अथातो नवेगान्धारणीयमध्यायं व्याख्यास्यामः ॥ १ ॥ इति ह स्माह भगवानात्रेयः ॥ २ ॥
We shall now expound the chapter on “Non-Suppression of Natural Urges”. Thus said Lord Atreya. [1-2]
Non suppressible urges :
न वेगान् धारयेद्धीमाञ्जतान् मूत्रपुरीषयोः । न रेतसोन वातस्य न छर्द्याः क्षवथोर्न च ॥ ३ ॥ नोद्गारस्य न जृम्भाया न वेगान् क्षुत्पिपासयोः । न वाष्पस्य न निद्राया निःश्वासस्य श्रमेण च ॥ ४ ॥
One should not supress the natural urges relating to urine, faeces, semen, flatus, vomiting, sneezing, eructation, yawning, hunger, thirst, tears, sleep and breathing caused by over exertion. [3-4 ]
For living a normal healthy life, it is necessary that the needs of these natural urges are satisfied instantaneously, i.e. as soon as they are explicit. As regards breathing, suppression of urges relating to all types of breathing is prohibited but it is all the more so with to the breathing caused by over exertion.- cf. sutra 7 :24. Susruta has also explained that by suppressing breathing caused by over exertion one gets heart diseases, fainting or even phantom tumour in the abdomencf. Susruta; uttaratantra 55:17
एतान् धारयतो जातान् वेगान् रोगा भवन्ति ये । पृथक्पृथक्चिकित्सार्थं तान्मे निगदतः शृणु ॥
Various types of diseases occur by the suppression of these urges. For the purpose of their treatment, they are being dealt here with one by one. 
Effects of suppression of natural urges and their treatment
Micturition reflex :
बस्तिमेहनयोः शूलं मूत्रकृच्छ्रं शिरोरुजा । विनामो वंक्षणानाहः स्याल्लिङ्गं मूत्रनिग्रहे ॥ ६ ॥
स्वेदावगाहनाभ्यङ्गान् सर्पिषश्चावपीडकम् । मूत्रे प्रतिहते कुर्यात्रिविधं वस्तिकर्म च ॥ ७ ॥
Suppression of the urge for micturition causes pain in bladder and phallus, dysuria, headache, bending of the body and distension of the lower abdomen.
If the suppression of urine has been done, tub bath, massage, nasal drops of ghee and all the three types of basti should he given. [6-7]
Avapida means the use of a particular drug for inhalation in excess. The three types of basti are as follows:
(i) Niruha- otherwise known as asthapana, this type of enema is prepared predominantly with the decoctions of medicinal plants.
(ii) Anuvasana-This is a type of enema prepared by medicated fat. (iii) Uttarabasti-This is uretheral and vaginal douche.
पक्काशयशिरःशूलं वातवर्चोऽप्रवर्तनम् । पिण्डकोद्वेष्टनामानं पुरीषे स्याद्विधारिते ॥ ८ ॥
स्वेदाभ्यगावगाहाश्च वर्तयो बस्तिकर्म च । द्दितं प्रतिहते वर्चस्यन्नपानं प्रमाथि च ॥ ९ ॥
If one holds the urge for defecation it causes colic pain, headache, retention of facces and flatus, cramps in the calf muscles and distension of abdomen. APA NA DIHAM
In such cases, fomentation, massage, tub bath, suppositories and enema should be given and one should take foods and drinks which are laxative in nature. [8-9]
Seminal discharge reflex:
मेढ़ वृषणयोः शूलमङ्गमर्दो हृदि व्यथा | भवेत् प्रतिहते शुक्रे विबद्धं सूत्रमेव च ।। १० ।।
तत्राभ्यङ्गोऽवगाहश्च मदिरा चरणायुधाः । शालिः पयो निरूहश्च शस्तं मैथुनमेव च ॥ ११ ॥
Pain in the phallus and testicles, malaise, cardiac pain and retention of urine are caused by the suppression of the urge for seminal discharge. In that case massage, tub bath, madira type of wine, chicken, sali rice (Oryza sativa Linn.), milk, non-greezy enema and sexual intercourse are prescribed. [ 10-11]
Flatus passing reflex :
सङ्गो विमूत्रवाताना माध्मान वेदना कुमः | जठरे वातजाश्चान्ये रोगाः स्युर्वातनिग्रहात् ॥ १२ ॥
स्नेहस्वेदविधिस्तत्र वर्तयो भोजनानि च । पानानि बस्तयश्चैव शस्तं वातानुलोमनम् ॥ १३ ॥
If one suppresses the urge for passing flatus, this causes retention of faeces, urine and flatus, distension of abdomen, pain, kalaexhaustion and other abdominal diseases due to the vitiation of vata. In that case, oleation, fomentation, suppositories, intake of foods and drinks having carminative action and enema are prescribed. [ 12-13 ]
