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The term ‘hetu’ means a cause or etiological factor.  Understanding the cause of the disease is crucial for complete knowledge of pathogenesis and treatment. Eradication or removal of the cause is the primary treatment of any abnormal condition. It helps in the prevention and recurrence of diseases, too. (SAT-C.60)  The current healthcare system focuses on finding out a pathogenic micro-organism that causes diseases. Ayurveda, on the contrary, emphasizes the lacunae or defects in biological systems (kha -vaigunya) that occurred due to various reasons including, improper diet and lifestyle. The defense mechanism or immunity is vital to preserving health and prevent disease. The long-term exposure of weak causes or short-term exposure of potent causes can adversely affect the body channels. This gives a chance to the micro-organisms to overpower immunity, spread their toxins, and cause diseases. In the case of non-communicable diseases, the endogenous causes can cause damage. This article describes the etiology, various types of causes, and their importance in medical practice.

The term ‘hetu’ means a cause or etiological factor.  Understanding the cause of the disease is crucial for complete knowledge of pathogenesis and treatment. Eradication or removal of the cause is the primary treatment of any abnormal condition. It helps in the prevention and recurrence of diseases, too. (SAT-C.60)<ref>National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/sat</ref>    

 

The current healthcare system focuses on finding out a pathogenic micro-organism that causes diseases. Ayurveda, on the contrary, emphasizes the lacunae or defects in biological systems (kha -vaigunya) that occurred due to various reasons including, improper diet and lifestyle. The defense mechanism or immunity is vital to preserving health and prevent disease. The long-term exposure of weak causes or short-term exposure of potent causes can adversely affect the body channels. This gives a chance to the micro-organisms to overpower immunity, spread their toxins, and cause diseases. In the case of non-communicable diseases, the endogenous causes can cause damage. This article describes the etiology, various types of causes, and their importance in medical practice.

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{{Infobox

{{Infobox

|label2 = Authors

|label2 = Authors

|data2 =  Deole Y.S.,Anagha S.

|data2 =  Deole Y.S., Anagha S.

|label3 = Reviewer and Editor

|label3 = Reviewer and Editor

|data5 = carakasamhita@gmail.com

|data5 = carakasamhita@gmail.com

|label6 = Date of first publication:

|label6 = Publisher

|data6 = July 10, 2021

|label7 = DOI

 

|data7 = In process

|label7 = Date of first publication:

|data7 = July 10, 2021

|label8 = DOI

|data8 = 10.47468/CSNE.2021.e01.s09.065

}}

}}

==Etymology and derivation==

==Etymology and derivation==

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The word ‘hetu’ is derived from the Sanskrit word root ‘hi’ by adding the suffix ‘tun’. It means to cause, reason, object, motive etc.  

The word ‘hetu’ is derived from the Sanskrit word root ‘hi’ by adding the suffix ‘tun’. It means to cause, reason, object, motive etc.<ref>Jha Srujan. Amarkosha online application</ref>

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==Synonyms==

==Synonyms==

a) External causes (bahya hetu): External causes include alterations in diet, lifestyle, and seasonal influences.  

a) External causes (bahya hetu): External causes include alterations in diet, lifestyle, and seasonal influences.  

b) Internal causes (abhyantara hetu): Internal causes disequilibrium of functions of [[doṣha]], [[dhatu]], [[mala]], [[agni]] and [[indriya]].  

b) Internal causes (abhyantara hetu): Internal causes disequilibrium of functions of [[dosha]], [[dhatu]], [[mala]], [[agni]] and [[indriya]].  

'''III. As per the site of cause:'''  

'''III. As per the site of cause:'''  

The causes influencing pathogenesis are categorized as below:   

The causes influencing pathogenesis are categorized as below:   

a) [[Dosha]] specific causes ([[dosha]] hetu): These include factors that aggravate [[doṣha]]. For example, day time sleep caused aggravation of [[kapha]] [[dosha]].  

a) [[Dosha]] specific causes ([[dosha]] hetu): These include factors that aggravate [[dosha]]. For example, day time sleep caused aggravation of [[kapha]] [[dosha]].  

b) Disease specific causes (vyadhi hetu): These are factors that cause a disease.  For example, repeated use of hot and cold things at same time (sheetoshnaviparyaya) is a specific cause of skin diseases (kushtha).

b) Disease specific causes (vyadhi hetu): These are factors that cause a disease.  For example, repeated use of hot and cold things at same time (sheetoshnaviparyaya) is a specific cause of skin diseases (kushtha).

c) [[Dosha]] and disease specific causes (ubhaya hetu): These are factors that aggravate [[doṣha]] and cause specific disease. For example, excess consumption of sweet, unctuous and heavy diet is the cause of [[kapha]] dushti ([[dosha]] hetu), as well as for [[kapha]] [[dosha]] dominant disorders (vyadhi hetu) like sthaulya (obesity) and madhumeha (diabetes)  

c) [[Dosha]] and disease specific causes (ubhaya hetu): These are factors that aggravate [[dosha]] and cause specific disease. For example, excess consumption of sweet, unctuous and heavy diet is the cause of [[kapha]] dushti ([[dosha]] hetu), as well as for [[kapha]] [[dosha]] dominant disorders (vyadhi hetu) like sthaulya (obesity) and madhumeha (diabetes)

=== Fourfold classification (hetu chatushtayam) ===

=== Fourfold classification (hetu chatushtayam) ===

==Contemporary approach and current researches ==

==Contemporary approach and current researches ==

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In the epidemiological literature, multiple definitions of causation are observed. Causes are conditions that play essential part in producing the occurrence of disease.  

