The external opinions cited by the Suśrutasaṃhitā
In the main text of the Suśrutasaṃhitā, there are numerous expressions with the structure,
… ity eke / kecid ācāryāḥ tat tu na samyak
Some / certain teachers say that …; but that is not correct.
Who are these external “some” whose views are being refuted? In some cases, but not all, it seems that the views being refuted are found in the Carakasaṃhitā.
An additional complication is that not all the “some say” statements that are found in the vulgate edition of the Suśrutasaṃhitā are to be found in the more archaic Nepalese version of the work.
The use of present tense (bruvate, bhāṣante) may suggest that the “others” are contemporaries of the author(s) of the Suśrutasaṃhitā.
SS Vulgate 1.10.4: Three vs six diagnostic methods
In this case the ity eke expression is found in the vulgate but not in the Nepalese version. The Nepalese version reads:
tato dūtanimittaśakunamaṅgalānulomyenāturagṛham āgamyopaviśyāturam abhipaśyet spṛśet pṛcchec ca tribhir etair vijñānopāyaiḥ dīrgham āyuṣo ‘lpāyuṣo veditavyāḥ
This passage talks about three methods of clinical diagnosis:
- inspection
- palpation
- interrogation
This helps the physician to know whether the patient will live long or short.
The vulgate has a similar reading but rejects this view by adding the ity eke phrase. The reading goes like this:
tato dūtanimittaśakunamaṅgalānulomyenāturagṛhamabhigamya, upaviśya, āturamabhipaśyet spṛśet pṛcchec ca tribhir etair vijñānopāyai rogāḥ prāyaśo veditavyā ity eke; tat tu na samyak, ṣaḍvidho hi rogāṇāṃ vijñānopāyaḥ, tad yathā— pañcabhiḥ śrotrādibhiḥ praśnena ceti 4
According to this reading, some people consider the three methods—inspection, palpation, and interrogation—as the usual methods of clinical diagnosis. But this is not correct. The method of diagnosis of diseases is of six types: inspection with the five sense organs as well as interrogation.
The vulgate here adds a passage that is taken to be a reference to the doctrines of the Carakasaṃhitā. See HIML 1A, 351-352. The commentary Bhānumatī by Cakrapāṇidatta does not support this added passage (ayaṃ pāṭhaś cakrāsaṃmataḥ: Ācārya 1939: 77, note 2).
SS Vulgate 1.20.3: Nothing is absolutely wholesome or unwholesome vs substances can be absolutely wholesome, unwholesome, or both
In this case, the “some say” statement is found in both the Nepalese version and the vulgate. The Nepalese version reads:
yad vāyoḥ pathyan tat pittasyāpathyam ity anena hetunā na kiñcid dravyam ekāntena hitam ahitam vāst**īti kecid ācāryā bruvate tat tu na samyak ** iha khalu dravyāṇi svabhāvataḥ saṃyogataś ca ekāntahitāni ekāntāhitāni hitāhitāni ca bhavanti
This passage raises objection against the opinion of certain other teachers that a substance is never absolutely wholesome or unwholesome because we see what is wholesome for the wind is wholesome for the bile. The Suśrutasaṃhitā does not accept this view. It believes that whether by their inherent nature or through specific combination, substances can be absolutely wholesome or absolutely unwholesome or both wholesome and unwholesome.
From the discussion in Carakasaṃhitā 1.25, it is clear that the text maintains that certain foods are inherently wholesome and others inherently unwholesome, a position congruent with the view of the Suśrutasaṃhitā.
SS Vulgate 1.27.18:
In this case, the “some say” statement appears only in the vulgate and unlike most of the other cases, this opinion is not rejected in the text. The vulgate reads:
ajātuṣaṃ tu jatumadhūcchiṣṭapraliptayā śalākayā pūrvakalpenety eke
The reading ity eke is likely not read by Ḍalhaṇa. In the Nepalese version, this sentence and the following sentence of the vulgate constitute a single sentence.
