Changes

Longevity is the desire of most human beings - to lead a healthy and long life. There is also desire for wealth - to enjoy all the worldly pleasures and also spend on spiritual rituals. The process of birth and rebirth is a ''karmic'' cycle and the quality of an individual’s afterlife and the remaining part of his present life depends upon the good and bad deeds done in the life. As a result of good deeds, we can enjoy material (or heavenly) pleasures and lead healthy lives.

Longevity is the desire of most human beings - to lead a healthy and long life. There is also desire for wealth - to enjoy all the worldly pleasures and also spend on spiritual rituals. The process of birth and rebirth is a ''karmic'' cycle and the quality of an individual’s afterlife and the remaining part of his present life depends upon the good and bad deeds done in the life. As a result of good deeds, we can enjoy material (or heavenly) pleasures and lead healthy lives.

Prior chapters dealt with maintainence of health and cure for diseases. The aim of a healthy life is for attainment of happiness/ bliss in this world and the world after death. The chapter begins with a description about three basic desires of human life, which should be fulfilled during one’s lifetime - longevity, material comforts, and a blissful after-life. Charaka has stated about the methods and means to fulfil these ''eshanas'', or desires:  ''Pranaeshana'', or the desire for longevity can be achieved by following a healthy lifestyle. ''Dhanaeshana'', or the desire for earning may be fulfilled by adopting appropriate and ethical means of livelihood. A wealthy person is respected by the society, therefore earning is essential for maintaining health as well as to perform various spiritual rituals to fulfil the third desire, i.e. ''Parlokeshaeshana'', to get happiness in the next world after death. The third desire is vague, since there are no means to perceive life after death for an individual. On this subject, there are two schools of thoughts - ''astik'', or theism (belief in a supernatural power responsible for creation of the world), and atheism (belief that there is no God or believing only objects or experiences that can be perceived). Different opinions about creation are explained according to different schools of thought. It is concluded that there is existence of many things in this universe even though they are not directly perceptible, so their existence cannot be denied, and therefore the theory of reincarnation cannot be denied unless proven otherwise.  

Prior chapters dealt with maintainence of health and cure for diseases. The aim of a healthy life is for attainment of happiness/ bliss in this world and the world after death. The chapter begins with a description about three basic desires of human life, which should be fulfilled during one’s lifetime - longevity, material comforts, and a blissful after-life. Charak has stated about the methods and means to fulfil these ''eshanas'', or desires:  ''Pranaeshana'', or the desire for longevity can be achieved by following a healthy lifestyle. ''Dhanaeshana'', or the desire for earning may be fulfilled by adopting appropriate and ethical means of livelihood. A wealthy person is respected by the society, therefore earning is essential for maintaining health as well as to perform various spiritual rituals to fulfil the third desire, i.e. ''Parlokeshaeshana'', to get happiness in the next world after death. The third desire is vague, since there are no means to perceive life after death for an individual. On this subject, there are two schools of thoughts - ''astik'', or theism (belief in a supernatural power responsible for creation of the world), and atheism (belief that there is no God or believing only objects or experiences that can be perceived). Different opinions about creation are explained according to different schools of thought. It is concluded that there is existence of many things in this universe even though they are not directly perceptible, so their existence cannot be denied, and therefore the theory of reincarnation cannot be denied unless proven otherwise.  

The four ''pariksha'' or fourfold methods for getting correct knowledge are explained viz. ''aptopadesha'' (authoritative/scriptural testimony), ''pratyaksha''(direct observation by senses), ''anumana''(inference) by guessing, and ''yukti''(reasoning) by applying intelligence. These four ''pariksha'' are defined vividly and their importance in establishing the theory of reincarnation is explained. Afterwards, the factors in maintenance of good health are described, three ''upastambhas''(supporting pillars of life)- ''ahara''(food), ''swapna''(sleep) and bramhacharya (celibacy). By following these well regulated lifestyle factors, the body is bestowed with strength, increasing the three forms of ''bala'' (strength, immunity) – ''sahaja'' (constitutional strength, immunity), ''kalaja'' (seasonal strength, immunity) and ''yuktikrita'' (acquired immunity). Various diseases may arise if there is stress, unhealthy lifestyle, or through the effects of unhealthy season over the mind and the body. Further this chapter briefly describes three basic causes of diseases, three disease pathways, three types of treatments and therapies, three categories of physicians based on their qualities.

The four ''pariksha'' or fourfold methods for getting correct knowledge are explained viz. ''aptopadesha'' (authoritative/scriptural testimony), ''pratyaksha''(direct observation by senses), ''anumana''(inference) by guessing, and ''yukti''(reasoning) by applying intelligence. These four ''pariksha'' are defined vividly and their importance in establishing the theory of reincarnation is explained. Afterwards, the factors in maintenance of good health are described, three ''upastambhas''(supporting pillars of life)- ''ahara''(food), ''swapna''(sleep) and bramhacharya (celibacy). By following these well regulated lifestyle factors, the body is bestowed with strength, increasing the three forms of ''bala'' (strength, immunity) – ''sahaja'' (constitutional strength, immunity), ''kalaja'' (seasonal strength, immunity) and ''yuktikrita'' (acquired immunity). Various diseases may arise if there is stress, unhealthy lifestyle, or through the effects of unhealthy season over the mind and the body. Further this chapter briefly describes three basic causes of diseases, three disease pathways, three types of treatments and therapies, three categories of physicians based on their qualities.

