An Assembly of Sages Discuss the Origins of Man and Disease
Āyurveda teaches that understanding the components which create human life, allows one to understand what can possibly malfunction and create disease. This allows a healer to distinguish the source of a disorder in a patient and guide them to the most efficient treatments. The components which create life and therefore disease are discussed in Chapter 25 of the Charaka Saṁhita, Sūtrasthāna, called the ‘Explanation of the Origin of Man’:
There is an old story about the Venerable Punarvasu,
who could clearly see the nature of things.
He was in an assembly, discussing the origin of human beings and their diseases. [3-4]
Within the gathering, Vāmaka, the King of Kāśī, who was good with words,
had approached the assembly of sages and asked respectfully,  “Does disease originate from the same source as man?”
The venerable Punarvasu spoke to the sages and said,  “You all have immense knowledge and are confident in your understanding.
You are capable of removing the doubts of the King of Kāśī.” 
Pārīkṣi, the thinker, who has thought deeply about this, said, ‘The human being
is generated from the soul and disease is born of the soul because it is the [root] cause,  which enjoys actions and their consequences and collects them.
Happiness and suffering cannot arise without this element of consciousness. 
Śaralomā, with spiked hair, disagreed, believing that, “The nature of the soul is averse to
pain and suffering and couldn’t be responsible for bringing these about.  It is the mind, known as sattva, which becomes seized by rajas and tamas
and causes the body and its defects.” 
Vāryovida, the leach teacher, disagreed, saying, “The mind alone cannot be the cause,
since without the body there is no bodily disease or place for the mind to abide.  Hence, living beings are the product of the digestive nourishment (rasa),
Just as water makes various things strong (filled with sap),
digestive nourishment (rasa) is known as the cause of development. 
Hiraṇyākṣa said the [spiritual level of the] soul cannot be a product of digestion (rasa), nor can the mind which cannot be seen with the senses, yet has sensory disorders. A human is made of the [five elements and the soul],
and disease comes through these six components.
The sages of the Sāṁkhya tradition say we are an aggregate of these six elements. 
When he was done speaking, Kauśika, the dictionary maker, said, its not like this,
Without a mother and a father, how can one arise from the six elements?  A human is born from a human, as a cow from a cow and a horse from a horse.
Diseases like diabetes are known to be hereditary, in this way genetics are the cause. 
Bhadrakāpya, who is always punctual, disagreed and said, the blind don’t give birth
to the blind, and also, where did the parents initially originate?  Creatures are born from prior actions and diseases are born from prior actions.
Without karma, human beings and disease are not born. 
Bharadvāja said, this is not so, as the doer always proceeds an action,
so without action there is no apparent results [of karma] that create a human.  The self-nature (svabhāva) is the cause for the existence of the human and its diseases,
Just as the nature of [earth, water, air and] fire are hard, fluid, fluctuating, and hot. 
Kāṅkāya said it’s not like this because the initial results would already exist.
Success and failure would be from self-nature not caused [by any of one’s actions].  He concluded, that the will of the Lord of Creations (Prajāpati) created
the sentient and insentient world as well as happiness and suffering. 
Then the monastic Ātreya said, no, the Lord of Creatures is always
favourable to the creation, and doesn’t make them suffer like an unkind person.  A human being and their disease is born from Time, as
The whole world is controlled by Time and it is Time who causes everything. 
The sage, Punarvaṣu, heard them debating in this way and said,
“It is difficult to see the ‘that which is’ if you are dwelling on just one aspect. 
Those who speak their opinions while refuting the views of others, as if their modality
is the end, will just go round and round, [as the turning of] an oil press. 
Be free of arguments as man is understood to be of the nature between [these views],
Remove the blindspot (tamas) of your modality to advance in learning this knowledge. 
The factors which in a wholesome state produce a human being,
When in an unwholesome state create various disorders. 
The sages argue that their modality is the cause of the human being and his diseases. It is similar to a nutritionist saying that it is the food that is the cause of disease, while the chiropractor says the bone alignment is the cause of disease, and an energetic healer says it’s blockages in the energetic body causing disease. The conclusion is that all components that create who we are have the possibility of being out of alignment and malfunctioning. When the mechanism which creates us is functioning it creates health and that same factor malfunctioning creates disease.
The soul is an aspect of the human beings that creates the ‘experience’ of life. When we live a life that is not in alignment with our soul purpose, then the soul doesn’t want to live in this body and misery and disease ensue. The mind is made of sattva and it becomes imbalanced by rajas and tamas, which lead to mental, emotional and eventually physical disease. In these cases, diseases caused by an unwholesome life or unwholesome emotions and require spiritual and mental guidance and therapies.
The digestive nutrition (rasa) can strengthen health, but when the digestion is weak or unwholesome food is eaten it will cause disease. The balance of the five elements and their coordinator are taken into account by Chinese medicine and general Āyurvedic doṣa analysis. Diseases caused by these sources need herbs and proper diet. But the genetic predisposition of an individual can also create certain diseases.
Some disease is caused by the nature of who we are (svabhāva). Just as fire is hot, some people live a fast life with little sleep while others live a lazy life with little exercise. Here an individual learns practises that compensate or balance the nature of who they are. Some diseases are the result of present and past life actions (karma). They require donation and service (seva) to counteract the negative karma creating suffering and disease in the present.
Time is taught as a source of human beings and disease, but here Time means much more than the time on a clock or the effects of a season. Time is defined as change, and the first change was when Prakṛti separated from Puruṣa. Time is the initial urge (force) that pushed forth all creation. All things continue to change because of Time. There are healthy and happy times in one’s life as well as times of suffering and disease. When Time is the source of disease, then patience is the best medicine used along with prayer/mantra and rituals/pūjā to mitigate the time period.
There are other components that create who we are and disease, which are not mentioned here, as this is not a final list. It is indicative of the more popular ideologies at the time of the gathering. All these various sources require a treatment based upon their source. If we are blinded by our modality to see only our way of treatment, then we can fail our patient.
Understanding the sources of disease, and integrating therapies to work on the level of manifestation of disorder as well as the root is the greatest healing that can be offered.