Charak Samhita – Sutrasthana – Chapter 11 (Tistraishaniya Adhyaya)

Abstract

Desires are characteristic of humans, and only people strive to achieve them. The three fundamental human wants of lifespan, prosperity (or material comforts), and a happy afterlife are explained in this chapter. This chapter also includes instructions on how to follow them in order to live a healthy and moral life, hence it falls under the tetrad of healthcare management recommendations. Eight triads are described, along with instructions on how to treat patients who have mental or physical illnesses. Reincarnation and universe creation hypotheses are examined and explained. The four ways of attaining true knowledge, which are investigation (Pariksha), inference based on evidence (Anumana), logical management (Yukti), and clearly perceivable (Pratyaksha) are detailed in-depth along with how they contribute to the development of the concept of reincarnation. These techniques allow a doctor to fully understand a patient’s disease and condition, allowing them to make informed treatment decisions and select the best medications. So in this section, we will discuss the Charaka Samhita chapter eleven Tistraishaniya Adhyaya in brief.

Introduction

Most people want to live long, healthy lives. This is what they define as longevity. Also, there is a desire for riches, which allows one to indulge in all of life’s joys as well as engage in religious rites. A person’s quality of afterlife as well as the remaining period of his current existence depends on bad and good deeds committed throughout his or her lifetime. Birth and rebirth are a karmic cycle. We can experience financial joys and live healthy lives as a result of our good deeds. The maintenance of wellness and the treatment of diseases were the topics of earlier chapters. The goal of living healthy lives is to find joy or happiness in this lifetime as well as the world beyond death. Longevity, financial comforts, and a happy afterlife are described as the three fundamental human aspirations that should be satisfied during a person’s life at the beginning of the chapter.

Three Desires

If someone has a sound mind, intelligence, energy, physical strength, and psychological power and wants to benefit from this world and the next (after death), they should endeavor to achieve three desires. The three main desires are to live (Long and healthily), to be wealthy (And have a livelihood), and to experience happiness in the afterlife.

1. The Desire For Life

Out of all these desires, one should follow the desire to live first. Why? because on the departure of life, everything departs. That can be maintained by the observance of the code of conduct for healthy and non-carelessness in the alleviation of disorders in the diseased. The strategies for managing one’s health and the ways that diseases are treated have been reviewed in the previous chapters and will be covered in more detail in the chapters that follow. The first aspiration for life is thus explained.

2. The Desire For Wealth

Hereafter, one should pursue the desire for wealth. Next to life, is wealth which is to be sought. There is nothing more sinful than to have a long life without means. Hence one should make an effort to achieve these means, the methods for which are mentioned here such as agriculture, animal husbandry, trade and commerce, government service, etc., and other such works which are not discarded by noble persons and are promoters of livelihood-such works one should start doing. By working in this way one lives a long life without any dishonor. This provides an explanation for the second desire for money.

The Desire For Another World After Death

Now, one should pursue the third desire for the other world. Here is doubt, why? because whether we shall be reborn after departing (From this world) or not. The background of such doubt is that some scholars devoted to perception only have accepted negativism because rebirth is imperceptible while others hold rebirth only on evidence of scriptures. Then, there is also a difference of opinion among the scriptures as some consider parents as the cause of birth while others hold nature, creation by others (Creator), and chance as the same. Hence it is doubtful whether there is a rebirth or not.

Direct Perception (Pratyaksha) And Unknown Perception (Apratyaksha)

It is up to intellectuals to disprove the unorthodox theory of reincarnation and any related skepticism. Because there is a huge, unexplored realm of knowledge and because perception is highly limited, understanding this theory can only be learned by inference, reasoning, and the scriptures.

1. Obstructions To Direct Perception

Even the existing forms can’t be known by perception due to various factors such as excessive nearness, too much distance, covering, inability to sense organs, instability of mind, mixing up with similar objects, overshadowing, and excessive minuteness. Hence it is illogical to say that only perception is there and nothing else. The scriptures too cannot stand because of contradiction to reasoning. If the self of the parents migrates to the progeny, it may go either wholly or partly. In case it goes wholly, the parents should die invariably, and as regards the other alternative, there cannot be any part of the subtle self. As in the case of self, decisions may be taken in cases of intellect and mind too. Moreover, in the opinion of people having such a view, there cannot be fourfold categories of (Moving ones). Though specific characters of the nature of six dhatus are there, their conjunction and disjunction (Responsible for birth and death respectively) depend upon the causation of action.

Opinions On Paranirmana (The Soul As The Universe’s Creator)

The creation of a beginningless and sustainer of consciousness (Self) by some other (Creator) does not look logical. If the word para means atman himself then this may be accepted as the cause (Of creation).