Vomiting reflex :
कण्डूकोठा रुचिव्यङ्गशोथपाण्ड्वामयज्वराः कुष्ठहृल्लासवीसर्पाञ्छर्दिनिग्रहजा भुक्त्वा प्रच्छर्दनं धूमो लङ्घनं रक्तमोक्षणम् । रूक्षान्नपानं व्यायामो विरेकश्चात्र शस्यते ॥ १५ ॥ । गदाः ॥ १४ ॥
The diseases caused by the suppression of the urge for vomiting are pruritus, urticaria, anorexia, black pigmentation of face, oedema, anemia, fever, skin diseases, nausea and erysipelas. In such cases, induction of vomiting, smoking, fasting, bloodletting, non-greezy foods and drinks, physical exercise and purgation are prescribed. [ 14-15]
Sneezing reflex :
मन्यास्तन्भः शिरःशूलमर्दितार्धावभेदकौ । इन्द्रियाणां च दौर्बल्यं क्षवथोः स्याद्विधारणात् ॥ १६ ॥
तत्रोर्ध्वजत्रुकेऽभ्यङ्गः स्वेदो धूमः सनावनः | हितं वातघ्नमाद्यं च घृतं चौत्तरभक्तिकम् ॥ १७ ॥
By the suppression of the urge for sneezing, ailments like torticollis, headache, facial paralysis, hemicrania and weakness of the sense organs are caused. For that one should apply massage and fomentation in the head-neck region, and use smoking alongwith nasal drops. One should also take food which is useful for the alleviation of vata and should take ghee after meals. [ 16-17]
हिक्का श्वासोऽरुचिः कम्पो विबन्धो हृदयोरसोः । उद्गारनिग्रहात्तत्र हिक्कायास्तुल्यमौषधम् ॥ १८ ॥
Suppression of eructation causes hiccough, dyspnoea, anorexia, tremor, obstacles in the proper functioning of heart and lungs. The treatment for this condition is the same as for hiccough. [ 18 ]
Yawning reflex :
विनामाक्षेपसंकोचा: सुप्तिः कम्पः प्रवेपनम् । जृम्भाया निग्रहात्तत्र सर्व वातघ्नमौषधम् ॥ १९ ॥
Suppression of yawning causes bending, convulsion, contractions, numbness, tremor and shaking ( pravepana ) of the body and the treatment for these are the drugs used for alleviating vata. [ 19 ]
Hunger reflex :
कार्यदौर्बल्यवैवर्ण्यमङ्गमर्दोऽरुचिर्भ्रमः क्षुद्वेगनिग्रहात्तत्र स्निग्धोष्णं लघु भोजनम् ॥ २० ॥
By suppressing hunger, one subjects himself to emaciation, weakness, change in bodily complexion, malaise, anorexia and giddiness. In that case, one, should take unctuous, hot and light food. [ 20 ]
Thirst reflex :
कण्ठास्यशोषो बाधिर्य श्रमः सादो हृदि व्यथा । पिपासनिग्रहा शीतं तर्पणमिष्यते ॥ २१ ।।
Suppression of thirst causes dryness of throat and mouth, deafness, exhaustion, weakness and cardiac pain. In that case, one should take cold demulcent drinks. 
Tear reflex :
प्रतिश्यायोऽक्षिरोगश्च हृद्रोगश्चारुचिर्भ्रमः । बाष्पनिग्रहणात्तत्र स्वप्नो मद्यं प्रियाः कथाः ॥ २२ ॥
By suppressing tears, one gets rhinitis, eye diseases, heart diseases, anorexia and giddiness. For that, sleep, intake of wine and pleasing talks are helpful. [ 22 ]
Sleeping urge :
जृम्भाऽङ्गमर्दस्तन्द्रा च शिरोरोगोऽक्षिगौरवम् । निद्राविधारणात्तत्र स्वप्नः संवाहनानि च ॥ २३ ॥
Suppression of the urge for sleep causes yawning, malaise, drowsiness, headache and heaviness in the eyes. To overcome that one should resort to sound sleep and massage of the body. [ 23 ]
Breathing reflex :
गुल्महृद्रोगसंमोहाः श्रमनिःश्वासधारणात् । • जायन्ते तत्र विश्रामो वातघ्न्यश्च क्रिया हिताः ॥ २४
By the suppression of breathing coming out of exertion, phantom tumour, heart diseases and fainting are caused. In that case one should take rest and resort to the regimen prescribed for the alleviation of vata. [ 24 ]
Prevention of diseases caused by suppression of natural urges :
वेगनिग्रहजा रोगा य पते परिकीर्तिताः । इच्छंस्तेषामनुत्पत्ति वेगानेतान्न धारयेत् ॥ २५ ॥
These are the diseases caused by the suppression of the various natural urges. One desirous of preventing these diseases, should not suppress an of these natural urges. 
