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A History of Indian Medical Literature v3.c42.s6: Special features

A History of Indian Medical Literature v3.c42.s6

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Special features

v3.c42.s6.1

Suppression (dhāraṇa) of the urges (vega) of pitta and kapha is described (Sū.6.5); 95 the urges of hunger, thirst and heavy breathing due to exercise are left unmentioned. 96 The drinking of water before or during a meal is advised against (Sū.6.43–44). The rule concerning the use of triphalā with every meal differs from the prescription in the *Carakasaṃhitā* (Sū.8.19). 97 The main properties of the mahābhūtas are slightly different (Sū.9.15cd–16). 98 The three types of digestion are characterized by three types of eructation (udgāra; Sū.10.13–14ab). The list of disorders arising from corruption of the element rasa disagrees with Caraka's list. 99 The same applies, to a varying degree, to the lists of disorders arising from corruption of blood, fatty tissue, bone marrow, and semen. 100 The *Bhelasaṃhitā* adds a series of disorders due to abnormalities during pregnancy. 101 The disorders brought about by corruption of other constituents of the body, described by Caraka, 102 are omitted by Bhela.

v3.c42.s6.2

Bhela permits the combination of milk and fish, with the exception of the fish called cilicima (Sū.12.7–8). 103 The janapadavibhakṭīya chapter (Sū.13), concerned with feeding habits and diseases prevalent in particular regions, has no counterpart in a separate chapter of the *Carakasaṃhitā*. 104 Rainy periods are described as dangerous and having a high incidence of disease (janamāra; Sū.13.8–9). The names of fever in various animals are enumerated (Sū.13.11–13). The disease called batālīkā, unknown from other sources, is described as a risky ailment, requiring urgent treatment; its main symptom is the appearance of boils (piṭakā) in the armpits, groins, and elsewhere (Sū.13.14cd–18). 105 Bhela's ten abodes of prāṇa (prāṇāyatana; Sū.17.1–2) disagree with Caraka's list (Sū.29.3). 106 The preparation called yavāgū is said to be of eight types, while wholesome articles of food are twelve in number (Sū.17.6). The description of the heart (Sū.20.5–6) resembles that found in the *Suśrutasaṃhitā* (Śā.4.32). Eight types of sudation (sveda) are described (Sū.22), 107 whereas Caraka has a larger number (Sū.14). Disorders brought about by obstipation (gādhapuriṣa) are described (Sū.23.1–5), as well as disorders which occur when bile affects one of the seven bodily elements (Sū.25.25cd–29ab). Two varieties of pṛṣṭharoga 108 are mentioned (Sū.26.6); their names are upakṣārin and kṣārin (Sū.26.27ab). 109 Six varieties of kāca, liṅganāśa and timira are mentioned, distinguished by their colours (Sū.26.1 and 9). 110 Five causes of baldness (khālitya) and turning grey (palita) are distinguished (Sū.26. 10–11). 111 Bhela acknowledges five varieties of arbuda (Sū.26.12), 112 mukharoga (Sū.26.13), 113 bhagandara (Sū.26.14), 114 and granthi (Sū.26.17), 115 four varieties of abhiṣyandā and adhimantha (Sū.26.18), 116 klaibya (Sū.26.19), 117 eye diseases (Sū.26.20), 118 upadamśa (Sū.26.21), 119 āsrāva (Sū.26.22), 120 pipāsā (Sū.26.23), 121 rohiṇikā (Sū.26.24), 122 and arman (Sū.26.25). 123 Three types of alaī are mentioned (Sū.26.28ab) 124 and also three types of vidradhi (Sū.26.28ab). 125

v3.c42.s6.3

Seven forms of sātmya are acknowledged (Sū.26.30cd–31ab), connected with one of the six tastes or all of them. 126 Seven types of ślīpada are referred to (Sū.26.7). 127 Twenty kinds of parasites (kṛmi) are enumerated (Sū.26.31cd–33). 128

v3.c42.s6.4

Two main categories of prameha are described: prakṛtiprabhava or sahaja, and sakṛta or janmottarāja (Ni.6.1–6). 129 A variety of unmāda caused by poison is absent, as it is from the Carakasamhitā. 130 The āgantuja type of unmāda does not include mental disorders caused by intense emotions, which are classified as mada, distinct from unmāda. 131 The Nidāna chapter on unmāda denies that insanity may be the result of possession by supernatural beings (7.10). The Nidāna chapter on epilepsy (apasmāra) relates that an attack comes about when one or more of the doṣas seize the ten vessels located above the heart, and obstruct the pathway of the mind (Ni.8.3 and 8). 132 A supernatural aetiology of apasmāra is rejected (Ni.8.13). 133

