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This includes [[Sharira|body]] components like twak (skin), [[Rakta dhatu|rakta dhatu]] (blood), and other similar [[Sharira|body]] consituents. [Cha.Sa.[[Sutra Sthana|Sutrasthana]] 11/48] It is similar to a branch of tree.<ref name="ref13">Jyoti Devangamath Et Al: Crucial Role Of Rogamarga To Understand Vyadhi. International Ayurvedic medical Journal {online} 2016 {cited 2016 July} Available from: http://www.iamj.in/posts/images/upload/1291_1296.pdf </ref>

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Thus, to show the remoteness of these structures, they have been termed as shakha. These are the structures seen one after another in a sequence. [[Rasa|Rasa]], [[Rakta dhatu|rakta]], [[Mamsa dhatu|mamsa]], [[Meda|meda]], [[Majja dhatu|majja]] pertaining to the internal structures like liver, spleen, brain etc. should not come under bahya roga marga. For example, hrdayagata rasa, yakrita gata rakta should come under abhyantara roga marga. The accessory appendages of skin like hair, nails, tactile cells, sebaceous glands etc. should be considered under bahya rogamarga. Mammary glands, ext. ear, tonsils, adenoids should also be considered under bahya rogamarga. Thus, looking to the structures and [[Vyadhi|diseases]] allotted to bahya rogamarga, it is evident that this marga has entities, which are superficial (compared to the madhyama rogamarga) and these entities are the first line of contact with the external stimulus and hence the pathology occurring is easily diagnosed and approachable. The madhyama roga marga includes [[Marma|marma]] (vital organs) like heart, brain, kidneys, bones, joints, ligaments, tendons. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 11/48]

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Thus, to show the remoteness of these structures, they have been termed as shakha. These are the structures seen one after another in a sequence. [[Rasa|Rasa]], [[Rakta dhatu|rakta]], [[Mamsa dhatu|mamsa]], [[Meda|meda]], [[Majja dhatu|majja]] pertaining to the internal structures like liver, spleen, brain etc. should not come under bahya roga marga. For example, hrdayagata rasa, yakrita gata rakta should come under abhyantara roga marga. The accessory appendages of skin like hair, nails, tactile cells, sebaceous glands etc. should be considered under bahya rogamarga. Mammary glands, ext. ear, tonsils, adenoids should also be considered under bahya rogamarga. Thus, looking to the structures and [[Vyadhi|diseases]] allotted to bahya rogamarga, it is evident that this marga has entities, which are superficial (compared to the madhyama rogamarga) and these entities are the first line of contact with the external stimulus and hence the pathology occurring is easily diagnosed and approachable. The madhyama roga marga includes [[Marma|marma]] (vital organs) like heart, brain, kidneys, bones, joints, ligaments, tendons. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 11/48]

The grouping of structures of madhyama roga marga is quite different from that of other roga-marga. Although these organs are not connected with each other, they perform vital functions of the [[Sharira|body]] and any damage to them will give rise to serious consequences.

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The abhyantara roga marga is termed as kostha. It includes the gastrointestinal tract and all visceral organs. While enumerating koshtangas basti, hridaya and vrikka included in them will be included in abhyantara rogamarga. But in text these organs and [[Vyadhi|diseases]] related to them are ascribed to madhyama roga marga, which maybe explained as under

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The abhyantara roga marga is termed as kostha. It includes the gastrointestinal tract and all visceral organs. While enumerating koshtangas [[Basti|basti]], [[Hridaya|hridaya]] and vrikka included in them will be included in abhyantara rogamarga. But in text these organs and [[Vyadhi|diseases]] related to them are ascribed to madhyama roga marga, which maybe explained as under

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Kosthanga are mainly responsible for nutrition and excretion of mala. Hridaya is considered a kosthanga for; it is responsible for nutrition and excretion of blood impurities. Same is the case with vikka and basti. But the reason for not considering these organs under kostha may be that the structural disorders of any of the organs may influence the material flowing through them but not the organs of mahasrotas (A.Rm.) In case of the [[Vyadhi|diseases]] related to abhyantara rogamarga, there may be indirect influence on the vahana dravya of these organs. eg. rakta mutrata in pittaja [[Jwara|jwara]], hrdaya asuddhi in ama [[Jwara|jwara]], bahu mutrata in ajirna etc. Thus, being influenced by kostha and their [[Vyadhi|diseases]], these might have been included in kosthanga. But when the point of roga marga comes, these organs are to be studied under madhyama roga marga as is in the texts.

