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Charak Samhita - Sutrasthana - Chapter 9 (Khuddakachatushpada Adhyaya)


The elements of healthcare management are discussed in Nirdesh Chatushka (Tetrad on recommendation of healthcare management), which is read after Swastha Chatushka (Tetrad on health). The four elements that make up the best possible healthcare are covered in this chapter. These parts are the doctor, the patient, the medication, and the caregiver. Additionally, typical characteristics of these elements are explained. Definitions of illness, wellness, therapy, etc., as well as various categories of doctors, are also clarified in relation to healthcare administration. The ninth chapter of the Charak Samhita Sutra Sthana, Khuddakachatushpada Adhyaya, will be examined in this article.

Chapter 9, Charaka Samhita, Khuddakachatushpada Adhyaya, Sutrasthana, Symptoms Of Khuddakachatushpada Adhyaya, Chapter 9 - Khuddakachatushpada Adhyaya, Acharya Charak


The chapter, as its name implies, focuses on four small but equally significant aspects of healthcare management. Khud, that means short/minor, Chatu, which means four, and Pada, which means parts/components. The name "Chatushpada," which translates to "four equivalent components," denotes that although the doctor performs the most significant role, each of the four aspects contributes in an equal manner to the effective administration of health and sickness. Treatment effectiveness is guaranteed by combining the best traits of each component, including the doctor, patient, medication, and caregiver. A lack of proper performance by any one of these parts could result in poor disease control. This chapter outlines the traits that the perfect doctor should possess as well as the duties that go along with being a medical professional. Ayurveda offers an extensive structure for healthcare administration that takes into account all important management factors.

Four Elements Of Healthcare

Four Elements — doctor, medication, attendant, and patient—all work together in the greatest possible way to completely cure disease.

Definitions Of Illness, Good Health, Happiness, And Sadness

Disease is a dhatus' disequilibrium, while health is a dhatus' balance. Disorder is equated with sadness, whereas health is referred to as happiness.

Definition Of Therapeutic

The term "Therapeutics" refers to the practice of using all four of the best in order to restore equilibrium when the dhatu is out of balance.

Characteristics Of The Best Physician (Vaidya)

Excellence in theoretical knowledge, dexterity, cleanliness and great practical experience-this is the quadruple of qualities of a physician.

Characteristics Of Medicines (Dravya)

The four characteristics of the perfect medication are abundance (in terms of availability), effectiveness (With excellent pharmacological attributes), a variety of pharmaceutical forms, and intact attributes of pharmaceuticals.

Characteristics Of Ideal Attendant

Four characteristics of an attendant are dexterity, sympathy for the patient, purity of mind and body, and knowledge of patient care (Nursing).

Physician's Role And Importance

  • This quadruple consisting of sixteen qualities is the cause of success but here also the physician is the main due to his having specialized knowledge, administrative capabilities, and managerial abilities.
  • As in the act of cooking, fuel, fire and utensils and in victory of the victorious land, army and weapons are causative factors, similarly, in the success of a physician in treating patients etc, are mentioned as causative factors. Thus the physician is the principal cause. 
  • Without a potter, the stick, soil, thread, wheel, etc. serve no function in constructing a pot; similarly, all the other three elements are useless without the doctor.
  • Even the most simple disorders worsen despite the other three therapy pillars of medications, nurse, and patient (With all their qualities), while really serious disorders disappear like the (Imaginary) town of the Gandharvas (Magician). The two results mentioned above are due, respectively, to knowledgeable and uninformed physicians. 
  • Self-immolation is preferable to receiving medical care from a quack, just as a blind person moves in fearfully groping motions with the aid of his hand or a ship without crew is forced to navigate a storm without its crew. The doctor moves forward in the field of therapeutic treatment with excessive dread and lacking confidence when he or she has no understanding of the science or medicine involved.
  • Such an individual, who regards himself as a doctor, miraculously heals a patient whose survival is guaranteed (Who was intended to live), but kills hundreds of people whose survival is in doubt.

Characteristics Of A Pranabhisara (Life-Saving) Doctor

As a result, a doctor is described as a pranabhisara—one who promotes life—if they possess the four attributes of scientific knowledge, good comprehension, practical experience, and appropriate application.

Characteristics Of A Royal Doctor

The ideal physician is one who is qualified to serve as a king's physician and is knowledgeable about the causes, symptoms, treatments, and prevention of ailments.

Characteristics Of A Ideal Vaidya

Weapons, water and scriptures all have benefits and drawbacks depending on who uses them. Therefore, a doctor should cleanse his mind (To fill in the gaps) before administering treatment. Nothing is out of his reach if he possesses the following six qualities: learning, reason or the ability to think creatively, particular scientific knowledge, devotion, good memory, and action. Even one of these qualities—wisdom, learning, practical knowledge, successes, experience, and ongoing guidance from illustrious mentors—can add significantly to a degree of vaidya. The person deserving of holding the honorable title of vaidya who bestows bliss on all living things is the one who holds all the fortunate traits, such as learning, etc.

The Significance Of Scientific Research

Science-based writings offer enlightenment, and the mind's faculties are like eyes. When both are used correctly, the doctor does not make mistakes while treating patients because the remaining three elements of treatment depend on the doctor. The doctor should therefore make every effort to improve his qualities.

Ideal Behavior Of A Doctor Towards Patients

The four qualities of a perfect doctor are friendliness, sympathy for the sick, an intense connection with those who can be treated, and apathy toward people who are nearing the end of their lives.


This chapter on the four components of management of healthcare has descriptions of the four therapeutic components, the four vital characteristics of each of them, the rationale behind the chief "component" status of the doctor, the characteristics of the doctor, the components of knowledge, and the fourfold mindset of the perfect doctor.

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Best Ayurvedic Doctor - Dr. Meenakshi Chauhan

Dr. Meenakshi Chauhan


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Best Ayurvedic Doctor in Mohali - Dr. Vikram Chauhan

Dr. Vikram Chauhan


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