2,171
edits
Changes
→Vidhi Vimarsha (Applied Inferences)
*Classification of diseases, including abdominal ones, have been discussed in this chapter. Since diseases are innumerable, the classification is only restricted to diseases prevalent at that time. [Verse no. 1-2]
*Classification of diseases, including abdominal ones, have been discussed in this chapter. Since diseases are innumerable, the classification is only restricted to diseases prevalent at that time. [Verse no. 1-2]
*In this chapter, diseases have been classified according to ''sankhya samprapti'' (by the number of variants of the disease), ''vidhi samprapti'' (i.e., by features or symptoms of the disease). [Verse 3, 4(1)]
*In this chapter, diseases have been classified according to ''sankhya samprapti'' (by the number of variants of the disease), ''vidhi samprapti'' (i.e., by features or symptoms of the disease). [Verse 3, 4(1)]
*The common thing among these three diseases with seven varieties is that their manifestation site is skin but they vary in clinical features, severity, chronicity etc. Nomenclature of ''kushtha'' and ''pidaka'' is based mainly on clinical manifestation and ''visarpa'' subtypes have been mentioned according to ''doshas'' involved. [Verse no. 4(2)]
*The common thing among these three diseases with seven varieties is that their manifestation site is skin but they vary in clinical features, severity, chronicity etc. Nomenclature of ''kushtha'' and ''pidaka'' is based mainly on clinical manifestation and ''visarpa'' subtypes have been mentioned according to [[dosha]] involved. [Verse no. 4(2)]
*Diseases are classified into six types on the basis of their etiological factors involved. During classifying ''atisara'' both physical and mental factors are considered while classification of ''udavarta'' is based on suppression of six important natural urges. [Verse no. 4(3)]
*Diseases are classified into six types on the basis of their etiological factors involved. During classifying ''atisara'' both physical and mental factors are considered while classification of ''udavarta'' is based on suppression of six important natural urges. [Verse no. 4(3)]
*In this verse 12 diseases have been mentioned which have 5 subtypes. If we analyze five subtypes of each disease we will find that in most of the cases four sub-types are ''vataja, pittaja, kaphaja'' and ''sannipataja''. Fifth type varies in many of above mentioned diseases like in ''gulma'' and ''pliha dosha - raktaja'', in ''chhardi- dwistarthsangyogaja'', in ''bhaktasyanasana - dweshaja,'' in ''shiroroga'' and ''hridroga - krimija'', in ''pandu – mridbhakshanaja'' and in ''unmada – agantuja''. Any cause other than ''dosha'' remarkably changes pathogenesis of disease so keeping this fact in mind, last subtypes have been separately mentioned and named. For the same reason in ''kasa'', in place of ''sannipataja, kshataja'' and ''kshayaja kasa'' and in ''trishna'' in place of ''kaphaja - aamaja, trishna'' have been mentioned. In ''shvasa'' division has been done on the basis of prominent symptoms and in ''hikka'' it is based on both symptoms and causative factors. [Verse no. 4(4)]
*In this verse 12 diseases have been mentioned which have 5 subtypes. If we analyze five subtypes of each disease we will find that in most of the cases four sub-types are [[vata]]ja, [[pitta]]ja,[[kapha]]ja and sannipataja. Fifth type varies in many of above mentioned diseases like in ''gulma'' and ''pliha dosha - raktaja'', in ''chhardi- dwistarthsangyogaja'', in ''bhaktasyanasana - dweshaja,'' in ''shiroroga'' and ''hridroga - krimija'', in ''pandu – mridbhakshanaja'' and in ''unmada – agantuja''. Any cause other than [[dosha]] remarkably changes pathogenesis of disease so keeping this fact in mind, last subtypes have been separately mentioned and named. For the same reason in ''kasa'', in place of ''sannipataja, kshataja'' and ''kshayaja kasa'' and in ''trishna'' in place of ''kaphaja - aamaja, trishna'' have been mentioned. In ''shvasa'' division has been done on the basis of prominent symptoms and in ''hikka'' it is based on both symptoms and causative factors. [Verse no. 4(4)]
*In eight out of set of ten diseases mentioned, classification into subtypes has been based on involvement of ''soshas''. ''Sosha and klaibya'' pathogenesis and treatment varies with cause of the disease so they are classified on the basis of causative agent involved. [Verse no. 4(5)]
