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Susruta has enumerated the specific causes which aggravate the respective Dosas Vayu, Pitta and Kapha (SS.Su.

310 21:19-24). Charaka, however, has first described the general causes which produce a disease and then in Nidanasthana, he has enumerated in details the specific causes which aggravate the particular Dosa to produce a particular kind of disease. We shall first take up these general causes, remembering that anything which produces a disease must first of all has to derange the Dosas. (a) GENERAL CAUSES OF DISEASE Charaka says that the causes of disease both bodely and mental may be briefly stated to be of three kinds, excessive and wrongful conjunction or total lack of conjunction or use (1) of weather characteristics, (2) of action or of intelligence and (3) of sense objects (CS.Su. 1:59) CS.Su.11:37). Later on, he says (CS.Vi.6:6; CS.1.1:3) that the causes of derangement of the two kinds of Dosas (bodily and mental) are of three varieties - (1) Asatmyendriyartha Samyoga, i.e. improper and harmful conjunction of the five sense objects with the respective senses. (2) Prajnaparadha, or misuse of intelligence. (3) Parinama, or the improper functioning or manifestation of the climatic changes brought about by the different seasons. After thus briefly enumerating the above three causes of disease, Charaka next goes on to explain them in details

311 (CS.Su.11:37-44 ; CS.Sa.I:98-129). FACTORS OF DISEASE (1) ASATMYCENDRIYARTHA SAMYOGA (unwholesome contact of the sense with their objects) Sound, touch, colour taste and smell, these are the five sense-objects corresponding to the five senses whenever there is an 'asatmya' or harmful conjunction between a sense and its object, there is a potential cause of disease. Harmful conjunction means either excessive or wrongful conjunction or no conjunction at all. (i) EXCESSIVE USE OF SENSE-OBJECTS Too much hearing of very loud sounds such as that of the roaring of thunder or the excessive use of the sense of hearing. Similarly, too much or handling of very cold or very hot things or too much bathing or massage, too much seeing of very bright objects or of powerful light, too much use of the six Rasas and too much smelling of very strong or putrid substances are examples respectively of the excessive association of the senses of touch, sight, taste and smell. (ii) Non-use of sense-objects Not to hear at all any kind of sound, not to touch anything either hot or cold, not to have a sight of any kind of object, not to have a taste of any of the six Rasas and not to smell anything at all are 'Ayogya' or non-use of the five senses.

312 (iii) WRONGFUL USE OF THE SENSE OBJECTS (a) Hearing of harsh or disagreeable or fearful sounds or of mournful news, (b) to have touch of poisonous air or stormy winds or to be exposed to any untimely advent of hot or cold whether or to be struck by anything, (c) to see extremely fine and small objects or objects very near to the eye or at a very great distance or to see any loathsome, dreadful or hostile object or any distorted vision, (d) to have recourse to only one kind of taste in excess or to exclude one altogether or take very little of one, or to include to one's diet articles of food whose combination is harmful, (e) to smell putrid, poisonous, nauseating things, are examples of 'Mittiya-yoga or wrongful conjunction of the five senses with their respective objects. (2) PRAJNA PARODHA Intelectual Blasphemy Prajna pa radha has been described as the ayoga, atiyoga and mithyayoga of arina or action which has been defined as any effort of the body, mind or speech, "karma-vanmanas sarira-pravrittih" (CS.Su.11:39). Later on Charaka has defined " prajnaparadha" as any harmful or undesirable action perpetrated by any body who has lost his understanding, intellect or memory (CS.Su.1:102). Excessive activities of speech, mind and body are

313 'atiyoga' and their non-activities are 'ayoga' of these three. Suppression of the desires of nature, trying to pass urine, etc. when there is no desire for them, excessive sexual indulgence, holding up one's breath, excessive massage or any undue physical exertion are examples of 'mithyayoga' of the body. Speaking anything harsh or unkind or false, quarrelling, abusing etc. are examples of wrongful activities of speech. Fear, grief, anger, avarice, hallucination, jealousy etc. are examples of the wrongful activities of the mind. (3) PARINAMA Seasonal Vagaries Parinama is another name for Kala or Time (C.SI:12: 42). The whole year divided into different seasons is Kala. The main elimatic characteristics of these seasons are recognised by cold, heat or rains. When a particular season manifests its own characteristic of cold, heat or rains in excessive degree, we have 'atiyoga of hala; when these characteristics are deficient we have 'ayoga' of kala; and when a season manifests symptoms which are opposite of its own special characteristics, we have 'mithyayoga' of Kala. Whatever may be the cause of any possible disease, it must fall under one or the other of the above three heads.

