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Divins remèdes

Ines G. Županov
Caterina Guenzi

Le religieux dans le médical

Between Medicine and Religion: Discursive Shifts in Early Āyurvedic Narratives of Conception and Gestation

Entre médecine et religion. Registres discursifs dans les récits ayurvédiques sur la conception et la gestation

Martha Ann Selby


Les récits de conception, de grossesse, et de naissance s’étendent sur d’assez vastes sections des deux manuels médicaux les plus anciens conservés en sanskrit, les Caraka-saṃhitā (circa ier siècle de n. è.) et les Suśruta-saṃhitā (circa iie siècle de n. è.). Les deux textes offrent un récit prescriptif cohérent de ce qui devrait idéalement prendre place dans l’organisation et le soin à apporter à la femme enceinte depuis la conception jusqu’à l’accouchement et au-delà. Ces récits sont également exceptionnels dans leur contenu, en comparaison de ceux qui figurent dans d’autres parties de ces ouvrages. Il en émerge de nombreuses voix faisant autorité: on trouve la voix masculine attendue des sāstra (traités); les voix des brahmanes, des sages védiques tels Ātreya et Bhadrakapya, et des spécialistes de médecine et de rituels de toutes sortes. On entend aussi les voix – à la fois réfutées et révérées – de femmes âgées ayant enfanté plusieurs fois. Tous sont impliqués dans la création de technologies médicales et rituelles qui sont conduites par l’exigence de produire une progéniture de la plus haute qualité possible.
Dans cette étude, je suis la trace de différents registres de discours qui apparaissent dans ces passages où l’on trouve des paradigmes cosmogoniques tirés des Veda et des sāṃkhya, des mythèmes issus d’anciens hymnes, mêlés à des développements vertigineux sur la théorie de l’émanation, émaillés de descriptions fades, franches et cliniques de la masse tissulaire embryonique de toute évidence très attentivement observée dans des contextes variés de traitement. Je démontre que certaines homologies fondées sur les catégories des sāṃkhya sont utilisées comme moyens de médiation entre mondes invisibles et visibles. Je soutiens que de telles homologies trouvent aussi une expression stratégique dans des rituels impliquant des procédures élaborées pour de futures mères, en en déduisant que c’est la sāṃkhya qui agit comme un filtre logique à travers lequel des phénomènes médicaux peuvent être reliés à des logiques rituelles.

Texte intégral

1In the new introduction to the 1993 edition of his book, Religious Medicine: The History and Evolution of Indian Medicine, Kenneth Zysk valiantly attempts “to fill in the gaps between Vedic and classical āyurvedic medicine” (Zysk 1933 :IX). Rather than assuming that the latter was a direct development from and an elaboration of the former, Zysk theorizes that early healers were marginalized and ostracized by the priestly community. Basing his argument on Dumézil’s tripartite classification of Indo-European society, Zysk suggests that these healers were

forced to remain among their own communities located at the margins of society where contact with many sorts of people with different healing traditions might well have taken place. This removal of healers and their medical craft from mainstream Vedic priestly culture led eventually to a radical shift in medical thinking, resulting in what has come to be known as classical āyurveda [ibid.: XI].

2Whether Zysk’s imaginative theory is correct is not really at issue here. What he is right about is his characterization of the existence of a “gap” between Vedic medicine and classical āyurveda. But to characterize this “gap” as a product of a “radical shift” or “movement” still implies some sort of a connection and continuity between the two; that āyurveda still somehow blossomed forth from Vedic healing practices, although in Zysk’s view, somewhat circuitously. There are, indeed, elements of Vedic material in āyurveda, especially when rituals are performed within certain contexts of treatment, or when an extraordinary medical event must be marked in a religious way, as I will demonstrate below. But rather than thinking in terms of a Vedic brand of medicine based, as Zysk writes, on “magico-religious beliefs and practices” wherein, by and large, diseases were believed to be caused by malefic invasions of the body, juxtaposed with a more systematized āyurveda based on “empirico-rational principles and practices” (loc. cit.) and informed by observation and reason, it might be more fruitful to look at specific instances within the classical texts themselves to see how religious and medical discourses work with each other to explain and mark specific physical phenomena.

3What were the intellectual materials at hand that were used by these medical writers to analyze, taxonomize, and define well-being, illness, and treatment? Is humoral theory, the hallmark of classical āyurveda, an indication of an empirical reflex at work; of a higher, more rational systematization of medical phenomena? What are the elements that helped early physicians to make sense of sets of symptoms and of medical events?

  • 1 For the various arguments on the historical identities of these two authors, see Meulenbeld 1999-20 (...)

4Before turning to these questions, it might be helpful at this juncture to characterize the two texts under consideration for the purposes of this essay, as well as their respective “styles” of presenting information. The two medical collections (saṃhitās) with which I am currently working are named after their redactors, Caraka and Suśruta.1 Both texts were composed in Sanskrit, and the materials therein are generally presented in the form of symposia in which a master relays medical knowledge to an assembled body of colleagues and students; Ātreya via Agniveśa in the case of the Caraka-saṃhitā and Dhanvantari, physician to the gods incarnate in the body of the king of Kasi in the case of the Suśruta-saṃhitā. Dominik Wujastyk emphasizes the fundamental importance of both texts thus:

Suśruta’s Compendium is one of the two early major encyclopedias of classical Indian medicine, the other being the Caraka-saṃhitā or “Compendium of Caraka”, and these two works between them define and delineate Āyurveda, or classical Indian medicine [Wujastyk 2004 : 350].

  • 2 Basham 1976, 20-21. As Wujastyk (2003: 3-5; 63-64) cautions us in his medical reader, it is most di (...)
  • 3 Basham 1976: 27. For more elaboration on a variety of surgical procedures, as well as excellent tra (...)

5The problems of dating the texts are many, but it is generally accepted that the Caraka-saṃhitā had taken its present form by around the first or second century C.E.2, and is the earliest surviving medical manual in Sanskrit. The Suśruta-saṃhitā was redacted perhaps a hundred or so years later. The texts are somewhat similar in their structural organization and worldview. Both texts employ similar philosophical language to discuss links between cosmology and personhood, and both also display interesting and rather eclectic inflections from a number of early philosophical “schools”, or more correctly, darśanas, or “viewpoints”, those of sāṃkhya (“enumeration”) and vaiśeṣika ( “distinction”), in particular. They differ in the respect that the Suśruta-saṃhitā includes descriptions of surgeries and surgical instruments, whereas the Caraka-saṃhitā refers to surgery and surgeons, but for the most part leaves any sort of invasive surgical technique undescribed. Here, “surgery” refers to the proper removal of arrow shafts and large splinters, the removal of bladder stones, the resectioning of intestines due to serious abdominal wounds, and performing Caesarian sections in cases in which a mother dies in childbirth with a viable fetus inside her. The Suśruta-saṃhitā also demonstrates a very sophisticated understanding of plastic surgery, particularly in techniques involving rhinoplasty and in repairing torn earlobes.3 Also, stylistically speaking, the Caraka-saṃhitā is very matter-offact in its writing, whereas the Suśruta-saṃhitā trails off into speculative fancy from time to time, and is simultaneously much more graphic in its descriptions of bodies, diseases, and the consequences of prescribed cures.

6In reading these two texts, I have gained no sense of a coherent idea of “gynecology” in the Greco-Roman sense, or in our contemporary western sense, but this has much more to do with the ways in which disorders and their treatments are taxonomically understood and arranged, rather than with a lack of information, or with some covert agenda of erasure or “silencing” of this information by masculinist authors living in masculinist cultures. But for whatever reason, it remains true that the bodies of women seem somehow fragmented and dispersed across the wholes that are these two texts. There is, however, one huge and logical exception to these seemingly fragmented taxonomies of illnesses, disorders, and treatments of either sex. The narratives of conception, pregnancy, and birth—in other words, obstetrics—range over quite large sections of these two texts, presenting a coherent narrative prescription (not a description) for what should ideally take place in the management and care of a pregnant woman from the moment of conception up to the moment of delivery and beyond. These narratives are also quite exceptional in tenor from those that appear in other parts of these works. They acknowledge and employ female wisdom, not easily or readily, but it is discernible. Women appear in these narratives not just in their expected roles as midwives and wet-nurses, but as expert friends and advisors during the experience of labor and birth.

