speech and hearing science in ancient india—a review of sanskrit literature

J. COMMUN. DISORD. 21(1988), 271-317

SPEECH AND HEARING SCIENCE IN ANCIENT INDIA-A REVIEW OF SANSKRIT LITERATUREa

S.R. SAVITHRI AIISH, Manasagangothri, Mysore, India

INTRODUCTION

Speech and hearing is a young profession that began half a century ago, concerned with the most human characteristic-speech. The field makes unique contributions to the understanding and care of the most important of all the human functions -speech and hearing. In brief, the field covers the areas of speech production, transmission, reception, speech and language disorders, their causes and treatment, as well as disorders of hearing and their causes, symptoms, and treatment.

The field of speech and hearing had its birth and developed in a number of countries, especially in America. It is only about twenty years old in India. Hence most of the contributions can be attributed to Westerners, primarily to Americans. However, Sanskrit literature is rich and goes back 3500 years, and it deals with the areas concerned with speech and hearing. Using knowledge obtained from Sanskrit literature, great and surprising achievements have been made in many other fields such as cardiology. However, the young field of speech and hearing has not yet paid much attention to the information contained in the Sanskrit literature.

From early times the Indian system of medicine has been known as a vast storehouse of literature and hereditary knowledge. Centuries ago, when Indian culture was the center of international attention, Ayurvedab shone in its full glory and attracted scholars from many parts of the world.

Address correspondence to S. R. Savithri, Ph.D., Department of Speech Science, All India Institute of Speech and Hearing, Manasagangothri, Mysore-570006, India

This is a revised version of the authors dissertation, entitled Speech and Hearing Science in ancient India: A Survey of Sanskrit literature, originally submitted to the Uni- versity of Mysore in 1979 as a partial fulfillment for the postgraduate degree in Speech and Hearing.

b See, for example, Denyse Rockey and Penelope Johnstone. (1979). Medieval Arabic views on speech disorders: al-Razi (c. 865-925). J. Commun. Disord. 12:232, 240, which shows Indian influences on the Persian medical writer al-Razi.

Q 1988 by Elsevier Science Publishing Co., Inc. 271 52 Vanderbilt Ave., New York, NY 10017 OOZI-9924l88lS3.50

272 S. R. SAVITHRI

It was then a great source of medical knowledge. But unfortunately this source of knowledge was not made good use of and hence was forgotten.

Indians often tend to show the utmost habitual indifference if not hos- tility to it, though we have with us a great source of medical knowledge. As contrasted to this spirit, we have on the other hand insistent demands for medical relief and medical education on Western lines. As a result of this, the Indian literature in medicine has not been paid much attention.

India is a vast country. Medical help given is costly. People cannot afford the medical treatment available in many hospitals. Most of them depend on inexpensive medical knowledge, often derogatively called na- tive medicines, possessed by a few among them.

So there is a greater need for specialists and drugs that are efficient, safe, readily available, cheap, and easy to administer.

The development of Ayurveda in India is beset with many serious difficulties. Though we have a few recognized practitioners whose cures seem almost miraculous, we cannot claim that they have made any study concerned with those medicines.

Until recently, all instruction in Ayurveda was left to private agencies. The universities and authorities directing research showed little faith in the possibilities of any improvement in human knowledge from this source. A feeling also prevailed that there was nothing very scientific in these systems and that they were all based on quackery. The Ayurvedic doctors were often called barefoot doctors, a term which in recent times is shedding its derogatory connotation. In general, the trend begins to look more promising, with more and more attention now being paid to the Indian system of medicine.

Under the influence of ideas borrowed from the system of Ayurveda, marvelous achievements have been made in the field of modern medical science, and the system has now begun to throb with new life. It has earned the admiration of many distinguished practitioners of other systems.

Thanks to the interest in Ayurveda shown by Westerners, we have now begun to pay more attention to it in India. Dr. Charles (1936) confessed that what you Hindus had in a perfect state two thousand years ago, I am going to teach you in an imperfect state. Professor Weber says, In surgery too, the Indians seem to have attained a special proficiency, and in this department, European surgeons might, perhaps, even at the present day still learn something from them, as indeed they have already borrowed from them the operation of rhinoplasty. Hypnotism or suggestive ther- apeutics has also been employed in India from early times, as is corro- borated by many Western savants. Dr. Emile Cove and Dr. J. Lewis say

The Ayurvedic compendium, Cur&z-Samhita, was one of the sources of Arabic medicine (particularly in the area of pharmacopoeia), which was in turn the basis of medieval Western medicine. Cf. Johnstone and Rockey (1979).

SPEECH AND HEARING SCIENCE IN ANCIENT INDIA 273

Ages ago Hindus employed hypnotism. From India it spread to Chaldea, Mesapotamia, Syria and Egypt.d

Thanks to the strong emphasis placed upon it by Shri Rajnarain, the Honorable Union Minister for Health and Family Welfare, Dr. Karan Singh, the former Union Minister for Health and Family Planning, and Shri H. N. Channasbasappa, former Minister for Health and Family Plan- ning of Kamataka, the system of Ayurveda has gained momentum and importance in the present society of India.

Ayurvedic colleges and schools have been started under direct or in- direct government protection as in Mysore, Patna, Hardwar, and Madras. A large number of charitable dispensaries and a few indoor hospitals have also been started, not only in the great cities of India but also in many of the small towns. The Banaras Hindu University has a fully equipped Ayurvedic College with an excellent Ayurvedic garden and a hospital giving efficient surgical and medical aid. In Bengal, there are three Ayurvedic institutions. A Central Council of Indian Medicine has been started in Delhi and an Ayurvedic research institute has been started in the National Institute of Mental Health and Neurosciences. Suffice it to say, the status given to Indian medicine at the national level is high.

In recent times, we can see allopathic doctors using drugs borrowed from Indian medicine. Recently, the Government of Karnataka has de- cided to open many dispensaries providing both allopathic and Indian systems of medicine.

It is in this context of a renewed interest in Ayurvedic and Sanskrit literature, along with a lack of coordinated information, that the present study has been planned. It is necessary to carry out research in order to explore the possibilities of the Sanskrit literature with a view of making them self-sufficient and efficient. The knowledge contained in the ancient books should therefore be reexamined in the light of modem science and research.

Any research work could be done in the following stages: (1) survey and review of the material, (2) experimental verification, and (3) clinical application.

The first and the foremost step in this as in any study is to survey and compile available information. This permits understanding of rationale and necessary modifications of present thinking.

Purpose ofthe Present Study. The purpose of this article is to compile the available information in the Sanskrit literature with respect to the field of speech and hearing.

d A report of the All-India Ayurvedic Conference and Exhibition held at Mysore during December, 1936.

Deccan Herald (a daily newspaper), 13th April, 1978 p. 1.

274 S. R. SAVITHRI

Areas under Study. The study is mainly concerned with three broad areas, namely, diseases in general, speech pathology, and audiology.

Under speech pathology the following are studied: Definitions of normal and abnormal speech, production of voice, perception of speech, phonetics, intonation and rhythm, speech disorders and their causes, and treatment of speech disorders.

Under audiology the following are dealt with: Diseases of the ear, their causes and symptoms, and treatment of ear diseases.

The first section is an introductory part, the second section deals with the method, and the third section deals with diseases in general and the place of speech and language disorders. The fourth and fifth sections deal with speech and hearing disorders and their treatment, and the final section is a summary with recommendations.

The present study has many advantages. First of all, it is hoped that it will give us a picture of the information available in the Sanskrit literature. It may make people aware of the information available in the field of speech and hearing, which may be beneficial to them.

Because the field of Speech and Hearing is very young and because not much has yet been achieved, any extra information that could possibly be revealed by this survey should lead to its development. Under the inspiration of ideas borrowed from the Sanskrit literature, good achievements have been made in the areas of modem medical science. Hence we can assume that the ideas borrowed by the field of Speech and Hearing may also help in the development of the field.

Such a study may be helpful in comparing two literatures of different languages, whether in the same country or in two different countries.

Further, one may also hope that it can stimulate clinical trials and ap- plications to research that may be appropriate to our country.

The present study was limited to books from a few libraries. Since the time available for the study was very short (6 months), many

books were not referred to. The books available in the following Libraries were the only ones used: the Oriental Research Institutes Library, the Maharajas Sanskrit College Library, and the Government College of In- dian Medicines Library, all in Mysore, Kamataka, India.

