Chikitsa Sthana
Preamble of Chikitsa Sthana
Chikitsa Sthana deals with the study of preservation of health, prevention and management of various diseases.
Fundamental principles
The term Chikitsa means treatment or therapy. [1] . It is important to note that the status of health and etio-pathogenesis of disease depends upon status of Agni (digestion and metabolism). [Cha.Sa.Chikitsa Sthana 15/4] Therefore, the treatment is based upon correcting the digestion and metabolism.
Literally, the term Kaya comprehends entire process of metabolism, rather than either anabolism as denoted by Deha or catabolism denoted by Sharira. Therefore, the word “Kaya-chikitsa” indicates medical management of diseases caused by impaired “Agni”. The medical practice of Kayachikitsa is based upon an intimate understanding of nutrition and the factors responsible for digestion, absorption and metabolism.[2] Chikitsa Sthana is the most important section focusing on objectives of Ayurveda for preservation of health and treatment of diseased[Cha.Sa.Sutra Sthana 30/25]
Structural dimensions of the section
This section relates mainly to therapeutics. However each chapter in this section starts with comprehensive information about etio-pathogenesis along with symptomatology, prognosis and classification of diseases before delving into detailed treatment. In therapeutic section of chapters, a general pattern is adopted to describe the management: The first principle of treatment (chikitsa sutra) of that particular disease is given in terms of langhana or brimhana, snehana or rukshana, swedana or stambhana and related measures of shodhana followed by their judicious use in particular state and stage of the disease. It is followed by description of single or compound preparations along with their constituents, method of preparation and indications. The drugs are mentioned in the form of fresh juice and paste, powder, tablet, decoctions, avaleha (jam), asava (fermented preparations mainly from juices), arishta (fermented preparations mainly from decoctions), medicated ghee and oil etc.
Specialties of Ayurveda therapeutics
The medical therapeutics today has been classified into many branches focused on a defined group of patients, diseases, skills, or philosophy.[3]. Each chapter in this section deals with a separate specialty. Being primarily a treatise of kayachikitsa (medicine), twenty three chapters in the Chikitsa Sthana deal with medical therapeutics. Other aspects of therapeutics like preservation and promotion of physical, mental, spiritual and sexual health is dealt in the first two chapters of Rasayana Chikitsa and Vajikarana Chikitsa. The chapter Dwivraniya Chikitsa pertains to wound management and briefs about surgical procedures (shalya). The chapter Visha Chikitsa on the management of poisoning (visha) deals with agada-tantra (toxicology). In Ayurveda, psychiatry is dealt with under the heading of bhuta-vidya and two chapters viz. Unmada Chikitsa and Apasmara Chikitsa focus on this aspect of medicine. The last chapter Yonivyapat Chikitsa describes disorders of male and female infertility, gynecological disorders with paediatrics diseases. The chapter also mentions important principles of time of administration of medicine i.e. chrono-pharmacology and factors for deciding dose i.e. posology.
Glimpses of chapters
Eight groups of major diseases were described in Nidana Sthana, each representing one specific clinical feature from diagnostic point of view. Management of those eight diseases is explained in detail from the third to the tenth chapter.
In all, There are thirty chapters in Chikitsa Sthana.
- The first chapter is on Rasayana Chikitsa (rejuvenation therapy) , further divided into four sections (or sub-chapters). The chapter describes a number of medicine preparations by means of which one can prevent and retard aging and live a longer, happier life. Rasayana measures promote physical and mental health and provide general immunity to prevent diseases as well as strength to the tissues to be able to fight diseases effectively. Thus this chapter highlights principles of geriatrics and old age care as well as prevention of aging process.
- The second chapter, on Vajikarana Chikitsa, also comprises of four sub-chapters and deals with enhancing sexual health in healthy persons, consequently leading to healthy progeny. The chapter reveals principles of aphrodisiac medicines.
- The management of Jwara (fever) associated diseases are described in the 3rd chapter, Jwara Chikitsa. It includes therapeutic measures for acute and chronic fever, continuous, intermittent, malarial and seasonal fevers, mild, moderate and severe fevers, fever with or without ama, fevers occurring from one, two or three combination of dosha, fever occurring in dhatu and so on. All the aspects affecting treatment and prognosis of various types of fever are also described. This chapter describes principles related with thermo-regulatory mechanisms in the body.
- The fourth chapter deals with the management of bleeding disorders under the heading of Raktapitta Chikitsa, which is of two types i.e. bleeding from the upper and lower channels. Management principles of bleeding disorders are mentioned in this chapter.
- The fifth chapter,Gulma Chikitsa describes protuberance of abdomen under two headings, local and generalized. Local lump in abdominal cavity is termed as gulma and is of five types which includes simple gas phantom to new growth and their treatment.
- Urinary diseases are described according to the presenting symptoms of excessive urine or scanty urine with difficulty/pain. This chapter deals with the treatment of urinary problems with presenting sign of excessive urine under the heading of Prameha Chikitsa which is of twenty types and includes madhumeha (diabetes mellitus). Principles of treatment for disorders due to impaired fat metabolism are also described.
- The management of eighteen types of Kushtha (skin diseases including leprosy) is described in the seventh chapter entitled Kushtha Chikitsa. Chronic non-purulent bacterial, fungal and allergic skin disorders are described under this heading. These disorders are further divided into two groups viz. 11 types of kshudra kushtha (minor skin diseases) and 7 types of mahakushtha (major skin disorders). The chapter describes principles of dermatology specialty.
