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Āyurveda and the Hindu Philosophical Systems

Author(s): Gerald James Larson


Source: Philosophy East and West, Vol. 37, No. 3 (Jul., 1987), pp. 245-259
Published by: University of Hawai'i Press
Stable URL: https://www.jstor.org/stable/1398518
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Gerald James Larson Ayurveda and the Hindu philosophical systems

INTRODUCTION

An inquiry into the conceptual framework of traditional South A


is important not only from an anthropological and historical p
is to say, from the perspective of uncovering archaic and anc
symbolization with respect to notions of "health" and disease" tog
development of these patterns synchronically and diachronica
perhaps more importantly, from a philosophical and interpretive
the terms "philosophical" and "interpretive" I have in mind tw
cerns: (a) a concern for "understanding" vis-a-vis them, or, in oth
realization that millions of persons throughout South Asia a
currently utilize or practice some form of Ayurvedic medicin
essential for us as modern researchers to grasp the indigenous co
with which these millions live, if we are to continue to make pro
standing" the nature of the multicultural world in which we
concern for "appropriating" vis-a-vis ourselves, or, in other word
tion that our own modern conceptualizations of medical theory a
usefully be supplemented and enriched by taking seriously some
and practices of traditional South Asian medicine. It is certainly n
to suggest that our modern notions of health care and the treatme
remarkably limited and in need of serious reform on the level of v
and conceptualization. Although important progress has bee
fields as embryology, immunology, physiology, surgery, and so f
health-delivery systems (in the United States, Western Europe
regularly break down; the cost of medical research and train
outrageous levels; the doctor-patient relationship frequently b
ical and callous; and, most important of all, the authentic ben
medical science are largely available only in those areas of the
technologically and economically advantaged-and even withi
areas, the inequities in medical care are staggering. This is no
genuine contributions or the experimental methodology of m
nor is it to suggest that we should adopt traditional South Asian
own. Indeed, there appears to be little of scientific importanc
medicine; or, to put the point somewhat less polemically, whatever
value in traditional medicine is handled in a more productive mann
methodologies of modern science. What is of importance in tradi
however, is a way of valuing and a way of conceptualizin
"illness" that is interestingly different from our own and th
incompatible with the rigorous precision of modern scientific me
with both of these concerns in mind, then, that I am undertaking
traditional South Asian medicine.

Gerald James Larson is Professor of Religious Studies at the University of California, Santa Barbara.
Philosophy East and West, volume 37, no. 3 (July 1987). O by the University of Hawaii Press. All rights reserved.

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246 Larson

I. THE HISTORY AND LITERATURE OF AYURVEDA

The term dyurveda means "knowledge" (veda) concerning the m


"life" (dyus), and the origins of this "knowledge" are already e
A tharvaveda (the contents of which can be dated somewhere betw
and 1000 B.C.). To be sure, the treatment of disease (cikitsa) in the
is largely religious and ritualistic, emphasizing such practices as th
of "sacred utterances" (mantra), penances (niyama), sacred oblat
homa), and purificatory rites (prdyascitta); but the Atharvaved
material about human anatomy, herbal medicines (bhaisajya), and t
tion of diseases (vyadhi). Reference is made to "wandering medical
(cdranavidya) and those who are "trained in medical science" (va
logically, the Ayurvedic tradition assures us that the first speciali
science was none other than the creator god, Brahma, himself. Brah
knowledge with Prajapati, who in turn passed on the tradition to t
Indra. Surgery (salya) was revealed by Indra primarily to the hu
Divodasa, the king of Kasi, who was also an incarnation of the
vantari, culminating finally in the classical Susruta tradition of Ay
gery and medicine. Internal medicine (kdyacikitsa) was revealed
marily to the human school of Atreya Punarvasu, culminating
classical Caraka tradition of Ayurvedic general medicine. Moreover
vedic tradition informs us that from ancient times specializations
nose, and throat disease (sadlkya), psychiatric disorders (bhutavidy
(kaumdrabhrtya), toxicology (agadatantra), geriatrics (rasdyana
(vdjfkarana) also developed. All of this traditional medical lore
by the general term ayurveda; and vis-a-vis the sacred, liturgical V
the Rg, Sdma, and Yajur collections together with the purely religio
the Atharva), the dyurveda is characterized as an updhga ("supplem
tion"), or as an upaveda ("supplementary Veda"), or even as a "f
From a historical-critical point of view the evidence indicates th
medicine is at least as old as the sacred brahmanical tradition and t
compilations of medical knowledge were prevalent before the time
the Buddha (563-483 B.C.). Indeed, the very presentation of Buddhi
the older literature (for example, in texts such as the Dhammacakk
sutta of the Satiyutta-nikdya or the Mdlufkydputta-sutta of
nikdya, with their emphasis on existential disease or injury, its
prognosis, and treatment) suggests that some sort of systematic m
tion(s) was widely known and respected. It is, however, in the first
that the older medical traditions were compiled and systematized i
that have come down to us, namely, the Caraka-sathhitd (purporte
of an old text on general medicine known as the Agnivesa-tant
revised by a certain Caraka who was possibly a court physician to k
in the first century A.D., and finally completed by a certain Drdhab

