamūlaśotha (18.27), 250 plīhābhivṛddhi (18.28), 251 gulma (18.29), 252 vṛddhi (18.30), 253 udara (18.31), 254 ānāha (18.32), 255 adhimāṃsa (18.33), 256 arbuda (18.33), 257 and rohiṇī (18.34–36). 258

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The classification of diseases is discussed again. Mild (mṛdu) and severe (dāruṇa) diseases are distinguished (18.37–47). 259

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Some functions of vāta, pitta and kapha are enumerated (18.48–53).

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Chapter nineteen, called aṣṭodarīya, 260 begins with enumerations of diseases of which there are eight to two varieties, one type only, or twenty varieties. The total number of these groups is forty-eight (19.3). The varieties belonging to each group are listed (19.4).

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There are eight varieties of udara, 261 mūtrāghāta, 262 kṣīradoṣa, 263 retodoṣa (defects of semen), 264 seven varieties of kuṣṭha, 265 piḍakā, 266 visarpa, 267 six varieties of atīsāra 268 and udāvarta, 269 five varieties of gulma, 270 plīhadoṣa, 271 kāsa, 272 śvāsa, 273 hikkā, 274 tṛṣṇā, 275 chardi, 276 bhaktānaśana, 277 śiroroga, 278 hṛdroga, 279 pāṇḍuroga, 280 unmāda, 281 four varieties of apasmāra, 282 akṣiroga, 283 karṇaroga, 284 pratīśyāya, 285 mukharoga, 286 grahaṇīdoṣa, 287 mada, 288 mūrchāya, 289 śoṣa, 290 klaibya, 291 three varieties of śotha, 292 kilāsa, 293 raktapitta, 294 two varieties of jvara, 295 vraṇa, 296 āyāma, 297 gṛdhrasī, 298 kāmalā, 299 āma, 300 vātarakta, 301 arśas. 302

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Diseases of one type only are ūrustambha, 303 saṃnyāsa, 304 and the major disease (mahāgada) called atattvābhiniveśa. 305

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Parasites (krimi) are of twenty kinds. 306 Twenty varieties of prameha 307 and yonivyāpad 308 are enumerated.

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Some diseases are not mentioned in the list; aśmarī, kṣatakṣīṇa and madātyaya are absent. 309 Remarkable is the classification of āyāma and gṛdhrasī, separate from the vāta diseases to which they belong, and of kāmalā, separate from pāṇḍuroga.

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The chapter ends with statements stressing that all the endogenous (nija) disorders arise from the three doṣas (19.5–6) and, finally, a verse on the connections between endogenous and exogenous disorders (19.7).

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Chapter twenty, called mahāroga, begins with an exposition on endogenous and exogenous diseases (20.3–7), 310 followed by the main seats of the doṣas (20.8).

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The larger part of the chapter is devoted to the nānātmaja disorders, 311 which are contrasted with those called sāmānyaja, 312 discussed in the preceding chapter. The nānātmaja disorders of vāta, pitta and kapha are enumerated, together with signs enabling a physician to determine which doṣa is disturbed in a particular disorder. The general management of disturbances of vāta, pitta and kapha is also dealt with.

