Caraka, the master physician, is believed to have lived in the first century AD. The Samhita– composed by him forms the bedrock of ayurvedic practice today. His contribution to India’s cultural inheritance was profound. Caraka Samhita– was, in fact, a revision of an older text Agnivesa– Tantra, which was written several centuries before Caraka’s time. Caraka’s revision became so popular that it was translated into Tibetan, Arabic, English and many Indian languages. The Legacy of Caraka retells the Samhita– in a new format. Instead of adhering to the sequence of the Stha–nas in the original, the author has retold the Samhita– through thematically structured chapters, in contemporary idiom. The retelling has involved some degree of restructuring and condensation but has ensured that whatever is stated can be traced back to the original. In a detailed introduction, the author has commented on specific aspects of Caraka’s philosophy, concepts and practice, as seen from the point of view of modern medicine. This book will be of special interest to students of a–yurveda, medicine and other sciences, and those interested in the history of science in India.
Dr MS Valiathan is primarily a cardiac surgeon who received his surgical qualifications in the UK and cardiac surgery training at the Johns Hopkins and Georgetown Hospital in the US. His main interests span pediatric cardiac surgery, endomyocardial fibrosis and the development of cardiovascular devices including the Chitra tilting disc valve (which is now commercially available). His contributions are embodied in a monograph, many scientific papers and a family of medical devices including a tilting disc heart valve, all of which are used widely in India. His parallel interest is the history of medicine, particularly ayurveda. Dr Valiathan is a National Research Professor of the Government of India.
Introduction I Caraka and his legacy Historical Caraka - Philosophical moorings - Medical science Pharmacology - Practice of medicine - Caraka the teacher - Human destiny
II Atharva Veda to Caraka Atharvan echoes in Caraka - Human body in Atharva Veda III Diseases in Caraka's period Infectious diseases and infected conditions (disgestive disorders, fever; lepros)l smallpox, pulmonary TB, abscess, cellulitis, sores) - Non-infectious diseases (seizures, piles, gaseous lumps, heart diseases, alcohol-related disorders, pallor, polyuria, bleeding disorders, insanity)
IV Doctrines and concepts Five constituents of matter (paficabhuta) - Three dosas (tridosa). A regimen dictated by seasons (rtucarya) - Natural urges (Vegas)
V Five evacuative procedures (pancakarma) VI Procedures for rejuvenation and enhanced virility (rasayana and vajikarana)
VII Medicinal plants Classification - Mechanism of action - Preparation· of formulations Anti-dosa plants
VIII Food and Drinks IX Habitat X Learning to be a physician
Section 1
Mind and matter; life and death; health and disease; food and drugs; a code of living; a physician's calling
1 Ayurveda Branches of ayurveda - Categories in ayurveda - Equilibrium of dhatus Equilibrium of dhatus - Settling disturbed equilibrium of dosas - Summary of drug formulations
2 Drugs formulations in therapeutics
3 Sense perception and well-being Oiling the body - Role of smoking, food, sexual intercourse, general conduct, traditions
4 Life in accord with the seasons 5 Suppression of natural urges; comments on physical miscellany
6 The medical quartet Types of physicians - Forecasting outcome
7 Three desires, means of knowledge and some triads Means of knowledge (authority, perception, inference and reasoning) – Rebirth - Disease and treatment (triads of life, strength, causation, action, time, diseases, disease channels, physician and treatment)
8 Lubricants in therapeutics Action _ Candidates for therapy - Administration - Basis of dosage Method of therapy 9 Fomentation Choice of candidate – Techniques 10 Evacuative therapy A house for therapy - Two forms of therapy 11 Imbalance of dosas - varied expressions Disorders of the head - Disorders of the heart - Abscesses - Swellings – Imbalance of dosas 12 Slimming and building up in therapeutics 13 Obesity and leanness; stray remarks on sleep Obesity - Leanness – Sleep 14 Blood Narcosis - Fainting – Coma 15 Food as the source of man and his diseases Origin of man and his diseases - Food as the source - Wholesome and unwholesome food 16 Rasas Evolution and attributes - Six rasas - Action of tastes - Antagonisms in Foods 17 Food and drink Food - Drink - Water - post-prandial drinks 18 The fate of food and drinks in the body Food and drink - Dhatus as targets of dosa perturbation 19 Physicians - genuine and fraudulent 20 Rasas, dosas and a healthful diet Rasa-dosa interaction - Downstream aspects - Dietetic rules
21 Epidemics; reflections on lifespan
22 Norms for the quantity of meals
23 Body - a network of channels Flow through body channels - The heart and its ten great vessels
