विविधाशितपीतीय मध्यायं व्याख्यास्यामः ॥ १ ॥ इति ह स्माह भगवानात्रेयः ॥ २ ॥ अताथो
We shall now expound the chapter dealing with “Various Types of Food and Drinks”. Thus said Lord Atreya. [ 1-2 ]
In the previous chapter food is said to sustain vital breath-cf. Sutra 27349. This chapter will elaborate the process through which trans. formation takes place in food so as to sustain vital breath.
Primary Function of Food
विविधमशितं पीतं लोढं खादितं जन्तोर्हितमन्तरग्निसन्धुक्षितवलेन यथास्वेनोष्मणा सम्यग्विपच्यमानं कालवदनव स्थित सर्वधातुपाकमनुपहतसर्वधातूष्ममारुतस्रोतः केवलं शरीरमुपचयबलवर्णसुखायुषा योजयति शरीरधातूनूर्जयति च । धातवो हि धात्वाहाराः प्रकृतिमनुवर्तन्ते ॥ ३ ॥
Being stimulated by the antaragni ( the enzymes responsible for gastro-intestinal digestion), agnis (specific to differentmahabhutas) digest the various types of wholesome eatebles, beverages, linctus and masticable food articles producing thereby plumpless, strength, complexion, happiness as well as growth of the tissue elements of the entire body where the process of metabolism goes on incessantly like the passage of time and where all the dhatvagnis (enzymes responsible for tissue metabolism), vata (factor responsible for the movement of finished and unfinished products of metabolism from one place to another) and channels of circulation are unimpeded. The tissue elements of the body are sustained being fed by their nourishing factors (posaka dhatus). 
It is only when the individual takes wholesome food that plumpness etc., are brought about in the body and not otherwise. Food articles are composed of fivc mahubhutas. Agnis specific to these five mahabhutas help in the digestion of their respective food ingredients (converting the heterogenous material into homogenous ones)-cf. Chikitsa 15: 13. These bhutagnis start their work only when stimulated by antaragni ( the enzymes responsible for gasto-intentinal digestion. )
To imbue plumpness etc., in the body, it is also necessary that ( the break down product of) food articles should undergo metabolic transformation (puka) by dhatvagnis or enzymes specific to each category of tissue elements. The process of metabolism goes on incessantly in the body by which there is continuous depletion of tissues elements (like the passage of time) which is replenished by the food and thus, the plumpness of the body is maintained.
Some other commentators, interpret “कालवदनवस्थितसर्वधातुपाक” in a different way by attributing this to be the epithet of body. According to them. only timely intake of food is responsible for the causation of plumpness etc., of the body. The process of trausformation of food into the bodily tissue elements. according to them, should go on incessantly. If the nutrition to any tissue element is obstructed, there will be no replenishment of the loss or growth of that particular tissue element. Hence the question of plumpness etc., would not arise. This explanation does not appear to be relevant. This will be a repetition as this idea is already contained in one of the subsequent statements viz., “अनुपहतसर्वंधातूष्ममारुतत्त्रोत:” which actually is the epithet of the body. In order that the promotion of plumpness of the body is maintained, it is necessary that all the dhatvagnis ( enzymes responsible for the metabolism of various categories of tissues), the vyanavayu which is the force for the transportation of nutrient material to various tissues and the channels of transport ( circulntion ) should remain unimpaired.
Virtuous acts are also necessary for the proper utilisation of food in the body metabolism.
Tissue elements of the body undorgo continuous depletion and this loss is replenished by the nutrient material supplied through rasa (plasma) etc., derived from the food material. Thus the individual maintains proper health.
Digestion of food and nourishment of body tissues
तत्राहारप्रसादाख्यो रसः किट्टं च मलाखयमभिनिर्वर्तते । किट्टात् स्वेदमूत्रपुरीषवातपित्तश्लेष्माणः कर्णाक्षिनासिकास्य लोमकूपप्रजननमलाः केशश्मश्रुलोमनखादयश्चावयवाः पुष्यन्ति । पुष्यन्ति त्वाहाररसाद्वसरुधिरमांसमे दोस्थिमज्जशुक्रौजांसि पञ्चेन्द्रियव्याणि धातुप्रसादसंशकानि शरीरसन्धिवन्धपिच्छादयश्चावयवाः । ते सर्व एव धातवो मलाख्याः प्रसादाख्याश्च रसमलाभ्यां पुष्यन्तः स्वं मानमनुवर्तन्ते यथावयःशरीरम् । एवं रसमलौ स्वप्रमाणावस्थितावाश्रयस्य समधातीर्घातुसाम्यमनुवर्तयतः । निमित्ततस्तु क्षीणवृद्धानां प्रसादाख्यानां धातूनां वृद्धिक्षयाभ्यामाहारमूलाभ्यां रसः साम्यमुत्पादयत्यारोग्याय, किट्टं च मलानामेवमेव । स्वमानातिरिक्ताः पुनरुत्सर्गिणः शीतोष्णपर्यायगुणैश्चोपचर्यमाणा मलाः शरीरधातुसाम्यकराः समुपलभ्यन्ते ॥ ४ ॥
Food, after digestion takes two forms viz., the prasada or the essence, also known as rasa, and the kitta or the refuse. The latter provides nutrition to sweat, urine, stool, vata, pitta. kapha, excreta of the ear, eye, nose, mouth, hair follicles, as well as genital organs and also to hair of the head, beard, small hair of the body, nails etc. The former, that is the essence of food, provides nutrition to rasa (plasma and such other fluid constants of the body), rakta (erythrocyte) muscle, fat, bone, marrow, semen, ojas (2), the material constituents of the five sense organs which are the essence of the tissue elements, joints, ligaments and mucin etc., of the body.
