Ancient Science of Life, Vol No. VI No.

3 January 1987, Pages 129 - 134

KARMA AND AYURVEDA*

MITCHELL G WEISS

Harvard Medical School, Department of Social Medicines and Health Policy Department of
Psychiatry, Cambridge Hospital – 1493 Cambridge Street – Cambridge, Massachusetts
02139 United States of America
* Paper presented to the International Conference on Traditional Asian Medicine, Canberra,
Australia, (1979)

Received: 14 March 1986 Accepted: 20 July, 1986

ABSTRACT: Belief in the role of Karma explains a variety of Phenomena in India. For a
traditional medical system such as Ayurveda, the conflict between simultaneously held beliefs in
fatalism and the efficacy of medical interventions poses an interesting dilemma that the tradition
has taken pains to consider. Caraka Samhita discusses the role of karma as a determinant of the
qualities and personality of the individual, lifespan, etiology of illness, and otherwise personality
of the individual, lifespan, etiology of illness, and otherwise incomprehensible epidemics. Such
speculations produce practical solutions to the dilemma, and these solutions in turn enhance the
medical doctrine.

The formulation of the karma doctrine actions in previous incarnations of the

according to Ayurveda responded to an person whom the fetus will become and
inherent conflict between a belief in fatalism actions of the expectant parents that may
and faith in the efficacy of therapeutic influence the sex, character and health of
interventions: that is, if etiologic forces by their child.
themselves are the sole determinants of the
course and outcome of one’s illness, then it As in the Puranas and elsewhere in Sanskrit
follows that interventions are useless, and literature, Karma and fate (daiva) are
medical treatment loses its viability. The equated and used interchangeably. These
medical treatment loses its viability. The are contrasted with actions in the present life
medical system has never been challenged (Purusakara) (Caraka Samhita [Car]
as an integral part of the culture; but deeply 3.3.30). Procedence by one or the other
rooted ideas about the immutability of the depends upon their relative strength.
influence of karma survive, providing a According to Atreya Punarvasu, the sage
rationable for incurable or otherwise who articulates the oldest strata of the
unexplainable illnesses. The Classical medical doctrine in Caraka Samhita, there
treatises of Ayurveda also consider the are three kinds of karma: the weak from
influence of karma in chapters concerned hina is overcome by individual action, the
with development of the embryo during strong form (uttama) overcomes individual
gestations and the process of its becoming a action, and there is also a middle form
person with a distinct personality. One finds (Madhya) (Car 3.3.31, 33 – 34).
a degree of tension between the influence of

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Antecedents to the Birth of a Person and in a child with a urinary disorder and so
Personality forth (Car 4.8.21).

In the Ayurvedic texts, two factors Among the factors determining the childs
determine the sex, character, and health of a character (sattva), Ayurveda refers to karma.
child at birth: the influence of the (yet Other determinants include activities of the
unborn) child. Karma may be a critical expectant mother, as we have indicated,
determinant in the latter case. Because of its personalities of both parents, what is heard
interest in issues with practical implications, by the woman at the moment of conception
Caraka considers the influence of the parents and several other factors (Car 4.8.16).
in some detail. The text offers elaborate Actions of the father prior to conception
instructions intended to help a couple influence the offspring through their effects
achieve pregnancy and impede obstacles to on the father’s semen. According to the
it (Car. 4.4.41). To produce a son Caraka theory of conception articulated in the
(4.8.5) advises that a couple should copulate (sarirasthana) section of the Ayurvedic
only on even days following the onset of texts, a viable embryo (garbha) results from
menstruation, and for a daughter they should the successful union of semen (sukra) and
copulate on odd days (Car 4.8.5). A woman menstrual blood (artava) etc. When blood
should not lie prone or on either side during predominates a girl is formed, when semen a
intercourse, because phlegm (Slesman) boy. Karma also explains the birth of twins.
might sbstruct the passage of semen to the It may cause the semen – blood complex to
womb, or the semen might be burned by pile split and a multiple birth will occur (Car
(pitta) in that position (Car 4.8. 6ff). 4.2.12 – 16). The texts refer to karma to
Reciting mantras will help a woman achieve explain eight sexual abnormalities,
pregnancy and bear a child with desirable developmental and functional, including
qualities. She should eat special hermaphroditism, abnormality situated
preparations of rice and barely and gaze (ectopic) testes, importance, infertility, and
upon a white stallion or bull. Caraka several others (Car 4.2.21).
recommends various other rituals and
procedures reminiscent of Dharmasastra Caraka advises that one can predict an
(Car. 4. 8. 8 – 9ff). infant’s life expectancy at birth from various
signs such as the quality of skin and scalp
The pregnant woman should avoid certain hair, size of the head, facial features and
activities or suffer specific consequences. various anatomical relationships (Car 4. 8.
For example, one who sleeps without a 51). Other sings might indicate particular
cover or goes about in the nude will bear medical problems that would develop in due
insane offspring; a shrewish quarrelsome course, and these are attributed to fate
woman will give birth to an epileptic; the (daiva), which is equivalent to karma (Car
child of an alcoholic becomes a drunk, will a 5.1.7). Some of these signs are not
bad memory or become insane; a woman necessarily present at birth but could be
who eats the meat of a lizard will bear latent and might appear at any time.
offspring with kidney stones or other urinary
disorder; a woman who eats too much fish A viable embryo must have five
will bear a child with a fixed gaze who constituents, without which the development
rarely blinks; addition to sweets will result of the fetus cannot proceed. Contributions
from the mother (matrja) and father (pitrja)