24 Disease - manifold expressions of deranged dosas 25 Infestation by worms (krmi) Evacuative measures for intestinal and head worms - Eradicative measures
26 Training of a physician - theory, practice and ethics The physician at the bedside - The body of the patient - Initiation of treatment – Drugs for evacuative therapy 27 The body and its knower The individual (mind, sense organs, intellect, prakrti) – The self -The supreme Self- Causes of sorrow and disease
28 Conception Begetting a child - A religious ceremony - Perturbed dosas - Early pregnancy and gender of the baby - Signs and symptoms of pregnancy The self and the embryo
29 Genesis of the embryo
30 Pregnancy - fetal development, Anomalies and personality types Pregnancy (sequential development of fetus) - Fetal development and anomalies - Personality types
31 Antenatal and postnatal management and care of the baby The fetus and the course of pregnancy - Antenatal care - Miscarriage A house for delivery - Childbirth - After delivery - Breastfeeding The nursery
32 The individual and the cosmos
33 A count of body parts Skin, the body frontier - The parts of the body - Bones - Sense orgar.~ Vital principles - Viscera - The body essences
34 The spectre of death Warning signs - Sudden death - Prognostic role of a house call
Section 2
Rejuvenant and virile therapy; diseases and the regimens for treatment
35 Rejuvenant therapy (rasayana) Celestial origin - Two regimens for rejuvenation (intramural and extramural) – Rasayana formulations - Rasayana formulations with metals
36 Virile therapy (vajikarana) 37 Fevers (jvara) Causation - Classification and clinical features - 'Treatment - Other fevers 38 Pitta-induced bleeding disorders~rakta pitta Cause - Clinical features - Clinical outcome - 'Treatment 39 Gaseous and hemorrhagic lumps of the abdomen (gulma) Five types of lumps - Signs and symptoms - Formulations in treatment – Abdominal lumps in women 40 Polyurias (pramehas) Kaphaja prameha - Pittaja prameha - Vataja prameha - Treatment – General measures 41 Skin disorders including leprosy (kustha) Causation - Seven types of kustha - Other skin disorders (~ksudra ~kustas) - Treatment 42 Phthisis (sosa) Causes - Premonitory signs and clinical course - Body processes as the basis of clinical features - 'Treatment.
43 Insanity (unmada) Classification on the basis of causation – Treatment 44 Epilepsy (apasmara) Clinical features - Treatment - Delusional state in epilepsy – Disease begetting disease
45 Chest injuries and their sequelae (ksata ksina) Clinical features - 'treatment - Diet – Formulations 46 Swelling (svayathu) Classification - Sites – Treatment 47 Abdominal disease with distension (udara) Classification – Treatment 48 Piles (aria) Congenital piles - Disturbance of dosas - Clinical course – Treatment 49 Digestion and digestive disorders (grahani) Digestion - Digestive disorders – Treatment 50 Disorders of pallor (panduroga) anemias Kamala - Earth eating (pica) - Jaundice with white stools 51 Hiccup; shortness of breath (hikka svasa) Causes and mechanisms - Types – Management 52 Cough (kasa) Causes – Management 53 Diarrhea (atisara) Types - Management
54 Vomiting (chhardi) Causes - Management 55 Cellulitis (visarpa) Types - Clinical features - Management 56 Thirst (trsna) Clinical features - Management 57 Cellulitis (visarpa) Types - Qualities - Clinical course - Clinical features - Snakes and snake bite – Bites by spiders and other creatures - Procedures - Other measures of management - Suspected bites . Homicidal poisoning
58 Alcoholic disorders (madatyaya) Proper and other uses - Clinical features - Management - Complications 59 Sores and injuries (vrat:ta) Causes - Classifications . Clinical fearnres . Clinical course - Treatment 60 Three regional disorders (basti, hfdaya and siras) Vital regions (marmas) of the body - Disorders of the vital regions Disorders of. the head - Pelvis - Heart region and chest disorders - The head region 61 Numb and immobile thights (Urustambha)
62 Disorders of perturbed vata (vatavyadhi) Clinical features - Treatment - Mixed types - Wrapping
63 Disorders of perturbed vata and blood vatasonita) Clinical features and types - Treatment
64 Disorders of the reproductive system; reflections on the principles of therapeutics Disorders of the female genital organs - Disorders of breast milk (ksira dosa) Seminal disorders and impotence (sukradosa). Principles of therapeutics
65 Drugs for evacuation (emetics and purgatives) Emetics - Purgatives - Preparations/formulations
66 Evacuative procedures (pancakarma) and formulations Emesis and purgation (general guidelines, complications and management) - Head evacuation - Suitable and unsuitable clinical conditions for evacuation (emesis, purgation) - Enema (non-lubricant, lubricant) - Head evacuation - Enemas (general conditions, procedural details, formulations for non-lubricant and lubricant enemas) Complications of enemas and guidelines for management - Special enemas - Post-evacuation management Epilogue Botanical names Glossary Index