Literature in Ayurveda

CHARAKA SAMHITA

Charaka Samhita is a huge treatise on ancient Indian medicine. It contains eight divisions (ashtanga sthanas) viz., sutra, nidana, vimana, sharia, indriya, chikitsa, kalpa and siddha. Each division is further divided into numerous chapters; it describes not only the existing knowledge about medicinal aspects but also the philosophy and logic behind the medical systems. The present manuscript of Charaka Samhita has a long history behind it. As stated earlier, it was originally composed by Agnivesa one of the six students of Atreya, and it embodied the teachings of the latter. Agnivesha's treatise appears to have been available till the eleventh century, as Chakrapanidatta, its commentator, quotes from it.
With the passage of time, as new knowledge accumulated, it looks; it was felt necessary that Agnivesha tantra should be revised. This was done by Charaka and the revised edition of Agnivesha tantra came to be called Charaka Samhita. During the ninth century, Charaka Samhita was again edited and reconstructed by a Kashmiri Pandit named Dridhabala, son of Kapilabala, a resident of Panchanadapura, now known as Panjor situated seven miles north of Srinagar . The present form which Charaka Samhita has was given to it by Dridhabala. He not only added the missing chapters but also edited the whole samhita.
Charaka Samhita deals elaborately with subjects such as foetal generation and development, anatomy of the human body, function and malfunction of the body depending upon the equilibrium or otherwise of the three humours of the body, viz., of vayu, pitta and kapha. It describes etiology, classification, pathology, diagnosis treatment of various diseases and the science of rejuvenation of the body. It discusses elaborately the etiology of diseases on the basis of the tridosa theory. It gives a detailed description of the various diseases including those of the eyes, the female genital organs, normal and abnormal deliveries and diseases of the children. Charaka's materia medica consists chiefly of vegetable products though animal and earthy products are also included in it. All these drugs are classified into 50 groups on the basis of their action on the body.
This vast treatise also gives an idea of the various categories of the practitioners of the healing art, specialization in different medical subjects, physicians and their fees, nursing care, centers of medical learning, schools of philosophy such as Nyaya and Vaiseshika which formed the fundamental basis of medical theories, medical botany and classification of the animal kingdom, particularly in regard to properties of their flesh etc. It also describes various customs, tradition, legends, routine of daily life, habits of smoking and drinking, dress and clothing of the people of that epoch.
Commentary on Charaka Samhita by Chakrapanidatta, called ‘Charaka Tatparya-Tika’ or ‘Ayurveda Dipika’, done in the 11^th century (1066 A.D.), is very famous.
Charaka Samhita was translated from Sanskrit into Arabic in the beginning of the 8^th century and its name ‘Sharaka Indianus’ occurs in the Latin translation of Avicenna, Razes, and Serapion, a translation of the Karka from Sanskrit into Persian and from Persian into Arabic is mentioned in the Fihrst (finished in A.D. 987). It is likewise mentioned by Alberuni. Charaka Samhita was first translated into English by A.C. Kaviratnain 1897.
The life and times of Charaka are not known with certainty. Some Indian scholars have stated that Charaka of Charaka Samhita existed before Panini, the grammarian, who is said to have lived before the sixth century B. C. Another school argues that Patanjali wrote a commentary on the medical work of Charaka, which is corroborated by his commentator, Chakrapanidatta. They say that if Patanjali lived around 175 B.C., Charaka must have lived some time before him. Another source about the identity of Charaka and his times is provided by the French orientalist Sylvan Levi. He discovered in the Chinese translation of the Buddhist Tripitaka, a person named Charaka who was a court physician to the Indo-Scythian king Kanishka, who in all probability reigned in the second century A.D. From the above discussion, it would seem that Charaka may have lived between the second century B.C. to the second century A.D. Till such time as further and more conclusive evidence is available, to narrow down this period would not be justifiable.

