Vajikarana Tantra (Reproductive Medicine in Ayurveda)

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Dr. J.L. Sastry hails from a traditional Ayurvedic family. He is born at Narasapuram (W.G. Dist., Andhra Pradesh) on 60-07-1965).

He had School studies at Kakinada (E.G. Dist., A.P.) and passed B.A.M.S. in 1989 from Dr. N.R.S. Govt. Ayu. College, Vijayawada (A.P.) in first class. He completed M.D. (Ay.) in Dravya Guna Speciality from Dr. B.R.K.R. Govt. Ayur. College, Hyderabad in 1998 October.

He stood first in A.P.P.S.C. Selection (January 1990) and worked as Med. Officer (Ayu.) for Govt. of A.P. in the Indian Medicine & Homoeopathy Dept., (1992-99). Between 1998-99 he acted as Research Projects Coordinator at the Govt. Research Dept. of Ayurveda, Hyderabad.

He stood first at the UPSC (1998) and Joined as Medical Officer (Ay.) in CGHS, Chennai in June 1999.

The author is the recipient of two gold medals from Nagarjuna Univ. (A.P.) for the merit shown during B.A.M.S. (1988).

The author presented several clinical and scientific papers at Regional, National and International seminars.

He had more than 15 publications in standard journals and also published several articles in newspapers.

Author also had given Radio-talks and given guest lectures at various prestigious institutes (both Ayurvedic & Modern Medicine).

He published a book 40 Years of research in Ayurveda in A.P. (on behalf of grda, Hyderabad).

Through the subject Vajikarana is the most sought for branch of Ayurveda, there is no published (exclusive) work on Vajikarana.

Vajikarana is often promoted / pronounced as Sexual Medicine or Sexology. This text for the first time, conceptualized the theme 'Vajikarana Tantra' vis a vis 'Reproductive Medicine'.

This text covers both male and female perspective of Vajikarana tantra. Most importantly, several reference about the utility of Vajikarana Cikista in Yonivyapats (gynaecological disorders) is comprehensively dealt.

Extensive description of both male infertility and female infertility is made under respective chapters. Both Ayurvedic and moderns perspectives are summarized with appropriate comparisons. Various aspects of Impotency and Frigidity are also explained in detail.

An attempt is made for the first time to define Shanda and Klaibya as Infertility and Impotencyrespectively.

This text covers the Vajikarana topic in the CCIM syllabus (paper-IV, part-A). Therefore, it not only acts as a reference text for the students, but also is a guide for the teachers as well as the practitioners.

This is the one and only text with all the Ayurvedic references on Vajikarana.

A mathematician was once asked to define God and the reploed, "God is a big circle whose center is very where and circumference no where". And, according to Socrates the nobles of all investigations is the study of what man is and what he should pursue.

These statements reflect the eternal quest of man to find answers to the most challenging questions: What is man? What for he is? Whence came he? And whither directing his course, Answers that were worked out time and again proved to be tentative and iadequate, if not improper. The quest, however, kept him in confrontation with the boundless macroscopic and the bottomless microscopic worlds. At the same time it provided him, in the process, with many benefits to lead increasingly easy and comfortable life. But it also made, him to face as many critical problems as the advantages, if not more. Yet, his resolve is undaunted and the quest continues. In these times he is engages at the forefront of researched with a task which is minutest in proportion but gigantic in confrontation. His aim is to clinch the presence of 'the certain thing' which is believed to underlie the principle of uncertainity. It is hoped that it will enable man to arrive at the final theory which is expected to solve the riddle, once for all, hopefully revealing the ultimate connection between the macroscopic and the microscopic to comlete the circle, the other way round.

There has always been a wide gap between the occidental and oriental cultures and the religious beliefs. It has been there inspite of a continual connectivity and a commonality of the goal. But cutting across the gap, there have been also several dichotomies in the perceptions of mankind. They are primarily centered around theism, and materialism and spiritualsm. These in turn reflect in accepting or denying two fundamental concepts or beliefs: "God" and "Rebirth of living being".

