Sushruta Samhita Sutrasthana Chapter 20: Hitahitiya Adhyaya (Suitable and Unsuitable for Health)

The 20th chapter of Sutrasthana of Sushruta Samhita is named as Hitahitiya Adhyaya. This chapter deals with the information on Suitable and Unsuitable for Health.

अथातोहिताहितीयमध्यायंव्याख्यास्यामः॥१॥
यथोवाचभगवान्धन्वन्तरी॥२॥

We will expound the chapter by name Hitahitiya- suitable and unsuitable for health; as revealed by the venerable Dhanvantari.

Dravya Bhedas: Kinds of substances

यद्धायोःपथ्यंतत्पित्तस्यापथ्यमित्यनेनहेतुनानकिंचिद्रव्यमेकान्तेनहितमहितंवाऽस्तीतिकेचिदाचार्याबुवते।तत्तुनसम्यक्; इहखलुयस्माद्रव्याणिस्वभावतःसंयोगतश्चैकान्तहितान्येकान्ताहितानिहिताहितानिचभवन्ति॥३॥

“Those substances which are pathya i.e. suitable or conducive for Vayu (vata) are not suitable / conducive for pitta”. This includes medicines, foods, activities, behaviors etc. Based on this principle some authorities (masters) opine that no substances (in the world) are either absolutely or always, completely or surely ‘suitable or unsuitable’ at all times and in all conditions and for all individuals

This opinion seems to be incorrect. Because according to the Dhanvantari school, all the substances by their nature and as a result of their combination (or by chance) are always either

i.                absolutely suitable, or
ii.              absolutely unsuitable or
iii.            absolutely both i.e. suitable and unsuitably (as per situation, need or usage).

These three are also the kinds of substances.

Ekanta Hita, Ekanta Ahita and Hita-Ahita Dravya

तत्र, एकान्तहितानीजातिसात्म्यात्सलिलघृतदुग्धौदनप्रभृतीनि; एकान्ताहितानितुदहनपचनमारणादिषुप्रवृत्तान्यलक्षारविषादीनि, संयोगादपराणिविषतुल्यानिभवन्ति, हिताहितानितुयद्धायोःपथ्यंतत्पित्तस्यापथ्यमिति॥४॥

Ekanta Hita Dravya – Among these, the substances like water, ghee, milk, porridge (boiled rice) and similar others are always suitable because of being accustomed through lineage of generations (genetically accustomed over a period of generations) or accustomed to the man right from the birth.

Ekanta Ahita – Similarly, the substances like fire, caustic alkali and poison used for dahana (burning), pachana (cooking) and marana (causing death) respectively are (completely, surely) always unsuitable.

Due to combination some suitable substances also act similar to poison. Therefore, they are also always unsuitable.

Hita Ahita Dravya – These substances are both suitable and unsuitable. Example – Those substances suitable for vata and unsuitable for pitta etc. mentioned above.

Pathyatama Ahara: Food materials which are best suited for health

अतःसर्वप्राणिनामयमाहारार्थंवर्गउपदिश्यते; तद्यथा- रक्तशालिषष्टिककङ्गकमुकुन्दकपाण्डुकपीतकप्रमोदककालकासनपुष्पककर्दमकशकुनाहृतसुगन्धककमनीवारकोद्रवोद्दाल कश्यामाकगोधूमयववैणवैणहरिणकुरङ्गमृगमातृकाश्वदंष्ट्राकरालक्रकरकपोतलावतित्तिरिकपिञ्जलवर्तिरवर्तिकामुद्रवनमुद्रमकुष्ठकलायमसूरमङ्गल्यचणकहरेण्वाढकीसतीनाश्चिल्लिवास्तुकसुनिषण्णकजीवन्तीतण्डुलीयकमण्डूकपर्ण्यः , गव्यंघृतं, सैन्धवं , दाडिमामलकमित्येषवर्गःसर्वप्राणिनांसामान्यतःपथ्यतमः॥५॥

So, further on, is enumerated such substances which are useful as food for all living beings, such as –

–        Raktasali, Sastika, Kanguka, Mukhundaka, Panduka, Pitaka, Pramodaka, Kalaka, Asanapuspaka, Kardamaka, Sakunahrta, Sugandhaka, Kalama (all are different varieties of Paddy / rice),
–        Nivara, Kodrava, Uddalaka, Syamaka (all are millets),
–        Godhuma (wheat), Yava (barly), VenuYava (seed of bamboo tree);
–        (meat of) Ena, Harina, Kuranga, Mrgamatrka, Svasamstra, Karala (all are different kinds of deer); Krakara, Kapota, Lava, Tittiri, Kapinjala, Vartira, Vartika (all are varieties of birds);
–        Mudga, Vanamudga, Makustaka, Kalaya, Masura, Mangalya, Canaka, Harenu, Adhaki, Satina (these are legumes / pulses)
–        Cilli, Vastuka, Sunisannaka, Jivanti, Tanduliyaka, Mandukaparni (these are leafy vegetables),
–        Cow’s ghee,
–        Saindhava,
–        Dadima and
–        Amalaka;

The substances of this group are generally best suited to all living beings.