MATERIALS ANTI METHOD

The materials used in this study are taken purely from Sanskrit books written between 1500 BC and 1904 AD. On only one occasion was the original Sanskrit book not available, and hence in that case an English translation was used. The materials were selected as follows: (1) The diseases and the treatment are dealt with in the same way as in the medical books that were used as sources for the materials. (2) The subject of voice is exclusively dealt with in books concerned with music. Hence these


books were also referred to. (3) Books concerned with logic also formed part of the source since they cover the definitions of speech and language and the propagation of sound. (4) Books on grammar deal with phonetics and the rules of pronounciation, so these were aso used. (5) In addition, since the vedas, upanisats, samhitas, and puranas are supposed to be the oldest available Indian literature, these were also consulted.

Some of the books may not be mentioned in the body of the paper, since the materials taken from several books were the same. The selection of speech and hearing subjects in the books mentioned above was carried out as follows:

In some books, an index was available. Most of the books concerned with medicine include a separate chapter concerned with the diseases of the ear, their etiology, symptomatology, and treatment. So, selecting the subject concerned with hearing was done mainly from these chapters. But the same was not true for speech pathology. It is nowhere dealt with as an independent chapter. Voice disorders are mentioned separately in some books. For the other areas under speech pathology, the chapters dealing with neurological disorders and their treatment were mainly referred to, because speech disorders and their treatments were mentioned in them.

When no index was available, the books were scanned from beginning to end and anything concerned with speech and hearing was collected. Translation from Sanskrit to English was done as follows: (1) Whenever a Sanskrit-English translation was available, it was used. Sometimes it was modified when the present investigator felt that the original translations were not clear. (2) When translations were not available, they have been done by the investigator. (3) Whenever extra difficulties were encountered, professional help was sought. (4) When suitable translations were not obtained by the abovementioned methods, the following were used as guides: (i) Sanskrit-English Dictionary by Monier Williams; (ii) Indian Materia Medica by A. K. Nadkami. (5) When equivalent terms were not found in English, the Sanskrit terms were retained. For the transliteration, the system used by Julius Jolly was used, since it is the one most commonly used (Appendix A).

Those Sanskrit verses that could not be understood by any of the above five methods were left untouched. For some words that have two or three meanings, the appropriate meaning was obtained by consulting a professional person. For some words like v%ta, pitta, etc., where direct translations like wind, bile, etc., were found useless, interpretations of these were obtained from modem books.

In some verses, when the meaning of a particular word could not be properly understood, that word was left untranslated. But when the same situation was met with in the verses that deal with the treatment and hence mention names of medicinal herbs, the whole verse was not translated, as it would have severely hindered the meaning.

276 S. R. SAVITHRI

Areas such as piercing the ear and surgery concerned with the mistakes done in piercing were not included in the present review.

DISEASES IN GENERAL

Health is defined by Caraka as a state in which the function-structure relationship is in a state of equilibrium.

SuSruta defines health as follows: He is known as healthy in whom the threefold functions of the body are in a state of equilibrium and the basic and supporting tissues are in a proper state of integrity, whose soul, sense organs and the mind are clear and bright.2 These definitions of health lay emphasis on the physical, mental, and spiritual constituents of an individual. In contrast disease is defined as follows: Disease is the imbalance of the function-structure relationship. Caraka says that health is characterized by a sense of ease and pleasure and disease is characterized by a sense of pain.3

All diseases are classified under the following seven categories, according to Susruta:

1. Adibalapravata (hereditary); 2. Janmabalapravcta (congenital); 3. Dosabalapravltta (chemical); 4. Sanghatabalapravltta (traumatic); 5. K%labalapra@ta (seasonal); 6. Daivabalapraltta (parasitic); 7. Svabhivabalapravltta (natural).4

~dibalupruv@z. The origin of diseases included under this heading is attributed to defects inherent in either the male or the female reproductive elements that form the primary factor of the embryo, for example: leprosy, hemorrhoids, etc.5

Junmabulupruv~tu. The kind of diseases included under this category comprise congenital diseases. They are attributed to errors in the conduct of the mother during the period of pregnancy. It includes various diseases such as congenital blindness, deafness, nasal voice, speechlessness, dwarfism, etc. This may be of two types:

1. Due to chemical imbalance in the mother; and 2. Due to ungratified cravings of the mother during the period of

pregnancy.6

Do~ubulupruvgtu. These include the disease that are due to the disturbed action of the three dosfis-vata, pitta, and kapha. These are disturbed owing to errors in diet. They are of two types:

1. Amacaya (part of tthe stomach where food is not yet digested). This is of two types: (a) physical, and (b) psychological


2. Pakkacaya (part of the stomach where food is converted into con- stituent elements of the body like blood, flesh, etc). This is also of two types: (a) physical (b) psychological.

Under this category a subcategory called neurological disorder is mentioned. Under this are included both speech and hearing disorders. How- ever, it is found that speech and hearing disorders are also mentioned elsewhere, e.g., under congenital diseases.

Sa~ghtitabalupr~vflta. Diseases belonging to this category include those caused by trauma such as external and internal injuries, due to blows or inflicted by sharp instruments, or due to overstrain by wrestling with opponent of superior strength. These are of two types:

1. Diseases caused by external injuries; 2. Diseases caused by the bite of a wild animal or poisonous reptile.6

Kdabalapravflta. These include diseases that are caused by meteo- rological changes such as variations in the atmospheric temperature, hu- midity, dryness, rain, wind, and changes in seasons. These again are of two types:

1. Disorders arising out of the usual adaptive reactions of the .body; 2. Disorders consequent to the inability of the body to adapt itself to

sudden seasonal variations.

Daivabaluprav~ta. These include disorders caused by forces beyond human control. They are considered to be caused by providential dis- pensation or acts of God. According to the ancient way of thinking, some of the diseases included under this category are considered to be due to divine wrath or displeasures or to mystic powers of charms and spells mentioned in Atharvaveda. These are of two types: (1) diseases due to events such as when one is struck by lightning; (2) diseases due to the influence of invisible malignant forces of nature. These again have been classified under two subheads: (a) diseases that assumes the form of ep- idemic, and (b) diseases that are accidental or confined to isolated inci- dence. This may be sporadic or endemic.

Svabh~vabalupruv~ta. This includes the diseases that arise out of natural or organic and functional changes in the body and mind such as may be due to senility, death, hunger, thirst, sleep, etc. brought about in persons who have strictly followed the prescribed rules of health. It is of two types: (1) Kalaja-This includes diseases that occur in the normal course of events due to effects of time. (2) AkSlaja-This includes the occurrence of changes in the body and mind prematurely. It covers largely due to the leading of unhealthy modes of life.

278 S. R. SAVITHRI

According to the system of Indian medicine, there are three DOS&S in the body: Vata, pitta, and kapha. In a healthy person these three humors will be in a state of equilibrium.

According to Caraka, the main function attributed to vata are enthu- siasm, inspiration, expiration, voluntary actions like talking and walking, proper functioning of excretary organs, and proper circulation in the body.i2 It maintains the cohesive unity of the body as a whole. It brings about speech. It is the basis of sound and touch.

Since many of the physical and mental phenomena are ascribed by modem physiologists primarily to activities of the nervous system, the actions of central, vegetative, peripheral, and autonomous systems can be identified with the concept of v&a. Hence the term vata includes all the phenomenon that come under the functions of the nervous system.

Pitta is thought to be responsible for the following actions: vision, digestion, heat, production, hunger, thirst, softness and suppleness of the body, luster, cheerfulness, and intelligence.13

In modem medical science most of these actions are the acttivities of the thermogenetic and nutritional systems. So the term pitta may probably refer to the actions of thermogenetic and nutritional systems.

The actions of Kapha are smooth working of the joints, general stability of the body, build, strength, courage, and greedlessness.14

Hence it not only includes mental phenomena such as courage and understanding, but also bodily phenomena such as production of bodily strength and maintenance of smooth working of joints. These are included under the activities of the skeletal and anabolic systems. So the word kapha includes or refers to the activities of skeletal and anabolic systems.

These three-vata, pitta, and kapha-are designated as dosas because of the capacity to vitiate others or of themselves vitiated by other factors. They are also known as dhatu, which means an essential element, a con- stituent, a humor, or a supporter.

