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Various examples of ''upashaya'':
 
Various examples of ''upashaya'':
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Upashaya Aushadha Anna Vihara
 
Upashaya Aushadha Anna Vihara
Hetu viparita Usage of shunthi in sheeta kaphaja jwara due to its hotness. Intake of meat juice in case of vata jwara and fatigue Remaining awake at night in aggravation of kapha dosha due to day sleeping
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Hetu viparita Usage of shunthi in sheeta kaphaja jwara due to its hotness.Intake of meat juice in case of vata jwara and fatigue Remaining awake at night in aggravation of kapha dosha due to day-sleeping
 
Vyadhi viparita Use of antidiarrheal drugs like Patha etc. in diarrhoea Intake of food like masur etc. in diarrhoea due to its antidiarrheal property. Pravahana  improving downwards peristalsis is the treatment for udavarta rogi
 
Vyadhi viparita Use of antidiarrheal drugs like Patha etc. in diarrhoea Intake of food like masur etc. in diarrhoea due to its antidiarrheal property. Pravahana  improving downwards peristalsis is the treatment for udavarta rogi
 
Hetu-vyadhi viparita Usage of dashmoola qwath in case of vataja jwara due to its vatahara and shothhara property Usage of hot substances and antipyretic gruel against sheetottha jwara, which subsides cold and fever. Night awakening etc. which brings roughness in case of tandra, which is the result of consumption of Slimy substances followed by day sleeping.
 
Hetu-vyadhi viparita Usage of dashmoola qwath in case of vataja jwara due to its vatahara and shothhara property Usage of hot substances and antipyretic gruel against sheetottha jwara, which subsides cold and fever. Night awakening etc. which brings roughness in case of tandra, which is the result of consumption of Slimy substances followed by day sleeping.
 
Hetu viparitarthakari Usage of vrishya drugs like pippali, shunthi etc. in case of shukrakshaya due to intake of excess pungent substances. Usage of food substances which are hot in pachyamana shoth caused due to pitta dosha. Inducing fear to the patients who are suffering from vataja unmada.
 
Hetu viparitarthakari Usage of vrishya drugs like pippali, shunthi etc. in case of shukrakshaya due to intake of excess pungent substances. Usage of food substances which are hot in pachyamana shoth caused due to pitta dosha. Inducing fear to the patients who are suffering from vataja unmada.
 
Vyadhi viparitarthakari Usage of emetic drugs like madanaphala in case of chardi (vomitting) Intake of milk in case of atisar, which induces purgation. Inducing vomiting by external support in case of chardi.
 
Vyadhi viparitarthakari Usage of emetic drugs like madanaphala in case of chardi (vomitting) Intake of milk in case of atisar, which induces purgation. Inducing vomiting by external support in case of chardi.
Hetu-vyadhi viparitarthakari Use of hot drugs like agaru dravya lepa in case of agniplushta dagdha (burn due to fire). Usage of intoxicating alcohol against alcoholism induced due to consumption of excessive alcohol. Swimming therapy advised in the form of exercise in case of vatavyadhi manifested due to excessive exercise
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Hetu-vyadhi viparitarthakari Use of hot drugs like agaru dravya lepa in case of agniplushta dagdha (burn due to fire).  
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Usage of intoxicating alcohol against alcoholism induced due to consumption of excessive alcohol. Swimming therapy advised in the form of exercise in case of vatavyadhi manifested due to excessive exercise
    
Vagbhata defines upashaya as satmya (compatible). (A H Ni. 1/).[17]
 
Vagbhata defines upashaya as satmya (compatible). (A H Ni. 1/).[17]
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In nutshell, upashaya is the therapeutic test that is helpful in diagnosing the doubtful stages of different diseases. This is adopted during differential diagnoses of the disease. [10]
 