v3.c42.s6.5

An intensely burning digestive fire (tīkṣṇāgni) is attributed to the combined action of vāta and pitta (Vi.3.5). 134 Three types of vipāka are mentioned: madhura and amla during the digestive process, kaṭu at the end of it (Vi.3.12). 135 Ten dehanibandhanas are enumerated (Vi.3.17). 136 The chapter on the constitutions (prakṛti) mentions seven cosmic constituents, also called prakṛti, consisting of avyakta, have the five mahābhūtas, to which svabhāva 137 and kāla, the five senses, the five kinds of objects of the senses, and five kinds of buddhi are added (Vi.4.10–11). 138

v3.c42.s6.6

The mental state of the parents during intercourse determines whether the child will be of a sāttvika, rājasa or tāmasa nature (Śā.3.17–20). 139

v3.c42.s6.7

The five types of pitta are described (Śā.4.3–9). 140 Two kinds of ālocakapitta are distinguished: cakṣurvaiśeṣika, engaged in gross visual perception, and buddhivaiśeṣika, located between the eyebrows and engaged in subtle visual perception (Śā.4.4–5). 141

v3.c42.s6.8

The description of the digestive fire (kāyāgni; jāṭharāgni) mentions a somamaṇḍala (lunar disc) in the centre of the navel, having a sūryamaṇḍala (solar disc) within it, while in the centre of the latter the digestive fire is located (Śā.4.11cd–12). 142 The size of the abdominal fire in various animals is said to depend on their body size (Śā.4.16–17ab). 143 The main task of a physician (kāyacikitsaka) consists of the treatment of disorders of the digestive fire (Śā.4.17cd–18ab). 144 The view that the heart is the first part of an embryo to develop is attributed to Parāśara (Śā.4.30). 145

v3.c42.s6.9

The view that epilepsy (apasmāra) is caused by supernatural beings is categorically rejected (Śā.4.29). 146 Rasa is considered to be the most important bodily constituent (Śā.4.33). Twelve seats of ojas and tejas (i.e., the fiery element) are enumerated (Śā.5.

v3.c42.s6.10

1). Four classes (yoni) of living beings are distinguished: jarāyuja (placentals), aṇḍaja (oviparous), udbhijja (germinating), and svedaja (engendered by moisture) (Śā.5.2). 147 The embryo is thought to develop out of six elements (kāya), 148 namely the five mahābhūtas and rasa (Śā.5.10). The puruṣa is described as śaddhātu, i.e., composed of the five bhūtas, together with brahman, which is avyakta (Śā.5.11). 149 Seven varieties of divine (divya) and seven of human (mānuṣa) character types (kāya) are described (Śā.5. 15–25). 150

v3.c42.s6.11

The six layers of the skin (Śā.7.1) are identical with those of the Carakasamhitā. 151 The osteological system shows some peculiarities (Śā.7.2). 152

v3.c42.s6.12

The list of viscera (koṣṭhāṅga; Śā.7.4) omits the pakvāśaya. 153 The list of pratyaṅgas (Śā.7.5) differs from Caraka's enumeration; 154 the items listed are: two gulphas (ankles), 155 two nitambas, 156 two jaṅghās (legs), 157 two piṇḍikās (calves), two ūrupiṇḍikās, 158 two parts called sphic, 159 two vṛṣaṇas (testicles), the śepha(s) (penis), two śaṅkhas (temples), 160 two vaṅkṣaṇas (groins), two kukundaras, 161 the basti (bladder), 162 the śīrṣa (head), 163 the udara (abdomen), two stanas (breasts), two bāhus (arms), 164 two amsakas, 165 the cubuka (chin), two oṣṭhas (lips), two dantaveṣṭas (gums), two sṛkkaṇīs (corners of the mouth), the tālu (palate), the galaśuṇḍikā (uvula), two karṇas (ears), two karṇaśāṣkulikās, 166 two gaṇḍas (cheeks), two akṣikūṭas, 167 four parts called akṣivartman (eyelids), and two akṣis (eyes). The transmigration of the ātman is discussed (Śā.7.7), as it is in the Carakasamhitā. 168 The human body is said to contain one añjali of mastiṣka and śukla. 169 The list of sixteen adhyātmadevatās, who preside over bodily and mental functions (Śā.7.8), disagrees with the corresponding list of the Carakasamhitā; 170 Bhela's list consists of: agni, pṛthivī, āpaḥ, ākāśa, vāyu, 171 vidyut, 172 Parjanya, 173 Indra, gandharva, Mṛtyu, 174 Āditya, Candramas, 175 Tvaṣṭar, 176 Viṣṇu, 177 Prajāpati, and Brahmā.