ityagniveshakRute tantre carakapratisaMskRute shlokasthAne tisraiShaNIyonAmaikAdasho~adhyAyaH||11||  

ityagniveshakRute tantre carakapratisaMskRute shlokasthAne tisraiShaNIyonAmaikAdasho~adhyAyaH||11||  

Thus ends the work by Agnivesha, redacted by Charaka of [[Sutra Sthana]] eleventh chapter on “Three desires of life”. [11]

Thus ends the work by Agnivesha, redacted by Charak of [[Sutra Sthana]] eleventh chapter on “Three desires of life”. [11]

=== ''Tattva Vimarsha'' ===

=== ''Tattva Vimarsha'' ===

In geometry, two straight lines cannot possibly enclose any space or form a plane figure. Neither can two plane surfaces form a solid. Three lines are necessary to form a plane figure, and three dimensions of length, breadth, and height, are necessary to form a solid (a cube, for instance). Three, therefore, stands for that which is solid, real, substantial, complete, and entire. <ref>"The Symbolism and Spiritual Significance of the Number Three",  http://www.greatdreams.com/three/three.htm  </ref>

In geometry, two straight lines cannot possibly enclose any space or form a plane figure. Neither can two plane surfaces form a solid. Three lines are necessary to form a plane figure, and three dimensions of length, breadth, and height, are necessary to form a solid (a cube, for instance). Three, therefore, stands for that which is solid, real, substantial, complete, and entire. <ref>"The Symbolism and Spiritual Significance of the Number Three",  http://www.greatdreams.com/three/three.htm  </ref>

''Brihadaranyaka Upanishad'' (B. U. 4/4/22) states three ''eshanas'' or desires of a person from a social context: ''Putraeshana'' (desire to have son), ''vittaeshana'' (to earn) and ''lokaeshana''(recognition by society).<ref>Dr. Brahmanand Tripathi, Charaka Samhita of Agnivesha, elaborated by Charaka & Dridhabala edited with ‘Charaka- Chandrika’ Hindi commentary along with special deliberations, 5th edition 1997, Sutra Sthana, Chapter 11, Chaukhambha Surbharati Prakashan, Varanasi. </ref> Vedic traditions are patriarchal, where the first desire of a married person is to have a son. The son gets the family name and the tradition passes down through all future generations. The son is also supposed to do all the religious rituals after the death of a person. Ancient societies were primarily agrarian and relied on physical strength, which necessitated the presence of male children in a family. Thus, the desire for son could be justified.  

''Brihadaranyaka Upanishad'' (B. U. 4/4/22) states three ''eshanas'' or desires of a person from a social context: ''Putraeshana'' (desire to have son), ''vittaeshana'' (to earn) and ''lokaeshana''(recognition by society).<ref>Dr. Brahmanand Tripathi, Charak Samhita of Agnivesha, elaborated by Charak & Dridhabala edited with ‘Charak- Chandrika’ Hindi commentary along with special deliberations, 5th edition 1997, Sutra Sthana, Chapter 11, Chaukhambha Surbharati Prakashan, Varanasi. </ref> Vedic traditions are patriarchal, where the first desire of a married person is to have a son. The son gets the family name and the tradition passes down through all future generations. The son is also supposed to do all the religious rituals after the death of a person. Ancient societies were primarily agrarian and relied on physical strength, which necessitated the presence of male children in a family. Thus, the desire for son could be justified.  

The second desire is to earn, since wealth is required to maintain a healthy lifestyle, perform spiritual rituals, as well as give alms – an important aspect of vedic traditions. A wealthy person is respected in society.  

The second desire is to earn, since wealth is required to maintain a healthy lifestyle, perform spiritual rituals, as well as give alms – an important aspect of vedic traditions. A wealthy person is respected in society.  

The institution of marriage is integral to the ''grahastha ashram'', since progeny helped grow the society and also further traditions and moral values (e.g., sharing one’s resources with the family (or families) and contributing to social rituals within one’s community). Marriages were also a means to forge relationships between families, towns, and kingdoms – and therefore did not mean relationships for mere fulfilment of sexual desires.  <ref>The vivaha (marriage ceremonies),  http://www.sanathanadharma.com/samskara/ marriage/morl.htm</ref> As mentioned, since the growth of a family represented the growth of a community, a society, and a way of life, most scriptures and spiritual texts have emphasized upon the critical role of family, and therefore, the desire for a wife. The second desire is for son and the third desire is to earn a livelihood.  

The institution of marriage is integral to the ''grahastha ashram'', since progeny helped grow the society and also further traditions and moral values (e.g., sharing one’s resources with the family (or families) and contributing to social rituals within one’s community). Marriages were also a means to forge relationships between families, towns, and kingdoms – and therefore did not mean relationships for mere fulfilment of sexual desires.  <ref>The vivaha (marriage ceremonies),  http://www.sanathanadharma.com/samskara/ marriage/morl.htm</ref> As mentioned, since the growth of a family represented the growth of a community, a society, and a way of life, most scriptures and spiritual texts have emphasized upon the critical role of family, and therefore, the desire for a wife. The second desire is for son and the third desire is to earn a livelihood.  