*In eight out of set of ten diseases mentioned, classification into subtypes has been based on involvement of ''soshas''. ''Sosha and klaibya'' pathogenesis and treatment varies with cause of the disease so they are classified on the basis of causative agent involved. [Verse no. 4(5)]
*The basis of classification is different in all the three above mentioned diseases. The ''shotha'' subtypes are classified on the basis of ''dosha'', in ''kilasa'' it is based on clinical features and in ''lohitapitta'' it is classified on the basis of site of manifestation. [Verse no. 4(6)]
*The basis of classification is different in all the three above mentioned diseases. The ''shotha'' subtypes are classified on the basis of ''dosha'', in ''kilasa'' it is based on clinical features and in ''lohitapitta'' it is classified on the basis of site of manifestation. [Verse no. 4(6)]
*Diseases are classified into two types based on etiology, clinical features, severity etc. mainly aimed to properly understand pathogenesis as well as to plan treatment. [Verse no. 4(7)]
*Diseases are classified into two types based on etiology, clinical features, severity etc. mainly aimed to properly understand pathogenesis as well as to plan treatment. [Verse no. 4(7)]
*Diseases with no subtypes have been mentioned. The above set includes possible variation of physical and mental causes. ''Urustambha'' occurs due to three ''doshas'' and ''ama, sanyasa'' is psycho-somatic in nature and in ''mahagada'' there is involvement of mental entities only. [Verse no. 4(8)]
*Diseases with no subtypes have been mentioned. The above set includes possible variation of physical and mental causes. ''Urustambha'' occurs due to three [dosha]] and ''ama, sanyasa'' is psycho-somatic in nature and in ''mahagada'' there is involvement of mental entities only. [Verse no. 4(8)]
*While describing diseases with large number of subtypes separate way of classification was used. All the mentioned diseases are first broadly classified in a group and then sub-types are mentioned. ''Krimi'' are first classified into ''bahya, raktaja, shleshmaja'' and ''purishaja'' and then among these four groups twenty types of ''krimi'' have been mentioned.[Cha.Sa.[[Vimana Sthana]]7] Twenty types of ''prameha'' are broadly classified in three groups on basis of ''doshas'' and then subtypes are mentioned, Similarly, ''yoni vyapada'' are broadly classified as diseases due to ''dosha'' and diseases due to amalgamation of ''dosha'' and ''dushyas'' and under second category 16 types of diseases have been mentioned. [Verse no. 4(9)]
*While describing diseases with large number of subtypes separate way of classification was used. All the mentioned diseases are first broadly classified in a group and then sub-types are mentioned. ''Krimi'' are first classified into ''bahya, raktaja, shleshmaja'' and ''purishaja'' and then among these four groups twenty types of ''krimi'' have been mentioned.[Cha.Sa.[[Vimana Sthana]]7] Twenty types of ''prameha'' are broadly classified in three groups on basis of [[dosha]] and then subtypes are mentioned, Similarly, ''yoni vyapada'' are broadly classified as diseases due to [[dosha]] and diseases due to amalgamation of [[dosha]] and ''dushyas'' and under second category 16 types of diseases have been mentioned. [Verse no. 4(9)]
*Importance of ''dosha'' in disease production has been mentioned. Equilibrium of ''dosha'' is important aspect of ''swasthya'' or health and if ''doshas'' are vitiated they will lead to disease formation. Three important factors by which one can diagnose disease have been mentioned in the above verse. [Verse no. 5]
*Importance of [[dosha]] in disease production has been mentioned. Equilibrium of [[dosha]] is important aspect of ''swasthya'' or health and if [[doshas]] are vitiated they will lead to disease formation. Three important factors by which one can diagnose disease have been mentioned in the above verse. [Verse no. 5]
*It has been emphasized that there is separate category of disease (''agantuja vyadhi'') in which involvement of ''doshas'' may not be necessary. [Verse no. 6]
*It has been emphasized that there is separate category of disease (''agantuja vyadhi'') in which involvement of [[doshas]] may not be necessary. [Verse no. 6]
*It has been clarified that exogenous and endogenous diseases can coexist and at times endogenous diseases are followed by the exogenous ones and even the exogenous ones are followed by the endogenous one. So, while treating such type of conditions secondary development and the primary nature of the disease should be properly analyzed. [Verse no.7]