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247

500), and the Susruta-sathhita (purportedly an old tradition of surgical theory


and practice, put into final form in the second or third century A.D. and later
revised by a certain Nagarjuna either in the sixth or the tenth century A.D.). The
basic commentary on Caraka-samhitd, the Ayurveda-dfpikd of Cakrapanidatta,
was composed in the eleventh century, and the basic commentaries on the
Susruta-samhhita, namely the Bhdnumatf of Cakrapanidatta and the Nibandha-
samhgraha of Dalhana, in the eleventh and thirteenth centuries, respectively.
Other important texts include the Bhela-sathhitd (possibly earlier than Caraka),
the Astdngahrdaya-sathhitd of Vagbhata (circa A.D. 600) and the Mddhavaniddna
of Madhavakara (circa A.D. 700.) Numerous other texts on medicine were
regularly composed through the centuries, and the Ayurvedic tradition con-
tinued as a vigorous scientific tradition down into the sixteenth century. More-
over, in the last several decades of the present century the Government of India
has been actively supporting research in ayurveda, and some of the leading
research universities in modern India (for example, Banaras Hindu University)
have established research programs in Ayurvedic studies. Thus, historically and
textually, we are dealing with a vast, ancient, and largely unbroken tradition,
which ranges from the anatomical speculations and medical practices of the
Atharvaveda (that is to say, from the latter half of the second millennium B.C.) to
present-day research programs in modern Indian universities.1

II. THE THEORY OF AYURVEDIC MEDICINE

Jean Filliozat, in his important work La Doctrine Classique


Indienne (Paris, 1949), comments that Ayurvedic medicine is a "r
based on "experience" and that throughout conceptualization
and in almost every instance is easily adapted to usage.2 Filliozat
be readily documented in the two major classical medical texts (n
samhhita and Susruta-sathhita) and their commentaries, for it is
outset that the medical literature is oriented practically and ope
texts present a symposium-like format in which a practical s
fever (jvara) or dysentery (atisdra), or a disease such as pulmona
(rdjayaksman), is discussed, classified as to type, contextualized (
prodromes, syndrome, and prognosis), and finally dealt with th
this respect the South Asian medical literature is much like a
textbook-that is to say, overall theory is largely presupposed
given to symptomatology, diagnosis, and treatment. It is possibl
reconstruct (by comparing and piecing together occasional theor
an overall conceptualization of medical theory and to relate that
tion to the larger intellectual environment of classical Indian th
be noted, though, that there is no one-to-one correlation. T
tellectual influences on Ayurveda are those of the Sarhkhy
philosophies, although one also finds terms and notions from
Vedanta, Nyaya, Yoga, and early Buddhist and Jain reflection. It

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248 Larson

determine whether Ayurvedic notions were shaped by classical Indian


ical notions or if the latter were shaped by the former. Perhaps, ther
Weberian notion of "elective affinity" is the most appropriate charact
notion which allows for an ongoing exchange between the classi
philosophies, on the one hand, and the practice of traditional Ayurved
cine, on the other. In other words, it is probably not possible to sugg
relation one way or the other, but one can argue that there was a natur
between the naturalistic philosophical systems and Ayurvedic medical
which generated a mutually influential pattern of ongoing interaction
According to one important interpretation of Ayurvedic theory, "li
arises because of the association (sathyoga) of body (sarTra), sense
(indriya-s), mind (sattva or manas), and self (atman) (Caraka 1.1.42
further said that body (sarira) (including the sense capacities), mind (s
self (atman) make up a tripod (tridandavat), which is the "person" (pur
which is the subject matter of dyurveda (Caraka I. 1.46-47). The body
collocation of the atomic constituents (anu-s or bhuta-s) of wind (
(tejas), water (ap), and earth (prthivT). The body exists in an all-
environment or medium of space (dkasa) in which time (kdla) and exte
place (dis) are the most important dimensions. Mind (sattva or manas)
the body as one more atomic constituent. The mind is considered to b
because it can only attend to one apprehension at a time (that is to say,
is not omniscient); and (b) because it can move (for example, it transm
and only nonpervasive things can move. The self (atman) is an all
entity which comes into association with the atomic mind (sattva or m
this association (samtyoga) provides the environment for the rise of "
ness" (cetana) and for the development of a karmic heritage, thus bec
important determinant (along with dharma and adharma or "virtue" a
of virtue") for future transmigrations. All of these items (namely, w
water, earth, space, time, extension, and self) are called "substances" (
Wind, fire, water, earth, and mind are construed to be atomic "substa
space, time, extension, and self are construed to be all-pervasive "s
All of these "substances" have certain properties (guna-s) or secondary
(for example, touch, form, taste, smell, and so forth), and the at
stances" also possess motion (karman). Properties (guna-s) and
(karman-s) "inhere" (samavdya) in substances (dravya-s). Moreover, all
the world that are constructed from the dravya-s can also be described
their generic essence or class identity (sdmdnya) and in terms of their p
or specificity (visesa). Thus, in addition to the basic "substances" whic
the world (namely, wind, fire, water, earth, space, time, extension, m
self), there are six fundamental "categories" (paddrtha-s) by mean
everything is apperceived, namely, substance (dravya), property (guna
(karman), generality (sdmdnya), particularity (visesa), and inherence (
Such a theoretical account, of course, is clearly Vaisesikan in ins

