Difference between revisions of "Chikitsa Sthana"

 
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|title = [[Charaka Samhita]] Chikitsa Sthana
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{{#seo:
|header1 = Sections
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|title=Chikitsa Sthana
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|titlemode=append
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|keywords=Chikitsa Sthana, Rasayana Chikitsa, Vajikarana Chikitsa, Jwara Chikitsa, Raktapitta Chikitsa, Gulma Chikitsa, Prameha Chikitsa, Kushtha Chikitsa, Rajayakshma Chikitsa, Unmada Chikitsa, Apasmara Chikitsa, Kshatakshina Chikitsa, Shvayathu Chikitsa, Udara Chikitsa, Arsha Chikitsa, Grahani Chikitsa, Pandu Chikitsa, Hikka Shwasa Chikitsa, Kasa Chikitsa, Atisara Chikitsa, Chhardi Chikitsa, Visarpa Chikitsa, Trishna Chikitsa, Visha Chikitsa, Madatyaya Chikitsa, Dwivraniya Chikitsa, Trimarmiya Chikitsa , Urustambha Chikitsa, Vatavyadhi Chikitsa,Vatarakta Chikitsa, Yonivyapat Chikitsa
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|description=Chikitsa Sthana deals with the study of preservation of health, prevention and management of various diseases
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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|image_alt=charak samhita
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|type=article
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}}
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{{ Infobox
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|title = [[Charak Samhita]] Chikitsa Sthana-Preamble
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|label1 = Section/Chapter
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|data1 = [[Chikitsa Sthana]] Section 6/ Preamble
 +
|label2 = Preceding section
 +
|data2 = [[Indriya Sthana]]
 +
|label3 = Succeeding section
 +
|data3 = [[Kalpa Sthana]]
 +
|label4 = Other Sections
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|data4 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Siddhi Sthana]]
 +
|label5 = Author
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|data5 = Singh G.
 +
|label6 = Reviewer
 +
|data6  = [[Gopal Basisht|Basisht G.]]
 +
|label7 = Editors
 +
|data7  = [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
 +
|label8 = Year of publication
 +
|data8 = 2020
 +
|label9 = DOI
 +
|data9  = [https://doi.org/10.47468/CSNE.2020.e01.s06.001 10.47468/CSNE.2020.e01.s06.001]
 +
|header10 = Chapters
 +
|label11 =
 +
|data11 = 1.[[Rasayana Chikitsa]], 2.[[Vajikarana Chikitsa]], 3.[[Jwara Chikitsa]], 4.[[Raktapitta Chikitsa]], 5.[[Gulma Chikitsa]], 6.[[Prameha Chikitsa]], 7.[[Kushtha Chikitsa]], 8.[[Rajayakshma Chikitsa]], 9.[[Unmada Chikitsa]], 10.[[Apasmara Chikitsa]], 11.[[Kshatakshina Chikitsa]], 12.[[Shvayathu Chikitsa]], 13.[[Udara Chikitsa]], 14.[[Arsha Chikitsa]], 15.[[Grahani Chikitsa]], 16.[[Pandu Chikitsa]], 17.[[Hikka Shwasa Chikitsa]], 18.[[Kasa Chikitsa]], 19.[[Atisara Chikitsa]], 20.[[Chhardi Chikitsa]], 21.[[Visarpa Chikitsa]], 22.[[Trishna Chikitsa]], 23.[[Visha Chikitsa]], 24.[[Madatyaya Chikitsa]], 25.[[Dwivraniya Chikitsa]], 26.[[Trimarmiya Chikitsa]] , 27.[[Urustambha Chikitsa]], 28.[[Vatavyadhi Chikitsa]], 29.[[Vatarakta Chikitsa]], 30.[[Yonivyapat Chikitsa]]}}
  
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'''<big>Preamble of Chikitsa Sthana</big>'''
  
|label2 = Preceding
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Chikitsa Sthana deals with the study of preservation of health, prevention and management of various diseases.
|data2 = [[Indriya Sthana]]
 
  
 +
==Fundamental principles==
 +
<div style="text-align:justify;">
 +
The term ''Chikitsa'' means treatment or therapy. <ref> Available from http://spokensanskrit.org/index.php?tran_input=cikitsA&direct=se&script=hk&link=yes&mode=3</ref> .  It is important to note that the status of health and etio-pathogenesis of disease depends upon status of Agni (digestion and metabolism). [Cha.Sa.[[Chikitsa Sthana]] 15/4]  Therefore, the treatment is based upon correcting the digestion and metabolism.
  