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Kosthanga are mainly responsible for nutrition and excretion of [[Mala|mala]]. [[Hridaya|Hridaya]] is considered a kosthanga for; it is responsible for nutrition and excretion of blood impurities. Same is the case with vikka and [[Basti|basti]]. But the reason for not considering these organs under kostha may be that the structural disorders of any of the organs may influence the material flowing through them but not the organs of mahasrotas (A.Rm.) In case of the [[Vyadhi|diseases]] related to abhyantara rogamarga, there may be indirect influence on the vahana [[Dravya|dravya]] of these organs. eg. rakta mutrata in pittaja [[Jwara|jwara]], hrdaya asuddhi in [[Ama|ama]] [[Jwara|jwara]], bahu mutrata in ajirna etc. Thus, being influenced by kostha and their [[Vyadhi|diseases]], these might have been included in kosthanga. But when the point of roga marga comes, these organs are to be studied under madhyama roga marga as is in the texts.

== Physiological aspect of roga-marga ==

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| Bahya rogamarga

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| It is the site of dhatwagni, responsible for the dhatu nirmana

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| It is the site of dhatwagni, responsible for the [[Dhatu|dhatu]] nirmana

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* As the nutrition is processed through abhyantara roga marga, at least two rogamaragas are functionally interlinked; and many cause and effect phenomena can be observed in these two margas.

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| Madhyam rogamarga

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| It includes organs such as sira, hridaya and basti, other [[Marma|marmas]], asthi-sandhi etc.

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| It includes organs such as sira, [[Hridaya|hridaya]] and [[Basti|basti]], other [[Marma|marmas]], asthi-sandhi etc.

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* These organs have nothing in common either physiologically nor have anatomical continuity.

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* These organs have nothing in common either physiologically nor have anatomical continuity.

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* They are the main seats of prana according to Ayurveda

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* They are the main seats of [[Prana|prana]] according to [[Ayurveda|Ayurveda]]

* They have large quantity of blood circulation.

* These organs are interlinked with each other pathologically, as the pathology of one affects the other.

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== Pathological understanding of roga marga vs. [[Vyadhi|disease]] pathways ==

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In a normal [[Sharira|body]], as such, there will be no rogamarga for the [[Dosha|dosha]] to travel. The healthy srotas/organs are rendered weak by the intake of nidana sevana and this renders the srotas weak, which is termed as [[Kha vaigunya|khavaigunya]]. This results in directing the [[Samprapti|samprapti]] and spread of [[Vyadhi|disease]]. Such weak srotas/ organs becomes rogamarga.

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In a normal [[Sharira|body]], as such, there will be no rogamarga for the [[Dosha|dosha]] to travel. The healthy [[Srotas|srotas]]/organs are rendered weak by the intake of nidana sevana and this renders the [[Srotas|srotas]] weak, which is termed as [[Kha vaigunya|khavaigunya]]. This results in directing the [[Samprapti|samprapti]] and spread of [[Vyadhi|disease]]. Such weak [[Srotas|srotas]]/ organs becomes rogamarga.

Rogamargas have crucial role to play in the [[Samprapti|samprapti]] of a [[Vyadhi|disease]]. The very definition of [[Samprapti|samprapti]] brings forth two things. One is that, the accumulated and spreading [[Dosha|dosha]] virtually reaches each and every part of the [[Sharira|body]] and the general channel of flow is rasayani. [ A.H. Ni. 1/23]

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== Role of roga-marga in various stages of [[Samprapti|samprapti]] ==

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<ul style='text-align:justify;'><li style="font-weight: bold;">Sub clinical or formative stages : Of the six stages, accumulaton (chaya), aggravation (prakopa), spread (prasara) are sub-clinical. The symptoms manifested in chaya stage are imprecise, depending on invoved [[Dosha|dosha]]. Prakopa avastha exhibits the symptomatology but not [[Vyadhi|disease]]. In the prasara avastha, when the spread of the morbid [[Dosha|doshas]] starts, the manifestation at roga marga comes into picture. Albeit , as the accumulation (chaya avastha) occurs at the root (mula / utpatti sthana) of the [[Dosha|dosha]], the involvement of roga marga maybe inferred from accumulation stage (chaya avastha) itself. </li>