Yadrichha (Free Will)

For the negativist whose consciousness has been injured by (Accepting) the theory of chance, there is no examination, one to be examined, doer, cause, gods, sages, accomplished persons, action, the result of action, and also the self. This holding up of negativism is the worst among the sinful. An educated individual should cast off such pessimistic ideas and view the world via the prism of the wisdom lamp held up by smart persons.

Four-Fold Analysis

The two categories of truth and false can be applied to all things in the world. Scriptures or books (Words of wise people or sages), inference, direct perception (Direct observation), and reasoning are the four ways of examination.

Authoritative Sages

Rajas and Tamas (psychological doshas) are completely absent from people who are knowledgeable and enlightened. They are referred to as authorities (Aptas) as a result of their Trikala (Past, present, and future) knowledge. They are often referred to as knowledgeable and vibuddha (Enlightened) individuals. There is no question in anyone’s mind that what they said was true. They aren’t controlled by rajas or tamas, so how can they tell a lie?

2. Direct Perception Of Knowledge

Direct observation (Pratyaksha), also referred to as perception, is the process of learning something while one’s soul, senses, and mind are in close proximity to the thing being studied or observed.

Inference (Anumana)

Inference is based on prior perception. It is of three types and is related to the three times. One can infer covered fire from the smoke, sexual intercourse from observing the fetus, and the future fruit from seed. By observing the bearing of similar fruit, the learned infer the causation of the seed.

Reasoning (Yukti)

The growth of crops is observed from the combination of water, ploughing, seed, and climate and so is the growth of a fetus from the combination of six dhatus. This is a Yuki-proper and rational combination of all constituent factors. Similar is the case of the production of fire from the combination of one to be churned, the churning process, and the churning stick. So is the arrangement of four legs of therapeutics which alleviates diseases if combined and used rationally. Yukti (reasoning) is the term used to describe how the intellect views things using a mix of aspects that are true in the present, the past, and the future. This aids in achieving the three primary goals of human life—dharma, obligations, money, and desire.

Applications And Importance Of Fourfold Examination

This is the method and instrument of examination and not any other, by which all to be examined, existent and non-existent, is examined. On examining this, it is proved that rebirth is true. Authoritative scripture is the Veda or any other source of learning which is not in disagreement with the Veda, is composed by critical scholars, approved by noble persons, and implemented for the well-being of the people. This is the authoritative scripture. From the authoritative scripture, it is known that penance, religious sacrifice, non-violence, charity, celibacy, and truthfulness lead to perfect well-being. For those who are devoid of all defects, in religious scriptures, freedom from rebirth is not mentioned for those who have not overcome their psychological doshas of tamas and rajas. Rebirth has been established on perceiving with divine vision by early and earlier great sages who were devoted to religious scriptures, are devoid of aversion, fear, confusion, conceit, greed, attachment, devoted to ultimate knowledge, endowed with authoritative knowledge, having practical experience and having movement of mind and intellect quite underanged. So one should decide like that.

By the perception, also it is observed-progeny dissimilar to parents, differences in complexion, voice, mind, physiognomy, intellect, and fate in spite of the similar genetic source, birth in a superior and inferior clan, slavery and sovereignty, happy and unhappy life, inequality in life span, achievement of the result of the deed here, the inclination of untrained ones to weeping, breast-suckling, laughing, fear, etc, the appearance of marks in body parts, the difference in result in spite of the similarity in action, intellectual interest or otherwise of previous birth showing the coming back of the persons who had left the world, liking or otherwise in spite of similar face. Supporting evidence for the rebirth theory: It can be concluded that fate refers to actions taken in former lives that were inevitable, eternal, and continuous. The deeds taken in this life’s journey and the outcomes of which are joyful in this life will have consequences in another life. This process never ends since fruit comes from seed and seed from the fruit. Rebirth is justified by the fact that the pancha mahabhutas and the atman combine to make the garbha or embryo. When the doer and the tool are working together, action is manifested. The outcomes we experience are a direct result of our activities; without action, there would be no outcomes. Seed is what causes germination, action always follows the result, and the seed cannot produce a heterogeneous product. This is an argument. The rebirth concept is established by all four types of knowledge (scriptures, reasoning, observation, and inference); therefore, one should focus their mind on the way of eternal duty. The paths include serving the teachers, elders, and preachers, studying, practicing spiritual acts, getting married, having kids, caring for servants, showing respect for visitors, giving alms, avoiding greed for other people’s money, doing penance, avoiding jealousy, doing acts that have no impact on the physical, verbal, or mental faculties, and engaging in meditation. Similar behaviors that are, supportive of living well in the present moment, as well as achieving heaven after passing away should be followed. One can get fame and heaven after passing away by performing such deeds. The third fundamental want is thus explained.

Important Triads

There are three sub-pillars that hold up life, three types of strength, three causes, three diseases, three routes of diseases, three types of physicians, and three types of therapy.

