lYIedadhara-Kala :— The third Kald is called Medadharai (adipose tissue). Meda (fat) is present (chiefly) in the abdomen of all animals, as well as in the cartila- ges (small bones). The fatty substance present in large bones is called Majjai (marrow), ir.
lYIemorable Verse :— Marrow is found inside
large bones, whereas a substance similar in appearance
and found inside other bony structures (cartilages) should
be considered as Meda, mixed with blood. The fats,
present in purely muscular structures, go by the name
of Vassi (muscle-fat). 12-13.
[Chap. IV. SARIRA STHANAM.
dleshmsLdhar^C-Kala :— The fourth Kala is
called Sleshmaidharai (Synovial tissues) and is present
about all the bone-joints of animals. 14.
IVIemorable Verse : -As a wheel easily turns
upon a well greased axle, so the joints moistened by the
mucous (Sleshma) contained in these sacs admit of easy
movements, i^.
Purishadhara-Kala :— The fifth kala is
called Purishadharai and being situated in the Kostha
(abdomen) serves to separate the faecal refuse in the
(Pakvasaya) lower gut (from other ingested matters). 16.
Memorable Verse : —This Kala extends about the liver, upper and lower intestines and other abdominal viscera and keeps the foeces in the lower intestines (Un- dukam) separate and hence is called Maladhara-kald 17.
Pittadhara-Kala:— The sixth Kald is called Pittapharat-kalSL ; it holds (the chyme derived from) the four kinds of solid and liquid foods (in the Pitta-sthanam or biliary region; propelled from the stomach (Amds'aya or Grahani-Nadi) and on its way to the (Pakasaya) intestines (for the proper action of the digestive juices upon it) 18.
IVIemorable Verse :— The four kinds of food,
viz. those that are chewed, swallowed, drunk, or licked,
and brought into the intestines (Kostha) of a man, are
digested in proper time through the heating agency
(action) of the Pittam 19.
^Ukradhara-Kala :-Thc seventh Kala is
called S'lkradharsi (semen-bearing), which extends
throughout the entire body of all living creatures. 20.
Memorable Verse : -The physician should
know that like fat (Sarpi) in the milk, or sugar in the
expressed juice of sugar-cane, the (seat of) semen is co-
extensive with the whole organism of a man (or animal).
148 THE SUSHRUTA SAMHITA. [Chap. IV.
The semen passes through the ducts situated about two
fingers' breadth on either side (vas deferens) and just
below the neck of the bladder and finally flows out
through the canal. The semen of a man during an act of
sexual intercourse with a female under exhilaration
comes down from all parts of his body owiiig to the
extreme excitement (engendered by the act). 21-33.
The orifices of the Artava— carrying channels (vessels
of the uterine mucosa) of a pregnant woman are ob-
structed by the foetus during pregnancy and hence there
is no show of menses (during gestation). The menstrual
blood thus obstructed in its downward course ascends
upwards ; a part of it accumulates and goes to the
formation of placenta (Apara' , while the rest ascends
higher up and reaches the breasts ; this is the reason
why the breasts of a pregnant woman become full and
plump. 24.
The spleen and liver of the foetus are formed out
of blood ; the lungs are made of the froth of the
blood ; and the Unduka or faecal receptacle, of the refuge
matter (Mala) of the blood. 25,
Metrical Texts :— The intestines (Antra), the
bladder (Vasti), and the anus (Guda) of the foetus are
formed out of the essence of the blood and Kapham,
baked by the Pittam into which VAyu enters as well.
As fire fed by draughts of air refines the dregs of
golden ore and transforms it into pure metal, so blood
and Kapham acted upon by the heat of the Pittam
are transformed into the shape of the intestines etc.