SUSHRUTA SAMHITA

This treatise is the main source of knowledge about surgery in ancient India . Sushruta Samhita, as we know it now, is not in the original form which he gave it and which he called. It was first called Shalya Tantra consisted of only five divisions, viz., ‘Sutra’, ‘Nidana’, ‘Sharira’, ‘Chikitsa’, and ‘Kalpa’. Shalya Tantra was later revised and supplemented. Later addition of ‘Uttara-tantra' consisting of three divisions called ‘Shalakya’, ‘Bhuta-Vidya’ and ‘Kalamara-Bhrtya’, makes eight divisions in the present Sushruta Samhita.
Of the commentaries on Sushruta Samhita, the most renowned is that of ‘Dalhana’ called ‘Nibandha Samgraha’ written in the 12^th century AD. Another commentary is by ‘Chakrapanidatta’ written in the eleventh century. It is called ‘Bhanumati’ and only a portion of it is available now.
Sushruta Samhita was translated into Arabic before the end of the eighth century A.D. It was called ‘Kitabshaw-shoon-a Hindi’ or ‘Kitabi-i-Susrud. Rhazes’, the famous Arab physician, often quoted from it and mentioned Sarad as an authority on surgery. It was translated in Latin by Hassler and in German by Ullers.
It was translated into English, in part only, by U.C. Datta (1883), A. Chattopadhyaya (1891) and Hoernle (1897). K.L. Bhisagaratna translated it in full between the years 1908 and 1917 and it is this translation which is available now.
Who was Sushruta, the composer of Shalya Tantra and when did he live, is not known with any certainty, but for a hint here and there. In connection with the bones of the human body, Sushruta in Sushruta Samhita introduces his own exposition with a remark pointing to the difference between the Atreya system and his own in respect of the total number of bones. This proves that Sushruta could not have lived before Atreya. Another hint is provided by ‘Shatapatha Brahmana’, which seems to be acquainted with Sushruta's enumeration of bones. The exact data of Shatapatha Brahmana is not known, but it is said to belong to the sixth century B.C. If that is so, Sushruta may have lived around the time when Agnivesha composed his Tantra under the direction of Atreya.
Sushruta of Shalya Tantra was a great surgeon, teacher of repute and an admirable author. He made great improvements in the general techniques of surgery and performed many new and major operations. He also described a variety of surgical instruments.
He taught his students the surgical techniques first on the dummies and later on the dead bodies. His techniques of dissection of the human body are unique, practical and revealing of the structure of the body. His operations of making a new nose or ear-lobe, of lithotomy, of taking out the dead foetus, and abdominal operations, are classical marvels.
Before Sushruta's time, knowledge and practice of surgery in India was more or less of the same standard as in other contemporary civilizations like Egypt , Mesopotamia and Greece . In India , the profession of healing was practiced by surgeons (ahalya vaidas), physicians (bhesajas) priest doctors (bhisaj atharvana], poison-curers (vishaharas) and demon doctors (krtyaharas). To practise their art, these professionals had to go out into the open streets, calling out for patients. They lived in houses surrounded by gardens of medicinal herbs. Surgery was not considered a respectable profession before Sushruta's time.

BHELA SAMHITA

Bhela was one of the six students of Atreya. He is said to have composed a treatise called Bhela Samhita. This was not traceable for many centuries, but in the year 1880, a palm leaf manuscript of it, composed in Sanskrit but written in the Telugu script, was found in the Palace Library at Tanjore. This manuscript, written in about 1650 BC, abounds in mistakes and some of it has been disfigured beyond recognition. But whatever has survived gives evidence of the same ancient tradition as Charaka Samhita does. It has also eight divisions like the Charaka Samhita and each section end with the words: “Thus spake Atreya” as it is in Charaka Samhita. Bhela Samhita essentially corroborates what Charaka Samhita says. Occasionally, it differs from it in some details.

NAVA-NITAKA

The practice of Ayurvedic medicine entered a new phase when instead of the ‘samhitas’ on medicine and surgery, compendia of prescriptions for various diseases began to appear. The first of such treatises which we have with us now is Nava Nitaka. This manuscript was discovered by a man of Kuchar, an oasis of Eastern Turkistan in Central Asia on the caravan route to China . This route was used by the Buddhist monks of India for traveling to far off places. This man dug in the hope of getting some treasure in an area supposed to contain an underground city. He did not find any wealth but discovered a manuscript which was bought for a small sum by L.H. Bower, who had gone there on a private mission from the Government of India. This manuscript was forwarded to J. Waterhouse, the then President of the Asiatic Society. It was deciphered and published by A.F. Hoernle, who spent 21 years on its study. Afterwards, the manuscript was sold to the Bodlein Library in Oxford .
Nava Nitaka manuscript by its name or by its contents has been mentioned by different authors between the tenth and the sixteenth century. After that, this manuscript has not been mentioned by anyone until it was re-discovered. The present manuscript is composed of very defective Sanskrit mixed with Prakrit. It was written in the ‘Gupta’ script of the 4^th or 5^th century. The material on which it is written is birch bark, cut into longish folios like the palm leaves of southern and western India . The contents suggest Buddhist influence in its composition.
According to Hoernle, the whole manuscript consists of not less five distinct parts. The author quotes from Charaka and Sushruta and Bhela Samhita. The title 'Nava-Nitaka', which means butter, is indicative of the manner of its composition; just as a small amount of butter is extracted out milk, so does this work contain the essential formulae extracted from other larger works. According to one scholar, the author of Nava-Nitaka was Navanita.
Nava-Nitaka for the first time gives details about the use of garlic various diseases such as consumption (rajya yakshma) and scrofulous glands in the neck. Tied with a thread, it was also hung on the door; this was supposed to check the spread of infectious diseases like small-pox. Garlic was recommended to be used in winter and spring.

havamisra quoted these treatises repeatedly in their works.

