Sushruta Samhita Sharirasthana Chapter 4 Garbha Vyakarana Shariram (Details of Fetus)

The 4th chapter of Sharirasthana of Sushruta Samhita is named as Garbha Vyakarana Shariram Adhyaya. This chapter deals with Details of the fetus.

अथातो गर्भव्याकरणं शारीरं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound the chapter by name Garbha Vyakarana-detailed description of the fetus; as revealed by the venerable Dhanvantari.

Table of Contents

Prana – Life

अग्निः सोमो वायुः सत्त्वं रजस्तमः पञ्चेन्द्रियाणि भूतात्मेति प्राणाः ||३||

The below mentioned entities collectively constitute Prana i.e. life –

– Agni

– Soma

– Vayu

– Sattva

– Rajas

– Tamas

– Pancha Indriyas – i.e. five sense organs and

– Bhutatma – soul

Sapta Tvaca – Seven layers of skin

तस्य खल्वेवम्प्रवृत्तस्य शुक्रशोणितस्याभिपच्यमानस्य क्षीरस्येव सन्तानिकाः सप्त त्वचो भवन्ति |
तासां प्रथमाऽवभासिनी नाम, या सर्वान् वर्णानवभासयति पञ्चविधां च छायां प्रकाशयति, सा व्रीहेरष्टादशभागप्रमाणा, सिध्मपद्मकण्टकाधिष्ठाना; द्वितीया लोहिता नाम, षोडशभागप्रमाणा, तिलकालकन्यच्छव्यङ्गाधिष्ठाना; तृतीया श्वेता नाम, द्वादशभागप्रमाणा, चर्मदलाजगल्लीमषकाधिष्ठाना; चतुर्थी ताम्रा नामाष्टभागप्रमाणा, विविधकिलासकुष्ठाधिष्ठाना; पञ्चमी वेदिनी नाम पञ्चभागप्रमाणा, कुष्ठविसर्पाधिष्ठाना; षष्ठी रोहिणी नाम व्रीहिप्रमाणा, ग्रन्थ्यपच्यर्बुदश्लीपदगलगण्डाधिष्ठाना; सप्तमी मांसधरा नाम व्रीहिद्वयप्रमाणा, भगन्दरविद्रध्यर्शोऽधिष्ठाना |
यदेतत् प्रमाणं निर्दिष्टं तन्मांसलेष्ववकाशेषु, न ललाटे सूक्ष्माङ्गुल्यादिषु च; यतो वक्ष्यत्युदरेषु- ‘व्रीहिमुखेनाङ्गुष्ठोदरप्रमाणमवगाढं विध्येत्’ (चि.१४) इति ||४||

When the milk is boiled, the cream is formed and raises to the surface. Just like that when the product formed by the union of sukra – sperm and sonita – ovum is getting cooked (processed) by the action of heat, in the uterus, seven layers of tvaca – skin are formed and rises to the surface of the body.

Below mentioned are the names and features of the seven kinds / layers of tvaca.

Layer	Name of the layer of Tvaca	Features
1st Layer	Avabhasini – that which reflects	Expresses all the varna – colors Illuminates five types of chaya – shades of colors or complexion Dimension – 18th of vrihi (paddy, rice grain) in thickness Seat of – diseases like Sidhma, Padmakantaka etc.
2nd Layer	Lohita – that which is red / reddish	Red in color Dimension – one by sixteenth part of vrihi in thickness Seat of – diseases like Tilakalaka, Nyaccha and Vyanga
3rd Layer	Sveta – that which is white in color	White in color Dimension – one twelfth of vrihi in thickness Seat of – diseases like Carmadala, Ajagallika and Masaka
4	Tamra – that which is coppery in color	Coppery color Dimension – one eight of vrihi in thickness Seat of – many kinds of Kilasa and Kusta
5	Vedini – that which perceives sensations of touch, pain etc.	Perceives touch, pain etc sensations, Dimension – one fifth of vrihi in thickness Seat of – Kustha and Visarpa
6	Rohini – that which is growing	It keeps growing Dimension – one vrihi in thickness Seat of – diseases like granthi – benign tumor or cystic swelling, apaci – cervical lymphadenoma, arbuda – malignant tumor, slipada – filariasis and galaganda – cervical lymphadenitis / goiter / thyroid swelling
7	Mamsadhara – that which holds and supports muscles	Holds and supports muscles Dimension – 2 vrihi in thickness Seat of – diseases like bhagandara – fistula-in-ano, vidradhi – abscess and arsas – piles

We need to note that the thickness of the tvaca mentioned above is limited only for muscular parts and not for the skin on the forehead, small fingers etc. parts. Therefore, in the treatment of Jalodara – ascites, it has been mentioned that the abdomen should be punctured to a thickness of ‘middle portion of the thumb’ (Su.Chi.14).

Kala – Membranes / Sheaths / Septa

कलाः खल्वपि सप्त भवन्ति धात्वाशयान्तरमर्यादाः ||५||

The ‘Kalas’ are also seven in number. They are present inside the dhatus – tissues and ashayas – hollow organs.

यथा हि सारः काष्ठेषु छिद्यमानेषु दृश्यते |
तथाहि धातुर्मांसेषु छिद्यमानेषु दृश्यते ||६||
स्नायुभिश्च प्रतिच्छन्नान् सन्ततांश्च जरायुणा |
श्लेष्मणा वेष्टितांश्चापि कलाभागांस्तु तान् विदुः ||७||

Some verses here-

When the wood / stem of the tree is cut or split, we can see its pith inside. Just like that, when we cut open the dhatus like mamsa etc, we can see the kala inside them. These are differentiated as –

– Snayu Pratichchanna – covered by or formed by the ligaments,

– Jarayu Santata – continuation or extension of fetal covering and

– Sleshma Vesthita – coated with kapha

Kala Bheda – kinds of membranes

Mamsadhara Kala

तासां प्रथमा मांसधरा, यस्यां मांसे सिरास्नायुधमनीस्रोतसां प्रताना भवन्ति ||८||
यथा बिसमृणालानि विवर्धन्ते समन्ततः |
भूमौ पङ्कोदकस्थानि तथा मांसे सिरादयः ||९||

The first kala among the seven kinds of Kala is called Mamsadhara Kala.

Location – it is present inside the muscles.

