Physician as depicted in Manasollasa
by Sri B. S. Hebballi | 2001 | 75,801 words
This thesis critically evaluates the role of physicians in Ayurvedic literature, particularly in King Somesvara's Manasollasa. It explores the connection between mind and body health, emphasizing the influence of diet and actions....
3. Quantity of food and digestion
According to Manasollasa - (1.19.149 to 153) the amount of food which, without disturbing the equilibrium (of dhatus and dosas of the body), gets digested as well as metabolised in proper time, is to be regarded as the proper quantity. The relation of the quantity of food and the power of digestion and metabolism, needs some explanation. How shall we know that a given amount of food is just enough for a particular individual ? This can be known only by correlating the food taken with its proper digestion within a time limit. If food taken in the evening does 9. cf. yavaddhyasyasanamasitamanupahatya prakrtim yathakalam jaram gacchati tavadsya matrapramanam veditavyam bhavati || carakasamhita - sutrasthana . 4
210 not disturb the equilibrium of dosas as well as dhatus and gets digested and metabolised by the morning then that would be the standard quantum of food to be taken by the individual. This quantum varies from individual to individual. No standard quantum can be prescribed for all individuals. In fact, the power of digestion even of a single individual varies from time to time and so there is bound to be some variation in the standard quantum of food for an individual which is to be determined on the basis of his digestive capacity. It is not that the food that gets digested in time may not disturb the equilibrium. It does so, owing to some inherent defects in its components, (premature curd), lakuca (Artocarpus lakoocha Roxb), etc. do disturb the equilibrium, irrespective of their quantity taken. Measurement of food is in fact, of two types, viz. food as a whole and of its different ingredients having different tastes like sweet, sour, etc. If food as a whole is taken according to the prescribed measurement but its ingredients having different tastes like sweet, sour, etc. are not in prescribed ratio, the equilibrium of dhatus and dosas gets definitely disturbed due to imbalance in the ratio of the composing rasas (tastes). Consequently the timely digestion of food as a whole, will also be affected. According to Caraka Samhita - matravaddhyasanamasitamanupahatya prakrtim balavarnasukhayusa yojayatyupayoktaramavasyamiti || ( carakasamhita - sutrasthana - 8) Taken in appropriate quantity, food certainly helps the individual in bringing about strength, complexion, happiness and longevity without disturbing the equilibrium of dhatus and dosas of the body. Thus, the determination of the quantity of food depends upon the power of digestion and metabolism as well as the heaviness or lightness of the food articles concerned. Food taken in proper quantity, helps in bringing about the strength, complexion, happiness and longevity.
211 Of course, there are other factors like inappropriateness of time, nonobservance of ethical rules and unwholesomeness of auditory, tactile, visual, gustatory and olfactory sensations which might minimise the effects of taking wholesome food in proper time. But then other things being normal, food taken in proper quantity must do good to the body. Caraka Samhita opines 10 that - Good health stands at the very root of virtuous acts, acquirement of wealth, gratification of desire and final emancipation. Manasollasa says the same view for fazi gra bhavyam pathyasina nityam jayate tatah | vyadhibhirvarjito raja rajakarya ksamo bhavet || 2.1.10. Diseases are destroyers of health, well being and life. Dharma is associated with the soul itself which is to be inferred from its results. Artha is the attainment of wealth like gold, etc. Kama is the fulfilment of desire like embracing women. Moksa is liberation from the world. Arogya, i.e., health, represents the equilibrium of dhatus in the absence of diseases. Thus, health is the root cause par excellence of the attainment of all these four objects of human life in as much as one suffering from a disease is absolutely incapable of performing any act conducive to the attainment of any of these four objects. As a matter of fact, the manifestation of diseases is synchronous with the impediments to the objects of human life. It is not correct to say that a disease is caused first and then it spoils health. The combination of a positive and a negative object would rather lead to a negative rather than a positive result. An impediment to the objects of human life, on the other hand, is to be treated as something positive rather than negative. Manasollasa 10. dharmarthakamamoksanamarogyam mulamuttamam || rogastasyapahartarah sreyaso jivitasya ca | pradurbhuto manusyanamantarayo mahanayam | | kah syattesamsamopaya ityuktva dhyanamasthitah | atha te saranam sakram dadrsurdhyanacaksusa | | sa vaksyati samopayam yathavadmaraprabhuh | - carakasamhita - sutrasthana - 1.15 17