- Rajayakshma (Syndrome like Tuberculosis) has been a problem since time immemorial. It is described in the chapter entitled Rajayakshma Chikitsa. According to its etio-pathogenesis, it is classified into four types and its detailed treatment is described. The chapter deals with treatment of various diseases due to impaired immunity.
- Bhuta-vidya (psychiatric disorders) are described in two chapters. The ninth chapter entitled Unmada Chikitsa describes the management of insanity and various other psychotic disorders.
- The tenth chapter entitled Apasmara Chikitsa deals with the management of epilepsy, seizures and memory disorders. Both chapters describe management principles of psychiatric disorders.
- Kshata-kshina occurs by indulgence in activities beyond one’s strength or cruel activities such as bull fighting leading to chest injuries, bleeding and cachexia. The management is described in eleventh chapter entitled Kshatakshina Chikitsa. This chapter mentions principles of management of chest injuries and occupational health hazards.
- Three groups of diseases with swelling (utsedha), edema and inflammation at various sites are described in the twelfth chapter entitled Shvayathu Chikitsa.
- The conditions leading to generalized enlargement of abdomen such as ascites, hepatomegaly and splenomegaly are described in thirteenth chapter entitled Udara Chikitsa.
Both chapters describe management principles of disorders due to impaired fluid and osmotic balance in body.
- Types of hemorrhoids and warts etc. are described along with their treatment in the next chapter entitled Arsha Chikitsa. The chapter describes medical or conservative management of haemorrhoids.
- Grahani Chikitsa, the fifteenth chapter elaborates physiological principles of Agni (digestion and metabolism) at various levels and its importance in clinical practice. Various processes of digestion, metabolism leading to the formation of dhatu ( body tissues) and mala (metabolic wastes) are also described. The comprehensive management of disorders of gastrointestinal tract is described.
- Two diseases caused mainly by vitiation of rakta (blood tissue) viz. pandu roga (anemia and blood deficiency disorders) and kamala (jaundice and hepatic disorders) are described in sixteenth chapter entitled Pandu Chikitsa. Thus management principles of haematological disorders are described in this chapter.
- The seventeenth chapter, entitled Hikka Shwasa Chikitsa deals with disorders of respiratory system. Clinical presentations and management of five types of hiccups and dyspnoea are described.
- Kasa Chikitsa, the eighteenth chapter deals with cough of various origin and its management.
- The management principles of various types of diarrhea and irritable bowel syndrome are described in nineteenth chapter entitled Atisara Chikitsa.
- The next chapter Chhardi Chikitsa describes management of Vomiting (chhardi) due to various somatic and psychological origin.
- Types of acute inflammatory dermatological conditions such as erysipelas are described under the heading of visarpa in twenty-first chapter entitled Visarpa Chikitsa.
- The conditions manifested in the form of excessive thirst (trishna) are described in chapter entitled Trishna Chikitsa.
- The next chapter, Visha Chikitsa deals with the management of acute and slow poisoning (visha) relating with agada-tantra (toxicology).
- The management of its various acute and chronic stages of alcoholic intoxication and its complications are tackled in twenty fourth chapter entitled Madatyaya Chikitsa. The management principles for substance abuse and addiction can be referred in this chapter.
- Wound management and surgical procedures (shalya) are described in twenty fifth chapter entitled Dwivraniya Chikitsa.
- The next chapter, Trimarmiya Chikitsa describes disorders due to obstruction to free movement of vata dosha. The gastrointestinal diseases such as udavarta(reverse movement of vata), anaha (distension of abdomen), aruchi (anorexia) etc. are described. Disorders of three vital organs like heart, brain and kidney are described as main context of chapter. Thus this chapter describes management principles of disorders in cardiac region, head region and urinary system. Brief description of management of diseases pertaining to hair, ear, nose and throat with passing reference to eye diseases is also dealt in this chapter.
- Disorders of spinal- neuro- muscular degeneration in thigh and hip joint are described in twenty seventh chapter entitled Urustambha Chikitsa.
- Vata dosha is the key initiating factor responsible for all physiological and psychological mechanisms in the body. The types of vata dosha, their functions and disorders are described in Vatavyadhi Chikitsa. Disorders caused by Vata dosha in body, like digestive system, nervous system, musculo-skeletal system and their managements are described in this chapter.
- The next chapter, Vatarakta Chikitsa specifically describes disorders due to vitiation of vata dosha and rakta dhatu. The conditions involving deformities in small joints, those of vascular system involving blood vessels are highlighted in this chapter with their management.
- The last chapter, entitled Yonivyapat Chikitsa) describes disorders related to male and female reproductive system, infertility and other gynecological disorders. The diseases in children (kaumarabhritya) are mentioned as well. The principles related to time of administration of medicine and dose is also highlighted.
Importance
The section is a quick reference manual for therapeutics. This section provides comprehensive information about all aspects of clinical practice including etio-pathogenesis, management and drug formulary. It is obvious from the foregoing that Chikitsa Sthana is a treasure of therapeutic knowledge and by mastering this part one can become expert physician who can tackle all types of acute and chronic disease successfully.
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External links
References
- ↑ Available from http://spokensanskrit.org/index.php?tran_input=cikitsA&direct=se&script=hk&link=yes&mode=3
- ↑ Dwarkanath C. Introduction to Kayachikitsa.Chaukhambha Orientalia;third edition. Varanasi. 1996 p.2
- ↑ Specialties of Medical Practice available from https://en.wikipedia.org/wiki/Specialty_(medicine) retrieved on April 24, 2019