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<ul style='text-align:justify;'><li style="font-weight: bold;">Sub clinical or formative stages : Of the six stages, accumulaton (chaya), [[Prakopa|aggravation (prakopa)]], spread (prasara) are sub-clinical. The symptoms manifested in chaya stage are imprecise, depending on invoved [[Dosha|dosha]]. [[Prakopa|Prakopa]] avastha exhibits the symptomatology but not [[Vyadhi|disease]]. In the prasara avastha, when the spread of the morbid [[Dosha|doshas]] starts, the manifestation at roga marga comes into picture. Albeit, as the accumulation (chaya avastha) occurs at the root (mula / utpatti sthana) of the [[Dosha|dosha]], the involvement of roga marga maybe inferred from accumulation stage (chaya avastha) itself. </li>

<li style="font-weight: bold;">Clinical stage : A list of [[Vyadhi|diseases]] are mentioned under a particular roga marga. So, it can be said that roga marga plays significant role in the clinical stages viz. sthana samshraya and vyakti avastha.

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Rogamarga is the site of [[Kha vaigunya|kha-vaigunya]] which later on cultivates for interaction of dosh and dushya. [Su.Sa.[[Sutra Sthana|Sutrasthana]] 24/10] [[Kha vaigunya|Kha-vaigunya]] plays directive role for the pathology to spread in different srotas (systems).

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Rogamarga is the site of [[Kha vaigunya|kha-vaigunya]] which later on cultivates for interaction of dosh and [[Dushya|dushya]]. [Su.Sa.[[Sutra Sthana|Sutrasthana]] 24/10] [[Kha vaigunya|Kha-vaigunya]] plays directive role for the pathology to spread in different [[Srotas|srotas]] (systems).

Sthanasamshraya avastha is an important transition stage between the sub clinical and the clinical stages; wherein the structural lesions begin to occur alongwith the functional disturbances, which leads to localization of the pathology. </li>

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<li style="font-weight: bold;">In the vyakti avastha, the outcome of the interaction of dosha-dushya is revealed. According to respected Vaidya Shiva Charan Dhyani, in the book “Nidana Panchaka”, at this stage, (i) completion of dosha dushya sammurcchana (ii) Srotodusti and its features and (iii) lakshana sammuchaya of [[Vyadhi|diseases]], are manifested. [Nidana Panchaka by Vaidya Shivacharana Dhyani, Chaukhambha Surabharati prakashana, edition 2022, pag no, 58] </li>

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<li style="font-weight: bold;">In the vyakti avastha, the outcome of the interaction of [[Dosha|dosha]]-[[Dushya|dushya]] is revealed. According to respected Vaidya Shiva Charan Dhyani, in the book “Nidana Panchaka”, at this stage, (i) completion of [[Dosha|dosha]] [[Dushya|dushya]] sammurcchana (ii) Srotodusti and its features and (iii) [[Lakshana|lakshana]] sammuchaya of [[Vyadhi|diseases]], are manifested. [Nidana Panchaka by Vaidya Shivacharana Dhyani, Chaukhambha Surabharati prakashana, edition 2022, pag no, 58] </li>

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Though the dosha dushya sammurcchana is initiated in the previous stage, its completion is achieved in vyakti avastha. The sroto dushti occurs at roga-marga

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Though the [[Dosha|dosha]] [[Dushya|dushya]] sammurcchana is initiated in the previous stage, its completion is achieved in vyakti avastha. The sroto dushti occurs at roga-marga

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<li style="font-weight: bold;">Complicated clinical (post clinical) stage : Bheda stage is considered as the advanced clinical stage. In this stage, the [[Vyadhi|disease (vyadhi)]] may become chronic or progressive and leads to other [[Vyadhi|diseases]]. In this phase, the roga vriddhi takes place. Advancement of [[Vyadhi|disease]] (roga vriddhi) takes place by different modes, which are listed briefly as follows: </li>

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<li style="font-weight: bold;">Complicated clinical (post clinical) stage : Bheda stage is considered as the advanced clinical stage. In this stage, the [[Vyadhi|disease (vyadhi)]] may become chronic or progressive and leads to other [[Vyadhi|diseases]]. In this phase, the [[Vyadhi|roga]] vriddhi takes place. Advancement of [[Vyadhi|disease]] ([[Vyadhi|roga]] vriddhi) takes place by different modes, which are listed briefly as follows: </li>

