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Rogamarga (view source)

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Roga marga means pathways of [[Vyadhi|disease]] progression and manifestations. It is essential to know the path of progression and manifestation of the [[Vyadhi|disease]] to plan the protocol for its management. Roga marga is a place of vitiation of [[Sharira|body]] channels ([[Kha vaigunya|kha vaigunya]]). The [[Vyadhi|disease]] can be cured, if the exact site of vitiation is targeted. Through the applicability of roga-marga, the recurrence of the [[Vyadhi|disease]] may be reduced. [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]] 15/36-37] The specific medicines for specific receptors can be developed. [Cha.Sa. [[Sutra Sthana|Sutra Sthana]] 4/22] Acharya Charaka has explained roga marga as under.<ref name="ref1">Agnivesha , Dridhbala , Charaka , Charaka Samhita , Sutrasthana , Taistraishaniya Adhyaya , 11/48 , reprinted 2020 , Chaukhamba Surbharati Prakashana , Varanasi , Page No. 77 </ref> [Cha.Sa.[[Sutra Sthana~~|Sutrasthana~~]] 11/48]

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Roga marga means pathways of [[Vyadhi|disease]] progression and manifestations. It is essential to know the path of progression and manifestation of the [[Vyadhi|disease]] to plan the protocol for its management. Roga marga is a place of vitiation of [[Sharira|body]] channels ([[Kha vaigunya|kha vaigunya]]). The [[Vyadhi|disease]] can be cured, if the exact site of vitiation is targeted. Through the applicability of roga marga, the recurrence of the [[Vyadhi|disease]] may be reduced. [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]] 15/36-37] The specific medicines for specific receptors can be developed. [Cha.Sa. [[Sutra Sthana|Sutra Sthana]] 4/22] Acharya Charaka has explained roga marga as under.<ref name="ref1">Agnivesha , Dridhbala , Charaka , Charaka Samhita , Sutrasthana , Taistraishaniya Adhyaya , 11/48 , reprinted 2020 , Chaukhamba Surbharati Prakashana , Varanasi , Page No. 77 </ref> [Cha.Sa.[[Sutra Sthana]] 11/48]

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# Three roga ~~maragas~~ viz. external (bahya), middle (madhyama) and internal (abhyantara)

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# Three roga margas viz. external (bahya), middle (madhyama) and internal (abhyantara)

# Each roga marga has set of structural / physiological entities.

# List of [[Vyadhi|diseases]] of roga marga

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== Significance ==

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As an important phase of [[Samprapti|pathogenesis (samprapti)]], the vitiated [[Dosha|dosha]] travel and settle at the suitable places. [Madhu Kosha commentary on Madhava Nidana Sarvaroga Nidana Adhyaya]<ref name="ref2">Madhavakara ,Madhav Nidana with Madhukosha commentary by Vijayrakshita and Shreekanthadatta revised and edited by Prof. Yadunanda Upadhyaya ,Sarvaroganidana Adhyaya , 1/10 , Page No. 60 </ref> This is termed as prasara (sthana samshraya). It can be said that for both of these phases, roga-marga plays a vital role. Also, the movement of [[Dosha|dosha]] (dosha gati) mentioned as normal ([[Prakriti|prakriti]]) and abnormal (vaikrita) are with the same nomenclature viz. [[Koshtha|koshtha]], shakha, [[Marma|marma]]-[[Asthi|asthi]]-sandhi. This shows the significance of roga marga from physiological view point (prakrita gati of [[Dosha|dosha]]). Roga marga also contributes to the prognosis of the [[Vyadhi|diseases]]. [Chakrapani commentary on Cha. Su. 11/48]<ref name="ref3">Chakrapani commentary on Charaka istraishSamhita Sutrasthana , Tistraishaniya Adhyaya, 11/48reprinted 2020 , Chaukhamba Surbharati Prakashana , Varanasi , Page No. </ref> Further, ~~rogamarga~~ is explained for precise treatment. [Madhukosha Commentary on Madhava Nidana Sarvaroga Nidana Adhyaya]<ref name="ref4">Madhavakara ,Madhav Nidana with Madhukosha commentary by Vijayrakshita and Shreekanthadatta revised and edited by Prof. Yadunanda Upadhyaya ,Sarvaroganidana Adhyaya , 1/4 , Page No. 21 </ref>