v3.c42.s6.13

Religious elements in the treatment of fevers are mentioned (Ci.1.46–51; 2.39–41): paying homage to Vṛṣabhadhvaja, i.e., Śiva (1.46; 178 2.40) and Bhūtādhipati (2.40), as well as the recitation of Vedic mantras (1.49); the exorcist (bhūtavaidya) 179 should employ the caṇḍakarman 180 characteristic of bhūtavidyā (1.50). A series of opinions on the aetiology of irregular fevers (viṣamajvara) is referred to, rejected by Bhela, who asserts that they are caused by saṃnipāta (2.1–5). These fevers are thought to corrupt bone marrow, osseous tissue and fatty tissue on the first day, muscular tissue and blood on the second day, kapha and vāta on the third day, pitta on the fourth day (Ci.2.6–7). Religious elements are mentioned again in the treatment of irregular fevers: paying homage to Acyuta, i.e., Viṣṇu (2.40), and Vṛṣabhadhvaja, i.e., Śiva (2.40), as well as measures belonging to the realm of bhūtavidyā (2.41).

v3.c42.s6.14

The Bhelasaṃhitā records that yakṣman or śoṣa presents either six or eleven symptoms (Ci.4.7ab). 181 Nine incurable types of kuṣṭha, caused by one's karman, are described: puṇḍarīka, śvitra, ṛṣyajihva, kākaṇa, audumbara, śatāruṣka, carmakuṣṭha, ekakuṣṭha, and vaipādika, as well as nine curable types, caused by the doṣas: sidhma, vicarcikā, pāmā, dadru, kiṭika or kiṭiba, kapālakuṣṭha, sthūlāru, maṇḍala, and viṣaja (Ci.6.18cd–38). 182 The chapter on the treatment of prameha (Ci.7) refers to the following varieties: ikṣumeha, 183 udakameha (also called ambu- and vārimeha), 184 sāndrameha, 185 bhasmameha, 186 lavaṇameha, 187 sikatāmeha, śuklameha, kṣārameha, śītameha, raktameha, nīlameha,¹⁸⁸ and hastimeha (also called gajameha).¹⁸⁹

v3.c42.s6.15

The description of the pathogenesis of insanity (unmāda) is remarkable; the Bhelasaṃhitā regards it as a process in which the doṣas, seated in the space between palate and skull, first affect the manas, then the citta,¹⁹⁰ and finally the buddhi (Ci. 8.10–12ab). Possession (bhūtonmāda) is mentioned,¹⁹¹ but not given much attention to. The Bhelasaṃhitā seems to accept a division of labour between physicians and exorcists; the chapter on the treatment of insanity explicitly states that it is the task of physicians to prescribe drugs to patients with mental disorders, whereas the bhūtacikitsaka, the exorcist, should occupy himself with the religious treatment (Ci. 8.33),¹⁹² Less serious mental disorders, which may eventually develop into insanity, are designated by the term mada (Ci.8.12cd–18).¹⁹³

v3.c42.s6.16

The chapter on the treatment of epilepsy (apasmāra) contains a second version, different from that in the Nidānasthāna, of the pathogenesis (samprāpti) of this disorder, described in the following way: when the mind (citta), due to various causes, is disturbed, the heart becomes desiccated; subsequently, vāta obstructs the bodily heat (ūṣman) and reaches the channel (nāḍī) which transports water; the person, suffering from this ailment, is oppressed by thirst, becomes confused, and develops epilepsy (Ci. 9.2–4). The involvement of bhūtas in the causation of epilepsy is not mentioned, which is no matter of surprise, because an involvement has been rejected categorically on previous occasions.¹⁹⁴

v3.c42.s6.17

The āma variety of diarrhoea (atīsāra) is considered to belong to the kapha type of this disease (Ci.10.11).¹⁹⁵ Varieties of diarrhoea caused by fear (bhaya) and grief (śoka) are described (Ci.10.42–43).¹⁹⁶ The chapter on diarrhoea deals with viṣūcī, vilambikā and ālasa (Ci.10.50–59).¹⁹⁷ It is also concerned with annavibhrama (Ci.10. 60),¹⁹⁸ and, curiously, with ardita (facial paresis), which is a vāta disease. A variety of ardita, caused by vāta obstructed by kapha (śleṣmopastabdhārdita), is separately discussed (Ci.10².10–12ab).¹⁹⁹

