अथातोऽष्टौनिन्दितीयमध्यायं व्याख्यास्यामः ॥ १ इति ह स्माह भगवानात्रेयः ॥ २ ॥
We shall now expound the chapter on “The Eight Types of Undesirable Constitutions”.
So said Lord Atreya. [ 1-2 ]
In the quadrate of chapters on diseases ( Sutra 17-20 ) all types of diseases have been described. Similarly drugs have been described in the quadrate ( Sutra 1-4) dealing with drugs. The present quadrate deals with the interrelationship of diseases and drugs. This relationship varies depending on the physical constitution of the individual. So the present chapter being the first of the quadrate deals with the eight undesirable types of physical constitutions.
Eight undesirable constitutions – Ashtaniditiya Purusha
इह खलु शरीरमधिकृत्याष्टौ पुरुषा निन्दिता भवन्ति; तद्यथा- अतिदीर्घश्च, अतिहस्वश्च, अतिलोमा च, अलोमा च, अतिकृष्णश्च, अतिगौरश्च, अतिस्थूलश्च, अतिकृशश्चेति ॥ ३ ॥
From the standpoint of physical constitution, the following are the eight types of undesirable persons — too tall, too short, too hairy, hairless, too black, too white, too corpulent and too emaciated. [ 3 ]
The above description of undesirable persons is from the standpoint of physical constitution only. So it does not include psychologically perverted persons like the scoundrel, mean-minded, etc. out of the eight types mentioned above, the first six are not significant for medical purposes, they only present the popular sentiment about undesirable persons. Undesirable persons like hunch-backed (kubja ) may also be taken here as undesirable.
Aetiopathology of obesity
तत्रातिस्थूलकृशयोर्भूय एवापरे निन्दितविशेषा भवन्ति । अतिस्थूलस्य तावदायुषो हासो जवोपरोधः कृच्छ्रव्यवायता दौर्बल्यं दौर्गन्ध्यं स्वेदाबाधः क्षुदतिमात्रं पिपासातियोगश्चेति भवन्त्यष्टौ दोषाः । तदतिस्थौल्यमतिसंपूरणागुरुमधुरशीतस्निग्धोपयोगादव्यायामाव्यवायाद्दिवास्वप्नाद्धर्षनित्यत्वादचिन्तनाद्वीजस्वभा वाच्चोपजायते । तस्य ह्यतिमात्र मेदस्विनो मेद एवोपचीयते न तथेतरे धातवः, तस्मादस्यायुषो हासः, शैथिल्यात् सौकुमार्याद्गुरुत्वाच्च मेदसो जवोपरोधः, शुक्राबहुत्वान्मेदसाऽऽवृतमार्गत्वाच्च कृच्छ्रव्यवायता, दौर्बल्यमसमत्वाद्धातूमां, दौर्गन्ध्यं मेदोदोषान्मेदसः स्वभावात् स्वेदनत्वाच्च मेदसः श्लेष्मसंसर्गाद्विष्यन्दित्वाद्वहुत्वाद्गुरुत्वाद्व्यायामासहत्वाच्च स्वेदाबाधः, तीक्ष्णाग्नित्वात् प्रभूतकोष्ठवायुत्वाच्च क्षुदतिमात्रं पिपासातियोगश्चेति ॥ ४ ॥
The too corpulent and too emaciated have more of unwanted distinctive features than other undesirable types of persons. Those of the too corpulent category are deficient in longevity, slow in movement; they find it difficult to indulge in sexual intercourse; they are weak; they emit bad smell; they have much of sweating, hunger and thirst. These are the eight defects inherent in them.