*It has been clarified that exogenous and endogenous diseases can coexist and at times endogenous diseases are followed by the exogenous ones and even the exogenous ones are followed by the endogenous one. So, while treating such type of conditions secondary development and the primary nature of the disease should be properly analyzed. [Verse no.7]
*With the advancement of scientific knowledge and technology mode of disease classification has changed a lot but the basic principles remain the same. At present, disease classification is based upon etiology, pathogenesis, clinical features etc. So, basis remains the same but due to enhancement in knowledge nomenclature has changed. [Verse no.3]
*With the advancement of scientific knowledge and technology mode of disease classification has changed a lot but the basic principles remain the same. At present, disease classification is based upon etiology, pathogenesis, clinical features etc. So, basis remains the same but due to enhancement in knowledge nomenclature has changed. [Verse no.3]
Cardinal feature of ''udara roga'' is swelling in abdomen so all diseases having presentation with abdominal swelling/distension can be taken under common term ''udara roga''. In general diseases of stomach and bowel can be included in it. <ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 184 </ref>[Madhukosh on M.Ni.35/1] [Cha.Sa.[[Sutra Sthana 18/31]
Cardinal feature of ''udara roga'' is swelling in abdomen so all diseases having presentation with abdominal swelling/distension can be taken under common term ''udara roga''. In general diseases of stomach and bowel can be included in it. <ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 184 </ref>[Madhukosh on M.Ni.35/1] [Cha.Sa.[[Sutra Sthana 18/31]
So, ''udara rogas'' described in [[Ayurveda]] can be correlated with different intra-abdominal conditions in which abdominal swelling/distension is the prime feature eg. abdominal tumours, hepato/splenomegaly, intestinal obstruction, perforation, ascites etc. Subtypes of ''udara roga'' are named and described on the cause of swelling/distension. First four types are named after ''dosha'' involved. Description of ''pleehodara'' in [[Chikitsa Sthana]] closely resembles with spleen enlargement. ''Pliha'' refers to spleen so all conditions with predominant splenomegaly which cause visible abdominal swelling/distension can be taken by the term ''pleehodara''. ''Baddha'' means obstruction, and so obstructive conditions leading to abdominal swelling/distension can be clubbed as ''baddhodara''. Cause and symptoms closely resembles with that of intestinal obstruction so intestinal obstruction could be the possible modern correlate. ''Chhidra'' refers to cavity or hole. In description of ''chhidrodara'' it is clearly mentioned that intestine is injured which leads to exudation of material from intestine to abdominal cavity from the injured site. This condition closely resembles intestinal perforation. ''Udaka'' literally refers to water. ''Udakodara'' or ''jalodara'' is a condition in which fluid is accumulated in intestine. Based on resemblance in clinical features it can be correlated with ascites.
So, ''udara rogas'' described in [[Ayurveda]] can be correlated with different intra-abdominal conditions in which abdominal swelling/distension is the prime feature eg. abdominal tumours, hepato/splenomegaly, intestinal obstruction, perforation, ascites etc. Subtypes of ''udara roga'' are named and described on the cause of swelling/distension. First four types are named after [[dosha]] involved. Description of ''pleehodara'' in [[Chikitsa Sthana]] closely resembles with spleen enlargement. ''Pliha'' refers to spleen so all conditions with predominant splenomegaly which cause visible abdominal swelling/distension can be taken by the term ''pleehodara''. ''Baddha'' means obstruction, and so obstructive conditions leading to abdominal swelling/distension can be clubbed as ''baddhodara''. Cause and symptoms closely resembles with that of intestinal obstruction so intestinal obstruction could be the possible modern correlate. ''Chhidra'' refers to cavity or hole. In description of ''chhidrodara'' it is clearly mentioned that intestine is injured which leads to exudation of material from intestine to abdominal cavity from the injured site. This condition closely resembles intestinal perforation. ''Udaka'' literally refers to water. ''Udakodara'' or ''jalodara'' is a condition in which fluid is accumulated in intestine. Based on resemblance in clinical features it can be correlated with ascites.
