सन्तीन्द्रियाणि सन्त्यर्था योगो न [१] च न चास्ति रुक्| न सुखं, कारणं तस्माद्योग एव चतुर्वधः ||१३१||
Even if there are sense organs and their objects present, there would be no disease, nor any happiness unless the fourfold combination is involved. So, this contact itself constitutes a causative factor for happiness and miseries.
As a matter of fact, no happiness or misery can be caused without the soul, the sense organs, mind, intellect, objects of sense organs and results of past action/deeds. But in the context of the science of medicine, it is only the fourfold contact which is relevant as a causative factor of happiness and miseries, that is to say the wholesome contact is required to be adhered to and the unwholesome one to be given up for the maintenance of good health.
इच्छाद्वेषात्मिका तृष्णा सुखदुःखात् प्रवर्तते| तृष्णा च सुखदुःखानां कारणं पुनरुच्यते ||१३४||
Happiness and miseries bring about desire in the form of likes and dislikes respectively. Then again this desire is responsible cause for happiness and miseries. It is desire which gathers several factors, which serve as substrata for happiness and misery.
Unless such factors are gathered, there will be no contact whatsoever and there can be no happiness or miseries without such contacts (Cause for such type of contact is again purusha).