These three do@ are found everywhere in the body. There are however, certain areas in the body that are stated to be their special seats. The seat of vata is the umbelicus, that of pitta is between the umbelicus and the heart, and that of kapha is above the heart.

Whatever may be the nature of exciting factors of the disease, the actual intrinsic factors that become excited are the three do@. Hence, a state of disease arises when the action of any of these three is disturbed.

SPEECH PATHOLOGY Communication is mainly with the help of speech. Hence the action of the whole universe is solely based on sounds.

Speech Normal and Abnormal: A Definition

Speech to be properly so called should be subtle, discriminative and orderly. It should lead to a decision and indicate a purpose.16

SPEECH AND HEARING SCIENCE IN ANCIENT INDIA

Normal speech is defined as that which is not insufficient and redundant, not meaningless, not incoherent, not inconsistent and which con- tains sufficiently expressive and suitable words and is unobjectionable.

More emphasis is laid on meaning in another definition: A good speech is that which has sense and which is unequivocal, fair, pleonastic, smooth, determinative, not bombastic, agreeable, truthful, not harmful, refined, not too brief, not hard to understand, not unsystematic, not far-fetched, not superfluous, not inopportune and not devoid of an object.*

In addition to these qualities, if its words are neither inadequate nor redundant then it is said to be excellent speech.

With further emphasis on communication clear speech is defined as that in which there is agreement between it on the one hand and the speaker and the listener on the other. A speech, though clear to the speaker himself, if uttered without any regard for the listener produces no impressions in the latter.

The description of a speaker he alone is a speaker who employs words which, while expressing his own meaning, are also understood by his 1istenerl also conveys the same awareness of the importance of speech being appropriate to the listener.

It can also be noted that speech, if it is to be free from faults of judgment, should not be prompted by lust, wrath, fear, greediness, crook- edness, shamefulness or conceit.

Speech has been categorized into three grades; Normal, good and excellent. Table 1 indicates the characteristics that go to form normal, good, and excellent speech. The plus and minus signs in the table indicate, respectively, the presence or absence of that characteristic.

To summarize, normal speech is not redundant but adequate, and it has meaning. It is efficient, intelligible, acceptable, and informative. In addition to these, moral values and appropriateness to the situation are stressed in good speech. In excellent speech aesthetic value is given more importance.

It will be noticed that a great deal of stress is placed on the aesthetic

Table 1. Characteristics of Normal, Good, and Excellent Speech

Normal Good Characteristics sneech soeech

Excellent soeech

Meaning + + Amount of information + + Efftciency + + Intelligibility + + Acceptability + + Nonredundancy + + Moral values + Appropriateness for situation + Aesthetic values - -

280 S. R. SAVITHRI

and moral values of speech. These definitions also consider the speaker, the listener, the message, and the situation but not articulation and voice. But it is not as if the ancient writers were unaware of the speech process. It can be noted that Rama compliments Hanumanthas speech in terms of articulation, gestures, and facial expression, in addition to choice of words, grammar, and scholarship. 23 Description of defective speech also indicates this awareness. Further, the ancient writers have described articulatory phonetics in detail.

Defective Speech. Speech is said to be defective where there is in- sufficiency, redundancy or want of meaning or misjoinder in utterances.24 Redundancy is repetition of matter that is even relevant. It may be of two kinds: Repetition of meaning and repetition of words.25 Repetition of meaning is where one insists on different words expressive of the same meaning and repetition of words is a repeated use of the same word.26

Unmeaningfulness is where speech affords no sense but consists of a group of letters.27 NZlg&juna defines defective speech in a similar way.2m

Incoherence is a combination of words each of which has a meaning, but the meanings are not connected with each other. For example, curds- family-Diamond-sun etc.28

It is said that shyness, fear, extreme loudness, indistinctness, undue nasalization, repressed tone, undue cerebralization, nonobservance to the places of articulation, improper accent, harshness, creating undue separation between words, uneven tone, haste, and palatalization are the 14 faults in a reader.2p

The words indistinct, undue nasalization, undue cerebralization, nonobservance of places of articulation, and palatalization refer to the articulation component of speech and hence any defect in articulation is considered a speech disorder. The terms extreme loudness, repressed tone, and harsh tone refer to voice disorder.

The definition also gives importance to the emotional aspect of a person, which indicates that any emotional disturbance during speech should qual- ify it as defective. Intonation and rhythm are also emphasized by the use of the words improper accent, uneven tone, and undue separation between words.

This can be compared with the definition of defective speech given by Van Riper: Speech is defective when it deviates so far from the speech of other people that it calls attention to itself, interferes with communication, or causes its possessor to be maladjusted (Van Riper, 1971). This definition refers to conspicuousness of speech, intelligibility, maladjust- ment, and emotional handicap.

Normal Voice. According to Caraka those voices are designated as normal or natural which resemble the voice of swans, cranes, sparrows, crows, pigeons and dundhubhis (a sound-making instrument).30 All the


other voices that are seen to be appropriate to the ancestral lines of persons, however much they may differ from normal, should be regarded as normal voices.31 In summary, the pitches of persons that resemble the pitches of these birds and instruments are considered to be normal. It is also clearly said that if a particular group of people have been using a particular voice, it should be considered normal, thus giving importance to social values and group norms. As far as this definition goes, society is apparently the best judge of the normalcy of voice.

In contrast, the following voices when observed in patients are regarded as abnormal: 1) that which resembles the voice of a parrot, 2) that which is very low, 3) that which is totally choked in its utterance, 4) that which is indistinct, 5) that which is half-uttered, 6) that which is weak, 7) that which is uttered with pain, and 8) that which is the result of repeated efforts.32

Any deviation in pitch, clarity, or loudness, is a voice disorder. Ease of utterance is also regarded as one of the factors in normal voicing. Organic conditions are considered as well.

The sudden appearance in the voice of modifications from normal to abnormal or the combination of many pitches into one [monotonous?] or the division of one voice into many [diplophonia?] is regarded as an un- favorable symptom.33

Different types of speech have been described as follows: Speech of Children: Childrens speech will have lisping [aspsfavar-

nasamyukta] which leaves syllables unfinished.34 Speech in sleep: Speech in sleep proceeds with a heavy voice. Words

sometimes will be distinct and sometimes indistinct. Sometimes the same meaning will be repeated twice. This speaking depends on the recollection of the past.35

Speech of old people: They will have a faltering voice with misarticulations.36

Speech of a person dying: Syllables produced will be relaxed and heavy. The faltering voice resembles the sound of small bells and it will be accompanied by misarticulation, hiccup, hard breathing, and repetition.37

These are from the Nattya SBstra of Bharata, where it is said that actors impersonating a child, an old person, a person sleeping, and a person dying should speak as described. The author has either observed the speech of different people and has suggested how the actor can imply these in a naturalistic way or these may be stylized speech patterns and may have been recommended as the accepted forms of representation, However, some of the descriptions, such as the speech of a person near death are also given by some medical authors like Caraka and Vagbhata.

Production of Voice

The production of voice is described as follows according to Indian philosophy:

282 S. R. SAVITHRI

The soul inspires the mind, which being set into action, activates the fire in the body. This fire stimulates the wind.38 The stimulated wind in the brahmagranthi travels upward [There are three granthis (glands), situated in the regions of the stomach (diaphragm?), chest, and head, among which the brahmagranthi is the one situated in the region of stomach (diaphragm?)]. This air while traveling upwards generates n&da (an all- pervading eternal sound) at the levels of the stomach, heart, throat, head, and tongue (mouth).39

The nada produced at these different levels are named differently. That generated at the level of the stomach is designated as atisiik$ma (fine) and that generated at the level of heart is called stiksma (minute). At the level of the throat it is known as apqfa (soft). Pqta (loud) is the name given to it at the level of the head and k$rima (artificial) at the level of the tongue.&

The words atisOkSma and siik$ma convey that the n&la at the levels of stomach (diaphragm?) and heart is so minute that it is inaudible under normal conditions, whereas that generated at the level of the tongue is perfect, loud, and rich.

It is said that the whole universe is filled with n&da. Hence ntida may be thought of as a sound that is not audible, or it may be an all-pervading, preexisting condition of sound that may not be audible.