Gynecology and obstetrics in Āyurveda Literature

7In the production of gynecological and obstetrical knowledge in these two texts, many authoritative voices emerge: we find the expected, even-toned, and although there are certainly interesting exceptions, stylistically neutral male voice of the śāstra in the writing; the voices of brahmins, Vedic sages such as Ātreya and Bhadrakāpya, and medical and ritual specialists of all sorts. We also hear the voices—both refuted and revered—of elderly, multiparous women, the āptāstriyaḥ, literally, “accomplished women”, quoted second-hand, indicating that there must have been complex dialogues between these women and the medical men. All are involved in creating medical and ritual technologies that are driven by the urge to produce śreyasī prajā, the very best of offspring. Both texts are very explicit in their language and grammar that the product of choice is male, for well-documented ritual and economic reasons.

8The narratives of the care of a woman during the nine months of gestation occur in various places for equally various purposes in both texts. The passages that I wish to examine here have been culled from Caraka-saṃhitā, śārīra-sthāna IV.1-26 and Suśruta-saṃhitā, śārīra-sthāna III (entire), for in these passages, we hear yet another loud, booming, and insistent voice, that of the fetus itself, who communicates his needs to the outside world through the instrument of his mother’s voice, thereby participating in the creation of his own identity and the traits of his own personality. I would like to examine these narratives in depth, paying strict attention to the points at which certain terms are used for “womb”. I would also like to trace the nuanced flow of the various registers of discourse that appear in these passages, for here, we find cosmogonic paradigms culled from the Vedas and sāṃkhya, mythemes from hymns fused with dizzying spins on emanation theory. This inter-uterine “big bang” language is interspersed with bland, frank, and pragmatic clinical descriptions of the embryonic tissue mass, obviously keenly observed in some sort of context, either by men in direct observation or possibly by female attendants who then report to men. The cosmic language of conception and that of clinical observation are also augmented by a third category of information composed of descriptions of what is happening to the outer bodily surfaces of the woman herself.

9First of all, it is necessary to indicate the sorts of phenomena that I characterize as betraying “religious” qualities or inhabiting “religious” positions in the examples that I have chosen for discussion below. As Jean Filliozat (1964: 26) has emphatically stated, “It is only in the case of certain therapeutic prescriptions, or in the case of ceremonies connected with birth that religion and magic are brought in” and included in the early medical collections. Some elements are more recognizably “religious” than others. I would include references to cosmogony— and the rather ingenious use of cosmogonic ideas to make sense of what happens at the moment of conception—in the religious category, although it is crucial to note here that the moment in the texts at which this appears is celebrated in a discursive shift in which the language is at once hymnic and explanatory. There are also obvious moments of priestly intervention: I include below translations and analyses of specific passages from the eighth chapter of the Caraka-saṃhitā’s śārīra-sthāna (literally, the “section on the body”), in which a priest is brought in to perform rituals to ensure that a woman will conceive a son with a desirable complexion and physique, as well as a description of the puṃsavana ritual ( “male production rite”), performed for a woman as soon as conception is confirmed, to ensure that the embryo she is carrying will be male.

10The element that links medical discourse to religious expression is, I would argue, philosophy, and sāṃkhya philosophy, in particular. It is philosophy, in fact, that seems to hover between medicine and religion, bringing together logics that, on the surface, at least, appear to be disparate and eclectic. As I will demonstrate below, homologies based on sāṃkhya categories are used as a means for mediating between unseen and visible worlds. They also inspire more commonplace, informal theories of personality development and psychic tendency. I would also argue, moreover, that sāṃkhya-inspired homologic ways of thinking provide the “logic behind the rituals” that we encounter in these passages. They have given rise to ritual “technologies” and more formal, priestly interventions, such as the puṃsavana rite documented in earlier gṛhya-sūtra literature, that can be categorized as belonging to older complexes of “magico-religious” practices that do not seem to belong in the realm of āyurvedic “empirico-rational practice”. Sāṃkhya is what makes the inclusion of such material in the early medical collections possible. Like Zysk, Frederick Smith (2006: 479-480) also characterizes the āyurvedic texts as “rational” and “rationalizing”. He writes that “without Sāṃkhya, āyurveda would look very different; indeed, it is Sāṃkhya that weaves the disparate threads of āyurveda into a coherent system” (ibid.: 486). Although this is a gross overstatement—sāṃkhya is only one of many equally important organizing principles in these texts, and is certainly not the only element that makes āyurveda “cohere”, Smith is right at least in terms of the understanding of the āyurvedic body on one specific theoretical level: “The evolutionary principles (tattvas) that constitute Sāṃkhya’s main doctrine are the building blocks of the āyurvedic body, mind, and cosmos” (loc. cit.).

Obstetrical Metaphores

11It is also very important to acknowledge the primary and very powerful metaphor that is employed in the Caraka-saṃhitā especially when we make attempts to understand the treatment of a pregnant woman’s body and the webs of discourse that surround, augment, and compound this treatment. In classical āyurvedic narratives of obstetrics, the woman in the text is always an inexperienced one, a naive primipara, and her body is explicitly described as a “pot” in which the fetus is conceived and cooked. At first glance, this may seem a rather unremarkable trope, but it completely generates and drives the language of maintenance wherever pregnant women are concerned. Unlike the classical Greek Hippokratics, who likened the female body to a ploughed and seeded field and her uterus to a jug, and even though we certainly find the field imagery in legal, poetic, and epic literature, in the Sanskrit medical saṃhitās, it is not the uterus that is the jug or pot: it is the whole woman herself; not just her womb, but the whole of her. The uterus itself is called by several names in these texts, but it is never referred to as pātra or kumbha. The terms that are most commonly used for “uterus”, however, are employed by the writers in fairly specific and consistent ways. These terms are rather surprisingly “unmetaphorical”, and are quite banal and utilitarian, mostly. In the narratives of conception and gestation, a uterus is referred to as kukṣi, “belly”, “cavity”, “womb”, before a garbha, “embryo”, “fetus”, enters into the discussion. When these passages move from the sex act to the actual moment of conception and beyond, the phrase used to refer to the uterus is garbhāśaya, literally the “resting place for the fetus”. The language, therefore, moves from the generalities of location to the specifics of function.

12The word kukṣi means “belly”, and refers to the abdominal cavity in general, but also “womb” or “uterus” in certain contexts (Das 2003 : 91). Although Stephanie Jamison (1987) writes about the word’s “uncertainties” especially in its dual form (kukṣi) in Vedic literature, arguing that kukṣi acquires the meaning “belly” only in later Sanskrit and in Middle Indic, H.W. Bodewitz (1992: 23) convincingly refutes Jamison, stating that “the meaning ‘belly’ is not exclusively post-Vedic” and that it also “may denote the belly of male human beings” (ibid.: 24-25); that it is an “inexact term” (ibid.: 26) that refers to a “reservoir, container, receptacle” (ibid.: 27). Bodewitz argues that kukṣi is a “general term and is best translated with another general term such as ‘belly’”; that it is a “vague” term that seems to indicate a container rather than an organ (loc. cit.), and I would add that it refers to a general location on the body more than anything else.

13On the other hand, garbhāśaya is more specific in that it indicates function rather than location. The term literally means the “resting place” (āśaya) of the “embryo” (garbha), as I have translated it above. Like kukṣi, āśaya can refer to a “receptacle ; any recipient ; any vessel of the body” (Monier-Williams 1996 : 157), but when compounded with garbha, we can of course assume that it means “uterus” or “womb”. As Das notes, these two specific terms “need not tally at all with what a modern physician would understand” by them (Das 2003 : 7 n12), but Das regularly translates garbhāśaya as “uterus” or “womb” throughout his book, and I have no qualms in doing so. As I stated above, the language used in these narratives is characteristically utilitarian —although one might be tempted to translate āśaya in this instance as “bed”, “abode”, or even “cradle”, doing so would simultaneously romanticize and erase the functionality that I think is intended in the phrase—āśaya in the sense of “resting place”, certainly, but also as a “receptive vessel”, a notion which precisely fits the context of conception.

14A woman’s body is, in general, “flexibly adjusting and constantly changing”, (Martin 1992: XV) as well as a constant source of male, medical, and ritual alarm due to its “pliancy and porousness” (Carson 1990 : 158). The body of a woman is “constantly crossing lines which it should not cross”, (ibid.: 136) due to its openness, redness, and heat. Menstruation and birth are those junctures in a woman’s life when she is at her most open, at her scarlet best, and she must be isolated and insulated to keep her from polluting and from being polluted, especially if she is menstruating and about to conceive or is already with child (Selby 2005 : 262). In the paragraphs below, I will briefly examine what and how color “means” in this system, for it is crucial to the understanding of the ways in which the mother, the pot, and the fetus, its contents, interact and communicate with each other.