Depending upon their nourishment from the essence or the refuse of the food after digestion, tissue elements are of two types-the pure and the waste products. By virtue of the nourishment they maintain their quality, according to the size and age of the body.
Thus the essence as well as refuse of food after digestion having remained in their own quantity, maintain the normalcy of tissue elements, viz. the pure and waste products of a healthy individual. Due to certain causes, the tissue elements which are pure products may undergo decrease or increase. They can be brought to normalcy by the digestive product of food that is taken in increased or decreased quantity. Similarly, waste products undergo change by refuse of food after digestion.
When the waste, products (specially doshas) of the body exceed in quantity they can be brought to normalcy by eliminating those which have come out of their abodes and by treating with therapies having opposite qualities like hot and cold unctuous and ununctuous etc., that is when the waste products exceed their normal quality due to hot, then cold things should be administered and vice versa. 
From the refuse of food after digestion, urine, stool and flatus are produced. During the process of formation of rasa (plasma), kapha is produced. Similarly pitta is the waste product of rakta (erythrocytes); excreta of the sense organs viz. ear, eye, nose, tongne and skin, of mamsa (muscle tissue); sweat of medas (fat), hair of the head and small hair of the body of asthi (bone tissue); urctuous substances of the eye, stool and skin, of majja (marrow)-cf. Chikitsa 15: 18-19.
Vata is caused not only by the refuse of food which are ununctuous and excretory in nature, but also by fasting, physical exercise, bath etc.
Material constituents of sense organs viz. cars, skin, eyes, tongue and nose are akasa, vayu, tejas, jala and prithvi respectively. These constituents are drawn during the process of metabolism from the pure products of tissue elements.
From the essence of food after digestion menstrual blood and milk are produced in addition to the tissue elements enumerated in the above verse.
From the digestive products of food, rasa (plasma and such other fluid contents of the body), rakta (erythrocytes), mamsa (muscle tissue), medas (fat tissue), asthi (bone tissue), majja (marrow) and sukra (semen) are formed in the progressive order. The following are the three different views about the process of transformation of different tissue elements.
1. Kshiradadhinyaya 🙁 The Law of Transformation)
As milk is entirely converted into curd, so also rasa in its entirety is converted into rakta, Similarly, mamsa, medas, asthi, majja and sukra are formed by virtue of the progressive stages of transformation.
2. Kedarikulyanyaya: ( The Law of Transmission)
The digestive product of food goes to the abodes of rasadhutu and some portion of the former is utilised for the nourishment of the latter. The remaining portion of the digestive product of food comes to the site of rakta, takes the colour and smell of the latter and some portion of it is utilised in the nourishment or rakta. The remaining portion of the digestive product of food goes to mamsa where it behaves as it did in the case of rakta. Similar processes are involved in the cases of medas etc. Thus, the statement in Cikitsu 5. 15 that rakta is formed from rasa, mamsa from rakta, medas from mumsa, asthi from medas, majja from asthi, sukra from majja and the embryo from the essence of the semen is justifiable. Harita has also said. “Being acted upon by pittosma (enzymes), rasa is imparted with a colour and converted to rakta. From white colour it is changed to kapota (brown)-green-yellow-padma (violet like the colour of lotus )-reddish like the colour of kimsuka (flower of Butea monosperma Kuntze) and deep red like that of alaktaka or lac. Each stage takes one day. Thus the whole process of transmission from rasa to rakta takes seven days. Susruta has also said, “The digestive product of food which is in a liquid form remains in each dhatu (tissue element ) for 3015 kalus or five days (one kala is approximately equal to 143 seconds). Thus, it takes one month for the digestive product to be transmitted to sukra (semen )-cf. Susruta: Sutra 14 : 14.
III. Khale-kapotanyaya ( The Law of selectivety)
The digestive product of food according to this view goes to various dhatus (tissue elements) through different channels and provide them with nutrition. The portion of digestive product meant to provide nourishment to a particular dhatu does not come in contact with other dhatus. Channels for carrying nutrition to rasa, rakta, mamsa, medas, asthi, majja, and sukra are longer as well as finer in diameter in progressive order. As the length of the channel increases and the diameter decreases, it takes longer time for the nutrition to pass through. Thus the portion of the digestive product of food meant to nourish rasadhatu passes through its own channel and provides nutrition to it. After providing nutrition to rasa, the portion of the digestive product of food meant to provide nutrition to rakta dhatu does its job through its specific channels. After the nourishment of rakta, mamsa gets its nutrition from another portion of the digestive product through its specific channel. This takes a longer time because the nutrition has to pass through a longer and finer channel. Similar is the case with the nonrishment of medas etc. So the statement in Chikitsa 15 16 can be interpreted as “Rakta formation takes place after rasa, mamsa formation after rakta etc.,” Statements of Susruta and Harita can also be explained accordingly. In the chapter dealing with the treatment of tuberculosis, it is said, “Due to the obstruction in the passage, rakta does not reach mamsadhatu etc.,” cf. Chikitsa 8:58. If Khalekapotanyaya or the Law of selectivity is accepted, then rakta in this statement will have to be interpreted as the blood circulating through heart and not the posaka (nutrient) rakta.