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As an important phase of [[Samprapti|pathogenesis (samprapti)]], the vitiated [[Dosha|dosha]] travel and settle at the suitable places. [Madhu Kosha commentary on Madhava Nidana Sarvaroga Nidana Adhyaya]<ref name="ref2">Madhavakara ,Madhav Nidana with Madhukosha commentary by Vijayrakshita and Shreekanthadatta revised and edited by Prof. Yadunanda Upadhyaya ,Sarvaroganidana Adhyaya , 1/10 , Page No. 60 </ref> This is termed as prasara and sthana samshraya. It can be said that for both of these phases, roga marga plays a vital role. Also, the movement of [[Dosha|dosha]] (dosha gati) mentioned as normal ([[Prakriti|prakriti]]) and abnormal (vaikrita) are with the same nomenclature viz. [[Koshtha|koshtha]], shakha, [[Marma|marma]]-[[Asthi|asthi]]-sandhi. This shows the significance of roga marga from physiological view point (prakrita gati of [[Dosha|dosha]]). Roga marga also contributes to the prognosis of the [[Vyadhi|diseases]]. [Chakrapani commentary on Cha. Su. 11/48]<ref name="ref3">Chakrapani commentary on Charaka istraishSamhita Sutrasthana , Tistraishaniya Adhyaya, 11/48reprinted 2020 , Chaukhamba Surbharati Prakashana , Varanasi , Page No. </ref> Further, roga marga is explained for precise treatment. [Madhukosha Commentary on Madhava Nidana Sarvaroga Nidana Adhyaya]<ref name="ref4">Madhavakara ,Madhav Nidana with Madhukosha commentary by Vijayrakshita and Shreekanthadatta revised and edited by Prof. Yadunanda Upadhyaya ,Sarvaroganidana Adhyaya , 1/4 , Page No. 21 </ref>

== Etymology ==

<ol type="A" style='text-align:justify;'><li style="font-weight: bold;">[[Vyadhi|Roga]] : The word [[Vyadhi|roga]] is derived from the root ‘ruj’ which means unpleasant, discomfort or pain, to break or disintegrate. It is evident that [[Vyadhi|roga]] is the outcome of the disintegration of equilibrium of [[Dosha|dosha]] (or dhatusamyata) – Homeostasis, which culminates into pain – physical or psychological. [Arundatta on A.H.[[Nidana Sthana|Nidana Sthana]] 1/1]<ref name="ref5">Arundatta commentary on Ashtang Hridaya edited by Pt. Hari Sadashiv Sastri Paradkar , Nidanasthana , Sarvaroganidana , 1/1 , reprinted 2018, Chaukhamba Sanskrit Sansthan , Varanasi , Page No. 440 </ref></li>

<li style="font-weight: bold;">Marga : The Sanskrit word marga means to go along, or path. [Shabda Kalpadrum]<ref name="ref6">Radhakantadeva, Vasu, v. and Vasu, h. (1886).Shabdakalpadrumah , Page No. 708 </ref> Marga is derived from the Sanskrit verb ‘mruj’ that means purified channel or route. The dictionary meanings of the word marga are path, way, manner, mode, methods, process, indicative of how [[Samprapti|pathogenesis]] is to take place. [Sir. M.M. Williams]<ref name="ref7">Monier-Williams, m. (1899). A Sanskrit-English dictionary , Page. No. 812</ref></li></ol>

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Rogamarga can be understood as the way of [[Vyadhi|disease]] occurrence, progression and recurrence as well. The word Roga marga maybe understood as ‘A weak spot’ or ‘Costus specious’. Textbook of Pathology by Boyd quotes “The science of pathology seeks to determine the cause of [[Vyadhi|disease]], to discover how [[Vyadhi|disease]] injures the patient, to describe the lesions produced, to follow how the lesions change as [[Vyadhi|disease]] progresses, to understand how [[Vyadhi|disease]] produces secondary effects in the patient, and to record how the lesions heal as the patient recovers.” -<ref name="ref8">Boyd, William. "Text-book of Pathology." (1953). </ref>

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Rogamarga can be understood as the way of [[Vyadhi|disease]] occurrence, progression and recurrence as well. The word Roga marga maybe understood as ‘A weak spot’ or ‘Costus specious’. Textbook of Pathology by Boyd quotes “The science of pathology seeks to determine the cause of [[Vyadhi|disease]], to discover how [[Vyadhi|disease]] injures the patient, to describe the lesions produced, to follow how the lesions change as [[Vyadhi|disease]] progresses, to understand how [[Vyadhi|disease]] produces secondary effects in the patient, and to record how the lesions heal as the patient recovers.” <ref name="ref8">Boyd, William. "Text-book of Pathology." (1953). </ref>

== Definition ==

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The external pathway of [[Vyadhi|disease]] is called bahya ~~rogamarga~~.<ref name="ref9">Hemadri commentary on Ashtang Hridaya edited by Pt. Hari Sadashiv Sastri Paradkar , Sutrasthana , Doshabhediya Adhyaya, 12/45 , reprinted 2018, Chaukhamba Sanskrit Sansthan , Varanasi , Page No. 200 </ref> [Hemadri and Arunadatta on A.H. ~~Su.~~ 12/45] By this meaning, abhyantara (internal) and madhyama (medial) roga marga will be interpreted as internal and medial pathway of [[Vyadhi|disease]] respectively.

