Charak Samhita - Sutrasthana - Chapter 20 (Maharoga Adhyaya)
This chapter expands on the discussion of disease categorization in terms of endogenous and external causes, fundamental nature, place of origin, and clinical manifestations. Both endogenous and external diseases have specific causes that are explained. The chapter continues on to identify illnesses that are caused by just one dosha along with their causes. This clarifies the idea of distinct one-dosha illness types. Only an unbalanced vata can cause up to eighty varieties, pitta can cause forty, and kapha can cause twenty. A thorough examination of each dosha, their sites, and their features would be necessary for any efficient diagnosis or therapy of these disorders. This information is given to support the notion that in clinical medicine, understanding the ailment is essential before beginning treatment. The principles of illness knowledge outlined in the tetrad are summarised in this chapter. So today we will discuss the Charaka Samhita Sutra sthana chapter twentieth Maharoga adhyaya in detail.
The four categories of disorders discussed in this chapter are Vataja, Kaphaja, Pittaja and exogenous. Single-dosha endogenous diseases have been handled separately in this section because they can be considered as primary ailments. Endogenous and exogenous illnesses, as well as the locations of where they develop inside the body, were previously discussed in the Sutra Sthana and are being done so once more here. Exogenous diseases precede endogenous ones, as was described in the chapters above, and vice versa. Single-dosha endogenous illnesses contribute sporadically to the development of external illnesses. As was also previously noted, there are numerous diseases due to a variety of etiopathological variables as well as dhatu and dosha involvement. Since all diseases are caused by vitiated doshas, it is essential to comprehend both their expected or normal activities as well as the harmful impacts of their vitiated versions. This chapter tackles offering detailed scenarios of illnesses and their suggested course of therapy by taking these important factors into account.
Four different forms of illnesses caused by extrinsic factors, vata, kapha and pitta dosha. All four have abnormalities in common and from this point of view they are one. From an etiological point of view, they are of two types- exogenous and innate. Their location is also two fold- body and mind. But the disorders are innumerable because of innumerable variations in location, aetiology, constitution, symptoms and proportion of causative factors.
Causes Of Diseases
Exogenous diseases occur due to biting with teeth and nails, curse, exorcism, injury, contact with evil spirits, binding, piercing, compression, burns, twisting, hanging, wounds from weapons, infection with organisms and thunder bolt etc. The innate disorders originate from the disequilibrium of vata, kapha and pitta.
Three Main Causes Of Diseases
The common underlying causes of both external and endogenous disorders include improper sensory organ-to-object interaction, intellectual flaws, and the impacts of results. When all of these four diseases become more severe, accompany each other, still they do not create any doubt among themselves.
Endogenous And External Illnesses Definition
Exogenous illnesses start with pain and eventually disrupt the balance of the dosha. On the contrary, endogenous disorders first result in dosha vitiation then pain occurs.
Locations Of Three Dosha
The following are the three main places where these three doshas originated:-
- The locations of vata include the urinary bladder, waist, bones, colon, thighs, legs and rectum. The colon is the most significant of these sites.
- The locations of pitta include the sweat, lasika (Lymph), rasa (Plasma), duodenum, lower area of stomach and Rakta. The duodenum is the most significant of these sites.
- The locations of kapha include the neck, chest, joints, upper area of stomach, Meda (Fats), and head. The chest is the most significant of these sites.
Specific Illnesses Carried By Dosha
Vata, kapha and pitta pervade the entire body and thus produce bad and good consequences in the whole body when vitiated and non vitiated. In the state of normalcy good consequences like strength, development, cheerfulness, complexion etc. while in that of abnormality they cause bad consequences known as diseases. Endogenous illnesses again fall into two categories: those brought on by the unbalance of two or more doshas, and those brought on by a single dosha. The preceding chapter covered common illnesses. The latter is the focus of this chapter. A total of 140 different single-dosha disorders, of which 80 are vata, 40 pitta, and 20 kapha-related.
80 Diseases Resulting From Vata Dosha
There may be countless variations of vataja nanatmaja vikaras, sometimes called vataja nanatmaja vyadhis, but the following are the 80 most common or well-known varieties such as nakhabheda (Nails cracking), pada shula (Foot pain), gulphagraha (Stiffness in ankle region), gridhrasi (Sciatica), vipadika (Soles cracking), pada suptata (Feet numbness), urustambha (Thigh stiffness), pangulya (Paraplegia), gudarti (Anus pain), kubjatva (Kyphosis), vid bheda (Diarrhoea), hriddrava (Tachycardia), manyastambha (Torticollis), timira (Vision loss), karnashoola (Ear ache), badhirya (Deafness), ardita (Facial paralysis), vepathu (Tremor), hikka (Hiccup), parushya (Coarseness), etc.
Vata Dosha Characteristics And Pathogenic Effects
Even though the inherent qualities of vata are only partially present in any of the vataja number of diseases listed, these are however classified as vata disorders and given vata-specific diagnosis and treatment. While the main features of vata are recognized to be coolness, roughness, non-sliminess, motion, lightness, instability and shapelessness there are numerous different manifestations of the dosha based on the organ that affects: bhramsha (Dislocation), bheda (Separation), tarsha (Thirst/desire), chala (Motion), kampa (Tremors), harsha (Excitation), parusha (Roughness), sanga (Obstruction), vishada (Non-sliminess), shosha (Wasting), supti (Numbness), stambha (Stiffness), vyatha (Aching pain), vyasa (Expansion), etc.