तथाब्रह्मचर्यनिवातशयनोष्णोदकस्नाननिशास्वप्रव्यायामाश्चैकान्ततःपथ्यतमाः॥६॥

Similarly, the below mentioned are also best suited always –

–        celibacy,
–        sleeping at a place devoid of breeze,
–        bathing in hot water,
–        sleeping at nights,
–        physical exercises etc.,

एकान्तहितान्येकान्ताहितानितुप्रागुपदिष्टानि, हिताहितानितुयद्वायोःपथ्यंतत्पित्तस्यापथ्यमिति॥७॥

The substances which are always suitable and always unsuitable were explained earlier. The suitable-unsuitable substances are those whose description can be found in the treatises like, ‘those suitable to vata but unsuitable to pitta’ and similar such examples.

Samyoga viruddha: Incompatible by combination

संयोगतस्त्वपरणिविषतुल्यानिभवन्ति।तद्यथा- वल्लीफलकवक्करीराम्लफललवणकुलत्थपिण्याकदधितैलविरोहिपिष्टशुष्कशाकाजाविकमांसनद्यजाम्बवचिलिचिममत्स्यगोधावराहांश्चनैकध्यमश्नीयात्पयसा॥८॥

Some substances when combined with some other substances become similar to poison in effect. Example – the below mentioned things should never be consumed by combining them with milk –

–        Valliphala – fruits of creepers,
–        Kavaka
–        Karira
–        Amla phala – sour tasting fruits,
–        Lavana – salts,
–        Kulattha – horse gram
–        Pinyaka – sesame paste
–        Dadhi – curds,
–        Taila – oil
–        Virohi – germinated grains
–        Pista – flour,
–        Suska saka – dried leafy vegetables,
–        Aja avi mamsa – meat of goat and sheep,
–        Madya – wine
–        Jambu phala
–        Chilicima Matsya – type of fish
–        Godhra Varaha mamsa – meat of iguana, boar etc.

Factors to consider before administering these substances

रोगंसात्म्यंचदेशंचकालंदेहंचबुद्धिमान्।
अवेक्ष्याग्न्यादिकान्भावान्रोगवृत्तेःप्रयोजयेत्॥९॥

After carefully considering his diseases, habituation, accustomment, habitat (region), time (seasons), body (physical constitution), digestive fire and other aspects the intelligent physician may administer these substances to the patient.

अवस्थान्तरबाहुल्याद्रोगादीनांव्यवस्थितम्।
द्रव्यंनेच्छन्तिभिषजइच्छन्तिस्वस्थरक्षणे।१०॥
अवस्थान्तरबाहुल्याद्रोगादीनांव्यवस्थितम्।
द्रव्यंनेच्छन्तिभिषजइच्छन्तिस्वस्थरक्षणे।१०॥
द्वयोरन्यतरादानेवदन्तिविषदुग्धयोः।
द्ग्धस्यैकान्तहिततांविषमेकान्ततोऽहितम्॥११॥
एवंयुक्तरसेष्वेषुद्रव्येषुसलिलादिषु।
एकान्तहिततांविद्धिवत्ससुश्रुतनान्यथा॥१२॥

Stages of the diseases and other factors mentioned above are innumerable in number. The physicians do not prefer to discriminate or classify the substances as ‘always suitable’, ‘always unsuitable’ or ‘suitable-unsuitable’ strictly. But they would always wish to consider either of them for protection of the health of ailing individuals, as and when needed and suitable.   

From the perspective of (administering these to) the patients, if the physician needs to select any one, he will obviously pick milk which is always suitable and not the poison because it is always unsuitable.

Dear son Sushruta, in this manner one should understand and consider the substances such as water etc, which have normal tastes are always suitable for health. On the other hand, even these substances, when they have abnormal taste etc. are not suitable for health.

