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Abstract
The earliest among the classical medical texts of India are Caraka Sahit and Suruta Sahit,
and of the two Carakas compendium, essentially on medicine, is believed to be earlier. Suruta Sahit,
the other medical treatise is more systematic, concise and precise and is the oldest known work to deal
predominantly on surgical practices. The significance of these two ancient treatises lies in their detailed
message on promotion of human health and treatment of diseases based on rational concepts. The objective
of Caraka Sahit is to enumerate medical practices for achieving dhtusmya or equilibrium of sustaining
and nourishing factors of the body, so that man can enjoy a happy long life devoid of ailments. Suruta
Sahit , although dealing with alyatantra or surgery, also projects the basic philosophy of preservation
of health and longevity. The historical dating of the works as well as the identities of both Caraka and
Suruta have been extensively debated, but there is no doubt regarding their importance with respect to
the content which exposes the state of understanding of health, diseases and their treatment in early India.
hratattava or diet and nutrition is an integral part of Caraka Sahit and Annapnavidhi or proper
intake of food has been emphasized in Suruta Sahit for good health. Knowledge on the concept of a
balanced diet is also well expressed in the two Sahits where mention is made of Sarvagraha meaning
total quantity of food and Parigraha denoting quality of individual items essential for a wholesome
diet from the nutritional viewpoint and adverse influence of unwholesome food items in the context of
health and disease. It appears that a detailed search on this important aspect of medicine (health and
nutrition) documented in the two antique medical texts did not receive their due attention so far. The
present narration therefore is to highlight the significant features of dietary principles related in the
outstanding medical texts which reflect an understanding of food, diet and nutrition for preservation and
protection of normal health and their association and role in aetiology and management of diseases in
early Indian medical practice.
Key words: hratattva, Annapnavidhi, Caraka Sahit, Diet, Food, Nutrition, Suruta
Sahit.
growth rate, resistance to infectious diseases and constraints in selection are cultural and economic
increase in life expectancy. However many factors. In the modern global campaign on health
diseases emerged as a long term effect of affluent for all, promotion of proper nutrition has been
diet characterized by an excess of energy-dense highlighted and nutritional indicators have been
fats and sugars, which became so apparent as to developed to monitor the health status.
draw specific attention to healthy food. The Food has been classified in many ways in
dynamic association between changes in a different periods of history viz. by origin, chemical
populations diet and its health is well reflected in composition, nutritive value, predominant
the disease and mortality profiles of a population. function etc. The importance of the relationship
Health of a population is found to largely depend between proper food and good health has however
on specific components of the diet which can been realized at all times. The association of some
increase or decrease the probability of disease risk dietary factors and particular diseases were also
and mortality. not unknown in the early days. Existence of man
Food consists of any solid or liquid has in fact been largely controlled by its struggle
substance, of plant or animal origin, which is in search of food through centuries. The science
consumed to sustain life by providing nutritional of nutrition however had a limited range until the
support to the body. The substance ingested is 19th century. Yet it is amazing to know the level of
assimilated in the body cells to produce energy, understanding on the role of food for growth,
maintain life and stimulate growth. The essential reproduction, maintenance and repair of the body
nutrients of food are comprised of carbohydrates, since ancient times in India. Consideration of food
fats, proteins, vitamins and minerals. The sum total in relation to health is reflected in some Vedic
of foods or mixture of foods consumed daily by mantras and philosophical discourses of
an individual is referred to as diet. The term diet Upaniads. The gveda has attributed divinity to
also implies use of intake of specific food items anna (food) as God Pitu. The word pitu frequently
to provide nutrition according to bodys need in mentioned in gveda has been explained as
different ages and conditions for example for plakamannam implying nourishment. Indian
maintaining good health, management of weight medical texts have dealt in great detail and depth
and diseases and to prevent or recover from the classification of food with respect to origin,
diseases. Dietary habits may vary according to function and nutritive value. Specific
individual choice or culture. Generally humans are recommendations were made keeping in view the
omnivores but each culture and each person holds age, climatic and seasonal factors, state of health
some food preferences or some food taboos due of a person, all of which suggest a profound
to personal tastes or ethical reasons. It can define knowledge on the principles of nutrition.
cultures and can often be related to religion. According to early Indian medical practices the
Traditionally followed dietary choices are usually food we consume and the manner in which it is
more or less healthy and play a significant role in taken is in harmony with our nature which has
the quality of life, health and longevity. Nutrition strong bearing on health and emergence of disease.
is actually the science of food and its relationship Practice of medicine in the system has therefore
to body growth and development and maintenance incorporated dietary therapy as one of its essential
of health. Dietetics is the practice of the principles component since early times.
of nutrition. Human nutrition is complex as there Knowledge on the concept of a balanced
is the freedom to select from unlimited and diet is well expressed in Caraka Sahit where
accessible range of foods, although the major mention is made of Sarvagraha meaning total
HISTORICAL NOTE: FOOD AND NUTRITION AND DIETARY RECOMMENDATION 133
quantity of food and Parigraha denoting quality we are in the dark about the date, circumstances
of individual items essential from the nutritional leading to its discovery and even its authenticity.
viewpoint. Mention has been made of It is assumed that based on the teachings of treya,
wholesome and unwholesome food items in the physician who formulated the basic concepts
the context of health and disease. Suruta Sahit in medicine representing the School of treya, his
underlined prudent food as the foundation of disciple Agnivea composed the Agnivea Tantra.
strength and vitality. haratattva or diet and This was further refined and enlarged as Caraka
nutrition is an integral part of Caraka Sahit and Sahit and redacted by Dhabala - a scholar
Annapnavidhi or proper intake of food has been from Kashmir in around 6th / 9th century AD. No
emphasized in Suruta Sahit for good health. definite dating of the physicians and compositions
The present study is an exploration of the has been universally accepted. Some scholars,
understanding on food, diet and nutrition, referred based on Chinese sources, identify Caraka as a
to in these two outstanding texts on medical and physician in the court of Kanika who ruled in the
surgical practices of ancient India, with respect to second century AD. Internal evidence indicates
normal health as well as their association with the that this Sahit is a compilation and Caraka was
aetiology of diseases and in their management. probably an intermediate editor and reconstructor
of the work.