In the Susruta, 13 types of udavarta have been enumerated corresponding the suppression of 13 natural urges. But in the chapter entitled “Astodariya” ( Sutra 19 ), Charaka enumerates only six types of udavarta corresponding to the suppression of the six natural urges, viz. those relating to the micturition, defecation, vata (flatus ), semenial discharge, vomiting and sneezing. He probably intends to include the other seven types of udavarta corresponding to the suppression of the remaining seven types of natural urges under the suppression of vata. Suppressible
इमांस्तु धारयेद्वेगान् हितार्थी प्रेत्य चेह च । साहसानामशस्तानां मनोवाक्कायकर्मणाम् ॥ २६ ॥
One desirous of his well-being during his lifetime and after, should suppress urges relating to rashness and evil deedsmentally, orally and physicially. [ 26 ]
Not that all the urges have got to be satisfied. There are some urges which need be suppressed. The urge for rash action ( for example, running towards a wild elephant) or urge for doing evil deeds have got to be very carefully restrained-mentally, orally and physically.
लोभशोकभयक्रोधमानवेगान् नैर्लज्ज्येष्र्ष्यातिरागाणामभिध्यायाश्च विधारयेत् ।
(Similarly), a wise person should refrain from satisfying the urges relating to greed, grief, fear, anger, vanity, shamelessness, jealousy, too much of attachment and malice. [ 27 ]
बुद्धिमान् ॥ २७ ॥ परुषस्यातिमात्रस्य सूचकस्यानृतस्य वाक्यस्याकालयुक्तस्य धारयेद्वेग मुत्थितम् ॥ २८ ॥
One should also refrain from letting loose the urges of speaking extremely harsh words, back-biting, lying and use of untimely words. [ 28 ]
देहप्रवृत्तिर्या काचिद्विद्यते परपीडया । स्त्रीभोगस्तेयहिंसाद्या तस्यावेगान्विधारयेत् ॥ २९ ॥
Violence to others whatsoever, urges relating to such physical actions including adultery, theft and persecution are to be restrained. [ 29 ]
The physical restraint prescribed in the present verse also includes such careless insulting acts like streching the legs before superiors, etc.
पुण्यशब्दो विपापत्वान्मनोवाक्कायकर्मणाम् । धर्मार्थकामान् पुरुषः सुखी भुङ्के चिनोति च ॥ ३० ॥
The virtuous one, who is free from all vices relating to mind, speech and physical actions, is indeed happy and he alone enjoys the fruits of virtue ( dharma ), wealth ( artha ), and desire ( kama ). [ 30 ]
Exercise : Definition according to Ayurveda
शरीरचेष्टा या चेष्टा स्थैर्यार्था बलवर्धिनी । देहव्यायामसंख्याता मात्रया तां समाचरेत् ॥ ३१ ॥
Such a physical action which is desirable and is capable of bringing about bodily stability and strength is known as physical exercise. This has to be practised in moderation. [ 31 ]
Physical exercises are to be practised only in moderation. If they are over-done, they cause over-exertion, giddiness etc., which is not desirable. So they are to be practised until they bring about lightness, etc. in the body cf Susruta: Chikitsa 24:80.
Good effects of exercise :
लाघवं कर्मसामर्थ्य स्थैर्य दुःखसहिष्णुता । दोषक्षयोऽग्निवृद्धिश्च व्यायामादुपजायते ॥
३२ ॥ Physical exercise brings about lightness, ability to work, stability, resistance to discomfort and alleviation of dosas (specially kapha ). It stimulates the power of digestion. [ 32 ]
Bad effects of excessive exercise :
श्रमः कृमः क्षयस्तृष्णा रक्तपित्तं प्रतामकः । अतिव्यायामतः कासो ज्वरश्छर्दिश्च जायते ॥ ३३ ॥
Physical exercise in excess causes exertion, exhaustion, consumption, thirst, bleeding from different parts of the body (raktapitta ), pratamaka ( a type of dyspnoea ), cough, fever and vomiting. [ 33 ]
Features of correct exercise:
( स्वेदागमः श्वासवृद्धिर्गात्राणां लाघवं तथा । हृदयापरोधश्च इति व्यायामलक्षणम् ॥ १ ॥
Perspiration, enhanced respiration, lightness of the body, inhibition of the heart and such other organs of the body are indicative of the exercise being performed correctly. Excess of following behaviours is bad:
व्यायामहास्यभाष्याध्वग्राम्यधर्म प्रान् ।
नोचितानपि सेवेत बुद्धिमानतिमात्रया ॥ ३४ ॥
One should not practise, exercise, laughing, speaking, travelling on foot, sexual activities and night wakings, in excess even if one is accustomed to these. [ 34 ]
Simile on the bad effects of their excessive use :
एतानेवंविधांश्चान्यान् योऽतिमात्रं निषेवते ।
गजं सिंह इवाकर्षन् सहसा स विनश्यति ॥ ३५ ॥
One who indulges in these and such other activities in excess, suddenly perishes like a lion trying to drag an ( huge ) elephant. 