Three Supporting Pillars Of Life

Food (Ahara), sleep (Nidra), and the practice of celibacy (Brahmacharya) are the three foundations that maintain life. If a person refrains from engaging in practices that are harmful to their health, which are covered in this chapter, they can achieve a body that is strong, has a healthy complexion, and grows properly throughout their lifetime.

Three Types Of Strength (Bala)

Strength is of three types-congenital (Sahaja), periodic or seasonal (Kalaja), and acquired (Yuktikrita). Congenital is that which is natural to the body and mind, periodic is due to seasonal variations and age factors. Acquired one is produced by the proper application of diet and exercise.

Causes Of Disease

There are three causes of disease-excessive (Atiyoga), non-utilization (Ayoga), and wrong utilization (Mithyayoga), of sense objects, actions, and time. Such as-excessive gazing at an over-brilliant object is excessive use, avoiding looking altogether is negative use, and seeing too near, too distant, fierce, frightful, disliked, deformed, wonderful, disgusting, and terrifying objects is perverted use of visual objects. Likewise, to hear too much of the loud sound of clouds, cries, drums, etc, is excessive use, not at all hearing is negative use, and hearing of harsh and frightful words and those which indicate the death of dear ones, loss, humiliation, etc, is perverted use of auditory objects. Too much smelling of too sharp, intense, and congestant odors is excessive use, not at all smell is negative use, and smelling of fetid, impure, poisoned air, disliked, decomposed, cadaverous odor, etc, is perverted use of olfactory objects. Likewise, too much intake of rasas (Tastes) is excessive use, not at all taking is negative use of gustatory objects. Perverted use of those will be described in the chapter dealing with the methods of eating except the quantity. Too much indulgence in very hot and very cool objects and also in baths, massages, anointing, etc, is excessive use of tactile objects, total abstinence from them is negative use and application of tactile objects such as hot and cold baths, etc, without the usual order and also the touch of uneven surface, organisms, injury, dirty objects, etc, is perverted use of the tactile object.

Three Causes Of Diseases

1. Asatmyendriyarthasamyoga

Out of all the senses, the tactile sense alone pervades all the sense organs and is also associated inherently with the mind so due to pervading of tactile sense, the mind also pervades. So the condition of all the sense organs produced by the overall tactile sensation, because of being harmful, is known as the unwholesome conjunction of sense organs and its objects which is of five types each having three subdivisions. The objects which are accepted properly are known as wholesome ones.

Intellectual Defects (Prajnaparadha)

Action is the application of speech, body, and mind. Too much application of these is excessive use and their total non-application is negative use. Holding up or forcing urges, sleeping, posturing, and falling on uneven places, abnormal posturing, pressing, heating, obstructing breathing and torturing is the perverted use of bodily actions, words indicating betrayal, lying, untimely speech, quarrel, unliking, irrelevance, indiscipline, and harshness, etc, come under the perverted uses of speech, fear, anger, grief, confusion, envy, conceit, wrong knowledge, greed, is the perverted use of the mind. In short, the harmful action of the mind, body, and speech that remain unsaid except for excessive and negative uses can be taken as their perverted use. This threefold action, each having three subdivisions is taken as prajnaparadha (Intellectual error).

Kala or Parinama (Time)

Time is the year which again consists of winter, summer, and rainy seasons with characters of cold, heat, and rain respectively. If there is an excess of the specific character of time, it is called an excessive occurrence, deficiency in these characters denotes the deficient occurrence, and time having characters opposite to its own ones indicates the perverted occurrence. Time is again known as a consequence. Thus, the unwholesome conjunction of sense organs and objects, intellectual error, and consequence-these three with three subdivisions each are causes of disorders while conjoined in balanced combinations are causes of normalcy. The existence and non-existence of all the objects are not met with or without proper and improper (Excessive, negative, and perverted) uses respectively. Existence and non-existence depend on the respective uses.

Three Types Of Diseases

There are three types of diseases-innate, exogenous and psychic. Innate is that which arises due to imbalanced doshas in the body, and exogenous is that which is caused by Bhuta (Organisms and spirits), poisoned air, trauma, fire, air, etc. Psychic is that which is caused by non-fulfillment of desires and facing the undesired. There, the wise person should adopt the mental faculties which are opposite to the mental disorder and should strive for abstaining from unwholesome virtue, wealth, and enjoyment and for pursuing the wholesome ones, constantly keeping an eye on wholesomeness and otherwise. No mental happiness or unhappiness can occur in this world without these three. Hence, this should be practiced-effort to remain in touch with the experts and to properly know the self, clan, strength, time, place, and capacity. As a result, it is believed that adhering to behavior connected to kama (desire), dharma (virtue), and artha (wealth), is the best way to deal with psychological illnesses. Serving those who are knowledgeable about psychiatric illnesses and adhering to their guidance to learn more about oneself, etc.