2. Importance of Caraka Sahit Suruta Sahit, the other medical treatise
and Suruta Sahit is predominantly a surgical text representing the
Caraka and Suruta Sahit are the Indian School of alyatantra, which also projects
earliest among the classical medical texts of India. the basic philosophy of yurveda for preservation
The treatises are significant because of their of health and longevity. This text is more
rational basis to the concepts and discourse. Of systematic, concise and precise than Caraka
the two, Carakas compendium, essentially on Sahit and is the oldest known work to deal
medicine, is believed to be earlier. The objective exclusively on surgical practices. Suruta is
of Caraka Sahit is to enumerate medical regarded as the Father of Anatomy and Surgery
practices for achieving dhtusmya or equilibrium and the first to describe the method of dissection
of sustaining and nourishing factors of the body, of human cadavers. The chronology Committee
so that man can enjoy a happy long life devoid of of the National Institute of Science of India (1952)
ailments. As stated in the scientific synopsis opined that third fourth centuries AD may be
published by the Indian National Science accepted as the date of recension of Suruta
Academy, Caraka Sahit was actually a Sahit by Ngrjuna which formed the basis of
redaction by Caraka of the original work of treya Dallanas commentary. Bower Manuscripts
Punarvasu who was a teacher in Taxila University discovered in 1890 at Kashgarh in Chinese
during the age of Buddha (Ray and Gupta,1965, Turkistan make mention of Surutas name along
p.26) There are several legends centred round the with treya, Jivaka and other old Masters (Saha,
name of treya, the venerable medical authority. 1985, p.7). Paleographically these manuscripts
Evidence of a historical treya has been put belong to the fourth to sixth century AD
forward by the existence of a manuscript entitled (Chattopadhyay, 1977, p. 38). Hence it is assumed
treya Sahit in the British catalogue number that the Suruta Sahit was probably compiled
2640, consisting of 164 folios (Naqvi, 2011, p.56). prior or within this time-frame. The original
Unfortunately no translation or editorial work has Suruta Sahit is considered to be a
ever been carried out on this document. Therefore representation of a series of discourses by the holy
134 INDIAN JOURNAL OF HISTORY OF SCIENCE
sage Dhanvantari -the so called creator of the knowledge in India dates back to Vedas and
science of surgery to his disciples (Ray, Gupta and yurveda is believed to be a branch (upaveda or
Roy, 1980, p.32). upga) of Atharvaveda which deals with the
healing art. While modern medicine interprets
Although the dating of the works as well
disease in terms of pathophysiology of the body,
as the identities of both Caraka and Suruta have
yurveda considered all diseases to be a result of
been debated by scholars, there is no doubt
an imbalance or derangement of the three doas
regarding the importance of these ancient medical
or biological humors the primary life forces in
texts with respect to their content which exposes
the body viz. vta, pitta and kapha which
the state of understanding of health, diseases and
correspond to the elements of air, fire and water.
their treatment in early India.
As active or mobile elements they control the life
process of growth and decay. The three doas
3. Definition of Health and Disease in
account for all the psycho-biological functions of
Caraka-Suruta Sahits
living being. They are the functional elements of
Caraka Sahit defines health as a the body which remain in an unstable and
condition which is the best source of virtue, vulnerable state. In healthy condition they remain
wealth, gratification and emancipation while in a balanced state. The most unstable of the three
diseases are destroyers of this source of welfare doas is vyu and kapha is the most stable one.
and life itself (CS.S.1.15-17). According to All doas have specific properties in the body. The
Suruta Sahit a healthy person is one in whom physical and physiological attributes of vyu
there is perfect balance of all body functions in comprise of mobility, breathing, natural urges, all
equilibrium with the mind and soul, any deviation motor and sensory functions, secretions and
from which results in diseases (SS.S.15,41). excretions and its psychological attributes are
These definitions are so comprehensive restlessness, anxiety and fear. Pitta contribute to
incorporating the physical, psychological, social physiological generation of heat, hunger, thirst,
and spiritual aspects of human life that it can in digestion, metabolism and vision and is associated
no way be underrated in comparison to the modern with intelligence, anger, hate and malice. Body
definition of health as a state of complete building, stability and immunity are controlled by
physical, mental and social well-being and not kapha and attribute to patience, forgiveness and
merely absence of disease and infirmity provided attachment. In brief, vta control all neurological
by WHO based on the conference held in New function/activities, pitta control digestion and
York in 1946 (WHO 1946). This statement was metabolism and kapha attributes to anabolic
further amplified in 1978 to include the ability activities and body building.
to lead a socially and economically productive
Doas act on the dhtus or body
life (WHO, 1978; Ustin, and Jacob, 2005).
constituents which comprise of rasa-the primary
essence derived from food (body fluid), which
4. Basic Principles of yurveda
produce rakta (blood), msa (muscle), meda
In order to understand and appreciate the (fat), asthi (bone), majj (marrow) and ukra (egg
recommendations made with respect to food, diet and sperm), to determine the state of health or
and nutrition in health and disease, it would be disease in the body. Thus when out of balance,
appropriate to consider the basic principles of the doas are the causative factors in the disease
yurveda or the science of life(Dash 1978; process. The essence of health is thus a balance
Frawley1997, pp.13-45). The history of medical of dhtus and doas i.e. dhtusmya.
HISTORICAL NOTE: FOOD AND NUTRITION AND DIETARY RECOMMENDATION 135
Likewise, annapa vidhi or the code of proper diseases and in case of suppression or absence of
dietary practice has been stressed upon throughout the same there is an end to life (CS.Ci.15.3-4).
