Introduction

शुक्लाम्बरधरम् विष्णुम् शशिवर्णम् चतुर्भुजम्।
प्रसन्नवदनम् ध्यायेद् सर्व विघ्नोपशान्तये॥

The literal translation of Ashtanga Hridayam (aShTA~Nga hR^idayam) is "heart of eight limbs". Here eight limbs refers to Ayurveda as it contains the following eight branches:

1. Kaya (internal medicine)
2. Bala (pediatrics)
3. Graha (mental disease)
4. Urdvanga (facial organs)
5. Salya (surgery)
6. Dhamshtra (toxicology)
7. Jara (geriatrics)
8. Vrisha (virilification)

AH was written by Vag Bhatta and is considered to be one of the three well-known treatises on Ayurveda (Brihat-Trayi). The other two are Charaka Samhita and Susruta Samhita. AH is an abridged version of several Ayurvedic texts which existed before the author's time.

AH consists of 120 chapters, divided into 6 sections. The sections are arranged in a different order than the Ayurvedic branches. The sections (or also called as sthanas) are as follows:

1. Sutra - Fundamentals, Health, Prevention, Lifestyle, Diseases
2. Sarira - Anatomy, Physiology, Physiognomy
3. Nidana - Monitoring, Diagnostics
4. Chikitsa - Therapautics
5. Kalpa Siddhi - Pharmacy
6. Uttara - covers the other branches from #2 to #8 of Ayurveda

The coverage given to Internal Medicine (Kaya Chikitsa) is quite obvious as the first 5 sections mainly deal with it and the last section deals with rest of the 7 branches of the Ayurveda.

This blog is to capture my notes from the English translation of Sri. K.R. Srikantha Murthy. It uses ITRANS format 5.3 for Sanskrit words.

ITRANS 5.3 Format

ITRANS 5.30 Encoding
Scheme for Devanagari
Copyright ©
1991-2004 Avinash Chopde. All Rights Reserved.

Note:

For more details on the ITRANS encoding scheme, see
http://www.aczone.com/itrans.

1. AyuSh kAmIya - Desire for Long Life

1. Invocation: Prayer to apUrva vaidya who fixes everything, without any residue.


2. Purpose of desiring health and long life: To achieve dharma, artha, and sukha (sukha refers both to kAma and mOkSha)


3. Lineage of Propogation: brahmA, prajApati, ashwini Twins, indrA, Atreya's son (Atreya punarvasu), agnivesA and others.


4. What is Ashtanga Hridayam ?: Gist of all the previous treatises, mainly written by agnivesA and others; Neither too elaborate nor too succinct.


5. AyurvedA Limbs (8):


• kAya (internal medicine)
• bAla (pediatrics)
• graha (mental disease)
• UrdhvAJNga (facial organs)
• shalya (surgery)
• damShTra (toxicology)
• jarA (geriatrics)
• vR^iSha (virilification)


6. dOShAs (3):


• vAyu or vAta
• pittam
• kapham

In normalcy they nourish the body and in abnormal condition, they destruct the body.


7. Doshas predominant presence in the body:
   
   Although pervading all over the body, they are predominant as follows:
   
   • Vata - below the navel
   • Pitta - between the navel and heart
   • Kapha - above the heart
   
   
8. Doshas predominant presence in other aspects:

Life Stage(Age), During the day, During the night, Digestive Stage

• Vata - late: oldage (> 60), 3 - 7 PM, 3 - 7 AM, end of the digestion
• Pitta - middle: adults (20 - 50), 11 - 2 PM, 11 - 2 AM, middle of the digestion
• Kapha - early: childhood (0 - 20),


9. Kinds of agni - Digestive Fire(4):


• Increase in Vata will result in viShama agni - Poisonous, Mischievous
• Increase in Pitta will result in tIkShNa agni - Penetrating
• Increase in Kapha will result in manda agni - Dull
• Balance of doshas will result in sama agni - Balanced


10. Kinds of kOShTha -Alimentary Tract (3):


• Increase in Vata will result in krUra condition - Hard, Rough
• Increase in Pitta will result in mR^idu condition - (too) Soft
• Increase in Kapha will result in madhya condition - Average
• Balance of doshas will result in Madhya condition, as well - Average
  


11. Body Constitution - Deha Prakruti (7):

Results from unification of Sukra (sperm) and Artava (ovum) , influenced by the parents' prakruti just as how poisonous worms get produced from the poison (so that even bad combination of prakritis sustain as long as the person continues to live).