The following are the three important fallacies in Kshiradadhinyaya or the Law of Transformation
I. There are certain diets and drugs like milk etc., which increase the quantity of sukra (semen) instantaneously. According to Ksiradadhinyaya (The Law of Transformation) the digestive products of such diets and drugs has to undergo instanstaneous transformation from one dhatu to the other so as to produce the last dhatu, that is sukra, instantaneously. According to Khalekapotanyaya (The Law of Selectivity) the digestive products of such diets and drugs due to their specific action, come in contact with semen and nourish the latter instanstaneously.
II. Further, if there is vitiation of the digestive product of food, according to the Ksiradadhinyaya or the Law of Transformation all other dhatus should also get vitiated, as all of them are produced from rasa and a vitiated rasa, accoadigg to this nyaya can transform itself only as vitiated dhutus. According to Khalekapotanyaya or the Law of Selectivity only those dhatus get vitiated whose nutrient portions in the digestive product of food are vitiated and not others because the nutrient portions of these dhatus remain unaffected.
III. If there is excess of medodhutus, then according to Ksiradadhinyaya (The Law of transformation) the quantity of asthidhatu should also increase but it is seen that when there is excess of medodhatu, the quantity of asthidhatu decreases. As it is said, “In an over corpulent individual fat accumulates in excess and not other dhatus; they are rather reduced in quantity.”-cf. Sutra 21:4.
Thus, Ksiradhinyaya or the Law of Transformation, appears to be fallacious. According to this law an individual should die if he is on fast for 3/4 days as there will be no rasa and rakta in the body. On fasting for one month, the whole body should be of sukra (semen ) only. Kedarikulyanyaya ( The Law of Transmission) and Khalekapotanyaya (The Law of Selectivity) are of equal importance. According to both the nyayas. it is by specific action that the digestive product of aphrodisiac diets and drugs pass through the dhatus, viz. rakta etc., and instantaneously produce the semen. Similarly, according to these laws, all dhatus viz. rakta etc., need not get vitiated by the vitiation of rasa or digestive product of food because the portions of it responsible for the nourishment of rakta etc., remain unaffected. According to Kedarikulyanyaya or the Law of Transmission, the entire rasa does not get converted into rakta but only the portion homologous to rakta undergoes such a change. The remaining portions while coming in contact with raktadhatu only get the colour etc. of rakta (not actually converted into rakta). Thus an increase in medas need not necessarily increase asthi because asthidhatu does not get nourishment from medas. Asthidhatu gets nourishment from the digestive product of food ( rasa) whicn only looks like medas after coming in contact with the latter.
Both these-nyayas-the Kedarikulyunyaya (The Law of Transmission) and the Khalekapotanyaya (The Law of Selectivity) are considered to be equally valuable for a due appreciation of the process of the transformation of tissue elements. Hence it is not possible to say as to which one of them is more correct specially when our present day knowledge about such phenomena is limited. The nyayas do not contradict each other with regard to the actual menifestation of tissue elements. So there need not be any controversy about the comparative merits or demerits of these nyayas.
In the above passage, rasadhatu is said to get nourishment from the ahararasa or the digestive product of food. Thus the existence of two types of rasa is accepted in principle. But the quantity of ahararasa ( digestive product of food) is not mentioned because it has no fixed quantity, it undergoes variations, depending upon the increase or decrease in the quantity of food intake. The site of this type of rasa is dhamani or the pulsating channels. In other places, this nutrient fiuid which is the digestive product of food is not separately mentioned because it is taken care of by a mention of its products, viz., rasa etc.
Ojas is only the essence of all the seven dhatus and has no separate existence as such. Even then, it is separately enumerated in the above paragraph because of its power to sustain life. Some scholars, however, hold the view that ojas is the eighth dhatu and it is derived from sukra or semen. This view is not acceptable; “Ojas is the supreme essence of all the dhatus, beginning with rasa” and ending with sukra,-cf. Susruta Sutra 15: 19.
Even waste products like sweat, urine etc., in their normal state, are useful in the maintenance of the body so much so that they are called dhatus (Lit. a substance which sustains the body ).
The nutritional requirement of the dhatus of the body varies, depending upon the age of the individual (e. g. young, adult and old) as well as the size of the body, (e. g. tall, dwarf, emaciated and corpulent ). For the maintenance of health, the pure as well as waste products of food after digestion supply a fixed amount of nourishment to the body neither more nor less.
If the increase or decrease of dhutus takes place as a result of arista (viz. the sign of imminent death), then of course no change in the quantity of food intake would ever helf restore normalcy.
When dhatus are above or below, their normal quantity they are required to be reduced and increased respectively in order to restore health. Decrease or excessive increase of normal dhatus is responsible for the various diseases.
In this verse three types of therapies are prescribed in order to correct the aggravated doshas. They are:
I. Nidunaparivarjana or withdrawal from the causative factors: When doshas are in excess, food, aggravating such doshas may not be taken; or such food articles as may not aggravate the doshas may be taken.
II. Sodhana or elimination: Doshas which have came out of their abodes due to aggravation in excess are to be eliminated by panchakarma therapy.
III. Samana or alleviation : Aggravated doshas are to be alleviated by prescribing suitable therapies like hot things for those aggavated due to cold and vice versa.