Either ways, these perceptions have been incessantly influencing mankind through ages rights to the core of his existences and his actions. In most of the eastern cultures and religions several view points exits about the intrinsic and intricate relationships between man and his originator. [He is revered as God by many; for some, it is the indomitable and unfathomable energy-field which creates, transforms and annihilates]. Rebirth, according to such views has a crucial role to play in that relationship. Virtually, there is no realm of life that is conceived untouched by this perception.

In the Indian Context, the Vedas are the eternal form and source of all knowledge. They emphatically state the eternity of God and the entire creation as his manifestation. The ultimate goal of man is emanicipation from the bondage with the cycle of rebirth. It is a matter of common sense that for such a final emanicipation one has to essentially pass through several stages of emanicipation in actual life. For that, Vedas call for a conduct of orderly living which may be briefly stated as 'Samyak Karmacharana Vidhi preceded by Samyak Janana'. The whole activity is brought under four purusharthas, namely, Dharma, Artha, Kama and Moksha. Among these, Moksha is the ultimate goal. It is pursued for which the help of Artha and Kama which, in turn, are qualified by Dharma. The bottom line is that it is vitally important to possess a perfect means or agent (Karana or Sadhana or efficient cause).

Ayurved, the ancient medical science of India which owes allegaince Vedas, to Atharvaveda in particular, clearly recognized this absolute necessity. It advocates measures so systematized that it can be called a way of life rather than mere medical system. The primary goal, the immediate one, is to achieve, preserve and promote the inherent potential of the living body at its optimum. After the conduct of a full meaningful and accomplished life, these practices enable the agent to attain the ultimate goal. Nishtha (or Moksha) Chikitsa or Naisthikichikitsa are the two terms which represent these two modes of practise and preparation.

According to Ayurveda, formation of the living body is facilitated by a relationship between the governing force of creation involving through Shareeri and the physical matrix composed of the 'Pum beeja and Stree beeja' (Sperma and Ovum)'. The resultant product, the living body, is termed as Shatdhatupurusha right from the moment of inception of the synthesis. The role of a Daivi and Purusakara in the synthesis is well laid in Ayurveda. Parjnaparadha, Punarjanma Niyata Aniyata Ayu and Karmaja Vyadhis are fundamental aspects related to these two concepts.

The pumbeeja and Streebeeja must combine to provide the matrix and to initiate the formation of the sixfold (or fourfold) whole. (The manifested product, the Shatdhatu Purusha is composed of Pancha bhootas and Shereeri (Samanaskata); hence it is sixfold and this unit is also called Chikitsa Purusha. The panchabhootas involved in this combination do so though their manifested form, i.e., Shareera (the physical body) and Indriyas (te subtle sense organs). These two, together with Satva (Mans) and Atma constitute the fourfold which represents Ayu, the period connecting birth and death.

Regarding the union of Sukra Artava, there is scope to achieve an optimum quality and quantity to ensure a highly viable product fully capable of strive of the purusharthas. The high degree of viability is exhibited as 'Arogya' in the form of Sama prakriti endowed with sukha and hita Ayu'. He measures and practices used for this purpose represent the 'Comprehensive Health Care' at its best right from the initial stage of formations of the being. It comprised of acquiring, preserving and promoting of the prerequisite material and conditions in the male and the female. By that, it ensures production of not merely of an offspring but a progeny of optimum quality and quantity as well as its succession in turn. The tern Apatyasantanakara aptly expresses these aspects (Na Patatyanena Pita Narakamiti Apatyam). The word 'Santana' means 'parampara' i.e., an uninterrupted series or succession.

In a nutshell, this is what Vrisha Chikitsa is all about. No wonder that the precetors of Ayurveda accorded a rearguard position to Vrishachikitsa in the Ashtangas of Ayurveda. This positioning also implies that is ensures Kaya right from its inception to acquire highly capable vanguard capabilities (Kaya Chikitsa stands at foremost of Ashtangas).