As per the ''Bhela Samhita'' <ref>Dr. K. H.Krishnamurthy, Bhel Samhita – text with English translation, commentary and Critial notes, editor. Prof. P.V. Sharma, First Edition-2000, Choukhambha Visvabharati, Varanasi.  </ref> (Sutra 15), the three objectives are ''pranaeshana'', ''dhanaeshana'' and ''dharmaeshana'' (performing religious acts). The first two desires are same as mentioned by Charaka, while third ''dharmeshana'' is to follow the duties of individual towards one’s self, family, society, and realm, etc. abide by the moral and ethical traditions laid down in the scriptures, and maintain harmony between self and the society and environment, in general.

As per the ''Bhela Samhita'' <ref>Dr. K. H.Krishnamurthy, Bhel Samhita – text with English translation, commentary and Critial notes, editor. Prof. P.V. Sharma, First Edition-2000, Choukhambha Visvabharati, Varanasi.  </ref> (Sutra 15), the three objectives are ''pranaeshana'', ''dhanaeshana'' and ''dharmaeshana'' (performing religious acts). The first two desires are same as mentioned by Charak, while third ''dharmeshana'' is to follow the duties of individual towards one’s self, family, society, and realm, etc. abide by the moral and ethical traditions laid down in the scriptures, and maintain harmony between self and the society and environment, in general.

==== Why is ''kamaeshana'' not included as a desire to be pursued? ====

==== Why is ''kamaeshana'' not included as a desire to be pursued? ====

==== The Cause of Birth ====

==== The Cause of Birth ====

Charaka asks whether life exists after death or not.  Some support the idea of rebirth or reincarnation on the basis of scriptures but others do not. If the cause of birth is only attributed to parents, it is accepting only that which is perceptible. If only ''swabhava'' (natural trait or instinct) is considered as a reason (which does not sound to be a compelling reason), it is denying the existence of God. ''Paranirmana'' is accepted as the cause for birth, since it considers the existence of God, and if ''yadrichcha'' (supernatural power) is the only reason attributed to birth, then it supports the theory of supernatural power but does not support the existence of God.

Charak asks whether life exists after death or not.  Some support the idea of rebirth or reincarnation on the basis of scriptures but others do not. If the cause of birth is only attributed to parents, it is accepting only that which is perceptible. If only ''swabhava'' (natural trait or instinct) is considered as a reason (which does not sound to be a compelling reason), it is denying the existence of God. ''Paranirmana'' is accepted as the cause for birth, since it considers the existence of God, and if ''yadrichcha'' (supernatural power) is the only reason attributed to birth, then it supports the theory of supernatural power but does not support the existence of God.

==== Four ''Pariksha'' and their clinical significance ====

==== Four ''Pariksha'' and their clinical significance ====

The theory of reincarnation is explained by means of fourfold ''parikshas'' (examinations)- ''aptopadesha, pratkysha, anumana'' and ''yukti''. These are considered to be the correct means of getting information regarding an individual’s birth and therefore, play a significant role in the diagnosis of diseases and deciding the course of treatment to be employed. In [[Vimana Sthana]], Charaka considers the first three types of ''pariksha'', i.e., ''aptopdesha, pratyaksha'' and ''anumana'' as acceptable means of examination. One should first examine the patient with the help of all the ''parikshas'' and then diagnose the disease. One should acquire knowledge systematically through "aptopadesha" followed by ''pratyakhsha'' and ''anumana''. Use of all the three types of examination is recommended, and not any one of them alone [Cha.Vi 4/5-1][13]

The theory of reincarnation is explained by means of fourfold ''parikshas'' (examinations)- ''aptopadesha, pratkysha, anumana'' and ''yukti''. These are considered to be the correct means of getting information regarding an individual’s birth and therefore, play a significant role in the diagnosis of diseases and deciding the course of treatment to be employed. In [[Vimana Sthana]], Charak considers the first three types of ''pariksha'', i.e., ''aptopdesha, pratyaksha'' and ''anumana'' as acceptable means of examination. One should first examine the patient with the help of all the ''parikshas'' and then diagnose the disease. One should acquire knowledge systematically through "aptopadesha" followed by ''pratyakhsha'' and ''anumana''. Use of all the three types of examination is recommended, and not any one of them alone [Cha.Vi 4/5-1][13]

==== ''Aptopdesha'': Clinical Significance [Ch. Vi.4/6] ====

==== ''Aptopdesha'': Clinical Significance [Ch. Vi.4/6] ====

==== Clinical Application ====

==== Clinical Application ====

Since there are many things that cannot be perceived using sensory organs alone, ''anumana'' or the power to deduce or infer is an important and effective tool that a physician may employ. Charaka has enumerated the following factors to be observed by inference:  

Since there are many things that cannot be perceived using sensory organs alone, ''anumana'' or the power to deduce or infer is an important and effective tool that a physician may employ. Charak has enumerated the following factors to be observed by inference:  

# ''Agni'' (digestive fire), from the power of digestion

# ''Agni'' (digestive fire), from the power of digestion

# '''''Yuktikrita''''': Acquired strength or immunity is attained by healthy practices related to diet like ghee, meat, milk etc. and activities such as proper rest, exercise etc. It can also be improved by the use of rejuvenation therapies.   

# '''''Yuktikrita''''': Acquired strength or immunity is attained by healthy practices related to diet like ghee, meat, milk etc. and activities such as proper rest, exercise etc. It can also be improved by the use of rejuvenation therapies.   