212 opines that life without happiness is not worth living. Conversely life with happiness alone is worth living. After keeping in mind the above prescriptions, one should take food so as to avoid any possible disorders. It is also necessary to take food after the previous meal is digested and real appetite demands it. It is not easy for others to determine whether anybody is hungry. Each has to know whether he/she is really hungry. - hunger, if genuine, is a sign of good health. Want of or loss of appetite is a symptom of disorder or disease. It is for this very reason that diet is considered as one of the pillars of health. Ayurveda prescribes diet-restriction - as a must and so physicians always advise to avoid 97 over-eating, visamasana irregular eating and samasana mixed eating. Any food taken before the previous meal is digested is called. Irregularity in respect of quantity and time is considered fc. When wholesome and unwholesome items are mixed together it is called . These three are known as perversions of eating and one would do well to avoid them." - It is considered advisable to keep a gap of three hours before two meals. If one eats earlier, it causes indigestion. Late meals always result in weakness. This relates to time-gap in taking food. Even regarding quantity to be consumed, there are rules to be followed strictly. If the diet consists of two parts of solid and one part of liquid, it is considered very ideal. The remaining part or one quarter is better to be kept vacant in the stomach. This is necessary because it facilitates easy movement of dosas.12 11. purvabhukte'jirne punarasanam jneyamahitamadhyasanam | visamasanantu visamam matrakaladibhih proktam || samasanamiha tat proktam pathyapathyasya yatra sankaryam | vividho mithyaharastvesu naraih sarvatha tyajyah || Quoted in P.V.Sharma's sodasangahrdaya - svasthavrttam 61-62, p. 256. 12. dvau bhagavantena dravatastvekam prapurayejjathare | riktastvekah sthapyah dosanam samyagayanaya || Ibid., 64.
213 It is necessary to keep in mind the fact that barring a few common substances, articles of food vary from climate to climate and place to place. This in turn necessitates change in food habits of people living in different climates. This results in the consumption of vegetarian and nonvegetarian dishes. Rice, wheat and vegetables may be considered as common everywhere. They are items of stable food also. Pulses are also used as food for human beings and feed for cattle. Normally a smaller percentage of the people are purely vegetarians whereas the majority supplement the diet with meat. Use of intoxicant drinks and juices are also common. King Somesvara is all praise for good food prepared by expert cooks. Good food is essential for nourishment and maintenance of health. Good food served with love acts as a tonic. Even scholars in the west agree on this point - "Good food is a symbol of love, having psychological value which may even exceed its sensory and physiological contributions." 13 Instructions regarding proper preparation of some food items are found in Manasollasa. It is remarkable that Somesvara had time and patience to observe this aspect of life also minutely. The detailed description of the preparation of payasa, mandaka, pilika, purika, dosaka, iddarika, gharika, vatika etc. bear testimony to the fact that he was also a an expert who knew the art of cooking and selection of noted items in the diet. Preparation of non-vegetarian dishes has also not missed Somesvara's attention. He suggests mild fire or low temperature heat as most suitable in preparing meat dishes. Details of preparing several nonvegetarian dishes are given in third Prakarana of chapter 13 Annopabhogya, in Manasollasa. This is corraborated by western experts 13. Adelle Dairs 'Let's cook it right' (George Allen & Union Ltd., London 1971. p. 13) Quoted in M.N. Joshi's "Treatment of Secular Arts & Sciences in Somesvara's Manasollasa" Ph.D. Thesis (unpublished), K.U.D., p.335.