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<ol><li style="font-weight: bold;">In the same organ, sthanantara swarupa roga vriddhi : In skin disorders and other contagious [[Vyadhi|diseases]], due to anatomical continuity in skin, the pathogens can travel in the same organ. E.g visarpa. [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]] 21/15] </li>

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<ol><li style="font-weight: bold;">In the same organ, sthanantara swarupa [[Vyadhi|roga]] vriddhi : In [[Skin diseases in Integrative Medicine|skin disorders]] and other contagious [[Vyadhi|diseases]], due to anatomical continuity in skin, the pathogens can travel in the same organ. E.g visarpa. [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]] 21/15] </li>

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<li style="font-weight: bold;">Dhatugata swarupa roga vriddhi : The transfer of [[Vyadhi|disease]] or [[Samprapti|samprapti]] from one dhatu to another is also the manifestation of roga vriddhi (dhatu gatatva). Dhatugata vyadhi and dhatugata vata are explained to get a clear idea. Apart from the dhatugatatva of [[Dosha|dosha]], it is explained in certain other contexts also. They are the following : </li>

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<li style="font-weight: bold;">Dhatugata swarupa [[Vyadhi|roga]] vriddhi : The transfer of [[Vyadhi|disease]] or [[Samprapti|samprapti]] from one [[Dhatu|dhatu]] to another is also the manifestation of [[Vyadhi|roga]] vriddhi ([[Dhatu|dhatu]] gatatva). Dhatugata vyadhi and dhatugata [[Vata dosha|vata]] are explained to get a clear idea. Apart from the dhatugatatva of [[Dosha|dosha]], it is explained in certain other contexts also. They are the following : </li>

<ol type="i"><li>Dhatugatatva of [[Jwara|jwara]] (the morbid [[Dosha|dosha]] causing [[Jwara|fever]] penetrates into deeper tissues) [Cha. Sa. [[Chikitsa Sthana|Chikitsa sthana]] 3/ 70-83], [Su.Sa.Uttara Tantra 29/83-89]</li>

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<li>Dhatugatatva of kushtha (the morbid [[Dosha|dosha]] causing skin [[Vyadhi|diseases]] penetrates into deeper tissues) [Su. Sa. [[Nidana Sthana|Nidana Sthana]] 5/20-27] </li>

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<li>Dhatugatatva of [[Kushtha Chikitsa|kushtha]] (the morbid [[Dosha|dosha]] causing skin [[Vyadhi|diseases]] penetrates into deeper tissues) [Su. Sa. [[Nidana Sthana|Nidana Sthana]] 5/20-27] </li>

<li>Dhatugatatva of masurika (the morbid [[Dosha|dosha]] causing chicken pox penetrates into deeper tissues) [Ma. Ni. 54 / 14-23] </li>

<li>Dhatugatatva of visha vega (the poison penetrates into deeper tissues) [A.Hr.Uttara tantra 19/26] [Su.Sa. Kalpa Sthana 4/39] </li>

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The examples of dhatugatatva given in skin diseases (kushtha) can be taken as a model for understanding the symptomatology of dhatugatatva of kapha dominant [[Vyadhi|diseases]]. Likewise, dhatugatatva of [[Jwara|jwara]] for pittaja vyadhis and dhatugatatva described in vatavyadhi for vata dominant disorders.</ol>

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The examples of dhatugatatva given in skin diseases ([[Kushtha Chikitsa|kushtha]]) can be taken as a model for understanding the symptomatology of dhatugatatva of [[Kapha dosha|kapha]] dominant [[Vyadhi|diseases]]. Likewise, dhatugatatva of [[Jwara|jwara]] for pittaja vyadhis and dhatugatatva described in vatavyadhi for [[Vata dosha|vata]] dominant disorders.</ol>

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<li style="font-weight: bold;">Nidanarthakara swarupa roga vriddhi : Sometimes one [[Vyadhi|disease]] may become nidana for the other disease. This is also a kind of roga-vriddhi. Eg., [[Jwara|Jwara]] to raktapitta (the heat of the [[Jwara|fever]] causes bleeding disorders), pratishyaya to kasa (coryza causes coughing), kasa to swasha (Coughing may lead to asthama kind of breathlessness), atisara to grahani (Diarrhoea causes sprue syndrome), grahani to arsha (Sprue syndrome may cause piles), etc. [Cha.Sa.[[Nidana Sthana|Nidana Sthana]] 8/17-19] </li>