SS Vulgate 1.36.5: Seasonal Collection by Plant Part vs Seasonal Collection by Plant Nature
Here as well, others’ opinion is rejected in both the Nepalese version and the vulgate. The Nepalese version reads:
tatra kecid ācāryāḥ prāvṛṭvarṣāśaraddhemantavasantagrīṣmeṣu yathāsaṃkhyam mūlapattratvacakṣīrasāraphalāny ādadīta tat tu na samyak kasmāt saumyāgneyatvāj jagataḥ saumyāny auṣadhāni saumyeṣv ṛtuṣv ādadīta āgneyāny āgneyeṣv evam avyāpannāni bhavanti saumyāny auṣadhāni saumyeṣv ṛtuṣu gṛhītāni somaguṇabhūyiṣṭhāyāṃ bhūmau madhuratarāsnigdhatarāṇiśītatarāṇi bhavanti
The issue here concerns the proper time for collecting medicinal plants. The rejected opinion maintains that the root, leaf, bark, latex, pith, and fruit should be collected respectively in the early rainy season, the rainy season, autumn, winter, spring, and summer. This idea is found in the Carakasaṃhitā. It reads:
teṣāṃ śākhāpalāśam aciraprarūḍhaṃ varṣāvasantayor grāhyaṃ , grīṣme mūlāni śiśire vā śīrṇaprarūḍhaparṇānāṃ, śaradi tvakkandakṣīrāṇi, hemante sārāṇi, yathartu puṣpaphalam iti… Ca.Sa. 7.1.10
The Suśrutasaṃhitā, however, does not accept a schedule based on plant parts. Instead, it proposes a more general principle based on the two fundamental natures of the world, the watery (saumya) and the igneous (āgneya), and the corresponding two-fold division of seasons. Accordingly, watery plants should be collected in the watery seasons and igneous plants in the igneous seasons, since when collected in their proper seasons they remain unspoiled and possess superior qualities.
SS Vulgate 1.45.5: Determination of the taste of water in various lands: according to colour vs according to element
The divergent opinion arises about how the taste of the water in a particular land is determined. Michio Yano, discussing water as a component of materia medica, pointed out that the Carakasaṃhitā classified water according to the colour of the soil from which it issues, while the Suśrutasaṃhitā classified water according to the predominance of the element present in it (Yano, 1986, pp. 332ff). The Suśrutasaṃhitā presented its own view as a contrast to the view held “by some others.”
The Nepalese version of the text reads:
tatra lohitakapilapāṇḍupītanīlaśukleṣv avanipradeśeṣu madhurāmlalavaṇakaṭutiktakaṣāyā yathāsaṃkhyam udakarasā bhavant**īty eke bhāṣante tat tu na samyak** pṛthivyādīnām anyo ‘nyānupraveśakṛtaḥ sa khalūdakaraso bhavaty utkarṣāpakarṣakṛtena saṃyogaviśeṣeṇa
The view rejected in the Suśrutasaṃhitā is the taste of the water is depends on the colour of the land: sweet, sour salty, pungent, bitter, and astringent tastes appear in red, brown, pale, blue, yellow, and white lands respectively.
This corresponding passage in the Carakasaṃhitā was discussed by Angermeier (Angermeier, 2020, pp. 183-186). it reads:
śvete kaṣāyaṃ bhavati pāṇḍare syāttu tiktakam kapile kṣārsaṃsṛṣṭam ūṣare lavaṇānvitam
kaṭu parvatavistāre madhuraṃ kṛṣṇamṛttike etat ṣāḍguṇyam ākhyātaṃ mahīsthasya jalasya hi Ca.Sa.1.27.199–200 (Ācārya, 1941, pp. 163-164)
According to the Suśrutasaṃhitā, however, the taste in water arises from the mutual interpenetration of the five basic elements, viz., earth, water, fire, wind, and sky. The taste is produced through a particular kind of combination determined by predominance and subordination among them.