The Poetics of Colour and Substance

  • 4 Inspired by Zimmermann 1987, I am paying less attention to the literary conventions, structures, an (...)
  • 5 For a full treatment of the role of menstrual fluid in conception, see Das 2003 passim, but see esp (...)

15The “poetics”4 of gender and sexuality in classical Āyurveda is largely based on color, and on only two colors, at that: red and white. Women and the “feminine” are red; men and the “masculine” are white. The redness of women and the whiteness of men are based on the colors of their observable sexual effluents: menstrual fluid5 in the case of women, and semen in the case of men (Selby 2005 : 260).

16These colors and their qualities can be seen as expressions of a powerful archetypal binary pair in early Indian culture, that of agni, “fire” and soma, most typically a sacrificial beverage, but used to denote cooling, watery properties (Wujastyk 2004: 347-370). Blood and semen, and by extension, red and white, are explicitly tied to agni and soma by Ḍalhaṅa, an eleventh-century commentator on the Suśruta-saṃhitā. Wujastyk notes that Ḍalhaṅa “spells out the fact that the woman’s menstrual blood is fiery, in contrast to the man’s semen which is of the nature of soma, and it is their union that creates an embryo” (ibid.: 356). White and red exist in a dominant/subordinate relationship, both in the medical texts themselves and within the larger and more articulated contexts of Hindu social hierarchy. It is by no small accident that the word for class is varṇa, which means “color”. Each of the four classical varṇas has varṇa, in other words, and this

refers not to any supposed racial characteristics, but to a system of color symbolism reflecting the social hierarchy as well as the qualities (guṇa) which are present in varying degrees in all things. The Brahmans were associated with white, the color of purity and lightness, the Kṣatriyas with red, the color of passion and energy, the Vaiśyas with yellow, the color of the earth, and the Śūdras with black, the color of darkness and inertia [Flood 1996: 59].

17This system of color ranking by varṇa is also expressed in certain medical practices related to birth, as described, for example, in the śārīra-sthāna of the Suśruta-saṃhitā in the first half of X.5:

In the ninth month, the woman should be made to enter the birthing house when the stars, the lunar phases, and so on are auspicious. In this case, a sturdy [house should be built] in a place (bhūmi-pradeśeṣu) where the soil is white, red, yellow, or black (śveta-rakta-pīta-kṛṣṇeṣu) [in quality, according to whether the expectant mother is a] Brahman, Kṣatriya, Vaiśya, or Śūdra (brāhmaṇa-kṣatriya-vaiśya-śudrāṇām).

18Thus, color as it exists in hierarchical rank is understood and used in these two texts, not just in the particularized way I have just described, but also in terms of how conception, sex determination, the way in which bodies are put together internally and externally, and the ways in which sexual and other substances are medically configured, coded, and interpreted in these systems.

19In general, white always predominates, with red and other colors ranked below it. White is the color of coolness, celibacy, virility, purity, and goodness, whereas red represents heat, sexuality, permeability, taint, and energy. White is “male” and “closed”; red is “female” and “open”. It is a woman’s redness and openness that cause her susceptibility to all kinds of outside influences, both good and bad, and her porousness and fluidity allow for an exchange to occur in which elements in the environment—sights, sounds, and smells, as well as foods and medicines that are actually prescribed and ingested—all leave impressions in a woman’s body that are incorporated into any embryo that she is actually carrying or soon might be carrying. Therefore, the care and maintenance of a woman who is either trying to conceive or is newly pregnant are formulated along the lines of engineering her redness and openness to produce the best “product” possible, a male child, a material and ritual heir, with desirable physical and mental traits. Also, pregnancy in general is a hot, red state, and the procedures described for a woman whose pregnancy is in trouble basically involve “cooling down” and “whitening” her redness (Selby 2005: 261).

20As a receptacle in pregnancy, a woman’s body must be tempered, patched, and prevented from leaking; it is not to be placed on rough surfaces where it might topple over and void itself of its precious contents. It should not be squeezed, beaten, jostled, or agitated in any way to avoid rippling the liquid, quickening surfaces of what it contains. And if the pot springs a leak, there are sūtras that detail the procedures for what to do if a bloody discharge appears at certain crucial points in a woman’s pregnancy, and it is clear that not only are these procedures specifically “engineered” to plug up or stop leaks with the use of especially prepared tampons and by positioning the woman’s body in ways to stop outward flows. Many of these procedures also conform to the standard medical semiotics of color and heat that I have detailed above. It is also just as important to keep the woman “white” and “cool”, since it appears that exaggerated “redness” and “heat” are the primary causes of miscarriage as understood in this system (ibid.: 262-263).

21In trying to rationalize the āyuredic body, it is important to keep larger, prevailing cultural and intellectual paradigms in mind: āyurvedic humoral theory, obviously, as well as the more ancient hot/cold, agneya/saumya ( “fiery/watery”), red/white polarities that I have discussed above. The medical saṃhitās also exhibit very strong but eclectic philosophical elements, as well, and at this juncture, I would like to explore some specific instances in which philosophical elements, particularly those from saṃkhyā emanation theory, are used to understand and further rationalize the hot/cold body in the contexts of conception and gestation. As I will demonstrate below, the authors of the Caraka—and Suśruta-saṃhitās were using intellectual materials at hand to try to think empirically about the moment of conception. More specifically, how did these authors understand an invisible microcosm—in this case, that contained within a woman’s womb, the garbhāśaya—by using theories about the evolution of a seen and knowable macrocosm? In other words, how did they use early prevalent theories about the creation of the wider world to describe creation in miniature, another cosmogonic event of sorts, but minute and invisible, that of conception in the womb? I will now turn to the necessary task of characterizing the philosophical elements that we encounter in these texts.

Philosophical Aspects of Human Conception

22In his 1990 book Making Sex: Body and Gender from the Greeks to Freud, Thomas Laqueur notes that in older, pre-Enlightenment models of anatomy that the body was viewed as a “microcosm of some larger order” in which each bit of nature was “positioned within layer upon layer of signification”. Laqueur describes these layers as arranged in “hierarchies of analogies” which incorporate (literally) “resemblances that bring the whole world into every scientific endeavor” (Laqueur 1990: 10). These observations can also be applied to early formulations of anatomical models in classical Indian contexts, and the early medical writers in Sanskrit drew upon prevalent philosophical ideas to express the analogies drawn between the human form and the wider world in which it was situated. Without putting too fine a point on it, Julius Jolly (1977: 56) has described the philosophy of the medical authors as “essentially that of the sāṃkhya system”, adding that “according to the principles of philosophy, the soul entering the womb is an emanation of the Universal Being” (ibid.: 66). The śārīra-sthānas ( “sections on the body”) of both saṃhitās, in fact, begin with lengthy disquisitions on sāṃkhya philosophy in their opening chapters. G. Jan Meulenbeld (1999 1A : 38) characterizes the philosophy found in this chapter of the Caraka-saṃhitā as “mainly concerned with Sāṃkhya and Vaiśeṣika doctrines and their application to medical thought” and likewise that of the Suśruta-saṃhitā as being “devoted to an exposition of the Sāṃhkya philosophy and its relevance to medicine” (ibid.: 243).

23As Gerald Larson (1969: 2) writes, the word sāṃkhya itself means “‘reckoning’, ‘summing up’, ‘numeration’, ‘calculation’”, and by extension, “‘inve stigation’, ‘analysis’”, and emphasizes “the enumeration of principles, evolutes, or emergents”. Both Larson (ibid. : 109) and Surendranath Dasgupta (1965, 1 : 212) characterize the type of sāṃkhya found in the Caraka-saṃhitā as representative of “an earlier school”, writing that this version accepts “twenty-four rather than twenty-five principles;” a version that combines “puruṣa (‘anima-principle’) and avyakta (‘primordial element’) into one tattva (‘true principle’)” (Larson 1969: 109) ; essentially, that puruṣa and prakṛti are counted as one (Dasgupta 1965 : 1, 213). Dasgupta notes further that Caraka quotes one of the Vaiśeṣika-sūtras, concluding that the Caraka-saṃhitā was “probably written at a time when the Vaiśeṣika doctrines were undergoing changes and well-known compendiums were beginning to be written on them” (ibid.: 281).