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<li style="font-weight: bold;">[[Nidanarthakara roga|Nidanarthakara]] swarupa [[Vyadhi|roga]] vriddhi : Sometimes one [[Vyadhi|disease]] may become [[Nidana|nidana]] for the other [[Vyadhi|disease]]. This is also a kind of roga-vriddhi. Eg., [[Jwara|Jwara]] to [[Raktapitta|raktapitta]] (the heat of the [[Jwara|fever]] causes bleeding disorders), pratishyaya to [[Kasa Chikitsa|kasa]] (coryza causes coughing), [[Kasa Chikitsa|kasa]] to swasha (Coughing may lead to asthama kind of breathlessness), [[Atisara Chikitsa|atisara]] to [[Grahani Chikitsa|grahani]] (Diarrhoea causes sprue syndrome), [[Grahani Chikitsa|grahani]] to [[Arsha Chikitsa|arsha]] (Sprue syndrome may cause piles), etc. [Cha.Sa.[[Nidana Sthana|Nidana Sthana]] 8/17-19] </li>

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<li style="font-weight: bold;">Vyadhisankara swarupa roga vriddhi : Vyadhi sankara means the occurance of 2-3 [[Vyadhi|diseases]] at a time. Sometimes, the [[Vyadhi|disease]] itself subsides after producing some other [[Vyadhi|disease]] and sometimes it persists and becomes more troublesome.

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<li style="font-weight: bold;">Vyadhisankara swarupa [[Vyadhi|roga]] vriddhi : [[Vyadhi|Vyadhi]] sankara means the occurance of 2-3 [[Vyadhi|diseases]] at a time. Sometimes, the [[Vyadhi|disease]] itself subsides after producing some other [[Vyadhi|disease]] and sometimes it persists and becomes more troublesome.

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e.g. Pratishyaya and kasa (coryza and coughing together),. [Cha.Sa.[[Nidana Sthana|Nidana Sthana]] 8/22] </li>

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e.g. Pratishyaya and [[Kasa Chikitsa|kasa]] (coryza and coughing together),. [Cha.Sa.[[Nidana Sthana|Nidana Sthana]] 8/22] </li>

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<li style="font-weight: bold;">Upadrava swarupa roga vriddhi : [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]]21/40] Upadrava also signifies roga vrddhi. In a vigunita sthana, dosha dushya sammurcchana takes place. If it is not treated at early stage and nidana sevana continued then this dosha dushya melaka becomes more virulent and travels to other places and produces upadrava. eg. Upadrava of udara roga (obstinate abdominal [[Vyadhi|diseases]] including ascites) are chhardi (vomiting), atisara (diarrhoea), shwasa (dyspnoea), kasa (cough), trishna (morbid thirst), hikka (hiccup), aruchi (anorexia) etc. [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]] 13/49] </li>

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<li style="font-weight: bold;">Roga vrddhi in same srotas in a sequential order : Roga initiates from sroto mula or a part of srotas and spreads to whole srotas, if nidana parivarjana is not done and chikitsa not applied. eg. Nasal Polyp leads to Bronchitis, which in turn may lead to asthma. </li>

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<li style="font-weight: bold;">[[Vyadhi|Roga]] vrddhi in same [[Srotas|srotas]] in a sequential order : [[Vyadhi|Roga]] initiates from sroto mula or a part of [[Srotas|srotas]] and spreads to whole [[Srotas|srotas]], if [[Nidana|nidana]] parivarjana is not done and chikitsa not applied. eg. Nasal Polyp leads to Bronchitis, which in turn may lead to asthma. </li>

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<li style="font-weight: bold;">Roga vrddhi according to [[Dosha|dosha]] sthana : The best example given to study this is in [[Jwara|Jwara]] Prakarana of Sushruta Uttara Sthana. [Nibandha Sangraha commentary by Dalhana on Su.Sa. Uttara tantra 39/ 51-52]

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<li style="font-weight: bold;">[[Vyadhi|Roga]] vrddhi according to [[Dosha|dosha]] sthana : The best example given to study this is in [[Jwara|Jwara]] Prakarana of Sushruta Uttara Sthana. [Nibandha Sangraha commentary by Dalhana on Su.Sa. Uttara tantra 39/ 51-52]