|label3 = Succeeding
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Literally, the term Kaya comprehends entire process of metabolism, rather than either anabolism as denoted by Deha or catabolism denoted by Sharira.  Therefore, the word  “Kaya-chikitsa”  indicates medical  management of diseases  caused by  impaired “Agni”. The medical practice of Kayachikitsa is based upon an intimate understanding of nutrition and the factors responsible for digestion, absorption and metabolism.<ref> Dwarkanath C. Introduction to Kayachikitsa.Chaukhambha Orientalia;third edition. Varanasi. 1996 p.2</ref>  [[Chikitsa Sthana]] is the most important section focusing on objectives of [[Ayurveda]] for preservation of health and treatment of diseased[Cha.Sa.[[Sutra Sthana]] 30/25]
|data3 = [[Kalpa Sthana]]
 
  
 +
==Structural dimensions of the section==
  
|label4 = All Sections
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This section relates mainly to therapeutics. However each chapter in this section starts with comprehensive information about etio-pathogenesis along with symptomatology, prognosis and classification of diseases before delving into detailed treatment. In therapeutic section of chapters, a general pattern is adopted to describe the management: The first principle of treatment (''chikitsa sutra'') of that particular disease is given in terms of ''[[langhana]]'' or ''[[brimhana]], [[snehana]]'' or ''[[rukshana]], [[swedana]]'' or ''[[stambhana]]'' and related measures of ''shodhana'' followed by their judicious use in particular state and stage of the disease. It is followed by description of single or compound preparations along with their constituents, method of preparation and indications. The drugs are mentioned in the form of fresh juice and paste, powder, tablet, decoctions, ''avaleha'' (jam), ''asava'' (fermented preparations mainly from juices), ''arishta'' (fermented preparations mainly from decoctions), medicated ghee and oil etc.
|data4 = [[Sutra Sthana]],[[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 
  
|header5 = Chapters
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==Specialties of [[Ayurveda]] therapeutics ==
  
|label7 =
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The medical therapeutics today has been classified into many branches focused on a defined group of patients, diseases, skills, or philosophy.<ref>Specialties of Medical Practice available from https://en.wikipedia.org/wiki/Specialty_(medicine) retrieved on April 24, 2019</ref>. Each chapter in this section deals with a separate specialty. Being primarily a treatise of ''kayachikitsa'' (medicine), twenty three chapters in the [[Chikitsa Sthana]] deal with medical therapeutics. Other aspects of therapeutics like preservation and promotion of physical, mental, spiritual and sexual health is dealt in the first two chapters of [[Rasayana Chikitsa]] and [[Vajikarana Chikitsa]]. The chapter [[Dwivraniya Chikitsa]] pertains to wound management and briefs about surgical procedures (''shalya''). The chapter [[Visha Chikitsa]] on the management of poisoning (''visha'') deals with ''agada-tantra'' (toxicology). In [[Ayurveda]], psychiatry is dealt with under the heading of ''bhuta-vidya'' and two chapters viz. [[Unmada Chikitsa]] and [[Apasmara Chikitsa]] focus on this aspect of medicine. The last chapter  [[Yonivyapat Chikitsa]] describes disorders of male and female infertility, gynecological disorders with paediatrics diseases. The chapter also mentions important principles of time of administration of medicine i.e. chrono-pharmacology and factors for deciding dose i.e. posology.
|data7 = [[Rasayana]], [[Vajikarana]], [[Jwara Chikitsa]], [[Raktapitta Chikitsa]], [[Gulma Chikitsa]], [[Prameha Chikitsa]], [[Kushtha Chikitsa]], [[Rajayakshma Chikitsa]], [[Unmada Chikitsa]], [[Apasmara Chikitsa]], [[Kshatakshina Chikitsa]], [[Svayatu Chikitsa]], [[Udara Chikitsa]], [[Arsha Chikitsa]], [[Grahani Chikitsa]], [[Pandu Chikitsa]], [[Hikka Shwasa Chikitsa]], [[Kasa Chikitsa]], [[Atisara Chikitsa]], [[Chhardi Chikitsa]], [[Visarpa Chikitsa]], [[Trishna Chikitsa]], [[Visha Chikitsa]], [[Madatyaya Chikitsa]], [[Dwivraniya Chikitsa]], , [[Urusthambha Chikitsa]], [[Vatavyadhi Chikitsa]],[[Vatarakta Chikitsa]] }}
 
  
<div style="text-align:justify;">''Chikitsa'' in Sanskrit means treatment and this section is about therapeutics in Ayurveda. Since the objective of Ayurveda is the prevention and treatment of disease, the first two chapters viz. [[Rasayana]] and [[Vajikarana]] deal with the preservation and promotion of physical, mental, and sexual health of a healthy person and the remaining chapters deal with therapeutics for the cure of diseases.
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==Glimpses of chapters==
 
[[Charaka Samhita]] being primarily a treatise of ''kayachikitsa'' (medicine) , most of the chapters in the [[Chikitsa Sthana]] deal with ''kayachikitsa'' while chapter 25 pertains to surgical disorders (''shalya'') and chapter 23 on the management of poisoning (''visha'') deals with ''agada-tantra'' (toxicology). In Ayurveda, psychiatry is dealt with under the heading of ''bhuta-vidya'' and two chapters - 9th and 10th - deal with ''unmada'' and ''apasmara'' focus on this aspect of medicine. Finally, the 30th chapter describes miscellaneous matters including the gynecological disorders and pediatrics (''kaumarabhritya'').
 