Suruta Sahit. While highlighting the Food and its digestion was known to be the source
importance of wholesome food combination of body heat and food ingested was considered to
(samsana), avoidance of irregular eating, like undergo digestion in two phases, prapka in the
food taken in excess, in small quantity or untimely mouth and vipka in the gastro intestine before it
(viamsana), as well as eating during indigestion is absorbed in the large intestine (CS.Ci.15.5, 9-
(adhysana), is mentioned (SS.S.46: 508-509). 11).
The influence of food and drinks in health and It is interesting to note that rasa is
disease and the importance of selecting a variety perceived as the pure (sara) and most minute
of food items in the daily diet under different (paramasukma) essence of well digested food
physiological, pathological and seasonal which circulates in the body through ten
conditions have been explicitly discussed ascending, ten descending and four oblique irs
throughout this chapter (SS.S. 46). Carakas (blood vessels) originating in the heart to sustain
emphasis on virudhhra i.e. dietary and maintain the normal functions of the body
incompatibility is to be taken note of. It has been (SS.S.14,3) and that digestion involves
mentioned that eighteen external and internal upayuktasya (ingestion) i.e. proper intake of food
factors like quantity, composition, place, time, according to the rules prescribed under the code
season, agni, doa, health conditions, processing of healthy conduct. Different types of ajra
of food, eating rules etc determine whether food (indigestion) have been described which is caused
is wholesome for a person or not. These factors by not following the rules of proper food intake
have been clearly explained and exemplified in (SS.S.46,499).
the text. (CS.S. 26, 86-101)
In connection with food an important
Modern dietetics has provided strong feature of Caraka-Suruta Sahits is the
evidences for the importance of food selection elaborate listing and categorization of food items.
with respect to these factors known to the early Carakas concept on dvdaa hra varga reflects
Indian physicians. A comprehensive concept of a sound knowledge base with respect to diversity
food metabolism found in the two medical texts of food and their source. This is so exhaustive that
also merits appreciation. Food being properly there seems to be no space for further addition
consumed and digested were to be metabolised to even today. In Caraka Sahit food items are
produce agni (vital energy), rasas (clear essence classified with respect to their source and grouped
of food) and malas (waste products like sweat, as heavy, light, cold and hot and the list includes
urine, faecal matters). The hra rasa (nutrients cereals, legumes, leafy green and other vegetables,
from food) thus produced nourish the dhtus to fruits, meat of a wide variety of animals, fish, milk,
maintain the normal body growth and functions honey, sugar, edible oil, salt and multifarious
while the malas are excreted (CS.S.28,4); the drinks (CS.S.27). The taste, digestibility,
body is thus a product of food eaten, drunk, licked metabolic and physiological action and medical
and devoured, the wholesome and unwholesome efficacy of food items have been described
determining health and disease in conjunction with elaborately in Suruta Sahit (SS.S.45;
other factors (CS.S.28,5). Production of agni or SS.S.46). Food is regarded as soft, liquid, lickable
body heat (metabolic energy) was thought to be and hard which according to the composition and
the basis of life process (metabolism) (CS.Vi. ways of processing exert different effects in the
6.12). Any abnormality in the body heat results in body; therefore without knowing the basic nature
HISTORICAL NOTE: FOOD AND NUTRITION AND DIETARY RECOMMENDATION 137
of food, the physician is not to prescribe them emancipation is a disease free condition and that
(SS.S.46.3). Fruits (phala varga) are grouped as diseases destroy all these sources of welfare and
mla (sour), madhura (sweet) and tikta-kaya life itself (CS.S.1.15-17). A state of dhtusmya
(bitter pungent) and their variants along with their (healthy state) can be achieved by use of pacifiers
biological properties (SS.S.46, 139-210). Milk of the doas which can be obtained from different
has been considered as a complete food for body food sourced from animals, plants and earth (CS.
and brain (CS.S.1.105-113; SS.S.45.44-68) and S.1, 67-73). Reference to all the three sources of
mlaka as best among fruits (SS.S. 46,143-144). food suggest the knowledge that the essential food
Mention is to be found of many food preparations components which are needed to provide complete
like maas (thick creamy preparation), yusas nourishment for the body (the macronutrients -
(soup) and gruels and sweet dishes, prepared by protein, carbohydrate, fat and the micronutrients
combination of a variety of rice, legumes, - essential vitamins, phytochemicals and trace
vegetable, meat, ghee and milk, which are elements) are not available from a single source.
flavoured with spices, sweetened or scented, as Interestingly specific mention is made of earth
well as juices and alcoholic drinks. being the source of gold and lohas viz. silver,
copper, iron, tin, silica, calcites and salts
Since the essence of food and drinks (CS.S.1,68-73). It is to be noted that one who
saturates all the physiological elements, one desires happiness were advocated to make the best
should protect rasa with proper food, drink and effort to practice the wholesome in respect to
behaviour (SS.S.14.11-12). hra rasa normally diet, conduct and action(CS.S.7,60) which can
nourishes all dhtus, but is deficient in the old be compared to what we now refer to as healthy
due to geriatric decay in the body (SS.S.14.19). lifestyle in relation to prevention of chronic
Dhtus remain in a balanced state in those who diseases like diabetes, heart diseases, and cancer
take moderate diet regularly, due to which the body (WHO 2003).
attain a good physique, capable of all activities, is
strong and tolerant to difficult physiological and Wholesome food are those which maintain
seasonal situations (SS.S.15.34). Both obese and the balanced state in normal condition and is able
lean persons are incapable of attaining this state to restore equilibrium in mal-balanced ones, while
and hence susceptible to diseases (SS.S.15, 35- others that do not have these qualities are
36). Those who have no self restraint and eat unwholesome (CS.S.25,33). Therefore only the
voraciously without considering the quantity, gets wholesome food was considered to promote
growth and development and consumption of the
indigestion, the root cause of many
unwholesome is the root cause of all disorders
diseases(SS.Ci.39.37). These observations are
(CS.S.25.31). It has been stated that no substance
strong indicators of the existence of a scientific
is absolutely wholesome or unwholesome, but can
perception and cardinal concept on human
be so by nature (svbhvatah) and combination
dietetics in early Indian medical thought.