314 (b) CAUSES OF DERANGEMENT OF DOSAS The specific causes which aggravate Vayu, Pitta and Kapha have been enumerated by Susruta and the two Vagbhatas (SS.Su.21:19-24; AS & AH III 1). (a) CAUSES OF DERANGEMENT OF VAYU causes, Vayu is aggravated by the following amongst other (i) wrestling with one of superior strength or with fierce animals, (ii) excessive fighting. (iii) excessive gymnastics or manual labour, (iv) excessive sexual undulgence or waste of any body- (v) dhatu, excessive study, (vi) speaking or reading in a very highpitched voice, (vii) fear or grief or anxiety, (ix) falling from a great height (x) excessive running (xi) great pressure or squeeze kii) violent blows (xiii) high jumps and vaults, (xiv)leamping gait (xv) excessive swimming or swimming against current, (xvi) keeping of late hours (xvii) carrying of heavy loads, (xviii) excessive riding on horses, elephants, etc. or excessive use of carriages,

315 (xix) excessive fasting or excessive eating or eating irregularly and Suppressing the calls of nature, e.g. the passing of wind or urine or faces or semen or eructations or the forceful stopping of the desire to vomit or to sreeze of the outflow of tears. Vayu is also aggravated by the partaking of too much better, pungent, astringent or dry substances, by very light food, by dry meat and by the continued use of some particular. Kind of pulses and rice (mudga, masura, adhaki, harenu etc. mentioned by Susruta). Vayu is naturally aggravated in the cold and rainy seasons, specially on cloudy and stormy days, in the early morning, in the evening and at the completion of the digestive process. (2) CAUSES OF DERANGEMENT OF PITTA Pitta is aggravated by (1) anger, (ii) grief, (iii) fear, (iv) physical exertion, (v) ill-digestion or acidformation in the body and (vi) unnatural sexual intercourse. Pitta is also aggravated by the partaking of too much bitter acid, salty and dry substances and by the too much use of mustard, sesamum and linseed oils, fish, mutton, some of the green leafy vegetables, wines, curd, whey, etc. and by excessive exposure to the sun. Pitta is naturally aggravated in the summer and in the autumn, at noon, at midnight and during the process of digestion.

316 (3) CAUSES OF DERANGEMENT OF KAPHA Kapha is aggravated by (i) total lack of physical exercise, (ii) sedentary habits, (iii) sleeping in the day time and (iv) the partaking of too much sweet, acid, salty, cooling and oily substances. It is aggravated by heavy food and by the too much use of milk, curd, sugar, fats, wheat, cakes, sweet fruits, meat of aquatic animals etc. Kapha is naturally aggravated in the winter and in the spring, in the forenoon and in the evening and just after taking a meal. The causes which bring about the derangement of Dosas and the abnormal symptoms of Dosas are tabulated below: Dosa Causes of Derangement Vayu Abnormal Symptoms Heavy exercise, fasting, falling from a height, fracture, wakefulness, suppressing the calls of nature, excessive cold and fear, habituation in pungent, bitter, astringent and dry things (Natural aggravation at the clouding of the skies, after meals, in the afternoon/. Tympanitis, stiffness, roughness of the skin, eruption, excitement, shivering, pain, hoarseness fatique, deafness, melancholia, yawning, horripilation, dryness, thirst.

Pitta 317 Habituation in salts, and in bitter, sour, acrid and very hot things, excessive anger and cohabitation, indulgence in drinks. (Natural aggravation during meals, in autumn, in the middle of the night, at noon). Acidity, delirium, swooning, nerapiration, restlessness, thirst, desire for cold, paleness of the skin. Kapha Indulgence in cold, heaving and sweet things, excessive use of milk, ghee and such like articles, sleeping during the day time. (Natural aggravation in the beginning of a meal, at the fall of snow, in the morning, in spring. leaviness of the limbs, drowsiness, constipation, itching, whiteness of the skin.