Excessive indulgence in activities, whatsoever, is prohibited, inasmuch as such indulgence may cause instantaneous death. Even a powerful animal like a lion meets with death due to the vitiation of vata caused by over-exertion, if he tears open a disproportionately huge elephant.
Contra-indication of exercise:
(अतिव्यवायभाराध्वकर्मभिश्चातिकर्शिताः क्रोधशोकभयायासैः क्रान्ता ये चापि मानवाः ॥ १ ॥
ये चोच्चै बहुभाषकाः । बालवृद्धप्रवाताश्च ते वर्जयेयुर्व्यायामं क्षुधितास्तृषिताश्च ये ॥ २ ॥ )
Exercise is contra-indicated for persons who are emaciated due to excessive sexual activity, weight lifting and by travelling on foot and for those who are in grip of anger, grief, fear, exhaustion and for the children, for the old persons and for persons having vatika constitution and profession of speaking too much. One should not do exercise while he is hungry and thirsty also.
Schedule for giving up the addictions :
उचितादहिताद्धीमान् क्रमशो विरमेन्नरः । हितं क्रमेण सेवेत क्रमश्चात्रोपदिश्यते ॥ ३६ ॥
प्रक्षेपापचये ताभ्यां क्रमः पादांशिको भवेत् । एकान्तरं ततश्चोर्ध्वं द्व्यन्तरं त्र्यन्तरं तथा ॥ ३७ ॥
A wise person should give up by and by unwholesome practices to which he is addicted and he should correspondingly adopt ones which are wholesome. The schedule for the same is given below.
On the first day one should give up a quarter of the unwholesome practice (still maintaining of it,) and correspondingly adopt a quarter of wholesome. On the second day half of the unwholesome practice is to be given up and half of the wholesome one is to be adopted; this is to be continued for the third day also. On the fourth day, of the unwholesome practice is to be given up and of the wholesome one is to be adopted. This process is to be continued on the 5th and 6th day also. The process of giving up of the unwholesome practice and adoption of the wholesome practice is completed fully on the 7th day. [ 36-37]
There is, however, difference of opinion as to the process and duration of giving up and adopting the unwholesome and wholesome practices respectively. And accordingly it may take longer time.
Importance of following the schedule:
क्रमेणापचिता दोषाः क्रमेणोपचिता गुणाः । सन्तो यान्त्यपुनर्भावमप्रकम्प्या भवन्ति च ॥ ३८ ॥
By slowly and gradually giving up the unwholesome practices and by increasing the wholesome practices correspondingly the unwholesome pratices are eradicated for ever and the wholesome practices are fully adopted. [ 38 ]
One should not be in a hurry to give up and to adopt the unwholesome and wholesome practices respectively. A sudden change in habits is likely to cause immense harm to the body cf. Astanga hrdaya : Sutra 3:58. Only a slow and steady process as indicated in the text above can absolutely eradicate the effects of unwholesome practices and stabilise the effects of wholesome ones.
समपित्तानिलकफाः केचिद्गर्भादि मानवाः । दृश्यन्ते वातलाः केचित्पित्तलाः श्लेष्मलास्तथा ॥ ३९
वातलाद्याः सदातुराः । ह्येषां देहप्रकृतिरुच्यते ॥ ४० ॥ तेषामनातुराः पूर्वे दोषानुशयिता ॥
Some persons maintain the equilibrium of vata, pitta and kapha from the very time of conception; some are dominated by vata, some by pitta and some by kapha.