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The nānātmaja disorders of vāta are eighty in number: 313 nakhabheda (cracking of nails), 314 vipādikā, 315 pādaśūla (piercing pain in the feet), 316 pādabhraṃśa, 317 pādasuptatā (insensibility of the feet), 318 vātakuṇḍatā, 319 gulphagraha, 320 piṇḍikodveṣṭana (cramps in the calves), 321 gṛdhrasī (sciatica), 322 jānubheda (tearing pain in the knees), 323 jānuviśleṣa (dislocation of the knee or kneecap), 324 ūrustambha (stiffness of the thighs), 325 ūrusāda (weakness of the thigh muscles), 326 pāṅgulya (lameness of the legs), 327 gudabhraṃśa (prolapse of the anus or rectum), 328 gudārti (proctalgia), 329 vṛṣaṇākṣepa, 330 śephastambha, 331 vaṅkṣaṇānāha, 332 śroṇibheda (a tearing pain in the pelvic region), 333 viḍbheda (loosening of faecal matter), 334 udāvarta, 335 khañjatva (limping), 336 kubjatva (kyphoscoliosis), 337 vāmanatva (dwarfism), 338 trikagraha (pain in the sacral region), 339 pṛṣṭhagraha (pain in the back), 340 pārśvāvamarda, 341 udarāveṣṭa (a constricting pain in the abdomen), 342 hṛnmoha (cardiac dysfunction), 343 hṛddrava, 344 vakṣa-uddharṣa, 345 vakṣa-uparodha, 346 vakṣastoda (a pricking pain in the thorax), 347 bāhuśoṣa (wasting of the arms), 348 grīvāstambha (stiffness of the neck), 349 manyāstambha (stiffness of the sternomastoid muscles), 350 kaṇṭhoddhvaṃsa (hoarseness), 351 hanubheda (tearing pain in the jaw), 352 oṣṭhabheda (fissures of the lips), 353 akṣibheda, 354 dantabheda, 355 dantaśailthilya (loose teeth), mūkatva (dumbness), 356 vākyasaṅga, 357 kaṣāyāsyatā (an astringent taste in the mouth), 358 mukhaśoṣa (dryness of the mouth), 359 arasajñatā (loss of taste), 360 ghrāṇaṇāśa (loss of smell), 361 karṇaśūla (piercing pain in the ears), 362 aśabdaśravaṇa, 363 uccaiḥśruti, 364 bādhirya (deafness), 365 vartmastambha (stiffness of the eyelids), 366 vartmasamkoca, 367 timira (loss of vision), 368 akṣiśūla (piercing pain in the eyes), akṣivyudāsa, 369 bhrūvyudāsa, 370 śaṅkhabheda (tearing pain in the temporal region), lalāṭabheda (tearing pain in the forehead), śiroruj (headache), 371 keśabhūmiṣpuṭana, 372 ardita (facial paresis), 373 ekāṅgaroga (monoplegia), 374 sarvāṅgaroga (tetraplegia), 375 pakṣavadha (hemiplegia), 376 ākṣepaka (convulsions), 377 daṇḍaka (a type of convulsions), 378 tamas, 379 bhrama, 380 vepathu (trembling), 381 jṛmbhā (yawning), 382 hikkā (hiccup), 383 viṣāda, 384 atiralāpa (very confused speech), 385 raukṣya, 386 pāruṣya, 387 śyāvāruṇāvabhāsatā, 388 asvapna (insomnia), 389 and anavasthitacittatva (mental instability) (20.11).390

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This list of vāta disorders is of a mixed character; some are vāta diseases and described as such (Ca.Ci.26), some are found in lists of symptoms brought about by vāta.391 Moreover, the list is incomplete, because many more types of śūla, etc., are known than those enumerated in it.392 Nevertheless, the eighty vāta disorders have become an established element of āyurvedic doctrine and are found in many later treatises.393

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The forty nānātmaja disorders of pitta are: 394 oṣa, 395 ploṣa, 396 dāha, 397 davathu, 398 dhūmaka, 399 amlaka, 400 vidāha, 401 antardāha (a burning sensation in chest and belly), 402 aṃsadāha (a burning sensation in the shoulder region), ūṣmādhikya (a high body temperature), atisveda (excessive perspiration), 403 aṅgagandha (a foul body odour), aṅgāvadaraṇa, 404 śoṇitakleda, 405 māṃsakleda, 406 tvagdāha (a burning sensation in the skin), tvagavadaraṇa (desquamation), 407 carmadalana (excoriation), 408 raktakoṭha (red weals), 409 raktavisphoṭa (red vesicles), 410 raktapitta, 411 raktamaṇḍala (round erythematous patches), 412 haritatva (a greenish colour), 413 hāridratva (a yellow colour), nīlikā (dark moles), 414 kakṣā (herpes zoster), 415 kāmalā (jaundice), 416 tiktāsyatā (a bitter taste in the mouth), 417 lohitagandhāsyatā, 418 pūtimukhatā (foetor oris), tṛṣṇādhikya (excessive thirst), 419 atṛpti (absence of satisfaction after a meal), 420 āsyavipāka (stomatitis), 421 galapāka (pharyngitis), akṣipāka (inflammation of the eyes), gudapāka (inflammation of anus and rectum), 422 meḍhrapāka (inflammation of the penis or the urethra), jīvādāna,423 tamaḥpraveśa (loss of consciousness),424 and haritāḥaridranetramūtravarcastva (a greenish or yellow colour of eyes, urine and faeces) (20.14).