SS Vulgate 2.8.4: Fourfold classification of mispositioned fetuses vs numerous ways of confounding
In this passage, the Suśrutasaṃhitā refers to the classification of mispositioned fetuses into four types as an opinion of some people. These four types of mispositioned fetuses:
- wedge: when it obstructs the vaginal opening like a wedge with the head and a leg upward,
- hoof-like: when hands, feet, and head are out but the torso is stuck,
- seed-like: when the head and a hand comes out, and
- bar: when it stays around the vaginal opening like a bar. The Suśrutasaṃhitā rejects this classification citing the reason that when the fetus is pressed by disordered vital air, it moves in the vaginal passage in many ways, exceeding the count four.
sa kīlaḥ pratikhurobījakaḥ parigha iti caturvidho mūḍhagarbho bhavat**īty eke bhāṣante ** ya ūrdhvaṃ śiraḥpādābhyāṃ yonimukhan niruṇaddhi kīla iva sa kīlaḥ niḥsṛtahastapādaśiraḥkāyaśaktaḥ sa pratikhuraḥ yas tu nirgacchatiśirobhujaḥ sa bījakaḥ parigha iva yonimukham āvṛtya tiṣṭhet sa parigha iti **tat tu na samyak ** sa yadā viguṇānilapīḍito ‘patyapatham anekadhā pratipadyate tadā catuḥsaṃkhyā hīyate
No reference to such fourfold classification of mispositioned fetuses is not found in the Carakasaṃhitā, so some other external authority must have proposed views on fetal presentation.
SS Vulgate 3.2.35: Colour of the food determining fetal complexion
In this case, the discussion concerns factors that determine the complexion of the child. Here, however, the Suśrutasaṃhitā cites the “opinion of others” without refuting it. It says that whatever colour the food consumed by a pregnant woman has, the offspring will possess the same complexion. In the Nepalese version, the text reads as follows:
yādṛdvarṇṇam āhāram upasevate tadvarṇṇaḥ prasavo bhavatīty eke bhāṣante
The sentence appears in a context where the Suśrutasaṃhitā discusses the role of the primary elements in determining the complexion of the fetus. The view that the colour of the food consumed by the pregnant woman determines the complexion of the child does not necessarily conflict with the Suśrutasaṃhitā’s broader account of the factors governing fetal complexion.
Although there is no identical statement found in Carakasaṃhitā, it did recommend that a pregnant woman should surround herself with a particular colour, so that the son inherits that complexion.
putravarṇānurūpas tu yathāśīr eva tayoḥ paribarho ‘nyaḥ kāryaḥ syāt Ca.Sa. 4.8.12 (Ācārya, 1941, p. 342)
It also advised that she should adopt the diet, recreation, customs, and attire of the people from the regions she wants her son to resemble.
tato yā yā yeṣāṃ yeṣāṃ janapadānāṃ manuṣyāṇām anurūpaṃ putram āśāsīta sā sā teṣāṃ teṣāṃ janapadānāṃ manuṣyāṇām āhāravihāropacāraparicchadān anuvidhatsveti vācyā syāt Ca.Sa. 4.8.14 (Ācārya, 1941, p. 342)
SS Vulgate 3.3.32: Sequential vs simultaneous development of the embryo
In this passage, the opinions of several authorities, namely Śaunaka, Kṛtavīrya, Pārāśarya, Mārkaṇḍeya, and Subhūtigautama, are presented and subsequently dismissed with specific reasoning. The central debate concerns embryological development, specifically which body part emerges first. While these figures suggest the head, heart, navel, hands and feet, or torso respectively, the Suśrutasaṃhitā contends that all body parts are formed simultaneously. According to this view, these parts are initially imperceptible due to their minuteness, becoming clearly manifest only over time. The text illustrates this with the analogies of a maturing mango and a bamboo shoot, noting that just as the internal structures of a fruit are present but unseen in its early stages, the embryo’s limbs and organs exist from the beginning. The passage reads as follows:
garbbhasya khalu sambhavataḥ pūrvvaṃ śiraḥ sambhavatīty āha śaunakas tanmūlatvāt pradhānendriyāṇāṃ hṛdayam iti kṛtavīryaḥ buddher manasaś ca sthānaṃ nābhir iti pārāśaryas tato varddhate dehadehinaḥ prāṇaḥ pāṇipādam iti mārkkaṇḍeyas tanmūlatvāc ceṣṭāyāḥ garbbhasya śarīram iti subhūtigautamas tatra nibandhatvāt sarvvagātrasambhavasya **tat tu na samyak ** sarvvāṇy aṅgapratyaṅgāni yugapat sambhavanti kāle garbbhasya sūkṣmatvān nopalabhyante vaṃśāṅkuravac cūtaphalavac ca tad yathā cūtaphale vipakve keśaramāṃsāsthimajjānaḥ pṛthak pṛthag dṛśyante kālaprakarṣāt tāny eva taruṇe nopalabhyante sūkṣmatvāt teṣāṃ sūkṣmāṇāṃ keśarādīnām pravyaktaṃ kālaḥ karoti etenaiva vaṃśāṅkuro vyākhyātaḥ evaṃ garbbhasya tāruṇye sarvveṣv aṅgapratyaṅgeṣu satsv api saukṣmyād anupalabdhis tāny eva kālaprakarṣāt pravyaktāni bhavanti pūrvvottarakālayogo nāstīti kevalan tu saukṣmyān nābhivyajyante yathākālaṃ pravyaktāni bhavanti
The Carakasaṃhitā (4.6.21) maintains a similar view, indicating that, unlike several other instances marked by the tat tu na samyak phrase, there is no disagreement between Caraka and Suśruta on this point. However, a philological discrepancy exists regarding the attribution of this final view: the vulgate attributes this final summary view to Dhanvantari (Meulenbeld, 1999, pp. 1A, 247), while the Nepalese version does not. Ḍalhaṇa apparently did not have this attribution in the text before him, suggesting that it may have been added after the twelfth century. However, in the Carakasaṃhitā, this view is attributed to Dhanvantari. It seems likely that the name Dhanvantari was here added to the Suśrutasaṃhitā because of the passage in the Carakasaṃhitā.
SS Vulgate 3.9.3: dhamanī, śirā and srotas are essentially the same vs they are different
The discussion here concerns the distinction between pipes (dhamanī), ducts (śirā), and tubes (srotas). The Suśrutasaṃhitā introduces and subsequently dismisses the view of certain teachers who argue that there is no difference between ducts, pipes, and tubes, because pipes and tubes are just types of ducts. Rejecting this opinion, the text maintains that Pipes, tubes and ducts are quite different because of the difference in their colours, in their connections to their roots, because of their divergent functions, and because of traditional doctrine. The text explains that that the distinct functions only appear to have no functional difference because of the close proximity of their mutual ramifications, the similarity of their functions, and their smallness.
The passage in the Nepalese version is as follows:
caturvviṃśatir dhamanyo bhavanti tās tu nābhiprabhavāḥ **tatra kecid āhur ācāryāḥ ** sirādhamanīsrotasām avibhāgaḥ sirāvikārā eva hi dhamanyaḥ srotāṃsi ceti tat tu na samyag atrocyate anyā eva hi dhamanyaḥ srotāṃsi sirāśceti kasmād vyañjanānyatvāt mūlasanniyamāt karmavaiśeṣyād āgamāc ca kevalaṃ tu parasparapratānasannikarṣāt sadṛśakarmatvāt saukṣmyāc ca vibhaktakarmaṇām apy avibhāga eva karmasu bhavati
In the Carakasaṃhitā (3.5.9), these vessels are considered synonymous:
srotāṃsi, sirāḥ, dhamanyaḥ, rasāyanyaḥ, rasavāhinyaḥ, nāḍyaḥ, panthānaḥ, mārgāḥ, śarīracchidrāṇi, saṃvṛtāsaṃvṛtāni, sthānāni, āśayāḥ, niketāś ceti śarīradhātvavakāśānāṃ lakṣyālakṣyāṇāṃ nāmāni bhavanti
SS vulgate 3.10.16: postpartum period lasts one month and a half vs until menses restart
This passage, found in the vulgate but absent from the Nepalese version, concerns the management of the postpartum period. The text prescribes a specific regimen for the puerpera to follow for a month and a half after childbirth. It then records an alternative view, marked by the phrase ity eke, which recommends that these prescriptions continue until the menses reappear. Notably, this view appears as an acceptable alternative opinion as the passage lacks the dismissive tat tu na samyak phrase. Ḍalhaṇa does not comment on the sentence containing the ity eke phrase. Thus, it is not clear whether his version of the text included this sentence. The passage is as follows:
anena vidhinādhyardhamāsam upasaṃskṛtā vimuktāhārācārā vigatasūtikābhidhānā syāt, punar ārtavadarśanād ity eke 16
No parallel passage is found in the Carakasaṃhitā.