 
 
It is important to note here that though [[Chikitsa Sthana]] relates with therapeutics, each chapter provides a brief etio-pathogenesis along with symptomatology, prognosis and classification of the disease before delving into its detailed treatment. In therapeutic chapters a general pattern is adopted to describe the management: The first principle of treatment (''chikitsa sutra'') of that particular disease is given in terms of ''langhana'' or ''brimhana, snehana'' or ''rukshana, svedana'' or ''stambhana'' and concerned measures of ''shodhana'' followed by their judicious use in particular state and stage of the disease. It is followed by description of single or compound preparations along with their constituents, method of preparation and indications. The drugs are mentioned in the form of fresh juice and paste, powder, tablet, decoctions, ''avaleha'' (jam), ''asava'' (fermented preparations mainly from juices), ''arishta'' (fermented preparations mainly from decoctions), medicated ghee and oil etc.
 
  
 
Eight groups of major diseases were described in [[Nidana Sthana]], each representing one specific clinical feature from diagnostic point of view. Management of those eight diseases is explained in detail from the third to the tenth chapter.  
 
Eight groups of major diseases were described in [[Nidana Sthana]], each representing one specific clinical feature from diagnostic point of view. Management of those eight diseases is explained in detail from the third to the tenth chapter.  
  
Thus, there are thirty chapters in [[Chikitsa Sthana]]:
+
In all, There are thirty chapters in [[Chikitsa Sthana]].
 
   
 
   
The first chapter is on [[Rasayana]] (rejuvenation therapy) , further divided into four sections (or sub-chapters). The chapter describes a number of drugs and preparations by means of which one can prevent and retard aging and live a longer, happier life. [[Rasayana]] drugs promote physical and mental health and provide general immunity to prevent diseases as well as strength to the tissues to be able to fight diseases effectively.  
+
*The first chapter is on [[Rasayana Chikitsa]] (rejuvenation therapy) , further divided into four sections (or sub-chapters). The chapter describes a number of medicine preparations by means of which one can prevent and retard aging and live a longer, happier life. [[Rasayana]] measures promote physical and mental health and provide general immunity to prevent diseases as well as strength to the tissues to be able to fight diseases effectively. Thus this chapter highlights principles of geriatrics and old age care as well as prevention of aging process.  
  
The second chapter, on [[Vajikarana]], also comprises of four sub-chapters and deals with enhancing sexual health in healthy persons, consequently leading to healthy progeny.  
+
*The second chapter, on [[Vajikarana Chikitsa]], also comprises of four sub-chapters and deals with enhancing sexual health in healthy persons, consequently leading to healthy progeny. The chapter reveals principles of aphrodisiac medicines.  
  
The management of ''jwara'' (fever) associated diseases are described in the 3rd chapter, [[Jwara Chikitsa]]. It includes therapeutic measures for acute and chronic fever, continuous, intermittent, malarial and seasonal fevers, mild, moderate and severe fevers, fever with or without ''ama'', fevers occurring from one, two or three combination of ''dosha'', fever occurring in ''dhatu'' and so on. All the aspects affecting treatment and prognosis of various types of fever are also described.  
+
*The management of ''[[Jwara]]'' (fever) associated diseases are described in the 3rd chapter, [[Jwara Chikitsa]]. It includes therapeutic measures for acute and chronic fever, continuous, intermittent, malarial and seasonal fevers, mild, moderate and severe fevers, fever with or without [[ama]], fevers occurring from one, two or three combination of [[dosha]], fever occurring in [[dhatu]] and so on. All the aspects affecting treatment and prognosis of various types of fever are also described. This chapter describes principles related with thermo-regulatory mechanisms in the body.  
  
The fourth chapter deals with the management of bleeding disorders under the heading of [[Raktapitta Chikitsa]], which is of two types i.e. bleeding from the upper and lower channels.  
+
*The fourth chapter deals with the management of bleeding disorders under the heading of [[Raktapitta Chikitsa]], which is of two types i.e. bleeding from the upper and lower channels. Management principles of bleeding disorders are mentioned in this chapter. 
  
The fifth chapter,[[Gulma Chikitsa]] describes protuberance of abdomen under two headings, local and generalized. Local enlargement of belly is ''gulma'' and is of five types which includes simple gas phantom to new growth and their treatment.  
+
*The fifth chapter,[[Gulma Chikitsa]] describes protuberance of abdomen under two headings, local and generalized. Local lump in abdominal cavity is termed as ''gulma'' and is of five types which includes simple gas phantom to new growth and their treatment.  
 