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249

although it should be noted that Ayurveda utilizes these Vaisesikan notions in


ways that sometimes markedly diverge from the classical philosophical expo-
sition. In any case, this general conceptualization is clearly implicit throughout
the Sutra-sthdna portion of the Caraka-satzhitd (Caraka I, chapters 1-30).
According to another important interpretation of Ayurvedic theory (for
example, in Caraka-samhhitd IV. 1 and Susruta-samthitd III. 1, and so forth), "life"
(dyus) is a product of the co-presence of "consciousness" (purusa) and primor-
dial materiality (prakrti). Primordial materiality is made up of three material
constituents (guna-s), namely, the subtle matter of pure thought or sattva, the
kinetic matter of pure energy or rajas, and the reified matter of inertia or tamas.
(It is important to note, by the way, that the term guna is being used in a
fundamentally different way in this second theoretical elaboration. Whereas in
Vaisesika a guna is simply a quality or attribute of substance (dravya), in this
second theoretical elaboration guna is actually a material constituent of primor-
dial materiality.) These material constituents (guna-s) dialectically interact with
one another and generate the manifest world of subjective experience and objec-
tive existence. Subjectively, primordial materiality emanates into the forms of
intellect (buddhi), ego (ahahimkra), mind (manas), the ten sense capacities (of
cognition and action) and the five subtle elements (tanmdtra-s) or the generic
essences of sound, touch, form, taste, and smell. Among these emanations,
intellect, ego, mind, and the ten sense capacities are largely made up of sattva.
The five subtle elements or generic essences are largely made up of tamas. That
which impels or activates the process or transformation (parinama) of the
emanation process is rajas. Finally, the five subtle elements or generic essences
(made up largely of the guna, tamas) generate the five gross material elements of
space (adkasa), wind (vdyu), fire (tejas), water (ap), and earth (prthivt). The gross,
physical body is a collocation of these latter five gross elements, which are present
throughout nature and which are transmitted genetically through the semen
(sukra) of the father and the ovum and blood (sonita) of the mother. Life, there-
fore, according to this interpretation, has several distinct supporting compo-
nents, namely, (a) a general all-pervasive co-presence of consciousness (purusa)
and primordial materiality (prakrti) (with its material constituents or guna-s
of sattva, rajas, and tamas); (b) a subjective yet material subtle body (lihga-
sarfra or siksma-sarlra), made up of intellect, ego, mind, the ten sense capacities,
and the five subtle elements or generic essences, which transmigrates (samsdzra)
from one life to another; (c) a gross organic body made up of the collocation of
space, wind, fire, water, and earth that is physically transmitted genetically
through father and mother but which is separately enlivened by the transmigrat-
ing subtle body; and (d) collocations of gross inorganic elements. Running
throughout nature on all levels (subjective and objective as well as microcosmic
and macrocosmic), however, are the ongoing transformations (parindma) or
transactions of sattva, rajas, and tamas. Such a theoretical account, of course, is
clearly Srahkhyan in inspiration, although here, too, it is to be noted that there

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250 Larson

are a number of variations and divergences in the medical texts from


philosophical account of Samhkhya, but again, this general conceptual
clearly set forth in the SarTra-sthdna portion of Susruta-samthitd (III.
allied but divergent Sahkhyan interpretation (albeit with a Vedan
can also be found in the first portion of the Sarlra-sthana section
sathhitd (IV. 1.1-156).3
Although these two explanatory idioms (namely, Vaisesika and Samh
clearly dominant in the medical literature, it is not the case that anci
medical theorizing represents a "tight" or "hard" appropriation of the
darsana-s. Medical practitioners undoubtedly knew their philosophies,
clear enough from the use of terminology that they understood t
darsana-s in technical detail. It is also clear, however, that they u
technicalities of Indian philosophy for their own purposes even if
stretching various conceptualizations beyond the parameters of p
losophical usage. In discussions of "essence" (sdmdnya) and "part
(visesa), for example, in the Sutra-sthdna portion of Caraka (1.1.4
following pages), these terms are not employed in their correct p
usage as categorical notions in ontology and epistemology, but,
organic notions having to do with homeostasis and the disruption of
homoeostasis in a living body. Or, again, the discussion of imperceptibility in
Caraka (at Suitra-sthdna I. 11.8), though almost a word-for-word quotation from
Samkhya discussions of imperceptibility (see Sdthkhya-karikd VIII), does not
address the well-known Srmkhya problem. Srahkhya philosophy has the prob-
lem of accounting for the existence of purusa and prakrti, even though both
principles are imperceptible. Sahkhya proceeds, then, by a series of inferences to
show that existent things need not be perceived. In the Caraka discussion,
however, the discussion of imperceptibility concerns the existence of a trans-
migrating entity-admittedly, an interesting problem, but very definitely not the
more general philosophical problem as set forth in philosophical Srahkhya
traditions. Even more revealing in this regard is the discussion of the pramdna-s
or "means of knowledge" in the Caraka-sathitd (I. 11). Four are listed as being
authoritative, namely, reliable testimony (dptopadesa), perception (pratyaksa),
inference (anumdna), and what might be called heuristic reasoning (yukti). The
first three are discussed in what one might call a "tight" or "hard" philosophical
manner characteristic of the classical darsana-s. Heuristic reasoning (yukti),
however, is a much more flexible or "soft" means of knowing. It is described in
Caraka-samhitd 1.11, at verses 23 and 24:

