A History of Indian Medical Literature v1.c9: Chapter 2

A History of Indian Medical Literature v1.c9

Language: English

Chapter 2 v1.c9.1

Chapter one is devoted to the nidāna¹ of fever (jvara).

The general features of nidāna are discussed first: the synonyms of nidāna² and its three types: asātmyendriyārthasaṃyoga, prajñāparādha and pariṇāma;³ the classification of diseases into three groups: āgneya (= caused by pitta), saumya (= caused by kapha) and vāyavya (= caused by vāyu), to which the rājasa and tāmasa diseases are added; the synonyms of vyādhi (disease); the five means to acquire knowledge (upalabdhi) about a disease: nidāna, pūrvarūpa, liṅga, upaśaya and saṃprāpti;⁴ the synonyms of pūrvarūpa (prodrome),⁵ liṅga (symptom),⁶ upaśaya (therapeutic diagnosis)⁷ and saṃprāpti (onset);⁸ the subdivisions of saṃprāpti: saṃkhyā (number), prādhānya (predominance), vidhi (type), vikalpa (proportional variation), and balakāla (the time of aggravation); definitions of saṃkhyā,⁹ prādhānya,¹⁰ vidhi,¹¹ vikalpa,¹² and balakāla¹³ (1.3–12).

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Reference is made to the eight diseases which will be discussed in the Nidānasthāna. These diseases arose from lobha (greed), abhidroha (malice) and kopa (anger).¹⁴ Their treatment will also be described, but only summarily, because this subject will be dealt with in extenso in the Cikitsāsthāna (1.15).

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Jvara (fever)¹⁵ is described first, because it was the earliest somatic¹⁶ disease to appear among living beings (1.16).¹⁷

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Eight types of fever are to be distinguished:¹⁸ caused by vāta, pitta, kapha, the three combinations of two doṣas, the three doṣas together, and exogenous factors (āgantu) (1.17).¹⁹ The doṣic types are described (1.18–29).²⁰ An āgantu (exogenous) fever is brought about by abhighāta (injury),²¹ abhiṣaṅga (intense emotions and possession by malignant beings), abhicāra (sorcery), and abhiśāpa (curses) (1.30). Various classifications of fevers are mentioned (1.32).²² The prodromes of fever are described (1.33).²³ General features of fever as an affliction occurring in all living beings are dealt with; its first origin from Maheśvara’s anger is referred to (1.35).²⁴ The treatment of fever is succinctly discussed (1.36–40).

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Chapter two is about raktapitta (blood-bile, i.e., haemorrhagic disorders).²⁵

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The subjects dealt with are: the nidāna and saṃprāpti of raktapitta; the meaning of the term raktapitta (2.3–5);²⁶ the prodromes (2.6);²⁷ the complications (upadrava; 2.7);²⁸ the characteristics of the upwards (ūrdhvabhāga) and downwards (adhobhāga) moving types, and of the type following both pathways (2.8);²⁹ the first appearance of raktapitta in the wake of the destruction of Dakṣa’s sacrifice (2.10);³⁰ the curability of the upwards moving type, palliability of the downwards moving type, incurability of the type moving along both pathways; characteristics of these types, and the possibilities of treatment (2.9 and 11–27).31

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Chapter three is concerned with gulma (visceral swellings).32

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The subjects dealt with are: the five types of gulma, caused by vāta, pitta, kapha, all three doṣas together, and blood (3.3);33 knowledge about these types, to be acquired from their aetiology, prodromes, symptoms, types of pain (vedanā)34 and upaśaya (3.5); the aetiology, symptoms, types of pain and upaśaya of the four doṣic types (3.6–12);35 gulma caused by blood (raktagulma), a disorder only occurring in women,36 characterized by symptoms simulating pregnancy (3.13–14);37 the general prodromes of gulma (3.15); general rules about the treatment of gulma (3.16).

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Chapter four is concerned with prameha (urinary disorders).38

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The subjects dealt with are: generalities about the origin of prameha and its becoming manifest (4.3–4);39 the aetiology of prameha brought about by kapha (4.5); the constituents of the body (dūṣya) which are corrupted in prameha: medas,40 māṃsa (muscular tissue), śarīrajakleda (body-fluids), śukra (semen), śoṇita (blood), vasā (muscle fat),41 majjā (bone marrow), lasīkā (serous fluid),42 rasa (nutrient fluid), and ojas (4.7); the saṃprāpti of prameha due to kapha (4.8); kapha and medas, after their transformation into urine, give rise to ten kinds of prameha, due to their association with ten properties (guṇa) of kapha; these ten properties are: śveta (white), śīta (cold), mūrta (thickly viscous), picchila (thinly mucous), accha (transparent), snigdha (oily), guru (heavy), madhura (sweet), sāndraprasāda (clear), and manda (slowly flowing);43 the ten kinds of kaphajaprameha are connected with one or more of these properties (4.9);44 these ten pramehas are: udakameha,45 ikṣuvālikārasameha,46 sāndrameha,47 sāndraprasādameha,48 śuklameha,49 śukrameha,50 śītameha,51 si-katāmeha,52 śanairmeha,53 and ālālameha54 (4.10);55 the curability of these ten disorders (4.11);56 descriptions of these ten pramehas (4.13–22);57 the aetiology of the six kinds of prameha arising from pitta; their names: kṣārameha,58 kālameha,59 nīlameha,60 lohitameha,61 māñjiṣṭhameha,62 and hāridrameha;63 the six properties of pitta, associated with them: kṣāra (alkaline), amla (acid), lavaṇa (salty), kaṭuka (pungent), visra (smelling after raw meat), and uṣṇa (hot)64 (4.24–26); the palliability of the pittaja pramehas (4.27);65 descriptions of these six pramehas (4.29–34);66 the aetiology and saṃprāpti of prameha due to vāta; the four kinds, called vasāmeha,67 majjāmeha,68 hastimeha69 and madhumeha,70 arise when the vasā, majjā, lasīkā and ojas are corrupted by vāta (4.36–37); the incurability of these disorders (4.38);71 descriptions of these four pramehas (4.41–44);72 the general prodromes of prameha (4.47);73 its complications (4.48);74 a succinct statement on the treatment of prameha (4.49).

