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== Pathological understanding of roga marga vs. disease pathways ==
<p style='text-align:justify;'>In a normal body, as such, there will be no rogamarga for the 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 khavaigunya. This results in directing the samprapti and spread of disease. Such weak srotas/ organs becomes rogamarga.
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Rogamargas have crucial role to play in the samprapti of a disease. The very definition of samprapti brings forth two things. One is that, the accumulated and spreading dosha virtually reaches each and every part of the body and the general channel of flow is rasayani. [ A.H. Ni. 1/23]
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Along with it, this subject has been emphasized for sadhyasahdyata i.e. prognosis, according to Cakrapani and for therapeutic application according to madhukosakara. This points towards the pathological importance of rogamarga. </p>
== Role of roga-marga in various stages of samprapti ==
<ul style='text-align:justify;'><li style="font-weight: bold;">Sub clinical or formative stages : <br/><span style="font-weight: normal;">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. Prakopa avastha exhibits the symptomatology but not disease. In the prasara avastha, when the spread of the morbid 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, the involvement of roga marga maybe inferred from accumulation stage (chaya avastha) itself. </span></li>
<li style="font-weight: bold;">Clinical stage : <br/><span style="font-weight: normal;">A list of 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 which later on cultivates for interaction of dosh and dushya. [Su.Sa.Sutrasthana 24/10] Kha-vaigunya plays directive role for the pathology to spread in different srotas (systems).
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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. </span></li>
<li style="font-weight: bold;"><span style="font-weight: normal;">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 diseases, are manifested. [Nidana Panchaka by Vaidya Shivacharana Dhyani, Chaukhambha Surabharati prakashana, edition 2022, pag no, 58] </span></li>
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
<li style="font-weight: bold;">Complicated clinical (post clinical) stage : <br/><span style="font-weight: normal;">Bheda stage is considered as the advanced clinical stage. In this stage, the disease (vyadhi) may become chronic or progressive and leads to other diseases. In this phase, the roga vriddhi takes place. Advancement of disease (roga vriddhi) takes place by different modes, which are listed briefly as follows: </span></li>
<ol><li style="font-weight: bold;">In the same organ, sthanantara swarupa roga vriddhi : <br/><span style="font-weight: normal;">In skin disorders and other contagious diseases, due to anatomical continuity in skin, the pathogens can travel in the same organ. E.g visarpa. [Cha.Sa.Chikitsa Sthana 21/15] </span></li>
<li style="font-weight: bold;">Dhatugata swarupa roga vriddhi : <br/><span style="font-weight: normal;">The transfer of disease or 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, it is explained in certain other contexts also. They are the following : </span></li>
<ol type="i"><li>Dhatugatatva of jwara (the morbid dosha causing fever penetrates into deeper tissues) [Cha. Sa. Chikitsa sthana 3/ 70-83], [Su.Sa.Uttara Tantra 29/83-89]</li>
<li>Dhatugatatva of kushtha (the morbid dosha causing skin diseases penetrates into deeper tissues) [Su. Sa. Nidana Sthana 5/20-27] </li>
<li>Dhatugatatva of masurika (the morbid 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>
The examples of dhatugatatva given in skin diseases (kushtha) can be taken as a model for understanding the symptomatology of dhatugatatva of kapha dominant diseases. Likewise, dhatugatatva of jwara for pittaja vyadhis and dhatugatatva described in vatavyadhi for vata dominant disorders.</ol>
<li style="font-weight: bold;">Nidanarthakara swarupa roga vriddhi : <br/><span style="font-weight: normal;">Sometimes one disease may become nidana for the other disease. This is also a kind of roga-vriddhi. Eg., Jwara to raktapitta (the heat of the 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 8/17-19] </span></li>
<li style="font-weight: bold;">Vyadhisankara swarupa roga vriddhi : <br/><span style="font-weight: normal;">Vyadhi sankara means the occurance of 2-3 diseases at a time. Sometimes, the disease itself subsides after producing some other 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 8/22] </span></li>
<li style="font-weight: bold;">Upadrava swarupa roga vriddhi : [Cha.Sa.Chikitsa Sthana21/40] <br/><span style="font-weight: normal;"> 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 diseases including ascites) are chhardi (vomiting), atisara (diarrhoea), shwasa (dyspnoea), kasa (cough), trishna (morbid thirst), hikka (hiccup), aruchi (anorexia) etc. [Cha.Sa.Chikitsa Sthana 13/49] </span></li>
<li style="font-weight: bold;">Roga vrddhi in same srotas in a sequential order : <br/><span style="font-weight: normal;">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. </span></li>
<li style="font-weight: bold;">Roga vrddhi according to dosha sthana : <br/><span style="font-weight: normal;">The best example given to study this is in Jwara Prakarana of Sushruta Uttara Sthana. [Nibandha Sangraha commentary by Dalhana on Su.Sa. Uttara tantra 39/ 51-52]
* Satata jwara in amashaya (In continuous fever, the morbid doshas are in the stomach)
* Anyedhyushka in hridaya (In intermittent fever, the morbid doshas are in the heart / heart region)
* Trutiyaka in kantha (In tertian fever, the morbid doshas are in the throat / throat region)
* Chaturthaka in sandhi (In quartan type of fever the morbid doshas are in the joints) </span></li>
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>