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The twenty disorders of kapha are:425 tṛpti (absence of appetite),426 tandrā (drowsiness),427 nidrādhikya (excessive sleep), staimitya,428 gurugātratā (a feeling of heaviness in the limbs),429 ālasya,430 mukhamādhurya (a sweet taste in the mouth),431 mukhasrāva (an excess of salivation), śleṣmodgiraṇa (the expectorator of phlegm), malasyādhikya (an excess of secretion and excretion),432 balāsaka,433 apakti (a deficient digestion), hṛdayopalepa,434 kaṇṭhopalepa (an increased production of phlegm in the throat),435 dhamanīpraticaya,436 galagaṇḍa (goitre),437 atisthaulya (excessive obesity), śītāgnitā (sluggishness of the digestive fire),438 udarda (urticaria),439 śvetāvabhāsatā (a white lustre of the skin),440 and śvetamūtranetravarcastva (a white colour of urine, eyes and faeces) (20.17).

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These pitta and kapha disorders are, like those by vāta, of a mixed character. Their enumeration is not exhaustive.441 Related lists are found in many treatises.442

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Chapter twenty-one, called aṣṭauninditīya, is about discreditable (nindita) physical conditions in patients.

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Eight types are enumerated: persons who are too tall or too short, too hirsute or too smooth, too dark or too light in colour, too obese or too lean (21.3).

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The last two types are discussed in detail; the causes of these conditions are described, their characteristics, physiology, the diseases they lead to, and their treatment (21.4–34).443

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The second part of the chapter is devoted to sleep,444 in particular sleeping during the day, which is beneficial in lean, harmful in obese patients. Rules concerning sleeping at night and during the day are formulated (21.35–57).445 Six types of sleep are distinguished: caused by tamas, kapha, fatigue; exogenous factors, diseases and the night (21.58–59).446

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Chapter twenty-two, called laṅghana-bṛṃhaṇīya, gives an account of six basic forms of treatment (ṣaḍupakrama; 22.44), which consist of reducing (laṅghana), roborant (bṛṃhaṇa) and desiccating (rūkṣaṇa) measures, oleation (snehana), sudation (svedana), and checking (stambhana).447 The theory underpinning these treatments is discussed (22.9–17),448 the medicinal substances employed in them, their indications, the signs of their proper and improper application, etc. (22.18–43).449

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Chapter twenty-three, called saṃtarpaṇīya, is concerned with nourishing (saṃtarpaṇa) and depleting (apatarpaṇa) treatments.

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The causes, signs and effects of overnutrition (saṃtarpaṇa) and undernutrition (apatarpaṇa) are described. Saṃtarpaṇa is counteracted by apatarpaṇa, apatarpaṇa by saṃtarpaṇa.

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Chapter twenty-four, called vidhiśoṇitīya, deals with blood (śoṇita, rakta, rudhira) and some related topics.

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Pure (śuddha)450 blood is described (24.3–4), the causes of corruption (duṣṭi) of the blood (24.5–10), and the disorders brought about by corrupted blood (24.11–16).451 Diseases which, although being curable, do not subside by means of the usual methods, should be diagnosed as caused by blood (24.17)452 and be treated by specific procedures, consisting of purgation, fasting and bloodletting (śoṇitasrāvaṇa) (24.18). The signs of corruption of the blood by vāta, kapha, pitta and all three doṣas together are described (24.20–21), the characteristics of pure blood (24.22),453 rules for bloodletting, its after-treatment, and the signs pointing to success (24.19, 23–24).