Functions – This kala allows the siras – blood vessels / veins, snayu – ligaments and dhamanis – arteries and their branches to spread out inside the muscles

Analogy – The siras, snayus and dhamanis grow and spread inside the muscles, just like the bisa – lotus rhizome and mrnala – lotus stalk present in muddy water in the ground keeps constantly keep growing (spreading).

Raktadhara Kala

द्वितीया रक्तधरा मांसस्याभ्यन्तरतः, तस्यां शोणितं विशेषतश्च सिरासु यकृत्प्लीह्नोश्च भवति ||१०||
वृक्षाद्यथाभिप्रहतात् क्षीरिणः क्षीरिमावहेत् |
मांसादेवं क्षतात् क्षिप्रं शोणितं सम्प्रसिच्यते ||११||

The second Kala is called by the name Raktadhara Kala.

Location – it is present inside the muscles. Within this kala, sonita – blood is present, especially in the siras of yakrt – liver and pliha – spleen.

Analogy – When the trees with milky sap are cut or when their barks are bruised with some sharp object, the milky sap flows out of them. Similarly, when the muscles are cut, the blood which is located in the raktadhara kala in them, flows out quickly in great quantity.

Medodhara Kala

तृतीया मेदोधरा; मेदो हि सर्वभूतानामुदरस्थमण्वस्थिषु च, महत्सु च मज्जा भवति ||१२||
स्थूलास्थिषु विशेषेण मज्जा त्वभ्यन्तराश्रितः |
अथेतरेषु सर्वेषु सरक्तं मेद उच्यते |
शुद्धमांसस्य यः स्नेहः सा वसा परिकीर्तिता ||१३||

The name of the third kala is Medodhara Kala.

Location – Meda i.e. fat is present in the udara – abdomen and anu asthi – small bones of all living beings. It will be known by the name Majja while in big bones especially. Mainly in the big bones, it is the majja – bone marrow that is inside them. On the other hand, in all other bones i.e. small, flat and curved bones, this fat will be called by the name Sarakta Meda i.e. red colored marrow or marrow with blood.

Vasa – The pure form of meda – fat present in the muscles is known as vasa – muscle fat.

Slesmadhara Kala

चतुर्थी श्लेष्मधरा सर्वसन्धिषु प्राणभृतां भवति ||१४||
स्नेहाभ्यक्ते यथा ह्यक्षे चक्रं साधु प्रवर्तते |
सन्धयः साधु वर्तन्ते संश्लिष्टाः श्लेष्मणा तथा ||१५||

The fourth kind of Kala is known as Sleshmadhara Kala.

Location – It is present in all the bony joints of all the living beings.

Analogy of function and importance of slesmadhara kala – When the axle hole of the wheel is lubricated with oil, it moves easily. Similarly, the bony joints of the body too will move easily and freely when they are lubricated by sleshma – kapha. This sleshma is produced by the slesmadhara kala located in the joints.

Purisadhara Kala

पञ्चमी पुरीषधरा नाम; याऽन्तःकोष्ठे मलमभिविभजते पक्वाशयस्था ||१६||
यकृत्समन्तात् कोष्ठं च तथाऽन्त्राणि समाश्रिता |
उण्डु(न्दु)कस्थं विभजते मलं मलधरा कला ||१७||

The fifth Kala is known by the name Purisadhara Kala.

Location – Purisadhara Kala is located in the Pakvasaya – large intestine. To be precise, it is located inside the alimentary tract, commencing from Yakrt – liver and intestines. Being located in the Unduka, this maladhara kala (synonym of purishadhara kala) bifurcates and separates the mala – feces.

Functions – It separates the mala – waste products of digestion, feces mainly, from the food material after the digestion of food.

Pittadhara Kala

षष्ठी पित्तधरा; या चतुर्विधमन्नपानमामाशयात् [२] प्रच्युतं पक्वाशयोपस्थितं धारयति ||१८||
अशितं खादितं पीतं लीढं कोष्ठगतं नृणाम् |
तज्जीर्यति यथाकालं शोषितं पित्ततेजसा ||१९||

The sixth Kala is known as Pittadhara Kala.

Location – amashaya – stomach, pakvashaya – small intestine here (large intestine also included)

Functions – Pittadhara Kala retains and supports the four kinds of foods and drinks that we consume, which are pushed out from the Amasaya – stomach after the initial part of digestion and staying in the pakvasaya – small and large intestine (small intestine to be precise).

The below mentioned four kinds of foods after reaching the kostha – alimentary tract undergoes digestion therein in due course of time –

– Asita – eaten or swallowed,

– Khadita – chewed

– Pita – drunk and

– Lidha – licked

After getting digested, these four kinds of food get absorbed by the heat of pitta.

Sukradhara Kala

सप्तमी शुक्रधरा, या सर्वप्राणिनां सर्वशरीरव्यापिनी ||२०||
यथा पयसि सर्पिस्तु गूढश्चेक्षौ रसो यथा |
शरीरेषु तथा शुक्रं नृणां विद्याद्भिषग्वरः ||२१||
द्व्यङ्गुले दक्षिणे पार्श्वे बस्तिद्वारस्य चाप्यधः |
मूत्रस्रोतःपथाच्छुक्रं पुरुषस्य प्रवर्तते ||२२||
कृत्स्नदेहाश्रितं शुक्रं प्रसन्नमनसस्तथा |
स्त्रीषु व्यायच्छतश्चापि हर्षात्तत् सम्प्रवर्तते ||२३||

The seventh kala is known by the name Sukradhara Kala.

Location – In all the living beings, sukradhara kala pervades the entire body i.e. it is present in the entire body.

Analogy – Ghee is present in an invisible form within the milk. Jaggery is present in the sugarcane / sugarcane juice in an invisible form. Similarly, it should be understood by a wise physician that the Sukra too is present in an invisible form in the human body.

Ejaculation of sukra – Sukra comes out through the mutra srotas i.e. urinary passages of the man, from a distance of two angulas (4 cm approximately), beneath the bastidwara i.e. orifice or urethral opening of urinary bladder, on the right side. When the man indulges in copulation with a woman with pleasantness of his mind, the sukra present in the entire body gets ejaculated.