Relation of Food with Body and Diseases
तेषां तु मलप्रसादाख्यानां धातूनां स्रोतांस्ययनमुखानि । तानि यथाविभागेन यथास्वं धातूनापूरयन्ति । एवमिदं शरीरमशितपीतलीटखावितप्रभवम् । अशितपीतलीढखादितप्रभवाश्चास्मिञ् शरीरे व्याधयो भवन्ति । हिताहितोपयोगविशेषास्त्वत्र शुभाशुभविशेषकरा भवन्तीति ॥ ५ ॥
The pure as well as waste products (of digestion and metabolism) enter into the various channels of circulation and circulate through them. These channels carrying specific nutrient material provide nourishment in reqnired quantity to various dhatus. Thus the body is the result of nourishment drawn ( in fourfold manner) from eatables, beverages, linctus, and masticales. Diseases are also manifested in the body by the food taken in four-fold manner, (viz, eating, drinking, licking and masticating). Intake of wholesome and unwholesome food is responsible for the maintenance of health and production of diseases respectively. 
Pure products and waste products of food after digestion and metabolism enter into and circulate through the same channel. Each dhatu has the channel meant specifically for its circulation. Through these specific channels, required quantity of nutrition is taken to the dhatus-cf. Chikitsa 8 : 39. It is not that the same type of food is responsible both for health and diseases. When wholesome food is taken it maintains health, unwholesome food causes diseases.
Agnivesa’s querry :
एवंवादिनं भगवन्तमात्रेयमग्निवेश उवाच-दृश्यन्ते हि भगवन् ! हितसमाख्यातसध्याहारमुपयुञ्जाना व्याधिमन्तश्चागदाश्च तथैवाहितसमाख्यातम्; एवं दृष्टे कथं हिताहितोपयोगविशेषात्मकं शुभाशुभ विशेषमुपलभामह इति ॥ ६॥
On hearing these observations of Lord Atreya, Agnivesa enquired, “O : Lord, people taking such food articles as are known to be wholesome are found to suffer from diseases even though some of them are healthy also. Similar is the case of those who take unwholesome food. In view of this, how to draw the conclusion that health and diseases are conditioned by wholesome and unwholesome food respectively. [ 6 ] .
Cansation of Diseases :
तमुवाच भगवानात्रेयः – न हिताहारोपयोगिनामग्निवेश ! तन्निमित्ता व्याधयो जायन्ते, न च केवलं हिताद्वारोपयोगादेव सर्वव्याधिभयमतिक्रान्तं भवति, सन्ति हयुत्तेऽव्याहिताहारोपयोगादन्या रोगप्रकृतयः, तद्यथा- कालविपर्ययः, प्रज्ञापराधः, शब्दस्पर्शरूपरसगन्धाश्चासात्म्या इति । ताश्च रोगप्रकृतयो रसान् सम्यगुपपुरुषमशुभेनोपपादयन्ति; तस्माद्धिताहारोपयोगिनोऽपि दृश्यन्ते युआनमपि व्याधिमन्तः । अहिताहारोपयोगिनां पुनः कारणतो न सद्यो दोषवान् भवत्यपचारः । न हि सर्वाण्यपथ्यानि तुल्यदोषाणि, न च सर्वे दोषास्तुल्यवलाः, न च सर्वाणि शरीराणि व्याधिक्षमत्वे समर्थानि भवन्ति । तदेव ह्यपथ्यं देशकालसंयोगवीर्यप्रमाणातियोगाद्भयस्तरमपथ्यं संपद्यते । स एव दोषः संसृटयोनिर्विरुद्धोपक्रमो गम्भीरानुगतंश्चिरस्थितः प्राणायतनसमुत्थो मर्मोपघाती कष्टतमः क्षिप्रकारितमञ्च संपद्यते । शरीराणि चातिस्थूलान्यतिकृशान्यनिविष्टमांसशोणितास्थीनि दुर्बलान्यसात्म्याहारोपचितान्यल्पाहाराण्यल्पसत्त्वानि च भवन्त्यव्याधिसहानि, विपरीतानि पुनर्व्याधिसहानि। एभ्यश्चैवापथ्याहारदोषशरीरविशेषेभ्यो व्याधयो मृदवो दारुणाः क्षिमसमुत्थाश्चिरकारिणश्च भवन्ति । त एव वातपित्तश्लेष्माणः स्थानविशेषे प्रकुपिता व्याधिविशेषानभिनिर्वर्तयन्त्यग्निवेश ! ॥ ७ ॥
Lord Atreya replied, “It is not that individuals accustomed to wholesome food suffer from diseases due to wholesome food nor is it that only by taking wholesome food one can overcome all diseases. Apart from unwholesome diet, there are other factors for the causation of diseases viz. seasonal abnormality, intellectual blasphemy and unwholesome contacts of sense faculties with their objects like sound, touch, vision, taste and smell. These factors may produce diseases even in individuals accustomed to wholesome food. Due to certain factors, even unwholesome food does not produce diseases immediately. All unwholesome food articles are not equally bad; all doshas are not of equal strength nor are all bodies capable of resisting diseases equally.
An unwholesome food article is all the more harmful depending upon the nature of the locality, time combination potency and excess of quantity. The doshas are exceedingly painful, acute and difficult to cure if they are combined with each other, if they require mutually contradictory therapics, if they are deep seated, if chronic, if vitiated in one of the ten resorts of life and if they afflict the vital organs. Individuals whose body is either very corpulent or too emaciated or having loose muscle, blood and bone or weak or nourished with unwholesome food or accustomed to the intake of less food or having feeble mind, are unable to resist diseases. On the otherhand, individuals having opposite type of physical constitution are capable of resisting diseases. The intake of unwholesome food, as well as the doshas and physical constitution of above description gives rise to diseases of many types, viz. mild or severe and acute or chronic. The doshas, viz. vata, pitta and kapha give rise to various types of diseases depending upon the site of their vitiation. 