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Chapter five is devoted to kuṣṭha (skin diseases, including leprosy).75

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The subjects dealt with are: the seven constituents of the body which, when they are subject to pathological changes (vikṛti), lead to kuṣṭha: the three doṣas and four elements of the body (dūṣya, dhātu): tvac (the layers of the skin), māṃsa (muscular tissue), śoṇita (blood) and lasīkā (serious fluid) (5.3);76 seven, eighteen or innumerable varieties of kuṣṭha can be distinguished, which differ in several respects, but only seven of these will be described (5.4);77 these varieties are characterized by the predominance of one, two or three doṣas: vāta predominates in kapālakuṣṭha, pitta in audumbara, kapha in maṇḍalakuṣṭha; vāta and pitta predominate in ṛṣyajihva, pitta and kapha in puṇḍarīka, 78 kapha and vāta in sidhmakuṣṭha, all three doṣas in kākaṇaka (5.5);79 the aetiology and samprāpti of all kinds of kuṣṭha (5.6);80 their prodromes (5.7);81 descriptions of the seven (mahā)kuṣṭhas (5.8); their curability, etc., and their complications (5.9–11).82

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Chapter six is devoted to śoṣa83 (wasting diseases).84

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The subjects dealt with are: the aetiology and onset of śoṣa; its four causes: inconsiderate behaviour (sāhasa),85 suppression of natural urges (saṃdhāraṇa), deficiency of the rasa (nutrient fluid) staying in the heart, deficiency of the semen, and an unbalanced diet (viśamāśana) (6.3–11);86 śoṣa, the most troublesome of all diseases, is also called rājayakṣman (kingly consumption),87 because the venerable Soma, the king of the asterisms (uḍurāja), was afflicted by it in ancient times88 (6.12);89 the prodromes (6.13);90 the eleven symptoms (6.14);91 curable and incurable forms of the disease (6.15–16).92

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Chapter seven is devoted to unmāda (insanity).93

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It deals with the following subjects: the five types of this disease: caused by vāta, pitta, kapha, all three doṣas together, and exogenous factors (āgantu) (7.3);94 the persons in whom insanity may arise when the excited doṣas go to the heart and obstruct the channels carrying the manas (7.4);95 a definition of unmāda (7.5);96 the prodromes (7.6);97 the symptoms of insanity caused by vāta, pitta, kapha and all three doṣas simultaneously (7.7);98 the treatment of the three curable types (caused by one doṣa) (7.8–9);99 the exogenous type, basically caused by errors in judgment (prajñāparādha), but aggravated due to possession by gods, demons, etc.;100 the prodromes of possession (bhūtonmāda); the ways in which it is initiated (ārambhaviśeṣa);101 its symptoms; the circumstances making one susceptible to possession (abhighātakāla); the three objectives (prayojana) of beings who may induce possession: hiṃsā (violence), rati (pleasure), abhyarcana (worship);102 treatment (7.10–16); combinations of endogenous and exogenous insanity (7.18); insanity is always the result of one’s own deeds and should not (primarily) be attributed to (possession by) gods, demons, etc. (7.19–23).103

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Chapter eight, on apasmāra (epilepsy) and a number of other subjects is concerned with: the four types of epilepsy:104 caused by vāta, pitta, kapha and all three doṣas together (8.3);105 persons susceptible to apasmāra; its samprāpti (8.4);106 a definition of apasmāra (8.5);107 the prodromes (8.6);108 the symptoms of the four doṣic types (8.8);109 the secondary involvement (anubandha) of an exogenous factor (8.9);110 treatment (8.10).

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The diseases which arose in the wake of the destruction of Dakṣa’s sacrifice111 are mentioned; gulma, prameha, kuṣṭha, unmāda, apasmāra, jvara, raktapitta and rājayakṣman (8.11).112

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A disease may serve as the cause of another disease, in which case it is called nidānarthakara or hetvarthakārin; diseases may present themselves as such and remain in that condition, or mainly as the cause of another disease, or they may do both (8.16–23). One cause may lead to one or to several disorders; one disorder may be brought about by diverse factors, and the same factors may also give rise to various diseases (8.24–26). A particular symptom may occur in one disease or many diseases; numerous symptoms are common to various diseases (8.27–29). The same principles apply to treatment; a particular measure may be useful in one or many disorders; one disorder may require one or several measures (8.30–32). The chapter ends with some verses on general aspects of therapy (8.33–41).

Linked texts (1)

Carakasaṃhitā — Agniveśa (Āyurveda) & Caraka, Sanskrit