Heuristic reasoning is the other source of knowledge. Examples include the


growth of crops on account of appropriate irrigation, properly ploughed land,
good seed, and the determination of the correct season. Or again, the develop-
mental stages of the embryo on account of the appropriate combination of the
five gross elements together with the Self or atman; or yet again, the production
of fire on account of the correct use of implements and an appropriate drilling
technique, or the cure of diseases on account of the fourfold therapeutic tech-

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251

niques. Heuristic reasoning is a source of general knowledge-that is to say, it


encompasses past, present, and future-that arises when one attends to the
multiple causal factors that operate among things in the world...." (Translation
mine)

Here reasoning functions as a set of regulative ideas that are pragmatically and
empirically employed for purposes of getting a useful heuristic grasp on the
complexities of the natural world (not unlike the heuristic use of reasoning in
Kant's third critique). Many interpreters have suggested that heuristic reasoning
can be reduced to inference (anumdna), but such a reduction misses the genius of
what the medical practitioners are trying to get at with their notion of yukti,
namely, an empirical and, indeed, experimental scientific (in the modern sense)
approach to reality and experience. Perhaps the most revealing example, how-
ever, of how the medical tradition functions vis-a-vis the more technical philos-
ophical schools can be found in Caraka-sathhitd 1.25.1-32, wherein a symposium
is described on the subject of the "origin of man and his diseases." Various
philosophical positions are described which deal with the subject of the sym-
posium, including the dtman school, the sattva school, the rasa school, the six-
dhdtu school, the mdtd-pitr school, the karman school, the svabhdva school, and
the Prajdpati-Kala school. Not enough is said about each school to determine its
precise historical identification, but one has the impression that these schools
represent, respectively, an older form of Veddnta, an old form of Vaisesika or
Nydya, an old school of materialism, the old Samhkhya school, an old naturalist
school, older Mimahsaka-s and Buddhists, possibly Carvaka-s (Svabhava-
vadins), and one or another variety of theistic schools. Punarvasu Atreya, the
leader of the symposium and the chief theoretician in the medical tradition, then
enters the discussion with the following concluding remarks on the symposium
topic:

Punarvasu then spoke to the experts who had been discoursing on the problem of
the origin of man and his diseases. "Do not let yourselves become embroiled in
complex arguments and counter-arguments nor let yourselves pretend that truth
is obvious and easy to attain if one adheres to a single philosophical position
(paksasamsraya). By your clever argumentation you will all end up going in
circles, like a person sitting on an oil press that moves round and round. Free
yourselves from simplistic biases and search for the truth dispassionately. (In-
deed, such a dispassionate inquiry will show that) the very same factors which
under some circumstances lead to health and well-being, under other circum-
stances bring about various diseases. (Translation mine)

Punarvasu Atreya then begins a long discourse on the importance of food in


maintaining health, but this need not concern us for purposes of my present
point. What is interesting in the passage is the explicit rejection of any one
philosophical position as an adequate conceptualization of the human condition.
Philosophy, to be sure, has an important role to play in generating heuristic
interpretations that may be useful under certain circumstances, but primary
emphasis is placed on empirical and experimental dimensions of everyday life.

