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Diseases are classified according to the dominance of ''doshas''-involved and their mutual amalgamation, which are of four types. The 5th type of ''chhardi'' (''dwishtarthayoga'') is due to aversive food related to the involvement of ''panchagyanendriyas'' (five sense organs) and their ''vishaya upalabdhi'' (Cha su 1/54) (perceivance of senses). The contact through ''rupa'' (visible) or ''rasa'' (taste) or ''gandha'' (smell) or ''sparsha'' (touch) or ''shabda'' (hear) or in combination with each other, stimulates body mechanism which results in ''dwistarthayoga chhardi'' (vomiting due to aversion). One cannot exclude the role of ''manah'' (mind) as predisposing factor in causing ''dwistarthayoga chhardi''.  
 
Diseases are classified according to the dominance of ''doshas''-involved and their mutual amalgamation, which are of four types. The 5th type of ''chhardi'' (''dwishtarthayoga'') is due to aversive food related to the involvement of ''panchagyanendriyas'' (five sense organs) and their ''vishaya upalabdhi'' (Cha su 1/54) (perceivance of senses). The contact through ''rupa'' (visible) or ''rasa'' (taste) or ''gandha'' (smell) or ''sparsha'' (touch) or ''shabda'' (hear) or in combination with each other, stimulates body mechanism which results in ''dwistarthayoga chhardi'' (vomiting due to aversion). One cannot exclude the role of ''manah'' (mind) as predisposing factor in causing ''dwistarthayoga chhardi''.  
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''Douhruda janita'' (pregnancy induced vomitting), ''satmya prakopaja'' (vomiting due to inadequacy of substances) and ''krimija'' (vomiting due to microbial infection) type of ''chhardi'' are other causes of ''chhardi''.  
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''Douhruda janita'' (pregnancy induced vomitting), ''satmya prakopaja'' (vomiting due to inadequacy of substances) and ''krimija'' (vomiting due to microbial infection) type of ''chhardi'' are other causes of ''chhardi''.<ref>Shastri Ambika Dutt, Sushruta Samhita, Hindi commentary by Kaviraj 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi</ref>
    
===== ''Vataja chhardi'' =====   
 
===== ''Vataja chhardi'' =====   
 
    
 
    
There are many factors that increase ''vata'' in the ''sharira'' . Particular ''ahara'' (food), ''vihara'' (lifestyle) and mental factors increase ''vata'' and its ''gunas'' (properties). This aggravation of ''vata gunas'' like ''rukshata'' (dryness), ''laghuta'' (lightness), etc. plays a role in causing ''vataja chhardi''. ([[Sutra Sthana]] 1/59) ''doshas'' conjugate (''sammurchhana'' ([[Sutra Sthana]] 18/46) with a particular organ (''mahasrotas, amashaya, marma'' (vital organ), ''urdhwabhaga'' (upper trunk, etc) as ''dushyas'' (affected ''dhatus'') to cause ''vataja chhardi'' (as ''utkshepana'' (upward movement), ''adhahkshepana'' (downward movement), etc are the ''karmas'' (actions) of ''vayu'')-(7-9).
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There are many factors that increase ''vata'' in the ''sharira'' .<ref>Shastri Ambika Dutt, Sushruta Samhita, Sutra sthana 21/19. Hindi commentary by Kaviraj 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi </ref> Particular ''ahara'' (food), ''vihara'' (lifestyle) and mental factors increase ''vata'' and its ''gunas'' (properties). This aggravation of ''vata gunas'' like ''rukshata'' (dryness), ''laghuta'' (lightness), etc. plays a role in causing ''vataja chhardi''. ([[Sutra Sthana]] 1/59) ''doshas'' conjugate (''sammurchhana'' ([[Sutra Sthana]] 18/46) with a particular organ (''mahasrotas, amashaya, marma'' (vital organ), ''urdhwabhaga'' (upper trunk, etc) as ''dushyas'' (affected ''dhatus'') to cause ''vataja chhardi'' (as ''utkshepana'' (upward movement), ''adhahkshepana'' (downward movement), etc are the ''karmas'' (actions) of ''vayu'')-(7-9).
    