Excessive corpulence is caused by over intake; intake of heavy, sweet, cooling and unctuous food, want of physical exercise, abstinence from sexual intercourse, days-leep, uninterrupted cheerfulness, lack of mental exercise and heredity. So in the case of fatty persons, other dhatus do not grow to the extent, fat grows. This affacts longevity; the bodily movement is impaired due to the looseness, tenderness and heaviness of fats. This makes sexual act difficult because of the small quantity of semen and also due to the obstruction to the channel of semen by medas; weakness prevails as the equilibrium of dhatus is disturbed; bad smell is caused by the inherent defect and nature of the fat tissue and also due to excessive sweating; as the fat is associated with kapha and as it is fluid, multitudinous and heavy, as such, it cannot withstand physical exercise and it brings about excessive sweating in the body; because of the sharp digestive power and the presence of vayu in excessive quantity, there is excessive hunger and thirst. 
Even by nature, the fat emits The vitiated fat has a foetid odour. fleshy smell.
Pathophysiology of Obesity
मेदसाऽऽवृतमार्गत्वाद्वायुः कोष्ठे विशेषतः । चरन् संधुक्षयत्यग्निमाहारं शोषयत्यपि ॥ ५ ॥ तस्मात् स शीघ्रं जरयत्याहारं चातिकांक्षति । विकारांचाच्नुते घोरान् कांश्चित्कालव्यतिक्रमात् ॥ ६ ॥ एतावुपद्रवकरौ विशेषादग्निमारुतौ । एतौ हि दहतः स्थूलं वनदावो वनं यथा ॥ ७ ॥ मेदस्यतीव संवृद्धे सहसैवानिलादयः । विकारान् दारुणान् कृत्वा नाशयन्त्याशु जीवितम् ॥८॥ मेदोमांसातिवृद्धत्वाञ्चलस्फिगुदरस्तनः अयथोपचयोत्साहो नरोऽतिस्थूल उच्यते ॥ ९ ॥ इति मेदस्विनो दोषा हेतवो रूपमेव च । निर्दिष्टं,
Due to the obstruction of the passage by the fat, the movement of vata is specially confined to kostha (abdominal viscera) resulting in the stimulation of the digestive power and absorption of the food. So the patient digests food quickly and becomes a voracious eater. If he does not get food ( as and ) when he needs it, he can be subjected to many diseases of serions nature. The agni ( pitta responsible for degestion ) and vata are the two most troublesome factors; they burn the fat ones as the forest fire burns the forest. In the event of disproportionate increase of fat, diseases of very serious types are caused, all of a sudden, by vata, etc. which may lead to instantaneous death. Owing to an excessive increase of fat and muscle tissue, the buttock, abdomen and breast become pendulous and his strength is rendered disproportionate with his physical growth. Thus, the defects of the Obese persons, their causes, signs and symptoms have been explained. [ 5-10 ]
Aetiopathology and clinical features of emaciation
वक्ष्यते वाच्यमतिकार्ये त्वतः परम् ॥ १० ॥ सेवा रूक्षानपानानां लङ्घनं प्रमिताशनम् । क्रियातियोगः शोकश्च वेगनिद्राविनिग्रहः ॥ ११ ॥ रुक्षस्योद्वर्तनं स्नानस्याभ्यासः प्रकृतिर्जरा । विकारानुशयः क्रोधः कुर्वन्त्यतिकृशं नरम् ।। १२ ।। व्यायाममतिसौहित्यं क्षुत्पिपासामयौषधम् । कृशो न सहते तद्वदतिशीतोष्णमैथुनम् ॥ १३ ॥ प्लीहा कासः क्षयः श्वासो गुल्मोऽशंस्युदराणि च । कृशं प्रायोऽभिधावन्ति रोगाश्च शुष्कस्फिगुदरग्रीवो ग्रहणीगताः ॥ १४ ॥ धमनीजालसन्ततः । त्वगस्थिशेषोऽतिकृशः स्थूलपर्वा नरो मतः ॥ १५ ॥
Now the etiology, signs, cons and defects of excessive emaciation are being described. Excessive emaciation is caused by the intake of unuctuous diets and drinks, fasting, intake of food in inadequate quantity, over admininistration of elimination therapies, grief, suppression of the natural urges, including the urge for sleep, unction with unuctuous material, repeated baths, heredity, old age, continued illness and anger.