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252 Larson

Philosophy for the medical tradition, in other words, is always th


maiden" of natural observation and experimental usage.
It is neither an accident nor a contradiction, therefore, to find mor
philosophical position set forth in the medical literature. Nor is it an ac
the Vaisesika and Sramkhya should frequently find favor with the med
ticians, for these systems appear to be most congenial to a natura
commonsense approach to ordinary life and experience. Moreover
pragmatic and usage-oriented perspective of Ayurvedic medical theory
argued that in an important sense both theoretical elaborations-that is
that inspired by Vaisesika and that by Sarhkhya-are remarkably alike
fundamental postulates-fundamental postulates that probably represen
tean Urphilosophie of South Asia that predates as well as underlies the
sophisticated darsana-s. These fundamental postulates appear to include
the following:

(a) The genetic body born of father and mother is a collocation o


physical constituents, either "atoms" (anu-s as dravya-s) or gross el
(mahdbhuita-s).
(b) The mind or psychic apparatus is of the same nature as the gr
although it is a more subtle manifestation of material reality (e
dravya or as a product of the material constituent, sattva).
(c) The psychic apparatus transmigrates from one life to the next, enl
genetic, physical body born of father and mother but is construed t
separate from genetic inheritance. That is to say, in any give
organism is determined both (1) by its genetic, physical heritage and
psychic heritage.4
(d) Nevertheless, there is a fundamental ontological uniformity th
nature-that is to say, the gross, physical body and the psychic
are both manifestations of subtle matter (either as dravya or as th
sattva)-which thereby encompasses our conventional Western po
subjective/objective, mind/body, or microcosm/macrocosm.5
(e) Finally, the self or soul (purusa or dtman) is clearly distinguished f
psychic apparatus so that the notion of "self" or "soul" has noth
with notions of mind, ego, intellect, personal identity, and so fort

The two theoretical elaborations (namely, Vai§esika and Samikhya) diff


in the heuristic explanatory models they construct to account for
postulates just mentioned. Whereas Vaisesika prefers a mechanistic
ontology and epistemology of pluralistic realism, Samhkhya prefers an
structuralist model based on the dialectical manifestations of sattva, r
tamas (both on the level of subjective experience and objective existenc
for purposes of medical theorizing, one has the impression that the Sa
explanatory model was superior in its subtlety, elegance, and explanato
and even from a modern point of view, the Samrkhya approach resonat
ingly to systems theory, semiotics, structuralism, and other contempora
tory models. Vaisesika atomism always had the problem-a problem
be noted, that plagues any theory of atomism, ancient or modern--of

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253

how that which has no extension (namely, atoms) can generate a world that has
extension, whereas the Samhkhya notion of an all-pervasive prakrti with its
continuous transformation (parindma) and combination (samtghdta) of sattva,
rajas, and tamas and with its inherent capacity for manifestation (pravrtti) and
dissolution or disappearance (pralaya) was a powerful theoretical concept that
obviously avoided the atomistic dilemma. Similarly, the Vaisesika invariably had
problems with its theory of discontinuous causation-namely, that the effect is
different from the cause-which always threatened to deny significant relations
between entities in the real world and required a complicated (and frequently
lame) notion of inherence (samavdya), whereas the Sramkhya notion of con-
tinuous causation-namely, that the effect is a manifestation or a reordering of
what is already present in a cause-was a more useful conceptualization and was
especially attractive to medical practitioners working with the complex networks
of causal factors that operate in the generation of illness and disease. Both
Vaisesika and Sarhkhya, however, proved to be heuristically useful in Ayurvedic
contexts, and it can be argued that Ayurvedic medicine unfolds within the
parameters of these two overall theoretical constructions.
That which Ayurveda adds to these overall theoretical elaborations is a specific
account of gross, physical life-that is to say, ordinary biological existence-and
the manner in which everyday existence interacts with the overall theoretical
constructions. Caraka comments (in Caraka-sarhhitd 1.11.3), for example, that
whereas the purpose of the religious systems is to attain moksa or "release," the
purpose of Ayurveda is to encourage the three ordinary, worldly desires for (a)
long life (prdnaisana), (b) reasonable wealth (dhanaisana), and (c) patterns of
behavior that will bring about a good rebirth (paralokaisana).
Both Srahkhya and Vaisesika carry their analyses to the level of the physical
body, but the focus of attention in Vaisesika and Sarhkhya qua philosophical
systems is largely on categorial issues, philosophical psychology, and soteriology
(moksa). Ayurveda, as it were, moves in the opposite direction. It begins with the
gross, constituent components and moves immediately into everyday biological
life. Of the five gross elements (namely, space, wind, fire, water, and earth), the
most important from a biological point of view are the middle three: wind (vayu),
fire (tejas), and water (ap). Space (dakda), being all-pervasive, is simply a medium
for biological life and, hence, not a great deal can be said about it other than its
being an appropriate medium.6 Earth (prthivT) is largely a composite of the other
elements and represents, therefore, the level of sheer immediacy. Again, not a
great deal can be said about it other than to refer to its composite structure and to
classify its various modalities.
Wind (vdyu), fire (tejas), and water (ap), however, are fundamental for Ayur-
vedic biological theory, for they are the principal components for life and
movement. Taken together (and assuming, of course, the larger theoretical
frameworks already discussed), they generate a nutrient fluid (rasa), which is
sometimes construed to be the lymphatic chyle fluid from the small intestine or

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254 Larson

the more general notion of nutrient fluid that nourishes the body as a w
nutrient fluid (rasa) is the first of the seven manifest constituents (dhatu
body, namely:

1) nutrient fluid (rasa)