    
 
    
Urinary diseases are described according to the presenting symptoms of excessive urine or scanty urine with difficulty/pain. Sixth chapter deals with the treatment of urinary problems with presenting sign of excessive urine under the heading of [[Prameha Chikitsa]] which is of twenty types and includes ''madhumeha'' (diabetes mellitus).  
+
*Urinary diseases are described according to the presenting symptoms of excessive urine or scanty urine with difficulty/pain. This chapter deals with the treatment of urinary problems with presenting sign of excessive urine under the heading of [[Prameha Chikitsa]] which is of twenty types and includes ''madhumeha'' (diabetes mellitus). Principles of treatment for disorders due to impaired fat metabolism are also described. 
  
The management of eighteen types of ''kushtha'' (skin diseases including leprosy) is described in the 7th chapter ([[Kushtha Chikitsa]]). Chronic non-purulent bacterial, fungal and allergic skin disorders are described under this heading. These disorders are further divided into two groups viz. 11 types of ''kshudra kushtha'' (minor skin diseases) and 7 types of ''mahakushtha'' (major skin disorders).
+
*The management of eighteen types of ''Kushtha'' (skin diseases including leprosy) is described in the seventh chapter entitled [[Kushtha Chikitsa]]. Chronic non-purulent bacterial, fungal and allergic skin disorders are described under this heading. These disorders are further divided into two groups viz. 11 types of ''kshudra kushtha'' (minor skin diseases) and 7 types of ''mahakushtha'' (major skin disorders). The chapter describes principles of dermatology specialty.  
  
''Rajayakshma'' (Tuberculosis) has been a problem since time immemorial and according to its etio-pathogenesis it is classified into four types and its detailed treatment is described in the 8th chapter.
+
*''Rajayakshma'' (Syndrome like Tuberculosis) has been a problem since time immemorial. It is described in the chapter entitled [[Rajayakshma Chikitsa]]. According to its etio-pathogenesis, it is classified into four types and its detailed treatment is described. The chapter deals with treatment of various diseases due to impaired immunity.  
 
    
 
    
''Bhuta-vidya'' (psychological diseases); Ninth chapter describes the management of ''unmada'' (insanity/psychotic disorders).  
+
*''Bhuta-vidya'' (psychiatric disorders) are described in two chapters. The ninth chapter entitled  [[Unmada Chikitsa]] describes the management of insanity and various other psychotic disorders.  
  
The tenth chapter deals with the management of epilepsy described under the heading of ''apasmara''.
+
*The tenth chapter entitled [[Apasmara Chikitsa]] deals with the management of epilepsy, seizures  and memory disorders.  Both chapters describe management principles of psychiatric disorders.  
 
   
 
   
''Kshata-kshina'' occurs by indulgence in activities beyond one’s strength or cruel activities such as bull fighting leading to ulcer in chest, bleeding and cachexia is described in 11th chapter.
+
*''Kshata-kshina'' occurs by indulgence in activities beyond one’s strength or cruel activities such as bull fighting leading to chest injuries, bleeding and cachexia. The management is described in eleventh chapter entitled [[Kshatakshina Chikitsa]]. This chapter mentions principles of management of chest injuries and occupational health hazards.  
+
 
Three groups of diseases with swelling (''utsedha''), edema and inflammation occurring in the skin and glands are described under the heading of ''shotha'' in the 12th chapter.
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*Three groups of diseases with swelling (''utsedha''), edema and inflammation at various sites are described in the twelfth chapter entitled [[Shvayathu Chikitsa]].
 +
 
 +
*The conditions leading to generalized enlargement of abdomen such as ascites, hepatomegaly and splenomegaly are described in thirteenth chapter entitled [[Udara Chikitsa]]. 
 +
Both chapters describe management principles of disorders due to impaired fluid and osmotic balance in body.
 +
 
 +
*Types of hemorrhoids and warts etc. are described along with their treatment in the next chapter entitled [[Arsha Chikitsa]].  The chapter describes medical or conservative management of haemorrhoids. 
 +
 
 +
* [[Grahani Chikitsa]], the fifteenth chapter elaborates physiological principles of Agni (digestion and metabolism) at various levels and its importance in clinical practice. Various processes of digestion, metabolism leading to the formation of ''[[dhatu]]'' ( body tissues) and ''[[mala]]'' (metabolic wastes) are also described. The comprehensive management of disorders of gastrointestinal tract is described.
 +
 
 +
*Two diseases caused mainly by vitiation of ''[[rakta]]'' (blood tissue) viz. ''pandu roga'' (anemia and blood deficiency disorders) and ''kamala'' (jaundice and hepatic disorders) are described in sixteenth chapter entitled [[Pandu Chikitsa]].  Thus management principles of haematological disorders are described in this chapter.
 +
 