At times unwholesome food does not cause diseases immediately because of certain factors which come in the way of their manifestation. But in the long run intake of unwholesome food mostly causes diseases. Resistance to diseases or immunity from diseases includes both attenuation of the manifested diseases as well as prevention of the unmanifested ones.
In view of the contextual propriety, factors which neutralize the effects of unwholesome food should have been described in the above paragraph. But factors which aggravate the harmful effects of unwholesome food as mentioned here also serve the same purpose,
Nature of the locality etc., aggravate the harmful effects of unwholesome corns. For example, vrihi type of corn is unwholesome as it aggravates pitta. It is however, more unwholesome if taken a marshy land or in the autumn season or if combined with curd, penidium etc. or if taken hot or taken in a large quantity; it is less unwholesome if taken in a land other than the marshy land or in the hementa season or if combined with honey etc. or if taken cold or taken in a small quantity.
When various factors combine together to vitiate a particular dosha or when the dhutu affected has the qualities identical with those of the concerned dosha( s ), the dosha gets exceedingly aggravated. For example, when the vitiated pitta afflicts raktadhatu, it leads to painful and acute diseases. Vitiation of doshas and dhatus requiring mutually contradictory therapies also cause serious diseases. For example, meha (obstinate urinary disorders) caused among others, by the vitiation of pitta is palliable because drugs having sweet taste etc., which alleviate pitta go against medodhutu ( fat) which is also vitiated in meharoga and drugs having pungent taste etc,, which correct the vitiation of medas (fat) aggravate pitta-cf. Nidana 4:27. When a dosha affects the deeper dhatus like majja (marrow) etc., then it becomes more harmful-cf. Chikitsa 39: 19. Doshas vitiated for a longer period create conditions too difficult to cure because the former are firmly seated in the affected part. Ten resorts of life will be described in the next chapter-cf. Sutra 29: 3. Diseases situated in these ten resorts of life and other vital organs like ksipra, talahrdaya etc., (specially diseases in the ten resorts of life) are too difficult to cure.
It is only when all the causative factors combine together to vitiate a dosha that the resultant disease is rendered too difficult to cure, painful and acute. Otherwise the disease may vary in intensity. When an individual constantly takes unwholesome food, his body becomes saturated with vitiated doshas; hence suseptible to serious diseases.
तत्र रसादिषु स्थानेषु प्रकुपितानां दोषाणां यस्मिन् स्थाने ये ये व्याधयः संभवन्ति तांस्तान् यथावदनुव्याख्यास्यामः ॥ ८ ॥
We shall now describe the various diseases which occur in different sites (dhatus) like rasa due to the aggravation of the doshas. 
The three doshas, viz. vata, pitta and kapha produce different signs and symptoms when aggravated. But when a particular dhatu is affected by them, the signs and symptoms specific to the dhatu concerned manifest themselves irrespective of the nature of the dosha vitiated. These symptoms like asraddha (disinclination for food etc.,) as coused by the affliction of rasadhutu may however, undergo some modification in their intensity due to the vitiation of one or the other of the doshas.
Some commentators suggest that the signs and symptoms enumerated for the vitiation of different dhatus manifest themselves only when the dosha capable of producing them is also vitiated and not otherwise. For example, heaviness of the body will be caused due to the affliction of rasadhatu by kapha only and not by vata. This type of explanation does not appear to be correct.
Diseases due to vitiated Rasa
अथद्ध हल्लासो गौरवं तन्द्रा साङ्गमर्दो ज्वरस्तमः ॥ ९ ॥ पाण्डुत्वं स्रोतसां रोधः फ्लैव्यं सादः कृशाङ्गता । नाशोऽग्नेरयथाकालं वलयः पलितानि च ॥ १० ॥ रसप्रदोषजा रोगा,
Following diseases are caused by the vitiation of rasadhatu. Disinclination for food, anorexia, disgeusia, ageusia, nausea, heaviness, drowsiness, fever with molaise fainting, anemia, obstruction of the channels of circulation, impotency, asthenia, emaciation, loss of the power of digestion and premature appea. rance of winkles and gray hairs. [9-10]
The term asraddha represents loss of desire for food. A person suffering from asraddha has however, no difficulty in taking food when taken in. Aruci (anorexia ) means the disapproval of food even after it has been taken in. Asyavairasya is the manifestation of an abnormal taste in the mouth. Arasajnata is the absence of the perception of taste.
Diseases due to vitialed Rakta
वक्ष्यन्ते रक्तदोषजाः । रक्तपित्तमसृग्दरः ॥ ११ ॥ कुष्प्रवीसर्पपिडका गुदमेदास्यपाकञ्च प्लीहा गुल्मोऽथ विद्रधिः । नीलिका कामला व्यङ्गः पिप्लवस्तिलकालकाः ॥ १२ ॥ दद्रुश्चर्मदलं श्वित्रं पामा कोठास्त्रमण्डलम् । रक्तप्रदोषाज्जायन्ते,
Following diseases are caused by the vitiation of rakta: Kustha (obstinate skin diseases including leprosy ), visarpa (acute spreading diseases of the skin including erysipelas), pimples, raktapitta (a disease characterised by bleeding from different parts of the body ), menorrhagia, inflammation of the rectum, phalhus and mouth, splenic disorders, gulma (abdominal tumour), abscesses, nilika ( blue moles), jaundice; vyanga ( freckles), piplu (portwine mark ), tilakalaka ( black mole), ringworm, carmadala (dermatitis), leucoderma, papules, kotha (urticaria) and asramandala (red circular patches ). [11-12]
Diseases like ringworm are included under kustha (obstinate skin diseases including leprosy ). Even then, ringworm etc. are separately enumerated here with a view to indicating their frequency of occurance when rakta is vitiated.