• Born from one dosha - Ekadoshaja (Hina - Poor)
  Vata (Hina - Poor)
  Pitta (Madhyama - Average)
  Kapha (Uttama - Best)



• Born from two doshas - Dvidoshaja - Samsarga (Madhyama - Average)
  Vata - Pitta
  Pitta - Kapha
  Kapha - Vata



• Born from all three doshas - Tridoshaja - Sannipaata (Uttama - Best)
  Vata - Pitta - Kapha



12. Qualities of Doshas


• Vata:
  Ruksha - Dry; Laghu - Light (in weight); Sita - Cold; Khara - Rough; Sukshma - Subtle; Chala - Mobile


• Pitta:
  Sasneha - Slightly Unctous; Tikshna - Penetrating; Usnam - Hot; Laghu - Light (in weight); Visram - Bad Smelling; Saram - Free Flowing; Dravam - Liquid


• Kapha: Snigdha - Unctous; Sita - Cold; Guru - Heavy; Manda - Slow; Slakshna - Smooth; Mrutsna (or Picchila) - Slimy; Sthira - Stable


13. Tissues - Dhatus or Dushyas (7):


• Rasa - Plasma
• Asruk - Blood
• Mamsa - Muscle
• Medha - Fat
• Asti - Bone
• Majja - Bone marrow
• Sukra (Artava) - Sperm (ovum)

These are called "Dushyas" since these are the ones mainly impacted by Doshas.



14. Wastes - Malas


• Mutra - urine
• Sakrut - feces
• Sweda - sweat
• etc


15. Effect on Doshas using similarities:

Use of similars will increase (or aggravate) the doshas, whereas dissimilars will decrease (or neutralize) the doshas.

16. Tastes - Rasas (6):


• Swaad - Sweet
• Amla - Sour
• Lavana - Salty
• Tikta - Bitter
• Ushana - Pungent
• Kashaya - Astringent

The tastes provide nourishment in the descending order, given above, starting Sweet with the most nourishment and Kashaya with the least.

17. Tastes on Doshas:


• Swaad, Amla, & Lavana mitigate Vata; other three aggravate Vata
• Kashaya, Tikta, & Swaad mitigate Pitta; other three aggravate Pitta
• Tikta, Usana, & Kashaya mitigate Kapha; other three aggravate Kapha


18. Kinds of Substances:


• Samanam - Neutralizing (or mitigating)
• Kopanam - Aggravating
• Swastha hitam - Enriching


19. Potency - Virya (2):


• Ushna - Heat
• Sita - Cold


20. End Product of Digestion - Vipaka(3):


• Swaad - Sweet
• Amla - Sour
• Katu - Astringent


21. Qualities starting with Heavy - Gurvadi gunah:




• Guru (heavy) X Laghu (light in weight)


• Manda (slow moving) X Sara or ??? (fast moving)


• Hima or Shita (cold) X Ushna (hot in temp)


• Snighda (unctous) X Ruksha (dry)


• Slakshna (smooth) X khara (rough)


• Sandra(dense) X drava (liquid)


• Mrudu (soft) X Katina (hard)


• Sthira(stable) X Chala (mobile)


• Sukshma (subtle) X Sthula (gross)


• Vishada(non-slimy) X Picchila or Mrutsna(slimy)




22. Root Cause Factors for Disease & Health - Roga Arogya Karanam:

Having
• Hina (Poor), Mithya (Perverse), or Ati (Excess)
conduct in
• Kala (time-related aspects), Artha (objects of the senses), and Karma (actions)
will result in disease.

On the other hand, having Samyak (Balanced) conduct in Kala, Artha, and Karma will result in health.

From Doshas perspective, this can be described as follows:
Whenever Doshas are disturbed, it will result in disease. When they are in equilibrium, that is a healthy state.


23. Classification of Diseases:


• By origin:
  Nija - Organic (from inside the body)
  Agantu - Developed due to external factors (from outside the body)
  


• By seat of manifestation:
  Kaya - Body
  Manas - Mind



24. Doshas of Mind - Manas (2):


• Rajas - Passionate
• Tamas - Lethargic

Sattva (Pious) is considered to be the healthy state of Manas.


25. Examination of Patient - Rogi Parikshanam (3):


• Darshanam - Visual Inspection
• Sparsanam - Palpation
• Sodhanam - Interrogation


26. Examination of Disease - Roga Parikshanam (5):


• Nidana - root cause diagnosis
• Pragrupa - Pre-monitory symptoms
• Lakshana - Manifested symptoms
• Upasaya - Diagnostic aids & equipments
• Apti - Pathogenesis


27. Kinds of Habitat - Desa (3):


• Jangala - Arid land; breezy; less vegetation (considered to be Vata land)
• Anupa - Lushing with green; well irrigated; (considered to be Kapha land)
• Sadharana - Normal vegetation, mountains, water, etc; (considered to be Balanced land)


28. Kinds of Time - Kala (2):


• Internal (follows the path of the disease)
• External


• Kshana - 1 sec
• Kashta - 2 sec (1/30 of Kala)
• Kala - 1 min or 48 sec
• Nadika - 24 mins
• Muhurta - 48 mins
• Yama - 3 hours (1/8 of Ahoratra)
• Ahoratra - 24 hours or Day & Night
• Paksha - 1/2 month
• Masa - a month
• Rutu - 2 months or season (Shishira, Vasanta, Grishma, Varsha, Sarad, and Hima)
• Ayana - 1/2 year (Uttara & Dakshina)
• Samvatsara - a year