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nutrients individual self (atman) through proper; he doesn’t fight and he doesn’t
which the influence of karma is manifest, forget. Varuna type seems to indicate a
and a constitutional integrity (satmya) certain strength of character. He is resolute,
binding these together, which is responsible clean, intolerant of fifth, fastidious in the
for health, clarity and virility (Car 4.3.11). performance of sacrifices, and in control of
Blood, fat, heart, lungs and other vital his anger and tranquility. Kubera type
organs derive from maternal contributions; commands honor and attendants. He is
from the father come hair, beard, nails, teeth emotional and enjoys his leisure and
and muscle. The fact of arising in a pleasures. Gandharva traits indicate a man
particular womb, life span, intellect, instinct, who is fond of laughter, dancing, music and
emotion and a sense of self are each stories; he is well-versed in Itihasa and
governed by the atman. Nourishment is Purana, and he likes garlands, women and
responsible for the formation and growth of sport.
the body, maintaining life, satiety and
strength (Car 4.3. 12), and nourishment is There are six categories in the rajasa class,
essential for both pregnant mother and each identified with stereotyped classes of
foetus of fetus. Sattva specifies an demons, manifesting some degree of
individual’s intellectual and emotional antisocial and otherwise undesirable
character, and it arises spontaneously from behaviour. The Asura is fierce,
atman in a given birth and departs at death; contemptuous of others, lordly, deceitful and
it also influences the manifestations of easily enraged. He is self-serving and lacks
atman in the next birth. When pure it admits compassion. Raksasa type is even worse,
memory of past incarnations, and Caraka highly tolerant and not just easily enraged,
identifies sattva as the essential determinant but always enraged. He is faultfinding,
of an individual’s particular personality cruel, fond of meat, gluttonous, jealous and
traits. Karma is primarily a property of lazy. Pisaca type is also gluttonous and
atman, but it also mediates other effeminate. He is filthy, crowardly and a
manifestations of atman and is associated bully. The Sarpa (snake) personality is
with sattva (Car 4.3. 17). powerful when angry but otherwise
cowardly and often lazy. He may frighten
Caraka Samhita (4. 4. 37 – 39) discusses others in the area and considers his own
three classes of sattva: pure (sudha), food and pleasure above all else. The preta
impassioned (rajasa) and foolish (tamasa), (ghost) type has a morbid character. He
and from these three proceed a variety of likes food and is jealous and selfish. Sakuna
personality types. They are also associated (bird) type refers to a hedonist, forever
with specific types of body build, but the preoccupied with pleasure. For him food
text provides no further details. Character and sport come first; he is unstable and
types under the sudha class are named after impatient, living from moment to moment,
deities. Brahama personality is pure, without concern for the past or future.
truthful, wise and free of passions. Rsi
(sage) type is devoted to sacrifices, study, Among the three tamasa categories of sattva
vows and similar concerns. The Indra are the Pasu (animal), Matsya (fish) and
personality is powerful, acquisitive, virile Vanaspati (tree) types. Pasu personality is
and concerned with his possessions and obstructive and stupid. His diet and
pleasures. Yama type is more conservative: behaviour are considered rather disgusting,
he does what he is supposed to and what is and he holds sleep and sex foremost. The