=== ''Mutraghata'' ===
=== ''Mutraghata'' ===
In ''mutraghata'' main symptom is either oliguria or enuria due to suppression of urine formation and obstructive uropathy.''Vijayarakshita'' has mentioned difference between ''mutrakrichra'' and ''mutraghata''. In ''mutrakrichra'' there is painful and frequent micturition <ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 825 </ref> so it can be correlated with dysuria as in urinary tract infection. All conditions in which urinary output is low or absent can be interpreted as ''mutraghata''.[ Ma.Ni.31/1] [Dalhana on Su.Sa.Uttara Tantra 58/1]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>, [Chakrapani on Cha.Sa.[[Chikitsa Sthana]] 26/43-44]
In ''mutraghata'' main symptom is either oliguria or enuria due to suppression of urine formation and obstructive uropathy.''Vijayarakshita'' has mentioned difference between ''mutrakrichra'' and ''mutraghata''. In ''mutrakrichra'' there is painful and frequent micturition <ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 825 </ref> so it can be correlated with dysuria as in urinary tract infection. All conditions in which urinary output is low or absent can be interpreted as ''mutraghata''.[ Ma.Ni.31/1] [Dalhana on Su.Sa.Uttara Tantra 58/1]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>, [Chakrapani on Cha.Sa.[[Chikitsa Sthana]] 26/43-44]
Four types of ''mutraghata'' are classified according to ''dosha'' <ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 114 </ref>:
Four types of ''mutraghata'' are classified according to [[dosha]] <ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 114 </ref>:
*''Ashmarija mutraghata'' (''Ashmari'' means stone) can be taken as obstruction of urine due to urolithiasis.
*''Ashmarija mutraghata'' (''Ashmari'' means stone) can be taken as obstruction of urine due to urolithiasis.
*In the same way based on the nomenclature ''sharkaraja mutraghata'' can be taken as condition with gravels in urinary tract,
*In the same way based on the nomenclature ''sharkaraja mutraghata'' can be taken as condition with gravels in urinary tract,
=== ''Udavarta'' ===
=== ''Udavarta'' ===
''Udavarta'' word refers to excretion <ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 185 </ref> and is caused by suppression of natural urges due to which path of ''vata'' is obstructed resulting in hampering of normal functioning and movement of ''vata''. [Madhukosha Teeka on M.Ni. 27/1] Conditions characterized by retention of feces, urine and flatus, associated with pain and leading to or caused by anti-peristaltic movements in the body.
''Udavarta'' word refers to excretion <ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 185 </ref> and is caused by suppression of natural urges due to which path of [[vata]] is obstructed resulting in hampering of normal functioning and movement of [[vata]]. [Madhukosha Teeka on M.Ni. 27/1] Conditions characterized by retention of feces, urine and flatus, associated with pain and leading to or caused by anti-peristaltic movements in the body.
=== ''Gulma'' ===
=== ''Gulma'' ===
=== ''Chhardi'' ===
=== ''Chhardi'' ===
In ''chhardi'' (vomiting), food and ''dosha'' are forcefully expelled out through mouth.
In ''chhardi'' (vomiting), food and [[dosha]] are forcefully expelled out through mouth.
=== ''Arochaka'' ===
=== ''Arochaka'' ===
=== ''Unmada'' ===
=== ''Unmada'' ===
''Unmada'' is a syndrome with multiple manifestations and heterogeneous causes, including psychosis and mood disorders. It is characterized by perturbation / confusion (''vibhrama'') of mind (''manas''), intellect (''buddhi''), consciousness (''sangyaa''), knowledge (''jnana''), memory (''smriti''), desire (''bhakti''), manner (''sheela''), behaviour (''cheshta''), conduct (''aachaara''). This is cardinal sign of ''unmada''.
''Unmada'' is a syndrome with multiple manifestations and heterogeneous causes, including psychosis and mood disorders. It is characterized by perturbation / confusion (''vibhrama'') of mind ([[manas]]), intellect ([[buddhi]]), consciousness (''sangyaa''), knowledge (''jnana''), memory ([[smriti]]), desire (''bhakti''), manner (''sheela''), behaviour (''cheshta''), conduct (''aachaara''). This is cardinal sign of ''unmada''.
=== ''Apasmara'' ===
=== ''Apasmara'' ===
=== ''Jwara'' ===
=== ''Jwara'' ===
[[Jwara]] refers to fever.<ref>Monier Williams , Sanskrit – English Dictionary, Motilal Varanasi Publications, Reprint- 1997, Page no 428 </ref>
=== ''Vrana'' ===
=== ''Vrana'' ===