Speech Perception. In general, the process of perceiving any sensory object is as follows:

There are five senses, viz., vision, hearing, scent, touch, and taste, and five materials that constitute these senses, viz., space, wind, life, water, and earth. There are five seats of these senses, viz., eyes, ears, nose, tongue, and skin, respectively. The five objects of these senses are form, sound, scent, touch and taste.41

The sensory object reaches the sensory nerve through its apparatus. From the sensory nerve, it reaches the memory or the storage and from there it goes to the mind and ~0~1.~~

Perception springs from the union of the sensory object, the mind, and the soul. It is of two types, transitory and durable.43

All the senses are incapable of acting at one and the same time. The senses become capable of seizing their respective objects only when they are led by the mind. * This is summarized in Figure 1.

(artha) (indriya) (indriya (mana) (Htma) adhistana) . .

Figure 1. Process of perception.


Applying this to speech perception: The Sensory object (sound) reaches the sensory nerve (auditory nerve) through the sensory apparatus (the ear). From the sensory nerve it reaches the storage or memory and from there it goes to the mind and soul, after which sound is perceived.

Sound is said to be perceived when the sound (speech), the mind, and the soul unite. This is summarized in Figure 2.

Sound is defined as a quality perceived by the ear.45 Nyaya-vaiSeSika theories distinguish three vaieties of sound in view of the three kinds of causes that may produce them. These are (1) sound caused by contact (samyogaja), (2) sound caused by disjunction (vibhagaja), and (3) sound caused by another sound (Sabdaja).&

The first variety arises when a drum is beaten by a stick. The second variety arises when a bamboo is split. The third variety is to be found in the series of sounds successively arising in the space (CikaSa) intervening between a drum, for instance, and the sense of hearing. In Indian philosophy, a considerable measure of speculative value is attached to the Nyaya theory of Sabdaja Sabda or series of successive and exactly similar sounds arising in a continuous chain, beginning with the first sound, caused in the portion of space determined by the substance that is struck, such as a drum, and ending with the last sound, caused in the portion of space representing the sense of hearing, which is actually heard.47

The naiyayikas explain the way in which the sound series is produced by means of two illustrations: (1) illustration of a little wave and a big wave (Vicitaranga nyaya), and (2) illustration of the flowering of a kadamba filament (Kadamba mukula nyaya).

These two illustrations suggest two ways of explaining how a sound is heard on all sides and in all the ten directions, including the intermediate points and up and down, A little circular wave springs up: around it a bigger wave arises; around it a still bigger wave, and so on. In this way, a circular wave of sound is caused around it, a bigger sound wave and so on, until at least a certain sound wave is produced in such a way that it reaches the sense of hearing, which may be ready to perceive the sound. In this explanation there is only one series consisting of several circular sound waves each moving outward in all the ten directions. The second explanation is illustrated by the kadamba flower, in which one filament first shoots up, thus causing several filaments to shoot up simultaneously in all the parts of the flower. In the same way the first sound produced

(vlk) (karlfa) indriyI (mana) (Htma) dhiafana

Figure 2. Process of speech perception.

284 S. R. SAVITHRI

at some point causes ten sound waves to spring up simultaneously, and these cause ten more waves to spring up in all the ten directions, and so on, and thus the sound in question comes to be heard on all sides.48

The anatomy of the ear is briefly described by Varier in his Astanga &riram (1904 AD). However, only a few words, like cochlea, external ear, and auditory nerve find place in other ancient Sanskrit texts. It is possible that Variers work indicates the growth of Sanskrit literature as influenced by Western thoughts.

Phonetics, Intonation and Rhythm. This section covers the articulatory description of speech sounds, kinds of intonation and their descriptions, and use of pauses. It also discusses primary and secondary effort involved in speech.

In the Taittiriya upanisat, in the chapter on phonetics, it is said that Siksa (phonetics) includes the study of varna (phoneme), svara (voicing), matra (duration), balaxir (Intensity), sama (Intonation), and santana (conjunction).49

Varna are those such as a, a, . . . etc.; Svara refers to pitches (high, low); matra refers to duration (short, long, prolated . . .); Balam refers to the intensity of the speech sound; sama refers to the intonation patterns; and santana refers to the conjunction between several sounds.

Speech sounds are 63 or 64, according to their origin.50 They can be classified on the basis of pitch, quantity, place of articulation, primary effort, and secondary effort51

According tci Pitch Some consider that there are seven different pitches. These are Sadja, Eabha, gandhara, madhyama, paticama, dhaivata, and [email protected] These seven correspond to the notes used in the musical scales. Others accept only three pitches, udatta (high), anudatta (low), and svarita (high-low).53

However, of the seven pitchs mentioned, n&&da, and gandhara arise in the high pitch and hence can be included under udatta. Similarly $abha and dhaivata arise in low pitch and can be included under unudatta. Sadja, madhyama, and paiicama can be included under svarita(?). Variations in pitch lead to variations in inflection, thus changing the meaning of a sentence.

In an utterance there can be nine kinds of inflections, which are as follows:

1. Antodatta: the end of the utterance is high pitched. 2. Adyudatta: the beginning of the utterance is high pitched. 3. Udatta: whole utterance is high pitched. 4. Anudatta: whole utterance is low pitched.


5. Nica-svarita: the utterance is in low-high-low pitch. 6. Madhyodatta: the middle part of the word is high pitched. 7. Svarita: the utterance is in high-low pitch. 8. Dyudatta: high pitch occurs twice in an utterance. 9. Tryudatta: high pitch occurs three times in an utterance.

These are with respect to words.54

Use ofDifferent Types of Pitch. It has already been said that there are three different kinds of pitch. Out of these three, high pitch should be used when one is at a distance. When the person being addressed is not at a great distance middle pitch should be used, and low pitch should be used when addressing someone nearer.55

It is also said that one should not suddenly proceed from high to low pitch or from low to high pitch.56

We now know that normally it is the loudness that varies, but not the pitch. However, pitch variations accompany loudness variations. So the above descriptions have merit.

Amding to Quantity (Time Taken)

Quantity is the time taken for the utterance of speech sounds. On the basis of quantity vowels were classified as short (Hpsva), long (dirgha), and prolated (pluta). 57 Those sounds that are uttered in the time of one matra (a unit of time) were called hrasva, those that took two matras for their utterance were called dirgha, and those which took three matras were termed pluta.58

The stop and nasal consonants were considered to be I/q, 1/2, and 1 matra by various authors.59 Paniniya Siksa opines that voiced consonants were one-half the duration of voiceless consonants.m

According to the Place of Articulation

The eight places of articulation were: Chest, throat, palate (roof of the mouth), root of the tongue, teeth, nose, lips, and palate.61 According to the place of articulation, the Sanskrit speech sounds were classified as in Table 2.62

This is a more complete description than found in Western books. It also includes the chest and throat as articulators.

The Ayurvedu szitru attributes the production of different sounds to different venal plexuses, which are assumed to be situated in different parts of the mouth.

According to this, the n sound is produced by the venal plexus situated in the neck, which is surrounded by 16 veins.63 For the production

S. R. SAVITHRI

Table 2. Sanskrit Speech Sounds: Classified on the Basis of Place of Articulation

Manner of articulation

Stop consonants WrSa)

Vowels Unvoiced Voiced Nasals Semivowels Sibilants (Svara) (aghosa) (ghosa) (nasika) (Antastha) (usma)

Wta (velar glottal?)

T%hl (palatai)

Miirdhna (cerebral/ retoflex)

Dan@ (dentals)

Osta (lab&)

Dantosta (labiodental)

KalJtat&l (palatovelar)

Kantosta (velarlabial)

a k, kh g, gh it h

i c, ch j,jh d Y s

T ?Sh P, dh I? r s

1 t, th d, dh n I S

u P, ph b, bh m

V

e,ai

0,au

of /d/ and /dh/ sounds the venal plexus in the neck surrounded by 105 veins is responsible. 64 The /r/ sound is produced with the help of the venal plexus in the lips, which is surrounded by 16 veins.65 The venal plexus in the dental region is surrounded by 30 veins and is helpful in the production of lksl. S The two venal plexuses in the palatal region are surrounded by one vein each and are responsible for the production of the /s/ sound.67 The venal plexus in the vacaspati region(?) is surrounded by the veins and is responsible for the production of /l/.68 Surrounded by the two veins, the plexuses in the region of the salivary glands activate the production of the /y/ sound.69

This has not been dealt with in any other text. West, Annsberry, and Cat-r (1956) attribute the production of different sounds to the action of different muscles, supplied by nerve endings, whereas here it is considered that venal plexuses in different regions are responsible for the production of sounds. However, it is not clear whether the word sir& in this context refers to vein or nerve ending.