Adrstartava – cessation of menstrual flow – Amenorrhoea

गृहीतगर्भाणामार्तववहानां स्रोतसां वर्त्मान्यवरुध्यन्ते गर्भेण, तस्माद्गृहीतगर्भाणामार्तवं न दृश्यते; ततस्तदधः प्रतिहतमूर्ध्वमागतमपरं चोपचीयमानमपरेत्यभिधीयते; शेषं चोर्ध्वतरमागतं पयोधरावभिप्रतिपद्यते, तस्माद्गर्भिण्यः पीनोन्नतपयोधरा भवन्ति ||२४||

The artavavaha srotas i.e. channels which convey menstrual blood gets blocked by the pressure of the fetus which is developing in the womb in a woman who has conceived. Hence, in pregnancy, there will be no menstruation.

The menstrual blood thus obstructed below in the passages of artava, moves upwards and helps in the development of yet another organ known as apara – placenta. The remaining portion of it further moves upwards reaches the breasts. This is the reason why the breasts of the pregnant women are elevated and enlarged.

Asayotpatti – formation of Viscera

गर्भस्य यकृत्प्लीहानौ शोणितजौ, शोणितफेनप्रभवः फुप्फुसः, शोणितकिट्टप्रभव उण्डुकः ||२५||

Organs of the fetus	Formed from
Yakrit – liver Pliha – spleen	Sonita – blood
Phuppusa – lungs	Sonita phena – froth of blood
Unduka – caecum	Sonita kitta – waste of blood

असृजः श्लेष्मणश्चापि यः प्रसादः परो मतः |
तं पच्यमानं पित्तेन वायुश्चाप्यनुधावति ||२६||
ततोऽस्यान्त्राणि जायन्ते गुदं बस्तिश्च देहिनः |
उदरे पच्यमानानामाध्मानाद्रुक्मसारवत् ||२७||
कफशोणितमांसानां साराज्जिह्वा प्रजायते |
यथार्थमूष्मणा युक्तो वायुः स्रोतांसि दारयेत् ||२८||
अनुप्रविश्य पिशितं पेशीर्विभजते तथा |
मेदसः स्नेहमादाय सिरास्नायुत्वमाप्नुयात् ||२९||
सिराणां तु मृदुः पाकः स्नायूनां च ततः खरः |
आशय्याभ्यासयोगेन करोत्याशयसम्भवम् ||३०||

Antrani – the two intestines (large and small), Guda – rectum and anus and Basti – urinary bladder are formed inside the abdomen

↓

when the vayu traverses

↓

the prasada i.e. essence of asrk – blood along with slesma – kapha

↓

while they are being processed by pitta

Analogy – These organs are formed just like the essence of gold gets formed when air is blown into the molten gold.

Jjihva – Formation of Jihva – tongue – takes place from the essence of kapha, rakta and mamsa.

Srotas – When vayu combines with usma – heat or pitta, the srotas – channels or pores are formed.

Pesi – Pesi or muscles are formed when the vayu, on entering the mamsa divides it.

Sira and Snayu – Both Sira – veins and Snayu – ligaments are formed from the unctuous portion of medas – fat. When the unctuous portion of medas undergo mrdupaka i.e. mildly processed, siras are formed while kharapaka of unctuous portion of medas i.e. more processing would lead to formation of snayu – ligaments.

Asayas – Vayu creates asayas – hollow organs when it resides for some time at certain places in the fetal mass, when the fetus is developing.

रक्तमेदःप्रसादाद्वृक्कौ; मांसासृक्कफमेदःप्रसादाद्वृषणौ; शोणितकफप्रसादजं हृदयं, यदाश्रया हि धमन्यः प्राणवहाः; तस्याधो वामतः प्लीहा फुप्फुसश्च, दक्षिणतो यकृत् क्लोम च; तद्विशेषेण चेतनास्थानम्, अतस्तस्मिंस्तमसाऽऽवृते सर्वप्राणिनः स्वपन्ति ||३१||

Vrkka – Kidneys are formed from the essence of rakta – blood and medas – fat.

Vrsana – The two testes are formed from the essence of mamsa – muscles, asrk – blood, kapha and medas – fat.

Hrdaya – Hrdaya(heart) is formed by the essence of sonita (blood) and kapha. The dhamanis (arteries) and the Pranavaha Dhamani (arteries sustaining respiration and life) are attached to it (hrdaya – heart).

Pliha – spleen and Phuppusa – left lung is located below and to the right of Hrdaya. On the other hand, Yakrt – liver and Kloma – right lung is located to the right side of the Hrdaya.

Hrdaya is the seat of cetana – consciousness or soul. This is the reason why all the living beings sleep when the hrdaya is covered (enveloped) with Tamas – ignorance or darkness.

पुण्डरीकेण सदृशं हृदयं स्यादधोमुखम् |
जाग्रतस्तद्विकसति स्वपतश्च निमीलति ||३२||

Another verse here-

Hrdaya is similar to Pundarika – lotus but. It faces downwards. Hrdaya opens when the person is awake and when he sleeps, it closes.

Nidra – Sleep

निद्रां तु वैष्णवीं पाप्मानमुपदिशन्ति, सा स्वभावत एव सर्वप्राणिनोऽभिस्पृशति |
तत्र यदा सञ्ज्ञावहानि स्रोतांसि तमोभूयिष्ठः श्लेष्मा प्रतिपद्यते तदा तामसी नाम निद्रा सम्भवत्यनवबोधिनी, सा प्रलयकाले; तमोभूयिष्ठानामहःसु निशासु च भवति, रजोभूयिष्ठानामनिमित्तं, सत्त्वभूयिष्ठानामर्धरात्रे; क्षीणश्लेष्मणामनिलबहुलानां मनःशरीराभितापवतां च नैव, सा वैकारिकी भवति ||३३||

Nidra – sleep has been described as Vaisnavi – related to Lord Vishnu.

Nidra is also described as Papma – sinful or a form of sin (makes for committing sins). Sleep by nature encroaches all the living beings by the time of death.

Tamasi Nidra – It is a kind of sleep which gets manifested when the sanjnavaha srotas (channels carrying sensations or consciousness) become filled with kapha and dominated by tamo guna. It is said that the person can never be awoken from this state of sleep. Such sleep occurs at the time of death.