(samyoga) of substances (SS.S.20.3). Absolutely
wholesome items in general are water, ghee, milk,
6. RECOMMENDATIONS ON FOOD AND DIET
rice, pulses, barley, wheat, malaka, rock salt etc.
FOR A HEALTHY LIFE
which can be prescribed in diet of all persons
The emphasis on food as promoter and (SS.S.20,4-5). Combination of cucurbitous fruits,
protector of health is to be noted from the first mushrooms, bamboo shoot, horse gram, sour
chapter of the first section (Strasthnam) of fruits, meat, wine etc should not be mixed with
Caraka Sahit. Here it is stated that the best milk as that becomes absolutely unwholesome
source of virtue, wealth, gratification and (SS.S.20.8). Whatever food that aggravates doa
138 INDIAN JOURNAL OF HISTORY OF SCIENCE
and does not expel or vitiate rasa is unwholesome Importance of anupna or drinks to be
(SS.S.20.20) taken in association with food was also reiterated.
Food being motionless and un-moistened produces
Diet may consist of preparations which can
be eatable, chewable, drinkable and lickable, and distress if suitable liquid drink is not taken with
according to the property of food items food (SS.S.46.439). Hot water is the best drink
innumerable variations can be made. They have in vta and kapha and cold water in rakta pitta.
been defined from different aspects in the Sahits Anupna quenches thirst, stimulates digestion,
and are grouped as hot, cold, heavy, light, pacifies doas, removes fatigue and exhaustion
unctuous, rough, dull, sharp, stable, mobile, soft, (SS.S. 46, 434-437).
hard, non-slimy, slimy, smooth, course, minute, Among the beneficial food items repeated
gross, viscous and liquid. According to their effect mentioned of li rice is to be found. It is sweet,
on the body they are to be considered as light and easily digested, promote strength,
wholesome or unwholesome (CS.S.25.36). Some pacifies pitta but slightly increases vta and
of the wholesome items mentioned are li rice, kapha; lohitaka (red) is adjudged as the best
green gram, rain water, rock salt, jivanti variety of li rice because it is tridoa alleviating,
(Dendrobium macrei Linn. or cork (swallow wort), diuretic, wholesome for eyes and voice, promoter
antelope or quail meat, rohita fish, cows milk and of complexion, pacifier of thirst and eliminates
ghee, sesamum oil, fish fat, ginger, grapes, cane all diseases (SS.S.46,4-6). Mugda and masrika
sugar and a diet composed from these substances are recommended for being superior among pulses
are naturally wholesome (CS. S.25.38). Yavaka (SS.S.46,29-30) and Bengal gram pacifies kapha
(barley), black gram, river water- particularly in and rakta pitta and is an excellent pacifier of vta
rainy season, beef and frog meat, sheep milk and when mixed with ghee (ghta) (SS.S.46.31-32).
ghee, potato etc are among the unwholesome items Godhma (wheat) is heavy, unctuous, excessively
(CS.S.25.39). Attention has been drawn on cold, laxative, promote strength and semen,
aavidha hra or eight principles of diet which pacifies vta and pitta and increases kapha
are to be taken into consideration in planning of a (SS.S.46.43). Yava (barley), though included
wholesome diet viz. nature, processing, under unwholesome in Caraka Sahit, is
combination, quantity of food items, time, place considered wholesome due to being sweet and
and rules of food intake as well as the personal astringent with pitta and kapha pacifying
nature of the consumer ( CS.Vi. 1,21). An important properties (SS.S.46.41-42). Meat of black and
and specific recommendation on hravidhi is to white deer are beneficial because of their role in
eat after considering his own self (CS.Vi.1,25). One stimulation of digestion and strength promotion;
who lives following the dietary rules never suffer they are also light and pacifier of all three doas
from severe disorders. According to Suruta (SS.S.46.55-56). Both the texts have provided
Sahit the twelve factors that need to be exhaustive lists of a wide range of food items to
considered in relation to food consumption are choose from during formulation of balanced
whether it is cold, hot, unctuous, rough, liquid, wholesome diets.