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The external pathway of [[Vyadhi|disease]] is called bahya roga marga.<ref name="ref9">Hemadri commentary on Ashtang Hridaya edited by Pt. Hari Sadashiv Sastri Paradkar , Sutrasthana , Doshabhediya Adhyaya, 12/45 , reprinted 2018, Chaukhamba Sanskrit Sansthan , Varanasi , Page No. 200 </ref> [Hemadri and Arunadatta on A.H. Sutra Sthana 12/45] By this meaning, abhyantara (internal) and madhyama (medial) roga marga will be interpreted as internal and medial pathway of [[Vyadhi|disease]] respectively.

These definitions suggest the appearance of clinical features can be representing a particular roga marga. However, in some cases the [[Samprapti|pathogenesis]] can be different with different pathways. For example, carbuncles due to diabetes ([[Prameha Nidana|prameha]] pitika) appearing in the bahya roga marga, needs additional treatments besides other [[Vyadhi|diseases]] which occur in bhaya roga marga.<ref name="ref10">Bhojani Meera Et Al: A study on Nirdesha Chatushka of Charaka Samhita and applied aspect of Trayo-Rogamarga, MD Thesis, 2003, IPGT&RA, Jamnagar </ref> Hence, it can be interpreted that the [[Dosha|dosha]] [[Samprapti|samprapti]] can travel to any roga marga during the process.

== Movement of [[Dosha|dosha]] and pathways of [[Vyadhi|diseases]] (roga marga vis-a-vis [[Dosha|dosha]] gati) ==

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Three types of movements of [[Dosha|dosha]] are mentioned. [Cha. Sa.[[Sutra Sthana|Sutra Sthana]] 17/113] The same are termed as three types of roga marga viz. shakha, [[Koshtha|koshtha]] and ~~marmasthi~~ sandhi.<ref name="ref11">Agnivesha , Dridhbala , Charaka , Charaka Samhita , Sutrasthana , Kiyantashirasiya Adhyaya, 17/112-113 , reprinted 2020 , Chaukhamba Surbharati Prakashana , Varanasi , Page No. 105 </ref> [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 11/48]

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Three types of movements of [[Dosha|dosha]] are mentioned. [Cha. Sa.[[Sutra Sthana|Sutra Sthana]] 17/113] The same are termed as three types of roga marga viz. shakha, [[Koshtha|koshtha]] and [[marma]] asthi sandhi.<ref name="ref11">Agnivesha , Dridhbala , Charaka , Charaka Samhita , Sutrasthana , Kiyantashirasiya Adhyaya, 17/112-113 , reprinted 2020 , Chaukhamba Surbharati Prakashana , Varanasi , Page No. 105 </ref> [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 11/48]

These are the different movements of [[Dosha|dosha]]. As these gati are further classified into prakrita (normal) and vaikrita (abnormal), the healthy channels will render the passage for [[Dosha|dosha]] and when the same channels are weaker/vulnerable, they act as ‘roga marga’.

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=== [[Vyadhi|Diseases]] observed in each roga marga ===

[[Vyadhi|Diseases]] occurring in different rogamarga are tabulated as under:

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{| class="wikitable" style='text-align:justify;'

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! Diseases occurring in bahya roga marga

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'''Table 1: Diseases in different roga marga'''

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! Diseases occurring in madhyama roga marga

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{| class="wikitable" style="text-align:justify;"

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! Diseases occurring in ~~Abhyantara Roga~~ marga

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! Diseases occurring in bahya roga marga

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! Diseases occurring in bahya and abhyantara roga marga

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! Diseases occurring in madhyama roga marga

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! Diseases occurring in abhyantara roga marga

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! Diseases occurring in bahya and abhyantara roga marga

|-

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| [[Vyadhi|Diseases]] like ~~Goitre~~, pimples, boil, warts, granuloma etc. which are manifested on the [[Sharira|body]] and can be accessed easily and palpable

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|[[Vyadhi|Diseases]] like goitre, pimples, boil, warts, granuloma etc. which are manifested on the [[Sharira|body]] and can be accessed easily and palpable

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| [[Vyadhi|Diseases]] involving the pathology of the vital organs like hemiplegia, facial paralysis etc., [[Vyadhi|diseases]] of cardiovascular system, [[Vyadhi|diseases]] of urinary system, [[Vyadhi|diseases]] of joints

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|[[Vyadhi|Diseases]] involving the pathology of the vital organs like hemiplegia, facial paralysis etc., [[Vyadhi|diseases]] of cardiovascular system, [[Vyadhi|diseases]] of urinary system, [[Vyadhi|diseases]] of joints