Predominance of Gunas / Doshas	Nature of Sleep
Tamo guna	Sleep manifests naturally both during day and night
Rajo guna	Sleep occurs at any time, without any reason
Sattva Guna	Sleep occurs at midnights – It is called Swabhavika Nidra – natural sleep
Decreased Sleshma – kapha and Increased Anila – vata	Sleep does not occur at all, at any time – This nidra is called Vaikariki Nidra – abnormal or pathological sleep
In persons whose mind and body are troubled by diseases etc.	Vaikariki Nidra – as explained above (4)

हृदयं चेतनास्थानमुक्तं सुश्रुत ! देहिनाम् |
तमोभिभूते तस्मिंस्तु निद्रा विशति देहिनम् ||३४||
निद्राहेतुस्तमः, सत्त्वं बोधने हेतुरुच्यते |
स्वभाव एव वा हेतुर्गरीयान् परिकीर्त्यते ||३५||

Some verses here

Dear Sushruta, as said earlier – ‘Hrdaya is the seat of Chetana – consciousness in all the living beings. When Hrdaya gets invaded by Tamo Guna, the person will go to sleep. While Tamo Guna causes sleep, Sattva Guna is responsible for awakening. These are considered as the chief and natural causes (for sleep)’.

Svapna – dreams

पूर्वदेहानुभूतांस्तु भूतात्मा स्वपतः प्रभुः |
रजोयुक्तेन मनसा गृह्णात्यर्थाञ् शुभाशुभान् ||३६||
करणानां तु वैकल्ये तमसाऽभिप्रवर्धिते |
अस्वपन्नपि भूतात्मा प्रसुप्त इव चोच्यते ||३७||

Bhutatma – the soul is said to be svapatah prabhu i.e. the lord of the sleepers (those who sleep). When he is associated with the Rajo Guna in his mind, he perceives both the auspicious and inauspicious indriyarthas i.e. objects of sense organs – experienced in the previous lives.

When there is disorder of the sense organs and when Tamo Guna is greatly increased, the Bhutatma is said to be sleeping, though he is not sleeping actually.

Diva Svapna – sleeping during day / day sleep

सर्वर्तुषु दिवास्वापः प्रतिषिद्धोऽन्यत्र ग्रीष्मात्, प्रतिषिद्धेष्वपि तु बालवृद्धस्त्रीकर्शितक्षतक्षीणमद्यनित्ययानवाहनाध्वकर्मपरिश्रान्तानामभुक्तवतां मेदःस्वेदकफरसरक्तक्षीणानामजीर्णिनां च मुहूर्तं दिवास्वपनमप्रतिषिद्धम् |

रात्रावपि जागरितवतां जागरितकालादर्धमिष्यते दिवास्वपनम् |

विकृतिर्हि दिवास्वप्नो नाम; तत्र स्वपतामधर्मः सर्वदोषप्रकोपश्च, तत्प्रकोपाच्च कासश्वासप्रतिश्यायशिरोगौरवाङ्गमर्दारोचकज्वराग्निदौर्बल्यानि भवन्ति; रात्रावपि जागरितवतां वातपित्तनिमित्तास्त एवोपद्रवा भवन्ति ||३८||

With the exception of Grishma Rtu – summer season, sleeping during day time is prohibited in all the other seasons.

In spite of day sleep being generally prohibited, sleeping for a duration of 1 muhurta i.e. 28 minutes approximately or for short period of time during day time is not prohibited in the below mentioned conditions –

– the children,

– the aged,

– those fatigued from woman (copulation),

– the injured,

– the emaciated;

– those who drink wine habitually,

– those exhausted by journey in chariots, riding on animals, walking long distances, hard physical activities;

– those who have not partaken food,

– those who are having decrease of fat, sweat, Kapha, Rasa and Rakta and

– those who are having indigestion

If the person has kept awake at night, he should sleep half of that time of keeping awake, for sleeping during the day time.

Sleeping during day time is definitely abnormal. It is also unrighteous and improper. It aggravates all the doshas. Aggravation of all doshas would cause the below mentioned diseases –

– cough,

– dyspnea,

– nasal catarrh,

– heaviness of the head,

– body aches,

– anorexia,

– fever,

– weakness of digestive fire

The same diseases produced by vata and pitta may arise even in persons who keep awake at nights.

तस्मान्न जागृयाद्रात्रौ दिवास्वप्नं च वर्जयेत् |
ज्ञात्वा दोषकरावेतौ बुधः स्वप्नं मितं चरेत् ||३९||
अरोगः सुमना ह्येवं बलवर्णान्वितो वृषः |
नातिस्थूलकृशः श्रीमान् नरो जीवेत् समाः शतम् ||४०||
(निद्रा सात्म्यीकृता यैस्तु रात्रौ च यदि वा दिवा|)
दिवारात्रौ च ये नित्यं स्वप्नजागरणोचिताः |
न तेषां स्वपतां दोषो जाग्रतां वाऽपि जायते ||४१||

Some verses here:-

Therefore, people should not keep awake at night. Also, they should not be sleeping during day time.

A wise person should always indulge in mita swapna – sleeping moderately knowing that both these i.e. day sleep and night awakening aggravate the doshas.

Below mentioned are the benefits of sleeping in moderation –

– freedom from diseases,

– pleasantness of the mind,

– will gain good strength, color / complexion and virility,

– he will be neither too stout nor too lean,

– will be bestowed with beautiful appearance

– longevity – a life span of hundred years

Such day sleep and night wakefulness do not cause harm to those people who are habituated to these patterns of sleep.

Nidra Nasa – loss of sleep / insomnia

निद्रानाशोऽनिलात् पित्तान्मनस्तापात् क्षयादपि |
सम्भवत्यभिघाताच्च प्रत्यनीकैः प्रशाम्यति ||४२||
निद्रानाशेऽभ्यङ्गयोगो मूर्ध्नि तैलनिषेवणम् |
गात्रस्योद्वर्तनं चैव हितं संवाहनानि च ||४३||
शालिगोधूमपिष्टान्नभक्ष्यैरैक्षवसंस्कृतैः |
भोजनं मधुरं स्निग्धं क्षीरमांसरसादिभिः ||४४||
रसैर्बिलेशयानां च विष्किराणां तथैव च |
द्राक्षासितेक्षुद्रव्याणामुपयोगो भवेन्निशि ||४५||
शयनासनयानानि मनोज्ञानि मृदूनि च |
निद्रानाशे तु कुर्वीत तथाऽन्यान्यपि बुद्धिमान् ||४६||

Below mentioned are the causes of loss of sleep –

– aggravation of vata and pitta,

– exhaustion of mind,

– loss of tissues

– injury to the body

Indulgence in the opposites helps in curing the ‘loss of sleep’.