An excessively emaciated person does not stand physical exercise, intake of food in large quantity, hunger, thirst, diseases and drugs. They also cannot stand excessive cold, heat and sexual acts. Such emaciated persons are often subjecd to splenic diseases, cough, wasting, dyspnoea, gulma (abdominal tumour), piles, obstinate abdominal diseases and diseases of the small intestine ( grahani = duodenum ? ). Their buttocks, abdomen and neck are emaciated, there is vascular net work in the skin; the joints are prominently seen and the man appears to have bone and skin only. [ 10-15 ]
Comparative disadvantage of Obesity and emaciation
व्याधितावेतावतिस्थूलकृशौ नरौ । चोपचय हि कर्शनैर्वृहणैरपि ॥ १६ ॥ स्थौल्यकायें वरं कार्य समोपकरणौ हि तौ । सततं सततं
यद्युभौ व्याधिरागच्छेत् स्थूलमेवातिपीडयेत् ॥ १७ ॥ Both the types-exceedingly Obesity as well as exceedingly emaciated persons suffer from some diseases or the other all the time; they are to be treated by sliming and nourshing therapies respectively. Of the two, emaciation is less harmful than Obesity even though both of them are equally in need of treatment. When subjected to diseases, the volume of suffering in the case of Obese persons is far greater than in emaciated ones. [ 16-17] The main difficulty with the obese persons is that if they are given nourshing treatment, they will grow more obese, they cannot even stand sliming therapy because of their strong digestive power. This is not the case with emaciated persons who can always be benefited by nourishing therapy.
Importance of good built
सममांसप्रमाणस्तु समसंहननो हढेन्द्रियो विकाराणां न बलेनाभिभूयते ॥ १८ ॥
क्षुत्पिपासातपसहः शीतव्यायामसंसहः । समपक्ता समजरः सममांसचयो मतः ॥ १९ ॥
Persons having proportionate musculature and compactness of the body no doubt possess very strong sensory and motor organs and as such they are not overcome by the onslaught of diseases. They can stand hunger, thirst, the heat of the sun, cold and physical exercises. They can digest and assimilate properly. [ 18-19]
Principles of treatment for obese and emaciated persons
गुरु चातर्पणं चेष्टं स्थूलानां कर्शनं प्रति । कृशानां वृंहणार्थं च लघु संतर्पणं च यत् ॥ २० ॥
Heavy and non-nourishing diet is prescribed for sliming in the case of the over obesity. Light and nourishing diet for the nourishment of the slim. [ 20 ]
In order that the obese ones are brought to normal health, heavy but non-nourishing diet like honey may be given. By virtue of their heaviness such diets would minimise the force of the aggravated power of digestion and due to their non-nourishing nature they would help to reduce fat.
In the cases of emaciated persons light and nourishing diets (like old sali rice) are required to be given so as to bring about proper nourishment in them. Such diets being light, serve as stimulants of digestive power and bring about nourishment due to their nourishing property.
The above mentioned two devices for emaciating and nourishing the over corpulent and the emaciated persons respectively are no doubt the most effective ones. There are diets which are light and non-nourishing like prasatika ( Setaria italica Beauy. ), priyangu ( Aglaia roxburghiana Mig.) which can also be given for reducing over corpulence, provided they are made heavy by means of suitable devices. Similarly, heavy, and nourishing diets like newly harvested rice can also be given for the nou. rishment of emaciated persons after their heaviness is neutralised by appropriate means.