214 also on cookery. Adelle Davis says on this point - Meat should be cooked at low temperature. There are many advantages in cooking meat at low temperature. At low temperature meats shrink a little and they become juicier and more delicious.14 Manasollasa mentions how congenial it is to change dishes and drinks in accordance with the need of different seasons. "Pungent things in spring, sweet and cold things in summer, salty things in rainy season, sweet things in autumn, greasy and hot things in early winter and sour things in late winter are most suited for health." 15 This is in accordance with the prescription of Ayurveda. It also mentions that butter-milk after lunch, milk after dinner and water early in the morning are very beneficial drinks for maintaining good health. Food is the main stay of life. But the same thing consumed without discrimination becomes poison, harming life. Dishes prepared out of milk are tasty. Without ghee it is tasteless. Food with ghee, soup and thick curds are most welcome. Food without meat is not relished by many. Varieties of dishes are enjoyed by one and all. Taste alone is not the criterion in diet. It must be wholesome and healthy and nourishing as well. Harmless and easily digestable food is always welcome. Balanced diet, taken in time, is the best for maintaining health. Irregular food causes painful diseases and so the physician always prescribes a healthy, limited and timely diet and advises the patient to be wary of being tempted by taste. Overeating and undue fasting also are to be avoided even by a healthy person, what to speak of a patient. Only food digested gets assimilated as discarding the unassimilated portion as HM. 14. Ibid., pp.363-364. 15. vasante vasante katu casniyat grisme madhurasitalam | varsasu ca tatha ksaram madhuram saradi smrtam || hemante snigdhamusnam ca sisire'pyusnamamlakam | evam bhunjita yadbhupo annabhogah sa kathyate | | 3.14.1599-1600
215 Drugs prove efficacious only when the patient is looked after by the attendants providing him/her with proper nourishing diet. Time-gap, quantity to be consumed, quantum of solid and liquid contents etc. have to be strictly observed by the attendants who are in charge of the ailing patient. In short, medication along with nursing with love helps in restoring the normal physical and mental health of a patient. Encouraging response from the patient's side makes the physician attending on him to be more enthusiastic in helping him for steady and speedy recovery. Looking at the slow improvement of the patient, the physician allows him/her orderly exercises. Drug, diet and activity form the main factors in this course of restoration of normal health. Drug is prescribed after proper diagnosis and thorough testing. Diet is advised as a suitable nourishment both for the body and the mind. Activity is suggested to suit the requirement of the patient to recover as early as possible. It is worth remembering here that the pan of a balance bends too low with heavy weight. With light weight, it goes up. With equal weight on eitherside, it maintains balance. Similarly, the body with normal diet and activity can respond to the drug effectively. yathabharena namate laghunonnamate tula | samatisthati yuktena bhojyeneyam tatha tanuh || tasmadabhyavahartavyam svasaktimanupasyata | natimatram ca natyalpam meyam manavasadapi || saundarananda | 16 A normally healthy person can satisfy realise his/her hunger and take suitable diet. He/she can also decide upon the quantity he/she has to take. 16. Quoted in ayurvedopadesasamgrhah arogyasubhasitani By Dr. M.N.Joshi p. 43.
216 But a diseased person cannot do so. He/she has to depend on the persons attending on him/her who are advised by the physician treating him/her. These attendants have to remember that, gastric fire, of a patient is dormant. As the process of 4-digestion and transformation depend upon the patient has to be under liquid or solid diet according to the interval or time-gap suggested by the physician. It is also necessary for the attendant to watch not only the intake of or essence for nourishment, but also the time evacuation of excreta or 4 and urine of the patient. They are also to give authentic report of the colour of urine and hard or smooth evacuation of excreta. The quantity of urine and stool thrown out has also to be brought to the notice of the physician. H thrown out periodically helps the body of the patient to assimilate W. Ad stuck up defiles the body and the patient cannot relish any dish in that state. Drugs also will not yield the desired result. agni is the invariable agent in the process of dhatupaka - metabolism. ayurveda mentions three types of agni - jatharagni, bhutagni and dhatvagni . jatharagni is gastric fire also known as . This is present in all living beings. This is essential for digestion of food. It transforms food into rasa and mala . bhutagni is expected to act upon the bhoutika portions of food and nourish the pamcabhuta s. dhatvagni acts upon the dhatu s. Each dhatu is of three types. The gross part is to be thrown out. The fine part remains as it is. The finer one helps in the formation of dhatu . 