In Ayurvedic texts word ''bala'' is used as a synonym of ''ojas'' and also for ''vyadhikshamatava'' (immunity). Charaka has considered normal ''kapha'' as ''bala''. ''Sahaja bala'' can be considered as innate immunity while ''yuktikrita bala'' can be considered as acquired immunity that can be achieved by various methods like good quality diet, exercise, vaccination etc.

In Ayurvedic texts word ''bala'' is used as a synonym of ''ojas'' and also for ''vyadhikshamatava'' (immunity). Charak has considered normal ''kapha'' as ''bala''. ''Sahaja bala'' can be considered as innate immunity while ''yuktikrita bala'' can be considered as acquired immunity that can be achieved by various methods like good quality diet, exercise, vaccination etc.

The assessment of ''sharirik bala'' (physical strength) is done by ''anumana'' (inference) by analyzing the capacity of an individual to do physical exercise (or his endurance) (Ch. Vi. 4/8).

The assessment of ''sharirik bala'' (physical strength) is done by ''anumana'' (inference) by analyzing the capacity of an individual to do physical exercise (or his endurance) (Ch. Vi. 4/8).

Apart from this classification, diseases are classified in various other ways. For instance, in the preceding chapter, diseases have been classified broadly as ''sadhya'' (curable) and ''asadhya'' (incurable). The sadhya diseases have been further classified into ''sukha sadhya'' (easily curable) and ''kriccha sadhya'' (curable with difficulty), while the ''asadhya'' have been classified into ''yapya'' (palliable) and ''anupakrama'' (non-treatable). ''Sadhya vyadhis'' have also been classified into ''alpa upaya sadhya'' (curable with mild treatment), ''madhya upaya sadhya'' (curable with moderate treatment) and ''utkristta upaya sadhya'' (curable with aggressive treatment modalities).

Apart from this classification, diseases are classified in various other ways. For instance, in the preceding chapter, diseases have been classified broadly as ''sadhya'' (curable) and ''asadhya'' (incurable). The sadhya diseases have been further classified into ''sukha sadhya'' (easily curable) and ''kriccha sadhya'' (curable with difficulty), while the ''asadhya'' have been classified into ''yapya'' (palliable) and ''anupakrama'' (non-treatable). ''Sadhya vyadhis'' have also been classified into ''alpa upaya sadhya'' (curable with mild treatment), ''madhya upaya sadhya'' (curable with moderate treatment) and ''utkristta upaya sadhya'' (curable with aggressive treatment modalities).

The [[Charaka Samhita]] also provides classifications and counts of diseases by the organs afflicted or their causative factors. For example, in [[Sutra Sthana]] Chapter 19 (''Astodariyadhyaya''), a count of all disease systems has been provided (that were known at that time), grouped by organs afflicted. These 48 diseases have been grouped into 8 types of ''udara rogas'', 8 types of ''mutraghata'', 7 ''kushthas'', 7 ''pidikas'', 6 ''atisara'', 5 ''gulma'', 5 ''kasa'', 5 ''swasa'', etc. Similarly, in [[Sutra Sthana]] Chapter 20, 4 types of diseases are mentioned according to the causative factor- ''agantuja'' (exogenous), ''vataja, pittaja'' and ''kaphaja''. ''Nanatmaja vikaras'' of ''vata'' are of 80 types; those of ''pitta'' are of 40 types; and ''kapha'' are of 20 types.   

The [[Charak Samhita]] also provides classifications and counts of diseases by the organs afflicted or their causative factors. For example, in [[Sutra Sthana]] Chapter 19 (''Astodariyadhyaya''), a count of all disease systems has been provided (that were known at that time), grouped by organs afflicted. These 48 diseases have been grouped into 8 types of ''udara rogas'', 8 types of ''mutraghata'', 7 ''kushthas'', 7 ''pidikas'', 6 ''atisara'', 5 ''gulma'', 5 ''kasa'', 5 ''swasa'', etc. Similarly, in [[Sutra Sthana]] Chapter 20, 4 types of diseases are mentioned according to the causative factor- ''agantuja'' (exogenous), ''vataja, pittaja'' and ''kaphaja''. ''Nanatmaja vikaras'' of ''vata'' are of 80 types; those of ''pitta'' are of 40 types; and ''kapha'' are of 20 types.   

In [[Vimana Sthana]] Chapter 6, ''Dasharoganikadhyaya'', diseases are classified by their ''prabhava'' (effect) into 10 types, by curability into two types (''sadhya'' (curable) and ''asadhya'' (incurable)), by their ''bala'' (strength) of ''vyadhi'' (disease) into two types (''mridu'' (mild) and ''daruna'' (severe)), by their ''adhisthana'' (location) into two types (''manasika'' (psychic) and ''sharirik'' (somatic)), according to cause into ''nija'' (endogenous) and  ''agantuja'' ( exogenous), according to ''ashaya bheda'' (organ of origin) into ''amashaya samuttha'' (originating from stomach) and ''pakwasaya samuttha'' (originating from large intestines).  