Diseases caused by vitiated Mamsa
शृणु मांसप्रदोषजान् ॥ १३ ॥ अधिमांसार्बुद कीलं गलशालूकशुण्डिके। पूतिमांसालजीगण्डगण्डमालोपजिद्दिकाः ॥ १४ ॥ विद्यान्मांसाश्रयान्,
Following diseases are caused by the vitiation of mamsa ( muscle tissue ), granuloma, myoma, piles, galasalaka ( uvulitis ), galasundika ( tonsilitis ), sloughing of flesh, alajr ( boils ), goiter, cervical adenitis and inflammation of epiglotis. [ 13-14 ]
Diseases due to vitiated Meda
मेदःसंश्रयस्तु प्रचक्ष्महे । निन्दितानि प्रमेहाणां पूर्वरूपाणि यानि च ॥ १५ ॥
Such of the premonitory signs and symptoms of prameha (obstinate urinary disorders including diabetes mellitus ) as are despisable ( i.e. matting of hair ) are produced by the vitiation of medas. [ 15 ]
Diseases caused by vitiated Asthi
अध्यस्थिदन्तौ दन्तास्थिभेदशूलं विवर्णता । केशलोमनखश्मश्रुदोषाश्चास्थि प्रदोषजाः ॥ १६ ॥
Following diseases are caused by the vitiation of asthi (bone tissue): Hypertrophy of the bones and teeth, cracking sensation in the teeth and pain in bone, discoloration and morbidity in hair of the head, small hair of the body, nail as well as beard. [ 16 ]
Diseases due to vitiated Majja
रुक् पर्वणां भ्रमो मूर्च्छा दर्शनं तमसस्तथा । अरुषां स्थूलमूलानां पर्वजानां च दर्शनम् ।। १७ ।। मज्जप्रदोषात्,
Following diseases are caused by the vitiation of majja (marrow ) : Pain in joints, giddiness, fainting, entering into darkness and manifestation of deep-seated abscesses in joints. [ 17 ]
Diseases due to vitiated Shukra
शुक्रस्य दोषात् क्लैब्यमहर्षणम् । रोगि वा क्लीबमल्पायुविरूपं वा प्रजायते ॥ १८ ॥ न चास्य जायते गर्भः पतति प्रस्नवत्यपि । शुक्रं हि दुष्टं सापत्यं सदारं बाधते नरम् ॥ १९ ॥
Due to the vitiation of sukra or semen the individual becomes impotent (no erection of the male genital organ) and there will be aharsana (even if there is erection of the genital organ there is no power of penitration ). His progeny ( if any ) will be sick, sterile, short lived and disfigured. Either there is no conception or there will be abortion or miscarriage. Thus the vitiation of sukra (semen ) brings misery for the individual as well as to his wife and progency. [ 18-19 ]
Vitiation of sense organs
इन्द्रियाणि समाश्रित्य प्रकुप्यन्ति यदा मलाः ।
उपघातोपतापाभ्यां योजयन्तीन्द्रियाणि ते ॥ २० ।।
Sense organs are either totally or partially destroyed when dosos of the respective places get vitiated. [ 20]
Affectation of other structures :
स्नायौ सिराकण्डराभ्यो दुष्टाः क्लिनन्ति मानवम् । स्तम्भसंकोचखल्लीभिग्रन्थिस्फुरणसुतिभिः ॥ २१ ॥
Doshas when vitiated in ligaments, vessels and tendons cause stiffness, contraction, neuralgia of the upper and lower extremities, tumours in ligaments etc., throbbing sensation and numbness. [ 21]
Vitiation of waste products
मलानाश्रित्य कुपिता भेदशोषप्रदूषणम् । दोषा मलानां कुर्वन्ति सङ्गोत्सर्गावतीव च ॥ २२ ॥
When doshas get vitiated in waste products, there is dislogement ( of stool ), desiccation ( of all excretory material ), impai rement of the natural complexion of the body) and absolute retention or excessive elimination of these waste products. 