Treatment of loss of sleep –Below mentioned are the effective measures for ‘loss of sleep’ –

– abhyanga – oil massage – anointing the body with medicated oil

– murdnitaila – oil therapies over the head,

– udwarthana – massage done with herbal powders done in upward direction, opposite to the direction of body hairs

– samvahana – trampling over the body / kneading

– use of rice, wheat, flour of grains, eatables prepared from sugarcane juice is ideal foods

– foods which are sweet in taste, unctuous, used along with milk and meat soup

– soup of meat of bileshaya – animals which live in burrow sand of Viskira birds;

– draksa, sugar and products of sugarcane juice – at nights,

– pleasant and soft cot, seats and vehicles,

– any other thing or measure which induces sleep

Ati Nidra – excess sleep

निद्रातियोगे वमनं हितं संशोधनानि च |
लङ्घनं रक्तमोक्षश्च मनोव्याकुलनानि च ||४७||

Below mentioned are the best measures for combating excess sleep and its effects –

– vamana – emesis,

– samshodhana – mild purificatory therapies,

– langhana – fasting, lightening therapies,

– raktamoksha – bloodletting

– mano vyakulana – inducing worry in the mind

Conditions in which keeping awake at nights and day sleeping are beneficial

कफमेदोविषार्तानां रात्रौ जागरणं हितम् |
दिवास्वप्नश्च तृट्शूलहिक्काजीर्णातिसारिणाम् ||४८||

Keeping awake at nights is beneficial in the below mentioned conditions –

– for those suffering from aggravation of kapha

– for those suffering from aggravation of medas – fat and

– for those suffering from visa – poisons

Day time sleeping is beneficial for those suffering from the below mentioned conditions –

– thirst,

– pain in abdomen,

– hiccup,

– indigestion and

– diarrhea

Tandra – stupor

इन्द्रियार्थेष्वसम्प्राप्तिर्गौरवं जृम्भणं क्लमः |
निद्रार्तस्येव यस्येहा तस्य तन्द्रां विनिर्दिशेत् ||४९||

A person is said to be having Tandra – stupor in the presence of the below mentioned signs –

– indriyartheshu asampraptih – non perception of sense objects by the respective sense organs,

– gauravam – heaviness of the body,

– jrmbhanam – excessive yawning,

– klamah – exhaustion,

– nidrartasyaiva – activities similar to those of a person who is sleeping

Jhrmbha – Yawn

पीत्वैकमनिलोच्छ्वासमुद्वेष्टन् विवृताननः |
यं मुञ्चति सनेत्रास्रं स जृम्भ इति सञ्ज्ञितः ||५०||

Jrmbha means yawning.

It is characterized by the below mentioned signs –

– swallowing of air firstly through inspiration and

– letting out the air through the open mouth accompanied with,

– flow of tears in the eyes

Klama- exhaustion

योऽनायासः श्रमो देहे प्रवृद्धः श्वासवर्जितः |
क्लमः स इति विज्ञेय इन्द्रियार्थप्रबाधकः ||५१||

Klama means exhaustion or fatigue.

Klama is characterized by the below mentioned signs –

– feel of fatigue without doing any work

– not accompanied with dyspnea,

– great disturbance of sensory perception

Alasya – Lazyness

सुखस्पर्शप्रसङ्गित्वं दुःखद्वेषणलोलता |
शक्तस्य चाप्यनुत्साहः कर्मस्वालस्यमुच्यते ||५२||

Alasya – lassitude is a condition characterized by –

– desire for comfortable touch,

– hatred towards discomfort and hardships (he tries to keep away from anything which is discomfortable)

– lack of enthusiasm in doing any kind of work in spite of he being capable of doing it

Utklesa – Nausea

उत्क्लिश्यान्नं न निर्गच्छेत् प्रसेकष्ठीवनेरितम् |
हृदयं पीड्यते चास्य तमुत्क्लेशं विनिर्दिशेत् ||५३||

Utklesha – nausea is a condition characterized by –

– the food which we have consumed is trying to come out (stomach is trying hard to throw it out) but does not come out in spite of being stimulated, accompanied with

– salivation and

– expectoration, and

– causes discomfort of the heart

Glani – fatigue

वक्त्रे मधुरता तन्द्रा हृदयोद्वेष्टनं भ्रमः |
न चान्नमभिकाङ्क्षेत ग्लानिं तस्य विनिर्दिशेत् ||५४||

Glani – fatigue is a condition characterized by –

– feeling of sweetness in the mouth,

– stupor,

– oppression or feeling of severe discomfort in the region of the heart,

– giddiness,

– absence of desire for food

Gaurava – feeling of heaviness

आर्द्रचर्मावनद्धं वा यो गात्रं मन्यते नरः |
तथा गुरु शिरोऽत्यर्थं गौरवं तद्विनिर्दिशेत् ||५५||

Gaurava – feeling of heaviness is characterized by –

– person feeling as if his body has been covered with moist skin / leather and

– his head is very heavy

Dosha predominance in Murccha, Bhrama, Tandra and Nidra

मूर्च्छा पित्ततमःप्राया, रजःपित्तानिलाद्भ्रमः |
तमोवातकफात्तन्द्रा, निद्रा श्लेष्मतमोभवा ||५६||

Condition	Dosha and Guna predominance
Murcha – fainting, syncope	Pitta, Tamo guna
Bhrama – giddiness	Rajo Guna, Pitta, Vata
Tandra – stupor	Tamo Guna, Vata, Kapha
Nidra – sleep	Sleshma (Kapha), Tamo Guna

Garbha Vrddhi – growth of the fetus

गर्भस्य खलु रसनिमित्ता मारुताध्माननिमित्ता च परिवृद्धिर्भवति ||५७||

Below mentioned factors are responsible for growth of fetus –

– rasa – circulation of nutrients and

– maruta adhmana – inflation caused by vata

तस्यान्तरेण नाभेस्तु ज्योतिःस्थानं ध्रुवं स्मृतम् |
तदाधमति वातस्तु देहस्तेनास्य वर्धते ||५८||
ऊष्मणा सहितश्चापि दारयत्यस्य मारुतः |
ऊर्ध्वं तिर्यगधस्ताच्च स्रोतांस्यपि यथा तथा ||५९||

Some verses say:-

The fact that the Jyoti sthana – seat of digestive fire is present beneath (inside) the umbilicus of the fetus is definite without any doubt. The body grows when this is inflated by Vata, combined with Usma i.e. heat or pitta. The body of the fetus grows in accordance to the srotas becoming dilated and spreading upward, sideward and downward.