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* Satata [[Jwara|jwara]] in amashaya (In continuous [[Jwara|fever]], the morbid [[Dosha|doshas]] are in the stomach)

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* Satata [[Jwara|jwara]] in [[Amashaya|amashaya]] (In continuous [[Jwara|fever]], the morbid [[Dosha|doshas]] are in the stomach)

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* Anyedhyushka in hridaya (In intermittent [[Jwara|fever]], the morbid [[Dosha|doshas]] are in the heart / heart region)

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* Anyedhyushka in [[Hridaya|hridaya]] (In intermittent [[Jwara|fever]], the morbid [[Dosha|doshas]] are in the heart / heart region)

* Trutiyaka in kantha (In tertian [[Jwara|fever]], the morbid [[Dosha|doshas]] are in the throat / throat region)

* Chaturthaka in sandhi (In quartan type of [[Jwara|fever]] the morbid [[Dosha|doshas]] are in the joints) </li>

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In this way, looking at the different procedures of roga vriddhi, it is evident that roga marga plays a definite role in the roga vriddhi, which may take place in the same roga marga or in other roga marga. </ol></ul>

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In this way, looking at the different procedures of [[Vyadhi|roga]] vriddhi, it is evident that [[Vyadhi|roga]] marga plays a definite role in the [[Vyadhi|roga]] vriddhi, which may take place in the same [[Vyadhi|roga]] marga or in other [[Vyadhi|roga]] marga. </ol></ul>

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== The inter-connectedness of the different roga marga ==

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== The inter-connectedness of the different [[Vyadhi|roga]] marga ==

[[Dosha|Dosha]] can move from one marga to another. The movement of the [[Dosha|dosha]] from internal pathway towards other marga will be clear in most of the [[Vyadhi|diseases]]. But in the case of external pathways, the movement of [[Dosha|dosha]] from shakha towards [[Koshtha|koshtha]] is not so easy. The reason may be that the [[Vyadhi|diseases]] of the internal pathway produce many symptoms externally. But the [[Vyadhi|diseases]] of the external pathway generally may not have any serious symptoms and signs pertaining to internal or medial pathway. The reason for this can be given in the following paras. <ol type="a"><li>[[Sharira|Body]] due to its defense mechanism generally tries to push out the factors, which are not suitable to it. If the [[Koshtha|koshtha]] is filled with such morbid factors, in order to defend the organs of [[Koshtha|koshtha]] from any type of damage they are pushed to other margas if not expelled out. This is done preferably through the marga of poshana. The causes of movement of the [[Dosha|doshas]] from [[Koshtha|koshtha]] to shakha have been mentioned by acharya Charak. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 28/31] </li>

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<li>The same case is not found in the [[Vyadhi|diseases]] of external pathways. Because the morbid [[Dosha|dosha]] will not be able to move back to [[Koshtha|koshtha]] easily. This is because the viloma gati of [[Dosha|dosha]] will have to take place here. This sort of movement is possible only with the co-operation of the srotas. The causes of movement of [[Dosha|doshas]] from shakha to [[Koshtha|koshtha]], mentioned by acharya Charak, plays role for this. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 28/32] Thus, compared to abhyantar rogamarga, the [[Vyadhi|diseases]] of bahya roga marga takes longer duration. </li></ol>

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<li>The same case is not found in the [[Vyadhi|diseases]] of external pathways. Because the morbid [[Dosha|dosha]] will not be able to move back to [[Koshtha|koshtha]] easily. This is because the viloma gati of [[Dosha|dosha]] will have to take place here. This sort of movement is possible only with the co-operation of the [[Srotas|srotas]]. The causes of movement of [[Dosha|doshas]] from shakha to [[Koshtha|koshtha]], mentioned by acharya Charak, plays role for this. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 28/32] Thus, compared to abhyantar rogamarga, the [[Vyadhi|diseases]] of bahya roga marga takes longer duration. </li></ol>

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The movement of the morbid factors in the [[Vyadhi|diseases]] of medial pathways will be of different type. In these [[Vyadhi|diseases]], the movement of the [[Dosha|dosha]] will be from one organ to the other organ of the same roga marga. In [[Vyadhi|diseases]] like amavata, vatarakta, etc. which are related with the joints coming under medial pathway, signs and symptoms of the malfunction of heart (hridaya) or bladder (basti) or both etc. will be present. In the same way, the involvement of the heart may produce signs and symptoms related with extrenal pathway in their premonitory stage (purvarupavastha). [[Prameha Nidana|Prameha]] and rajayakshma, which are the [[Vyadhi|diseases]] of medial pathway, may be quoted as examples. In these disorders, excessive growth of hair, nails etc. are observed in premonitory stage.