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| [[Vyadhi|Diseases]] like [[Jwara|fever]], diarrhoea, vomiting, cholera, constipation, [[Vyadhi|diseases]] of abdomen, splenic disorders, cough, dyspnoea, hiccough etc. which are caused due to indigestion

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|[[Vyadhi|Diseases]] like [[Jwara|fever]], diarrhoea, vomiting, cholera, constipation, [[Vyadhi|diseases]] of abdomen, splenic disorders, cough, dyspnoea, hiccough etc. which are caused due to indigestion

| Skin [[Vyadhi|diseases]] having acute spread like erysepelas, oedema, abdominal tumours, piles and abscess

|}

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== Anatomical aspects ==

Certain exemplary organs are grouped under different roga margas. The organic implications of each rogamarga can be discussed as follows.

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=== Bahya rogamarga ===

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=== Bahya rogamarga (external pathway) ===

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This includes [[Sharira|body]] components like twak (skin), [[Rakta dhatu|rakta dhatu]] (blood), and other similar [[Sharira|body]] constituents. [Cha.Sa.[[Sutra Sthana|Sutrasthana]] 11/48] It is similar to a branch of tree.<ref name="ref13">Jyoti Devangamath Et Al: Crucial Role Of Rogamarga To Understand Vyadhi. International Ayurvedic medical Journal {online} 2016 {cited 2016 July} Available from: http://www.iamj.in/posts/images/upload/1291_1296.pdf </ref>

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This includes [[Sharira|body]] components like twak (skin), [[Rakta dhatu|rakta dhatu]] (blood), and other similar [[Sharira|body]] constituents. [Cha.Sa.[[Sutra Sthana|Sutrasthana]] 11/48] It is similar to a branch of tree.<ref name="ref13">Jyoti Devangamath Et Al: Crucial Role Of Rogamarga To Understand Vyadhi. International Ayurvedic medical Journal {online} 2016 {cited 2016 July} Available from: http://www.iamj.in/posts/images/upload/1291_1296.pdf </ref>

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Thus, to show the remoteness of these structures, they have been termed as shakha. These are the structures seen one after another in a sequence. [[Rasa|Rasa]], [[Rakta dhatu|rakta]], [[Mamsa dhatu|mamsa]], [[Meda|meda]], [[Majja dhatu|majja]] pertaining to the internal structures like liver, spleen, brain etc. should not come under bahya roga marga. For example, hrdayagata [[rasa dhatu]], yakrita gata [[rakta dhatu]] should come under abhyantara roga marga. The accessory appendages of skin like hair, nails, tactile cells, sebaceous glands etc. should be considered under bahya roga marga. Mammary glands, ext. ear, tonsils, adenoids should also be considered under bahya ~~rogamarga~~. Thus, looking to the structures and [[Vyadhi|diseases]] allotted to bahya rogamarga, it is evident that this marga has entities, which are superficial (compared to the madhyama roga marga) and these entities are the first line of contact with the external stimulus and hence the pathology occurring is easily diagnosed and approachable. The madhyama roga marga includes [[Marma|marma]] (vital organs) like heart, brain, kidneys, bones, joints, ligaments, tendons. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 11/48]

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Thus, to show the remoteness of these structures, they have been termed as shakha. These are the structures seen one after another in a sequence. [[Rasa|Rasa]], [[Rakta dhatu|rakta]], [[Mamsa dhatu|mamsa]], [[Meda|meda]], [[Majja dhatu|majja]] pertaining to the internal structures like liver, spleen, brain etc. should not come under bahya roga marga. For example, hrdayagata [[rasa dhatu]], yakrita gata [[rakta dhatu]] should come under abhyantara roga marga. The accessory appendages of skin like hair, nails, tactile cells, sebaceous glands etc. should be considered under bahya roga marga. Mammary glands, ext. ear, tonsils, adenoids should also be considered under bahya roga marga. Thus, looking to the structures and [[Vyadhi|diseases]] allotted to bahya rogamarga, it is evident that this marga has entities, which are superficial (compared to the madhyama roga marga) and these entities are the first line of contact with the external stimulus and hence the pathology occurring is easily diagnosed and approachable. The madhyama roga marga includes [[Marma|marma]] (vital organs) like heart, brain, kidneys, bones, joints, ligaments, tendons. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 11/48]

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=== Madhyama rogamarga ===

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=== Madhyama rogamarga (medial pathway) ===

The grouping of structures of madhyama roga marga is quite different from that of other roga-marga. Although these organs are not connected with each other, they perform vital functions of the [[Sharira|body]] and any damage to them will give rise to serious consequences.