24In a more recent article, Larson (1987: 247) reflects with more care on the nature of the philosophical material found in early āyurveda, adding to the dominant strains of Sāṃkhya and Vaiśeṣika identifiable elements from “Vedānta, Nyāya, Yoga, and early Buddhist and Jain reflection”. Writing on this readily apparent philosophical eclecticism of the texts, Larson states that

there are a number of variations and divergences in the medical texts from the purely philosophical accounts of Sāṃkhya… clearly set forth in the śārīra-sthāna portion of the Suśruta-saṃhitā (III.1.1-23). An allied but divergent Sāṃkhyan interpretation (albeit with a Vedāntin overlay) can also be found in the first portion of the śārīra-sthāna section of Caraka-saṃhitā (IV.1.156) [Larson 1987 : 249-250].

25More usefully, Larson (1987: 257 n3) adds that “the Caraka material in the śārīra-sthāna is clearly a Vedānticized Sāṃkhya, and not at all an early form of pure Sāṃkhya”.

26Larson also speculates on the nature of the relationship between medicine and philosophy as one not of dialogue, but of Weberian “elective affinity”, a notion that

allows for an ongoing exchange between the classical Indian philosophies, on the one hand, and the practice of traditional Āyurvedic medicine, on the other […] one can argue that there was a natural affinity between the naturalistic philosophical systems and Āyurvedic medical practice, which generated a mutually influential pattern of ongoing interaction [Larson 1987: 247-248].

27I would characterize this relationship as far less passive than this, however. I would argue that philosophical elements are often imported into the texts for very precise and specific purposes, as I will demonstrate below in my analysis of how the texts describe systems of communication and exchange between a pregnant woman and her embryo/fetus, as well as the all-important cosmogonic moment of conception in the Caraka-saṃhitā, found in the texts at śārīra-sthāna IV.3-8.

  • 6 All translations from Sanskrit are my own. The text editions that I have used in preparing this ess (...)
  • 7 This is how I have chosen to translate the troubling word kloman, which has been variously rendered (...)

28One of the key sūtras for our understanding of the relationship between mother and fetus occurs at Caraka-saṃhitā, śārīra-sthāna IV.4. The first half of this sūtra provides us with a list of all the ingredients necessary for conception to occur: “The embryo arises from the following assembled entities—a mother, a father, a soul (atman), wholesome habits, chyle, and Mind” (mātṛtaḥ pitṛta ātmataḥ sātmyato rasataḥ sattvata iti etebhyo bhāvebhyaḥ samuditebhyo garbhaḥ saṃbhavati).6 The second half reminds us that different parts of the fetus originate in and correspond to the listed entities, referring us back to a passage found at śārīra-sthāna III.6-7, where we find catalogues of exactly which physical organs are contributed by the mother’s “redness” (her śonita, or blood) and the father’s “whiteness” (his śukra, or semen). The mother contributes skin, blood, flesh, fat, the umbilical cord, the heart, the lungs,7 the liver, the spleen, the kidneys, the bladder, rectum, stomach, the upper and lower parts of the anus, the small and large intestines, the mesentery, and the omentum. The father’s “whiteness” contributes the hair on the head and facial hair, the nails, the small hairs of the body, teeth, bones, veins, ligaments, arteries, and semen. In other words, the “feminine” gives rise to the soft, squishy red parts, the viscera, and the father’s semen gives rise to all that is white, hard, and structural. This red/white coding, by the way, is also operative in certain hymns from the Ṛgveda, so this way of talking about the body is actually quite old (see, for example, Ṛgveda I.164.4).

29Sūtra 5 then defines garbha for us: “Now, when the combination of semen, blood, and soul has settled in the belly, it is then called ‘embryo’” (śukra-śonita-jīva-saṃyoge tu khalu kukṣi-gate garbha-saṃjña bhavati). What follows then at sūtra 6 is an explanation of how the fetus is further derived from the five mahābhūtas (Space, Wind, Fire, Water, and Earth), which serve as a stratum of sorts for the sixth item, the cetanā-dhātu, or “consciousness component”:

Further, the embryo is a product of Space, Wind, Fire, Water, and Earth, which, in turn, are the elements of the foundation for consciousness (garbhas tu khalu antarikṣa-vāyu-agni-toya-bhūmi-vikāraś-cetanā-adhiṣṭhāna-bhūtaḥ). Thus, by means of this combination, the embryo is composed of an aggregate of derivatives from the five great elements, and is itself the element that is the basis for consciousness, said to be the embryo’s sixth component (evam anayā yuktyā pañca-mahābhūta-vikāra-samudāya-ātmako garbhaś-cetanā-adhiṣṭhāna-bhūtaḥ; sa hi asya ṣaṣṭho dhātur uktam).

30What we find in sūtra 7 is a remarkably clinical description of precisely what happens to bodies during intercourse (including an interesting description of male orgasm), and then, what follows is a wild shift in discourse to mark the moment of conception as an internal cosmic “event”, mirroring both in language and in structure the emanation of the cosmos found in various religious and philosophical texts. The first few words of this passage retain a clinical tone: “Then, first of all, the consciousness component, having Mind as its assistant, proceeds to assume characteristics” (tatra pūrvaṃ cetanā-dhātuḥ sattva-karaṇo guṇa-grahaṇāya pravartate). And herein lies the shift (the “it” in the passage refers to the embryo’s cetanā-dhātu:

… for it is the cause, the reason, and the motive; it is undecaying, the maker, the thinker, the knower, the perceiver, the seer, the supporter, Brahmā; the maker of the universe, the form of the universe, Puruṣa, the source, imperishable and eternal; it has qualities, it is the grasper, the chief thing indivisible, the life-essence; intelligence, personality and consciousness; it is omnipresent, the essence of the elementss, the essence of the organes of sense, and the inner essence, as well (sa hi hetuḥ kāraṇaṃ nimittam akṣaraṃ kartā mantā veditā boddha draṣṭā dhātā brahmā viśvakarma viśvarūpaḥ puruṣaḥ prabhavo ‘vyayo nityo guṇi grahaṇaṃ pradhānam avyaktaṃ jīvo jñaḥ pudgalaś cetanāvān vibhur bhūtātmā ca indriyātmā ca antarātmā ca iti). At the time of the taking on of elements, it takes on Space first and foremost before the other elements, just as, when the time of dissolution passes, the undecaying Self, wishing to create the elements and having Mind, as its Motive, emits Space, first and foremost, and then in steps, emits the four other components on the list beginning with Wind, which are more distinct. Then, as the cetanā-dhātu proceeds to take on a body, it takes on Space itself, first and foremost, then in steps, takes on the four other elements beginning with Wind, which are more distinct (sa guṇa-upādāna-kāle ‘ntarikṣaṃ pūrvataram anyebhyo guṇebhya upādatte, yathā pralayātyaye sisṛkṣur bhūtāni akṣara-bhūta ātmā sattva-upādānaḥ pūrvataram ākāśaṃ sṛjati, tataḥ krameṇa vyaktatara-guṇān dhātūn vāyu-ādikāś-caturaḥ, tathā deha-grahaṇe ‘pi pravartamānaḥ pūrvataram ākāśam eva upādatte, tataḥ krameṇa vyaktatara-guṇān dhātūn vāyu-ādikāṃś caturaḥ). The whole act of taking on the elements comes to pass in an atomically minute amount of time (sarvam api tu khalu etad guṇa-upādānam aṇunā kālena bhavati).

31The text then jarringly shifts back into keenly observed, clinical descriptions of the month-by-month progress of the fetus. Sūtras 9-11 read thus:

9. Possessed of all of the elements, and having thereby acquired the characteristics of an embryo, in the first month, it congeals, all of the components are muddied up together, and it resembles phlegm (sa sarva-guṇavān garbhatvam āpannaḥ prathame māsi saṃmūrcchitaḥ sarva-dhātu-kaluṣī-kṛtaḥ kheṭa-bhūto bhavati). Its parts are indistinguishable, with the major and minor limbs being both apparent and unapparent (avaykta-vigrahaḥ sad-asad-bhūta-aṅga-avayavaḥ).
10. In the second month, the embryo is transformed into a dense mass, either knob-shaped, ovoid, or shaped like a tumor
(tṛitīye māsi ghanaḥ saṃpadyate piṇḍaḥ peśi arbudaṃ vā). Moreover, a knob indicates a male, a female is indicated by an ovoid shape, and a shape like that of a tumor indicates a child of indeterminate sex (tatra ghanaḥ puruṣaḥ peśī strī arbudaṃ napuṃsakam).
11. In the third month, all of the organs of sense and and all of the major an minor parts are simultaneously generated
(tritiye masi sarva-indriyani sarva-aṅga-avayavāś ca yauga-padyena abhinirvartante).