According to Primary Effort (Yatna)

Primary effort is of two kinds, viz., internal effort and external effort. Internal effort (Abhyantara prayatna) is of four types:


1. Sp@a: complete contact; 2. fsatspr$a: slight contact; 3. Vivrta: open and; 4. Sar&ta: contracted.l

Internal effort is the effort made before the production of speech sounds within the oral cavity. It refers to the degree of contact between the articulator and place of articulation and the degree of opening between the articulator and the place of articulation.

In the production of stop and nasal consonants, there will be close contact between the articulator and the place of articulation. This effort is termed Sp@a.

In the production of semivowels the articulator approaches the place of articulation and a slight contact will be made. This effort is known as isatsp@a. 73 While producing sibilants and vowels the mouth is open and the effort is termed vivrta.74 In the production of the /a/ sound, the mouth is contracted and this &fort is known as Sarhvlta.75

External efforts of eleven types were mentioned: (1) samv&ra, (2) vivka, (3) Svasa, (4) n&da, (5) ghosa, (6) aghosa, (7) alpaprana, (8) mahap- rana, (9) udatta, (10) anudatta, and (11) svarita.76 External efforts are the efforts taking place after the production of (mental) speech sounds. Sarh- vka and Viv&ra are the efforts related to the movement of the vocal cords. Samvara denotes the closure (contraction, vibration) and vivka denotes the open status of the vocal cord. For voiced sounds vocal cords will be vibrating or perform an effort called sarhv&ra, and for voiceless speech sounds they are wide open or perform the effort viv?ua.76a Svasa/aghosa and nada/ghosa are the efforts concerned with the type of source utilized in speech sound production.

In the production of voiced speech sounds the vocal cords vibrate (perform the effort samvara) and thus modify the airstream. Hence modified air forms the source for voiced speech sounds. This effort is termed nada/ ghosa. In the production of voiceless speech sounds, the vocal cords are wide open (perform the effort vivara) and the airstream is not modified at the level of glottis, or the unmodified airstream passes through the glottis. This effort is termed Svasa/aghosa.76b Alpaprana and MahiiprQa are the efforts concerned with the amount of air utilized in speech sound production. Alpaprana is when the volume of air utilized is less and ma- hapr&na is when the volume of air utilized is more. /k/, /g/, /c/, /j/, /t/, Id/ It/, Id/, lpl, lb/ are considered to utilize less air and /khl, lghl, /&I, /jh/, /th/, /dh/, /th/, /dh/, /ph/, /bh/ and sibilants are considered to utilize more air.76c

Udatta, anudatta, and svarita are the efforts taking place when high, low, and high-low pitches are produced. In the production of high-pitched voice the effort involved is udatta, i.e., when the speech organs are stiff-

288 S. R. SAVITHRI

ened, the aperture of the vocal cords become small, and air travels fast, and the voice is hard and high pitched, then the effort taking place is termed udatta.76d When the speech organs are loosened, the aperture of the vocal cords is expanded, the air travels slowly, and voice becomes soft and low pitched then the effort taking place is termed anudatta.76

When in a syllable first udatta or high pitch is used and then anudatta or low pitch is used, then it is termed svarita.76f

These three efforts apply only to the vowels as pitch applies only to them. Hence any vowel can be intoned in any pitch.

According to Secondary Effort (Anupradiina)

The term anupradana is equivalent to after-effort or secondary effort, which means stiffening or loosening of vocal cords.

Intonation. This is of two kinds: (1) entailing expectation (sak%iksa) and (2) entailing no expectation (nirz3kariksa).77 These relate to the sentence structure. A sentence that has not completely expressed its intended meaning is said to be sak&iksa. A sentence that has completely expressed its intended meaning is nir&k&iksa. The former has notes from the throat and chest and begins with a high pitch and ends in a low pitch. The latter has notes from the head and begins with a low pitch and ends in a high pitch.78

In the Natya Sastra, it is suggested that different types of intonation should be used in different situations. It is said that intonation will always be made high, excited, and fast in a rejoinder, in confusion, in a harsh approach, when representing sharpness and roughness, agitation, weep- ing, challenging one who is not present, threatening, terrifying, and calling someone at distance.79

Intonation will be grave and slow in conditions of sickness, fever, grief, hunger, thirst, deliberations, deep wound from a weapon, communicating confidential words, and in states of anxiety. Intonation will be grave and fast in womens soothing children, refusal to a lovers overture, panic, and attack of cold.80

Intonation will be slow and excited and of low pitch following loss of an object after having seen, hearing anything untoward about a desired object or person, in communicating something desired, mental deliberations, envy, ensure, saying something that cannot be adequately expressed, telling stories, rejoinder, conclusion, an action involving excess, wounded and diseased limb, misery, grief, surprise, jealousy, anger, joy, and lamentation.*l

Grave and slow intonation can be used in words containing a pleasant sense and bringing happiness. Excited and high intonations can be used in words that express sharpness and roughness.82


It can be noted that both high-excited-fast and low-excited-slow intonations are said to be of use in rejoinder, which is either a contradiction or an indication of acceptable alternatives.

Pause. A pause is due to the completion of sense and is to depend on the situation. Care should be taken with regard to pauses, since they clarify the meaning-in fact, meaning depends on pauses.83

When words and syllables are combined into compound utterance or the utterance is quick, confusion about different meanings is liable to arise. Hence pauses should be observed as required by the breath. In the remaining cases pauses should depend upon meaning.84

There is a direct relationship between the duration of the pause and the length of the syllable. When the pause is of greater duration, the syllable produced will always be long. But the duration of the pause should not be more than six kZiIlBs.85

Ktia is a measure of time that has not been defined. Two types of pauses, namely, pausing for breath and pausing for meaning, have been identified here.

These descriptions of intonation and pauses have been taken from the treatise on dramatics, and refer primarily to instructions to actors in the use of speech in drama. It is not clear whether they are based on the observation of intonation of different people, or are stylistic devices following accepted patterns.

Speech Disorders and Their Causes

In this section, the types of speech disorders and their causes in general are dealt with.

Most of the speech disorders dealt with come under the category vata vyadhi (neurological) disorders. The following are the speech disorders that have been encountered by the present author:

1. Mukata: speechlessness (aphasia?); 2. Vaksatiga: difftculty in speaking or unintelligibility of speech (dys-

arthria?) (stuttering); 3. Minmina: nasal voice; 4. Svaraksaya: aphonia; 5. Gadgada: Misarticulation/partial omission (stuttering); 6. Kantopadvarhsa: hoarse voice.86

Some of the conditions in which speech disorders are found are (1) ostabheda (cleft lip), ardhita (facial palsy), and (3) hanustatfrbha (temporomandibular dislocation) .86

Causes of Speech Disorders. The causes of any disorder in general are three. It may be due to the faults of judgements (of the perceiver), lack

290 S. R. SAVITHRI

of harmony between the sense and object (hence one cannot hear, speak, feel, etc.), or effects of time.

Most of the speech disorders come under the category of neurological disorders. Hence, in general it can be considered that speech is disturbed whenever the functions of the central or sympathetic nervous system is impaired. Specifically, the causes of speech disorders are as follows:

Causes of V&s&ga. SuSruta is of the opinion that bulb poison causes vaksariga. 88 Carrying heavy weight, making too many jokes, and chewing hard substances disturbs the neural force and this leads to asymmetry of the face. The patient looks as though he is laughing. His head starts shak- ing. Sneezing will be suppressed. He develops hearing loss, loss of sense of smell, and amnesia, and he will have v&ksa.riga.89

When both the functions of the central and the sympathetic nervous systems and thermogenesis are attenuated, the doss (kapha) concerned with the functions of thermogenesis (heat regulation) brings on suppres- sion of voice and v&ksatiga.gO (According to the Indian system of medicine, it will be recalled, there are three dosas in the body maintaining the state of health. Kapha is one of them.)

This can be compared with some Western statements. Seeman (1934) constructed a theory of the nature and causes of stuttering based on the malfunctioning of the subcortical areas of the brain. He believes that the sympathetic part of the autonomous nervous system becomes hyperac- tive, in part because of emotional stress or because of lack of inhibition from the cortex, and that this produces disturbances in all of their fundamental processes on which the speech is based.