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=== Abhyantara rogamarga ===

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=== Abhyantara rogamarga (internal pathway) ===

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The abhyantara roga marga is termed as [[koshtha]]. It includes the gastrointestinal tract and all visceral organs. While enumerating koshthangas [[Basti|basti]], [[Hridaya|hridaya]] and vrikka included in them will be included in abhyantara roga marga. But in text these organs and [[Vyadhi|diseases]] related to them are ascribed to madhyama roga marga, which maybe explained as under

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The abhyantara roga marga is termed as [[koshtha]]. It includes the gastrointestinal tract and all visceral organs. While enumerating koshthangas [[Basti|basti]], [[Hridaya|hridaya]] and vrikka included in them. These will be included in abhyantara roga marga. But in text these organs and [[Vyadhi|diseases]] related to them are ascribed to madhyama roga marga, which maybe explained as under.

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Koshthanga are mainly responsible for nutrition and excretion of [[Mala|mala]]. [[Hridaya|Hridaya]] is considered a koshthanga for; it is responsible for nutrition and excretion of blood impurities. Same is the case with vrikka and [[Basti|basti]]. But the reason for not considering these organs under koshtha may be that the structural disorders of any of the organs may influence the material flowing through them but not the organs of mahasrotas. ~~(A.Rm.)~~ In case of the [[Vyadhi|diseases]] related to abhyantara roga marga, there may be indirect influence on the vahana [[Dravya|dravya]] of these organs. eg. rakta mutrata in pittaja [[Jwara|jwara]], hridaya ashuddhi in [[Ama|ama]] [[Jwara|jwara]], bahu mutrata in ajirna etc. Thus, being influenced by koshtha and their [[Vyadhi|diseases]], these might have been included in koshthanga. But when the point of roga marga comes, these organs are to be studied under madhyama roga marga as is in the texts.

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Koshthanga are mainly responsible for nutrition and excretion of [[Mala|mala]]. [[Hridaya|Hridaya]] is considered a koshthanga for; it is responsible for nutrition and excretion of blood impurities. Same is the case with vrikka and [[Basti|basti]]. But the reason for not considering these organs under koshtha may be that the structural disorders of any of the organs may influence the material flowing through them but not the organs of mahasrotas. In case of the [[Vyadhi|diseases]] related to abhyantara roga marga, there may be indirect influence on the vahana [[Dravya|dravya]] of these organs. eg. rakta mutrata in pittaja [[Jwara|jwara]], hridaya ashuddhi in [[Ama|ama]] [[Jwara|jwara]], bahu mutrata in ajirna etc. Thus, being influenced by koshtha and their [[Vyadhi|diseases]], these might have been included in koshthanga. But when the point of roga marga comes, these organs are to be studied under madhyama roga marga as is in the texts.

== Physiological aspect of roga-marga ==

Physiologically, the various organs occurring in a particular roga marga are inter-connected. This could be explained as under:

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'''Table 2: Peculiarities of roga marga'''

{| class="wikitable"

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! Roga marga

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! Roga marga

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! Important physiological aspect

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! Important physiological aspect

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! Other peculiarities

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! Other peculiarities

|-

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| Abhyantara ~~rogamarga~~

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| Abhyantara roga marga

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| It is the prime site of jatharagni and concerned with digestion, absorption and excretion,

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| It is the prime site of jatharagni and concerned with digestion, absorption and excretion,

|

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* It has the mula sthana of the [[Dosha|dosha]] [Su.Su.21/6] .

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* It has the mula sthana of the [[Dosha|dosha.]] [Su.Sa.Sutra Sthana 21/6]

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* The koshthanga are in the abhyantara rogamarga

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* The koshthanga are in the abhyantara rogamarga

|-

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| Bahya ~~rogamarga~~

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| Bahya roga marga

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| It is the site of dhatwagni, responsible for the [[~~Dhatu|~~dhatu]] nirmana

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| It is the site of dhatwagni, responsible for the [[dhatu]] nirmana

|

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* As the nutrition is processed through abhyantara roga marga, at least two ~~rogamaragas~~ are functionally interlinked; and many cause and effect phenomena can be observed in these two margas.

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* As the nutrition is processed through abhyantara roga marga, at least two roga margas are functionally interlinked; and many cause and effect phenomena can be observed in these two margas.

|-

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| Madhyam ~~rogamarga~~

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| Madhyam roga marga

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| It includes organs such as sira, [[~~Hridaya|~~hridaya]] and [[~~Basti|~~basti]], other [[Marma|marmas]], asthi-sandhi etc.

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| It includes organs such as sira, [[hridaya]] and [[basti]], other [[Marma|marmas]], asthi-sandhi etc.

|

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* These organs have nothing in common either physiologically nor have anatomical continuity.

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* These organs have nothing in common either physiologically nor have anatomical continuity.

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* They are the main seats of [[~~Prana|~~prana]] according to [[~~Ayurveda|Ayurveda~~]]

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* They are the main seats of [[prana]] according to [[ayurveda]]

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* They have large quantity of blood circulation.