 +
* The seventeenth chapter,  entitled [[Hikka Shwasa Chikitsa]] deals with disorders of respiratory system.  Clinical presentations and management of five types of hiccups and dyspnoea are described.
 +
 
 +
* [[Kasa Chikitsa]], the eighteenth chapter deals with cough of various origin and its management.
 +
 
 +
*The management principles of various types of diarrhea and irritable bowel syndrome are described in nineteenth chapter entitled [[Atisara Chikitsa]]. 
 +
 
 +
*The next chapter [[Chhardi Chikitsa]] describes management of Vomiting (''chhardi'') due to various somatic and psychological origin.
 +
 
 +
*Types of acute inflammatory dermatological conditions such as erysipelas are described under the heading of ''visarpa'' in twenty-first chapter entitled [[Visarpa Chikitsa]]. 
 +
 
 +
*The conditions manifested in the form of excessive thirst (''trishna'') are described in chapter entitled [[Trishna Chikitsa]]. 
 +
 
 +
*The next chapter, [[Visha Chikitsa]] deals with the management of acute and slow poisoning (''visha'') relating with ''agada-tantra'' (toxicology).
 +
 
 +
*The management of its various acute and chronic stages of alcoholic intoxication and its complications are tackled in twenty fourth chapter entitled [[Madatyaya Chikitsa]]. The management principles for substance abuse and addiction can be referred in this chapter.
 +
 
 +
*Wound management and surgical procedures (''shalya'') are described in twenty fifth chapter entitled [[Dwivraniya Chikitsa]]. 
 +
 
 +
*The next chapter, [[Trimarmiya Chikitsa]] describes disorders due to obstruction to free movement of [[vata dosha]].  The gastrointestinal diseases such as ''udavarta''(reverse movement of [[vata]]), ''anaha'' (distension of abdomen), ''aruchi'' (anorexia) etc. are described. Disorders of three vital organs like heart, brain and kidney are described as main context of chapter. Thus this chapter describes management principles of disorders in cardiac region, head region and urinary system.  Brief description of management of diseases pertaining to hair, ear, nose and throat with passing reference to eye diseases is also dealt in this chapter.
 +
 
 +
*Disorders of spinal- neuro- muscular degeneration in thigh and hip joint are described in twenty seventh chapter entitled [[Urustambha Chikitsa]].
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 +
*[[Vata dosha]] is the key initiating factor responsible for all physiological and psychological mechanisms in the body. The types of [[vata dosha]], their functions and disorders are described in [[Vatavyadhi Chikitsa]]. Disorders caused by [[Vata dosha]] in body,  like digestive system, nervous system, musculo-skeletal system and their managements are described in this chapter.
 +
 
 +
*The next chapter, [[Vatarakta Chikitsa]] specifically describes disorders due to vitiation of [[vata dosha]] and [[rakta dhatu]]. The conditions involving deformities in small joints, those of vascular system involving blood vessels are highlighted in this chapter with their management.
 +
 
 +
*The last chapter, entitled [[Yonivyapat Chikitsa]]) describes disorders related to male and female reproductive system, infertility and other gynecological disorders. The diseases in children (''kaumarabhritya'') are mentioned as well. The principles related to time of administration of medicine and dose is also highlighted.  
  
The conditions leading to generalized enlargement of abdomen such as ascites, splenomegaly are described in 13th chapter under the heading of ''udara roga''.
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==Importance==
  
Various types of hemorrhoids and warts etc. are described along with their treatment in the 14th chapter.  
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The section is a quick reference manual for therapeutics. This section provides comprehensive information about all aspects of clinical practice including etio-pathogenesis, management and drug formulary. It is obvious from the foregoing that [[Chikitsa Sthana]] is a treasure of therapeutic knowledge and by mastering this part one can become expert physician who can tackle all types of acute and chronic disease successfully.
  
''Grahani'' (mal-absorption) and its management is explained in the 15th chapter. Various processes of digestion, metabolism leading to the formation of ''dhatu'' and ''mala'' are also described.
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<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
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Two diseases caused mainly by involvement of ''rakta'' viz. ''pandu roga'' (anemia) and ''kamala'' (jaundice) are described in 16th chapter.
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[[Category: Ayurveda therapeutics]]
 
Five types of disorders having presentation of dyspnea are explained in 17th chapter along with five types of hiccough.
 
  
Other diseases of respiratory system viz.  
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==External links==
 +
*[https://kayachikitsagau.blogspot.com/ Case reports on various conditions are available on this blog.]
  
*Cough (''kasa'') is described in 18th chapter and
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==References==
*Diarrheal disorders (''atisara'') are described in 19th chapter.
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</div>
*Vomiting (''chhardi'') has been devoted a full 20th chapter.   
 