Management of obesity
वातघ्नान्यन्नपानानि लेष्ममेदोहराणि रूक्षोष्णा वस्तयस्तीक्ष्णा रूक्षाप्युद्वर्तनानि च ॥ २१ ॥ गुडूचीभद्रमुस्तानां प्रयोगस्त्रैफलस्तथा । तक्रारिष्टप्रयोगश्च प्रयोगो माक्षिकस्य च ॥ २२ ॥ मधु । उच्यते ॥ २३ ॥ विडङ्गं नागरं क्षारः काललोहरजो यवामलकचूर्ण च प्रयोगः श्रेष्ठ बिल्वादिपञ्चमूलस्य प्रयोगः शिलाजतुप्रयोगश्च साग्निमन्थरसः परः ॥ २४ ॥ क्षौद्रसंयुतः । प्रशातिका प्रियङ्गुश्च श्यामाका यवका यवाः । जूर्णाह्रा कोद्रवा मुद्गाः कुलत्थाश्चक्रमुद्रकाः ॥ २५ ॥ आढकीनां च वीजानि पटोलामलकैः सह । भोजनार्थ प्रयोज्यानि पानं चानु मधूदकम् ॥ २६ ॥ अरिष्टांश्चानुपानार्थ मेदोमांसकफापहान् । अतिस्थौल्यविनाशाय संविभज्य प्रयोजयेत् ॥ २७ ॥ प्रजागरं व्यवायं च व्यायामं चिन्तनानि च । स्थौल्यमिच्छन् परित्यक्तुं क्रमेणाभिप्रवर्धयेत् ॥ २८ ॥
For reducing over corpulence the following are the prescriptions par excellence :
1. Diets and drinks that alleviate vata and kapha and which can reduce fat.
2. Enema with drugs that are sharp, unuctuous and hot.
3. Unction with ununctuous drugs.
4. Intake of guduchi ( Tinspora cordifolia Miers), musta ( Cyperus rotundus Linn). haritaki (Terminalia chebula Linn.), bibhitaka (Terminalia belerica Roxb.) and amalaka (Emblica officinalis Gaertn.)
5. Administration of takrarista.
6. Administration of honey.
7. Intake of vidanga (Embelia ribes Burm f.), nagara (Zingiber officinale Rose. ), yavaksara ( a preparation of barley containing among others sodium and potassium bicarbonate), powder of black iron along with honey and powder of yava (Hordeum vulgaraz Linn.) and amalaki ( Emblica officinalis Gaertn.)
8. Administration of bilvapanchamula ( roots of 1. Aegle marmelos) Corr., 2. Oroxylum indicum Vent., 3. (Gmelina arborea Linn., 4. Stereospermum suaveolens Dc., 5. Clerodendrum phlomidis Linn. f.)
9. Administration of silajatu ( mineral pitch. )
10. Administration of the juice of Agnimantha ( Clerodendrum phlomidis Linn. f.)
11. Intake of prasatika (Setaria italica Beauv.), priyangu (Aglaia roxburghiana Mig.), syamaka (Echinochloa frumentacea Linn.), yavaka (small variety of Hordeum vulgare Linn. ), yava ( Hordeum vulgare Linn.), jurnahva (Sorghum vulgare Pers.), kodrava (Paspalum scrobiculatum Linn.), mudga ( Phaseolus mungo Linn.), kulattha (Dolichos biflorus. Linn.), cakramudgaka (?), seeds of adhaki (Cajanus cajan Millsp.) along with patola (Trichosanthes cucumerina Linn. ) and amalaka ( Emblica officinalis Gaertn. ) as food, followed by honey water.
12. Alchholic preparations that help to reduce fat, muscle and kapha may be used as post-prandial drinks.
The above are to be prescribed in proper doshage for the reduction of corpulence. One desirous of reducing overcorpu. lence should indulge more and more in vigil, sexual act, physical and mental exercises. [ 21-78 ]
Honey belongs to that category of drugs which have their effects depending on their combination with other drugs; so honey is nourishing when combined with a nourshing substance; it causes emaciation when combined with another non-nourishing substance. Vidanga ( Embelia ribes Burm. f.) etc., even though not heavy helps to reduce corpulence due to their specific action.