===== ''Pittaja chhardi'' =====
 
===== ''Pittaja chhardi'' =====
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Nidanas of pittaprakopaka increase pitta in nature   and cause provocation of gunas like ushna (hot), tikshna (sharp), snigdha (unctous), etc. (Charaka sutra sthana 1/60) in the body. This aggravated pitta joins (Sammurchhana) with a particular organ (rasāyani, amāshaya, marma, urdhwabhaga, etc) as dushyas. The conjugation of dosha and dushya has affinity towards urdhwabhaga which results in pittaja chhardi (10-11).
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''Nidanas'' of ''pittaprakopaka'' increase ''pitta'' in nature <ref>Shastri Ambika Dutt, Sushruta Samhita, Sutra sthana 21/21 Hindi commentary by Kaviraj 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi </ref>and cause provocation of ''gunas'' like ''ushna'' (hot), ''tikshna'' (sharp), ''snigdha'' (unctous), etc. ([[Sutra Sthana]] 1/60) in the body. This aggravated ''pitta'' joins (''sammurchhana'') with a particular organ (''rasayani, amashaya, marma, urdhwabhaga,'' etc) as ''dushyas''. The conjugation of ''dosha'' and ''dushya'' has affinity towards ''urdhwabhaga'' which results in ''pittaja chhardi'' (10-11).
    
===== ''Kaphaja chhardi'' =====
 
===== ''Kaphaja chhardi'' =====
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Nidānas of kaphaprakopaka increase kapha in nature  which causes provocation of gunas like guru (heavyness), sheeta (coldness), manda (slowness), etc. (Charaka Sutra sthana 1/60) in the body. This aggravated Kapha joins (sammurchhana) with a particular organ (urah (chest), shirah (head), rasāyani marma, urdhwabhaga, etc.) as dushyas. This amalgamation of dosha and dushya has affinity towards urdhwabhaga which results in kaphaja chhardi (12-13).
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''Nidanas'' of ''kaphaprakopaka'' increase ''kapha'' in nature  which causes provocation of ''gunas'' like ''guru'' (heavyness), ''sheeta'' (coldness), ''manda'' (slowness), etc. ([[Sutra Sthana]] 1/60) in the body. This aggravated ''kapha'' joins (''sammurchhana'') with a particular organ (''urah'' (chest), ''shirah'' (head), ''rasayani marma, urdhwabhaga,'' etc.) as ''dushyas''. This amalgamation of ''dosha'' and ''dushya'' has affinity towards ''urdhwabhaga'' which results in ''kaphaja chhardi'' (12-13).
    
===== ''Sannipataja chhardi'' =====
 
===== ''Sannipataja chhardi'' =====
 
   
 
   
Intake of diet containing all rasas or tastes ideal but the intake of food with imbalances in rasas leads to the vitiation of tridoshas(Ch.Su.26/90-101)and causes sannipataja chhardi which has varied manifestations covering broad signs of tridosha involvement ( verses 14-15).  
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Intake of diet containing all ''rasas'' or tastes ideal but the intake of food with imbalances in ''rasas'' leads to the vitiation of ''tridoshas''(Ch.Su.26/90-101)and causes ''sannipataja chhardi'' which has varied manifestations covering broad signs of ''tridosha'' involvement ( verses 14-15).  
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The sama-varna-gandha (color & smell similar to) of vomitus is due to conjugation with purisha (stool) and mutra (urine). This conjugation indicates involvement of multiple srotasas and have tendency towards asadhyata (incurable)(Charaka Vimana 5/3) ( verses 16-17).
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The ''sama-varna-gandha'' (color & smell similar to) of vomitus is due to conjugation with ''purisha'' (stool) and ''mutra'' (urine). This conjugation indicates involvement of multiple ''srotasas'' and have tendency towards ''asadhyata'' (incurable)([[Vimana Sthana]] 5/3) ( verses 16-17).
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Excessive loss of any dhatu (rasa-rakta-vasa, etc) due to physical exercise or vamana vega (bouts) or arising out of any complications in the form of diseases like kasa (cough), shwasa (asthama), jwara (fever), etc. are considered to be life threatening.
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Excessive loss of any ''dhatu'' (''rasa-rakta-vasa'', etc) due to physical exercise or ''vamana vega'' (bouts) or arising out of any complications in the form of diseases like ''kasa'' (cough), ''shwasa'' (asthama), ''jwara'' (fever)<ref>Shastri Suderashan, Madhava Nidana of Madhavakara, 4th Edition, 1975, Chaukhamba Sanskrit Series, Varanasi, Ma. Ni 15</ref>, etc. are considered to be life threatening.
    
==== Treatment ====
 
==== Treatment ====