*Various types of inflammatory skin conditions such as erysipelas are described under the heading of ''visarpa'' in Chapter 21. 
 
*Various conditions manifested in the form of thirst (''trishna'') are described in Chapter 22.
 
*Chaper 23 is on the management of poisoning (''visha'') relating with ''agada-tantra'' (toxicology).
 
*Alcoholism was a major problem in ancient India and the management of its various acute and chronic stages and complications are tackled in Chapter 24 under the heading of ''madatyaya''.
 
*Chapter 25 pertains to ''vrana chikitsa'' (wound management) and surgical disorders (''shalya'')
 
*Chapter 26 describes other gastrointestinal diseases such as ''udavarta'', ''annaha'' (distension of abdomen), ''aruchi'' (anorexia) etc. The urinary problems with scanty urine occurring with difficulty and accompanied with burning sensation or pain are also described under the heading of ''mutra-krichhra'' and ''ashmari''. Management of other diseases, pertaining to five types of heart diseases and ear, nose, throat and scalp diseases with passing reference to eye diseases.
 
*Disorders of spinal neuro muscular degeneration or ''Urustambha'' are described in Chapter 27.
 
*Various nervous system and related disorders including joints (''sandhi-gata-vata'', ''avabahuka'' etc), stroke and their managements are described in Chapter 28, under the caption of ''vata-vyadhi''.
 
*Chapter 29, under the heading of ''vatarakta'',deals with gout but other joint disorders and condition resembling thrombo angitis obliterans is described.
 
*Chapter 30 describes miscellaneous matters including the gynecological disorders and children diseases (''kaumarabhritya'').
 
  
It is obvious from the foregoing that [[Chikitsa Sthana]] is a treasure of therapeutic knowledge and by mastering this part one can become expert physician who can tackle all types of acute and chronic disease successfully.</div>
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Latest revision as of 10:59, 23 February 2024

Cite.png

Preamble of Chikitsa Sthana

Charak Samhita Chikitsa Sthana-Preamble
Section/Chapter Chikitsa Sthana Section 6/ Preamble
Preceding section Indriya Sthana
Succeeding section Kalpa Sthana
Other Sections Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Siddhi Sthana
Author Singh G.
Reviewer Basisht G.
Editors Deole Y.S., Basisht G.
Year of publication 2020
DOI 10.47468/CSNE.2020.e01.s06.001
Chapters
1.Rasayana Chikitsa, 2.Vajikarana Chikitsa, 3.Jwara Chikitsa, 4.Raktapitta Chikitsa, 5.Gulma Chikitsa, 6.Prameha Chikitsa, 7.Kushtha Chikitsa, 8.Rajayakshma Chikitsa, 9.Unmada Chikitsa, 10.Apasmara Chikitsa, 11.Kshatakshina Chikitsa, 12.Shvayathu Chikitsa, 13.Udara Chikitsa, 14.Arsha Chikitsa, 15.Grahani Chikitsa, 16.Pandu Chikitsa, 17.Hikka Shwasa Chikitsa, 18.Kasa Chikitsa, 19.Atisara Chikitsa, 20.Chhardi Chikitsa, 21.Visarpa Chikitsa, 22.Trishna Chikitsa, 23.Visha Chikitsa, 24.Madatyaya Chikitsa, 25.Dwivraniya Chikitsa, 26.Trimarmiya Chikitsa , 27.Urustambha Chikitsa, 28.Vatavyadhi Chikitsa, 29.Vatarakta Chikitsa, 30.Yonivyapat Chikitsa

Chikitsa Sthana deals with the study of preservation of health, prevention and management of various diseases.

Fundamental principles

The term Chikitsa means treatment or therapy. [1] . It is important to note that the status of health and etio-pathogenesis of disease depends upon status of Agni (digestion and metabolism). [Cha.Sa.Chikitsa Sthana 15/4] Therefore, the treatment is based upon correcting the digestion and metabolism.

Literally, the term Kaya comprehends entire process of metabolism, rather than either anabolism as denoted by Deha or catabolism denoted by Sharira. Therefore, the word “Kaya-chikitsa” indicates medical management of diseases caused by impaired “Agni”. The medical practice of Kayachikitsa is based upon an intimate understanding of nutrition and the factors responsible for digestion, absorption and metabolism.[2] Chikitsa Sthana is the most important section focusing on objectives of Ayurveda for preservation of health and treatment of diseased[Cha.Sa.Sutra Sthana 30/25]

Structural dimensions of the section

This section relates mainly to therapeutics. However each chapter in this section starts with comprehensive information about etio-pathogenesis along with symptomatology, prognosis and classification of diseases before delving into detailed treatment. In therapeutic section of chapters, a general pattern is adopted to describe the management: The first principle of treatment (chikitsa sutra) of that particular disease is given in terms of langhana or brimhana, snehana or rukshana, swedana or stambhana and related measures of shodhana followed by their judicious use in particular state and stage of the disease. It is followed by description of single or compound preparations along with their constituents, method of preparation and indications. The drugs are mentioned in the form of fresh juice and paste, powder, tablet, decoctions, avaleha (jam), asava (fermented preparations mainly from juices), arishta (fermented preparations mainly from decoctions), medicated ghee and oil etc.