Considering the specific purpose ascribed to Vrisha Chikitsa it is not only unfair but also improper to equate this to Sexology or Aphrodisiac Medicine. Surely, Reproductive Medicine is a better term. But the noble and spiritual aim implied in Vrisha Chikitsa calls for a term deeper in reach and nearer to the theme. The term Progenitative Medicine may serve that need better. The world Rogeny is originated from the Latin word 'prigenies' which means 'lineage'. Progenitive is the given adjective form of the word and means 'Capable of bearing an offspring'. The suffix 'Ative' means, 'of, relating to, or tending to' as in the words 'informative, authoritative'. Progenetative Medicine addresses progeny (which implies lineage) rather that merely the act or capability which are also covered, however, by implication. Hence the term is suggested for consideration to use for Vrisha Chikitsa (subject to allowance made by linguistics).

Vrisha Chikitsa is commonly known as Vajikarana. The former refers to begetting progeny achieving of which is dependent on several on several physical and mental factors whereas the latter term manly refers to the most prominent of those factors. The whole aspects may be placed under the following three facets:

1. The optimal quality and quantity of the Beeja (pum -, as well as stree).

2. The optimal healthy condition of the organs involved in terms of structure and functions. In brief, this reflects in the erectile power of normal penis as well as the healthy condition of yoni and Garbhasaya (the Kshetra).

3. The environmental, internal as well as the external conditions that influence the above.

The best combination of all these factors invariably results in begetting Apatyasantana and in that context there Visha Chikitsa (Vrishya) is preferred. When the organs and the sexual prowess are referred to Vajikarana is the term of choice. It particularly reflects the Kamasakti and Suratasukha which are in one way common to both male and female. Adhamalla's observation is relavent to this aspects.

In Charaka Samhita, Sukradosha and Klaibya are covered in 'Yonivyapat Chikitsitiyam' (30th Chapter in Chikitsasthana). According to some scholars, as mentioned by Chakrapani himself, those portions of the text are Anarsha i.e., not authentic but interpolated at a later period. In has acceptance of Kashmiradi desa. The Acharyas takes up the discussion on these two and pradara being requested by the disciple Agnivesa. Before that, treatment and also mentions that Pumbeeja should also be examined for doshas and if necessary, be treated by suitable medicines after purifying the person by yonivyapat context is based on the fact that both sukra and artava are gobha hetus and that garbha is the desired goal in treating yonivyapat. Chakrapani clearly observes this aspects.

In Susruta Samhita, measures to achieve beeja suddhi both for male and female are give in 'Sukrasonita Suddhi Sarira', the 2nd chapter in Sarira Sthana. In 'Kshina Baliya Vajikarana', the 26th chapter of Chikitsa sthana vajikarana yogas are prescribed to induce and enhance the strength to first he act of intercourse at optimal level. In that context, first he describes the Klaibya with its six varieties as being impediments to the performance. He identifies three varieties of Klaibya as amenable to treatment and mentions 'Hetuviparyaya Karya' as the measures to be applied there. Next, he takes up Vajikarana yogas are efficacious in treating Klaibya. In the 28th chapter of Uttara sthana, 'Yonivyapati Pratishedha' is discussed. For the treatment of yonivyapat he brings in applying Atidesa and Atitavekshana tantra-yuktis. The measures mention for sukra-artava Dosha (in the 2nd chapter of sarira sthana) and for Klaibya (in the 26th chapter of chikitsa) as applicable to yonivyapati also.

Thus it appears that Vajikarana Oushadha which is specirfic for the male in particular aspects has a wider appeal in improving the reproductive system in common.

The anatomical concepts on the male and female reproductive systems envisaged in Ayurveda may have significance of their own from Ayurvedic perspective. Varied implications arise from several such reference; purpose of few such reference is fiven hereunder:

1. The term "Agrapraroha" implies the natures of the muscular structure of penis.

2. The key role of Svabhava in causing Sareera Sannivesa.

3. Pravyaktata of Angapratyangas in the fourth months and Pravyaktataratva in the seventh months.

4. Simultaneous origination of all the angapratyangas (in sookshma state) in the embryo (with Vamsaankura and Chootaphala) as similies.

5. Avaratatrayapesi constituting the female reproductive organs and the 'matsyamukhaakara' of Garbhaasya.

6. The situation of Artavahachidra below the Smaratapatra.

Such references call for a critical studfy of the anatomical aspects from Ayurvedic perspective with reference to prakrita Kriya. Vikriti Vignana and Chikitsa- kaya, as well as Salya.