+

The movement of the morbid factors in the [[Vyadhi|diseases]] of medial pathways will be of different type. In these [[Vyadhi|diseases]], the movement of the [[Dosha|dosha]] will be from one organ to the other organ of the same roga marga. In [[Vyadhi|diseases]] like [[Amavata|amavata]], [[Vatarakta Chikitsa|vatarakta]], etc. which are related with the joints coming under medial pathway, signs and symptoms of the malfunction of [[Hridaya|heart (hridaya)]] or bladder ([[Basti|basti]]) or both etc. will be present. In the same way, the involvement of the heart may produce signs and symptoms related with extrenal pathway in their premonitory stage (purvarupavastha). [[Prameha Nidana|Prameha]] and [[Rajayakshma Chikitsa|rajayakshma]], which are the [[Vyadhi|diseases]] of medial pathway, may be quoted as examples. In these disorders, excessive growth of hair, nails etc. are observed in premonitory stage.

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It can be said that most of the [[Vyadhi|diseases]] of external pathway originate from colon (pakwashayottha). In the [[Vyadhi|diseases]] of external pathway apart from the external treatment (bahya chikitsa or bahirparimarjana chikitsa), virechana is preferred. It is only through suitable virechana dravyas, skin [[Vyadhi|diseases]] are treated successfully.

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It can be said that most of the [[Vyadhi|diseases]] of external pathway originate from colon (pakwashayottha). In the [[Vyadhi|diseases]] of external pathway apart from the external treatment (bahya chikitsa or bahirparimarjana chikitsa), [[Virechana|virechana]] is preferred. It is only through suitable [[Virechana|virechana]] [[Dravya|dravyas]], skin [[Vyadhi|diseases]] are treated successfully.

−

Virechana have special influence on colon (pakwashaya). Thus, the disorders, which subside by means of virechana, the [[Vyadhi|diseases]] of external pathways may be said to originate from colon (pakwashayottha).

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[[Virechana|Virechana]] have special influence on colon (pakwashaya). Thus, the disorders, which subside by means of [[Virechana|virechana]], the [[Vyadhi|diseases]] of external pathways may be said to originate from colon (pakwashayottha).

== Rogamarga related to prognosis ==

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Roga marga is explained in view of precise treatment for [[Vyadhi|diseases]] occurring in a particulat rogamarga. [Madhukosha on Madhava Nidana, Sarvaroga Nidana Adhyaya Shloka No.10]

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As [[Koshtha|koshtha]]/abhyantar roga-marga is the place of jatharagni, all its [[Vyadhi|diseases]] manifest due to poor agni (agnimandya or agni dushti), resulting into ama. Vamana and virechana maybe the line of treatment for shodhana purpose for the [[Vyadhi|diseases]] occurring here, depending on the classification of origin from stomach (amashaya samuttha) and colon (pakwashaya samuttha vyadhi).

+

As [[Koshtha|koshtha]]/abhyantar roga-marga is the place of jatharagni, all its [[Vyadhi|diseases]] manifest due to poor agni (agnimandya or agni dushti), resulting into ama. Vamana and [[Virechana|virechana]] maybe the line of treatment for shodhana purpose for the [[Vyadhi|diseases]] occurring here, depending on the classification of origin from stomach ([[Amashaya|amashaya]] samuttha) and colon (pakwashaya samuttha vyadhi).

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In the [[Vyadhi|diseases]] of external pathways, dhatwagnimandya will be prominent. Snehana-swedana will be of use for bringing the [[Dosha|dosha]] from shakha to [[Koshtha|koshtha]] and removal through the nearby orifice. Virechana and raktamokshana are one of the best shodhana measures for the [[Vyadhi|diseases]] of external patways. In addition, kshara, and agnikarma can also be applied for the [[Vyadhi|diseases]].