Principles For Treating Vata Problems
A variety of hot therapeutic techniques and unctuous, including fomentation, oleation, inhalation, unction, diet, unctuous and non-unctuous enema, massage, fomentation, effusion, etc., should be used to treat vitiated vata. These medications should have a sour, saline, or sweet taste. The medications or treatments should have against the vataja characteristics and should be given at the right dose and timing. Because enema reaches the colon fast and addresses the vitiated vata at its point of origin, unctuous and non-unctuous enema are seen to be the most efficient kinds of treatment regarding the management of diseases of vataja out of all the techniques discussed above. As a result, when vata in the colon is overcome, the problems of vata affecting other areas of the body are immediately alleviated, similar to the cutting of a tree from the root causes the tree's flowers, trunk, sprouts, branches, leaves, fruits, etc. to naturally die.
Diseases Of Pitta Dosha
Similar to the vata group of illnesses, there are countless pittaja nanatmaja vyadhis (Pitta dosha related disorders), but the following 40 are the most common such as daha (Burning), osha (Heating), amlaka (Hyperacidity), antardaha (Internal burning), atisveda (Excessive sweating), angavadarana (Body parts tearing), davathu (Intense heat), amsadaha (Burning feeling in the arm), dhoomaka (Fuming), trishnadhikya (Polydipsia), gudapaka (Anus inflammation), akshipaka (Eyes inflammation), medhrapaka (Penis inflammation), asyavipaka (Stomatitis), neelika (Blue moles), kamala (Jaundice), ushmadhikya (Hyperthermia), raktapitta (Bleeding disorders), etc.
Pitta Dosha Characteristics And Pathogenic Effects
All of the diseases of the pittaja type listed above should be recognized and managed as pitta disorders even if only a partial portion of the unbalanced pitta manifests. The characteristics of pitta include, for example, liquidity, heat, mild unctuousness, sharpness, all colours other than red and white, pungent, sour taste, fluidity and fishy smell. However, the manifestations of the pitta might vary based on which organs they affect such as aushnya (Heat), sweda (Perspiration), raga (Redness), kandu (Itching), daha (Burning sensation), paka (Inflammation/suppuration), kleda (Moisture), strava (Discharge), etc.
Principles For Treating Pitta Problems
Treatment for abnormal pitta problems should include medications with astringent, bitter, cooling and sweet characteristics. Any therapeutic techniques used, including massage, affusion, oleation, fasting, purgation, and so on, must provide against the characteristics of pittaja and must be given in the optimum dose and timing. Purgation is considered to be the most effective method of management for pittaja vyadhi out of all the techniques previously described. Pitta diseases in other areas of the body are naturally controlled when pitta in the stomach (Amashaya) gets controlled through the administration of the purgative drugs, just like the fire chamber which becomes cold when a fire is extinguished.
Diseases Of Kapha Dosha
The following are the twenty common kapha diseases, or Shleshma nanatmaja vyadhi such as tandra (Drowsiness), alasya (Lassitude), nidradhikya (Excess sleep), mukha strava (Salivation), gurugatrata (Body heaviness), staimitya (Immobility/rigidity), balasaka (Strength loss), galaganda (Goiter), apakti (Indigestion), Shitagnita (Decreased agni), atisthaulya (Excessive obesity), udarda (Urticarial rashes), etc.
Kapha Dosha Characteristics And Pathogenic Effects
All of the diseases of kapha the following ones are the specific features and actions based on which, partly or wholly, the expert doctor diagnose the case without any doubt as diseases of kapha such as coldness, heaviness, unctuousness, whiteness, steadiness, viscosity, sweetness and sliminess are the particular properties of kapha. This sort of kapha exhibits the following actions in respective body parts when it reaches into them such as shaitya (Coldness), sthairya (Stability), sneha (Unctuousness), Shvaitya (Whiteness), kandu (Itching), gaurava (Heaviness), supti (Numbness), madhurya (Sweetness), etc. the problem associated with these should be diagnosed as the kaphaja one.
Principles For Treating Kapha Problems
Drugs with hot, bitter, pungent, sharp, astringent and dry properties as well as other treatment modalities like emesis, fomentation, exercise, evacuating dosha from the head, etc. should be used to regulate abnormal kapha. These have qualities to pacify kaphaja dosha, and these need to be given at the right time and dose. Emesis is thought to be the most efficient method of treatment for kaphaja illnesses out of all the treatments previously discussed since it addresses the kapha vitiation at its origin as soon as it enters the stomach. As a result, when kapha in the stomach is overcome, any ailments caused by kapha in other regions of the body are instantly pacified, like the crops, plants of paddy, barley etc. drying up in absence of moisture when the obstructing ridge of the field is damaged.
The Significance Of Diagnosis Before Treatment Planning
A doctor should first make a diagnosis of the illness before choosing the best treatment. The therapy should then be administered by him using his already acquired knowledge of medical science. A doctor who starts treatment without a proper diagnosis about the illness can only succeed in his goal by chance, meaning he cannot be certain of his success. Although he is well-versed in the practical use of medicine knowledge, this does not imply that he will succeed. On the contrary, a doctor skilled in disease diagnosis, adept at administering medications, and knowledgeable about the methods to be employed in the treatment (That differs from location to location and seasons to seasons) is certain to get the intended effect without a doubt.
Brief introduction and categorization of diseases, manifestation sites, nature, cause primary as well as secondary, specific and interchangeability disease identity, dosha sites, listing of particular illnesses caused by dosha, the particular characters and actions of the doshas along with their management-all this has been explained completely by the seer of reality in the chapter on Maharoga Adhyaya.