Those of the first category are not susceptible to diseases and the rest of them are always likely to suffer. The body constitution (Deha Prakrti) of persons is named according to the predominance of Dosas. [39-40 ]
At the time of conception, in certain individuals, there is equilibrium of vata, pitta and kapha; some are dominated by vata (vatala ); some are dominated by pitta (pittala); some are dominated by kapha (slesmala); some are dominated by two dosas, i. e. by vatta-pitta, vattakapha and pitta-kapha. Out of these categories, individuals of the first category, by nature, maintain a normal health. Those belonging to other categories always suffer from one or the other of the bodily defects, although they might apparently be having normal health. For example, even if a person is healthy therewise, but if he is by nature dominated by vata, he will be susceptible to the cracking of the different parts of the body. This happens because, the very normal condition of health of such individuals is dominated by the one or the other of the dosas. Such individuals are said to have normal health, not because their bodily conditions are absolutely normal, but because the condition of their body whatsoever they have it since birth.
It might be argued that the various types of natural conditions (prakrti) of the body as produced at the time of conception are invariable and as such continue for the whole life. Such conditions are changed in certain individuals only to indicate imminent death. As it has been stated by Susruta, “The dosas relating to the natural conditions of the body (prakrti) get never enhanced, transformed or diminished except in the cases of moribund individuals”-vide Susruta: Sarira 4 : 78. But then if one possessing an equilibrium of dosas or the one dominated by vata, is subjected to diseases like epilepsy caused by the vitiation of vata, naturally the original vata is enhanced. Similarly if one, dominated by vata suffers from diseases due to the vitiation of pitta, the bodily natural condition (prakrti) dominated by vata gets transformed into the one dominated by pitta. Sometimes, the one in position of the natural condition of the body (prakrti) having equilibrium of dosas suffer from diseases caused by the diminution of one of the dosas, then the dosas responsible for the causation of the natural condition of the body (prakrti) are diminished-cf. Sutra 18: 52. How to reconcile this contradiction. If diseases similar to the natural bodily condition (prakrti) occur, the enhancement is found not in the dosas relating to the natural bodily condition but in the dosas caused by some extraneous factors. The dosa, which is responsible for the causation of prakrti, is different from the dosa subsequently vitiated to cause the diseases. Dosas of the former category do not play any direct role in the production of the disease. The statement of Charaka, given below, corroborates this view. “When a dosa is joined with homologous seasons, tissue elements and prakrti (natural condition of the body) it becomes too powerful to be contested and as such causes the disease known as santata: this is very difficult to be tolerated”-vide Chikitsa 3:55. Thus is a person of vata-prakrrti suffers from diseases caused by pitta, the original physical condition dominated by the vata remains absolutely unaffected causing as it does the cracking in hands and feet; it is neither augmented nor diminished. To sum up: dosas responsible for the causation of prakrti (natural body constitution), neither gets aggravated, nor changed, nor diminished. So, an individual possessing the physical constitution, caused by the equilibrium of dosas at the time of conception cannot imbibe the qualities of individuals having other prakrytis. This applies to all other prakrtis in general.
The dominent dosas, at the time of conception do not affect the body at a later stage inasmuch as they constitute the very nature of the body. And so, being inseparably related to the body, they, in themselves do not cause any bodily defects. As Susruta says, “As an insect produced out of the poison, does not die of his own poison, so the body is not too much affected by the dosas responsible for causing its constitution at the time of conception”-vide Susruia: Sarira 4:79. An identical reference is available in Asvavaidyaka-a treatise on the treatment of horses.
The dosas aggravated at the time of conception do affect the embryo but they do not altogether impair the productivity of sperm and ovum. If, however, the dosas are too much aggravated, they might even impair the productive power of sperm and ovum, causing thereby complete destruction of the ovum. This all depends upon the extent of vitiation of the concerned dosas.
Principles of dietetics and regimen for persons having different constitutions:
विपरीतगुणस्तेषां स्वस्थवृत्तेर्विधिर्हितः । समसर्वरसं सात्म्यं समधातोः प्रशस्यते ॥ ४१ ॥
Such of the diets and regimen, as stand in contradistinction with the dosas responsible for the production of the particular prakrti (body constitution) are prescribed for the maintenance of positive health. For individuals having equipoised state of dosas, habitual intake of diets consisting of all rasas ( tastes) in proportionate quantity is prescribed. [ 41 ]
The prescription of diets consisting of all rasas in proper (same ) quantity for individuals of samaprakrti ( having equipoised state of dosas) needs further elucidation. It is not that all the rasas are intended to be taken in equal quantity. No healthy person will relish as much of pungent food as of sweet dishes. It will also not be helpful for the maintenance of health in the healthy person so the proportion of rasas is to be determined according to the individual’s taste and food value.-cf. Sutra 6: 11. A vata-prakrti man may require more of diets having madhura (sweet), amla (sour) and lavana (saline) taste during winter, whereas for a sama-prakrti man, diets having all the tastes specially amla (sour) and lavana (saline) tastes are prescribed. Thus, the proportion of rasa is to be determined according to the bodily constitution (prakrti), season, and dietetic property-vide Astanga hrdaya Sutra 3:57.