In [[Vimana Sthana]] Chapter 6, ''Dasharoganikadhyaya'', diseases are classified by their ''prabhava'' (effect) into 10 types, by curability into two types (''sadhya'' (curable) and ''asadhya'' (incurable)), by their ''bala'' (strength) of ''vyadhi'' (disease) into two types (''mridu'' (mild) and ''daruna'' (severe)), by their ''adhisthana'' (location) into two types (''manasika'' (psychic) and ''sharirik'' (somatic)), according to cause into ''nija'' (endogenous) and  ''agantuja'' ( exogenous), according to ''ashaya bheda'' (organ of origin) into ''amashaya samuttha'' (originating from stomach) and ''pakwasaya samuttha'' (originating from large intestines).  

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 name=ref15>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=ref15>Mahamohpadhyaya Sri Gangadhar Kaviratna Kaviraja Edited & Revised by Kaviraj Shree Narendranath Sengupta & Lalai Sengupta, Charak Samhita by The Great Sage Bhagavata  Agnivesha, thoroughly revised by Maharsi Charak & 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''.

==== Three ''bhishaja'' (physicians)====

==== Three ''bhishaja'' (physicians)====

Three types of physicians are mentioned- ''Chhadmachara'' (Pseudophysician or Quack), ''siddhasadhit'' (feigned physician) and ''jivitabhisara'' (genuine physician). In the ancient times, there were people practising medicine without appropriate knowledge about the science, Charaka has mentioned the qualities of physician to whom we should rely upon for treatment and to keep away from the quacks and the dangers of getting treated from them, even loosing life.

Three types of physicians are mentioned- ''Chhadmachara'' (Pseudophysician or Quack), ''siddhasadhit'' (feigned physician) and ''jivitabhisara'' (genuine physician). In the ancient times, there were people practising medicine without appropriate knowledge about the science, Charak has mentioned the qualities of physician to whom we should rely upon for treatment and to keep away from the quacks and the dangers of getting treated from them, even loosing life.

[[Sutra Sthana]] Chapter 1 ([[Deerghanjiviteeya Adhyaya]]), verse 124<ref name=ref3/> states the qualities of good physician as, ‘one who examines the patient and in consonance with habitat, time, individual variations, applies appropriate medicine is best physician’. The medicine which can cure disease is best medicine and the physician who can give relief to the patients of their ailments is best physician. The wise person who aspires to be physician should acquire the qualities of physician, knowledge of science and also the practical knowledge of the diseases and medicine, to become life saver.

[[Sutra Sthana]] Chapter 1 ([[Deerghanjiviteeya Adhyaya]]), verse 124<ref name=ref3/> states the qualities of good physician as, ‘one who examines the patient and in consonance with habitat, time, individual variations, applies appropriate medicine is best physician’. The medicine which can cure disease is best medicine and the physician who can give relief to the patients of their ailments is best physician. The wise person who aspires to be physician should acquire the qualities of physician, knowledge of science and also the practical knowledge of the diseases and medicine, to become life saver.

''Dasha pranayatana'' or the ten important resorts of life are two temples, three vital organs (head, heart and bladder), throat, blood, semen, ''ojas'' and rectum. The physician who has knowledge of these resorts, senses, knowledge of science similar to  

''Dasha pranayatana'' or the ten important resorts of life are two temples, three vital organs (head, heart and bladder), throat, blood, semen, ''ojas'' and rectum. The physician who has knowledge of these resorts, senses, knowledge of science similar to  

Ayurveda (all medical fields), reason of consciousness- soul, causes of diseases and recovery from diseases is known as “Saviour of life”. Those who are born in noble families, who have deep knowledge of science, who are skillful in preparing medicines, who have vast practical experience of treating patients medically and surgically, who are hygienic, self controlled, well equipped, sense organs functioning normally, well acquainted with the symptoms of disease and the ''prakriti'' of patient and having the knowledge of the etiological factors of diseases are the saviours of life of patients. Two types of physicians are described by Charaka in [[Sutra Sthana]] Chapter 29 - ''pranabhisara vaidya'' (saviour of life) and ''rogabhisara vaidya'' (bad physician/votaries of diseases), the qualities of these may be referred to [[Sutra Sthana]] chapter 30, “pallavaghrahita vidya” the physicians with superficial knowledge and their qualities are described (verse 72- 77).  

Ayurveda (all medical fields), reason of consciousness- soul, causes of diseases and recovery from diseases is known as “Saviour of life”. Those who are born in noble families, who have deep knowledge of science, who are skillful in preparing medicines, who have vast practical experience of treating patients medically and surgically, who are hygienic, self controlled, well equipped, sense organs functioning normally, well acquainted with the symptoms of disease and the ''prakriti'' of patient and having the knowledge of the etiological factors of diseases are the saviours of life of patients. Two types of physicians are described by Charak in [[Sutra Sthana]] Chapter 29 - ''pranabhisara vaidya'' (saviour of life) and ''rogabhisara vaidya'' (bad physician/votaries of diseases), the qualities of these may be referred to [[Sutra Sthana]] chapter 30, “pallavaghrahita vidya” the physicians with superficial knowledge and their qualities are described (verse 72- 77).  

In present context the utility of this is for selecting doctor for treatment, the qualification of the physician, validity of his medical degree and medical registration, clinical and surgical skills of the physician and the surgeon to whom approaching for treatment. If these things are not checked and the person who is doing treatment is not well qualified, then there is fear of losing money without getting cured and also of losing life.

In present context the utility of this is for selecting doctor for treatment, the qualification of the physician, validity of his medical degree and medical registration, clinical and surgical skills of the physician and the surgeon to whom approaching for treatment. If these things are not checked and the person who is doing treatment is not well qualified, then there is fear of losing money without getting cured and also of losing life.

