Changes

Treatment of any disease is possible only after the proper knowledge of causative factors and sign and symptoms. Treatment principles described in [[Nidana Sthana]] should be incorporated in the ''upashaya'' (pacification factors). ''Nidana'' means the causative factor of the diseases. The term ''vyadhibodhakam'' means the diagnosis of diseases with the help of ''nidana, poorvarupa, rupa, upashaya'' and ''samprapti''. 1-2 [6]

Treatment of any disease is possible only after the proper knowledge of causative factors and sign and symptoms. Treatment principles described in [[Nidana Sthana]] should be incorporated in the ''upashaya'' (pacification factors). ''Nidana'' means the causative factor of the diseases. The term ''vyadhibodhakam'' means the diagnosis of diseases with the help of ''nidana, poorvarupa, rupa, upashaya'' and ''samprapti''. 1-2 [6]

If diseases are not properly known, one cannot start the treatment. Therefore, ''Nidanapanchaka'' (the five factors associated with understanding an affliction) is described as the specific measures to diagnose the disease. [7]

If diseases are not properly known, one cannot start the treatment. Therefore, ''Nidanapanchaka'' (the five factors associated with understanding an affliction) is described as the specific measures to diagnose the disease. <ref>Chakrapani, Commentator, Charaka SamhitaNidanasthana Adhyaya 1/6, Edited by Jadavaji Trikamji, Fifth Edition Chaukhambha Sanskrit Sansthana, Varanasi, 2001, 194. </ref>

Vagbhata also endorsed these five components as the means of understanding the disease. [6] [8]

Vagbhata also endorsed these five components as the means of understanding the disease. [6] [8]

#'''''Prakritahetu''''': Natural aggravation of ''doshas'' in the respective seasons and age is called as ''prakritahetu'' which does not cause the disease alone but with the help of other aggravating factors may cause the disease.

#'''''Prakritahetu''''': Natural aggravation of ''doshas'' in the respective seasons and age is called as ''prakritahetu'' which does not cause the disease alone but with the help of other aggravating factors may cause the disease.

#'''''Vaikritahetu''''': If ''doshas'' are aggravated in the seasons other than their natural aggravation time and create the disease then they are termed as ''vaikritahetu''.  E.g. Aggravation of ''pitta dosha'' in ''Vasanta'' (spring) season. (natural aggravation time of ''pitta dosha'' is ''Sharada ritu''.)(7) [9]

#'''''Vaikritahetu''''': If ''doshas'' are aggravated in the seasons other than their natural aggravation time and create the disease then they are termed as ''vaikritahetu''.  E.g. Aggravation of ''pitta dosha'' in ''Vasanta'' (spring) season. (natural aggravation time of ''pitta dosha'' is ''Sharada ritu''.)(7) <ref>Madhavakar, Madhava Nidanam, Pancha Nidanalakshanam,  Edited by Prof. Yadunandana Upadhyaya, Thirtyth Edition Chaukhambha Sanskrit Sansthana, Varanasi, 2000, 196. </ref>

==== ''Poorvarupa'' (premonitory signs) ====

==== ''Poorvarupa'' (premonitory signs) ====

#''Poorvarupa'' caused due to ''doshadushyasammurchana'' (interaction of vitiated ''dosha'' and ''dushya'') that are different from the previous ones. e.g. feeling of hatred towards children or horripilation seen in ''jwara''. These types of ''poorvarupas'' are not seen when the ''jwara'' is manifested completely. But if they are seen then the prognosis of the disease is ''asadhyata'' (incurable). These signs are symptomatic of the diseases to be seen in the near future and do not indicate ''dosha'' predominance in that disease.  

#''Poorvarupa'' caused due to ''doshadushyasammurchana'' (interaction of vitiated ''dosha'' and ''dushya'') that are different from the previous ones. e.g. feeling of hatred towards children or horripilation seen in ''jwara''. These types of ''poorvarupas'' are not seen when the ''jwara'' is manifested completely. But if they are seen then the prognosis of the disease is ''asadhyata'' (incurable). These signs are symptomatic of the diseases to be seen in the near future and do not indicate ''dosha'' predominance in that disease.  

In some acute diseases, the disease is presented directly with signs and symptoms. In these cases, the unmanifested form of the actual symptoms (''rupa'') described in the text should be treated as the ''poorvarupa'' of a disease. [10]

In some acute diseases, the disease is presented directly with signs and symptoms. In these cases, the unmanifested form of the actual symptoms (''rupa'') described in the text should be treated as the ''poorvarupa'' of a disease. <ref>Chakrapani, Commentator, Charaka SamhitaNidanasthana Adhyaya 1/8, Edited by Jadavaji Trikamji, Fifth Edition Chaukhambha Sanskrit Sansthana, Varanasi, 2001, 195. </ref>

Vagbhata opines that ''poorvarupa'' are signs and symptoms that appear earlier to the actual disease, not specifically assignable to the ''doshas'' as they are mild (not clearly recognizable) and few in number. (A. H. Ni. 1/) [11]. This is also substantiated in the Ashtanga Sangraha (A S Ni 1/8) [13]

Vagbhata opines that ''poorvarupa'' are signs and symptoms that appear earlier to the actual disease, not specifically assignable to the ''doshas'' as they are mild (not clearly recognizable) and few in number. (A. H. Ni. 1/) <ref>Vagbhata, Ashtang Hridayam, Nidanasthana Adhyaya 1/3, Edited by Harishastri Paradkar Vaidya, Ninth Edition, Chaukhambha Orientalia, Varanasi, 2002, 441 </ref>. This is also substantiated in the Ashtanga Sangraha (A S Ni 1/8) [13]

Gangadhara, commentator of [[Charaka Samhita]], describes two types of ''Poorvarupa'':

Gangadhara, commentator of [[Charaka Samhita]], describes two types of ''Poorvarupa'':

#'''''Samanya Poorvarupa''''' (general premonitory features): These are the general symptoms of disease which appear before the manifestation of the disease but do not indicate affliction of ''doshas''.

#'''''Samanya Poorvarupa''''' (general premonitory features): These are the general symptoms of disease which appear before the manifestation of the disease but do not indicate affliction of ''doshas''.

#'''''Vishesha Poorvarupa''''' (specific premonitory features): These are the general symptoms of disease which manifest before the manifestation of the disease and indicate involvement of ''doshas''. [12]

#'''''Vishesha Poorvarupa''''' (specific premonitory features): These are the general symptoms of disease which manifest before the manifestation of the disease and indicate involvement of ''doshas''. <ref>Gangadhar, Commentator, Charaka SamhitaNidansthana Adhyaya 1/5, Edited by Narendranath Sengupta, Reprint edition, Rashtriya Sanskrit Sansthana, Varanasi, 2002, 1213 </ref>

==== ''Rupa'' (clinical signs and symptoms) ====

==== ''Rupa'' (clinical signs and symptoms) ====