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Kiyanta Shiraseeya Adhyaya (view source)
Revision as of 11:05, 24 October 2017
, 11:05, 24 October 2017→Samsarga and Sannipata
12. Increased Decreased Decreased Compression of the vital centres, destroys consciousness or excessively trembles the whole body
12. Increased Decreased Decreased Compression of the vital centres, destroys consciousness or excessively trembles the whole body
''Ojas'': Ojas is well known and defined in Ayurveda in terms of its functions, its importance, its types and its sites of functions within the body. It has been described in this text as a clear and slightly red-yellowish fluid situated in the heart is known as ojas, the destruction of which leads to death. Its colour resembles to that of ghee, taste is like honey and its smell is like that of roasted paddy (Verses 73-75). But its interpretation in modern physiological terms is confusing. In this chapter a hint has been given in this regard that ojas is a first thing created in the body of all living creatures. The symptoms of diminished ojas include timidity, debility, constant worry, discomfort of the senses, loss of lustre, neurasthenia, dryness and emaciation.
'''''Ojas''''': Ojas is well known and defined in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] in terms of its functions, its importance, its types and its sites of functions within the body. It has been described in this text as a clear and slightly red-yellowish fluid situated in the heart is known as ''ojas'', the destruction of which leads to death. Its colour resembles to that of ''ghee'', taste is like honey and its smell is like that of roasted paddy (Verses 73-75). But its interpretation in modern physiological terms is confusing. In this chapter a hint has been given in this regard that ''ojas'' is a first thing created in the body of all living creatures. The symptoms of diminished ''ojas'' include timidity, debility, constant worry, discomfort of the senses, loss of lustre, neurasthenia, dryness and emaciation.
Āvarita madhumeha (type 1 Diabetes mellitus): Two scenarios that cause provocation of vata have been mentioned: decrease of dhatu (dhatu kshaya) and avarana(cover) [Cha. Chi. 28/59]. The description of madhumeha, provided earlier in this chapter, provides a good example of aavarana. That a provoked or vitiated vata causes madhumeha has also been reiterated in the Nidana Sthana. All the factors that cause decrease of body tissues lead to provocation of vāta. But even though madhumeha is caused by a vitiated vata, its etiological factors also cause an increase in kapha and pitta. The comparison of nidana of madhumeha mentioned in these two different references is tabulated here:
'''''Āvarita madhumeha (type 1 Diabetes mellitus)''''': Two scenarios that cause provocation of ''vata'' have been mentioned: decrease of ''dhatu'' (''dhatu kshaya'') and ''avarana''(cover)[Cha. Chi. 28/59]. The description of ''madhumeha'', provided earlier in this chapter, provides a good example of ''avarana''.That a provoked or vitiated ''vata'' causes ''madhumeha'' has also been reiterated in the [[Nidana Sthana]]. All the factors that cause decrease of body tissues lead to provocation of ''vāta''. But even though ''madhumeha'' is caused by a vitiated ''vata'', its etiological factors also cause an increase in ''kapha'' and ''pitta''. The comparison of ''nidana'' of ''madhumeha'' mentioned in these two different references is tabulated here:
Causative Factors Causative factors of
Causative Factors Causative factors of
Dhatu kshayaja VaatikMadhumeha (Nidana Sthana) Causative factors of Aavaranjanya vatik Madhumeha
Dhatu kshayaja VaatikMadhumeha (Nidana Sthana) Causative factors of Aavaranjanya vatik Madhumeha
vata
vata
It is obvious from the above table that in case of avarita, madhumeha initially causes an increase in kapha, pitta, meda and māmsa leading to an obstruction of functional pathways of vata, furthering its provocation, thereby increasing the severity of madhumeha. In such a condition, the treatment is apatarpana and not of vata i.e. santarpana (Verses 78-81).
It is obvious from the above table that in case of ''avarita'', ''madhumeha'' initially causes an increase in ''kapha, pitta, meda'' and ''māmsa'' leading to an obstruction of functional pathways of ''vata,'' furthering its provocation, thereby increasing the severity of ''madhumeha''. In such a condition, the treatment is ''apatarpana'' and not of ''vata'' i.e. ''santarpana'' (Verses 78-81).
Prameha pidika mentioned in this chapter usually occurs as a complication of avaranjanaya samprapti of madhumeha as medas dushti occurs in this type of madhumeha, the factor, a must for pathogenesis of prameha pidika. This resembles with presentation of metabolic syndrome which includes dys-lipidemia (Verse 82-111).
Charaka has mentioned seven varieties of prameha pidika whereas Sushruta and Vagbhata have added three more to this list that includes masoorika, putrini and vidarika.
''Prameha pidika'' mentioned in this chapter usually occurs as a complication of ''avaranjanaya samprapti'' of ''madhumeha'' as ''medas dushti'' occurs in this type of ''madhumeha'', the factor, a must for pathogenesis of ''prameha pidika''. This resembles with presentation of metabolic syndrome which includes dys-lipidemia (Verse 82-111).
The Shiroroga described in this chapter are various clinical presentations of headache depending upon dosha dominance and krimi infestation. Krimi in Ayurveda is a generic term for a large number of pathological organisms ranging from microorganisms found in blood (raktaja krimi) to intestinal worms as well as external parasites such as lice [Cha. Vi. 7/11-13]
As mentioned earlier in the document, the diseases of the head (verses 13-14) include hemicrania, coryza, headache (caused as a side-effect of diseases of the mouth, nose, eyes and ears), giddiness/vertigo, facial paralysis, tremors of the head, and stiffness of the neck, nape and jaw (there are additional varieties of shiroroga viz. frontal sinusitis, trigeminal neuralgia, and shankhaka are also described [Cha. Si. 9/70-87].