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The four doṣic varieties of the disorders called mada (intoxication)454 and mūrcchāya (fainting)455 are discussed. These disorders arise when the channels (srotas) transporting blood, rasa and conscious perception (saṃjñā) are obstructed by the doṣas. Mada is of three types: caused by alcoholic drinks, poisons and blood. Both mada and mūrcchāya subside spontaneously, without treatment (24.25–42).456

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Saṃnyāsa (prolonged loss of consciousness)457 has the same origin as mada and mūrcchāya, but does not disappear without treatment (24.42–53).

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Therapeutic measures which are helpful in counteracting mada and mūrcchāya are described at the end of the chapter (24.54–58).458

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Chapter twenty-five, called yajjaḥpuruṣīya, begins with a discussion among a group of sages459 about the origin (prāgutpatti) of man (puruṣa), who consists of an aggregate of ātman, the senses (indriya), manas, the objects of the senses and the multitude (rāśi) of his diseases (25.4).

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Vāmaka, king of Kāśī, inquires whether the origin of man is the same as that of his diseases. Pārīkṣi Maudgalya brings forward that, as the puruṣa arises from ātman, the diseases also arise from it. Śaraloman disagrees; in his view, manas, also called sattva, when pervaded by rajas and tamas, is the basis of the human body and its diseases. Vāryovida contradicts him, being convinced that rasa is to be regarded as the prime cause. Hiraṇyākṣa says that the puruṣa originates from the six dhātus, as expounded by the ancient Sāṃkhyas.460 Kauśika proposes that a human being originates from his parents, who also transmit the diseases inherent in the human condition. The puruṣa and his diseases are a product of karman in Bhadrakāpya’s eyes, but of svabhāva in Bharadvāja’s opinion. Kāṅkāyana posits Prajāpati as the prime cause, bhikṣu Ātreya regards kāla (time) as such.461 At the end of this discussion, Ātreya Punarvasu declares that all the entities (bhāva) that generate a human being, when suitably combined, cause his disorders when this suitable combination is interfered with (25.5–29).462

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Vāmaka then asks Ātreya about the underlying cause of these suitable (sampad) and unsuitable (vipad) combinations. Ātreya replies that wholesome food makes the puruṣa develop, whereas unwholesome food leads to diseases. Agniveśa is desirous of knowing how these two types of diet may be defined. Ātreya gives these definitions and proceeds with a long excursion about diet (25.30–35).

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Articles of food (āhāra) are of one kind regarded as food, of two kinds with respect to their source: of vegetable and animal origin; they are of two kinds as to their effect: wholesome (hita) and unwholesome (ahita), of four kinds with regard to their way of intake: drinkable (pāna), eatable (aśana), chewable (bhakṣya) and suitable to be licked (lehya),463 of six kinds according to their taste, and of twenty kinds according to their properties (25.30–35).464

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The most wholesome465 and unwholesome among groups of articles of diet are enumerated (25.38–39),466 followed by a list of one hundred and fifty-two drugs, remedial measures and other items considered to be foremost (agrya) among those constituting a particular group (25.40–41).467

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Some verses about what is wholesome (pathya) and unwholesome (apathya) conclude this section.

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The last part of the chapter is about fermented pharmaceutical preparations called āsava.468 Eighty-four varieties are enumerated, distinguished into eight groups according to their source: cereals (dhānya; six items), fruits (twenty-six items),469 roots (eleven items), heart-woods (sāra; twenty-items), flowers (ten items), stems (kāṇḍa; four items), leaves (two items), barks (tvac; four items), and śarkarā (one item).470 The uses of āsavas are explained (25.48–50).