dry, deficient in quantity, doa pacifier, maintains
body and to be taken once or twice daily and is to The different requirement of nourishing
be taken mixed with drug(SS.Utt.64,36). The food with respect to seasonal variation also did
rationality of this dietary practice cannot be not escape attention. For this purpose the year was
overlooked and appreciated despite the fact that grouped as adana comprising of isira, vasanta
in the present frame of time and situation some of and gma (winter, spring and summer) and
the factors many not seem relevant. visarga to include var, arad and hemanta
HISTORICAL NOTE: FOOD AND NUTRITION AND DIETARY RECOMMENDATION 139
(monsoon, autumn and early winter, CS.S.6.4) substances were delivered from the mother to the
when the weather conditions demanded specific growing embryo through the umbilical cord
dietary selection and accordingly recommendation (CS..6.21; SS..3.31). Therefore the pregnant
were made (CS.S.6,6-7; SS.Utt.64.5). Like, in women were advised to take relishing and
rainy season to avoid sluggishness in digestion nutritious food and drinks and refrain from eating
and aggravated vyu, the prescribed diet was to dry, stale, rotten and decomposed food
contain astringent, bitter and pungent items; those (SS..10.3). In the context of origin of embryo,
food that are warm and appetizing, neither too fatty mention is made of food components comprising
nor rough, were beneficial along with cooled of six rasas (nourishment) from which embryo
boiled water preferably mixed with honey develops (CS..2.4). The six rasas are madhura
(SS.Utt.64,6-8). Suggestion for autumn (sweet), amla (sour), lavaa (saline), kau
(SS.Utt.64.13-14) was to carefully choose (pungent), tikta (bitter) and kaya (astringent)
astringent, sweet and bitter items like milk, (CS.S.26.9) which when used in proper quantity
sugarcane, honey, li rice, green gram, meat of are beneficial, otherwise they become harmful
wild animals etc. Wholesome for winter consists (CS.S.26.40-44), necessitating their presence in
of salty, alkaline, bitter, sour and pungent items, the right quantity according to the physiological
warm food with ghee and oil (SS.Utt.64.18-19). requirement. Importance of wholesome diet for
In springtime food items which are irritant, rough, easy delivery of fully formed normal foetus
alkaline, pungent and astringent eg. barley, green (CS..2.6) and lack of proper nutrition as a factor
gram, honey etc. are useful (SS.Utt.64,23-24). for foetal abnormality (CS..2.29-30) also did not
Drinks beneficial in summer are sweet mantha remain undermined/ unnoticed. Maintenance of
(lassi) and fragrant cold drinks mixed with sugar the foetus was known to be accomplished by
and food are to be sweet, light and cold wholesome substances from the pregnant women
(SS.Utt.64.29-30). Following this code of food since the foetus gets connected to the mother
consumption for different seasons one is spared through vessels (CS..4.15). Items which were
of many seasonal disorders (SS.Utt.64.35). This hot, heavy, irritant and intoxicating, received from
idea definitely has a scientific basis and may be the mother, were considered likely to affect the
considered still relevant. We all know thoughtful foetus and were therefore to be avoided by the
selection of food items do help in protecting from pregnant woman (CS..14.18). To ensure dietary
many seasonal health problems. management of proper nutrition for both mother
and child and for a complication free easy delivery
The nutritive fluid derived from food was specific recommendation was made (SS..10.4).
known to pervade the body through channels and It was suggested that the pregnant woman
to be responsible for formation of blood, flesh, consume mainly sweet, cold liquids in the first
fat, bone marrow, semen, ligaments and clear fluid three months of pregnancy, followed by boiled
(plasma/serum) as well as the sensory faculties sasika rice with milk in the third month. Food
(CS.S.28,3-5). mixed with milk and butter and relishing
It was observed that nutrition, which is preparations of meat was also to be given from
required for physical and mental growth and the fourth month along with adequate quantity of
development, had to be provided from the foetal fluid. During fourth to six months, rice with curd,
stage. The embryo after formation in the uterus milk and ghee were considered beneficial. Liquid
grows with the utilization of suitable nourishment gruels of rice, vegetables, meat and ghee provided
and in condition of malnutrition conception of proper nourishment. It was also suggested that
embryo is not possible (CS.S.3.12). Nutritional addition of substances be made to the diet which
140 INDIAN JOURNAL OF HISTORY OF SCIENCE
would help in elimination of wind and faeces by Suruta Sahits still hold true and is in agreement
proper bowel movement. Realizing the importance with the requirement in developing process.
of nourishment for the growing foetus, the mother
Culinary skill and eating practices are both
and for lactation (CS..6.21,23), a good dietary science and art of healthy living and progress in
regimen is therefore recommended for the
these aspects may be used as an index of evolution
pregnant woman(CS..8.32,48-49) where
of civilized society. Considering this parameter,
digestibility and nourishment seems to be the main
both Caraka and Suruta Sahits reflect the
concern. It is also stated that the foetus dries up in
existence of a highly cultured culinary practice in
a state of malnutrition of the mother (CS..8.26). early India. Various food preparations are
The rationality and scientific basis of this diet
described and the palatability of food preparations
planning conceived in the early times cannot be were highlighted, which is supported by mention
overlooked in the current context.
of a wide range of herbs, seeds etc which we know
The post-delivery diet, both for mother and to be spices/condiments not only for food
child, also received equal attention. The diet flavouring but also for providing the important
suggested for the mother to enhance strength and phytochemicals beneficial for health promotion
digestive power comprised of fatty gruel or milk and protection. Existence of a concept of a well
gruel for three days followed by cooked ali rice balanced diet, consisting of all the nutrients and
and meat juice processed with barley, jujube the essential non-nutrients required for cellular
(Indian plum) and horse gram (SS..10.16). function, metabolism and body building, is clearly
Feeding a diet consisting of barley, wheat, ali or evident from a scrutiny of the two medical texts.
svstika rice, meat juice, wine, sour gruel, oil cake, Along with the understanding of the nutritional
garlic, fish and vegetables was recommended for value of food, the aesthetics and hygiene of how
proper lactation (SS..10.30). This undoubtedly food was to be prepared and served also received
reflects the knowledge on the relation between diet much attention. Food properly cooked and served
and milk production, the benefit of breast feeding is indeed associated with digestion and
as well as the role of mothers milk in physical assimilation.
development and health promotion of the child.
Food and drinks with desirable smell, taste
During birth ceremony immediately after and touch is considered to be a source of vital
the delivery, the new born was given to lick gold strength for mind, sense organs and body
powder mixed with honey and ghee (SS..10.13). (CS.S.27.3). There is elaborate description in the
The significance of this ritual needs to be explored Sahits of how to process and present food
in connection with nourishment of the baby. Could preparations, plan and maintain hygiene of the
it be a way of providing micronutrients to the child kitchen, and the utensils where food was to be
from external sources other than mothers milk? served. Cleanliness of the body and surrounding,
It appears that supplementation of milk or solid which epitomizes the progress of mind, has been
food of the child with herbs and fruits in later considered important for all aspects associated
stages for ensuring health, strength, intellect and with food consumption. Cleaning of body prior
life span (SS. . 10.45) was evidently to provide to eating and avoidance of stale food is stressed
vitamins and micronutrients and roughage (fibres). (CS.S.8.20). Purity and cleanliness of drinking
In the absence of breast milk, intake of goat or water is also mentioned (CS.S.27.196-197). The
cow milk (SS..10.48) and solid but light food expression of the thought that there can be a variety
was to be started from the sixth month of food combinations in the presence of abundant
(SS..10.49). These recommendations in Caraka- eatable substances in plant and animal kingdom
HISTORICAL NOTE: FOOD AND NUTRITION AND DIETARY RECOMMENDATION 141
(CS.S.25.36) and different ways of processing and suffering recorded in these texts in context to
and preparing food (CS.Vi.1.21.1-4) speaks highly treatment are well thought of and seems rational.