Charaka has mentioned seven varieties of ''prameha pidika'' whereas Sushruta and Vagbhata have added three more to this list that includes ''masoorika, putrini'' and ''vidarika''.
In contemporary science, headache is not a disease and can be vascular, myogenic, cervicogenic, and inflammatory in origin. The drug choices also depend upon the causative factors of headache. Similarly in Ayurveda, though headache is a common manifestation of all five types of diseases of the head, different forms of headache can give an idea of dosha predominance which may further decide the preference of procedures or drug in its treatment.
The ''shiroroga'' described in this chapter are various clinical presentations of headache depending upon ''dosha'' dominance and ''krimi'' infestation. ''Krimi'' in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] is a generic term for a large number of pathological organisms ranging from microorganisms found in blood (''raktaja krimi'') to intestinal worms as well as external parasites such as lice [Cha. Vi. 7/11-13]
As mentioned earlier in the document, the diseases of the head (verses 13-14) include hemicrania, coryza, headache (caused as a side-effect of diseases of the mouth, nose, eyes and ears), giddiness/vertigo, facial paralysis, tremors of the head, and stiffness of the neck, nape and jaw (there are additional varieties of ''shiroroga'' viz. frontal sinusitis, trigeminal neuralgia, and ''shankhaka'' are also described [Cha. Si. 9/70-87].
In contemporary science, headache is not a disease and can be vascular, myogenic, cervicogenic, and inflammatory in origin. The drug choices also depend upon the causative factors of headache. Similarly in [https://en.wikipedia.org/wiki/Ayurveda Ayurveda], though headache is a common manifestation of all five types of diseases of the head, different forms of headache can give an idea of ''dosha'' predominance which may further decide the preference of procedures or drug in its treatment.
The term headache implies pain in the region of cranial vault which is one of the most common and difficult clinical problems in medicine and can be due to serious intracranial conditions like raised intracranial pressure or space occupying lesion or various inflammatory changes of brain tissue or meninges. Further, any pain in the head may also be due to lesions in nearby structures such as the eyes and ear causing referred headache.
The term headache implies pain in the region of cranial vault which is one of the most common and difficult clinical problems in medicine and can be due to serious intracranial conditions like raised intracranial pressure or space occupying lesion or various inflammatory changes of brain tissue or meninges. Further, any pain in the head may also be due to lesions in nearby structures such as the eyes and ear causing referred headache.
Carbuncles are common complications occurring in uncontrolled diabetes patients where the infection spreads extensively in the dermal and underlying soft tissue. This presents itself as a complex localized abscess or as several separate abscesses with multiple discharge sinuses usually caused due to staphylocooocus aureus infection.
The forms or manifestations of headache (and referred headache) associated with a ''shiroroga'' may include migraine, stress induced headache, cluster headache, chronic paroxysmal hemicraina, and miscellaneous forms not associated with structural lesions or headache associated with vascular disorders.
Thus, this chapter is very important as it deals with the disorders of three vital parts of the body (trimarma). It also describes very important aspects of pathogenesis caused due to combinations of vitiated dosha viz. samsarga and sannipata. The description of ojas is a unique concept of Ayurveda. The detailed descriptions along with etiological factors of each prameha pidika are very helpful in planning their prevention and cure.
Similarly the five presentations of heart diseases have also been mentioned in this chapter that resemble different manifestations of chest pain and could be in the form of angina, pain associated with myocardial infarction and dissecting aortic aneurysm, pericarditis, oesophageal spasm, or musculo skeletal chest pain. The clinical picture of cardiac disorders is quite similar to the features of ''hridroga'' mentioned in [[Charaka Samhita]], such as choking or constriction, squeezing, crushing, burning or aching chest pain, or a feeling of sharp, tearing or stabbing chest pain that is usually felt retrosternally and may radiate to the left arm or more rarely to the right arm and then to the throat, jaws and teeth, or through the back. In addition to the individual features of five types of ''hridaroga'', in [[Chikitsa Sthana]], the general sign and symptoms of ''hridroga'' such as discolouration, syncope, fever, cough, hiccups, dyspnoea, vomiting, water brash, chest discomfort, indigestion or distaste of mouth are also mentioned (Ca Ch 26/78). These are mentioned as common symptoms of heart disease in medicine books.
Carbuncles are common complications occurring in uncontrolled diabetes patients where the infection spreads extensively in the dermal and underlying soft tissue. This presents itself as a complex localized abscess or as several separate abscesses with multiple discharge sinuses usually caused due to staphylococcus aureus infection.
Thus, this chapter is very important as it deals with the disorders of three vital parts of the body (''trimarma''). It also describes very important aspects of pathogenesis caused due to combinations of vitiated dosha viz. samsarga and sannipata. The description of ojas is a unique concept of [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. The detailed descriptions along with etiological factors of each prameha pidika are very helpful in planning their prevention and cure.
Table 2: Types of Pidika in different classics:
Table 2: Types of Pidika in different classics:
Sr. No. Types of Pidikā Charaka Sushruta Vagbhata Bhoj Kashypa
Sr. No. Types of Pidikā Charaka Sushruta Vagbhata Bhoj Kashypa