SS Vulgate 4.1.5: Clean wound as the sixteenth type
In this passage, after mentioning the vitiation of humours as of fifteen types, the text introduces a sixteenth type: the clean wound, which is free from vitiation of all humours. The reference to this sixteenth type is marked by the phrase ity eke in the vulgate, whereas the Nepalese version reads ity ucyate instead. The reading of the vulgate is as follows:
doṣopaplavaviśeṣaḥ punaḥ samāsataḥ pañcadaśaprakāraḥ, prasaraṇasāmarthyāt, yathokto vraṇapraśnādhikāre; śuddhatvāt ṣoḍaśaprakāra ity eke
In the Nepalese version, it reads:
doṣopaplavaviśeṣaḥ punaḥ samāsataḥ pañcadaśaprakāro bhavati yathokte vraṇapraśnādhyāye prasaraṇasāmarthyāc chaddhaś ceti ṣoḍaśaprakāra ity ucyate*
This ity eke phrase in the vulgate is most likely a corrupt reading. Notably, it is not followed by the dismissive tat tu na samyak phrase. Therefore, it is clear that the Suśrutasaṃhitā in fact endorses this opinion. Furthermore, Ḍalhaṇa’s use of the lemma śuddhaḥ, which appears in the Nepalese version, instead of śuddhatvāt of the vulgate, suggests that Ḍalhaṇa’s version is closer to the Nepalese version in this case than to the vulgate.
SS Vulgate 4.5.3: Vātarakta: two separate states vs a continuum
This passage discusses the classification of vātarakta (a disease caused by vitiated wind and blood). The view discarded in the Suśrutasaṃhitā refers to its two types: superficial (uttāna) and deep (avagāḍha). The text argues against this opinion explaining that, much like certain skin condition such as kuṣṭha, the disease initially appears superficially and then, over time, taturally progresses into deeper level. Thus, the disease should not be classified into two separate types.
dvividhaṃ vātaraktam uttānam avagāḍhaṃ **cety eke bhāṣante tat tu na samyak** kasmāt kuṣṭhavad uttānam bhūtvā kālāntareṇāvagāḍhībhavati tasmād dvitvasaṃkhyā hīyate
Emmerick 1984:101 pointed out that the view being criticized in Su.4.5.3 is found in Carakasaṃhitā 6.29.19. It is also found in 1.19.3.
SS Vulgate 4.6.4: Sprinkling a piles patient with cold water vs hot water
This passage occurs in the context of the procedure for treating piles. After performing the recommended procedure the physician has the patient bathe in warm water and sprinkles him with cold water; according to some, however, hot water should be used. This alternative view is not rejected in the text.
The text in the Nepalese version reads as follows:
tato yaṣṭīmadhukamiśreṇasarpiṣā nirvāpya yantram upanīyotthāpy āturam uṣṇodake ‘vagāhya śītābhir adbhiḥ pariṣecayet aśītābhir adbhir ity eke
The Carakasaṃhitā does mention bathing the patient in warm water (6.14.47), but it does not refer to any procedure for sprinkling the patient with either cold or hot water.
SS Vulgate 4.7.33: Surgical removal of urinary calculi: incision on the left side vs right side of the raphe
This passage presents two differing opinions regarding the surgical procedure for the removal of urinary calculi. The primary instruction says that the incision should be made on the left side of the perineal raphe. However, an alternative view suggests that the incision may be made on the right side for the sake of procedural convenience.
The text in the Nepalese version reads as follows:
tataḥ sevanyāḥ savye pārśve sevanī yavamātreṇāvamucyāvacārayec chastraṃ aśmarīpramāṇād dakṣiṇato vā kriyā saukaryahetor ity eke
The alternative view, introduced by the phrase ity eke, is not followed by a dismissive clause. Instead, both approaches are presented as optional techniques.
The Carakasaṃhitā does not include a discussion of this procedure.
SS Vulgate 4.31.6: Proportions in the preparation of herbal decoction
In this passage, the dismissed opinion concerns the preparation of herbal decoction. It says that according to some, one part of plant material, such as bark, leaves, fruit, root etc., should be boiled in four parts water and reduced to one-fourth of its original volume—this is the method of preparing decoction. The text explicitly rejects this method, arguing that it lacks scriptural authority.