2) blood (rakta)
3) flesh (mdrisa)
4) fat (medas)
5) bone (asthi)
6) marrow (majjd)
7) semen (sukra)

These dhatu-s derive one from the other, starting with rasa, and, therefo
the primordial manifest substance of the living, physical organism. Som
this rasa is correlated with the notion of tejas or "liquid energy," someti
the notion of water (ap) as the basic nutrient of life. Thus, the rasa as
fluid is related to both water (ap) and fire (tejas), and this primordial sub
taken to be the "life force" or "vital juice" (ojas) of the functioning org
Taken separately (that is to say, taking vdyu, tejas, and ap individuall
or wind manifests itself as the motorsystem (vata or prdna) of the
(including the motor activities of respiration, swallowing, speaking, dig
excretion, ejaculation, the labor activity of childbirth, circulation, a
activity generally). This is the vdta-dhdtu (or motor constituent) of
which includes prdna (the breath of the mouth for respiration), ud
"breath" of the vocal cavity for speaking), samdna (the "breath" of the
which aids digestion), apdna (the "breath" of the lower extremities for
sexual activity, and the labor activity of childbirth), and vydna (the "b
all the limbs for circulation). Both the rasa or nutrient fluid and the prd
principal process of the motor system reside primarily in the heart (hr
flow to other parts of the body through various arteries, veins, capilla
channels (dhamani-s, sird-s, srota-s, and ni.d-s). Tejas or fire manifests
the energy system of the body (pitta, literally "bile" because it shows its
bilious secretions of the liver, and so forth) (including the actual "cook
pacaka in the digestion of food, the coloring agent in blood and complex
energizer of desire, the presupposition of vision, and the sensory-nervo
paratus generally). Ap or water manifests itself as the integrating syst
body (kapha or slesman, literally "phlegm," for it shows itself in mucu
and so forth) which holds together the limbs and tissues and main
organism in a kind of steady state or homeostasis. Vdta, pitta, and kapha
bile, and phlegm), then, are the overall respiratory, digestive, and integ
components of the biological system, which provide the homeostatic
ment in which the previously mentioned seven nutrient constituen
function.7 When vdta, pitta, and kapha are in balance and harmony
referred to as the tri-dhdtu ("three systemic constituents"), which one
therefore, call organismic "health." When vdta, pitta, and kapha ar

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255

harmony or are unbalanced, they are referred to as the tri-dosa ("three systemic
problems"), which one might, therefore, call organismic pain or "illness." Vdta,
pitta, and kapha are also used typologically so that, according to Ayurveda, every
person tends to be a vdta type or a pitta type or a kapha type. The task of the
physician (vaidya, bhisaj) is to be able to diagnose the imbalances that occur in
persons or in specific illnesses, and Ayurvedic medicines (bhaisajya) are pre-
scribed to counteract these imbalances and, hence, to restore the healthy balance
of vdta, pitta, and kapha that is characteristic of a given patient. Moreover,
because the nutrient fluid (rasa) is so basic both in the anatomy and in the
chemistry of the body, a concern for food and "tastes" (rasa-s) plays a crucial
role in the maintenance of organismic health. It is essential for health that
persons maintain a balanced diet of sweet (svddu), sour (amla), salty (lavana),
pungent (katuka), bitter (tikta), and astringent (kasdya) "tastes" (rasa-s), which
represent the fundamental nutrients of the functioning organism. According to
Caraka (at 1.26.40), "tastes" (rasa-s) derive from the mahdbhuta-s as follows: the
sweet taste (svddu-rasa) derives from water (jala or ap); the sour (amla) from
earth (prthivl) and fire (agni); the salty (lavana) from water (ap) and fire (agni);
the pungent (katuka) from fire (agni) and wind (vdyu); the bitter (tikta) from wind
(vdyu) and space (dkasa); and the astringent (kasdya) from wind (vdyu) and earth
(prthivT). Among the sense capacities those of touch and taste were of particular
interest to the medical practitioners. The tactile sense would, of course, be the
most important (see Caraka 1.11.38), since every sensation and perception
presupposes some kind of contact and involves, therefore, some sort of tactile
apprehension. Feeling or touch, therefore, is basic to symptomatology, and this
is undoubtedly one of the primary reasons why the feelings of "pain" (duhkha)
and "pleasure" (sukha) are so fundamental in Indian thought and culture.
Almost as important, however, is the sense capacity of taste (rasa), for more than
any other of the sense capacities, the sense of taste functions at the intersection of
transaction between the natural world and the organism. Taste would, therefore,
be a crucial measuring or determining faculty with respect to what the organism
imbibes, digests, assimilates, discharges, and, of course, becomes! To control
taste is to get a handle on the larger transactional environment in which the
organism functions. Hence, it is no accident that Ayurveda, and Indian culture
generally, is preoccupied (even obsessed) with "wholesome" food (hitdhdra-
upayoga) and "unwholesome" food (ahitdhdra), which, respectively, are equiva-
lent to "health" and "disease" (see Caraka 1.25.33 and pages following) and
which likewise become the operational definitions of the "pure" and the "im-
pure." Moreover, when fundamental themes such as these are then combined
with the equally fundamental theme of transmigration and rebirth, one begins to
understand more clearly why birth and caste come to play such a significant role
in everyday life in South Asia. Obsessive attention is given to food, season,
habitat, lifestyle, and social interaction in Ayurvedic diagnoses and thereapies,
for the notions of "health" (tri-dhdtu) and "disease" (tri-dosa) are but compo-