Management of emaciation
स्वप्नो हर्षः सुखा शय्या मनसो निर्वृतिः शमः । चिन्ताव्यवायव्यायामविरामः प्रियदर्शनम् ॥ २९ ।। नवान्नानि नवं मद्यं ग्राम्यानूपौदका रसाः । संस्कृतानि च मांसानि दधि सर्पिः पयांसि च ॥ ३० ॥ इक्षवः शालयो माषा गोधूमा गुडवैकृतम् । बस्तयः स्निग्धमधुरास्तैलाभ्यङ्गश्च सर्वदा ॥ ३१ ॥ स्निग्धमुद्वर्तनं स्नानं गन्धमाल्यनिषेवणम् । शुलं वासो यथाकालं दोषाणामवसेचनम् ॥ ३२ ॥ रसायनानां वृष्याणां योगानामुपसेवनम् । हत्वाऽतिकार्यमाधत्ते नृणामुपचयं परम् ॥ ३३ ॥ अचिन्तनाच्च कार्याणां ध्रुवं संतर्पणेन च । स्वप्नप्रसङ्गाञ्च नरो वराह इव पुष्यति ॥ ३४ ॥
Sleep, joy, comfortable bed, contentment, tranquility of mind, abstinence from anxiety, sexual act and physical exercise, pleasant sights, intake of freshly harvested rice, fresh wine, meat soup of domestic, marshy and aquatic animals, well prepared meat, curd, ghee, milk, sugar cane, sali rice, masa ( Phaseolus radiatus Linn. ), wheat, sugar candy preparations, enema consisting of unctuous and sweet drugs, regular oil massage, unctuous unction bath, use of scents and garlands, use of white apparel, elimination of doshas in time and administration of rejuvenating and aphrodisiac drugs remove emaciation and bring out nourishment in the body.
Freedom from anxiety about any work, intake of nourishing diet and adequate sleep makes the man fatty like a boar. [29-34]
Newly harvested rice is heavy but nourshing. In order that its heaviness does not suppress the power of digestion, it is required to be neutralised by special methods of cooking. Thus, newly harvested rice has to be made light by special devices in order to be effective in providing nourishment. Such special devices are not necessary in the cases of red variety of sali rice which by nature is light and at the same time nourishing because of its sweetness. Both the newly harvested rice as well as the red variety of sali rice are intended to be included as nourishing diets-the one made light by special devices and the other light by nature.
Physiology of Sleep
यदा तु मनसि क्लान्ते कर्मात्मानः कुमान्विताः ।
विषयेभ्यो निवर्तन्ते तदा स्वपिति मानवः ॥ ३५ ॥
When the mind including sensory and motor organs is exhausted and they dissociate themselves from their objects, then the individual sleeps. [ 25 ]
When the mind (as well as the soul) gets exhausted or become inactive and the sensory and motor organs become inactive then the individual gets sleep. Sleep is nothing but the location of the mind in a place unconnected with the sensory or motor organs.
In the event of the exhaustion of the mind, the individuals also get exhausted because action of individuals is dependant on that of the mind; so when mind dissociates itself from its objects, individuals also dissociate themselves from their objects. The sensory and motor organs are not active because of the inaction of individuals.
Effect of Sleep
निद्रायत्तं सुखं दुःखं पुष्टिः कार्य बलाबलम् । वृषता क्लीवता ज्ञानमज्ञानं जीवितं न च ॥ ३६ ॥ अकालेऽतिप्रसङ्गाच न च निद्रा निषेविता । सुखायुषी पराकुर्यात् कालरात्रिरिवापरा ॥ ३७ ॥ सैव युक्ता पुनर्युङ्गे निद्रा देहं सुखायुषा | पुरुषं योगिनं सिद्ध्या सत्या बुद्धिरिवागता ।। ३८ ।।
strength, Happiness, misery, nourishment, emaciation, , weakness, virility, sterility, knowledge, ignorance, life and death -all these occur depending on the proper or improper sleep. Like the night of destructions, untimely and excessive sleep away both happiness and longevity and prolonged vigil take The same sleep, if properly enjoyed brings about happiness and longevity in human beings as the real knowledge brings about Siddhi (spiritual power) in a yogin.