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Matsya type is cowardly and dull, and he If all life spans were fixed, then in search of
covets food. He is fond of water and good healthy none would employ
unstable, satisfied one moment and angry efficacious remedies or verses, herbs, stones
the next. The Vanaspati type is idle, and amulets… There would be no disturbed,
solitary, intent on food, and bereft of any ferocious of ill-mannered cattle, elephants or
praiseworthy mental faculties. camels… and nothing such as polluted
winds to be avoided. No anxiety about
falling from mountains or rough impassable
Determinism, Death and Medical Efficacy waters….no enemies, no raging fires, and
none of the various poisonous creepers and
In a chapter on the medical schools snakes; no violent acts, no actions out of
Dasgupta recognized the uniqueness of the place or untimely, no kingly wrath. For the
formulation of karma advocated by the early occurrence of these and the like would not
medical tradition. cause death if the term of all life were fixed
and predetermined. Also, the feat of
[Nowhere else] do we find the sort of ultimately death would not be set those who
common-sense eclecticism that we find in did not practice the means for fending off
Caraka. For here it is only the fruits of fear of untimely death…. Even Indra with
extremely bad actions that cannot be his thunderbold could not stay an enemy
arrested by the normal efforts of good whose life span was fixed; the Asvins, even
conduct. The fruits of all ordinary actions with their medicines, could not comfort one
can be arrested by normal physical ways of who suffers; the great seers could not attain
well-balanced conduct, the administration of their desired life span by means of
proper medicines and the like. This implies austerities….(Car 3.3.36).
that our ordinary non-moral actions in the
proper care of health, taking proper tonics, Atreya also refers to common experience to
medicines and the like, can modify or arrest illustrate his point:
the ordinary course of fruition of our
karma… According to the other theories the Furthermore….. we perceive that over the
laws of karma are immutable (Dasgupta course of a great many battles, the life span
1932 : 403). of the thousands of men who fight compared
with those who don’t is not the same,
By shifting the emphasis from actions in similarly for those who treat every medical
previous incarnations to the present life, conditions that may arise versus those who
Ayurveda effectively renders the immutable don’t…Duration of life is based on salutary
theory manageable. practices…we perceive that proper regard
for these will bring about freedom from
Caraka Samhita confronts the issue directly disease. On the one hand we observe it and
in a chapter on catastrophe and epidemics on the other we teach it (Car 3.3.36).
(Car 3.3), in which Atreya is questioned by
his principal student, Agnivesa, about where In the response to further questioning,
life expectancy is necessarily predetermined. Atreya elaborates on his diatribe against
His response weighs the implications of a determinism by comparing a man’s life span
cosmological theory of karma and to the axle of a cart. An axle will function
implications for the medical doctrine. properly in a carriage until it wears out, and
the health of mans body remains until his