in the abdomen. The tongue is made of the essence
of the flesh, blood and Kapham. The Vdyu, com-
bined with heat (Pittam) in adequate proportion, rends
through the internal channels into the flesh and trans-
forms them into muscles (Pesi). The Vdyu, by taking off
Chap. IV.] SARIRA STHANAM. 149
the oily principles of fat (Meda), transforms them into (Sirat' and (fibrous tissues) Sna^yu,the underbaked (Mridu) ones being converted into the Sir^ and the overbaked (Kshara) ones into the Sndyu. The internal cavities (As'ayas) of the body mark the spots or regions where the Vayu had constantly stayed in its embryo stage. 26-29. The kidneys (Vrikkas) are made out of the essence of the blood and fat. The testes are formed out of the essence of the blood, flesh, Kapham and fat. The heart is formed out of the essence of blood and Kapham ; and the vessels (Dhamanis) carrying the vital principles of the body are attached to it (heart). The spleen and the lungs are situated below and beneath the heart on the left side, and the liver and Kloma (Pancreas ?) below
and beneath it (heart) on the right. The heart is the special seat of consciousness (ChetaiiS^) in all creatures.
Sleep sets in when this viscus heart) of a person becomes
enveloped by the effects of the Tamas (principles of
illusion or nescience). 30-31.
IVIemorable Verse S— The heart which is of
the shape of a lotus bud hangs with its apex downward,
folding itself up during sleep and expanding with the
return of wakening or consciousness. 32.
Sleep and its virtues :— Sleep is the illu-
sive energy of God ^lit. — the all-pervading deity; and
naturally has its sway over all created beings. The
kind of sleep which sets in when the sensation-carrying
channels iSn^yu) of the body are choked by Sleshma,
which abounds in the quality of Tamas, is known as
Tatmasi-nidrai. It is this sleep which produces uncon-
sciousness at the time of dissolution or death. A man
of Tatrnxsika-temperament sleeps both in the day and
night ; one of the Ra^asika-temperament sleeps either in
the day or in the night ; while sleep never visits the
T50 THE SUSIIRUTA SAMHITA. Chap. IV.]
eyelids of a man of Sa^ttvika-temperament before mid- night. Persons with enfeebled Kapham and aggra- vated Vayu, or suffering from bodily and mental troubles, get little sleep, and if at all, their sleep is of the Vaika- rika or delirious type {i.e. much disturbed)* 33-34.
IVIemorabIC Verses : -O SusVuta ! the heart is
said to be the primary seat of consciousness (Chetan^) in
the animated beings. Sleep overcomes a man whenever
the heart is enveloped in the illusive effects of Tamas.
Sleep is the offspring of Tamas and it is the quality of
Sattvam that brings on awakening. This is the funda-
mental law of Nature. The self-conscious individuality
(Self), ensconced in the material frame of man which
is composed of the five material elements, recollects
through the agency of the mind (Manah), which abounds
in the quality of Rajas, the renaissance of his by-gone
existences, and wakens up in his psychic plane the pic-
tures of good or evil deeds done by him therein.
Dreams are but the embodiment of these recollections.
The self or Jivatmai, though he sleeps not himself, is
said to be sleeping, whenever the sense organs are over-
powered by the illusive energy of Tamas. 35.
Day sleep is forbidden in all seasons of the year,
except in summer and in the case of infants, old men,
and persons enfeebled by sexual excesses, or in Kshata-
kshina diseases and in case of habitual tipplers. A sleep
in the day may be enjoyed after the fatigue of a long
journey, riding, or physical labour, or on an empty
stomach. It may be allowed as well to men suffering
from the loss of fat, Kapham or blood, to those of
* Such persons may get sleep only, when bting tired and exhausted they cease to think of their affairs.
C f. Charaka :— When the active self of a person, tired in body and jnind, loses touch with his worldly affairs, sleep comes to him,
Chap. IV.] SARIRA STHANAM. 151
scanty perspiration, or of dry or parched constitution ;
and also to those who have been suffering from indi^
gestion and who may sleep for a Muhurta (48 minutes)
in the day time. Those who have kept late hours in
the night may sleep in the day for half the time they
have watched in the night (and no more). Day sleep is
the outcome of perverted nature and all the Doshas of
the body are aggravated by a sleep in the day, bringing
on many a troublesome complaints such as cough,
asthma, catarrh,heaviness of the body, aching or lassitude
in the limbs, fever, loss of appetite etc. On the other
hand, the keeping of late hours in the night develops
symptoms (Upadrava) which are peculiar to the deranged
Vayu and Pittam. ^6.
lYIemorable Verses :~Hence, one should not
sleep in the day, nor keep late hours. Having known both these acts to be injurious, the wise should observe moderation in sleep. A conformity to the preceding rule of conduct is rewarded with health, good humour, strength, healthful complexion, virility and beauty, a frame which is neither too fat nor too thin, and a long life of a hundred years). A day sleep may not prove injurious^ to those who are habituated to it and conversely keeping late hours at night may not tell upon the health of those to whom it is customary. 37-39.