Three types of therapies are mentioned: ''daivavyapashraya'' (spiritual therapy), ''yuktivyapasharaya'' (therapy based on reasoning) and ''satvavajaya'' (psychotherapy). In [[Sutra Sthana]] Chapter 1, verse 58, the treatment modalities for somatic diseases is ''daivavyapasharaya'' and for psychological diseases is ''satvavajaya'':

Three types of therapies are mentioned: ''daivavyapashraya'' (spiritual therapy), ''yuktivyapasharaya'' (therapy based on reasoning) and ''satvavajaya'' (psychotherapy). In [[Sutra Sthana]] Chapter 1, verse 58, the treatment modalities for somatic diseases is ''daivavyapasharaya'' and for psychological diseases is ''satvavajaya'':

===== ''Daivavyapasharaya'' <ref name=ref3/> <ref name=ref15/>  <ref>Acharya Vidyadhara Shukla, Prof. Ravidutt Tripathi, Charaka Samhita ofAgnivesha, elaborated by Charaka and redacted by Dridhabala, Vol-I, edited with ‘Vaidyamanorama’ hindi commentary along with special deliberations, Chowkhambha Sanskrit Pratisthana, Delhi, second edition-2000. </ref>=====

===== ''Daivavyapasharaya'' <ref name=ref3/> <ref name=ref15/>  <ref>Acharya Vidyadhara Shukla, Prof. Ravidutt Tripathi, Charak Samhita ofAgnivesha, elaborated by Charak and redacted by Dridhabala, Vol-I, edited with ‘Vaidyamanorama’ hindi commentary along with special deliberations, Chowkhambha Sanskrit Pratisthana, Delhi, second edition-2000. </ref>=====

This is the treatment for diseases arising due to ''purva janmakruta papa karma'' (sins of past life) or ''karmaja vyadhis'' (karmic ailments). This type of treatment was done in the ''Rigvedic'' period in majority and ''yuktivyapasharaya'' was neglected. The observance of ''yama'' (''ahimsa''(non violence), ''satya'' (truth), ''astaya''(not to steal), ''bramhacharya''(control over sexual desire),and ''aparigraha'' (accumulation of prosperities)) and ''niyama'' (''shaucha'' (cleanliness), ''santosha'' (satisfaction), ''tapas'' (conquest of all desires), ''swadhyaya'' (self-study), ''ishwara pranidhana'' (surrender to God)) is also part of this treatment. This form of treatment includes chanting mantras, wearing amulets on body, wearing gems, precious stones etc. performing auspicious rituals, offerings to God, oblations, ''homa'', following ''niyama, prayachhitta, upavasa, svastyayana, pranipata'' and going to holy places.  

This is the treatment for diseases arising due to ''purva janmakruta papa karma'' (sins of past life) or ''karmaja vyadhis'' (karmic ailments). This type of treatment was done in the ''Rigvedic'' period in majority and ''yuktivyapasharaya'' was neglected. The observance of ''yama'' (''ahimsa''(non violence), ''satya'' (truth), ''astaya''(not to steal), ''bramhacharya''(control over sexual desire),and ''aparigraha'' (accumulation of prosperities)) and ''niyama'' (''shaucha'' (cleanliness), ''santosha'' (satisfaction), ''tapas'' (conquest of all desires), ''swadhyaya'' (self-study), ''ishwara pranidhana'' (surrender to God)) is also part of this treatment. This form of treatment includes chanting mantras, wearing amulets on body, wearing gems, precious stones etc. performing auspicious rituals, offerings to God, oblations, ''homa'', following ''niyama, prayachhitta, upavasa, svastyayana, pranipata'' and going to holy places.  

Wearing gems is an age old practice and, per Vedic texts, can play a significant role in influencing human health, <ref>Dr.  Shaikh Abbas Borhany, Gems Science in Islam: Its medicinal & Mystical value, published in Daily News- Pakistan, March 2010. </ref> Dr. Robert Frost revealed that gems have remedial properties, by wearing appropriate gems reduces pain, helps in allergies, improves coordination and even improves muscle strength.

Wearing gems is an age old practice and, per Vedic texts, can play a significant role in influencing human health, <ref>Dr.  Shaikh Abbas Borhany, Gems Science in Islam: Its medicinal & Mystical value, published in Daily News- Pakistan, March 2010. </ref> Dr. Robert Frost revealed that gems have remedial properties, by wearing appropriate gems reduces pain, helps in allergies, improves coordination and even improves muscle strength.