दृष्टिश्च रोमकूपाश्च न वर्धन्ते कदाचन |
ध्रुवाण्येतानि मर्त्यानामिति धन्वन्तरेर्मतम् ||६०||

According to the opinion of Lord Dhanvantari, drsti – vision and romakupa – hair follicles are permanent in human beings. They do not grow at any time, after getting formed once.

शरीरे क्षीयमाणेऽपि वर्धेते द्वाविमौ सदा |
स्वभावं प्रकृतिं कृत्वा नखकेशाविति स्थितिः ||६१||

Nakha – nails and Kesha – hairs (on the head) continue to grow constantly even the body is decaying and for this, swabhava – nature itself being the Prakriti – cause, is definite.

Deha prakrti – human body constitution – Somato types

सप्त प्रकृतयो भवन्ति- दोषैः पृथक्, द्विशः, समस्तैश्च ||६२||
शुक्रशोणितसंयोगे यो भवेद्दोष उत्कटः |
प्रकृतिर्जायते तेन तस्या मे लक्षणं शृणु ||६३||

Seven kinds of Prakriti – constitutions or body types are formed. They are –

– by each dosha separately – vata, pitta and kapha – eka doshaja prakriti

– by the combination of two doshas – vata-pitta, vata-kapha and kapha-pitta – dvandva or samsarga prakriti

– by combination of all three doshas – vata, pitta and kapha – sammisra, sannipata prakriti

The prakriti of the person gets formed from whichever dosha or doshas predominant at the time of union of sukra and sonita.

Now listen to the features of these prakritis.

Vata prakrti purusa laksana – features of person of vata constitution

तत्र वातप्रकृतिः प्रजागरूकः शीतद्वेषी दुर्भगः स्तेनो मत्सर्यनार्यो गन्धर्वचित्तः स्फुटितकरचरणोऽल्परूक्षश्मश्रुनखकेशः क्राथी दन्तखादी च भवति ||६४||
अधृतिरदृढसौहृदः कृतघ्नः कृशपरुषो धमनीततः प्रलापी |
द्रुतगतिरटनोऽनवस्थितात्मा वियति च गच्छति सम्भ्रमेण सुप्तः ||६५||
अव्यवस्थितमतिश्चलदृष्टिर्मन्दरत्नधनसञ्चयमित्रः |
किञ्चिदेव विलपत्यनिबद्धं मारुतप्रकृतिरेष मनुष्यः ||६६||
(वातिकाश्चाजगोमायुशशाखूष्ट्रशुनां तथा |
गृध्रकाकखरादीनामनूकैः कीर्तिता नराः) ||६७||

Below mentioned are the features of person of Vata Prakriti –

– more awake and sleeps less

– hates cold,

– appearance – ugly, thin (emaciated),

– nature – thievish, jealous, uncultured, cruel, ungrateful,

– skilled in music and other fine arts,

– has cracks in his hands and feet

– has less of moustaches, nails and hairs,

– moustaches, nails and hairs are rough,

– grinds his teeth in his sleep

– less courageous,

– does not have firmness in friendship,

– has prominence of veins all over the body,

– walks quickly,

– is very talkative,

– wanders too much,

– has unsteadiness of mind and disorganized mind as well,

– has dreams as if he is moving in the sky

– has unsteady vision,

– poor in accumulation and collection of precious stones (gems), wealth and friends,

– speaks less and irrelevant things

Persons of Vata Prakriti resemble the below said in their physical and mental behaviors –

– goat

– goyal ox or gomayu – fox,

– rabbit

– rat

– camel

– dog

– vulture

– crow

– donkey etc.

Pitta Prakrti purusa Laksana – features of person of pitta constitution:-

पित्तप्रकृतिस्तु स्वेदनो दुर्गन्धः पीतशिथिलाङ्गस्ताम्रनखनयनतालुजिह्वौष्ठपाणिपादतलो दुर्भगो वलीपलितखालित्यजुष्टो बहुभुगुष्णद्वेषी क्षिप्रकोपप्रसादो मध्यबलो मध्यायुश्च भवति ||६८||
मेधावी निपुणमतिर्विगृह्य वक्ता तेजस्वी समितिषु दुर्निवारवीर्यः |

सुप्तः सन् कनकपलाशकर्णिकारान् सम्पश्येदपि च हुताशविद्युदुल्काः ||६९||
न भयात् प्रणमेदनतेष्वमृदुः प्रणतेष्वपि सान्त्वनदानरुचिः |
भवतीह सदा व्यथितास्यगतिः स भवेदिह पित्तकृतप्रकृतिः ||७०||
(भुजङ्गोलूकगन्धर्वयक्षमार्जारवानरैः |
व्याघ्रर्क्षनकुलानूकैः पैत्तिकास्तु नराःस्मृताः) ||७१||

Below mentioned are the features of person of Pitta Prakriti –

– has more sweating,

– body emits bad smell,

– has yellowish and flabby body parts,

– coppery color of nails, eyes, palate, tongue, lips, palms and soles,

– appearance – ugly in looks, has skin wrinkling, grey hairs, baldness

– eats large quantities of food,

– hates hot things and comforts,

– quickly gets angry and also quickly comes out of it,

– has moderate strength,

– has moderate longevity of life

– is intelligent, wins over other persons in talks,

– is brilliant and undefeatable in debates and assemblies,

– has dreams of gold, flowers of Palasa and Karnikara (which are red in color), fire, lightening, meteors etc.