32The third month is crucial, for it is at this time when the embryo develops limbs and becomes totally sensate. Prior to this, the embryo “resembled phlegm”, though let us not forget that it is a phlegm-like mass that possesses omniscience. Sūtra 15 demonstrates for us in detail why this is crucial, explaining the consequences for the mother as well as for the embryo. It reads:

At the very time at which his organs of sense are established, he also obtains unchecked sensation in his consciousness; from that time onwards, the embryo quickens, and longs for whatever thing he experienced in his previous lives. This is what the wise term dvai-h¨dayya, or “double-heartedness” (tasya yat-kālam eva indriyāṇi saṃtiṣṭhante, tat-kālam eva cetasi vedanā nirbandhaṃ prāpnoti; tasmāt tadā prabhṛti garbhaḥ spandate, prārthayate ca janma-antara-anubhūtaṃ yat kiṃcit, tad dvai-hṛdayyam ācakṣate vṛddhāḥ). Its heart originates in its mother, and it becomes bound to the mother’s own heart via the vessels that transport chyle to it; therefore, desire (bhakti) quickens to life (saṃspandate) in the both of them through these vessels (mātṛjaṃ ca asya hṛdayaṃ mātṛ-hṛdayena abhisaṃbaddhaṃ bhavati rasa-vāhinībhiḥ saṃvāhinībhiḥ ; tasmāt tayos tābhir bhaktiú saṃspandate). So, for that very reason, the desires of the embryo expressed through double-heartedness must be considered and never ignored (tat ca eva kāraṇam avekṣamāṇā na dvai-hṛdayyasya vimānitaṃ garbham icchanti kartum), for if ignored, then death or deformity of the embryo will occur (vimānane hi asya dṛśyate vināśo vikṛtir vā). And what is more, in regard to certain matters, the mother is regarded on equal terms with the embryo in all matters relating to health and welfare (samāna-yoga-kṣemā hi tadā bhavati garbhena keṣucid artheṣu mātā). Therefore, people who are skilled in these matters care especially for a pregnant woman with liked and wholesome things (tasmāt priya-hitābhyāṃ garbhiṇīṃµ viśeṣeṇa-upavaranti kuśalāḥ).

33Following this passage is another intervention, a clinical list of pregnancy symptoms, then a return to a discussion of dvai-hṛdayya and the repercussions of the voicing of what is interpreted as fetal, not maternal, desire, though these cravings, at least in the grammar of the text, are attributed to her. Sūtra 17 states that whatever she asks for should be given to her, except those things that may damage the fetus. The following sūtra lists things of a potentially harmful nature, and we must note here that all of these items are implicitly or explicitly “red” in quality: no heavy, hot, or “sharp-tasting” foods. A pregnant woman must not wear red clothing (raktāni vasāṃsi) lest she attract attacking gods, demons, or members of their retinues. She must not take wine or meat, nor should she take things that are repulsive to the sense organs, or, interestingly, any other items that elderly women know of and advise against.

  • 8 See Das 2003: 530-535, for an excellent summary of the opinions expressed on the identification of (...)

34The narrative of gestation continues, wherein the text describes the fetus as taking on more and more bulk, becoming stable at the fourth month. Because the garbha takes on more “ballast” as each month proceeds, the woman becomes increasingly thin and sickly, losing body mass, strength, color, and energy. In the eighth month, exchanges of vital fluid (which is how I choose to translate the term ojas for the time being, following Das8) occur between mother and fetus via the same channels used for communicating all that bhakti and desire for substance, and this exchange is viewed as dangerous for the both of them. It can cause a kind of manic depression in the mother, who is exhilarated by the ojas “surges” from the fetus, then depressed when they drop off. The fetus experiences the same surges, exhilarations, and depressions, and for this reason, delivery in the eighth month is considered extremely problematic, called agayṇam, “unreckonable” or “unpredictable” by skilled people.

35The Suśruta-saṃhitā, in its own manner, duplicates the narrative found in its predecessor, including a similar but shorter list of hymn-like elements to mark the moment of conception, at śārīra-sthāna 3.4, followed by discourses on sexual intercourse and sex determination, and the month-by-month “biography” of the growing fetus. It differs in several significant ways, however. The Suśruta-saṃhitā shifts the moment of fetal “quickening” from the third to the fourth month, and therefore, the state of dvai-hṛdayya does not come into the picture until then. More importantly, this text adds some rather fascinating details—I characterized the text at the beginning of this essay as being more “graphic” as well as more freely imaginative, than the Caraka-saṃhitā, and there are some improvisations in these passages that warrant note and discussion. For instance, sūtra 18 warns us that if the desires of the fetus expressed through dvai-hṛdayya go ignored, the results will appear in a child who is paralyzed, hunch-backed, who has crooked limbs, or is stunted or blind.

36There are also lists of omens and indicators found in sūtras 22-28, which act as “predictors” for personality traits and possible future occupations of a child, according to the desired substance, object, or activity. Examples are based on quite predictable correspondences, and echo lists found elsewhere in the Suśruta-saṃhitā and also in its predecessor, where we find lists of things that must be monitored in the categories of diet, environment, comportment, and emotions. Both texts state that all potentially bad influences that may attach themselves to a woman whether she invites them or not must be “sieved away” at any possible place of ingress, where they can enter her body and cause irreversible damage to the child that she is carrying. In other words, anything that is unwholesome or impure in her own sensory range or in her own comportment will be automatically ingested by or imprinted on her fetus, and remade in it with extremely unpleasant and undesirable results through a very regular series of gestalts and correspondences. For example, if a woman longs to see a king, the fetus will grow up to be wealthy and well positioned in life. A mother who longs for silks and ornaments is carrying a future aesthete, and a craving for a visit to a hermitage indicates progeny of a pious, self-controlled nature. Longings for beef, partridge meat, or pork, however, indicate children with bovine, timid, or piggish ways, respectively.

37Is dvai-ṛhdayya a construct in which fetal desire is all, and the maternal “pot” is just that, a vessel that needs to be constantly tempered with cooling, saturating treatments? Or is it a covert strategy to ensure good prenatal care, good maternal nutrition; no beatings or upsets by husbands and mothers-in-law? Or is it mere speculation, as Sudhir Kakar describes it, “deriving from the magico-religious realm”, thereby circling us back to Zysk, that he urges us to take into account when trying to understand the “mother-child unit” in contemporary India in general (Kakar 1981 : 193-196) ? I would suggest, in fact, that these “speculations” are not so much expressions of a belief in “magic” as they are cousins to the same sort of homologous correspondences between microcosm and macrocosm that we find expressed in Sāṃkhya itself.

38These homologies also find strategic expression in rituals, and I would like to present here my translations of the specific sūtras that present elaborate procedures performed for hopeful mothers. These rituals are largely based on colors and characteristics, the relationships and relative hierarchies of which are worked out in intricate detail in the rites and regimens described below. These are found in the Caraka-saṃhitā, śārīra-sthāna VIII.9-14. It is significant that the details of these rites occur in the text after the opening disquisitions on sāṃkhya and the month-by-month gestational narrative, for it is sāṃkhya that acts as a logical filter by which medical phenomena can be linked to ritual logics. The following sūtras describe rituals performed for a woman who is trying to conceive, before she becomes pregnant:

  • 9 See Ṛgveda X.184.1.