===== ''Yuktivyapasharaya'' <ref>Ayurvedacharya Sri JayadevVidya Alankara, Charaka Samhita – Maharshi Bhagvan Agnivesha pranita (Mahamuni Charaka Pratisanskrita), Purva bhaga, Motilal Banarasidas, Delhi, ninth edition: 1975, reprint: 79, 86, 94, 98. </ref> =====

===== ''Yuktivyapasharaya'' <ref>Ayurvedacharya Sri JayadevVidya Alankara, Charak Samhita – Maharshi Bhagvan Agnivesha pranita (Mahamuni Charak Pratisanskrita), Purva bhaga, Motilal Banarasidas, Delhi, ninth edition: 1975, reprint: 79, 86, 94, 98. </ref> =====

This is the therapy done by the planned use of drugs, foods and regimen for the treatment of diseases caused by vitiation of bodily ''doshas''. This is widely practiced and is further classified into three types: ''Antahaparimarjana'' (internal purification), ''Bahirparimarjana'' (external purification) and ''Shastrapranidhana'' (surgical therapy). ''Antahaparimarjana'' is administered for the diseases of ''kostha'' also for the diseases of ''shakha'' to losen the vitiated ''doshas'' from ''shakha'' and bring them into ''kostha'', internal medications are prescribed oral drugs, ''vamana, virechana, basti, uttara basti, shirovirechana'' etc. ''Bahirparimarjana'' is the treatment for the diseases of ''shakha'', also ''bahaya snehana''- ''swedana'' or ''purvakarma'' is done for loosening the vitiated ''doshas'' from the ''shakhas'' and bring them into ''kostha'' for elimination. It is also done for skin disorders application of ''snehana, swedana, lepa,'' ointment, dusting powders and unctions etc. details of various formulations for skin disorders are well discussed in [[Sutra Sthana]], Chapter 3 ([[Aragvadhiya Adhyaya]]). ''Shastrapranidhana'', even though not mentioned in detail in Charaka, is the treatment modality for various diseases not cured by medicinal treatment, for the diseases of exogenous factors like trauma, fractures also for diseases like ''arsha, arbuda, granthi'' etc.

This is the therapy done by the planned use of drugs, foods and regimen for the treatment of diseases caused by vitiation of bodily ''doshas''. This is widely practiced and is further classified into three types: ''Antahaparimarjana'' (internal purification), ''Bahirparimarjana'' (external purification) and ''Shastrapranidhana'' (surgical therapy). ''Antahaparimarjana'' is administered for the diseases of ''kostha'' also for the diseases of ''shakha'' to losen the vitiated ''doshas'' from ''shakha'' and bring them into ''kostha'', internal medications are prescribed oral drugs, ''vamana, virechana, basti, uttara basti, shirovirechana'' etc. ''Bahirparimarjana'' is the treatment for the diseases of ''shakha'', also ''bahaya snehana''- ''swedana'' or ''purvakarma'' is done for loosening the vitiated ''doshas'' from the ''shakhas'' and bring them into ''kostha'' for elimination. It is also done for skin disorders application of ''snehana, swedana, lepa,'' ointment, dusting powders and unctions etc. details of various formulations for skin disorders are well discussed in [[Sutra Sthana]], Chapter 3 ([[Aragvadhiya Adhyaya]]). ''Shastrapranidhana'', even though not mentioned in detail in Charak, is the treatment modality for various diseases not cured by medicinal treatment, for the diseases of exogenous factors like trauma, fractures also for diseases like ''arsha, arbuda, granthi'' etc.

The various causes of the diseases are reasoned out and suitable means and methods are designed to cure, based on fundamental principles of  Ayurveda viz. ''Pancha mahabhuta, tridosha, samanya visesha'' etc. <ref name=ref23>A. R. V. Murthy and R. H. Singh, The concept of psychotherapy in ayurveda with special reference to satvavajaya, ancient science of life, vol no. Vi no. 4 april 1987, pages 255 - 261</ref>The path of pathogenesis is broken by the administration of appropriate medicines and by advising suitable diets and regimens. These methods include both internal and external application of medication.  

The various causes of the diseases are reasoned out and suitable means and methods are designed to cure, based on fundamental principles of  Ayurveda viz. ''Pancha mahabhuta, tridosha, samanya visesha'' etc. <ref name=ref23>A. R. V. Murthy and R. H. Singh, The concept of psychotherapy in ayurveda with special reference to satvavajaya, ancient science of life, vol no. Vi no. 4 april 1987, pages 255 - 261</ref>The path of pathogenesis is broken by the administration of appropriate medicines and by advising suitable diets and regimens. These methods include both internal and external application of medication.  

''Sattvavajaya'',<ref name=ref23/> or Psychotherapy, is one of the three principal categories of the approach to the patients care as described in Ayurvedic classics. In principle, ''sattvavajaya'' is applicable in varying forms in all kinds of diseases but it is essentially indicated in mental diseases.  

''Sattvavajaya'',<ref name=ref23/> or Psychotherapy, is one of the three principal categories of the approach to the patients care as described in Ayurvedic classics. In principle, ''sattvavajaya'' is applicable in varying forms in all kinds of diseases but it is essentially indicated in mental diseases.  

Charaka was the first scholar to give the name ''sattvavajaya'', his definition gives lot of scope for expansion of the Sanskrit phrase ''sattvavajayah punah ahitebhyo manonigraha''. This definition gives emphasis on three words i.e. ''ahita, artha'' and ''manonigraha''. <ref name=ref24>Karel nespor and R. H. Singh. The experiences with ayurvedic psychotherapy ‘sattvavajaya’ in europe, Ancient Science of Life, Vol No. V No. 3 January 1986, Pages 154 – 155 </ref>

Charak was the first scholar to give the name ''sattvavajaya'', his definition gives lot of scope for expansion of the Sanskrit phrase ''sattvavajayah punah ahitebhyo manonigraha''. This definition gives emphasis on three words i.e. ''ahita, artha'' and ''manonigraha''. <ref name=ref24>Karel nespor and R. H. Singh. The experiences with ayurvedic psychotherapy ‘sattvavajaya’ in europe, Ancient Science of Life, Vol No. V No. 3 January 1986, Pages 154 – 155 </ref>

The word ''Ahita'' conveys that something is unwholesome. ''Artha'' is wide variety of objects that can be perceived by sense organs. Each ''indriya'' (sense apparatus) has its own ''artha'' or the object that it can perceive. Similarly, ''sattva'' which is considered as ''ubhayendriya'' any thing that can be perceived by ''sattva'' can also be included in this category. In ''sattvavajaya'', it is to consider ''mano arthas'' though it may not be objectionable to include, ''panchendriarthas'', because ultimately ''sattva'' (mind) materializes the perception of the objects through ''indriyas'' (senses).  