Principles of Management of Diseases caused by Errors in Food
विविधादशितात् पीतादद्दिताल्लीढस्खादितात् । भवन्त्येते मनुष्याणां विकारा य उदाहृताः ॥ २३ ॥ तेषामिच्छन्ननुत्पत्ति सेवेत मतिमान् सदा । हितान्येवाशितादीनि न स्युस्तजास्तथाऽऽमयाः ॥ २४ ॥ रसजानां विकाराणां सर्व लङ्घनमौषधम् । विधिशोणिति केऽध्याये रक्तजानां भिषग्जितम् ॥ २५ ॥ मांसजानां तु संशुद्धिः शस्त्रक्षाराग्निकर्म च । अष्टौनिन्दितिकेऽध्याये मेदोजानां चिकित्सितम् ॥ २६ ॥ अस्थ्याश्रयाणा व्याधीनां पञ्चकर्माणि भेषजम् । बस्तयः क्षीरसपींषि तिक्तकोपहितानि च ॥ २७ ॥ मज्जशुक्रसमुत्थानामौषधं स्वादुतितकम् । अनं व्यवायव्यायामौ शुद्धिः काले च मात्रया ॥ २८ ॥ शान्तिरिन्द्रियजानां तु त्रिमर्मीये प्रवक्ष्यते । स्वाय्वादिजानां प्रशमो वक्ष्यते वातरोगिके ॥ २९ ॥ नवेगान्धारणेऽध्याये चिकित्सासंग्रहः कृतः । मलजानां विकाराणां सिद्धिश्चोक्ता क्वचित्कचित् ॥ ३० ॥
Diseases enumerated in verses 9 to 22 are caused by the improper intake of food comprising eatables beverages, lickables and masticables. One should always take wholesome food with a view to preventing the occurrence of such diseases. For the cure of diseases caused by the vitiation of rasa, one should take recourse to fasting of all types. Treatment of diseases caused by the vitiation of rakta is described in the 24th chapter of this section. Diseases due to the vitiation of of mansa ( muscle tissue ) can be treated by surgery, alkalies, Treatment of diseases caused by the vitiation of medo dhatu (fat) is discribed in the 21st chapter of this section. Diseases due to the vitiation of asthidhatu (bone tissue) can be treated by the Panchakarma (five elimination therapies). Specially enema, milk and ghee medicated with bitter drugs. Diseases due to the vitiation of majjadhatu (marrow ) and sukradhatu (semen ) can be treated with diets of sweet as well as bitter tastes, sexual intercourse, exercise and timely elemination of doshas in proper quantity. Therapy for the cure of diseases of sensory organs will be described in the 26th chapter of Chikitsasthana (the section on the treatment of diseasess ). Treatment of diseases of ligaments etc., will be discribed in the 28th chapter of Gikitsasthana. Therepeutic measures for the diseases caused by the waste products have already been described in the seventh chapter of this section.
Such therapies will further be described in other places like the 15th and 19th chapters of Chikitsasthana dealing with the treatment of grahani (sprue) and atisara (diarrhoea) respectively. [23-30]
A latent disease
व्यायामादूष्मणस्तैक्षण्याद्धितस्यानवचारणात् कोष्ठाच्छाखा मला यान्ति द्रुतत्वान्मारुतस्य तत्रस्थाच विलम्बन्ते कदाचिन्न समीरिताः । नादेशकाले कुप्यन्ति भूयो हेतुप्रतीक्षिणः ॥ ३२ ॥ च ॥ ३१ ॥
Due to exercise, acuteness of the power of digestion, nonobservance of wholesome regimen and pressure of vata, the vitiated doshas from the cantral part of the body, viz., alimentary tract etc., spread to the perifery or the tissue elements and skin. In the absence of any exciting cause, these vitiated doshas at times remain in quiscent stage till they meet with the causative factors at the appropriate time and place for the manifestation of their effects. [31-32 ]
The dhatus mentioned in verses 28-30 and also earlier, constitute the sakha or the perifery of the body;. The procedure involved in the spread of vitiated doshas from the central part of the body of the alimen tary tract to the perifery is described in the above verses.
Violent movement of the body caused during the exercise and the resultant acute digestive power help in the dislodgement and absorption of vitiated doshas from the alimentary tract to the perifery.
Non-observance of whole some regimen all the more aggravate tnese vitiated doshas and this causes overflow of vitiated doshas from the alimentary tract to the perifery. There are different types of vata. One type of vata helps in bringing out pressure on another types of vata resulting in the spread of the latter from the alimentary tract to the perifery. The vitiated doshas having spread to the perifery do not invariably manifest diseases. If they are not strong enough to cause diseases, they remain in quiscent stage and await suitable time and place for the manifestation of their effects Doshas strongly aggravated, however, do not remain in quiscent stage; they immediately manifest diseases,
Traction of peripheral doshas to the centre
वृद्ध या विष्यन्दनात् पाकात् स्रोतोमुखविशोधनात् । शाखा मुक्त्वा मलाः कोष्टं यान्ति वायोश्च निग्रहात् ॥ ३३ ॥
Due to further aggravation, increase influidity, suppuration, removal of the obstruction at the entrance of the channel of circulation and reduced pressure, the vitiated doshas leave the periphery and come to the central part of the body, that is the alimentary tract. 
When the fluidity of vitiated dosha is increased, it comes to the alimentary tract, the latter being situated at a lower level. Suppuration results in the detachment of the dosha from the place of lodgement. The vitiated dosha cannot go from the perifery to the alimentary tract, if the entrance of the channel of circulation is not clear. It does so when the obstruction is removed. Pressure of vata helps the spread of doshas from the alimentary tract to the perifery of the body. But when this pressure is withdrawn, dasas automatically come from the perifery to their normal abode, i. e. is alimentary tract.
अजातानामनुत्पत्तौ जातानां विनिवृत्तये । रोगाणां यो विधिईटः सुखार्थी तं समाचरेत् ॥ ३४ ॥
सुखार्थाः सर्वभूतानां मताः सर्वाः प्रवृत्तयः । ज्ञानाज्ञानविशेषासु मार्गामार्गप्रवृत्तयः ॥ ३५ ॥ In order to prevent the unmanifested diseases and to cure the manifested ones, an indivioual desirous of happyness, should follow the regimen prescribed in this text. All the psychosomatic activities, of living beings, are directed towards the aim of achieving happiness. A wise man follows the proper path. An ignorant one makes an individual to go astray. [34-35] The principle of the treatment of all diseases is described in brief in the above verse. The regimen that should be followed to get happiness in life is prescribed in various chapters of this text. Nobody intentionally does anything so as to invite misery for himself. But those who are ignorant of the science of medicine sometimes choose for themselves a wrong way of life, assuming that this will bring about happiness.