The authors firmly based their approach to deal with the subject on the principles enunciated in the classics. They justified the reasons for including the detailed description of male and female reproductive systems. It has been dealt in a composite manner than an integrated method, which deserves appreciation as it suits the present trend of progress in science. They also deserve appreciation for bring out a detailed text on Vajikarana which is expected to remove misconception prevaolenty on Vajikarana.

Finally, the authors observation 'merely translating something into English', is relevant to the times and worth perusing. There has always been an imperative need to resist such temptation. In the wake of advancement rapidly taking place these days at the forefront of science it is highly desirable to give up the tendency and focus more on delving deeper into the subject proper of Ayurvedic classics well quipped before hand with a form grasp of fundamental principles based on Vedic and Darsanic liferature. After all, language is a tool (like Mathematics to Physics) but it has potential to make and unmake the meaning intended to be communicated.

May lord Dhanvantari showers his blessings on all the living beings for health and peace.

Ayurveda as complete medical science, is propagated with its eight branches (astanga) from times immemorial. The spectrum of medical specialities being with kayacikisa (general medicine) and ends with vrsa cikitsa / vajikarana cikitsa. Author is of the opinion that the chronology of eight branches has great significance. Placing vrsya at the end does not mean it is the last, rather it means that 'vrsya at the ends does not mean it is the last, rather it means that 'vrsa cikitsa is the ultimate branch.

On the other hand, separating the two arms of svasthaurjaskara cikitsa into two specialties indicate towards their specific utility in different conditions. Through it is claimed that both rasayana and vajikarana may act vice-versa, they are described as two separate entities. This division is probably made to emphasize their individual importance.

Author made an interesting observation that an apta (seer) like agnivesa / caraka, made 'pratijna' in 30th chapter of caraka samhita cikista, "all the aspects related to yoniroga (gynaecological conditions) will be dealt". But, we find references about sukra, sukradosa and klaibya in this chapter. No where acarya agnivesa /caraka deviated from the pratijna. In the above context also he did not mention any irrelevant subject. It is essential to realize that 'male infertility' is a part of gynaecology eve today. Therefore, caraka's approach is fully justifiable.

Unfortunately, today we are promoting vajikarana as aphrodisiac -aphrodisiac property. Actually vajikarana is much beyond the understanding of existing evidence-based medicine (EBM). Infact, vajikarana comprehensively covers 'human re-productive function'. Hence, vajikarana may be aptly called as 'reproductive medicine".

Adhamalla clearly stated that vajikarana is meant for both male as well as female. There are several references in brhat trayi texts where yonivyapats and/or artava dosas are treated with vajikarana dravyas/yogas. Similarly, sukra dosas are treated with dravyas/yogas useful for yoni vyapats.

The other salient feature of Ayurveda is, wide range of pharmacological activities related to spermatogenesis and re-productive system were provided by the acharyas. About seven different activities viz., sukrarecaka; sukravardhaka; sukravardhaka-recaka; sukra-stambhaka; sukra; sukrasodhaka and sukrasosaka are available in the ancient texts.

Students often express doubt about sukrabharakala which is said to be spread all over the body. But, the same student is very much convinced when he is taught about the prostaglandin and its presence all over the body. Probably, prostaglandin related activity of reproduction is depicted under the concept of sukradharakala.

The author realized that thee is no existing text on vajikarana concept except 'kucarama tantra'. On the other hand sexology texts like 'vatsyayana kamasutra' and 'anangaranga' are introduced by some Ayurvedic scholars under vajikarana context. It is an unfair approach and objectionable attitude to the spirit of ayurveda. Ayurveda projected vajikarana as an answer to the male and female infertility. This branch also attended complaints like decreased libido or erectile dysfunction, but does not deal with any of the subject matter of sexology texts. One needs to strike a balance between vajikarana and kamasutra aspects.

After about ten years of continuous exploration into various texts of ayurveda, the author decided to bringout this work with the title "vajikarana tantra" which deals with re-productive medicine. The author is endebdted to his teacher Prof. Dr. K.Nishteswar who extended his co-operation in the compilation as senior-author.

The authors Prof. DR. Veerabharam for providing the forword.

Chaukhambha Orientalia must be thanked for bringing out such an important reference book on the subject of Vajikarana.