9. If she should hope for a desirable son, great, white-complexioned, with amber eyes, vigorous, pure, and endowed with goodness, then, after a bath in clear water, one should mix a concoction of white grains with honey and ghī (clarified, liquefied butter), and shaking it up with the milk of a white cow who has a calf of similar appearance, one should give it to her to drink in a pot of silver or brass at regular intervals continually for seven days (sā ced evam āsāśīta – bṛhantam avadātaṃ hary-akṣam ojasvinaṃ śuciṃ sattva-saṃpannaṃ putram iccheyam iti, śuddha-snānāt prabhṛty asyai mantham avadāta-yavānāṃ madhu-sarpirbhyāṃ saṃsṛjya śvetāyā goḥ sa-rūpa-vatsāyāḥ payasā ’’loṭya rājate kāṃsye vā pātre kāle saptāhaṃ satataṃprayacchet pānāya). Every morning, she should eat food made of rice and barley, having mixed them with yogurt, honey, and either ghī or milk (prātaś ca prātaś ca śāli-yava-anna-avikārān dadhi-madhu-sarpibhiḥ payobhir vā saṃsṛjya bhuñjīta). Then, in the evening, there should be for her use a white dwelling, bed, seat, beverage, clothing, and ornaments (tathā sāyam avadāta-śaraṇa-śayana-āsana-pāna-vasana-bhūṣaṇā ca syāt). Mornings and evenings, she should frequently gaze at a great white bull or a horse of good stock that has been daubed with light-colored sandal-paste (sāyaṃ prātaś ca śaśvac-chvetaṃ mahāntaṃ vṛṣabham ājāneyaṃ vā hari-candana-aṅgadaṃ paśyet). One should regale her with stories that are pleasant [here, saumya, meaning both “white” and “cooling”] and agreeable to the mind (saumyābhiś ca-enāṃ kathābhir manonuku-labhir upāsīta). She should gaze at other women and men who have pleasant ( “white”) forms, words, habits, and manners, and also at any sense objects that are white in color (saumya-ākṛti-vacana-upacāra-ceṣṭāṃś ca strī-puruṣān itarān api ca indriya-arthān avadātān paśyet). Her girlfriends should wait upon her constantly with things that are white and wholesome, and so should her husband (sahacaryaś ca enāṃ priya-hitābhyāṃ satatam upacareyus tathā bhartā), and the two of them should not make the error of having intercourse (na ca miśrībhāvam āpadyeyātām iti). She should adhere to this regimen for seven nights, and on the eighth day, she should take a full head-bath from head to toe (anena vidhinā sapta-rātraṃ sthitvā ’ṣṭhame ’hany-āplutyādibhiḥ saśiraskaṃ). Then, along with her husband, she should dress in white clothing, and should wear white garlands and ornaments (saha bhartā ahatāni vastrāṇy ācchādayed avadātāni, avadātāś ca srajo bhūṣaṇāni ca bibhṛyāt).
10. Then the priest, having considered a spot in a northeastern direction from the house, a place that slopes toward either the east or the north, and smearing the bare ground with a slurry of cow dung and water, then sprinkling it with water, he should build an altar on it (tatra ṛtvik prāg-uttarasyāṃ diśy-agārasya prāgpravaṇaṃ udak-pravaṇaṃ vā pradeśam abhisamīkṣya, gomaya-udakābhyāṃ sthaṇḍilam upalipya, prokṣya ca udakena, vedīm asmin sthāpayet). He should take a seat to the west of it on a pile of undamaged cloth or even on the hide of a white bull, if he is a brahmin; but if he is a kṣatriya, on a tiger skin or on that of an ox; and if he is a vaiśya, on the hide of an antelope or on that of a goat (tāṃ paścimena ahata-vastra-sacaye śveta-ṛṣabhe vā ’py ājina upaviśed brāhmaṇa-prayuktaḥ, rājanya-prayuktas tu vaiyāghre carmaṇy ānaḍuhe vā, vaiśya-prayuktas tu raurave bāste vā). Then, seated, having kindled a fire with sticks of palāśa, iṅguda, udumbara, or madhūka wood, scattering the kuśa grass, and having encompassed the fire with the enclosing sticks, he should strew the area with parched grains and with white and fragrant flowers (tatra upaviṣṭaḥ pālāśībhir iṅgudībhir audumbarībhir mādhūkībhir vā samidbhir agnim uasamādhāya, kuśaiḥ paristīrya, paridhibhiś ca paridhāya, lājaiḥ śuklābhiś ca gandhavatībhiḥ sumanobhir upakiret). Then, having sanctified the ritual water pot with mantras and refining the ghī for the purpose of the oblation, he should situate the list of items beginning with the horse, of the color mentioned above, on all sides (tatra praṇīyodapātraṃ pavitrapūtam upasaṃskṛya sarpir ājyārthaṃ yathā ukta-varṇān ājāneya-ādīn samantataḥ sthāpayet).
11. Then, the woman who desires a son, sitting to the west of the fire and to the south of the brahmin, should undergo the rites along with her husband, yearning for a son in accordance with her wishes (tatra putra-kāmā paścimato ’gniṃ brāhmaṇam upaviśya anvālabhate saha bhartā yatheṣṭaṃ putram āśāsānā). Then the priest, making reference to Prajāpati, should perform the wish-fulfilling rite in order to completely satisfy her hopes for what is in her womb, along with the auspicious prayer beginning with the words, “May Viṣṇu fashion this womb”9 (tatas tasyā āśāsānāyā ṛtvik prajāpatim abhinirdiśya yonau tasyāḥ kāma-paripūraṇa-arthaṃ kāmyām iṣṭiṃ nirvartayed ‘viṣṇur-yoniṃ kalpayatu’ ity anayarcā). And only then, having mixed the milk and grains, should he offer it three times along with the oblation, and he should burn it in accordance with the texts (tataś ca eva ājyena sthālīpākam abhidhārya trirjuhuyād duyād yathāmnāyam). He should give to her the water pot blessed with mantras, instructing her to perform all of her water ceremonies with it (mantra-upamantritam udapātraṃ tasyai dadyāt sarva-udaka-arthān kuruṣva iti). Then, when the rite is finished, she should walk around the fire along with her husband in a clockwise manner, presenting her right foot first (tat samāpte karmaṇi pūrvaṃ dakṣiṇa-pādam abhiharantī pradakṣiṇam agnim anuparikrāmet saha bhartā). Then, imploring the brahmins to recite their blessings, the man should first consume what remains of the oblation, and after him the woman, and they should not leave a remnant of it behind (tato brāhmaṇān svasti vācayitvā ’jyaśeṣaṃ prāśnīyāt pūrvaṃ pumān paścāt strī; na ca ucchiṣṭam avaśeṣayet). Then, the two of them together should have intercourse for eight nights, clad in garments of such qualities listed (tatas tau saha saṃvaseyātām aṣṭa-rātraṃ, tathāvidha-paricchadāu eva ca syātām). In this way, they should produce the son of their desires (tathā iṣṭa-putraṃ janayetām).
12. Moreover, a woman who might hope for a son who is dusky, copper-eyed, with a broad chest and great arms, or a woman who [desires a son] who is black with black hair that is long and soft, pale-eyed, with white teeth, splendid, and self-possessed, these women should follow this same set of rules for oblations for these two types, as well (yā tu strī śyāmaṃ lohita-akṣaṃ vyūḍha-uraskaṃ mahābāhuṃ ca putram āśāsīt, yā vā kṛṣṇa-mṛdu-dīrgha-keśaṃ śukla-akṣaṃ śukladantaṃ tejasvinam ātmavantam; eṣa eva anayor api homa-vidhiḥ). Likewise, all of the items should be the same [as above] save for the color, because the other items to be used for those two types should correspond to the son’s color, according to their hopes (putra-varṇa-anurūpas tu yathā āśīr eva tayoḥ parivarho ’nyaḥ kāryaḥ syāt).
13. But a śūdra woman should only make obeisance to the gods, fire, the twice-born, elders, ascetics, and perfected beings (śūdrā tu namaskāram eva kuryāt (deva-agni-dvija-guru-tapasvi-siddhebhyaḥ).
14. Moreover, whatever woman who might wish for a son of a certain type, having heard of the sort of son that she might desire, should visit various regions with her mind (yā yā ca yathā-vidhaṃ putram āśāsīta tasyās tasyās tāṃ tāṃ putra-āśi·am anuniśamya tāṃs tāñ janapadān manasā ’nuparikrāmayet). Then, whatever woman might desire a son who would take after the men of such and such a region, should be told to adopt the food, pastimes, manners, and dress of the men of those regions (tato yā yā yeṣāṃ yeṣāṃ janapadānāṃ manuṣyāṇām anurūpaṃ putram āśāsīta sā sā teṣāṃ te·āµ janapadānāṃ manuśyāṇām āhāra-vihāra-upacāra-paricchadān anuvidhasva iti vācyā syāt). Such is the procedure, narrated in its entirety, which ensures the great success of the hope for a son (ity etat sarvaṃ putra-āśiṣāṃ samṛddhikaraṃ karma vyākhātaṃ bhavati).