Sovak (1935) gave adrenalin to stutterers, which increases sympathetic arousal, and found that his stutterers got worse, while pilocarpin, which activates the parasympathetic system, caused a reduction of stuttering.

The ancient Sanskrit scholars, however, opine that the reduced action of the sympathetic nervous system causes stuttering, whereas the theory of Seeman states the opposite. Perhaps there is a certain optimum level of action for the sympathetic nervous system (for each individual), above and below which stuttering may be caused.

In hemiplegia or paralysis of one side of the body, the neural force seizes the nerves controlling the function of one side of the body and produces loss of movement, pain, and v5iksatiga.

Causes of Gadgada (hIiwticulations)

Cysts or polyps in lips, palate, or larynx tend to make speech indistinct.92 Weak and slow poison (animal, vegetable, or chemical) may cause gadgada. Excess consumption of fat may bring on gadgada.%


Causes of Miikata (Speechlessness)

This may be either congenital or acquired. The congenital diseases follow such causes as chemical inbalance in the mother and ungratified cravings of the mother during pregnancy. This can produce deafness, blindness, and miikata in the child.95 The woman who is addicted to sweets gives birth to a child that is mentally retarded or unable to speak% (mtikam).

Faults caused by defects of the womb, timing and defects of food, and defects in the movement of the mother during the period of gestation cause defects of the body, complexion, or organs (both of sense and action) in the embryo. Hence the child will be unable to speak.97

Among the acquired causes, snake bite is found to cause loss of speech in most cases.98 A strongly provoked neural force localized in the back, the sides of the neck, and constricting the external vessels, causes a bow- like ridigity of the body, which is called dhanustamba (tetanus). The body being bent like a bow, the head of the patient gets retracted, almost touch- ing his back, and his chest is thrown forward, the sides of the neck become rigid, and there is a squeezing pain the neck. The attack c%tises speechlessness (vaggraha), or it may even kill the patient.-

This may either refer to aphasia or stuttering as a form of tetany. A number of researchers have investigated the biochemistry of stuttering-primarily the composition of the blood, urine, and saliva. The rationale for these studies has usually been that these secretions, which are controlled primarily by the autonomic nervous system, might reveal an organic pathology or malfunctioning of that system that could make the person more prone to stutter. Stuttering is characterized by excessive tension, or clonic and tonic behaviors. So also is tetany, a calciometabolic imbalance that results in hyperirritability of neuromuscular activity causing clonic and tonic spasms. Tetany may also be latent, appearing only under stress. Kopp (1934) in his biochemical study of blood composition in stutterers, interpreted his data as supporting the concept of stuttering as a term of latent tetany. Shackson (1936) interprets his results as indicating a possible latent tetany in stutterers.

From eating dry substances, from any external injury, the neural force in the temporomandibular space is disturbed, and this causes dislocation of the temporomandibular joint. In this condition one cannot take food, nor can one close or open the mouth. One will be unable to speak (ab- hasanaxh).OO When there is a ranula on the tongue, the patient will not be able to speak (vakyavighata) . lo1

Specific kinds of food are also thought to cause speech disorders. For example, meat of domesticated animals, of those that live in marshy regions, and of those that are acquatic should not be consumed in conjunction. With honey, lotus stalks, seseme oil, molasses, milk, garden radish, and paddy that have put forth sprouts. If these are consumed, diseases such as deafness, rigidity, loss of speech (miikata), and nasal voice (minmina) are caused. It may even lead to death.lo2

In the second and third stages of alchoholic drunkenness and in the

292 S. R. SAVITHRI

coma stage, one loses ones speech and loses control over all ones actions. lo3

Improper administration of oil to the parts of the body causes stoppage of speech.lM When the tongue is paralyzed it causes inability to take food and to speak. A hysterical patient will also lose his speech.lM

Causes of Svarabheda (Voice Disorders)

The neural force when disturbed by such causes as extremely loud speaking, taking poison, reading at the top of ones voice, external injury, and exposure to cold causes voice disorders. These are of six types.

In the vataja type of voice disorder, the patients eyes, face, and feces will turn black, and in the pittaja type of voice disorder they will be yellow in color. In the first condition the patients speech is sometimes heard as stuttering, and the second condition will be accompanied by chestpain. lo8

In the Kaphaja type of voice disorder, because of the phlegm, the patient speaks with a soft voice. His voice will be worse in the mornings. In the sannipataja type, all the above characteristics can be observed and his speech will be unclear. This condition is very difficult to treat.@)

A patient who has the ksayaja type of voice disorder will start speaking but suddenly lose his voice. This condition is not curable. In the medoja voice disorders, the voice will be very soft and speech is unclear.

In tuberculosis and leprosy patients, the voice will be disturbed (svarabheda). 11 A young child who drinks contaminated milk will have a soft voice (in terms of loudness) (k@masvarah).*

These descriptions of speech and voice disorders are mainly based on the system of three dosas. The speech and language disorders are generally considered to be organic in nature. It is interesting to note that even the listeners judgement is considered one of the causes. Prenatal, psychological, and organic factors are listed as causes of speech and language disorders.

Facial Palsy (Arditah). This has been known to result from excessive hemorrhage or loss of blood. The neural force that is disturbed by continuous talking in an extremely loud voice, chewing of hard substances, loud laughter, yawning, carrying extremely heavy loads, and lying down in an uneven position on the ground, lodges in the region of the head, nose, upper lip, chin, forehead and the joints of the eye and produces facial palsy (arditam).13 Old and enfeebled persons, infants, and pregnant women are most prone to fall victims to this disease.l14

SYMPTOMS. The neck and half of the face longitudinally suffer distortion and the head shakes. One will be having misarticulations. Eyes are dis- torted. Portions of the neck and the chin as well as the teeth on the affected side become painful. * SuSruta refers to it as facial palsy (arditam) where one half of the face is paralyzed. Caraka uses the term arditam when one or both halves of the face are paralyzed.


PREMONITORY SYMPTOMS. The disease usually commences with shiv- ering, dimness of vision, anaesthesia, a pricking pain in the affected locality, and paralysis of the jaw or of the cervical muscles of the neck.16 PROGNOSIS. When the patient is very old and exhibits such symptoms

as unblinking vision, or misarticulated speech that barely seems to come out of the throat and when it persists for more than three years, it will have a very poor prognosis. 1 l7

Treatment of Speech and Language Disorders

Preventive and curative treatments have been advocated. Preventive treatments are those that cause the speech of a child to be clear and that prevent any speech disorder that may occur in time. These are given to the child usually at an early age. Curative treatments are those that are given to overcome existing speech and language disorders. They are administered during the course of the disorder. This may further be of two types, medical and surgical. Drugs are used in some of the disorders such as misarticulation, voice disorders, mtikata, and vakstambha. Surgery is advised in cases of cleft lip. The following preventive measures were advised:

1. Tongue exercises: Tongue exercises such as the lateral movement, elevation, and protrusion of the tongue help in speech development. *

2. Drinking clarified butter daily helps in improving voice, strength, and complexion and lengthens the life.19

3. One who has taken oil and digested it already should avoid physical exercises, loud speech, exposure to cold and heat, and all places that are breezy. izo

4. Bitter things should be consumed very often as they have the capacity to enhance speech.*

5. One should suppress the rising impulses of harshness and speech that is disagreeable to others.**

6. The companionship of those who are sinful in conduct and speech should be avoided. *29

Curative Treatment. This again can be considered under two headings:

1. Treatment of neurological disorders in general; 2. Treatment of specific speech disorders.

Treatment of neurological disorders in general: It is advised that sweet and salty food and purified butter are beneficial to the patient.i24

The following are found to be of good use in cases of neurological disorders: Administration of medicated ghee, anointment of the body, administration of oil purgatives, rubbing of oils on head, oily fumigations,

294 S. R. SAVITHRI

gargling with tepid oil, use of oily errhines, use of meat soup, milk, and clarified butter, use of oil or other food, use of all kinds of acid fruits, salt and lukewarm washes, gentle massage and use of saffron, wearing of wool, silk, cotton, or any other thick kind of garments, living in a warm room or in one not exposed to air or in an inner chamber, and use of a soft bed. 12

oil of Chagaladya

This is very useful in cases of miikata, minmina (nasal voice), and gadgada (misarticulation/stuttering?).126

In diseases brought about by improper administration of oils, the following are the treatments:

1. Vomiting by administration of emetics; 2. Production of perspiration through heat; and 3. Abstention from food till the oils taken are digested.27

In conditions where speech is obstructed, thin gruel prepared with ghee and meat, application of medicated ghee, oil, fat, which serves to lubricate the body, and application of heat are useful.28

Treatment of M&ata

Kaficika mixed with salt should be gargled. Aniseed, brahma beeja, and salt of equal proportions should be mixed with the same proportion of achorus calamus and should be made into a paste with ghee and honey. Ten grams of this should be taken after the consumption of milk with rice. The person who does not have any speech and who takes this becomes such a good speaker as to master thousands of books.129

KaIyiiqaka leha

This is a powder that is thought to be beneficial in cases of gadgada and mtikata. It is prepared as follows: Cumin seed and salt should be taken in equal proportion and a paste of this should be made. This powder should be mixed with whin seed and taken orally daily. In 21 nights the intensity of ones voice will become as loud as a dundhubhi (a sound-making instrument used in wars) or like the sound of thunder.13

Treatment of Voice Disorders

In case of the vataja types of voice disorders, oil mixed with salts should be used. Rice should be mixed with ghee and jaggery and taken, after which warm water should be consumed. 13* In cases of the pittaja type of

SPEECH AND HEARING SCIENCE IN, ANCIENT INDIA 295

voice disorders, honey mixed with ghee should be given. Rice can be mixed with milk and taken, after which ghee should be consumed.13* Clarified butter should be constantly used with milk in these cases.133 In cases of the kaphaja types of voice disorders, gargling of salts and bitter elements is very useful. By this the phlegm in the neck, tongue, and roof of the teeth will come out and the voice becomes clear.134 Powders of pungent drugs can be taken with oil and honey in these cases.13

In cases where one has a high-pitched voice, milk prepared with the drugs of the madhura group, fried bengalgram, and honey should be mixed and taken.36

An oil called nar-ayana taila is said to be of use in cases of misarticulation. 13

Devadaru, honey, and seeds -of brinjal egg plant made into a paste is very good in cases of lisping/stuttering (vacaskalana).13

Surgery for Cleft Lip. SuSruta and Vagbhata mention cleft lip and de- scribe the surgical procedures in such cases. Vagbhala opines that the two borders of the separated lip should be brought close and stitched. SuSruta describes rhinoplasty, which he states can be applied in cases of cleft lip also.

Most of the treatments are purely medical in nature. It is noteworthy that the theory and treatment correlate with eachsother. But the treatments of voice disorders appear to be like those for colds and coughs. However, without experimental testing of these medicines, no definite conclusions can be drawn regarding their use.

AUDIOLOGY

Diseases of the Eur. According to Caraka, Susruta, and most of the other authors, there are 28 types of ear diseases. In addition to these Madhavacarya and Vaghbhata mention parilehi and kucikarqaka. The 28 diseases are as follows:

1. Karna@lam (ear ache); 2. Badhiryam (deafness); 3. Pranada (tinnitus); 4. Ksveda (labyninthetis); 5. Karnasrava (ear discharge); 6. Karqakandu (itching of the ear); 7. Karnagutha (wax in the ear); 8. Kemikaqra (vermin-infested ears); 9. Vidradi (furunculosis) two types;

10. Prattinaha (obstruction of the eustachian tube); 11. Karnap%ka (suppurative otitis media); 12. Ptitikarna (fetid discharge in the ear); 13. Arsas (cysts or polyps)-four types;

2% S. R. SAVITHRI

14. Arbudam (tumors)-seven types; 15. Sotha (swelling or inflammatory condition of the ears)-four

types.39

1. Ear Ache. This is caused by the disturbed movement of the air in the middle ear and is aggravated by the disturbed actions of the humors in that locality. There will be violent aching pain in the region of the ear. 40

2. Tinnitus. When the movement of the air in the middle ear is disturbed and when it gets into the wrong path and remains there stuffed in the sound-carrying channels of the organ, then ringing and various other sounds are heard. This produces a low-frequency sound like the sound of a drum.i4 The air that is associated with pitta (phlegm) produces high- frequency sounds in the ear that resemble the sound of a flute.14

3. Deafness. When the air associated with pitta stays in the nerves for a long time and when it is not treated properly, it results in deafness.43

No mention has been made as to whether the deafness is conductive or perceptive.

4. Labyrinthitis. The causes of this are use of any cold things, exposure to cold after being treated with a head-purging remedy, air staying in the nerves for a long time, a washing process in the system, or eating foods that have an astringent taste.la

5. Discharge in the Eur. This is usually caused by a blow on the head or long immersion in water or a spontaneous separation or bursting of an abscess in the ear. The ear is filled with water and there will be watery discharge from the ear.145

6. Itching in the Eur. This is caused by the aggravation of the local kapha. An excessive itching sensation will be reported by the patient.&

7. Wax in the Eur. This is caused by mucus accumulation in the ear, dried and hardened by the heat of the pitta.14

8. Obstruction of the Eustachian Tube. The dried accumulation of mucus becomes liquefied and comes out through the cavity of the nose. This produces obstruction of the eustachian tube and head diseases.&

9. Vermin-Znfested Ears. This refers to the germination of vermin or other local parasites in the ear cavity. This completely impairs the faculty of hearing. 149


IO. Local Abscess. It is caused by a blow or an idiopathic abscess in the cavity of the ear. This is marked by a choking and burning sensation and the patient will have piercing and sucking pain. There will be a red, yellow, or reddish bloody discharge. 150

11. Suppurative Otitis Media. This is caused by the disturbed action of pitta. There will be a sensation of blocking in the ear canal.151

12. Fetid Discharge in the Ear. When the pitta is not functioning properly, the mucus accumulation in the passage of the ear will be liquefied owing to an excess of heat produced. This is accomplished by a fetid discharge from the ear. There may be pain in the ear.*

13. Swelling or Injlammatory Condition of the Ear. This might have different causes such as disturbed action of vata, pitta, or kapha, disturbed function of blood, concerted action of all three dosas, or trauma.53

A swelling caused by the disturbed action of vata will be reddish or blackish in color and is shifting in its characteristic. It feels rough and soft to touch and is accompanied by an aching pain, which disappears at intervals. 154 A swelling due to disturbed function of pitta will be yellowish in color. It is soft to touch and under pressure it fluctuates. Blood will accumulate in the swelling, and this swiftly shifts from one part of the body to another. It is accompanied by a burning or a sucking pain.15 A swelling that is due to the disturbed function of kapha will be grey or whitish in color. The skin becomes glossy and cold. The swelling very slowly changes its original site, if it shifts at all, accompanied by pain and itching. lJ6

A swelling caused by the concerted action of all the three humors successively manifests the symptoms and assumes the colors peculiar to each of them. 15

The symptoms that mark a swelling caused by a disturbed function of the blood are identical to those exhibited in the swelling caused by the disturbed function of pitta, except that in this variety, the swelling will be black in color.

That of traumatic origin manifests symptoms peculiar to that of pitta and blood origin types.

A swelling that does not respond either to internal or external remedies on account of the insticient or contrary effects of the antibiotics goes to the stage of suppuration.lm

The unsuppurated stage continues as long as the skin of the swelling retains its natural color, marked by little pain and heat in its inside and coldness, hardness, and a slight elevation of its surface.61

The suppurative stage gives rise to a stage of pricking pain in the affected locality. The swelling seems as if it is being pricked with needles

S. R. SAVITHRI

or as though a host of ants were wandering over it, or as though it were being cut with a knife or pierced with a spear or thrashed with a club or pressed with a hand or scraped with fingers or burnt with an alkali. The patient complains of a sort of pain in the swelling of a fixed or shifting character. The patient, as though stung by a scorpion, will not be able to find comfort in any place or position.