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* They have large quantity of blood circulation.

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* These organs are interlinked with each other pathologically, as the pathology of one affects the other.

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* These organs are interlinked with each other pathologically, as the pathology of one affects the other.

|-

|}

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In a normal [[Sharira|body]], as such, there will be no rogamarga for the [[Dosha|dosha]] to travel. The healthy [[Srotas|srotas]]/organs are rendered weak by the intake of nidana sevana and this renders the [[Srotas|srotas]] weak, which is termed as [[Kha vaigunya|khavaigunya]]. This results in directing the [[Samprapti|samprapti]] and spread of [[Vyadhi|disease]]. Such weak [[Srotas|srotas]]/ organs becomes rogamarga.

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~~Rogamargas~~ have crucial role to play in the [[Samprapti|samprapti]] of a [[Vyadhi|disease]]. The very definition of [[Samprapti|samprapti]] brings forth two things. One is that, the accumulated and spreading [[Dosha|dosha]] virtually reaches each and every part of the [[Sharira|body]] and the general channel of flow is rasayani. [ A.H. ~~Ni.~~ 1/23]

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Roga margas have crucial role to play in the [[Samprapti|samprapti]] of a [[Vyadhi|disease]]. The very definition of [[Samprapti|samprapti]] brings forth two things. One is that, the accumulated and spreading [[Dosha|dosha]] virtually reaches each and every part of the [[Sharira|body]] and the general channel of flow is rasayani. [ A.H. Nidana Sthana 1/23]

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Along with it, this subject has been emphasized for sadhyasahdyata i.e. prognosis, according to ~~Cakrapani~~ and for therapeutic application according to ~~madhukosakara~~. This points towards the pathological importance of ~~rogamarga~~.

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Along with it, this subject has been emphasized for sadhyasahdyata i.e. prognosis, according to Chakrapani and for therapeutic application according to madhukoshakara. This points towards the pathological importance of roga marga.

== Role of roga-marga in various stages of [[Samprapti|samprapti]] ==

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<li style="font-weight: bold;">Clinical stage : A list of [[Vyadhi|diseases]] are mentioned under a particular roga marga. So, it can be said that roga marga plays significant role in the clinical stages viz. sthana samshraya and vyakti avastha.

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~~Rogamarga~~ is the site of [[Kha vaigunya|kha-vaigunya]] which later on cultivates for interaction of dosh and [[Dushya|dushya]]. [Su.Sa.[[Sutra Sthana~~|Sutrasthana~~]] 24/10] [[Kha vaigunya|Kha-vaigunya]] plays directive role for the pathology to spread in different [[Srotas|srotas]] (systems).

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Roga marga is the site of [[Kha vaigunya|kha-vaigunya]] which later on cultivates for interaction of dosh and [[Dushya|dushya]]. [Su.Sa.[[Sutra Sthana]] 24/10] [[Kha vaigunya|Kha-vaigunya]] plays directive role for the pathology to spread in different [[Srotas|srotas]] (systems).

Sthanasamshraya avastha is an important transition stage between the sub clinical and the clinical stages; wherein the structural lesions begin to occur alongwith the functional disturbances, which leads to localization of the pathology. </li>

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<li style="font-weight: bold;">In the vyakti avastha, the outcome of the interaction of [[Dosha|dosha]]-[[Dushya|dushya]] is revealed. According to respected Vaidya Shiva Charan Dhyani, in the book “Nidana Panchaka”, at this stage, (i) completion of [[Dosha|dosha]] [[Dushya|dushya]] sammurcchana (ii) Srotodusti and its features and (iii) [[Lakshana|lakshana]] sammuchaya of [[Vyadhi|diseases]], are manifested. ~~[Nidana Panchaka by~~ Vaidya Shivacharana Dhyani, Chaukhambha Surabharati prakashana~~, edition~~ 2022~~, pag no~~, 58] </li>

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<li style="font-weight: bold;">In the vyakti avastha, the outcome of the interaction of [[Dosha|dosha]]-[[Dushya|dushya]] is revealed. According to respected Vaidya Shiva Charan Dhyani, in the book “Nidana Panchaka”, at this stage, (i) completion of [[Dosha|dosha]] [[Dushya|dushya]] sammurcchana (ii) Srotodusti and its features and (iii) [[Lakshana|lakshana]] sammuchaya of [[Vyadhi|diseases]], are manifested.<ref>Vaidya Shivacharana Dhyani.Nidana Panchaka. Chaukhambha Surabharati prakashana.Varanasi. 2022, 58.</ref> </li>

Though the [[Dosha|dosha]] [[Dushya|dushya]] sammurcchana is initiated in the previous stage, its completion is achieved in vyakti avastha. The sroto dushti occurs at roga-marga