The word ''Ahita'' conveys that something is unwholesome. ''Artha'' is wide variety of objects that can be perceived by sense organs. Each ''indriya'' (sense apparatus) has its own ''artha'' or the object that it can perceive. Similarly, ''sattva'' which is considered as ''ubhayendriya'' any thing that can be perceived by ''sattva'' can also be included in this category. In ''sattvavajaya'', it is to consider ''mano arthas'' though it may not be objectionable to include, ''panchendriarthas'', because ultimately ''sattva'' (mind) materializes the perception of the objects through ''indriyas'' (senses).  

# '''''Trivarga anveksana''''': The therapy of mental disorders is done by following the ''trivargas'' i.e. the ''dharma, artha'' and ''kama'' (virtue, wealth and pleasure). The person with mental aliment should be made to remain in touch with the experts of treating mental illnesses and to know about ''atma'' (self), ''desha'' (place), ''kala'' (time), ''shakti'' (strength) and capacity properly.  

# '''''Trivarga anveksana''''': The therapy of mental disorders is done by following the ''trivargas'' i.e. the ''dharma, artha'' and ''kama'' (virtue, wealth and pleasure). The person with mental aliment should be made to remain in touch with the experts of treating mental illnesses and to know about ''atma'' (self), ''desha'' (place), ''kala'' (time), ''shakti'' (strength) and capacity properly.  

# Psycho-supportive Techniques: Charaka has described several psychological supportive techniques, under the category of ''sattvavajaya chikitsa''. He advocates ''aswasana'' (reassurance and explanation), ''suhritvakya'' (guidance and suggestion), ''dharmartha vakya'' (education of individual and family), ''ishta vinashana'' (verbal shock), ''adbhuta darshana'' (showing extra ordinary things), ''tadana'' (physical shock), ''trasana'' (mental shock), ''santwana'' (rehabilitation,reassurance, or consolation), which are also known as psychological intervention.  

# Psycho-supportive Techniques: Charak has described several psychological supportive techniques, under the category of ''sattvavajaya chikitsa''. He advocates ''aswasana'' (reassurance and explanation), ''suhritvakya'' (guidance and suggestion), ''dharmartha vakya'' (education of individual and family), ''ishta vinashana'' (verbal shock), ''adbhuta darshana'' (showing extra ordinary things), ''tadana'' (physical shock), ''trasana'' (mental shock), ''santwana'' (rehabilitation,reassurance, or consolation), which are also known as psychological intervention.  

# Promotion of ''jnayana'' (cognition): The methods for improving ''jnayana'' (cognition) and its components like ''dhi'' (intellect), ''dhrti'' (controlling power) and ''smrti'' (recollection/ memory) are part of ''sattavavajaya chikitsa''. Some important techniques / steps in promoting ''jnana'' are- recognizing and correcting negative automatic thoughts, teaching reattribution techniques, increasing objectivity in perspectives, keeping spiritual  understanding of life, identifying and testing maladaptive assumption, and decentering and it may also include such behavioural techniques as activity scheduling, homework assignments, graded task assignment, behavioural rehearsal, role playing and diversion techniques and teaching problem solving skills

# Promotion of ''jnayana'' (cognition): The methods for improving ''jnayana'' (cognition) and its components like ''dhi'' (intellect), ''dhrti'' (controlling power) and ''smrti'' (recollection/ memory) are part of ''sattavavajaya chikitsa''. Some important techniques / steps in promoting ''jnana'' are- recognizing and correcting negative automatic thoughts, teaching reattribution techniques, increasing objectivity in perspectives, keeping spiritual  understanding of life, identifying and testing maladaptive assumption, and decentering and it may also include such behavioural techniques as activity scheduling, homework assignments, graded task assignment, behavioural rehearsal, role playing and diversion techniques and teaching problem solving skills

# Promotion of ''vijnayana''- It is mentioned in the scriptures and texts about the activities of the physical world, social and personal conducts, knowledge of the activities and interrelationship of body and mind, dietary rules, rules to be followed in disease state. The promotion of ''vijnana'' in context to ''sattvavajya'' includes the development and uses of behavioral techniques for treating psychosomatic and psychiatric disease. This relieves the patient's apprehensions and calms his disturbed mind.

# Promotion of ''vijnayana''- It is mentioned in the scriptures and texts about the activities of the physical world, social and personal conducts, knowledge of the activities and interrelationship of body and mind, dietary rules, rules to be followed in disease state. The promotion of ''vijnana'' in context to ''sattvavajya'' includes the development and uses of behavioral techniques for treating psychosomatic and psychiatric disease. This relieves the patient's apprehensions and calms his disturbed mind.