In nutshell, upashaya is the therapeutic test that is helpful in diagnosing the doubtful stages of different diseases. This is adopted during differential diagnoses of the disease. [10]
Samprapti (pathogenesis):
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Samprapti is a compound word meaning samyak aapti/ prapti i.e. complete manifestation of a disease or the stage where the disease could be understood well. This pathogenesis explains the pattern of disequilibrium of dosha interacting with body tissues and thus, gives a clearer picture of disease. This covers all the six stages (chayaprakopadi) of the disease as told by Sushruta and the physician gets a complete understanding of the nidanas (causes), poorvarupas, rupas and upashayanupashaya with the help of samprapti. Mostly patients come to physician when the process of samprapti is completed and at that time there may not be any existence of nidanas or poorvarupas.  
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==== ''Samprapti'' (pathogenesis) ====
Jati: This synonym indicates the janan (genesis) of the disease as explained above
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Aagati: Literally means the manifestation and remission of the disease. In this process of disease manifestation (samprapti), the physician gets the knowledge in the form of qualitative and quantitative progress of the disease.  
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''Samprapti'' is a compound word meaning ''samyak aapti''/ ''prapti'' i.e. complete manifestation of a disease or the stage where the disease could be understood well. This pathogenesis explains the pattern of disequilibrium of ''dosha'' interacting with body tissues and thus, gives a clearer picture of disease. This covers all the six stages (''chayaprakopadi'') of the disease as told by Sushruta and the physician gets a complete understanding of the ''nidanas'' (causes), ''poorvarupas, rupas'' and ''upashayanupashaya'' with the help of ''samprapti''. Mostly patients come to physician when the process of ''samprapti'' is completed and at that time there may not be any existence of ''nidanas'' or ''poorvarupas''.  
While the symptoms of a disease manifest completely after pathogenesis (samprapti), still for the purpose of diagnosis, the knowledge of samprapti is not as important as the knowledge of linga (symptoms). Hence samprapti is described at the end. [18]  
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Vagbhata has defined these synonyms as:  “The process of manifestation of the disease, by the morbid doshas (humors) which are circulating all over the body, is known as samprapti or jati or agati. (A H Ni. 1/8) [19][11]
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''Jati'' is a synonym of ''samprapti'' that indicates the ''janan'' (genesis) of the disease as explained above.
In order to allay the apprehension of incomplete description of samprapti for each disease, the samprapti in general of all diseases is described here in this chapter. [20]
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''Aagati'': Literally means the manifestation and remission of the disease. In this process of disease manifestation (''samprapti''), the physician gets the knowledge in the form of qualitative and quantitative progress of the disease.  
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While the symptoms of a disease manifest completely after pathogenesis (''samprapti''), still for the purpose of diagnosis, the knowledge of ''samprapti'' is not as important as the knowledge of ''linga'' (symptoms). Hence ''samprapti'' is described at the end. [18]  
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Vagbhata has defined these synonyms as:  “The process of manifestation of the disease, by the morbid ''doshas'' (humors) which are circulating all over the body, is known as ''samprapti'' or ''jati'' or ''agati''. (A H Ni. 1/8) [19][11]
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In order to allay the apprehension of incomplete description of ''samprapti'' for each disease, the ''samprapti'' in general of all diseases is described here in this chapter. [20]
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Vagbhata has not described vidhi samprapti. He has described only five kinds of samprapti i.e. samkhya, vikalpa, pradhanya, bala and kala samprapti. (A H Ni. 1/)[21] [12]. Pradhanya samprapti indicates the primacy of a samprapti (A H Ni. 1/)[22] When a dosha gets vitiated and becomes a causative factor of a disease, it does not necessarily mean that all its attributes also get vitiated. Vitiation of vata for example may mean aggravation of its coldness, lightness or ununctuousness.  
 
Vagbhata has not described vidhi samprapti. He has described only five kinds of samprapti i.e. samkhya, vikalpa, pradhanya, bala and kala samprapti. (A H Ni. 1/)[21] [12]. Pradhanya samprapti indicates the primacy of a samprapti (A H Ni. 1/)[22] When a dosha gets vitiated and becomes a causative factor of a disease, it does not necessarily mean that all its attributes also get vitiated. Vitiation of vata for example may mean aggravation of its coldness, lightness or ununctuousness.  
 
Kala samprapti means the type that is governed by seasonal variations. Aggravation/ manifestation of shleshmika/kaphaja type of fever during winter season is the example of seasonal variation. Some Ayurveda practitioners attribute an extreme form of manifestation to deeds in the patient’s past life, and define vidhi samprapti as an affliction attributed to such deeds. [23] The timing of disease manifestation shows variation in the samprapti or pathogenesis. This aspect of samprapti helps in clearly determining the specific characteristics of a disease.
 
Kala samprapti means the type that is governed by seasonal variations. Aggravation/ manifestation of shleshmika/kaphaja type of fever during winter season is the example of seasonal variation. Some Ayurveda practitioners attribute an extreme form of manifestation to deeds in the patient’s past life, and define vidhi samprapti as an affliction attributed to such deeds. [23] The timing of disease manifestation shows variation in the samprapti or pathogenesis. This aspect of samprapti helps in clearly determining the specific characteristics of a disease.
 
Vagbhata describes that bala samprapti is important to assess the severity of disease. (A H Ni. 1/)[24] [12-5]
 
Vagbhata describes that bala samprapti is important to assess the severity of disease. (A H Ni. 1/)[24] [12-5]
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Significance of knowledge of nidana:
 
Significance of knowledge of nidana:
 
1. Knowledge of causative factors plays an important role in the prognosis of diseases. A disease becomes more difficult to cure with the rise in number of causative factors responsible for the diseases. [26]
 
1. Knowledge of causative factors plays an important role in the prognosis of diseases. A disease becomes more difficult to cure with the rise in number of causative factors responsible for the diseases. [26]
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4 Sthanasanshraya Poorvarupa
 
4 Sthanasanshraya Poorvarupa
 
5 Vyakti Rupa, Upashaya
 
5 Vyakti Rupa, Upashaya
6 Bheda
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6 Bheda
 
      
=== References ===
 
=== References ===

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