The color of the skin changes and the swelling goes on increasing like an inflated leather bag. Fever, thirst, a burning sensation, aversion to food, etc. gradually occur.162

This stage is marked by pain, and the color of the skin will be yellowish. It exhibits fluctuation under pressure and comes back to its original size when the pressure is removed. The pus changes its place or shifts from one part to another. The distressing symptoms gradually subside. The patient again evidences a desire for food and feels a constant desire to scratch the affected part, which is still characterized by pain. Sometimes, as in the case of traumatic swelling, the suppurating process is restricted to the deeper tissues, and hence, fails to exhibit its characteristic symptoms. This is a fact that often misleads the physician. But knowledge that a process of suppuration is occurring that becomes as compact as a stone would ward off all apprehension of error of judgement.163

14. Atresia of fhe Eur. During pregnancy, owing to anoxia the pinna will be compressed, as a result of which it will be very small in size.ia

15. Parilehi. Owing to the mixing of kapha and blood small insects are produced in the edges of the ear, which reproduce and adheres to the pinna. This is known as parilehi.65

16. As a consequence of hearing sounds that are very loud and harsh, or of hearing no sounds at all, or of hearing sounds that are very low in intensity, one gets hearing 10~s.~

The first of these probably refers to noise-induced hearing loss. Though in listing the diseases polyps and tumors are mentioned, no descriptions are available for this.

TREATMENT OF EAR DISEASES

The treatment of the ear diseases can be dealt with in two broad categories, namely, general treatment and treatment of particular diseases. This section deals with both the general treatment and the treatment of specific diseases, which include medical and surgical lines of treatment.

SPEECH AND HEARING SCIENCE 1.NANCIENT INDIA 299

General Treatment. In most of the ear diseases the following are usually advised: use of ghee, renunciation of all sorts of physical exercises, baths without immersing the head, abstinence from talkativeness. 167

Treatment of Earache, Tinnitus, Deafness and Labyrinth&is. In cases of earache, application of fomentation with the fumes of barley, and bamboo boiled in kanala (fermented rice gruel) is very helpful.168

A bowl-shaped cup should be made with the leaves of Asvattha soaked in curds and it should be heated by flames of charcoal fire. The oil thus obtained should be used as an ear drop. This gives instantaneous relief in cases of earache. The affected ear should be fumigated with the fumes of burning pieces of linen cloth and with clarified butter and bdelium mixed together. 169

A rice diet should be forgone in the night and clarified butter with milk should be taken. The Sata pakavala oil should be prescribed as Sirovasti. It may also be given internally in cases of earache.17

In case of tinnitus and labyrinthitis the following is the treatment: Oil should be first administered and the patient should be purged with purgatives. He should be given antibiotics in the manner of nadi sweda (fomentation through a pipe). 17

Treatment of Deafness. Oil cooked with water, milk, and bilva and made into a paste with cows urine should be used as an ear drop. Oil should first be cooked with goats yastimadhu and vimbi fruit. When cooked down, it should be churned by hand and the oil should be separated. The oily part, after being stirred in the decoction of bilva, should again be cooked with milk weighing ten times and sugar, yasfimadhu(?), and sandal wood. It should be thickened and used as an ear drop in these cases.172

Treatment of Discharge, Vermin-Znfested Ears, Fetid Discharge. Er- hines, fumigations, and cleaning of the cavity of the ear are employed. The affected ear should be washed with the decoction of the drugs of the rajavcksadi or the surasadi group and filled with powders of these drugs. 173

In case of discharge, the cavity of the ear should be filled with the powders of the pafica kasaya drugs mixed with honey and juice of kapitta. 174

RasMjana rubbed and dissolved in breast milk and mixed with honey is very efficient even in chronic and long-standing cases of fetid discharge. 17

Fumigation with the fumes of vartaku or mustard oil, administration of emetics, smoke, inhalation, and gargles are beneticial.N

300 S. R. SAVITHRI

Treatment of Itching and Local Abscess. Mustard oil is very useful in the treatment of itching. Local abscess should be treated as an ordinary abscess. The affected ear should be filled with oil to soften the filthy deposit and the filthy matter should be extracted with a probe.177

Treatment of Wax and Obstruction of Eustachian Tube. Fumigation of the part with the help of a tube, smoke inhalations, and head purging are used in the treatment of wax.178

Administration of medicated oil, induction of perspiration, and the application of heat purgatives should be made when there is an obstruction of the eustachian tube.79

Treatment of Suppurative Otitis media. Any filth should be removed with the help of a probe or by cutting it with a hom.lsO

Treatment of Swelling. Surgical acts in connection with the swelling may be divided into seven kinds: (1) mutilation of the swelling by massage, (2) bleeding through application of leeches, (3) poulticing, (4) opening or incision, (5) purification of the internal morbid matter of an incised boil with corrective medicines, (6) heating, and (7) restoration of the natural color of the skin through cicartrization.181

Treatment of Atresia. Sweet potato mixed with buffalos butter should be kept in a dish and closed. The dish should be kept inside the heap of corn for seven nights and then the mixture should be applied to the pinna by which the pinna grows.ls2

Operation of the Injured Ear. When there is no lobule from loss of both the outer and inner portions, the form of operation is called %harya. In this, two pieces of skin, one taken from the cheek and the other from the back of the ear are brought together and a lobule is stitched.

It is interesting to note that medical treatment of atresia forms a part of treatment of ear diseases. However, it cannot be said to be valid until ex- perimented on.

SUMMARY AND RECOMMENDATIONS

Some of our findings agree with lines of modem thinking and some do not. It has been seen that the Sanskrit literature uses efficiency, intelligibility, redundancy, intensity, frequency, and cultural and aesthetic values for the evaluation of speech. The ancient writers have classified speech sounds according to the place of articulation, pitch, quality, and primary and secondary efforts. The production of consonants is attributed to venal plexus in different parts of the mouth.


Intonation is related to the sentence structure and different types of intonation have been described for different situations.

Pauses are said to contribute to the clarity of meaning, and they are seen to relate to both breathing and meaning. A direct relationship between the duration of a pause and the length of the syllable is assumed.

It is interesting to note that the propogation of sound waves is explained very well in the examples of the big wave and the small wave and the budding of the kadamba filaments.

Speech disorders like aphonia, hoarse voice, nasal voice, stuttering (dysarthria), and loss of speech are mentioned. In the general classifi- cation of diseases speech and hearing disorders come under the category of neurological disorders. Some of the speech disorders are recognized to be congenital, while only a few are considered functional. The causes of speech disorders are rather conditions with which a speech defect is associated as a symptom. Most of the diseases are said to be acquired except for a few like atresia deafness, which is thought of as congenital.

It can also be noted that attention was paid to noise-induced hearing loss, which is evident from statements like exposure to loud noise causes hearing loss. But no further preventive or curative treatment is advised for this.

In general, the whole system of Ayurvedic medicine is based on the theory of three do@. All the diseases are said to arise because of the disturbed action of these three humors.

Similarly, treatment is also based on the same theory in that all treatment aims at bringing back the actions of the dosas to their original state.

The treatment of speech and hearing disorders is mainly dealt with under two headings, namely, medical and surgical. In the medical lines of treatment curatives are also suggested and surgery is advised only in cases of cleft lip and injured ears. No reference is available regarding the surgery of cleft palate or of the ear. Tongue exercises are suggested as preventive measures.

This survey of literature has brought out many interesting details and points to the following further paths for research:

1. Using references on other materials more comprehensive studies need to be done.

2. Attempts at closer study can be made so that exact translations are established. Explanations of several terms that do not have equiv- alents in English are essential. This is beyond the limits of time available for this study.

3. Clinical trials of suggested therapy and treatment procedures can be done for experimental verification.

4. Experimental analysis of some of the subjects like preeffort and posteffort with reference to voicing could be done. These terms

302

5.

S. R. SAVITHRI

may refer to the same concepts as in the voicing studies made by Ladefoged (1975). Greater awareness of this information must be encouraged in stu- dents of speech and hearing.

APPENDIX A: SYSTEM OF TRANSLITERATION

a

an ai

t

kh

B

ch

Ep

th

i5

th

(9

ph v;

r

7

au

ah

sh v

jh R

dh a

dh

8

bh

W

V

?

I thank Dr. N. Rathna, Director, Ali Yavar Jung National Institute for the Hearing Handi- capped, Bombay, Dr. S. Nikam, Head, Department of Audiology, AIISH, Mysore, Dr. B. G. Gopinath, Lecturer, P. G. Section, Government College of Indian Medicine, Mysore. I also thank Vidwan Seshachala Sharma, Assistant Professor, Maharajas Sanskrit College, Mysore, Dr. Surendracarya, Lecturer, Department of Anatomy, Government College of Indian Medicine, Mysore, and Mr. Samba Murthy, Head, Department of Sanskrit, Yuva- rajas College, Mysore.

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We cant however, explain the development of the whole of this great literature if we assume as late a date as round about 1200-

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