of the imagination and urge for appetising food as It is interesting to note that all diseases were
well as avoidance of monotony in dietary practice. thought of as vitiation of vta, pitta and kapha
It also appears that the knowledge that inclusion etiologically related to intake of hot food and also
of variety in food items afford more benefit to the eating before previous meal was digested. This
body than depending on a single item, which is expression has been repeated throughout the text
likely to produce deficiency by misbalancing or implying a pivotal role of food in disease
disturbing equilibrium of dhtus (CS..6.7-10). causation. Faulty diet has been emphasized as
Current nutritional guideline does emphasize this aggravator of doas in persons who are delicate,
point. obese and of a sedentary nature (SS.Ci.5.5).
It has been categorically mentioned that Therefore the general advise was to incorporate
food has to be properly processed to ensure it is those food entities that alleviate vta, pitta and
delicious and wholesome (SS.S.46.451) and kapha in therapeutics designed for most of the
should be cooked faithfully, properly and diseases (CS.S.25.42-44) and a proper dietary
hygienically in a kitchen which is spacious, clean regimen became an important element in
and well positioned (SS.S.46.446-447). Serving management of both external and internal diseases
of food also necessitated following certain rules (SS.Ci.5.7). Pathya (wholesome diet) which is not
and specific recommendations are enumerated harmful to the body and provide strength is
(SS.S.46.451,454-457). This includes serving of prescribed for the sick during treatment and during
liquid items like juices and meat soup in silver recovery (CS.S.25.45-50), which is to be planned
cups and use of stone cups for buttermilk and by the physician on the basis of the measure of
vegetable soup. Iron cup is to be used for serving diminished doas (SS.Ci.39.5-6). Mention of food
ghee and silver cup for liquid gruels. Use of proper items like ali rice, meat soup, vegetables viz.
food utensils is indeed important for avoiding toxic malaka and pomegranate and milk find repeated
reactions of food with the material of the container. mention in the medical texts in connection with
The seating posture during eating need to be diet for the sick and those recovering after therapy.
comfortable and food is to be taken in proper time Milk processed with pacamli (root of medicinal
and right measure (SS.S.46.465). This code of herb?), meat soup soured with fruits or soup of
eating satiates, gets easily digested, promotes cereals are considered wholesome food for those
strength and maintains equilibrium of dhtus suffering from different disorders of the head, ear,
(SS.S.46.466-467, 471-474). Drinking pure water stomach, urinary bladder, blood, joints and
in proper quantity is recommended during and ligaments (SS.Ci.4.13).
after eating (SS.S.46.482) as it aids in digestion. Fever (jvara) is described as king of all
diseases and destructive for all creatures
7. Dietary Recommendation for (CS.Ci.3.345). In case of fever arising from
Diseased Conditions different conditions of the vyu, pitta and kapha,
Apart from the normal requirement of wholesome but light diet of vegetable, lentil or
nourishing food, the healing and preventive role meat soup is recommended along with drinking
of food items, their harmful effects, beneficial of plenty of pure water; boiled rice may be given
support during treatment of diseases and during after remission(SS.Utt.39.147-148,253). Boiled
convalescence have been asserted throughout the milk with sugar, honey and ghee was also thought
two Sahits. The dietary planning for the sick to be useful in intermittent fever. Solid food is to
142 INDIAN JOURNAL OF HISTORY OF SCIENCE
juices in conjunction with lack of exercise and of etiological factors were considered important
oversleeping were associated with development for successful management of gulmas (tumors)
of madhumeha (CS.Ci.6.18-24) and food (CS.Ci.11.27-34). For patients wasted, emaciated
recommended in this condition consisted of barley or with wounds due to various medical conditions
preparation, sali or sastika rice with palatable meat inclusion of items like sugar, barley, wheat, honey
soup, mugda (green gram) or bitter vegetables with and milk along with meat soup was the dietary
oil of ingudi (linseed) and mustard oil (SS.Ci.12.4). recommendation (CS.Ci.12.20) and all
Avoidance of sweet diet is prescribed for unwholesome and heavy food were to be avoided
management diabetic boils (pramehapidika) (SS. Utt.44.3,18,23,24). Wholesome diet with juice
(SS.Utt.43.3-4). In case of hdya roga (heart of malaka, sugar cane and honey are
diseases), among other factors, use of hot and recommended along with mention of iron slag
rough food in excessive quantity, incompatible and (lauha) for preparation of drug for puroga
improperly cooked unsuitable food as well as (anemia) caused by aggravated doas (CS.S.21.4)
eating during indigestion were to be avoided Obesity was considered to be due to
(SS.Utt.43,14). Diet for these patients is old sali excessive intake of heavy, sweet and fatty diet,
rice with meat soup added with ghee and use of defective metabolism and lack of exercise (CS.