Indications of day sleep
गीताध्ययनमद्यस्त्री कर्मभाराध्व कर्शिताः अजीर्णिनः क्षताः क्षीणा वृद्धा बालास्तथाऽवलाः ॥ ३९ ॥ तृष्णातीसारशूलार्ताः भ्वासिनो हिक्किनः कृशाः । पतिताभिहतोन्मत्ताः कान्ता यानप्रजागरैः ॥ ४० ॥ क्रोधशोकभयक्कान्ता दिवास्वप्नोचिताश्च ये । सर्व पते दिवास्वप्नं सेवेरन सार्वकालिकम् ॥ ४१ ॥ धातुसाम्यं तथा ह्येषां वर्ल चाप्युपजायते । श्लेष्मा पुष्णाति चाङ्गानि स्थैर्य भवति चायुषः ॥ ४२ ॥ ग्रीष्मे त्वादानरूक्षाणां वर्धमाने च मारुते । रात्रीणां चातिसंक्षेपाद्दिवास्वप्नः प्रशस्यते ॥ ४३ ॥
Sleeping during the day time in all seasons is prescribed for those who are exhausted by singing, study, alcoholic drinks, sexual acts, elimination therapy, carrying heavy weight, walking long distance; those suffering from phthisis, wasting, thirst, diarrhoea, colic pain, dysponea, hiccup, insanity, those who are too old, too young, weak and emaciated; those injured by fall and assault, those exhausted by journey by a vehicle, vigil, anger, grief and fear, and those who are accustomed to day sleep. By this the equilibrium of dhatus and strength are maintained and the kapha nourishes the organs and ensures longevity.
In summer season nights become shorter and vata gets aggravated in the body due to the absorption of fluid ( adana ). Therefore, during this season, sleep during day time is prescribed for all. [ 39-43 ]
Those exhausted by singing, etc. attain their normal health due to the nourishment of their dhatus by sleep during the day time. Sleep during day time is specially useful for those suffering from diarrhoea, etc. Those suffering from indigestion get rid of their ailment if they sleep during the day time because the sleep enhances the digestive power by obstructing the passage of heat out of the body resulting in the quick digestion of food. Those who are accustomed to sleep during day time should not give up this habit all of a sudden as it might lead to undesirable consequences. Those who have remained awake during the night should also sleep in the day time in order to alleviate vitition of vata caused by the vigil. As it has been stated by Ksarapani,
“If one does not sleep properly in the night for a specified period, he should make it up by sleeping during the day time for half the period spent in the night vigil”. Sleep during the day time..is to be enjoyed before taking lunch because as stated by Harita, “One should not sleep after taking his food, since by so doing, even a healthy person may subject himself to miseries. Even elsewhere, it is stated that one can sleep for any lenght of time in the day time before food.