Importance of choosing wholesome regimen
हितमेवानुरुध्यन्ते प्रपरीक्ष्य परीक्षकाः । रजोमोहावृतात्मानः प्रियमेव तु लौकिकाः ॥ ३६ ॥ श्रुतं बुद्धिः स्मृतिर्दाक्ष्यं धृतिर्हितनिषेषणम् । वाग्विशुद्धिः शमो धैर्यमाश्रयन्ति परीक्षकम् ॥ ३७ ॥ लौकिकं नाश्रयन्त्येते गुणा मोहरजःश्रितम् । तन्मूला बहवो यन्ति रोगाः शारीरमानसाः ॥ ३८ ॥
The wise observe wholesome regimen after proper examination whereas other with their minds covered with rajas illusion run after apparently pleasing regimen. The wise endowed with knowledge, intelligence, memory, skill, ovservance and are of wholesome regimen, correctness of speech, tranquility and patience. Ignorant individuals being shrouded with illusion and rajas are deprived or those virtues and therefore, succumble to various types of psychosomatic diseases. [ 36-38 ]
Observance of certain regimen may cause temporary unhappiness but in the long run it leads to happiness. The wise adopt one or the other of them after proper examination. Ignorant people follow such of the regime as bring them temporary happiness but in the long run they lead to misery.
Consequence of ignorance
प्रज्ञापराधाद्व्यहितानर्थान् पश्च निषेवते । संधारयति वेगांश्च सेवते साहसानि च ॥ ३९ ॥
तदात्व सुखसंज्ञेषु भावेष्वज्ञोऽनुरज्यते । रज्यते न तु विज्ञाता विज्ञाने ह्यमलीकृते ॥ ४० ॥
Due to intellectual blasphemy, the ignorant indulge in unwholesome gratification of five senses, suppression of natural urges, exposure to strain beyond their capacity and adoption of such of the regime as are pleasing only temporarily. But the wise do not indulge in them because of their clarity of vision. [ 39-40 ]
Selection of food
परीक्ष्य रागान्नाप्यविज्ञानादाहारानुपयोजयेत् । हितमश्रीयाद्देहो ह्याहारसंभवः ॥ ४१ ॥
The body is constituted of food Hence one should take wholesome food only after careful examination and should not indulge in unwholesome ones out of greed or ignorance. [ 41 ]
Out of greed some individuals indulge in unwholesome food even though they are fully aware of its harmful effects. Some others, out of ignorance, treat unwholesome food as useful one and take it. Both of them subject themselves to misery.
Observation of eight factors
आहारस्य विधावष्टौ विशेषा हेतुसंज्ञकाः । शुभाशुभसमुत्पत्तौ तान् परीक्ष्य प्रयोजयेत् ॥ ४२ ॥
There are eight factors (described in Vimana 1:21) to be considered in dietetics. They are responsible for causing happiness or misery. These factors are to be examined before taking any food. [ 42 ]
Need to abserve wholesome rules
परिहार्याण्यपथ्यानि सदा परिहरन्नरः । भवत्यनृणतां प्राप्तः साधूनामिह पण्डितः ॥ ४३ ॥
यत्तु रोगसमुत्थानमशक्यमिह केनचित् । परिहर्तु न तत् प्राप्य शोचितव्यं मनीषिभिः ॥ ४४ ॥
The wise who always avoid the intake of unwholesome food are held in high esteem by saints. There are however, certain diseases which nobody can avoid and in such events the wise should not worry. [ 43-44 ]
Intake of wholesome food does not always prevent a man from getting diseases. Due to the sinful acts of past life even individuals with wholesome habit may subject themselves to diseases. But it does not mean that the wholesome habit of such individuals are without any good results. Such persons even if suffering from diseases command the goodwill of the enlightened sages who are fully aware that no human efforts can ever prevent the occurence of a diseases strongly pre-determined by the sinful acts of the past life.
Summing up the contents :
तत्र श्लोकाः- आहारसंभवं वस्तु हिताहितविशेषाच विशेषः सहत्वे चासहत्वे च दुःखानां देहसवयोः । विशेषो रोगसङ्घाश्च धातुजा ये पृथक्पृथक् ॥ ४६ ॥ तेषां चैव प्रशमनं कोष्ठाच्छाखा उपेत्य च । दोषा यथा प्रकुप्यन्ति शाखाभ्यः कोष्ठमेत्य च ॥ ४७ ॥ प्राशाशयोर्विशेषश्च स्वस्थातुरहितं च यत् । विविधाशितपीतीये तत् सर्व संप्रकाशितम् ॥ ४८ ॥ रोगाश्चाद्दारसंभवाः । सुखदुःखयोः ॥ ४५ ॥
The body as well as diseases are caused by food; wholesome and unwholesome food are responsible for happiness and misery respectively, individuals who have immunity from and susceptibility to the various psychosomatic diseases, various diseases specific to each of the dhatus, ( tissue elements ), therapies for their cure, the method by which doshas get vitiated and come to the perifery from the alimentary tract and vice versa, specific. characteristics of wise and ignorant individuals, regime useful for healthy individuals as well as patients-all these are described in this chapter on “Various Types of Food and Drinks.” [ 45–48 ]
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते सूत्रस्थाने विविधाशितपीतीयो नामाष्टाविंशोऽध्यायः ॥ २० ॥
इत्यन्नपानचतुष्कः ॥ ७ ॥
Thus ends the twenty-eighth chapter on “Various Types of Food and Drinks” of the Sutra section of Agnivesa’s work as redacted by Garaka. [ 20 ]
Thus ends the quadrate on Diets and Drinks.