Samyoga Viruddha: Incompatible by combinations

अतोऽन्यन्यापिसंयोगादहितानिवक्ष्यामः- नवविरुढधान्यैर्वसामधुपयोगुडषैर्वाग्राम्यानूपौदकपिशितादीनिनाभ्यवहरेत् ; नपयोमधुभ्यांरोहिणीशाकंजातुकशाकंवाऽश्रीयात्, बलाकांवारुणिकुम्लाषाभ्यां, काकमाचींपिप्पलीमरिचाभ्यांनाडीभङ्गशाककुटदधीनिचनैकध्य’मधुचोष्णोदकानुपानं ;पित्तेनचाममांसानि; सुराकृशरापायसंश्चनैकध्यं;सौवीरकेणसहतिलशष्कुलीं; मत्स्यैःसहेक्षुविकारान्; गुडेनकाकमाचीं, मधुनांमूलकंगुडेनवाराहंमधुनाचसहविरुद्धं, क्षीरेणमूलकम्, आम्रजाम्बवश्वाविच्छूकरोधाश्च; सर्वाश्चमत्स्यान्पयसा, विशेषेणचिलिचिमं; कदलीफलंतालफलेनपयसादध्नातक्रेणवा; लकुचफलंपयसादध्यामाषसूपेनवा, प्राक्पयसःपयसोऽन्तेवा॥१३॥

From here on, some more unsuitable combinations will be described (i.e. some other substances which are unsuitable for health when combined with other substances) –

Meat, blood, fat, bone marrow etc. of animals living in marshy lands and water should never be consumed by combining them with freshly harvested grains, sprouted grains, muscle fat, honey, milk, jaggery and black gram.

Rohini shaka or jatuka shaka, should not be consumed along with milk or honey.

Meat of balaka should not be consumed with varuni (a type of alcohol / wine) and kulmasa (half boiled grains).

Kakamaci should not be consumed along with Pippali and Marica.

Nadibhangasaka, should not be taken with meat of cock and curds mixed together all at once.

Hot water as an after-drink should not be taken after consuming honey.

Uncooked meat should not be taken along with pitta (bile).

The below mentioned should not be consumed by at once, combining them all together –

–        Sura – beer
–        Krsara – rice boiled with green gram or black gram
–        Payasa – milk pudding

Tila Saskuli – sesame paste fried in oil or ghee is not a good combination with Suviraka – a kind of gruel and hence should not be consumed together.

Likewise, the sugarcane products i.e. jaggery, sugar etc. do not form an ideal combination with fish and hence should not be taken in combination.

Kakamaci along with jaggery and Mulaka in combination with honey should not be consumed since they form incompatible combinations.

Likewise, boar meat should not be eaten in combination with honey or jaggery.

The below mentioned should not be taken along with milk –

–        mulaka,
–        fruit of Amra and Jambu,
–        meat of porcupine, boar and Iguna

All fishes do not go well with milk. Even among the fishes, the cilicima fish should never be taken along with milk.

Fruits of Kadali and Tala should not be taken along with milk, curds or buttermilk.

Lakuca fruit should not be consumed with –

–        milk
–        curds
–        soup of black gram
–        before or after taking milk

Karma viruddha: Incompatible by processing

अतःकर्मविरुद्धान्वक्ष्यामः- कपोतान्सर्षपतैलभृष्टान्नद्यात्; कपिञ्जलमयूरलावतित्तिरिगोधाश्चैरण्डदार्व्यग्रिसिद्धाएरण्डतैलसिद्धावानाद्यात्; कांस्यभाजनेदशारत्रपर्युषितंसर्पिः ;मधुचोष्णैरुष्णेवा; मत्स्यपरिपचनेश्रुङ्गवेरपरिपचनेवाकाकमचीं; तिलकल्कसिद्धमुपोदिकाशाकं ; नारिकेलेनवराहवसपरिभृष्टांबलाकां; भासमङ्गारशूल्यंनाश्रीयादिति॥१४॥

Hereafter, incompatible foods based on their processing will be explained. The below mentioned foods should not be consumed as they are harmful –

Meat of Kapota – pigeon, fried in mustard oil

Meat of the below mentioned along with fuel of Eranda – castor plant or Darvi – turmeric tree or cooked in castor oil

–        Kapinjala
–        Mayura
–        Lava
–        Tittiri
–        Godha

One should not consume ghee kept in a bronze vessel for ten days or more.

Honey should never be consumed with hot substances or in hot seasons.