curd and powered sesamum are mentioned S. 21, 10-15) and over lean persons were small
(SS.Utt.42.53) eaters with weak metabolism (CS.S.21.51). Both
Cancer has found mention in both Caraka obese and lean persons are considered incapable
Sahit and Suruta Sahit where it is referred of all normal activities and mostly prone to or
to as karkaa, arbuda, gulma and granthi with affected with diseases, so the importance of
respect to their appearance, nature and site of wholesome diet for maintaining body weight was
growth in the body. For patients of gulma or emphasized (SS.S.15.34-35). A moderate diet
abdominal tumor/lumps lukewarm soup of meat which includes sasika or red ali rice, uail meat,
processed with fatty medium and medicinal herbs pomegranate and tanduliya are mentioned as food
(trikatu) is a beneficial drink (SS.Utt.42,54) and for maintenance of body weight (CS.S.21, 21-
liquid gruel processed with vta alleviating drugs 28). Honey, triphala, malaka and barley
is the recommended diet (SS.Utt.42,55). In case combined with other food items in right
of retention of faeces and flatus, milk mixed with proportions suited both groups (SS.S.19.16-18).
fresh ginger is useful (SS.Utt.42.65). Preparation Obesity and overweight is still a growing threat
of barley with milk and some fatty substance is to health at the present time which is associated
with high-fat energy dense diets (WHO, 2000).
also mentioned in this connection (SS.Ni.11. 17-
18). Mmsarbuda or muscle tumor is specifically Surgical patients were to avoid in their diet
mentioned to be due to derangement of doas as a new cereals, black gram, horse gram, sesamum,
result of over eating of different forms of meat green salads and vegetables, sour, salty and
(SS.Utt.42.75). One suffering from gulma should pungent food, products of jaggery and flour, dried
not eat dried meat, roots, vegetables and fish meat and vegetables, meat, muscle fat, cold water,
(SS.Utt.42.100). In case of pain, light warm gruel milk and milk preparations (pyasa) and wine as
and soup is suggested (SS.Utt.42.108). Juice of they aggravate pathological conditions and have
parusaka (Grewia asiatica L.), grape, dates and a damaging effect in wound healing (SS.S.19.32-
some aquatic tubers were also considered as 34). A diet of warm old ali rice with meat of wild
remedies for relieving colic pain (CS.Ci.5.183- animals helps during recovery and healing of
189). Wholesome food and drink and avoidance wounds; the patients should drink boiled water
144 INDIAN JOURNAL OF HISTORY OF SCIENCE
and malaka and dadima are considered beneficial associated with various skin diseases (SS.Ni.5.3)
(SS.Ci.1.131). In general dietary prescription for (SS. Ci.9.3). Those suffering from skin diseases
all wound patients is light food in small amount are to abstain from meat, muscle fat, milk, curd,
which should be unctuous, warm and appetizing oil, horse gram, black gram, products of sugarcane,
(SS.Ci.3.5,13). During treatment for fracture rice flour, sour or incompatible food (SS.Ci.9.4).
(bhga), rough food is to be avoided and cow Bitter group of vegetables and nimbi leaves are
milk, ghee, meat or pea soup, li rice and other recommended for skin disease patients (SS. Ci.
health promoting food and drinks are the 9.5).
recommendation (SS.Ci.39.3-5). Urinary disorders are associated with
For management of complications after indulgence in eating of cold, unctuous, sweet, fatty
unction, emesis, purgation, bloodletting and food and drinks (SS.Ni.6,3). Udararoga or
emanation as measures of treatment for various abdominal enlargement is associated with poor
health disorders, food need to be light and in small digestive power increased by unwholesome eating
measure instead of heavy food, as the digestive or continuous intake of dry or putrid food
power in such conditions are weak (SS.Ci.24.68). (SS.Ni.7.5). Many different conditions are
described under Udararoga which include
To prevent future ailments, it is necessary
perforation, obstruction, gastritis, constipated
to provide nourishing food which will increase
condition etc. and dietary sanction are made
strength immediately, sustain body and promote
accordingly. In general heavy food is to be
brilliance, energy, memory, ojas and digestive
avoided, but in some cases nothing but only milk
power (SS.Ci.39.6). The diet is to be prescribed
is recommended as food and drink (SS.Ci.14.4,10).
on the basis of measure of eliminated doas which
Milk and meat soup of wild animals are prescribed
may be regarded as inferior, medium and superior
in most of the udararoga (SS.Ci.14,19).
according to the measures (SS.Ni.2.4) It has been
Unwholesome and incompatible food is also the
advocated that foods which are related to the
cause of internal abscess (SS.Ni.9.15-18).
causes of many ailments need to be avoided. For
example where diagnosis of piles (arsas) is Many of the observation on association of
discussed, incompatible food and eating before disease with food items and practices have been
previous food is digested or eating too little is held identified and clarified by case control studies of
responsible for causing piles (SS.Ni.2.4), hence recent times, particularly with respect to the
these are to be avoided. Predominantly warm chronic (life style) diseases (WHO Study Group,
liquid diet in small quantities is recommended for 2003).
piles patients during treatment (SS.Ci.6.4). Items These are but only some important
like sali or svastika rice, barley and wheat taken examples, from the ancient medical texts under
with ghee and milk, soup of nimba (neem) or review, of diseased conditions having etiological
patola (snake gourd) are mentioned as beneficial association with food and a rational dietary
in this condition (SS.Ci.6.6). Haritak (myrobalan) approach towards their management to
mixed with jaggery taken regularly in the morning complement therapy. Scanning through the entire
is one of the palliative treatments for piles volumes of these texts it is inspiring to find how
(SS.Ci.6.13); haritak being digestive and laxative exhaustively nutritional guidelines are provided
its use in piles is justified. and all aspects of diet for the patients under
Faulty diet, eating of unwholesome items treatment and during recuperation have received
and frequent consumption of meat has been due attention.