In the epidemiological literature, multiple definitions of causation are observed.<ref>M Parascandola, D L Weed, Causation in epidemiology, J Epidemiol Community Health 2001;55:905–912.</ref> Causes are conditions that play essential part in producing the occurrence of disease.<ref>Krieger N. Epidemiology and the web of causation: has anyone seen the spider? Soc Sci Med 1994;39:887–903</ref>

*'''Necessary causes:''' A necessary cause is a condition without which the effect cannot occur. For example, HIV infection is a necessary cause of AIDS.  

*'''Necessary causes:''' A necessary cause is a condition without which the effect cannot occur. For example, HIV infection is a necessary cause of AIDS.<ref>Charlton BG. Attribution of causation in epidemiology:chain or mosaic? J Clin Epidemiol 1996;49:105–7.</ref>

*'''Sufficient cause:''' A sufficient cause guarantees that its effect will occur; when the cause is present, the effect must occur.  

*'''Sufficient cause:''' A sufficient cause guarantees that its effect will occur; when the cause is present, the effect must occur.<ref>Rothman KJ. Causes. Am J Epidemiol 1976;104:587–92</ref>

*'''Sufficient-component cause:''' A sufficient-component cause is made up of several components. None of the components is sufficient to cause disease on its own. However, all components can cumulatively make up a sufficient cause.  

*'''Sufficient-component cause:''' A sufficient-component cause is made up of several components. None of the components is sufficient to cause disease on its own. However, all components can cumulatively make up a sufficient cause.<ref>Rothman K, Greenland S. Modern epidemiology. 2nd ed. Philadelphia: Lippincott Williams and Wilkins, 1998.</ref>

*'''Probabilistic cause:''' It increases the probability of its effect occurring.  

*'''Probabilistic cause:''' It increases the probability of its effect occurring.<ref>Olsen J. Causes and prevention. Scand J Soc Med 1991;19:1–6.</ref>

*'''Counterfactual cause:''' It makes a difference in the outcome (or the probability of the outcome) when present, compared with when it is absent, while all else is held constant.  

*'''Counterfactual cause:''' It makes a difference in the outcome (or the probability of the outcome) when present, compared with when it is absent, while all else is held constant.<ref>Maldonado G, Greenland, S. Estimating causal e Vects. [abstract]. Presented at the Society for Epidemiologic Research 31st Annual Meeting, Chicago, Illinois, June, 1998. Am J Epidemiol 1998;147:S80.</ref>

== Hetu Kosha==

== Hetu Kosha==

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A profound database of all etiological factors described in Charak Samhita, Sushruta Samhita, Ashtanga Hridaya and Ashtanga Samgraha is prepared under the heading of ‘Triskandha kosha’. This research project was conducted at Tilak Maharashtra Vidyapeetha, Pune, Maharashtra, India.  The first part of this database is known as ‘Hetu kosha’. It includes nearly 3200 pages in print form. Ayuta Nidana is a diagnostic software developed by the team based on this database. It is helpful to Ayurveda physicians, researchers as a handy tool to search causative factors in a patient and diagnose.   

A profound database of all etiological factors described in Charak Samhita, Sushruta Samhita, Ashtanga Hridaya and Ashtanga Samgraha is prepared under the heading of ‘Triskandha kosha’. This research project was conducted at Tilak Maharashtra Vidyapeetha, Pune, Maharashtra, India.  The first part of this database is known as ‘Hetu kosha’. It includes nearly 3200 pages in print form. Ayuta Nidana is a diagnostic software developed by the team based on this database. It is helpful to Ayurveda physicians, researchers as a handy tool to search causative factors in a patient and diagnose.<ref>Available from http://www.tmv.edu.in/pdf/Ayurved/Triskandha%20Kosha%20Project.pdf cited on 08/07/2021 </ref>  

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==Theses done==

==Theses done==

2. Ashok Bhinshnoi (2018): Concept of Dukha hetavah in Brihattrayi w.s.r to Chittodvega(anxiety) and its management with Saraswatachoorna and diet and lifestyle modifications, Department of Basic principles, IPGT &RA, Jamnagar.

2. Ashok Bhinshnoi (2018): Concept of Dukha hetavah in Brihattrayi w.s.r to Chittodvega(anxiety) and its management with Saraswatachoorna and diet and lifestyle modifications, Department of Basic principles, IPGT &RA, Jamnagar.

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==References:==

==References:==