Changes

In the process of ''sthana samshraya doshas'' after circulating all over the body, get accumulated in ''dushyas'' in particular ''strotas'', next step is ''dosha- dushya sammurchhana'', ''doshas'' vitiate the ''dushyas'' and first produce premonitory symptoms. The manifestation of symptoms of disease follows a route depending upon the movement of vitiated ''doshas'' inside the body and the involvement of ''strotas''. Ayurveda considers three ''rogamargas'' or ''rogayatana''/ routes for manifestation of diseases - ''shakha'' (''bahya rogamarga'': ''twachha'' and ''raktadi dhatus'' - periphery), ''marma asthisandhi'' (''madhyam rogamarga'': Vital organs, bones, joints & ligaments-tendons), ''kostha'' (''abhyantara rogamarga'': Gastrointestinal tract and central part of body). The diseases manifesting in particular ''rogamarga'' is also described.  

In the process of ''sthana samshraya doshas'' after circulating all over the body, get accumulated in ''dushyas'' in particular ''strotas'', next step is ''dosha- dushya sammurchhana'', ''doshas'' vitiate the ''dushyas'' and first produce premonitory symptoms. The manifestation of symptoms of disease follows a route depending upon the movement of vitiated ''doshas'' inside the body and the involvement of ''strotas''. Ayurveda considers three ''rogamargas'' or ''rogayatana''/ routes for manifestation of diseases - ''shakha'' (''bahya rogamarga'': ''twachha'' and ''raktadi dhatus'' - periphery), ''marma asthisandhi'' (''madhyam rogamarga'': Vital organs, bones, joints & ligaments-tendons), ''kostha'' (''abhyantara rogamarga'': Gastrointestinal tract and central part of body). The diseases manifesting in particular ''rogamarga'' is also described.  

Charkapani has commented that three ''rogamargas'' <ref>Mahamohpadhyaya Sri Gangadhar Kaviratna Kaviraja Edited & Revised by Kaviraj Shree Narendranath Sengupta & Lalai Sengupta, Charaka Samhita by The Great Sage Bhagavata  Agnivesha, thoroughly revised by Maharsi Charaka & Dridhabala with Ayurvedadipika Commentaries of Srimat Chakrapani Datta & Jalpakalpataru Explanatory notes & Annotations, Sutra Sthana (First part), Chowkhambha Orientalia, Delhi, Third edition, ISBN: 978-81-89469-30-6. </ref> include ''marma asthi sandhi'' as one route, ''shakha'' nomenculature is given for the practical purpose, as the ''dhatus'' here are like the branches of tree. ''Twachha'' denotes here the ''rasa dhatu'' which is present in ''twachha''(skin), directly it is not stated as ''rasa'', as it is different from the ''rasa dhatu'' present in ''hridaya'' (heart). The vitiation of ''rasa'' residing in ''hridaya'' is considered in ''kostha'', also the vitiated ''rakta dhatu'' which is present in ''yakrita'' (liver) and ''pleeha'' (spleen). ''Ama sthana – amashaya'' (stomach), ''agni sthana'' (site of ''agni''- pancreas), site of digested food –''pakwashaya'' (terminal ileum and large intestine), ''mutrashaya'' (urinary bladder), ''rudhir sthana'' (''yakrita''-liver, ''pleeha''- spleen), ''hridaya'' (heart), ''unduka'' (caecum), ''phuphhupus'' (lungs) are considered as part of ''kostha'' (Su.Chi.2). ''Asthi sandhi'' stands for the joints and the tendons and ligaments. The description of ''rogamarga'' helps in knowing the prognosis of diseases.  

Charkapani has commented that three ''rogamargas'' <ref name=ref/>Mahamohpadhyaya Sri Gangadhar Kaviratna Kaviraja Edited & Revised by Kaviraj Shree Narendranath Sengupta & Lalai Sengupta, Charaka Samhita by The Great Sage Bhagavata  Agnivesha, thoroughly revised by Maharsi Charaka & Dridhabala with Ayurvedadipika Commentaries of Srimat Chakrapani Datta & Jalpakalpataru Explanatory notes & Annotations, Sutra Sthana (First part), Chowkhambha Orientalia, Delhi, Third edition, ISBN: 978-81-89469-30-6. </ref> include ''marma asthi sandhi'' as one route, ''shakha'' nomenculature is given for the practical purpose, as the ''dhatus'' here are like the branches of tree. ''Twachha'' denotes here the ''rasa dhatu'' which is present in ''twachha''(skin), directly it is not stated as ''rasa'', as it is different from the ''rasa dhatu'' present in ''hridaya'' (heart). The vitiation of ''rasa'' residing in ''hridaya'' is considered in ''kostha'', also the vitiated ''rakta dhatu'' which is present in ''yakrita'' (liver) and ''pleeha'' (spleen). ''Ama sthana – amashaya'' (stomach), ''agni sthana'' (site of ''agni''- pancreas), site of digested food –''pakwashaya'' (terminal ileum and large intestine), ''mutrashaya'' (urinary bladder), ''rudhir sthana'' (''yakrita''-liver, ''pleeha''- spleen), ''hridaya'' (heart), ''unduka'' (caecum), ''phuphhupus'' (lungs) are considered as part of ''kostha'' (Su.Chi.2). ''Asthi sandhi'' stands for the joints and the tendons and ligaments. The description of ''rogamarga'' helps in knowing the prognosis of diseases.  

[[Sutra Sthana]] Chapter 28 has explained the causes responsible for the movement of ''doshas'' from ''kostha'' to ''shakha''. Due to strenuous exercise, hyperfunctioning of ''agni'' (digestive power), non-observance of wholesome regimen and the pressure of vitiated ''vata'' ''dosha'' causes movement of ''doshas'' from ''kostha'' to ''shakhas'', they remain there till further aggravation. If already in stage of aggravation, then only they produce disease (Ch. Su.28/31-32). The factors responsible for the movement of ''doshas'' from ''shakha'' to ''kostha'' are also mentioned, aggravation of ''doshas'', increase in their fluidity, ''paka'' (suppuration), by the removal of the obstruction at the entrance of the channels and reduced pressure of ''vata dosha''. This knowledge helps in planning the treatment for the vitiated ''doshas'' accumulated in particular ''rogamarga''.

[[Sutra Sthana]] Chapter 28 has explained the causes responsible for the movement of ''doshas'' from ''kostha'' to ''shakha''. Due to strenuous exercise, hyperfunctioning of ''agni'' (digestive power), non-observance of wholesome regimen and the pressure of vitiated ''vata'' ''dosha'' causes movement of ''doshas'' from ''kostha'' to ''shakhas'', they remain there till further aggravation. If already in stage of aggravation, then only they produce disease (Ch. Su.28/31-32). The factors responsible for the movement of ''doshas'' from ''shakha'' to ''kostha'' are also mentioned, aggravation of ''doshas'', increase in their fluidity, ''paka'' (suppuration), by the removal of the obstruction at the entrance of the channels and reduced pressure of ''vata dosha''. This knowledge helps in planning the treatment for the vitiated ''doshas'' accumulated in particular ''rogamarga''.