Table - 4 Cakrapāṇidatta’s Comments on Anatomical Terms

kloma hr̥dayasthapipāsāsthānaṃ.Vi.5.8 vapāvahanaṃ vapā udarasthā snigdhavartikā yāmāhurnāstailavarttiketi.Vi.5.8. suśrute tu medovahānāṃ mūlaṃ vr̥kkau kaṭī ca ityuktaṃ tadatrātindriyārthadarśigamye nāsmadvidhānāṃ buddhayaḥ prabhavanti.Vi.5.8. jaṅgā jānvadhastāducyate.Vi.8.117 trikamiti gudāsthaḥ prabhr̥ti kaṭikapālordhaparyantaṃ.Vi.8.117 bhagāsthi abhimukhaṃ kaṭīsandhānakārakaṃ. Sa.7.6 jānu jaṅghorvoḥ sandhiḥ.Sa.7.6 klomaḥ pipāsāsthānaṃ.Sa.7.10 bastiḥ mūtrāśayaḥ.Sa.7.10 uttaragudaḥ yatra purīṣamavatiṣṭhate,yena tu purīṣaṃ niṣkrāmati tadadharagudaṃ.Sa.7.10 vapāvahanaṃ medaḥsthānaṃ tailavarttikā iti khyātaṃ.Sa.7.10 kukundarau sphicoruparī unnatabhāgau.Sa.7.11 bastiśiro nābheradhaḥ.Sa.7.11 śleṣmabhuvau kaṇṭhasya pārśvayorvyavasthithau kaṭhinau bhāgau.Sa.7.11. upajihvike iti jihvāyā adhogatā tathā uparigatā grāhyā.Sa.7.11 gojihviketi gaurvāk tasyāḥ kāraṇabhūtā jihvā gojihvā;tena vacanakāraṇabhūtā pradhānajihvaiva ghr̥hyate.Sa.7.11. karṇaśaṣkulike karṇagatāvartakau.Sa.7.11 karṇaputrakau tu bāhyakarṇāveva.Sa.7.11 akṣikūṭake akṣigolake.Sa.7.11 kanīnikā śabdena nāsāyāḥ samamakṣisandhirabhidhīyate.Sa.7.11 vasā māṃsasnehaḥ.Sa.7.15. pr̥ṣṭheṣikā pr̥ṣṭhavaṃśaḥ.I.3.6 maṇikaḥ karamaṇisandhiḥ.I.3.6 manye galapārśvagate dhamanyau.I.3.6 grahaṇī hi jaṭharāgnisthānaṃ.Ci.3.129-131 kloma hr̥dayāvayava viśeṣaḥ.Ci.13.45-49 ghrāṇaśrotrākṣitarpaṇīnāṃ sirāṇāṃ sannipātaḥ śr̥ṅgāṭakaḥ.Ci.26.134-143 piṇḍikā jānujaṅghāmadhyamāṃsapiṇḍikā.Su.7.5-25

Nidāna

Cakrapāṇidatta explains the rationale behind the separate narration of hetus or etiological factors as their enumeration in sūtrasthāna is very concise and their elaborate exegesis is done in nidānasthāna. Their narration is a prerequisite for proper treatment and that is the reason why the brief narrations of basic principles of the treatment of diseases are mentioned along with the enumeration of their nidānas³⁴². The salient feature of nidana is that it sets apart the entities of the same class from those of a different class. This implies the specificity of aetiological factors with regard to specific illness and the specific action of all qualities of these factors in the disease genesis³⁴³. So by jvara nidāna, one must infer the nidānapañcaka as well as cikitsāsūtra of jvara³⁴⁴. The fundamental concepts related about the nidānapañcaka are applicable for all diseases explained in the treatise³⁴⁵.The narration of various synonyms of nidana are for the sake of common practice of the system. This also facilitates the comprehension of salient features of aetiology and it must be remembered that words used in a regular order and meaning are called as each other’s synonyms.They are considered as synonyms only in this context or order (not in other contexts). Importance of contexts should be understood in other cases like the narration of synonyms of pūrvarūpa and cikitsā³⁴⁶. The explanation seen in Āyurvedadīpikā regarding the enumeration of synonyms (eight) reveals influx of purāṇic brahmaṇical ideology in later Āyurveda scholars. Cakrapāṇidatta clarifies that owing to the auspiciousness of aṣṭasankhya or number eight, other synonyms like yoni, mukha etc; are left out of the list of synonyms of nidāna. They must be reckoned as synonyms of nidana, when they are used to signify it³⁴⁷. Cakrapāṇidatta highlights the importance of diagnosis of a disease in its treatment and without a proper knowledge of a disease one cannot effectively treat the ailment. So the fivefold means of knowing the disease is explained from a treatment point of view³⁴⁸.