<li style="font-weight: bold;">Complicated clinical (post clinical) stage : Bheda stage is considered as the advanced clinical stage. In this stage, the [[Vyadhi|disease (vyadhi)]] may become chronic or progressive and leads to other [[Vyadhi|diseases]]. In this phase, the [[Vyadhi|roga]] vriddhi takes place. Advancement of [[Vyadhi|disease]] ([[Vyadhi|roga]] vriddhi) takes place by different modes, which are listed briefly as follows: </li>

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e.g. Pratishyaya and [[Kasa Chikitsa|kasa]] (coryza and coughing together),. [Cha.Sa.[[Nidana Sthana|Nidana Sthana]] 8/22] </li>

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<li style="font-weight: bold;">[[Upadrava|Upadrava]] swarupa [[Vyadhi|roga]] vriddhi : [Cha.Sa.[[~~Chikitsa Sthana|~~Chikitsa Sthana]]21/40] [[Upadrava|Upadrava]] also signifies [[Vyadhi|roga]] vrddhi. In a vigunita sthana, [[Dosha|dosha]] [[Dushya|dushya]] sammurcchana takes place. If it is not treated at early stage and [[Nidana|nidana]] sevana continued then this [[Dosha|dosha]] [[Dushya|dushya]] melaka becomes more virulent and travels to other places and produces [[Upadrava|upadrava]]. eg. [[Upadrava|Upadrava]] of udara [[Vyadhi|roga]] (obstinate abdominal [[Vyadhi|diseases]] including ascites) are [[Chhardi Chikitsa|chhardi (vomiting)]], [[Atisara Chikitsa|atisara (diarrhoea)]], [[Shwasa|shwasa (dyspnoea)]], [[Kasa Chikitsa|kasa]] (cough), [[Trishna Chikitsa|trishna]] (morbid thirst), [[Hikka Shwasa Chikitsa|hikka (hiccup)]], aruchi (anorexia) etc. [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]] 13/49] </li>

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<li style="font-weight: bold;">[[Upadrava|Upadrava]] swarupa [[Vyadhi|roga]] vriddhi : '''[Cha.Sa. [[Chikitsa Sthana]] 21/40]''' [[Upadrava|Upadrava]] also signifies [[Vyadhi|roga]] vrddhi. In a vigunita sthana, [[Dosha|dosha]] [[Dushya|dushya]] sammurcchana takes place. If it is not treated at early stage and [[Nidana|nidana]] sevana continued then this [[Dosha|dosha]] [[Dushya|dushya]] melaka becomes more virulent and travels to other places and produces [[Upadrava|upadrava]]. eg. [[Upadrava|Upadrava]] of udara [[Vyadhi|roga]] (obstinate abdominal [[Vyadhi|diseases]] including ascites) are [[Chhardi Chikitsa|chhardi (vomiting)]], [[Atisara Chikitsa|atisara (diarrhoea)]], [[Shwasa|shwasa (dyspnoea)]], [[Kasa Chikitsa|kasa]] (cough), [[Trishna Chikitsa|trishna]] (morbid thirst), [[Hikka Shwasa Chikitsa|hikka (hiccup)]], aruchi (anorexia) etc. [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]] 13/49] </li>

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<li style="font-weight: bold;">[[Vyadhi|Roga]] ~~vrddhi~~ in same [[Srotas|srotas]] in a sequential order : [[Vyadhi|Roga]] initiates from sroto mula or a part of [[Srotas|srotas]] and spreads to whole [[Srotas|srotas]], if [[Nidana|nidana]] parivarjana is not done and chikitsa not applied. eg. Nasal Polyp leads to Bronchitis, which in turn may lead to asthma. </li>

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<li style="font-weight: bold;">[[Vyadhi|Roga]] vriddhi in same [[Srotas|srotas]] in a sequential order : [[Vyadhi|Roga]] initiates from sroto mula or a part of [[Srotas|srotas]] and spreads to whole [[Srotas|srotas]], if [[Nidana|nidana]] parivarjana is not done and chikitsa not applied. eg. Nasal Polyp leads to Bronchitis, which in turn may lead to asthma. </li>

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<li style="font-weight: bold;">[[Vyadhi|Roga]] ~~vrddhi~~ according to [[Dosha|dosha]] sthana : The best example given to study this is in [[Jwara|Jwara]] Prakarana of Sushruta Uttara Sthana. [Nibandha Sangraha commentary by Dalhana on Su.Sa. Uttara tantra 39/ 51-52]

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<li style="font-weight: bold;">[[Vyadhi|Roga]] vriddhi according to [[Dosha|dosha]] sthana : The best example given to study this is in [[Jwara|Jwara]] Prakarana of Sushruta Uttara Sthana. [Nibandha Sangraha commentary by Dalhana on Su.Sa. Uttara tantra 39/ 51-52]