– faces any situation courageously and does not submit self to fear,

– does not easily surrender and is not soft towards those who are stiff and stubborn,

– is expert in consoling those who are obedient or loyal with him,

– finds difficulty to speak always (because he is frequently troubled by ulcerations in the mouth)

Persons of Pitta Prakriti resemble the below said in their physical and mental behaviors –

– snake,

– owl,

– cat,

– monkey,

– tiger,

– bear,

– mongoose,

– Gandharva,

– Yaksa

Kapha Prakrti purusa Laksana – features of persons of kapha constitution

श्लेष्मप्रकृतिस्तु दूर्वेन्दीवरनिस्त्रिंशार्द्रारिष्टकशरकाण्डानामन्यतमवर्णः सुभगः प्रियदर्शनो मधुरप्रियः कृतज्ञो धृतिमान् सहिष्णुरलोलुपो बलवांश्चिरग्राही दृढवैरश्च भवति ||७२||
शुक्लाक्षः स्थिरकुटिलालिनीलकेशो लक्ष्मीवान् जलदमृदङ्गसिंहघोषः |
सुप्तः सन् सकमलहंसचक्रवाकान् सम्पश्येदपि च जलाशयान् मनोज्ञान् ||७३||
रक्तान्तनेत्रः सुविभक्तगात्रः स्निग्धच्छविः सत्त्वगुणोपपन्नः |
क्लेशक्षमो मानयिता गुरूणां ज्ञेयो बलासप्रकृतिर्मनुष्यः ||७४||
(दृढशास्त्रमतिः स्थिरमित्रधनः परिगण्य चिरात् प्रददाति बहु |
परिनिश्चितवाक्यपदः सततं गुरुमानकरश्च भवेत् स सदा ||७५||
ब्रह्मरुद्रेन्द्रवरुणैः सिंहाश्वगजगोवृषैः |
तार्क्ष्यहंससमानूकाः श्लेष्मप्रकृतयो नराः ) ||७६||

Below mentioned are the features of person of Kapha Prakriti –

– body or skin color resembling the color of any one of the durva, indivara, nistrimsa, moist aristaka or sarakanda

– appearance – beautiful looks, attractive, will have white eyes, has hairs which are strong (deep rooted), curly and blue like bee, eyes which are reddish at their angles, well demarcated parts of the body, greasy complexion,

– likes sweet things / foods,

– grateful,

– courageous,

– withstands hardships,

– not sensuous,

– not greedy,

– strong,

– understands things slowly,

– harbors enmity for long time,

– rich,

– voice – resembles that of thunder, cymbal and roar of lion,

– dreams of water bodies like ponds, lakes, rivers etc. having lotus, swans and Cakravaka bird, beautiful water reservoirs which are pleasing in mind

– predominant in sattva guna – they will have virtuous and benevolent behavior,

– withstands hardships of life,

– respects the preceptors and elders,

– immensely focused in shastras – learning of sciences,

– will have stable and constant friend circle and wealth,

– after considering and thinking about the recipient for a long time, he gifts them in plenty,

– speech – speaks with selected and well thought of words and sentences

– always upholds the status of preceptors

Persons of Kapha Prakriti resemble the below said in their physical and mental behaviors –

They will have strength and activities similar to that of –

– Brahma,

– Rudra,

– Indra,

– Varuna,

– lion,

– horse,

– elephant,

– cow,

– bull,

– red eagle and

– swan

Samsarga Prakrti

द्वयोर्वा तिसृणां वाऽपि प्रकृतीनां तु लक्षणैः |
ज्ञात्वा संसर्गजा वैद्यः प्रकृतीरभिनिर्दिशेत् [१] ||७७||

Samsarga Prakriti is a mixed constitution and can be identified and understood on finding the presence of features of two or three doshas together in the constitution of any person.

Prakrti does not harm the person

प्रकोपो वाऽन्यथाभावो क्षयो वा नोपजायते |
प्रकृतीनां स्वभावेन जायते तु गतायुषः ||७८||
विषजातो यथा कीटो न विषेण विपद्यते |
तद्वत्प्रकृतयो मर्त्यं शक्नुवन्ति न बाधितुम् ||७९||

The features of prakritis of human beings will neither increase, nor change otherwise nor decrease naturally on their own accord. These changes happen only in dying person.

Analogy – The constitutions i.e. doshas constituting one’s prakriti will not harm the person just like insects born in poison are not killed by the same poison.

Pancabhautika Prakrti

प्रकृतिमिह नराणां भौतिकीं केचिदाहुः
पवनदहनतोयैः कीर्तितास्तास्तु तिस्रः |
स्थिरविपुलशरीरः पार्थिवश्च क्षमावाञ्
शुचिरथ चिरजीवी नाभसः खैर्महद्भिः ||८०||

According to some experts, Prakrti arises from Bhutas – the five primary elements of nature,

– 1 from Pavana – Vata

– 1 from Dhana – agni or Pitta

– 1 from Toya – ap / jala or Kapha

– 1 – the fourth one from Prithvi – characterized with strong and big physique and good capacity to withstand troubles,

– 1 – the fifth one from Nabhasa – Akasa – having features like cleanliness and longevity of life, will have bigger orifices in the body

Manasa Prakrti – Psyche / mental constitutions

Satvika Kaya

शौचमास्तिक्यमभ्यासो वेदेषु गुरुपूजनम् |
प्रियातिथित्वमिज्या च ब्रह्मकायस्य लक्षणम् ||८१||
माहात्म्यं शौर्यमाज्ञा च सततं शास्त्रबुद्धिता |
भृत्यानां भरणं चापि माहेन्द्रं कायलक्षणम् ||८२||
शीतसेवा सहिष्णुत्वं पैङ्गल्यं हरिकेशता |
प्रियवादित्वमित्येतद्वारुणं कायलक्षणम् ||८३||
मध्यस्थता सहिष्णुत्वमर्थस्यागमसञ्चयौ |
महाप्रसवशक्तित्वं कौबेरं कायलक्षणम् ||८४||
गन्धमाल्यप्रियत्वं च नृत्यवादित्रकामिता |
विहारशीलता चैव गान्धर्वं कायलक्षणम् ||८५||
प्राप्तकारी दृढोत्थानो निर्भयः स्मृतिमाञ्छुचिः |
रागमोहमदद्वेषैर्वर्जितो याम्यसत्त्ववान् ||८६||
जपव्रतब्रह्मचर्यहोमाध्ययनसेविनम् |
ज्ञानविज्ञानसम्पन्नमृषिसत्त्वं नरं विदुः ||८७||
सप्तैते सात्त्विकाः काया… |८८|

Brahma Kaya – Below mentioned are the features of persons of Brahma Kaya –

– Clean

– Believes in God,

– Believes in scriptures etc.