Excretory orifices :
द्वे अधः सप्त शिरसि खानि स्वेदमुखानि च । बाध्यन्ते दुष्टैर्मात्राधिकैर्मलैः ॥ ४२ ॥
मलायनानि मलवृद्धिं गुरुतया लाघवान्मलसंक्षयम् । मलायनानां बुध्येत सङ्गोत्सर्गादतीव च ॥ ४३ ॥
of There are two orifices in the lower part of the body (viz., the rectum and urethra ), seven orifices in head ( viz., two eyes, two ears, two nostrils and mouth ) and there are multiple openings of sweat glands, i. e. hair roots serving the purpose excretion. These are affected by the increase in quantity of excretions and by their vitiation. If there is heaviness in the excretory orifices or there is excessive excretion, it is indicative of an increase in excreta. On the other hand, if there is lightness in the excretory orifices or there is no excretion it indicates the decrease in excreta. [ 42-43 ]
Principles of treatment for excretory disorders:
तान् दोषलिङ्गैरादिश्य व्याधीन् साध्यानुपाचरेत् । व्याधिहेतुप्रतिद्वन्द्वैर्मात्राकालौ विचारयन् ॥ ४४ ॥
One should ascertain from signs and symptoms indicated above the exact nature of the diseases due to the increase of the excreta and then should treat the curable one by prescribing therapies which are having opposite qualities from the diseases and their causes, paying due regard to the dose and time. [ 44 ]
Description of therapies opposite to diseases and its causes includes even such of the therapies as are apparently not opposite but cure the ailments when administered.
Importance of following the regimen for healthy persons :
विषमस्वस्थवृत्तानामेते रोगास्तथाऽपरे । जायन्तेऽनातुरस्तस्मात् स्वस्थवृत्तपरो भवेत् ॥ ४५ ॥
Those, who do not follow a course of life conducive to the maintenance of good health, are susceptible to the above-mentioned and similar other diseases. A healthy person should, therefore, follow a course of life conducive to the maintenance of good health. [ 45 ]
Rules for the prevention of endogenous diseases:
माधवप्रथमे मासि सहस्यप्रथमे चैव नभस्यप्रथमे पुनः । हारयेद्दोषसंचयम् ॥ ४६ ॥ स्निग्धस्विन्नशरीराणामूर्ध्वं चावश्च नित्यशः । •वस्तिकर्म ततः कुर्यान्नस्यकर्म च बुद्धिमान् ॥ ४७ ॥ यथाक्रमं यथायोग्यमत ऊर्ध्वं प्रयोजयेत् । रसायनानि सिद्धानि वृष्ययोगांश्च कालवित् ॥ ४८ ॥ रोगास्तथा न जायन्ते प्रकृतिस्थेषु धातुषु । धातवश्वाभिवर्धन्ते जरा मान्द्यमुपैति च ।। ४९ ॥ विधिरेष विकाराणामनुत्पत्तौ निदर्शितः । निजानामितरेषां पृथगेवोपदेक्ष्यते ॥ ५० ॥ तु
In the months of Caitra, Sravana and Margasirsa (approximately March-April, July-August and November-December respectively), one should administer elimination therapies.
After the oleation and fomentation therapies, one should administer emetics and purgatives. Then one should apply enema and inhalation therapies in proper sequence according to the requirement. And thereafter one should administer rejuvenerative and fertility agents with due regard to the temporal propriety. If this is done, the tissue elements are maintained in homeo statis and diseases are not caused; there is proper growth of tissue elements and the process of aging is delayed.
Thus, the ways and means of preventing endogenous diseases have been described. Those for the exogenous ones will be described separately. [ 46-50]
In order that one may not be affected by the diseases, one should take recourse to preventive therapy well in advance. The months suitable for the administration of elimination thepapy generally are Caitra (MarchApril), Sravana (July-August), and Margasirsa (November-December) included respectively in the spring, rainy and autumn seasons–cf. Vimana 8: 125 and Siddhi 6:5. A similar reference is also found in Susruta: Sutra 6:10. The elimination therapy is to be administered in accordance with the procedure and order indicated in the Sixth Chapter of Siddhisthana. Moreover, this is to be noted that this therapy will be required to be administered in the later half of the seasons concerned, when the dosas are already accumulated and it is more convenient to eliminate them. Kapilabala is also in agreement with this view.