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256 Larson

nents in a much larger, holistic, systemic, and transactional network of


interaction that structures the apprehension of traditional South Asia

CONCLUSIONS

Returning now to the "philosophical" and "interpretive" conce


pressed at the beginning of this article, let me briefly conclud
attention to three aspects of the conceptual basis of Ayurvedic med
outlined it, that could be productively pursued (both in empirical
theoretical reflection) in our own modern medical science.

(1) Ayurvedic theory (with its Vaisesika-cum-Sahkhya theore


its systemic notions of "illness" and "disease") calls into seriou
conventional modern notions of the individual person and our mod
of isolating a sick patient. Of course, contagious disease must b
antisepsis and asepsis rigorously pursued in view of modern
pathology and bacteriology. Ayurvedic theory in its modern form
nizes this. For Ayurveda, however, the "individual" is really "di
McKim Marriott's idiom)-that is to say, the "individual" is a kin
construct, a heuristic residue, as it were.8 What is more basic or im
"dividual" transactional environment within which culture occurs,
of "health" and "disease" come to have much richer connotatio
cations in such a transactional, "dividual" conceptualization. Th
food, the larger social reality, and the notion of a regulated home
and outside of the body come to have greater importance. Health c
delivery, is no longer an ad hoc response to acute disease (although
course, it must be that) but becomes a much broader conceptu
encompasses the totality of the "life" of a culture.

(2) Ayurvedic theory interprets the "dividual" transactional mod


life of culture in terms of a "reductive materialism" in which our conventional
notions of the polarity or duality of mind/body, subjective/objective are no
longer relevant. Ayurveda stresses not only what we would call psychosomatic
medicine, but even more than that, what might be called a "sociobiological"
medicine.

(3) Finally, Ayurvedic theory poses the possibility of a "holistic" medicine


that encompasses more than one life. That is to say, Ayurveda assumes that we
are much more than a genetic heritage of father and mother. We possess in
addition psychic components that may reach back over many lives and may be
projected many lives hence. Ayurveda, of course, uses the traditional South
Asian idiom for talking about a holistic medicine that encompasses more than
one life (in terms ofkarman, rebirth, transmigration, and so forth). One wonders,
however, if it might be possible to translate this ancient idiom into a modern

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257

format for research and study. If such could be accomplished, we might be


surprised at the new vistas for philosophical anthropology that would be opened,
and we might be surprised to discover that in an important sense the ancient
wisdom of traditional South Asian culture has been quietly waiting to be "re-
born" and to reveal again its mysteries to us.

