An English Translation of the Sushruta Samhita, Vol. I: Sutrasthanam — trans. Kaviraj Kunja Lal Bhishagratna (1907)

The process of growth or building goes on up to the twentieth year of life, when youth or the age of maturity sets in and holds sway over the body of a man up to the thirtieth year of his life, — the strength, semen, and all the organs and vital principles of the body attain (their full maturity at the age of forty. Thenceforth decay gradually sets in up to the seventieth year of life. After that the strength and energy of a man dwindle day by dav. The organs and virility grow weak and suffer deterioration. The hair turns to a silvery white, the parched skin looks shrivelled and becomes impressed with marks of dotage (crow's feet-marks). The skin hangs down and becomes flabby, the hair begins to fall off, and symptoms of alopecia mark the smooth, sheen and balded pate. The respiration becomes laboured and painful. The body, worn out like an old and dilapidated building, shakes with fits of

*=^p. 323 distressing cough. Such a man is incapable of all acts, and does but imperfectly perform all bodily functions. He has grown old.

The dose of medicine should be increased with the age of a patient till the age of decay, and reduced after the expiry of the seventieth year to the quantity ( which is usuall}' prescribed for an youth of sixteen).

Authoritative verses on the Subject :— Kapham is increased during the years of childhood and Pittam in middle age ; while an increase of VcCyu (nervous derangement^ marks the closing years of life. The use of strong or drastic purgatives, and cauterisation are alike prohibited in cases of children and old men. They should be used only in weakened or modified forms if found indispensably necessary.

It has been stated before that the body of a person is either stout, thin or of an average (middling) bulk. A stout' person should be reduced in bulk with depletive measures, while a physician should try to make a thin patient gain in flesh. A human body, which is neither too thin nor too stout, should be made to maintain its shapely rotundity.

We have already discoursed on the strength of the body. Now in a particular case under treatment, it is primarily incumbent on the physician to enquire whether the patient is naturally weak, or has become

p. 324

THE SUSHRUTA SAMHITA. [Chap. XXXy, so through a deranged condition of the bodily humours or old age. And since it is the strength of a patient which makes all remedial measures (such as cauterisation, etc.) possible, it should be regarded as the grandest auxiliary to a medical treatment of whatsoever nature it may be.

lYIetrical Texts : —There are some men who are strong though thin ; while others are weak, though stout ; and accordingly a physician should determine the bodily strength of a patient by enquiring about the capacity of his physical endurance and labour. Sattvam or fortitude denotes a kind of (stoic) indifference of one's mind to sensations and sources of pleasure or pain.

A man of strong fortitude (Sattvika temperament) is capable of enduring everything, or any amount of pain by repressing his mind with the help of his will or intellect. A man of a Rajasika turn of mind (strong, active, energetic) may be made to patiently submit to a course of painful medical treatment by means of persuasive counsels and the logic of the inevitable, whereas a man of a Tamasika temperament (a worldly cast of mind characterised by Nescience) is simply overwhelmed at the prospect of bodily pain.

Later on, we shall have occasion to deal with the different types of physical treatment and of remedial agents in general. A particular country, or a seasonChap. XXXV. ] SUTRASTHANAM. ^25 of the year, a particular disease or a peculiar mode of living, any particular kind of physical labour or exercise, or the specific properties of the water of any particular locality, or day sleep, or a juice of any particular taste, is or are said to be congenial (Satmya) to a man, or a man is said to be naturalised to these conditions and environments, when they fail to produce any injurious effect on his health, though naturally unwholesome to others.

Metrical Texts :— A thing of any taste whatsoever, or any kind of habit or physical exercise is said to be congenial to a man which, instead of in any way telling on his health, contributes to his positive pleasure and comfort.

Features of an Anupa country:— A

country may be classed either as an Anupa, Jangala or a Sadharana one, according to its distinctive physical features. An Anupa watery or swampy) country contains a large number of pools, and is wooded and undulated with chains of lofty hills traversing its area, and which is impassable owing to its net- works of rivers and sheets of accumulated rain-water rippling before the currents of the gentle, humid air. It is inhabited by a race of stout, shapely and softbodied men, susceptible to Vatala and Kaphaja diseases.

Features of Ja'ngala and Sardharrana countries : — The country, which presents a fiat

326 THE SUSHRUTA SAMHITA. [ Chap. XXXV.