Preface- Charak Samhita New Edition

Charak Samhita is the core text of ancient Indian medical system - Ayurveda. It is indeed a moment of great pleasure to present this first edited version of Charak Samhita. This is the result of cumulative efforts of seven years by over 150 ayurvedic scholars since its inception in 2013.

Preface -Charak Samhita New Edition

Author	Dr. Gopal Basisht MD, Orlando, Florida, USA
Affiliation	Chief Editor, Charak Samhita New Edition, Charak Samhita Research, Training and Development Centre
Correspondence email	carakasamhita@gmail.com
Date of publication	15 October 2020
DOI	10.47468/CSNE.2021.e01.s09.059

Current scenario

In early years of last century, there was prevalence of acute infectious diseases like cholera, polio etc. and millions of people lost their lives and suffered from disability. Thanks to discovery of antibiotics that many of those diseases have been eradicated and average lifespan of people in the world has increased. Besides infectious diseases there have been great advancements in treatment of disease like cancer, surgical procedures, transplants to name a few. In spite of such progress, diseases are increasing, and more people are suffering and healthcare costs are skyrocketing. The current, so-called healthcare system is dominated by allopathic system which is mainly the disease care system and has a system to recognize a disease by identifying the physical symptoms, signs and laboratory abnormalities. The system works mainly by answering four questions:

1. What disease is causing the symptoms? (diagnosis)
2. What is causing the disease? (etiology)
3. What is the effect of disease on body? (pathology and pathophysiology).
4. What modality to use to remove or control disease? (treatment)

In other words, we identify the disease and try to remove it? Which is an offense strategy. This is like arresting more and more criminals in a crime infested society without working on its deranged societal conditions. We understand the solution for such crime infested areas is to improve the “Health” of such neighborhoods besides punishing the criminals. For prevention of diseases or to have defence strategy, system needs to identify the “symptoms and signs of health” which are not clear to the modern healthcare system and thus lacks the preventive strategy. In order to win war against disease we must have dual strategy of offense and defence. On the other hand Ayurveda has comprehensive understanding of health as described by Charak and Sushruta where five components of health are described as follows:

• Three dosha (interaction between epigenes and genes)- vata, pitta, and kapha - are the fundamental physiological governing regulators of the body,
• Agni (metabolic and digestive processes) This is characterized by interactions down to the subcellular level.
• Dhatu (principles that uphold the formation of body tissues) This includes but is not limited to bodily fluids, muscular, adipose, bony, and nervous tissue.
• Mala or bodily wastes produced to be recycled by or expelled from the body, and
• The state of sense organs, mind and the Soul.

A trained Ayurvedic physician can clinically identify disequilibrium of these factors and rectify them to prevent disease.

Relationship of humans with environment

In addition to understanding the concepts of equilibrium within a physical body, Ayurveda explores the relationship of the body in the context of the environment in which humanity exists today. In order to make sense of the relationship that humanity has with the environment we need to examine the 3 main challenges that threaten our co-existence with the ecosystem around us:

1. Rising incidence of chronic and autoimmune diseases, while newer diseases are emerging.
2. Increasing polarity/discord in the thinking of people in the society and increasing violence.
3. Environmental degradation evidenced by global warming, pollution, melting of glaciers and polar ice caps.

In this paradigm we must dissect the relationship among these 3 separate challenges to determine if there is a single causative factor and a common, workable solution.

Vedic scholars in India for thousands of years have known a concept - Yatha Pinde Tatha Bramhande - meaning that the state of a human body corresponds to – or mirrors - the state of the universe. In other words, a human being is a microcosm of the universe or the planet. Leonardo Da Vinci compared human organs and tissues with nature. His Vitruvius Man reflects this same concept, of a man as a microcosm and the world as a macrocosm. The common causative factor for the abovementioned challenges is the deteriorating health of the humans, the society and the planet. Considering the above viewpoint, it can be argued that if the health of human beings improves, the other two challenges should also get sorted.

Offense and defence strategies

Health is defined by the World Health Organization (WHO) as physical, mental, and social well-being, not merely the absence of disease or infirmity. This is a broadly inclusive definition of health and implementation of the roadmap to achieve this goal has to be actionable. The most effective way to attain this goal is to employ strategies both for the treatment of disease (offense strategies) and prevention or the restoration of health (defence strategies) at the same time. Healthcare providers should be trained to assess the following nine key factors according to combined offense and defence strategies.