39The brief śūtras that follow, however, remind all concerned reader not to depend solely on ritual for desired results. Śūtra 15 states that the components originating in the five great elements (the mahābhūtas) combine to determine a child’s complexion:

15. But this is by no means the only procedure for the production of a particular complexion (na khalu kevalam etad eva karma varṇa-vaiśe·ya-karaṃ bhavati). The fiery element, as well, along with large portions of the elements of water and ether, is a producer of a white color (api tu tejo-dhātur apy udaka-antarikṣa-dhātu-prāyo ‘vadāta-varṇa-karo bhavati); large components of the elements of earth and wind bring about a black color (pṛthivī-vāyu-dhātu-prāyaḥ kṛṣṇa-varṇa-karaḥ); while all of the elements in equal and abundant proportions produce a dusky color (sama-sarva-dhātu-prāyaḥ śyāma-varṅa-karaḥ).

40This is then followed by a reminder that an ensuing child’s eventual temperament is based on the dispositions of its parents and other elements, as well. Śūtra 16 reads:

16. Again, the causes of particular dispositions of various living creatures (are due to) the dispositions of the mother and father, the repeated news heard by the pregnant woman, and the actions of each individual, which have consequences for any peculiarities of character (sattva-vaiśeṣya-karāṇi punas teṣāṃ teṣāṃ prāṇināṃ mātā-pita-sattvāni antarvatnyāḥ śrutaś ca abhīkṣṇaṃ sva-ucitaṃ ca karma sattva-viśeṣa-abhyāsaś ca iti).

41The procedure for the puṃsavana ritual is then explained in some detail at VIII.19. The puṃsavana is performed for a newly-pregnant woman, and as it will become clear, it is relevant to my argument, for it is this particular ritual that is situated at the juncture at which so many things culminate, for here, sāṃkhya-based homologies, medical ministrations, and ritual techniques all come together in one single prescribed procedure:

  • 10 This is a particularly auspicious lunar conjunction, during which it is believed that medicines eit (...)
  • 11 I observed a puṃsavana ritual in Chennai in the summer of 2003. It seems that nowadays, the ritual (...)

19. The changing of the two sexes is specified with a rite that is proclaimed in the Vedas [specifically, the gṛhya-sūtras] and properly utilized before the embryo’s sexual characteristics become distinct (tayoḥ karmaṇā veda-uktena vivartanam upadiśyate prāg-vyaktībhāvāt prayuktena samyak). For indeed, the desired result of the rites undertaken under excellent conditions of place and time is inevitable, but if other than this, a different result [will be gained] (karmāṇāṃ hi deśa-kāla-saṃpad-upetānāṃ niyatam iṣṭa-phalatvam, tathā itareṣām itaratvam). So, seeing that the woman has conceived an embryo, one should administer to her the rite for ensuring male progeny before the embryo becomes distinct (tasmād āpannagarbhāṃ striyam abhisamīkṣya prāg-vyaktībhāvād garbhasya puṃsavanam asyai dadyāt). Plucking two buds from an eastern and a northern branch of a banyan tree growing in a cow-pen along with two measures of grain in perfect condition or with two measures of white mustard seed, and casting it in yogurt, she should drink it during the asterism of Puṣya10 (goṣṭhe jātasya nyagrodhasya prāg-uttarābhyāṃ śākhābhyāṃ śuṅge anupahate ādāya dvābhyāṃ dhānyam āṣābhyāṃ saṃpad-upetābhyāṃ gaura-sarṣapābhyāṃ vā saha dadhni prakṣipya puṣyeṇa pibet). In addition, having prepared pastes of jīvaka, ṛṣabhaka, apāmārga, or similar herbs, she should drink them with milk, either all together or serially, as desired (tathā eva aparāñ jīvaka-ṛṣabhaka-apāmārga-sahacara-kalkāṃś ca yugapad ekaikaśo yathā iṣṭam vā ’py upasaṃskṛtya payasā). Casting a kuḍya insect or a tiny fish in a handful of water, she should drink this in the asterism of Puṣya (kuḍya-kīṭakaṃ matsyakaṃ vā udaka-añjalau prakṣipya puṣyeṇa pibet). Then, casting little men the color of fire and atom-sized, which have been fashioned of gold, silver, and iron into yogurt, milk, or a handful of water, she should drink this in the Puṣya asterism, not leaving a drop behind (tathā kanaka-mayān rājatān āyasāṃś ca puruṣakān agni-varṇan aṇu-pramāṇan dadhni payasy udakāñ jalau vā prakṣipya pibed anavaśeṣatā puṣyeṇa). Also, in the same Puṣya asterism, having inhaled the vapor from boiling rice flour, and having placed the essence of water mixed with the flour of this very mixture on the threshold, she should dribble this herself into her right nostril, using a piece of cotton (puṣyeṇa eva ca śāli-piṣṭasya pacyamānasya uṣmāṇam upāghrāya tasya eva va piṣṭasya udaka-saṃsṛṣṭasya rasaṃ dehalyām upanidhāya dakṣiṇe nāsāpuṭe svayam āsiñcet picunā). And whatever else that brahmins or authoritative women might say as appropriate for the puµsavana ritual, that should be done, as well (yac ca anyad api brāhmaṇā brūyur āptā vā striyā puṃsavanam iṣṭam tac ca anuṣṭheyam). Thus are the rites for the puṃsavana (iti puṃsavanāni).11


42Ultimately, these materials indicate to me a real need to reassess the ways in which we think about personality formation, conception, and female “agency”, in a sense, in the South Asian classical world. One particular problem that these gestational narratives have presented for me has to do with the questions pertaining to the “moment of conception”. Both texts understand a “moment” of conception in the coming together of semen, blood, and life-essence (śukra, śonita, and jīva), and both texts celebrate it with hymn-like praises of the imperishability and utter omniscience of the cetanā-dhātu in that marked shift of discursive register. But the redness of a woman’s body prior to conception is also of utmost importance, for it is during menstruation when she is susceptible to forces that leave impressions in her body which, in turn, show up as “stamps” upon the personalities and physical traits of any ensuing issue, and, as I have demonstrated above, practices of a ritual nature have been imported into the texts to reinforce practices that might be categorized as more “medical” in nature in order to ensure desirable results; again, based on homologic correspondences.

43This implies, at least to me, that “conception” is an on-going process in a post-pubescent woman’s body, where future habits, traits, and emotional tendencies are laid down in intricate strata of gestalts in her womb— “hierarchies of analogies”, as Laqueur would call them—and this, coupled with the dvai-hṛdayya formulation after the first trimester, leads me to argue for a construction of personality development that begins with a woman’s menstrual period, continues with that actual moment of “conception” so marked and celebrated by both texts, manipulated and reinforced by ritual interventions, and is further developed by the fetus itself through its own constant demands for sensory gratification after it becomes sensate. All of these factors are tied up with a woman’s redness, the openness and unbounded nature of her form, which allow her, either unwittingly or intentionally, to absorb, going in one direction, factors that have direct consequences for her child, and it is the redness of dvai-hṛdayya, as well, traveling in the other, outer direction, which allows the fetus to “make himself” as he sees fit, and ensuring his survival by eliciting constant attention to his mother’s care, desires, and own physical needs. I have come to view female redness as the feminine attribute that creates knowledge pathways—these are not just channels for substance, for mutual affection, or for the assertion of an incessant fetal desire. A woman’s redness also creates channels and rivulets through which there is constant two-way traffic of desire, information, traits; ultimately, a subtle feminine way of knowing the world and of remaking the world within.



Sanskrit Texts

Agniveśa. Caraka-saṃhitā: Text with English Translation and Critical Exposition, R. K. Sharma B. Dash, tr. 7 vols. Varanasi ( “Chowkhamba Sanskrit Series Office”), 1976-2002.

Agniveśa. The Charakasaṃhitā of Agniveśa. Revised by Charaka and Dṛidhabala. With the “Āyurveda-dīpikā” commentary of Chakrapāṇidatta. Edited by Vaidya Jādavaji Trikamji Āchārya. 4th edition. Delhi, Munshiram Manoharlal Publishers Pvt. Ltd., 1981. (Repr. of the 1941 Nirnaya Sagar Press ed.)

Suśruta. Suśruta saṃhitā of Suśruta with the Nibandhasaṅgraha Commentary of Śrī Ḍalhaṇācārya and Nyāyacandrika Pañjikā of Śrī Gayadāsācārya on Nidānasthāna, J. Trikamjī & N. Rām, eds. Varanasi, Krishnadas Academy, 1998. (Repr.)