Three Disease Pathways

There are three passages of the diseases-periphery, vital parts along with bone joints, and the digestive system. Periphery consists of dhatus-blood etc and twak (Skin including rasa dhatu located in that). This is the external passage of disease. Vital parts are the urinary bladder, head, heart, etc, bone joints are those where bones meet along with the bound ligaments and tendons-this is the middle passage of diseases. The digestive system is commonly known as the great channel in the middle of the body extending from above downwards including the stomach (Amasaya) and intestines (Pakwasaya). This route of disease is the internal one.

Diseases like boils, warts, goiter, diabetic boils, granuloma, scrofula, leprosy, moles, and other skin diseases freckles, etc, erysipelas, edema, piles, abscess, gaseous tumor, etc, occurring in the external passage are the diseases following the route of the periphery. Hemiplegia, convulsion, stiffness of sides, wasting, facial paralysis, pain in bone joints, rectum prolapse, etc, and also the diseases of the heart, urinary bladder, and head are the diseases following the middle passage. Diarrhea, fever, sluggish intestine, vomiting, cough, cholera, hiccup, dyspnea, abdominal enlargement, bowels hardness, and spleen enlargement, etc along with edema, piles, erysipelas, abscess, gaseous tumor, etc occurring in the internal passage are the diseases which follow the route of the digestive system.

Three Types Of Physicians

Three different categories of physicians exist:

• False doctors/impostors (Chhadmachara bhishag)
• Pretending to be doctors (Siddhasadhit)
• Real/genuine physicians with fundamental attributes (Vaidya guna yukta/jivitabhisara)

People that appear to be vaidyas while carrying tools, medications, green herbs, and books, are actually merely frauds or fake vaidyas who are unaware of medical knowledge.
A person who falsely represents himself as wealthy, well-known, knowledgeable, or an expert (Siddha) falls under a group of feigned physicians.

Jivitabhisara (Savior of life), the characteristics of a true physician, include the practical application of numerous therapies as well as the in-depth understanding of Ayurvedic science, as well as insight, notoriety, success, and the ability to provide delight to the patients.

Three Different Types Of Treatment Methods

There are three types of therapy that are spiritual, rational, and psychological. Spiritual therapy consists of the recitation of mantras, wearing gems and roots, offerings, auspicious acts, oblations, atonement, gifts, following religious precepts, fasting, falling on the feet of the gods, invoking blessings, pilgrimage, etc. Rational therapy consists of the rational administration of diet and drugs. Psychological therapy is restraint of mind from unwholesome objects.

Three Types Of Therapies

In the case of vitiation of bodily doshas, three types of therapy are administered in relation to the body-they are: internal cleansing, external cleansing, and surgical operation. Internal cleansing means the therapy which, entering into the body inside, alleviates the disorders caused by diet. The therapy which is by external contact through massage, pasting, pressing, fomentation, sprinkling, etc, removes the disorders. The surgical operation consists of incision, scraping, scarifying, excision, puncturing, rupturing, extraction, probing, and application of leeches and alkali.

Method Of Determining A Sick State

A smart person can regain their health after contracting a sickness by receiving surgical treatment, and internal and external purification. Due to their ignorance or absence of awareness, fools ignore the disease, just as they are unaware of their adversaries. Early on, the sickness is negligible, but as time goes on, it gets worse. After that, it spreads deeply and robs the victim of their power and life. Fools are unaware of any anomaly until it badly affects them, and once they are gravely ill, they only consider curing the illness. Then he collects his son, kin, and wife and requests them to bring some physician even at the cost of his entire possession, but who is able to save him, devoid of life, emaciated, weak, anxious, afflicted, and with the sense organs waned away. Thus not finding a savior that fool leaves his life like an iguana with her tail bound and dragged by a strong person. Hence one, who wishes for happiness, should counteract with medicines before the disorder is produced or when it is newly risen.

Conclusion

In this chapter, we read about the desires, sub-pillars, causes, strengths, passages, disorders, physicians, and therapies. These eight things have been described as threefold by Krsnatreya, wise and detached from worldly things. On these, all is based. A trio of supporting pillars (Upasthambha) is suggested to maintain health. The triad of strength (balas), which is described, is bestowed upon one if the supporting pillars are strictly followed. Disease is likely to manifest if an individual is exposed to disease-related environmental factors (nidana sevana). These elements again fall into three categories. Diseases can present in one of three ways, and a qualified physician is required for treatment. There are three distinct categories of doctors. A good doctor uses one of three sorts of therapy to treat the ailment. Three different sorts of therapy can be used to treat ailments that are brought on by vitiated body doshas. In this way, each of the factors discussed in this chapter is connected to the others.