Kakamaci cooked in a vessel in which fish or ginger was cooked should never be consumed.

Upodika saka prepared with paste of tila should not be consumed.

The below mentioned types of processed meat too should not be consumed –

–        Meat of balaka bird fried in fat of boar added with narikela (coconut)
–        Meat of bhasa bird pierced by iron rods and roasted in flame of fire

Mana viruddha: Incompatible by proportion

अतोमानविरुद्धान्वक्ष्याम:-मध्वम्बुनीमधुसर्पिषीमानतसुल्येनाश्रीयात्ःस्नेहौमधुस्नेहौजलस्नेहौवाविशेषादान्तरीक्शोदकानुपानौ॥१५॥

After this, incompatible foods combinations by their quantity (proportion) shall be enumerated.

The below mentioned should not be consumed mixed in equal quantities –

–        Honey and water
–        Honey and ghee

The below mentioned should not be consumed in the form of anupana i.e. after-drinks –

–        Two kinds of Sneha – fats
–        Honey and fats
–        Fats and water, especially rain water mixed in equal quantity

Rasa Viruddha: Incompatible by tastes etc.

अतऊर्वंरसद्वन्द्वानिरसतोवीर्यतोविपाकतश्चविरूद्धानिवक्ष्यामः- तत्रमधुराम्लौरसवीर्याविरुद्धौमधुरलवणौच, मधुरकटुकौचसर्वतः, मधुरतिक्तौरसविपाकाभ्यांमधुरकषायौच, अम्ललवणौरसतः,  अम्लकटुकौरसविपाकभ्याम् , अम्लतिक्तावम्लकषायौचसर्वतः, लवणकटूकौरसविपाकाभ्यांलवणतिक्तौलवणकषायौचसर्वतः , कटुतिक्तौरसवीर्याभ्यांकटुकषायौच, तिक्तकषायौरसतः॥१६॥

Hereafter, the incompatibility of foods in respect of combination by rasa – taste, virya – potency and vipaka – taste after digestion. They are as enumerated below –

Incompatible in respect of taste and potency – Mixture of two tastes i.e.

–        sweet and sour or
–        sweet and salt

Incompatible in respect of taste, potency and taste after digestion – mixture of sweet and pungent tastes

Incompatible in terms of taste and taste after digestion – mixture of sweet and bitter tastes

Incompatible in respect of taste –

–        combination of sweet and astringent and also
–        combination of sour and salt tastes

Incompatible in terms of taste and taste after digestion – sour and pungent tastes mixed together

Incompatible by all respects –

–        sour and bitter tastes mixed tastes or
–        sour and astringent tastes mixed together

Incompatible in terms of taste and taste after digestion – mixture of salt and pungent tastes

Incompatible in all respects – mixture of –

–        Salt and bitter tastes
–        Salt and astringent tastes

Incompatible with respect to taste and taste after digestion –

–        Pungent and bitter taste
–        Pungent and astringent taste

Incompatible in terms of taste – bitter and astringent tastes

Combinations which need to be avoided

तरतमयोगयुक्तांश्चभावानतिस्निग्धानतिरूक्षानत्युष्णानतिशीतानित्येवमादीनविवर्जयेत्॥१७॥

Such combinations which are profound and more profound in respect to taste, potency and taste after digestion should be avoided. Example –

Too much of unctuousness or too much of dryness

Too much heat or too much cold etc.

भवन्तिचात्र:-
विरुद्वान्येवमादीनिवीर्यतोयानिकानिचित्॥
तान्येकान्ताहितान्येवशेषंविद्याद्धिताहितम्॥१८॥

Some verses here:-

All ‘incompatible by potency’ categories of substances should be regarded as absolutely and always incompatible to health.

On the other hand, all the other substances should be regarded as suitable or unsuitable.

Consequences of consuming substances having incompatible tastes and potency

व्याधिमिन्द्रियदौर्बल्यंमरणंचाधिगच्छति।
विरुद्धरसविसविर्याणिभुञ्जानोऽनात्मवान्नरः॥१९॥

All those persons would become victims of diseases when they consume food substances which are incompatible in respect of tastes and potency, without any self-restraint. They will also become victims of debility of sense organs (improper sense perceptions) and even death.

यात्किंचिद्दोषमुत्क्लेश्यभुक्तंकायान्ननिर्हरेत्।
रसादिष्वयथार्थंवातद्विकारायकल्पते॥२०॥

Those substances which when consumed will cause increase (aggravation) of the doshas but will not expel them out of the body. These doshas which are not removed from the body would contaminate the rasa and other tissue in the body and would bring about abnormalities in them and give rise to many diseases.

