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Speculations in the Medical Schools [ch. various names is an old subject in Ayur-veda literature existing before Caraka, from which Caraka collected them.
We know that Ayur-veda was primarily concerned with three questions, viz. how diseases originated, how they were known, and what were their cures. It was in this connection that the principle of causality was first from a practical necessity applied in Ayur-veda. Thus, if it is known that a person has been exposed to sudden cold or has enjoyed a heavy feast, then, since it is known that cold leads to fever and over-feeding to indigestion, with the very first symptoms of uneasiness one may at once infer that the patient is likely to get fever or to have diarrhea or acute indigestion. Or, if it is known that the patient has a strong diarrhea, then it can similarly be inferred that he has eaten indigestible articles. Thus the two principal kinds of inference which were of practical use to the Ayur-veda physicians were inference of the occurrence of a disease from a knowledge of the presence of the causes of that disease, i.e. from cause to effect, and inference of the specific kinds of unhygienic irregularity from the specific kind of disease of the patient, i.e. from the effect to the cause. The other and third kind of inference is that of inference of disease from its early prognostications (pūrva-rūpa). Cakrapāņi, in commenting on the possibility of inference of specific diseases from their early specific prognostications, compares it with inference of rain from an assemblage of dark clouds or of the future rise of the Kșttika constellation from the rise of the constellation Rohiņī, which immediately precedes it. Both these are cases of inference of future occurrences of causation or coexistence. The prognostication may, however, be of the nature of an immediately and invariably associated antecedent which may drop altogether when the disease shows itself. Thus before a high fever the hair of the patient may stand erect; this standing erect of the hair in a specific manner is neither the cause nor is it coexistent with fever, since it may vanish when the fever has actually come. It is, however, so invariably associated with a specific kind of fever that the fever can be inferred from it. Again, when there is any doubt among a number of causes as to which may be the real cause of the disease, the physician has to employ the method of difference or
i These two kinds of pūrva-rūpa are thus described by Cakrapāņi in his commentary on Caraka-samhitā, ii. 1.7: tac ca pūrva-rūpam dvi-vidham ekam bhāvi - vyādhy-avyakta - lingam...dvittyam tu dosa-dūşya - sammürchanā-janyam avyakta-lingad anyad eva yathā jvare bāla-pradveşa-roma-harşādi.