+

In the [[Vyadhi|diseases]] of external pathways, dhatwagnimandya will be prominent. Snehana-swedana will be of use for bringing the [[Dosha|dosha]] from shakha to [[Koshtha|koshtha]] and removal through the nearby orifice. [[Virechana|Virechana]] and raktamokshana are one of the best shodhana measures for the [[Vyadhi|diseases]] of external patways. In addition, kshara, and agnikarma can also be applied for the [[Vyadhi|diseases]].

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For the [[Vyadhi|diseases]] of medial pathway, prana and vyana vayu are found to be involved. Basti and nasya maybe more beneficial. As the [[Vyadhi|diseases]] of madhyama roga-marga are generally originated from colon (pakwashayottha) and due to obstructed vayu, basti maybe the first line of treatment. Basti is capable of preventing and overcoming the afflictions of [[Marma|marma]], asthi sandhi etc. [Cha. Sa. Siddhi Sthana 9/ 7]. Additionally, the [[Vyadhi|diseases]] of head like facial paralysis (ardita), neck stiffness (manyastambha), hemiplegia (pakshaghata), etc. can be treated with nasya.

+

For the [[Vyadhi|diseases]] of medial pathway, [[Prana|prana]] and vyana vayu are found to be involved. [[Basti|Basti]] and nasya maybe more beneficial. As the [[Vyadhi|diseases]] of madhyama roga-marga are generally originated from colon (pakwashayottha) and due to obstructed vayu, [[Basti|basti]] maybe the first line of treatment. [[Basti|Basti]] is capable of preventing and overcoming the afflictions of [[Marma|marma]], asthi sandhi etc. [Cha. Sa. Siddhi Sthana 9/ 7]. Additionally, the [[Vyadhi|diseases]] of head like facial paralysis (ardita), neck stiffness (manyastambha), hemiplegia (pakshaghata), etc. can be treated with nasya.

Similarly, shamana aushadha may also be categorized as acting specifically on a particular roga marga.

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== Contemporary approach ==

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The contemporary approach to understand the [[Sharira|body]] and the [[Samprapti|pathogenesis]] of any [[Vyadhi|disease]] is analytical. Whereas that of ayurveda is holistic and comprehensive. With this basic difference, it maybe said that such a concept of ‘rogamarga’ is also unique in Ayurveda, where different set of [[Vyadhi|diseases]] are said to occur under a single rogamarga. Further, the prognostic approach of contemporary medical science is not based on the systems involved; whereas this concept of rogamarga is also having significance for the prognosis.

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The contemporary approach to understand the [[Sharira|body]] and the [[Samprapti|pathogenesis]] of any [[Vyadhi|disease]] is analytical. Whereas that of [[Ayurveda|ayurveda]] is holistic and comprehensive. With this basic difference, it maybe said that such a concept of ‘rogamarga’ is also unique in [[Ayurveda|Ayurveda]], where different set of [[Vyadhi|diseases]] are said to occur under a single rogamarga. Further, the prognostic approach of contemporary medical science is not based on the systems involved; whereas this concept of rogamarga is also having significance for the prognosis.

== Current researches ==

=== Thesis ===

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<ul style='text-align:justify;'><li>Bhojani Meera et al: A study on Nirdesha Chatushka of Charaka Samhita and applied aspect of Trayo-Rogamarga, MD Thesis, 2003, IPGT&RA, Jamnagar : A detailed description on the concept of rogamarga and doshagati is explained. A clinical trial is done on the patients of tamaka shwasa and pravahika, based on the concept of rogamarga. It was found that the line of treatment for the [[Vyadhi|diseases]] occurring in a single rogamarga maybe similar and for the abhyantara rogamarga, the treatment maybe focused on jatharagni centered (correction of the digestion). </li></ul>

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<ul style='text-align:justify;'><li>Bhojani Meera et al: A study on Nirdesha Chatushka of Charaka Samhita and applied aspect of Trayo-Rogamarga, MD Thesis, 2003, IPGT&RA, Jamnagar : A detailed description on the concept of rogamarga and doshagati is explained. A clinical trial is done on the patients of tamaka [[Shwasa|shwasa]] and pravahika, based on the concept of rogamarga. It was found that the line of treatment for the [[Vyadhi|diseases]] occurring in a single rogamarga maybe similar and for the abhyantara rogamarga, the treatment maybe focused on jatharagni centered (correction of the digestion). </li></ul>

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