Specialties of Ayurveda therapeutics

The medical therapeutics today has been classified into many branches focused on a defined group of patients, diseases, skills, or philosophy.[3]. Each chapter in this section deals with a separate specialty. Being primarily a treatise of kayachikitsa (medicine), twenty three chapters in the Chikitsa Sthana deal with medical therapeutics. Other aspects of therapeutics like preservation and promotion of physical, mental, spiritual and sexual health is dealt in the first two chapters of Rasayana Chikitsa and Vajikarana Chikitsa. The chapter Dwivraniya Chikitsa pertains to wound management and briefs about surgical procedures (shalya). The chapter Visha Chikitsa on the management of poisoning (visha) deals with agada-tantra (toxicology). In Ayurveda, psychiatry is dealt with under the heading of bhuta-vidya and two chapters viz. Unmada Chikitsa and Apasmara Chikitsa focus on this aspect of medicine. The last chapter Yonivyapat Chikitsa describes disorders of male and female infertility, gynecological disorders with paediatrics diseases. The chapter also mentions important principles of time of administration of medicine i.e. chrono-pharmacology and factors for deciding dose i.e. posology.

Glimpses of chapters

Eight groups of major diseases were described in Nidana Sthana, each representing one specific clinical feature from diagnostic point of view. Management of those eight diseases is explained in detail from the third to the tenth chapter.

In all, There are thirty chapters in Chikitsa Sthana.

  • The first chapter is on Rasayana Chikitsa (rejuvenation therapy) , further divided into four sections (or sub-chapters). The chapter describes a number of medicine preparations by means of which one can prevent and retard aging and live a longer, happier life. Rasayana measures promote physical and mental health and provide general immunity to prevent diseases as well as strength to the tissues to be able to fight diseases effectively. Thus this chapter highlights principles of geriatrics and old age care as well as prevention of aging process.
  • The second chapter, on Vajikarana Chikitsa, also comprises of four sub-chapters and deals with enhancing sexual health in healthy persons, consequently leading to healthy progeny. The chapter reveals principles of aphrodisiac medicines.
  • The management of Jwara (fever) associated diseases are described in the 3rd chapter, Jwara Chikitsa. It includes therapeutic measures for acute and chronic fever, continuous, intermittent, malarial and seasonal fevers, mild, moderate and severe fevers, fever with or without ama, fevers occurring from one, two or three combination of dosha, fever occurring in dhatu and so on. All the aspects affecting treatment and prognosis of various types of fever are also described. This chapter describes principles related with thermo-regulatory mechanisms in the body.
  • The fourth chapter deals with the management of bleeding disorders under the heading of Raktapitta Chikitsa, which is of two types i.e. bleeding from the upper and lower channels. Management principles of bleeding disorders are mentioned in this chapter.
  • The fifth chapter,Gulma Chikitsa describes protuberance of abdomen under two headings, local and generalized. Local lump in abdominal cavity is termed as gulma and is of five types which includes simple gas phantom to new growth and their treatment.
  • Urinary diseases are described according to the presenting symptoms of excessive urine or scanty urine with difficulty/pain. This chapter deals with the treatment of urinary problems with presenting sign of excessive urine under the heading of Prameha Chikitsa which is of twenty types and includes madhumeha (diabetes mellitus). Principles of treatment for disorders due to impaired fat metabolism are also described.
  • The management of eighteen types of Kushtha (skin diseases including leprosy) is described in the seventh chapter entitled Kushtha Chikitsa. Chronic non-purulent bacterial, fungal and allergic skin disorders are described under this heading. These disorders are further divided into two groups viz. 11 types of kshudra kushtha (minor skin diseases) and 7 types of mahakushtha (major skin disorders). The chapter describes principles of dermatology specialty.
  • Rajayakshma (Syndrome like Tuberculosis) has been a problem since time immemorial. It is described in the chapter entitled Rajayakshma Chikitsa. According to its etio-pathogenesis, it is classified into four types and its detailed treatment is described. The chapter deals with treatment of various diseases due to impaired immunity.
  • Bhuta-vidya (psychiatric disorders) are described in two chapters. The ninth chapter entitled Unmada Chikitsa describes the management of insanity and various other psychotic disorders.
  • The tenth chapter entitled Apasmara Chikitsa deals with the management of epilepsy, seizures and memory disorders. Both chapters describe management principles of psychiatric disorders.
  • Kshata-kshina occurs by indulgence in activities beyond one’s strength or cruel activities such as bull fighting leading to chest injuries, bleeding and cachexia. The management is described in eleventh chapter entitled Kshatakshina Chikitsa. This chapter mentions principles of management of chest injuries and occupational health hazards.
  • Three groups of diseases with swelling (utsedha), edema and inflammation at various sites are described in the twelfth chapter entitled Shvayathu Chikitsa.
  • The conditions leading to generalized enlargement of abdomen such as ascites, hepatomegaly and splenomegaly are described in thirteenth chapter entitled Udara Chikitsa.