Contra-indications of day sleep
ग्रीष्मवर्येषु कालेषु दिवास्वप्नात् प्रकुष्यतः । श्लेष्मपित्ते दिवास्वप्नस्तस्मात्तेषु न शस्यते ॥ ४४ ॥ मेद स्विनः स्नेह नित्याः श्लेष्मलाः श्लेष्मरोगिणः । दूषीविषार्ताश्च दिवा न शयीरन् हलीमकः शिरःशूलं स्तैमित्यं गुरुगात्रता । कदाचन ॥ ४५ ॥ अङ्गमर्दोऽग्झिनाशश्च प्रलेपो हृदयस्य च ॥ ४६ ॥ । शोफारोचकहल्लास पीनसार्धावभेदकाः कोठारुः पिडकाः कण्डूस्तन्द्रा कासो गलामयाः ॥ ४७ ॥ स्रोतसां ज्वरः । स्मृतिबुद्धिप्रमोहश्च संरोधः इन्द्रियाणामसामर्थ्य विषवेगप्रवर्त (धं) नम् ॥ ४८ ।। भवेन्नृणां दिवास्वप्नस्याहितस्य निषेवणात् । तस्माद्धिताहितं स्वप्नं बुद्धवा स्वप्यात् सुखं बुधः ॥ ४९ ॥
Sleeping during the day time in the seasons other than summer is not advisable as it causes vitiation of kapha and pitta. Persons with excessive fat, those who are addicted to taking unctuous substance, those with slaismika constitution, those suffering from diseases due to the vitiation of kapha and those suffering from dusivisa (artificial poisoning) should never sleep during day time. If one violates the prescription regarding sleep during the day time, he would subject himself to halimaka (serious type of jaundice ), headache, timidness, heaviness of the body, malaise, loss of digestive power, hydayopalepa ( a feeling as if phlegm adhered to the heart ), ocdema, anorexia, nausea rhinitis, hemicrania, urticaria, eruption, abscess, pruritus, drowsiness, coughing, diseases of the throat, impairement of the memory and intelligence, obstruction of the circulating channels of the body, fever, weakness of sensory and motor organs and enhancement of the toxic effects of artificial poisons. So one should keep in view the merits and demerits of sleep in various seasons and situations in order that it may bring happiness to him. [ 44-49 ]
Persons of the above descripiton should never sleep during the day time even in the summer. The question as to whether those exhausted by singing, etc. should be allowed to sleep during the day time may be decided, depending on the strength or weakness of various …ctors.
Effect of night awakening
रात्री जागरणं रूक्षं स्निग्धं प्रस्वपनं दिवा । अरूक्षमनभिष्यन्दि त्वासीनप्रचलायितम् ॥ ५० ॥
Vigil during night causes roughness in the body; sleep during day time causes unctuousness and dosing in sitting posture does neither cause roughness nor unctuousness. [ 50]
Dosing in sitting posture is mainly seen amongst the monks of monasteries.
The role of sleep in obesity
स्वप्नाहारसमुत्थे च स्थौल्यकार्ये विशेषतः ॥ ५१ ॥ Like proper diet, proper sleep is also essential for the maintenance of the body. Corpulence and emaciation are specially conditioned by proper or improper sleep and diet. [ 51 ]
देहवृत्तौ यथाऽऽहारस्तथा स्वप्नः सुखो मतः
Methods and measures to induce good sleep
अभ्यङ्गोत्सादनं स्नानं ग्राम्यानूपौदका रसाः । शाल्यन्नं सदधि क्षीरं स्नेहो मद्यं मनःसुखम् ।। ५२ ।। मनसोऽनुगुणा गन्धाः शब्दाः संवाहनानि च । चक्षुषोस्तर्पणं लेपः शिरसो वदनस्य च ॥ ५३ ॥ स्वास्तीर्ण शयनं वेश्म सुखं कालस्तथोचितः । आनयन्त्यचिरान्निद्रां प्रनष्टा या निमित्ततः ॥ ५४ ॥
If for some reason or other, one is subjected to sleeplessness, he can be instantaneously cured by massage, unction, bath, intake of soup of domestic marshy and aquatic animals, sali rice with curd, milk, unctuous substance and alcohol, psychic pleasure, smell of scents and hearing of sounds of one’s own taste, samvahana (rubbing the body by hand), application of soothing ointment to the eyes, head and face, comfortable bed and home and proper time. [ 52-54]
One can sleep comfortably only at the time when he is accustomed to sleep. The above prescription do not apply to the sleeplessness indicative of arista or bad prognostic symptoms leading to death.