Cakrapāṇidatta groups the nidānas broadly into two sādhāraṇa and asādhāraṇa. The former group includes those factors which are common to all living beings and the later includes the factors which are specific to individuals. The sādhāraṇa group includes the air (vāyu), water (udaka), land (deśa) and seasons (kāla). The asādhāraṇakārṇa indicates to the vitiation of vātadi dośas as a result of unwholesome food and regimens³⁴⁹. Āyurvedadīpikā classifies aetiology into viprakṛṣṭā and sannikṛṣṭa.Cakrapāṇidatta considers the doṣas as the sannikṛṣṭakāraṇa (adjacent cause) for all illnesses and the unwholesome utilisation of sense organs (asātymendriyārtha saṃyoga), erroneous judgement (prajñāparādha) and unwholesome disposition of temporal factors (pariṇāma) as viprakṛṣṭanidānas (distant causes) specific to each disease depending on the involvement of these in the specific condition.

Cakrapāṇidatta explains in case of visual apparatus only the total non utilisation sense organs will results in ill afflictions to the body.³⁵⁰ Only the exceedingly luminous objects will result in bodily afflictions when contacted by the visual faculty. Therefore no over utilization results even if one gazes at a pitcher which does not have a dazzling effect.³⁵¹Cakrapāṇidatta states that the objects that terrify human beings and such other objects may not necessarily be the direct objects of visual sensation. They are shapes and sizes of different dimensions. Even such shapes and sizes being associated with the direct objects of visual sensation do come under the purview of visual faculty. This is so even with regard to gustatory and tactile sensations where many such factors are included as are not, strictly speaking, direct objects of their respective sense faculties.³⁵²In case of rasa the quantity or rāsi of āhāra is not playing any role in mithyāyoga or wrong utilistaion.³⁵³ Cakrapāṇidatta quotes the opinion of scholars who included the pāpakarmas or sinful acts under the mithyayoga of kāla, since its result is felt after some time.³⁵⁴

The general distant causes for all diseases are considered as adharma (non-righteousness).When raktapitta is resulted from jvara, then jvara is considered as the viprakrishstha nidana of raktapitta³⁵⁵. In cikitsāsthāna, the nidāna are again classified in to vyavahitaṃ and pratyāsanna; the former group includes the aetiological factors like (use of) rūkṣaguṇa etc and pratyāsannakāraṇa or the immediate cause in the form of doṣas.³⁵⁶ We can see a similar classification of nidāna in Sarvāṅgasundaraṭikā and Madhukośaṭīkā too where the doṣas are reckoned as intimate causative factor of diseases. The former uses the term atyāsannakāraṇa and later chooses the term abhyantarakāraṇa.³⁵⁷

The knowledge of nidāna helps the physician to formulate therapies antagonistic to them; it gives a clue about the ailment that may manifest the future. The knowledge about the causative factors clarifies the doubt also can provide clearer diagnosis³⁵⁸. According to Cakrapāṇidatta, the term trīvidha signifies the three fold division of asātymendriyārthasaṃyoga i.e., atiyoga, ayoga, and mithyāyoga. This term trīvidha also signifies all the subtler variations and its permutation- combinations of these three-fold causes.³⁵⁹According to Cakrapāṇidatta, the noncongenial contact of senseorgans (asātmyendriyārthasamyoga) is having a relative importance among the triad of causative factors. The logic behind this placement is that all the effects kāla and prajñāparadhā can contact the body through the senses only.³⁶⁰ The three doṣas are mentioned in compounded form (samāsatapada i.e., āgneyasaumyavāyvāśca) to emphasis the fact that any one of these three fold causes can initiate diseases by all the three doṣas.³⁶¹

Separate narration of mānsadoṣas as rajas and tamas is interpreted as suggestive of its lesser utility in śārīravyādhis or physical ailments and their enumeration is only to give a comprehensive look for the treatise.³⁶²