HISTORICAL NOTE: FOOD AND NUTRITION AND DIETARY RECOMMENDATION 145
specific food items for formulating the conditions, as well as perhaps availability of the
wholesome dietary combinations do suggest food items in different regions. Prescription of diet
awareness on the biological properties and role made according to body constitution, age, state of
of food items in various body functions. For health, season, place etc. also seem justified in
example, the idea of deriving nourishment from a modern light. An interesting and important point
food combination that would provide all the six that demands attention is that there seemed to be
rasas in the right amount as well as procuring food no taboo or strictures with respect to food (like
items from different sources in nature (plant, beef, pork, hen egg, onion, garlic or alcohol) unless
animal and earth) is indicative of a clear insight they were unwholesome for health. However,
of a Balanced Diet to include all the essential moderation in intake of alcoholic drinks, minimal
requisites of nutrition i.e. carbohydrate, protein, consumption of fried and fatty food and avoidance
fat, vitamins and minerals and in the right of stale, rotten and unhygenically processed/
proportions. The concept of a balanced diet is well prepared food were advocated. Summarising from
expressed all through the texts with relevant the two Sahits it appears a well planned diet,
dietary guidelines on food selection. Among containing a variety of items made palatable by
innumerable variables inclusion of cereals, pulses, proper cooking in a hygienic atmosphere taken in
meat, poultry, egg, milk, fruits, vegetables, oils moderate amount at regular intervals to suit the
and flavouring agents (spices and herbs) were seasonal needs according to the body constitution,
ensured. Meat was considered as bulk promoting, is the basic recommendation for maintenance of
cereals for providing strength and energy and milk health and protection from diseases. The statement
was rated as a complete food. Intake of amalaka, that a patient who does not achieve the fruit of
citrus fruits and leafy vegetables were perhaps diet even if prepared under the guidance of a
advised to supplement the macronutrients with the physician rarely survive (CS.Intr.12.8) definitely
vitamins, minerals and fibre. Fruit juices, wine and is a pointer to the central role assigned to nutrition
other alcoholic drinks were identified as digestive for existence of life and living. The broad
and fatigue alleviating, though plain clean water guidelines of Caraka and Suruta Sahit have
was ranked as the best of all drinks. Attention is stood the test of time and have its relevance even
drawn on certain food items like red sali rice today. Nutrition is accepted to be a major
among grains, mudga (green gram) and masurika modifiable determinant of most chronic diseases,
(lentil) among pulses, rohita among fishes, and scientific evidence is increasingly supporting
vension among meat , ginger among bulbs, milk the view that diet has both positive and negative
among dairy products, honey among sweeteners, influence on health throughout life. Most
seasame oils and ghee (clarified butter) among oils importantly, dietary adjustments not only
etc. Meat or vegetable soup with ghee and determine present health, but also whether an
condiments was the tonic of choice in all individual will develop or not such diseases like
conditions of health and mention of a wide variety cancer, cardiovascular disease and diabetes in later
of gruels and maas (mashed preparations) life. Unfortunately these concepts are yet to be
prepared from cereals, meat, vegetables, ghee and widely practiced in modern medicine (WHO,
spices in different combinations for patients during 2003). Moreover, much remains to be understood
treatment and convalescence is bound to find with respect to food and nutrition with an objective
analogy in modern forms of sick diet. The of defining healthy food that would reduce the
exhaustive list furnished also subscribes to their occurrence and impact of chronic diseases where
realization of proper nutrition and diet planning food and lifestyle are etiologically associated.
according to the specific needs at different Ancient Indian science of healthy living provide
HISTORICAL NOTE: FOOD AND NUTRITION AND DIETARY RECOMMENDATION 147
many guidelines for ensuring a disease free life Frawley, D. Ayurvedic Healing, Motilal Banarsidas
where role of food and nutrition as well as Publ.Pvt.Ltd., Delhi, 1997.
disciplined eating habits are highlighted. A Mennell, S, Murcolt A and Van Otterloo AH. The Sociology
recently published monograph (Rastogi, 2014) has of Food : Eating, Diet and Culture, Sage, London,
presented a comprehensive account on the science 1993.
of dietetics in early Indian medical thought. A Naqvi, NH. A Study of Indian Medicine and Surgery in
more critical analysis and un-prejudiced Gandhara, Motilal Banarsidas Pvt Ltd., Delhi, 2011.
assessment of ancient Indian medical texts is still Payne, A and Barker HM (eds). Advancing Dietetics and
underway where the merits and shortcomings of Clinical Nutrition, Elsevier Churchill Livingstone,
the perception, concept and recommendations on London, 2010.
dietetics in early India and their present relevance Prakash, Om. Food and Drinks in Ancient India, Munshiram
are likely to be revealed. Manoharlal, Delhi, 1961.
Note: All the references are from P.V. Sharmas Rastogi S (ed.) Ayurvedic Science of Food and Nutrition,
Caraka Sahit. Agniveas treatise refined and Springer, New York, 2014.
annotated by Caraka, reducted by Dhbala, Text Ray, P and Gupta, HN. Caraka Sahit-A Scientific
with English Translation,Vol.1(2010) and Synopsis, INSA,New Delhi, 1965.
Vol.2(2011), Chaukhamba Orientalia, Varanasi Ray, P., Gupta, HN and Roy, M. Suruta Sahit -A
and P.V. Sharmas Suruta Sahit. English Scientific Synopsis, New Delhi, 1980.
Translation of Text and Dalhanas commentary
Saha K. Indian Medical Texts in Central Asia, Firma
and critical notes, Vol.1(2010), Vol.2(2010) and
K.L.Mukhopadhyay, Calcutta, 1985.
Vol.3(2005), Chaukhamba Orientalia, Varanasi.
Sizer, F.S. and Whitney, E.N. Nutrition : Concepts and
Controversies, West Publ.Co, New York, 1994.
Acknowledgement
Ustin, B and Jacob R. Re-defining Health. Bull. WHO
This article is a part of an ongoing research 83(2005): 802.
project supported by the Indian National Science
Webster-Gandy J, Madden A and Holdsworth M (ed.) Oxford
Academy, New Delhi, for which the author is very
Handbook of Nutrition and Dietetics, Oxford
grateful. The kind academic support received from Univ.Press, Oxford, 2011.
Prof. (Dr.) Sukla Das is acknowledged with
thanks. WHO International Health Conference, New York, June
19-22, 1946.
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