Components of Offense system	Components of Defence system
Diagnosis	Equilibrium of three dosha
Etiology	Equilibrium of agni
Pathology/Pathogenesis	Equilibrium of dhatu
Treatment	Proper excretion of mala (waste products)
--	Blissful state of mana (mind), indriya(five senses) and atma (soul)

I practiced modern medicine for fifty years. When I started using this system in my practice, I call Symbiohealth, I found better results. The dose of medicine required, started to come down and in many patients the disease went into remission. Thus, an effective implementation of both these strategies would help attain the physical, mental and social well-being of individuals and communities, while decreasing the incidence of occurrence of diseases. Such a system would certainly be more sustainable, less expensive, more effective, and less toxic leading to healthier people, the society and the planet. The foundational base of any proposed system is its core treatise or reference manual used for practice. Allopathy has many advanced texts to refer, but Ayurveda has a few and have not been updated.

Need for a new edition of Ayurveda compendiums

Ayurveda, the science of life, is known for centuries in its original Sanskrit textual form. This science of lifecare, healthcare and disease care has not been updated since centuries. With increasing urbanization of societies, dietary habits, lifestyle patterns, social structures, geographical distributions of medicinal flora, etc. have enormously changed. However, still the ancient Ayurveda medical system is following same Sanskrit texts for defending the newer challenges. The principles of Ayurveda are universally applicable and have potential to help humanity to live healthy and happy life. Therefore, the edition of ancient compendium to make them contemporarily applicable in today’s era is need of the hour. Charak Samhita is the most referred text of Ayurveda. This attempt to update ancient text Charak Samhita was started with the help of Ayurveda experts in the year 2013. The methods followed and details of earlier phases can be read on the link of Charak Samhita New Edition Project.

First ever collaborative work in Ayurveda

In recent past, mainly English translations of Charak Samhita have been published by authors in print format. However, the translations are person centric and thus limit the presentation to individualistic wisdom of that scholar. This also limits the authenticity and scientific validity of the work. Proposition, debate, critical comments, acceptance or rejection and continuous improvement after being examined by reviewers is the process of establishment of any scientific theory as documented by Charak in Vimana Sthana. The present Charak Samhita New Edition is the first ever collaborative edition of any Ayurveda compendium following the original traditional methods described in Ayurveda. More than 150 experts of Ayurveda have contributed in various capacities of translator, commentator, editor and reviewer in this edition to make the content diversified, yet precise. This edition proposes to validate age old theories of Ayurveda through the research methods described in the text and acceptable to current society. The online edition is already available for open access in wiki format. This electronic edition is made available for scholars to help in offline reading and referencing.

Unique features of Charak Samhita

Charak Samhita includes many important concepts which are unique and helpful to understand human biology. The concepts of holistic human being (purusha), basic constitution of individual (prakriti), five fundamental elements (panchamahabhuta), physiology of digestion and metabolism (agni), adaptability (satmya) are some of the concepts which add to medical knowledge database. These concepts are researched and published in the form of monographs. If these concepts are kept in mind, while doing research, we can develop a more comprehensive system of medicine.

Concepts and Contemporary practices

A separate section on such important concepts and their contemporary practices is developed in this edition and monographs are published in this edition for better understanding. The monographs include literary review of concepts in Ayurveda texts, research done on the topic followed by contemporary practices. This can form a bridge between the two medical systems and lead to better symbiotic research.

Future vision

In the present edition, the core concepts of Charak Samhita in its original form are focused in the content up to tattva vimarsha part. However, the vidhi vimarsha part i.e. the clinical applications and research updates is still in progress. As we say, the online version of Charak Samhita is a live edition, vidhi vimarsha of every chapter and content is continuously being updated with contemporary researches. We intend to publish the offline electronic version with the updates periodically. The technological features are adopted to make the text better understandable. Audio visual recordings of deliberations by experts is also in progress, so that the classical Sanskrit texts can be better understood in contemporary biomedical language. The Charak Samhita Research, Training and Skill Development Centre is established for this purpose. We invite interested scholars to contribute to the live edition and be a part of this journey. I wish this continuous update of Ayurveda text Charak Samhita be ideal reference manual to make healthcare system even better across the globe.

Sanskrit is a very rich language with largest vocabulary of all languages, thus it becomes difficult to translate accurately. Efforts have been made to be accurate.

We extend an invitation for interested scholars to contribute to the live edition and be a part of the journey to make this information dynamic, improving the translation of ancient text, and updating the Charak Samhita in the context of the world in which we live to improve healthcare across the globe.

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