Causes of Insomnia
कायस्य शिरसश्चैव विरेकश्छर्दनं भयम् । चिन्ता क्रोधस्तथा धूमो व्यायामो रक्तमोक्षणम् ॥ ५५ ॥ उपवासोऽसुखा शय्या सच्चौदार्य तमोजयः । निद्राप्रसङ्गमहितं arrafa समुत्थितम् ॥ ५६ ॥ एत एव च विज्ञेया निद्रानाशस्य हेतवः । कार्य कालो विकारश्च प्रकृतिर्वायुरेव च ।। ५७ ।।
Elimination of doshas from the bod and head through purgation and emesis, fear, anxiety, anger, smoke, physical exercise, blood letting, fast, uncomfortable bed, predominance of sattva and suppression of tamas go a longway towards overcoming the sleep in excess.
The above-mentioned factors alongwith overwork, old age, diseases, specially these due to the vitiation of vata like colic pain, etc. are known to cause sleeplessness even in normal individuals. Some are insomniac even by nature. [ 55-57 ]
Old age usually causes sleeplessness. Some people suffer from sleeplessness by nature,
Classification of sleep
तमोभवा लेष्मसमुद्भवा च मनःशरीरश्रमसंभवा च । आगन्तुकी व्याध्यनुवर्तिनी च रात्रिस्वभावप्रभवा च निद्रा ॥ ५८ ।।
Sleep is of the following types :
1. Caused by tamas;
2. Caused by (vitiated ) kapha;
3. Caused by mental exertion ;
4. Caused by physical exhaustion ;
5. Agantuka or indicative of bad prognosis leading to imminent death;
6. Caused as a complication of other diseases like samnipata jvara, etc.; and
7. Caused by the sleep). 
very nature of the night (physiological Mental and physical exertion bring about inactivity of the mind resulting in the dissociation of the mind and the sense organs from their objects which is responsible for sleep. But if there is excessive exertion, this may cause vitiation of vata leading to sleeplessness. Thus, even though, exertion is a causative factor for sleep, excessive exertion is responsible for the aggravation of vata which causes sleeplessness. By nature, the night serves as a causative factor for sleep. Sleep during the day time is caused by tamas, etc.
Good and bad sleep
रात्रिस्वभावप्रभवा मता या तां भूतधात्रीं प्रवदन्ति तज्ज्ञाः । तमोभवामाहुरघस्य मूलं शेषाः पुनर्व्याधिषु निर्दिशन्ति ॥ ५९ ॥
The sleep caused by the nature of the night is the sleep par excellence; this is known as “bhutadhatri” ( that nurses all the living beings). The one caused by tamas is the root cause of all sinful acts. The remaining types are to be treated as diseases.  individual is unable
Tamas always causes excessive sleep. Thus, the to perform the virtuous rites and so he subjects himself to sinful behaviour. The agantuki type of sleep is caused as a complication of an incurable disease and as such it is in itself incurable.
निन्दिताः पुरुषास्तेषां यौ विशेषेण निन्दितौ । निन्दिते कारणं दोषास्तयोर्निन्दितभेषजम् ॥ ६० ॥ येभ्यो यदा हिता निद्रा येभ्यश्चाप्यहिता यदा । अतिनिद्रायानिद्राय भेषजं यद्भवा च सा ॥ ६१ ॥ या या यथाप्रभावा च निद्रा तत् सर्वमत्रिजः । अष्टौनिन्दितसंख्याते व्याजहार पुनर्वसुः ॥ ६२ ॥
To sum up :
Lord Punarvasu on the chapter on,”Eight Types of Undesirable Constitutions” has explained the following.
1. Enumeration of undesirable constitutions;
2. The two most undesirable types of persons ;
3. Cause of undesirability ;
4. Demerits of undesirable persons ;
5. Their treatment;
6. Indications and contra-indications of sleep depending upon the nature of the individual and time;
7. Treatment of excessive sleep and sleeplessness;
8. Factors that are responsible for causation of sleep; and
9. Types and effects of sleep. [ 60-62]
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते लोकस्थानेऽष्टौनिन्दितीयो नामैकविंशतितमोऽध्यायः ॥ २१ ॥
Thus ends the twenty-first chapter on “Eight Types of Undesirable Constitutions” of the Sutra section of Agnivesa’s work as redacted by Garaka.