29. Kinds of Therapies:

For the body:

• Sodhanam - purificatory
• Samanam - palliative (or neutralizing)

The best therapies for the following aggravated doshas:



• For Vata, Basthi (enema) using Thaila (oil)


• For Pitta, Vireka (purgation) using Ghrutam (ghee or butter fat)


• For Kapha, Vamanam (emesis) using madhu(honey)



For the mind:

• Dhi - ability to discriminate (between good and bad)
• Dhairya - courage (to choose good between the two)
• Atma Vignana - knowledge about Self


30. Four Pillars (or Legs) of the treatment - Chikitsa Padah:




1. Bhishak (or Vaidya) - Physician


2. Dravya (or Aushada) - Medicine


3. Upasthatha (or Paricharaka) - Nurse or Medical Assistant


4. Rogi - Patient



Each of the above is further assumed to have four qualities.
Bhishak (or Vaidya) - Physician



1. Daksha - Skillful; Expert; Not to be frightened by the disease


2. Thirthartha Shastrartha - Having assimilated the deeper meanings from studying the scriptures (under a Guru's guidance)


3. Drishta Kala(?) - Having long practice


4. Suchi - Cleanliness (in body, speech, and mind)



Dravya (or Aushada) - Medicine



1. Bahu Kalpa - Being an active ingredient in many medical recipes


2. Bahu Guna - Possessing many good qualities, in taste, potency, etc.


3. Sampanna - Easily available and accessible


4. Yogya - Suitable to treat many diseases



Upasthatha (or Paricharaka) - Nurse or Medical Assistant



1. Anurakta - Affectionate (to the patient)


2. Suchi - Cleanliness (in body, speech, and mind)


3. Daksha - Skillful (in implementing doctor's instructions as is)


4. Bhuddhiman - Being intelligent or having common sense



Rogi - Patient



1. Adya - Wealthy (enough to afford the treatment)


2. Bhishak Vashya - Obedient to the doctor(to follow his instructions)


3. Gnapaka - Having good memory (to remember and explain the disease condition, i.e.,symptoms, habits, etc.)


4. Sattvavaan - Ability to withstand the pain (which may result from the treatment)




31. Kinds of Diseases (2/2):


• Saadhya - Possible (to cure)


• Susaadhya - Easily Possible (to cure)
• Krichra - Possible (to cure) with difficulty


• Asaadhya - Impossible (to cure)


• Yaapya - Controllable
• Anupakrama - Not curable




32. Features of Susaadhya disease (patient, disease, environment) :


• One who can withstand different kinds of treatment


• adult
• Male


• One who has self-awareness


• One which does not involve vital organs
• One which is having simple or known cause
• One which manifest pre-monitory symptoms
• One which does not cause (too much) pain
• One which is dissimilar in doshas with respect to Dhatus (tissues), Desa (lands), Ritu (seasons), and Prakriti
• All four limbs (stated above) of the treatment in excellent condition
• One who is having favorable planetary conditions
• One which is developed from just one dosha
• One which takes pathogenesis in one dosha's path
• One which is New




33. Features of Krichra disease:


• One which needs the use of an instrument (Surgical procedure)
• Having combination or multiples of the above Susaadhya's features




34. Features of Yaapya disease:


• One which remains with the patient, remainder of his/her life
• One which can only be controllable by maintaining strict regimen


• Having (combination or multiples of - ???) the above Susaadhya's features




35. Features of Anupakrama disease:


• One which remained for a long duration
• One who is at the end of life (too old)


• One which produces Aauthsukhya - anxiety (about possible death), Moha - delusion, and Aarati - discomfiture


• Having fatal signs


• Having failure of vital organs


• Having just opposite of the above listed Susaadhya's features




36. The following patients needs to be rejected:


• One who is hated by a physician(s) or a king and one who hates them


• One who hates himself


• One who does not possess necessary instruments(or means)


• One who is (too) busy (! - in other activities, taking necessary time away from looking after one's own health)


• One who is dis-obedient (to listen to the doctor's advice)


• One who is at the end of life (too old)


• One who is of evil mind (violent)


• One who is immersed in grief


• One who is full of fear


• One who does destructive activities


• One who thinks himself/herself a physician

2. Dina Charya - Daily Regimen

1. Prathur uttana - Getting up in the morning:

Best time to get up during the Brahma muhurtha ( 3 - 6 AM)in the morning

2. Danta vardhana - Protection of teeth


3. Anjana - Eye Salve


4. Gandusha - Mouth goggle


5. Naasya - Nasal drops


6. Tambula - Betal chewing


7. Abyanga - Oil massage/bath


8. Vyayama - (Physical) Exercise


9. Udvartana - (dry) Massage


10. Snana - Bathing


11. Sad vrata - Good conduct