The text in the Nepalese version reads as follows:
tatra kecid āhus tvakpatrapuṣpaphalādīnāṃ bhāgas taccaturguṇam udakaṃ caturthāṃśāvaśeṣitaṃ kvāthyāvatārayed ity eṣa kaṣāyakalpaḥ tat tu na samyak kasmād āgamasiddhatvāt
The vulgate version explands on this passage by also including the preparation of medicinal fat base, which is absent in the Nepalese version. The vulgate rejects the proposed methods for both preparations simultaneously. The text in the vulgate reads as follows:
tatra kecid āhuḥ tvakpatraphalamūlādīnāṃ bhāgas taccaturguṇaṃ jalaṃ caturbhāgāvaśeṣaṃ niṣkvāthyāpahared ity eṣa kaṣāyapākakalpaḥ; snehaprasṛteṣu ṣaṭsu caturguṇaṃ dravam āvapya caturaś cākṣasamān bheṣajapiṇḍānity eṣa snehapākakalpaḥ etat tu na samyak; kasmāt āgamāsiddhatvāt
There is no parallel passage in the Carakasaṃhitā.
SS Vulgate 4.35.9: Size of the orifice of enema nozzle: like a jujube seed vs like a moistened pea
This passage occurs in the context of the enema therapy. For patients above the age of twenty-five, the text recommends that the orifice of the enema nozzle be the size of a jujube seed (kolāsthi), while an alternative view suggests it should be the size of a moistened pea (klinna-kalāya). The alternative opinion, introduced by the phrase ity eke, is not followed by a dismissive clause. Thus, the second view remains as an acceptable option.
The text in the Nepalese version reads as follows.
pañcaviṃśativarṣād ūrddhvaṃ dvādaśāṅgulapramāṇam aṅguṣṭhodarapariṇāham agre tryaṅgulasanniviṣṭakarṇikaṃ gṛdhrapatranāḍītulyapraveśaṃ kolāsthimātraṃ cchidraṃ klinnakalāyamātracchidram ity eke
A similar parameter is found in the Carakasaṃhitā (8.3.8), which states that the size of the orifice of the enema nozzle for a patient twenty years of age should be the size of a jujube seed (karkandhu).
ṣaḍdvādaśāṣṭāṅgulasammitāni ṣaḍviṃśatidvādaśavarṣajānām syur mudgakarkandhusatīnavāhicchidrāṇi vartyāpihitāni caiva Carakasaṃhitā 8.3.8
SS Vulgate 5.4.34: Paternal vs maternal traits in hybrid offspring of snakes
This passage concerns the hereditary dominance of traits in hybrid snakes. According to the Suśrutasaṃhitā, their poison is like that of their father due to the superiority of the paternal trait (utkarṣāt). The text also recognizes the alternative opinion of others, introduced by the phrase ity eke, which states that the poison resembles that of the mother. Because this alternative view is not followed by a dismissive clause, it remains an acceptable option.
The text in the Nepalese version is as follows:
vaikarañjās tu trayāṇāṃ varṇṇānāṃ vyatirekajās tad yathā mākuliḥ poṭagalaḥ snigdharājiś ceti tatra kṛṣṇasarpeṇa gonasyāṃ vaiparītyena vā jāto mākuliḥ rājilena gonasyāṃ vaiparītyena vā jātaḥ poṭagalaḥ kṛṣṇasarpeṇa rājimatyāṃ vaiparītyena vā jātaḥ snigdharājir iti teṣāṃ pitṛvad viṣam utkarṣād dvayor mātṛvad ity eke
There is no parallel passage in the Carakasaṃhitā.
References
2020
- Regenzeiten, Feuchtgebiete, Körpersäfte: Das Wasser in der klassischen indischen Medizin2020
1999
1986
- A Comparative Study of \emphSūtrasthānas: Caraka, Suśruta, and VāgbhaṭaIn History of Traditional Medicine: Proceedings of the 1st and 2nd International Symposia on the Comparative History of Medicine—East and West, 1986
1941
- महर्षिणा पुनर्वसुनोपदिष्टा, तच्छिष्येणाग्निवेशेन प्रणीता, चरकदृढबलाभ्यां प्रतिसंस्कृता चरकसंहिता, श्रीचक्रपाणिदत्तविरचितया आयुर्वेददीपिकाव्याख्यया संवलिता1941
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