v3.c42.s6.18

The chapter on grahaṇī refers to the digestive fire as the basis of a person's life span (āyus) and the seat of the prāṇas (Ci.11.1); it enumerates the diseases to which grahaṇīdoṣa may give rise (Ci.11.9–11); the disorders of the digestive fire are also mentioned (Ci.11.12–1). The chapter on mūtrakṛcchra (Ci.12) probably also dealt with mūtrāghāta and aśmarī.²⁰¹ Special types of udara described, apart from the doṣic varieties,²⁰⁰ are dūsyodara (Ci.13.10–15ab),²⁰¹ udakodara (Ci.13.15cd–18ab),²⁰² kṣatodara (Ci.13. 18cd–21ab),²⁰³ baddhodara (Ci.13.21cd–25ab),²⁰⁴ and plīhodara (Ci.13.25cd–26).²⁰⁵ The Bhelasaṃhitā fails to mention of the special types of visarpa, caused by a combination of two doṣas (Ci.15).²⁰⁶

v3.c42.s6.19

The chapter on śopha (Ci.17) does not describe the numerous varieties mentioned in the Carakasaṃhitā (Sū.18), but restricts itself to four doṣic types and one āgantu type.²⁰⁷ The pitta type of cough (pittakāsa; Ci.20.8–10) resembles the variety of pāṇḍuroga usually called kāmalā.²⁰⁸

v3.c42.s6.20

The chapter on diseases of the head and ears (Ci.21) mentions the following diseases of the head: śaṅkhaka, sūryāvarta, anantavāta, ardhāvabheda, śirahkampa, and mūrdhaśvayathu (Ci.21.1–34);²⁰⁹ diseases of the ears referred to are: bādhirya, karṇasrāva, karṇaśūla, karṇaśvayathu, karṇavāta, karṇavedanā, krimija karṇaroga,

v3.c42.s6.21

and raktaja karṇaroga (Ci.21.51–77).²¹⁰ The same chapter is concerned with the treatment of arocaka (Ci.21.38cd–48) and with the origin, symptoms and treatment of galaśuṇḍī, a disease of the throat (Ci.21.49–50).²¹¹ A separate chapter, preserved fragmentarily, is devoted to sleep and fainting. This chapter describes the physiology of sleep and fainting (Ci.23.1–8), excessive sleep, and insomnia (Ci.23.9–13);²¹² it ends with some verses on mūrcchā (Ci.23.14–16).²¹³

v3.c42.s6.22

The chapter on vāta diseases (Ci.24) is incomplete. It describes the treatment of corrupted vāta, located in various constituents of the body, refers to the eighty vāta diseases, and mentions specific varieties.²¹⁴ The chapter on plīhan and halimaka (Ci. 25) distinguishes four doṣic types of plīhan, a disease already described as plīhodara in a previous chapter (Ci.13).²¹⁵

v3.c42.s6.23

A separate chapter (Ci.26) is devoted to apatantraka and its treatment.²¹⁶ The same chapter is concerned with the aetiology, symptoms and therapy of ardita, facial paresis (Ci.26.26cd–32), a vāta disease already dealt with in a preceding chapter (Ci.10).

v3.c42.s6.24

The chapter on treatment of vraṇa (Ci.27) mentions twelve vraṇadoṣas (Ci.27. 15)²¹⁷ and thirty-six ways of treatment (upakrama; Ci.27.16);²¹⁸ specialists in internal medicine (kāyacikitsaka) and surgery (śalyakṛt) are referred to (Ci.27.14, 16, 20).²¹⁹ The chapter on pāṇāt yaya (Ci.28) describes four doṣic varieties²²⁰ and one specific disorder, called pāṇājīrṇa (Ci.28.91cd–93ab).²²¹

v3.c42.s6.25

In contrast with the Carakasaṃhitā, the Kalpasthāna of the Bhelasaṃhitā does not enumerate the synonyms of the medicinal plants dealt with in this section.

v3.c42.s6.26

The Siddhisthāna is differently arranged, when compared with the corresponding section of the Carakasaṃhitā. The first chapter is concerned with emetic and purgative treatments. Chapter two deals with drugs administered by way of the nostrils (nasya); four varieties are distinguished: avapīḍa, anuvāsa, dhūma, and pradhamana (Si.2.1).