* Satata [[Jwara|jwara]] in [[Amashaya|amashaya]] (In continuous [[Jwara|fever]], the morbid [[Dosha|doshas]] are in the stomach)

* Anyedhyushka in [[Hridaya|hridaya]] (In intermittent [[Jwara|fever]], the morbid [[Dosha|doshas]] are in the heart / heart region)

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== Rogamarga related to prognosis ==

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The purpose for describing roga-marga is to know prognosis (sukha sadhyatvadi jnanartham). [Chakrapani on Cha.Sa.[[Sutra Sthana~~|Sutrasthana~~]] 11/48] [Chakrapani on Cha.Sa.[[Sutra Sthana~~|Sutrasthana~~]] 10/12] [Chakrapani on Cha.Sa.[[Sutra Sthana~~|Sutrasthana~~]] 10/15,16] [Cha.Sa.[[Sutra Sthana~~|Sutrasthana~~]] 10/18,19] The contribution of roga marga to prognosis depends on the robustness of the site.[Chakrapani on Cha.Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 30/327]

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The purpose for describing roga-marga is to know prognosis (sukha sadhyatvadi jnanartham). [Chakrapani on Cha.Sa.[[Sutra Sthana]] 11/48] [Chakrapani on Cha.Sa.[[Sutra Sthana]] 10/12] [Chakrapani on Cha.Sa.[[Sutra Sthana]] 10/15,16] [Cha.Sa.[[Sutra Sthana]] 10/18,19] The contribution of roga marga to prognosis depends on the robustness of the site.[Chakrapani on Cha.Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 30/327]

== Rogamarga for precise treatment ==

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In the [[Vyadhi|diseases]] of external pathways, dhatwagnimandya will be prominent. [[Snehana (unction therapy)|Snehana]]-[[Swedana|swedana]] will be of use for bringing the [[Dosha|dosha]] from shakha to [[Koshtha|koshtha]] and removal through the nearby orifice. [[Virechana|Virechana]] and [[Raktamokshana|raktamokshana]] are one of the best [[Shodhana|shodhana]] measures for the [[Vyadhi|diseases]] of external patways. In addition, kshara, and agnikarma can also be applied for the [[Vyadhi|diseases]].

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For the [[Vyadhi|diseases]] of medial pathway, [[Prana|prana]] and vyana vayu are found to be involved. [[Basti|Basti]] and [[Nasya|nasya]] maybe more beneficial. As the [[Vyadhi|diseases]] of madhyama roga-marga are generally originated from colon (pakwashayottha) and due to obstructed vayu, [[Basti|basti]] maybe the first line of treatment. [[Basti|Basti]] is capable of preventing and overcoming the afflictions of [[Marma|marma]], asthi sandhi etc. [Cha. Sa. [[Siddhi Sthana|Siddhi Sthana]] 9/ 7]. Additionally, the [[Vyadhi|diseases]] of head like facial paralysis (ardita), neck stiffness (manyastambha), hemiplegia (pakshaghata), etc. can be treated with [[Nasya|nasya]].

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For the [[Vyadhi|diseases]] of medial pathway, [[Prana|prana]] and vyana vayu are found to be involved. [[Basti|Basti]] and [[Nasya|nasya]] maybe more beneficial. As the [[Vyadhi|diseases]] of madhyama roga marga are generally originated from colon (pakwashayottha) and due to obstructed vayu, [[Basti|basti]] maybe the first line of treatment. [[Basti|Basti]] is capable of preventing and overcoming the afflictions of [[Marma|marma]], asthi sandhi etc. [Cha. Sa. [[Siddhi Sthana|Siddhi Sthana]] 9/ 7] Additionally, the [[Vyadhi|diseases]] of head like facial paralysis (ardita), neck stiffness (manyastambha), hemiplegia (pakshaghata), etc. can be treated with [[Nasya|nasya]].

Similarly, [[Shamana|shamana]] [[Aushadha|aushadha]] may also be categorized as acting specifically on a particular roga marga.

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== Roga ~~Marga~~ : a special type of classification of [[Vyadhi|diseases]] ==

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== Roga marga : a special type of classification of [[Vyadhi|diseases]] ==

Some of the expert ayurvedic physicians believe that the description of roga marga denotes special type of [[Vyadhi|disease]] classification. Such a classification is exceptional in comparison to systemic classification of [[Vyadhi|disease]]. The systemic classification does not give any contribution in the field of prognosis and management. Whereas it is not so in the case of ayurvedic classification of [[Vyadhi|diseases]] in terms of roga marga. The systemic classification is based on the anatomical and physiological continuity, whereas not always the organs of a particular roga marga have anatomical attachment. e.g. madhyama roga marga. The connection between the organs of a particular marga is evident pathologically, hence termed as roga marga.

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