Suśruta. Suśruta-saṃhitā with English Translation of Text and Ḍalhaṇa’s Commentary along with Critical Notes, P. V. Sharma, transl. & ed., 3 vols. Varanasi, Chaukhambha Visvabharati, 1999-2001.

Secondary Sources

Basham, A. L. (1976), “The practice of medicine in Ancient and Medieval India”, in C. Leslie, ed., Asian Medical Systems. Berkeley, University of California Press, pp. 18-43.

Bodewitz, H. W. (1992), “Belly, pelvis, buttocks or cheeks? Vedic Kukṣī (Dual)”, Indo-Iranian Journal, 35 (1), pp. 19-31.

Carson, A. (1990), “Putting her in her place: woman, dirt, and desire”, in D. Halperin, J. Winkler, & F. Zeitlen, eds., Before Sexuality: The Construction of Erotic Experience in the Ancient Greek World. Princeton, Princeton University Press, pp. 135-169.

Das, R. P. (2003), The Origin of the Life of a Human Being: Conception and the Female According to Ancient Indian Medical and Sexological Literature. Delhi, Motilal Banarsidass.

Dasgupta, S. ( [1922] 1965), A History of Indian Philosophy, 5 vols. Cambridge, Cambridge University Press.

Filliozat, J. (1964), The Classical Doctrine of Indian Medicine. Delhi, Munshiram Manoharlal.

Flood, G. (1996), An Introduction to Hinduism. Cambridge, CUP.

Jamison, S. (1987), “Linguistic and philological remarks on some Vedic body parts”, in C. Watkins, ed., Studies in Memory of Warren Cowgill (1929-1985). Berlin, de Gruyter, pp. 66-91.

Jolly, J. (1977), Indian Medicine; transl. from German by C.G. Kashikar. Delhi, Munshiram Manoharlal.

Kakar, S. (1981), The Inner World: A Psycho-analytic Study of Childhood and Society in India. New Delhi, Oxford University Press.

Laqueur, T. (1990), Making Sex: Body and Gender from the Greeks to Freud. Cambridge, MA., Harvard University Press.

Larson, G. (1969), Classical Sāṃkhya: An Interpretation of its History and Meaning. Delhi, Motilal Banarsidass.

Larson, G. (1987), “Āyurveda and the Hindu philosophical systems”, Philosophy East and West, 37 (3), pp. 245-259.

Martin, E. (1992), The Woman in the Body: A Cultural Analysis of Reproduction. Boston, Beacon Press.

Meulenbeld, G. J. (1974), The Madhavanidāna and its Chief Commentary: Chapters 1-10, Introduction, Translation and Notes. Leiden, E. J. Brill.

Meulenbeld, G. J. (1999-2002), A History of Indian Medical Literature, 5 vols. Groningen, Egbert Forsten.

Monier-Williams, M. (1996), Sanskrit-English Dictionary. Varanasi, Indica Books. (Repr. of the 1872 ed.)

Selby, M. A. (2005), “Narratives of conception, gestation, and labour in sanskrit āyurvedic texts”, Asian Medicine: Tradition and Modernity, 1 (2), pp. 254-275.

Smith, F. M. (2006), The Self Possessed: Deity and Spirit Possession in South Asian Literature and Civilization. New York, Columbia University Press.

Stork, H. (1992). “Mothering rituals in Tamilnadu: some magico-religious beliefs”, in I. J. Leslie, ed., Roles and Rituals for Hindu Women. Delhi, Motilal Banarsidass, pp. 89-105.

Wujastyk, D. (2003), The Roots of Āyurveda: Selection from Sanskrit Medical Writings. London, Penguin Books.

Wujastyk, D. (2004), “Agni and Soma: a universal classification”, Studia Asiatica: International Journal for Asian Studies, IV-V, pp. 347-370.

Zimmermann, F. (1987), The Jungle and the Aroma of Meats. Berkeley, University of California Press. (Orig. ed. 1982.)

Zysk, K. (1991), Asceticism and Healing in Ancient India: Medicine in the Buddhist Monastery. New York, OUP.

Zysk, K. (1993), Religious Medicine: The History and Evolution of Indian Medicine. New Brunswick, N.J., Transaction Publishers.


1 For the various arguments on the historical identities of these two authors, see Meulenbeld 1999-2002, vol. 1A: 105-115 and 333-351. Meulenbeld states that the philosophical inflections found throughout the Caraka-saṃhitā indicate that “the author called Caraka cannot have lived later than about A.D. 150-200 and not much earlier than about 100 B.C.” (ibid.: 114). The identity of Suśruta, most likely a composite figure, is much more difficult to establish. Meulenbeld (ibid.: 342) proposes that Suśruta is a “literary fiction”. The name can mean “the famous one” or one who has “listened well” to his own preceptors.

2 Basham 1976, 20-21. As Wujastyk (2003: 3-5; 63-64) cautions us in his medical reader, it is most difficult to establish dates for these texts, because they contain a great deal of material that was added by various redactors to what may very well have been core textual fragments. For further elaboration and speculation on the dates of these texts, see the opening chapters of Zysk 1991, especially: 13-17 and 21-33. Also see Meulenbeld 1999-2002, vol. 1A: 105-115 and 350-352 for a discussion of the chronological relations between the Caraka-saṃhitā and the Suśruta-saṃhitā. Meulenbeld presents arguments that show that the Suśruta-saṃhitā could be earlier or later than the Caraka-saṃhitā, but is inconclusive about a date for the former. He does remark, however, that the Hārīta-saṃhitā, a later work, understands the Caraka-saṃhitā to be the Suśruta-saṃhitā’s predecessor, although in terms of yugas (eons) rather than mere centuries. Meulenbeld (ibid.: 351) also notes that “[m]ost scholars regard Suśruta as later than Caraka and describes the Caraka-saṃhitā as possibly belonging to “the waning stages of the Mauryan empire or the period of the Śuṅgas” (ibid.: 112). Basham (1976: 33) dates the Suśruta-saṃhitā to the Gupta period.

3 Basham 1976: 27. For more elaboration on a variety of surgical procedures, as well as excellent translations of pertinent passages from the Suśruta-saṃhitā, see Wujastyk 2003: 65-72, 83-109.

4 Inspired by Zimmermann 1987, I am paying less attention to the literary conventions, structures, and effects that he means by the use of this term. I use the word “poetics” in a broader cultural sense that seems to be grounded simultaneously in texts as well as in practice; a poetics that is therefore probably more akin to what we might call “cultural semiotics”.

5 For a full treatment of the role of menstrual fluid in conception, see Das 2003 passim, but see especially the materials summarized in Das’s conclusion, (ibid.: 487-495).

6 All translations from Sanskrit are my own. The text editions that I have used in preparing this essay are included in my list of references. The numberings follow these specific editions.

7 This is how I have chosen to translate the troubling word kloman, which has been variously rendered as “lung” (as I do above), “pancreas”, “gall bladder”, “trachea”, or “pharynx”. Several commentators seem to agree that this organ is somehow related to thirst. The kloman, according to Cakrapāṇidatta, is the pipāsā-sthāna, the “place where thirst is located”. See his commentary on Caraka-saṃhitā, śārīra-sthāna VII.10. I would hazard that kloman is probably a word whose meaning is governed by context, and as translators of these texts, we must try to imagine the context of specific observers and what they might have seen in relation to other organs or groups of organs in making their particular formulations. See also Meulenbeld 1974: 338, 457-458.

8 See Das 2003: 530-535, for an excellent summary of the opinions expressed on the identification of this substance by a wide variety of authorities.

9 See Ṛgveda X.184.1.

10 This is a particularly auspicious lunar conjunction, during which it is believed that medicines either concocted or consumed will become more efficacious. See Stork (1992: 92).

11 I observed a puṃsavana ritual in Chennai in the summer of 2003. It seems that nowadays, the ritual is performed as a part of other ceremonies done on behalf of a pregnant woman in the late stages of pregnancy, rather than prior to quickening, as the gṛhya texts prescribe. When I interviewed the participants afterward, the mother-to-be reported that she had no idea that this ritual was done to ensure the birth of a son. When I asked her about the ministrations that were specifically performed on her (which were done out of my view behind a white sheet), she reported that the substances dribbled into her right nostril “stung a little”. In this case, the ritual “worked”: a son was born to the couple six weeks later.


Associate Professor of South Asian Studies at the University of Texas (Austin), her specialties include Tamil, Sanskrit, and Prākrit poetry and poetics, as well as representations of women and gender dynamics in classical-period texts.

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