Both chapters describe management principles of disorders due to impaired fluid and osmotic balance in body.

  • Types of hemorrhoids and warts etc. are described along with their treatment in the next chapter entitled Arsha Chikitsa. The chapter describes medical or conservative management of haemorrhoids.
  • Grahani Chikitsa, the fifteenth chapter elaborates physiological principles of Agni (digestion and metabolism) at various levels and its importance in clinical practice. Various processes of digestion, metabolism leading to the formation of dhatu ( body tissues) and mala (metabolic wastes) are also described. The comprehensive management of disorders of gastrointestinal tract is described.
  • Two diseases caused mainly by vitiation of rakta (blood tissue) viz. pandu roga (anemia and blood deficiency disorders) and kamala (jaundice and hepatic disorders) are described in sixteenth chapter entitled Pandu Chikitsa. Thus management principles of haematological disorders are described in this chapter.
  • The seventeenth chapter, entitled Hikka Shwasa Chikitsa deals with disorders of respiratory system. Clinical presentations and management of five types of hiccups and dyspnoea are described.
  • Kasa Chikitsa, the eighteenth chapter deals with cough of various origin and its management.
  • The management principles of various types of diarrhea and irritable bowel syndrome are described in nineteenth chapter entitled Atisara Chikitsa.
  • The next chapter Chhardi Chikitsa describes management of Vomiting (chhardi) due to various somatic and psychological origin.
  • Types of acute inflammatory dermatological conditions such as erysipelas are described under the heading of visarpa in twenty-first chapter entitled Visarpa Chikitsa.
  • The conditions manifested in the form of excessive thirst (trishna) are described in chapter entitled Trishna Chikitsa.
  • The next chapter, Visha Chikitsa deals with the management of acute and slow poisoning (visha) relating with agada-tantra (toxicology).
  • The management of its various acute and chronic stages of alcoholic intoxication and its complications are tackled in twenty fourth chapter entitled Madatyaya Chikitsa. The management principles for substance abuse and addiction can be referred in this chapter.
  • Wound management and surgical procedures (shalya) are described in twenty fifth chapter entitled Dwivraniya Chikitsa.
  • The next chapter, Trimarmiya Chikitsa describes disorders due to obstruction to free movement of vata dosha. The gastrointestinal diseases such as udavarta(reverse movement of vata), anaha (distension of abdomen), aruchi (anorexia) etc. are described. Disorders of three vital organs like heart, brain and kidney are described as main context of chapter. Thus this chapter describes management principles of disorders in cardiac region, head region and urinary system. Brief description of management of diseases pertaining to hair, ear, nose and throat with passing reference to eye diseases is also dealt in this chapter.
  • Disorders of spinal- neuro- muscular degeneration in thigh and hip joint are described in twenty seventh chapter entitled Urustambha Chikitsa.
  • Vata dosha is the key initiating factor responsible for all physiological and psychological mechanisms in the body. The types of vata dosha, their functions and disorders are described in Vatavyadhi Chikitsa. Disorders caused by Vata dosha in body, like digestive system, nervous system, musculo-skeletal system and their managements are described in this chapter.
  • The next chapter, Vatarakta Chikitsa specifically describes disorders due to vitiation of vata dosha and rakta dhatu. The conditions involving deformities in small joints, those of vascular system involving blood vessels are highlighted in this chapter with their management.
  • The last chapter, entitled Yonivyapat Chikitsa) describes disorders related to male and female reproductive system, infertility and other gynecological disorders. The diseases in children (kaumarabhritya) are mentioned as well. The principles related to time of administration of medicine and dose is also highlighted.

Importance

The section is a quick reference manual for therapeutics. This section provides comprehensive information about all aspects of clinical practice including etio-pathogenesis, management and drug formulary. It is obvious from the foregoing that Chikitsa Sthana is a treasure of therapeutic knowledge and by mastering this part one can become expert physician who can tackle all types of acute and chronic disease successfully.

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External links

References

  1. Available from http://spokensanskrit.org/index.php?tran_input=cikitsA&direct=se&script=hk&link=yes&mode=3
  2. Dwarkanath C. Introduction to Kayachikitsa.Chaukhambha Orientalia;third edition. Varanasi. 1996 p.2
  3. Specialties of Medical Practice available from https://en.wikipedia.org/wiki/Specialty_(medicine) retrieved on April 24, 2019