विरुद्धाशनजान्रोगान्प्रतिहन्तिविरेचनम्।
वमनंशमनंवाऽपिपूर्वंवाहितसेवनम्॥२१॥

When the below mentioned are administered fight from the moment of commencement of diseases, the diseases arising from consumption of incompatible foods would get cured –

–        Virechana – therapeutic purgation
–        Vamana – therapeutic emesis
–        Shamana – alleviating / pacification therapies
–        Hita sevanam – regular use of suitable substances conducive for health

Persons who are not harmed by incompatible foods

सत्म्यतोऽल्पतयावाऽपिदीप्ताग्रेस्तरुणस्यच॥
स्निग्धव्यायामबलिनांविरुद्धंवितथंभवेत्॥२२॥

In the below mentioned conditions and persons even the incompatible foods (when consumed) will become ineffective (will not harm the body) –

–        due to satmya or being accustomed / habituated to incompatible foods for a long time
–        when consumed in small quantities
–        when consumed by the person who has keen digestive fire (digestive capacity),
–        in a young person
–        in those who have become strong by the effect of using unctuous (fatty) foods and physical exercises,

Vataguna: Properties of breeze

अथवातगुणान्वक्ष्यामः :-
पूर्वः समधुरः स्निग्धो लवणश्चैव मारुतः।
गुरुर्विदाहजननो रक्तपित्ताभिवर्धनः॥२३॥
क्षतानां विषजुष्टानां व्रणिनः श्लेष्मलाश्च ये।
तेषामेव विशेषेण सदा रोगविवर्धनः॥२४॥
वातलानां प्रशस्तश्च श्रान्तानां कफशोषिणाम्।
मधुरश्चाविदाही च कषायानुरसो लघुः।
दक्षिणो मारुतः श्रेष्ठश्चक्षुष्यो बलवर्धनः॥२५॥
रक्तपित्तप्रशमनः न च वातप्रकोपणः।
विशदोरुक्ष परुषः खरः स्नेहबलापहः॥२६॥
पश्चिमो मारुतः तीक्ष्णः कफमेदोविशोषणः।
सद्यः प्राणक्षयकरः सोषणस्तु शरीरिणाम्॥२७॥
उत्तरो मारुतः स्निग्धो मृदुर्मधुर एव च।
कषायानुरसः शीतो दोषाणां चाप्रकोपणः॥२८॥
तस्माच्च प्रकृतिस्थानां क्लेदनः बलवर्धनः।
क्षीणक्षयविषार्तानां विशेषेण तु पूजितः॥१९॥

Purva Vayu: Breeze flowing from East

Below mentioned are the features of the breeze flowing from the east –

–        sweet and pleasant
–        unctuous and salty
–        heavy
–        produces burning sensation
–        always aggravates blood and pitta
–        causes exacerbation of diseases of those suffering from wounds, poison, ulcers
–        exacerbates diseases in persons of kapha prakriti

This breeze is good for persons of –

–        vata constitution,
–        those who are fatigued and
–        those in whom kapha has dried up

But if these people are having ulcers / wounds, this breeze will increase the moistness in those wounds.

Dakshina Vayu: Breeze flowing from South

Below mentioned are the features of the breeze flowing from the south –

–        sweet
–        does not cause heartburn
–        has astringent as sub-taste
–        is light
–        best for health
–        good for eyes / vision
–        increases strength
–        alleviates aggravated blood and pitta
–        does not aggravate vata

Paschima Vayu: Breeze flowing from the west

Below mentioned are the features of the breeze flowing from the west –

–        is clear and calm
–        dry
–        rough
–        strong
–        decreases unctuousness and strength
–        penetrating,
–        dries up kapha and meda (fat)
–        reduces prana – strength and endurance / longevity
–        causes emaciation

Uttara Vayu: Breeze flowing from the North

Below mentioned are the features of the breeze flowing from the North –

–        is unctuous
–        soft
–        sweet
–        has astringent as secondary taste
–        does not cause aggravation of doshas
–        causes moistness and enhances strength in healthy persons|
–        beneficial for those suffering from emaciation, consumption and poison

इतिश्रीसुश्रुतसंहितायांसूत्रस्थानोहिताहितीयोनामविंशोऽध्यायः॥२०॥

 Thus ends the Twentieth chapter by name Hitahitiya – In Sutra Sthana of Susruta Samhita.