Aupasargika vyadhi

The word aupasargika means contagious. The diseases that spread from one person or organism to another person or organism are ‘aupasargika roga’. These types of disease can spread through same or the other pathogenic factors (microbes) like protozoa, yeast, bacteria, virus etc. Ayurveda classics have mentioned concept of epidemic/pandemic in context of janapadodhvamsa (community destruction). Air pollution, water pollution, climate changes and environmental factors are responsible for the spread of diseases on large scale resulting in epidemic/pandemic. Causes of vitiation of air, water, climate and place along with their characteristics are described in context of janpadodhwansa. The causes of contagious diseases are also described in ancient classical texts at various places. Technological advances in medical science have enabled to know precise micro-organisms responsible for causing and spreading contagious diseases. This chapter deals with the diagnosis and principles of management of contagious diseases described in ayurveda and its contemporary practices.

Contributors

Section/Chapter/topic	Concepts & Contemporary practices/Vyadhi/Aupasargika vyadhi
Authors	Sapra Umesh 1, Deole Y.S. 2
Reviewer & Editor	Basisht G.3
Affiliations	1 Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India 2 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India 3 Rheumatologist, Orlando, Florida, U.S.A.
Correspondence emails	umeshsapra123@gmail.com, carakasamhita@gmail.com
Publisher	Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of publication:	September 27, 2023
DOI	10.47468/CSNE.2023.e01.s09.149

Etymology

1. The word Aupasargika is derived from ‘upasarga’ meaning (औपसर्गिक)- superior to adversity, able to cope with calamity [gana] [Pāṇini 5-1, 101]
2. superinduced, produced in addition to (or out of another disease), [Suśruta]
3. infectious (as a disease), [Suśrutai, 271, 13]

Synonyms

• Sankramaka vyadhi (contagious disease)
• samsargaja vyadhi (infectious diseases)

Difference in infectious disease and contagious disease

A clinically manifested disease of man caused by a micro-organism is an infectious disease. The disease that spreads from one person to another person is a contagious disease. All infectious diseases are not contagious.

Mode of transmission

Sushruta observed the modes of transmission of contagious diseases and listed them as follows. [Su.Sa.Nidansthan5/33-34]

• Close physical contact (prasangat)
• Touching the affected person (gatra samsparshat)
• Droplets exhaled in air (nishwasat)
• Sharing bed with affected person (saha shayya)
• Eating together or sharing food with affected person (sahabhojanat).
• Sitting together / closely with the affected person (saha aasanat).
• Using clothes, ornaments etc. of affected person (vastra mala anulepanat).

There are seven types of diseases as per acharya Sushruta. [Su.Sa. Sutra Sthana 24/4 Vyadhisamuddeshiya] These are

1. Adibala pravrutta (hereditary diseases)
2. Janmabala pravrutta (congenital diseases)
3. Doshabala pravrutta (dosha dominant diseases)
4. Sanghatabala pravrutta (accidental bites, attack of animals)
5. Kaala bala pravrutta (time/age/season related based diseases)
6. Daiva bala pravrutta (diseases caused due to previous deeds etc.)
7. Swabhava bala pravrutta (diseases occurs due to natural processes like ageing, death) [Su.Sa.Sutra Sthana 24/4]

Daiva bala pravrutta diseases (previous deeds)are classified as [Su.Sa.Sutrasthan24/7]

1. Contagious or communicable (aupasargika roga)
2. Accidental (akasmik)

List of diseases

Ayurveda texts have listed the diseases that can spread through above means as below:

• Kushtha (~skin diseases)
• Jwara (~fever)
• Netrabhishyanada (~conjunctivitis)
• Shosha (~emaciation/tuberculosis)
• Visuchika (~cholera)
• Shleshmak jwara with pratishyaya (fever with rhinitis)
• Upadamsha (~chancroid/soft chancre)
• Hepatitis A, B, C, D
• Influenza
• Masurika (chickenpox)
• Romantika (measles)
• Granthi (cysts)
• Visarpa (erysipelas)
• Kandu (pruritus)

Bhavamishra described following Aupsargika diseases:

• Kandu (pruritus)
• Kushtha (skin diseases)
• Upadansha (sexually transmitted disease like chancroid/soft chancre)
• Bhuta-unmada (psychosis due to infection of micro-organisms)
• Jwara (fever)

Dalhana described following aupasargika diseases:

Shwasa (respiratory disorder), kasa (cough) and pratishyaya (allergic rhinitis) diseases can spread through droplet infection. Jwara (fever) and masurika can spread through skin contact.

Causes

• The causes of abovementioned diseases are described in the respective chapters. However, the contagious nature of the diseases can affect other person susceptible for similar diseases.
• Ayurveda believe in seed and soil theory, where seeds are microorganisms like bacteria, virus etc. and soil is body. When the soil is healthy, then no disease can prevail in the body. But if the seeds are more potent, they can produce a disease. Therefore, the occurrence of diseases depend on interaction of dosha, dushya, and causes. If the inherent immunity (vyadhikshamatva) is superior, then the affecting micro-organisms cannot multiply and cause diseases. However, if the immunity is poor, then the micro-organisms can lead to infectious diseases. The transmission of microbes from one person to other depends on nature of microbe and availability of its favourable transmission mode like air, soil, water etc.
• As per contemporary medical literature, communicable diseases are caused by viruses or bacteria. These micro-organisms are transmitted to one another through contact with contaminated surfaces, bodily fluids, blood products, insect bites, or through the air. The modes of transmission are described by Sushruta as mentioned earlier.

Role of aupsargika roga in current era

With every passing era, mankind has faced healthcare challenges in the form of pandemics like COVID-19, epidemics like cholera, plague etc. These are all aupasargika in nature. Understanding aupsargika roga not only helps to prevent the diseases at individual level, but also helps to prevent epidemics or pandemics.

Root cause for epidemics (janapadodhawansa)-

Root cause for vitiation of air etc. factors is 'adharma' or misdeeds performed by intellectual errors (prajnaparadha). Sinful acts may be in the form of wars, demons, germs & curse. In the present day, sinful act can include different activities like antinational elements indulging in bomb blast, crime, deforestation, not obeying government rules in the industries, discharge of untreated polluted water in to the river, automobile pollutions etc., which produce air pollution. Disposal of waste water in an improper method on land leads to pollution of soil. The basic cause of such act is intellectual errors (prajnaparadha), due to rajas & tamas predominance resulting in greed, selfishness, tendency to harm people, jealousy & anger. All these factors not only influence the individual, but also the society leading to janapadodhwansa.

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