Haricandra is, however, of the view that the word “sahasya’ in the present verse represents the sixth case ending of the word “saha” ending in ‘a’ and, as such, he interpretes “sahasya prathame” as the month preceding Margasirsa ( saha) i.e. Kartika. Vagbhata also follows himself
Astanga hydaya : Sutra 13:33. He says, “one should promptly eleminate vata, pitta and kapha accumulated respectively in summer, the rainy season and winter in the months of Sravana, Kartika and Caitra respectively.” Some commentators have attempted a reconciliation between the interpretations given above by taking recourse to another reading, presumably interpolated, where an interval of three months is prescribed in between any two of the consecutive elimination therapies (trimasantaritan), But this is a side issue not to be taken seriously.
Emesis, purgation and enema are not to be administered in the order of the seasons indicated in the text. They are rather to be administered in accordance with the therapeutic needs of the respective seasons. That to is say, emesis is to be administered in Caitra, purgation in Margasirsa and enema therapy in Sruvana.
By administering the emesis, purgation and enema therapies, one is not only immuned to the vitiation of endogenous dosas ( disease causing factors) but also to the exogenous produced by evil spirits, wind, etc., as well as mental defects.
Agents causing exogenous diseases:
नृणामागन्तवो रोगाः प्रज्ञा तेष्वपराध्यति ॥ ५१ ॥ ईर्ष्याशोकभयक्रोधमानद्वेषादयश्च ये ।
मनोविकारास्तेऽप्युक्ताः सर्वे प्रज्ञापराधजाः ॥ ५२ ॥
Exogenous diseases produced by evil spirits, poison, wind, fire, assault from which human beings suffer are essentially the results of the defect in one’s own mental faculty. Even the emotions as malice, despair, fear, anger, vanity and hatred, etc. are the result of defects in one’s own mental faculty. [51-52 ]
Even the endogenons diseases are caused by some defects in the intellectual faculty (for example, exposing oneself to external wind, taking undesirable, rough food, etc. ) still they are as a matter of fact direct results of vitiation of the internal dosas like vata, etc..
Prevention of exogenous diseases:
त्यागः प्रज्ञापराधानामिन्द्रियोपशमः स्मृतिः । देशकाला त्मविज्ञानं सद्वृत्तस्यानुवर्तनम् ॥ ५३ ॥
निदर्शितः । आगन्तूनामनुत्पत्तावेष मार्गो प्राशः प्रागेव तत् कुर्याद्धितं विद्याद्यदात्मनः ॥ ५४ ॥
Exogenous diseases can be prevented by taking recourse to the avoidance of intellectual errors; restraint of sense organs; good memory; knowledge of the place, time and one’s own capability and good conduct. One desirous of his own well-being should follow this up well in advance. [53-54 ]
Restraint of sense organs implies abstinence from indulgence in their objects. Good memory includes memory or concsiousness relating to morality of one’s kith and kin as also other human beings. As it has been said, one can get rid of mental ailments by remembering the exact nature of the objects. Thus, restraint of sense organs and good memory go a long way in preventing mental diseases. One, who is conversant with local features, would avoid moving in a solitary house, forest and countries where there are calamities, etc. Similarly, one conversant with temporal features will follow all the prohibitions relating to the full moon day, etc. and also those relating to such odd times as are known for the attack of evil spirits. One who is aware of his own capabilities will avoid any contact with strong blaze, etc. Salient features of good conduct will be explained in the next chapter.
आप्तोपदेशप्रज्ञानं प्रतिपत्तिश्च विकाराणामनुत्पत्तावत्पन्नानां च कारणम् । शान्तये ॥ ५५ ॥
Knowledge about the prescriptions of authoritative sages and assimilation of such instructions can only help in the prevention and treatment of diseases. [ 55 ]
Aptas or sages are those enlightened human beings who are free from attachment and prejudices-cf. Sutra 11: 18-19. Diseases can be prevented by avoiding the causative factors. Diseases already manifested can be cured by following prescribed regimen and diet. But this regimen includes a thorough knowledge of the authentic sages and those in practice.