ASHTANGA SANGRAHA AND ASHTANGA HRIDAYA SAMHITA

This book is still studied all over India , more so in the south. It is composed in a combination of verse and prose form. It was written by Vagbhatta around the 7^th century AD. It is predominantly based on the teachings of Charaka and Sushruta Samhita as though it also gives its own views on different topics. Commentaries on Ashtanga Sangraha were written by Arunadatta about 1220 A.D. and by Hemadri a few decades later.
Ashtanga Hridaya Samhita is divided into six divisions – ‘Sutra Sthana’, ‘Nidana Sthana’, ‘Sharira Sthana’, ‘Chikitsa Sthana’, ‘Kalpa Sthana’, and ‘Uttara Sthana’ and it is also written by Vagbhatta. It contains 120 chapters and the author quotes Charaka, Sushruta, Bhela, Nimi, Kashyapa, Dhanvantari and other earlier authors and their works; the chief source, however, is Ashtanga Sangraha. It is a complete but concise description of Ayurvedic medicine.
Particular stress is laid upon surgery. It does not mention the user of opium in the treatment of diseases and feeling of the pulse for diagnosis. Use of 'killed' (oxidized) metals is also not given in it. ‘Sutra-sthana’ of Ashtanga Hridaya is especially popular. A popular later couplet says: "The best authorities in medicine are Madhava for nidana (diagnosis), Vagbhatta for sutra sthana (theoretical basis or general principles), Sushruta for sharira (structure of the body) and Charaka for chikitsa (treatment)."
Ashtanga Hridaya has all along been a very popular treatise. Commentaries on it have been written from time to time by as many as 35 important Ayurvedic physicians, each one interpreting it to the best of his knowledge and experience.
Ashtanga Hridaya was translated from Sanskrit into Persian in 1473 A.D. by Hakim Ali Mohammed Bin Ali Ismaili Asavali Aseeli, and dedicated to Mahmood Shah I, the ruler of Gujarat .
Ashtanga Sangraha and Ashtanga Hridaya, particularly the latter, indicate advancement in knowledge over the two samhitas of Charaka and Sushruta. This is particularly noticeable in the new drugs and some of the new surgical procedures that have been introduced. These treatises of Vagbhatta were extensively used and, in fact, they overshadowed the earlier samhitas to the extent that some portions of them were lost never to be recovered. Later writers like Sharangadhara, Chakrapanidatta and B

RUG VINISHCHAYA

Rug Vinishchaya, Madhavakara's famous treatise, is written in simple language and style. It is easily understandable by ordinary physicians and became very popular and came to be known as Madhava nidana or simply Nidana. It specializes in the diagnosis of the diseases. The order in which it describes the causes, symptoms and complications of the important diseases sets an example for the future authors such as Vrinda, Vangasena and Chakrapanidatta. Its description of diseases shows a significant advancement compared with that of Charaka and Sushruta Samhita.
A special chapter is devoted to small-pox, which previously was described only in a minor way. It, however, literally quotes, many a time, Charaka and Sushruta, which shows the borrowing it made from these sources.
In later times, numerous commentaries were written on Madhava's Nidana, which indicate the fame and popularity of this work. The most famous of these commentaries was ‘Madhukosh’ by Vijayaraksita and his pupil Srikanthadatta in the 14^th century. The other commentary ‘Antak-darpan’ by Vachaspati also belongs to the later half of the 14^th century.
The time of Madhavakara, son of Indrakara, cannot be stated with certainty. Vagbhatta mentions Charaka and Sushruta but not Madhava. Madhava, on the other hand, does not mention anything about Dridhabala's edition of Charaka Samhita. So Madhava came after Vagbhatta but before Dridhabala. Furthermore, Vrinda knew about Madhava. These indirect sources indicate that Madhava may have existed in the 9^th or 10^th century A.D.

SIDDHA YOGA

Vrinda composed Siddha Yoga probably around 1000 A.D. This treatise is a medico-chemical work which incorporates some of the material from Charaka, Sushruta, Vagbhatta, Madhavakara and Nagarjuna. This became very popular. A commentary called ‘Kusumavali’ was written on it by Sri Kanthadatta around fourteenth century A.D. The commentator states that Siddha Yoga makes particular mention of the diseases prevalent in western India ; may be Vrinda belonged to that region. Siddha Yoga is in the nature of a sangraha and follows the methods of Vagbhatta and others and gives a survey of the classical method of treatment. This is the first large treatise dealing with the prescriptions; in it Vrinda prescribes mercury for internal use. Siddha Yoga of Vrinda was considered to be very important treatise. It was among the books translated into Arabic.