An aggravated condition of the bodily Vayu or
Pittam, an aggrieved state of the mind, loss of vital
fluid, and a hurt or an injury may bring on insomnia, the
remedy being the adoption of measures antagonistic to
those which destroy sleep. The following measures are
useful in cases of sleeplessness -such as anointing the
body, rubbing of oil on the head, soft massages of the
body (with cleansing paste) and shampooing ; a diet
consisting of cakes and pastry made up of Sali-rice and
152 THE SUSHRUTA SAMHITA. Chap. IV.]
wheat prepared with sugar or other derivatives of sugar-
cane, sweet or soothing articles with milk or meat juice
or flesh of animals of the Biskira or Viles'aya class,
and eating of grapes, sugar and sugar-cane at night, are
beneficial (^in such cases; ; so also a soft and pleasant
bed, and easy and convenient seats and means of loco-
motion. Hence, a wise physician should advise those
and similar other measures to allay insomnia. 40-41.
Excessive sleep should be remedied by emetics, Sansodhana measures, fastings, bleeding, and works which tend to disturb the mental equanimity of man. Keeping up at night is beneficial to persons afflicted with obesity, poison or the deranged Kapham ; so also a nap in the day is beneficial to people troubled with hiccough, colic pain, dysentery, indigestion, or thirst. 42-43.
Somnolence or Drowsiness etc. : -in
this kind of ligHt sleep, or in th^ preliminary stage of
sleep, the sense organ? are overpowered and remain
only partially cognisant of their respective objects and
all (subjective and objective) symptoms of a sleepy
person such as, yawning, sense off atigue and heaviness
o( the limbs, present themselves in succession ; these are
the special features of Tandrai. One (prolonged) inha-
ling of the air through a widely open mouth and
subsequent exhaling with the contraction of the limbs
and tearful eyes are (all together) called Jrimbha^ or
yawning.
A sense of fatigue without any physical labour which comes upon a person unaccompanied by hurried res- piration is called Klama. It obstructs the proper functions of the senses as also the workings of the active organs.* An inordinate love of pleasure and a great aversion to pain, attended with an apathy to all sorts of
* Hand, leg, anus, and generative organ etc.
Chap. IV.] SARIRA STHANAM. 1 53
work even with the capacity of carrying them through is
called Alasyam (laziness). Nausea, without vomiting of
invested food, attended with salivation and formation
of sputum, and cardiac distress are the symptoms of
Utklesham. A sweet taste in the mouth, drowsiness,
a beating pain in the heart, dizziness, and non-relish
for food are the signs of Glaiai (languor). A feeling as
if the whole body were wrapped in a wet sheet, accom-
panied by an extreme heaviness of the heart, is called
Gauravam. 44- 50-
Loss of consciousness (Murchchai) is due to an excess
of the deranged Pittam and to the quality of the Tamas ;
vertigo (Bhrama) is due to an aggravated state of the
Vdyu, Pittam, and to the quality of the Rajas ; drowsiness
(Tandra() is due to a similar condition of the Vdyu,
Kapham and to the quality of the Tamas ; while sleep
(Nidratj is produced by the predominance of Kapham and
to the quality of the Tamas in the organism. 51.
The growch of a foetus in the womb is effected by
the serum (Rasa) prepared out of the food (assimilated
by its mother) incarcerated by the Vdyu in the internal
passage of its body. 52.
Memorable Verses :— Be it dearly under-
stood that there exists fire or heat (Jyoti) in the umbilical
region of the foetus which is fanned by its bodily
Vdyu and thus contributes to the growth of its body.
The same Vayu in combination with the heat (thus
generated), expands the upward, downward, and lateral
channels (in the body of the embryo) and thus leads
to the growth of the foetus. The eyes (Dristi— aper-
ture of sight) and the hair-follicles of a man do not