17 17. agnistu pakakarmanyavinabhavena sadhako jneyah | te samkhya trayodasa jathara - bhutastha - dhatusamsthasca | | tesam sarvadhyaksah khyato vaisvanaro'nalo jathare | yo hi caturvidhabhuktam pacati rasartham malarthanca | | bhutagnayastu panca pratyekam bhuktanitabhutamsam | parinamayanti yathasvam bhutanam posanartham hi || dhatvagnayastu sapta pratyekam dhatumanjasasritya | bhagatraye pacanti sthule suksme'tisuksme ca || sthulo bhagah kittam suksmah svo dhatubhaga eva syat | �
217 As the patient has delicate physique, this 307 which is very active in the process of 41, digestion and transformation, is below normal in heat. So digestion is not easy and transformation is slow. In order to activate them, the physician resorts to extra-drugs and determines their dosage required for the purpose. This is brought to the notice of the attendants who have to strictly adhere to the instructions and help the patient to regain his stamina and build up resistance. It is worth remembering at this stage that vata, pitta and kapha when aggravated, cause all disorders and diseases. These aggravated dosas need to be pacified by the prescribed drug and diet. Soothing substances and intake of sweet and salty sour items are known for pacifying MA. Pitta gets pacified with sweets, bitters and astringents and intake and sprinkling of cold water. Bitter, astringent and pungent substances bring down. Even after the acute disorder or disease is brought under control and normalcy is restored, patient's state of health remains delicate. At such a crucial stage, even the slightest negligence regarding drug and diet intake on the part of the patient, is harmful. There is every chance of relapse. Therefore, the attendant has to exercise great tact in persuading the patient to resist all temptations for delicious dishes in the diet. The physician also gives the patient a mild warning and advises him to be visiting him for observation. Ayurvedic treatment is a little harsher in regard to as compared to the allopathic treatment. But one should always remember that Ayurvedic treatment always aims at curing an ailment and not merely preventing or suppressing it. � parinamyate'tisuksmascottadhatau kramascaisah || evam pakavidhanat parinamo drsyate tanau dvividhah | ekah prasarabhutah kittakhyastyajya evanyah | | zinyfa: murz: faceransvilafzyjai fafa: | adyah prinati vapuh kurute malinam dvitiyastu | - sodasangahrdayam - maulika siddhantah Dr. P. V. Sharma p.177.
218 Our ancient literature has given some information about digestion and health. Some general statements on the subject are are quoted below 18: (1) Even after a lapse of a long time, the following do not harm a person; well-digested food; a very smart son; a well- disciplined wife; a beneficient ruler; a well thought-provoking speech and a methodical action. 19 (2) One, who takes food after the earlier food is properly disgested, does not contract any disease. 20 (3) Disturbed study is harmful for learning. Soiled clothes spoil the beauty of a woman. Proper digestion of food wards off diseases. Exhibition of prowess weakens an enemy. 21 22 (4) A fool does not begin to work being afraid of faulting. My dear friend! Does any one stop eating being afraid of food causing indigestion ? (5) Normally, irregualr food causes indigestion. Diseases crop up due to indigestion. Diseases vanish when the cause of indigestion is stopped. 23 18) All these (1-7) statements are quoted from - Ayurvedacharya Bhaskar Govind Ghanekar's "Vaidyakiya Subhasita Sahityam", Chaukhamba Sanskrit Samsthana, Varanasi - 1977. 19 ) sujirnamannam, suvicaksanah sutah yanfum zl, zafa: grafan: | sucintya coktam, suvicarya yatkrtam sudirghakale'pi na yati vikriyam || (hitopadesa ) 20) jirnabhojinam vyadhirnopasarpati || (canakyasutra ) 21) vidyaghato hyanabhyasah, strinam ghatah kucailata | vyadhinam bhojanam jirnam, satrorghatah prapancata || (brhaspati ) 22) dosabhiteranarambhastatkapurusalaksanam | kairajirnabhayadbhratarbhojanam parihiyate || (hitopadesa ) 23) prayenaharavaisamyadajirnam jayate nrnam | tanmulo rogasanghatastadvinasadvinasyati || (astangasamgraha )
219 (6) Improper learning, undigestible food, gossipping by a poor man, a young wife for an aged person, all these are injurious like poison. 24 (7) If unhealthy food once taken is not digested properly, one should not take even a healthy food. 25