RASARATNAKARA

Rasaratnakara deals with the preparation and use of metallic compounds, more particularly of mercury (rasa). It describes certain recipes in which vegetable or animal products are used to transform other metals into compounds which look like gold and could be passed off as gold. These compounds, particularly of mercury, were prepared and used in order to make the body undecayable and strong.
Rasaratnakara was written by Nagarjuna. From the internal evidence of this book, it appears, it is a work composed after the time of Vagbhatta i.e., in the 8^th century. Alberuni mentions of a Nagarjuna resident of the fort Daibhak near Somnath, who composed a book ‘Rasayana’. According to him, this Nagarjuna lived about a hundred years before his times. It appears, Nagarjuna lived sometimes between the 8^th and 9^th century A.D. Nagarjuna composed some other works also, which include ‘Kakshaputa Tanim’ and ‘Arogya Manjari’. According to Dalhana, a commentator of Sushruta, Nagarjuna reconstructed Sushruta Samhita and added Uttara Tantra to it. Nagarjuna was quoted as an authority on ‘rasayana’ by later authors such as Vrinda and Chakrapani.
Until the seventh and eighth centuries, Ayurvedic drugs consisted mainly of vegetable products. Metals, such as iron, silver, tin and lead, were very sparingly used for medical purposes. Use of metallic compounds particularly began with Nagarjuna and it increased progressively.

SHARANGADHARA SAMHITA

The earliest Indian medical treatise to mention of nadi-pariksha (pulse examinations) is of the 12^th century. Written in the 13^th century, Sharangadhara Samhita describes different types of pulse in different disease conditions.
Sharangadhara Samhita is not a ‘tantric’ treatise though the author devotes the "Madhya khanda" to a detailed description of metals and their purification, mercury and the methods of 'swooning', 'killing' and fixing of mercury. It follows the orthodox system of therapeutics of the ancient classical authorities, but admits into the Indian pharmocopoeia, important drugs like mercury and opium, and utilizes them in therapy.
It also marks certain important advances in the physiology of respiration, in medical diagnosis and therapeutics. Sharangadhara Samhita was translated into Hindi, Gujarati, Bengali and Marathi languages; this shows that it was very popular.
Two commentaries on Sharangadhara Samhita were written: one by Adhamalla called ‘Dipika’ in the 13^th century, the second by Kashiram called ‘Gurartha dipika’ in the 16^th century.

BHAVAPRAKASHA

To the middle of the sixteenth century belongs Bhava Misra whose treatise Bhavaprakasha is an important medical work. Bhava Misra is the last of the great men of Indian Medicine. He was the son of Lataka Misra and lived at Varanasi in the year 1550 A.D. He was considered as "a jewel among the physicians" and the best of the scholars of his time. He is said to have taught and trained at least 400 students in medicine.
In his important and voluminous treatise called Bhavaprakasha he describes the best of the available material of the previous authors and sets forth his own views and experiences. It is also divided into three khandas (parts): ‘purva’, ‘madhya’ and ‘uttara’. In it the author systematically deals with the origin of Indian medicine, cosmology, human anatomy, embryology, physiology, pathology, medicine, diseases of the children, surgery, Materia Medica, therapeutics, dietetics, rejuvenants and elixirs to prolong life. His clear style and excellent arrangement of the subject matter has thrown a flood of light on many obscure and disputed views of the ancient writers. He describes nadi-pariksha (examination of the pulse) and also the use of mercury and opium.
By the time of Bhava Misra, foreigners from European countries, particularly Portuguese, had started pouring into India to enrich themselves by commercial pursuits. Many of them, however, were suffering from syphilis and so passed on the .disease to the Indian population also. Indian physicians were quite unfamiliar with this scourge and all their previous medical treatises were silent on this subject, even though they did describe other diseases of the genital organs. A new name was needed for this malady and as this disease was brought into the country by the Portuguese, it was called Phiranga roga. Mercury in the form of calomel, catechu, Spilanthese oleracea and honey in certain proportions are the recommended medicines. Certain other recipes are also mentioned.
Bhava Misra's Bhavaprakasha is still popular and is consulted by Ayurvedic physicians in India . He composed another small pharmacological work called ‘Gunaratnamala’. It mentions China root called Tobchini in the vernacular, as a remedy of "phiranga roga." He was the first to mention certain drugs of foreign countries as badhkashani naspasi, khorabani and parasika vacha (Acorus calamus), sulemani kharjura (date fruit of Suleman) and opium. Surgery is mentioned only in brief.
A copy of Bhavaprakasha dated 1558, according to Jolly, was available in Tubingen .