v3.c42.s6.27

Chapter four describes the symptoms and ten disorders (vyāpad) brought about by the improper administration of emetics and purgatives; these ten disorders are: parisrāva, ādhmāna, vibandha, gudaṃhśrava, hṛdroga, śūla, parikartikā, jīvādāna, śiroroga, and pravāhikā.²²² Chapter five, concerned with clysters, refers to divergent opinions on this subject and Bhela's own view. Chapters six and seven are on the same subject. Chapter seven mentions disagreeing views on the best drug for use in an enema; Bhela himself maintains an eclectic position (7.2–3).²²³ Chapter eight is about the ten disorders caused by the injudicious use of enemas²²⁴ and on specific enemas.

v3.c42.s6.28

Some interesting names of disorders, mentioned incidentally, are: ādhyavāta (Ci.14.19),²²⁵ amlapitta (Ka.6.11),²²⁶ kacchū (Sū.11.8),²²⁷ khuḍavāta (Ci.14.19),²²⁸ nirvāhikā (Ci.16.12; Si.7.45, 48, 50),²²⁹ pārśvaroga (Sū.21.4 and 6), tapaḥsphoṭa (Sū.4.19),²³⁰ and vipātikā (Sū.11.8).²³¹

v3.c42.s6.29

Many formulae and therapeutic rules find their counterparts in the Carakasaṃhitā; some recipes, absent there, recur, usually in more or less altered versions, in later treatises.²³²

v3.c42.s6.30

Names of medicinal plants, mentioned in the Bhelasaṃhitā, but absent from the Carakasaṃhitā, are: ādaṇḍa (Ci.16.69),²³³ āraṇyapippalī (Ci.21.30),²³⁴ bhadrombarikā (Sū.4.12 and 15),²³⁵ brahmabhūtikā (Sū.27.23), candrākaśāka (Sū.28.41),²³⁶ candravallī (Ci.26.21), 237 caṭaka (Sū.27.11), 238 gavādanī (Sū.4.5), 239 hemavidārikā (Ci.14.12), kadambapuṣpī (Ci.26.21), 240 kālamānaka (Sū.27.10), 241 kapila (Ci.24.23), 242 karṇamoṭa (Ci.27.2), 243 ketu (Sū.27.12), 244 keśamāriṇī (Ci.9.6), 245 keśavatī (Ci.26.21), kūlaka (Sū.27.12), 246 kulīśa (Sū.4.13), 247 kumārī (Ci.24.25), kurūtikā (Sū.28.32), 248 kuṭiñjaka (Sū.28.42), mācipattra (Ci.2.31), mahānimba (Ci.16.70), 249 mahāvallī (Ci.26.17), 250 modakī (Ci.24.27), 251 nikuñcikā (Sī.7.7), 252 nīrakadambaka (Ci.24.25), 253 pāribhadraka (Ci.8.24; 28.86), 254 puṣkaravartaka (Sū.28.31), 255 pūtanā (Ci.2.35; 9.6), 256 rājatṛṇa (Sī.7.14), 257 rubūka (Ci.21.68; Si.4.32), 258 rūpasthā (Ci.9.6), samudrāntā (Ci.15.22; 27.5 and 8), 259 śītikā (Sū.28.32), śukānanā (Ci.6.68; Si.1.16), 260 śukanāsā (Ci.26.17; 27.3), 261 sūkarī (Ci.2.35), 262 suvarṇapuṣpī (Sū.4.4), 263 svādukaṇṭaka (Vi.5.6), 264 takkola (Ci.24.8), 265 turaṅgī (Sī.7.14), 266 vadhūṭikā (Sī.8.41), 267 and veṇucchatrāka 268 (Sū.28.26). 269

v3.c42.s6.31

Some plant names which are characteristic of the Carakasaṃhitā are also found in the Bhelasaṃhitā: avākpuṣpī (Ci.16.40), bhaṇḍī (Sī.4.22), cāraṭī (Ci.2.35), jayā (Ci.2.34), kāyasthā (Ci.2.34; 24.26), kuñcikā (Ci.13.27), nalikā (Ci.24.8), parṇāśa (Sū.27.10), pīluparṇī (Ci.14.13), potagala (Ka.3.7), rohiṣa (Ci.24.24; Ka.4.2; 5.2; 9.1; Si.7.14), śilodbheda (Ci.10.31), śuṣkaśāka (Sū.10.1), svarṇayūthikā (Ci.16.79; 27.8), and vīrā (Ci.2.34; 24.25).

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