Charaka, Charaka Samhita and Ayurveda
CHARAKA (300 BCE)
“A physician who fails to enter the body of a patient with the lamp of knowledge and understanding can never treat diseases. He should first study all factors, including the environment, which influence a patient’s disease and then prescribe treatment. It is more important to prevent the occurrence of disease than to seek cure.” This is a quote from Acharya Charak, found in Charaka Samhita.
Charaka (or Caraka) is widely known as the Father of Indian Medicine and the author of the compendium in Ayurveda, that bears his name (Charaka Samhita). This compendium’s origin can be traced to the great sage and physician Atreya (date unknown), which was later revised by Agnivesa in 8th Century BCE. There were other versions written by renowned physicians, in succession, Bhela, Jatukarna, Parashara, Harita and Ksharapani. It was the version that Charaka wrote after these eminent physicians that remains the basis of the indigenous Indian Medicine, the Ayurveda. His compendium was later revised by Dridhabala in 6th century CE.
- Charaka Smhita has 8 “Sthanas” (books) and contains a total of 120 chapters. Agnivesa’s compendium was written in 46,000 verses; the students of Ayurveda are required to commit these verses to memory. Charaka’s Compendium is divided into eight branches as follows:
- Sutra-Sthana (30 chapters that deal with general principles, philosophy, definitions, prevention by healthy living etc)
- Nidana-Sthana ( 8 chapters dealing with pathology)
- Vimana-Sthana (8 chapters dealing with training of the physician, ethics of medical practice, pathology and dietetics)
- Sharira-Sthana (8 chapters on embryology and anatomy)
- Indryiya-Sthana ( 12 chapters on diagnosis and prognosis)
- Chikitsa-Sthana (30 chapters dealing with therapeutics and Internal Medicine)
- Kalpa-Sthana (12 chapters on pharmaceutics and toxicology)
- Siddhi-Sthana (12 chapters describing successful treatment)
- Dridhabala added 17 chapters on Chikisa sthana and he added Kala sthana and Siddhi sthana new to the compendium.
Charaka considered four parts to the medical practice; all four are essential for recovery of the patient. These are, the patient, the physician, the nurse and the medicines (treatment). He laid down codes of behavior for physicians in considerable detail. A synopsis of these is given below:
"The physician must provide the knowledge and coordinate the treatment. He must display compassion, cheer and confidence. The physician must seek consent before entering a patient’s quarters, must be accompanied by a male member of the family when attending to a woman or child. He should never indulge in extortion or enter into business activities with the patient. He should speak with soft voice and never use cruel words. Also, always maintain patient’s privacy." Charaka also describes in detail the appropriate circumstances, tone and maintenance of privacy when another physician is consulted in the care of the patient.
These codes of behavior are reminiscent of the Hippocrate’s Oath that modern physicians take. However, it is worthwhile to consider that Charaka’s “Oath” is at least two centuries older than that of Hippocrates.
NUTRITION AND DIET:
The value of diet and nutrition was elaborated by Charaka in Chapters 5,6,25,26 and 27 of Charaka Samhita. A passage from the Samhita is given below:
“The tastes are six: sweet, sour, salt, pungent, bitter and astringent. Properly used, they nourish the body. Improperly used (either deficient or in excess), they verily lead to provocation of the Dosha. These are three: Vayu, Pitta and Kapha. When they are in their normal state, they are beneficial to the body. When, however, they are disorganized, verily then afflict the body with diseases of diverse kinds.”
Many chapters of the Samhita deal with identifying the flowers, seeds, toots, leaves, barks, stems and many plant juices, mountain herbs and many animal products, including milk, different types of honey, salts, stones etc. Many recipes for preparing medicinal products are also given. An example is given below:
ANU TAILA RECIPE: (Charaka Samhita 6. XXVI)
“Take a measure of sesame seeds.
Macerate them in goat’s milk
Then pound them in goat’s milk
Place the pounded product on a piece of clean cloth
Place the product and cloth over a vessel filled with goat’s milk
Apply mild heat to the vessel. Let vapors from heated milk slightly boil the sesame past.
Mix the boiled paste with pulverized liquorice, adding an equal measure of goat’s milk
Press the oil out of the mixed product
Add this oil to the (standard) decoction of ten roots in the ratio of one to four
To this oil mix, add paste of Rasna, Madhuka and Saindhava salt in the ration of four to one
Boil all these together. Filter. Extract and collect the oil
Repeat the root-past-salt-oil combining and boiling process ten times
The resulting oil is called “Anu-taila””
We will end this section on Charaka and Charaka Samhita with a quote from the latter, on students’ responsibility upon assuming apprenticeship:
“ Thou shalt be a brahmacharya, wear beard and mustache, thou shalt always be truthful, abstain from meat and unclean diet, never harbor envy, never bear weapons, thou shalt do anything I say except if that may lead to another person’s death or to great harm or to a sin, thou shalt behave like my son, never be impatient, always be attentive, behave with humility, act after reflection, and always seek whether sitting or standing the good of all living creatures.”