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original measure of strength expires in due beliefs in healing power derived from non-
course and he dies. That is a timely death biomedical interpretations of illness.
(mrtyuh kale) (Car 3. 3. 38). But if the load
in the wagon is excessive, the roads poor, With the emphasis on obeying the dictates
drivers and animals clumsy etc., the axle of sensible behaviour (prajnaparadha)
wears out prematurely. Thus there is also Caraka adds force to its advocacy of salutary
untimely (akale) death. The enumeration of habits. This text indicates more of
factors that may bring this about includes willingness to reinterpret traditional ideas
overexertion, bad food, excessive sexual about karma to serve the needs of the
activity, spirits, drugs and avoiding medical medical doctrine than the later texts of
treatment. He recognizes the adverse effects Ayurveda. Caraka argues against an
of medical malpractice. external locus of control or supernatural
etiology. Even where the text considers
We also observe untimely death among these factors, there is an emphasis on the
those who are improperly treated for an present life and the individual’s ability to
illness such as fever (Car. 3.3.38). exert a significant degree of influences on
his own well-being.
Illness and Karma in Ayurveda
In case of disease born of his own deeds
According to Caraka, all illnesses can be (karman), the result of prajnaparadha,
attributed either to endogenous factors (nija) The wise man does not blame the Devas,
(i.e. an imbalance of the three humors (dosa) Pitrs, or Raksasas.
or exogenous factors (agantu). The latter
group ultimately refers to violations of good He should regard only himself as the cause
sense (prajnaparadha). Ayurveda infers of his unhappiness and misery;
that karma also plays a critical role from the
special features of an atypical illness or the Therefore, he should keep to a salutary path
course of an illness that is resistant to and not falter (Car 2.7.21 – 22).
treatment (Car [Link], 116 – 117). By
invoking karma, the medical system Epidemics and Castrophe
preserves the integrity of its theory and the
validity of a revealed doctrine even in the In the chapter on epidemics and catastrophe
face of admitted failure to heal certain (Janapadaddavamsana (Car 3.3)), Atreya
patients. This device is useful, for it enables notes that indiscriminate and high rates of
Ayurveda to draw upon those philosophical morbidity may sometimes frustrate the
and spiritual modes of solace that are attempts of medical theory to explain them
available from the resources of the culture at (Car 3.3.5). Even in epidemics, however,
large. Consider a Western analogue: specific cases respond well to treatment, and
Although Christian Science and Western herbal remedies are especially useful. He
medicine regard one another as refers to karma to explain cases that do not
incompatible, physicians nonetheless refer respond and end in fatality (Car 3.3.13). In
to the “Will of God” with impunity upon the 11th Century, Cakrapanidatta commented
reaching the periphery of their clinical on this passage, explaining that only some
competence. Even the most academic karma will produce deadly illness when it
hospitals, temples of biomedical technology, matures, deeds like burning a village or
commonly include a chapel, in defence to murder in a previous life. He surmises that
because such events are rare, so are the
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fatalities. Without engaging in that sort of obtuse speculations on karma rooted in the
speculation, Atreya attributes epidemics and distant past.
catastrophe to the immorality (adharma) of
corrupt leaders, the effects of which spiral Discussion
down the social order. He also refers to bad
karma (asat-karman), implying an effect of Although a concept of karma had been
group karma (Car 3.3.20 – 23). Both incorporated into Ayurveda from its earliest
adharama and asat-karman are rooted in stages to explain the cause of otherwise
prajnaparadha (Car 3.3.19). incomprehensible illnesses, therapeutic
failure and striking differences between
Prescribing certain behaviours that are parents and children, the zenith in the rising
considered bad judgement (prajnaparadha) impact on the classical medical system of
tends to preserve the integrity of cultural more traditional ideas in he extra – medical
values. Caraka warns against violating culture about karma is best represented in an
social customs and insulting venerable men, obscure monograph surviving from the later
indulging in unhealthy activities, middle ages. Though unrepresentative in
indiscriminate use of drugs, roaming about the extreme to which its position is taken –
at improper times in improper places and and so interesting for the same reason –
forth – all of which are undesirable practices Jnanabhaskara is a text consisting of a
stemming from impaired judgement (Car dialogue between Surya and his charioteer
4.1.103 – 109). This formulation of on the evils of human existence and a host
prajnaparadha, unique in Ayurveda, of diseases, all attributed to karma.
facilitated Atryea’s unparallel emphasis on
clinical empiricism over dogmatism and his Indian culture encompasses many
reliance on rational theory. Village burning inconsistent, yet coexisting beliefs and
and murder committed in a prior life readily practices. The dichotomy of fatalism and a
came to mind for Cakrapanidatta as he belief in the efficacy of medical
sought to understand the relationship interventions, however, leads to speculation
between karma and epidemics specified in about a rational solution to a characteristic
Car 3.3.13. This focus on a previous dilemma. From this speculation emerges a
incarnations, however, belies Atreya’s practical solution that enhances the medical
predilection for addressing more mundane doctrine of Ayurveda.
activities in the world of the present over

REFERENCES

Caraka Samhita, The Caraka Samhita of Agnivesa with the Ayurvedic – Dipika Commentary of
Cakrapanidatta. Ed. by Gangasahaya pandeya in 2 Vols. Sanskrit and Hindi. Kashi Sanskrit
Series, No. 194. Varanasi : Chowkhamba Sanskrit Series Office. (1969).

- The Caraka Samhita : Expounded by the Worshipful Atreya punarvasu, Compiled by the Great
Sage Agnivesa and Redacted by Caraka & Drdhabala. 6 Vols. Sanskrit text with intro. & trans.
into Hindi, Gujarati and English by Shree Gulabkunverba Ayurvedic Society. Jamnagar :
Gulabkunverba, (1949).

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Dasgupta, Surendranath. “Speculations in the Medical Schools”. Ch. XIII, Vol.2, Pp. 273 – 436
in S. Dasgupta, History of Indian Philosophy, 5 Vols. Cambridge: The Univ. Press, (1932).

Jnanabhaskara, Ms. 2719 (2030), Pp. 962 – 4 in Catalogue of Sanskrit Mss. in the Library of the
India Office. Comp. by E. W. O. Windisch & J. Eggeling. 2 Vols. In 4 pts. London : Secretary
of state for India in Council, (1887 – 1935).

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