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Chapter twenty-six, called ātreyabhadrakāpyīya,471 begins with a discussion among a group of sages472 in the Caitraratha grove about the number of tastes (rasa) to be distinguished.473

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Bhadrakāpya advances that there is only one taste, not different from that of water.474 The brāhmaṇa Śākunteya distinguishes two tastes, chedanīya475 and upaśamanīya,476 Pūrṇākṣa Maudgalya three tastes, chedanīya, upaśamanīya and an intermediate one (sādhāraṇa). Hiraṇyākṣa Kauśika prefers a number of four tastes: palatable (svādu) and wholesome (hita), palatable and unwholesome, unpalatable and wholesome, unpalatable and unwholesome. Five tastes, derived from the five mahābhūtas, are acknowledged by Kumāraśiras Bharadvāja. The royal sage Vāryovida recognizes six tastes: guru (heavy), laghu (light), śīta (cold), uṣṇa (hot), snigdha (oleaginous), rūkṣa (dry). Nimi, the king of Videha, has a predilection for seven tastes: madhura (sweet), amla (acid), lavaṇa (salty), kaṭu (pungent), tikta (bitter), kaṣāya (astringent), and kṣāra (alkaline), while Baḍiśa Dhāmārgava opts for eight tastes, adding avyakta (indistinct) to the series of Nimi. Kānkāyana, the physician from Bāhlīka, claims that the tastes are innumerable (26.3–8).

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Ātreya Punarvasu decides that there are six tastes: madhura, amla, lavaṇa, kaṭu, tikta and kaṣāya. Their common source (yoni) is water. Chedana and upaśamana are actions of the tastes; the same applies to sādhāraṇa. Palatability and unpalatability depend on subjective preferences (bhakti); wholesomeness and unwholesomeness are effects of prabhāva (specific action). The products (vikāra) of the five mahābhūtas form the substratum of the tastes. The six tastes of Vāryovida are qualities (guṇa) of substances (dravya). Kṣāra is a substance, endowed with a number of tastes. Indistinctness is found in the source of the tastes (i.e., water) and in (substances) with an after-taste (anurasa) (26.9).

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The properties and actions of (medicinal) substances in which one of the five mahābhūtas predominates are described (26.10–12),477 followed by a verse on the factors which make a (medicinal) substance active (26.13).478

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The next section (26.14–44) is devoted to the tastes, a series of properties (guṇa), and the relationships between the tastes and the mahābhūtas.

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Sixty-three combinations of tastes are distinguished;479 these combinations become innumerable if the after-tastes (anurasa) are also taken into consideration. Taste and after-taste are defined.480 Successful treatment depends on the proper administration of drugs with a particular combination of tastes (26.14–28).

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The list of ten guṇas481 consists of paratva (superiority), aparatva (inferiority),482 yukti,483 saṃkhyā (number), saṃyoga (conjunction),484 vibhāga (disjunction),485 pṛthaktva (separateness),486 parimāṇa (measurement), saṃskāra (processing),487 and abhyāsa (repetitive practice) (26.29–35).

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The relationships between the six tastes and the five mahābhūtas are discussed (26.39–41).488

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The properties and actions of each of the six tastes are elaborately described (26.43),489 followed by relationships between tastes on the one hand, vīrya, guṇa and karman on the other; exceptions to general rules are given; the three degrees of the six chief properties (guṇa) with regard to the tastes are discussed (26.45–56).490

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Vipāka (post-digestive taste) is dealt with; kaṭu, tikta and kaṣāya are transformed into kaṭu, amla remains amla, madhura and lavaṇa are madhura after digestion; three degrees of vipāka are distinguished (26.57–63).491

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Vīrya is taken account of; the number of vīryas is either eight: mṛdu (soft), tīkṣṇa (sharp), guru (heavy), laghu (light), snigdha (oleaginous), rūkṣa (dry), uṣṇa (hot) and śīta (cold), or two only: śīta and uṣṇa (26.64–67).492

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Prabhāva (specific action) is described as a property which cannot be explained, being beyond reasoning (acintya) (26.68–71).493

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Vipāka is declared to be stronger than rasa, vīrya overcomes vipāka, and prabhāva is even stronger than vīrya (26.72).494

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Actions of the tastes are mentioned again (26.74–79).495

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After this long exposition of Ātreya, Agniveśa asks him to give an account of disagreeing (vairodhika) articles of food.496 Ātreya, complying with this request, says that substances may be antagonistic to constituents (dhātu) of the body due to their properties, combination, processing, nature (svabhāva), etc. As an example he mentions the combination of fish and milk. Bhadrakāpya objects, asserting that milk may freely be taken together with fish, the fish called cilicima excepted (26.80–83).497

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