NOTES

1. For useful and recent discussions of the history of the literature of Ayurveda, see the Int
tion and Appendix Two in G. J. Meulenbeld, ed., The Mddhavaniddna and Its Chief Comm
chapters 1-10; Orientalia Rheno-Traiectina (Leiden: E. J. Brill, 1974), pp. 1-27, 389-436;
the Introduction in Claus Vogel, ed., Vdgbhata's Astdhgahrdayasarhhitd (The First Five Cha
Its Tibetan Version), Abhandlungen fur die Kunde des Morgenlandes, XXXVII, 2 (Wie
Deutsche Morgenlandische Gesellschaft, 1965), pp. 1-43.
2. Filliozat's classic study has been available for some years in a good English translation,
J. Filliozat, The Classical Doctrine of Indian Medicine, trans. D. R. Chanana (Delhi: Mu
Manoharlal, 1964).
3. This divergent interpretation of Srmkhya has been carefully described by Surendran
gupta in A History of Indian Philosophy (Cambridge, 1963 printing), vol. 1, pp. 213 ff, and
need not be repeated here. I also have discussed this interpretation of Srahkhya vis-a-vis other
of preclassical Sramkhya in Gerald James Larson, Classical Samkhya, 2d rev. ed. (Delhi
Banarsidass, 1979), pp. 103 ff. Dasgupta argues that this Caraka form of Srakhya is a
Samrkhya that is later reworked by the classical Samhkhya thinkers. A. B. Keith and some oth
argued, on the other hand, that the Caraka form of Sramkhya is a later, syncretistic form of Sr
clearly under Vedanta influence. My own view of the problem has changed in recent years. For
years I was convinced by Dasgupta's discussion, but now that I have been reading the med
with greater care I am convinced that the Caraka material in the SarTra-sthdna is clearly
ticized Sriakhya, and not at all an early form of pure Sarhkhya.
4. I use the ambiguous phrase "psychic apparatus" deliberately, for the Indian philo
schools differ considerably as to the precise characterization of that which transmigrates.
and Vedanta argue for a subtle body, Sarhkhya suggesting that the subtle body is made up of i
ego, the eleven indriya-s (including mind), and the five subtle elements, Vedanta suggesting
"sheaths" (kosa-s) that accompany the transmigrating entity. Nyaya, Vaisesika, and Yoga,
other hand, argue against the notion of a subtle body. The Nyaya-Vaisesika notion of m
atomic eliminates the need for any vehicle, for an atomic entity has no extension to begin
Yoga notion of citta being all-pervasive likewise eliminates the need for a subtle body, since ci
as it were, no place to go! It is already there at the moment of conception. It is interesting to o
this regard that Ayurveda clearly sides with Srmhkhya and Vedanta-that is to say, there is
body that transmigrates from life to life.
5. In modern philosophical discourse such a view is referred to as "reductive materialism"
to say, intellect, ego, mind, and so forth are viewed as manifestations of subtle materiality. O
awareness (antahkarana-vrtti or citta-vrtti), therefore, is simply a reflection or manifest
material stuff (prakrti or dravya, and so forth). Indian thought generally, however, m
additional (and crucial) claim, namely, that consciousness (as purusa, dtman, and so forth)
clearly distinguished from awareness. Nyaya-Vaisesika realism, of course, tends to see cons
as an attribute that emerges because of the contact between Self and mind (and thus
dangerously close to a thoroughgoing materialism, although most Nyaya-Vaisesika thinkers
to go all the way on this issue), whereas Sramkhya, Yoga, and Vedanta argue for a fun
difference in kind between consciousness and awareness. It is interesting to observe in this reg
Ayurveda tends to side with Nyaya-Vaisesika.
6. The materialistic bias is undoubtedly also a reason for the absence of discussions of akd
medical literature. The materialists accepted such notions as wind, fire, water, and earth an
ignored the notion of adkda.

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258 Larson

7. It is perhaps tempting to correlate vdta, pitta, and kapha with the three guna-
philosophy (namely, sattva, rajas, and tamas), and indeed, Dalhana, the commentator
samihitd, makes just such a correlation, arguing that vdta can be correlated with ra
sattva, and kapha with tamas. His attempted correlation is understandable, given
Sarhkhya bias of Su§ruta both in its earlier portions as well as in the later Uttara-tantra
a theoretical point of view, however, such a correlation is simplistic and unconvincin
speaking, vdta, pitta, and kapha are tamasic manifestations since they emerge from the
which themselves are derived from the tamasic form of aharhkdra, namely, the five sub
tanmdtra-s. It could hardly be the case, therefore, that there is any kind of sim
correlation between vdta, pitta, and kapha and sattva, rajas, and tamas. If one wishes to
kind of correlation, it is possible to work it out, but the procedure is much more com
Dalhana's commentary suggests. One would have to move in the following fashion a
scheme of symbolic notations: In Srhkhya philosophy, the divine realm is sattvic (S
realm is rajasic (R) and the animal realm is tamasic (T). The human realm is a collocatio
guna-s, therefore, with a rajasic predominance, or R(s + r + t) = prakrti (as apprehe
human perspective). Ego (or aharhkdra) in its tamasic mode (or, in other words, as it show
five tanmdtra-s) would have the following notation: R(t(s1,rl,tl) (sr)), which mea
overall human rajasic realm, when a second-level tamas is dominant and the second-
sattva and rajas and latent, and when third-level forms of sattva, rajas, and tamas be
dialectically (namely, si, r1, t1), one has reached the level of a subtle element or tanmdt
takes the subtle element rasa, for example, and its correlates water (ap) and its dhatu
namely, kapha, a reasonably correct guna correlation would be the following: R(t
Needless to say, it is hard to imagine that Dalhana had any such approach in mind w
suggested a correlation between vdta, pitta, and kapha and the three guna-s of the Srhk
add, parenthetically, that the use of symbolic notations in trying to work out the impli
Sahkhya philosophy is not as far-fetched as it may seem at first glance. Sarhkhya enum
to focus on the sequence of prime numbers (namely, 2, 3, 5, 7, 11, 13, and 17). If one then
sequence of prime numbers with 1 (= prakrti) and 0 (= purusa), one is able to generat
numbers. If one also correlates derived quotients with various "entities" (for example, bu
mahdbh;ita, and so forth), one soon finds oneself working on a kind of mathematic
physics not unlike the kind of theoretical physics one finds in ancient Pythagoreanis
8. For a systematic discussion of Marriott's notions of "dividual," "transactional,"
see McKim Marriott, "Hindu Transactions: Diversity without Dualism," in Tra
Meaning: Directions in the Anthropology of Exchange and Symbolic Behavior, ed., B.
Essays in Social Anthropology, I (Philadelphia, Pennsylvania: ISHI Publications, 1976)

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