– Practices studying Vedas,

– Worships guests and preceptors,

– Performs fire sacrifices

Mahendra Kaya – Below mentioned are the features of persons of Mahendra Kaya –

– Glorious

– Courageous

– Commanding

– Have knowledge of sciences

– Always protect and support servants

Varuna Kaya – Below mentioned are the features of persons of Varuna Kaya –

– Desirous of food

– Has forbearance,

– Has yellow eyes,

– Has brown hairs,

– Speaks affectionately

Kaubera Kaya – Below mentioned are the features of persons of Kubera Kaya –

– Adopts middle path in all activities,

– Withstands difficulties / hardships of life,

– Good at bringing and accumulating wealth,

– Has good capacity to produce many children

Gandharva Kaya –Below mentioned are the features of persons of Gandharva Kaya –

– Is fond of perfumes and garlands,

– Loves to dance and playing musical instruments

– Loves going for picnics

Yama Kaya –Below mentioned are the features of persons of Yamya Kaya –

– Performs all actions at proper time, with strong will and determination,

– He does not get afraid of anything, is courageous,

– Has good memory,

– Clean,

– Devoid of passion, delusion, intoxication, pride and hatred

Rshi Satva (Kaya) –Below mentioned are the features of persons of Rishi Kaya –

– Constantly indulges himself in meditation, vows, celibacy, fire sacrifice and study of scriptures,

– Endowed with general and special knowledge,

The above explained seven kinds of Kaya are Satvika Kaya (constitutions predominant of satva guna).

2.Rajasa Kaya

…राजसांस्तु निबोध मे |
ऐश्वर्यवन्तं रौद्रं च शूरं चण्डमसूयकम् ||८८||
एकाशिनं चौदरिकमासुरं सत्त्वमीदृशम् |
तीक्ष्णमायासिनं भीरुं चण्डं मायान्वितं तथा ||८९||
विहाराचारचपलं सर्पसत्त्वं विदुर्नरम् |
प्रवृद्धकामसेवी चाप्यजस्राहार एव च ||९०||
अमर्षणोऽनवस्थायी शाकुनं कायलक्षणम् |
एकान्तग्राहिता रौद्रमसूया धर्मबाह्यता ||९१||
भृशमात्रं तमश्चापि राक्षसं कायलक्षणम् |
उच्छिष्टाहारता तैक्ष्ण्यं साहसप्रियता तथा ||९२||
स्त्रीलोलुपत्वं नैर्लज्ज्यं पैशाचं कायलक्षणम् |
असंविभागमलसं दुःखशीलमसूयकम् ||९३||
लोलुपं चाप्यदातारं प्रेतसत्त्वं विदुर्नरम् |
षडेते राजसाः कायाः,.. |९५|

Asura Kaya –Demon like temperament – Below mentioned are the features of persons of Asura Kaya –

– they are wealthy

– terrifying,

– courageous,

– overtly angry,

– jealous,

– eats food alone and is a glutton – eats in plenty and fills his stomach with large quantities of food

Sarpa Kaya – Snake like temperament – Below mentioned are the features of persons of Sarpa Kaya –

– sharp and quick in actions,

– gets tired very quickly,

– fearful and angry,

– deceiving in nature,

– desires and loves recreation and other past times,

Sakuna Kaya – Bird like temperament – Below mentioned are the features of persons of Sakuna Kaya –

– indulges greatly in sexual activities,

– uninterruptedly eats food,

– is impatient,

– does not remain at one place and constantly keeps roaming around

Raksasa Kaya – Demon like temperament – Below mentioned are the features of persons of Raksasa Kaya –

– eats food alone while hiding from others,

– terrifying,

– jealous,

– violates stipulated rules and regulations of righteousness,

– greatly flatters himself

Pisaca / Paisaca Kaya –Demon like temperament – Below mentioned are the features of persons of Pisaca Kaya –

– consumes foods which have been described by others,

– cruel,

– loves adventures,

– desires women

– devoid of shyness

Preta Kaya – Devil or ghost like temperament – Below mentioned are the features of persons of Preta Kaya –

– does not share anything, especially foods with others,

– lazy,

– always grief stricken,

– jealous,

– greedy,

– does not give anything to other

The above explained six kinds of Kaya are Rajas Kaya- constitution predominant of Rajo Guna.

Tamasa Kaya

…तामसांस्तु निबोध मे ||९४||
दुर्मेधस्त्वं मन्दता च स्वप्ने मैथुननित्यता |
निराकरिष्णुता चैव विज्ञेयाः पाशवा गुणाः ||९५||

Pasu Kaya – animal like temperament – Below mentioned are the features of persons of Pasu Kaya –

– always thinks bad,

– is slow in doing all activities,

– dreams himself indulging in copulation every day,

– is in denial of everything

अनवस्थितता मौर्ख्यं भीरुत्वं सलिलार्थिता |
परस्पराभिमर्दश्च मत्स्यसत्त्वस्य लक्षणम् ||९६||

Matsya Kaya –Fish like temperament – Below mentioned are the features of persons of Matsya Kaya –

– unsteady

– idiot,

– fearful,

– desires water,

– fights with one another

एकस्थानरतिर्नित्यमाहारे केवले रतः |
वानस्पत्यो नरः सत्त्वधर्मकामार्थवर्जितः ||९७||
इत्येते त्रिविधाः कायाः प्रोक्ता वै तामसास्तथा |९८|

VanaspatyaKaya –Vegetative like temperament – Below mentioned are the features of persons of Vanaspatya Kaya –

– always likes to remain at one place,

– always engaged in eating food,

– devoid of acts of truthfulness,

– devoid of acts of righteousness,

– devoid of lust and wealth

The above mentioned three kinds of Kaya are Tamasa Kaya – constitution predominant of Tamo Guna.

कायानां प्रकृतीर्ज्ञात्वा त्वनुरूपां क्रियां चरेत् ||९८||
महाप्रकृतयस्त्वेता रजःसत्त्वतमःकृताः |
प्रोक्ता लक्षणतः सम्यग्भिषक् ताश्च विभावयेत् ||९९||

Appropriate treatments have to be done to the persons after having understood the natures of persons of these constitutions.

These Prakritis known as Maha Prakritis, produced by Sattva, Rajas and Tamas Gunas have been described along with their features until here. The wise physician should understand these Prakritis diligently.

CÌiÉ इति सुश्रुतसंहितायां शारीरस्थाने गर्भव्याकरणं शारीरं नाम चतुर्थोऽध्यायः ||४||

Thus ends the Fourth chapterby name Garbha Vyakarana- in sariraSthana of Susrutasamhita.