Unsuitable persons for company:
पापवृत्तवचः सच्वाः सूचकाः कलहप्रियाः । मर्मोपहासिनो लुब्धाः परवृद्धिद्विषः शठाः ॥ ५६ ॥
परावाद .. निर्घृणास्त्यक्तधर्माणः परिवर्ज्या नराधमाः ॥ ५७ ॥
Such wretched human beigns, who are of sinful conduct, speech and mind, back biters, those who are quarrelsome by nature, those who indulge in sarcastic remarks about others, the greedy, those who envy the prosperity of others, the cruel, those who indulge in defaming others, the fickle minded, those who serve the enemy, those devoid of compassion and those who do not follow the virtuous course of life are to be boycotted. [56-57]
Suitable persons for company:
बुद्धिविद्यावयः शीलधैर्यस्मृतिसमाधिभिः । वृद्धोपसेविनो वृद्धाः स्वभावज्ञा गतव्यथाः ॥ ५८ ॥ सुमुखाः सर्वभूतानां प्रशान्ताः शंसितव्रताः । सेव्याः सन्मार्गवक्तारः पुण्यश्रवणदर्शनाः ॥ ५९ ॥
Those who have attained maturity by virtue of wisdom, learning, age, conduct, patience, memory and meditation; those who are matured and learned ones; those who maintain the company of matured persons; those who are acquainted with the human nature; those who are devoid of all anxities; those who are well behaved with every body; those who are pacified; those who follow righteous course of action; those who advocate good conduct and those whose very name and sight are auspicious should be accompanied. [ 58-59 ]
आहाराचारचेष्टासु सुखार्थी प्रेत्य चेह च । परं प्रयत्नमातिष्ठेद्बुद्धिमान् हितसेवने । ६० ।।
One desirous of well being in this world and the world beyond, should try his level best to follow the principles of health relating to diet, conduct and action. [ 60]
Rules for using curd as per Ayurveda and Acharya Charaka
न नक्तं दधि भुञ्जीत न चाप्यघृतशर्करम् । नामुद्द्रयूषं नाक्षौद्रं नोष्णं नामलकैर्विना ॥ ६१ ॥
ज्वरासृविपत्तवीसर्पकुष्ठपाण्ड्वामयभ्रमान् । प्राप्नुयात्कामलां चोग्रां विधि हित्वा दधिप्रियः ॥ ६२ ॥
One should not take curd at night; It should not be taken alone without ghee, sugar, green gram soup, honey or amalaka ( Emblica officinalis Gaertn. ) and it should not be taken hot also.
If one fond of curd does not follow these rules he is likely to suffer from diseases like fever, raktapitta ( bleeding from different parts of the body ), visarpa ( erysipelas ), kustha [ obstinate skin diseases including leprosy, pandu ( anemia ), bhrama ( giddiness ) and kamala .( jaundice ). [ 61–62 ]
The word ‘na’ signifying the negative sense and occuring before ‘nakta’ or night as well as ‘usna’ or hot is directly connected with the verb “bhunjita”––by implication, hot curd is absolutely prohibited at night. The negative sense in the compounded words like “aghrta sarkara” etc; is on the otherhand directly connected with the word “na”. That is to say, by force of two negatives, each of the other clauses has got a positive sense. Thus, one can take curd with ghee or sugar or greengram soup or honey or amalaka ( Emblica officinalis Gaertn. ) powder. It is possible that all words conveying a negative sense in this verse are directly connected with the verb. If this interpretation is accepted, then curd mixed up with green gram soup but without ghee or sugar will become edible. Jatukarna would rather be in agreement with this interpretation. He says that curd should not be taken at night nor it should be taken hot nor without ghee, honey, sugar, greengram soup and amalaka ( Emblica Officinalis Gaertn.) powder.
तत्र श्लोकाः –
वेगा वेगसमुत्थाश्च रोगास्तेषां च भेषजम् । येषां वेगा विधार्याश्च यदर्थं यद्धिताहितम् ॥ ६२ ॥ उचिते चाहिते वर्ज्य सेव्ये चानुचिते क्रमः । यथा प्रकृति चाहारो मलायनगदौषधम् ॥ ६४ ॥ भविष्यतामनुत्पत्तौ रोगाणामौषधं च यत् । वर्ज्याः सेव्याश्च पुरुषा धीमताऽऽत्मसुखार्थिना ॥ ६५ ॥ विधिना दधि सेव्यं च येन यस्मात्तत्रिजः । नवेगान्धारणेऽध्याये सर्वमेवावदन्मुनिः ॥ ६६ ॥
To sum up :
In this chapters on “Non-suppression of Natural urges”, Lord Atreya has explained, all about natural urges, diseases arising out of them, their cure, the urges that are to be suppressed, what is wholesome, what is unwholesome; the order relating to the adoption of healthy practices and discarding unhealthy ones, proper diet according to the natural conditions of the body, the diseases relating to the excretory orifices and their treatment, prevention of diseases, persons who should be accompanied and who should not be and rules regarding intake of curd. [ 63-66]
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते श्लोकस्थाने
• नवेगान्धारणीयो नाम सप्तमोऽध्यायः ॥ ७ ॥
Thus ends the seventh chapter on the “Non-suppression of Natural Urges” of the Sutra section of Agnivesa’s work as redacted by Charaka.